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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2129-2132, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018427

RESUMO

Cardiovascular diseases are the biggest threat to human being's health all over the world, and carotid atherosclerotic plaque is the leading cause of ischemic cardiovascular diseases. To determine the location and shape of the plaque, it is of great significance to detect the intima-media (IM). In this paper, a new IM detection method based on convolution neural network (IMD-CNN) is proposed for the detection of IM of blood vessels in longitudinal ultrasonic images. In IMD-CNN, firstly the region of interest (ROI) is automatically extracted by morphological processing, then the patch-wise training data are constructed, and finally a simple CNN is trained to detect the IM. The experimental results obtained on 23 images show that the test accuracy of IMD-CNN is over 86% and the performance of IMD-CNN is also visually proved to be effective.


Assuntos
Meios de Comunicação , Placa Aterosclerótica , Espessura Intima-Media Carotídea , Humanos , Redes Neurais de Computação , Placa Aterosclerótica/diagnóstico por imagem , Ultrassonografia
2.
Zhonghua Yi Xue Za Zhi ; 100(38): 2990-2996, 2020 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-33086449

RESUMO

Objective: To investigate the appropriate cut-off point of time in range (TIR) for evaluating glucose control in type 2 diabetes mellitus (T2DM) patients, and analyze the prevalence of abnormal carotid intima-media thickness (CIMT) and diabetic retinopathy (DR) in different TIR categories. Methods: A total of 2 161 subjects with T2DM (1 183 males) were enrolled from hospitalized patients at the Department of Endocrinology and Metabolism of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from January 2005 to February 2012. The age of the enrolled participants was (60.4±11.9) years. Each patient underwent continuous glucose monitoring (CGM) for three consecutive days, then TIR (3.9-10.0 mmol/L), time above range (TAR) and time below range (TBR) were calculated. Fundus photography and carotid artery Doppler ultrasound were performed to diagnose DR and abnormal CIMT (defined as CIMT≥1.0 mm), respectively. Multivariate logistic regression models were used to examine the independent association of different TIR groups with CIMT and DR. Results: All subjects were divided into 4 groups according to TIR:≤40%, 41%-70%, 71%-85% and>85%. Significant linear trends in age, diabetes duration, body mass index (BMI), total cholesterol, glycated hemoglobin A1c (HbA1c), TAR and mean glucose (MG) existed among the 4 groups (all P(trend)<0.05). However, there was only a weak correlation between TIR and TBR (<3.9 mmol/L) (r=0.087, P<0.001), and no significant association was observed between TBR (<3 mmol/L) and the TIR categories (P(trend)=0.378). The overall prevalence of abnormal CIMT and DR was 12.1% and 23.8%, respectively. The prevalence of abnormal CIMT in the 4 groups with ascending levels of TIR was 16.9% (59/349), 12.9% (96/746), 11.2% (57/510) and 9.0% (50/556) (P(trend)<0.001), respectively. And the prevalence of DR was 30.7% (107/349), 29.4% (219/746), 20.8% (106/510) and 14.9% (83/556), respectively (P(trend)<0.001). In the binary logistic regression model by adjusting confounding factors, compared with TIR≤ 40%, the risk of abnormal CIMT was reduced by 33.8% (OR=0.662, 95%CI: 0.456-0.963, P=0.031), 40.8% (OR=0.592, 95%CI: 0.390-0.899, P=0.014), and 45.0% (OR=0.550, 95%CI: 0.358-0.846, P=0.006) in the other three groups, respectively. And the risk of DR was reduced by 2.9% (OR=0.971, 95%CI: 0.725-1.301, P=0.844), 33.4%(OR=0.666, 95%CI: 0.479-0.924, P=0.015) and 53.3% (OR=0.467, 95%CI: 0.331-0.657, P<0.001), respectively. Conclusion: Using 40%, 70% and 85% as cut-off point of TIR helps stratify the risk of diabetic complications, and assess the glucose control (Poor: TIR≤40%; Unsatisfactory: TIR≤70%; Satisfactory: TIR>70%; Optimal: TIR>85%) in patients with T2DM.


Assuntos
Glicemia , Diabetes Mellitus Tipo 2 , Automonitorização da Glicemia , Espessura Intima-Media Carotídea , China , Humanos , Masculino
3.
Medicine (Baltimore) ; 99(35): e21953, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871943

RESUMO

H-type hypertension, defined as a combination of hypertension and hyperhomocysteinemia (Hhcy), is associated with atherosclerosis and, therefore, increased stroke risk. However, the role of hypertension and Hhcy in high-risk stroke populations has not been studied. The present study investigated the prevalence of H-type hypertension in a high-risk stroke population of Hainan Province, China and to assess possible joint effects between hypertension and Hhcy for increased carotid intima-media thickness (CIMT). In this community-based cross-sectional study, 959 high-risk stroke subjects (age, 65.8 ±â€Š10.8 years; 46.6% men) were recruited from Hainan Province, China. The demographic and clinical characteristics were collected, and blood samples were obtained. Analysis of variance or chi-square tests were performed to compare variates among groups based on both homocysteine levels and blood pressure status. The associations of hypertension and Hhcy with increased CIMT were evaluated through logistic regression. The prevalence of H-type hypertension was 34.8% in this population, with a higher ratio of H-type hypertension in men than in women. Compared with the normotension and normal homocysteine subgroup, the risk of increased CIMT was significantly higher in the subgroup with hypertension and Hhcy (odds ratio [OR] = 2.639; 95% confidence interval [CI], 1.690-4.091) after adjusting for age and sex. Increased CIMT was affected by an additive synergetic interaction between Hhcy and hypertension (synergy index = 1.105). It emphasized the clinical importance of anti-hypertension and lowering Hhcy in the high-risk stroke population.


Assuntos
Espessura Intima-Media Carotídea , Hiper-Homocisteinemia/complicações , Hipertensão/complicações , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Hiper-Homocisteinemia/fisiopatologia , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos
4.
PLoS One ; 15(8): e0237739, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817629

RESUMO

OBJECTIVE: To assess the effect of HIV infection and combined antiretroviral therapy (c-ART) on various proatherogenic biomarkers and lipids and to investigate their relationship with subclinical atherosclerosis in a cohort of treatment-naive HIV-infected patients. METHODS: We performed a prospective, comparative, multicenter study of 2 groups of treatment-naive HIV-infected patients (group A, CD4>500 cells/µL, not starting c-ART; and group B, CD4<500 cells/µL, starting c-ART at baseline) and a healthy control group. Laboratory analyses and carotid ultrasound were performed at baseline and at months 12 and 24. The parameters measured were low-density lipoprotein (LDL) particle phenotype, lipoprotein-associated phospholipase A2 (Lp-PLA2), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), sCD14, sCD163, monocyte chemoattractant protein-1(MCP-1), and asymmetric dimethylarginine (ADMA). A linear mixed model based on patient clusters was used to assess differences in biomarkers between the study groups and over time. RESULTS: The study population comprised 62 HIV-infected patients (group A, n = 31; group B, n = 31) and 22 controls. Age was 37 (30-43) years, and 81% were men. At baseline, the HIV-infected patients had a worse LDL particle phenotype and higher plasma concentration of sCD14, sCD163, hs-CRP, and LDL-Lp-PLA2 than the controls. At month 12, there was an increase in total cholesterol (p = 0.002), HDL-c (p = 0.003), and Apo A-I (p = 0.049) and a decrease in sCD14 (p = <0.001) and sCD163 (p<0.001), although only in group B. LDL particle size increased in group B at month 24 (p = 0.038). No changes were observed in group A or in the healthy controls. Common carotid intima-media thickness increased in HIV-infected patients at month 24 (Group A p = 0.053; group B p = 0.048). Plasma levels of sCD14, sCD163, and hs-CRP correlated with lipid values. CONCLUSIONS: In treatment-naive HIV-infected patients, initiation of c-ART was associated with an improvement in LDL particle phenotype and inflammatory/immune biomarkers, reaching values similar to those of the controls. HIV infection was associated with progression of carotid intima-media thickness.


Assuntos
Aterosclerose/sangue , Biomarcadores/sangue , Infecções por HIV/sangue , Lipídeos/sangue , Adulto , Antirretrovirais/administração & dosagem , Antirretrovirais/sangue , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Aterosclerose/tratamento farmacológico , Aterosclerose/virologia , Proteína C-Reativa/metabolismo , Espessura Intima-Media Carotídea , Colesterol/sangue , Grupos Controle , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Humanos , Inflamação/sangue , Inflamação/tratamento farmacológico , Inflamação/virologia , Lipoproteínas LDL/sangue , Masculino , Estudos Prospectivos
5.
Ann Afr Med ; 19(3): 170-175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32820728

RESUMO

Introduction: Doppler sonography of the cervical segment of the carotid arteries is becoming a popular tool for evaluating atherosclerosis of the carotid artery. We present the audit of findings on carotid ultrasound examination among patients with clinical suspicion and risks for cerebrovascular disease and possible correlates in Northern Nigeria. Materials and Methods: We performed carotid ultrasound examination on all patients referred for screening and clinical suspicion of cerebrovascular disease within the year 2017. The patients' characteristics, risk factors, presence of atheroma and characteristic of the atheroma, degree of stenotic disease as well as the presence of incidental ultrasound findings were reviewed and documented. Results: Out of the 62 patients, 55 (88.7%) of them had various degrees and types of atheromatous plaques in different segments of the cervical carotid arteries, whereas 7 (11.3%) were normal. The predominant risk factor was smoking followed by diabetes mellitus, whereas the highest indication for the scan was transient ischemic attack. Incidental thyroid lesions such as nodules and cysts were encountered in 14 (22.6%) of the patients. There is a statistically significant difference between sex and age with the side of lesion, degree of stenosis, segment involved, and type of atheromatous plaque. Conclusion: There is a statistically significant difference between sex and age with the side of lesion, degree of stenosis, segment involved, and type of atheromatous plaque. About one-fifth of our patients had incidental thyroid lesions. Therefore, routine screening of population at risk is highly recommended.


Assuntos
Artérias Carótidas/diagnóstico por imagem , Placa Aterosclerótica/diagnóstico por imagem , Fumar/efeitos adversos , Ultrassonografia Doppler/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Espessura Intima-Media Carotídea , Estenose das Carótidas/complicações , Estenose das Carótidas/epidemiologia , Feminino , Humanos , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Nigéria , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico
6.
Ecotoxicol Environ Saf ; 204: 111039, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32738627

RESUMO

PURPOSE: Lead (Pb) or cadmium (Cd) exposure has been linked to atherosclerosis. Co-exposure of these two heavy metals often occurs in humans. Recent evidence has indicated a crucial role of DNA methylation in atherosclerosis, while Pb or Cd exposure has also been shown to alter DNA methylation. However, it is still unknown whether DNA methylation plays a role in the pathological mechanism of these two heavy metals in atherosclerosis. APPROACH AND RESULTS: We enrolled 738 participants (12-30 years) to investigate the association among concentrations of urine Pb or Cd, the 5mdC/dG value (a global DNA methylation marker) and the carotid intima-media thickness (CIMT). When each heavy metal was modeled separately, the results showed urine Pb and Cd concentrations were positively associated with the 5mdC/dG value and CIMT, respectively. When the two heavy metals were analyzed in the same model, urinary Pb concentrations were positively associated with the 5mdC/dG value and CIMT, while urinary Cd concentrations were only positively associated with the CIMT. When Pb and Cd are simultaneously considered in the same logistic regression model, the odds ratios (OR) of thicker CIMT (greater than 75th percentile) with one unit increase in ln-Pb level was 1.67 (95% C.I. = 1.17-2.46, P = 0.005) when levels of 5mdC/dG were above 50th percentile, which is higher than 5mdC/dG bellow the 50th percentile (OR = 1.50 (95% C.I. = 0.96-2.35), P = 0.076). In structural equation model (SEM), Pb or Cd levels are directly associated with CIMT. Moreover, Pb or Cd had an indirect association with CIMT through the 5mdC/dG. When we considered Pb and Cd together, Pb levels had a direct association with CIMT and an indirect association with CIMT through the 5mdC/dG value, while Cd only had a direct association with CIMT. CONCLUSIONS: Our findings imply that Pb and Cd exposure might be associated with subclinical atherosclerosis, and global DNA methylation might mediate Pb-associated subclinical atherosclerosis in this young population. Future effort is necessary to elucidate the causal relationship.


Assuntos
Aterosclerose/epidemiologia , Cádmio/urina , Espessura Intima-Media Carotídea , Metilação de DNA , Poluentes Ambientais/urina , Chumbo/urina , Adolescente , Adulto , Aterosclerose/induzido quimicamente , Biomarcadores , Estudos Transversais , Feminino , Humanos , Masculino , Taiwan/epidemiologia , Adulto Jovem
7.
J Assoc Physicians India ; 68(8): 19-23, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32738835

RESUMO

Objective: Leptin levels are increased in obesity and have been found to be strongly associated with obesity, increased risk of cardiovascular diseases and morbidity. While, carotid intima-media thickness (CIMT) is measured to predict atherosclerosis in early phase. Thus, the objective of this study was to evaluate the leptin levels and CIMT in overweight and obese individuals. Methods: This cross-sectional study involving 95 subjects, was performed over a period of 1 year in the Department of Medicine, King George's Medical University, Lucknow. Anthropometric measurements included weight, height, waist circumference (WC), and BMI (Kg/m2). Baseline investigations were fasting blood glucose and lipid profile. Quantitative estimation of leptin was done by leptin ELISA, and CIMT was measured using a high-resolution B-mode ultrasound scanner with a 7 MHz linear transducer. Unpaired t-test or ANNOVA was used to compare quantitative variables, and chi-square or fisher's exact test was used to compare categorical variables. Pearson's correlation coefficient was used to test the strength of correlation. A p value of < 0.05 was considered as statistically significant. Results: Based on both BMI and WC, mean leptin levels were significantly increased in overweight and obese subjects (p < 0.05) as compared to normal subjects. Similarly, based on both BMI and WC, significantly higher proportion of overweight and obese subjects had increased CIMT values (p < 0.05), as compared to normal subjects. Mean leptin levels were positively and significantly correlated with weight, WC, BMI, total cholesterol, triglyceride, LDL-cholesterol, and CIMT. Similarly, CIMT values were positively and significantly correlated with age, weight, WC, BMI, total cholesterol, triglyceride, HDL-cholesterol. Conclusion: Findings of this study indicates that overweight and obesity results in significant increase in both leptin levels and CIMT values. Furthermore, increased leptin levels and CIMT values are positively correlated with increase in BMI and WC.


Assuntos
Espessura Intima-Media Carotídea , Leptina , Índice de Massa Corporal , Estudos Transversais , Humanos , Obesidade , Sobrepeso , Fatores de Risco
8.
Artigo em Chinês | MEDLINE | ID: mdl-32842211

RESUMO

Objective:To study the carotid intima-media thickness (IMT) level of OSA patients of different severity, the proportion of Th17 cells in peripheral blood and the mRNA level of nuclear transfer factor RORγt, and to explore the relationship between Th17 cells and atherosclerosis in OSA patients. Method:Sixty-two patients who underwent respiratory and sleep monitoring were selected and divided into three groups according to the AHI index: 15 patients in the normal control group(AHI<5), there were 22 cases in the mild group(AHI 5-15) and 25 cases in the moderate and severe group(AHI≥15). Carotid intima-media thickness(IMT) was measured in all subjects, the ratio of Th17 cells in peripheral blood monouelear cells(PBMC) were analysed by flow cytometry. The expression of RORγt mRNA were detected by real-time polymerase chain reaction. Result:The carotid IMT of patients in the normal control group, the mild OSA group and the moderate to severe OSA group were (0.74±0.21) mm, (1.09±0.23) mm and (1.60±0.30) mm, respectively. The moderate to severe group was higher than the mild group and the normal control group, the difference was statistically significant (P<0.01). The proportion of Th17 in peripheral blood of the three groups was(2.54±0.20)%, (4.34±0.30)%, and (8.27±0.31)%, respectively. The moderate to severe group was significantly higher than the mild group and the control group (P<0.01), the difference was statistically significant. The relative mRNA expression levels of RORγt in the three groups were 0.92±0.24, 2.60±0.59, and 4.93±0.72, respectively. The moderate to severe group was significantly higher than the mild group and the control group (P<0.01), the difference was statistically significant. The proportion of Th17 in peripheral blood and the relative expression of RORvt mRNA were positively correlated with the carotid IMT (r value was 0.80, 0.78, respectively, all P<0.01). Conclusion:Th17 cells differentiation is increased in OSA patients, and Th17 cells are correlated with indicators reflecting the progression of atherosclerosis. Th17 cells may be involved in the development of atherosclerosis in OSA patients.


Assuntos
Aterosclerose , Apneia Obstrutiva do Sono , Espessura Intima-Media Carotídea , Humanos , Leucócitos Mononucleares , Células Th17
9.
Mymensingh Med J ; 29(3): 572-578, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32844796

RESUMO

Type 2 diabetes considered as a compound of metabolic syndrome. It can cause both micro and macrovascular complications. Diabetes is a strong risk factor in the development of atherosclerosis and likewise carotid artery disease. Carotid artery stenosis may cause stroke. Doppler ultrasound is the most common imaging technique for the diagnosis of carotid disease. Objective of the study was to assess the percentage of atherosclerotic carotid disease in asymptomatic Type 2 diabetics (T2D) by Doppler sonography and to find out the association of different risk factors of diabetic patient with atherosclerosis. A cross sectional study was done. A total of 43 type 2 diabetic patients (27 male, 16 female) referred from the out patient department and admitted patients in Mymensingh Medical College Hospital (MMCH) during January 2017 to December 2017 for the purpose of evaluation of intima media thickness (IMT) and carotid artery stenosis by Duplex color Doppler ultrasonography examination were enrolled in this study. Patients with previous history of recent stroke or transient ischemic attack (<6 weeks), history of carotid surgery or cervical radiotherapy were excluded. Carotid artery disease was found 65.1% in asymptomatic type 2 diabetics. Among them increased IMT in 48.8% and carotid stenosis was present in 37.2% and >50% stenosis (Peak systolic velocity >125cm/sec) was present in 9.3%. Age >50% years, smoking, duration of DM >10 years, hypertension, history of ischaemic heart disease and history of diabetic retinopathy were found to be associated with carotid atherosclerosis as well as carotid stenosis. High percentage of carotid artery disease (65.1%) was found in asymptomatic type 2 diabetes mellitus. This result suggests the need for carotid Doppler evaluation of all Type 2 diabetics as a first measure of stroke prevention, with the hope that timely intervention might avert stroke and its accompanying disability.


Assuntos
Doenças das Artérias Carótidas , Estenose das Carótidas , Diabetes Mellitus Tipo 2 , Artérias Carótidas , Espessura Intima-Media Carotídea , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco
10.
PLoS Med ; 17(7): e1003183, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32692751

RESUMO

BACKGROUND: Undernutrition during intrauterine life and early childhood is hypothesised to increase the risk of cardiovascular disease (Developmental Origins of Health and Disease Hypothesis), but experimental evidence from humans is limited. This hypothesis has major implications for control of the cardiovascular disease epidemic in South Asia (home to a quarter of world's population), where a quarter of newborns have low birth weight. We investigated whether, in an area with prevalent undernutrition, supplemental nutrition offered to pregnant women and their offspring below the age of 6 years was associated with a lower risk of cardiovascular disease in the offspring when they were young adults. METHODS AND FINDINGS: The Hyderabad Nutrition Trial was a community-based nonrandomised controlled intervention trial conducted in 29 villages near Hyderabad, India (1987-1990). Protein-calorie food supplement was offered daily to pregnant and lactating women (2.09 MJ energy and 20-25 g protein) and their offspring (1.25 MJ energy and 8-10 g protein) until the age of six years in the 15 intervention villages, but not in the 14 control villages. A total of 1,826 participants (949 from the intervention villages and 877 from the control villages, representing 70% of the cohort) at a mean age of 21.6 years (62% males) were examined between 2009 and 2012. The mean body mass index (BMI) of the participants was 20 kg/m2 and the mean systolic blood pressure was 115 mm Hg. The age, sex, socioeconomic position, and urbanisation-adjusted effects of intervention (beta coefficients and 95% confidence intervals) on outcomes were as follows: carotid intima-media thickness, 0.01 mm (-0.01 to 0.03), p = 0.36; arterial stiffness (augmentation index), -1.1% (-2.5 to 0.3), p = 0.097; systolic blood pressure, 0.5 mm Hg (-0.6 to 1.6), p = 0.36; BMI, -0.13 kg/m2 (-0.75 to 0.09), p = 0.093; low-density lipoprotein (LDL) cholesterol, 0.06 mmol/L (-0.07 to 0.2), p = 0.37; and fasting insulin (log), -0.06 mU/L (-0.19 to 0.07), p = 0.43. The limitations of this study include nonrandomised allocation of intervention and lack of data on compliance, and potential for selection bias due to incomplete follow-up. CONCLUSIONS: Our results showed that in an area with prevalent undernutrition, protein-calorie food supplements offered to pregnant women and their offspring below the age of 6 years were not associated with lower levels of cardiovascular risk factors among offspring when they were young adults. Our findings, coupled with evidence from other intervention studies to date, suggest that policy makers should attach limited value to cardiovascular health benefits of maternal and child protein-calorie food supplementation programmes.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Adolescente , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , Feminino , Seguimentos , Humanos , Índia , Masculino , Desnutrição/dietoterapia , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Fatores de Risco , Adulto Jovem
11.
Arch Biochem Biophys ; 690: 108460, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32603715

RESUMO

BACKGROUND: Our previous research revealed that trypsin is abundantly expressed in atherosclerotic plaques and its distribution overlaps with that of matrix metalloproteinase-9 (MMP-9). This study was performed to explore the possible roles of trypsin in vulnerable atherosclerotic plaque formation. METHODS AND RESULTS: Twenty-four rabbits were randomly assigned to a normal (control) group, an atherosclerosis (experimental) group and a trypsin inhibitor (aprotinin) group. In the 13th feeding week, the aprotinin group was treated with 5 mg/kg/day aprotinin via ear vein for 4 weeks. At the end of the 16th week, coronary arterial and aortic expression of trypsin, proteinase-activated receptor-2 (PAR-2), activated MMP-9, and pro-inflammatory cytokines were significantly greater in the experimental group than in the control group. Aprotinin decreased trypsin expression and activation in plaques, blocked PAR-2 and MMP-9 activation, and decreased cytokine expression; it also increased fibrous cap thickness, decreased the intima-media thickness and intimal/medial ratio, thus significantly ameliorating plaque vulnerability. Upregulated trypsin, MMP-9 and PAR-2 were also found in coronary intimal atherosclerotic plaques of patients undergoing coronary artery bypass grafting. CONCLUSIONS: Ectopic trypsin was significantly upregulated in atherosclerotic plaques, which increased pro-inflammatory cytokine levels by activating PAR-2 and promoted plaque instability by activating proMMP-9, thereby promoting atherosclerosis and plaque vulnerability. In addition, the high trypsin expression in human coronary intimal atherosclerotic plaques suggests that targeting trypsin may be a new strategy for acute coronary syndrome prevention.


Assuntos
Aterosclerose/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Placa Aterosclerótica/química , Tripsina/metabolismo , Animais , Aorta/química , Aprotinina/administração & dosagem , Aprotinina/metabolismo , Espessura Intima-Media Carotídea , Citocinas/metabolismo , Regulação da Expressão Gênica , Humanos , Masculino , Coelhos , Receptor PAR-2/metabolismo , Tripsina/genética , Inibidores da Tripsina/administração & dosagem , Inibidores da Tripsina/metabolismo
12.
Angiology ; 71(10): 920-933, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32696658

RESUMO

The objectives of this study are to (1) examine the "10-year cardiovascular risk" in the common carotid artery (CCA) versus carotid bulb using an integrated calculator called "AtheroEdge Composite Risk Score 2.0" (AECRS2.0) and (2) evaluate the performance of AECRS2.0 against "conventional cardiovascular risk calculators." These objectives are met by measuring (1) image-based phenotypes and AECRS2.0 score computation and (2) performance evaluation of AECRS2.0 against 12 conventional cardiovascular risk calculators. The Asian-Indian cohort (n = 379) with type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), or hypertension were retrospectively analyzed by acquiring the 1516 carotid ultrasound scans (mean age: 55 ± 10.1 years, 67% males, ∼92% with T2DM, ∼83% with CKD [stage 1-5], and 87.5% with hypertension [stage 1-2]). The carotid bulb showed a higher 10-year cardiovascular risk compared to the CCA by 18% (P < .0001). Patients with T2DM and/or CKD also followed a similar trend. The carotid bulb demonstrated a superior risk assessment compared to CCA in patients with T2DM and/or CKD by showing: (1) ∼13% better than CCA (0.93 vs 0.82, P = .0001) and (2) ∼29% better compared with 12 types of risk conventional calculators (0.93 vs 0.72, P = .06).


Assuntos
Artéria Carótida Primitiva/diagnóstico por imagem , Espessura Intima-Media Carotídea , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Hipertensão/diagnóstico por imagem , Insuficiência Renal Crônica/diagnóstico por imagem , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Hipertensão/complicações , Índia , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/complicações , Estudos Retrospectivos , Medição de Risco
13.
PLoS One ; 15(7): e0232741, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649699

RESUMO

INTRODUCTION: Inflammation plays a major role in the development of atherosclerosis and cardiovascular morbidity and mortality in chronic kidney disease (CKD) patients. Toll-like receptor-4 (TLR4) is a major receptor for lipopolysaccharides (endotoxin) and other ligands involved in the pathogenesis of inflammation. We determined whether endotoxin levels and the presence of TLR4 polymorphisms are associated with markers of inflammation and atherosclerosis among South African CKD patients. MATERIALS AND METHODS: Endotoxin, lipopolysaccharide binding protein (LBP), serum CD14 (sCD14), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1) and carotid intima media thickness (CIMT) were measured in 160 participants (120 CKD patients and 40 controls). Associations between endotoxins and CIMT in the presence of sCD14, IL-8 and MCP-1, were assessed using odds ratios. Participants were screened for the presence of Asp299Gly and Thr399Ile TLR4 polymorphisms, and CIMT and inflammatory markers were compared between subjects with and without TLR4 polymorphisms. RESULTS: Endotoxin levels correlated with sCD14 (r = 0.441, p<0.001) and MCP-1 (r = 0.388, p<0.001) levels while increased CIMT was associated with MCP-1 (r = 0.448, p<0.001), sCD14 levels (r = 0.476, p<0.001), LBP (r = 0.340, p<0.001), and IL-8 (r = 0.395, p<0.001). Atherosclerosis was associated with endotoxin levels (odds ratio: 4.95; 95% confidence interval: 2.52-9.73; p<0.001), and was predicted by higher serum levels of inflammatory markers. Analysis of patients with TLR4 polymorphisms showed reduced serum levels of inflammatory markers and CIMT values compared with the patients carrying the wild type TLR4 alleles. CONCLUSION: The study demonstrated associations between circulating endotoxaemia, systemic inflammation and accelerated atherosclerosis among South African CKD patients, and showed that the atherogenic predictive power of endotoxaemia was significantly increased by the presence of elevated levels of inflammatory markers. Additional findings, which must be confirmed, suggest that TLR4 polymorphisms are associated with low levels of inflammatory markers and CIMT values.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Aterosclerose/complicações , Grupos Populacionais/estatística & dados numéricos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Adulto , Espessura Intima-Media Carotídea , Estudos de Coortes , Suscetibilidade a Doenças , Feminino , Genótipo , Humanos , Inflamação/complicações , Masculino , Polimorfismo Genético , Insuficiência Renal Crônica/genética , Insuficiência Renal Crônica/metabolismo , Risco , Receptor 4 Toll-Like/genética
15.
Anatol J Cardiol ; 24(1): 62-63, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628151
16.
PLoS One ; 15(7): e0236151, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726349

RESUMO

BACKGROUND: Fuels burned in households for cooking cause indoor air pollution, exposing those who are cooking. Despite the mounting evidence of the effects of fuels use on health, few studies focus on the effect of cooking fuels have on carotid intima-media thickness (CIMT), a surrogate atherosclerosis biomarker in the early stages of pregnancy. This study aimed to examine the association between the use of cooking fuels and CIMT during early trimester of pregnancy among cooking women in Myanmar. METHODOLOGY: In this cross-sectional study, a part of an ongoing birth cohort analysis, a total of 192 cooking pregnant women over 18 years with gestational weeks less than 18 were recruited from 15 rural health centers in Nay Pyi Taw from September to November 2019. Sociodemographic data, residential data, and fuels use data were collected with semi-structured questionnaires in face-to-face interviews. Anthropometric, hemodynamic, blood lipids, and ultrasound CIMT measurements were performed under standard protocols. Multiple linear regression was modeled to explore associations. RESULTS: The study included 70 firewood fuel users, 26 charcoal fuel users, and 96 electricity fuel users. Following adjustments for potential confounding factors, firewood use was significantly associated with the increase of all CIMT analyzed. Importantly, a greater increase of mean CIMT of the right common carotid artery (RCCA; ß = 0.033 mm; 95%CI: 0.006, 0.058; P<0.05) had significant association with charcoal use compared to firewood use (ß = 0.029 mm; 95%CI: 0.010, 0.049; P<0.05). CONCLUSIONS: Our findings demonstrate that the indoor use of cooking fuels that cause indoor air pollution, such as firewood and charcoal, is a considerable risk factor for human health and is associated with increased CIMT, wherein charcoal use contributes to more increase of mean CIMT of the RCCA. Measures to prevent health risks related to the use of such fuels should be instituted early on during pregnancy.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Aterosclerose/epidemiologia , Espessura Intima-Media Carotídea , Culinária/métodos , Exposição por Inalação/efeitos adversos , Fumaça/efeitos adversos , Adulto , Aterosclerose/induzido quimicamente , Estudos Transversais , Características da Família , Feminino , Humanos , Incidência , Mianmar/epidemiologia , Gravidez , Fatores de Risco
17.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32632021

RESUMO

OBJECTIVES: To examine how overweight and obesity at specific ages and overall BMI growth patterns throughout childhood predict cardiometabolic phenotypes at 11 to 12 years. METHODS: In a population-based sample of 5107 infants, BMI was measured every 2 years between ages 2 to 3 and 10 to 11 years. We identified 5 BMI trajectories using growth curve models. At ages 11 to 12 years, 1811 children completed assessments for metabolic syndrome risk scores, carotid-femoral pulse wave velocity, and carotid intima-media thickness. Multivariable regression models were used to estimate associations, adjusted for potential confounders (eg, age, sex, smoking exposure, and small for gestational age). RESULTS: Overweight and obesity from early childhood onward were strongly associated with higher cardiometabolic risk at 11 to 12 years of age. At age 6 to 7 years, compared with those with a healthy weight, children with overweight had higher metabolic syndrome risk scores by 0.23 SD units (95% confidence interval 0.05 to 0.41) and with obesity by 0.76 SD units (0.51-1.01), with associations almost doubling by age 10 to 11 years. Obese (but not overweight) children had higher outcome pulse wave velocity (0.64-0.73 SD units) from ages 6 to 7 years and slightly higher outcome carotid intima-media thickness (0.20-0.30 SD units) at all ages. Cumulative exposure to high BMI from 2 to 3 years of age carried the greatest cardiometabolic risk, with a gradient of risk across trajectories. CONCLUSIONS: High early-childhood BMI is already silently associated with the development of cardiometabolic risk by 11 to 12 years, highlighting the urgent need for effective action to reduce overweight and obesity in early childhood.


Assuntos
Índice de Massa Corporal , Diagnóstico Precoce , Programas de Rastreamento , Obesidade Pediátrica/epidemiologia , Austrália/epidemiologia , Espessura Intima-Media Carotídea , Criança , Pré-Escolar , Fatores de Confusão Epidemiológicos , Metabolismo Energético , Feminino , Seguimentos , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Recém-Nascido Pequeno para a Idade Gestacional , Masculino , Síndrome Metabólica/epidemiologia , Sobrepeso/epidemiologia , Pandemias , Fenótipo , Análise de Onda de Pulso , Risco
18.
Saude e pesqui. (Impr.) ; 13(2): 411-419, abr.-jun. 2020. tab, ilus
Artigo em Português | LILACS | ID: biblio-1103985

RESUMO

O objetivo foi avaliar se a espessura íntima carotídea está associada à vitamina D, perfil glicêmico e antropométrico. Foram coletados dados pessoais, antropométricos, bioquímicos e laudo de ultrassonografia carotídea, o qual foi utilizado a fim de avaliar o espessamento em milímetros e constatar ou não placas ateroscleróticas. As variáveis estudadas foram tratadas com o coeficiente de correlação de Pearson, ANOVA e Kruskal-Wallis. A média do IMC dos 51 pacientes foi de 29,47±6,39 kg/m². A espessura carotídea foi ≥1 mm em 54,90%. Quanto à vitamina D, 41,18% apresentaram hipovitaminose. A correlação da espessura carotídea com dados antropométricos, glicemia de jejum e HbA1c foi diretamente proporcional e inversamente com os valores de vitamina D, embora sem diferença significativa. As variáveis estudadas não puderam ser associadas com diferença significativa à espessura da camada média intimal da carótida nesta amostra.


The aim of this study was to evaluate the association of carotid intima thickness with vitamin D, glycemia and anthropometry. Personal, anthropometric and biochemical data, and carotid ultrasound report (to check thickening in millimeters and for the presence of atherosclerotic plaques) were collected. The variables studied were treated with Pearson's correlation coefficient, ANOVA and Kruskal-Wallis. The mean BMI of the 51 patients was 29.47 ± 6.39kg/m². The carotid thickness was ≥1mm in 54.90%. Regarding vitamin D, 41.18% had hypovitaminosis. The carotid thickness was directly proportionally correlated with anthropometric data, fasting blood glucose and HbA1c, and inversely correlated with vitamin D values, although without significant difference. The studied variables were not significantly associated with carotid intima thickness in this sample.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Vitamina D , Glicemia , Artérias Carótidas , Antropometria , Espessura Intima-Media Carotídea
19.
Environ Pollut ; 265(Pt B): 114912, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32540595

RESUMO

Di-(2-ethylhexyl) phthalate (DEHP) has been utilized in many products for years. DEHP exposure has been linked to cardiovascular diseases (CVD) and its risk factors. Recent evidence has found a crucial role for epigenetics, including DNA methylation, in CVD. Moreover, DEHP exposure has proved to alter DNA methylation in epidemiological studies. However, the interplay between DEHP exposure, global DNA methylation, and atherosclerosis has never been reported. In this current study, we enrolled 793 participants (12-30 years) from a Taiwanese population to investigate the association between concentrations of DEHP metabolites, 5mdC/dG (global DNA methylation marker) and the carotid intima-media thickness (CIMT). The results showed urine mono-2-ethylhexyl phthalate (MEHP) level was positively correlated with 5mdC/dG and CIMT, respectively. In logistic regression models, the odds ratios (OR) of thicker CIMT (greater than 75th percentile) with one unit increase in ln-MEHP level was higher when levels of 5mdC/dG were above 50%. In structural equation model, the result showed urine MEHP levels are directly associated with CIMT. Moreover, MEHP had an indirect association with CIMT through the 5mdC/dG after adjusting other confounding effects. In the current study, urine DEHP metabolite levels were positively correlated with 5mdC/dG, and CIMT. Our results showed DEHP had a direct and indirect association with CIMT through the 5mdC/dG. The finding implies that DNA methylation may mediate the association between DEHP exposures and subclinical atherosclerosis in this young population. Future effort is needed to elucidate the causal relationship between DEHP exposure, DNA methylation and CVD.


Assuntos
Aterosclerose , Dietilexilftalato , Ácidos Ftálicos , Espessura Intima-Media Carotídea , Metilação de DNA , Humanos
20.
Neurol Neurochir Pol ; 54(4): 323-328, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32510570

RESUMO

Atrial fibrillation (AF) and atherosclerotic disease are independent risk factors for acute ischaemic stroke (AIS). The optimal biological marker which could allow differentiation between AF and non-AF AIS patients is still not available. AIM OF THE STUDY: Aim of the present study was to investigate the role of pentosidine as a potential biological marker for AF in an AIS patient group. MATERIALS AND METHODS: Sixty-three acute ischaemic hemispheric stroke patients were recruited and divided into two groups according to the presumed underlying mechanism: with or without atrial rhythm disorders. Ten healthy volunteers were a reference group for serum level of pentosidine. Carotid artery ultrasound was performed, and common carotid artery stiffness and intima-media thickness were measured. Serum levels of pentosidine and selected routine biochemical risk factors for atherosclerosis (cholesterol and its lipoprotein fractions, homocysteine) were examined. RESULTS: A higher serum level of pentosidine was observed in patients without atrial fibrillation (1,509 ± 485.13pmol/ml); a statistically significant difference was observed compared to the reference group (1,041.52 ± 411.17pmol/ml; p = 0.01), but not the AF patients (1,438.19 ± 495.97pmol/ml; p = 0.59). No significant difference in the non-AF group compared to the AF group for carotid intima-media thickness (IMT)/stiffness and pentosidine serum level was recorded. CONCLUSIONS AND CLINICAL IMPLICATIONS: A higher serum level of pentosidine was observed in AIS patients without atrial fibrillation compared to the healthy volunteers. According to the results of the present study, no difference between these patients in the selected risk factors of atherosclerosis were observed. Further studies are needed to identify a reliable marker of AF that would bring added value to the standard diagnostic workup after acute ischaemic stroke.


Assuntos
Fibrilação Atrial , Isquemia Encefálica , Acidente Vascular Cerebral , Arginina/análogos & derivados , Espessura Intima-Media Carotídea , Humanos , Lisina/análogos & derivados , Fatores de Risco
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