Endothelial dysfunction and carotid atherosclerosis in Malawian adults: A cross-sectional study

Background and objective

In sub-Saharan Africa, data on prevalence, risk factors and pathobiology of carotid atherosclerosis are scarce. We aimed to investigate the relationship between biomarkers of endothelial dysfunction and carotid atherosclerosis.

Methods

Carotid ultrasound was performed in 66 patients. Plasma concentration of ICAM-1, PAI-1, VEGF, and soluble thrombomodulin were measured by ELISA. A univariable logistic regression analysis was performed to study the relationship between carotid atherosclerosis, biomarkers of endothelial dysfunction, and various demographic and clinical parameters of the participants.

Results

The mean age of the participants was 58.7 years (95% CI: 54.4–63.1). Carotid atherosclerosis was diagnosed in 39.4% (95% CI: 27.6–52.2). In the univariable logistic regression, the following factors were associated with carotid atherosclerosis: age > 45 years (OR = 12.0, 95% CI: 1.4–98.8, p = .02), hypertension (OR = 3.8, 95% CI: 1.2–12.1, p = .02), and high-level of soluble thrombomodulin (OR = 3.4, 95% CI: 1.2–10.0, p = .02).

Conclusions

There is an association between high levels of soluble thrombomodulin and carotid atherosclerosis in Malawian adults. Further studies with a larger sample size are needed to confirm our findings in other African populations.