Mean Carotid Intima-media Thickness Values Research Articles

The relationship between serum uric acid level and carotid intima-media thickness in hemodialysis patients.

We aimed to evaluate the relationship between carotid intima-media thickness (CIMT), which is a known indicator of cardiovascular risk and atherosclerosis, and uric acid level, which may be an easy marker for cardiovascular diseases due to its antioxidant and pro-oxidant properties in hemodialysis patients. In this cross-sectional study, we evaluated 77 hemodialysis patients. The mean CIMT of these patients was measured and recorded by Doppler ultrasonography. Patients were divided into two groups according to their serum uric acid levels. Correlation analysis and linear regression analysis were used to define the relationship between study parameters. The mean CIMT levels in the normouricemic group and the hyperuricemic group were 0.95 ± 0.15 and 1.07 ± 0.15, respectively. There was a statistically significant difference between the two groups (p = 0.001). There was a statistically significant and moderate linear correlation between serum uric acid level and mean CIMT (r = 0.402; p = 0.002). Univariate and multivariate linear regression analyses were performed to identify variables that could independently affect the mean CIMT value. According to analysis, uric acid (p < 0.001), hypertension (p = 0.008), albumin (p = 0.029), and C-reactive protein (p = 0.042) were found independent risk factors for mean CIMT value. We found a significant relationship between serum uric acid level and CIMT, which indicates carotid atherosclerosis. Serum uric acid level is a low-cost laboratory parameter that can be measured in almost all laboratories, and it may be valuable in the hemodialysis patient group to identify patients at high risk of carotid atherosclerosis.

Assessment of Subclinical Cardiovascular Disease Risk by Measuring Carotid Intima Media Thickness in Rheumatoid Arthritis Patients: A Cross-sectional Study

Introduction: Rheumatoid Arthritis (RA) is a chronic inflammatory disease that affects both synovial joints and extra-articular regions. Patients with RA have an increased risk of Cardiovascular Disease (CVD), leading to premature mortality. Aim: To assess subclinical atherosclerosis in RA patients using Carotid Intima Media Thickness (CIMT) and compare it with age-matched healthy individuals. Materials and Methods: This cross-sectional study included 50 RA patients and 50 healthy age- and sex-matched controls. Ultrasound was used to measure CIMT, which serves as an indicator of subclinical atherosclerosis. Framingham, Atherosclerotic CVD (ASCVD) risk scores, and QRISK3 scores were used to estimate the 10-year CVD risk. Student’s t-test and Chi-square test were used to identify statistically significant differences. Results: RA patients had significantly higher mean CIMT values compared to controls (p-value&lt;0.001), indicating an increased burden of atherosclerosis. While ASCVD scores were comparable, Framingham scores were significantly lower (p-value=0.028), and QRISK3 scores were significantly higher (p-value=0.007) in RA patients. This suggests an underestimation of CVD risk by Framingham and potentially better prediction by QRISK3. Conclusion: The study highlights that RA patients have a higher burden of atherosclerotic disease compared to healthy adults of the same age when CIMT is used as a marker of atherosclerosis. These findings indicate the need for early CVD risk assessment and intervention in RA patients using appropriate risk-scoring systems and tools. Further research with larger sample sizes and longitudinal follow-up is warranted to confirm these findings.

Correlation of Carotid Intima-Media Thickness with One-hour Postload Plasma Glucose (1h-PPG) in Overweight and Obese North Indian Adults

Background: Cardiovascular morbidities like arterial stiffness and atherosclerosis have a negative association with insulin resistance, which can be identified by carotid intima media thickness (CIMT) measurement. One-hour postload plasma glucose (1 h-PPG) is a novel marker for early identification of insulin resistance, but very few studies are available on its relationship with CIMT. Objective: To identify the correlation of CIMT with 1 h-PPG in overweight and obese adults without diabetes. Methods: Individuals not having known diabetes or other chronic illnesses were identified and subjected to the initial anthropometric analysis for body mass index (BMI) calculation. A standard oral glucose tolerance test was performed on individuals with a BMI of ≥25 kg/m2 for 1 h-PPG values, and a B-mode ultrasound scan of the neck was used for CIMT measurement. A Pearson’s correlation statistical test was applied for correlation identification. Results: A total of 94 nondiabetic individuals participated, of whom 55 (58.5%) were women. Mean age, BMI, and CIMT values of the study population were 38.8 (±8.09) years, 29.6 (±3.22) kg/m2, and 0.72 (±0.10) mm, respectively. Average 1 h-PPG levels were 150.7 (±21.11) mg/dl, and the Pearson’s coefficient ( r) value with CIMT was 0.5792 ( P &lt; 0.05). Further, correlation analysis demonstrated an r-value of −0.0029 for BMI, −0.1293 for waist-hip ratio, −0.0047 for waist-height ratio, 0.3862 for glycated hemoglobin (HbA1c), and −0.2930 for 2 h-PPG. Conclusion: In euglycemic adults, the early insulin resistance defining parameter, i.e., 1 h-PPG levels had a consistent positive correlation with CIMT, which is a marker of the initial stages of atherosclerosis.

Carotid intima-media thickness and incident hypertension: the Brazilian Longitudinal Study of Adult Health.

High blood pressure (BP) increases carotid intima-media thickness (CIMT). On the other hand, it is not clear whether the vascular abnormalities reflected in high CIMT may predict incident hypertension. The present study aims to investigate the association between CIMT and incident hypertension after 4 years of follow-up in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multiethnic sample of middle-aged adults from six Brazilian cities. We analyzed data from 6682 ELSA-Brasil participants (aged 35-74) without hypertension and with complete CIMT data at baseline. After 4 years of follow-up, we describe hypertension incidence, stratifying the sample according to age, sex, and race-specific CIMT quartiles. We also built crude and adjusted Poisson regression models to analyze the association between mean and maximal CIMT values and incident hypertension. We found incident hypertension in 987 (14.8%) participants. According to mean CIMT quartile groups, hypertension incidence varied from 10.2% (first quartile group) to 22.4% (fourth quartile group; P for trend <0.001). In fully adjusted models, 0.1 mm increments in mean CIMT values were associated with a 16% [relative risk (RR):1.16; 95% confidence interval (95% CI) 1.10-1.21; P < 0.001] higher risk of incident hypertension, respectively. Results were similar when maximal CIMT values were considered instead of mean CIMT values. CIMT values at baseline strongly predicted incident hypertension after 4 years of follow-up in this large multiethnic cohort. This highlights the relationship between CIMT and BP and may provide important insights into the significance of this ultrasound measurement.

The Interconnection between Carotid Intima-Media Thickness and Obesity: Anthropometric, Clinical and Biochemical Correlations.

Background and Objectives: Carotid intima-media thickness (CIMT) and obesity are considered independent determinants of cardio- and cerebrovascular events. The aim of our study was to investigate the effect of obesity on CIMT and to define which traditional cardiovascular risk factors correlate the most with CIMT values in patients with obesity. Materials and Methods: Anthropometric measurements were collected for the whole study group, as well as body composition and blood pressure data, and biochemical blood analyses were also performed. Results: Although our study group was significantly older according to vascular compared with chronological age, the mean CIMT values were lower when compared with the reference values. We found a statistically significant correlation of CIMT with chronological and vascular age, systolic blood pressure, fasting glucose, total cholesterol and triglyceride levels, waist-to-hip ratio, waist circumference, body muscle mass and skeletal muscle mass index. Atherosclerotic Cardiovascular Disease (ASCVD) risk assessment and SCORE (Systematic COronary Risk Evaluation) showed significant positive correlations, but there was only a weak correlation of ASCVD with CIMT. Conclusions: To deduce, since no diagnostic tool currently includes body weight as an individual risk factor, further trials are highly needed to determine if SCORE, SCORE2, ASCVD risk assessment or CIMT would be the most accurate and relevant diagnostic tool for prediction of risk for future CV events in patients with obesity.

Association between rotating night shift work and carotid intima-media thickness among Chinese steelworkers: a cross-sectional survey.

This study aimed to examine the association between rotating night shift work and subclinical athero-sclerosis among Chinese steelworkers. We evaluated 3582 steelworkers who participated in the legally required health examination in 2017. Carotid intima-media thickness (CIMT) was measured using ultrasonography. Different exposure metrics of night shifts collected by face-to-face personal interviews were used to examine the relationship between night shift work and the mean CIMT. The mean CIMT values were 0.66 (standard deviation 0.22) mm in the study population. Current shift workers shown higher mean CIMT compared to day workers. There were no significant associations between the current shift status, the duration of night shifts, the cumulative number of night shifts, the average frequency of night shifts, and the mean CIMT after all confounding factors adjusted both in male and female. Rotating night shift work is not associated with subclinical atherosclerosis among steelworkers. Further large-scale prospective longitudinal studies are warranted to confirm our findings.

Impact of Bariatric Surgery on Carotid Intima-Media Thickness in Patients with Morbid Obesity: a Prospective Study and Review of the Literature.

One of the main causes of mortality among obese patients is cardiovascular disease (CVD). Carotid intima-media thickness (CIMT) is an independent predictor for atherosclerosis and risk of CVD, and has been demonstrated to be related with obesity. This study aimed to evaluate the effect of substantial weight loss after bariatric surgery on CIMT. This prospective study was performed on patients with morbid obesity and standard indications for bariatric surgery in a tertiary referral center in Iran. The mean CIMT values were assessed using B-mode ultrasonography before and 6 months after bariatric surgery. A total of 32 patients (25 females, 7 males) with a mean age of 38.18 ± 1.18 years were enrolled. Body mass index (BMI) was significantly reduced from 43.66 ± 6.44 to 29.01 ± 2.56 kg/m2 during 6 months following surgery (p: 0.001). The mean CIMT values at 6 months after surgery were significantly lower than the baseline (0.53 ± 0.06 vs. 0.50 ± 0.08; p: 0.001). Along with a significant hypertension and metabolic syndrome remission, we observed considerable reduction in FBS (p: 0.019), cholesterol (p: 0.061), triglycerides (p: 0.001), and insulin levels (p: 0.001). Besides, liver stiffness was significantly decreased after surgery (6.15 ± 0.82 vs. 5.26 ± 0.83; p: 0.001). There was no statistically significant correlation between changes in quantitative variables and changes in CIMT. Bariatric surgery results in significant reduction in CIMT, metabolic syndrome factors, and liver stiffness in patients with morbid obesity.

Progression of carotid intima-media thickness in patients treated with lipoprotein apheresis: real-world evidence over 12 years

Abstract Background The extent of intervention effects on carotid intima-media thickness (CIMT) can predict the degree of atherosclerotic cardiovascular disease (ASCVD) risk reduction. There is limited evidence of long-term effects of lipoprotein apheresis on the CIMT progression. Purpose We hypothesized that regular lipoprotein apheresis over the course of 10 years may slow down progression of CIMT in patients with severe hypercholesterolemia. Methods This case series describes ten Caucasian patients (mean age 60±9 years, 70% female, 80% statin intolerant) with familial hypercholesterolemia and/or hyperlipoproteinemia(a) treated with lipoprotein apheresis at a single academic center between 2005 and 2020. The mean and maximum diastolic CIMT of the distal 1 cm of the far wall of the right and left common carotid arteries was measured by the same, trained sonographer utilizing an automated border-detection algorithm. Results The median pre-treatment low-density lipoprotein cholesterol (LDL-C) level was 214 mg/dL (95% confidence interval, 145 to 248), lipoprotein(a), 26 mg/dL (15 to 109; 40% with lipoprotein(a) &amp;gt;60 mg/dL). Using the imputed trajectories, period-specific on-treatment time-weighted averages for LDL-C and lipoprotein(a) were 141 mg/dL (IQR, 89 to 152) and 24 mg/dL (IQR, 12 to 119), respectively. The baseline mean CIMT was 850±170μm and maximum CIMT was 1040±220μm across the age range of 46 to 70 years. Over a median duration of 12 years, regular treatment with lipoprotein apheresis resulted in an average reduction in the mean CIMT of −40μm (IQR, −50 to 20) and maximum CIMT −30μm (IQR, −60 to −10). Among tested lipid and lipoprotein fractions in this sample, the follow-up mean CIMT values strongly correlated only with the baseline lipoprotein(a) levels. Median CIMT progression rates were as follows: mean common carotid, −4μm/y (IQR, −9 to 1), mean common carotid, −12μm/3y (IQR, −26 to 4), maximal common carotid, −3μm/y (IQR, −8 to −1). This translated into 70% (7/10) of cases demonstrating composite mean CIMT below their expected chronologic age, gender and race-stratified vascular age. There was a strong direct correlation between the mean CIMT value at the end of the treatment period and the age of treatment initiation. In this cohort of primary and secondary prevention of patients with severe hypercholesterolemia, the overall rate of ASCVD was 37.5 per 1000 person-years while on lipoprotein apheresis. Conclusions Our observation performed in the clinical setting, demonstrated a real-world effectiveness of lipoprotein apheresis. This analysis supports implementation of aggressive lipid-modifying strategies across all ages. Surveillance with CIMT allows for continued monitoring of atherosclerosis progression and increases compliance with the lipid-modifying therapies in the high-risk patients with poor statin tolerance in the clinical setting. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): KUMC

Carotid Intima-Media Thickness in Patients with Psoriasis

Introduction: Since the early 20th century, findings have demonstrated that psoriasis is frequently associated with atherosclerosis and cardiovascular diseases. The Carotid Intima-Media Thickness (CIMT) is a surrogate marker of atherosclerotic vascular disease. Objective: The aim of this study was to investigate the CIMT in patients with psoriasis and investigate its correlation with the clinical features. Methods: The present case-control study involved 70 patients with psoriasis who visited Ho Chi Minh City Hospital of Dermato-Venereology from September 2018 to April 2019 and 35 healthy subjects. Serum triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels were measured in both groups. Linear Doppler scanning was performed to evaluate the CIMT of the common, internal, and external carotid arteries and the presence of atherosclerotic plaques. Results: The mean CIMT value in psoriasis patients was significantly higher than that of controls [0.59 mm (0.53 - 0.71) vs. 0.54 mm (0.52 - 0.62), respectively, p = 0.036]. Multiple linear regression analysis revealed a significant correlation between the CIMT and age (p = 0.043) and CIMT and the Psoriasis Area and Severity Index (p &lt; 0.0001). Moreover, the mean number of atherosclerotic plaques in psoriasis patients was significantly higher than that in controls [0.27 ± 0.68 vs. 0.03 ± 0.17, respectively, p = 0.035]. Conclusion: Elderly patients with severe psoriasis should be evaluated carefully regarding CIMT and atherosclerotic plaques, as these signs are representative of increased cardiovascular risk.

Carotid intima-media thickness and serum proinflammatory cytokine levels in rosacea patients without cardiovascular risk factors.

There is a growing body of evidence linking rosacea to various systemic disorders, even though data regarding the association between rosacea and cardiovascular diseases are presently controversial. We sought to investigate the potential association of rosacea with subclinical atherosclerosis and serum proinflammatory/proatherogenic markers. This study included 44 patients with rosacea and 44 age-matched and sex-matched healthy control subjects. Patients with traditional cardiovascular risk factors or a history of cardiovascular events were excluded. Demographic, clinical, and laboratory data, including serum interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) levels were assessed. Carotid intima-media thickness (CIMT) and carotid plaques were measured by carotid ultrasonography. Serum IL-1β (P < .001), IL-6 (P < .001), TNF-α (P < .001), and hs-CRP (P < .001) levels were significantly higher in the patient group compared with the control group. Mean CIMT values did not differ significantly between the patient group and control group (P > .05). Patients with moderate to severe rosacea had a significantly greater CIMT than those with mild rosacea (P = .047). Rosacea patients with eye involvement had a significantly greater CIMT than those without eye involvement (P = .008). There was no significant correlation between CIMT values and inflammation parameters. As conclusion, in the absence of other traditional cardiovascular risk factors, rosacea does not seem to affect mean CIMT value. However, specific subgroups such as patients with moderate to severe disease or with eye involvement are associated with increased subclinical atherosclerosis and may require additional attention for cardiovascular disease prevention.

The Effect of Laparoscopic Sleeve Gastrectomy on Subclinical Atherosclerosis in Patients with Severe Obesity.

Cardiovascular diseases (CVD) are one of the leading causes of mortality in obese patients. In this study, we investigated the effects of laparoscopic sleeve gastrectomy (LSG) operation on carotid intima-media thickness (CIMT), epicardial fat thickness (EFT), and serum endocan levels, which are independent predictors of subclinical atherosclerosis. A total of 47 patients (35 females and 12 males) with a mean age of 38 ± 10.48 with standard indications for LSG were prospectively included in the study. Mean CIMT values with B-mode duplex ultrasound, EFT measurements with standard transthoracic 2D echocardiography, and serum endocan levels were measured before the operation and 6months after the operation. Delta (Δ) values were obtained by subtracting sixth month values from baseline values. Body mass index (BMI) decreased significantly from an average of 47.31 ± 6.10 to 37.25 ± 5.61kg/m2 in the sixth month after LSG (p < 0.001). EFT, CIMT, and serum endocan values decreased significantly in the sixth month after surgery (0.67 ± 0.15 vs. 0.60 ± 0.14mm, p < 0.001; 1.07 ± 0.05 vs. 1.00 ± 0.14mm, p < 0.001; and 89.18 ± 66.22 vs. 37.74 ± 15.37, p < 0.001, respectively). There were mild-moderate positive relationships between Δ-BMI and the values of EFT and CIMT (r = 0.386, p = 0.007 and r = 0.314, p = 0.024, respectively). We also found weak linear relationships between Δ-BMI and Δ-endocan (r = 0.267, p = 0.036), and between Δ-EFT and Δ-CIMT (r: 0.221; p: 0.046). LSG can lead to reduction in the risk of cardiovascular disease by providing improvements in CIMT, EFT, and serum endocan values, which reflect early structural atherosclerotic changes in patients with severe obesity.

Determinants of carotid intima-media thickness in asymptomatic elders: a population-based cross-sectional study in rural China

ABSTRACT Objective: To examine the mean carotid intima-media thickness (CIMT) and potentially relevant determinants of increased CIMT in elders. Method: Stroke-free and cardiovascular disease-free residents aged ≥65 years were recruited in a low-income population in China. B-mode ultrasonography was performed to measure CIMT. Results: A total of 1039 individuals (47.9% men) were recruited. The mean CIMT value was 0.60 (SD: 0.09) mm. The mean CIMT was 24.07 (SEM: 6.52) µm greater in men than in women (P < 0.001) and 28.29 (SEM: 7.47) µm greater in patients with hypertension than in those without hypertension (P < 0.001). Moreover, the mean CIMT increased by 1.53 (SEM: 0.49) µm for each 1-year increase in age (P = 0.002). However, the mean CIMT decreased by 5.55 (SEM: 2.40) μm and 6.45 (SEM: 2.62) μm for every 1-mmol/L increase in triglyceride concentration and the high-density lipoprotein cholesterol: low-density lipoprotein cholesterol ratio, respectively (P < 0.05). However, high triglyceride level was negatively associated with mean CIMT only among individuals without metabolic syndrome (P = 0.036). Discussion: These findings suggest that there is an urgent need to delay atherosclerosis progression and reduce the stroke burden by managing hypertension, especially for men. Moreover, to decrease the stroke burden in rural China, caution is advised regarding lipid-lowering treatment in elderly patients without metabolic syndrome.

B-mode ultrasound assessment of carotid intima–media thickness among adult diabetics and normal adults in Gombe, Northeastern Nigeria

Background: The carotid intima–media thickness (CIMT) has been established as an early predictor of general arteriosclerosis in patients with diabetes. However, there is a paucity of information on CIMT of the common carotid artery (CCA) in healthy patients and in patients with risk factors for cardiovascular diseases such as diabetics, hypertension, and obesity in our environment. The aim of this study was to compare the CIMT in adult patients with diabetes and normal subjects in our institution in Gombe, Northeastern Nigeria. Materials and Methods: This case–control study was conducted over a period of 8 months (from April 2015 to December 2015) at Federal Teaching Hospital, Gombe, on 105 adult diabetic patients and 105 normal adults aged 18 years and above. The CCA was scanned with a PHILIPS HD-9 ultrasound scanner equipped with Doppler facility using a 7.5 MHz linear transducer. Three measurements of the CIMT were obtained at 1 cm proximal to the right and left carotid bulbs and the mean value of the measurements was recorded. Results: The age range of the diabetics comprising 54% of males and 46% of females was 23–79 years, while the range of control group comprising of 53% of males and 47% of females was 18–68 years. The overall mean CIMT (MCIMT) was 0.97 ± 0.4 mm and 0.73 ± 0.1 mm for diabetics and nondiabetic subjects, respectively. MCIMT was significantly higher in diabetics compared to nondiabetic subjects (P = 0.000). In diabetics, overall MCIMT values were 0.96 ± 0.2 mm and 0.91 ± 0.2 mm on the right and left sides, respectively, with a statistically significant difference between the two sides (P = 0.000), while in the normal group, the overall MCIMT values on the right and left sides were 0.75 ± 0.1 mm and 0.73 ± 0.1 mm, respectively, with a statistically significant difference between the two sides (P = 0.021). Furthermore, CIMT correlated positively with age in both diabetic and control groups. Conclusion: This study has shown a statistically significant increase in CIMT in diabetics compared to nondiabetics and age shows a significant correlation with CIMT. Reference value for CIMT in nondiabetic subjects in Northeastern Nigeria has been obtained.

Could a nonfunctional adrenal incidentaloma be a risk factor for increased carotid intima-media thickness and metabolic syndrome

BackgroundThis study was designed to detect the potential association of a nonfunctional adrenal incidentaloma (NFAI) with insulin resistance and associated metabolic disturbances, with a subsequent increase in cardiovascular risk factors. MethodsEighty-three NFAI patients and 56 volunteers (controls) without any adrenal abnormalities on computed tomography (CT) were included. Fasting blood glucose (FBG), fasting insulin, lipid profiles, uric acid, homocysteine, fibrinogen, high sensitivity C-reactive protein (hs-CRP), and adiponectin levels were measured in both groups. Blood pressure (BP), waist circumference, body mass index (BMI), and carotid intima media thickness (CIMT) were evaluated in both the patients and volunteers. ResultsThere were no significant difference between the NFAI and control groups with respect to age, sex, BMI, waist circumference, systolic and diastolic BP, smoking, concomitant disease, and medications. Fasting insulin and glucose levels and homeostasis model of assessment-insulin resistance (HOMA-IR) scores were significantly higher in the NFAI group as compared with those in the control group (p<0.01). The frequency of metabolic syndrome in the NFAI group was higher than that in the control group (p<0.01). All the lipid fractions, except triglyceride (TG), (p<0.05), homocysteine (p=0.01), and fibrinogen levels (p<0.001), were significantly higher in the NFAI group as compared with the levels in the control group. There were no significant differences between the NFAI and control groups in terms of uric acid, hs-CRP, and adiponectin levels. The CIMT values in the NFAI group were significantly higher than those in the control group (0.74±0.14 vs. 0.53±0.09, p<0.001). The mean CIMT value showed a statistically positive correlation with age (r=0.245, p=0.004); the HOMA-IR score (r=0.490, p<0.001); and FBG (r=0.521, p<0.001), fasting insulin (r=0.432, p<0.001), total cholesterol (TC) (r=0.267, p=0.002), and fibrinogen (r=0.398, p<0.001) levels in the NFAI group. ConclusionsThe results indicated that the NFAI patients had an elevated risk of insulin resistance, with metabolic syndrome and increased CIMT values. Long-term follow-up studies should be designed to evaluate postsurgical alterations in metabolic parameters and cardiovascular risk factors in NFAI patients.

Correlating Carotid Intima-Media Thickness With Lipid Profile: Does It Improve Sonographic Diagnosis of Subclinical Atherosclerosis?

Objective. The purpose of this prospective study was to ascertain if lipid profile parameters could serve as predictors of carotid intima-media thickness (CIMT), which, when combined, may improve the sensitivity of sonographic CIMT measurement in the diagnosis of subclinical atherosclerotic changes. Methods. The lipid profiles and CIMT of 181 subjects without cardiovascular risk factors were measured at the internal, external, common, and bulbar segments. Results. The mean CIMT values obtained were 0.620 ± 0.055 cm for men and 0.575 ± 0.051 cm for women, and the η2 values (η2 &lt; 0.04) were used as a measure of association. Across all segments of both carotid arteries, lipid profiles were significantly and moderately associated with but not predictive of CIMT (fasting blood sugar, total cholesterol, and low-density lipoprotein: η2 = 0.99–0.24). Conclusions. Although lipid profiles were moderately associated with CIMT, they are not significant predictors; hence, combining them with CIMT does not improve the diagnostic sensitivity of sonography in atherosclerosis screening.

Evaluation of subclinical atherosclerosis by ultrasound radiofrequency data technology in patients with Behçet's disease.

We aimed to evaluate subclinical atherosclerosis based on carotid intima-media thickness (CIMT) and arterial stiffness measurements in patients with Behçet's disease (BD), using ultrasound (US) radiofrequency (RF) data technology. We included 33 BD patients and 33 healthy controls in this study. The participants did not have any primary cardiovascular risk factors, such as diabetes mellitus, hypertension, hyperlipidemia and obesity. All participants were evaluated using Doppler ultrasonography. Arterial stiffness and CIMT measurements were performed in bilateral common carotid arteries using the US RF data technology. The right, left and mean CIMT values were similar between the patient and control groups (P >0.05). There was also no statistically significant difference in the right side α and β stiffness indices despite higher values in the patient group (P> 0.05). The right, left and mean distensibility coefficient (DC) and compliance coefficient (CC) values of the patient group were significantly lower than the control group (P< 0.05). The left and mean α- and β-stiffness indices, and the right, left and mean pulse wave velocity (PWV) values were significantly higher in the patient group (P< 0.05). We found higher mean CIMT and PWV values, and α- and β-stiffness indices in patients with mucocutaneous involvement compared with those with major organ involvement, while the mean DC and CC values were lower in the former. However, these results did not reach a statistically significant level. This study demonstrated evidence of subclinical atherosclerosis in BD in the absence of major atherosclerotic risk factors.

Could a nonfunctional adrenal incidentaloma be a risk factor for increased carotid intima-media thickness and metabolic syndrome

BackgroundThis study was designed to detect the potential association of a nonfunctional adrenal incidentaloma (NFAI) with insulin resistance and associated metabolic disturbances, with a subsequent increase in cardiovascular risk factors. MethodsEighty-three NFAI patients and 56 volunteers (controls) without any adrenal abnormalities on computed tomography (CT) were included. Fasting blood glucose (FBG), fasting insulin, lipid profiles, uric acid, homocysteine, fibrinogen, high sensitivity C-reactive protein (hs-CRP), and adiponectin levels were measured in both groups. Blood pressure (BP), waist circumference, body mass index (BMI), and carotid intima media thickness (CIMT) were evaluated in both the patients and volunteers. ResultsThere were no significant difference between the NFAI and control groups with respect to age, sex, BMI, waist circumference, systolic and diastolic BP, smoking, concomitant disease, and medications. Fasting insulin and glucose levels and homeostasis model of assessment-insulin resistance (HOMA-IR) scores were significantly higher in the NFAI group as compared with those in the control group (p<0.01). The frequency of metabolic syndrome in the NFAI group was higher than that in the control group (p<0.01). All the lipid fractions, except triglyceride (TG), (p<0.05), homocysteine (p=0.01), and fibrinogen levels (p<0.001), were significantly higher in the NFAI group as compared with the levels in the control group. There were no significant differences between the NFAI and control groups in terms of uric acid, hs-CRP, and adiponectin levels. The CIMT values in the NFAI group were significantly higher than those in the control group (0.74±0.14 vs. 0.53±0.09, p<0.001). The mean CIMT value showed a statistically positive correlation with age (r=0.245, p=0.004); the HOMA-IR score (r=0.490, p<0.001); and FBG (r=0.521, p<0.001), fasting insulin (r=0.432, p<0.001), total cholesterol (TC) (r=0.267, p=0.002), and fibrinogen (r=0.398, p<0.001) levels in the NFAI group. ConclusionsThe results indicated that the NFAI patients had an elevated risk of insulin resistance, with metabolic syndrome and increased CIMT values. Long-term follow-up studies should be designed to evaluate postsurgical alterations in metabolic parameters and cardiovascular risk factors in NFAI patients.

The association of carotid intima-media thickness with body mass index and cortisol level in fibromyalgia syndrome

Objectives: Patients with fibromyalgia syndrome (FMS) may have the risk for atherosclerotic disease because of chronic stress, disrupted neuroendocrine axis, high BMI and inflammation. This is study aimed to research the stress and the stress-related diseases in patients with FMS by measuring obesity, morning serum cortisol level, and carotid intima-media thickness (CIMT), which is the early indicator of the atherosclerosis. Methods: This case-control study included 57 patients who were diagnosed with FMS according to 2010 American College of Rheumatology (ACR) Criteria and visited the outpatient clinic in February 2016. As a control group, 36 healthy females who visited the outpatient clinic in the same month were included. Carotid intima-media thickness and cortisol levels were analysed. Results: The present study included 93 females between 15 and 79 years old. The mean age of the 57 females with FMS and 37 healthy females was 44.5 ± 10.6 years and 47.9 ± 18.5 years, respectively (p = 0.260). The mean CIMT value of the FMS and control groups was 0.64 ± 0.17 mm and 0.59 ± 0.16 mm, respectively (p = 0.170). The morning blood cortisol level in the FMS and control groups was 7.8 ± 3.3 ng/dL and 8.7 ± 2.8 ng/dL, respectively (p = 0.460). The CIMT and morning blood cortisol level were not correlated in the FMS group. Conclusion: According to the present study, CIMT value and morning blood cortisol level were not found significantly different in FMS group, and also were not found correlated with each other.

Correlation Between Carotid Intima-Media Thickness and the Activity of Rheumatoid Arthritis: A 1-Year Cross-Sectional Study

Background and objectives: Among several noninvasive techniques available, a high-resolution B-mode ultrasonography is the widely used technique to measure carotid intima-media thickness (CIMT) in rheumatoid arthritis (RA) patients with elevated cardiovascular risk. The present study was undertaken to explore the clinical relationship between CIMT and disease activity in patients with RA. Methods: This study involved 50 adult patients with RA. Demographic, physical, systemic, and clinical data and history of the patients were recorded. Investigations, such as erythrocyte sedimentation rate, highly sensitive C-reactive protein, renal and liver function tests, RA factor, and anticyclic citrullinated peptide antibody tests were performed. CIMT was assessed using highresolution B-mode ultrasonography and the disease severity was assessed based on disease activity score (DAS) 28. Results: The mean age of the RA patients was 49.88 ± 12.12 years with male predilection. The mean duration, mean European League Against Rheumatism (EULAR) criteria score, and mean DAS 28 score in RA patients were 3.62 ± 3.25 years, 8.10 ± 1.58, and 4.91 ± 1.11, respectively. The mean CIMT observed in RA patients was 0.94 ± 0.31 cm. Significant difference was observed in the mean CIMT values of different variables, including duration of joint pain (P = 0.007), tender joint count (P &lt; 0.001), swollen joint count (P &lt; 0.001), EULAR criteria score (P &lt; 0.001), and DAS 28 score (P &lt; 0.001). Also, CIMT correlated positively with tender joint count (r = 0.711; P &lt; 0.001), swollen joint count (r = 0.673; P &lt; 0.001), EULAR criteria score (r = 0.611; P &lt; 0.001), and DAS 28 score (r = 0.729; P &lt; 0.001). Conclusion: A strong correlation was observed between CIMT and disease activity in patients with RA. Hence, CIMT can be a useful surrogate marker for detecting atherosclerosis in patients with RA.

Comparison of carotid intima–media thickness and coronary artery calcium score for estimating subclinical atherosclerosis in patients with fatty liver disease

SummaryIntroductionFatty liver disease (FLD) is correlated with cardiovascular disease. Carotid intima–media thickness (CIMT) and coronary artery calcium score (CACS) can noninvasively identify subclinical atherosclerosis and predict risk for cardiovascular events. This study evaluated CIMT and CACS measurements to detect subclinical atherosclerosis in patients with and without FLD.MethodsPatients who underwent carotid and abdominal ultrasounds as well as cardiac computed tomography (CT) scans were evaluated retrospectively. The differences between the mean CIMT value and CACS measurements in patients with FLD and those with normal livers were estimated.ResultsAmong 819 patients (average age of 53.3 ± 11.2 years), 330 had FLD. The CIMT was greater in patients with FLD compared to the controls (0.79 ± 0.17 vs 0.76 ± 0.17 mm, p = 0.012), and carotid plaques were more commonly seen in patients with FLD. The incidence of a composite of larger CIMT (≥ 75th percentile) plus plaque presence was higher in FLD patients (43.3 vs 36.0%, p = 0.041). Particularly among young patients (≤ 50), the CIMT was larger in patients with FLD than in the controls. FLD increased the risk of a composite of large CIMT plus plaque presence in young patients (odds ratio 1.92, 95% confidence interval 1.05–3.49, p = 0.034). However, patients with FLD had no greater incidence of CACS of over 100 than the controls.ConclusionCIMT was a better marker of underlying subclinical atherosclerotic risk among patients with FLD than CACS. FLD particularly, increases the risk of subclinical atherosclerosis in patients younger than 50 years of age. These patients should undergo screening CIMT to detect atherosclerosis and modify risk factors.