title: Increased age, high body mass index and low HDL-C levels are related to an echolucent carotid intima-media: the METEOR study.
abstract: BACKGROUND
  Echolucent plaques are related to a higher cardiovascular risk. Studies to investigate the relationship between echolucency and cardiovascular risk in the early stages of atherosclerosis are limited. We studied the relationship between cardiovascular risk factors and echolucency of the carotid intima-media in low-risk individuals.
  
  
  METHODS
  Data were analysed from the Measuring Effects on Intima-Media Thickness: an Evaluation of Rosuvastatin (METEOR) study, a randomized placebo-controlled trial including 984 individuals which showed that rosuvastatin attenuated the rate of change of carotid intima-media thickness (CIMT). In this post hoc analysis, duplicate baseline ultrasound images from the far wall of the left and right common carotid arteries were used for the evaluation of the echolucency of the carotid intima-media, measured by grey-scale median (GSM) on a scale of 0-256. Low GSM values reflect echolucent, whereas high values reflect echogenic structures. The relationship between baseline GSM and cardiovascular risk factors was evaluated using linear regression models.
  
  
  RESULTS
  Mean baseline GSM (± SD) was 84 ± 29. Lower GSM of the carotid intima-media was associated with older age, high body mass index (BMI) and low levels of high-density lipoprotein cholesterol (HDL-C) [beta -4.49, 95% confidence interval (CI) -6.50 to -2.49; beta -4.51, 95% CI -6.43 to -2.60; beta 2.45, 95% CI 0.47 to 4.42, respectively]. Common CIMT was inversely related to GSM of the carotid intima-media (beta -3.94, 95% CI -1.98 to -5.89).
  
  
  CONCLUSIONS
  Older age, high BMI and low levels of HDL-C are related to echolucency of the carotid intima-media. Hence, echolucency of the carotid intima-media may be used as a marker of cardiovascular risk profile to provide more information than thickness alone.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. s.a.e.peters@umcutrecht.nl
authors.forename: S A E
authors.initials: SA
authors.lastname: Peters
authors.forename: L
authors.initials: L
authors.lastname: Lind
authors.forename: M K
authors.initials: MK
authors.lastname: Palmer
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: J R
authors.initials: JR
authors.lastname: Crouse
authors.forename: D H
authors.initials: DH
authors.lastname: O'Leary
authors.forename: G W
authors.initials: GW
authors.lastname: Evans
authors.forename: J
authors.initials: J
authors.lastname: Raichlen
authors.forename: M L
authors.initials: ML
authors.lastname: Bots
authors.forename: H M
authors.initials: HM
authors.lastname: den Ruijter
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000517:prevention & control; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D008076:Cholesterol, HDL; D002097:C-Reactive Protein