Inflammation, homocysteine and carotid intima-media thickness
Alexandre P Baptista1, Sanjiva Cacdocar, Hugo Palmeiro
1Hospital Distrital de Faro, Faro, Portugal. baptistalexandre@gmail.com
Insights
Age and homocysteine levels are key factors associated with increased carotid intima-media thickness (CIMT) in chronic kidney disease patients. These findings highlight potential markers for atherosclerosis risk in this vulnerable population.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Cardiovascular disease is a leading cause of death in chronic kidney disease (CKD) patients.
- Carotid intima-media thickness (CIMT) is a validated marker for atherosclerosis.
- Identifying atherosclerosis risk factors in CKD is crucial for patient management.
Purpose of the Study:
- To investigate factors associated with increased CIMT in patients with CKD.
- To evaluate the correlation between laboratory parameters and CIMT in this cohort.
Main Methods:
- 56 CKD patients (mean age 68.6 years, eGFR 15.8 ml/min) were studied.
- Laboratory markers including hsCRP, IL-6, TNF-alpha, and homocysteine were assessed.
- Internal carotid artery CIMT was measured using high-resolution B-mode ultrasonography.
Main Results:
- Simple linear regression identified correlations between CIMT and age, hemoglobin, logCRP, logIL-6, and homocysteine.
- Multiple regression analysis revealed independent correlations between CIMT and age (p=0.001) and homocysteine (p=0.027).
- LogIL-6 showed a trend towards significance (p=0.057), potentially limited by sample size.
Conclusions:
- Age and homocysteine are independently correlated with CIMT in chronic renal patients.
- These factors can serve as important markers or risk factors for atherosclerosis in CKD.
- Further research with larger cohorts may clarify the role of inflammatory markers like IL-6.
Introduction:
Cardiovascular disease is the main cause of morbidity and mortality in chronic renal patients. Carotid intima-media thickness (CIMT) is one of the most accurate markers of atherosclerosis risk. In this study, the authors set out to evaluate a population of chronic renal patients to determine which factors are associated with an increase in intima-media thickness.
Methods:
We included 56 patients (F=22, M=34), with a mean age of 68.6 years, and an estimated glomerular filtration rate of 15.8 ml/min (calculated by the MDRD equation). Various laboratory and inflammatory parameters (hsCRP, IL-6 and TNF-alpha) were evaluated. All subjects underwent measurement of internal carotid artery intima-media thickness by high-resolution real-time B-mode ultrasonography using a 10 MHz linear transducer.
Results:
Intima-media thickness was used as a dependent variable in a simple linear regression model, with the various laboratory parameters as independent variables. Only parameters showing a significant correlation with CIMT were evaluated in a multiple regression model: age (p=0.001), hemoglobin (p=00.3), logCRP (p=0.042), logIL-6 (p=0.004) and homocysteine (p=0.002). In the multiple regression model we found that age (p=0.001) and homocysteine (p=0.027) were independently correlated with CIMT. LogIL-6 did not reach statistical significance (p=0.057), probably due to the small population size.
Conclusion:
The authors conclude that age and homocysteine correlate with carotid intima-media thickness, and thus can be considered as markers/risk factors in chronic renal patients.
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