scholarly journals Calcium Kidney Stones are Associated with Increased Risk of Carotid Atherosclerosis: The Link between Urinary Stone Risks, Carotid Intima-Media Thickness, and Oxidative Stress Markers

2020 ◽  
Vol 9 (3) ◽  
pp. 729
Author(s):  
Ho Shiang Huang ◽  
Pao Chi Liao ◽  
Chan Jung Liu

Previous studies have suggested that kidney stone formers are associated with a higher risk of cardiovascular events. To our knowledge, there have been no previous examinations of the relationship between carotid intima-media thickness (IMT) and urinary stone risk factors. This study was aimed toward an investigation of the association between dyslipidemia, IMT, and 24-hour urinalysis in patients with calcium oxalate (CaOx) or calcium phosphate (CaP) stones. We prospectively enrolled 114 patients with kidney stones and 33 controls between January 2016 and August 2016. All patients were divided into four groups, according to the stone compositions—CaOx ≥ 50% group, CaP group, struvite group, and uric acid stones group. Carotid IMT and the carotid score (CS) were evaluated using extracranial carotid artery doppler ultrasonography. The results of a multivariate analysis indicated that a higher serum total cholesterol (TC) and low-density lipoprotein (LDL) were all associated with lower urinary citrate and higher CS in both the CaOx ≥ 50% and CaP groups. Higher serum TC and LDL were also associated with increased serum 8-OHdG levels in both groups. The levels of carotid IMT and CS in the CaOx ≥ 50% and CaP groups were all significantly higher than in the controls. These findings suggest a strong link between dyslipidemia, carotid atherosclerosis, and calcium kidney stone disease.

Author(s):  
Massimo R. Mannarino ◽  
Matteo Pirro ◽  
Bruna Gigante ◽  
Kai Savonen ◽  
Sudhir Kurl ◽  
...  

Background The association between elevated serum uric acid (SUA), cardiovascular disease (CVD) risk, and carotid atherosclerosis has long been explored, and contrasting results have been reported. Therefore, the role of SUA as an independent risk factor for vascular events (VEs) and carotid atherosclerosis deserves further attention. We investigated the relationship between SUA, incident VEs, carotid intima‐media thickness (cIMT), and cIMT progression in subjects at moderate‐to‐high CVD risk. Methods and Results In the IMPROVE (IMT‐Progression as Predictors of VEs) study, 3686 participants (median age 64 years; 48% men) with ≥ 3 vascular risk factors, free from VEs at baseline, were grouped according to SUA quartiles (division points: 244–284–328 µmol/L in women, 295–336–385 µmol/L in men). Carotid‐IMT and its 15‐month progression, along with incident VEs, were recorded. A U‐shaped association between SUA and VEs was observed in men, with 2.4‐fold ( P = 0.004) and 2.5‐fold ( P = 0.002) increased CVD risk in the first and fourth SUA quartiles as compared with the second. Adjusted hazard ratios (HRs) for cerebro‐VEs in men were the highest (first and fourth quartile versus second: HR, 5.3, P = 0.010 and HR, 4.4, P = 0.023, respectively). SUA level was independently associated with cIMT progression in men (β = 0.068, P = 0.014). No significant association between SUA levels, CVD end points, and cIMT progression were found in women. Conclusions Both low and high SUA levels are associated with an increased risk of VEs in men at moderate‐to‐high CVD risk but not in women. Only elevated SUA levels predict cIMT progression and at a lesser but not significant extent in women.


2014 ◽  
Vol 5 (01) ◽  
pp. 40-45 ◽  
Author(s):  
Amit Shankar Singh ◽  
Virendra Atam ◽  
Besthenahalli Erappa Yathish ◽  
Liza Das ◽  
Seiddhartha Koonwar

ABSTRACT Background: Inflammation mediates a key role in the pathogenesis of atherosclerosis which is an important cause of ischemic stroke. An elevated erythrocyte sedimentation rate (ESR) may, therefore, be a marker of the extent andor intensity of a general atherosclerotic process and thus a marker for advanced atherosclerosis heralding increased risk of arterial thrombosis leading to ischemic stroke. Materials and Methods: ESR was calculated in ischemic stroke patients by Westergren′s method along with carotid sonography using high resolution 7.5 MHz techniques to find the prevalence of increased carotid intima-media thickness (CIMT) and presence of plaque according to Mannheim Carotid Intima-Media Thickness Consensus. Results: Average value of ESR in all patients was 27.89 ± 9.73 mm/h. A significant association was found between ESR and markers of carotid atherosclerosis, that is, high CIMT of more than 0.8 mm (P < 0.0001) and presence of plaque (P-0.026) in univariate analysis. Also, a significant positive correlation was found between ESR and serum fibrinogen, another inflammatory marker. (r = 0.88, P < 0.0001). Conclusion: The extent of inflammation may reflect in part the propensity of atherosclerotic lesions to lead to clinical disease. Study shows the association of ESR with markers of atherosclerosis confirming the strength of the inflammatory response associated with carotid atherosclerosis and might conceivably carry important prognostic information regarding occurrence of such catastrophic events in future.


1994 ◽  
Vol 72 (04) ◽  
pp. 563-566 ◽  
Author(s):  
Tuomo Rankinen ◽  
Sari Väisänen ◽  
Michele Mercuri ◽  
Rainer Rauramaa

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.


2020 ◽  
Vol 16 ◽  
Author(s):  
Harish A Rao ◽  
Prakash Harischandra ◽  
Srikanth Yadav

Introduction: Diabetes mellitus is a well-known risk factor for cardiovascular disease, because of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral subcutaneous fat and is inversely associated with occurrence of carotid plaques (CP). Multiplicative and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in event of CP suggest that the two measures should be taken into account commonly while assessing vascular risk profile. Aim & Objective: To ascertain if waist to calf circumference ratio (WCR) is a marker of Carotid atherosclerosis in patients with type 2 diabetes mellitus. To asses s the correlation between waist to calf circumference ratio and carotid intima media thickness (CIMT ) in patients with Type 2 diabetes. Materials and methods: A cross sectional study at Hospital affiliated to Kasturba Medical college Mangalore from Sept 2016 to Sept 2018 . Method of study: Patients with type 2 DM as per ADA criteria, age >18years are recruited for the study. Results and discussion: In our study with 150 population 25 patients had carotid atherosclerosis and 20 patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07 and 99.85 & the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the range of 3.12 to 3.26. The difference was statistically significant with a p value of <0.05. In our study it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly calf circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR. Conclusion: To conclude, in our population based study of 150 subjects we found that carotid atherosclerosis is significantly more in people with increased waist calf circumference ratio. WCR may be a new, useful and practical anthropometric index that facilitates the early identification of diabetic subjects with high risk for cardiovascular disease. Validation of this finding in individual populations is required. Future studies should test the association of calf circumference with carotid intima media thickness and carotid plaques using better measures than ultrasound such as magnetic resonance imaging. Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is required.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 367-368
Author(s):  
Desiree Bygrave ◽  
Regina Wright

Abstract Carotid atherosclerosis has emerged as an early predictor of reduced cognitive function. Underlying this association are risk factors, such as overweight and obesity, that promote carotid atherosclerosis and poor cognitive outcomes. Given the prevalence of overweight and obesity among older adults, there is a critical need to better understand how atherosclerosis influences cognitive function in the context of elevated weight. To address this gap, the current study examined relations between carotid atherosclerosis (carotid intima-media thickness [IMT]), and attention (Trailmaking Test) and executive function (Verbal Fluency Test) performance, and whether they varied as a function of weight status (body mass index [BMI] classification). Data were analyzed from 162 older adults (mean age = 68.43y, 34% male, 41% African American), free of major disease. Mutliple regression and analysis of variance analyses, adjusted for age, sex, education and mean arterial pressure, showed a statistically significant IMT x BMI interaction for Verbal Fluency performance (p=.04) and a trending IMT x BMI interaction for Trailmaking A performance (p=.05). Simple effects analysis of IMT and Verbal Fluency performance showed that this association was most pronounced among those who are obese. Findings suggest atherosclerosis may influence executive function in the context of obesity among older adults. As the development of carotid atherosclerosis is strongly related to aging, our findings suggest that maintaining a healthy weight may reduce its impact on executive function in older adulthood.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Yuanjie Pang ◽  
Yingying Sang ◽  
Shoshana Ballew ◽  
Morgan Grams ◽  
Gerardo Heiss ◽  
...  

Introduction: Carotid intima-media thickness (IMT) has been reported to predict kidney function decline. However, whether carotid IMT is associated with a hard kidney endpoint, end-stage renal disease (ESRD), has not been investigated. Hypothesis: We assessed the hypothesis that increased carotid IMT is associated with ESRD risk. Methods: We studied 13,197 ARIC participants at visit 1 (1987-1989) without history of cardiovascular disease including coronary heart disease, stroke and heart failure and assessed whether carotid IMT measured by B-mode ultrasound is associated with ESRD risk using Cox proportional-hazards models. Regarding carotid IMT parameters, we investigated the mean and maximum values of overall and segment-specific (common, bifurcation and internal carotid arteries) measurements. Results: Mean age was 54.0 (SD 5.7) years, and there were 3,373 (25.6%) blacks and 7,370 (55.8%) women. During a median follow-up of 22.7 years, 433 participants developed ESRD (1.4/1,000 person-years). After adjusting for shared risk factors for atherosclerosis and kidney disease, including baseline kidney function, carotid IMT was significantly associated with ESRD risk (hazard ratios between quartiles 4 and 1, 1.43 [95%CI: 1.01-2.04] for overall mean IMT and 1.73 [95%CI: 1.22-2.44] for overall maximum IMT). The associations were largely consistent in demographic and clinical subgroups. When we explored segment-specific IMTs, the associations with ESRD were most robust for bifurcation carotid. The adjusted hazard ratios between quartiles 4 and 1 were 1.48 (95%CI: 1.04-2.11) for mean bifurcation IMT and 1.42 (95%CI: 0.99-2.03) for maximum bifurcation IMT. Conclusions: Carotid IMT was independently associated with incident ESRD in the general population. Our findings suggest the shared etiology between atherosclerosis and ESRD and highlight the importance of monitoring kidney function over time in individuals with subclinical atherosclerosis.


2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Takeki Suzuki ◽  
Wanmei Wang ◽  
Anthony Wilsdon ◽  
Kenneth R. Butler ◽  
Selcuk Adabag ◽  
...  

Background Sudden cardiac death (SCD) is associated with severe coronary heart disease in the great majority of cases. Whether carotid intima‐media thickness (C‐IMT), a known surrogate marker of subclinical atherosclerosis, is associated with risk of SCD in a general population remains unknown. The objective of this study was to investigate the association between C‐IMT and risk of SCD. Methods and Results We examined a total of 20 862 participants: 15 307 participants of the ARIC (Atherosclerosis Risk in Communities) study and 5555 participants of the CHS (Cardiovascular Health Study). C‐IMT and common carotid artery intima‐media thickness was measured at baseline by ultrasound. Presence of plaque was judged by trained readers. Over a median of 23.5 years of follow‐up, 569 participants had SCD (1.81 cases per 1000 person‐years) in the ARIC study. Mean C‐IMT and common carotid artery intima‐media thickness were associated with risk of SCD after adjustment for traditional risk factors and time‐varying adjustors: hazard ratios (HRs) with 95% CIs for fourth versus first quartile were 1.64 (1.15–2.63) and 1.49 (1.05–2.11), respectively. In CHS, 302 participants developed SCD (4.64 cases per 1000 person‐years) over 13.1 years. Maximum C‐IMT was associated with risk of SCD after adjustment: HR (95% CI) for fourth versus first quartile was 1.75 (1.22–2.51). Presence of plaque was associated with 35% increased risk of SCD: HR (95% CI) of 1.37 (1.13–1.67) in the ARIC study and 1.32 (1.04–1.68) in CHS. Conclusions C‐IMT was associated with risk of SCD in 2 biracial community‐based cohorts. C‐IMT may be used as a marker of SCD risk and potentially to initiate early therapeutic interventions to mitigate the risk.


VASA ◽  
2009 ◽  
Vol 38 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Giannoukas ◽  
Antoniou ◽  
Saleptsis ◽  
Baros ◽  
Griffin ◽  
...  

Background: The common carotid intima-media thickness (IMT) is considered as a marker of cardiovascular disease, while the value of the common femoral IMT is not well defined. The aim of the present study was to investigate the value of common femoral IMT alone or in combination with the common carotid IMT as a marker of cardiovascular disease in asymptomatic adults. Patients and Methods: Eighty-three individuals with no history of cardiovascular disease were subjected to IMT measurement of both common carotid and common femoral arteries with high-resolution ultrasonography. The Framingham Heart Study (FHS) risk score was calculated for each subject (according to gender) and was correlated with the carotid IMT, femoral IMT, and the combined IMT measured at both arterial sites. Results: The carotid and femoral IMT separately and in combination were found to be correlated with the FHS risk score, calculated based on either the total cholesterol or low density lipoprotein plasma levels (carotid IMT: r = 0.28, p = 0.035, and r = 0.35, p = 0.007, respectively, femoral IMT: r = 0.38, p = 0.003, and r = 0.43, p = 0.001, respectively, carotid-femoral IMT: r = 0.37, p = 0.005, and r = 0.46, p = 0.0001, respectively). In addition, femoral IMT was found to be correlated with the carotid IMT (r = 0.41, p = 0.001). Conclusions: Common carotid and common femoral IMT showed similar correlation with the FHS risk score. Additionally, the combination of IMT from both arterial sites was found to have similar correlation with the FHS risk score to carotid IMT alone.


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