Abstract:Aim To investigate the relationship between the concentration of plasma lipocalin-2 （LCN2） and common carotid artery intima-medial thickness （CCA-IMT） in newly diagnosed type 2 diabetic patients. Method 166 newly diagnosed type 2 diabetic patients （age 35～70, duration≤1 year） and 65 healthy people were recruited. CCA-IMT was detected by high-resolution ultrasonography, plasma concentration of LCN2 was measured by enzyme-linked immunosorbent assay. Results Adjusting for age and sex, type 2 diabetics’ plasma concentration of LCN2 was significantly higher than that in the healthy group （P<0.05）. According to the three tilter of plasma concentration of LCN2, the highest concentration group’s CCA-IMT was significantly higher than that in the lowest concentration group （P0.026）.

Abstract:Aim To investigate the effects of atorvastatin calcium on plasma homocysteine （Hcy） and carotid artery atherosclerosis in patients with H type hypertension. Methods 180 cases of H type hypertensive patients （50～79 years old） were randomly divided into atorvastatin （10 mg/d） treatment group （n＝92） and conventional treatment group i.e.control group （n＝88）. Blood pressure,blood lipids,Hcy,high-sensitive C-reactive protein （hs-CRP）,and intima-media thickness （IMT） were determined before and after 6 months treatment in all patients. Results In atorvastatin treatment group,after 6 months treatment,the level of low density lipoprotein cholesterol was significantly decreased from 2.69±0.44 mmol/L to 1.95±0.37 mmol/L the level of Hcy was significantly decreased from 15.86±3.37 μmol/L to 9.96±3.35 μmol/L the level of hs-CRP was significantly decreased from 5.88±2.82 mg/L to 3.75±2.37 mg/L the IMT was significantly decreased from 1.97±0.76 mm to 1.47±0.68 mm （all P＜0.05）. No significant change was observed in control group. Conclusion On the basis of conventional antihypertension,atorvastatin can significantly decrease the level of plasma Hcy,inhibit inflammatory reaction,and slow down the formation of atherosclerotic plaque in patients with H type hypertension.

Abstract:AimThe present study investigated the effect of lifestyle modification on arterial stiffness in patients with impaired glucose tolerance (IGT).MethodsThere were 162 subjects with IGT were randomized to either a usual care control group (n＝78) or an intensive lifestyle intervention group (n＝84).Both two groups, their height, weight, body mass index and blood pressure were measured.The carotid intima-media thickness (IMT) was measured by ultrasonography, the brachial-ankle pulse wave velocity (baPWV) was measured by automatic atherosclerosis assay instrument at the baseline and after intervention.ResultsThe intervention group showed a significant difference in triglycerides, oral glucose tolerance test 2-hour plasma glucose (OGTT2hPG) following the 24 months of intervention compared with baseline (p<0.01), without differences in changes of the values of carotid IMT and baPWV.At 24 months, significant improvements were noted in most anthropometric values in the intervention group than the control group (p<0.05 or p<0.01), and the values of carotid IMT were significantly lower than the control group (p<0.05), without significant differences in baPWV between the two groups.ConclusionThe finding suggests the active intervention may have beneficial effects on arterial stiffness for the patients at-risk for diabetes through improving anthropometric and certain metabolic outcomes.

Abstract:AimTo investigate the correlation between serum total bilirubin level and intima-media thickness (IMT) of carotid artery in chronic kidney disease (CKD) patients.MethodsForty-eight non-dialytic CKD patients and sixteen healthy volunteers were involved in the study.CKD patients were classified into three groups according to glomerular filtration rate (GFR): CKD 2-3 stage, CKD 4 stage and CKD 5 stage.Their serum bilirubin levels were measured and compared.Intima-medial thickness of carotid artery and the presence of atherosclerotic plaques were determined by using noninvasive high-resolution B-mode ultrasonography.ResultsSermu total bilirubin, IMT and prevalence of atherosclerotic plaques in CKD patients were significantly lower than those in healthy groups (p<0.01).The serum total bilirubin will lower following with the decreased renal function.The serum total bilirubin and concentrations were significantly decreased in CKD patients with atherosclerosis of carotid artery group (5.38±1.95 μmol/L vs 9.15±3.53 μmol/L, p<0.01).The linear correlation analysis indicated the serum total bilirubin was correlated negatively with urea nitrogen and serum creatinine (r＝－0.611, p<0.0001; r＝－0.492, p<0.0001).The serum total bilirubin level was correlated positively with glomerular filtration rate and hemoglobin (r＝0.693, p<0.0001; r＝0.602, p<0.0001).Logistic regression analysis further indicated that serum total bilirubin (β＝0.918, p＝0.004) was an independent risk factor of atherosclerosis in non-dialytic CKD patients.ConclusionsHypobilirubinemia exists in the patients of CKD.

Abstract:Aim To investigate the correlation between serum leptin level and intima-media thickness of carotid artery in chronic kidney disease patients (CKD). Methods Seventy-nine non-dialytic CKD patients and fifteen healthy volunteers were involved in the study. CKD patients were classified into three groups according to glomerular filtration rate (GFR):CKD 2～3 stage,CKD 4 stage and CKD 5 stage,the serum leptin was tested by the radio-immunity method; Intima-medial thickness (IMT) of carotid artery and the presence of atherosclerotic plaques were determined by using noninvasive high-resolution B-mode ultrasonography. Results Sermu leptin,IMT and prevalence of atherosclerotic plaques in CKD patients were significantly higher than those in healthy groups (P><0.01). The serum leptin and CRP concentrations were significantly increased in CKD patients with atherosclerosis of carotid artery group (17.06±1.06 ng/L vs 14.27±0.70 ng/L;P><0.05),(3.32±0.19 mg/L vs 2.55±0.17 mg/L;P><0.01). The linear correlation analysis indicated the serum leptin was correlated positively with urea nitrogen,serum creatinine,C-reaction and body mass index (r=0.293,P><0.01,r=0.324,P><0.01;r=0.539,P><0.01;r=0.312,P><0.05). The serum leptin level was correlated negatively with glomerular filtration rate,hemoglobin and albumin (r=-0.389,P><0.01;r=-0.454,P><0.01;r=-0.246,P><0.05). Logistic regression analysis further indicated that Leptin (β=1.527,P><0.05) was an independent risk factor of atherosclerosis in non-dialytic CKD patients. Conclusion The patients of CKD exist hyperleptinemia. The serum leptin was significantly correlated with IMT. Hyperleptinemia was an independent risk factor and might play a role in pathogenesis and progression of atherosclerosis.

Abstract:Aim To investigate the relationship between the concentration of serum total bilirubin and artery intima-medial thickness(IMT) in newly diagnosed type 2 diabetes patients. Methods 357 newly diagnosed type 2 diabetes patients(age 35～70,duration≤1year)were recruited,178 patients with higher IMT and 179 patients with normal IMT,and then clinical feature and serum total bilirubin were compared in the two groups.Based on the concentration of serum total bilirrubin these patients were divided into four groups: lowest bilirubin group,lower bilirubin group,higher bilirubin group,highest bilirubin group,and patients common carotid artery(CCA)-IMT,common iliac artery(CIA)-IMT,femoral artery(FA)-IMT and the incidence rate of plaque were compared in four groups.Serum total billirubin and other factors related to diabetic subclinical atherosclerosis were analyzed by multiple stepwise Logistic regressive analysis. Results The concentration of serum total bilirubin of the IMT thickening group was significantly lower than that of the IMT normal group(P><0.05).Among the four groups which were divided based on the concentration of serum total bilirubin,the lowest bilirubin groups CCA-IMT,CIA-IMT,FA-IMT,the incidence rate of plaque and higher IMT was the highest in the four groups,and was significantly higher than highest bilirubin groups(P><0.01).To define the independent association between serum total bilirubin and diabetic artery IMT,the multiple stepwise Logistic regressive analysis was used.Serum total bilirubin,but not other parameters,was related independently and significantly with higher IMT,so did age and systolic hypertension. Conclusion The study suggested that serum total bilirubin was probably an independent risk factor for higher IMT in newly diagnosed type 2 diabetes.

Abstract:Aim To determine the effect of atorvastatin on macroangiopathy in patients with type 2 diabetes mellitus(DM) and further to explore the possible mechanism. Methods 120 patients with DM were enrolled in the present study and randomly divided into routine treatment group and atorvastatin treatment group.Flow-mediated dilation(FMD) and intima-medial thickness(IMT) was measured before treatment and after 6-month treatment.The levels of plasma monocyte chemoattractant protein-1(MCP-1),nitric oxide(NO),and vonwillebrand factor(vWF) were also determined. Results After 6 months therapy,the levels of blood glucose and blood pressure were well controlled in two groups.FMD and the levels of NO and vWF were also improved in both groups.However,compared with routine treatment group,endothelial function was more significantly improved by treatment with atorvastatin(P<0.05).Atorvastatin treatment controlled blood lipid,attenuated the levels of MCP-1 and the progress of IMT(P<0.05),but routine treatment had no effect. Conclusion Atorvastatin may induce a markedly protective effect on the macroangiopathy of DM,which may be related to regulating blood lipids,protecting vascular endothelium and inhibiting vascular inflammation.

Abstract:Aim By studying intravascular ultrasound(IVUS),coronary angiography (CAG) and the results of carotid body ultrasonic testing of carotid artery disease to analyze the relationship between carotid atherosclerosis and coronary heart disease,to further explore carotid atherosclerosis on the predictive value of coronary heart disease.Methods 38 cases of initial diagnosis for patients with coronary heart disease accepted CAG and IVUS examination,surface carotid artery ultrasound testing.8 patients with no significant coronary artery stenosis (non-coronary heart disease) were used as the control group;30 cases with significant coronary artery stenosis were divided into groups of coronary heart disease,including 18 cases of unstable angina pectoris (UAP) and 12 cases of stable angina pectoris (SAP).The results of carotid ultrasound indicators,CAG and IVUS examination were analyzed and compared.Results The average diameter stenosis rate of CAG was 71.21%±9.81% in 30 cases with coronary heart disease.IVUS showed that 30 cases of coronary heart disease in patients with different types of atherosclerotic plaque and the average rate of the narrow area was 80.88%±7.77%;There were significant difference between the average diameter stenosis rate of CAG and the average rate of the narrow area of IVUS (P<0.01);They also had significant correlation between the two indicators (r=0.663,P<0.01).It prompted that CAG underestimated the degree of stenosis of coronary lesions to some extent compared with IVUS.The coronary Gensini integral according to the calculation of CAG had a significant correlation with the carotid atherosclerosis grade integral,Crouse integral,plaque volume(P<0.01).Carotid artery plaque on the positive predictive value of coronary heart disease was 70%(21/30)and the negative predictive value was 75%(6/8).Conclusion It canclearly show the coronary artery wall structure and accurately diagnose coronary artery plaque on the nature,accurately measure the rate of coronary artery stenosis by application of the IVUS imaging.IVUS assessment of coronary artery disease is more accurate compared with CAG.There are very good correlation between the carotid atherosclerosis and the severity of coronary artery IVUS results.Carotid ultrasound detection has some predictive value to coronary heart disease.

Abstract:Aim To study the effects of pioglitazone on intima-medial thickness(IMT) of carotid artery in type 2 diabetic mellitus(T_2DM) patients.Methods T_2DM patients(n=68) were divided into pioglitazone group(n=34) and placebo group(n=34) by the rule of random and double-blind.The IMT of carotid artery was detected by B-mode ultrasound 3 months later.After 3 months treatment,postprandial blood glucose(PBG),HbA1c,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDLC)and high density lipoprotein cholesterol(HDLC)were measured.Results IMT of carotid artery in pioglitazone group was significantly lower than that in placebo group(p<0.01).Compared with placebo group,the serum levels of PBG,HbA1C and TG in pioglitazone treatment group were significantly lower(p<0.01) and the level of HDLC was markedly increased(p<0.01).No significant difference of TC and LDLC was found between the two groups. The decreased IMT of carotid artery was significantly associated with chang of LDLC and HDLC.Conclusion Pioglitazone could significantly reduce IMT of carotid artery in T_2DM patients and have positive effects on improving vascular complications of T_2DM patients.