Preclinical Carotid and Femoral Atherosclerosis in Healthy Subjects: Its Relation to Postprandial Lipemia, Fibrinolysis and Insulin Sensitivity

pp 193-200

Abstract

With the objective to find and validate simple methods for early stages of atherosclerosis and atherotrombotic risk, we studied 30 apparently healthy subjects, both sex, aged 31-60, normolipidemic, non-obese, non-smokers. According to fasting triglyceride (f-TG) levels were classed in group1: TG between 150-200 mg/dl and group 2: TG less than 150 mg/dl. After a 12hours overnight fasting, lipidic profile, glucose, insulin, fibrinogen, PAI-1 antigen (ag),t-PA ag levels and insulin sensitivity were evaluated. After a standarized load meal, post-prandial (PP) TG, PAI-1 ag, t-PA ag levels, glucose oral tolerance and blood pressure levels were studied. Intima-media thickness (IMT) arterial wall and eventual plaque presence were studied by B-mode ultrasound in both: carotid and femoral beds. Group 1 showed significantly higher triglyceride area under the curve (TG-AUC), lower insulin sensitivity and significantly higher PAI-1 ag and t-PA ag fasting levels. PAI-1 ag showed significative correlation with glucose/insulin ratio and diastolic blood pressure. In group 1 we observed higher IMTin carotid and femoral beds; furthermore the rate of plaque presence was 3 to 1 as compared to group2. The results suggests that healthy subjects withTG>150 mg/dl can develope a silent atherotrombotic syndrome performed by higher PP lipemia, lower insulin sensitivity, procoagulating state and carotid and/or femoral atherosclerosis; the identification of fat intolerance or PP hyperlipemia(closely associated to different metabolic and haemostatic disorders) and arterial B-mode ultra-sound, contributes as important tools to the diagnostic in early stages of atherosclerosis.