Carotid Intimal Thickness and Flow-Mediated Dilatation in Diabetic and Nondiabetic Continuous Ambulatory Peritoneal Dialysis Patients

2009 ◽  
Vol 29 (2_suppl) ◽  
pp. 96-101 ◽  
Author(s):  
Narayan Prasad ◽  
Sudeep Kumar ◽  
Anurag Singh ◽  
Archana Sinha ◽  
Kamal Chawla ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Inorganic Phosphate ◽  
Pearson Correlation ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional ◽  
Flow Mediated Dilatation ◽  
Serum Inorganic Phosphate

Objectives We compared carotid intima media thickness (CIMT) and flow-mediated dilatation (FMD) between cases [end-stage renal disease patients (diabetic and nondiabetic) on peritoneal dialysis (PD)] and controls (diabetic and hypertensive patients with normal renal function) with the objective of identifying risk factors predicting atherosclerosis. Methods This cross-sectional study involved 124 subjects (62 cases, 62 controls). In both the case and control populations, we used B-mode ultrasonography to study CIMT and endothelium-dependent FMD, according to American College of Cardiology guidelines on brachial artery measurement. Pearson correlation was used to evaluate the correlation between CIMT and other variables. Results Compared with controls, cases had significantly higher systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglycerides, serum uric acid, inorganic phosphate, C-reactive protein, and parathyroid hormone, and significantly lower hemoglobin, calcium, and high-density lipoprotein. Compared with controls, cases showed significantly greater CIMT (0.60 ± 0.08 mm vs 0.54 ± 0.03 mm, p < 0.001) and significantly lower FMD (0.15 ± 0.08 cm vs 0.21 ± 0.04 cm, p = 0.02). Among cases, patients with diabetes had significantly greater CIMT (0.62 ± 0.08 mm vs 0.58 ± 0.07 mm, p = 0.05) than did patients without diabetes; FMD was similar in diabetic and nondiabetic patients on continuous ambulatory PD (0.16 ± 0.03 cm vs 0.18 ± 0.03 cm, p = 0.20). Conclusions Compared with controls, cases had significantly higher CIMT and lower FMD. Cases with diabetes had significantly higher CIMT than did cases without diabetes, but FMD was similar in diabetic and nondiabetic cases. Serum inorganic phosphate is an independent risk factor for atherosclerosis and was significantly correlated with CIMT. The noninvasive CIMT and FMD tests can be used to monitor atherosclerosis and endothelial dysfunction.

P6261Aortic stiffness and carotid intima thickness in hypercholesterolemic males with erectile dysfunction: relation to smoking status and statin therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Ioakeimidis ◽  
C Vlachopoulos ◽  
D Terentes-Printzios ◽  
I Koutagiar ◽  
S Pantou ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Statin Therapy ◽  
Smoking Status ◽  
Low Density Lipoprotein ◽  
Harmful Effect ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Statin Treatment ◽  
Cross Sectional

Abstract Purpose Aim of the study was to examine possible differentiation of aortic stiffness and carotid atherosclerosis among hypercholesterolemic patients with erectile dysfunction (ED) according to smoking status and statin therapy. Methods We measured carotid intima-media thickness (cIMT) and carotid-femoral pulse wave velocity (cfPWV) in three age-matched groups of ED patients with a moderate cardiovascular risk (SCORE) and low-density lipoprotein cholesterol (LDL-C) level greater than or equal to 100 mg/dL: Smokers not receiving statin therapy (n=106), Smokers actively under statin treatment for at least three months with no dose adjustment for a minimum of six weeks (n=59) and Non-smokers not receiving statin therapy (n=97). The severity of ED was evaluated with measurements of penile peak velocity (PSV) 20 min after the intracavernous injection of prostaglandin E1 (20 μg). Results The groups of untreated smokers and non-smokers had similar mean LDL-C level. The mean LDL-C of patients under statin therapy was lower, however the differences with the level of the untreated patients was not statistically significant. Overall 33 (56%) of the patients under statin therapy reached their LDL-C goal. Body mass index and the prevalence of hypertension were not different between the three groups. The PSV was significantly lower in smokers with or without therapy compared to that of non-smokers, denoting significant influence of smoking status on the smaller in size penile arteries and consequently, a unfavorable effect on erectile function. Figure illustrates the differences in cfPWV (left plot) and cIMT (right plot) mean (±SE) values between the three groups. Smokers not receiving statin therapy had significantly higher cfPWV compared to the other groups while smokers under statin therapy had no different cfPWV than that of non-smokers not receiving therapy. The cIMT values were not different between the three groups. Smoking, statins and vascular changes Conclusions Smokers ED patients receiving statin therapy exhibited similar atherosclerotic burden compared to untreated hypercholesterolemic individuals, however, the cfPWV was significantly lower, possibly because of the known pleiotropic effects of these drugs on the aortic elastic properties. Although the cross-sectional design precludes drawing conclusions of causal relationships, the findings of this study have important clinical implications given the harmful effect of both hypercholesterolemia and smoking in men suffering from ED and the higher risk for future cardiovascular events that ED confers.

scholarly journals Association of Body Mass Index in Youth With Adult Cardiometabolic Risk

2020 ◽  
Vol 9 (14) ◽  
Author(s):  
Feitong Wu ◽  
Markus Juonala ◽  
Matthew A. Sabin ◽  
Marie‐Jeanne Buscot ◽  
Katja Pahkala ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Lipoprotein Cholesterol ◽  
Stiffness Index ◽  
Overweight Or Obesity

Background Whether long‐term exposure to overweight or obesity from early life to adulthood has a detrimental influence on health outcomes is unknown. We aimed to investigate whether duration of overweight or obesity from youth to adulthood is associated with adult cardiometabolic risk. Methods and Results A population‐based cohort study was performed of 1268 youths, aged 3 to 18 years, with follow‐ups at 3, 6, 9, 12, 21, 27, and 31 years. Duration of overweight or obesity over 31‐year follow‐up was calculated. Adulthood outcomes included type 2 diabetes mellitus, impaired fasting glucose, high insulin levels, high carotid intima‐media thickness, hypertension, low high‐density lipoprotein cholesterol, high low‐density lipoprotein cholesterol and triglycerides, arterial pulse wave velocity, carotid artery compliance, Young elastic modulus, and stiffness index. Rates of overweight/obesity were 7.9% at baseline and 55.9% after 31 years. After adjustment for confounders, longer duration of overweight or obesity was associated with increased risk of all outcomes (relative risk ranged from 1.45–9.06 for type 2 diabetes mellitus, impaired fasting glucose, carotid intima‐media thickness, hypertension, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, and triglycerides; β from 0.370–0.543 m/s for pulse wave velocity; –0.193 to –0.237 %/10 mm Hg for carotid artery compliance; 52.1–136.8 mm Hg·mm for Young elastic modulus; and 0.554–0.882 for stiffness index). When body mass index was further adjusted, these associations disappeared or were substantially reduced. Detrimental associations of adult body mass index with all outcomes were robust to adjustment for confounders and duration of overweight or obesity. Conclusions Overweight or obesity in adulthood rather than childhood appears to be more important for adult cardiometabolic health.

Morphological and functional vascular changes induced by childhood obesity

2011 ◽  
Vol 18 (6) ◽  
pp. 831-835 ◽  
Author(s):  
Marco Matteo Ciccone ◽  
Vito Miniello ◽  
Roberto Marchioli ◽  
Pietro Scicchitano ◽  
Francesca Cortese ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endothelial Dysfunction ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Vascular Changes ◽  
Obese Children ◽  
Erythrocyte Sedimentation ◽  
Flow Mediated Dilatation ◽  
Anterior Posterior

Background: To investigate endothelial dysfunction and morphological vascular changes in childhood obesity. Methods: 93 overweight/obese children (body mass index 26 ± 5 kg/m2; median 26 kg/m2; interquartile range 22–28 kg/m2), mean age 10.9 ± 2.7 years, underwent a check-up of total, high-density lipoprotein- and low-density lipoprotein-cholesterol, triglycerides, C-reactive protein, erythrocyte sedimentation rate, and white blood cell count, together with ultrasound measures of flow-mediated dilatation, carotid intima-media thickness, and anterior-posterior diameter of the abdominal aorta. Results: The body mass index of overweight/obese children had a statistically significant linear relationship ( p < 0.05) with triglycerides, erythrocyte sedimentation rate, carotid intima-media thickness, anterior-posterior diameter of the abdominal aorta, and flow-mediated dilatation values. Conclusions: Overweight/obese children have an initial endothelial dysfunction and vascular damage, i.e., the first stage in the development of atherosclerosis.

scholarly journals Hypoglycemia In The Emergency, But What Awaits Us For Cardiac Risks In The Future?

2021 ◽  
Author(s):  
Onur Akhan ◽  
İsa Ardahanlı
Keyword(s):  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Blood Tests ◽  
Flow Mediated Dilatation ◽  
Endothelial Dysfunctions

Introduction: Several homeostatic changes like an increase in sympathoadrenal response and oxidative stress occur in hypoglycemia. As a result of these findings, an increase in inflammation and pre-atherogenic factors is observed and these changes may lead to endothelial dysfunction. Aim: Our study aims to reveal possible cardiac risks (systolic-diastolic functions and endothelial dysfunctions) in patients who have applied to the emergency department with hypoglycemia. Methods: This cross-sectional, case-control study included 46 hypoglycemia patients who admitted to the emergency with symptoms compatible with hypoglycemia and diagnosed with hypoglycemia and 30 healthy volunteers. All patients were evaluated with baseline echocardiography, tissue-doppler imaging(carotid and brachial artery). Also, the fasting blood tests of the patients referred to the internal medicine department were examined. Results: There were no differences between the groups regarding age, weight, body mass index, and systolic blood pressure. Total cholesterol, LDL, HDL, Vitamin B12, TSH, and fasting blood glucose levels were similar in the groups’ blood tests (all p values>0.05). We observed a statistically significant decrease in diastolic dysfunction parameters: E/A and E/e’ ratios (respectively, p=0.020 and 0.026). It was shown that insulin resistance was influential in forming these considerable differences. The patient group observed that the carotid intima-media thickness was more remarkable(p=0.001), and the brachial flow-mediated dilatation value was smaller(p=0.003), giving an idea about endothelial functions.

scholarly journals Correlating Carotid Intima-Media Thickness With Lipid Profile: Does It Improve Sonographic Diagnosis of Subclinical Atherosclerosis?

2019 ◽  
Vol 35 (6) ◽  
pp. 453-458 ◽  
Author(s):  
Felicitas U. Idigo ◽  
Eberechukwu N. Ayogu ◽  
Sobechukwu W. I. Onwuzu ◽  
Angel-Mary C. Anakwue ◽  
Uloma B. Nwogu ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Subclinical Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Lipid Profiles ◽  
Media Thickness ◽  
Measure Of Association ◽  
Atherosclerotic Changes

Objective. The purpose of this prospective study was to ascertain if lipid profile parameters could serve as predictors of carotid intima-media thickness (CIMT), which, when combined, may improve the sensitivity of sonographic CIMT measurement in the diagnosis of subclinical atherosclerotic changes. Methods. The lipid profiles and CIMT of 181 subjects without cardiovascular risk factors were measured at the internal, external, common, and bulbar segments. Results. The mean CIMT values obtained were 0.620 ± 0.055 cm for men and 0.575 ± 0.051 cm for women, and the η2 values (η2 < 0.04) were used as a measure of association. Across all segments of both carotid arteries, lipid profiles were significantly and moderately associated with but not predictive of CIMT (fasting blood sugar, total cholesterol, and low-density lipoprotein: η2 = 0.99–0.24). Conclusions. Although lipid profiles were moderately associated with CIMT, they are not significant predictors; hence, combining them with CIMT does not improve the diagnostic sensitivity of sonography in atherosclerosis screening.

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