A Population-based Prospective Cohort Study On The Atherosclerosis Progress

PurposeTo explore the incidence and risk factors of atherosclerosis and carotid plaques in low socio-economic status population in the rural areas of north China,and provides a theoretical basis for the intervention of atherosclerosis and carotid artery plaque in rural areas.MethodsThe study was conducted in May 2014 in Yangjinzhuang Town,Ji County,Tianjin.Total of 2716 people aged 45 and over were recruited in this study.In the baseline survey,we recorded demographic characteristics,medical history,personal habits and physical examination of participant,and all participants were examined by carotid ultrasonography.The second carotid ultrasound measurement was performed in April 2019,76 people died in the term of follow-up,and 528 did not have second ultrasound measurement.Finally,a total of 2112 participants had twice carotid ultrasonography examination.Compare the demographic characteristics,medical history,lifestyle habits,and distribution of other risk factors between the atherosclerosis and non-atherosclerosis populations.Linear regression and logistic regression analysis were used to estimate the risk factors of CIMT and hazard ratio of each relevant factor of atherosclerosis and carotid plaques.Moreover,the related risk factors were stratified by gender and education levels to analyze the differences in atherosclerosis and plaque risk factors among different gender and education levels.Results2116 participants were recruited in this follow-up study,including 850 males and 1262 females.The prevalence of atherosclerosis and carotid plaques was 40.3%ans 40.1%,respectively,in 2014.A total of 275 cases of atherosclerosis and 261 case of carotid plaques were found during 5 years of follow-up,the incidence of atherosclerosis was 21.81%(male was 27.66% and female was 18.66%,respectively).The incidence of carotid plaques was 20.63%(male was 25.85% and female was17.72%,respectively).The incidence of atherosclerosis and carotid plaques washighest in ≥75 years population.After logistic regression analysis,compared 45-54 years group,the risk of atherosclerosis and carotid plaques in 55-64 years group increased 3.407 times and 2.766 times,respectively(P< 0.05).Moreover,compared non-diabetes group,the risk of atherosclerosis and carotid plaques in diabetes group increased 0.737 times and 0.798 times,respectively(P< 0.05).In addition,snoring was the risk factor of atherosclerosis and carotid plaques.CIMT changes was analyzed by linear regression analysis.Each increased of 1 years old resulted in CIMT increases by 0.001 mm between 5years(P< 0.05).Among those who have thickened CIMT between followed-up,each increased of 1 mmol/L LDL-C resulted in CIMT increases by 0.014 mm between 5years(P< 0.05).ConclusionThis study is a prospective cohort study of the incidence and risk factors of atherosclerosis and carotid plaques in rural Chinese.The results of the study showed that the incidence of atherosclerosis and carotid plaques in the study population was21.81% and 20.63%,respectively.Age,snoring,type 2 diabetes,and stroke are risk factors for atherosclerosis and carotid plaques.Moreover,CIMT increased with age and LDL-C increasing.Additionally,risk factors contribute differently to atherosclerosis and carotid plaque in different genders.Targeted prevention and control strategies should be developed for different populations to reduce the burden of disease caused by atherosclerosis.