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Li B, Zhou X, Liu Y, Zhang Y, Mu Y. Remnant Cholesterol is More Strongly Associated with Arterial Stiffness than Traditional Lipids and Lipid Ratios in the General Chinese Population. J Atheroscler Thromb 2024; 31:587-602. [PMID: 38171806 PMCID: PMC11079499 DOI: 10.5551/jat.64146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 10/22/2023] [Indexed: 01/05/2024] Open
Abstract
AIM Studies on the relationship between remnant cholesterol (RC) and arterial stiffness (AS) are limited. This study aims to investigate the relationship between RC and AS and to explore RC, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), non-HDL-C, LDL-C/HDL-C, TG/HDL-C, lipoprotein combine index (LCI), and TC/HDL-C, which are lipid parameters most strongly associated with AS. METHODS A total of 4653 participants from the REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals) study were recruited. AS was defined as a brachial-ankle pulse wave velocity of ≥ 1400 cm/s. Multiple logistic regression analyses were performed to detect its association with lipid parameters (RC, TG, TC, HDL-C, LDL-C, non-HDL-C, LDL-C/HDL-C, TG/HDL-C, LCI, and TC/HDL-C). RESULTS Logistic regression analysis showed that compared with other traditional or non-traditional lipid parameters, the association between RC and AS was the strongest (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.30-1.95, P<0.001). In the stratified analysis, RC was significantly associated with AS in both sexes and at any age, as well as blood glucose, blood pressure, and body mass index levels. Besides, RC and AS were still significantly associated when TG<1.7 mmol/L (OR:1.58, 95% CI: 1.02-2.45, P=0.04), LDL-C <3.4 mmol/L (OR:1.32, 95% CI: 1.01-1.73, P=0.041), HDL-C ≥ 1.0 mmol/L (OR:1.67, 95% CI: 1.34-2.08, P<0.001), or non-HDL-C<4.1 mmol/L (OR: 1.42, 95% CI: 1.10-1.82, P=0.007) are controlled within the appropriate range. CONCLUSION In conclusion, compared with traditional lipids and lipid ratios, RC is more strongly associated with AS. The association between RC and AS remains significant even when TG, LDL-C, HDL-C, or non-HDL-C levels are controlled within the appropriate range.
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Affiliation(s)
- Binqi Li
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
| | - Xin Zhou
- Graduate School, Chinese PLA General Hospital, Beijing, China
- Department of Medical Oncology, Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China>
- The Second Medical Center of Chinese PLA General Hospital, Beijing, China>
| | - Yang Liu
- Department of Endocrinology, Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Yue Zhang
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
| | - Yiming Mu
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First medical center of PLA General Hospital, Beijing, China
- Graduate School, Chinese PLA General Hospital, Beijing, China
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Saiki A, Takahashi Y, Nakamura S, Yamaoka S, Abe K, Tanaka S, Watanabe Y, Yamaguchi T, Nagayama D, Ohira M, Oshiro T, Tatsuno I, Shirai K. Relationship between Lipoprotein Lipase Derived from Subcutaneous Adipose Tissue and Cardio-Ankle Vascular Index in Japanese Patients with Severe Obesity. Obes Facts 2024; 17:255-263. [PMID: 38342095 PMCID: PMC11149971 DOI: 10.1159/000537687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/24/2024] [Indexed: 02/13/2024] Open
Abstract
INTRODUCTION Cardio-ankle vascular index (CAVI) is an arterial stiffness index that correlates inversely with body mass index (BMI) and subcutaneous fat area. Lipoprotein lipase (LPL) that catalyzes the hydrolysis of serum triglycerides is produced mainly in adipocytes. Serum LPL mass reflects LPL expression in adipose tissue, and its changes correlate inversely with changes in CAVI. We hypothesized that LPL derived from subcutaneous adipose tissue (SAT) suppresses the progression of arteriosclerosis and examined the relationship of LPL gene expression in different adipose tissues and serum LPL mass with CAVI in Japanese patients with severe obesity undergoing laparoscopic sleeve gastrectomy (LSG). METHODS This study was a single-center retrospective database analysis. Fifty Japanese patients who underwent LSG and had 1-year postoperative follow-up data were enrolled (mean age 47.5 years, baseline BMI 46.6 kg/m2, baseline HbA1c 6.7%). SAT and visceral adipose tissue (VAT) samples were obtained during LSG surgery. LPL gene expression was analyzed by real-time PCR. Serum LPL mass was measured by ELISA using a specific monoclonal antibody against LPL. RESULTS At baseline, LPL mRNA expression in SAT correlated positively with serum LPL mass, but LPL mRNA expression in VAT did not. LPL mRNA expression in SAT was correlated, and serum LPL mass tended to correlate inversely with the number of metabolic syndrome symptoms, but LPL mRNA expression in VAT did not. LPL mRNA expression in SAT and CAVI tended to correlate inversely in the group with visceral-to-subcutaneous fat ratio of 0.4 or higher, which is considered metabolically severe. Serum LPL mass increased 1 year after LSG. Change in serum LPL mass at 1 year after LSG tended to be an independent factor inversely associated with change in CAVI. CONCLUSIONS Serum LPL mass reflected LPL mRNA expression in SAT in Japanese patients with severe obesity, and LPL mRNA expression in SAT was associated with CAVI in patients with visceral obesity. The change in serum LPL mass after LSG tended to independently contribute inversely to the change in CAVI. This study suggests that LPL derived from SAT may suppress the progression of arteriosclerosis.
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Affiliation(s)
- Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Yuka Takahashi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Shoko Nakamura
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Shuhei Yamaoka
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Kazuki Abe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Sho Tanaka
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Daiji Nagayama
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Nagayama Clinic, Tochigi, Japan
| | - Masahiro Ohira
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Takashi Oshiro
- Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Kohji Shirai
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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Nagayama D, Krakauer JC, Krakauer NY, Sugiura T, Watanabe Y, Shimizu K, Saiki A, Suzuki K, Fujishiro K, Shirai K. Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study. J Atheroscler Thromb 2023; 30:1870-1881. [PMID: 37197950 DOI: 10.5551/jat.64221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
AIM To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness. METHODS Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0. RESULTS Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (Rs: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (Rs: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks. CONCLUSION Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | | | - Nir Y Krakauer
- Department of Civil Engineering, City College of New York
| | | | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Kazuhiro Shimizu
- Division of Cardiovascular Medicine, Toho University, Sakura Medical Center
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Kenji Suzuki
- Research and Development Division, Japan Health Promotion Foundation
| | - Kentaro Fujishiro
- Research and Development Division, Japan Health Promotion Foundation
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital
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Nagayama D, Watanabe Y, Yamaguchi T, Fujishiro K, Suzuki K, Shirai K, Saiki A. Relationship of serum lipid parameters with kidney function decline accompanied by systemic arterial stiffness: a retrospective cohort study. Clin Kidney J 2023; 16:2289-2298. [PMID: 37915913 PMCID: PMC10616449 DOI: 10.1093/ckj/sfad131] [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: 03/29/2023] [Indexed: 11/03/2023] Open
Abstract
Background Dyslipidemia is associated with kidney function decline (KFD), although the non-linear relationship of lipid parameters to KFD has not been fully elucidated. We aimed to determine the detailed relationship of baseline lipid parameters with KFD, considering the mediation of arterial stiffness. Methods A total of 27 864 urban residents with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 at baseline, who participated in a median of three (range two to eight) consecutive annual health examinations were studied. Arterial stiffness was assessed by cardio-ankle vascular index (CAVI). KFD was defined as development of eGFR <60 mL/min/1.73 m2. Results During the study period, 1837 participants (6.6%) developed KFD. Receiver operating characteristic analysis determined that the cutoff values independently associated with KFD are 123 mg/dL for low-density lipoprotein cholesterol (LDL-C) [area under the curve (95% confidence interval) 0.570 (0.557-0.583)], 65 mg/dL for high-density lipoprotein cholesterol (HDL-C) [0.552 (0.539-0.566)], 82 mg/dL for triglycerides (TG) [0.606 (0.593-0.618)] and 1.28 for TG/HDL-C ratio [0.600 (0.587-0.612)]. These cut-offs were independently associated with KFD in Cox analysis. Regarding the contribution of each lipid parameter to KFD, a linear relationship was observed for both TG and TG/HDL-C, and a U-shaped relationship for HDL-C. A adjusted mediating effect of CAVI on the relationship of TG or TG/HDL-C ratio with KFD was observed (mediating rate: 2.9% in TG, 2.5% in TG/HDL-C ratio). Regarding the association to KFD, a linear relationship was observed for both TG and TG/HDL-C, and a U-shaped relationship for HDL-C. A mediating effect of CAVI on the relationship of TG or TG/HDL-C ratio with KFD was observed after adjustment for confounders. Conclusions TG and TG/HDL-C ratio related linearly to KFD and this was partially mediated by CAVI. A U-shaped relationship was observed between HDL-C and KFD risk. LDL-C showed no significant association. Further study should investigate whether intensive TG-lowering treatment prevents KFD via decreasing CAVI.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Oyama, Tochigi, Japan
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Sakura, Chiba, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Sakura, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Sakura, Chiba, Japan
| | | | - Kenji Suzuki
- Japan Health Promotion Foundation, Shibuya-Ku, Tokyo, Japan
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Chiba, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Sakura, Chiba, Japan
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Xuereb RA, Magri CJ, Xuereb RG. Arterial Stiffness and its Impact on Cardiovascular Health. Curr Cardiol Rep 2023; 25:1337-1349. [PMID: 37676581 DOI: 10.1007/s11886-023-01951-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular diseases are the leading cause of mortality globally. Identifying patients at risk is important to initiate preventive strategies. Over the last few decades, the role of the endothelium and its impact on arterial stiffness have been recognised as playing a pivotal role in cardiovascular disease. This review will focus on the effect of arterial stiffness in different patient cohorts with regard to cardiovascular morbidity and mortality, as well as its use in clinical practice. RECENT FINDINGS Arterial stiffness is associated with a range of cardiovascular risk factors and is an independent predictor of cardiovascular mortality. The gold standard for evaluating arterial stiffness is pulse wave velocity. Recently, cardio-ankle vascular index has been implemented as an easy and highly reproducible measure of arterial stiffness. Moreover, certain pharmacologic agents may modify arterial stiffness and alter progression of cardiovascular disease. The endothelium plays an important role in cardiovascular disease. Implementing assessment of arterial stiffness in clinical practice will improve stratification of patients at risk of cardiovascular disease and help modify disease progression.
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Affiliation(s)
| | - Caroline J Magri
- Department of Cardiology, Mater Dei Hospital, Msida, Malta
- University of Malta, Msida, Malta
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Hung T, Jhan JY, Lin JH, Yang KT, Hsu BG, Chang JC. Serum Malondialdehyde-Oxidized Low-Density Lipoprotein Level Is Associated with Arterial Stiffness by Cardio-Ankle Vascular Index in Coronary Artery Bypass Graft Patients. J Clin Med 2023; 12:4191. [PMID: 37445227 DOI: 10.3390/jcm12134191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/29/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023] Open
Abstract
A high malondialdehyde-oxidized low-density lipoprotein (MDA-oxLDL) level is associated with atherosclerotic cardiovascular diseases and major adverse cardiovascular events. A higher cardio-ankle vascular index (CAVI) is independently associated with an increased risk of cardiovascular events, cardiovascular mortality, myocardial infarction, and stroke in patients with cardiovascular risk. Thus, this study aimed to evaluate the relationship between serum MDA-oxLDL levels and CAVI in patients with triple-vessel coronary artery disease who underwent coronary artery bypass graft (CABG) surgery. Fasting blood samples and baseline characteristics were obtained from 88 patients who had undergone CABG. A commercialized enzyme-linked immunosorbent assay was used to measure MDA-oxLDL levels. An automatic pulse wave analyzer was used to measure CAVI values, and each side of CAVI values of ≥9 was designated as arterial stiffness. In total, 47 participants were assigned to the arterial stiffness group. More patients had diabetes mellitus, were older, and had higher serum MDA-oxLDL levels in the arterial stiffness group than in the control group. A multivariate logistic regression analysis disclosed that MDA-oxLDL and diabetes mellitus were independent predictors of arterial stiffness. Moreover, according to the Spearman's correlation analysis, the serum MDA-oxLDL level was positively associated with both left and right CAVI. Serum MDA-oxLDL levels were positively associated with arterial stiffness in patients who had undergone CABG.
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Affiliation(s)
- Ting Hung
- Division of Cardiovascular Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
| | - Jin-You Jhan
- Division of Cardiovascular Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
| | - Jian-Hong Lin
- Division of Experimental Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
| | - Kun-Ta Yang
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Bang-Gee Hsu
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Division of Nephrology, Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
| | - Jui-Chih Chang
- Division of Cardiovascular Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
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The Correlation of Arterial Stiffness Parameters with Aging and Comorbidity Burden. J Clin Med 2022; 11:jcm11195761. [PMID: 36233629 PMCID: PMC9572768 DOI: 10.3390/jcm11195761] [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: 07/22/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of the study was to evaluate the relationships between carotid-femoral pulse wave velocity (PVW-cf), cardio-ankle vascular index (CAVI) and CAVI0 (which is a mathematical elaboration of CAVI, theoretically less dependent on blood pressure), age and comorbidity burden. Furthermore, 183 patients (119 female, mean age 67.5 ± 14.3 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included; demographic, clinical and blood analysis data were collected. Charlson Comorbidity Index (CCI), PVW-cf, CAVI and CAVI 0 were obtained. Significant correlations were found between CAVI, CAVI0, PVW-cf and both age (r = 0.698, r = 0.717, r = 0.410, respectively p < 0.001 for all) and CCI, (r = 0.654; r = 0.658; r = 0.448 respectively and p < 0.001 for all), still significant after adjustment for several variables. In a stepwise multiple regression model, considering several variables, CCI was the only predictor of PWV-cf, whereas age and CCI were significant predictors of both CAVI and CAVI 0. In conclusion, all arterial stiffness indexes are associated with CCI and aging; the latter correlation is more evident for CAVI and CAVI 0 than for PVW-cf. Arterial stiffness parameters can complement the characterization of patients affected by a remarkable comorbidity burden across aging; arterial stiffening might mirror the complexity of these individuals.
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Nagayama D, Sugiura T, Choi SY, Shirai K. Various Obesity Indices and Arterial Function Evaluated with CAVI - Is Waist Circumference Adequate to Define Metabolic Syndrome? Vasc Health Risk Manag 2022; 18:721-733. [PMID: 36120718 PMCID: PMC9480599 DOI: 10.2147/vhrm.s378288] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
Obesity has been known to relate to various diseases and metabolic disorders. Since the implication of body shape has been mentioned, obesity can be divided into visceral obesity and subcutaneous obesity. The former is considered the upstream pathophysiology of metabolic syndrome (MetS), and has been emphasized worldwide for the prevention of cardiovascular diseases in the last quarter century. However, some prospective studies have shown that cardiovascular mortality and morbidity are not necessarily higher in patients with MetS compared to those without. Recently, cardio-ankle vascular index (CAVI) has been established as an indicator of arteriosclerosis. This parameter is independent of blood pressure at the measuring time, and reflects systemic arterial stiffness from the aortic origin to the ankle. However, since CAVI is not necessarily high in MetS patients, attempts have been made to clarify this unexpected phenomenon. In several studies, CAVI was found to correlate negatively with body mass index (BMI), and also with waist circumference (WC) which is a widely used representative visceral obesity index. On the other hand, a body shape index (ABSI) is also a visceral obesity index designed to be minimally associated with BMI, and is calculated by dividing WC by an allometric regression of weight and height. Replacing high WC with high ABSI in MetS diagnosis promoted the identification of MetS patients with increased CAVI in cross-sectional studies on Japanese and Korean populations. Additionally, the incidence of MetS diagnosed using high ABSI was associated with significant increase in CAVI after 1 year of observation. Enhanced predictive ability for renal function decline by replacing WC with ABSI in MetS diagnosis was also observed in a longitudinal study in Japanese urban residents. These findings suggest that MetS diagnosis using high ABSI instead of high WC as a visceral obesity index needs to be reconsidered. However, further research is desirable on Caucasian, whose body shape differs slightly from that of Asians.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan.,Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Su-Yeon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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Starzak M, Stanek A, Jakubiak GK, Cholewka A, Cieślar G. Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610368. [PMID: 36012003 PMCID: PMC9407885 DOI: 10.3390/ijerph191610368] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 05/07/2023]
Abstract
Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of the diagnostic criteria, making it difficult to conduct scientific discourse in this area. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. The purpose of this paper is to present the results of the review of the literature concerning the relationship between MS and its components, and AS assessed by PWV, including clinical usefulness of PWV measurement in patients with MS and its components.
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Affiliation(s)
- Monika Starzak
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Specialistic Hospital No. 2 in Bytom, Batorego 15 St., 41-902 Bytom, Poland
| | - Agata Stanek
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
- Correspondence: or
| | - Grzegorz K. Jakubiak
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
| | - Armand Cholewka
- Faculty of Science and Technology, University of Silesia, Bankowa 12 St., 40-007 Katowice, Poland
| | - Grzegorz Cieślar
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
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Nagayama D, Fujishiro K, Nakamura K, Watanabe Y, Yamaguchi T, Suzuki K, Shimizu K, Saiki A, Shirai K. Cardio-Ankle Vascular Index is Associated with Prevalence and New-Appearance of Atrial Fibrillation in Japanese Urban Residents: A Retrospective Cross-Sectional and Cohort Study. Vasc Health Risk Manag 2022; 18:5-15. [PMID: 35140470 PMCID: PMC8819161 DOI: 10.2147/vhrm.s351602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/14/2022] [Indexed: 12/17/2022] Open
Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
- Correspondence: Daiji Nagayama, Nagayama Clinic, 2-12-22, Tenjin-Cho, Oyama-City, Tochigi, 323-0032, Japan, Tel/Fax +81-285-22-0219, Email
| | | | - Keijiro Nakamura
- Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Tokyo, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Kazuhiro Shimizu
- Division of Cardiovascular Medicine, Toho University, Sakura Medical Center, Chiba, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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11
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Nagayama D, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Fujishiro K, Shirai K. Issue of Waist Circumference for the Diagnosis of Metabolic Syndrome Regarding Arterial Stiffness: Possible Utility of a Body Shape Index in Middle-Aged Nonobese Japanese Urban Residents Receiving Health Screening. Obes Facts 2022; 15:160-169. [PMID: 35008086 PMCID: PMC9021625 DOI: 10.1159/000520418] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. This cross-sectional study aimed to clarify whether replacing WC with "A Body Shape Index (ABSI)," an abdominal obesity index, in MetS diagnosis detects individuals with arterial stiffening assessed by cardio-ankle vascular index (CAVI). METHODS A retrospective cross-sectional study was conducted in 46,872 Japanese urban residents (median age 40 years) who underwent health screening. Exclusion criteria were current treatments and a past history of cardiovascular disease (CVD). The Japanese, International Diabetes Federation, and NCEP-ATPIII criteria were used to diagnose MetS. High CAVI was defined as CAVI ≥9.0. RESULTS CAVI correlated positively with ABSI (β = 0.127), but negatively with WC (β = -0.186), independent of age, sex, systolic blood pressure, fasting plasma glucose, and high-density lipoprotein--cholesterol. Receiver operating characteristic (ROC) analysis showed that ABSI had a stronger contribution to high CAVI (area under the ROC curve [AUC] = 0.730) than WC (AUC = 0.595) and body mass index (AUC = 0.520). ABSI ≥0.080 was defined as abdominal obesity based on the results of ROC analysis for high CAVI and estimated glomerular filtration rate <60 mL/min/1.73 m2. Logistic regression analysis revealed that replacing high WC with ABSI ≥0.080 in MetS diagnosis enhanced the detection of subjects with high CAVI. DISCUSSION/CONCLUSION Use of ABSI can detect subjects with arterial stiffening, which may lead to efficient stratification of CVD risk. Further studies are needed to confirm whether MetS diagnosis using ABSI predicts CVD morbidity and mortality.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
- *Daiji Nagayama,
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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12
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Sekizuka H, Hoshide S, Kabutoya T, Kario K. Determining the Relationship between Triglycerides and Arterial Stiffness in Cardiovascular Risk Patients Without Low-Density Lipoprotein Cholesterol-Lowering Therapy. Int Heart J 2021; 62:1320-1327. [PMID: 34853225 DOI: 10.1536/ihj.21-309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Data examining the relationship between arterial stiffness and triglyceride (TG) and other cardiovascular risk factors have remained to be sparse.Of the 5,109 patients with any cardiovascular risk factors in the Cardiovascular Prognostic Coupling Study in Japan (the Coupling Registry), the data of 1,534 patients who had no history of cardiovascular disease and were without low-density lipoprotein cholesterol (LDL-C) -lowering therapy (average age 67.9 ± 12.0 years, 55% males) were analyzed. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). Among the clinical and behavioral cardiovascular risk factors, the significant factors that constituted the CAVI value were smoking, diabetes, lower high-density lipoprotein cholesterol, and higher TG. After adjustment for age, sex, and body mass index (BMI), only TG (odds ratio [OR] per 1 standard deviation, 1.26 [95% confidence interval, 1.12-1.44]) and diabetes (OR, 1.52 [1.22-1.90]) were found to be associated with a risk of higher CAVI (≥ 9.0). TG (C-statistic, 0.80 [0.78-0.82]; P = 0.040) and diabetes (C-statistic, 0.80 [0.78-0.82]; P = 0.038) significantly improved the discrimination of the risk of a higher CAVI beyond the model that included age, sex, and BMI.TG was associated with a risk of arterial stiffness, and its contribution was slight but almost the same as that of diabetes among patients who had cardiovascular risk without a history of cardiovascular disease and LDL-C-lowering therapy.
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Affiliation(s)
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine
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13
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Nagayama D, Fujishiro K, Tsuda S, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Shirai K. Enhanced prediction of renal function decline by replacing waist circumference with "A Body Shape Index (ABSI)" in diagnosing metabolic syndrome: a retrospective cohort study in Japan. Int J Obes (Lond) 2021; 46:564-573. [PMID: 34824353 PMCID: PMC8872991 DOI: 10.1038/s41366-021-01026-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 11/09/2022]
Abstract
Background Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. Objective To examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline. Subjects/Methods In total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m2) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII. Results In Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis. Conclusion In this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, 2-12-22, Tenjin-cho, Oyama-city, Tochigi, 3230032, Japan. .,Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.
| | - Kentaro Fujishiro
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Shinichi Tsuda
- Fukuda Denshi Co., Ltd., 3-39-4, Hongo, Bunkyo-ku, Tokyo, 1130033, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kenji Suzuki
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kohji Shirai
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.,Department of Internal Medicine, Mihama Hospital, 1-1-5, Uchise, Mihama-ku, Chiba, 2610013, Japan
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14
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Ohira M, Tanaka S, Watanabe Y, Nakamura S, Oka R, Yamaguchi T, Ban N, Saiki A, Ishihara N, Murano T, Murase T, Nakamura T, Tatsuno I. Association of Plasma Xanthine Oxidoreductase with Arterial Stiffness in Type 2 Diabetes with Liver Dysfunction. Am J Med Sci 2021; 363:242-250. [PMID: 34619144 DOI: 10.1016/j.amjms.2021.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/24/2021] [Accepted: 09/30/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Type 2 diabetes is a risk factor for atherosclerosis. Oxidative stress, which is a causative factor in insulin resistance, leads to atherosclerosis in patients with diabetes. Xanthine oxidoreductase (XOR) is an enzyme that catalyzes the oxidation of hypoxanthine to xanthine and xanthine to uric acid and is related to oxidative stress. We aimed to examine the influence of plasma XOR activity on arterial stiffness in patients with type 2 diabetes. METHODS In total, 458 patients with type 2 diabetes not receiving antihyperuricemic agents were enrolled and their clinical parameters including plasma XOR activity and the cardio-ankle vascular index (CAVI) were measured. Patients were divided into the liver dysfunction and absence of liver dysfunction groups. Multiple regression analysis was performed. RESULTS The median plasma XOR activity level was 64.3 pmol/h/mL (33.3-147.3 pmol/h/mL). Plasma XOR activity was correlated significantly and positively with aspartate transaminase and alanine transaminase (ρ > 0.5). The level of plasma XOR activity in the liver dysfunction group was eight-fold higher than that in the absence of liver dysfunction group. A significant positive correlation was observed between plasma XOR activity and the CAVI only in the liver dysfunction group (ρ = 0.3968, P < 0.0043). Multiple regression models demonstrated that plasma XOR activity was an independent predictor of the CAVI in the liver dysfunction group (P = 0.0055). CONCLUSIONS Our results suggest that plasma XOR activity is associated with arterial stiffness and may have a role in atherosclerosis development in patients with type 2 diabetes and liver dysfunction.
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Affiliation(s)
- Masahiro Ohira
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
| | - Shou Tanaka
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
| | - Yasuhiro Watanabe
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
| | - Shoko Nakamura
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
| | - Rena Oka
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
| | - Takashi Yamaguchi
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
| | - Noriko Ban
- Department of Internal Medicine, Chiba Aoba Municipal Hospital, Chiba, Japan.
| | - Atsuhito Saiki
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
| | - Noriko Ishihara
- Clinical Laboratory Program, Faculty of Science, Toho University, Chiba, Japan.
| | - Takeyoshi Murano
- Clinical Laboratory Program, Faculty of Science, Toho University, Chiba, Japan.
| | - Takayo Murase
- Radioisotope and Chemical Analysis Center, Sanwa Kagaku Kenkyusho Co., Ltd., Mie, Japan,.
| | - Takashi Nakamura
- Pharmacological Study Group, Pharmaceutical Research Laboratories, Sanwa Kagaku Kenkyusho Co., Ltd., Mie, Japan.
| | - Ichiro Tatsuno
- Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan; Chiba Prefectural University of Health Sciences, Chiba, Japan.
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15
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Hitsumoto T. Clinical Significance of the Cardio-Ankle Vascular Index in Postmenopausal Women With Hypercholesterolemia. J Clin Med Res 2021; 13:276-282. [PMID: 34104279 PMCID: PMC8166294 DOI: 10.14740/jocmr4509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 05/04/2021] [Indexed: 12/21/2022] Open
Abstract
Background The cardio-ankle vascular index (CAVI) is a physiological indicator of arterial elasticity. However, limited information regarding the clinical significance of the CAVI in patients with hypercholesterolemia is available. This cross-sectional study aimed to elucidate the clinical significance of the CAVI for the primary prevention of cardiovascular disease (CVD) among postmenopausal women with hypercholesterolemia. Methods A total of 168 untreated postmenopausal hypercholesterolemic women (low-density lipoprotein cholesterol levels ≥ 140 mg/dL, mean age ± standard deviation, 63 ± 10 years) with no history of CVD events were enrolled. The CAVI was measured using commercial devices, after which, its relationships with various clinical parameters, such as carotid artery ultrasonography findings and CVD biomarkers, were examined. Results A significant positive correlation was observed between the CAVI and maximum intima-media thickness of the common carotid artery (max-C-IMT), which was evaluated using carotid artery ultrasonography (r = 0.49, P < 0.001). Regarding CVD biomarkers, the CAVI was significantly correlated with estimated glomerular filtration rate (r = -0.18, P < 0.001), high-sensitivity C-reactive protein (r = 0.36, P < 0.001), whole blood passage time as a marker of blood rheology (r = 0.41, P < 0.001), and skin autofluorescence as a marker of advanced glycation end products in tissues (r = 0.46, P < 0.001), although no significant correlation was noted between serum lipid parameters and the CAVI. Multiple regression analysis identified max-C-IMT (β = 0.35, P < 0.001), whole blood passage time (β = 0.18, P = 0.007), skin autofluorescence (β = 0.17, P = 0.011), and age (β = 0.16, P = 0.018) as variables independently associated with CAVI. Conclusion The present study indicated that the CAVI is an essential CVD risk factor among postmenopausal women with hypercholesterolemia. Moreover, impaired blood rheology and increase of skin autofluorescence were associated with elevated CAVI in such patients.
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Affiliation(s)
- Takashi Hitsumoto
- Hitsumoto Medical Clinic, 2-7-7, Takezakicyou, Shimonoseki City, Yamaguchi 750-0025, Japan.
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16
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Nagayama D, Saiki A, Watanabe Y, Yamaguchi T, Ohira M, Sato N, Kanayama M, Moroi M, Miyashita Y, Shirai K, Tatsuno I. Prevention of Cardiovascular Events with Pitavastatin is Associated with Increased Serum Lipoprotein Lipase Mass Level: Subgroup Analysis of the TOHO-LIP. J Atheroscler Thromb 2021; 29:451-463. [PMID: 33642441 PMCID: PMC9090481 DOI: 10.5551/jat.62141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim:
To clarify the mechanism by which pitavastatin reduced cardiovascular (CV) events more effectively than atorvastatin in the TOHO Lipid Intervention Trial Using Pitavastatin (TOHO-LIP), the changes in (Δ) non-heparinized serum level of lipoprotein lipase mass (LPL mass) during administration of the respective statins were investigated.
Methods:
From TOHO-LIP data, 223 hypercholesterolemic patients with any CV risks followed at Toho University Sakura Medical Center were analyzed. The patients were randomized to pitavastatin (2 mg/day) group (
n
=107) or atorvastatin (10 mg/day) group (
n
=116), and followed for 240 weeks. In this subgroup study, the primary and secondary end points were the same as those in TOHO-LIP, and 3-point major adverse cardiovascular events (3P-MACE) was added. The relationship between ΔLPL mass during the first year and the incidences of each end point was analyzed.
Results:
The lipid-lowering effect was not different between the two statins. Cumulative 240-week incidence of each end point was significantly lower in pitavastatin group (primary: 1.9% vs. 10.3%, secondary: 4.7% vs. 18.1%, 3P-MACE: 0.9% vs. 6.9%). Mean LPL mass (64.9 to 69.0 ng/mL) and eGFR (70.1 to 73.6 ml/min/1.73m
2
) increased in pitavastatin group, but not in atorvastatin group during the first year. Cox proportional-hazards model revealed that ΔLPL mass (1 ng/mL or 1SD) contributed to almost all end points.
Conclusions:
Pitavastatin administration reduced CV events more efficaciously than atorvastatin despite similar LDL cholesterol-lowering effect of the two statins. Increased LPL mass during the first year by pitavastatin treatment may be associated with this efficacy.
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Affiliation(s)
- Daiji Nagayama
- Nagayama Clinic.,Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Naoko Sato
- Pharmaceutical Unit, Toho University Sakura Medical Center
| | | | - Masao Moroi
- Division of Cardiovascular Medicine (Ohashi), Department of Internal Medicine, Faculty of Medicine, Toho University
| | | | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
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17
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Saiki A, Watanabe Y, Yamaguchi T, Ohira M, Nagayama D, Sato N, Kanayama M, Takahashi M, Shimizu K, Moroi M, Miyashita Y, Shirai K, Tatsuno I. CAVI-Lowering Effect of Pitavastatin May Be Involved in the Prevention of Cardiovascular Disease: Subgroup Analysis of the TOHO-LIP. J Atheroscler Thromb 2020; 28:1083-1094. [PMID: 33342941 PMCID: PMC8560841 DOI: 10.5551/jat.60343] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM In the TOHO Lipid Intervention Trial Using Pitavastatin (TOHO-LIP), a multicenter randomized controlled trial, pitavastatin significantly reduced cardiovascular (CV) events compared to atorvastatin in patients with hypercholesterolemia. To investigate the mechanism by which pitavastatin preferentially prevents CV events, we investigated the relationship between CV events and cardio-ankle vascular index (CAVI) using the TOHO-LIP database. METHODS For the subgroup analysis, we selected patients from a single center, Toho University Sakura Medical Center. After excluding those who had CV events at baseline or during the first year, 254 patients were enrolled. The primary end point was the same as that of TOHO-LIP, and three-point major cardiac adverse events (3P-MACE) was added as secondary end point. RESULTS The cumulative 5-year incidence of 3P-MACE (pitavastatin 1.6%, atorvastatin 6.1%, P=0.038) was significantly lower in pitavastatin group (2 mg/day) than in atorvastatin group (10 mg/day). CAVI significantly decreased only in pitavastatin group during the first year (9.50-9.34, P=0.042), while the change in low-density lipoprotein cholesterol (LDL-C) did not differ between the two groups. The change in CAVI during the first year positively correlated with 3P-MACE and tended to be an independent predictor of 3P-MACE in Cox proportional hazards model (hazard ratio, 1.736; P=0.079). The annual change in CAVI throughout the observation period was significantly higher in subjects with CV events compared to those without. CONCLUSIONS In this subgroup analysis, the reduction in CV events tended to be associated with the CAVI-lowering effect of pitavastatin, which was independent of the LDL-C-lowering effect.
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Affiliation(s)
- Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Daiji Nagayama
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center.,Nagayama Clinic
| | - Naoko Sato
- Pharmaceutical Unit, Toho University Sakura Medical Center
| | | | - Mao Takahashi
- Division of Cardiovascular Medicine (Sakura), Department of Internal Medicine, Faculty of Medicine, Toho University
| | - Kazuhiro Shimizu
- Division of Cardiovascular Medicine (Sakura), Department of Internal Medicine, Faculty of Medicine, Toho University
| | - Masao Moroi
- Division of Cardiovascular Medicine (Ohashi), Department of Internal Medicine, Faculty of Medicine, Toho University
| | | | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
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18
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Nagayama D, Watanabe Y, Yamaguchi T, Saiki A, Shirai K, Tatsuno I. High hemoglobin glycation index is associated with increased systemic arterial stiffness independent of hyperglycemia in real-world Japanese population: A cross-sectional study. Diab Vasc Dis Res 2020; 17:1479164120958625. [PMID: 32985267 PMCID: PMC7919210 DOI: 10.1177/1479164120958625] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIMS To investigate the association of metabolic parameters including hemoglobin glycation index (HGI, observed HbA1c - predicted HbA1c) with systemic arterial stiffness assessed by cardio-ankle vascular index (CAVI). SUBJECTS We analyzed the cross-sectional data from 22,696 subjects (mean age 48.0 years, mean FPG 88 mg/dL, mean HbA1c 5.5%) with or without past history of metabolic disorders including diabetes. RESULTS Men had higher body mass index (BMI), CAVI, blood pressure (BP), FPG, HbA1c, total cholesterol and triglyceride; and lower age, HGI and HDL-cholesterol. After stratifying subjects into HGI quartiles, the highest quartile (Q4) group showed higher age, female ratio, and frequencies of obesity, hypertension, diabetes, and dyslipidemia. Furthermore, bivariate logistic regression model revealed that the Q4 of HGI was a significant predictor of high CAVI (⩾9.0) independent of the presence of diabetes. CONCLUSION High HGI is associated with systemic arterial stiffening independent of hyperglycemia. This index is therefore expected to be not only a predictor of hypoglycemia, but also a therapeutic guide for atherosclerosis.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine,
Nagayama Clinic, Oyama-City, Tochigi, Japan
- Daiji Nagayama, Department of Internal
Medicine, Nagayama Clinic, 2-12-22, Tenjin-Cho, Oyama-City, Tochigi 323-0032,
Japan.
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
| | - Kohji Shirai
- Department of Internal Medicine, Mihama
Hospital, Chiba-City, Chiba, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
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19
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Kario K, Okada K, Murata M, Suzuki D, Yamagiwa K, Abe Y, Usui I, Tsuchiya N, Iwashita C, Harada N, Okawara Y, Ishibashi S, Hoshide S. Effects of luseogliflozin on arterial properties in patients with type 2 diabetes mellitus: The multicenter, exploratory LUSCAR study. J Clin Hypertens (Greenwich) 2020; 22:1585-1593. [PMID: 32810338 PMCID: PMC7590106 DOI: 10.1111/jch.13988] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/17/2020] [Indexed: 12/12/2022]
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the occurrence of cardiovascular and renal complications in patients with type 2 diabetes mellitus (T2DM) and represent guideline-recommended therapy in this indication. However, precise mechanisms underlying the beneficial cardiovascular effects of SGLT2 inhibitors are not fully understood. This study investigated the effects of the SGLT2 inhibitor, luseogliflozin, on arterial properties and home blood pressure (BP) in patients with T2DM. This multicenter, single-arm study enrolled adults with T2DM, glycosylated hemoglobin (HbA1c) 6.5%-8.9% in the previous 4 weeks, and an indication for new/additional antidiabetic therapy. Luseogliflozin 2.5 mg/d was given for 12 weeks. Primary outcome was change in cardio-ankle vascular index (CAVI) from baseline to Week 4 and Week 12. Home and office BP, BP variability, and metabolic parameters were secondary endpoints. Forty-seven patients (mean age 63.5 ± 10.7 years) treated with luseogliflozin were included in the full analysis set. CAVI did not change significantly from baseline (mean [95% confidence interval] 8.67 [8.37-8.97]) to Week 12 (8.64 [8.38-8.91]; P = .750), but there were significant reductions from baseline in morning home BP, HbA1c, body weight, body mass index, and serum uric acid levels during luseogliflozin therapy. The reduction in morning home systolic BP was ≥ 5 mm Hg and was independent of baseline BP and BP control status. In conclusion, there was no change in arterial stiffness (based on CAVI) during treatment with luseogliflozin, but changes in BP and metabolic parameters were consistent with the known beneficial effects of SGLT2 inhibitors in T2DM.
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Affiliation(s)
- Kazuomi Kario
- Jichi Medical University School of Medicine, Tochigi, Japan.,Washiya Hospital, Tochigi, Japan
| | - Kenta Okada
- Jichi Medical University School of Medicine, Tochigi, Japan
| | | | - Daisuke Suzuki
- Jichi Medical University School of Medicine, Tochigi, Japan.,Jichi Medical University Saitama Medical Center, Saitama, Japan.,Nanbu Kousei Hospital, Saitama, Japan
| | | | | | - Isao Usui
- Washiya Hospital, Tochigi, Japan.,Dokkyo Medical University, Tochigi, Japan
| | | | - Chie Iwashita
- Jichi Medical University School of Medicine, Tochigi, Japan
| | - Noriko Harada
- Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yukie Okawara
- Jichi Medical University School of Medicine, Tochigi, Japan
| | - Shun Ishibashi
- Jichi Medical University School of Medicine, Tochigi, Japan
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Pavlovska I, Kunzova S, Jakubik J, Hruskova J, Skladana M, Rivas-Serna IM, Medina-Inojosa JR, Lopez-Jimenez F, Vysoky R, Geda YE, Stokin GB, González-Rivas JP. Associations between high triglycerides and arterial stiffness in a population-based sample: Kardiovize Brno 2030 study. Lipids Health Dis 2020; 19:170. [PMID: 32669093 PMCID: PMC7362636 DOI: 10.1186/s12944-020-01345-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022] Open
Abstract
Background The term arterial stiffness (ArSt) describes structural changes in arterial wall related to the loss of elasticity and is known as an independent predictor of cardiovascular diseases (CVD). The evidence relating to ArSt and triglycerides (TG) shows contradictory results. This paper means to survey the association between high TG and ArSt, utilizing the cardio-ankle vascular index (CAVI). Methods Subjects aged between 25 and 64 years from a random population-based sample were evaluated between 2013 and 2016. Data from questionnaires, blood pressure, anthropometric measures, and blood samples were collected and analyzed. CAVI was measured using VaSera VS-1500 N devise. Subjects with a history of CVD or chronic renal disease were excluded. Results One thousand nine hundred thirty-four participants, 44.7% of males, were included. The median age was 48 (Interquartile Range [IQR] 19) years, TG levels were 1.05 (0.793) mmol/L, and CAVI 7.24 (1.43) points. Prevalence of high CAVI was 10.0% (14.5% in males and 6.4% in females; P < 0.001) and prevalence of hypertriglyceridemia was 20.2% (29.2% in males and 13% in females, P < 0.001). The correlation between TG and CAVI was 0.136 (P < 0.001). High CAVI values were more prevalent among participants with metabolic syndrome (MetS), high blood pressure, dysglycemia, abdominal obesity, high LDL-cholesterol (LDL-c), and high total cholesterol. Using binary regression analysis, high TG were associated with high CAVI, even after adjustment for other MetS components, age, gender, smoking status, LDL-c, and statin treatment (β = 0.474, OR = 1.607, 95% CI = 1.063–2.429, P = 0.024). Conclusion TG levels were correlated with ArSt, measured as CAVI. High TG was associated with high CAVI independent of multiple cardiometabolic risk factors. Awareness of the risks and targeted treatment of hypertriglyceridemia could further benefit in reducing the prevalence of CVD and events.
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Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic. .,Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Sarka Kunzova
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Juraj Jakubik
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Jana Hruskova
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Maria Skladana
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Irma Magaly Rivas-Serna
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Yonas E Geda
- Department of Neurology, Barrow Neurological Institute, Phoenix, USA
| | - Gorazd B Stokin
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic
| | - Juan P González-Rivas
- International Clinical Research Center (ICRC), St. Ann's University Hospital Brno
- FNUSA-ICRC, Brno, Czech Republic.,Department of Global Health and Population
- Harvard T.H. Chan School of Public Health, Boston, USA
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Saiki A, Ohira M, Yamaguchi T, Nagayama D, Shimizu N, Shirai K, Tatsuno I. New Horizons of Arterial Stiffness Developed Using Cardio-Ankle Vascular Index (CAVI). J Atheroscler Thromb 2020; 27:732-748. [PMID: 32595186 PMCID: PMC7458785 DOI: 10.5551/jat.rv17043] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Arterial stiffness is recognized mainly as an indicator of arteriosclerosis and a predictor of cardiovascular events. Cardio-ankle vascular index (CAVI), which reflects arterial stiffness from the origin of the aorta to the ankle, was developed in 2004. An important feature of this index is the independency from blood pressure at the time of measurement. A large volume of clinical evidence obtained using CAVI has been reported. CAVI is high in patients with various atherosclerotic diseases including coronary artery disease and chronic kidney disease. Most coronary risk factors increase CAVI and their improvement reduces CAVI. Many prospective studies have investigated the association between CAVI and future cardiovascular disease (CVD), and proposed CAVI of 9 as the optimal cut-off value for predicting CVD. Research also shows that CAVI reflects afterload and left ventricular diastolic dysfunction in patients with heart failure. Furthermore, relatively acute changes in CAVI are observed under various pathophysiological conditions including mental stress, septic shock and congestive heart failure, and in pharmacological studies. CAVI seems to reflect not only structural stiffness but also functional stiffness involved in acute vascular functions. In 2016, Spronck and colleagues proposed a variant index CAVI0, and claimed that CAVI0 was truly independent of blood pressure while CAVI was not. This argument was settled, and the independence of CAVI from blood pressure was reaffirmed. In this review, we summarize the recently accumulated evidence of CAVI, focusing on the proposed cut-off values for CVD events, and suggest the development of new horizons of vascular function index using CAVI.
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Affiliation(s)
- Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | | | - Naomi Shimizu
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
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Nagayama D, Imamura H, Endo K, Saiki A, Sato Y, Yamaguchi T, Watanabe Y, Ohira M, Shirai K, Tatsuno I. Marker Of Sepsis Severity Is Associated With The Variation In Cardio-Ankle Vascular Index (CAVI) During Sepsis Treatment. Vasc Health Risk Manag 2019; 15:509-516. [PMID: 31806982 PMCID: PMC6842284 DOI: 10.2147/vhrm.s228506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 10/14/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction The main pathophysiology of sepsis is considered to be circulation crisis with an imbalance of vasodilation and vasoconstriction mechanisms, which contributes to multiple organ failure. However, sepsis-induced hemodynamic changes have not been fully validated by novel arterial stiffness parameter. The aim of this study was to clarify the acute vascular alteration and hemodynamic change in sepsis using cardio-ankle-vascular index (CAVI). Methods Twenty-one Japanese patients (14 males and 7 females, age 62.8 ± 19.0 years) with sepsis were recruited. CAVI was measured before and 1-week after sepsis treatment. Results The leading underlying cause of sepsis was pyelonephritis, followed by pneumonia, lung abscess, hepatic abscess and cholecystitis. All subjects recovered from sepsis. Analysis of all subjects showed a significant increase in CAVI after 1-week treatment (7.9 ± 2.4 to 9.6 ± 1.8, P < 0.001), but no significant change in blood pressure (BP) was observed. Significant correlations were observed for all combinations among the change in CAVI, systolic BP and ln[procalcitonin (PCT)], respectively. Additionally, in subjects with PCT at presentation ≥2.0 ng/mL, the increase in CAVI after treatment was significantly greater compared to those with PCT < 2.0 ng/mL (2.4 ± 1.6 vs 1.1 ± 0.9, P = 0.037). Discussion CAVI may reflect sepsis-induced vascular alteration which is not indicated by BP change, and is associated with sepsis severity. These findings suggest the usefulness of CAVI in the management of circulatory failure in sepsis patients.
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Affiliation(s)
| | - Haruki Imamura
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Yuta Sato
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Masahiro Ohira
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
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Yamaguchi T, Shirai K, Nagayama D, Nakamura S, Oka R, Tanaka S, Watanabe Y, Imamura H, Sato Y, Kawana H, Ohira M, Saiki A, Shimizu N, Tatsuno I. Bezafibrate Ameliorates Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Hypertriglyceridemic Patients with Type 2 Diabetes Mellitus. J Atheroscler Thromb 2018; 26:659-669. [PMID: 30584220 PMCID: PMC6629745 DOI: 10.5551/jat.45799] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM Cardio-ankle vascular index (CAVI) reflects arterial stiffness and has been established as a useful surrogate marker of atherosclerosis. Contrary to the abundant data indicating slower progression of atherosclerosis with statins, studies on fibrates remain scarce. The aim of this study was thus to clarify the effect of bezafibrate on CAVI as well as on oxidative stress. METHODS A randomized, open-label, controlled study was performed. 66 hypertriglyceridemic patients with type 2 diabetes were assigned to two groups: bezafibrate (400 mg/day) group and eicosapentaenoic acid (EPA 1.8 g/day) group. Patients were administered the respective treatment for 12 weeks. CAVI, glycolipid metabolic parameters, and diacron-reactive oxygen metabolites (d-ROMs) were evaluated before and after the study period. RESULTS Serum triglycerides (TG), remnant-like particle cholesterol (RLP-C), fasting plasma glucose, HbA1c and d-ROMs decreased, while HDL-cholesterol increased significantly in the bezafibrate group but did not change in the EPA group. The decreases in TG, RLP-C, HbA1c and d-ROMs were significantly greater in the bezafibrate group than in the EPA group. CAVI decreased significantly only in the bezafibrate group and the decrease was significantly greater in bezafibrate group than in EPA group. Simple regression analysis showed no significant relationship between the change in CAVI and changes in other variables. Multivariate logistic regression analysis identified high baseline CAVI, low HDL-cholesterol level, and bezafibrate administration as significant independent predictors of CAVI decrease. CONCLUSION Bezafibrate treatment ameliorates arterial stiffness accompanied by improvement of glycolipid metabolism and oxidative stress. These effects potentially have important beneficial health consequences in hypertriglyceridemic patients with type 2 diabetes.
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Affiliation(s)
- Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | | | | | - Shoko Nakamura
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Rena Oka
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Sho Tanaka
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Haruki Imamura
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Yuta Sato
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Hidetoshi Kawana
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Naomi Shimizu
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
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