Soneye M A, Adekanmi A J
Radiology department, University College Hospital, Ibadan, Nigeria.
Radiology department, College of Medicine, University of Ibadan, Nigeria.
J West Afr Coll Surg. 2018 Oct-Dec;8(4):67-93.
Ultrasonographic intima media thickness is now the imaging modality of choice for the clinical evaluation of large arterial wall thickening (atherosclerosis). It is a proven simple, reliable, accurate, reproducible, affordable and ionizing radiation-free marker of atherosclerosis. Carotid intima media thickness (IMT) values have been widely employed as a surrogate marker of atherosclerosis; normal values have been documented for Nigerians and values above the nomogram are regarded as evidence of atherosclerosis. However, recent scientific evidence shows that the femoral artery intima-media thickness is a better indicator of atherosclerosis, compared to the IMT of the carotid artery. Despite the femoral IMT being a better indicator of atherosclerosis, there is paucity of data on femoral intima media thickness among healthy Nigerian adults.
To determine the femoral IMT among a healthy, normotensive, normoglycemic adult Nigerian cohort, and its relationship with age, sex and body mass index among the study population.
This was a hospital-based cross-sectional study among a cohort of normotensive, non-diabetic adult healthy volunteers. The socio-demographic characteristics, anthropometric and clinical parameters, as well as the B-mode ultrasonographic IMT of both common femoral arteries were evaluated. The data was analysed using IBM SPSS version 23.0. The student t-test and One-way-ANOVA were used to test the association between age, sex and FIMT as appropriate. The correlations between the FIMT and age and BMI were assessed by Pearson's correlation coefficients; linear regression analysis was done to determine the equation relating FIMT to factors with significant correlation coefficients among the subjects. p values <0.05 were taken as statistically significant.
A total of 106 femoral arteries in 53 individuals were evaluated in this preliminary study. The mean age was 50.7(SD14.4) years (range 27-77 years). Twenty-eight (52.8%) were males and 25 (47.2%) were females. The mean Femoral Intima Media Thickness (FIMT) for the whole group was 0.53(SD0.05) mm. The FIMT in males, 0.54(SD0.05) mm was not significantly different from that in females, 0.52(SD0.06) mm (p= 0.221). The mean left FIMT, 0.54(SD0.05) mm was significantly higher than the right FIMT, 0.52(SD0.06) mm (p<0.001)There was a significant positive Pearson correlation coefficient between FIMT and age, (r=0.719, p<0.001). The linear regression equation was FIMT = 0.39 + 0.003*Age (years) indicating a mean increase of 0.003 mm in FIMT for every one-year increase in age.There was no significant correlation between BMI and FIMT, (r=0.008, p=0.952).
The overall mean FIMT among a cohort of South-West Nigerian adults without cardiovascular risk factors was 0.53(0.05) mm. The mean FIMT in males was not significantly different from that in females, but the mean FIMT on the left was significantly higher than that on the right. There was a significant positive correlation between FIMT and age, with an increase in FIMT of 0.003mm for every one-year increase in age. There was no correlation between FIMT and BMI. Screening FIMT may help in the early discovery of increased IMT, which would be of value in re-classification of cardiovascular risk.
超声内膜中层厚度现已成为临床评估大动脉壁增厚（动脉粥样硬化）的首选成像方式。它是一种经证实的简单、可靠、准确、可重复、经济且无电离辐射的动脉粥样硬化标志物。颈动脉内膜中层厚度（IMT）值已被广泛用作动脉粥样硬化的替代标志物；尼日利亚人的正常数值已有记录，高于列线图的值被视为动脉粥样硬化的证据。然而，最近的科学证据表明，与颈动脉IMT相比，股动脉内膜中层厚度是动脉粥样硬化的更好指标。尽管股动脉IMT是动脉粥样硬化的更好指标，但关于尼日利亚健康成年人股动脉内膜中层厚度的数据却很匮乏。
确定尼日利亚健康、血压正常、血糖正常的成年人群队列中的股动脉IMT，及其与研究人群中年龄、性别和体重指数的关系。
这是一项基于医院的横断面研究，研究对象为血压正常、非糖尿病的成年健康志愿者队列。评估了社会人口学特征、人体测量和临床参数，以及双侧股总动脉的B型超声IMT。使用IBM SPSS 23.0版对数据进行分析。根据情况，使用学生t检验和单因素方差分析来检验年龄、性别与股动脉IMT之间的关联。通过Pearson相关系数评估股动脉IMT与年龄和体重指数之间的相关性；进行线性回归分析以确定股动脉IMT与研究对象中具有显著相关系数的因素之间的方程。p值<0.05被视为具有统计学意义。
在这项初步研究中，共评估了53名个体的106条股动脉。平均年龄为50.7（标准差14.4）岁（范围27 - 77岁）。男性28名（52.8%），女性25名（47.2%）。整个组的平均股动脉内膜中层厚度（FIMT）为0.53（标准差0.05）mm。男性的FIMT为0.54（标准差0.05）mm，与女性的0.52（标准差0.06）mm无显著差异（p = 0.221）。左侧平均FIMT为0.54（标准差0.05）mm，显著高于右侧FIMT的0.52（标准差0.06）mm（p<0.001）。FIMT与年龄之间存在显著的正Pearson相关系数（r = 0.719，p<0.001）。线性回归方程为FIMT = 0.39 + 0.003×年龄（岁），表明年龄每增加一岁，FIMT平均增加0.003mm。体重指数与FIMT之间无显著相关性（r = 0.008，p = 0.952）。
在无心血管危险因素的尼日利亚西南部成年人群队列中，总体平均FIMT为0.53（0.05）mm。男性的平均FIMT与女性无显著差异，但左侧的平均FIMT显著高于右侧。FIMT与年龄之间存在显著的正相关，年龄每增加一岁，FIMT增加0.003mm。FIMT与体重指数之间无相关性。筛查FIMT可能有助于早期发现IMT增加，这对于重新分类心血管风险具有重要价值。
