scholarly journals Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Xiangming Hu ◽  
Wei Li ◽  
Chenyang Wang ◽  
Haotian Zhang ◽  
Haoyu Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Carotid Artery ◽  
Carotid Atherosclerosis ◽  
Hemoglobin A1c ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Plaque Burden ◽  
Carotid Artery Plaque ◽  
Glycosylated Hemoglobin A1c

Background. Diabetes mellitus (DM) and dyslipidemia are the main risk factors for atherosclerosis. Elevated glycosylated hemoglobin A1c (HbA1c) and reduced high-density lipoprotein cholesterol (HDL-C) are associated with the progression of atherosclerosis. The aim of this study is at exploring the relationship between the HbA1c/HDL-C ratio and atherosclerosis evaluated using carotid artery intima-media thickness (cIMT) and carotid artery plaque. Methods. In this retrospective study, we enrolled 1304 patients who had multiple cardiovascular risk factors or symptoms of suspected coronary artery disease. cIMT and carotid artery plaque were measured using ultrasonography. Logistic regression was used to explore the correlation between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque. We used restricted cubic spline curves to assess nonlinear relationships between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque. Results. With increased quartiles of HbA1c/HDL-C, patients had higher cIMT and a greater carotid plaque burden. After adjusting for other relevant clinical covariates, patients with the highest HbA1c/HDL-C ratio (quartile 4 (Q4)) had a 2.88 times (95% confidence interval (CI): 2.02–4.10, P < 0.001 ) more abnormal mean cIMT, 3.72 times (95% CI: 2.55–5.44, P < 0.001 ) more abnormal maximum cIMT, and 2.58 times (95% CI: 1.70–3.91, P < 0.001 ) greater carotid artery plaque burden compared with patients who had the lowest HbA1c/HDL-C ratio (Q1). Moreover, the association of HbA1c/HDL-C with atherosclerosis remained significant in a subsample of patients with and without DM. Conclusion. As a novel compound indicator for evaluating blood glucose homeostasis and dyslipidemia, the HbA1c/HDL-C ratio was positively correlated with carotid atherosclerosis evaluated using the mean and maximum cIMT as well as the carotid artery plaque burden.

scholarly journals Association Between Plasma Glycosylated Hemoglobin A1c/high-density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Real-world Study

2021 ◽  
Author(s):  
Xiangming Hu ◽  
Wei Li ◽  
Chenyang Wang ◽  
Haotian Zhang ◽  
Haoyu Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
High Density Lipoprotein ◽  
Carotid Atherosclerosis ◽  
Hemoglobin A1c ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Plaque Burden ◽  
Carotid Artery Plaque ◽  
Glycosylated Hemoglobin A1c

Abstract Background: Diabetes mellitus (DM) and dyslipidemia are the main risk factors for atherosclerosis. Elevated glycosylated hemoglobin A1c (HbA1c) and reduced high-density lipoprotein cholesterol (HDL-C) are associated with the progression of atherosclerosis. The aim of this study is to explore the relationship between the HbA1c/HDL-C ratio and atherosclerosis evaluated using carotid artery intima-media thickness (cIMT) and carotid artery plaque.Methods: In this retrospective study, we enrolled 1304 patients who had multiple cardiovascular risk factors or symptoms of suspected coronary artery disease. cIMT and carotid artery plaque were measured using ultrasonography. Logistic regression was used to explore the correlation between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque. We used restricted cubic spline curves to assess nonlinear relationships between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque.Results: With increased quartiles of HbA1c/HDL-C, patients had higher cIMT and a greater carotid plaque burden. After adjusting for other relevant clinical covariates, patients with the highest HbA1c/HDL-C ratio (Quartile 4 [Q4]) had a 2.88-times (95% confidence interval [CI]: 2.02–4.10, P<0.001) more abnormal mean cIMT, 3.72-times (95% CI: 2.55–5.44, P<0.001) more abnormal maximum cIMT, and 2.58-times (95% CI: 1.70–3.91, P<0.001) greater carotid artery plaque burden compared with patients who had the lowest HbA1c/HDL-C ratio (Q1). Moreover, the association of HbA1c/HDL-C with atherosclerosis remained significant in a subsample of patients with and without DM.Conclusions: As a novel compound indicator for evaluating blood glucose homeostasis and dyslipidemia, the HbA1c/HDL-C ratio was positively correlated with carotid atherosclerosis evaluated using the mean and maximum cIMT as well as the carotid artery plaque burden.

scholarly journals Prevalence of Subclinical Carotid Atherosclerosis and Associated Risk Factors in Individuals Without Cardiovascular Risk Factors: Insights from General Population

2021 ◽  
Author(s):  
Yuanmeng Tian ◽  
Suli Zhang ◽  
Ru Li ◽  
Weishuang Xue ◽  
Liying Xing ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Atherosclerosis ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Adverse Outcomes ◽  
Lipoprotein Cholesterol ◽  
Cardiovascular Risks ◽  
Cross Sectional ◽  
Paradoxical Response ◽  
Associated Risk Factors

Abstract Objective: Individuals without conventional cardiovascular risks (CVRFs) still have the risk of adverse outcomes, and subclinical carotid atherosclerosis is a known predictor of cardiovascular events. We aimed to assess the prevalence and associated risk factors of subclinical carotid atherosclerosis in CVRF-free population. Methods: The cross-sectional study was conducted in rural northeast China in 2017-2018. CVRFs freedom was defined as untreated blood pressure < 140/90 mmHg, fasting plasma glucose < 7.0 mmol/L, untreated total cholesterol < 6.22 mmol/L, low-density lipoprotein cholesterol < 4.14 mmol/L, high-density lipoprotein cholesterol (HDL-C) ≥ 1.04 mmol/L, and no current smoking. This subgroup population included 1449 individuals, and ultrasound was used to detect carotid atherosclerosis. Results: The mean carotid intima-media thickness is 0.74 ± 0.14 mm. The prevalence of carotid plaque is 23.4% (95%CI: 21.2%-25.6%) among CVRFs-free population, significantly higher in men than in women (37.1% vs 20.0%, p<0.001), and rises steeply with advancing age. 1.31% have moderate-to-severe carotid stenosis. Advancing age, man, glycosylated hemoglobin (OR, 1.90; 95% CI, 1.20-1.32), HDL-C level (OR, 2.31; 95% CI, 1.75-3.04), and pulse pressure (OR, 1.03; 95% CI, 1.01-1.05) are potentially related to presence of carotid atherosclerosis. Adjusted-dose-response association shows a linear relationship between HDL-C and prevalence of carotid atherosclerosis. Conclusions: The prevalence of subclinical carotid atherosclerosis in CVRF-free population was relatively high, indicating poorly defined factors might contribute to the early atherogenesis. Moreover, we observed a paradoxical response between subclinical carotid atherosclerosis and HDL-C levels, suggesting that treatment targeting to increase HDL-C levels might not reduce future cardiovascular risks.

scholarly journals Association of Carotid Atherosclerosis With White Matter Hyperintensity in an Asymptomatic Japanese Population: A Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Li Zhang ◽  
Quan Zhou ◽  
Li Hua Shao ◽  
Jun Wen ◽  
Jun Xia
Keyword(s):  
White Matter ◽  
Carotid Artery ◽  
Japanese Population ◽  
Carotid Atherosclerosis ◽  
Smoking Status ◽  
White Matter Hyperintensity ◽  
Large Artery ◽  
Cross Sectional ◽  
Carotid Artery Plaque ◽  
Plaque Score

Objective: A limited number of scholars concentrated on the relationship between carotid atherosclerosis (CAS) and white matter hyperintensity (WMH) (i.e., CAS-WMH relationship). The current research aimed to clarify the CAS-WMH relationship in Japanese population.Methods: All participants underwent MRI of head and ultrasonography of the carotid artery. WMH was diagnosed from MRI results. The carotid ultrasound findings, carotid artery plaque score (PS), and plaque number (PN) could be achieved to indicate the severity of CAS. We also employed multivariate logistic regression models to estimate the CAS-WMH relationship. Interaction and stratified analyses were undertaken on the basis of a number of factors (e.g., gender, age, smoking status, drinking habit, and history of chronic diseases).Results: A total of 1,904 Japanese subjects were included, and the prevalence of WMH was 54.8% (1,044/1,904). It was unveiled that frequency of CAS was greater in cases with WMH. In a fully adjusted model, high PS was associated with the frequency of WMH, followed by high PN. Further analyses revealed a dose-response relationship between PS and incidence of WMH.Conclusion: PS and PN exhibited the greatest influences on determining the frequency of WMH, highlighting the potentially important pathophysiological role of large artery atherosclerosis in intensifying WMH.

scholarly journals Patterns of Cardiovascular Risk Factors in the Years Before Pregnancy in Nulliparous Women With and Without Preterm Birth and Small‐for‐Gestational‐Age Delivery

2021 ◽  
Author(s):  
Ravi Retnakaran ◽  
Baiju R. Shah
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Preterm Delivery ◽  
Alanine Aminotransferase ◽  
Fasting Glucose ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Nulliparous Women ◽  
Over Time

Background Women with either preterm or small‐for‐gestational‐age (SGA) delivery have an elevated lifetime risk of cardiovascular disease that has been attributed to the accrual of vascular risk factors over time. We sought to determine whether an adverse cardiovascular risk factor profile develops in the years before pregnancies complicated by preterm delivery or SGA. Methods and Results Using administrative databases, we identified all 156 278 nulliparous women in Ontario, Canada, who had singleton pregnancies between January 2011 and December 2018 and ≥2 measurements of the following analytes between January 2008 and the start of pregnancy: glycosylated hemoglobin, glucose, lipids, and alanine aminotransferase. There were 11 078 women with preterm delivery and 19 367 with SGA. The 2 most recent pregravid tests were performed at median 0.6 (interquartile range, 0.3–1.4) and 1.9 (interquartile range, 1.1–3.3) years before pregnancy, respectively. Women with preterm delivery had higher pregravid glycosylated hemoglobin, glucose, low‐density lipoprotein cholesterol, triglycerides, and alanine aminotransferase, and lower high‐density lipoprotein cholesterol, than those without preterm delivery. In contrast, women with SGA had lower pregravid fasting glucose, random glucose, and triglycerides than those without SGA. In the years before pregnancy, women with preterm delivery had higher annual increases than their peers in glycosylated hemoglobin (0.7‐times higher), triglycerides (7.9‐times higher), and alanine aminotransferase (2.2‐times higher). During this time, fasting glucose increased in women who developed preterm delivery but decreased in their peers. Conclusions An adverse cardiovascular risk factor profile evolves over time in the years before pregnancy complicated by preterm delivery, but does not necessarily precede SGA.

scholarly journals Sex, Age, and BMI Modulate the Association of Physical Examinations and Blood Biochemistry Parameters and NAFLD: A Retrospective Study on 1994 Cases Observed at Shuguang Hospital, China

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Zhengli Tang ◽  
Minh Pham ◽  
Yiming Hao ◽  
Fang Wang ◽  
Devashru Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Retrospective Study ◽  
Effect Size ◽  
Density Lipoprotein ◽  
Blood Biochemistry ◽  
Lipoprotein Cholesterol ◽  
Obese People ◽  
Physical Examinations ◽  
Study Participants

Objective. Previous studies have shown that some metabolic risk factors are related to nonalcoholic fatty liver disease (NAFLD). This retrospective study was performed to investigate the associations between physical examinations and blood biochemistry parameters and NAFLD status and to identify possible risk factors of NAFLD. Methods. Study participants underwent general physical examinations, blood biochemistry, and abdominal ultrasound evaluations. In addition, data regarding sex, age, ethnicity, medical history, and alcohol consumption of participants were recorded. Among the study participants (N=1994), 57.8% were male, 41.2% over the age of 50, and 52.6% with BMI≥24. 986 patients had NAFLD and 1008 had no NAFLD. We used effect size analysis and logistic regression to determine which physical examinations and blood biochemistry parameters were significant for the association between these parameters and NAFLD status. Results. Both the effect size and logistic regression indicated that BMI, diastolic blood pressure (DBP), triglycerides (TG), and serum uric acid (SUA) show a significant association with NAFLD. Females are overall at a higher risk of NAFLD, but factors such as high BMI, DBP, TG, and SUA increase the associated risk for both sexes. Compared with males, females have a higher risk of NAFLD given that they are over 50, overweight and obese (BMI at or over 24), or have high SUA. In terms of age, people older than 50 with high SUA, and people younger than 50 with high DBP and low-density lipoprotein cholesterol (LDL-C) all increase the risk of NAFLD. For BMI, high DBP and low high-density lipoprotein cholesterol (HDL-C) are risk factors for NAFLD in overweight and obese people (BMI at or over 24), whereas in normal weight and underweight people (BMI under 24), elevated LDL-C increases the risk of NAFLD. Conclusions. Our results revealed sex, age, and BMI modulate the association of physical examinations and blood biochemistry parameters and NAFLD, which may facilitate the development of personalized early warning and prevention strategies of NAFLD for at-risk populations.

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