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Humayra S, Yahya N, Ning CJ, Raffali MAAFBM, Mir IA, Mohamed AL, Manan HA. Relationship between carotid intima-media thickness and white matter hyperintensities in non-stroke adults: a systematic review. Front Neuroanat 2024; 18:1394766. [PMID: 38903057 PMCID: PMC11188707 DOI: 10.3389/fnana.2024.1394766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction Literature suggests a common pathophysiological ground between carotid atherosclerosis (CAS) and white matter alterations in the brain. However, the association between carotid intima-media thickness (CIMT) and white matter hyperintensities (WMH) has not been conclusively reported. The current systematic review explores and reports the relationship between CIMT and WMH among asymptomatic/non-stroke adults. Methods A recent literature search on PubMed, SCOPUS, and Web of Science databases was conducted in compliance with the PRISMA protocol. The pre-defined Population-Intervention-Comparison-Outcome-Study (PICOS) criteria included observational studies investigating the CIMT-WMH association among non-stroke adults undergoing magnetic resonance imaging and carotid ultrasound. Results Out of 255 potential results, 32 studies were critically assessed for selection, and finally, 10 articles were included, comprising 5,116 patients (females = 60.2%; males = 39.8%) aged between 36-71 years. The included studies earned high quality ratings (6-9) based on the Newcastle-Ottawa-Scale criteria. Qualitative synthesis showed a significantly parallel relationship between increased CIMT and greater WMH burden in 50% of the studies. In addition, significant risk factors related to the CIMT-WMH association included older age, hypertension, depression, migraine, Hispanic ethnicity, and apolipoprotein E (ɛ4) in postmenopausal women. Conclusion Overall, the cumulative evidence showed a consistent CIMT-WMH association in asymptomatic middle-aged and older non-stroke adults, indicating that CAS may contribute to the progression of pathologically hyperintense white matter in the brain. However, further research is warranted to infer the plausible relationship between CIMT and WMH in the absence of stroke.
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Affiliation(s)
- Syeda Humayra
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Program, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chai Jia Ning
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (UKM Specialist Children’s Hospital), Universiti Kebangsaan Malaysia, Malaysia
| | | | - Imtiyaz Ali Mir
- Department of Physiotherapy, M Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Malaysia
| | | | - Hanani Abdul Manan
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (UKM Specialist Children’s Hospital), Universiti Kebangsaan Malaysia, Malaysia
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Alizargar J, Bai CH. Value of the arterial stiffness index and ankle brachial index in subclinical atherosclerosis screening in healthy community-dwelling individuals. BMC Public Health 2019; 19:65. [PMID: 30646893 PMCID: PMC6332638 DOI: 10.1186/s12889-019-6398-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 01/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Carotid intima media thickness (cIMT) and the carotid plaque score (cPS) are valid markers for detecting subclinical atherosclerosis. Evaluation of ASI and ABI for detection of atherosclerosis is assessed in this study. Finding a model to see which individual has a risk of having atherosclerosis, so those people can be further assessed by invasive but more accurate atherosclerosis detection methods like angiography is another objective of this study. METHODS Data of 212 healthy community-dwelling subjects, consisting of carotid duplex records, ASI and ABI measurements, certain laboratory tests, and related cardiovascular disease (CVD) risks were analyzed for correlations. RESULTS The ABI was independently associated with high cPS. Age, hypertension and Waist circumference are determinants of subclinical atherosclerosis as in high cIMT and high cPS. CONCLUSIONS The use of the ASI cannot replace carotid ultrasound in detecting subclinical atherosclerosis because it is not independently associated with high cIMT and cPS while ABI can be used in detection of high cPS in healthy community-dwelling individuals. Public health policies to encourage weight reduction and treating hypertension can help prevention of subclinical atherosclerosis in healthy community-dwelling individuals. Models consist of age, body compositions like waist circumference and hypertension history can be used in further assessment of atherosclerosis.
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Affiliation(s)
- Javad Alizargar
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 11031 Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 11031 Taiwan
- Department of Public Health, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 11031 Taiwan
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Kucuk A, Uğur Uslu A, Icli A, Cure E, Arslan S, Turkmen K, Toker A, Kayrak M. The LDL/HDL ratio and atherosclerosis in ankylosing spondylitis. Z Rheumatol 2017; 76:58-63. [PMID: 27312464 DOI: 10.1007/s00393-016-0092-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES In ankylosing spondylitis (AS) patients, cardiac and vascular involvement may manifest as atherosclerosis and coronary artery disease. Systemic inflammation, oxidative stress, increased low-density lipoprotein (LDL) cholesterol and decreased high-density lipoprotein (HDL) cholesterol constitute a significant risk for atherosclerosis. This study investigated the relationship between carotid intima-media thickness (CIMT), LDL/HDL ratio, total oxidant status (TOS; an indicator of oxidative stress) and ischemic modified albumin (IMA; an ischemic marker in AS patients). PATIENTS AND METHODS Sixty AS patients were diagnosed using the Modified New York Criteria; 54 age- and gender-matched participants were included as controls. CIMT, LDL/HDL ratio, TOS and IMA were measured using the most appropriate methods. RESULTS IMA was higher in AS patients compared to controls (p < 0.0001). TOS was also increased in AS patients (p = 0.005); as was CIMT (p < 0.0001). The LDL/HDL ratio was also greater in AS patients compared to controls (p = 0.047). A positive correlation was found between CIMT and LDL/HDL ratio among AS patients. CONCLUSION Elevated CIMT, IMA and TOS levels suggest an increased risk of atherosclerotic heart disease in AS patients. The LDL/HDL ratio was higher in AS patients compared to controls, and there was a correlation between LDL/HDL ratio and CIMT, albeit statistically weak. Therefore, the LDL/HDL ratio is not a reliable marker to predict atherosclerotic heart disease in AS patients.
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Affiliation(s)
- A Kucuk
- Division of Rheumatology, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
| | - A Uğur Uslu
- Eskişehir Military Hospital, Eskisehir, Rize, Turkey
| | - A Icli
- Necmettin Erbakan University, Konya, Turkey
| | - E Cure
- Recep Tayyip Erdogan University, Rize, Turkey
| | - S Arslan
- Necmettin Erbakan University, Konya, Turkey
| | - K Turkmen
- Necmettin Erbakan University, Konya, Turkey
| | - A Toker
- Necmettin Erbakan University, Konya, Turkey
| | - M Kayrak
- Necmettin Erbakan University, Konya, Turkey
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Kucuk A, Uğur Uslu A, Icli A, Cure E, Arslan S, Turkmen K, Toker A, Kayrak M. The LDL/HDL ratio and atherosclerosis in ankylosing spondylitis. Z Rheumatol 2016. [PMID: 27312464 DOI: 10.1007/s00393-016-0092-4.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES In ankylosing spondylitis (AS) patients, cardiac and vascular involvement may manifest as atherosclerosis and coronary artery disease. Systemic inflammation, oxidative stress, increased low-density lipoprotein (LDL) cholesterol and decreased high-density lipoprotein (HDL) cholesterol constitute a significant risk for atherosclerosis. This study investigated the relationship between carotid intima-media thickness (CIMT), LDL/HDL ratio, total oxidant status (TOS; an indicator of oxidative stress) and ischemic modified albumin (IMA; an ischemic marker in AS patients). PATIENTS AND METHODS Sixty AS patients were diagnosed using the Modified New York Criteria; 54 age- and gender-matched participants were included as controls. CIMT, LDL/HDL ratio, TOS and IMA were measured using the most appropriate methods. RESULTS IMA was higher in AS patients compared to controls (p < 0.0001). TOS was also increased in AS patients (p = 0.005); as was CIMT (p < 0.0001). The LDL/HDL ratio was also greater in AS patients compared to controls (p = 0.047). A positive correlation was found between CIMT and LDL/HDL ratio among AS patients. CONCLUSION Elevated CIMT, IMA and TOS levels suggest an increased risk of atherosclerotic heart disease in AS patients. The LDL/HDL ratio was higher in AS patients compared to controls, and there was a correlation between LDL/HDL ratio and CIMT, albeit statistically weak. Therefore, the LDL/HDL ratio is not a reliable marker to predict atherosclerotic heart disease in AS patients.
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Affiliation(s)
- A Kucuk
- Division of Rheumatology, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
| | - A Uğur Uslu
- Eskişehir Military Hospital, Eskisehir, Rize, Turkey
| | - A Icli
- Necmettin Erbakan University, Konya, Turkey
| | - E Cure
- Recep Tayyip Erdogan University, Rize, Turkey
| | - S Arslan
- Necmettin Erbakan University, Konya, Turkey
| | - K Turkmen
- Necmettin Erbakan University, Konya, Turkey
| | - A Toker
- Necmettin Erbakan University, Konya, Turkey
| | - M Kayrak
- Necmettin Erbakan University, Konya, Turkey
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Madisetty MK, Kumaraswami K, Katkam S, Saumya K, Satyanarayana Raju Y, Chandra N, Jyotsna M, Patnaik S, Kutala VK. Assessment of Oxidative Stress Markers and Carotid Artery Intima-Media Thickness in Elderly Patients Without and with Coronary Artery Disease. Indian J Clin Biochem 2015; 31:278-85. [PMID: 27382198 DOI: 10.1007/s12291-015-0530-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/21/2015] [Indexed: 11/26/2022]
Abstract
We aimed to assess whether measuring carotid intima-media thickness (CIMT) and oxidative stress markers such as protein carbonyls, malondialdehyde, nitrate and glutathione in plasma of elderly patients without and with coronary artery disease (CAD) identifies early risk for CAD. A total of 50 cases with cardiovascular risk factors over the age of 60 years without CAD, and 50 patients with angiographically documented CAD over the age of 60 years were included in the study. Control group consists of 200 healthy individuals without the risk factors. Demographic details were obtained from all the subjects and CIMT measured by high frequency ultrasound and oxidative stress markers such protein carbonyls, malondialdehyde and total glutathione were determined in plasma by spectrophotometric methods. The distribution of cardiovascular risk factors in without CAD and CAD cases were smokers (16 vs 56 %), hypertension (26 vs 64 %), diabetes (16 vs 56 %) and dyslipidemia (18 vs 58 %) and positive family history (4 vs 38 %). None of the control group had any cardiovascular risk factors. Among the CAD cases, 16 % had single vessel disease, 44 % had double vessel disease and 40 % had triple vessel disease. The CIMT was significantly increased in CAD cases as compared to cases without CAD and healthy controls. On the other hand, CIMT was significantly increased in cases without CAD as compared to healthy controls. CIMT also increased with the duration of diabetes in patients without CAD and severity of disease in CAD cases. The levels of oxidants like plasma malondialdehyde, protein carbonyls, were significantly elevated and antioxidant glutathione levels and nitrate levels were significantly reduced in cases with and without CAD as compared to healthy controls. Oxidative stress markers and CIMT was found to be significantly increased in patients with cardiovascular risk factors like diabetes, family history of CAD, dyslipidemia, hypertension and smoking when compared to patients without risk factors. In patients with diabetes, CIMT increased as duration of disease increases and also in poorly controlled diabetes. In CAD group, when number of vessel involvement (severity of coronary disease) increases, the CIMT also increases confirming that CIMT is a quantifiable risk factor for CAD.
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Affiliation(s)
- Murali Krishna Madisetty
- Department of General Medicine, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 500082 India
| | - Konda Kumaraswami
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, 500082 India
| | - Shivakrishna Katkam
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, 500082 India
| | - Kankanala Saumya
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, 500082 India
| | - Y Satyanarayana Raju
- Department of General Medicine, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 500082 India
| | - Naval Chandra
- Department of General Medicine, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 500082 India
| | - Maddury Jyotsna
- Department of Cardiology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 500082 India
| | - Sujatha Patnaik
- Department of Radiology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 500082 India
| | - Vijay Kumar Kutala
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, 500082 India
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