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Stevens B, Abdool-Carrim T, Woodiwiss AJ. Left versus right carotid artery IMT: differential impact of age, gender, and cardiovascular risk factors. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024:10.1007/s10554-024-03245-1. [PMID: 39325213 DOI: 10.1007/s10554-024-03245-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 09/16/2024] [Indexed: 09/27/2024]
Abstract
Carotid artery intima-media thickness (IMT), an important clinical marker of atherosclerosis, is used widely in screening for cardiovascular risk and prognosis. Measurements of carotid artery IMT are made on both the left and right sides of the body, however as per the Mannheim consensus, an average of these measurements is usually reported. Nevertheless, there is considerable debate whether there are side differences in the carotid artery IMT in terms of both measurements and determinants. In a large sample of Caucasian patients (n = 1888) referred for cardiovascular risk assessment, we compared the left and the right common carotid artery IMT measurements, and assessed whether age, gender and cardiovascular risk factors have differential effects. We found that the left common carotid artery IMT (0.7141 ± 0.1733 mm) is larger than the right (0.6861 ± 0.1594, p < 0.0001), but not in the young (< 30 years) or the elderly (> 69 years), and that this side difference is less in women (0.019 ± 0.116 mm) than in men (0.036 ± 0.148 mm, p < 0.001). In addition to age (p < 0.0001) and gender (p < 0.0001), the left common carotid artery IMT was determined by dyslipidaemia (protective, p = 0.016) and diabetes mellitus (p = 0.022); whereas the right common carotid artery IMT was determined by hypertension (p = 0.0002). The differential determinants of left versus right common carotid artery IMT were similar in men and women, and in young and old. In conclusion, side differences in measurements of the common carotid artery IMT depend upon age and gender. In addition, cardiovascular risk factors have differential effects on the left and right common carotid artery IMT.
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Affiliation(s)
- Belinda Stevens
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand Medical School, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Talib Abdool-Carrim
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand Medical School, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Angela J Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand Medical School, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
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Wang Z, Barinas-Mitchell E, Brooks MM, Crawford SL, Leis AM, Derby CA, Thurston RC, Hedderson MM, Janssen I, Jackson EA, McConnell DS, El Khoudary SR. HDL-C criterion of the metabolic syndrome and future diabetes and atherosclerosis in midlife women: The SWAN Study. Am J Prev Cardiol 2024; 19:100687. [PMID: 39070021 PMCID: PMC11279330 DOI: 10.1016/j.ajpc.2024.100687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/21/2024] [Accepted: 06/12/2024] [Indexed: 07/30/2024] Open
Abstract
Objective High-density lipoprotein cholesterol (HDL-C) is one of 5 components [high blood pressure, glucose, triglycerides, waist circumference, low HDL-C], 3 of which, needed to diagnose metabolic syndrome (MetS). Evolving research shows that higher HDL-C is not necessarily cardioprotective in midlife women, supporting a need to re-evaluate HDL-C's contribution to risks related to MetS. We tested whether risk of future diabetes and higher carotid intima-media thickness (cIMT) differ by HDL-C status in midlife women diagnosed with MetS based on the other 4 components. Methods Midlife women were classified into 3 groups 1) no MetS, 2) MetS with HDL-C ≥ 50 mg/dL (MetS hiHDL), and 3) MetS with HDL-C < 50 mg/dL (MetS loHDL). cIMT was measured 13.8 ± 0.6 years post baseline. Incident diabetes was assessed yearly. Results Among 2773 women (1350 (48 %) of them had cIMT), 2383 (86 %) had no MetS, 117 (4 %) had MetS hiHDL, 273 (10 %) had MetS loHDL. Compared with no MetS, both MetS- hiHDL and loHDL groups had higher cIMT and diabetes risk. Risk of having high cIMT did not differ between MetS loHDL vs. hiHDL groups. Adjusting for levels of MetS criteria other than HDL-C at baseline explained the associations of each of the two MetS groups with cIMT. Conversely, after adjustment, associations of MetS hiHDL and MetS loHDL with incident diabetes persisted. Conclusions In midlife women, HDL-C status matters for predicting risk of incident diabetes but not higher cIMT beyond other MetS components.
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Affiliation(s)
- Ziyuan Wang
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
| | - Maria M. Brooks
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
| | - Sybil L. Crawford
- Tan Chingfen Graduate School of Nursing, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Aleda M. Leis
- Department of Epidemiology, The University of Michigan, Ann Arbor, MI, USA
| | - Carol A. Derby
- Departments of Neurology, and of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rebecca C. Thurston
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Monique M. Hedderson
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA, USA
| | - Imke Janssen
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Elizabeth A. Jackson
- Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Samar R. El Khoudary
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh PA, USA
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Moe ÅM, Ytterstad E, Hopstock LA, Løvsletten O, Carlsen MH, Sørbye SH. Associations and predictive power of dietary patterns on metabolic syndrome and its components. Nutr Metab Cardiovasc Dis 2024; 34:681-690. [PMID: 38161114 DOI: 10.1016/j.numecd.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) defines important risk factors in the development of cardiovascular diseases and other serious health conditions. This study aims to investigate the influence of different dietary patterns on MetS and its components, examining both associations and predictive performance. METHODS AND RESULTS The study sample included 10,750 participants from the seventh survey of the cross-sectional, population-based Tromsø Study in Norway. Diet intake scores were used as covariates in logistic regression models, controlling for age, educational level and other lifestyle variables, with MetS and its components as response variables. A diet high in meat and sweets was positively associated with increased odds of MetS and elevated waist circumference, while a plant-based diet was associated with decreased odds of hypertension in women and elevated levels of triglycerides in men. The predictive power of dietary patterns derived by different dimensionality reduction techniques was investigated by randomly partitioning the study sample into training and test sets. On average, the diet score variables demonstrated the highest predictive power in predicting MetS and elevated waist circumference. The predictive power was robust to the dimensionality reduction technique used and comparable to using a data-driven prediction method on individual food variables. CONCLUSIONS The strongest associations and highest predictive power of dietary patterns were observed for MetS and its single component, elevated waist circumference.
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Affiliation(s)
- Åse Mari Moe
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elinor Ytterstad
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ola Løvsletten
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Monica H Carlsen
- Division of Nutritional Epidemiology, University of Oslo, Oslo, Norway
| | - Sigrunn H Sørbye
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, Tromsø, Norway
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Banks CA, Pearce BJ. Interventions in Carotid Artery Surgery: An Overview of Current Management and Future Implications. Surg Clin North Am 2023; 103:645-671. [PMID: 37455030 DOI: 10.1016/j.suc.2023.05.003] [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: 07/18/2023]
Abstract
Atherosclerotic carotid artery disease has been well studied over the last half-century by multiple randomized controlled trials attempting to elucidate the appropriate modality of therapy for this disease process. Surgical techniques have evolved from carotid artery endarterectomy and transfemoral carotid artery stenting to the development of hybrid techniques in transcarotid artery revascularization. In this article, the authors provide a review of the available literature regarding operative and medical management of carotid artery disease.
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Affiliation(s)
- Charles Adam Banks
- Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, 1808 7th Avenue South, Boshell Diabetes Building 652, Birmingham, AL 35294, USA
| | - Benjamin J Pearce
- Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, 1808 7th Avenue South, Boshell Diabetes Building 652, Birmingham, AL 35294, USA.
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Analysis of Risk Factors for Vulnerable Plaque Formation and Pathogenic in Carotid Artery. J Craniofac Surg 2023; 34:e182-e186. [PMID: 36036515 DOI: 10.1097/scs.0000000000008953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/10/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The formation of vulnerable carotid artery plaque may be closely related to a single factor or caused by multiple factors. This paper discusses the pathogenic risk factors for vulnerable plaque in patients with severe internal carotid artery (ICA) stenosis who received endarterectomy through regression analysis. MATERIALS AND METHODS A total of 98 patients with a complete clinical and laboratory assessment underwent carotid endarterectomy. Metabolic syndrome (MetS) and MetS components, ICA plaque thickness and ICA peak systolic velocity, previous ischemic stroke or transient ischemic attack (TIA), and other risk factors were included in the pathogenic risk factor for vulnerable plaque. Univariate logistic regression analysis was used to determine vulnerable carotid plaque risk factors. If P <0.2, it was considered potential confounders. Binary logistic regression model was controlled for potential confounders. RESULTS Among the 98 patients, stable carotid plaques 38 (39%) and unstable carotid plaques 60 (61%), male 76 (77.6%) and female 22 (22.4%), and Han Chinese 68 (68.4%) and Mongols 30 (30.6%). Univariate logistic regression to P <0.2 has 6 risk factors, which are previous ischemic stroke or TIA, ICA peak systolic velocity, ICA plaque thickness, body mass index, total cholesterol, and alcohol consumption. The significant result of the binary logistic regression analysis was the previous ischemic stroke or TIA (OR=4.52; 95% CI, 1.67-12.09), P =0.003 and ICA peak systolic velocity (OR=1.01; 95% CI, 1.00-1.02), P =0.014. CONCLUSIONS The patients with previous ischemic stroke or TIA and higher ICA peak systolic velocity are associated with vulnerable plaque pathogenic features. There is no obligatory association between MetS and formation of carotid plaque vulnerability.
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Zhan C, Wang Q, Chen Z, Pang H, Tu J, Ning X, Wang J, Fei S, Ji X. Association of metabolic syndrome with carotid atherosclerosis in low-income Chinese individuals: A population-based study. Front Cardiovasc Med 2022; 9:943281. [PMID: 36061552 PMCID: PMC9437543 DOI: 10.3389/fcvm.2022.943281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThis study aimed to explore the association of the presence and number of components of metabolic syndrome (MetS) with carotid atherosclerosis by measuring the presence of carotid plaque and total plaque area (TPA) in a population from a low-income area with high incidence of stroke of northern China.MethodsA cross-sectional study was conducted in a rural area of Tianjin, China from April 2014 to January 2015. The presence of plaque and TPA measurement was determined by carotid ultrasound. The presence and number of components of MetS was ascertained using the modified International Diabetes Federation criteria for the Asian population.ResultsAmong a total of 3,583 individuals aged ≥ 45 years, the overall prevalence of MetS was 54.5%. MetS and its components were related to the presence of carotid plaque as well as TPA. Multivariate analysis showed MetS was associated with a 20% higher risk of carotid plaque presence (95% confidence interval: 1.01, 1.42; P = 0.036) and an 18% increase in TPA (95% confidence interval: 0.08, 0.27; P < 0.001). The number of MetS components showed an increasing trend with the risk of carotid plaque presence and increased TPA. Among single components of MetS, high BP accounted for the largest proportion and was an independent risk factor of carotid plaque and increased TPA.ConclusionsAmong individuals aged 45 years or more, we confirmed MetS and its components were associated with carotid atherosclerosis in a low-income population of northern China. The presence of MetS and a higher number of MetS components exacerbated the risk of carotid atherosclerosis; among the five MetS components, high blood pressure was associated with the greatest risk. Targeted atherosclerosis prevention and intervention should include identification and treatment of MetS, especially high blood pressure.
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Affiliation(s)
- Changqing Zhan
- Department of Neurology, Wuhu No. 2 People's Hospital, Wuhu, China
| | - Qiao Wang
- Department of Pathology, Wuhu No. 2 People's Hospital, Wuhu, China
| | - Zongsheng Chen
- Department of Neurology, Wuhu No. 2 People's Hospital, Wuhu, China
| | - Hongbo Pang
- Department of Neurology, Wuhu No. 2 People's Hospital, Wuhu, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
- Jinghua Wang
| | - Shizao Fei
- Department of Neurology, Wuhu No. 2 People's Hospital, Wuhu, China
- Shizao Fei
| | - Xuelei Ji
- Department of Endocrinology, Wuhu No. 2 People's Hospital, Wuhu, China
- *Correspondence: Xuelei Ji
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Zhang Y, Zhang H. Identification of Biomarkers of Autophagy-Related Genes Between Early and Advanced Carotid Atherosclerosis. Int J Gen Med 2022; 15:5321-5334. [PMID: 35669594 PMCID: PMC9166959 DOI: 10.2147/ijgm.s350232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Accumulating evidence demonstrates that autophagy is important in inhibiting inflammation and cholesterol efflux. It suggested the autophagy may be a treatment of atherosclerosis. Thus, we screened autophagy-related mRNA to explore their mechanism of scientific basis for early diagnosis and therapy of atherosclerosis. Methods The GSE28829 datasets were assessed to analyze differentially expressed genes by GEO2R. And autophagy-related hub genes were identified by HADb. The biological function of autophagy-related DEmRNAs was examined by Metascape. The construction of a protein–protein network was explored by String. Cytohubba was utilized to screen hub genes. Analysis of DEmiRNA-mRNA pairs was executed by DIANA microT-CDS database. Finally, correlation analysis was carried out to identify the relationship between DEARGs and clinical and prognostic factors. Results A number of 1087 DEGs and 19 autophagy-related DEmRNAs were identified in advanced carotid atherosclerotic plaque compared with the early. The biological function containing development and growth was enriched. Moreover, we screened the top hub nodes with the highest degrees. MicroRNAs (miRNAs) are confirmed to participate in genesis and progression of atherosclerosis, so we further analyzed the miRNA–mRNA regulatory network genes with four hub genes to explore their potential mechanism in atherosclerosis. Then, we revealed co-expression of four key genes CTSB, ITGB1, CXCR4, TNFSF10 and autophagy-related genes. As for the clinical factors, hypertension factor showed higher expression of ITGB1. The probability of coronary heart disease factor was significantly increased with high expression of CTSB and CXCR4, as well as low expression of ITGB1 and TNFSF10. Diabetes factor tended to express distinguished levels of CTSB and ITGB1. TNFSF10 was highly expressed in both hyperlipidemia and ischemic stroke factor. Conclusion CTSB, ITGB1, CXCR4 and TNFSF10 may be critical in atherosclerosis development and were thought to be potential diagnostic biomarkers for atherosclerosis.
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Affiliation(s)
- Yuanyuan Zhang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - He Zhang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
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8
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Yang Q, Lin Q, Guo D, Wang H, Liu J, Zhang X, Tu J, Ning X, Yang Q, Wang J. Association of Carotid Intima Media Thickness With Metabolic Syndrome Among Low-Income Middle-Aged and Elderly Chinese: A Population-Based Cross-Sectional Study. Front Cardiovasc Med 2021; 8:669245. [PMID: 34869618 PMCID: PMC8639590 DOI: 10.3389/fcvm.2021.669245] [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: 02/19/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: We aimed to evaluate the relationship between metabolic syndrome (MetS) including its components and carotid intima media thickness (CIMT) in a low-income Chinese population aged ≥45 years. Methods: The participants underwent a general health screening and B-mode carotid ultrasonography that measured CIMT. The diagnosis of MetS and its components was based on the modified International Diabetes Federation Criteria for the Asian Population. The univariate and multivariable linear regression analyses were used to evaluate the relationship between MetS and CIMT. Results: A total of 3,583 participants (mean age, 60 years) was included in the analyses (41.4% male and 58.6% female); more than 50% of the participants were diagnosed with MetS. In the multivariable linear regression analysis, the mean CIMT was 0.009 mm greater in the participants with MetS than in those without MetS (β = 0.009; 95% CI, 0.003–0.014; P < 0.05). Moreover, a high number of MetS components was associated with greater CIMT values; for example, CIMT increased by 0.007 and 0.015 mm for the individuals diagnosed with 3–4 and 5 MetS components, respectively. Among the MetS components, elevated blood pressure (β = 0.022; 95% CI, 0.015–0.029; P < 0.001) and abdominal obesity (β = 0.008; 95% CI, 0.001–0.015; P < 0.001) were positively correlated with CIMT. However, the increased triglyceride levels were negatively associated with CIMT (β = −0.008; 95% CI: −0.015 to −0.002; P = 0.012), especially among the elderly population. Conclusions: The risk of carotid atherosclerosis increased in the presence of multiple MetS components in a low-income, middle-aged, and elderly population. Accordingly, more detailed management strategies are essential for the early prevention and intervention of atherosclerosis in this low-income population with MetS, in China.
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Affiliation(s)
- Qiaoxia Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
| | - Dandan Guo
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Hanhua Wang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
| | - Xin Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China.,Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China.,Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China.,Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
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9
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Buzas R, Ivan VS, Gheorghe-Fronea OF, Morgovan AF, Ardelean M, Albulescu N, Dorobantu M, Lighezan DF. Arterial Hypertension and Serum Uric Acid in Elderly- SEPHAR III Study. Arq Bras Cardiol 2021; 117:378-384. [PMID: 34495236 PMCID: PMC8395801 DOI: 10.36660/abc.20200004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 08/16/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hyperuricemia is a frequent finding in patients with arterial hypertension, and there is increasing evidence that this entity is also a risk factor for cardiovascular disease. OBJECTIVE In the context of an aging population, this study aims to evaluate serum uric acid levels and arterial hypertension prevalence and control in a subgroup of Romanian adults (>65 years), concerning the influence of age on these parameters. METHOD The study sample consists of 1,920 adults included in SEPHAR III survey, of whom 447 were elderly patients (>65 years of age). During the two study visits, three blood pressure (BP) measurements were performed at 1-min intervals and serum uric acid levels, kidney function by estimated glomerular filtration rate, blood pressure, and intima media thickness measurements were conducted. Hypertension and controls were defined according to the current guidelines. Intima-media thickness evaluation was assessed by B-mode Doppler ultrasound evaluation. A significance level p < 0.05 was adopted for the statistical analysis. RESULTS Adult patients had a significant lower serum uric acid levels, compared to elderly patients, regardless of glomerular filtration rate levels. Adult patients showed a significantly lower intima-media thickness levels, when compared to elderly patients. CONCLUSION Similar to previous studies, in the present study, age represented one of the factors contributing to the increased level of serum uric acid. An increasing prevalence of arterial hypertension with age, together with a poor control of blood pressure, was also obtained.
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Affiliation(s)
- Roxana Buzas
- University of Medicine and Pharmacy Victor Babes Timisoara - Department of Internal Medicine, Timisoara - Romênia
| | - Vlad-Sabin Ivan
- University of Medicine and Pharmacy Victor Babes Timisoara - Department of Internal Medicine, Timisoara - Romênia
| | | | - Adina Flavia Morgovan
- University of Medicine and Pharmacy Victor Babes Timisoara - Department of Internal Medicine, Timisoara - Romênia
| | - Melania Ardelean
- University of Medicine and Pharmacy Victor Babes Timisoara - Department of Internal Medicine, Timisoara - Romênia
| | - Nicolae Albulescu
- University of Medicine and Pharmacy Victor Babes Timisoara - Department of Internal Medicine, Timisoara - Romênia
| | - Maria Dorobantu
- Carol Davila University of Medicine and Pharmacy - Cardio-Thoracic Pathology Department, Bucuresti - Romênia
| | - Daniel Florin Lighezan
- University of Medicine and Pharmacy Victor Babes Timisoara - Department of Internal Medicine, Timisoara - Romênia
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10
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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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11
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Maloberti A, Bombelli M, Vallerio P, Milani M, Cartella I, Tavecchia G, Tognola C, Grasso E, Sun J, De Chiara B, Riccobono S, Grassi G, Giannattasio C. Metabolic syndrome is related to vascular structural alterations but not to functional ones both in hypertensives and healthy subjects. Nutr Metab Cardiovasc Dis 2021; 31:1044-1052. [PMID: 33549437 DOI: 10.1016/j.numecd.2020.11.011] [Citation(s) in RCA: 9] [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: 08/24/2020] [Revised: 11/01/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Metabolic Syndrome (MS) has been related to an impairment in arterial structural and functional properties with heterogeneous results. In this paper we focused on the effects of MS on arterial carotid-femoral PWV and common carotid IMT in two different populations, one of hypertensive patients and one of healthy controls. METHODS AND RESULTS We enrolled 816 consecutive HT and 536 healthy controls. Vascular structural (IMT) and functional (PWV) properties were evaluated. NCEP-ATP-III criteria were used for diagnosis of MS. MS was diagnosed in 26.9% and 6.9% in hypertensive and control subjects, respectively. PWV was similar in controls with and without MS (7.7 ± 1.9 vs 7.6 ± 1.1 m/s, p = 0.69), while IMT was higher in controls with than those without MS (0.64 ± 0.18 vs 0.57 ± 0.13 mm, p = 0.02). Hypertensives with MS were older (57.9 ± 12.2 vs 52.7 ± 14.1 years, p < 0.001) and showed higher PWV (9.0 ± 2.3 vs 8.4 ± 2.1 m/s, p = 0.001) and IMT (0.72 ± 0.22 vs 0.65 ± 0.17 mm, p < 0.001) than those without MS, however at the age-adjusted analysis only the difference in IMT was confirmed (p = 0.007). Regression models showed that MS was an independent determinant of IMT in both controls (β = 0.08, p = 0.03) and hypertensives (β = 0.08, p = 0.01), but not of PWV either in controls (β = 0.006, p = 0.886 and β = 0.04, p = 0.19, respectively). CONCLUSIONS the main finding of our work is that MS is a significant determinant of IMT while this is not the case for PWV. This result have been confirmed both in hypertensive subjects and in healthy controls.
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Affiliation(s)
- Alessandro Maloberti
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy.
| | - Michele Bombelli
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Paola Vallerio
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Martina Milani
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Iside Cartella
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | | | - Chiara Tognola
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Enzo Grasso
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Jinwei Sun
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Benedetta De Chiara
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Salvatore Riccobono
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Guido Grassi
- Health Science Department, Milano-Bicocca University, Milan, Italy
| | - Cristina Giannattasio
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; Health Science Department, Milano-Bicocca University, Milan, Italy
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12
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López-Melgar B, Varona JF, Ortiz-Regalón R, Sánchez-Vera I, Díaz B, Castellano JM, Parra Jiménez FJ, Fernández-Friera L. Carotid Plaque Burden by 3-Dimensional Vascular Ultrasound as a Risk Marker for Patients with Metabolic Syndrome. J Cardiovasc Transl Res 2021; 14:1030-1039. [PMID: 33768510 DOI: 10.1007/s12265-021-10121-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/08/2021] [Indexed: 01/21/2023]
Abstract
Our aim was to analyse the associations between carotid plaque burden (CPB), cardiovascular risk factors (CVRF), and surrogate markers of CV risk in subjects with metabolic syndrome (MetS). We consecutively included 75 asymptomatic outpatients with MetS components, <60 years old and non-smokers. We determined the presence of CVRF, left ventricular hypertrophy (LVH), carotid intima-media thickness (cIMT), albumin-creatinine ratio (ACR), coronary artery calcium score (CACS) and CPB by 3-dimensional vascular ultrasound (3DVUS) for comparison. A total of 50 (67%) subjects had MetS defined by harmonized criteria. A CPB >0 mm3 and a CACS >0 AU were the risk biomarkers most frequently observed (72% and 77%, respectively), followed by LVH (40%). CPB and CACS revealed association with cardiovascular risk (r = 0.308; p = 0.032 and r = 0.601 p < 0.01, respectively), and CPB also showed association with the burden of CVRF (r = 0.349; p = 0.014). CPB by 3DVUS was a prevalent CV risk marker, directly associated with CVRF and cardiovascular risk in MetS subjects.
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Affiliation(s)
- Beatriz López-Melgar
- Departamento de Cardiología, Hospital Universitario HM Montepríncipe, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Av. de Montepríncipe, 25, 28660 Boadilla del Monte, Madrid, Spain.
- Unidad de Imagen Cardiaca, Hospital Universitario de La Princesa, Diego de León st, 62, 28006, Madrid, Spain.
| | - José Felipe Varona
- Servicio de Medicina Interna, Hospital Universitario HM Montepríncipe, Madrid, Spain
- Facultad de Medicina, Universidad CEU-San Pablo, CEU Universities, Madrid, Spain
| | - Roberto Ortiz-Regalón
- Servicio de Medicina Interna, Hospital Universitario HM Montepríncipe, Madrid, Spain
| | - Isabel Sánchez-Vera
- Departamento Ciencias Médicas Básicas, Facultad de Medicina, Universidad CEU San Pablo, CEU Universities, Madrid, Spain
| | - Belén Díaz
- Departamento de Cardiología, Hospital Universitario HM Montepríncipe, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Av. de Montepríncipe, 25, 28660 Boadilla del Monte, Madrid, Spain
- Unidad de Imagen Cardiaca, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Madrid, Spain
| | - José María Castellano
- Departamento de Cardiología, Hospital Universitario HM Montepríncipe, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Av. de Montepríncipe, 25, 28660 Boadilla del Monte, Madrid, Spain
- Facultad de Medicina, Universidad CEU-San Pablo, CEU Universities, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Francisco Javier Parra Jiménez
- Departamento de Cardiología, Hospital Universitario HM Montepríncipe, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Av. de Montepríncipe, 25, 28660 Boadilla del Monte, Madrid, Spain
| | - Leticia Fernández-Friera
- Facultad de Medicina, Universidad CEU-San Pablo, CEU Universities, Madrid, Spain
- Unidad de Imagen Cardiaca, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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13
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Fan L, Yang Q, Zhang X, Lin Q, Guo D, Liu J, Tu J, Wang J, Li Y, Ning X. Sex -Specific Differences in the Association Between Metabolic Syndrome and Carotid Intima-Media Thickness Among a Low-Income Population in China: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:3263-3272. [PMID: 34290511 PMCID: PMC8289329 DOI: 10.2147/dmso.s313702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/26/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Carotid atherosclerosis is a well-established biomarker associated with future cardiovascular disease and stroke. We explored the influence of sex on the relationship between metabolic syndrome (MetS) and its components with carotid intima-media thickness (CIMT) among a low-income population in China, which has a high incidence of stroke. METHODS This population-based study recruited participants aged ≥45 years from rural areas of Tianjin, China between April 2014 and January 2015. Anthropometric characteristics and biochemical profiles were measured. CIMT was assessed using ultrasonography. Diagnosis of MetS and its components was made using the modified International Diabetes Federation criteria for the Asian population. A multivariate linear regression model was used to evaluate the effects of sex on the relationship between the presence of MetS and its components and CIMT. RESULTS A total of 3583 individuals (men, 41.4%; women, 58.6%) were included in the analyses. MetS was prevalent in 54.5% (men, 42.3%; women, 63.2%) of the participants. Mean CIMT was 0.57 ± 0.09 mm. In the multivariate analysis, for both sexes, CIMT increased significantly when MetS was present compared with when it was not (both P < 0.001). A common trend was observed in both sexes, in that CIMT increased as the number of MetS components increased, with β (95% confidence interval [CI]) = 0.021 (0.000, 0.042) for men and 0.014 (0.002, 0.026) for women (both P < 0.05). Of the five MetS components, elevated blood pressure was an independent risk factor for increased CIMT in both sexes (men: β = 0.013; 95% CI: 0.003, 0.023; P = 0.008; women: β = 0.024; 95% CI: 0.016, 0.033; P < 0.001). Moreover, abdominal obesity was also an independent risk factor for increased CIMT in men (β = 0.013; 95% CI: 0.003, 0.023; P = 0.008) but not in women. CONCLUSION The presence and number of components of MetS were associated with CIMT in both men and women. Sex differences were found in the impact of individual components of MetS on CIMT. Early identification and management of MetS according to sex-specific risk of MetS should be considered to reduce the prevalence and burden of carotid atherosclerosis in rural China, which has a high incidence of stroke, a known consequence of carotid atherosclerosis.
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Affiliation(s)
- Liming Fan
- Department of Medical Clinical Laboratory, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Qiaoxia Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Xin Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Dandan Guo
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Jie Liu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Yan Li
- Department of Anesthesiology, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
- Yan Li Department of Anesthesiology, Tianjin Jizhou People’s Hospital, 18 Nanhuan Road, Jizhou District, Tianjin, 301900, People’s Republic of ChinaTel/Fax +86-22- 60733586 Email
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
- Correspondence: Xianjia Ning Department of Neurology, Tianjin Medical University General Hospital, Laboratory of Epidemiology, Tianjin Neurological Institute & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of ChinaTel +86-22-60817505Fax +86-22-60817448 Email
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14
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Frigerio B, Werba JP, Amato M, Ravani A, Sansaro D, Coggi D, Vigo L, Tremoli E, Baldassarre D. Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials. Curr Pharm Des 2020; 26:11-24. [PMID: 31838990 DOI: 10.2174/1381612825666191213120339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/02/2019] [Indexed: 12/24/2022]
Abstract
In the present review, associations between traditional vascular risk factors (VRFs) and carotid intimamedial thickness progression (C-IMTp) as well as the effects of therapies for VRFs control on C-IMTp were appraised to infer causality between each VRF and C-IMTp. Cohort studies indicate that smoking, binge drinking, fatness, diabetes, hypertension and hypercholesterolemia are associated with accelerated C-IMTp. An exception is physical activity, with mixed data. Interventions for the control of obesity, diabetes, hypertension and hypercholesterolemia decelerate C-IMTp. Conversely, scarce information is available regarding the effect of smoking cessation, stop of excessive alcohol intake and management of the metabolic syndrome. Altogether, these data support a causative role of several traditional VRFs on C-IMTp. Shortcomings in study design and/or ultrasonographic protocols may account for most negative studies, which underlines the importance of careful consideration of methodological aspects in investigations using C-IMTp as the outcome.
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Affiliation(s)
| | - José P Werba
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | | | - Daniela Coggi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita di Milano, Milan, Italy
| | - Lorenzo Vigo
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Elena Tremoli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita di Milano, Milan, Italy
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Medical Biotechnology and Translational Medicine, Università di Milano, Milan, Italy
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15
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de Marañón AM, Iannantuoni F, Abad-Jiménez Z, Canet F, Díaz-Pozo P, López-Domènech S, Roldán-Torres I, Morillas C, Rocha M, Víctor VM. Association between Proinflammatory Markers, Leukocyte-Endothelium Interactions, and Carotid Intima-Media Thickness in Type 2 Diabetes: Role of Glycemic Control. J Clin Med 2020; 9:E2522. [PMID: 32764458 PMCID: PMC7465892 DOI: 10.3390/jcm9082522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
Glycated hemoglobin monitorization could be a tool for maintaining type 2 diabetes (T2D) under control and delaying the appearance of cardiovascular events. This cross-sectional study was designed to assess the role of glycemic control in modulating early-stage markers of cardiovascular complications. One hundred and eight healthy controls and 161 type 2 diabetic patients were recruited and distributed according to their glycemic control, setting the threshold at 6.5% (good control). Biochemical and anthropometrical parameters were registered during the initial visit, and peripheral blood was extracted to obtain polymorphonuclear cells and analyze inflammatory markers, adhesion molecules, leukocyte-endothelium interactions, and carotid intima-media thickness. Correlations between these parameters were explored. We found that inflammatory markers and adhesion molecules were augmented in type 2 diabetic subjects with poor glycemic control. Polymorphonuclear leukocytes interacted more with the endothelium in the diabetic population, and even more significantly in the poorly controlled subjects. In parallel, carotid intima-media thickness was also increased in the diabetic population, and the difference was greater among poorly controlled subjects. Finally, correlation measurement revealed that carotid intima-media thickness was related to glycemic control and lipid metabolism in diabetic patients. Our results suggest that glycemic control delays the onset of cardiovascular comorbidities in diabetic subjects.
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Affiliation(s)
- Aranzazu Martinez de Marañón
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
| | - Francesca Iannantuoni
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
| | - Zaida Abad-Jiménez
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
| | - Francisco Canet
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
| | - Pedro Díaz-Pozo
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
| | - Sandra López-Domènech
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
| | - Ildefonso Roldán-Torres
- Service of Cardiology, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain;
| | - Carlos Morillas
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
| | - Milagros Rocha
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
- Centro de Investigación Biomédica en Red (CIBERehd)—Department of Pharmacology, University of Valencia, 46010 Valencia, Spain
| | - Víctor M. Víctor
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (A.M.d.M.); (F.I.); (Z.A.-J.); (F.C.); (P.D.-P.); (S.L.-D.); (C.M.)
- Centro de Investigación Biomédica en Red (CIBERehd)—Department of Pharmacology, University of Valencia, 46010 Valencia, Spain
- Department of Physiology, University of Valencia, 46010 Valencia, Spain
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16
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The Effect of Metabolic Syndrome on the Occurrence of Restenosis After Carotid Endarterectomy. Eur J Vasc Endovasc Surg 2019; 58:805-812. [PMID: 31653610 DOI: 10.1016/j.ejvs.2019.06.008] [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: 12/05/2018] [Revised: 05/25/2019] [Accepted: 06/11/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease. The effect of MetS on clinical outcome in patients with cerebrovascular disease remains largely unknown because conflicting results have been published. This study aimed to determine the influence of MetS on the occurrence of restenosis after carotid endarterectomy (CEA). METHODS All patients who underwent CEA between June 2003 and December 2014 in two tertiary academic referral centres in The Netherlands were included. MetS was defined if three or more of the following criteria were present: hypertension, obesity, high fasting serum blood glucose, high serum triglycerides, or low serum high density lipoprotein cholesterol. The primary outcome measure was the occurrence of ipsilateral restenosis after index surgery. The secondary outcome measure was (all cause) mortality during follow up. For the primary analysis, missing data were multiply imputed using multivariable imputation by chained equations. A Cox proportional hazards model was used to perform an adjusted analysis on the multiply imputed data sets. RESULTS A total of 1668 CEA procedures (in 1577 patients) were performed. The presence or absence of MetS could not be determined in 263 patients because of missing data. There was no significant difference in freedom from restenosis in the MetS group vs. the no-MetS group (hazard ratio [HR], 1.10; 95% confidence interval [CI] 0.98-1.23; p = .10) or in all cause mortality (HR 1.20; 95% CI 0.94-1.54; p = .14). CONCLUSION This study shows that MetS does not predict restenosis after CEA. Also, the presence of MetS did not influence patient survival negatively.
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17
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Yang YJ, Park HJ, Won KB, Chang HJ, Park GM, Kim YG, Ann SH, Park EJ, Kim SJ, Lee SG. Relationship between the optimal cut-off values of anthropometric indices for predicting metabolic syndrome and carotid intima-medial thickness in a Korean population. Medicine (Baltimore) 2019; 98:e17620. [PMID: 31626142 PMCID: PMC6824692 DOI: 10.1097/md.0000000000017620] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Anthropometric measurements are simple and useful methods for predicting metabolic syndrome (MetS) because obesity is a predominant feature of MetS. Although carotid intima-medial thickness (IMT) is generally used to evaluate subclinical atherosclerosis, the relationship between the optimal cut-off anthropometric values for predicting MetS and carotid IMT has not been analyzed in a Korean population.Anthropometric measurements including waist circumference (WC), waist hip ratio (WHR), waist height ratio (WHtR), body mass index (BMI), and carotid IMT were assessed in 2560 Korean subjects without previous history of cardiovascular disease, cerebrovascular disease, neurological abnormalities, or malignancy who participated in baseline health examinations in a self-referral setting in the Seoul area between April 2010 and November 2012. MetS was defined using the National Cholesterol Education Program-Adult Treatment Panel III criteria.In both men and women, the levels of all anthropometric indices were significantly higher in subjects with MetS than in those without MetS. According to the receiver operating characteristic curve, the values of 80.8 cm for WC, 0.87 for WHR, 0.52 for WHtR, and 24.6 kg/m for BMI were the optimal cut-offs for predicting MetS in women. The values of 89.3 cm for WC, 0.90 for WHR, 0.52 for WHtR, and 25.1 kg/m for BMI were the optimal cut-offs for predicting MetS in men. After adjusting for confounding factors, the WC optimal cut-off values for predicting MetS were independently associated with carotid IMT in both women and men (women: β = 0.016, P = .008; men: β = 0.033, P = .009). The optimal BMI cut-off value was independently associated with carotid IMT in men only (β = 0.027, P = .032).Among anthropometric indices including WC, WHR, WHtR, and BMI, the WC optimal cut-off values for MetS were independently associated with an increased carotid IMT in both women and men in a Korean population.
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Affiliation(s)
- Yu Jin Yang
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Ho-Jong Park
- Division of Vascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Ki-Bum Won
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Hyuk-Jae Chang
- Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul
| | - Gyung-Min Park
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Yong-Giun Kim
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Soe Hee Ann
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Eun Ji Park
- Medical Information Center, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Shin-Jae Kim
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Sang-Gon Lee
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
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18
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Lu M, Peng P, Qiao H, Cui Y, Ma L, Cui B, Cai J, Zhao X. Association between age and progression of carotid artery atherosclerosis: a serial high resolution magnetic resonance imaging study. Int J Cardiovasc Imaging 2019; 35:1287-1295. [PMID: 30739271 DOI: 10.1007/s10554-019-01538-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/16/2019] [Indexed: 01/15/2023]
Abstract
This study aimed to investigate the association between age and progression of carotid atherosclerotic plaques using serial high resolution magnetic resonance imaging (MRI). Symptomatic patients who had carotid atherosclerosis with 30-70% stenosis were enrolled in this study. Carotid MRI was performed at baseline and follow-up time point (≥ 6 months after baseline), respectively. The characteristics of carotid plaque progression among different age groups (> 75 years old, 60-75 years old and < 60 years old) were compared. Logistic regression was performed to relate age with carotid plaque progression. Of recruited 84 patients, 73 (mean age, 66.5 ± 11.4 years old; males, 82.2%) with 96 plaques were included in the final analysis. Compared with younger patients, older ones had significantly higher incidence of calcification in carotid plaques (> 75 years old: 91.3%, 60-75 years old: 65.7% and < 60 years old: 55.3%, p = 0.013), greater annual change of carotid wall volume (> 75 years old: 39.0 (4.3-104.6) mm3, 60-75 years old: 28.7 (- 28.0 to 73.7) mm3 and < 60 years old: 4.8 (- 27.1-31.9) mm3, p = 0.032) and maximum carotid wall area (> 75 years old: 6.1 (- 3.5 to 17.2) mm2, 60-75 years old: 2.4 (- 4.7 to 15.1) mm2 and < 60 years old: 1.4 (- 5.8 to 6.9) mm2, p = 0.046). Age (OR 1.44; 95% CI 1.10-1.89; p = 0.009) and hypertension (OR 4.61; 95% CI 1.41-15. 02; p = 0.011) were independent predictors in discriminating upper quartile of annual change of carotid wall volume after adjusting for all clinical factors. Older patients have faster progression rate in carotid plaques than younger ones and age is independently associated with carotid plaque progression. Our findings suggest that the carotid plaques of older patients need to be monitored more frequently.
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Affiliation(s)
- Mingming Lu
- Department of Radiology, PLA General Hospital, Beijing, 100853, China.,Department of Radiology, Pingjin Hospital, Logistics University of Chinese People's Armed Police Forces, Tianjin, China
| | - Peng Peng
- Department of Radiology, Pingjin Hospital, Logistics University of Chinese People's Armed Police Forces, Tianjin, China
| | - Huiyu Qiao
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Yuanyuan Cui
- Department of Radiology, PLA General Hospital, Beijing, 100853, China
| | - Lu Ma
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Bao Cui
- Department of Radiology, Chinese PLA Bethune International Peace Hospital, Shijiazhuang, China
| | - Jianming Cai
- Department of Radiology, PLA General Hospital, Beijing, 100853, China.
| | - Xihai Zhao
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, 100084, China.
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19
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Burggraaf B, van Breukelen – van der Stoep DF, de Vries MA, Klop B, van Zeben J, van de Geijn GJM, van der Meulen N, Birnie E, Prinzen L, Castro Cabezas M. Progression of subclinical atherosclerosis in subjects with rheumatoid arthritis and the metabolic syndrome. Atherosclerosis 2018; 271:84-91. [DOI: 10.1016/j.atherosclerosis.2018.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/02/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
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20
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21
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Cuspidi C, Sala C, Tadic M, Gherbesi E, Grassi G, Mancia G. Association of metabolic syndrome with carotid thickening and plaque in the general population: A meta-analysis. J Clin Hypertens (Greenwich) 2018; 20:4-10. [PMID: 29194933 PMCID: PMC8031311 DOI: 10.1111/jch.13138] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 08/30/2017] [Accepted: 09/03/2017] [Indexed: 12/01/2022]
Abstract
We performed a meta-analysis of population studies reporting data on carotid intima-media thickness and plaque in patients with and without metabolic syndrome (MetS) to provide a new piece of information on the relationship of MetS with both phenotypes of vascular damage. The Ovid MEDLINE, PubMed, and Cochrane CENTRAL databases were searched without time restriction up to December 31, 2016. Overall, 19 696 patients (22.2% with MetS) were included in eight studies. Common carotid intima-media thickness was greater in patients with MetS compared with those without it (788 ± 47 μm vs 727 ± 44 μm), with a standard means difference of 0.28 ± 0.06 (P = .00003). Increased intima-media thickness in patients with MetS was paralleled by a higher prevalence of plaques. The present meta-analysis shows that MetS is associated with both ultrasonographic phenotypes of carotid damage. This finding is consistent with the view of MetS as a cluster of hemodynamic and nonhemodynamic factors promoting vascular hypertrophy and plaque.
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Affiliation(s)
- Cesare Cuspidi
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMilanoItaly
- Istituto Auxologico ItalianoMilanoItaly
| | - Carla Sala
- Department of Clinical Sciences and Community HealthUniversity of Milano and Fondazione Ospedale Maggiore Policlinico di MilanoMilanoItaly
| | - Marijana Tadic
- Department of CardiologyCharité‐University‐Medicine Campus Virchow KlinikumBerlinGermany
| | - Elisa Gherbesi
- Department of Clinical Sciences and Community HealthUniversity of Milano and Fondazione Ospedale Maggiore Policlinico di MilanoMilanoItaly
| | - Guido Grassi
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMilanoItaly
- Istituto di Ricerche a Carattere Scientifico MultimedicaMilanItaly
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22
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Wu TW, Hung CL, Liu CC, Wu YJ, Wang LY, Yeh HI. Associations of Cardiovascular Risk Factors with Carotid Intima-Media Thickness in Middle-Age Adults and Elders. J Atheroscler Thromb 2016; 24:677-686. [PMID: 27874838 PMCID: PMC5517541 DOI: 10.5551/jat.37895] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aims: Elevated carotid intima-media thickness (cIMT) is a preclinical phenotype of atherosclerotic diseases. There are significant sex differences in the morbidities of cardiovascular diseases and their major determinants, and we explored the sex-specific effects of cardiovascular factors on cIMT by a community-based study. Methods: We measured the cIMT and cardiovascular profiles of 1579 residents aged 40–74 years in northern Taiwan. Multivariate regression analyses were used to assess the effects and contributions of these factors on cIMT. Results: Males had significantly higher mean (± SD) of cIMT than females (0.668 ± 0.113 vs. 0.632 ± 0.100 nm, p < 0.0001). The common factors of the best-fit regression models in both sexes were age, BMI, and LDL-/HDL-C ratio; however, their contributions and effects were different. The partial coefficients of determination (r2) were 17.9, 5.8, and 4.1%, respectively, for males and were 27.8, 1.4, and 1.2%, respectively, for females. Test statistics showed that the regression coefficients of BMI and LDL-/HDL-C ratio of males were significantly higher than those of females. As compared with females, per 1.0 SD increases of BMI and LDL-/HDL-C in males resulted in 0.0971 (p = 0.030) and 0.1177 (p = 0.0087), respectively, SD increases in cIMT. There was no difference in the means of cIMT between pre- and post-menopausal women of the same age groups. Conclusions: There was a significant sex difference in cIMT. The contributions and effects of LDL-/HDL-C ratio and BMI on cIMT were more profound in males. Our findings indicate that sex-specific factors, but possibly not menstrual status-related factors, contribute to thicker cIMT.
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Affiliation(s)
- Tzu-Wei Wu
- Department of Medicine, Mackay Medical College
| | - Chung-Lieh Hung
- Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College
| | - Chun-Chieh Liu
- Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College
| | - Yih-Jer Wu
- Department of Medicine, Mackay Medical College.,Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College.,Institute of Biomedical Sciences, Mackay Medical College
| | - Li-Yu Wang
- Department of Medicine, Mackay Medical College.,Institute of Biomedical Sciences, Mackay Medical College
| | - Hung-I Yeh
- Department of Medicine, Mackay Medical College.,Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College.,Institute of Biomedical Sciences, Mackay Medical College
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Liu Z, Xu Y, Hao H, Yin C, Xu J, Li J, Wang Y, Xu D. Efficacy of high intensity atorvastatin versus moderate intensity atorvastatin for acute coronary syndrome patients with diabetes mellitus. Int J Cardiol 2016; 222:22-26. [DOI: 10.1016/j.ijcard.2016.07.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
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Wang A, Wu L, Liu X, Su Z, Luo Y, Chen S, Li H, Liu X, Tao L, Guo J, Zhang F, Cao Y, Zhao X, Wu S, Guo X. The prevalence of carotid plaque with different stability and its association with metabolic syndrome in China: The Asymptomatic Polyvascular Abnormalities Community study. Medicine (Baltimore) 2016; 95:e4619. [PMID: 27559957 PMCID: PMC5400324 DOI: 10.1097/md.0000000000004619] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Few studies have investigated the prevalence of carotid plaque with different stability in Chinese. As is well known, carotid atherosclerosis is tightly associated with metabolic syndrome (MetS); however, the data about the association between the presence of carotid plaque with different stability and MetS was limited. The aim of our study was to investigate the prevalence of carotid plaque with different stability and its potential association with MetS in general Chinese population.The Asymptomatic Polyvascular Abnormalities Community study is a community-based study to investigate the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults. A total of 5393 participants were finally eligible and included in this study. The carotid plaque and its stability were assessed using ultrasonography. The MetS was defined using the criteria from US National Cholesterol Education Program-Adult Treatment Panel III. Data were analyzed with multivariate logistic regression models.Of the 5393 subjects, 1397 (25.9%) participants had stable carotid plaque, 1518 (28.1%) had unstable carotid plaque in participants, and 1456 (27.0%) had a MetS. MetS was, respectively, significantly associated with the prevalence of carotid plaque (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.07, 1.47), stable carotid plaque (OR: 1.23; 95% CI: 1.02,1.48), and unstable carotid plaque (OR: 1.27; 95% CI: 1.03,1.56) after adjusting for age, gender, level of education, income, smoking, drinking, physical activity, body mass index, low-density lipoprotein, and high-sensitivity C-reactive protein. With the number of MetS components, the prevalence of carotid plaque, stable carotid plaque, and unstable carotid plaque significantly increased (P for trend <0.0001), respectively.In summary, the prevalence of carotid plaque was 54.1%, stable carotid plaque was 25.9%, and unstable carotid plaque was 28.1%. Our study revealed that the prevalence of carotid plaque, stable carotid plaque, and unstable carotid plaque was, respectively, significantly associated with MetS in the general population.
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Affiliation(s)
- Anxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
- China National Clinical Research Center for Neurological Diseases
- Center of Stroke, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing
| | - Lingyun Wu
- North China University of Science and Technology
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan
| | - Zhaoping Su
- Department of Epidemiology and Health Statistics, Academy of Public Health and Management, Weifang Medical University, Weifang
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing
| | - Jin Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing
| | - Feng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing
| | - Yibin Cao
- Department of Neurology, Tangshan Gongren Hospital
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
- China National Clinical Research Center for Neurological Diseases
- Center of Stroke, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing
- Correspondence: Xiuhua Guo, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China (e-mail: ); Shouling Wu, Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan 063000, China (e-mail: ); Xingquan Zhao, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China (e-mail: )
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
- Correspondence: Xiuhua Guo, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China (e-mail: ); Shouling Wu, Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan 063000, China (e-mail: ); Xingquan Zhao, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China (e-mail: )
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing
- Correspondence: Xiuhua Guo, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China (e-mail: ); Shouling Wu, Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan 063000, China (e-mail: ); Xingquan Zhao, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China (e-mail: )
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25
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The association between coronary microvascular dysfunction and carotid intima media thickness in patients with cardiac syndrome X. Int J Cardiol 2016; 214:383-6. [DOI: 10.1016/j.ijcard.2016.04.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/03/2016] [Indexed: 11/18/2022]
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26
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Gómez-Marcos MÁ, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Rodríguez-Sanchez E, Maderuelo-Fernandez JA, Gómez-Sánchez L, Gomez-Sanchez M, García-Ortiz L. Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study. BMJ Open 2016; 6:e010400. [PMID: 27251684 PMCID: PMC4893862 DOI: 10.1136/bmjopen-2015-010400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES We prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease. SETTING 2 primary care centres in Salamanca, Spain. PARTICIPANTS We performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years. PRIMARY AND SECONDARY OUTCOME MEASURES Measurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices. RESULTS In year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2. CONCLUSIONS This prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group. TRIAL REGISTRATION NUMBER NCT01065155; Results.
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Affiliation(s)
- Manuel Ángel Gómez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain Medicine Department, University of Salamanca, Salamanca, Spain Statistics Department, University of Salamanca, Salamanca, Spain
| | - José Ignacio Recio-Rodríguez
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain Medicine Department, University of Salamanca, Salamanca, Spain
| | - María Carmen Patino-Alonso
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain Biomedical and Diagnostic Sciences Department, University of Salamanca, Salamanca, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain Medicine Department, University of Salamanca, Salamanca, Spain
| | - Emiliano Rodríguez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain Medicine Department, University of Salamanca, Salamanca, Spain Statistics Department, University of Salamanca, Salamanca, Spain
| | - Jose Angel Maderuelo-Fernandez
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain Medicine Department, University of Salamanca, Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Marta Gomez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Luís García-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain Castilla and León Health Service-SACYL, REDIAPP: Research Network on Preventive Activities and Health Promotion, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain Medicine Department, University of Salamanca, Salamanca, Spain LOD-DIABETES Group, REDIAPP: Research Network on Preventive Activities and Health Promotion, Salamanca, Spain
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27
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Hirata C, Miyai N, Idoue A, Utsumi M, Hattori S, Iwahara A, Uematsu Y, Shiba M, Arita M. Effect of metabolic syndrome components and their clustering on carotid atherosclerosis in a sample of the general Japanese population. Hypertens Res 2016; 39:362-6. [DOI: 10.1038/hr.2015.152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 10/21/2015] [Accepted: 10/26/2015] [Indexed: 11/09/2022]
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28
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Shimabukuro M, Hasegawa Y, Higa M, Amano R, Yamada H, Mizushima S, Masuzaki H, Sata M. Subclinical Carotid Atherosclerosis Burden in the Japanese: Comparison between Okinawa and Nagano Residents. J Atheroscler Thromb 2015; 22:854-68. [PMID: 26133316 DOI: 10.5551/jat.26674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The prevalence of overweight and a change in atherosclerotic lipid profiles may be linked to region-specific differences in atherosclerotic diseases. We evaluated whether the lipid phenotype could be linked to region- and sex-specific differences in the degree of atherosclerosis. METHODS Non-diabetic subjects included Okinawa (n=1674) and Nagano (n=1392) residents aged 30-75 years who underwent carotid ultrasonography for the measurement of maximum intima-media thickness (max IMT). RESULTS Average max IMT was higher in Okinawa men and women, and the increase in max IMT with age was enhanced in men. Multiple regression analysis showed that in addition to age and systolic blood pressure, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol were IMT determinants only in men for both Okinawa and Nagano. Meanwhile, HDL-cholesterol was a determinant for Okinawa men and women, but not for Nagano men and women. CONCLUSIONS This is the first report to show region- and sex-specific differences in the determinants for max IMT in a Japanese population. The evaluation of the relationship between lipid profile patterns and region- and sex-specific differences in carotid atherosclerosis burden may be required.
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Affiliation(s)
- Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, The University of Tokushima Graduate School
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Lu J, Hou X, Zhang L, Hu C, Zhou J, Pang C, Pan X, Bao Y, Jia W. Associations between clinical characteristics and chronic complications in latent autoimmune diabetes in adults and type 2 diabetes. Diabetes Metab Res Rev 2015; 31:411-20. [PMID: 25448723 DOI: 10.1002/dmrr.2626] [Citation(s) in RCA: 23] [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] [Received: 05/29/2014] [Revised: 11/17/2014] [Accepted: 11/24/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study aimed to assess the associations between clinical characteristics and chronic complications in latent autoimmune diabetes in adults (LADA) and type 2 diabetes. METHODS This is a retrospective study. Our diabetes registry included 6975 patients aged 30-75 years old with phenotypic type 2 diabetes who underwent islet autoantibody screening between 2003 and 2012; 384 patients were identified to have LADA. Rates of chronic complications for LADA and type 2 diabetes were compared using a 1 : 2 matched design. Logistic models were fitted to identify the presence of chronic diabetic complications using clinical characteristics including gender, age, duration of diabetes, glycemic control and metabolic syndrome. RESULTS When duration of diabetes is <5 years, the prevalence of diabetic nephropathy (nephropathy; 12.2% versus 21.8%, p = 0.018) and diabetic retinopathy (retinopathy; 8.1% versus 15.9%, p = 0.011) were significantly lower in patients with LADA than in patients with type 2 diabetes; the prevalence of nephropathy and retinopathy were comparable between both groups when duration is ≥5 years. There was no significant difference in the prevalence of macrovascular complications between groups. The areas under the receiver operating characteristic curves based on the nephropathy and retinopathy models were larger for LADA than for type 2 diabetes (0.72 versus 0.61, p = 0.013; 0.76 versus 0.68, p = 0.056). CONCLUSIONS Patients with LADA had a lower prevalence of microvascular complications than patients with type 2 diabetes when the duration of diabetes was <5 years. Regression equation fitted by clinical characteristics can better predict the risk of microvascular complications in LADA than in type 2 diabetes.
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Affiliation(s)
- Jun Lu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
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30
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Metabolic syndrome showed significant relationship with carotid atherosclerosis. Heart Vessels 2015; 31:664-70. [PMID: 25810113 DOI: 10.1007/s00380-015-0668-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/20/2015] [Indexed: 10/23/2022]
Abstract
Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease. We assessed the associations between MetS and the indicators of carotid atherosclerosis as assessed by ultrasonography taking into consideration of confounders in the general population. A total of 1281 subjects (856 males, 425 females) were included in the present study. The total plaque score and maximum intima-media thickness (IMT) of the carotid arteries were measured as indicators of atherosclerosis. Cardiovascular risk factors were several metabolic components, serum uric acid, serum C-reactive protein (CRP), and lifestyle factors. MetS was defined according to the criteria of the National Cholesterol Education Program. The prevalences of an elevated total plaque score (≥5) and elevated IMT (>1 mm) of the carotid arteries were significantly higher in subjects with MetS as compared to subjects without MetS. Furthermore, a trend was observed towards higher prevalences of these indicators of atherosclerosis as the number of components of MetS increased. Logistic regression analysis revealed a significant association between elevated plaque score and MetS even after adjustments for age, serum uric acid, serum CRP and lifestyle factors in the males. Among the indicators of atherosclerosis assessed by carotid ultrasonography, a significant independent association was observed between the total plaque score and MetS in males in the general population.
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31
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Garg R, Aggarwal S, Kumar R, Sharma G. Association of atherosclerosis with dyslipidemia and co-morbid conditions: A descriptive study. J Nat Sci Biol Med 2015; 6:163-8. [PMID: 25810656 PMCID: PMC4367030 DOI: 10.4103/0976-9668.149117] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Dyslipidemia (Dys), the commonest cause of cardiovascular diseases, leads to lipid deposits on the arterial wall, thereby aggravating the process of atherosclerosis. To assess the impact of Dys and other co-morbid conditions on atherosclerosis (i.e., increased intimo medial thickness (IMT) or plaques) in the common carotid arteries (CCAs) we studied the incidence and association of plaques and increased IMT in dyslipidemic patients from North Indian population (south-west of Punjab, India). Materials and Methods: A cross-sectional study consisting of 88 (male-39 and female-49) dyslipidemic patients (age group 30-80 years); was designed. Blood pressure, waist circumference (WC), hip circumference (HC) were measured and fasting lipid profile, renal function, and liver function tests were performed. B-mode sonography, for CCA, was performed to assess IMT. Results: Average value (mg/dl) of total cholesterol, triglyceride, low density lipoprotein and high density lipoprotein in males and females was 220.30 versus 231.93, 240.3 versus 242.14, 125.29 versus 133.62 and 44.33 versus 46.09 respectively (P > 0.05, all), while WC, HC, systolic blood pressure and diastolic blood pressure were 101.8 versus 96.53 cm, 98.23 versus 99.53 cm, 143.23 versus 138.98 mmHg and 91.53 versus 88.97 mmHg respectively. Increased IMT and atherosclerotic plaques were observed in 36.36% cases (n = 32, male - 14 and female - 18) and 29.54% cases (n = 26, male 14, female 12) respectively. Odd ratio (OR) for plaques was more for Dys with coronary artery disease (CAD; 11.43) and Dys with CAD (Dys-CAD) + hypertension (HT) (24) respectively vs isolated Dys. Conclusion: Dyslipidemia patients have higher waist and HCs than normal subjects. Incidence and OR of plaques is higher in Dys-CAD or Dys-CAD + HT when compared to isolated Dys or Dys with HT. Hence, treatment of dyslipidemic patients’ needs to be intensified if more than one risk factor(s) is present simultaneously.
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Affiliation(s)
- Ravinder Garg
- Department of Medicine, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Simmi Aggarwal
- Department of Radio Diagnosis, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Raj Kumar
- Department of Pharmacology, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Ghansham Sharma
- Department of Social and Preventive Medicine, GGS Medical College and Hospital, Faridkot, Punjab, India
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Won KB, Chang HJ, Niinuma H, Niwa K, Jeon K, Cho IJ, Shim CY, Hong GR, Chung N. Inverse association between central obesity and arterial stiffness in Korean subjects with metabolic syndrome: a cross-sectional cohort study. Diabetol Metab Syndr 2015; 7:3. [PMID: 25810782 PMCID: PMC4373323 DOI: 10.1186/1758-5996-7-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 01/09/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with increased risks of diabetes and atherosclerotic cardiovascular disease. Whether central obesity (CeO) is a prerequisite for the diagnosis of MetS in the International Diabetes Federation (IDF) definition is a substantial issue because it may influence the clinical value of MetS for predicting subclinical atherosclerosis. METHODS We investigated the relation between MetS, as defined by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria, and arterial stiffness according to CeO status in 2,560 healthy Korean subjects who participated in a community-based cohort study. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). RESULTS The prevalence of MetS was 37%; 84% of MetS subjects had CeO. The prevalence of diabetes was significantly higher in MetS subjects than in non-MetS subjects (30 vs. 8%, p <0.001). The number of MetS components was significantly correlated with baPWV (r = 0.311, p <0.001). In a subgroup analysis of MetS subjects, the prevalence of diabetes was not significantly different in MetS subjects with and without CeO. MetS subjects without CeO had significantly higher baPWV than those with CeO (1654 ± 315 vs. 1578 ± 270 cm/s, p = 0.002). Multiple regression models revealed that waist circumference was independently associated with decreased baPWV in MetS subjects. CONCLUSIONS Despite the significant correlation between the number of MetS components and arterial stiffness, there appeared to be an inverse association between CeO and arterial stiffness in MetS subjects. In contrast to the IDF definition, our findings suggest that CeO is not crucial for the diagnosis of MetS in otherwise healthy Koreans having multiple metabolic risk factors with respect to subclinical atherosclerosis reflected in arterial stiffness.
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Affiliation(s)
- Ki-Bum Won
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
- />Division of Cardiology, St. Luke’s International Hospital, Tokyo, Japan
| | - Hyuk-Jae Chang
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
- />Severance Biomedical Science Institute, Seoul, Republic of Korea
| | - Hiroyuki Niinuma
- />Division of Cardiology, St. Luke’s International Hospital, Tokyo, Japan
| | - Koichiro Niwa
- />Division of Cardiology, St. Luke’s International Hospital, Tokyo, Japan
| | - Kyewon Jeon
- />Severance Biomedical Science Institute, Seoul, Republic of Korea
| | - In-Jeong Cho
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
| | - Chi-Young Shim
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
| | - Geu-Ru Hong
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
| | - Namsik Chung
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
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Tenenbaum A, Klempfner R, Fisman EZ. Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor. Cardiovasc Diabetol 2014; 13:159. [PMID: 25471221 PMCID: PMC4264548 DOI: 10.1186/s12933-014-0159-y] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 11/25/2014] [Indexed: 12/27/2022] Open
Abstract
The existence of an independent association between elevated triglyceride (TG) levels, cardiovascular (CV) risk and mortality has been largely controversial. The main difficulty in isolating the effect of hypertriglyceridemia on CV risk is the fact that elevated triglyceride levels are commonly associated with concomitant changes in high density lipoprotein (HDL), low density lipoprotein (LDL) and other lipoproteins. As a result of this problem and in disregard of the real biological role of TG, its significance as a plausible therapeutic target was unfoundedly underestimated for many years. However, taking epidemiological data together, both moderate and severe hypertriglyceridaemia are associated with a substantially increased long term total mortality and CV risk. Plasma TG levels partially reflect the concentration of the triglyceride-carrying lipoproteins (TRL): very low density lipoprotein (VLDL), chylomicrons and their remnants. Furthermore, hypertriglyceridemia commonly leads to reduction in HDL and increase in atherogenic small dense LDL levels. TG may also stimulate atherogenesis by mechanisms, such excessive free fatty acids (FFA) release, production of proinflammatory cytokines, fibrinogen, coagulation factors and impairment of fibrinolysis. Genetic studies strongly support hypertriglyceridemia and high concentrations of TRL as causal risk factors for CV disease. The most common forms of hypertriglyceridemia are related to overweight and sedentary life style, which in turn lead to insulin resistance, metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM). Intensive lifestyle therapy is the main initial treatment of hypertriglyceridemia. Statins are a cornerstone of the modern lipids-modifying therapy. If the primary goal is to lower TG levels, fibrates (bezafibrate and fenofibrate for monotherapy, and in combination with statin; gemfibrozil only for monotherapy) could be the preferable drugs. Also ezetimibe has mild positive effects in lowering TG. Initial experience with en ezetimibe/fibrates combination seems promising. The recently released IMPROVE-IT Trial is the first to prove that adding a non-statin drug (ezetimibe) to a statin lowers the risk of future CV events. In conclusion, the classical clinical paradigm of lipids-modifying treatment should be changed and high TG should be recognized as an important target for therapy in their own right. Hypertriglyceridemia should be treated.
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Affiliation(s)
- Alexander Tenenbaum
- Cardiac Rehabilitation Institute, Sheba Medical Center, 52621, Tel-Hashomer, Israel. .,Sackler Faculty of Medicine, Tel-Aviv University, 69978, Tel-Aviv, Israel. .,Cardiovascular Diabetology Research Foundation, 58484, Holon, Israel.
| | - Robert Klempfner
- Cardiac Rehabilitation Institute, Sheba Medical Center, 52621, Tel-Hashomer, Israel. .,Sackler Faculty of Medicine, Tel-Aviv University, 69978, Tel-Aviv, Israel.
| | - Enrique Z Fisman
- Sackler Faculty of Medicine, Tel-Aviv University, 69978, Tel-Aviv, Israel. .,Cardiovascular Diabetology Research Foundation, 58484, Holon, Israel.
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Watanabe K, Ouchi M, Ohara M, Kameda W, Susa S, Oizumi T, Wada M, Suzuki T, Kawanami T, Oba K, Kato T. Change of carotid intima-media thickness is associated with age in elderly Japanese patients without a history of cardiovascular disease. Geriatr Gerontol Int 2014; 15:1023-30. [PMID: 25312290 DOI: 10.1111/ggi.12402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2014] [Indexed: 11/26/2022]
Abstract
AIM The present study aimed to evaluate the relationship between the change of carotid intima-media thickness (CIMT) and clinical characteristics in Japanese patients without a history of cardiovascular disease. METHODS The study participants were 149 Japanese patients without a history of cardiovascular disease treated in our outpatient department. The in all participants CIMT was measured with ultrasonography at baseline and after a mean interval of 2.4 years. Study participants were divided into a middle-aged group (younger than 65 years: n = 59) and an elderly group (65 years or older: n = 90). The annual CIMT change (ΔCIMT) was calculated, and the associations between ΔCIMT and clinical characteristics, including age, were evaluated in both groups. RESULTS The ΔCIMT was significantly correlated with age in all participants (r = 0.222; P < 0.05) and in elderly participants (r = 0.234; P < 0.05), but was not correlated with other risk factors. The annual ΔCIMT was significantly higher in elderly participants (0.015 ± 0.096 mm) than in middle-aged participants (-0.018 ± 0.088 mm; P < 0.05). Multivariate linear regression analysis with ΔCIMT as a dependent variable and risk factors as independent variables showed that ΔCIMT was significantly associated with age in all participants (β = 0.002; P < 0.05) and in elderly participants (β = 0.004; P < 0.05), but not with other risk factors. CONCLUSIONS Annual CIMT change is associated with age, rather than with other clinical characteristics, including traditional cardiovascular risk factors, such as diabetes and hypertension, in elderly Japanese patients without a history of cardiovascular disease.
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Affiliation(s)
- Kentaro Watanabe
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Motoshi Ouchi
- Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Makoto Ohara
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Wataru Kameda
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Toshihide Oizumi
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Manabu Wada
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tatsuya Suzuki
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
| | - Toru Kawanami
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Kenzo Oba
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
| | - Takeo Kato
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Yamagata, Japan
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Hattori Y, Kitamura A, Tsuji M, Nagatsuka K, Ihara M. Motor and cognitive impairment in a mouse model of ischemic carotid artery disease. Neurosci Lett 2014; 581:1-6. [PMID: 25123442 DOI: 10.1016/j.neulet.2014.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/20/2014] [Accepted: 08/03/2014] [Indexed: 01/08/2023]
Abstract
We have recently established a novel mouse model of bilateral common carotid artery gradual occlusion. This model serves as a mimic of severe carotid artery disease with multiple cerebral infarctions induced by cerebrovascular insufficiency. In this study, we examined whether locomotor and cognitive impairment was induced in these mice using a test battery for neurological and cognitive functions. Adult C57BL/6J male mice were subjected to either ameroid constrictor (AC) placement to gradually narrow the bilateral common carotid arteries or to sham surgery. At 28 days post-surgery, locomotor activity was assessed by rotarod and wire hang tests, and cognitive function was assessed using the Y-maze and Morris water maze tests. Rotarod and wire hang tests showed a significantly shorter latency to fall in mice subjected to the placement of ACs compared with sham surgery mice. AC-implanted mice showed significant impairments in working memory on the Y-maze test and in spatial learning and reference memory on the Morris water maze test. Therefore, the current mouse model with AC placement on the bilateral common carotid arteries showed locomotor disability, learning deficits, and memory impairment, which well-replicated the outcomes of patients with ischemic carotid artery disease. This model will be useful for investigating the mechanisms underlying the neurological and cognitive deficits following cerebrovascular insufficiency and for exploring pharmacological interventions for stroke patients with severe carotid artery disease.
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Affiliation(s)
- Yorito Hattori
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Akihiro Kitamura
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masahiro Tsuji
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Kazuyuki Nagatsuka
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Masafumi Ihara
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan; Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
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Yan Z, Liang Y, Jiang H, Cai C, Sun B, Qiu C. Metabolic Syndrome and Subclinical Carotid Atherosclerosis Among Chinese Elderly People Living in a Rural Community. Metab Syndr Relat Disord 2014; 12:269-76. [PMID: 24588080 DOI: 10.1089/met.2013.0135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Zhongrui Yan
- Department of Neurology, Jining First People's Hospital, Shandong, China
| | - Yajun Liang
- School of Public Health, Jining Medical University, Shandong, China
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Hui Jiang
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, Shandong, China
| | - Chuanzhu Cai
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, Shandong, China
| | - Binglun Sun
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, Shandong, China
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Tripolt NJ, Narath SH, Eder M, Pieber TR, Wascher TC, Sourij H. Multiple risk factor intervention reduces carotid atherosclerosis in patients with type 2 diabetes. Cardiovasc Diabetol 2014; 13:95. [PMID: 24884694 PMCID: PMC4041351 DOI: 10.1186/1475-2840-13-95] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/18/2014] [Indexed: 11/25/2022] Open
Abstract
Background Patients with rapid progression of carotid intima media thickness (CIMT) were shown to have a higher future risk for cardiovascular events. The aim of this study was to investigate the impact of multiple risk factor intervention on CIMT progression and to establish whether new cardiovascular surrogate measurements would allow prediction of CIMT changes. Materials and methods In this prospective, open, 2-years study, we included 97 patients with type 2 diabetes and at least two insufficiently treated cardiovascular risk factors, i.e. HbA1c > 7.5% (58 mmol/mol); LDL-cholesterol >3.1 mmol/l or blood pressure >140/90 mmHg. Treatment was intensified according to current guidelines over 3 months with the aim to maintain intensification over 2 years. The primary outcome was the change in CIMT after 2 years. We also assessed markers of mechanical and biochemical endothelial function and endothelial progenitor cells before and after 3 months of treatment intensification. For testing differences between before and after multifactorial treatment measurements we used either the paired student’s t-test or the Wilcoxon signed-rank test, depending on the distribution of the data. Additional, explorative statistical data analysis was done on CIMT progression building a linear multivariate regression model. Results Blood glucose, lipids and blood pressure significantly improved during the first 3 months of intensified treatment, which was sustained over the 2-year study duration. Mean CIMT significantly decreased from baseline to 2 year (0.883 ± 0.120 mm vs. 0.860 ± 0.130 mm; p = 0.021). None of the investigated surrogate measures, however, was able to predict changes in IMT early after treatment intensification. Conclusions Intensification of risk factor intervention in type 2 diabetes results in CIMT regression over a period of 2 years. None of the biomarkers used including endothelial function parameters or endothelial progenitor cells turned out to be useful to predict CIMT changes. Trial registration Clinical Trial Registration – Unique identifier:
NCT00660790
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Affiliation(s)
| | | | | | | | | | - Harald Sourij
- Department for Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria.
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Claessen KMJA, Appelman-Dijkstra NM, Pereira AM, Joustra SD, de Mutsert R, Gast KB, den Heijer M, Smit JWA, Dekkers OM, Biermasz NR. Abnormal metabolic phenotype in middle-aged GH-deficient adults despite long-term recombinant human GH replacement. Eur J Endocrinol 2014; 170:263-72. [PMID: 24217935 DOI: 10.1530/eje-13-0764] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Adult GH deficiency (GHD) is associated with increased cardiovascular mortality. Recombinant human GH (rhGH) replacement has beneficial short-term metabolic effects. Although these positive effects sustain during longer follow-up, the prevalence of the metabolic syndrome (MS) remains increased in comparison with population data not adjusted for the higher mean BMI in GHD adults. OBJECTIVE To explore whether middle-aged patients with proposed physiological rhGH replacement have been normalized with respect to MS and its individual components in comparison with the general population, adjusted for age, sex, and BMI. METHODS One hundred and sixty-one GHD patients (aged 40-70 years) were studied before the start and after 5 years of rhGH replacement, and were compared with 1671 subjects (aged 45-66 years) from the general population (NEO Study). RESULTS MS PROPORTION IN GHD PATIENTS WAS 41.0% BEFORE THE START OF RHGH SUPPLETION, INCREASING TO 53.4% AFTER 5 YEARS (P=0.007). DESPITE CHRONIC RHGH REPLACEMENT, GHD PATIENTS HAD A 1.3-TIMES HIGHER MS PROPORTION THAN THE GENERAL POPULATION, INDEPENDENTLY OF AGE, SEX, AND BMI (95% CI 1.11.5, P=0.008). THE GHD POPULATION SHOWED A DIFFERENT METABOLIC PROFILE THAN THE GENERAL POPULATION WITH SIMILAR BMI: an increased risk of hypertriglyceridemia (adjusted prevalence ratio (PR) 2.0, 95% CI 1.7-2.3) and low HDL-C (adjusted PR 1.8, 95% CI 1.5-2.2), but less hyperglycemia (adjusted PR 0.5, 95% CI 0.4-0.7). CONCLUSIONS Despite 5 years of rhGH replacement, GHD patients still have a different metabolic profile and more frequently MS than the general population. These differences were independent of BMI, and resemble the unfavorable metabolic profile of untreated GHD patients, pointing to question the long-term benefits of rhGH replacement.
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Affiliation(s)
- K M J A Claessen
- Department of Endocrinology and Metabolic Diseases C7-Q and Center for Endocrine Tumors, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
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Jung JM, Young Kwon D, Han C, Park MH. Metabolic syndrome and early carotid atherosclerosis in the elderly. J Atheroscler Thromb 2014; 21:435-44. [PMID: 24477027 DOI: 10.5551/jat.18655] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS To investigate whether metabolic syndrome(MetS) can predict the new onset of carotid plaque or the progression of carotid intima-media thickness(C-IMT) and identify other associated factors in an elderly population without evidence of early carotid atherosclerosis. METHODS B-mode carotid ultrasonography was used to assess the presence of carotid plaque and the C-IMT at baseline and follow-up. Participants with carotid plaque or an increased C-IMT(≥1.0mm) at baseline were excluded from the study. The new occurrence of carotid plaque, defined as early carotid atherosclerosis and the progression of C-IMT, was evaluated. Multiple regression analyses were used to determine predictors of these findings. RESULTS A total of 370 participants over 60 years of age(median age=66 years, 34.1% men) were enrolled. After a median follow-up period of 25 months, 64 participants(17.3%) had newly developed carotid plaque. After adjusting for variables determined to be statistically significant in univariate analyses, a multivariable regression analysis showed that predictors of newly developed carotid plaque were metabolic syndrome(hazard ratio [HR]=1.916; 95% confidence interval [CI]: 1.059-3.466), white blood cell count(HR=1.313; 95% CI: 1.094-1.576) and vitamin B12(HR=1.001; 95% CI: 1.000-1.002) and total cholesterol(HR=1.009; 95% CI: 1.001-1.017) levels. A multiple linear regression analysis showed that the rate of change for C-IMT tended to be associated with the development of metabolic syndrome. CONCLUSIONS Metabolic syndrome is associated with the progression of early carotid atherosclerosis in the general population, suggesting that metabolic syndrome plays an important role in initiating the atherosclerotic process.
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Affiliation(s)
- Jin-Man Jung
- Departments of Neurology, Korea University Ansan Hospital, Korea University College of Medicine
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Matsumura T, Taketa K, Motoshima H, Senokuchi T, Ishii N, Kinoshita H, Fukuda K, Yamada S, Kukidome D, Kondo T, Hisada A, Katoh T, Shimoda S, Nishikawa T, Araki E. Association between circulating leukocyte subtype counts and carotid intima-media thickness in Japanese subjects with type 2 diabetes. Cardiovasc Diabetol 2013; 12:177. [PMID: 24373412 PMCID: PMC3878795 DOI: 10.1186/1475-2840-12-177] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/21/2013] [Indexed: 11/24/2022] Open
Abstract
Background An increased leukocyte count is an independent risk factor for cardiovascular events, but the association between leukocyte subtype counts and carotid atherosclerosis in patients with diabetes has not been determined. We therefore investigated the correlation between leukocyte subtype counts and intima-media thickness of the common carotid artery (CCA-IMT) in subjects with type 2 diabetes. Methods This cross-sectional study involved 484 in-patients with type 2 diabetes (282 males and 202 females), who were hospitalized for glycemic control and underwent carotid ultrasonography at Kumamoto University Hospital between 2005 and 2011. Mean and maximum CCA-IMT was measured by high-resolution B-mode ultrasonography. Results Univariate analyses revealed that mean CCA-IMT was positively correlated with age, systolic blood pressure, brachial-ankle pulse wave velocity (PWV), urinary albumin excretion and duration of diabetes, but was negatively correlated with diastolic blood pressure and fasting plasma glucose. Maximum CCA-IMT was positively and negatively correlated with the same factors as mean CCA-IMT except for fasting plasma glucose. Mean CCA-IMT was positively correlated with total leukocyte (r = 0.124, p = 0.007), monocyte (r = 0.373, p < 0.001), neutrophil (r = 0.139, p = 0.002) and eosinophil (r = 0.107, p = 0.019) counts. Maximum CCA-IMT was positively correlated with total leukocyte (r = 0.154, p < 0.001), monocyte (r = 0.398, p < 0.001), neutrophil (r = 0.152, p < 0.001) and basophil counts (r = 0.102, p = 0.027). Multiple regression analyses showed that monocyte count, age and PWV were significant and independent factors associated with mean CCA-IMT (adjusted R2 = 0.239, p < 0.001), and that monocyte count, age and urinary albumin excretion were significant and independent factors associated with maximum CCA-IMT (adjusted R2 = 0.277, p < 0.001). Conclusions Monocyte counts were positively correlated with both mean CCA-IMT and maximum CCA-IMT in patients with type 2 diabetes. Monocyte count may be a useful predictor of macrovascular complications in patients with type 2 diabetes. Trial registration Trial registry no:
UMIN000003526.
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Affiliation(s)
- Takeshi Matsumura
- Department of Metabolic Medicine, Kumamoto University, Kumamoto, Japan.
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Novo S, Peritore A, Trovato RL, Guarneri FP, Di Lisi D, Muratori I, Novo G. Preclinical atherosclerosis and metabolic syndrome increase cardio- and cerebrovascular events rate: a 20-year follow up. Cardiovasc Diabetol 2013; 12:155. [PMID: 24152423 PMCID: PMC4016285 DOI: 10.1186/1475-2840-12-155] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intima-media thickness (IMT) is a validated marker of preclinical atherosclerosis and a predictor of cardiovascular events. PATIENTS We studied a population of 529 asymptomatic patients (age 62 ± 12.8 years), divided into two groups of subjects with and without Metabolic Syndrome (MetS). METHODS All patients, at baseline, have had a carotid ultrasound evaluation and classified in two subgroups: the first one without atherosclerotic lesions and the second one with preclinical atherosclerosis (increased IMT or asymptomatic carotid plaque). Cardiovascular endpoints were investigated in a 20-years follow-up. RESULTS There were 242 cardiovascular events: 144 among patients with MetS and 98 among in healthy controls (57.4% vs. 35.2%; P < 0.0001). 63 events occurred in patients with normal carotid arteries, while 179 events occurred in patients with preclinical atherosclerosis (31.8% vs. 54.1%; P < 0.0001). Of the 144 total events occurred in patients with MetS, 36 happened in the subgroup with normal carotid arteries and 108 in the subgroup with preclinical atherosclerosis (45% vs. 63.15%; P = 0.009). 98 events occurred in patients without MetS, of which 27 in the subgroup with normal carotid arteries and 71 in the subgroup with preclinical atherosclerosis (22.88% vs. 44.37%; P = 0.0003). In addition, considering the 63 total events occurred in patients without atherosclerotic lesions, 36 events were recorded in the subgroup with MetS and 27 events in the subgroup without MetS (45% vs. 22.88%; P = 0.0019). Finally, in 179 total events recorded in patients with preclinical carotid atherosclerosis, 108 happened in the subgroup with MetS and 71 happened in the subgroup without MetS (63.15% vs. 44.37%; P = 0.0009). The Kaplan-Meier function showed an improved survival in patients without atherosclerotic lesions compared with patients with carotid ultrasound alterations (P = 0.01, HR: 0.7366, CI: 0.5479 to 0.9904). CONCLUSIONS Preclinical atherosclerosis leads to an increased risk of cardiovascular events, especially if it is associated with MetS.
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Affiliation(s)
- Salvatore Novo
- Chair of Cardiovascular Disease and Centre for the Early Diagnosis of Preclinical and Multifocal Atherosclerosis and for Secondary Prevention, Department of Internal Medicine and Specialties (DIBIMIS), University of Palermo, Via del Vespro n, 139-90127, Palermo, Italy.
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Differential impact of metabolic syndrome on subclinical atherosclerosis according to the presence of diabetes. Cardiovasc Diabetol 2013; 12:41. [PMID: 23452437 PMCID: PMC3599532 DOI: 10.1186/1475-2840-12-41] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 02/22/2013] [Indexed: 12/24/2022] Open
Abstract
Background Metabolic syndrome (MS) is associated with increased risks of diabetes and atherosclerotic cardiovascular disease. However, data on the impact of MS and its individual components on subclinical atherosclerosis (SCA) according to diabetes status are scarce. Methods Surrogate markers of SCA, brachial–ankle pulse wave velocity (baPWV), and carotid intima–medial thickness (IMT) and plaque were assessed in 2,560 subjects (60 ± 8 years, 33% men) who participated in baseline health examinations for a community-based cohort study. Results The participants included 2,149 non-diabetics (84%) and 411 diabetics (16%); 667 non-diabetics (31%) and 285 diabetics (69%) had MS, respectively. Diabetics had significantly higher baPWV and carotid IMT, and more plaques than non-diabetics (p < 0.001, respectively). Individuals with MS had significantly higher baPWV and carotid IMT than those without MS only among non-diabetics (p < 0.001, respectively). Among MS components, increased blood pressure was significantly associated with the exacerbation of all SCA markers in non-diabetics. The number of MS components was significantly correlated with both baPWV and carotid IMT in non-diabetics (baPWV: r = 0.302, p < 0.001; carotid IMT: r = 0.217, p < 0.001). Multiple regression showed both MS and diabetes were significantly associated with baPWV (p < 0.001, respectively), carotid IMT (MS: p < 0.001; diabetes: p = 0.005), and the presence of plaque (MS: p = 0.041; diabetes: p = 0.002). Conclusions MS has an incremental impact on SCA in conditions without diabetes. The identification of MS and its individual components is more important for the risk stratification of CVD in non-diabetic individuals.
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Li LX, Zhao CC, Ren Y, Tu YF, Lu JX, Wu X, Zhang WX, Zhu JA, Li MF, Yu LB, Bao YQ, Jia WP. Prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed patients with ketosis-onset diabetes: a cross-sectional study. Cardiovasc Diabetol 2013; 12:18. [PMID: 23324539 PMCID: PMC3583071 DOI: 10.1186/1475-2840-12-18] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 01/11/2013] [Indexed: 11/10/2022] Open
Abstract
Background The features of carotid atherosclerosis in ketosis-onset diabetes have not been investigated. Our aim was to evaluate the prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed Chinese diabetic patients with ketosis but without islet-associated autoantibodies. Methods In total, 423 newly diagnosed Chinese patients with diabetes including 208 ketosis-onset diabetics without islet-associated autoantibodies, 215 non-ketotic type 2 diabetics and 79 control subjects without diabetes were studied. Carotid atherosclerosis was defined as the presence of atherosclerotic plaques in any of the carotid vessel segments. Carotid intima-media thickness (CIMT), carotid atherosclerotic plaque formation and stenosis were assessed and compared among the three groups based on Doppler ultrasound examination. The clinical features of carotid atherosclerotic lesions were analysed, and the risk factors associated with carotid atherosclerosis were evaluated using binary logistic regression in patients with diabetes. Results The prevalence of carotid atherosclerosis was significantly higher in the ketosis-onset diabetic group (30.80%) than in the control group (15.2%, p=0.020) after adjusting for age- and sex-related differences, but no significant difference was observed in comparison to the non-ketotic diabetic group (35.8%, p=0.487). The mean CIMT of the ketosis-onset diabetics (0.70±0.20 mm) was markedly higher than that of the control subjects (0.57±0.08 mm, p<0.001), but no significant difference was found compared with the non-ketotic type 2 diabetics (0.73±0.19 mm, p=0.582) after controlling for differences in age and sex. In both the ketosis-onset and the non-ketotic diabetes, the prevalence of carotid atherosclerosis was markedly increased with age (both p<0.001) after controlling for sex, but no sex difference was observed (p=0.479 and p=0.707, respectively) after controlling for age. In the ketosis-onset diabetics, the presence of carotid atherosclerosis was significantly associated with age, hypertension, low-density lipoprotein cholesterol and mean CIMT. Conclusions The prevalence and risk of carotid atherosclerosis were significantly higher in the ketosis-onset diabetics than in the control subjects but similar to that in the non-ketotic type 2 diabetics. The characteristics of carotid atherosclerotic lesions in the ketosis-onset diabetics resembled those in the non-ketotic type 2 diabetics. Our findings support the classification of ketosis-onset diabetes as a subtype of type 2 diabetes.
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Affiliation(s)
- Lian-Xi Li
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China.
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Fukushima Y, Daida H, Morimoto T, Kasai T, Miyauchi K, Yamagishi SI, Takeuchi M, Hiro T, Kimura T, Nakagawa Y, Yamagishi M, Ozaki Y, Matsuzaki M. Relationship between advanced glycation end products and plaque progression in patients with acute coronary syndrome: the JAPAN-ACS sub-study. Cardiovasc Diabetol 2013; 12:5. [PMID: 23289728 PMCID: PMC3571912 DOI: 10.1186/1475-2840-12-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 12/13/2012] [Indexed: 01/29/2023] Open
Abstract
Background The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial demonstrated that early aggressive statin therapy in patients with ACS significantly reduces plaque volume (PV). Advanced glycation end products (AGEs) and the receptors of AGEs (RAGE) may lead to angiopathy in diabetes mellitus (DM) and may affect on the development of coronary PV. The present sub-study of JAPAN-ACS investigates the association between AGEs and RAGE, and PV. Methods Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) was undertaken, followed by the initiation of statin treatment (either 4 mg/day of pitavastatin or 20 mg/day of atorvastatin), in patients with ACS. In the 208 JAPAN-ACS subjects, PV using IVUS in non-culprit segment > 5 mm proximal or distal to the culprit lesion and, serum levels of AGEs and soluble RAGE (sRAGE) were measured at baseline and 8–12 months after PCI. Results At baseline, no differences in the levels of either AGEs or sRAGE were found between patients with DM and those without DM. The levels of AGEs decreased significantly with statin therapy from 8.6 ± 2.2 to 8.0 ± 2.1 U/ml (p < 0.001), whereas the levels of sRAGE did not change. There were no significant correlations between changes in PV and the changes in levels of AGEs as well as sRAGE. However, high baseline AGEs levels were significantly associated with plaque progression (odds ratio, 1.21; 95% confidence interval, 1.01 - 1.48; p = 0.044) even after adjusting for DM in multivariate logistic regression models. Conclusions High baseline AGEs levels were associated with plaque progression in the JAPAN-ACS trial. This relationship was independent of DM. These findings suggest AGEs may be related to long-term glucose control and other oxidative stresses in ACS. Trial registration NCT00242944
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Affiliation(s)
- Yoshifumi Fukushima
- Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan
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Herder M, Arntzen K, Johnsen S, Mathiesen EB. Correction: The metabolic syndrome and progression of carotid atherosclerosis over 13 years: the Tromsø study. Cardiovasc Diabetol 2013. [PMCID: PMC3874744 DOI: 10.1186/1475-2840-12-144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Panayiotou AG, Griffin M, Kouis P, Tyllis T, Georgiou N, Bond D, Nicolaides AN. Association between presence of the metabolic syndrome and its components with carotid intima-media thickness and carotid and femoral plaque area: a population study. Diabetol Metab Syndr 2013; 5:44. [PMID: 23962225 PMCID: PMC3765162 DOI: 10.1186/1758-5996-5-44] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/08/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We aimed to explore the association between presence and number of components of the Metabolic Syndrome (MetS) and subclinical atherosclerosis outcomes (common carotid intima media thickness, plaque presence and sum of plaque area) in both the carotid and femoral bifurcations. METHODS Cross-sectional analysis of 771 volunteers from the ongoing epidemiological Cyprus Study (46% male; mean age = 60.1 ± 9.8). (a) Carotid intima-media thickness (IMTcc), (b) sum of plaque area in the carotid bifurcations (sum of the largest plaques in each carotid bifurcation-SPAcar), (c) sum of plaque area in the femoral bifurcations (sum of the largest plaques in each femoral bifurcation-SPAfem) and (d) sum of plaque area in both carotid and femoral bifurcations (sum of the areas of the largest plaques present in each of the four bifurcations-SPA) were measured at baseline using ultrasound. Presence and number of components of the MetS was ascertained using the National Cholesterol Education Program ATPIII definition and their association tested using multivariable regression models. RESULTS MetS was present in 259 (33.6%) individuals and was associated with a 0.02 mm increase in IMTcc (95% CI: 0.00 to 0.04, p = 0.047) after adjustment for age, sex, family history of CVD, alcohol consumption (BU/week) and smoking (pack-years). Each additional component of the MetS was associated with a 16% higher SPA (95% CI: 6.8% to 25.2%, pfor trend = 0.001), a 10% higher SPAcar (95% CI: 5% to 24%, pfor trend = 0.003) and a 14% higher SPAfem in the adjusted model. CONCLUSIONS We confirm an association between the MetS and IMTcc as well as report for the first time an association between the MetS and its components and femoral plaque area, in a general population over 40 years of age. Having any risk factors for the MetS increases the risk for subclinical atherosclerosis, with the risk increasing with each additional component. Using the dichotomous definition of the MetS may be overlooking the risk for subclinical atherosclerosis -and by inference future cardiovascular events- associated with having less than 3 risk factors.
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Affiliation(s)
- Andrie G Panayiotou
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, P.O. Box: 50329, Limassol, Cyprus
- The Cyprus Cardiovascular Disease Educational and Research Trust, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Maura Griffin
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
| | - Panayiotis Kouis
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, P.O. Box: 50329, Limassol, Cyprus
| | - Theodosis Tyllis
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Niki Georgiou
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Dawn Bond
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
| | - Andrew N Nicolaides
- The Cyprus Cardiovascular Disease Educational and Research Trust, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
- Department of Vascular Surgery, Imperial College, London SW72BX, UK
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Viscogliosi G, Andreozzi P, Marigliano V. Associations of plasma glucose levels and traits of metabolic syndrome with carotid intima media thickness in nondiabetic elderly subjects: are they mediated by insulin resistance? Metab Syndr Relat Disord 2012; 11:41-5. [PMID: 23067236 DOI: 10.1089/met.2012.0087] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The independent role of insulin resistance (IR) and high fasting blood glucose (FBG) levels within the normal range on vascular diseases is still under debate. This study was designed to explore whether IR, FBG levels, and the traits of metabolic syndrome are associated with increased carotid intima media thickness (IMT), the early marker of subclinical atherosclerosis, independently of each other in nondiabetic elderly subjects. METHODS Blood analytes and anthropometric measurements were obtained. Carotid IMT was measured by ultrasonography; metabolic syndrome was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. IR was assessed through homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS At total of 207 subjects aged 68.2±3.6 years were enrolled. Subjects with increased carotid IMT (50.7%) were older (P=0.001), had a higher prevalence of metabolic syndrome (P<0.0001) and all its traits, impaired fasting glucose (IFG) (P<0.0001), and values of HOMA-IR (P<0.0001) than normal subjects. Increased carotid IMT significantly correlated with metabolic syndrome, its traits, IFG, and HOMA-IR. When multivariable regression models were constructed, central obesity [B=0.392; 95% confidence interval (CI) 0.280-0.505; P<0.0001], high-density lipoprotein cholesterol (HDL-C) (B=-0.007; 95% CI -0.013-0.000; P=0.042], hypertension (B=0.475; 95% CI 0.363-0.587; P<0.0001), and IFG (B=0.230; 95% CI 0.092-0.367; P=0.001) were found to be the independent determinants of increased carotid IMT independently of HOMA-IR, but not FBG (B=0.013; 95% CI 0.000-0.026; P=0.050) and HOMA-IR itself. CONCLUSIONS Our results suggest that hypertension, low HDL-C, and central obesity are independently associated with increased carotid IMT in nondiabetic elderly subjects. These associations seem to be not affected by IR. The associations of FBG levels within the normal range and IR with carotid IMT should be investigated further.
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Affiliation(s)
- Giovanni Viscogliosi
- Predictive Medicine Unit, Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University, Rome, Italy.
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