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Published on: February 7, 2015
Endothelial dysfunction and carotid atherosclerosis in Malawian adults: A cross-sectional study
Joseph Kamtchum-Tatuene1,2, Gloria Mwangalika Kachingwe1, Henry C Mwandumba1,3
1Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.
Insights
High soluble thrombomodulin levels are linked to carotid atherosclerosis in Malawian adults. This study highlights a potential biomarker for endothelial dysfunction and cardiovascular risk in sub-Saharan Africa.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Epidemiology
Background:
- Carotid atherosclerosis data is limited in sub-Saharan Africa.
- Endothelial dysfunction plays a role in atherosclerosis.
- Understanding risk factors is crucial for public health.
Purpose of the Study:
- Investigate carotid atherosclerosis prevalence and risk factors in Malawian adults.
- Examine the association between biomarkers of endothelial dysfunction and carotid atherosclerosis.
- Identify potential predictors of carotid atherosclerosis in the region.
Main Methods:
- Carotid ultrasound performed on 66 patients.
- Plasma levels of ICAM-1, PAI-1, VEGF, and soluble thrombomodulin measured via ELISA.
- Univariable logistic regression analyzed associations with atherosclerosis, biomarkers, and clinical factors.
Main Results:
- Carotid atherosclerosis detected in 39.4% of participants (mean age 58.7 years).
- Significant associations found with age > 45 years (OR=12.0), hypertension (OR=3.8), and high soluble thrombomodulin (OR=3.4).
- High soluble thrombomodulin levels showed a 3.4-fold increased odds of carotid atherosclerosis.
Conclusions:
- High soluble thrombomodulin levels are associated with carotid atherosclerosis in Malawian adults.
- Soluble thrombomodulin may serve as a biomarker for endothelial dysfunction and atherosclerosis risk.
- Further research with larger cohorts is recommended for broader African populations.
Background And Objective:
In sub-Saharan Africa, data on prevalence, risk factors and pathobiology of carotid atherosclerosis are scarce. We aimed to investigate the relationship between biomarkers of endothelial dysfunction and carotid atherosclerosis.
Methods:
Carotid ultrasound was performed in 66 patients. Plasma concentration of ICAM-1, PAI-1, VEGF, and soluble thrombomodulin were measured by ELISA. A univariable logistic regression analysis was performed to study the relationship between carotid atherosclerosis, biomarkers of endothelial dysfunction, and various demographic and clinical parameters of the participants.
Results:
The mean age of the participants was 58.7 years (95% CI: 54.4-63.1). Carotid atherosclerosis was diagnosed in 39.4% (95% CI: 27.6-52.2). In the univariable logistic regression, the following factors were associated with carotid atherosclerosis: age > 45 years (OR = 12.0, 95% CI: 1.4-98.8, p = .02), hypertension (OR = 3.8, 95% CI: 1.2-12.1, p = .02), and high-level of soluble thrombomodulin (OR = 3.4, 95% CI: 1.2-10.0, p = .02).
Conclusions:
There is an association between high levels of soluble thrombomodulin and carotid atherosclerosis in Malawian adults. Further studies with a larger sample size are needed to confirm our findings in other African populations.
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