Expression and diagnostic value of lncRNA MALAT1 and NLRP3 in lower limb atherosclerosis in diabetes.

OBJECTIVE: This study aimed to examine the diagnostic predictive value of long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1(MALAT1) and NOD-like receptor protein 3(NLRP3) expression in patients with type 2 diabetes mellitus(T2DM) and lower extremity atherosclerosis disease (LEAD). METHODS: A total of 162 T2DM patients were divided into T2DM with LEAD group (T2DM + LEAD group) and T2DM alone group (T2DM group). The lncRNA MALAT1 and NLRP3 expression levels were measured in peripheral blood, and their correlation was examined. Least absolute shrinkage and selection operator (LASSO) regression model was used to screen for the best predictors of LEAD, and multivariate logistic regression was used to establish a predictive model and construct the nomogram. The effectiveness of the nomogram was assessed using the receiver operating characteristic (ROC) curve, area under the curve (AUC), calibration curve, and decision curve analysis (DCA). RESULTS: The levels of the lncRNA MALAT1 and NLRP3 in the T2DM + LEAD group were significantly greater than those in the T2DM group (P <0.001), and the level of the lncRNA MALAT1 was positively correlated with that of NLRP3 (r = 0.453, P<0.001). The results of the LASSO combined with the logistic regression analysis showed that age, smoking, systolic blood pressure (SBP), NLRP3, and MALAT1 were the influencing factors of T2DM with LEAD(P<0.05). ROC curve analysis comparison: The discriminatory ability of the model (AUC = 0.898), MALAT1 (AUC = 0.804), and NLRP3 (AUC = 0.794) was greater than that of the other indicators, and the predictive value of the model was the greatest. Calibration curve: The nomogram model was consistent in predicting the occurrence of LEAD in patients with T2DM (Cindex = 0.898). Decision curve: The net benefit rates obtained from using the predictive models for clinical intervention decision-making were greater than those obtained from using the individual factors within the model. CONCLUSION: MALAT1 and NLRP3 expression increased significantly in T2DM patients with LEAD, while revealing the correlation between MALAT1 and NLRP3. The lncRNA MALAT1 was found as a potential biomarker for T2DM with LEAD.

Independent association of blood cadmium with subclinical lower extremity atherosclerosis: An observational study based on dose-response analysis.

BACKGROUND: Atherosclerosis is an increasingly public health issue globally. Previous studies have showed a causal link between heavy metal exposure and atherosclerosis. However, the association of cadmium concentration with subclinical lower extremity atherosclerosis (SLEA) remains unclear. AIMS: To investigate the association of blood cadmium with SLEA and its extent, and further analyze the potential dose-response relationship. METHODS: Blood cadmium concentration was measured using inductively coupled plasma mass spectrometry. SLEA and its extent were assessed by ultrasound diagnosis system. Multivariate models were applied to evaluate the association of blood cadmium with SLEA and its extent. Restricted cubic splines were performed to explore the potential dose-response relationship. RESULTS: This observational study consisted of 1664 participants from cardiovascular outpatient, with an average age of 62.4 years and 1218 (73.2%) men. When blood cadmium was included as a categorical variable in multivariate models, logistic regression analysis showed that high quartile in blood cadmium was an independent risk factor of SLEA (OR = 2.704, 95%CI 1.866-3.919). After log-transformed for SLEA extent parameters, linear regression analysis indicated that high quartile in blood cadmium was significantly associated with higher Crouse score (GMR = 1.21, 95%CI 1.15-1.28), plaque maximum thickness (GMR = 1.13, 95%CI 1.09-1.18) and diseased vessel count (GMR = 1.14, 95%CI 1.10-1.19), respectively. When blood cadmium was used as a continuous variable in restricted cubic splines, the dose-response relationship presented a positive progression in SLEA (P = 0.302), plaque maximum thickness (P = 0.145) and diseased vessel count (P = 0.055) apparently that did not deviate from linearity. CONCLUSIONS: Blood cadmium exhibited an independent association with SLEA, and this dose-response relationship was progressive without significant departure from linearity.

[Quality of life in patients with lower extremity atherosclerosis during standard treatment and therapeutic angiogenesis]. / Kachestvo zhizni u patsientov s aterosklerozom nizhnikh konechnostei pri ispol'zovanii standartnogo lecheniia i terapevticheskogo angiogeneza.

AIM: To compare the impact of standard conservative treatment (SCT) and its combination with therapeutic angiogenesis for 3 to 5 years on quality of life in patients with Stage II (according to the classification developed by A.V. Pokrovsky-Fontaine) lower extremity atherosclerosis. SUBJECTS AND METHODS: 92 patients (69 men and 23 women) (mean age 65.2±7.7 years) were examined and divided into 2 groups of 46 people each. Only SCT (statins at an individually adjusted dose, antiaggregants, and graded exercise walking 3 to 5 km daily were used in Group 1; while Group 2 received SCT in combination with double injection of a plasmid-based VEGF165 gene drug (1.2 mg) into the ischemic limb muscles. The Russian version of the standard SF-36 questionnaire was applied; pain-free walking distances were measured before treatment and then every year; limb preservation and survival rates were determined in the patients. RESULTS: It was determined that standard treatment did not significantly affect patients' quality of life throughout the follow-up period. Addition of gene therapy leads to a significant improvement in both physical (p=0.00001) and psychological (p=0.00002) health components just in the first year of the follow-up. This is achieved through a significant (500%) increase in the average leg pain-free walking distance; p=0.007). CONCLUSION: The obtained result is consistently high throughout the subsequent period. There was no statistically significant difference in survival rates between the groups; limb preservation remained comparable.

Evaluation on effect of rosuvastatin in treatment of lower extremity atherosclerotic disease in elderly / 吉林大学学报(医学版)

Objective To observe the clinical effect of rosuvastatin in the treatment of lower extremity atherosclerotic disease in the elderly,and to provide clinical basis of the application of statins in lower extremity atherosclerotic disease in the elderly.Methods 90 patients diagnosed as lower extremity atherosclerotic disease (aged 60 years or over)were randomly divided into simvastatin group and rosuvastatin group (n=45),and they were treated with simvastatin and rosuvastatin,respectively,based on the regular treatment.The total cholesterol (TC),low density lipoprotein-cholesterol (LDL-C), and high sensitivity C-reactive protein (hs-CRP)of the patients in two groups were detected at the begining of treatment and the ending of 32 weeks;at the same time,the lower limb artery intima thickness, strength of hardened, plaque, and artery stenosis degree scores were compared.Results 32 weeks after treatment,the levels of TC,LDL-C and hs-CRP of the patients in two groups were decreased statistically compared with before treatment (P <0.05);the levels of TC,LDC-C,and hs-CRP in rosuvastatin group were lower than those in simvastatin group (P < 0.05 ). 32 weeks after treatment in two groups,compared with before treatment,the lining thickness and plaque,stenosis scores were decreased (P <0.05);the lining thickness,plaque and stenosis scores in rosuvastatin group were lower than those in simvastatin group (P <0.05);the gardening strength grades had no statistical difference between before and after treatment. Conclusion Statins is lipid-lowering and resistant to lower limb arteriosclerosis,and rosuvastatin is better than simvastatin.

Relationship Between Lower Extremity Atherosclerosis and Cardiovascular Risk Factors in Elder People / 中国循环杂志

Objective: To explore the relationship between lower extremity atherosclerosis disease (LEAD) and cardiovascular risk factors in elder people. Methods: A total of 700 consecutive patients receive lower extremity Color Doppler ultrasound in our hospital from 2013-05 to 2014-11 were investigated. The patients were divided into 3 age groups: Young and middle group, n=83, Elder group, n=377 and Senile group, n=240. Based on ultrasound scoring system, the patients were divided into 4 groups: Normal group, n=112, Mild atherosclerosis (Mild) group, n=81, Moderate group, n=466 and Severe group, n=41. The cardiovascular risk factors among different groups were compared. Results: Multivariate unconditional logistic regression analysis showed that age, smoking, history of diabetes, uric acid (UA), ankle-brachial index (ABI) were the independent risk factors for LEAD (B=0.144, 1.496, 0.963, 0.004, -2.510; 95% CI: 1.120-1.190, 2.257-8.824, 1.456-4.716, 1.001-1.007, 0.012-0.534;P=0.000, 0.000, 0.001, 0.006, 0.009 respectively. Ordinal logistic regression analysis indicated that age, male gender, smoking, ABI, UA, history of hypertension were related to the severity of atherosclerosis (B=0.130, 0.737, 0.592, -3.365, 0.003, 0.735; 95% CI: 0.097-0.162, 0.222-1.252, 0.052-1.132, -4.674 to -2.055, 0.001-0.005, 0.313-1.157;P=0.000, 0.005, 0.032, 0.000, 0.005, 0.001 respectively. Compared with Young and Middle groups, Elder and Senile groups had increased rates of moderate and severe arteriosclerotic lesions; compared with Elder group, Senile group presented the higher incidence of moderate and severe lesions, allP Conclusion: Lower extremity atherosclerosis lesions were more severe in elder patient, and it was particularly severe in senile patients.