2023, 31(8):697-704.
Abstract:Aim To investigate the serum plasminogen activator inhibitor-1 (PAI-1) level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and its correlation with carotid intima-media thickness(CIMT) and plaque stability. Methods 167 patients who underwent polysomnography (PSG) in Baoji Municipal Central Hospital from July 2019 to January 2021 were enrolled and divided into control group (n=46), mild OSAHS group (n=15), moderate OSAHS group (n=39), and severe OSAHS group (n=67) according to sleep apnea-hypopnea index (AHI). Clinical data, PSG-related indexes, blood biochemical indicators, serum PAI-1 level, and CIMT were compared in the three groups. The relationship between CIMT and serum PAI-1 concentration in OSAHS patients was analyzed. According to CIMT, carotid plaque morphology, and ultrasonographic features, OSAHS patients were divided into simple OSAHS group (n=37), OSAHS stable plaque group (n=46), and OSAHS unstable plaque group (n=38). PAI-1 level in each group was compared. Multivariate Logistic regression analysis was used to explore the risk factors of carotid plaque stability in OSAHS patients. Results There were statistically significant differences between the four groups regarding sex, body mass index (BMI), hypertension, smoking history, AHI, oxygen depletion index (ODI), oxygen saturation less than 90% of the time in sleeping time (Ts90%), the lowest nocturnal oxygen saturation (L-SaO2), CIMT and serum PAI-1 level (P<0.05). Pearson correlation analysis showed that CIMT was positively correlated with PAI-1 level in OSAHS patients (r=0.675,P<0.001). The level of PAI-1 in the simple OSAHS group was 1.20 times, in the OSAHS stable plaque group was 1.79 times, and in the OSAHS unstable plaque group was 2.01 times that of the control group, and the difference had statistical significance (all P<0.05). Multiple linear regression suggested that CIMT was independently associated with AHI (B=0.019, P=0.001), PAI-1 (B=0.012, P<0.001), and low density lipoprotein cholesterol (LDLC)(B=0.081, P=0.028) after calibrating confounders. Multivariate Logistic regression analysis showed that after calibrating confounders, hypertension (OR=4.1,5%CI:2.034~18.117), diabetes (OR=1.0,5%CI:1.158~3.645), PAI-1 level (OR=1.1,5%CI:1.039~1.145), moderate OSAHS (OR=1.7,5%CI:1.162~3.730), severe OSAHS (OR=5.4,5%CI:1.085~31.370) were independent risk factors for unstable carotid plaque in patients with OSAHS (P<0.05). Conclusion The level of PAI-1 might increase gradually accompanied by the severity of OSAHS and the level of PAI-1 might be positively correlated with CIMT. PAI-1 might be an independent risk factor for unstable arterial plaque in OSAHS.
2023, 31(9):785-790.
Abstract:Aim To explore the correlation between ultrasound evaluation of epicardial adipose thickness (EAT) and right common carotid artery elasticity and carotid intima-media thickness (CIMT) in middle-aged and elderly coronary heart disease (CHD) patients. Methods The middle-aged and elderly patients (100 cases) who visited Nanyang Central Hospital from February 2018 to June 2021 and were diagnosed with CHD by coronary angiography(CAG) were selected as the research subjects. According to the number of diseased branches, they were divided into single (31 cases), double (36 cases) and triple (33 cases) vessel lesions groups. In addition, physical examination population without coronary heart disease (50 cases) at Nanyang Central Hospital during the same period were selected as the control group. The general information and ultrasonic testing parameters of the four groups of subjects were compared and analyzed. Pearson was used to analyze the correlation between EAT and the elasticity of the right common carotid artery, CIMT. The receiver operating characteristic (ROC) curve was used to analyze the value of EAT, right common carotid artery elasticity and CIMT in predicting CHD. Results Compared with the control group, vascular stiffness (β), elastic modulus (Ep), pulse wave velocity (PWV-β), CIMT, and EAT were increased in the single vessel lesion group, double vessel lesions group, and triple vessel lesions group (all P<0.05), aortic compliance (AC) were decreased (all P<0.05). Pearson analysis showed that EAT was positively correlated with β, Ep, PWV-β and CIMT (P<0.05), and negatively correlated with AC (P<0.05). The results of ROC curve analysis showed that the sensitivity, specificity and Youden index of the three combined detection (EAT, CIMT and right common carotid artery elasticity) were 89%, 82% and 71%in predicting the occurrence of CHD, respectively. Conclusion EAT in middle-aged and elderly patients with CHD has a good correlation with the elastic changes of the right common carotid artery, CIMT. The combined detection of EAT, right common carotid artery elasticity changes, and CIMT can provide a good basis for clinical prediction of CHD.
2020, 28(8):662-667.
Abstract:Aim The purpose of this study was to investigate the relationship between carotid intima-media thickness (C-IMT) and glutamate decarboxylase antibody (GADA) titer in latent autoimmune diabetes in adults (LADA).Methods The data of 160 patients were selected from a randomized controlled clinical trial “Multi-center study of optimized LADA treatment based on protecting islet β-cell function” (NCT02407899) led by the National Clinical Research Center for Metabolic Diseases of the Second Xiangya Hospital of Central South University from September 2015 to April 2019. GADA titer was used as the cut-off value to divide LADA patients into LADA-1 (GADA≥0.3) with high titer and LADA-2 (0.05≤GADA<0.3) with low titer. C-IMT data and other clinical data were also collected for the cross-sectional study. Results Patients with type LADA-2 had significantly higher age, hypertension ratio, metabolic syndrome ratio, weight, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, fasting C-peptide, HOMA-IR and triglyceride levels(P<0.05), but lower insulin usage ratio than patients with LADA-1(P<0.01). Compared with patients with LADA-1, patients with LADA-2 had significantly higher percentage of thickened C-IMT (P<0.01)and thicker C-IMT (P<0.001). The difference is still significant after adjusting for related factors of metabolic syndrome. Multiple linear regression analysis showed that C-IMT was positively correlated with drinking history (P<0.01) and negatively correlated with GADA titer (P<0.01). The LADA patients were divided into low HOMA-IR (HOMA-IR≤2.0) and high HOMA-IR(HOMA-IR>2.0) groups. LADA-1 patients with high HOMA-IR had significantly increased C-IMT than those with low HOMA-IR. (P<0.01), but there was no difference between LADA-2 patients with low and high HOMA-IR. Conclusion LADA patients with low GADA titer have a higher risk of atherosclerosis than LADA patients with higher GADA titer, and the risk is associated with insulin resistance. GADA titer is an independent factor of C-IMT in LADA patients.
2020, 28(10):890-894.
Abstract:Aim To investigate the changes of carotid intima media thickness (CIMT) in patients with sleep apnea hypopnea syndrome (OSAHS), and to explore the correlation between CIMT and 25(OH)D levels in OSAHS patients.Methods The portable sleep monitor (PM) was used to monitor the sleep condition of the people reference for the health examination. According to sleep apnea hypopnea index (AHI), they were divided into control group, mild OSAHS group, moderate OSAHS group and severe OSAHS group. CIMT and the levels of 25(OH)D in the four groups were compared to analyze the correlation between CIMT and 25(OH)D. Results CIMT in severe OSAHS group was higher than that in control group and mild OSAHS group ((0.88±0.15) mm vs (0.75±0.14) mm and (0.76±0.14) mm, all P<0.05), the difference was statistically significant. The level of 25(OH)D in the moderate and severe OSAHS group was lower than that in the control group ((19.06±6.04) μg/L and (17.67±4.73) μg/L vs (22.78±7.40) μg/L, all P<0.05), the difference was statistically significant. After adjusting the influences of various hybrid factors, multiple linear regression analysis demonstrated that CIMT in OSAHS patients was positively correlated with AHI (P=0.006) and negatively correlated with 25(OH)D (P=0.024). Conclusion CIMT in OSAHS patients increases with the increase of severity. 25(OH)D deficiency may be a risk factor for carotid intimal thickening in OSAHS patients.
2019, 27(5):417-420.
Abstract:Aim To investigate the correlation between serum cystathionine-β-synthase(CBS), hydrogen sulfide (H2S) levels and carotid intima-media thickness (CIMT) in patients with hypertension. Methods Between October 2017 and March 2018, a total of 116 patients with essential hypertension were enrolled from in-patient department of our hospital. The blood pressure, homocysteine (Hcy), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC) and low density lipoprotein cholesterol (LDLC) were measured in all selected hypertensive patients.At the same time, the levels of CIMT, CBS and H2S were detected. According to the levels of Hcy, the patients with hypertension were divided into two groups:H hypertension group (Hcy≥10 μmol/L) and non H hypertension group (Hcy<10 μmol/L), and the differences of Hcy, blood lipids, CBS, H2S and CIMT were compared. The correlation between the indexes and CIMT was analyzed by Pearson test. Results The CIMT of H hypertension group was higher than that of non H hypertension group (P<0.05), and the levels of H2S and CBS in H hypertension group were lower than that in non H hypertension group (P<0.05). Correlation analysis showed that Hcy was positively correlated with CIMT in hypertensive patients (r=0.752, P<0.05). CBS and H2S were negatively correlated with Hcy (r =-0.413, -0.698, P<0.05) and with CIMT (r=-0.518, -0.779, P<0.05). Conclusions Compared with non H hypertensive patients, the degree of carotid atherosclerosis is more pronounced in patients with H hypertension. In patients with hypertension, the levels of CBS and H2S are closely related with carotid atherosclerosis, which is expected to be an early predictor of atherosclerosis in hypertensive patients.
2019, 27(7):635-638, 644.
Abstract:Obstructive sleep apnea hypopnea syndrome(OSAHS) is characterized by recurrent hypoxemia and hypercapnia at night. Recent fingdings show that OSAHS is closely associated with atherosclerosis cardiovascular disease(ASCVD)such as stroke,heart failure. And carotid intima-media thickness(CIMT)can predict ASCVD. So it is significant for preventing atherosclerosis(As) in OSAHS patients to study the relationship between IMT and OSAHS. This review summarized the recent research progress on the relationship between obstructive sleep apnea hypopnea syndrome and carotid intima-media thickness, including human epidemiological and related mechanism studies and related treatments. It can provide a background reference for interrupting the progress of As in OSAHS patients.
2017, 25(9):919-922.
Abstract:Aim To investigate the relationship between serum levels of fibroblast growth factor 23 (FGF-23), Klotho protein and carotid atherosclerosis in non-dialysis patients with chronic kidney disease (CKD) 2-5 stage. Methods 126 CKD 2-5 stage patients were involved in the study. Carotid intima-media thickness (CIMT) was measured by color Doppler ultrasonography. The patients were divided into CIMT thickening group and CIMT normal group according to CIMT. Serum levels of FGF-23 and Klotho protein were determined by enzyme-linked immunosorbent assay, and the general data and clinical biochemical indexes were collected. The relative indexes of the two groups were compared, and the correlation between FGF-23, Klotho protein and carotid atherosclerosis was analyzed. Unconditional Logistic regression analysis was used for multivariate analysis of CIMT influencing factors. Results The serum FGF-23 level in CIMT thickening group was significantly higher than that in CIMT normal group (435.39±221.20 vs 360.22±194.26, P<0.05), and the level of Klotho protein was significantly lower than that in CIMT normal group (446.54±132.49 vs 499.36±121.38, P<0.05). Multivariate stepwise regression analysis showed that Klotho protein was an independent protective factor for CIMT thickening in patients with CKD (OR=1.086, P<0.05), while age increase and FGF-23 were independent risk factors for CIMT thickening in patients with CKD (OR=1.075, P<0.05; OR=1.238, P<0.05). Conclusion CIMT thickening is related to FGF-23 and Klotho proteins in non-dialysis patients with CKD 2-5 stage. FGF-23 and Klotho protein play an important role in the occurrence and development of carotid atherosclerosis.
2016, 24(1):85-91.
Abstract:Aim To investigate the impact of cardiovascular health behaviors and health factors on the carotid intima-media thickness in middle-aged population. Methods A cross-sectional study method was used in this study. Subjects with myocardial infarction, ischemic stroke(not including lacunar infarction), data incomplete were excluded from the study. The total of 5353 employees (the retired employers from Tangshan Kailuan company) aged 40 years and over were included through stratified random sampling. Information was obtained from the unified questionnaire, measurements of blood biochemistry and carotid ultrasonography. Multivariate linear regression analysis was applied to test the relationship between cardiovascular health score and carotid intima-media thickness. Multivariate logistic regression analysis was applied to analyze the influence of cardiovascular health behavior and factors on carotid atherosclerosis. Results A total of 5353 subjects were included in our study. Their average age was 55.1±11.8 years old (from 40 to 94 years old).Of which, 3209 subjects were male, accounting for 59.5% of the study population. ① The carotid intima-media thickness was 0.89±0.19 mm, 0.88±0.19 mm, 0.85±0.19 mm, 0.82±0.18 mm, 0.80±0.18 mm and 0.76±0.15 mm in the group with less than 2,2, 3,4, 5 and greater than 5 components of ideal cardiovascular health behaviors and health factors,respectively. The incidence of carotid atherosclerosis was 32.6%, 31.4%, 24.7%, 20.3%, 15.9% and 9.5%, respectively. ②Multiple linear regression analysis showed that after adjusting age, sex, TG, HDLC and LDLC cardiovascular health score and carotid intima-media thickness were negatively correlated. The B value of cardiovascular health score was -0.012(95%CI:-0.014~-0.011, P<0.001). Multivariate logistic regression analysis showed that compared with less than 2 components of ideal cardiovascular health behaviors and factors, the detection risk values (OR) of incidence of carotid atherosclerosis in the group with 3,4, 5 and greater than 5 components of ideal cardiovascular health behaviors and factors were 0.2,0.0,0.1,0.18, respectively. Conclusions The ideal cardiovascular health behaviors and factors are protective factors of carotid intima-media thickness in middle-aged population. With the increase of components and scores of ideal cardiovascular health behaviors and factors, both the values of carotid intima-media thickness and the incidence of carotid atherosclerosis decrease.
2016, 24(7):705-710.
Abstract:Aim To investigate the relationship between reactive hyperemia index(RHI) and blood homocysteine (Hcy) or carotid intima-media thickness (IMT) in patients with unstable angina pectoris(UAP). Methods A total of 245 consecutive patients taken coronary angiography(CAG)were enrolled in this study, and then divided, according to CAG, into normal group (n=65), SAP group (n=49) and UAP group (n=131). Vascular endothelial function was reviewed and RHI was calculated by using peripheral arterial tension (PAT) detection with Endo-PAT2000 (Itamar Medical Inc). IMT were measured with Color Doppler, and serum Hcy level was determined with enzymatic cycling assay. Results The RHI was significantly lower in UAP group than in the SAP group and normal group (UAP group<SAP group<normal group,P<0.05);IMT was significantly higher in the UAP group than in SAP group or in normal group (UAP group>SAP group>normal group,P<0.05);Hcy was significantly higher in UAP group than in normal group(P<0.05); In UAP group,RHI was negatively correlated with serum Hcy level and carotid IMT (r=-0.494,r=-0.513,P<0.01); Multiple linear regression analysis showed that it was independently correlated between IMT(X1), systolic pressure(X2), BMI(X3) and RHI(Y) in patients with UAP. Conclusion The serum Hcy level and IMT are positively associated with endothelial dysfunction(ED) in UAP patients, the serum Hcy level, IMT and RHI are correlated with the condition of patients with coronary heart disease.
2016, 24(10):1019-1022.
Abstract:Aim To study relevance of essential hypertension (EH) patients with brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (cIMT) and homocysteine (Hcy), D-dimer. Methods The study was performed on 246 essential hypertension patients. According to baPWV they were divided into normal group (baPWV<1700 cm/s) and abnormal group (≥1700 cm/s). According to cIMT they were divided into normal group (cIMT<0.9 mm), thickening group (0.9 ≤cIMT<1.2 mm), plaque group (cIMT≥1.2 mm). And Hcy, D-dimer and blood biochemistry were detected. Results Hcy and D-dimer levels in abnormal arterial stiffness group were significantly increased compared with those in normal arterial stiffness group (P<0.05). Hcy and D-dimer levels in the normal cIMT group, the thickening group, the plaque group were gradually increased. Partial correlation analysis showed that after excluded age, weight, blood lipids and blood glucose, baPWV was positively correlated with Hcy and D-dimer (r=0.18, r=0.32, P<0.05), cIMT was positively correlated with Hcy and D-dimer (r=0.56, r=0.27, P<0.05), BaPWV was positively correlated with cIMT (r=0.29, P<0.05). Conclusion The increase of Hcy and D-dimer were correlated with cIMT and baPWV which predicted artery disease.