The Relationship Between NLRP3 Inflammasome and Its Downstream Inflammatory Factors in Obstructive Sleep Apnea Patients with Carotid Atherosclerosis Under Cigarette Exposure

Aim:To study the relationship between NLRP3(nucleotide oligomerization domain[NOD]-,leucine-rich repeats[LRR]-,and pyrin domain-containing protein 3)inflammasome and its downstream inflammatory factors in obstructive sleep apnea(OSA)patients with carotid atherosclerosis(CAS)under cigarette exposure,further exploring the risk factors of CAS in OSA patients.Methods:A total of 109 adult males who underwent polysomnography and carotid artery ultrasonography in our hospital from October 2019 to December 2021 were selected.According to the detection results,they were divided into the OSA group,the CAS group,and the OSA combined CAS group;additionally,29 healthy subjects who underwent a physical examination were also included.According to whether they were smoking,the groups were further divided into smoking and non-smoking groups.The age,body mass index(BMI),blood pressure,apnea-hypopnea index(AHI),lowest blood oxygen saturation(LSaO2),carotid intima-media thickness(CIMT),levels of blood sugar,blood low-density lipoprotein cholesterol(LDLc),and serum NLRP3,interleukin-1β(IL-1β),and interleukin-18(IL-18)of all subjects were recorded.Results:The OSA combined CAS group had higher LDLc levels and AHI and lower LSaO2 than the OSA group and CAS group.The levels of serum NLRP3,IL-1β,and IL-18 in the OSA group were higher than those in the normal control group(P<0.05);and those in the OSA combined CAS group were higher than the OSA group and CAS group(P<0.05),regardless of cigarette exposure.Considering cigarette exposure,serum NLRP3,IL-1β,and IL-18 levels were higher in the OSA,CAS,and OSA combined CAS smoking groups than those in the non-smoking group(P<0.05).Under cigarette exposure,AHI,LDLc,NLRP3,IL-1β,and IL-18 were significantly positively correlated(P<0.05),and LSaO2 was negatively correlated with CAS in OSA(P<0.05).AHI,LSaO2,LDLc,NLRP3,and IL-1βare the risk factors for OSA combined with CAS.Conclusion:LSaO2,AHI,LDLc,NLRP3,and IL-1βare the important risk factors for OSA combined with CAS under cigarette exposure,and their levels can be used to predict the occurrence of CAS in OSA.

Research progress on the influence of local hemodynamics on carotid atherosclerosis

The reasons for the formation of atherosclerosis are diverse and complex,and atherosclerosis as a kind of systemic disease has the characteristics of focal selectivity,which occurs in the carotid bifurcation.The feature enables a large number of studies have found that the severe local hemodynamic characteristics has a great influence to the occurrence of this disease.This paper briefly reviews the related research on the local hemodynamics of carotid bifurcation.The relevant parameters of local hemodynamics were sorted out and summarized,and the effects of wall shear force and its derived parameters on the generation,progression and rupture of carotid atherosclerosis and their clinical applications were reviewed,in order to provide mechanical information for the early warning of carotid plaque rupture.At the same time,this paper describes the transformation of local hemodynamics research in the clinical application of carotid atherosclerosis disease,in order to provide personalized selection and basis for the clinical treatment of this disease.

Relationship between Carotid Atherosclerosis and Cerebral Infarction

Objective To study the relationship between carotid atherosclerosis and cerebral infarction (CI). Methods Between November 2008 and March 2009,147 CI patients (CI group) and 48 patients with non-cerebrovascular diseases (control group) were enrolled from inpatients of Neurology Department of our hospital. The diagnostic criterion of thickened carotid intima was set as 1.0 mm≤intima-media thickness (IMT) <1.5 mm and that of carotid plaque was as IMT≥1.5 mm. Carotid atherosclerosis was divided into three levels: normal intima,thickened intima,and plaque formation. The color Doppler ultrasonography data of carotid arteries in all patients were analyzed and the severity of carotid atherosclerosis was compared between the two groups. Results In the CI group,36 (24.5%) patients had normal carotid intima,22 (15.0%) had thickened carotid intima,and 89 (60.5%) had carotid plaque. In the control group,22 (45.8%) patients had normal carotid intima,4 (8.3%) had thickened carotid intima,and 22 (45.8%) had carotid plaque. The severity of carotid atherosclerosis in the CI group was higher than that in the control group (P=0.022). There was significant difference in the constitution of carotid plaque between the two groups (P=0.001); the CI group mainly had the soft plaque (55/89,61.8%),whereas the control group mainly had the hard plaque (17/22,77.3%). The first three common locations of carotid plaque in both groups were carotid bifurcation (CI group: 73.7%; control group: 64.1%),common carotid artery (CI group: 20.4%; control group: 25.6%),and internal carotid artery (CI group: 5.9%; control group: 10.3%). The location of carotid plaque between the two groups was not significantly different (P=0.438). There was no difference in the carotid inner diameter or resistance index between the two groups (P>0.05). Conclusions Carotid atherosclerosis is to some extent able to reveal the atherosclerotic condition of cerebral arteries and act as an important predictor for the risk of CI. The color Doppler ultrasonography of carotid arteries can provide a convenient way for the prevention and treatment of CI.

Association between Metabolic Syndrome and Carotid Atherosclerosis: A Cross-sectional Study in Northern China

Objective Increased carotid artery intima-media thickness(CIMT)and carotid plaque as manifestations of carotid atherosclerosis have been used as markers of cardiovascular disease(CVD).The components of metabolic syndrome(Met S)are linked to CVD,but the association between Met S and CVD is controversial.Methods A total of 8,933 Chinese adults aged 40 years or older from 2010 to 2014 were selected from the Jidong and Kailuan communities.Met S was defined by the International Diabetes Federation criteria.CIMT and carotid plaque were measured using color Doppler ultrasound.Logistic regression models were used to assess the association of Met S with carotid plaque and CIMT.Results Met S was found among 3,461(3,461/8,933)participants.The odds ratio and 95%confidence internal(CI)for carotid plaques in participants with Met S was 1.16(1.03-1.30).The risk of carotid plaques increased with the number of Met S components.The average CIMT was higher in participants with Met S(β=0.020,95%CI,0.014-0.027)and in participants with more Met S components.Conclusion Individuals with Met S are at an increased risk for carotid atherosclerosis compared to those without MetS.

Feature selection and machine learning approach for carotid atherosclerosis in asymptomatic adults

Objective:The presence of carotid atherosclerosis reflects the overall atherosclerotic load and may predict cardiovascular and cerebrovascular accidents.Studies have reported risk factors for carotid atherosclerosis.However,few practical models have been established to predict carotid atherosclerosis risk.Thus,this study was conducted to investigate important features of carotid atherosclerosis and to propose a machine learning-based method for predicting carotid atherosclerosis in asymptomatic adults.Methods:Cross-sectional study was conducted using routine medical check-up data of individuals from January 2019 to January 2020.Pearson’s correlation analysis was performed to correlate the features.Then,features were selected by python’s feature-selection library and analyzed through three algorithms.Multiple machine learning algorithms,including Decision Tree,Random Forest and Logistic Regression(LR)were used to predict the risk of carotid atherosclerotic plaques and compared their precision,accuracy,recall,F1-score and area under the curve.Results:A total of 150 individuals were enrolled in this study,30(20%)of them were found with carotid atherosclerotic plaques.Sex,age,body mass index,total cholesterol,Systolic blood pressure(SBP),and carbohydrate antigen 724(CA724)were independently correlated to carotid atherosclerosis.Pepsinogen Ⅰ and pepsinogen Ⅱ serum levels had no correlations with Carotid intima-media thickness and pulse wave velocity.SBP,diastolic blood pressure age,low-density lipoprotein,Pepsinogen I,pepsinogen II,body mass index,Waist,CA724,and Uric Acid contribute to the cumulative importance of 0.9,and SBP was the most crucial feature for carotid atherosclerosis.LR algorithm has the precision(0.92),values of recall(0.91),F1(0.9),and area under the curve(0.95),and showed the optimal performance to predict the presence or absence of carotid atherosclerosis in asymptomatic adults.The code for analysis in this article was uploaded to GitHub(https://github.com/ganbingliangyi/machine-learning).Conclusions:SBP was the most crucial feature in ranking features,the LR algorithm showed the optimal performance to predict the presence or absence of carotid atherosclerosis in asymptomatic adults.

Research Progress of Traditional Chinese Medicine in the Treatment of Carotid Atherosclerosis

Carotid atherosclerosis is a partial manifestation of arteriosclerosis of organism.In recent years,its incidence rate is increasing year by year.Traditional Chinese medicine(TCM)has a broad prospect in the clinical development of CAS treatment by holism concept and the principle of treatment based on syndrome differentiation.This paper reviews the etiology,pathogenesis,TCM dialectics and TCM treatment of carotid atherosclerosis,in order to provide theoretical guidance for TCM treatment of CAS patients.

Carotid Endothelial VCAM-1 Is an Early Marker of Carotid Atherosclerosis and Predicts Coronary Artery Disease in Swine

Objective: The aim was to determine if endothelial VCAM-1 (eVCAM-1) expression in the common carotid artery (CCA) would correlate with predictive markers of atherosclerotic disease, would precede reduction of markers of endothelial cell function and would predict coronary artery disease (CAD). Methods and results: Carotid arterial segments (bifurcation, proximal and distal CCA) were harvested from 14 and 24 month-old male castrated familial hypercholesterolemic (FH) swine, a model of spontaneous atherosclerosis. Quantification of local expression of eVCAM-1, intimal macrophage accumulation, oxidative stress, intima-media (I/M) ratio, intima-media thickness (IMT), endothelial nitric oxide synthase (eNOS) and phosphorylated eNOS (p-eNOS) in selected regions of the carotids revealed a relationship between local inflammation and atherosclerotic plaque progression. Importantly, inflammation was not uniform throughout the CCA. Endothelial VCAM-1 expression was the greatest at the bifurcation and increased with age. Finally, eVCAM-1 best estimated the severity of CAD compared to blood levels of glucose, hypercholesterolemia, carotid IMT, and p-eNOS. Conclusion: Our data suggested that eVCAM-1 was closely associated with atherosclerotic plaque progression and preceded impairment of EDD. Thus, this study supported the use of carotid VCAM-1 targeting agents to estimate the severity of CAD.

The impact of vascular risk factors multiplicity on severity of carotid atherosclerosis—A retrospective analysis of 1969 Egyptian subjects

Background and Purpose: Carotid atherosclerosis has been recognized as a major cause of stroke. The cur-rent study aimed to describe the effect of multiplicity rather than the type of vascular risk factors on severity of carotid atherosclerosis among a large sample of Egyptian population. Methods: We analyzed the data of 1969 Egyptian subjects, who proved to have extra cranial carotid atherosclerotic disease by duplex scanning at the vascular laboratories of Cairo Uni-versity Hospitals. Demographic, clinical data and causes of referral were recorded and correlated with ultrasound findings. Atherosclerotic indices, namely IMT, plaque number and percentage of stenosis were used for evaluation of severity of carotid atherosclerosis. Furthermore, subjects were classified according to multiplicity of major atherosclerotic risk factors and multivariate regression analysis was performed to detect independent predictors of significant carotid disease. Results: Out of 1969 subjects with proved signs of extracranial carotid atherosclerosis by duplex ultrasonographic scan, 225 (11.4%) showed hemody-namic significant stenosis (≥50%). Multiplicity of risk factors beyond the age of 50 years was the strongest predictor of significant stenosis. Conclusion: Age more than 50 years and multiplicity rather than the type of risk factors were the strongest predictors of significant carotid atherosclerotic disease (CAD).

The Correlation between Hypertensive Intracerebral Hemorrhage and Internal Carotid Atherosclerosis Investigated by Carniocervial CTA

Objective: To investigate the relationship between hypertensive intracerebral hemorrhage and internal carotid atherosclerosis and its risk factors by CTA (Computed tomography angiography). Methods: The clinical materials of hypertensive intracerebral hemorrhage patients with carniocervial CTA from January 2018 to August 2019 in Puren Hospital of Wuhan were analyzed retrospectively. The correlation and risk factors between hypertensive intracerebral hemorrhage and internal carotid atherosclerosis were studied by logistic regression and descriptive analysis, at the same time, the application value of carniocervial CTA in patients with cerebral hemorrhage was evaluated. Results: There was a correlation between hypertensive intracerebral hemorrhage and internal carotid atherosclerosis (χ2 = 5.319, P = 0.021 1), which indicated that internal carotid atherosclerosis was the risk factor of hypertensive intracerebral hemorrhage, and there was no significant correlation between the location of internal carotid atherosclerosis, multiple atherosclerosis of internal carotid artery and hypertensive intracerebral hemorrhage. Monofactor analysis showed that the risk factors of hypertensive intracerebral hemorrhage with internal carotid atherosclerosis were sex, age, diabetes and hyperlipidemia. According to the logistic regression analysis, hyperlipidemia and diabetes were independent risk factors for hypertensive. Conclusion: The occurrence of hypertensive intracerebral hemorrhage is related to internal carotid atherosclerosis and is affected by many factors. Carniocervial CTA is helpful to the diagnosis of cerebral hemorrhage.

Association between Serum Alkaline Phosphatase and Carotid Atherosclerosis in a Chinese Population: A Community-based Cross-sectional Study

Objective This study aimed to investigate the relationship between alkaline phosphatase(ALP) and common carotid intima media thickness(IMT), carotid plaque, and extracranial carotid artery stenosis(ECAS). Methods A total of 3,237 participants aged ≥ 40 years were recruited from Jidong community in 2013-2014. Participants were divided into five quintile groups based on their serum ALP levels. Carotid atherosclerosis was assessed using ultrasound. Abnormal IMT, carotid plaque, and ECAS were defined as IMT > 0.9 mm, IMT > 1.5 mm, and ≥ 50% stenosis in at least one extracranial carotid artery, respectively. Results Common carotid IMT values and the prevalence of carotid plaque increased across serum ALP quintiles. Higher ALP quintiles were correlated with an increased risk of abnormal IMT [fourth quintile: odds ratio(OR) 1.78, 95% confidence interval(CI) 1.13-2.82, P = 0.0135;fifth quintile: OR = 1.82, 95% CI: 1.15-2.87, P = 0.0110] and ECAS compared to the lowest quintile(fifth quintile: OR = 1.47, 95% CI: 1.09-1.97, P = 0.0106). The association between ALP and prevalence of carotid plaque became insignificant after adjustment for confounders. Conclusion Serum ALP levels were independently associated with abnormal common carotid IMT and ECAS. These conclusions need to be further corroborated in future prospective cohort studies.

Correlating cognitive impairment with carotid atherosclerosis and carotid artery stenosis in patients with acute cerebral infarction

BACKGROUND：Studies have demonstrated that carotid atherosclerosis and carotid artery stenosis are closely associated with cognitive impairment in patients with and without clinically evident cerebrovascular disease. OBJECTIVE： To investigate the correlation between the degree of pathological changes in carotid atherosclerosis, carotid artery stenosis, and cognitive impairment in patients with acute cerebral infarction through the use of color Doppler imaging. DESIGN, TIME AND SETTING： The present concurrent, non-randomized, controlled experiment was performed at the Departments of Neurology and Ultrasound, Affiliated Hospital of North Sichuan Medical College between November 2006 and August 2007. PARTICIPANTS： Fifty-five patients with cerebral infarction, consisting of 35 males and 20 females, aged 50–82 years, were admitted to the hospital between November 2006 and August 2007 and recruited for this study. An additional 30 subjects consisting of 18 males and 12 females, aged 47–78 years, that concurrently received a health examination at the same hospital, were also included as normal controls. METHODS： Intima-media thickness （IMT）, plaque shape, size, and echo intensity of all subjects were detected by color Doppler flow imaging. Assessment criteria： IMT 〉 1.0 mm was considered to be intimal thickening, and IMT 〉 1.2 mm was determined to be formed atherosclerotic plaques. In the position of the largest plaque, the degree of carotid artery stenosis was determined by the following formula： （1-cross-sectional area of residual vascular luminal area/vascular cross-sectional area） × 100%. Less than 30% exhibited mild stenosis, 30%-40% moderate stenosis, and 〉 50% severe stenosis. MAIN OUTCOME MEASURES： IMT and the degree of carotid artery stenosis were evaluated by color Doppler flow imaging. The Mini-Mental State Examination （MMSE）, as well as the clinical memory scale, was compared between patients with cerebral infarction and normal controls. RESULTS： In the cerebral infarction group, IMT was increased, the degree of carotid artery stenosis was aggravated, and the MMSE and MQ scores of clinical memory scale were decreased. In particular, orientation of time and place, attention, calculation, and short-time memory were decreased. There were statistically significant differences in MMSE and MQ of clinical memory scale between patients with cerebral infarction and normal controls （P 〈 0.01）. The scores from the two scales were significantly lower in patients with cerebral infarction with carotid plaque subgroup compared to the cerebral infarction with no carotid plaque subgroup （P 〈 0.01）. The scores from the two scales were also significantly lower in patients with IMT 〉 1.0 mm, as well as moderate and severe carotid artery stenosis, compared to patients with IMT ≤ 1.0 mm, and normal and mild stenosis group （P 〈 0.05）. CONCLUSION： More severe atherosclerotic and carotid artery stenosis leads to more obvious cognitive impairment.

Pathological Mechanism of “Phlegm, Blood stasis, Toxin ”in a Rabbit Model of Carotid Atherosclerosis Based on Gut Microbiota-host Metabolism Interactions

Background:In Traditional Chinese Medicine(TCM)theory,"phlegm,blood stasis and toxin"are the pathogenesis of carotid atherosclerosis(CAS).The rabbit carotid atherosclerosis(CAS),which is induced by high-cholesterol diet combined with carotid artery balloon injury,is a classic model for studying CAS.Many studies indicate that gut microbiota and host metabolic disorders are involved in the pathogenesis of rabbit CAS.However,the TCM pathological features and syndromes of this classic rabbit CAS model have not been reported.Objective:To explore the pathogenesis of the rabbit CAS model and its TCM syndrome types from the perspective of"phlegm,blood stasis,and toxin".Methods:Twelve male New Zealand white rabbits were randomly divided into NC group and CAS group according to their body weight,followed by feeding of basic feed and a 1%high cholesterol diet,respectively.After two weeks,the rabbits in the CAS group underwent common carotid artery(CCA)balloon injury,while the rabbits in the NC group underwent only CCA separation without balloon injury.The two groups received differential feed postoperatively for six more weeks,after which,changes in lipids,hemorheology,inflammation,oxidative stress,and CAS phenotypes were analyzed.In addition,the colon contents and serum were collected for 16S rRNA sequencing and ^(1)H-NMR metabonomic analysis.Results:The CAS rabbits were observed to form noticeable abnormalities in lipid metabolism and blood rhe-ology,a sharp increase in oxidative stress levels,excessive release of inflammatory factors and apparent CAS plaque formation.Furthermore,10 specific gut microbiota(such as Akkermansia muciniphila,Barnesiellaceae and Faecalibacterium)and 14 characteristic metabolites(such as trimethylamine oxide,acetic acid and L-carnitine)were identified in the CAS rabbits,which were significantly related to the CAS phenotypes.The pathway func-tion analysis showed that the gut microbiota and its metabolites mainly affected cholesterol metabolism,energy metabolism,inflammation and oxidative stress.Conclusion:The rabbit CAS model conforms to the“phlegm,blood stasis and toxin damage”theory.The gut microbiota and host metabolic disorders of the CAS rabbits interact and promote internal and external toxins,aggravating the progression of CAS.Our study provided experimental evidence for the application of this model in the TCM-based research of CAS.

Association between Fundus Atherosclerosis and Carotid Arterial Atherosclerosis

Objective: To investigate the correlation between fundus atherosclerosis and carotid arterial atherosclerosis. Methods: A total of 516 people undergoing physical examination in Deyang People’s Hospital between June 2020 and December 2022 were randomly selected. Fundus atherosclerosis and carotid arterial atherosclerosis were evaluated by fundus photography and carotid artery ultrasonography, respectively. Results: Among the 516 physical examination patients, 198 (38.4%) had normal fundus examination, and 318 (61.6%) had fundus arteriosclerosis. Among them, 166 cases were of grade I (32.2%), 86 cases were of grade II (16.7%), and 66 cases were of grade III (12.8%). There were 286 cases (55.4%) without carotid atherosclerosis, 201 cases (38.9%) with carotid atherosclerotic plaque, and 33 cases (6.4%) with carotid stenosis. Fundus arteriosclerosis is independently associated with carotid artery intima-media thickness, vulnerable plaques, plaque scores, and carotid artery stenosis (P Conclusion: In summary, there is a close relationship between carotid artery disease and the degree of arteriosclerosis in the eyeground. Fundus photography is a simple, non-invasive, and easily acceptable method of inspection. The results obtained from it are useful in determining the severity of carotid atherosclerosis and guiding early detection and intervention in clinical cases. This can help reduce the incidence of cardiovascular and cerebrovascular diseases.

Carotid Atherosclerosis and Cognitive Impairment in Nonstroke Patients

Objective： As a vascular risk factor, carotid atherosclerosis is crucial to cognitive impairment. While carotid intima-media thickness, carotid artery plaque, and carotid stenosis can reflect carotid atherosclerosis in different stages, this review aimed to explore researches on the role of carotid intima-media thickness, carotid artery plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and tried to illustrate the possible mechanisms. Data Sources： We searched the PubMed database for recently published research articles up to July 2017, with the key words of ＂carotid atherosclerosis,＂ ＂carotid intima-media thickness,＂ ＂carotid plaque,＂ ＂carotid stenosis,＂ ＂nonstroke,＂ and ＂cognitive impairment.＂Study Selection： Articles were obtained and reviewed to analyze the role of carotid atherosclerosis such as carotid intima-thickness, carotid plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and the possible mechanisms. Results： In recent years, most studies proved that by evaluating carotid atherosclerosis with ultrasonography, carotid atherosclerosis accounts for the development of cognitive decline in nonstroke patients. Carotid atherosclerosis not only impairs the subtle general cognitive function but also decreases the specific domains of cognitive function, such as memory, motor function, visual perception, attention, and executive function. But, it is still controversial. The possible mechanisms of cognitive impairment in nonstroke patients with carotid atherosclerosis can be classified as systemic global cerebrovascular function, small-vessel diseases, and the mixed lesions. Conclusions： Carotid atherosclerosis can be used to predict the risk of cognitive impairment. Furthermore, diagnosing and treating carotid atherosclerosis at early stage might help clinicians prevent and treat vascular cognitive impairment in nonstroke patients.

ASSESSMENT OF AUTOPSIC SAMPLES OF CAROTID ATHEROSCLEROSIS IN THE AGED BY INTRAVASCULAR ULTRASOUND

To assess the value of intravascular ultrasound in detecting carotid atherosclerosis,we compared the ultrasound images of 48 carotid artery segments from autopsies with their histological findings.The results showed that by intravascular ultrasonography one could distinguish between elastic and

Effects of apolipoprotein A polymorphism on plasma levels of lipids, progression of carotid atherosclerosis and response to statin therapy

Background Studies have shown that the apt （a） gene （LPA） rs3798220 polymorphism is associated with thelevels of lipids and the curative effect of statin therapy for carotid atherosclerosis （CAS）. Whether carriers ofan apt （a） variant benefit more from statin remains unclear. Methods One hundred and three patients with CAS were recruited from April 2012 to April 2013 in the Shunde First People＇s Hospital Affiliated to Southern Medical University in Foshan. All patients were administered atorvastatin 20 mg/d and were followed-up for 2 years, with the levels of plasma Lp （a）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein （HDL）, low density lipoprotein （LDL）. LPA rs3798220 genotypes of all patients were analyzed. Results Statin treatment significantly reduced the levels of IMT, TC, TG, LDL and increased the level of HDL, but statin treatment did not reduce the level ofLp （a）. According to the curative effect of statin therapy in patients with CAS, rs3798220 polymorphism had a certain influence on LDL and TC levels, but not on the improvement of the IMT, TG, HDL and Lp （a）. Conclusion Rs 3798220 polymorphism has a certain impact on the curative effects of statin, on LDL and TC levels.

Evaluation of the neutrophil to lymphocyte ratio in newly diagnosed nondiabetic hypertensive patients with carotid atherosclerosis

Background Carotid intimal thickness(IMT),a marker of subclinical atherosclerosis,was widely used for predicting cardiovascular events. Recent studies have shown that inflammation plays a vital role in the development and progression of atherosclerosis. The neutrophil to lymphocyte ratio(NLR)is a new marker of inflammation because it is closely related to cardiovascular,metabolic and inflammatory diseases. However,the relationship between NLR and carotid atherosclerosis is currently unknown. Methods A total of 882 patients underwent blood sampling for neutrophil and lymphocyte counts,serum lipids,total homocysteine(tHcy),and carotid scan by ultrasonography(US)to evaluate abnormalities of carotid wall. Results NLR was found to be statistically significantly higher in the carotid atherosclerosis group(2.0±0.8 vs. 1.7±0.6,P<0.001). The NLR,expressed as both quartiles(odds ratio[OR],2.36;95% confidence interval[CI],1.37 to 3.47;P=0.001)and continuous values(OR,1.83;95% CI,1.43 to 2.33;P<0.001),was significantly associated with a higher risk for carotid atherosclerosis. The optimal NLR cutoff value for detecting carotid atherosclerosis was 1.60 based on receiver operating curve(ROC)analysis with a sensitivity of 64.0% and a specificity of 57.0%. Conclusion NLR is significantly associated with carotid atherosclerosis in newly diagnosed nondiabetic hypertensive patients.

CXCL5通过诱导血管钙化参与颈动脉斑块的形成

背景:CXC基序趋化因子5(CXC-motif chemokine 5,CXCL5)为上皮细胞衍生的中性粒细胞激活肽,研究发现其可能参与动脉病变。然而,CXCL5在血管钙化中的作用未见报道。目的:探讨CXCL5在颈动脉粥样硬化的血管钙化中的作用。方法:①细胞实验:将小鼠血管平滑肌细胞分成以下各组:成骨培养基组,Vector组(空白质粒转染到细胞中),CXCL5组(CXCL5质粒转染到细胞中),si-NC组(CXCL5阴性对照siRNA转染到细胞中),si-CXCL5组(CXCL5 siRNA转染到细胞中),Vector+LY2157299组和CXCL5+LY2157299组(细胞转染24 h后,将转化生长因子β受体1激酶抑制剂LY2157299加入细胞中)。进行茜素红染色、碱性磷酸酶染色和钙含量测定以评估血管平滑肌细胞成骨分化水平。②动物实验:48只ApoE-/-小鼠随机分成4组:Con+si-NC组、Con+si-CXCL5组、CAS+si-NC组和CAS+si-CXCL5组,前2组不造模,尾静脉注射si-NC或si-CXCL5慢病毒;后2组制备颈动脉粥样硬化模型,尾静脉注射si-NC或si-CXCL5慢病毒。采用Von Kossa染色和免疫组织化学染色评估小鼠颈动脉血管钙化以及CXCL5、转化生长因子β受体1表达情况。结果与结论:①CXCL5组细胞Runt相关转录因子2蛋白水平上调、α-平滑肌肌动蛋白水平下调,si-CXCL5组中的发现与其相反;CXCL5过表达上调了转化生长因子β受体1水平,而CXCL5敲低抑制了转化生长因子β受体1水平。②与Vector组相比,CXCL5组细胞茜素红染色的强度、碱性磷酸酶活性和钙含量显著增加(P<0.05);与si-NC组相比,si-CXCL5组上述2项指标显著降低(P<0.05);当用LY2157299抑制转化生长因子β受体1表达时,CXCL5对平滑肌细胞的成骨转化作用减弱。③与Con+si-NC组相比,CAS+si-NC组大鼠颈动脉中CXCL5蛋白表达和血管钙化面积显著增加(P<0.05);与CAS+si-NC组相比,CAS+si-CXCL5组颈动脉中上述2项指标显著降低(P<0.05)。④与Con+si-NC组相比,CAS+si-NC组大鼠颈动脉中Runt相关转录因子2蛋白表达显著增加(P<0.05)和α-平滑肌肌动蛋白表达显著降低(P<0.05);与CAS+si-NC组相比,CAS+si-CXCL5组颈动脉中上述2项指标呈相反变化(P<0.05)。⑤结果说明,CXCL5通过激活转化生长因子β受体1通路诱导血管平滑肌细胞成骨样转化,抑制CXCL5表达对于改善颈动脉粥样硬化小鼠颈动脉血管钙化是有效的。

TyG和TyG-BMI与冠心病患者颈动脉粥样硬化的相关性

目的分析冠心病患者颈动脉粥样硬化与TyG及TyG-BMI的关系。方法选取2021年1月~2022年12月天津市人民医院心内科收治并进行冠脉造影和颈动脉超声检查患者592例为研究对象。依据冠脉造影结果分为正常对照组(n=103)及CAD组(n=489)。收集患者临床资料,计算TyG指数和TyG-BMI水平。分析TyG和TyG-BMI与冠心病患者颈动脉病变程度的相关性。结果与正常对照组比较,CAD组TyG指数和TyGBMI水平明显升高(均P<0.01)。按照Gensini评分三分位数将患者分为三组,中分组(均P<0.05)和高分组(均P<0.01)TyG指数和TyG-BMI水平显著高于低分组。高分组TyG指数和TyG-BMI水平显著高于中分组(均P<0.01)。Spearman相关性分析显示TyG与TyG-BMI和Gensini评分呈现正相关,且TyG指数关联性更强(均P<0.01)。与颈动脉正常组相比,颈动脉粥样硬化组TyG指数更高(P<0.01),TyG-BMI更高(P<0.05)。二元Logistic回归分析发现年龄(OR=1.114,95%CI:1.05~1.18,P<0.01)与高血压(OR=2.913,95%CI:1.27~6.70,P<0.05)是颈动脉粥样硬化的独立危险因素),HDL-C(OR=0.108,95%CI:0.03~0.43,P<0.01)是保护因素。多元Logistic回归分析结果提示高水平TyG和TyG-BMI是颈动脉斑块形成的危险因素。以颈动脉正常为参照,排除混杂因素(如性别、年龄、BMI、收缩压、吸烟史、高血压病史、糖尿病史、药物服用情况)后,高TyG指数组CAD患者发生颈动脉斑块形成的风险是低TyG组的2.56倍,高TyG-BMI组发生颈动脉斑块的风险是低水平TyG-BMI组的4.35倍。Spearman相关性分析发现,TyG指数和颈动脉斑块厚度呈显著正相关(P<0.05),而TyGBMI和斑块厚度无相关。ROC曲线分析结果显示,TyG指数对冠心病患者合并颈动脉斑块形成具有较好的预测价值。结论TyG指数和TyG-BMI是冠心病患者颈动脉斑块形成的危险因素,且TyG指数对颈动脉斑块的预测价值优于TyG-BMI。

外周血CD4^(+)CD25^(+)Treg细胞、TLR4、hCMV-IgM与动脉粥样硬化型急性脑梗死患者颈动脉粥样硬化的关系

目的探讨外周血CD4^(+)CD25^(+)Treg细胞、TLR4、人巨细胞病毒(hCMV)-IgM与动脉粥样硬化型急性脑梗死(As-ACI)患者颈动脉粥样硬化的关系。方法选取89例As-ACI患者(脑梗死组),另选取健康体检者43例(对照组)。根据颈内动脉超声结果将As-ACI患者分为内膜正常组、内膜增厚组、斑块组、狭窄组。比较各组外周血CD4^(+)CD25^(+)Treg细胞水平、单个核细胞TLR4表达水平、hCMV-IgM抗体阳性率和内膜中膜厚度(IMT)。分析As-ACI患者颈动脉狭窄的危险因素,分析CD4^(+)CD25^(+)Treg细胞、TLR4与IMT的相关性及其对颈动脉狭窄的预测价值。结果脑梗死组CD4^(+)CD25^(+)Treg细胞、HDLC水平低于对照组,TLR4表达、hCMV-IgM抗体阳性率、TC、TG、LDLC、hs-CRP水平、IMT高于对照组(P<0.05)。内膜正常组、内膜增厚组、斑块组、狭窄组CD4^(+)CD25^(+)Treg细胞水平依次降低,TLR4表达、hCMV-IgM抗体阳性率、IMT依次增高(P<0.05)。CD4^(+)CD25^(+)Treg细胞水平与IMT呈负相关,TLR4表达与IMT呈正相关(P<0.05)。高血压、CD4^(+)CD25^(+)Treg表达、TLR4表达、hCMV-IgM抗体阳性是As-ACI患者颈动脉狭窄的危险因素(P<0.05)。CD4^(+)CD25^(+)Treg细胞、TLR4表达水平联合检测的预测价值高于单独检测(P<0.05)。结论外周血CD4^(+)CD25^(+)Treg细胞、TLR4、hCMV-IgM抗体阳性率与As-ACI患者颈动脉粥样硬化进展有关,外周血CD4^(+)CD25^(+)Treg细胞、TLR4联合可以较好预测病变过程。