Echogenecity of the carotid intima–media complex is related to cardiovascular risk factors, dyslipidemia, oxidative stress and inflammation: The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study

Andersson, Jessika; Sundström, Johan; Gustavsson, Thomas; Hulthe, Johannes; Elmgren, Anders; Zilmer, Kersti; Zilmer, Mihkel; Lind, Lars

doi:10.1016/j.atherosclerosis.2008.10.038

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Volume 204, Issue 2 , Pages 612-618, June 2009

Echogenecity of the carotid intima–media complex is related to cardiovascular risk factors, dyslipidemia, oxidative stress and inflammation:

The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study

Jessika Andersson
- Department of Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden
- Corresponding author. Tel.: +46 186110000.
Johan Sundström
- Department of Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden
Thomas Gustavsson
- Department of Signals and Systems, Chalmers University of Technology, Sweden
Johannes Hulthe
- Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
- AstraZeneca R&D Mölndal, Sweden
Anders Elmgren
- AstraZeneca R&D Mölndal, Sweden
Kersti Zilmer
- Department of Biochemistry, University of Tartu, Estonia
Mihkel Zilmer
- Department of Biochemistry, University of Tartu, Estonia
Lars Lind
- Department of Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden

Received 4 July 2008; received in revised form 5 October 2008; accepted 21 October 2008. published online 09 February 2009.

Abstract

Background

Increased carotid artery intima–media thickness (IMT), measured by ultrasound, is related to an increased risk of cardiovascular disease. Since presence of echolucent plaques increases the risk further, we investigated if echogenecity of the carotid intima–media complex is related to markers of cardiovascular risk. Our aim was therefore to investigate if intima–media echogenecity is related to cardiovascular risk factors, or to markers of inflammation and oxidation in an exploratory investigation.

Methods

The PIVUS cohort study is an observational study of 1016 (509 women and 507 men) randomly chosen individuals aged 70 living in Uppsala, Sweden. Carotid artery ultrasound measurements were performed. IMT and the grey scale median (GSM) value were calculated in the intima–media complex (IM-GSM) in the far wall of the common carotid artery. Traditional risk factors were evaluated together with indices of oxidative stress and inflammation.

Results

In the multiple regression analysis, HDL-cholesterol, body mass index, conjugated diens, glutathione, e-selectin and TNF alfa were significantly related to IM-GSM. IMT was independently related to blood pressure, smoking and body mass index.

Conclusion

The echolucency of the carotid intima–media was related to several cardiovascular risk factors not related to IMT, such as dyslipidemia, oxidative stress and inflammation. Since the echogenecity of the carotid intima–media complex was related to different risk factors compared to carotid IMT, it is worthwhile to further explore the usefulness of this new marker of the vascular wall.

Keywords: Atherosclerosis, Ultrasound, Echogenecity, Carotid artery, Risk factor, Lipids, Oxidation