초음파를 이용한 경동맥 내-중막 두께와 대사증후군 진단지표의 연관성

고경선(Kyung-Sun Ko),허경화(Kyung-Hwa H대),원용림(Yong-Lim Won),이성국(Sung-Kook Lee),김기웅(Ki-Woong Kim) 대한방사선과학회(구 대한방사선기술학회) 2009 방사선기술과학 Vol.32 No.3

본 연구의 목적은 대사증후군(MetS) 진단지표와 경동맥 내-중막 두께(carotid IMT)의 관련성을 이해하기 위하여 수행하였다. 연구대상자는 동맥경화와 기타 심혈관계 질환이 없는 남성 근로자 315명으로 하였다. 이 연구는 한국산업안전보건공단 산업안전보건연구원의 생명윤리위원회의 승인을 받은 후, 연구대상자의 동의를 받고 수행하였다. 인체계측과 혈청생화학 항목에 대한 검사는 체성분분석기기와 생화학자동분석 기기를 이용하여 측정하였고, MetS의 진단은 NCEP-ATP Ⅲ 기준에 의하여 판단하였다. Carotid IMT는 고행상도 B-mode 초음파기기를 이용하여 경동맥 분지점과 근위부의 내-중막 두께를 측정하여따. Carotid IMT는 0.739±0.137mm이었고 연령증가와 더불어 유의하게 증가되었다. 또한 수축기 및 이완기혈압, 중성지방 및 공복혈당도 연령증가에 따라 유의한 증가를 보였다. Carotid IMT는 BMI(r=0.0701, p=0.004), 수축기(r=0.147, p=0.011)와 이완기혈압(r=0.123, p=0.036) 및 HDL-cholesterol(r=-0.164, p=0.005)과 통계적으로 유의한 상관성을 보였다. Mest 진단지표와 carotid IMT에 대한 다중 로지스틱 회귀분석을 실시한 결과, carotid IMT는 혈압(교차비=4.220, p<0.01)과 MetS(교차비=1.301, p<0.05)과 유의한 관련성을 보였다. 이상의 결과는 혈압과 대사증후군이 중상동맥경화증의 중요한 위험인자로 작용함을 보여주는 결과라 판단된다. The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipments and the NCEP-ATP Ⅲ criteria were used to define MtrS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was 0.739±0.137mm and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.

Association of 10-Year Atherosclerotic Cardiovascular Disease Risk Score with Carotid Intima-Media Thickness and Plaque

Dong-Goo Lee,Jee-Hye Han,Kil-Young Kwon,Jung-Hwan Kim,Kun-Hee Han,Eun-Ji Lee 대한가정의학회 2015 Korean Journal of Family Medicine Vol.36 No.6

Background: The aim of this study was to determine the association between carotid intima-media thickness (IMT) and newly developed 10-year atherosclerotic cardiovascular disease (ASCVD) risk score. Methods: Participants were 201 Korean adults who underwent carotid ultrasonography at the Health Promotion Center of the Eulji General Hospital. We obtained information about medical history and lifestyle, and conducted laboratory tests. Carotid IMT by B-mode ultrasonography was measured. Carotid injury was considered present when the maximum carotid IMT was ≥0.9 mm or when arteriosclerotic plaques were detected. The 10-year ASCVD risk score was calculated using the 2013 American College of Cardiology/American Heart Association guidelines. Results: Men had higher 10-year ASCVD risk score than did women (mean±standard deviation: 7.15±6.04 vs. 2.53±3.67, respectively; P<0.001). Ten-year ASCVD risk was significantly correlated with right maximum carotid IMT (r=0.307), left maximum carotid IMT (r=0.230), right mean carotid IMT (r=0.322), and left mean carotid IMT (r=0.264). The group with high 10-year ASCVD risk were at even higher risk of carotid injury than were the group with low 10-year ASCVD risk (odds ratio, 2.201; 95% confidence interval, 1.162–4.1706; P=0.019). Only 10-year ASCVD risk score was significantly associated with carotid injury (odds ratio, 4.104; 95% confidence interval, 1.570– 10.729). Variables that were not included in the 10-year ASCVD risk score were not significantly associated with carotid injury. Conclusion: The findings of this study suggest that 10-year ASCVD risk score is associated with carotid injury.

Sonographic assessment of carotid intima-media thickness in healthy young Thai adults

Wariya Panprasit,Onanong Chai-u-dom Silkosessak,Panida Mukdeeprom,Pornkawee Charoenlarp Korean Academy of Oral and Maxillofacial Radiology 2023 Imaging Science in Dentistry Vol.53 No.-

Purpose: Early detection of carotid stenosis can reduce cardiovascular risk. In this study, the maximum-carotid intima-media thickness (CIMT), the mean-CIMT, and the presence of plaque were examined in healthy young Thai adults. Additionally, correlations between CIMT and cardiovascular risk factors were assessed. Materials and Methods: Left and right carotid arteries of 302 participants(15-45 years old) were scanned, with CIMT measured at the far walls of the common carotid artery, carotid bulb, and internal carotid artery. Demographics and risk factors were assessed using a questionnaire. Ten random participants were re-scanned after 4 weeks. Results: The study included 123 (40.70%) male and 179 (59.30%) female participants. The max-CIMT, mean-CIMT, and plaque thickness were 0.400±0.100, 0.403±0.095 and 1.520±0.814 mm, respectively. Male participants had significantly higher CIMT values for nearly all locations and age groups. The right-sided CIMT values were higher for all locations. The carotid bulb had the greatest CIMT values(0.437±0.178 mm), followed by the common (0.403±0.095 mm) and internal(0.361±0.099 mm) carotid arteries. Plaque was present in 18 locations (1.00%), affecting 15 participants (4.97%). These plaques were found in the right carotid bulb (n=9; 0.50%), left carotid bulb (n=7; 0.39%), and right internal carotid artery (n=2; 0.11%). Adjusted multivariable regression revealed significant positive associations between CIMT and male, increased age and "other" occupation (P<0.05). Conclusion: Both max-CIMT and mean-CIMT were approximately 0.4 mm. Plaque was observed in 4.97% of patients, with an average thickness of 1.5 mm. The most influential risk factors for increased CIMT were sex, age, and occupation.

한국인 뇌졸중 예측모형에 의한 뇌졸중 10년 발생 위험도와 경동맥 내중막 두께의 관련성

정보우,손효경,양진훈,이화평,이채용 대한신경과학회 2012 대한신경과학회지 Vol.30 No.4

Background: Both carotid intima-media thickness (IMT) and global risk score of cardiovascular disease were independent risk factors of stroke and heart disease. We assessed the correlation between the 10-year risk of Korean Stroke Risk Prediction model (KSRP) and carotid intima-media thickness. Additionally, from a perspective of carotid IMT measurement following KSRP risk stratification, we analyzed the difference of carotid IMT and plaque according to the KSRP risk strata. Methods: Subjects were 282 persons who visited one hospital for the screening of stroke. The 10-year risk was calculated automatically based on the equation of KSRP model. The maximal carotid IMT and the plaque were adopted as the study variables. The sensitivity and the positive predictive value of the KSRP risk categories were calculated. Results: The correlation coefficient between the KSRP risk and the maximal carotid IMT was 0.29 (p<0.01). The mean (±standard deviation) of KSRP risk of the group with carotid plaque was statistically significantly higher, 5.3 (±4.1), than that of the group without plaque, 3.3 (±3.1) (p≤0.01). The sensitivity of the risk stratum with more than 6% of KSRP risk for the plaque was 28.2%. The positive predictive value of the above cut-point was 48.8%. Conclusions: The 6% of KSRP risk may be considered as the beginning point of intermediate risk stratum to recommend the carotid ultrasonography. However, generalization needs further studies for various populations.

관상동맥 질환 환자에서 경동맥 초음파의 유용성

방덕원 ( Duk Won Bang ),심윤숙 ( Yun Suk Shim ),박병원 ( Byoung Won Park ),현민수 ( Min Su Hyon ),김성구 ( Sung Koo Kim ),권영주 ( Young Joo Kwon ) 대한내과학회 2007 대한내과학회지 Vol.73 No.1

목적: 경동맥 초음파로 측정한 내중막 두께 및 경화반의 유무와 관상동맥 질환 여부와의 관련성에 관한 보고가 있었으나, 이들과 관상동맥 질환의 중증도와의 관련성에 관한 연구는 적었다. 저자들은 이들 지표들과 관상동맥 질환의 중증도의 관련성을 검토하여 관상동맥질환 환자에서 경동맥 초음파의 유용성을 평가하였다. 방법: 2005년 11월부터 2006년 11월까지 관상동맥조영검사와 경동맥 초음파를 시행한 환자를 대상으로 하였고, 관상동맥 질환의 중증도는 50% 이상의 협착이 있는 관상동맥의 수에 따라 1군, 2군, 3군으로, 그리고 정상인 경우를 대조군(0군)으로 분류하여, 경동맥 초음파상 좌우 총경동맥 내중막 두께의 평균치, 최대치 및 동맥 경화반 유무를 비교하였다. 결과: 총 환자수는 90명이었고, 3군으로 갈수록 남자가 많았다(p=0.001). 총경동맥 내중막 두께의 평균치는 3군으로 갈수록 유의한 증가를 보였다(0군, 0.67±0.11 mm; 1군, 0.66±0.13 mm; 2군, 0.68±0.08 mm; 3군, 0.78±0.10 mm, p=0.001). 내중막 두께의 최대치도 유사한 결과를 나타내었다(0군, 0.88±0.16 mm; 1군, 0.85±0.20 mm; 2군, 0.89±0.13 mm; 3군, 1.06±0.17 mm, p=0.000). 경화반의 빈도도 3군으로 갈수록 유의한 증가를 보였다(p=0.004). 결론: 경동맥 내중막 두께 및 경화반의 유무 등 경동맥 초음파 지표들과 관상동맥 질환의 중증도의 관련성을 평가한 결과 관상동맥 질환이 심할수록 경동맥 내중막 두께가 증가하고, 동맥 경화반의 빈도도 증가되었다. 경동맥 초음파는 관상동맥 질환을 가진 환자에서 관상동맥 질환의 중증도를 평가하는데 유용하게 사용될 것으로 사료된다. Background: Carotid intima-media thickness (IMT) or the presence of carotid plaque has been reported to be related to coronary artery disease (CAD). We evaluated the relationship of the parameters of carotid ultrasonography (US) with the severity of the CAD. Methods: From November, 2005 to November, 2006, the patients who underwent both coronary angiography and carotid US were enrolled in our study. The severity of CAD was defined by the number of diseased major coronary arteries with a percent diameter stenosis over 50. Four groups including Group 0, which has normal coronary arteries, were compared. The average and maximal IMT and the presence of plaque were used as the parameters of carotid US. Results: The total number of patients was 90. Men had a greater severity of CAD (p=0.001). The average carotid IMTs were increased with the severity of CAD (Group 0, 0.67±0.11 mm; Group 1, 0.66±0.13 mm; Group 2, 0.68±0.08 mm; Group 3, 0.78±0.10 mm; p=0.001). The maximal carotid IMTs were also increased (Group 0, 0.88±0.16 mm; Group 1, 0.85±0.20 mm; Group 2, 0.89±0.13 mm; Group 3, 1.06±0.17 mm; p=0.000). Carotid plaques were also more frequently present with the increased severity of CAD (p=0.004). Conclusions: Increased carotid IMT and the presence of carotid plaque were related to the severity of CAD. Carotid ultrasonography is useful for evaluating the severity of CAD.(Korean J Med 73:11-17, 2007)

Gallstones are Associated with Intima-Media Thickness of Common Carotid Arteries in Men

Jung-Hwan Kim,Jung-Gum Ryoo,Jeong-Won Lee,Ji-Hye Kim 대한가정의학회 2014 Korean Journal of Family Medicine Vol.35 No.3

Background: The prevalence of gallstone disease is increasing in Korea. Gallstone disease and atherosclerosis share common risk factors. Ultrasonographic carotid intima-media thickness is an independent predictor of atherosclerosis. We measured the carotid intima-media thickness among men who had gallstones to establish the association between atherosclerosis and gallstones.Methods: A total of 330 men who visited the health promotion center of the IS Hallym Hospital from January 2011 to July 2012 were recruited. Both abdomen and carotid ultrasonographies were performed. Demographic, anthropometric, and biochemical data were collected.Results: The prevalence of gallstones was 6.6%. The carotid intima-media thickness, age, and body mass index were higher in subjects with gallstones (P < 0.05 for all). After Pearson correlation analysis, gallstone, age, body mass index, and fasting blood sugar were significantly associated with carotid intima-media thickness. A statistically positive association between gallstone and carotid intima-media thickness was demonstrated in a multivariate analysis adjusted for age, body mass index, and fasting blood sugar.Conclusion: Carotid intima-media thickness is higher in male subjects with gallstones, indicating that they are at greater risk for atherosclerosis.

당뇨병 신증 환자에서 초음파로 관찰된 경동맥 두께와 Angiotensin Converting Enzyme 유전자와 Apolipoprotein E 유전자 다형성에 대한 연구

강성귀(Sung Kyew Kang),박성광(Sung Kwang Park),김원(Won Kim),김달식(Dal Sik Kim),박태선(Tae Sun Park),백홍선(Hong Sun Baek) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.3

N/A Backgroud: We evaluated the distribution of the polymorphisms of apolipoprotein E and angiotensin converting enzyme gene in patients with diabetic nephropathy and also evaluated possible association between the apolipoprotein E carriers and angioten-sin converting enzyme genotypes and intima-media thickness of the common carotid artery. Methods: Study participants were 92 patients with diabetic nephropathy(50 men and 42 women). Hb(A1C), albuminuria, and lipid status were assessed by standard laboratory techniques ; the apolipopro-tein E carriers were assessed by modified amplifi- cation refractory mutation system and the angioten-sin converting enzyme genotypes were assessed by polymerase chain reaction. The intima-media thick- ness was measured by high-resolution ultrasonog-raphy. Results : The apolipoprotein E frequencies of patients were E2 8%, E3 76%, and E4 16%. The intima-media thickness varied by apo E groups. E2 group has less common carotid intima-media thickness than E3 and E4 groups(p<0.05). The angiotensin converting enzyme genotypes were distributed as follows ; 35% II, 49% ID, 16% DD. The intima-media thickness value did not differ among patients with various angiotensin converting enzyme genotypes. Multiple logistic regression analysis showed that age and apolipoprotein E genotypes were determinants for the intima-media thickness. Conclusion: Our results suggested that apolipo- protein E polymorphism is associated with carotid artery intima-media thickness in diabetic nephro-pathy. But, we could not find an association between carotid artery intima-media thickness and angioten-sin converting enzyme gene polymorphism in dia- betic nephropathy.

대사증후군 유발 인자에 따른 경동맥 내중막 두께의 변화 분석

안난희,지태정,김현진 한국방사선학회 2023 한국방사선학회 논문지 Vol.17 No.4

This study retrospectively analyzed the test results of 235 patients who visited a medical institution in Busan from May 2022 and February 2023 and conducted both carotid ultrasonography and blood tests. The purpose of this study was to investigate the effect on intima-media thickness and blood flow velocity by measuring the intima-media thickness and blood flow velocity through carotid ultrasonography and analyzing the factors influencing the subject’s body mass index and metabolic syndrome. Correlation analysis between carotid intima-media thickness and body mass showed (p=0.000) confirming that there is a correlation. As a result Correlation analysis between blood flow velocity and body mass index (p=0.015) was found, comfirming that there was a correlation. Age (p= 0.000), fasting blood glucose (p=0.002) and alcohol consumption (p=0.006) were found to be correlated with carotid intima-media thickness. An increase in Carotid intima-media thicknesses causes an increase in events caused by cardiovascular disease. Therefore, efforts must be made to exclude factors that increase Carotid intima-media thicknesses, and it will be most important to prevent cardiovascular disease through research on various prediction methods and regular checkups.

관상동맥협착 정도 예측을 위한 경동맥 초음파 검사의 유용성

고광일,박병현,오석규,김남호,조정구,정진원 대한노인병학회 2001 대한노인병학회지 Vol.5 No.4

초음파검사의 경동맥내중막두께와 심장이완기능의 상관관계 분석

오송미(Song-Mi Oh),이상훈(Sang-Hun Lee),지태정(Tae-Jeong Ji) 대한방사선과학회(구 대한방사선기술학회) 2022 방사선기술과학 Vol.45 No.5

In this study, 230 subjects of medical examination were investigated to figure out the relationship with common carotid artery intima-media thickness and cardiac diastolic function. In addition, the change in the carotid artery intima- media thickness according to the presence or absence of metabolic syndrome was examined. As a result of the study the carotid artery intima-media thickness was thick as the age increased and there was a large difference in those in their 60s and over. There was no gender difference. As for metabolic syndrome the carotid artery intima-media thickness was thicker in the study subjects with high blood pressure diabetes and dyslipidemia. The correlation between the carotid artery intima-media thickness and diastolic function indexes was significant. As a result of hierarchical regression analysis the thicker the intima-media thickness in the carotid artery the lower cardiac diastolic function.