Carotid intima-media thickness: influence of drug treatment and clinical implications

Ubels, F.L.; Terpstra, WF; Smit, Andries J.

doi:10.1016/s0300-2977(99)00053-4

Cited by 21 publications

(10 citation statements)

References 26 publications

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“…However, current evidence suggests that cardiovascular events in PCOS are only slightly increased (37)(38)(39) and there is a discrepancy between the common finding of increased markers in early atherosclerosis and the development of cardiovascular events. In addition, it has been shown that increased IMT in young women with PCOS may be rapidly reversible with metformin (20), a finding that is different from that found in the general population (21).…”

Section: Discussionmentioning

confidence: 80%

“…In particular, carotid IMT has been found to be increased even in young women with PCOS (17,18) and is generally believed to reflect the early appearance of atherosclerosis (19). However, in most women with PCOS, the increase in carotid IMT is generally small and rapidly reversible with metformin (20); a finding that is uncommon in the general population (21).…”

Section: Introductionmentioning

confidence: 99%

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Correlates of increased lean muscle mass in women with polycystic ovary syndrome

Carmina¹,

Guastella²,

Longo³

et al. 2009

European Journal of Endocrinology

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Objective: Muscle mass plays an important role in determining cardiovascular and metabolic risks in polycystic ovary syndrome (PCOS). In addition, whether lean mass influences carotid intima-media thickness (IMT) in PCOS has not been assessed. Design: Prospective investigation. Methods: Ninety-five women with PCOS were age-and weight-matched to 90 ovulatory controls. All women had dual X-ray absorptiometry for lean, fat and bone mass, and bone mass density (BMD). Serum testosterone, sex hormone-binding globulin, insulin, and glucose and carotid IMT were determined. Free androgen index (FAI) and insulin resistance (by QUICKI) were calculated. Results: In PCOS, waist circumference and insulin were higher and QUICKI lower than in controls (P!0.01). Trunk fat mass, % trunk fat, and lean mass were higher in PCOS compared to controls (P!0.01), while total bone mass and BMD were similar. IMT was increased in PCOS (P!0.01) but only 15% of PCOS patients had abnormal (R0.9 mm) values. Lean mass correlated with fat parameters, insulin, QUICKI, and FAI, but not with total testosterone; and after adjustments for insulin and QUICKI, lean mass still correlated with fat mass (P!0.01) but not FAI. Lean mass correlated with IMT (P!0.01), but this was dependent on insulin. However, excluding those patients with abnormal IMT values, IMT correlated with lean mass independently of insulin. Bone mass correlated with lean and fat mass, but not with insulin or androgen. PCOS patients with 'pathological' IMT values had higher % trunk fat, lean mass, and insulin, lower QUICKI, and higher testosterone and FAI compared with those with normal IMT. Conclusion: Lean mass is increased in PCOS, while bone mass is similar to that of matched controls. The major correlates of lean mass are fat mass and insulin but not androgen. Lean mass also correlated with IMT, and although influenced by insulin, small changes in IMT may partially reflect changes in muscle mass, while clearly abnormal values relate to more severe abnormalities of PCOS.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Correlates of increased lean muscle mass in women with polycystic ovary syndrome

Carmina¹,

Guastella²,

Longo³

et al. 2009

European Journal of Endocrinology

View full text Add to dashboard Cite

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“…The 2-y progression rate of the carotid IMT (0.05 mm) is in line with previously a-Linolenic acid, atherosclerosis and inflammation WJE Bemelmans et al reported rates in the placebo arm of secondary prevention studies, where it varied between À0.02 and 0.034 mm/y. In these studies, the differences between statin and placebo groups varied between 0.01 and 0.03 mm/y (Ubels et al, 1999). Our study may have been underpowered to exclude an effect of ALA on progression of IMT.…”

Section: Discussionmentioning

confidence: 89%

Increased α-linolenic acid intake lowers C-reactive protein, but has no effect on markers of atherosclerosis

et al. 2004

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Objective: To investigate the effects of increased alpha-linolenic acid (ALA)-intake on intima-media thickness (IMT), oxidized low-density lipoprotein (LDL) antibodies, soluble intercellular adhesion molecule-1 (sICAM-1), C-reactive protein (CRP), and interleukins 6 and 10. Design: Randomized double-blind placebo-controlled trial. Subjects: Moderately hypercholesterolaemic men and women (55710 y) with two other cardiovascular risk factors (n ¼ 103). Intervention: Participants were assigned to a margarine enriched with ALA (fatty acid composition 46% LA, 15% ALA) or linoleic acid (LA) (58% LA, 0.3% ALA) for 2 y. Results: Dietary ALA intake was 2.3 en% among ALA users, and 0.4 en% among LA users. The 2-y progression rate of the mean carotid IMT (ALA and LA: þ 0.05 mm) and femoral IMT (ALA: þ 0.05 mm; LA: þ 0.04 mm) was similar, when adjusted for confounding variables. After 1 and 2 y, ALA users had a lower CRP level than LA users (net differences À0.53 and À0.56 mg/l, respectively, Po0.05). No significant effects were observed in oxidized LDL antibodies, and levels of sICAM-1, interleukins 6 and 10. Conclusions: A six-fold increased ALA intake lowers CRP, when compared to a control diet high in LA. The present study found no effects on markers for atherosclerosis. Sponsorship: The Dutch 'Praeventiefonds'.

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“…Inclusion and exclusion criteria for the METEOR study Inclusions One or more maximum IMT measurements of ≥1.2 and <3.5 mm (assessed at both visits 2 and 3) Aged 45-70 years (male) or 55-70 years (female) Asymptomatic for any atherosclerosis-related disease Fasting LDL-C levels of ≥120 mg/dl (3.1 mmol/l) and <160 mg/dl (4.1 mmol/l) at visit 1 (−6 weeks) (for subjects with ≥2 risk factors and a 10-year CHD risk of <10%) Fasting LDL-C levels of ≥120 mg/dl (3.1 mmol/l) and <190 mg/dl (4.9 mmol/l) at visit 1 (for subjects with no additional CHD risk factor other than age) HDL-C ≤60 mg/dl (1.6 mmol/l) and triglyceride levels of <500 mg/dl ( For measurement of MeanMax IMT, the maximum IMT in each of the 12 segments is defined as the largest measurement derived from five interrogation angles, each one 30 degrees different to the adjacent angle. Assessment of the MeanMax from 12 segments is most frequently applied in studies of this design [25], and is based on evidence that aggregating data across a larger number of vessel segments increases the reliability of longitudinal (i.e. change over time) measurements [26].…”

Section: Ultrasound and Imt Measurementsmentioning

confidence: 99%

Measuring Effects on Intima Media Thickness: An Evaluation of Rosuvastatin in Subclinical Atherosclerosis—The Rationale and Methodology of the METEOR Study

Crouse

Grobbee

O’Leary

et al. 2004

Cardiovasc Drugs Ther

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Summary. Background: Increased carotid intima media thickness (IMT) is associated with established coronary heart disease (CHD) and is a marker of atherosclerosis.Statins are an effective treatment for dyslipidaemia, and have been shown to retard progression or promote carotid IMT regression in patients at high risk of CHD. Rosuvastatin is a highly efficacious statin, and the Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin (METEOR) study is designed to assess the impact of rosuvastatin on carotid IMT progression in low risk subjects with signs of subclinical atherosclerosis.Methods: In this randomised, parallel-group study, asymptomatic subjects at low risk of cardiovascular disease, but with evidence of atherosclerosis (defined as carotid IMT ≥1.2 mm and <3.5 mm), will receive rosuvastatin (40 mg/day) or placebo for 104 weeks. The study will enrol 840 European and US subjects randomised 5:2 between rosuvastatin and placebo. The primary end point will be the change in carotid IMT from baseline to study end, measured using B-mode ultrasonography. Other efficacy end points include changes in the serum lipid profile and C-reactive protein. Safety parameters will also be assessed. Conclusion:The METEOR study will evaluate whether long-term rosuvastatin treatment promotes regression, or slows progression, of subclinical atherosclerosis in asymptomatic subjects at low risk of cardiovascular disease.

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Carotid intima-media thickness: influence of drug treatment and clinical implications

Cited by 21 publications

References 26 publications

Correlates of increased lean muscle mass in women with polycystic ovary syndrome

Correlates of increased lean muscle mass in women with polycystic ovary syndrome

Increased α-linolenic acid intake lowers C-reactive protein, but has no effect on markers of atherosclerosis

Measuring Effects on Intima Media Thickness: An Evaluation of Rosuvastatin in Subclinical Atherosclerosis—The Rationale and Methodology of the METEOR Study

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