Traditional Risk Factors Are Not Major Contributors to the Variance in Carotid Intima-Media Thickness

Rundek, Tatjana; Blanton, Susan H.; Bartels, Susanne; Dong, Chuanhui; Raval, Ami P.; Demmer, Ryan T.; Cabral, Digna; Elkind, Mitchell S.V.; Sacco, Ralph L.; Desvarieux, Moïse

doi:10.1161/strokeaha.111.000745

Cited by 82 publications

(77 citation statements)

References 56 publications

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“…Although these are still relatively low values, our analyses resulted with higher R 2 coefficients compared with the previous work by Rundek et al 15 Some population characteristics can explain different results between the 2 studies. Models including only age and race as explanatory variables in ELSA-Brasil yielded higher R 2 coefficients (≤0.298, Table II in the online-only Data Supplement) than the R 2 coefficients yielded in NOMAS.…”

Section: Discussioncontrasting

confidence: 80%

Low Impact of Traditional Risk Factors on Carotid Intima-Media Thickness

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Rundek

et al. 2015

ATVB

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Objective— There is little information about how much traditional cardiovascular risk factors explain common carotid artery intima-media thickness (CCA-IMT) variance. We aimed to study to which extent CCA-IMT values are determined by traditional risk factors and which commonly used measurements of blood pressure, glucose metabolism, lipid profile, and adiposity contribute the most to this determination in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort baseline. Approach and Results— We analyzed 9792 individuals with complete data and CCA-IMT measurements. We built multiple linear regression models using mean left and right CCA-IMT as the dependent variable. All models were stratified by sex. We also analyzed individuals stratified by 10-year coronary heart disease risk and, in separate, those with no traditional risk factors. Main models’ R 2 varied between 0.141 and 0.373. The major part of the explained variance in CCA-IMT was because of age and race. Indicators of blood pressure, lipid profile, and adiposity that most frequently composed the best models were pulse pressure, low-density lipoprotein/high-density lipoprotein ratio, and neck circumference. The association between neck circumference and CCA-IMT persisted significant even after further adjustment for vessel sizes and body mass index. Indicators of glucose metabolism had smaller contribution. Conclusions— We found that >60% of CCA-IMT were not explained by demographic and traditional cardiovascular risk factors, which highlights the need to study novel risk factors. Pulse pressure, low-density lipoprotein/high-density lipoprotein ratio, and neck circumference were the most consistent contributors.

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Section: Discussioncontrasting

confidence: 80%

Low Impact of Traditional Risk Factors on Carotid Intima-Media Thickness

Santos

Alencar

Rundek

et al. 2015

ATVB

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“…Even a large population-based study on carotid intima media thickness demonstrated that only 16% of the variance in the anatomical imaging data could be explained by a final multivariable model containing adiponectin and 9 traditional risk factors such as body mass index and smoking. 30 There are several limitations to be considered in interpreting our results (please refer to the Supplementary Discussion for more information). Further studies with a larger sample size are required to confirm if exercise training could actually decrease WD-mediated plaque vulnerability to rupture by attenuating matrix disorganization that includes degradation of collagen, through the mechanism proposed in this study (i.e., exercise-mediated anti-atherosclerotic modulation of the adiponectin/resistin/VCAM-1-related systemic cytokine network, culminating in the reduction of monocytes/macrophage recruitment, M1/M2 ratio, and MMP activity in atheromatous arteries).…”

Section: Discussionmentioning

confidence: 99%

Cytokine Response to Diet and Exercise Affects Atheromatous Matrix Metalloproteinase-2/9 Activity in Mice

Shon

Jang

Schellingerhout

et al. 2017

Circ J

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plaque, even if the animals remained on a high fat diet and plaque growth was not attenuated. 5 The study suggested that circulating adiponectin and soluble vascular cell adhesion molecule-1 (sVCAM-1) might be related to the reduced MMP activity in atheromas, but the mechanisms for this effect were not known. The present study aims to address the mechanisms leading to this observation, relating the MMP-modulating effect of diet and exercise to cytokine homeostasis. We also considered body mass and visceral fat amount, which could be affected by diet and exercise, and ultimately contribute to obesity-related re-A theromatous matrix metalloproteinase (MMP) activity is related to plaque vulnerability and rupture, the final common pathway for the thromboembolic complications of atherosclerosis, such as ischemic stroke or myocardial infarction. 1-4 Identifying the principal factors that affect atheromatous MMP activity may help predict and prevent these events.Using an MMP-activatable protease reporter, we previously described that 10-weeks of treadmill exercise reduced in vivo atheromatous MMP-2/9 activity in Apolipoprotein-E (ApoE) knock-out (ApoE −/− ) mice with pre-existing Background: The aim of this study is to identify the principal circulating factors that modulate atheromatous matrix metalloproteinase (MMP) activity in response to diet and exercise.

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“…As other unmeasured determinants, the difference in access to medical care, difference in socioeconomic status 31,32) , difference in psychological factors 33) , difference in other environmental factors 34) , frequency, and intensity of physical activity 35) could be involved.…”

Section: Sex-specific Determinants: Ldl-cholesterol and Non-hdl-cholementioning

confidence: 99%

Subclinical Carotid Atherosclerosis Burden in the Japanese: Comparison between Okinawa and Nagano Residents

Shimabukuro

Hasegawa

Higa

et al. 2015

JAT

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Aim:The prevalence of overweight and a change in atherosclerotic lipid profiles may be linked to region-specific differences in atherosclerotic diseases. We evaluated whether the lipid phenotype could be linked to region-and sex-specific differences in the degree of atherosclerosis. Methods: Non-diabetic subjects included Okinawa (n 1674) and Nagano (n 1392) residents aged 30 -75 years who underwent carotid ultrasonography for the measurement of maximum intimamedia thickness (max IMT). Results: Average max IMT was higher in Okinawa men and women, and the increase in max IMT with age was enhanced in men. Multiple regression analysis showed that in addition to age and systolic blood pressure, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol were IMT determinants only in men for both Okinawa and Nagano. Meanwhile, HDL-cholesterol was a determinant for Okinawa men and women, but not for Nagano men and women. Conclusions: This is the first report to show region-and sex-specific differences in the determinants for max IMT in a Japanese population. The evaluation of the relationship between lipid profile patterns and region-and sex-specific differences in carotid atherosclerosis burden may be required. J Atheroscler Thromb, 2015; 22: 854-868.

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Traditional Risk Factors Are Not Major Contributors to the Variance in Carotid Intima-Media Thickness

Cited by 82 publications

References 56 publications

Low Impact of Traditional Risk Factors on Carotid Intima-Media Thickness

Low Impact of Traditional Risk Factors on Carotid Intima-Media Thickness

Cytokine Response to Diet and Exercise Affects Atheromatous Matrix Metalloproteinase-2/9 Activity in Mice

Subclinical Carotid Atherosclerosis Burden in the Japanese: Comparison between Okinawa and Nagano Residents

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