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Sun H, Tian Y, Wu H, Zhu C, Lin L, Chen S, Wu S, Wu Y. Chinese visceral adipose index is more closely associated with risk of arterial stiffness than traditional obesity indicators: a cohort study. Diabetol Metab Syndr 2024; 16:196. [PMID: 39143568 PMCID: PMC11323351 DOI: 10.1186/s13098-024-01436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/01/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The Chinese visceral adiposity index (CVAI) is a new index to evaluate visceral adipose tissue in the Chinese population. Arterial stiffness (AS) is a kind of degeneration of the large arteries, and obesity is an essential contributing factor to AS. Our study aimed to explore the longitudinal association between CVAI and the risk of AS and to compare the predictive power of CVAI, body mass index (BMI), and waist circumference (WC) for AS. METHODS Between 2010 and 2020, a total of 14,877 participants participating in at least two brachial-ankle pulse wave velocity (baPWV) measurements from the Kailuan study were included. The Cox proportional hazard regression models were performed to evaluate the longitudinal association between CVAI and the risk of AS. The area under the receiver operating characteristic (ROC) curve was calculated to compare the predictive power of CVAI, BMI, and WC for AS. RESULTS After adjusting for potential confounding factors, CVAI was significantly associated with the risk of AS. Compared with the first CVAI quartile, the hazard ratios (HR) and 95% CI of the second, third, and fourth quartiles were 1.30 (1.09-1.56), 1.37 (1.15-1.63), and 1.49 (1.24-1.78), respectively. The area under ROC curve of CVAI was 0.661, significantly higher than BMI (AUC: 0.582) and WC (AUC: 0.606). CONCLUSION CVAI may be a reliable indicator to identify high-risk groups of AS in the Chinese general population, and the predictive power of CVAI for AS was better than BMI and WC.
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Affiliation(s)
- Huayu Sun
- School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
- Kailuan General Hospital, Tangshan, 063000, China
| | - Yan Tian
- School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
| | - Hao Wu
- School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
| | - Chenrui Zhu
- Kailuan General Hospital, Tangshan, 063000, China
| | - Liming Lin
- Kailuan General Hospital, Tangshan, 063000, China
| | - Shuohua Chen
- Kailuan General Hospital, Tangshan, 063000, China
| | - Shouling Wu
- Kailuan General Hospital, Tangshan, 063000, China
| | - Yuntao Wu
- Kailuan General Hospital, Tangshan, 063000, China.
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Li B, Zhou X, Liu Y, Zhang Y, Mu Y. Remnant Cholesterol is More Strongly Associated with Arterial Stiffness than Traditional Lipids and Lipid Ratios in the General Chinese Population. J Atheroscler Thromb 2024; 31:587-602. [PMID: 38171806 PMCID: PMC11079499 DOI: 10.5551/jat.64146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 10/22/2023] [Indexed: 01/05/2024] Open
Abstract
AIM Studies on the relationship between remnant cholesterol (RC) and arterial stiffness (AS) are limited. This study aims to investigate the relationship between RC and AS and to explore RC, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), non-HDL-C, LDL-C/HDL-C, TG/HDL-C, lipoprotein combine index (LCI), and TC/HDL-C, which are lipid parameters most strongly associated with AS. METHODS A total of 4653 participants from the REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals) study were recruited. AS was defined as a brachial-ankle pulse wave velocity of ≥ 1400 cm/s. Multiple logistic regression analyses were performed to detect its association with lipid parameters (RC, TG, TC, HDL-C, LDL-C, non-HDL-C, LDL-C/HDL-C, TG/HDL-C, LCI, and TC/HDL-C). RESULTS Logistic regression analysis showed that compared with other traditional or non-traditional lipid parameters, the association between RC and AS was the strongest (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.30-1.95, P<0.001). In the stratified analysis, RC was significantly associated with AS in both sexes and at any age, as well as blood glucose, blood pressure, and body mass index levels. Besides, RC and AS were still significantly associated when TG<1.7 mmol/L (OR:1.58, 95% CI: 1.02-2.45, P=0.04), LDL-C <3.4 mmol/L (OR:1.32, 95% CI: 1.01-1.73, P=0.041), HDL-C ≥ 1.0 mmol/L (OR:1.67, 95% CI: 1.34-2.08, P<0.001), or non-HDL-C<4.1 mmol/L (OR: 1.42, 95% CI: 1.10-1.82, P=0.007) are controlled within the appropriate range. CONCLUSION In conclusion, compared with traditional lipids and lipid ratios, RC is more strongly associated with AS. The association between RC and AS remains significant even when TG, LDL-C, HDL-C, or non-HDL-C levels are controlled within the appropriate range.
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Affiliation(s)
- Binqi Li
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
| | - Xin Zhou
- Graduate School, Chinese PLA General Hospital, Beijing, China
- Department of Medical Oncology, Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China>
- The Second Medical Center of Chinese PLA General Hospital, Beijing, China>
| | - Yang Liu
- Department of Endocrinology, Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Yue Zhang
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
| | - Yiming Mu
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
- Graduate School, Chinese PLA General Hospital, Beijing, China
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Abdullah N, Blin JA, Kamalul Arifin AS, Abd Jalal N, Ismail N, Mohd Yusof NA, Abdullah MS, Husin NF, Dauni A, Kamaruddin MA, Mohammed Nawi A, Ahmad N, Hassan MR, Jamal R. Cardiovascular risk prediction with cardio-ankle vascular index in the malaysian cohort study. Curr Probl Cardiol 2024; 49:102192. [PMID: 37952789 DOI: 10.1016/j.cpcardiol.2023.102192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
The cardio-ankle vascular index (CAVI) is an important parameter assessing arterial function. It reflects arterial stiffness from the origin of the aorta to the ankle, and the algorithm is blood pressure independent. Recent data have suggested that a high CAVI score can predict future cardiovascular disease (CVD) events; however, to date, no study has been done in Malaysia. We conducted a prospective study on 2,168 The Malaysian Cohort (TMC) CVD-free participants (971 men and 1,197 women; mean age 51.64 ± 8.38 years old) recruited from November 2011 to March 2012. This participants were followed-up until the emergence of CVD incidence and mortality (endpoint between May to September 2019; duration of 7.5 years). Eligible participants were assessed based on CAVI baseline measurement which categorised them into low (CAVI <9.0) and high (CAVI ≥ 9.0) scores. The CVD events in the group with high CAVI (6.5 %) were significantly higher than in the low CAVI (2.6 %) group (p < 0.05). CAVI with cut-off point ≥ 9.0 was a significant independent predictor for CVD event even after adjustment for male, ethnicity, age, and intermediate atherogenic index of plasma (AIP). Those who have higher CAVI have 78 % significantly higher risk of developing CVD compared to those with the low CAVI (adjusted OR [95 % CI] = 1.78 [1.04 - 3.05], p =0.035). In addition, the participants with higher CAVI have significantly lower survival probability than those who have lower CAVI values. Thus, this study indicated that the CAVI can predict CVD event independently among the TMC participants.
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Affiliation(s)
| | - Joan Anak Blin
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | | | - Nazihah Abd Jalal
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | - Norliza Ismail
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | | | | | - Nurul Faeizah Husin
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | - Andri Dauni
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | | | - Azmawati Mohammed Nawi
- Department of Public Health Medicine, Faculty of Medicine, UKM, Kuala Lumpur 56000, Malaysia.
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, UKM, Kuala Lumpur 56000, Malaysia.
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, UKM, Kuala Lumpur 56000, Malaysia.
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
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Yeboah K, Essel S, Agyekum J, Dzudzor B. Association between cardio-ankle vascular index and cardiometabolic risk factors in HIV patients in Ghana. Libyan J Med 2023; 18:2215636. [PMID: 37207315 DOI: 10.1080/19932820.2023.2215636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
Human immunodeficiency virus (HIV) infection is associated with increased cardiovascular diseases (CVDs) even in patients with viral suppression by combination antiretroviral therapy (cART). Arterial stiffness is an independent predictor of CVDs in diseased individuals and the general population. Cardio-ankle vascular index (CAVI) is an index of arterial stiffness that has been shown to predict target organ damage. CAVI is less studied in HIV patients. We compared the levels of arterial stiffness using CAVI and associated factors among cART-treated and cART-naïve HIV patients to those of non-HIV controls. In a case-control design, 158 cART-treated HIV patients, 150 cART-naïve HIV patients and 156 non-HIV controls were recruited from a periurban hospital. We collected data on CVD risk factors, anthropometric characteristics, CAVI, and fasting blood samples to measure plasma glucose, lipid profile, and CD4+ cell counts. Metabolic abnormalities were defined using the JIS criteria. CAVI increased in cART-treated HIV patients compared to cART-naïve HIV patients and non-HIV controls (7.8 ± 1.4 vs 6.6 ± 1.1 vs 6.7 ± 1.4 respectively, p < 0.001). CAVI was associated with metabolic syndrome in non-HIV controls [OR (95% CI) = 2.14 (1.04-4.4), p = 0.039] and cART-naïve HIV patients [1.47 (1.21-2.38), p = 0.015], but not in cART-treated HIV patients [0.81 (0.52-1.26), p = 0.353]. In cART-treated HIV patients, a tenofovir (TDF)-based regimen (β = -0.46, p = 0.023) was associated with decreased CAVI and decreased CD4+ cell count (β = -0.23, p = 0.047) was associated with increased CAVI. In a periurban hospital in Ghana, compared to non-HIV controls or cART-naïve HIV patients, cART-treated HIV patients had increased arterial stiffness measured as CAVI. CAVI is associated with metabolic abnormalities in non-HIV controls and cART-naïve HIV patients, but not in cART-treated HIV patients. Patients on TDF-based regimens had decreased CAVI.
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Affiliation(s)
- Kwame Yeboah
- Department of Physiology, University of Ghana Medical School, Accra, Ghana
| | - Samuel Essel
- Department of Physiology, University of Ghana Medical School, Accra, Ghana
- Department of Physician Assistant Studies, Central University, Accra, Ghana
| | - Jennifer Agyekum
- Department of Physiology, University of Ghana Medical School, Accra, Ghana
- Medical Laboratory Unit, Mamprobi Hospital, Ghana Health Service, Accra, Ghana
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, Accra, Ghana
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Bolibar Ribas B, Llobera-Cànaves J, García-Ortiz L, Bellón JÁ, Ramos R, García-Campayo J, Sánchez-Pérez Á, Claveria A, Martínez V, Vicens E, Minué C, Gil-Guillen V, Berenguera A, Moleras-Serra A. [The Research Network on Preventive Activities and Health Promotion (redIAPP): a reference network and promoter of primary care research]. Aten Primaria 2023; 55:102694. [PMID: 37481824 PMCID: PMC10391719 DOI: 10.1016/j.aprim.2023.102694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/14/2023] [Accepted: 05/21/2023] [Indexed: 07/25/2023] Open
Abstract
The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.
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Affiliation(s)
- Bonaventura Bolibar Ribas
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - Joan Llobera-Cànaves
- Unitat de Recerca en Atenció Primaria de Mallorca, Servei de Salut de les Illes Balears (Ib-Salut), Palma, España; Institut de Investigació Sanitària de les Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, España
| | - Luis García-Ortiz
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de salud de Castilla y León (SACyL), Salamanca, España; Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España; Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, España
| | - Juan-Ángel Bellón
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, España; Centro de Salud El Palo, Servicio Andaluz de Salud (SAS), Málaga, España; Departmento de Salud Pública y Psiquiatría, Facultad de Medicina, Universidad de Málaga (UMA), Málaga, España
| | - Rafel Ramos
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Grup de Recerca en Salut Vascular, Institut d'Investigació Biomèdica de Girona (IdibGi), Parc Hospitalari Martí Julià, Girona, España; Department de Ciències Mèdiques, Facultat de Medicina, Campus Salut, Universitat de Girona, Girona, España; Atenció Primària, Institut Català de la Salut, Girona, Catalonia, España
| | - Javier García-Campayo
- Grupo de Aragón en Investigación en Atención Primaria (GAIAP), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España; Servicio de Psiquiatría, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
| | - Álvaro Sánchez-Pérez
- Unidad de Investigación Atención Primaria de Bizkaia, Subdirección para la Coordinación de la Atención Primaria, Dirección General Osakidetza, Bilbao, España; Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios Sanitarios, Instituto Investigación Biocruces Bizkaia, Barakaldo, España
| | - Ana Claveria
- Área Sanitaria de Vigo. Servicio Galego de Saúde (SERGAS), Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Galicia, España
| | - Vicente Martínez
- Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Cuenca, España; Facultad de Medicina, Universidad Autónoma de Chile, Talca, Chile
| | - Enric Vicens
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, España
| | - César Minué
- Grupo Clínico Asociado Madrid. Servicio Madrileño de Salud. CS Perales del Río, Madrid, España
| | - Vicente Gil-Guillen
- Departamento de Medicina Clínica. Universidad Miguel Hernández, Alicante, España; Unidad de Investigación. Hospital General Universitario de Elda, Alicante, España; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL. Hospital General Universitario de Alicante, Alicante, España
| | - Anna Berenguera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - Anna Moleras-Serra
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España.
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Guo W, Jia J, Zhan M, Li X, Zhu W, Lu J, Zhao X, Xu N, Zhang Q. Association of metabolically unhealthy non-obese and metabolically healthy obese individuals with arterial stiffness and 10-year cardiovascular disease risk: a cross-sectional study in Chinese adults. Nutr J 2023; 22:44. [PMID: 37726745 PMCID: PMC10510138 DOI: 10.1186/s12937-023-00870-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/13/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The relationship between metabolically healthy obese individuals (MHO) and cardiovascular disease (CVD) risk is disputed. This study investigated the association of metabolically unhealthy non-obese(MUNO) individuals and MHO with arterial stiffness and 10-year CVD risk. METHODS A total of 13,435 participants were enrolled and further divided into the metabolically healthy non-obese (MHNO) phenotype (n = 4927), MUNO phenotype (n = 1971), MHO phenotype (n = 2537) and metabolically unhealthy obese (MUO) phenotype (n = 4000) according to body mass index (BMI) and metabolic status. We used brachial ankle pulse wave velocity (baPWV) to measure arterial stiffness and the Framingham risk score (FRS) to evaluate the 10-year CVD risk. RESULTS The MUO and MUNO phenotypes had higher mean baPWV values than the MHO and MHNO phenotypes, regardless of age (1446.19 ± 233.65 vs. 1423.29 ± 240.72 vs. 1283.57 ± 213.77 vs. 1234.08 ± 215.99 cm/s, P < 0.001). Logistic regression analysis indicated that the MUNO and MUO phenotypes were independently correlated with elevated baPWV and 10-year CVD risk, while the MHO phenotype was independently associated with only the 10-year CVD risk. In metabolically healthy subjects, BMI showed a dose-dependent increase in the risk of elevated baPWV, with an adjusted OR of 1.007 (95% CI 1.004-1.010, P < 0.001). However, in metabolically unhealthy participants, the estimate for the relationship between elevated baPWV and BMI was nonsignificant. CONCLUSIONS The MUNO phenotype exhibits increased arterial stiffness and 10-year CVD risk. However, BMI is positively and dose-dependently correlated with arterial stiffness only in metabolically healthy subjects. We speculate that metabolic status may be a strong confounder in the obesity-elevated baPWV association.
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Affiliation(s)
- Wen Guo
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Jue Jia
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Jiangsu University, Zhenjiang, 212000 China
| | - Mengyao Zhan
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166 China
| | - Xiaona Li
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Wenfang Zhu
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Jing Lu
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Xin Zhao
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Nainzhen Xu
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Qun Zhang
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
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Alinezhad‐Namaghi M, Eslami S, Nematy M, Rezvani R, Khoshnasab A, Bonakdaran S, Philippou E, Norouzy A. Association of time-restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome. Health Sci Rep 2023; 6:e1385. [PMID: 37408869 PMCID: PMC10318230 DOI: 10.1002/hsr2.1385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 07/07/2023] Open
Abstract
Background Time-restricted feeding (TRF) is a kind of intermittent fasting defined as eating and drinking only during a certain number of hours in a day. It has been suggested that intermittent fasting may improve cardiovascular risk factors. This study evaluated the association of TRF and arterial stiffness, using pulse wave velocity (PWV), pulse wave analysis, and arterial age in metabolic syndrome participants. Methods A cohort study was carried out among metabolic syndrome adults who were followed over the Ramadan fasting period (used as a model of TRF since food was only allowed for about 8 h/day). The subjects were divided into Ramadan fasting and Ramadan nonfasting groups. The aortic PWV and central aortic pressure waveform were measured. Central systolic pressure, central pulse pressure, and indices of arterial compliance, such as augmentation pressure and augmentation index (AIx), were determined from waveform analysis. Results Ninety-five adults (31.57% female, age: 45.46 ± 9.10 years) with metabolic syndrome (based on the International Diabetes Federation definition) participated in this study. Ramadan fasting and Ramadan nonfasting groups were including 80 and 15 individuals respectively. A significant reduction was seen in PWV (0.29 m/s), central systolic pressure (4.03 mmHg), central pulse pressure (2.43 mmHg), central augmentation pressure (1.88 mmHg), and central AIx (2.47) in the Ramadan fasting group (p = 0.014, p < 0.001, p = 0.001, p = 0.003, and p = 0.036 respectively). There were no significant changes in these indices among the Ramadan nonfasting group. Conclusions This study suggested that TRF reduces arterial age and improves arterial stiffness among people with metabolic syndrome. This might be considered a beneficial nutrition strategy for extending healthspan (and perhaps longevity).
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Affiliation(s)
- Maryam Alinezhad‐Namaghi
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Saeid Eslami
- Pharmaceutical Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mohsen Nematy
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Reza Rezvani
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Adeleh Khoshnasab
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Shokoofeh Bonakdaran
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and EngineeringUniversity of NicosiaCyprus
- Department of Nutritional SciencesKing's CollegeLondonUK
| | - Abdolreza Norouzy
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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Shirai K. Should the Definition of Metabolic Syndrome be Reconsidered from the Aspect of Arterial Stiffness? J Atheroscler Thromb 2022; 29:1701-1703. [PMID: 35781276 PMCID: PMC9881545 DOI: 10.5551/jat.ed209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Kohji Shirai
- Clinical Research Center, Seijinkai Mihama Hospital, Chiba, Japan
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9
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Kim S, Choi SY, Lee H, Ju Kim J, Eun Park H. Sex and Age Differences in the Impact of Metabolic Syndrome and Its Components including A Body Shape Index on Arterial Stiffness in the General Population. J Atheroscler Thromb 2022; 29:1774-1790. [PMID: 35354700 PMCID: PMC9881533 DOI: 10.5551/jat.63371] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIM We investigated the effects of metabolic syndrome (MetS) and its components, including a body shape index (ABSI), on increased arterial stiffness measured using the cardio-ankle vascular index (CAVI) according to sex and age strata. METHODS A total of 7127 asymptomatic Korean participants aged 21-90 years (men, 69.4%) were included. Age-sex-specific increased CAVI was defined as having the highest quartile of CAVI in each age group. RESULTS The CAVI increased with age and was higher in men. MetS was associated with an increased risk of high CAVI by 1.30 times in men and 1.45 times in women. The risk of high CAVI with an increasing MetS risk score was greater in women. MetS was significantly associated with increased CAVI in men only aged 51-70 years and in women aged ≥ 51 years, and the size of association increased with age (odds ratio (OR) of 1.41 in 51-70 years vs. OR of 2.96 in ≥ 71 years of women). Among MetS components, triglyceride (men, all ages), hypertension (men, 51-70 years; women, ≤ 70 years), glucose intolerance (men, 51-70 years; women, ≥ 51 years), and HDL-cholesterol (women, ≥ 71 years) were associated with increased CAVI.Unlike increased waist circumference (WC), increased ABSI revealed an association with high CAVI. MetS diagnosed with ABSI instead of WC was more significantly associated with increased CAVI in all age-sex groups. CONCLUSION The association of MetS and its components with increased CAVI differed with age and sex, which might provide a new insight for the management of MetS risk factors to promote vascular health.
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Affiliation(s)
- Sunmie Kim
- Department of Obstetrics and Gynecology,
Seoul National University College of Medicine, Seoul National University Hospital
Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Su-Yeon Choi
- Department of Internal Medicine,
Seoul National University College of Medicine, Seoul National University Hospital Healthcare
System Gangnam Center, Seoul, Republic of Korea
| | - Heesun Lee
- Department of Internal Medicine,
Seoul National University College of Medicine, Seoul National University Hospital Healthcare
System Gangnam Center, Seoul, Republic of Korea
| | - Jin Ju Kim
- Department of Obstetrics and Gynecology,
Seoul National University College of Medicine, Seoul National University Hospital
Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Hyo Eun Park
- Department of Internal Medicine,
Seoul National University College of Medicine, Seoul National University Hospital Healthcare
System Gangnam Center, Seoul, Republic of Korea
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10
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Limpijankit T, Jongjirasiri S, Meemook K, Unwanatham N, Thakkinstian A, Laothamatas J. Predictive values of coronary artery calcium and arterial stiffness for long-term cardiovascular events in patients with stable coronary artery disease. Clin Cardiol 2022; 46:171-183. [PMID: 36448219 PMCID: PMC9933115 DOI: 10.1002/clc.23955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/01/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Subclinical atherosclerosis detected by increased coronary artery calcium (CAC) or arterial stiffness as reflected by cardio-ankle vascular index (CAVI) has been associated with major adverse cardiovascular events (MACEs). However, comparative data from these two assessments in the same population are still limited. METHODS From 2005 to 2013, patients with stable coronary artery disease (CAD), both asymptomatic and symptomatic who underwent both coronary computed tomography and CAVI were enrolled and followed for occurrence of MACEs (cardiovascular [CV] death, nonfatal myocardial infarction [MI], and nonfatal stroke) until December 2019. A cause-specific hazard model was applied to assess the associations of CAC score, and CAVI with long-term MACEs. RESULTS A total of 8687 patients participated. Of them, CAC scores were 0, 1-99, 100-399, and ≥400 in 49.7%, 31.9%, 12.3%, and 6.1%, respectively. Arterial stiffness (CAVI ≥ 9.0) was associated with the magnitude of CAC in 23.8%, 36.3%, 44.5%, and 56.2%, respectively. During an average of 9.9 ± 2.4 years follow-up, MACEs occurred in 8.0% (95% CI: 7.4%, 8.6%) of subjects. After adjusting for covariables, CAC scores of 100-399 and ≥400, and CAVIs of ≥9.0 were found to independently predict the occurrence of MACEs with the hazard ratios (95% CI) of 1.70 (1.13, 1.98), 1.87 (1.33, 2.63), and 1.27 (1.06, 1.52), respectively. Other risk predictors were hypertension, diabetes mellitus (DM), chronic kidney disease (CKD), aspirin, and statin therapy. CONCLUSIONS A CAC score ≥100 or a CAVI ≥ 9.0 predicts the long-term occurrence of MACEs in both asymptomatic and symptomatic patients with stable CAD. These two noninvasive tests can be used as screening tools to guide treatment for the prevention of future CV events.
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Affiliation(s)
- Thosaphol Limpijankit
- Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Sutipong Jongjirasiri
- Department of Radiology, Faculty of Medicine, Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Krissada Meemook
- Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Nattawut Unwanatham
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
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11
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Nagayama D, Sugiura T, Choi SY, Shirai K. Various Obesity Indices and Arterial Function Evaluated with CAVI - Is Waist Circumference Adequate to Define Metabolic Syndrome? Vasc Health Risk Manag 2022; 18:721-733. [PMID: 36120718 PMCID: PMC9480599 DOI: 10.2147/vhrm.s378288] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
Obesity has been known to relate to various diseases and metabolic disorders. Since the implication of body shape has been mentioned, obesity can be divided into visceral obesity and subcutaneous obesity. The former is considered the upstream pathophysiology of metabolic syndrome (MetS), and has been emphasized worldwide for the prevention of cardiovascular diseases in the last quarter century. However, some prospective studies have shown that cardiovascular mortality and morbidity are not necessarily higher in patients with MetS compared to those without. Recently, cardio-ankle vascular index (CAVI) has been established as an indicator of arteriosclerosis. This parameter is independent of blood pressure at the measuring time, and reflects systemic arterial stiffness from the aortic origin to the ankle. However, since CAVI is not necessarily high in MetS patients, attempts have been made to clarify this unexpected phenomenon. In several studies, CAVI was found to correlate negatively with body mass index (BMI), and also with waist circumference (WC) which is a widely used representative visceral obesity index. On the other hand, a body shape index (ABSI) is also a visceral obesity index designed to be minimally associated with BMI, and is calculated by dividing WC by an allometric regression of weight and height. Replacing high WC with high ABSI in MetS diagnosis promoted the identification of MetS patients with increased CAVI in cross-sectional studies on Japanese and Korean populations. Additionally, the incidence of MetS diagnosed using high ABSI was associated with significant increase in CAVI after 1 year of observation. Enhanced predictive ability for renal function decline by replacing WC with ABSI in MetS diagnosis was also observed in a longitudinal study in Japanese urban residents. These findings suggest that MetS diagnosis using high ABSI instead of high WC as a visceral obesity index needs to be reconsidered. However, further research is desirable on Caucasian, whose body shape differs slightly from that of Asians.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan.,Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Su-Yeon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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12
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Zhang A, Liu Y, Ma S, Bao Q, Sun J, Su Y, Cai S, Cheng B, Li M, Zhang Y, Tao T, Qiu J, Dong J, Song G, Zhu P, Wang S. Effects of ankle-brachial index and brachial-ankle pulse wave velocity on all-cause mortality in a community-based elderly population. Front Cardiovasc Med 2022; 9:883651. [PMID: 36176985 PMCID: PMC9513615 DOI: 10.3389/fcvm.2022.883651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are both important indicators of arterial stiffness and vascular injury. At present, most studies on the relationship between ABI and baPWV and all-cause mortality in community-based elderly are analyzing ABI or baPWV alone, and will focus on a single special population such as diabetes and stroke. The purpose of this study was to evaluate the relationship between ABI and baPWV in a Chinese community-based elderly population, and to analyze their impact on all-cause mortality in a community-based population through a follow-up of nearly 10 years. Methods Participants were residents of the Wanshou Road community in Beijing, China. A total of 2,162 people in the community were included, with an average age of 71.48 years. During a mean follow-up period of 9.87 years, 1,826 subjects completed follow-up. Kaplan-Meier survival analysis and different Cox regression models were used to verify the association of ABI and baPWV with all-cause mortality. The selected subjects were divided into two groups according to ABI and baPWV, and ABI was divided into two groups with 0.90 as the cut-off point (group 1: 0.9 < ABI ≤ 1.3; group 2: ABI ≤ 0.9); according to the level of baPWV, they were divided into three groups (Tertile 1: baPWV <1761.5 cm/s; Tertile 2: 1761.5 ≤ baPWV <2121.5 cm/s; Tertile 3: baPWV ≥2121.5 cm/s). Results 1,826 people were included in the statistical analysis, and the total mortality rate was 181.3/1000. The 10-year all-cause mortality rate of the abnormal ABI group (group 2) was 44.7%, and that of the normal ABI group (group 1) was 17.0%; The 10-year all-cause mortality rates from low to high in the baPWV tertile were 10.0%, 18.7%, and 26.4%. In the Cox proportional hazards model, after adjusting for possible confounders, the effect of baPWV on all-cause mortality was significant, with the 3rd tertile having a 1.647-fold higher risk of all-cause mortality than the 1st tertile (P = 0.014 ). Conclusions ABI and baPWV are risk factors affecting all-cause mortality in the elderly community population, and baPWV is an independent predictor of all-cause mortality in the elderly community population.
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Affiliation(s)
- Anhang Zhang
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yupeng Liu
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shouyuan Ma
- Department of Geriatric Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qiligeer Bao
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jin Sun
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yongkang Su
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shuang Cai
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Bokai Cheng
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Man Li
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yan Zhang
- Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Tianqi Tao
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jiaojiao Qiu
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jing Dong
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ge Song
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ping Zhu
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Ping Zhu
| | - Shuxia Wang
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Shuxia Wang
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Su HY, Hsu BG, Lin YL, Wang CH, Lai YH. Serum adipocyte fatty acid-binding protein level is positively associated with aortic stiffness in nondialysis chronic kidney disease patients: A cross-sectional study. Medicine (Baltimore) 2022; 101:e29558. [PMID: 35866771 PMCID: PMC9302354 DOI: 10.1097/md.0000000000029558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aortic stiffness (AS) is a major predictor of cardiovascular disease and mortality in patients with chronic kidney disease (CKD) and adipocyte fatty acid-binding protein (A-FABP) is a novel adipokine that is positively correlated with AS in the general population. Therefore, we investigated the correlation between serum A-FABP levels and AS in nondialysis CKD patients. Fasting blood samples and baseline characteristics were obtained in 270 patients with nondialysis CKD. Serum A-FABP concentrations were determined by enzyme immunoassay and carotid-femoral pulse wave velocity (cfPWV) measurements were acquired using a validated tonometry system. Patients with cfPWV >10 m/s formed the AS group, while those with values ≤10 m/s comprised the comparison group. Among 270 CKD patients, 92 patients (34.1%) were in the AS group. Compared to those in the comparison group, patients in the AS group were older (P < .001), had a higher prevalence of diabetes, along with higher serum A-FABP level (P < .001), larger waist circumference (P = .004), and lower estimated glomerular filtration rate (P = .001) but higher levels of body fat mass (P = .010), systolic blood pressure (P < .001), fasting glucose (P = .014), blood urea nitrogen (P = .009), and serum creatinine (P = .004). The serum log-A-FABP level was positively associated with log-cfPWV (β = 0.178, P = .001) in nondialysis CKD patients and multivariable logistic regression analysis identified serum A-FABP (P = .006), age (P = .001), and systolic blood pressure (P = .015) as independent predictors of AS in nondialysis-dependent CKD patients. Elevated A-FABP levels may be a significant predictor of AS in nondialysis CKD patients.
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Affiliation(s)
- Hsiao-Yuan Su
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Bang-Gee Hsu
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Li Lin
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chih-Hsien Wang
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Hsien Lai
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- * Correspondence: Yu-Hsien Lai, MD, PhD, Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, 97004 Hualien, Taiwan (e-mail: )
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Nagayama D, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Fujishiro K, Shirai K. Issue of Waist Circumference for the Diagnosis of Metabolic Syndrome Regarding Arterial Stiffness: Possible Utility of a Body Shape Index in Middle-Aged Nonobese Japanese Urban Residents Receiving Health Screening. Obes Facts 2022; 15:160-169. [PMID: 35008086 PMCID: PMC9021625 DOI: 10.1159/000520418] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. This cross-sectional study aimed to clarify whether replacing WC with "A Body Shape Index (ABSI)," an abdominal obesity index, in MetS diagnosis detects individuals with arterial stiffening assessed by cardio-ankle vascular index (CAVI). METHODS A retrospective cross-sectional study was conducted in 46,872 Japanese urban residents (median age 40 years) who underwent health screening. Exclusion criteria were current treatments and a past history of cardiovascular disease (CVD). The Japanese, International Diabetes Federation, and NCEP-ATPIII criteria were used to diagnose MetS. High CAVI was defined as CAVI ≥9.0. RESULTS CAVI correlated positively with ABSI (β = 0.127), but negatively with WC (β = -0.186), independent of age, sex, systolic blood pressure, fasting plasma glucose, and high-density lipoprotein--cholesterol. Receiver operating characteristic (ROC) analysis showed that ABSI had a stronger contribution to high CAVI (area under the ROC curve [AUC] = 0.730) than WC (AUC = 0.595) and body mass index (AUC = 0.520). ABSI ≥0.080 was defined as abdominal obesity based on the results of ROC analysis for high CAVI and estimated glomerular filtration rate <60 mL/min/1.73 m2. Logistic regression analysis revealed that replacing high WC with ABSI ≥0.080 in MetS diagnosis enhanced the detection of subjects with high CAVI. DISCUSSION/CONCLUSION Use of ABSI can detect subjects with arterial stiffening, which may lead to efficient stratification of CVD risk. Further studies are needed to confirm whether MetS diagnosis using ABSI predicts CVD morbidity and mortality.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
- *Daiji Nagayama,
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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15
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Plunde O, Franco-Cereceda A, Bäck M. Cardiovascular Risk Factors and Hemodynamic Measures as Determinants of Increased Arterial Stiffness Following Surgical Aortic Valve Replacement. Front Cardiovasc Med 2021; 8:754371. [PMID: 34957246 PMCID: PMC8692982 DOI: 10.3389/fcvm.2021.754371] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Valvular and arterial function are tightly intertwined, both in terms of structural changes and hemodynamics. While proximal valvulo-vascular coupling contributes to the cardiovascular consequences of aortic stenosis, less is known on how peripheral arterial stiffness relates to aortic valve disease. Previous studies have shown conflicting results regarding the impact of aortic valve replacement on arterial stiffness. The aim of the present study was therefore to determine predictors of arterial stiffness in patients with and without aortic valve disease undergoing cardiac surgery. Cardio ankle vascular index (CAVI) and carotid femoral pulse wave velocity (cfPWV) were measured to determine arterial stiffness the day before and 3 days after surgery for either ascending aortic or aortic valve disease. Stratification on indication for surgery revealed that CAVI was significantly lower in patients with aortic valve stenosis (n = 45) and aortic valve regurgitation (n=30) compared with those with isolated ascending aortic dilatation (n = 13). After surgery, a significant increased CAVI was observed in aortic stenosis (median 1.34, IQR 0.74-2.26, p < 0.001) and regurgitation (median 1.04, IQR 0.01-1.49, p = 0.003) patients while cfPWV was not significantly changed. Age, diabetes, low body mass index, low pre-operative CAVI, as well as changes in ejection time were independently associated with increased CAVI after surgery. The results of the present study suggest aortic valve disease as cause of underestimation of arterial stiffness when including peripheral segments. We report cardiovascular risk factors and pinpoint the hemodynamic aspect ejection time to be associated with increased CAVI after aortic valve surgery.
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Affiliation(s)
- Oscar Plunde
- Unit of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Theme Heart and Vessels, Division of Valvular and Coronary Disease, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Franco-Cereceda
- Theme Heart and Vessels, Division of Valvular and Coronary Disease, Karolinska University Hospital, Stockholm, Sweden
- Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Bäck
- Unit of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Theme Heart and Vessels, Division of Valvular and Coronary Disease, Karolinska University Hospital, Stockholm, Sweden
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Angoff R, Mosarla RC, Tsao CW. Aortic Stiffness: Epidemiology, Risk Factors, and Relevant Biomarkers. Front Cardiovasc Med 2021; 8:709396. [PMID: 34820427 PMCID: PMC8606645 DOI: 10.3389/fcvm.2021.709396] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/30/2021] [Indexed: 12/19/2022] Open
Abstract
Aortic stiffness (AoS) is a maladaptive response to hemodynamic stress and both modifiable and non-modifiable risk factors, and elevated AoS increases afterload for the heart. AoS is a non-invasive marker of cardiovascular health and metabolic dysfunction. Implementing AoS as a diagnostic tool is challenging as it increases with age and varies amongst races. AoS is associated with lifestyle factors such as alcohol and smoking, as well as hypertension and comorbid conditions including metabolic syndrome and its components. Multiple studies have investigated various biomarkers associated with increased AoS, and this area is of particular interest given that these markers can highlight pathophysiologic pathways and specific therapeutic targets in the future. These biomarkers include those involved in the inflammatory cascade, anti-aging genes, and the renin-angiotensin aldosterone system. In the future, targeting AoS rather than blood pressure itself may be the key to improving vascular health and outcomes. In this review, we will discuss the current understanding of AoS, measurement of AoS and the challenges in interpretation, associated biomarkers, and possible therapeutic avenues for modulation of AoS.
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Affiliation(s)
- Rebecca Angoff
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ramya C Mosarla
- Division of Cardiology, Department of Medicine, New York University Langone Health, New York, NY, United States
| | - Connie W Tsao
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
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Nagayama D, Fujishiro K, Tsuda S, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Shirai K. Enhanced prediction of renal function decline by replacing waist circumference with "A Body Shape Index (ABSI)" in diagnosing metabolic syndrome: a retrospective cohort study in Japan. Int J Obes (Lond) 2021; 46:564-573. [PMID: 34824353 PMCID: PMC8872991 DOI: 10.1038/s41366-021-01026-7] [Citation(s) in RCA: 11] [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: 08/25/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 11/09/2022]
Abstract
Background Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. Objective To examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline. Subjects/Methods In total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m2) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII. Results In Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis. Conclusion In this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, 2-12-22, Tenjin-cho, Oyama-city, Tochigi, 3230032, Japan. .,Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.
| | - Kentaro Fujishiro
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Shinichi Tsuda
- Fukuda Denshi Co., Ltd., 3-39-4, Hongo, Bunkyo-ku, Tokyo, 1130033, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kenji Suzuki
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kohji Shirai
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.,Department of Internal Medicine, Mihama Hospital, 1-1-5, Uchise, Mihama-ku, Chiba, 2610013, Japan
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Relación del envejecimiento vascular saludable con los estilos de vida y el síndrome metabólico en población general española. Estudio EVA. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Gómez-Sánchez M, Gómez-Sánchez L, Patino-Alonso MC, Alonso-Domínguez R, Sánchez-Aguadero N, Recio-Rodríguez JI, González-Sánchez J, García-Ortiz L, Gómez-Marcos MA. Relationship of healthy vascular aging with lifestyle and metabolic syndrome in the general Spanish population. The EVA study. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:854-861. [PMID: 33132098 DOI: 10.1016/j.rec.2020.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/29/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES Our objective was to study the relationship of healthy vascular aging (HVA) with lifestyle and the components of metabolic syndrome. We also analyzed the differences between chronological age and heart age (HA) and vascular age (VA) in the Spanish adult population without cardiovascular disease. METHODS This descriptive cross-sectional study selected 501 individuals without cardiovascular disease (mean age, 55.9 years; 50.3% women) via random sampling stratified by age and sex. HA was estimated with the Framingham equation, whereas VA was estimated with the VaSera VS-1500 device. HVA was defined as a <5-year difference between the chronological age and the HA or VA and the absence of a vascular lesion, hypertension, and diabetes mellitus. RESULTS Compared with the chronological age, the mean HA and VA were 2.98±10.13 and 3.08±10.15 years lower, respectively. Smoking (OR, 0.23), blood pressure ≥ 130/85mmHg (OR, 0.11), altered baseline blood glucose (OR, 0.45), abdominal obesity (OR, 0.58), triglycerides ≥ 150mg/dL (OR, 0.17), and metabolic syndrome (OR, 0.13) decreased the probability of HVA estimated by HA; an active lifestyle (OR, 1.84) and elevated high-density lipoprotein-cholesterol (OR, 3.26) increased the probability of HVA estimated by HA. Smoking (OR, 0.45), blood pressure ≥ 130/85mmHg (OR, 0.26), altered baseline blood glucose (OR, 0.42), and metabolic syndrome (OR, 0.40) decreased the probability of HVA estimated by VA; abdominal obesity (OR, 1.81) had the opposite effect. CONCLUSIONS HA and VA were 3 years lower than the chronological age. HA was associated with tobacco consumption, physical activity, and the components of metabolic syndrome. Meanwhile, VA was associated with tobacco consumption, blood pressure, waist circumference, and altered baseline glycemia. CLINICAL TRIAL REGISTRATION http://www.clinicaltrials.gov. Identifier: NCT02623894.
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Affiliation(s)
- Marta Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - M Carmen Patino-Alonso
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Estadística, Universidad de Salamanca (USAL), Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Enfermería y Fisioterapia, Universidad de Salamanca (USAL), Salamanca, Spain
| | - José I Recio-Rodríguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Enfermería y Fisioterapia, Universidad de Salamanca (USAL), Salamanca, Spain
| | - Jesús González-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Enfermería y Fisioterapia, Universidad de Salamanca (USAL), Salamanca, Spain
| | - Luis García-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain; Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain.
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20
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Nabeel PM, Chandran DS, Kaur P, Thanikachalam S, Sivaprakasam M, Joseph J. Association of incremental pulse wave velocity with cardiometabolic risk factors. Sci Rep 2021; 11:15413. [PMID: 34326391 PMCID: PMC8322136 DOI: 10.1038/s41598-021-94723-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/06/2021] [Indexed: 02/07/2023] Open
Abstract
We investigate the association of incremental pulse wave velocity (ΔC; the change in pulse wave velocity over a cardiac cycle) with cardiometabolic risk factors and report the first and (currently) the largest population-level data. In a cross-sectional study performed in a cohort of 1373 general population participants, ΔC was measured using clinically validated ARTSENS devices. There were 455 participants in the metabolic syndrome (MetS) group whose average ΔC was ~ 28.4% higher than that of the non-metabolic syndrome (Non-MetS) group. Females with MetS showed ~ 10.9% elevated average ΔC compared to males of the Non-MetS group. As the number of risk factors increased from 0 to 5, the average ΔC escalated by ~ 55% (1.50 ± 0.52 m/s to 2.33 ± 0.91 m/s). A gradual increase in average ΔC was observed across each decade from the younger (ΔC = 1.53 ± 0.54 m/s) to geriatric (ΔC = 2.34 ± 0.59 m/s) populations. There was also a significant difference in ΔC among the blood pressure categories. Most importantly, ΔC ≥ 1.81 m/s predicted a constellation of ≥ 3 risks with AUC = 0.615, OR = 2.309, and RR = 1.703. All statistical trends remained significant, even after adjusting for covariates. The study provides initial evidence for the potential use of ΔC as a tool for the early detection and screening of vascular dysfunction, which opens up avenues for active clinical and epidemiological studies. Further investigations are encouraged to confirm and establish the causative mechanism for the reported associations.
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Affiliation(s)
- P. M. Nabeel
- grid.417969.40000 0001 2315 1926Healthcare Technology Innovation Centre, IIT Madras, Chennai, 600113 India
| | - Dinu S. Chandran
- grid.413618.90000 0004 1767 6103Department of Physiology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Prabhdeep Kaur
- grid.419587.60000 0004 1767 6269National Institute of Epidemiology, Indian Council of Medical Research, Chennai, 600077 India
| | - Sadagopan Thanikachalam
- grid.412734.70000 0001 1863 5125Sri Ramachandra Institute of Higher Education and Research, Chennai, 600116 India
| | - Mohanasankar Sivaprakasam
- grid.417969.40000 0001 2315 1926Healthcare Technology Innovation Centre, IIT Madras, Chennai, 600113 India ,grid.417969.40000 0001 2315 1926Department of Electrical Engineering, Indian Institute of Technology Madras, Chennai, 600036 India
| | - Jayaraj Joseph
- grid.417969.40000 0001 2315 1926Department of Electrical Engineering, Indian Institute of Technology Madras, Chennai, 600036 India
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21
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Qu G, Zhang Z, Zhu H. Discordance between apolipoprotein B or non-HDL-cholesterol and LDL-cholesterol in middle-aged and elderly Chinese patients predicts arterial stiffness. Lipids Health Dis 2021; 20:80. [PMID: 34325713 PMCID: PMC8320094 DOI: 10.1186/s12944-021-01509-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/19/2021] [Indexed: 01/22/2023] Open
Abstract
Background Discordance of lipid parameters is closely associated with residual cardiovascular risk. This study investigated the discordance between non-high-density lipoprotein cholesterol (non-HDL-C) or apolipoprotein B (apoB) and low-density lipoprotein cholesterol (LDL-C), and assessed arterial stiffness risk. Methods This study included a total of 402 middle-aged and elderly Northern Chinese individuals whose brachial-ankle pulse wave conduction velocity (baPWV), and clinical and biochemical data were measured. Arterial stiffness was defined by inclusion in the upper quartile of the baPWV. All participants were divided into four mutually exclusive concordance/discordance groups based on the lipid goal for high-risk populations, according to the 2019 European Society of Cardiology / European Atherosclerosis Society guidelines. Discordance was defined as LDL-C ≥ 1.81 mmol/L with non-HDL-C < 2.59 mmol/L, or apoB < 0.80 mmol/L, or vice versa. Results The mean age of the participants was 65.9 ± 13.0 years; 59.5% of the participants were male. The mean LDL-C was 2.41 ± 0.81 mmol/L, non-HDL-C: 3.06 ± 0.94 mmol/L, and apoB: 0.84 ± 0.21 mmol/L. LDL-C was observed to be discordant with non-HDL-C (20.1%) and apoB (30.8%). When stratified according to LDL-C levels, the baPWV was greater in those patients with higher non-HDL-C or apoB levels. In the adjusted logistic regression model, low LDL-C and high non-HDL-C or apoB discordance were also associated with the risk of arterial stiffness (OR: 13.412 and OR: 13.054, respectively). Conclusions There was discordance between LDL-C and non-HDL-C, or apoB in middle-aged and elderly Chinese individuals; this was associated with a higher risk of arterial stiffness. Non-HDL-C or apoB levels could be used to identify individuals who may benefit from more comprehensive lipid modification.
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Affiliation(s)
- Geyue Qu
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
| | - Zhongying Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Hong Zhu
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
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22
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Wang A, Wang Y, Zuo Y, Tian X, Chen S, Ma Y, Han X, Wu S, Zhao X. Risk of arterial stiffness according to metabolically healthy obese phenotype: a combined cross-sectional and longitudinal study in kailuan cohort. Aging (Albany NY) 2021; 13:15114-15125. [PMID: 34081619 PMCID: PMC8221340 DOI: 10.18632/aging.203075] [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: 10/30/2020] [Accepted: 03/23/2021] [Indexed: 01/22/2023]
Abstract
We aim to investigate the risk of incident arterial stiffness according to metabolically healthy obese (MHO) phenotype in Chinese population. 37,180 participants with at least one-time measurement of branchial-ankle pulse wave velocity (baPWV) were included in the cross-sectional analysis, and 16,236 participants with repeated measurement of baPWV during the follow-ups were included in the longitudinal study. Cross-classification of body mass index (BMI) categories and metabolic health status created six groups. Linear and logistic regression analyses were used. The results of cross-sectional and longitudinal investigation were essentially the same, as the abnormality of baPWV increased with BMI categories in metabolically healthy participants, while the increasing tendency disappeared in metabolically unhealthy participants. A 1.4-fold, 2.2-fold increased risk for the new occurrence of arterial stiffness were documented in MHO and metabolically unhealthy obese participants compared to metabolically healthy normal-weight controls in the fully adjusted model. Further stratified analysis showed that metabolic health status was an interaction factor between BMI and arterial stiffness in all study populations (P=0.0001 for cross-sectional study and P=0.0238 for longitudinal study). In conclusion, metabolic health status and BMI categories contribute to the progression of arterial stiffness, while BMI is positively associated with arterial stiffness only in metabolically healthy participants.
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Affiliation(s)
- Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yihan Ma
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.,Graduate School of North China University of Science and Technology, Tangshan, China
| | - Xu Han
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.,Graduate School of North China University of Science and Technology, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xingquan Zhao
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
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23
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Sequí-Domínguez I, Cavero-Redondo I, Álvarez-Bueno C, Saz-Lara A, Mesas AE, Martínez-Vizcaíno V. Association between arterial stiffness and the clustering of metabolic syndrome risk factors: a systematic review and meta-analysis. J Hypertens 2021; 39:1051-1059. [PMID: 33323912 DOI: 10.1097/hjh.0000000000002754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Metabolic syndrome (MetS) is a cluster of different cardiometabolic risk factors (CMRFs), and its different combinations with other CMRFs, such as arterial stiffness have been hypothesized to explain, at least partially, increased risk of cardiovascular disease. Thus, in this systematic review and meta-analysis, we aimed to synthesize the evidence regarding the association between the clustering of MetS-related CMRFs and arterial stiffness measured using pulse wave velocity (PWV). METHODS Original studies analysing the association between arterial stiffness, measured using PWV, and MetS were systematically searched. Pooled effect size estimates and their respective 95% confidence intervals (CI) were calculated using the DerSimonian and Laird method for two separate analyses: the diagnosis of MetS and PWV values and the number of CMRFs and PWV values. RESULTS Moderate effect size estimates were observed between MetS and PWV (0.68, 95% CI: 0.54-0.82) with a slightly higher effect size for the low-risk compared with the high-risk population group (0.75, 95% CI: 0.58-0.92; and 0.51, 95% CI: 0.32-0.82, respectively). A trend between the number of MetS-related CMRFs and PWV was found with the pooled effect size nearly doubling as the number of MetS-related CMRFs increased, 0.11 (95% CI: 0.04-0.17) for one MetS-related CMRF, 0.26 (95% CI: 0.13-0.4) for two, and 0.4 (95% CI: 0.2-0.6) for three or more. CONCLUSION These results demonstrated a clinically relevant association between MetS and PWV and an increasing trend in PWV values, such as a MetS-related CMRF increase. Although these results should be considered cautiously because of the considerable heterogeneity, our findings reinforce the rationale of MetS as an aggregation of risk factors with common causes, which could provide additional useful information to guide clinical management.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Arthur E Mesas
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidade Estadual de Londrina, Department of Public Health, Paraná, Brazil
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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24
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Verner VA, Mel'nik MV, Knjazeva SA. [Cardio-ankle vascular index (CAVI) in diagnostics, risk and severity evaluation of magistral vessels lesion in patients with cardio-vascular diseases and type 2 diabetes]. TERAPEVT ARKH 2021; 93:87-93. [PMID: 33720632 DOI: 10.26442/00403660.2021.01.200599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 11/22/2022]
Abstract
Assesment of arterial stiffness the substantional prognostic factor for evaluating complications of cardiovascular diseases (CVD) in patients with atherosclerosis, hypertension and type 2 diabetes, may be performed using different parameters, including cardio-ankle vascular index (CAVI). The main purpose of this review is to analyze data from studies where CAVI is used to test the arterial wall stiffness in magistral vessels. CAVI measurement is non-invasive and performed by portable devices which makes it comfortable for ambulatory use in patients who come for a check-up and also in those who already are hospitalized. It does not require any special knowledge from investigator and the test lasts a couple of minutes long. CAVI does not depend on blood pressure changes and is more specific in structural changes of arterial wall assessment than brachial-ankle pulse wave velocity (baPWV). CAVI shows considerable correlation with markers of CVD like atherosclerotic plaques in vessels, diastolic disfunction of left ventricle and angina pectoris. CAVI may be used for early monitoring and assessing the lesions of target organs in patients with atherosclerosis, chronic hypertension and type 2 diabetes. Establishing CAVI as a standart parameter in assessing patients who are at risk of CVD can help to improve complications prevention, reduce mortality and prolong their lifespan.
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Affiliation(s)
- V A Verner
- Sechenov First Moscow State Medical University (Sechenov University)
| | - M V Mel'nik
- Sechenov First Moscow State Medical University (Sechenov University)
| | - S A Knjazeva
- Sechenov First Moscow State Medical University (Sechenov University)
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25
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Taivainen SH, Laitinen TM, Yli-Ollila H, Juonala M, Kähönen M, Raitakari OT, Laitinen TP. Carotid artery longitudinal wall motion alterations associated with metabolic syndrome and insulin resistance. Clin Physiol Funct Imaging 2021; 41:199-207. [PMID: 33340230 DOI: 10.1111/cpf.12687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/26/2020] [Accepted: 12/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Our objective was to study relationships between the new biomarker of vascular health, carotid artery longitudinal wall motion (CALM) and metabolic syndrome (MetS). METHODS Carotid ultrasound and assessment of MetS and its components were performed with 281 subjects aged 30-45 years. In the longitudinal motion analysis, the amplitude of motion and the antegrade-oriented and retrograde-oriented components of motion between the intima-media complex and adventitial layer of the common carotid artery wall were assessed. RESULTS Metabolic syndrome, according to the harmonized criteria, was detected in 53 subjects (19%). MetS was significantly associated with increased antegrade and decreased retrograde longitudinal motion in the carotid artery wall. Augmented antegrade amplitude of longitudinal motion was associated with obesity (β = 0.149, p < .05) and low HDL cholesterol (β = 0.177, p < .01). Attenuated retrograde amplitude of longitudinal motion was associated with hypertension (β = -0.156, p < .05), obesity (β = -0.138, p < .05) and hyperinsulinaemia (β = -0.158, p < .01). Moreover, insulin resistance (homeostasis model assessment index above 2.44) was associated with adverse changes in CALM. CONCLUSION Metabolic syndrome and insulin resistance were associated with alterations in CALM. In particular, hypertension, obesity and hyperinsulinaemia were associated with reduced total peak-to-peak amplitude as well as increased antegrade and reduced retrograde amplitudes, all of which might be markers of unfavourable vascular health.
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Affiliation(s)
- S Helena Taivainen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tiina M Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Heikki Yli-Ollila
- Department of Radiology, Kanta-Häme Central hospital, Hämeenlinna, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Tomi P Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland, Kuopio, Finland
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26
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Zhang X, Bai R, Zou L, Zong J, Qin Y, Wang Y. Brachial-Ankle Pulse Wave Velocity as a Novel Modality for Detecting Early Diabetic Nephropathy in Type 2 Diabetes Patients. J Diabetes Res 2021; 2021:8862573. [PMID: 33628837 PMCID: PMC7886592 DOI: 10.1155/2021/8862573] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/11/2020] [Accepted: 01/07/2021] [Indexed: 12/24/2022] Open
Abstract
Brachial-ankle pulse wave velocity (baPWV) has been shown to correlate with a host of disorders associated with arterial stiffness. Type 2 diabetes is associated with the involvement of both small vessels and large vessels. Studies on the relevance of baPWV to early diabetic nephropathy are scarce. This retrospective observational case-control study enrolled 120 patients with type 2 diabetes from our medical records. We classified patients into two groups depending on the magnitude of albuminuria: 60 patients with microalbuminuria were classified as the early diabetic nephropathy group (EDN group) and 60 patients without albuminuria were classified as the diabetes without nephropathy group (DWN group). An additional 30 nondiabetic age- and sex-matched controls were also enrolled. Data regarding the lipid profile, blood pressure, baPWV, high-sensitivity C reactive protein (hs-CRP) level, anthropometric measurements, urine albumin/creatinine ratio (UACR), serum creatinine level, and glycemic control indices (i.e., fasting plasma glucose (FPG), postprandial glucose (PPG), and glycosylated hemoglobin (hemoglobin A1c, HbA1c)) were recorded for all enrolled participants. baPWV was significantly higher in the EDN group than in the DWN group. Moreover, baPWV was positively correlated with age, duration of diabetes, obesity, poor glycemic control, and high serum levels of triglycerides (TG), hs-CRP, creatinine, and uric acid as well as a high UACR (all P < 0.01). A significant negative correlation was found between baPWV and high-density lipoprotein levels (P < 0.05). Multivariate regression analysis showed that the hs-CRP level and duration of diabetes most strongly influenced baPWV. baPWV may be a convenient, noninvasive, and reproducible method for detecting early diabetic nephropathy.
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Affiliation(s)
- Xueyang Zhang
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ran Bai
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Linxuan Zou
- Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Junwei Zong
- Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yang Qin
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yongbo Wang
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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27
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Sri-Amad R, Huipao N, Prasertsri P, Roengrit T. Aortic Pulse Wave Velocity, Ankle-Brachial Index, and Malondialdehyde in Older Adults with or without Metabolic Syndrome. Pulse (Basel) 2020; 8:31-39. [PMID: 32999876 DOI: 10.1159/000505838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/08/2020] [Indexed: 12/14/2022] Open
Abstract
Metabolic syndrome is an important health problem associated with both subclinical atherosclerosis and an increased risk of cardiovascular disease and it leads to an elevated total mortality. Aortic pulse wave velocity (aPWV) is widely used for noninvasive assessment of arterial stiffness. Ankle-brachial index (ABI) predicts peripheral arterial disease (PAD) of the lower extremities. In addition, malondialdehyde (MDA) is thought to be involved in the development of arterial stiffness. The present study aimed to: (1) compare aPWV, ABI, and MDA between participants with MetS and those without MetS and (2) investigate the correlation of aPWV and ABI with the components of MetS and MDA. A total of 48 Thai elderly subjects were divided into 2 groups (MetS and non-MetS) according to the parameters set by the International Diabetes Federation (IDF). aPWV and ABI were measured using the VaSera VS-1500 system (Fukuda Denshi Co., Tokyo, Japan). MDA was determined by spectrophotometry. aPWV and MDA were significantly higher in the MetS group compared to the participants in the non-MetS group (9.33 ± 2.72 vs. 7.95 ± 1.37 m/s, p = 0.03, and 0.74 ± 0.71 vs. 0.45 ± 0.20 μmol, p = 0.02, respectively). However, ABI did not differ between the groups. Analysis of the risk factors of aPWV in each group revealed that there were no statistical associations between the components of MetS and MDA and aPWV in both the MetS and the non-MetS groups. A high aPWV is more prevalent among patients with MetS than among those without MetS. Monitoring of aPWV might help to explore potential detection of vascular damage in the elderly.
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Affiliation(s)
- Ruchada Sri-Amad
- Department of Physiology, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Nawiya Huipao
- Department of Physiology, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Piyapong Prasertsri
- Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand.,Exercise and Nutrition Sciences and Innovation Research Unit, Burapha University, Chonburi, Thailand
| | - Thapanee Roengrit
- Department of Physiology, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
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Pavlovska I, Kunzova S, Jakubik J, Hruskova J, Skladana M, Rivas-Serna IM, Medina-Inojosa JR, Lopez-Jimenez F, Vysoky R, Geda YE, Stokin GB, González-Rivas JP. Associations between high triglycerides and arterial stiffness in a population-based sample: Kardiovize Brno 2030 study. Lipids Health Dis 2020; 19:170. [PMID: 32669093 PMCID: PMC7362636 DOI: 10.1186/s12944-020-01345-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022] Open
Abstract
Background The term arterial stiffness (ArSt) describes structural changes in arterial wall related to the loss of elasticity and is known as an independent predictor of cardiovascular diseases (CVD). The evidence relating to ArSt and triglycerides (TG) shows contradictory results. This paper means to survey the association between high TG and ArSt, utilizing the cardio-ankle vascular index (CAVI). Methods Subjects aged between 25 and 64 years from a random population-based sample were evaluated between 2013 and 2016. Data from questionnaires, blood pressure, anthropometric measures, and blood samples were collected and analyzed. CAVI was measured using VaSera VS-1500 N devise. Subjects with a history of CVD or chronic renal disease were excluded. Results One thousand nine hundred thirty-four participants, 44.7% of males, were included. The median age was 48 (Interquartile Range [IQR] 19) years, TG levels were 1.05 (0.793) mmol/L, and CAVI 7.24 (1.43) points. Prevalence of high CAVI was 10.0% (14.5% in males and 6.4% in females; P < 0.001) and prevalence of hypertriglyceridemia was 20.2% (29.2% in males and 13% in females, P < 0.001). The correlation between TG and CAVI was 0.136 (P < 0.001). High CAVI values were more prevalent among participants with metabolic syndrome (MetS), high blood pressure, dysglycemia, abdominal obesity, high LDL-cholesterol (LDL-c), and high total cholesterol. Using binary regression analysis, high TG were associated with high CAVI, even after adjustment for other MetS components, age, gender, smoking status, LDL-c, and statin treatment (β = 0.474, OR = 1.607, 95% CI = 1.063–2.429, P = 0.024). Conclusion TG levels were correlated with ArSt, measured as CAVI. High TG was associated with high CAVI independent of multiple cardiometabolic risk factors. Awareness of the risks and targeted treatment of hypertriglyceridemia could further benefit in reducing the prevalence of CVD and events.
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Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic. .,Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Sarka Kunzova
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Juraj Jakubik
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Jana Hruskova
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Maria Skladana
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Irma Magaly Rivas-Serna
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Yonas E Geda
- Department of Neurology, Barrow Neurological Institute, Phoenix, USA
| | - Gorazd B Stokin
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Juan P González-Rivas
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic.,Department of Global Health and Population
- Harvard T.H. Chan School of Public Health, Boston, USA
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Yuan Y, Mu JJ, Chu C, Zheng WL, Wang Y, Hu JW, Ma Q, Yan Y, Liao YY, Chen C. Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study. Nutr Metab (Lond) 2020; 17:50. [PMID: 32625239 PMCID: PMC7330959 DOI: 10.1186/s12986-020-00474-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/25/2020] [Indexed: 01/14/2023] Open
Abstract
Background Metabolically healthy obesity (MHO) has been reported to be associated with the development of vascular damage by the carotid intima-media thickness, but the relationship between metabolic health and obesity phenotypes and arterial stiffness is still unknown. Our hypothesized that different metabolic health and obesity phenotypes might be associated with the development of arterial stiffness, and that subjects in MHO phenotype might not have increased risks of arterial stiffness compared with those in metabolically healthy nonobesity phenotype (MHNO), while metabolic unhealthy individuals might have increased risks of arterial stiffness. Methods A prospective cohort of 2076 participants (aged 36-48 years) who were enrolled in the Hanzhong Adolescent Hypertension Cohort Study in 2017 was analyzed in a cross-sectional analysis. A subgroup of 202 participants from 2005 to 2017 was selected by an isometric sampling method and was included in the final longitudinal analysis. Results We identified four metabolic health and obesity phenotypes for both the cross-sectional and longitudinal analyses as follows: MHNO, metabolically unhealthy nonobesity (MUNO), MHO, and metabolically unhealthy obesity (MUO). In the cross-sectional analysis, individuals with the MHO phenotype had the lowest brachial-ankle pulse wave velocity (baPWV) levels of the four phenotypes (P < 0.001), and participants with the MHO phenotype had a similar risk of arterial stiffness after fully adjustment [odds ratio (OR) = 0.99 (0.61-1.60)] as the MUNO subjects. Subjects with metabolically unhealthy status had a significantly higher risk of arterial stiffness than the MHNO individuals, particularly females (P < 0.005). In the longitudinal analysis, subjects with the MUNO and MUO phenotypes had a significantly higher risk of arterial stiffness than the MHNO individuals after adjustment for age and sex [OR = 5.21 (2.26-12.02), OR = 3.32 (1.18-9.32), respectively]. Conclusions The MHO phenotype did not significantly increase the progression of arterial stiffness. Metabolically unhealthy individuals (MUNO, MUO), regardless of obesity status, showed a worse effect for the development of arterial stiffness, particularly females. Trial registration NCT02734472. Registered 12 April 2016 - Retrospectively registered, http:www.clinicaltrials.gov.
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Affiliation(s)
- Yue Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jian-Jun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Wen-Ling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jia-Wen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yue-Yuan Liao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chen Chen
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
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30
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Lin YK, Liu PY, Fan CH, Tsai KZ, Lin YP, Lee JM, Lee JT, Lin GM. Metabolic biomarkers and long-term blood pressure variability in military young male adults. World J Clin Cases 2020; 8:2246-2254. [PMID: 32548155 PMCID: PMC7281053 DOI: 10.12998/wjcc.v8.i11.2246] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Metabolic syndrome is a cluster of cardiovascular risk factors, including central obesity, high blood pressure, elevated plasma glucose, reduced high-density lipoprotein and elevated triglyceride levels.
AIM To investigate the relationship between metabolic biomarkers and long-term blood pressure variability (BPV) in young males.
METHODS A cohort of 1112 healthy military males aged 18-40 years from the cardiorespiratory fitness and hospitalization events in armed forces study in eastern Taiwan was prospectively included. The following metabolic biomarkers were used: Waist circumference, serum uric acid (SUA), triglycerides, high density lipoprotein, triglycerides, and fasting glycose. BPV was assessed by average real variability (ARV) and standard deviation (SD) across 4 clinic visits during the study period (2012-14, 2014-15, 2015-16, and 2016-18). Multivariable linear regression analysis was used to determine the association after adjusting for age, body mass index, systolic and diastolic blood pressure (SBP and DBP), lipid profiles, physical activity, alcohol intake and tobacco smoking status.
RESULTS In the unadjusted model, waist circumference was significantly and positively correlated with ARVDBP and SDDBP [β (standard errors) = 0.16 (0.049) and 0.22 (0.065), respectively], as was SUA [β = 0.022 (0.009) and 0.038 (0.012), respectively]. High-density lipoprotein was negatively correlated with ARVSBP [β = −0.13 (0.063)]. There were no associations with the other metabolic biomarkers. In contrast, only SUA was significantly correlated with SDSBP and SDDBP [β = 0.019 (0.011) and 0.027 (0.010), respectively] in the adjusted model.
CONCLUSION Our findings showed that of traditional metabolic biomarkers, SUA had the strongest positive correlation with long-term systolic and diastolic BPV in young male adults, and the clinical relevance needs further investigation.
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Affiliation(s)
- Yu-Kai Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
- Departments of Neurology, Tri-Service General Hospital, and Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
| | - Pang-Yen Liu
- Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan
| | - Chia-Hao Fan
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
| | - Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
| | - Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu-Chi General Hospital, New Taipei City 231, Taiwan
| | - Ju-Mi Lee
- Department of Preventive Medicine, Eulji College of Medicine, Daejeon 34824, South Korea
| | - Jiunn-Tay Lee
- Departments of Neurology, Tri-Service General Hospital, and Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
- Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
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Kruszyńska E, Łoboz-Rudnicka M, Palombo C, Vriz O, Kozakova M, Ołpińska B, Morizzo C, Łoboz-Grudzień K, Jaroch J. Carotid Artery Stiffness in Metabolic Syndrome: Sex Differences. Diabetes Metab Syndr Obes 2020; 13:3359-3369. [PMID: 33061497 PMCID: PMC7524178 DOI: 10.2147/dmso.s262192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The effect of metabolic syndrome (MS) on carotid stiffness (CS) in the context of gender is under research. OBJECTIVE We examined the relationship between the MS and CS in men (M) and women (W) and investigated if the impact of cardiovascular risk factors on CS is modulated by gender. PATIENTS AND METHODS The study included 419 subjects (mean age 54.3 years): 215 (51%) with MS (109 W and 106 M) and 204 (49%) without MS (98 W and 106 M). Carotid intima-media thickness (IMT) and CS parameters (beta stiffness index (beta), Peterson's elastic modulus (Ep), arterial compliance (AC) and one-point pulse wave velocity (PWV-beta)) were measured with the echo-tracking (eT) system. RESULTS ANCOVA demonstrated that MS was associated with elevated CS indices (p = 0.003 for beta and 0.025 for PWV-beta), although further sex-specific analysis revealed that this relationship was significant only in W (p = 0.021 for beta). Age was associated with CS in both M and W, pulse pressure (PP) and body mass index turned out to be determinants of CS solely in W, while the effect of mean arterial pressure (MAP) and heart rate was more pronounced in M. MANOVA performed in subjects with MS revealed that age and diabetes mellitus type 2 were determinants of CS in both sexes, diastolic blood pressure and MAP - solely in M and systolic blood pressure, PP and waist circumference - solely in W (the relationship between the waist circumference and AC was paradoxical). CONCLUSION The relationship between MS and CS is stronger in W than in M. In subjects with MS, various components of arterial pressure exert different sex-specific effects on CS - with the impact of the pulsative component of arterial pressure (PP) observed in W and the impact of the steady component (MAP) observed in M.
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Affiliation(s)
- Ewa Kruszyńska
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
| | - Maria Łoboz-Rudnicka
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Correspondence: Maria Łoboz-Rudnicka Email
| | - Carlo Palombo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, School of Medicine, Pisa, Italy
| | - Olga Vriz
- Department of Cardiology and Emergency, San Antonio Hospital, Udine, Italy
| | - Michaela Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Bogusława Ołpińska
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
| | - Carmela Morizzo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, School of Medicine, Pisa, Italy
| | - Krystyna Łoboz-Grudzień
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Joanna Jaroch
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
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Avagimyan AA, Mkrtchyan LG, Navasardyan GA, Gevorkyan AA, Ananyan EA, Pashinyan NE, Abgaryan KG. The role of Helicobacter pylori in cardiovascular toxicity mechanisms. ACTA ACUST UNITED AC 2019. [DOI: 10.15829/1560-4071-2019-12-169-174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Despite the long history of the concept where infection plays a significant role in cardiovascular diseases (atherosclerosis in particular), today it is relevant and represented a significant interest.This article discusses H. pylori role in mechanisms of cardiovascular homeostasis disturbance. H. pylori involvement in atherogenic damage of arteries, and/or plaque destabilization is no doubt. This vidence is detailed in this review article.
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Czippelova B, Turianikova Z, Krohova J, Wiszt R, Lazarova Z, Pozorciakova K, Ciljakova M, Javorka M. Arterial Stiffness and Endothelial Function in Young Obese Patients - Vascular Resistance Matters. J Atheroscler Thromb 2019; 26:1015-1025. [PMID: 30930343 PMCID: PMC6845697 DOI: 10.5551/jat.47530] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/13/2019] [Indexed: 12/11/2022] Open
Abstract
AIM Motivated by the paradoxical and differing results of the early atherosclerosis related indices - Cardio-Ankle Vascular Index (CAVI) reflecting arterial stiffness and Reactive Hyperemia Index (RHI) evaluating endothelium dependent flow-induced vasodilation - in obesity, we aimed to assess CAVI and RHI in obese adolescents and young adults in the context of differences in systemic vascular resistance (SVR). METHODS We examined 29 obese (14f, 15.4 [12.3-18.5] y; BMI: 33.2±4.4 kg.m-2) and 29 non-obese gender and age matched adolescents and young adults (BMI: 21.02±2.3 kg.m-2). CAVI and RHI were measured using VaSera VS-1500 (Fukuda Denshi, Japan) and Endo-PAT 2000 (Itamar Medical, Israel), respectively. Hemodynamic measures were recorded using volume-clamp plethysmography (Finometer Pro, FMS, Netherlands) and impedance cardiography (CardioScreen 2000, Medis GmbH, Germany). SVR and sympathetic activity related indices - Velocity Index (VI) and Heather Index (HI), and LFSAP (spectral power in low frequency band of systolic blood pressure oscillations) were determined. RESULTS In obese group, CAVI (4.59±0.88 vs. 5.18±0.63, p=0.002) and its refined version CAVI0 (6.46±1.39 vs.7.33±0.99, p=0.002) were significantly lower. No significant difference in RHI was found. SVR and sympathetic activity indices were all significantly lower in the obese group than in the non-obese group. RHI correlated positively with SVR (r=0.390, p=0.044) in obese subjects. CONCLUSION Our results indicate that both indices used for the detection of early atherosclerotic changes are influenced by vascular tone. Vascular resistance could influence CAVI and RHI results impairing their interpretation.
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Affiliation(s)
- Barbora Czippelova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Martin, Slovakia
| | - Zuzana Turianikova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Martin, Slovakia
| | - Jana Krohova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
| | - Radovan Wiszt
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
| | - Zuzana Lazarova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
| | - Katarina Pozorciakova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Clinic of Children and Adolescents, Martin, Slovakia
| | - Miriam Ciljakova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Clinic of Children and Adolescents, Martin, Slovakia
| | - Michal Javorka
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Martin, Slovakia
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Sugiura T, Dohi Y, Takagi Y, Yoshikane N, Ito M, Suzuki K, Nagami T, Iwase M, Seo Y, Ohte N. Relationships of Obesity-Related Indices and Metabolic Syndrome with Subclinical Atherosclerosis in Middle-Aged Untreated Japanese Workers. J Atheroscler Thromb 2019; 27:342-352. [PMID: 31462618 PMCID: PMC7192820 DOI: 10.5551/jat.50633] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: Obesity is a social problem due to the prevalence of the Western lifestyle. In particular, visceral fat accumulation, which is a main component of metabolic syndrome, is closely associated with the progression of atherosclerosis. This study aimed to investigate the relationships of obesity-related indices and metabolic syndrome with subclinical atherosclerosis in middle-aged untreated workers. Methods: Employees undergoing their periodic health check-up but without previous cardiovascular events or cardiovascular medications were enrolled in this study (n = 7,750). Body mass index (BMI), percent body fat, waist circumference, and visceral fat area were evaluated as obesity-related indices. Assessment of visceral fat area was performed by computed tomography (CT). Subclinical atherosclerosis was assessed by measuring arterial stiffness using cardio-ankle vascular index (CAVI) and by ultrasound examination of carotid intima-media thickness (IMT). Results: Obesity-related indices were significantly correlated with each other and were positively associated with carotid IMT but negatively associated with CAVI in multivariate regression analysis. In a logistic regression analysis including CAVI and carotid IMT simultaneously, CAVI was negatively associated, but carotid IMT was positively associated, with obesity defined by each obesity-related index. In contrast, both CAVI and carotid IMT were positively associated with the presence of metabolic syndrome based on visceral fat accumulation. Conclusions: Obesity-related indices were negatively associated with CAVI and positively associated with carotid IMT in middle-aged untreated workers, while both CAVI and carotid IMT were worsened in the presence of metabolic syndrome.
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Affiliation(s)
- Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences.,Health Support Center WELPO, Toyota Motor Corporation
| | - Yasuaki Dohi
- Department of Internal Medicine, Faculty of Rehabilitation Science, Nagoya Gakuin University.,Health Support Center WELPO, Toyota Motor Corporation
| | - Yasuyuki Takagi
- Health Support Center WELPO, Toyota Motor Corporation.,Toyota Memorial Hospital
| | | | - Mitsuhisa Ito
- Health Support Center WELPO, Toyota Motor Corporation
| | - Kenji Suzuki
- Health Support Center WELPO, Toyota Motor Corporation
| | | | | | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
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Association of Low Serum l-Carnitine Levels with Peripheral Arterial Stiffness in Patients Who Undergo Kidney Transplantation. Nutrients 2019; 11:nu11092000. [PMID: 31450550 PMCID: PMC6770900 DOI: 10.3390/nu11092000] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/11/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023] Open
Abstract
l-carnitine is an important co-factor in fatty-acid metabolism, and its deficiency is associated with insulin resistance, which is independently associated with arterial stiffness. This study evaluated the relationship between serum l-carnitine level and peripheral arterial stiffness (PAS) in kidney transplantation (KT). Fasting blood samples were collected from 65 patients who underwent KT. We measured the brachial–ankle pulse wave velocity, and 36 patients (55.4%) had PAS. Patients with PAS had a significantly higher percentage of diabetes (p = 0.001), hypertension (p = 0.033), and metabolic syndrome (p = 0.044); higher waist circumference (p = 0.010), systolic blood pressure (p = 0.002), serum triglyceride level (p = 0.040), insulin level (p = 0.002), and homeostasis model assessment of insulin resistance (p = 0.002); lower high-density lipoprotein cholesterol (p = 0.036) and serum l-carnitine levels (p < 0.001); older age (p = 0.041); and a longer KT duration (p = 0.025) than those without PAS. Statistical analysis revealed an independent association between PAS in KT and KT duration (95% confidence interval (CI): 1.003–1.054, p = 0.029) and serum l-carnitine levels (95% CI: 0.842–0.998, p = 0.044). The area under the receiver operating characteristic curve indicated that the diagnostic power of l-carnitine to predict PAS was 0.789 (95% CI: 0.670–0.881, p < 0.001). Serum-free l-carnitine level is negatively associated with PAS in patients who undergo KT.
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36
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Aroor AR, Whaley-Connell A, Sowers JR. Utility of obesity and metabolic dyslipidemia (a non-insulin based determinate of the metabolic syndrome and insulin resistance) in predicting arterial stiffness. J Clin Hypertens (Greenwich) 2019; 21:1071-1074. [PMID: 31318126 DOI: 10.1111/jch.13615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Increased arterial stiffening is not only a hallmark of the aging process but the consequence of many metabolic abnormalities such as insulin resistance (IR), obesity, and metabolic dyslipidemia. In patients with the cardiometabolic syndrome, arterial stiffening is consistently observed across all age groups. A core feature linking obesity and the metabolic syndrome to arterial stiffness has been IR. However, including other metabolic abnormalities such as metabolic dyslipidemia increases the risk prediction of arterial stiffness in a dose-dependent fashion. Chronic hyperinsulinemia also increases the activity of both the systemic and the local RAAS which contributes to the development of arterial stiffness. All of these relevant metabolic features that predict arterial stiffness are appropriately incorporated in the METS-IR used in the current study.
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Affiliation(s)
- Annayya R Aroor
- Diabetes and Cardiovascular Center, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Department of Medicine, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Division of Endocrinology and Metabolism, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA
| | - Adam Whaley-Connell
- Diabetes and Cardiovascular Center, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Department of Medicine, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Division of Endocrinology and Metabolism, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Division of Nephrology and Hypertension, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri, USA
| | - James R Sowers
- Diabetes and Cardiovascular Center, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Department of Medicine, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Division of Endocrinology and Metabolism, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri, USA.,Department of Medical Pharmacology and Physiology, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Dalton Cardiovascular Research Center, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA
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Omboni S, Posokhov I, Parati G, Rogoza A, Kotovskaya Y, Arystan A, Avolio A, Barkan V, Bulanova N, Cardona Muñoz E, Grigoricheva E, Konradi A, Minyukhina I, Muiesan ML, Mulè G, Orlova I, Pereira T, Peixoto Maldonado JM, Statsenko ME, Tilea I, Waisman G, Rogoza A, Forcada P, Zelveian P, Butlin M, Barin E, Tan I, Ghiadoni L, Bruno RM, Sarzani R, Espinosa E, Volpe M, Savoia C, Tocci G, Borghi C, Schillaci G, Pucci G, Paini A, Rizzoni D, Ramos C, Alanis A, Varga A, Volkov D, Kurlykina N, Rotar O, Orlov A, Gorbunov V, Boytsov S, Fedorova E, Korneva V, Kuznetsova T, Kulikova N, Evdokimov VV, Kuznetsova A, Zheleznyak E, Kobalava Z, Borisova I, Svetozarsky T, Gubanova M, Lazareva V, Derevyanchenko MV, Kopylov P, Sirenko Y, Recovets O. Ambulatory blood pressure and arterial stiffness web‐based telemonitoring in patients at cardiovascular risk. First results of the VASOTENS (Vascular health ASsessment Of The hypertENSive patients) Registry. J Clin Hypertens (Greenwich) 2019; 21:1155-1168. [DOI: 10.1111/jch.13623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit Italian Institute of Telemedicine Varese Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Igor Posokhov
- Hemodynamic Laboratory Ltd Nizhniy Novgorod Russian Federation
| | - Gianfranco Parati
- Department of Cardiology Istituto Auxologico Italiano Milan Italy
- Department of Medicine and Surgery University of Milano‐Bicocca Milan Italy
| | - Anatoly Rogoza
- Department of New Diagnostic Methods Russian Cardiology Research and Production Complex Moscow Russian Federation
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology Pirogov Russian National Research Medical Moscow Russian Federation
| | - Ayana Arystan
- Department of Functional Diagnostics Medical Center Hospital of President’s Affairs Administration of The Republic of Kazakhstan Astana Kazakhstan
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia
| | - Vitaliy Barkan
- Diagnostics Department The Hospital within the Russian Railroad Network Chita Russian Federation
| | - Natalia Bulanova
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | | | | | - Alexandra Konradi
- Department of Epidemiology North‐West Federal Medical Research Center St. Petersburg Russian Federation
| | - Irina Minyukhina
- Lomonosov Moscow State University Clinic Moscow Russian Federation
| | - Maria Lorenza Muiesan
- Dipartimento di Scienze Mediche e Chirurgiche Università di Brescia, Medicina 2 Brescia Italy
| | - Giuseppe Mulè
- Unità Operativa di Nefrologia ed Ipertensione, Centro di Riferimento Regionale per l'Ipertensione Arteriosa Policlinico Paolo Giaccone Palermo Italy
| | - Iana Orlova
- Volga District Medical Center Nizhniy Novgorod Russian Federation
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra Instituto Politécnico de Coimbra Coimbra Portugal
| | | | | | - Ioan Tilea
- Cardiac Rehabilitation Clinic Tirgu Mures Emergency Clinical County Hospital Tirgu Mures Romania
| | - Gabriel Waisman
- Servicio de Clínica Médica y Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires Argentina
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Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population. Hypertens Res 2019; 42:1223-1230. [PMID: 30918334 PMCID: PMC8075960 DOI: 10.1038/s41440-019-0251-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/10/2019] [Accepted: 02/21/2019] [Indexed: 12/14/2022]
Abstract
Several lipid parameters are closely associated with residual cardiovascular risk. We aimed to confirm that in a range of low-density lipoprotein cholesterol (LDL-c) levels (from <70 mg/dl to ≥160 mg/dl), other lipid parameters, such as triglyceride (TG) level, non-high-density lipoprotein cholesterol (non-HDL-c) level, and the total cholesterol (TC)/HDL-c ratio, are still related to arterial stiffness, which is a recognized marker of atherosclerosis. In this cross-sectional study, we measured brachial-ankle pulse wave velocity (baPWV), as well as clinical and biochemical indices in 16,733 Chinese adult volunteers who underwent health check-ups from January 2014 to January 2015. Arterial stiffness was defined as the upper quartile of baPWV. We applied multivariable logistic regression models to examine the associations between lipid parameters and arterial stiffness. Both men and women with high baPWV were more likely to have an atherogenic lipid phenotype. Among participants with LDL-c <70 mg/dl, participants with non-HDL-c ≥100 mg/dl had a multivariable adjusted OR for arterial stiffness of 1.66 (1.11–2.50) compared to those with non-HDL-c <100 mg/dl; participants with TG ≥150 mg/dl had an OR of 2.44 (1.61–3.71) compared to those with TG <150 mg/dl; and participants with a TC/HDL-c ratio ≥4 had an OR of 1.74 (1.15–2.65) compared to those with a TC/HDL-c ratio <4. Similar results were observed at other LDL-c levels. We found that non-HDL-c, TG, and the TC/HDL-c ratio were consistently associated with arterial stiffness in a range of LDL-c levels, even when LDL-c was below 70 mg/dl. These lipid measures are related to residual cardiovascular risk, possibly due to their detrimental effects on vascular structure.
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Khoshdel AR, Eshtiaghi R. Assessment of Arterial Stiffness in Metabolic Syndrome Related to Insulin Resistance in Apparently Healthy Men. Metab Syndr Relat Disord 2019; 17:90-96. [PMID: 30620239 DOI: 10.1089/met.2018.0090] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Assessment of subclinical atherosclerosis in metabolic syndrome is one of the global health targets' priorities. This study aimed to evaluate the subclinical atherosclerosis in metabolic syndrome related to insulin resistance in healthy and physically active men. METHODS A consecutive group of 68 healthy men, 30-55 years of age, was studied. Anthropometric parameters, proinflammatory factors, and insulin level were measured, and pulse wave analysis (PWA) was performed by applanation tonometry and then processed with dedicated software (SphygmoCor®). The metabolic syndrome was defined according to International Diabetes Federation (IDF) and metabolic health as ≤1 component of metabolic syndrome according to the Joint Interim Statement criteria. RESULTS The odds ratio of insulin resistance for metabolic syndrome was 5.16 (95% confidence interval: 1.44-18.5), P = 0.008. In PWA, metabolically healthy subjects had lower aortic systolic and diastolic, and cardiac end-systolic pressures (103.5 ± 9.9 vs. 108.8 ± 11.0), P = 0.03, (76.2 ± 8.8 vs. 80.6 ± 7.8), P = 0.04, and (96.5 ± 9.2 vs. 101 ± 10.1), P = 0.05, respectively. Furthermore, metabolic syndrome was accompanied by higher ejection duration% (38.8 ± 3.5 vs. 36.9 ± 2.8), P = 0.04, and lower subendocardial viability ratio (SEVR) (139.8 ± 17.7 vs. 150.9 ± 17.6), P = 0.05. Insulin resistance was associated with higher cardiac end-systolic pressure (103.0 ± 6.9 vs. 96.7 ± 10.4), P = 0.015. CONCLUSION Metabolic risk factors had incremental correlations with central arterial pressures and cardiac end-systolic pressure. Furthermore, the composite of metabolic syndrome components imposed additional load on cardiac muscle by higher cardiac ejection duration and impairment in perfusion with lower Buckberg SEVR. Likewise, insulin resistance could be an early marker of arterial stiffness in healthy and active young to middle-age men.
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Affiliation(s)
- Ali Reza Khoshdel
- 1 Epidemiology Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
- 2 Department of Nephrology, John Hunter Hospital, University of Newcastle, New South Wales, Australia
| | - Radina Eshtiaghi
- 3 Division of Metabolic Diseases, Epidemiology Research Center, AJA University of Medical Science, Tehran, Iran
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Capacity adiposity indices to identify metabolic syndrome in subjects with intermediate cardiovascular risk (MARK study). PLoS One 2019; 14:e0209992. [PMID: 30682054 PMCID: PMC6347134 DOI: 10.1371/journal.pone.0209992] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 12/16/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Obesity increases mortality, and is linked to cardiovascular diseases and metabolic syndrome (MetS). Therefore, the purpose of this study was to analyze the ability of different adiposity indices to identify subjects with MetS among people with intermediate cariovascular risk. MATERIALS AND METHODS The cross-sectional study involved 2478 subjects, recruited by the MARK study. Adiposity measures: general adiposity by body mass index (BMI), central adiposity by waist-to-height ratio (WHtR), fat mass percent by the Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), percentage of body fat and of visceral adipose tissue by body roundness index (BRI) and visceral obesity and general adiposity with body shape index (ABSI). The diagnosis of MetS was made in accordance with the criteria established in the international consensus of the Joint Scientific Statement National Cholesterol Education Program III. RESULTS The highest correlation coefficients were obtained by the glycemic components (HbA1c and FPG) of the MetS and ranged from 0.155 to 0.320. The exception was ABSI, which showed lower values in the global analysis and in the males. Values of the area under the ROC curve with the adiposity indices ranged from 0.773 with the BMI in males to 0.567 with ABSI in males. In the logistic regression analysis, all adiposity factors, except ABSI, showed similar OR values of MetS after adjusting for possible confounding factors. In the global analysis, the adiposity index that showed a highest OR of MetS was CUN-BAE (OR 5.50; 95% CI 4.27-7.09). In the analysis by gender, the highest ORs were BMI in males (OR 5.98; 95% CI 4.70-7.60) and both WHtR and BRI in females (OR 4.15; 95% CI 3.09-5.58). CONCLUSION All adiposity indices, except for ABSI, show an association with MetS and similar ability to detect subjects with MetS among people with intermediate cariovascular risk.
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Zhan B, Huang X, Wang J, Qin X, Zhang J, Cao J, Song Y, Liu L, Li P, Yang R, Wu Y, Wu Q, Zhang Y, Li J, Huo Y, Wang B, Xu X, Bao H, Cheng X. Association Between Lipid Profiles and Arterial Stiffness in Chinese Patients With Hypertension: Insights From the CSPPT. Angiology 2019; 70:515-522. [PMID: 30651004 DOI: 10.1177/0003319718823341] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Arterial stiffness plays a key role in the pathogenesis of cardiovascular disease. However, the relationship between lipid levels and arterial stiffness is controversial. We aimed to investigate the association between lipid parameters and brachial-ankle pulse-wave velocity (baPWV) in Chinese patients with hypertension. A total of 14 071 participants with hypertension in the China Stroke Primary Prevention Trial (CSPPT) were enrolled in the present study. Patients were assigned to 4 equal groups according to their baPWV. Participants in the highest baPWV group were older with a higher prevalence of stroke and diabetes mellitus as well as higher body mass index (BMI), blood pressure, fasting plasma glucose, uric acid, total cholesterol (TC), triglycerides (TG), homocysteine (Hcy), and vitamin B12 levels ( P < .001). After adjusting for age, sex, BMI, and other cardiovascular risks, high-density lipoprotein cholesterol (HDL-C) was negatively related to baPWV (β = -0.22, P = .012), TC (β = 0.08, P = 0.001), TG (β = 0.14, P = .001); non-HDL-C (β = 0.12, P = .001) and positively related to baPWV. The effect was not observed for low-density lipoprotein cholesterol (LDL-C; β = 0.12, P = .335).These results suggested that non-HDL-C, TG, and TC were associated with arterial stiffness in a Chinese population with hypertension. HDL-C was inversely associated with arterial stiffness.
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Affiliation(s)
- Biming Zhan
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
| | - Xiao Huang
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
| | - Jiancheng Wang
- 2 Renal Division, Nanfang Hospital, National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China
| | - Xianhui Qin
- 2 Renal Division, Nanfang Hospital, National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China
| | - Jingping Zhang
- 3 Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Jingjing Cao
- 3 Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Yun Song
- 4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Lishun Liu
- 4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Ping Li
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
| | - Renqiang Yang
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
| | - Yanqing Wu
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
| | - Qinghua Wu
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
| | - Yan Zhang
- 5 Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- 5 Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- 4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.,5 Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Binyan Wang
- 3 Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xiping Xu
- 2 Renal Division, Nanfang Hospital, National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China.,3 Institute of Biomedicine, Anhui Medical University, Hefei, China.,4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Huihui Bao
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
| | - Xiaoshu Cheng
- 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China
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Syed-Abdul MM, Hu Q, Jacome-Sosa M, Padilla J, Manrique-Acevedo C, Heimowitz C, Parks EJ. Effect of carbohydrate restriction-induced weight loss on aortic pulse wave velocity in overweight men and women. Appl Physiol Nutr Metab 2018; 43:1247-1256. [DOI: 10.1139/apnm-2018-0113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Increased aortic stiffness, measured by carotid-to-femoral pulse wave velocity (PWV), is an independent predictor of cardiovascular disease, and past data have shown that low-fat and low-energy diets, fed for 8–24 weeks, lower PWV. The purpose of this study was to determine whether a reduction in PWV would be achieved by dietary carbohydrate (CHO) restriction, shown to bring about weight loss over a shorter timeframe. Men (n = 10, age: 41.8 ± 10.2 years, BMI: 34.2 ± 3.0 kg/m2 (mean ± SD)) and women (n = 10, age: 38.6 ± 6.1 years, BMI: 33.5 ± 3.8 kg/m2) with characteristics of insulin resistance and the metabolic syndrome consumed a structured, CHO-restricted diet for 4 weeks (energy deficit, 645 kcal/day). For the whole group, subjects lost 5.4% ± 0.5% (P < 0.001) of body weight and experienced significant reductions in blood pressure (6%–8%), plasma insulin (34%), and triglycerides (34%). PWV was reduced by 6% ± 2% (7.1 ± 0.2 m/s to 6.7 ± 0.2 m/s, P = 0.008) and surprisingly, in women, it fell significantly (from 7.2 ± 0.3 m/s to 6.3 ± 0.3 m/s, P = 0.028), while no changes were observed in men (7.2 ± 0.3 vs. 7.0 ± 0.3 m/s, P = 0.144). This is the first study to demonstrate that weight loss can improve PWV in as little as 4 weeks and that dietary CHO restriction may be an effective treatment for reducing aortic stiffness in women. Future studies are needed to establish the mechanisms by which dietary CHO restriction may confer more cardiovascular benefits to women than to men.
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Affiliation(s)
- Majid M. Syed-Abdul
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Qiong Hu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Miriam Jacome-Sosa
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Camila Manrique-Acevedo
- Division of Endocrinology, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | | | - Elizabeth J. Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
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Gomez-Marcos MA, Gomez-Sanchez L, Patino-Alonso MC, Recio-Rodriguez JI, Gomez-Sanchez M, Rigo F, Marti R, Agudo-Conde C, Ramos R, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Garcia-Ortiz L. A body shape index and vascular structure and function in Spanish adults (MARK study): A cross-sectional study. Medicine (Baltimore) 2018; 97:e13299. [PMID: 30461641 PMCID: PMC6392544 DOI: 10.1097/md.0000000000013299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
A body shape index (ABSI) has been introduced as a marker of the relationship between body composition and all-cause mortality. However, until now, the relationships between ABSI and vascular structure and function have not been evaluated. The aim of this study was to investigate the association of ABSI with vascular structure and function in Spanish adults with intermediate cardiovascular risk. This cross-sectional study analyzed the data of 2354 subjects [age, 35-74 years (median, 62.0 years [range, 56.0-67.0 years]), 61.9% men] enrolled into the MediAte Risk management (MARK) study. ABSI was calculated by using the following formula: ABSI = waist circumference (m)/[body mass index × height (m))]. Vascular function was assessed by measuring cardio-ankle vascular index (CAVI) with the VaSera device and brachial ankle pulse wave velocity (baPWV) by using a validated equation. Vascular structure was assessed by measuring carotid intima-media thickness (IMT) by ultrasonography. Median value of ABSI was 0.083 (range, 0.081-0.090), mean CAVI was (8.5 ± 1.2), and median IMT was 0.727 (range, 0.672-0.799). The values of ABSI and CAVI were higher in men. After adjusting for confounders, ABSI was positively associated with CAVI, baPWV, and average mean IMT. Thus, for each unit increase in ABSI, CAVI increased by 0.16 units, baPWV by 0.25 m/s, and IMT by 0.033 mm. In the logistic regression analysis, the odds ratio of ABSI was > 1 for high CAVI ≥ 9, baPWV ≥ 15 m/s, and IMT ≥ 0.90 mm in the overall subject group, and in the sex- and age-specific (> 62 years, ≤ 62 years) subgroups, after adjusting for confounders. The area under the receiver-operating characteristic curve of the ABSI was 0.631 (95% confidence interval [CI], 0.608-0.654) for CAVI ≥ 9, and 0.617 (95% CI, 0.593-0.641) for high baPWV ≥ 15 m/s. ABSI showed a positive association with vascular structure and function, independent of other confounders that might influence weight and fat mass distribution in Spanish subjects at intermediate cardiovascular risk.Trial Registration: ClinicalTrials.gov Identifier: NCT01428934 (registered: September 2, 2011; last updated: September 8, 2016).
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Affiliation(s)
- Manuel A. Gomez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
- Health Service of Castilla and León (SACyL)
- Department of Medicine
| | - Leticia Gomez-Sanchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
| | - Maria Carmen Patino-Alonso
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
- Department of Statistics
| | - Jose I. Recio-Rodriguez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca
| | - Marta Gomez-Sanchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
| | - Fernando Rigo
- San Agustín Health Center, IllesBalears Health Service (IBSALUT), Palma of Mallorca
| | - Ruth Marti
- Unidad of Soporte la Recerca of Girona, Instituto Universitario de Investigación in Atención Primària Jordi Gol (IDIAP Jordi Gol)
- Institututi de Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI)
| | - Cristina Agudo-Conde
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
| | - Rafel Ramos
- Unidad of Soporte la Recerca of Girona, Instituto Universitario de Investigación in Atención Primària Jordi Gol (IDIAP Jordi Gol)
- Institututi de Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI)
- Departament of Ciències Mèdiques, Facultat of Medicina, Universitat of Girona, Girona
| | - Emiliano Rodriguez-Sanchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
- Health Service of Castilla and León (SACyL)
- Department of Medicine
| | - Jose A. Maderuelo-Fernandez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
- Health Service of Castilla and León (SACyL)
| | - Luis Garcia-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit The Alamedilla Health Center
- Health Service of Castilla and León (SACyL)
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca
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Cozma A, Sitar-Taut A, Orăşan O, Leucuta D, Alexescu T, Stan A, Negrean V, Sampelean D, Pop D, Zdrenghea D, Vulturar R, Fodor A. Determining Factors of Arterial Stiffness in Subjects with Metabolic Syndrome. Metab Syndr Relat Disord 2018; 16:490-496. [PMID: 30183523 DOI: 10.1089/met.2018.0057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MS) is a clustering entity characterized by obesity, hypertension, hyperglycemia, dyslipidemia, and insulin resistance. Early detection of atherosclerosis is important in patients with MS because cardiovascular diseases are the main cause of mortality in these patients. METHODS We aimed to investigate the factors influencing arterial stiffness, pulse wave velocity, and the augmentation index, respectively, in 150 subjects with MS (94 women and 56 men; mean age 60.56 ± 9.8 years). Arterial stiffness was measured using the TensioMed™ Arteriograph. We tested the relationship between arterial parameters and insulin resistance measured by the determination of insulinemia (the ELISA method) and the homeostasis model assessment index (HOMA). RESULTS In multivariate analysis we identified the independent factors that influence arterial stiffness: systolic blood pressure (coefficient of determination 3.586; P < 0.0001), serum triglycerides (coefficient of determination 3.579; P < 0.0001), and age (coefficient of determination 3.510; P = 0.001) are independent predictive factors for pulse wave velocity. The independent predictive factors of the augmentation index were the body mass index (coefficient of determination 0.55; P = 0.009), the presence of diabetes mellitus (coefficient of determination 4.7; P = 0.03), mean arterial pressure (coefficient of determination 0.44; P < 0.0001), gender (coefficient of determination 9.2; P < 0.0001), age (coefficient of determination 0.3; P < 0.0001), and heart rate (coefficient of determination 0.66; P < 0.0001). Insulin resistance (HOMA index) was a predictor of the brachial augmentation index (β coefficient 3.4; P < 0.001) and was not a predictor of pulse wave velocity (β = -0.3; P = 0.6) in our study. CONCLUSIONS Given the known predictive value of pulse wave velocity for cardiovascular events, identifying the factors responsible for the increase in arterial stiffness is extremely important.
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Affiliation(s)
- Angela Cozma
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Adela Sitar-Taut
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Olga Orăşan
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Daniel Leucuta
- 2 Med Informat & Biostat Department, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Teodora Alexescu
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Adina Stan
- 3 Department of Neurology and Clinical Rehabilitation Hospital, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Vasile Negrean
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Dorel Sampelean
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Dana Pop
- 4 Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Dumitru Zdrenghea
- 4 Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Romana Vulturar
- 5 Department of Cell Biology, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Adriana Fodor
- 6 Clinical Center of Diabetes, Nutrition, Metabolic Diseases, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
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Baier D, Teren A, Wirkner K, Loeffler M, Scholz M. Parameters of pulse wave velocity: determinants and reference values assessed in the population-based study LIFE-Adult. Clin Res Cardiol 2018; 107:1050-1061. [PMID: 29766282 PMCID: PMC6208658 DOI: 10.1007/s00392-018-1278-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/08/2018] [Indexed: 01/27/2023]
Abstract
AIMS AND BACKGROUND Parameters of arterial stiffness such as pulse wave velocity (PWV) were recently proposed as independent risk factors of cardiovascular events. We analyse three PWV parameters in the large population-based study LIFE-Adult to identify risk factors, normal and reference values. METHODS AND RESULTS Brachial-ankle (ba), brachial-femoral (bf) and carotid-femoral (cf) PWV assessment was performed using Vicorder device. 8509 participants aged 19-80 were analysed. PWV parameters were moderately correlated (r(ba/bf) = 0.6, r(ba/cf) = 0.46, r(bf/cf) = 0.59). Age and blood pressure are the dominant determinants of PWV parameters explaining > 18% of variability. Sex was only relevant for bfPWV and cfPWV. All further analysed cardiovascular and other risk factors are of minor importance. We provide age-dependent percentiles for the population (reference values) and for the subgroup of normotonic individuals. All percentiles show a strong increase with age. The difference between normotonic and all individuals is small for younger age groups but increases up to 1 m/s for elderly subjects. CONCLUSION Our study confirms and further underpins the strong impact of age and blood pressure on arterial stiffness and the relatively weak contribution of other factors, supporting an independent role of arterial stiffness in cardiovascular disease development. Age-dependent reference and normal values were provided on the basis of the so far largest study sample facilitating the implementation of PWV assessment in clinical practice. Due to better compliance, handling and stronger association with age and blood pressure, baPWV could serve as an alternative to cfPWV. Follow-up data are required to estimate the clinical significance of specified PWV cut-offs.
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Affiliation(s)
- Daniel Baier
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Andrej Teren
- LIFE Research Center for Civilization Diseases, Leipzig, Germany.,Heart Center Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- LIFE Research Center for Civilization Diseases, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany.,LIFE Research Center for Civilization Diseases, Leipzig, Germany
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany. .,LIFE Research Center for Civilization Diseases, Leipzig, Germany.
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Kadoya M, Kurajoh M, Kakutani-Hatayama M, Morimoto A, Miyoshi A, Kosaka-Hamamoto K, Shoji T, Moriwaki Y, Inaba M, Koyama H. Low sleep quality is associated with progression of arterial stiffness in patients with cardiovascular risk factors: HSCAA study. Atherosclerosis 2018; 270:95-101. [DOI: 10.1016/j.atherosclerosis.2018.01.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/27/2017] [Accepted: 01/24/2018] [Indexed: 11/17/2022]
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Tuttolomondo A, Petta S, Casuccio A, Maida C, Corte VD, Daidone M, Di Raimondo D, Pecoraro R, Fonte R, Cirrincione A, Zafonte R, Cabibi D, Cammà C, Di Marco V, Licata A, Magliozzo F, Marchesini G, Merlino G, Craxì A, Pinto A. Reactive hyperemia index (RHI) and cognitive performance indexes are associated with histologic markers of liver disease in subjects with non-alcoholic fatty liver disease (NAFLD): a case control study. Cardiovasc Diabetol 2018; 17:28. [PMID: 29452601 PMCID: PMC5815178 DOI: 10.1186/s12933-018-0670-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 02/01/2018] [Indexed: 12/13/2022] Open
Abstract
Background No study evaluated vascular health markers in subjects with non-alcoholic fatty liver disease (NAFLD) through a combined analysis of reactive hyperemia peripheral arterial tonometry (RH-PAT) and arterial stiffness indexes. Aim of the study We aimed to assess whether NAFLD and its histological severity are associated with impairment of arterial stiffness and RH-PAT indexes in a mixed cohort of patients with biopsy-proven NAFLD. Materials and methods The Kleiner classification was used to grade NAFLD grade. Pulse wave velocity (PWV) and augmentation index (Aix) were used as markers of arterial stiffness, whereas endothelial function was assessed using reactive hyperemia index (RHI). The mini-mental state examination (MMSE) was administered to test cognitive performance. Results 80 consecutive patients with biopsy-proven NAFLD and 83 controls without fatty liver disease. NAFLD subjects showed significantly lower mean RHI, higher mean arterial stiffness indexes and lower mean MMSE score. Multivariable analysis after correction for BMI, dyslipidaemia, hypertension, sex, diabetes, age and cardiovascular disease showed that BMI, diastolic blood pressure and RHI are significantly associated to NAFLD. Simple linear regression analysis showed among non-alcoholic steatohepatitis (NASH) subjects a significant negative relationship between ballooning grade and MMSE and a significant positive association between Kleiner steatosis grade and augmentation index. Conclusions Future research will be addressed to evaluate the relationship between inflammatory markers and arterial stiffness and endothelial function indexes in NAFLD subjects. These study will evaluate association between cardiovascular event incidence and arterial stiffness, endothelial and cognitive markers, and they will address the beneficial effects of cardiovascular drugs such as statins and ACE inhibitors on these surrogate markers in NAFLD subjects.
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Affiliation(s)
- Antonino Tuttolomondo
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy.
| | - Salvatore Petta
- Sezione di Gastroenterologia e Epatologia, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, University of Palermo, Palermo, Italy
| | - Carlo Maida
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
| | - Vittoriano Della Corte
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
| | - Mario Daidone
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
| | - Domenico Di Raimondo
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
| | - Rosaria Pecoraro
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
| | - Roberto Fonte
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
| | - Anna Cirrincione
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
| | | | - Daniela Cabibi
- Cattedra di Anatomia Patologica, University of Palermo, Palermo, Italy
| | - Calogero Cammà
- Sezione di Gastroenterologia e Epatologia, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy
| | - Vito Di Marco
- Sezione di Gastroenterologia e Epatologia, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy
| | - Anna Licata
- Sezione di Gastroenterologia e Epatologia, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy
| | | | - Giulio Marchesini
- Dipartimento di Scienze Mediche e Chirurgiche, "Alma Mater Studiorum", University of Bologna, Bologna, Italy
| | | | - Antonio Craxì
- Sezione di Gastroenterologia e Epatologia, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy
| | - Antonio Pinto
- U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche n.2, Palermo, 90127, Italy
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Pasha EP, Birdsill AC, Oleson S, Haley AP, Tanaka H. Impacts of Metabolic Syndrome Scores on Cerebrovascular Conductance Are Mediated by Arterial Stiffening. Am J Hypertens 2017; 31:72-79. [PMID: 28992237 PMCID: PMC5861594 DOI: 10.1093/ajh/hpx132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/24/2017] [Accepted: 07/19/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals with metabolic syndrome (MetS) exhibit reduced cerebral blood flow. The mechanisms of this reduction remain unknown but arterial stiffening has been implicated as a contributor. We determined if MetS was associated with reduced cerebral blood flow at midlife, and if so, whether arterial stiffness was responsible for mediating their relation. METHODS Middle-aged (40-60 years) community dwelling adults (n = 83) were studied. MetS score was calculated for each subject. Middle cerebral artery hemodynamics was measured using transcranial Doppler ultrasound. Indices of aortic, systemic, and carotid artery stiffness were derived. RESULTS Subjects had subclinical MetS pathology (MetS score = 19.8 ± 10.4) that was inversely associated with cerebrovascular conductance (CVC: r = -0.261, P = 0.02). Carotid-femoral pulse wave velocity (cfPWV) (r = -0.188, P = 0.09), brachial-ankle pulse wave velocity (baPWV) (r = -0.161, P = 0.15), and carotid artery distensibility (r = -0.10, P = 0.37) abrogated the direct association of MetS score and CVC, demonstrating full mediation. Nonparametric bootstrapping further indicated significant indirect effects of cfPWV, baPWV, and carotid artery distensibility, fully mediating reductions of CVC exerted from sublcinical MetS. Carotid artery distensibility demonstrated the greatest effect on CVC (B = -0.0019, SE = 0.0012, -0.0050 to -0.0002 95% confidence interval). CONCLUSIONS Arterial stiffness, particularly the stiffness of the carotid artery, mediated reductions in CVC related to MetS.
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Affiliation(s)
- Evan P Pasha
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, USA
| | - Alex C Birdsill
- Department of Psychology, The University of Texas at Austin, USA
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, USA
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, USA
- Imaging Research Center, The University of Texas at Austin, USA
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, USA
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Gómez-Sánchez L. Importance of arterial stiffness as a cardiovascular risk factor. Med Clin (Barc) 2017; 149:493-495. [PMID: 28756996 DOI: 10.1016/j.medcli.2017.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/09/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Leticia Gómez-Sánchez
- Unidad de Investigación de Atención Primaria La Alamedilla, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España.
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Yue M, Liu H, He M, Wu F, Li X, Pang Y, Yang X, Zhou G, Ma J, Liu M, Gong P, Li J, Zhang X. Gender-specific association of metabolic syndrome and its components with arterial stiffness in the general Chinese population. PLoS One 2017; 12:e0186863. [PMID: 29073198 PMCID: PMC5658088 DOI: 10.1371/journal.pone.0186863] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/09/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Metabolic syndrome (MS) is considered to be a cluster of interrelated risk factors for metabolism, which may increase arterial stiffness and cardiovascular morbidity. The cardio-ankle vascular index (CAVI) is a reliable indicator of arterial stiffness and early arteriosclerosis. The main objective of this study is to evaluate the gender-specific relationship between MS and CAVI in the general Chinese population. METHODS A total of 1,301 subjects aged 20 to 60 years participated in this study. CAVI was measured noninvasively using a Vasera VS-1000 device. Blood samples and waist circumference were examined to identify metabolic syndrome according to the criteria set forth in the 2009 Joint Scientific Statement. RESULTS The prevalence of MS in the study subjects was 17.4% (30.7% in males and 7.0% in females, P < 0.001). CAVI values were significantly higher in MS subjects than in non-MS subjects and increased linearly as the number of MS components increased in females, but not in males. Using multiple regression analysis, we found that BMI was correlated with CAVI in the overall population and in both genders, and that high-density lipoprotein cholesterol (HDL-C) was associated with CAVI in males, while the number of MS components was related to CAVI in females. CAVI values increased linearly with age in both genders (P-trend < 0.001 for both), and this correlation was stronger in males than in females. CONCLUSIONS There are gender-specific differences in the association of MS and CAVI. First, the effects of the number of MS components on CAVI are stronger in females than in males. Second, the effect of each MS component on arterial stiffness may differ in relation to gender. In addition, aging affects arterial stiffness more severely in males, and the increase in arterial stiffness tends to occur at a younger age in males than in females. Larger samples and longitudinal studies are needed to further confirm our results in the future.
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Affiliation(s)
- Mengjia Yue
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Fangyuan Wu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xuanxuan Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yingxin Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaodi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ge Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Juan Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Meitian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ping Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Jinghua Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
- * E-mail:
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