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Acosta S, Fatemi S, Zarrouk M, Gottsäter A. Novel Plasma Biomarkers Associated with Future Peripheral Atherosclerotic Disease and Abdominal Aortic Aneurysm-Insights from Contemporary Prospective Studies from the Malmö Diet and Cancer Study. Biomolecules 2024; 14:844. [PMID: 39062558 PMCID: PMC11275106 DOI: 10.3390/biom14070844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/06/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION The potential utility of inflammatory and hemodynamic plasma biomarkers for the prediction of incident lower extremity arterial disease (LEAD), carotid artery stenosis (CAS), isolated atherosclerotic disease without concomitant abdominal aortic aneurysm (AAA), and isolated AAA without concomitant atherosclerotic disease has not yet been integrated in clinical practice. The main objective of this prospective study was to find predictive plasma biomarkers for cardiovascular disease and to evaluate differences in plasma biomarker profiles between asymptomatic and symptomatic CAS, as well as between isolated atherosclerotic disease and isolated AAA. METHODS Blood samples collected at baseline from participants in the prospective Malmö Diet and Cancer study (MDCS) cardiovascular cohort (n = 5550 middle-aged individuals; baseline 1991-1994) were used for plasma biomarker analysis. Validation of each incident cardiovascular diagnosis was performed by random sampling. Cox regression analysis was used to calculate hazard ratios (HRs) per one standard deviation increment of each respective log-transformed plasma biomarker with 95% confidence intervals (CI). RESULTS Adjusted lipoprotein-associated phospholipase A2 (Lp-PLA2) activity (HR 1.33; CI 1.17-1.52) and mass (HR 1.20; CI 1.05-1.37), C-reactive protein (CRP) (HR 1.55; CI 1.36-1.76), copeptin (HR 1.46; CI 1.19-1.80), N-terminal pro-B-type natriuretic peptide (N-BNP) (HR 1.28; 1.11-1.48), and cystatin C (HR 1.19; 95% 1.10-1.29) were associated with incident symptomatic LEAD. Adjusted N-BNP (HR 1.59; CI 1.20-2.11), mid-regional proadrenomedullin (HR 1.40; CI 1.13-1.73), cystatin C (HR 1.21; CI 1.02-1.43), and CRP (HR 1.53; CI 1.13-1.73) were associated with incident symptomatic but not asymptomatic CAS. Adjusted HR was higher for Lp-PLA2 (mass) for incident isolated AAA compared to for isolated atherosclerotic disease. CONCLUSIONS Plasma biomarker profile data support that subclinical vascular inflammation and cardiovascular stress seem to be relevant for the development of atherosclerotic disease and AAA.
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Affiliation(s)
- Stefan Acosta
- Department of Clinical Sciences, Lund University, 20213 Malmö, Sweden; (S.F.); (M.Z.); (A.G.)
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Ruth Lundskogsgata 10, 20502 Malmö, Sweden
| | - Shahab Fatemi
- Department of Clinical Sciences, Lund University, 20213 Malmö, Sweden; (S.F.); (M.Z.); (A.G.)
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Ruth Lundskogsgata 10, 20502 Malmö, Sweden
| | - Moncef Zarrouk
- Department of Clinical Sciences, Lund University, 20213 Malmö, Sweden; (S.F.); (M.Z.); (A.G.)
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Ruth Lundskogsgata 10, 20502 Malmö, Sweden
| | - Anders Gottsäter
- Department of Clinical Sciences, Lund University, 20213 Malmö, Sweden; (S.F.); (M.Z.); (A.G.)
- Department of Internal Medicine and Emergency Medicine, Skåne University Hospital, 20502 Malmö, Sweden
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Wu TW, Wu YJ, Chou CL, Cheng CF, Lu SX, Wang LY. Hemodynamic parameters and diabetes mellitus in community-dwelling middle-aged adults and elders: a community-based study. Sci Rep 2024; 14:12032. [PMID: 38797773 PMCID: PMC11128448 DOI: 10.1038/s41598-024-62866-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024] Open
Abstract
Hemodynamic parameters have been correlated with stroke, hypertension, and arterial stenosis. While only a few small studies have examined the link between hemodynamics and diabetes mellitus (DM). This case-control study enrolled 417 DM patients and 3475 non-DM controls from a community-based cohort. Peak systolic velocity (PSV), end-diastolic velocity (EDV), blood flow velocity (MFV), pulsatility index (PI), and the resistance index (RI) of the common carotid arteries were measured by color Doppler ultrasonography. Generalized linear regression analyses showed that as compared to the non-DM controls, the age-sex-adjusted means of PSV, EDV, and MFV were - 3.28 cm/sec, - 1.94 cm/sec, and - 2.38 cm/sec, respectively, lower and the age-sex-adjusted means of RI and PI were 0.013 and 0.0061, respectively, higher for the DM cases (all p-values < 0.0005). As compared to the lowest quartiles, the multivariable-adjusted ORs of DM for the highest quartiles of PSV, EDV, MFV, RI, and PI were 0.59 (95% confidence interval [CI] 0.41-0.83), 0.45 (95% CI 0.31-0.66), 0.53 (95% CI 0.37-0.77), 1.61 (95% CI 1.15-2.25), and 1.58 (95% CI 1.12-2.23), respectively. More importantly, the additions of EDV significantly improved the predictabilities of the regression models on DM. As compared to the model contained conventional CVD risk factors alone, the area under the receiver operating curve (AUROC) increased by 1.00% (95% CI 0.29-1.73%; p = 0.0059) and 0.80% (95% CI 0.15-1.46%; p = 0.017) for models that added EDV in continuous and quartile scales, respectively. Additionally, the additions of PSV and MFV also significantly improved the predictabilities of the regression models (all 0.01 < p-value < 0.05). This study reveals a significant correlation between DM and altered hemodynamic parameters. Understanding this relationship could help identify individuals at higher risk of DM and facilitate targeted preventive strategies to reduce cardiovascular complications in DM patients.
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Affiliation(s)
- Tzu-Wei Wu
- Department of Medicine, MacKay Medical College, No. 46, Sec. 3, Jhong-Jheng Rd., San-Jhih District, New Taipei City, Taiwan.
| | - Yih-Jer Wu
- Department of Medicine, MacKay Medical College, No. 46, Sec. 3, Jhong-Jheng Rd., San-Jhih District, New Taipei City, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan
- Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chao-Liang Chou
- Department of Medicine, MacKay Medical College, No. 46, Sec. 3, Jhong-Jheng Rd., San-Jhih District, New Taipei City, Taiwan
- Department of Neurology, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Chun-Fang Cheng
- Tamsui Health Station, Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Shu-Xin Lu
- Department of Neurology, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Li-Yu Wang
- Department of Medicine, MacKay Medical College, No. 46, Sec. 3, Jhong-Jheng Rd., San-Jhih District, New Taipei City, Taiwan.
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Rimmele DL, Borof K, Jensen M, Behrendt CA, Cheng B, Debus ES, Gerloff C, Thomalla G. Association Between Carotid Atherosclerosis and Atrial Fibrillation, Cardiac, and Renal Function. Eur J Vasc Endovasc Surg 2022; 63:641-647. [DOI: 10.1016/j.ejvs.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 11/03/2022]
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Skrzypczyk P, Okarska-Napierała M, Pietrzak R, Pawlik K, Waścińska K, Werner B, Pańczyk-Tomaszewska M. NT-proBNP as a Potential Marker of Cardiovascular Damage in Children with Chronic Kidney Disease. J Clin Med 2021; 10:4344. [PMID: 34640365 PMCID: PMC8509500 DOI: 10.3390/jcm10194344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022] Open
Abstract
Assessing cardiovascular disease (CVD) in children with chronic kidney disease (CKD) is difficult. Great expectations have been associated with biomarkers, including the N-terminal pro-brain natriuretic peptide (NT-proBNP). This study aimed to determine the correlation between NT-proBNP and cardiovascular complications in children with CKD. Serum NT-proBNP, arterial stiffness, common carotid artery intima-media thickness (cIMT), echocardiographic (ECHO) parameters (including tissue Doppler imaging), and biochemical and clinical data were analyzed in 38 pediatric patients with CKD (21 boys, 12.2 ± 4.2 years). Mean NT-proBNP in CKD patients was 1068.1 ± 4630 pg/mL. NT-proBNP above the norm (125 pg/mL) was found in 16 (42.1%) subjects. NT-proBNP correlated with glomerular filtration rate (GFR) (r = -0.423, p = 0.008), and was significantly higher in CKD G5 (glomerular filtration rate grade) patients compared to CKD G2, G3, and G4 children (p = 0.010, p = 0.004, and p = 0.018, respectively). Moreover, NT-proBNP correlated positively with augmentation index (AP/PP: r = 0.451, p = 0.018, P2/P: r = 0.460, p = 0.016), cIMT (r = 0.504, p = 0.020), and E/E' in ECHO (r = 0.400, p = 0.032). In multivariate analysis, logNT-proBNP was the only significant predictor of cIMT Z-score (beta = 0.402, 95CI (0.082-0.721), p = 0.014) and P2/P1 (beta = 0.130, 95CI (0.082-0.721), p = 0.014). Conclusions: NT-proBNP may serve as a possible marker of thickening of the carotid artery wall in pediatric patients with CKD. The final role of NT-proBNP as a biomarker of arterial damage, left ventricular hypertrophy, or cardiac diastolic dysfunction in CKD children needs confirmation in prospective studies.
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Affiliation(s)
- Piotr Skrzypczyk
- Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.O.-N.); (M.P.-T.)
| | - Magdalena Okarska-Napierała
- Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.O.-N.); (M.P.-T.)
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Radosław Pietrzak
- Department of Paediatric Cardiology and General Paediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland; (R.P.); (B.W.)
| | - Katarzyna Pawlik
- Student Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.P.); (K.W.)
| | - Katarzyna Waścińska
- Student Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.P.); (K.W.)
| | - Bożena Werner
- Department of Paediatric Cardiology and General Paediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland; (R.P.); (B.W.)
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Sasaki N, Maeda R, Ozono R, Nakano Y, Higashi Y. Association of Flow Parameters and Diameter in the Common Carotid Artery with Impaired Glucose Metabolism. J Atheroscler Thromb 2021; 29:654-666. [PMID: 34011802 PMCID: PMC9135665 DOI: 10.5551/jat.62790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Diameter, intima-media thickness (IMT), and flow parameters, including resistance index (RI) and pulsatility index (PI), in the common carotid artery (CCA) are markers of arterial remodeling, atherosclerosis, and vascular resistance, respectively. We investigated the differences among these markers in association with plasma glucose level, serum insulin level, and insulin resistance in participants without cardiovascular disease. METHODS CCA parameters (including the CCA interadventitial diameter and mean IMT at the time of 75-g oral glucose tolerance testing) were assessed in 4218 participants. RI and PI were assessed in 3380 of these participants. To assess plasma glucose and serum immunoreactive insulin profiles during oral glucose tolerance testing, we used the total areas under the curves (AUCglu and AUCins, respectively). We used the homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda index to assess insulin resistance. Insulin secretion was assessed with the HOMA-β. RESULTS AUCglu was significantly associated with CCA interadventitial diameter (β=0.048, P<0.001), RI (β=0.144, P<0.001), and PI (β=0.103, P<0.001) but not with mean IMT. AUCins (β=-0.064, P<0.001) and HOMA-β (β=-0.054, P<0.001) were significantly and negatively associated with CCA interadventitial diameter, but not with mean IMT. Both HOMA-IR and Matsuda index were significantly associated with RI and PI. CONCLUSIONS These findings indicate that all CCA parameters except IMT are associated with impaired glucose metabolism in patients without cardiovascular disease.
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Affiliation(s)
- Nobuo Sasaki
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council
| | - Ryo Maeda
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council
| | - Ryoji Ozono
- Department of General Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
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Fatemi S, Acosta S, Zarrouk M, Engström G, Melander O, Gottsäter A. Pro B-type Natriuretic Peptide and Midregional Proadrenomedullin are Associated with Incident Carotid Stenosis During Long Term Follow-up. J Stroke Cerebrovasc Dis 2020; 30:105403. [PMID: 33160126 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/08/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Plasma biomarkers may be useful to detect healthy individuals at increased risk for atherosclerotic manifestations, such as carotid artery stenosis. The aim of this longitudinal cohort study was to evaluate new biomarkers in relation to C-reactive protein and conventional risk factors for carotid artery stenosis during long term follow-up METHODS: The following markers were measured in 5550 middle-aged subjects: C-reactive protein, lipoprotein-associated phospholipase A2, proneurotensin, midregional pro-adrenomedullin, midregional pro-atrial natriuretic peptide, N-terminal pro B-type natriuretic peptide, copeptin, and cystatin C. Subjects with prevalent carotid artery stenosis were excluded. Subjects were followed in national patient registers for 23.4 (interquartile range 19.5-24.3) years regarding incident carotid artery stenosis, both operated and non-operated. RESULTS When including conventional risk markers in Cox regression, N-terminal pro B-type natriuretic peptide (Hazard ratio 1.36; 95% confidence interval 1.12-1.65; p = 0.002) was independently associated with incident carotid artery stenosis, whereas there were trends for C-reactive protein (HR 1.20; 95% confidence interval 0.98-1.48; p = 0.071), and midregional pro-adrenomedullin (Hazard ratio 1.21; 95% confidence interval 0.99-1.47; p = 0.061). Midregional pro-adrenomedullin (Hazard ratio 1.30; 95% confidence interval 1.03-1.65; p = 0.029) was independently associated with incident surgery for carotid artery stenosis, whereas there was a trend for N-terminal pro B-type natriuretic peptide (Hazard ratio 1.31; 95% confidence interval 1.00-1.72; p = 0.052). CONCLUSIONS N-terminal pro B-type natriuretic peptide and midregional pro-adrenomedullin can be used as predictors for clinically detected carotid artery stenosis during long-term follow-up of healthy subjects.
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Affiliation(s)
- Shahab Fatemi
- Department of Clinical Sciences, Malmö, Sweden; Lund University, Department of Internal and Emergency Medicine, Malmö, Sweden.
| | - Stefan Acosta
- Department of Clinical Sciences, Malmö, Sweden; Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Malmö, Sweden.
| | - Moncef Zarrouk
- Department of Clinical Sciences, Malmö, Sweden; Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Malmö, Sweden.
| | - Gunnar Engström
- Department of Clinical Sciences, Malmö, Sweden; Lund University, Department of Internal and Emergency Medicine, Malmö, Sweden.
| | - Olle Melander
- Department of Clinical Sciences, Malmö, Sweden; Lund University, Department of Internal and Emergency Medicine, Malmö, Sweden.
| | - Anders Gottsäter
- Department of Clinical Sciences, Malmö, Sweden; Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Malmö, Sweden.
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