Artmış karotis intima-media kalınlığı için sınır değerleri belirlemede yaş göz önünde bulundurulmalıdır

Age should be considered in cut-off values for increased carotid intima-media thickness

Özet

Amaç: Yaş ve cinsiyetten bağımsız olarak kılavuzlarda artmış karotis intima-media kalınlığı (C-IMT) için sınır değer olarak >0.9 mm kabul edilmektedir. Çalışmamızda, yaş ve cinsiyetin C-IMT üzerine olan etkisini ve değişik yaş gruplarında C-IMT sınır değerlerini araştırmayı planladık. Yöntemler: Bu geriye dönük çalışmaya 20–90 yaş aralığında en az bir kardiyovasküler risk faktörü olan C-IMT ölçümü yapılmış 644 hasta alındı. Karotid ultrasonografisinde (USG) ana ve internal C-IMT (CC-IMT ve IC-IMT) ölçümleri elde edildi. Hastaların klinik ve demografik parametreleri belirlendi. Çalışmaya dahil edilen hastalar; Grup I (20–40), Grup II (41–50), Grup III (51–60), Grup IV (61–70) ve Grup V (>70) olarak beş gruba ayrıldı. Bulgular: CC-IMT ve IC-IMT değerleri Grup I’den Grup V’e anlamlı olarak artmaktaydı (p

Abstract

mm to define abnormally increased carotid intima-mediathickness (C-IMT), regardless of age or gender. This studywas conducted to examine the effects of age and gender onC-IMT and cut-off values for C-IMT in different age groups.Methods: A total of 644 patients with a recorded C-IMT measurement,at least 1 cardiovascular risk factor, and aged between20 and 90 years were included in the study. Commonand internal C-IMT (CC-IMT and IC-IMT) measurementswere obtained using carotid ultrasonography (USG). Thepatients were divided into 5 groups based on age: GroupI (20–40 years), Group II (41–50 years), Group III (51–60years), Group IV (61–70 years), and Group V (>70 years).Results: The CC-IMT and IC-IMT values were significantlygreater as the age of the group increased. Group I to GroupV had a median CC-IMT value of 0.70 mm, 0.70 mm, 0.75mm, 0.75 mm, and 0.85 mm, respectively. The median ICIMTvalue for each group was 0.60 mm, 0.65 mm, 0.70 mm,0.70 mm, and 0.80 mm, respectively. The median CC-IMTvalue was 50 μm greater than the median IC-IMT value inall groups. Only the CC-IMT value was significantly differentin males (0.80±0.20 mm vs. 0.76±0.19 mm; p=0.020).Age, hypertension (HT), smoking, hyperlipidemia, systolicdiastolicblood pressure, and body mass index measureswere associated with increased C-IMT. Regression analysisrevealed that increased C-IMT was independently associatedwith age and HT presence. Each decade of life and thepresence of HT revealed an incidence of increased C-IMTby 44% and 53%, respectively.Conclusion: C-IMT significantly increased with age. New,age-appropriate cut-off values are needed for C-IMT assessment.In addition, it was observed that the CC-IMTvalue was approximately 50 μm greater than the IC-IMTmeasurement in all age groups. CC-IMT measurementsshould be included in USG reports.