Search Results (242)

Background: Metabolic syndrome (MetS) refers to the coexistence of cardiometabolic disorders, such as hyperglycemia, elevated blood pressure, visceral obesity, or features of atherogenic dyslipidemia. A diagnosis of MetS significantly increases the risk of cardiovascular disease (CVD). However, the exact relationship between the number of MetS components, regardless of their constellation, and features of subclinical cardiovascular dysfunction remains unclear. This study aimed to explore the relationship between the number of MetS components and features of subclinical atherosclerosis and arterial stiffness (AS) in patients without clinically overt CVD. Methods: This retrospective study included 100 patients (mean age: 58.8 ± 16.81 years), without signs of acute illness or diagnosed atherosclerotic CVD, who were admitted to a clinic for scheduled internal medicine diagnostics. Participants were assessed for MetS components and underwent cardiovascular tests, including Doppler ultrasonography of the carotid, vertebral, and lower limb arteries; measurement of intima–media thickness (IMT) in the carotid (cIMT), common femoral (cfIMT), and superficial femoral (sfIMT) arteries; and assessment of AS using carotid–femoral pulse wave velocity (cfPWV) and pulse wave analysis (PWA). Results: Univariate analysis revealed significant correlations between the number of MetS components and IMT in all vascular beds: cIMT (R = 0.371; p < 0.001), cfIMT (R = 0.343; p < 0.001), and sfIMT (R = 0.516; p < 0.001). Significant correlations were also found for several AS and PWA parameters: cfPWV (R = 0.398; p < 0.001), central pulse pressure (cPP) (R = 0.223; p < 0.026), and end-systolic pressure (ESP) (R = 0.241; p = 0.016). Meanwhile, in the multivariable analysis adjusted for sex, age, and body mass index (BMI), only the association between the subendocardial viability ratio (SEVR) and the number of MetS components was significant (β = 0.33; 95% CI 0.084–0.577; p = 0.009); however, this association does not remain significant after Benjamini–Hochberg correction (p = 0.108). Conclusions: Although the number of MetS components correlated significantly with several parameters of subclinical atherosclerosis and AS, most associations were explained by confounding variables. These results do not support the use of a simple count of MetS components as an indicator of subclinical cardiovascular dysfunction related to atherosclerosis and AS. Full article

Background/Objectives: Carotid intima–media thickness (CIMT) is widely recognized as an established biomarker of systemic atherosclerosis and coronary artery disease (CAD). Nevertheless, the connection between circulating miR-29 family members, CIMT and CAD severity has not yet been determined. The aim of this study was to investigate the association of plasma miR-29a and miR-29c with CIMT and CAD severity. Methods: A total of 628 patients scheduled for elective coronary angiography were included in the study. CAD severity was estimated using the Gensini scoring system and was classified into mild, moderate, and severe categories. Additionally, CIMT was evaluated using high-resolution B-mode ultrasonography, while plasma miR-29a and miR-29c levels were detected using qRT-PCR. Results: CIMT increased significantly with CAD severity (0.76 ± 0.15, 0.94 ± 0.18, and 1.12 ± 0.22 mm for mild, moderate, and severe CAD, respectively; p < 0.001). MiR-29a expression progressively increased, whereas miR-29c expression decreased with advancing CAD (both p < 0.001). MiR-29a correlated positively with CIMT (r = 0.612) and Gensini score (r = 0.658), while miR-29c showed negative correlations (r = −0.527 and −0.584, respectively; all p < 0.001). CIMT, miR-29a, and miR-29c were found to be independently associated with CAD severity. Their combined model demonstrated a powerful association with severe CAD (AUC = 0.927; sensitivity 88.6%; specificity 84.1%). Conclusions: Plasma miR-29a and miR-29c are independent biomarkers of CIMT and CAD severity. Their combination with CIMT can improve diagnosis of severe CAD and may enhance cardiovascular risk stratification. Full article

Obstructive sleep apnea syndrome (OSAS) is heavily implicated in subclinical cardiovascular disease; however, traditional polysomnographic metrics fail to capture the localized mechanical trauma exerted on the carotid artery. To address this methodological gap, this study evaluated exploratory associations between frequency-domain snoring characteristics and right carotid artery alterations in 50 patients with OSAS. Snoring was quantified using a dual-modality bioelectronic approach: an ambient microphone captured airborne snoring sound energy (SSE), while a portable neck-surface piezoelectric sensor recorded tissue-conducted snoring vibratory energy (SVE). Subclinical vascular changes, including carotid intima-media thickness (CIMT) and atherosclerosis, were assessed via ultrasonography. Hierarchical multivariable regression demonstrated that acoustic SSE%-404–500 Hz and mechanical SVE%-112–144 Hz independently correlated with preliminary CIMT increases (adjusted β = 0.033 and 0.021, respectively; both p < 0.05), alongside neck circumference. Conversely, SSE%-404–500 Hz emerged as an exploratory marker for focal carotid atherosclerosis (adjusted odds ratio = 1.828; p = 0.009). Integrating this metric with baseline parameters yielded exploratory diagnostic capacity (area under the curve = 0.833; p < 0.001), achieving 89% sensitivity and 69% specificity. These findings suggest that dual-modality spectral analysis provides a non-invasive exploratory framework for cardiovascular risk stratification, isolating localized mechanotransduction phenotypes independently of systemic hypoxia. Full article

Congenital hypothyroidism (CH) is a common endocrine disorder characterized by thyroid hormone deficiency and has dramatic consequences if diagnosis and treatment are delayed. Although neonatal screening (NNS) and early levothyroxine (L-T4) treatment have markedly improved neurodevelopmental outcomes, evidence suggests that cardiovascular alterations may persist into later life. Thyroid hormones regulate lipid metabolism, endothelial nitric oxide (NO) availability, myocardial relaxation, vascular tone and arterial wall homeostasis. Early clinical studies in patients with CH reported variable lipid and lipoprotein abnormalities, whereas more recent studies have demonstrated endothelial dysfunction, increased arterial stiffness, and elevated carotid intima–media thickness (IMT), even in the absence of classical cardiovascular risk factors. These alterations appear to be associated with cumulative exposure to thyroid-stimulating hormone (TSH) abnormalities rather than isolated biochemical measurements. These findings suggest that CH may affect cardiovascular biology through multiple pathways, including dyslipidemia, endothelial dysfunction, vascular remodeling, and cumulative exposure to thyroid-stimulating hormone abnormalities. This review summarizes the available evidence linking congenital hypothyroidism to early vascular and atherosclerotic changes and discusses its conceptual relationship to familial hypercholesterolemia as another model of early-life cumulative cardiovascular risk. Full article

Background and Objectives: Despite the presence of atherosclerosis risk factors and symptoms associated with occlusive atherosclerotic cardiovascular disease (ASCVD), up to 30% of individuals do not present significant atherosclerotic lesions at the point of diagnostic evaluation. Those in whom ASCVD was ruled out once might be believed to be at low risk of future major cerebral and cardiac events (MACCEs). Despite this, they might still have some residual risk for MACCEs. Therefore, in the present study we aimed to evaluate risk factors for atherosclerosis progression to the stage of occlusive arterial disease in patients with cardiovascular risk factors but initially free from significant ASCVD. Materials and Methods: Between March 2012 and February 2014, a total of 686 consecutive patients presenting with clinical suspicion of significant coronary artery disease were evaluated. The actual status of atherosclerosis burden was verified in four major arterial territories (coronary, carotid, renal, lower limb arteries) with the use of angiography, computed tomography and ultrasonography. For the present study purpose, 188 (27.4%) patients were enrolled, in whom significant ASCVD (in any of the examined territories) was ruled out. In all patients, the incidence and severity of atherosclerotic risk factors, carotid intima–media complex thickness (CIMT) and carotid plaque presence were evaluated during first hospital admission. A ten-year follow-up period for a composite endpoint of MACCEs was included. Univariate and multivariate Cox proportional hazard analyses with the Simon–Makuch method for new-onset type 2 diabetes mellitus (T2DM) were performed for MACCEs. Results: MACCEs occurred in 30 (16%) of 188 patients, including 5 cardiovascular deaths, 19 non-fatal myocardial infarctions, and 6 non-fatal ischemic strokes, in a median of 48 (Q1; Q3: 25; 86) months. Univariate Cox proportional hazard analysis revealed that individuals who presented with baseline LDL cholesterol > 3.2 mmol/L, CIMT > 1 mm, carotid plaque, or experienced new-onset T2DM were predisposed to MACCE with hazard ratios (HRs) of 3.21 (p = 0.003), 3.82 (p = 0.001), 5.41 (p < 0.001), and 36.89 (p < 0.001), respectively. In multivariate Cox analysis, its associations with MACCEs were retained (HRs between 2.19 and 21.47), respectively. Conclusions: Our findings support the need for continued risk factor optimization despite the initial exclusion of obstructive ASCVD. In this study, we identified new-onset T2DM, initial LDL cholesterol, and the presence of subclinical atherosclerosis as risk factors for MACCEs. Full article

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants increasingly associated with cardiovascular disease. Identifying early manifestations of vascular aging before the onset of overt disease is essential for improving cardiovascular risk stratification and prevention. Emerging evidence suggests that PFAS exposure contributes to early vascular and atherosclerotic alterations detectable by imaging techniques, including increased carotid intima–media thickness (CIMT), arterial stiffness, and endothelial dysfunction. In contrast, evidence for associations with coronary artery calcium progression and coronary stenosis remains scarce. Mechanistically, PFAS exposure promotes endothelial dysfunction, oxidative stress, chronic inflammation, lipid dysregulation, and genetic and epigenetic modifications, all of which contribute to premature vascular aging and metabolic disturbances. The integration of imaging and molecular biomarkers may provide complementary insights into the structural, functional, and biological processes underlying PFAS-related vascular damage; however, to date, this field remains largely unexplored. This narrative review summarizes current evidence on imaging and molecular biomarkers of PFAS-induced vascular aging and discusses their potential role in cardiovascular risk assessment. It also highlights key knowledge gaps and the need for robust epidemiological and multi-omics studies to validate these biomarkers, clarify causal mechanisms, and support their application in cardiovascular and environmental health surveillance. Full article

Background: Recent research has drawn attention to potential systemic inflammation in patients with inherited epidermal differentiation disorders (EDD)—rare genetic skin conditions that may contribute to vascular dysfunction. Objective: This study assessed selected vascular, inflammatory, and biochemical parameters in 20 patients with selected EDD and 20 matched healthy controls. Methods: Assessments included Doppler ultrasound, ankle-brachial index, intima-media thickness (IMT), and laboratory profiling focused on lipid metabolism and systemic inflammation. Results: EDD patients showed significantly lower LDL cholesterol and higher interleukin-17A (IL-17A) than controls. IMT values were similar across groups and disease types, but correlated positively with age, body weight, waist circumference, triglycerides, and glucose, and negatively with reactive lymphocytes. No link was found between IMT and self-reported cardiovascular symptoms. Conclusions: In patients with selected EDD, we observed a distinct biochemical profile characterized by lower LDL cholesterol and higher IL-17A concentrations, without accompanying structural arterial changes—carotid IMT and ABI did not differ from controls and remained stable at short-term follow-up. These alterations may reflect disease-specific disturbances of lipid and inflammatory homeostasis rather than classical atherosclerosis. Although they could be of theoretical relevance to long-term vascular health, no structural arterial abnormality was demonstrated. Longitudinal studies incorporating endothelial function testing are needed to clarify their significance. Full article

Background/Objectives: Long COVID-19 (LC) has been associated with persistent inflammation and impaired vascular health. Dietary minerals are involved in oxidative stress, endothelial homeostasis, and arterial stiffness; however, their relationship with vascular health in LC remains poorly explored. This study aimed to examine the association between energy-adjusted dietary mineral intake and markers of vascular stiffness and vascular aging in adults with LC, while exploring potential sex-specific patterns. Methods: A total of 304 adults with LC from the BioICOPER study were included. Dietary mineral intake was assessed using a validated 7-day dietary record from the EVIDENT tool and expressed as mineral density per 1000 kcal for the regression analyses. Vascular assessment included carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), brachial-ankle pulse wave velocity (baPWV), and the vascular aging index (VAI). Hierarchical multivariable linear regression models, false discovery rate (FDR) correction, restricted cubic spline analyses, sensitivity analyses excluding supplement users, and formal sex × mineral interaction tests were performed. Results: In descriptive adequacy analyses, adequate iron intake was associated with lower baPWV. In energy-adjusted linear regression models, no mineral-outcome association remained statistically significant after FDR correction. In the fully adjusted sensitivity model, zinc density showed a nominal positive association with cfPWV, but this association did not survive FDR correction. Restricted cubic spline analyses suggested possible non-linear associations of magnesium and potassium density with cfPWV and VAI. Formal interaction analyses did not provide robust evidence of sex-related effect modification. Conclusions: After energy adjustment and correction for multiple testing, the evidence for independent linear associations between dietary mineral density and vascular outcomes in adults with LC was limited. These exploratory findings suggest that mineral intake, dietary sources, and non-linear patterns deserve further evaluation in prospective studies and nutritional intervention trials. Full article

Background: Long COVID (LC) has been associated with persistent endothelial dysfunction and vascular impairment. Although nutrition is a key modifiable determinant of cardiovascular health, the relationship between dietary macronutrient intake and vascular alterations in LC remains poorly understood. Objective: To evaluate the association between dietary macronutrient intake and markers of vascular structure, arterial stiffness, and vascular aging in patients with LC, including potential sex differences. Methods: We conducted a cross-sectional study including 304 patients with LC. Dietary intake was assessed using a validated 7-day dietary record (EVIDENT study). Vascular evaluation included carotid intima–media thickness (cIMT), carotid–femoral pulse wave velocity (cfPWV), brachial–ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI), augmentation index adjusted to a heart rate of 75 beats per minute (AIx@75), and vascular aging index (VAI), measured using carotid ultrasound and validated devices (SphygmoCor^® and VaSera^®). Results: The mean age was 53 ± 12, higher in men (p = 0.001). The study included 207 women (68%) and 97 men (32%). Energy intake and carbohydrate intake in g/day showed a negative association with cfPWV in Model 2 (energy intake: β = −0.06; 95% CI: −0.11 to −0.01; p = 0.02; carbohydrate intake: β = −0.47; 95% CI: −0.87 to −0.07; p = 0.02). The percentage of carbohydrate/total energy intake was positively associated with AIx@75 in Model 2 (β = 0.8; 95% CI 0.12 to 1.49; p = 0.02), and percentage of fat/total energy intake showed a consistent inverse association (β = −0.30; 95% CI: −0.49 to −0.11; p = 0.002). No significant associations were observed for cIMT, baPWV, CAVI or VAI. Conclusions: In patients with LC, total energy intake and absolute carbohydrate intake were negatively associated with cfPWV, whereas the relative contribution of carbohydrates and fats to total energy intake showed divergent associations with AIx@75. These findings suggest that both absolute macronutrient intake and relative macronutrient distribution may be related to central arterial stiffness and wave reflection parameters LC. However, given the cross-sectional design of the study, these results should be interpreted as exploratory and do not allow causal inference. Further longitudinal and interventional studies are needed to confirm these findings and to assess whether nutritional strategies may contribute to modulating vascular risk in this population. Full article

Background/Objectives: Rheumatoid arthritis (RA) has been associated with accelerated atherosclerosis and cerebrovascular alterations. Our 2017 study compared 60 RA patients to healthy controls, assessing vascular, neurological, and cognitive parameters. The present study is a follow-up of these RA patients to evaluate disease progression and vascular changes over time, using their 2017 results as baseline. Methods: In 2023, we reassessed 43 of the original 60 RA patients using laboratory testing, carotid ultrasound, functional transcranial Doppler (TCD) and brain magnetic resonance imaging (MRI) examinations. Changes over time were analyzed within the same individuals. Results: Inflammatory markers and lipid profiles showed a trend toward improvement, though changes were not statistically significant, except for a significant increase in vitamin D (p < 0.001) and a decrease in Disease Activity Score in 28 Joints (DAS28) scores (p < 0.001). Carotid ultrasound revealed a significant increase in plaque burden (p = 0.022 on the right side and p = 0.008 on the left), while carotid intima media thickness (cIMT) showed a non-significant rise. TCD measurements indicated significantly increased pulsatility (p < 0.001 on the right, p = 0.001 on the left side) and resistance (p = 0.001 on the right, p = 0.012 on the left side) indices and reduced flow velocities (p < 0.001 on the right and p = 0.001 on the left side) in bilateral middle cerebral arteries (MCAs). The cerebrovascular reserve capacity was significantly lower on the right side overall (p = 0.013), with further decline noted in the methotrexate (MTX)-treated subgroup on the left side (p = 0.043). MRI findings showed non-significant numerical trends toward worsening lacunar small-vessel disease (p = 0.405) and cerebral atrophy (p = 0.063), with higher but stable lacunar infarction scores among MTX users (p = 0.023). Conclusions: Despite improved inflammatory control, RA patients demonstrated progressive vascular and hemodynamic alterations over time, while MRI changes should be interpreted as trends. These findings support multimodal vascular monitoring in RA. Full article

Background: Cardiovascular disease (CVD) is the leading cause of global mortality, necessitating its early detection. Carotid intima-media thickness (CIMT) is a validated biomarker of CVD. In Saudi Arabia (SA), population-specific CIMT data for young adults are lacking. This pilot study aimed to generate single-institution preliminary CIMT data using the Butterfly iQ+ handheld ultrasound device (HHUD) and identify CVD risks. Methods: A cross-sectional observational study was conducted on 63 medical students. CIMT was measured bilaterally on common carotid artery (CCA), using the Butterfly iQ+ HHUD. Data on sex, age, ethnicity, BMI, mean arterial pressure (MAP), family history, and dietary habits were collected and analysed using t-tests, one-way ANOVA, Chi-square tests, Spearman’s rho (ρ) correlation, and stepwise multiple linear regression. Results: Mean age was 19.19 ± 1.89 years, and mean BMI was 24.93 ± 4.72 kg/m². Mean CIMT was 0.053 ± 0.006 cm. Males demonstrated thicker right CIMT (0.055 cm; 95% CI: 0.053–0.058 cm) than females (0.051 cm; 95% CI: 0.048–0.053 cm; mean difference: 0.005 cm, 95% CI: 0.001–0.008 cm; p = 0.012) and higher mean CIMT (0.0548 vs. 0.0513 cm; mean difference: 0.004 cm, 95% CI: 0.000–0.007 cm; p = 0.031). Height (ρ = 0.266; p = 0.035) and weight (ρ = 0.320; p = 0.011) correlated with right CIMT. Stepwise regression identified sex as the sole independent predictor (R² = 0.105; F = 6.541; p = 0.013). Conclusions: This pilot study establishes preliminary single-institution CIMT data for young healthy medical students at a single university in Riyadh, Saudi Arabia. Sex, height, and body weight are key early determinants of carotid wall thickness. The Butterfly iQ+ HHUD is a feasible point-of-care tool for CIMT measurement, supporting community-based CVD screening in the region. Full article

Background: Carotid atherosclerosis is a recognised manifestation of systemic vascular disease, and its association with coronary artery disease (CAD) has been well described. However, previous studies have largely been conducted under conventional diagnostic conditions and have focused on carotid plaque, intima–media thickness, or simple present-versus-absent stenosis classifications, rather than duplex-derived haemodynamic markers across the spectrum of angiographic CAD burden. The COVID-19 pandemic and post-pandemic period changed referral patterns and created more variable cardiovascular presentations, including symptoms that could resemble or mask obstructive CAD. Therefore, we investigated whether the established association between carotid stenosis severity and CAD burden remains detectable in a diagnostically heterogeneous real-world cohort, and whether routinely available carotid duplex haemodynamic parameters provide a clinically relevant signal in this setting. Methods: This single-centre, cross-sectional study was performed as a carotid-focused secondary analysis of the BG Study cohort. We included 902 consecutive patients who underwent invasive coronary angiography between 2021 and 2023 and carotid duplex ultrasonography during the same hospitalisation. CAD burden was defined according to the number of major coronary vessels with ≥70% diameter stenosis and classified as no CAD, one-vessel, two-vessel, or three-vessel disease. Carotid duplex parameters included peak systolic velocities of the common, internal, and external carotid arteries, as well as ICA stenosis severity graded according to NASCET criteria. Associations with CAD burden were assessed using a staged statistical approach combining χ² tests, Kruskal–Wallis tests with post hoc pairwise comparisons, Spearman correlation, inverse probability weighting, and ordered logistic regression. Results: The prevalence of measured ICA stenosis of any grade and severe ICA stenosis increased with greater CAD burden (both p < 0.001). Median PSV values of the bilateral ICAs and ECAs differed significantly across CAD groups on global intergroup testing. Post hoc pairwise analyses showed that significant corrected differences were concentrated between patients without CAD and those with multivessel or three-vessel CAD, particularly for ICA stenosis measures and bilateral ECA PSV. Spearman analysis demonstrated weak but statistically significant correlations between carotid parameters and CAD burden (ρ = 0.085–0.134). After inverse probability weighting, covariate balance was achieved, with all post-IPW standardised mean differences being <0.01. In ordered logistic regression (OLR) analysis, patient-reported history of carotid stenosis (OR 2.25, 95% CI 1.38–3.67; p < 0.001), right external carotid artery PSV per 10 cm/s (OR 1.31, 95% CI 1.09–1.57; p = 0.004), left ICA PSV per 10 cm/s (OR 1.17, 95% CI 1.01–1.36; p = 0.034), and left ICA stenosis per 10% (OR 1.24, 95% CI 1.11–1.39; p < 0.001) were independently associated with higher CAD burden. Exploratory ratio-based analyses showed that the ECA/CCA PSV ratio was associated with CAD presence and higher CAD burden, whereas the ICA/CCA ratio showed weaker associations; neither ratio-based index outperformed absolute ECA PSV. Conclusions: In this carotid-focused secondary analysis of a pandemic-era angiography cohort, carotid stenosis severity and duplex-derived haemodynamic parameters were independently but modestly associated with increasing angiographic CAD burden. These findings support carotid duplex markers as adjunctive indicators of systemic atherosclerotic burden rather than standalone tools for CAD detection or treatment decision-making. Future validation in vascular surgery populations is warranted to determine whether routinely available carotid duplex parameters can contribute to targeted cardiovascular risk recognition before major vascular procedures. Full article

Background/Objectives: Atherosclerosis is a multifaceted inflammatory condition closely linked to immunonutritional status. The C-reactive protein–albumin–lymphocyte (CALLY) index is a composite marker of immunonutrition. We assessed the relationship between this index, age, and carotid stenosis in individuals undergoing carotid Doppler ultrasonography. Methods: Individuals who underwent routine carotid Doppler ultrasonography were retrospectively analyzed. Carotid stenosis was categorized by severity, and bilateral intima–media thickness was recorded. The composite index integrating C-reactive protein, albumin, and lymphocyte parameters was derived from laboratory parameters. Traditional cardiovascular risk factors, including hypertension, diabetes mellitus, hyperlipidemia, and smoking status, were also recorded and incorporated into multivariable analyses. Sex-related differences were additionally evaluated using sex-stratified correlation analyses. Results: Among 1516 patients, 895 (59.1%) were younger than 65 years and 621 (40.9%) were aged 65 years and above. Carotid artery stenosis and intima–media thickness were significantly higher in individuals aged 65 years and above. The mean index value was significantly lower in the older group (4.0 versus 8.3; p < 0.001). Hypertension, diabetes mellitus, and hyperlipidemia were significantly more prevalent in patients with carotid stenosis (p < 0.001 for all), whereas smoking was not associated (p > 0.05). Male sex was independently associated with carotid stenosis, and sex-stratified analyses demonstrated similar inverse associations between age and CALLY index values in both sexes. In multivariable analysis, lower index values were independently associated with carotid stenosis and carotid intima–media thickness in both age groups. In the overall cohort, the index demonstrated moderate discriminatory performance (area under the curve = 0.724). Similar moderate performance was observed in the <65 (AUC = 0.681) and ≥65 (AUC = 0.685) subgroups. Conclusions: The CALLY index was independently associated with carotid stenosis and CIMT after adjustment for traditional cardiovascular risk factors. Although effect sizes were comparable between age groups, CALLY index levels were lower in older individuals. These findings suggest that the CALLY index may provide complementary information in the assessment of carotid atherosclerosis, particularly in elderly populations. However, given the retrospective cross-sectional design and moderate discriminatory performance, it should not be interpreted as a standalone, causal, or disease-specific marker. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a systemic disorder linked to cardio-kidney–metabolic (CKM) syndrome, early vascular injury and redox imbalance. Inflammatory adipokines such as retinol-binding protein 4 (RBP4) and lipocalin-2 (LCN2) may contribute to this hepatic–vascular interplay by integrating metabolic inflammation, oxidative stress and endothelial dysfunction. Therefore, the present study aimed to investigate the contribution of the inflammatory adipokines retinol-binding protein 4 (RBP4) and lipocalin-2 (LCN2) to the hepatic–vascular interplay in MASLD within the cardio-kidney–metabolic (CKM) syndrome. Materials and Methods: We performed a systematic review and meta-analysis of studies evaluating circulating RBP4 and LCN2 levels in MASLD. PubMed, Scopus, and Web of Science were searched. Twenty studies were included in the qualitative synthesis, and ten in the quantitative meta-analysis. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Vascular findings were synthesized narratively because of heterogeneity in outcomes. Results: Circulating RBP4 levels were significantly higher in MASLD patients than in controls (SMD = 0.64, 95% CI: 0.08 to 1.20, p = 0.026; I² = 91.2%). LCN2 levels were also significantly elevated (SMD = 1.92, 95% CI: 0.83 to 3.00, p < 0.001; I² = 98.0%). Compared with RBP4, LCN2 showed a larger pooled effect size, although heterogeneity remained very high. In the qualitative synthesis, adipokines, particularly LCN2, were associated with markers of vascular injury, including carotid intima–media thickness, plaque burden, arterial stiffness, endothelial dysfunction, coronary severity, and cardiovascular events. Conclusions: Both RBP4 and LCN2 were elevated in MASLD, supporting a link between adipokine dysregulation and hepatic metabolic dysfunction within the broader cardio-kidney–metabolic (CKM) syndrome. LCN2 appeared to better reflect the inflammatory, metabolic, and vascular burden of disease. These findings support the view of MASLD as a systemic disorder within the CKM syndrome and highlight the potential of inflammatory adipokines as non-invasive biomarkers of integrated hepatic, metabolic, and vascular dysfunction. Full article

Background: Atherosclerosis is a degenerative-proliferative disease that leads to lesions primarily in the tunica intima and media of the arteries. Atherosclerotic plaques undergo progressive calcification, and the hydroxyapatite deposited within them absorbs X-rays. The coronary artery calcification score (CAC-score) can be assessed using computed tomography. Intima–media thickness (IMT) and endothelial function, evaluated by flow-mediated dilatation (FMD) of the brachial artery, can be measured using ultrasound. This study aimed to assess the relationship between CAC-score, atherosclerosis risk factors, IMT, and FMD in women, with particular emphasis on the comparison of IMT measurement sites. Methods: The study included 124 women divided into three groups based on CAC-score. The following parameters were evaluated: risk factors for coronary artery disease (CAD), FMD, and IMT. CAD risk factors included age, BMI, smoking status, hypertension, diabetes, and lipid disorders, which were obtained from medical history. Results: A significant positive correlation was observed between CAC-score and IMT of the common carotid artery in women. IMT measured at the carotid bifurcation showed the strongest correlation with CAC-score. No correlation was found between CAC-score and endothelial dysfunction assessed by FMD. Conclusions: IMT, particularly when measured at the carotid bifurcation, was associated with CAC-score in women without diagnosed CAD, whereas no association was observed between FMD and CAC-score in this population. Full article