PURPOSE: Although inconsistent, reports have shown fibrinogen levels to be associated with atherosclerosis. Accordingly, since cigarette smoking is associated with increased levels of fibrinogen and atherosclerosis, it may also affect the association between fibrinogen and atherosclerosis. We investigated the associations between fibrinogen and carotid intima-media thickness (IMT) according to smoking status in a Korean male population. MATERIALS AND METHODS: Plasma fibrinogen levels were measured in 277 men aged 40-87 years without a history of myocardial infarction or stroke. High-resolution B-mode ultrasonography was used to examine the common carotid arteries. IMT level was analyzed both as a continuous (IMT-max, maximum value; IMT-tpm, 3-point mean value) and categorical variable (higher IMT; presence of plaque). Serial linear and logistic regression models were employed to examine the association between fibrinogen and IMT according to smoking status. RESULTS: Fibrinogen levels were positively associated with IMT-max (standardized beta=0.25, p=0.021) and IMT-tpm (standardized beta=0.21, p=0.038), even after adjusting for age, body mass index, systolic blood pressure, fasting glucose, and total cholesterol to high-density lipoprotein cholesterol ratio in current smokers (n=75). No significant association between fibrinogen and IMT, however, was noted in former smokers (n=80) or nonsmokers (n=122). Adjusted odds ratios (95% confidence interval) for having plaque per one standard deviation higher fibrinogen level were 2.06 (1.09-3.89) for current smokers, 0.68 (0.43-1.10) for former smokers, and 1.06 (0.60-1.87) for nonsmokers. CONCLUSION: Our findings suggest that cigarette smoking may modify the association between fibrinogen and carotid atherosclerosis. Further studies are required to confirm this finding in different populations.
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/*statistics & numerical data ; Atherosclerosis/*ultrasonography ; Blood Pressure ; Body Mass Index ; Carotid Artery Diseases/*blood/epidemiology/ultrasonography ; Carotid Artery, Common ; *Carotid Intima-Media Thickness ; Cholesterol/blood ; Cholesterol, HDL ; Cross-Sectional Studies ; Fibrinogen/*analysis ; Humans ; Lipoproteins, HDL/blood ; Logistic Models ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Smoking/*adverse effects/blood/epidemiology ; Surveys and Questionnaires

This study aimed to gain insight into the underlying pathogenesis of erectile dysfunction in young men under the age of 40 years without widely-known risk factors. Compared with normal controls, patients with erectile dysfunction had increased carotid intima-media thickness, fasting levels of blood glucose and insulin, and homeostatic model assessment index, as well as lower flow-mediated vasodilation and testosterone levels (P < 0.05), though all of these values were within their respective normal range. Multivariate logistic regression analysis identified carotid intima-media thickness, flow-mediated vasodilation, insulin level, and homeostatic model assessment index as significant predictors of erectile dysfunction. Young men with flow-mediated vasodilation <10.65% were 11.645 times more likely to have erectile dysfunction, young men with carotid intima-media thickness >0.623 mm had a 4.16-fold, and young men with homeostatic model assessment index >1.614 had a 5.993-fold greater risk of having erectile dysfunction. In conclusions, in young men with normal results from general clinical screening, an increased carotid intima-media thickness and homeostatic model assessment index and reduced flow-mediated vasodilation were associated with a higher incidence of erectile dysfunction. Erectile dysfunction may appear before the detection of traditional cardiovascular risk factors and may be the earliest clinical sign of subclinical cardiovascular disease.
Adult ; Atherosclerosis/complications* ; Blood Glucose/analysis* ; Carotid Artery Diseases/epidemiology* ; Carotid Intima-Media Thickness ; Erectile Dysfunction/epidemiology* ; Humans ; Incidence ; Insulin/blood* ; Male ; ROC Curve ; Risk Factors ; Testosterone/blood* ; Ultrasonography ; Vasodilation ; Young Adult

Aged ; Body Mass Index ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Artery Diseases ; diagnosis ; epidemiology ; etiology ; Cholesterol, HDL ; blood ; Fatty Liver ; complications ; diagnosis ; epidemiology ; Female ; Humans ; Insulin Resistance ; Intercellular Signaling Peptides and Proteins ; blood ; Male ; Metabolic Syndrome ; complications ; Middle Aged ; Obesity ; complications ; Risk Factors ; Triglycerides ; blood ; Tunica Intima ; diagnostic imaging ; pathology ; Ultrasonography