Relationship between cardiovascular risk factors and the echogenicity and pattern of the carotid intima-media complex in men

Relação entre os fatores de risco cardiovascular e a ecogenicidade e o padrão do complexo íntima-média carotídeo em homens

CONTEXT AND OBJECTIVE:

The thickness of the carotid intima-media complex (C-IMC) is considered to be a marker of early atherosclerosis, but visual and echogenic changes to the C-IMC can also be noted. The objective here was to evaluate the relationship between cardiovascular risk factors and the echogenicity of the C-IMC and identify those most associated with an "abnormal" C-IMC.

DESIGN AND SETTING:

Cross-sectional study in the ultrasound sector of the Department of Diagnostic Imaging, Universidade Federal de São Paulo.

METHODS:

Eighty men were evaluated. Measurements of arterial blood pressure, waist circumference (WC), lipid profile, fasting glucose, uric acid and high-sensitivity C-reactive protein were obtained. The thickness of the C-IMC was measured by means of B-mode ultrasound, and the intima-media gray-scale mean (IM-GSM) and standard deviation (IM-SD) were calculated.

RESULTS:

The following were discriminating variables: fasting glucose (r² = 0.036; P = 0.013), uric acid (r² = 0.08; P = 0.03), IM-SD (r² = 0.43; P < 0.001), IM-GSM (r² = 0.35; P < 0.001) and thickness of the C-IMC (r² = 0.29; P < 0.001). IM-GSM showed significant correlations with WC (r = -0.22; P = 0.005), fasting glucose (r = -0.24; P = 0.002) and high-density lipoprotein cholesterol (HDL-C) (r = 0.27; P = 0.0007).

CONCLUSION:

IM-GSM showed correlations with WC, fasting glucose and HDL-C. However, uric acid and IM-SD presented the greatest discriminating impact. These results suggest that visual changes in C-IMC may help identify patients with potential cardiovascular risk, independently of the thickness of the C-IMC.

Ultrasonography; Carotid intima-media thickness; Atherosclerosis; Risk factors; Metabolic syndrome X