Healthy Clinical Trial
Official title:
Brasília Study on Healthy Aging
BSHA is a cohort study of healthy elderlies enrolled voluntarily. It has been ongoing since December 2008. And the purpose of this study is to assess clinical and biological markers of cardiovascular risk in very elderly participants.
Non-institutionalized outpatients under preventive care were voluntarily enrolled into the
study. Participants were aged of 80 years or over, have never manifested myocardial
infarction, stroke or peripheral arterial disease. Enrolled participants underwent a detailed
clinical examination, including assessment of anthropometric measures, quality of life by the
WHOQOL-BREF, psychological test by Geriatric Depression Scale (GDS) and cognitive function by
the mini-mental state examination (MMSE). After 12h of overnight fasting, the study
participants underwent to blood sampling collection for biochemical analysis and freezing of
plasma, serum and DNA. Immediately after blood collection, participants underwent to
cardiovascular ultrasound evaluations and computed tomography (CT) scans during the week
following the initial assessment. After baseline measurements, all participants were referred
to the study as outpatient clinic for prospective medical follow-up evaluations.
Anthropometric measures: body weight, height, waist circumference and skinfold thickness
(triceps, biceps, suprailiac and subscapular) were measured. Body mass index (BMI) was
calculated. Skinfold thickness was the mean of triplicate measurements at the right side,
using a skinfold caliper (WCS Plus®, Cardiomed, Curitiba, Brazil).
Biochemical analysis: After collection, EDTA blood was centrifuged at 5 ◦ C, 4500 rpm for
15min to separate plasma and carrying out the following measurements: glucose (Glucose
GOD-PAP, Roche Diagnostics, Mannheim, USA), total cholesterol (CHOD-PAP, Roche Diagnostics,
Mannheim, USA), triglycerides (GPO-PAP, Roche Diagnostics, Mannheim, USA), HDL-C (HDL
cholesterol without pretreatment, Roche Diagnostics, Mannheim, USA), C-reactive protein
(highly sensitive, CardioPhase, Dade Behring, Marburg, USA), urea and creatinine (GLDH,
Hitachi, Tokyo, Japan), fibrinogen (Sysmex CA 1500, Siemens, Munich, Germany), interleukin
(IL) 10 and tumor necrosis factor type alpha (TNF-alpha) (eBioscience, San Diego, CA, USA).
Parathyroid hormone (PTH) and calcitonin (Immulite 2000, Siemens, Los Angeles, CA, USA), bone
fraction of alkaline phosphatase (Hitachi Autoanalyzer, Tokyo Japan), calcium (Hitachi
Autoanalyzer, Tokyo, Japan), apoA and apoB (Behring Nephelometer BNII, Dade Behring, Marburg,
Germany) were also measured.
Carotid ultrasound: The evaluation of intima-media thickness (IMT) and presence of carotid
plaques were assessed using high-resolution B-mode ultrasound (Philips, model IE 33, 3-9 MHz
linear transducer, Philips Medical Systems, Andover, MA, USA) according to the protocols of
the American Association of Echocardiography. Bilateral measurements were made at the
posterior wall of the bulb of the common carotid artery and at the internal carotid artery
through a program of automatic edge detection (QLAB version 6.0 software). Carotid plaque was
defined as the presence of focal thickening of at least 50% higher than surrounding areas or
as focal region with IMT > 1.5 mm and distinct adjacent edges.
Cardiac computed tomography: Computed tomography was performed in a 64-slice scanner
(Aquillion 64, Toshiba, Ottawara, Japan). Axial slices of 3 mm thickness with 3 mm table-feed
were acquired at 70% of R-R interval with prospective ECG triggering. Coronary artery
calcification was defined as a minimum of 3 contiguous pixels with a peak Hounsfield unit
density > 130. Coronary artery calcifications were scored by a certified radiologist. The
Agatston score was used to express the value of CAC.
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