scholarly journals SCREENING MARKERS

2016 ◽  
Vol 23 (08) ◽  
pp. 932-938
Author(s):  
Sikandar Hayat Khan ◽  
Syed Aown Raza Bokhari ◽  
Muhammad Shahzad Hanif
Keyword(s):  
Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Radiology Department ◽  
Cardiovascular Risks ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Experienced Radiologist ◽  
Diagnosed Diabetes

The screening measures to identify various cardiovascular risks relatedto hyperglycemia, hypertension and hypercholesterolemia are involves both anatomicassessments like anthropometric measures or body’s physiological evaluation by performingbiochemical parameters. In this regard “lipid accumulation product” (LAP) has surfaced as amarker to incorporate both these anatomic and physiological considerations. Objectives: 1. Tomeasure the LAP differences between subjects having normal and higher levels of glucose, totalcholesterol, age, carotid intima media thickness and subjects with and without hypertension. 2.To compare BMI and LAP in terms of effectiveness as a screening marker for diagnosis of diabetesmellitus and hypertension through ROC curve calculation. Design: Cross-sectional analysis.Place and duration of study: This study was carried out at the departments of pathology, PNSRAHAT hospital from Jan-2011 to Oct-2011. Subjects and methods: After several exclusionsincluding know diabetics a total of 202 subjects were enrolled to undergo sampling for Fastingblood glucose, and lipids in exact medical fasting status. These subjects were later evaluatedfor their various anthropometric measurements including BMI and WHpR (Wait to hip ratio) asper the WHO protocol. Then the individuals went to radiology department where carotid intimamedia thickness measurements were made by experienced radiologist. LAP (Lipid accumulationproducts) score was calculated as: LAP score (Male) = [WC (cm) - 65] x triglycerides (mmol/L)LAP score (Female) = [WC (cm) – 58] x triglycerides (mmol/L). LAP scores, BMI. WHpR andmean CIMT readings were grouped as per their high or low results. Results: Out of BMI, WHpRand LAP score, only groups based upon LAP score were observed to be significantly differentfor fasting blood glucose, total cholesterol and mean CIMT levels. Hypertensive subjects hadhigher LAP scores and WHpR than non-hypertensive subjects; however, BMI differences werenot considered significant. One way ANOVA shows the LAP scores progressively rising formnormoglycemic subjects {58.38 (95% CI: 51.08-65.67)} to subjects having IFG {70.94(95%CI:60.88-81.00)} to newly diagnosed diabetes mellitus {101.59(95%CI: 78.35-124.83)}.[P=0.001]The AUCs for diagnosing hypertension was higher for LAP scores than for BMI and WHpR[{(LAP score: 0.648 (95% CI: 0.536-0.760), p= 0.027} vs {(WHpR: 0.588 (95% CI: 0.466-0.709),p= 0.191} vs {(BMI: 0.541 (95% CI: 0.412-0.670), p=0.545}]. Similarly, the AUCs for BMI andWHpR were lower than that of LAP score for predicting a diagnosis of diabetes mellitus [{(LAPscore: 0.584 (95% CI: 0.502-0.665), p= 0.047} vs {(BMI: 0.531 (95% CI: 0.448-0.613), p=0.468}vs {WHpR: 0.518 (95% CI: 0.435-0.601), p=0.668}]. Conclusion: LAP scores were higherin subjects with established cardiovascular risks like hyperglycemia, hypercholesterolemia,accelerated atherosclerosis and hypertension that simple anthropometric indices like BMI andWHpR.

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 Association of prehypertension and hyperhomocysteinemia with subclinical atherosclerosis in asymptomatic Chinese: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019829 ◽  
Author(s):  
Bo Liu ◽  
Zhihao Chen ◽  
Xiaoqi Dong ◽  
Guangming Qin
Keyword(s):  
Risk Factor ◽  
Subclinical Atherosclerosis ◽  
Multiple Logistic Regression Analysis ◽  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Control Group ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference

ObjectivesComorbid hypertension and hyperhomocysteinemia is an important risk factor for carotid atherosclerotic plaque formation. We put forward the hypothesis that the subjects with comorbid prehypertension and hyperhomocysteinemia also had an increased risk of subclinical atherosclerosis, using carotid intima–media thickness (CIMT) as the marker of the atherosclerotic process.MethodsA total of 4102 asymptomatic Chinese subjects aged 18–60 years were divided into four groups according to blood pressure (BP) and homocysteine (HCY) level: the control group without prehypertension or hyperhomocysteinemia, isolated prehypertension group, simple hyperhomocysteinemia group and prehypertension with hyperhomocysteinemia group. Serum lipids, fasting blood glucose (FBG), HCY and CIMT were measured.ResultsThere was significant difference in the positive rates of increased CIMT among four groups. Compared with the controls, the subjects in the other three groups had a higher risk of increased CIMT (isolated prehypertension group, OR 2.049, 95% CI 1.525 to 2.754; simple hyperhomocysteinemia group, OR 2.145, 95% CI 1.472 to 3.125; prehypertension and hyperhomocysteinemia group, OR 3.199, 95% CI 2.362 to 4.332). However, by multiple logistic regression analysis, only comorbid prehypertension and hyperhomocysteinemia was independently associated with increased CIMT (OR 1.485, 95% CI 1.047 to 2.108, P<0.05).ConclusionsComorbid prehypertension and hyperhomocysteinemia was an independent risk factor of subclinical atherosclerosis in asymptomatic Chinese, but isolated prehypertension or hyperhomocysteinemia was not. Therefore, combined intervention for prehypertension and hyperhomocysteinemia may contribute to decrease the incident of cardiovascular disease.

scholarly journals Accuracy of Different Metabolic Syndrome Definitions for Detecting Increased Carotid Intima-media Thickness in Peruvian Type 2 Diabetes Mellitus Subjects without Cardiovascular Disease.

2020 ◽  
Author(s):  
Alberto Teruya-Gibu ◽  
Marlon Yovera-Aldana ◽  
Diana Urquiza-Salvador ◽  
Laurie Marcilla-Trullenque
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional ◽  
Media Thickness ◽  
Bilateral Carotid

Abstract Backrgound: To estimate the accuracy of metabolic syndrome definitions for detecting Carotid Intima-Media thickness (CIMT) in Peruvian type 2 diabetes mellitus (T2DM) subjects without cardiovascular events.Methods: We performed a cross-sectional evaluation of T2DM subjects from the endocrinology service of two reference health centers without stroke or coronary disease. . Bilateral carotid intima-media thickness was measure by B mode ultrasound one only operator. We performed four definitions of Metabolic Syndrome; 1. Cholesterol Education Program Adult Treatment Panel III (ATP III), 2. Harmonized criteria; 3. Gurka's Metabolic syndrome severity score (MSSS) formula. 4. Non-glucose modified MSSS. We calculated the area under the receiver operator curve (AUROC) for detecting increased CIMT (≥ 0.86 mm) between metabolic syndrome definitions. Results: We included 184 subjects with T2DM, 29% were men with a mean age of 61.5 ± 10.5 years old. Median diabetes time was 10.8 years (IQR 4.8 to 19.4), and 26.8% achieved HbA1c goals. Non-glucose modified MSSS was the only definition significantly correlated with elevated CIMT (r = 0.19; p<0.01), and it showed the best accuracy for predicting elevated CIMT (AUC: 0.61, CI95%: 0.52-0.70). Adjusting for age, sex, and HbA1c, each point increase in the non-glucose MSSS Z score, the risk of altered CIMT increases by 59% RP 1.59 (CI 95% 1.09 - 2.35; p=0.017). Conclusions: Non-glucose modified MSSS had a weak accuracy for elevated CIMT and was the best compared to ATP III, harmonized, and original MSSS. Further research on no MS-factors is required to predict better elevated CIMT.

Correlation of Waist to Calf Circumference Ratio and Carotid Intima Media Thickness in Diabetes Mellitus

2020 ◽  
Vol 16 ◽  
Author(s):  
Harish A Rao ◽  
Prakash Harischandra ◽  
Srikanth Yadav
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Calf Circumference ◽  
Media Thickness

Introduction: Diabetes mellitus is a well-known risk factor for cardiovascular disease, because of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral subcutaneous fat and is inversely associated with occurrence of carotid plaques (CP). Multiplicative and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in event of CP suggest that the two measures should be taken into account commonly while assessing vascular risk profile. Aim & Objective: To ascertain if waist to calf circumference ratio (WCR) is a marker of Carotid atherosclerosis in patients with type 2 diabetes mellitus. To asses s the correlation between waist to calf circumference ratio and carotid intima media thickness (CIMT ) in patients with Type 2 diabetes. Materials and methods: A cross sectional study at Hospital affiliated to Kasturba Medical college Mangalore from Sept 2016 to Sept 2018 . Method of study: Patients with type 2 DM as per ADA criteria, age >18years are recruited for the study. Results and discussion: In our study with 150 population 25 patients had carotid atherosclerosis and 20 patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07 and 99.85 & the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the range of 3.12 to 3.26. The difference was statistically significant with a p value of <0.05. In our study it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly calf circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR. Conclusion: To conclude, in our population based study of 150 subjects we found that carotid atherosclerosis is significantly more in people with increased waist calf circumference ratio. WCR may be a new, useful and practical anthropometric index that facilitates the early identification of diabetic subjects with high risk for cardiovascular disease. Validation of this finding in individual populations is required. Future studies should test the association of calf circumference with carotid intima media thickness and carotid plaques using better measures than ultrasound such as magnetic resonance imaging. Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is required.

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

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.

scholarly journals Caesarean delivery is associated with increased blood pressure in young adult offspring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amaraporn Rerkasem ◽  
Sarah E. Maessen ◽  
Antika Wongthanee ◽  
Sakda Pruenglampoo ◽  
Ampica Mangklabruks ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Birth Cohort ◽  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Adjusted Relative Risk ◽  
Obesity Risk ◽  
Chiang Mai ◽  
Clinical Assessments

AbstractWe examined the associations between caesarean section (CS) delivery and cardiovascular risk factors in young adults in Thailand. Participants were 632 offspring from a birth cohort in Chiang Mai (Northern Thailand), born in 1989–1990 and assessed in 2010 at a mean age of 20.6 years, including 57 individuals (9.0%) born by CS and 575 born vaginally. Clinical assessments included anthropometry, blood pressure (BP), carotid intima-media thickness, and fasting blood glucose, insulin, and lipid profile. Young adults born by CS had systolic BP (SBP) 6.2 mmHg higher (p < 0.001), diastolic BP 3.2 mmHg higher (p = 0.029), and mean arterial pressure (MAP) 4.1 mmHg higher (p = 0.003) than those born vaginally. After covariate adjustments, SBP and MAP remained 4.1 mmHg (p = 0.006) and 2.9 mmHg (p = 0.021) higher, respectively, in the CS group. The prevalence of abnormal SBP (i.e., pre-hypertension or hypertension) in the CS group was 2.5 times that of those born vaginally (25.0% vs 10.3%; p = 0.003), with an adjusted relative risk of abnormal SBP 1.9 times higher (95% CI 1.15, 2.98; p = 0.011). There were no differences in anthropometry (including obesity risk) or other metabolic parameters. In this birth cohort in Thailand, CS delivery was associated with increased blood pressure in young adulthood.

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