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Carotid artery intima-media thickness (IMT), an important clinical marker of atherosclerosis, is used widely in screening for cardiovascular risk and prognosis. Measurements of carotid artery IMT are made on both the left and right sides of the body, however as per the Mannheim consensus, an average of these measurements is usually reported. Nevertheless, there is considerable debate whether there are side differences in the carotid artery IMT in terms of both measurements and determinants. In a large sample of Caucasian patients (n = 1888) referred for cardiovascular risk assessment, we compared the left and the right common carotid artery IMT measurements, and assessed whether age, gender and cardiovascular risk factors have differential effects. We found that the left common carotid artery IMT (0.7141 ± 0.1733 mm) is larger than the right (0.6861 ± 0.1594, p < 0.0001), but not in the young (< 30 years) or the elderly (> 69 years), and that this side difference is less in women (0.019 ± 0.116 mm) than in men (0.036 ± 0.148 mm, p < 0.001). In addition to age (p < 0.0001) and gender (p < 0.0001), the left common carotid artery IMT was determined by dyslipidaemia (protective, p = 0.016) and diabetes mellitus (p = 0.022); whereas the right common carotid artery IMT was determined by hypertension (p = 0.0002). The differential determinants of left versus right common carotid artery IMT were similar in men and women, and in young and old. In conclusion, side differences in measurements of the common carotid artery IMT depend upon age and gender. In addition, cardiovascular risk factors have differential effects on the left and right common carotid artery IMT. [ABSTRACT FROM AUTHOR]

Background: Obesity in adolescents is increasing worldwide and associated with an elevated cardiovascular risk later in life. In a group-comparative study, we investigated the association between adiposity in adolescents and signs of vascular aging and inflammation. Methods: Thirty-nine adolescents (10–18 years old), 19 with obesity and 20 with normal weight, were enrolled. The intima thickness and intima/media thickness ratio (I/M) were assessed using high-resolution ultrasound in the common carotid artery (center frequency 22 MHz) and the distal radial artery (RA; 50 MHz). Increased intima and high I/M are signs of vascular aging. Body characteristics, high-sensitivity C-reactive protein (hs-CRP), plasma lipids, and glycemic parameters were measured. Results: Adolescents with obesity, compared to normal-weight peers, had elevated plasma lipid, insulin c-peptide, and hs-CRP levels, the latter increasing exponentially with increasing adiposity. Obese adolescents had a thicker RA intima layer [0.005 mm; 95% confidence intervals (0.000, 0.009); P = 0.043] and a higher RA I/M [0.10; (0.040, 0.147); P < 0.0007]. Group differences for the RA I/M remained significant after adjustment for age, sex, fasting plasma insulin, and body mass index, both separately and together (P = 0.032). The RA I/M was correlated with hs-CRP, and both were correlated with the analyzed cardiovascular risk factors. Receiver operating curve c-values for RA I/M (0.86) and hs-CRP (0.90) strongly indicated correct placement in the obese or non-obese group. Conclusions: Adolescents with obesity had significantly more extensive vascular aging in the muscular RA, than normal-weight peers. The findings support an inflammatory link between obesity and vascular aging in adolescents.

Background The origins of sex differences in cardiovascular diseases are not well understood. We examined the contribution of childhood risk factors to sex differences in adult carotid artery plaques and intima‐media thickness (carotid IMT). Methods and Results Children in the 1985 Australian Schools Health and Fitness Survey were followed up when they were aged 36 to 49 years (2014–19, n=1085–1281). Log binomial and linear regression examined sex differences in adult carotid plaques (n=1089) or carotid IMT (n=1283). Childhood sociodemographic, psychosocial, and biomedical risk factors that might contribute to sex differences in carotid IMT/plaques were examined using purposeful model building with additional adjustment for equivalent adult risk factors in sensitivity analyses. Women less often had carotid plaques (10%) than men (17%). The sex difference in the prevalence of plaques (relative risk [RR] unadjusted 0.59 [95% CI, 0.43 to 0.80]) was reduced by adjustment for childhood school achievement and systolic blood pressure (RR adjusted 0.65 [95% CI, 0.47 to 0.90]). Additional adjustment for adult education and systolic blood pressure further reduced sex difference (RR adjusted 0.72 [95% CI, 0.49 to 1.06]). Women (mean±SD 0.61±0.07) had thinner carotid IMT than men (mean±SD 0.66±0.09). The sex difference in carotid IMT (β unadjusted −0.051 [95% CI, −0.061 to −0.042]) reduced with adjustment for childhood waist circumference and systolic blood pressure (β adjusted −0.047 [95% CI, −0.057 to −0.037]) and further reduced with adjustment for adult waist circumference and systolic blood pressure (β adjusted −0.034 [95% CI, −0.048 to −0.019]). Conclusions Some childhood factors contributed to adult sex differences in plaques and carotid IMT. Prevention strategies across the life course are important to reduce adult sex differences in cardiovascular diseases.

Background The brain is one of the main target organs affected by hypertension. Impaired cerebral oxygenation during exercise is an indicator of cerebral dysfunction. We aimed to investigate whether cerebral oxygenation during exercise correlates with subclinical markers of early target organ damage in a population of middle-aged, newly diagnosed hypertensive and healthy individuals. Methods Carotid intima–media thickness (cIMT) was measured using ultrasound, arterial stiffness was estimated measuring the augmentation index and pulse wave velocity, and retinal vessel diameter was assessed via the central retinal-arteriolar and vein equivalent and retinal-arteriovenous ratio. Participants (n = 93) performed a 3-minute isometric handgrip exercise. Cerebral prefrontal oxygenation was measured continuously using near infrared spectroscopy. The average exercise responses in oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), and total hemoglobin (tHb) were assessed. Univariate analyses were performed; partial correlation was used to account for traditional cardiovascular risk factors to identify independent associations between cerebral-oxygenation indices and early markers of target organ damage. Results Mean cIMT was negatively correlated with the average exercise response in cerebral oxygenation (rhoO2Hb = −0.348, P O2Hb = 0.001; rhotHb = −0.253, P thb = 0.02). Augmentation index was negatively correlated with cerebral oxygenation during exercise (rhoO2Hb = −0.374, P < 0.001; rhotHb = −0.332, P = 0.02), whereas no significant correlation was observed between pulse wave velocity and cerebral-oxygenation indices. In the adjusted analysis, cerebral oxygenation was correlated with central retinal arteriolar diameter (CRAE r = 0.233, P = 0.043). Conclusions Our novel findings suggest that indices of lower cerebral oxygenation during a submaximal physical task are associated with markers of early, subclinical target organ damage, namely increased cIMT, arterial stiffness, and arteriolar retinal narrowing in newly diagnosed, untreated, hypertensive individuals. [ABSTRACT FROM AUTHOR]

Background: Obesity in adolescents is increasing worldwide and associated with an elevated cardiovascular risk later in life. In a group-comparative study, we investigated the association between adiposity in adolescents and signs of vascular aging and inflammation. Methods: Thirty-nine adolescents (10-18 years old), 19 with obesity and 20 with normal weight, were enrolled. The intima thickness and intima/media thickness ratio (I/M) were assessed using high-resolution ultrasound in the common carotid artery (center frequency 22 MHz) and the distal radial artery (RA; 50 MHz). Increased intima and high I/M are signs of vascular aging. Body characteristics, high-sensitivity C-reactive protein (hs-CRP), plasma lipids, and glycemic parameters were measured. Results: Adolescents with obesity, compared to normal-weight peers, had elevated plasma lipid, insulin c-peptide, and hs-CRP levels, the latter increasing exponentially with increasing adiposity. Obese adolescents had a thicker RA intima layer [0.005 mm; 95% confidence intervals (0.000, 0.009); P = 0.043] and a higher RA I/M [0.10; (0.040, 0.147); P < 0.0007]. Group differences for the RA I/M remained significant after adjustment for age, sex, fasting plasma insulin, and body mass index, both separately and together (P = 0.032). The RA I/M was correlated with hs-CRP, and both were correlated with the analyzed cardiovascular risk factors. Receiver operating curve c-values for RA I/M (0.86) and hs-CRP (0.90) strongly indicated correct placement in the obese or non-obese group. Conclusions: Adolescents with obesity had significantly more extensive vascular aging in the muscular RA, than normal-weight peers. The findings support an inflammatory link between obesity and vascular aging in adolescents. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate whether human immunodeficiency virus (HIV) infection affects carotid and brachial artery wall thickness and whether measurement of this thickness contributes to traditional cardiovascular risk scoring in individuals living with HIV., Materials and Methods: The patient group included people living with HIV who were followed up in the infectious disease clinic, and the control group included patients without HIV. In both groups, carotid artery intima-media thickness (cIMT) was measured with B-mode ultrasonography (B-USG). cIMT 0.9 mm and above was considered subclinical atherosclerosis., Results: The patient group consisted of 66, and the control group consisted of 40 participants. The median cIMT of the patient and control groups was 0.92 (0.45-1.45) mm and 0.55 (0.35-1.25) mm, respectively ( p <0.001). Brachial artery IMT was significantly higher in the patient group with 0.45 (0.30-0.76) mm, while it was 0.35 (0.17-0.50) mm in the control group ( p <0.001). Although the difference between the cIMT and brachial artery IMT results of the patient and control groups was significant between 18-59 years of age, this difference disappeared in older ages. In the patient group, subclinical atherosclerosis was detected with cIMT in individuals under 30 years of age for whom FRS (Framingham risk score) could not be calculated and in low-risk groups according to FRS (20% and 62.9%, respectively)., Conclusion: cIMT and brachial artery IMT were found to be significantly higher in people living with HIV. The cIMT measurement seems to be very useful in calculating the CVD risk in individuals living with HIV, especially at young ages, in catching patients who are overlooked by traditional scoring systems., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Objective: The objective of this work was to investigate technical validation and usability of an innovative, technically simple, easy-to-use, and portable integrated system to assess carotid function and structure by ultrasound.Methods: The studied system integrated a hardware (the Interson SP-L01 embedded ultrasound probe [Interson, Pleasanton, CA, USA]) and a software measuring the instantaneous diameter of the carotid artery in real-time from B-mode ultrasound image sequences (Carotid Studio, by Quipu Srl [Pisa, Italy]). Technical validation was evaluated by intra-operator reproducibility of two measurements acquired by an expert operator, and agreement with state-of-the-art technique (Mylab25 by Esaote SpA [Genova, Italy], Carotid Studio 4.3 by Quipu Srl) was evaluated in laboratory settings in 12 healthy volunteers; usability of the portable integrated system was investigated by administering questionnaires to users and the results were reported with scores based on a five-point scale.Results: Twelve (12) healthy volunteers (five men, mean age 44.5±13.6 years, free of cardiovascular disease or risk factors), were recruited. Agreement with state-of-the-art technique was satisfactory, with no significant bias. Coefficient of variation (intra-operator reproducibility) was 3.2% (2.5% SD) for intima-media thickness, 0.9% (0.7% SD) for diameter, and 2.5% (2.2% SD) for distension. Usability questionnaires showed an overall positive judgement of the integrated system with respect to the traditional one, obtaining an average score greater than 4 (on a five-point scale).Conclusions: A portable, innovative prototype to easily assess ultrasound carotid parameters of vascular ageing was successfully designed, developed, and demonstrated to be comparable with state-of-the art technique. Usability was also satisfactory. [ABSTRACT FROM AUTHOR]

Background and Aim: Childhood obesity is one of the most serious public health challenges of the 21st century. Body mass index (BMI), the most widely used marker of body fatness, has serious limitations, particularly in children, since it does not accurately discriminate between lean and fat mass. Aim of our study was to investigate if the estimate of fat mass, as derived by a new prediction model, was associated with carotid intima media thickness (IMT) and the cross-sectional area of the intima media complex (CSA-IMC) in overweight or obese children.Methods and Results: As many as 375 overweight/obese Italian children, 54.7% males, aged 5-15 years, admitted to a tertiary care hospital, were consecutively enrolled in a study on cardiovascular markers of atherosclerosis. All children underwent an ultrasound carotid examination. Mean weight was 62.2 ± 20.8 Kg and fat-mass was 26.2 ± 10.7 Kg. Multiple regression analyses showed a significant association of fat mass with carotid IMT (β 0.156, p 0.01) and CSA-IMC (β 0.216, p < 0.001); these associations remained significant after controlling for the main cardiovascular risk factors (age, sex, blood pressure, HOMA-index, triglycerides, LDL-cholesterol, HDL-cholesterol, birth weight and high-sensitivity C-reactive protein).Conclusion: Fat mass calculated with the new formula is independently associated with subclinical atherosclerosis in overweight/obese children. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a chronic multifactorial disease characterized by mainly changes of blood lipids profile and inflammation in vessel wall. The cardiovascular disease based on atherosclerosis is currently the leading cause of mortality in developed countries. Therefore, timely prevention and therapy of atherosclerosis are able to reduce the risk of the development of its clinical manifestations. Anti-atherosclerotic activity of medicinal plants mainly appears in their multiple effects such as anti-inflammatory, antioxidant, anti-atherogenic, hypotensive, lipid-lowering, anti-thrombotic. Moreover, most of medicinal plants are characterized by their pleiotropic anti-atherosclerotic action. In addition, the medicinal plants-derived pharmacological substances and/or compounds are characterized by relative safety and fewer side effects that allows considering them as one of potential anti-atherosclerotic effective agents. The direct anti-atherosclerotic effect of some medicinal plants was confirmed in clinical trials of carotid Intima-media thickness (IMT) progression during long-term medication with medicinal plants. This review attempted to determine the current status of the databases PubMed and Scopus (until November, 2019) to investigate the medicinal plants possessing anti-atherosclerotic activity in experimental and clinical studies.

Objective: Moderately elevated level of thyroid-stimulating hormone accompanied by normal serum concentrations of free thyroxine, suggesting subclinical hypothyroidism, is the most common hormonal abnormality in obese children. Controversy remains, whether a thyroid dysfunction related to obesity has an influence on the cardiovascular risk factors. The aim of the study was to assess correlation between thyroid-stimulating hormone and free thyroxine and chosen atherogenic lipid indicators, and carotid intima media thickness in obese children and adolescents. Methods: A study group consisted of 110 obese children (11.5 ± 2.9 years) and 38 healthy children (13.4 ± 2.6 years). Obesity was defined using International Obesity Task Force criteria. In each patient anthropometric measurements, thyroid-stimulating hormone, free thyroxine, a lipid profile were evaluated. Carotid intima-media thickness was measured in 74 obese children and 28 lean children. The resulting data were used to calculate indicators of atherogenesis: total cholesterol to HDL cholesterol ratio; triglycerides to HDL cholesterol ratio and LDL cholesterol to HDL cholesterol ratio. Results: Obese children had higher mean serum thyroid-stimulating hormone levels compared to their lean peers and an adverse atherogenic lipid profile. Serum free thyroxine concentrations were comparable between the groups. Serum thyroid-stimulating hormone values correlated with total cholesterol to HDL cholesterol ratio; triglycerides to HDL cholesterol ratio, LDL cholesterol to HDL cholesterol ratio, and intima-media thickness. In a multivariate regression analysis, thyroid-stimulating hormone weakly correlated only with intima-media thickness after adjustment for age, gender and Body Mass Index (β = 0.249, p = 0.04). This relationship weakened after considering a lipid profile (β = 0.242, p = 0.058). No relationship was found for free thyroxine. Conclusion: Serum level of thyroid-stimulating hormone in obese children did not seem to impact atherogenic lipid indicators and carotid intima-media thickness. Therefore, an adverse lipid profile should still be considered the main risk factor for development of cardiovascular diseases in obese children.

Background and aims: Chemerin is an adipokine with an emerging role in the crosstalk between adipose tissue and immune system. It is overexpressed in severe obesity, affects adipogenesis and glucose homeostasis and it correlates with early vascular damage. The aim of this study is to investigate the correlation between circulating levels of chemerin and early vascular damage in subjects with severe obesity, before and after laparoscopic sleeve gastrectomy (LSG). Methods: Fifty‐six obese subjects eligible for LSG were enrolled in the study. The following parameters were evaluated: body mass index (BMI), glycemia, insulinemia, glycated haemoglobin, lipid profile, plasma chemerin levels and carotid intima‐media thickness (cIMT). Fifty‐four subjects were evaluated 1 year after the intervention. Results: Univariate analysis showed a direct and significant correlation between chemerin and waist circumference, insulin resistance, glycated haemoglobin and cIMT. Chemerin was a better predictor of intima‐media thickening than waist circumference and glycated haemoglobin at the ROC curve analysis, with a cut‐off value for chemerin of 140 ng/mL. The reduction of chemerin is independently associated with the reduction of cIMT and the improvement of insulin sensitivity after LSG. Conclusion: Chemerin is involved in the development and progression of early vascular damage and insulin resistance in subjects with severe obesity, and in their healing after bariatric surgery. Chemerin could also have a role in the assessment of cardiovascular risk in subjects with severe obesity. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a chronic multifactorial disease characterized by mainly changes of blood lipids profile and inflammation in vessel wall. The cardiovascular disease based on atherosclerosis is currently the leading cause of mortality in developed countries. Therefore, timely prevention and therapy of atherosclerosis are able to reduce the risk of the development of its clinical manifestations. Anti-atherosclerotic activity of medicinal plants mainly appears in their multiple effects such as anti-inflammatory, antioxidant, anti-atherogenic, hypotensive, lipid-lowering, anti-thrombotic. Moreover, most of medicinal plants are characterized by their pleiotropic anti-atherosclerotic action. In addition, the medicinal plants-derived pharmacological substances and/or compounds are characterized by relative safety and fewer side effects that allows considering them as one of potential anti-atherosclerotic effective agents. The direct anti-atherosclerotic effect of some medicinal plants was confirmed in clinical trials of carotid Intima-media thickness (IMT) progression during long-term medication with medicinal plants. This review attempted to determine the current status of the databases PubMed and Scopus (until November, 2019) to investigate the medicinal plants possessing anti-atherosclerotic activity in experimental and clinical studies. [ABSTRACT FROM AUTHOR]

Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant. [ABSTRACT FROM AUTHOR]

Abstract Background Mean or maximal intima-media thickness (IMT) is commonly used as surrogate endpoint in intervention studies. However, the effect of normalization by surrounding or median IMT or by diameter is unknown. In addition, it is unclear whether IMT inhomogeneity is a useful predictor beyond common wall parameters like maximal wall thickness, either absolute or normalized to IMT or lumen size. We investigated the interrelationship of common carotid artery (CCA) thickness parameters and their association with the ipsilateral internal carotid artery (ICA) stenosis degree. Methods CCA thickness parameters were extracted by edge detection applied to ultrasound B-mode recordings of 240 patients. Degree of ICA stenosis was determined from CT angiography. Results Normalization of maximal CCA wall thickness to median IMT leads to large variations. Higher CCA thickness parameter values are associated with a higher degree of ipsilateral ICA stenosis (p 50%), 55 arteries (15%) are reclassified to another risk category. Conclusions It is more reasonable to normalize maximal wall thickness to end-diastolic diameter rather than to IMT, affecting risk classification and suggesting modification of the Mannheim criteria. Trial registration Clinical trials.gov NCT01208025 .

Introduction: This study aims to investigate how image settings affect carotid Intima-Media-Thickness (IMT) and diameter estimation performed with Carotid Studio (Quipu-Srl). Methods: Fourteen healthy volunteers (24.4 ± 4.4 years; eight men) were recruited. Longitudinal scans 3-cm-deep of common-carotid-arteries with the same region-of-interest were obtained by expert operator, starting from a “default-setup” (central Time Gain Compensation-TGC; gain: 50 dB; no persistence filter) and adjusting one parameter at a time (oblique TGC; gain: 10 dB increments from 30 to 70 dB; persistence filter). The acquisition was performed twice, and repeatability was expressed for each setup as Coefficient of Variation (CV). Significant changes (p ≤ 0.05) compared with the “default-setup” were analysed by Wilcoxon signed-rank-test. Results: Sixty and 70 dB gain resulted in overestimating IMT (from 0.460 ± 0.001 to 0.506 ± 0.030 mm and 0.538 ± 0.011 mm, p = 0.002 and 0.023 respectively vs. default-50 dB), underestimating the mean diameter (from 6.044 ± 0.040 mm to 5.763 ± 0.004 mm, p = 0.008 and to 5.698 ± 0.225 mm, p = 0.002), and for 70 dB, increasing IMT CV from 2.14 ± 1.92% to 6.85 ± 5.23% (p = 0.01) and diameter CV from 1.79 ± 1.22% to 4.77 ± 4.71% (p = 0.05). Distension CV increased from 5.71 ± 4.31% to 10.84 ± 5.91% (p = 0.041) and to 12.59 ± 7.97% (p = 0.021) for 60 and 70 dB respectively. Persistence and TGC did not affect repeatability, whereas diameter (5.955 ± 0.033 mm, p = 0.005) and distension (from 0.816 ± 0.019 mm to 0.655 ± 0.018 mm, p = 0.002) values were underestimated when persistence filter was active. Discussion: Precision and reproducibility of carotid parameters, automatically assessed by Carotid Studio, are affected by high gain levels, due to image grey-level saturation. Persistence filter activation leads to underestimate diameter and distension, possibly due to mathematical operator behaviour and image temporal filtering. Since ultrasound setup significantly affects carotid parameter assessment, it should be reported and replicated in follow-up scans. HIGHLIGHTS •We investigated how ultrasound imaging setup may affect carotid parameters. •Carotid parameters’ reproducibility was lower with high-gain values. •Persistence filter leads to underestimation of diameter and distension. •The scan projection seems to influence carotid parameter estimation. •Image depth should be kept at the lowest attainable value for best repeatability.

Introduction: This study aims to investigate how image settings affect carotid Intima-Media-Thickness (IMT) and diameter estimation performed with Carotid Studio (Quipu-Srl). Methods: Fourteen healthy volunteers (24.4 ± 4.4 years; eight men) were recruited. Longitudinal scans 3-cm-deep of common-carotid-arteries with the same region-of-interest were obtained by expert operator, starting from a "default-setup" (central Time Gain Compensation-TGC; gain: 50 dB; no persistence filter) and adjusting one parameter at a time (oblique TGC; gain: 10 dB increments from 30 to 70 dB; persistence filter). The acquisition was performed twice, and repeatability was expressed for each setup as Coefficient of Variation (CV). Significant changes (p ≤ 0.05) compared with the "default-setup" were analysed by Wilcoxon signed-rank-test. Results: Sixty and 70 dB gain resulted in overestimating IMT (from 0.460 ± 0.001 to 0.506 ± 0.030 mm and 0.538 ± 0.011 mm, p = 0.002 and 0.023 respectively vs. default-50 dB), underestimating the mean diameter (from 6.044 ± 0.040 mm to 5.763 ± 0.004 mm, p = 0.008 and to 5.698 ± 0.225 mm, p = 0.002), and for 70 dB, increasing IMT CV from 2.14 ± 1.92% to 6.85 ± 5.23% (p = 0.01) and diameter CV from 1.79 ± 1.22% to 4.77 ± 4.71% (p = 0.05). Distension CV increased from 5.71 ± 4.31% to 10.84 ± 5.91% (p = 0.041) and to 12.59 ± 7.97% (p = 0.021) for 60 and 70 dB respectively. Persistence and TGC did not affect repeatability, whereas diameter (5.955 ± 0.033 mm, p = 0.005) and distension (from 0.816 ± 0.019 mm to 0.655 ± 0.018 mm, p = 0.002) values were underestimated when persistence filter was active. Discussion: Precision and reproducibility of carotid parameters, automatically assessed by Carotid Studio, are affected by high gain levels, due to image grey-level saturation. Persistence filter activation leads to underestimate diameter and distension, possibly due to mathematical operator behaviour and image temporal filtering. Since ultrasound setup significantly affects carotid parameter assessment, it should be reported and replicated in follow-up scans. Highlights: We investigated how ultrasound imaging setup may affect carotid parameters. Carotid parameters' reproducibility was lower with high-gain values. Persistence filter leads to underestimation of diameter and distension. The scan projection seems to influence carotid parameter estimation. Image depth should be kept at the lowest attainable value for best repeatability. [ABSTRACT FROM AUTHOR]

Antiplatelet drugs are effective in preventing recurrence of atherosclerosis in type 2 diabetes (T2D) patients. However, the efficacy and usefulness of antiplatelet drugs on the progression of carotid intima-media thickness (IMT), a marker for evaluating early atherosclerotic vascular disease, has not been analyzed. We conducted a prospective, randomized, open, 36-month trial comparing cilostazol vs. aspirin. A total of 415 T2D patients (age range 38–83 years; 206 females) without macrovascular complications were randomized to either an aspirin (100 mg/day) or cilostazol (200 mg/day) treatment. Patients underwent B-mode ultrasonography annually to assess the IMT and serum levels of inflammatory markers were measured before and after each treatment. Potential confounders were statistically adjusted, and included lipid profiles, HbA1c, body mass index, waist circumference, anti-hypertensive and statin medications. The decrease in mean left, maximum left, mean right and maximum right IMT were significantly greater with cilostazol compared with aspirin (− 0.094 ± 0.186 mm vs. 0.006 ± 0.220 mm, p < 0.001; − 0.080 ± 0.214 mm vs. 0.040 ± 0.264 mm, p < 0.001; − 0.064 ± 0.183 mm vs. 0.004 ± 0.203 mm, p = 0.015; − 0.058 ± 0.225 mm vs. 0.023 ± 0.248 mm, p = 0.022, respectively). And these differences remained significant after adjustment of potential confounders. Compared with aspirin, cilostazol treatment was associated with significantly increased HDL cholesterol (p = 0.039) and 25-hydroxy vitamin D levels (p = 0.001). Cilostazol treatment was associated with significantly lowered IMT in T2D patients compared to aspirin, independent of conventional cardiovascular risk factors. Cilostazol may inhibit plaque formation and have beneficial effects on atherosclerosis through vasodilatory and antiplatelet effects. [ABSTRACT FROM AUTHOR]

Objective: Moderately elevated level of thyroid-stimulating hormone accompanied by normal serum concentrations of free thyroxine, suggesting subclinical hypothyroidism, is the most common hormonal abnormality in obese children. Controversy remains, whether a thyroid dysfunction related to obesity has an influence on the cardiovascular risk factors. The aim of the study was to assess correlation between thyroid-stimulating hormone and free thyroxine and chosen atherogenic lipid indicators, and carotid intima media thickness in obese children and adolescents. Methods: A study group consisted of 110 obese children (11.5 ± 2.9 years) and 38 healthy children (13.4 ± 2.6 years). Obesity was defined using International Obesity Task Force criteria. In each patient anthropometric measurements, thyroid-stimulating hormone, free thyroxine, a lipid profile were evaluated. Carotid intima-media thickness was measured in 74 obese children and 28 lean children. The resulting data were used to calculate indicators of atherogenesis: total cholesterol to HDL cholesterol ratio; triglycerides to HDL cholesterol ratio and LDL cholesterol to HDL cholesterol ratio. Results: Obese children had higher mean serum thyroid-stimulating hormone levels compared to their lean peers and an adverse atherogenic lipid profile. Serum free thyroxine concentrations were comparable between the groups. Serum thyroid-stimulating hormone values correlated with total cholesterol to HDL cholesterol ratio; triglycerides to HDL cholesterol ratio, LDL cholesterol to HDL cholesterol ratio, and intima-media thickness. In a multivariate regression analysis, thyroid-stimulating hormone weakly correlated only with intima-media thickness after adjustment for age, gender and Body Mass Index (ß = 0.249, p = 0.04). This relationship weakened after considering a lipid profile (ß = 0.242, p = 0.058). No relationship was found for free thyroxine. Conclusion: Serum level of thyroid-stimulating hormone in obese children did not seem to impact atherogenic lipid indicators and carotid intima-media thickness. Therefore, an adverse lipid profile should still be considered the main risk factor for development of cardiovascular diseases in obese children. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) constitutes a major public health care problem in Thailand and worldwide. Many complications can occur, especially atherosclerotic change in the vessels leading to coronary, cerebrovascular and peripheral arterial disease. Objective: Using B-mode ultrasound (US), to study the carotid intima media thickness (IMT) and carotid plaque in patients with type 2 DM without cardiovascular disease, and to identify the factors that are related to plaque formation. Material and Method: This was a prospective cross-sectional study, conducted in Rajavithi Hospital between September 2016 and February 2017, of 150 patients with type 2 DM who had no history of symptomatic coronary, cerebrovascular or peripheral arterial disease. Measurement of carotid IMT and carotid plaque was performed by a single radiologist. Results: There were 150 patients, 68.7% of whom were women and 31.3% men, and their mean age was 66 years (48 to 79 years old). Mean carotid IMT of the right and left common carotid artery were 0.79±0.26 mm and 0.83±0.28 mm, respectively. Plaque levels at the right and left carotid bulb were 1.46±0.69 mm and 1.37±0.61 mm respectively, while plaque levels at the right and left internal carotid artery were 1.24±2.88 mm and 1.03±0.45 mm, respectively. A total of 87.3% of subjects were associated with hypertension and 96.0% with dyslipidemia during medical treatment. A rate of less than 50% carotid stenosis was found in 26.7% of the patients, while those with more than 50.0% carotid stenosis accounted for 10.0%. There was no gender-related difference in carotid plaque formation in this study. The rate of positive carotid plaque was associated with the duration of DM (p-value = 0.004), and serum triglyceride levels (p-value = 0.004). Multivariate regression analysis indicated that significant carotid plaque was associated with receiving ACEI/ARB for treatment of hypertension (p-value = 0.029). Conclusion: Carotid atherosclerosis was found in 36.7% of cases. Most of the patients in the present study were normal or had no significant carotid atherosclerosis. There were varying degrees of vessel stenosis ranging between less than 50.0% stenosis and 50.0 to 70.0%. Ten percent of patients had more than 50.0% stenosis and received aspirin to prevent future vascular events. [ABSTRACT FROM AUTHOR]

Background: In Bangladesh, CVD accounts for the majority of non-communicable mortality. The purpose of this study was to determine the role of socioeconomic status (SES) on subclinical atherosclerosis measured as carotid intima-media thickness (IMT) in a rural Bangladesh population.Methods: Carotid IMT was measured between 2010 and 2011 in 1022 participants (average age 46, 40% male) randomly selected from the Health Effects of Arsenic Longitudinal Study (HEALS), a population-based prospective cohort study based in rural Bangladesh. SES was measured as occupation type, land ownership, educational attainment, and television ownership.Results: Half of the participants received formal education (53%) and under half owned land (48%) and a television (44%). Women were primarily homemakers (95%) and men worked as factory workers (24%), laborers (18%), or in business (55%). In univariate analysis, those owning greater than one acre of land (p=0.03), owning a television (p=0.02), or laborers and business owners compared to factory workers had higher levels of carotid IMT (p<0.01). In multivariate analysis after adjustment for confounders, only men employed in the business sector had elevated carotid IMT compared to factory workers. The association was strongest in older men (58.7μm, 95% CI 17.2-100.0, ≥50years old) compared to younger men (13.7μm, 95% CI -7.8-35.2, <50years old).Conclusion: Business sector employment was positively associated with subclinical atherosclerosis after adjustment for confounders. This finding is consistent with evidence from other developing nations suggesting that certain SES factors are independent predictors of CVD. [ABSTRACT FROM AUTHOR]

Background: Mean or maximal intima-media thickness (IMT) is commonly used as surrogate endpoint in intervention studies. However, the effect of normalization by surrounding or median IMT or by diameter is unknown. In addition, it is unclear whether IMT inhomogeneity is a useful predictor beyond common wall parameters like maximal wall thickness, either absolute or normalized to IMT or lumen size. We investigated the interrelationship of common carotid artery (CCA) thickness parameters and their association with the ipsilateral internal carotid artery (ICA) stenosis degree.Methods: CCA thickness parameters were extracted by edge detection applied to ultrasound B-mode recordings of 240 patients. Degree of ICA stenosis was determined from CT angiography.Results: Normalization of maximal CCA wall thickness to median IMT leads to large variations. Higher CCA thickness parameter values are associated with a higher degree of ipsilateral ICA stenosis (p < 0.001), though IMT inhomogeneity does not provide extra information. When the ratio of wall thickness and diameter instead of absolute maximal wall thickness is used as risk marker for having moderate ipsilateral ICA stenosis (>50%), 55 arteries (15%) are reclassified to another risk category.Conclusions: It is more reasonable to normalize maximal wall thickness to end-diastolic diameter rather than to IMT, affecting risk classification and suggesting modification of the Mannheim criteria.Trial Registration: Clinical trials.gov NCT01208025 . [ABSTRACT FROM AUTHOR]

Background: Some patients experience statin-induced side effects or prefer nutraceutical approaches for the treatment of dyslipidemia. This has led to a search for alternative therapeutic approaches for dyslipidemia management. In recent studies Citrus bergamia (known as Bergamot) juice was able to reduce serum levels of lipids. Such benefit may be attributed to high amounts of flavonoids contained in Bergamot fruit juice (neoeriocitrin, neohesperidin, naringin). The aim of the present study was to fully investigate the effects of a Bergamot extract on cardio-metabolic parameters, including plasma lipids, atherogenic lipoproteins and subclinical atherosclerosis. Methods: Eighty subjects (42 men and 38 women, mean age: 55±13 years) with moderate hypercholesterolemia (e.g., with plasma LDL-cholesterol concentrations between 160 and 190 mg/dl [between 4.1 and 4.9 mmol/l]) were included. A Bergamot-derived extract (Bergavit®) was given at a fixed dose daily (150 mg of flavonoids, with 16% of neoeriocitrin, 47% of neohesperidin and 37% of naringin) for 6 months. Lipoprotein subfractions were assessed by gel electrophoresis. With this methodology low density lipoprotein (LDL) subclasses are distributed as seven bands (LDL-1 and -2 as large LDL, and LDL-3 to -7 as atherogenic small, dense LDL). Subclinical atherosclerosis was assessed by carotid intima-media thickness (cIMT) using B-mode ultrasound. Results: After 6 months, Bergavit® reduced total cholesterol (from 6.6±0.4 to 5.8±1.1 mmol/l, p

Background and aims Evidence suggests that combining 1-hour plasma glucose ≥155 mg/dl during an oral glucose tolerance test (OGTT) with glycosylated hemoglobin (HbA1c) significantly increases their predictive power for incident diabetes, while their individual and joint associations with cardio-metabolic risk factors remain undefined. Herein, we evaluated whether 1-hour post-load plasma glucose ≥155 mg/dl combined with HbA1c may identify pre-diabetic individuals with a higher cardio-metabolic risk. Methods Anthropometric and metabolic characteristics, insulin sensitivity and insulin secretion assessed by OGTT-derived indexes, carotid intima-media thickness (IMT), pulse pressure, and rate pressure product were evaluated in 1495 individuals. Results As compared with subjects with 1-hour post-load glucose <155 mg/dl, individuals with 1-hour post-load glucose ≥155 mg/dl exhibited a significantly worse cardio metabolic profile, both in the group with HbA1c <5.7%, and in the group with prediabetes (HbA1c 5.7–6.4%). Specifically, in both groups, subjects with 1-hour post-load glucose ≥155 mg/dl had higher fasting and 2-h post-load glucose ( p < 0.0001 for all in both groups), higher HOMA-IR ( p < 0.0001 in both groups), and carotid IMT ( p = 0.05 in the group with HbA1c <5.7% and p = 0.03 in the group HbA1c 5.7–6.4%), as well as lower Matsuda index, insulinogenic index and disposition index ( p < 0.0001 in both groups), and lower insulin-stimulated glucose disposal ( p < 0.0001 in the group with HbA1c <5.7% and p = 0.03 in the group HbA1c 5.7–6.4%). Conclusions Hyperglycemia at 1-hour during an OGTT may be a useful tool to identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of developing type 2 diabetes and cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background and objective Percutaneous coronary interventional procedures need advance planning prior to stenting or an endarterectomy. Cardiologists use intravascular ultrasound (IVUS) for screening, risk assessment and stratification of coronary artery disease (CAD). We hypothesize that plaque components are vulnerable to rupture due to plaque progression. Currently, there are no standard grayscale IVUS tools for risk assessment of plaque rupture. This paper presents a novel strategy for risk stratification based on plaque morphology embedded with principal component analysis (PCA) for plaque feature dimensionality reduction and dominant feature selection technique. The risk assessment utilizes 56 grayscale coronary features in a machine learning framework while linking information from carotid and coronary plaque burdens due to their common genetic makeup. Method This system consists of a machine learning paradigm which uses a support vector machine (SVM) combined with PCA for optimal and dominant coronary artery morphological feature extraction. Carotid artery proven intima-media thickness (cIMT) biomarker is adapted as a gold standard during the training phase of the machine learning system. For the performance evaluation, K -fold cross validation protocol is adapted with 20 trials per fold. For choosing the dominant features out of the 56 grayscale features, a polling strategy of PCA is adapted where the original value of the features is unaltered. Different protocols are designed for establishing the stability and reliability criteria of the coronary risk assessment system (cRAS). Results Using the PCA-based machine learning paradigm and cross-validation protocol, a classification accuracy of 98.43% (AUC 0.98) with K = 10 folds using an SVM radial basis function (RBF) kernel was achieved. A reliability index of 97.32% and machine learning stability criteria of 5% were met for the cRAS. Conclusions This is the first Computer aided design (CADx) system of its kind that is able to demonstrate the ability of coronary risk assessment and stratification while demonstrating a successful design of the machine learning system based on our assumptions. [ABSTRACT FROM AUTHOR]

Background: Some patients experience statin-induced side effects or prefer nutraceutical approaches for the treatment of dyslipidemia. This has led to a search for alternative therapeutic approaches for dyslipidemia management. In recent studies Citrus bergamia (known as Bergamot) juice was able to reduce serum levels of lipids. Such benefit may be attributed to high amounts of flavonoids contained in Bergamot fruit juice (neoeriocitrin, neohesperidin, naringin). The aim of the present study was to fully investigate the effects of a Bergamot extract on cardio-metabolic parameters, including plasma lipids, atherogenic lipoproteins and subclinical atherosclerosis. Methods: Eighty subjects (42 men and 38 women, mean age: 55 ± 13 years) with moderate hypercholesterolemia [e.g., with plasma LDL-cholesterol concentrations between 160 and 190 mg/dl (between 4.1 and 4.9 mmol/l)] were included. A Bergamotderived extract (BergavitR) was given at a fixed dose daily (150 mg of flavonoids, with 16% of neoeriocitrin, 47% of neohesperidin and 37% of naringin) for 6 months. Lipoprotein subfractions were assessed by gel electrophoresis. With this methodology low density lipoprotein (LDL) subclasses are distributed as seven bands (LDL-1 and -2 as large LDL, and LDL-3 to -7 as atherogenic small, dense LDL). Subclinical atherosclerosis was assessed by carotid intima-media thickness (cIMT) using B-mode ultrasound. Results: After 6 months, BergavitR reduced total cholesterol (from 6.6 ± 0.4 to 5.8 ± 1.1 mmol/l, p < 0.0001), triglycerides (from 1.8 ± 0.6 to 1.5 ± 0.9 mmol/l, p = 0.0020), and LDL-cholesterol (from 4.6 ± 0.2 to 3.7 ± 1.0 mmol/l, p < 0.0001), while HDL- cholesterol increased (from 1.3 ± 0.2 to 1.4 ± 0.4 mmol/l, p < 0.0007). In addition, a significant increase in LDL-1 (from 41.2 ± 0.2 to 49.6 ± 0.2%, p < 0.0001) was accompanied by decreased small, dense LDL-3, -4, and 5 particles (from 14.5 ± 0.1 to 9.0 ± 0.1% p < 0.0001; 3.2 ± 0.1 to 1.5 ± 0.1% p = 0.0053; 0.3 ± 0.0% to 0.1 ± 0.0% p = 0.0133, respectively). cIMT also decreased from 1.2 ± 0.4 to 0.9 ± 0.1 mm (p < 0.0001). Conclusion: This is the first study investigating the effects of Bergamot flavonoids supplementation on cardio-metabolic risk in dyslipidemic subjects. BergavitR (Bergamot juice extract) supplementation significantly reduced plasma lipids and improved the lipoprotein profile. cIMT was also reduced significantly over a relatively short time frame of 6 months. [ABSTRACT FROM AUTHOR]

Background The origins of sex differences in cardiovascular diseases are not well understood. We examined the contribution of childhood risk factors to sex differences in adult carotid artery plaques and intima-media thickness (carotid IMT). Methods and Results Children in the 1985 Australian Schools Health and Fitness Survey were followed up when they were aged 36 to 49 years (2014-19, n=1085-1281). Log binomial and linear regression examined sex differences in adult carotid plaques (n=1089) or carotid IMT (n=1283). Childhood sociodemographic, psychosocial, and biomedical risk factors that might contribute to sex differences in carotid IMT/plaques were examined using purposeful model building with additional adjustment for equivalent adult risk factors in sensitivity analyses. Women less often had carotid plaques (10%) than men (17%). The sex difference in the prevalence of plaques (relative risk [RR] unadjusted 0.59 [95% CI, 0.43 to 0.80]) was reduced by adjustment for childhood school achievement and systolic blood pressure (RR adjusted 0.65 [95% CI, 0.47 to 0.90]). Additional adjustment for adult education and systolic blood pressure further reduced sex difference (RR adjusted 0.72 [95% CI, 0.49 to 1.06]). Women (mean±SD 0.61±0.07) had thinner carotid IMT than men (mean±SD 0.66±0.09). The sex difference in carotid IMT (β unadjusted -0.051 [95% CI, -0.061 to -0.042]) reduced with adjustment for childhood waist circumference and systolic blood pressure (β adjusted -0.047 [95% CI, -0.057 to -0.037]) and further reduced with adjustment for adult waist circumference and systolic blood pressure (β adjusted -0.034 [95% CI, -0.048 to -0.019]). Conclusions Some childhood factors contributed to adult sex differences in plaques and carotid IMT. Prevention strategies across the life course are important to reduce adult sex differences in cardiovascular diseases.

In order to assess the progression of carotid-artery disease in type 2 diabetic cohort (n=207 patients), the dynamic change in carotid intima-media thickness (CIMT) and the occurrence of plaques were followed for a period of 31.35±10.59 months. The mean CIMT at the beginning of the study was 0.9178±0.1447 mm, with a maximal value of 1.1210±0.2366 mm. The maximal value of CIMT changed by 0.07 mm/year. Progression of CIMT was noted in 86.8% and its regression in 7.8% of patients. The occurrence of carotid plaques was detected in 41.8% of patients. Multiple regression analysis revealed the maximal value of CIMT to be associated with diastolic blood pressure, despite mean CIMT being predicted by body mass index. The presence of peripheral arterial disease and hypo-high-density lipoproteinemia were found to be predictors for the occurrence of carotid plaques. Our data have clinical implications in predicting risk factors for the progression of carotid-artery disease in type 2 diabetic patients for their appropriate management. [ABSTRACT FROM AUTHOR]

Lifestyle risk factors, inflammation and genetics play a role in the development of atherosclerosis. We therefore studied Fc gamma receptor (FcγR) polymorphisms, interleukin (IL)-10 polymorphisms and other biomarkers related to carotid intima-media thickness (cIMT) in patients with ischemic stroke at a young age. Patients were evaluated 12 years after stroke occurrence. Patients ( n = 232) 49 years of age or younger with an index stroke between 1988 and 1997 were retrospectively selected. Blood samples were taken at a first follow-up 6 years after the stroke. At a second follow-up, additional arterial events were registered for 140 patients, new blood samples were taken, and measurements of cIMT and blood pressure (BP) were performed. Unadjusted logistic regression analysis showed that cIMT ≥1 mm was associated with age, male gender, additional arterial events, BP, cholesterol, sedimentation rate, haemoglobin, triglycerides, creatinine, glycolysed haemoglobin (HbA1c) and FcγRIIIB-NaII/NaII. Adjusted backward stepwise logistic regression showed significance for age (odds ratio (OR) 1.13, 95 % confidence interval (CI) 1.04 to1.23, p = 0.003), male gender (OR 4.07, 95 % CI 1.15 to 14.5, p = 0.030), HbA1c (OR 6.65, 95 % CI 1.21 to 36.5, p = 0.029) and FcγRIIIB-NaII/NaII (OR 3.94, 95 % CI 1.08 to 14.3, p = 0.037). In this long-term follow-up study of patients with ischemic stroke at a young age, FcγRIIIB-NaII/NaII was identified as a possible contributing factor for cIMT ≥1 mm together with known risk factors, such as age, male gender, systolic BP, additional arterial events and HbA1c. [ABSTRACT FROM AUTHOR]

Background The role of atherosclerosis in the progression of global left ventricular dysfunction and cardiovascular events has been well recognized. Left ventricular (LV) dyssynchrony is a measure of regional myocardial dysfunction. Our objective was to investigate the relationship of subclinical atherosclerosis with mechanical LV dyssynchrony in a population-based asymptomatic multi-ethnic cohort. Methods and Results Participants of the Multi-Ethnic Study of Atherosclerosis (MESA) at exam 5 were evaluated using 1.5T cardiac magnetic resonance (CMR) imaging, carotid ultrasound (n = 2062) for common carotid artery (CCA) and internal carotid artery (ICA) intima-media thickness (IMT), and cardiac computed tomography (n = 2039) for coronary artery calcium (CAC) assessment (Agatston method). Dyssynchrony indices were defined as the standard deviation of time to peak systolic circumferential strain (SD-TPS) and the difference between maximum and minimum (max-min) time to peak strain using harmonic phase imaging in 12 segments (3-slices × 4 segments). Multivariable regression analyses were performed to assess associations after adjusting for participant demographics, cardiovascular risk factors, LV mass, and ejection fraction. In multivariable analyses, SD-TPS was significantly related to measures of atherosclerosis, including CCA-IMT (8.7 ms/mm change in IMT, p = 0.020), ICA-IMT (19.2 ms/mm change in IMT, p < 0.001), carotid plaque score (1.2 ms/unit change in score, p < 0.001), and log transformed CAC+1 (0.66 ms/unit log-CAC+1, p = 0.018). These findings were consistent with other parameter of LV dyssynchrony i.e. max–min. Conclusion In the MESA cohort, measures of atherosclerosis are associated with parameters of subclinical LV dyssynchrony in the absence of clinical coronary event and left-bundle-branch block. [ABSTRACT FROM AUTHOR]

The article presents the results of a study which looked at the lifestyle factors associated with mean carotid intima media thickness (IMT), a predictor for future cardiovascular risk (CVD). Topics mentioned include cardiovascular disease as a leading cause of morbidity and mortality globally, the use of carotid IMT measurements as a noninvasive technique for measuring artherosclerotic plaque burden, and carotid IMT as a predictor for future CVD event risk.

Background : Psoriasis is an immune-mediated inflammatory skin condition of unknown aetiology which usually requires life-long treatment. It is regarded a systemic inflammatory disease with a possible increased risk of cardiovascular disease. The aim of this study was to assess carotid intima-media thickness (IMT), plaque prevalence and carotid stenosis as surrogate measures for cardiovascular disease in psoriasis patients and healthy controls. Methods : Sixty-two patients with psoriasis and thirty-one healthy controls were included in the study. All were examined by Colour duplex ultrasound of the carotid arteries to compare carotid IMT values, carotid plaques and carotid stenosis in the two groups. Adjustments were made for traditional cardiovascular risk factors. Results : Patients with psoriasis had increased carotid IMT values compared to the controls: mean ± SD 0.71 ± 0.17 mm vs. 0.59 ± 0.08 mm; p = 0.001. When adjusted for known atherosclerotic risk factors this difference remained significant ( p = 0.04). Carotid plaques were also more common ( p = 0.03) in patients with psoriasis 13 (21%) compared to controls 1 (3%). There was no difference with regard to the number of carotid stenoses in patients and controls. Conclusion : The results of this study support previous evidence which suggests that psoriasis is associated with an increased risk for atherosclerosis and subsequent cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background Intima-media thickness (IMT) of the common carotid artery is a surrogate end point of cardiovascular disease (CVD). Identifying the factors associated with a higher IMT may contribute to the identification of subjects with higher CVD risk. Our objective was to compare the common carotid IMT of type 1 diabetes patients to healthy control subjects. The secondary objective was to determine factors associated with a higher carotid IMT. Methods We conducted a cross-sectional study between March 2009 and October 2013, comprising 127 type 1 diabetes patients and 125 control subjects matched by age, gender and body mass index (BMI). Carotid IMT was measured using semi-automated edge detection software. Results Type 1 diabetes patients had a higher median IMT compared with control subjects (0.538, IQR: 0.500-0.607 vs 0.513 mm; IQR: 0.481-0.557, respectively p = 0.001). Women with type 1 diabetes had a higher median IMT difference compared to the control group (0.537, IQR: 0.495-0.596 vs 0.502 mm, IQR: 0.472-0.543, respectively p = 0.003) than did men with type 1 diabetes (0.547, IQR: 0.504-0.613 vs 0.528 mm, IQR: 0.492-0.575, respectively p = 0.2). Age and diabetes duration had an additive effect on the IMT of type 1 diabetes patients. Multivariate gamma regression model analysis showed that in type 1 diabetes patients, the IMT was associated with age (Exp (β) = 1.006, p < 0.001), duration of diabetes (Exp (β) = 1.004, p = 0.001), BMI (Exp (β) = 1.005, p = 0.021), family history of type 2 diabetes (Exp (β) = 1.044, p = 0.033), total cholesterol (Exp (β) = 0.999, p = 0.001) and creatinine clearance (Exp (β) = 1.000, p = 0.043). Conclusions Patients with type 1 diabetes have increased IMT, a marker of subclinical atherosclerosis. The CVD risk may be similar between men and women with type 1 diabetes, suggesting a loss of gender protection. Also, CVD risk may be higher in those with a family history of type 2 diabetes. Prospective studies are needed to confirm the predictive value of these findings and the causal effect between IMT and CVD in patients with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Purpose: Women with previous gestational diabetes mellitus (pGDM) are at high risk for type 2 diabetes and cardiovascular disorders. In this study, we aimed to compare plasma apelin levels between women with and without pGDM, and to investigate the possible association of apelin with cardiometabolic risk factors. Methods: Among 252 consecutive Caucasian women with GDM being included in a prospective postpartum follow-up protocol, 141 women eligible for the study protocol were enrolled. Control group consisted of 49 age- and body mass index-matched healthy women without pGDM. Circulating apelin, IL-6 and plasminogen activator inhibitor levels, and carotid intima media thickness (IMT) were measured. To evaluate carbohydrate intolerance, 75-g oral glucose tolerance test was performed. Fasting insulin and lipids were measured, and homeostasis model assessment index was calculated. Results: Plasma apelin levels were reduced in women with pGDM ( p < 0.001). In multiple regression analysis, apelin was negatively associated with fasting ( r 0.090, β −0.273, p = 0.001) and post-load glucose ( r 0.061, β −0.187, p = 0.022), serum IL-6 ( r 0.082, β −0.234, p = 0.002), and carotid IMT ( r 0.057, β −0.168, p = 0.033). Conclusions: Our results suggested that suppressed apelin levels were associated with increased cardiovascular risk in women with pGDM. [ABSTRACT FROM AUTHOR]