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Lima do Vale MR, Buckner L, Mitrofan CG, Tramontt CR, Kargbo SK, Khalid A, Ashraf S, Mouti S, Dai X, Unwin D, Bohn J, Goldberg L, Golubic R, Ray S. A synthesis of pathways linking diet, metabolic risk and cardiovascular disease: a framework to guide further research and approaches to evidence-based practice. Nutr Res Rev 2023; 36:232-258. [PMID: 34839838 DOI: 10.1017/s0954422421000378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cardiovascular disease (CVD) is the most common non-communicable disease occurring globally. Although previous literature has provided useful insights into the important role that diet plays in CVD prevention and treatment, understanding the causal role of diets is a difficult task considering inherent and introduced weaknesses of observational (e.g. not properly addressing confounders and mediators) and experimental research designs (e.g. not appropriate or well designed). In this narrative review, we organised current evidence linking diet, as well as conventional and emerging physiological risk factors, with CVD risk, incidence and mortality in a series of diagrams. The diagrams presented can aid causal inference studies as they provide a visual representation of the types of studies underlying the associations between potential risk markers/factors for CVD. This may facilitate the selection of variables to be considered and the creation of analytical models. Evidence depicted in the diagrams was systematically collected from studies included in the British Nutrition Task Force report on diet and CVD and database searches, including Medline and Embase. Although several markers and disorders linked to conventional and emerging risk factors for CVD were identified, the causal link between many remains unknown. There is a need to address the multifactorial nature of CVD and the complex interplay between conventional and emerging risk factors with natural and built environments, while bringing the life course into the spotlight.
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Affiliation(s)
| | - Luke Buckner
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | | | | | | | - Ali Khalid
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | - Sammyia Ashraf
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | - Saad Mouti
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
| | - Xiaowu Dai
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
| | | | - Jeffrey Bohn
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
- Swiss Re Institute, Zürich, Switzerland
| | - Lisa Goldberg
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
| | - Rajna Golubic
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Diabetes Trials Unit, University of Oxford, Oxford, UK
| | - Sumantra Ray
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
- University of Ulster, School of Biomedical Sciences, Coleraine, UK
- University of Cambridge, School of the Humanities and Social Sciences, Cambridge, UK
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Dawoud NM, Dawoud MM, El Hefnawy SM, Abdellatif HA, Abdellatif NH, Gaafar SS, Seleit I. Circulating and/or cutaneous irisin resistance: A novel link among androgenetic alopecia, comorbid metabolic syndrome and cardiovascular risks. J Cosmet Dermatol 2023; 22:2584-2597. [PMID: 37128821 DOI: 10.1111/jocd.15760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/10/2023] [Accepted: 03/23/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a common cause of hair loss in both genders that may be associated with disturbed systemic metabolism. Irisin is a hormone-like myokine that greatly influences systemic metabolism and is linked to cardiovascular diseases. AIM To detect irisin role in AGA and its associated metabolic syndrome (MetS) and cardiovascular risk. PATIENTS/METHODS This case-control study included 44 AGA patients of both genders and 22 healthy individuals. Serum irisin level was measured using ELISA and scalp biopsy was taken to detect irisin immunohistochemically. Carotid Doppler ultrasonography was performed to measure carotid intima media thickness (CIMT). RESULTS Higher serum irisin was significantly detected in AGA patients (p ˂ 0.001), and in males (p = 0.01) particularly severe cases (p ˂ 0.001). It was significantly higher in AGA patients presenting with MetS and those suffering from dyslipidemia (p ˂ 0.001 for both). Multivariate regression analysis proved BMI (p = 0.01) and serum irisin (p = 0.02) as independent predictors of CIMT abnormality among AGA patients. Regarding cutaneous irisin expression, the epidermal H-score was significantly higher in AGA patients with MetS compared to those without (p = 0.04). Epidermal H-score ˃100 was significantly associated with male gender (p = 0.05), severe AGA (p = 0.02), MetS (p = 0.03), dyslipidemia (p = 0.03), and abnormal CIMT (p = 0.03). CONCLUSION High serum irisin and upregulated epidermal irisin expression are associated with the incidence of MetS, dyslipidemia, and CIMT abnormality among AGA patients. This may indicate resistance to irisin, which hinders its favorable cardiometabolic actions. Further studies are warranted to investigate the concept of irisin resistance in AGA patients, which was uniquely discussed in the present study.
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Affiliation(s)
- Noha M Dawoud
- Department of Dermatology, Andrology and STDs, Faculty of medicine, Menoufia University, Shebine Elkom, Egypt
| | - Marwa M Dawoud
- Department of Pathology, Faculty of medicine, Menoufia University, Shebine Elkom, Egypt
| | - Sally M El Hefnawy
- Department of Biochemistry, Faculty of Medicine, Menoufia University, Shebine Elkom, Egypt
| | - Hayam A Abdellatif
- Department of Radiology, Faculty of Medicine, Menoufia University, Shebine Elkom, Egypt
| | | | | | - Iman Seleit
- Department of Dermatology, Andrology and STDs, Faculty of medicine, Menoufia University, Shebine Elkom, Egypt
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S VC, S S, R NK, S N MS, P A A. Association of Serum Cystatin C Level With Carotid Arterial Wall Elastic Resistance as a Potential Marker for Detection of Early Stage Atherosclerosis. Cureus 2023; 15:e38543. [PMID: 37273348 PMCID: PMC10239270 DOI: 10.7759/cureus.38543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Early diagnosis of atherosclerosis is exigent in patients with known cardiovascular disease (CVD) risk factors. During the initial phases of atherosclerosis, appearance of plaques can be detected by the ultrasonic phased tracking method which measures the arterial wall elasticity. However, reliable and easily available biochemical markers are not evaluated in the diagnosis of early-stage atherosclerosis. So the current study was carried out to assess the serum cystatin C level as an atherosclerotic marker, by evaluating its association with carotid arterial elastic modulus using the phased tracking method. MATERIALS AND METHODS A cross-sectional study was conducted on 115 patients having risk factors for atherosclerosis but not meeting carotid intima-media thickness (IMT) criteria. The early-stage atherosclerosis was detected by using the ultrasonic phased tracking method and the patients were divided based on low and high carotid elastic modulus. Serum levels of cystatin-C were measured in association with IMT, and elastic modulus was calculated using a novel method. This study also put forth the evaluation of the sensitivity and specificity of cystatin C for early diagnosis of atherosclerosis. RESULTS Cystatin C was strongly related to carotid elasticity (r=0.650). Based on multi-linear regression analysis, cystatin C showed significant association with carotid elasticity (β=0.509; p<0.001). It also displayed significant positive association with high carotid elastic modulus (β=0.511; p=0.02). Cystatin C showed a sensitivity of 85% in the prediction of high carotid elastic modulus. CONCLUSION For patients who are at risk to evolve atherosclerosis but are not evident with arterial plaques, cystatin C exhibits a significant association with carotid wall elastic modulus, which eases the detection of atherosclerosis. Thus, cystatin C is a potential biochemical marker for early diagnosis of atherosclerosis.
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Affiliation(s)
- Vishnu Chander S
- Department of General Medicine, SRM Institute of Science and Technology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Sarumathy S
- Department of Pharmacy Practice, SRM Institute of Science and Technology, SRM College of Pharmacy, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Nanda Kumar R
- Department of General Medicine, SRM Institute of Science and Technology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Meenakshi Sundari S N
- Department of General Medicine, SRM Institute of Science and Technology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Anuba P A
- Department of Pharmacy Practice, SRM Institute of Science and Technology, SRM College of Pharmacy, Faculty of Medicine and Health Sciences, Kattankulathur, IND
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Enhesari A, Abasnia R, Baniasad A, Narouee Nosrati S, Najafipour H, Najafzadeh MJ, Gozashti MH. Investigating the Relationship between Carotid Intima-Media Thickness (CIMT), Opium Addiction, and Components of the Metabolic Syndrome. ADDICTION & HEALTH 2023; 15:93-99. [PMID: 37560392 PMCID: PMC10408763 DOI: 10.34172/ahj.2023.1388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/07/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Atherosclerosis has an essential role in causing cardiovascular diseases. Various factors affect the risk of coronary artery atherosclerosis, and the increase in the carotid intima-media thickness (CIMT) is a primary marker for detecting atherosclerotic changes in the artery wall. Since opioid use is one of the leading social and health problems in many countries, this study aimed to detect the factors influencing the increase in CIMT in opium consumers. METHODS This cross-sectional study was conducted on 350 participants of the phase 2 of the KERCADRS cohort study who visited Besat clinic in Kerman and were divided into addicted and non-addicted groups. The participants in both groups underwent carotid artery ultrasound, and the Philips IU22 ultrasound machine was used to measure the CIMT. FINDINGS The mean age of the participants was 42.28±12.58 in the addicted group and 35.99±15.38 in the non-addicted group (P=0.001). CIMT was similar in the two groups (P=0.170). Moreover, CIMT had a significant positive correlation with age, waist circumference, systolic blood pressure (SBP), body mass index (BMI), fasting plasma glucose (FPG), and triglyceride in both addicted and non-addicted groups. Age, weight, waist circumference, SBP, and BMI in the multivariate model were significant determinants of CIMT in the addicted group. CONCLUSION The results revealed that age, weight, waist circumference, SBP, and BMI were the factors influencing intima thickness in opium consumers, and no significant relationship was observed between addiction to opium and CIMT.
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Affiliation(s)
- Ahmad Enhesari
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Roohollah Abasnia
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Amir Baniasad
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahin Narouee Nosrati
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Najafipour
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Mohammad Hossein Gozashti
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
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Aoki E, Hirashima T, Kumamoto Y, Yamamoto Y, Suzuki N, Oshima T, Saito D, Hirano T. Clinical significance of skin autofluorescence for diabetic macroangiopathy and comparison with conventional markers of atherosclerosis: a cross-sectional and prospective study. Diabetol Int 2023; 14:145-154. [PMID: 37090128 PMCID: PMC10113414 DOI: 10.1007/s13340-022-00608-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022]
Abstract
Background Skin autofluorescence (SAF) is a marker for the accumulation of advanced glycation end products (AGEs), and is associated with diabetic macroangiopathy. However, whether SAF is superior to conventional markers of atherosclerosis such as carotid intima-media thickness (IMT) and pulse wave velocity (PWV) in detecting macroangiopathy remains unclear. Methods We recruited 845 patients with type 2 diabetes enrolled in a community diabetes cohort (ViNA cohort) who had SAF, IMT, and PWV measured at baseline. The prevalence of macroangiopathy at baseline and new cardiovascular events during the 2-year follow-up period was investigated. SAF was measured using an AGE reader. Coronary artery calcification (CAC) was measured by computed tomography in 485 patients. Peripheral artery disease (PAD) was defined as the ankle-brachial blood pressure ratio of ≤ 0.9. Results SAF, IMT, and PWV were significantly correlated with each other, and age, diabetes duration, and estimated glomerular filtration rate were their strong confounders. SAF was associated with baseline stroke and new stroke after adjusting for confounders, but not with coronary artery disease (CAD) or PAD. The nonsignificant relationship between SAF and CAD was consistent with the relationship between SAF and CAC. Multivariate analysis showed a significant association of SAF with baseline and new stroke independent of IMT and PWV. Maximum-IMT was significantly associated with baseline CAD, PAD, and stroke, but not with a new stroke, whereas PWV was associated with a new stroke. Conclusion Among diabetic macroangiopathies, SAF is a good stroke biomarker, but not for CAD and PAD. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-022-00608-8.
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Affiliation(s)
- Ema Aoki
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Takeshi Hirashima
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Yuko Kumamoto
- Department of Clinical Laboratory, Ebina General Hospital, Ebina, Japan
| | - Yuko Yamamoto
- Department of Clinical Laboratory, Ebina General Hospital, Ebina, Japan
| | - Natsuko Suzuki
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Taito Oshima
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Daizo Saito
- Department of Nutrition, Ebina General Hospital, Ebina, Japan
| | - Tsutomu Hirano
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
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Seo DH, Cho Y, Seo S, Ahn SH, Hong S, Ha KH, Shim JS, Kim HC, Kim DJ, Kim SH. Association between Metabolically Healthy Obesity and Subclinical Atherosclerosis in the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) Cohort. J Clin Med 2022; 11:jcm11092440. [PMID: 35566567 PMCID: PMC9103721 DOI: 10.3390/jcm11092440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/18/2022] Open
Abstract
We aimed to investigate the association between a new definition of metabolic health (MH) and subclinical atherosclerosis in a cohort of patients without previous cardiovascular disease (CVD). In total, 7824 community-dwelling adults were categorized as normal weight, overweight, or obese. Metabolically healthy obesity (MHO) was defined as obesity accompanied by all of the following criteria: systolic blood pressure (BP) < 130 mmHg, no use of BP-lowering medication, waist-hip ratio <0.832 (women) and <0.887 (men), and no prevalent diabetes. Carotid atherosclerosis was defined as carotid plaque or mean carotid intima-media thickness ≥ 1.1 mm. The prevalence of carotid atherosclerosis was 8.3% and 1113 (14.2%) patients were classified as having MHO. All individuals classified as metabolically unhealthy were at an increased risk of carotid atherosclerosis independent of body mass index categories. Conversely, the risk of carotid atherosclerosis in individuals with MHO was not significantly increased compared to that in metabolically healthy normal weight participants (hazard ratio 1.20, 95% confidence interval 0.87−1.67). This new definition of MH was able to identify people with MHO without an increased risk of CVD in an Asian community cohort.
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Affiliation(s)
- Da Hea Seo
- Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon 22212, Korea; (D.H.S.); (Y.C.); (S.S.); (S.H.A.); (S.H.)
| | - Yongin Cho
- Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon 22212, Korea; (D.H.S.); (Y.C.); (S.S.); (S.H.A.); (S.H.)
| | - Seongha Seo
- Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon 22212, Korea; (D.H.S.); (Y.C.); (S.S.); (S.H.A.); (S.H.)
| | - Seong Hee Ahn
- Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon 22212, Korea; (D.H.S.); (Y.C.); (S.S.); (S.H.A.); (S.H.)
| | - Seongbin Hong
- Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon 22212, Korea; (D.H.S.); (Y.C.); (S.S.); (S.H.A.); (S.H.)
| | - Kyung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (J.-S.S.); (H.C.K.)
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (J.-S.S.); (H.C.K.)
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon 16499, Korea;
- Correspondence: (D.J.K.); (S.H.K.)
| | - So Hun Kim
- Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon 22212, Korea; (D.H.S.); (Y.C.); (S.S.); (S.H.A.); (S.H.)
- Correspondence: (D.J.K.); (S.H.K.)
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Cheng X, Li Z, Yang M, Liu Y, Wang S, Huang M, Gao S, Yang R, Li L, Yu C. Association of HbA1c with carotid artery plaques in patients with coronary heart disease: a retrospective clinical study. Acta Cardiol 2022; 78:442-450. [PMID: 35356852 DOI: 10.1080/00015385.2022.2040822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Haemoglobin A1c (HbA1c) levels have been shown to be related to carotid artery plaques. However, studies on the relationship between HbA1c levels and carotid artery plaques in patients with coronary heart disease (CHD) are limited and inconsistent. Our objective was to examine the correlation between HbA1c levels and carotid artery plaques in patients with CHD. METHODS The study comprised 9275 Chinese adults with CHD from January 1, 2014, to September 30, 2020. HbA1c levels were assessed, and colour Doppler ultrasound was used to evaluate the carotid artery, including plaque presence, intima-media thickness, and plaque echo properties, to investigate the association between HbA1c and carotid plaque. A logistic regression model was used to assess the association between carotid artery plaques, carotid plaque echogenicity, and HbA1c. RESULTS The HbA1c level of the plaque-present group was higher than that of the plaque-absent group [6.1 (5.6-7.2) vs. 5.8 (5.5-6.5), p < 0.001]. In multiple linear regression analysis, intima-media thickness was associated with HbA1c (p < 0.001). Logistic regression showed that a higher HbA1c level was associated with plaque incidence as well as hyperechoic and heterogeneous plaques (p < 0.001). These associations persist after adjusting for age, sex, blood pressure, lipid profiles, alcohol consumption, and tobacco exposure. CONCLUSION HbA1c levels are notably associated with carotid artery plaque incidence, intima-media thickness, and plaque echogenicity in patients with CHD. These findings show that different levels of HbA1c may be an indicator for carotid artery plaques and thus, should be observed in patients with CHD.
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Affiliation(s)
- Xufeng Cheng
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhu Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mingjie Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yijia Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shuo Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mengnan Huang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shan Gao
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rongrong Yang
- School of Health Science and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lin Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunquan Yu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Yao X, Wang Y, Wang L, Cao M, Chen A, Zhang X. Expression patterns of serum MicroRNAs related to endothelial dysfunction in patients with subclinical hypothyroidism. Front Endocrinol (Lausanne) 2022; 13:981622. [PMID: 36147570 PMCID: PMC9485940 DOI: 10.3389/fendo.2022.981622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Increasing evidence has shown that elevated Thyroid stimulating hormone (TSH) levels are positively correlated with atherosclerosis (ATH) in patients with subclinical hypothyroidism (SCH). Some researchers found that the dysfunction of Endothelial Cells (ECs) in SCH plays an important role in the pathogenesis of ATH in SCH, but the association remains controversial. OBJECTIVES To determine the expression profiles of serum microRNAs critical to the function of Endothelial cells (ECs) may help reanalyze the possible mechanism underlying ATH in SCH and the association between ATH and SCH. METHODS We used qRT-PCR to perform microRNA profiling and analysis in normal control subjects (NC), patients with SCH alone (SCH), patients with SCH and ATH (SCH+ATH), and patients with ATH without SCH (ATH). RESULTS Both miR-221-3p and miR-222-3p showed a decreasing expression trend between the SCH and SCH+ATH groups. In addition, miR-126-3p and miR-150-5p showed a stepwise decrease from the NC to SCH groups and then to the SCH+ATH or ATH group. miR-21-5p was unregulated in the SCH, SCH+ATH, and ATH groups. Furthermore, elevated levels of miR-21-5p in SCH+ATH group were higher than SCH and ATH group. No differences were found in the levels of miR-150, miR-126, miR-221 and miR-222 between the ATH and the SCH+ATH subjects. CONCLUSIONS miR-21-5p may be involved in the atherosclerosis process in patients with SCH (SCH and SCH+ATH groups). miR-150-5p may be sensitive risk markers for predicting endothelial dysfunction in patients with ATH (ATH and SCH+ATH groups).
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Affiliation(s)
- Xuelin Yao
- Shandong Academy of Medical Sciences, Shandong First Medical University, Taian, China
| | - Ying Wang
- Department of Endocrinology, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Li Wang
- Department of Pharmacy, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Mingfeng Cao
- Department of Endocrinology, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Aifang Chen
- Ultrasound Department, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
- *Correspondence: Aifang Chen, ; Xinhuan Zhang,
| | - Xinhuan Zhang
- Department of Endocrinology, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
- *Correspondence: Aifang Chen, ; Xinhuan Zhang,
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Data-driven machine learning: A new approach to process and utilize biomedical data. PREDICTIVE MODELING IN BIOMEDICAL DATA MINING AND ANALYSIS 2022. [PMCID: PMC9464259 DOI: 10.1016/b978-0-323-99864-2.00017-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Peng LH, He Y, Xu WD, Zhao ZX, Liu M, Luo X, He CS, Chen J. Carotid intima-media thickness in patients with hyperuricemia: a systematic review and meta-analysis. Aging Clin Exp Res 2021; 33:2967-2977. [PMID: 33837500 DOI: 10.1007/s40520-021-01850-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/27/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Despite the high incidence and mortality of cardiovascular events in hyperuricemia patients, the role of serum uric acid in cardiovascular diseases is still controversial. The aim of this meta-analysis was to explore the difference of carotid intima-media thickness in hyperuricemia and control groups. METHODS We performed this meta-analysis by searching the PubMed, Cochrane Library, Embase and Web of Science databases up to July 2020. The 95% confidence intervals and standard mean differences were calculated to analyze the differences in carotid intima-media thickness in hyperuricemia groups and control groups. Sensitivity analysis, subgroup analysis and meta-regression were used to explore the sources of heterogeneity. Publication bias was evaluated by funnel plot and Begg's regression test. We used Stata 14.0 software to complete our analyses. RESULTS A total of 8 articles were included. The results showed that there was a significant increase in carotid intima-media thickness in the hyperuricemia groups compared with the control groups [SMD = 0.264, 95% CI (0.161-0.366), P < 0.001]. Subgroup analyses showed that age, sample size, blood pressure and body mass index were not the source of heterogeneity. Meta-regression enrolled the method of CIMT measurement, location, age, smoking and diabetes mellitus as categorical variables, but none of these factors was found to be significant in the model. The Begg's test value (P = 0.174) was greater than 0.05, indicating there was no publication bias. CONCLUSION The results showed that carotid intima-media thickness was increased in hyperuricemia patients compared with controls, which indicated that hyperuricemia patients may have a higher risk of cardiovascular diseases.
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Affiliation(s)
- Li-Hui Peng
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Yue He
- Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Wang-Dong Xu
- Department of Evidence-Based Medicine, School of Public Health, Southwest Medical University, Luzhou, Sichuan, China
| | - Zi-Xia Zhao
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Mao Liu
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Xiao Luo
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Cheng-Song He
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Jie Chen
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China.
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El-Eshmawy MM, Gad DF, El-Baiomy AA. Elevated Serum Levels of Ischemia Modified Albumin and Malondialdehyde are Related to Atherogenic Index of Plasma in a Cohort of Prediabetes. Endocr Metab Immune Disord Drug Targets 2021; 20:1347-1354. [PMID: 32359342 DOI: 10.2174/1871530320666200503052226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Prediabetes, defined as impaired glucose tolerance and/or impaired fasting glucose, is a risk factor for future type 2 diabetes, dyslipidemia, cardiovascular disease and all-cause mortality. High serum levels of ischemia modified albumin (IMA) and malondialdehyde (MDA) as oxidative stress markers were determined in diabetes, however, no studies have investigated these markers together in prediabetes. The aim of the present study was to investigate the circulating levels of both IMA and MDA in a cohort of prediabetic adults. The possible associations between both markers and the atherogenic index of plasma (AIP) were also evaluated. METHODS This study enrolled 100 adults with prediabetes and 50 healthy controls matched for age and sex. Anthropometric measurements, fasting and 2-hour post load glucose, glycosylated hemoglobin (A1c), lipids profile, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), high sensitivity C-reactive protein (hs-CRP), AIP, IMA and MDA were assessed. RESULTS IMA, MDA, hs-CRP and AIP were significantly higher in adults with prediabetes than in healthy controls. Male gender, fasting and post load glucose, A1c, fasting insulin, TGs, HDL-C, hs- CRP, AIP and MDA were independent predictor variables of IMA, whereas male gender, WC, fasting and post load glucose, A1c, fasting insulin, TC, TGs, LDL-C, HDL-C, hs-CRP and AIP were independent predictor variables of MDA. CONCLUSION The elevation of IMA concomitantly with MDA reflecting the antioxidant status in prediabetes, and their associations with hs-CRP and AIP should reinforce the idea of screening and treatment of prediabetes.
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Affiliation(s)
- Mervat M El-Eshmawy
- Internal Medicine Department, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Doaa F Gad
- Internal Medicine Department, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Azza A El-Baiomy
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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12
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A practical means of evaluating the prognosis of acute pancreatitis, as measurement of carotid artery intima-media thickness. Acta Gastroenterol Belg 2021; 84:437-442. [PMID: 34599568 DOI: 10.51821/84.3.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND STUDY AIMS Factors such as age, obesity, diabetes mellitus and hyperlipidemia that cause adverse prognosis in acute pancreatitis also cause an increase in carotid intima-media thickness. In this study, we aimed to investigate the usability of the measurement of carotid intima-media thickness, which is an easy to apply, cost-effective means of measurement applied to the patients, in predicting AP prognosis, apart from the criteria currently utilized to predict AP prognosis. PATIENTS AND METHODS 101 patients diagnosed with acute pancreatitis were prospectively enrolled into the study. Right and left common carotid artery intima-media thickness, right and left internal carotid artery intima-media thickness were measured with ultrasonographic images performed within the first 24 hours of hospitalization. local or systemic complications and organ failure development were monitored in the follow-up of the patients. RESULTS After the ROC analysis was performed and the threshold value was determined. The patients with main and internal carotid artery intima-media thickness above 0.775 mm were seen to have a more severe AP (p = 0.000). Local and systemic complications and organ failure were also more common in these patients. CONCLUSIONS Measurement of carotid intima-media thickness is a non-invasive method that can be used to predict the prognosis in patients with acute pancreatitis at presentation.
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Taya N, Katakami N, Mita T, Okada Y, Wakasugi S, Yoshii H, Shiraiwa T, Otsuka A, Umayahara Y, Ryomoto K, Hatazaki M, Yasuda T, Yamamoto T, Gosho M, Shimomura I, Watada H. Associations of continuous glucose monitoring-assessed glucose variability with intima-media thickness and ultrasonic tissue characteristics of the carotid arteries: a cross-sectional analysis in patients with type 2 diabetes. Cardiovasc Diabetol 2021; 20:95. [PMID: 33947398 PMCID: PMC8097791 DOI: 10.1186/s12933-021-01288-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/27/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The association between glucose variability and the progression of atherosclerosis is not completely understood. We aimed to evaluate the associations of glucose variability with the progression of atherosclerosis in the early stages. METHODS We conducted a cross-sectional analysis to investigate the associations of glucose variability, assessed by continuous glucose monitoring, with intima-media thickness (IMT) and gray-scale median (GSM) of the carotid arteries, which are different indicators for the progression of atherosclerosis. We used baseline data from a hospital-based multicenter prospective observational cohort study among Japanese patients with type 2 diabetes without a history of cardiovascular diseases aged between 30 and 80 years. Continuous glucose monitoring was performed by Freestyle Libre Pro, and glucose levels obtained every 15 min for a maximum of eight days were used to calculate the metrics of glucose variability. IMT and GSM were evaluated by ultrasonography, and the former indicates thickening of intima-media complex in the carotid artery wall, while the latter indicates tissue characteristics. RESULTS Among 600 study participants (age: 64.9 ± 9.2 (mean ± SD) years; 63.2%: men; HbA1c: 7.0 ± 0.8%), participants with a larger intra- and inter-day glucose variability had a lower GSM and most of these associations were statistically significant. No trend based on glucose variability was shown regarding IMT. Standard deviation of glucose (regression coefficient, β = - 5.822; 95% CI - 8.875 to - 2.768, P < 0.001), glucose coefficient of variation (β = - 0.418; - 0.685 to - 0.151, P = 0.002), mean amplitude of glycemic excursion (β = - 1.689; - 2.567 to - 0.811, P < 0.001), mean of daily differences (β = - 6.500; - 9.758 to - 3.241, P < 0.001), and interquartile range (β = - 4.289; - 6.964 to - 1.614, P = 0.002) had a statistically significant association with mean-GSM after adjustment for conventional cardiovascular risk factors, including HbA1c. No metrics of glucose variability had a statistically significant association with IMT. CONCLUSIONS Continuous glucose monitoring-assessed glucose variability was associated with the tissue characteristics of the carotid artery wall in type 2 diabetes patients without cardiovascular diseases.
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Affiliation(s)
- Naohiro Taya
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Satomi Wakasugi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20, Shinsuna, Koto-ku, Tokyo, Japan
| | | | - Akihito Otsuka
- Department of Internal Medicine, Kawasaki Hospital, 3-3-1, Higashiyamacho, Hyogo-ku, Kobe, Hyogo, Japan
| | - Yutaka Umayahara
- Department of Diabetes and Endocrinology, Osaka General Medical Center, 3-1-56, Bandaihigashi, Sumiyoshi-ku, Osaka-shi, Osaka, Japan
| | - Kayoko Ryomoto
- Center for Diabetes Mellitus, Osaka Rosai Hospital, 1179-3, Nagasonecho, Kita-ku, Sakai, Osaka, Japan
| | - Masahiro Hatazaki
- Department of Internal Medicine, Japan Community Health Care Organization Osaka Hospital, 4-2-78, Fukushima, Fukushima-ku, Osaka-shi, Osaka, Japan
| | - Tetsuyuki Yasuda
- Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31, Kitayamacho, Tennoji-ku, Osaka-shi, Osaka, Japan
| | - Tsunehiko Yamamoto
- Diabetes and Endocrinology, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Fan J, Chen M, Luo J, Yang S, Shi J, Yao Q, Zhang X, Du S, Qu H, Cheng Y, Ma S, Zhang M, Xu X, Wang Q, Zhan S. The prediction of asymptomatic carotid atherosclerosis with electronic health records: a comparative study of six machine learning models. BMC Med Inform Decis Mak 2021; 21:115. [PMID: 33820531 PMCID: PMC8020544 DOI: 10.1186/s12911-021-01480-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Screening carotid B-mode ultrasonography is a frequently used method to detect subjects with carotid atherosclerosis (CAS). Due to the asymptomatic progression of most CAS patients, early identification is challenging for clinicians, and it may trigger ischemic stroke. Recently, machine learning has shown a strong ability to classify data and a potential for prediction in the medical field. The combined use of machine learning and the electronic health records of patients could provide clinicians with a more convenient and precise method to identify asymptomatic CAS. METHODS Retrospective cohort study using routine clinical data of medical check-up subjects from April 19, 2010 to November 15, 2019. Six machine learning models (logistic regression [LR], random forest [RF], decision tree [DT], eXtreme Gradient Boosting [XGB], Gaussian Naïve Bayes [GNB], and K-Nearest Neighbour [KNN]) were used to predict asymptomatic CAS and compared their predictability in terms of the area under the receiver operating characteristic curve (AUCROC), accuracy (ACC), and F1 score (F1). RESULTS Of the 18,441 subjects, 6553 were diagnosed with asymptomatic CAS. Compared to DT (AUCROC 0.628, ACC 65.4%, and F1 52.5%), the other five models improved prediction: KNN + 7.6% (0.704, 68.8%, and 50.9%, respectively), GNB + 12.5% (0.753, 67.0%, and 46.8%, respectively), XGB + 16.0% (0.788, 73.4%, and 55.7%, respectively), RF + 16.6% (0.794, 74.5%, and 56.8%, respectively) and LR + 18.1% (0.809, 74.7%, and 59.9%, respectively). The highest achieving model, LR predicted 1045/1966 cases (sensitivity 53.2%) and 3088/3566 non-cases (specificity 86.6%). A tenfold cross-validation scheme further verified the predictive ability of the LR. CONCLUSIONS Among machine learning models, LR showed optimal performance in predicting asymptomatic CAS. Our findings set the stage for an early automatic alarming system, allowing a more precise allocation of CAS prevention measures to individuals probably to benefit most.
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Affiliation(s)
- Jiaxin Fan
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Mengying Chen
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Jian Luo
- Faculty of Electronic and Information Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Shusen Yang
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China
| | - Jinming Shi
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Qingling Yao
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Xiaodong Zhang
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Shuang Du
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Huiyang Qu
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Yuxuan Cheng
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Shuyin Ma
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Meijuan Zhang
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Xi Xu
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China
| | - Qian Wang
- Department of Health Management, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuqin Zhan
- Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Five Road, Xi'an, 710004, Shaanxi, China.
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15
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Notable Underlying Mechanism for Pancreatic β-Cell Dysfunction and Atherosclerosis: Pleiotropic Roles of Incretin and Insulin Signaling. Int J Mol Sci 2020; 21:ijms21249444. [PMID: 33322512 PMCID: PMC7763860 DOI: 10.3390/ijms21249444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 12/25/2022] Open
Abstract
Under healthy conditions, pancreatic β-cells produce and secrete the insulin hormone in response to blood glucose levels. Under diabetic conditions, however, β-cells are compelled to continuously secrete larger amounts of insulin to reduce blood glucose levels, and thereby, the β-cell function is debilitated in the long run. In the diabetic state, expression levels of insulin gene transcription factors and incretin receptors are downregulated, which we think is closely associated with β-cell failure. These data also suggest that it would be better to use incretin-based drugs at an early stage of diabetes when incretin receptor expression is preserved. Indeed, it was shown that incretin-based drugs exerted more protective effects on β-cells at an early stage. Furthermore, it was shown recently that endothelial cell dysfunction was also associated with pancreatic β-cell dysfunction. After ablation of insulin signaling in endothelial cells, the β-cell function and mass were substantially reduced, which was also accompanied by reduced expression of insulin gene transcription factors and incretin receptors in β-cells. On the other hand, it has been drawing much attention that incretin plays a protective role against the development of atherosclerosis. Many basic and clinical data have underscored the importance of incretin in arteries. Furthermore, it was shown recently that incretin receptor expression was downregulated in arteries under diabetic conditions, which likely diminishes the protective effects of incretin against atherosclerosis. Furthermore, a series of large-scale clinical trials (SPAED-A, SPIKE, LEADER, SUSTAIN-6, REWIND, PIONEER trials) have shown that various incretin-related drugs have beneficial effects against atherosclerosis and subsequent cardiovascular events. These data strengthen the hypothesis that incretin plays an important role in the arteries of humans, as well as rodents.
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16
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Mantella LE, Colledanchise KN, Hétu MF, Feinstein SB, Abunassar J, Johri AM. Carotid intraplaque neovascularization predicts coronary artery disease and cardiovascular events. Eur Heart J Cardiovasc Imaging 2020; 20:1239-1247. [PMID: 31621834 DOI: 10.1093/ehjci/jez070] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/25/2019] [Indexed: 11/15/2022] Open
Abstract
AIMS It is thought that the majority of cardiovascular (CV) events are caused by vulnerable plaque. Such lesions are rupture prone, in part due to neovascularization. It is postulated that plaque vulnerability may be a systemic process and that vulnerable lesions may co-exist at multiple sites in the vascular bed. This study sought to examine whether carotid plaque vulnerability, characterized by contrast-enhanced ultrasound (CEUS)-assessed intraplaque neovascularization (IPN), was associated with significant coronary artery disease (CAD) and future CV events. METHODS AND RESULTS We investigated carotid IPN using carotid CEUS in 459 consecutive stable patients referred for coronary angiography. IPN was graded based on the presence and location of microbubbles within each plaque (0, not visible; 1, peri-adventitial; and 2, plaque core). The grades of each plaque were averaged to obtain an overall score per patient. Coronary plaque severity and complexity was also determined angiographically. Patients were followed for 30 days following their angiogram. This study found that a higher CEUS-assessed carotid IPN score was associated with significant CAD (≥50% stenosis) (1.8 ± 0.4 vs. 0.5 ± 0.6, P < 0.0001) and greater complexity of coronary lesions (1.7 ± 0.5 vs. 1.3 ± 0.8, P < 0.0001). Furthermore, an IPN score ≥1.25 could predict significant CAD with a high sensitivity (92%) and specificity (89%). The Kaplan-Meier analysis demonstrated a significantly higher proportion of participants having CV events with an IPN score ≥1.25 (P = 0.004). CONCLUSION Carotid plaque neovascularization was found to be predictive of significant and complex CAD and future CV events. CEUS-assessed carotid IPN is a clinically useful tool for CV risk stratification in high-risk cardiac patients.
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Affiliation(s)
- Laura E Mantella
- Department of Biomedical and Molecular Sciences, Queen's University, 18 Stuart Street, Kingston, Ontario, Canada
| | - Kayla N Colledanchise
- Department of Biomedical and Molecular Sciences, Queen's University, 18 Stuart Street, Kingston, Ontario, Canada
| | - Marie-France Hétu
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston Health Sciences Centre, 76 Stuart Street, Kingston, Ontario, Canada
| | - Steven B Feinstein
- Department of Medicine, Rush University Medical Center, 1653 W Congress Pkwy, Chicago, IL, USA
| | - Joseph Abunassar
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston Health Sciences Centre, 76 Stuart Street, Kingston, Ontario, Canada
| | - Amer M Johri
- Department of Biomedical and Molecular Sciences, Queen's University, 18 Stuart Street, Kingston, Ontario, Canada.,Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston Health Sciences Centre, 76 Stuart Street, Kingston, Ontario, Canada
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17
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Yasuda M, Sato H, Hashimoto K, Osada U, Hariya T, Nakayama H, Asano T, Suzuki N, Okabe T, Yamazaki M, Uematsu M, Munakata M, Nakazawa T. Carotid artery intima-media thickness, HDL cholesterol levels, and gender associated with poor visual acuity in patients with branch retinal artery occlusion. PLoS One 2020; 15:e0240977. [PMID: 33091078 PMCID: PMC7580897 DOI: 10.1371/journal.pone.0240977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/06/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To investigate factors associated with poor visual acuity (VA) in branch retinal artery occlusion (BRAO). METHODS This was a retrospective cross-sectional study of 72 eyes with BRAO of 72 patients. For statistical comparison, we divided the patients into worse-VA (decimal VA < 0.5) and better-VA (decimal VA > = 0.5) groups. We examined the association of clinical findings, including blood biochemical test data and carotid artery ultrasound parameters, with poor VA. RESULTS Median age, hematocrit, hemoglobin and high-density lipoprotein (HDL) differed significantly between the groups (P = 0.018, P < 0.01, P < 0.01, and P = 0.025). There was a tendency towards higher median IMT-Bmax in the worse-VA group (worse-VA vs. better-VA: 2.70 mm vs. 1.60 mm, P = 0.152). Spearman's rank correlation test revealed that logMAR VA was significantly correlated to IMT-Bmax (rs = 0.31, P < 0.01) and IMT-Cmax (rs = 0.24, P = 0.035). Furthermore, logMAR VA was significantly correlated to HDL level (rs = -0.33, P < 0.01). Multivariate logistic regression analysis revealed that IMT-Bmax (odds ratio [OR] = 2.70, P = 0.049), HDL level (OR = 0.91, P = 0.032), and female gender (OR = 15.63, P = 0.032) were independently associated with worse VA in BRAO. CONCLUSIONS We found that increased IMT-Bmax, decreased HDL, and female sex were associated with poor VA in BRAO patients. Our findings might suggest novel risk factors for visual dysfunction in BRAO and may provide new insights into the pathomechanisms underlying BRAO.
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Affiliation(s)
- Masayuki Yasuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hajime Sato
- Yaotome Sato Hajime Eye Clinic, Miyagi, Japan
| | - Kazuki Hashimoto
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Urara Osada
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takehiro Hariya
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hiroko Nakayama
- Department of Ophthalmology, JR Sendai Hospital, Sendai, Miyagi, Japan
| | - Toshifumi Asano
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Noriyuki Suzuki
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tatsu Okabe
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Ophthalmology, Tohoku Rosai Hospital, Sendai, Miyagi, Japan
| | - Mai Yamazaki
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Seiryo Eye Clinic, Miyagi, Japan
| | - Megumi Uematsu
- Department of Ophthalmology, Tohoku Rosai Hospital, Sendai, Miyagi, Japan
| | - Masanori Munakata
- Division of Hypertension & Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Miyagi, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- * E-mail:
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18
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Park J, Na Y, Jang Y, Park SY, Park H. Correlation of Pre-Hypertension with Carotid Artery Damage in Middle-Aged and Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207686. [PMID: 33096848 PMCID: PMC7589827 DOI: 10.3390/ijerph17207686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022]
Abstract
The intima–media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and β-stiffness of the carotid artery (CA) are considered as independent risk factors for cardiovascular diseases (CVDs). Pre-hypertension (PHT) is also an independent CVD risk factor. This study investigated the association between CA damage (CAD) and PHT. A total of 544 adults participated; their blood pressures (BPs) and CA characteristics were measured using a mercury-free sphygmomanometer and ultrasound. Analysis of covariance (ANCOVA) was performed to assess the differences in the CA characteristics according to the BPs, multinomial logistic regression to evaluate the risk of CAD associated with PHT. In ANCOVA, the CA characteristics of PHT were significantly different from normotensive. The odds ratios (ORs) of IMTmax, LDmax, LDmin, peak-systolic FV (PFV), end-diastolic FV (EFV), PFV/LDmin, EFV/LDmax, compliance, and β-stiffness of PHT were 4.20, 2.70, 3.52, 2.41, 3.06, 3.55, 3.29, 2.02, and 1.84 times higher than those of the normotensive, respectively, in Model 2. In Model 3 adjusted for age, the ORs of LDmax, LDmin, EFV, PFV/LDmin, and EFV/LDmax of PHT were 2.10, 2.55, 1.96, 2.20, and 2.04 times higher than those of the normotensive, respectively. Therefore, the present study revealed that CAD is closely correlated with pre-hypertensive status in adults.
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Affiliation(s)
- Jinkee Park
- Department of Sport Rehabilitation, Dong-Ju College, Busan 49318, Korea;
| | - Yongseong Na
- Department of Health Science, Dong-A University, Busan 49315, Korea; (Y.N.); (Y.J.)
| | - Yunjung Jang
- Department of Health Science, Dong-A University, Busan 49315, Korea; (Y.N.); (Y.J.)
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska Omaha, Omaha, NE 68182, USA;
| | - Hyuntae Park
- Department of Health Science, Dong-A University, Busan 49315, Korea; (Y.N.); (Y.J.)
- Institute of Convergence Bio-Health, Dong-A University, Busan 49315, Korea
- Correspondence: ; Tel.: +82-51-200-7517
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19
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Seo DH, Lee YH, Suh YJ, Ahn SH, Hong S, Choi YJ, Huh BW, Park SW, Lee E, Kim SH. Low muscle mass is associated with carotid atherosclerosis in patients with type 2 diabetes. Atherosclerosis 2020; 305:19-25. [PMID: 32593855 DOI: 10.1016/j.atherosclerosis.2020.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/15/2020] [Accepted: 05/27/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Sarcopenia leads to metabolic and vascular abnormalities. However, little is known regarding the independent relationship between skeletal muscle mass and atherosclerosis in patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association between skeletal muscle mass and carotid atherosclerosis in men and women with T2DM. METHODS In this cross-sectional study, a total of 8202 patients with T2DM were recruited from the Seoul Metabolic Syndrome cohort. Skeletal muscle mass was estimated using bioimpedance analysis, while skeletal muscle mass index (SMI, %) was defined as total skeletal muscle mass (kg)/body weight (kg) × 100. Both carotid arteries were examined by B-mode ultrasound. Carotid atherosclerosis was defined by having a carotid plaque or mean carotid intima-media thickness (IMT) ≥1.1 mm. RESULTS Among the entire population, 4299 (52.4%) subjects had carotid atherosclerosis. The prevalence of carotid atherosclerosis increased with decreasing SMI quartiles for both sexes. The odds ratios for carotid atherosclerosis were 2.33 (95% confidence interval [CI], 1.17-4.63) and 2.24 (95% CI, 1.06-4.741) in the lowest versus highest SMI quartile in men and women, respectively, after the adjustment for clinical risk factors. In men, the risk of atherosclerosis increased linearly with decreasing SMI quartiles (p for trend = 0.036). CONCLUSIONS Low skeletal muscle mass was independently associated with the presence of carotid atherosclerosis in men and women with T2DM.
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Affiliation(s)
- Da Hea Seo
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Republic of Korea
| | - Seong Hee Ahn
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea
| | - Seongbin Hong
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea
| | | | | | - Seok Won Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunjig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - So Hun Kim
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea.
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Long-term vitamin D and high-dose n-3 fatty acids' supplementation improve markers of cardiometabolic risk in type 2 diabetic patients with CHD. Br J Nutr 2019; 122:423-430. [PMID: 31309919 DOI: 10.1017/s0007114519001132] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study was performed to evaluate the effects of vitamin D and n-3 fatty acids' co-supplementation on markers of cardiometabolic risk in diabetic patients with CHD. This randomised, double-blinded, placebo-controlled trial was conducted among sixty-one vitamin D-deficient diabetic patients with CHD. At baseline, the range of serum 25-hydroxyvitamin D levels in study participants was 6·3-19·9 ng/ml. Subjects were randomly assigned into two groups either taking 50 000 IU vitamin D supplements every 2 weeks plus 2× 1000 mg/d n-3 fatty acids from flaxseed oil (n 30) or placebo (n 31) for 6 months. Vitamin D and n-3 fatty acids' co-supplementation significantly reduced mean (P = 0·01) and maximum levels of left carotid intima-media thickness (CIMT) (P = 0·004), and mean (P = 0·02) and maximum levels of right CIMT (P = 0·003) compared with the placebo. In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β -0·40 mmol/l; 95 % CI -0·77, -0·03; P = 0·03), insulin (β -1·66 μIU/ml; 95 % CI -2·43, -0·89; P < 0·001), insulin resistance (β -0·49; 95 % CI -0·72, -0·25; P < 0·001) and LDL-cholesterol (β -0·21 mmol/l; 95 % CI -0·41, -0·01; P = 0·04), and a significant increase in insulin sensitivity (β +0·008; 95 % CI 0·004, 0·01; P = 0·001) and HDL-cholesterol (β +0·09 mmol/l; 95 % CI 0·01, 0·17; P = 0·02) compared with the placebo. Additionally, high-sensitivity C-reactive protein (β -1·56 mg/l; 95 % CI -2·65, -0·48; P = 0·005) was reduced in the supplemented group compared with the placebo group. Overall, vitamin D and n-3 fatty acids' co-supplementation had beneficial effects on markers of cardiometabolic risk.
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Cao L, Guo Y, Zhu Z. Study of the Inflammatory Mechanisms in Hyperhomocysteinemia on Large-Artery Atherosclerosis Based on Hypersensitive C-Reactive Protein-A Study from Southern China. J Stroke Cerebrovasc Dis 2019; 28:1816-1823. [PMID: 31080137 DOI: 10.1016/j.jstrokecerebrovasdis.2019.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To study the inflammatory mechanism of hyperhomocysteinemia on large-artery atherosclerosis based on hypersensitive C-reactive protein in patients. METHODS In all, 153 inpatients and 1357 physical examinees were selected. The levels of homocysteine were compared between the carotid/intracranial artery stenosis group and the nonstenosis group, between the carotid artery unstable plaque group and the nonplaque group, and between the intima-media thickness (IMT) greater than or equal to 1 group and the normal IMT group. The hypersensitive C-reactive protein levels were compared between the lacunar infarction (LI) group and the nonstroke control group and between the unstable plaque group and the nonplaque group. RESULTS Homocysteine level was significantly higher in the carotid/intracranial artery stenosis group than in the nonstenosis group, in the LI group than in the inpatient nonstroke group, and in the IMT greater than or equal to 1 group than in the normal IMT group. The hypersensitive C-reactive protein level was significantly higher in the LI group than in the nonstroke group and in the unstable plaque group than in the nonplaque group. CONCLUSIONS Hyperhomocysteinemia may aggravate the development of IMT, carotid atherosclerotic plaque instability, and carotid/intracranial artery stenosis by increasing inflammation, ultimately leading to the occurrence of LI. Hyperhomocysteinemia-induced inflammation mechanism warrants further study.
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Affiliation(s)
- Liming Cao
- Department of neurology, The First Affiliated Hospital of Jinan University, Guang zhou, China; Department of Neurology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen City, China.
| | - Yi Guo
- Department of Neurology, Shenzhen People's Hospital, Shenzhen City, China
| | - Zhishan Zhu
- Department of Neurology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen City, China
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22
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Yoshioka K. Skin autofluorescence is associated with high-sensitive cardiac troponin T, a circulating cardiac biomarker, in Japanese patients with diabetes: A cross-sectional study. Diab Vasc Dis Res 2018; 15:559-566. [PMID: 29972075 DOI: 10.1177/1479164118785314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The study aims to evaluate the relationship between skin autofluorescence, a marker of advanced glycated end-products accumulation in tissue, and high-sensitive cardiac troponin T, a cardiovascular biomarker, in Japanese subjects with diabetes. A total of 145 subjects with diabetes and 32 nondiabetic subjects as control attending the outpatient clinic were examined. Skin autofluorescence was measured using the AGE Reader™. Univariate and multivariate regression analyses were used to identify the factors associated with the high-sensitive cardiac troponin T and N-terminal pro-B-type natriuretic peptide values. Skin autofluorescence, high-sensitive cardiac troponin T, and maximum intima-media thickness values were significantly higher in subjects with diabetes than in nondiabetic subjects. Diabetic subjects with skin autofluorescence level⩾2.47 AU (median value) had higher levels of N-terminal pro-B-type natriuretic peptide ( p = 0.006), high-sensitive cardiac troponin T ( p < 0.0001), pentosidine ( p = 0.011) and maximum intima-media thickness ( p = 0.017) compared to those with skin autofluorescence level <2.47 AU. A multivariate regression analysis using variables that were significantly correlated with high-sensitive cardiac troponin T and N-terminal pro-B-type natriuretic peptide, revealed that estimated glomerular filtration rate (β = -0.364, p < 0.001) and skin autofluorescence (β = 0.254, p = 0.0022) were independent determinants of high-sensitive cardiac troponin T, but the variables that were significant in the univariate analysis were no longer predictors for N-terminal pro-B-type natriuretic peptide. Skin autofluorescence measured with the AGE Reader™ could be an easy and noninvasive surrogate marker for identifying diabetic subjects at high risk for subclinical cardiac injury.
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Atwa H, Gad K, Hagrasy H, Elkelany A, Azzam M, Bayoumi N, Gobarah A, Shora H. Is subclinical atherosclerosis associated with visceral fat and fatty liver in adolescents with type 1 diabetes? Arch Med Sci 2018; 14:1355-1360. [PMID: 30393490 PMCID: PMC6209700 DOI: 10.5114/aoms.2018.74226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/24/2017] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION There is a 3-fold higher prevalence of cardiovascular complications in patients with type 1 diabetes. The aim was to assess the relationship between subclinical atherosclerosis and visceral fat and fatty liver in diabetic adolescents. MATERIAL AND METHODS The study was performed on 110 adolescents with type 1 diabetes (T1D) attending the Pediatric Diabetes Clinic of the University Hospital, Ismailia, Egypt. Their mean age was 14.2 ±0.7 years with a mean duration of diabetes 6 ±0.3 years. They were divided into group 1 which consisted of 55 adolescents with T1D and normal carotid intima media thickness (cIMT) and the second group which included 55 adolescents with T1D and subclinical atherosclerosis. All adolescents were normotensive, normo-albuminuric and had no retinopathy. Visceral fat thickness was measured as the distance between the anterior wall of the aorta and the posterior surface of the rectus abdominis muscle. Hepatic steatosis was diagnosed based on enlarged liver size and evidence of diffuse hyper-echogenicity of liver relative to kidneys. RESULTS The mean visceral fat was significantly higher in adolescents with increased cIMT (4.8 ±1.6) than in the normal thickness group (3.9 ±1.4). Liver size was also significantly larger in the former group (13.73 ±2.26 versus 12.63 ±2.20) (p = 0.022). After adjusting for other variables, logistic regression demonstrated that glycated hemoglobin (HbA1c) and fatty liver are independent factors affecting cIMT, OR = 1.426 (p < 0.05) and OR = 4.71 (p < 0.05). CONCLUSIONS In the present study, fatty liver and HbA1c were associated with subclinical atherosclerosis in lean adolescents with T1D.
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Affiliation(s)
- Hoda Atwa
- Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Khaled Gad
- Department of Diagnostic Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hala Hagrasy
- Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Amany Elkelany
- Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mona Azzam
- Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nouran Bayoumi
- Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ayman Gobarah
- Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hassan Shora
- Department of Medicine, Port Said University, Port Said, Egypt
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Yuan Y, Yang J, Zhang X, Han R, Chen M, Hu X, Ma Y, Wu M, Wang M, Xu S, Pan F. Carotid Intima-Media Thickness in Patients with Ankylosing Spondylitis: A Systematic Review and Updated Meta-Analysis. J Atheroscler Thromb 2018; 26:260-271. [PMID: 30089757 PMCID: PMC6402883 DOI: 10.5551/jat.45294] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: Inflammatory arthritis (IA) diseases are relevant with subclinical atherosclerosis, but the data in ankylosing spondylitis (AS) were inconsistent. Therefore, we performed this meta-analysis to explore the relationship between the marker of subclinical atherosclerosis (carotid intima-media thickness (IMT)) and AS. Methods: We performed a systematic literature review using PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases up to March 2018. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to assess the association between carotid IMT and AS. Subgroup analysis, sensitivity analysis, and meta-regression were applied to explore the sources of heterogeneity, and publication bias was calculated to access the quality of pooled studies. Results: A total of 24 articles were collected. The carotid IMT was significantly increased in AS compared with healthy controls (SMD = 0.725, 95% CI = 0.443–1.008, p < 0.001). Subgroup analyses showed the Bath Ankylosing Spondylitis Activity Index (BASDAI) was the source of heterogeneity. Notably, IMT was not significantly increased in those studies that included > 50% patients treated with anti-TNF. Meta-regression revealed severe inflammation status (BASDAI and C-reactive protein (CRP)) could significantly impact carotid IMT in AS. Conclusions: Carotid IMT was significantly increased in patients with AS compared with healthy controls, which suggested subclinical atherosclerosis is related to AS.
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Affiliation(s)
- Yaping Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Jiajia Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Xu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Renfang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Mengya Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Xingxing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Meng Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Mengmeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
| | - Shengqian Xu
- Department of Rheumatism and Immunity, the First Affiliated Hospital of Anhui Medical University
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University
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Kaneko R, Sawada S, Tokita A, Honkura R, Tamura N, Kodama S, Izumi T, Takahashi K, Uno K, Imai J, Yamada T, Miyachi Y, Hasegawa H, Kanai H, Ishigaki Y, Katagiri H. Serum cystatin C level is associated with carotid arterial wall elasticity in subjects with type 2 diabetes mellitus: A potential marker of early-stage atherosclerosis. Diabetes Res Clin Pract 2018; 139:43-51. [PMID: 29453992 DOI: 10.1016/j.diabres.2018.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/29/2018] [Accepted: 02/01/2018] [Indexed: 11/29/2022]
Abstract
AIMS Detection of early-stage atherosclerosis in type 2 diabetes mellitus (T2DM) patients is important for preventing cardiovascular disease. A phased tracking method for evaluating arterial wall elasticity sensitively detects early-stage atherosclerosis. However, biochemical markers for early-stage atherosclerosis have yet to be established. METHODS This cross-sectional study enrolled 180 T2DM patients, who were classified as not having atherosclerosis according to the carotid intima-media thickness (IMT) criteria. We measured serum cystatin C, the estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR), and analyzed the associations between these markers and arterial wall elasticity (Eθ), IMT and the cardio-ankle velocity index. RESULTS Multiple linear regression analyses revealed that cystatin C was significantly associated with Eθ, while neither eGFR nor ACR showed an association. Furthermore, among the examined atherosclerotic markers, Eθ was most reliably associated with cystatin C. Additionally, the association between cystatin C and Eθ disappeared in the low elasticity subgroup, which included subjects in whom no atherosclerotic changes had yet been initiated. CONCLUSIONS In T2DM patients without apparent arterial wall thickening, cystatin C is strongly and independently associated with arterial wall elasticity, which reflects the degree of subclinical atherosclerosis. Thus, cystatin C is a potentially useful marker of early-stage atherosclerosis.
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Affiliation(s)
- Rei Kaneko
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shojiro Sawada
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Ai Tokita
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rieko Honkura
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriko Tamura
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shinjiro Kodama
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohito Izumi
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takahashi
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenji Uno
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junta Imai
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tetsuya Yamada
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukiya Miyachi
- Medical Systems Research and Development Center R&D Management Headquarters, FUJIFILM Corporation, Kaisei, Japan
| | - Hideyuki Hasegawa
- Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
| | - Hiroshi Kanai
- Department of Electronic Engineering, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasushi Ishigaki
- Department of Internal Medicine, Division of Diabetes and Endocrinology, Iwate Medical University Hospital, Morioka, Japan
| | - Hideki Katagiri
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Yoshioka K. Skin Autofluorescence is a Noninvasive Surrogate Marker for Diabetic Microvascular Complications and Carotid Intima-Media Thickness in Japanese Patients with Type 2 Diabetes: A Cross-sectional Study. Diabetes Ther 2018; 9:75-85. [PMID: 29177923 PMCID: PMC5801225 DOI: 10.1007/s13300-017-0339-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Advanced glycation end-products (AGEs) are known to play an important role in the pathogenesis of diabetic complications. Skin autofluorescence (AF), a marker of AGE accumulation in tissue, can be measured noninvasively using a skin AF reader. The present study aimed to evaluate the relationships of skin AF with diabetic microvascular complications and carotid intima-media thickness (IMT), a surrogate marker for atherosclerosis, in Japanese subjects with type 2 diabetes (T2D). METHODS One hundred sixty-two subjects with T2D and 42 nondiabetic control subjects attending the outpatient clinic were examined. Skin AF and carotid max-IMT were measured using an AGE Reader™ and ultrasonography, respectively. Nephropathy was classified into five stages based on the urinary albumin-to-creatinine ratio (UACR) as follows: (1) pre-nephropathy (stage 1) (UACR < 30 mg/g Cr); (2) incipient nephropathy (stage 2) (30 ≤ UACR < 300 mg/g Cr); (3) overt nephropathy (stage 3) (UACR ≥ 300 mg/g Cr); (4) kidney failure (stage 4) (estimated glomerular filtration rate (eGFR) < 30 ml/min/1.732); and (5) dialysis therapy (stage 5). Patients with kidney failure and those receiving dialysis therapy were excluded because the sample size was too small. Retinopathy was diagnosed as nondiabetic retinopathy (NDR), nonproliferative retinopathy (NPDR), or proliferative retinopathy (PDR). Diabetic peripheral neuropathy (DPN) was diagnosed if two or more of the following were present: neuropathic symptoms (decreased sensation, positive neuropathic sensory symptoms), symmetric decreased distal sensation, and unequivocally decreased or absent ankle reflexes. RESULTS Skin AF values were significantly higher in subjects with T2D (2.53 ± 0.45 AU) than in nondiabetic subjects (2.19 ± 0.34 AU, p < 0.001). Skin AF significantly increased with the severity of DPN (2.39 ± 0.37 with DPN vs 2.80 ± 0.48 without DPN, p < 0.001), retinopathy (NDR 2.42 ± 0.45, mild and moderate NPDR 2.64 ± 0.42, p = 0.042, severe NPDR and PDR 2.85 ± 0.35, p < 0.001), and nephropathy (pre-nephropathy 2.42 ± 0.44, incipient nephropathy 2.62 ± 0.45, p = 0.049, overt nephropathy 2.59 ± 0.46, p = 0.80). Skin AF was an independent determinant of the presence of DPN (OR 8.49, 95% CI 2.04-44.32, p = 0.006) and retinopathy (OR 3.73, 95% CI 1.20-12.90, p = 0.028) but not of diabetic nephropathy after correcting for confounding factors. In addition, skin AF (β = 0.170, p = 0.029) was an independent determinant of max-IMT, as was age (β = 0.436, p < 0.0001), after adjusting for other risk factors. CONCLUSION Skin AF as measured using an AGE Reader is a noninvasive surrogate marker for diabetic microvascular complications and early-stage atherosclerosis.
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Nam JS, Ahn CW, Kang S, Kim KR, Park JS. Red Blood Cell Distribution Width Is Associated with Carotid Atherosclerosis in People with Type 2 Diabetes. J Diabetes Res 2018; 2018:1792760. [PMID: 29770339 PMCID: PMC5892241 DOI: 10.1155/2018/1792760] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/21/2018] [Indexed: 11/18/2022] Open
Abstract
AIMS Red cell distribution width (RDW) has been shown to be associated with cardiovascular diseases (CVD). The relationship between RDW and carotid intima-media thickness (C-IMT), a marker of subclinical atherosclerosis, has been inconsistent in subjects with cardiovascular risk factors. In this study, we investigated the relationship between RDW and carotid atherosclerosis in people with type 2 diabetes. METHODS Four hundred sixty-nine people with type 2 diabetes without history of cardiovascular or cerebrovascular diseases were enrolled. Anthropometric measures and various biochemical parameters including RDW were assessed. Ultrasonographic measurement of carotid intima-media thickness was used to evaluate subclinical atherosclerosis. RESULTS The participants were stratified into 3 groups according to RDW. The C-IMT increased gradually according to RDW tertiles (lowest, second, highest RDW tertiles; 0.740 ± 0.120, 0.772 ± 0.138, and 0.795 ± 0.139, respectively; p < 0.01). Multiple regression analysis and multivariate logistic regression analysis revealed that RDW was associated with C-IMT in people with type 2 diabetes, and it remained significant after control for various cardiovascular risk factors including body mass index, blood pressure, insulin resistance, and smoking status in multivariate logistic regression analysis. CONCLUSION RDW is associated with subclinical atherosclerosis assessed by carotid IMT after control of various covariates in people with type 2 diabetes without cardiovascular or cerebrovascular diseases.
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Affiliation(s)
- J. S. Nam
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - C. W. Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S. Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K. R. Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - J. S. Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
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Association between Fluorescent Advanced Glycation End-Products and Vascular Complications in Type 2 Diabetic Patients. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7989180. [PMID: 29362717 PMCID: PMC5736945 DOI: 10.1155/2017/7989180] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/11/2017] [Accepted: 09/10/2017] [Indexed: 11/18/2022]
Abstract
Objectives Diabetes is a major health problem associated with hyperglycemia and chronically increased oxidative stress and enhanced formation of advanced glycation end-products (AGEs). The aim of this study was to determine whether oxidative plasma biomarkers in diabetic patients could be evidenced and associated with vascular complications. Methods Oxidative stress biomarkers such as thiols, ischemia-modified albumin (IMA), glycated albumin (GA), fructosamine, and AGEs were measured in 75 patients with poorly controlled type 2 diabetes (HbA1c > 7.5%) with (44) or without (31) vascular disease and in 31 nondiabetic controls. Results Most biomarkers of oxidation and glycation were significantly increased in diabetic patients in comparison with nondiabetics. Fructosamines, GA, IMA, and AGEs were positively correlated and levels of fluorescent AGEs were significantly increased in the plasma from patients presenting vascular complication. Conclusions These results bring new evidence for the potential interest of glycated albumin, oxidative stress, and glycoxidation parameters in the monitoring of type 2 diabetic patients. Furthermore, it emphasizes fluorescent AGEs as a putative indicator for vascular event prediction in diabetic patients.
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Carotid Intima-Media Thickness as a Cardiovascular Risk Factor and Imaging Pathway of Atherosclerosis. Crit Pathw Cardiol 2017; 15:152-160. [PMID: 27846007 DOI: 10.1097/hpc.0000000000000087] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Assessment of carotid intima-media thickness (IMT) has emerged as a simple and noninvasive technique for measuring atherosclerotic burden. Although serum biomarkers have been linked to the risk of developing atherosclerosis, carotid IMT has the theoretical advantage of directly visualizing a final consequence of the disease itself, namely atherosclerosis in the vessel wall. The current widespread application of carotid IMT measurements has been based on the validity, standardization, and reproducibility of the measurement and the evidence that an increased carotid IMT can be regarded as an attractive biomarker of atherosclerosis and of increased cardiovascular risk, potentially useful as a therapeutic target in those at increased cardiovascular risk. The utilization of carotid IMT measurements as a surrogate end point in clinical trials evaluating a specific drug intervention may result in considerably smaller efforts and costs than when using a hard end point such as myocardial infarction, stroke, or death. In addition, the use of carotid IMT measurement as a screening tool in clinical practice in association with traditional risk factors may improve risk classification and decisions regarding therapeutic interventions. However, although carotid IMT may be correlated with clinical outcomes, changes in surrogate end points over time that result from a particular therapy may not necessarily be predictive of future cardiovascular events. Therefore, it is necessary to perform more clinical studies to clearly define the relationship between the modifications in carotid IMT and the changes in cardiovascular events. In an era of economic burden, when there is a clear combination of limited resources with high expense of innovation in drug development, carotid IMT represents a reasonable, worthwhile surrogate trial end point with a history of nearly 30 years of technical progress and clinical research. Current data strongly suggest that carotid IMT will continue to successfully be used as a valuable tool in clinical atherosclerosis research.
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Kucuk A, Uğur Uslu A, Icli A, Cure E, Arslan S, Turkmen K, Toker A, Kayrak M. The LDL/HDL ratio and atherosclerosis in ankylosing spondylitis. Z Rheumatol 2017; 76:58-63. [PMID: 27312464 DOI: 10.1007/s00393-016-0092-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES In ankylosing spondylitis (AS) patients, cardiac and vascular involvement may manifest as atherosclerosis and coronary artery disease. Systemic inflammation, oxidative stress, increased low-density lipoprotein (LDL) cholesterol and decreased high-density lipoprotein (HDL) cholesterol constitute a significant risk for atherosclerosis. This study investigated the relationship between carotid intima-media thickness (CIMT), LDL/HDL ratio, total oxidant status (TOS; an indicator of oxidative stress) and ischemic modified albumin (IMA; an ischemic marker in AS patients). PATIENTS AND METHODS Sixty AS patients were diagnosed using the Modified New York Criteria; 54 age- and gender-matched participants were included as controls. CIMT, LDL/HDL ratio, TOS and IMA were measured using the most appropriate methods. RESULTS IMA was higher in AS patients compared to controls (p < 0.0001). TOS was also increased in AS patients (p = 0.005); as was CIMT (p < 0.0001). The LDL/HDL ratio was also greater in AS patients compared to controls (p = 0.047). A positive correlation was found between CIMT and LDL/HDL ratio among AS patients. CONCLUSION Elevated CIMT, IMA and TOS levels suggest an increased risk of atherosclerotic heart disease in AS patients. The LDL/HDL ratio was higher in AS patients compared to controls, and there was a correlation between LDL/HDL ratio and CIMT, albeit statistically weak. Therefore, the LDL/HDL ratio is not a reliable marker to predict atherosclerotic heart disease in AS patients.
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Affiliation(s)
- A Kucuk
- Division of Rheumatology, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
| | - A Uğur Uslu
- Eskişehir Military Hospital, Eskisehir, Rize, Turkey
| | - A Icli
- Necmettin Erbakan University, Konya, Turkey
| | - E Cure
- Recep Tayyip Erdogan University, Rize, Turkey
| | - S Arslan
- Necmettin Erbakan University, Konya, Turkey
| | - K Turkmen
- Necmettin Erbakan University, Konya, Turkey
| | - A Toker
- Necmettin Erbakan University, Konya, Turkey
| | - M Kayrak
- Necmettin Erbakan University, Konya, Turkey
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Mita T, Katakami N, Shiraiwa T, Yoshii H, Gosho M, Shimomura I, Watada H. Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis. Diabetes Ther 2017; 8:1135-1146. [PMID: 28933039 PMCID: PMC5630563 DOI: 10.1007/s13300-017-0309-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Dipeptidyl peptidase-4 (DPP-4) inhibitors reduce blood glucose in a dose-dependent manner, but the dose-dependent effect relationship between DPP-4 inhibitors and atherosclerosis has not been investigated. METHODS Patients with type 2 diabetes mellitus (T2DM) treated with insulin were randomized to the sitagliptin (n = 137) or conventional treatment group (n = 137). In the sitagliptin group, each investigator was allowed to adjust the sitagliptin dose to avoid hypoglycemia. In this post hoc analysis, subjects in the sitagliptin group were divided into two groups based on the average dose of sitagliptin during the study period: greater than or equal to median (higher sitagliptin dose group) or less than median (lower sitagliptin dose group). RESULTS In this study, subjects were divided into three groups: the conventional treatment group (n = 137), lower sitagliptin dose group (n = 42), and higher sitagliptin dose group (n = 95). The higher sitagliptin dose group had a significantly larger reduction in HbA1c (-0.62 ± 1.05%) than the conventional treatment group (-0.20 ± 0.91%, P = 0.007). Over 104 weeks, the higher sitagliptin dose significantly reduced the mean intima media thickness-common carotid artery (IMT-CCA) and left max-IMT-CCA relative to baseline. In addition, the higher sitagliptin dose significantly inhibited the progression in mean-IMT-CCA compared with conventional treatment. Multiple linear regression analysis showed that changes in mean-IMT-CCA and left max-IMT-CCA decreased with higher sitagliptin dose. CONCLUSIONS Addition of sitagliptin to insulin therapy might attenuate the progression of atherosclerosis in patients with T2DM in a dose-dependent manner. FUNDING Mitsubishi Tanabe Pharma Co., Ono Pharmaceutical Co., and Novo Nordisk. CLINICAL TRIAL REGISTRATION UMIN000007396.
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Affiliation(s)
- Tomoya Mita
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Toshihiko Shiraiwa
- Shiraiwa Medical Clinic, 4-10-24 Houzenji, Kashiwara, Osaka, 582-0005, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology and Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Shinsuna 3-3-20, Koto-ku, Tokyo, 136-0075, Japan
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
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Novel combined index of cardiometabolic risk related to periarterial fat improves the clinical prediction for coronary artery disease complexity. Atherosclerosis 2017; 268:76-83. [PMID: 29195108 DOI: 10.1016/j.atherosclerosis.2017.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/07/2017] [Accepted: 09/13/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular (CV) risk assessment based on conventional risk factors has a limited performance in the prediction of obstructive coronary artery disease (CAD). Therefore, our aim was to provide a complete assessment on the associations between single or combined cardiovascular ultrasound indexes and the complexity of CAD in high and very-high risk patients. METHODS Two hundred fifteen patients scheduled for elective coronary angiography were enrolled in the study (F/M: 80/135 pts; age: 61.8 ± 7.9 years). Detailed clinical characteristics, including several obesity parameters, and the following ultrasound indexes were obtained: carotid intima-media thickness (IMT) and extra-media thickness (EMT), epicardial fat thickness (EFT) and intra-abdominal fat thickness (IAT). CAD severity and complexity were assessed based on the well-evidenced SYNTAX score (SS) algorithm. RESULTS The study patients (79% with a very high CV risk) had central obesity (77%), and arterial hypertension (81%), one-third (37%) had diabetes and most of the individuals (74%) were current or previous smokers. In the study group, male sex, higher number of CV risk factors, diabetes and increased carotid vascular indexes (IMT or EMT ≥ 900 μm) were associated with significantly higher SS (p < 0.05). Paradoxically, obese patients revealed a significantly lower SS compared to non-obese individuals (3.65 ± 6.66 vs. 5.93 ± 8.8; p < 0.01), which was not explained by the number of CV risk factors or age. All the ultrasound indexes (except for visceral fat - IAT) revealed significant associations with the SS and the highest correlation coefficient was found for PATIMA combined index (r = 0.45; p < 0.01). Hence, none of the obesity-related clinical indexes showed any associations with CAD complexity. Multivariate regression analysis showed that male sex, chronic kidney disease and the PATIMA index were independently associated with the Syntax Score. The ROC analysis showed that the highest sensitivity (71% and 82%) and specificity (77% and 72%) in prediction of either SS > 1 or SS > 7 were found for the combined PATIMA index (negative predictive value = 92% for SS > 7). CONCLUSIONS We present the first study showing that a combination of ultrasound indexes related to periarterial fat and vascular wall (PATIMA index) is associated with more complex CAD in high and very-high risk patients. PATIMA index revealed improved predictive value compared to other single ultrasound indexes and clinical risk assessment.
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Wu Y, He J, Sun X, Zhao YM, Lou HY, Ji XL, Pang XH, Shan LZ, Kang YX, Xu J, Zhang SZ, Wang YJ, Ren YZ, Shan PF. Carotid atherosclerosis and its relationship to coronary heart disease and stroke risk in patients with type 2 diabetes mellitus. Medicine (Baltimore) 2017; 96:e8151. [PMID: 28953658 PMCID: PMC5626301 DOI: 10.1097/md.0000000000008151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Carotid atherosclerosis (CA) and carotid plaque (CP) are highly correlated with cardiovascular disease. We aimed to determine the prevalence of CA and CP and their relationship with 10-year risks of stroke and coronary heart disease (CHD) in type 2 diabetes mellitus (T2DM).We studied 1584 T2DM patients aged 20 years and older. CA and CP were detected using ultrasonography. Ten-year stroke and CHD risk were determined using the United Kingdom Prospective Diabetes Study (UKPDS) risk engine.The prevalence of CA and CP increased gradually with age. Men had a higher prevalence of CA than women (CA: 58.18% vs 51.54%, P < .01). The 10-year CHD risk (27.9% vs 15.4%, P < .001) and stroke risk (15.2% vs 5.70%, P < .001) were higher in patients with CA than that of those without CA. Compared with patients without CA, the odds ratios (ORs) of CHD in CA and CP group were 4.47 and 10.78 for men, and 4.19 and 5.20 for women, respectively; in the case of stroke, the OR in CA and CP group were 8.83 and 12.07 for men, and 4.35 and 4.90 for women, respectively (P < .001 for all). Multivariate binary logistic regression analysis showed that CA was an independent risk factor for CHD [OR = 2.66, 95% confidence interval (95% CI), 2.05-3.46, P < .001] and stroke (OR = 3.11, 95% CI, 2.38-4.07, P < .001).CA and CP were prevalent in patients with T2DM and positively correlated with 10-year CHD and stroke risk. CA was an independent risk factor for 10-year CHD risk.
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Affiliation(s)
- Yan Wu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
- Department of Endocrinology and Metabolism, Zhejiang Greentown Cardiovascular Hospital
| | - Jie He
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Xue Sun
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Yi-Ming Zhao
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Han-Yu Lou
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Xiao-li Ji
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Xiao-Hong Pang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Li-Zhen Shan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Ying-Xiu Kang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | | | - Song-Zhao Zhang
- Department of Clinical Laboratory, the Second Affiliated Hospital ZheJiang University College of Medicine, Hangzhou, Zhejiang, P.R. China
| | - Yong-Jian Wang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Yue-Zhong Ren
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
| | - Peng-Fei Shan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital ZheJiang University College of Medicine
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Masson W, Francesca SD, Molinero M, Siniawski D, Mulassi A, Morales FE, Huerin M, Lobo M, Molinero G. Estimation of cardiovascular risk and detection of subclinical carotid atheromatosis in patients with diabetes without a history of cardiovascular disease. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:122-129. [PMID: 28225988 PMCID: PMC10118858 DOI: 10.1590/2359-3997000000234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 10/10/2016] [Indexed: 11/22/2022]
Abstract
Objectives Cardiovascular risk estimated by several scores in patients with diabetes mellitus without a cardiovascular disease history and the association with carotid atherosclerotic plaque (CAP) were the aims of this study. Materials and methods Cardiovascular risk was calculate using United Kingdom Prospective Diabetes Study (UKPDS) risk engine, Framingham risk score for cardiovascular (FSCV) and coronary disease (FSCD), and the new score (NS) proposed by the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol. Ultrasound was used to assess CAP occurrence. A receiver operating characteristic (ROC) analysis was performed. Results One hundred seventy patients (mean age 61.4 ± 11 years, 58.8% men) were included. Average FSCV, FSCD and NS values were 33.6% ± 21%, 20.6% ± 12% and 24.8% ± 18%, respectively. According to the UKPDS score, average risk of coronary disease and stroke were 22.1% ± 16% and 14.3% ± 19% respectively. Comparing the risks estimated by the different scores a significant correlation was found. The prevalence of CAP was 51%, in patients with the higher scores this prevalence was increased. ROC analysis showed a good discrimination power between subjects with or without CAP. Conclusion The cardiovascular risk estimated was high but heterogenic. The prevalence of CAP increased according to the strata of risk. Understanding the relationship between CAP and scores could improve the risk estimation in subjects with diabetes.
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Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Salvador De Francesca
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Micaela Molinero
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Daniel Siniawski
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Andrés Mulassi
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Frank Espinoza Morales
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Melina Huerin
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi" of the Argentine Society of Cardiology, Buenos Aires, Argentina
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Kundi H, Kiziltunc E, Ates I, Cetin M, Barca AN, Ozkayar N, Ornek E. Association between plasma homocysteine levels and end-organ damage in newly diagnosed type 2 diabetes mellitus patients. Endocr Res 2017; 42:36-41. [PMID: 27111290 DOI: 10.3109/07435800.2016.1171235] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of the present study was to investigate the association between plasma homocysteine (Hcy) levels and carotid, cardiac, and renal end-organ damage in newly diagnosed type 2 diabetes mellitus (T2DM) patients. METHODS Newly diagnosed normotensive T2DM patients (n = 390) were enrolled in this study. The patients were not taking any medications over the duration of the study. The left ventricular mass index (LVMI), carotid intima media thickness (CIMT), and creatinine levels and 24-h microalbuminuria were used to determine cardiac, carotid, and kidney end-organ diseases, respectively. RESULTS Using univariate logistic regression analysis; age, 24-h microalbuminuria, fasting blood glucose, CIMT, creatinine level, and LVMI were found to be significantly associated with the Hcy level. When those six variables were included in a multivariate regression model, CIMT, LVMI, and creatinine were found to be significantly associated with the Hcy level. We determined that an Hcy level >12.5 µmol/L was predictive of high LVMI, with a sensitivity of 70.1% and a specificity of 68%. An Hcy level >13.5 µmol/L was predictive of high CIMT, with a sensitivity of 67.5% and a specificity of 63.1%. CONCLUSION In this study, LVMI, CIMT, and creatinine level were positively correlated with the Hcy level. We believe that the Hcy level may be a useful predictor of end-organ damage, including cardiac, carotid, and renal diseases, in newly diagnosed T2DM patients.
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Affiliation(s)
- Harun Kundi
- a Department of Cardiology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Emrullah Kiziltunc
- a Department of Cardiology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Ihsan Ates
- b Department of Internal Medicine , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Mustafa Cetin
- a Department of Cardiology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Ayşe Nurdan Barca
- c Department of Radiology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Nihal Ozkayar
- d Department of Nephrology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Ender Ornek
- a Department of Cardiology , Ankara Numune Education and Research Hospital , Ankara , Turkey
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Temma J, Matsuhisa M, Horie T, Kuroda A, Mori H, Tamaki M, Endo I, Aihara KI, Abe M, Matsumoto T. Non-invasive Measurement of Skin Autofluorescence as a Beneficial Surrogate Marker for Atherosclerosis in Patients with Type 2 Diabetes. THE JOURNAL OF MEDICAL INVESTIGATION 2017; 62:126-9. [PMID: 26399335 DOI: 10.2152/jmi.62.126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Advanced glycation end-products (AGEs) are thought to play a major role in the pathogenesis of diabetic vascular complications. Skin autofluorescence (AF) was recently reported to represent tissue AGEs accumulation with a non-invasive method. The aim of the present study was to evaluate association between AF value and diabetic vascular complications, such as retinopathy, nephropathy and cervical atherosclerosis using the carotid intima-media thickness (IMT), an established marker of cardiovascular disease in patients with type 2 diabetes. A total of 68 patients with type 2 diabetes were enrolled in a cross-sectional manner. AGEs accumulation was measured with AF reader. Clinical parameters were collected at the time of AF and IMT measurement. Max-IMT was correlated with age and AF (r=0.407, p=0.001), but not with HbA1c, GA, and pentosidine. Also, AF was not correlated with HbA1c, GA and pentosidine, but was correlated with age (r=0.560, p<0.001), duration of diabetes (r=0.256, p<0.05). Multivariate regression analysis revealed that AF, but not age, was an independent determinant of max-IMT. In conclusion, AF might be a beneficial surrogate marker for evaluating carotid atherosclerosis in patients with type 2 diabetes non-invasively. J. Med. Invest. 62: 126-129, August, 2015.
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Affiliation(s)
- Jin Temma
- Department of Hematology, Endocrinology & Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School
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Zaid M, Fujiyoshi A, Kadota A, Abbott RD, Miura K. Coronary Artery Calcium and Carotid Artery Intima Media Thickness and Plaque: Clinical Use in Need of Clarification. J Atheroscler Thromb 2016; 24:227-239. [PMID: 27904029 PMCID: PMC5383538 DOI: 10.5551/jat.rv16005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Atherosclerosis begins in early life and has a long latent period prior to onset of clinical disease. Measures of subclinical atherosclerosis, therefore, may have important implications for research and clinical practice of atherosclerotic cardiovascular disease (ASCVD). In this review, we focus on coronary artery calcium (CAC) and carotid artery intima-media thickness (cIMT) and plaque as many population-based studies have investigated these measures due to their non-invasive features and ease of administration. To date, a vast majority of studies have been conducted in the US and European countries, in which both CAC and cIMT/plaque have been shown to be associated with future risk of ASCVD, independent of conventional risk factors. Furthermore, these measures improve risk prediction when added to a global risk prediction model, such as the Framingham risk score. However, no clinical trial has assessed whether screening with CAC or cIMT/plaque will lead to improved clinical outcomes and healthcare costs. Interestingly, similar levels of CAC or cIMT/plaque among various regions and ethnic groups may in fact be associated with significantly different levels of absolute risk of ASCVD. Therefore, it remains to be determined whether measures of subclinical atherosclerosis improve risk prediction in non-US/European populations. Although CAC and cIMT/plaque are promising surrogates of ASCVD in research, we conclude that their use in clinical practice, especially as screening tools for primary prevention in asymptomatic adults, is premature due to many vagaries that remain to be clarified.
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Affiliation(s)
- Maryam Zaid
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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Kucuk A, Uğur Uslu A, Icli A, Cure E, Arslan S, Turkmen K, Toker A, Kayrak M. The LDL/HDL ratio and atherosclerosis in ankylosing spondylitis. Z Rheumatol 2016. [PMID: 27312464 DOI: 10.1007/s00393-016-0092-4.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES In ankylosing spondylitis (AS) patients, cardiac and vascular involvement may manifest as atherosclerosis and coronary artery disease. Systemic inflammation, oxidative stress, increased low-density lipoprotein (LDL) cholesterol and decreased high-density lipoprotein (HDL) cholesterol constitute a significant risk for atherosclerosis. This study investigated the relationship between carotid intima-media thickness (CIMT), LDL/HDL ratio, total oxidant status (TOS; an indicator of oxidative stress) and ischemic modified albumin (IMA; an ischemic marker in AS patients). PATIENTS AND METHODS Sixty AS patients were diagnosed using the Modified New York Criteria; 54 age- and gender-matched participants were included as controls. CIMT, LDL/HDL ratio, TOS and IMA were measured using the most appropriate methods. RESULTS IMA was higher in AS patients compared to controls (p < 0.0001). TOS was also increased in AS patients (p = 0.005); as was CIMT (p < 0.0001). The LDL/HDL ratio was also greater in AS patients compared to controls (p = 0.047). A positive correlation was found between CIMT and LDL/HDL ratio among AS patients. CONCLUSION Elevated CIMT, IMA and TOS levels suggest an increased risk of atherosclerotic heart disease in AS patients. The LDL/HDL ratio was higher in AS patients compared to controls, and there was a correlation between LDL/HDL ratio and CIMT, albeit statistically weak. Therefore, the LDL/HDL ratio is not a reliable marker to predict atherosclerotic heart disease in AS patients.
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Affiliation(s)
- A Kucuk
- Division of Rheumatology, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
| | - A Uğur Uslu
- Eskişehir Military Hospital, Eskisehir, Rize, Turkey
| | - A Icli
- Necmettin Erbakan University, Konya, Turkey
| | - E Cure
- Recep Tayyip Erdogan University, Rize, Turkey
| | - S Arslan
- Necmettin Erbakan University, Konya, Turkey
| | - K Turkmen
- Necmettin Erbakan University, Konya, Turkey
| | - A Toker
- Necmettin Erbakan University, Konya, Turkey
| | - M Kayrak
- Necmettin Erbakan University, Konya, Turkey
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Al Nasser Y, Moura MC, Mertens L, McCrindle BW, Parekh RS, Ng VL, Church PC, Mouzaki M. Subclinical cardiovascular changes in pediatric solid organ transplant recipients: A systematic review and meta-analysis. Pediatr Transplant 2016; 20:530-9. [PMID: 26890272 DOI: 10.1111/petr.12689] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 12/28/2022]
Abstract
CV disease is a major cause of morbidity and mortality following solid organ transplantation in adults. While the prevalence of multiple cardiometabolic risk factors is increased in pediatric solid organ transplant recipients, it is not clear whether they have subclinical CV changes. cIMT, central pWV, and CAC are indicative of subclinical CV disease, and, in adults, predict future CV events. The objective of this systematic review and meta-analysis was to investigate the prevalence of subclinical CV changes, as measured by cIMT, pWV, and CAC among pediatric solid organ transplant recipients. We searched MEDLINE(®) and EMBASE and conducted meta-analysis for studies that evaluated cIMT, central pWV, and CAC among pediatric solid organ transplant recipients (kidney, lung, intestine and liver). The search identified nine eligible studies that included a total of 259 patients and 685 healthy controls. Eight studies reported on kidney transplant recipients and one study on a combined cohort of kidney and liver transplant recipients. The mean cIMT of transplant recipients was significantly higher than that of healthy controls (mean difference = 0.05 mm, 95% CI 0.02-0.07; p < 0.0001) with an estimated pooled prevalence of elevated cIMT of 56.0% (95% CI 17.0-95.0). The one study that assessed pWV showed increased vascular stiffness in transplant recipients compared to healthy controls. No studies assessing for CAC were found. There were limited data regarding subclinical CV disease following pediatric solid organ transplantation. In conclusion, kidney transplantation in childhood is associated with a higher prevalence of subclinical CV changes compared to healthy children. Longitudinal studies are needed to determine whether children have increased CV morbidity and mortality after transplantation.
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Affiliation(s)
- Yasser Al Nasser
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Marta C Moura
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Luc Mertens
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada.,Division of Cardiology, Hospital for Sick Children, Toronto, ON, Canada
| | - Brian W McCrindle
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada.,Division of Cardiology, Hospital for Sick Children, Toronto, ON, Canada
| | - Rulan S Parekh
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada.,Division of Nephrology, Hospital for Sick Children, Toronto, ON, Canada.,SickKids Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Vicky L Ng
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada.,SickKids Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Peter C Church
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada
| | - Marialena Mouzaki
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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França MM, Nogueira CR, Hueb JC, Mendes AL, Padovani CR, Mazeto GMFDS. Higher Carotid Intima-Media Thickness in Subclinical Hypothyroidism Associated with the Metabolic Syndrome. Metab Syndr Relat Disord 2016; 14:381-385. [PMID: 27228324 DOI: 10.1089/met.2016.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The subclinical hypothyroidism (SH) and the metabolic syndrome (MS) have been associated with increased risk of atherosclerosis and cardiovascular disease (CVD). The measurement of carotid intima-media thickness (IMT) is capable of detecting early signs of atherosclerotic disease. The goal of the study was to compare the carotid IMT of patients with SH with and without the MS. METHODS Twenty-nine SH patients were subdivided into two groups: one with MS (SH + MS) and one without MS (SH - MS). The study also assessed a group of euthyroid patients (n = 31), also subdivided into two groups: one with MS (EU + MS) and one without MS (EU - MS). The clinical and laboratory data and the mean and maximum carotid IMT of the groups were compared. RESULTS Maximum (P = 0.012) and mean (P = 0.025) IMT were higher in the SH + MS group than in the SH-MS group. Maximum IMT was higher in the SH + MS group than in the EU + MS group (P = 0.048). Maximum IMT was positively correlated with fasting glucose (FG; R = 0.621; P < 0.01) and body mass index (R = 0.258; P = 0.041) and negatively correlated with low-density lipoprotein cholesterol (LDL-C) (R = -0.297; P = 0.017). Mean IMT was positively correlated with FG (R = 0.580; P < 0.01), systolic blood pressure (R = 0.292; P = 0.02), and triglycerides (R = 0.250; P = 0.048) and negatively correlated with LDL-C (R = -0.288; P = 0.022). CONCLUSIONS SH + MS patients have higher IMT than SH - MS or EU + MS patients, suggesting that SH may be one more CVD risk factor in patients with the MS.
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Affiliation(s)
- Mariana Martins França
- 1 Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University , UNESP, Botucatu, Brazil
| | - Célia Regina Nogueira
- 1 Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University , UNESP, Botucatu, Brazil
| | - João Carlos Hueb
- 1 Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University , UNESP, Botucatu, Brazil
| | - Adriana Lúcia Mendes
- 1 Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University , UNESP, Botucatu, Brazil
| | - Carlos Roberto Padovani
- 2 Department of Biostatistics, Biosciences Institute, Sao Paulo State University , UNESP, Botucatu, Brazil
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Okahara A, Sadamatsu K, Matsuura T, Koga Y, Mine D, Yoshida K. Coronary Artery Disease Screening With Carotid Ultrasound Examination by a Primary Care Physician. Cardiol Res 2016; 7:9-16. [PMID: 28197263 PMCID: PMC5295529 DOI: 10.14740/cr456w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2016] [Indexed: 01/18/2023] Open
Abstract
Background In this study, we investigated the feasibility of primary care physicians using carotid ultrasound to perform coronary artery disease screening in asymptomatic patients with multiple coronary risk factors. Methods We retrospectively collected the data of 135 consecutive asymptomatic patients (mean age: 68.5 ± 8.4 years; male, 75%) who were referred to our institution due to abnormal findings on a carotid ultrasound performed by a primary care physician and who underwent coronary computed tomography angiography. Results The mean number of risk factors was 4.1 ± 1.2 and the mean intima-media thickness was 2.00 ± 0.63 mm. Mild (≤ 50%), moderate (51-75%), and severe (> 76%) coronary stenosis was observed in 54 (40%), 27 (20%), and 25 patients (19%), respectively, while no plaque was found in 24 patients (18%), and five patients (4%) could not be evaluated due to calcification. Consequently, coronary angiography was performed in 56 (41%) patients and coronary intervention was required in 31 patients (23%). A multivariate logistic regression analysis demonstrated that the ratio of low-density lipoprotein cholesterol levels to high-density lipoprotein cholesterol levels, the use of calcium channel blockers and the value of the diastolic blood pressure were related to > 50% coronary stenosis. Conclusions The use of carotid ultrasound in the coronary artery disease screening by primary care physicians resulted in a high prevalence of coronary artery disease and high probabilities of coronary angiography and revascularization, and thus it is considered to be a useful and feasible strategy for the screening of asymptomatic patients.
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Affiliation(s)
- Arihide Okahara
- Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Kenji Sadamatsu
- Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Taku Matsuura
- Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Yasuaki Koga
- Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Daigo Mine
- Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Keiki Yoshida
- Department of Cardiology, Saga-Ken Medical Centre Koseikan, Saga, Japan
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Calcagno C, Mulder WJM, Nahrendorf M, Fayad ZA. Systems Biology and Noninvasive Imaging of Atherosclerosis. Arterioscler Thromb Vasc Biol 2016; 36:e1-8. [PMID: 26819466 PMCID: PMC4861402 DOI: 10.1161/atvbaha.115.306350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Claudia Calcagno
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.).
| | - Willem J M Mulder
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
| | - Matthias Nahrendorf
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
| | - Zahi A Fayad
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
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Lv P, Tong X, Peng Q, Liu Y, Jin H, Liu R, Sun W, Pan B, Zheng L, Huang Y. Treatment with the herbal medicine, naoxintong improves the protective effect of high-density lipoproteins on endothelial function in patients with type 2 diabetes. Mol Med Rep 2016; 13:2007-16. [PMID: 26781332 PMCID: PMC4768949 DOI: 10.3892/mmr.2016.4792] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 12/23/2015] [Indexed: 12/28/2022] Open
Abstract
The protective effect of high-density lipoprotein (HDL) on endothelial function is impaired in patients with type 2 diabetes mellitus (T2DM), which may result in atherosclerotic complications. Naoxintong (NXT) is a compound preparation that includes Radix Astragali, Angelicae sinensis, Radix Paeoniae Rubra and Ligusticum wallichii. It is widely administered in China to prevent atherosclerotic complications. In the present study, NXT was administered to 69 patients with T2DM. HDLs were isolated from patient blood samples prior to and following the intervention. In vitro endothelial functions of HDL, including proliferation, migration, angiogenesis, and anti-apoptosis were investigated by bromodeoxyuridine, wound healing, Transwell and Matrigel tube formation assays on human umbilical vein endothelial cells (HUVECs). The results from the present study demonstrated that HUVECs treated with HDL isolated from diabetic patients following NXT therapy exhibited increased proliferative effects (10–27%; P<0.05), and improved migration ability (15–35%; P<0.05), anti-apoptotic function (23–34%; P<0.05) and angiogenesis (30–54%; P<0.001). Furthermore, the phosphorylation levels of Akt (26–36%; P<0.01) and extracellular signal-regulated kinase (16–80%; P<0.01) were increased following NXT therapy. The present in vitro study demonstrates that the protective effect of HDL on endothelial function is markedly impaired in diabetic patients who tend to develop atherosclerosis, and the impaired function may be partly abrogated by NXT.
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Affiliation(s)
- Pu Lv
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
| | - Xunliang Tong
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
| | - Qing Peng
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
| | - Yuanyuan Liu
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
| | - Haiqiang Jin
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
| | - Ran Liu
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
| | - Wei Sun
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
| | - Bing Pan
- The Institute of Cardiovascular Sciences and Institute of Systems Biomedicine, School of Basic Medical Sciences, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Peking University Health Science Center, Beijing 100191, P.R. China
| | - Lemin Zheng
- The Institute of Cardiovascular Sciences and Institute of Systems Biomedicine, School of Basic Medical Sciences, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Peking University Health Science Center, Beijing 100191, P.R. China
| | - Yining Huang
- Department of Neurology, Peking University First Hospital, Beijing 100034, P.R. China
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Gracia M, Betriu À, Martínez-Alonso M, Arroyo D, Abajo M, Fernández E, Valdivielso JM. Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD. Clin J Am Soc Nephrol 2015; 11:287-96. [PMID: 26668022 DOI: 10.2215/cjn.01240215] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 11/02/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Ultrasonographic detection of subclinical atheromatosis is a noninvasive method predicting cardiovascular events. Risk factors predicting atheromatosis progression in CKD are unknown. Predictors of atheromatosis progression were evaluated in patients with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Our multicenter, prospective, observational study included 1553 patients with CKD (2009-2011). Carotid and femoral ultrasounds were performed at baseline and after 24 months. A subgroup of 476 patients with CKD was also randomized to undergo ultrasound examination at 12 months. Progression of atheromatosis was defined as an increase in the number of plaque territories analyzed by multivariate logistic regression. RESULTS Prevalence of atheromatosis was 68.7% and progressed in 59.8% of patients after 24 months. CKD progression was associated with atheromatosis progression, suggesting a close association between pathologies. Variables significantly predicting atheromatosis progression, independent from CKD stages, were diabetes and two interactions of age with ferritin and plaque at baseline. Given that multiple interactions were found between CKD stage and age, phosphate, smoking, dyslipidemia, body mass index, systolic BP (SBP), carotid intima-media thickness, plaque at baseline, uric acid, cholesterol, 25-hydroxy vitamin D (25OH vitamin D), and antiplatelet and phosphate binders use, the analysis was stratified by CKD stages. In stage 3, two interactions (age with phosphate and plaque at baseline) were found, and smoking, diabetes, SBP, low levels of 25OH vitamin D, and no treatment with phosphate binders were positively associated with atheromatosis progression. In stages 4 and 5, three interactions (age with ferritin and plaque and plaque with smoking) were found, and SBP was positively associated with atheromatosis progression. In dialysis, an interaction between body mass index and 25OH vitamin D was found, and age, dyslipidemia, carotid intima-media thickness, low cholesterol, ferritin, and uric acid were positively associated with atheromatosis progression. CONCLUSIONS Atheromatosis progression affects more than one half of patients with CKD, and predictive factors differ depending on CKD stage.
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Affiliation(s)
- Marta Gracia
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Àngels Betriu
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | | | - David Arroyo
- Nephrology, University Hospital Arnau de Vilanova, Lleida, Spain
| | - María Abajo
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | | | - José M Valdivielso
- Experimental Nephrology, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain;
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Haberka M, Gąsior Z. A carotid extra-media thickness, PATIMA combined index and coronary artery disease: Comparison with well-established indexes of carotid artery and fat depots. Atherosclerosis 2015; 243:307-13. [PMID: 26414210 DOI: 10.1016/j.atherosclerosis.2015.09.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/24/2015] [Accepted: 09/15/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND The clinical utility of traditional cardiovascular (CV) risk factors to predict coronary artery disease (CAD) is insufficient and limited. Our aim was to evaluate the association between a novel ultrasound index of periarterial fat and adventitia (carotid extra-media thickness; EMT) and the severity of CAD and to compare this with well-known vascular indexes in patients with high and very high CV risk. METHODS AND RESULTS Four hundred twenty two patients scheduled for elective coronary angiography were included in the study (age: 61.3 ± 7.4 years; males 65%). Several clinical parameters of obesity were obtained as well as the following ultrasound indexes: carotid EMT and intima-media thickness (IMT), epicardial and pericardial fat thickness (EFT and PFT), and intra-abdominal fat thickness (IAT). These were then related to CAD severity in all individuals. Our study patients had a very high estimated CV risk (82%), and most (60%) fulfilled the MS criteria. Most individuals (71%) had CAD (≥50% stenosis) with equal rates of one, two, or three-vessel disease, and critical (≥70%) coronary stenosis was found in 40% of patients. Carotid EMT was significantly increased in patients with CAD (812 ± 116 vs 746 ± 131 μm) and patients with critical coronary stenosis (829 ± 119 vs 769 ± 122 μm) compared to the appropriate control groups. Moreover, carotid EMT was significantly associated with the severity of CAD. Carotid IMT and EFT (but not PFT and IAT) also revealed significant relations to the number of diseased vessels. Carotid EMT and the new proposed combined index (PATIMA = EMT/BMIx35 + IMT + EFTx60) were predictive for CAD (AUC: 686 ± 304 and 755 ± 260, sensitivity: 60 and 62%, specificity: 76 and 81% for 772 μm and 2015u). CONCLUSIONS We present the first study showing that the new vascular index (carotid EMT) and the proposed combined index PATIMA are associated with the presence and the severity of CAD.
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Affiliation(s)
- Maciej Haberka
- School of Health Sciences, Medical University of Silesia, Department of Cardiology, Katowice, Poland.
| | - Zbigniew Gąsior
- School of Health Sciences, Medical University of Silesia, Department of Cardiology, Katowice, Poland
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Barsanti C, Lenzarini F, Kusmic C. Diagnostic and prognostic utility of non-invasive imaging in diabetes management. World J Diabetes 2015; 6:792-806. [PMID: 26131322 PMCID: PMC4478576 DOI: 10.4239/wjd.v6.i6.792] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/23/2014] [Accepted: 04/14/2015] [Indexed: 02/05/2023] Open
Abstract
Medical imaging technologies are acquiring an increasing relevance to assist clinicians in diagnosis and to guide management and therapeutic treatment of patients, thanks to their non invasive and high resolution properties. Computed tomography, magnetic resonance imaging, and ultrasonography are the most used imaging modalities to provide detailed morphological reconstructions of tissues and organs. In addition, the use of contrast dyes or radionuclide-labeled tracers permits to get functional and quantitative information about tissue physiology and metabolism in normal and disease state. In recent years, the development of multimodal and hydrid imaging techniques is coming to be the new frontier of medical imaging for the possibility to overcome limitations of single modalities and to obtain physiological and pathophysiological measurements within an accurate anatomical framework. Moreover, the employment of molecular probes, such as ligands or antibodies, allows a selective in vivo targeting of biomolecules involved in specific cellular processes, so expanding the potentialities of imaging techniques for clinical and research applications. This review is aimed to give a survey of characteristics of main diagnostic non-invasive imaging techniques. Current clinical appliances and future perspectives of imaging in the diagnostic and prognostic assessment of diabetic complications affecting different organ systems will be particularly addressed.
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Gavrilova NE, Metelskaya VA, Boytsov SA, Gumanova NG, Yarovaya EB. [Markers of visceral adipose tissue metabolic abnormalities in patients with coronary atherosclerosis in relation to the presence of type 2 diabetes mellitus]. TERAPEVT ARKH 2015; 87:31-36. [PMID: 26978171 DOI: 10.17116/terarkh2015871031-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To assess the specific features of visceral adipose tissue metabolism in patients with coronary atherosclerosis, complicated or uncomplicated type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS A cohort of 429 patients (325 men and 104 women; mean age, 61.3±9.4 years) with coronary atherosclerosis who had been admitted to the National Research Centre for Preventive Medicine, Ministry of Health of Russia, to undergo coronarography (CG) and to receive high-tech treatments and met the criteria for being included in and excluded from this investigation, was examined. The Gensini scoring scale was used to estimate the magnitude of coronary atherosclerosis from CG RESULTS: Carotid artery duplex ultrasound scanning estimating the intima-media thickness was performed in 48% of the patients. DM was diagnosed from examination results (fasting plasma glucose ≥7.0 mmol/l and glycated hemoglobin >6.5%) and an endocrinologist's report. 94% of the patients took statins. RESULTS Overall, 18% of the examinees had DM that was 2.5 times more common in the women than in the men (32.7 and 13.2%, respectively (p=0.000). The diabetic and non-diabetic patients showed no significant differences in age: 62.9±8.3 and 60.9±9.6 years, respectively (p=0.105). There were statistically significant differences in the magnitude of coronary artery atherosclerosis according to the Gensini scale in relation to the presence of T2DM; thus, the median Gensini score was 48 in the diabetic patients and 46 in the persons with no signs of the disease (Mann-Whitney test; p=0.03). Analysis of adipokine levels showed that the median leptin level was significantly higher than that in the male patients with T2DM than in the persons with no signs of the disease. In the patients with T2DM, the median adiponectin level turned out to be significantly lower in both men and women. CONCLUSION The coronary atherosclerosis severity rated using the Gensini scale is shown to increase in the presence of T2DM. The probability of detecting obvious (>45%) carotid artery lesion is associated with the presence of DM in both men and women. The male patients with T2DM concurrent with coronary atherosclerosis are noted to have an elevated leptin level, but a lower adiponectin concentration was found in both the men and women.
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Affiliation(s)
- N E Gavrilova
- National Research Center for Preventive Medicine, Moscow, Russia
| | - V A Metelskaya
- National Research Center for Preventive Medicine, Moscow, Russia
| | - S A Boytsov
- National Research Center for Preventive Medicine, Moscow, Russia
| | - N G Gumanova
- National Research Center for Preventive Medicine, Moscow, Russia
| | - E B Yarovaya
- National Research Center for Preventive Medicine, Moscow, Russia
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Ndip A, Wilkinson FL, Jude EB, Boulton AJM, Alexander MY. RANKL-OPG and RAGE modulation in vascular calcification and diabetes: novel targets for therapy. Diabetologia 2014; 57:2251-60. [PMID: 25112376 DOI: 10.1007/s00125-014-3348-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/17/2014] [Indexed: 12/18/2022]
Abstract
Type 2 diabetes is associated with increased cardiovascular morbidity and mortality and early vascular ageing. This takes the form of atherosclerosis, with progressive vascular calcification being a major complication in the pathogenesis of this disease. Current research and drug targets in diabetes have hitherto focused on atherosclerosis, but vascular calcification is now recognised as an independent predictor of cardiovascular morbidity and mortality. An emerging regulatory pathway for vascular calcification in diabetes involves the receptor activator for nuclear factor κB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG). Important novel biomarkers of calcification are related to levels of glycation and inflammation in diabetes. Several therapeutic strategies could have advantageous effects on the vasculature in patients with diabetes, including targeting the RANKL and receptor for AGE (RAGE) signalling pathways, since there has been little success-at least in macrovascular outcomes-with conventional glucose-lowering therapy. There is substantial and relevant clinical and basic science evidence to suggest that modulating RANKL-RANK-OPG signalling, RAGE signalling and the associated proinflammatory milieu alters the natural course of cardiovascular complications and outcomes in people with diabetes. However, further research is critically needed to understand the precise mechanisms underpinning these pathways, in order to translate the anti-calcification strategies into patient benefit.
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Affiliation(s)
- Agbor Ndip
- Department of Medicine and Diabetes, Manchester Royal Infirmary, Manchester, UK,
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Avci A, Demir K, Kaya Z, Marakoglu K, Ceylan E, Ekmekci AH, Yilmaz A, Demir A, Altunkeser BB. Arterial stiffness and carotid intima-media thickness in diabetic peripheral neuropathy. Med Sci Monit 2014; 20:2074-81. [PMID: 25351260 PMCID: PMC4222449 DOI: 10.12659/msm.892648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background We investigated the relationship between peripheral neuropathy and parameters of arterial stiffness and carotid intima media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). Material/Methods The study included 161 patients (80 females and 81 males), 69 of whom had peripheral neuropathy. All patients underwent 24-h blood pressure monitoring, and arterial stiffness parameters were measured. The CIMT was measured using B-mode ultrasonography and patients also underwent transthoracic echocardiographic examination. Results Patients with peripheral neuropathy, compared with those without it, were older (54.68±8.35 years vs. 51.04±7.89 years; p=0.005) and had T2DM for longer periods (60 vs. 36 months; p=0.004). Glycated hemoglobin (HbA1c) values (8.55±1.85 mg/dL vs. 7.30±1.51 mg/dL; p<0.001), pulse wave velocity (PWV) (7.74±1.14 m/s vs. 7.15±1.10 m/s; p=0.001), CIMT (anterior 0.74±0.15 mm vs. 0.67±0.13 mm; p=0.01), and left ventricular mass (LVM) index (98.68±26.28 g/m2vs. 89.71±19.70 g/m2; p=0.02) were all significantly increased in the group with peripheral neuropathy compared to the group without peripheral neuropathy. We determined that duration of diabetes, HbA1c, and LVM index were predictors of peripheral neuropathy. Conclusions A significant relationship was found between diabetic neuropathy and increased PWV, a parameter of arterial stiffness, as well as CIMT, a marker of systemic atherosclerosis. Diabetic peripheral neuropathy may be a determinant of subclinical atherosclerosis in T2DM.
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Affiliation(s)
- Ahmet Avci
- Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Kenan Demir
- Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Zeynettin Kaya
- Department of Cardiology, Mevlana University Faculty of Medicine, Konya, Turkey
| | - Kamile Marakoglu
- Department of Family Medicine, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Esra Ceylan
- Department of Family Medicine, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Ahmet Hakan Ekmekci
- Department of Neurology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Ahmet Yilmaz
- Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Aysegul Demir
- Department of Neurology, Selcuk University Faculty of Medicine, Konya, Turkey
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Ibrahim HA, Mohammed MO, Dhahir HAR, Mahmood KA, Nuradeen BE. Impact of <i>Helicobacter pylori</i> Infection on Serum Lipid Profile and Atherosclerosis of Carotid Artery. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ijcm.2014.515125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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