Evaluation of atherosclerosis using data on serum lipids, serum adiponectin, carotid ultrasonography, and pulse wave velocity: implications for preventive medical care.

A database was constructed facilitating the earlier detection and treatment of atherosclerosis on the basis of data from clinical examinations. Carotid ultrasonography and measurement of the pulse wave velocity (PWV) were performed in patients with hyperlipidemia or type 2 diabetes and in those with both diseases together compared with normal healthy controls. The study excluded patients with a severe medical condition but included hyperlipidemic patients with total cholesterol <300 mg/dl or triglycerides <300 mg/dl, and type 2 diabetic patients with fasting blood glucose levels <200 mg/dl. Serum levels of total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C), the fasting blood glucose level, hemoglobin Alc (HbA1c) values, adiponectin levels, findings obtained from carotid ultrasonography (IMT and measurement of blood flow velocity), and PWV values were collated. None of the healthy control group had an intima-media complex thickness (IMT) > 1.1 mm, but 48% of the hyperlipidemic patients and 40% of type 2 diabetic patients did, and 33% of patients with both syndromes showed an increased IMT. Patients with both diseases also had the highest PWV of 1896 cm/s. There was no significant correlation between IMT values and serum lipids (neither total cholesterol, triglycerides, HDL-cholesterol, nor LDL-cholesterol), fasting blood glucose levels, or adiponectin levels. We conclude that not only the blood tests routinely conducted at present, but also functional tests such as ultrasonographic examination and measurement of the pulse wave velocity are necessary as screening tests.