Sampson Uchechukwu K A, Harrell Frank E, Fazio Sergio, Nwosu Sam, Mercaldo Nate, Mensah George A, Davidson Michael H, Coll Blai, Feinstein Steve B
Department of Medicine, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee; Department of Pathology, Microbiology and Immunology, VUMC, Nashville, Tennessee; Department of Radiology and Radiological Sciences, VUMC, Nashville, Tennessee.
Echocardiography. 2015 Feb;32(2):264-70. doi: 10.1111/echo.12646. Epub 2014 Jun 13.
Vasa vasorum (VV) vessels are critical in the genesis of atherosclerosis. Therefore, we assessed measures of carotid VV, intima-media thickness (CIMT), and patient risk factors in a primary prevention population.
We used multivariable linear models to evaluate the relationship between baseline covariates and a measure of carotid VV (VV ratio) and CIMT among 324 diabetics and 141 nondiabetics.
Median CIMT (in mm) and VV ratio among nondiabetics were 0.82 ± 0.22 and 0.80 ± 0.19, respectively, and 1.06 ± 0.19 and 1.21 ± 0.26 among diabetics (P < 0.0001). Diabetes was associated with 36% (95% CI: 24.3-48.0, P < 0.001) higher VV ratio whereas a unit change in BMI was associated with ≈1% (95% CI: 0.5-1.4, P < 0.001) change in VV ratio. A 10-year increase in age was associated with 4% (95% CI: 1-7, P = 0.005) higher CIMT. Each 10 mmHg increase in mean systolic blood pressure was associated with 2% (95% CI: 1-4, P = 0.003) higher CIMT whereas diabetes conferred 31% (95% CI: 19.1-42.1, P < 0.001) higher CIMT. Female sex was associated with a 9% (95% CI: -12.9 to -4.1, P < 0.001) lower CIMT. Low density lipoprotein (LDL) cholesterol, blood pressure, and CIMT were not significantly associated with VV ratio.
In this cohort of patients with low CIMT, VV ratio, and CIMT were distinctly unrelated, but each independently associated with diabetes. VV ratio and CIMT relationships warrant further investigation in large-scale studies and across a spectrum of atherosclerostic states.
血管滋养血管（VV）在动脉粥样硬化的发生中起关键作用。因此，我们在一级预防人群中评估了颈动脉VV、内膜中层厚度（CIMT）及患者风险因素的指标。
我们使用多变量线性模型评估324名糖尿病患者和141名非糖尿病患者中基线协变量与颈动脉VV指标（VV比率）及CIMT之间的关系。
非糖尿病患者的CIMT中位数（单位：mm）和VV比率分别为0.82±0.22和0.80±0.19，糖尿病患者分别为1.06±0.19和1.21±0.26（P<0.0001）。糖尿病与高36%（95%CI：24.3-48.0，P<0.001）的VV比率相关，而BMI每变化一个单位与VV比率约1%（95%CI：0.5-1.4，P<0.001）的变化相关。年龄每增加10岁与高4%（95%CI：1-7，P=0.005）的CIMT相关。平均收缩压每升高10 mmHg与高2%（95%CI：1-4，P=0.003）的CIMT相关，而糖尿病使CIMT高31%（95%CI：19.1-42.1，P<0.001）。女性与低9%（95%CI：-12.9至-4.1，P<0.001）的CIMT相关。低密度脂蛋白（LDL）胆固醇、血压和CIMT与VV比率无显著关联。
在这个CIMT较低的患者队列中，VV比率与CIMT明显无关，但二者均独立与糖尿病相关。VV比率与CIMT之间的关系值得在大规模研究及不同动脉粥样硬化状态中进一步探究。
