Premature atherosclerosis in patients with xanthelasma.
BACKGROUND
Only about half the patients with xanthelasma are hyperlipidemic. The clinical significance of xanthelasma as a marker of cardiovascular disease is not yet well defined.


OBJECTIVE
To determine the risk of cardiovascular disease in patients with normolipidemic and hyperlipidemic xanthelasma.


METHODS
Carotid ultrasonography (7 MHz using B-mode images, Advanced Technology Laboratories) was used to detect carotid plaques and measure the intima-media thickness (IMT) of the common carotid arteries. Seventeen patients with normolipidemic and hyperlipidemic xanthelasma were examined and compared with 21 age-matched normal subjects.


RESULTS
The risk of cardiovascular disease was significantly increased in patients with xanthelasma. Carotid plaques were more frequent in patients with xanthelasma than in controls (64.7% and 23.8%, respectively; P = 0.020), and IMT was significantly higher (mean +/- SD: 1.1 +/- 0.1 and 0.6 +/- 0.2 mm, respectively; P < 0.001). The difference of carotid IMT between normolipidemic xanthelasma and hyperlipidemic xanthelasma was not statistically different (mean +/- SD: 1.1 +/- 0.1 and 1.1 +/- 0.2 mm, respectively; P = 0.577).


CONCLUSIONS
Premature carotid atherosclerosis is observed in patients with normolipidemic and hyperlipidemic xanthelasma. Patients with xanthelasma should be considered to have an increased risk of cardiovascular disease independently to the level of plasma lipids. A larger number of patients is, however, needed to confirm this preliminary study.
Noël
B
B
Department of Dermatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. bernard.noel@chuv.ch
D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014463:Ultrasonography; D014973:Xanthomatosis / Q000150:complications*