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Mita T, Katakami N, Okada Y, Yoshii H, Osonoi T, Nishida K, Shiraiwa T, Kurozumi A, Taya N, Wakasugi S, Sato F, Ishii R, Gosho M, Shimomura I, Watada H. Continuous glucose monitoring-derived time in range and CV are associated with altered tissue characteristics of the carotid artery wall in people with type 2 diabetes. Diabetologia 2023; 66:2356-2367. [PMID: 37750893 PMCID: PMC10627957 DOI: 10.1007/s00125-023-06013-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 08/07/2023] [Indexed: 09/27/2023]
Abstract
AIMS/HYPOTHESIS Previous studies have suggested that glucose variability may accelerate atherosclerosis progression in people with type 2 diabetes. Current guidelines recommend assessing glycaemic control using continuous glucose monitoring (CGM), which provides a comprehensive glycaemic profile to supplement HbA1c measurement. However, the association between CGM-derived metrics and atherosclerosis progression is not entirely clear. METHODS This exploratory study used baseline data and data obtained after 104 weeks from an ongoing prospective, multicentre, observational study. Six hundred study participants with type 2 diabetes and no apparent history of symptomatic cardiovascular disease underwent CGM and ultrasonographic atherosclerosis measurements of the carotid arteries, including the intima-media thickness (IMT) and grey-scale median (GSM), at baseline and 104 weeks. Non-invasive ultrasonic tissue characterisation of the carotid artery wall or plaque using the GSM reflects vascular composition. Multivariate regression models were used to analyse the association between CGM-derived indices, mainly time in range (TIR) and CV, and changes in carotid atherosclerosis index values. RESULTS Over the 104-week study period, there were modest increases in mean IMT (from 0.759±0.153 to 0.773±0.152 mm, p<0.001) and thickened-lesion GSM (from 43.5±19.5 to 53.9±23.5 units, p<0.001), but no significant changes in common carotid artery maximum-IMT (from 1.109±0.442 to 1.116±0.469 mm, p=0.453) or mean GSM (from 48.7±19.3 to 49.8±20.8 units, p=0.092). In a linear regression model with adjustment for possible atherosclerotic risk factors, including HbA1c, TIR and CV at baseline were significantly associated with the annual change in mean GSM (regression coefficient per 10% increase in TIR 0.52; 95% CI 0.06, 0.98; Hochberg-adjusted p value 0.038; regression coefficient per 1% increase in CV -0.12; 95% CI -0.22, -0.02; Hochberg-adjusted p value 0.038). TIR and CV at baseline were also significantly associated with the annual change in thickened-lesion GSM (regression coefficient per 10% increase in TIR 0.95; 95% CI 0.12, 1.79; Hochberg-adjusted p value 0.038; regression coefficient per 1% increase in CV -0.19; 95% CI -0.36, -0.01; Hochberg-adjusted p value 0.038). Participants who achieved target CGM-derived metrics at baseline, as proposed by an international consensus, showed significant annual changes in mean GSM compared with those who did not (0.94±6.88 vs -0.21±6.19 units/year, p=0.007). CONCLUSIONS/INTERPRETATION TIR and CV were significantly associated with changes in the tissue characteristics of the carotid artery wall. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry, number UMIN000032325.
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Affiliation(s)
- Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | | | | | | | - Akira Kurozumi
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Naohiro Taya
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satomi Wakasugi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fumiya Sato
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryota Ishii
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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The Role of Carotid Stenosis in a Prediction of Prognosis of Coronary Artery Disease. ACTA ACUST UNITED AC 2021; 42:53-66. [PMID: 33894121 DOI: 10.2478/prilozi-2021-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aims: The aim of this paper is to indicate if carotid stenosis is predictive for the prognosis of coronary artery disease.Method and materials: Our study is a prospective cohort study. 1031 patients with proven coronary artery disease (CAD) were recruited consecutively. Carotid ultrasound was used to assess IMT, plaque, or stenosis. They were followed for 24 months for adverse cardiovascular events. Selected demographic date such as smoking history, dyslipidemia, hypertension, laboratory values, and clinical data (associated diseases and risk) were collected from each patient. Total cardiovascular events and mortality rate were followed up for the study population. The results were collected prospectively and retrospectively. The study was organized as a clinical, cross-sectional study and comparative study.From the data collected with the clinical research, a file was formed in the statistical program with the help of which the data were statistically analyzed.From the methods of descriptive statistics, absolute frequencies, percentages, arithmetic mean, median, measures of variability, minimum, maximum, standard deviation and logistic regression models were used.Result: Of the total number of patients 1026 had arterial hypertension (HTA). Data on hyperlipidemia (HLP) had been reported in 895 patients. 1.023 patients had peripheral artery disease (PAB). 1031 patients were presented with multivessel coronary artery disease (CAD). There were 1,029 patients with diabetes mellitus (DM), while 1,013 patients had coronary artery by-pass (CABG), and 1,012 had stroke (CVI). Elevated systolic blood pressure was reported in 966 patients. 184 patients had elevated triglycerides and 187 had elevated cholesterol. 1,008 patients have had a history of myocardial infarction. Carotid artery stenosis (CAS) has been found in 1,009 patients, increased body mass index (BMI) in 270 patients.1.031 patients were followed for 24 months. Cardiovascular events were reported in 54 patients (or 5.2%). Revascularization was performed in 28 (4.1%) patients, while 12 (1.8%) of patients died. Diabetes mellitus (OR 1.878 95% CI 0.491 7.184) and Carotid stenosis (OR 2.185 95% CI 0.731 6.53) were found to be predictive factors for future cardiovascular events.Conclusion: Due to our results carotid ultrasound may be a useful tool for risk stratification of coronary artery disease pts.
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Lee I, Lee HH, Cho Y, Choi YJ, Huh BW, Lee BW, Kang ES, Park SW, Cha BS, Lee EJ, Lee YH, Huh KB. Association Between Serum Bilirubin and the Progression of Carotid Atherosclerosis in Type 2 Diabetes. J Lipid Atheroscler 2020; 9:195-204. [PMID: 32821731 PMCID: PMC7379078 DOI: 10.12997/jla.2020.9.1.195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 12/31/2019] [Accepted: 01/12/2020] [Indexed: 12/21/2022] Open
Abstract
Objective This study investigated whether serum bilirubin levels can predict the progression of carotid atherosclerosis in individuals with type 2 diabetes mellitus (T2DM). Methods This observational study included 1,381 subjects with T2DM in whom serial measurements of carotid intima-media thickness (CIMT) were made at 1- to 2-year intervals for 6–8 years. The progression of carotid atherosclerosis was defined as newly detected plaque lesions on repeat ultrasonography. After dividing total serum bilirubin levels into tertiles, the association between total serum bilirubin at baseline and plaque progression status was analyzed. Results Among 1,381 T2DM patients, 599 (43.4%) were categorized as having plaque progression in their carotid arteries. Those with plaque progression were significantly older; showed a higher prevalence of hypertension, abdominal obesity, and chronic kidney disease; and had a longer duration of T2DM, higher levels of total cholesterol (TC), triglycerides, and insulin resistance, and lower total bilirubin concentrations than those with no plaque progression. When total serum bilirubin levels were divided into tertiles, the highest tertile group was younger than the lowest tertile group, with higher levels of TC and high-density lipoprotein cholesterol. Multiple logistic regression analysis demonstrated that higher serum bilirubin levels were associated with a significantly lower risk of CIMT progression (odds ratio, 0.584; 95% confidence interval, 0.392–0.870; p=0.008). Age (p<0.001), body mass index (p=0.023), and TC (p=0.019) were also associated with the progression of carotid atherosclerosis in T2DM patients. Conclusion Total serum bilirubin is independently associated with progression of atherosclerosis in the carotid arteries in T2DM patients.
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Affiliation(s)
- Inkuk Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeok-Hee Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Yongin Cho
- Graduate School, Yonsei University College of Medicine, Seoul, Korea.,Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea
| | - Young Ju Choi
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Byung Wook Huh
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Byung-Wan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate School, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate School, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Won Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Bong-Soo Cha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate School, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jig Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate School, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Graduate School, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Kap Bum Huh
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea
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Safri LS, Lip HTC, Saripan MI, Huei TJ, Krishna K, Md Idris MA, Harunarashid H. Older age and duration of exposure to type 2 diabetes in selective screening of asymptomatic carotid artery stenosis for primary stroke prevention-A single institution experience. Prim Care Diabetes 2020; 14:364-369. [PMID: 31744790 DOI: 10.1016/j.pcd.2019.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/06/2019] [Accepted: 10/08/2019] [Indexed: 12/19/2022]
Abstract
AIMS To evaluate the incidence and risk factors for carotid artery stenosis amongst asymptomatic type 2 diabetes from a single Malaysian tertiary institution. METHODS This is a prospective cross-sectional study of asymptomatic type 2 diabetics selected from the outpatient ophthalmology and endocrine clinics for carotid duplex ultrasound scanning performed by a single radiologist. The duplex ultrasound criteria were based on the North American Symptomatic Carotid Endarterectomy Trial (NASCET) classification of carotid artery stenosis. Univariate and multivariate analysis was performed to identify possible risk factors of carotid artery stenosis. RESULTS Amongst the 200 patients, the majority were males (56%) and Malay predominance (58.5%). There were 12/200 patients (6%) with mean age of 69.2 years identified to have carotid artery stenosis. Univariate analysis of patients with asymptomatic carotid artery stenosis identified older age of 69.2 years (p=0.027) and duration of exposure to diabetes of 17.9 years (p=0.024) as significant risk factors. CONCLUSION Patients with longer exposure of diabetes and older age were risk factors of carotid artery stenosis in asymptomatic type 2 diabetics. These patients should be considered for selective screening of carotid artery stenosis during primary care visit for early identification and closer surveillance for stroke prevention.
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Affiliation(s)
- Lenny Suryani Safri
- Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, 50603 Kuala Lumpur, Malaysia.
| | - Henry Tan Chor Lip
- Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, 50603 Kuala Lumpur, Malaysia; Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia.
| | - M Iqbal Saripan
- Department of Computer and Communication Systems Engineering, Faculty of Engineering, Universiti Putra Malaysia.
| | - Tan Jih Huei
- Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, 50603 Kuala Lumpur, Malaysia; Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia.
| | - K Krishna
- Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, 50603 Kuala Lumpur, Malaysia.
| | - Mohamad Azim Md Idris
- Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, 50603 Kuala Lumpur, Malaysia.
| | - Hanafiah Harunarashid
- Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, 50603 Kuala Lumpur, Malaysia.
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Mancheva M, Paljoskovska Jordanova S, Bosevski M. Carotid intima media thickness is in a relation to risk factors for coronary artery disease. ANGIOLOGIIA I SOSUDISTAIA KHIRURGIIA = ANGIOLOGY AND VASCULAR SURGERY 2020; 26:11-16. [PMID: 33332301 DOI: 10.33529/angio2020412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Carotid intima-media thickness (CIMT) is a double line pattern measured from the lumen-intima to media-adventitia interface. Measuring CIMT with B-mode ultrasound can detect early arterial wall changes. We aimed to measure CIMT in manifested atherosclerotic disease and find a relation to present risk factors. MATERIAL AND METHODS This cross sectional study included a population of 657 patients, with documented coronary artery disease (CAD), 66,1% were men (469 pts), 33,9% were women (241 pts). The mean age of patients was 64,72 years (55,6-73,8). The measurement of CIMT (maximal and mean) was performed with B-mode ultrasound, on longitudinal view, on multiple plaque-free segments at the level of common carotid artery, on the far wall, on both sides. Multivariate regression analysis was done to estimate independent factors for CIMT, when risk factors, age, and sex included in analysis. RESULTS The mean value of maximal CIMT was 0,96 mm (0,52-1,4), mean value of mean CIMT was 0,88 mm (range 0,61-1,15) and mean systolic blood pressure of 133,21 mm Hg (108,03-158,39) was found. Increased CIMT was found in 75,7% of patients (502 pts). Smoking was found as an independent risk factor for increased CIMT with odds ratio (OR) 4,7 (95% CI; 0,67-5,32) and diabetes mellitus with OR 1,6 (95% CI; 0,47-2,16). CONCLUSION Diabetes and smoking are independently related to increased CIMT. These are preliminary results of National survey on 657 pts with coronary artery disease.
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Affiliation(s)
- Mimi Mancheva
- Vascular Laboratory, University Clinic of Cardiology, University "Ss. Cyril and Methodius", Skopje, R.N. Macedonia
| | | | - Marijan Bosevski
- Vascular Laboratory, University Clinic of Cardiology, University "Ss. Cyril and Methodius", Skopje, R.N. Macedonia; Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, R.N. Macedonia
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Faiz Karnam A, Riyazuddeen M, Gopinath L, Iqbal N. Association of cardiovascular risk estimate with degree of atherosclerosis in patients with type 2 diabetes mellitus. JOURNAL OF CURRENT RESEARCH IN SCIENTIFIC MEDICINE 2019. [DOI: 10.4103/jcrsm.jcrsm_20_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Laguna P, Robles NR, Lopez Gomez J, Barroso S, Collado G. Lack of Correlation of Carotid Intima-Media Index and Peripheral Artery Disease. High Blood Press Cardiovasc Prev 2018; 25:379-383. [PMID: 30251108 DOI: 10.1007/s40292-018-0282-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 09/20/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Increased carotid intima-media thickness (IMT) measurement is usually seen as a surrogate marker of peripheral artery disease (PAD) but there is scarce cumulated evidence to support this view. AIM To evaluate prevalence of increased IMT among patients with symptomatic PAD as well as the frequency of some cardiovascular risk factors in these patients. METHODS They were recruited 230 patients with diagnosis of medium peripheral artery disease in the Vascular Surgery Service outpatient's office. Serum cystatin C, homocysteine, and lipoprotein (a) were measured. GFR was estimated using the CKD-EPI equation and the Larsson one from cystatin C. RESULTS The global prevalence of increased IMT was 16.5% (n = 38, 95% CI 12.3-21.9). In all the frequency of hyperlipoproteinemia (a) was 34.2% (95% CI 28.4-40.5%). The global prevalence of hyperhomocysteinemia was 61.5% (95% CI 54.6-68.1%) and the proportion of patients with high cystatin C levels was 38.5% (95% CI 32.1-42.5). The prevalence of stage III chronic kidney disease or higher by CKD-EPI formula was much lesser (13.6%, 95% CI 9.7-18.7) as was the frequency obtained by the Larsson equation (28.7%, 95% CI 23.2-34.9). No differences were found between groups. CONCLUSIONS Increased IMT is not common among PAD patients. Hyperlipoproteinemia (a) and hyperhomocysteinemia are very frequent in these patients. High serum cystatin levels are also very prevalent but reduced GFR is not so frequent. There were no differences in the prevalence of the studied cardiovascular risk factors between those patients with increased IMT and those ones with normal IMT.
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Affiliation(s)
- Paloma Laguna
- Servicio de Cirugía Vascular, Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Carretera de Portugal s/n., 06070, Badajoz, Spain
| | - Nicolás Roberto Robles
- Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Carretera de Portugal s/n., 06070, Badajoz, Spain.
- Cátedra de Riesgo Cardiovascular, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain.
| | - Juan Lopez Gomez
- Servicio de Bioquímica Clínica, Hospital Infanta Cristina, Badajoz, Spain
| | - Sergio Barroso
- Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Carretera de Portugal s/n., 06070, Badajoz, Spain
| | - Gabriel Collado
- Servicio de Cirugía Vascular, Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Carretera de Portugal s/n., 06070, Badajoz, Spain
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Kitagami M, Yasuda R, Toma N, Shiba M, Nampei M, Yamamoto Y, Nakatsuka Y, Sakaida H, Suzuki H. Impact of Hypertriglyceridemia on Carotid Stenosis Progression under Normal Low-Density Lipoprotein Cholesterol Levels. J Stroke Cerebrovasc Dis 2017; 26:1793-1800. [PMID: 28495179 DOI: 10.1016/j.jstrokecerebrovasdis.2017.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/06/2017] [Accepted: 04/09/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dyslipidemia is a well-known risk factor for carotid stenosis progression, but triglycerides have attracted little attention. The aim of this study was to assess if serum triglycerides affect progression of carotid stenosis in patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels. METHODS This is a retrospective study in a single hospital consisting of 71 Japanese patients with internal carotid artery stenosis greater than or equal to 50% and normal serum LDL-C levels who underwent angiographic examination with or without the resultant carotid artery stenting or endarterectomy from 2007 to 2011, and were subsequently followed up for 4 years. Clinical factors including fasting serum triglyceride values were compared between the progression (≥10% increase in degree of carotid stenosis on ultrasonography) and the nonprogression groups. RESULTS During 4 years, 15 patients (21.1%) had carotid stenosis progression on either side. Cox regression analysis demonstrated that symptomatic cases (hazard ratio [HR], 4.327; P = .019), coexisting intracranial arteriosclerotic stenosis (HR, 5.341; P = .005), and hypertriglyceridemia (HR, 6.228; P = .011) were associated with subsequent progression of carotid stenosis. Kaplan-Meier plots demonstrated that the progression-free survival rate was significantly higher in patients without hypertriglyceridemia and intracranial arteriosclerotic stenosis at baseline. CONCLUSIONS Among patients with moderate to severe carotid stenosis and well-controlled LDL-C, hypertriglyceridemia was an important risk factor for progression of carotid stenosis irrespective of surgical treatments. It would be worthwhile to test if triglyceride-lowering medications suppress carotid stenosis progression.
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Affiliation(s)
- Masayuki Kitagami
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Ryuta Yasuda
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Naoki Toma
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Masato Shiba
- Department of Innovative Neuro-Intervention Radiology, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan; Vascular and Heart Center, Mie University Hospital, Mie, Japan
| | - Mai Nampei
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Yoko Yamamoto
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Yoshinari Nakatsuka
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Hiroshi Sakaida
- Department of Innovative Neuro-Intervention Radiology, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan; Vascular and Heart Center, Mie University Hospital, Mie, Japan
| | - Hidenori Suzuki
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan.
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Soluble TWEAK and atheromatosis progression in patients with chronic kidney disease. Atherosclerosis 2017; 260:130-137. [DOI: 10.1016/j.atherosclerosis.2017.03.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/24/2017] [Accepted: 03/30/2017] [Indexed: 12/18/2022]
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Mita T, Katakami N, Shiraiwa T, Yoshii H, Kuribayashi N, Osonoi T, Kaneto H, Kosugi K, Umayahara Y, Gosho M, Shimomura I, Watada H. Relationship between frequency of hypoglycemic episodes and changes in carotid atherosclerosis in insulin-treated patients with type 2 diabetes mellitus. Sci Rep 2017; 7:39965. [PMID: 28067320 PMCID: PMC5220284 DOI: 10.1038/srep39965] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022] Open
Abstract
The effect of hypoglycemia on the progression of atherosclerosis in patients with type 2 diabetes mellitus (T2DM) remains largely unknown. This is a post hoc analysis of a randomized trial to investigate the relationship between hypoglycemic episodes and changes in carotid intima-media thickness (IMT). Among 274 study subjects, 104 patients experienced hypoglycemic episodes. Increases in the mean IMT and left maximum IMT of the common carotid arteries (CCA) were significantly greater in patients with hypoglycemia compared to those without hypoglycemia. Classification of the patients into three groups according to the frequency of hypoglycemic episodes showed that high frequency of hypoglycemic events was associated with increases in mean IMT-CCA, and left max-IMT-CCA and right max-IMT-CCA. In addition, repetitive episodes of hypoglycemia were associated with a reduction in the beneficial effects of sitagliptin on carotid IMT. Our data suggest that frequency of hypoglycemic episodes was associated with changes in carotid atherosclerosis.
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Affiliation(s)
- Tomoya Mita
- Department of Metabolism &Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan.,Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Toshihiko Shiraiwa
- Shiraiwa Medical Clinic, 4-10-24 Houzenji, Kashiwara, Osaka 582-0005, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology &Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Shinsuna 3-3-20, Koto-ku, Tokyo 136-0075, Japan
| | | | - Takeshi Osonoi
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Hideaki Kaneto
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Keisuke Kosugi
- Osaka Police Hospital, 10-31 Kitayamacho, Tennoji-ku, Osaka 543-0035, Japan
| | - Yutaka Umayahara
- Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hirotaka Watada
- Department of Metabolism &Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
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