Predictor Of Carotid Atherosclerosis Research Articles

Urinary Adiponectin as a Predictor of Carotid Atherosclerosis in Metabolic Syndrome in Type 2 Diabetics

Urinary Adiponectin as a Predictor of Carotid Atherosclerosis in Metabolic Syndrome in Type 2 Diabetics

Correlation of monomeric C-reactive protein level with subclinical carotid atherosclerosis progression in patients with low-grade carotid stenoses and moderate score risk

Background and Aims : Residual inflammatory risk is identified by hsCRP level ≥2.0 mg/l. Monomeric CRP (mCRP) is an emerging inflammatory biomarker. We studied whether mCRP level is a better predictor of carotid atherosclerosis (CA) progression than hsCRP in patients with low-grade CA and moderate SCORE risk which achieved target LDL cholesterol (LDL-C) level.

Relationship of sortilin and proprotein convertase subtilisin/kexin type 9 in blood serum with the severity of carotid and coronary atherosclerosis in hypertensive patients

Sortilin is an important molecular protein involved in lipid metabolism, atherosclerosis, and aortic valve calcification. Sortilin presumably regulates the PCSK9 signaling pathways.Aim. To study correlations of sortilin and PCSK9 with atherosclerosis development in hypertensive patients.Material and methods. The study included 161 patients aged 30 to 65 years. We performed collection of complaints and anamnesis, physical examination, blood biochemical test with the determination of total cholesterol, low-density lipoprotein cholesterol, triglycerides, blood glucose, serum creatinine with estimation of glomerular filtration rate. Serum PCSK9, sortilin and interleukins 8, 10 were determined by enzyme-linked immunosorbent assay. The following investigations were also performed: electrocardiography, echocardiography, extracranial artery ultrasound, coronary angiography.Results. Sortilin levels (b=2,37; odds ratio (OR), 10,74; 95% CI, 1,05-109,47, p=0,045), IL-8 (b=-2,42; OR, 9,74; 95% CI, 0,01-0,81, p=0,032), age (b=0,21; OR, 1,24; 95% CI, 1,12-1,37, p<0,001) were identified as independent predictors of coronary atherosclerosis with a sensitivity of 87% and a specificity of 70%. PCSK9 (b=0,005; OR, 1,00; 95% CI, 1,00-1,01, p=0,038) and IL-8 (b= -0,33; OR, 0,72; 95% CI, 0,55-0,94, p=0,014) were identified as independent predictors of carotid atherosclerosis with a sensitivity of 75% and a specificity of 71%.Conclusion. In addition to non-invasive imaging, the determination of atherosclerosis biomarkers can make a significant contribution to the diagnosis and prediction of carotid and coronary atherosclerosis progression. It is noteworthy that not only PCSK9, but also sortilin can be a potential therapeutic target. Further large-scale studies are needed.

T-Cadherin and the Ratio of Its Ligands as Predictors of Carotid Atherosclerosis: A Pilot Study.

In the cardiovascular system, atherogenic low-density lipoproteins (LDL) and the protective hormone adiponectin bind to the same receptor, T-cadherin. In this study, we tested the hypothesis that the ratio of circulating LDL to high-molecular weight (HMW) adiponectin could predict the development of atherosclerosis. Using enzyme-linked immunosorbent assay, we measured the level of circulating HMW adiponectin in the blood of donors together with ultrasound measuring of intima-media thickness (IMT) of carotid arteries. Single-nucleotide polymorphisms in the T-cadherin gene were identified using polymerase chain reaction. We found that carotid artery IMT is inversely correlated with the level of HMW in male subjects. We also found that the G allele of rs12444338 SNP in the T-cadherin gene correlates with a lower level of circulating T-cadherin and thinner IMT and therefore could be considered as an atheroprotective genotype. Despite our data, we could not provide direct evidence for the initial study hypothesis. However, we did uncover an important correlation between circulating T-cadherin and thinner carotid IMT.

Epicardial adipose tissue thickness as a possible predictor of carotid atherosclerosis in patients with abdominal obesity

Aim. To assess epicardial adipose tissue (EAT) thickness using echocardiography as one of the possible predictors of subclinical carotid atherosclerosis in patients with abdominal obesity in prospective follow-up.Material and methods. The study included 224 men (mean age, 49,1±2,4 years), without hypertension, carotid atherosclerosis, type 2 diabetes and symptoms of cardiovascular diseases, with abdominal obesity and SCORE risk <5%. The levels of albuminuria, lipid and glucose profiles, C-reactive protein, uric acid, blood creatinine, EAT thickness, ultrasound parameters of abdominal obesity and perivascular adipose tissue (PVAT) were assessed. At the follow-up end (mean duration, 48,2±4,8 months), repeated triplex ultrasound of the brachiocephalic arteries was performed.Results. Patients with developed carotid atherosclerosis (n=70) had higher baseline values of blood pressure, fasting glycemia, C-reactive protein, as well as a higher incidence of prediabetes, hyperuricemia, and high-grade albuminuria. They were also distinguished by high values of EAT thickness (6,1±0,6 mm vs 5,0±1,0 mm, p <0,001), abdominal visceral to subcutaneous fat ratio (3,1±0,5 vs 2,7±0,6, p <0,05) and carotid extra-media thickness (0,64±0,08 mm vs 0,50±0,11 mm, p <0,01). According to multivariate logistic regression, EAT thickness was characterized by the maximum standardized regression coefficient (0,443, p <0,001), and the total percentage of correct mathematical model classifications was 88,2%. According to the ROC-analysis, the area under the curve was 0,86. With a cut-off value of EAT thickness of 5,9 mm, the sensitivity and specificity of the predictive model were 71,5% and 92,3%, respectively.Conclusion. EAT thickness assessed by echocardiography, as a marker of the severity of visceral EAT, can serve as a predictor of subclinical carotid atherosclerosis in persons with abdominal obesity and initially low cardiovascular risk according to the SCORE calculator. Patients with verified epicardial visceral obesity require more active preventive measures.

Fresh vegetable and fruit consumption and carotid atherosclerosis in high-cardiovascular-risk population: a cross-sectional study in Jiangsu, China.

This study aimed to investigate the association of vegetable and fruit consumption with carotid plaque (CP) and carotid intima-media thickness (CIMT), two predictors of carotid atherosclerosis, within urban and rural adults at high risk of developing cardiovascular diseases (CVDs) in regional China. A total of 11,392 adults at high CVD risk were identified from general population of 71,511 in this cross-sectional study, conducted between November of 2015 and May of 2016 in the Jiangsu Province. Among these 11,392 high risk participants, CP prevalence was 36.7%. The independent variables, vegetable and fruit intake frequency, were assessed by a food frequency questionnaire. The outcome variables, CIMT and CP, were measured by ultrasound examination. The ANCOVA analysis showed no association between CIMT values and vegetable and fruit intake frequencies. Multivariate logistic regression models were introduced to examine the association between vegetable and fruit intake and CP. After adjustment for potential confounders, the odds ratios (ORs) for participants who occasionally and daily consumed vegetable to experience any CP were 0.67 (95%CI: 0.58-0.78) and 0.70 (95%CI: 0.62-0.79), respectively, compared with those rarely consumed vegetable. While the adjusted ORs were 0.77 (95%CI: 0.64-0.92) and 0.80 (95%CI: 0.68-0.94), separately, for occasional and daily vegetable consumers to develop single CP relative to their counterparts who rarely consumed any vegetables. However, no significant association between fruit consumption and CP was observed. Among the Chinese population at high CVD risk, consumption of fresh vegetables was negatively associated with the risk of developing carotid plaque.

Asociación de desórdenes autonómicos con aterosclerosis subclínica

Introduction and objectivesAlterations of the sympathetic and parasympathetic nervous system have been proposed as precursors of the genesis and perpetuation of atherosclerosis for a long time. The objective of this study is to determine if there is an association between the presence of carotid atherosclerosis and the reduction in heart rate variability. MethodsUsing a prospective case-control design, the heart rate variability and the presence of carotid atherosclerosis was investigated in 54 patients, divided into 2groups according to the presence or absence of carotid atherosclerosis. An analysis was made of the heart rate variability variables of the frequency (spectral) domain in high frequency band, low frequency band, parasympathetic autonomic balance, and the total spectral band. ResultsOf the 54 individuals evaluated without previous cardiovascular disease consecutively, 26 of them (48%) presented with subclinical carotid atherosclerosis (ATE+). A reduction in heart rate variability was observed in the ATE+group represented by the low frequency (LF) spectrum (P<.0001). The parasympathetic activity specifically represented in the high frequency (HF) band was also lower in the ATE+group in the univariate analysis (P<.0001), same as the total spectral power (P<.0001), an index of integral autonomic regulation. No significant differences were found in the LF/HF analysis (P=.1598). After analysing variables with significant differences in the univariate analysis with a logistic regression model, only systolic blood preassure and the total spectral power were shown to be independent predictors of ATE+. ConclusionA reduction in heart rate variability was found in subjects with carotid atherosclerosis. Some spectral components of heart rate variability, like low frequency or total spectral power, were better predictors of carotid atherosclerosis than the parasympathetic autonomic balance. In this study it seems that total spectral power is an adequate measurement for analysing autonomic function.

Prediction of carotid atherosclerosis in patients with impaired glucose tolerance - a performance analysis of machine learning techniques

Prediction of carotid atherosclerosis in patients with impaired glucose tolerance - a performance analysis of machine learning techniques

Prediction of carotid atherosclerosis in patients with impaired glucose tolerance - a performance analysis of machine learning techniques

The focus of this paper is to examine factors associated with carotid atherosclerosis in patients with impaired glucose tolerance (IGT), and to predict the rapid progression of carotid intima-media thickness (IMT). The proposed machine learning methods performed well and accurately predicted the progression of carotid IMT. The linear support vector machine, nonlinear support vector machine with a radial basis kernel function, multilayer perceptron (MLP), and the Naive Bayes method were employed. A comparison of these methods was conducted using the Brier score, and the accuracy was tested using a confusion matrix.

Neutrophil-to-Lymphocyte Ratio is a strong predictor of atherosclerotic carotid plaques in older adults

Background and aimsThe Neutrophil-to-Lymphocyte Ratio (NLR), an index of systemic inflammation, has been reported to be associated with subclinical atherosclerosis, but its predictive role of the presence of carotid atherosclerotic plaques remains undefined. This study aims to assess this association which gives additional value to this biomarker, with respect to the main risk factors, in the prediction of carotid atherosclerosis in older adults. Methods and resultsWe recruited 324 patients, aged ≥65 years, without hematopoietic disorders, and/or history of malignancies, evidence of acute infections, chronic inflammatory status, and history of glucocorticoid therapy within the past three months, hospitalized in the Unit of Internal Medicine, University of Catania, Catania, Italy from January 2014 to December 2016. All patients underwent blood sampling for white blood cell, neutrophil, lymphocyte and platelet counts, and for measurements of inflammatory markers, NLR was calculated as the ratio of the absolute neutrophil count to the absolute lymphocyte count. Patients also underwent carotid scan by ultrasonography (US) to evaluate abnormalities of carotid wall. NLR resulted a strong predictor of the presence of carotid plaques. NLR > 2.4 predicted with 80% probability carotid plaques (p < 0.01), while NLR > 3.68 gave 97% probability (p = 0.013). Furthermore, NLR > 2.4 was associated with an average presence of 2.86 carotid plaques (p < 0.001). Fibrinogen and CRP performed well, but with lesser significance, as predictors of the presence of carotid plaques (p = 0.002). ConclusionNLR is a strong predictor of the presence and the number of carotid atherosclerotic plaques. Its use could be useful to identify the risk of harboring carotid plaques.

Plasma Proprotein Convertase Subtilisin Kexin Type 9 as a Predictor of Carotid Atherosclerosis in Asymptomatic Adults

Atherosclerosis is a lipid-driven inflammatory disease of the arterial wall involving complex and multifactorial processes. Proprotein convertase subtilisin kexin type 9 (PCSK9) may play a role in the development of atherosclerosis. We investigated the associations between serum PCSK9 and carotid intima-medial wall thickness (IMT), a measure of subclinical atherosclerosis that predicts cardiovascular events, in 295 asymptomatic subjects from community. Carotid IMT was determined by high-resolution B-mode carotid ultrasonography and serum PCSK9 was measured by immunoassay. In univariate analysis, serum PCSK9 concentration was positively (P<0.05 in all) associated with age (r=0.204), BMI (r=0.149), waist circumference (r=0.139), systolic blood pressures (r=0.116), glucose (r=0.211), insulin (r=0.178), HOMA score (r=0.195), plasma triglyceride (r=0.285), total cholesterol (r=0.241) and LDL-cholesterol concentrations (r=0.172). In multivariate regression including male gender, hypertension, smoking status, HOMA score, obesity, LDL-cholesterol, lipoprotein (a) or markers of inflammation, serum PCSK9 remained an independent predictor of mean carotid IMT (P<0.001). These data suggest that serum levels of PCSK9 may contribute to increased risk of subclinical carotid atherosclerosis independent of conventional risk factors. Whether PCSK9 inhibition improves cardiovascular outcomes remains to be demonstrated in large, ongoing clinical trials.

FP598NONALCOHOLIC FATTY LIVER DISEASE - A NEW CARDIOVASCULAR RISK FACTOR IN PERITONEAL DIALYSIS PATIENTS

Although the significant improvement in the reduction of infectious complications was fulfill during the last years, cardiovascular (CVD) mortality in peritoneal dialysis (PD) patients remains unchanged. Therefore, searching for new causes of increased CVD risk in PD patients has attracted further research interest. Recent investigations indicated that nonalcoholic fatty liver disease (NAFLD), a hepatic component of metabolic syndrome, is associated with an increased risk of CVD. Accordingly, we were interested to explore the frequency of NAFLD in PD patients and to analyze factors in PD patients associated with NAFLD occurrence. In addition, we were interested to investigate is NAFLD associated with higher CVD risk in our PD patients. In the present cross-sectional study, we analyzed 58 PD patients. The controlled attenuation parameter (CAP) was used to detect and quantify liver steatosis with the help of transient elastography (TE) (Fibroscan®, Echosense SA, Paris, France). A carotid ultrasound was performed in all patients to measure carotid intima-media thickness (ITM) and plaque as surrogate measures of increased CVD risk and to investigate their association with NAFLD. NAFLD was present in 74.1% of PD patients. PD/NAFLD patients had significantly lower hemoglobin (113.6±13.8 vs. 127.5±21.3 ; p=0.007) and serum iron (11.8±4.1 vs. 16.9±7 ; p=0.002) values in comparison to the non-NAFLD/PD patients. Furthermore, PD/NAFLD patients had significantly higher values of hs-CRP (7.6±7.9 vs. 2.2±1.7 ; p=0.02) and ferritin (286.1±157.4 vs. 146.2±118 ; p=0.005) than PD patients without NAFLD. The daily number of glucose solutions (p=0.04), obesity (p=0.02), and presence of hypertension (p=0.01), diabetes (p<0.0001) and dyslipidemia (p<0.0001) were found to be independent predictors of NAFLD occurrence in PD patients. PD patients with NAFLD showed more carotid atherosclerosis than PD patients without NAFLD (table 1). In additional, CAP values (as indicator of liver steatosis) had shown strong positively association with IMT (r=0.801 ; p<0.0001). In multivariate analysis NAFLD was a strong and an independent predictor of carotid atherosclerosis in PD patients. NAFLD is highly prevalent in PD patients. PD patients with NAFLD are at high risk for atherosclerosis. The clinical implication of this finding is that presence of NAFLD in PD patients may help in cardiovascular risk stratification and assessment.The use of CAP as a screening method for NAFLD detection in PD patients could be beneficial since it is a non-invasive and quick method that is easy to perform and may be repeated.

Mitral and aortic valve sclerosis/calcification and carotid atherosclerosis: results from 1065 patients

This study assesses whether aortic valve sclerosis (AVS) and mitral annulus calcification (MAC) are associated with carotid artery atherosclerosis, independently of traditional cardiovascular risk factors. A total of 1065 patients underwent both echocardiography and carotid artery ultrasound scanning. AVS and MAC were defined as focal areas of increased echogenicity and thickening of the aortic leaflets or mitral valve annulus. Carotid artery atherosclerosis was defined as presence/absence of any atherosclerotic plaque or presence/absence of plaque >50 %. Of 1065 patients (65 ± 9 years; 38 % female) who comprised the study population, 642 (60 %) had at least one atherosclerotic plaque. AVS, but not mitral valve sclerosis; was associated with the presence of carotid atherosclerosis (odds ratio (OR) 1.9, 95 % confidence interval (CI) 1.2-3.9; P = 0.005) and the degree of carotid atherosclerosis (OR 2.1, 95 % CI 1.2-3.9; P = 0.01) in a multivariate model including age, gender, previous ischemic heart disease, hypertension, dyslipidemia, smoking, diabetes, family cardiovascular history, left ventricular size, mass, and ejection fraction, and left atrial size. AVS is a significant predictor of carotid atherosclerosis, independently of other cardiovascular clinical and echocardiographic risk factors.

Aging, components of metabolic syndrome and serum C-reactive protein showed significant relationship with carotid atherosclerosis

Objective: metabolic syndrome (MetS) is known to be associated with an increased risk for cerebro- as well as cardio-vascular disease. Prediction of carotid atherosclerosis by components of MetS, serum C-reactive protein, aging and related factors was conducted for Japanese inhabitants. Methods: A total of 887 subjects (761 males, 126 females) were included in the present study. Early atherosclerosis was assessed by measurement of the intima-media thickness of the common carotid arteries. Results: The carotid arterial intima-media thickness on both the right and left sides significantly increased as the number of components of MetS increased. The maximum intima-media thickness values in the right (left) carotid arteries in the male and female subjects who fulfilled the criteria for MetS were 0.65 ± 0.18 (0.66 ± 0.17) mm and 0.58 ± 0.12 (0.59 ± 0.11) mm, respectively. After adjustment for several factors, the intima-media thickness related significantly with aging, some components of MetS and serum C-reactive protein by multiple regression analysis. β-coefficient of age was largest, presenting 0.457 in right side and 0.479 in left side. Conclusions: Aging, metabolic components and serum C-reactive protein are independent predictors of intima-media thickness in subjects.

Follow-up study on prediction of carotid atherosclerosis in adulthood based on obesity and hypertension in childhood

Objective: To explore the predictive risks of carotid atherosclerosis (CAS) in adulthood based on obesity and hypertension in childhood. Methods: The population-based sample used was the 7th Five Years Programs for Science and Technology Development of China, “Beijing children and adolescents BP study cohort”. 3198 people aged 6–18 were included in this research in 1987. 1126 subjects were followed up and CAS risk factors and carotid ultrasound examinations were measured in 2010. Height, weight, blood pressure and other cardiovascular risk factors were measured. To assess CAS in common carotid artery intima-media thickness (cIMT), the numbers of plaque were calculated in different groups in the CAS. SPSS 18.0 was applied to conduct multivariate logistic regression analysis to evaluate odd ratios (OR) and 95% confident interval (CI). Results: 1) With one unit change in BMI, cIMT in adulthood changed 0.158 mm, every change a unit in SBP, cIMT changed 0.163 mm. 2) After adjusting for other risk factors, the ability of childhood obesity on the risk prediction CAS was 3.07 (95%CI: 1.40–6.73) times than normal group. Childhood blood pressure on the risk prediction CAS was 2.51 (95%CI: 1.54–4.07) times than normal group. Interaction analysis found that childhood obesity and hypertension had the interaction effect on predict CAS in adulthood, P<0.05. Compared with the normal group, the OR (95%CI) in simple childhood hypertension group was 2.92 (1.03–8.28). Both childhood obesity and hypertension group compared with the normal group, OR (95%CI) was 11.33 (5.30–24.26). Conclusions: Obesity and hypertension in childhood increase the risk of CAS in adulthood. It might also be noted that an elevated risk of adult CAS among the children who has hypertension but not obese.

Association between metabolic syndrome and carotid atherosclerosis in individuals without diabetes based on the oral glucose tolerance test

Introduction Whether or not metabolic syndrome is predictive of atherosclerotic disorders may depend on the population studied. We investigated whether metabolic syndrome is associated with carotid atherosclerosis in individuals who were shown not to have diabetes mellitus based on results of the 75-g oral glucose tolerance test (OGTT). Methods and results Between 1994 and 2003, 3904 individuals underwent general health screening that included the OGTT. Among these 3904 individuals, 3679 had a fasting plasma glucose of <126 mg/dL (subgroup 1), and 3488 had a 2-h post-OGTT glucose value of <200 mg/dL (subgroup 2). In both subgroups, metabolic syndrome was found to be a risk factor for carotid plaque and for carotid intima-media thickening in men, and tended to be a risk factor for carotid plaque in women after adjustment for age. Among 3473 individuals who had both a fasting plasma glucose value of <126 mg/dL and a 2-h post-OGTT glucose of <200 mg/dL, 2440 did not have hypertension, which was defined as systolic and diastolic blood pressure of <140/90 mmHg and absence of use of anti-hypertensive medication. In these non-diabetic non-hypertensive individuals, the association between metabolic syndrome and carotid plaque or carotid intima-media thickening was not statistically significant even with adjustment only for age. Conclusions In men who did not have impaired fasting glycemia and/or in those without impaired glucose tolerance, metabolic syndrome was a predictor of carotid atherosclerosis after age adjustment, although metabolic syndrome was not found to be a predictor of carotid atherosclerosis when hypertensive individuals were excluded from the study population.

Abstract 1196: Endogenous Nitric Oxide Synthase Inhibitors, Arterial Hemodynamics And Subclinical Vascular Disease: A Population-based Study

Background: Asymmetric dimethylarginine (ADMA) and NG-monomethyl-L-arginine (NMMA), endogenous nitric oxide-synthase inhibitors (End-NOSI), have been associated with cardiovascular risk factors (CVRF) and atherosclerosis. In addition, acute administration of NOSI cause hypertension through hemodynamic effects, but whether circulating End-NOSI are associated with these abnormalities is unknown. Methods: We studied 922 adults in a population-based study (PREVENCION study). We examined the correlation between End-NOSI/L-arginine and CVRF, as well as the relationship between these biomarkers and arterial hemodynamics, carotid-femoral pulse wave velocity (cf-PWV) and carotid intima-media thickness (c-IMT). We used general linear modeling for statistical analyses. Estimates (β) are standardized. Results: In multivariate analyses, LDL-cholesterol and C-reactive protein (CRP) were independent predictors of ADMA, whereas LDL-cholesterol and gender independently predicted NMMA. Age, gender, HDL-cholesterol and CRP were independent predictors of L-arginine. ADMA (β=0.09;p=0.008) and NMMA (β=0.11; p=0.001), but not L-arginine, were strong predictors of c-IMT, even after adjustment for CVRF, CRP and renal function. In contrast, ADMA and NMMA were not predictors of cf-PWV, blood pressure or hemodynamic abnormalities. Higher L-arginine independently predicted higher central (aortic) pulse pressure (β=0.09; p=0.002), incident wave amplitude (β=0.11; p&lt;0.001) and late systolic augmented pressure from wave reflections (β=0.07; p=0.003), but not systemic vascular resistance or cardiac output. Conclusions: ADMA and NMMA are differentially associated with CVRF, but both End-NOSI are independently predictors of carotid atherosclerosis. In contrast, they are not associated with large artery stiffness, hypertension or hemodynamic abnormalities. Our findings are consistent with a role for End-NOSI in atherosclerosis, but not in large artery stiffnening, hypertension or long-term hemodynamic regulation. L-arginine is independently associated with abnormal pulsatile hemodynamics, which may reflect abnormal L-arginine transport, leading to decreased intracellular bioavailability for NO synthesis.

Smoking, Fasting Serum Insulin, and Obesity Are the Predictors of Carotid Atherosclerosis in Relatively Young Subjects

The purpose of this study was to identify predictors of atherosclerosis in a healthy young cohort comprised of 241 subjects who underwent a regular employee medical check-up at Ohshima National Sanatorium over a 9-month period. All subjects underwent carotid ultrasound examinations to determine maximal common carotid artery intima media thickness. In addition, serum total cholesterol, triglycerides, high-density lipoprotein cholesterol, blood urea nitrogen, creatinine, glucose, and insulin were evaluated. The subjects were relatively young (mean age, 44 years; range, 18 to 62 years), with 130 females (54%) and 111 males (46%). Maximal common carotid artery intima media thickness was predicted by smoking habit, body mass index, fasting blood sugar, fasting serum insulin, and systolic blood pressure (F(5,235) = 52.8, P < 10(-5)). There was clear separation in common carotid artery intima media thickness values based on body mass index, smoking, and fasting serum insulin, and somewhat more overlap with systolic blood pressure and fasting blood sugar. These findings suggest that smoking and high values of body mass index, fasting serum insulin, systolic blood pressure, and fasting blood sugar are warning factors for early atherosclerosis development, and could conceivably serve as the basis of diagnostic screening. Smoking is particularly deleterious, as smokers with high body mass index, high fasting serum insulin, or high systolic blood pressure tend to have larger common carotid artery intima media thickness values than would have been predicted by consideration solely of the individual risk factors.

Preβ1-HDL Concentration Is a Predictor of Carotid Atherosclerosis in Type 2 Diabetic Patients

Pre-β1-HDL is a minor HDL subfraction that stimulates cholesterol efflux from cell membranes (1,2). However, the fasting preβ1-HDL concentration is elevated in patients with coronary artery disease (CAD), hyperlipidemia, and obesity and in hemodialysis patients (3–7). We examined whether the preβ1-HDL concentration is elevated in type 2 diabetic patients and whether elevated preβ1-HDL concentration is a predictor of carotid atherosclerosis. We measured the preβ1-HDL concentration in 30 patients with type 2 diabetes (mean ± SD age 58.5 ± 12.3 years, 13 men and 17 women) and in 30 age- and sex-matched healthy control subjects. We excluded patients receiving hypolipidemic agents and those with renal dysfunction. The diabetic group had a long duration of disease (9.9 ± 8.6 years), high A1C levels (10.4 ± 2.0%), and high BMI (26.1 ± 6.5 kg/m2). The preβ1-HDL in frozen plasma, pretreated with sucrose solution for stabilization, was measured using an immunoassay (8). In the diabetic group, we evaluated the severity of carotid atherosclerosis using ultrasonography with a 7.5-MHz probe. The greatest intima-media thickness (max IMT) and plaque score were determined as previously reported (9). The diabetic group had higher triglyceride concentrations than the control subjects (166.9 ± 138.4 vs. 90.9 ± 28.6 mg/dl, P < 0.01), while the two groups did not differ significantly in total cholesterol (215.1 ± 49.9 vs. 201.0 ± 20.9 mg/dl), LDL cholesterol (135.9 ± 37.1 vs. 125.3 ± 17.9 mg/dl), or HDL cholesterol (55.5 ± …

O0012 Is excessive daytime sleepiness a predictor of carotid atherosclerosis in sleep apnea?

O0012 Is excessive daytime sleepiness a predictor of carotid atherosclerosis in sleep apnea?