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García-Mateo S, Martínez-Domínguez SJ, Gargallo-Puyuelo CJ, Gallego B, Alfambra E, Aso MC, Martinez-Micaelo N, Amigó N, Martínez-García J, Baptista PM, Sanz B, Ballesta S, Espinosa J, Tejero C, Gomollón F. Cardiovascular risk assessment in inflammatory bowel disease with metabolic dysfunction-associated steatotic liver disease. Med Clin (Barc) 2024:S0025-7753(24)00004-6. [PMID: 38423940 DOI: 10.1016/j.medcli.2023.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease (IBD) has been reported to increase the risk of early atherosclerosis even in young patients. Moreover, metabolic dysfunction-associated steatotic liver disease (MASLD), which has been linked to IBD, is a well-recognized but underdiagnosis entity related to cardiovascular risk. We analyze the impact of MASLD in IBD patients' cardiovascular risk through both advanced lipoprotein profile sorted by nuclear magnetic resonance spectroscopy, and carotid artery intima-media thickness (CIMT). METHODS Cross-sectional cohort study which involves 941 IBD adult outpatients. Of them, 50 patients with IBD who met criteria for MASLD and 50 with IBD without MASLD, matched by sex and age were included. Alterations in CIMT were evaluated considering abnormal measures above the 75th percentile adjusted for sex and age. Specific advanced lipoprotein profile was also carried out. RESULTS Most of the patients had an abnormal CIMT (58%). MASLD (OR=5.05, CI 95%=1.71-14.92) and female sex (OR=3.32, CI 95%=1.03-10) were significantly associated with CIMT alterations. Dense LDL particles (with high cholesterol composition in general cohort (OR=3.62, 95% CI=1.07-12.19) and high triglycerides density in young subgroup (OR=6.25, 95% CI=1.04-50) but not total LDL cholesterol were associated with CIMT alterations. CONCLUSIONS MASLD and female sex are associated with early atherosclerosis in IBD patients. Dense LDL particle in combination with vascular imaging findings should be evaluated as non-invasive tools in the management of cardiovascular risk in IBD patients.
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Affiliation(s)
- Sandra García-Mateo
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain.
| | - Samuel J Martínez-Domínguez
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Carla J Gargallo-Puyuelo
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Beatriz Gallego
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Erika Alfambra
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - María C Aso
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | | | - Nuria Amigó
- School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain; Biosfer Teslab, Plaça del Prim 10, 2on 5a, 43201 Reus, Spain
| | - Javier Martínez-García
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain; University of Zaragoza, Department of Multiscale in Mechanical and Biological Engineering, Spain
| | - Pedro M Baptista
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain; CIBER Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain
| | - Borja Sanz
- Department of Endocrinology, Manises Hospital, 46940 Valencia, Spain
| | - Sara Ballesta
- Department of Neurology, Lozano Blesa University Hospital, 50009 Zaragoza, Spain
| | - Judith Espinosa
- Department of Neurology, Lozano Blesa University Hospital, 50009 Zaragoza, Spain
| | - Carlos Tejero
- Department of Neurology, Lozano Blesa University Hospital, 50009 Zaragoza, Spain
| | - Fernando Gomollón
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
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Grandys M, Majerczak J, Frolow M, Sztefko K, Chlopicki S, Zoladz JA. Age-related decrease in serum dihydrotestosterone concentration is accompanied by impaired vascular status. Exp Gerontol 2023; 173:112104. [PMID: 36693531 DOI: 10.1016/j.exger.2023.112104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/03/2022] [Accepted: 01/20/2023] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The effect of androgens on the cardiovascular system in humans is ambiguous. Moreover, still little is known about the effects of the most potent androgen, dihydrotestosterone, on arterial stiffness and endothelial function. The aim of this study was to evaluate whether age-dependent alterations in serum concentration of dihydrotestosterone and its circulating metabolite are accompanied by changes in endothelial function and arterial stiffness. METHODS In 12 young and 11 older men, basal serum concentrations of testosterone, dehydroepiandrosterone sulfate (DHAE-S), androstenedione (AE), dihydrotestosterone (DHT) and androstanediol glucuronide (ADG) were analyzed in relation to vascular status including cIMT - carotid intima media thickness, cAI - central augmentation index, crPWV - carotid radial pulse wave velocity, SI - stiffness index, endothelial and inflammatory markers. RESULTS Although concentration of testosterone was not different between young and older group, it was demonstrated that DHT, DHEA-S, AE and ADG were significantly lower in older men in comparison to young men (p < 0.01). Interestingly the most surprising difference was found for DHT concentration, that was as much as 61 % lower in aged men that displayed significantly higher values of cIMT, AI, crPWV and SI (p < 10-4), suggestive of arterial stiffness. Furthermore, DHT was negatively correlated to all arterial wall parameters (cAI, crPWV, SI and cIMT), c-reactive protein (CRP) and hyaluronic acid (HA) concentration, as well as positively correlated to markers of endothelial function (MNA and 6-keto-PGF1α) in all studied individuals (n = 23). CONCLUSIONS We have shown that ageing leads to a significant decrease in DHT concentration that is accompanied by impaired arterial wall characteristics and worsened endothelial function. Therefore more attention should be paid to the DHT, DHEA-S and ADG concentrations as a biomarkers for vascular dysfunction in ageing men.
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Akram W, Nori W, Abdul Ghani Zghair M. Metformin effect on internal carotid artery blood flow assessed by area under the curve of carotid artery Doppler in women with polycystic ovarian syndrome. World J Clin Cases 2023; 11:1318-1329. [PMID: 36926136 PMCID: PMC10013102 DOI: 10.12998/wjcc.v11.i6.1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Insulin resistance (IR) was reported in most polycystic ovarian syndrome (PCOS) cases. Metformin, a biguanide drug, successfully reduced IR. Homeostatic Model Assessment for IR (HOMA-IR) and Doppler parameters assessed metformin's effectiveness.
AIM To verify whether the area under the curve of the internal carotid artery (AUC-ICA) Doppler wave can be a useful marker for assessing IR among PCOS cases who presented with menstrual irregularity and were treated with metformin over 6 mo.
METHODS An observational, cross-sectional study recruited 54 eligible PCOS women; the anthropometrics were as follows: age, body mass index (BMI), menstrual cycle days, biochemical serum cholesterol, low and high-density lipoprotein, sex hormone-binding globulin, fasting blood glucose, and HOMA-IR, hormonal testosterone, luteinizing hormone over follicle-stimulating hormone ratio, and ultrasonic pulsatility index (PI) and resistance index (RI), carotid artery intima-media thickness (CIMT) and (AUC-ICA) parameters were initially recorded and repeated 3 mo and 6 mo later with metformin tab 500 mg; three times/day for 6 mo. In addition, AUC-ICA was assessed by taking repeated systolic and diastolic wave height measurements.
RESULTS Metformin caused a progressive reduction in BMI, menstrual cycle days, biochemical hormonal, and Doppler parameters (CIMT, PI, RI, and AUC-ICA). AUC-ICA correlated strongly to all PCOS parameters. AUC-ICA correlated inversely with treatment time (r = -0.98, P < 0.001) and positively with HOMA-IR (r = 0.98, P < 0.0001). Via the best subset regression model, the AUC-ICA had the highest predictive value for HOMA-IR.
CONCLUSION AUC-ICA preceded PI, RI, and CIMT with a strong, meaningful correlation to all PCOS parameters, making it a reliable marker for the assessment of IR, especially during metformin therapy. Further studies are recommended to promote the application in practice.
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Affiliation(s)
- Wisam Akram
- Department of Obstetrics and Gynecology, Mustansiriyah, Al Saydihya 10052, Baghdad, Iraq
| | - Wassan Nori
- Department of Obstetrics and Gynecology, Mustansiriyah, Al Saydihya 10052, Baghdad, Iraq
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Yapicioglu H, Seckin SC, Yontem A, Yildizdas D. Infants with macrosomia and infants of diabetic mothers have increased carotid artery intima-media thickness in childhood. Eur J Pediatr 2023; 182:203-211. [PMID: 36278997 DOI: 10.1007/s00431-022-04653-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/07/2022] [Accepted: 10/06/2022] [Indexed: 01/12/2023]
Abstract
UNLABELLED Incidence of diabetes during pregnancy is increasing worldwide, and intrauterine hyperglycemia exposure may have long-term adverse effects on the cardiovascular health of children. We investigated prospectively the risk of atherosclerosis and carotid intima-media thickness (CIMT) in infants born macrosomic and in infants of diabetic mothers (IDM) at the age of 8-9 years in 2021. A total of 49 infants of diabetic mothers (IDM group) and 13 macrosomic infants (macrosomic group) were included in the study. They were compared with 26 age-matched healthy children with birth weight appropriate for gestational age born to non-diabetic mothers (control group). Anthropometric measurements, atherosclerosis risk factors, and CIMT measurements were performed. There was no significant difference between the groups in terms of age, gender, actual anthropometric measurements, blood pressure measurements, laboratory parameters, or atherosclerosis risk factors. Gestational age was lower in the IDM group (p < 0.001), while birth weight was higher in the macrosomic group (p < 0.001). High-density lipoprotein cholesterol level was lower in the IDM group than the other groups. Duration of exclusive and total breastfeeding was lower in IDM group than in the control group (p < 0.001 for both). Body mass index, skinfold thickness, waist-to-hip ratio, and waist-to-height ratio were higher in those breastfed for less than 6 months in the IDM group. The CIMT values were statistically higher in IDM [0.43 ± 0.047 (0.34-0.60)] and macrosomic [0.40 ± 0.055 (0.33-0.50)] groups than control group [0.34 ± 0.047 (0.26-0.45)]. CONCLUSION CIMT values were higher in IDM and macrosomic groups at 8-9 years old age compared to children born with normal birth weight. This indicates intrauterine exposure in both groups. And also, breastfeeding seems very important for IDMs. WHAT IS KNOWN • Intrauterine hyperglycemia exposure has long-term adverse effects on the cardiovascular health of children. • Infants of diabetic mothers have higher carotid artery intima-media thickness at birth. WHAT IS NEW • Both infants of diabetic mothers and infants with macrosomia have increased carotid artery intima-media thickness at the age of 8-9 years. • Duration of breast feeding is important especially in infants of diabetic mothers as body mass index, skinfold thickness, waist to hip and height ratio were higher in those breastfed less than 6 months.
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Affiliation(s)
- H Yapicioglu
- Faculty of Medicine, Division of Neonatology, Department of Pediatrics, Cukurova University, 01330, Adana, Turkey.
| | - S C Seckin
- Faculty of Medicine, Division of Neonatology, Department of Pediatrics, Cukurova University, 01330, Adana, Turkey
| | - A Yontem
- Faculty of Medicine, Division of Pediatric Intensive Care, Department of Pediatrics, Cukurova University, 01330, Adana, Turkey
| | - D Yildizdas
- Faculty of Medicine, Division of Pediatric Intensive Care, Department of Pediatrics, Cukurova University, 01330, Adana, Turkey
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Lin F, Pa J, Karim R, Hodis HN, Han SD, Henderson VW, St John JA, Mack WJ. Subclinical carotid artery atherosclerosis and cognitive function in older adults. Alzheimers Res Ther 2022; 14:63. [PMID: 35526057 PMCID: PMC9077926 DOI: 10.1186/s13195-022-00997-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/02/2022] [Indexed: 12/01/2022]
Abstract
Background The combined effects of increased life expectancy and the considerable number of persons reaching old age will magnify the dementia epidemic in the USA. Demonstration that subclinical atherosclerosis precedes and is associated with cognitive impairment suggests a modifiable risk factor for age-associated cognitive impairment and dementia. The purpose of this study is to determine whether subclinical atherosclerosis as measured by carotid artery intima-media thickness (CIMT) is associated with changes in cognitive function over time in older adults. Methods This study combined longitudinal data from three clinical trials conducted between 2000 and 2013: the B-Vitamin Atherosclerosis Intervention Trial (BVAIT), the Women’s Isoflavone Soy Health (WISH) trial, and the Early versus Late Intervention Trial with Estradiol (ELITE). Participants were recruited from the general population in the Greater Los Angeles area and were free of cardiovascular disease and diabetes; no cognitive or psychiatric exclusion criteria were specified. The same standardized protocol for ultrasound image acquisition and measurement of CIMT was used in all trials. CIMT measurements performed at baseline and 2.5 years were used in these analyses. Cognitive function was assessed at baseline and 2.5 years using a battery of 14 standardized cognitive tests. All clinical trials were conducted at the University of Southern California Atherosclerosis Research Unit, Los Angeles, and had at least 2.5 years of cognitive follow-up. Results A total of 308 men and 1187 women, mean age of 61 years, were included in the combined longitudinal dataset for the primary analysis. No associations were found between CIMT and cognitive function at baseline or at 2.5 years. There was a weak inverse association between CIMT measured at baseline and change in global cognition assessed over 2.5 years (β (SE) = − 0.056 (0.028) units per 0.1 mm CIMT, 95% CI − 0.110, − 0.001, p = 0.046). No associations between CIMT at baseline and changes in executive function, verbal memory, or visual memory were found. Conclusions In this sample of healthy older adults, our findings suggest an association between subclinical atherosclerosis and change in global cognitive function over 2.5 years. Stronger associations were observed longitudinally over 2.5 years than cross-sectionally. When analysis was stratified by age group (<65 and ≥65 years old), the inverse association remained statistically significant for participants in the older age group. Subclinical atherosclerosis of the carotid artery may be a modifiable correlate of cognitive decline in middle and older age. Trial registration BVAIT, NCT00114400. WISH, NCT00118846. ELITE, NCT00114517.
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Affiliation(s)
- Felice Lin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Roksana Karim
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Howard N Hodis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - S Duke Han
- Department of Family Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Neurology, University of Southern California, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA.,School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Victor W Henderson
- Departments of Epidemiology and Population Health and of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Jan A St John
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Wendy J Mack
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Miao M, Zhou G, Bao A, Sun Y, Du H, Song L, Cao Y, You S, Zhong C. Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke. Cardiovasc Diabetol 2022; 21:43. [PMID: 35303881 PMCID: PMC8933990 DOI: 10.1186/s12933-022-01472-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Triglyceride glucose (TyG) index was recently reported to be associated with an increased risk of the development and recurrence of cardiovascular events, and atherosclerosis is a main speculative mechanism. However, data on the relationship between TyG index and atherosclerosis, especially in the setting of ischemic stroke, is rare. We aimed to explore the association between TyG index and carotid atherosclerosis in patients with ischemic stroke. METHODS A total of 1523 ischemic stroke patients with TyG index and carotid artery imaging data were enrolled in this analysis. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Carotid atherosclerosis was measured by common carotid artery intima-media thickness (cIMT), and abnormal cIMT was defined as a mean cIMT and maximum cIMT value ≥ 1 mm. Multivariable logistic regression models and restricted cubic spline models were used to assess the relationships between TyG index and abnormal cIMT. Risk reclassification and calibration of models with TyG index were analyzed. RESULTS The multivariable-adjusted odds ratios (95% CIs) in quartile 4 versus quartile 1 of TyG index were 1.56 (1.06-2.28) for abnormal mean cIMT and 1.46 (1.02-2.08) for abnormal maximum cIMT, respectively. There were linear relationships between TyG index and abnormal mean cIMT (P for linearity = 0.005) and abnormal maximum cIMT (P for linearity = 0.027). In addition, the TyG index provided incremental predictive capacity beyond established risk factors, shown by an increase in net reclassification improvement and integrated discrimination improvement (all P < 0.05). CONCLUSIONS A higher TyG index was associated with carotid atherosclerosis measured by cIMT in patients with ischemic stroke, suggesting that TyG could be a promising atherosclerotic marker.
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Affiliation(s)
- Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China.,Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Guo Zhou
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Department of Cardiology, Nantong Third People's Hospital, Nantong University, Nantong, 226006, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China
| | - Yaming Sun
- Department of Neurology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215600, China
| | - Huaping Du
- Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou, 215200, China
| | - Liyan Song
- Department of Neurology, The First People's Hospital of Taicang, Suzhou, 215400, China
| | - Yongjun Cao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China.
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Magalhães JP, Hetherington-Rauth M, Júdice PB, Correia IR, Rosa GB, Henriques-Neto D, Melo X, Silva AM, Sardinha LB. Interindividual Variability in Fat Mass Response to a 1-Year Randomized Controlled Trial With Different Exercise Intensities in Type 2 Diabetes: Implications on Glycemic Control and Vascular Function. Front Physiol 2021; 12:698971. [PMID: 34603073 PMCID: PMC8481940 DOI: 10.3389/fphys.2021.698971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Little is known about the interindividual variability in fat mass (FM) loss in response to high-intensity interval training (HIIT) and moderate continuous training (MCT) in individuals with type 2 diabetes mellitus (T2DM). Moreover, the impact on health-related outcomes in those who fail to reduce FM is still unclear. The aims of this investigation were (1) to assess if the individuals with T2DM who FM differed across MCT, HIIT, and control groups over a 1-year intervention and (2) to assess the changes on glycemic control and vascular function in the exercising patients who failed to lose FM. Methods: Adults with T2DM were randomized into a 1-year intervention involving a control group (n=22), MCT with resistance training (RT; n=21), and HIIT with RT (n=19). FM was assessed using dual-energy X-ray absorptiometry and a change in total body FM above the typical error was used to categorize FM responders. Glycemic control and vascular stiffness and structure were assessed. A chi-square test and generalized estimating equations were used to model the outcomes. Results: Both MCT (n=10) and HIIT (n=10) had a similar proportion of individuals who were categorized as high responders for FM, with the percent change in FM on average −5.0±9.6% for the MCT and −6.0±12.1% for the HIIT, which differed from the control group (0.2±7.6%) after a 1-year intervention (p<0.05). A time-by-group interaction for carotid artery intima-media thickness (cIMT) (p for interaction=0.042) and lower-limb pulse wave velocity (LL PWV; p for interaction=0.010) between those categorized as low FM responders and the control group. However, an interaction was observed between the high responders for FM loss and controls for both brachial and carotid hemodynamic indices, as well as in cIMT, carotid distensibility coefficient, carotid beta index, and LL PWV (p for interactions <0.05). No interactions were found for glycaemic indices (p for interaction >0.05). Conclusion: Our results suggest that the number of FM responders did not differ between the MCT or HIIT, compared to the control, following a 1-year exercise intervention in individuals with T2DM. However, low responders to FM may still derive reductions in arterial stiffness and structure. Clinical Trial Registration: Comparing Moderate and High-intensity Interval Training Protocols on Biomarkers in Type 2 Diabetes Patients (D2FIT study) – number: NCT03144505 (https://clinicaltrials.gov/ct2/show/NCT03144505).
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Affiliation(s)
- João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro B Júdice
- CIDEFES - Centro de Investigação em Desporto, Educação Física e Exercício e Saúde, Universidade Lusófona, Lisbon, Portugal
| | - Inês R Correia
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Duarte Henriques-Neto
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Xavier Melo
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal.,Ginásio Clube Português, GCP Lab, Lisbon, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
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Yari FA, Shabani P, Karami S, Sarmadi N, Poustchi H, Bandegi AR. Circulating levels of FAM19A5 are inversely associated with subclinical atherosclerosis in non-alcoholic fatty liver disease. BMC Endocr Disord 2021; 21:153. [PMID: 34344333 PMCID: PMC8335939 DOI: 10.1186/s12902-021-00820-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Family with sequence similarity 19 (chemokine (C-C motif)-like) member A5 (FAM19A5) is a newly identified adipokine. There is a limited number of studies linking FAM19A5 to metabolic disorders. In the current study, we aimed to explore if FAM19A5 is associated with nonalcoholic fatty liver disease (NAFLD). We also sought to determine the possibility of FAM19A5 association with subclinical atherosclerosis in NAFLD patients. METHODS A total of 69 subjects including 37 NAFLD and 32 control subjects were included in this cross-sectional study. Plasma concentration of FAM19A5 was measured with the ELISA method. Carotid artery intima-media thickness (cIMT) was assessed by the ultrasonography. RESULTS Plasma concentration of FAM19A5 in patients with NAFLD was significantly lower in NAFLD patients than controls. Moreover, we observed significant negative correlations between plasma level of FAM19A5 and body mass index (BMI), visceral fat, alanine amino transferase (ALT), aspartate amino transferase (AST), liver stiffness (LS), and cIMT. Following stepwise multiple linear regression analysis, ALT and cIMT were the only determinants of FAM19A5 level. CONCLUSIONS This is the first report to describe association of circulating FAM19A5 levels with NAFLD. Our findings provide further evidence showing relation of FAM19A5 with the risk of atherosclerosis. However, more studies are necessary to unravel the contribution of lower FAM19A5 levels to the NAFLD pathogenesis and the higher risk of atherosclerosis in these patients.
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Affiliation(s)
- Fatemeh Ali Yari
- Department of Biochemistry, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Parisa Shabani
- Department of Biochemistry, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Sara Karami
- Department of Biochemistry, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Negar Sarmadi
- Department of Biochemistry, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ahmad Reza Bandegi
- Department of Biochemistry, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran.
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9
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Qayum O, Alshami N, Ibezim CF, Reid KJ, Noel-MacDonnell JR, Raghuveer G. Lipoprotein (a): Examination of Cardiovascular Risk in a Pediatric Referral Population. Pediatr Cardiol 2018; 39:1540-1546. [PMID: 29948030 DOI: 10.1007/s00246-018-1927-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/06/2018] [Indexed: 11/29/2022]
Abstract
Atherosclerotic cardiovascular disease (CVD), a leading cause of death globally, has origins in childhood. Major risk factors include family history of premature CVD, dyslipidemia, diabetes mellitus, and hypertension. Lipoprotein (a) [Lp(a)], an inherited lipoprotein, is associated with premature CVD, but its impact on cardiovascular health during childhood is less understood. The objective of the study was to examine the relationship between Lp(a), family history of premature CVD, dyslipidemia, and vascular function and structure in a high-risk pediatric population. This is a single-center, cross-sectional study of 257 children referred to a preventive cardiology clinic. The independent variable, Lp(a), separated children into high-Lp(a) [Lp(a) ≥ 30 mg/dL] and normal-Lp(a) groups [Lp(a) < 30 mg/dL]. Dependent variables included family history of premature CVD; dyslipidemia, defined as low-density lipoprotein cholesterol > 130 mg/dL, high-density lipoprotein cholesterol (HDL-C) < 45 mg/dL, triglycerides (TG) > 100 mg/dL; and vascular changes suggesting early atherosclerosis, as measured by carotid-femoral pulse wave velocity (PWV) and carotid artery intima-media thickness (CIMT). Of the 257 children, 110 (42.8%) had high Lp(a) and 147 (57.2%) had normal Lp(a). There was a higher prevalence of African-American children in the high-Lp(a) group (19.3%) compared to the normal-Lp(a) group (2.1%) (p < 0.001). High Lp(a) was associated with positive family history of premature CVD (p = 0.03), higher-than-optimal HDL-C (p = 0.02), and lower TG (p < 0.001). There was no difference in PWV or CIMT between groups. High Lp(a) in children is associated with family history of premature CVD and is prevalent in African-American children. In children with high Lp(a), promotion of intensive lifestyle modifications is prudent to decrease premature CVD-related morbidity.
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Affiliation(s)
- Omar Qayum
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Noor Alshami
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Chizitam F Ibezim
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Kimberly J Reid
- Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO, 64108, USA
| | | | - Geetha Raghuveer
- Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO, 64108, USA
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10
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Chen A, Sun Y, Cui J, Zhao B, Wang H, Chen X, Mao Y. Associations of sclerostin with carotid artery atherosclerosis and all-cause mortality in Chinese patients undergoing maintenance hemodialysis. BMC Nephrol 2018; 19:264. [PMID: 30314461 PMCID: PMC6186107 DOI: 10.1186/s12882-018-1046-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 09/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous clinical studies found inconsistent relationship between circulating sclerostin levels and treatment outcome in patients undergoing maintenance hemodialysis (MHD). Therefore, this study aimed to assess the associations of sclerostin with carotid artery atherosclerosis and all-cause mortality in Chinese patients undergoing MHD. METHODS This retrospective study assessed 84 patients undergoing MHD at the Nephrology Department of Beijing Hospital from January to April 2012, with a median follow-up of 61.2 months (range: 11.5 to 63 months). Carotid artery intima-media thicknesses (CIMTs) and atherosclerotic plaques were measured by B-mode Doppler ultrasound at baseline. Blood samples were collected for measuring serum sclerostin and soluble klotho (s-klotho) levels. The associations of sclerostin levels with carotid artery atherosclerosis was evaluated by correlation methods. Predictive factors of mortality were assessed by multivariate COX regression. RESULTS Baseline serum sclerostin averaged 162.01 pmol/L, with an interquartile range of 121.69 to 225.22 pmol/L, while CIMT values were 1.35 ± 0.39 mm. Carotid artery atherosclerotic plaques were detected in 68 subjects (81%). Subjects with sclerostin levels above the median value had higher CIMT (p = 0.038) and higher prevalence of atherosclerotic plaque (p = 0.025). During follow-up, 27 patients died; Kaplan-Meier curves indicated that subjects with high sclerostin levels (above the median value at baseline) had shorter survival (log rank p = 0.011). In multivariate COX regression analysis, serum sclerostin (HR, 1.095; 95% confidence interval [CI] 1.022-1.174, p = 0.010) and albumin (HR, 0.742; 95%CI 0.612-0.900, p = 0.002) levels were independent predictors of all-cause mortality. CONCLUSIONS Sclerostin is positively associated with CIMT. In addition, patients with low baseline serum sclerostin undergoing MHD show better survival.
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Affiliation(s)
- Aiqun Chen
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Ying Sun
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Ju Cui
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Ban Zhao
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Haitao Wang
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Xianguang Chen
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Yonghui Mao
- Department of Nephrology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China.
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11
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Osawa K, Trejo MEP, Nakanishi R, McClelland RL, Blaha MJ, Blankstein R, McEvoy JW, Ceponiene I, Stein JH, Sacco RL, Polak JF, Budoff MJ. Coronary artery calcium and carotid artery intima-media thickness for the prediction of stroke and benefit from statins. Eur J Prev Cardiol 2018; 25:1980-1987. [PMID: 30183342 DOI: 10.1177/2047487318798058] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Current guidelines suggest treatment for many individuals who may never develop a stroke. We hypothesized that a combination of coronary artery calcification (CAC) and carotid artery intima-media thickness (C IMT) data could better individualize risk assessment for ischemic stroke and transient ischemic attack events. METHODS A total of 4720 individuals from the Multi-Ethnic Study of Atherosclerosis were evaluated for ischemic stroke and transient ischemic attack. Cox proportional hazards models for time to incident ischemic stroke/transient ischemic attack were used to examine CAC and CIMT as ischemic stroke/transient ischemic attack predictors in addition to traditional risk factors. We calculated the 10-year number needed to treat by applying the benefit observed in ASCOT-LLA to the observed event rates within CAC and CIMT strata. RESULTS Median follow-up was 13.1 years. Compared with individuals with no CAC and with CIMT ≤ 75th percentile, stroke/transient ischemic attack risk increased progressively with each CAC category (0, 1-100, >100) among individuals with CIMT > 75th percentile. Among participants eligible for statin therapy based on the 2013 atherosclerotic cardiovascular disease (ASCVD) guidelines (ASCVD risk of >5%), 739/2906 (25%) had no CAC and CIMT ≤ 75th percentile and an observed ischemic stroke/transient ischemic attack rate of 2.49 per 1000 person-years. The predicted 10-year number needed to treat was 292 for no CAC and CIMT ≤ 75th percentile and 57 for CAC > 100 and CIMT > 75th percentile. CONCLUSION The combination of CIMT and CAC could serve to further refine risk calculation for ischemic stroke/transient ischemic attack prevention and may prioritize those in most need of statin therapy to reduce ischemic stroke/transient ischemic attack risk.
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Affiliation(s)
- Kazuhiro Osawa
- 1 LA Biomedical Research Institute at Harbor University of California Los Angeles, Torrance, USA
| | | | - Rine Nakanishi
- 1 LA Biomedical Research Institute at Harbor University of California Los Angeles, Torrance, USA
| | | | - Michael J Blaha
- 3 Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, USA
| | - Ron Blankstein
- 4 Cardiovascular Division, Department of Medicine, and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - John W McEvoy
- 3 Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, USA
| | - Indre Ceponiene
- 1 LA Biomedical Research Institute at Harbor University of California Los Angeles, Torrance, USA.,5 Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - James H Stein
- 6 University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Ralph L Sacco
- 7 Departments of Neurology and Public Health Sciences, Miller School of Medicine, University of Miami, USA
| | | | - Matthew J Budoff
- 1 LA Biomedical Research Institute at Harbor University of California Los Angeles, Torrance, USA
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12
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Osawa K, Nakanishi R, McClelland RL, Polak JF, Bishop W, Sacco RL, Ceponiene I, Nezarat N, Rahmani S, Qi H, Kanisawa M, Budoff MJ. Ischemic stroke/transient ischemic attack events and carotid artery disease in the absence of or with minimal coronary artery calcification: Results from the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2018; 275:22-27. [PMID: 29852401 DOI: 10.1016/j.atherosclerosis.2018.05.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/19/2018] [Accepted: 05/16/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The association between minimally elevated coronary artery calcification (CAC) and cerebrovascular disease is not well known. We assessed whether individuals with minimal CAC (Agatston scores of 1-10) have higher ischemic stroke or transient ischemic attack (TIA) frequencies compared with those with no CAC. We also investigated the relative prevalence of carotid atherosclerosis in these two groups. METHODS A total of 3924 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) without previous cardiovascular events, including stroke, and with baseline CAC scores of 0-10 were followed for the occurrence of incident ischemic stroke/TIA. We used carotid ultrasound to detect carotid artery plaques and to measure the intima-media thickness (IMT). RESULTS During a median follow-up of 13.2 years, 130 participants developed incident ischemic stroke/TIA. There was no significant difference in the ischemic stroke/TIA incidence between those with minimal CAC and no CAC (3.7 versus 2.7 per 1000 person-years). In participants with minimal CAC, we observed a significant association of the condition with an internal carotid artery (ICA) that had a greater-than-average IMT (ICA-IMT; β = 0.071, p = 0.001) and a higher odds ratio (OR) for carotid artery plaques (OR 1.46; with a 95% confidence interval [CI] of 1.18-1.80; p < 0.001). CONCLUSIONS A CAC score of 0-10 is associated with a low rate of ischemic stroke/TIA, and thus a minimal CAC score is not a valuable predictive marker for ischemic stroke/TIA. A minimal CAC score may, however, provide an early and asymptomatic sign of carotid artery disease.
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Affiliation(s)
- Kazuhiro Osawa
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA
| | - Rine Nakanishi
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA
| | | | | | | | - Ralph L Sacco
- Departments of Neurology, Public Health Sciences, and Human Genetics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Indre Ceponiene
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA; Department of Cardiology and Radiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Negin Nezarat
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA
| | - Sina Rahmani
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA
| | - Hong Qi
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA
| | - Mitsuru Kanisawa
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA
| | - Matthew J Budoff
- Los Angeles Biomedical Research Institute at Harbor University of California Los Angeles, CA, USA.
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13
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Conkar S, Güven Yılmaz S, Koska İÖ, Berdeli A, Mir S. Evaluation of development of subclinical atherosclerosis in children with uveitis. Clin Rheumatol 2017; 37:1305-1308. [PMID: 28695435 DOI: 10.1007/s10067-017-3741-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/10/2017] [Accepted: 06/25/2017] [Indexed: 11/24/2022]
Abstract
Uveitis is a chronic inflammatory disease. Chronic inflammation has been shown to have a role in pathogenesis of atherosclerosis. Atherosclerosis is the most important risk factor of cardiovascular diseases and is shown to start as early as childhood. In this study, we investigated the presence of subclinical atherosclerosis in children with uveitis. Seventy five patients who were diagnosed as having uveitis in ophthalmology and pediatric rheumatology clinics were included in the study. Patients with hypertension, obesity, dyslipidemia, diabetes, and with history of early cardiovascular disease were excluded. Arterial stiffness, carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), and carotid artery intima-media thickness (cIMT) were measured for each patient. These measurements were compared with 50 healthy children with similar age and sex as controls. The mean age of patients in this study was 12.24 ± 2.69 years, and the mean age of controls was 11.32 ± 4.52 years. PWV and AIx values were higher in the patient group (p = 0.04, p = 0.03). cIMT levels were not different in patient and control groups. When patients were grouped as having uveitis for more than 5 years or not, patients with longer duration of uveitis had higher PWV, AIx, and cIMT levels (p values were 0.01, 0.02, and 0.04 respectively). Vascular functions deteriorate first with endothelial damage in children with uveitis and as disease continues, increase in cIMT is added. We think that for follow-up of the disease and evaluation of the treatment, non-invasive subclinical atherosclerosis markers should be used along with activation criteria of primary diseases.
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Affiliation(s)
- Seçil Conkar
- Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.
| | - Suzan Güven Yılmaz
- Departments of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey
| | - İlker Özgür Koska
- Department of Radiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Afig Berdeli
- Department of Pediatric Rheumatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Sevgi Mir
- Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.,Department of Pediatric Rheumatology, Ege University Faculty of Medicine, Izmir, Turkey
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Abstract
Sustained by its relative ease of assessment, carotid artery intima-media thickness (cIMT) has emerged as an important surrogate marker of target organ damage in hypertensive heart disease over the last three decades. However, the prognostic utility of cIMT in hypertensive heart disease differs depending on its application. This review outlines cIMT and its prognostic utility among patients with hypertensive heart disease. It provides an overview of limitations of cIMT and areas for future research.
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Affiliation(s)
- Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, 7001 Tasmania Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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15
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Peluso G, García-Espinosa V, Curcio S, Marota M, Castro J, Chiesa P, Giachetto G, Bia D, Zócalo Y. High Central Aortic Rather than Brachial Blood Pressure is Associated with Carotid Wall Remodeling and Increased Arterial Stiffness in Childhood. High Blood Press Cardiovasc Prev 2017; 24:49-60. [PMID: 28101819 DOI: 10.1007/s40292-017-0179-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 01/06/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION In adults, central blood pressure (cBP) is reported to associate target organ damages (TODs) rather than peripheral blood pressure (pBP). However, data regarding the association of pre-clinical TODs with cBP and pBP in pediatric populations are scarce. AIM To evaluate in children and adolescents the importance of cBP and pBP levels, in terms of their association with hemodynamic and vascular changes. METHODS 315 subjects [age (mean/range) 12/8-18 years] were included. MEASUREMENTS pBP (oscillometry, Omron-HEM433INT and Mobil-O-Graph), cBP levels and waveforms (oscillometry, Mobil-O-Graph; applanation tonometry, SphygmoCor), aortic wave reflection-related parameters, carotid intima-media thickness (CIMT) and carotid (elastic modulus, stiffness-index) and aortic stiffness (carotid-femoral pulse wave velocity, PWV). Four groups were defined considering pBP and cBP percentiles (th): cBP ≥90th, cBP <90th, pBP ≥90th, pBP <90th. In each group, haemodynamic and vascular parameters were compared for subgroups defined considering the level of the remaining blood pressure (cBP or pBP). Subgroups were matched for anthropometric and cardiovascular risk factors (propensity matching-score). RESULTS Subjects with high cBP showed a worse cardiovascular risk profile in addition to worse peripheral hemodynamic conditions. The CIMT, carotid and aortic stiffness levels were also higher in those subjects. CIMT and carotid stiffness remained statistically higher when subjects were matched for pBP and other cardiovascular risk factors. There were no differences in arterial properties when subjects were analyzed (compared) considering similar pBP levels, during normal and high cBP conditions. CONCLUSION Compared with pBP, the cBP levels show a greater association with vascular alterations (high CIMT and arterial stiffness), in children and adolescents.
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16
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Scanlon EM, Mankad R, Crowson CS, Kullo IJ, Mulvagh SL, Matteson EL, Kvrgic Z, Davis JM. Cardiovascular risk assessment in patients with rheumatoid arthritis: a correlative study of noninvasive arterial health testing. Clin Rheumatol 2016; 36:763-771. [PMID: 27988813 DOI: 10.1007/s10067-016-3515-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/11/2016] [Indexed: 11/25/2022]
Abstract
This study aimed to determine the relationship between noninvasive measures of arterial health and both estimated 10-year cardiovascular risk and measures of disease activity over time in established rheumatoid arthritis. Fifty rheumatoid arthritis patients underwent noninvasive arterial health testing (brachial artery reactivity, aortic augmentation index [AIx], pulse wave velocity, carotid artery intima-media thickness, and carotid artery plaque presence) and assessment of clinical disease activity (tender or swollen joint counts, Clinical Disease Activity Index [CDAI], and Health Assessment Questionnaire II [HAQ-II]). Clinical measures during 3 years before the study visit were averaged. Arterial health testing was compared with the American Heart Association/American College of Cardiology (AHA/ACC) Pooled Cohort Equation. Spearman methods identified correlations between disease activity measures, cardiac biomarkers, and arterial health parameters. Among the patients (mean age, 57.5 years), disease activity was moderate (mean [SD] CDAI, 16.9 [15.3]). At the study visit, corrected aortic augmentation index correlated with CDAI (r = 0.37, P = .009) and HAQ-II (r = 0.33, P = .02). AIx correlated with time-averaged tender joint count (r = 0.37, P = .008), CDAI (r = 0.36, P = .01), HAQ-II (r = 0.36, P = .01), swollen joint count (r = 0.36, P = .10), patient global assessment (r = 0.33, P = .02), physician global assessment (r = 0.35, P = .01), and pain score (r = 0.38, P = .007). The AHA/ACC low-risk group (<5% 10-year risk) had highest prevalence of carotid plaques. Arterial health testing may identify increased risk of cardiovascular disease compared with risk obtained through AHA/ACC Pooled Cohort Equation. Measures of arterial stiffness correlate with the burden of disease activity over time.
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Affiliation(s)
- Erin M Scanlon
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
| | - Rekha Mankad
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Cynthia S Crowson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Iftikhar J Kullo
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Sharon L Mulvagh
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Eric L Matteson
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.,Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Zoran Kvrgic
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - John M Davis
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
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Li X, Shen J, Lu Z, Chen M, Fang X, Wang G. High neutrophil-to-lymphocyte ratio is associated with increased carotid artery intima-media thickness in type 2 diabetes. J Diabetes Investig 2016; 8:101-107. [PMID: 27220111 PMCID: PMC5217917 DOI: 10.1111/jdi.12541] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/12/2016] [Accepted: 05/22/2016] [Indexed: 01/09/2023] Open
Abstract
Aims/Introduction Emerging evidence suggests that the neutrophil‐to‐lymphocyte ratio (NLR) is a novel potential marker of inflammatory responses. The objective was to evaluate the association between NLR and carotid artery intima‐media thickness (cIMT) in type 2 diabetes. Materials and Methods We carried out a case–control study involving 320 patients with type 2 diabetes, and 250 age‐, sex‐ and body mass index‐matched healthy controls who all underwent carotid ultrasonography and took a blood examination. We divided the diabetes patients into two groups according to cIMT: 188 diabetes patients with high cIMT and 132 diabetes patients with low cIMT, and compared baseline characteristics and NLR between the two groups and healthy controls. Results The mean NLR was significantly higher in the group of diabetes patients with high cIMT than the group of diabetes patients with low cIMT, who in turn showed a significantly higher NLR compared with control participants. Logistic regression analysis showed that the NLR was an independent risk factor for diabetes patients with high cIMT (odds ratio 140.89, 95% CI 1.71–11615.30, P = 0.028). Based on the receiver operating characteristic curve, use of the NLR as an indicator for diabetes patients with high cIMT diagnosis was projected to be 3.16, and yielded a sensitivity and specificity of 36.2% and 93.2%, respectively, with an area under the curve of 0.606 (95% CI 0.544–0.667). Conclusions High NLR might be a potential biomarker for the increased cIMT in type 2 diabetes patients. Future studies are required to validate our findings.
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Affiliation(s)
- Xueqin Li
- Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China
| | - Jun Shen
- Department of Neurology, Huai'an Hospital Affiliated of Xuzhou Medical College and Huai'an Second People's Hospital, Huai'an, Jiangsu, China
| | - Zhenghong Lu
- Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China
| | - Min Chen
- Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China
| | - Xiaozheng Fang
- Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China
| | - Gongcheng Wang
- Department of Urology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China
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18
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Privitera G, Spadaro L, Alagona C, Calanna S, Piro S, Rabuazzo AM, Purrello F. Hepatic insulin resistance in NAFLD: relationship with markers of atherosclerosis and metabolic syndrome components. Acta Diabetol 2016; 53:449-59. [PMID: 26496770 DOI: 10.1007/s00592-015-0816-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 10/07/2015] [Indexed: 01/30/2023]
Abstract
AIMS Fat accumulation in the liver and in the muscle results in hepatic and muscle insulin resistance and has been associated with increased cardiovascular risk. It is unclear whether the individual role of hepatic and muscle insulin resistance in the onset of dyslipidaemia is observed in nonalcoholic fatty liver disease (NAFLD) patients and whether this association is mediated through traditional risk factors. The aim of this study was to assess hepatic and muscle insulin resistance in NAFLD and its relationship with carotid artery intima-media thickness (IMT) and the apoB/apoAI ratio as markers of atherosclerosis. METHODS We studied 132 patients with a non-invasive diagnosis of NAFLD stratified into two groups according to the severity of steatosis at ultrasound scan. In all subjects, we measured hepatic insulin resistance (H-IR) and muscle insulin sensitivity index (MISI) by oral glucose tolerance test as proposed by DeFronzo, IMT, apoB/apoAI and the components of the metabolic syndrome (MS) as defined by ATP III. RESULTS H-IR was significantly higher in moderate/severe steatosis than in the mild steatosis group (p < 0.0001). By contrast, MISI did not differ between the two groups. There was a significant correlation between H-IR, MISI and all of the components of MS. H-IR was significantly correlated with carotid IMT (r = 0.35; p < 0.0001) and the apoB/apoAI ratio (r = 0.43; p < 0.0001). Otherwise, a significant correlation was observed only between MISI and apoB/apoAI ratio. Multivariate analysis revealed that H-IR is related to early markers of atherosclerosis independent of MS components. CONCLUSIONS In our study population, NAFLD was positively associated with carotid IMT, and this association is independent of MS components, but strictly related to H-IR that might contribute to the development of atherosclerosis through an impairment of the lipid profile in terms of the apoB/apoAI ratio. By contrast, no significant relation was observed between MISI and carotid IMT.
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Affiliation(s)
- Graziella Privitera
- Department of Clinical and Molecular Biomedicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy
| | - Luisa Spadaro
- Department of Clinical and Molecular Biomedicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy
| | - Corradina Alagona
- Department of Clinical and Molecular Biomedicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy
| | - Salvatore Calanna
- Department of Clinical and Molecular Biomedicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Molecular Biomedicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy
| | - Agata Maria Rabuazzo
- Department of Clinical and Molecular Biomedicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Molecular Biomedicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy.
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Tenjin A, Nagai Y, Yuji S, Ishii S, Kato H, Ohta A, Tanaka Y. Short-term change of carotid intima-media thickness after treatment of hyperglycemia in patients with diabetes: a cross-sectional study. BMC Res Notes 2016; 9:281. [PMID: 27215550 PMCID: PMC4877758 DOI: 10.1186/s13104-016-2080-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 05/07/2016] [Indexed: 01/25/2023] Open
Abstract
Background The carotid artery intima-media thickness (CIMT) has been used as a predictor of cardiovascular events, but it remains unclear whether CIMT can change over the short term. We evaluated changes of CIMT in patients with diabetes during admission to hospital for 2 weeks. Methods A total of 279 inpatients with diabetes aged 61 ± 14 years were recruited. They were on treatment with insulin and/or oral agents, excluding drugs that influence the fluid balance and hemodynamics. CIMT was measured on the day after admission and on the day before discharge, and the association of ΔCIMT (calculated by subtracting the baseline value from that on the day before discharge) with clinical factors was evaluated. Results Based on the reported annual increase of CIMT (0.04 mm/year), the patients were divided into three groups, in which CIMT increased [I: ΔCIMT ≥ 0.04 mm, n = 64, ΔCIMT = 0.077 ± 0.048 (mean ± SD)], CIMT decreased (D: ΔCIMT ≤ −0.04 mm, n = 51, ΔCIMT = −0.090 ± 0.086), or CIMT was unchanged (N: −0.04 mm < ΔCIMT < 0.04 mm, n = 164, ΔCIMT = 0.002 ± 0.022). Binary logistic regression analysis showed that baseline CIMT and hemoglobin (Hb) were positively correlated, while Hb on the day before discharge was negatively correlated, with a decrease of CIMT. In contrast, baseline HbA1c and Hb were negatively correlated, while Hb on the day before discharge was positively correlated, with an increase of CIMT. Conclusions CIMT may show plasticity in patients with diabetes and can change even after short-term treatment of hyperglycemia for 2 weeks.
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Affiliation(s)
- Ayumi Tenjin
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yoshio Nagai
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
| | - Sayaka Yuji
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Satoshi Ishii
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Hiroyuki Kato
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Akio Ohta
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yasushi Tanaka
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
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Leach NV, Dronca E, Vesa SC, Sampelean DP, Craciun EC, Lupsor M, Crisan D, Tarau R, Rusu R, Para I, Grigorescu M. Serum homocysteine levels, oxidative stress and cardiovascular risk in non-alcoholic steatohepatitis. Eur J Intern Med 2014; 25:762-7. [PMID: 25262992 DOI: 10.1016/j.ejim.2014.09.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/09/2014] [Accepted: 09/08/2014] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Hyperhomocysteinemia is considered an independent risk factor for cardiovascular disease. Oxidative stress is one of the major pathogenic mechanisms in non-alcoholic fatty liver disease and atherosclerosis. AIM Our study aimed to evaluate serum homocysteine levels and oxidative stress in patients with biopsy-proven non-alcoholic steatohepatitis and possible association with cardiovascular risk measured by carotid artery intima-media thickness (c-IMT). PATIENTS AND METHODS 50 patients with non-alcoholic steatohepatitis and 30 healthy controls, age and gender matched, were recruited. Lipid profile, liver biochemical markers, serum homocysteine, vitamins B6 and B12, folic acid, glutathione (reduced and total), erythrocyte superoxide dismutase, whole blood glutathione peroxidase, malondialdehyde and carotid intima-media thickness were assayed. RESULTS Patients had an altered lipid profile and liver biochemical markers; carotid intima-media thickness and serum homocysteine levels were significantly higher compared to controls, but there were no differences in folate, B12 and B6 vitamins levels. Patients had significantly lower levels of glutathione peroxidase activity, total and reduced glutathione and higher levels of malondialdehyde, but unchanged superoxide dismutase activity compared to control group. Also, serum homocysteine level showed significant positive correlation with waist circumference, body mass index, free cholesterol, triglycerides, LDL-cholesterol, amino transferases and negative correlation with reduced and total glutathione, superoxide dismutase and γ-GT. CONCLUSION Non-alcoholic steatohepatitis is an independent cardiovascular risk factor, associated with elevated homocysteine levels, oxidative stress and c-IMT. c-IMT could be used as an indicator of early atherosclerotic changes initiated by dyslipidemia and oxidative stress, while higher level of homocysteine might be an effect of liver damage.
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Affiliation(s)
- Nicoleta V Leach
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Eleonora Dronca
- Department of Medical Genetics, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Stefan C Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dorel P Sampelean
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Elena C Craciun
- Department of Pharmaceutical Biochemistry and Clinical Laboratory, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Monica Lupsor
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Crisan
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana Tarau
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Razvan Rusu
- Department of Medical Biochemistry, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Para
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mircea Grigorescu
- 5th Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Pacifico L, Bonci E, Andreoli G, Romaggioli S, Di Miscio R, Lombardo CV, Chiesa C. Association of serum triglyceride-to-HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents. Nutr Metab Cardiovasc Dis 2014; 24:737-743. [PMID: 24656140 DOI: 10.1016/j.numecd.2014.01.010] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 12/17/2013] [Accepted: 01/07/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS The triglyceride (TG)/high-density lipoprotein-cholesterol (HDL-C) ratio has been reported as a useful marker of atherogenic lipid abnormalities, insulin resistance, and cardiovascular disease. We evaluated in a large sample of children and adolescents the association of TG/HDL-C ratio with early signs of morphological vascular changes and cardiometabolic risk factors including nonalcoholic fatty liver disease (NAFLD). METHODS AND RESULTS The study population, including 548 children (aged 6-16 years), of whom 157 were normal-weight, 118 overweight, and 273 obese, had anthropometric, laboratory, liver and carotid ultrasonography (carotid artery intima-media thickness-cIMT) data collected. Subjects were stratified into tertiles of TG/HDL-C. There was a progressive increase in body mass index (BMI), BMI-SD score (SDS), waist circumference, blood pressure (BP), liver enzymes, glucose, insulin, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein (hsCRP), and cIMT values across TG/HDL-C tertiles. The odds ratios for central obesity, insulin resistance, high hsCRP, NAFLD, metabolic syndrome, and elevated cIMT increased significantly with the increasing tertile of TG/HDL-C ratio, after adjustment for age, gender, pubertal status, and BMI-SDS. In a stepwise multivariate logistic regression analysis, increased cIMT was associated with high TG/HDL-C ratio [OR, 1.81 (95% CI, 1.08-3.04); P < 0.05], elevated BP [5.13 (95% CI, 1.03-15.08); P < 0.05], insulin resistance [2.16 (95% CI, 1.30-3.39); P < 0.01], and NAFLD [2.70 (95% CI, 1.62-4.56); P < 0.01]. CONCLUSION TG/HDL-C ratio may help identify children and adolescents at high risk for structural vascular changes and metabolic derangement.
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Affiliation(s)
- L Pacifico
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Italy
| | - E Bonci
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - G Andreoli
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Italy
| | - S Romaggioli
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Italy
| | - R Di Miscio
- Department of Radiological Sciences, Sapienza University of Rome, Italy
| | - C V Lombardo
- Department of Radiological Sciences, Sapienza University of Rome, Italy
| | - C Chiesa
- Institute of Translational Pharmacology, National Research Council, Via del Fosso del Cavaliere 100, 00133 Rome, Italy.
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Oyama JI, Ishizu T, Sato Y, Kodama K, Bando YK, Murohara T, Node K. Rationale and design of a study to evaluate the effects of sitagliptin on atherosclerosis in patients with diabetes mellitus: PROLOGUE study. Int J Cardiol 2014; 174:383-4. [PMID: 24768387 DOI: 10.1016/j.ijcard.2014.03.204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 03/31/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Jun-Ichi Oyama
- Department of Cardiovascular Medicine, Saga University Faculty of Medicine, Saga, Japan.
| | - Tomoko Ishizu
- Faculty of Medicine, Division of Clinical Medicine, Tsukuba University, Tsukuba, Japan
| | - Yasunori Sato
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Kazuhisa Kodama
- Department of Cardiovascular Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Yasuko K Bando
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University Faculty of Medicine, Saga, Japan
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Cure MC, Tufekci A, Cure E, Kirbas S, Ogullar S, Kirbas A, Unal H, Yuce S, Cakmak S. Low-density lipoprotein subfraction, carotid artery intima-media thickness, nitric oxide, and tumor necrosis factor alpha are associated with newly diagnosed ischemic stroke. Ann Indian Acad Neurol 2013. [PMID: 24339567 DOI: 10.4103/0972-2327.120438.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Small dense (sd) low-density lipoprotein (LDL), tumor necrosis factor (TNF) alpha (α), and nitric oxide (NO) have recently emerged as important stroke risk factors. The aim of the study was to investigate the effects of increased levels of small LDL particle size, TNF-α and NO on the developed ischemic stroke and increased carotid artery intima-media thickness (CIMT). MATERIALS AND METHODS A total of 29 women and 25 men (a total of 54 ischemic stroke patients) and a similar age group of 50 controls (29 females and 21 males) were included in the study. CIMT, C-reactive protein (CRP), TNF-α, NO, and lipid subfraction test of the two groups were measured. RESULTS The mean LDL particle size was smaller in patients with stroke than in the controls (26.8 ± 0.31 nm vs. 27.0 ± 0.31 nm, P = 0.003). sd-LDL, TNF-α, NO, CRP, right CIMT, and left CIMT were higher in patients with stroke than in the controls (respectively; 8.2 ± 7.8 mg/dL vs. 3.3 ± 3.5 mg/dL, P < 0.001;75.6 ± 25.0 pg/mL vs. 65.4 ± 9.1 pg/mL, P = 0.009;76.4 ± 53.3 mmol/L vs. 41.5 ± 27.0 mmol/L, P < 0.001;1.9 ± 2.6 mm vs. 0.4 ± 0.3 mm P < 0.001;0.97 ± 0.38 mm vs. 0.83 ± 0.15 mm, P = 0.007;1.04 ± 0.44 mm vs. 0.87 ± 0.19 mm, P = 0.010). CONCLUSION These results show that sd-LDL is independently associated with the incidence of stroke and may be a risk factor in the development of stroke. In addition, TNF-α, NO, right CIMT, and left CIMT may be a risk factor in the development of ischemic stroke.
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Affiliation(s)
- Medine Cumhur Cure
- Department of Biochemistry, University of Recep Tayyip Erdogan, Rize, Turkey
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Chin SO, Hwang JK, Rhee SY, Chon S, Hwang YC, Oh S, Ahn KJ, Chung HY, Woo JT, Kim SW, Kim YS, Kang JH, Jeong IK. Risk factors for the progression of intima-media thickness of carotid arteries: a 2-year follow-up study in patients with newly diagnosed type 2 diabetes. Diabetes Metab J 2013; 37:365-74. [PMID: 24199166 PMCID: PMC3816138 DOI: 10.4093/dmj.2013.37.5.365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 05/07/2013] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Intima-media thickness (IMT) of the carotid arteries is known to have a positive correlation with the risk of cardiovascular disease. This study was designed to identify risk factors affecting the progression of carotid IMT in patients with type 2 diabetes mellitus (T2DM). METHODS Patients with newly diagnosed T2DM with carotid IMT measurements were enrolled, and their clinical data and carotid IMT results at baseline and 2 years later were compared. RESULTS Of the 171 patients, 67.2% of males and 50.8% of females had abnormal baseline IMT of the left common carotid artery. At baseline, systolic blood pressure, body mass index and smoking in male participants, and fasting plasma glucose and glycated hemoglobin levels in females were significantly higher in patients with abnormal IMT than in those with normal IMT. Low density lipoprotein cholesterol (LDL-C) levels in males and high density lipoprotein cholesterol (HDL-C) levels in females at the 2-year follow-up were significantly different between the nonprogression and the progression groups. Reduction of the United Kingdom Prospective Diabetes Study (UKPDS) 10-year coronary heart disease (CHD) risk score after 2 years was generally higher in the nonprogression group than the progression group. CONCLUSION LDL-C levels in males and HDL-C levels in females at the 2-year follow-up were significantly different between participants with and without progression of carotid IMT. Furthermore, a reduction in the UKPDS 10-year CHD risk score appeared to delay the advancement of atherosclerosis. Therefore, the importance of establishing the therapeutic goal of lipid profiles should be emphasized to prevent the progression of carotid IMT in newly diagnosed T2DM patients.
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Affiliation(s)
- Sang Ouk Chin
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jin Kyung Hwang
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - You-Cheol Hwang
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seungjoon Oh
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyu Jeung Ahn
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ho Yeon Chung
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jeong-taek Woo
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sung-Woon Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Young Seol Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ja-Heon Kang
- Department of Ophthalmology, Kyung Hee University School of Medicine, Seoul, Korea
| | - In-Kyung Jeong
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
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Cure MC, Tufekci A, Cure E, Kirbas S, Ogullar S, Kirbas A, Unal H, Yuce S, Cakmak S. Low-density lipoprotein subfraction, carotid artery intima-media thickness, nitric oxide, and tumor necrosis factor alpha are associated with newly diagnosed ischemic stroke. Ann Indian Acad Neurol 2013; 16:498-503. [PMID: 24339567 PMCID: PMC3841588 DOI: 10.4103/0972-2327.120438] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 07/22/2013] [Accepted: 09/01/2013] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Small dense (sd) low-density lipoprotein (LDL), tumor necrosis factor (TNF) alpha (α), and nitric oxide (NO) have recently emerged as important stroke risk factors. The aim of the study was to investigate the effects of increased levels of small LDL particle size, TNF-α and NO on the developed ischemic stroke and increased carotid artery intima-media thickness (CIMT). MATERIALS AND METHODS A total of 29 women and 25 men (a total of 54 ischemic stroke patients) and a similar age group of 50 controls (29 females and 21 males) were included in the study. CIMT, C-reactive protein (CRP), TNF-α, NO, and lipid subfraction test of the two groups were measured. RESULTS The mean LDL particle size was smaller in patients with stroke than in the controls (26.8 ± 0.31 nm vs. 27.0 ± 0.31 nm, P = 0.003). sd-LDL, TNF-α, NO, CRP, right CIMT, and left CIMT were higher in patients with stroke than in the controls (respectively; 8.2 ± 7.8 mg/dL vs. 3.3 ± 3.5 mg/dL, P < 0.001;75.6 ± 25.0 pg/mL vs. 65.4 ± 9.1 pg/mL, P = 0.009;76.4 ± 53.3 mmol/L vs. 41.5 ± 27.0 mmol/L, P < 0.001;1.9 ± 2.6 mm vs. 0.4 ± 0.3 mm P < 0.001;0.97 ± 0.38 mm vs. 0.83 ± 0.15 mm, P = 0.007;1.04 ± 0.44 mm vs. 0.87 ± 0.19 mm, P = 0.010). CONCLUSION These results show that sd-LDL is independently associated with the incidence of stroke and may be a risk factor in the development of stroke. In addition, TNF-α, NO, right CIMT, and left CIMT may be a risk factor in the development of ischemic stroke.
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Affiliation(s)
- Medine Cumhur Cure
- Department of Biochemistry, University of Recep Tayyip Erdogan, Rize, Turkey
- For correspondence: Dr. Medine Cumhur Cüre, Department of Biochemistry, University of Recep Tayyip Erdogan, School of Medicine, Rize - 53100, Turkey. E-mail:
| | - Ahmet Tufekci
- Department of Neurology, University of Recep Tayyip Erdogan, Rize, Turkey
| | - Erkan Cure
- Department of Internal Medicine, University of Recep Tayyip Erdogan, Rize, Turkey
| | - Serkan Kirbas
- Department of Neurology, University of Recep Tayyip Erdogan, Rize, Turkey
| | - Sabri Ogullar
- Department of Radiology, University of Recep Tayyip Erdogan, Rize, Turkey
| | - Aynur Kirbas
- Department of Biochemistry, University of Recep Tayyip Erdogan, Rize, Turkey
| | - Huseyin Unal
- Department of Radiology, University of Recep Tayyip Erdogan, Rize, Turkey
| | - Suleyman Yuce
- Department of Internal Medicine, University of Recep Tayyip Erdogan, Rize, Turkey
| | - Sevim Cakmak
- Department of Neurology, University of Recep Tayyip Erdogan, Rize, Turkey
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Oz F, Elitok A, Bilge AK, Mercanoglu F, Oflaz H. Relationship Between Brachial Artery Flow-Mediated Dilation, Carotid Artery Intima-Media Thickness and Coronary Flow Reserve in Patients With Coronary Artery Disease. Cardiol Res 2012; 3:214-221. [PMID: 28348690 PMCID: PMC5358134 DOI: 10.4021/cr219w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2012] [Indexed: 12/17/2022] Open
Abstract
Background The aim of this study was to assess the relationship between brachial artery flow mediated dilation (FMD), carotid artery intima-media thickness (IMT) and coronary flow reserve (CFR) in patients with coronary artery disease (CAD). Methods Fifty patients with coronary artery disease, except left anterior descending artery (LAD), who showed no cardiac symptoms and 45 control subjects underwent assessment of brachial artery FMD, carotid artery intima-media thickness by high-resolution ultrasound. In addition, transthoracic second harmonic Doppler echocardiography was used to measure CFR. Results All of the parameters were found to be correlated with each other. CFR correlated with brachial artery FMD (r = 0.232, P < 0.05) and with carotid IMT (r = -0.403, P < 0.001). Carotid IMT correlated with brachial artery FMD (r = -0.211, P < 0.05). Conclusion Transthoracic CFR correlated with well-established noninvasive predictors of atherosclerosis and we suggest that it can be used as a surrogate for coronary atherosclerosis.
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Affiliation(s)
- Fahrettin Oz
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ali Elitok
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Fehmi Mercanoglu
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Huseyin Oflaz
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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