title: Predictors of the intima-media thickness of carotid artery in asymptomatic newly detected severe hypercholesterolemic patients.
abstract: BACKGROUND
  Data about predictors of intima-media thickness (IMT) of common carotid artery (CCA) in asymptomatic subjects with newly detected severe hypercholesterolemia is scarce.
  
  
  OBJECTIVE
  This research is aimed at studying the predictors of the IMT of CCA among basic atherogenic risk biomarkers - lipid [total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein (LDL) cholesterol, Apolipoprotein-B, Apolipoprotein-Ai, Apolipoprotein-B/A(1) index] and non-lipid, [asymmetric dimethylarginine (ADMA), total homocysteine, cell adhesion molecules] in asymptomatic subjects with newly detected severe hypercholesterolemia.
  
  
  METHODS
  Two hundred and fifty asymptomatic patients with severe, newly hypercholesterolemia and 200 controls were evaluated. Hypercholesterolemia was defined as TC > 7.5 mm and LDL cholesterol > 4.9 mm. The ADMA and cell adhesion molecules were determined by ELISA and total homocysteine by high-performance liquid chromatography.
  
  
  RESULTS
  There was significant difference between the two groups in respect to all lipid biomarkers (P<0.001). Hypercholesterolemic patients had significantly higher level of ADMA, sVCAM-1, sICAM-1, IMT (P<0.001), whereas no significant difference was found between two groups with respect to total homocysteine, P-selectin and E-selectin (P>0.05). A strong positive correlation between IMT mean and age (r(xy) = 0.714; P<0.001), Apolipoprotein-B (r(xy) = 0.706; r(xy) < 0.001), Apolipoprotein-B/A(1) (r(xy) = 0.324; P<0.001), ADMA (r(xy) = 0.603; P<0.001) was found. The subsequent linear and multiple regression analysis selected age and Apolipoprotein-B as most significant factors in relation to IMT mean. Apolipoprotein-B is a better factor for assessment of risk, as LDL cholesterol underestimates the risk in asymptomatic subjects with newly detected severe hypercholesterolemia, until more rapid and feasible methods for measurement of small and dense LDL are available.
authors.affiliation: Clinic of Cardiology, Medical University of Plovdiv, 66 Peshtersko Shose Blvd. 4000 Plovdiv, Bulgaria. kitov@vip.bg
authors.forename: L
authors.initials: L
authors.lastname: Vladimirova-Kitova
authors.forename: T
authors.initials: T
authors.lastname: Deneva
authors.forename: B
authors.initials: B
authors.lastname: Marinov
mesh_terms: D000328:Adult; D000367:Age Factors; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002031:Bulgaria; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D008055:Lipids; D006710:Homocysteine; C018524:N,N-dimethylarginine; D001120:Arginine