The Demographic Features And Risk Factors Of Carotid Intima-media Thickness And Plaque In Middle-aged And Elderly Rural Population In Ji County, Tianjin

Objective To describe the demographic features of carotid intima-media thickness(IMT) and plaque; and analyze its association with cardiovascular risk factors among adults in Ji county, Tianjin.Methods During April to June in 2014, a cross-sectional examination for B-mode carotid ultrasound imaging and cardiovascular risk factors were performed in a rural population aged 45 and over in Ji County, Tianjin.Measurement of IMT of the carotid artery, detects the presence of carotid plaque, and calculates the prevalence of carotid artery plaque in the crowd. The relationship Between risk factors of cardiovascular diseases and the prevalence of carotid plaque was analyzed.Results(1)This study investigated a total of 3789 people consisit of 1560 males and 2229 females.The mean age was 59.92±9.70(45~93).The average years of schooling was 5.36±3.70, the men’s average years of schooling was 6.31±3.36, the women’s average years of schooling was 4.67±3.38(2)The mean BMI=25.57 ±3.68 Kg/m2, the mean SBP =146.42 ± 22.17 mm Hg, the mean DBP=86.81 ±11.40 mm Hg, the mean fasting blood glucose=5.92±1.57mmol/l, the mean TC=4.86± 1.09mmol/l, the mean TG=1.76 ± 1.24mmol/l,the mean HDL-C=1.46 ±0.46mmol/l,the mean LDL-C=2.70±1.25mmol/l.The prevalence rate of hypertension was 68.2%,the prevalence rate of diabetes was 7.4%, The prevalence rate of family history of hypertension was 20.3%, The prevalence rate of family history of diabetes was 4.1%, The prevalence rate of family history of stroke was 7.8%, the rate of overweight was 42.3%; the rate of obesity was 23.4%,the rate of smoking was 20.5%, the rate of quit smoking was 4.6%,the rate of drinking was 14.7%, the rate of quit drinking was 1.3% the prevalence of low HDL-C was 14.4%,the prevalence rate of high LDL-C was 7.9%,the prevalence rate of high TC was 10.4%, the prevalence rate of high TG was 21.9%, the prevalence rate of high fasting blood glucose was 27.9%, the prevalence rate of hypertension Ⅰ was 33.7%, the prevalence rate of hypertension Ⅱwas 22.2%, the prevalence rate of hypertension Ⅲ was 7.2%(3) The mean IMT=0.5671±0.0879 mm,the maximum IMT=0.6706±0.2338 mm, the minimum IMT=0.4693±0.1332, The prevalence of carotid plaque for subjects was 41.5%, There are significant gender differences in the prevalence of carotid plaque.The plaque prevalence rate was 50.1% for male and 35.5% for female(χ2=80.516,p<0.001).IMT and prevalence rate of carotid plaque increased with elevated levels of age in both males and females(4)①For male,the Mean-IMT,Min-IMT,and Max-IMT increased with elevated levels of systolic blood pressure,the Mean-IMT and Min-IMT decreased with elevated levels of diastolic blood pressure, the Max-IMT increased with elevated levels of fasting blood glucose while the Min-IMT decreased with elevated levels of fasting blood glucose,the Max-IMT decreased with elevated levels of TG, The Mean-IMT,and Max-IMT increased with elevated levels of LDL-C(p<0.01 or p<0.05). the total number of carotid plaque increased with elevated levels of systolic blood pressure and LDL-C decreased with elevated levels of diastolic blood pressure. The total area of carotid plaque increased with elevated levels of systolic blood pressure fasting blood glucose and LDL-C, decreased with elevated levels of diastolic blood pressure.(p<0.01). Hypertension, diabetes, smoking,and high LDL-C were the risk factors of prevalence rate of carotid plaque.Their adjusted values were OR=1.58(1.24~2.02),P<0.001;OR=2.12(1.33~3.39),P=0.002;OR=1.51(1.18~1.94),P=0.001;OR=4.12(2.30~7.40),p<0.001 respectly. Drinking was protective factors for carotid plaque, the adjusted OR values and P values was 0.68(0.53~0.87)and 0.002.②For female,the Mean-IMT,Min-IMT,and Max-IMT increased with elevated levels of systolic blood pressure,the Mean-IMT and Min-IMT decreased with elevated levels of diastolic blood pressure, the Mean-IMT and Max-IMT increased with elevated levels of fasting blood glucose,the Min-IMT decreased with elevated levels of TG whlie Mean-IMT and Max-IMT increased with elevated levels of TG, The mean-IMTand Max-IMT increased with elevated levels of LDL-C. the total number and area of carotid plaque increased with elevated levels of systolic blood pressure and LDL-C, decreased with elevated levels of diastolic blood pressure.(p<0.01).Hypertension, diabetes, and high LDL-C were the risk factors of prevalence rate of carotid plaque.Their adjusted OR values and P values were OR=1.47(1.19~1.81),P<0.001;OR=1.56(1.12~2.17),P=0.008;OR=5.13(3.40~7.73),P<0.001 respectly. TC was protective factors for carotid plaque, the adjusted OR values and P values was 0.67(0.47~0.95)and 0.023Conclusions:(1)The cartid atherosclerosis was common in middle and older age rural Chinese.(2) The carotid intima-media thickness and plaque were associated with multiple risk factors of cardio-cerebrovascular disease and their associations was different:There was a positive correlation between age, systolic blood pressure,high LDL-C and carotid artery thickness. Negative correlation between diastolic blood pressure and carotid artery thickness was found. Age, hypertension, diabetes, high LDL-C were the risk factors for carotid artery plaque(3)The relationship of carotid atherosclerosis with the risk factors of cardio-cerebrovascular disease was different in different gender :Positive correlation between fasting blood glucose and carotid art--ery thickness was found in females.There was a negative correlation between TG an--d carotid artery thickness in females. Positive correlation between fasting blood gluc--ose and total carotid plaque area was found in males. Smoking is a risk factor while drinking is the protective factor for carotid artery plaque in males. And high TC is a protective factor for carotid artery plaque in females.