Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?
Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?
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DOI：
10.1177/2047487315625543
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发表时间：
2016-07-01
影响因子：
8.3
通讯作者：
Price, Jackie F.
中科院分区：
文献类型：
--
作者：
Liao, Ximing;Norata, Giuseppe D.;Price, Jackie F.
背景颈动脉内膜中层厚度（cIMT）的临床应用需要正常值，这可能会受到地理因素，种族或测量细节的变化。这些因素的影响很少被研究。本研究的目的是确定是否规范cIMT值及其与事件风险之间的关联是generalizable across population.Design Meta-analysis of individual participant data.Method从22个一般人群cohort来自欧洲，北美和亚洲，我们选择的主题免费的心血管疾病。分别评估每个队列的cIMT和cIMT进展的百分位数。血管事件的考克斯比例风险模型用于估计每个队列中cIMT的风险比。这些估计值在欧洲、北美和亚洲进行了汇总，并进行了随机效应荟萃分析。结果地理因素、种族和超声方案对cIMT及其进展的百分位数没有影响，对cIMT血管事件的风险比也没有影响。cIMT和cIMT进展的分布异质性太大，无法建立有意义的标准值。结论cIMT值的分布异质性太大，无法定义普遍或区域的人群参考值。CIMT值在不同的研究之间差异很大，无论种族，地理位置和超声方案如何。在所有队列、种族和地区中，cIMT值对血管事件的预测更为一致。
Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations.Design Meta-analysis of individual participant data.Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression.Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values.Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.