Risk Factors For Intima-media Thickness Research Articles

Subclinical atherosclerosis in primary Sjögren's syndrome: comparable risk with diabetes mellitus.

It has been found that the risk of subclinical atherosclerosis in some connective tissue diseases (CTDs) was equivalent to type 2 diabetes mellitus (T2DM). There is no clinical study focusing on the differences of subclinical atherosclerosis between primary Sjögren's syndrome (pSS) and T2DM. Our aim is to investigate the prevalence of subclinical atherosclerosis in pSS patients, compare the differences in subclinical atherosclerosis between pSS and T2DM patients, and determine the risk factors of subclinical atherosclerosis. A retrospective case-control study of 96 patients with pSS, 96 age- and sex-matched T2DM patients and healthy individuals underwent evaluation, including clinical data and carotid ultrasound examination. Univariate and multivariate models were used to explore the related factors of carotid intima-media thickness (IMT) and carotid plaque. Increased IMT scores were detected in patients with pSS and T2DM compared to controls. The percentages of carotid IMT were detected in 91.7% of pSS and 93.8% of T2DM patients versus 81.3% in the controls. Carotid plaques were detected in 82.3%, 82.3% and 66.7% of pSS, T2DM, and controls, respectively. Age and the presence of pSS and T2DM emerged as risk factors for IMT (adjusted OR = 1.25, 4.40, and 9.92, respectively). In addition, age, total cholesterol, and the presence of pSS and T2DM emerged as risk factors for carotid plaque (adjusted OR = 1.14, 1.50, 4.18, and 3.79, respectively). The prevalence of subclinical atherosclerosis in pSS patients was increased, which was comparable to that in T2DM patients. The presence of pSS is associated with subclinical atherosclerosis. Key Points • The prevalence of subclinical atherosclerosis is higher in primary Sjögren' s syndrome. • The risk of subclinical atherosclerosis is similar in primary Sjögren's syndrome and diabetes mellitus patients. • Advanced age was an independent predictor of carotid IMT and plaque formation in primary Sjögren's syndrome. • Primary Sjögren's syndrome and diabetes mellitus are associated with atherosclerosis.

Number of Teeth and Nutritional Status Parameters Are Related to Intima-Media Thickness in Dalmatian Kidney Transplant Recipients.

Although kidney transplantation significantly improves the quality of life of patients with end-stage renal disease (ESRD), the prevalence of cardiovascular disease (CVD) in kidney transplant recipients (KTRs) remains high. Atherosclerosis, post-transplantation metabolic changes, immunosuppressive therapy, and periodontitis contribute to elevated cardiovascular risk in this population. The aim of the study was to evaluate carotid intima-media thickness (IMT) as a surrogate marker of atherosclerosis and to analyze the possible risk factors for IMT in Dalmatian KTRs. Ninety-three KTRs were included in this study. Data on clinical and laboratory parameters, body composition, anthropometry, advanced glycation end-product (AGE) measurements, blood pressure, and arterial stiffness were collected. All participants underwent ultrasound examination of IMT and evaluation of periodontal status. KTRs with carotid IMT ≥ 0.9 were significantly older, had a lower level of total cholesterol, fat mass, end-diastolic velocity (EDV), and had fewer teeth. They also had significantly higher values of pulse wave velocity (PWV) and resistive index (RI). We found positive correlations between carotid IMT and duration of dialysis, age, PWV, AGE, RI, and average total clinical attachment level (CAL). The regression model showed that IMT in KTRs is associated with higher PWV, lower fat mass, and fewer teeth. The results of our study suggest that nutritional and periodontal status are associated with carotid IMT in KTRs.

Gender differences in the risk factors associated with atherosclerosis by carotid intima-media thickness, plaque score, and pulse wave velocity.

Cardiovascular disease (CVD) remains the leading cause of death, but the risk factors for CVD differ between men and women. Although carotid intima-media thickness (IMT), carotid plaque, and pulse wave velocity (PWV) are useful atherosclerotic parameters, patient backgrounds have differed in previous reports. Therefore, this study aimed to investigate gender differences in associations between these three parameters and traditional risk factors in the same population. We enrolled 3888 participants (women: 743) who underwent routine health checkups. High IMT, high carotid plaque score (PS), or high brachial-ankle PWV (baPWV) were defined by the median values for each gender. We analyzed the association between each parameter and atherosclerotic risk factors, such as obesity, smoking, blood pressure (BP) elevation, impaired fasting glucose (IFG), and dyslipidemia (DL). In both sexes, BP elevation was the only common risk factor for high IMT, high PS, and high baPWV in the multivariate logistic regression analysis adjusted for age. In men, IFG and DL were common risk factors for the three parameters. Furthermore, obesity was an additional risk factor for high IMT and smoking was an additional risk factor for high IMT and high PS. In contrast, in women, obesity, DL, or IFG was an additional risk factor for high IMT, high PS, or high baPWV, respectively. The risk factors for IMT, PS, and baPWV differ in in men and women. The management for atherosclerotic risk factors on early stage should be considered in terms of gender-specific risk factors.

Association between the level of fasting blood glucose over 35-year-old and carotid intima-media thickness in Han, Uygur and Kazak population from Xinjiang Uygur Autonomous Region from 2007 to 2010

To analyze the relationship between different levels of fasting blood glucose over 35-year old and carotid intima-media thickness (IMT) in Han, Uygur and Kazak adult population from Xinjiang Uygur Autonomous Region. From October 2007 to April 2010, the present study was performed in 13 935 inhabitants among Han, Uygur and Kazak adult population of aged 35 years old and over by multi-stage stratified cluster random sampling principles from 7 regions in Xinjiang Uygur Autonomous and we excluded the IMT over 0.9 millimeter, long-term out and the floating population. All subjects were measured fasting blood glucose and IMT values of carotid artery. The subjects were divided into three groups according to different fasting blood glucose levels: normal, impaired fasting glucose (IFG) and diabetes mellitus (DM) and we used the analysis of variance to compare the differences among groups of IMT. Multiple linear regression model was used to explore factors of carotid IMT. The IMT of males of Han, Uygur and Kazak were (0.81 ± 0.29), (0.71 ± 0.27) and (0.79 ± 0.21) mm respectively, the differences were significant (F = 88.50, P < 0.05) . The IMT in DM group ((0.82 ± 0.29) mm) was significantly higher than the normal ((0.77 ± 0.26) mm) and the IFG groups ((0.79 ± 0.27) mm) (F = 7.49, P < 0.05). The IMT of females of Han, Uygur and Kazak were (0.72 ± 0.27), (0.63 ± 0.25) and (0.77 ± 0.22) mm, respectively, the differences were significant (F = 173.93, P < 0.05) . The IMT in DM group ((0.75 ± 0.29) mm) and the IFG groups ((0.74 ± 0.26) mm) were significantly higher than the normal group ((0.70 ± 0.25) mm) (F = 10.46, P < 0.05). Multivariate regression analysis showed that diastolic blood pressure (β = 0.101, P < 0.01) , total cholesterol (β = 0.056, P < 0.05) and fasting blood glucose (β = 0.023, P = 0.009) were independent risk factors of IMT. The level of fasting blood glucose was an independent influence factor of carotid IMT and had a positive correlation in Han, Uygur and Kazak population of Xinjiang Autonomous Region.

Abstract 38: Segment-Specific Association of Body Mass Index with Carotid Plaque and Intima-Media Thickness: The Northern Manhattan Study

Objective: Obesity is a risk factor for cardiovascular disease and stroke, and carotid intima-media thickness (IMT) and plaque are markers of subclinical atherosclerotic disease. The differential relationship of body mass index (BMI) to IMT and plaque at different carotid segments has not been studied. In the present analysis, we evaluated the segment-specific association of BMI with IMT and plaque presence in a community-based cohort from the Northern Manhattan Study (NOMAS). Methods and Results: A total of 1653 NOMAS subjects (mean age 69±9 years, 40% male, 18% white, 20% black and 62% Hispanic) underwent B-mode ultrasound examination of the common carotid artery (CCA), internal carotid artery (ICA) and bifurcation (BIF). Generalized linear modeling was performed to evaluate the relations of BMI to IMT or plaque presence in CCA, ICA and BIF, adjusted for age, sex, race-ethnicity, smoking, physical activity, alcohol drinking, systolic and diastolic blood pressure, fasting glucose, LDL, HDL, medications for hypertension, diabetes, and high cholesterol. Overall, the mean BMI was 28±5 kg/m2 (29% obese, 45% overweight). The mean IMT was 0.73±0.09 mm in CCA, 0.64±0.08 mm in ICA, and 0.74±0.10 mm in BIF. The prevalence of plaque was 9% in CCA, 20% in ICA and 53% in BIF. The change in IMT (mm) for per unit BMI increase was largest in CCA (Beta=0.002, P&lt;0.0001), intermediate in ICA (Beta=0.001, P=0.002), and smallest in BIF (Beta=0.0006, P=0.22). Similarly, compared with those with normal weight, obese individuals had larger IMT in CCA (Beta=0.03, P&lt;0.0001) and ICA (Beta=0.02, P=0.01) but not in BIF (Beta=0.006, P=0.40). No association was found between BMI and plaque presence in CCA (P=0.74), ICA (P=0.69), or BIF (P=0.94). There was no significant effect modification by race-ethnicity or sex on the association of BMI with IMT or plaque presence at a specific segment. Conclusion: BMI may be a risk factor for IMT in CCA and ICA rather than BIF or presence of plaque at any specific segment. Given that these carotid segments differ in geometry, shear stress, extracellular matrix structure, and cell composition, further studies are needed to explore the differences in mechanisms underlying the development of atherosclerosis lesions in different carotid segments.

Relationship between central blood pressures and carotid intima-media thickness in prehypertensive participants

ObjectiveTo investigate the relationship between central blood pressures and carotid intima-media thickness in prehypertensive participants.MethodsAccording to the blood pressure level, 346 individuals were divided into two groups. Namely, normotensive controls...

Beneficial effects of intensive therapy on arterial intima-media thickness and its risk factors in type 2 diabetic patients

Objective To analyze the changes of the intima-media thickness(IMT)of carotid and femoral arteries, serum advanced glycosylation end-products(AGEs),and AGEs soluble receptor(sRAGE)after intensively controlling blood glucose, blood pressure, and lipid. Methods One hundred and thirty-two type 2 diabetic patients were divided into 3 groups and followed for 5 years: 20 patients were treated with intensive control of blood glucose and blood pressure, 80 patients with intensive control of blood glucose, blood pressure, and lipid; and 32 patients with conventional therapy. AGEs, sRAGE, and IMT of carotid and femoral arteries were measured and compared among different groups. Results The IMT of carotid and femoral arteries and serum level of AGEs were significantly decreased after intensive treatment. The ratio of sRAGE and HbA1C(sRAGE/HbA1C)were negatively correlated with the mean of HbA1Cin the past five years(r=-0.417, P＜0.001)and the fluctuation of HbA1C(r=-0.309,P＜0.001). Multinomial regression analysis showed that AGEs were the important risk factors of IMT of femoral artery(β=0.152,P=0.068). Conclusion Intensive treatment is significant in controlling the growing IMT of carotid and femoral arteries, while decreasing serum level of AGEs. Key words: Glycosylation end-products, advanced; Soluble receptor of advanced glycosylation end-products; Diabetes mellitus, type 2; Intima-media thickness of arteries; Intensive control

Association between plasmavisfatin and intima-media thickness of carotid artery in patients with type 2 diabetes

：Seventy-three patientswith type 2 diabetes mellitus were divided into atheroselerosis(AS) group and non-AS groupaccording to the intima-media thickness(IMT)of the carotid artery.The plasma visfatinlevel in AS group was higher than that in non-As group[(44.95±10.14 vs 34.52±9.08)μg/L,P<0.05],andboth of them were higher than that of the control [(24.46±7.18)μg/L,both P<0.05 ].The visfatinlevel Was positively correlated with IMT,waist-to-hip ratio,visceral fat thickness,fastinginsulin,and HOMA insulin resistance index.Age,duration of diabetes,HbA_(1C),and visfatinlevel were the major risk factors for IMT of the carotid artery. Key words: Visfatin; Diabetesmeilitus; type 2; Atherosclerosis; Intima-media thickness

Factors involved in the progress of preclinical atherosclerosis associated with systemic lupus erythematosus: a 2-year longitudinal study

ObjectivesTo assess the changes in carotid intima-media thickness (IMT) and the associated risks factors in patients with low severity systemic lupus erythematosus (SLE).MethodsCommon carotid IMT measurements were obtained by ultrasound...

Intima-media thickness of the carotid arteries is related to serum osteoprotegerin levels in healthy postmenopausal women

Osteoprotegerin (OPG) regulates bone mass by inhibiting osteoclast differentiation and activation, and also plays a role in vascular calcification. The objective of this study was to evaluate the relationship between serum OPG levels, and carotid artery intima-media thickness (IMT) and carotid plaque formation in healthy postmenopausal women. We recruited 68 healthy postmenopausal women for the study. Carotid plaque presence and IMT were evaluated by high resolution B-mode ultrasound. IMT was positively correlated with presence of plaque, age, menopause age and OPG, and inversely correlated with Apolipoprotein A1 (Apo A1). Serum OPG level was positively correlated with IMT (r = 0.366; p < 0.003) and age (r = 0.324; p < 0.008), and negatively correlated with Apo A1 (r = –0.481; p < 0.0001). We did not observe any significant relation between plaque occurrence and levels of serum OPG. In regression analysis OPG (p < 0.02) and menopause age (p < 0.05) were independent risk factors for IMT, and age (p < 0.05) and IMT (p < 0.05) were independent risk factors for plaque formation. Although the role of OPG in the vascular biology is poorly understood, our results suggest that elevated levels of serum OPG is associated with IMT and may play a role in the pathogenesis of atherosclerotic disease.

Workplace and Leisure Time Physical Activity: Opposing Relations with Progression of Early Atherosclerosis. The Los Angeles Atherosclerosis Study.

P74 Background. While exercise during leisure is a consistent protective factor for CVD, there is inconsistency across studies concerning the impact of physical activity during work. The current study investigated the relationship between progression of sub-clinical atherosclerosis and physical activity during work and during leisure time. Methods. Participants were from a cohort of 573 randomly sampled utility workers asymptomatic for CVD who were aged 40-60 years at entry. Physical activity during leisure was determined from the number of times per week the subject reported working up a sweat; physical activity during work was ascertained from an NHLBI Physical Activity Index. Sub-clinical atherosclerosis was measured as intima-media thickness (IMT) of the common carotid arteries by high resolution B-mode ultrasound. 36 month change in IMT was measured in microns per year. Results. The mean (±SD) IMT in the sample with complete follow-up (n=447) was 678±106 μm. Those scoring in the highest quintile of workplace activity had significantly more IMT progression compared with those in the lowest quintile (mean±SE = 13.0±1.8 vs 6.9±1.8 μm/yr, respectively; p for trend=0.02 in a model adjusted for age, sex, age-sex interaction, smoking status, alcohol use, use of blood pressure and/or cholesterol lowering medications, BMI, HDL-c, total serum cholesterol, heart rate, systolic blood pressure, and intake of supplemental vitamin C and E). For leisure activity, significantly less IMT progression was found with more activity, but only among those in the highest quintile of activity relative to those in the other 4 quintiles (6.5±1.8 vs 10.9±0.9 μm/yr; p=0.03 in a model adjusted for the same covariates listed above). No significant interaction with sex was detected. Workplace activity was strongly correlated with workplace psychological stress (ρ=0.56), which was previously shown to be a risk factor for IMT in this cohort. Conclusions. These findings suggest that protective effects of physical activity may be blocked or counteracted when activity is performed in a psychologically stressful context.

Risk factors related to the wall thickness of carotid artery assessed by ultrasonography

Progression of atherosclerotic lesion of the carotid artery is suggested to induce the development of cerebrovascular events. We evaluate the risk factors related to carotid artery, wall thickness by ultrasonography. A total of 159 patients, who had received no medication for hypertension or hyperlipidemia were enrolled in this study. The wall thickness of carotid artery was evaluated as an intima-media (IM) complex measured by B-mode ultrasonography with a 7.5 MHz probe. Simple regression analysis demonstrated significant correlation between the IM complex and both age and systolic blood pressure, but not with fasting levels of plasma glucose, hemoglobin A1c, total and HDL cholesterol, triglyceride or gender. Stepwise regression analysis showed age and systolic blood pressure contribute to IM thickness (r = 0.623). However, in patients aged 60 or over, blood pressure did not contribute to the IM wall thickness. Smoking was not a risk factor for IM thickness, but the Brinkman Index (daily consumption of cigarettes x years smoking) was significantly higher in patients with plaques in the carotid artery than those without it. These results suggest that high blood pressure is a risk factor for mild atherosclerotic lesions of the carotid artery for those aged under 60. Smoking may contribute to the formation of plaque, which may consequently lead to the ischemic cerebrovascular disease.