Cardiovascular Risk in Women With Premature Ovarian Insufficiency Compared to Premenopausal Women at Middle Age

Abstract Context: A young age at menopause has been associated with increased cardiovascular disease (CVD) risk. Objective: To compare the cardiovascular risk profile between women with premature ovarian insufficiency (POI) and premenopausal controls of comparable age. Design: Cross-sectional case control study. Setting: Two university medical centers. Participants: Women above 45 years of age who were previously diagnosed with POI (n = 83) and premenopausal population controls of comparable age (n = 266). Main Outcome Measures: Blood pressure, body mass index, waist circumference, electrocardiogram, bilateral carotid intima media thickness, estradiol, T, androstenedione, dehydroepiandrosterone sulfate, SHBG, insulin, glucose, lipids, TSH, free T4, N-terminal pro-B-type natriuretic peptide, C-reactive protein, uric acid, creatinine, and homocysteine were measured. Potential associations between POI status and subclinical atherosclerosis were assessed. Results: Women with POI exhibited an increased waist circumference (β = 5.7; 95% confidence interval [CI], 1.6, 9.9), C-reactive protein (β = 0.75; 95% CI, 0.43, 1.08), free T4 levels (β = 1.5; 95% CI, 0.6, 2.4), and lower N-terminal pro-B-type natriuretic peptide (β = −0.35; 95% CI, −0.62, −0.08), estradiol (β = −1.98; 95% CI, −2.48, −1.48), T (β = −0.21; 95% CI, −0.37, −0.06), and androstenedione (β = −0.54; 95% CI, −0.71, −0.38) concentrations compared to controls, after adjusting for confounders. After adjustment, a trend toward increased hypertension (odds ratio = 2.1; 95% CI, 0.99; 4.56) and decreased kidney function was observed in women with POI (creatinine β = 3.5; 95% CI, −0.05, 7.1; glomerular filtration rate β = −3.5; 95% CI, −7.5, 0.46). Women with POI exhibited a lower mean carotid intima media thickness (β = −0.17; 95% CI, −0.21, −0.13) and decreased odds of plaque presence compared to controls (odds ratio = 0.08; 95% CI, 0.03; 0.26). Conclusions: Women with POI exhibited an unfavorable cardiovascular risk profile, including higher abdominal fat, elevated chronic inflammatory factors, and a trend toward increased hypertension and impaired kidney function compared to controls. However, we observed no signs of increased subclinical atherosclerosis in women with POI. Additional studies are required to identify specific determinants of long-term CVD risk in women with POI.

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Serum Levels of Anticyclic Citrullinated Peptide Antibodies, Interleukin-6, Tumor Necrosis Factor-α, and C-Reactive Protein Are Associated with Increased Carotid Intima-Media Thickness: A Cross-Sectional Analysis of a Cohort of Rheumatoid Arthritis Patients without Cardiovascular Risk Factors

BioMed Research International ◽

10.1155/2015/342649 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

Mónica Vázquez-Del Mercado ◽

Lourdes Nuñez-Atahualpa ◽

Mauricio Figueroa-Sánchez ◽

Eduardo Gómez-Bañuelos ◽

Alberto Daniel Rocha-Muñoz ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cardiovascular Risk ◽

Cardiovascular Events ◽

Tumor Necrosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

C Reactive Protein ◽

Reactive Protein ◽

Citrullinated Peptide ◽

Necrosis Factor

The main cause of death in rheumatoid arthritis (RA) is cardiovascular events. We evaluated the relationship of anticyclic citrullinated peptide (anti-CCP) antibody levels with increased carotid intima-media thickness (cIMT) in RA patients.Methods. Forty-five anti-CCP positive and 37 anti-CCP negative RA patients, and 62 healthy controls (HC) were studied. All groups were assessed for atherogenic index of plasma (AIP) and cIMT. Anti-CCP, C-reactive protein (CRP), and levels of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA).Results. The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative (P<0.001). Anti-CCP positive versus anti-CCP negative RA patients, had increased AIP, TNFαand IL-6 (P<0.01), and lower levels of high density lipoprotein cholesterol (HDL-c) (P=0.02). The cIMT correlated with levels of anti-CCP (r=0.513,P=0.001), CRP (r=0.799,P<0.001), TNFα(r=0.642,P=0.001), and IL-6 (r=0.751,P<0.001). In multiple regression analysis, cIMT was associated with CRP (P<0.001) and anti-CCP levels (P=0.03).Conclusions. Levels of anti-CCP and CRP are associated with increased cIMT and cardiovascular risk supporting a clinical role of the measurement of cIMT in RA in predicting and preventing cardiovascular events.

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High-Sensitivity C-Reactive Protein and Carotid Intima Media Thickness as Markers of Subclinical Inflammation and Atherosclerosis in Pediatric Patients with Hypercholesterolemia

Molecules ◽

10.3390/molecules25215118 ◽

2020 ◽

Vol 25 (21) ◽

pp. 5118

Author(s):

Lana Blinc ◽

Matej Mlinaric ◽

Tadej Battelino ◽

Urh Groselj

Keyword(s):

Subclinical Atherosclerosis ◽

Elevated Serum ◽

High Sensitivity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Low Grade ◽

C Reactive Protein ◽

Atherosclerosis Progression ◽

Reactive Protein ◽

Media Thickness

Hypercholesterolemia is a major cause of atherosclerosis development and premature cardiovascular disease (CVD). It leads to inflammation, which further accelerates atherosclerosis progression. Familial hypercholesterolemia (FH) is an autosomal dominant disorder characterized by elevated serum LDL-c from birth, due to a disease-causing variant in one of the causative genes (LDLR, APOB, PCSK9). In polygenic hypercholesterolemia (PH), the disease-causing genetic variant is absent; it is likely the cumulative result of multiple single nucleotide polymorphisms in LDL metabolism-related genes and other factors, such as lifestyle and environment. In high risk groups, such as patients with FH, an effective primary prevention of CVD must begin in childhood. High-sensitivity C-reactive protein (hsCRP) and carotid intima media thickness (cIMT) are two potential minimally invasive correlates of inflammation and subclinical atherosclerosis progression. hsCRP and cIMT have been shown to be significantly increased in patients with FH and PH relative to healthy controls, with some studies yielding conflicting results. In this review, we aim to summarize current knowledge and recent findings regarding the applicability of hsCRP and cIMT as markers of low-grade inflammation and subclinical atherosclerosis, focusing especially on children and adolescents with hypercholesterolemia.

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Metabolic Syndrome and Carotid Intima-Media Thickness in Young Adults: Roles of Apolipoprotein B, Apolipoprotein A-I, C-Reactive Protein, and Secretory Phospholipase A2: The Cardiovascular Risk in Young Finns Study

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.110.204669 ◽

2010 ◽

Vol 30 (9) ◽

pp. 1861-1866 ◽

Cited By ~ 21

Author(s):

Noora Mattsson ◽

Costan G. Magnussen ◽

Tapani Rönnemaa ◽

Ziad Mallat ◽

Joelle Benessiano ◽

...

Keyword(s):

Metabolic Syndrome ◽

Cardiovascular Risk ◽

Apolipoprotein B ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Secretory Phospholipase A2 ◽

C Reactive Protein ◽

Reactive Protein ◽

Apolipoprotein A ◽

Young Finns Study

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On-treatment C-reactive protein and HDL cholesterol levels in patients at intermediate cardiovascular risk: Impact on carotid intima-media thickness

Life Sciences ◽

10.1016/j.lfs.2013.07.008 ◽

2013 ◽

Vol 93 (8) ◽

pp. 338-343 ◽

Cited By ~ 4

Author(s):

Matteo Pirro ◽

Gaetano Vaudo ◽

Graziana Lupattelli ◽

Leonella Pasqualini ◽

Massimo R. Mannarino ◽

...

Keyword(s):

Cardiovascular Risk ◽

Hdl Cholesterol ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

C Reactive Protein ◽

Reactive Protein ◽

Media Thickness ◽

Cholesterol Levels

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High-Sensitivity C-Reactive Protein is Not Independently Associated with Peripheral Subclinical Atherosclerosis

Angiology ◽

10.1177/0003319708322387 ◽

2008 ◽

Vol 60 (1) ◽

pp. 12-20 ◽

Cited By ~ 2

Author(s):

Mario Bo ◽

Laura Corsinovi ◽

Alessia Brescianini ◽

Alessandro Sona ◽

Marco Astengo ◽

...

Keyword(s):

Risk Factors ◽

Subclinical Atherosclerosis ◽

High Sensitivity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

C Reactive Protein ◽

Reactive Protein ◽

Lipid Clinic ◽

Hs Crp ◽

Cv Disease

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.

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The Relationship between Cardiovascular Risk Scores and Several Markers of Subclinical Atherosclerosis in an Asymptomatic Population

Journal of Clinical Medicine ◽

10.3390/jcm10050955 ◽

2021 ◽

Vol 10 (5) ◽

pp. 955

Author(s):

Ovidiu Mitu ◽

Adrian Crisan ◽

Simon Redwood ◽

Ioan-Elian Cazacu-Davidescu ◽

Ivona Mitu ◽

...

Keyword(s):

Risk Score ◽

Subclinical Atherosclerosis ◽

Ankle Brachial Index ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Risk Scores ◽

Cvd Risk ◽

Cross Sectional ◽

Single Center Study ◽

Asymptomatic Individuals

Background: The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals. Methods: A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI). Results: The mean age was 52.01 ± 10.73 years. For cIMT—SCORE was more sensitive; for PWV—Framingham score was more sensitive; for AIXbr—QRISK and PROCAM were more sensitive while for AIXao—QRISK presented better results. As for SBPao—SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score. Conclusions: All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.

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Meta-analysis of epigenome-wide association studies of carotid intima-media thickness

European Journal of Epidemiology ◽

10.1007/s10654-021-00759-z ◽

2021 ◽

Author(s):

Eliana Portilla-Fernández ◽

Shih-Jen Hwang ◽

Rory Wilson ◽

Jane Maddock ◽

W. David Hill ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dna Methylation ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Association Studies ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness

AbstractCommon carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = −0.0264, p value = 3.5 × 10–8) in the discovery panel and was replicated in replication panel (beta = −0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10–13). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.

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AB0258 CAROTID INTIMA-MEDIA THICKNESS AND SERUM BIOMARKERS IN PARAGUAYAN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6520 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1428.2-1428

Author(s):

V. Valinotti ◽

A. Paats ◽

R. Acosta ◽

L. Roman ◽

I. Acosta-Colman ◽

...

Keyword(s):

Cardiovascular Risk ◽

Disease Duration ◽

Subclinical Atherosclerosis ◽

High Sensitivity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Serum Biomarkers ◽

Carotid Plaques ◽

Media Thickness ◽

Hs Crp

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

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