BACKGROUND: Ultrasound measurement of carotid artery intima-media thickness (IMT) is regarded as a valid index of atherosclerosis. Age and sex differences in the distribution of, and risk factors for, IMT have not been investigated thoroughly. METHODS: In 1994-1995 a total of 6408 men and women aged 25-84 years living in the municipality of Tromsø, Norway, underwent ultrasound examination of carotid artery IMT and measurements of cardiovascular risk factors. RESULTS: Age, systolic blood pressure, total cholesterol, HDL cholesterol, body mass index, and smoking were independent predictors of IMT in both sexes. Fibrinogen levels and physical activity were associated with IMT in men only, whereas triglyceride levels were associated with IMT independently of HDL cholesterol in women only. A family history of cardiovascular disease (CVD) was an independent predictor of IMT in both sexes, also when controlling for traditional CVD risk factors. The magnitude of the association between most risk factors and IMT did not differ depending on age, but the effects of physical activity and triglycerides were more pronounced at higher age. CONCLUSION: These data suggest that there are significant age and sex differences in the distribution and the determinants of subclinical atherosclerosis.
There is substantial epidemiological data suggesting a J- or U-shaped association between alcohol consumption and coronary events. However, some studies in experimental animals suggest that alcohol may increase atherosclerosis. Therefore, our aim was to study whether alcohol consumption is associated with carotid intima-media thickness (IMT), marker of subclinical atherosclerosis, in young, healthy adults.
Alcohol consumption, carotid IMT and conventional cardiovascular risk factors were investigated in 2074 subjects, aged 24-39 years.
In subjects consuming none, >0 to or=4 units of alcohol per day, the respective carotid IMT values were 0.57+/-0.004, 0.59+/-0.003, 0.59+/-0.006, and 0.60+/-0.012 mm (mean+/-S.E.M., P
Polymorphisms of the upstream transcription factor 1 (USF1) have been associated with familial combined hyperlipidemia and coronary heart disease. The impact of this gene on subclinical atherosclerosis is unknown. Associations of 3 allelic variants of the USF1 gene and their haplotypes with carotid artery intima - media thickness (IMT), carotid artery compliance (CAC) and brachial artery flow mediated dilatation (FMD) were studied in a population of Finnish healthy young adults.
The study population comprised 2,281 individuals participating in the Cardiovascular Risk in Young Finns study. IMT, CAC and FMD values were measured by ultrasound examination. Genotypes were analysed using the 5' nuclease assay. A significant difference in IMT was found for usf1s1 (rs3737787) and usf1s8 (rs2516838) genotypes (p-values 0.046 and 0.021, respectively). Moreover, there was a significant difference between groups in haplotype 1 and haplotype 2 for IMT (p-values 0.011 and 0.028 respectively). In multivariate stepwise linear regression models adjusted by age, sex, body mass index, systolic and diastolic blood pressures, smoking, C-reactive protein, glucose, high- and low-density lipoprotein-cholesterols and triglycerides there were significant associations for the usf1s1 minor genotype AA to predict low IMT (p=0.038) and usf1s8 minor genotype GG to predict high IMT (p=0.003). There was also a significant association for haplotype 2 to predict low IMT in the otherwise similar multivariate model (p=0.006). No associations were found for polymorphisms and CAC, FMD or serum lipids.
The rs2516838 and rs3737787 polymorphisms of USF1 influence the carotid artery IMT, which is a new finding.
We investigated the associations of anger and cynicism with carotid artery intima-media thickness (IMT) and whether these associations were moderated by childhood or adulthood socioeconomic status (SES). The participants were 647 men and 893 women derived from the population-based Cardiovascular Risk in Young Finns Study. Childhood SES was measured in 1980 when the participants were aged 3-18. In 2001, adulthood SES, anger, cynicism, and IMT were measured. There were no associations between anger or cynicism and IMT in the entire population, but anger was associated with thicker IMT in participants who had experienced low SES in childhood. This association persisted after adjustment for a host of cardiovascular risk factors. It is concluded that the ill health-effects of psychological factors such as anger may be more pronounced in individuals who have been exposed to adverse socioeconomic circumstances early in life.
Association between carotid intima-media thickness and low-density lipoprotein size and susceptibility of low-density lipoprotein to oxidation in asymptomatic members of familial combined hyperlipidemia families.
In addition to low-density lipoprotein (LDL) cholesterol, small, dense LDL particles and oxidative modification of LDL have been linked to the pathogenesis of atherosclerosis. The present study was aimed at investigating the association between carotid artery intima-media thickness (IMT) and LDL particle size and susceptibility of LDL to oxidation in vitro in asymptomatic members of familial combined hyperlipidemia (FCHL) families.
LDL particle size, susceptibility of LDL to oxidation in vitro, and carotid IMT were measured in 148 asymptomatic FCHL family members.
LDL particle size and lag time for LDL oxidation were reduced in hyperlipidemic compared with normolipidemic family members. LDL particle size, serum total cholesterol, and alpha-tocopherol in LDL were independently associated with lag time for LDL oxidation in multivariate analysis. LDL particle size was associated with carotid mean IMT independently of clinical, lipid, and antioxidant variables in multivariate analysis. Although the susceptibility of LDL to oxidation in vitro was correlated with mean IMT, it did not have a significant independent contribution to variation in mean IMT in the multivariate model.
We conclude that LDL particle size but not susceptibility of LDL to oxidation in vitro is independently associated with carotid IMT in asymptomatic FCHL family members. These results imply that small, dense LDL as an inherent feature of FCHL is an important diagnostic indicator for coronary artery disease risk in FCHL.
Both clinical and epidemiologic studies have shown an association between atherosclerotic changes in the aorta or lumbar arteries and lumbar disc degeneration. However, the association between atherosclerosis and sciatica remains unknown. The aim of this study was to investigate the association between carotid intima-media thickness and sciatica.
The target population consisted of people aged 45 to 74 years, who had participated in a Finnish nationwide population study during the period 2000 to 2001 and lived within 200 km of the 6 study clinics. Of the 1867 eligible subjects, 1386 (74%) were included in the study. We used high-resolution B-mode ultrasound imaging to measure intima-media thickness, and local or radiating low back pain was determined by a standard interview and clinical signs of sciatica through a physician's clinical examination.
Carotid intima-media thickness was associated with continuous radiating low back pain and with a positive unilateral clinical sign of sciatica among men only. After adjustment for potential confounders, each standard deviation (0.23 mm) increment in carotid intima-media thickness showed an odds ratio of 1.6 (95% confidence interval 1.1-2.3) for continuous radiating low back pain and 1.7 (95% confidence interval 1.3-2.1) for a positive unilateral clinical sign of sciatica. Carotid intima-media thickness was not associated with local low back pain.
Sciatica may be a manifestation of atherosclerosis, or both conditions may share common risk factors.
We examined whether metabolic syndrome (MetS) predicts increased alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) levels in young adults, whether spontaneous recovery from MetS has a favorable effect on liver enzyme activities, and whether these enzymes contribute to the atherogenicity of MetS (assessed by carotid intima-media thickness (IMT)).
The study included 1,553 subjects (base-line age 31.5 ± 5.0 years). ALT and GGT were measured in 2007. MetS was diagnosed by the new Joint Interim Societies definition.
ALT and GGT levels were higher in subjects with MetS compared to those without in 2007. The association was independent of alcohol intake and BMI. In multivariable models adjusted for base-line age, LDL cholesterol, CRP, alcohol intake, and adiponectin, MetS in 2001 predicted increased ALT (ß ± SEM = 0.320 ± 0.062, P
To assess how multidimensional personality-trait theories, such as the Psychobiological Model of Temperament and Character, and the Five-factor Model of Personality, are associated with subclinical atherosclerosis as indicated by carotid intima-media thickness (IMT). The analysis was designed to tolerate non-linear development in which the same personality profiles can have multiple final outcomes and different antecedent profiles can have the same final outcome.
605 men and 844 women (average age 31.6year, s.d.=5.0, range=24-39) provided data on IMT and traits of the psychobiological model, 725 men and 1011 women were assessed for IMT and the five-factor model (age 37.7year, s.d.=5.0, range=30-45). Robust multidimensional Hotelling's T(2) statistic was used to detect personality differences between participants with high IMT and others. Model-based clustering method further explored the effect.
Those with a high level of subclinical atherosclerosis within the sample (highest IMT-decile) had a combined higher persistence (i.e., were perseverative or perfectionistic), more disorganized (schizotypal) character, and more antisocial temperamental configuration than others (P=0.019). No effect was found for the five-factor model (P=0.978). Traditional methods that did not account for multidimensionality and nonlinearity did not detect an association.
Psychological well-being may have positive effects on health that reduce atherosclerosis in the population as a whole. Increased subclinical atherosclerosis was associated with a profile that combines known risk factors, such as cynical distrust and hostile tendencies. More frequent use of statistical procedures that can cope with non-linear interactions in complex psychobiological systems may facilitate scientific advances in health promotion.
CONTEXT: Some previous studies have reported an association between circulating adiponectin and selected measures of vascular function and morphology, but most of these studies have been performed in small samples of patients with preexisting disease. OBJECTIVE: We aimed to evaluate associations between circulating adiponectin and comprehensive measures of vascular function and morphology in a large sample of individuals from the community. DESIGN, SETTINGS, AND PARTICIPANTS: We conducted a cross-sectional investigation of 981 70-yr-old participants (50% women) of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). MAIN OUTCOME MEASURES: Measures of outcome included vascular function [common carotid artery (CCA) distensibility, flow-mediated dilation, endothelium-dependent and endothelium-independent vasodilation using invasive methods] and vascular morphology [intima-media (IM) thickness, plaque presence, gray scale median (GSM) in the IM and plaques]. RESULTS: In age- and sex-adjusted models, adiponectin was positively associated with IM-GSM, plaque GSM, CCA distensibility, endothelium-dependent and endothelium-independent vasodilation. In multivariable models (with additional adjustment for body mass index; systolic blood pressure; antihypertensive, antidiabetic, and lipid-lowering medication; fasting blood glucose; total cholesterol; high-density lipoprotein cholesterol; creatinine; and smoking), adiponectin remained positively associated with IM-GSM [beta = 2.06; 95% confidence interval (CI), 0.54, 3.58], plaque GSM (beta = 3.11; 95% CI, 0.36, 5.86), and CCA distensibility (beta = 0.04; 95% CI, 0.00, 0.07). CONCLUSIONS: Serum levels of adiponectin were positively associated with IM-GSM and plaque GSM (indicating lower fat content in the IM and plaques) and CCA distensibility (indicating higher wall elasticity), independent of potential confounders. Our results imply that adiponectin is associated with less arterial pathology.
A low frequency of ischemic heart disease in Eskimos (Inuit) has been regarded as an expression of absent or low atherosclerosis. The true extent of atherosclerosis in the Eskimo populations of the World is not known due to low autopsy activity. In order to register atherosclerotic changes in the carotid and femoral arteries 61 Native Greenlanders from two settlements with a traditional Eskimo life style in the Uummannaq district of Northwestern Greenland were examined ultrasonographically with a portable scanner (Aloka) using a 7.5 MHz 4 cm linear array transducer. The results obtained were compared to an age and sex matched urban control group of 122 Danes from Copenhagen. The investigation showed that the Native Greenlanders had almost the same degree and extent of atherosclerosis in the carotid and femoral arteries as the Danes. Thus, the low incidence of ischemic heart disease in Native Greenlanders may not be attributed to lesser atherosclerosis. Further studies, particularly autopsy studies are needed.