Prevalence Of Subclinical Disease Research Articles

Prevalence and associated risk factors of peripheral artery disease in virologically suppressed HIV-infected individuals on antiretroviral therapy in Kwara state, Nigeria: a cross sectional study

BackgroundThe association between HIV and cardiovascular disease (CVD) has been reported in several studies. However, there is paucity of information on the prevalence of subclinical disease as well as its associated risk factors in sub-Saharan African population. The aim of this study was to determine the prevalence and associated risk factors of peripheral artery disease (PAD) among virologically suppressed HIV-infected participants in Kwara State, Nigeria.MethodsThis study was conducted between July 2018 and December 2018. A total of 150 HIV-infected participants aged between 20 and 55 years and 50 HIV non-infected age-matched controls were randomly recruited in the study. Sociodemographic, anthropometric and clinical data were collected using a well-structured questionnaire. Ankle brachial index (ABI) was measured, PAD was defined as ABI of < 0.9. Cryopreserved serum was used to evaluate lipid profile parameters. Student’s t-test and Chi-square were used to compare continuous and categorical variables. Associations of CVD risk factors and clinical data, and lipid profile with low ABI were assessed using logistic regression analysis.ResultsThe study participants had a mean age of 43.73 ± 8.74, majority were females (72.7%) with a mean duration on ART of 7.73 ± 3.52 years. Hypertension was present in 15.9%, diabetes 4%, family history of CVD 8.6% and metabolic syndrome 17.3% in the study group. The study participants recorded significantly lower mean values for ABI, HDL-C and significantly higher mean values of TG (P < 0.05) compared to the control group. The prevalence of low ABI (14.6%) was higher in the study group compared to the control group (2%). A significantly negative correlation between ABI and duration on ART (r = − 0.163, P = 0.041) and a positive correlation between viral load and TG were observed in the study group. TC (OR 1.784, P = 0.011), LDL-C (OR 1.824, P = 0.010) and CD4 cell count < 200 cells/mm3 (OR 2.635, P = 0.364) were associated with low ABI in the participants.ConclusionViral suppression with combined antiretroviral therapy and long term treatment is associated with dyslipidaemia, with increased risk of PAD. Prevalence of PAD in virologically-suppressed individuals does not differ from the controls in the population studied.

Early Atherosclerosis Detection in Asymptomatic Patients: A Comparison of Carotid Ultrasound, Coronary Artery Calcium Score, and Coronary Computed Tomography Angiography

BackgroundDetailed multimodality assessment of subclinical atherosclerosis in asymptomatic subjects referred for risk stratification has not been performed. We analyzed the detection of early atherosclerosis using 3 imaging modalities: coronary artery calcium (CAC) scoring, carotid ultrasound (US), and coronary computed tomography angiography (CCTA). MethodsAsymptomatic subjects free of known vascular disease scheduled to undergo a carotid US for risk stratification were invited to undergo CCTA/CAC. Subjects taking lipid-lowering medication were excluded. All images were assessed by experienced core laboratory personnel. Carotid intima media thickness ≥ 75th percentile for age and sex, CAC > 0, and detection of either carotid or coronary artery plaque were indicators of atherosclerosis. ResultsFifty patients were included with a median age of 53 years. Atherosclerosis was observed in 28%, 78%, and 90% of subjects using CAC, CCTA, and carotid US, respectively. All subjects showed atherosclerosis on at least 1 modality. In 36 patients with a CAC score = 0, 69% and 86% had atherosclerosis on CCTA and carotid US, respectively. ConclusionsIn this detailed analysis, all subjects identified to warrant further risk stratification had subclinical atherosclerosis on at least 1 imaging modality. Concordance between modalities was highly variable, dependent on the specific definition of atherosclerosis used. Carotid US and CCTA detection of plaque were significantly more sensitive than CAC > 0 in this middle-aged population. Considering the prevalence of subclinical disease on carotid US and CCTA, the threshold at which to treat warrants further research.

Abstract P439: Risk Factor Profile and Prevalence of Subclinical Disease in African Americans with Diabetes and Metabolic Syndrome: The Jackson Heart Study

Background . Metabolic derangements such as diabetes (DM) and metabolic syndrome (MetS) are common in African Americans (AA) and contribute to the higher cardiovascular disease (CVD) mortality in this group. A greater prevalence of subclinical disease (ScD) among those with DM and MetS in the AA community may be an explanatory factor. Objective . We assessed the CVD risk factor profile and distribution of ScD among AA with DM and MetS in the Jackson Heart Study (JHS). Methods . We evaluated 4,365 AA participants [mean age (SD) of 53.8 (12.3) years, 64.5% women] free of overt CVD who attended JHS Exam 1 (between 2000- 2004), when ScD assessment was routinely performed(with the exception of CT for coronary calcium that occurred in Exam2). SCD measures included 1) peripheral artery disease (PAD, defined as ankle-brachial index&lt;0.9), 2) high coronary artery calcium (CAC, defined as score&gt;100), 3) left ventricular (LV) hypertrophy (LVH defined as left ventricular mass index&gt;51 g/m 2.7 , 4) low LV ejection fraction (low EF, defined as an EF&lt;50%), and 5) microalbuminuria (MA, defined as an albumin-to-creatinine ratio&gt;25 μg/mg in men and &gt;35 μg/mg in women). We compared the distribution of standard CVD risk factors and ScD prevalence in 1) those without DM or MetS (referent), 2) those with MetS but no DM and 3) those with DM. Results . In our study sample, 1,089 (24.9%) had MetS with no DM and 752 (17.2%) had DM. Compared to the referent group, groups with metabolic derangement tended to be older, female, hypertensive, obese, and had lower HDL, higher fasting glucose, and higher triglycerides levels. Table 1 compares the distribution of ScD for the three groups, and demonstrates the greater odds of. CAC, LVH and microalbuminuria in participants with MetS or DM. Conclusion . In our large community-based sample of AAs, we observed a significantly high prevalence of ScD overall, especially so in participants with MetS and DM. These findings likely contribute to the high CVD rates in AA with MetS and DM. -->

Vitamin D and retinoids in parathyroid glands (review).

Vitamin D and retinoids are important regulators of differentiation and proliferation in a number of tissues, and have been implicated as chemopreventive agents in several different tumors. While vitamin D is known to be important for regulation of parathyroid function and proliferation, it has recently been established that parathyroid cells also are targets for retinoids. Hyperparathyroidism (HPT) is a common disorder, and evaluation of the disease has indicated high prevalence of subclinical disease, as well as clear benefits of offering treatment for the disease. This review summarizes the data so far gathered concerning parathyroid cells, vitamin D and retinoids, with clear implication on prospects of possible medical treatment of hyperparathyroidism.

An abattoir-based study of the prevalence of subclinical Johne's disease in adult cattle in south west England.

The prevalance of subclinical Johne's disease was estimated in adult cattle slaughtered at three major abattoirs in south west England. A polymerase chain reaction (PCR) based on IS900 was used to detect Mycobacterium paratuberculosis in intestinal lymph nodes of 1553 cattle. Culture was also carried out on all PCR positive and inconclusive samples. The prevalence of subclinical disease in adult cattle was 3.5% (95% confidence intervals (CI) 2.6-4.7) by PCR and 2.6% (CI 1.8-3.6) by culture. The proportion of the disease in each month ranged from 1.6% (CI 0.2-5.5) in April to 4.6% (CI 2.8-6.9) in November, but the difference was not significant (P > 0.05). The proportion of PCR positive lymph nodes in each abattoir ranged from 2.8% (CI 1.6-4.6) to 4.9% (CI 2.9-7.6), this difference was not significant either (P > 0.05). The prevalence in young cattle was 2.0% (CI 0.6-4.5). The difference between age groups was not statistically significant (P > 0.05).

Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study.

The prevalence of subclinical atherosclerosis and cardiovascular disease was evaluated among the 5,201 adults aged > or = 65 years in four communities participating in the Cardiovascular Health Study from June 1989 through May 1990. A combined index based on electrocardiogram and echocardiogram abnormalities, carotid artery wall thickness and stenosis based on carotid ultrasound, decreased ankle-brachial blood pressure, and positive response to a Rose Questionnaire for angina or intermittent claudication defined subclinical disease. The prevalence of subclinical disease was 36% in women and 38.7% in men and increased with age. Among women, low-density lipoprotein cholesterol, systolic blood pressure, blood glucose, and cigarette smoking were positively associated, and high-density lipoprotein cholesterol negatively associated, with subclinical disease. In men, systolic blood pressure, blood glucose, and cigarette smoking were independent risk factors in multiple logistic regression analyses. The risk factors for subclinical disease are, therefore, similar to those for clinical disease at younger ages, especially among women. It is possible that older individuals with subclinical disease are at very high risk of developing clinical disease and that more aggressive interventions to prevent clinical disease should be oriented to individuals with subclinical disease.

Geographical distribution of subclinical autoimmune thyroid disease in Britain: A study using highly sensitive direct assays for autoantibodies to thyroglobulin and thyroid peroxidase

In order to determine whether the geographical distribution of autoimmune thyroid disease in Britain is influenced by the pattern of iodine intake, the prevalence of subclinical disease (detectable antithyroid antibodies in biochemically euthyroid individuals) has been measured in female blood donors from seven towns in England and Wales previously characterised in terms of past and present iodine intake. Thyroglobulin antibody and thyroid peroxidase antibody were measured by highly sensitive assays which are based on the direct interaction between antibody and radiolabelled antigen. Excluding cases of overt thyroid disease (biochemically hypo- or hyperthyroid with thyroid antibodies), the overall prevalences of the antibodies in sera from the 698 female blood donors were 17.8% for thyroglobulin antibody and 17.8% for thyroid peroxidase antibody. Both antibodies were found in 12.3% of the female blood donors. In contrast, the prevalences of thyroglobulin antibody and thyroid peroxidase antibody were 41 and 43%, respectively, in the 117 female relatives of 18 probands with autoimmune thyroid disease, but the highest prevalences were observed in groups of women patients with Graves' disease (N = 39) or Hashimoto's disease (N = 39) (51, and 97% for thyroglobulin antibody, respectively, and 72 and 97% for thyroid peroxidase antibody, respectively). Antibody prevalence increased with age in the female blood donors rising from 10.6% at age 18-24 to 30.3% at age 55-64 for thyroglobulin antibody and from 14.9% at age 18-24 to 24.2% at age 55-64 for thyroid peroxidase antibody. Geographical differences in the prevalences of both antibodies were not significant and did not correlate with either the previous goitre prevalence or with current differences in iodine intake.(ABSTRACT TRUNCATED AT 250 WORDS)