Key result
In hemodialysis patients, maximum carotid IMT was independently associated with age, diabetes, smoking, and intact PTH, whereas mean IMT was associated with age, hypertension, dyslipidemia, intact PTH, and lipoprotein (a).
Why the study?
What are the independent risk factors for maximum versus mean carotid intima-media thickness in hemodialysis patients?
Cross-Sectional (n=112)
Single-blind
No
What are the independent risk factors for maximum versus mean carotid intima-media thickness in hemodialysis patients?
Effect estimate: R=0.569 for maximum IMT; R=0.602 for mean IMT
p-value: p=<0.0001
Risk factors for maximum carotid IMT (including plaque) and mean IMT (excluding plaque) differ in hemodialysis patients, suggesting distinct pathophysiological mechanisms for arterial wall thickening versus atheroma formation.
May indicate distinct mechanisms for wall thickening versus plaque in hemodialysis; hypothesis-generating, needs prospective validation before clinical use.
OBJECTIVE: High-resolution B-mode ultrasonography has been widely used for the noninvasive assessment of atherosclerosis in hemodialysis patients. But, there are two major methods of carotid ultrasonography: one including plaque and the other excluding plaque. METHODS: The subjects were 112 hemodialysis patients (58 men and 54 women) with a mean age of 55.8 +/- 13.0 years. The maximum intima-media thickness (IMT) of the carotid artery (including plaque) was measured as an index of arterial wall thickening and atheroma formation, while the mean IMT (without plaque) was measured as an index of arterial wall thickening. In addition the value of (maximum-mean) IMT was calculated as an index of atheroma formation. Therefore, the independent risk factors associated with the maximum IMT, mean IMT, and (maximum-mean) IMT were investigated by stepwise multiple regression analysis. RESULTS: The independent risk factors associated with the maximum IMT were age, diabetes mellitus, smoking, and intact parathyroid hormone (PTH) (R = 0.569, p < 0.0001), while factors associated with the mean IMT were age, hypertension, dyslipidemia, intact PTH, and lipoprotein (a) (R = 0.602, p < 0.0001). The independent risk factors associated with the (maximum-mean) IMT were age, diabetes mellitus, smoking, and intact PTH (R = 0.515, p < 0.0001). CONCLUSION: These findings suggest that risk factors for the maximum IMT and mean IMT are somewhat different in hemodialysis patients.
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Nakashima et al. (2003) conducted a cross-sectional in Hemodialysis (n=112). Cardiovascular risk factors (age, diabetes, smoking, hypertension, dyslipidemia, intact PTH, lipoprotein (a)) was evaluated on Independent risk factors associated with maximum IMT and mean IMT (R=0.569 for maximum IMT; R=0.602 for mean IMT, p=<0.0001). In hemodialysis patients, maximum carotid IMT was independently associated with age, diabetes, smoking, and intact PTH, whereas mean IMT was associated with age, hypertension, dyslipidemia, intact PTH, and lipoprotein (a).
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