Association between Serum Uric Acid Level and Carotid Atherosclerosis in Chinese Individuals Aged 75 Years or Older: A Hospital-Based Case-Control Study

Metabolic score and its components are associated with carotid plaque prevalence in young adults

PURPOSE

No study has comprehensively assessed the relationship of metabolic factors including insulin resistance, hypertension, hyperuricemia, and hypercholesterolemia with the development of carotid plaque. Therefore, we constructed metabolic scores based on the above metabolic factors and examined its association with carotid plaque in young and older Chinese adults.

METHODS

This study included 17,396 participants who underwent carotid ultrasound examinations, including 14,173 young adults (<65 years) and 3,223 older adults (≥65 years). Individual metabolic score was calculated using triglyceride-glucose (TyG) index, mean arterial pressure (MAP), uric acid, and total cholesterol (TC). Logistic regression models were conducted to examine the role of metabolic score and its components in the prevalence of carotid plaque. The nonlinear relationship was examined using restricted cubic spline regression. Meanwhile, subgroup, interaction, and sensitivity analyses were conducted.

RESULTS

The multivariate logistic regression analysis showed that TyG (OR: 1.088; 95%CI: 1.046-1.132), MAP (OR: 1.121; 95%CI: 1.077-1.168), TC (OR: 1.137; 95%CI: 1.094-1.182) and metabolic score (OR: 1.064; 95%CI: 1.046-1.082) were associated with carotid plaque prevalence in young adults rather than older adults. The nonlinear association was not observed for metabolic scores and carotid plaque. Subgroup analyses showed significant associations between metabolic scores and carotid plaque prevalence in men, women, normal-weight, and overweight young adults. No interaction of metabolic score with sex and BMI were observed.

CONCLUSIONS

The results support that control of TyG, MAP, TC, and metabolic scores is a key point in preventing the prevalence of carotid plaque in the young adults.

Evaluating Atherosclerosis of the Abdominal Aorta in Rabbits Using 2-D Strain Imaging

After establishment of an animal model of atherosclerosis, speckle tracking imaging was performed to analyze the correlation between ultrasound characteristics and pathological manifestations. Rabbits were divided into the normal control (NC) and atherosclerosis (AS) groups. Rabbits in the AS group were subjected to ultrasound-guided balloon injury of the abdominal aorta and fed a high-fat diet for 16 wk. Rabbits in the NC group were fed a normal diet for the same period. After 16 wk, all animals underwent serological tests, ultrasound and speckle tracking circumferential strain analysis. In the AS group, 28 hypo-echoic plaques had formed. The circumferential strain of six segments at the short axis of plaques in the AS group was lower than that in the NC group (p < 0.001), and global circumferential strain (GCS) in the AS group was significantly reduced compared with the NC group (p < 0.001). In the AS group, the area ratio of type I to type III collagen fibers was smaller than that in the NC group. The GCS of atherosclerotic plaques was positively correlated with the area ratio of type I to type III collagen fibers in plaques (r = 0.7181, p < 0.001). In conclusion, there is a significant positive correlation between the decreased circumferential strain and the decreased area ratio of type I to type III collagen fibers in hypo-echoic plaques.

Age and Gender Differences Between Carotid Intima-Media Thickness and Serum Uric Acid

Studies have explored the relation between serum uric acid (SUA) and carotid intima-media thickness (CIMT), but the relation remains controversial. The purpose of this study was to examine SUA concentration and its correlation with carotid artery atherosclerosis according to age group and gender. Subjects who underwent physical examinations at the First Affiliated Hospital of Chongqing Medical University from 2016 to 2020 were selected. Using traditional atherosclerosis risk factors as adjustment variables, the association between blood uric acid level and atherosclerosis was assessed by logistic regression analysis. A total of 15,843 subjects (73.90% men) were included, with an average age of 52 ± 12 years. The prevalence of increased CIMT was 9.51%, and the prevalence of plaque was 28.59%. Univariate analysis results showed that there were significant differences in the occurrence of increased CIMT and plaque among different SUA-level groups in both men and women (p <0.0001). After adjustment for conventional cardiovascular risk factors, increased SUA level was significantly associated with an increased risk of carotid intima-media thickening. Correlation analysis in each age subgroup showed that CIMT was significantly associated with SUA in men ≥60 years old and women 45 to 60 years old or ≥60 years old (p <0.0001). In conclusion, in both men and women, increased SUA levels are closely associated with increased CIMT. The age at which this association was observed was lower in women than in men; whether the lower age in women is due to changes in hormone levels between before and after menopause remains to be prospectively studied.

Association between serum uric acid and carotid atherosclerosis in elderly postmenopausal women: A hospital-based study

BACKGROUND

Carotid atherosclerosis (CAS) is associated with increased cardiovascular risk and implicated in 20-30% of strokes.

METHODS

504 patients were included in this study. The detailed medical history and the results of physical examination, carotid ultrasound examination, and routine laboratory tests were collected. Logistic regression analyses were conducted to analyze the relationship between the SUA and the presence of carotid plaques. And the relationship between SUA and the progression of CAS was analyzed by multiple linear regression. The effect of hormone replacement therapy (HRT) on CAS has also be evaluated.

RESULTS

412 patients (81.7%) had carotid plaques of different sizes by carotid ultrasound examination. We found a positive association between the level of SUA and the probability of having carotid plaque by univariate logistic regression (OR: 2.01, 95% CI: 1.83-2.19, p = 0.003). At 2 years post-discharge, we found that 1 mg/dL increase in SUA levels was expected to 0.946% increase in plaque score and 0.026 cm increase in carotid intima-media thickness, separately. Moreover, patients treated by long-term HRT (≥5 years) had a lower level of SUA and blood lipid and the less change of plaque score and carotid intima-media thickness than patients without HRT.

CONCLUSION

The presence and progression of CAS had significantly positive associations with the level of SUA. And the HRT may have the ability to prevent the presence and progression of CAS. However, the safety and long-term outcome of HRT on CAS should be evaluated in further studies.