| Purpose:At present,subclinical carotid atherosclerosis(SCAS)has a high prevalence,slow and insidious development,and is difficult to be detected before causing related organ lesions,which poses a serious threat to human health.We aimed to study the detection rate of SCAS and its related influencing factors in healthy physical examination population,and provide novel evidence-based medical evidence for the early detection and comprehensive management of SCAS and the primary prevention of cardiovascular and cerebrovascular diseases.Method:A total of 5041 subjects who underwent physical examination and completed carotid artery ultrasound examination in Health Management Center of the First Affiliated Hospital of Dalian Medical University from January 1,2019 to December 31,2021 were recruited,and their age,gender,past medical history,height,weight,waist circumference,systolic blood pressure,diastolic blood pressure,relevant laboratory indicators and carotid artery ultrasound results were recorded.SCAS was diagnosed in patients with increased carotid intima media thickness(CIMT)or presence of carotid plaque on ultrasound.According to the presence of SCAS,the study population was divided into SCAS group and no SCAS group.According to the thickness of carotid intima media,the study population was further divided into increased CIMT group and normal CIMT group.According to the presence of carotid plaque,the study population was further divided into carotid plaque group and no carotid plaque group.In addition,according to the results of carotid ultrasound,the study population were divided into normal carotid ultrasound group,increased CIMT group and carotid artery plaque group.According to the plaque morphology and echodensity,carotid plaques were divided into stable plaques group and unstable plaques group.Univariate and multivariate logistic analysis were used to analyze the influencing factors of SCAS,increased CIMT,and carotid artery plaque to calculate the odds ratio(OR)and 95% confidence interval(95%CI).Results:1.At total of 5041 subjects aged 52.56 ± 13.13 years were enrolled in this study,including 3043 males(60.4%)and 1998 females(39.6%).A total of 2609 subjects(51.8%)were detected with SCAS,and the mean age of the SCAS detection group was59.63 ± 11.22 years,with 1663 males(63.7%).A total of 1960 patients(38.9%)were included in the increased CIMT group,and the mean age was 59.85 ± 11.31 years old,including 1223 males(62.4%).A total of 1655 patients(32.8%)were included in the carotid artery plaque group,with a mean age of 61.87 ± 11.12 years,including 1186males(71.7%).2.The detection rate of SCAS increased along with aging,and the detection rate of SCAS increased significantly in people over 45 years old.In the whole population and different age groups,the detection rate of male SCAS was higher than that of female.More than 80% of the subjects detected with SCAS suffered from various cardiovascular diseases,and more than half of them coexist metabolism-related diseases,indicating cardiovascular and metabolism-related diseases were important comorbid conditions related to SCAS in clinical practice.The detection of increased CIMT and carotid plaque were similar to SCAS.3.In this study,carotid artery plaques were detected mainly at the bifurcation of carotid artery in 1291 cases(55%),followed by internal carotid artery in 499 cases(21%),common carotid artery in 439 cases(18%),and external carotid artery which had the lowest detection rate in 134 cases(6%).With age increasing,the detection rate of unstable plaques also increased.The detection rate of male subjects was significantly higher than that of female subjects,and 54.4% of the elderly males(≥age 65)detected unstable plaques.4.Multivariate logistic regression analysis showed that:(1)age(1.121[1.111～1.131]),hypertension(1.387 [1.108～1.737]),diabetes(1.637 [1.096～2.446]),the ratio of LDL cholesterol to HDL cholesterol(LDL-C/HDL-C)(1.414 [1.232-1.623]),and total cholesterol(TC)(1.175[1.075-1.284])were independent risk factors for SCAS.Female(0.599 [0.491～0.732])and total bilirubin(TBil)(0.982 [0.970～0.995])were protective factors for SCAS.(2)age(1.084 [1.076～1.092]),LDL-C/HDL-C(1.285[1.136～1.454])and TC(1.173[1.083～1.272])were independent risk factors for increased CIMT.Female(0.743 [0.621～0.889])and TBil(0.978 [0.966～0.990])were protective factors for increased CIMT.(3)age(1.105 [1.095～1.114]),hypertension(1.449 [1.187～1.771]),coronary heart disease(2.085[1.259～3.452]),diabetes(1.662[1.185～2.331]),LDL-C/HDL-C(1.264[1.107～1.444])and TC(1.133[1.036～1.239])were independent risk factors for carotid artery plaque.Female(0.305 [0.248～0.375])and TBil(0.982 [0.969～0.995])were protective factors for carotid plaque.Conclusion:1.In healthy physical examination population,the detection rate of SCAS increased with age increasing.The detection rate in men was higher than in women,and54.4% of elderly males were found to have unstable plaques.It is recommended to focus on screening carotid artery ultrasound and atherosclerosis related tests in middle-aged and elderly population,especially in men.2.For people suffering from various cardiovascular diseases and metabolic related diseases,early identification of SCAS should be strengthened.High-risk patients should be identified as early as possible and reasonable intervention should be carried out to reduce the risk of future cardiovascular and cerebrovascular events.3.The associations between age,gender,hypertension,diabetes,lipid metabolism indexes,total bilirubin and SCAS are intimate,therefore,more attention should be paid to the screening of the above influencing factors.The threshold of prevention and treatment of cardiovascular events should be moved forward,and individualized intervention strategies should be formulated according to cardiovascular risk stratification. |
PDF Full Text Request