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Latorre Uriza C, Roa NS, Velosa-Porras J, Villamil Poveda JC, Otero L, Ruiz AJ, Escobar Arregoces FM. Relationship between Carotid Intima-Media Thickness, Periodontal Disease, and Systemic Inflammation Biomarkers in an Adult Population. Biomedicines 2024; 12:1425. [PMID: 39062000 PMCID: PMC11274352 DOI: 10.3390/biomedicines12071425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 07/28/2024] Open
Abstract
A positive relationship has been reported between advanced periodontitis and carotid intima-media thickness (cIMT) measurement. The aim of this study was to investigate this relationship with parameters for periodontitis, such as PISA and systemic inflammation biomarkers. An observational descriptive cross-sectional study was conducted. A blood sample was collected from 75 subjects to analyze glucose, total cholesterol, HDL, LDL, and cytokine values. Increased cIMT was found in 32% of the patients with fewer teeth. Patients with periodontitis had a larger periodontal inflamed surface area (PISA) (p = 0.000) and had a 1.42-times-higher risk of having increased cIMT values compared to periodontally healthy individuals, though without a statistically significant association. Higher values in the left cIMT, IL-8, and TNF-α were found in men than in women with significant differences. In the multivariate analysis involving cytokines, age continues to be linked to increased cIMT values. INF-γ showed a trend towards a protective effect; as the IMT-M decreases, there is an increase in the expression of INF-γ, and a higher proportion of subjects with elevated INF-γ concentrations demonstrated normal IMT-C. This study did not find a statistically significant association between cIMT and periodontal disease, but the risk of having increased cIMT is 1.42-times higher for individuals with periodontitis.
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Affiliation(s)
- Catalina Latorre Uriza
- Centro de Investigaciones Odontológicas, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.V.-P.); (J.C.V.P.); (L.O.); (F.M.E.A.)
| | - Nelly S. Roa
- Centro de Investigaciones Odontológicas, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.V.-P.); (J.C.V.P.); (L.O.); (F.M.E.A.)
| | - Juliana Velosa-Porras
- Centro de Investigaciones Odontológicas, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.V.-P.); (J.C.V.P.); (L.O.); (F.M.E.A.)
| | - Jean Carlos Villamil Poveda
- Centro de Investigaciones Odontológicas, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.V.-P.); (J.C.V.P.); (L.O.); (F.M.E.A.)
| | - Liliana Otero
- Centro de Investigaciones Odontológicas, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.V.-P.); (J.C.V.P.); (L.O.); (F.M.E.A.)
| | - Alvaro J. Ruiz
- Departamento de Medicina Interna, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
- Departamento de Epidemiología Clínica y Bioestadística, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | - Francina María Escobar Arregoces
- Centro de Investigaciones Odontológicas, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.V.-P.); (J.C.V.P.); (L.O.); (F.M.E.A.)
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Cao LN, Wang YY, Hou XY, Zheng HD, Wei RZ, Zhao RR, Shen WY, Yang Y, Chu JF, Tian GY, Xiao J, Tian T. New insights on the association of weight loss with the reduction in carotid intima-media thickness among patients with obesity: an updated systematic review and meta-analysis. Public Health 2024; 226:248-254. [PMID: 38091813 DOI: 10.1016/j.puhe.2023.11.013] [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: 04/21/2023] [Revised: 10/09/2023] [Accepted: 11/07/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES Carotid intima-media thickness (CIMT) is a noninvasive marker of atherosclerosis, a typical pathologic process underlying cardiovascular diseases (CVDs). It is essential to explore the relationships between weight loss and the reduction of CIMT. STUDY DESIGN This was an updated systematic review and meta-analysis. METHODS A systematic literature search was conducted to collect relevant clinical trials. The pooled results of meta-analyses were assessed by weighted mean difference (WMD) and the corresponding 95 % confidence interval (95% CI). RESULTS Thirty-three articles involving 2273 participants were collected in this meta-analysis. Among all participants with obesity, the pooled mean of weight loss was -23.26 kg (95% CI: -27.71 to -18.81), and the pooled mean change of CIMT was -0.06 mm (95% CI: -0.08 to -0.04). Compared with Non-surgical interventions, Surgical ones could lead to much higher weight loss (Pbetween groups < 0.001). A more significant CIMT reduction was identified among Surgical intervention patients than among Non-surgical intervention participants (Pbetween groups < 0.001). CONCLUSIONS Effective interventions, especially Surgical interventions, could reduce the weight of patients with obesity, followed by the decline of CIMT, which might further disturb atherosclerosis progression and lower CVD risk.
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Affiliation(s)
- L N Cao
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China
| | - Y Y Wang
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China
| | - X Y Hou
- The Center for Disease Control and Prevention of Nantong, Nantong 226007, China
| | - H D Zheng
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China
| | - R Z Wei
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China
| | - R R Zhao
- The Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou 225202, China
| | - W Y Shen
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China
| | - Y Yang
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China
| | - J F Chu
- The Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou 225202, China
| | - G Y Tian
- The Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou 225202, China.
| | - J Xiao
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China.
| | - T Tian
- The Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226019, China.
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Sukun A, Önal C. Factors Affecting Carotid Artery Stenosis in the Elderly Living at High Altitudes. Cureus 2023; 15:e47048. [PMID: 37846346 PMCID: PMC10576857 DOI: 10.7759/cureus.47048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Factors affecting carotid artery stenosis have been generally investigated. However, considering the protective effect of altitude, studies on elderly individuals at high altitudes are few. Our aim is to investigate the systematic adaptive changes caused by high-altitude exposure through the causes of carotid artery stenosis. MATERIALS AND METHODS Carotid Doppler ultrasound was performed on 250 patients over the age of 50 years. The patients' age, gender, height, weight, smoking history, place of residence, and presence of comorbidities were questioned. Those with diabetes, hypertension, hyperlipidemia, and coronary disease were excluded from the study. Those who did not reside at high altitudes were excluded from the study. One hundred and thirty-five patients were included in the study. Carotid artery Doppler findings and biochemical parameters were recorded. Factors affecting stenosis in the carotid arteries were compared. RESULTS In our study, the factors affecting carotid stenosis were determined to be age, gender, presence of plaque, plaque type, and mean carotid intima-media thickness (CIMT). The mean CIMT of the patients was calculated as 0.71±0.14 mm. The mean CIMT measurement level was significantly higher in patients with plaque in the carotid artery (p<0.05). According to receiver operating characteristic curves, CIMT values higher than 0.72 mm increase plaque and stenosis formation in the common carotid artery (CCA) and internal carotid artery (ICA) in elderly people living at high altitudes (p<0.05, area under the curve [AUC]: 0.71-0.83). CONCLUSIONS The most important factors affecting carotid stenosis in individuals living at high altitudes are age, gender, CIMT, plaque, and plaque type. When soft plaques were detected, the risk of stenosis was found to be higher than in calcific plaques. Additionally, the number of factors affecting stenosis was greater on the left (ICA). This suggests that the left carotid system is more vulnerable. It can be said that in elderly individuals living at high altitudes, a CIMT higher than 0.72 mm is a cutoff value in the presence of plaque and stenosis in the carotid arteries.
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Affiliation(s)
- Abdullah Sukun
- Radiology, Baskent University Alanya Research and Application Center, Antalya, TUR
| | - Canver Önal
- Radiology, Kars Harakani State Hospital, Kars, TUR
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Sigl M, Winter L, Schumacher G, Helmke SC, Shchetynska-Marinova T, Amendt K, Duerschmied D, Hohneck AL. Comparison of Functional and Morphological Estimates of Vascular Age. In Vivo 2023; 37:2178-2187. [PMID: 37652489 PMCID: PMC10500512 DOI: 10.21873/invivo.13317] [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: 04/25/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM Vascular age (VA) is an emerging metric in preventive cardiovascular (CV) medicine. VA can be derived from morphological parameters such as carotid intima-media thickness (CIMT), or functional parameters such as pulse wave analysis (PWA), which celebrates its 100th birthday. This study aimed to investigate whether the results of both approaches are comparable. PATIENTS AND METHODS On the occasion of the double 100th anniversary of PWA and the Mannheim Clinic, 100 volunteers underwent a) bilateral CIMT assessment using high-resolution ultrasound and b) oscillometric PWA at the brachial forearm site. The respective VAs were calculated using previously published equations. RESULTS Median age of the participants was 53.6 years (range=39.8-62.6 years), and 56% were female. Median CIMT was 632.5 μm (range=548.8-730.0 μm). Median PWA-derived VA was 55.3 years (36.5-70.5 years). Different values were obtained for CIMT-derived VA, depending on the reference cohort used as calculation basis, ranging from median 43.7 (26.2-59.5 years) to median 64.0 years (43.5-82.1 years). In 46% of the participants divergent VAs were found, that is, the calculated age was higher according to one method and lower according to the other. Correlation analysis revealed a strong dependence of VA (both PWA- and CIMT-derived) and chronological age, as well as an increase in CV risk factors and the detection of plaques with age. CONCLUSION Different approaches for estimating VA are not comparable and often produce contradictory results. The current methods and their validity must be critically assessed if they are not standardized.
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Affiliation(s)
- Martin Sigl
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Laura Winter
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | | | | | - Tetyana Shchetynska-Marinova
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Klaus Amendt
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Daniel Duerschmied
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Anna Lena Hohneck
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
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Kawnayn G, Kabir H, Huq MR, Chowdhury MI, Shahidullah M, Hoque BS, Anwar MB. The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke. Cureus 2023; 15:e41384. [PMID: 37546130 PMCID: PMC10401067 DOI: 10.7759/cureus.41384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Carotid atherosclerosis is an important etiological factor for ischemic stroke. Early carotid lesion detection may prevent further strokes. Doppler ultrasound measures carotid artery blood flow, intima-media thickness, stenosis, plaques, and lumen and wall changes. OBJECTIVE The objective of this study is to determine the association of carotid plaque size (CPS), carotid intima-media thickness (CIMT), resistive index (RI), and pulsatility index (PI) with acute ischemic stroke. METHODOLOGY A total of 60 participants were taken, including 30 cases and 30 age- and sex-matched controls. Patients with acute ischemic stroke were included as cases and age- and sex-matched healthy volunteers were included as controls. A carotid duplex study was done in both groups, and the findings were compared. RESULTS The mean age of the ischemic stroke cases was 63.33±10.79 years; more than half were aged >60 years. Male patients were 73.3% and female patients were 26.7% of the cases. Age and gender were statistically similar (p>0.05) in groups (cases and controls). The plaques were homogenous in 30% of patients, calcified in 26.7%, and mixed in 6.7%. About 36.6% of patients did not have any plaque. CPS was greater among cases than controls in the right and left internal and left common carotid arteries; however, it was not statistically significant (p>0.05). The mean CIMT was 0.79±0.10 mm on the right side and 0.90±0.17 mm on the left side among cases. CIMT was significantly higher in the cases group than in the controls (p<0.05). The mean RI was significantly greater in the left common carotid artery (CCA) among the cases than in the controls (p<0.05). Patients aged over 60 years had significantly higher RI and PI values in the left internal carotid artery (ICA) compared to the younger cases (p<0.05). Smoking history had a significant association with left CCA RI and PI values (p<0.05). However, RI, PI, CPS, and CIMT among cases were similar in different groups like diabetic, non-diabetic, hypertensive, and non-hypertensive patients (p>0.05). CONCLUSION CIMT was significantly thicker among the patients with ischemic stroke compared to the control group. RI in the left CCA was significantly greater among the stroke patients than in the control group. The age of the patient and smoking habit had an association with RI and PI values. Most of the parameters were found to be significant on the left side, suggesting carotid atherosclerosis may not be symmetrical. A large-scale further study is needed to see the association of these variables with ischemic stroke patients.
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Affiliation(s)
| | | | | | | | - Md Shahidullah
- Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
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Adedokun TA, Kwaghe VG, Adedokun O, Badru T, Odili AN, Alfa J, Kolade-Yunusa HO, Ojji DB. Prevalence and risk factors for subclinical atherosclerosis amongst adults living with HIV in University of Abuja Teaching Hospital, Gwagwalada. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1092211. [PMID: 36819143 PMCID: PMC9935581 DOI: 10.3389/frph.2023.1092211] [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: 11/07/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
Background Subclinical atherosclerosis characterizes cardiovascular diseases (CVD), and Human Immunodeficiency Virus (HIV) infection and antiretroviral therapy (ART) are identified risk factors for atherosclerosis. Meanwhile, data on HIV and atherosclerosis in Nigeria are limited. Objectives We sought to estimate the prevalence of subclinical atherosclerosis and associated risk factors amongst adult persons living with HIV/AIDS (PLHIV) enrolled at University of Abuja Teaching Hospital, Gwagwalada, Abuja (UATH). Methods This was a cross-sectional study of 277 consecutively selected PLHIV ≥18 years enrolled for HIV care and treatment at UATH. Pretested structured questionnaire was used to collect data from consenting ART-experienced and ART-naïve patients on risk factors of atherosclerosis. Carotid intima media thickness (CIMT) ≥0.71 mm as measured by Doppler ultrasonography was used to identify patients with sub-clinical atherosclerosis. Two logistic regression models with (Model-A) and without (Model-B) traditional risk factors were fitted to identify risk factors of subclinical atherosclerosis. Results Participants' mean age was 39.44 ± 10.71 years with female preponderance (64.26%). Overall prevalence of subclinical atherosclerosis was 43.32% (62.25% in ART-experienced). Model-A identified male sex [AOR 4.33(1.74-10.76), p = 0.002], advancing age [30-39 years AOR 5.95(1.31-26.96), p = 0.021]; ≥40 years AOR 19.51(4.30-88.56), p ≤ 0.001), advancing HIV infection [≥WHO stage II AOR 4.19(1.11-15.92), p = 0.035], hypercholesterolemia [AOR 3.88(1.47-10.25), p ≤ 0.001] and ≥5 year duration on ART [AOR 9.05(3.16-25.92), p ≤ 0.001] as risk factors of subclinical atherosclerosis. In Model-B (excluding traditional risk factors) on the other hand, advancing HIV infection [≥WHO stage II AOR 3.93(1.19-13.042), p = 0.025] and duration on ART [≥5 years AOR 11.43(4.62-28.29), p = 0.001] were found as risk factors of subclinical atherosclerosis. Conclusion Subclinical atherosclerosis was higher in ART-experienced patients, and this was irrespective of presence or absence of traditional risk factors. And advancing HIV disease and duration on ART were found as significant risk factors for subclinical atherosclerosis. We therefore recommend routine CVD risk screening in PLHIV.
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Affiliation(s)
- Taiwo A. Adedokun
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, FCT, Nigeria,Correspondence: Taiwo A. Adedokun
| | - Vivian G. Kwaghe
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, FCT, Nigeria
| | - Oluwasanmi Adedokun
- Center for International Health, Education, and Biosecurity (Ciheb), Maryland Global Initiatives Corporation (MGIC) - an Affiliate of University of Maryland Baltimore, Abuja, Nigeria
| | - Titilope Badru
- Strategic Information Department, FHI360, Abuja, Nigeria
| | - Augustine N. Odili
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, FCT, Nigeria
| | - Jacob Alfa
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, FCT, Nigeria
| | - Hadijat O. Kolade-Yunusa
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, FCT, Nigeria
| | - Dike B. Ojji
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, FCT, Nigeria
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