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颈动脉内膜中层复合体的回声性与心血管危险因素、血脂异常、氧化应激及炎症相关:乌普萨拉老年人群血管前瞻性研究(PIVUS)

Echogenecity of the carotid intima-media complex is related to cardiovascular risk factors, dyslipidemia, oxidative stress and inflammation: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.

作者信息

Andersson Jessika, Sundström Johan, Gustavsson Thomas, Hulthe Johannes, Elmgren Anders, Zilmer Kersti, Zilmer Mihkel, Lind Lars

机构信息

Department of Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden.

出版信息

Atherosclerosis. 2009 Jun;204(2):612-8. doi: 10.1016/j.atherosclerosis.2008.10.038. Epub 2008 Nov 11.

Abstract

BACKGROUND

Increased carotid artery intima-media thickness (IMT), measured by ultrasound, is related to an increased risk of cardiovascular disease. Since presence of echolucent plaques increases the risk further, we investigated if echogenecity of the carotid intima-media complex is related to markers of cardiovascular risk. Our aim was therefore to investigate if intima-media echogenecity is related to cardiovascular risk factors, or to markers of inflammation and oxidation in an exploratory investigation.

METHODS

The PIVUS cohort study is an observational study of 1016 (509 women and 507 men) randomly chosen individuals aged 70 living in Uppsala, Sweden. Carotid artery ultrasound measurements were performed. IMT and the grey scale median (GSM) value were calculated in the intima-media complex (IM-GSM) in the far wall of the common carotid artery. Traditional risk factors were evaluated together with indices of oxidative stress and inflammation.

RESULTS

In the multiple regression analysis, HDL-cholesterol, body mass index, conjugated diens, glutathione, e-selectin and TNF alfa were significantly related to IM-GSM. IMT was independently related to blood pressure, smoking and body mass index.

CONCLUSION

The echolucency of the carotid intima-media was related to several cardiovascular risk factors not related to IMT, such as dyslipidemia, oxidative stress and inflammation. Since the echogenecity of the carotid intima-media complex was related to different risk factors compared to carotid IMT, it is worthwhile to further explore the usefulness of this new marker of the vascular wall.

摘要

背景

通过超声测量的颈动脉内膜中层厚度(IMT)增加与心血管疾病风险增加相关。由于无回声斑块的存在会进一步增加风险,我们研究了颈动脉内膜中层复合体的回声性是否与心血管风险标志物相关。因此,我们的目的是在一项探索性研究中调查内膜中层回声性是否与心血管危险因素、炎症标志物或氧化标志物相关。

方法

PIVUS队列研究是一项对瑞典乌普萨拉1016名(509名女性和507名男性)随机选取的70岁个体进行的观察性研究。进行了颈动脉超声测量。计算颈总动脉远壁内膜中层复合体(IM-GSM)的IMT和灰度中位数(GSM)值。评估了传统危险因素以及氧化应激和炎症指标。

结果

在多元回归分析中,高密度脂蛋白胆固醇、体重指数、共轭二烯、谷胱甘肽、E-选择素和肿瘤坏死因子α与IM-GSM显著相关。IMT与血压、吸烟和体重指数独立相关。

结论

颈动脉内膜中层的无回声性与一些与IMT无关的心血管危险因素相关,如血脂异常、氧化应激和炎症。由于与颈动脉IMT相比,颈动脉内膜中层复合体的回声性与不同的危险因素相关,因此值得进一步探索这种血管壁新标志物的有用性。

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