Small dense low-density lipoprotein and carotid atherosclerosis in relation to vascular dementia.

Vascular dementia (VaD) and Alzheimer's disease (AD) are the most common causes of dementia in the elderly. The aim of this study was to investigate carotid atherosclerosis, serum lipid profiles, and atherogenic hormone levels in nondiabetic Japanese men with VaD or AD. Carotid artery intima-media thickness (IMT) and plaque, serum lipid and lipoprotein profiles, including low-density lipoprotein (LDL) particle size, as well as insulin-like growth factor-I (IGF-I, somatomedin C) and testosterone levels, were determined in 34 patients with AD, 37 patients with VaD, and 63 healthy male controls. Age, body mass index, systolic and diastolic blood pressure, and fasting plasma glucose, hemoglobin A(1c) (HbA(1c)), triglyceride, high-density lipoprotein (HDL)-cholesterol, and apolipoproteins (apo) A-I, B, and E levels did not differ significantly among the 3 groups. However, the mean value of carotid IMT, the frequency of atherosclerotic plaque deposition, the serum levels of LDL-cholesterol, lipoprotein(a), and lipid peroxides, and the incidence of small dense LDL (particle diameter

Increased levels of insulin-like growth factor binding protein-3 in hypertensive patients with carotid atherosclerosis.

BACKGROUND: It has been proven that the intima-media thickness (IMT) of the carotid artery increases in patients with essential hypertension. Serum levels of insulin-like growth factor-1 (IGF-1) increase in hypertensive patients with ventricular hypertrophy. However, the relationship between carotid atherosclerosis and serum levels of IGF-1 and its binding protein-3 (IGFBP-3) in patients with essential hypertension has not been established. METHODS: The carotid IMT, blood pressure (BP), serum lipid profiles, and serum IGF-1 and IGFBP-3 contents were determined in 54 hypertensive patients (19 with and 35 without carotid plaque) and 52 normotensive controls without plaque. RESULTS: Systolic, diastolic, and mean BPs and serum IGFBP-3 level were significantly higher in the hypertensive patients (with and without plaque) than in the normotensive controls. The IGFBP-3 level correlated with systolic BP (r = 0.204, P =.0354). Age, gender, body mass index, and serum levels of HDL cholesterol, triglycerides, lipoprotein(a), lipid peroxides, insulin, and fasting plasma glucose did not differ significantly among the three groups. Hypertensive patients with plaque, compared with those without plaque or the normotensive controls, had the highest values of carotid IMT, LDL cholesterol, IGF-1, and IGFBP-3. Multiple logistic regression analysis revealed that the IGFBP-3 level was associated with a ninefold (95% confidence interval 2.6-31) higher risk of carotid plaque formation compared with LDL cholesterol or IGF-1 levels. CONCLUSIONS: These results suggest that an increased level of IGFBP-3 may play a crucial role in the development of carotid atherosclerosis in hypertensive patients.