• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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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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• v.42 no.5
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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.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.285-291
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• 2009

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 MetS. 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 $0.739{\pm}0.137\;mm$ 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.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.935-938
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• 2005

Purpose : The aim of the present study was to ascertain whether the increase of carotid intima-media thickeness(cIMT) as one of premature pathologic changes of atherosclerosis, was present in obese children compared to normal weight children. Methods : The obese group consisted of 21 obese/overweight(body mass index(BMI) above 85 percentile of age, sex standards) children and the control group of 11 normal weight children. None of the children had any chronic illnesses or previous medication history. We investigated the age, sex, height, weight, and systolic/diastolic blood pressure. We measured cIMT by ultrasonogram. In 19 of the obese group, we tested the serum glucose level, liver transaminase level, and cholesterol level etc. Results : The increase of cIMT in obese group did not achieved statistical significance(obese group vs. control group; 0.42 vs. 0.40 mm, P=0.0592). In addition, cIMT showed no significant correlation with any physical/laboratory variables including BMI(P=0.0585). Conclusion : To our knowledge, this is the first study to measure the cIMT in Korean children. Though the results approached statistical significance, we could not prove an increase of cIMT in obese children or an association between cIMT and BMI, due to the study's small sample size. In the future, larger and more extensive trials are needed.

• The KIPS Transactions:PartA
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• v.14A no.2
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• pp.77-84
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• 2007

The intima media thickness(IMT) of the carotid artery from B mode ultrasound images has recently been proposed as the most useful index of individual atherosclerosis and can be used to predict major cardiovascular events. Ultrasonic measurements of the IMT are conventionally obtained by manually tracing interfaces between tissue layers. The drawbacks of this method are the inter and intra observer variability and its inefficiency. In this paper, we present a multiresolution snake method combined with the dynamic programming, which overcomes the various noises and sensitivity to initialization of conventional snake. First, an image pyramid is constructed using the Gaussian pyramid that maintains global edge information with smoothing in the images, and then the boundaries are automatically detected in the lowest resolution level by minimizing a cost function based on dynamic programming. The cost function includes cost terms which are representing image features and geometrical continuity of the vessel interfaces. Since the detected boundaries are selected as initial contour of the snake for the next level, this automated approach solves the problem of the initialization. Moreover, the proposed snake improves the problem of converging th the local minima by defining the external energy based on multiple image features. In this paper, our method has been validated by computing the correlation between manual and automatic measurements. This automated detection method has obtained more accurate and reproducible results than conventional edge detection by considering multiple image features.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2009.05a
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• pp.27-28
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• 2009

경동맥 내중막두께(intima media thickness: IMT)는 2000년 미국심장학회에서 관상동맥 질환이나 허혈성 뇌질환 위험도의 독립적인 인자임을 인정하여 일차 진단지표로 권장함에 따라 세계적으로 그 관심이 확산되고 있다. 최근 국내에서도 서구화되어 가는 식생활 패턴으로 인해 고혈압, 동맥경화, 뇌졸중, 관상동맥 질환 등의 심뇌혈관계 질환 발병률이 높아지고 있다. 서구의 연구결과에 의하면 경동맥 내중막 두께는 인종, 성별, 연령에 따라 많은 차이를 보이기 때문에 임상적 진단에 기초가 되는 한국형 경동맥 내숭막두께 정상치 확립이 요구된다. 경동맥의 내중막두께는 경동맥 팽대부에서 근위부 10 mm 부위의 far wall 총경동맥 부위에서 심혈관계 위험 인자와 가장 상관성이 많은 것으로 보고되고 있다.

• Journal of the Korean Society of Radiology
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• v.10 no.3
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• pp.187-193
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• 2016

In this study, we performed the carotid artery ultrasound targeting 140 subjects who have conducted to evaluate the changes in intima-media thickness(IMT) and plaque correlated with the presence or absence of a hematological test of the carotid artery. Considering that the IMT thickness more than 1mm is abnormal based on the carotid artery ultrasound to assess the presence or absence of plaque, and examined the correlation by classifying the blood lipid value and the fasting blood glucose level through the serum test. Consequently, the fasting blood glucose level is being analyzed as independent predictors of causing dental plaque(p=0.033), cut off value was determined as 126 mg/dL(sensitivity 56.25%, specificity 68.38%) in ROC curve analysis. Furthermore, the odds ratio appeared 1.01 times the value in the Logistic regression. Therefore, it seemed that the necessity to prospective studies in a number of subjects are considered, and also taking into account a number of blood test values along with the sonography of the carotid artery as a valuable part for effective primary prevention and follow-up observation of the cardiac and brain vascular disease is highly recommended.

• Journal of the Korea Society for Simulation
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• v.16 no.1
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• pp.21-29
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• 2007

In this paper, we present a method of detecting the boundary of the intima-media complex for automated measurement based on dynamic programming from carotid artery B-mode ultrasound images and then show the experimental results. We apply the dynamic programming for determining the optimal locations that a cost function is minimized. The cost function includes cost terms which are representing image features such as intensity, intensity gradient and geometrical continuity of the vessel interfaces. Moreover, we improve the boundary continuity by applying the B-spline to smooth the rough boundary due to noise such as speckle, dropout and weak edges. The proposed method has obtained more accurate reproducible results than conventional edge-detection by considering multiple image features and ensures efficient automated measurement by solving the problems of the inter- and intra-observer variability and its inefficiency due to manual measurement.

• Journal of Preventive Medicine and Public Health
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• v.43 no.6
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• pp.486-495
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• 2010

Objectives: The effect of meat consumption on cardiometabolic risk has been continuously studied, but their associations are not conclusive. The aim of this study is to examine the association between the consumption of meat or red meat and carotid intima-media thickness (IMT) in healthy Korean adults. Methods: This study evaluated 2374 community-dwelling adults (933 men and 1441 women) who were free of cardiovascular disease or cancer, living in a rural area in Korea. Total meat and red meat intakes were assessed with a validated 103 item-food frequency questionnaire. Carotid IMT was evaluated ultrasonographically, IMTmax was defined as the highest value among IMT of bilateral common carotid arteries. Results: After adjustment for potential confounding factors, the mean IMTmax tended to increase in higher meat consumption groups in both men and women with metabolic syndrome (p for trend= 0.027 and 0.049, respectively), but not in participants without metabolic syndrome. Frequent meat consumption (${\geq}5$ servings/week) was significantly associated with higher IMTmax in men with metabolic syndrome (by 0.08 mm, p=0.015). Whereas, the association was not significant in women (by 0.05 mm, p=0.115). Similar but attenuated findings were shown with red meat intake. Conclusions: Our findings suggest that a higher meat consumption may be associated with a higher carotid IMT in Korean adults with metabolic syndrome. The frequent meat consumption (${\geq}5$ servings/week), compared with the others, was associated with a higher carotid IMTmax only in men with metabolic syndrome. Further research is required to explore optimal meat consumption in people with specific medical conditions.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1091-1096
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• 2007

Purpose : The of common carotid artery intima media thickness (IMT) is an acknowledged noninvasive marker for early atherosclerotic changes. We investigate whether common carotid IMT is different between obese and normal-weight children and also evaluate the relationships IMT with cardiovascular risk factors. Methods : We collected the clinical data (age, sex, pubertal stage, body mass index) and measured blood pressure, glucose, insulin, lipid profiles and adiponectin in 49 obese children (mean age, 12 years) and 24 nonobese children as controls. The control group was composed of 24 nonobese children of the same age, sex and pubertal stage. We measured the carotid IMT of all subjects by B-mode ultrasound with a 7.5-MHz linear transducer and analyzed. Results : Obese children demonstrated a significantly thicker intima media (mean, 0.34 mm, peak, 0.42 mm) compared to the control group (mean, 0.31 mm, peak, 0.38 mm, P<0.01). IMT was significantly correlated to the BMI (r=0.431, P<0.01), age (r=0.317, P<0.01), total cholesterol (r=0.377, P< 0.01), triglyceride (r=0.253, P<0.05) and low-density lipoprotein cholesterol (r=0.289, P<0.05). Serum adiponectin was significantly lower in obese children than in controls (11.2 ng/mL vs. 14.7 ng/mL, P<0.05) and negatively related with IMT (r=-0.267, P<0.05). Conclusion : Obesity is associated with increased carotid artery IMT in children. Our results suggest vascular changes in obesity seem to occur already in childhood and vascular ultrasonography may helpful for screening cardiovascular complications in obese children.