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2.
Medicine (Baltimore) ; 98(39): e17297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574853

RESUMO

As a modifiable risk factor for cardiovascular disease, presence of hypertension (HT) necessitates the awareness of asymptomatic organ damage (AOD). The aim of this study was to measure plasma micro RNA-21 (miR-21) and the parameters that reflect AOD such as carotid intima-media thickness (CIMT), microalbuminuria (MAU) in hypertensive patients compared with healthy controls. In addition, the aim of this study was to evaluate plasma miR-21 levels in HT patients with AOD.This study was designed as a cross-sectional observational study. The study includes 2 groups: 32 patients with HT and 32 healthy controls. First, we compared these 2 groups. Then, to underline the relationship between plasma miR-21 and HT, hypertensive patients were divided into 2 groups: with AOD and without AOD.Sixteen patients with HT had AOD. MiR-21 levels significantly correlated with clinical systolic and diastolic blood pressure, MAU, C-reactive protein, and CIMT. CIMT, miR-21, and MAU levels were significantly higher in patients with AOD.Our study showed increased miR-21 levels in HT patients with AOD.


Assuntos
Albuminúria , Doenças Cardiovasculares , Hipertensão , MicroRNAs/sangue , Adulto , Albuminúria/diagnóstico , Albuminúria/etiologia , Doenças Assintomáticas/epidemiologia , Pressão Sanguínea/fisiologia , Proteína C-Reativa/análise , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , MicroRNA Circulante/análise , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/genética , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia
3.
Rev Assoc Med Bras (1992) ; 65(8): 1042-1047, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31531599

RESUMO

BACKGROUND: We investigated the serum annexin V and anti-annexin V levels and their relationship with metabolic parameters in patients recently diagnosed type 2 diabetic. METHODS: A total of 143 patients recently diagnosed type 2 diabetes and 133 control subjects were included in the study. Body mass index (BMI), hs-CRP, HOMA-IR, carotid intima-media thickness, and serum levels of annexin V and anti-annexin V were investigated. RESULTS: HOMA-IR, serum hs-CRP, and carotid intima-media thickness were found to be statistically significant. The Pearson correlation analysis revealed a statistically significant positive relationship between the carotid intima-media thickness and the annexin V level (r=0.29, p=0.006*). A statistically significant positive relationship was also detected between the Annexin V level and level of serum hs-CRP (r=0.29 p=0.006*). CONCLUSION: A positive relationship was observed between the carotid intima-media thickness and annexin V at the end of our investigation. In this regard, we also believe that serum levels of annexin V may be increased for cardiovascular protection in the elevation of carotid intima-media thickness.


Assuntos
Anexina A5/sangue , Autoanticorpos/sangue , Diabetes Mellitus Tipo 2/sangue , Adulto , Idoso , Anexina A5/imunologia , Anexina A5/metabolismo , Índice de Massa Corporal , Espessura Intima-Media Carotídea , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Homeostase , Humanos , Masculino , Pessoa de Meia-Idade
6.
Braz J Med Biol Res ; 52(8): e8711, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31389494

RESUMO

Carotid artery assessment by ultrasound is a non-invasive evaluation of subclinical atherosclerosis and a predictor of cardiovascular events. However, ultrasound examinations are operator-dependent. In the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), ultrasound images have been acquired from more than 10,000 participants. In this article, we describe the reproducibility of carotid intima-media thickness (CIMT), carotid plaque detection, and carotid plaque score (defined as the number of arterial sites with plaques) using ELSA-Brasil protocol, in a subset of 118 participants. Two board-certified radiologists and a trained technician read carotid images. We calculated intra- and inter-observer intraclass correlation (ICC) for CIMT values. We also present kappa coefficients for plaque detection and weighted kappa coefficients for carotid plaque score. Participants were aged 58.2±6.6 years, and 60 (50.8%) were men. For common carotid artery CIMT measurements, intra- and inter-observer ICC values were very good to excellent, ranging from 0.90 (95% confidence interval [95%CI]: 0.72-0.95) to 0.98 (95%CI: 0.97-0.99). For carotid plaque, intra- (0.96 [95%CI: 0.96-0.96]) and inter- (0.99 [95%CI: 0.99-0.99]) observer weighted kappa coefficients were very good. Intra- and inter-observer Kappa coefficients for the presence of plaques by site were good to very good, ranging from 0.69 to 1.00. In conclusion, we found very good reproducibility for carotid plaque score and CIMT measurements in the ELSA-Brasil at baseline. These results are comparable to the best findings from similar large cohorts that analyzed carotid ultrasound data.


Assuntos
Aterosclerose/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Placa Aterosclerótica/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Reprodutibilidade dos Testes , Ultrassonografia
7.
Am J Dent ; 32(4): 191-200, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31436940

RESUMO

PURPOSE: To review the literature on the effects of non-surgical periodontal treatment on surrogate markers of cardiovascular diseases (CVDs) and to clarify the impact of periodontal disease on systemic inflammation. METHODS: PRISMA guidelines for systematic reviews and meta-analyses have been adopted. An electronic search in PubMed up to December 2018 was performed using the following search terms and keywords alone or in combination: non surgical periodontal therapy, atherosclerotic vascular disease (AVD), operative surgical procedures, CVD, IL-6, CRP, cholesterol, LDL, oxidized low density lipoprotein, HDL, endothelial dysfunction, dependent dilatation, carotid intima media thickness, periodontitis, tunica intima. RESULTS: The electronic search resulted in the inclusion of 28 articles that were grouped and discussed based on the investigated surrogate markers. Meta-analysis was not carried out due to the heterogeneity of the results. The included studies demonstrated that periodontal treatments contribute to the resolution of oral inflammation and in turn might positively modulate the levels of systemic inflammatory markers. The initial phase of periodontal therapy has a positive impact on the short-term reduction of a series of systemic markers that are considered as surrogate markers of AVD. CLINICAL SIGNIFICANCE: The non-surgical therapy of periodontal disease would positively reduce the levels of systemic inflammation markers, decreasing the vascular risk and the possibility of developing CVD or the subclinical progression of the disease.


Assuntos
Biomarcadores , Doenças Cardiovasculares , Doenças Periodontais , Periodontite , Biomarcadores/análise , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico , Espessura Intima-Media Carotídea , Humanos , Doenças Periodontais/complicações , Doenças Periodontais/terapia , Periodontite/complicações , Periodontite/terapia
8.
Medicine (Baltimore) ; 98(34): e16966, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441902

RESUMO

The importance of optimal blood pressure control for preventing or reducing the impairment of vascular and cognitive functions is well known. However, the reversibility of early alterations in vascular and cognitive functions through antihypertensive agents is under-investigated. In this study, we evaluated the influence of 3 months of angiotensin-converting enzyme (ACE) inhibition treatment on the morphological and functional arterial wall and cognitive performance changes in 30 newly diagnosed primary hypertensive patients.Common carotid intima-media thickness (IMT) and brachial artery flow-mediated dilatation (FMD) were detected by ultrasonography. Arterial stiffness indicated by augmentation index (AIx) and pulse wave velocity (PWV) was assessed by arteriography. Cognitive functions were assessed by neuropsychological examination.The executive function overall score was significantly higher at 3-month follow-up than at baseline (median, 0.233 (IQR, 0.447) vs -0.038 (0.936); P = .001). Three-month ACE inhibition did not produce significant improvement in IMT, FMD, AIx and PWV values. Significant negative associations were revealed between IMT and complex attention (r = -0.598, P = .0008), executive function (r = -0.617, P = .0005), and immediate memory (r = -0.420, P = .026) overall scores at follow-up. AIx had significant negative correlations with complex attention (r = -0.568, P = .001), executive function (r = -0.374, P = .046), and immediate memory (r = -0.507, P = .005). PWV correlated significantly and negatively with complex attention (r = -0.490, P = .007).Timely and effective antihypertensive therapy with ACE inhibitors has significant beneficial effects on cognitive performance in as few as 3 months. Early ACE inhibition may have an important role in the reversal of initial impairments of cognitive function associated with hypertension-induced vascular alterations.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/farmacologia , Cognição/efeitos dos fármacos , Rigidez Vascular/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Adulto , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Artéria Braquial/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Feminino , Seguimentos , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
9.
Neoplasma ; 20192019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31305124

RESUMO

Long-term survivors of Hodgkin lymphoma during childhood or adolescence (HL survivors) are at high risk of developing treatment-related late cardiovascular sequelae. In our study we evaluated the presence of modifiable cardiovascular risk factors (hypertension, hyperlipoproteinemia, hyperinsulinemia, obesity), endothelial and inflammatory markers (E-selectin, PAI-1, hs-CRP) and atherosclerotic changes in the common carotid arteries. Assessment was performed in 80 young adult Hodgkin lymphoma long-term survivors at more than 10 years after the potentially cardiovascular toxic anticancer treatment (median age at evaluation 34.7 years; range 24.1-40.9 years). The HL survivors were compared with 83 age- and gender-matched healthy volunteers. The HL survivors showed unfavorable lipid profiles compared to those of healthy controls: triglycerides (p=0.01), total cholesterol (p=0.0004), low density lipoprotein cholesterol (p=0.005). In HL survivors, we found a higher prevalence of hypertension (p=0.004) and insulin resistance - HOMA-IR (p=0.0002). Ultrasonographic examination of both common carotid arteries revealed a higher prevalence of atherosclerotic plaques (p=0.0009) and higher carotid intima-media thickness (p<0.0001) in HL survivors. Markers of oxidative stress (advanced oxidation protein products, oxidized low-density lipoprotein), inflammation (hs-CRP) and endothelial dysfunction (E-selectin, PAI-1) were also higher in HL survivors (p<0.0001, p=0.0002, p=0.0031, p=0.0087, p=0.004, respectively). Adult survivors of Hodgkin lymphoma during childhood and adolescence need closer follow-up with screening of metabolic syndrome components, unfavorable lifestyle factors and early management of these risk factors.


Assuntos
Aterosclerose , Doença de Hodgkin , Hiperlipoproteinemias , Resistência à Insulina , Adolescente , Adulto , Aterosclerose/etiologia , Aterosclerose/fisiopatologia , Espessura Intima-Media Carotídea , Criança , Doença de Hodgkin/complicações , Humanos , Hiperlipoproteinemias/etiologia , Hiperlipoproteinemias/fisiopatologia , Sobreviventes , Adulto Jovem
10.
Biomed Environ Sci ; 32(6): 446-453, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31262390

RESUMO

OBJECTIVE: This study aimed to investigate the relationship between alkaline phosphatase (ALP) and common carotid intima media thickness (IMT), carotid plaque, and extracranial carotid artery stenosis (ECAS). METHODS: A total of 3,237 participants aged ⪖ 40 years were recruited from Jidong community in 2013-2014. Participants were divided into five quintile groups based on their serum ALP levels. Carotid atherosclerosis was assessed using ultrasound. Abnormal IMT, carotid plaque, and ECAS were defined as IMT > 0.9 mm, IMT > 1.5 mm, and ⪖ 50% stenosis in at least one extracranial carotid artery, respectively. RESULTS: Common carotid IMT values and the prevalence of carotid plaque increased across serum ALP quintiles. Higher ALP quintiles were correlated with an increased risk of abnormal IMT [fourth quintile: odds ratio (OR) 1.78, 95% confidence interval (CI) 1.13-2.82, P = 0.0135; fifth quintile: OR = 1.82, 95% CI: 1.15-2.87, P = 0.0110] and ECAS compared to the lowest quintile (fifth quintile: OR = 1.47, 95% CI: 1.09-1.97, P = 0.0106). The association between ALP and prevalence of carotid plaque became insignificant after adjustment for confounders. CONCLUSION: Serum ALP levels were independently associated with abnormal common carotid IMT and ECAS. These conclusions need to be further corroborated in future prospective cohort studies.


Assuntos
Fosfatase Alcalina/sangue , Doenças das Artérias Carótidas/sangue , Estenose das Carótidas/sangue , Adulto , Idoso , Doenças das Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
Braz J Med Biol Res ; 52(7): e8432, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314853

RESUMO

Peripheral arterial disease (PAD) can impair healing of diabetic foot (DF) in patients with diabetes mellitus. To determine whether carotid intima-media thickness (CIMT) can predict lower limb arterial lesions in patients with DF, this cross-sectional study enrolled patients with DF at West China Hospital (China) between January 2012 and December 2015. Ultrasonography was used to measure CIMT, assess the internal carotid arteries (ICA) for plaques, and evaluate lower limb segmental arteries for stenosis. The optimal CIMT cutoff for detecting lower limb PAD was determined by receiver operating characteristic (ROC) curve analysis. Factors associated with PAD were identified by logistic regression analyses. A total of 167 patients (mean age: 69.7±10.3 years; 102 men) were included. Patients with PAD were older and had higher levels of total cholesterol and low-density lipoprotein than patients without PAD (P<0.05). The area under the ROC curve was 0.747 (P<0.001). At the optimal CIMT cutoff of 0.71 mm, the sensitivity, specificity, positive predictive value, and negative predictive value were 79.65, 61.11, 81.08, and 58.93%, respectively. Compared with those without PAD, more patients with PAD had CIMT ≥0.71 mm (79.65 vs 38.89%; P<0.001) and ICA plaques (66.37vs 11.11%; P<0.001). Multivariate logistic regression revealed that age (odds ratio [OR]: 1.118; 95% confidence interval [95%CI]: 1.056-1.183; P<0.001), ICA plaques (OR: 13.452; 95%CI: 4.450-40.662; P<0.001), and CIMT ≥0.71 mm (OR: 2.802; 95%CI: 1.092-7.188; P=0.032) were associated with PAD.CIMT may be a surrogate marker of PAD in patients with DF.


Assuntos
Doenças das Artérias Carótidas/complicações , Espessura Intima-Media Carotídea/efeitos adversos , Pé Diabético/etiologia , Extremidade Inferior/irrigação sanguínea , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/patologia , Estudos Transversais , Feminino , Humanos , Extremidade Inferior/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos
12.
Zhongguo Zhen Jiu ; 39(7): 703-7, 2019 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-31286730

RESUMO

OBJECTIVE: To observe the characteristics of carotid intima-media thickness (IMT) and cerebral blood flow velocity in patients with mild-to-moderate hypertension, and to evaluate the effects of acupuncture on carotid IMT and blood flow velocity of middle cerebral artery and vertebral-basilar artery. METHODS: A total of 240 patients with mild-to-moderate hypertension who met the inclusion criteria were treated with Huoxue Sanfeng acupuncture method proposed by academician SHI Xue-min. The acupoints of Renying (ST 9), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3) were selected. The treatment was given once a day, five times a week for 3 months. The carotid ultrasonography and transcranial color Doppler were performed before treatment and 3 months after treatment to evaluate the improvements of carotid IMT and brain blood flow velocity. RESULTS: Among 175 patients, 94.3% suffered from impaired carotid IMT. After acupuncture intervention, 7.7%-10.9% patients had improved IMT but 4.6%-6.3% had aggravated carotid IMT. There was no significant difference of carotid IMT before and after treatment (P>0.05). About 50% patients had abnormal intracranial blood flow velocity; after acupuncture intervention, 27.4%-33.3% patients who had the abnormal blood flow velocity had normal one, but 27.0%-52.5% patients who had normal blood flow velocity had abnormal one. After acupuncture intervention, the low-speed blood flow of MCA, VA and BA in female patients aged 41-60 years and the low-speed blood flow of MCA and VA in female patients aged 61-70 years were significantly improved (all P<0.05); the high-speed blood flow of MCA and VA in male patients aged 61-70 years and the high-speed blood flow of VA and BA in female patients aged 41-60 years were significantly decreased (all P<0.05). CONCLUSION: Nearly 95% of patients with mild-to-moderate hypertension had carotid IMT, and about 50% had abnormal blood flow velocity of intracranial artery. The present study failed to found significant effects of acupuncture on carotid IMT, but it shows acupuncture can generally improve the low blood flow velocity in women with mild-to-moderate hypertension.


Assuntos
Terapia por Acupuntura , Hipertensão , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Espessura Intima-Media Carotídea , Circulação Cerebrovascular , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 692-695, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288339

RESUMO

Objective: To examine the association of abnormal metabolic indexes and its clustering with carotid intima-media thickness (cIMT) in childhood. Methods: A convenient sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 240 children who had complete data of questionnaires, physical examinations, and blood biochemical tests were included for analysis. Covariance analysis was used to analyze the association of the single abnormal metabolic indices and its clustering with cIMT. The multivariable linear regression model was used to quantify the relationship between the number of abnormal metabolic indices and cIMT. Results: The age of 1 240 children was (8.9±1.5) years, and 657 boys accounted for 53.0%. The highest detection rate of abnormal metabolic indicators was found in abdominal obesity, accounting for 30.9% (203/657) of boys and 29.7% (173/583) girls respectively.The cIMT of boys and girls were (0.49±0.08) and (0.45±0.07) mm, respectively. After adjusting for sex, age, consumption of fruits, vegetables and carbonated drinks, sleep duration, screen time and physical activity, abdominal obesity, elevated blood pressure, total triglyceride and fasting glucose were associated with cIMT (all P values <0.001). Children with 0, 1, 2 and ≥3 abnormal metabolic indicators had cIMT values of (0.45±0.07), (0.48±0.08), (0.50±0.09) and (0.53±0.08) mm, respectively. That was, cIMT values increased with the number of abnormal metabolic indexes (P(trend)<0.001). Conclusion: Abdominal obesity, elevated blood pressure, total triglyceride, fasting glucose and clustering of the above factors are associated with cIMT.


Assuntos
Espessura Intima-Media Carotídea/estatística & dados numéricos , Doenças Metabólicas/epidemiologia , Criança , China/epidemiologia , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco
14.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 696-700, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288340

RESUMO

Objective: To develop the reference values of carotid intima-media thickness (cIMT) in Chinese children aged 6-11 years. Methods: A convenient cluster sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 033 children aged 6-11 years (excluding children with obesity or hypertension) were included. Percentile curves for cIMT were drawn using the lambda, mu and sigma (LMS) method. Results: This study developed the cIMT reference values (P(90) and P(95)) for sex and age aged 6-11 years, including P(90) and P(95) reference values of mean cIMT, left cIMT and right cIMT, respectively. With the increase of age, the cIMT percentile values also increased. For the same age and the same percentile, the cIMT values of boys were higher than those of girls. Conclusion: This study developed sex-specific and age-specific cIMT percentile reference values in children aged 6-11 years.


Assuntos
Espessura Intima-Media Carotídea , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Valores de Referência
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 731-736, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288346

RESUMO

Childhood obesity has been an important public health issue worldwide. We searched PubMed, CNKI, and Wanfang databases to perform a systematic review of how to identify early target organ (including heart, vessel, kidney and liver etc) damage in children, the effects of obesity on early target organ damage (including left ventricular hypertrophy, left ventricular diastolic dysfunction, increased carotid intima-media thickness, increased arterial stiffness, impaired glomerular filtration rate, and non-alcoholic fatty liver disease, etc), the possible biological mechanisms (including hemodynamic changes, abnormal metabolic indices, and effects of cytokines and inflammatory factors, etc), and the effects of exercise training and dietary interventions on target organ damage in obese children. Thus, it is important to take effective measures to prevent and control childhood obesity, and finally to reduce the prevalence of target organ damage.


Assuntos
Obesidade Pediátrica/fisiopatologia , Espessura Intima-Media Carotídea/estatística & dados numéricos , Criança , Taxa de Filtração Glomerular/fisiologia , Humanos , Hipertrofia Ventricular Esquerda/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Rigidez Vascular/fisiologia , Disfunção Ventricular Esquerda/epidemiologia
16.
Zhonghua Er Ke Za Zhi ; 57(6): 471-476, 2019 Jun 02.
Artigo em Chinês | MEDLINE | ID: mdl-31216806

RESUMO

Objective: To examine the plasma fibroblast growth factor-23 (FGF-23) concentration in children with primary hypertension and to investigate the association between plasma FGF-23 and subclinical cardiovascular damages,and to identify its predictive value for diagnosis. Methods: With prospective study,77 patients (61 males and 16 females) who were diagnosed as primary hypertension with the average age of (11.8±2.2) years were enrolled with informed consent in Children's Hospital,Capital Institute of Pediatrics from October 2016 to December 2017. Carotid wall intima-media thickness (cIMT) measured by Doppler ultrasound and left ventricular hypertrophy (LVH) identified by echocardiography were assessed as parameters of subclinical cardiovascular damages. Patients were divided into increased cIMT group (n=18) and normal cIMT group (n=46) (64 patients with complete data of cIMT). According to left ventricular geometry,patients were divided into LVH group (n=27) and normal geometry group (n=50). Concentration of plasma FGF-23 was detected in all children by enzyme linked immunosorbent assay test. Mann-Whitney U test was used to compare plasma levels of FGF-23 between groups. Kendall's tau-b correlation coefficient was used to analyze the correlation between plasma FGF-23 and cIMT/LVH. Receiver operating characteristic (ROC) curve was used to analyze the value of plasma FGF-23 in the prediction of subclinical cardiovascular damage. Results: The concentration of plasma FGF-23 in the increased cIMT group was higher than that in the normal cIMT group (55.6 (46.2,63.5) vs. 48.6 (39.4, 57.3) ×10(3) RU/L, Z=-2.143, P=0.032) . Also, plasma FGF-23 showed positive correlation with cIMT(r=0.222, P=0.032). According to ROC curve analysis,the cutoff value of plasma FGF-23 for prediction of increased cIMT was 53.9×10(3) RU/L (55.6% sensitivity and 71.7% specificity). The concentration of plasma FGF-23 in the LVH group was significantly higher than that in normal geometry group (55.0 (46.8, 65.7) vs. 48.2 (39.5, 56.0)×10(3) RU/L, Z=-2.375, P=0.018). And,plasma FGF-23 was correlated positively with LVH (r=0.224, P=0.018). The concentration of plasma FGF-23 in patients with concentric remodeling (n=10) was significantly higher than that of the normal geometry group (56.9 (49.6, 66.3) vs. 48.2 (39.5,56.0) ×10(3) RU/L, Z=-2.093, P=0.036). According to ROC curve analysis,the cutoff value of plasma FGF-23 for prediction of LVH was 49.1×10(3) RU/L (70.4% sensitivity and 60.0% specificity). Conclusion: The concentration of plasma FGF-23 in children with primary hypertension was correlated positively with LVH and cIMT and had certain predictive value of diagnosis for subclinical cardiovascular damages.


Assuntos
Artérias Carótidas/diagnóstico por imagem , Fatores de Crescimento de Fibroblastos/sangue , Hipertensão/diagnóstico , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Adolescente , Biomarcadores/sangue , Espessura Intima-Media Carotídea , Criança , Ecocardiografia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Hipertensão/sangue , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Túnica Íntima/diagnóstico por imagem , Túnica Média/diagnóstico por imagem , Ultrassonografia Doppler
17.
Vasc Health Risk Manag ; 15: 101-107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31190848

RESUMO

Introduction: Theoretically, first-degree relatives (FDRs) of type 2 diabetes mellitus (T2DM) are predisposed to have earlier and more severe atherosclerosis than non-FDR due to hereditary insulin resistance. A previous study reported that atherosclerotic plaques were found in 45.2% of young adults FDR of T2DM, but the study did not include non-FDR as control group. The aim of this study was to compare subclinical atherosclerosis (carotid intima-media thickness, CIMT) between FDR of T2DM and non-FDR. Method: This was a cross-sectional study involving 16 FDR subjects and 16 age-sex matched non-FDR subjects, aged 19-40 years, with normal glucose tolerance and no hypertension. Collected data included demographic characteristic, anthropometric measurement (BMI and waist circumference), laboratory analysis (fasting blood glucose, HbA1c, lipid profile), and CIMT examination (using B-mode ultrasound). Results: The mean of CIMT in the FDR group was higher than that in the non-FDR group (0.44 mm vs 0.38 mm, p=0.005). After adjusting for waist circumference, BMI, low-density lipoprotein cholesterol, and triglyceride, CIMT maintained significant difference between FDR and non-FDR subjects. BMI and waist circumference showed moderate correlation with CIMT. Conclusion: CIMT in young adult FDR of T2DM is thicker than that in age-and sex-matched non-FDR population.


Assuntos
Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Diabetes Mellitus Tipo 2/genética , Adulto , Doenças Assintomáticas , Biomarcadores/sangue , Glicemia/análise , Pressão Sanguínea , Artérias Carótidas/patologia , Doenças das Artérias Carótidas/genética , Doenças das Artérias Carótidas/patologia , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Predisposição Genética para Doença , Hereditariedade , Humanos , Masculino , Linhagem , Fenótipo , Placa Aterosclerótica , Valor Preditivo dos Testes , Fatores de Risco , Adulto Jovem
18.
Angiology ; 70(10): 929-937, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31234636

RESUMO

The morphology and function of the arteries can be directly measured using different established methods. This prospective cohort study aimed to translate 2 of these, aortic pulse wave velocity (aPWV) and carotid intima-media thickness (cIMT), into a combined Vascular Aging Index (VAI) and then evaluate the predictive power of aPWV, cIMT, and VAI. Patients (n = 2718) were included from the cardiovascular arm of the Malmö Diet and Cancer Study (median age 71.9 years, 62.2% females). Total follow-up time was 16 448 person-years and a composite cardiovascular disease (CVD) end point was used. Cox regressions yielded adjusted hazard ratios (95% confidence interval) per 1 standard deviation increment of loge aPWV, loge cIMT, and loge VAI of 1.25 (1.08-1.45, P = .003), 1.27 (1.13-1.44, P < .001), and 1.45 (1.26-1.68, P < .001), respectively. The C-statistics increased from 0.714 to 0.734 when adding aPWV and cIMT to a model of conventional risk factors. Net Reclassification Index also showed a significant (P < .001) improvement for the classification of event-free patients and no change for patients with events. A VAI based on aPWV and cIMT had a good predictive performance. Used together, aPWV and cIMT incrementally and significantly improve the prediction of CVD events by correctly down-adjusting the predicted risk for noncases.


Assuntos
Envelhecimento , Aorta/fisiopatologia , Doenças Cardiovasculares/mortalidade , Espessura Intima-Media Carotídea/mortalidade , Idoso , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Análise de Onda de Pulso/métodos , Fatores de Risco , População Urbana/estatística & dados numéricos
19.
Kardiologiia ; 59(5): 45-52, 2019 May 25.
Artigo em Russo | MEDLINE | ID: mdl-31131767

RESUMO

AIM: to assess possibility of the use of carotid wall shear rate (WSR) as a marker of systemic atherosclerosis and atherosclerotic cardiovascular disease (ASCVD). MATERIALS AND METHODS: We included into this study 200 patients with different cardiovascular risk (142 patients already had one or more ASCVD). All patients underwent ultrasound scanning of carotid and lower limb arteries with measurement of the ankle-brachial index. Carotid WSR was determined during ultrasonic scanning of carotid arteries in accordance with the Hagen-Poiseuille law. RESULTS: Mean WSR value in this cohort of patients was 434±139 s-1. Based on the results of the ROCanalysis, it was found that WSR below the threshold value of 300 s-1 allowed to predict the presence of ASCVD with sensitivity of 97.1 % and specificity of 84.6 %. WSR <300 s-1 was associated with relative risk (RR) of ASCVD presence 11.2 (95 % CI 1.26-99.3, p=0.03), adjusted for factors such as sex, age, smoking, obesity, hypertension, estimated glomerular filtration rate (eGFR), low density lipoprotein cholesterol, and high sensitivity C-reactive protein, carotid intima-media thickness. The model which included carotid WSR, as well as factors such as the presence of type 2 diabetes, obesity, sex, age, eGFR, allowed to diagnose combined atherosclerotic lesions of peripheral arteries with a sensitivity of 73.1 % and a specificity of 90.3 %. CONCLUSION: Evaluation of the carotid WSR allows to diagnose with satisfactory sensitivity and specificity the presence of combined atherosclerosis of peripheral arteries and ASCVD.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Doenças das Artérias Carótidas , Diabetes Mellitus Tipo 2 , Artérias Carótidas , Espessura Intima-Media Carotídea , Humanos , Fatores de Risco
20.
J Stroke Cerebrovasc Dis ; 28(7): 1816-1823, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31080137

RESUMO

OBJECTIVE: To study the inflammatory mechanism of hyperhomocysteinemia on large-artery atherosclerosis based on hypersensitive C-reactive protein in patients. METHODS: In all, 153 inpatients and 1357 physical examinees were selected. The levels of homocysteine were compared between the carotid/intracranial artery stenosis group and the nonstenosis group, between the carotid artery unstable plaque group and the nonplaque group, and between the intima-media thickness (IMT) greater than or equal to 1 group and the normal IMT group. The hypersensitive C-reactive protein levels were compared between the lacunar infarction (LI) group and the nonstroke control group and between the unstable plaque group and the nonplaque group. RESULTS: Homocysteine level was significantly higher in the carotid/intracranial artery stenosis group than in the nonstenosis group, in the LI group than in the inpatient nonstroke group, and in the IMT greater than or equal to 1 group than in the normal IMT group. The hypersensitive C-reactive protein level was significantly higher in the LI group than in the nonstroke group and in the unstable plaque group than in the nonplaque group. CONCLUSIONS: Hyperhomocysteinemia may aggravate the development of IMT, carotid atherosclerotic plaque instability, and carotid/intracranial artery stenosis by increasing inflammation, ultimately leading to the occurrence of LI. Hyperhomocysteinemia-induced inflammation mechanism warrants further study.


Assuntos
Proteína C-Reativa/análise , Estenose das Carótidas/sangue , Homocisteína/sangue , Hiper-Homocisteinemia/sangue , Mediadores da Inflamação/sangue , Inflamação/sangue , Arteriosclerose Intracraniana/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Espessura Intima-Media Carotídea , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/etiologia , Estudos de Casos e Controles , China , Feminino , Humanos , Hiper-Homocisteinemia/complicações , Hiper-Homocisteinemia/diagnóstico , Inflamação/diagnóstico , Inflamação/etiologia , Arteriosclerose Intracraniana/diagnóstico por imagem , Arteriosclerose Intracraniana/etiologia , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica , Prognóstico , Fatores de Risco , Ruptura Espontânea , Índice de Gravidade de Doença
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