Nonlinear relationship with saturation effect observed between neutrophil to high-density lipoprotein cholesterol ratio and atherosclerosis in a health examination population: a cross-sectional study.

BACKGROUND: The relationships between inflammatory indexes and atherosclerosis as well as those between blood lipid indexes and atherosclerosis have been widely studied, but the relationship between the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and atherosclerosis had not been investigated until the present study. METHODS: For this cross-sectional study, we continuously collected data from a health examination population in the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 1978). The collected data included clinical data, hematological indexes, and brachial-ankle pulse wave velocity (Ba-PWV). Atherosclerosis was defined as Ba-PWV ≥ 1400 cm/s. The relationship between the NHR and atherosclerosis was explored via univariate regression analysis, multivariate regression analysis, smoothing function analysis, and analysis of a threshold saturation effect. RESULTS: Among 1978 participants, the mean age was 54 years, 1189 participants (60.11%) were male, and 1103 (55.76%) had a history of atherosclerosis. Univariate analysis showed a positive association between the NHR and atherosclerosis [odds ratio (OR) = 1.19, 95% confidence interval (CI): 1.11-1.27, P < 0.01], and this positive association remained significant on multivariate analyses with adjustments for confounding factors (OR = 1.14, 95% CI: 1.06-1.24, P < 0.01). Generalized additive model results revealed a non-linear relationship with a saturation effect between the NHR and atherosclerosis, with a threshold at 3.32. At values ≤ 3.32, the NHR was positively associated with atherosclerosis, but the association was not statistically significant for values > 3.32. CONCLUSION: A nonlinear relationship with a certain saturation effect was observed between the NHR and atherosclerosis in a health examination population.

Detection of Early Vascular Atherosclerosis in Type 2 Diabetes Mellitus Using Ultrasound Radiofrequency-Data Technique.

OBJECTIVES: To quantitatively evaluate changes in vascular elasticity and intima-media thickness (IMT) of the common carotid artery (CCA) with Ultrasound radiofrequency (RF)-data technology in asymptomatic patients with type-2 diabetes mellitus (T2DM) and controls. MATERIALS AND METHODS: Thirty-seven T2DM patients and 39 controls were enrolled. Arterial elasticity and CCA-IMT were quantitatively assessed by RF-data technology. The CCA diameters in the diastolic and systolic phases, carotid distensibility (CD), IMT, values of stiffness (ß) and local pulse wave velocity (PWVß) were measured and compared between the two groups. RESULTS: The T2DM group had significantly larger CCA diastolic and systolic diameter, lower CD values, higher IMT measurements (all p < 0.001), and higher values of ß and PWVß (all P < 0.05) than the controls. Significant differences were not revealed in the mean values of IMT, ß, PWVß and CD across both sides of the CCA (all P > 0.05). CONCLUSIONS: Higher IMT measurement and lower arterial elasticity of the CCA are significantly pronounced in asymptomatic T2DM patients and may suggest atherosclerotic changes, and the ultrasound RF-data technique may be used as a potential approach for detection of early-stage atherosclerosis.

Simultaneous occurrence of papillary thyroid carcinoma, medullary thyroid carcinoma, and lymphoma: A case report.

BACKGROUND: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, the coexistence of PTC and medullary thyroid carcinoma (MTC) is uncommon. While the simultaneous occurrence of both cancers with small lymphocytic lymphoma (SLL) in lymph nodes with PTC metastasis is very rare. This study presents a unique case of concurrent PTC, MTC, and SLL, highlighting the exceptional rarity of these coexisting tumors. METHODS: A 75-year-old female with a thyroid tumor underwent total thyroidectomy, bilateral central neck lymph node dissection, and right radical neck lymph node dissection. Histopathological examination revealed a low-grade medullary thyroid carcinoma (MTC) in the left lobe and classical papillary thyroid carcinoma (PTC) in the right lobe, with PTC metastasis in the cervical lymph nodes and concurrent SLL in the affected lymph nodes. RESULTS: Coexistence of PTC, MTC and SLL in the same patient is rare, there are currently no standardized treatment guidelines due to the limited literature. However, it is essential to consider not only the treatment for each type of tumor but also the potential risks or conflicts associated with the treatments. In the case reported in this paper, the papillary carcinoma invaded the capsule of the right lobe of the thyroid and metastasized to the cervical lymph nodes, warranting radioactive iodine therapy. However, considering the potential negative impact of radioactive iodine on the pre-existing lymphoma, the radioactive iodine therapy was postponed. Meanwhile, constant monitoring of calcitonin and thyroid globulin should be performed to monitor tumor recurrence as was performed in the present case. CONCLUSION: Since MTC, PTC, and SLL may coexist, patients with PTC deserve careful surveillance for the other disease entities. This case underscores the need for heightened awareness among clinicians, radiologists, and pathologists regarding the possibility of concurrent thyroid tumors and abnormal lymph nodes, guiding comprehensive pre-operative evaluations and postoperative monitoring strategies. This study aims to provide a warning for routine pathological diagnosis and contribute data for related research.

Assessment of the predictive value of carotid color Doppler ultrasound Crouse score combined with high-sensitivity C-reactive protein in elderly diabetics with cerebral infarction.

BACKGROUND: Both the carotid Crouse score and high-sensitivity C-reactive protein (hs-CRP) levels are commonly used to evaluate atherosclerosis and vascular inflammatory response. This study was to investigate the correlation between the Crouse score and hs-CRP and cerebral infarction (CI) in elderly diabetics. METHODS: We compared the carotid Crouse scores and hs-CRP levels between two groups of diabetic patients with and without CIs (n = 100 each) and the relationship between changes in these indices and CI. RESULTS: Between the four groups (control, diabetic with a large CI, diabetic with a small CI, and diabetic with a lacunar CI) there was a significant difference in the age, sex, Crouse scores and hs-CRP levels, as well as fasting blood glucose (FBG) and glycated haemoglobin (HbA1c) (all p < 0.05). Logistic regression analysis with CI as the dependent variable showed that the age (odds ratio [OR] = 1.114, 95% confidence interval [CFI]: 1.063-1.167, p = 0.000), FBG (OR = 1.260, 95% CFI: 1.102-1.570, p = 0.039), HbA1c (OR = 2.036, 95% CFI: 1.348-3.703, p = 0.001), Crouse score (OR = 2.721, 95% CFI: 1.800-4.114, p = 0.000) and hs-CRP level (OR = 3.364, 95% CFI: 2.185-5.180, p = 0.000) were risk factors for a CI in combination with diabetes mellitus. Significant differences were found in age, diastolic blood pressure, Crouse scores and hs-CRP levels between the male diabetic-non-CI subgroup, female diabetic-non-CI subgroup, male diabetic-CI subgroup and female diabetic-CI subgroup (All p < 0.05). CONCLUSION: The carotid Crouse score method has high reliability and reflects the severity of carotid atherosclerosis. The age, sex, fasting blood glucose, HbA1c, Crouse score, an elevated hs-CRP level, and the occurrence of CI in elderly with diabetes mellitus are closely related.

Value of transcranial color-code Doppler in evaluating intracranial atherosclerotic stenosis in patients with diabetes mellitus type 2: a comparison of transcranial Doppler and computed tomography angiography.

BACKGROUND: There are several imaging assessment methods for intracranial atherosclerotic stenosis (ICAS). This study investigated the most efficient method by which to diagnose ICAS in patients with diabetes mellitus. METHODS: One hundred seven patients with type 2 diabetes mellitus were enrolled as the experimental group and 68 healthy subjects were designated as the control group. The experimental group was examined with transcranial color-code Doppler (TCCD) and transcranial Doppler (TCD). Sixty-five patients in the experimental group were diagnosed by computed tomography angiography (CTA) on a voluntary basis. The 68 subjects in the control group were examined by TCCD alone. RESULTS: Based on TCCD examinations, the ICAS positivity rate was 71.0% (76/107) in the experimental group, which was greater than the 42.6% (29/68) in the control group (χ2=13.954, P<0.001). The middle cerebral artery was most frequently affected by ICAS (χ2=4.684, P=0.030), with a higher incidence of moderate and severe stenosis (χ2=4.510, P=0.034). The ICAS positivity rate was 64.6% (42/65) by TCCD, 75.4% (49/65) by CTA, and 53.8% (35/30) by TCD. There was a statistically significant difference between the TCCD and CTA (χ2=1.795, P=0.180) and between the TCD and CTA (χ2=6.594, P=0.010) positivity rates. CONCLUSIONS: ICAS is expected to occur in patients with diabetes mellitus more often than healthy subjects, and to involve the middle cerebral artery with moderate-to-severe stenosis. The ICAS positivity rate evaluated by TCCD was lower than CTA and higher than TCD.

Continuous Positive Linear Association between the Monocyte to High-Density Lipoprotein Cholesterol Ratio and Hypertension: A Cross-Sectional Study.

Background: Hypertension poses a major threat to human health, and inflammation is associated with hypertension. The monocyte to high-density lipoprotein cholesterol ratio (MHR) represents a new inflammatory indicator. However, the relationship between the MHR and hypertension remains unclear. The present study investigated the association of MHR with hypertension. Method: For this cross-sectional study, we continuously collected data from the Physical Examination Centre of the Second Hospital of Hebei Medical University (N = 6632). The data included patients' demographic information and clinical information including blood pressure, blood biochemical measurements, and MHR. The relationship between the MHR and hypertension was examined using different methods in univariate and multivariate logistic analysis, smooth function analysis, the threshold saturation effect analysis and subgroup analysis. Results: The results showed that MHR was positively associated with hypertension without adjustment (odds ratio [OR] = 1.10, 95% confidence interval [CI]: 1.08-1.12, P < 0.001). The positive association still existed in minimally and fully adjusted models (OR = 1.08, 95% CI: 1.06-1.10, P < 0.001; OR = 1.07, 95% CI: 1.05-1.10, P < 0.001). Smooth function analysis of a generalized additive model revealed a continuous positive linear association between the MHR and hypertension throughout all MHR data (OR = 1.07, 95% CI: 1.05-1.10, P < 0.001). Subgroups analysis showed the homogeneity of the positive association among different subgroups. Conclusions: A continuous positive linear association was found between the MHR and hypertension in a health examination population.

Quantitative evaluation of the structure and function of the common carotid artery in hypertriglyceridemic subjects using ultrasound radiofrequency-data technology.

Assessment of the properties of blood-vessel walls by ultrasound radiofrequency (RF)-data technology is an innovative technique. We quantitatively evaluated the intima-media thickness (IMT) and arterial elasticity of the common carotid artery (CCA) in asymptomatic subjects with hypertriglyceridemia (HTG) using RF-data technology. Thirty HTG subjects and 30 matched controls were enrolled in the study. The common carotid arterial systolic diameter, diastolic diameter, IMT, carotid distensibility (CD), local pulse wave velocity (PWVß), and stiffness (ß) were compared between the two groups, as was the correlation between triglyceride level and the parameters mentioned above. The HTG group had significantly higher values of CCA-IMT compared with the control group (p<0.001). There were significant differences between the HTG group and controls in terms of higher values of PWVß and ß, and lower values of CD (all p<0.05). No difference was observed in terms of the systolic and diastolic diameter of the CCA (p>0.05). The level of triglycerides had significant positive correlations with CCA-IMT (r=0.493, p<0.001), whereas significant correlations with CD, PWVß, and ß were not observed in the HTG group. Ultrasound RF-data technology can be used to non-invasively and quantitatively detect the change in the structure and function of the CCA in asymptomatic HTG subjects for evaluating preclinical atherosclerosis.

Evaluation of intima-media thickness and vascular elasticity of the common carotid artery in patients with isolated systolic hypertension using ultrasound radiofrequency-data technology.

BACKGROUND: Radiofrequency (RF) data technology is a newly developed method to evaluate vascular disease, especially subclinical atherosclerotic change. Data regarding predictors of intima-media thickness (IMT) and vascular elasticity of the common carotid artery (CCA) in subjects with isolated systolic hypertension (ISH) using ultrasound RF-data technology are scarce. AIMS: We evaluated the change in IMT and vascular elasticity of the CCA in patients with ISH at an early phase using US RF-data technology. METHODS: Thirty-nine patients with ISH and 41 age-matched control subjects were the study population. The common carotid arterial systolic diameter (Ds), diastolic diameter (Dd), IMT, carotid distensibility (CD), local pulse wave velocity (PWVß) and stiffness (ß) were compared between the two groups, as were correlations between pulse pressure (PP) and parameters of vascular stiffness. RESULTS: Common carotid arterial Ds, Dd, IMT, PWVß and ß increased whereas CD decreased more significantly in the ISH group than in age-matched controls. The level of PP in the ISH group had significant positive correlations with PWVß (r = 0·298, P<0·05) and ß (r = 0·291, P<0·05), whereas significant correlations with CD were not observed. CONCLUSIONS: US RF-data technology could be used to accurately and quantitatively evaluate increased IMT and decreased arterial elasticity of the CCA in patients with ISH compared with normal subjects.