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Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia.

Zech LA, Hoeg JM - Lipids Health Dis (2008)

Bottom Line: The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue.This is a cross-sectional study of 17 patients homozygous for familial hypercholesterolemia presenting to the Clinical Center of the National Institutes of Health.Corneal arcus and Achilles tendon width were strongly correlated and predictive of each other.

View Article: PubMed Central - HTML - PubMed

Affiliation: Molecular Disease Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Building 10/Room 7N115, 10 Center Drive MSC 1666, Bethesda, MD 20892, USA. lzech@uiuc.edu

ABSTRACT

Background: A relationship between corneal arcus and atherosclerosis has long been suspected but is controversial. The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue. They have both advanced atherosclerosis and corneal arcus.

Methods: This is a cross-sectional study of 17 patients homozygous for familial hypercholesterolemia presenting to the Clinical Center of the National Institutes of Health. Plasma lipoproteins, circumferential extent of arcus, thoracic aorta and coronary calcific atherosclerosis score, and Achilles tendon width were measured at the National Institutes of Health.

Results: Patients with corneal arcus had higher scores for calcific atherosclerosis (mean 2865 compared to 412), cholesterol-year score (mean 11830 mg-yr/dl compared to 5707 mg-yr/dl), and Achilles tendon width (mean 2.54 cm compared to 1.41 cm) than those without. Corneal arcus and Achilles tendon width were strongly correlated and predictive of each other. Although corneal arcus was correlated with calcific atherosclerosis (r = 0.67; p = 0.004), it was not as highly correlated as was the Achilles tendon width (r = 0.855; p < 0.001).

Conclusion: Corneal arcus reflects widespread tissue lipid deposition and is correlated with both calcific atherosclerosis and xanthomatosis in these patients. Patients with more severe arcus tend to have more severe calcific atherosclerosis. Corneal arcus is not as good an indicator of calcific atherosclerosis as Achilles tendon thickness, but its presence suggests increased atherosclerosis in these hypercholesterolemic patients.

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Best fit plots for Achilles tendon width. Scatter plots with the best-fit lines for (A) log (CA+1), (B) arcus score, (C) log (CYS), and (D) age, against Achilles tendon width in 17 FH homozygotes. The hourglass shaped boundaries represent the 95% confidence intervals.
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Figure 4: Best fit plots for Achilles tendon width. Scatter plots with the best-fit lines for (A) log (CA+1), (B) arcus score, (C) log (CYS), and (D) age, against Achilles tendon width in 17 FH homozygotes. The hourglass shaped boundaries represent the 95% confidence intervals.

Mentions: Figure 3 illustrates the best-fit lines for log (CA+1), Achilles tendon width, log (CYS), and age plotted against arcus grade. It shows that arcus grade predicts Achilles tendon width best. Figure 4 shows the best-fit lines for the same regressions as in Figure 3 against Achilles tendon width. It shows that Achilles tendon width predicts log (CA+1) best. In both figures the boundaries represent the 95th confidence bands about the fitted lines.


Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia.

Zech LA, Hoeg JM - Lipids Health Dis (2008)

Best fit plots for Achilles tendon width. Scatter plots with the best-fit lines for (A) log (CA+1), (B) arcus score, (C) log (CYS), and (D) age, against Achilles tendon width in 17 FH homozygotes. The hourglass shaped boundaries represent the 95% confidence intervals.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2279133&req=5

Figure 4: Best fit plots for Achilles tendon width. Scatter plots with the best-fit lines for (A) log (CA+1), (B) arcus score, (C) log (CYS), and (D) age, against Achilles tendon width in 17 FH homozygotes. The hourglass shaped boundaries represent the 95% confidence intervals.
Mentions: Figure 3 illustrates the best-fit lines for log (CA+1), Achilles tendon width, log (CYS), and age plotted against arcus grade. It shows that arcus grade predicts Achilles tendon width best. Figure 4 shows the best-fit lines for the same regressions as in Figure 3 against Achilles tendon width. It shows that Achilles tendon width predicts log (CA+1) best. In both figures the boundaries represent the 95th confidence bands about the fitted lines.

Bottom Line: The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue.This is a cross-sectional study of 17 patients homozygous for familial hypercholesterolemia presenting to the Clinical Center of the National Institutes of Health.Corneal arcus and Achilles tendon width were strongly correlated and predictive of each other.

View Article: PubMed Central - HTML - PubMed

Affiliation: Molecular Disease Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Building 10/Room 7N115, 10 Center Drive MSC 1666, Bethesda, MD 20892, USA. lzech@uiuc.edu

ABSTRACT

Background: A relationship between corneal arcus and atherosclerosis has long been suspected but is controversial. The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue. They have both advanced atherosclerosis and corneal arcus.

Methods: This is a cross-sectional study of 17 patients homozygous for familial hypercholesterolemia presenting to the Clinical Center of the National Institutes of Health. Plasma lipoproteins, circumferential extent of arcus, thoracic aorta and coronary calcific atherosclerosis score, and Achilles tendon width were measured at the National Institutes of Health.

Results: Patients with corneal arcus had higher scores for calcific atherosclerosis (mean 2865 compared to 412), cholesterol-year score (mean 11830 mg-yr/dl compared to 5707 mg-yr/dl), and Achilles tendon width (mean 2.54 cm compared to 1.41 cm) than those without. Corneal arcus and Achilles tendon width were strongly correlated and predictive of each other. Although corneal arcus was correlated with calcific atherosclerosis (r = 0.67; p = 0.004), it was not as highly correlated as was the Achilles tendon width (r = 0.855; p < 0.001).

Conclusion: Corneal arcus reflects widespread tissue lipid deposition and is correlated with both calcific atherosclerosis and xanthomatosis in these patients. Patients with more severe arcus tend to have more severe calcific atherosclerosis. Corneal arcus is not as good an indicator of calcific atherosclerosis as Achilles tendon thickness, but its presence suggests increased atherosclerosis in these hypercholesterolemic patients.

Show MeSH
Related in: MedlinePlus