Investigation of the relationship of plasma aterogenic index with metabolic components and carotis intima media thickness in patients with obesity

Introduction and objective: Obesity is a multifactorial disease that is defined as body mass index (BMI) ≥30 kg/m2 and is frequently seen in our country and in the world. Many studies have shown that there is a close relationship between rapidly increasing obesity and blood fats. Plasma atherogenic index (PAI); It is a new index consisting of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) ratios. PAI was found to be significantly higher in patients with abdominal obesity than in patients without abdominal obesity, and it was discussed that it could be a new and better biomarker for obesity. Carotid intima-media thickness (CIMT) is a new parameter for detecting atherosclerosis (AS) and can be measured in a simple, reproducible and non-invasive way. In the light of all information, it has been observed that there is no other study in the literature evaluating the relationship between PAI and CIMT measurement in obesity patients. For this purpose, we aimed to examine the relationship of PAI with metabolic components and CIMT in obesity patients. Material and Method: This study was planned as a retrospective case study and ethics committee approval was obtained before the study. Within the scope of the study, the data of the patients who applied to the Balıkesir University Hospital Internal Medicine Department were scanned, and they were divided into obese (BMI 30 and above) and non-obese. Demographic (age, gender), anthropometric measurements of the patients [height, weight, waist circle (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP)], laboratory [fasting blood glucose (FG), TG, total cholesterol (TC), high density lipoprotein (HDL-C), urea, creatinine, glomerular filtration rate (eGFR), uric acid, alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, Ca, Mg, P, whole blood, HOMA-IR] and radiological (CIMT) data were analyzed and recorded in the computer system. All parameters were compared between the groups in terms of effect, and correlation analysis of PAI with all variables was performed. In addition, regression analysis was performed between the obese groups for PAI and CIMT. Results: Within the scope of the study, 234 participants (92 men, 142 women) were evaluated, 98 (42%) were obese, 136 (58%) were in the control group, and age and gender were similar in both groups. BMI level of the obese group (34.35±5.48) and WC (107.5±12.75) compared to the control group BMI (26.95±4.27), WC (91.5±17, 5) was statistically significantly higher (p<0.001). In the comparison analysis between groups, SBP, DBP, HOMA-IR, ALT, uric acid, albumin, PAI levels and right CIMT were statistically different in the obese group compared to the control group. In the whole group correlation analysis; Statistically significant correlation was found between PAI and WC, SBP, DBP, TC, AST, ALT HOMA-IR, uric acid: [For WC (r=+0.224); (p=0.02), for SBP (r=+0.27); (p=0.006) for DBP (r=+0.22); (p=0.02), for TC (r=+0.202); (p=0.046), for ALT (r=+0.436); (p<0.001) for AST (r=+0.354); (p<0.001) for HOMA-IR (r=+0.418); (p=0.001), for uric acid (r=+0.27); (p=0.007)]. In logistic regression analysis, it was observed that PAI for obesity (OR =3.13, 95% CI =1.01-9.66; p =0.047) could be significant compared to CIMT, regardless of age and gender. Discussion and Conclusion: In our study, the PAI value in patients with obesity was found to be significantly higher than those without obesity. In addition, PAI; In obese patients, there was a significant correlation with metabolic parameters (BMI, WC, ALT), especially insulin resistance, and cardiovascular disease (CVD) related parameters (SBP, DBP, uric acid). It was determined that PAI increased with BD and the increase in PAI caused an increase in the detection rate of abdominal obesity. These results; WC and PAI are parameters related to lipid metabolism, indicating that there may be a significant relationship between PAI level and obesity. In patients with obesity, PAI can show inflammation and atherosclerosis rapidly, non-invasively. In addition, it has been observed that PAI may be a more effective method detecting obesity in earlier period than CIMT. Keywords: Obesity, PAI, CIMT