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Shilo S, Keshet A, Rossman H, Godneva A, Talmor-Barkan Y, Aviv Y, Segal E. Continuous glucose monitoring and intrapersonal variability in fasting glucose. Nat Med 2024; 30:1424-1431. [PMID: 38589602 DOI: 10.1038/s41591-024-02908-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/04/2024] [Indexed: 04/10/2024]
Abstract
Plasma fasting glucose (FG) levels play a pivotal role in the diagnosis of prediabetes and diabetes worldwide. Here we investigated FG values using continuous glucose monitoring (CGM) devices in nondiabetic adults aged 40-70 years. FG was measured during 59,565 morning windows of 8,315 individuals (7.16 ± 3.17 days per participant). Mean FG was 96.2 ± 12.87 mg dl-1, rising by 0.234 mg dl-1 per year with age. Intraperson, day-to-day variability expressed as FG standard deviation was 7.52 ± 4.31 mg dl-1. As there are currently no CGM-based criteria for diabetes diagnosis, we analyzed the potential implications of this variability on the classification of glycemic status based on current plasma FG-based diagnostic guidelines. Among 5,328 individuals who would have been considered to have normal FG based on the first FG measurement, 40% and 3% would have been reclassified as having glucose in the prediabetes and diabetes ranges, respectively, based on sequential measurements throughout the study. Finally, we revealed associations between mean FG and various clinical measures. Our findings suggest that careful consideration is necessary when interpreting FG as substantial intraperson variability exists and highlight the potential impact of using CGM data to refine glycemic status assessment.
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Affiliation(s)
- Smadar Shilo
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
- The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ayya Keshet
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Hagai Rossman
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
- Pheno.AI, Tel-Aviv, Israel
| | - Anastasia Godneva
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Yeela Talmor-Barkan
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel
| | - Yaron Aviv
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel
| | - Eran Segal
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel.
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel.
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Hussein M, Saif A, Amin M, Khalafallah O, Hussien A, Aboulsoud S, Mousa S. Plasma Adiponectin and Its Correlation with Carotid Intima-Media Thickness in Obesity and in Type 2 Diabetes and Nonalcoholic Fatty Liver Disease. J Nutr Metab 2023; 2023:6661585. [PMID: 37692464 PMCID: PMC10484655 DOI: 10.1155/2023/6661585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 11/13/2022] [Accepted: 08/05/2023] [Indexed: 09/12/2023] Open
Abstract
Methods and Results The study included 200 Egyptian subjects. They were divided into four equal groups: group 1: obese patients with NAFLD and T2DM (O+/NAFLD+/DM+), group 2: nonobese patients with NAFLD and T2DM (O-/NAFLD+/DM+), group 3: obese nondiabetic patients with NAFLD (O+/NAFLD+/DM-), and group 4: nonobese healthy control subjects. Plasma adiponectin was measured using ELISA (enzyme-linked immunosorbent assay) technique. Ultrasonography was used to diagnose NAFLD. CIMT was assessed using Doppler ultrasonography. Plasma adiponectin was significantly lower and CIMT was significantly higher in O+/NAFLD+/DM+, as compared with O-/NAFLD+/DM+, O+/NAFLD+/DM-, and control subjects (p < 0.001 for all). A significant negative correlation was found between adiponectin and CIMT in obese patients with NAFLD (p < 0.05), but not in patients with NAFLD and T2DM. The significant independent predictors of CIMT were diabetes duration, BMI (body mass index), albumin/creatinine ratio, and cholesterol. Conclusion Plasma adiponectin is inversely correlated with CIMT in obese patients with NAFLD, but not in patients with NAFLD and T2DM. Hypoadiponectinemia could be a good indicator of cardiovascular risk in obese patients with NAFLD, with or without T2DM, but not in nonobese patients with NAFLD.
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Affiliation(s)
- Maha Hussein
- Internal Medicine Department, Cairo University, Giza, Egypt
| | - Aasem Saif
- Internal Medicine Department, Cairo University, Giza, Egypt
| | - Mona Amin
- Internal Medicine Department, Cairo University, Giza, Egypt
| | - Osama Khalafallah
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
| | - Ahmed Hussien
- Internal Medicine Department, Cairo University, Giza, Egypt
| | | | - Shrook Mousa
- Internal Medicine Department, Cairo University, Giza, Egypt
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AlGhibiwi HK, Sarawi WS, Alosaimi ME, Alhusaini AM, Assiri MA, Algarzae NK. The Association between Cardiovascular Risk Factors and Carotid Intima-Media Thickness in 42,726 Adults in UK Biobank: A Cross-Sectional Study. J Cardiovasc Dev Dis 2023; 10:358. [PMID: 37754787 PMCID: PMC10532383 DOI: 10.3390/jcdd10090358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Traditional modifiable cardiovascular risk factors, such as high blood pressure, have long been positively correlated with high carotid intima-media thickness (cIMT). However, traditional cardiovascular risk factors made a minor contribution to cIMT variance, meaning that other markers may be regarded as independent markers for increasing cIMT. AIMS To investigate the simple demographic patterns of carotid intima-media thickness (cIMT) in the UK Biobank and to identify which upstream cardiovascular disease (CVD) risk factors are independently associated with cIMT. METHODS AND RESULTS A cross-sectional-based study of healthy middle-aged people recruited in the UK between 2006 and 2010 (n = 42,726). RESULTS This study showed that the cardiovascular risk profile generally worsened across the cIMT quantiles from lowest to highest. The lowest cIMT quartile was defined as having a mean cIMT < 588 µm, while the highest cIMT quartile was defined as having a mean cIMT > 748 µm. Specifically, the highest cIMT quantile group had a worse CVD risk factors profile compared to the lowest cIMT quantile group. It was found that, for every one SD increase in age and systolic blood pressure, the mean cIMT increased by 0.357 SD and 0.115 SD, respectively. CONCLUSION Systolic blood pressure and age were the strongest independent risk factors for a high cIMT value compared to other risk factors.
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Affiliation(s)
- Hanan K. AlGhibiwi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11149, Saudi Arabia; (W.S.S.); (A.M.A.); (M.A.A.)
| | - Wedad S. Sarawi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11149, Saudi Arabia; (W.S.S.); (A.M.A.); (M.A.A.)
| | - Manal E. Alosaimi
- Department of Basic Health Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Ahlam M. Alhusaini
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11149, Saudi Arabia; (W.S.S.); (A.M.A.); (M.A.A.)
| | - Mohammed A. Assiri
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11149, Saudi Arabia; (W.S.S.); (A.M.A.); (M.A.A.)
| | - Norah K. Algarzae
- Department of Physiology, College of Medicine, King Saud University, Riyadh 11149, Saudi Arabia;
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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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Gao Y, Xu B, Yang Y, Zhang M, Yu T, Zhang Q, Sun J, Liu R. Association Between Serum Uric Acid and Carotid Intima-Media Thickness in Different Fasting Blood Glucose Patterns: A Case-Control Study. Front Endocrinol (Lausanne) 2022; 13:899241. [PMID: 35712254 PMCID: PMC9197240 DOI: 10.3389/fendo.2022.899241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/07/2022] [Indexed: 12/03/2022] Open
Abstract
Our objective was to analyze the correlation between serum uric acid (SUA) levels and carotid intima-media thickness (CIMT) and explore the relationship between SUA and carotid atherosclerosis in different glucose metabolism patterns. A total of 614 patients were enrolled in this case-control study, including 406 in the normouricemia group and 208 in the hyperuricemia group. The two groups were each divided into three groups according to fasting blood glucose (FBG) level: normal, impaired fasting glucose (IFG), and diabetes mellitus (DM). CIMT and the CIMT thickening rate in the hyperuricemia group were significantly higher than those in the normouricemia group: 0.17 (0.11-0.24) cm vs. 0.12 (0.08-0.15) cm and 73.56% vs. 51.97% (p < 0.001). Pearson's correlation analysis showed that age, systolic blood pressure (SBP), diastolic blood pressure, FBG, triglyceride, SUA, creatinine, and blood urea nitrogen were positively correlated with CIMT, whereas high-density lipoprotein cholesterol and total cholesterol were negatively correlated with CIMT. Multiple linear regression analysis showed that age, SUA, FBG, and SBP were independent factors that affected CIMT. Furthermore, age and SBP were independent factors in the normouricemia group, and FBG was an independent factor that affected CIMT in the hyperuricemia group (p < 0.05). In the hyperuricemia group, CIMT in the DM group was significantly higher than that in the normal group [0.20 (0.14-0.25)cm vs. 0.15 (0.1-0.25); p < 0.05], and the CIMT thickening rate in the DM group was significantly higher than those in the IFG and normal groups (90.38% vs. 78.38%, 90.38% vs. 65.81%; p < 0.05). The ROC curve analysis showed that uric acid combined with age, SBP, and FBG had the highest area under the curve (AUC) for predicting CIMT thickening [0.855 (95% confidence interval (CI): 0.804-0.906)], followed by uric acid combined with FBG [AUC: 0.767 (95% CI: 0.726-0.808)]. In conclusion, SUA was closely associated with an increase in CIMT in patients with specific FBG metabolic patterns and may be an independent risk factor for carotid atherosclerosis. SUA, especially in combination with other factors (such as age, SBP, FBG), may serve as a specific model to help predict the incidence of CIMT thickening. Clinical Trial Registration: http://www.chictr.org.cn, identifier ChiCTR2000039124.
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Affiliation(s)
- Yuanyuan Gao
- Department of VIP Unit, China-Japan Union Hospital of Jilin University, Changchun, China
- Department of Endocrinology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Baofeng Xu
- Department of Stroke Center, First Hospital of Jilin University, Changchun, China
| | - Yanyan Yang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Mei Zhang
- Department of VIP Unit, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Tian Yu
- Department of VIP Unit, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Qiujuan Zhang
- Department of VIP Unit, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jianwei Sun
- Department of Neurosurgery, Weifang People’s Hospital, Weifang, China
| | - Rui Liu
- Department of VIP Unit, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Rui Liu,
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Carotid Ultrasound Screening Programs in Rural Communities: A Systematic Review. J Pers Med 2021; 11:jpm11090897. [PMID: 34575673 PMCID: PMC8465856 DOI: 10.3390/jpm11090897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 01/04/2023] Open
Abstract
Carotid atherosclerosis assessments inform about stroke and cardiovascular risk. It is known that stroke and cardiovascular disease (CVD) prevalence is higher in rural communities than in urban communities. We aimed to conduct a systematic review of rural carotid ultrasound screening programs to define carotid atherosclerosis using traditional and emerging imaging biomarkers, prevalence, and risk factors. We searched Ovid/MEDLINE, Ovid/EMBASE, SCOPUS and CINAHL from inception to 3 April 2020 for rural population studies that utilized carotid ultrasound screening for adults ≥40 years of age and free of known cerebrovascular disease. Studies were included if participants received a bilateral ultrasound scanning of the carotid arteries and reported at least one marker of carotid atherosclerosis pathology. A random effect meta-analyses calculated the estimated prevalence of carotid plaque. In total, 22/3461 articles that met all of the inclusion criteria were included. Studies reported increased intima media thickness (IMT), carotid plaque presence and carotid artery stenosis. There were no studies reporting on novel imaging markers, such as carotid stiffness, carotid plaque morphology or neovascularization. The overall random effect pooled prevalence of carotid plaque was 34.1% (95% CI, 33.6–35.0); the prevalence of increased IMT was 11.2–41.5%, and the prevalence of carotid artery stenosis was 0.4–16.0%. There is an absence of data necessary to understand the carotid atherosclerosis prevalence across global rural populations. Represented studies have focused on East Asian countries where a high burden of rural carotid artery disease has been reported. There is no rural evidence to guide the use of novel ultrasound carotid biomarkers such as stiffness or neovascularization.
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Liu M, Jia J, Fan F, Sun P, Wu Z, Jiang Y, He D, Liu B, Yang Y, Zhang Y. Association of depressive symptoms with the progression of carotid intima-media thickness in a community-based cohort in Beijing, China. BMJ Open 2021; 11:e050254. [PMID: 34404713 PMCID: PMC8372881 DOI: 10.1136/bmjopen-2021-050254] [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: 02/15/2021] [Accepted: 08/03/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To determine the relationship between depressive symptoms and progression of carotid intima-media thickness (cIMT) in a Beijing community-based population. DESIGN Prospective cohort study between 2014 and 2018. SETTING Dwellers without cardiovascular disease, hypertension or diabetes from a Beijing community. PARTICIPANTS 3849 Chinese community-dwelling individuals who underwent baseline screening for depressive symptoms were invited to participate in the study in 2014 and follow-up visit in 2018. Among them, 2124 participants completed carotid ultrasound examination both at baseline and a follow-up visit. After further excluding patients with a history of stroke, myocardial infarction or lower extremity arterial stenosis and those with a diagnosis of hypertension or diabetes and ankle-brachial index ≤0.9 at baseline, 1011 eligible participants were finally included. PRIMARY OUTCOME MEASURE The rate of mean cIMT change. RESULTS Over a median follow-up period of 4.40 years, the overall rate of mean cIMT change was 2.23% (-5.64% to 9.51%). After adjustment for 13 covariates, there was an increase of 2.36% (β=2.36, 95% CI: 0.37 to 4.36, p=0.020) for the rates of mean cIMT change in the depressive group compared with the control group. Furthermore, this association was modified by drinking status (β=3.22, 95% CI: 1.25 to 5.19, P-interaction=0.006). CONCLUSION Depressive symptoms were independently associated with progression of mean cIMT in a community-based cohort in Beijing, China. Furthermore, this relationship was modified by drinking status.
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Affiliation(s)
- Mengyuan Liu
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Jia Jia
- Department of cardiology, Peking University First Hospital, Beijing, China
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Pengfei Sun
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Zhongli Wu
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yimeng Jiang
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Danmei He
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Bo Liu
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Ying Yang
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
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Rinkūnienė E, Dženkevičiūtė V, Petrulionienė Ž, Majauskienė E, Ryliškytė L, Puronaitė R, Badarienė J, Navickas R, Laucevičius A. Hypertriglyceridemia impact on arterial parameters in patients with metabolic syndrome. BMC Cardiovasc Disord 2021; 21:393. [PMID: 34388967 PMCID: PMC8361842 DOI: 10.1186/s12872-021-02202-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/09/2021] [Indexed: 12/14/2022] Open
Abstract
Background The development of metabolic syndrome (MS) augments risk for atherosclerotic cardiovascular disease (CVD), but pathophysiological mechanisms of this relation are still under discussion. Overlapping CVD risk factors make it difficult to assess the importance of individual elements. This study aimed to analyze subclinical atherosclerosis based on arterial structure and function parameters in patients with MS and different triglycerides levels. Methods Patients (aged 40–65 years) were divided into two groups: patients with MS and with or without hypertriglyceridemia (hTG). Noninvasive assessment of vascular parameters—aortic augmentation index adjusted for heart rate 75 bpm (AIxHR75), pulse wave velocity (PWV), and common carotid artery intima-media thickness (cIMT) were performed. Results Carotid-femoral PWV (cfPWV) and carotid-radial PWV (crPWV) were significantly higher in patients with hTG. After adjusting for age, gender, waist circumference, fasting glucose, smoking status, cardiovascular family history and mean arterial pressure, crPWV (OR 1.150; CI 95% 1.04–1.28), cfPWV (OR 1.283; CI 95% 1.14–1.42) and cIMT (OR 1.13; CI 95% 1.02–1.25) were significantly associated with hTG (p < 0.05), while AIxHR75 did not show significant association. Conclusion Increased triglycerides are independently associated with a cfPWV, crPWV, and cIMT and may modify CVD risk in patients with MS. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02202-3.
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Affiliation(s)
- Egidija Rinkūnienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Vilma Dženkevičiūtė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Žaneta Petrulionienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Eglė Majauskienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania.
| | - Ligita Ryliškytė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Roma Puronaitė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania.,Faculty of Mathematics and Informatics, Vilnius University, Vilnius, Lithuania
| | - Jolita Badarienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Rokas Navickas
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Aleksandras Laucevičius
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania.,State Research Institute Centre of Innovative Medicine, Vilnius, Lithuania
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Park HB, Gwark JY, Kam M, Jung J. Association between fasting glucose levels and adhesive capsulitis in a normoglycemic population: a case-control study. J Shoulder Elbow Surg 2020; 29:2240-2247. [PMID: 32713668 DOI: 10.1016/j.jse.2020.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/14/2020] [Accepted: 03/20/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hyperglycemia is the most commonly cited risk factor for adhesive capsulitis. However, no study has established whether fasting glucose levels within the normoglycemic range are associated with idiopathic adhesive capsulitis (IAC). This study hypothesized that increments of fasting glucose levels within the normoglycemic range would be linked to IAC. This study investigated any association between normoglycemic fasting glucose levels and IAC. METHODS This case-control study comprised a group of 151 patients with IAC without intrinsic shoulder lesions, extrinsic causes, or known metabolic risk factors such as diabetes, dyslipidemia, and thyroid dysfunction. The control group comprised 453 age- and sex-matched persons seeking general check-ups at the authors' health promotion center during the same period as the case group. Control subjects had normal shoulder function, no previous diagnosis of adhesive capsulitis or of metabolic disease, and no history of trauma or of shoulder surgery. The studied variables were body mass index, serum lipid profiles, thyroid hormone levels, fasting glucose levels, glycosylated hemoglobin A1c, and high-sensitivity C-reactive protein. Fasting glucose levels were studied as scale data and categorical data (<85, 85-89, 90-94, and 95-99 mg/dL). Multivariable conditional logistic regression analysis evaluated the matched sets of subjects. Odds ratios and 95% confidence intervals were determined for various potentially associated factors. RESULTS Fasting glucose level, hypercholesterolemia, and high-sensitivity C-reactive protein were significantly associated with IAC (P ≤ .030). Fasting glucose levels in the <85 mg/dL quartile were significantly negatively associated with IAC (P ≤ .001). In contrast, fasting glucose levels in the 90-94 mg/dL quartile or higher were significantly positively associated with IAC (P ≤ .034). CONCLUSION IAC is positively associated with fasting glucose levels of 90-99 mg/dL, which are currently considered normoglycemic.
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Affiliation(s)
- Hyung Bin Park
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea; Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.
| | - Ji-Yong Gwark
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Mincheol Kam
- Department of Orthopaedic Surgery, Himchan Hospital, Changwon, Republic of Korea
| | - Jaehoon Jung
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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Nonterah EA, Boua PR, Klipstein-Grobusch K, Asiki G, Micklesfield LK, Agongo G, Ali SA, Mashinya F, Sorgho H, Nakanabo-Diallo S, Debpuur C, Kyobutungi C, Alberts M, Norris S, Tollman S, Tinto H, Soo CC, Mukomana F, Hazelhurst S, Wade AN, Kahn K, Oduro AR, Grobbee DE, Sankoh O, Ramsay M, Bots ML, Crowther NJ. Classical Cardiovascular Risk Factors and HIV are Associated With Carotid Intima-Media Thickness in Adults From Sub-Saharan Africa: Findings From H3Africa AWI-Gen Study. J Am Heart Assoc 2019; 8:e011506. [PMID: 31304842 PMCID: PMC6662137 DOI: 10.1161/jaha.118.011506] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Studies on the determinants of carotid intima-media thickness ( CIMT ), a marker of sub-clinical atherosclerosis, mostly come from white, Asian, and diasporan black populations. We present CIMT data from sub-Saharan Africa, which is experiencing a rising burden of cardiovascular diseases and infectious diseases. Methods and Results The H3 (Human Hereditary and Health) in Africa's AWI-Gen (African-Wits-INDEPTH partnership for Genomic) study is a cross-sectional study conducted in adults aged 40 to 60 years from Burkina Faso, Kenya, Ghana, and South Africa. Cardiovascular disease risk and ultrasonography of the CIMT of right and left common carotids were measured. Multivariable linear and mixed-effect multilevel regression modeling was applied to determine factors related to CIMT. Data included 8872 adults (50.8% men), mean age of 50±6 years with age- and sex-adjusted mean (±SE) CIMT of 640±123μm. Participants from Ghana and Burkina Faso had higher CIMT compared with other sites. Age (β = 6.77, 95%CI [6.34-7.19]), body mass index (17.6[12.5-22.8]), systolic blood pressure (7.52[6.21-8.83]), low-density lipoprotein cholesterol (5.08[2.10-8.06]) and men (10.3[4.75- 15.9]) were associated with higher CIMT. Smoking was associated with higher CIMT in men. High-density lipoprotein cholesterol (-12.2 [-17.9- -6.41]), alcohol consumption (-13.5 [-19.1--7.91]) and HIV (-8.86 [-15.7--2.03]) were inversely associated with CIMT. Conclusions Given the rising prevalence of cardiovascular diseases risk factors in sub-Saharan Africa, atherosclerotic diseases may become a major pan-African epidemic unless preventive measures are taken particularly for prevention of hypertension, obesity, and smoking. HIV -specific studies are needed to fully understand the association between HIV and CIMT in sub-Saharan Africa.
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Affiliation(s)
- Engelbert A Nonterah
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana.,2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Palwende R Boua
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso.,4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Kerstin Klipstein-Grobusch
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands.,6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Gershim Asiki
- 10 African Population and Health Research Centre (APHRC) Nairobi Kenya
| | - Lisa K Micklesfield
- 7 MRC/Wits Developmental Pathways for Health Research Unit Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Godfred Agongo
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | - Stuart A Ali
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Felistas Mashinya
- 11 Dikgale Health Demographic Surveillance Site Department of Pathology and Medical Sciences School of Health Care Sciences Faculty of Health Sciences University of Limpopo Polokwane South Africa
| | - Herman Sorgho
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Seydou Nakanabo-Diallo
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Cornelius Debpuur
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | | | - Marianne Alberts
- 11 Dikgale Health Demographic Surveillance Site Department of Pathology and Medical Sciences School of Health Care Sciences Faculty of Health Sciences University of Limpopo Polokwane South Africa
| | - Shane Norris
- 7 MRC/Wits Developmental Pathways for Health Research Unit Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Stephen Tollman
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Halidou Tinto
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Cassandra C Soo
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Freedom Mukomana
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Scott Hazelhurst
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Alisha N Wade
- 8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Kathleen Kahn
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Abraham R Oduro
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | - Diederick E Grobbee
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Osman Sankoh
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Michèle Ramsay
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Michiel L Bots
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Nigel J Crowther
- 9 Department of Chemical Pathology National Health Laboratory Services (NHLS) Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
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11
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Liu M, Ao L, Hu X, Ma J, Bao K, Gu Y, Zhao J, Huang W. Influence of blood glucose fluctuation, C-peptide level and conventional risk factors on carotid artery intima-media thickness in Chinese Han patients with type 2 diabetes mellitus. Eur J Med Res 2019; 24:13. [PMID: 30782217 PMCID: PMC6381641 DOI: 10.1186/s40001-019-0370-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/02/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Some studies have suggested that blood glucose fluctuation and C-peptide level were considered as predictive factors for carotid artery intima-media thickness (CIMT). However, the relationships of these variables are unclear. This research was aimed to identify the potential effects of blood glucose fluctuation, C-peptide level and conventional risk factors on CIMT. METHODS A total of 280 type 2 diabetes mellitus (T2DM) patients were enrolled into this study. Population characteristics were obtained through medical history and clinical parameters. The patients were divided into two groups according to the critical value of CIMT (0.9). Research data were analyzed to identify risk factors of CIMT between the two groups. RESULTS The comparison results of basic information showed that differences in age and illness years between the two groups were statistically significant (p = 0.0002 and p = 0.0063). Logistic regression analysis results indicated that smoking, uric acid (UA) levels, 2 h C-peptide and standard deviation of blood glucose (SDBG) were the influence factors for CIMT thickening (p = 0.032, p = 0.047, p = 0.049 and p = 0.042, respectively). Blood glucose fluctuation could affect the risk of some complications. In largest amplitude of glycemic excursions (LAGE) > 4.4 group, the CIMT abnormal rate was 27.10%, which was significantly higher than 12.12% in the LAGE ≤ 4.4 group (p = 0.012). The CIMT abnormal rate of SDBG > 2.0 group was 27.81%, which was significantly higher than that of the SDBG ≤ 2.0 group (p = 0.018). CONCLUSIONS Blood glucose fluctuation is an independent risk factor associated with CIMT in T2DM patients, in addition to conventional risk factors, such as smoking, high UA level and 2 h C-peptide. Therefore, more attention should be given to the change of CIMT and the complications.
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Affiliation(s)
- Min Liu
- Department of Scientific Research, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Li Ao
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Cheng Bei Road, Jiading District, Shanghai, 201800, China
| | - Xinyu Hu
- The Former Dalian Sanatorium of Shenyang Military Region, Dalian, Liaoning, China
| | - Jianning Ma
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Cheng Bei Road, Jiading District, Shanghai, 201800, China.
| | - Kena Bao
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Cheng Bei Road, Jiading District, Shanghai, 201800, China
| | - Ye Gu
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Cheng Bei Road, Jiading District, Shanghai, 201800, China
| | - Jing Zhao
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Cheng Bei Road, Jiading District, Shanghai, 201800, China
| | - Weiping Huang
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Cheng Bei Road, Jiading District, Shanghai, 201800, China.
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12
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Khanna NN, Jamthikar AD, Araki T, Gupta D, Piga M, Saba L, Carcassi C, Nicolaides A, Laird JR, Suri HS, Gupta A, Mavrogeni S, Kitas GD, Suri JS. Nonlinear model for the carotid artery disease 10-year risk prediction by fusing conventional cardiovascular factors to carotid ultrasound image phenotypes: A Japanese diabetes cohort study. Echocardiography 2019; 36:345-361. [PMID: 30623485 DOI: 10.1111/echo.14242] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 12/04/2018] [Indexed: 12/11/2022] Open
Abstract
MOTIVATION This study presents a novel nonlinear model which can predict 10-year carotid ultrasound image-based phenotypes by fusing nine traditional cardiovascular risk factors (ethnicity, gender, age, artery type, body mass index, hemoglobin A1c, hypertension, low-density lipoprotein, and smoking) with five types of carotid automated image phenotypes (three types of carotid intima-media thickness (IMT), wall variability, and total plaque area). METHODOLOGY Two-step process was adapted: First, five baseline carotid image-based phenotypes were automatically measured using AtheroEdge™ (AtheroPoint™ , CA, USA) system by two operators (novice and experienced) and an expert. Second, based on the annual progression rates of cIMT due to nine traditional cardiovascular risk factors, a novel nonlinear model was adapted for 10-year predictions of carotid phenotypes. RESULTS Institute review board (IRB) approved 204 Japanese patients' left/right common carotid artery (407 ultrasound scans) was collected with a mean age of 69 ± 11 years. Age and hemoglobin were reported to have a high influence on the 10-year carotid phenotypes. Mean correlation coefficient (CC) between 10-year carotid image-based phenotype and age was improved by 39.35% in males and 25.38% in females. The area under the curves for the 10-year measurements of five phenotypes IMTave10yr , IMTmax10yr , IMTmin10yr , IMTV10yr , and TPA10yr were 0.96, 0.94, 0.90, 1.0, and 1.0. Inter-operator variability between two operators showed significant CC (P < 0.0001). CONCLUSIONS A nonlinear model was developed and validated by fusing nine conventional CV risk factors with current carotid image-based phenotypes for predicting the 10-year carotid ultrasound image-based phenotypes which may be used risk assessment.
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Affiliation(s)
- Narendra N Khanna
- Department of Cardiology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Ankush D Jamthikar
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Tadashi Araki
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Deep Gupta
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Matteo Piga
- Department of Rheumatology, University Clinic and AOU of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Carlo Carcassi
- Department of Genetics, University of Cagliari, Cagliari, Italy
| | - Andrew Nicolaides
- Department of Vascular Surgery, Imperial College, London, UK.,Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, California
| | | | - Ajay Gupta
- Department of Radiology and Feil Family Brain and Mind Research Institute, Weill Cornell Medical Center, New York, New York
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - George D Kitas
- Arthritis Research UK Centre for Epidemiology, Manchester University, Manchester, UK.,Director of Research & Development-Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, California
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13
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Oxidative DNA Damage and Carotid Intima Media Thickness as Predictors of Cardiovascular Disease in Prediabetic Subjects. J Cardiovasc Dev Dis 2018. [PMID: 29518984 PMCID: PMC5872363 DOI: 10.3390/jcdd5010015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Prediabetes is considered as a risk factor for the development of diabetes mellitus and cardiovascular disease. The present study was conducted with the aim of finding out the relationship between oxidative DNA damage and carotid intima media thickness for the prediction of cardiovascular disease in prediabetic subjects. The study included 100 prediabetic subjects and 100 normal individuals as controls. In both cases and controls, 8-OHdG was measured by ELISA, and CIMT was measured by B mode ultrasonography. Both 8-OHdG and CIMT were significantly higher in subjects with prediabetes as compared to controls (185.80 ± 10.72 pg/mL vs. 126.13 ± 16.01 pg/mL, p < 0.001 and 0.70 ± 0.04 mm vs. 0.57 ± 0.03 mm, p < 0.001, respectively). There was significant and positive correlation of IGT with 8-OHdG (r = 0.783; p < 0.001) and CIMT (r = 0.787; p < 0.001) in prediabetic subjects. Moreover, 8-OHdG showed significant positive correlation with CIMT (r = 0.704; p < 0.001) in prediabetic subjects. In conclusion, increased 8-OHdG and CIMT in prediabetic subjects indicate that biochemical changes of atherosclerosis start even before the onset of diabetes mellitus. Hence, 8-OHdG and CIMT could be used as indicators of cardiovascular disease risk in these subjects.
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14
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Gao L, Bai L, Shi M, Ni J, Lu H, Wu Y, Tu J, Ning X, Wang J, Li Y. Association between carotid intima-media thickness and fasting blood glucose level: A population-based cross-sectional study among low-income adults in rural China. J Diabetes Investig 2017; 8:788-797. [PMID: 28160451 PMCID: PMC5668475 DOI: 10.1111/jdi.12639] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/08/2017] [Accepted: 01/25/2017] [Indexed: 12/29/2022] Open
Abstract
Aims/Introduction Carotid intima‐media thickness (CIMT) is an established predictor of cardiovascular disease and stroke. We aimed to identify the association between CIMT and blood glucose, as well as the risk factors associated with increased CIMT in a low‐income Chinese population. Materials and Methods Stroke‐free and cardiovascular disease‐free residents aged ≥45 years were recruited. B‐mode ultrasonography was carried out to measure CIMT. Results There were 2,643 participants (71.0%) in the normal group, 549 (14.7%) in the impaired fasting glucose group and 533 (14.3%) in the diabetes mellitus group. The determinants of increased CIMT were older age; male sex; low education; hypertension; smoking; high levels of systolic blood pressure, fasting blood glucose and low‐density lipoprotein cholesterol; and low levels of diastolic blood pressure, triglycerides and high‐density lipoprotein cholesterol, after adjusting for covariates. Age and hypertension were the common risk factors for increased CIMT in all three groups. Furthermore, male sex, smoking and high low‐density lipoprotein cholesterol level were positively associated with the mean CIMT in the normal group; high triglycerides levels were negatively associated with the mean CIMT in the impaired fasting glucose group; and alcohol consumption was an independent risk factor for mean CIMT in the diabetes mellitus group. Hypertension was the greatest risk factor for increased CIMT. Conclusions These findings suggest that it is crucial to manage and control traditional risk factors in low‐income populations in China in order to decelerate the recent dramatic increase in stroke incidence, and to reduce the burden of stroke.
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Affiliation(s)
- Liu Gao
- Department of Endocrinology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lingling Bai
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Heping District, Tianjin, China
| | - Min Shi
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Heping District, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Heping District, Tianjin, China
| | - Hongyan Lu
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Heping District, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Heping District, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Heping District, Tianjin, China.,Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Heping District, Tianjin, China.,Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Yukun Li
- Department of Endocrinology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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