Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors
Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors
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DOI：
10.1093/eurheartj/ehs380
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发表时间：
2013-08-01
影响因子：
39.3
通讯作者：
Briet, Marie
中科院分区：
文献类型：
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作者：
Engelen, Lian;Ferreira, Isabel;Briet, Marie
目的颈总动脉内中膜厚度(CCIMT)作为动脉粥样硬化的替代指标，因其与心血管疾病(CVD)的相关性而被广泛应用。然而，由于缺乏参考值，CCIMT值的解释一直受到阻碍。因此，我们的目标是建立CCIMT的参考区间，利用目前可能最准确的方法(即回声跟踪)来帮助解释这些测量。方法和结果我们综合了来自全球24个研究中心的24871名个体(53名男性，年龄范围15-101岁)的CCIMT数据。没有心血管疾病、心血管危险因素(CV-RF)和降血压、降血脂和/或降血糖药物的个体构成了一个健康的亚群(n=4234)，用于建立不同年龄的CCIMT百分位数的性别方程。通过这些方程，我们在不同的参考子群体中生成了CCIMT Z分数，从而允许对相同年龄和性别的个体的观察值和预测(正常)值进行标准化比较。在没有接受心血管疾病和治疗的人群中(n=14609)，在男性和女性中，CCIMT Z评分分别与收缩压[标准化S 0.19(95 CI：0.16~0.22)和0.18(0.15~0.21)]、吸烟[0.25(0.19~0.31)和0.11(0.04~0.18)]、糖尿病[0.19(0.05~0.33)和0.19(0.02~0.36)]独立相关。总胆固醇/高密度脂蛋白比值[0.07(0.04-0.10)和0.05(0.02-0.09)]，以及体重指数[0.14(0.12-0.17)和0.07(0.04-0.10)]。结论我们估计了健康人群中CCIMT的年龄和性别特定百分位数，并评估了CV-RFS与CCIMT Z评分的相关性，这使得比较具有不同心血管风险特征的(患者)组的IMT值，有助于解释在研究和临床环境中获得的此类测量。
Aims Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures.Methods and results We combined CCIMT data obtained by echotracking on 24 871 individuals (53 men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n = 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference sub-populations, thereby allowing for a standardized comparison between observed and predicted (normal) values from individuals of the same age and sex. In the sub-population without CVD and treatment (n = 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized s 0.19 (95 CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)].Conclusion We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CV-RFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings.