Ankle Vascular Index Research Articles

Association between atherosclerosis and handgrip strength in non-hypertensive populations in India and Japan.

AimAlthough several risk factors contribute to the development of sarcopenia, whether preclinical atherosclerosis contributes to the risk of sarcopenia is not established. The present cross‐sectional study aimed to investigate if there is an association between preclinical atherosclerosis and muscle strength among two ethnic populations.MethodsParticipants included individuals aged ≥40 years and enrolled in the third follow‐up examination of the Andhra Pradesh Children and Parents Study, India, and in the baseline assessments of the Nagasaki Islands Study, Japan. Preclinical atherosclerosis was evaluated by carotid intima‐media thickness, brachial‐ankle pulse wave velocity, cardio‐ankle vascular index. The association of carotid intima‐media thickness and pulse wave velocity/cardio‐ankle vascular index with handgrip strength (HGS) was analyzed separately in the sexes and for hypertensive status from the two cohorts using a multivariable linear regression model.ResultsData on a total of 1501 participants in India and 3136 participants in Japan were analyzed. Carotid intima‐media thickness was negatively associated with HGS in non‐hypertensive Indian men (B coefficient = −5.38, P = 0.036). Arterial stiffness was also associated with HGS in non‐hypertensive Indian men (B = −0.97, P = 0.001), but not in hypertensive Indian men. Same as Indian men, we found the significant associations between arterial stiffness and HGS in non‐hypertensive women in both India and Japan (B = −0.44, P = 0.020, B = −0.63, P = 0.016, respectively), but not in hypertensive women.ConclusionsThe negative association between preclinical atherosclerosis and HGS was dominantly found in non‐hypertensive participants. Geriatr Gerontol Int 2018; 18: 1071–1078.

Lipid Parameters are Independently Associated with Cardio-Ankle Vascular Index (CAVI) in Healthy Japanese Subjects.

Aim: To investigate the associations of conventional lipid parameters with arterial stiffness assessed by cardio — ankle vascular index (CAVI).Methods: A retrospective cross-sectional study was conducted in 23,257 healthy Japanese subjects (12,729 men and 10,528 women, aged 47.1 ± 12.5 years, body mass index (BMI) 22.9 ± 3.4 kg/m2) who underwent health screening between 2004 and 2006 in Japan.Results: Male subjects had significantly higher BMI, CAVI and triglycerides (TG), and lower high-density lipoprotein cholesterol (HDL-C) compared to female subjects. After adjusting for confounders, including gender, age, systolic blood pressure and BMI identified by multiple regression analysis, adjusted CAVI was lower in normolipidemic than in dyslipidemic subjects. Among dyslipidemic subjects, those with hypertriglyceridemia had higher adjusted CAVI. A trend test detected linear relations between adjusted CAVI and all the conventional lipid parameters throughout the entire range of serum levels. After adjusting for confounders, logistic regression models showed that all lipid parameters contributed independently to high CAVI (≥ 90th percentile). Receiver–operating–characteristic analysis determined reliable cut-off values of 93 mg/dl for TG (area under the curve, AUC = 0.735), 114 mg/dl for low-density lipoprotein cholesterol (AUC = 0.614) and 63 mg/dl for HDL-C (AUC= 0.728) in predicting high CAVI. These cut-off values were confirmed to independently predict high CAVI in a bivariate logistic regression model.Conclusion: The present study demonstrated independent contribution of conventional lipid parameters to CAVI, indicating a possible association of lipid parameters with early vascular damage.

EFFECTS OF BODY WEIGHT REDUCTION ON ARTERIAL STIFFNESS AND ENDOTHELIAL FUNCTION AFTER BARIATRIC SURGERY IN MORBIDLY OBESE PATIENTS: A 4-YEAR CLINICAL STUDY.

To determine the long-term effect of weight loss on arterial stiffness, metabolic parameters in morbidly obese patients who underwent laparoscopic adjustable gastric banding (LAGB). Forty-eight morbidly obese Caucasian subjects underwent LAGB from January 2009 to January 2010 and completed 4 years follow-up. Patients were evaluated for body mass index (BMI), waist circumference, arterial blood pressure (BP), metabolic factors: leptin, adiponectin, glucose, glycated haemoglobin (HbA1c), insulin. Endothelial function - evaluated as reactive hyperemic index (RHI). Arterial stiffness - determined by cardio - ankle vascular index (CAVI). Average BMI decreased from 46.48±7.06 kg/m2 to 39.78±7.36 kg/m2 (1year, p<0.001) and 37.29±7.49 kg/m2 (4years, p=0.012). The systolic BP and heart rate reduction were observed after the 4 years. Changes in cardiovascular parameters were accompanied by waist circumference reduction and improvement of glucose metabolism,reduction of insulin, HbA1c, leptin, C-reactive protein values. However, there were statistically significant increases in CAVI 6.58±1.77m/s vs. 7.03±2.00 m/s (p=0.014) at 1 year, but not significant 7.12±2.19 (p=0.153) after 4 years. Endothelial changes were observed only in diabetic patients one year after LAGB 2.18±0.57 vs. 1.86±0.34 (p=0.021) vs. 2.05±0.42 (p=0.086). Weight reduction induced by LAGB was associated with changes in body weight and metabolic parameters, but it was no improvement on endothelial function and arterial stiffness.

PRECLINICAL ATHEROSCLEROSIS AND MODERN METHODS OF ITS DIAGNOSIS

The article deals with modern methods of diagnosis of pre-clinical atherosclerosis, a new method of assessing arterial stiffness - definition of heart ankle vascular index. Practical value of this parameter for the study of the elastic properties of the vascular wall (bibliography: 35 refs).

Duration of diabetes mellitus is a significant predictor of arterial stiffness in patients with arterial hypertension and type 2 diabetes mellitus

BackgroundDiabetic complications increase with disease duration but little is known about the relationships between aortic stiffness and diabetes duration.Aimto assess associations of diabetes mellitus (DM) duration and parameters of arterial stiffness in patients with arterial hypertension (AH) and T2DM.Methods90 patients with AH and T2DM were included (39%males, mean age63,8 ± 11,6 years, 44%smokers). Mean office BP was 146 ± 23/ 86 ± 10 mmHg. All patients received combined AHT, target BP < 140/ 85 mmHg was achieved in 52,7% of patients. Median duration of DM was 8,5 years (IQR 2; 13 years), mean glucose was 8,0 ± 2,4mmol/l, mean HbA1c 9,2 ± 2,0%. BP was measured with a validated oscillometric device. Parameters of arterial stiffness were assessed by applanation tonometry, cardio- ankle vascular index (CAVI) and vascular age were measured (VaSera 1500). p < 0,05 was considered significant.ResultsMean central BP was 132 ± 18/79 ± 12 mmHg, mean cfPWV–10,5 ± 2,4m/s, mean R- CAVI-8,8 ± 1,9, L-CAVI-8,9 ± 1,8. Further analysis was performed in subgroups according to tertiles of DM duration (G1 < 4 years (n = 31), G2–4-10 years (n = 30), G3 > 10 years (n = 29)). Patients in G3 were older (69,5 ± 11,1 vs 62,1 ± 11,2 vs 60,0 ± 10,8 years), had higher vascular age (73,8 ± 9,0 vs 68,6 ± 11,8 vs 64,5 ± 13,4 years) and R-CAVI (9,3 ± 1,9 vs 9,0 ± 1,8 vs 8,1 ± 1,9); p < 0,05 for trend. Patients from G3 and G2 had the highest level of cfPWV compared to G1 (11,0 ± 2,0 and 11,4 ± 2,4 vs 9,1 ± 2,4m/s, p = 0,0009). There were significant correlations between duration of DM and age (r = 0,35), vascular age (r = 0,30), creatinine (r = 0,23), cfPWV (r = 0,34), and R-CAVI (r = 0,3). Only age and DM duration were predictors of PWV increase (β = 0,3, p = 0,02 and b = 0,2, p = 0,04, respectively).ConclusionsIn diabetic patients, aortic stiffness is strictly correlated with diabetes duration, independently of blood pressure level and diabetes control.

Relationship between Serum Uric Acid and Vascular Function and Structure Markers and Gender Difference in a Real-World Population of China-From Beijing Vascular Disease Patients Evaluation Study (BEST) Study

Aim: The study was done to establish the relationship between serum uric acid (UA) and vascular function and structure parameters including carotid femoral pulse wave velocity (CF-PWV), carotid radial pulse wave velocity (CR-PWV), cardio ankle vascular index (CAVI), ankle brachial index (ABI), and carotid intima-media thickness (CIMT), and the gender difference in a real-world population from China.Methods: A total of 979 subjects were enrolled (aged 60.86 ± 11.03 years, male 416 and female 563). Value of UA was divided by 100 (UA/100) for analysis.Results: Body mass index (BMI), diastolic blood pressure (DBP), fasting plasma glucose (FPG), UA, and UA/100 were significantly higher in males compared with females (all p < 0.05); pulse pressure (PP), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were lower in males than females (all p < 0.05). All vascular parameters including CF-PWV, CR-PWV, CAVI, ABI, and CIMT were higher in males than females (all p < 0.05). Multiple linear regression analysis showed that UA/100 was independently positively linearly correlated with CAVI (B= 0.143, p = 0.001) and negatively correlated with ABI in the male population (B = −0.012, p = 0.020). In people with higher UA, the risk of higher CF-PWV was 1.593 (p < 0.05).Conclusions: 1. All vascular parameters were higher in males than females. There was no gender difference in the relationship between UA and vascular markers except in ABI. 2. UA was independently linearly correlated with CAVI. 3. In people with higher UA level, the risk of higher CF-PWV increased. Therefore, higher UA may influence the vascular function mainly instead of vascular structure.

Abstract P249: Effects of Lifestyle Changes on Metabolism and Early Vascular Lesion in Healthy People

Objective: Through propaganda and education on lifestyle change, we study the effects on metabolism and vascular lesions in healthy people. Methods: the healthy subjects that conform to the requirements, through propaganda and education on vascular health, through moderate exercise, proper control of starchy foods, low salt, low fat diet, reduce smoking and other lifestyle changes, compare changes in weight, renal function, fasting blood glucose, blood lipids and ankle brachial index (ABI), cardio ankle vascular index(CAVI) before and after lifestyle changes. Results: After lifestyle changed, the subjects’ body mass index [(23.13±3.18)kg/m 2 vs (22.67±3.36)kg/m 2 ], ABI[1.11±0.08 vs 1.09±0.09], CAVI[(7.14±1.13 ) vs (7. 01±1.18) ], serum creatinine[(84.31±22.41)umol/L vs (79.92±23.64)umol/L], blood uric acid[(337.79±102.17 )umol/L vs (328.12±88.33)umol/L], low density lipoprotein cholesterol[(2.49±0.65) mmol/L vs (2.37±0.69) mmol/L],all have good changes. Conclusion: Healthy lifestyle is good for metabolism and early vascular lesions, can improve metabolic disorder and slow the occurrence of arteriosclerosis.

PP.09.03] CONCORDANCE BETWEEN TWO FORMS OF ARTERIAL STIFFNESS REGISTER AND CORRELATION WITH BRACHIAL AND CENTRAL BLOOD PRESSURE

Objective: Carotid-femoral pulse wave velocity (cfPWV) is recognized as the gold standard for the assessment of arterial stiffness. Cardio Ankle Vascular Index (CAVI), which is determined automatically has been proposed as an alternative. We aimed to assess the correlation between these two methods and their association with central and peripheral BP. Design and method: These is an observational study in 43 essential hypertensive patients, 60% males, aged 48 ± 14 years. cfPWV was determined by pulse waveform analysis using the validated and calibrated Sphygmocor Xcel device (AtCor Medical, West Ryde, Australia). Brachial and central BP (transfer function) were determined used the same device. CAVI and the ankle-brachial index were determined by VaSera VS-Series Vascular Screening System (Fukuda Denshi, Tokyo, Japan). Agreement between the two methods was assessed by both Pearson's and intraclass correlation coefficients. The correlation between either cfPWV or CAVI with central and peripheral BP were estimated by Pearson's correlation coefficients and possible differences evaluated by calculating z-statistics. Results: Mean values of cfPWV CAVI were respectively 7.5 ± 1.9 m/s and 8.6 ± 2.0 units. The concordance between CAVI and PWV was considered good (Pearson's correlation coefficient of 0.724 (p < 0.001) and intraclass correlation coefficient of 0.840). Correlations were all significants for both cfPWV and CAVI and for both central and peripheral SBP and PP. No differences were observed between the intensity of correlation obtained by CAVI or PWV (non-significant z statistics). Conclusions: There is a good correlation between the measurement of arterial stiffness by PWV and CAVI, and both measures are similarly correlated with BP.

PS 17-45 ARTERIAL STIFFNESS, MONITORED WITH CARDIO ANKLE VASCULAR INDEX IS ADJUSTING THE OCULAR MICROCIRCULATION OBTAINED FROM LASER SPECKLE FLOWGRAPHY

Objective: Laser speckle flowgraphy (LSFG) is a noninvasive quantitative method of determining ocular microcirculation. Impaired ocular microcirculation is an important predictive factor for ocular diseases such as glaucoma. However, it is still unknown whether arterial stiffness affecting the ocular microcirculation in detail. The purpose of current study was to clarify whether arterial stiffness, monitored with cardio ankle vascular index (CAVI) is affecting to ocular microcirculation shown by LSFG. Design and method: Design of this study is cross-sectional. We studied consecutive 131 men who had visited Toho University Sakura Medical Center. Mean age was 60 ± 11 yrs. The mean blur rate (MBR) is an indicator of microcirculation obtained from LSFG. We measured MBR in the optic nerve head (ONH) and analyzed MBR pulse waveform variables: Skew and blowout time (BOT). CAVI and other parameters were also measured at the same day of LSFG measurements. The single and multiple regression analysis were used to determine whether the CAVI is independent factors for Skew and BOT in the ONH, comparing with the other parameters. Results: Single regression analysis showed CAVI was significantly positively correlated with Skew (r = 0.39, P Conclusions: Arterial stiffness, monitored with CAVI might be adjusting the ocular microcirculation in ONH obtained from LSFG.

OS 30-02 ANNUAL CHANGE OF CARDIO-ANKLE VASCULAR INDEX PREDICT NEW ONSET OF RETINAL ABNORMALITY IN THE URBAN JAPANESE RESIDENTS

Objective: Cardio ankle vascular index (CAVI) represents arterial stiffness of the aorta, femoral artery and tibial artery. We investigated whether annual change of CAVI is related to the onset of retinal abnormality on optic fundus. Design and Method: Subjects were 1,148 (male 47.4%) urban residents who participated in cardiovascular disease (CVD) screening in Japan during 2005- 2011. All subjects had normal finding of optic fundus at first health check and had not received medical treatment for CVD risk factor during this study. Annual change of cardio-ankle vascular index (ΔCAVI) was obtained by cox hazard ratio from least-square method for three years by each year. Several atherosclerosis risk factors were also studied. Eye examination was defined with Scheie classification. Results: Subjects were devised into two groups, normal group (group A) (n = 1,103, male 46.5%) and new onset of Scheie H1-4 and/or S1-4 group (group B) (n = 45, male 68.9%). In first health check data, creatinine and high-density cholesterol are not different but age, body mass index, systolic blood pressure (sBP), diastolic pressure, triglyceride (TG) and CAVI were higher in group B than that of group A regardless of gender. Comparison with two groups in change of CVD risk factors for three years revealed that ΔsBP and age were selected as independent contributing factor for abnormal change of optic fundus in male, and age, ΔsBP, ΔTG, and ΔCAVI were selected as independent contributing factor for abnormal change of optic fundus in female. ΔCAVI was much more significant than CAVI at the beginning in female. Conclusions: We demonstrated predictive value of CVD risk factors and CAVI for new onset of abnormal findings on optic fundus. There are gender differences regarding effect on optic fundus by change of CVD risk factor and CAVI.

OS 25-04 THE CHANGES OF ARTERIAL STIFFNESS MONITORED WITH CARDIO ANKLE VASCULAR INDEX (CAVI) DURING RAISED INTRACRANIAL PRESSURE IN THE RABBIT

Objective: Cardio ankle vascular index (CAVI) is reflecting stiffness of the arterial tree from the origin of aorta to the ankles. We observed elevated CAVI in patients who suffered from apoplexy attack. To clarify the role and the mechanism by which arterial stiffness elevated just after apoplexy attack, the effect of enhanced intracranial pressure (ICP) by injecting saline into the cisterna magna of the rabbit on blood pressure, CAVI and cervical blood flow, were studied. Furthermore the role of sympathetic nerve was studied. Design and Method: The system of measuring CAVI of the New Zealand white rabbit was set up. General anesthesia was performed by ketamine and xylazine, and the respirator was set. Intracranial pressure (ICP) was monitored using a catheter inserted into subarachnoid space via right frontal bone craniotomy. Saline (15 ml) was inserted to raise ICP. Ganglion blocker, hexamethonium (10 μg/kg/10 min, and 100 μg/kg/10min) was administered just before saline injection. Results: When saline was injected into the cisterna magna and ICP was raised over 20 mmHg at least, blood pressure (62 ± 7.43 → 135 ± 27.41 mmHg), and CAVI (3.3 ± 0.39 → 4.8 ± 0.89) were increased. The heart rate and blood flow of common carotid artery increased. When hexamethonium (10 μg/kg/10 min and 100 μg/kg/10min) was administered before raising ICP, enhanced IPP -induced blood pressure increase (123 ± 9.58, 90 ± 5.42 mmHg, respectively) and CAVI increase (4.3 ± 0.35, 4.0 ± 0.16, respectively) were inhibited dose-dependently. Conclusions: Raised ICP induced an increase of blood pressure accompanying with an increase of CAVI, suggesting that enhanced stiffness of muscle artery might partly induce high blood pressure. Blocking sympathetic nerve by hexamethonium diminished raised blood pressure and CAVI, indicating that ICP increase-induced blood pressure and CAVI increases were mediated by sympathetic nerve activation.

Arterial stiffness, as monitored by cardio&amp;ndash;ankle vascular index, is affected by obstructive sleep apnea, blood glucose control, and body weight &amp;ndash; a case with 8 years follow up

The cardio–ankle vascular index (CAVI) is an indicator of arterial stiffness from the heart to the ankles. The CAVI increases as arteriosclerosis progresses, but it can be decreased by appropriate treatment. There are several risk factors for coronary artery disease, however, the degree of stress caused by each separate risk factor to arteries cannot be assessed. CAVI increases with age and according to the severity of atherosclerosis. We found that CAVI also changes in response to the control of risk factors, which may be associated with the functional stiffness of arteries. CAVI can be a useful indicator of risk control for coronary artery disease. We followed a patient aged 71 years who had diabetes mellitus and obstructive sleep apnea (OSA) by measuring CAVI for 8 years from age 63. He underwent coronary artery bypass grafting due to angina pectoris when he was 63 years old. Before coronary artery bypass grafting, CAVI was 11.8 on the right and 11.5 on the left. Three years later he was found to have OSA and received treatment with continuous positive airway pressure. There was a marked improvement in CAVI after continuous positive airway pressure (age 68; right 10.4, left 10.2). However, following a gradual increase in body weight and worsening of diabetes mellitus, CAVI showed an increasing trend. CAVI decreased with biguanides treatment, but increased again with an increase in body weight. In conclusion, CAVI responded to the patient’s conditions including obesity, diabetes mellitus, and OSA. CAVI is not only a marker of arterial stiffness, but can also be a useful indicator of physiological status; it may be effective in total risk control for coronary artery disease.

The Effects of Myofascial Release Massage on Arteriosclerosis Level Index in Elderly Women

Background/Objectives: This study aimed to investigate the changes in arteriosclerosis level index of elderly women after 8 weeks of myofascial release massage. Hence, experimental group and control group were set to compare the effects of treatment. Methods/Statistical Analysis: The massage sessions were 3 times a week for 8 weeks counting total of 24 sessions. Myofascial release massage was pushing, rubbing, massaging, shaking, traction. Analysis was performed using SPSS for Windows 18.0 Version. Findings: Among the factors related with arteriosclerosis level index Cardio Ankle Vascular Index (CAVI), R-cavi showed significant interaction effect between EG and CG with p<.05. L-cavi showed significant interaction effect between EG and CG with p<.05. Among the factors related with arteriosclerosis level index ABI, R-abi showed significant interaction effect between EG and CG with p<.05. L-abi showed significant interaction effect between EG and CG with p<.05. Application/Improvements: Through this process, arteriosclerosis such as CAVI and ABI showed interaction effects. Myofascial release massage showed positive effect on the arteriosclerosis level index of elderly women.

Association between different risk factors and vascular accelerated ageing (EVA study): study protocol for a cross-sectional, descriptive observational study

IntroductionThe process of population ageing that is occurring in developed societies represents a major challenge for the health system. The aim of this study is to analyse factors that have...

2F32 心臓足首血管指数(CAVI)と脈波伝播時間に及ぼす計測姿勢の影響

There is a need for new methods to measure the level of arterial stiffness easily at home. A previous report investigating the effect of measurement position on brachial-ankle pulse wave velocity (baPWV) showed that baPWV were higher in the sitting position than in the supine position. This was probably because the increased ankle PWV was associated with increased hydrostatic pressure in the arteries of lower extremities. Therefore, we investigated the effect of measurement position on the cardio-ankle vascular index (CAVI), which is hardly affected by blood pressure. CAVI was measured in 50 healthy males (20-74 years) in five positions: supine, sitting, sitting with the knees flexed at 0°, reclining 50°, and standing. Compared to other positions, CAVI in the supine position was the lowest (P < 0.01); t_b (the time difference between the second heart sound and the notch of the pulse wave in the upper arm) in the supine position was the highest (P < 0.01); and t_<ba> (the time difference between the minimum upper arm and ankle pulse wave pattern values) in the supine position was the highest (P < 0.01). Thus, our results indicated that changes in measurement position reduced pulse arrival time (increasing pulse wave velocity). We also observed a strong correlation between CAVI in the supine position and that in other positions. The present study showed that the measurement position affected CAVI as much as it affected baPWV. Accordingly, correcting for the measurement position would be required when the position differs from supine.

Relationship between vascular function indexes, renal arteriolosclerosis, and renal clinical outcomes in chronic kidney disease.

Hypertension contributes critically to the development of renal arteriolosclerosis in chronic kidney disease (CKD), but the impact of vascular function indexes including central blood pressure on renal arteriolosclerosis has not been investigated. We determined whether vascular function indexes were related to renal arteriolosclerosis and renal clinical outcomes in CKD. This cross-sectional study was implemented in our hospital. Subjects were in-patients with CKD aged ≥20 years who underwent a renal biopsy. Vascular function indexes included central systolic blood pressure (SBP), cardio-ankle vascular index (CAVI), and renal resistive index. Central SBP was measured non-invasively using an automated device. Arteriolosclerosis was assessed histologically. Renal clinical outcomes included estimated glomerular filtration rate using serum creatinine (eGFRcreat) or cystatin C (eGFRcys), and the urinary albumin-creatinine ratio. Among vascular function indexes, central SBP was weakly correlated with renal arteriolosclerosis (n = 55). Renal arteriolosclerosis was increased in hypertensive or hyperuricaemic patients, and negatively correlated with serum high-density lipoprotein (HDL) cholesterol and eGFRcys, which were independent risk factors for renal arteriolosclerosis in a stepwise multivariate regression analysis. Of the vascular function indexes, CAVI showed the strongest correlation with all renal clinical outcomes. Central SBP was correlated with only urinary albumin-creatinine ratio, while renal resistive index was correlated with eGFRcreat and urinary albumin-creatinine ratio. Decreased serum HDL cholesterol was independently and most closely associated with renal arteriolosclerosis. Of the vascular function indexes, CAVI had the greatest impact on renal clinical outcomes, although it was not associated with renal arteriolosclerosis.

PP.09.20

Objective: To assess if 24 h urinary steroid metabolite profiles are related to vascular parameters such as arterial stiffness and blood pressure (BP) Design and method: 43 eligible participants, 25–81 years, with eGFR > 45 mL/min and no serious illness. Urine was collected over 24 h (12 h day and night samples). Peripheral BP, central pulse wave velocity (aPWV) (by Arteriograph) and cardio ankle vascular index (CAVI) (by VaSera) measures were performed on the collection day. Steroids were extracted from urine aliquots and conjugates hydrolysed by Helix pomatia digestive juice. Free steroids were re-extracted and methyl oxime-trimethylsilyl ether derivatives prepared for GC-MS analysis. Pearson correlation and multiple regression analysis were performed. Results: The urinary steroid metabolites detailed in the figure (figure on the following page) were quantified. Systolic BP and aPWV correlated positively with the ratio of cortisol to cortisone metabolites [aTHF, THF, αcol and βcol: THE, αcone and βcone, (colmets: conemets)]; r = 0.32, 0.37 respectively, p < 0.05 for day samples and r = 0.33, 0.34 respectively, p < 0.05 for night samples. Both BP and aPWV also correlated negatively in the day samples with the ratio αcol, βcol, αcone and βcone: aTHF, THF and THE (20OH: 20oxo); r = -0.33, -0.32 respectively, p < 0.05. Night samples only showed this correlation with diastolic BP r = 0.31, p < 0.05. No correlations were seen with CAVI. Regression analysis with these metabolite ratios (including age and body mass index) did not show they were associated with BP or CAVI (including BP). While aPWV was borderline associated with colmets: conemets, p = 0.077, 20OH: 20oxo was significantly associated (p = 0.026). BP and BMI remained independent predictors. Conclusions: 24 h urinary 20OH:20oxo ratio was independently related to aPWV in those with or at risk of T2D and colmets:conemets had borderline associations with aPWV. There were no associations with the urinary steroids and BP.

Association of Serum Antibody Levels against TUBB2C with Diabetes and Cerebral Infarction

Cerebral infarction (CI), cardiovascular disease (CVD), diabetes mellitus (DM) and chronic kidney disease (CKD) are atherosclerosis-related diseases, which are major causes of health damage. For early and sensitive diagnosis, development of novel biomarkers is expected and of significant practical importance. First screening was carried out by phage expression cloning to identify antigen proteins recognized by serum IgG antibodies in patients with atherosclerosis. RPA2, LRPAP1, EEF1A1, SPOCK1, LOC729260, tubulin beta 2C (TUBB2C) and KIAA0020 markers were identified. We then compared the serum antibody levels against the candidate proteins between healthy donors (HD) and patients with CI, CVD, DM, or CKD by Alpha (amplified luminescent proximity homogeneous assay)-LISA method. The results showed that the serum TUBB2C antibody levels were significantly higher in patients with CI, DM, or CKD than those in HD. Using the average + 2SD of HD as the cut-off value, the positive thresholds of TUBB2C antibody markers were 14.8% in CI, 25.8% in DM, and 18.3% in CKD. TUBB2C antibody levels were well correlated with artery stenosis degrees such as plaque score, maximum intima-media thickness and cardio ankle vascular index. Consequently, TUBB2C antibody markers are useful to diagnose atherosclerosis, DM, and CKD, and can be applied to the prediction of the onset of CI. The serum anti-TUBB2C antibody markers are useful for the diagnosis of DM and CKD. Keywords: Atherosclerosis; Diabetes mellitus; Chronic kidney disease; Cerebral infarction; Cardiovascular disease; Antibody biomarker

Control of Hypertension in Erderly Patients Receiving Primary Care in Portugal: A Cross-sectional Study in 2013

Methods: Early vascular lesion detection technology was approved by Ministry of Health of the People’s Republic of China to be promoted to the whole China in 2004 and it was popularized in hundreds of hospitals in more than 20 provinces from 2004 to 2013. We started Chinese Arterial Stiffness Evaluation Study (CASE) in 2004. Results: The results of CASEStudy showed that: (1)Pulse wave velocity (PWV) and cardio ankle vascular index (CAVI) were significantly higher in vascular-related diseases including hypertension, metabolic syndrome and peripheral arterial diseases, and metabolic accompaniments might involve the increasing of arterial stiffness in hypertensionpatients. (2)Plasma homocysteine and N-Terminal pro-brain natriuretic peptide were positively correlated with arterial stiffness in hypertension and coronary artery disease patients indicating the relationship between arterial stiffness and biomarkers in vascular-related diseases. (3)There were differences about arterial stiffness between She nationality, Miao tribe and Buddhist monk population and life style modification was important for vascular health and vegetarian diet longer than 0.2 of life time could reduce arterial stiffness. (4)We founded and organized the first international vascular medicine congress-Chinese International Congress of VascularMedicine (CCVM) and established the first vascularmedicine center in China and set upVascularMedicine professional course inmedical colleges (PekingUniversityHealth Science Center) firstly. We established the early vascular lesion detection system and published the first guideline in 2005 and renewed this guideline in 2011. Conclusions: Our series studies have showed the importance of arterial function evaluation in vascular-related diseases; and a new disciplinevascular medicine has showed its great prospect in future.

Association between nt-probnp and cavi

Objectives: The natriuetic peptide; pro-BNP, is released from cardiac muscle into the circulation when cardiac function is disturbed. Pro-BNP is then metabolized into BNP, the biologically active form, and inactive N-terminal pro-BNP (NT-proBNP) at an even molecular ratio. NT-proBNP has recently become more clinically utilized than BNP. Beyond cardiac dysfunction, however, the role of BNP on the endothelial function of arteries has also been demonstrated. The aim of this study was to determine the relationship between serum NT-proBNP levels and arterial stiffness estimated by Cardio- ankle vascular index (CAVI).