Factors associated with carotid Intima media thickness and carotid plaque score in community-dwelling and non-diabetic individuals

[Relationship between lipid metabolism molecules in plasma and carotid atheroscle-rotic plaques, traditional cardiovascular risk factors, and dietary factors]

OBJECTIVE

To explore the relationship between lipid metabolism molecules in plasma and carotid atherosclerotic plaques, traditional cardiovascular risk factors and possible dietary related factors.

METHODS

Firstly, among 1 312 community people from those who participated in a 10-year follow-up study of subclinical atherosclerosis cohort in Shijingshan District, Beijing, 85 individuals with 2 or more carotid soft plaques or mixed plaques and 89 healthy individuals without plaques were selected according to the inclusive and the exclusive criteria (< 70 years, not having clinical cardiovascular disease and other diseases, etc.). Secondly, 10 cases and 10 controls were randomly selected in the above 85 and 89 individuals respectively. Carotid plaques were detected using GE Vivid i Ultrasound Machine with 8L detector. Lipid metabolism molecules were detected by high performance liquid chromatography-mass spectrometry. The detection indexes included 113 lipid metabolism molecules. Traditional cardiovascular risk factors were collected by unified standard questionnaires, and dietary related factors were collected by main dietary frequency and weight scale. The difference of lipid metabolism molecules between the case group and the control group was analyzed by Wilcoxin rank test. In the control group, the Spearman correlation method was used to analyze the correlation between statistically significant lipid metabolism molecules and traditional cardiovascular risk factors and dietary factors.

RESULTS

Among the 113 lipid metabolism molecules, 53 lipid metabolism molecules were detected. C24:0 sphingomyelin (SM), C22:0/ C24:0 ceramide molecules, C18:0 phosphoethanolamine (PE) molecules, and C18:0/C18:2 (Cis) phosphatidylcholine (PC) were significantly higher in the carotid atherosclerotic plaque group than in the control group. The correlation analysis showed that C24:0 SM was significantly positively correlated with low density lipoprotein cholesterol (LDL-C, r=0.636, P < 0.05), C18:2 (Cis) PC (DLPC) was significantly positively correlated with systolic pressure (r=0.733, P < 0.05), C18:0 PE was significantly positively correlated with high sensitivity C-response protein (r=0.782, P < 0.01), C22:0, C24:0 ceramide and C18:0 PE were negatively correlated with vegetable intake (r=-0.679, P < 0.05;r=-0.711, P < 0.05;r=-0.808, P < 0.01), C24:0 ceramide was also negatively correlated with beans food intake (r=-0.736, P < 0.05) in the control group.

CONCLUSIONS

The increase of plasma C24:0 SM, C22:0, C24:0 ceramide, C18:0 PE, C18:2 (Cis) PC (DLPC), C18:0 PC (DSPC) may be new risk factors for human atherosclerotic plaques. These molecules may be related to blood lipid, blood pressure or inflammatory level and the intake of vegetables and soy products, but the nature of the association needs to be verified in a larger sample population.

Association of IL-18 gene polymorphisms with clinical aspects of hyperlipidemia in middle-aged and early people in the community

Hyperlipidemia is notorious for causing coronary artery disease (CAD). IL-18 is a proinflammtory cytokine that contributes to the pathogenesis of CAD. Previous reports have revealed that genetic polymorphism of IL-18 is associated with its expression level as well as the susceptibility to CAD. In the present study, we aim to investigate the relationship between IL-18 single nucleotide polymorphisms (SNPs) and hyperlipidemia in the Han Chinese population in Taiwan. A total of 580 participants older than 30 were recruited from the community. We collected the demographics, self-reported disease histories, and lifestyles. We also assessed the levels of lipid profiles including total cholesterol (CHOL), triglyceride, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol. Two SNPs, rs3882891C/A (intron 5) and rs1946518A/C (promoter -607) of IL-18 were elucidated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. Our results revealed that rs3882891 AA was associated with lower risk of hypercholesterolemia, higher CHOL and LDL-C in subjects (p=0.003, p=0.000 and p=0.005 separately), and rs1946518 CC was associated with hypercholesterolemia, higher CHOL and LDL-C as well (p=0.021, p=0.003 and p=0.001 separately) Furthermore, both SNPs were associated with IL-18 expression level, which was examined by Genotype-Tissue Expression (GTEx) Portal (p=0.042 and 0.016 separately). Finally, the haplotype of IL-18 was subsequently arranged in the order of rs3882891 and rs1946518. The result revealed that the AC haplotype of 2 IL-18 SNPs was also associated with lower risk of hypercholesterolemia, lower levels of CHOL and LDL-C (p=0.01, p=0.001 and 0.003). The current study is the first to report the association between IL-18 SNPs and hyperlipidemia in the Chinese Han population.

Impact of Classical Risk Factors on Subclinical Carotid Atherosclerosis Progression: Insights from a Non-Diabetic Cohort

Background

Several markers have been proposed for the detection and progression of subclinical atherosclerosis. We aimed to analyse the impact of classical risk factors on the presence and short-term progression of subclinical carotid atherosclerosis in a non-diabetic, primary prevention cohort.

Methods

This analysis included participants with completed visits at baseline and at 5-year follow-up (N = 141; 56.7% females, 43.3% males; aged 49.6 ± 4.7 years). Clinical and laboratory parameters, risk profiles, carotid artery intima-media thickness (CIMT) and plaque presence were analysed.

Results

There was a significant progression in mean CIMT (0.54 ± 0.09 mm-0.62 ± 0.10 mm; p < 0.001), prevalence of carotid plaque (4.8%-17.9%; p < 0.001) and age- and sex-adjusted abnormal CIMT (52.9%-78.8%; p < 0.001) at the end of follow-up, compared to baseline. In multivariate regression analysis, among the classical risk factors, their number, metabolic syndrome and SCORE (Systematic Coronary Risk Estimation) risk only the number of risk factors showed an independent and significant impact on the occurrence of a carotid plaque (Exp(B) = 1.71; p = 0.017) and 5-year CIMT progression.

Conclusions

During a short follow-up, the significant progression of subclinical atherosclerosis was confirmed. The number of risk factors predicted the occurrence of carotid plaques and CIMT progression. The high prevalence and short-term progression of subclinical carotid atherosclerosis underly the rationale for its screening in personalized cardiovascular risk stratification in asymptomatic middle-aged subjects over 50 years old, at low-to moderate cardiovascular risk, particularly with several risk factors.

Control of cardiometabolic risk factors and their association with carotid intima media thickness among patients with type 2 diabetes mellitus-single center experience in a developing country

Background/aim

Type 2 diabetes mellitus (T2DM) is closely associated with atherosclerotic cardiovascular diseases (ASCVD). The objective of this study was to describe the degree of ASCVD risk factor control and their association with carotid intima-media thickness (CIMT) in T2DM patients followed up at a diabetes clinic in Southern, Sri Lanka.

Materials and methods

A crosssectional study was conducted to examine the association between CIMT and nonalcoholic fatty liver disease (NAFLD)in 300 T2DM patients. Both CIMT and its associations with modifiable cardiometabolic risk factors were examined using ultrasonography. The recommended optimal targets for risk factors were defined as glycated hemoglobin (HbA1C) < 7 %, absence of NAFLD, albumin-to-creatinine ratio (ACR) < 30 mg, triglyceride (TG) < 150 mg/dL, low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, high-density lipoprotein cholesterol (HDL-C) in men > 40 and in women > 50 mg/dL, systolic blood pressure (SBP) < 130 mmHg, and diastolic blood pressure (DBP) < 80 mmHg.

Results

SBP, DBP, LDL-C, TG, HDL-C, HbA1C, and ACR were optimally controlled in 59.3%, 75.0%, 46.7%, 84.3%, 46.0%, 33.0%, and 18.7% of patients, respectively. Notably, nearly half of the study subjects did not have NAFLD. Only three patients (1%) had achieved all therapeutic targets. There were statistically significant differences in CIMT between optimally controlled TG and suboptimally controlled TG group (p = 0.027) and between the groups with and without NAFLD (p = 0.045) when adjusted for age and duration of diabetes. CIMT showed significant and positive associations with LDL-C (p = 0.024), TG (p = 0.026), and NAFLD (p = 0.005). Among these, the presence of NAFLD had the highest odds of having higher CIMT when compared to LDL-C and TG.

Conclusion

The majority of patients have not achieved the recommended targets for ASCVD risk factors and are at high risk of ASCVD. It is therefore necessary to identify the reasons for not achieving the treatment targets in order to reduce the ASCVD burden by controlling LDL-C, TG, and NAFLD.

Association Between Fatty Liver Index, Controlled Attenuation Parameter, and Metabolic Syndrome Stages: A Community-Based Study

BACKGROUND Controlled attenuation parameter (CAP) is a recent ultrasound-based method for measuring hepatic steatosis, which is common in patients with metabolic syndrome (MetS). The fatty liver index (FLI), an algorithm-based method, is frequently used to evaluate hepatic steatosis. This study assessed how FLI and CAP relate to the earlier MetS stage and their ability to identify it. MATERIAL AND METHODS A total of 170 community-based individuals were studied. Demographic information, body mass index, waist circumference, and blood pressures were collected. CAP was assessed by FibroScan. Fasting glucose, lipid tests, and γ-glutamyl transferase were measured. The CAP and FLI results were categorized into quartiles, with the MetS stages as the main outcomes. The odds ratio (OR) of the outcomes was calculated using logistic regression. The area under the curve in receiver operating characteristic analysis (AUC-ROC) was used to detect the stages of MetS. Sensitivity, specificity, and appropriate cut-offs based on ROC analysis are shown. RESULTS The higher the FLI or CAP category, the lower the proportion of non-MetS and the higher the proportion of moderate MetS. Each single-quartile increase in FLI and CAP was associated with an increased likelihood of being in the higher MetS stages - FLI: adjusted OR 3.1 (2.23-4.32); CAP: adjusted OR 1.96 (1.48-2.59). In the ROC analysis, FLI had a higher AUC-ROC than CAP in separating the stages of MetS, although findings were significant (P<0.001). FLI in detecting the stages of mild-to-severe versus non-MetS performed well (AUC-ROC [95% confidence interval]: 0.79 [0.72-0.87]), with high sensitivity (0.86) but low specificity (0.62). CONCLUSIONS FLI and CAP were positively associated with the MetS stage and its components, suggesting that they could be used as a MetS screening tool in community studies.

Plasma Adiponectin and Its Correlation with Carotid Intima-Media Thickness in Obesity and in Type 2 Diabetes and Nonalcoholic Fatty Liver Disease

Methods and Results

The study included 200 Egyptian subjects. They were divided into four equal groups: group 1: obese patients with NAFLD and T2DM (O+/NAFLD+/DM+), group 2: nonobese patients with NAFLD and T2DM (O-/NAFLD+/DM+), group 3: obese nondiabetic patients with NAFLD (O+/NAFLD+/DM-), and group 4: nonobese healthy control subjects. Plasma adiponectin was measured using ELISA (enzyme-linked immunosorbent assay) technique. Ultrasonography was used to diagnose NAFLD. CIMT was assessed using Doppler ultrasonography. Plasma adiponectin was significantly lower and CIMT was significantly higher in O+/NAFLD+/DM+, as compared with O-/NAFLD+/DM+, O+/NAFLD+/DM-, and control subjects (p < 0.001 for all). A significant negative correlation was found between adiponectin and CIMT in obese patients with NAFLD (p < 0.05), but not in patients with NAFLD and T2DM. The significant independent predictors of CIMT were diabetes duration, BMI (body mass index), albumin/creatinine ratio, and cholesterol.

Conclusion

Plasma adiponectin is inversely correlated with CIMT in obese patients with NAFLD, but not in patients with NAFLD and T2DM. Hypoadiponectinemia could be a good indicator of cardiovascular risk in obese patients with NAFLD, with or without T2DM, but not in nonobese patients with NAFLD.

Association between hemoglobin A1c and asymptomatic carotid intima-media thickness in middle-aged and elderly populations without diabetes

BACKGROUND AND AIMS

Carotid atherosclerosis, including carotid artery intima-media thickness, plaques, and stenosis, is an important risk factor for stroke. However, the association between hemoglobin A1c (HbA1c) and carotid intima-media thickness (cIMT) was inconsistent. The aim of this study was to explore the association between HbA1c and the risk of increased cIMT among the Chinese population aged ≥40 years without diabetes.

METHODS AND RESULTS

A total of 3528 participants without diabetes from the China National Stroke Screen Survey program were enrolled in this study. cIMT was measured using duplex ultrasound examination. Logistic regression models were used to assess the association between HbA1c level and the risk of increased cIMT. A total of 565 (16.0%) participants had increased cIMT. After adjustment for other potential confounding factors, higher levels of HbA1c increased the risk of increased cIMT compared with the lowest level, and the odds ratios for quartile 2, quartile 3, and quartile 4 were 1.58, 1.67, and 1.98, respectively. Age had an interaction impact on the association between HbA1c level and the risk of increased cIMT.

CONCLUSION

In this large-scale and cross-sectional study, high-normal HbA1c was associated with the risk of increased asymptomatic cIMT in a rural Chinese population without diabetes, especially in individuals aged <60 years.

Correlation of Carotid Artery Intima-Media Thickness with Calcium and Phosphorus Metabolism, Parathyroid Hormone, Microinflammatory State, and Cardiovascular Disease

The internal thickness of the carotid artery is the vertical distance between the intima of the carotid artery and the middle mold. Its normal thickness is less than 1 mm. It can be used to judge the degree of arteriosclerosis. Under normal circumstances, the change of the internal thickness of the carotid artery is caused by cardiovascular disease. The purpose of this article is to study the relationship between the thickness of the carotid artery and the metabolism of calcium and phosphorus, parathyroid hormone, microinflammatory state, and cardiovascular disease. This article uses ultrasound measurement to measure the IMT of ESRD patients and carotid arteries with normal renal function. The analysis includes blood pressure, blood phosphorus, blood calcium, blood creatinine, blood urea nitrogen, blood sugar, glycosylated hemoglobin, blood lipids, parathyroid hormone, and C reaction. The correlation between clinical indicators includes protein and carotid IMT in ESRD patients which can be used in designing a diagnostic plan for patients through correlation research. The results showed that the carotid artery IMT of ESRD nondialysis patients was 13% thicker than that of those with normal renal function, and it was significantly positively correlated with age, blood pressure, blood phosphorus, glycosylated hemoglobin, and C-reactive protein. The correlation ratio with calcium and phosphorus was about 0.1.

Hypoadiponectinemia as a marker of increased cardiovascular risk in patients with non-alcoholic fatty liver disease: correlation with albumin/creatinine ratio

OBJECTIVE

We assessed plasma adiponectin and its correlation with carotid intima-media-thickness (CIMT), as a marker of atherosclerosis, and urine albumin/creatinine ratio (ACR) in patients with non-alcoholic fatty liver disease (NAFLD).

METHODS

The study included 100 Egyptian subjects (50 patients with NAFLD with no history of diabetes or hypertension and 50 age and sex-matched normal healthy control subjects). Urine albumin/creatinine ratio (ACR) was assessed in all participants and fasting plasma adiponectin was measured using ELISA technique. Ultrasonography was used to diagnose NAFLD. CIMT was assessed using high-resolution Doppler ultrasonography.

RESULTS

Mild albuminuria was detected in patients with NAFLD (mean urine ACR = 42 ± 30 mg/g). Plasma adiponectin was significantly lower and urine ACR and CIMT significantly higher in patients with NAFLD as compared with the control group (P < 0.001 for all). A significant negative correlation was found between plasma adiponectin and both urine ACR and CIMT in patients with NAFLD (P < 0.001 and < 0.05 respectively). A significant positive correlation was also found between CIMT and urine ACR in those patients (P < 0.05). Plasma adiponectin and urine ACR were independent determinants of CIMT in patients with NAFLD (P < 0.01 and < 0.05 respectively).

CONCLUSION

Patients with NAFLD, without diabetes, have an increased risk of atherosclerosis and cardiovascular disease. Hypoadiponectinemia and low-grade albuminuria are important markers of that risk.

The prediction of asymptomatic carotid atherosclerosis with electronic health records: a comparative study of six machine learning models

BACKGROUND

Screening carotid B-mode ultrasonography is a frequently used method to detect subjects with carotid atherosclerosis (CAS). Due to the asymptomatic progression of most CAS patients, early identification is challenging for clinicians, and it may trigger ischemic stroke. Recently, machine learning has shown a strong ability to classify data and a potential for prediction in the medical field. The combined use of machine learning and the electronic health records of patients could provide clinicians with a more convenient and precise method to identify asymptomatic CAS.

METHODS

Retrospective cohort study using routine clinical data of medical check-up subjects from April 19, 2010 to November 15, 2019. Six machine learning models (logistic regression [LR], random forest [RF], decision tree [DT], eXtreme Gradient Boosting [XGB], Gaussian Naïve Bayes [GNB], and K-Nearest Neighbour [KNN]) were used to predict asymptomatic CAS and compared their predictability in terms of the area under the receiver operating characteristic curve (AUCROC), accuracy (ACC), and F1 score (F1).

RESULTS

Of the 18,441 subjects, 6553 were diagnosed with asymptomatic CAS. Compared to DT (AUCROC 0.628, ACC 65.4%, and F1 52.5%), the other five models improved prediction: KNN + 7.6% (0.704, 68.8%, and 50.9%, respectively), GNB + 12.5% (0.753, 67.0%, and 46.8%, respectively), XGB + 16.0% (0.788, 73.4%, and 55.7%, respectively), RF + 16.6% (0.794, 74.5%, and 56.8%, respectively) and LR + 18.1% (0.809, 74.7%, and 59.9%, respectively). The highest achieving model, LR predicted 1045/1966 cases (sensitivity 53.2%) and 3088/3566 non-cases (specificity 86.6%). A tenfold cross-validation scheme further verified the predictive ability of the LR.

CONCLUSIONS

Among machine learning models, LR showed optimal performance in predicting asymptomatic CAS. Our findings set the stage for an early automatic alarming system, allowing a more precise allocation of CAS prevention measures to individuals probably to benefit most.

Arterial endothelial function, carotid artery intima-media thickness and abdominal aortic calcification in diabetic and nondiabetic CKD stage 4-5 patients not on dialysis

AIMS

We aimed to study the effect of diabetes (DM) on endothelial dysfunction assessed by flow-mediated vasodilatation (FMD), carotid intima-media thickness (cIMT) and abdominal aortic calcification score (AAC) in chronic kidney disease (CKD) stage 4-5 patients not on dialysis.

METHODS

Altogether 199 non-dialysis CKD stage 4-5 patients enrolled in the Chronic Arterial Disease, quality of life and mortality in chronic KIDney injury (CADKID) study with plain lumbar radiograph for the assessment of AAC were included. Data on cIMT and FMD were available for 172 and 161 patients, respectively.

RESULTS

Median age was 65 (IQR 54-76) years, 88 (44.2%) patients had DM and median eGFR was 12 (IQR 10-14) ml/min/1.73 m² in the study. FMD [controls: 3.3(2.0-6.7)% vs. DM-patients: 4.3(1.3-6.6)%, p = 0.73] and cIMT [controls: 0.65(0.58-0.87)mm vs. DM-patients: 0.67(0.59-0.81)mm, p = 0.65], were similar between the groups. AAC was higher in patients with DM [controls: 5(1-9) vs. DM-patients: 7(2-13), p = 0.01]. The significant multivariate determinants for AAC were older age (β = 0.22, p < 0.0001), pulse pressure (β = 0.05, p < 0.0001), DM (β = 1.33, p = 0.04) and ProBNP (per µg/l β = 0.18, p = 0.0008). AAC and cIMT were associated with incident cardiovascular death independent of DM.

CONCLUSIONS

DM is associated with increased AAC but not increased cIMT or attenuated FMD in advanced CKD patients.

The Anti-inflammatory and Antiatherogenic In Vivo Effects of Pomegranate Peel Powder: From Waste to Medicinal Food

The highest causes of worldwide morbidity and mortality are cardiovascular diseases (CVD) that pose a major health concern affecting patients' quality of life. Pomegranate fruit contains unique compounds with various bioactivities and has been used as a powerful medicinal food in various illnesses, including CVD. Several trials confirmed the therapeutic impacts of its edible portion, but trials on pomegranate peel's impacts are fewer. Our aim was to evaluate the anti-inflammatory and antiatherogenic in vivo effects of pomegranate peel powder (PPP) in rats fed a high-fat diet (HFD). Twenty-eight albino rats were distributed among four groups: I (control), II (on HFD), III (on HFD and PPP 0.5 g/kg BW), and IV (on HFD and 1 g/kg BW). Blood samples were tested for interleukin-6 (IL-6), C-reactive protein (CRP), serum amyloid-A (SAA), total cholesterol (TC), high density lipoprotein cholesterol (HDL), and some primary biochemical parameters. HFD induced significant elevations in cholesterol and inflammatory markers as compared with controls. Nevertheless, HDL, alanine aminotransferase, creatinine, and albumin showed no change in all rats. In both PPP treatment groups, CRP and SAA levels were reduced significantly with significant decrease in TC. Samples of thoracic aorta from treatment groups showed a normal appearance and amelioration of subclinical atherosclerotic changes found in HFD group. PPP exhibited anti-inflammatory and antiatherogenic effects in comparison to HFD controls.

Carotid plaque and lumbar bone mineral density status in post-menopausal women: An age-matched, analytical cross-sectional study

Objective

To explore the association between carotid plaque and lumbar spine osteoporosis in post-menopausal women.

Study design

Age-matched, cross-sectional study.

Main outcome measures

Carotid plaque and carotid intima media thickness were measured with B-mode ultrasound. Lumbar spine bone mineral density was measured with dual-energy X-ray absorptiometry. Prevalence odds ratios and the respective 95% confidence intervals (95%CI) were calculated to determine the association.

Results

Seventy-two post-menopausal women with lumbar spine osteoporosis and 72 post-menopausal women with normal lumbar spine bone mineral density were enrolled. The adjusted prevalence odds ratio of carotid plaque presence in post-menopausal women with lumbar spine osteoporosis was 1.73 (95%CI; 0.60 to 4.94) when compared to post-menopausal women with normal lumbar spine bone mineral density. The presence of vulnerable plaque was greater in post-menopausal women with lumbar spine osteoporosis; however, the difference was not statistically significant after adjusting for other risk factors of cardiovascular disease (odds ratio 1.31; 95%CI; 0.39 to 4.43). There was no significant difference in carotid intima media thickness between the two groups. Multiple logistic regression analysis with backward elimination in assessment of potential risk factors for the presence of carotid plaque showed that the year since menopause, family history of cardiovascular disease and systolic blood pressure were nominally significant associated factors with a respective adjusted odds ratio of 1.06 (95%CI; 1.01 to 1.12), 6.23 (95%CI; 1.65 to 23.46) and 1.03 (95%CI; 1.01 to 1.06).

Conclusions

The current study indicates that lumbar spine osteoporosis is not associated with the presence of carotid plaque, whereas year since menopause, family history of cardiovascular disease and systolic blood pressure are associated factors.

Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes

Background

Diabetes has been reported to be associated with carotid artery plaque (CAP). However, it remains unclear whether hemoglobin A1c (HbA1c) level, a marker for long-term glycemic status, is associated with altered CAP risk in individuals with fasting blood glucose (FBG) concentrations below the current cutoff for diabetes.

Methods

Included were 16,863 Chinese adults (aged 18 years or more; 9855 men and 7008 women) with fasting blood glucose < 7.0 mmol/L at baseline (2013). Both HbA1c level and CAP (assessed via ultrasound B-mode imaging) were annually assessed during 2014–2018. All the participants were further classified into three groups based on baseline HbA1c level: ≤ 5.6%, 5.7–6.4%, and ≥ 6.5%. We used Cox proportional-hazards model to evaluate the association between HbA1c level and incident CAP, adjusting for a series of potential confounders.

Results

During 5 years of follow up, 3942 incident CAP cases were identified. Individuals with higher baseline HbA1c had higher future risk of CAP (p-trend < 0.001). In the full-adjusted model, each percent increase of HbA1c was associated with a 56% (HR = 1.56, 95% CI 1.37, 1.78) higher risk of CAP. Excluding participants with chronic inflammation, as assessed by high-sensitivity C-reactive protein and white blood cell, and those with FBG ≥ 5.6 mmol/L at baseline generated similar results.

Conclusions

Elevated HbA1c level was associated with high risk of developing CAP in Chinese adults without FBG defined diabetes.

Association of Kidney Function Tests with a Cardio-Ankle Vascular Index in Community-Dwelling Individuals with a Normal or Mildly Decreased Estimated Glomerular Filtration Rate

Background and objectives: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD). Previous studies reported controversial results about the independence of CKD as a risk factor for atherosclerosis. In this study, we tried to determine whether the estimated glomerular filtration rate (eGFR) and other renal function tests are independent factors associated with arterial stiffness in community-dwelling individuals with a normal (≥90) or slightly decreased eGFR (60-90). Materials and Methods: Data of 164 community individuals were analyzed, and demographic information, related disease history, atherosclerosis risk factors, certain laboratory tests, the estimated eGFR, and urine albumin creatinine ratio (UACR) were recorded for each individual. Results: The age, systolic blood pressure (SBP), hypertension (HTN), and cardio-ankle vascular index (CAVI) significantly differed between individuals with a normal and those with a slightly decreased eGFR. Blood urea nitrogen (BUN), glycated hemoglobin (HBA1c), and the eGFR significantly differed between the high- and low-CAVI groups and were also significantly correlated with the CAVI. The relationship between the eGFR and CAVI was shown to be independent of other atherosclerosis risk factors in a multiple linear regression model. Conclusions: We concluded that evaluations of the eGFR, HTN, body-mass index, and SBP can be used in a model for arterial stiffness risk assessments for community-dwelling individuals with a normal or slightly decreased eGFR.

Uric acid: from a biological advantage to a potential danger. A focus on cardiovascular effects

Non-communicable diseases represent nowadays the most common cause of death worldwide, having largely overcome infectious diseases. Among them, cardiovascular diseases constitute the majority. Given these premise, great efforts have been made by scientific societies to emphasize the fundamental role of cardiovascular prevention and risk factors control. In addition to classical cardiovascular risk factors such as smoking, arterial hypertension, hypercholesterolemia and male gender, new risk factors are emerging from international literature. Among them, uric acid is the protagonist. Several evidences show a direct role of hyperuricemia in the determinism of metabolic and vascular disorders. From the other hand, some researchers have demonstrated that uric acid is only a marker of cardiovascular damage and not a risk factor for its development. Aim of this review is to evaluate the scientific evidences on the role of uric acid in cardiovascular diseases in order to shed light on this confusing topic.

Value of the arterial stiffness index and ankle brachial index in subclinical atherosclerosis screening in healthy community-dwelling individuals

BACKGROUND

Carotid intima media thickness (cIMT) and the carotid plaque score (cPS) are valid markers for detecting subclinical atherosclerosis. Evaluation of ASI and ABI for detection of atherosclerosis is assessed in this study. Finding a model to see which individual has a risk of having atherosclerosis, so those people can be further assessed by invasive but more accurate atherosclerosis detection methods like angiography is another objective of this study.

METHODS

Data of 212 healthy community-dwelling subjects, consisting of carotid duplex records, ASI and ABI measurements, certain laboratory tests, and related cardiovascular disease (CVD) risks were analyzed for correlations.

RESULTS

The ABI was independently associated with high cPS. Age, hypertension and Waist circumference are determinants of subclinical atherosclerosis as in high cIMT and high cPS.

CONCLUSIONS

The use of the ASI cannot replace carotid ultrasound in detecting subclinical atherosclerosis because it is not independently associated with high cIMT and cPS while ABI can be used in detection of high cPS in healthy community-dwelling individuals. Public health policies to encourage weight reduction and treating hypertension can help prevention of subclinical atherosclerosis in healthy community-dwelling individuals. Models consist of age, body compositions like waist circumference and hypertension history can be used in further assessment of atherosclerosis.

Comparison of Carotid Ultrasound Indices and the Triglyceride Glucose Index in Hypertensive and Normotensive Community-Dwelling Individuals: A Case Control Study for Evaluating Atherosclerosis

Background and objectives: Hypertension (HTN) is an important risk factor for cardiovascular diseases. High blood pressure is a major cause of atherosclerosis which leads to myocardial infarction and stroke. Insulin resistance (IR) is correlated with HTN and atherosclerosis. To determine differences between the effects of HTN on the intima media thicknesses (IMTs) of the internal (ICA), external (ECA), and common carotid arteries (CCA), and evaluate the carotid plaque presence between hypertensive and normotensive individuals, a case-control study was designed among community-dwelling individuals. The relationship between the triglyceride glucose (TyG) index and atherosclerosis was also investigated in this study. Materials and Methods: Data from 77 hypertensive and 199 normotensive individuals were analyzed in this study. Results: The IMTs of the CCA, ICA, and ECA, and the TyG index were all higher in hypertensive individuals compared to the control group (all p < 0.05). After controlling for age, sex, the body-mass index, and TyG index, HTN was an independent predictor of a high CCA IMT (odds ratio (OR) = 2.48; 95% confidence interval (CI) = 1.24–4.93) and presence of plaque (OR = 2.36; CI = 1.15–4.85) in the carotid artery. Conclusions: HTN was an independent risk of carotid IMT thickening and atherosclerosis. TyG index could only predict the CCA IMT independent of other risk factors (OR = 2.09; CI = 1.07–4.09).