ORIGINAL ARTICLE   

Minerva Medica 2023 October;114(5):601-7

DOI: 10.23736/S0026-4806.22.07579-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Predictors of subclinical atherosclerosis and microalbuminuria in middle-aged women: a cross-sectional study

Sara XUEREB ¹, Caroline J. MAGRI ^{1, 2}, Rachel A. XUEREB ², Robert G. XUEREB ^{1, 2}, Joseph GALEA ^{1, 2}, Stephen FAVA ^{1, 2} ✉

¹ Mater Dei Hospital, Msida, Malta; ² Medical School, Mater Dei Hospital, University of Malta, Msida, Malta

BACKGROUND: Cardiovascular disease is of increasing concern in women. The aim was to assess the role of clinical and anthropometric measures in the development of subclinical atherosclerosis.
METHODS: A cross-sectional study in 203 Europid females to determine the prevalence of abnormal carotid intima-media thickness (CIMT) and associated clinical parameters.
RESULTS: The study population had a mean age of the 38.3±5.4 years, a median Body Mass Index of 29.25 (IQR 25.06-36.11) kg/m² and median waist index (WI) of 1.15 (IQR 1.06-1.34). Increased CIMT was present in 169 (83.25%) participants. Linear regression analysis revealed WI to be the sole predictor of increased CIMT (β=24.387, P<0.001). Post-hoc ROC analysis revealed a WI of 1.12 has 62% sensitivity and 53% specificity for predicting increased CIMT (AUC 0.63, 95% CI 0.55-0.72, P=0.016). The median urinary albumin-creatinine ratio (ACR) was 4.4 mg/g, and the prevalence of microalbuminuria was 8.9%; serum triglycerides were the only independent predictor of ACR.
CONCLUSIONS: Atherosclerosis, as detected by abnormal CIMT, is very prevalent in middle-aged women. Waist index is the major predictor of subclinical atherosclerosis in a contemporary premenopausal female population. A WI of 1.12 exhibits relatively good sensitivity and specificity in predicting the presence of atherosclerosis in this patient population.

KEY WORDS: Atherosclerosis; Sex; Women