Ping Ye

Association of serum lipids with arterial stiffness in a population-based study in Beijing

Eur J Clin Invest 2011; 41 (9): 929–936

Association of risk factors for cardiovascular disease and glomerular filtration rate: a community-based study of 4925 adults in Beijing

BACKGROUNDnSeveral large prospective studies have reported that a low estimated glomerular filtration rate (eGFR) or chronic kidney disease (CKD) is independently associated with cardiovascular disease (CVD) events and all-cause mortality in high-risk populations. However, findings from community-based population studies are scarce and inconsistent. We investigated the level of eGFR and the relationship between CVD risk factors and eGFR or CKD in the population of Beijing, China.nnnMETHODSnThis is a community-based observational survey in residents from three communities in Beijing for a routine health status checkup. Out of 5100 individuals who were eligible for inclusion, 4925 (96.57%) had complete data and were investigated the level of eGFR and the associated factors of reduced renal function. 2085 individuals with albuminuria values were included in the analyses on the associated factors of CKD. A questionnaire was used for risk factors of CVD. Anthropometry and blood pressure were measured. Serum creatinine, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and serum glucose were detected. The urine albumin-creatinine ratio (ACR) was used as an expression for albumin excretion. The oral glucose tolerance test was performed for the participants with no history of diabetes to diagnose diabetes. eGFR was evaluated by the Chinese modified Modification of Diet in Renal Disease equation. Reduced renal function was defined as normal renal function: eGFR ≥90 mL/min/1.73 m(2); mild reduced renal function: eGFR 89-60 mL/min/1.73 m(2); moderate to severe reduced renal function: eGFR <60 mL/min/1.73 m(2). CKD was diagnosed as eGFR <60 mL/min/1.73 m(2) or albuminuria was present.nnnRESULTSnThe prevalence of mild reduced renal function (eGFR 89-60 mL/min/1.73 m(2)), moderate to severe reduced renal function (eGFR <60 mL/min/1.73 m(2)) and CKD was 41.12% (2025/4925), 1.89% (93/4925) and 18.90% (394/2085) in the present study, respectively. The proportion of risk factors was higher in the low level of eGFR. Risk factors that exposed to reduced renal function were slightly different between male and female. The results of multivariate logistic regression analysis showed older age [increased by 10 years; odds ratios (OR)u2009=u20091.22], male gender (ORu2009=u20091.38), diabetes (ORu2009=u20091.67), hypertension (ORu2009=u20091.84) and hypertriglyceridaemia (≥1.7 mmol/L; ORu2009=u20091.68) were independently associated with CKD.nnnCONCLUSIONSnIn the general population in Beijing, China, multiple CVD risk factors increased with a decline in eGFR and older age, hypertension, diabetes and elevated TG were independently associated with CKD.

Association between serum homocysteine and arterial stiffness in elderly: a community-based study.

Background Arterial stiffness and homocysteine are both powerful predictors of cardiovascular disease, especially in older populations. Previous studies have investigated the association of homocysteine with arterial stiffness in human subjects, while the relationship between homocysteine and arterial stiffness in the elderly is still indefinite. The current study examined the association of homocysteine with arterial stiffness in Chinese community-based elderly persons. Methods We related serum levels of homocysteine to two measures of arterial stiffness (carotid-femoral pulse wave velocity (PWV) and carotid-radial PWV) in 780 participants (46.3% men, mean age 71.9 years (ranging 65–96 years old)) from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. Results In multiple-adjusted models, homocysteine levels were strongly associated with the carotid-femoral PWV (standardized β = 0.13, P < 0.001), even after adjustment for classical risk factors of cardiovascular disease. The association is also stronger when the carotid-femoral PWV is elevated above normal, whereas no significant association with homocysteine was observed for carotid-radial PWV. Conclusions In Chinese elderly persons, serum homocysteine levels are associated with alterations of aortic stiffness.

Influence of Low High‐Density Lipoprotein Cholesterol on Arterial Stiffening and Left Ventricular Diastolic Dysfunction in Essential Hypertension

J Clin Hypertens (Greenwich). 2011;13:710–715. ©2011 Wiley Periodicals, Inc.

Association of glomerular filtration rate with high-sensitivity cardiac troponin T in a community-based population study in Beijing

Background Reduced renal function is an independent risk factor for cardiovascular disease mortality, and persistently elevated cardiac troponin T (cTnT) is frequently observed in patients with end-stage renal disease. In the general population the relationship between renal function and cTnT levels may not be clear because of the low sensitivity of the assay. In this study, we investigated the level of cTnT using a highly sensitive assay (hs-cTnT) and evaluated the association of estimated glomerular filtration rate (eGFR) with detectable hs-cTnT levels in a community-based population. Methods The serum hs-cTnT levels were measured in 1365 community dwelling population aged ≥45 years in Beijing, China. eGFR was determined by the Chinese modifying modification of diet in renal disease (C-MDRD) equation. Results With the highly sensitive assay, cTnT levels were detectable (≥3pg/mL) in 744 subjects (54.5%). The result showed that eGFR was associated with Log hs-cTnT (ru200a=u200a−0.14, P<0.001). After adjustment for the high predicted Framingham Coronary Heart Disease (CHD) risk (10-year risk >20%) and other prognostic indicators, moderate to severe reduced eGFR was independently associated with detectable hs-cTnT, whereas normal to mildly reduced eGFR was not independently associated with detectable hs-cTnT. In addition, after adjustment for other risk factors, the high predicted Framingham CHD risk was associated with detectable hs-cTnT in the subjects with different quartile levels of eGFR. Conclusion The levels of hs-cTnT are detectable in a community-based Chinese population and low eGFR is associated with detectable hs-cTnT. Moreover, eGFR and high predicted Framingham CHD risk are associated with detectable hs-cTnT in subjects with moderate-to-severe reduced renal function.

Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function

Objective Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

Epidemiological associations between hyperuricemia and cardiometabolic risk factors: a comprehensive study from Chinese community

BackgroundThis study aimed to assess the associations of serum uric acid (SUA) levels and hyperuricemia with cardiometabolic risk factors in a Chinese community-dwelling population.MethodsA large cohort of 4706 residents was enrolled in this study. Physical examinations and laboratory tests were performed following a standardized protocol. Multiple linear and logistic regression analyses were conducted with adjustment of cardiometabolic risk factors including age, sex, body mass index (BMI), blood pressure (BP), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c) and fasting blood glucose (FBG) levels using SPSS version 17 software.ResultsThe prevalence of hyperuricemia was 7.6xa0%. There were significant differences in age, BMI, BP, TG, HDL-c, LDL-c and FBG levels and the proportion of men between participants with and without hyperuricemia. Multiple linear regression analysis showed that SUA levels were positively associated with age, sex, BMI, BP, TG and LDL-c levels, but negatively associated with HDL-c and FBG levels. Multiple logistic regression analysis showed that per unit increase in age was associated with a 1.014 times higher odds of the presence of hyperuricemia. Men had a 1.858 times higher odds of the presence of hyperuricemia compared with women. Per unit increases in BMI, BP, TG and LDL-c levels were associated with 1.103, 1.016, 1.173 and 1.200 times higher odds of the presence of hyperuricemia, respectively. Per unit increases in HDL-c and FBG levels were associated with 0.616 and 0.900 times lower odds of the presence of hyperuricemia, respectively.ConclusionsIn a Chinese community-dwelling population, age, sex, BMI, BP, TG, HDL-c, LDL-c and FBG levels are cardiometabolic risk factors that are significantly associated with SUA levels, as well as the presence of hyperuricemia.

Changes in carotid plaque tissue composition in subjects who continued and discontinued statin therapy

BACKGROUNDnChanges in plaque tissue components such as lipid-rich necrotic core (LRNC) and fibrous tissue with long-term statin treatment or discontinuation have not been studied.nnnOBJECTIVEnLRNC and fibrous tissue by magnetic resonance imaging were evaluated in subjects who continued and discontinued statin therapy for 2xa0years after a prospective study.nnnMETHODSnThe Rosuvastatin Evaluation of Atherosclerotic Chinese Patients study in 32 lipid treatment naïve subjects showed a significant reduction in LRNC during 24xa0months of rosuvastatin therapy. After Rosuvastatin Evaluation of Atherosclerotic Chinese Patients was completed, 15 subjects continued taking statins and 17 discontinued despite receiving an instruction to continue statin therapy. LRNC and fibrous tissue were compared between 24 and 48xa0months within each group and between the 2 groups.nnnRESULTSnAt 48xa0months, LRNC volume and composition decreased significantly compared with that at 24xa0months in the statin-continued group (101xa0±xa076 vs 76xa0±xa065xa0mm(3); Pxa0=xa0.001 and 17.3xa0±xa011.9% vs 12.6xa0±xa07.6%; Pxa0=xa0.04), whereas fibrous tissue increased significantly in both volume (337xa0±xa0160 vs 357xa0±xa0169xa0mm(3); Pxa0<xa0.001) and composition (76.3xa0±xa010.5% vs 83.1xa0±xa010.1%, Pxa0=xa0.002). Such changes were not seen in subjects who discontinued statin. Furthermore, the changes in LRNC volume and composition and fibrous tissue composition from 24 to 48xa0months were significantly different between the statin-continued and -discontinued groups (-25xa0±xa018 vs 9xa0±xa014xa0mm(3); Pxa0<xa0.001) and (-4.6xa0±xa08.2% vs 1.3xa0±xa02.8%; Pxa0=xa0.009) and (6.9xa0±xa06.8% vs 1.3xa0±xa05.4%, Pxa0=xa0.018).nnnCONCLUSIONSnContinued statin therapy leads to continued decrease in LRNC and increase in fibrous tissue, which indicates improved plaque stability and supports long-term statin therapy.

Association of cardiac and renal function with extreme N-terminal fragment Pro-B-type natriuretic peptide levels in elderly patients

BackgroundThe data are inconsistent regarding whether extreme N-terminal fragment pro-B-type natriuretic peptide (NT pro-BNP) levels are associated with impaired renal function. Furthermore, the relationship between extreme NT pro-BNP levels and cardiac and renal function in elderly patients has not been reported. The aim of the present study was to examine a hypothesis that extreme NT pro-BNP levels may be associated with impaired cardiac and renal function in elderly patients.MethodsWe retrospectively analyzed the data of demographic, clinical, and echocardiographic features on 152 consecutive elderly patients aged more than 80u2009years old (average age, 83.65u2009±u20093.58u2009years) with NT pro-BNP levelsu2009≥u20093000u2009pg/ml. The participants were divided into two categories according to their NT pro-BNP levels: (1) 3000–10000u2009pg/mL and (2) >10000u2009pg /mL.ResultsThe number of patients with impaired renal function (Pu2009=u20090.019) and the mortality (Pu2009<u20090.001) in the period of inpatient was higher in the group with NT pro-BNPu2009>u200910000u2009pg /mL. The levels of serum creatinine and creatine kinase MB (CK-MB) in the group of NT pro-BNPu2009>u200910000u2009pg / mL were higher than those in the group of NT pro-BNPu2009=u20093000-10000u2009pg/mL (Pu2009=u20090.001 and Pu2009=u20090.023, respectively). Furthermore, no significant difference in the distribution by NYHA class in different NT pro-BNP levels was observed. Multiple linear regression analyses demonstrated that with NT pro-BNP levels as the dependent variable, NT pro-BNP levels were positively correlated with CK-MB (βu2009=u20090.182, Pu2009=u20090.024) and creatinine levels (βu2009=u20090.281, Pu2009=u20090.001). The area under the receiver-operating characteristic (ROC) curve of NT pro-BNP levels and clinical diagnosis of impaired renal function was 0.596 and reached significant difference (95%CI:0.503-0.688, Pu2009=u20090.044).ConclusionThese data suggest that the extreme elevation of NT pro-BNP levels (≥3000u2009pg/ml) is mainly determined by impaired renal function in elderly patients above 80u2009years. Extreme NT pro-BNP levels may be useful for assessing the severity of impaired renal function.

Early decrease in carotid plaque lipid content as assessed by magnetic resonance imaging during treatment of rosuvastatin

BackgroundStatin therapy has shown to deplete atherosclerotic plaque lipid content and induce plaque regression. However, how early the plaque lipid depletion can occur with low-density lipoprotein cholesterol (LDL-C) lowering in humans in vivo has not been fully described.MethodsWe enrolled 43 lipid treatment naïve subjects with asymptomatic carotid atherosclerosis and LDL-Cu2009≥u2009100 andu2009≤u2009250xa0mg/dl. Rosuvastatin 5–20xa0mg/day was used to lower LDL-C levels tou2009<u200980xa0mg/dl. Lipid profile and carotid MRI scans were obtained at baseline, 3, 12, and 24xa0months. Carotid plaque lipid-rich necrotic core (LRNC) and plaque burden were measured and compared between baseline and during treatment.ResultsAmong the 32 subjects who completed the study, at 3xa0months, an average dose of rosuvastatin of 11xa0mg/day lowered LDL-C levels by 47% (125.2u2009±u200924.4xa0mg/dl vs. 66.7u2009±u200917.3xa0mg/dl, pu2009<u20090.001). There were no statistically significant changes in total wall volume, percent wall volume or lumen volume. However, LRNC volume was significantly decreased by 7.9xa0mm3, a reduction of 7.3% (111.5u2009±u2009104.2xa0mm3 vs. 103.6u2009±u200995.8xa0mm3, pu2009=u20090.044). Similarly, % LRNC was also significantly decreased from 18.9u2009±u200911.9% to 17.9u2009±u200911.5% (pu2009=u20090.02) at 3xa0months. Both LRNC volume and % LRNC continued to decrease moderately at 12 and 24xa0months, although this trend was not significant.ConclusionsAmong a small number of lipid treatment naïve subjects, rosuvastatin therapy may induce a rapid and lasting decrease in carotid plaque lipid content as assessed by MRI.Trial registrationClinicalTrials.Gov numbers NCT00885872