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To the Editor:I read with interest the article by De Michele et al in the December issue of Stroke .1 The authors acknowledged that the association between obesity and atherosclerotic disease is controversial. However, their study demonstrated a graded and independent association between general and abdominal obesity reflected by high body mass index (BMI) and waist-hip ratio (WHR) and carotid artery wall thickening in a population of middle-aged women.A review of their results in the light of ongoing work in our laboratory revealed a rather complex interaction of carotid plaque, body adiposity, and serum lipoprotein levels. Ninety consecutive patients aged 56.2±14 years (60 male and 30 female) were studied. All were right-handed.2 Color-flow Doppler and B-mode ultrasound of the carotid were performed to determine the percentage stenosis in the internal carotid artery.3 BMI was calculated as weight divided by height squared (kg/m2); WHR was calculated as waist divided by hip. Lipid profile was determined using the enzymatic method.4History of hypertension was present in 56.18% of patients, diabetes mellitus was present in 20.45%, and coronary heart disease was present in 61.36%; 44% of patients were pre-obesed and 25.6% were obesed with BMI >30; 51.8% of patients had increased LDL levels >2.586 mmol/L, and 75.9% of patients had decreased HDL levels 70%) was present in the right internal carotid artery (RICA) in 60% of patients, and in the left internal carotid artery (LICA) in 53.3% of patients.Analysis of 3D surface plots of data obtained from results of piecewise linear regression (using ICA percentage stenosis as …

Differential Effects of Body Adiposity and Serum Lipids on Right and Left Carotid Artery Lesions