Comprehensive ultrasound assessment of the state complex intima-media brachiocephalic arteries in patients with metabolic syndrome

Objective. Comprehensive ultrasound assessment of the state complex intima-media (CIM) of brachiocephalic arteries in patients with metabolic syndrome (MS). 

Materials and methods. 82 patients were examined, including 62 patients with MS and 20 practically healthy individuals. All patients underwent biochemical blood analysis, ultrasound of the extracranial sections of the brachiocephalic arteries with an assessment of the qualitative and quantitative characteristics of CIM bifurcation of the brachiocephalic trunk (BCT), common carotid arteries (CCA) and vertebral arteries (VA).

Results. 100% of patients with MS, changes in the echostructure of CIM were recorded in the form of pathological layering, 9 (14.5%) patients – in the form of hyperechogenic inclusions. Thickness of CIM in the bifurcation of BCT and CCA in patients with MS statistically significantly exceeds the same indicator in practically healthy persons and demonstrates direct correlation between the components of MS. The modified Carnegan index patients with MS is statistically significantly higher than the same indicator in practically healthy individuals and demonstrates direct correlation with the thickness of CIM estimated in different segments of the brachiocephalic arteries (BCT k 0.356, RCCA k 0.718, LCCA k 0.846, in the bifurcation of CCA on the right k 0.431, on the left k 0.519).

Conclusion. Comprehensive ultrasound assessment of the state brachiocephalic arteries in patients with MS allows us to obtain complex of qualitative and quantitative signs characteristic of metabolic angiopathy.

1. Mychka V.B., Vertkin A.L., Vardaev L.I. et al. Experts’ consensus on the interdisciplinary approach towards the management, diagnostics, and treatment of patients with metabolic syndrome. Cardiovascular Therapy and Prevention. 2013; 12 (6): 41–81. (In Russian)

2. Arkhipova E.V. Metabolic syndrome: pathogenesis, diagnostic criteria and treatment. BSU bulletin. Medicine and pharmacy. 2019; 2: 3–9. https://doi.org/10.18101/2306-1995-2019-2-3-9 (In Russian)

3. Sharipova G.Kh., Saidova M.A., Zhernakova Yu.V., Chazova I.E. The influence of metabolic syndrome on heart abnormalities in patients with arterial hypertension. Almanac of Clinical Medicine. 2015; 1: 102–110 (In Russian)

4. Lelyuk V.G., Lelyuk S.E. Differential diagnosis in ultrasound angiology. Moscow: Real Time, 2019. 44 p. (In Russian)

5. Kamenskiy A., Pipinos I.I., Carson J.S., MacTaggart J.N., Baxter B.T. Age and disease-related geometric and structural remodeling of the carotid artery. J. Vasc. Surg. 2015; 6: 1521–1528. https://doi.org/10.1016/j.jvs.2014.10.041

6. Lelyuk V.G., Lelyuk S.E. Methods of ultrasound examination of vascular system: scanning technology, normative indicators. M.: Real Time, 2019. 48 p. (In Russian)

7. Sasaki N., Maeda R., Ozono R. et al. Association of Flow Parameters and Diameter in the Common Carotid Artery with Impaired Glucose Metabolism. Journal of Atherosclerosis and Thrombosis. 2002; 29 (5): 654–666. https://doi.org/10.5551/jat.62790

8. Rzaeva R.A. Presence of metabolic syndrome does not influence intima-media thickness and interadventitial diameter of main arteries in patients with type 2 diabetes mellitus // Kazan Medical Journal. 2018; 99 (2): 235–239. https://doi.org/10.17816/KMJ2018-235 (In Russian)

9. Bashuk V.V., Anosova E.V., Prashchayeu K.I., et al. The intima-midia complex as new morphofunctional object for investigation of processes of polymorridity Scientific Bulletins. Series: Medicine, Pharmacy. 2013; 147 (4): 22–27. (In Russian)

10. Pacifico L., Bonci E., Andreoli G. et al. Association of serum triglyceride-to-HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents. Nutr. Metab. Cardiovasc. Dis. 2014; 24 (7): 737–743. https://doi.org/10.1016/j.numecd.2014.01.010

11. Jia X., Zhu Y., Qi Y. et al. Association between triglyceride glucose index and carotid intima-media thickness in obese and nonobese adults. J. Diabetes. 2022; 14 (9): 596–605. https://doi.org/10.1111/1753-0407.13312

12. Efimov A.S. Diabetic angiopathies. M.: Medicine. 1989. 228 p. (In Russian)

13. Lelyuk V.G., Lelyuk S.E. Ultrasound angiology. Pub. 3. M.: Real time, 2007. 416. p(In Russian)

14. Golovin D.A., Lelyuk S.Eh., Lelyuk V.G. Ultrasound in Assessment of Diabetic Macroangiopathy and Microangiopathy in Patients with Type 2 Diabetes Mellitus. Ultrasound and Functional Diagnostics. 2016; 3: 72–81. (In Russian)

15. Arutyunyan N.M., Lelyuk S.E. Ultrasound Diagnostic Criteria of Diabetic Macroangiopathy Early Manifestation in Patients with Type 2 Diabetes Mellitus Ultrasound and Functional Diagnostics. 2007; 5: 76–83. (In Russian)

16. Ivashkin V.T., Drapkina O.M., Korneeva O.N. Clinical variants of metabolic syndrome. M.: Med. inform. Agency, 2011. 220 p. (In Russian)

17. Muscelli E., Kozàkovà M., Flyvbjerg A., et al.; RISC investigators. The effect of menopause on carotid artery remodeling, insulin sensitivity, and plasma adiponectin in healthy women. Am. J. Hypertens. 2009; 22 (4): 364–370. https://doi.org/10.1038/ajh.2009.16

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