The levels of hemoglobin are positively associated with arterial stiffness in community-dwelling Chinese adults

Background and aimsHemoglobin (Hb) concentrations are known to be related to cardiovascular diseases. This study investigated the association between Hb levels and arterial stiffness, as assessed by measurement of the brachial-ankle pulse wave velocity (baPWV).Methods and results3576 adults (2139 males and 1437 females) from the general Chinese population who had their physical check-ups in the health examination centers of Jiangmen Central Hospital were enrolled into the study. The anthropometrics and laboratory data as well as the baPWV and Hb levels were subsequently obtained. Age-adjusted partial correlation and multivariable stepwise linear regression analyses were used to evaluate the relationships between Hb and baPWV for men and women separately. In both sexes, Hb levels were positively associated with body mass index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, glutamic-pyruvic transaminase, γ-glutamyltranspeptidase, uric acid and baPWV, but negatively correlated with the estimated glomerular filtration rate. Multivariable linear regression analysis showed that Hb was significantly and independently associated with arterial stiffness in men (β = 0.043, 95% CI 0.010–0.077, p < 0.05) and women (β = 0.035, 95% CI 0.001–0.069, P < 0.05), after adjustment for confounding factors.ConclusionThe data indicate that high Hb concentration significantly correlate with increased baPWV in general Chinese population.     

Arterial stiffness and wave reflection: Biomarkers of cardiovascular risk

Arterial stiffness and excessive pressure pulsatility have emerged as important risk factors for cardiovascular disease. Arterial stiffness increases with age and in the presence of traditional cardiovascular disease risk factors, such as hypertension, diabetes and lipid disorders. Pathologic stiffening of large arteries with advancing age and risk factor exposure predominantly involves the elastic aorta and carotid arteries, whereas stiffness changes are relatively limited in muscular arteries. Aortic stiffening is associated with increased pulse wave velocity and pulse pressure, which are related but distinct measures of the pulsatile energy content of the pressure waveform. A dramatic increase in pulsatile energy content of pressure and flow waves in the arterial system places considerable pulsatile stress on the heart, large arteries and distal circulation. Large artery stiffening is associated with abnormalities in microvascular structure and function that may contribute to tissue damage, particularly in susceptible high flow organs such as the brain and kidneys. This brief review summarizes results of recent research on risk factors for and adverse effects of large artery stiffening.     

High-sensitivity cardiac troponin T in geriatric inpatients

BackgroundHigh-sensitivity cardiac troponin T (hs-cTnT) is detectable in elderly patients without clinical diagnosed cardiovascular disease. Elevated hs-cTnT levels predict increased cardiovascular risks and poor prognosis. The aim of this study was to determine the distribution and associated factors of hs-cTnT in geriatric inpatients without acute coronary syndrome (ACS).MethodsHs-cTnT was measured with a highly sensitive assay in 679 geriatric inpatients without ACS. Patients were further divided into 3 groups according to the tertile of hs-cTnT levels and single and multiple variable analyses were performed to assess the association of hs-cTnT to cardiovascular risk factors, biochemical measurements and echocardiographic abnormalities.ResultsHs-cTnT was detectable (≥3 ng/L) in 98.4% of the subjects and 52.0% of the subjects had hs-cTnT levels ≥14 ng/L, which is at the 99th percentile Upper Reference Limit (URL). The levels of hs-cTnT were independently associated with N-terminal pro-brain natriuretic peptide (NT-proBNP), male gender, older age, estimated glomerular filtration rate (eGFR), left ventricular mass index (LVMI), diabetes mellitus (DM) and left ventricular ejection fraction (LVEF). There were no significant differences in hs-cTnT levels between geriatrics patients with stable coronary artery disease (SCAD) and those without SCAD.ConclusionHs-cTnT elevation caused by non-ischemic acute conditions was very common in geriatric hospitalized patients. Due to increases in baseline hs-cTnT in the elderly, detection of a rise and/or fall in hs-cTnT levels is essential for determining a diagnosis of ACS or AMI in geriatric patients. Further studies are needed to establish age-specific 99th percentile values of hs-cTnT for elderly individuals.     

血压、脉压水平及高血压病程对高血压患者动脉僵硬度的影响

目的探讨血压、脉压水平及高血压病程对高血压患者动脉僵硬度的影响。方法从上海市宝山区6家社区卫生中心及本院入选1026例高血压患者,收集相关病史信息,检测其颈-股动脉(C-F)、颈-桡动脉(C-R)、颈-足背动脉(C-D)脉搏波传导速度(PWV),672例患者在随访1年后复测PWV。从血压、脉压、高血压病程3者的不同水平进行分组比较及随访前后对照分析。结果 (1)1、2、3级高血压患者的C-FPWV随血压水平的增高而增快,分别为(12.61±2.76)m/s,(14.35±3.41)m/s,(15.50±2.93)m/s(均为P<0.01)。1级高血压组较2级、3级高血压组C-FPWV差异有统计学意义(均为P<0.01)。(2)随访前后C-FPWV在1级和2级高血压组分别为(12.73±2.91)m/s和(13.39±3.25)m/s,(13.96±3.07)m/s和(14.75±4.10)m/s,差异有统计学意义,而在3级高血压组差异无统计学意义。(3)脉压<40 mm Hg,40～60 mm Hg,≥60 mm Hg 3组C-FPWV随脉压的增大而增快,分别为(11.95±2.60)m/s,(12.94±2.85)m/s,(14.89±3.22)m/s(均为P<0.01)。随访1年后3组的C-FPWV分别较前增快0.70 m/s,0.65 m/s,0.85 m/s,差异均有统计学意义。(4)高血压病程<5年、5～10年、≥10年3组C-FPWV分别为(12.77±2.75)m/s,(12.85±3.07)m/s,(13.76±3.05)m/s,3组比较差异有统计学意义(均为P<0.01),病程越长,C-FPWV越快。结论(1)C-FPWV较C-RPWV、C-DPWV更能反映动脉僵硬度的变化。(2)C-FPWV随血压、脉压水平的增高及高血压病程的延长而增快,3者均为动脉僵硬度的重要影响因素。     

Plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women

Objectives To investigate the associations of the plasma homocysteine (HCY) levels with the alterations in arterial stiffness in a community-based cohort. The gender differences in these associations were examined. Methods We evaluated the relationship between plasma HCY levels to three measures of vascular function [carotid-femoral pulse wave velocity (CF-PWV), carotid-ankle PWV (CA-PWV) and heart rate corrected augmentation index (AI)] in 1680 participants (mean age: 61.5 years; 709 men, 971 women) from communities of Beijing, China. Results In univariate analysis, plasma HCY levels was positively related to the CF-PWV (r = 0.211, P < 0.0001) and CA-PWV (r = 0.148, P < 0.0001), whereas inversely associated with AI (r = ?0.052, P = 0.016). In multiple linear regression models adjusting for covariants, plasma HCY remained positively related to the CF-PWV (standardized β = 0.065, P = 0.007) in total cases. When the groups of men and women were examined separately, plasma HCY remained positively associated with the CF-PWV (standardized β = 0.082, P = 0.023) in men, whereas the relations between HCY and any of the arterial stiffness indices were not further present in women. Conclusions In Chinese population, plasma HCY levels are independently associated with alterations of large artery stiffness in men but not in women.     

Echocardiographic epicardial fat thickness is associated with arterial stiffness

Background

Epicardial adipose tissue represents visceral adiposity, the early detection of which could be helpful for assessing subclinical target organ damage. Although previous studies have reported a relationship between epicardial fat thickness (EFT) and carotid intima-media thickness, there have been no studies detailing the relationship between EFT and brachial–ankle pulse wave velocity (baPWV).

Methods

We consecutively enrolled 655 subjects (445 men, 55 ± 9 years) who underwent echocardiography and baPWV and had an ankle–brachial index greater than 0.95. The subjects were divided into four quartile groups depending on EFT. Subjects were also classified into two groups according to baPWV: group I (324 subjects), baPWV ≤ 1366 cm/s, and group II (331 subjects), baPWV > 1366 cm/s.

Results

The EFT in group II was significantly higher than in group I (4.2 mm vs. 3.7 mm, p < 0.001). There were significant differences in baPWV values among the EFT quartile groups (quartile I, 1327 ± 148.8 cm/s; quartile II, 1371 ± 215.0 cm/s; quartile III, 1434 ± 228.3 cm/s; quartile IV, 1507 ± 233.1 cm/s; p-value < 0.001). In multivariate regression models, the highest quartile groups of EFT had higher odds ratios (ORs) for increased baPWV compared with that of the lowest quartile group (OR [95% confidence interval (CI)]: 2.19[1.21–3.95]), irrespective of confounding factors. Moreover, EFT was an independent determinant of baPWV (standard β = 0.113, p = 0.001).

Conclusions

This study demonstrates an independent relationship between EFT and arterial stiffness, suggesting that echocardiographic EFT measurement could be an easy-to-measure tool for early detection of subclinical target organ damage.     

急性心肌梗死患者血清高敏肌钙蛋白T及线粒体偶联因子-6含量的变化

目的观察急性心肌梗死（AMI）患者血清高敏肌钙蛋白T（hs-TnT）及线粒体偶联因子-6（CF6）含量在冠状动脉循环中的变化。方法纳入2009年4月到2011年3月期间我院收诊的AMI患者60例,同期选取冠脉造影结果无狭窄或狭窄程度〈50%的患者30例作为对照组。取两组受试者冠状静脉窦、冠状动脉与外周血清,分别采用发光免疫法和放射免疫法测定hs-TnT及CF6浓度。结果 AMI患者冠状静脉窦、冠状动脉与外周静脉血清中hs-TnT、CF6浓度与对照组相比,差异均有统计学意义（P〈0.01）;AMI患者冠状静脉窦血清hs-TnT、CF6较冠状动脉血清hs-TnT、CF6均值升高,差异有统计学意义（P〈0.01）。结论 AMI可导致冠脉循环hs-TnT和CF6浓度升高,二者可在一定程度上预测心肌梗死面积。     

Arterial stiffness is increased in healthy subjects with a positive family history of hypertension

Abstract

A positive family history of hypertension is a risk factor for cardiovascular diseases. We investigated the value of pulse wave velocity (PWV) in healthy subjects with a positive family history of hypertension. 255 healthy subjects (M/F: 75/180) were divided into two groups according to without (group 1) or with (group 2) a positive family history of hypertension. Carotid-femoral pulse wave velocity (CF-PWV) was measured by Complior apparatus. Our results showed that CF-PWV was significantly higher in group 2 than in group 1 (7.90?±?1.31 versus 7.32?±?1.15?m/s, p?<?0.001). High-density lipoprotein cholesterol (HDL-C) was significantly higher in group 1 than in group 2. Multiple linear regressions showed that age, family history, GLU, and MAP were independent influencing factors of CF-PWV in the entire study group. Our present study showed PWV is significantly higher in healthy subjects with a positive family history of hypertension. Family history might play an important role in this process.     

Arterial stiffness in patients with non-alcoholic fatty liver disease is related to fibrosis stage and epicardial adipose tissue thickness

Objective: Non-alcoholic fatty liver disease (NAFLD) is associated with atherosclerosis and reduced vascular compliance. The purpose of this study was to examine the relationships between arterial stiffness measures, the histological severity of NAFLD, and epicardial fat thickness (EFT). Methods: A total of 100 patients with biopsy-proven NAFLD and 50 age- and sex-matched controls were enrolled. The histological severity was assessed in all NAFLD patients. Measurements of arterial stiffness [pulse-wave velocity (PWV) and augmentation index (AIx)] were carried out using a Mobil-O-Graph arteriograph system. EFT was assessed by means of echocardiography. Results: Compared with controls, NAFLD patients had significantly higher PWV and AIx values. Stepwise linear regression analysis demonstrated that the liver fibrosis score and EFT were independent predictors of both PWV and AIx values in NAFLD patients. Conclusions: Patients with NAFLD have an increased arterial stiffness, which reflects both the severity of liver fibrosis and increased EFT values.     

心力衰竭患者血清基质金属蛋白酶及骨桥蛋白、cTnI、cTnT与心室重构的关系

目的研究及观察心力衰竭患者血清基质金属蛋白酶(matrix metalloproteinase,MMP)及骨桥蛋白(osteopontin,OPN)、心肌肌钙蛋白(cardiac troponin,c Tn)I、c Tn T与心室重构的关系。方法选取2012年8月至2014年3月四川省阆中市人民医院收治的70例心力衰竭患者为观察组;另外选择同时期的70名健康人为对照组。将两组的血清MMP及OPN、c Tn I、c Tn T浓度分别进行检测及比较,然后比较观察组不同左心室舒张末期容积指数(left ventricular end-diastolic volume index,LVEDVI)及左心室体积指数(left ventricular mass index,LVMI)患者的上述指标,并以Logistic分析处理上述血清指标与心室重构的关系。结果观察组的血清MMP及OPN、c Tn I、c Tn T浓度均高于对照组,差异有统计学意义(P<0.05);且观察组中不同ΔLVEDVI和LVMI患者上述指标比较,差异有统计学意义(P<0.05)。Logistic分析结果显示,血清MMP及OPN、c Tn I、c Tn T浓度与心室重构均有密切的关系(P<0.05)。结论心力衰竭心室重构患者的血清MMP及OPN、c Tn I、c Tn T浓度呈现异常的状态,上述指标对于心室重构均有较高的反映价值。     

Increased augmentation index is paradoxically associated with lower in-hospital mortality in patients with acute ischemic stroke

Objective

To evaluate the association between arterial stiffness and stroke severity and in-hospital outcome in patients admitted with acute ischemic stroke.

Methods

We prospectively studied 415 consecutive patients who were admitted with acute ischemic stroke (39.5% males, age 78.8 ± 6.6 years). On the third day of hospitalization, the following markers of arterial stiffness were recorded: central systolic blood pressure (cSBP), diastolic BP (cDBP), mean pressure (cMP), pulse pressure (cPP), augmentation index (AIx) and pulse wave velocity (PWV). The severity of stroke was assessed on admission with the National Institutes of Health Stroke Scale (NIHSS) score. The outcome was evaluated with rates of dependency at discharge (modified Rankin scale score between 2 and 5) and in-hospital mortality.

Results

None of the markers of arterial stiffness showed significant correlation with the NIHSS score on admission. However, there was a trend for an inverse correlation with AIx (r = −0.142, p = 0.064) and for a positive correlation with PWV (r = 0.235, p = 0.054). None of the markers of arterial stiffness differed between patients who were dependent at discharge and those who were independent. Patients who died during hospitalization had higher cDBP and cMP but lower cPP and AIx than patients who were discharged. In binary logistic regression analysis, independent predictors of in-hospital mortality were NIHSS score on admission (relative risk (RR) 1.16, 95% confidence interval (CI) 1.08–1.25, p < 0.001), presence of atrial fibrillation (RR 6.41, 95% CI 1.37–29.93, p = 0.018) and AIx (RR 0.94, 95% CI 0.89–0.99, p = 0.030).

Conclusions

Increased AIx appears to be associated with lower in-hospital mortality rates in elderly patients with acute ischemic stroke. Other markers of arterial stiffness do not appear to be associated with short-term outcome in this population.     

Factors associated with the release of cardiac troponin T following percutaneous transluminal coronary angioplasty

Background: Recent studies have suggested that immunoassay of cardiac troponin T (cTnT) provides a more sensitive measurement of myocardial necrosis than creatine kinase MB (CK-MB) mass concentration. Hypothesis: The purpose of this study was to compare the release of cTnT and CK-MB isoenzyme in patients undergoing percutaneous coronary angioplasty, and to investigate the clinical, procedural, and angiographic correlates of abnormal elevations of both of these markers. Methods: Total creatine kinase (total CK), CK-MB, and cTnT levels were measured immediately before and 12 h following intervention in 110 patients, including 100 consecutive patients undergoing coronary angioplasty and 10 control patients undergoing diagnostic cardiac catheterization. All patients had normal levels of all three markers at baseline. A postintervention total CK level >225 U/l, an increase in CK-MB >5.0 ng/ml, and/or an increase in cTnT >0.04 ng/ml were considered indicative of myocardial injury. Results: Coronary angioplasty was successfully performed in all 100 patients without emergency bypass surgery or death, although six patients required emergent placement of an intra-coronary stent for threatened closure. Eight patients demonstrated an abnormal increase in total CK, including six who were undergoing primary angioplasty for an acute myocardial infarction. One of these patients sustained a Q-wave infarction. Post angioplasty, 18 patients had elevations of both CK-MB and cTnT, 23 had elevations of only cTnT, and the remaining 59 patients had elevations of neither. All patients with CK-MB elevation also had cTnT elevation. Neither serologic marker increased in the diagnostic catheterization control patients. In comparison with patients without postintervention cTnT rise, patients with abnormal cTnT levels had a higher incidence of complex lesion morphology (p<0.01) and intra-coronary thrombus (p ≤0.0001) prior to coronary angioplasty, and a higher incidence of coronary dissection (p≤0.01), abrupt closure (p≤0.05), and side-branch occlusion (p≤0.01) during angioplasty. In patients with elevation of both cTnT and CK-MB, postintervention CK-MB levels were 12-fold higher and cTnT levels were 21-fold higher than in patients with isolated elevation of only cTnT (p<0.01). Conclusions: These data indicate that >40% of patients undergoing coronary angioplasty have evidence of minor degrees of myocardial damage, as evidenced by cTnT release. High-risk coronary lesions and both minor and major complications of angioplasty are associated with cTnT release. cTnT appears to be a more sensitive marker of myocardial injury than CK-MB under these circumstances. In comparison with isolated cTnT rise, elevation of both CK-MB and cTnT may be indicative of greater levels of myocardial injury.     

Elevated cardiac troponin T in predialysis patients is associated with inflammation and predicts mortality

OBJECTIVES: Cardiac troponin T (cTnT) is a highly sensitive and specific marker of myocardial damage. It has been shown that elevated serum concentrations of cTnT in haemodialysis (HD) patients are associated with poor prognostic outcome. The aim of the present study was to investigate the predictive value of cTnT in samples from predialysis patients and to investigate associations between cTnT and inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6). DESIGN: Cohort, follow-up study. SETTING: Huddinge University Hospital, Sweden. SUBJECTS: A total of 115 (62% males, 28% diabetic patients) end-stage renal disease (ESRD) patients (52 +/- 1 years), of which 29% had cardiovascular disease (CVD), were studied shortly before the onset of dialysis therapy. Sixty-four patients started peritoneal dialysis (PD) as renal replacement therapy, whilst 49 started HD during the follow-up. MAIN OUTCOME MEASURES: The cTnT was analysed with the third generation TnT assay on Elecsys 2010. The prognostic value was calculated for cTnT, IL-6, age, CVD, malnutrition, diabetes mellitus (DM) and gender. Survival analyses were made with Kaplan-Meier and Cox regression analyses, with all-cause mortality as the clinical end point (mean follow-up period 2.7 +/- 0.1 years). RESULTS: Significant correlations were found between cTnT and CKMB (rho = 0.52, P < 0.0001), IL-6 (rho = 0.23, P < 0.05), CRP (rho = 0.30, P < 0.05), and serum albumin (rho = -0.31, P < 0.001), respectively. Diabetic patients had higher median serum cTnT level (0.09 microg L-1; range <0.01-0.51 vs. 0.04 microg L-1; range <0.01-0.67 microg L-1; P < 0.005) compared with nondiabetic patients. Likewise, patients with CVD had a significantly higher median level (0.08 microg L-1; range <0.01-0.67 microg L-1 vs. 0.04 microg L-1; range <0.01-0.61 microg L-1; P < 0.01) of cTnT compared with patients without CVD. Patients with cTnT > or =0.10 microg L-1 had a higher cumulative mortality rate than patients with cTnT < 0.10 microg L-1 (chi2 = 7.04; P < 0.01). Whilst age, CVD, malnutrition, DM, IL-6, cTnT and male gender were associated with poor outcome in the univariate analysis, only DM (P < 0.05) and cTnT (P < 0.05) were independently associated with mortality in a multivariate analysis. CONCLUSIONS: The present study demonstrates that serum concentrations of cTnT > or =0.10 microg L-1 is a significant predictor of mortality in patients starting dialysis. Moreover, the positive correlations between cTnT and IL-6, and CRP, respectively, suggest an association between inflammation and cTnT levels. Finally, the results of the present study suggest that cTnT is an independent predictor of mortality in ESRD patients starting dialysis.     

未治疗原发性高血压患者脉搏波速度与血浆同型半胱氨酸水平相关性分析

目的 研究未经治疗的原发性高血压患者各动脉节段脉搏波速度（PWV）变化及其相关因素.方法 选取未经治疗的原发性高血压患者97例,健康对照组97例.采用Complior分析仪测定颈-股动脉脉搏波传导速度（CF-PWV）、颈-桡动脉脉搏波传导速度（CR-PWV）和颈-踝动脉脉搏波传导速度（CA-PWV）.采用全自动生化分析仪检测血糖、血脂、尿酸、同型半胱氨酸、高敏C反应蛋白等血液生化指标.结果 与对照组比较,未治疗的原发性高血压患者CF-PWV、CR-PWV和CA-PWV、血压、心率、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、尿酸和同型半胱氨酸均显著增加（P＜0.05或P＜0.01）.高密度脂蛋白胆固醇、肌酐和高敏C反应蛋白无明显变化.多因素逐步回归分析显示,CF-PWV的独立相关因素是高血压（β=0.333,P＜0.01）、脉压差（β=0.269,P＜0.01）和同型半胱氨酸（β=0.124,P＜0.05）.CR-PWV的独立相关因素是高血压（β=0.376,P＜0.01）、心率（β=0.148,P＜0.05）和同型半胱氨酸（β=0.135,P＜0.05）.CA-PWV的独立相关因素是高血压（β=0.556,P＜0.01）、体质量指数（β=-0.163,P＜0.01）和同型半胱氨酸（β =0.145,P＜0.05）.结论 未治疗原发性高血压患者各动脉节段PWV增加,血浆同型半胱氨酸水平是其独立相关因素之一.     

Prognostic performance of kinetic changes of high-sensitivity troponin T in acute coronary syndrome and in patients with increased troponin without acute coronary syndrome

Background

We sought to evaluate the prognostic impact of absolute and relative kinetic changes of high-sensitivity cardiac Troponin T (hs-cTnT) in comparison to baseline hs-cTnT elevations for risk stratification in acute coronary syndrome (ACS) and non-ACS conditions with increased hs-cTnT.

Methods

hs-cTnT was measured serially in patients presenting with acute symptoms to our emergency department. We assessed the prognostic performance of baseline and serial hs-cTnT concentrations in all consecutive patients with ACS (n = 406) or hs-cTnT increases not due to ACS (n = 442) within 3–6 h after admission.

Results

Mortality rates were higher, albeit not statistically, in non-ACS (53/442 = 12.0%) than ACS patients (36/406 = 8.9%). In ACS patients, receiver operating characteristics (ROC) revealed optimized cut-off values of 12.2 ng/L for absolute δ-change (AUC = 0.66, p < 0.001), 31.2 ng/L for baseline hs-cTnT (AUC = 0.71, p < 0.001) and 45.2 ng/L for maximal hs-cTnT (AUC = 0.68, p < 0.001). C-statistics showed superiority of absolute δ-changes (p = 0.0003), baseline hs-cTnT (p = 0.04) and maximal hs-cTnT (p = 0.02) compared to relative δ-changes. However, the combination of baseline hs-cTnT values with either absolute or relative δ-changes did not improve risk prediction compared to baseline hs-cTnT alone (p = n.s.). In non-ACS conditions, the ROC-optimized cut-off value of 46.2 ng/L for baseline hs-cTnT (AUC = 0.661, p < 0.001) was superior to absolute (p = 0.007) and relative δ-changes regarding prognostication (p = 0.045).

Conclusions

Our data suggest that the magnitude of baseline hs-cTnT, and not acute dynamic changes, convey superior long-term prognostic information in ACS and non-ACS conditions. Moreover, absolute and relative kinetic δ-changes of hs-cTnT do not add significant incremental value in risk assessment in both conditions.     

Association between serum homocysteine and arterial stiffness in elderly: a community-based study

Background Arterial stiffness and homocysteine are both powerful predictors of cardiovascular disease, especially in older popula tions. Previous studies have investigated the association of homocysteine with arterial stiffness in human subjects, while the relationship between homocysteine and arterial stiffness in the elderly is still indefinite. The current study examined the association of homocysteine with arterial stiffness in Chinese community-based elderly persons. Methods We related serum levels of homocysteine to two measures of arte- rial stiffness （carotid-femoral pulse wave velocity （PWV） and carotid-radial PWV） in 780 participants （46.3% men, mean age 71.9 years （ranging 65-96 years old）） from two communities of Beijing, China. Arterial stiffness were measured within two days of the time of bio- marker measurement. Results In multiple-adjusted models, homocysteine levels was strongly associated with the carotid-femoral PWV （standardized 13 = 0.13, P 〈 0.001）, even after adjustment for classical risk factors of cardiovascular disease. The association is also stronger when the carotid-femoral PWV is elevated above normal, whereas no significant association with homocysteine was observed for ca-rotid-radial PWV. Conclusions In Chinese elderly persons, serum homocysteine levels are associated with alterations of aortic stiffness.     

Skeletal muscle mass to visceral fat area ratio is associated with metabolic syndrome and arterial stiffness: The Korean Sarcopenic Obesity Study (KSOS)

Aims

Sarcopenia measured as appendicular skeletal muscle mass (ASM), and central obesity measured as visceral fat area (VFA) may act synergistically to influence metabolic syndrome and atherosclerosis. However, several previous studies reported that metabolic risk is higher in non-sarcopenic obesity groups than in sarcopenic obesity groups because of the close relationship between muscle mass and body fat. We investigated the association of the ASM to VFA ratio, which we have termed the muscle-to-fat ratio (MFR), with metabolic syndrome and arterial stiffness.

Methods

This study was performed in 526 apparently healthy adults enrolled in the Korean Sarcopenic Obesity Study, an ongoing prospective observational cohort study. ASM was evaluated with dual energy X-ray absorptiometry and VFA with computed tomography. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV).

Results

MFR was significantly associated with waist circumference, blood pressure, lipid profiles, glucose and baPWV. By multiple logistic regression analysis, the odds ratio for metabolic syndrome was 5.43 (lowest versus highest tertile of MFR, 95% confidence interval, 2.56-13.34). Multiple stepwise regression analysis showed that MFR was an independent determinant of baPWV (R² = 0.57).

Conclusions

MFR, a new index of sarcopenic obesity, showed an independent negative association with metabolic syndrome and arterial stiffness.     

Familial history of hypertension as a predictor of increased arterial stiffness in normotensive offspring

Background

Increased arterial stiffness can be used as a prognostic marker of arterial hypertension. The relationship between arterial stiffness and arterial hypertension seems to be reciprocal.