Background Chronic kidney disease (CKD) is associated with accelerated cardiovascular (CV) risk, particularly due to subclinical atherosclerosis. Carotid intima-media thickness (CIMT) is a non-invasive marker of early athero-sclerotic changes. Altered mineral metabolism in CKD, also known as CKD-mineral bone disorder (CKD-MBD), may contribute to vascular damage. We evaluated the association between CIMT and mineral metabolism markers in people with diabetes who had pre-dialysis CKD. Methods A cross-sectional observational study was done in 110 adults with diabetes and pre-dialysis CKD. Biochemical markers including serum phosphate, intact parathyroid hormone (iPTH), fibroblast growth factor (FGF)-23, and 24-hour urinary phosphate were analyzed. CIMT was measured using B-mode ultrasonography. Correlation and regression analyses were performed. Results CIMT showed significant positive correlations with serum phosphate, FGF-23, iPTH, and serum creatinine, and negative correlations with nephron index and urinary phosphate excretion. Serum phosphate >6 mg/dl strongly predicted CIMT >0.9 mm. Conclusion Mineral metabolism markers, particularly serum phosphate and FGF-23, are significantly associated with subclinical atherosclerosis in CKD. Monitoring these parameters may aid in assessment of early CV risk in patients with CKD.

T50 is the time required for primary calciprotein particles (CPPs) to transform into secondary CPPs in vitro, reflecting serum calcification propensity, and used as a biomarker for calcification stress. Since secondary CPPs induce inflammation and oxidative stress, they may promote atherosclerosis. We investigated whether or not T50 was associated with carotid artery intima-media thickness (IMT). This was a cross-sectional study of 202 health examinees. T50 was measured by the established nephelometric method. Carotid artery IMT was measured by high-resolution ultrasonography. The association between T50 and IMT was evaluated by a multivariable-adjusted linear regression analysis. In a univariate analysis, IMT was not significantly correlated with T50. A multivariable-adjusted linear regression analysis showed that IMT was independently associated with age, sex, diabetes mellitus, dyslipidemia, and fetuin-A but not with T50 in the total subjects. However, when stratified by the estimated glomerular filtration rate (eGFR), T50 was independently and inversely associated with IMT in the subgroup with an eGFR ＜60 mL/min/1.73 m2 (β = -0.418, P = 0.013), whereas it was not in the subgroup with an eGFR ≥ 60 mL/min/1.73 m2. T50 was independently and inversely associated with IMT in health examinees with a reduced kidney function, suggesting a novel link between calcification stress and atherosclerosis, particularly in those with chronic kidney disease.

BackgroundMounting evidence shows relationships between the cerebrovasculature, cognitive decline, neurodegeneration, and amyloid accumulation that underscores the contribution of cerebrovascular atherosclerotic disease (CA) to the pathogenesis of Alzheimer's disease and related dementias (AD/ADRD). Previously, we identified 114 brain proteins associated with CA as measured by carotid artery intimal media thickness (IMT). That finding suggests that surrogate brain biomarkers of CA may hold promise as sensitive markers for early ADRD detection. Compared to brain tissue, cerebrospinal fluid (CSF) is more accessible and can be collected from living persons. Thus, among the brain proteins profiled, we also profiled 6 (CBR1|P16152, ENDOD1|O94919, MOG|Q16653. PCSK1|P29120, PLP1|P60201, and QDPR|P09417) in CSF. In this follow‐up study, we explored the CSF proteome for associations between profiled proteins and CA as measured by carotid artery IMT. Hence, this study aims to explore potential biomarkers of CA and ADRD risk by examining associations between CSF proteins and IMT.MethodAll CSF samples and vascular measurements were collected from Emory Goizueta Alzheimer's Disease Research Center research participants. We described the CSF collection steps and multiplex proteomic steps previously.7 We performed proteomic analysis on 86 CSF samples, followed by linear regression adjusted for age, sex, and cognitive diagnosis (control vs. impaired) to test associations with CA. We applied BoxCox transformation to IMT measures to improve normality and we excluded participants with AD.ResultData for 83 people were analyzed. The sample's mean age was 65.8 (8.02); 60% were female, 70% were white adults, and 69% were controls. Among white participants, QDPR|P09417 (neurotransmitter production) was associated with higher IMT. For AA participants, PLP1|P60201 (myelin sheath) was associated with higher IMT. In meta‐analysis (both groups), QDPR|P09417 and MOG|Q16653 (myelin sheath) were associated with higher mean carotid IMT.ConclusionVascular disease can co‐occur with AD. Our results show associations between CSF proteins involved in structural integrity and chemical signaling and CA in a sample with impaired and normal cognition. Further, we detected racial differences in these associations. Given these findings among cognitively normal and impaired people, these proteins may have promise as early disease indicators. More extensive study with a larger sample is needed.

Correlation between anti-Müllerian hormone, hypertension and vascular age: the Generation R Study, a population-based prospective cohort study.

Anti-black police violence and harassment have been identified as public health issues. However, studies have primarily focused on direct and/or vicarious police encounters. A dearth of studies has also examined vigilance related to future police encounters, and to our knowledge, no studies have examined all 3 kinds of police-related stress among African American women. We employed a latent class analysis (LCA) approach to identify classes of African American women ( N = 422), aged 30 to 46, based on the patterning of various forms of self-reported police-related stress: direct, vicarious, police-related vigilance for self, and police-related vigilance for children. We then examined associations between latent class membership and carotid intima media thickness (IMT), a marker of cardiovascular risk. We identified 3 latent classes of police-related stress: (1) high child vigilance-high personal exposure, (2) no child vigilance-high personal exposure, and (3) moderate child vigilance-low self vigilance-low personal exposure class. Findings from the fully adjusted model reveal that the no child vigilance-high personal exposure class had lower common carotid artery (CCA) IMT than the high child vigilance-high personal exposure and moderate child vigilance-low self vigilance-low personal exposure classes. Vigilance for children's future police encounters may be associated with increased cardiovascular risk in African American women. Agency, system, and policy-level solutions may be needed to reduce anti-black police violence and improve the cardiovascular health of this high-risk population.

Background: Hypertension affects wide range of organs, eventually resulting in events like heart failure, chronic kidney disease, stroke and blindness. However, there are only subtle changes present initially, like microalbuminuria (MA), elevated CCIMT and retinopathy, in patients with uncontrolled hypertension. Patients with microalbuminuria are postulated to have significantly high risk of TOD and this study aims to explore this association. The primary objective of this study was to explore prevalence of MA in patients of essential hypertension and ascertain its correlation with elevated CCIMT and retinopathy. Methods: A cross-sectional study was done on 250 patients of essential hypertension, designated as per JNC8 guidelines. Patients of diabetes (Type I/II), thyroid disorders, CKD, UTI, obesity (BMI>30 kg/m2), cataract and those with history of stroke, were excluded from this study. A statistical analysis was performed and relationship between microalbuminuria and TOD evaluated. Results: Significant prevalence of TOD was seen, namely, microalbuminuria in 44.8%, retinopathy in 56.8% and elevated CCIMT in 35.6% patients. Significant association could also be appreciated in hypertensive patients with microalbuminuria when compared to those without, with respect to the presence of other TOD, specifically, retinopathy (OR 6.21, 95% CI, p-value<0.001) and elevated CCIMT (OR 26.5 95% CI, p value<0.001). Conclusions: Given the high prevalence and significant association, it was concluded that microalbuminuria could function as a great tool to identify possibility of other on-going target organ damage and initiate timely treatment, to prevent the occurrence of catastrophic events in the future.

Background: Psychological distress and cognitive difficulties are prevalent among postmenopausal women. While some studies suggest distress affects memory or executive functions, findings are inconsistent. We evaluated associations of psychological distress with multiple cognitive domains in postmenopausal women. Participants and Setting: The Early versus Late Intervention Trial with Estradiol was a randomized, double-blinded, placebo-controlled trial of 643 healthy postmenopausal women, conducted between 2005 and 2013. A psychosocial substudy included 448 women. Methods: In this secondary analysis, psychological distress was assessed as a latent factor using validated scales (Perceived Stress, Center for Epidemiologic Studies Depression, Liebowitz Social Anxiety, Penn State Worry Questionnaire, National Anxiety Disorders Screening Day Survey). Cognitive composite scores for executive functions, visuospatial ability, verbal memory, and visual memory were assessed three times over 5 years. Linear mixed-effect models (630 observations, 388 participants) included covariates of age, education, income, treatment assignment, carotid artery intima-media thickness, and hysterectomy status. Results: Psychological distress was significantly associated with lower executive functions (β [95% confidence interval or CI] = -0.07 [-0.13, -0.01], p = 0.03) and visuospatial ability (β [95% CI] = -0.08 [-0.16, -0.01], p = 0.03), but not with verbal (β [95% CI] = 0.01 [-0.07, 0.09], p = 0.74) or visual memory (β [95% CI] = 0.02 [-0.06, 0.10], p = 0.63). Conclusions: Findings highlight the importance of addressing psychological distress as part of interventions to maintain cognitive health in postmenopausal women and the need for comprehensive models that integrate emotional and biological factors to better understand cognitive aging in this population.

Purpose Pulse wave velocity (PWV) is a measure of arterial stiffness that reflects vascular ageing and predicts risk for cardiovascular disease. We developed a PWV measurement method that uses dual-impedance cardiography (d-ICG) to address limitations of other common methods (e.g. ultrasound, tonometry, etc.), as well as to enable PWV assessments across a broader range of populations. This pre-registered, cross-sectional study tested for the first time the extent to which d-ICG PWV associates with cardiometabolic risk factors (i.e. blood pressure and other metabolic syndrome components) and vascular markers of preclinical atherosclerosis (i.e. carotid-artery intima-media thickness [C-IMT] and plaque). Methods Participants were 366 healthy adults (aged 28–57; 63.4% female). In a subsample (N = 179), estimates of d-ICG PWV were compared for the first time against carotid-femoral PWV (cfPWV) measured by a Complior device. Results d-ICG PWV and cfPWV measures were comparably associated with age and blood pressure (r’s ≥ .28, p’s ≤ .001), and they exhibited moderate consistency (ICCs = 0.51 to 0.55, p’s < .001). Across all cardiometabolic risk factors and markers of preclinical atherosclerosis, there were no clinically meaningful differences in the average composite (Fisher’s Z-score) correlations with arterial stiffness measured by d-ICG and cfPWV based on Cohen’s q values (q’s = 0.042 to 0.097). Conclusion d-ICG PWV may be a low-cost, reliable, and alternative method for obtaining estimates of arterial stiffness that track with cardiometabolic risk factors and preclinical atherosclerosis.

Polygenic predisposition to increased LDL-cholesterol concentration and Carotid Artery Intima Media Thickness in childhood and early adulthood

Background: Non-hemorrhagic stroke (NHS) is a leading cause of global morbidity and mortality, with intracranial atherosclerotic disease (ICAD) as an important etiology. Intima–media thickness (IMT) is widely used as an early marker of atherosclerosis in both cerebral and coronary circulation. However, evidence on IMT and ICAD as predictors of short-term major adverse cardiovascular events (MACE) after NHS, and their mutual relationship, remains limited and inconsistent. Objective: This study aimed to evaluate the ability of common carotid artery IMT and ICAD to predict 90-day MACE in NHS patients, to determine a reliable IMT cutoff, and to assess the association between IMT and ICAD in this population. Methods: This prospective cohort study enrolled NHS inpatients at RSUP Prof. dr. I.G.N.G. Ngoerah. IMT was measured at admission by carotid ultrasonography, and ICAD was assessed with angiography imaging according to the hospital’s clinical protocol. Patients were followed for 90 days for MACE. The optimal IMT cutoff was identified using receiver operating characteristic (ROC) analysis. Associations of IMT and ICAD with MACE, and IMT with ICAD, were tested using proportion comparisons. Survival was analyzed with Kaplan–Meier curves and the log-rank test. Independent predictors were identified using multivariable Cox regression and reported as adjusted hazard ratios (AHRs). Results: 52 patients were included in this study. The optimal IMT cutoff to predict MACE was 0.82 mm (AUC 0.717; sensitivity 72.7%; specificity 68.3%). On chi-square analysis, higher IMT (RR 3.9; 95% CI 1.17–13.14; p=0.014) and ICAD (RR 4.6; 95% CI 1.34–15.39; p=0.005) were associated with 90-day MACE. IMT was not significantly associated with ICAD (RR 1.64; 95% CI 0.80–3.33; p=0.172). In multivariable analysis, elevated IMT was an independent predictor of short-term MACE (AHR 13.10; 95% CI 1.03–166.93; p=0.047), whereas ICAD was not an independent risk factor after adjustment (AHR 5.06; 95% CI 0.76–33.68; p=0.094). Additional independent predictors were atrial fibrillation (AHR 20.81; p=0.008), NIHSS severity (AHR 6.99; p=0.040), left-ventricular ejection fraction (AHR 0.89 per 1%; p=0.007; protective), and leukocyte count (AHR 1.42 per 10⁹/L; p=0.028). Conclusion: IMT at admission is an independent predictor of 90-day MACE in NHS patients. ICAD shows clinical relevance but is not an independent risk factor after adjustment, likely due to the limited number of events and collinearity with other covariates. No significant association between IMT and ICAD was observed. These findings support IMT for early risk stratification and underline the need for larger studies to validate the role of ICAD as a short-term MACE risk factor in the NHS.

Circulating markers of inflammation may be associated with carotid artery intima-media thickness (CIMT), a marker of subclinical atherosclerosis associated with cardiovascular and cerebrovascular disease, although the exact relationship between these circulating markers of inflammation and progression of CIMT is unclear. We hypothesize that markers of circulating inflammation and endothelial dysfunction are associated with progression of CIMT in the FHS (Framingham Heart Study) cohort. Multivariable linear regression was used to assess the association between specific circulating markers of inflammation with cross-sectional internal CIMT (ICIMT) measurement and ICIMT progression defined as rate of change of intima-media thickness (mm/y) in the internal carotid artery. Our primary analyses adjusted for age, sex, hypertension, diabetes, APOE4, body mass index, and smoking at the time of baseline CIMT measurement. Secondary analyses additionally adjusted for baseline CIMT measurements. We studied 2264 participants (mean age 57.2 years, 54% women). In our primary multivariable adjusted analysis, we observed that participants with higher baseline C-reactive protein (β=0.057 [95% CI, 0.012-0.102]; P=0.013), lipoprotein-associated phospholipase A activity (β=0.050 [95% CI, 0.006-0.094]; P=0.027), and isoprostanes (β=0.054 [95% CI, 0.013-0.101]; P=0.012) had significantly higher ICIMT progression, after adjusting for vascular risk factors and baseline CIMT. In a cross-sectional analysis at follow-up, we also observed that participants with higher levels of interleukin-6, osteoprotegerin, and P-selectin had significantly higher ICIMT. Specific markers of inflammation and endothelial dysfunction were associated with increased ICIMT and carotid atherosclerosis progression.

Introduction A key indicator of cardiovascular risk, especially in people with hypertension, is the carotid artery's intima-media thickness (IMT). This article focuses on how IMT and hypertension are related, how well IMT predicts cardiovascular events, and how antihypertensive medications affect the course of IMT. Aim To search into the relationship between IMT and hypertension and evaluate how antihypertensive medication affects IMT in people with hypertension. Material and methods A detailed analysis of the existing literature body served as the foundation for this investigation. Several electronic databases, including Embase, PubMed, Scopus, Web of Science, Cochrane Library, Frontiers, Taylor &amp; Francis Online, Springer, and Elsevier, were searched systematically using pertinent keywords. Thirty articles were found to be eligible for review. Results and discussion Increased IMT is closely linked to hypertension, suggesting that high blood pressure causes arterial wall thickening. Future cardiovascular events, including myocardial infarction and stroke, can be accurately predicted by elevated IMT. It has been demonstrated that antihypertensive medications, especially those that target the renin-angiotensin-aldosterone system, can effectively slow the progression of IMT. Improving patient outcomes requires early identification of subclinical atherosclerosis using IMT measurement and individualized treatment plans. To effectively manage hypertensive patients with elevated IMT, healthcare providers must work together. Conclusions Reducing cardiovascular risk in hypertensive patients requires a multidisciplinary approach. Frequent IMT evaluation is useful for treatment planning and cardiovascular risk assessment. Furthermore, anesthesia professionals are essential to maintaining patient safety and maximizing pain control.

Background: Exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to increased atherosclerosis. However, longitudinal studies are limited, particularly in postmenopausal women who are at high risk of atherosclerosis. Hypothesis: We hypothesized that PFAS exposure was associated with accelerated atherosclerosis progression. Methods: This study included 641 women (60.6 ± 6.9 years) from the Early versus Late Intervention Trial with Estradiol. Plasma concentrations of 2-(N-methyl-perfluorooctane sulfonamido) acetate (MeFOSAA), perfluorohexane sulfonate (PFHxS), perfluorononanoate (PFNA), perfluorodecanoate (PFDA), perfluoroundecanoate (PFUnDA), sum of perfluoromethylheptane sulfonates (Sm-PFOS), linear perfluorooctane sulfonate (n-PFOS), and linear perfluorooctanoate (n-PFOA) were measured at a pre-randomization visit and 36-month follow-up using online solid phase extraction–high performance liquid chromatography–isotope dilution–tandem mass spectrometry. Subclinical atherosclerosis was assessed biannually over a median 5-year follow-up using high-resolution B-mode ultrasound. Linear regression and linear mixed-effects models were used to assess cross-sectional and longitudinal associations between log 2 -transformed PFAS levels and atherosclerosis measures, adjusting for baseline age, race/ethnicity, education, smoking, lipid-lowering medication, time since menopause (&lt;6 years or ≥10 years), and treatment (estradiol or placebo). Results: Carotid-artery intima-media thickness (CIMT) increased, and gray-scale median of intima-media complex (IM-GSM) decreased over the follow-up period. At baseline, CIMT was 8.4 µm thicker (95% confidence interval: 4.1, 16.4) per doubling of PFUnDA levels. During the follow-up, each doubling of average PFHxS, PFNA, PFDA, PFUnDA, and n-PFOA levels across baseline and follow-up was associated with a faster increase in CIMT by 0.49 (0.20, 0.79), 0.64 (0.23, 1.04), 0.84 (0.48, 1.21), 0.51 (0.23, 0.78), and 0.82 (0.44, 1.21) µm/year, respectively. Each doubling of average PFDA and n-PFOA levels was associated with a faster decrease in IM-GSM by -0.23 (-0.38, -0.07) and -0.27 (-0.44, -0.10) per year, respectively. Conclusion: Our findings suggest that PFAS exposure may accelerate atherosclerosis progression in postmenopausal women, independent of key treatments and risk factors, highlighting the potential for incorporating PFAS, a modifiable environmental factor, into the cardiovascular disease prevention efforts.

Neutrophil-lymphocyte and platelet-lymphocyte ratios as predictors of atherosclerotic thrombotic risk in patients with myelofibrosis

Carotid artery intima–media thickness (cIMT), a pre-clinical vascular change that accompanies atherosclerosis is considered as a cardiovascular risk factor. Coagulation factor XIII (FXIII) stabilizes the fibrin clot and increases its resistance to fibrinolysis. Regarding FXIII Val34Leu polymorphism, the protective effect of the Leu34 allele in the presence of elevated fibrinogen levels against myocardial infarction was demonstrated. Our aim was to investigate the effect of FXIII polymorphisms on cIMT. Patients with obesity (n = 69), type 2 diabetes mellitus (T2DM) (n = 104), and age- and sex-matched healthy controls (n = 82) were enrolled. FXIII polymorphisms (Val34Leu, His95Arg, Intron-K C>G) were determined by RT-PCR with FRET detection and melting curve analysis. cIMT was determined by B-mode ultrasound. Differences in cIMT between control (median: 0.5965, IQR: 0.5115–0.6580 mm) and T2DM (median: 0.7105, IQR: 0.5948–0.7568 mm), as well as between obese (median: 0.6105, IQR: 0.5455–0.6780 mm) and diabetic groups, were found (p < 0.0001 and p = 0.003, respectively). Genotype and allele frequencies of the studied polymorphisms did not differ between subgroups. In the study group (n = 255) after adjustment for age and sex, the presence of Intron-K G allele showed a significant and independent protective effect against cIMT progression in a separate model (p = 0.005) and after adjusting for other parameters associated with cIMT (p = 0.015). FXIII Intron-K G allele provides a protective effect against subclinical vascular disease in the studied population, and this effect is independent of the presence of obesity, as well as T2DM, Leu34 allele, and fibrinogen levels.

BackgroundPathological changes in the arterial vasculature play a pivotal role in the development of macrovascular and microvascular complications of diabetes mellitus (DM). Compared with traditional measurements of carotid artery intima-media thickness, separate measurements of the thickness of the intima and the media using high-resolution ultrasonography could reveal vascular anatomical changes more precisely. Homocysteine (HCY) is closely related to vascular complications in DM patients. This study aimed to explore the thickness of the intima and media separately in the carotid, radial, and dorsalis pedis arteries in DM patients, to examine their diagnostic value for DM with complications and their relationship with HCY.MethodsThis was a cross-sectional study. A total of 123 DM patients and 102 healthy controls were enrolled. Arterial ultrasonography was performed using a 24-MHz probe to measure the thickness of the intima and media in the carotid, radial, and pedal arteries. Serum levels of fasting glucose, low-density lipoprotein cholesterol, HCY, and clinical information were also collected. Multivariate linear regression was performed to investigate the association between ultrasonographic parameters and risk factors, and binary logistic regression was used to explore the diagnostic value of combination model for DM with complications.ResultsCarotid, radial, and pedal artery intima thickness were substantially thicker in DM patients than controls. Compared with DM patients without macrovascular complications, those with macrovascular complications exhibited a thicker media in all three arteries, a thicker carotid intima, and a thicker carotid artery intima-media thickness. The relative difference was greatest for carotid artery media thickness (28.4%). HCY positively correlated with all MTs and CIT in DM patients. CIT was associated with traditional risk factors including age, systolic blood pressure and HCY. Combination model of age, SBP and CIT provides a satisfactory diagnostic value for DM patients with macrovascular complications (area under the curve, 0.827).ConclusionsMeasurement of arterial intima and media thickness using high-resolution ultrasonography might be a promising tool to reveal arterial pathological changes in DM patients.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12902-025-02064-2.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent in adolescents with obesity and is linked to insulin resistance and cardiovascular disease (CVD). Pancreas steatosis might be associated with MASLD and early CVD. Imaging-based analyses of these associations have not been studied extensively in children. Objectives: To assess the reproducibility of liver and pancreatic steatosis and volume measurement on MRI in adolescents with obesity and MASLD and their association with homeostatic model assessment of insulin resistance (HOMA-IR) and subclinical vascular changes on ultrasound. Methods: This is an observational study on adolescents with MASLD and obesity. Hepatic and pancreatic steatosis, volume, and abdominal fat were assessed using magnetic resonance spectroscopy and proton density fat fraction. Reproducibility of these measurements was performed. Vascular markers included non-invasive vascular elastography (NIVE), carotid artery intima-media thickness (IMT), and pericardial fat thickness. Fasting blood tests measured the HOMA-IR. Bivariate correlation and simple linear regression were performed using SPSS. Results: We obtained 23 participants aged 12 to 17 years (78.3% male). Measurements were reproducible [ICC 0.807-0.998]. Liver steatosis was positively correlated with HOMA-IR (p = 0.015). Pancreas steatosis was positively correlated with HOMA-IR (p = 0.02), IMT/diameter (p = 0.002), and pericardial fat (p = 0.03). Liver steatosis was not significantly correlated with pancreas steatosis nor vascular markers. There were negative associations between NIVE metrics and visceral abdominal fat (p = 0.009) and intraperitoneal fat (p = 0.047). Conclusions: Liver and pancreas steatosis measurements on MRI are reproducible. In this exploratory study, adolescents with obesity and MASLD, pancreas steatosis, and pancreas volume show association with subclinical CVD markers. Visceral and intraperitoneal abdominal fat show association with increased vascular stiffness, suggesting a potential role of imaging-based cardiovascular risk assessment in this population if validated. These preliminary findings require validation in larger, diverse prospective cohorts.

BackgroundCathepsin K (CatK) contributes to vessel collagene remodelling and high CatK concentrations have been found in atherosclerotic lesions. CatK ablation in a murine model determined an amelioration of diabetes-induced hyperglycemia and cardiovascular structural/functional abnormalities. To date, it is unknown whether glucose tolerance status affects circulating levels of CatK, and if CatK is involved with the cardiovascular complications associated with type 2 diabetes (T2DM).MethodsWe assayed the levels of serum CatK in a cohort of 544 well-characterized Caucasian adults. assessing subclinical cardiovascular organ damage defined by carotid artery intima-media thickness (c-IMT) and left ventricular mass index (LVMI) in our T2DM cohort.ResultsCatK levels were significantly higher in individuals with T2DM (2.3 ± 0.8 ng/ml; N = 263) compared to normoglycemia (NGT; 1.2 ± 0.5 ng/ml; N = 146) or predabetes (IFG/IGT; 1.2 ± 0.3 ng/ml; N = 135). Consistent with the literature, CatK levels correlated with age (r = − 0.190, p = 0.001), 2 h-PG (r = − 0.118, p = 0.048) and c-IMT (r = 0.157, p < 0.01) in the subset without T2DM. In the T2DM group, CatK positively correlated with FPI (r = 0.277; p < 0.001), HOMA-IR (r = 0.269; p < 0.001) and c-IMT (r = 0.155; p = 0.013). Multiple logistic regression analysis, adjusted for potential confounders, revealed that a one-quintile increment in CatK levels was associated with a 6.5-fold increased odds of T2DM. Furthermore, multiple linear regression analysis in T2DM patients, including sex, age, BMI, hypotensive therapy, and HOMA-IR (or alternatively HbA1c or FPI) as covariates, identified age and CatK as the strongest determinants of c-IMT. CatK levels did not correlate with LVMI in either the T2DM or non-T2DM cohorts.ConclusionsOur data show that the variability of CatK circulating levels is associated with glucose tolerance status, and with early signs of atherosclerosis in a population with T2DM as well as in non-diabetic individuals. These findings, combined with the established role of CatK in vascular remodeling, suggest that CatK may play a role in the early etiopathogenesis of cardiovascular complications in T2DM.

Effect of Detection of Subclinical Atherosclerosis on Carotid Ultrasound on Cardiovascular Events in a Primary Prevention Clinical Setting.

Background: Beta-thalassemia major (β-TM) is a severe hemoglobinopathy requiring lifelong transfusions, leading to iron overload and complications. Evidence links β-TM to premature vascular changes, including atherosclerosis, indicated by increased carotid intima-media thickness (CIMT) due to iron overload, chronic inflammation, and oxidative stress. Despite known cardiovascular risks, data on subclinical atherosclerosis in β-TM are scarce. Aims and Objective: This study aims to determine the prevalence of premature subclinical atherosclerosis in transfusion-dependentβ-TM by measuring CIMT and correlating findings with clinical and biochemical parameters for early cardiovascular risk prevention. Materials and Methods: This prospective observational study was conducted at the Department of Pediatrics, Hassan Institute of Medical Sciences, Hassan, over 3 months (May–September 2023), involving 70 children (35 β-TM and 35 controls). Inclusion criteria were transfusion-dependent β-TM (2–18 years) with ≥8 transfusions/year, whereas children with congenital heart disease or familial hypercholesterolemia were excluded. Demographic, clinical, and laboratory data (complete blood count, lipid profile, C-reactive protein, ferritin, and liver enzymes) were recorded. CIMT was measured via B-mode ultrasound. Results: This study revealed a high prevalence of premature subclinical atherosclerosis, with significantly increased carotid and femoral artery intima-media thickness (IMT) (P&lt;0.001) and dyslipidemia (76.3%). Hemoglobin was lower (8.06 vs. 11.37 g/dL, P&lt;0.001), and serum ferritin was elevated (2080.70 vs. 128.03 ng/mL, P&lt;0.001), indicating anemia with iron overload. About 60.5% of patients had both dyslipidemia and increased IMT. Age and serum ferritin significantly predict increased CIMT, with ferritin showing a stronger association, indicating early vascular changes. Conclusion: This study confirms a high prevalence of premature subclinical atherosclerosis in transfusion dependent β-TM patients, evidenced by increased CIMT. These findings justify early cardiovascular screening and intervention to mitigate long-term vascular risks in this vulnerable population.