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1.
Medicine (Baltimore) ; 99(8): e19207, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080108

RESUMEN

Cigarette smoking is associated with thicker carotid intima-media thickness (IMT), probably partly through inflammatory pathways. However, to what extent does inflammation mediate the smoking-carotid atherosclerosis association is unclear. We investigated the mediating effect of inflammation on the association between cigarette smoking and carotid IMT, and quantified the respective contributions of inflammatory markers to this association.A total of 1752 participants from Guangzhou Biobank Cohort Study-Cardiovascular Disease Sub-cohort (GBCS-CVD) were included. Using causal mediation analysis under the counterfactual framework, we decomposed total effects of cigarette smoking on IMT into indirect effects (through inflammatory response) and direct effects (not through inflammatory response).After adjusting for traditional risk factors, the indirect effects of per 10/L increment in leukocyte and granulocyte, per mg/L increment in high-sensitivity C-reactive protein (hs-CRP), and per mg/dL increment in fibrinogen on carotid IMT was 0.0028 mm (95% confidence interval [CI], 0.0011-0.0047), 0.0019 mm (95% CI, 0.0006-0.0034), 0.0017 mm (95% CI, 0.0006-0.003), and 0.001 mm (95% CI, 0.0001-0.0021), respectively. No evidence for a mediating role of lymphocyte was found. The proportion of the smoking-IMT association mediated by leukocyte, granulocyte, hs-CRP, and fibrinogen was 12.57% (95% CI, 8.50%-22.11%), 8.50% (95% CI, 5.76%-15.09%), 7.64% (95% CI, 5.20%-13.79%), and 4.48% (95% CI, 3.04%-8.03%), respectively. Restricting data analysis to men showed similar results.The effects of cigarette smoking on IMT were partly mediated by leukocyte, hs-CRP, and fibrinogen. The mediating role of leukocyte was likely mainly driven by higher granulocyte.


Asunto(s)
Grosor Intima-Media Carotídeo , Fumar Cigarrillos/fisiopatología , Mediadores de Inflamación/metabolismo , Inflamación/fisiopatología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Factores Socioeconómicos
2.
Medicine (Baltimore) ; 99(8): e19278, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080140

RESUMEN

To investigate whether the control of morning blood pressure (MBP) reflects the control of blood pressure (BP) in other periods (daytime, nighttime and 24-hour) and to assess whether morning BP displays a closer association with subclinical target organ damage (TOD) than the BP measured in other periods.One thousand one hundred forty patients with primary hypertension who completed subclinical TOD detection and 24-hour ambulatory BP monitoring were included in the analysis. Pearson correlation analysis, Kappa consistency test, multiple linear regression analysis, and area under the receiver operating curve were used to analyze the data.Morning BP and daytime BP displayed good agreement, but not 24-hour BP , particularly the nighttime BP (all P < .001). Approximately 39.4% of the hypertensive patients receiving drug treatment who had achieved control of the morning BP presented masked nocturnal hypertension, which was associated with worse subclinical TOD. The BP measured in all periods correlated with subclinical TOD, and the correlation was more obvious in the treatment subgroup. However, morning BP did not independently affect subclinical TOD. Morning BP appeared to exhibit less discriminatory power than nighttime BP, particularly with respect to the urinary albumin to creatinine ratio.The use of morning BP for monitoring during hypertension management may not be enough. Masked uncontrolled nocturnal hypertension should be screened when morning BP is controlled.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Ritmo Circadiano/fisiología , Hipertensión/fisiopatología , Hipertensión Enmascarada/diagnóstico , Albuminuria , Antihipertensivos/uso terapéutico , Grosor Intima-Media Carotídeo , Creatinina/orina , Estudios Transversales , Ecocardiografía , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Hipertensión/tratamiento farmacológico , Masculino , Hipertensión Enmascarada/fisiopatología , Persona de Mediana Edad
3.
Medicine (Baltimore) ; 99(5): e18940, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000412

RESUMEN

Soluble suppression of tumorigenicity 2 (sST2) is a free form of membrane-bound ST2, which is a member of the interleukin-1 receptor family. Previous research has shown that sST2 is associated with diabetes, but cardiovascular risk factors have not been established.To analyze the relationship between sST2 and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM).After screening, a total of 118 subjects with T2DM were divided into 2 groups according to the measurement of CIMT (normal CIMT (NCIMT), n = 58; abnormal CIMT (ACIMT), n = 60), and 60 healthy subjects (normal control (NC), n = 60) were recruited in this study. CIMT was measured by a color Doppler ultrasound, and sST2 and other metabolic parameters were measured as well.The median concentration of sST2 was elevated in the ACIMT group (31.30 ng/ml) compared with the NCIMT group (28.29 ng/ml, P < .01) and the NC group (20.15 ng/ml, P < .01). After adjustment for age and sex, log sST2 was strongly associated with smoking history (ß = 0.197, 95% CI, 0.084-0.311, P < .01), FPG level (ß = 0.302, 95% CI, 0.162-0.442, P < .01) and HbA1c level (ß = 0.296, 95% CI, 0.165-0.426, P < .01) and negatively correlated with HDL level (ß = -0.153, 95% CI, -0.259 to -0.046, P < .01). Furthermore, sST2 level was a risk factor for increased CIMT in patients with T2DM.Increased sST2 level not only was associated with indicators of glucose and lipid metabolism but also was a risk factor for increased CIMT in patients with T2DM. Thus, sST2 may be a potential novel marker to assess the progression of diabetic macrovascular complications.


Asunto(s)
Grosor Intima-Media Carotídeo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico por imagen , Proteína 1 Similar al Receptor de Interleucina-1/sangre , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo
4.
Mymensingh Med J ; 29(1): 209-214, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915360

RESUMEN

Most of the mortalities among Diabetic Nephropathy patients are cardiovascular, if we identify the risk factor, measures can be taken to prevent it. Hence an objective was set to evaluate the association between carotid artery intima media thickness (CIMT) with eGFR in patients of CKD stage III, IV and V among patients with type 2 diabetes mellitus; also, correlation with age, BMI, lipid profile. This cross-sectional, observational study was performed in 70 patients in different stages of CKD in Diabetic Patients selected by Inclusion Criteria (Diabetic nephropathy patients with stages III, IV, V and exclusion Criteria (Acute kidney injury, History of carotid surgery, Patients of MI and stroke). This study was performed in Department of Nephrology, Dhaka Medical College in collaboration with the Department of Radiology and Imaging, laboratory of Department of Biochemistry and Department of Microbiology at Dhaka Medical College Hospital (By standard method in laboratory) from 1st January 2016 to 31st December 2016. eGFR was measured by MDRD formula and the CIMT was measured using an ultrasonographic examination. The mean CIMT was 0.9±0.21mm, and 62.9% of the subjects showed IMT thickening (≥1mm). The carotid IMT elevated significantly with the stage progression of CKD (Overall eGFR mean 28.8±14.5mL/min/1.73m² in CIMT<1mm with range from 6 to 54 and 9.1±9.0mL/min/1.73m² in CIMT ≥1mm with range from 3 to 32 (p=0.001). The eGFR was significantly lower in the patients with CIMT thickening than those without CIMT thickening. eGFR was also significantly associated with CKD stages (p=0.001), serum creatinine (p=0.001), BMI (r = -0.330, p=0.005), and negatively associated with age group, duration of hypertension, smoking. However, the CIMT was not significantly different among the patients at different stages of diabetic nephropathy (r = -0.172, p=156) and age group. It has been concluded that the mean CIMT was markedly high in patients with CKD compared to normal expected value. This study showed a relationship between the CIMT and the renal parameters as eGFR and the stages of diabetic nephropathy with a confirm association between the CIMT and diabetic macroangiopathy.


Asunto(s)
Arterias Carótidas/patología , Grosor Intima-Media Carotídeo , Diabetes Mellitus Tipo 2/fisiopatología , Diabetes Mellitus/patología , Riñón/fisiopatología , Insuficiencia Renal Crónica/fisiopatología , Bangladesh/epidemiología , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Tasa de Filtración Glomerular , Humanos , Insuficiencia Renal Crónica/epidemiología
5.
Eur J Endocrinol ; 182(3): 343-350, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31958313

RESUMEN

Background: To investigate the association between fasting serum insulin and glucose levels with atherosclerotic plaque composition in the carotid artery. Impaired insulin and glucose levels are implicated in the etiology of cardiovascular disease; however, their influence on the formation and composition of atherosclerotic plaque remains unclear. Methods: In 1740 participants (mean age 72.9 years, 46% women, 14.4% diabetes mellitus) from the population-based Rotterdam Study, we performed carotid MRI to evaluate the presence of calcification, lipid core, and intraplaque hemorrhage in carotid atherosclerosis. All participants also underwent blood sampling to obtain information on serum insulin and glucose levels. Using logistic regression models, we assessed the association of serum insulin and glucose levels (per s.d. and in tertiles) with the different plaque components, while adjusting for sex, age, intima-media thickness, and cardiovascular risk factors. Results: Serum insulin levels were associated with the presence of intraplaque hemorrhage (adjusted odds ratio (OR): 1.42 (95% CI: 1.12-1.7)) We found no association with the presence of calcification or lipid core. Sensitivity analyses restricted to individuals without diabetes mellitus yielded similar results. No associations were found between serum glucose levels and any of the plaque components. Conclusions: Serum insulin levels are associated with the presence of vulnerable components of carotid plaque, specifically with intraplaque hemorrhage. These findings suggest a complex role for serum insulin in the pathophysiology of carotid atherosclerosis and in plaque vulnerability.


Asunto(s)
Glucemia/metabolismo , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Insulina/sangre , Placa Aterosclerótica/diagnóstico por imagen , Calcificación Vascular/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Enfermedades de las Arterias Carótidas/sangre , Enfermedades de las Arterias Carótidas/metabolismo , Grosor Intima-Media Carotídeo , Femenino , Hemorragia/sangre , Hemorragia/diagnóstico por imagen , Hemorragia/metabolismo , Humanos , Modelos Logísticos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Países Bajos , Placa Aterosclerótica/sangre , Placa Aterosclerótica/metabolismo , Calcificación Vascular/sangre , Calcificación Vascular/metabolismo
6.
Int Heart J ; 61(1): 103-108, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31956154

RESUMEN

Waist circumference (WC) is measured for the assessment of abdominal obesity, whereas carotid intima-media thickness (IMT) is a marker of preclinical atherosclerosis. The relationship between WC and carotid IMT in the general population is not fully understood. In this study, we examined 1,182 subjects (658 men and 524 women, 62.3 ± 11.7 years on average) who underwent voluntary health check-ups and sought to determine the optimal cut-off value of WC for predicting carotid IMT thickness. Receiver operating characteristic curve analysis of WC was utilized to predict high carotid IMT (defined as carotid IMT ≥ 1.1 mm). We determined that the appropriate WC cut-off value was a WC ≥ 79 cm for men and women. There was a statistically significant difference in the prevalence of high carotid IMT between WC ≥ 79 cm and WC < 79 cm in both men and women. However, multivariable logistic regression analysis demonstrated that the WC category was independently associated with high carotid IMT in men, but not in women. Our study indicates that the optimal cut-off value of WC to identify preclinical atherosclerosis may be lower than the current Japanese diagnostic criteria for metabolic syndrome (MetS) in both men and women. Compared to women, the association between WC and preclinical atherosclerosis may be more pronounced in men.


Asunto(s)
Aterosclerosis/diagnóstico , Obesidad Abdominal/diagnóstico , Anciano , Aterosclerosis/epidemiología , Grosor Intima-Media Carotídeo , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/epidemiología , Prevalencia , Curva ROC , Factores Sexuales , Circunferencia de la Cintura
7.
Rev Esp Cardiol (Engl Ed) ; 73(1): 43-52, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31521574

RESUMEN

INTRODUCTION AND OBJECTIVES: To describe, for the first time, reference values for the cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (BA-PWV), carotid-femoral pulse wave velocity (CF-PWV), and the central augmentation index and to establish their association with cardiovascular risk factors in the Spanish adult population aged 35 to 75 years without cardiovascular disease. METHODS: We conducted a cross-sectional study. Through random sampling stratified by age and sex, we included 501 participants without cardiovascular disease. The mean age was 55.9 years and 50.3% were women. The measurements were taken using the SphigmoCor and Vasera VS-1500 devices. RESULTS: Values for all measures, except those for the central augmentation index, were higher in men and increased with age and blood pressure. The mean values were as follows: CAVI, 8.01±1.44; BA-PWV, 12.93±2.68m/s; CF-PWV, 6.53±2.03 m/s, and central augmentation index, 26.84±12.79. On multiple regression analysis, mean blood pressure was associated with the 4 measures, glycated hemoglobin was associated with all measures except the central augmentation index, and body mass index showed an inverse association with CAVI. The explanatory capacity of age, sex, and mean blood pressure was 62% for BA-PWV, 49% for CF-PWV 49%, 54% for the CAVI, and 38% for the central augmentation index. On logistic regression, hypertension was associated with the CAVI (OR=3.45), VOP-BT (OR=3.44), VOP-CF (OR=3.38) and with the central augmentation index (OR=3.73). CONCLUSIONS: All arterial stiffness measures increased with age. The CAVI and CF-PWV were higher in men and the central augmentation index was higher in women, with no differences in BA-PWV. This study is registered at ClinicalTrials.gov. Identifier NCT02623894.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Vigilancia de la Población , Rigidez Vascular/fisiología , Adulto , Anciano , Índice Tobillo Braquial , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Análisis de la Onda del Pulso , Valores de Referencia , Factores de Riesgo , España/epidemiología
8.
J Stroke Cerebrovasc Dis ; 29(2): 104576, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31839546

RESUMEN

BACKGROUND: Little is known on factors influencing cognitive function in rural communities. Using the Atahualpa Project cohort, we aimed to assess whether the carotid intima-media thickness (cIMT) - used as a surrogate of extracranial carotid atherosclerosis - is associated with cognitive performance and further decline in community-dwelling adults living in a rural setting. METHODS: The study included Atahualpa residents aged greater than or equal to 40 years who had ultrasound examination of the extracranial carotid arteries and a baseline Montreal Cognitive Assessment (MoCA), as well as the subset of individuals who also had a follow-up MoCA at least 1 year after baseline. Relationship between cIMT and cognitive function was assessed by means of generalized linear and longitudinal models, adjusted for relevant covariates. Mediation analysis was utilized to establish the proportion of the effect between increased cIMT and cognitive performance, which is mediated by age. RESULTS: A total of 561 individuals were included for the cross-sectional study, and 510 of them were assessed for the prospective cohort. Univariate analysis showed a significant association between increased cIMT and worse cognitive performance (P < .001), which vanishes after considering the effect of age and low scholarity. Causal mediation analysis confirms that age captures 82.6% (95% C.I.: 63.9% to 100%) of the effect of this association. There was no relationship between increased cIMT and cognitive decline in the follow-up. CONCLUSIONS: In this rural population, the association between increased cIMT and cognitive dysfunction is mostly mediated by increasing age.


Asunto(s)
Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Grosor Intima-Media Carotídeo , Cognición , Envejecimiento Cognitivo/psicología , Disfunción Cognitiva/psicología , Salud Rural , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Enfermedades de las Arterias Carótidas/epidemiología , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/epidemiología , Estudios Transversales , Ecuador/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
10.
Angiology ; 71(2): 122-130, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31303025

RESUMEN

The ability of carotid intima-media thickness (IMT) to predict risk beyond plaque is controversial. In 952 participants (critical limb ischemia [CLI] or stroke, n = 473; community, n = 479), we assessed whether relationships with events for IMT complement the impact of plaque in young patients depending on the extent of thrombotic versus atherosclerotic disease. The extent of atherosclerotic versus thrombotic occlusion was determined in 54 patients with CLI requiring amputations. Thrombotic occlusion in CLI was associated with younger age (P < .0001) and less plaque (P = .02). Independent relations between plaque and CLI were noted in older (>50 years; P < .005 to <.0001) but not younger (P > .38) participants, while independent relations between plaque and stroke (P < .005 to <.0001) and between IMT and CLI (P < .0001) were noted in younger participants. Although in performance (area under the receiver operating curve) for event detection, IMT thresholds failed to add to plaque alone in older patients (0.680 ± 0.020 vs 0.664 ± 0.017, P = .27), IMT improved performance for combined stroke and CLI detection when added to plaque in younger patients (0.719 ± 0.023 vs 0.631 ± 0.026, P < .0001). Because in younger participants the high prevalence of thrombotic occlusion in CLI is associated with less plaque, IMT adds information in associations with arterial vascular events.


Asunto(s)
Grosor Intima-Media Carotídeo , Isquemia/complicaciones , Isquemia/diagnóstico por imagen , Pierna/irrigación sanguínea , Pierna/diagnóstico por imagen , Placa Aterosclerótica/complicaciones , Placa Aterosclerótica/diagnóstico por imagen , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico por imagen , Trombosis/complicaciones , Trombosis/diagnóstico por imagen , Factores de Edad , Anciano , Enfermedad Crítica , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas
11.
J Stroke Cerebrovasc Dis ; 29(2): 104563, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31831329

RESUMEN

OBJECTIVE: Juvenile-onset mixed connective tissue disease (JMCTD) is a chronic inflammatory disease. We have previously demonstrated preclinical atherosclerosis in these patients, now exploring this further by assessing markers of endothelial dysfunction. METHODS: Thirty-three patients with JMCTD and 33 age-and sex-matched controls were included. Soluble intercellular adhesion molecule-1 (sICAM-1), Il-6 and, von Willenbrand factor (vWF) were assayed from blood taken at the time of carotid ultrasound. RESULTS: Our major findings were: (1) Levels of sICAM-1 (P < .001), IL-6 (P = .004), and vWF (P = .001) were higher, whereas (2) high density lipoprotein cholesterol (<.01) and apolipoprotein A1 (P < .01) were lower in the patient group compared to controls. CONCLUSIONS: Patients with JMCTD had significantly increased levels of markers of endothelial dysfunction.


Asunto(s)
Biomarcadores/sangre , Enfermedades de las Arterias Carótidas/sangre , Endotelio Vascular/metabolismo , Molécula 1 de Adhesión Intercelular/sangre , Interleucina-6/sangre , Enfermedad Mixta del Tejido Conjuntivo/sangre , Factor de von Willebrand/análisis , Adulto , Factores de Edad , Apolipoproteína A-I/sangre , Enfermedades de las Arterias Carótidas/diagnóstico , Grosor Intima-Media Carotídeo , Estudios de Casos y Controles , HDL-Colesterol/sangre , Femenino , Humanos , Masculino , Enfermedad Mixta del Tejido Conjuntivo/diagnóstico por imagen , Enfermedad Mixta del Tejido Conjuntivo/tratamiento farmacológico , Ultrasonografía Doppler en Color , Regulación hacia Arriba , Adulto Joven
12.
Clin Exp Hypertens ; 42(1): 16-23, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30554536

RESUMEN

Objective: The aim of this study was to assess indices of a comprehensive panel of central aortic pressure and arterial stiffness for prediction of cardiovascular events in a hypertensive cohort.Methods: Noninvasive measurements of central aortic blood pressure, brachial pressure, wave reflection augmentation index, pressure amplification, pulse wave velocity (PWV) and carotid intima-media thickness (IMT) were obtained in 675 hypertensive patients (age 61 ± 9 years, 425 males) for a mean follow-up period 25 ± 4 months. The primary endpoints were defined as cardiovascular disease (CVD) events or death from CVD.Results: After adjusting for confounding factors, central systolic (cSBP) and pulse pressure (cPP) showed higher hazard ratios (HR/10 mmHg) for cardiovascular events (CV) compared to peripheral pressure indices (pSBP, pPP) at age >60 years (cSBP: HR = 1.18, pSBP: HR = 1.17, p = 0.034; cPP: HR = 1.28, pPP: HR = 1.2, p = 0.019). Each SD increase in IMT and in central augmented pressure (cAP) entailed a 1.4 times higher risk of increased total events in elderly patients (age >60 years). For males, each SD increase in cAP was associated with 1.36 times higher risk of increased total events. For females, each SD increase in cAIx and cAP was associated with 0.4 and 0.5 times lower risk of increased total and major CV, respectively. This sex difference is most likely due to lack of age-related increase of cAIx in females after age >60 years compared to males.Conclusions: Central pressure improved prediction of CVD compared to peripheral pressure during a relatively short-term follow up of approximately 2 years at age >60 years.


Asunto(s)
Presión Arterial , Hipertensión/fisiopatología , Rigidez Vascular , Anciano , Angina Inestable/epidemiología , Aorta , Determinación de la Presión Sanguínea , Grosor Intima-Media Carotídeo , Puente de Arteria Coronaria/estadística & datos numéricos , Muerte Súbita Cardíaca/epidemiología , Femenino , Estudios de Seguimiento , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Intervención Coronaria Percutánea/estadística & datos numéricos , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Análisis de la Onda del Pulso , Resucitación/estadística & datos numéricos , Accidente Cerebrovascular/epidemiología
13.
Rev Med Suisse ; 15(674): 2229-2231, 2019 Dec 04.
Artículo en Francés | MEDLINE | ID: mdl-31804033

RESUMEN

Cardiovascular (CV) diseases are still one of the most important -killers in developed countries. In the last 40 years, great progresses have been achieved in recognizing and treating these diseases and their underlying risk factors. Risk assessment models using tradi-tional risk factors estimate the probability of a cardiovascular event in most cases and drive preventive treatment. However, these risk assessment models have weaknesses, and it is estimated that about 30 % of cardiovascular events are related to undetected risks. Many surrogate parameters have been investigated and have the potential to better predict CV risk beyond classical risk factors. The aim of this article is to assess the value of measuring the intima-media thickness and the detection of atheroma of the carotid and femoral bifurcation by ultrasound.


Asunto(s)
Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/patología , Grosor Intima-Media Carotídeo , Humanos , Medición de Riesgo , Ultrasonografía
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1432-1438, 2019 Nov 10.
Artículo en Chino | MEDLINE | ID: mdl-31838817

RESUMEN

Objective: To understand the prevalence of carotid plaque (CP) in population at high-risk for cardiovascular disease (CVD) in Jiangsu province and identify related influencing factors. Methods: Based on the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project from 2015 to 2016, a total of 11 392 persons at high-risk for CVD were selected from six project areas in Jiangsu province for the questionnaire survey, physical measurement, laboratory test and bilateral ultrasound examination of carotid arteries. The prevalence of CP and influencing factors of abnormal carotid arteries, CP and plaque burden (CP≥2) were analyzed. Results: Among the persons surveyed, 4 821 (42.3%) were males. The age of the persons surveyed was (59.4±8.9) years. There were 5 971 abnormal carotid arteries cases (52.4%), including 1 782 carotid intima-media thickness thickening cases (15.6%), 3 811 CP cases (33.5%) and 378 carotid stenosis cases (3.3%). Older age (OR=2.253, 95%CI: 2.127-2.386), urban residence (OR=2.622, 95%CI: 2.375-2.895), hypertension (OR=1.439, 95%CI: 1.195-1.732), smoking (OR=1.441, 95%CI: 1.259- 1.650), pulse pressure difference (OR=1.270, 95%CI: 1.198-1.347), fasting plasma glucose (FPG) (OR=1.109, 95%CI: 1.059-1.161) and LDL-C/HDL-C (OR=1.225, 95%CI: 1.164-1.288) were possible risk factors of CP in population at high risk for CVD. Being women (OR=0.558, 95%CI: 0.494-0.630), high BMI (OR=0.948, 95%CI: 0.904-0.994), higher levels of education (OR=0.708, 95%CI: 0.531-0.945), and higher annual household income (OR=0.773, 95%CI: 0.669-0.894) were the possible protective factors. Conclusions: Over half of the population at high-risk for CVD in Jiangsu showed abnormal carotid arteries. High blood pressure, high blood glucose, high blood lipids and smoking were the main factors that could be changed.


Asunto(s)
Arterias Carótidas/patología , Enfermedades de las Arterias Carótidas/etnología , Grosor Intima-Media Carotídeo , Placa Aterosclerótica/epidemiología , Adulto , Anciano , Grupo de Ascendencia Continental Asiática , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etnología , Enfermedades Cardiovasculares/patología , Enfermedades de las Arterias Carótidas/patología , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo
15.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 428-434, Oct.-Dec. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1041351

RESUMEN

ABSTRACT Objective: To contribute to the assessment of normal parameters of carotid intima-media thickness (CIMT) in healthy adolescents. Methods: A cross-sectional study was conducted through clinical, laboratory and ultrasound evaluation in 61 healthy adolescents. The inclusion criteria consisted of being in good health. The exclusion criteria were: presence or history of any chronic disease; being obese or overweight according to the World Health Organization (WHO) established criterion; continuous use of medication; or presenting a febrile condition or requiring medication within 48-hours prior to assessment. The pubertal stages were evaluated using the Tanner criteria. The high-resolution B-mode ultrasound examinations were performed according to the recommendations of the Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Results: Adolescents were 14±2.6 years old, 62.3% female, 19 (31%) at early puberty (Tanner II and III), and 38 (62%) at late puberty (Tanner IV and V). They presented normal clinical and laboratorial parameters. CIMT values were 0.46±0.04 to 0.55±0.04 mm on the right and 0.48±0.02 to 0.53±0.04 mm on the left, according to pubertal maturation. CIMT values increased significantly on the right and left sides, according to pubertal stage (p<0.001 and p=0.016), and maximum internal diameters of the common carotid artery (p<0.025 and p<0.003). It was higher in males compared to females. Conclusions: An increase in CIMT in the healthy adolescents group, according to both age, and the degree of pubertal maturation should be considered when evaluating adolescents in diagnostic procedures.


RESUMO Objetivo: Contribuir para a avaliação dos parâmetros normais da espessura médio-intimal carotídea (EMIC) em adolescentes saudáveis. Métodos: Estudo transversal realizado por meio de avaliações clínicas, laboratoriais e ultrassonográficas em 61 adolescentes saudáveis. O critério de inclusão foi ter boa saúde. Os critérios de exclusão foram: presença ou histórico de doença crônica; obesidade ou sobrepeso segundo os parâmetros estabelecidos pela Organização Mundial da Saúde (OMS); uso contínuo de medicação; e quadro febril ou que necessitasse de uso de medicação nas 48 horas anteriores à avaliação. Os estágios puberais foram avaliados pela escala de Tanner. As ultrassonografias em modo B de alta resolução foram realizadas seguindo as recomendações do Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force (Declaração de Consenso da Força Tarefa da Sociedade Americana de Ecocardiografia sobre Espessura Médio-Intimal Carotídea). Resultados: Os adolescentes tinham 14±2,6 anos, 62,3% eram do sexo feminino, 19 (31%) estavam em estágios iniciais da puberdade (2 e 3) e 38 (62%) em estágios avançados (4 e 5) de acordo com a escala de Tanner. Todos apresentavam parâmetros clínicos e laboratoriais normais. Os valores da EMIC variaram de 0,46±0,04 a 0,55±0,04 mm do lado direito e 0,48±0,02 a 0,53±0,04 mm do lado esquerdo, conforme a maturação puberal. Houve aumento significativo nos valores da EMIC em ambos os lados de acordo com o estágio puberal (p<0,001 e p=0,016) e os diâmetros internos máximos da artéria carótida comum (p<0,025 e p<0,003). A EMIC foi maior em participantes do sexo masculino em relação ao feminino. Conclusões: O aumento da EMIC em adolescentes saudáveis, conforme a idade e o grau de maturação puberal, deve ser levado em consideração nas avaliações diagnósticas.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto Joven , Pubertad/psicología , Grosor Intima-Media Carotídeo , Estudios Transversales , Salud del Adolescente , Voluntarios Sanos
16.
Nutr Metab Cardiovasc Dis ; 29(12): 1273-1287, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31669106

RESUMEN

AIMS: Dietary pattern (DP) analysis has emerged as a holistic method to understand the effects of food intake on health outcomes. Though dietary intake has been associated with cardiovascular disease, the association of DPs and carotid intima-media thickness (CIMT), a robust early marker of cardiovascular disease progression has not been comprehensively investigated. This study systematically explores the association of a posteriori and a priori DPs and CIMT. DATA SYNTHESIS: Through a systematic search of MEDLINE, CINAHL, and Web of Science, twenty studies that derived DPs using a posteriori or a priori methods with CIMT as an outcome were included. Four cross-sectional studies and 1 cohort paper reported a statistically significant association between increased consumption of 'unhealthy' foods (i.e processed meat, soda drinks and refined grain) and increased CIMT. While four cross-sectional studies reported a statistically significant association of DPs characterized by increased consumption of 'healthy' foods (i.e fruit and vegetables, fish) and decreased CIMT. DPs derived from each study varied depending on derivation method, study design and use of dietary data collection method. CONCLUSION: Findings from this review are generally supportive of a trend between DPs with higher consumption of 'healthy' foods and lower consumption of 'unhealthy' foods and decreased CIMT; however, the association was largely not statistically significant. Evidence was overwhelmingly heterogeneous due to differences seen in DPs based on location and culture, sample characteristics and adjustment for confounders. Long-term prospective observational and interventional studies with standardized sample selection and dietary data collection are needed to significantly establish the role of DPs on CIMT.


Asunto(s)
Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Grosor Intima-Media Carotídeo , Dieta , Conducta Alimentaria , Conducta de Reducción del Riesgo , Adulto , Anciano , Enfermedades de las Arterias Carótidas/epidemiología , Enfermedades de las Arterias Carótidas/prevención & control , Dieta/efectos adversos , Dieta Mediterránea , Enfoques Dietéticos para Detener la Hipertensión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Nutritivo , Valor Predictivo de las Pruebas , Prevención Primaria , Pronóstico , Factores Protectores , Ingesta Diaria Recomendada , Medición de Riesgo , Factores de Riesgo
17.
Medicine (Baltimore) ; 98(44): e17805, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31689862

RESUMEN

Carotid intima-media thickness (C-IMT) increases in patients with adult type-2 diabetes mellitus (DM) and is used for early detection of macrovascular complications. We aimed to investigate the change of C-IMT in prediabetes and type-2 DM patients compared to subjects with normal glucose metabolism (NGM).A total of 180 individuals (60 subjects with NGM, 60 patients with prediabetes and 60 patients with type-2 DM) were included in this study. Routine laboratory and micro-macrovascular involvement were investigated. Urine albumin-creatinine ratio (ACR) was measured for urinary albuminuria detection. In addition to routine laboratory examination, right-left common and internal C-IMT (CC-IMT and IC-IMT) were measured.Systolic and diastolic blood pressure values were found to be higher in prediabetes and type-2 DM groups than NGM group. The prevalence of nephropathy and presence of CAD were higher in type-2 DM groups than prediabetes. Glucose, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, blood urea nitrogen, creatinine, high sensitive C reactive protein (hs-CRP) levels and urinary ACR were significantly higher in patients within prediabetes and type-2 DM groups than NGM group. Glucose, HbA1c and hs-CRP levels were found to be higher in type-2 DM groups than prediabetes. Estimated glomerular filtration rate and high-density lipoprotein (HDL) cholesterol level was found to be lower in patients within prediabetes and type-2 DM groups than NGM group. Right-left-mean CC-IMT and IC-IMT values were found to be higher in prediabetes and type-2 DM groups than NGM group. Left IC-IMT, left CC-IMT, and mean IC-IMT values were found to be higher in type-2 DM patients compared to prediabetes. LDL and HDL cholesterols, HbA1c, and hs-CRP levels were independently associated with IC-IMT and CC-IMT.C-IMT values were significantly higher in impaired glucose metabolism compared to NGM. C-IMT measurement may be used as part of routine screening of macrovascular complication in patients with prediabetes and newly diagnosed type-2 DM.


Asunto(s)
Grosor Intima-Media Carotídeo , Diabetes Mellitus Tipo 2/diagnóstico por imagen , Angiopatías Diabéticas/diagnóstico , Estado Prediabético/diagnóstico por imagen , Anciano , Glucemia/metabolismo , Presión Sanguínea , Proteína C-Reactiva/metabolismo , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Enfermedad de la Arteria Coronaria/diagnóstico , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Hemoglobina A Glucada/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Estado Prediabético/sangre , Estado Prediabético/fisiopatología
18.
J Food Sci ; 84(12): 3555-3564, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31721202

RESUMEN

Camellia brevistyla (Hayata) Coh. Stuart seeds are used to produce edible oil. The seed pomace is an agricultural waste, containing approximately 8% saponin, which has antihypertensive effects. Nω -nitro-L-arginine methyl ester (L-NAME) can induce hypertension with no deficiency on mice. Here, we investigated the effects of ethanol extract from C. brevistyla seed pomace (CBPE) in L-NAME-induced hypertension mice. The results showed that all doses of CBPE significantly decreased systolic (117 ± 5-122 ± 5 mmHg) and diastolic (72 ± 16-77 ± 8 mmHg) blood pressure, aortic intima media thickness (48 ± 5-53 ± 5 µm), and also reduced the MDA adduct and protein carbonyl levels in the liver (101 ± 19-114 ± 17 ρmol/mL and 4.8 - 5.2 nmol/mg) compared to those observed in the L-NAME group (140 ± 3 and 95 ± 8 mmHg, 65 ± 10 µm, 145 ± 25 ρmol/mL, and 7.8 nmol/mg; P < 0.05). These results suggest that CBPE has profitable antihypertensive properties which are preventing aorta remodeling and reducing liver oxidative stress in hypertensive mice.


Asunto(s)
Antihipertensivos/administración & dosificación , Camellia/química , Hipertensión/tratamiento farmacológico , Extractos Vegetales/administración & dosificación , Animales , Aorta/efectos de los fármacos , Arginina/análogos & derivados , Presión Sanguínea/efectos de los fármacos , Grosor Intima-Media Carotídeo , Humanos , Hipertensión/inducido químicamente , Hipertensión/metabolismo , Hipertensión/fisiopatología , Masculino , Ratones , Ratones Endogámicos BALB C , NG-Nitroarginina Metil Éster/efectos adversos , Estrés Oxidativo/efectos de los fármacos , Semillas/química
20.
Environ Int ; 133(Pt B): 105184, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31648154

RESUMEN

Exposure to light at inappropriate times in relation to the solar cycle can disturb circadian endocrine and metabolic rhythms. Previous studies have suggested an association between light exposure at night (LAN) and obesity, an important risk factor of atherosclerosis, although it remains unclear whether LAN associates with progression of atherosclerosis. To evaluate the longitudinal association between bedroom LAN intensity and progression of carotid atherosclerosis, light intensity in the bedroom at baseline and carotid artery intima-media thickness (IMT) at baseline and follow-up were measured in 989 elderly participants (945 at baseline and 780 at a median follow-up time of 34 months). The mean age of the participants was 71.4 ±â€¯6.9 years. The average mean and maximal carotid IMT at baseline were 0.88 ±â€¯0.15 and 1.10 ±â€¯0.32 mm, respectively. The median intensity of bedroom LAN was 0.68 lx (IQR, 0.07-3.29). In multivariable analysis adjusted for potential confounders, the highest LAN group exhibited a significant increase in mean carotid IMT (adjusted ß, 0.028; 95% CI, 0.005-0.052; P = 0.019) compared with the lowest LAN quartile group. A similar relationship was found between LAN and maximal carotid IMT (adjusted ß, 0.083; 95% CI, 0.037-0.129; P < 0.001). In conclusion, we found a clear and significant association between bedroom LAN intensity and progression of subclinical carotid atherosclerosis, which was independent of known risk factors for atherosclerosis, including age, obesity, smoking, economic status, hypertension, and diabetes. Indoor light pollution may be a potential risk factor for atherosclerosis in the general population.


Asunto(s)
Enfermedades de las Arterias Carótidas/etiología , Luz , Anciano , Grosor Intima-Media Carotídeo , Progresión de la Enfermedad , Contaminación Ambiental , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores de Riesgo
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