Serum insulin levels are associated with vulnerable plaque components in the carotid artery: the Rotterdam Study

Mujaj, Blerim; Bos, Daniël; Kavousi, Maryam; Lugt, Aad van der; Staessen, Jan A.; Franco, Oscar H.; Vernooij, Meike W.

doi:10.1530/eje-19-0620

Cited by 11 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consequently, energy production from free fatty acids oxidation will increase and lipotoxicity may occur, leading to increased oxygen consumption, stress, and reduced cardiac contractility (28). Alternatively, serum insulin levels were associated with a higher presence of intraplaque hemorrhage in existing atherosclerotic plaque (29), a plaque feature responsible for plaque progression in coronary arteries (30), leading to RV coronary ischemia (31). However, the link between the RV function and pulmonary circulation remains poorly understood (14).…”

Section: Discussionmentioning

confidence: 99%

Serum insulin is associated with right ventricle function parameters and lung volumes in subjects free of cardiovascular disease

Krüchten

Lorbeer

Rospleszcz

et al. 2021

European Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

Background: Diabetes mellitus is an established risk factor for cardiovascular diseases. Even impaired levels of glucose and insulin might harm organ function prior to diabetes onset. Whether serum glucose or insulin plays a direct role in cardiac dysfunction or lung volume reduction remains unclear. The aim was to investigate the relationship between glucose and insulin with the right ventricle and lung volumes within KORA-MRI FF4 study. Methods: From the KORA-MRI FF4 cohort study 337 subjects (mean age 55.7±9.1 years; 43% women) underwent a whole-body 3T MRI scan. Cardiac parameters derived from a cine-steady-state free precession sequence using cvi42. MRI-based lung volumes derived semi-automatically using an in-house algorithm. Fasting serum glucose, fasting insulin levels, and HOMA-index was calculated in all study subjects. Linear regression analyses performed to assess the relationships between glucose and insulin levels with right ventricle volumes and lung volumes adjusted for age, sex, BMI, and cardiovascular risk factors. Results: In univariate and multivariate-adjusted models, high serum insulin was associated with low end-diastolic volume (ß=–12.43, p<0.001), end-systolic volume (ß=–7.12, p<0.001), stroke volume (ß=–5.32, p<0.001), but not with ejection fraction. The association remained significant after additional adjustment for lung volumes. Similarly, serum insulin was inversely associated with lung volume (ß=–0.15, p=0.04). Sensitivity analysis confirmed results after excluding subjects with known diabetes. Conclusions: Serum insulin was inversely associated with right ventricle function and lung volumes in subjects from the general population free of cardiovascular disease, suggesting that increased insulin levels may contribute to subclinical cardiopulmonary circulation impairment.

show abstract

Section: Discussionmentioning

confidence: 99%

Serum insulin is associated with right ventricle function parameters and lung volumes in subjects free of cardiovascular disease

Krüchten

Lorbeer

Rospleszcz

et al. 2021

European Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the Rotterdam study, a large population study of individuals with ≥2.5 mm plaque, it was shown that systolic blood pressure and pulse pressure were significantly positively associated with IPH (OR: 1.13, 95% CI: 0.99-1.28; OR: 1.22, 95% CI: 1.07-1.40, respectively) after adjustment for age and sex (139). The serum insulin levels are also associated with IPH (OR: 1.42, 95% CI: 1.12-1.7), while they were not associated with the presence of calcifications or a LRNC (140). Recently, Pletsch-Borba et al (141) showed in a sub-analysis of 198 participants of the Rotterdam study, that hypertension is significantly associated with new IPH and new calcifications over a 4 year period (OR: 3.87, 95% CI: 1.90-7.90; OR: 2.20, 95% CI: 1.07-4.40, respectively), while higher levels of cholesterol were associated with LRNC progression (OR: 1.40, 95% CI: 1.10-1.70).…”

Section: Relation Between Plaque Composition and Clinical Risk Factorsmentioning

confidence: 91%

Magnetic resonance imaging of carotid plaques: current status and clinical perspectives

Kassem¹,

Florea²,

Mottaghy³

et al. 2020

Ann Transl Med

View full text Add to dashboard Cite

Rupture of a vulnerable carotid plaque is one of the leading causes of stroke. Carotid magnetic resonance imaging (MRI) is able to visualize all the main hallmarks of plaque vulnerability. Various MRI sequences have been developed in the last two decades to quantify carotid plaque burden and composition.Often, a combination of multiple sequences is used. These MRI techniques have been extensively validated with histological analysis of carotid endarterectomy specimens. High agreement between the MRI and histological measures of plaque burden, intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), fibrous cap (FC) status, inflammation and neovascularization has been demonstrated. Novel MRI sequences allow to generate three-dimensional isotropic images with a large longitudinal coverage. Other new sequences can acquire multiple contrasts using a single sequence leading to a tremendous reduction in scan time. IPH can be easily identified as a hyperintense signal in the bulk of the plaque on strongly T 1weighted images, such as magnetization-prepared rapid acquisition gradient echo images, acquired within a few minutes with a standard neurovascular coil. Carotid MRI can also be used to evaluate treatment effects.Several meta-analyses have demonstrated a strong predictive value of IPH, LRNC, thinning or rupture of the FC for ischemic cerebrovascular events. Recently, in a large meta-analysis based on individual patient data of asymptomatic and symptomatic individuals with carotid artery stenosis, it was shown that IPH on MRI is an independent risk predictor for stroke, stronger than any known clinical risk parameter. Expert recommendations on carotid plaque MRI protocols have recently been described in a white paper. The present review provides an overview of the current status and applications of carotid plaque MR imaging and its future potential in daily clinical practice.

show abstract

“…Diabetes is known to play an important role in stroke. The Rotterdam Study showed that IPH is associated with increased serum insulin levels but not with increased glucose levels [ 42 ]. Previous studies have also found that diabetes was highly associated with lipid-rich necrotic cores (LRNC) of plaques and that the volume ratio of LRNC > 22.0% in carotid plaques could be an independent risk factor for acute cerebral infarction [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Integrated head and neck imaging of symptomatic patients with stroke using simultaneous non-contrast cardiovascular magnetic resonance angiography and intraplaque hemorrhage imaging as compared with digital subtraction angiography

Jia

Liu

Zhang

et al. 2022

Journal of Cardiovascular Magnetic Resonance

View full text Add to dashboard Cite

Background Both stenosis rate and intraplaque hemorrhage (IPH) are important predictors of stroke risk. Simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) cardiovascular magnetic resonance (CMR) imaging can detect both stenosis rate and IPH. We aimed to evaluate consistency between SNAP and digital subtraction angiography (DSA) to assess symptomatic patients with stroke and explore the performance of SNAP to identify IPH and the clinical factors associated with IPH. Methods Eighty-one symptomatic patients with stroke, admitted to Wuhan Union Hospital who underwent CMR high-resolution vessel wall imaging (HR-VWI) and SNAP, were retrospectively identified. For patients who received interventional therapy, the imaging functions of SNAP and HR-VWI were compared with DSA. The diameters of the intracranial and carotid vessels were measured, and stenotic vessels were identified. The consistency of SNAP and HR-VWI in identifying IPH was also examined, and the correlations between IPH and clinical factors were analyzed. Results SNAP was more consistent with DSA than HR-VWI in measuring vascular stenosis (intraclass correlation coefficient [ICC]SNAP-DSA = 0.917, ICC HR-VWI-DSA = 0.878). Regarding the diameter measurements of each intracranial and carotid vessel segment, SNAP was superior or similar to HR-VWI, and both were consistent with DSA in the measurement of major intracranial vascular segments. HR-VWI and SNAP exhibited acceptable agreement in identifying IPH (Kappa = 0.839, 95% confidence interval [CI]: 0.704–0.974). Patients who underwent interventional therapy had a higher plaque burden (P < 0.001). Patients with IPH had lower levels of high-density lipoprotein cholesterol (HDL) (P = 0.038) and higher levels of blood glucose (P = 0.007) and cystatin C (P = 0.040). Conclusions CMR SNAP is consistent with DSA in measuring vessel diameters and identifying atherosclerosis stenosis in each intracranial and carotid vessel segment. SNAP is also a potential alternative to HR-VWI in identifying stenosis and IPH.

show abstract

Serum insulin levels are associated with vulnerable plaque components in the carotid artery: the Rotterdam Study

Cited by 11 publications

References 29 publications

Serum insulin is associated with right ventricle function parameters and lung volumes in subjects free of cardiovascular disease

Serum insulin is associated with right ventricle function parameters and lung volumes in subjects free of cardiovascular disease

Magnetic resonance imaging of carotid plaques: current status and clinical perspectives

Integrated head and neck imaging of symptomatic patients with stroke using simultaneous non-contrast cardiovascular magnetic resonance angiography and intraplaque hemorrhage imaging as compared with digital subtraction angiography

Contact Info

Product

Resources

About