Carotid Intimal Thickness Research Articles

Correlation of serum phosphate levels and carotid intimal thickness in CKD patients

Correlation of serum phosphate levels and carotid intimal thickness in CKD patients

Correlation of uric acid with carotid intima media thickness in obese adolescents

obesity in the pediatric population is a public health problem. The correlation of uric acid and carotid intima media thickness in adults has been demonstrated. to identify the correlation of uric acid and carotid intima media thickness in adolescents with obesity. an observational, cross-sectional study was carried out. Patients aged ten to 16 years with a diagnosis of obesity were included. Uric acid, lipid profile and carotid intima media thickness were determined. In relation to the statistical analysis, carotid intima media thickness was correlated with uric acid levels through Spearman's correlation coefficient. one hundred and sixty-nine adolescents were included with a median age of 13 years, without predominance of sex. A positive correlation of uric acid with carotid intima media thickness was identified (r = 0.242, p = 0.001). When stratified according to sex, there was no correlation in women (r = -0.187, p = 0.074), while in men it increased (r = 0.36, p = 0.001) and by pubertal stage, pubertal male adolescents had a positive correlation (p = 0.384, p = 0.002). a weak positive correlation was identified between carotid intimal thickness and uric acid in obese adolescents.

Systemic comorbidities in patients of psoriasis

Background There is paucity of Indian studies on comprehensive assessment of systemic comorbidities in psoriasis. This study aimed at assessing the systemic comorbidities in patients of psoriasis in India. Patients and methods A case–control study was conducted from September 2019 to August 2021. Study participants of more than 18 years, with 30 psoriasis patients as cases and 30 healthy individuals as controls. Assessment of Psoriasis Area Severity Index in cases, BMI, waist circumference, blood pressure, and detailed systemic index evaluation was done in both the groups. Analyses were done using χ 2 test and independent t test. Analysis of variance test is used to compare continuous variables among more than two groups. Odds ratio (OR) and 95% confidence interval were calculated. Results The mean age of psoriasis cases was 45.03±13.1 years with 73.3% of male and 26.7% of female population. Mean duration of psoriasis observed is 6.9±4.2 years with the mean Psoriasis Area Severity Index of 17.73±6.389. Comparison of systemic indices demonstrated significant increase in neutrophil count (P=0.006), erythrocyte-sedimentation rate (P<0.0001), glycated hemoglobin (P=0.037), low-density lipoprotein (P=0.0418), T3 (P<0.0001), and T4 (P=0.018). No significant difference in the liver-function test and renal-function test was seen in both the groups. Comparison of the prevalence of diseases associated with psoriasis, shows that the prevalence of metabolic syndrome (60 vs. 30%, OR=3.5, P=0.021), nonalcoholic fatty liver disease (26.6 vs. 6.6%, P=0.002, OR=14), increase in the carotid artery intimal thickness on both sides (right P=0.007, OR=5; left P=0.005, OR=7), and the inflammatory marker C-reactive protein (70 vs. 33.3%, P=0.005, OR=4.66) is significantly increased in cases as compared with controls. Other diseases like obesity (BMI: OR=2.0417, P=0.187; waist circumference: OR=2.25, P=0.123), type-2 diabetes mellitus (P=0.56, OR=1.40), hypertension (P=0.78, OR=1.15), and renal disease (P=1, OR=1) is found to have greater risk in psoriasis patients than controls, but the reflecting difference is not statistically significant. Conclusion The study revealed that the patients of psoriasis are more likely to have systemic comorbidities as compared with patients without psoriasis.

Antiplatelet Effects of Inhibiting Coagulation Factor XI in a Diet-Induced Obesity Model of Early Atherosclerosis

Background: Atherosclerosis-associated cardiovascular disease (CVD) remains the leading cause of non-communicable death worldwide. In the setting of atherosclerosis, platelets facilitate monocyte trafficking and drive inflammatory pathways. Previous studies have shown that coagulation factor (F) XI can interact directly with multiple pathways that are complicit in CVD, including platelet activation. Therefore, the objective of this study was to investigate the effects of pharmacologically inhibiting FXI on systemic platelet function in a diet-induced obesity model of early atherosclerosis. Methods: Five rhesus macaques on a high-fat diet for ≥2 years with detectable carotid intimal thickening were administered a FXI function-blocking antibody, h1A6 (2 mg/kg). Blood was collected at baseline, one, and seven days after treatment. Flow cytometry studies were performed to asses platelet function in lean rhesus macaques on a standard chow diet, as well as obese rhesus macaques a high fat diet before and after treatment with h1A6. Platelet reactivity and platelet-leukocyte aggregate (PLA) formation in response to platelet hemostatic agents against GPVI (collagen-related peptide, CRP-XL) and PAR-1 (thrombin analog, TRAP-6) were measured by P-selectin expression. The coagulability of platelets in response to CRP-XL or TRAP-6 was measured by phosphatidylserine (PS) exposure. Results: Obese NHPs demonstrated increased P-selectin expression and phosphatidylserine exposure in response to GPVI and PAR-1 agonists relative to lean NHPs. This suggests that diet-induced obesity may increase platelet sensitivity, PLA formation, and platelet coagulability. Administration of a FXI function-blocking antibody resulted in prolonged clotting times, decreased GPVI- and PAR-1 mediated platelet sensitivity, and reduced PLA formation compared to basal levels. Phosphatidyl serine exposure was not affected by FXI inhibition. Conclusions: Pharmacological inhibition of FXI reversed the elevated platelet sensitivity and PLA formation observed in the diet-induced obesity model. Taken together, this suggests that coagulation FXI may modulate the exacerbated platelet function that is associated with atherosclerosis.

Carotid atherosclerosis: An independent risk factor for small fiber nerve dysfunction in patients with type 2 diabetes mellitus.

To explore whether carotid atherosclerosis is an independent risk factor for small fiber nerve dysfunction in type 2 diabetes mellitus patients. A total of 247 type 2 diabetes patients from Nanjing Drum Tower Hospital received carotid ultrasonography and quantitative sensory testing, including cold and warm detection thresholds, and some patients received cold and heat pain detection thresholds, respectively. According to the results of quantitative sensory testing, patients were divided into normal small fiber nerve function (NSF)and small fiber nerve dysfunction (SFD) group. Meanwhile, patients were divided into the non-carotid atherosclerosis group, carotid intimal thickening, unilateral carotid atherosclerosis and bilateral carotid atherosclerosis group. The correlation between carotid ultrasonography with quantitative sensory testing parameters was analyzed by SPSS 26.0. First, the incidence rate of SFD increased significantly in patients with carotid atherosclerosis (72.2%, P < 0.001) especially in bilateral carotid atherosclerosis (81.7%, P < 0.001). Second, compared with the NS group, the carotid intima-media thickness in SFD was thicker (P=0.018) and the size of atherosclerotic plaque was larger (P < 0.001). In addition, the cold detection threshold decreased (P < 0.001), whereas the warm detection threshold (P < 0.001) and heat pain detection threshold (P < 0.001) increased as aggravation of carotid atherosclerosis. In the correlation analysis, the size of atherosclerotic plaque presented a positive correlation with the warm detection threshold (r=0.476, P < 0.001) and heat pain detection threshold (r=0.213, P < 0.001), but presented a negative correlation with the cold detection threshold (r=-0.239, P < 0.01). Furthermore, carotid atherosclerosis (odds ratio 2.326, P=0.017), especially bilateral carotid atherosclerosis (odds ratio 5.042, P=0.001), was an independent risk factor for SFD (P < 0.05). Carotid atherosclerosis was significantly associated with quantitative sensory testing and found to be an independent risk factor for small fiber nerve dysfunction in type 2 diabetes patients.

Association of Elevated Oxidized Low Density Lipoprotein to Low Density Lipoprotein Ratio (Ox LDL/LDL) with Sub Clinical Atherosclerosis in Patients Receiving Maintenance Haemodialysis

Objective: To assess the oxidized low density lipoprotein (ox-LDL) to low density lipoprotein (LDL) ratio as an indicator of subclinical atherosclerosis in haemodialysis patients Methodology: This case control study was carried out at Jinnah Post Graduate Medical Center Karachi, from January to December 2018. The haemodialysis patients were selected from the dialysis center (group B) whereas the controls were recruited from normal healthy population (group A). To access the status of atherosclerosis, doppler ultrasonography technique was employed to detect the intima media thickness (IMT) ratio of common carotid artery of study subjects as well as controls. Lipid peroxidation was detected by serum oxidized LDL (ox-LDL) levels. Results: The mean of carotid artery intima thickness in group A was 0.43±0.02, the mean intima thickness of group B samples was 1.0±0.09. The mean ratio of Ox-LDL/LDL in group A was 0.003±0.001. While in group B the mean of Ox-LDL: LDL was 0.012±0.002. Ox-LDL was found to have a positive linear relationship with mean carotid artery intima media thickness ratio (r=0.8) in haemodialysis group. Conclusion: Ox-LDL to LDL ratio is much enhanced in patients on maintenance haemodialysis showing increased lipid peroxidation. Ox-LDL has a positive linear relationship with mean carotid artery intima media thickness ratio which is a marker of sub clinical atherosclerosis. Early detection of elevated Ox-LDL will help nephrologists in early detection and treatment of sub clinical atherosclerosis.

Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index.

Subclinical atherosclerosis can be present in individuals with an optimal cardiovascular risk factor profile. Traditional risk scores such as the Framingham risk score do not adequately capture risk stratification in low-risk individuals. The aim of this study was to determine if markers of metabolic syndrome and insulin resistance can better stratify low-risk individuals. A cross-sectional study of 101 healthy participants with a low Framingham risk score and no prior morbidities was performed to assess prevalence of subclinical atherosclerosis using computed tomography (CT) and ultrasound. Participants were compared between groups based on Metabolic Syndrome (MetS) and Insulin-Sensitivity Index (ISI-cal) scores. Twenty three individuals (23%) had subclinical atherosclerosis with elevated CT Agatston score ≥1. Presence of both insulin resistance (ISI-cal <9.23) and fulfillment of at least one metabolic syndrome criterion denoted high risk, resulting in significantly improved AUC (0.706 95%CI 0.588-0.822) over the Framingham risk score in predicting elevated CT Agatston score ≥1, with net reclassification index of 50.9 ± 23.7%. High-risk patients by the new classification also exhibited significantly increased carotid intima thickness. The overlap of insulin resistance and presence of ≥1 criterion for metabolic syndrome may play an instrumental role in identifying traditionally low-risk individuals predisposed to future risk of atherosclerosis and its sequelae.

Regional and demographic variations of Carotid artery Intima and Media Thickness (CIMT): A Systematic review and meta-analysis.

Carotid artery intima media thickness (CIMT) is a strong predictor of Coronary Heart Disease (CHD) and independent phenotype of early atherosclerosis. The global variation of CIMT and its demographic association is yet unclear. We evaluated regional variations of CIMT based on WHO regions and assessed the differences by age and sex. A systematic search was conducted on studies published between 1980 January up to December 2020. PubMed, Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase data bases were used for searching. Supplementary searches were conducted on the Web of Science and Google Scholar. Grey literature was searched in "Open Grey" website. The two major criteria used were "adults" and "carotid intima media". The search strategy for PubMed was created first and then adapted for the Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase databases. Covidence software (Veritas Health Innovation, Melbourne, Australia; http://www.covidence.org) was used to manage the study selection process. Meta-analyses were done using the random-effects model. An I2 ≥ 50% or p< 0:05 were considered to indicate significant heterogeneity. Of 2847 potential articles, 46 eligible articles were included in the review contributing data for 49 381 individuals (mean age: 55.6 years, male: 55.8%). The pooled mean CIMT for the non-CHD group was 0.65mm (95%CI: 0.62-0.69). There was a significant difference in the mean CIMT between regions (p = 0.04). Countries in the African (0.72mm), American (0.71mm) and European (0.71mm) regions had a higher pooled mean CIMT compared to those in the South East Asian (0.62mm), West Pacific (0.60mm) and Eastern Mediterranean (0.60mm) regions. Males had a higher pooled mean CIMT of 0.06mm than females in the non CHD group (p = 0.001); there were also regional differences. The CHD group had a significantly higher mean CIMT than the non-CHD group (difference = 0.23mm, p = 0.001) with regional variations. Carotid artery segment-specific-CIMT variations are present in this population. Older persons and those having CHD group had significantly thicker CIMTs. CIMT varies according to region, age, sex and whether a person having CHD. There are significant regional differences of mean CIMT between CHD and non-CHD groups. Segment specific CIMT variations exist among regions. There is an association between CHD and CIMT values.

Intima-media Thickness Measured at the Common-carotid Artery in Patients Treated with Lipoprotein Apheresis

<h3>Lead Author's Financial Disclosures</h3> Nothing to disclose. <h3>Study Funding</h3> None. <h3>Background/Synopsis</h3> Common carotid intima-thickness (CIMT) is as a marker of arterial wall injury and arteriosclerosis. Healthy asymptomatic young and middle-aged individuals of the European-ancestry show mean CIMT of 610 + /-110μmmicrometers with a strong linear relation between age and CIMT. In the general population, an annual rate of change in mean common CIMT is estimated at 15μm (95% CI, 12 to 17), with a median standard deviation of 53. <h3>Objective/Purpose</h3> We sought to compare annual CIMT progression rates in 10 patients with severe hypercholesterolemia treated with lipoprotein apheresis with published annual CIMT progression estimates in age-comparable 1) healthy individuals based on the nomograms, 2) patients with elevated lipoprotein(a), and 3) familial hypercholesterolemia (FH). <h3>Methods</h3> Patients (mean age 60+/-9 years, 70% female, 80% statin intolerant) were treated with the dextran sulfate adsorption apheresis system for primary and secondary atherosclerotic cardiovascular disease (ASCVD) prevention every two weeks between 2005 and 2020 (mean duration, 10+/-4 years). To minimize intra-individual and inter-individual variability in CIMT assessment we used computerized algorithms with measurements performed by the same sonographer. <h3>Results</h3> The baseline mean CIMT was 850+/-170μm and maximum CIMT was 1040+/-220um across the age range of 46 to 70 years. The baseline median levels of total cholesterol were 317 (interquartile range (IQR), 262 to 361); LDL-C, 214 (133 to 253); HDL-C, 56 (44 to 68); triglycerides, 170 (121 to 215), lipoprotein(a), 26 (9 to 120), all in mg/dL. Acute effects of lipoprotein apheresis determined as a difference before and immediately after the procedure were estimated as a median of 72+/-8% and 75+/-7% reduction in the LDL-C and lipoprotein(a) levels, respectively. Regular treatment with lipoprotein apheresis resulted in average reduction in the mean CIMT of −40μm (IQR, −50 to 20). An annual CIMT progression rate was associated with the combined percentage reduction in the lipoprotein(a) (P=0.032) and LDL-C levels (P=0.029). Using the Bayesian Estimation Supersedes the t -Test (BEST) method, the annual rate of CIMT progression was compared to those reported in the literature (Table 1). <h3>Conclusions</h3> Composite CIMT progression rates were slowed with lipoprotein apheresis. In this cohort of high-risk patients with poor statin tolerance, the use of CIMT surveillance was noted to increase compliance with long-term lipid-modifying therapies in the clinical setting.

Postmenapozal Hastalarda Trombosit Hacmi, Trombosit/Lenfosit ve Nötrofil/Lenfosit Oranlarının Vücut Kitle İndeksine Göre Karşılaştırılması ve Bu Sonuçların Kardiyovasküler Risk ve Sıcak Basması Üzerine Etkileri

Amaç: Postmenopozal dönemindeki kadınlarda nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacminin kardiyovasküler riski öngören birer belirteç olup olmadıklarının tespit edilmesi hedeflenmiştir.&#x0D; Gereç ve Yöntem: Kardiyovasküler hastalığı olmayan, postmenapozal dönemindeki hastalar çalışmamıza dahil edilmiştir. Boy ve kilo ölçümleri yapılarak vücut kitle indeksleri hesaplanmış, hemogram ve lipid profili analizleri yapılmış ve karotis intima kalınlıkları ölçülmüştür. Bu değerlere göre kardiyovasküler riski yüksek olan grup ve düşük olan grup arasında nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacmi değerleri açısından anlamlı farklılık olup olmadığı analiz edilmiştir. &#x0D; Bulgular: Çalışmamıza 158 kadın hasta dahil edilmiştir. Vücut kitle indexi ≥30 olan grubun total kolesterol, trigliserid, düşük yoğunluklu lipoprotein ve lenfosit düzeyi ve ayrıca bilateral karotis intima kalınlıkları anlamlı olarak daha yüksek bulunmuştur. İki grup arasında nötrofil sayısı, trombosit sayısı, ortalama trombosit hacmi, nötrofil/lenfosit oranı ve yüksek dansiteli lipoprotein düzeyleri açısından anlamlı farklılık tespit edilemezken, trombosit/lenfosit oranı VKİ ≥30 olan grupta daha düşük bulunmuştur.&#x0D; Sonuç: Çalışmamızda kardiyovasküler hastalığı olmayan postmenopozal dönemdeki hastalar kardiyovasküler hastalık gelişimi açısından yüksek ve düşük riskli olarak ikiye ayrılarak kıyaslanmıştır. Çalışmanın sonucu bu inflamatuar belirteçlerin henüz hastalık tablosu ortaya çıkmamış hastalarda risk öngörmede anlamlı belirteçler olmadığını göstermiştir.

Assessment of asymmetric dimethylarginine and homocysteine in epileptic children receiving antiepileptic drugs

BackgroundEpilepsy is a neurological disease that requires long-term antiepileptic drugs (AEDs). The old generation of AEDs may affect serum homocysteine and asymmetric dimethylarginine (ADMA) and disturb lipid levels. The aim of the study was to evaluate serum ADMA, homocysteine, lipid profile, and carotid intima-media thickness (CIMT) in epileptic children.MethodsThis study was implemented on 159 epileptic children who were subdivided into 3 subgroups, with 53 receiving sodium valproate, 53 receiving levetiracetam, and 53 receiving polytherapy, for over 6 months and 53 healthy children.ResultsLow-density lipoprotein, triglycerides, and cholesterol levels were increased in epileptic children (p < 0.001), which were higher in those receiving multidrug followed by a valproate receiver. While high-density lipoprotein was lower in those receiving multidrug more than those receiving valproate. ADMA and homocysteine levels increased in epileptic patients than in controls (p < 0.001). Higher ADMA was also observed in the multidrug receiver (5.78 ± 0.62), followed by the levetiracetam group (5.56 ± 0.61). Homocysteine levels were significantly higher in multidrug and valproate-treated children than those treated with levetiracetam. CIMT was significantly higher in multidrug and valproate-treated patients (p < 0.001).ConclusionsLong-term use of AEDs, especially old-generation polytherapy, can elevate lipid profiles, homocysteine, ADMA levels, and carotid intima-media thickness compared to the minimal effect of new AEDs.ImpactThe long-term use of antiepileptic drugs, especially old-generation polytherapy, can increase lipid profiles, homocysteine levels, ADMA, and carotid intima thickness compared to the minimal effect of new antiepileptic generation.A routine follow-up of these markers and a lifestyle modification are recommended to avoid cerebrovascular events as much as possible.

1093-P: Vascular Health across the Lifespan in Women with and without Type 1 Diabetes (TID)

Introduction: Cardiovascular disease (CVD) is the leading cause of death in people with T1D, and women with T1D are disproportionately affected. However, few studies have examined how T1D affects vascular health in women across the lifespan. Methods: Women ages 18-79 with (N=309) and without T1D (n=351) were examined cross-sectionally for markers of CVD: pulse wave velocity (PWV) , augmentation index (AiX) , pulse height (PH) , brachial artery distensibility (BrachD) , subendocardial viability index (SVI) , and carotid intima thickness (cIMT) . Menopausal status was self-reported. Body composition was measured by Dual Xray Absorptiometry. CVD markers were examined by diabetes status and age using linear regression models adjusted for menopausal status. Results: Age did not differ in women with and without diabetes (49 ± 12 vs. 50±14 years, p=0.32) . Women with T1D had higher systolic blood pressure (SBP) , cIMT, PWV and PH, and lower BrachD and SVI than non-diabetic women (Table 1) . Changes in blood pressure, cIMT, AiX, and SVI with age differed by diabetes status, as demonstrated by a significant interaction. While SBP and Aix were increased more in women with T1D at younger ages, cIMT and SVI worsened with age to a greater extent in T1D. Conclusions: Women with T1D have worse CVD markers than women without diabetes across the lifespan, with more arterial stiffness at younger ages and more atherosclerosis and lower SVI later in life. Disclosure C.J.Chartier-logan: None. A.C.Alman: None. V.Shah: Advisory Panel; Medscape, Sanofi, Consultant; Dexcom, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc.

PHARMACOLOGICAL TREATMENT OF ARTERIAL HYPERTENSION GUIDED BY PERIPHERAL OR CENTRAL BLOOD PRESSURE: COMPARISON OF THE TWO STRATEGIES IN THE INCIDENCE OF INTERMEDIATE OUTCOMES

Objective: To compare the parameters of central and peripheral blood pressure measurements, arterial stiffness, target organ damage (TOD), biochemical and renal profiles among participants who had the therapeutic strategy guided by central (CG) and peripheral (PG) blood pressure values. Design and method: Randomized study in two groups: CG and PG. Five visits were carried out, the first (V1) being selection and randomization followed by intermediate visits, every 3 months, to assess blood pressure and adjust antihypertensive drugs. The procedures performed in the initial and final visit (V5) were: measurement of central arterial pressure and pulse wave velocity (PWV) (mobil-o-graph) and peripheral (OMRON HEM1100), carotid ultrasound, echodopplercardiogram and laboratory tests. Paired and unpaired t and chi-square tests were used. Adopted significance level of 5% and a confidence interval of 95%. Results: A total of 59 participants were evaluated (30 from the CG and 29 from the PG). Age, BMI, central and peripheral blood pressure measurements, PWV, left ventricular mass index (LVMI), carotid intimal mean thickness, biochemical profile and glomerular filtration rate did not differ between the two groups (p &gt; 0.05) in randomization. The augmentation index (AIx) was higher in the CG than in the PG at randomization (27.3% ± 12.2% vs 20.3% ± 13.3% p 0.041). After 1 year of follow-up, in the analysis between the groups, the central diastolic pressure was lower in the CG (78.9mmHg ± 9.7mmHg vs 84.3 ± 10.4mmHg, p 0.024) and the difference in AIx between the groups ceased to exist. When intra-group comparisons were made before and after the intervention, a reduction in the PWV (p &lt; 0.001) and LVMI (p = 0.018) was observed in the CG. In PG there was an increase in PWV (p &lt; 0.001) and LVMI (p = 0.003). Conclusions: The intervention guided by central pressure, after 1 year of follow-up, was able to reduce the central diastolic pressure and correct the AIx parameter and, in the intra-group analysis, it promoted a reduction in PWV and LVMI. There was no difference between the two groups regarding the improvement of outcomes related to central and peripheral blood pressure, cardiac and vascular TOD, biochemical and renal profile.

CARDIOVASCULAR RISK MARKERS IN PATIENTS WITH STRUCTURAL AND NUMERIC ABERRATIONS OF X CHROMOSOME

Objective: To assess the relationship between RAS, karyotype and cardiovascular risk factors in patients with X chromosome abnormalities. Design and method: Observational, prospective study with 7 years of evolution. Inclusion Criteria: Presence of aberrations that affect the number or morphology of the X chromosome in karyotype study. Exclusion Criteria: Those who did not give their informed consent to participate in the study. The detection of Y chromosome sequences was performed. The cardiovascular risk factors present were analyzed. Furthermore, exploration of carotid intimal thickness is by ultrasound was performed. The degree of dynamic endothelial dysfunction in the brachial artery (BMD) was also determined. ACE2 and Angiotensin II genes expression were indirectly evaluated in peripheral blood. Results: The monosomy of the X chromosome was the most frequent. There are 57.4% had overweight or obese, 23% had diabetes, 40% had a new diagnosis of hypertension, and 51% had dyslipidemia. In no case, in the patients evaluated with Turner syndrome, was the presence of the Y chromosome sequence found. One patient was found with a short-arm duplication that includes the SHOX gene, evaluated by MLPA. 89% of the patients presented endothelial dysfunction parameters, and 22% presented carotid plaques in the ultrasound study. In multivariate analysis, patients were separated into tertiles, according to the amount of X chromosomal material in the cytogenetic formula to analyze vascular findings. (Table 1) Conclusions: Central obesity present in childhood and adolescence could contribute to the early diagnosis of the metabolic syndrome so characteristic in these patients. The presence of hypertension could have relationship with renin-angiotensin system alterations. Women with monosomy are the ones who would most suffer an early lack of the protective effect of ACE2 with its vasodilator, antiproliferative and antifibrotic properties, among others. The vascular alterations were an independent factor of the variables studied.

Immune correlates of cardiovascular co-morbidity in HIV infected participants from South India

BackgroundUnderstanding the immune correlates of cardiovascular disease (CVD) risk in HIV infection is an important area of investigation in the current era of aging with HIV infection. Less is known about CVD risk and HIV infection in developing nations where additional risk factors may be playing a role in the CVD development. In this study, we assessed the effects of systemic inflammation, microbial translocation (MT), T cell immune activation (IA), and nadir CD4 counts on cardiac function and arterial stiffness as markers of subclinical atherosclerosis in HIV-infected individuals. MethodsPeople with HIV (PWH) who were ART naïve (n = 102) or virally suppressed on ART (n = 172) were stratified on nadir CD4 counts and compared to HIV-uninfected controls (n = 64). Determination was made of cardiac function via radial pulse wave and carotid intima thickness (C-IMT) measurements. Plasma biomarkers of inflammation and MT by ELISA or multiplex assays, and immune activation (IA) of T cells based HLA-DR and CD38 expression were investigated by flow cytometry. T-test, Mann–Whitney U test, and Spearman correlation were used to analyze study parameters.ResultsReduction in cardiac function with lower cardiac ejection time (p < 0.001), stroke volume (p < 0.001), cardiac output (p = 0.007), higher arterial stiffness (p < 0.05) were identified in ART-naïve participants, compared to PWH on ART (p < 0.05). No significant difference in C-IMT values were noted. Higher inflammatory and MT markers were found in the ART-naïve group compared to treated group who were comparable to uninfected participants, except for having higher TNF-α (p < 0.001) and sCD14 (p < 0.001). Immune activation of CD4 and CD8 T-cells was greater in ART-naïve participants compared to ART-treated and uninfected controls (p < 0.05). Lower nadir CD4 counts, higher inflammation, and higher MT predicted poor cardiac measures in the ART-naïve with nadir CD4 < 200cells/mm3 manifesting the highest arterial stiffness, and lowest cardiac function, whereas ART-treated, even with nadir < 200 cells/mm3 were similar to uninfected in these measures.ConclusionsIn HIV-infected individuals, initiation of ART even at nadir of < 200 cells/mm3 may prevent or reverse cardiovascular disease outcomes that are easily measurable in low income countries.

Rapid eye movement sleep apnea and carotid intima thickness in men and women: a SHE-MUSTACHE cohort study.

Rapid eye movement (REM) obstructive sleep apnea might be particularly harmful to the cardiovascular system. We aimed to investigate the association between sleep apnea during REM sleep and signs of atherosclerotic disease in the form of carotid intima thickness in a community-based sample of men and women and possible sex differences in this association. The association between sleep apnea during REM sleep and intima thickness was analysed cross-sectionally in women from the community-based "Sleep and Health in Women" (SHE) study (n=253) and age- and body mass index (BMI)-matched men from the "Men in Uppsala; a Study of sleep, Apnea and Cardiometabolic Health" (MUSTACHE) study (n=338). Confounders adjusted for were age, BMI, gender, alcohol, and smoking. All participants underwent a full-night polysomnography, high-resolution ultrasonography of the common carotid artery, anthropometric measurements, blood pressure measurements, and answered questionnaires. There was an association between sleep apnea during REM sleep and thicker carotid intima that remained after adjustment for confounding (adjusted β=0.008, p=0.032). The intima was increased by 9.9% in the group with severe sleep apnea during REM sleep, and this association between severe sleep apnea during REM sleep and increased intima thickness remained after adjustment for confounders (adjusted β=0.043, p=0.021). More women than men had severe sleep apnea during REM sleep; moreover, in sex-stratified analyses, the association between sleep apnea during REM sleep and intima thickness was found in women but not in men. We conclude that severe REM sleep apnea is independently associated with signs of atherosclerosis. When stratified by sex, the association is seen in women but not in men.

The Relationship Between Lipoproteins and Insulin Sensitivity in Youth With Obesity and Abnormal Glucose Tolerance.

Youth with obesity and abnormal glucose tolerance have an increased risk for atherosclerosis but the relative contributions of insulin resistance and hyperglycemia to dyslipidemia and the development of subclinical atherosclerosis are unknown. This work aims to determine the association between insulin resistance, dyslipidemia, and carotid intimal thickness (cIMT) in adolescents with normal and abnormal glucose tolerance. An observational cohort study in 155 youth: 44 obese insulin sensitive (OIS; fasting insulin ≤ 20 µM/mL, body mass index [BMI] ≥ 95th percentile), 35 obese insulin resistant (OIR; fasting insulin > 20 µM/mL, BMI ≥ 95th percentile), 34 obese abnormal glucose tolerant (AGT; BMI ≥ 95th percentile), and 42 Lean (BMI 5th-85th percentile). Lipids, lipoprotein particle size and concentration (-P), insulin sensitivity (SI an intravenous glucose test), and CMIT were compared using linear models adjusted for age, race/ethnicity, biological sex, and Tanner stage. Lipid/lipoprotein profile and CMIT were reevaluated in a subset after 2 years. Compared to OIS and Lean, OIR and AGT had elevated triglycerides and low high-density lipoprotein cholesterol (HDL-C) but similar total cholesterol and low-density lipoprotein cholesterol (LDL-C). Among OIS, OIR, AGT, lower SI was associated with atherogenic lipids (higher triglycerides, LDL-C, non-HDL-C, and lower HDL-C) and lipoproteins (higher total LDL-P and small HDL-P, and lower large HDL-P). There was a steeper decline in the association of SI with HDL-C and large HDL-P in AGT compared with OIR and OIS. cIMT was comparable across groups and inversely correlated with SI, with no change after 2 years. Among youth with obesity, insulin resistance was associated with an atherogenic lipoprotein/lipid profile and cIMT, regardless of glucose tolerance status. Insulin resistance in AGT youth was associated with a shift to smaller HDL-P compared to normoglycemic youth with obesity. Alterations in HDL-P metabolism may be early adverse manifestations of hyperglycemia in youth with obesity.

Abstract 9768: Relationship of Atherogenic Lipoproteins with Insulin Resistance and Carotid Intimal Thickness in Youth at Risk for Cardiovascular Disease

Introduction: Youth with obesity and abnormal glucose tolerance (AGT) have an atherogenic lipoprotein (Lp) profile (small dense HDL and small LDL) and an increased risk for atherosclerotic disease, but the relative contributions of hyperglycemia and insulin resistance to the development of subclinical atherosclerosis in youth are not well defined. Hypothesis: Atherogenic Lp concentrations (ApoB, small LDLp, small HDLp) are associated with lower insulin sensitivity (Si) and greater carotid intimal thickness (cIMT), irrespective of glycemic status. Methods: In 155 youth with obesity (14.5±1.4y (mean±SD), 50% female; 42 lean (LC: BMI 25-85%ile), 44 insulin sensitive (OIS, fasting insulin ≤20μM/mL, BMI≥95%ile), 35 insulin resistant (OIR; fasting insulin&gt;20μM/mL, BMI≥95%ile) and 34 with AGT (23 prediabetes, 11 type 2 diabetes) we compared a standard lipid panel and Lp size and number. Linear regressions were used to test the associations between lipids/ NMR-derived Lp with Si index derived from a minimal model during an intravenous glucose test. cIMT was determined by ultrasonography. In a subset of 56 youth (21 LC, 19 OIS, 10 OIR, and 7 AGT) we explored the change in Si with the change in Lp and cIMT after 2 years. Results: OIR and AGT had higher triglycerides and lower HDL compared to LC, P &lt;0.01. Total cholesterol, LDL, and cIMT were comparable among all youth. ApoB, total triglyceride-rich Lp, LDLp and small LDLp) were similar in OIS, OIR, and AbGT and higher compared to LC. Among adolescents with obesity, Si was inversely associated with ApoB (β=-0.016), total LDLp (β=-0.91), small HDLp (β=-0.11) and cIMT (β= -2.99), all P &lt;0.001. There was no effect modification by obesity group. LnSi was associated with total HDL (β=1.30), large HDLp (β= 0.23) and small HDLp (β=-0.11), all P &lt;0.01) with steeper associations between AGT vs OIR and AGT vs OIS. After 2 years, the change in insulin sensitivity was not associated with changes in lipoproteins or cIMT. Conclusions: Among youth with obesity, insulin resistance was associated with atherogenic lipoproteins and cIMT, regardless of glucose tolerance status. Alterations in HDL particle number and size were distinct early manifestations that were observed in youth with AGT compared to their peers.

Abstract 14336: Association of Mid-Life Cardiovascular Disease and Late-Life Alzheimer's Disease Pathology: Insights From Heart Score Study

Introduction: Data show an association of CVD risk factors in mid-life with older age dementia. Atherosclerosis (ATH) and arteriosclerosis (ART) are both implicated in incident dementia however their relationship with incident Alzheimer’s disease (AD) remains elusive. We investigated the association of mid-life cardiovascular risk factors and mid-life subclinical CVD (ATH and ART) with late-life AD pathology. Methods: Non-demented participants over the age of 65 from the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study underwent brain PET acquisition (2018-2020) for AD specific amyloid deposition [by Pittsburgh Compound B (PiB)]. Pearson’s correlation and OR (95% CI) using Cox regression for association of cortical PiB retention with mid-life (2003-2005) markers of ATH (coronary artery calcium [CAC] score and carotid intima thickness [CIMT]) and ART (vascular stiffness) were calculated. Results: Among 121 participants in late-life (mean age ~79y), age was significantly correlated to lower cognition ( r =0.19, p=0.03) but gender, race and diabetes were not. Late-life AD pathology was not significantly associated with mid-life CAC (&gt;150) [OR=0.12 (0.01, 2.36); p=0.16] or CIMT [OR=1.80 (0.84, 3.86); p=0.40]. Presence of increased vascular stiffness in mid-life showed a significant association with late-life PiB retention (Table ). Conclusions: In a small number of biracial middle-aged adults, subclinical markers of atherosclerosis did not independently predict increased biomarkers of AD pathology. However, vascular stiffness in mid-life was significantly associated with late-life brain biomarkers of Alzheimer’s disease pathology. Further research can elucidate the role of mid-life athero- and arteriosclerosis in Alzheimer's disease dementia.

Association between Abdominal Wall Fat Index (AFI) on Ultrasonography with Carotid Intima Media Thickness (CIMT) and Lipid Profile

Abstract Background: Many international organizations have rec-ognized obesity as a chronic disease, with significant contri-bution to the global mortality and morbidity. Besides, obese patients are at higher risk of death than non-obese individuals. Obesity is a major driver for disability, early retirement, and psychological disorders as well. Abdominal wall fat index (AFI) is a widely utilized sonographic measure for regional fat accumulation; it is calculated as a ratio of the highest to lowest preperitoneal and subcutaneous fat thicknesses, respectively. Carotid Intima Media Thickness (CIMT) is a well-established marker for early atherosclerosis. In this study we investigated the relationship between abdominal wall fat index (AFI) and Carotid Intima Thickness (CIMT) with lipid profile among overweight and obese patients. Aim of Study: Investigating the relationship between abdominal wall fat index (AFI) and Carotid Intima Media Thickness (CIMT) as measured by ultrasonography with lipid profile among overweight and obese patients. Patients and Methods: We conducted a cross-sectional study on 60 adult participants ranging from 22 to 66 years old of both genders. The patients were divided into three groups according to the AFI value into: Group I (AFI <0.7), group II (AFI <1.4), and group III (AFI ³1.4). AFI and CIMT measured using ultrasonography and lipid profile was obtained. Results: Participants in group III (mean=53.7±11.0 years old) were significantly older than other studied groups; and were more likely to be hypertensive and diabetic. There was a statistically significant difference between studied groups regarding body mass index (BMI; p=0.001), the highest level was among group III (mean BMI=34.1±5.8Kg/m2). There were positive correlations between lipid profile parameters and the AFI. Furthermore, there was a statistically significant difference between groups regarding CIMT (p=0.001). CIMT was the highest among group III (mean of 1.4±0.3mm), followed by group II (mean of 1.2±0.3mm), and group I (mean of 0.7±0.3mm).CIMT was positively correlated with AFI (r=0.747, p=0.001). BMI was highest among group III (mean of 34.1±5.8), followed by group II (mean of 30.3±4.0), and group I (mean of 25.0±2.2) BMI was positively correlated with AFI (p=0.001). Conclusions: AFI has a significant positive correlation with CIMT and preperitoneal fat thickness. AFI can be a useful marker in evaluating and predicting disorders of me-tabolism, circulation and atherosclerosis.