title: Significance of CAVI, hs-CRP and homocysteine in subclinical arteriosclerosis among a healthy population in China.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the ability of cardio-ankle vascular index (CAVI), high-sensitivity C-reactive protein (hs-CRP) levels and homocysteine (Hcy) levels to screen for subclinical arteriosclerosis (subAs) in an apparently healthy population, with the view to obtaining an optimal diagnostic marker or profile for subAs.
  
  
  METHODS
  Subjects (152) undergoing routine health examinations were recruited and divided into two groups: carotid arteriosclerosis (CA) and non-carotid arteriosclerosis (NCA), according to carotid intima-media thickness (CMIT). CAVI was calculated based on blood pressure and pulse wave velocity. Serum hs-CRP and Hcy levels were also measured. A Receiver Operating Characteristic (ROC) curve was plotted to evaluate the efficacy of each in carotid arteriosclerosis screening. Ten parameter combinations, designated W1 to W10, were compared in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).
  
  
  RESULTS
  The levels of all three parameters were significantly higher in the CA group, compared with the NCA group. ROC curves showed that the area under the curve (AUC) for CAVI was 0.708 (95%CI: 0.615-0.800), which is significantly larger than that of either hs-CRP (0.622) or Hcy (0.630), respectively (P < 0.001). Maximum sensitivity (100%) and NPV (100%) were attained with W10, while maximum specificity (86.2%) and PPV (46.7%) were obtained with W7. With W9, the maximum Youden index (0.416) was obtained, with a sensitivity of 77.8% and specificity of 63.8%.
  
  
  CONCLUSIONS
  CAVI is more effective than hs-CRP or Hcy for subAs screening. The optimal profile was obtained with a combination of CAVI and other parameters.
authors.affiliation: Clinical Laboratories, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
authors.forename: Jinpeng
authors.initials: J
authors.lastname: Zhong
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Wang
authors.forename: Fengzeng
authors.initials: F
authors.lastname: Li
authors.forename: Yulei
authors.initials: Y
authors.lastname: Hou
authors.forename: Haixia
authors.initials: H
authors.lastname: Luo
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001161:Arteriosclerosis / Q000097:blood* / Q000175:diagnosis*; D001794:Blood Pressure; D001795:Blood Pressure Determination; D002097:C-Reactive Protein / Q000032:analysis*; D002339:Carotid Arteries / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D002681:China; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods
chemical_list: D006710:Homocysteine; D002097:C-Reactive Protein