Clinical and dietary predictors of common carotid artery intima media thickness in a population with type 1 and type 2 diabetes: A cross-sectional study

AIM To determine the clinical and dietary predictors of common carotid artery intima media thickness(CCA IMT) in a cohort of subjects with type 1 and type 2 diabetes. METHODS Participants with type 1(n = 23) and type 2 diabetes(n = 127) had mean and mean maximum CCA IMT measured using B mode ultrasound. Dietary intake was measured using a food frequency questionnaire. Clinical and dietary predictors of mean and mean maximum CCA IMT were determined using linear regression analysis adjusted for potential confounders. RESULTS The main predictors of mean and mean maximum CCA IMT were age and weight. After multivariate adjustment there were no dietary predictors of CCA IMT. However,in subjects that were not prescribed a lipid lowering medication alcohol consumption was positively associated with CCA IMT after multivariate adjustment. No difference existed in CCA IMT between subjects with type 1 or type 2 diabetes once age was adjusted for. CONCLUSION CCA IMT was predominantly predicted by age and weight in these subjects with diabetes. The finding that CCA IMT was not different between people with type 1 and type 2 diabetes warrants further investigation in a larger cohort.

Relationship between Waist Circumference and Elevation of Carotid Intima-media Thickness in Newly-diagnosed Diabetic Patients

Objective Waist circumference, as a brief indicator of visceral obesity, is associated with multi-metabolic disorders and cardiovascular diseases. The present study was aimed to find out the relationship between waist circumference and carotid intima media thickness （C-IMT）, as well as the best waist circumference cutoff for identifying C-IMT elevation in Chinese male patients with newly-diagnosed diabetes. Methods Five hundred and seventy-eight patients from Department of Endocrinology and Metabolism in Shanghai Sixth People＇s Hospital affiliated to Shanghai Jiao Tong University were enrolled. Both physical examination （for measurement of waist circumference） and carotid ultrasonography （for measurement of C-IMT） were performed. Results After grouping according to the quartiles of C-IMT, the waist circumference increased across all its quartiles. The waist circumference in 3rd and 4th quartiles （90.7_＋9.8 cm and 90.8＋9.6 cm） was significant higher than in 1st and 2nd quartiles （P〈0.05）. When subjects were divided into 4 groups according to waist circumference, the C-IMT of subjects with waist circumference 90-95 cm was significant higher than that of subjects with waist circumference 85-90 cm and less than 85 cm respectively （P〈0.05）. Both spearman and partial correlation analysis showed that C-IMT was positively correlated with waist circumference （P〈0.01）. C-IMT was found significantly elevated with the increase of waist circumference. Multiple stepwise regression analysis showed that waist circumference was one of the independent risk factors of C-IMT. After an average of 2.23_＋0.85 years follow up, there was a significant elevation of C-IMT in the group with baseline waist circumference over 90 cm P〈0.05）, while no significant difference was detected in the group with baseline waist circumference less than 90 cm （P=0.27）. Logistic regression showed that baseline waist circumference over 90 cm was associated with a relative risk to C-IMT elevation of 1.132 （95% CI 1.043-1.431, P〈0.05）. Conclusion Among newly-diagnosed diabetic male patients, waist circumference over 90 cm not only reflects sub-clinical atherosclerosis in early stage, but also predicts the progression of atherosclerosis.

The relationship between serum trimethylamine N-Oxide level and carotid intima media thickness in untreated essential hypertension patients

Background Circulating trimethylamine N-Oxide （TMAO） level has been linked to adverse cardiovascular outcome and mortality in the general population, and atherosclerosis is a window of the cardiovascular disease. Therefore, the present study was designed to investigate the relationship between TMAO level and atherosclerosis in untreated essential hypertension patients. Methods We measured serum TMAO level in atherosclerosis, subclinical atherosclerosis and controls matched by age and sex. The link between serum TMAO level and CIMT was subsequently assessed. Results The level of serum TMAO was significantly higher in atherosclerosis pa- tients than in controls. Serum TMAO level was positively correlated with carotid intima media thickness （r = 0.783, P 〈 0.001）, and logistic regression indicated that TMAO was a risk factor of atherosclerosis （OR, 1.904; 95% CI, 1.197- 2.733, P 〈 0.001）. Conclusions Serum TMAO concentration positively correlates to carotid intima media thickness, and should be a good predicted biomarker for atherosclerosis.

Correlation between Waist Circumference and Carotid Intima-Media Thickness in Women from Shanghai, China

Objective To evaluate whether waist circumference （WC） 〉85 cm is related to asymptomatic preclinical atherosclerosis in women from Shanghai, China. Methods A total of 2365 females aged 〉20 years recruited from 4 communities underwent physical examination and carotid artery scanning. Their carotid intima-media thickness （C-iMT） was measured. Results The C-IMT was significantly higher in overweight or obese women with their BMI 〉25.0 kg/m2 {P〈O.01） and in those with their WC _〉85 cm than in those with their WC 〈85 cm （P〈O.01）. Spearman and partial correlation analysis showed that the C-IMT was significantly correlated with WC which was independent of menopausal status. The C-IMT significantly increased with the increasing WC and reached to a platform in about 85 cm. An increment tendency was found in the subgroup with its WC 〈 85 cm （P〈O.01） while no significant tendency was found in the subgroup with its WC_〉85 cm （P=0.07）. Multiple stepwise regression analysis showed that the WC was an independent risk factor for C-IMT. In logistic regression model, the odd ratio of WC _〉80 cm, _〉80 cm and 〈85 cm and 〉85 cm for evaluating the risk of C-IMT elevation was 2.632, 2.501, and 1.878, respectively. Conclusion WC is significantly correlated with C-IMT in women from Shanghai, China, and WC_〉85 cm may be used in identifying the risk of subclinical carotid atherosclerosis.

Ultrasound Assessraent of Intima-media Thickness and Diameter of Carotid Arteries in Patients Undergoing Hemodialysis or Renal Transplantation

Renal transplant （RT） recipients have a high risk of developing cardiovascular diseases. However, the effects of renal transplantation on the development of arteriosclerosis have been controversial. The carotid intima-media thickness （CIMT） and diameter （CD） are important indicators of vascular remodeling and arteriosclerosis. In this study, 31 patients with hemodialysis （HD）, 31 RT recipients and 84 age- and gender-matched control subjects were enrolled. Their CIMT and CD were measured by ultrasonic radiofrequency tracking, and the linear regression models and Z test were used to identify the progression of arteriosclerosis and the risk factors. Compared with HD group, RT group had significantly lower CIMT and CD. CIMT was found to be associated with age, body weight, resistance index and diastolic velocity, while CD was associated significantly with age, body weight, pulsatility index, end diastolic velocity and diastolic blood pressure （DBP）, respectively. The correlation curves between CIMT and age showed the slopes of curves were decreased successively in control, RT and HD groups, and the curves between CD and age showed the slopes were decreased in order of RT 〉 control 〉 HD groups. It was concluded that CIMT and CD were significantly correlated with age in RT and moderately with age in HD patients. RT could reduce the progress of arteriosclerosis in patients with end-stage renal disease.

Relationship between Carotid Intima-Media Thickness and Diabetes Clinical Risk Factors among Normotensive Type 2 Diabetes Mellitus among Native Black African Population

Background: Type 2 diabetes mellitus is frequently associated with atherosclerosis with changes in the thickness of the intima-media of carotid arteries which causes increased risk of cardiovascular diseases. Cardiovascular disease is a major cause of morbidity and mortality in this group of patients. The carotid artery reflects the degree of atherosclerosis in the various vessels especially coronary arteries. Measurement of the carotid artery thickness with real time, relatively cheap and non-invasive ultrasonography method is used in monitoring atherosclerotic disease progression and response to treatment. This study is aimed at ultrasonographic evaluation of the carotid intima-media thickness (CIMT) in adult Type 2 Diabetic patients compared to non-diabetic healthy controls matched for age, gender and body mass index (BMI). And to also determine its association if any with selected clinical factors among a native Black African population. Methodology: This was a prospective case control study involving 54 adult type 2 diabetics and 54 adult non-diabetic controls. CIMT was measured at 3 segments of the extracranial carotid arteries by a 7.5 - 10 MHz linear transducer of a portable Mindray M5 ultrasound machine. Results: Among the native black African population studied, there was significant difference in CIMT of adult type 2 diabetics compared to healthy non-diabetics adults (p value = 0.012 and 0.001 on the right and left respectively). The mean carotid intima-media thickness in diabetics was 0.81 mm and 0.85 mm, while in non-diabetics it was 0.74 mm and 0.75 mm on the right and left respectively. The presence of diabetes showed independent positive correlation with CIMT (beta: 0.24, p value = 0.004). Age (beta: 0.30, p value = 0.001) and plasma cholesterol level (beta: 0.30, p value = 0.013) also had positive correlation with CIMT. Conclusion: There was statistically significant difference in carotid intima-media thickness between adult type 2 diabetics and age, sex matched non-diabetics. DM showed independent correlation with CIMT.

Relationship between peripheral arterial disease, carotid intima-media thickness and C-reactive protein in elderly diabetic patients

Purpose: To study the association between carotid intima media thickness (CIMT) and high sensitivity CRP (hs-CRP) level as markers for PAD in elderly patients with DM. Subjects: A case-control study on 90 participants aged 60 years and older divided into 60 cases (30 patients with DM alone and 30 patients with DM and comorbidities) and 30 healthy controls. All were assessed by measuring CIMT, ankle brachial index (AB), and markers for cardiovascular disease such as high-sensitivity CRP (hs-CRP), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL). Results: hs-CRP levels showed statistically significant difference being highest among patients with DM and comorbidities and lowest among controls (P < 0.001). Also, symptoms of PAD were significantly higher among cases than controls. ABI was able to detect PAD in many asymptomatic patients. Color changes were present in only 43.30% (n = 26) of positive PAD cases while delayed wound healing, claudication pain, rest pain, cold extremities, and trophic changes were present in 23.30% (n = 14), 16.71% (n = 10), 16.71% (n = 10), 45.00% (n = 27), and 21.7% (n = 13). Using logistic regression analysis revealed that DM, CIMT, and hs-CRP were independent predictors for PAD (OR = 4.194, 7.236, 1.003;P value = 0.044, 0.25, 0.031) after adjustment of other coronary risk factors such as sex, smoking, hypertension, TC, and TG. Conclusion: Diabetic elderly have higher prevalence of asymptomatic PAD thannon-diabetics using solely ABI. DM, CIMT, and hs-CRP are independent predictors for the occurrence of PAD. Hs-CRP levels are highest among diabetics with comorbidities.

Evaluation of carotid intima-media thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy

Background:Adenotonsillar hypertrophy can produce cardiopulmonary disease in children.However,it is unclear whether adenotonsillar hypertrophy causes atherosclerosis.This study evaluated carotid intimamedia thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy.Methods:The study included 40 children with adenotonsillar hypertrophy(age:5-10 years)and 36 healthy children with similar age and body mass index.Systolic blood pressure,diastolic blood pressure,and pulse pressure were measured in all subjects.Carotid intima-media thickness,carotid arterial systolic diameter,and carotid arterial diastolic diameter were measured using a high-resolution ultrasound device.Based on these measurements,carotid arterial strain,carotid artery distensibility,beta stiffness index,and elasticity modulus were calculated.Results:Carotid intima-media thickness was greater in children with adenotonsillar hypertrophy(0.36±0.05 mm vs.0.34±0.04 mm,P=0.02)compared to healthy controls.Beta stiffness index(3.01±1.22 vs.2.98±0.98,P=0.85),elasticity modulus(231.39±99.23 vs.226.46±83.20,P=0.88),carotid arterial strain(0.17±0.06 vs.0.17±0.04,P=0.95),and carotid artery distensibility(13.14±3.88 vs.12.92±3.84,P=0.75)were similar between children with adenotonsillar hypertrophy and the healthy controls.Conclusions:The present study revealed increased carotid intima-media thickness in children with adenotonsillar hypertrophy.The risk of subclinical atherosclerosis may be higher in children with adenotonsillar hypertrophy.

身体活动水平对2型糖尿病患者颈动脉内膜中层厚度增厚的影响研究

背景心血管疾病是2型糖尿病(T2DM)患者的主要死亡原因,颈动脉内膜中层厚度(CIMT)增厚可预测心血管疾病的发生。中高水平的身体活动(PA)可改善患者的血糖水平并降低心血管疾病的发生率和死亡风险。探讨这一可改变的生活方式与CIMT的关系可能是预防心血管疾病的有效策略。目的分析不同PA水平与T2DM患者CIMT增厚的关系,为患者推荐个性化活动方案提供科学依据。方法本研究为横断面研究,选取2019年1月—2022年2月于江苏省两家三级甲等医院内分泌门诊就诊的3099例T2DM患者为研究对象,采用国际身体活动量表(IPAQ)短问卷评估患者的PA水平,将患者分为轻度及以下PA组、中度PA组和高强度PA组。通过二元Logistic回归分析探讨PA与CIMT增厚的关系,并按照不同肥胖程度和血压、血脂及糖化达标状况进行分层分析。将PA水平作为连续变量绘制限制性立方样条评价PA与CIMT增厚的剂量反应关系。结果与轻度及以下PA患者(n=981)相比,中度(n=1389)和高强度(n=729)PA患者的年龄较小,糖化血红蛋白(HbA_(1c))和低密度脂蛋白胆固醇(LDL-C)水平较高(P<0.05)。二元Logistic回归分析结果显示,中度PA与发生CIMT增厚的风险呈负关联(OR=0.775,95%CI=0.629~0.956,P<0.05),这种关联独立于社会人口学、生活方式及血脂等生化指标。进一步绘制限制性立方样条结果显示,PA与CIMT增厚的风险之间存在非线性关系(P_(非线性)=0.014)。分层分析结果显示,在体质量正常(n=996)和超重(n=1395)的患者中未发现PA与CIMT的关系(P>0.05);而在肥胖患者(n=708)中仅中度PA与CIMT增厚相关(OR=0.614,95%CI=0.382~0.987,P<0.05);血压、血脂及糖化3项指标均不达标(n=324)和仅1项指标达标(n=1416)的患者,中度PA与发生CIMT增厚呈负相关(P<0.05)。结论PA水平与CIMT增厚存在剂量反应关系,中度PA与CIMT增厚呈负相关,尤其是在肥胖、血压、血脂及糖化控制较差的人群中,而高强度PA对CIMT的影响不显著。

Significance of Increased CIMT with Coexisting Carotid Plaques in Cerebral White Matter Lesions in Elders

It is very common that increased carotid intima media thickness （CIMT） and carotid plaque coexist in a single subject in elderly patients with white matter lesions （WMLs）. In this study we inves- tigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups： without either increased CIMT （I） or carotid plaque （P）： I（-）P（-）; with only increased CIMT： I（＋）P（-）; with only carotid plaque： I（-）P（＋）; and with both increased CIMT and carotid plaque： I（＋）P（＋） The presence and severity of periventricular WMLs （PWMLs） and deep WMLs （DWMLs） were as- sessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I（-）P（-）〈 I（＋）P（-）〈 I（-）P（＋）〈 I（＋）P（＋） （P〈0.0001）. For the pa- tients with DWMLs, the grades of both I（＋）P（-） and I（＋）P（＋） were increased significantly compared to I（-）P（-） （P〈0.0025, P〈0.05, respectively） without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.

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.

Subclinical carotid atherosclerosis predicts all-cause mortality and cardiovascular events in obese patients with negative exercise echocardiography

BACKGROUND Obesity is a major health problem due to its high prevalence. The relationship between obesity and cardiovascular disease is unclear. Some studies agree that certain conditions associated with obesity, such as physical inactivity or cardiovascular risk factors, are responsible for cardiovascular risk excess among obese people. Carotid intima-media thickness and carotid plaques(CP) have been associated with cardiovascular adverse events in healthy populations, and recent data suggest a higher prevalence of subclinical carotid atherosclerosis in obese and metabolically unhealthy patients. However, there are no studies correlating subclinical atherosclerosis and adverse events(AE) in obese subjects.AIM To determine the association between carotid disease and AE in obese patients with negative exercise echocardiography(EE).METHODS From January 1, 2006 to December 31, 2010, 2000 consecutive patients with a suspicion of coronary artery disease were submitted for EE and carotid ultrasonography. Exclusion criteria included previous vascular disease, left ventricular ejection fraction < 50%, positive EE, significant valvular heart disease and inferior to submaximal EE. An AE was defined as all-cause mortality,myocardial infarction and cerebrovascular accident. Subclinical atherosclerosis was defined as CP presence according to Manheim and the American Society of Echocardiography Consensus.RESULTS Of the 652 patients who fulfilled the inclusion criteria, 226(34.7%) had body mass indexes ≥ 30 kg/m2, and 76 of them(33.6%) had CP. During a mean follow-up time of 8.2(2.1) years, 27 AE were found(11.9%). Mean event-free survival at 1, 5 and 10 years was 99.1%(0.6), 95.1%(1.4) and 86.5%(2.7), respectively. In univariate analysis, CP predicted AE [hazard ratio(HR) 2.52, 95% confidence interval(CI) 1.17-5.46; P = 0.019]. In multivariable analysis, the presence of CP remained a predictor of AE(HR 2.26, 95%CI 1.04-4.95, P = 0.041). Other predictors identified were glomerular filtration rate(HR 0.98, 95%CI 0.96-0.99; P= 0.023), peak metabolic equivalents(HR 0.83, 95%CI 0.70–0.99, P = 0.034) and moderate mitral regurgitation(HR 5.02, 95%CI 1.42–17.75, P = 0.012).CONCLUSION Subclinical atherosclerosis defined by CP predicts AE in obese patients with negative EE. These patients could benefit from aggressive prevention measures.

Association between fasting and postprandial triglyceride levels and carotid intima-media thickness in type 2 diabetes patients

OBJECTIVE: To investigate the association of fasting and postpiandial triglyceride with carotid intima-media thickness among type 2 diabetic patients in southeast China. METHODS: A total of 78 type 2 diabetic patients from southeast China were recruited. All the subjects underwent a standardized mixed-meal test (SMMT) and an oral glucose tolerance test. Carotid intima-media thickness (IMT) was measured by color doppler ultrasound examination. RESULTS: Postprandial triglyceride (PTG) after SMMT increased significantly in type 2 diabetic patients. The carotid IMT in patients with postprandial hypertriglyceridemia was significantly greater than that in patients with postprandial normal-triglyceridemia (0.90 mm vs 0.81 mm, P 0.05). CONCLUSION: The results suggest that postprandial hypertriglyceridemia may be an independent risk factor of early atherosclerosis in type 2 diabetes.

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.

Effect of short term intensive multitherapy on carotid intima-media thickness in patients with newly diagnosed type 2 diabetes mellitus

Background Controlling plasma glucose levels, blood pressure and lipid levels is proven to reduce the risk of vascular complications in patients with type 2 diabetes mellitus. This has prompted intensive multitherapy targeted at several macrovascular risk factors. Carotid intima-media thickness （cIMT） is a reliable measure of early atherosclerosis. We sought to determine whether a 6-month intensive mutiltherapy program resulted in better goal attainment than usual care and its effect on the development of cIMT among patients with newly diagnosed type 2 diabetes mellitus. Methods The study randomly assigned 220 patients with newly diagnosed type 2 diabetes mellitus to intensive or traditional therapy groups. The clinical parameters, such as fasting plasma glucose, total cholesterol, triglyceride, blood pressure, body weight and insulin were assessed at the baseline and after the 6-month therapy, cIMT of the patients was also obtained. Results The average levels of fasting plasma glucose, hemoglobin Alc, total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-C） in the intensive group were significantly lower than those in the control group at the end of 6-month treatment. By 6 months, a higher proportion of patients in the intensive therapy group than in the control group attained goals for fasting plasma glucose （FPG）, TC, LDL-C and hemoglobin Alc. With intensive multherapy the level of carotid intima-media thickness in the intensive therapy group was lower than that in the control group （（0.88±0.26） mm vs （0.96±0.22） mm, P 〈0.01）. Conclusions The evidence from this clinical trial demonstrates that intensive glucose, lipid and blood pressure control in patients with newly diagnosed type 2 diabetes is associated with diabetic macrovascular benefits. Intensive multitherapy allows more patients to achieve aims of control and may reduce macrovascular complications and delay disease progression.

Association between Carotid Intima-media Thickness and Aldehyde Dehydrogenase 2 Glu504Lys Polymorphism in Chinese Han with Essential Hypertension

Background： Aldehyde dehydrogenase 2 （ALDH2） is involved in the pathophysiological processes of cardiovascular diseases. Recent studies showed that mutant ALDH2 could increase oxidative stress and is a susceptible factor for hypertension. In addition, wild-type ALDH2 could improve the endothelial functions, therefore reducing the risk of developing atherosclerosis. The aim of the present study was to explore the frequency of the Glu504Lys polymorphism of the ALDH2 gene and its relation to carotid intima-media thickness （CIMT） in a group of patients with essential hypertension （EH） and to investigate the association between the Glu504Lys polymorphism and CIMT in Chinese Han patients with EH. Methods： In this study, 410 Chinese Han patients with EH who received physical examinations at the People＇s Hospital of Sichuan Province （China） were selected. DNA microarray chip was used for the genotyping of the Glu504Lys polymorphism of the ALDH2 gene. The differences in CIMT among patients with different Glu504Lys ALDH2 genotypes were analyzed. Results： The mean CIMT of the patients carrying AA/AG and GG genotypes was 1.02 ± 0.31 mm and 0.78 ±0.28 mm, respectively. One-way ANOVA showed that the CIMT of the patients carrying the AA/AG genotype was significantly higher than in the ones carrying the GG genotype （P 〈 0.001）. Multivariate logistic regression showed that the Glu504Lys AA/AG genotype of the ALDH2 gene was one of the major factors influencing the CIMT in patients with EH （odds ratio = 3.73 l, 95% confidence interval = 1.589-8.124, P = 0.001）. Conclusions： The Glu504Lys polymorphism of the ALDH2 gene is associated with the CIMT of Chinese Han patients with EH in Sichuan, China.

常规体检指标对颈动脉硬化发生的预测价值

目的探讨常规体检指标如性别、年龄、血压、血脂、同型半胱氨酸等在颈动脉硬化发生的预测价值。方法采用回顾性研究方法。选取2016年1月至2021年12月连续6年在我院接受健康体检人群985例作为研究对象。收集受试者一般资料、体格检查指标、实验室检查指标、颈动脉超声结果等信息。受试者在随访中经颈动脉超声诊断为颈动脉内中膜厚度(cIMT)>1mm或有颈动脉斑块形成则被认为出现颈动脉粥样硬化进展并结束随访。受试者若未出现颈动脉粥样硬化进展,则直至2021年12月随访结束。将研究对象按随访过程中cIMT是否增加分为硬化组、进展组和对照组。分析颈动脉硬化发生的影响因素,并采用受试者操作特征曲线分析体检指标对颈动脉硬化的诊断效能。结果进展组在颈动脉硬化发病后TC、LDL-C、FBG、UA、Hcy和SBP均高于发生前,HDL-C低于发病前,差异有统计学意义(P<0.05);硬化组除HDL-C和Hcy指标差异没有统计学意义外,其他指标如男性比例、年龄、TC、TG、LDL-C、FBG、UA、SBP、DBP、BMI指标均高于对照组,差异有统计学意义(P<0.05);其中FBG、LDL-C和SBP为颈动脉硬化发生的独立风险因素(OR=5.505、4.222、1.071,P<0.05),以上指标联合诊断颈动脉硬化的曲线下面积高于各项单独检测,差异有统计学意义(P<0.01)。结论FBG、LDL-C和BMP与颈动脉硬化的发生密切相关,联合检测对颈动脉硬化有较好的诊断效能。

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。

Relationship of plasma level of Lp-PLA_2 and pulse wave velocity and carotid intima-media thickness

Background Increased plasma level of Lp-PLA2 is a potential risk factor for atherosclerosis. Nevertheless, whether Lp-PLA2 has effects on both vascular function and structure changes is still unclear. Method One hundred and eighty-six outpatient subjects without overt cardiovascular disease were enrolled and anthropomet- ric data, plasma level of Lp-PLA2 and other related laboratory parameters were collected. Measurements of pulse wave velocity （PWV） and carotid intima-media thickness （CIMT） were performed by an experienced investigator. According to plasma level of Lp-PLA2, all the subjects were divided into two groups as follows： 〈 200 ng/mL （n = 96） and ≥200 ng/mL （n = 90）. Result Body mass index, smoking, diabetic mellitus, systolic blood pressure, and LDL-C level were positive correlation with plasma level of Lp-PLA2, while use of statins was negatively correlative. Both PWV and CIMT positively correlated with smoking, systolic blood pressure, LDL-C level and plasma level of Lp-PLA2, while negatively correlated with HDL-C level and usage of statins. CIMT in the group with plasma level of Lp-PLA2 〈 200 ng/mL （0.9 ± 0.2 mm, n = 96） was sig- nificantly less than that with plasma level of Lp-PLA2≥200 ng/mL （1.2 ±0.4 mm, n = 90, P = 0.32）, and similar finding was also observed in PWV （9.1± 0.5 m/s vs 12.7 ± 0.4 m/s, P = 0.38）. Conclusion Our present study shows that in subjects without overt CVD, increased plasma level of Lp-PLA2 is associated with vascular function （PWV） and structure （CIMT） deterioration.

系统性红斑狼疮患者心外膜脂肪厚度与心血管疾病风险的相关性

目的:研究系统性红斑狼疮(SLE)患者心外膜脂肪组织厚度(EFT)的改变,并探讨其与心脏彩超参数及心血管疾病(CVD)传统危险因素的相关性。方法:纳入2019年10月至2021年10月于我院住院的SLE患者作为病例组,同期健康人群作为对照组,测量2组的EFT,根据EFT是否增厚将SLE患者分为增厚组及不增厚组,比较2组炎症指标、心脏彩超参数及CVD传统危险因素之间的差异,并应用Logistic回归分析寻找EFT的危险因素。结果:SLE组患者的EFT[4.40(2.60)mm]较对照组[3.10(1.60)mm]显著增厚(P<0.001)。病例组患者中EFT增厚者占42.0%(76/131),对照组EFT增厚者仅占9.5%(9/95)。病例组中EFT增厚组与不增厚组比较结果显示,EFT增厚组的年龄、体质量指数(BMI)、左心房直径(LAD)、右心室内径(RVD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)及颈动脉内膜中层厚度(CIMT)均显著高于不增厚组。EFT与年龄、病程、BMI、甘油三酯、低密度脂蛋白、LAD、RVD、IVST、LVPWT及CIMT等呈正相关。Logistic回归分析显示LVPWT增加是EFT增厚的危险因素。结论:SLE患者的EFT增厚与心脏结构或功能参数的改变相关,提示应对EFT增厚及心脏结构或功能参数异常的SLE患者进一步筛查心血管病变的危险因素。