Risk Factor For Carotid Atherosclerosis Research Articles

Skin Autofluorescence is Associated with Early-stage Atherosclerosis in Patients with Type 1 Diabetes

Aim: Accumulation level of fluorescent advanced glycation end products (AGEs) in the skin can be measured non-invasively as skin autofluorescence (skin AF) by autofluorescence reader. The aim of this study was to assess possible associations between skin AF and diabetic complications, especially early-stage atherosclerosis, in Japanese type 1 diabetic patients.Methods: Skin AF was measured by AGE reader® in 105 Japanese type 1 diabetic patients (34 men and 71 women, aged 37.4 ± 12.4 years (± SD)) and 23 age-matched healthy non-diabetic subjects. Ultrasonic carotid intima-media thickness (IMT), ankle-brachial index (ABI), and brachial ankle pulse wave velocity (baPWV) were evaluated as indices of early-stage diabetic macroangiopathy. Urinary albumin-to-creatinine ratio (UACR), the coefficient of variation of R-R intervals (CVR-R), and presence of retinopathy were also evaluated.Results: Skin AF values were significantly higher in type 1 diabetic patients than in healthy controls (2.07 ± 0.50 (mean ± SD) and 1.90 ± 0.26, respectively, p = 0.024). Skin AF was associated with carotid IMT (r = 0.446, p <0.001) and baPWV (r = 0.450, p <0.001), but not with ABI (r = −0.019, p = 0.8488). Notably, skin AF was an independent risk factor for IMT thickening. Similarly, skin AF was associated with log (UACR) (r = 0.194, p = 0.049) and was an independent risk factor for UACR. Furthermore, skin AF values were significantly higher in patients with diabetic retinopathy than in those without (2.21 ± 0.08 and 1.97 ± 0.06, respectively, p = 0.020).Conclusions: Skin AF was significantly associated with the presence and/or severity of diabetic complications and was an independent risk factor for carotid atherosclerosis.

The Association Between Obstructive Sleep Apnea and Carotid Intima–Media Thickness: A Systematic Review and Meta-Analysis

Obstructive sleep apnea (OSA) has been suggested as a risk factor for carotid atherosclerosis. The present meta-analysis aimed to evaluate the association between OSA and carotid intima-media thickness (CIMT). Eighteen studies comparing CIMT of patients with OSA versus non-OSA patients were included. Quantitative data synthesis was used to pool weighted standardized difference in means (SMD) of CIMT in a random-effects model. Compared to healthy controls, patients with OSA had a significantly higher CIMT (SMD: 0.881; 95% confidence interval [CI]: 0.647-1.115; P < .001). Due to the great heterogeneity, a subgroup analysis was conducted based on the study design. The pooled SMD of CIMT between patients with OSA and healthy controls were 0.810 (95% CI: 0.676-0.943; P < .001) and 1.008 (95% CI: 0.506-1.510; P < .001) in matched and unmatched group, respectively. Moreover, the correlation of apnea-hypopnea index and CIMT was moderate ( r = .389; 95% CI: 0.315-0.459; P < .001). After adjustment for several major confounders, OSA is an independent risk factor for CIMT. These findings remind clinicians to screen for cardiovascular diseases in patients with OSA.

Factors Significantly Associated With the Increased Prevalence of Carotid Atherosclerosis in a Northeast Chinese Middle-aged and Elderly Population: A Cross-sectional Study.

Carotid atherosclerosis is associated with many serious cardiovascular diseases; hence, it is necessary to identify factors related to its occurrence in order to develop preventive and therapeutic strategies. This study was conducted to identify risk factors associated with carotid atherosclerosis among the population residing in Northeast China.This epidemiological survey was conducted in a representative group of relatively healthy community residents. All participants answered questions about their medical histories and underwent physical examination, blood biochemical analysis, and ultrasonography examinations of their necks and abdomens. The prevalence rates of carotid atherosclerosis under different factors and conditions were then analyzed.The results of this study showed that age, gender, and diabetes significantly affected the prevalence of carotid atherosclerosis in this Northeast Chinese population. In addition, gender-based subgroup analysis revealed additional factors correlated with the prevalence of carotid atherosclerosis in men or women, although their correlations were not significant in the overall population. While high serum TC and LDL-C levels were risk factors for carotid atherosclerosis in men, it showed no clear correlation with the prevalence of carotid atherosclerosis in women. In contrast, the prevalence of carotid atherosclerosis in female participants with high serum TG level, hypertension, obesity and nonalcoholic fatty liver disease were higher than that of the control population, a trend not observed in male participants.Older age, male sex, and diabetes were independently associated with increased risk of carotid atherosclerosis in Northeast China. These findings could lead to improved screening for carotid atherosclerosis for better disease management.

Periodontal disease and carotid atherosclerosis: A meta-analysis of 17,330 participants

Background and objectivesThe association between periodontal disease and carotid atherosclerosis has been evaluated primarily in single-center studies, and whether periodontal disease is an independent risk factor of carotid atherosclerosis remains uncertain. This meta-analysis aimed to evaluate the association between periodontal disease and carotid atherosclerosis. MethodsWe searched PubMed and Embase for relevant observational studies up to February 20, 2015. Two authors independently extracted data from included studies, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for overall and subgroup meta-analyses. Statistical heterogeneity was assessed by the chi-squared test (P<0.1 for statistical significance) and quantified by the I2 statistic. Data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software. ResultsFifteen observational studies involving 17,330 participants were included in the meta-analysis. The overall pooled result showed that periodontal disease was associated with carotid atherosclerosis (OR: 1.27, 95% CI: 1.14–1.41; P<0.001) but statistical heterogeneity was substantial (I2=78.90%). Subgroup analysis of adjusted smoking and diabetes mellitus showed borderline significance (OR: 1.08; 95% CI: 1.00–1.18; P=0.05). Sensitivity and cumulative analyses both indicated that our results were robust. ConclusionsFindings of our meta-analysis indicated that the presence of periodontal disease was associated with carotid atherosclerosis; however, further large-scale, well-conducted clinical studies are needed to explore the precise risk of developing carotid atherosclerosis in patients with periodontal disease.

Serum ferritin is associated with carotid atherosclerotic plaques but not intima-media Thickness in patients with abnormal glucose metabolism

BackgroundWe investigated the association between serum ferritin and carotid artery lesions in populations with abnormal glucose metabolism. MethodsWe included 70 participants with abnormal glucose metabolism and 170 participants with normal glucose metabolism and measured their baseline serum ferritin levels. During follow-up carotid intima-media thickness and carotid plaque were evaluated. ResultsSerum ferritin levels were higher in the participants with abnormal glucose metabolism (p<0.01). We further divided the patients with abnormal glucose metabolism into subgroups with and without intima-media proliferation, and found that ferritin was excluded from the final equation in the logistic regression. Furthermore, age, waist circumference, ferritin, 2h-PG, and total cholesterol were significantly different between the subgroups with and without carotid plaque. When the above data were included in a logistic regression model, the p values obtained for age, ferritin, and 2h-PG were 0.004, 0.032, and 0.011, respectively. ConclusionsIn the Chinese population, serum ferritin levels are significantly increased in patients with abnormal glucose metabolism. The carotid intima-media thickness showed no independent relationship with serum ferritin in patients with abnormal glucose metabolism. However, high serum ferritin is an important risk factor for carotid atherosclerosis in these patients.

Effects of smoking on serum paraoxonase 1 activity and carotid atherosclerosis

Objective To explore the effects of smoking on serum paraoxonase1( PON1) activity and carotid atherosclerosis. Methods 478 subjects from residents of health screening for cardiovascular disease were enrolled from June 2012 to July 2014 in Huangpu district, shanghai. Smoking, drinking, exercise and cardiovascular disease risk factor data were recorded and gathered. All subjects accepted carotid artery ultrasound examination and were measured serum PON1 activity. The lowest quartile of serum PON1 activity level was taken as low PON1 activity level. Results (1) Serum PON1 activity in smokers was lower than that in non-smokers((206.5±25.6)kU/L vs (230.9±38.1)kU/L, P<0.01), incidence of carotid artery atherosclerosis in smoking group was higher than non-smoking group(75.7% vs 56.1%, P<0.01). (2) Multivariate logistic regression analyses indicated smoking, lack of exercise, creatinine, LDL-C were the independence factors of PON1 activity. (3) Multivariate logistic regression analyses indicated smoking, serum PON1 activity, age, gender, systolic pressure, were the independence factors of carotid atherosclerosis. Conclusion Smoking reduces serum activity. Smoking and lower serum PON1 activity level are independent risk factors of carotid atherosclerosis. Key words: Smoking; Paraoxonase 1; Carotid atherosclerosis; Risk factors

Effects of active and passive smoking on the development of cardiovascular disease as assessed by a carotid intima-media thickness examination in patients with type 2 diabetes mellitus.

Carotid intima-media thickness has been widely used as a surrogate end-point for cardiovascular disease, myocardial infarction, and stroke. This study aimed to assess the effects of active and passive smoking exposure on the development of cardiovascular disease in patients with type 2 diabetes mellitus. Seven hundred twenty-two patients with type 2 diabetes mellitus were recruited for the study. A standardized questionnaire on smoking status, pack-years of smoking, and the number of years of smoking cessation was provided to the patients, and their responses were collected for analysis. The carotid intima-media thickness, carotid plaque, and the internal diameter of the common carotid artery were determined by high-resolution B-mode ultrasonography. Compared to non-smokers, passive female smokers had a higher risk of cardiovascular disease (odds ratio = 3.50, 95% confidence interval: 1.29-9.49, P = 0.009); they also had a significantly larger common carotid artery (P = 0.041) and risk of carotid plaque (odds ratio = 2.20, 95% confidence interval: 1.1980-4.0505, P = 0.01). Both active and passive male smokers had a significantly greater carotid intima-media thickness than non-smokers (P = 0.003 and P = 0.005, respectively). Male active smokers had a significantly higher risk of carotid plaque (odds ratio = 2.88, 95% confidence interval: 1.4788-5.6094, P = 0.001). In conclusion, cumulative active and passive smoking exposures are significant risk factors for carotid atherosclerosis in patients with type 2 diabetes mellitus. Our results highlight the importance of endorsing a smoke-free environment for patients with type 2 diabetes mellitus.

Is white-coat hypertension a risk factor for carotid atherosclerosis? A review and meta-analysis.

The association of white-coat hypertension (WCH) with target organ damage is still debated; in particular, the relationship of this blood pressure phenotype with subclinical vascular damage remains controversial. Thus, we carried out a systematic review and meta-analysis to provide updated information on carotid structural changes in WCH. Studies were identified using the following search terms: 'white coat hypertension', 'isolated clinic hypertension', 'carotid artery', 'carotid atherosclerosis', 'carotid intima-media thickness', 'carotid damage', 'carotid thickening'. Full articles published in the English language in the last two decades reporting studies on adults were considered. A total of 3478 untreated patients, 940 normotensive (48% men), 666 WCH (48% men), and 1872 hypertensive individuals (57% men) included in 10 studies, were analyzed. Common carotid intima-media thickness (IMT) showed a progressive increase from normotensive (718±36 μm) to WCH (763±47 μm, standardized mean difference 0.54±0.13, P<0.01) and to hypertensive patients IMT (817±47 μm, standardized mean difference 0.45±0.14, P<0.01). After assessing data for publication bias, only the difference between normotensive and WCH patients remained significant. Our meta-analysis documents that common carotid IMT, a prognostically validated marker of vascular damage, is greater in WCH patients than in true normotensive individuals and is not different from sustained hypertensives. This finding supports the concept that WCH is not an entirely benign condition.

Association between hemoglobin A1c and carotid atherosclerosis in rural community-dwelling elderly Japanese men.

BackgroundRecent studies have reported an association between both higher and lower levels of hemoglobin A1c (HbA1c) and higher mortality of diabetes patients. Like diabetes, carotid atherosclerosis is a well known lifestyle-related disease. However, no studies have yet reported an association between HbA1c levels and carotid atherosclerosis.MethodsWe conducted a cross-sectional study of 1,150 Japanese elderly men aged ≥60 years who were undergoing general health checkups. Carotid atherosclerosis was defined as a carotid intima-media thickness (CIMT) ≥1.1 mm. Since body mass index (BMI) is regarded as a cardiovascular risk factor that exerts a strong influence on both HbA1c levels and carotid atherosclerosis, we performed a stratified analysis of this risk based on BMI.ResultsUsing the intermediate HbA1c quintile as a reference group, the groups in the lowest HbA1c quintiles showed a significantly higher risk of carotid atherosclerosis in patients with low BMI (≤23 kg/m2) vs. no increased risk in those with high BMI (>23 kg/m2). The association of HbA1c with carotid atherosclerosis became slightly stronger when these analyses were limited to subjects who were not taking glucose-lowering medications or medications for hyperlipidemia and cardiovascular disease. After adjusting for classical cardiovascular risk factors, adjusted odds ratios (ORs) for carotid atherosclerosis were 1.36 (0.84 to 2.20) for total subjects, 2.29 (1.12 to 4.66) for low-BMI groups, and 0.68 (0.33 to 1.41) for high-BMI groups.ConclusionsLower HbA1c level is a significant risk factor for carotid atherosclerosis in rural community-dwelling elderly Japanese men with low, but not high BMI, particularly in those not taking glucose-lowering medication.

Blood pressure reverse-dipping is associated with early formation of carotid plaque in senior hypertensive patients.

Nocturnal variations in blood pressure (BP) were associated with carotid intima-media thickness. However, the precise relationship between circadian variations of BP and carotid plaques remains unknown. Therefore, the prognostic value of reverse-dipper pattern of BP for carotid plaque was investigated. In this cross-sectional study, a total of 524 hypertensive patients were recruited and evaluated with ambulatory BP monitoring between April 2012 and June 2013. Carotid plaque was classified into Grade 0 (normal or no observable plaque), Grade 1 (mild stenosis, 1%-24% narrowing), and Grade 2 (moderate stenosis, ≥25% narrowing). Multinomial logistic regression was applied to analyze the relationship between different degrees of carotid plaque and ambulatory BP monitoring results. Reverse-dipper pattern of BP was more common in older patients, smokers, and those with elevated fasting glucose. The incidences of coronary artery disease, lacunar infarction, and diabetes were also higher among hypertensive with reverse-dipper pattern. Multinomial logistic regression analysis showed that reverse dipper (odds ratio [OR] 2.500; 95% confidence interval [CI] 1.320-4.736; P = 0.005), age (OR 1.089; 95% CI 1.067-1.111; P < 0.001), smoke (OR 1.625; 95% CI 1.009-2.617; P = 0.046), and diabetes (OR 1.759; 95% CI 1.093-2.830; P = 0.020) were significantly different between mild carotid plaque and normal. Our results also suggested that mild carotid plaque was closely related to reverse-dipper pattern of BP (2.308; 95% CI 1.223-4.355; P = 0.010). Reverse-dipper pattern of BP may be a risk factor for carotid atherosclerosis and play a crucial role in the early formation of carotid plaque.

Nonalcoholic fatty liver disease and age are strong indicators for atherosclerosis in morbid obesity.

Whether nonalcoholic fatty liver disease (NAFLD) can predict atherosclerosis in obese patients remains unclear. The aim of our study was to investigate the usefulness of NAFLD and other cardiometabolic parameters in predicting subclinical atherosclerosis in obese patients. We studied 314 consecutive obese subjects (223 women; mean age, 45·04±9·34years; body mass index 44·3±5kg/m(2) ) and 47 healthy lean individuals. Hepatic steatosis and atherosclerosis [carotid intima-media thickness (cIMT) >0·8mm and/or presence of plaques] were evaluated ultrasonographically. Liver biopsies were obtained in 51 patients. In obese patients, mean c-IMT was greater in those with NAFLD (P<0·001). Hepatic steatosis and age were independent predictors of atherosclerosis: the NAFLD-associated OR for atherosclerosis was 5·96 (95%CI, 1·60-22·25; P=0·008) in men and 8·26 (95%CI, 4·02-16·99; P<0·001) in women, and the age-associated OR for atherosclerosis was 1·14 (95%CI, 1·07-1·22; P<0·001) in men and 1·12 (95%CI, 1·08-1·17; P<0·001) in women. The sensitivity, specificity and positive and negative predictive values of steatosis for atherosclerosis were 78·70%, 70·50%, 74·00% and 75·60% (AUC=0·840) in men ≥43·5years and 86·90%, 52·50%, 68·80% and 76·80% (AUC=0·761) in women ≥47·5years, respectively. Agreement between ultrasound-diagnosed steatosis and histology was good (ICC=0·79). Combined NAFLD and age was the strongest predictor of atherosclerosis in obesity. Nonalcoholic fatty liver disease and age may be independent risk factors for carotid atherosclerosis in obese individuals. Obese men and women with steatosis aged over 43·5 and 47·5years, respectively, should be screened for carotid atherosclerosis. However, further evidence is necessary before suggesting an intervention based on current findings.

Hepatitis C as a risk factor for carotid atherosclerosis – a systematic review

Observational studies on the association of chronic hepatitis C with carotid atherosclerosis have yielded varying results. In addition, previous related systematic reviews were limited in synthesis. By more careful selection and further synthesis, we summarize current body of evidence on the relationship between chronic hepatitis C and carotid atherosclerosis. All published observational studies related to the topic identified by systematic searches of PubMed and Scopus were screened based on diagnosis of chronic hepatitis C and diagnosis and estimation of the risk of a carotid atherosclerosis-related outcome. Selected studies were subjected to quality assessment, and eligible studies were used in subsequent narrative and quantitative syntheses. The initial search identified 190 unique publications, which were narrowed by preliminary review to 16 potentially relevant original articles. After quality assessment, seven studies were eligible and were used in narrative synthesis. Five studies assessed the risk of increased carotid intimal media thickening using B mode ultrasonography; five studies assessed the risk of carotid plaque formation using B mode ultrasonography. Five of these studies were used in subsequent meta-analysis. The risk of a person with chronic hepatitis C developing carotid intimal media thickening is about 4·03 times the risk of an uninfected person. The risk of a person with chronic hepatitis C developing carotid plaque is about 3·94 times the risk of an uninfected person. Current evidence shows that hepatitis C virus (HCV) or factors associated with HCV infection can promote the occurrence and progression of carotid atherosclerosis.

P.Q192R SNP of PON1 seems not to be Associated with Carotid Atherosclerosis Risk Factors in an Asymptomatic and Normolipidemic Brazilian Population Sample.

BackgroundEvidences suggest that paraoxonase 1 (PON1) confers important antioxidant and anti-inflammatory properties when associated with high-density lipoprotein (HDL).ObjectiveTo investigate the relationships between p.Q192R SNP of PON1, biochemical parameters and carotid atherosclerosis in an asymptomatic, normolipidemic Brazilian population sample.MethodsWe studied 584 volunteers (females n = 326, males n = 258; 19-75 years of age). Total genomic DNA was extracted and SNP was detected in the TaqMan® SNP OpenArray® genotyping platform (Applied Biosystems, Foster City, CA). Plasma lipoproteins and apolipoproteins were determined and PON1 activity was measured using paraoxon as a substrate. High-resolution β-mode ultrasonography was used to measure cIMT and the presence of carotid atherosclerotic plaques in a subgroup of individuals (n = 317).ResultsThe presence of p.192Q was associated with a significant increase in PON1 activity (RR = 12.30 (11.38); RQ = 46.96 (22.35); QQ = 85.35 (24.83) μmol/min; p < 0.0001), HDL-C (RR= 45 (37); RQ = 62 (39); QQ = 69 (29) mg/dL; p < 0.001) and apo A-I (RR = 140.76 ± 36.39; RQ = 147.62 ± 36.92; QQ = 147.49 ± 36.65 mg/dL; p = 0.019). Stepwise regression analysis revealed that heterozygous and p.192Q carriers influenced by 58% PON1 activity towards paraoxon. The univariate linear regression analysis demonstrated that p.Q192R SNP was not associated with mean cIMT; as a result, in the multiple regression analysis, no variables were selected with 5% significance. In logistic regression analysis, the studied parameters were not associated with the presence of carotid plaques.ConclusionIn low-risk individuals, the presence of the p.192Q variant of PON1 is associated with a beneficial plasma lipid profile but not with carotid atherosclerosis.

Decision tree analysis of traditional risk factors of carotid atherosclerosis and a cutpoint-based prevention strategy.

BackgroundReducing the exposure to risk factors for the prevention of cardio-cerebral vascular disease is a crucial issue. Few reports have described practical interventions for preventing cardiovascular disease in different genders and age groups, particularly detailed and specific cutpoint-based prevention strategies.MethodsWe collected the health examination data of 5822 subjects between 20 and 80 years of age. The administration of medical questionnaires and physical examinations and the measurement of blood pressure, fasting plasma glucose (FPG) and blood lipids [total cholesterol (TC), triglycerides (TG), high density lipoprotein–cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C)] were performed by physicians. Carotid ultrasound was performed to examine the carotid intima-media thickness (CIMT), which was defined as carotid atherosclerosis when CIMT ≥0.9 mm. Decision tree analysis was used to screen for the most important risk factors for carotid atherosclerosis and to identify the relevant cutpoints.ResultsIn the study population, the incidence of carotid atherosclerosis was 12.20% (men: 14.10%, women: 9.20%). The statistical analysis showed significant differences in carotid atherosclerosis incidence between different genders (P<0.0001) and age groups (P<0.001). The decision tree analysis showed that in men, the most important traditional risk factors for carotid atherosclerosis were TC (cutpoint [CP]: 6.31 mmol/L) between the ages of 20–40 and FPG (CP: 5.79 mmol/L) between the ages of 41–59. By comparison, LDL-C (CP: 4.27 mmol/L) became the major risk factor when FPG ≤5.79 mmol/L. FPG (CP: 5.52 mmol/L) and TG (CP: 1.51 mmol/L) were the most important traditional risk factors for women between 20–40 and 41–59 years of age, respectively.ConclusionTraditional risk factors and relevant cutpoints were not identical in different genders and age groups. A specific gender and age group-based cutpoint strategy might contribute to preventing cardiovascular disease.

Relationship between serum 25-hydroxy vitamin D3 level and carotid atherosclerosis plaque in elderly patients with type 2 diabetes

Objective To explore the relationship between serum 25-hydroxy vitamin D 3 level and carotid atherosclerosis plaque in elderly patients with type 2 diabetes .Methods 308 elderly patients with type 2 diabetes were selected .The carotid artery intimal plaque was measured .According to the characteristics and size of plaque ,they were divided into the medium/big group,small plaque group and no plaque group .Blood pressure,body mass index （BMI）,fasting plasma glucose（FPG）,glycosylated hemoglobin（HbA1c）,blood lipids,c-reactive protein（CRP）and the concentration of serum 25-hydroxy vitamin D 3 were detected .The risk factors forcarotid atherosclerosis plaque were analyzed,exploring the the relationship between serum 25-hydroxy vitamin D3 level and carotid atherosclerosis plaque . Results Age,CRP（4.21 ±1.61） mg/L in the medium/big group was significantly higher than those of the small plaque group（3.41 ±1.92）mg/L and the no plaque group（2.52 ±1.18）mg/L（t=1.96,3.14,all P<0.05）.The level of serum 25-hydroxy vitamin D3 in the medium/big group（15.28 ±5.86）nmol/L was significantly less than that of the small plaque group（24.30 ±7.60）nmol/L and the no plaque group（32.74 ±8.13）nmol/L（t=4.67,3.41,all P<0.01）.The level of serum 25-hydroxy vitamin D3 in the small plaque group was significantly less than that of the no plaque group（t=2.51,P<0.05）.There was positive correlation between carotid atherosclerotic plaques and age , BMI,HbA1c,CRP and LDL-C（ r=0.45,0.38,0.53,0.47,all P<0.05）.There was negtive correlation between carotid atherosclerotic plaques and 25-hydroxy vitamin D3（r=-0.62,P<0.05）.Logstic regression analysis showed that age,BMI,HbA1c,CRP,LDL-C and 25-hydroxy vitamin D3 were independent risk factors for the development of carotid atherosclerotic plaque .Conclusion The risk factors for carotid atherosclerotic plaques in elderly patients with type 2 diabetes are age,BMI,HbA1c,CRP,LDL-C and 25-hydroxy vitamin D3 concentration.25-hydroxy vitamin D3 may be a predictor of carotid atherosclerotic plaques . Key words: Diabetes mellitus, type 2 ; 25-hydroxy vitamin D3 ; Atherosclerosis ; Carotid artery diseases ; Aged

SAT0141 Vitamin D Deficiency is A Risk Factor for Carotid Atherosclerosis in Women with Rheumatoid Arthritis

BackgroundAlthough there is increasing evidence that low serum 25-hydroxy vitamin D (25-OHD) is associated with a higher frequency of cardiovascular diseases (CVDs) in the general population, little attention has been...

Abstract T P156: Chronic Kidney Disease as a Risk Factor for Carotid Atherosclerosis : A Case Control Study

Background: Chronic kidney disease (CKD) increases risk of cardiovascular diseases, which might be mediated by facilitation of atherosclerosis. However, impact of CKD on progression of atherosclerosis has not been fully evaluated, and we sought to investigate associations between CKD and extent of carotid atherosclerosis. Methods: Between January 2009 and February 2013, we enrolled a consecutive series of 147 CKD patients and compared the same number of age, sex and vascular risk factor-matched 147 control subjects who visited our hospital during the same period. Carotid atherosclerosis was examined with MR angiography of internal carotid artery (ICA). The degree of stenosis of the internal carotid artery (ICA) in each patient was classified into 5 grades; (1) normal; (2) mild (&lt;50%); (3) moderate (50-69%) ;(4) severe (70-99%); (5) occlusion. Results: Mean age of the subjects was 72.2±8.7 years, and 208 were male (70.7%) among the total of 294 subjects. Significant stenosis of ICA (stenosis more than 50%) was more prevalent in CKD patients [odds ratio (OR) 6.7; 95% confidence interval (CI) 2.2-20.4, p=0.001). The presence of CKD was an independently risk factor for increasing the severity of stenosis of ICA (mild, OR 4.5, 95% CI 2.0-10.2; moderate, OR 3.9, 95% CI 1.3-22.4; severe, OR 12.0, 95% CI 4.3-34.6; occlusion, 14.1, 95% CI 2.1-92.2). Conclusion: In the current case-control study, we found that CKD is associated with incidence of significant carotid stenosis and increases the severity of carotid stenosis. Our results indicate that CKD should be treated as a new risk factor for carotid atherosclerosis.

PNPLA3 I148M variant as a risk factor for carotid atherosclerosis in chronic hepatitis C

PNPLA3 I148M variant as a risk factor for carotid atherosclerosis in chronic hepatitis C

Apolipoprotein E gene polymorphisms as risk factors for carotid atherosclerosis.

Atherosclerosis is still the leading cause of death in Western world. Development of atherosclerotic plaque involves accumulation of inflammatory cells, lipids, smooth muscle cells and extracellular matrix proteins in the intima of the vascular wall. Apolipoprotein E participates in the transport of exogenous cholesterol, endogenously synthesized lipids and triglycerides in the organism. Apolipoprotein E gene has been identified as one of the candidate genes for atherosclerosis. Previous studies in different populations have clearly implicated apolipoprotein E genetic variation (E polymorphisms) as a major modulator of low density lipoprotein cholesterol levels. Data considering apolipoprotein E polymorphisms in relation to carotid atherosclerosis gave results that are not in full compliance. The aim of present study was to investigate the apolipoprotein E polymorphisms in association with carotid plaque presence, apolipoprotein E and lipid serum levels in patients with carotid atherosclerosis from Serbia. The study group enrolled 495 participants: 285 controls and 210 consecutive patients with carotid atherosclerosis who underwent carotid endarterectomy. Genotyping of apolipoprotein E polymorphisms were done using polymerase chain reaction and restriction fragment length polymorphism methods. Patients had significantly decreased frequency of the epsilon2 allele compared to controls. Patients who carry at least one epsilon2 allele had a significantly higher level of serum apolipoprotein E and significantly lower low density lipoprotein cholesterol levels compared to those who do not carry this allele. Our results suggest protective effect of apolipoprotein E epsilon2 allele on susceptibility for carotid plaque presence as well as low density lipoprotein cholesterol lowering effect in Serbian patients with carotid atherosclerosis. Further research of multiple gene and environmental factors that contribute to the appearance and the progression of atherosclerosis should be continued with respect to different populations.

Mean postprandial triglyceride concentration is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetes

BackgroundPostprandial hypertriglyceridemia is a risk factor for atherosclerotic disease. However, the postprandial triglyceride (PTG) concentration fluctuates markedly and is poorly reproducible. The aim of this study was to determine whether the mean PTG (mean-PTG) concentration is a risk factor for carotid atherosclerosis in patients with type 2 diabetes. MethodsWe measured the fasting and postprandial lipid concentrations, and the maximum intima-media thickness (max IMT) of carotid arteries by ultrasound in 115 diabetic patients. A carotid plaque was defined as max IMT of >1.0mm. The mean-PTG concentration was calculated from several PTG concentrations measured on different days during a 1-year follow-up period. ResultsPTG concentrations showed marked intra-individual variability, and ranged from 0.29 to 6.03mmol/l. Patients with carotid plaques had higher mean-PTG concentrations than those without carotid plaques (1.51±0.57 vs. 1.29±0.47mmol/l, p=0.025). Neither fasting triglycerides nor one-point PTG concentrations differed between the two groups. Multivariate stepwise logistic regression analysis revealed that the mean-PTG concentration was significantly associated with carotid plaques [OR 1.20 (95% CI, 1.05–1.37), p=0.009], even after adjusting for traditional risk factors including HDL-cholesterol, LDL-cholesterol, age, hypertension, and duration of diabetes. ConclusionsThe mean-PTG concentration is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetes.