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Park YJ. Association between blood glucose levels and arterial stiffness marker: comparing the second derivative of photoplethysmogram and cardio-ankle vascular index scores. Front Endocrinol (Lausanne) 2023; 14:1237282. [PMID: 37810890 PMCID: PMC10552567 DOI: 10.3389/fendo.2023.1237282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/30/2023] [Indexed: 10/10/2023] Open
Abstract
Objective This study aimed to compare the association between fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) levels using the second derivative of photoplethysmogram (SDPTG) index and the cardio-ankle vascular index (CAVI). Methods Electronic medical records of 276 participants (160 men, 116 women) who visited the health promotion center of a university hospital were examined. Age, sex, body mass index (BMI), blood pressure, and lipid profile were considered as risk factors for arterial stiffness, together with the FPG, HbA1c, CAVI, and SDPTG indices. Hierarchical regression models were constructed, and all participants were divided into low-normal, high-normal, prediabetic, and diabetic groups to examine the group-based differences in CAVI and SDPTG indices. Results FPG and HbA1c were independently predictive of increased CAVI, and their predictive powers for CAVI were equivalent (β = 0.214 and 0.200, respectively). Risk factors, including age, BMI, and male sex, were also predictive of CAVI (β= 0.593-0.630, -0.256 - -0.280, and 0.142-0.178, respectively). None of the FPG and HbA1c values were predictive of the SDPTG indices. The CAVI was higher in the diabetes group than in the other three groups according to HbA1c level, while the d/a index of the SDPTG decreased in the prediabetes group and increased in the diabetes group. Conclusions CAVI may not be substituted for SDPTG indices when evaluating arterial stiffness based on the glucose level. Moreover, the progression rate of arterial stiffness may differ between the diabetic and nondiabetic stages.
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Affiliation(s)
- Young-Jae Park
- Department of Biofunctional Medicine & Diagnostics, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
- Department of Diagnosis and Biofunctional Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
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Pan J, Xu L, Lam TH, Jiang CQ, Zhang WS, Zhu F, Jin YL, Neil Thomas G, Cheng KK, Adab P. Relationship between pulmonary function and peripheral vascular function in older Chinese: Guangzhou biobank cohort study-CVD. BMC Pulm Med 2018; 18:74. [PMID: 29783975 PMCID: PMC5963074 DOI: 10.1186/s12890-018-0649-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Findings describing the relationship between pulmonary function and peripheral vascular function have been inconclusive. We explored this relationship in Guangzhou Biobank Cohort Study-Cardiovascular Subcohort (GBCS-CVD). METHODS Brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) were measured by a waveform analyser, and pulmonary function by turbine flowmeter spirometry. Predicted forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were derived using equations for Chinese. Regression analyses were used to investigate the association. RESULTS Of 1528 older Chinese, 980 (64.1%) had arterial stiffness (baPWV ≥1400 cm/s), but only 29 (1.9%) had peripheral arterial disease (PAD) (ABI < 0.9). The mean (±standard deviation, SD) baPWV was 1547 (±298) cm/s and mean (±SD) ABI 1.09 (±0.09). Before and after adjusting for potential confounders, baPWV was negatively associated with FEV1 and FVC % predicted (% predicted = observed/predicted × 100%) (adjusted β: - 0.95 and - 1.16 respectively, p < 0.05), and ABI was marginally non-significantly positively associated with FEV1% predicted (adjusted β 0.02, p = 0.32) and FVC% predicted (adjusted β 0.02, p = 0.18). Compared to participants in the highest tertile of pulmonary function, those in the lowest had higher risk of arterial stiffness (adjusted odds ratio (AOR) 1.51, 95% CI 1.09-2.10 for FEV1 and AOR 1.69, 95% CI 1.22-2.33 for FVC), but the higher risk of PAD was marginally non-significant (AOR 1.64, p = 0.42 for FEV1 and AOR 1.65, p = 0.24 for FVC). CONCLUSION In older relatively healthy normal weight Chinese, pulmonary function was inversely dose-dependently associated with arterial stiffness, while the association with PAD was much weaker.
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Affiliation(s)
- Jing Pan
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | | | - Wei Sen Zhang
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - Feng Zhu
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - Ya Li Jin
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - G. Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Glycemic markers and relation with arterial stiffness in Caucasian subjects of the MARK study. PLoS One 2017; 12:e0175982. [PMID: 28414819 PMCID: PMC5393622 DOI: 10.1371/journal.pone.0175982] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/03/2017] [Indexed: 12/20/2022] Open
Abstract
Background Effect of prediabetes and normal glucose on arterial stiffness remains controversial. The primary aim of this study was to investigate the relationship of fasting plasma glucose (FPG), postprandial glucose (PG) and glycosylated haemoglobin (HbA1c) with brachial-ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) in Caucasian adults. The secondary aim was to analyse this relationship by glycaemic status. Methods Cross-sectional study. Setting: Primary care. Participants: 2,233 subjects, 35–74 years. Measures: FPG (mg/dL) and HbA1c (%) of all subjects were measured using standard automated enzymatic methods. PG (mg/dL) was self-measured at home two hours after meals (breakfast, lunch and dinner) for one day using an Accu-chek ® glucometer. CAVI was measured using a VaSera VS-1500® device (Fukuda Denshi), and baPWV was calculated using a validated equation. Results CAVI and baPWV values were significantly higher in subjects with diabetes mellitus than in glucose normal and prediabetes groups (p<0.001). FPG, PG and HbA1c were positively associated with CAVI and baPWV. The β regression coefficient for: HbA1c was 0.112 (CI 95% 0.068 to 0.155) with CAVI, 0.266 (CI 95% 0.172 to 0.359) with baPWV; for PG was 0.006 (CI 95% 0.004 to 0.009 and for FPG was 0.005 (CI 95% 0.002 to 0.008) with baPWV; and for PG was 0.002 (CI 95% 0.001 to 0.003) and 0.003 (CI 95% 0.002 to 0.004) with CAVI (p<0.01 in all cases). When analysing by hyperglycaemic status, FPG, PG and HbA1c were positively associated with CAVI and baPWV in subjects with type 2 diabetes mellitus. Conclusion FPG, PG and HbA1c show a positive association with CAVI and baPWV, in Caucasian adults with intermediate cardiovascular risk factors. When analysing by hyperglycaemic status, the association is only maintained in subjects with type 2 diabetes mellitus. Trial registration Clinical Trials.gov Identifier: NCT01428934. Registered 2 September 2011. Retrospectively registered. Last updated September 8, 2016.
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Cai K, Luo Q, Zhu B, Han L, Wu D, Dai Z, Wang K. Neutrophil-lymphocyte ratio is associated with arterial stiffness in patients with peritoneal dialysis. BMC Nephrol 2016; 17:191. [PMID: 27881094 PMCID: PMC5122148 DOI: 10.1186/s12882-016-0394-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 11/09/2016] [Indexed: 01/28/2023] Open
Abstract
Background Patients with peritoneal dialysis are in the persistent inflammation state and have elevated arterial stiffness. Neutrophil-lymphocyte ratio(NLR) is a new inflammatory marker in renal and cardiac disorders. Brachial-ankle pulse wave velocity (baPWV) is a non-invasive measurement, which is widely used as a surrogate marker of arterial stiffness. However, there is little evidence to show an association between NLR and baPWV in patients with peritoneal dialysis. The aim of this cross-section study was to investigate the relationship between NLR and arterial stiffness measured by baPWV in patients with peritoneal dialysis. Methods In this cross-section study, 101 patients with peritoneal dialysis were enrolled from January 2014 to June 2015. According to average baPWV level (1847.54 cm/s), the patients were categorized into two groups, low group and high group. baPWV, which reflects arterial stiffness, was calculated using the single-point method. Clinical data were collected in details. NLR was calculated using complete blood count. Associations between NLR and baPWV were assessed using Pearson’s correlation and linear regression analysis. Results The NLR was significantly lower in the low baPWV group than in the high baPWV group (p = 0.03). There were positive correlations between baPWV and neutrophil count (r = 0.24, p = 0.01) and NRL(r = 0.43, P < 0.01), and there was a negative correlation between baPWV and lymphocyte count (r = -0.23, p = 0.01). In addition, albumin, phosphorous and intact parathyroid hormone showed negative correlations with baPWV (r = −0.32, p < 0.01; r = −0.28, p < 0.01; r = −0.25, p = 0.01, respectively). Age and hsCRP showed positive correlations with baPWV (r = 0.47, p < 0.01; r = 0.25, p = 0.01). In multivariate analysis, NLR independently correlated with baPWV in patients with peritoneal dialysis (β = 0.33, p < 0.01), even after adjustment for various confounders. Conclusion Our study suggests that NLR was an independently associated with arterial stiffness in patients with peritoneal dialysis. However, further prospective studies are needed to confirm cause-and-effect relationship between NLR and baPWV, and to investigate whether anti-inflammatory treatment could improve arterial stiffness in patients with peritoneal dialysis. Electronic supplementary material The online version of this article (doi:10.1186/s12882-016-0394-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kedan Cai
- Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China
| | - Qun Luo
- Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
| | - Beixia Zhu
- Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China
| | - Lina Han
- Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China
| | - Dan Wu
- Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China
| | - Zhiwei Dai
- Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China
| | - Kaiyue Wang
- Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China
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Yu KJ, Zhang JR, Li Y, Huang X, Liu T, Li C, Wang RT. Gallstone disease is associated with arterial stiffness progression. Hypertens Res 2016; 40:31-34. [PMID: 27558931 DOI: 10.1038/hr.2016.109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 12/16/2022]
Abstract
Gallstones have been linked to dyslipidemia, metabolic syndrome and cardiovascular disease. Arterial stiffness is an indicator of subclinical atherosclerosis. The aim of this study was to prospectively examine the relationship between gallstone disease and arterial stiffness progression in 347 men and 454 women. These subjects were followed for 7 years. Arterial stiffness progression was measured based on increases in brachial-ankle pulse wave velocity. Changes in brachial-ankle pulse wave velocity during the study period were significantly greater in patients with gallstones than in subjects without gallstones. After adjusting for multiple risk factors, gallstone disease was found to be a significant and independent predictor of brachial-ankle pulse wave velocity progression (β=0.189; P<0.001). In conclusion, gallstone disease is an independent predictor of arterial stiffness progression, even after adjusting for other cardiovascular risk factors.
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Affiliation(s)
- Kai-Jing Yu
- Department of Intensive Care Unit, the Third Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Ji-Rong Zhang
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Ying Li
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, China.,International Physical Examination and Health Center, the Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Xiaoyi Huang
- Biotherapy Center, the Third Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Tiemin Liu
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Chuanfu Li
- Department of Surgery and the Center of Excellence in Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Rui-Tao Wang
- Department of Intensive Care Unit, the Third Affiliated Hospital, Harbin Medical University, Harbin, China
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6
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Li XS, He H, Zhao YL, Li Y, Liu ZP, Liu T, Zhang Y, Yu KJ, Wang RT. Bone Mineral Density Is Negatively Associated With Arterial Stiffness in Men With Hypertension. J Clin Hypertens (Greenwich) 2016; 18:1106-1111. [PMID: 27255660 DOI: 10.1111/jch.12848] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/17/2016] [Accepted: 03/27/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Xue-song Li
- Department of Orthopedics; The First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - Hui He
- Department of Orthopedics; The First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - Yi-lin Zhao
- Harbin Medical University (Da Qing); Harbin Heilongjiang China
| | - Ying Li
- Department of Geriatrics; The Second Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - Zhi-ping Liu
- Departments of Internal Medicine and Molecular Biology; University of Texas Southwestern Medical Center; Dallas TX
| | - Tiemin Liu
- Division of Hypothalamic Research; Department of Internal Medicine; UT Southwestern Medical Center; Dallas TX
| | - Yong Zhang
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China; Key Laboratory of Cardiovascular Research; Ministry of Education); Harbin Medical University; Harbin Heilongjiang China
| | - Kai-jiang Yu
- Department of Intensive Care Unit; The Third Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - Rui-tao Wang
- Department of Intensive Care Unit; The Third Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
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7
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Kotani K, Yamada T. Association between urinary 8-OHdG and pulse wave velocity in hypertensive patients with type 2 diabetes mellitus. Singapore Med J 2015; 55:202-8. [PMID: 24763836 DOI: 10.11622/smedj.2014053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Oxidative stress, assessed using 8-hydroxy-2'-deoxyguanosine (8-OHdG), can be associated with arterial stiffness in patients with type 2 diabetes mellitus (T2DM) and/or hypertension (HT). We investigated the correlation between urinary 8-OHdG and pulse wave velocity (PWV) in hypertensive and non-hypertensive T2DM patients with fair glycaemic control to determine the clinical significance of HT as a comorbidity in the diabetic state. METHODS Clinical data, including traditional cardiovascular risk factors, diabetic complications, prescribed agents, urinary 8-OHdG level and brachial-ankle PWV, was collected from T2DM patients with and without HT. RESULTS There were 76 patients (45 men, 31 women; mean age 61 years; mean haemoglobin A1c level 6.5%) in the study cohort. T2DM patients with HT had significantly higher mean PWV than patients without HT (1,597 cm/s vs 1,442 cm/s; p < 0.05). Patients with HT showed no significant difference in 8-OHdG levels relative to those without HT (median 7.9 ng/mg creatinine vs 8.8 ng/mg creatinine; p > 0.05). Simple linear correlation and stepwise multiple linear regression analyses revealed that 8-OHdG levels correlated independently, significantly and positively with PWV among T2DM patients with HT (r = 0.33, p < 0.05; β= 0.23, p < 0.05). No significant correlation was observed between 8-OHdG levels and PWV among T2DM patients without HT. CONCLUSION In the hypertensive state, oxidative stress can be responsible for the development of arterial stiffness, even in patients with fairly well controlled T2DM. Oxidative stress management may be necessary for the prevention of cardiovascular disease in this population.
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Affiliation(s)
- Kazuhiko Kotani
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-City, Tochigi, 329-0498, Japan.
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8
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Yu XY, Li XS, Li Y, Liu T, Wang RT. Neutrophil-lymphocyte ratio is associated with arterial stiffness in postmenopausal women with osteoporosis. Arch Gerontol Geriatr 2015; 61:76-80. [PMID: 25882272 DOI: 10.1016/j.archger.2015.03.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 03/22/2015] [Accepted: 03/25/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Systemic inflammation may be a common mechanism for the development of osteoporosis (OP) and atherosclerosis. Elevated arterial stiffness is an index of subclinical atherosclerosis. Recent studies found that neutrophil/lymphocyte ratio (NLR), is a useful marker of cardiovascular disease and a more powerful predictor than any other leukocyte subtypes. However, little research has been conducted to investigate the relationship between NLR and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV). METHODS In this cross-sectional study, we examined the relationship between NLR and baPWV in 512 subjects. RESULTS Compared to the control subjects, NLR and baPWV increased in patients with OP. Partial correlation analysis revealed that there was a significant correlation between NLR and baPWV after adjusting for confounding factors in OP. Multivariate linear regression analysis showed that NLR was a significant factor for increased baPWV in patients with OP (β=0.249, p<0.001). However, there was no association between NLR and baPWV in control subjects. CONCLUSION NLR and baPWV are elevated in OP. Moreover, NLR is independently associated with baPWV. Further studies are warranted to investigate whether anti-inflammatory treatment could improve arterial stiffness in postmenopausal women with OP.
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Affiliation(s)
- Xin-yang Yu
- Harbin Medical University, Harbin, Heilongjiang, China
| | - Xue-song Li
- Department of Orthopedics, the First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Li
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Tiemin Liu
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Rui-tao Wang
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
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Li N, Zhang GW, Zhang JR, Jin D, Li Y, Liu T, Wang RT. Non-alcoholic fatty liver disease is associated with progression of arterial stiffness. Nutr Metab Cardiovasc Dis 2015; 25:218-223. [PMID: 25456154 DOI: 10.1016/j.numecd.2014.10.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/27/2014] [Accepted: 10/02/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS NAFLD is an independent risk factor for increased cardiovascular disease. Arterial stiffness is an index of subclinical atherosclerosis. The aims of this study were to examine prospectively the relationship between Non-alcoholic fatty liver disease (NAFLD) and the progression of arterial stiffness. METHODS AND RESULTS A prospective study of 728 men and 497 women free of hypertension, and diabetes at the baseline were conducted. The subjects were followed for 5 years. The progression rate of arterial stiffness was measured by calculating the increase in brachial-ankle pulse wave velocity (baPWV) the changes of the baPWV (adjusted for age) during the study period was significantly greater in the patients with NAFLD (172.4 ± 42.1 cm/s for men, 95.8 ± 36.7 cm/s for women) than in the subjects without NAFLD (70.3 ± 56.5 cm/s for men, 55.4 ± 42.2 cm/s for women). For the subjects with metabolic syndrome, after adjusting for multiple risk factors, NAFLD was a significant predictor of baPWV progression (for male, β = 0.843; P < 0.001; for female, β = 0.575; P < 0.001, respectively). In addition, results were unmodified in subjects without metabolic syndrome. CONCLUSIONS NAFLD was found to be an independent predictor of faster progression of baPWV even after adjusting other cardiovascular risk factors. These prospective data support a pathogenic role for NAFLD in the development of arterial stiffness.
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Affiliation(s)
- N Li
- Department of Cardiology, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - G-w Zhang
- Department of Cardio-Vascular Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - J-r Zhang
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - D Jin
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Y Li
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China; International Physical Examination and Healthy Center, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - T Liu
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - R-t Wang
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
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Li RY, Cao ZG, Zhang JR, Li Y, Wang RT. Decreased Serum Bilirubin Is Associated With Silent Cerebral Infarction. Arterioscler Thromb Vasc Biol 2014; 34:946-51. [DOI: 10.1161/atvbaha.113.303003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective—
The presence of silent cerebral infarction (SCI) increases the risk of transient ischemia attack, symptomatic stroke, cardiovascular disease, and dementia. Total bilirubin (TB) levels were demonstrated to be decreased in carotid intima–media thickness, cardiovascular disease, stroke, and peripheral arterial disease. However, little information is available concerning the correlation between TB and SCI.
Approach and Results—
A cross-sectional study was conducted to evaluate the association between TB and SCI in 2865 subjects (1831 men and 1034 women) undergoing medical checkup. The participants with SCI had lower TB levels than those without SCI. The subjects with a low TB had a higher prevalence of SCI. Moreover, partial correlation showed that TB levels were tightly correlated with brachial-ankle pulse wave velocity after adjusting for confounding covariates (
r
=−0.149;
P
<0.001). Multivariate logistic regression analysis revealed that higher TB was associated with a lower risk of SCI (odds ratio, 0.925; 95% confidence interval, 0.897–0.954;
P
<0.001).
Conclusions—
TB is a novel biochemical indicator for SCI regardless of classical cardiovascular risk factors. Early measurement of TB may be useful to assess the risk of SCI.
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Affiliation(s)
- Rui-Yan Li
- From the Departments of Neurosurgery (R.-Y.L.), Interventional Radiology (Z.-G.C.), and Geriatrics (J.-R.Z., Y.L., R.-T.W.) and International Physical Examination and Healthy Center (Y.L.), the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhi-Gang Cao
- From the Departments of Neurosurgery (R.-Y.L.), Interventional Radiology (Z.-G.C.), and Geriatrics (J.-R.Z., Y.L., R.-T.W.) and International Physical Examination and Healthy Center (Y.L.), the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ji-Rong Zhang
- From the Departments of Neurosurgery (R.-Y.L.), Interventional Radiology (Z.-G.C.), and Geriatrics (J.-R.Z., Y.L., R.-T.W.) and International Physical Examination and Healthy Center (Y.L.), the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Li
- From the Departments of Neurosurgery (R.-Y.L.), Interventional Radiology (Z.-G.C.), and Geriatrics (J.-R.Z., Y.L., R.-T.W.) and International Physical Examination and Healthy Center (Y.L.), the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Rui-Tao Wang
- From the Departments of Neurosurgery (R.-Y.L.), Interventional Radiology (Z.-G.C.), and Geriatrics (J.-R.Z., Y.L., R.-T.W.) and International Physical Examination and Healthy Center (Y.L.), the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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11
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Yu KJ, Zhang MJ, Li Y, Wang RT. Increased whole blood viscosity associated with arterial stiffness in patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol 2014; 29:540-4. [PMID: 23981121 DOI: 10.1111/jgh.12368] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Non-alcoholic fatty liver disease (NAFLD) is an independent risk factor for increased cardiovascular disease. The brachial-ankle pulse wave velocity (baPWV) is a marker for early atherosclerotic changes. Recently, the effect of changed blood rheology on atherosclerosis has received attention. A study confirmed that whole blood viscosity (WBV) is a predictor of cardiovascular events. Therefore, this study aimed to investigate the association of WBV with baPWV in patients with NAFLD. METHODS In this cross-sectional study, the relationship between WBV and baPWV was investigated in 2032 participants (1035 men and 997 women) with NAFLD in a general health examination. RESULTS Different metabolic parameters were compared across WBV (3/s) quartiles. The mean values of baPWV gradually increased with WBV (3/s) quartiles. Stepwise multiple linear regression analysis revealed that WBV (3/s) is a significant determinant for increased baPWV both in men and in women (for male, β = 0.229; P < 0.001; for female, β = 0.672; P < 0.001). CONCLUSIONS The findings showed that baPWV elevated as WBV (3/s) increased in NAFLD. Moreover, WBV (3/s) is independently associated with baPWV even after adjusting other cardiovascular risk factors. Early detection of abnormal WBV levels at low shear rate should warrant for early search of undetected arterial stiffness in patients with NAFLD.
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Affiliation(s)
- Kai-Jiang Yu
- Department of Intensive Care Unit, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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Sun WX, Jin D, Li Y, Wang RT. Increased arterial stiffness in stable and severe asthma. Respir Med 2013; 108:57-62. [PMID: 24238772 DOI: 10.1016/j.rmed.2013.10.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 10/20/2013] [Accepted: 10/27/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Systemic inflammation is related to disease progression in asthma. The brachial-ankle pulse wave velocity (baPWV) is a marker for early atherosclerotic changes. The aim of this study is to evaluate the baPWV levels in patients with stable and severe asthma. METHODS We examined baPWV, high sensitivity C-reactive protein (CRP), lung function parameters, and arterial blood gas analysis in patients with asthma and control subjects. 85 stable asthma patients and 85 severe asthmatics were investigated. 85 control subjects matched for age, gender, body mass index (BMI) and smoking status were recruited. RESULTS The patients with severe asthma had increased baPWV and CRP compared with the patients with stable asthma and control subjects. Furthermore, baPWV was elevated in stable asthma compared with control subjects. There was a negative correlation between baPWV and forced expiratory volume in 1 s (FEV1), after adjusting age, gender, BMI and smoking status (r = -0.414, p < 0.001). Similarly, baPWV was negatively correlated with FEV1/forced vital capacity (FVC) (r = -0.431, p < 0.001). Although there was no correlation between CRP and baPWV in patients with stable asthma, CRP was positively correlated with baPWV in patients with severe asthma (r = 0.229, p = 0.039). CONCLUSIONS baPWV tends to increase as pathogenic condition aggravated in asthma. In addition, elevated baPWV correlates with impaired lung function. Our observation suggests that baPWV is useful for early detection of subclinical atherosclerosis in asthma.
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Affiliation(s)
- Wen-Xue Sun
- Department of Respiratory, The First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Di Jin
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Li
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China; International Physical Examination and Healthy Center, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Rui-Tao Wang
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
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13
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Li Y, Meng SY, Meng CC, Yu WG, Wang RT. Decreased serum bilirubin is associated with arterial stiffness in men. Nutr Metab Cardiovasc Dis 2013; 23:375-381. [PMID: 22118956 DOI: 10.1016/j.numecd.2011.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 09/10/2011] [Accepted: 09/12/2011] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS The brachial-ankle pulse wave velocity (baPWV) is a marker for early atherosclerotic changes. Serum total bilirubin (TB) is an effective antioxidant and has been associated with carotid intima-media thickness, cardiovascular disease, stroke and peripheral arterial disease, all of which may be caused by arteriosclerosis. This study aimed to investigate the association of TB with arterial stiffness. METHODS AND RESULTS In this cross-sectional study, we investigated the relationship between TB and baPWV in 2207 participants (1331 men, 876 women) in a general health examination. Different metabolic parameters were compared across TB quartiles. Age-adjusted mean values of baPWV gradually decreased with TB quartiles in men (Q1 = 1348, Q2 = 1266, Q3 = 1215, and Q4 = 1154 cm/s). However, the age-adjusted means of baPWV had no significance in women according to TB quartiles. Univariate analysis showed that age, smoking status, BMI, SBP, DBP, AST, ALT, GGT, TB, TG, and HDL-C were significantly associated with baPWV in men, whereas only age, BMI, SBP, DBP, TG and FPG were significantly associated with baPWV in women. In addition, BMI, SBP, TB, age, TG, and AST were significant factors in the multivariate model with baPWV in men; only BMI and FPG were significant factors with baPWV in women. CONCLUSION The findings show that serum total bilirubin concentration is negatively correlated to arterial stiffness in Chinese men. Early detection of abnormal bilirubin levels could potentially serve as an early biomarker for arterial stiffness.
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Affiliation(s)
- Y Li
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, NO.246 Xuefu ST, Nangang District, Harbin 150086, Heilongjiang, China
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Meng C, Sun M, Wang Z, Fu Q, Cao M, Zhu Z, Mao J, Shi Y, Tang W, Huang X, Duan Y, Yang T. Insulin Sensitivity and Beta-Cell Function Are Associated with Arterial Stiffness in Individuals without Hypertension. J Diabetes Res 2013; 2013:151675. [PMID: 23671853 PMCID: PMC3647586 DOI: 10.1155/2013/151675] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 01/04/2013] [Indexed: 11/17/2022] Open
Abstract
Aim. We investigated the relationship between brachial-ankle pulse wave velocity (baPWV) and glucose levels, insulin sensitivity, and beta-cell function in Chinese individuals with or without hypertension. Methods. We recruited 3137 nondiabetic individuals whose age, body mass index (BMI), glucose levels, blood pressure (BP), lipids, hemoglobin A1C (HbA1c), baPWV, and insulin levels were measured. Results. In normotensive group, 2 h glucose levels (β = 0.046, P < 0.001) associated with baPWV, showed a significant increase in patients with NG as compared to those with DM (P = 0.032). The hypertensive group showed no such differences. The Matsuda index (β = 0.114, P < 0.001) and HOMA- β (β = 0.045, P < 0.001) were negatively correlated with baPWV while lnHOMA-IR (β = 0.196, P = 0.076) and the Quantitative Insulin Sensitivity Check Index (QUICKI) (β = 0.226, P = 0.046) showed a borderline negative correlation. BaPWV significantly decreased (P = 0.032) with an increase in insulin sensitivity in individuals with both normal BP and glucose tolerance. Conclusions. BaPWV was significantly associated with 2 h glucose levels, insulin sensitivity and beta-cell function in normotensive population, whereas in hypertensive individuals, BP was the dominant factor influencing arterial stiffness. Individuals with abnormal insulin sensitivity in the absence of diabetes and hypertension are also at an increased risk of arterial stiffness.
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Affiliation(s)
- Chuchen Meng
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Min Sun
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Zhixiao Wang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Qi Fu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Mengdie Cao
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Zhenxin Zhu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Jia Mao
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Yun Shi
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Wei Tang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Xiaoping Huang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Yu Duan
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
- *Yu Duan: and
| | - Tao Yang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
- *Tao Yang:
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Zhu C, Xiong Z, Zheng Z, Chen Y, Qian X, Chen X. Association of serum gamma-glutamyltransferase with arterial stiffness in established coronary artery disease. Angiology 2012; 64:15-20. [PMID: 23000601 DOI: 10.1177/0003319712459799] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Serum gamma-glutamyltransferase (GGT) has been reported to predict vascular risk. We enrolled 978 patients (507 men and 471 women) with established coronary artery disease (CAD). The GGT, brachial-ankle pulse wave velocity ([baPWV] to assess arterial stiffness), and conventional risk factors were evaluated. The means of baPWV tend to increase in both genders according to GGT tertiles. Body mass index, GGT, logarithmical (systolic blood pressure [LnSBP]), uric acid (UA), total bilirubin, Ln (cholinesterase), and Ln (total cholesterol) were correlated with baPWV in men in a multivariate model. However, only GGT, LnSBP, UA, and Ln (high-density lipoprotein cholesterol) were correlated with baPWV in women. The GGT was a significant determinant for increased baPWV both in men (β = 0.017; P < .001) and in women (β = 0.015; P < .001). In conclusion, GGT was independently associated with increased arterial stiffness both in men and in women with established CAD.
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Affiliation(s)
- Cansheng Zhu
- Department of Neurology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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16
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C-reactive protein is associated with aortic stiffness in a cohort of African American and white women transitioning through menopause. Menopause 2012; 18:1291-7. [PMID: 21892111 DOI: 10.1097/gme.0b013e31821f81c2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Arterial stiffness is a marker of cardiovascular health. Arterial stiffness and C-reactive protein (CRP) are linked to cardiovascular outcomes. Increases in both inflammation and arterial stiffness are known to occur with menopause. The association between CRP and arterial stiffness is well accepted; however, no study has determined whether there are differences in this association by menopause status and race, independent of age. METHODS The cross-sectional association between CRP and aortic pulse wave velocity (PWV), a validated measure of central arterial stiffening, was evaluated in 307 African American and white women enrolled in an ancillary study to the Study of Women's Health Across the Nation. Women were categorized into premenopausal or early perimenopausal (n = 185) and late perimenopausal or postmenopausal (n = 122). RESULTS Natural log-transformed CRP was not associated with PWV in a linear regression model adjusted for age and cardiovascular risk factors (β = 15.9, P = 0.11). Moreover, models stratified by menopause status showed a linear relationship between CRP and PWV among late perimenopausal or postmenopausal women (β = 36.2, P = 0.049) but not for premenopausal or early perimenopausal women (β = 5.9, P = 0.61). The menopause status × log-transformed CRP and menopause status × race interactions were significant in their respective models adjusted for age and risk factors (P = 0.03 for both); however, when combined into one model, the two interactions were slightly attenuated (P = 0.063 and 0.052, respectively). CONCLUSIONS Menopause is strengthening the association between CRP and PWV, independent of age, and this effect seems to be stronger among African American women. This study provides a potential mechanism for the increased risk of cardiovascular disease among postmenopausal women.
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Shalhoub J, Davies KJ, Hasan N, Thapar A, Sharma P, Davies AH. The utility of collaborative biobanks for cardiovascular research. Angiology 2011; 63:367-77. [PMID: 21900342 DOI: 10.1177/0003319711418958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Differences between animal and human atherosclerosis have led to the requirement for clinical data, imaging information and biological material from large numbers of patients and healthy persons. Where such "biobanks" exist, they have been fruitful sources for genomewide association, diagnostic accuracy, ethnicity, and risk stratification cohort studies. In addition once established, they attract funding for future projects. Biobanks require a network of medical contributors, secure storage facilities, bioinformatics expertise, database managers, and ethical working practices to function optimally. There is the opportunity for collaboration between individual biobanks to further amplify the advantages afforded.
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Affiliation(s)
- Joseph Shalhoub
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College, London, UK.
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18
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Shin JY, Lee HR, Lee DC. Increased arterial stiffness in healthy subjects with high-normal glucose levels and in subjects with pre-diabetes. Cardiovasc Diabetol 2011; 10:30. [PMID: 21492487 PMCID: PMC3098149 DOI: 10.1186/1475-2840-10-30] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 04/15/2011] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increased fasting plasma glucose (FPG), which includes impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes, is a risk factor for arterial stiffness. While IFG is widely accepted as a cardiovascular risk factor, recent studies have argued that subjects with high-normal glucose level were characterized by a high incidence of cardiovascular disease. The purpose of this study is to investigate the relationship between FPG and arterial stiffness in non-diabetic healthy subjects. METHODS We recruited 697 subjects who visited the health promotion center of a university hospital from May 2007 to August 2008. Age, sex, body mass index (BMI), resting heart rate, smoking habits, alcohol intake, exercise, blood pressure, medical history, FPG, lipid profile, high sensitivity C-reactive protein (hs-CRP), and Brachial-ankle pulse wave velocity (ba-PWV) were measured. We performed correlation and multiple linear regression analyses to divide the research subjects into quartiles: Q1(n=172), 65 mg/dL≤FPG<84 mg/dL; Q2(n=188), 84 mg/dL≤FPG<91 mg/dl; Q3(n=199), 91 mg/dL≤FPG<100 mg/dL; Q4(n=138), 100 mg/dL≤FPG<126 mg/dL. RESULTS FPG has an independent, positive association with ba-PWV in non-diabetic subjects after correcting for confounding variables, including age, sex, BMI, blood pressure, resting heart rate, hs-CRP, lipid profile, and behavioral habits. The mean ba-PWV of the high-normal glucose group (Q3, 1384 cm/s) was higher than that of the low-normal glucose group (1303±196 cm/s vs.1328±167 cm/s, P<0.05). The mean ba-PWV value in the IFG group (1469±220 cm/s) was higher than that in the normoglycemic group (P<0.05, respectively). CONCLUSIONS An increase in FPG, even within the normal range, was associated with aggravated arterial stiffness. Further research is needed to determine the glycemic target value for the prevention of arterial stiffness in clinical and public health settings.
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Affiliation(s)
- Jin Young Shin
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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19
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Wang RT, Li Y, Zhu XY, Zhang YN. Increased mean platelet volume is associated with arterial stiffness. Platelets 2011; 22:447-51. [DOI: 10.3109/09537104.2011.565431] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Xu L, Jiang CQ, Lam TH, Bao B, Cheng KK, Thomas GN. Plasminogen activator inhibitor-1 and HbA1c defined prediabetes: the Guangzhou Biobank Cohort Study-CVD. Clin Endocrinol (Oxf) 2011; 74:528-31. [PMID: 21128994 DOI: 10.1111/j.1365-2265.2010.03948.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine the association between plasminogen activator inhibitor-1 (PAI-1) and diabetes status. RESEARCH DESIGN AND METHODS One thousand three hundred and ninety-three older Chinese were randomly selected from the Guangzhou Biobank Cohort Study. Diabetes status was classified as impaired HbA1c (IA1c) level of 5·7-6·4%, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or diabetes using the American Diabetes Association diagnosis criteria in 2010. RESULTS Compared to the normoglycemic (NG) group, 421 subjects with IA1c, but without diabetes, IFG or IGT, had adverse levels of vascular risk factors, including PAI-1, lipid profile, blood pressure and anthropometry. After adjusting for multiple potential confounders, compared to the NG group, the level of plasma PAI-1 was independently and significantly increased in the IA1c and the IFG/IGT group (mean difference: 32·0 (95% confidence interval: 5·5-58·6) ng/ml and 33·3 (6·3-60·3) ng/ml, respectively; P<0·01). CONCLUSIONS Plasma PAI-1 level was increased in people with haemoglobin A1c (HbA1c) of 5·7-6·4% but without IFG or IGT, and in people with IFG/IGT, suggesting an increased risk for future diabetes and cardiovascular diseases in these groups.
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Affiliation(s)
- Lin Xu
- Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong, China
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