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Mercantepe F, Baydur Sahin S, Cumhur Cure M, Karadag Z. Relationship Between Serum Endocan Levels and Other Predictors of Endothelial Dysfunction in Obese Women. Angiology 2023; 74:948-957. [PMID: 36369649 DOI: 10.1177/00033197221129358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Endocan, or endothelial cell-specific molecule-1 (ESM-1), is a potential inflammatory marker implicated in endothelial dysfunction. The purpose of this study was to determine the correlation between serum endocan levels and the presence and severity of endothelial dysfunction, and the relationships with serum intracellular adhesion molecule-1 (ICAM-1), adiponectin (a marker of inflammation), high sensitivity C-reactive protein (hsCRP) levels, and carotid intima-media thickness (cIMT) in obese subjects. Serum endocan, ICAM-1, adiponectin, hsCRP levels, and cIMT were evaluated in 76 obese women (BMI > 30 kg/m2) and 53 controls (BMI < 25 kg/m2). ICAM-1 (P = .01), hs-CRP (p < 0.001), and cIMT (p < .001) were significantly higher, while adiponectin (P = .006) was significantly lower, in obese women compared with the controls. Serum endocan levels were similar between the obese (470.5 ± 171.3 pg/mL) and controls (471.9 ± 146.3 pg/mL) (P = .732). There was no correlation between serum endocan values and the endothelial dysfunction markers, hsCRP (r = -.021), ICAM-1 (r = -.054), adiponectin (r = .113), or cIMT (r = -.060) in obesity. Endocan is not a suitable marker of endothelial dysfunction in the context of obesity. More research is required to evaluate the role of endocan in the regulation of inflammatory processes in obesity.
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Affiliation(s)
- Filiz Mercantepe
- Department of Endocrinology and Metabolism Disease, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Serap Baydur Sahin
- Department of Endocrinology and Metabolism Disease, Medistate Kavacik Hospital, Istanbul, Turkey
| | | | - Zakir Karadag
- Department of Cardiology, Systems Hospital, Kayseri, Turkey
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The Value of SIRT1/FOXO1 Signaling Pathway in Early Detection of Cardiovascular Risk in Children with β-Thalassemia Major. Biomedicines 2022; 10:biomedicines10102601. [PMID: 36289866 PMCID: PMC9599077 DOI: 10.3390/biomedicines10102601] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Atherosclerosis represents one of the major causes of morbidity in children with β-thalassemia major (β-TM). Aim: This study was designed to investigate SIRT1-FOXO1 signaling in β-TM children and their role in early detection of premature atherosclerosis. Methods: We equally subdivided 100 Egyptian children aged 6−14 years with β-TM according to carotid intima media thickness (CIMT) into 50 with CIMT < 0.5 mm and 50 with CIMT ≥ 0.5 mm, and 50 healthy children of matched age were included. They were subjected to evaluation of SIRT1, heat shock protein 72 (HSP72), and hepcidin levels via ELISA and forkhead box protein 1 (FOXO1) mRNA expression using real-time PCR in PBMCs; meanwhile, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase activities were evaluated spectrophotometrically. Results: Our results show significantly high values for CIMT, β-stiffness, atherogenic index of plasma (AIP), MDA, HSP72 and FOXO1, ferritin with significantly low hepcidin, SOD, catalase, and SIRT1 in β-TM as compared to controls with a more significant difference in β-TM with CIMT ≥ 0.5 mm than those with CIMT < 0.5 mm. A significant positive correlation between CIMT and MDA, HSP72, and FOXO1 gene expression was found, while a significant negative correlation with hepcidin, SOD, catalase, and SIRT1 was found. FOXO1 gene expression and HSP72 levels were the strongest independent determinants of CIMT. Conclusion: In β-TM, FOXO1 signaling is activated with low levels of SIRT1, and this is attributed to accelerated atherosclerosis in β-TM, which would be crucial in prediction of atherosclerosis.
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Regional and demographic variations of Carotid artery Intima and Media Thickness (CIMT): A Systematic review and meta-analysis. PLoS One 2022; 17:e0268716. [PMID: 35819948 PMCID: PMC9275715 DOI: 10.1371/journal.pone.0268716] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 05/05/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective
Carotid artery intima media thickness (CIMT) is a strong predictor of Coronary Heart Disease (CHD) and independent phenotype of early atherosclerosis. The global variation of CIMT and its demographic association is yet unclear. We evaluated regional variations of CIMT based on WHO regions and assessed the differences by age and sex.
Methods
A systematic search was conducted on studies published between 1980 January up to December 2020. PubMed, Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase data bases were used for searching. Supplementary searches were conducted on the Web of Science and Google Scholar. Grey literature was searched in “Open Grey” website. The two major criteria used were “adults” and “carotid intima media”. The search strategy for PubMed was created first and then adapted for the Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase databases. Covidence software (Veritas Health Innovation, Melbourne, Australia; http://www.covidence.org) was used to manage the study selection process. Meta-analyses were done using the random-effects model. An I2 ≥ 50% or p< 0:05 were considered to indicate significant heterogeneity.
Results
Of 2847 potential articles, 46 eligible articles were included in the review contributing data for 49 381 individuals (mean age: 55.6 years, male: 55.8%). The pooled mean CIMT for the non-CHD group was 0.65mm (95%CI: 0.62–0.69). There was a significant difference in the mean CIMT between regions (p = 0.04). Countries in the African (0.72mm), American (0.71mm) and European (0.71mm) regions had a higher pooled mean CIMT compared to those in the South East Asian (0.62mm), West Pacific (0.60mm) and Eastern Mediterranean (0.60mm) regions. Males had a higher pooled mean CIMT of 0.06mm than females in the non CHD group (p = 0.001); there were also regional differences. The CHD group had a significantly higher mean CIMT than the non-CHD group (difference = 0.23mm, p = 0.001) with regional variations. Carotid artery segment-specific-CIMT variations are present in this population. Older persons and those having CHD group had significantly thicker CIMTs.
Conclusions
CIMT varies according to region, age, sex and whether a person having CHD. There are significant regional differences of mean CIMT between CHD and non-CHD groups. Segment specific CIMT variations exist among regions. There is an association between CHD and CIMT values.
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Peralta AA, Schwartz J, Gold DR, Vonk JM, Vermeulen R, Gehring U. Quantile regression to examine the association of air pollution with subclinical atherosclerosis in an adolescent population. ENVIRONMENT INTERNATIONAL 2022; 164:107285. [PMID: 35576730 PMCID: PMC9890274 DOI: 10.1016/j.envint.2022.107285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/08/2022] [Accepted: 05/05/2022] [Indexed: 05/15/2023]
Abstract
BACKGROUND Air pollution has been associated with carotid intima-media thickness test (CIMT), a marker of subclinical atherosclerosis. To our knowledge, this is the first study to report an association between ambient air pollution and CIMT in a younger adolescent population. OBJECTIVE To investigate the associations beyond standard mean regression by using quantile regression to explore if associations occur at different percentiles of the CIMT distribution. METHODS We measured CIMT cross-sectionally at the age of 16 years in 363 adolescents participating in the Dutch PIAMA birth cohort. We fit separate quantile regressions to examine whether the associations of annual averages of nitrogen dioxide (NO2), fine particulate matter (PM2.5), PM2.5 absorbance (a marker for black carbon), PMcoarse and ultrafine particles up to age 14 assigned at residential addresses with CIMT varied across deciles of CIMT. False discovery rate corrections (FDR, p < 0.05 for statistical significance) were applied for multiple comparisons. We report quantile regression coefficients that correspond to an average change in CIMT (µm) associated with an interquartile range increase in the exposure. RESULTS PM2.5 absorbance exposure at birth was statistically significantly (FDR < 0.05) associated with a 6.23 µm (95% CI: 0.15, 12.3) higher CIMT per IQR increment in PM2.5 absorbance in the 10th quantile of CIMT but was not significantly related to other deciles within the CIMT distribution. For NO2 exposure we found similar effect sizes to PM2.5 absorbance, but with much wider confidence intervals. PM2.5 exposure was weakly positively associated with CIMT while PMcoarse and ultrafine did not display any consistent patterns. CONCLUSIONS Early childhood exposure to ambient air pollution was suggestively associated with the CIMT distribution during adolescence. Since CIMT increases with age, mitigation strategies to reduce traffic-related air pollution early in life could possibly delay atherosclerosis and subsequently CVD development later in life.
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Affiliation(s)
- Adjani A Peralta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States; Institute for Risk Assessment Sciences, Utrecht University, The Netherlands.
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, United States.
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, United States.
| | - Judith M Vonk
- Department of Epidemiology and Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, The Netherlands.
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands.
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands.
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Yazarlı E, Ünsal Saç R, Şimşek B, Engiz Ö, Dallar Bilge Y, Alioğlu B. The relation between increased carotid intima-media thickness with fibrin monomers in obese children. Int J Clin Pract 2021; 75:e14199. [PMID: 33794044 DOI: 10.1111/ijcp.14199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 11/26/2022] Open
Abstract
AIM This study aimed to investigate the association between carotid intima-media changes that play a part in the atherosclerotic process in childhood obesity and fibrin monomers as an important indicator of fibrin plaque. METHODS This is a cross-sectional study of obese children and non-obese healthy control subjects. Height, weight, body mass index, waist/hip ratio, systolic/diastolic blood pressures were recorded, in addition, biochemistry, haemogram, fibrin monomers and d-dimer were measured in both groups. Right and left common carotid intima-media thicknesses were measured by ultrasonography and mean carotid intima-media thickness was calculated. RESULTS Obese children (n = 89, 46.1% girls, median age: 12.6 ± 2.3 years) and healthy control group (n = 40, 52.5% girls, median age: 13.2 ± 2.2 years) were comparable in terms of gender, age and puberty stage. Mean carotid intima-media thickness was higher in obese children than the healthy control group (P = .002). There was no difference between the two groups in terms of fibrin monomers and d-dimer levels. In obese children, there was a weak negative correlation between mean carotid intima-media thickness and fibrin monomers (P = .030, r = -0.233). CONCLUSION In obese children, mean carotid intima-media thickness was determined higher, as an early indicator of atherosclerosis. We want to emphasise that obese children are at risk for cardiovascular disease and should be evaluated in terms of atherosclerosis. This study investigates the relation between increased carotid intima-media thickness and fibrin monomers, in children, the first time in Literature.
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Affiliation(s)
- Esra Yazarlı
- Department of Pediatrics, Faculty of Medicine Hatay Mustafa Kemal University, Hatay, Turkey
| | - Rukiye Ünsal Saç
- Department of Pediatrics, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Betül Şimşek
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Özlem Engiz
- Department of Pediatric Endocrinology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Yıldız Dallar Bilge
- Department of Pediatrics, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Bülent Alioğlu
- Department of Pediatric Hematology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
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Tsai SY, Shen RS, Kuo CJ, Chen PH, Chung KH, Hsiao CY, Huang SH. The association between carotid atherosclerosis and treatment with lithium and antipsychotics in patients with bipolar disorder. Aust N Z J Psychiatry 2020; 54:1125-1134. [PMID: 32900219 DOI: 10.1177/0004867420952551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Patients with bipolar disorder are at high risk of cardiovascular diseases. Among cardiovascular diseases, coronary heart disease and stroke are the leading causes of premature death and both share the pathogenesis of arterial atherosclerosis. Increased carotid intima-media thickness is sensitive for detecting early atherosclerosis and a practical index for predicting cardiovascular diseases. However, few studies investigated carotid intima-media thickness in adults with bipolar disorder. We attempted to determine the factors associated with carotid intima-media thickness in adults with bipolar disorder. METHODS The euthymic out-patients with bipolar I disorder aged over 20 years were recruited to measure the carotid intima-media thickness value through B-mode carotid ultrasound. Those with any psychiatric disorder, acute or life-threatening medical condition were excluded. All clinical information was obtained by reviewing medical records and directly interviewing patients with reliable others. RESULTS Of the 106 participants with a mean age of 44.5 years, 40.6% (N = 43) had concurrent cardiovascular/endocrine/metabolic diseases. A multivariate regression indicated that higher assumed daily lithium dosage was significantly associated with a decreased carotid intima-media thickness in the whole sample. In the young subgroup (⩽45 years old, N = 63), higher current daily lithium dosage and lower body mass index were associated with lower carotid intima-media thickness. In those without concurrent cardiovascular/endocrine/metabolic diseases, higher ratio of first-generation antipsychotics exposure in relation to illness chronicity was associated with higher carotid intima-media thickness, after controlling for body mass index or age. CONCLUSION Lithium treatment may be associated with less progression in carotid intima-media thickness and the reduced risk for atherosclerosis in adults with bipolar disorder, including those with high cardiovascular disease risk. In addition to age and body mass index, antipsychotics may increase carotid intima-media thickness even in the low cardiovascular disease-risk patients.
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Affiliation(s)
- Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ruei-Siang Shen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Clinical Psychology, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chian-Jue Kuo
- Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Pao-Huan Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Hsuan Chung
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yi Hsiao
- Department of Cardiology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shou-Hung Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
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Haberal İ, Yesiltas MA, Koyuncu AO, Batur S, Ozsoy SD, Yilmaz HA, Buge A. Is it possible to predict atherosclerosis in the ascending aorta by the patient's lipid panel? Arch Med Sci Atheroscler Dis 2020; 5:e237-e244. [PMID: 33305062 PMCID: PMC7717447 DOI: 10.5114/amsad.2020.98940] [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: 05/23/2020] [Accepted: 07/25/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Atherosclerosis is a chronic inflammatory event characterized by stiffness and thickening of the vascular walls. In our daily practice, we assume the atherosclerotic potential of the patient by following the total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglyceride levels (lipid panel). We aimed to understand the relation between the HDL, LDL, cholesterol levels and the atherosclerosis in large vascular structures such as the ascending aorta. MATERIAL AND METHODS We have searched for atherosclerosis in the aortic tissue samples from 48 patients. It is a study in which we examine the correlation of preoperative cholesterol values (HDL, LDL, triglyceride, total cholesterol) by dividing the patients into two groups according to the presence of plaque. RESULTS Forty-three (89.6%) male and 5 (10.4%) female patients between 39 and 81 years of age were included in the study. There was no statistically significant difference between the patients' preoperative cardiovascular risk assessments. The free T3 values were within the normal range in all patients, but there was a difference that patients in the non-atherosclerosis group had lower values. There was no statistically significant difference between the two groups' HDL, LDL, total cholesterol, or triglyceride parameters. CONCLUSIONS As a result, in our study, no significant difference was found between HDL-C, LDL-C, triglyceride, total cholesterol values and the pathological process of aortic atherosclerosis. As a result of this study, we believe that it was necessary to correct the error margins of these parameters. In addition, it required the need for a clearer laboratory parameter to demonstrate atherosclerosis.
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Affiliation(s)
- İsmail Haberal
- Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Mehmet Ali Yesiltas
- Department of Cardiovascular Surgery, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Ozan Koyuncu
- Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Sebnem Batur
- Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Sadiye Deniz Ozsoy
- Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Hülya A.K. Yilmaz
- Department of Anesthesiology and Reanimation, Institute of Cardiology, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Aysim Buge
- Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Park S, Choi JR, Kim SK, Lee S, Lee K, Kim JY, Oh SS, Koh SB. Increased risk of atherosclerosis associated with pesticide exposure in rural areas in Korea. PLoS One 2020; 15:e0232531. [PMID: 32357160 PMCID: PMC7194402 DOI: 10.1371/journal.pone.0232531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 04/16/2020] [Indexed: 12/15/2022] Open
Abstract
Atherosclerosis is a progressive inflammation in systemic vessels, and pesticide exposure has been emerging as its risk factor. This cross-sectional study investigated the association between pesticide exposure and the risk of atherosclerosis in a rural population in Korea using carotid intima-media thickness (CIMT). This study used dataset from the baseline survey of the Korea Farmers Cohort Study between November 2005 and January 2008, and the final analysis included 477 participants. Well-structured questionnaires were used to estimate pesticide exposure. CIMT ≥ 0.9 mm was established for carotid atherosclerosis. Multiple logistic regression analyses were undertaken to evaluate the association between pesticide exposure and atherosclerosis, adjusting demographic and health-related confounders. Even after adjustments, the increased risk of atherosclerosis was significantly associated with pesticide exposure, such as a lifetime history of farming (odds ratio [OR] 3.25 95% confidence interval [CI] 1.51–6.98), a history of using pesticide (OR 3.42 95% CI 1.63–7.16), using pesticide 10 times or more annually (OR 2.55 95% CI 1.21–5.39), and higher cumulative exposure index level (OR 3.63 95% CI 1.65–7.97). Further prospective studies are required to elucidate effects of pesticide exposure on the risk of atherosclerosis.
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Affiliation(s)
- Sungjin Park
- Department of Occupational and Environmental Medicine, Cheonan Medical Center, Cheonan, Korea
| | - Jung Ran Choi
- Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung-Kyung Kim
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Solam Lee
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyungsuk Lee
- National Academy of Agricultural Science, Rural Development Administration, Jeonju, Korea
| | - Jang-Young Kim
- Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung-Soo Oh
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sang-Baek Koh
- Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Center for Global Health and Social Medicine, Institute of Poverty Alleviation and International Development, Yonsei University, Wonju, Korea
- * E-mail:
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Siwamogsatham S, Chutinet A, Vongsayan P, Samajarn J, Putcharoen O, Aponpong T, Hiransuthikul A, Gatechompol S, Han WM, Chattranukulchai P, Kerr SJ, Ruxrungtham K, Avihingsanon A, Ohata PJ, Supakawee K, Jamthong J. Low CD4 Cell Counts Are Associated with Carotid Plaque and Intima-Media Thickness in Virologically Suppressed HIV-Infected Asians Older Than 50 Years. AIDS Res Hum Retroviruses 2019; 35:1160-1169. [PMID: 31530175 DOI: 10.1089/aid.2019.0126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Information about the prevalence, and risk factors for subclinical atherosclerosis in an Asian HIV-infected population is limited. Carotid intima-media thickness (cIMT) is one predictor for the risk of cardiovascular disease (CVDs) and mortality. We evaluated the prevalence and risk factors related to carotid atherosclerosis among well-suppressed HIV-infected adults receiving long-term ART from Thailand. This was a cross-sectional study of HIV-infected adults >50 years of age and free from CVDs from Thailand during 1 March 2016 and 30 May 2017. Ultrasonography of the carotid was performed and read by cIMT experienced neurologists who were blinded from the patient care. Subclinical atherosclerosis was defined by carotid plaque or cIMT of the common carotid artery (CCA) >0.9 mm. Totally 316 HIV-infected adults (61% males) were included. Median age was 54.4 years and 15.8% were diabetic, 40.2% had hypertension, and 12.7% were current smokers. The median duration of ART was 16.3 years and 32% were currently on boosted protease inhibitor. The mean overall cIMT of the common carotid arteries were 0.63 (IQR 0.55-0.72) mm. Men had higher cIMT than women, 0.64 (IQR 0.56-0.76) vs. 0.60 (IQR 0.53-0.70), p = .03. Overall, 3.8% had cIMT >0.9 mm and 24.4% had carotid plaque. From the multivariate logistic regression analysis, age per 1 year increase [odds ratio (OR) 1.06; 95% confidence interval (CI) 1.003-1.12; p = .04] and nadir CD4 < 200 cells/mm3 (OR 1.8; 95%CI 1.02-3.18, p = .04) were significantly associated with subclinical atherosclerosis. High-sensitivity C-reactive protein was not associated with subclinical atherosclerosis. In this well-suppressed HIV-infected Aging Asian cohort with relatively low prevalence of current smokers, 26.9% of them had subclinical atherosclerosis. Advanced age and low nadir CD4 cell count were significantly associated with subclinical atherosclerosis. Given that approximately a quarter of the patients had carotid plaques, longitudinal studies to evaluate the development of future overt coronary artery disease and stroke are warranted.
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Affiliation(s)
- Sarawut Siwamogsatham
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Chula Clinical Research Center, Bangkok, Thailand
| | - Aurauma Chutinet
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pongpat Vongsayan
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jitrada Samajarn
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Opass Putcharoen
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tanakorn Aponpong
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Akarin Hiransuthikul
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Sivaporn Gatechompol
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Win Min Han
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Pairoj Chattranukulchai
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Stephen J. Kerr
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Faculty of Medicine, Biostatistics Excellence Center, Chulalongkorn University, Bangkok, Thailand
| | - Kiat Ruxrungtham
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Anchalee Avihingsanon
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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10
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Kulkarni S, Xavier D, George B, Umesh S, Fathima S, Bantwal G. Effect of intensive lifestyle modification & metformin on cardiovascular risk in prediabetes: A pilot randomized control trial. Indian J Med Res 2019; 148:705-712. [PMID: 30778004 PMCID: PMC6396550 DOI: 10.4103/ijmr.ijmr_1201_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background & objectives: Prediabetes is associated with increased prevalence of cardiovascular disease (CVD). In participants with prediabetes, the effects of exercise and metformin were evaluated on high-sensitivity C-reactive protein (hsCRP) and carotid intima-media thickness (CIMT), surrogate markers of atherosclerosis and CVD compared with standard care. Methods: In a pilot randomized control trial, the participants were randomized in to three arms: standard care (STD), intensive lifestyle modification (ILSM) or ILSM and metformin (ILSM+Met) and followed up for six months. Monitoring of ILSM was done by a trained healthcare facilitator. hsCRP, CIMT and other relevant parameters were measured before and after intervention. Results: A total of 103 participants were randomized into three arms and followed up for six months. At six months, there was a reduction from baseline in weight and fasting blood sugar (FBS) (P<0.01) in all three arms and a reduction in haemoglobin A1c (P=0.03) only in the ILSM+Met arm. The differences in hsCRP over six months within the STD, ILSM and ILSM+Met arms were −0.12 (95% confidence interval, −1.81, 2.08), −0.58 (−2.64, 0.43) and −0.11 (−1.84, 1.56), respectively. There was no difference in hsCRP, CIMT (right) or CIMT (left) between the three arms at six months. Interpretation & conclusions: There was a reduction in weight and FBS from baseline in all three arms. There was, however, no difference seen in hsCRP and CIMT in the two intervention arms compared to standard care. Larger studies with long-term follow up need to be done to detect differences in risk markers for CVD in prediabetes.
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Affiliation(s)
- Shruthi Kulkarni
- Department of Medicine, St. John's Medical College Hospital, Bengaluru, India
| | - Denis Xavier
- Department of Pharmacology, St. John's Medical College Hospital; Division of Clinical Research & Training, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Belinda George
- Department of Endocrinology, St. John's Medical College Hospital, Bengaluru, India
| | - Soumya Umesh
- Department of Medicine, St. John's Medical College Hospital, Bengaluru, India
| | - Saba Fathima
- Department of Medicine, St. John's Medical College Hospital, Bengaluru, India
| | - Ganapathi Bantwal
- Department of Endocrinology, St. John's Medical College Hospital, Bengaluru, India
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11
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Kaydu A, Güven DD, Gökcek E. Can ultrasonographic measurement of carotid intima-media thickness predict hypotension after induction of general anesthesia? J Clin Monit Comput 2018; 33:825-832. [PMID: 30465109 DOI: 10.1007/s10877-018-0228-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/16/2018] [Indexed: 02/06/2023]
Abstract
Hypotension in patients under general anesthesia is prevalent and causes unfavorable outcomes. Carotid intima-media thickness (CIMT) is a surrogate marker for atherosclerosis and useful for evaluating the risk of cardiovascular diseases. We investigated the usefulness of preoperative CIMT measurement as a predictor of post-induction hypotension (PIH). The ultrasonographic measurement of CIMT was performed preoperatively on 82 patients scheduled for elective surgery under general anesthesia in a prospective, observational study. Mean blood pressure (MBP) was recorded before induction. Hypotension was defined as a 20% decrease in MBP from baseline. The ultrasonographic measurement of CIMT was unsuccessful in 2 (2.43%) patients, leaving 80 patients for analyses. Hypotension developed in 41 patients. CIMT was higher in the patient group with PIH than in the group without PIH (p < 0.001). There was statistically significant correlation between MBP decrease after induction and CIMT (r = 0.529, p < 0.0001). CIMT correlated positively with age (r = 0.739, p < 0.0001). The area under curve for CIMT was 0.753 [95% confidence interval (CI) 0.642-0.863]. The optimal cutoff value of CIMT was 0.65 mm with a sensitivity of 75.6% and a specificity of 74.4%. CIMT was an independent predictor of PIH after adjusting other factors with an odds ratio of 1.833 (95% CI 1.23-2.72; p = 0.003). The ultrasonographic imaging and measurement of CIMT can reliably predict hypotension with a 0.65-mm threshold level. We believe that the ultrasonographic measurements of CIMT may be included in point-of-care application in anesthesiology.
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Affiliation(s)
- Ayhan Kaydu
- Department of Anesthesiology, Diyarbakır State Hospital, 21100, Diyarbakir, Turkey.
| | - Dilek Duman Güven
- Department of Anesthesiology, Diyarbakır State Hospital, 21100, Diyarbakir, Turkey
| | - Erhan Gökcek
- Department of Anesthesiology, Diyarbakır State Hospital, 21100, Diyarbakir, Turkey
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12
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van den Munckhof IC, Jones H, Hopman MT, de Graaf J, Nyakayiru J, van Dijk B, Eijsvogels TM, Thijssen DH. Relation between age and carotid artery intima-medial thickness: a systematic review. Clin Cardiol 2018; 41:698-704. [PMID: 29752816 PMCID: PMC6489962 DOI: 10.1002/clc.22934] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/22/2018] [Accepted: 02/23/2018] [Indexed: 12/29/2022] Open
Abstract
Carotid artery intima-medial thickness (cIMT) represents a popular measure of atherosclerosis and is predictive of future cardiovascular and cerebrovascular events. Although older age is associated with a higher cIMT, little is known about whether this increase in cIMT follows a linear relationship with age or it is affected under influence of cardiovascular diseases (CVD) or CVD risk factors. We hypothesize that the relationship between cIMT and age is nonlinear and is affected by CVD or risk factors. A systematic review of studies that examined cIMT in the general population and human populations free from CVD/risk factors was undertaken. The literature search was conducted in PubMed, Scopus, and Web of Science. Seventeen studies with 32 unique study populations, involving 10,124 healthy individuals free from CVD risk factors, were included. Furthermore, 58 studies with 115 unique study populations were included, involving 65,774 individuals from the general population (with and without CVD risk factors). A strong positive association was evident between age and cIMT in the healthy population, demonstrating a gradual, linear increase in cIMT that did not differ between age decades (r = 0.91, P < 0.001). Although populations with individuals with CVD demonstrated a higher cIMT compared to populations free of CVD, a linear relation between age and cIMT was also present in this population. Our data suggest that cIMT is strongly and linearly related to age. This linear relationship was not affected by CVD or risk factors.
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Affiliation(s)
| | - Helen Jones
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Maria T.E. Hopman
- Department of PhysiologyRadboud University Nijmegen Medical CentreNijmegenNetherlands
| | - Jacqueline de Graaf
- Department of Internal MedicineRadboud University Nijmegen Medical CentreNijmegenNetherlands
| | - Jean Nyakayiru
- Department of PhysiologyRadboud University Nijmegen Medical CentreNijmegenNetherlands
| | - Bart van Dijk
- Department of PhysiologyRadboud University Nijmegen Medical CentreNijmegenNetherlands
| | - Thijs M.H. Eijsvogels
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- Department of PhysiologyRadboud University Nijmegen Medical CentreNijmegenNetherlands
| | - Dick H.J. Thijssen
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- Department of PhysiologyRadboud University Nijmegen Medical CentreNijmegenNetherlands
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13
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Curcio S, García-Espinosa V, Castro JM, Peluso G, Marotta M, Arana M, Chiesa P, Giachetto G, Bia D, Zócalo Y. High Blood Pressure States in Children, Adolescents, and Young Adults Associate Accelerated Vascular Aging, with a Higher Impact in Females' Arterial Properties. Pediatr Cardiol 2017; 38:840-852. [PMID: 28289784 DOI: 10.1007/s00246-017-1591-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/15/2017] [Indexed: 12/22/2022]
Abstract
The aims of the study were to determine (1) whether the presence of High blood pressure (HBP) states in the youth associate a steeper rate of age-related change in arterial geometrical and wall properties with respect to subjects with no previous cardiovascular risk factor (CRF) exposure, (2) in which parameters and in what magnitude, and (3) the existence of a gender-related difference in the impact of this condition on arterial properties. 300 individuals (mean/range: 15/4-29 years; 133 females) were included. Two groups were assembled: (1) Reference: nonprevious exposure to traditional CRF and (2) HBP: subjects with arterial hypertension and/or elevated blood pressure (BP) levels during the study. Additionally, HBP subjects were separated in BP-related subgroups. Measured parameters were (1) central (aortic) arterial BP and aortic pulse wave analysis parameters, (2) carotid and femoral artery local (pressure-strain elastic modulus) and regional (pulse wave velocity; PWV) stiffness, and (3) arterial diameters and carotid intima-media thickness (CIMT). Age-related changes in these parameters (absolute values and z-scores) were explored by obtaining simple linear regression models for each group. HBP presented a steeper rate of change (accelerated vascular aging; VA) for most of the parameters assessed, mainly in central (aortic) hemodynamics. VA increased as the HBP level got higher. Both males' and females' aging rates were affected by this condition, but females presented a more marked relative age-related increase with HBP exposure. HBP states in the youth gradually associate accelerated VA, with a progressive hemodynamic-structural-functional onset of damage, with females presenting a more marked relative HBP-associated arterial repercussion.
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Affiliation(s)
- S Curcio
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
| | - V García-Espinosa
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
| | - J M Castro
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
| | - G Peluso
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
| | - M Marotta
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.,Basic Medicine Department, Faculty of Medicine, Clinical Hospital, Republic University, Avenida Italia w/n, 11600, Montevideo, Uruguay
| | - M Arana
- Clínica Pediátrica "C", Centro Hospitalario Pereira Rossell, ASSE - Republic University, Boulevard Artigas 1550, 11600, Montevideo, Uruguay
| | - P Chiesa
- Servicio de Cardiología Pediátrica, Centro Hospitalario Pereira Rossell, ASSE-Ministry of Public Health, Boulevard Artigas 1550, 11600, Montevideo, Uruguay
| | - G Giachetto
- Clínica Pediátrica "C", Centro Hospitalario Pereira Rossell, ASSE - Republic University, Boulevard Artigas 1550, 11600, Montevideo, Uruguay
| | - D Bia
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
| | - Yanina Zócalo
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
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14
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Wu TW, Hung CL, Liu CC, Wu YJ, Wang LY, Yeh HI. Associations of Cardiovascular Risk Factors with Carotid Intima-Media Thickness in Middle-Age Adults and Elders. J Atheroscler Thromb 2016; 24:677-686. [PMID: 27874838 PMCID: PMC5517541 DOI: 10.5551/jat.37895] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aims: Elevated carotid intima-media thickness (cIMT) is a preclinical phenotype of atherosclerotic diseases. There are significant sex differences in the morbidities of cardiovascular diseases and their major determinants, and we explored the sex-specific effects of cardiovascular factors on cIMT by a community-based study. Methods: We measured the cIMT and cardiovascular profiles of 1579 residents aged 40–74 years in northern Taiwan. Multivariate regression analyses were used to assess the effects and contributions of these factors on cIMT. Results: Males had significantly higher mean (± SD) of cIMT than females (0.668 ± 0.113 vs. 0.632 ± 0.100 nm, p < 0.0001). The common factors of the best-fit regression models in both sexes were age, BMI, and LDL-/HDL-C ratio; however, their contributions and effects were different. The partial coefficients of determination (r2) were 17.9, 5.8, and 4.1%, respectively, for males and were 27.8, 1.4, and 1.2%, respectively, for females. Test statistics showed that the regression coefficients of BMI and LDL-/HDL-C ratio of males were significantly higher than those of females. As compared with females, per 1.0 SD increases of BMI and LDL-/HDL-C in males resulted in 0.0971 (p = 0.030) and 0.1177 (p = 0.0087), respectively, SD increases in cIMT. There was no difference in the means of cIMT between pre- and post-menopausal women of the same age groups. Conclusions: There was a significant sex difference in cIMT. The contributions and effects of LDL-/HDL-C ratio and BMI on cIMT were more profound in males. Our findings indicate that sex-specific factors, but possibly not menstrual status-related factors, contribute to thicker cIMT.
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Affiliation(s)
- Tzu-Wei Wu
- Department of Medicine, Mackay Medical College
| | - Chung-Lieh Hung
- Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College
| | - Chun-Chieh Liu
- Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College
| | - Yih-Jer Wu
- Department of Medicine, Mackay Medical College.,Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College.,Institute of Biomedical Sciences, Mackay Medical College
| | - Li-Yu Wang
- Department of Medicine, Mackay Medical College.,Institute of Biomedical Sciences, Mackay Medical College
| | - Hung-I Yeh
- Department of Medicine, Mackay Medical College.,Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College.,Institute of Biomedical Sciences, Mackay Medical College
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15
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Kaligis RWM, Adiarto S, Nugroho J, Pradnyana BA, Lefi A, Rifqi S. Carotid Intima-Media Thickness in Indonesian Subjects with Cardiovascular Disease Risk Factors Who Were Not Receiving Lipid-Lowering Agents. Int J Angiol 2016; 25:174-80. [PMID: 27574385 DOI: 10.1055/s-0036-1572365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Carotid intima-media thickness (CIMT) is frequently utilized for detection of subclinical atherosclerosis. This study aims to investigate the association between the CIMT values and demographic characteristics, cardiovascular disease (CVD) risk factors, lipid biochemistry profiles, and high-sensitivity C-reactive protein (hs-CRP) levels among the Indonesian population. Subjects who had two or more CVD risk factors but were not receiving lipid-lowering therapy were recruited from six hospitals of Indonesia. Measurements of CIMT are obtained by ultrasonography of 12 sites within the common carotid artery. CVD risk factors, lipid and glucose profiles, and hs-CRP values were analyzed with respect to distribution of CIMT. The mean-max CIMT was 0.805 ± 0.190 mm (minimum, 0.268 mm; maximum, 1.652 mm) and the mean-mean CIMT was 0.614 ± 0.190 mm (minimum, 0.127 mm; maximum, 1.388 mm). Multivariate analyses confirmed an independent association between increasing CIMT and increasing age (regression coefficient = 0.004; p = 0.004). Our data show normative mean-mean CIMT data for Indonesian subjects with two or more CVD risk factors who are not receiving lipid-lowering therapy, which may guide CVD risk stratification of asymptomatic individuals in Indonesia.
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Affiliation(s)
- Rinambaan W M Kaligis
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia
| | - Suko Adiarto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia
| | | | - Johanes Nugroho
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University, Soetomo Hospital, Surabaya, Indonesia
| | - Bagus Ari Pradnyana
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Udayana University, Sanglah Hospital, Denpasar, Indonesia
| | - Achmad Lefi
- Department of Cardiology and Vascular Medicine, Darmo Hospital, Surabaya, Indonesia
| | - Sodiqur Rifqi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro Univesity, Kariadi Hospital, Semarang, Indonesia
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16
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Liao X, Norata GD, Polak JF, Stehouwer CDA, Catapano A, Rundek T, Ezhov M, Sander D, Thompson SG, Lorenz MW, Balakhonova T, Safarova M, Grigore L, Empana JP, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Schminke U, Lind L, Willeit P, Yanez DN, Steinmetz H, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Iglseder B, Friera A, Xie W, Plichart M, Su TC, Srinivasan SR, Schmidt C, Tuomainen TP, Völzke H, Nijpels G, Willeit J, Franco OH, Suarez C, Zhao D, Ducimetiere P, Chien KL, Robertson C, Bergström G, Kauhanen J, Dörr M, Dekker JM, Kiechl S, Sitzer M, Bickel H, Sacco RL, Hofman A, Mathiesen EB, Gabriel R, Liu J, Berenson G, Kavousi M, Price JF. Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin? Eur J Prev Cardiol 2016; 23:1165-73. [DOI: 10.1177/2047487315625543] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 12/15/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Ximing Liao
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Giuseppe D Norata
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Italy
- SISA Centre for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Joseph F Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, USA
| | - Coen DA Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, The Netherlands
| | - Alberico Catapano
- IRCSS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, USA
| | - Marat Ezhov
- Atherosclerosis Department, Cardiology Research Centre, Moscow, Russia
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing & Feldafing, Feldafing, Germany
- Department of Neurology, Technische Universität München, Germany
| | - Simon G Thompson
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, UK
| | - Matthias W Lorenz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | | | - Maya Safarova
- Atherosclerosis Department, Cardiology Research Centre, Moscow, Russia
| | - Liliana Grigore
- SISA Centre for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Sorbonne Paris Cité, France
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Stela McLachlan
- Centre for Population Health Sciences, University of Edinburgh, UK
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Germany
| | - Lars Lind
- Department of Medicine, Uppsala University, Sweden
| | - Peter Willeit
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, UK
- Department of Neurology, Medical University Innsbruck, Austria
| | - David N Yanez
- Department of Biostatistics, University of Washington, Seattle, USA
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Holger Poppert
- Department of Neurology, Technische Universität München, Germany
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Radiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Stein Harald Johnsen
- Department of Clinical Medicine, University of Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Bernhard Iglseder
- Parcelsus Medical University, Salzburg, Austria
- Department of Geriatric Medicine, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik, Salzburg, Austria
| | - Alfonsa Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Spain
| | - Wuxiang Xie
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China
| | - Matthieu Plichart
- Assistance Publique, Hôpitaux de Paris, Hôpital Broca, Paris, France
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Sathanur R Srinivasan
- Center for Cardiovascular Health, Department of Epidemiology, Biochemistry, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, Greifswald, Germany
| | - Giel Nijpels
- Department of General Practice, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Austria
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Spain
| | - Dong Zhao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China
| | | | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Marcus Dörr
- Department B for Internal Medicine, University Medicine Greifswald, Germany
- German Centrefor Cardiovascular Research (DZHK), partner site Greifswald, Germany
| | - Jaqueline M Dekker
- Department of Epidemiology and Biostatistics, University Medical Centre, Amsterdam, The Netherlands
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Austria
| | - Matthias Sitzer
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
- Department of Neurology, Klinikum Herford, Germany
| | - Horst Bickel
- Department of Psychiatry and Psychotherapy, Technische Universität München, Germany
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, USA
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, University of Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Rafael Gabriel
- Instituto de Investigación IdiPAZ, Hospital Universitario La Paz, Madrid, Spain
| | - Jing Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China
| | - Gerald Berenson
- Department of Medicine, Pediatrics, Biochemistry, Epidemiology, Tulane University School of Medicine and School of Public Health and Tropical Medicine, New Orleans, USA
| | - Maryam Kavousi
- Department of Epidemiology and Biostatistics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jackie F Price
- Centre for Population Health Sciences, University of Edinburgh, UK
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17
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Saklamaz A, Uyar B, Yalcin M, Cengiz H. Isotretinoin increased carotid intima-media thickness in acne patients. Hippokratia 2016; 20:14-18. [PMID: 27895437 PMCID: PMC5074391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Isotretinoin (Iso) in acne treatment may cause dyslipidemia and increase in liver enzymes. Moreover, its effect on lipid and glucose metabolism may induce atherosclerotic complications. The aim of this study was to evaluate carotid intima-media thickness (CIMT), osteopontin (OPN), lipid, high sensitive C-reaktive protein (hs-CRP) levels, and insulin resistance (HOMA-IR) in acne patients before and after Iso treatment. MATERIALS Twenty-one acne patients were treated with Iso (0.5-0.8 mg/kg) for four months. Blood tests for lipid profile, fasting glucose, liver enzymes, OPN, HOMA-IR, hs-CRP and CIMT measurements were performed before and after Iso treatment. Serum levels of OPN and, hs-CRP were measured by ELISA and particle-enhanced turbidimetric immunoassay respectively. RESULTS Iso treatment significantly increased lipid levels, CIMT (0.60-0.74 mm; p ˂0.001); whereas it non-significantly increased HOMA-IR (0.91-1.87; p =0.70), OPN (4.32-5.44 ng/ml; p =0.27), and hs-CRP (0.08-0.09 mg/dl; p =0.88) levels. There was no correlation between OPN and CIMT (p =0.77). CONCLUSION Isotretinoin treatment for four months significantly increased CIMT in acne patients. Hippokratia 2016, 20(1): 14-18.
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Affiliation(s)
- A Saklamaz
- Department of Endocrinology and Metabolism, Medical Faculty, Sifa University, Izmir, Turkey
| | - B Uyar
- Department of Dermatology, Medical Faculty, Sifa University, Izmir, Turkey
| | - M Yalcin
- Department of Internal Medicine, Medical Faculty, Sifa University, Izmir, Turkey
| | - H Cengiz
- Department of Biostatistics, Medical Faculty, Sifa University, Izmir, Turkey
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18
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Choi JH, Joo SJ, Kim J. Determining the necessity for right heart catheterization in pulmonary hypertension associated with connective tissue diseases assessed by echocardiography. Int J Rheum Dis 2015; 19:65-73. [PMID: 26820839 DOI: 10.1111/1756-185x.12769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The prognosis of pulmonary hypertension (PH) in systemic sclerosis (SSC) and in systemic lupus erythematosus (SLE) is different. According to the guidelines, right heart catheterization (RHC) is necessary in pulmonary arterial hypertension (PAH) associated with connective tissue diseases (CTD). However, there is little supporting evidence. Therefore, we attempted to determine the necessity for RHC and the causes of differences in prognosis of PH by comparing SSC to SLE. METHODS The inclusion criteria were all patients with SSC or SLE with exertional dyspnea. Echocardiography and carotid Doppler ultrasound were performed. RESULTS Twenty-three patients with SSC and 23 with SLE participated in this study. There was no difference in the right ventricular systolic pressure (RVSP) between SSC and SLE (33.0 mmHg, range 25.3-41.7 mmHg vs. 32.4 mmHg, range 27.0-37.7 mmHg; P = 0.835). In multiple linear regression analysis, the ratio of peak tricuspid regurgitant velocity to right ventricular outflow tract time-velocity integral, which represents pulmonary vascular resistance (PVR), was correlated with RVSP in SSC (r(2) = 0.928, β = 0.362, P = 0.003), and the independent predictor of increased RVSP was the ratio of early diastolic transmitral filling velocity to early diastolic septal mitral annular velocity, which represents diastolic dysfunction in SLE (R(2) = 0.806, β = 0.803, P = 0.023). CONCLUSIONS PVR was an important cause of PH in SSC. Left ventricular dysfunction was an important cause of PH in SLE. Thus, these findings demonstrate the necessity for RHC and differences in prognosis of PH in CTD.
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Affiliation(s)
- Joon Hyouk Choi
- Division of Cardiology, Internal Medicine, Jeju National University Hospital, Jeju, Korea
| | - Seung-Jae Joo
- Division of Cardiology, Internal Medicine, Jeju National University Hospital, Jeju, Korea
| | - Jinseok Kim
- Division of Rheumatology, Internal Medicine, School of Medicine, Jeju National University, Jeju, Korea
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Calmarza P, Trejo JM, Lapresta C, López P. [Intima-media thickness in a middle-old age sample of the Spanish general population]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2014; 27:111-7. [PMID: 25542632 DOI: 10.1016/j.arteri.2014.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 09/28/2014] [Accepted: 09/29/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To ascertain reference values of carotid intima-media thickness (cIMT) in a middle and old-aged sample of the Spanish general population and to establish the 75(th) percentile above which it is necessary to control more strictly other cardiovascular risk factors. To determine cIMT values and the number of carotid plaques in age and sex subgroups, and whether there are differences between them. MATERIAL AND METHODS Lipids, apolipoproteins, number of carotid atherosclerotic plaques if any, and cIMT of both common carotid arteries were determined in 171 individuals, representative of the adult general population of Burgos (Spain). RESULTS The median age of the patients was 63 years (interquartile range = 20) and the 75th percentile of carotid IMT was 0,88 mm and 0,81 mm in men and women, respectively. This study shows that the values of cIMT median increase with age and are higher in men than in women in all age groups, except in individuals over 74 years where cIMT median values are similar. The presence or absence of atherosclerotic plaques was not statistically different between men and women at different ages. CONCLUSIONS This population study shows the reference values of cIMT in a middle and old-aged sample of the Spanish population and shows that age, male gender, systolic blood pressure (SBP) and personal history of coronary heart disease are the main determinants of increased cIMT.
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Affiliation(s)
- Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - José María Trejo
- Servicio de Neurología, Complejo Hospitalario de Burgos, Burgos, España
| | - Carlos Lapresta
- Servicio de Medicina Preventiva, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Pilar López
- Servicio de Urgencias, Complejo Hospitalario de Burgos, Burgos, España
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20
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Ratchford EV, Carson KA, Jones SR, Ashen MD. Usefulness of coronary and carotid imaging rather than traditional atherosclerotic risk factors to identify firefighters at increased risk for cardiovascular disease. Am J Cardiol 2014; 113:1499-504. [PMID: 24630792 DOI: 10.1016/j.amjcard.2014.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/04/2014] [Accepted: 02/04/2014] [Indexed: 01/20/2023]
Abstract
Cardiovascular disease (CVD) accounts for 45% of deaths in on-duty firefighters, in contrast to 15% of all deaths occurring on conventional jobs. Therefore, with the goal of developing a tailored prevention program, we assessed CVD risk in a cohort of 50 firefighters using imaging and traditional risk factors. Participants were aged ≥40 years without a history of CVD or diabetes. CVD risk was assessed by way of history, physical examination, blood tests, risk scores, coronary artery calcium (CAC), and carotid intima-media thickness (cIMT). Median age was 46 years; 90% of subjects were men, 92% were white, and 30% were former smokers. Only 4% of subjects were hypertensive but 48% were prehypertensive. Only 14% of subjects had a normal body mass index; 38% were overweight, 48% were obese, and 46% had a high waist circumference. Based on fasting glucose ≥100 mg/dl or hemoglobin A1c ≥5.6%, 50% of subjects had prediabetes and 2% had diabetes. Median total cholesterol was 196 mg/dl; median high-sensitivity C-reactive protein was 1.0 mg/L. CAC was detected in 22% of subjects and carotid plaque was detected in 36%. Using standard reference databases, 54% of subjects had cIMT greater than the seventy-fifth percentile; 66% had carotid plaque and/or cIMT greater than the seventy-fifth percentile. Atherogenic lipoprotein markers and risk scores did not differ between firefighters who had subclinical atherosclerosis and those who did not. Traditional CVD risk assessment does not adequately identify at-risk firefighters. In contrast, CAC and cIMT were useful for identifying increased risk and implementing primary prevention. In conclusion, early detection and integration of imaging with traditional risk assessment will be important in preventing premature death and disability among firefighters.
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21
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Normative and mean carotid intima-media thickness values according to metabolic syndrome in Koreans: The Namwon Study. Atherosclerosis 2014; 234:230-6. [DOI: 10.1016/j.atherosclerosis.2014.02.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 02/05/2014] [Accepted: 02/25/2014] [Indexed: 10/25/2022]
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Mahmoud MZ. Sonography of common carotid arteries' intima: media thickness in the normal adult population in Sudan. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:88-94. [PMID: 23641368 PMCID: PMC3624725 DOI: 10.4103/1947-2714.107523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background: Carotid ultrasonography is a useful diagnostic tool for assessing carotid disease. It is highly reliable, has no radiation risk, and has no risks when compared to conventional angiography. Aim: The study was to determine the common carotid artery (CCA) intima–media thickness (IMT) in the normal adult Sudanese so as to create standards for defining abnormalities. Materials and Methods: In 440 participants, the intima–media thickness was obtained sonographically in the supine position at the point of 1 cm section distal to the carotid bulb. Due to ethnic variations, participants were divided into a five ethnic groups according to their geographic distribution in Sudan. Results: The ranges of IMT found in the study were from 0.04 cm to 0.07 cm in carotids. Ethnically, males and females from West and East of Sudan show the highest IMT (0.070 ± 0.00 cm and 0.065 ± 0.01 cm) for CCA while males and females from the South of Sudan show the lowest IMT (0.055 ± 0.01 cm and 0.058 ± 0.004 cm). Conclusion: Mean carotids’ IMT was slightly higher in females compared to males. No significant differences were found between IMT and different ethnics but significance was noted among participants’ age and IMT of both sexes.
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Affiliation(s)
- Mustafa Z Mahmoud
- Department of Radiology and Medical Imaging, Salman bin Abdulaziz University, College of Applied Medical Science, Al-Kharj, Kingdom of Saudi Arabia, Sudan ; Department of Fundamental Medical Radiologic Sciences, Sudan University of Science and Technology, College of Medical Radiological Science, Khartoum, Sudan
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Oh BH, Kaligis RWM, Wang Y, Punzalan FER, Suwanwela NC, Nguyen VL, Lee TH, Sim KH, Itoh Y, Bahadur N, Leong J. Survey of atherosclerotic disease in Asian subjects with cardiovascular disease risk factors who were not receiving lipid-lowering agents. Int J Cardiol 2013; 168:2761-6. [PMID: 23618432 DOI: 10.1016/j.ijcard.2013.03.132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 03/19/2013] [Accepted: 03/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Carotid intima media thickness (CIMT) is a surrogate marker for atherosclerosis, used to identify asymptomatic individuals at increased risk of cardiovascular events. The primary objective of this study was to obtain the distribution of CIMT measurements in Asian individuals with cardiovascular disease (CVD) risk factors who were not receiving lipid-lowering agents. METHODS Mean CIMT based on ultrasonographic measurement of 12 sites within the common carotid artery was recorded for 2726 subjects across eight Asian countries who had two or more CVD risk factors but were not receiving lipid-lowering therapy. CVD risk factors and lipid and glucose profiles were analyzed with respect to distribution of CIMT and high-sensitivity C-reactive protein (hs-CRP) values. RESULTS The overall mean (SD) of mean CIMT (mean-mean CIMT) was 0.662 (0.16) mm. There was a significant variation in mean-mean CIMT across countries (P<0.0001). Mean-mean CIMT values (mm) by age were: 0.485, 0.527, 0.614, 0.665, 0.715 and 0.797 for ≤ 29, 30-39, 40-49, 50-59, 60-69 and ≥ 70 years, respectively. Multivariate analyses confirmed a significant association between increasing mean-mean CIMT and increasing age, male gender, low high-density lipoprotein-cholesterol (HDL-C) levels and elevated fasting blood glucose levels. Analysis of log-transformed hs-CRP levels showed significant association with increasing waist circumference, low-density lipoprotein-cholesterol, body-mass index, high blood glucose levels and low HDL-C. CONCLUSIONS Our data show normative mean-mean CIMT data for Asian subjects with two or more CVD risk factors who are not receiving lipid-lowering therapy, which may guide CVD risk-stratification of asymptomatic individuals in Asia.
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Affiliation(s)
- Byung-Hee Oh
- Seoul National University Hospital, Seoul, Republic of Korea.
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Engelen L, Ferreira I, Stehouwer CD, Boutouyrie P, Laurent S. Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors. Eur Heart J 2012. [PMID: 23186808 DOI: 10.1093/eurheartj/ehs380] [Citation(s) in RCA: 189] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIMS Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures. METHODS AND RESULTS We combined CCIMT data obtained by echotracking on 24 871 individuals (53% men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n = 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference sub-populations, thereby allowing for a standardized comparison between observed and predicted ('normal') values from individuals of the same age and sex. In the sub-population without CVD and treatment (n = 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized βs 0.19 (95% CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)]. CONCLUSION We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CV-RFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings.
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Affiliation(s)
- Lian Engelen
- Department of Pharmacology and INSERM U970, Hôpital Européen Georges Pompidou, Paris, France
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