| ObjectiveTo investigate the relation between intrauterine growth and adult coronary heartdisease risk factors and the development of carotid atherosclerosis in later life in Chinesepeople.Materials and MethodsThe population-based sample used for this research included 2036 people agedabove fifty who were born in Peking Union Hospital from 1921 to 1941 and from 1948to 1954 and all had complete birth records.A medical history was taken and physicalexamination was performed by a physician.Height,weight and waist circumference weremeasured.Three blood pressure determinations were made after the participant had beensitting at least 10 minutes,and the average was used for analyses.Venous blood wasdrawn at the baseline examination after an overnight fast and analysed for variousbiochemical parameters.They were asked to fill in the cardio-cerebrovascularquestionnaire.The Framingham score sheet was developed for each sex using lowdensity lipoprotein(LDL) categorical variables instead of traditional cardiovascular riskfactors to estimate risk for coronary heart disease over a period of 10 years.Theintima-media thickness(IMT) was measured with ultrasonography on the far wall of thebifurcation and the common carotid 2.0cm proximal to the bifurcation and divided intonormal and thicken group.The carotid IMT≥1.0mm or the IMT of bifurcation≥1.2mm ofany side was considered abnormal.A plaque was defined as a focal structure thatdemonstrates a thickness of≥1.5mm as measured from the media-adventita interface tothe intima-lumen interface.According to IMT,all participants were divided into plaquegroup with IMT≥1.5mm,simply thicken group with IMT less than 1.5mm,and normalgroup.The relation between carotid atherosclerosis with various parameters at birth andin adult life was assessed with univariable analysis and logistics regression.Ulceratedplaques were defined as recesses in the contour of the lesion at least 2mm in depth andwidth.Results1.11.7% (238/2036) subjects had simply increased carotid IMT,carotid plaquespresent in 37.9% participants without any ulcerated plaques.2.The prevalence of diabetes mellitus was greater in those weighed 2500g or less than other groups.The birthweight and head circumference were reduced in people whohad increased carotid IMT and plaques compared to normal carotid IMT.3.Univariable analysis showed significant difference between simple thicken,plaque group and normal group in father's occupation,maternal age and headcircumference.4.The prevalence of variable risk factors in adult life was higher in subjects withraised IMT and plaques,such as hypertension,high cholesterol,high glucose level,et al.5.No significant difference was found between normal and simply thicken,plaquegroup in both intrauterine growth and variable risk factors in adult life.6.Multivariable logistics regression analysis manifested the significant associationbetween the age of pregnant mothers,birthweight,head circumference and increasedcarotid IMT.The incidence rate of carotid atherosclerosis was greater in those weighed2500g or less,whose maternal age of pregnancy older than 35 years or headcircumference less than 31 cm compared with reference values.The Framingham score ofhigh risk and renal function failure showed a similar pattern in relation to carotid IMT.ConclusionAdvanced maternal age older than 35 years,low birthweight,small headcircumference,Framingham score as well as renal failure are independent risk factors forcarotid intimal-medial thickness. ObjectiveTo investigate the relationship between carotid atherosclerosis with coronary heartdisease risk factors.Materials and MethodsSonographic assessment of carotid was performed in 219 people aged above fiftywho came for physical examination.The mean intima-media thickness(IMT) wasmeasured with ultrasonography on the far wall from three well-defined vessel wallsegments in the left and fight carotid arteries.According to IMT,all participants weredivided into plaque group with IMT≥1.5mm,simply thicken group with IMT less than1.5mm,and normal group.Categoricd plaques into simple and complex types on thebasis of plaque homogeneity,recorded the number of plaques and the blood vesselsegments with plaques,then evaluated plaque index according to plaque thicknesses andnumbers.Blood pressure,height,weight,fast blood glucose and lipid were measured.The history of hypertension,diabetes and smoking were questioned.The relationbetween carotid IMT,various plaque parameters and the coronary heart disease riskfactors were assessed.Results1.There were 72(24.7%) cases with total 131 carotid plaques.The simple plaqueswere more common than the complex.Fifty-four(24.7%) subjects present simplyincreased carotid IMT,and 93(42.5%) with normal carotid IMT.One hundred andtwenty-four(43.06%) blood vessel segments were detected with plaques.2.Univariate.analyses indicated simply thicken and plaque group weresignificantly higher than normal group in age,male,smoking,systolic blood pressure,serum uric acid(UA) and triglycerides(TG).The prevalence of diabetes mellitus andhypertension was greater in those with increase IMT or plaques than normal group,butwithout significant difference.Male in plaque group was much more than in those simplythicken.3.Multivariate stepwise regression analysis indicated age,gender,systolic bloodpressure,triglycerides(TG) and UA still had direct correlation with mean intima-mediathickness.No relationship was found between the incidence of smoking and IMT.4.Higher plaque index showed positive correlation with blood pressure and higherUA level.No relationship was found between the number of blood vessel segment withplaques and cardiovascular risk factors mentioned above. ConclusionAging,male,increased systolic blood pressure,LDL and UA level were associatedwith carotid intima-media thickness and plaques.They were risk factors for carotidatherosclerosis.
|
PDF Full Text Request