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Huang Y, Shi W, He Q, Tan J, Tong J, Yu B. Racial and ethnic influences on carotid atherosclerosis: Epidemiology and risk factors. SAGE Open Med 2024; 12:20503121241261840. [PMID: 39045542 PMCID: PMC11265241 DOI: 10.1177/20503121241261840] [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: 11/24/2023] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
Carotid atherosclerosis-related stenosis, marked by atherosclerotic plaque formation in the carotid artery, significantly increases ischemic stroke risk. Its prevalence varies across ethnic groups, reflecting racial disparities. Epidemiological studies have highlighted different susceptibilities to carotid stenosis among racial groups. Native Americans and Whites show greater vulnerability, indicating genetic and environmental influences. The impact of carotid stenosis is more severe in Hispanic and Black populations, with a higher incidence of related brain injuries, underscoring the need for targeted interventions. Comparative imaging studies between Chinese and White individuals reveal unique patterns of carotid stenosis, enhancing understanding of its pathophysiology and management across ethnicities. This review also categorizes risk factors, distinguishing those with racial disparity (such as genetic loci, sleep apnea, and emotional factors, socioeconomic status) from those without. In summary, racial disparities affect carotid stenosis, leading to varying susceptibilities and outcomes among ethnic groups. Recognizing these differences is essential for developing effective prevention, diagnosis, and management strategies. Addressing these disparities is critical to reducing ischemic stroke's burden across populations. Continued research and targeted interventions are crucial to improve outcomes for individuals at risk of carotid stenosis and its complications.
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Affiliation(s)
- Yijun Huang
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Weihao Shi
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Qing He
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jinyun Tan
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jindong Tong
- Department of Vascular Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
- Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Bo Yu
- Department of General Surgery, Huashan Hospital Affiliated to Fudan University, Shanghai, China
- Department of Vascular Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
- Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
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Li H, Xu X, Luo B, Zhang Y. The Predictive Value of Carotid Ultrasonography With Cardiovascular Risk Factors-A "SPIDER" Promoting Atherosclerosis. Front Cardiovasc Med 2021; 8:706490. [PMID: 34447790 PMCID: PMC8382941 DOI: 10.3389/fcvm.2021.706490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
Insufficient recommendations do not support the clinical use of carotid ultrasonography for further risk stratification in moderate-to-high risk patients with cardiovascular disease (CVD). A literature review was performed to assess six aspects of the research progress and limitations of carotid ultrasonography and carotid atherosclerosis-related risk factors: (1) structures of the carotid intima and media; (2) plaques; (3) inflammation; (4) dynamics of carotid blood flow; (5) early detection and intervention; and (6) risk factors for CVD. Although carotid intima-media thickness and carotid plaques are well-acknowledged independent predictors of CVD risk, normative and cut-off values are difficult to define due to the heterogeneous measurements reported in previous studies. Plaque properties, including location, number, density, and size, become more important risk predictors for cardiovascular disease, but a better approach for clinical use needs to be further established. Three-dimensional ultrasound and contrast-enhanced ultrasound are promising for promoting risk stratification with more details on plaque morphology. Moreover, inflammatory diseases and biomarkers should be evaluated for a full assessment of the inflammatory burden for atherosclerosis. Carotid flow velocity is not only an indicator for stenosis but also a potential risk predictor. Carotid atherosclerosis should be detected and treated early, and additional clinical trials are needed to determine the efficacy of these measures in reducing CVD risk. Cardiovascular risk factors tend to affect carotid plaques, and early treat-to-target therapy might yield clinical benefits. Based on the aforementioned six aspects, we consider that these six important factors act like a “SPIDER” spinning the web of atherosclerosis; a timely comprehensive assessment and intervention may halt the progression to CVD. Carotid ultrasound results should be combined with other atherosclerotic factors, and a comprehensive risk assessment may help to guide cardiovascular prevention decisions.
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Affiliation(s)
- Hongwei Li
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Xiaolin Xu
- Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Baoming Luo
- Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
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Liu Y, Zhang Z, Xia B, Wang L, Zhang H, Zhu Y, Liu C, Song B. Relationship between the non-HDLc-to-HDLc ratio and carotid plaques in a high stroke risk population: a cross-sectional study in China. Lipids Health Dis 2020; 19:168. [PMID: 32660519 PMCID: PMC7359500 DOI: 10.1186/s12944-020-01344-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/06/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Evidence on the association between the non-high-density lipoprotein cholesterol (non-HDLc)-to-high-density lipoprotein cholesterol (HDLc) ratio (non-HDLc/HDLc) and carotid plaques is still limited. This study aims to assess the relationship between the non-HDLc/HDLc and carotid plaques in a population with a high risk of stroke. METHODS A cross-sectional study based on the community was conducted in Yangzhou, China. Residents (no younger than 40 years old) underwent questionnaire interviews, physical examinations, and laboratory testing during 2013-2014. The subjects with a high risk of stroke were further selected (at least three of eight risk factors including hypertension, atrial fibrillation, type 2 diabetes mellitus, dyslipidaemia, smoking, lack of exercise, overweight, and family history of stroke) or a transient ischaemic attack (TIA) or stroke history. Carotid ultrasonography was then performed on the high stroke risk participants. Carotid plaque was defined as a focal carotid intima-media thickness (cIMT) ≥1.5 cm or a discrete structure protruding into the arterial lumen at least 50% of the surrounding cIMT. Logistic regression was employed to evaluate the relationship between the non-HDLc/HDLc and carotid plaques. RESULTS Overall, 839 subjects with a high risk of stroke were ultimately included in the analysis, and carotid plaques were identified in 341 (40.6%) of them. Participants in the highest non-HDLc/HDLc tertile group presented a higher proportion of carotid plaques than did those in the other two groups. After adjustment for other confounders, each unit increase in the non-HDLc/HDLc was significantly associated with carotid plaques (OR 1.55, 95%CI 1.28-1.88). In the subgroup analysis, the non-HDLc/HDLc was positively and significantly associated with the presence of carotid plaques in most subgroups. Additionally, the non-HDLc/HDLc interacted significantly with three stratification variables, including sex (OR 1.31 for males vs. OR 2.37 for females, P interaction = 0.016), exercise (OR 1.18 for subjects without lack of exercise vs. OR 1.99 for subjects with lack of exercise, P interaction = 0.004) and heart diseases (OR 1.40 for subjects without heart diseases vs. OR 3.12 for subjects with heart diseases, P interaction = 0.033). CONCLUSION The non-HDLc/HDLc was positively associated with the presence of carotid plaques in a Chinese high stroke risk population. A prospective study or randomized clinical trial of lipid-lowering therapy in the Chinese population is needed to evaluate their causal relationship.
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Affiliation(s)
- Yan Liu
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 8 Huadian East Road, Nanjing, 210028 China
- Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Zhenwen Zhang
- Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Binlan Xia
- Department of Ultrasonography, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Liping Wang
- Department of Biobank, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Hengzhong Zhang
- Department of Center of Health Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Yan Zhu
- Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Chao Liu
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 8 Huadian East Road, Nanjing, 210028 China
| | - Bin Song
- Department of Center of Health Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
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Chen H, Chen Y, Wu W, Chen Z, Cai Z, Chen Z, Yan X, Wu S. Prolonged hyperlipidemia exposure increases the risk of arterial stiffness in young adults: a cross-sectional study in a cohort of Chinese. BMC Public Health 2020; 20:1091. [PMID: 32652962 PMCID: PMC7353800 DOI: 10.1186/s12889-020-09211-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 07/05/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hyperlipidemia is associated with arterial stiffness. Herein, We examined the effect of prolonged exposure to hyperlipidemia on the risk of arterial stiffness in young adults. METHODS A study cohort (35-55 years old) that received health check-ups in the Kailuan study (2014-2016) were assessed. Hyperlipidemia was defined as a low-density lipoprotein cholesterol ≥160 mg/dL according to the Chinese Guidelines for the Management of Dyslipidemia in Adults. Subjects were divided into three groups based on the number of years with hyperlipidemia: normal (0 years), low exposure (1-5 years), and high exposure (5-10 years) groups. Arterial stiffness was defined as brachial-ankle pulse wave velocity > 1400 cm/s. For all subjects and subjects that did not meet statin treatment criteria under guidelines, logistics regression was used to analyze the effect of prolonged hyperlipidemia exposure on arterial stiffness in different age groups. RESULTS Among 12,431 subjects, the mean age was 46.42 ± 5.34 years with 9000 men (72.4%). Brachial-ankle pulse wave velocity gradually increased with increased exposure duration. Logistic regression analysis showed that hyperlipidemia exposure was a risk factor for arterial stiffness in the low (1.22 times) and high (1.49 times) exposure groups compared with the normal group. In the different age groups, the risk of arterial stiffness increased with the duration of hyperlipidemia exposure, apart for the 35-40-year-old population. The effect of hyperlipidemia exposure duration on arterial stiffness in young adults that did not meet statin treatment criteria under guidelines was similar to the general population. CONCLUSIONS Prolonged exposure to hyperlipidemia in young adults increases the risk of arterial stiffness. Young adults with this condition may benefit from more aggressive primary prevention. TRIAL REGISTRATION Name of the registry: Risk factors and intervention for cardiology, cerebrovascular and related disease (Kailuan Study) Trial registration number: CHiCTR-TNC1100 1489 Date of registration: Aug 24, 2011 URL of trial registry record: http://www.chictr.org.cn/showproj.aspx?proj=8050.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College, NO.22 Xinling Road, Jinping District, Shantou City, 515041 Guangdong Province China
- Department of Cardiology, First Hospital of Medical College of Shantou University, NO.57 Changping Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
- School of Foreign Language, Guangdong Polytechnic Normal University, NO.293 Zhongshan Avenue West, Tianhe District, Guangzhou, 510665 Guangdong China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Zekai Chen
- Shantou University Medical College, NO.22 Xinling Road, Jinping District, Shantou City, 515041 Guangdong Province China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Zefeng Cai
- Shantou University Medical College, NO.22 Xinling Road, Jinping District, Shantou City, 515041 Guangdong Province China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Xiuzhu Yan
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, NO.57 Xinhua East Road, Lubei District, Tangshan City, 063001 Hebei Province China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, NO.57 Xinhua East Road, Lubei District, Tangshan City, 063001 Hebei Province China
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5
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Sivanesan H, Vanderloo LM, Keown-Stoneman CDG, Parkin PC, Maguire JL, Birken CS. The association between screen time and cardiometabolic risk in young children. Int J Behav Nutr Phys Act 2020; 17:41. [PMID: 32345327 PMCID: PMC7189472 DOI: 10.1186/s12966-020-00943-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 02/28/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES While studies exist on the association between screen time and cardiometabolic risk among adolescents, research examining the effect of screen time on cardiometabolic risk in young children is lacking. The primary objective of this study was to examine the association between daily screen time and cardiometabolic risk (CMR) [sum of age- and sex-standardized z-scores of systolic blood pressure (SBP), glucose, log-triglycerides, waist circumference (WC), and negative high-density lipoprotein (HDL) cholesterol divided by the square root of five] in young children. Secondary objectives included examining individual CMR risk factors, including waist-to-height ratio and non high-density lipoprotein (non-HDL) cholesterol, as well as the individual cut-offs of these risk factors. Additional analyses include examining the association between screen time and CMR by handheld/non-handheld devices. METHODS A study was conducted among young children 3 to 6 years from the TARGet Kids! practice-based research network in Toronto and Montreal, Canada. Children with one or more measures of screen time and CMR were included in this study. Generalized estimating equation (GEE) multivariable linear regressions and multivariable logistic regressions, using published cut-offs, were conducted to evaluate these associations. RESULTS Data from 1317 children [mean age 52 months (SD = 13.36), 44.34% female] were included for analyses. There was no evidence of associations between screen time and total CMR score or individual risk factors (p > 0.05) after adjusting for confounders. A statistically significant, but small association between daily screen time and non-HDL cholesterol was found (B = 0.046; CI = [0.017 to 0.075]; p = 0.002. CONCLUSIONS Though no relationship was reported between daily screen time and the majority of CMR factors in early childhood, there was an association between daily screen time and non-HDL cholesterol. As the relationship between daily screen time and CMR factors may not be apparent in early childhood, studies to evaluate longer-term cardiometabolic effects of screen time are needed. Although there is an evidence-based rationale to reduce screen time in early childhood, prevention of cardiometabolic risk may not be the primary driver.
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Affiliation(s)
- Harunya Sivanesan
- Master of Public Health, Epidemiology, University of Toronto, Toronto, Canada.,The Hospital for Sick Children Research Institute, Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
| | - Leigh M Vanderloo
- The Hospital for Sick Children Research Institute, Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.
| | - Charles D G Keown-Stoneman
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada.,The Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Catherine S Birken
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
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Wu J, Zhang J, Wang A, Chen S, Wu S, Zhao X. Association between non-high-density lipoprotein cholesterol levels and asymptomatic vulnerable carotid atherosclerotic plaques. Eur J Neurol 2019; 26:1433-1438. [PMID: 31002203 DOI: 10.1111/ene.13973] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 04/15/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE Carotid atherosclerosis, especially rupture of plaques, is related to cerebrovascular diseases. Non-high-density lipoprotein cholesterol (non-HDL-C) is relevant to cerebrovascular diseases and may be a potential risk factor. We designed this study to investigate the association between non-HDL-C and the prevalence of asymptomatic vulnerable carotid atherosclerotic plaques. METHODS We enrolled 2888 participants who underwent carotid atherosclerotic plaque detection and non-HDL-C measurement, with no history of taking lipid-lowering agents, from the Asymptomatic Polyvascular Abnormalities in Community study. We used multivariable logistic regression to estimate the association between non-HDL-C levels and the presence of asymptomatic vulnerable carotid atherosclerotic plaques. RESULTS In our study, 1505 subjects had asymptomatic vulnerable carotid atherosclerotic plaques and 1383 subjects had stable plaques. After adjustment for confounding factors, the odds ratios for vulnerable plaques of non-HDL-C levels in the middle and highest tertile groups were 1.02 (95% confidence interval, 0.84-1.23) and 1.50 (95% confidence interval, 1.23-1.82), respectively (P trend < 0.01). CONCLUSION In our community-based observational and cross-sectional study, non-HDL-C level was a significant risk factor for the occurrence of asymptomatic vulnerable carotid plaques.
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Affiliation(s)
- J Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - J Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - A Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - S Chen
- Department of Neurology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - S Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - X Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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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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Yang S, Jiao X, Huo X, Zhu M, Wang Y, Fang X, Yang Y, Yue W, Qin Y. Association between circulating full-length angiopoietin-like protein 8 and non-high-density lipoprotein cholesterol levels in Chinese non-diabetic individuals: a cross-sectional study. Lipids Health Dis 2018; 17:161. [PMID: 30021605 PMCID: PMC6052512 DOI: 10.1186/s12944-018-0802-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 06/15/2018] [Indexed: 01/19/2023] Open
Abstract
Background Angiopoietin-like protein 8 (ANGPTL8) is a novel hormone involved in the regulation of lipid metabolism and glucose homeostasis. There are inconsistent results regarding the association between ANGPTL8 and lipids in humans. We aimed to investigate the associations between ANGPTL8 and lipids in people without diabetes. Methods This was a cross-sectional study of 107 patients with dyslipidemia and 141 patients without. Dyslipidemia diagnosis was based on Chinese guidelines for the prevention and treatment of dyslipidemia in adults. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C) were examined. Non-HDL-C was calculated by subtracting HDL-C from TC. Circulating full-length ANGPTL8 concentrations were measured using enzyme-linked immunosorbent assay. Associations between log-transformed circulating full-length ANGPTL8 and serum lipids were examined using multivariate linear regression analysis. Results Circulating ANGPTL8 concentrations were significantly elevated in patients with dyslipidemia compared with patients without dyslipidemia. Circulating full-length ANGPTL8 concentrations were positively associated with non-HDL-C, TG and TC levels after adjusting for age, gender, body mass index, high-sensitivity C-reactive protein, alanine aminotransferase, and creatinine. Conclusion In people without diabetes, circulating full-length ANGPTL8 concentrations in patients with dyslipidemia were significantly elevated compared with non-dyslipidemia, and ANGPTL8 was positively associated with serum non-HDL-C levels. Electronic supplementary material The online version of this article (10.1186/s12944-018-0802-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Song Yang
- Beijing An Zhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Xiaolu Jiao
- Beijing An Zhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Xiaoguang Huo
- Zibo Central Hospital, Zibo, 255000, Shandong Province, China
| | - Miaomiao Zhu
- Beijing An Zhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Yi Wang
- Beijing An Zhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Xiangnan Fang
- Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, 063000, Hebei Province, China
| | - Yunyun Yang
- Beijing An Zhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Weidong Yue
- The Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, China.
| | - Yanwen Qin
- Beijing An Zhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
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9
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Zhang L, Zeng Y, Qi J, Xu Y, Zhang S, Zhou X, Ping R, Fu S. A cynomolgus monkey model of carotid atherosclerosis induced by puncturing and scratching of the carotid artery combined with a high-fat diet. Exp Ther Med 2018; 16:113-120. [PMID: 29977359 PMCID: PMC6030911 DOI: 10.3892/etm.2018.6143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 04/06/2018] [Indexed: 11/08/2022] Open
Abstract
Cardio-cerebrovascular disease is one of the three major causes of mortality in humans and constitutes a major socioeconomic burden. Carotid atherosclerosis (CAS) is a very common lesion of the arterial walls, which leads to narrowing of the arteries, in some cases occluding them entirely, increasing the risk of cardiovascular events. The aim of the present study was to evaluate a cynomolgus monkey model of carotid atherosclerosis (CAS) induced by puncturing and scratching combined with a high-fat diet. A total of 12 cynomolgus monkeys were randomly divided into four groups: A, puncturing and scratching carotid artery intimas + high-fat diet (n=3); B, puncturing and scratching carotid artery intimas + regular diet (n=3); C, high-fat diet only (n=3); and D, regular diet only (n=3). Blood was harvested at weeks 4, 6 and 8 and plasma lipid levels were assessed. At week 8, monkeys were sacrificed and carotid arteries were harvested for hematoxylin and eosin (H&E) staining to observe pathological changes. The results revealed that a high-fat diet led to increased plasma lipid levels and accelerated plaque formation. Carotid color Doppler ultrasonography was performed and, along with H&E staining, revealed plaque formation in group A. In summary, the results of the present study suggest that a cynomolgus monkey model of CAS model may be successfully constructed by puncturing and scratching of the carotid artery intimas in combination with a high-fat diet.
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Affiliation(s)
- Lei Zhang
- Orthopedics Department, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan 646600, P.R. China
| | - Yan Zeng
- Orthopedics Department, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan 646600, P.R. China
| | - Ji Qi
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Yanxiao Xu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Shaoqun Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Xin Zhou
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Ruiyue Ping
- Department of Dermatology, The Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510403, P.R. China
| | - Shijie Fu
- Orthopedics Department, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan 646600, P.R. China
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10
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Scicali R, Rosenbaum D, Di Pino A, Giral P, Cluzel P, Redheuil A, Piro S, Rabuazzo AM, Purrello F, Bruckert E, Gallo A. An increased waist-to-hip ratio is a key determinant of atherosclerotic burden in overweight subjects. Acta Diabetol 2018; 55:741-749. [PMID: 29680968 DOI: 10.1007/s00592-018-1144-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/09/2018] [Indexed: 12/24/2022]
Abstract
AIMS The association of overweight status and cardiovascular disease is not clear. In this study we aimed to investigate coronary atherosclerotic disease, evaluated as coronary artery calcium score (CACs), in overweight patients with or without abdominal obesity as defined by waist-to-hip ratio (WHR). METHODS We enrolled 276 patients aged between 40 and 70 years, with a body mass index of 25-29.9 kg/m2 and at least one cardiovascular risk factor. Exclusion criteria were history of diabetes, cardiovascular or renal disease. Patients were stratified in high WHR (H-WHR) or low WHR (L-WHR) group according to WHR (≥ 0.85 for women and ≥ 0.90 for men) and underwent multi-detector computed tomography for CACs. Mean carotid intima-media thickness (IMT) and plaque presence were equally assessed. RESULTS CACs was higher in the H-WHR group compared to L-WHR (9.05 [0.0-83.48] vs 0.0 [0.0-64.7] AU, p < 0.01); the prevalence of CACs > 0 in the H-WHR group was significantly higher than subjects with L-WHR (59.6% vs 38.5%, p < 0.001). Moreover, H-WHR group had higher mean IMT (0.64 [0.56-0.72] vs 0.59 [0.55-0.67] mm, p < 0.05) and higher carotid plaque prevalence (63.7% vs 50.8%, p < 0.05) compared to subjects with L-WHR. Logistic regression showed that H-WHR was associated with presence of CACs and carotid plaque (p < 0.01). In a multiple linear regression, WHR was positively associated with CACs and IMT (p < 0.01). CONCLUSIONS H-WHR is a marker of coronary and peripheral atherosclerotic burden in overweight patients.
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Affiliation(s)
- Roberto Scicali
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - David Rosenbaum
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - Philippe Giral
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), Paris, France
| | - Philippe Cluzel
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
- Département d'imagerie cardiovasculaire et de radiologie interventionnelle, Pôle Imagerie-Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alban Redheuil
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
- Département d'imagerie cardiovasculaire et de radiologie interventionnelle, Pôle Imagerie-Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - Agata Maria Rabuazzo
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy.
| | - Eric Bruckert
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), Paris, France
| | - Antonio Gallo
- Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France
- UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, Sorbonne Universités, Paris, France
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11
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Wang X, Li W, Song F, Wang L, Fu Q, Cao S, Gan Y, Zhang W, Yue W, Yan F, Shi W, Wang X, Zhang H, Zhang H, Wang Z, Lu Z. Carotid Atherosclerosis Detected by Ultrasonography: A National Cross-Sectional Study. J Am Heart Assoc 2018; 7:JAHA.118.008701. [PMID: 29622590 PMCID: PMC6015437 DOI: 10.1161/jaha.118.008701] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Carotid atherosclerosis (CA) is a reflector of generalized atherosclerosis that is associated with systemic vascular disease. Data are limited on the epidemiology of carotid lesions in a large, nationally representative population sample. We aimed to evaluate the prevalence of CA detected by carotid ultrasonography and related risk factors based on a national survey in China. Methods and Results A total of 107 095 residents aged ≥40 years from the China National Stroke Prevention Project underwent carotid ultrasound examination. Participants with carotid endarterectomy or carotid stenting and those with stroke or coronary heart disease were excluded. Data from 84 880 participants were included in the analysis. CA was defined as increased intima–media thickness (IMT) ≥1 mm or presence of plaques. Of the 84 880 participants, 46.4% were men, and the mean age was 60.7±10.3 years. The standardized prevalence of CA was 36.2% overall, increased with age, and was higher in men than in women. Prevalence of CA was higher among participants living in rural areas than in urban areas. Approximately 26.5% of participants had increased IMT, and 13.9% presented plaques. There was an age‐related increase in participants with increased IMT, plaque presence, and stenosis. In multiple logistic regression analysis, older age, male sex, residence in rural areas, smoking, alcohol consumption, physical inactivity, obesity, hypertension, diabetes mellitus, and dyslipidemia were associated with CA. Conclusions CA was highly prevalent in a middle‐aged and older Chinese population. This result shows the potential clinical importance of focusing on primary prevention of atherosclerosis progression.
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Affiliation(s)
- Xiaojun Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College
| | - Fujian Song
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, United Kingdom
| | - Longde Wang
- The National Health and Family Commission, Beijing, China
| | - Qian Fu
- School of Medicine and Health Management, Tongji Medical College
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College
| | - Wei Zhang
- Department of Medical Ultrasound, Tongji Hospital & Medical College
| | - Wei Yue
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Feng Yan
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Wenhuan Shi
- Department of Science and Education, The Third Hospital of Shijiazhuang, Shijiazhuang, Hebei, China
| | - Xiaoli Wang
- Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Hong Zhang
- Department of Science and Education, People's Hospital of Deyang City, Sichuan, China
| | - Hao Zhang
- Department of Neurology, Rizhao People's Hospital, Rizhao, Shandong, China
| | - Zhihong Wang
- Department of Neurosurgery, Shenzhen Second People's Hospital Shenzhen University, Shenzhen, Guangdong, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College
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