• 한국방사선학회논문지
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• 제12권7호
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• pp.853-859
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• 2018

본 연구에 목적은 연령별 대장용종의 발생과 경동맥 내중막 두께와의 상관관계를 알아보고자 하였다. 대장내시경과 경동맥 초음파를 동시에 시행한 환자를 대상으로 연령별로 나누어 경동맥 내중막 두께에 따라 대장용종 발생의 상관관계를 교차분석을 토대로 확인하였다. 분석결과 대사증후군 환자 중 연령별로 대장용종과 경동맥 내중막 두께와의 연관성은 고령일수록 높은 일치결과를 나타냈고, 경동맥 내중막 두께가 1.1mm이상일 때 용종발생비율이 높게 나타났다. 결론적으로 대사증후군 환자의 용종발생비율은 경동맥 초음파 검사와 대장내시경과 높은 상관관계가 있었고, 고령일수록 경동맥 내중막 두께가 두꺼울수록 높았다.

• Journal of Preventive Medicine and Public Health
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• 제42권1호
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• pp.29-34
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• 2009

Objectives : This study was performed to evaluate the relationship between C-reactive protein(CRP) and carotid intima-media thickness(carotid IMT) in a population of middle-aged Koreans. Methods : A total of 1,054 men and 1,595 women(aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause(women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. Results : Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women(p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men(p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women(p for trend=0.017), but not in men(p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55(95% CI=1.06-2.26) in women, but only 1.05(95% CI=0.69-1.62) in men. Conclusions : CRP and carotid IMT levels appear to be directly related in women, but not in men.

• 한국건강관리협회지
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• 제4권1호
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• pp.12-27
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• 2006

"본 논문은 대한내과학회지 2006년 제70권 제3호에 실렸던 논문으로 대한내과학회 편집위원회의 승인을 득하고 본 협회지에 게재함. Background : Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness(IMT) of the carotid artery as an indicator for early atherosclerosis. Itis known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. Methods: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. Resuts: Carotid IMT was increased in the abdominal obese group defined by waist circurference. However, there was no significant difference in carotid TMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bio electrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascvlar complications .Conclusion: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.

• Journal of Preventive Medicine and Public Health
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• 제40권5호
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• pp.411-417
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• 2007

Objectives: Although risk factors for coronary artery disease are also associated with increased carotid intima-media thickness (IMT), there is little information available on the asymptomatic, young adult population. We examined the association between multiple cardiovascular risk factors and the common carotid IMT in 280 young Korean adults. Methods: The data used for this study was obtained from 280 subjects (130 men and 150 women) aged 25 years who participated in the Kangwha Study follow-up examination in 2005. We measured cardiovascular risk factors, including anthropometries, blood pressure, blood chemistry, carotid ultrasonography, and reviewed questionnaires on health behaviors. Risk factors were defined as values above the sex-specific 75th percentile of systolic blood pressure, body mass index, total cholesterol/ high-density lipoprotein cholesterol ratio, fasting blood glucose and smoking status. Results: The mean carotid IMT${\pm}$standard deviation observed was $0.683{\pm}0.079mm$ in men and $0.678{\pm}0.067mm$ in women (p=0.567) and the evidence of plaque was not observed in any individuals. Mean carotid IMT increased with an increasing number of risk factors(p for trend <0.001) and carotid IMT values were 0.665 mm, 0.674 mm, 0.686 mm, 0.702 mm, and 0.748 mm for 0, 1, 2, 3, and 4 to 5 risk factors, respectively. The odds ratio for having the top quartile carotid IMT in men with 3 or more risk factors versus 0-2 risk factors was 5.09 (95% CI, 2.05-12.64). Conclusions: Current findings indicate the need for prevention and control of cardiovascular risk factors in young adults and more focus on those with multiple cardiovascular risk factors.

• 대한방사선기술학회지:방사선기술과학
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• 제36권1호
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• pp.25-30
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• 2013

경동맥 내중막 두께의 증가는 죽상경화증의 조기 표지자이며 관상동맥 질환과 뇌혈관 질환의 강력한 예측자이다. 이 연구의 목적은 성인에서 총경동맥 내중막 두께와 심혈관질환 위험인자들 사이의 연관성을 알아보고자 하였다. 총 134명을 대상으로 초음파를 이용하여 총경동맥 내중막 두께를 측정하였으며, 신체계측과 혈액검사를 시행하여 다음과 같은 결과를 얻었다. 연구결과 남성의 내중막 두께가 여성에 비해 더 두꺼운 것으로 나타났으며, 연령이 증가함에 따라 내중막 두께도 유의하게 증가하는 것으로 나타났다. 혈중지질 중 총 콜레스테롤과 동맥경화지수가 내중막 두께와 유의한 양의 상관관계가 있는 것으로 나타났다. 이상의 결과를 정리하면 성인에서 심혈관질환 위험인자는 총경동맥 내중막 두께 증가와 연관성이 있는 것으로 나타났다.

• Journal of Preventive Medicine and Public Health
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• 제41권2호
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• pp.107-114
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• 2008

Objectives : The aim of this study is to investigate the association between obesity indices(body mass index, weight, waist-hip ratio and waist circumference) in adolescents and the carotid intima-media thickness (C-IMT) in early adulthood. We also wanted to identify the best predictor for C-IMT among these obesity indices. Methods : This study used community-based prospective cohort study, known as the Kangwha Study, and the data we used were from subjects who were 16-years old in 1996 (defined as "adolescence") and 25 years-old in 2005 (defined as "early adulthood"). The 256 subjects (113 men and 143 women) who were used for analysis participated in both follow-ups, and they underwent B-mode ultrasonography of the carotid arteries at the early adulthood follow-up. Obesity indices were defined as the body mass index, weight, waist-hip ratio and waist circumference. The C-IMT was defined as the mean of the maximal IMT of each common carotid artery. The C-IMT and obesity indices associations were evaluated via multivariable regression, logistic regression and the receiver-operator characteristic curve analyses. Results : In men, all the obesity indices in adolescence were showed to have statistically significant positive association with C-IMT in early adulthood. However, no such relationship was showed in women. On multiple regression and logistic regression analysis, the waist-hip ratio showed the biggest relationship with the C-IMT among the 4 obesity indices. However, there were no statistical significant differences and no best predictor was found. For the women, the obesity incidences and C-IMT showed no relationships. Conclusions : This study suggested that obesity in adolescence was related to an increase C-IMT in healthy young Korean men.

• 대한방사선기술학회지:방사선기술과학
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• 제32권3호
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• pp.285-291
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• 2009

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 고해상도 B-mode 초음파기기를 이용하여 경동맥 분지점과 근위부의 내-중막 두께를 측정하였다. Carotid IMT는 $0.739{\pm}0.137\;mm$이었고 연령증가와 더불어 유의하게 증가되었다. 또한 수축기 및 이완기혈압, 중성지방 및 공복혈당도 연령증가에 따라 유의한 증가를 보였다. Carotid IMT는 BMI(r = 0.170, p = 0.004), 수축기(r = 0.148, 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. MetS 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 죽상동맥경화증의 중요한 위험인자로 작용함을 보여주는 결과라 판단된다.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.260-266
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• 2011

Objectives: We evaluated the association between common carotid artery intima-media thickness (CCA-IMT), brachialankle pulse wave velocity (baPWV), carotid plaque, and peripheral arterial disease (PAD) as indicators of macroangiopathy and diabetic retinopathy as an indicator of microangiopathy in type 2 diabetic patients. Methods: We analyzed 605 type 2 diabetic patients registered at a public health center in Korea. Following overnight fasting, venous blood and urine samples were collected and analyzed. The CCA-IMT, levels of carotid plaque, baPWV, and ankle-brachial index (ABI) of the subjects were assessed. We used non-mydriatic fundus photography to diagnose diabetic retinopathy. Multiple logistic regression analyses were used to evaluate the association between macroangiopathy and diabetic retinopathy. CCA-IMT and baPWV were divided into tertiles: CCA-IMT, 0.39 to 0.65 mm, 0.66 to 0.78 mm, and 0.79 to 1.30 mm; baPWV, 9.9 to 15.8 m/s, 15.9 to 18.9 m/s, and 19.0 to 38.0 m/s. Results: The association between baPWV and diabetic retinopathy remained significant after adjustment, with an increasing odds ratio (OR) in the second tertile (OR, 2.41; 95% confidence interval [CI], 1.27 to 4.55) and the third tertile (OR, 4.63; 95% CI, 2.33 to 9.21). No significant differences were observed in carotid plaque, PAD, and each tertile of CCA-IMT. Conclusions: BaPWV was associated with diabetic retinopathy, while CCA-IMT, carotid plaque, and PAD were not. This study suggests that the association between macroangiopathy and microangiopathy may be attributable to functional processes rather than structural processes within the vascular system.

• Journal of Preventive Medicine and Public Health
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• 제42권5호
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• pp.298-304
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• 2009

Objectives : The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. Methods : Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives ($\geq$140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. Results : Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT$\geq$1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. Conclusions : Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.

• 대한한방내과학회지
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• 제30권2호
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• pp.422-430
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• 2009

Background : Stroke is the second leading cause of death in Korea, following cancer. Stroke consists of ischemic and hemorrhagic stroke, and ischemic stroke can be largely classified as atherothrombotic stroke or embolic stroke. Carotid intima-media thickness (IMT) is an indicator of atherosclerosis used commonly as a screening test for abnormalities of the coronary artery. 24-hour ambulatory ECG is widely used to screen for underlying diseases that causes syncope, palpitation, arrhythmia, etc. Objectives : Since both carotid IMT and 24-hour ambulatory ECG are used to screen for cardiac problems, we endeavored to explore the correlation between carotid IMT and 24-hour ambulatory ECG of stroke patients. Methods : The records of ischemic stroke patients who were admitted to Kyunghee Medical Center Oriental Hospital ward from March 2006 to May 2009 were reviewed. 28 patients who had both carotid Doppler US and 24-hour ambulatory ECG test undertaken during their admission were analyzed. The relationship of abnormal ambulatory results and common carotid artery(CCA) IMT were statistically analyzed using Fisher's exact test and t-test. Results : The mean age of the abnormal ambulatory group was older than the normal group (74${\pm}$ 8.0 vs. 61${\pm}$12.1, p=0.0098). Although insignificant, the abnormal ambulatory group showed much thicker CCA-IMT than normal ambulatory group (2.l7${\pm}$ 1.16 vs. 1.51${\pm}$0.97. p=0.l389). Conclusion: No significant correlation was observed between abnormal ambulatory results and CCA-IMT. However, the difference in CCA-IMT between the two groups was too big to be ignored and further investigation with larger and better controlled trials are warranted.