Hyperhomocysteinaemia is an independent risk factor of abdominal aortic aneurysm in a Chinese Han population.

The associations between hyperhomocysteinaemia (HHcy), methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, and abdominal aortic aneurysm (AAA) remain controversial, with only few studies focused on these associations within the Chinese population. We performed subgroup and interaction analyses in a Chinese Han population to investigate these associations. In all, 155 AAA patients and 310 control subjects were evaluated for serum total homocysteine levels and MTHFR C677T polymorphisms. Multiple logistic regression models were used to evaluate the aforementioned associations. Interaction and stratified analyses were conducted according to age, sex, smoking status, drinking status, and chronic disease histories. The multiple logistic analyses showed a significant association between HHcy and AAA but no significant association between MTHFR C677T polymorphism and AAA. The interaction analysis showed that age and peripheral arterial disease played an interactive role in the association between HHcy and AAA, while drinking status played an interactive role in the association between MTHFR C677T polymorphism and AAA. In conclusion, HHcy is an independent risk factor of AAA in a Chinese Han population, especially in the elderly and peripheral arterial disease subgroups. Longitudinal studies and clinical trials aimed to reduce homocysteine levels are warranted to assess the causal nature of these relationships.

[Relationship between serum ß2-microglobulin and lower extremity atherosclerotic occlusive disease].

OBJECTIVE: To explore the relationship between fasting serum level of ß2-microglobulin (ß2-M) and the development of lower extremity atherosclerotic occlusive disease (LEAOD). METHODS: A total of 59 LEAOD patients at our hospital from March 2011 to August 2012 were recruited into the LEAOD group while another 32 non-LEAOD patients into the control group. Their clinical profiles and the parameters of ankle brachial index (ABI),ß2-M and high-sensitivity C-reactive protein (hsCRP) were recorded and analyzed. RESULTS: The patients had higher serum levels of ß2-M (5.3 ± 3.2 vs 2.6 ± 1.3) and hsCRP (15.1 ± 14.8 vs 8.0 ± 6.7) according to the severity in the LEAOD group than those in the control group (P < 0.05).ß2-M was correlated with smoking (ß 1.248, odds ratio[OR] 0.020, 95% confidence interval [CI] 1.221-9.942), diabetes (ß 1.524,OR 4.591, 95%CI 1.493-14.118) and ABI (ß-4.091,OR 0.017, 95%CI 0.002-0.136) . The receiver operating characteristic (ROC) curve showed that ß2-M level had some value of predicting the occurrence of LEAOD (ROCAUC 0.821, 95%CI 0.731-0.912, P < 0.01). CONCLUSION: Serum level of ß2-M may play a role in pathologic process of LEAOD. And further studies are needed to validate its value as a biomarker for LEAOD.

[Suppression of experimental abdominal aortic aneurysm by saturated hydrogen saline: a preliminary study with rats].

OBJECTIVE: To investigate the effects of saturated hydrogen saline on the prevention of abdominal aortic aneurysm (AAA) induced by calcium chloride in a rat model. METHODS: In healthy male Sprague-Dawley rats, AAA was induced by infiltration of abdominal arota with 0.5 mol/L calcium chloride. Saturated hydrogen saline (5 ml·kg(-1)·d(-1)) or saline was administred intraperitoneally once daily. Twenty-eight days later, the diameter of the aorta was measured, and the aortic tissue was exercised for histological examination. Pro-inflammatory cytokines (tumor necrosis factor α (TNF-α), IL-1ß) in AAA tissue were detected with ELISA. The protein expression and mRNA expression of matrix metalloproteinase 2 (MMP-2) and MMP-9 in AAA tissue were observed by immunohistochemistry staining and real-time PCR. RESULT: The aorta diameter of the experiment group and control group were (2.2 ± 0.3) mm and (3.4 ± 0.5) mm, the tissue IL-1ß levels were (81 ± 29) ng/L and (165 ± 51) ng/L, the tissue TNF-α levels were (109 ± 46) ng/L and (360 ± 51) ng/L, the relative mRNA expressions were 2.4 ± 1.0 and 11.8 ± 2.9, the relative mRNA expressions were 2.9 ± 0.6 and 6.7 ± 1.0 (t = 4.055 to 10.406, P < 0.05). Compared with the control group, the infiltration of inflammation, the injury of elastic fibers in the vessel wall, and the positive expression of MMP-2 and 9 protein of the experiment group were all reduced. CONCLUSIONS: Saturated hydrogen saline prevents the degradation of elastin in vessel wall and ameliorates the formation and development of AAA, which may be associated with its anti-inflammatory effects, thereby reduces the MMP-2 and 9 mRNA and protein expression.

[Effects of chemokine-like factor 1 on the proliferation and apoptosis of human vascular smooth muscle cell].

OBJECTIVE: To explore the effects of chemokine-like factor 1 (CKLF1) on the growth and apoptosis of human vascular smooth muscle cell and understand its mechanism for the induction of cell apoptosis. METHODS: After the transfection of human vascular smooth muscle cell with CKLF1, CCK8 assay was used to observe the growth of cell. The cell cycle and apoptosis was assessed by flow cytometry (FCM). And the mRNA and protein expressions of Bcl-2, Bax and Caspase-3 were detected by real-time polymerase chain reaction (PCR) and Western blot respectively. RESULTS: At 24, 48 and 72 h, the growth proliferation (15.8% ± 3.4%, 25.5% ± 9.8% and 37.2% ± 3.3%, P < 0.05) and inhibited apoptosis (5.5% ± 1.3%, 7.6% ± 0.7% and 11.4% ± 5.5%, P < 0.05) of vascular smooth muscle cell were detected. CKLF1 also down-regulated the level of mRNA expression of Bax (0.96 ± 0.14, 0.61 ± 0.15 and 0.37 ± 0.05), protein expression of Caspase-3 (1.94 ± 0.30, 1.09 ± 0.17 and 0.73 ± 0.09) and elevated the mRNA expression of Bcl-2 (1.59 ± 0.18, 2.05 ± 0.51 and 2.96 ± 0.27). CONCLUSION: CKLF1 can induce proliferation and inhibit apoptosis of human vascular smooth muscle cell through the down-regulation of Bax and Caspase-3 and the up-regulation of Bcl-2 expression.

[Approach and efficacy of endovascular repair for abdominal aortic aneurysm with hostile proximal landing zone].

OBJECTIVE: To explore the option and efficacy of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) with hostile aortic proximal landing anatomy. METHODS: The clinical data of 51 AAA patients with hostile aortic proximal landing anatomy treated by EVAR from January 2010 to June 2012 at our hospital was retrospectively analyzed. There were 44 males and 7 females with a mean age of 73 years (range: 42 - 94). The anatomic measurements included a diameter of aneurysm body 32 - 100 mm, a length of proximal neck 0 - 50 mm, a width of proximal neck 15 - 40 mm and infrarenal angulation 15 - 80 degrees. In addition, there were calcification (n = 10) and thrombus lining with aortic neck (n = 15) and irregular shape of aortic neck (n = 5) respectively. The stent-grafts were deployed by 4 femoral arteries. RESULTS: Many types of aortic stent were used, such as Endurant (n = 9), Talent (n = 5), Zenith (n = 31), Hercules (n = 5), Palmaz/CUFF (n = 6) and multilayer bare-stent (n = 2). And 11 patients underwent fenestrated EVAR and 31 with chimney EVAR involving renal artery (39 branches), superior mesenteric artery (3 branches) and celiac trunk (3 branches). The primary technical success rate was 100%. The perioperative endoleak rate was 17.6%. During the mean follow-up period of 13 months (2 - 28), the primary patency of stent was 96.1% and the thrombus rate of aneurysm 82.4%. Two cases of new endoleak and 3 cases of residual endoleak underwent secondary intervention. In addition, long-term follow-up was required for 3 patients with stent-graft migration (< 10 mm). There was no case of death, infection, occlusions, ischemia of lower limbs, aneurysm expansion or rupture. CONCLUSION: A variety of EVAR options are both safe and efficacious in the treatment of AAA with hostile proximal landing zone.