Prediabetes Is Independently Associated with Subclinical Carotid Atherosclerosis: An Observational Study in a Non-Urban Mediterranean Population

This was a prospective, observational study to compare the burden of subclinical atherosclerosis as measured by carotid ultrasonography in a cohort of subjects with prediabetes vs. subjects with normal glucose tolerance (NGT) from a non-urban Mediterranean population. Atherosclerosis was assessed through carotid intima-media thickness (c-IMT), the presence/absence of carotid plaques, and plaque number. Among 550 subjects included, 224 (40.7%) had prediabetes. The mean c-IMT and the prevalence of carotid plaque were significantly higher in the prediabetes group compared to the NGT group (0.72 vs. 0.67 mm, p < 0.001; and 37.9% vs. 19.6%; p < 0.001, respectively). Older age, male gender, and increased systolic blood pressure were positively correlated with c-IMT and were independent predictors of the presence of plaques. In contrast, prediabetes and low-density lipoprotein (LDL)-c were predictors of the presence of plaque (odds ratio [OR] = 1.64; 95% confidence interval [CI] = 1.05–2.57; p = 0.03 and OR = 1.01; 95% CI = 1.00–1.02; p = 0.006, respectively) together with tobacco exposure and the leukocyte count (OR = 1.77; 95% CI = 1.08–2.89; p = 0.023 and OR = 1.20; 95% CI = 1.05–1.38; p = 0.008, respectively). In a non-urban Mediterranean population, prediabetes was associated with established subclinical carotid atherosclerosis. These findings could have implications for the prevention and treatment of CV risk in these subjects before the first symptoms of cardiovascular disease appear.

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

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479319867617 ◽

2019 ◽

Vol 35 (6) ◽

pp. 453-458 ◽

Cited By ~ 1

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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Usefullnes of atherogenic indices and Ca-LDL level to predict subclinical atherosclerosis in patients with psoriatic arthritis?

Advances in Rheumatology ◽

10.1186/s42358-019-0096-2 ◽

2019 ◽

Vol 59 (1) ◽

Cited By ~ 1

Author(s):

Duygu Tecer ◽

Ismihan Sunar ◽

Ali Erhan Ozdemirel ◽

Rabia Tural ◽

Orhan Kucuksahin ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Subclinical Atherosclerosis ◽

Statistical Significance ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Atherogenic Index ◽

Model Assessment ◽

Amyloid A

Abstract Background To investigate the link between carbamylated low-density lipoprotein (ca-LDL), atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli’s risk indices I and II (CRI I and II) and subclinic atherosclerosis in psoriatic arthritis (PsA). Methods Thirty-ninepatients and 19 age, sex, body mass index matched healthy controls were included. Insulin resistance (IR) was assessed with homeostasis of model assessment-IR (HOMA-IR). Carotid intima-media thickness (CIMT) was measured at both common carotid arteries and mean CIMT was calculated. Results The mean age was 49.50 ± 11.86 years and 64.1% were females in PsA group. In the PsA group, CIMT and HOMA-IR were significantly higher (p = 0.003, p = 0.043, respectively). AIP, AC, TG/HDL, CRI-1, CRI-2 and ca-LDL levels were similar between groups. In PsA group, CIMT was positively correlated with HOMA-IR, TG/HDL and AIP. Although ca-LDL was positively correlated with serum amyloid A (r = 0.744, p < 0.001), no correlation was detected between ca-LDL and CIMT (r = 0.215, p = 0.195). PsA patients with IR tended to have higher ca-LDL levels than patients without IR, but this difference lacked statistical significance (33.65 ± 26.94, 28.63 ± 28.06, respectively, p = 0.237). Conclusions A significant increase in CIMT was seen in PsA patients without clinically evident cardiovascular disease or any traditional atherosclerosis risk factors. CIMT was correlated with HOMA-IR, TG/HDL and AIP.

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Endoglin and obestatin levels, cardiometabolic risk factors and subclinical atherosclerosis in children aged 10–18 years

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2016-0024 ◽

2016 ◽

Vol 29 (10) ◽

Cited By ~ 1

Author(s):

Nurullah Çelik ◽

Peyami Cinaz ◽

Aysun Bideci ◽

Betül Derinkuyu ◽

Hamdi Cihan Emeksiz ◽

...

Keyword(s):

Brachial Artery ◽

Subclinical Atherosclerosis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

The Body ◽

Control Group ◽

Obese Children ◽

And Control

AbstractBackground:The aim of this study was to investigate the early signs of atherosclerosis and to evaluate serum endoglin and obestatin levels as predictors of subclinical atherosclerosis in obese children.Methods:A total of 95 children (60 obese and 35 controls) aged 10–18 years were included in the study. Their endoglin and obestatin levels and biochemical parameters were measured. The carotid intima media thickness (cIMT) and brachial artery flow-mediated dilatation (FMD) responses were evaluated.Results:The cIMT values were higher (p < 0.001) and FMD responses were lower (p = 0.003) in the obese group than in the control group. A logistic regression multivariate analysis revealed that cIMT was independently associated with the body mass index (BMI) Z-score (β = 0.323, p = 0.003) and low density lipoprotein (LDL) (β = 0.29, p = 0.008), while FMD % was independently associated with waist circumference (β = −0.36, p = 0.002). The obese and control groups were similar in endoglin (p = 0.67) and obestatin levels (p = 0.70). The endoglin level was inversely correlated with the cholesterol and LDL levels (r = −0.23, p = 0.032; rho = −0.25, p = 0.019).Conclusions:The cIMT and brachial artery FMD response in obese children are significantly different compared to healthy controls. Circulating endoglin and obestatin levels are not predictive markers for subclinical atherosclerosis in obese children aged 10–18 years old.

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The Effect of Long-Term Atorvastatin Therapy on Carotid Intima-Media Thickness of Children With Dyslipidemia

Angiology ◽

10.1177/0003319720975635 ◽

2020 ◽

pp. 000331972097563

Author(s):

Georgios Karapostolakis ◽

Marina Vakaki ◽

Achilleas Attilakos ◽

Antonios Marmarinos ◽

Maria Papadaki ◽

...

Keyword(s):

Lipid Profile ◽

Subclinical Atherosclerosis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Healthy Controls ◽

Media Thickness ◽

Atorvastatin Therapy

Carotid intima-media thickness (cIMT) has been proposed as an early marker of subclinical atherosclerosis in high risk children. Children with heterozygous familial hypercholesterolemia have greater cIMT than matched healthy controls or their unaffected siblings. Statin therapy may delay the progression of cIMT, although long-term studies in children are scarce. We evaluated the effect of atorvastatin treatment on cIMT in children with dyslipidemia. We studied 81 children/adolescents, 27 with severe dyslipidemia (low-density lipoprotein cholesterol [LDL-C] ≥190 mg/dL) and 54 sex- and age-matched healthy controls; LDL-C ≤ 130 mg/dL and lipoprotein (a), Lp(a), ≤30 mg/dL. In the children with dyslipidemia, cIMT was measured twice, before and on treatment (18.2 ± 7.7 months). Anthropometric data, a full lipid profile, liver, kidney, and thyroid function were evaluated. Males with dyslipidemia had a greater cIMT than male controls after adjustment for other factors ( P = .049). In addition, a nonstatistically significant decrease in cIMT was observed after treatment ( P = .261). Treatment with atorvastatin resulted in a significantly improved lipid profile. Females with dyslipidemia had a significantly thinner cIMT than males. Children with normal and high Lp(a) levels had similar cIMT values. In conclusion, treatment with atorvastatin had a beneficial effect on the lipid profile and cIMT progression in children with severe dyslipidemia.

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LDL-C/HDL-C Ratio Predicts Carotid Intima-Media Thickness Progression Better Than HDL-C or LDL-C Alone

Journal of Lipids ◽

10.1155/2011/549137 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 30

Author(s):

Mika Enomoto ◽

Hisashi Adachi ◽

Yuji Hirai ◽

Ako Fukami ◽

Akira Satoh ◽

...

Keyword(s):

Subclinical Atherosclerosis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Analysis Of Covariance ◽

Lipoprotein Cholesterol ◽

Atherosclerosis Progression ◽

Media Thickness ◽

Better Than

High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are strong predictors of atherosclerosis. Statin-induced changes in the ratio of LDL-C to HDL-C (LDL-C/HDL-C) predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the best predictor of subclinical atherosclerosis remains unknown. Our objective was to investigate this issue by measuring changes in carotid intima-media thickness (IMT). A total of 1,920 subjects received health examinations in 1999, and were followed up in 2007. Changes in IMT (follow-up IMT/baselineIMT×100) were measured by ultrasonography. Our results showed that changes in IMT after eight years were significantly related to HDL-C (inversely,P<0.05) and to LDL-C/HDL-C ratio (P<0.05). When the LDL-C/HDL-C ratios were divided into quartiles, analysis of covariance showed that increases in the ratio were related to IMT progression (P<0.05). This prospective study demonstrated the LDL-C/HDL-C ratio is a better predictor of IMT progression than HDL-C or LDL-C alone.

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Carotid Plaques Correlates in Patients With Familial Hypercholesterolemia

Angiology ◽

10.1177/0003319715596281 ◽

2015 ◽

Vol 67 (5) ◽

pp. 471-477 ◽

Cited By ~ 9

Author(s):

Małgorzata Waluś-Miarka ◽

D. Czarnecka ◽

W. Wojciechowska ◽

M. Kloch-Badełek ◽

M. Kapusta ◽

...

Keyword(s):

Familial Hypercholesterolemia ◽

Subclinical Atherosclerosis ◽

Density Lipoprotein ◽

High Sensitivity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Apo B ◽

Carotid Plaques ◽

Premature Cardiovascular Disease ◽

Increased Risk

Patients with familial hypercholesterolemia (FH) are at increased risk of premature cardiovascular disease. We compared factors associated with the presence of carotid plaques and carotid intima–media thickness (cIMT), markers of subclinical atherosclerosis, in 241 patients with FH (98, 40.7% men; mean age 41 ± 18.4 years). Patients with FH having carotid plaques (36.5%) had mean age, apolipoprotein (apo) B, glucose, apoA1, systolic blood pressure (SBP) and diastolic BP, waist/hip ratio (WHR), and body mass index higher than patients without plaques. Logistic regression revealed that apoB (odds ratio [OR] per 1 unit change 1.03, P = .005), high-density lipoprotein cholesterol (HDL-C; OR per 1 standard deviation [SD] change 0.59, P = .015), and non-HDL-C (OR per 1SD change 1.53, P = .04) were significantly associated with the presence of plaques. The cIMT correlated with obesity parameters, BP, apoB, glucose, high-sensitivity C-reactive protein, creatinine, γ-glutamyl transpeptidase, and alanine transaminase ( P < .001). Regression analysis revealed that cIMT was significantly associated with apoB, SBP, and WHR. These results confirm the role of apoB-containing lipoproteins and low HDL-C with the presence of carotid plaques and apoB, BP, and WHR with cIMT.

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Abstract 441: Gamma-glutamyltransferase and Markers of Subclinical Atherosclerosis in Patients with Psoriasis

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.441 ◽

2016 ◽

Vol 36 (suppl_1) ◽

Author(s):

Kenan Demircioglu ◽

Feyza Aksu ◽

Mustafa Caliskan ◽

Yusuf Yilmaz

Keyword(s):

Subclinical Atherosclerosis ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

High Sensitivity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Control Group ◽

Gamma Glutamyltransferase ◽

Glucose Levels ◽

Hs Crp

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.

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Carotid Atherosclerosis Evolution When Targeting a Low-Density Lipoprotein Cholesterol Concentration <70 mg/dL After an Ischemic Stroke of Atherosclerotic Origin

Circulation ◽

10.1161/circulationaha.120.046774 ◽

2020 ◽

Vol 142 (8) ◽

pp. 748-757 ◽

Cited By ~ 2

Author(s):

Pierre Amarenco ◽

Cristina Hobeanu ◽

Julien Labreuche ◽

Hugo Charles ◽

Maurice Giroud ◽

...

Keyword(s):

Ischemic Stroke ◽

Carotid Arteries ◽

Carotid Atherosclerosis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Intima Media Thickness ◽

Target Group ◽

Low Density Lipoprotein Cholesterol ◽

Media Thickness ◽

Common Carotid Arteries

Background: The TST trial (Treat Stroke to Target) showed the benefit of targeting a low-density lipoprotein cholesterol (LDL-C) concentration of <70 mg/dL in terms of reducing the risk of major cardiovascular events in 2860 patients with ischemic stroke with atherosclerotic stenosis of cerebral vasculature. The impact on carotid atherosclerosis evolution is not known. Methods: TST-PLUS (Treat Stroke to Target–Plaque Ultrasound Study) included 201 patients assigned to an LDL-C concentration of <70 mg/dL and 212 patients assigned to a target of 100±10 mg/dL. To achieve these goals, investigators used the statin and dosage of their choice and added ezetimibe as needed. Ultrasonographers were certified and carotid ultrasound examinations were performed using M′Ath software at baseline and at 2, 3, and 5 years. All images were uploaded to the Intelligence in Medical Technologies database directly from the carotid ultrasound device. The central core laboratory performed all offline measurements of the intima–media thickness of both common carotid arteries blinded from the randomization arm. The main outcomes were newly diagnosed atherosclerotic plaque on carotid bifurcation or internal carotid artery using the Mannheim consensus definition and between-group comparison of common carotid arteries intima–media thickness change. Results: After a median follow-up of 3.1 years, the achieved LDL-C concentrations were 64 mg/dL (1.64 mmol/L) in the lower-target group and 106 mg/dL (2.72 mmol/L) in the higher-target group. Compared with the higher-target group, patients in the lower-target group had a similar incidence of newly diagnosed carotid plaque: 46/201 (5-year rate, 26.1%) versus 45/212 (5-year rate, 29.7%). The change in common carotid arteries intima–media thickness was −2.69 µm (95% CI, −6.55 to 1.18) in the higher-target group and −10.53 µm (95% CI, −14.21 to −6.85) in the lower-target group, resulting in an absolute between-group difference of −7.84 µm (95% CI, −13.18 to −2.51; P =0.004). Conclusions: In patients with ischemic stroke and atherosclerosis, an LDL-C target of <70 mg/dL (1.8 mmol/L) did not reduce the incidence of new carotid plaques but produced significantly greater regression of carotid atherosclerosis than an LDL-C target of 90 to 110 mg/dL. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875.

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Association of Body Mass Index in Youth With Adult Cardiometabolic Risk

Journal of the American Heart Association ◽

10.1161/jaha.119.015288 ◽

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.

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