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• Does the presence of carotid plaque offset cardiovascular sex differences in young hypertensive patients? • From the Campania Salute Network registry, 2419 hypertensive patients 51 years old or younger were enrolled. • Women without carotid plaque had a lower risk for major adverse cardiovascular events compared to men (HR, 0.51, 95 % CI, 0.27–0.99). • This sex difference was not present in women with carotid plaque (HR 1.3, 95 % CI, 0.6–2.9). • The presence of carotid plaque in young patients with treated hypertension offsets sex-specific cardiovascular protection in women. Women have a lower risk for cardiovascular (CV) disease compared to men. Whether this difference is influenced by the presence of hypertension-mediated organ damage is unknown. To assess whether the presence of carotid plaque (CP) impacts the sex difference in risk for CV events in treated hypertensive patients. From the Campania Salute Network Registry 2419 women and men <51 years of age with treated hypertension and free from prevalent CV disease were included. The presence of CP was identified by Doppler ultrasound (intima-media thickness≥1.5 mm). The primary outcome was a composite of fatal and non-fatal stroke or myocardial infarction, sudden death, TIA, myocardial revascularization, de novo angina, and atrial fibrillation. Among patients without CP at baseline (n = 1807), women were older, with higher systolic blood pressure, serum cholesterol level and prevalence of LVH but lower serum triglycerides and eGFR, compared to men (all p < 0.001). Among patients with CP (n = 612), women were older, used higher number of antihypertensive drugs, had higher serum cholesterol level and prevalence of left ventricular hypertrophy (LVH), but had lower serum triglycerides and eGFR compared to men (all p < 0.001). During follow-up, women without CP had a lower risk for CV disease than men (hazard ratio, HR, 0.51, 95 % confidence intervals, CI, 0.27–0.99, p = 0.04) after accounting for cardiovascular risk factors, LVH, and antihypertensive treatment. In contrast, among patients with CP, women had similar risk for CV disease compared with men (HR 1.3, 95 % CI, 0.59–2.9, p = 0.48). Our findings suggest that the presence of CP in young patients with treated hypertension offsets the CV disease protection in women. NCT02211365 [Display omitted] [ABSTRACT FROM AUTHOR]

Increasing evidence suggested nephrolithiasis has a close linkage with carotid atherosclerosis (CAS), with Randall's plaque (RP) being a precursor to kidney stones. Our study aimed to examine the crosstalk genes and potential molecular mechanisms between RP and CAS. We obtained microarray data for RP and CAS from the Gene Expression Omnibus (GEO) and used weighted gene co-expression network analysis (WGCNA) and differential gene expression (DEG) analysis to identify shared genes. By integrating WGCNA and DEG analysis, Asporin (ASPN) was identified as the key gene connecting RP and CAS, with its diagnostic potential assessed via a receiver operating characteristic (ROC) curve. Immune infiltration studies showed a significant correlation between ASPN and various immune cells in RP and CAS. ASPN was found to be less expressed in RP and CAS tissues compared to normal tissues, as confirmed by immunohistochemistry (IHC) and quantitative reverse-transcription PCR (qRT-PCR). The rat model confirmed the human tissue findings. ASPN can elucidate the shared pathogenic mechanisms underlying the two conditions, including immune response and osteoblast differentiation. [ABSTRACT FROM AUTHOR]

Up to the last update, the gut microbiome (GM) had been associated with a different physiologic host process, including those affecting cardiovascular health. The carotid intima-media thickness (IMT) is an indicator of atherosclerosis and cardiovascular risk. The GM influence on atherosclerosis progression has garnered growing attention in recent years but the consensus in subclinical atherosclerosis remains elusive. The aim of this narrative review is to investigate the connection between the GM and carotid IMT, encompassing mechanisms like the microbiome impact on metabolite production, and systemic inflammation, and its effects on endothelial function. The literature analysis revealed that the GM appears to exert an influence on carotid IMT development, likely through mechanisms involving metabolites' production, systemic inflammation, and endothelial function modulation. Additional research, however, is needed to finely elucidate the relationship between the GM and atherosclerosis. Specifically, more extensive studies are required to pinpoint individuals at the highest risk of developing atherosclerosis based on their GM composition. This will facilitate the enhancement and optimization of cardiovascular disease prevention strategies and enable the treatments' customization for each patient. Further investigations are required to refine patient outcomes in the context of probiotics and other interventions aimed at improving microbiome composition and function. [ABSTRACT FROM AUTHOR]

Background: Carotid atherosclerotic ischemic stroke threatens human health and life. The aim of this study is to establish a radiomics model of perivascular adipose tissue (PVAT) around carotid plaque for evaluation of the association between Peri-carotid Adipose Tissue structural changes with stroke and transient ischemic attack. Methods: A total of 203 patients underwent head and neck computed tomography angiography examination in our hospital. All patients were divided into a symptomatic group (71 cases) and an asymptomatic group (132 cases) according to whether they had acute/subacute stroke or transient ischemic attack. The radiomic signature (RS) of carotid plaque PVAT was extracted, and the minimum redundancy maximum correlation, recursive feature elimination, and linear discriminant analysis algorithms were used for feature screening and dimensionality reduction. Results: It was found that the RS model achieved the best diagnostic performance in the Bagging Decision Tree algorithm, and the training set (AUC, 0.837; 95%CI: 0.775, 0.899), testing set (AUC, 0.834; 95%CI: 0.685, 0.982). Compared with the traditional feature model, the RS model significantly improved the diagnostic efficacy for identifying symptomatic plaques in the testing set (AUC: 0.834 vs. 0.593; Z = 2.114, p = 0.0345). Conclusion: The RS model of PVAT of carotid plaque can be used as an objective indicator to evaluate the risk of plaque and provide a basis for risk stratification of carotid atherosclerotic disease. [ABSTRACT FROM AUTHOR]

Background: Few prospective studies explored the incidence and determinant of carotid atherosclerosis (CA) progression (CAP). This community-based prospective study focused on the effects of diabetes mellitus (DM) treatments and glucose levels on CAP risks. Methods: We followed up a group of 657 CA-positive middle-aged adults and elders for CAP. CAP was defined as an increase in the total number of carotid plaque and/or an increase in diameter stenosis by at least 10%. Results: After 4.05 years of followed-up, CAP was detected in 364 (55.4%) subjects. The multivariable-adjusted hazard ratios (HRs) were 1.805 (95% confidence interval [CI]: 1.374-2.358) and 0.694 (95% CI: 0.510-0.944) for elevated fasting plasma glucose (eFPG; FPG≥100 mg/dL) and glucose-lowering medications (GLM), respectively. As compared to GLM-negative+eFPG-positive subjects, the multivariable-adjusted HRs were 0.497 (95% CI: 0.373-0.662), 0.537 (95% CI: 0.306-0.942), and 0.586 (95% CI: 0.412-0.833) for GLM-negative +eFPG-negative, GLM-positive+eFPG-negative, and GLM-positive+ eFPG-positive subjects, respectively. The multivariable-adjusted risks of CAP were similar between GLM-negative+eFPG-negative and GLM-positive+ eFPG-positive subjects (p=0.77). Stratified analyses showed that the multivariable-adjusted HRs per 5.0 mg/dL increase in FPG were significantly increased among GLM-negative subjects (HR=1.131; 95% CI: 1.094-1.171) and non)significantly decreased among GLM-positive subjects (HR=0.985; 95% CI: 0.957-1.013). Conclusion: We found that more than 50% of CA-positive subjects had CAP in 4 years and higher FPG significantly increased and GLM significantly decreased the risks of CAP. Additionally, GLM and FPG demonstrated an interactive effect on CAP risks. It seems possible that GLM may induce effects beyond lowering glucose levels and subsequently lowers CAP risks. [ABSTRACT FROM AUTHOR]

Background: A previous study demonstrated that N-glycosylation profiles of IgG are associated with subclinical atherosclerosis in a British population. However, the generalisability of this finding to other ethnic groups remains to be investigated, and it has yet to account for additional traditional atherosclerotic risk factors. The present study, thus, aims to explore IgG N-glycosylation profiles in Han Chinese with atherosclerosis, and their potential role in atherosclerosis, while controlling for traditional atherosclerotic risk factors. Methods: Data of this case-control study were obtained from an established umbrella Health Examination Cohort Study (registration number: ChiCTR2100048740). The investigation was conducted at the Health Care Centre of the First Affiliated Hospital of Shantou University Medical College in China, from August 1, 2021, to July 31, 2022. A sample of 69 carotid atherosclerosis (CAS) cases was recruited from the umbrella cohort, along with 69 controls without carotid atherosclerosis, matched by traditional atherosclerosis-related risk factors, including gender, age, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia and obesity. Subsequently, serum IgG N-glycosylation was profiled using Ultra-Performance Liquid Chromatography. Results: After propensity score matching, the relative abundance of IgG fucosylation in CAS cases was significantly lower than that in controls [95.32 (92.96, 95.99) vs. 95.96 (94.70, 96.58), P = 0.022]. The traditional atherosclerosis-related risk factors showed no statistically significant difference between CAS cases and controls (P > 0.05). Conclusions: The reduced fucosylation of IgG in CAS cases underscores the pivotal role of afucosylation in CAS. Enhancing the inflammatory capability of IgG via initiating antibody-dependent cell-mediated cytotoxicity could be the potential mechanism behind this, which should be further verified by functional studies. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work was to study the relationship between carotid atherosclerosis (CAS) and several indexes and provide a basis for the prevention and treatment of cardiovascular and cerebrovascular diseases. Methods: There were 11,028 adults who underwent physical examination at the Guangzhou Cadre and Talent Health Management Center from January 2023 to December 2023 and were selected as research subjects. Retrospective analysis was used to understand the carotid atherosclerosis of the examined population and analyze its relationship with sex, age, blood pressure, blood glucose, blood lipids, renal function, 25-hydroxyvitamin D, neutrophil to lymphocyte count ratio (NLR), platelet to lymphocyte count ratio (PLR), systemic immune inflammation index (SII), monocyte count to high-density lipoprotein cholesterol ratio (MHR), triglyceride glucose body mass index (TyG-BMI), insulin resistance metabolic index (METS-IR), and other indicators. Results: Among 11,028 subjects, the detection rate of carotid atherosclerotic thickening (CAT) was 12.00% and carotid atherosclerotic plaque (CAP) was 25.11%. The CAT and CAP detection rates in men were 13.32% and 28.78%, respectively, which were higher than the CAT detection rate of 8.28% and CAP detection rate of 14.80% in women, and the differences were statistically significant (both p < 0.001). Multivariate logistic regression analysis using TyG-BMI and METS-IR as two indicators was modeled separately, and the results showed that CAS was associated with men, increasing age, and systolic blood pressure. The area under the curve (AUC) was analyzed using the subject's work characteristic (ROC) curve in the descending order of METS-IR, TyG-BMI, and MHR. The combination of the three indexes of sex, age, and METS-IR predicted atherosclerosis with the highest AUC values. Conclusion: Carotid atherosclerosis is highly prevalent in men. Elevation of systolic blood pressure, fasting glucose, MHR, and TyG-BMI (or METS-IR) with age are independent influences on carotid atherosclerosis. The three indexes of MHR, TyG-BMI, and METS-IR, respectively, in combination with sex and age, can be used as a new and effective index to predict CAS. [ABSTRACT FROM AUTHOR]

Periodontitis is a significant independent risk factor for atherosclerosis. Yet, the exact mechanism of action is still not fully understood. In this study, we investigated the effect of exosomes‐miR‐155‐5p derived from periodontal endothelial cells on atherosclerosis in vitro and in vivo. Higher expression of miR‐155‐5p was detected in the plasma exosomes of patients with chronic periodontitis (CP) and carotid atherosclerosis (CAS) compared to patients with CP. Also, the expression level of miR‐155‐5p was associated with the severity of CP. miR‐155‐5p‐enriched exosomes from HUVECs increased the angiogenesis and permeability of HAECs and promoted the expression of angiogenesis, permeability, and inflammation genes. Along with the overexpression or inhibition of miR‐155‐5p, the biological effect of HUVECs‐derived exosomes on HAECs changed correspondingly. In ApoE−/− mouse models, miR‐155‐5p‐enriched exosomes promoted the occurrence of carotid atherosclerosis by increasing permeable and angiogenic activity. Collectively, these findings highlight a molecular mechanism of periodontitis in CAS, uncovering exosomal miR‐155‐5p derived periodontitis affecting carotid endothelial cells in an 'exosomecrine' manner. Exosomal miR‐155‐5p may be used as a biomarker and target for clinical intervention to control this intractable disease in future, and the graphic abstract was shown in Figure S1. [ABSTRACT FROM AUTHOR]

Background: In mouse models of atherosclerosis, knockout of the PLA2G2A gene has been shown to reduce the volume of atherosclerotic plaques. Clinical trials have demonstrated the potential of using the sPLA2 inhibitor Varespladib in combination with statins to reduce lipid levels. However, this approach has not yielded the expected results in reducing the risk of cardiovascular events. Therefore, it is necessary to further investigate the mechanisms of PLA2G2A. Methods: Single-cell transcriptome data from two sets of carotid plaques, combined with clinical patient information. were used to describe the expression characteristics of PLA2G2A in carotid plaques at different stages. In order to explore the mechanisms of PLA2G2A, we conducted enrichment analysis, cell–cell communication analysis and single-cell regulatory network inference and clustering analyses. We validated the above findings at the cellular level. Results: Our findings indicate that PLA2G2A is primarily expressed in vascular fibroblasts and shows significant cell interactions with macrophages in the early-stage, especially in complement and inflammation-related pathways. We also found that serum sPLA2 levels have stronger diagnostic value in patients with mild carotid artery stenosis. Subsequent comparisons of single-cell transcriptomic data from early and late-stage carotid artery plaques corroborated these findings and predicted transcription factors that might regulate the progression of early carotid atherosclerosis (CA) and the expression of PLA2G2A. Conclusions: Our study discovered and validated that PLA2G2A is highly expressed by vascular fibroblasts and promotes plaque progression through the activation of macrophage complement and coagulation cascade pathways in the early-stage of CA. [ABSTRACT FROM AUTHOR]

Objective: To observe the value of superb micro-vascular imaging (SMI) in evaluating carotid atherosclerotic plaque neovascularization in patients with ischemic stroke. Methods: One hundred patients with ischemic stroke and carotid atherosclerotic plaques from January 2022 to December 2023 were selected. All patients underwent SMI examination and histopathological examination of plaque. The detection of neovascularization in the plaque was compared between the two methods. According to pathological results, the patients were divided into observation group (with neovascularization) and control group (without neovascularization). SMI scores and plaque characteristics of the two groups were compared. Results: Among the 100 patients included in this study, 81 patients were diagnosed with neovascularization through pathological examination and 78 patients were diagnosed with neovascularization through SMI examination. Kappa test showed that the coefficient of consistency between SMI examination and pathological examination was 0.78. ROC curves indicated that the sensitivity, specificity and accuracy of SMI for diagnosing neovascularization were 93.83%, 89.47% and 93.00%. The MVD value of neovascularization with SMI score of 2 was the highest, followed by that with SMI score of 1. The MVD value of neovascularization with SMI score of 0 was the lowest (P<0.05). SMI score, plaque length, thickness, calcification and fibrosis degree of the observation group were higher than those of the control group (P<0.05). Multivariate logistic regression analysis found that SMI score, plaque thickness and calcification degree were independent influencing factors of carotid atherosclerotic plaque neovascularization in patients with ischemic stroke(P<0.05). Spesrman correlation analysis showed that SMI score, plaque thickness and calcification degree were positively correlated with neovascularization (P<0.05). Conclusion: SMI can help to evaluate carotid atherosclerotic plaque neovascularization in patients with ischemic stroke accurately. SMI score, plaque thickness and calcification degree are closely related to carotid atherosclerotic plaque neovascularization in patients with ischemic stroke. Therefore, it is recommended to pay close attention to these factors. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between serum soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1), and carotid atherosclerosis in patients with H-type hypertension complicated by heart failure with preserved ejection fraction (HFpEF). Methods A total of 161 patients with H-type hypertension and HFpEF admitted to Cangzhou Traditional Chinese and Western Medicine Hospital from February 2021 to March 2023 were selected. They were divided into atherosclerosis and non-atherosclerosis groups based on the presence of carotid atherosclerosis. Additionally, 80 healthy volunteers undergoing routine health checks were selected as a control group. Clinical data were collected, and serum levels of sTWEAK and sLOX-1 were measured using enzyme-linked immunosorbent assay (ELISA). The serum levels of sTWEAK and sLOX-1 in patients with H-type hypertension and HFpEF were compared to those in the control group. Multivariate logistic regression analysis was conducted to identify factors influencing carotid atherosclerosis, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of serum sTWEAK and sLOX-1 for carotid atherosclerosis. Results Among the 161 patients, 65 were found to have carotid atherosclerosis, resulting in an incidence rate of 40. 37% (65/161). Significant differences were observed between the two groups regarding age, smoking, and lipid levels (P＜0. 05). Serum sTWEAK levels were lower in both atherosclerosis and non-atherosclerosis groups compared to the control group, while sLOX-1 levels were higher (P＜0. 05). Additionally, sTWEAK levels were lower and sLOX-1 levels were higher in the atherosclerosis group compared to the non-atherosclerosis group (P＜0. 05). Multivariate logistic regression analysis indicated that HDL-C, sTWEAK, age, LDL-C, and sLOX-1 levels were significant factors influencing the occurrence of carotid atherosclerosis (P＜0. 05). The ROC curve analysis revealed that the combined detection of serum sTWEAK and sLOX-1 had an area under the curve (AUC) of 0. 842 for predicting carotid atherosclerosis, demonstrating higher predictive efficacy than either marker alone. Conclusion Decreased serum sTWEAK levels and increased sLOX-1 levels in patients with H-type hypertension complicated by HFpEF are associated with the occurrence of carotid atherosclerosis. The combined measurement of both biomarkers holds predictive value for the onset of carotid atherosclerosis. [ABSTRACT FROM AUTHOR]

Carotid atherosclerosis is a major cause of stroke. Hemodynamic forces, such as shear stress and oscillatory shear, play an important role in the initiation and progression of atherosclerosis. The alteration of the immune microenvironment is the fundamental pathological mechanism by which diverse external environmental factors impact the formation and progression of plaques. However, Current research on the relationship between hemodynamics and immunity in atherosclerosis still lack of comprehensive understanding. In this study, we combined computational fluid dynamics (CFD) and Mass cytometry (CyTOF) technologies to explore the changes in the immune microenvironment within plaques under different hemodynamic conditions. Our results indicated that neutrophils were enriched in adverse flow environments. M2-like CD163+CD86+ macrophages were predominantly enriched in high WSS and low OSI environments, while CD163-CD14+ macrophages were enriched in low WSS and high OSI environments. Functional analysis further revealed T cell pro-inflammatory activation and dysregulation in modulation, along with an imbalance in M1-like/M2-like macrophages, suggesting their potential involvement in the progression of atherosclerotic lesions mediated by adverse flow patterns. Our study elucidated the potential mechanisms by which hemodynamics regulated the immune microenvironment within plaques, providing intervention targets for future precision therapies. [ABSTRACT FROM AUTHOR]

Aims There is increasing evidence that plaque instability in the extracranial carotid artery may lead to an increased stroke risk independently of the degree of stenosis. We aimed to determine diagnostic accuracy of vulnerable and stable plaque using noninvasive imaging modalities when compared to histology in patients with symptomatic and asymptomatic carotid atherosclerosis. Methods and results Medline Ovid, Embase, Cochrane Library, and Web of Science were searched for diagnostic accuracy of noninvasive imaging modalities (CT, MRI, US) in the detection of 1) vulnerable/stable plaque, and 2) vulnerable/stable plaque characteristics, compared to histology. The quality of included studies was assessed by QUADAS-2 and univariate and bivariate random-effect meta-analyses were performed. We included 36 vulnerable and 5 stable plaque studies in the meta-analysis, and out of 211 plaque characteristics from remaining studies, we classified 169 as vulnerable and 42 as stable characteristics (28 CT, 120 MRI, 104 US characteristics). We found that MRI had high accuracy [90% (95% CI: 82–95%)] in the detection of vulnerable plaque, similar to CT [86% (95% CI: 76–92%); P > 0.05], whereas US showed less accuracy [80% (95% CI: 75–84%); P = 0.013]. CT showed high diagnostic accuracy in visualizing characteristics of vulnerable or stable plaques (89% and 90%) similar to MRI (86% and 89%; P > 0.05); however, US had lower accuracy (77%, P < 0.001 and 82%, P > 0.05). Conclusion CT and MRI have a similar, high performance in detecting vulnerable carotid plaques, whereas US showed significantly less diagnostic accuracy. Moreover, MRI visualized all vulnerable plaque characteristics allowing for a better stroke risk assessment. Registration PROSPERO ID CRD42022329690 [ABSTRACT FROM AUTHOR]

Background: Evidence has demonstrated that visceral fat area (VFA) and subcutaneous fat area (SFA) have different influences on cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between the visceral fat area (VFA), the subcutaneous fat area (SFA) ratio (V/S), and carotid atherosclerosis (CAS) in patients with T2DM. Methods: From January 2018 to May 2023, 1838 patients with T2DM admitted to the National Metabolic Management Centre in our hospital were assigned to two groups based on comorbid CAS. Dual bioelectrical impedance analysis was used to measure the VAF and SFA, and the V/S was calculated. Patient characteristics and serum biochemical indices were compared between groups. Factors influencing comorbid CAS were determined, and correlations between V/S and other clinical indices were analyzed. Results: The group with comorbid CAS included 858 individuals and 980 without comorbid CAS. Those with comorbid CAS were older and had a longer disease duration, more significant systolic blood pressure, and greater V/S. The proportions of patients with comorbid hypertension increased significantly with the V/S ratio. The V/S ratio positively correlated with triglyceride (TG), low-density lipoprotein cholesterol levels, and waist circumference. According to binary logistic regression analysis, V/S was an independent risk factor for CAS. Conclusion: Elevated V/S is an independent risk factor for CAS in patients with T2DM.

Objective To investigate the relationship between renal resistance index (RRI) assessed by ultrasonography and carotid atherosclerosis in elderly patients with diabetic nephropathy. Methods A total of 120 elderly diabetic nephropathy patients admitted to Beijing Jishuitan Hospital affiliated to Capital Medical University from January 2023 to December 2023 were selected and grouped according to whether they had carotid atherosclerosis or not. Patients with thickening and/or plaque of carotid artery were selected as the study group (65 cases), otherwise as the control group (55 cases). General clinical data of patients were collected, the relationship between intima-media thickness (IMT) and RRI was analyzed by Pearson correlation analysis, the influencing factors of carotid atherosclerosis in elderly patients with diabetic nephropathy were analyzed by multivariate logistic regression analysis, and the predictive value of RRI on carotid atherosclerosis was analyzed by ROC curve. Results There were significant differences in duration of diabetes, glycosylated hemoglobin, fasting blood glucose, low-density lipoprotein cholesterol, uric acid, RRI, estimated glomerular filtration rate (eGFR), neutrophil-to-lymphocyte ratio (NLR) and carotid IMT between the two groups (P

Abstract Background A previous study demonstrated that N-glycosylation profiles of IgG are associated with subclinical atherosclerosis in a British population. However, the generalisability of this finding to other ethnic groups remains to be investigated, and it has yet to account for additional traditional atherosclerotic risk factors. The present study, thus, aims to explore IgG N-glycosylation profiles in Han Chinese with atherosclerosis, and their potential role in atherosclerosis, while controlling for traditional atherosclerotic risk factors. Methods Data of this case-control study were obtained from an established umbrella Health Examination Cohort Study (registration number: ChiCTR2100048740). The investigation was conducted at the Health Care Centre of the First Affiliated Hospital of Shantou University Medical College in China, from August 1, 2021, to July 31, 2022. A sample of 69 carotid atherosclerosis (CAS) cases was recruited from the umbrella cohort, along with 69 controls without carotid atherosclerosis, matched by traditional atherosclerosis-related risk factors, including gender, age, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia and obesity. Subsequently, serum IgG N-glycosylation was profiled using Ultra-Performance Liquid Chromatography. Results After propensity score matching, the relative abundance of IgG fucosylation in CAS cases was significantly lower than that in controls [95.32 (92.96, 95.99) vs. 95.96 (94.70, 96.58), P = 0.022]. The traditional atherosclerosis-related risk factors showed no statistically significant difference between CAS cases and controls (P > 0.05). Conclusions The reduced fucosylation of IgG in CAS cases underscores the pivotal role of afucosylation in CAS. Enhancing the inflammatory capability of IgG via initiating antibody-dependent cell-mediated cytotoxicity could be the potential mechanism behind this, which should be further verified by functional studies.

Abstract Background In mouse models of atherosclerosis, knockout of the PLA2G2A gene has been shown to reduce the volume of atherosclerotic plaques. Clinical trials have demonstrated the potential of using the sPLA2 inhibitor Varespladib in combination with statins to reduce lipid levels. However, this approach has not yielded the expected results in reducing the risk of cardiovascular events. Therefore, it is necessary to further investigate the mechanisms of PLA2G2A. Methods Single-cell transcriptome data from two sets of carotid plaques, combined with clinical patient information. were used to describe the expression characteristics of PLA2G2A in carotid plaques at different stages. In order to explore the mechanisms of PLA2G2A, we conducted enrichment analysis, cell–cell communication analysis and single-cell regulatory network inference and clustering analyses. We validated the above findings at the cellular level. Results Our findings indicate that PLA2G2A is primarily expressed in vascular fibroblasts and shows significant cell interactions with macrophages in the early-stage, especially in complement and inflammation-related pathways. We also found that serum sPLA2 levels have stronger diagnostic value in patients with mild carotid artery stenosis. Subsequent comparisons of single-cell transcriptomic data from early and late-stage carotid artery plaques corroborated these findings and predicted transcription factors that might regulate the progression of early carotid atherosclerosis (CA) and the expression of PLA2G2A. Conclusions Our study discovered and validated that PLA2G2A is highly expressed by vascular fibroblasts and promotes plaque progression through the activation of macrophage complement and coagulation cascade pathways in the early-stage of CA.

Background Carotid atherosclerosis (CAS) is often considered an early warning signal for cardiovascular diseases (CVD). The diagnostic technique of carotid artery Doppler ultrasonography has not been included in public health service programs, and the Framingham Risk Score (FRS) lacks accuracy in assessing CAS risk, hindering the identification of CAS by primary healthcare personnel. Currently, there is a lack of research on machine learning methods to identify CAS in the medium-high risk population assessed by FRS. Objective To construct a CAS risk prediction model for the medium-high risk population assessed by FRS using machine learning methods, compare its discriminative efficacy, select the optimal model, and assist primary healthcare personnel in identifying CAS more conveniently and accurately. Methods Using convenience sampling method, a total of 674 local residents from two townships in Liuzhou City, Guangxi Zhuang Autonomous Region, who met the inclusion criteria from 2019 to 2021 and 2023, were selected as the study subjects. Relevant information was collected, and biochemical indicators were measured in fasting blood and urine samples. FRS was used to assess the risk of CVD occurrence, and carotid ultrasound was used to diagnose CAS. Among the 517 subjects from 2019 to 2021, a random 8∶2 split was used to create a training set and a validation set. The training set was used to build Logistic regression, Random Forest (RF), Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), and Gradient Boosting Decision Tree (GBDT) models, while the validation set was used for internal validation. The 157 subjects from 2023 served as the test set for external validation. Feature variables were selected using Lasso regression analysis, and discriminative efficacy was evaluated using sensitivity, specificity, accuracy, F1 score, and area under curve (AUC) value. External validation assessed the generalization ability of the optimal model using AUC value, and the Shapley Additive exPlanation (SHAP) method explored the important variables influencing the optimal model's identification of CAS. Results Lasso regression analysis identified 15 feature variables: age, BMI, systolic blood pressure (SBP), smoking, drinking, hypertension, total cholesterol, high density lipoprotein cholesterol, C-reactive protein (CRP), fasting plasma glucose, apolipoprotein B (ApoB), lipoprotein a (LPA), aspartate aminotransferase (AST), AST/ alanine aminotransferase, urinary microalbumin creatinine ratio. The constructed Logistic regression, RF, SVM, XGBoost, and GBDT models exhibited high AUC values, with the GBDT model showing the best discriminative performance. Its sensitivity, specificity, accuracy, F1 score, and AUC value were 0.755 1, 0.836 4, 0.798 1, 0.778 9, and 0.834 9, respectively, and the external validation AUC value was 0.794 0. The SHAP method revealed that age, SBP, CRP, LPA, and ApoB were the top five factors influencing the GBDT model's identification of CAS. Conclusion Logistic regression, RF, SVM, XGBoost, and GBDT models for identifying CAS based on machine learning all demonstrated high discriminative performance, with the GBDT model exhibiting the best comprehensive discriminative efficacy and strong generalization ability.

KaiMing Wei,1,2,&ast; Yuan Cao,1,3,&ast; XiangJin Kong,1,2 ChuanZhen Liu,1,2 XingHua Gu1,2 1Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China; 2Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China; 3National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: XingHua Gu, Email guxinghua@email.sdu.edu.cnBackground: Cardiovascular diseases, such as aortic valve calcification (AVC) and carotid atherosclerosis (CAS), impose substantial health challenges on a global scale. Both disorders have overlapping risk factors, which might trigger similar immune-inflammatory reactions in both diseases.Methods: Shared differentially expressed genes (DEGs) were identified in the AVC and CAS datasets from the Gene Expression Omnibus (GEO). Candidate hub genes associated with immunity were identified using LASSO and immune cell infiltration analysis, and single gene set enrichment analysis (GSEA) was performed on the datasets. Subsequently, the hub genes were confirmed by qRT‒PCR validation in tissue samples.Results: A total of 140 upregulated and 65 downregulated common genes were screened. Enrichment analyses highlighted immune system processes, response to stress, and cytokine pathways among the identified CEGs. LASSO identified candidate hub genes, including ANGPTL1, CX3CR1, and CCL4. Immune cell infiltration analysis emphasized the participation of immune cells, including macrophages, γδ T cells, and resting NK cells. The three hub genes were validated by qRT‒PCR analysis.Conclusion: Our study explored immunological processes, including immune-related genes and cells, involved in the development of AVC and CAS. In particular, the identified hub genes ANGPTL1, CX3CR1, and CCL4 play crucial roles in mediating immune-inflammatory responses, which are central to the pathogenesis of these cardiovascular diseases, and the involvement of these genes in key immune pathways suggests that they could serve as potential biomarkers for early diagnosis or as targets for therapeutic strategies.Keywords: aortic valve calcification, carotid atherosclerosis, immune-related genes

Abstract Background The current clinical management of carotid atherosclerosis is based on the control of risk factors and medicine. However, the risk of adverse events associated with the medicine resulting in concerns and low medication compliance makes it necessary to seek a safer alternative therapy. This study assessed the effectiveness and safety of acupuncture as a treatment for carotid atherosclerosis. Methods In this randomized controlled trial, patients with carotid atherosclerotic plaques were included and randomly assigned (1:1) to receive real acupuncture or sham acupuncture for 12 weeks. The follow-up period was 12 weeks. The primary outcome included carotid intima-media thickness (cIMT), plaque score (PS), plaque volume (PV) and grey-scale median (GSM). Secondary outcome was pulse wave velocity (PWV). Adverse events results were recorded as safety outcomes. Results From January 2021 to February 2022, 60 eligible patients were included. 55 patients (91.7%) completed the intervention and the 12-week follow-up and there was no statistical difference in demographics between the groups. At the end of treatment, the real acupuncture group had significantly reduced PS (P = 0.002), PV (P = 0.000), and improved GSM (P = 0.044). There was no significant difference in the reduction in cIMT (Left cIMT: P = 0.338, Right cIMT: P = 0.204) and PWV between the groups (the left BS: P = 0.429; the left ES: P = 0.701; the right BS: P = 0.211; the right ES: P = 0.083). Three mild adverse reactions occurred during the study. Conclusion This study found that acupuncture had a certain effect on reducing the thickness and volume of carotid plaque and improving the stability of plaque with minor side effects. These findings suggest that acupuncture may be a potential alternative therapy for carotid atherosclerosis. Trial registration This trial has been registered at ClinicalTrials.gov (ChiCTR2100041762). Submitted 30 December 2020, Registered 4 January 2021 Prospectively registered.

Abstract The anatomical features spanning from the aortic arch to the proximal carotid artery and the associated cardiovascular risks might significantly influence the development of right carotid plaque. Our research aimed to compare these anatomical and risk factors between individuals with no carotid plaque and those with moderate right-side carotid plaque within a Korean cohort. We conducted a retrospective, cross-sectional analysis involving 413 participants, categorized into a normal group (n = 339) and a right moderate carotid plaque group (defined as > 50% stenosis based on NASCET criteria) (n = 74). We collected data on cardiovascular risk factors and conducted laboratory tests. A 3D model of the carotid artery was constructed using cranio-cervical computed tomography angiography (CTA) data through semi-automated software. Measurements taken on this 3D model included the common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), and carotid artery bifurcation (CAB) in terms of maximal vascular diameter, sectional area, angles of carotid bifurcation and ICA, and carotid tortuosity. When compared with the normal group, individuals in the right moderate carotid plaque group exhibited smaller angles at the carotid bifurcation, larger CCA diameter and sectional area (p

Background. Carotid atherosclerosis is one of the urgent problems due to the high risk of developing ischemic stroke and cognitive impairment. The dynamics of clinical disorders in patients with carotid stenosis is determined by a complex of neurophysiological, angiological, tissue and biomolecular reactions, the characteristics of which can act as predictors of the course of the pathology.The aim of the work. To determine the neurophysiological parameters and predictors of cognitive dysfunction in patients who underwent carotid endarterectomy.Materials and methods. The study included 59 people with carotid atherosclerotic disease. All included patients underwent carotid endarterectomy. We assessed the degree of stenosis of the internal carotid artery and cognitive status using the FAB (Frontal Assessment Battery) scale and MoCA (Montreal Cognitive Assessment) Test and recorded electroencephalogram (EEG), P300 cognitive evoked potentials and heart rate variability in patients at various terms (before surgery, 6 months after the surgery). Patients were divided into groups based on the dynamics of cognitive tests using cluster analysis (k-means) with identification of elements included in the clusters: patients of cluster 1 had a “preserved” profile of cognitive status; patients of cluster 2 – moderate cognitive dysfunction.Results. Patients of cluster 1 had a higher power of beta oscillations in the frontal lead, a higher amplitude of the P3 component of the P300 potential, and a greater variability of R-R intervals in terms of the total indicator and high-frequency power. We proposed a model that allows us to classify patients into groups according to the dynamics of cognitive function scores. According to the data obtained, the most significant predictors of the dynamics of cognitive status were the initial characteristics of the EEG and the P300 cognitive evoked potential.Conclusions. We determined the clinical and neurophysiological correlates of cognitive dysfunction: an association with greater preservation of activating effects on the EEG, processes of recognition and decision-making in the associative zones of the cortex, and less pronounced activity of stress-implementing mechanisms. Indicators of EEG spectral analysis and characteristics of the P300 cognitive evoked potential are predictors of the cognitive status dynamics.

Background Carotid atherosclerosis (CAS) is a significant indicator of early systemic atherosclerosis. Previous studies have demonstrated a close relationship between elevated remnant cholesterol (RC) levels and the pathogenesis of CAS. However, limited information is available regarding the association between RC and the development of CAS in menopausal women. Objective To investigate the correlation between RC and the pathogenesis of CAS in menopausal women. Methods A total of 307 menopausal women from Fengxiang Town, Anding District, Dingxi City were selected as the research subjects. These women had participated in the national high-risk stroke screening project and completed carotid artery ultrasound examination between January 2020 and October 2023. General information on the ordinary people was collected and participants' characteristics of the carotid artery intima were analyzed by means of using color doppler ultrasound. Based on the cervical ultrasound results, the subjects were divided into CAS group and non-CAS group. Spearman rank correlation analysis was used to explore the correlation between RC and other risk factors for CAS. Furthermore, multifactor Logistic regression was employed to analyze and explore the correlation between RC and CAS in menopausal women. Results The findings revealed that participants in the CAS group (n=130) has higher levels than those in the non-CAS group (n=177) in terms of menopausal female age, history of stroke and transient ischemic attack (TIA), fasting plasma glucose (FPG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), RC and pulse pressure (P

Atherosclerosis is a chronic inflammatory disorder which remains the main cause of cardiovascular morbidity and mortality, with carotid atherosclerosis (CA) being a major cause of ischemic stroke. Epigenetic regulation plays a significant role in CA progression and stroke, yet the impact of circulating microRNA expression, associated with atherogenesis, has not been clearly defined. We included 81 patients with moderate–severe CA (mean age 67 ± 7 years, 53% male), 42% of whom had prior ipsilateral ischemic stroke (i.e., were symptomatic). A total of 24 miRs were identified and their plasma expression levels were measured. We observed that several microRNAs were up-regulated in stroke survivors, namely miR-200c-3p (30.6 vs. 29.7, p = 0.047), miR-106b-3p (31.01 vs. 30.25, p = 0.004), and miR-494-5p (39 vs. 33, p < 0.001), while others (miR183-3p [25.5 vs. 28.6, p < 0.001], miR-126-5p [35.6 vs. 37.1, p = 0.03], and miR-216-3p [12.34 vs. 16.2, p < 0.001]) had lower plasma levels in symptomatic patients. In a multivariable logistic regression model for symptomatic CA, the only miRs showing statistical significance were miR-106b-5p, miR-183-3p, miR-216-3p, and miR-494-5p. Cluster analysis demonstrated differential miR expression in CA patients depending on their stroke status. Epigenetic modulation, represented as complex interplay between circulating miRs of different atherogenic potential, may play a significant role in CA development and progression. In our study, we show possible candidates for future research regarding CA and stroke. [ABSTRACT FROM AUTHOR]

Objective: To analyze the association between the peripheral blood lymphocyte subsets and the occurrence of carotid atherosclerosis (CAS) and discuss the risk factors of CAS, and to provide the basis for risk prediction and early intervention of CAS. Methods: A total of 419 subjects were selected according to the inclusion and exclusion criteria. All the subjects underwent carotid ultrasonography, and the detection of T lymphocyte, B lymphocyte, and natural killer (NK) cell subsets were performed. According to the carotid artery intima-media thickness (IMT), the subjects were divided into normal carotid artery group (n=166) and CAS group (n=253). The basic data and laboratory inspection indexes of the subjects n two groups were collected, including age, gender, blood pressure, medical history, smoking history, medication history, blood lipids, and percentages of T lymphocyte, B lymphocyte, and NK cell subsets. The risk factors for the occurrence of CAS of the subjects were analyzed using Logistic regression analysis. Results: The univariate analysis results showed that compared with normal carotid artery group, the age, morbidity rate of hypertension, morbidity rate of diabetes, and smoking rate of the subjects in CAS group were increased (P<0. 05), and the percentages of CD4+ T lymphocytes, CD4+ T lymphocyte count, CD4+/CD8+ ratio, CD16+CD56+NK cell count, and low-density lipoprotein cholesterol (LDL-c) level in peripheral blood were increased (P<0. 05), while the percentage of CD8+T lymphocyte was decreased (P<0. 05). The multivariable Logistic regression analysis results showed that age (OR= 1. 112, 95%CI: 1. 083-1. 142, P<0. 001), smoking (OR=1. 997, 95%CI: 1. 192-3. 346, P=0. 009), LDL-c (OR=1. 427, 95%CI: 1. 017-2. 001, P=0. 039), and percentage of CD4+T lymphocyte (OR=1. 044, 95%CI: 1. 002-1. 087, P=0. 039) were the independent risk factors for the occurrence of CAS. Conclusion: The percentage of CD4+ T lymphocyte is associated with the occurrence of CAS and it is a predictive risk factor for CAS. [ABSTRACT FROM AUTHOR]

Background: The TyG index, or triglyceride-glucose index, is primarily used as a marker to assess insulin resistance and metabolic health. It increases mortality risk in patients with NAFLD, atherosclerosis, ischemic stroke, or heart failure. However, its association with Carotid Atherosclerosis (CAS) risk in NAFLD patients remains uncertain. Methods: This retrospective cohort study enrolled 739 individuals who participated comprehensive health evaluations at a large public hospital in Yangzhou, China, between January 2021 and December 2023. Among them, 436 were men and 303 were women, and their mean (SD) age was 51.53 ± 11.46 years. The individuals were categorized into three tertiles (Q1, Q2, and Q3), according to the baseline TyG index. Our investigation focused on exploring the correlativity between the TyG and the occurrence of CAS utilizing Cox regression and RCS analyses. Results: During a 3-year follow-up period, 199 patients developed CAS (cumulative incidence rate: 26.93%). A statistical model, adjusted for age, gender, BMI, and other confounders indicated that the HR (95%CI) values for CAS risk in the Q2 and Q3 groups were 3.11(1.87-5.17) and 4.51(2.69-7.56), respectively, with P-values <0.001 for both groups. A sensitivity analysis confirmed these results. Kaplan-Meier survival analysis revealed that CAS risk varied across the groups (P non-linear < 0.05). Conclusion: In individuals diagnosed as NAFLD, the possibility for CAS escalates with the elevation of the TyG value. Therefore, the TyG index is an effective marker for assessing the risk of CAS within this demographic. Large-sample prospective studies are needed to confirm this conclusion in the future. [ABSTRACT FROM AUTHOR]

Context The excess risk of fatal and nonfatal cardiovascular events is roughly twice as high in women than in men with type 1 diabetes. Objective To evaluate the impact of preeclampsia and parity on sex-based discrepancies in preclinical atherosclerosis and on the diagnostic performance of a cardiovascular risk scale. Design Cross-sectional study. Setting Single tertiary hospital. Patients A total of 728 people with type 1 diabetes (48.5% women) without cardiovascular disease and age ≥40 years, nephropathy, and/or ≥10 years of diabetes duration with another risk factor. Intervention Standardized carotid ultrasonography. Main Outcome Measures Carotid plaque determined by ultrasonography and cardiovascular risk estimated according to the Steno T1 Risk Engine (Steno-Risk). Results Nulliparous women and parous women without previous preeclampsia had a lower risk for carotid plaque than men (adjusted odds ratio:.48, 95% confidence interval [.28-.82]; adjusted odds ratio:.51 [.33-.79], respectively), without differences in the preeclampsia group. The prevalence of carotid plaque increased as the estimated cardiovascular risk increased in all subgroups except for preeclampsia group. The area under the curve of the Steno-Risk for identifying ≥2 carotid plaques was lower in the preeclampsia group (men:.7886; nulliparous women:.9026; women without preeclampsia:.8230; preeclampsia group:.7841; P between groups =.042). Neither the addition of parity nor preeclampsia in the Steno-Risk led to a statistically significant increase in the area under the curve. Conclusion The risk for carotid plaque in women compared with men decreased as exposure to obstetric factors diminished. However, the addition of these factors did not improve the prediction of the Steno-Risk. [ABSTRACT FROM AUTHOR]

Background. The (embryonic lethal, abnormal vision, drosophila)-like protein 1 (ELAVL1) is a newly discovered protein associated with cerebral ischemic/reperfusion (I/R) injury. However, little is known of ELAVL1 in ischemic stroke patients. Objectives. To investigate the clinical significance of collateral circulation and serum ELAVL1 in patients with carotid atherosclerosis (CAS) and ischemic stroke. Materials and methods. The present prospective cohort investigation included 317 ischemic stroke patients and 300 CAS patients admitted between March 2020 and March 2022. Collateral circulation was measured using digital subtraction angiography (DSA) and graded using the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading system. Enzyme-linked immunosorbent assays (ELISAs) were used to measure serum ELAVL1, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α). The serum levels of total cholesterol (TC), triglyceride (TG), high-density leptin cholesterol (HDL-C), and low-density leptin cholesterol (LDL-C) were also measured. Results. The serum levels of ELAVL1, CRP, IL-6, TNF-α, and LDL-C were all markedly higher, while HDL-C was significantly lower in ischemic stroke patients compared to the CAS patients. Serum ELAVL1 was markedly higher in ASITN/SIR grade 0-1 patients compared to grade 2-4 patients. Also, ELAVL1 correlated positively with serum CRP, IL-6, TNF-α, TC, and LDL-C, and negatively with HDL-C. Receiver operating characteristic (ROC) curves showed that ELAVL1 and collateral circulation have the potential to be used as biomarkers for the diagnosis of ischemic stroke. Meanwhile, CRP, IL-6, TNF-α, HDL-C, ASITN/SIR grading, and ELAVL1 were independent risk factors for ischemic stroke. Conclusions. We found that serum ELAVL1 was associated with clinical outcomes of ischemic stroke patients, while the combination of ELAVL1 and collateral circulation could be used as a potential biomarker for ischemic stroke diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Current studies on the association between serum calcium levels and carotid atherosclerosis have yielded inconsistent results. This study aimed to elucidate this relationship through a comprehensive meta-analysis. Methods: A systematic search of PubMed, Embase, Cochrane Library, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Weipu (VIP), and Wanfang databases was conducted, supplemented by manual retrieval, from their inception to October 2023. Two independent researchers conducted literature searches, data extraction, and quality assessment. Meta-analysis was performed using Review Manager 5.3 software on studies that met the inclusion criteria. Results: The analysis included 9 cross-sectional studies, encompassing a total sample size of 9,720 participants. The meta-analysis revealed a significant statistical difference in serum calcium levels between the carotid atherosclerosis group and the control group (p = 0.03). The standardized mean difference between the two groups was 0.21 (95% CI: 0.02, 0.41) using the control group as a reference. Conclusions: Our systematic analysis indicates a significant positive correlation between serum calcium levels and carotid atherosclerosis. [ABSTRACT FROM AUTHOR]

The anatomical features spanning from the aortic arch to the proximal carotid artery and the associated cardiovascular risks might significantly influence the development of right carotid plaque. Our research aimed to compare these anatomical and risk factors between individuals with no carotid plaque and those with moderate right-side carotid plaque within a Korean cohort. We conducted a retrospective, cross-sectional analysis involving 413 participants, categorized into a normal group (n = 339) and a right moderate carotid plaque group (defined as > 50% stenosis based on NASCET criteria) (n = 74). We collected data on cardiovascular risk factors and conducted laboratory tests. A 3D model of the carotid artery was constructed using cranio-cervical computed tomography angiography (CTA) data through semi-automated software. Measurements taken on this 3D model included the common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), and carotid artery bifurcation (CAB) in terms of maximal vascular diameter, sectional area, angles of carotid bifurcation and ICA, and carotid tortuosity. When compared with the normal group, individuals in the right moderate carotid plaque group exhibited smaller angles at the carotid bifurcation, larger CCA diameter and sectional area (p < 0.01), advanced age, and a higher incidence of hypertension, diabetes, and stroke history (p < 0.05), along with reduced glomerular filtration rate (GFR) (p < 0.001). Multivariate analysis revealed that the sectional area of the bifurcation, calcification of the aortic bulb, and GFR were independently associated with the presence of right moderate carotid plaque (p < 0.01). Statistical analyses disclosed significant differences in both clinical risk factors and geometric changes in the region extending from the aortic arch to the proximal carotid artery among subjects with right moderate carotid plaque when compared to those without. [ABSTRACT FROM AUTHOR]

Background: The current clinical management of carotid atherosclerosis is based on the control of risk factors and medicine. However, the risk of adverse events associated with the medicine resulting in concerns and low medication compliance makes it necessary to seek a safer alternative therapy. This study assessed the effectiveness and safety of acupuncture as a treatment for carotid atherosclerosis. Methods: In this randomized controlled trial, patients with carotid atherosclerotic plaques were included and randomly assigned (1:1) to receive real acupuncture or sham acupuncture for 12 weeks. The follow-up period was 12 weeks. The primary outcome included carotid intima-media thickness (cIMT), plaque score (PS), plaque volume (PV) and grey-scale median (GSM). Secondary outcome was pulse wave velocity (PWV). Adverse events results were recorded as safety outcomes. Results: From January 2021 to February 2022, 60 eligible patients were included. 55 patients (91.7%) completed the intervention and the 12-week follow-up and there was no statistical difference in demographics between the groups. At the end of treatment, the real acupuncture group had significantly reduced PS (P = 0.002), PV (P = 0.000), and improved GSM (P = 0.044). There was no significant difference in the reduction in cIMT (Left cIMT: P = 0.338, Right cIMT: P = 0.204) and PWV between the groups (the left BS: P = 0.429; the left ES: P = 0.701; the right BS: P = 0.211; the right ES: P = 0.083). Three mild adverse reactions occurred during the study. Conclusion: This study found that acupuncture had a certain effect on reducing the thickness and volume of carotid plaque and improving the stability of plaque with minor side effects. These findings suggest that acupuncture may be a potential alternative therapy for carotid atherosclerosis. Trial registration: This trial has been registered at ClinicalTrials.gov (ChiCTR2100041762). Submitted 30 December 2020, Registered 4 January 2021 Prospectively registered. [ABSTRACT FROM AUTHOR]

Background: Carotid atherosclerosis (CAS) is a significant risk factor for cardiocerebrovascular events. The objective of this study is to employ stacking ensemble machine learning techniques to enhance the prediction of CAS occurrence, incorporating a wide range of predictors, including endocrinerelated markers. Methods: Based on data from a routine health check-up cohort, five individual prediction models for CAS were established based on logistic regression (LR), random forest (RF), support vector machine (SVM), extreme gradient boosting (XGBoost) and gradient boosting decision tree (GBDT) methods. Then, a stacking ensemble algorithm was used to integrate the base models to improve the prediction ability and address overfitting problems. Finally, the SHAP value method was applied for an in-depth analysis of variable importance at both the overall and individual levels, with a focus on elucidating the impact of endocrinerelated variables. Results: A total of 441 of the 1669 subjects in the cohort were finally diagnosed with CAS. Seventeen variables were selected as predictors. The ensemble model outperformed the individual models, with AUCs of 0.893 in the testing set and 0.861 in the validation set. The ensemble model has the optimal accuracy, precision, recall and F1 score in the validation set, with considerable performance in the testing set. Carotid stenosis and age emerged as the most significant predictors, alongside notable contributions from endocrinerelated factors. Conclusion: The ensemble model shows enhanced accuracy and generalizability in predicting CAS risk, underscoring its utility in identifying individuals at high risk. This approach integrates a comprehensive analysis of predictors, including endocrine markers, affirming the critical role of endocrine dysfunctions in CAS development. It represents a promising tool in identifying high-risk individuals for the prevention of CAS and cardio-cerebrovascular diseases. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is considered an independent risk factor for cardiovascular disease (CVD). The overall morbidity and mortality of CVD increase with higher fibrosis stage in NAFLD. Carotid atherosclerosis (CAS) is an important predictor of cardiovascular events. However, the relationship between liver fibrosis degree and the risk of CAS in NAFLD patients remains uncertain. We aimed to investigate the relationship between noninvasive liver fibrosis markers and CAS risk in patients with NAFLD. This study included 3,302 participants with NAFLD. Participants were divided into a CAS group and a non-CAS group based on carotid artery ultrasound results. They were then stratified into quartiles using various noninvasive liver fibrosis markers (fibrosis-4 (FIB-4), modified FIB-4 (mFIB-4), aminotransferase to platelet ratio index (APRI), aminotransferase to alanine aminotransferase ratio (AAR), AAR-to-platelet ratio index (AARPRI), and Forns index) to assess the associations between these markers and the risk of CAS. In the NAFLD population, individuals with CAS exhibited elevated levels of blood pressure, glucose, lipids, and noninvasive liver fibrosis markers (p < 0.001). The higher quartiles of noninvasive liver fibrosis markers, including FIB-4, mFIB-4, AAR, AARPRI, and Forns index, were significantly associated with increased risks of CAS, even after adjusting for multiple CVD risk factors. In individuals with NAFLD, increased noninvasive liver fibrosis markers were independently associated with elevated CAS risk, which may be beneficial in assessing the risk of CVD in individuals with NAFLD. [ABSTRACT FROM AUTHOR]

Aim: Early-stage phenotypes of carotid atherosclerosis (CAS), such as increased carotid intima-media thickness (cIMT), and advanced-stage phenotypes, such as carotid plaque (CP), are at risk for adverse ischemic stroke events. There is limited evidence regarding the causal association between dietary patterns and the risk of CAS in Chinese adults. We therefore examined multiple dietary patterns associated with the risk of CAS and identified the optimal dietary pattern for preventing CAS. Methods: We analyzed data collected from the prospective MJ Health Check-up Study (2004–2020), including 13,989 participants 18–80 years of age without CAS. The dietary intake was measured using validated food frequency questionnaires, and dietary pattern scores were calculated for four a priori and four a posteriori dietary patterns. The Cox model was used to estimate the adjusted hazard ratios (HRs) relating various dietary pattern scores to the risk of CAS. Results: During 43,903.4 person-years of follow-up, 3732 incidents of increased cIMT and 2861 incident CP events were documented. Overall, the seven dietary patterns, except for the high-protein diet, exhibited significant associations with the risk of increased cIMT and CP. Comparing the highest and lowest quartiles, the a posteriori high-fiber dietary pattern (HFIDP) score demonstrated the strongest inverse associations with the risk of increased cIMT (HR 0.65 [95% confidence interval (CI) 0.59–0.71]) and CP (HR 0.65 [95% CI 0.59–0.73]); conversely, another a posteriori high-fat dietary pattern (HFADP; i.e., incorporating high-fat and processed foods) demonstrated the strongest positive associations with the risk of increased cIMT (HR 1.96 [95% CI 1.75–2.20]) and CP (HR 1.83 [95% CI 1.61–2.08]) (all p for trend < 0.01). Conclusions: Multiple dietary patterns are significantly associated with the risk of early- and advanced-stage phenotypes of CAS. Notably, a high adherence to an HFIDP and low adherence to an HFADP may confer the greatest risk reduction for CAS. [ABSTRACT FROM AUTHOR]

Objectives. To detect subclinical carotid atherosclerosis in gout patients and its relation to musculoskeletal ultrasound (MSK US) manifestations and serum sclerostin (SCL) levels. Patients and methods. Thirty Egyptian gouty patients were classified into two groups: Group A included 15 patients with diagnostic MSK US manifestations of gout (double contour sign), and Group B included 15 patients without MSK US findings. MSK US was done for both knees and the first MTP joints. Carotid duplex ultrasonography was done to evaluate carotid intima-media-thickness (CIMT) and serum SCL level was measured in all patients by ELISA technique. Results. Gouty patients with MSK US findings had a significantly higher increase in serum SCL levels than those without MSK US findings (p <0.01). Group A patients had a significantly greater CIMT than patients of group B (p <0.01). Serum uric acid and SCL levels were found to be significantly positively correlated. The ROC curve revealed that the optimal SCL cutoff value for detecting positive MSK US findings in gout patients was >25.05 ng/ml. At this level, there was a significant difference between the patients with a CIMT >0.9 mm and the patients with a CIMT ≤0.9 mm (p <0.05). Conclusions. Patients with MSK US manifestations of gout are more liable to have subclinical carotid atherosclerosis than patients without these manifestations. SCL at a certain level >25.05 ng/ml in gout patients might predispose patients to radiographic findings of MSK US of gout and subclinical atherosclerosis. [ABSTRACT FROM AUTHOR]

Objective To investigate the association between serum myeloid-derived growth factor (MYDGF) levels and carotid atherosclerosis (CAS) in newly diagnosed type 2 diabetes mellitus (T2DM). Methods This cross-sectional study screened newly diagnosed T2DM patients admitted to the Endocrinology Department of Central Theater General Hospital between October 2022 and May 2023, and healthy physical examination subjects who underwent physical examination in the physical examination center of the hospital at the same time were chosen as the study subjects. The newly diagnosed T2DM patients were divided into non-carotid atherosclerosis (NCAS) group and CAS group according to the results of carotid artery color doppler ultrasound, and the healthy individuals who underwent physical examinations during the same period were included as the healthy control group. MYDGF, carotid intimedia thickness (CIMT), diastolic blood pressure (DBP), glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2 h-postprandial plasma glucose (2hPG), fasting insulin (FINS), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (Apo A1) were collected. FPG and FINS were used to calculate homeostasis model assessment of insulin resistance (HOMA-IR). Height and weight were measured and the body mass index (BMI) was calculated. One-way analysis of variance, Kruskal-Wallis H test or χ2 test were used to compare the groups, Spearman correlation analysis was used to analyze the correlation between CIMT and other indicators in newly diagnosed T2DM patients, and binary logistic regression analysis was used to explore the factors influencing newly diagnosed T2DM patients with CAS. Results A total of 136 newly diagnosed T2DM patients were enrolled, including 62 in the NCAS group and 74 in the CAS group. The healthy control group consisted of 60 subjects. Serum MYDGF in newly diagnosed T2DM patients in both the NCAS group and the CAS group were elevated compared with healthy controls (both P<0.05). Among newly diagnosed T2DM patients, BMI, DBP, HbA1c, FPG, 2hPG, FINS, HOMA-IR, TC and CIMT were higher in CAS group than in NCAS group, and HDL-C, Apo A1 and MYDGF were lower, with statistical significance (all P<0.05). Spearman correlation analysis showed that CIMT in newly diagnosed T2DM patients was positively correlated with BMI (r=0.400, P<0.001), DBP (r=0.240, P=0.005), HbA1c (r=0.428, P<0.001), FPG (r= 0.253, P=0.003), HOMA-IR (r=0.456, P<0.001) and TC (r=0.239, P=0.005), and negatively correlated with MYDGF (r=-0.789, P<0.001). Binary logistic regression analysis showed that DBP (OR=1.149, 95%CI 1.057-1.249, P=0.001), HbA1c (OR=1.604, 95%CI 1.060-2.427, P=0.025), HOMA-IR (OR= 1.443, 95%CI 1.034-2.015, P=0.031), TC (OR=9.839, 95%CI 2.830-34.201, P<0.001), MYDGF (OR= 0.935, 95%CI 0.906-0.964, P<0.001) were influential factors in newly diagnosed T2DM patients with CAS. Conclusion In newly diagnosed T2DM patients, serum MYDGF levels are negatively correlated with CIMT, and MYDGF is an influential factor in newly diagnosed T2DM complicated by CAS. [ABSTRACT FROM AUTHOR]

Post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) are common complications following a stroke, significantly impacting the quality of life and survival time of survivors. Currently, the comorbidity of PSCI and PSD is receiving increasing attention, as they share some common clinical characteristics, mechanisms, risk factors, radiological features, and treatment strategies. They influence each other, with the clinical prevalence of PSD comorbid with PSCI reaching as high as 26.15 %. The prevention, screening, diagnosis, and treatment of PSD and PSCI require collaboration across clinical, radiological, and neuropsychological evaluations. This paper aims to summarize the common radiological features of both conditions from a radiological perspective, which may aid in identifying early screening and predictive imaging biomarkers. [ABSTRACT FROM AUTHOR]

The fundamental role of qualitative alterations of lipoproteins in the early development of atherosclerosis has been widely demonstrated. Modified low-density lipoproteins (LDL), such as oxidized LDL (oxLDL), small dense LDL (sdLDL), and electronegative LDL [LDL(-)], are capable of triggering the atherogenic process, favoring the subendothelial accumulation of cholesterol and promoting inflammatory, proliferative, and apoptotic processes characteristic of atherosclerotic lesions. In contrast, high-density lipoprotein (HDL) prevents and/or reverses these atherogenic effects. However, LDL's atherogenic and HDL's anti-atherogenic actions may result altered in certain pathological conditions. The molecular mechanisms underlying the impaired effects of altered lipoproteins have been studied in numerous in vitro and in vivo studies, and have been extensively analyzed in coronary atherosclerosis, especially in the context of pathologies such as dyslipidemia, diabetes, obesity, and metabolic syndrome. However, the corresponding studies are scarcer in the field of ischemic stroke, despite carotid arteriosclerosis progression underlies at least 20% of ischemic strokes. The present review relates qualitative alterations of LDL and HDL with the development of carotid arteriosclerosis and the occurrence of ischemic stroke.

Background Autophagy plays a key role in the development of carotid atherosclerosis (CAS). This study aimed to identify key autophagy-related genes (ATGs) related with CAS using bioinformatics analysis, in vivo AS mouse model, and in vitro experiments. Methods The GSE100927 and GSE28829 datasets were downloaded from the Gene Expression Omnibus (GEO) database. An integrated bioinformatics analyses of differentially expressed ATGs (DE-ATGs) was conducted. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to identify the biological processes and pathways associated with DE-ATGs. Protein-protein interaction (PPI) network was constructed with the DE-ATGs to identify the key CAS-related DE-ATGs. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of the key CAS-related DE-ATGs. CIBERSORT analysis was performed to determine the infiltration status of 22 immune cell types and their correlation with the expression levels of the key CAS-related DE-ATGs. Hematoxylin and eosin (HE) staining was used to estimate the plaque histology in the AS mouse model. Western blotting, quantitative real-time PCR (qRT-PCR), and immunohistochemistry (IHC) were performed to validate the protein and mRNA expression levels of the key CAS-related DE-ATGs in the in vitro and in vivo models. Results We compared transcriptome profiles of 12 early CAS plaques and 29 advanced CAS plaques in the GSE100927 dataset and identified 41 DE-ATGs (33 up-regulated and eight down-regulated). Functional enrichment analysis showed that the DE-ATGs were closely related with apoptosis, autophagy, and immune activation. ROC curve analysis showed that the area under the curve (AUC) values for the three key CAS-related DE-ATGs (CCL2, LAMP2, and CTSB) were 0.707, 0.977, and 0.951, respectively. CIBERSORT analyses showed close association between the three key CAS-related DE-ATGs and the infiltration of immune cell types in the plaques. Finally, the western blot, qRT-PCR, and IHC staining confirmed that CCL2, LAMP2, and CTSB were highly expressed in the plaques of the AS model mice or ox-LDL-treated human umbilical vein endothelial cells (HUVECs) and human aorta vascular smooth muscle cells (HAoSMCs). Conclusion We identified and validated three key CAS-associated ATGs, namely, CCL2, LAMP2, and CTSB with high diagnostic value. These three key CAS-associated ATGs are promising diagnostic markers and therapeutic targets for patients with CAS.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is involved in lipid metabolism, has local and systemic effects in immunoregulation and atherogenesis in hypertensive patients.Aim. To personalize cardiovascular risk (CVR) stratification taking into account the diagnostic value of PCSK9 and inflammatory markers in men with hypertension and carotid atherosclerosis.Material and methods. The study included 162 males with stage I-III hypertension of various CVR. All patients underwent collection of complaints and medical history, physical examination with anthropometry. The following laboratory test were performed: complete blood count with white blood cell differential and erythrocyte sedimentation rate, assessment of fibrinogen, C-reactive protein (CRP), total cholesterol, low-density lipoprotein cholesterol, triglycerides, blood glucose, serum creatinine level. Glomerular filtration rate and microalbuminuria were also evaluated. Serum PCSK9, interleukins-8, 10 (IL-8, 10) were determined by enzyme immunoassay. In addition, 24-hour blood pressure monitoring, extracranial artery ultrasound with determination of intima-media thickness and carotid stenosis severity were performed. Patients were divided into 3 groups according to PCSK9 level.Results. Analysis of conventional cardiovascular factors and cytokine status (IL-8 and IL-10) in patients showed an inverse relationship between age and IL-8 (r=-0,230; p=0,036), IL-8/IL-10 (r=-0,309; p=0,005); heredity and IL-8/IL-10 (r=-0,423; p=0,001). There were following relationships between CVR factors and PCSK9: direct relationship between men's age (r=0,220, p=0,032), systolic and diastolic blood pressure (r=0,230, p=0,033; r=0,260, p=0,015) and PCSK9; inverse relationship between PCSK9 and heredity (r=-0,286, p=0,011). C-reactive protein and erythrocyte sedimentation rate were associated with IL-10 levels, which are associated with anti-inflammatory activity (r=0,78; p=0,02; r=0,78; p=0,02, respectively). The IL-8/IL-10 cytokine imbalance was most pronounced in patients with a night-peaker 24-hour systolic blood pressure profile (p=0,02). Patients with intima-media thickening and plaques had a highest level of PCSK9 (p=0,006). IL-8 levels were significantly higher with unchanged intima-media thickness (p=0,01).Conclusion. In patients with high levels of PCSK9, there is a close relationship between risk factors for hypertension and cytokine imbalance. The severity of extra­cranial artery atherosclerosis significantly depends on the increase in the levels of PCSK9 (p=0,006) and inflammatory markers (IL-10) (p=0,044).

Objective: To observe the changes of inflammatory markers, glucose and lipid metabolism, and atherosclerosis indicators in patients with type 2 diabetes mellitus (T2DM) and carotid atherosclerosis (CAS) treated with smeglutide and Jinlida granules. Methods: 138 patients with T2DM combine with CAS were divided into control group and observation group according to the random number table method, the number of cases in both groups was 69. All patients received basic treatment, control group received semeglutide treatment, and observation group received jinlida granules combine with semeglutide treatment. The total clinical effective rate, glycolipid metabolism indexes, inflammatory markers and arteriosclerosis indexes were compared in two groups. Results: The total clinical effective rate in observation group was higher than that in control group (P<0.05). Compared with control group, the level of high density lipoprotein cholesterol (HDL-C) in observation group was higher after treatment, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), 2-hour postprandial blood glucose (2hPG), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) levels and neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), carotid intima-media thickness (CIMT), resistance index (RI), carotid-femoral pulse wave velocity (cfPWV), arterial reflection wave enhancement index (Alx) were lower (P<0.05). Conclusion: Jinlida granules combined with semeglutide in the treatment of patients with T2DM combined with CAS can further improve the clinical efficacy, which is closely relate to the improvement of glycolipid metabolism, inflammatory markers and arteriosclerosis indexes. [ABSTRACT FROM AUTHOR]

ObjectiveTo understand the incidence of carotid atherosclerosis (CAS) and the association of CAS with stroke incidence in an occupational population of the Jinchang Cohort, and to provide an evidence for the prevention and treatment of CAS and stroke. MethodsThe analysis included 6 262 employees of a nonferrous metal company who participated in the Jinchang Cohort Study and had complete information from the baseline examination, including carotid color Doppler ultrasound, from June 2011 to December 2013 and two rounds of follow-up in 2015 and 2017. The cumulative incidence rates of CAS, carotid intima-media thickening, carotid atherosclerotic plaque, and stroke were calculated among the employees during the follow-up period. A multivariate unconditional logistic regression model was used to analyze the factors associated with CAS, carotid intima-media thickening, and carotid atherosclerotic plaque. A multivariate Cox proportional hazards regression model was used to analyze the risk of stroke incidence and its influencing factors in individuals with CAS, carotid intima-media thickening, and carotid atherosclerotic plaque. ResultsDuring the initial follow-up of a mean of 1.71 ± 0.55 years (ranging from 0.08 to 3.75 years), a total of 1 147 cases of CAS, 287 cases of carotid intima-media thickening, and 860 cases of carotid atherosclerotic plaque were observed, with cumulative incidence rates of 18.32%, 4.58%, and 13.73%, respectively. The results of multivariate unconditional logistic regression analysis showed that age ≥ 45 years, smoking, hypertension, diabetes, abnormal total cholesterol (TC), working as a cadre or technical personnel, and internal staff were risk factors for CAS in the occupational population; whereas education level of college or above was a protective factor; age ≥ 45 years, working as a cadre or technical personnel, smoking, having high-sugar diet, and hypertension were risk factors for carotid intima-media thickening, whereas female gender was a protective factor; females, age ≥ 45 years, working as internal staff, hypertension, diabetes, and abnormal TC were risk factors for carotid atherosclerotic plaque, whereas college education or higher was a protective factor. At the second follow-up of a mean of 2.67 ± 0.55 years (ranging from 0.06 to 4.37 years), a total of 240 stroke cases were identified, with a cumulative incidence of 3.83%. The numbers of stroke cases in subjects with CAS, carotid intima-media thickening, and carotid atherosclerotic plaque were 104, 19, and 85, with cumulative stroke incidences of 9.07%, 6.62%, and 9.88%, respectively. The results of the multivariate Cox proportional hazards regression model analysis showed that after adjusting for gender, age, education level, occupation, smoking, alcohol consumption, physical activity, high-salt diet, high-fat diet, high-sugar diet, hypertension, diabetes, hyperuricemia, body mass index (BMI), abnormal TC, abnormal triglycerides (TG), abnormal high-density lipoprotein cholesterol (HDL-C), abnormal low-density lipoprotein cholesterol (LDL-C), and reduced glomerular filtration rate, the risk of stroke was significantly increased in the individuals with CAS (hazard ratio [HR] = 1.421, 95% confidence interval [95%CI]: 1.030 – 1.961) compared with those without CAS. The results also showed that, age ≥ 45 years, high-salt diet, and overweight were risk factors for stroke incidence in the individuals with CAS; females and hyperuricemia were risk factors for stroke incidence in individuals with carotid intima-media thickening; and high school or technical secondary school education, high-salt diet, and overweight were risk factors for stroke incidence in individuals with carotid atherosclerotic plaque. ConclusionThe cumulative incidence of both CAS and stroke was high during follow-up in the occupational population of the Jinchang Cohort Study and in the occupational population, the individuals with CAS had a higher risk of stroke, and older age, high-salt diet, and overweight were the main risk factors for stroke in the individuals with CAS.

Abstract Background The metabolic score for visceral fat (METS-VF) quantifies the cumulative burden of visceral and intra-abdominal adipose tissues. However, the relationship between the METS-VF and carotid atherosclerosis (CAS) has not been extensively explored. Therefore, this study aimed to investigate the association between the METS-VF and CAS. Methods This cross-sectional study enrolled 7089 Chinese adults who underwent physical examinations at the Zhenhai Lianhua Hospital, Zhejiang, China, in 2020. Multivariable logistic regression analysis was used to explore the linear relationship between METS-VF and CAS. Generalised additive models (GAM) were employed to evaluate potential nonlinear associations. The inflection points of METS-VF were determined using segmented logistic regression analysis optimised for maximum likelihood ratios and recursive algorithms. Results Multivariable logistic regression analysis revealed a positive correlation between METS-VF and CAS (odds ratio [OR]: 1.824, 95% confidence interval [CI]: 1.753–1.899; P

Objective: Uridine might be a common link between pathological pathways in diabetes and cardiovascular diseases. This study aimed to investigate the predictive value of plasma uridine for type 2 diabetes (T2D) and T2D with atherosclerosis. Methods: Individuals with T2D and healthy controls (n = 218) were randomly enrolled in a cross-sectional study. Patients with T2D were divided into two groups based on carotid ultrasound: patients with carotid atherosclerosis (CA) (group DCA) and patients without CA (group D). Plasma uridine was determined using HPLC-MS/MS. Correlation and logistic regression analyses were used to analyze the results. Results: Fasting and postprandial uridine were significantly increased in patients with T2D compared with healthy individuals. Logistic regression suggested that fasting and postprandial uridine were independent risk factors for T2D. The receiver operating characteristic (ROC) curve showed that fasting uridine had a predictive value on T2D (95% CI, 0.686–0.863, sensitivity 74.3%, specificity 71.8%). Fasting uridine was positively correlated with LDL-c, FBG, and PBG and negatively correlated with fasting C-peptide (CP-0h) and HOMA-IS. The change in postprandial uridine from fasting baseline (Δuridine) was smaller in T2D patients with CA compared with those without (0.80 (0.04–2.46) vs 2.01 (0.49–3.15), P = 0.010). Δuridine was also associated with T2D with CA and negatively correlated with BMI, CP-0h, and HOMA-IR. Conclusion: Fasting uridine has potential as a predictor of diabetes. Δuridine is closely associated with carotid atherosclerosis in patients with T2D.

Ximisinuer Tusongtuoheti,1,2 Guoqing Huang,1,2 Yushan Mao1 1Department of Endocrinology, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo, People’s Republic of China; 2Health Science Center, Ningbo University, Ningbo, People’s Republic of ChinaCorrespondence: Guoqing Huang; Yushan Mao, Department of Endocrinology, The First Affiliated Hospital of Ningbo University, 247 Renmin Road, Ningbo, People’s Republic of China, Tel +86 15737939838; +86 13867878937, Email guoqinghuang1992@163.com; maoyushan@nbu.edu.cnPurpose: The aim of this study was to identify independent risk factors for carotid atherosclerosis (CAS) in a population with hyperuricemia (HUA) and develop a CAS risk prediction model.Patients and Methods: This retrospective study included 3579 HUA individuals who underwent health examinations, including carotid ultrasonography, at the Zhenhai Lianhua Hospital in Ningbo, China, in 2020. All participants were randomly assigned to the training and internal validation sets in a 7:3 ratio. Multivariable logistic regression analysis was used to identify independent risk factors associated with CAS. The characteristic variables were screened using the least absolute shrinkage and selection operator combined with 10-fold cross-validation, and the resulting model was visualized by a nomogram. The discriminative ability, calibration, and clinical utility of the risk model were validated using the receiver operating characteristic curve, calibration curve, and decision curve analysis.Results: Sex, age, mean red blood cell volume, and fasting blood glucose were identified as independent risk factors for CAS in the HUA population. Age, gamma-glutamyl transpeptidase, serum creatinine, fasting blood glucose, total triiodothyronine, and direct bilirubin, were screened to construct a CAS risk prediction model. In the training and internal validation sets, the risk prediction model showed an excellent discriminative ability with the area under the curve of 0.891 and 0.901, respectively, and a high level of fit. Decision curve analysis results demonstrated that the risk prediction model could be beneficial when the threshold probabilities were 1– 87% and 1– 100% in the training and internal validation sets, respectively.Conclusion: We developed and internally validated a risk prediction model for CAS in a population with HUA, thereby contributing to the CAS early identification.Keywords: hyperuricemia, carotid atherosclerosis, independent risk factors, prediction model, nomogram