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Frigerio B, Coggi D, Bonomi A, Amato M, Capra N, Colombo GI, Sansaro D, Ravani A, Savonen K, Giral P, Gallo A, Pirro M, Gigante B, Eriksson P, Strawbridge RJ, Mulder DJ, Tremoli E, Veglia F, Baldassarre D. Determinants of Carotid Wall Echolucency in a Cohort of European High Cardiovascular Risk Subjects: A Cross-Sectional Analysis of IMPROVE Baseline Data. Biomedicines 2024; 12:737. [PMID: 38672093 PMCID: PMC11154292 DOI: 10.3390/biomedicines12040737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/28/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Echolucency, a measure of plaque instability associated with increased cardiovascular risk, can be assessed in both the carotid plaque and the plaque-free common carotid intima-media (IM) complex as a gray-scale median (plaque-GSM and IM-GSM, respectively). The impact of specific vascular risk factors on these two phenotypes remains uncertain, including the nature and extent of their influence. This study aims to seek the determinants of plaque-GSM and IM-GSM. Plaque-GSM and IM-GSM were measured in subjects from the IMPROVE study cohort (aged 54-79, 46% men) recruited in five European countries. Plaque-GSM was measured in subjects who had at least one IMTmax ≥ 1.5 mm (n = 2138), whereas IM-GSM was measured in all subjects included in the study (n = 3188). Multiple regression with internal cross-validation was used to find independent predictors of plaque-GSM and IM-GSM. Plaque-GSM determinants were plaque-size (IMTmax), and diastolic blood pressure. IM-GSM determinants were the thickness of plaque-free common carotid intima-media complex (PF CC-IMTmean), height, systolic blood pressure, waist/hip ratio, treatment with fibrates, mean corpuscular volume, treatment with alpha-2 inhibitors (sartans), educational level, and creatinine. Latitude, and pack-yearscode were determinants of both plaque-GSM and IM-GSM. The overall models explain 12.0% of plaque-GSM variability and 19.7% of IM-GSM variability. A significant correlation (r = 0.51) was found between plaque-GSM and IM-GSM. Our results indicate that IM-GSM is a weighty risk marker alternative to plaque-GSM, offering the advantage of being readily measurable in all subjects, including those in the early phases of atherosclerosis where plaque occurrence is relatively infrequent.
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Affiliation(s)
- Beatrice Frigerio
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Daniela Coggi
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Alice Bonomi
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Nicolò Capra
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Gualtiero I. Colombo
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Daniela Sansaro
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Alessio Ravani
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
| | - Kai Savonen
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, 70100 Kuopio, Finland;
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, 70210 Kuopio, Finland
| | - Philippe Giral
- INSERM, Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Sorbonne Université, F-75013 Paris, France; (P.G.); (A.G.)
- Lipidology and Cardiovascular Prevention Unit, Department of Nutrition, APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| | - Antonio Gallo
- INSERM, Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Sorbonne Université, F-75013 Paris, France; (P.G.); (A.G.)
- Lipidology and Cardiovascular Prevention Unit, Department of Nutrition, APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| | - Matteo Pirro
- Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
| | - Bruna Gigante
- Department of Medicine Solna, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Karolinska University Hospital, 17177 Solna, Sweden; (B.G.); (P.E.); (R.J.S.)
| | - Per Eriksson
- Department of Medicine Solna, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Karolinska University Hospital, 17177 Solna, Sweden; (B.G.); (P.E.); (R.J.S.)
| | - Rona J. Strawbridge
- Department of Medicine Solna, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Karolinska University Hospital, 17177 Solna, Sweden; (B.G.); (P.E.); (R.J.S.)
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8TB, UK
- Health Data Research UK, Glasgow G12 8TA, UK
| | - Douwe J. Mulder
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
| | - Elena Tremoli
- Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy; (E.T.); (F.V.)
| | - Fabrizio Veglia
- Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy; (E.T.); (F.V.)
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (B.F.); (D.C.); (A.B.); (M.A.); (N.C.); (G.I.C.); (D.S.); (A.R.)
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, 20129 Milan, Italy
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Katakami N, Mita T, Maeda N, Sato Y, Watada H, Shimomura I. Evaluation of the effect of tofogliflozin on the tissue characteristics of the carotid wall—a sub-analysis of the UTOPIA trial. Cardiovasc Diabetol 2022; 21:19. [PMID: 35123483 PMCID: PMC8817596 DOI: 10.1186/s12933-022-01451-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Since sodium-glucose cotransporter 2 (SGLT2) inhibitors have a pleiotropic antiatherogenic effect, they are expected to attenuate the progression of atherosclerosis. However, whether SGLT2 inhibitors affect the tissue characteristics of the human arterial wall remains unclear. This study aimed to evaluate the effects of tofogliflozin, a selective SGLT2 inhibitor, on the tissue characteristics of the human arterial wall in type 2 diabetes (T2DM) patients without apparent cardiovascular disease (CVD). Methods The present study was a post hoc analysis based on data obtained from the Using Tofogliflozin for Possible Better Intervention against Atherosclerosis for Type 2 Diabetes Patients (UTOPIA) trial, which was a multicenter prospective, randomized, open-label, blinded-endpoint study conducted to evaluate the efficacy of tofogliflozin in preventing the progression of atherosclerosis in patients with T2DM. We evaluated the longitudinal change in the ultrasonic tissue characteristics of the carotid wall using gray-scale median (GSM), an established index of ultrasonic tissue characteristics. The right and left intima-medial areas were delineated, and the GSM values were evaluated (right GSM-CCA and left GSM-CCA). The average values of the right and left carotid arteries were defined as “mean GSM-CCA value.” Results In a mixed-effects model for repeated measures, mean GSM-CCA, along with the right and left GSM-CCA values, did not significantly change in either the tofogliflozin (n = 168) or conventional treatment group (n = 169). In addition, the tofogliflozin and conventional treatment groups did not significantly differ regarding the change of the mean GSM-CCA (mean difference [95% CI] − 1.24[− 3.87, 1.38], P = 0.35), along with the right (mean difference [95% CI] − 2.33[− 5.70, 1.05], P = 0.18) and the left GSM-CCA (mean difference [95% CI] − 0.29 [− 3.53, 2.95], P = 0.86) values. Similar findings were obtained even after adjusting for traditional cardiovascular risk factors and/or the administration of drugs at baseline. Conclusions The tissue characteristics of the carotid arterial wall did not change in either the tofogliflozin or conventional treatment group during the 104-week treatment period, and there was no significant difference between the treatment groups. Clinical trial registration UMIN000017607 (https://www.umin.ac.jp/icdr/index.html) Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01451-6.
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Kim K, Lim C, Kim G, Chung JH, Cho YS, Cho JH, Seo JB, Chung WY, Oh SJ, Choi JS, Kim JS, Park JJ, Suh JW, Youn TJ, Chae IH, Choi DJ. Association of Plasma Marker of Oxidized Lipid with Histologic Plaque Instability in Patients with Peripheral Artery Disease. Ann Vasc Surg 2019; 66:554-565. [PMID: 31706994 DOI: 10.1016/j.avsg.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/05/2019] [Accepted: 11/01/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The association between oxidized low-density lipoprotein (OxLDL) and plaque instability in coronary and carotid artery disease is well established. However, the association between OxLDL and the histologic changes of plaque in peripheral artery disease has not been clearly elucidated. This study aims to investigate the association between plasma OxLDL and histologic plaque instability in patients with peripheral artery disease. METHODS Prospectively obtained plaques from 48 patients who underwent endovascular atherectomy (n = 20), surgical endarterectomy (n = 9), or bypass surgery (n = 19) for treatment of atherosclerotic femoropopliteal artery disease were evaluated for histologic fibrosis, sclerosis, calcification, necrosis, cholesterol cleft, and foamy macrophages using hematoxylin and eosin, oil red O, and immunohistochemical staining. Unstable plaques were defined as plaques that were positive for foamy macrophages and with lipid content of more than 10% of the total plaque area. Plasma OxLDL levels were measured using an enzyme-linked immunosorbent assay (Mercodia AB, Uppsala, Sweden). RESULTS Of the 48 patients, 26 (54%) had unstable plaques. The unstable plaque group was younger, had fewer angiographic total occlusions, less calcification, and more CD68-positive and LOX-1-positive cells than the stable plaque group. Plasma OxLDL levels were significantly higher in the unstable plaque group than in the stable plaque group (57.4 ± 13.9 vs. 47.2 ± 13.6 U/L, P = 0.014). Multivariate analysis revealed that plasma OxLDL level, smoking, angiographic nontotal occlusion, and statin nonuse were independent predictors of unstable plaque. CONCLUSIONS Among patients with peripheral artery disease, the histologic instability of femoropopliteal plaque was independently associated with high plasma OxLDL, smoking, nontotal occlusion, and statin nonuse. Further large-scale studies are necessary to evaluate the role of noninvasive OxLDL measurement for predicting plaque instability and future adverse vascular event.
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Affiliation(s)
- Kichun Kim
- The Armed Forces Medical Command, Seongnam, South Korea
| | - Cheong Lim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Gilhyang Kim
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jin-Haeng Chung
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young-Seok Cho
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Jun Hwan Cho
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea
| | - Jae-Bin Seo
- Department of Internal Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Woo-Young Chung
- Department of Internal Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Se-Jin Oh
- Department of Cardiothoracic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jae-Sung Choi
- Department of Cardiothoracic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jun-Sung Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jin Joo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jung-Won Suh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Tae-Jin Youn
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - In-Ho Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Patel KV, Kumbhani DJ. Editorial Commentary: Oxidized LDL: The next “big thing”? Trends Cardiovasc Med 2019; 29:27-28. [DOI: 10.1016/j.tcm.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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Trpkovic A, Resanovic I, Stanimirovic J, Radak D, Mousa SA, Cenic-Milosevic D, Jevremovic D, Isenovic ER. Oxidized low-density lipoprotein as a biomarker of cardiovascular diseases. Crit Rev Clin Lab Sci 2014; 52:70-85. [DOI: 10.3109/10408363.2014.992063] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Prognostic impact of plaque echolucency in combination with inflammatory biomarkers on cardiovascular outcomes of coronary artery disease patients receiving optimal medical therapy. Atherosclerosis 2011; 216:120-4. [DOI: 10.1016/j.atherosclerosis.2011.01.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 01/03/2011] [Accepted: 01/29/2011] [Indexed: 11/21/2022]
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Mikelsaar M, Stsepetova J, Hütt P, Kolk H, Sepp E, Lõivukene K, Zilmer K, Zilmer M. Intestinal Lactobacillus sp. is associated with some cellular and metabolic characteristics of blood in elderly people. Anaerobe 2010; 16:240-6. [PMID: 20223288 DOI: 10.1016/j.anaerobe.2010.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 01/08/2010] [Accepted: 03/02/2010] [Indexed: 12/31/2022]
Abstract
The higher counts or particular groups (Firmicutes/Bacteroidetes) of intestinal microbiota are related to host metabolic reactions, supporting a balance of human ecosystem. We further explored whether intestinal lactobacilli were associated with some principal cellular and metabolic markers of blood in 38 healthy >65-year-old persons. The questionnaire, routine clinical and laboratory data of blood indices as much as the oxidized low-density lipoprotein (ox-LDL) and baseline diene conjugates in low-density lipoprotein (BDC-LDL) of blood sera were explored. The PCR-based intestinal Lactobacillus sp. composition and counts of cultivable lactobacilli (LAB) were tested. The facultative heterofermentative lactobacilli (Lactobacillus casei and Lactobacillus paracasei) were the most frequent (89 and 97%, respectively) species found, while Lactobacillus acidophilus, Lactobacillus plantarum and Lactobacillus reuteri were present in almost half of the elderly persons. The number of species simultaneously colonizing the individuals ranged from 1 to 7 (median 4). In elderly consuming probiotics the LAB counts were significantly higher than in these not consuming (median 7.8, range 4.2-10.8 vs. median 6.3, range 3.3-9.7 log cfu/g; p=0.005), adjusted (OR=1.71, CI95 1.04-2.82; p=0.035) for age and body mass index (BMI). The colonization by L. acidophilus was negatively related (r=-0.367, p=0.0275) to L. reuteri, staying significant after adjusting for age, sex and BMI (OR=0.16, CI95 0.04-0.73; p=0.018). However, the blood glucose concentration showed a tendency for a negative correlation for colonization with Lactobacillus fermentum (r=-0.309, p=0.062) adjusted for BMI (Adj. R(2)=0.181; p=0.013) but not for age and sex. The higher white blood cells (WBC) count was positively related (r=0.434, p=0.007) to presence of Lactobacillus reuteri adjusted for age, sex and BMI (Adj. R(2)=0.193, p=0.027). The lower values of ox-LDL were predicted by higher counts of cultivable lactobacilli adjusted by sex, age and BMI (r = -0.389, p = 0.016; Adj. R(2)=0.184 p=0.029). In conclusion, the pilot study of elderly persons shows that the intestinal lactobacilli are tightly associated with WBC count, blood glucose and content of ox-LDL which all serve as risk markers in pathogenesis of inflammation, metabolic syndrome and cardiovascular disease (CVD).
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Affiliation(s)
- Marika Mikelsaar
- Department of Microbiology, Medical Faculty, University of Tartu, Ravila 19, Tartu 50411, Estonia.
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Sigurdardottir V, Fagerberg B, Wikstrand J, Schmidt C, Hulthe J. Circulating oxidized LDL is associated with the occurrence of echolucent plaques in the carotid artery in 61‐year‐old men. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 68:292-7. [DOI: 10.1080/00365510701762723] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Andersson J, Sundström J, Kurland L, Gustavsson T, Hulthe J, Elmgren A, Zilmer K, Zilmer M, Lind L. The carotid artery plaque size and echogenicity are related to different cardiovascular risk factors in the elderly: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Lipids 2009; 44:397-403. [PMID: 19234732 DOI: 10.1007/s11745-009-3281-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Accepted: 12/29/2008] [Indexed: 01/22/2023]
Abstract
Carotid plaques can be characterised by ultrasound by size and echogenicity. Both size and echogenicity are predictors of cardiovascular events. The aim of this study was to examine whether traditional risk factors and markers of inflammation and oxidation were associated with plaque size and echogenicity. Computerised analysis of carotid plaque size and echogenicity (grey scale median, GSM) were performed by ultrasound in a population-based health survey in 1,016 subjects aged 70 years (PIVUS study). Information on cardiovascular risk factors was collected, together with markers of inflammation and oxidation. Increased Framingham risk score, systolic blood pressure, higher BMI and decreased HDL, lower glutathione levels were related to echolucent plaques. Previous or present smoking was common with significantly more pack-years related to the echorich plaques. Plaque size was associated with increased Framingham risk score, systolic blood pressure, blood glucose levels, smoking, ApoB/A1 ratio, OxLDL, TNF alpha, HOMA insulin resistance, leucocyte count, decreased BCD-LDL and low levels of l-selectin. Low HDL, increased BMI and decreased glutathione levels were associated with the echolucency of carotid plaques, implying metabolic factors to play a role for plaque composition. Markers of inflammation were related to plaque size alone, implying inflammation to be predominantly associated with the amount of atherosclerosis. These results suggest that plaque size and echogenicity are influenced by different risk factors.
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Affiliation(s)
- Jessika Andersson
- Department of Medicine, Uppsala University Hospital, 75185 Uppsala, Sweden.
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Verhoye E, Langlois MR. Circulating oxidized low-density lipoprotein: a biomarker of atherosclerosis and cardiovascular risk? Clin Chem Lab Med 2009; 47:128-37. [DOI: 10.1515/cclm.2009.037] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractLow-density lipoproteins (LDLs) are susceptible to structural modifications by oxidation, particularly the small dense LDL particles. The formation of lipid peroxidation derivates, such as thiobarbituric reactive substances, conjugated dienes, lipid hydroperoxides, and aldehydes, is associated with changes in apolipoprotein conformation and affects the functional properties of LDLs. Oxidized LDL (oxLDL) formation in the subendothelial space of the arterial wall is a key initiating step in atherosclerosis because it contributes to foam cell generation, endothelial dysfunction, and inflammatory processes. In the last decade, immunoassays were developed using monoclonal antibodies against oxidation-dependent epitopes of LDL which made it possible to directly measure oxLDL in the circulation. Increased circulating oxLDL concentrations have been related to cardiovascular disease in some studies, although not always independently after adjustment of classical lipid markers. The Asklepios Study, investigating 2524 healthy middle-aged subjects, showed that circulating oxLDL is affected by many biological and lifestyle factors, as well as (generalized) subclinical atherosclerosis.Clin Chem Lab Med 2009;47:128–37.
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Langlois MR, Rietzschel ER, De Buyzere ML, De Bacquer D, Bekaert S, Blaton V, De Backer GG, Gillebert TC. Femoral Plaques Confound the Association of Circulating Oxidized Low-Density Lipoprotein With Carotid Atherosclerosis in a General Population Aged 35 to 55 Years. Arterioscler Thromb Vasc Biol 2008; 28:1563-8. [PMID: 18511698 DOI: 10.1161/atvbaha.108.167346] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michel R. Langlois
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Ernst R. Rietzschel
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Marc L. De Buyzere
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Dirk De Bacquer
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Sofie Bekaert
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Victor Blaton
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Guy G. De Backer
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Thierry C. Gillebert
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
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Olson FJ, Schmidt C, Gummesson A, Sigurdardottir V, Hulthe J, Wiklund O, Fagerberg B. Circulating matrix metalloproteinase 9 levels in relation to sampling methods, femoral and carotid atherosclerosis. J Intern Med 2008; 263:626-35. [PMID: 18341531 DOI: 10.1111/j.1365-2796.2008.01927.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine whether circulating levels of matrix metalloproteinase 9 (MMP-9) were associated with ultrasound-assessed intima-media thickness (IMT) and echolucent plaques in the carotid and femoral arteries. To examine preanalytical sources of variability in MMP-9 concentrations related to sampling procedures. SUBJECTS AND DESIGN Plasma and serum MMP-9 levels were compared with ultrasound assessed measures of femoral and carotid atherosclerosis, in a cross-sectional study of 61-year-old men (n = 473). Preanalytical sources of variability in MMP-9 levels were examined in 10 healthy subjects. Main outcome measures were circulating levels of MMP-9 in serum and plasma, IMT of the carotid and femoral arteries, and plaque status based on size and echolucency. SETTING Research unit at university hospital. RESULTS Plasma concentrations of total and active MMP-9 were associated with femoral artery IMT independently of traditional cardiovascular risk factors, and were higher in subjects with moderate to large femoral plaques. Plasma MMP-9 concentration was higher in men with echolucent femoral plaques (P = 0.006) compared with subjects without femoral plaques. No similar associations were found for carotid plaques. MMP-9 concentrations were higher in serum than in plasma, and higher when sampling was performed with Vacutainer than with syringe. MMP-9 levels in serum were more strongly associated with peripheral neutrophil count compared with MMP-9 levels in plasma. CONCLUSIONS Plasma MMP-9 levels were associated with atherosclerosis in the femoral artery, and total MMP-9 concentration was higher in men with echolucent femoral plaques. The choice of sample material and sampling method affect the measurements of circulating MMP-9 levels.
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Affiliation(s)
- F J Olson
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
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Bibliography. Current world literature. Diabetes and the endocrine pancreas. Curr Opin Endocrinol Diabetes Obes 2008; 15:193-207. [PMID: 18316957 DOI: 10.1097/med.0b013e3282fba8b4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Faeh D, William J, Yerly P, Paccaud F, Bovet P. Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insulin resistance and adiposity. Cardiovasc Diabetol 2007; 6:32. [PMID: 17958881 PMCID: PMC2148037 DOI: 10.1186/1475-2840-6-32] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2007] [Accepted: 10/24/2007] [Indexed: 11/25/2022] Open
Abstract
Background Impaired glucose regulation (IGR) is associated with detrimental cardiovascular outcomes such as cardiovascular disease risk factors (CVD risk factors) or intima-media thickness (IMT). Our aim was to examine whether these associations are mediated by body mass index (BMI), waist circumference (waist) or fasting serum insulin (insulin) in a population in the African region. Methods Major CVD risk factors (systolic blood pressure, smoking, LDL-cholesterol, HDL-cholesterol,) were measured in a random sample of adults aged 25–64 in the Seychelles (n = 1255, participation rate: 80.2%). According to the criteria of the American Diabetes Association, IGR was divided in four ordered categories: 1) normal fasting glucose (NFG), 2) impaired fasting glucose (IFG) and normal glucose tolerance (IFG/NGT), 3) IFG and impaired glucose tolerance (IFG/IGT), and 4) diabetes mellitus (DM). Carotid and femoral IMT was assessed by ultrasound (n = 496). Results Age-adjusted levels of the major CVD risk factors worsened gradually across IGR categories (NFG < IFG/NGT < IFG/IGT < DM), particularly HDL-cholesterol and blood pressure (p for trend < 0.001). These relationships were marginally attenuated upon further adjustment for waist, BMI or insulin (whether considered alone or combined) and most of these relationships remained significant. With regards to IMT, the association was null with IFG/NGT, weak with IFG/IGT and stronger with DM (all more markedly at femoral than carotid levels). The associations between IMT and IFG/IGT or DM (adjusted by age and major CVD risk factors) decreased only marginally upon further adjustment for BMI, waist or insulin. Further adjustment for family history of diabetes did not alter the results. Conclusion We found graded relationships between IGR categories and both major CVD risk factors and carotid/femoral IMT. These relationships were only partly accounted for by BMI, waist and insulin. This suggests that increased CVD-risk associated with IGR is also mediated by factors other than the considered markers of adiposity and insulin resistance. The results also imply that IGR and associated major CVD risk factors should be systematically screened and appropriately managed.
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Affiliation(s)
- David Faeh
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Center and University of Lausanne, Bugnon 17, 1005 Lausanne, Switzerland.
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Ostling G, Hedblad B, Berglund G, Gonçalves I. Increased Echolucency of Carotid Plaques in Patients With Type 2 Diabetes. Stroke 2007; 38:2074-8. [PMID: 17525393 DOI: 10.1161/strokeaha.106.480830] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE Diabetes is associated with the presence of moderate to large atherosclerotic carotid plaques. Previous carotid ultrasound studies have associated plaques with low echogenicity with a higher risk of cerebrovascular events. The aim of this study was to evaluate whether patients with type 2 diabetes have different plaque echogenicity than do nondiabetic subjects. METHODS Forty-seven type 2 diabetic and 51 nondiabetic subjects with a carotid plaque in the right artery were included in this study. All patients were born in 1935 to 1936 and were participants in a population-based study. Carotid ultrasonography was performed and the risk factors for cardiovascular disease were determined. Plaque echogenicity was assessed quantitatively on B-mode ultrasound images by standardized gray-scale median values. RESULTS Gray-scale median values were significantly lower, indicating more echolucent plaques, in patients with type 2 diabetes compared with nondiabetics (37.0+/-14.8 vs 45.5+/-15.4, P=0.007). Of the other risk factors studied, only triglycerides were significantly associated with the echogenicity of the plaque. CONCLUSIONS Patients with type 2 diabetes have more echolucent plaques compared with nondiabetic subjects. This might be associated with the higher risk of cardiovascular events among diabetics.
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Affiliation(s)
- Gerd Ostling
- Clinical Research Unit, Malmö University Hospital, Malmö, Sweden.
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Hollman G, Kristenson M. The prevalence of the metabolic syndrome and its risk factors in a middle-aged Swedish population--mainly a function of overweight? Eur J Cardiovasc Nurs 2007; 7:21-6. [PMID: 17586094 DOI: 10.1016/j.ejcnurse.2007.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Revised: 05/17/2007] [Accepted: 05/21/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prevalence of obesity, one risk factor for developing the metabolic syndrome (MS), has increased during the last decades. It has therefore been assumed that the prevalence of MS would also increase. AIMS The aim was to analyse the prevalence of MS and its risk factors in a middle-aged Swedish population. METHODS Data were obtained between 2003 and 2004 from a random population based sample of 502 men and 505 women, 45-69 years old. Measures of plasma glucose, serum lipids, blood pressure, weight, height, waist circumference and self-reported data concerning presence of disease, medication and lifestyle were obtained. RESULTS The prevalence of MS was 14.8% among men and 15.3% among women, with an increase by age among women only, 10% to 25% (p=0.029). Among individuals with MS the most frequent risk factor was large waist circumference, present in 85% of men and 99% of women, followed by high blood pressure, high triglycerides, high glucose and HDL cholesterol (38% and 47% respectively). CONCLUSION The prevalence of MS was 15%, increasing with age only among women. Overweight was a dominant characteristic, and only half of the individuals with MS had glucose/HDL cholesterol levels beyond defined cut points of the syndrome.
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Affiliation(s)
- Gunilla Hollman
- Department of Medicine and Care, Division of Nursing Sciences, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden.
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