Carotid Intima-media Thickness Risk Research Articles

COMPARISON OF INFLUENCE OF OFFICE PULSE WAVE VELOCITY AND 24-HOUR AMBULATORY RECORDING OF AORTIC PULSE WAVE VELOCITY ON TARGET DAMAGE IN HYPERTENSION

Objective: Arterial stiffness, as measured by pulse wave velocity (PWV), is a significant determinant of target organ damage (TOD). The aim of this study was to assess the potential use of office PWV and 24-hour PWV for prediction of subclinical TOD in a hypertensive cohort. Design and method: We evaluated associations of TOD with office carotid-femoral pulse wave velocity (O-cf-PWV) by radial tonometry (SphygmoCor) and 24-hour ambulatory PWV measurements (24h-PWV, including day-PWV and night-PWV) by brachial oscillometry (Mobil-O-Graph 24h PWA Monitor) in 636 hospital inpatients (age 54 ± 13 years, 465 males) with primary hypertension. Subclinical TOD was defined as left ventricular hypertrophy (LVH) obtained by echocardiography, carotid intima-media thickness (IMT) >0.9mm and chronic kidney disease (CKD) including urine albumin/creatinine ratio (ACR) >3.5 mg/mmol in females and >2.5 mg/mmol in males or estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. Results: After adjusting for confounding factors, both O-cf-PWV and 24h-PWV or night-PWV showed significant association with LV mass index (p<0.05). Only day-PWV was associated with eGFR (p = 0.039). When O-cf-PWV and 24h-PWV, including other confounding factors, were forced into the same logistic regression model, only O-cf-PWV (OR = 1.117, 95% CI:1.009-1.236, p = 0.033) remained significant determinants of increased LVH. Each 1 m/s increase in 24-h-PWV and day-PWV was associated with decreased risk of eGFR (odds ratio [OR] = 0.340 and 0.43, respectively). Only each increase in night-PWV was associated with risk of carotid IMT > 0.9 mm (OR = 1.360, 95% CI: 1.004 -1.843, p = 0.047). For ACR, neither 24-h-PWV nor O-cf-PWV was significant. Conclusions: O-cf-PWV improved prediction of LVH compared to ambulatory 24h-PWV under ambulatory conditions. Day-PWV may improve prediction of eGFR decline.

Metabolically obese phenotype and its dynamic change are associated with increased carotid intima-media thickness: Results from a cohort study

Background and aimsTo examine associations between metabolically obese phenotypes or their changes and increased carotid intima-media thickness (CIMT). Methods and resultsThis prospective cohort included 13,681 Chinese adults aged 20–80 years who completed follow-up health examination with carotid ultrasound and were divided according to metabolic and weight status: metabolically healthy and normal weight (MHNW); metabolically obese but normal weight (MONW); metabolically healthy but obese (MHO); metabolically abnormal and obese (MAO). Cox and logistic regression were used to evaluate the associations of the phenotypes or their changes with increased CIMT.During a mean follow-up of 33 months, 1927 participants developed increased CIMT. After adjusting for age, sex and potential biochemical confounders, MAO was significantly associated with increased CIMT (HR 1.22, 95% CI [1.07, 1.4]); the association remained significant in those 40 years or older. Compared with stable MHNW, increased CIMT risk was higher for stable MAO (OR 1.35 [1.16, 1.57]), transitional MAO from MONW (OR 1.44 [1.04, 1.97]), and transitional MHO from MHNW (OR 1.59 [1.10, 2.26]) in demographic adjusted models; only stable MAO remained significant in the multivariate adjusted model (OR 1.23 [1.05, 1.45]). ConclusionMAO significantly elevated the risk of increased CIMT. Stable MAO and obese transitions also promoted CIMT progression.

Carotid Intima-Media Thickness Percentiles in Adolescence and Young Adulthood and Their Association With Obesity and Hypertensive Blood Pressure in a Population Cohort.

This study aimed to derive carotid intima media thickness (CIMT) percentiles from a population-based sample of adolescents and young adults using improved technology, standardization and quality control, and to investigate the association of CIMT with hypertensive blood pressure (BP) and obesity. Four thousand seven hundred nine 14- to 28-year-old participants of the German KiGGS cohort 11-year follow-up, which was based on a nationwide population sample, had B-mode ultrasound CIMT measurement with semi-automated edge-detection and automatic ECG-gated real-time quality control. CIMT percentiles were estimated from far wall CIMT during 2 to 6 heart cycles using the GAMLSS statistical model. Hypertensive BP, overweight, obesity, and a risk score from added Z scores of triglycerides, total/HDL (high-density lipoprotein)-cholesterol ratio, and glycated hemoglobin were based on standardized measurements at baseline and follow-up. CIMT differed by sex at all ages, furthermore by age and height in a nonlinear fashion. Percentiles were estimated simultaneously by age and height. Hypertensive BP and obesity were associated cross-sectionally and longitudinally with a higher risk of CIMT ≥75th percentile in log-binomial regression models adjusted for age, sex, height, current smoking, and cardiovascular risk score. For CIMT ≥90th percentile, the relative risk effect estimates were consistently >1 but often had large confidence intervals including 1, largest adjusted relative risk 3.37 (95% CI, 1.41-8.04) for the combination of hypertensive BP and obesity at follow-up. Based on state-of-the-art measurements and statistical techniques, these population-based CIMT percentiles by sex, age and height add unbiased evidence for the association of subclinical atherosclerosis with hypertensive BP and obesity in the young.

Nonalcoholic fatty liver disease and health outcomes: An umbrella review of systematic reviews and meta-analyses.

Purpose:A large number of systemic reviews and meta-analyses have explored the relationship between nonalcoholic fatty liver disease (NAFLD) and multiple health outcomes. The aim of this study is to conduct an umbrella review to assess the strength and evidence for the association between NAFLD and health outcomes.Methods:We systematically identified the present meta-analyses of observational studies reporting an association between NAFLD and health outcomes. For each meta-analysis, we assessed the quality with AMSTAR2 and graded the epidemiologic evidence.Results:Fifty-four articles comprising 111 unique meta-analyses were included in this study. Eighty-five unique outcomes showed significant associations (P ← 0.05), whereas 26 unique outcomes showed insignificant associations, and we cannot assess the epidemiologic evidence. For 85 significant health outcomes, four outcomes (carotid intima-media thickness (C-IMT), peak A velocity, left ventricle end-diastolic diameter, incident chronic kidney disease (CKD) in adult patients) was graded as high quality of evidence, 23 outcomes were graded as the moderate quality of evidence, and the remaining 58 outcomes were graded as weak quality of evidence. Fourty-seven (87.03%) studies showed critically low methodological quality.Conclusion:In this umbrella review, only four statistically significant health outcomes showed high epidemiologic evidence. NAFLD seems to relate to an increased risk of C-IMT, peak A velocity, left ventricle end-diastolic diameter, and incident CKD in adult patients.

The association between low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio cholesterol ratio and thickened carotid intima-media thickness: A case-control study.

It is indicated that Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C ratio) has greater predictive value for thickened carotid intima-media thickness (CIMT) comparing with classic lipid parameters. However, there have been few reports about their association in general Chinese population. We included a total of 1220 CIMT participants and 2440 matched controls, who had ultrasonography of carotid artery during 2009 and 2016. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for thickened CIMT risk associated with LDL-C/HDL-C ratio. In the univariate logistic regression model, there was significant association between LDL-C/HDL-C ratio and thickened CIMT (Q4 vs. Q1, OR = 1.94, 95% CI: 1.60-2.36; ptrend < 0.05). After adjusting for potential covariates, LDL-C/HDL-C ratio remained significantly associated with thickened CIMT (Q4 vs. Q1, OR = 1.81, 95% CI: 1.41-2.34, ptrend < 0.001; ≥3.05 v.s. <3.05, OR = 1.66, 95% CI: 1.37-2.02). In subgroup analyses, the association between LDL-C/HDL-C ratio and thickened CIMT remained significant in the subgroups stratified by sex, impaired fasting glucose (IFG), hypertension, and fatty liver disease but only remained significant in the subgroups of ≥45 years (OR = 2.01, 95% CI: 1.46-2.76; Ptrend<0.05), BMI ≥24 (kg/m2) (OR = 2.22; 95% CI = 1.63-3.03; Ptrend < 0.05) and BMI ≥25 (kg/m2) (OR = 2.50, 95% CI: 1.76-3.54; Ptrend < 0.05), dyslipidemia (OR = 3.28, 95% CI: 1.83-5,85; Ptrend < 0.001), and without periodontitis (OR = 2.08, 95% CI: 1.54-2.81 ; Ptrend < 0.05) comparing Q4 to Q1. Similar results were observed in the subgroup analyses for LDL-C/HDL-C ratio ≥3.05 v.s. <3.05 except for the age stratification. High LDL-C/HDL-C ratio could significantly increase the risk of thickened CIMT independent of gender, IFG, hypertension, and fatty liver disease in general Chinese population.

Early-life exposure to the Chinese famine and risk of carotid intima-media thickness increased in adulthood

Background and aimsLittle was known about the effect of famine exposure on carotid intima-media thickness (cIMT). The present study aimed to explore the relationship in a Chinese population. Methods and resultsParticipants were divided into five groups: not exposed to famine, exposed to famine in fetal, early, mid or late childhood. Elevated cIMT was defined as a thickness of >0.9 mm measured by carotid ultrasound. Multivariate logistic regression was performed to calculate odds ratio (OR) and confidence interval (CI) between famine exposure and cIMT. A total of 2637 (970 male, mean age 59.1 ± 3.65 years) participants were recruited, and 491 (18.62%) of them had elevated cIMT. When compared with the non-exposure group, the fully adjusted ORs for increased cIMT for exposure in fetal, early, mid to late childhood were 1.321 (95%CI: 0.872, 1.994, P = 0.186), 1.713 (95% CI: 1.188, 2.483, P = 0.004), 2.359 (95% CI: 1.674, 3.357, P < 0.001) and 2.485 (95% CI: 1.773, 3.518, P < 0.001), respectively. Subgroup analyses showed that the exposure to famine did not interact with body mass index, gender, smoking status, hypertension and diabetes history on its effect on cIMT. ConclusionOur findings indicated that early-life exposure to the Chinese famine might be associated with an increased risk of increased cIMT in adulthood.

Low-Density Lipoprotein Cholesterol/High-Density Lipoprotein Cholesterol Ratio and Carotid Intima-Media Thickness: A Cohort Study in China.

Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio may carry additional information and has been suggested as a better predictor for atherosclerosis progression and cardiovascular disease (CVD) than LDL-C and HDL-C alone. Therefore, we aim to explore the association between LDL-C/HDL-C ratio and high carotid intima-media thickness (CIMT) risk in a large Cohort in Beijing, China. This cohort study included 13,612 adults without high CIMT at first entry and who attended the baseline examination and at least one follow-up annual examination between 2009 and 2016. We used multivariable Cox regression to estimate hazard ratios (HR) with their 95% confidence intervals (CI) for the association between LDL-C/HDL-C ratio and risk of high CIMT. During 37,912 person-years of follow-up, 1996 (1268 men and 728 women) developed high CIMT. Compared with the first quartile of LDL-C/HDL-C ratio, the risk of high CIMT was significantly increased for the fourth quartile of LDL-C/HDL-C ratio (HR = 1.51, 95% CI: 1.29-1.78). We observed a significant association between LDL-C/HDL-C ratio and high CIMT risk comparing LDL-C/HDL-C ratio >2.78 with LDL-C/HDL-C ratio ≤2.78 and significant dose-response relationship between LDL-C/HDL-C ratio and risk of high CIMT. The restricted cubic spline showed a significant nonlinear association between LDL-C/HDL-C ratio and the risk of high CIMT (pnon-linearity = 0.009). We identify a significant association between LDL-C/HDL-C ratio and the risk of high CIMT in the Chinese Cohort study. Future studies are needed to evaluate the effectiveness of reducing LDL-C/HDL-C ratio treatment on the development of high CIMT.

Relation of protein energy wasting to carotid intima media thickness in hemodialysis patients.

Carotid intima media thickness (CIMT) can reflect the degree of atherosclerosis and cardiovascular risk in hemodialysis patients. Factors such as advanced age, male gender, family history, and smoking can increase the risk of CIMT. In hemodialysis (HD) patients, lower serum albumin level was found to be correlated with higher CIMT. This study aimed to evaluate the relation between CIMT and protein energy wasting (PEW) diagnosed according to the diagnostic criteria of International Society of Renal Nutrition and Metabolism (ISRNM) expert panel in HD patients. This study involved 45 HD patients who were divided into two groups according to the diagnostic criteria for PEW proposed by the ISRNM expert panel including group with PEW (11 patients) and group without PEW (34 patients). Caloric intake was evaluated by food frequency questionnaire for 3 days. Subjective global assessment (SGA) and malnutrition inflammation score (MIS) were fulfilled. Anthropometric measurements, as well as body composition, was evaluated by electrical bioimpedance analysis. Doppler ultrasonography was used to assess CIMT that was significantly higher in patients with PEW (p = 0.030). CIMT had significant positive correlation to age, SGA, and MIS (p = 0.008, 0.002, and 0.003, respectively). Significant negative correlation was observed between CIMT and serum albumin. Multiple linear regression analysis revealed that serum albumin was the only predictor of mean CIMT. In conclusion, CIMT seems to be related to malnutrition in HD patients. Low serum albumin was the only predictor of CIMT.

Interleukin 6 concentration elevation as a risk of carotid intimamedia thickness in chronic kidney disease patients with dialysis.

Aim To investigate the relationship between IL-6 concentration and the risk of carotid artery calcification in chronic kidney disease patients with dialysis (CKD-5D). Methods This analytic observational cross-sectional study includes 95 clinically stable patients who underwent regular haemodialysis for at least three months at Rasyida Renal Hospital Medan, Indonesia. Serum IL-6 level was measured using the enzyme-linked immunosorbent assay (ELISA). Carotid artery calcification was determined by measuring Carotid Intima-Media Thickness (CIMT) using Real-Time B-mode ultrasound. Results There were 53 males (55.8%) of the total samples with the mean duration of haemodialysis of 81.28±67.40 months. Ultrasound examination showed that 28 samples (29.5%) had carotid artery calcification. Statistical test significantly showed that patients with IL-6 ≥81.1 pg/mL were more likely to have carotid artery calcification with an increased risk of 12.92 times (95% CI: 5.54-30.12) compared to the group of patients who had IL-6 level <81.1 pg/mL (p <0.001). Conclusion This study proves that a high level of IL-6 can increase the risk of carotid artery calcification in CKD-5D patients.

LDL-cholesterol to HDL-cholesterol ratio discordance with lipid parameters and carotid intima-media thickness: a cohort study in China

BackgroundThe discordance of the low-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with alterative lipid parameters may explain the inconsistent association of CIMT with the LDL-C/HDL-C ratio. Therefore, this study aimed to explore the associations between LDL-C/HDL-C ratio discordance with alternative lipid parameters and elevated carotid intima-media thickness (CIMT) risk in a large cohort in Beijing, China.MethodsIn total, 13,612 adults who didn’t have elevated CIMT at baseline and who participated in at least one follow-up of annual examination between 2009 and 2016 were included in this cohort study. A multivariable Cox regression model was utilized to evaluate the associations of discordance of the LDL-C/HDL-C ratio with TC, TGs, LDL-C and HDL-C with elevated CIMT risk.ResultsDuring 37,999 person-years of follow-up, 2004 individuals (1274 men and 730 women) developed elevated CIMT. Among individuals with normal TC and TGs, 16.6 and 15.2% individuals had a discordantly high LDL-C/HDL-C ratio, respectively, and the risk of elevated CIMT increased by 1.54 (95% CI 1.33, 1.77) and 1.53 (95% CI 1.33, 1.76), respectively, comparing to individuals with a concordantly low LDL-C/HDL-C ratio. A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with LDL-C and HDL-C (P < 0.001). A low LDL-C/HDL-C ratio with discordantly normal HDL-C and high LDL-C (13.2% of individuals) had a 32% (HR = 1.32, 95% CI 1.11, 1.57) higher risk of elevated CIMT than concordantly low LDL-C and normal HDL-C. Sensitivity analysis by excluding CIMT developed in the first 2 years follow-up further confirmed the above results.ConclusionsA high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with TC, TGs, LDL-C and HDL-C Even a low LDL-C/HDL-C ratio with discordantly high LDL-C and normal HDL-C could also significantly increase CIMT risk. Individuals should maintain both the LDL-C/HDL-C ratio and LDL-C at normal levels to prevent elevated CIMT.

Serum Vitamin D Level and Carotid Intima-Media Thickness: A Systematic Review and Meta-Analysis of Observational Studies and Randomized Control Trials.

It is reported that vitamin D deficiency is associated with carotid intima-media thickness (CIMT). In addition, several randomized clinical trials (RCTs) have studied the influence of vitamin D supplement on CIMT. However, results are inconclusive. This review aimed to systematically explore the potential link of the serum vitamin D level with CIMT pooling together observational studies and RCTs. PubMed and Scopus were searched for studies published until February 13, 2018. The Fisher's z (SE) correlation coefficient, odds ratio (OR), and mean (SD) of changes in CIMT from baseline were used to perform meta-analysis in observational studies and RCTs, respectively. To pool data, both a fixed-effects model and a random-effects model (in case of heterogeneity) were used. Heterogeneity was assessed using Cochran's Q and I2 tests. Nineteen observational studies and 3 RCTs met inclusion criteria. The pooled correlation coefficients of 17 observational studies showed [(Fisher's z=- 0.41, 95% CI: -0.63 to -0.19, p<0.001), I2=96.9%, p < 0.001] a significant inverse association between serum vitamin D and risk of CIMT. Pooling three risk estimates of three studies [(OR = 1.69, 95% CI: 0.74 to 3.86, p=0.209); I2=085.1%, p<0.001)] indicated no significant association between serum vitamin D status and risk of CIMT. Combining data of RCTs showed vitamin D supplementation significantly reduced CIMT [(MD: -0.034, 95% CI: -0.62 to -0.05, p=0.012), I2=16.6%, p = 0.301]. Our findings show that serum vitamin D is inversely associated with CIMT and vitamin D supplementation may reduce CMIT.

Helicobacter pylori infection is not related to increased carotid intima-media thickness in general population

The aim is to determine whether there is an independent association between Hp infection and carotid intima-media thickness (CIMT) in a cross-section observational study. Among of 14588 routine health check-up participants, 13770 subjects underwent the 13C-urea breath test (13C-UBT) and ultrasound measurement of CIMT. Traditional atherosclerotic risk factors were also recorded. The ratio of increased CIMT in Hp positive group (28.6%) was not significant difference compared with Hp negative group (29.7%) (p = 0.164). The HP infection rates was no significant difference between increased CIMT (38.4%) and non- increased CIMT (39.7%) patients. However, all the traditional atherosclerotic risk factors including age, gender, BMI, waistline, total cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides, free fatty acid, homocysteine, systolic and diastolic blood pressure, fasting plasma glucose and C reactive protein were different between increased CIMT and non- increased CIMT participants. The odds of Hp infection for CIMT risk (OR 0.948; 95% CI 0.879–1.022; P = 0.164) was not higher in binary logistic regression analysis even after adjustment for traditional risk factors (OR 1.118; 95% CI 0.958–1.306; P = 0.157). Our study found no evidence of association between CIMT and HP infection.

High risk of subclinical atherosclerosis in COPD exacerbator phenotype.

It is not known whether COPD exacerbations contribute to an increased vascular risk already associated with the disease. For this reason, we prospectively evaluated 127 patients referred for a monographic COPD consultation. We classify as exacerbators those who had experienced two or more moderate exacerbations in the previous year, or who had had a hospital admission. All underwent a blood analysis, respiratory function tests, global cardiovascular and coronary risk estimates (with four of the most frequently used scores, and the Chronic Obstructive Pulmonary Disease Coronaropathy Risk (COPDCoRi) score, respectively); and an EcoDoppler to measure carotid intima-media thickness and the ankle-brachial index. Finally, we included 50 patients with exacerbator phenotypes and 57 with non-exacerbator phenotypes, ranging from 63 ± 7 years old, 74% of whom were male. The exacerbator phenotype increased the risk of carotid intima-media thickness above the 75th percentile range by a factor of almost three, independently of the severity of COPD and global cardiovascular risk. The association between the exacerbator phenotype and high c-IMT was more evident in patients under 65. In conclusion, the presence of subclinical atherosclerosis is independently associated with the exacerbator phenotype, with more pronounced differences in younger patient; which suggests that we should intensify control of vascular risk factors in these groups of patients.

PP.21.39] CAROTID INTIMA-MEDIA THICKNESS SCREENING ADDS VALUE IN A CANADIAN COHORT

Objective: Carotid Intima-Media Thickness (CIMT) is an independent risk factor for sub-clinical atherosclerosis. Despite evidence to support its use, CIMT is not currently reimbursed by the Ontario government payment plan. We accessed CIMT in a cohort of patients who chose to pay for the test. The objective is to see if CIMT will add predictive value to traditional risk assessment in this contemporary Canadian cohort. Design and method: We analyzed the first sequential 1,969 patients in a private pay clinic with CIMT from 19 December 2013-29 October 2014. CIMT values were calculated using a Panasonic Healthcare Co. CardioHealth Station bilateral B-mode ultrasound and compared to traditional Framingham Risk Scores (FRS). The CIMT measures considered were mean intima-media thickness (both left and right side) and risk percentiles (low<25%; medium 25–75%; high>75%). The CIMT risk percentiles are based on the original Carotid Atherosclerosis Progression Study (CAPS) database. Results: Of the 1,969 patients, 995 (51%) were classified as low risk, 579 (29%) were classified as moderate risk, and 395 (20%) were classified as high risk for future CV events based on CIMT data. We compared traditional FRS with CIMT results. FRS was only available for 288 of the high CIMT patients (73%). Of these 288 patients, 139 (48%) were considered low risk by traditional FRS. Of the 139 patients who were misclassified by Framingham's (low FRS, high CIMT) 30% of the patients were women; the average age in this group of patients was 51. Ongoing, multi-variant analysis is under way to look for predictors of CIMT values.Conclusions: In a contemporary Canadian cohort FRS has limitations in classifying cardio-vascular disease risk. This was seen in a relatively young population, many of whom were women. Consideration should be given to adopting more widespread use of CIMT screening. This has implications for patient management and funding of such preventive strategies.

Abstract P126: Influence of CIMT as a Motivator for Health Behavior Change in a Heart Health Program

Introduction: Carotid intima media thickness (CIMT) ultrasound is a known surrogate marker of atherosclerosis but few studies examine its influence on patient behavior. Motivation and self-efficacy (SE) are known predictors of health behavior change. This randomized, double-blind trial examined 1) use of CIMT images plus associated CVD risk to motivate adherence, and 2) the predictive ability of motivation and SE on adherence change. Methods: Patients with ≥ 2 cardiovascular disease (CVD) risk factors and subclinical atherosclerosis were assigned to either the intervention group [receive results weekly (R-CIMT)] or control group [withhold results (W-CIMT)]. All patients received a 12-week lifestyle program (Mediterranean diet, aerobic exercise, group support). Overall change in adherence from baseline to week 12 was determined using an ANCOVA model where % adherence was a composite measure of diet and exercise adherence. Initial motivation plus exercise and nutrition SE were assessed to determine their predictive ability of adherence in a standard regression model. Results: 166 patients randomized; 161 (R-CIMT n=81; W-CIMT n=80) eligible for intention-to-treat analysis. Patients were middle age (mean age = 54 ± 11 yrs), 62% (100 or 161) women, 48% (77 of 161) black. Baseline group differences: W-CIMT group was younger (52 vs 55 yrs; p=0.05), had a lower systolic blood pressure (120 vs 125; p=0.01), lower % family history of CVD (49 vs 65; p=0.03). In comparing R-CIMT vs W-CIMT groups, no difference was detected in overall % adherence change (16.4 ± 25.6 vs 19.8 ± 25.4; p=0.39). Initial motivation and SE measures were not predictive of change in adherence when added to group assignment (see Table). Conclusions: CIMT evidence of subclinical atherosclerosis increased participant CVD risk awareness but did not translate into actionable healthy behavior changes beyond those in the control group. Neither exercise nor dietary adherence was affected by initial motivation or self-efficacy when added to CIMT risk awareness.

Subclinical atheroesclerosis and metabolic syndrome in children

Metabolic syndrome (MS) in children has been associated to subclinical atherosclerosis as estimated by carotid intima-media thickness (CIMT). We aim to ascertain the influence of MS, insulin resistance (IR) and nutritional status on CIMT. Percentiles with an increased risk of CIMT were also explored. A cross-sectional study of 447 children attending public schools in Santiago, Chile, was performed during years 2009-2011. This sample was selected considering the presence of one or more MS component and IR. Anthropometry and BP were assessed. A blood sample for determination of glycemia, insulinemia and lipids was taken. CIMT was assessed using high resolution ultrasonography with automated software. Pearson correlation, Student's t-test, Chisquared test, and stepwise logistic regression were computed. Mean age was 11.5 ± 1.0 years old (range 10- 14); 59% girls; 93% pubertal; 72% excess weight; 24% MS; and 15% IR. Mean values of MS components in children with CIMT ≥ percentile 75 versus < percentile 75 had differences for systolic BP or diastolic BP ≥ percentile 90 (BP ≥ percentile 90) and high density lipoproteins cholesterol ≤ 40 mg/dL (CHDL ≤ 40 mg/dL). The logistic regression for CIMT ≥ percentile 75 only selected BP ≥ percentile 90 and CHDL ≤ 40 mg/dL. The logistic regression for CIMT ≥ percentile 90 did not select independent variables. In this group of children BP ≥ percentile 90 and CHDL ≤ 40 mg/dL values were associated to CIMT ≥ percentile 75. Influences of IR and nutritional status on CIMT were not found.

The SNP (rs2230500) in PRKCH Decreases the Risk of Carotid Intima-Media Thickness in a Chinese Young Adult Population

BackgroundThe SNP (rs2230500) in PRKCH (the gene encoding protein kinase C η) is associated with ischemic stroke and cerebral hemorrhage in the Chinese population, but the molecular mechanisms are not clear. The aim of the present study is to investigate the association between the SNP and atherosclerosis that is common pathological basis of ischemic stroke and cerebral hemorrhage.Methodology/Principal FindingsWe examined the associations of the SNP with carotid intima-media thickness (CIMT), atherosclerosis diagnosed by CIMT, and factors related with inflammation in the Beijing Child Blood Pressure Study. A total of 1190 subjects participated in the follow-up study. The SNP was genotyped by allele-specific real-time PCR assay. The SNP (rs2230500) in PRKCH was significantly associated with CIMT (in far wall of left common carotid arteries, P = 0.016; in far wall of right common carotid arteries, P = 0.012) under a recessive model after adjustment for age, gender, smoking, and hypertension. The SNP was also significantly associated with complement C3 (P = 0.012) under a dominant model after adjustment for age, gender, and high sensitivity C-reactive protein.Conclusions/SignificanceOur data provide evidence that the SNP (rs2230500) in PRKCH decreases the risk of CIMT that is a worthwhile predictor of stroke and complement system possibly mediates this process.