| 1. |
- Fatehali, Abd Al Hakim, et al.
(författare)
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Family history of cardiometabolic diseases and its association with arterial stiffness in the Malmö Diet Cancer cohort
- 2017
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Ingår i: Journal of Hypertension. - 0263-6352. ; 35:11, s. 2262-2267
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: Arterial stiffening increases with age and is associated with increased cardiovascular risk. Several risk factors have been shown to predict the development of arterial stiffening; however, a positive family history (FH+) of cardiometabolic disease (CMD) and hypertension has not been extensively studied. We hypothesize that FH+ of CMD plays a significant role in the development of arterial stiffening in offspring. METHODS:: We used data from the population-based Malmö Diet Cancer study (n?=?3056) examined in 1992–1996 and again in 2007–2012. Several variables were analysed, including anthropometrics, carotid–femoral pulse wave velocity and FH+. The association between FH+ of CMD and arterial stiffening in the offspring was analysed with analysis of covariance in SPSS. FH+ was subdivided into three categories: family history for cardiovascular events (FH-CVEs), family history for diabetes mellitus type 2 (FH-DM2) and family history for hypertension (FH-HT). The first analysis of covariance-model was adjusted for age, sex, mean arterial pressure and heart rate; the second model additionally adjusted for self-reported medical history in the offspring. RESULTS:: Data indicated that FH-CVE (F?=?14.64, P?
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| 2. |
- Gottsäter, Mikael
(författare)
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Epidemiological, mechanistic and genetic aspects of vascular ageing and arterial stiffness in the population
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The core feature of vascular ageing is the age-associated stiffening of the large, elastic arteries, or arteriosclerosis. This results in a diminished volume-buffering function and is therefore central for the increase in systolic blood pressure and pulse pressure seen with advancing age. Since there are considerable individual differences regarding the rate of vascular ageing, the aim was to describe vascular ageing and its relation to hemodynamic, circulating, morphological and genetic markers using cross-sectional and longitudinal data.This thesis is based on epidemiological data from the Malmö Diet and Cancer Study, a population-based cohort from the city of Malmö, Sweden.In Paper 1, adrenomedullin (ADM), a vasoactive peptide mainly produced by endothelial cells, was investigated. The results showed that ADM was positively associated with brachial pulse pressure and both carotid intima-media thickness and atherosclerotic plaques in adjusted models. This suggests a role for ADMin early hemodynamic pathophysiology related to arteriosclerosis and atherosclerosis.In Paper 2 and Paper 3, predictive and cross-sectional assocations between arterial stiffness and cardiovascular risk markers were investigated. In Paper 2, the stiffness of the abdominal aorta was assessed by ultrasound while in Paper 3 carotid-femoral pulse wave velocity (c-f PWV) was used, measuring regionalarterial stiffness along the carotid–aortic–iliac–femoral arterial segment. In Paper 3, markers of impaired glucose metabolism, dyslipidemia (high triglycerides, low high-lipoprotein cholesterol; HDLc), and waist circumference were all independent, non-hemodynamic, long-term predictors of arterial stiffness, following full adjustment in both sexes. Smoking, low density lipoprotein cholesterol (LDLc), and estimated glomerular filtration rate (eGFR) were not associated with arterial stiffness. These results were partly concurrent withresults from Paper 2, the main difference being that insulin resistance and low HDLc were associated with abdominal aortic stiffness among women, but not among men.In Paper 4, Mendelian randomization was used as a method of identifying causal risk factors for arterial stiffness, measured as c-f PWV. Genetic risk scores (GRS) were used as instrumental variables. Arterial stiffness was associated with GRS for fasting plasma glucose (FPG) and type 2 diabetes (T2D). However, ininverse-variance weighted analyzes, significance for FPG β coefficients remained (p=0.006) but the relationship between T2D β coefficients was lost (p=0.88). GRSs for body mass index, systolic blood pressure, LDLc, HDLc and triglycerides were not associated with arterial stiffness. In conclusion, genetically elevatedFPG, but not genetically elevated risk of T2D, was associated with arterial stiffness, suggesting a causal stiffening effect of glycemia on the arterial wall, independently of T2D.To summarize, in a population-based cohort, the risk markers for arteriosclerosis differ from risk markers for atherosclerosis. Results from Mendelian randomization analyses suggest that fasting plasma glucose is acausal risk factor for arteriosclerosis. However, this must be confirmed in future studies including newinterventions on hyperglycaemia to improve arteriosclerosis.
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| 3. |
- Muhammad, Iram Faqir, et al.
(författare)
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Acute phase proteins as prospective risk markers for arterial stiffness : The Malmö Diet and Cancer cohort
- 2017
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- Background and objectives: Arterial stiffness plays a significant role in the development and progression of adverse cardiovascular events and all-cause mortality. This observational study aims to explore the relationship between six acute phase proteins namely, ceruloplasmin, alpha-1-antitrypsin, orosomucoid, haptoglobin, complement C3 and C-reactive protein (CRP), and carotid-femoral pulse wave velocity (c-f PWV) in a population-based cohort, and to also explore the effect of low-grade inflammation on the relationship between diabetes and c-f PWV. Method: The study consisted of participants from the Malmö Diet and Cancer study with data from baseline examinations (1991–1994) and follow-up examinations (2007–2012). Arterial stiffness was measured at follow-up by determining c-f PWV. After excluding participants with missing data, the total study population included 2338 subjects. General linear models were used to assess the relationship between baseline acute phase proteins and c-f PWV. Results: After adjusting for traditional risk factors the participants in the 4th quartile vs 1st quartile of alpha-1-antitrypsin (geometric mean: 10.32 m/s vs 10.04 m/s) (<0.05), C3 (10.35 m/s vs 10.06 m/s) (p<0.05) and CRP (10.37 m/s vs 9.96 m/s) (<0.001) showed significant association with c-f PWV. Diabetes at follow-up was also associated with high c-f PWV, however, this relationship was independent of low grade inflammation. Conclusion: Alpha-1-antitrypsin, C3 and CRP are associated with arterial stiffness. The results indicate that low grade inflammation is associated with arterial stiffness in addition to established cardiovascular risk factors.
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| 4. |
- Muhammad, Iram Faqir, et al.
(författare)
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Arterial stiffness and incidence of diabetes : A population-based cohort study
- 2017
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 40:12, s. 1739-1745
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Diabetes is known to be associated with increased arterial stiffness. However, the temporal association between increased carotid-femoral pulse wave velocity (c-f PWV) and diabetes is unclear. The aim of this study is to explore the relationship between arterial stiffness, as determined by c-f PWV, and incidence of diabetes. Research Design and Methods: The study population included participants from the Malmö Diet and Cancer cardiovascular cohort, using measurements from the 2007-2012 reexamination as baseline. Arterial stiffness was evaluated by measuring c-f PWV (SphygmoCor). After excluding participants with prevalent diabetes (according to measurements of fasting glucose, oral glucose tolerance tests, and physician's diagnoses), the final study population consisted of 2,450 individuals (mean age = 71.965.6 years). Incidence of diabetes was followed by linkage to local and national diabetes registers. Cox proportional hazards regression was used to assess the incidence of diabetes in relation to the tertiles of c-f PWV, adjusted for potential confounders. Results: During a mean follow-up of 4.43 6 1.40 years, 68 (2.8%) participants developed diabetes. Crude incidence of diabetes (per 1,000 person-years) was 3.5, 5.7, and 9.5, respectively, for subjects in the first, second, and third tertiles of c-f PWV. After adjustment for potential confounders, the hazard ratio of diabetes was 1.00 (reference), 1.83 (95% CI 0.88-3.8), and 3.24 (95% CI 1.51-6.97), respectively, for the tertiles of c-f PWV (P for trend = 0.002). Conclusions: Increased c-fPWV is associated with increased incidence of diabetes, independent of other risk factors. These results suggest that increased arterial stiffness is an early risk marker for developing diabetes.
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