Associations of cardiovascular risk factors with two surrogate markers of subclinical atherosclerosis: Endothelial function and carotid intima media thickness

Abstract

Objective Endothelial function and carotid intima media thickness (cIMT) were investigated in a cohort of 54 healthy adults without known cardiovascular disease. Methods Pulse wave amplitude was determined with peripheral arterial tonometry (PAT) to obtain the reactive hyperemia (RH)-PAT ratio. Ultrasound was used to determine cIMT. Results cIMT and RH-PAT were significantly associated (rho = −0.35, P = 0.02) in univariate analysis. RH-PAT was significantly associated with age, triglycerides, fasting glucose, HDL, WHR, waist circumference and VAT. cIMT was associated with age, smoking history, fasting glucose, systolic blood pressure, diastolic blood pressure and LDL. In multivariate regression analyses, triglyceride level (P = 0.04) remained a significant determinant of RH-PAT whereas systolic blood pressure (P = 0.02) and smoking pack-year history (P = 0.046) were significant determinants of cIMT. Conclusion Determinants of cIMT and RH-PAT were different, dominated by triglyceride and abdominal adiposity measures for RH-PAT but traditional risk factors including blood pressure, glucose, smoking and LDL for cIMT.

Endothelial Dysfunction in Diabetes: Pathogenesis, Significance, and Treatment

“…Venous occlusion strain-gauge plethysmography can be utilized to measure blood flow changes in the forearm microcirculation following hyperemia, or intra-arterial infusion of muscarinic receptor agonists such as acetycholine [19,20]. An emerging non-invasive clinical tool to assess peripheral vasodilator response is digital peripheral arterial tonometry (PAT) (Endo-PAT, Itamar Medical) [21,22].…”

Determining factors for carotid mean/max intima-media thickness and brachial flow-mediated dilation in healthy young women

“…This result may be attributable to the relatively low LDL-C levels of our subjects; fewer than 20% of our subjects had an LDL-C level > 140 mg/dl. In healthy subjects, triglyceride level has been a significant determinant of endothelial function [16], but this study did not evaluate heart rate. In the Framingham Heart Study, the significant multivariate correlates of brachial FMD were age, gender, systolic blood pressure and heart rate [19], although mean age (61 years) and systolic blood pressure level ((122 ± 18) mm Hg) of the participants were much higher and mean brachial FMD (3.3%) was much lower than those of our subjects, who were all young women.…”

“…Although LDL-C level was significantly associated with both mean IMT and max IMT, the extent of the association was clearly different: LDL-C levels were closely associated with max IMT but only mildly associated with mean IMT. In previous studies with healthy subjects, age [14], dyslipidemia [14], hs-CRP [15], systolic blood pressure level [16] and smoking history [16] were shown to be important independent predictors of IMT. However, the difference in the determining factors between the mean IMT and the max IMT remains to be seen in these studies.…”

Dyslipidemia Induced by Stress

“…Intercellular adhesion molecule-1 may contribute to accelerating atherosclerosis in insulin-resistant states (Muniyappa et al, 2008). Hypertriglyceridemia associated with stress may also increase NF-kB, consequently activating proinflammatory molecules (Fitch et al, 2011). In addition, the accumulation of macrophages may also be associated with increased plasma concentration of C-reactive protein (CRP) (Ross, 1999).…”