Background:Cardio-ankle vascular index (CAVI) is an important indicator to evaluate arteriosclerosis. This study was to explore the changes and related factors of CAVI in the elderly population, providing a certain basis for the prevention and control of cardiovascular and cerebrovascular diseases. Methods:1117 subjects (M/F 488/629) were divided into three groups according to age: group 1: subjects with age 60-69 years; group 2: subjects with age 70-79 years; group 3: subjects with age≧80 years. CAVI value was recorded by using the VaseraVS-1000 vascular screening system. Results:There were significant differences about body mass index (BMI), CAVI, systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure, creatinine, fasting plasma glucose (FPG), total cholesterol, high-density lipoprotein cholesterol (HDL-C) and uric acid between these three groups. CAVI value was increasing year by year, with the increasing incidence of hypertension, coronary artery disease and stroke. General Linear Model analysis showed that age, incidence of diabetes mellitus, BMI, DBP and HDL-C were independent associating factors of CAVI in elderly subjects (β = 0.048, p < 0.001; β = 0.349, p = 0.012; β = -0.060, p = 0.001; β = 0.023, p = 0.001; β = -0.530, p = 0.020; respectively). Conclusions:CAVI was increasing with ageing. The influencing factors of CAVI varied among different age groups. Subjects aged 60-69 were needed to pay close attention to blood pressure and subjects aged 70-79 were needed to focus on diabetes meillitus, providing a theoretical basis for intervening in different targets in different age groups, to reduce or delay the progression of arteriosclerosis.

The association between mycotoxins and esophageal cancer (EC) risk remains poorly understood, highlighting the need for evidence from population-based prospective studies. We conducted a case-cohort study nested within the Taizhou Longitudinal Study to investigate this relationship, analyzing baseline urinary mycotoxins in 866 randomly selected subcohort members and 240 incident EC cases (including seven cases from the subcohort). Using ultra-high performance liquid chromatography-triple quadrupole-tandem mass spectrometry, we measured three mycotoxins: ochratoxin A (OTA), T-2 toxin (T-2), and fumonisin B1 (FB1). While FB1 was detectable in over 88% of urine samples, OTA and T-2 were detected in less than 30% of samples. EC cases showed slightly higher detection rates for all three mycotoxins compared to the subcohort subjects. Weighted Cox proportional hazards regression analyses for case-cohort studies revealed that, after adjusting for potential confounders, the urinary levels of three mycotoxins-OTA (hazard ratio [HR] = 1.07, 95% confidence interval [CI]: 0.73-1.56), T-2 (HR = 1.01, 95% CI: 0.51-2.00), and FB1 (HR = 0.94, 95% CI: 0.53-1.64)-as well as co-exposure to these three mycotoxins (HR = 1.33, 95% CI: 0.34-5.28), showed no significant association with EC risk. These results remained consistent even after excluding the first 2 years of follow-up to minimize the influence of potential reverse causation. Our case-cohort study found no clear associations between urinary mycotoxins-OTA, T-2, or FB1-and EC risk in the studied population.

Background:Ankle-brachial index (ABI) is used to diagnose peripheral artery disease. Arterial stiffness could be measured by carotid-femoral pulse wave velocity (CF-PWV). The study was to investigate relationship between ABI and CF-PWV in patients with hypertension and diabetes mellitus. Methods:1577 patients (M/F 812/765) from Department of Vascular Medicine were enrolled. ABI was recorded by VaseraVS-1000 vascular screening system (Fukuda Denshi, Tokyo, Japan). CF-PWV was recorded by Complior apparatus. Results:CF-PWV was significantly higher in hypertension patients with diabetes mellitus than hypertension patients without diabetes mellitus (13.77 ± 3.91 vs 11.83 ± 3.26 m/s, p < 0.05). Right ABI was significantly lower in hypertension patients with diabetes mellitus than hypertension patients without diabetes mellitus (1.062 ± 0.163 vs 1.102 ± 0.105, p < 0.05). Right ABI was negatively correlated with age, systolic blood pressure, CF-PWV and creatinine in entire study group (r = -0.081, p = 0.001; r = -0.069,p < 0.001; r = -0.178, p < 0.001; r = -0.124, p < 0.001, respectively). Multiple linear regressions found that CF-PWV, body mass index (BMI), gender, creatinine, total cholesterol, uric acid and diabetes mellitus were independent associating factors of RABI in all patients (β = -0.168, p < 0.001; β = 0.180, p < 0.001; β = -0.189, p < 0.001; β = -0.102, p = 0.008; β = 0.088, p = 0.004; β = -0.100, p = 0.009;β = -0.062, p = 0.043; respectively). CF-PWV, BMI, gender and HDL-C were independent associating factors of left ABI in all patients (β = -0.170, p < 0.001; β = 0.172, p < 0.001; β = -0.104, p = 0.001; β = 0.074, p = 0.023; respectively). Conclusions:ABI was significantly lower in hypertension patients with diabetes mellitus, with higher level of CF-PWV. CF-PWV was an independent associating factor of ABI, indicating the greater the elasticity of the large arteries, the higher the probability of lower limb artery occlusion.

Most previous studies have only examined the relationship between albumin or creatinine alone and the prognosis of patients with aortic disease (AD). Therefore, the aim of this study was to evaluate the association between serum albumin to creatinine ratio (sACR) and all-cause mortality (ACM) in patients with AD. This retrospective cohort study utilized the Medical Information Mart for Intensive Care IV, stratifying sACR into tertiles. The primary outcome (28-day ACM) and the secondary outcomes in critically ill AD patients were analyzed via restricted cubic splines and multivariate Cox proportional hazards models. Survival differences across sACR tertiles were assessed by Kaplan-Meier analysis, supplemented by subgroup interactions and receiver operating characteristic (ROC) curve evaluation of sACR's prognostic accuracy. This study included 499 AD patients (67.3% male). Multivariate Cox proportional hazards models with log10-transformed sACR revealed each tenfold sACR increase reduced mortality risk by 78% at 28 days (hazard ratio [HR] 0.22, 95% confidence interval [CI] 0.12-0.40), 78% at 90 days (HR 0.22, 95% CI 0.13-0.37), and 74% at 1 year (HR 0.26, 0.17-0.42; all P < 0.001). Restricted cubic splines confirmed linear dose-response relationships (P for non-linear > 0.05). Kaplan-Meier curves demonstrated significantly lower mortality in high sACR tertiles, consistent across subgroups. ROC analysis validated prognostic accuracy. sACR was negatively associated with both short- and long-term mortality in patients with AD. These findings advance prognostic biomarker research by confirming sACR's clinical utility in AD.

ABSTRACTThis study aimed to assess the correlation between estimated pulse wave velocity (ePWV) and mortality rates related to all‐cause and cardiovascular disease (CVD) among individuals diagnosed with chronic kidney disease (CKD) in the United States.A total of 4669 participants with CKD were identified from the National Health and Nutrition Examination Survey conducted between 1999 and 2018. We calculated the incidence of CKD using an estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m2. Our study examined the association between ePWV and mortality risk based on weighted Kaplan–Meier plots and multivariate Cox regression. Linear testing between ePWV and mortality from all causes and CVD was performed using restricted cubic splines and Cox regression. This study included 4669 patients with CKD from the NHANES, representing 37 million Americans with CKD. There was a mean age of 71.9 years, and 48.1% of participants were male. With every increase of 1 m/s in ePWV measurement, there is a corresponding 31% (hazard ratio [HR]: 1.31, 95% confidence interval [CI]: 1.28–1.34) increase in the rate of mortality from all causes and a 32% (HR: 1.32, 95% CI: 1.27–1.37) increase in the rate of mortality from CVD. A significantly higher rate of cardiovascular and all‐cause mortality was observed in patients with CKD with elevated ePWV than in those with lower ePWV, as shown in the weighted Kaplan–Meier plots. Patients with CKD have a significant relationship between ePWV and all‐cause and cardiovascular mortality.

BACKGROUNDS:The cardio-ankle vascular index (CAVI) is a new index of arteriosclerosis. The present study investigated the relationship between CAVI value and stroke in hypertension patients, especially the prevalence of stroke in patients with CAVI ≧9. METHODS:735 patients (M/F 293/442) with or without hypertension from Department of Vascular Medicine from 01/01/2012-31/21/2014 were divided into four groups: group 1: non-hypertension patients with CAVI<9, group 2: non-hypertension patients with CAVI ≧9, group 3: hypertension patients with CAVI<9, group 4: hypertension patients with CAVI ≧9. CAVI was measured by VS-1000 apparatus. RESULTS:Prevalence of stroke and coronary artery disease were significantly higher in group 2 than in group 1. And the prevalence of stroke and coronary artery disease were also significantly higher in group 4 than in group 3. In addition, the level of right intima-media thickness (RIMT) was significantly higher in group 4 than in group 3 (0.102±0.025 vs 0.094±0.023, p<0.05). Multiple linear regressions showed that CAVI and age were independent associating factors of stroke in all patients (β=0.268, p=0.040; β=0.135, p<0.001; respectively). CAVI was an independent associating factors of stroke in hypertension patients (β=0.398, p<0.001). CONCLUSION:The prevalence of stroke was higher in hypertension patients with CAVI ≧9 than in hypertension patients with CAVI<9, with higher level of right intima-media thickness. CAVI was an independent associating factors of stroke in hypertension patients.

Purpose:We aimed to identify the association between obesity and nonalcoholic fatty liver disease (NAFLD) and to quantify the mediating effects of insulin resistance (IR) and chronic inflammation through observational studies and Mendelian randomization (MR). Patients and Methods:In the current study, three IR-related indicators and three indicators of inflammation were included. The individual and combined mediated effects of IR and inflammation in the association between obesity and NAFLD were investigated in two cross-sectional studies, the Fuqing Cohort from China and the National Health and Nutrition Examination Survey (NHANES). Total, direct, and indirect effects were estimated through direct counterfactual imputation estimation, and the proportion of mediating effects was calculated. We applied a two-step MR to determine the causal mediating role of IR and chronic inflammation in the pathway between obesity and NAFLD by using single nucleotide polymorphisms as instrumental variables to predict obesity, IR, and inflammation genetically. Results:In the Fuqing Cohort, all obese phenotypes were associated with an elevated NAFLD risk. Moreover, indicators of IR such as homeostatic model assessment of insulin resistance (HOMA-IR) and indicators of inflammation such as C-reactive protein (CRP) were significantly and positively associated with NAFLD risk. Individuals with obesity had significantly higher levels of IR and inflammation indicators compared to non-obese individuals. The indirect proportions of insulin and HOMA-IR accounted for 50.97-66.72% in the associations between obese phenotypes and NAFLD risk, while the proportions of inflammation indicators were < 14%. Similar results were observed in the NHANES analysis. In the MR analysis, the indirect effects of HOMA-IR and CRP were statistically significant with a greater mediated proportion explained by HOMA-IR than CRP. Conclusion:Through two population-based studies and MR, we found the causal mediation roles of IR and inflammation in the association between obesity and NAFLD, in which HOMA-IR and CRP showed stable, significant mediation effects. Furthermore, HOMA-IR showed a higher mediation effect than CRP. We emphasize the vital role of HOMA-IR in NAFLD monitoring.

BACKGROUND:The aim of our study was to explore the characteristics of the arterial risk factors and ankle-brachial index (ABI) in patients with lower extremity chronic venous disease (LECVD).METHODS:A total of 2642 subjects were employed in our study. The lifestyle and clinical data were collected. The history of vascular diseases contained coronary artery disease, stroke, hypertension, and diabetes. ABI low than 0.9 was considered as lower extremity artery disease (LEAD). A series of blood indicators were measured.RESULTS:Patients with ABI low than 0.9 belonged to the group of LEAD. Age, smoking, drinking, hypertension, diabetes mellitus, lipid-lowering drug, antidiabetic, total protein, total protein, triglyceride, low-density lipoprotein cholesterol, glycosylated hemoglobin and homocysteine were the common risk factors shared by LEAD and LECVD (P<0.05). The prevalence of LEAD in patients with LECVD was higher than those without LECVD (P<0.05). In Pearson correlation analysis, LECVD was related to LEAD (P<0.05). Before and after adjusted shared factors, as the performance of the logistic regression models, LEAD was an independent risk factor for the prevalence of LECVD (OR=2.937, 95% CI: [1.956, 4.411], P<0.001).CONCLUSIONS:Our study demonstrated that an ABI lower than 0.9 is an independent risk factor for LECVD.

Abstract Aims Although central adiposity is a well-known risk factor for diabetes, the underlying mechanism remains unclear. The aim of this study was to explore the potential mediation role of circulating WBC counts in the association between central adiposity and the risk of diabetes. Materials and methods A cross-sectional study was conducted using data from the Fuqing cohort study, which included 6,613 participants aged 35–75 years. Logistic regression analysis and Spearman’s rank correlation analysis were used to examine the relationships between waist-to-hip ratio, WBC counts and glycemic status. Both simple and parallel multiple mediation models were used to explore the potential mediation effects of WBCs on the association of waist-to-hip ratio with diabetes. Results The study revealed a positive relationship between waist-to-hip ratio and risk of prediabetes (OR = 1.53; 95% CI, 1.35 to 1.74) and diabetes (OR = 2.89; 95% CI, 2.45 to 3.40). Moreover, elevated peripheral WBC counts were associated with both central adiposity and worsening glycemic status (P < 0.05). The mediation analysis with single mediators demonstrated that there is a significant indirect effect of central adiposity on prediabetes risk through total WBC count, neutrophil count, lymphocyte count, and monocyte count; the proportions mediated were 9.92%, 6.98%, 6.07%, and 3.84%, respectively. Additionally, total WBC count, neutrophil count, lymphocyte count, monocyte count and basophil count mediated 11.79%, 11.51%, 6.29%, 4.78%, and 1.76%, respectively, of the association between central adiposity and diabetes. In the parallel multiple mediation model using all five types of WBC as mediators simultaneously, a significant indirect effect (OR = 1.09; 95% CI, 1.06 to 1.14) were observed, with a mediated proportion of 12.77%. Conclusions Central adiposity was independently associated with an elevated risk of diabetes in a Chinese adult population; levels of circulating WBC may contribute to its underlying mechanisms.

Spontaneous celiac artery dissection is uncommon. Abdominal pain is a common clinical presentation. Conservative medical treatments, endovascular interventions, and open surgery are used to treat spontaneous celiac artery dissection. A 49-year-old male patient visited our hospital, with back and subxiphoid pain that had persisted for 11 hours. He has been smoking 40 cigarettes a day for 20 years. The blood pressure was 180/100mmHg. Aortic computed tomography angiography (CTA) images revealed dissection of the celiac artery, common hepatic artery, left hepatic artery, right hepatic artery, and splenic artery. Urapidil hydrochloride and isosorbide dinitrate were administered to lower the blood pressure to approximately 110/70 mmHg. However, the back and subxiphoid pain persisted without relief. Angiography was performed and a vascular stent (BARD, LIFE STENT, VASCULAR, 8 × 60) was implanted into the celiac artery without involving the branches. Pain was immediately relieved after interventional therapy. The patient was discharged after 4 days. A subsequent aortic CTA after 10 months confirmed that the celiac artery dissection had still not reoccurred.

Background: Whether poor oral health is associated with dementia risk remains unclear. Objective: We conducted a cohort study of 14,439 participants who were followed up for up to 40 years in Uppsala County, central Sweden, aiming to explore the association between poor oral health, namely the number of tooth loss, dental plaque status, and oral mucosal lesions, and the risk of dementia. Methods: We used Cox proportional hazards regression model to derive cause-specific hazard ratios (HR) and corresponding 95% confidence intervals (CI), while adjusting for baseline potential confounders as well as a time-varying covariate, Charlson's Comorbidity Index score. Results: Dementia risk was substantially higher among those with a higher number of tooth loss; compared to the group with tooth loss 0-10, the HRs were 1.21 (95% CI: 1.02, 1.42), 1.17 (95% CI: 0.97, 1.40), and 1.30 (95% CI: 1.09, 1.54) respectively for groups with increasing number of tooth loss. There was some evidence of dose-risk association in this study, with a HR of 1.10 (1.04, 1.18) comparing adjacent groups ( p(trend) = 0.001). In a stratified analysis by attained age, tooth loss was more pronouncedly associated with the risk of dementia onset before age 80 (those with 21-32 versus 0-10 lost teeth, HR= 1.82, (95%CI: 1.32, 2.51); HR= 1.22 (95%CI: 1.10, 1.35) comparing adjacent groups, p(trend) < 0.001). Conclusion: In summary, there are some indications that poor oral health, as indicated by more tooth loss, is positively associated with an increased risk of dementia, especially for dementia onset before age 80.

BackgroundIt is currently unclear whether and how the association between body composition and hypertension varies based on the presence and severity of fatty liver disease (FLD).MethodsFLD was diagnosed using ultrasonography among 6,358 participants. The association between body composition and hypertension was analyzed separately in the whole population, as well as in subgroups of non-FLD, mild FLD, and moderate/severe FLD populations, respectively. The mediation effect of FLD in their association was explored.ResultsFat-related anthropometric measurements and lipid metabolism indicators were positively associated with hypertension in both the whole population and the non-FLD subgroup. The strength of this association was slightly reduced in the mild FLD subgroup. Notably, only waist-to-hip ratio and waist-to-height ratio showed significant associations with hypertension in the moderate/severe FLD subgroup. Furthermore, FLD accounted for 17.26% to 38.90% of the association between multiple body composition indicators and the risk of hypertension.ConclusionsThe association between body composition and hypertension becomes gradually weaker as FLD becomes more severe. FLD plays a significant mediating role in their association.

Background: Bilirubin may prevent lipid peroxidation and have important antiatherosclerotic effects. We determined associations of serum bilirubin and lipid with peripheral atherosclerosis. Methods: We included 4290 participants (35% men; median age, 60 years) from the southeast China who underwent B-mode ultrasound examination. Increased intima-media thickness or a focal structure encroaching into the arterial lumen by at least 0.5 mm or >50% of the surrounding intima-media thickness value was regarded as having atherosclerosis. Fasting serum bilirubin and lipid levels were measured. Cholesterol/(HDL [high-density lipoprotein] cholesterol+bilirubin), and LDL (low-density lipoprotein cholesterol)/(HDL+bilirubin) ratios were calculated. Unconditional and multinomial logistic regression models were used to examine associations of bilirubin or lipid with prevalence of peripheral atherosclerosis. Mediation analyses were performed to assess the effect of bilirubin on atherosclerosis risk mediated via lipid. Results: Compared with participants with the lowest levels of bilirubin, those with the highest tertile were less likely to have carotid or femoral atherosclerosis (odds ratios were 0.55–0.74). The highest levels of bilirubin significantly reduced the odds of concurrent carotid and femoral atherosclerosis by 35% to 45%. Participants with the highest levels of cholesterol, LDL, cholesterol/(HDL+bilirubin), and LDL/(HDL+bilirubin) ratios had 2.8- to 3.7-fold increased odds of concurrent carotid and femoral atherosclerosis. LDL accounted for 25.65% of the total bilirubin-atherosclerosis association. LDL and cholesterol mediated the associations between direct bilirubin and atherosclerosis (proportion: 20.40%, 9.67%, respectively). Conclusions: Increased serum bilirubin levels are inversely associated with the prevalence of carotid or femoral atherosclerosis. LDL and cholesterol may mediate these associations.

Cardiovascular disease(CVD) has become a major disease burden affecting people's health in China. Blood vessels are very important for human health and are the "sentinel" for the development of many cardiovascular and cerebrovascular diseases. The key to effectively preventing fatal, disabling heart, brain and peripheral vascular events lies in controlling traditional and non-traditional risk factors for vascular health from the source, and early assessment and intervention of early vascular lesions. Since 2004, China government promoted the early detection technology of vascular lesions and vascular medicine, and proposed the Beijing Vascular Health Stratification (BVHS) to provide suggestions for the examination, evaluation and management of risk factors, and to provide new ideas for lifelong maintenance of vascular health. This review mainly introduces the establishment and development of the clinical discipline of "vascular medicine" in the past 20 years in China, introduces the indicators for detecting vascular function and structure and the predictive value of vascular events, and carries out intelligent and digital management of vascular health throughout the life cycle of individualized prevention, treatment and rehabilitation for people with different parts or degrees of lesions, effectively reducing the occurrence and development of cardiovascular and cerebrovascular diseases, and the prospect of new technology in maintaining vascular health.

Background and objective: Findings on the association between testosterone and cardiovascular risk in men have been inconsistent. Previous studies investigated this association based on testosterone level measured at one single point in time (e.g., testosterone level at the baseline visit), which might not be relevant for the future cardiovascular events that occurred many years later, given the dynamic changes of testosterone level over time. Additionally, as compared to patients without prior cardiovascular history, those with prior cardiovascular events are more likely to have pathological changes in coronary or peripheral vasculature, and therefore more susceptible to cardiovascular events when exposed to risk factors. However, whether time-varying testosterone level affects differently between patients with prior cardiovascular events and those without is unknown. The objective of this study was to investigate the association between time-varying testosterone level and risks of myocardial infarction and stroke, and compared the associations stratified by patient’s prior cardiovascular event history. Material and methods: We used data of 376 hypogonadal men from a registry study in Germany with up to 11 years’ follow-up and applied Cox proportional hazards regression models to investigate the proposed association. Results: No association was found between baseline testosterone level and risks of myocardial infarction and stroke. When taking into account the changes of testosterone level over time and including testosterone as a time-varying covariate in the model, the adjusted hazard ratio (HR) for myocardial infarction associated with 1 nmol/L increase in testosterone level was 0.78 (95% CI: 0.64, 0.97); no association between time-varying testosterone level and stroke was found. The associations between testosterone level and cardiovascular risk were not different among patients with prior cardiovascular event history and those without. Conclusion: One baseline measurement of testosterone level may be insufficient to predict one’s future risk of cardiovascular events; regular monitoring of testosterone levels may be useful to assess the short-term cardiovascular risk in men.

目的:研究下肢动脉硬化闭塞症患者踝肱指数(ABI)异常与冠状动脉狭窄严重程度的相关性.方法:选取2017年11月至2019年9月,73例在我院接受治疗并行冠状动脉CTA检查的下肢动脉粥样硬化闭塞症患者,取双下肢ABI最低值,按照ABI的缺血程度,ABI＜0.5重度缺血,ABI 0.5～0.75中度缺血,ABI 0.75-0.9轻度缺血,将下肢动脉粥样硬化闭塞症患者分为轻、中、重3组,同时通过冠状动脉CTA分析这些患者冠状动脉病变的严重程度,分析与冠状动脉严重程度的相关性.结果:73例下肢动脉粥样硬化闭塞症患者,ABI≤0.90可诊断为下肢动脉缺血,下肢血管病变越严重,ABI越低,冠状动脉血管发生病变的支数也越多.ABI与冠状动脉病变支数呈现负的相关趋势.结论:下肢动脉病变可以间接的反映冠状动脉病变严重程度.

Background:Massive or submassive pulmonary embolism (PE) carries a high mortality. Percutaneous mechanical thrombectomy using the Angiojet system is accepted for the treatment of PE. Here, we reported two submassive PE cases who were treated with the Angiojet system successfully, to provide some advice for the therapy of submassive PE.Method:Two patients with suffocation were admitted to our hospital. One patient was accompanied by lower blood pressure (20% lower than basal blood pressure) and higher pulmonary artery pressure (89 mmHg); the other patient had larger right ventricular transverse diameter (46 mm), decreased left ventricular end diastolic anteroposterior diameter (34 mm), and higher heartbeats (107 heartbeats per minute). Pulmonary artery computed tomography angiography showed bilateral pulmonary embolism.Result:The Angiojet system with a high-pressure jet spray pattern (urokinase 25 wiu + sodium chloride injection 50 ml) was used. Intravascular thrombolysis by urokinase (100 wiu/day for 1 day) was done after being back in the ward. And low molecular weight heparin was used in hospitalization, and rivaroxaban was used after discharge. Both patients were treated successfully. However, the level of platelet was significantly lower in one patient after Angiojet system usage and recovered to the preoperative level the next day. Another patient suffered from bradyarrhythmias during the usage of Angiojet, and bradyarrhythmias disappeared when the Angiojet system stopped. Pulmonary embolism was cured after 3 months in both patients.Conclusion:Angiojet could be a simple, safe, and well-tolerated treatment for massive or submassive PE. And hematocrit, platelet, kidney function, and heart rhythm should be monitored during perioperation.

目的 探讨全身动脉粥样硬化斑块与脑梗死的关系.方法 本研究纳入411例患者[(66.3±13.5)岁,男性52.9％],均进行全身血管超声检查.使用逻辑回归评估全身动脉粥样硬化斑块累及血管床数目、斑块部位与脑梗死的关系.结果 脑梗死组的3～5个部位斑块检出率和颈动脉合并其他部位斑块检出率高于无脑梗死组,伴随白介素-6和心-踝血管指数的明显升高.在未调整的模型中,3～5个部位粥样硬化斑块组、颈动脉合并其他部位粥样硬化斑块组发生脑梗死风险分别是无斑块组的2.595倍(95％CI 1.338～5.031,P<0.01)和2.551倍(95％CI 1.317～4.942,P<0.01).调整了性别和年龄后,斑块累及血管床数目和斑块部位与脑梗死的关系不显著.结论 在未调整的模型中,与无斑块组相比,3～5个部位血管床粥样硬化斑块组和颈动脉合并其他部位粥样硬化斑块组发生脑梗死的风险更高.

Objective:To investigate the correlation between carotid intima-media thickness (CIMT) and cardio-ankle vascular index (CAVI) in hypertension subjects.Methods:A total of 324 subjects in Department of Vascular Medicine, Peking University Shougang Hospital were enrolled into our study, and they were divided into two groups based on blood pressure levels: control group (173 cases) and hypertension group (151 cases). Two-dimensional ultrasound and VS-1000 were used to measure CIMT and CAVI.Results:The prevalence of coronary artery disease and stroke was significantly higher in the hypertension group than in the control group (P＜0.05). The levels of CIMT and CAVI were significantly higher in the hypertension group than in the control group [(0.62±0.23) mm vs (0.51±0.22) mm and 8.40±1.51 vs 7.46±1.10, respectively, P＜0.001 ]. There was a positive correlation between CIMT and CAVI in hypertension subjects (r=0.191, P＜0.05). Multivariate analysis showed that age and systolic blood pressure were independent risk factors for CIMT in hypertension subjects (β=0.253, P=0.004; β=0.283, P=0.001).Conclusion:CIMT is significantly higher and positively correlated with CAVI in hypertension subjects, indicating the role of CIMT in predicting arteriosclerosis.

Objectives: We aimed to evaluate the association of testosterone deficiency with inflammation and how long-term testosterone therapy affects inflammation biomarkers over time. Methods: We conducted a 2-component study. First, we conducted a cross-sectional study using the recently released 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to examine the association between testosterone deficiency and inflammation biomarkers including high sensitivity C-reactive protein (hsCRP), liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the US general population. Then we conducted a longitudinal study to investigate the longitudinal effect of testosterone therapy on inflammation biomarkers and the risk of cardiovascular events, using data from 776 hypogonadal men based on a registry study in Germany with up to 11 years’ follow-up. Results: The adjusted odds ratios (ORs) describing the associations between testosterone deficiency and hsCRP ≥ 3mg/L, ALT > 40U/L, and AST > 40U/L were 1.81 ( P-value < 0.001), 1.46 ( P-value = 0.009), and 0.99 ( P-value = 0.971), respectively. In the control group, CRP, ALT, and AST levels increased by 0.003 (95%CI: −0.001, 0.007) mg/L, 0.157 U/L (95%CI: 0.145, 0.170), and 0.147 (95%CI: 0.136, 0.159) U/L per month, while in the treatment group, CRP, ALT, and AST levels decreased by 0.05 (95%CI: −0.055, −0.046) mg/L, 0.142 U/L (95%CI: −0.154, −0.130), and 0.148 (95%CI: −0.158, −0.137) U/L per month. Conclusion: Testosterone deficiency was associated with an increased level of inflammation; long-term testosterone therapy alleviated inflammation among hypogonadal men, which may contribute to the reduced cardiovascular risk. Future large trials are warranted to confirm our observational study findings.