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Uemura T, Nishimoto M, Eriguchi M, Tamaki H, Tasaki H, Furuyama R, Fukata F, Kosugi T, Morimoto K, Matsui M, Samejima KI, Tsuruya K. Association of triglycerides to high-density lipoprotein cholesterol ratio with incident cardiovascular disease but not end-stage kidney disease among patients with biopsy-proven diabetic nephropathy. Hypertens Res 2023:10.1038/s41440-023-01197-y. [PMID: 36750609 DOI: 10.1038/s41440-023-01197-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023]
Abstract
Increased triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) are dyslipidemias characteristic of diabetes. Here, we aimed to examine associations of TG/HDL-C ratio with cardiovascular disease (CVD) and kidney dysfunction among patients with diabetic nephropathy. This retrospective observational study consists of patients with biopsy-proven diabetic nephropathy at Nara Medical University Hospital. Exposure of interest was TG/HDL-C ratio measured at kidney biopsy. Outcome variables were kidney histological findings, incident CVD and end-stage kidney disease (ESKD). Multivariable logistic regression models and Cox proportional hazard models were used to examined these associations. A total of 353 subjects were divided into quartiles based on TG/HDL-C ratio: Quartile 1 (reference), <1.96; Quartile 2, 1.96-3.10; Quartile 3, 3.11-4.55; and Quartile 4, ≥4.56. TG/HDL-C ratio was not a predictor of any histological findings in fully adjusted models. During median follow-up periods of 6.2 and 7.3 years, 152 and 90 subjects developed CVD and ESKD, respectively. Higher TG/HDL-C ratio was independently associated with higher incidences of CVD even after adjustments for potential confounders (hazard ratio [95% confidence interval] for Quartile 3 vs. reference; 1.73 [1.08-2.79] and Quartile 4 vs. reference; 1.86 [1.10-3.17]). Although there was a weak association between TG/HDL-C ratio and ESKD in the univariable model, the association was not significant in fully adjusted models. In conclusion, among patients with biopsy-proven diabetic nephropathy, higher TG/HDL-C ratio was independently associated with higher incidences of CVD but not with kidney outcomes, suggesting different impact of TG/HDL-C ratio on cardiorenal outcomes.
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Affiliation(s)
- Takayuki Uemura
- Department of Nephrology, Nara Medical University, Nara, Japan
| | | | | | - Hiroyuki Tamaki
- Department of Nephrology, Nara Medical University, Nara, Japan
| | - Hikari Tasaki
- Department of Nephrology, Nara Medical University, Nara, Japan
| | - Riri Furuyama
- Department of Nephrology, Nara Medical University, Nara, Japan
| | - Fumihiro Fukata
- Department of Nephrology, Nara Medical University, Nara, Japan
| | - Takaaki Kosugi
- Department of Nephrology, Nara Medical University, Nara, Japan
| | - Katsuhiko Morimoto
- Department of Nephrology, Nara Prefecture Seiwa Medical Center, Nara, Japan
| | - Masaru Matsui
- Department of Nephrology, Nara Medical University, Nara, Japan.,Department of Nephrology, Nara Prefecture General Medical Center, Nara, Japan
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Development of Machine Learning Tools for Predicting Coronary Artery Disease in the Chinese Population. DISEASE MARKERS 2022; 2022:6030254. [DOI: 10.1155/2022/6030254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/09/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022]
Abstract
Purpose. Coronary artery disease (CAD) is one of the major cardiovascular diseases and the leading cause of death globally. Blood lipid profile is associated with CAD early risk. Therefore, we aim to establish machine learning models utilizing blood lipid profile to predict CAD risk. Methods. In this study, 193 non-CAD controls and 2001 newly-diagnosed CAD patients (1647 CAD patients who received lipid-lowering therapy and 354 who did not) were recruited. Clinical data and the result of routine blood lipids tests were collected. Moreover, low-density lipoprotein cholesterol (LDL-C) subfractions (LDLC-1 to LDLC-7) were classified and quantified using the Lipoprint system. Six predictive models (k-nearest neighbor classifier (KNN), logistic regression (LR), support vector machine (SVM), decision tree (DT), multilayer perceptron (MLP), and extreme gradient boosting (XGBoost)) were established and evaluated by the confusion matrix, area under the receiver operating characteristic (ROC) curve (AUC), recall (sensitivity), accuracy, precision, and F1 score. The selected features were analyzed and ranked. Results. While predicting the CAD development risk of the CAD patients without lipid-lowering therapy in the test set, all models obtained AUC values above 0.94, and the accuracy, precision, recall, and F1 score were above 0.84, 0.85, 0.92, and 0.88, respectively. While predicting the CAD development risk of all CAD patients in the test set, all models obtained AUC values above 0.91, and the accuracy, precision, recall, and F1 score were above 0.87, 0.94, 0.87, and 0.92, respectively. Importantly, small dense LDL-C (sdLDL-C) and LDLC-4 play pivotal roles in predicting CAD risk. Conclusions. In the present study, machine learning tools combining both clinical data and blood lipid profile showed excellent overall predictive power. It suggests that machine learning tools are suitable for predicting the risk of CAD development in the near future.
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3
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Haslam DE, Chasman DI, Peloso GM, Herman MA, Dupuis J, Lichtenstein AH, Smith CE, Ridker PM, Jacques PF, Mora S, McKeown NM. Sugar-Sweetened Beverage Consumption and Plasma Lipoprotein Cholesterol, Apolipoprotein, and Lipoprotein Particle Size Concentrations in US Adults. J Nutr 2022; 152:2534-2545. [PMID: 36774119 PMCID: PMC9644170 DOI: 10.1093/jn/nxac166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/21/2022] [Accepted: 07/29/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Prospective cohort studies have found a relation between sugar-sweetened beverage (SSB) consumption (sodas and fruit drinks) and dyslipidemia. There is limited evidence linking SSB consumption to emerging features of dyslipidemia, which can be characterized by variation in lipoprotein particle size, remnant-like particle (RLP), and apolipoprotein concentrations. OBJECTIVES To examine the association between SSB consumption and plasma lipoprotein cholesterol, apolipoprotein, and lipoprotein particle size concentrations among US adults. METHODS We examined participants from the Framingham Offspring Study (FOS; 1987-1995, n = 3047) and the Women's Health Study (1992, n = 26,218). Concentrations of plasma LDL cholesterol, apolipoprotein B (apoB), HDL cholesterol, apolipoprotein A1 (apoA1), triglyceride (TG), and non-HDL cholesterol, as well as total cholesterol:HDL cholesterol ratio and apoB:apoA1 ratio, were quantified in both cohorts; concentrations of apolipoprotein E, apolipoprotein C3, RLP-TG, and RLP cholesterol (RLP-C) were measured in the FOS only. Lipoprotein particle sizes were calculated from nuclear magnetic resonance signals for lipoprotein particle subclass concentrations (TG-rich lipoprotein particles [TRL-Ps]: very large, large, medium, small, and very small; LDL particles [LDL-Ps]: large, medium, and small; HDL particles [HDL-Ps]: large, medium, and small). SSB consumption was estimated from food frequency questionnaire data. We examined the associations between SSB consumption and all lipoprotein and apoprotein measures in linear regression models, adjusting for confounding factors such as lifestyle, diet, and traditional lipoprotein risk factors. RESULTS SSB consumption was positively associated with LDL cholesterol, apoB, TG, RLP-TG, RLP-C, and non-HDL cholesterol concentrations and total cholesterol:HDL cholesterol and apoB:apoA1 ratios; and negatively associated with HDL cholesterol and apoA1 concentrations (P-trend range: <0.0001 to 0.008). After adjustment for traditional lipoprotein risk factors, SSB consumers had smaller LDL-P and HDL-P sizes; lower concentrations of large LDL-Ps and medium HDL-Ps; and higher concentrations of small LDL-Ps, small HDL-Ps, and large TRL-Ps (P-trend range: <0.0001 to 0.001). CONCLUSIONS Higher SSB consumption was associated with multiple emerging features of dyslipidemia that have been linked to higher cardiometabolic risk in US adults.
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Affiliation(s)
- Danielle E Haslam
- Nutritional Epidemiology Program, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Gina M Peloso
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| | - Mark A Herman
- Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, School of Medicine, Duke University, Durham, NC, USA
| | - Josée Dupuis
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA,National Heart, Lung, and Blood Institute's Framingham Heart Study and Population Sciences Branch, Framingham, MA, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Caren E Smith
- Nutrition and Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Paul F Jacques
- Nutritional Epidemiology Program, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Samia Mora
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicola M McKeown
- Programs of Nutrition, Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
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In Vitro Antilipidic and Antithrombotic Activities of Plectranthus glandulosus (Lamiaceae) Leaves Extracts and Fractions. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4145659. [PMID: 35178447 PMCID: PMC8844437 DOI: 10.1155/2022/4145659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/22/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2022]
Abstract
Objective The present study investigated the effect of the leaves extracts and fractions of Plectranthus glandulosus on the inhibition of pancreatic lipase, cholesterol esterase, adipocytes lipid uptake, and antithrombotic activity which may be important in atherosclerosis development. Methods Aqueous, ethanolic, and hydroethanolic extracts of Plactranthus glandulosus were prepared by maceration. The hydroethanolic extract was fractionated into n-hexane, ethylacetate, and n-butanol fractions and their inhibition of pancreatic lipase, cholesterol esterase, adipocytes lipid uptake, and antithrombotic activities measured. Liquid chromatography-high resolution mass spectrometry (LC-HRMS) analysis was carried out to determine phytochemical constituents present in the extracts. Results The standard orlistat exhibited a higher inhibitory activity on pancreatic lipase and cholesterol esterase (16.31 μg/mL and 15.75 μg/mL, respectively) compared to ethyl acetate fraction (IC50, 17.70 μg/mL and IC50, 24.8 μg/mL, respectively). Among crude extract, hydroethanolic extract showed a better inhibition against pancreatic lipase (IC50, 21.06 μg/mL) and cholesterol esterase (IC50, 25.14 μg/mL) though not comparable to the effect of orlistat. The best lipid uptake inhibition was observed in the hydroethanolic extract (IC50, 45.42 μg/mL) followed by the ethyl acetate fraction (IC50, 47.77 μg/mL). A better antithrombolytic activity was exhibited by the ethyl acetate fraction at all concentrations (50-800 μ/mL), while hydroethanolic extract exhibited the best activity among crude extract. However, these were not comparable to the standard aspirin. The LC-HRMS analysis revealed the presence of 7-O-methyl luteolin 5-O-β-D-glucopyranoside, chrysoeriol 5-O-β-D-glucopyranoside, 5,7-dihydroxy-3,2′,4′-trimethoxyflavone, and plectranmicin as major compounds in both hydroethanolic extract and ethyl acetate fraction. Conclusion Thus, our finding supports the traditional use of this plant, which might provide a potential source for future antiatherosclerotic drug discovery.
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Ginsberg HN, Packard CJ, Chapman MJ, Borén J, Aguilar-Salinas CA, Averna M, Ference BA, Gaudet D, Hegele RA, Kersten S, Lewis GF, Lichtenstein AH, Moulin P, Nordestgaard BG, Remaley AT, Staels B, Stroes ESG, Taskinen MR, Tokgözoğlu LS, Tybjaerg-Hansen A, Stock JK, Catapano AL. Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies-a consensus statement from the European Atherosclerosis Society. Eur Heart J 2021; 42:4791-4806. [PMID: 34472586 PMCID: PMC8670783 DOI: 10.1093/eurheartj/ehab551] [Citation(s) in RCA: 347] [Impact Index Per Article: 115.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/21/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022] Open
Abstract
Recent advances in human genetics, together with a large body of epidemiologic, preclinical, and clinical trial results, provide strong support for a causal association between triglycerides (TG), TG-rich lipoproteins (TRL), and TRL remnants, and increased risk of myocardial infarction, ischaemic stroke, and aortic valve stenosis. These data also indicate that TRL and their remnants may contribute significantly to residual cardiovascular risk in patients on optimized low-density lipoprotein (LDL)-lowering therapy. This statement critically appraises current understanding of the structure, function, and metabolism of TRL, and their pathophysiological role in atherosclerotic cardiovascular disease (ASCVD). Key points are (i) a working definition of normo- and hypertriglyceridaemic states and their relation to risk of ASCVD, (ii) a conceptual framework for the generation of remnants due to dysregulation of TRL production, lipolysis, and remodelling, as well as clearance of remnant lipoproteins from the circulation, (iii) the pleiotropic proatherogenic actions of TRL and remnants at the arterial wall, (iv) challenges in defining, quantitating, and assessing the atherogenic properties of remnant particles, and (v) exploration of the relative atherogenicity of TRL and remnants compared to LDL. Assessment of these issues provides a foundation for evaluating approaches to effectively reduce levels of TRL and remnants by targeting either production, lipolysis, or hepatic clearance, or a combination of these mechanisms. This consensus statement updates current understanding in an integrated manner, thereby providing a platform for new therapeutic paradigms targeting TRL and their remnants, with the aim of reducing the risk of ASCVD.
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Affiliation(s)
- Henry N Ginsberg
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH-10-305, New York, NY 10032, USA
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
| | - M John Chapman
- Sorbonne University Endocrinology-Metabolism Division, Pitié-Salpetriere University Hospital, and National Institute for Health and Medical Research (INSERM), 47 Hôpital boulevard, Paris 75013, France
| | - Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg and Sahlgrenska University Hospital, Blå Stråket 5, Gothenburg 413 45, Sweden
| | - Carlos A Aguilar-Salinas
- Unidad de Investigación en Enfermedades Metabólicas and Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, Mexico City 14080, Mexico.,Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto, Monterrey, Nuevo León 3000, Mexico
| | - Maurizio Averna
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities, University of Palermo, Marina Square, 61, Palermo 90133, Italy
| | - Brian A Ference
- Centre for Naturally Randomized Trials, University of Cambridge, Cambridge, UK
| | - Daniel Gaudet
- Clinical Lipidology and Rare Lipid Disorders Unit, Community Genomic Medicine Center, Department of Medicine, Université de Montréal, ECOGENE, Clinical and Translational Research Center, and Lipid Clinic, Chicoutimi Hospital, 305 Rue St Vallier, Chicoutimi, Québec G7H 5H6, Canada
| | - Robert A Hegele
- Department of Medicine and Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | - Sander Kersten
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Gary F Lewis
- Division of Endocrinology, Department of Medicine, Banting & Best Diabetes Centre, University of Toronto, Eaton Building, Room 12E248, 200 Elizabeth St, Toronto, Ontario M5G 2C4, Canada
| | - Alice H Lichtenstein
- Cardiovascular Nutrition, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St Ste 9, Boston, MA 02111, USA
| | - Philippe Moulin
- Department of Endocrinology, GHE, Hospices Civils de Lyon, CarMeN Laboratory, Inserm UMR 1060, CENS-ELI B, Univ-Lyon1, Lyon 69003, France
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Herlev 2730, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen DK-2200, Denmark
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 31 Center Dr Ste 10-7C114, Bethesda, MD 20892, USA
| | - Bart Staels
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Erik S G Stroes
- Department of Vascular Medicine, Academic Medical Center, 1541 Kings Hwy, Amsterdam 71103, The Netherlands
| | - Marja-Riitta Taskinen
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Lale S Tokgözoğlu
- Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Sıhhiye, Ankara, Turkey
| | - Anne Tybjaerg-Hansen
- Department of Clinical Biochemistry, Blegdamsvej 9, Rigshospitalet, Copenhagen 2100, Denmark.,Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark.,Copenhagen City Heart Study, Frederiksberg Hospital, Nordre Fasanvej, Frederiksberg 57 2000, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej, Copenhagen 3B 2200, Denmark
| | - Jane K Stock
- European Atherosclerosis Society, Mässans Gata 10, Gothenburg SE-412 51, Sweden
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano and IRCCS MultiMedica, Via Festa del Perdono 7, Milan 20122, Italy
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Kaur M, Ahuja KR, Khubber S, Zhou L, Verma BR, Meenakshisundaram C, Gad MM, Saad A, Dhaliwal K, Isogai T, Rajeswaran J, Toth A, Chahine J, Cho L, Puri R, Kapadia S. Effect of High-Density Lipoprotein Cholesterol Levels on Overall Survival and Major Adverse Cardiovascular and Cerebrovascular Events. Am J Cardiol 2021; 146:8-14. [PMID: 33535058 DOI: 10.1016/j.amjcard.2021.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 01/30/2023]
Abstract
Several studies designed to augment high density lipoprotein (HDL) levels have so far been unsuccessful in reducing rates of major adverse cardiovascular and cerebrovascular events (MACCE). In this study, we report the effect of HDL-C levels on overall survival outcomes and rates of MACCE following percutaneous coronary intervention (PCI). We reviewed patients who underwent PCI at the Cleveland Clinic from 2005 to 2017 and followed them through the end of 2018. Restricted cubic splines incorporated into Cox proportional hazard regression models were used to assess the outcomes. The HDL-C level associated with the lowest mortality was used as a reference value.15,633 patients underwent PCI during the study period, of which 70% were male, 81% were white, and 73% were on statins. The mean age at the time of procedure was 65.8 ± 11.8 years. After adjusting for demographics, co-morbidities, lipid profile, statin use, and date of procedure, our model demonstrated a U-shaped association between HDL-C and overall mortality, with HDL-C levels of 30-50 mg/dl associated with the most favorable outcomes, and HDL-C levels < 30 mg/dl or > 50 mg/dl associated with worse outcomes. A sensitivity analysis in men yielded a similar U-shaped association. In conclusion, our study shows that both low and high levels of HDL-C are associated with worse overall survival, with no effect on rates of MACCE in PCI patients. Further studies are required to understand the mechanism of this association between elevated HDL-C levels with increased overall mortality in patients with atherosclerotic cardiovascular disease (ASCVD).
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7
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Wu D, Yang Q, Su B, Hao J, Ma H, Yuan W, Gao J, Ding F, Xu Y, Wang H, Zhao J, Li B. Low-Density Lipoprotein Cholesterol 4: The Notable Risk Factor of Coronary Artery Disease Development. Front Cardiovasc Med 2021; 8:619386. [PMID: 33937355 PMCID: PMC8085268 DOI: 10.3389/fcvm.2021.619386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/23/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Coronary artery disease (CAD) is the leading cause of death worldwide, which has a long asymptomatic period of atherosclerosis. Thus, it is crucial to develop efficient strategies or biomarkers to assess the risk of CAD in asymptomatic individuals. Methods: A total of 356 consecutive CAD patients and 164 non-CAD controls diagnosed using coronary angiography were recruited. Blood lipids, other baseline characteristics, and clinical information were investigated in this study. In addition, low-density lipoprotein cholesterol (LDL-C) subfractions were classified and quantified using the Lipoprint system. Based on these data, we performed comprehensive analyses to investigate the risk factors for CAD development and to predict CAD risk. Results: Triglyceride, LDLC-3, LDLC-4, LDLC-5, LDLC-6, and total small and dense LDL-C were significantly higher in the CAD patients than those in the controls, whereas LDLC-1 and high-density lipoprotein cholesterol (HDL-C) had significantly lower levels in the CAD patients. Logistic regression analysis identified male [odds ratio (OR) = 2.875, P < 0.001], older age (OR = 1.018, P = 0.025), BMI (OR = 1.157, P < 0.001), smoking (OR = 4.554, P < 0.001), drinking (OR = 2.128, P < 0.016), hypertension (OR = 4.453, P < 0.001), and diabetes mellitus (OR = 8.776, P < 0.001) as clinical risk factors for CAD development. Among blood lipids, LDLC-3 (OR = 1.565, P < 0.001), LDLC-4 (OR = 3.566, P < 0.001), and LDLC-5 (OR = 6.866, P < 0.001) were identified as risk factors. To predict CAD risk, six machine learning models were constructed. The XGboost model showed the highest AUC score (0.945121), which could distinguish CAD patients from the controls with a high accuracy. LDLC-4 played the most important role in model construction. Conclusions: The established models showed good performance for CAD risk prediction, which can help screen high-risk CAD patients in asymptomatic population, so that further examination and prevention treatment might be taken before any sudden or serious event.
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Affiliation(s)
- Dongmei Wu
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Qiuju Yang
- Department of Cardiovascular Medicine, The First People's Hospital of Pingdingshan, Pingdingshan, China
| | - Baohua Su
- Department of Cardiovascular Medicine, Mianxian Hospital, Hanzhong, China
| | - Jia Hao
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Huirong Ma
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Weilan Yuan
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Junhui Gao
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Feifei Ding
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Yue Xu
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Huifeng Wang
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Jiangman Zhao
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Bingqiang Li
- Department of Cardiovascular Medicine, The First People's Hospital of Pingdingshan, Pingdingshan, China
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8
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Kaze AD, Santhanam P, Musani SK, Ahima R, Echouffo-Tcheugui JB. Metabolic Dyslipidemia and Cardiovascular Outcomes in Type 2 Diabetes Mellitus: Findings From the Look AHEAD Study. J Am Heart Assoc 2021; 10:e016947. [PMID: 33728932 PMCID: PMC8174364 DOI: 10.1161/jaha.120.016947] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Metabolic dyslipidemia (high triglyceride) and low high‐density lipoprotein cholesterol (HDL‐C) is highly prevalent in type 2 diabetes mellitus (T2DM). The extent to which diabetes mellitus–related abnormalities in the triglyceride–HDL‐C profile associates with cardiovascular disease (CVD) risk is incompletely understood. We evaluated the associations of triglyceride and HDL‐C status with CVD outcomes in individuals with T2DM. Methods and Results We analyzed data from 4199 overweight/obese adults with T2DM free of CVD with available data on triglyceride and HDL‐C at baseline (2001–2004) in the Look AHEAD (Action for Health in Diabetes) study. We used Cox proportional models to estimate hazard ratios (HRs) and 95% CIs of: (1) composite CVD outcome (myocardial infarction, stroke, hospitalization for angina, and/or death from cardiovascular causes); (2) coronary artery disease events; and (3) cerebrovascular accidents (stroke). Of the 4199 participants, 62% (n=2600) were women, with a mean age of 58 years (SD, 7), and 40% (n=1659) had metabolic dyslipidemia at baseline. Over a median follow‐up of 9.5 years (interquartile range, 8.7–10.3), 500 participants experienced the composite CVD outcome, 396 experienced coronary artery disease events, and 100 experienced stroke. Low HDL‐C was associated with higher hazards of the composite CVD outcome (HR, 1.36; 95% CI, 1.12–1.64 [P=0.002]) and coronary artery disease events (HR, 1.46; 95% CI, 1.18–1.81 [P=0.001]) but not stroke (HR, 1.38; 95% CI, 0.90–2.11 [P=0.140]). Compared with patients with normal triglyceride and normal HDL, participants with metabolic dyslipidemia had higher risks of the composite CVD outcome (HR, 1.30; 95% CI, 1.03–1.63 [P=0.025]) and coronary artery disease events (HR, 1.48; 95% CI, 1.14–1.93 [P=0.003]) but not stroke (HR, 1.23; 95% CI, 0.74–2.05 [P=0.420]). Conclusions In a large sample of overweight/obese individuals with T2DM, metabolic dyslipidemia was associated with higher risks of CVD outcomes. Our findings highlight the necessity to account for metabolic dyslipidemia in CVD risk stratification among patients with T2DM. Registration URL: https://www.lookaheadtrial.org; Unique identifier: NCT00017953.
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Affiliation(s)
- Arnaud D Kaze
- Department of Medicine University of Maryland Medical Center Baltimore MD
| | - Prasanna Santhanam
- Division of Endocrinology, Diabetes & Metabolism Department of Medicine Johns Hopkins School of Medicine Baltimore MD
| | - Solomon K Musani
- Department of Medicine University of Mississippi Medical Center Jackson MS
| | - Rexford Ahima
- Division of Endocrinology, Diabetes & Metabolism Department of Medicine Johns Hopkins School of Medicine Baltimore MD
| | - Justin B Echouffo-Tcheugui
- Division of Endocrinology, Diabetes & Metabolism Department of Medicine Johns Hopkins School of Medicine Baltimore MD.,Welch Prevention Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD
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9
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Pedrelli M, Parini P, Kindberg J, Arnemo JM, Bjorkhem I, Aasa U, Westerståhl M, Walentinsson A, Pavanello C, Turri M, Calabresi L, Öörni K, Camejo G, Fröbert O, Hurt-Camejo E. Vasculoprotective properties of plasma lipoproteins from brown bears (Ursus arctos). J Lipid Res 2021; 62:100065. [PMID: 33713671 PMCID: PMC8131316 DOI: 10.1016/j.jlr.2021.100065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 02/18/2021] [Accepted: 03/03/2021] [Indexed: 12/28/2022] Open
Abstract
Plasma cholesterol and triglyceride (TG) levels are twice as high in hibernating brown bears (Ursus arctos) than healthy humans. Yet, bears display no signs of early stage atherosclerosis development when adult. To explore this apparent paradox, we analyzed plasma lipoproteins from the same 10 bears in winter (hibernation) and summer using size exclusion chromatography, ultracentrifugation, and electrophoresis. LDL binding to arterial proteoglycans (PGs) and plasma cholesterol efflux capacity (CEC) were also evaluated. The data collected and analyzed from bears were also compared with those from healthy humans. In bears, the cholesterol ester, unesterified cholesterol, TG, and phospholipid contents of VLDL and LDL were higher in winter than in summer. The percentage lipid composition of LDL differed between bears and humans but did not change seasonally in bears. Bear LDL was larger, richer in TGs, showed prebeta electrophoretic mobility, and had 5-10 times lower binding to arterial PGs than human LDL. Finally, plasma CEC was higher in bears than in humans, especially the HDL fraction when mediated by ABCA1. These results suggest that in brown bears the absence of early atherogenesis is likely associated with a lower affinity of LDL for arterial PGs and an elevated CEC of bear plasma.
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Affiliation(s)
- Matteo Pedrelli
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Translational Science & Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
| | - Paolo Parini
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Metabolism Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Infection, Karolinska university Hospital, Stockholm, Sweden
| | - Jonas Kindberg
- Norwegian Institute for Nature Research, Trondheim, Norway; Swedish University of Agricultural Sciences, Department of Wildlife, Fish, and Environmental Studies, Umeå, Sweden
| | - Jon M Arnemo
- Swedish University of Agricultural Sciences, Department of Wildlife, Fish, and Environmental Studies, Umeå, Sweden; Department of Forestry and Wildlife Management, Inland Norway University of Applied Sciences, Campus Evenstad, Koppang, Norway
| | - Ingemar Bjorkhem
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Aasa
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Maria Westerståhl
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Walentinsson
- Translational Science & Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Chiara Pavanello
- Centro Enrica Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - Marta Turri
- Centro Enrica Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - Laura Calabresi
- Centro Enrica Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - Katariina Öörni
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
| | - Gérman Camejo
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ole Fröbert
- Swedish University of Agricultural Sciences, Department of Wildlife, Fish, and Environmental Studies, Umeå, Sweden; Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden
| | - Eva Hurt-Camejo
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Translational Science & Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
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10
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Jakubauskas D, Jansen M, Lyngsø J, Cheng Y, Pedersen JS, Cárdenas M. Toward reliable low-density lipoprotein ultrastructure prediction in clinical conditions: A small-angle X-ray scattering study on individuals with normal and high triglyceride serum levels. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2020; 31:102318. [PMID: 33091569 DOI: 10.1016/j.nano.2020.102318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/23/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
Atherosclerosis is the main killer in the west and therefore a major health challenge today. Total serum cholesterol and lipoprotein concentrations, used as clinical markers, fail to predict the majority of cases, especially between the risk scale extremes, due to the high complexity in lipoprotein structure and composition. In particular, low-density lipoprotein (LDL) plays a key role in atherosclerosis development, with LDL size being a parameter considered for determining the risk for cardiovascular diseases. Determining LDL size and structural parameters is challenging to address experimentally under physiological-like conditions. This article describes the biochemistry and ultrastructure of normolipidemic and hypertriglyceridemic LDL fractions and subfractions using small-angle X-ray scattering. Our results conclude that LDL particles of hypertriglyceridemic compared to healthy individuals 1) have lower LDL core melting temperature, 2) have lower cholesteryl ester ordering in their core, 3) are smaller, rounder and more spherical below melting temperature, and 4) their protein-containing shell is thinner above melting temperature.
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Affiliation(s)
- Dainius Jakubauskas
- Biofilms - Research center for Biointerfaces, Dept. of Biomedical Science, Faculty of Health and Society, Malmo University, Malmo, Sweden.
| | - Martin Jansen
- Institute of Clinical Chemistry and Laboratory Medicine, Medical Centre, University of Freiburg, Freiburg im Breisgau, Germany.
| | - Jeppe Lyngsø
- Department of Chemistry and Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Aarhus, Denmark.
| | - Yuanji Cheng
- Department of Materials Science and Applied Mathematics, Faculty of Technology and Society, Malmo University, Malmo, Sweden.
| | - Jan Skov Pedersen
- Department of Chemistry and Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Aarhus, Denmark.
| | - Marité Cárdenas
- Biofilms - Research center for Biointerfaces, Dept. of Biomedical Science, Faculty of Health and Society, Malmo University, Malmo, Sweden.
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11
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Kammar-García A, López-Moreno P, Hernández-Hernández ME, Ortíz-Bueno AM, Martínez-Montaño MDLC. Atherogenic index of plasma as a marker of cardiovascular risk factors in Mexicans aged 18 to 22 years. Proc (Bayl Univ Med Cent) 2020; 34:22-27. [PMID: 33456139 PMCID: PMC7785179 DOI: 10.1080/08998280.2020.1799479] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The aim of this cross-sectional study was to evaluate the use and application of the atherogenic index of plasma (AIP) in the prediction of cardiovascular risk factors including mixed hyperlipidemia, hypertension, hyperuricemia, and metabolic syndrome in a population of young Mexican adults. Values were obtained for metabolic parameters, such as glucose, triglycerides, cholesterol (total, high-density, low-density, and very low density), systolic and diastolic blood pressure, and uric acid. Through univariate and multivariate analysis, parametric comparisons were applied and receiver operating characteristic curves were plotted. Logistic regression analysis was used to assess the risk of hyperuricemia, hypertension, mixed hyperlipidemia, and metabolic syndrome from a high AIP. Metabolic parameters and AIP had a significant correlation, with higher rates observed with increased AIP. As a set, metabolic parameters increased with an AIP >0.21 (λ Wilks = 0.58, F(14,344) = 7.7, P < 0.0001). The area under the curve was statistically significant for prediction of hyperuricemia (0.6), mixed hyperlipidemia (0.9), hypertension (0.8), and metabolic syndrome (0.95). In conclusion, in a sample of young Mexican adults, AIP was strongly associated with cardiovascular risk factors and could serve as a useful marker for the prediction of metabolic alterations related to cardiovascular disease.
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Affiliation(s)
- Ashuin Kammar-García
- Department of Biochemistry, School of Medicine, Benemérita Universidad Autónoma de Puebla, Mexico,Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico,Corresponding author: Ashuin Kammar-García, PhD, Calle 13 Sur 2702, Los Volcanes, Puebla, Pue72420, México (e-mail: )
| | - Patricia López-Moreno
- Department of Biochemistry, School of Medicine, Benemérita Universidad Autónoma de Puebla, Mexico
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12
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Sniderman AD, Thanassoulis G, Glavinovic T, Navar AM, Pencina M, Catapano A, Ference BA. Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review. JAMA Cardiol 2020; 4:1287-1295. [PMID: 31642874 DOI: 10.1001/jamacardio.2019.3780] [Citation(s) in RCA: 289] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Importance The conventional model of atherosclerosis presumes that the mass of cholesterol within very low-density lipoprotein particles, low-density lipoprotein particles, chylomicron, and lipoprotein (a) particles in plasma is the principal determinant of the mass of cholesterol that will be deposited within the arterial wall and will drive atherogenesis. However, each of these particles contains one molecule of apolipoprotein B (apoB) and there is now substantial evidence that apoB more accurately measures the atherogenic risk owing to the apoB lipoproteins than does low-density lipoprotein cholesterol or non-high-density lipoprotein cholesterol. Observations Cholesterol can only enter the arterial wall within apoB particles. However, the mass of cholesterol per apoB particle is variable. Therefore, the mass of cholesterol that will be deposited within the arterial wall is determined by the number of apoB particles that are trapped within the arterial wall. The number of apoB particles that enter the arterial wall is determined primarily by the number of apoB particles within the arterial lumen. However, once within the arterial wall, smaller cholesterol-depleted apoB particles have a greater tendency to be trapped than larger cholesterol-enriched apoB particles because they bind more avidly to the glycosaminoglycans within the subintimal space of the arterial wall. Thus, a cholesterol-enriched particle would deposit more cholesterol than a cholesterol-depleted apoB particle whereas more, smaller apoB particles that enter the arterial wall will be trapped than larger apoB particles. The net result is, with the exceptions of the abnormal chylomicron remnants in type III hyperlipoproteinemia and lipoprotein (a), all apoB particles are equally atherogenic. Conclusions and Relevance Apolipoprotein B unifies, amplifies, and simplifies the information from the conventional lipid markers as to the atherogenic risk attributable to the apoB lipoproteins.
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Affiliation(s)
- Allan D Sniderman
- Mike and Valeria Rosenbloom Centre for Cardiovascular Prevention, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - George Thanassoulis
- Mike and Valeria Rosenbloom Centre for Cardiovascular Prevention, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Ann Marie Navar
- Duke Clinical Research Institute, Durham, North Carolina.,Associate Editor
| | - Michael Pencina
- Duke University School of Medicine, Durham, North Carolina.,Deputy Editor for Statistics
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Multimedica IRCCS, Milano, Italy
| | - Brian A Ference
- Centre for Naturally Randomized Trials, University of Cambridge, Cambridge, United Kingdom.,Institute for Advanced Studies, University of Bristol, Bristol, United Kingdom.,MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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13
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Kloska A, Malinowska M, Gabig-Cimińska M, Jakóbkiewicz-Banecka J. Lipids and Lipid Mediators Associated with the Risk and Pathology of Ischemic Stroke. Int J Mol Sci 2020; 21:ijms21103618. [PMID: 32443889 PMCID: PMC7279232 DOI: 10.3390/ijms21103618] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/19/2022] Open
Abstract
Stroke is a severe neurological disorder in humans that results from an interruption of the blood supply to the brain. Worldwide, stoke affects over 100 million people each year and is the second largest contributor to disability. Dyslipidemia is a modifiable risk factor for stroke that is associated with an increased risk of the disease. Traditional and non-traditional lipid measures are proposed as biomarkers for the better detection of subclinical disease. In the central nervous system, lipids and lipid mediators are essential to sustain the normal brain tissue structure and function. Pathways leading to post-stroke brain deterioration include the metabolism of polyunsaturated fatty acids. A variety of lipid mediators are generated from fatty acids and these molecules may have either neuroprotective or neurodegenerative effects on the post-stroke brain tissue; therefore, they largely contribute to the outcome and recovery from stroke. In this review, we provide an overview of serum lipids associated with the risk of ischemic stroke. We also discuss the role of lipid mediators, with particular emphasis on eicosanoids, in the pathology of ischemic stroke. Finally, we summarize the latest research on potential targets in lipid metabolic pathways for ischemic stroke treatment and on the development of new stroke risk biomarkers for use in clinical practice.
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Affiliation(s)
- Anna Kloska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.M.)
| | - Marcelina Malinowska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.M.)
| | - Magdalena Gabig-Cimińska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.M.)
- Laboratory of Molecular Biology, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Kładki 24, 80-822 Gdańsk, Poland
- Correspondence: (M.G.-C.); (J.J.-B.); Tel.: +48-585-236-046 (M.G.-C.); +48-585-236-043 (J.J.-B.)
| | - Joanna Jakóbkiewicz-Banecka
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.M.)
- Correspondence: (M.G.-C.); (J.J.-B.); Tel.: +48-585-236-046 (M.G.-C.); +48-585-236-043 (J.J.-B.)
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14
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Abstract
PURPOSE OF REVIEW To describe lipid abnormalities in diabetes, when they occur and the evidence base for lipid management with established and new drugs to prevent diabetes complications. We also discuss how to manage statin intolerance. RECENT FINDINGS Statins remain first-line therapy in patients with diabetes, though newer therapies to reduce LDL-C have emerged, including ezetimibe as an add-on therapy to statins, and injectable PCSK9 inhibitors, both of which are safe and effective in diabetes. Emerging evidence suggests a need to consider lipid-lowering therapies more often in younger patients with both type 1 and type 2 diabetes. Statins remain the cornerstone of lipid management in diabetes but other options are increasing. There is also now evidence for better managing apparent statin intolerance. Notably, younger patients lose the most life years from their diabetes, an observation that future guidelines need to consider.
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Affiliation(s)
- Anne Sillars
- The Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, G12 8TA UK
| | - Naveed Sattar
- The Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, G12 8TA UK
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15
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Piran S, Sarmasti S, Shabani M, Kakavandi N, Hosseni B, Khosravi M, Resaee S, Soltanmohammadi E, Naseri F, Mohammadi A, Najafi M. Association Between Fat-soluble Vitamins and Lipid Profile in the Overweight Population. Recent Pat Food Nutr Agric 2019; 11:56-62. [PMID: 31237223 DOI: 10.2174/2212798410666190618152134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/10/2019] [Accepted: 04/16/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND & AIMS It is well-known that the coronary artery stenosis is related to lipid profile. This is a descriptive cross-sectional study to investigate the relationship between the serum fat-soluble vitamins (A, E and D), circulating proprotein convertase subtilisin/kexin type 9 (PCSK9), and lipid profile in the study population. METHODS A total of 120 overweight subjects were participated in this study. The circulating PCSK9 and vitamin D were measured by ELISA technique. The serum vitamin A and vitamin E amounts were simultaneously measured by the HPLC method. The Serum Small Dense LDLCholesterol (sdLDL-C) values were evaluated using heparin-Mg2+ precipitation technique. The lipid profile was measured by routine laboratory techniques. RESULTS The serum vitamin E values correlated significantly to vitamin A (r= 0.47, P= 0.0001), VLDL-C (r= 0.30, P= 0.002), total cholesterol (r= 0.309, P= 0.001), PCSK9 (r= 0.233, P= 0.01) and total triglyceride (r= 0.61, P= 0.0001) values. The circulating PCSK9 values correlated significantly to LDL-C (r= 0.17, P= 0.05) and total cholesterol (r= 0.23, P= 0.009) values. However, there were not correlations between the levels of serum D and A vitamins, the serum LDL-C, sdLDL-C and total cholesterol values. CONCLUSION The data showed the correlations between serum vitamin E and PCSK9-related LDLC values lower than the normal range. Furthermore, the results suggested a nutritional need on the patents considering supplementation or fortification of vitamin E for the overweight subjects with higher LDL-C levels.
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Affiliation(s)
- Sadegh Piran
- Biochemistry Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Sarmasti
- Biotechnology Department, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shabani
- Biochemistry Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Kakavandi
- Biochemistry Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
| | - Bita Hosseni
- Biochemistry Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Khosravi
- Biochemistry Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Resaee
- Biochemistry Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Soltanmohammadi
- Pharmaceutical Sciences Department, University of South Carolina, Columbia, SC 29208, United States
| | - Faezeh Naseri
- Biochemistry Department, Shahid Beheshi University, Tehran, Iran
| | - Asghar Mohammadi
- Biochemistry Department, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Najafi
- Biochemistry Department, Medical School, Iran University of Medical Sciences, Tehran, Iran.,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.,Firoozabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
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16
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Öörni K, Lehti S, Sjövall P, Kovanen PT. Triglyceride-Rich Lipoproteins as a Source of Proinflammatory Lipids in the Arterial Wall. Curr Med Chem 2019; 26:1701-1710. [DOI: 10.2174/0929867325666180530094819] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/27/2017] [Accepted: 01/01/2018] [Indexed: 12/11/2022]
Abstract
Apolipoprotein B –containing lipoproteins include triglyceride-rich lipoproteins
(chylomicrons and their remnants, and very low-density lipoproteins and their remnants) and
cholesterol-rich low-density lipoprotein particles. Of these, lipoproteins having sizes below
70-80 nm may enter the arterial wall, where they accumulate and induce the formation of
atherosclerotic lesions. The processes that lead to accumulation of lipoprotein-derived lipids
in the arterial wall have been largely studied with a focus on the low-density lipoprotein particles.
However, recent observational and genetic studies have discovered that the triglyceriderich
lipoproteins and their remnants are linked with cardiovascular disease risk. In this review,
we describe the potential mechanisms by which the triglyceride-rich remnant lipoproteins can
contribute to the development of atherosclerotic lesions, and highlight the differences in the
atherogenicity between low-density lipoproteins and the remnant lipoproteins.
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Affiliation(s)
| | - Satu Lehti
- Wihuri Research Institute, Helsinki, Finland
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17
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Galletti F, Fazio V, Gentile M, Schillaci G, Pucci G, Battista F, Mercurio V, Bosso G, Bonaduce D, Brambilla N, Vitalini C, D'Amato M, Giacovelli G. Efficacy of a nutraceutical combination on lipid metabolism in patients with metabolic syndrome: a multicenter, double blind, randomized, placebo controlled trial. Lipids Health Dis 2019; 18:66. [PMID: 30885221 PMCID: PMC6421674 DOI: 10.1186/s12944-019-1002-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 03/01/2019] [Indexed: 01/14/2023] Open
Abstract
Background Nutraceuticals represent a new therapeutic frontier in the treatment of metabolic syndrom (MetS) and related cardiovascular risk factors. The aim of this study was to evaluate the potential beneficial effects of Armolipid Plus (AP) (berberine 500 mg, red yest rice, monacolin K 3 mg and policosanol 10 mg) on insulin resistance, lipid profile, particularly on small and dense LDL cholesterol (sdLDL-C), representing the most atherogenic components, as well as its effects on high sensitivity C-reactive protein, a notable marker of cardiovascular risk, blood pressure and cardiac remodeling in subjects affected by MetS, with left ventricular hypertrophy. Methods The study was a prospective, multi-center, randomized, double blind, placebo-controlled trial. One hundred and fifty eight patients, aged between 28 and 76 years old, were enrolled and randomized to receive either one tablet of AP or placebo (PL) once daily for 24 weeks. Anthropometric and vital parameters, total cholesterol (tot-C), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceridemia (TG), non-HDL cholesterol (NHDL-C) and sdLDL-C were evaluated. Results After 24 weeks of treatment, the analysis performed on 141 subjects (71 in AP arm and 70 in PL arm), showed a significant improvement of lipid profile in the AP group, with reduction in tot-C (− 13.2 mg/dl), LDL-C (− 13.9 mg/dl) and NHDL-C (− 15.3 mg/dl) and increase in HDL-C (+ 2.0 mg/dl). These changes were equally significant compared with placebo (tot-C: AP − 13.2 mg/dL vs PL + 2.7 mg/dL, p < 0.01; LDL-C: AP -13.9 mg/dl vs PL + 1.5 mg/dl, p < 0.01; NHDL-C: AP -15.3 mg/dl vs PL + 2.8 mg/dl, p < 0.01), Although no significant difference was observed between the two arms in the reduction of HDL-C nevertheless it increased significantly in the AP group (AP + 2 mg/dL p < 0.05, PL 0.13 mg/dL). Conclusion The results of this study, applicable to a specific local population show that, in a population of subjects affected by MetS, treatment with AP improves the lipid profile and the most atherogenic factors, thus suggesting a reduction in the risk of development and progression of atherosclerosis, particularly in subjects with high atherogenic risk, due to the presence of sdLDL-C.
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Affiliation(s)
- Ferruccio Galletti
- Department of Clinical Medicine and Surgery, ESH Excellence Centre of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy.
| | - Valeria Fazio
- Department of Clinical Medicine and Surgery, ESH Excellence Centre of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy
| | - Marco Gentile
- Department of Clinical Medicine and Surgery, ESH Excellence Centre of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy
| | - Giuseppe Schillaci
- Unit of Internal Medicine, Terni University Hospital, Department of Medicine, University of Perugia, Perugia, Italy
| | - Giacomo Pucci
- Unit of Internal Medicine, Terni University Hospital, Department of Medicine, University of Perugia, Perugia, Italy
| | - Francesca Battista
- Unit of Internal Medicine, Terni University Hospital, Department of Medicine, University of Perugia, Perugia, Italy
| | - Valentina Mercurio
- Department of Translational Medical Sciences, "Federico II" University of Naples Medical School, Naples, Italy
| | - Giorgio Bosso
- Department of Translational Medical Sciences, "Federico II" University of Naples Medical School, Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, "Federico II" University of Naples Medical School, Naples, Italy
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18
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Ferguson JJA, Wolska A, Remaley AT, Stojanovski E, MacDonald-Wicks L, Garg ML. Bread enriched with phytosterols with or without curcumin modulates lipoprotein profiles in hypercholesterolaemic individuals. A randomised controlled trial. Food Funct 2019; 10:2515-2527. [DOI: 10.1039/c8fo02512f] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A novel functional food containing phytosterols and curcumin significantly lowers blood cholesterol concentrations in hypercholesterolaemic individuals.
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Affiliation(s)
- Jessica J. A. Ferguson
- Nutraceuticals Research Program
- School of Biomedical Sciences & Pharmacy
- 305C Medical Science Building
- University of Newcastle
- Callaghan
| | - Anna Wolska
- Lipoprotein Metabolism Section
- National Heart
- Lung and Blood Institute
- NIH
- Bethesda
| | - Alan T. Remaley
- Lipoprotein Metabolism Section
- National Heart
- Lung and Blood Institute
- NIH
- Bethesda
| | - Elizabeth Stojanovski
- School of Mathematical and Physical Sciences
- University of Newcastle
- Callaghan
- Australia
| | - Lesley MacDonald-Wicks
- School of Health Sciences
- Faculty of Health & Medicine
- University of Newcastle
- Callaghan
- Australia
| | - Manohar L. Garg
- Nutraceuticals Research Program
- School of Biomedical Sciences & Pharmacy
- 305C Medical Science Building
- University of Newcastle
- Callaghan
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19
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Chooi YC, Ding C, Chan Z, Lo J, Choo J, Ding BTK, Leow MKS, Magkos F. Lipoprotein Subclass Profile after Progressive Energy Deficits Induced by Calorie Restriction or Exercise. Nutrients 2018; 10:nu10111814. [PMID: 30469333 PMCID: PMC6266835 DOI: 10.3390/nu10111814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/11/2018] [Accepted: 11/14/2018] [Indexed: 11/16/2022] Open
Abstract
Weight loss, induced by chronic energy deficit, improves the blood lipid profile. However, the effects of an acute negative energy balance and the comparative efficacy of diet and exercise are not well-established. We determined the effects of progressive, acute energy deficits (20% or 40% of daily energy requirements) induced by a single day of calorie restriction (n = 19) or aerobic exercise (n = 13) in healthy subjects (age: 26 ± 9 years; body mass index (BMI): 21.8 ± 2.9 kg/m²). Fasting plasma concentrations of very low-, intermediate-, low-, and high-density lipoprotein (VLDL, LDL, IDL, and HDL, respectively) particles and their subclasses were determined using nuclear magnetic resonance. Total plasma triglyceride and VLDL-triglyceride concentrations decreased after calorie restriction and exercise (all p ≤ 0.025); the pattern of change was linear with an increasing energy deficit (all p < 0.03), with no evidence of plateauing. The number of circulating large and medium VLDL particles decreased after diet and exercise (all p < 0.015), with no change in small VLDL particles. The concentrations of IDL, LDL, and HDL particles, their relative distributions, and the particle sizes were not altered. Our data indicate that an acute negative energy balance induced by calorie restriction and aerobic exercise reduces triglyceride concentrations in a dose-dependent manner, by decreasing circulating large and medium VLDL particles.
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Affiliation(s)
- Yu Chung Chooi
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117599, Singapore.
| | - Cherlyn Ding
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117599, Singapore.
| | - Zhiling Chan
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117599, Singapore.
| | - Jezebel Lo
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117599, Singapore.
| | - John Choo
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117609, Singapore.
| | - Benjamin T K Ding
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117609, Singapore.
| | - Melvin K-S Leow
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117599, Singapore.
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore 308433, Singapore.
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore 169857, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore.
| | - Faidon Magkos
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Singapore 117599, Singapore.
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore 117593, Singapore.
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, 1958 Frederiksberg C, Denmark.
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Impact of the triglyceride level on coronary plaque components in female patients with coronary artery disease treated with statins. Heart Vessels 2018; 33:1175-1184. [PMID: 29696358 DOI: 10.1007/s00380-018-1173-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/20/2018] [Indexed: 01/13/2023]
Abstract
Several studies have reported that elevated triglyceride (TG) levels may be more strongly associated with an increased risk of coronary artery disease (CAD) in females than in males. We examined gender differences in the relationship between TG levels and coronary atherosclerosis using integrated backscatter intravascular ultrasound (IB IVUS) in CAD patients treated with statins. Three hundred seventy-eight CAD patients (105 females and 273 males) who underwent percutaneous coronary intervention using IB IVUS, and who were already receiving statin treatment, were included. Gray-scale and IB IVUS examinations were performed for the non-culprit segment of a coronary artery and fasting serum TG concentrations were measured. We found that TG levels were significantly correlated with increased lipid (r = 0.40, p < 0.001) and decreased fibrous (r = - 0.37, p < 0.001) plaque components in females, but not in males. Low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were not related to either the gray-scale or IB IVUS parameters in both genders. After adjustment for conventional coronary risk factors by a multivariate stepwise regression analysis, higher TG levels in females were independently associated with increased lipid (β = 0.31, p< 0.001) contents in coronary plaques. In conclusion, among CAD patients treated with statins, TG levels were associated with lipid-rich coronary plaques in females, but not in males. TG levels may be more important indicators of residual risk after statin treatment in females than in males.
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Tastet L, Capoulade R, Shen M, Clavel MA, Côté N, Mathieu P, Arsenault M, Bédard É, Tremblay A, Samson M, Bossé Y, Dumesnil JG, Arsenault BJ, Beaudoin J, Bernier M, Després JP, Pibarot P. ApoB/ApoA-I Ratio is Associated With Faster Hemodynamic Progression of Aortic Stenosis: Results From the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) Study. J Am Heart Assoc 2018; 7:JAHA.117.007980. [PMID: 29440006 PMCID: PMC5850203 DOI: 10.1161/jaha.117.007980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Previous studies reported that middle-aged patients with atherogenic lipoprotein-lipid profile exhibit faster progression of aortic valve stenosis (AS). The ratio of apolipoprotein B/apolipoprotein A-I (apoB/apoA-I) reflects the balance between atherogenic and anti-atherogenic lipoproteins. The aim of this study was to examine the association between apoB/apoA-I ratio and AS hemodynamic progression and to determine whether this association varies according to age. METHODS AND RESULTS A total of 159 patients (66±13 years, 73% men) with AS were prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study. Hemodynamic progression of AS was determined by the change in peak aortic jet velocity (Vpeak) measured by Doppler-echocardiography between baseline and 2-year follow-up. Patients in the top tertile of apoB/apoA-I ratio (≥0.62) had a faster progression rate of AS compared with those in the bottom/mid tertiles (Vpeak progression: 0.30 [0.09-0.49] versus 0.16 [0.01-0.36] m/s, P=0.02). There was a significant interaction (P=0.007) between apoB/apoA-I ratio and age. Among younger patients (ie, aged <70 years; median value of the cohort), those in the top tertile of apoB/apoA-I ratio had a 3.4-fold faster AS progression compared with those in the bottom/mid tertiles (Vpeak progression: 0.34 [0.13-0.69] versus 0.10 [-0.03-0.31] m/s, P=0.002), whereas there was no significant difference between tertiles in the subgroup of older patients (P=0.83). After comprehensive adjustment, higher apoB/apoA-I ratio was significantly associated with faster AS progression in the subset of younger patients (all, standardized β≥0.36; P≤0.01). CONCLUSIONS Higher apoB/apoA-I ratio is significantly associated with faster hemodynamic progression of AS in the younger patients. These findings suggest that atherogenic lipid factors may play a crucial role in the pathogenesis of AS in younger patients, but may be are less important in older patients. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01679431.
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Affiliation(s)
- Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Nancy Côté
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Patrick Mathieu
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Alexe Tremblay
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Marilie Samson
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Yohan Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Benoit J Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Mathieu Bernier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Jean-Pierre Després
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
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Update on the laboratory investigation of dyslipidemias. Clin Chim Acta 2018; 479:103-125. [PMID: 29336935 DOI: 10.1016/j.cca.2018.01.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/03/2018] [Accepted: 01/09/2018] [Indexed: 01/08/2023]
Abstract
The role of the clinical laboratory is evolving to provide more information to clinicians to assess cardiovascular disease (CVD) risk and target therapy more effectively. Current routine methods to measure LDL-cholesterol (LDL-C), the Friedewald calculation, ultracentrifugation, electrophoresis and homogeneous direct methods have established limitations. Studies suggest that LDL and HDL size or particle concentration are alternative methods to predict future CVD risk. At this time there is no consensus role for lipoprotein particle or subclasses in CVD risk assessment. LDL and HDL particle concentration are measured by several methods, namely gradient gel electrophoresis, ultracentrifugation-vertical auto profile, nuclear magnetic resonance and ion mobility. It has been suggested that HDL functional assays may be better predictors of CVD risk. To assess the issue of lipoprotein subclasses/particles and HDL function as potential CVD risk markers robust, simple, validated analytical methods are required. In patients with small dense LDL particles, even a perfect measure of LDL-C will not reflect LDL particle concentration. Non-HDL-C is an alternative measurement and includes VLDL and CM remnant cholesterol and LDL-C. However, apolipoprotein B measurement may more accurately reflect LDL particle numbers. Non-fasting lipid measurements have many practical advantages. Defining thresholds for treatment with new measurements of CVD risk remain a challenge. In families with genetic variants, ApoCIII and lipoprotein (a) may be additional risk factors. Recognition of familial causes of dyslipidemias and diagnosis in childhood will result in early treatment. This review discusses the limitations in current laboratory technologies to predict CVD risk and reviews the evidence for emergent approaches using newer biomarkers in clinical practice.
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Chaudhary R, Mathew D, Bliden K, Tantry US, Sharma T, Gesheff MG, Franzese CJ, Pandya S, Toth PP, Gurbel PA. Low-density lipoprotein 4: a novel predictor of coronary artery disease severity. Curr Med Res Opin 2017; 33:1979-1984. [PMID: 28787217 DOI: 10.1080/03007995.2017.1365052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Hyperlipidemia is a well established risk factor for coronary artery disease (CAD). Severe CAD has been observed in patients with normal levels of total and low-density lipoprotein (LDL) cholesterol. Small dense LDL particle subtypes (LDL3 and LDL4) have been observed to be more oxidizable and atherogenic. We aimed to identify the role of cholesterol particle subtypes in predicting CAD severity. METHODS Blood samples were obtained immediately before cardiac catheterization in 179 consecutive patients with suspected CAD. Detailed lipid profiling was performed using a VAP cholesterol test. CAD severity was categorized angiographically as no/minor CAD (<20% luminal diameter stenosis [LDS]), moderate CAD (20% to 74% LDS) and severe CAD (>75% LDS of any major coronary vessel). RESULTS Patients with severe CAD had significantly higher LDL4 and triglycerides, and lower total HDL, HDL2, HDL3, LDL2 and LDL3 compared to patients with no/minor CAD (p < .05 for all). Multivariate analysis showed high LDL4 as an independent predictive of severe CAD. ROC analysis showed an area under the curve of 0.62 (p < .0001) with a cut-point of >16.9 mg/dL to predict severe CAD with a sensitivity of 53% and specificity of 79%. CONCLUSION Elevated LDL4 levels are associated with severe CAD. Further large-scale investigations are required to evaluate the utility of LDL4 in predicting CAD severity.
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Affiliation(s)
| | - Denny Mathew
- a Sinai Hospital of Baltimore , Baltimore , MD , USA
| | - Kevin Bliden
- b Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute , Fairfax , VA , USA
| | - Udaya S Tantry
- b Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute , Fairfax , VA , USA
| | - Tushar Sharma
- a Sinai Hospital of Baltimore , Baltimore , MD , USA
| | - Martin G Gesheff
- b Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute , Fairfax , VA , USA
| | - Christopher J Franzese
- b Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute , Fairfax , VA , USA
| | - Shachi Pandya
- a Sinai Hospital of Baltimore , Baltimore , MD , USA
| | - Peter P Toth
- c CGH Medical Center, Sterling Illinois, and University of Illinois College of Medicine , Peoria , IL , USA
| | - Paul A Gurbel
- b Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute , Fairfax , VA , USA
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Cho Y, Lee SG, Jee SH, Kim JH. Hypertriglyceridemia is a major factor associated with elevated levels of small dense LDL cholesterol in patients with metabolic syndrome. Ann Lab Med 2016; 35:586-94. [PMID: 26354346 PMCID: PMC4579102 DOI: 10.3343/alm.2015.35.6.586] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 04/22/2015] [Accepted: 08/13/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We aimed to determine the major contributing component of metabolic syndrome (MetS) that results in an elevated small dense LDL cholesterol (sdLDL-C) concentration and sdLDL-C/LDL-C ratio. METHODS Four hundred and forty-seven subjects (225 men; 222 women) with MetS were randomly selected from the Korean Metabolic Syndrome Research Initiatives-Seoul cohort study. Age- and sex-matched healthy controls (181 men; 179 women) were also randomly selected from the same cohort. RESULTS A comparison of the median values of the sdLDL-C concentration between subgroups, divided according to whether subjects met or did not meet the criteria for each MetS component in patients with MetS, revealed a significant difference in the sdLDL-C concentration only between subgroups divided according to whether subjects met or did not meet the triglyceride (TG) criteria (P<0.05 for each gender). The TG level showed a good correlation with sdLDL-C concentration (correlation coefficients [r]=0.543 for men; 0.653 for women) and the sdLDL-C/LDL-C ratio (r=0.789 for men; 0.745 for women). Multiple linear regression analyses conducted for the MetS group concordantly identified TG as one of the most significant contributors to sdLDL-C concentration (β=0.1747±0.0105, P<0.0001) and the sdLDL-C/LDL-C ratio (β=6.9518±0.3011, P<0.0001). CONCLUSIONS Among five MetS components, only the abnormal TG level was a differentiating factor for sdLDL-C concentration and sdLDL-C/LDL-C ratio. These results were reproducible in both genders, with or without MetS.
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Affiliation(s)
- Yonggeun Cho
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Guk Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Ho Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Do HDL and LDL subfractions play a role in atherosclerosis in end-stage renal disease (ESRD) patients? Int Urol Nephrol 2016; 49:155-164. [PMID: 27942970 DOI: 10.1007/s11255-016-1466-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/17/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Significantly increased cardiovascular mortality in patients with chronic kidney (CKD) disease cannot be explained by traditional risk factors. Recent studies revealed that the quality of HDL and LDL cholesterol may be more important than their serum levels. The aim of this study was to assess which LDL and HDL subfractions were more abundant in end-stage renal disease (ESRD) patients and to analyse whether subfraction distribution could be associated with accelerated atherosclerotic processes. METHODS This study included 50 ESRD patients undergoing dialysis and 20 healthy volunteers. LDL and HDL subfractions were analysed in serum with the use of Lipoprint system. All patients had intima-media thickness (IMT) measured. RESULTS Statistically significant differences in subfractions between control and study group were observed in case of: HDL1 (p < 0.0001), HDL2 (p = 0.009), HDL3 (p < 0.0001), HDL4 (p = 0.003), HDL5 (p = 0.01), HDL7 (p < 0.0001), HDL8 (p < 0.0001), HDL9 (p < 0.0001), HDL10 (p < 0.0001), large HDL (p < 0.0001), HDL Small (p < 0.0001) as well as IDL-B (p = 0.014), IDLA (p = 0.011), LDL2 (p = 0.007). Significant differences were also observed in HDL and LDL subfraction distribution between haemodialysis patients with normal and increased IMT: HDL6 (p = 0.020), HDL Large (HDL1-3) (p = 0.017), HDL Intermediate (HDL4-7) (p = 0.017). CONCLUSIONS This study revealed that ESRD influenced HDL subfractions. In HD patients, large HDL subfractions are more abundant while small HDL fraction is more frequent in healthy persons. It failed to show the influence of end-stage disease on LDL subfraction levels. Shift in HDL subfractions might be responsible for the increased risk of atherosclerosis in CKD patients.
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Di Meo S, Reed TT, Venditti P, Victor VM. Role of ROS and RNS Sources in Physiological and Pathological Conditions. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:1245049. [PMID: 27478531 PMCID: PMC4960346 DOI: 10.1155/2016/1245049] [Citation(s) in RCA: 756] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/04/2016] [Accepted: 05/23/2016] [Indexed: 12/19/2022]
Abstract
There is significant evidence that, in living systems, free radicals and other reactive oxygen and nitrogen species play a double role, because they can cause oxidative damage and tissue dysfunction and serve as molecular signals activating stress responses that are beneficial to the organism. Mitochondria have been thought to both play a major role in tissue oxidative damage and dysfunction and provide protection against excessive tissue dysfunction through several mechanisms, including stimulation of opening of permeability transition pores. Until recently, the functional significance of ROS sources different from mitochondria has received lesser attention. However, the most recent data, besides confirming the mitochondrial role in tissue oxidative stress and protection, show interplay between mitochondria and other ROS cellular sources, so that activation of one can lead to activation of other sources. Thus, it is currently accepted that in various conditions all cellular sources of ROS provide significant contribution to processes that oxidatively damage tissues and assure their survival, through mechanisms such as autophagy and apoptosis.
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Affiliation(s)
- Sergio Di Meo
- Dipartimento di Biologia, Università di Napoli “Federico II”, 80126 Napoli, Italy
| | - Tanea T. Reed
- Department of Chemistry, Eastern Kentucky University, Richmond, KY 40475, USA
| | - Paola Venditti
- Dipartimento di Biologia, Università di Napoli “Federico II”, 80126 Napoli, Italy
| | - Victor Manuel Victor
- Service of Endocrinology, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46010 Valencia, Spain
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Bando Y, Tohyama H, Aoki K, Kanehara H, Hisada A, Okafuji K, Toya D. Ipragliflozin lowers small, dense low-density lipoprotein cholesterol levels in Japanese patients with type 2 diabetes mellitus. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2016; 6:1-7. [PMID: 29067237 PMCID: PMC5644427 DOI: 10.1016/j.jcte.2016.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 05/14/2016] [Accepted: 06/13/2016] [Indexed: 02/06/2023]
Abstract
Small dense LDL-C (sd LDL-C) convey cardiovascular risk in type 2 diabetes (T2D). Ipragliflozin reduced sd LDL-C levels in Japanese patients with T2D. Changes in body weight, TG and LDL-C levels contributed to sd LDL-C reduction.
Aims This preliminary randomized, parallel-group comparative study evaluated the efficacy of ipragliflozin for reduction of small dense low-density lipoprotein cholesterol (sd LDL-C) levels in Japanese patients with type 2 diabetes mellitus (T2DM). Methods Sixty-two patients with T2DM (age, 56 ± 8 years; hemoglobin A1c levels, 8.1 ± 0.9%; BMI, 27.5 ± 3.3 kg/m2) were randomly assigned in a 2:1 ratio to receive ipragliflozin (50 mg/day) (treatment group; n = 40) or continued treatment (control group; n = 22) for 12 weeks. The primary endpoints were changes in sd LDL-C levels detected using the LipoPhor AS® system; the secondary endpoints included changes in the sd LDL-C/large buoyant LDL-C (lb LDL-C) ratio, a surrogate marker for LDL particle size, and percent changes in routine lipid parameters. Results The treatment group exhibited a statistically significant reduction from baseline for LDL-C levels (−0.37 mg/dL vs. 14.4 mg/dL, p = 0.038), sd LDL-C levels (−1.28 mg/dL vs. 2.81 mg/dL, p = 0.012), and sd LDL-C/lb LDL-C ratio (−3.20% vs. 4.58%, p = 0.040) compared with the control group. Multiple regression analysis among all subjects revealed change in TG levels (p = 0.011) and LDL-C levels (p = 0.024) as well as change in body weight (p = 0.006) as independent factors contributing to the reduction in sd LDL-C. Conclusions Ipragliflozin may have a potential for lowering sd LDL-C levels associated with increasing LDL particle size in Japanese patients with T2DM.
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Affiliation(s)
- Yukihiro Bando
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Hitomi Tohyama
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Keiko Aoki
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Hideo Kanehara
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Azusa Hisada
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Kazuhiro Okafuji
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Daisyu Toya
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
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Lee SH, Kim DH, Kim YH, Roh YK, Ju SY, Nam HY, Nam GE, Choi JS, Lee JE, Sang JE, Han K, Park YG. Relationship Between Dyslipidemia and Albuminuria in Hypertensive Adults: A Nationwide Population-Based Study. Medicine (Baltimore) 2016; 95:e3224. [PMID: 27100412 PMCID: PMC4845816 DOI: 10.1097/md.0000000000003224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in hypertensive Korean adults. Data obtained from the Korea National Health and Nutrition Examination Survey in 2011 to 2012 were analyzed. The study included 2330 hypertensive participants. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. Dyslipidemia parameters were defined as high TG ≥200 mg/dL, low HDL-C as HDL-C <40 mg/dL, high TC/HDL-C as TC/HDL-C ratio ≥4, high TG/HDL-C as TG/HDL-C ratio ≥3.8, and high LDL-C/HDL-C as LDL-C/HDL-C ratio ≥2.5. Albuminuria was defined as a urine albumin to creatinine ratio (ACR) ≥30 mg/g. Women with albuminuria showed significantly higher levels of TG, TC/HDL-C, and TG/HDL-C and a lower level of HDL-C than women without albuminuria (all P < 0.05). LogTG, TC/HDL-C, and logTG/HDL-C were positively correlated with ACR in both men and women; however, HDL-C was negatively correlated with ACR in women and non-HDL-C was positively correlated with ACR in men. In men, there was no association between ACR and lipid parameters. However, in women, higher values for logTG, TC/HDL-C, and logTG/HDL-C were associated with an increased odds ratio (OR) for albuminuria (OR [95% confidence interval]: 1.53 [1.06-2.21], 1.21 [1.02-1.45], and 1.78 [1.21-2.63], respectively) and HDL-C with a decreased OR for albuminuria (0.78 [0.67-0.92]) after adjusting for all covariates. LogTG, TC/HDL-C, and logTG/HDL-C were associated with an increased prevalence of albuminuria in hypertensive women. Screening and treatment for dyslipidemia may be necessary for hypertensive women to address potential albuminuria.
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Affiliation(s)
- Sung-Ho Lee
- From the Department of Family Medicine, Korea University, College of Medicine, Seoul (S-HL, DHK, Y-HK, H-YN, G-EN, J-SC, J-EL, J-ES); Department of Family Medicine, Hallym University, College of Medicine, Chunchon (YKR); Department of Family Medicine, Catholic University (SYJ); and Department of Biostatistics, The Catholic University of Korea, College of Medicine, Seoul (KDH, Y-GP), Republic of Korea
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Bando Y, Toyama H, Kanehara H, Hisada A, Okafuji K, Toya D, Tanaka N. Switching from atorvastatin to rosuvastatin lowers small, dense low-density lipoprotein cholesterol levels in Japanese hypercholesterolemic patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2016; 111:66-73. [PMID: 26589368 DOI: 10.1016/j.diabres.2015.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 10/09/2015] [Accepted: 10/09/2015] [Indexed: 11/21/2022]
Abstract
AIMS This open-label, randomized, parallel-group comparative study compared the efficacy of rosuvastatin (5mg/day) and atorvastatin (10mg/day) for reduction of small dense low-density lipoprotein cholesterol (sd LDL-C) levels in Japanese patients with type 2 diabetes mellitus (T2DM). METHODS Patients with T2DM and hypercholesterolemia with detectable sd LDL-C after receiving 10mg/day atorvastatin for ≥ 24 weeks were randomly assigned to receive rosuvastatin (5mg/day; switched treatment) or atorvastatin (10mg/day; continued treatment) for 12 weeks. The primary endpoints were changes in sd LDL-C levels and sd LDL-C/total LDL-C ratio evaluated using the LipoPhor AS(®) system. RESULTS There were no significant percent changes from baseline for LDL-C levels between the switched (n=55) and the continued treatment group (n=56). However, the former group exhibited a statistically significant reduction from baseline of sd LDL-C levels, sd LDL-C/total LDL-C ratio compared with the latter group (-3.8 mg/dL vs. -1.4 mg/dL, p=0.014; -2.3% vs. -0.6%, p=0.004, respectively). Multiple regression analysis among all subjects revealed that independent factors contributing to the reduction in sd LDL-C levels were a change in LDL-C (p=0.003) and triglyceride (TG) levels (p=0.006), treatment group (the switched group=1, the continued group=0; standard coefficient=-1.2, p=0.034) and baseline glycated hemoglobin A1c (HbA1c) (p=0.045), respectively. CONCLUSION Switching from 10mg atorvastatin to 5mg rosuvastatin may be a useful therapeutic option to reduce sd LDL-C levels in Japanese hypercholesterolemic patients with T2DM.
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Affiliation(s)
- Yukihiro Bando
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan.
| | - Hitomi Toyama
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Hideo Kanehara
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Azusa Hisada
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Kazuhiro Okafuji
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Daisyu Toya
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Nobuyoshi Tanaka
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
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Ryan DJ, Stebbings GK, Onambele GL. The emergence of sedentary behaviour physiology and its effects on the cardiometabolic profile in young and older adults. AGE (DORDRECHT, NETHERLANDS) 2015; 37:89. [PMID: 26315694 PMCID: PMC5005832 DOI: 10.1007/s11357-015-9832-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 08/20/2015] [Indexed: 04/17/2023]
Abstract
It has recently emerged that sedentary behaviour is independent of a lack of physical activity as individuals can be sufficiently active, based on the recommended physical activity guidelines, but also spend the majority of their waking hours engaging in sedentary behaviour. Individuals who follow this pattern of physical activity and sedentary behaviour are known as 'active couch potatoes'. Sedentary behaviour has been found to have detrimental effects on cardiometabolic markers associated with cardiovascular disease. Since the positive effects of moderate-to-vigorous intensity physical activity do not necessarily negate the deleterious effects of sedentary behaviour on cardiometabolic markers, it is postulated that engaging in light physical activity is an intervention that will successfully reduce levels of sedentary behaviour and may hence improve health markers of quality of life. We propose that such lifestyle changes may be particularly relevant to older populations as these engage in sedentary behaviour for the majority of their waking hours, thereby adding to the negative aging effect on cardiometabolic markers.
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Affiliation(s)
- D J Ryan
- Health Exercise and Active Living Research Centre, Department of Exercise and Sport Science, Manchester Metropolitan University, Crewe Green Road, Crewe, Cheshire, CW1 5DU, UK,
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Bédard A, Corneau L, Lamarche B, Dodin S, Lemieux S. Sex Differences in the Impact of the Mediterranean Diet on LDL Particle Size Distribution and Oxidation. Nutrients 2015; 7:3705-23. [PMID: 25988764 PMCID: PMC4446774 DOI: 10.3390/nu7053705] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/30/2015] [Accepted: 05/05/2015] [Indexed: 12/11/2022] Open
Abstract
Sex differences have been previously highlighted in the cardioprotective effects of the Mediterranean diet (MedDiet). The objective of this study was to investigate whether sex differences also exist with regard to LDL particle size distribution and oxidation. Participants were 37 men and 32 premenopausal women (24–53 years) with slightly elevated LDL-C concentrations (3.4–4.9 mmol/L) or total cholesterol/HDL-C ≥5.0. Variables were measured before and after a four-week isoenergetic MedDiet. Sex differences were found in response to the MedDiet for the proportion of medium LDL (255–260 Å) (p for sex-by-time interaction = 0.01) and small, dense LDL (sdLDL; <255 Å) (trend; p for sex-by-time interaction = 0.06), men experiencing an increase in the proportion of medium LDL with a concomitant reduction in the proportion of sdLDL, while an opposite trend was observed in women. A sex difference was also noted for estimated cholesterol concentrations among sdLDL (p for sex-by-time interaction = 0.03), with only men experiencing a reduction in response to the MedDiet. The MedDiet marginally reduced oxidized LDL (oxLDL) concentrations (p = 0.07), with no sex difference. Results suggest that short-termconsumption of the MedDiet leads to a favorable redistribution of LDL subclasses from smaller to larger LDL only in men. These results highlight the importance of considering sex issues in cardiovascular benefits of the MedDiet.
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Affiliation(s)
- Alexandra Bédard
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Laval University, Québec, QC G1V 0A6, Canada.
| | - Louise Corneau
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
| | - Benoît Lamarche
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Laval University, Québec, QC G1V 0A6, Canada.
| | - Sylvie Dodin
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- Department of Obstetrics and Gynaecology, Pavillon Ferdinand-Vandry, 1050 Medicine Avenue, Laval University, Québec, QC G1V 0A6, Canada.
| | - Simone Lemieux
- Institute of Nutrition and Functional Foods (INAF), 2440 Hochelaga Boulevard, Laval University, Québec, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Laval University, Québec, QC G1V 0A6, Canada.
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Kawakami Y, Yamanaka-Okumura H, Naniwa-Kuroki Y, Sakuma M, Taketani Y, Takeda E. Flaxseed oil intake reduces serum small dense low-density lipoprotein concentrations in Japanese men: a randomized, double blind, crossover study. Nutr J 2015; 14:39. [PMID: 25896182 PMCID: PMC4409715 DOI: 10.1186/s12937-015-0023-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/01/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The effects of alpha-linolenic acid (ALA) on cardiovascular risk factors considerably vary between published reports. Therefore, we investigated the effects of 12-week supplementation with flaxseed oil (FO), which is a rich source of ALA, on cardiovascular risk factors such as serum small dense low-density lipoprotein (sd-LDL) concentrations. METHODS In a randomized, double blind, crossover study, 15 subjects ingested 10 g of FO or corn oil (CO), containing 5.49 g and 0.09 g of ALA, respectively, once daily with dinner. Blood samples were collected at 0, 4 and 12 weeks, and were used for analysis of serum lipid, lipid-related proteins, serum fatty acids and serum sd-LDL cholesterol. Differences during the test period were identified using a repeated-measures analysis of variance (ANOVA) for within-group effects. Group differences were identified using paired t-test at each blood sampling time point. RESULTS ALA and eicosapentaenoic acid concentrations were significantly higher in the FO period at 4 and 12 weeks than in the CO period. No significant differences in docosahexaenoic acid concentrations were observed between two periods, and cholesteryl ester transfer protein and apolipoprotein B concentrations were significantly lower in the FO period than in the CO period at 12 weeks. FO supplementation was associated with a significant decrease in sd-LDL concentrations at 4 and 12 weeks, and CO supplementation had no effect. Moreover, sd-LDL concentrations were significantly lower in the FO period than in the CO period at 4 weeks. Among subjects with triglyceride (TG) concentrations of >100 mg/dl, FO supplementation markedly reduced sd-LDL concentrations at 4 and 12 weeks compared with baseline. Sd-LDL concentrations significantly differed between the periods at both 4 and 12 weeks. CONCLUSION This study indicates that the FO, which is a rich source of ALA, leads to lower sd-LDL cholesterol concentrations.
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Affiliation(s)
- Yuka Kawakami
- Department of Clinical Nutrition and Food Management, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Hisami Yamanaka-Okumura
- Department of Clinical Nutrition and Food Management, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Yuko Naniwa-Kuroki
- Department of Clinical Nutrition and Food Management, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Masae Sakuma
- Department of Clinical Nutrition and Food Management, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Yutaka Taketani
- Department of Clinical Nutrition and Food Management, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
| | - Eiji Takeda
- Department of Clinical Nutrition and Food Management, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
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Song TJ, Cho HJ, Chang Y, Youn M, Shin MJ, Jo I, Heo JH, Kim YJ. Low-density-lipoprotein particle size predicts a poor outcome in patients with atherothrombotic stroke. J Clin Neurol 2015; 11:80-6. [PMID: 25628741 PMCID: PMC4302183 DOI: 10.3988/jcn.2015.11.1.80] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE Low-density lipoprotein (LDL) particle size is considered to be one of the more important cardiovascular risk factors, and small LDL particles are known to have atherogenic potential. The aim of this study was to determine whether LDL particle size is associated with stroke severity and functional outcome in patients with atherothrombotic stroke. METHODS Between January 2009 and May 2011, 248 patients with first-episode cerebral infarction who were admitted to our hospital within 7 days after symptom onset were prospectively enrolled. LDL particle size was measured using the nondenaturing polyacrylamide gradient gel electrophoresis assay. Stroke severity was assessed by applying the National Institutes of Health Stroke Scale (NIHSS) at admission. Functional outcome was investigated at 3 months after the index stroke using the modified Rankin Scale (mRS), and poor functional outcome was defined as an mRS score of ≥3. RESULTS The LDL particle size in the 248 patients was 25.9±0.9 nm (mean±SD). LDL particle size was inversely correlated with the degree of cerebral artery stenosis (p=0.010). Multinomial multivariate logistic analysis revealed that after adjustment for age, sex, and variables with p<0.1 in univariate analysis, LDL particle size was independently and inversely associated with stroke severity (NIHSS score ≥5; reference, NIHSS score 0-2; odds ratio=0.38, p=0.028) and poor functional outcome (odds ratio=0.44, p=0.038). CONCLUSIONS The results of this study demonstrate that small LDL particles are independently correlated with stroke outcomes. LDL particle size is thus a potential biomarker for the prognosis of atherothrombotic stroke.
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Affiliation(s)
- Tae-Jin Song
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea. ; Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun-Ji Cho
- Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Yoonkyung Chang
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Minjung Youn
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Min-Jeong Shin
- Department of Food and Nutrition and Institute of Health Sciences, Korea University, Seoul, Korea
| | - Inho Jo
- Department of Molecular Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Ji Hoe Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Jae Kim
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
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Jacomella V, Gerber PA, Mosimann K, Husmann M, Thalhammer C, Wilkinson I, Berneis K, Amann-Vesti BR. Small dense low density lipoprotein particles are associated with poor outcome after angioplasty in peripheral artery disease. PLoS One 2014; 9:e108813. [PMID: 25265512 PMCID: PMC4181875 DOI: 10.1371/journal.pone.0108813] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/28/2014] [Indexed: 12/02/2022] Open
Abstract
Purpose In patients suffering from symptomatic peripheral artery disease (PAD), percutaneous revascularization is the treatment of choice. However, restenosis may occur in 10 to 60% in the first year depending on a variety of factors. Small dense low density lipoprotein (sdLDL) particles are associated with an increased risk for cardiovascular events, but their role in the process of restenosis is not known. We conducted a prospective study to analyze the association of sdLDL particles with the outcome of balloon angioplasty in PAD. The composite primary endpoint was defined as improved walking distance and absence of restenosis. Methods Patients with angiographically documented PAD of the lower extremities who were scheduled for lower limb revascularization were consecutively recruited for the study. At baseline and at three month follow-up triglyceride, total cholesterol, LDL size and subclasses and HDL cholesterol and ankle-brachial index (ABI) were measured. Three months after the intervention duplex sonography was performed to detect restenosis. Results Sixty-four patients (53% male) with a mean age of 68.6±9.9 years were included. The proportion of small- dense LDL particles (class III and IV) was significantly lower (33.1±11.0% vs. 39.4±12.1%, p = 0.038) in patients who reached the primary end-point compared with those who did not. Patients with improved walking distance and without restenosis had a significantly higher LDL size at baseline (26.6±1.1 nm vs. 26.1±1.1 nm, p = 0.046) and at follow-up (26.7±1.1 nm vs. 26.2±0.9 nm, p = 0.044) than patients without improvement. Conclusions Small-dense LDL particles are associated with worse early outcome in patients undergoing percutaneous revascularization for symptomatic PAD.
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Affiliation(s)
- Vincenzo Jacomella
- Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland
- * E-mail:
| | - Philipp A. Gerber
- Clinic for Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Kathrin Mosimann
- Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland
| | - Marc Husmann
- Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Ian Wilkinson
- Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kaspar Berneis
- Clinic for Endocrinology, University Hospital Zurich, Zurich, Switzerland
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Kikkawa K, Nakajima K, Shimomura Y, Tokita Y, Machida T, Sumino H, Murakami M. Small dense LDL cholesterol measured by homogeneous assay in Japanese healthy controls, metabolic syndrome and diabetes patients with or without a fatty liver. Clin Chim Acta 2014; 438:70-9. [PMID: 25050800 DOI: 10.1016/j.cca.2014.07.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/21/2014] [Accepted: 07/14/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND Serum small dense LDL-cholesterol (sdLDL-C) levels in healthy controls and the cases with diabetes (T2DM) and metabolic syndrome (MetS) with or without a fatty liver in a large, typical Japanese population was determined. METHODS The plasma lipids and lipoproteins, including sdLDL-C by homogeneous assay, were determined in controls, MetS and T2DM patients (n=5255). The cases with MetS and preliminary MetS (pre-MetS) as well as T2DM and preliminary T2DM (pre-DM) were selected based on the Japanese criteria for MetS and T2DM. Fatty liver was diagnosed using the ultrasonography. RESULTS The 75th percentile values for sdLDL-C were 27.5mg/dl for men and 23.3mg/dl for women and increased with age. The concentrations of sdLDL-C and sdLDL-C/LDL-C were significantly higher in pre-MetS and pre-T2DM patients than healthy controls as well as in MetS and T2DM patients. Significantly higher sdLDL-C was found in cases with a fatty liver than without a fatty liver in all five groups. CONCLUSIONS Significantly elevated sdLDL-C levels were found in pre-MetS, MetS and pre-T2DM, T2DM patients compared to the healthy controls. Fatty liver significantly enhanced serum sdLDL-C levels and the multiple regression analyses ascertained that fatty liver was an independent determinant for sdLDL-C.
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Affiliation(s)
- Koji Kikkawa
- Diabetes and Metabolic Disease Research Center, Hidaka Hospital, Takasaki, Gunma, Japan; Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
| | - Katsuyuki Nakajima
- Diabetes and Metabolic Disease Research Center, Hidaka Hospital, Takasaki, Gunma, Japan; Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Younosuke Shimomura
- Diabetes and Metabolic Disease Research Center, Hidaka Hospital, Takasaki, Gunma, Japan
| | - Yoshiharu Tokita
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Tetsuo Machida
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hiroyuki Sumino
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Masami Murakami
- Diabetes and Metabolic Disease Research Center, Hidaka Hospital, Takasaki, Gunma, Japan
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Rizzo M, Giglio RV, Nikolic D, Patti AM, Campanella C, Cocchi M, Katsiki N, Montalto G. Effects of chitosan on plasma lipids and lipoproteins: a 4-month prospective pilot study. Angiology 2014; 65:538-42. [PMID: 23785043 DOI: 10.1177/0003319713493126] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Chitosan can favorably modulate plasma lipids, but the available data are not conclusive. We evaluated the effect of chitosan on plasma lipids and lipoproteins in 28 patients with plasma triglyceride levels >150 mg/dL (mean age: 63 ± 12 years), not taking other lipid-lowering agents. All patients received a chitosan derived from fungal mycelium (Xantonet, Bromatech, Italy) at a fixed dose of 125 mg/d in addition to their current medications for 4 months. Polyacrylamide gel electrophoresis was used to measure low-density lipoprotein (LDL) subclasses. After treatment, total cholesterol reduced by 8%, LDL cholesterol by 2%, and triglycerides by 19%, with a concomitant 14% increase in high-density lipoprotein cholesterol. We also found a beneficial effect of chitosan on LDL subclasses, with a significant increase in LDL-2 particles (from 37 ± 8% to 47 ± 8%, P = .0001) and a decrease (although not significant) in atherogenic small, dense LDL. Whether these findings may affect cardiovascular risk remains to be established in future studies.
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Affiliation(s)
- Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy Department of Medicine, Euro-Mediterranean Institute of Science and Technology, Italy Paolo Sotgiu Institute for Quantitative and Evolutionary Psychiatry and Cardiology, L.U.de.S. University, Lugano, Switzerland
| | - Rosaria Vincenza Giglio
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Dragana Nikolic
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Angelo Maria Patti
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Claudia Campanella
- Department of Medicine, Euro-Mediterranean Institute of Science and Technology, Italy Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Italy
| | - Massimo Cocchi
- Paolo Sotgiu Institute for Quantitative and Evolutionary Psychiatry and Cardiology, L.U.de.S. University, Lugano, Switzerland
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Giuseppe Montalto
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Garoufi A, Vorre S, Soldatou A, Tsentidis C, Kossiva L, Drakatos A, Marmarinos A, Gourgiotis D. Plant sterols-enriched diet decreases small, dense LDL-cholesterol levels in children with hypercholesterolemia: a prospective study. Ital J Pediatr 2014; 40:42. [PMID: 24887013 PMCID: PMC4018958 DOI: 10.1186/1824-7288-40-42] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 04/22/2014] [Indexed: 11/24/2022] Open
Abstract
Background Small dense low density lipoprotein-cholesterol (sdLDL-C) molecules are more atherogenic compared with large buoyant ones. Phytosterols-enriched diets are effective in decreasing total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C) concentrations in hyperlipidemic children without significant adverse effects. Limited data on the impact of such a diet on sdLDL-C levels is available in adults while there are no reports concerning children. The purpose of this study is to prospectively evaluate the effect of the daily consumption of 2 g of plant sterols on sdLDL-C levels in children with hypercholesterolemia. Methods Fifty-nine children, 25 with LDL-C ≥ 3.4 mmol/l (130 mg/dl) and 34 with LDL-C < 3.4 mmol/l, aged 4.5-15.9 years, were included in the study. A yogurt-drink enriched with 2 g of plant sterols was added to the daily diet of hypercholesterolemic children and 6–12 months later lipid profiles were reassessed. Direct quantitative methods were used to measure LDL-C and sdLDL-C levels. Results The consumption of plant sterols reduced sdLDL-C significantly (p < 0.001), but levels remained higher compared with controls (p < 0.001). TC, LDL-C, non high density lipoprotein-cholesterol (NonHDL-C) and apolipoprotein B (ApoB) levels also decreased significantly (p < 0.05). The median reduction of sdLDL-C and LDL-C was 16.6% and 13%, respectively. These variables decreased >10% in sixteen children (64%), independently from baseline levels, sex, age and body mass index (BMI). High density lipoprotein-cholesterol (HDL-C), lipoprotein a [Lp(a)], and triglycerides (TGs) levels remained unaffected. Conclusions Plant sterols decrease sdLDL-C significantly and may be beneficial for children with hypercholesterolemia.
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Affiliation(s)
- Anastasia Garoufi
- Lipid Outpatient Clinic, Second Department of Pediatrics, Athens University, Athens, Greece.
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Grammer TB, Kleber ME, März W, Silbernagel G, Siekmeier R, Wieland H, Pilz S, Tomaschitz A, Koenig W, Scharnagl H. Low-density lipoprotein particle diameter and mortality: the Ludwigshafen Risk and Cardiovascular Health Study. Eur Heart J 2014; 36:31-8. [DOI: 10.1093/eurheartj/ehu055] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tanja B. Grammer
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Marcus E. Kleber
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Winfried März
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, Graz A-8036, Austria
- Synlab Academy, Mannheim, Germany
| | - Günther Silbernagel
- Department of Angiology, Swiss Cardiovascular Center, Inselspital, University of Bern, Bern, Switzerland
| | | | - Heinrich Wieland
- Division of Clinical Chemistry, University Medical Center Freiburg, Freiburg, Germany
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - Andreas Tomaschitz
- Department of Cardiology, Medical University of Graz, Graz, Austria
- Specialist Clinic for Rehabilitation PVA Bad Aussee, Bad Aussee, Austria
| | - Wolfgang Koenig
- Department of Internal Medicine II – Cardiology, University of Ulm Medical Centre, Ulm, Germany
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, Graz A-8036, Austria
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Ahmad S, Beg ZH. Elucidation of mechanisms of actions of thymoquinone-enriched methanolic and volatile oil extracts from Nigella sativa against cardiovascular risk parameters in experimental hyperlipidemia. Lipids Health Dis 2013; 12:86. [PMID: 23758650 PMCID: PMC3693939 DOI: 10.1186/1476-511x-12-86] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nigella sativa belonging to the Ranunculaceae family has been reported to use for thousands of years as protective and curative traditional medicine against a number of diseases. GC-MS analysis of methanolic extract (ME) and volatile oil (VO) extracted from Nigella sativa seed oil was performed by two different mass spectrometry libraries, WIlEY8 and NIST05s. The cholesterol lowering and antioxidant actions of VO and ME fractions were investigated in atherogenic suspension fed rats. METHODS In this study, four groups of male Wistar rats were used: normolipidemic control (NLP-C), hyperlipidemic control (HLP-C), methanolic extract (HLP-ME) and volatile oil treated (HLP-VO) groups for 30 days of duration. P value < 0.05 was assumed as significant data in groups. RESULTS Administration of atherogenic suspension to male Wistar rats for 30 days resulted in a marked increase of plasma triglycerides and total cholesterol, and significant change in plasma lipoprotein levels along with a decrease in antioxidant arylesterase activity in hyperlipidemic control (HLP-C) group. The oral feeding of 100 mg ME or 20 mg VO per rat/day effectively reduced the plasma triglycerides to near normal level, while high density lipoprotein cholesterol and its subfraction along with arylesterase activity levels were significantly increased. The test fractions elicited a significant decrease in hepatic HMG-CoA reductase activity. The fractions significantly blocked the ex vivo basal and in vitro maximal formation of conjugated diene and malondialdehyde, and lengthened the lag times of low density lipoprotein, small dense low density lipoprotein and large buoyant low density lipoprotein. ME possessing ω-6 linoleic acid along with palmitic acid active compounds was more effective than VO extract containing thymol and isothymol phenolic antioxidant compounds, thymoquinone phenolic compound common to the both extracts, via reduction in hepatic HMG-CoA reductase activity as well as antioxidant mechanisms. CONCLUSION The both extracts especially, ME significantly improve cardiovascular risk parameters in treated rats, and can be used in reactive oxygen species disorders such as cardiovascular diseases.
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Affiliation(s)
- Shafeeque Ahmad
- Department of Biochemistry, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, UP 202 002, India
| | - Zafarul H Beg
- Department of Biochemistry, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, UP 202 002, India
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Abstract
Insulin resistance is a complex metabolic defect that has several causes dependent on an individual's genetic substrate and the underlying pathophysiologic state. Atherogenic dyslipidemia, hyperinsulinemia, dysglycemia, inflammation associated with obesity, and ectopic steatosis in liver and skeletal muscle all collude to facilitate endothelial dysfunction and predispose to the initiation and propagation of atherosclerosis. As aggressive management of the various risk factors does not seem to abrogate the so-called residual risk, more research is needed to define ways by which intervention can fundamentally alter the metabolic and vascular milieu and slow the pace of atherosclerosis, thus favorably affecting outcomes.
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Affiliation(s)
- Vasudevan A Raghavan
- Division of Endocrinology, Department of Internal Medicine, Texas A&M Health Sciences Center and College of Medicine, Temple, TX 76508, USA.
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Baliarsingh S, Sharma N, Mukherjee R. Serum uric acid: marker for atherosclerosis as it is positively associated with "atherogenic index of plasma". Arch Physiol Biochem 2013; 119:27-31. [PMID: 23083415 DOI: 10.3109/13813455.2012.732580] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Serum uric acid (SUA) has been known to be associated with cardiovascular diseases. "Atherogenic index of plasma" (AIP) is considered a very sensitive predictor of future cardiovascular events. OBJECTIVES This study was conducted to analyse the association of AIP with SUA and various other lipid parameters. METHODS Parameters were measured on a fully automated analyser using standard reagent kits in a retrospective study involving 248 male Indian subjects between 40 to 59 years of age. RESULTS AIP correlates: moderately with TC/HDL-C (r = 0.47, p < 0.0001); to a lesser extent but comparably (r = 0.2, p < 0.01) with SUA, LDL-C/HDL-C and TC; negligibly with LDL-C and age. DISCUSSION AND CONCLUSION As SUA is positively associated with AIP it can be used as a supplementary marker for atherosclerosis/CVD in upper-middle-aged men.
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Affiliation(s)
- Simant Baliarsingh
- Department of Biochemistry, SRMS Institute of Medical Sciences, Bareilly, UP, India.
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Tamura K, Tsurumi-Ikeya Y, Wakui H, Maeda A, Ohsawa M, Azushima K, Kanaoka T, Uneda K, Haku S, Azuma K, Mitsuhashi H, Tamura N, Toya Y, Tokita Y, Kokuho T, Umemura S. Therapeutic Potential of Low-Density Lipoprotein Apheresis in the Management of Peripheral Artery Disease in Patients With Chronic Kidney Disease. Ther Apher Dial 2012; 17:185-92. [DOI: 10.1111/j.1744-9987.2012.01149.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Lakshmy R, Dorairaj P, Tarik M, Gupta R, Reddy KS. LDL particle heterogeneity, and its association with other established cardiovascular risk factors in a young Indian industrial population. HEART ASIA 2012; 4:141-5. [PMID: 27326051 PMCID: PMC4832615 DOI: 10.1136/heartasia-2012-010130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2012] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Low density lipoprotein (LDL) particles are heterogeneous in terms of size, density, chemical composition and electric charge with certain particle of LDL being more atherogenic than the others. The present study aimed to look at the LDL particle heterogeneity, particle size and association with other cardiovascular disease (CVD) risk factors in young Indian industrial population. METHODOLOGY 600 employees of an industry of Delhi, aged 20-39 years were selected for the study. Data on demographics, individual characteristics associated with major risk factors of CVD, past medical history, clinical and anthropometric profile was collected. Fasting glucose, lipid profile, apolipoprotein (A1, B, and E), lipoprotein (a), high sensitive C-reactive protein (hsCRP) and insulin were estimated. LDL particle size was determined in ethylenediamminetetraacetate (EDTA) plasma by 3% polyacrylamide gel electrophoresis. RESULT We found a prevalence of small dense LDL phenotype (LDL size ≤ 26.3) in 27.4% of males and 24.0% of females. The mean waist circumference, blood pressure, triglycerides (TAG), cholesterol, hsCRP, apolipoprotein (A1, B and E) and insulin were higher in males whereas mean high density lipoprotein was higher in females. Females also had a significantly higher mean LDL particle diameter as compared to males. CONCLUSION TAG, physical activity and lipoprotein (a) correlated with small dense LDL in this young Indian population.
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Affiliation(s)
- Ramakrishnan Lakshmy
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | | | - Mohamad Tarik
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Ruby Gupta
- Center for Chronic Disease Control, New Delhi, India
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Serum Small Dense Low-density Lipoprotein Concentrations are Elevated in Patients with Significant Coronary Artery Stenosis and are Related to Features of the Metabolic Syndrome. Lipids 2012; 47:963-72. [DOI: 10.1007/s11745-012-3706-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 07/30/2012] [Indexed: 10/28/2022]
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Emadzadeh MR, Alavi MS, Soukhtanloo M, Mohammadpour T, Rahsepar AA, Tavallaie S, Khojasteh R, Paydar R, Amini M, Parizadeh SMR, Akhlaghi S, Ghayour-Mobarhan M, Ferns GA. Changes in small dense low-density lipoprotein levels following acute coronary syndrome. Angiology 2012; 64:216-22. [PMID: 22539803 DOI: 10.1177/0003319712441855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Low-density lipoprotein (LDL), especially small dense LDL (sdLDL), plays a role in atherogenesis. We compared baseline sdLDL levels between healthy controls and patients with acute coronary syndrome (ACS). Blood samples were taken from patients diagnosed with myocardial infarction ([MI] n = 104) and unstable angina ([UA] n = 100). Both sdLDL and high-sensitivity C-reactive protein (hsCRP) levels were determined on admission and in the next 24 hours after the onset of symptoms. Baseline concentration of sdLDL was significantly higher in patients presenting with ACS than controls (P < .05). In the 24 hours following ACS, the sdLDL levels decreased insignificantly in both groups of patients with ACS (P > .05). The changes in sdLDL values were not significantly different between MI and UA participants (P > .05). Patients with ACS have higher concentration of sdLDL compared with the controls.
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Affiliation(s)
- Mahdi Reza Emadzadeh
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Science Mashhad, Iran
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Berger JS, McGinn AP, Howard BV, Kuller L, Manson JE, Otvos J, Curb JD, Eaton CB, Kaplan RC, Lynch JK, Rosenbaum DM, Wassertheil-Smoller S. Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women. Stroke 2012; 43:958-66. [PMID: 22308251 DOI: 10.1161/strokeaha.111.641324] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies simultaneously investigated lipids and lipoprotein biomarkers as predictors of ischemic stroke. The value of these biomarkers as independent predictors of ischemic stroke remains controversial. METHODS We conducted a prospective nested case-control study among postmenopausal women from the Women's Health Initiative Observational Study to assess the relationship between fasting lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides), lipoproteins (LDL, HDL, and very low-density lipoprotein [VLDL] particle number and size, intermediate-density lipoprotein [IDL] particle number, and lipoprotein (a)), and risk of ischemic stroke. Among women free of stroke at baseline, 774 ischemic stroke patients were matched according to age and race to control subjects, using a 1:1 ratio. RESULTS In bivariate analysis, baseline triglycerides (P<0.001), IDL particles (P<0.01), LDL particles (P<0.01), VLDL triglyceride (P<0.001), VLDL particles (P<0.01), VLDL size (P<0.001), LDL size (P=0.03), and total/HDL cholesterol ratio (P<0.01) were significantly higher among women with incident ischemic stroke, whereas levels of HDL-C (P<0.01) and HDL size (P<0.01) were lower. No significant baseline difference for total cholesterol (P=0.15), LDL-C (P=0.47), and lipoprotein (a) (P=0.11) was observed. In multivariable analysis, triglycerides (odds ratio for the highest versus lowest quartile, 1.56; 95% confidence interval, 1.13-2.17; P for trend=0.02), VLDL size (odds ratio, 1.59; 95% confidence interval, 1.10-2.28; P for trend=0.03), and IDL particle number (odds ratio, 1.46; 95% confidence interval, 1.04-2.04; P for trend=0.02) were significantly associated with ischemic stroke. CONCLUSIONS Among a panel of lipid and lipoprotein biomarkers, baseline triglycerides, VLDL size, and IDL particle number were significantly associated with incident ischemic stroke in postmenopausal women.
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Affiliation(s)
- Jeffrey S Berger
- FAHA, New York University School of Medicine, 530 First Ave, Skirball 9R, New York, NY 10016, USA.
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Maeda S, Nakanishi S, Yoneda M, Awaya T, Yamane K, Hirano T, Kohno N. Associations between small dense LDL, HDL subfractions (HDL2, HDL3) and risk of atherosclerosis in Japanese-Americans. J Atheroscler Thromb 2011; 19:444-52. [PMID: 22659528 DOI: 10.5551/jat.11445] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Small dense low-density lipoprotein (sdLDL) has been suggested to be more atherogenic than large buoyant LDL. High-density lipoprotein (HDL) consists of two major subfractions (HDL2, HDL3), and just as controversy remains regarding which of the two is the more powerful negative risk factor for atherosclerosis, associations between sdLDL and these HDL subfractions are unclear. METHODS We measured sdLDL cholesterol (sdLDL-C), HDL2 cholesterol (HDL2-C) and HDL3 cholesterol (HDL3-C) by a newly developed method in 481 Japanese-Americans who were not using lipid-lowering medication, and examined the associations of these cholesterol concentrations with variables related to atherosclerosis. RESULTS In multivariate analysis, sdLDL-C was positively correlated with the body mass index (BMI), fasting glucose and insulin, 2-h glucose, HOMA-IR, high sensitivity C-reactive protein (hsCRP), and carotid artery intima-media thickness (IMT) after adjustment for age and sex. In particular, sdLDL-C was positively correlated with IMT, even after adjustment for sex, age, smoking status, hypertension, diabetes mellitus and hsCRP. HDL2-C was more closely inversely correlated than total HDL-C with BMI, fasting glucose and insulin, 2-h glucose, HOMA-IR, and hsCRP, whereas HDL3-C was not correlated with these factors. Additionally, HDL2-C was more closely correlated than total HDL-C or HDL3-C with sdLDL-C, LDL-C, triglycerides (TG), and apolipoprotein B (apoB). CONCLUSIONS SdLDL-C was closely associated with insulin resistance and glucose tolerance, lending credence to its potential as a useful risk marker in assessing carotid artery IMT and the present degree of atherosclerosis in Japanese-Americans. The findings also suggest that subjects with higher HDL2-C levels were better protected from atherosclerosis.
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Affiliation(s)
- Shusaku Maeda
- Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Japan
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Carpentier Y, Komsa-Penkova R. Clinical Nutrition University. The place of nutrition in the prevention of cardiovascular diseases (CVDs). ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.eclnm.2011.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Maki KC, Bays HE, Dicklin MR, Johnson SL, Shabbout M. Effects of prescription omega-3-acid ethyl esters, coadministered with atorvastatin, on circulating levels of lipoprotein particles, apolipoprotein CIII, and lipoprotein-associated phospholipase A2 mass in men and women with mixed dyslipidemia. J Clin Lipidol 2011; 5:483-92. [DOI: 10.1016/j.jacl.2011.09.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 08/16/2011] [Accepted: 09/08/2011] [Indexed: 11/26/2022]
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Subramanian S, Chait A. Hypertriglyceridemia secondary to obesity and diabetes. Biochim Biophys Acta Mol Cell Biol Lipids 2011; 1821:819-25. [PMID: 22005032 DOI: 10.1016/j.bbalip.2011.10.003] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 09/09/2011] [Accepted: 10/03/2011] [Indexed: 02/04/2023]
Abstract
Hypertriglyceridemia is a common lipid abnormality in persons with visceral obesity, metabolic syndrome and type 2 diabetes. Hypertriglyceridemia typically occurs in conjunction with low HDL levels and atherogenic small dense LDL particles and is associated with increased cardiovascular risk. Insulin resistance is often an underlying feature and results in increased free fatty acid (FFA) delivery to the liver due to increased peripheral lipolysis. Increased hepatic VLDL production occurs due to increased substrate availability via FFAs, decreased apolipoprotein B100 degradation and increased lipogenesis. Postprandial hypertriglyceridemia also is a common feature of insulin resistance. Small dense LDL that coexist with decreased HDL particles in hypertriglyceridemic states are highly pro-atherogenic due to their enhanced endothelial permeability, proteoglycan binding abilities and susceptibility to oxidation. Hypertriglyceridemia also occurs in undertreated individuals with type 1 diabetes but intensive glucose control normalizes lipid abnormalities. However, development of visceral obesity in these patients unravels a similar metabolic profile as in patients with insulin resistance. Modest hypertriglyceridemia increases cardiovascular risk, while marked hypertriglyceridemia should be considered a risk for pancreatitis. Lifestyle modification is an important therapeutic strategy. Drug therapy is primarily focused on lowering LDL levels with statins, since efforts at triglyceride lowering and HDL raising with fibrates and/or niacin have not yet been shown to be beneficial in improving cardiovascular risk. Fibrates, however, are first-line agents when marked hypertriglyceridemia is present. This article is part of a Special Issue entitled Triglyceride Metabolism and Disease.
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Affiliation(s)
- Savitha Subramanian
- Diabetes Obesity Center of Excellence, Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA, USA
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