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社区居住的老年人主动脉动脉僵硬度、颈动脉内膜中层厚度与颈动脉斑块之间的关联:一项基于人群的研究。

The association between aortic arterial stiffness, carotid intima-media thickness and carotid plaques in community-dwelling older adults: A population-based study.

作者信息

Del Brutto Oscar H, Del Brutto Victor J, Mera Robertino M, Costa Aldo F, Peñaherrera Rubén, Peñaherrera Ernesto, Matcha Gautam, Generale Laura M, Torpey Andrew P, Peralta Leslie D, Hill John P, Rundek Tatjana, Romano José G, Sedler Mark J

机构信息

School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.

Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.

出版信息

Vascular. 2020 Aug;28(4):405-412. doi: 10.1177/1708538120913738. Epub 2020 Mar 30.

DOI:10.1177/1708538120913738
PMID:32228175
Abstract

OBJECTIVE

Information on the associations among arterial stiffness, carotid intima-media thickness (cIMT) and carotid plaques as biomarkers of atherosclerosis is limited in diverse populations. We aimed to assess whether aortic pulse wave velocity (aPWV) - as a surrogate of arterial stiffness - is associated with increased cIMT and the presence of carotid plaques in a cohort of older adults of Amerindian ancestry.

METHODS

Atahualpa residents aged ≥60 years ( = 320) underwent aPWV determinations, and carotid ultrasounds for cIMT and plaque assessment. Multivariate models were fitted to assess the independent association between the aPWV, and cIMT and carotid plaques, after adjusting for relevant confounders. Differences in risk factors across these biomarkers were investigated.

RESULTS

Mean values of aPWV were 10.3 ± 1.8 m/s, and those of cIMT were 0.91 ± 0.21 mm (24% had a cIMT >1 mm). Carotid plaques were observed in 118 (37%) subjects. In univariate analyses, risk factors associated with an increased aPWV included age, female gender, poor physical activity and high blood pressure. An increased cIMT was associated with age, male gender, a poor diet, high blood pressure and severe tooth loss. The presence of carotid plaques was associated with increasing age, poor physical activity and high blood pressure. Multivariate models showed a significant association between aPWV and cIMT (β: 0.028; 95% C.I.: 0.001-0.056; =0.047) but not between aPWV and carotid plaques (OR: 1.14; 95% C.I.: 0.83-1.56; =0.423).

CONCLUSIONS

This study shows an independent association between aPWV and cIMT but not with carotid plaques. These biomarkers may indicate distinct phenotypes for atherosclerosis.

摘要

目的

在不同人群中,关于动脉僵硬度、颈动脉内膜中层厚度(cIMT)和颈动脉斑块作为动脉粥样硬化生物标志物之间关联的信息有限。我们旨在评估作为动脉僵硬度替代指标的主动脉脉搏波速度(aPWV)是否与美洲印第安人后裔老年人群队列中cIMT增加和颈动脉斑块的存在相关。

方法

对320名年龄≥60岁的阿塔瓦尔帕居民进行aPWV测定,并进行颈动脉超声检查以评估cIMT和斑块。在调整相关混杂因素后,采用多变量模型评估aPWV与cIMT和颈动脉斑块之间的独立关联。研究了这些生物标志物在危险因素方面的差异。

结果

aPWV的平均值为10.3±1.8米/秒,cIMT的平均值为0.91±0.21毫米(24%的人cIMT>1毫米)。118名(37%)受试者观察到颈动脉斑块。在单变量分析中,与aPWV增加相关的危险因素包括年龄、女性性别、身体活动不足和高血压。cIMT增加与年龄、男性性别、饮食不良、高血压和严重牙齿脱落相关。颈动脉斑块的存在与年龄增加、身体活动不足和高血压相关。多变量模型显示aPWV与cIMT之间存在显著关联(β:0.028;95%置信区间:0.001 - 0.056;P = 0.047),但aPWV与颈动脉斑块之间无关联(比值比:1.14;95%置信区间:0.83 - 1.56;P = 0.423)。

结论

本研究表明aPWV与cIMT之间存在独立关联,但与颈动脉斑块无关。这些生物标志物可能表明动脉粥样硬化的不同表型。

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