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1.
Rev. cuba. med ; 61(1)mar. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1408975

ABSTRACT

RESUMEN Introducción: El hipotiroidismo subclínico se relaciona con alteraciones cardiovasculares como la aterosclerosis carotidea subclínica por daños endoteliales como consecuencia de varios factores siendo el grosor intima-media carotideo (GIMC) un marcador reconocido, cuya elevación se menciona con frecuencia asociada a esta disfunción tiroidea. Objetivo: Determinar los efectos del tratamiento sustitutivo de pacientes con hipotiroidismo subclínico en el GIMC. Métodos: Se realizó un estudio de intervención que incluyó 94 pacientes con diagnóstico de hipotiroidismo subclínico sin tratamiento sustitutivo, que acudieron a la consulta de Endocrinología del hospital 10 de octubre a los cuales se les realizó determinación de TSH, colesterol total, colesterol LDL, colesterol HDL, triglicéridos y se les realizó US carotideo al inicio del estudio y al año de logrado el estado eutiroideo con tratamiento sustitutivo, para establecer diferencias en los parámetros evaluados antes y después del tratamiento sustitutivo. Resultados: Previo al tratamiento se encontró hipercolesterolemia en el 87,2 % de los pacientes e hipertrigliceridemia en y 38,3 %, mientras que, que valores elevados de colesterol LDL y disminuidos de colesterol HDL fueron hallados en el 55,3 % y 19,3 % de los mismos, el GIMC se mostró dentro del rango de normalidad. Tras el tratamiento con levotiroxina todos los valores medios de los parámetros estudiados se modificaron excepto en el caso de los triglicéridos Conclusiones: El tratamiento sustitutivo del hipotiroidismo subclínico tiene efectos beneficiosos sobre el GIMC, lo que pudiera ser secundario, entre otros factores, a la mejoría del perfil lipídico.


ABSTRACT Introduction: Subclinical hypothyroidism is related to cardiovascular alterations such as subclinical carotid atherosclerosis due to endothelial damage as a consequence of various factors, carotid intima-media thickness (CIMT) being a recognized marker, whose elevation is frequently mentioned in association with this thyroid dysfunction. Objective: To determine the effects of replacement therapy in patients with subclinical hypothyroidism in CIMT. Methods: An intervention study was carried out in 94 patients diagnosed with subclinical hypothyroidism, who did not have substitutive treatment. They were treated in Endocrinology consultation at 10 de Octubre hospital. These subjects underwent determination of TSH, total cholesterol, LDL cholesterol, cholesterol HDL, triglycerides. They got carotid ultrasound at the beginning of the study and one year after achieving euthyroid status with replacement treatment, to establish differences in the parameters evaluated before and after replacement treatment. Results: Prior to treatment, hypercholesterolemia was found in 87.2% of patients and hypertriglyceridemia in 38.3%, while elevated LDL cholesterol and decreased HDL cholesterol values were found in 55.3% and 19. .3% of them, CIMT was within the normal range. After treatment with levothyroxine, all the mean values of the parameters studied were modified, except in the case of triglycerides. Conclusions: Subclinical hypothyroidism replacement therapy has beneficial effects on CIMT, which could be secondary, among other factors, to the improvement of the lipid profile.

2.
Clinics ; 77: 100107, 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1404330

ABSTRACT

Abstract Background: This study aimed to evaluate the associations between Lipoprotein (a) ‒ Lp(a) levels and carotid Intima-Media Thickness (cIMT) and with carotid plaques in healthy subjects because of previous contradictory data. Methods: A total of 317 healthy normolipidemic subjects (20‒77 years old) were selected. The cIMT and atherosclerotic plaques were determined by B-mode ultrasonography. Mann-Whitney tests were performed to compare the groups according to Lp(a) levels and to explore the associations between Lp(a), carotid plaques, and cIMT, logistic and linear regression analyses were performed. Results: Studied population (51% females, median age 43 years old) presented carotid plaques and cIMT ≥ 0.9 mm in 23% and 18% of the participants, respectively. The group with Lp(a) levels > 30 mg/dL presented significantly higher age and atherosclerotic plaques. Indeed, multivariate linear regression analysis showed a significant association between Lp(a), age, and race. On the other hand, logistic regression analysis demonstrated that the subjects with Lp(a) > 30 mg/dL have a significantly high risk of carotid plaques. Conclusion: The data from the present study indicate that Lp(a) levels above 30 mg/dL contribute to the development of carotid plaques even in apparently healthy participants.

3.
Adv Rheumatol ; 62: 4, 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1360069

ABSTRACT

Abstract Background: We aimed to assess the concordance of recommendation for initiating statin therapy according to the 2019 World Health Organization (WHO) cardiovascular disease (CVD) risk charts and to the presence of carotid plaque (CP) identified with carotid ultrasound in Mexican mestizo rheumatoid arthritis (RA) patients, and to determine the proportion of patients reclassified to a high cardiovascular risk after the carotid ultrasound was performed. Methods: This was a cross-sectional study nested of a RA patients' cohort. A total of 157 Mexican mestizo RA patients were included. The cardiovascular evaluation was performed using the 2019 WHO CVD risk charts (laboratory-based model) for the Central Latin America region. A carotid ultrasound was performed in all patients. The indication to start statin therapy was considered if the patient was classified as high risk, moderate risk if > 40 years with total cholesterol (TC) > 200 mg/dl or LDL-C > 120 mg/dl, and low risk if > 40 years with TC > 300 mg/dl, according to the WHO CVD risk chart or if the patient had carotid plaque (CP). Cohen's kappa (k) coefficient was used to evaluate the concordance between statin therapy initiation. Results: Initiation of statin therapy was considered in 49 (31.2%) patients according to the 2019 WHO CVD risk charts and 49 (31.2%) patients by the presence of CP. Cardiovascular risk reclassification by the presence of CP was observed in 29 (18.9%) patients. A slight agreement (k = 0.140) was observed when comparing statin therapy recommendations between 2019 WHO CVD risk charts and the presence of CP. Conclusion: The WHO CVD risk charts failed to identify a large proportion of patients with subclinical atherosclerosis detected by the carotid ultrasound and the concordance between both methods was poor. Therefore, carotid ultra-sound should be considered in the cardiovascular evaluation of RA patients.

4.
Article in Chinese | WPRIM | ID: wpr-906116

ABSTRACT

Objective:To discuss the clinical efficacy of modified Danshenyin and Erchentang in treating carotid atherosclerosis (CAS), and the effect on intimal injury. Method:Patients (151 cases) were divided into control group (75 cases) and observation group (76 cases). Specifically, 69 cases in control finished the treatment (4 cases fell off in follow-up, and 2 cases were eliminated), and 69 cases in observation group finished the treatment (3 cases fell off in follow-up, and 4 cases were eliminated). Patients in both group got atorvastatin calcium tablets, 10 mg/time, 1 time/day, and aspirin enteric-coated tablets, 100 mg/time, 1 time/day. Patients in control group got Hedan tablets, 2 tablets/time, 3 times/day. Patients in observation group got modified Danshenyin and Erchentang, 1 dose/day. The treatment lasted for 4 months. Before and after treatment, color Doppler ultrasound of carotid artery was detected, and carotid intima-media thickness (IMT), plaque number, plaque area, plaque thickness and hemodynamics were recorded. Levels of nitric oxide (NO), endothelin-1 (ET-1), von Willebrand factor (vWF), soluble intercellular adhesion molecule-1 (sICAM-1), vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), whole-blood low-shear viscosity (LBV), whole-blood high-shear viscosity (HBV), plasma viscosity (PV), platelet aggregation rate (PAR), fibrinogen (FIB), homocysteine (Hcy), interleukin-6 (IL-6), IL-10, tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), serum superoxide dismutase (SOD), malondialdehyde (MDA), oxidized low density lipoprotein (ox LDL) and circulating glutathione peroxidase (GSH-Px) were detected before and after treatment. And the safety was evaluated. Result:After treatment, IMT, number, area and thickness of plaque in observation group were less than those in control group (<italic>P</italic><0.01). Peak systolic velocity and end diastolic velocity in observation group were higher than those in control group (<italic>P</italic><0.01), while pulsatility index and resistance index were lower than those in control group (<italic>P</italic><0.01). And levels of ET-1, vWF, sICAM-1, VEGF, MMP-9, TG, TC, LDL-C, LBV, HBV, PV, PAR, FIB, Hcy, IL-6, TNF-<italic>α</italic>, MDA and ox-LDL were lower than those in control group (<italic>P</italic><0.01), whereas levels of NO, HDL-C, IL-10, SOD and GSH-Px were higher than those in control group (<italic>P</italic><0.01). And there was no adverse reaction caused by traditional Chinese medicine. Conclusion:Modified Danshenyin and Erchentang can reduce plaque, improve hemodynamics and hemorheology, and regulate blood lipid metabolism and vascular endothelial factor, with anti-inflammatory and anti-oxidation damages. It can protect vascular intima, and inhibit the occurrence and development of CAS, with a safety in clinical use.

5.
Article in Chinese | WPRIM | ID: wpr-855868

ABSTRACT

AIM: To analyze the effects of atorvastatin and folic acid tablets on homocysteine and carotid atherosclerosis in patients with type H hypertension. METHODS: A total of 140 patients with H-type hypertension admitted to our hospital from January 2016 to October 2018 were enrolled in the study. Random number table method was divided into observation group (70 cases) and control group (70 cases). The control group was treated with folic acid tablets on the basis of routine blood pressure reduction. The observation group was given atorvastatin calcium tablets on the basis of the control group, and the treatment was 10 weeks. Comparing the two groups of homocysteine, low-density lipoprotein, brachial-ankle pulse wave velocity, carotid intima-media thicknessbefore and after treatment, blood pressure and heart rate levels, and observed the occurrence of adverse reactions. During a follow-up of one year, the incidence of cardiovascular and cerebrovascular events was compared between the two groups. RESULTS:The plasma Hcy level and LDL level in the observation group was significantly lower than that in the control group (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSION:Atorvastatin combined with folic acid tablets can effectively reduce carotid atherosclerosis in patients with type H hypertension, and it can reduce the levels of Hcy and LDL, and it is clinically safe.

6.
Journal of Preventive Medicine ; (12): 563-568, 2020.
Article in Chinese | WPRIM | ID: wpr-822809

ABSTRACT

Objective@# To learn the interaction of serum direct bilirubin and blood lipids on the risk of carotid atherosclerosis and carotid plaque.@*Methods @#The subjects were selected from Hangzhou Wuyunshan Sanatorium from March 2016 to December 2018. Demographic information,laboratory testing results and carotid intima-media thickness(IMT)were collected. The logistic regression model was employed for the association of direct bilirubin,blood lipids and their interaction with the risk of carotid atherosclerosis and carotid plaque. @*Results@#Totally 8 308 subjects were recruited. Among them,616(7.41%) subjects had carotid atherosclerosis,and 2 409(29.00%)subjects had plaques. The results of multivariate and multinomial logistic regression analysis showed that high level of direct bilirubin was associated with decreased risks of carotid atherosclerosis(OR=0.701,95%CI:0.537-0.916)and carotid plaque(OR=0.647,95%CI:0.527-0.795);high TC level(OR=1.335,95% CI:1.106-1.611), high LDL-C level(OR=1.338,95%CI:1.098-1.629)and low HDL-C level(OR=1.431,95%CI:1.148-1.783)were associated with increased risks of carotid atherosclerosis;high TC level(OR=1.325,95% CI:1.151-1.525)and high LDL-C(OR=1.311,95%CI:1.130-1.520)were associated with increased risks of carotid plaque. There were interactions between direct bilirubin and TC or LDL-C on the risk of carotid plaque(P<0.05). Compared with the subjects with high level of direct bilirubin and normal level of TC,the subjects with normal level of direct bilirubin and high level of TC had significantly higher risk of carotid plaque(OR=1.831,95%CI:1.438-2.333);compared with the subjects with high level of direct bilirubin and normal level of LDL-C,the subjects with normal level of direct bilirubin and high level of LDL-C had significantly higher risk of carotid plaque(OR=1.814,95%CI:1.427-2.306).@*Conclusion @#The interactions between direct bilirubin and TC or LDL-C increase the risk of carotid plaque. It is important to strengthen blood lipid control in the patients with normal level of direct bilirubin and hyperlipidemia.

7.
Article in Chinese | WPRIM | ID: wpr-878680

ABSTRACT

Objective To investigate the relationship between serum cystatin C(CysC)level and vascular complications in type 2 diabetes mellitus(T2DM)patients with normal renal function. Methods Totally 218 T2DM patients who were treated in the Department of Endocrinology,Affiliated Hospital of Chengde Medical College from January 2017 to May 2018 were enrolled.All subjects were divided into four groups based on the quartiles of serum CysC levels:G1 group:≤ 0.56 mg/L,58 cases;G2 group:0.57-0.73 mg/L,52 cases;G3 group:0.74-1.11 mg/L,56 cases;G4 group:≥ 1.12 mg/L,52 cases.The general data,biochemical indicators,glycated albumin,hemoglobin A


Subject(s)
Biomarkers/blood , Cardiovascular Diseases/complications , Cystatin C/blood , Diabetes Mellitus, Type 2/complications , Humans , Kidney , Risk Factors
8.
China Occupational Medicine ; (6): 50-60, 2019.
Article in Chinese | WPRIM | ID: wpr-881756

ABSTRACT

OBJECTIVE: To explore the effects of cumulative noise exposure(CNE) on the intima-media thickness(IMT) of carotid artery in steel workers. METHODS: A cluster random sampling method was used to select 1 437 noise exposed workers in a steel company as study subjects. The CNE was calculated according to the noise intensity of the workplace, and the occupational health check was carried out to construct the structural equation model of noise to IMT. RESULTS: The detection rate of carotid atherosclerosis(CAS) in these 1 437 subjects was 38.3%. The CAS detection rates of steel workers increased with the increasing CNE(P<0.01). The structural equation model had good fitting effect. Path analysis showed CNE can indirectly affect IMT through blood pressure, triglycerides, fasting blood glucose, homocysteine, high-density lipoprotein & apolipoprotein A, low-density lipoprotein & apolipoprotein B. The total effects were-0.375, 0.337, 0.248, 0.117, 0.056, 0.056 and 0.018 respectively. CONCLUSION: CNE can indirectly increase the IMT of steel workers by acting on the proximal cause.

9.
Acta Anatomica Sinica ; (6): 800-804, 2019.
Article in Chinese | WPRIM | ID: wpr-844585

ABSTRACT

Objective: To investigate the effects of cervical rotatory manipulation (CRM) on severe carotid atherosclerosis of rabbits in hemodynamics. Methods: Totally 40 New Zealand rabbits were divided randomly into 3 groups, including the manipulation group, the model group and the control group. Left carotid atherosclerotic plaques models were developed in the rabbits of manipulation group and model group. Then, the manipulation group was treated with CRM lasting for 2 weeks; meanwhile no intervention was given on rabbits in the model group and control group. At the end of manipulation, flow sheer stress (FSS) was calculated with velocity and viscosity of blood. One way AN OVA and LSR-t test were performed to explore the significance. Results: FSS of left carotid artery in rabbit decreased significantly in the manipulation group and the model group, in comparison with the control group. Moreover, FSS in the manipulation group was lower than that in the model group. Conclusion: FSS of severe atherosclerotic carotid artery in rabbit may become decreased following with CRM.

10.
Article in Chinese | WPRIM | ID: wpr-843946

ABSTRACT

Objective: To investigate the relationship between carotid atherosclerosis and ischemic stroke in the population with a high risk for stroke from Yanta District, Xi'an. Methods: The subjects were selected from Screening and Prevention Program of Stroke in Yanta District, Xi'an, in 2012. All of them received carotid ultrasound examination and were followed up by telephone 4 years later. Chi-square test, analysis of variance, and multivariate cox regression model analysis were performed to investigate the correlation between carotid atherosclerosis and ischemic stroke. Results: A total of 774 subjects met the inclusion criteria, and 4 years later 39 lost to follow-up, 17 refused to be investigated, 4 patients underwent carotid artery stenting, and 4 patients had cerebral hemorrhage, Finally, 710 patients were included in the analysis, and the age was 45-98 years (59.75 years ±9.58 years) with males being 282 (39.7%). During the follow-up, 50 participants were diagnosed as having ischemic stroke. The incidence of ischemic stroke in the carotid atherosclerosis group was higher than that in the non-atherosclerosis group (13.1% vs. 5.2%, P<0.001). K-M survival analysis showed that the survival time in the non-carotid atherosclerosis group was longer than that in the carotid atherosclerosis group. Multivariable Cox regression analysis showed that age, history of stroke, family history of coronary heart disease or diabetes, medication on hypoglycemics and lipid-lowering drugs, abnormal level of high-density lipoprotein and carotid atherosclerosis were significantly associated with ischemic stroke. It also showed that carotid atherosclerosis was an independent factor for ischemic stroke (HR=2.529, 95% CI: 1.150-5.563, P=0.029). Conclusion: Carotid atherosclerosis in the population with a high risk for stroke significantly increases the risk of ischemic stroke.

11.
Article in Chinese | WPRIM | ID: wpr-755671

ABSTRACT

To investigate the association of serum 3-nitrotyrosine ( 3-NT ) with carotid atherosclerosis in newly diagnosed type 2 diabetic patients. 96 patients with newly diagnosed type 2 diabetes mellitus treated in the department of endocrinology of Tangshan Gongren Hospital were recruited, and were divided into two groups depending on their carotid atherosclerosis status as carotid atherosclerosis group ( CAS group, n = 54 ) and non-carotid atherosclerosis group ( NCAS group, n=42); while 51 healthy subjects without type 2 diabetes mellitus from the medical examination center were recruited as normal control group ( NC group, n=51) . Demographic and clinical data of all subjects were collected. Serum 3-NT levels were measured by Enzyme-Linked Immunosorbent Assay ( ELISA) . ( 1) The levels of 3-NT in CAS group and NCAS group were all higher than those in NC group, and the level of 3-NT in CAS group was higher than that in NCAS group (all P<0.05);(2) In type 2 diabetic patients, 3-NT was positively correlated with HbA1C and low density lipoprotein-cholesterol ( both P<0. 05); ( 3) Logistic regression analysis showed that age (OR=1.271, P=0.023), HbA1C(OR=1.812, P=0.005) , Hcy (OR=1.194, P=0.019), and 3-NT (OR=1.593, P=0.011) were risk factors of CAS in type 2 diabetic patients. Serum 3-NT was closely correlated with carotid atherosclerosis in newly diagnosed type 2 diabetic patients, suggesting that serum 3-NT may be involved in the carotid atherosclerosis of newly diagnosed type 2 diabetic patients.

12.
Article in Chinese | WPRIM | ID: wpr-755307

ABSTRACT

Objective To investigate the occurrence of carotid atherosclerosis in a population of permanent residents (age ≥40 years) at high risk of stroke in Xuejiadao Street,Huangdao District,Qingdao City,and to provide a scientific basis for reduction of carotid atherosclerosis in high-risk communities.Methods Using a cluster sampling method,10 007 permanent residents of age ≥40 years were enrolled in the study.Based on data from an early population screening project,1 478 subjects at high risk of carotid atherosclerosis and stroke were included for analysis.These study subjects were divided into a carotid atherosclerosis risk group and a normal group.General data were recorded,and the results of a physical examination and clinical and biochemical tests were used to analyze risk factors.Results Of 1 478 high-risk subjects aged (58.8± 9.7) years,726 had normal arteries.Of these,264 (36.36%) were males and 462 (63.64%)were females.Carotid atherosclerosis was identified in 752 cases aged (61.4± 9.5) years,with a detection rate of 50.88%.Of these,390 were males (51.86%) and 362 were females (48.14%).Univariate analysis showed that age,male sex,history of heart disease,diabetes,or hypertension,smoking,alcohol intake,waist circumference,and elevated homocysteine and low-density lipoprotein cholesterol levels were positively correlated with carotid atherosclerosis in those at high risk of stroke,while physical exercise showed a negative correlation;these results were statistically significant (P<0.05).Multiple logistic regression analysis [OR (95%CI)] showed that age [1.621 (1.410-1.865)],male sex [0.474 (0.378-0.594)],history of heart disease [1.336 (1.085-1.645)],diabetes [1.312 (1.021-1.685)],or hypertension [1.408 (1.074-1.846)],and increased low-density lipoprotein cholesterol [1.444 (1.191-1.751)] were positively correlated with carotid atherosclerosis in those at high risk of stroke,while physical exercise [0.810 (0.690-0.950)] showed a negative correlation;these results were statistically significant (P<0.05).Conclusion Targeting elderly men at high risk of stroke for intervention and guidance to manage hypertension,diabetes,and other chronic diseases,as well as comprehensive preventive and control measures,including reasonable physical exercise,can effectively reduce the occurrence of carotid atherosclerosis in communities.

13.
Article in Chinese | WPRIM | ID: wpr-753885

ABSTRACT

Objective To analyze the relationship between the abdominal fat and the progress of carotid atherosclerosis in the subject ageing 51-100 years.Methods 140 subjects receiving health examination in the department of health of Peking Union Medical College Hospital from 2015 to 2016 were included in the research.The abdominal fat area and distribution were calculated according to abdominal CT,and the progress of atherosclerosis in carotid artery was determined by ultrasound.Results In the population of 51-100 years old,there were no statistically significant difference in abdominal fat area and distribution among carotid artery plaque thickening group,arteriosclerosis nori-progressing group and plaque reducing group;In the population of 51-80 years old,the total abdominal fat was significantly higher in carotid artery plaque thickening group than in arteriosclerosis non-progressing group and plaque reducing group (P=0.05,P =0.03),abdominal visceral fat area also increased,but no significant difference was found (P>0.05),and no significant differences in abdominal fat distribution was found (P>0.05.Conclusion The less total area of abdominal fat is,the slower the progress of atherosclerosis in carotid artery is in the population of 51-80 years old.

14.
Clinical Medicine of China ; (12): 218-221, 2019.
Article in Chinese | WPRIM | ID: wpr-744987

ABSTRACT

Objective To explore relationship between the nature of carotid atherosclerotic plaque and the number and function of endothelial progenitor cells in peripheral blood.Methods A prospective study of 80 carotid atherosclerotic plaque patients were selected from June 2016 to March 2017 in Guangdong Second Provincial General Hospital.All patients were examined with Cranial magnetic resonance imaging or X-ray computed tomography,pathological examination,carotid artery color Doppler ultrasonography.Patients were divided into hard plaque group (n =42) and soft plaque group (n =38) according to the nature of carotid atherosclerotic plaque.Forty healthy subjects were selected as controls.Monocytes were obtained from 10 ml of elbow venous blood by density gradient centrifugation.Adherent cells were cultured and identified by confocal laser microscopy.The number,migration,proliferation and adhesion of EPCs in soft plaque group and hard plaque group were evaluated.Results The number of proliferating cells (0.847 ± 0.037),migrating cells(27.697±8.248) and adherent cells (46.184± 7.876) in the normal control group were significantly higher than those in the hard plaque group ((0.647±0.019),(18.643±3.289),(32.165±4.325)) and the soft plaque group ((0.679± 0.023),(23.576± 6.327),(40.587±6.523)) (all P< 0.001),while the proliferation,migration and adherent cells in the hard plaque group were lower than those in the soft plaque group (all P<0.001).Conclusion The nature of carotid atherosclerosis plaque is closely related to the number and function of endothelial progenitor cells in peripheral blood.The number of endothelial progenitor cells in carotid atherosclerosis patients with hard plaque is small,and their proliferation,migration and adhesion ability are impaired.

15.
Article in English | WPRIM | ID: wpr-781426

ABSTRACT

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 (MetS) are linked to CVD, but the association between MetS 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. MetS 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 MetS with carotid plaque and CIMT.@*RESULTS@#MetS was found among 3,461 (3,461/8,933) participants. The odds ratio and 95% confidence internal (CI) for carotid plaques in participants with MetS was 1.16 (1.03-1.30). The risk of carotid plaques increased with the number of MetS components. The average CIMT was higher in participants with MetS (β = 0.020, 95% CI, 0.014-0.027) and in participants with more MetS components.@*CONCLUSION@#Individuals with MetS are at an increased risk for carotid atherosclerosis compared to those without MetS.

16.
Journal of Medical Postgraduates ; (12): 954-957, 2019.
Article in Chinese | WPRIM | ID: wpr-818354

ABSTRACT

Objective At present, there are few reports on the stability of carotid plaque and left ventricular function at home and abroad. The article investigated the factors influencing the stability of left ventricular function on carotid atherosclerotic plaque. Methods 90 patients with carotid atherosclerosis (carotid intima-media thickness >0.2 cm) admitted in the Department of Neurology, Jiangsu Provincial Hospital of Traditional Chinese Medicine from June 10, 2017 to January 8, 2019 were selected and their stability of plaques was graded by contrast-enhanced ultrasound (CEUS). The patients were divided into two groups according to the stability of plaque. The differences of general clinical data, related biochemical indexes and left ventricular function indexes between the two groups were compared. The effects of left ventricular structural function on plaque stability were examined by logistic multivariate regression analysis. Results Univariate analysis showed that E peak (χ2=2.170, P=0.034), ventricular septal thickness (χ2=-1.972, P=0.049), diabetes history (χ2=10.102, P=0.001) were the risk factors of plaque stability and the differences were statistically significant (P < 0.05). Multivariate analysis showed that E peak (OR=0.022, P=0.014) and diabetes history (OR=0.185, P=0.002) were independent influencing factors of plaque stability. Conclusion There is an independent correlation between left ventricular function and plaque stability, and plaque stability can predict changes in ventricular structural function.

17.
Rev. cuba. angiol. cir. vasc ; 19(2): 119-132, jul.-dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-960335

ABSTRACT

Objetivo: Identificar la asociación entre los factores de riesgo aterogénico y la presencia de la lesión aterosclerótica carotidea. Métodos: Se realizó un estudio descriptivo, de corte transversal en 112 pacientes de ambos sexos, mayores de 40 años. Las variables fueron: edad, sexo, tensión arterial, hábito de fumar, diabetes mellitus, obesidad y soplo carotideo. Se realizó un eco-doppler carotideo para identificar la presencia de la lesión. Se aplicó una encuesta a los pacientes y las respuestas se recogieron en un una base de datos para su procesamiento estadístico. Resultados: Hubo predominio del sexo femenino. La edad media de presentación de la lesión fue 72,4 años. El 83 por ciento del total de pacientes presentaba tres y más factores de riesgo; en los portadores de lesión carotidea fueron: hipertensión arterial (65,5 por ciento), tabaquismo (71,1 por ciento), diabetes mellitus (64,3 por ciento) y con más de tres el 52,7 por ciento. El 51,8 por ciento de los pacientes presentaban lesión carotidea y de ellos el 24,1 por ciento con una estenosis carotidea inferior a 50 por ciento y superior a esta cifra el 4,5 por ciento, con mayor frecuencia en mujeres que en hombres (6,7 por ciento vs. 1,9 por ciento). El 18,8 por ciento mostraba un grosor intima medio carotideo mayor o igual a 1 mm, superior en los hombres que en las mujeres (21,2 por ciento vs. 16,7 por ciento). Conclusiones: La asociación de varios factores de riesgo con la presencia de una lesión carotidea demuestra la importancia de detectar el riesgo de desarrollar una enfermedad cerebrovascular en la población(AU)


Objective: To identify the association between the atherogenic risk factors and the presence of the carotid atherosclerotic lesion. Methods: A descriptive, cross-sectional study was conducted in 112 patients of both sexes and older than 40 years old. The variables were: age, sex, blood pressure, smoking habit, diabetes mellitus, obesity and carotid murmur. A carotid echo-doppler was performed to identify the presence of the lesion. A survey was done to the patients and the responses were collected in a database for statistical processing. Results: There was prevalence of female sex. The average age of appearance of the lesion was 72.4 years old. 83 percent of the total number of patients presented three and more risk factors. In the carriers of carotid lesion were: arterial hypertension (65.5 percent), smoking habit (71.1 percent), diabetes mellitus (64.3 percent) and with more than three risk factors: 52.7 percent. 51.8 percent of the patients had carotid injury and 24.1 percent of them had a inferior carotid stenosis to 50 percent, and 4.5 percent was higher than this figure, more often in females than in males (6.7 percent vs. 1.9 percent). 18.8 percent showed an carotid intima - media thickness bigger than or equal to 1 mm, higher in males than in women (21.2 percent vs. 16.7 percent). Conclusions: The association of several risk factors with the presence of carotid lesion demonstrates the importance of detecting the risk of developing a cerebrovascular disease in the population(AU)


Subject(s)
Humans , Male , Female , Echocardiography, Doppler/methods , Carotid Artery Diseases/etiology , Risk Factors , Epidemiology, Descriptive , Cross-Sectional Studies
18.
Biosci. j. (Online) ; 34(2): 534-539, mar./apr. 2018. ilus, graf
Article in English | LILACS | ID: biblio-966765

ABSTRACT

This study was to analyze the in vivo distribution of wall shear stress (WSS), velocity and inplane pressure difference in normal carotid artery by using computational fluid dynamics (CFD) based on contrastenhanced MRA (CE-MRA) data and to determine whether there were differences in these hemodynamic parameters between atherosclerosis-free and atherosclerosis-prone areas. CE-MRA was performed on 16 normal carotid arteries to obtain carotid three-dimensional surface data. CFD analysis was then performed to estimate those parameters in atherosclerosis-free (distal common carotid artery and distal internal carotid artery) and atherosclerosis-prone (carotid bifurcation) areas. One-way analysis of variance (ANOVA) was conducted to analyze differences among these three areas. CFD analysis revealed that WSS and velocity were significantly lower in carotid bifurcation compared to distal common carotid artery (CCA) (P =0.011, P <0.001, respectively) and distal internal carotid artery (ICA) (P <0.001, P <0.001, respectively). While in-plane pressure difference was significantly higher in carotid bifurcation compared to distal CCA (P <0.001) and distal ICA (P =0.005). Hemodynamic environment in carotid bifurcation of normal carotid artery which assessed by using CFD analysis appeared to be with lower WSS and lower velocity, while with higher in-plane pressure difference. These characterizations might facilitate the initiation of atherosclerosis.


Este estudo teve como objetivo analisar a distribuição in vivo da tensão de cisalhamento da parede (WSS), velocidade e plano diferença de pressão na artéria carótida normal usando dinâmica de fluidos computacional (CFD) baseada em contraste Dados do MRA (CE-MRA) e para determinar se houve diferenças nesses parâmetros hemodinâmicos entre áreas livres de aterosclerose e propensas à aterosclerose. O CE-MRA foi realizado em 16 artérias carótidas normais para obter dados de superfície tridimensional da carótida. A análise CFD foi então realizada para estimar esses parâmetros em livre de aterosclerose (artéria carótida comum distal e artéria carótida interna distal) e propensa a aterosclerose (carótida bifurcação). Análise de variância unidirecional (ANOVA) foi realizada para analisar as diferenças entre essas três áreas. A análise de CFD revelou que o WSS e a velocidade foram significativamente menores na bifurcação carotídea em comparação com a comum distal artéria carótida (ACC) (P = 0,011, P <0,001, respectivamente) e artéria carótida interna distal (ACI) (P <0,001, P <0,001, respectivamente). Enquanto a diferença de pressão no plano foi significativamente maior na bifurcação carotídea em comparação com a CCA distal (P <0,001) e ICA distal (P = 0,005). Ambiente hemodinâmico na bifurcação carotídea da artéria carótida normal que avaliada por meio de análise de CFD parece estar com menor WSS e menor velocidade, enquanto com maior pressão no plano diferença. Essas caracterizações podem facilitar o início da aterosclerose.


Subject(s)
Carotid Artery Diseases , Hemodynamics , Angiography , Carotid Arteries , Computational Biology , Stroke
19.
Chinese Journal of Diabetes ; (12): 304-308, 2018.
Article in Chinese | WPRIM | ID: wpr-703403

ABSTRACT

Objective To investigate the influence factors of serum Angptl 2 levels is to explore the relationship between serum Angptl 2 and carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods 114 cases of T2DM in clinic were selected.According to the results of color doppler ultrasonography,the patients were divided into T2DM with CAS group(T2DM + CAS,n=58)and simple T2DM group(n= 56).56 healthy subjects were selected as normal control (NC)group during the same period.ELISA method was used to detect the level of serum Angptl 2. Results Serum Angptl 2 levels were significantly higher in T2DM + CAS group and T2DM group than in NC group [(69.83 ± 12.07) vs (42.93 ± 10.44)vs (24.26 ± 8.78)ng/ml,P< 0.01].Correlation analysis showed that serum Angptl 2 was positively correlated with age,BMI,SBP,DBP,TC,TG,LDL-C,FPG and HbA1c in T2DM patients (r=0.574,0.325,0.528,0.308,0.396,0.387,0.295,0.536 and 0.601,respectively,P<0.01),and negatively correlated with HDL-C and FIns in T2DM patients (r= -0.248,-0.352,P<0.01).Similarly,multiple regression analysis showed that FIns,and HbA1c were the independent factors of serum Angptl 2 (β= -2.186,2.680,P<0.01). Conclusion Serum Angptl 2 level is closely related to obesity,blood pressure,blood glucose,blood lipid and insulin.Serum Angptl 2 may play an important role in the development of T2DM and carotid atherosclerosis.

20.
Article in Chinese | WPRIM | ID: wpr-699501

ABSTRACT

Objective To investigate the effect of folic acid and hypotensive drug on plasma homocysteine (Hcy),carotid atherosclerotic plaque and cerebral ischemic stroke in patients with type H hypertension.Methods A total of 300 patients with type H hypertension were randomly divided into control group and observation group,150 cases in each group.Eighty cases in the control group and twenty-six cases in the observation group were excluded during the follow-up period because of disobeying the doctor's advice or losing visits,132 cases in the control group and 124 cases in the observation group were rolled in this study at last.The patients in the control group were treated with conventional hypotensive drug.The patients in the observation group were treated with folic acid 2 mg orally,once a day for one year.The changes of blood pressure,plasma Hcy level,the carotid atherosclerosis and endpoint event were compared between the two groups.Results The systolic blood pressure(SBP) after 3 months of treatment was significantly lower than that after 6,9,and 12 months of treatment in the control group(P < 0.05).The SBP after 12 months of treatment was significantly lower than that after 6 months of treatment in the control group(P <0.05).There was no statistic difference in the diastolic blood pressure(DBP) of patients at the time point of 3,6,9 months after treatment in the control group(P <0.05);the DBP of patients at the 12 months after treatment was significantly lower than that at the 3 months after treatment in the control group(P <0.05);there was no statistic difference in the DBP of patients at the 12 months after treatment and 6,9 months after treatment in the control group(P < 0.05).The SBP after 6,9 and 12 months of treatment was significantly lower than that after 3 months of treatment in the observation group(P <0.05).The SBP after 9 and 12 months of treatment was significantly lower than that after 6 months of treatment in the observation group(P <0.05).The SBP after 12 months of treatment was significantly lower than that after 9 months of treatment in the observation group(P < 0.05).The DBP after 6,9 and 12 months of treatment was significantly lower than that after 3 months of treatment in the observation group(P <0.05);but there was no significant difference in DBP between 6,9 and 12 months of treatment(P <0.05).The SBP and DBP in the observation group were significantly lower than those in the control group after 3,6,9 and 12 months of treatment(P <0.05).There was no significant difference in plasma Hcy level between the time points of 3,6,9 and 12 months of treatment(P < 0.05).The plasma Hey level in the observation group decreased gradually after treatment,and there was significant difference between the different time points(P < 0.05),and the plasma Hcy level in the observation group was significantly lower than that in the control group (P < 0.05).There was no significant difference in carotid plaque detection rate and plaque stability between the two groups before treatment(x2 =0.303,0.422;P < 0.05).Compared with before treatment,the carotid plaque detection rate decreased significantly (x2 =14.582,32.904;P < 0.05),and the plaque stability increased significantly after 12 months of treatment in the two groups(x2 =35.352,12.878;P < 0.05).Compared with the control group,the carotid plaque detection rate in the observation group decreased significantly(x2 =7.375,P <0.05),and the plaque stability increased significantly after 12 months of treatment(x2 =12.427,P <0.05).There was no significant difference in the intima-media thicknes(IMT),resistance index(RI) and plaque area between the two groups before treatment(P <0.05).The IMT,RI and plaque area after 12 months of treatment were significantly lower than those before treatment in the two groups(P < 0.05);and the IMT,RI and plaque area in the observation group were significantly lower than those in the control group after 12 months of treatment (P < 0.05).In the control group and the observation group,there were 17 cases(12.88) and 4 cases(3.23%) of stroke,7 cases(5.30%) and 4 cases(3.23%) of cardiovascular events,15 cases (11.36%) and 2 cases(1.61%) of death,respectively;the incidences of stroke and death in the observation group were significantly lower than those in the control group(x2 =7.912,9.805;P <0.05).There was no significant difference in the incidence of cardiovascular events between the two gmups(x2 =0.671,P < 0.05).Conclusion Folic acid supplementation combined with antihypertensive treatment can significantly reduce the blood pressure and plasma Hey level,improve carotid atherosclerosis,and reduce the risks of stroke and death in patients with type H hypertension.

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