Tulane Center for Cardiovascular Health, Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
Am J Cardiol. 2011 Jan;107(1):114-9. doi: 10.1016/j.amjcard.2010.08.054.
Carotid intima-media thickness (CIMT) progression is predictive of future cardiovascular events in middle-age and older adults. However, information is scant on segment-specific CIMT progression by race (black vs white) and gender and its predictors during short-term follow-up in asymptomatic young adults. B-mode ultrasound images of the far walls of both carotid arteries were obtained in 842 subjects aged 24 to 43 years and enrolled in the Bogalusa Heart Study (70% whites and 42% men). The CIMT and cardiometabolic risk variables were measured at baseline and after an average of 2.4 years. The mean CIMT progression rates/year adjusted for age, race, and gender were greatest at the bulb, followed by the internal and common carotid segments (p <0.0001). In a multivariate logistic model, age, mean arterial pressure, and high-density lipoprotein cholesterol were significantly associated with common CIMT progression. Smoking, age, insulin resistance index, and mean arterial pressure were significantly associated with bulb CIMT progression; and the waist/height ratio, smoking, age, and mean arterial pressure were significantly associated with internal CIMT progression, independent of the baseline CIMT and traditional cardiometabolic risk variables, including adiponectin, C-reactive protein, and intercellular adhesion molecules. In addition, the status of progression was associated with a greater prevalence of metabolic syndrome (common and internal CIMT, p <0.05; bulb CIMT, p <0.0001) and diabetes (bulb CIMT only, p <0.001). In conclusion, in younger adults, the magnitude of progression of CIMT within a short period varied in a segment-specific manner, regardless of race or gender, and was predictable using modifiable traditional risk factors. This could have implications for preventive and interventional cardiology.
颈动脉内膜中层厚度（CIMT）进展可预测中年及老年人的未来心血管事件。然而，关于种族（黑人与白人）和性别特异性颈动脉内膜中层厚度进展的信息很少，并且在无症状年轻成年人的短期随访中，其预测因素也很少。在博加卢萨心脏研究（70%为白人，42%为男性）中，对 842 名年龄在 24 至 43 岁的参与者的双侧颈动脉远壁进行了 B 型超声检查。在基线和平均 2.4 年后测量颈动脉内膜中层厚度和心血管代谢风险变量。经年龄、种族和性别调整后的平均颈动脉内膜中层厚度进展率/年，以球部最高，其次是内颈动脉和总颈动脉段（p<0.0001）。在多元逻辑模型中，年龄、平均动脉压和高密度脂蛋白胆固醇与总颈动脉内膜中层厚度进展显著相关。吸烟、年龄、胰岛素抵抗指数和平均动脉压与球部颈动脉内膜中层厚度进展显著相关；腰围/身高比、吸烟、年龄和平均动脉压与内颈动脉内膜中层厚度进展显著相关，且与基线颈动脉内膜中层厚度和传统心血管代谢风险变量（包括脂联素、C 反应蛋白和细胞间黏附分子）无关。此外，进展状态与代谢综合征（总颈动脉内膜中层厚度和内颈动脉内膜中层厚度，p<0.05；球部颈动脉内膜中层厚度，p<0.0001）和糖尿病（仅球部颈动脉内膜中层厚度，p<0.001）的患病率增加相关。总之，在年轻成年人中，短期内 CIMT 的进展程度在特定节段有所不同，无论种族或性别如何，且可使用可改变的传统风险因素进行预测。这可能对预防和介入心脏病学具有重要意义。
