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The relationship between multiple cardiovascular and metabolic diseases and falls in middle-aged and elderly people

Yuhong GAI ; Fei GAO ; Mengshan CUI ; Kui FANG

Chinese Journal of Arteriosclerosis.2025;33(8):690-694. doi:10.20039/j.cnki.1007-3949.2025.08.006

Aim To explore the relationship between multiple cardiovascular and metabolic diseases and falls in middle-aged and elderly people.Methods Using the fifth dataset of the China Health and Retirement Longitudinal Study(CHARLS),18 968 middle-aged and elderly people aged 45 years and above were enrolled as study subjects.The relationship between multiple cardiovascular and metabolic diseases and falls was analyzed by Logistic regression model.Results The incidence rates of falls,severe falls and hip fractures in the study subjects were 17.3％,6.8％and 0.9％,respectively.Cardiovascular and metabolic diseases were positively associated with the risk of falls.Compared with study subjects without cardiovascular and metabolic diseases,those with 1,2,3 and 4 cardiovascular and metabolic disea-ses had a 13％,44％,69％and91％increased risk of falls,respectively,with OR(95％CI)of 1.13(1.02～1.25),1.44(1.29～1.61),1.69(1.48～1.93)and 1.91(1.56～2.32);the risk of serious falls increased by 22％,51％,69％and 102％,respectively,with OR(95％CI)of 1.22(1.05～1.42),1.51(1.27～1.78),1.69(1.38～2.05)and 2.02(1.54～2.66).The risk of hip fractures increased by 95％,147％and 157％in study subjects with2,3 and 4 cardiovascular and metabolic diseases,respectively,with OR(95％CI)of 1.95(1.24～3.05),2.47(1.50～4.07)and 2.57(1.26～5.20).Conclusion Multiple cardiovascular and metabolic diseases significantly increased the risk of falls in middle-aged and elderly people.

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PLIN2 promotes lipid accumulation in THP-1 derived macrophages by upregulating ACSL3 expression

Lan LIU ; Li YANG ; Yuting WANG ; Xindu LIU ; Zhonghua YUAN

Chinese Journal of Arteriosclerosis.2025;33(7):587-594. doi:10.20039/j.cnki.1007-3949.2025.07.005

Aim To investigate whether adipose differentiation-related proteins promote macrophage lipid accu-mulation by upregulating acyl-CoA synthetase long-chain family member 3(ACSL3)expression through PI3K/Akt.Methods The experiments were divided into 24 h group,different PLIN2 expression groups,HA-PLIN2+SC97 group and HA-PLIN2+LY294002 group.Western blot was used to detect the protein expression of PLIN2,Akt,p-Akt and ACSL3 in cells,RT-qPCR was used to detect the mRNA level of PLIN2 in cells,and oil red O was used to observe the degree of lipid accumulation in cells.Results The protein expression levels of Akt,p-Akt and ACSL3 in macrophages overex-pressing PLIN2 were significantly increased(P＜0.05),and p-Akt nuclear translocation was increased,with fluorescence labeling of PLIN2 and Akt overlapping.After adding the PI3K/Akt agonist SC97 to macrophages overexpressing PLIN2,the expression level of ACSL3 significantly increased(P＜0.05),and the degree of intracellular lipid accumulation in-creased;After adding the PI3K/Akt inhibitor LY294002 to macrophages overexpressing PLIN2,the expression level of AC-SL3 significantly decreased(P＜0.05),and the degree of intracellular lipid accumulation decreased.Conclusion PLIN2 upregulates ACSL3 expression through PI3K/Akt,thereby promoting macrophage lipid accumulation.

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Irisin alleviates the occurrence and development of atherosclerosis by inhibiting endo-thelial inflammation

Xia WANG ; Guo ZHOU ; Huanhuan HUO ; Ben HE

Chinese Journal of Arteriosclerosis.2025;33(7):595-601. doi:10.20039/j.cnki.1007-3949.2025.07.006

Aim To investigate the effect of irisin on endothelial inflammation and atherosclerosis(As)in mice.Methods ApoE-/-mice were randomly divided into control group,As model group,and irisin group(treated with irisin based on the As model),with 10 mice in each group.The carotid tissues were stained using pathological techniques and immunofluorescence.Human aortic endothelial cells(HAEC)were cultured in vitro,treated with irisin,and stimulated with cholesterol crystal(CC).The protein levels of vascular cell adhesion molecule-1(VCAM-1)and intercellular cell adhesion molecule-1(ICAM-1)were then detected by Western blot.The expression of inflammatory cytokines interleukin-1β(IL-1β),interleukin-6(IL-6)and chemokine(C-C motif)ligand 2(CCL2)were detected by RT-qPCR.The ad-hesion of monocytes was assessed using cell adhesion assay.Results The carotid plaque area in the mice of As model group was significantly increased compared with that in control group(P＜0.05).In contrast,the plaque area was re-duced in the irisin group compared with the As model group(P＜0.05).Compared with the control group,the expression of VCAM-1,the number of CD68+macrophages,and the deposition of CC were increased in the carotid arteries of the As model group(P＜0.05),while irisin could reduce the expression of VCAM-1,the number of CD68+macrophages,and the deposition of CC(P＜0.05).At the in vitro level,the expression of VCAM-1 and ICAM-1,as well as the adhesion of monocytes in CC-stimulated HAEC,were increased(P＜0.05).However,irisin could inhibit the increased expression of VCAM-1 and ICAM-1(P＜0.05),as well as the adhesion of monocytes induced by CC(P＜0.05).The mRNA levels of IL-1β,IL-6 and CCL2 in HAEC of CC stimulated group were increased(P＜0.05),while irisin could inhibit the mRNA expressions of IL-1β,IL-6 and CCL2 induced by CC(P＜0.05).Conclusion Irisin can inhibit vascular inflamma-tion,thereby reducing the occurrence and progression of atherosclerosis.

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Correlation between RBP4,LDLC/Alb,MHR and plaque stability in carotid athero-sclerosis population and their predictive value for acute ischemic stroke

Fan ZHANG ; Bo ZHAO ; Zhiwei ZHANG ; Liping ZHANG ; Huifang SU ; Wenhui KOU

Chinese Journal of Arteriosclerosis.2025;33(7):618-624. doi:10.20039/j.cnki.1007-3949.2025.07.009

Aim To analyze the correlation between serum retinol-binding protein 4(RBP4),low density lipo-protein cholesterol to albumin ratio(LDLC/Alb),monocyte to high density lipoprotein ratio(MHR)and plaque stability in carotid atherosclerosis population and their predictive value for acute ischemic stroke(AIS).Methods A total of 197 patients with asymptomatic carotid atherosclerosis admitted to our hospital from September 2021 to January 2023 were selected for a prospective cohort study,and they were categorized into occurred group and non-occurred group according to whether AIS occurred within 12 months.Baseline information at time of visit,results of the cervical ultrasonography and serum RBP4,LDLC/Alb,MHR levels were compared between the two groups.Spearman/Pearson and receiver operating characteristic(ROC)curve were used to analyze the corr-elation of RBP4,LDLC/Alb and MHR with carotid atherosclerosis and plaque stability,and the value of predicting AIS in carotid atherosclerosis population.Hosmer-Lemeshow goodness of fit test was used to evaluate the calibration ability of serum RBP4,LDLC/Alb and MHR to jointly predict AIS in carotid atherosclerosis population.Results The carotid intima-media thickness(IMT)was higher in occurred group than that in non-occurred group.There were more soft plaques and mixed plaques in occurred group than in non-occurred group(P＜0.05).Serum levels of RBP4,LDLC/Alb and MHR were higher in occurred group than those in non-occurred group(P＜0.05).The correlation analysis showed that the levels of serum RBP4,LDLC/Alb and MHR were positively correla-ted with IMT(r=0.803,0.740,0.710)and plaque properties(r=0.736,0.685,0.703)(P＜0.001).ROC curve a-nalysis showed that the AUC of serum RBP4,LDLC/Alb and MHR in predicting AIS in carotid atherosclerosis population was 0.796,0.821 and 0.828,respectively,and the AUC of MHR was the largest;the AUC of the combination of serum RBP4,LDLC/Alb and MHR was 0.936,which was higher than that of MHR(Z=2.978,P＜0.05),the predictive sensi-tivity and specificity were 88.24％and 87.40％.Hosmer-Lemeshow goodness of fit test showed that there was no signifi-cant difference between serum RBP4,LDLC/Alb and MHR in predicting AIS and the actual observation value in carotid atherosclerosis population(P＞0.05),and the prediction model had good calibration ability.Conclusion Serum RBP4,LDLC/Alb,and MHR are positively correlated with carotid atherosclerosis and plaque stability,and can predict the occurrence of AIS.Combined detection of the three can be used as a method for early identification of potential high-risk populations for AIS,providing a new,quantifiable guidance scheme for the prevention and treatment of AIS in carotid ath-erosclerotic population.

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One case of renal arteriovenous fistula formation caused by renal artery stent implan-tation

Huimin TAN ; Qiang ZHOU ; Lujin WU

Chinese Journal of Arteriosclerosis.2025;33(7):625-630. doi:10.20039/j.cnki.1007-3949.2025.07.010

Renal artery stenosis(RAS)is a common disease that endangers human health,usually caused by ath-erosclerosis or fibromuscular dyspalsia.RAS is also one of the most common causes of secondary hypertension,often leading to resistant hypertension with markedly elevated renin levels and early onset of progressive renal insufficiency.In addition,the activation of renin-angiotensin-aldosterone system(RAAS)caused by RAS and pathophysiological changes in-cluding glomerular sclerosis and atrophy,water and sodium retention can also lead to cardiovascular events such as heart failure,pulmonary edema,coronary heart disease and cerebral infarction.Therefore,early recognition of RAS and prompt revascularization in patients with severe stenosis are key to the treatment of RAS.Percutaneous renal artery stenting(PRAS)has become the preferred revascularization for patients with RAS due to its high response rate,minimally invasive-ness,fast recovery and low restenosis rate.However,there are still some unavoidable complications of PRAS,such as aortic dissection,renal artery rupture,puncture vascular aneurysm,contrast allergy and contrast-induced nephropathy.The occurrence of these complications may have adverse consequences for patients,and even death in severe cases.Renal arteriovenous fistula is a very rare complication of PRAS,and clinical experience in its recognition and management is very limited.Few cases that can be collected tend to favor re-surgical intervention.But surgical intervention undoubtedly in-creases the risk of patient suffering and mortality again.Thus,it is of great significance to summarize such complications and give a scientific recommendation to clinicians.This article reports a patient with resistant hypertension who underwent renal arteriography showing severe stenosis of renal vessels and developed a renal arteriovenous fistula after stent implanta-tion.Therefore,it is worth considering whether the renal arteriovenous fistula caused by PRAS should be treated with sur-gical intervention or conservative medical treatment.

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Progress in the treatment of endothelial dysfunction in atherosclerosis

Xinyu ZHANG ; Ziyue XIE ; Zi'an WANG ; Yu LI ; Ruigong ZHU

Chinese Journal of Arteriosclerosis.2025;33(8):721-728. doi:10.20039/j.cnki.1007-3949.2025.08.011

Atherosclerosis is a chronic vascular wall disease.The clinical manifestations are abnormal lipid depo-sition,fibrous hyperplasia,calcium deposition,etc.under the intima of the affected artery lesions.Its initial link is re-lated to endothelial cell dysfunction,which can be triggered and aggravated by different risk factors of atherosclerosis,in-cluding oxidative stress,hemodynamic abnormalities,endothelial cell senescence and inflammation,etc.Exploring the mechanism of endothelial cell dysfunction is conducive to the discovery of potential treatments for atherosclerosis.This ar-ticle summarizes the mechanism and research progress of drug therapy for endothelial cell dysfunction in atherosclerosis.

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Research progress on the treatment of in-stent restenosis in coronary drug-eluting stents

Chengwei HU ; Haiyan ZHANG ; Mingzhi LONG

Chinese Journal of Arteriosclerosis.2025;33(8):729-736. doi:10.20039/j.cnki.1007-3949.2025.08.012

With the widespread application of drug-eluting stent(DES)technology and rapid advancement in stent bioengineering,the efficacy and safety of percutaneous coronary intervention(PCI)have significantly improved.Howev-er,the incidence of in-stent restenosis(ISR)remains a critical issue,with approximately 1％to 2％of patients requiring repeat revascularization annually.Given the global implantation of millions of DES each year,ISR has emerged as a major clinical challenge demanding urgent resolution.The pathological mechanisms underlying DES-ISR are complex and heter-ogeneous,and with continuous progress in intracoronary imaging techniques,these mechanisms and classifications have been further elucidated.Concurrently,therapeutic tools and strategies for ISR are undergoing ongoing development and optimization.This review summarizes recent research progress and achievements in the definition,classification,patho-logical mechanisms,imaging characteristics,and treatment approaches related to DES-ISR.

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Recent advances in the pathogenesis and preventive strategies of abdominal aortic an-eurysm

Qingqing LEI ; Ziwen SHEN ; Mengxian SUN ; Tingting ZHANG

Chinese Journal of Arteriosclerosis.2025;33(7):579-586. doi:10.20039/j.cnki.1007-3949.2025.07.004

Abdominal aortic aneurysm(AAA)is characterized by a localized and irreversible enlargement of the abdominal aorta,which poses a significant risk to life in the event of rupture.Currently,the primary treatment for AAA is surgical intervention,as there are no effective pharmacological therapies available to prevent or slow postoperative vascular dilation.Therefore,understanding the detailed pathogenesis of AAA and identifying effective prevention and treatment strategies is essential.This review begins by examining the pathological and molecular mechanisms involved in AAA,fo-cusing on key research areas such as the phenotypic switching of vascular smooth muscle cells,inflammation and metabolic reprogramming.Based on a large of animal and clinical studies,this review then explores therapeutic strategies and prom-ising drugs for AAA,including mesenchymal stem cell therapy,nanomaterial applications,and immunomodulatory inter-ventions.The review aims to provide researchers with new ideas and directions for the prevention and treatment of AAA.

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The regulatory effects of coenzyme Q10 on blood lipid levels and intestinal flora abun-dance in atherosclerotic rats

Yutao WANG ; Like YANG ; Huayu WANG ; Ming LIU

Chinese Journal of Arteriosclerosis.2025;33(7):602-608. doi:10.20039/j.cnki.1007-3949.2025.07.007

Aim To investigate the regulatory effects of coenzyme Q10(CoQ10)on blood lipid level and intesti-nal flora abundance in atherosclerotic(As)rats.Methods 24 rats were randomly divided into control group,As group and CoQ10 intervention group.Rats in the As group and CoQ10 intervention group were fed with high-fat chow for 2 weeks,combined with abdominal aortic balloon injury to replicate the As model.CoQ10 was administered by gavage start-ing on the next day of modeling,once daily for 4 weeks.Aortic Movat's staining and lipid levels were used to verify the effect of CoQ10 intervention in As,and the abundance of intestinal flora in intestinal contents was analyzed using met-agenomics.Results Compared with the control group,rat aortic tissues in the As group showed endothelial damage,structural disorganization of the internal elastic plate and inflammatory infiltration,serum triglyceride(TG),total cholester-ol(TC)and low density lipoprotein cholesterol(LDLC)levels were increased,and high density lipoprotein cholesterol(HDLC)levels were decreased.Compared with the As group,the structure of the endothelial cells of the aorta and the structure of the endothelial cells,the internal elastic plates and the smooth muscle cell morphology were relatively regular,serum TC,TG and LDLC levels were decreased,and HDLC levels were increased in the CoQ10 intervention group.Com-pared with the control group,the intestinal bacterial biodiversity in the As group was reduced.At the phylum level,the abundance of the Firmicutes and the Bacteroidetes were down-regulated,whereas that of Proteobacteria was up-regulated.At the genus level,the relative abundance of Lactobacillus,Bacteroides,Akkermansia,Limosilactobacillus,Parabacteroides and Ligilactobacillus was down-regulated,and the relative abundance of Muribaculum was up-regulated.Compared with the As group,CoQ10 intervention restored the biodiversity of the intestinal microbiota in As rats and increased the relative abundance of Firmicutes,Bacteroidetes,Lactobacillus,Bacteroides,Akkermansia,Limosilactobacillus,Parabacteroides and Ligilactobacillus,while reducing the relative abundance of Proteobacteria and Muribaculum(all P＜0.05).Conclusion CoQ10 can regulate blood lipid levels in As rats,upregulate the abundance of beneficial microbiota,downregulate the abun-dance of harmful microbiota,and modulate the diversity of the gut microbiota.

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The efficacy and safety of simple drug-coated balloon in the treatment of pseudo-left main bifurcation lesions of coronary arteries

Yunzhe DENG ; Wanjie ZHU ; Daguo WAN ; Juan ZHANG

Chinese Journal of Arteriosclerosis.2025;33(7):609-617. doi:10.20039/j.cnki.1007-3949.2025.07.008

Aim To explore the safety and efficacy of simple drug-coated balloon(DCB)compared with provi-sional stenting(PS)in the treatment of pseudo-left main(pseudo-LM)bifurcation lesions.Methods A retrospective analysis was performed on 175 patients who underwent coronary angiography for pseudo-LM bifurcation lesions and interven-tional treatment at the Second Affiliated Hospital of Zhengzhou University from January 2018 to January 2023.According to the treatment strategy,they were divided into drug-eluting stent(DES)group(99 cases)and DCB group(76 cases).Preoperative and immediate postoperative quantitative coronary angiography(QCA)data were recorded,and patients were followed up.The follow-up endpoints included the occurrence of major adverse cardiovascular events(MACE)and hospi-tal re-admission.Coronary angiography and QCA data during follow-up were also recorded.Results The immediate postoperative minimum lumen diameter and lumen gain in the left main(LM),left anterior descending(LAD),and left circumflex(LCX)arteries of the DCB group were smaller than those of the DES group(P＜0.05),while the degree of re-sidual lumen stenosis immediately after surgery was greater than that of the DES group(P＜0.05).QCA was performed on the coronary angiography results of follow-up patients.The minimum lumen diameter in LM,LAD,and LCX was smaller in the DCB group than in the DES group during follow-up(P＜0.05).The degree of residual lumen stenosis dur-ing follow-up was greater in the DCB group than in the DES group(P＜0.05),but the late lumen loss in LM,LAD,and LCX was smaller in the DCB group than that in the DES group,with statistically significant differences(P＜0.05).There was no significant difference in the incidence of postoperative MACE between the two groups during the follow-up period(P＞0.05).Cox regression analysis showed that the choice of interventional treatment(DCB vs.PS)had no significant impact on the risk of MACE(P＞0.05).Conclusion Compared with PS,DCB alone demonstrates relatively satisfac-tory efficacy and safety in the treatment of pseudo-LM bifurcation lesions and can be considered as an alternative treatment strategy for interventional therapy of such lesions.

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