Abstract

Carotid intima-media thickness (IMT) can assess the cumulative effect of atherosclerotic risk factors and provides an independent predictor of future cardiovascular (CV) risk. The aim of this study was to investigate the progression of conventional risk factors in 933 long-term survivors from a Danish cohort with and without diabetes mellitus (DM) as predictors for attained carotid IMT during 35.6 (0.7) years of follow-up. Persons who participated in the first, the last and one of the intermediate rounds of the Copenhagen City Heart Study, and who had had an ultrasound-derived measure of the carotid IMT performed at the last examination were included in the analyses. The risk factors varied between persons with and without DM during the 36 years, but the difference in blood pressure disappeared in the fifth examination, where, in addition, total cholesterol was found to be lower in persons with DM. In this cohort there were no difference in attained carotid IMT between persons with and without DM at the last examination. The following risk factors were found to best predict carotid IMT: age, maximum systolic BP, average systolic BP, average BMI, minimum BMI, sex and years of smoking. The prediction of carotid IMT was clinically poor with a root mean-squared error of prediction (RMSEP) of 0.134 mm and a 95% prediction error probability interval of (−0.22; 0.30). Furthermore, the distribution of prediction errors was skewed to the right indicating that the prediction errors were larger among persons with high carotid IMT.

摘要

颈动脉内中膜厚度 (IMT) 可以评估动脉粥样硬化危险因素的累积效应，并提供未来心血管 (CV) 风险的独立预测因子。本研究的目的是调查丹麦队列中 933 名患有或不患有糖尿病 (DM) 的长期幸存者的常规危险因素的进展，作为在 35.6 (0.7) 年随访期间达到颈动脉 IMT 的预测因子。参与了哥本哈根城市心脏研究的第一轮、最后一轮和中间轮的人，以及在最后一次检查中对颈动脉 IMT 进行了超声衍生测量的人都包括在分析中。36 年间糖尿病患者和非糖尿病患者的危险因素各不相同，但第五次检查时血压差异消失，此外，发现糖尿病患者的总胆固醇较低。在该队列中，在最后一次检查时患有和不患有 DM 的人之间获得的颈动脉 IMT 没有差异。发现以下风险因素最能预测颈动脉 IMT：年龄、最大收缩压、平均收缩压、平均 BMI、最小 BMI、性别和吸烟年限。颈动脉 IMT 的预测在临床上很差，预测均方根误差 (RMSEP) 为 0.134 mm，95% 预测误差概率区间为 (-0.22; 0.30)。此外，预测误差的分布向右倾斜，表明颈动脉 IMT 高的人的预测误差更大。在该队列中，在最后一次检查时患有和不患有 DM 的人之间获得的颈动脉 IMT 没有差异。发现以下风险因素最能预测颈动脉 IMT：年龄、最大收缩压、平均收缩压、平均 BMI、最小 BMI、性别和吸烟年限。颈动脉 IMT 的预测在临床上很差，预测均方根误差 (RMSEP) 为 0.134 mm，95% 预测误差概率区间为 (-0.22; 0.30)。此外，预测误差的分布向右倾斜，表明颈动脉 IMT 高的人的预测误差更大。在该队列中，在最后一次检查时患有和不患有 DM 的人之间获得的颈动脉 IMT 没有差异。发现以下风险因素最能预测颈动脉 IMT：年龄、最大收缩压、平均收缩压、平均 BMI、最小 BMI、性别和吸烟年限。颈动脉 IMT 的预测在临床上很差，预测均方根误差 (RMSEP) 为 0.134 mm，95% 预测误差概率区间为 (-0.22; 0.30)。此外，预测误差的分布向右倾斜，表明颈动脉 IMT 高的人的预测误差更大。颈动脉 IMT 的预测在临床上很差，预测均方根误差 (RMSEP) 为 0.134 mm，95% 预测误差概率区间为 (-0.22; 0.30)。此外，预测误差的分布向右倾斜，表明颈动脉 IMT 高的人的预测误差更大。颈动脉 IMT 的预测在临床上很差，预测均方根误差 (RMSEP) 为 0.134 mm，95% 预测误差概率区间为 (-0.22; 0.30)。此外，预测误差的分布向右倾斜，表明颈动脉 IMT 高的人的预测误差更大。