Association of Elevated Non-HDL-C and LDL-C with Carotid atherosclerosis among Tibetans Living at High Altitudes: A Cross-sectional Study

Background: Hypoxic circumstances impair endothelial function and may contribute to carotid atherosclerosis. In high-altitude areas, there is a scarcity of data on the correlation between lipid particles and carotid atherosclerosis. Methods: A total of 587 patients who underwent carotid artery ultrasound and met the inclusion and exclusion criteria were enrolled in our cross-sectional study. All participants resided in Luhuo County, Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China (mean altitude: 3,860 meters). We used questionnaires, physical examination, blood sample testing, and ultrasound in our investigation. Spearman correlation analysis and multiple linear regression analysis were performed to explore the association between lipid particles and carotid atherosclerosis. We compared the disparity between lipid particles in predicting atherosclerosis using the receiver operator characteristic curve.Results: We found a statistically significant association between lipid particles and carotid atherosclerosis. After adjustment for certain variables, including age, gender, mean arterial pressure, and fasting blood glucose, we discovered that non-high-density lipoprotein-cholesterol (non-HDL-C) was a risk factor for carotid intima-media thickness (β = 0.012, p = 0.032) but not for low-density lipoprotein cholesterol (LDL-C) (p = 0.073). In terms of lifestyle, non-HDL-C was also found to be a risk factor for atherosclerosis independent of cigarette smoking and vegetarian (β = 0.012, p = 0.049). The area under the curve (AUC) of non-HDL-C was 0.644 (CI: 0.583 – 0.706) while LDL-C was 0.599 (CI: 0.534 - 0.664) in predicting carotid atherosclerosis. The optimal cut-off value of non-HDL-C was 3.625 mmol/L in predicting carotid plaques. Conclusions: Among Tibetans living in high-altitude areas, non-HDL-C is a better biomarker than LDL-C for carotid artery atherosclerosis independent of conventional risk factors. It is crucial to resolve non-HDL-C dyslipidemia in order to mitigate carotid atherosclerosis in Tibetans living at high-altitude settings.

Uric acid and uric acid/creatinine ratio and their correlations with the hemorheological determinants in subjects with subclinical carotid atherosclerosis

BACKGROUND AND OBJECTIVE: we have examined the concentration of serum uric acid and the serum uric acid/creatinine ratio as well as their correlations with the main determinants of the hemorheological profile in a group of subjects with subclinical carotid atherosclerosis. METHODS: we evaluated the concentration of serum uric acid and the serum uric acid/creatine ratio in 43 men and 57 women [median age 66.00 (25)] with subclinical carotid atherosclerosis, subsequently divided according to the number of traditional cardiovascular risk factors and to the insulin resistance degree. RESULTS: serum uric acid, but not the serum uric acid/creatinine ratio, results strongly influenced by the number of cardiovascular risk factors and by the insulin resistance degree. In the whole group and in the subgroups of subclinical carotid atherosclerosis subjects, serum uric acid and serum uric acid/creatinine ratio show significant correlation, besides with whole blood viscosity, with plasma viscosity and erythrocyte aggregation. The influence of the serum uric acid on the erythrocyte aggregability that is a part of the erythrocyte aggregation is to ascribe to the action carried out by serum uric acid on the erythrocyte zeta potential. CONCLUSIONS: it is reasonable to think that the treatment of the asymptomatic or symptomatic hyperuricemia with the urate-lowering therapy that reduces the serum uric acid concentration may reflect on the hemorheological profile which role on the atherosclerotic cardiovascular disease is well known.

Association between Insomnia and Subclinical Atherosclerosis Among Chinese Steelworkers: A Cross-sectional Survey

Background: Insomnia is a common prevalent sleep disorder. Difficulty maintaining sleep or poor in quality in insomnia caused by disrupted or misaligned circadian rhythms may play an important role in the development of atherosclerosis. This study aimed to examine the association between insomnia and subclinical atherosclerosis in Chinese steelworkers.Methods: A total of 3582 subjects from a large enterprise located in northern China were included in this study. The Athens Insomnia Scale (AIS) was used to assess the status of insomnia. Subclinical atherosclerosis was evaluated using ultrasonographic measurements of carotid plaque. Multivariable logistic regression was used to identify association between insomnia and carotid atherosclerosis.Results: The overall prevalence of insomnia and carotid plaque were 35.1% and 29.9% in the study population. Compared with non-insomnia workers, significantly increased odds of carotid plaque were observed among insomnia workers after adjustment for potential confounders, odds ratio (OR) = 1.38, 95% confidence interval (CI): 1.17 to 1.62. Exposure to current shift work and insomnia simultaneously can significantly elevated odds of carotid plaque. No significant association was found in female workers between insomnia and carotid plaque.Conclusion: Insomnia is associated with elevated odds of carotid atherosclerosis in male steelworkers. Insomnia problems of workers should receive further attention in occupational worker health interventions.

Multi-Sequence MRI Registration of Atherosclerotic Carotid Arteries Based on Cross-Scale Siamese Network

Cardiovascular disease (CVD) is a common disease with high mortality rate, and carotid atherosclerosis (CAS) is one of the leading causes of cardiovascular disease. Multisequence carotid MRI can not only identify carotid atherosclerotic plaque constituents with high sensitivity and specificity, but also obtain different morphological features, which can effectively help doctors improve the accuracy of diagnosis. However, it is difficult to evaluate the accurate evolution of local changes in carotid atherosclerosis in multi-sequence MRI due to the inconsistent parameters of different sequence images and the geometric space mismatch caused by the motion deviation of tissues and organs. To solve these problems, we propose a cross-scale multi-modal image registration method based on the Siamese U-Net. The network uses sub-networks with image inputs of different sizes to extract various features, and a special padding module is designed to make the network available for training on cross-scale features. In addition, to improve the registration performance, a multi-scale loss function under Gaussian smoothing is applied for optimization. For the experiments, we have collected a multi-sequence MRI image dataset from 11 patients with carotid atherosclerosis for a retrospective study. We evaluate our overall architectures by cross-validation on our carotid dataset. The experimental results show that our method can generate precise and reliable results with cross-scale multi-sequence inputs and the registration accuracy can be greatly improved by using the Gaussian smoothing loss function. The DSC of our Siamese structure can reach 84.1% on the carotid data set with cross-size input. With the use of GDSC loss, the average DSC can be improved by 5.23%, while the average distance between fixed landmarks and moving landmarks can be decreased by 6.46%.Our code is made publicly available at: https://github.com/MingHan98/Cross-scale-Siamese-Unet.

Association of Elevated Non-HDL-C and LDL-C with Carotid Atherosclerosis among Tibetans Living at High Altitudes: A Cross-sectional Study

Background: Hypoxic circumstances impair endothelial function and may contribute to carotid atherosclerosis. In high-altitude areas, there is a scarcity of data on the correlation between lipid particles and carotid atherosclerosis. Methods: A total of 587 patients who underwent carotid artery ultrasound and met the inclusion and exclusion criteria were enrolled in our cross-sectional study. All participants resided in Luhuo County, Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China (mean altitude: 3,860 meters). We used questionnaires, physical examination, blood sample testing, and ultrasound in our investigation. Spearman correlation analysis and multiple linear regression analysis were performed to explore the association between lipid particles and carotid atherosclerosis. We compared the disparity between lipid particles in predicting atherosclerosis using the receiver operator characteristic curve.Results: We found a statistically significant association between lipid particles and carotid atherosclerosis. After adjustment for certain variables, including age, gender, mean arterial pressure, and fasting blood glucose, we discovered that non-high-density lipoprotein-cholesterol (non-HDL-C) was a risk factor for carotid intima-media thickness (β = 0.012, p = 0.032) but not for low-density lipoprotein cholesterol (LDL-C) (p = 0.073). In terms of lifestyle, non-HDL-C was also found to be a risk factor for atherosclerosis independent of cigarette smoking and vegetarian (β = 0.012, p = 0.049). The optimal cut-off value of non-HDL-C was 3.625 mmol/L in predicting carotid plaques.Conclusions: Among Tibetans living in high-altitude areas, non-HDL-C is a better biomarker than LDL-C for carotid artery atherosclerosis independent of conventional risk factors.

Associations of Occupational Heat Stress and Noise Exposure with Carotid Atherosclerosis among Chinese Steelworkers: A Cross-Sectional Survey

Occupational exposure to heat stress and noise at the workplace are widespread physical hazards and have been associated with an increase in both morbidity and mortality. This study aims to examine the association between occupational heat stress and noise exposure and carotid atherosclerosis in Chinese steelworkers. A total of 3471 subjects were included in this study. Carotid plaque was measured using ultrasonography. The occupational information was collected by face-to-face personal interviews and all of the reported information was verified with the company’s records. Workers were divided into non-exposure and exposure groups according to the company’s records regarding previous and/or current heat stress and noise exposure status in the workplace. The prevalence of carotid plaque was 30.1% in the study population and workers exposed to both occupational heat stress and noise had the highest prevalence of carotid plaque at 37.2%. The odds of carotid plaque in individuals of different exposure status were significantly elevated after adjustment for potential confounders, especially in the heat stress and noise exposure combination group: OR = 1.32, 95% CI: 1.06 to 1.65, in individuals who had experienced heat stress exposure; OR = 1.49, 95% CI: 1.18 to 1.88, in individuals who had experienced noise exposure; OR = 2.02, 95% CI: 1.60 to 2.56, in the combination group. No significant association in female workers and no significant multiplicative or additive interactions were found between occupational heat stress and noise exposure and carotid plaque. Exposure to occupational heat stress and noise are statistically associated with carotid atherosclerosis among male steelworkers.

Covert Brain Infarcts in Patients with Philadelphia Chromosome-Negative Myeloproliferative Disorders

Backgrounds and Purpose. Philadelphia chromosome-negative myeloproliferative disorders (Ph-negative MPD) are a rare group of hematological diseases, including three distinct pathologies: essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF). They most often manifest with thrombotic complications, including cerebrovascular events. Covert brain infarcts (CBIs) are defin ed as predominantly small ischemic cerebral lesions that are detected using magnetic resonance imaging (MRI) in the absence of clinical stroke events. The relationship between MPD and CBIs remains unclear. Methods. Included in the study were 103 patients with the diagnosis of Ph-MPD (according to WHO 2016 criteria) (median age—47 (35; 54) years; 67% female). In total, 38 patients had ET, 42 had PV, and 23 had PMF. They underwent clinical examination, routine laboratory analyses (complete blood count), brain MRI, ultrasound carotid artery, flow-mediated dilatation (as a measure of endothelial dysfunction—FMD). Results. Overall, 23 patients experienced an ischemic stroke (as per MRI and/or clinical history), of which 16 (15.5%) could be classified as CBIs. The rate of CBIs per MPD subtype was statistically non-significant between groups (p = 0.35): ET–13.2%, PV–21.4%, and PMF–8.7%. The major vascular risk factors, including arterial hypertension, carotid atherosclerosis, and prior venous thrombosis, were not associated with CBIs (p > 0.05). Age was significantly higher in patients with CBIs compared to patients without MRI ischemic lesions: 50 (43; 57) years vs. 36 (29; 48) (p = 0.002). The frequency of headaches was comparable between the two groups. CBIs were associated with endothelial dysfunction (OR - 0.71 (95% CI: 0.49–0.90; p = 0.02)) and higher hemoglobin levels (OR—1.21 (95% CI: 1.06–1.55); p =0.03). Conclusions. CBIs are common in patients with Ph-negative MPD. Arterial hypertension and carotid atherosclerosis were not associated with CBIs in this group of patients. The most significant factors in the development of CBIs were endothelial dysfunction (as measured by FMD) and high hemoglobin levels. Patients with Ph-negative MPD and CBIs were older and had more prevalent endothelial dysfunction.