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Sonaglioni A, Piergallini E, Naselli A, Nicolosi GL, Ferrulli A, Bianchi S, Lombardo M, Ambrosio G. The effect of gestational diabetes mellitus on carotid artery intima-media thickness in and after pregnancy: a systematic review and meta-analysis. Acta Diabetol 2024; 61:139-149. [PMID: 37936027 DOI: 10.1007/s00592-023-02206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
AIMS The association between gestational diabetes mellitus (GDM) and common carotid artery (CCA) intima-media thickness (IMT) is still controversial. This systematic review and meta-analysis was performed to assess the correlation between GDM and CCA-IMT in and after pregnancy. METHODS PubMed and EMBASE databases were systematically reviewed on April 2023. Studies measuring CCA-IMT in both pregnant women with GDM and women with previous history of GDM (pGDM) vs. healthy controls were included. The subtotal and overall standardized mean differences (SMDs) of CCA-IMT were calculated using the random-effect model. RESULTS Nineteen studies with a total of 302 GDM and 861 pGDM women were analyzed. The average value of CCA-IMT measured in GDM/pGDM (0.59 ± 0.12 mm) was slightly increased in comparison to the accepted reference limits of IMT according to age classes. Substantial heterogeneity was detected for the studies involving both GDM and pGDM women, with an overall statistic I2 of 86.0% (p < 0.001). Large SMDs were obtained for the studies conducted on both GDM and pGDM women, with an overall SMD of 0.89 (95%CI 0.63-1.15, p < 0.001). Egger's test for a regression intercept gave a p-value of 0.37, indicating no publication bias. On meta-regression analysis, all potential confounders (number of patients, age at pregnancy, body mass index, measuring time, follow-up duration and GDM criteria) were not significantly associated with effect modification. CONCLUSIONS GDM in and after pregnancy is independently associated with subclinical atherosclerosis. The association between GDM and carotid remodeling is potentially mediated by the longstanding underlying risk.
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Affiliation(s)
| | | | | | | | - Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Stefano Bianchi
- Division of Gynecology and Obstetrics, IRCCS MultiMedica, Milan, Italy
| | | | - Giuseppe Ambrosio
- Cardiology and Cardiovascular Pathophysiology, Azienda Ospedaliero-Universitaria "S. Maria Della Misericordia", Perugia, Italy
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Cortés-Valencia A, Arvizu M, Monge A, Ortiz-Panozo E, López-Ridaura R, Cantu-Brito C, Chavarro J, Catzin-Kuhlmann A, Fagherazzi G, Yunes E, Lajous M. Sugar- and artificially-sweetened soda consumption and subclinical atherosclerosis among Mexican women. Nutr Metab Cardiovasc Dis 2022; 32:2052-2060. [PMID: 35941038 DOI: 10.1016/j.numecd.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Sugar-sweetened soda consumption is associated with most cardiometabolic risk factors. The role of artificially-sweetened beverages in cardiovascular disease (CVD) is inconclusive, but their consumption correlates with health impairment. Little is known about the contribution of soda consumption in subclinical stages of atherosclerosis. Therefore, we evaluated the relation between sugar- and artificially-sweetened soda consumption and carotid intima-media thickness (IMT) among Mexican women. METHODS AND RESULTS We cross-sectionally evaluated 1093 women enrolled in the Mexican Teachers' Cohort who were free of CVD, diabetes or cancer. Sugar- and artificially-sweetened soda consumption was estimated from a validated 140-item food frequency questionnaire in 2008 and all women underwent a carotid ultrasound assessment three years later. Participants were categorized into tertiles of soda consumption in servings/week. Subclinical atherosclerosis was defined as a mean left and/or right IMT ≥0.8 mm or the presence of plaque on either common carotid artery. In multivariable regression models, women in the highest tertile of sugar-sweetened soda consumption had 2.6% (95%CI: 0.8, 4.5) mean increased IMT, and had 2-fold the risk of carotid atherosclerosis (PR: 2.0, 95%CI: 1.3, 3.2) compared to those in the lowest tertile. In stratified analyses, older and postmenopausal women who consumed sugar-sweetened soda had an increased IMT and atherosclerosis risk. Artificially-sweetened soda consumption was not associated with IMT or carotid atherosclerosis. CONCLUSIONS Sugar-sweetened soda consumption was associated with subclinical atherosclerosis among disease-free Mexican women. Public health strategies to decrease CVD should consider the impact of sugar-sweetened soda consumption, particularly in older women.
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Affiliation(s)
- Adrian Cortés-Valencia
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Ruy López-Ridaura
- National Center for Preventive Programs and Disease Control, Ministry of Health, Mexico
| | - Carlos Cantu-Brito
- Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico; Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Nuevo Leon, Mexico
| | - Jorge Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrés Catzin-Kuhlmann
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Nuevo Leon, Mexico; Department of Medicine, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Guy Fagherazzi
- INSERM (Institut National de la Santé et de la Recherche Médicale), Center for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France; Paris-South University, UMRS, 1018, Villejuif, France
| | - Elsa Yunes
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Martin Lajous
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Cai WB, Wang Y, Wang J, Guo WG, Duan YY, Zhang L. Preliminary study of carotid variables under ultrasound analysis as predictors for the risk of coronary arterial atherosclerosis. Echocardiography 2022; 39:1054-1063. [PMID: 35781700 PMCID: PMC9544001 DOI: 10.1111/echo.15404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/13/2022] [Accepted: 05/30/2022] [Indexed: 12/01/2022] Open
Abstract
Background Carotid atherosclerosis by ultrasound scanning can be considered as an ideal window to reflect systemic artery atherosclerosis, which has aroused wide concern for predicting the severity of coronary artery atherosclerosis clinically. Ultrasound radio frequency (RF) data technology has enabled us to evaluate the carotid structure and elastic function precisely, for predicting the severity of coronary artery atherosclerosis. Methods Patients with suspected coronary artery disease (CAD) underwent coronary angiography and were assigned to four groups according to whether atherosclerotic plaque was found or not and it caused stenosis. Carotid artery intima‐media thickness (IMT) and arterial stiffness were investigated by quality intima‐media thickness (QIMT) and quality arterial stiffness (QAS) techniques during ultrasound scanning. Univariable and multivariable modeling were used to investigate correlations of carotid parameters to coronary artery atherosclerosis. Receive operating characteristic (ROC) curves were used to evaluate diagnostic performance of these ultrasound variables. Results Carotid IMT and stiffness variables pulse wave velocity (PWV), α, β and compliance coefficient (CC) were statistically different between every two‐group's comparisons. IMT correlated with stiffness variables significantly with r = 0.70, 0.77, 0.63, and −0.39, respectively. All variables correlated with the severity of coronary atherosclerosis with the odd ratio (OR) of 1.73, 1.67, 1.19, 1.23, and 0.56 accordingly as IMT, PWV, α, β and CC were concerned. The AUC of IMT, PWV, α, β and CC were 0.9257, 0.8910, 0.8016, 0.9383, 0.8581 with correctly classified rate of 88.16%, 83.77%, 78.07%, 86.84%, and 81.58%, respectively. Conclusions Carotid artery IMT and stiffness variable PWV, α, β and CC presented favorable predicting and differentiating values for patients with coronary atherosclerosis of different severity.
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Affiliation(s)
- Wen-Bin Cai
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.,Department of Ultrasound Diagnostics, General Hospital of Tibet Military Region, Lhasa, China
| | - Yi Wang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.,Disease Surveillance Division, Jiangsu International Travel Healthcare Center, Nanjing, China
| | - Jia Wang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wan-Gang Guo
- Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | - Yun-You Duan
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Li Zhang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
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Naguib M, Tarabay A, ElSaraf N, Rashed L, ElMeligy A. Beclin1 circulating level as predictor of carotid intima-media thickness in patients with type 2 diabetes mellitus. Medicine (Baltimore) 2021; 100:e26630. [PMID: 34260553 PMCID: PMC8284749 DOI: 10.1097/md.0000000000026630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/23/2021] [Indexed: 11/27/2022] Open
Abstract
Type 2 diabetes (T2DM) represents a major risk factor for atherosclerosis that is the underlying cause of most cardiovascular diseases. Identifying reliable predictive biomarkers are needed to improve the long-term outcome in diabetic patients. Autophagy plays a pivotal role in the pathogenesis of atherosclerosis. Beclin1 is a key regulatory protein of autophagy and has been localized in human atherosclerotic lesions. However, the relation of serum level of Beclin1 and atherosclerosis in patients with diabetes has not been clarified yet.To assess the relationship between serum level of Beclin1 and carotid intima-media thickness (CIMT) in patients with T2DM.In this case-control study participants were recruited from tertiary care hospitals in Egypt. The study enrolled 50 patients with T2DM and 25 healthy subjects between January, 2019 and January, 2020. Age, gender, and body mass index were recorded for all subjects. Laboratory works up including glycated hemoglobin, lipid panel, and serum Beclin1 (by enzyme-linked immunosorbent assay) were measured. CIMT was assessed by color Doppler. Comparisons between patients and the control group were done using analysis of variance and Chi-square test. Correlations between CIMT and Beclin1 level and different variables were done using the Pearson correlation coefficient. Receiver operator characteristic curve was constructed with the area under curve analysis performed to detect the best cutoff value of Beclin1 for detection of CIMT > 0.05 cm.The level of Beclin1 in the patient group was significantly lower compared with that in the control group (1.28 ± 0.51 vs 5.24 ± 1.22 ng/dL, P < .001). The level of Beclin1 apparently decreased in the higher CIMT group in T2DM patients. Serum Beclin1 levels were negatively correlated with CIMT (r = -0.762; P < .001), low-density lipoprotein-cholesterol (r = -0.283; P = .04), and triglycerides (r = -0.350; P = .01) but positively correlated with high-density lipoprotein-cholesterol (r = 0.491; P < .001) in patients with T2DM. Beclin1 level >2.2 ng/dL was an accurate predictor of CIMT >0.05 cm with an area under the curve value of 0.997, 93.9% sensitivity, and 100% specificity.Beclin1 levels were negatively correlated with atherosclerotic load in patients with T2DM and it may be considered as a promising diagnostic and therapeutic target.
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Affiliation(s)
- Mervat Naguib
- Diabetes and Endocrinology Unite, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt
- Internal Medicine Department, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt
| | - Aya Tarabay
- Diabetes and Endocrinology Unite, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt
- Internal Medicine Department, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt
| | - Nashwa ElSaraf
- Internal Medicine Department, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt
| | - Lila Rashed
- Department of Biochemistry, Faculty of Medicine, Cairo University, Egypt
| | - Amr ElMeligy
- Diabetes and Endocrinology Unite, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt
- Internal Medicine Department, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt
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Mejia-Vilet JM, López-Hernández YJ, Santander-Vélez JI, Trujeque-Matos M, Cruz C, Carranza de la Torre CA, Espinosa-Cruz V, Espinosa-González R, Uribe-Uribe NO, Morales-Buenrostro LE. Angiotensin II receptor agonist antibodies are associated with microvascular damage in lupus nephritis. Lupus 2020; 29:371-378. [PMID: 32041505 DOI: 10.1177/0961203320904787] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Angiotensin II type 1 receptor agonist antibodies (AT1R-AAs) have been associated with hypertension, atherosclerosis and vascular inflammation in human diseases. The aim of the study was to evaluate the prevalence of AT1R-AAs in active lupus nephritis (LN) patients and their association with vascular damage. One hundred and seven active LN patients underwent a complete clinical examination, measurement of AT1R-AAs, ambulatory blood pressure monitoring, carotid intima-media thickness measurement and morphometric analysis of subintimal fibrosis and medial hyperplasia of the vessels in the kidney tissue. Plasma AT1R-AAs were positive in 58 (54.2%) patients. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score, complement C3 and C4 levels and titers of anti-dsDNA antibodies were higher in the group with positive AT1R-AAs compared with those with negative AT1R-AAs. The AT1R-AA titers correlated with anti-dsDNA antibody titers and with complement C3 and C4 serum levels. In the kidney biopsy, the percentage of subintimal fibrosis and the area of medial hyperplasia were greater in the AT1R-AA-positive patients. No differences in arterial pressure, carotid intima-media thickness and response to therapy were detected. In conclusion, AT1R-AAs are prevalent in active LN patients and are associated with histologic features of microvascular damage.
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Affiliation(s)
- J M Mejia-Vilet
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Y J López-Hernández
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - J I Santander-Vélez
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - M Trujeque-Matos
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C Cruz
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C A Carranza de la Torre
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - V Espinosa-Cruz
- Department of Radiology and Imaging "Adan Pitol", Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - R Espinosa-González
- Department of Pathology and Pathologic Anatomy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - N O Uribe-Uribe
- Department of Pathology and Pathologic Anatomy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - L E Morales-Buenrostro
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Zhou YY, Qiu HM, Yang Y, Han YY. Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model. Diabetol Metab Syndr 2020; 12:8. [PMID: 32015760 PMCID: PMC6988356 DOI: 10.1186/s13098-020-0517-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/10/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with type 2 diabetes (T2DM). Carotid intima-media thickness (CIMT) is considered a preclinical stage of atherosclerosis. Therefore, it is necessary to identify the related risk factors for CIMT to facilitate the early prevention of CVD. Previous studies have shown that visceral fat area (VFA) is a risk factor for T2DM and CVD. However, few studies have focused on the effects of VFA on CIMT associated with T2DM. Moreover, considering that the body fat distribution shows regional and racial heterogeneity, the purpose of this study was to investigate the predictive value of VFA and other risk factors for CIMT associated with T2DM in Western China. METHODS In a cross-sectional study, a total of 1372 patients with T2DM were divided into the CIMT (-) group (n = 965) and the CIMT (+) group (n = 407) based on CIMT values. In addition to the univariate analyses, logistic regression analysis and a decision tree model were simultaneously performed to establish a correlation factor model for CIMT. RESULTS Univariate analyses showed that sex, smoking status, age, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight, body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, VFA, subcutaneous fat area, and the levels of 2-h C-peptide, serum creatinine, urea nitrogen and uric acid were significantly different between the two groups (all p < 0.05). Smoking, increased VFA, female sex and increased BMI were risk factors in the logistic regression analyses (OR = 5.759, OR = 1.364, OR = 2.239, OR = 1.186, respectively). In the decision tree model, smoking was the root node, followed by sex, waist circumference, VFA and chronic kidney disease (CKD) in order of importance. CONCLUSIONS In addition to smoking, sex and BMI, VFA has a significant effect on CIMT associated with T2DM in the Chinese Han population in Western China. In addition, the decision tree model could help clinicians make more effective decisions, with its simplicity and intuitiveness, making it worth promoting in future medical research.Trial registration ChiCTR, ChiCTR1900027739. Registered 24 November 2019-Retrospectively registered, http://www.chictr.org.cn/index.aspx.
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Affiliation(s)
- Yuan-Yuan Zhou
- Department of Endocrinology and Metabolism, Fourth Affiliated Hospital of Kunming Medical University, The Second People’s Hospital of Yunnan Province, Kunming, 650021 China
- Department of Endocrinology and Metabolism, Sixth Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, 653100 China
| | - Hong-Mei Qiu
- Department of Endocrinology and Metabolism, Sixth Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi, 653100 China
| | - Ying Yang
- Department of Endocrinology and Metabolism, Fourth Affiliated Hospital of Kunming Medical University, The Second People’s Hospital of Yunnan Province, Kunming, 650021 China
| | - Yuan-Yuan Han
- Center of Tree Shrew Germplasm Resources, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, 650021 China
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Carotid Intima Media Thickness Reference Intervals for a Healthy Argentinean Population Aged 11-81 Years. Int J Hypertens 2018; 2018:8086714. [PMID: 29992052 PMCID: PMC5832113 DOI: 10.1155/2018/8086714] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/29/2017] [Accepted: 01/15/2018] [Indexed: 12/25/2022] Open
Abstract
Reference intervals (RIs) of carotid intima media thickness (CIMT) from large healthy population are still lacking in Latin America. The aim of this study was to determine CIMT RIs in a cohort of 1012 healthy subjects from Argentina. We evaluated if RIs for males and females and for left and right carotids were necessary. Second, mean and standard deviation (SD) age-related equations were obtained for left, right, and average (left + right)/2) CIMT using parametric regression methods based on fractional polynomials, in order to obtain age-specific percentiles curves. Age-specific percentile curves were obtained. Males showed higher A-CIMT (0.577 ± 0.003 mm versus 0.566 ± 0.004 mm, P = 0.039) in comparison with females. For males, the equations were as follows: A-CIMT mean = 0.42 + 8.14 × 10-5⁎Age2; A-CIMT SD = 5.9 × 10-2 + 1.09 × 10-5⁎Age2. For females, they were as follows: A-CIMT mean = 0.40 + 8.20 × 10-5⁎Age2; A-CIMT SD = 4.67 × 10-2 + 1.63 × 10-5⁎Age2. Our study provides the largest database concerning RIs of CIMT in healthy people in Argentina. Specific RIs and percentiles of CIMT for children, adolescents, and adults are now available according to age and gender, for right and left common carotid arteries.
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Violi F, Loffredo L, Carnevale R, Pignatelli P, Pastori D. Atherothrombosis and Oxidative Stress: Mechanisms and Management in Elderly. Antioxid Redox Signal 2017; 27:1083-1124. [PMID: 28816059 DOI: 10.1089/ars.2016.6963] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
SIGNIFICANCE The incidence of cardiovascular events (CVEs) increases with age, representing the main cause of death in an elderly population. Aging is associated with overproduction of reactive oxygen species (ROS), which may affect clotting and platelet activation, and impair endothelial function, thus predisposing elderly patients to thrombotic complications. Recent Advances: There is increasing evidence to suggest that aging is associated with an imbalance between oxidative stress and antioxidant status. Thus, upregulation of ROS-producing enzymes such as nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and myeloperoxidase, along with downregulation of antioxidant enzymes, such as superoxide dismutase and glutathione peroxidase, occurs during aging. This imbalance may predispose to thrombosis by enhancing platelet and clotting activation and eliciting endothelial dysfunction. Recently, gut-derived products, such as trimethylamine N-oxide (TMAO) and lipopolysaccharide, are emerging as novel atherosclerotic risk factors, and gut microbiota composition has been shown to change by aging, and may concur with the increased cardiovascular risk in the elderly. CRITICAL ISSUES Antioxidant treatment is ineffective in patients at risk or with cardiovascular disease. Further, anti-thrombotic treatment seems to work less in the elderly population. FUTURE DIRECTIONS Interventional trials with antioxidants targeting enzymes implicated in aging-related atherothrombosis are warranted to explore whether modulation of redox status is effective in lowering CVEs in the elderly. Antioxid. Redox Signal. 27, 1083-1124.
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Affiliation(s)
- Francesco Violi
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
| | - Lorenzo Loffredo
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
| | - Roberto Carnevale
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy .,2 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome , Latina, Italy
| | - Pasquale Pignatelli
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
| | - Daniele Pastori
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
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Wang C, Lv G, Zang D. Risk factors of carotid plaque and carotid common artery intima-media thickening in a high-stroke-risk population. Brain Behav 2017; 7:e00847. [PMID: 29201548 PMCID: PMC5698865 DOI: 10.1002/brb3.847] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 08/01/2017] [Accepted: 08/28/2017] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION To analyze the risk factors of carotid plaque (CP) and carotid common artery intima-media thickening (CCAIMT) and the association between the risk factors and CP numbers and the side of the CCAIMT in a high-stroke-risk population. METHODS Carotid ultrasonography was conducted in 2025 participants with high stroke risk. Participants were divided into different groups according to the results of the ultrasound. The risk factors and blood biochemical indices were recorded. RESULTS The presence of CP and CCAIMT were 38.9% and 24.8% respectively. Multivariate logistic regression indicated that the risk factors of CP were age, high LDL-C and FBG levels, male gender, stroke, diabetes, hypertension, and tobacco use. Compared with participants without CPs, the participants who were male, and older in age, with risk factors of tobacco use, diabetes, high LDL-C levels, and a family history of hypertension were likely to have a single CP, whereas the participants with risk factors of tobacco use, diabetes, hypertension, male gender, older age, high LDL-C levels, stroke and AF or valvulopathy were prone to have multiple CPs. The risk factors of CCAIMT were male gender, stroke, hypertension, diabetes, AF or valvulopathy, tobacco use and age. Compared with the N-CCAIMT subgroup, the risk factors of left CCAIMT were tobacco use, diabetes, male gender, and age. The risk factors of right CCAIMT were male gender, high FBG levels, age, AF or valvulopathy. The risk factors of dual CCAIMT were high frequency of drinking milk, tobacco use, male gender, age, stroke, and hypertension. CONCLUSION These findings revealed the risk factors of CP and CCAIMT, and an association between the risk factors and the CP numbers and the side of the CCAIMT.
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Affiliation(s)
- ChunFang Wang
- First Central Clinical College of Tianjin Medical University Tianjin China.,Department of Neurology Tianjin First Central Hospital Tianjin China
| | - GaoPeng Lv
- Department of Neurology Tianjin First Central Hospital Tianjin University of Traditional Chinese Medicine Tianjin China
| | - DaWei Zang
- Department of Neurology Tianjin First Central Hospital Tianjin Medical University Tianjin China
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Gómez Restrepo C, Muñoz N S, Ruiz AJ, Lanas F. Latin American Clinical Epidemiology Network Series – Paper 1: The Latin American Clinical Epidemiology Network “LatinCLEN”. J Clin Epidemiol 2017; 86:71-74. [DOI: 10.1016/j.jclinepi.2016.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 10/10/2016] [Indexed: 01/28/2023]
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Mitu O, Roca M, Floria M, Petris AO, Graur M, Mitu F. Subclinical cardiovascular disease assessment and its relationship with cardiovascular risk SCORE in a healthy adult population: A cross-sectional community-based study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2017; 29:111-119. [PMID: 28377040 DOI: 10.1016/j.arteri.2016.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/09/2016] [Accepted: 10/17/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study is to evaluate the relationship and the accuracy of SCORE (Systematic Coronary Risk Evaluation Project) risk correlated to multiple methods for determining subclinical cardiovascular disease (CVD) in a healthy population. MATERIAL AND METHODS This cross-sectional study included 120 completely asymptomatic subjects, with an age range 35-75 years, and randomly selected from the general population. The individuals were evaluated clinically and biochemical, and the SCORE risk was computed. Subclinical atherosclerosis was assessed by various methods: carotid ultrasound for intima-media thickness (cIMT) and plaque detection; aortic pulse wave velocity (aPWV); echocardiography - left ventricular mass index (LVMI) and aortic atheromatosis (AA); ankle-brachial index (ABI). RESULTS SCORE mean value was 2.95±2.71, with 76% of subjects having SCORE <5. Sixty-four percent of all subjects have had increased subclinical CVD changes, and SCORE risk score was correlated positively with all markers, except for ABI. In the multivariate analysis, increased cIMT and aPWV were significantly associated with high value of SCORE risk (OR 4.14, 95% CI: 1.42-12.15, p=0.009; respectively OR 1.41, 95% CI: 1.01-1.96, p=0.039). A positive linear relationship was observed between 3 territories of subclinical CVD (cIMT, LVMI, aPWV) and SCORE risk (p<0.0001). There was evidence of subclinical CVD in 60% of subjects with a SCORE value <5. CONCLUSIONS As most subjects with a SCORE value <5 have subclinical CVD abnormalities, a more tailored subclinical CVD primary prevention program should be encouraged.
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Affiliation(s)
- Ovidiu Mitu
- Gr. T. Popa University of Medicine and Pharmacy, 16 University Street, Iaşi, Romania
| | - Mihai Roca
- Gr. T. Popa University of Medicine and Pharmacy, 16 University Street, Iaşi, Romania
| | - Mariana Floria
- Gr. T. Popa University of Medicine and Pharmacy, 16 University Street, Iaşi, Romania.
| | | | - Mariana Graur
- Gr. T. Popa University of Medicine and Pharmacy, 16 University Street, Iaşi, Romania
| | - Florin Mitu
- Gr. T. Popa University of Medicine and Pharmacy, 16 University Street, Iaşi, Romania
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Nezu T, Hosomi N, Aoki S, Matsumoto M. Carotid Intima-Media Thickness for Atherosclerosis. J Atheroscler Thromb 2015; 23:18-31. [PMID: 26460381 DOI: 10.5551/jat.31989] [Citation(s) in RCA: 194] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The carotid intima-media thickness (IMT) is a widely used surrogate marker for atherosclerosis worldwide. The carotid IMT can be simply, noninvasively, and reproducibly measured through B-mode carotid ultrasound. The carotid IMT is also a strong predictor of future cerebral and cardiovascular events. In addition, regressions of increased carotid IMT by lipid-lowering and antihypertensive drugs have been reported. Despite the strong association between increased carotid IMT and cardiovascular disease, it remains unclear whether routine carotid IMT measurement is useful for the detection of subclinical atherosclerosis in clinical practice. Researches should consider other methodological aspects, such as the definition of carotid plaques, the choice of measurement sites on the common or internal carotid artery, and the assessment of maximum or minimum IMT. The detailed guidelines for measuring carotid IMT vary by county. Thus, the usefulness of the carotid IMT may be assessed in different countries taking racial differences into account. Other important parameters revealed by carotid ultrasound, such as artery stenosis and the characteristics and size of plaques, should also be considered. Physicians should comprehensively interpret the results of carotid ultrasonography. Therefore, carotid ultrasonography is an essential tool for assessing cardiovascular risk in clinical settings.
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Affiliation(s)
- Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
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Michel-Chávez A, Estañol B, Gien-López JA, Robles-Cabrera A, Huitrado-Duarte ME, Moreno-Morales R, Becerra-Luna B. Heart rate and systolic blood pressure variability on recently diagnosed diabetics. Arq Bras Cardiol 2015; 105:276-84. [PMID: 26176187 PMCID: PMC4592176 DOI: 10.5935/abc.20150073] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 03/18/2015] [Indexed: 01/07/2023] Open
Abstract
Background Diabetes affects approximately 250 million people in the world.
Cardiovascular autonomic neuropathy is a common complication of diabetes
that leads to severe postural hypotension, exercise intolerance, and
increased incidence of silent myocardial infarction. Objective To determine the variability of heart rate (HR) and systolic blood pressure
(SBP) in recently diagnosed diabetic patients. Methods The study included 30 patients with a diagnosis of type 2 diabetes of less
than 2 years and 30 healthy controls. We used a Finapres® device to measure
during five minutes beat-to-beat HR and blood pressure in three experimental
conditions: supine position, standing position, and rhythmic breathing at
0.1 Hz. The results were analyzed in the time and frequency domains. Results In the HR analysis, statistically significant differences were found in the
time domain, specifically on short-term values such as standard deviation of
NN intervals (SDNN), root mean square of successive differences (RMSSD), and
number of pairs of successive NNs that differ by more than 50 ms (pNN50). In
the BP analysis, there were no significant differences, but there was a
sympathetic dominance in all three conditions. The baroreflex sensitivity
(BRS) decreased in patients with early diabetes compared with healthy
subjects during the standing maneuver. Conclusions There is a decrease in HR variability in patients with early type 2 diabetes.
No changes were observed in the BP analysis in the supine position, but
there were changes in BRS with the standing maneuver, probably due to
sympathetic hyperactivity.
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Affiliation(s)
- Anaclara Michel-Chávez
- Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, México Distrito Federal, MX
| | - Bruno Estañol
- Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, México Distrito Federal, MX
| | - José Antonio Gien-López
- Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, México Distrito Federal, MX
| | - Adriana Robles-Cabrera
- Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, México Distrito Federal, MX
| | | | - René Moreno-Morales
- Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, México Distrito Federal, MX
| | - Brayans Becerra-Luna
- Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, México Distrito Federal, MX
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Arterial Stiffness in a Rural Population of Argentina: Pilot Study. High Blood Press Cardiovasc Prev 2015; 22:403-9. [DOI: 10.1007/s40292-015-0110-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 06/03/2015] [Indexed: 01/20/2023] Open
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Li JW, He SY, Liu P, Luo L, Zhao L, Xiao YB. Association of gestational diabetes mellitus (GDM) with subclinical atherosclerosis: a systemic review and meta-analysis. BMC Cardiovasc Disord 2014; 14:132. [PMID: 25266849 PMCID: PMC4192280 DOI: 10.1186/1471-2261-14-132] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 09/24/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with an elevated risk of adverse health outcomes such as type 2 diabetes and cardiovascular diseases. Carotid intima-media thickness (cIMT) is increasingly used as a noninvasive marker for subclinical atherosclerosis. Whether there is a direct correlation between GDM and elevated cIMT is still controversial. METHODS PubMed, Embase and reference lists of relevant papers were reviewed. Studies assessing the relationship between GDM and cIMT were included. Weighted Mean Difference (WMD) of cIMT was calculated using random-effect models. RESULTS Fifteen studies with a total of 2247 subjects were included in our analysis, giving a pooled WMD of 0.05 (95% confidence interval [CI] 0.03 -0.07). Furthermore, meta regression and subgroup analysis found that the association between GDM and larger cIMT already existed during pregnancy, and this relation was stronger in obese GDM patients. CONCLUSIONS GDM in and after pregnancy is associated with subclinical atherosclerosis. Weight control may be helpful to prevent cardiovascular diseases for GDM patients.
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Affiliation(s)
- Jing-Wei Li
- Institute of Cardiovascular Surgery, PLA, Xinqiao Hospital, Third Military Medical University, No. 183 Xinqiao Street, Chongqing, 400037 PR China
| | - Si-Yi He
- Institute of Cardiovascular Surgery, PLA, Xinqiao Hospital, Third Military Medical University, No. 183 Xinqiao Street, Chongqing, 400037 PR China
| | - Peng Liu
- Institute of Cardiovascular Surgery, PLA, Xinqiao Hospital, Third Military Medical University, No. 183 Xinqiao Street, Chongqing, 400037 PR China
| | - Lin Luo
- Institute of Cardiovascular Surgery, PLA, Xinqiao Hospital, Third Military Medical University, No. 183 Xinqiao Street, Chongqing, 400037 PR China
| | - Liang Zhao
- Institute of Cardiovascular Surgery, PLA, Xinqiao Hospital, Third Military Medical University, No. 183 Xinqiao Street, Chongqing, 400037 PR China
| | - Ying-Bin Xiao
- Institute of Cardiovascular Surgery, PLA, Xinqiao Hospital, Third Military Medical University, No. 183 Xinqiao Street, Chongqing, 400037 PR China
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Reference values of pulse wave velocity in healthy people from an urban and rural argentinean population. Int J Hypertens 2014; 2014:653239. [PMID: 25215227 PMCID: PMC4158305 DOI: 10.1155/2014/653239] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/22/2014] [Accepted: 08/09/2014] [Indexed: 11/17/2022] Open
Abstract
In medical practice the reference values of arterial stiffness came from multicenter registries obtained in Asia, USA, Australia and Europe. Pulse wave velocity (PWV) is the gold standard method for arterial stiffness quantification; however, in South America, there are few population-based studies. In this research PWV was measured in healthy asymptomatic and normotensive subjects without history of hypertension in first-degree relatives. Normal PWV and the 95% confidence intervals values were obtained in 780 subjects (39.8 ± 18.5 years) divided into 7 age groups (10–98 years). The mean PWV found was 6.84 m/s ± 1.65. PWV increases linearly with aging with a high degree of correlation (r2 = 0.61; P < 0.05) with low dispersion in younger subjects. PWV progressively increases 6–8% with each decade of life; this tendency is more pronounced after 50 years. A significant increase of PWV over 50 years was demonstrated. This is the first population-based study from urban and rural people of Argentina that provides normal values of the PWV in healthy, normotensive subjects without family history of hypertension. Moreover, the age dependence of PWV values was confirmed.
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Touboul PJ, Labreuche J, Bruckert E, Schargrodsky H, Prati P, Tosetto A, Hernandez-Hernandez R, Woo KS, Silva H, Vicaut E, Amarenco P. HDL-C, triglycerides and carotid IMT: A meta-analysis of 21,000 patients with automated edge detection IMT measurement. Atherosclerosis 2014; 232:65-71. [DOI: 10.1016/j.atherosclerosis.2013.10.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/18/2013] [Accepted: 10/08/2013] [Indexed: 11/30/2022]
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Chien JD, Furtado A, Cheng SC, Lam J, Schaeffer S, Chun K, Wintermark M. Demographics of carotid atherosclerotic plaque features imaged by computed tomography. J Neuroradiol 2013; 40:1-10. [PMID: 23428245 DOI: 10.1016/j.neurad.2012.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 05/18/2012] [Accepted: 05/27/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This was a prospective, cross-sectional study to evaluate the risk factors and symptoms associated with specific carotid wall and atherosclerotic plaque features as seen on computed tomography-angiography (CTA) studies. MATERIALS AND METHODS A total of 120 consecutive consenting patients admitted to the emergency department with suspected cerebrovascular ischemia, and receiving standard-of-care CTA of the brain and neck on a 64-slice CT scanner, were prospectively enrolled in the study. The carotid wall features observed on CT were quantitatively analyzed with customized software using different radiodensities for contrast-phase acquisition of the carotids. Clinical datasets, including a complete medical history and examination, were obtained by research physicians or specially trained associates blinded to any findings on CT. Univariate and multivariate analyses were performed to assess the degree of association between clinical indicators and quantitative CT features of carotid atherosclerotic plaques. RESULTS Men tended to have increased carotid lumen (coefficient: 608.7; 95% CI: 356.9-860.6; P<0.001) and wall volumes (209.2; 54.5-364.0; P=0.008), and hypertension was associated with increased wall volume (260.6; 88.7-432.6; P=0.003). Advanced age was associated with increases in maximum wall thickness (0.02; 0.003-0.05; P=0.029), fibrous cap thickness (0.005; 0.001-0.008; P=0.016) and number of calcium voxels (2.7; 1.25-4.2; P<0.001), and the presence of a carotid bruit was associated with carotid stenosis length (21.0; 5.38-37.8; P=0.009). Exercise was inversely related to the number of calcium (-37.1; -71.5 - -2.7; P=0.035) and lipid (-7.9; -15.1 - -0.7; P=0.032) voxels. ACE inhibitor use was associated with fibrous cap thickness (0.1; 0.04-0.23; P=0.005). CONCLUSION Significant associations were found between clinical descriptors and carotid atherosclerotic plaque features as revealed by CT. Future studies are needed to validate our findings, and to continue investigations into whether CT features of carotid plaques can be used as biomarkers to quantify the impact of strategies aiming to correct vascular risk factors.
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Affiliation(s)
- Jeffrey D Chien
- University of California San Francisco, Department of Radiology and Biomedical Imaging, Neuroradiology Section, San Francisco, USA
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Farro I, Bia D, Zócalo Y, Torrado J, Farro F, Florio L, Lluberas R, Armentano RL. Aging-related changes and reference values for the carotid intima-media thickness in a Uruguayan population. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:5622-5. [PMID: 23367204 DOI: 10.1109/embc.2012.6347269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UNLABELLED Carotid intima-media thickness (CIMT) is a well-established subclinical marker of atherosclerosis. Non-invasive vascular evaluation has emerged as a useful tool to aid in individual cardiovascular (CV) risk stratification and diagnose. The use of CIMT in CV risk stratification requires knowing the expected reference values for the population studied. Our aim were: a) to evaluate the relationship between aging and CIMT, b) to analyze gender and side (right vs left) related-differences in CIMT and c) to determine the CIMT reference values for an Uruguayan population taking into account aging-related CIMT changes. METHODS 367 asymptomatic subjects without known CV disease or risk factors were included in the study. Subjects were divided into six age groups. High-resolution B-mode ultrasound images of both (right and left) common carotid arteries were obtained based on the techniques and recommendations described in international consensus. RESULTS No significant age-related differences in CIMT between men and women were observed. The mean left CIMT was thicker compared with right CIMT in groups 4, 5 and 6. However, there were no significant differences in those groups. The nomogram model was constructed from data base, in which the 95% confidence interval was considered. Diagnosis thresholds were determined as well. CONCLUSION We define reference values of CIMT for our population using gold standard techniques which contributes to standard techniques which contributes to an improved insight into clinical practice and can be used routinely for evaluation.
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Affiliation(s)
- Ignacio Farro
- Physiology Department and with the Centro Universitario de Investigación, Innovación y Diagnóstico (CUiiDARTE), Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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Romano JG, Arauz A, Koch S, Dong C, Marquez JM, Artigas C, Merlos M, Hernandez B, Roa LF, Rundek T, Sacco RL. Disparities in stroke type and vascular risk factors between 2 Hispanic populations in Miami and Mexico city. J Stroke Cerebrovasc Dis 2012; 22:828-33. [PMID: 22749627 DOI: 10.1016/j.jstrokecerebrovasdis.2012.05.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The heterogeneous nature and determinants of stroke among different Hispanic groups was examined by comparing hospitalized Hispanic stroke patients in Miami, where the Hispanic population is largely of Caribbean origin, to a Mestizo population in Mexico City. METHODS Consecutive Hispanic patients who were admitted with stroke or transient ischemic attack (TIA) and included in the prospective stroke registries of 2 tertiary care teaching hospitals were studied. Demographic factors, stroke subtypes, vascular risk factors, stroke severity, and outcomes were compared. Vascular risk factor definitions were standardized. RESULTS A total of 928 patients (520 Mexicans and 408 Miami Hispanics) were analyzed. Mexicans were younger, with a greater proportion of women. More cerebral venous thromboses (CVTs) were admitted in Mexico, while TIA and stroke mimics were more commonly admitted in Miami; cardioembolic strokes were more commonly ascertained in Miami, and more cryptogenic strokes in Mexico. Stroke severity was similar for intracerebral hemorrhages, but more severe ischemic strokes and CVTs were included in the Mexican registry. Outcome at 1 and 3 months was similar in both registries after adjusting for age and baseline stroke severity. After adjusting for age and sex, hypertension, dyslipidemia, and atrial fibrillation were more frequent, and diabetes mellitus was less frequent, among Miami Hispanics compared to Mexicans. CONCLUSIONS We found significant differences in the frequency of hypertension, diabetes, dyslipidemia, and atrial fibrillation in Miami Hispanics and Mexican stroke patients, highlighting the heterogeneity of the Hispanic ethnic group. Future studies are needed to clarify the relative contribution of genetic and environmental disparities amongst Mexican and Caribbean Hispanic stroke patients.
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Affiliation(s)
- Jose G Romano
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
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Pulse wave velocity as marker of preclinical arterial disease: reference levels in a uruguayan population considering wave detection algorithms, path lengths, aging, and blood pressure. Int J Hypertens 2012; 2012:169359. [PMID: 22666551 PMCID: PMC3362057 DOI: 10.1155/2012/169359] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 02/10/2012] [Accepted: 03/13/2012] [Indexed: 11/21/2022] Open
Abstract
Carotid-femoral pulse wave velocity (PWV) has emerged as the gold standard for non-invasive evaluation of aortic stiffness; absence of standardized methodologies of
study and lack of normal and reference values have limited a wider clinical implementation. This work was carried out in a Uruguayan (South American) population in order
to characterize normal, reference, and threshold levels of PWV considering normal age-related changes in PWV and the prevailing blood pressure level during the study.
A conservative approach was used, and we excluded symptomatic subjects; subjects with history of cardiovascular (CV) disease, diabetes mellitus or renal failure; subjects
with traditional CV risk factors (other than age and gender); asymptomatic subjects with atherosclerotic plaques in carotid arteries; patients taking anti-hypertensives or
lipid-lowering medications. The included subjects (n = 429) were categorized according to the age decade and the blood pressure levels (at study time). All subjects
represented the “reference population”; the group of subjects with optimal/normal blood pressures levels at study time represented the “normal population.” Results.
Normal and reference PWV levels were obtained. Differences in PWV levels and aging-associated changes were obtained. The obtained data could be used to define
vascular aging and abnormal or disease-related arterial changes.
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Bia D, Zócalo Y, Farro I, Torrado J, Farro F, Florio L, Olascoaga A, Brum J, Alallón W, Negreira C, Lluberas R, Armentano RL. Integrated Evaluation of Age-Related Changes in Structural and Functional Vascular Parameters Used to Assess Arterial Aging, Subclinical Atherosclerosis, and Cardiovascular Risk in Uruguayan Adults: CUiiDARTE Project. Int J Hypertens 2011; 2011:587303. [PMID: 22187622 PMCID: PMC3235479 DOI: 10.4061/2011/587303] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 08/26/2011] [Accepted: 08/27/2011] [Indexed: 11/20/2022] Open
Abstract
This work was carried out in a Uruguayan (South American) population to characterize aging-associated physiological arterial changes. Parameters markers of subclinical atherosclerosis and that associate age-related changes were evaluated in healthy people. A conservative approach was used and people with nonphysiological and pathological conditions were excluded. Then, we excluded subjects with (a) cardiovascular (CV) symptoms, (b) CV disease, (c) diabetes mellitus or renal failure, and (d) traditional CV risk factors (other than age and gender). Subjects (n = 388) were submitted to non-invasive vascular studies (gold-standard techniques), to evaluate (1) common (CCA), internal, and external carotid plaque prevalence, (2) CCA intima-media thickness and diameter, (3) CCA stiffness (percentual pulsatility, compliance, distensibility, and stiffness index), (4) aortic stiffness (carotid-femoral pulse wave velocity), and (5) peripheral and central pressure wave-derived parameters. Age groups: ≤20, 21-30, 31-40, 41-50, 51-60, 61-70, and 71-80 years old. Age-related structural and functional vascular parameters profiles were obtained and analyzed considering data from other populations. The work has the strength of being the first, in Latin America, that uses an integrative approach to characterize vascular aging-related changes. Data could be used to define vascular aging and abnormal or disease-related changes.
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Affiliation(s)
- Daniel Bia
- Physiology Department, School of Medicine and School of Science, CUiiDARTE, Republic University, General Flores 2125, 11800 Montevideo, Uruguay
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Kaźmierski R, Michalak S, Kozubski W. Ultrasound-based markers of carotid atherosclerosis correlate well with the number of classical atherosclerotic risk factors. Neurol Neurochir Pol 2011; 45:317-27. [DOI: 10.1016/s0028-3843(14)60102-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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