Determinants of endothelial dysfunction and carotid intima-media thickness in combined hyperlipidemia
Miran Sebestjen1, Branka Zegura, Viktor Videcnik
1Department of Angiology, Hospital of Internal Medicine, Ljubljana, Slovenia. miran.sebestjen@trnovo.kclj.si
Insights
Apolipoprotein B is linked to both arterial wall function and structure changes in men with hyperlipidemia. Proinflammatory cytokines impact function, while coagulation factors affect structure.
Area of Science:
- Cardiovascular Medicine
- Atherosclerosis Research
- Lipid Metabolism
Background:
- Atherosclerosis involves early endothelial dysfunction and increased intima-media thickness (IMT).
- These changes are linked to risk factors, but their association in combined hyperlipidemia requires further study.
Purpose of the Study:
- To investigate associations between risk factors and arterial wall functional (flow-mediated dilatation, FMD) and morphological (carotid IMT) changes.
- To identify predictors of FMD and IMT in men with combined hyperlipidemia.
Main Methods:
- Measured brachial artery FMD and carotid IMT in 72 male patients with combined hyperlipidemia.
- Assessed serum lipoproteins, coagulation parameters, glucose, and inflammatory markers including C-reactive protein.
Main Results:
- Tumor necrosis factor-alpha, interleukin 6, and apolipoprotein B independently predicted FMD (explaining 87% of variability).
- Total tissue factor pathway inhibitor and apolipoprotein B independently predicted increased carotid IMT (explaining 82% of variation).
Conclusions:
- Apolipoprotein B is associated with both functional and morphological arterial changes.
- In asymptomatic men with combined hyperlipidemia, functional changes correlate with proinflammatory cytokines, and morphological changes with coagulation parameters.
Background:
Early functional and morphological changes in the course of the atherosclerotic process are manifested as endothelial dysfunction and increased intima-media thickness (IMT) of the arterial wall. These are both associated with various atherosclerotic risk factors. We investigated whether the same factors are associated with functional and morphological changes of the arterial wall in men with combined hyperlipidemia.
Methods:
Flow-mediated dilatation (FMD) of the brachial artery and carotid IMT were measured in 72 male patients aged 46+/-5 years with combined hyperlipidemia. Serum lipoproteins, fibrinolytic and coagulation parameters, blood glucose, proinflammatory cytokines and C-reactive protein were also measured.
Results:
Tumor necrosis factor-alpha, interleukin 6 and apolipoprotein (apo) B were found to be independent predictors of FMD, explaining 87% of FMD variability in multivariate analysis. On the other hand, total tissue factor pathway inhibitor and apo B were independent predictors of increased carotid IMT, explaining 82% of the variation in carotid IMT.
Conclusions:
Apo B, which is a marker for the presence of the atherogenic lipoproteins, is associated with both functional and morphological changes of the artery wall. In addition, in asymptomatic overweight middle-aged men with combined hyperlipidemia, functional changes are associated with proinflammatory cytokines, while morphological changes are associated with coagulation parameters.
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