scholarly journals Independent associations of urinary albumin-to-creatinine ratio and serum cystatin C with carotid intima-media thickness in community-living Taiwanese adults

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiu-Shong Liu ◽  
Chia-Ing Li ◽  
Yuh-Cherng Guo ◽  
Chih-Hsueh Lin ◽  
Wen-Yuan Lin ◽  
...  

Abstract Background Renal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. The determinants of cystatin C, a novel marker of renal function, have not been extensively studied in the Asian population. This study aimed to assess the determinants of cystatin C and explore whether carotid thickening was associated with urinary albumin-creatinine ratio and cystatin C in community-living Taiwanese adults. Methods A cross-sectional study was conducted on participants from Taichung City, Taiwan. All the participants underwent carotid ultrasonography. Carotid IMT-mean and IMT-maximum were derived. Kidney biomarkers were measured on the basis of urinary albumin-to-creatinine ratio (ACR) and cystatin C. Multiple linear regression analysis was used. Results A total of 1032 individuals were recruited, and 469 (45.44%) of them were men. An increased cystatin C level was significantly associated with older age, male gender, lack of physical activity, low HDL cholesterol, abdominal obesity, high hs-CRP, and high ACR. The multivariate-adjusted mean carotid IMT-mean and IMT-maximum values significantly increased by 80.49 and 195.23 μm for every one unit of increase in cystatin C level and by 0.07 and 0.14 μm for every one unit of increase in ACR, respectively (all p < 0.001 except ACR on IMT-maximum with p < 0.01). Lack of physical activity, low HDL, abdominal obesity, high hs-CRP, and high ACR were the determinants of cystatin C. Conclusion Cystatin C and ACR were strongly and linearly associated with carotid thickening, a marker of subclinical atherosclerosis.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1428.2-1428
Author(s):  
V. Valinotti ◽  
A. Paats ◽  
R. Acosta ◽  
L. Roman ◽  
I. Acosta-Colman ◽  
...  

Background:The mechanism of increased cardiovascular risk in RA is not well understood and is independent of traditional CV risk factors. Intima-media thickness of the common carotid wall measured by ultrasonogram is a safe and useful biomarker of early stage atherosclerosis that correlates with coronary involvement; and it correlates with severity and duration of disease. Several studies have shown a relationship between inflammation markers, endothelial dysfunction markers, and carotid involvement. (1)Objectives:To determine the presence of inflammation biomarkers and its relationship with subclinical atherosclerosis measured by carotid ultrasound, and with the clinical characteristics in patients with established Rheumatoid Arthritis (RA)Methods:Descriptive, cross sectional, prospective study, in a Paraguayan cohort of patients with RA meeting ACR/EULAR2010 criteria. This study had two phases: the first one, included a standardized questionnaire according to the variables included in the Cardiovascular Risk project (PINV15-0346), from the National Sciences and Technology Council (CONACYT), and physical examination; the second one included laboratory sample collection performed by a specialized laboratory for serum biomarkers measurement for cardiovascular risk prediction (i.e endothelin, alpha-TNF, E-selectin, homocysteine, apolipoprotein, fibrinogen, and high sensitivity-CRP levels) and carotid ultrasound evaluation by a trained specialist, to evaluate subclinical atherosclerosis. Subclinical atherosclerosis was defined as carotid intima-media thickness (CIMT) >0,9mm and/or presence of carotid plaques. All patients signed informed consent. SPSS 23rd version was used for data analysis. Quantitative variables were presented as means and qualitative as frequencies. Chi square test was performed for comparisons between dichotomous variables and t Student for continuous, and p ≤ 0.05 for statistical significance.Results:100 patients were included, 87% were women, mean disease duration 130.9±102.64 months, 77% were RF positive, and 84.4% were ACPA positive, 43.4% had bone erosions, mean ESR-DAS28 was 3,42±1,1; 30% had remission criteria. 39% had extra-articular manifestations.Elevated serum biomarkers were found: fibrinogen >400 mg/dL 88.2%, high sensitivity-CRP (hs-CRP) >5mg/dL 42.9%, endothelin >2 ng/mL 20%, alpha-TNF >15,6 pg/mL 13.1%, E-selectin >79,2 ng/mL 6%. 25.3% had CIMT >0,9 mm and mean CIMT was 0.68±0.25mm. 27.14% had carotid plaques. Patients with CIMT>1mm had higher frequency of family history of arterial hypertension (p=0.006), greater mean disease duration (p=0.0007), hip circumference (p=0.014), blood pressure (SBP p=0.038, DBP p=0.027), HAQ levels (p=0,019) and hs-CRP levels (p=0.013), also lower mean height (p=0,04); while carotid plaques were related to higher homocysteine (p=0.026) and hs-CRP levels (p=0.024).Conclusion:A considerable percentage of patients had subclinical atherosclerosis. Patients with CIMT>0,9mm had a longer disease duration, higher HAQ levels, hip circumference, as well as higher BP. High levels of hs-CRP were more frequently related to the presence of subclinical atherosclerosisReferences:[1]Aday, A. targeting residual inflammatory risk: a shifting paradigm for atherosclerotic disease. Frontiers in cardiovascular medicine. 2019. 6:16.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6403155/pdf/fcvm-06-00016.pdfDisclosure of Interests:None declared


2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Kenan Demircioglu ◽  
Feyza Aksu ◽  
Mustafa Caliskan ◽  
Yusuf Yilmaz

Introduction: Gamma-glutamyltransferase(GGT) plays a catalytic role in degradation of glutathione. Serum GGT is accepted as a marker of oxidative stress.The aim of this study is to investigate the relationship between serum GGT levels and epicardial adipose tissue (EFT) thickness, carotid intima media thickness (CIMT) measurements in patients with psoriasis. Methods: The study population included 89 patients with psoriasis and 79 healthy volunteers. After overnight fasting, blood samples were taken for to determine blood glucose levels and establishing cholesterol profiles including TG, TC, LDL cholesterol and high-density lipoprotein (HDL) cholesterol; GGT; and high- sensitivity C-reaktive protein (hs-CRP) levels. A high-resolution B-mode ultrasound machine (Toshiba, aplio XU) with a 7.5 MHz linear transducer used for examing CIMT.The right common carotid artery (CCA), approximately 1 cm proximal to the bifurcation, was longitudinally selected and CIMT was defined as the distance between the intima and the media. Results: 89 patients with psoriasis (age:41.7±10.9 years;41 women, 48 men), and 71 healthy control subjects (age:40.4±8.2 years;39 women, 32 men) were included. There were no significant variation for age and sex between two groups(p>0.05).The hs-CRP and GGT values were significantly higher in psoriasis, compared with the controls (hs-CRP:1.35(0.9-3.6)mg/l for psoriasis group, 0.45(0.29-0.79)mg/l for control group, p<0.001; GGT:20.6±9.6 U/l for psoriasis group, 16.7±8.0 U/l for control group, p=0.02. In psoriatic patients, CIMT and EFT were significantly inreased (0.60(0.50-0.68)mm vs. 0.50 (0.40-0.60)mm;p=0.007, 0.67±0.20cm; 0.27±0.12cm; p<0.001, respectively) compared with the control group. CIMT significantly positively correlated with EFT, age, BMI, diastolic BP and GGT.EFT significantly positively correlated with GGT, CIMT, age, hs-CRP, systolic BP and TG and negatively correlated with HDL cholesterol. Discussion: The pathophysiology of atherosclerosis in psoriasis is not fully explained.GGT may be used as an indicator of subclinical atherosclerosis like CRP.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040890
Author(s):  
Shanshan Liu ◽  
Jingya Niu ◽  
Shujing Wu ◽  
Zhuojun Xin ◽  
Zhiyun Zhao ◽  
...  

ObjectiveWe aimed to examine the associations of urinary albumin-to-creatinine ratio (ACR) levels with risks of subclinical atherosclerosis, cardiovascular events and all-cause deaths.MethodsData from a large population-based cohort were used, which included 9580 participants aged ≥40 years free from cardiovascular diseases. Carotid intima–media thickness, brachial-ankle pulse wave velocity and ankle-brachial index were measured at baseline to assess subclinical atherosclerosis. After a median of 4.53 years’ follow-up, 486 cardiovascular events and 230 all-cause deaths were recorded.ResultsThe urinary ACR levels were categorised into three groups. Compared with the normal group (0≤ACR <7.82 mg/g), people with low-grade albuminuria (7.82≤ACR <30 mg/g) and albuminuria (ACR ≥30 mg/g) had higher levels of subclinical atherosclerosis. In prospective analysis, people with low-grade albuminuria was not significantly associated with cardiovascular events (HR=1.18; 95% CI 0.95 to 1.46], whereas people with albuminuria had a 50% higher risk of cardiovascular events (HR=1.50; 95% CI 1.11 to 2.03). People with low-grade albuminuria and albuminuria had 43% (HR=1.43; 95% CI 1.05 to 1.93) and 87% (HR=1.87; 95% CI 1.24 to 2.81) higher risks of all-cause deaths during follow-up, respectively. In stratified analysis, the association of higher ACR with risks of cardiovascular events and all-cause deaths was stronger among individuals with concomitant subclinical atherosclerosis, the presence of diabetes and more cardiovascular risk factors, respectively.ConclusionsACR levels were positively associated with subclinical atherosclerosis and predicted the risks of cardiovascular events and all-cause deaths. Evaluation of ACR levels should be integrated into risk stratification and prevention of cardiovascular events and all-cause deaths, especially among those with pre-existing subclinical atherosclerosis and cardiometabolic abnormalities.


Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 841
Author(s):  
Daniela Coggi ◽  
Beatrice Frigerio ◽  
Alice Bonomi ◽  
Massimiliano Ruscica ◽  
Nicola Ferri ◽  
...  

(1) Background and purpose: circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) is one of the key regulators of cholesterol metabolism. Despite this, its role as a player in atherosclerosis development is still matter of debate. Here, we investigated the relationships between this protein and several markers of subclinical atherosclerosis. (2) Methods: the IMPROVE study enrolled 3703 European subjects (54–79 years; 48% men; with ≥3 vascular risk factors), asymptomatic for cardiovascular diseases. PCSK9 levels were measured by ELISA. B-mode ultrasound was used to measure markers of carotid subclinical atherosclerosis. (3) Results: in the crude analysis, PCSK9 levels were associated with several baseline measures of carotid intima-media thickness (cIMT) (all p < 0.0001); with cIMT change over time (Fastest-IMTmax-progr) (p = 0.01); with inter-adventitia common carotid artery diameter (ICCAD) (p < 0.0001); and with the echolucency (Grey Scale Median; GSM) of both carotid plaque and plaque-free common carotid IMT (both p < 0.0001). However, after adjustment for age, sex, latitude, and pharmacological treatment, all the afore-mentioned correlations were no longer statistically significant. The lack of correlation was also observed after stratification for sex, latitude, and pharmacological treatments. (4) Conclusions: in subjects who are asymptomatic for cardiovascular diseases, PCSK9 plasma levels do not correlate with vascular damage and/or subclinical atherosclerosis of extracranial carotid arteries.


2010 ◽  
Vol 104 (8) ◽  
pp. 1202-1211 ◽  
Author(s):  
Yoon Jung Yang ◽  
Bo Youl Choi ◽  
Byung-Yeol Chun ◽  
Sun-Seog Kweon ◽  
Young-Hoon Lee ◽  
...  

The relationship between dietary Zn intake and the risk of atherosclerosis remains unclear, and no epidemiological studies have been reported on the effects of dietary Zn intake on morphological changes in the vascular wall. We examined the relationship between dietary Zn intake and common carotid intima-media thickness (IMT) as a marker of subclinical atherosclerosis among the middle-aged and elderly populations. A cross-sectional analysis of a prospective cohort baseline study was performed with 4564 adults aged 40–89 years and free of clinical CVD. Dietary data were collected by trained interviewers using an FFQ. Common carotid IMT was measured using a B-mode ultrasound imaging technique. Subclinical atherosclerosis was determined using carotid IMT, and defined as >80th percentile of carotid IMT or ≥ 1 mm of carotid IMT. After adjustment for potential confounders, the mean carotid IMT in the low Zn intake group was higher than that in the high Zn intake group. When subclinical atherosclerosis was defined as >80th percentile value of IMT or ≥ 1 mm of carotid IMT, after adjustment for potential confounders, Zn intake was inversely related to subclinical atherosclerosis (5thv.1st quintile, OR 0·64, 95 % CI 0·45, 0·90,Pfor trend = 0·069; 5thv.1st quintile, OR 0·34, 95 % CI 0·16, 0·70,Pfor trend = 0·005, respectively). In persons free of clinical CVD, dietary Zn intake was inversely correlated with subclinical atherosclerosis. The present findings suggest a putative protective role of dietary Zn intake against the development of atherosclerosis.


Angiology ◽  
2008 ◽  
Vol 60 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Mario Bo ◽  
Laura Corsinovi ◽  
Alessia Brescianini ◽  
Alessandro Sona ◽  
Marco Astengo ◽  
...  

Objective This study investigated whether high-sensitivity C-reactive protein (hs-CRP) levels are independently associated with subclinical peripheral atherosclerosis. Methods. Clinical variables, cardiovascular (CV) risk factors, 10-year CV risk, the antebrachial Index (ABI), and the carotid intima—media thickness (cIMT) were determined in a sample of consecutive subjects free from previous CV disease, admitted for a first visit at a lipid clinic. Results. In the overall sample (320 subjects, mean age 63 years, 35.8% men), hs-CRP levels were associated with major CV risk factors, 10-year CV risk, lower ABI, and higher cIMT values. In a logistic model, after adjustment for significant covariates, the associations of hs-CRP levels with ABI and cIMT were no longer statistically significant. Conclusions. Among asymptomatic, moderate- to-high CV risk subjects, hs-CRP levels were associated with severity of peripheral atherosclerosis, but these associations were not independent of traditional CV risk factors, suggesting a limited predictive role of hs-CRP for subclinical atherosclerosis.


Author(s):  
Chuan-Wei Yang ◽  
Yuh-Cherng Guo ◽  
Chia-Ing Li ◽  
Chiu-Shong Liu ◽  
Chih-Hsueh Lin ◽  
...  

Carotid intima–media thickness (IMT), plaque, and stenosis are widely used as early surrogate markers of subclinical atherosclerosis and strong predictors of future deaths and cardiovascular events. Albuminuria is an indicator of generalized endothelial dysfunction that speeds up atherosclerosis. However, previous studies reporting these associations cannot rule out the confounding effect of albuminuria. We aimed to examine the independent and joint relationships between IMT markers and 10-year mortality in community-dwelling Taiwanese adults. This work was a community-based prospective cohort study consisting of 2956 adults aged at least 30 years recruited in 2007 and followed up through 2019. Cox proportional hazard regression models were used to examine associations of these subclinical atherosclerosis markers with mortality. During an average of 9.41 years of follow up, 242 deaths occurred. The mortality rate was 8.70 per 1000 person-years. Compared with those with carotid IMT less than 1.0 mm, persons with severely increased carotid IMT (≥2.0 mm) had an increased risk for death (hazard ratio (HR): 1.79; 95% confidence interval (CI): 1.07, 3.00). Compared with those without carotid plaque, persons with carotid plaque were more likely to have an increased risk for death (1.65; 1.21–2.32). Compared with those with carotid stenosis less than 25%, persons with carotid stenosis of 25–36% had a significant increased risk for death (1.57; 1.12–2.22). Considering these three IMT markers along with the traditional risk factors (c-statistic: 0.85) significantly increased their predictive ability of mortality compared with any individual variable’s predictive ability (all p-values < 0.001 for comparisons of c-statistic values). Carotid IMT measures, including IMT thickness, carotid plaque, and carotid stenosis were significant independent predictors of mortality. Our study supports evidence of blood pressure-related media thickening markers to assess future mortality risks in Chinese adults of general population.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jarett D Berry ◽  
Kiang Liu ◽  
Aaron R Folsom ◽  
Joseph F Polak ◽  
Cora E Lewis ◽  
...  

Objective : The Adult Treatment Panel (ATP) III recommends estimating 10-year risk for cardiovascular disease (CVD), but this strategy identifies few individuals age ≤ 50 years as high risk. Many individuals have a lifetime risk up to 70% despite a low 10-year risk (<10%) for CVD. We hypothesized that individuals with low 10-year/high lifetime risk would have a greater burden of subclinical atherosclerosis compared to individuals with low 10-year/low lifetime risk. Methods : We included individuals age ≤ 50 from two multiethnic NHLBI-sponsored studies designed to assess the importance of risk factors in the development of CVD [2988 from Coronary Artery Risk Development in Young Adults (CARDIA) study;1076 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA)]. The ATP III 10-year risk and lifetime risk for CVD were estimated for each participant, permitting stratification into three groups: low 10-year (<10%)/low lifetime (<39%) risk, low 10-year (<10%)/high lifetime risk (≥ 39%), and high 10-year risk (≥ 10%). Diabetics were considered to have high 10-year (≥ 10%) risk in all analyses. Baseline levels (CAC, IMT) and change in levels of subclinical atherosclerosis (CAC progression) were compared across the 3 risk strata for both cohorts. Results : As expected, those with high 10-year risk (≥ 10%) had the greatest burden of subclinical atherosclerosis in both studies. Among individuals with low 10-year risk (91% of all participants) in CARDIA, individuals with a high lifetime risk had significantly greater carotid IMT, higher CAC prevalence, and greater incidence of CAC progression compared to individuals with low lifetime risk (see table ). A remarkably similar pattern of results was observed in MESA. Conclusions : Individuals with low 10-year but high lifetime risk for CVD have a greater subclinical disease burden and greater incidence of atherosclerotic progression compared to individuals with low 10-year but low lifetime risk. Baseline Carotid Intima-Media Thickness (IMT), Coronary Artery Calcium (CAC) Prevalence and Progression among CARDIA Participants


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Engelbert A. Nonterah ◽  
◽  
Nigel J. Crowther ◽  
Abraham Oduro ◽  
Godfred Agongo ◽  
...  

Abstract Background The cardiovascular health index (CVHI) introduced by the American Heart Association is a valid, accessible, simple, and translatable metric for monitoring cardiovascular health in a population. Components of the CVHI include the following seven cardiovascular risk factors (often captured as life’s simple 7): smoking, dietary intake, physical activity, body mass index, blood pressure, glucose, and total cholesterol. We sought to expand the evidence for its utility to under-studied populations in sub-Saharan Africa, by determining its association with common carotid intima-media thickness (CIMT). Methods We conducted a cross-sectional study involving 9011 participants drawn from Burkina Faso, Ghana, Kenya, and South Africa. We assessed established classical cardiovascular risk factors and measured carotid intima-media thickness of the left and right common carotid arteries using B-mode ultrasonography. Adjusted multilevel mixed-effect linear regression was used to determine the association of CVHI with common CIMT. In the combined population, an individual participant data meta-analyses random-effects was used to conduct pooled comparative sub-group analyses for differences between countries, sex, and socio-economic status. Results The mean age of the study population was 51 ± 7 years and 51% were women, with a mean common CIMT of 637 ± 117 μm and CVHI score of 10.3 ± 2.0. Inverse associations were found between CVHI and common CIMT (β-coefficients [95% confidence interval]: Burkina Faso, − 6.51 [− 9.83, − 3.20] μm; Ghana, − 5.42 [− 8.90, − 1.95]; Kenya, − 6.58 [− 9.05, − 4.10]; and South Africa, − 7.85 [− 9.65, − 6.05]). Inverse relations were observed for women (− 4.44 [− 6.23, − 2.65]) and men (− 6.27 [− 7.91, − 4.64]) in the pooled sample. Smoking (p < 0.001), physical activity (p < 0.001), and hyperglycemia (p < 0.001) were related to CIMT in women only, while blood pressure and obesity were related to CIMT in both women and men (p < 0.001). Conclusion This large pan-African population study demonstrates that CVHI is a strong marker of subclinical atherosclerosis, measured by common CIMT and importantly demonstrates that primary prevention of atherosclerotic cardiovascular disease in this understudied population should target physical activity, smoking, obesity, hypertension, and hyperglycemia.


1994 ◽  
Vol 72 (04) ◽  
pp. 563-566 ◽  
Author(s):  
Tuomo Rankinen ◽  
Sari Väisänen ◽  
Michele Mercuri ◽  
Rainer Rauramaa

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.


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