RESUMEN
This report compares quantitative measures of atherosclerosis in aortas and coronaries from autopsies of deceased men from Mexico City collected during 1960 to 1964 and 1986 to 1987. The comparison of lesions in two different time periods provides an opportunity for determining whether the extent of atherosclerosis has changed over time in Mexico City. Three pathologists independently evaluated the extent of fatty streaks (FS), fibrous plaques (FP), calcified plaques (CA), and complicated lesions (CO) in 165 aortas and 120 sets of coronary arteries collected during 1986 to 1987 for comparison with similar gradings of 128 aortas and coronary arteries from the International Atherosclerosis Project in 1960 to 1964. Neither FS nor more advanced lesions differed significantly in either the descending thoracic or abdominal aorta between the two collection periods. In contrast, there were more extensive FP and raised atherosclerotic lesions (RL = FP + CA + CO) in the coronary artery segments evaluated in the younger age groups in 1986 to 1987 versus 1960 to 1964. Additional analyses, based on 75 pairs of aortas and 32 pairs of coronary arteries from age-matched cases, all regraded by the team of pathologists after blind coding, showed more FS in both aortic segments and more extensive involvement with RL in the three main branches of the coronary arteries in the more recent study. An overview of our findings suggests that atherosclerosis, particularly in the coronary arteries, is increasing in Mexico City. This hypothesis merits careful testing in parallel with consideration of possible changes in the risk factors that could be responsible for changes in extent of lesions.
Asunto(s)
Arteriosclerosis/epidemiología , Adolescente , Adulto , Factores de Edad , Aorta Abdominal/patología , Aorta Torácica/patología , Arteriosclerosis/patología , Vasos Coronarios/patología , Humanos , Masculino , México , Persona de Mediana Edad , Distribución Aleatoria , Estudios RetrospectivosRESUMEN
Abdominal aortas from 78 Guatemalan men and 79 New Orleans white men were examined for lipid composition and for the extent of grossly visible atherosclerotic lesions. In the specimens examined, atherosclerotic lesions were more extensive in New Orleans than in Guatemala, confirming findings of studies performed 10 and 20 years earlier. Lipid accumulation differed greatly between the geographic locations with new Orleans specimens having more chemically determined lipids. Differences in lipid accumulation between New Orleans and Guatemala are more striking when expressed in terms of content (milligrams per 100 square centimeters than when expressed as concentration (milligrams per gram of dry defatted weight). Chemical analyses indicate that lipid accumulation in the aorta results principally from the atherosclerotic process rather than from aging. In the 15- to 24-year age group, the gross extent of fatty streaks was similar in both populations, but content and concentration of free cholesterol was significantly higher in New Orleans specimens than in Guatemalan specimens. This finding might be related to the more extensive development of raised lesions at later ages in New Orleans subjects.
Asunto(s)
Aorta Abdominal/análisis , Arteriosclerosis/patología , Lípidos/análisis , Adolescente , Adulto , Factores de Edad , Colesterol/análisis , Guatemala , Humanos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Fosfolípidos/análisis , Estados UnidosRESUMEN
Morphometric light microscope measurements were made on 154 abdominal aortas from 77 Guatemalan Indian-white (ladinos) men and from 77 new Orleans white men, aged 15 to 54 years. In each case, means were derived from 12 points measured independently. A progressive increase in intimal lipid with increasing age was observed in men from both countries. Extracellular intimal lipid was consistently higher in men from New Orleans than in those from Guatemala, although not always significantly so. Intimal thickness followed a similar pattern to intimal lipid regarding age and geographic location. Foam cells and leukocytes (mainly monocytes) did not follow a consistent pattern. The smooth muscle cell count was the only variable that was significantly greater in New Orleans men than in Guatemalans aged 15 to 34 years. Morphometric microscopic measurements were significantly correlated with unaided visual estimates of atherosclerotic lesions and with chemical determinations of lipid fractions in the arterial intima. All three methods, gross grading, microscopy, and chemistry, agree in revealing little or nor measureable difference between new Orleans men and Guatemalans younger than 35 years, but an accelerated divergence of the populations over age 35.
Asunto(s)
Aorta Abdominal/patología , Arteriosclerosis/patología , Adolescente , Adulto , Envejecimiento , Etnicidad , Espacio Extracelular/análisis , Guatemala , Humanos , Líquido Intracelular/análisis , Lípidos/análisis , Louisiana , Masculino , Persona de Mediana Edad , Músculo Liso Vascular/patologíaRESUMEN
The prevalence of adenomatous and hyperplastic polyps of the colon and the degree of involvement of the aorta by atherosclerotic lesions were evaluated in 842 autopsies from New Orleans. A positive statistical association between the two variables was found in white males under 75 years of age. In black males a positive correlation between atherosclerotic lesions and adenomatous (but not hyperplastic) polyps was found. The most extensive involvement of the aorta by atherosclerosis was found in patients in whom adenomatous and hyperplastic polyps coincided. The possibilities that dietary factors may account for these findings and its relevance in relation to colon cancer and coronary heart disease are discussed.
Asunto(s)
Neoplasias del Colon/epidemiología , Enfermedad Coronaria/epidemiología , Pólipos Intestinales/epidemiología , Adulto , Negro o Afroamericano , Anciano , Aorta Abdominal/patología , Argentina , Población Negra , Colesterol en la Dieta , Enfermedad Coronaria/complicaciones , Enfermedad Coronaria/patología , Dieta Aterogénica , Femenino , Finlandia , Humanos , Hiperplasia , Pólipos Intestinales/complicaciones , Pólipos Intestinales/patología , Louisiana , Masculino , Persona de Mediana Edad , Población BlancaRESUMEN
Based on a study of the prevalence of intestinal polyps in New Orleans and on international comparisons, the following conclusions are reached. 1) There is a close parallelism in the epidemiology of colon cancer and adenomatous polyps. Both conditions are statistically associated with respect to geography, anatomic localization, socioeconomic class, migration experience and time trends. 2) The strength of the association favors the notion of a direct, positive correlation between multiplicity, size and atypia of polyps, and cancer risk, equivalent to "dose-effect". 3) The epidemiologic findings are coherent with other biologic facts derived from clinical, morphological and experimental studies. 4) Adenomatous polyps are a good epidemiologic indicator of colon cancer risk and their presence should be helpful in advancing from studies of the epidemiology of colon cancer to the epidemiology of precursor lesions.