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Chuang TL, Chuang MH, Koo M, Lin CH, Wang YF. Association of bone mineral density and trabecular bone score with cardiovascular disease. Tzu Chi Med J 2020; 32:234-239. [PMID: 32955509 PMCID: PMC7485677 DOI: 10.4103/tcmj.tcmj_234_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/15/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022] Open
Abstract
Traditionally, osteoporosis and cardiovascular disease (CVD) are considered as separate chronic diseases. Increasing evidence now links osteoporosis with hypertension, abnormal lipid metabolism, atherosclerosis, vascular calcification (VC), and congestive heart failure. VC coexists with bone loss, and aortic calcification is a strong predictor of low bone mineral density (BMD) and fragility fractures. The same holds true for coronary artery calcification (CAC): the lower the BMD, the higher the CAC. Trabecular bone score (TBS) iNsight software can analyze the existing BMD database to obtain the bony microstructure score (TBS). Many TBS-related studies include fracture risk, normal aging, diabetes, potential genes, obesity, and asthma severity prediction. The inverse relationship of TBS to VC may provide insight into bone–vascular interactions in chronic kidney disease. A higher TBS has been associated with moderate, but not high, CAC. One explanation is that bone microstructural remodeling becomes more active during early coronary calcification. Increased risk of 10-year likelihood of hip fracture and major osteoporotic fracture as estimated by the fracture risk assessment tool FRAX® is significantly and independently associated with more severe CAC scores. Dual-energy X-ray absorptiometry and FRAX® can be used to predict fracture risk and CAC scores, identifying patients who may benefit from early intervention. This review will discuss the relationship and possible mechanism of BMD, TBS, and FRAX® with CVD and VC or CAC.
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Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Mei-Hua Chuang
- Faculty of Pharmacy, National Yang-Ming University, Taipei, Taiwan.,Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-Term Care, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Chun-Hung Lin
- Department of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan.,Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
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Clemente A, Traghella I, Mazzone A, Sbrana S, Vassalle C. Vascular and valvular calcification biomarkers. Adv Clin Chem 2020; 95:73-103. [PMID: 32122525 DOI: 10.1016/bs.acc.2019.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Vascular and valvular calcification constitutes a major health problem with serious clinical consequences. It is important for medical laboratorians to improve their knowledge on this topic and to know which biological markers may have a potential interest and might be useful for diagnosis and for management of ectopic calcifications. This review focuses on the pathophysiological mechanisms of vascular and valvular calcification, with emphasis on the mechanisms that are different for the two types of events, which underscore the need for differentiated healthcare, and explain different response to therapy. Available imaging and scoring tools used to assess both vascular and valvular calcification, together with the more studied and reliable biological markers emerging in this field (e.g., Fetuin A and matrix Gla protein), are discussed. Recently proposed functional assays, measuring the propensity of human serum to calcify, appear promising for vascular calcification assessment and are described. Further advancement through omic technologies and statistical tools is also reported. Clinical chemistry and laboratory medicine practitioners overlook this new era that will engage them in the near future, where a close cooperation of professionals with different competencies, including laboratorists, is required. This innovative approach may truly revolutionize practice of laboratory and of whole medicine attitude, making progression in knowledge of pathways relevant to health, as the complex calcification-related pathways, and adding value to patient care, through a precision medicine strategy.
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53
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Alekos NS, Moorer MC, Riddle RC. Dual Effects of Lipid Metabolism on Osteoblast Function. Front Endocrinol (Lausanne) 2020; 11:578194. [PMID: 33071983 PMCID: PMC7538543 DOI: 10.3389/fendo.2020.578194] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/25/2020] [Indexed: 12/14/2022] Open
Abstract
The skeleton is a dynamic and metabolically active organ with the capacity to influence whole body metabolism. This newly recognized function has propagated interest in the connection between bone health and metabolic dysfunction. Osteoblasts, the specialized mesenchymal cells responsible for the production of bone matrix and mineralization, rely on multiple fuel sources. The utilization of glucose by osteoblasts has long been a focus of research, however, lipids and their derivatives, are increasingly recognized as a vital energy source. Osteoblasts possess the necessary receptors and catabolic enzymes for internalization and utilization of circulating lipids. Disruption of these processes can impair osteoblast function, resulting in skeletal deficits while simultaneously altering whole body lipid homeostasis. This article provides an overview of the metabolism of postprandial and stored lipids and the osteoblast's ability to acquire and utilize these molecules. We focus on the requirement for fatty acid oxidation and the pathways regulating this function as well as the negative impact of dyslipidemia on the osteoblast and skeletal health. These findings provide key insights into the nuances of lipid metabolism in influencing skeletal homeostasis which are critical to appreciate the extent of the osteoblast's role in metabolic homeostasis.
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Affiliation(s)
- Nathalie S. Alekos
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Megan C. Moorer
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Baltimore Veterans Administration Medical Center, Baltimore, MD, United States
| | - Ryan C. Riddle
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Baltimore Veterans Administration Medical Center, Baltimore, MD, United States
- *Correspondence: Ryan C. Riddle
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Abstract
PURPOSE OF REVIEW In this review, we describe the mechanism behind coronary artery calcification formation and detection, as well as its implication in cardiovascular disease (CVD) risk stratification, intervention, and prognosis in asymptomatic individuals. RECENT FINDINGS Multiple cohort and population studies have shown that coronary artery calcium scoring is effective and reproducible in predicting the risk for cardiovascular disease. The updated 2018 ACC/AHA guideline has incorporated consideration of coronary artery calcification testing into cardiovascular disease risk stratification and therapy guidance. Coronary artery calcification's evidence-based role in detection, risk stratification, and ultimately its unique influence on therapeutic intervention and prognosis of cardiovascular disease in asymptomatic population is increasingly being recognized..
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Abstract
PURPOSE OF REVIEW This review addresses recent developments in studies of lipid regulation of calcific disease of arteries and cardiac valves, including the role of nuclear receptors. The role of lipid-soluble signals and their receptors is timely given the recent evidence and concerns that lipid-lowering treatment may increase the rate of progression of coronary artery calcification, which has been long associated with increased cardiovascular risk. Understanding the mechanisms will be important for interpreting such clinical information. RECENT FINDINGS New findings support regulation of calcific vascular and valvular disease by nuclear receptors, including the vitamin D receptor, glucocorticoid receptor, nutrient-sensing nuclear receptors (liver X receptor, farnesoid X receptor, and peroxisome proliferator-activated receptors), and sex hormone (estrogen and androgen) receptors. There were two major unexpected findings: first, vitamin D supplementation, which was previously believed to prevent or reduce vascular calcification, showed no cardiovascular benefit in large randomized, controlled trials. Second, both epidemiological studies and coronary intravascular ultrasound studies suggest that treatment with HMG-CoA reductase inhibitors increases progression of coronary artery calcification, raising a question of whether there are mechanically stable and unstable forms of coronary calcification. SUMMARY For clinical practice and research, these new findings offer new fundamental mechanisms for vascular calcification and provide new cautionary insights for therapeutic avenues.
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Affiliation(s)
- Tamer Sallam
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA 90095-1679
- Department of Physiology, University of California, Los Angeles, Los Angeles, CA 90095-1679
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095-1679
| | - Yin Tintut
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA 90095-1679
- Department of Physiology, University of California, Los Angeles, Los Angeles, CA 90095-1679
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA 90095-1679
| | - Linda L. Demer
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA 90095-1679
- Department of Physiology, University of California, Los Angeles, Los Angeles, CA 90095-1679
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095-1679
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Hong WJ, Chen W, Yeo KJ, Huang PH, Chen DY, Lan JL. Increased risk of osteoporotic vertebral fracture in rheumatoid arthritis patients with new-onset cardiovascular diseases: a retrospective nationwide cohort study in Taiwan. Osteoporos Int 2019; 30:1617-1625. [PMID: 31127317 DOI: 10.1007/s00198-019-04966-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/07/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Both cardiovascular diseases (CVD) and osteoporosis are common comorbidities in rheumatoid arthritis (RA) patients. Although accumulating evidence indicates a link between CVD and osteoporotic fracture, whether CVD contributes to osteoporotic fracture risk in RA has yet to be explored. We examined the incidence rate and risk factors of osteoporotic vertebral fracture in RA patients with new-onset CVD (RA-CVD) and evaluated the effects of medications on such fracture risk. METHODS A retrospective study was conducted using a nationwide database from 2000 to 2010: 1267 RA-CVD and 1267 non-CVD patients were enrolled from 30,507 patients with newly diagnosed RA. The main outcome was the development of osteoporotic vertebral fracture. After being adjusted for age, gender, and comorbidities, the Cox proportional hazard model was used to identify independent factors contributing to osteoporotic vertebral fracture. RESULTS The adjusted hazard ratio (aHR) of developing osteoporotic vertebral fracture was 1.47-fold greater in RA-CVD group than in non-CVD group (95% confidence interval 1.19-1.81, p < 0.001). Both the age above 40 years and female gender were significant risk factors for developing osteoporotic vertebral fracture in RA-CVD patients. Using patients not taking medication as a reference group, the aHR of osteoporotic vertebral fracture was significantly lower in those receiving statins (0.50), low-dose corticosteroids (0.57), or hydroxychloroquine (0.12). CONCLUSIONS The risk of osteoporotic vertebral fracture was significantly increased in RA-CVD patients, particularly women above 40 years of age, and could be reduced by statin therapy. However, the protective effect of low-dose corticosteroids or hydroxychloroquine on osteoporotic vertebral fracture risk needs further validation.
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Affiliation(s)
- W-J Hong
- Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan
| | - W Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - K-J Yeo
- Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan
| | - P-H Huang
- Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - D-Y Chen
- College of Medicine, China Medical University, Taichung, Taiwan.
- Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, No. 2, Yude Road, Taichung, 40447, Taiwan.
| | - J-L Lan
- College of Medicine, China Medical University, Taichung, Taiwan.
- Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, No. 2, Yude Road, Taichung, 40447, Taiwan.
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Adhikari R, Chen C, Waters E, West FD, Kim WK. Isolation and Differentiation of Mesenchymal Stem Cells From Broiler Chicken Compact Bones. Front Physiol 2019; 9:1892. [PMID: 30723419 PMCID: PMC6350342 DOI: 10.3389/fphys.2018.01892] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 12/14/2018] [Indexed: 12/17/2022] Open
Abstract
Chicken mesenchymal stem cells (MSCs) can be used as an avian culture model to better understand osteogenic, adipogenic, and myogenic pathways and to identify unique bioactive nutrients and molecules which can promote or inhibit these pathways. MSCs could also be used as a model to study various developmental, physiological, and therapeutic processes in avian and other species. MSCs are multipotent stem cells that are capable of differentiation into bone, muscle, fat, and closely related lineages and express unique and specific cell surface markers. MSCs have been isolated from numerous sources including human, mouse, rabbit, and chicken with potential clinical and agricultural applications. MSCs from chicken compact bones have not been isolated and characterized yet. In this study, MSCs were isolated from compact bones of the femur and tibia of day-old male broiler chicks to investigate the biological characteristics of the isolated cells. Isolated cells took 8–10 days to expand, demonstrated a monolayer growth pattern and were plastic adherent. Putative MSCs were spindle-shaped with elongated ends and showed rapid proliferation. MSCs demonstrated osteoblastic, adipocytic, and myogenic differentiation when induced with specific differentiation media. Cell surface markers for MSCs such as CD90, CD105, CD73, CD44 were detected positive and CD31, CD34, and CD45 cells were detected negative by PCR assay. The results suggest that MSCs isolated from broiler compact bones (cBMSCs) possess similar biological characteristics as MSCs isolated from other chicken tissue sources.
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Affiliation(s)
- Roshan Adhikari
- Department of Poultry Science, University of Georgia, Athens, GA, United States.,Regenerative Bioscience Center, University of Georgia, Athens, GA, United States
| | - Chongxiao Chen
- Department of Poultry Science, University of Georgia, Athens, GA, United States.,Regenerative Bioscience Center, University of Georgia, Athens, GA, United States
| | - Elizabeth Waters
- Regenerative Bioscience Center, University of Georgia, Athens, GA, United States.,Department of Animal and Dairy Science, University of Georgia, Athens, GA, United States
| | - Franklin D West
- Regenerative Bioscience Center, University of Georgia, Athens, GA, United States.,Department of Animal and Dairy Science, University of Georgia, Athens, GA, United States
| | - Woo Kyun Kim
- Department of Poultry Science, University of Georgia, Athens, GA, United States.,Regenerative Bioscience Center, University of Georgia, Athens, GA, United States
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Chang MC, Chen YJ, Lian YC, Chang BE, Huang CC, Huang WL, Pan YH, Jeng JH. Butyrate Stimulates Histone H3 Acetylation, 8-Isoprostane Production, RANKL Expression, and Regulated Osteoprotegerin Expression/Secretion in MG-63 Osteoblastic Cells. Int J Mol Sci 2018; 19:ijms19124071. [PMID: 30562925 PMCID: PMC6321057 DOI: 10.3390/ijms19124071] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 12/31/2022] Open
Abstract
Butyric acid as a histone deacetylase (HDAC) inhibitor is produced by a number of periodontal and root canal microorganisms (such as Porphyromonas, Fusobacterium, etc.). Butyric acid may affect the biological activities of periodontal/periapical cells such as osteoblasts, periodontal ligament cells, etc., and thus affect periodontal/periapical tissue destruction and healing. The purposes of this study were to study the toxic effects of butyrate on the matrix and mineralization marker expression in MG-63 osteoblasts. Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Cellular apoptosis and necrosis were analyzed by propidium iodide/annexin V flow cytometry. The protein and mRNA expression of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-B ligand (RANKL) were analyzed by Western blotting and reverse transcriptase-polymerase chain reaction (RT-PCR). OPG, soluble RANKL (sRANKL), 8-isoprostane, pro-collagen I, matrix metalloproteinase-2 (MMP-2), osteonectin (SPARC), osteocalcin and osteopontin (OPN) secretion into culture medium were measured by enzyme-linked immunosorbant assay. Alkaline phosphatase (ALP) activity was checked by ALP staining. Histone H3 acetylation levels were evaluated by immunofluorescent staining (IF) and Western blot. We found that butyrate activated the histone H3 acetylation of MG-63 cells. Exposure of MG-63 cells to butyrate partly decreased cell viability with no marked increase in apoptosis and necrosis. Twenty-four hours of exposure to butyrate stimulated RANKL protein expression, whereas it inhibited OPG protein expression. Butyrate also inhibited the secretion of OPG in MG-63 cells, whereas the sRANKL level was below the detection limit. However, 3 days of exposure to butyrate (1 to 8 mM) or other HDAC inhibitors such as phenylbutyrate, valproic acid and trichostatin stimulated OPG secretion. Butyrate stimulated 8-isoprostane, MMP-2 and OPN secretion, but not procollagen I, or osteocalcin in MG-63 cells. Exposure to butyrate (2⁻4 mM) for 3 days markedly stimulated osteonectin secretion and ALP activity. In conclusion, higher concentrations of butyric acid generated by periodontal and root canal microorganisms may potentially induce bone destruction and impair bone repair by the alteration of OPG/RANKL expression/secretion, 8-isoprostane, MMP-2 and OPN secretion, and affect cell viability. However, lower concentrations of butyrate (1⁻4 mM) may stimulate ALP, osteonectin and OPG. These effects are possibly related to increased histone acetylation. These events are important in the pathogenesis and repair of periodontal and periapical destruction.
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Affiliation(s)
- Mei-Chi Chang
- Chang Gung University of Science and Technology, Kwei-Shan, Taoyuan 333, Taiwan.
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei Branch, 6th Floor, 199, Tung-Hwa North Road, Taipei 105, Taiwan.
| | - Yunn-Jy Chen
- School of Dentistry and Department of Dentistry, National Taiwan University Hospital and National Taiwan University Medical College, Taipei 100, Taiwan.
| | - Yun-Chia Lian
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei Branch, 6th Floor, 199, Tung-Hwa North Road, Taipei 105, Taiwan.
| | - Bei-En Chang
- Graduate Institute of Oral Biology, National Taiwan University Medical College, Taipei 100, Taiwan.
| | - Chih-Chia Huang
- Department of Dentistry, Cardinal Tien Hospital, New Taipei City 234, Taiwan.
| | - Wei-Ling Huang
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei Branch, 6th Floor, 199, Tung-Hwa North Road, Taipei 105, Taiwan.
| | - Yu-Hwa Pan
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei Branch, 6th Floor, 199, Tung-Hwa North Road, Taipei 105, Taiwan.
- Graduate Department of Craniofacial Dentistry, Chang-Gung University Medical College, Taoyuan 333, Taiwan.
| | - Jiiang-Huei Jeng
- School of Dentistry and Department of Dentistry, National Taiwan University Hospital and National Taiwan University Medical College, Taipei 100, Taiwan.
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Tintut Y, Hsu JJ, Demer LL. Lipoproteins in Cardiovascular Calcification: Potential Targets and Challenges. Front Cardiovasc Med 2018; 5:172. [PMID: 30533416 PMCID: PMC6265366 DOI: 10.3389/fcvm.2018.00172] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/08/2018] [Indexed: 12/16/2022] Open
Abstract
Previously considered a degenerative process, cardiovascular calcification is now established as an active process that is regulated in several ways by lipids, phospholipids, and lipoproteins. These compounds serve many of the same functions in vascular and valvular calcification as they do in skeletal bone calcification. Hyperlipidemia leads to accumulation of lipoproteins in the subendothelial space of cardiovascular tissues, which leads to formation of mildly oxidized phospholipids, which are known bioactive factors in vascular cell calcification. One lipoprotein of particular interest is Lp(a), which showed genome-wide significance for the presence of aortic valve calcification and stenosis. It carries an important enzyme, autotaxin, which produces lysophosphatidic acid (LPA), and thus has a key role in inflammation among other functions. Matrix vesicles, extruded from the plasma membrane of cells, are the sites of initiation of mineral formation. Phosphatidylserine, a phospholipid in the membranes of matrix vesicles, is believed to complex with calcium and phosphate ions, creating a nidus for hydroxyapatite crystal formation in cardiovascular as well as in skeletal bone mineralization. This review focuses on the contributions of lipids, phospholipids, lipoproteins, and autotaxin in cardiovascular calcification, and discusses possible therapeutic targets.
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Affiliation(s)
- Yin Tintut
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Physiology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jeffrey J Hsu
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Linda L Demer
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Physiology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
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60
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Yang Y, Liu G, Zhang Y, Xu G, Yi X, Liang J, Zhao C, Liang J, Ma C, Ye Y, Yu M, Qu X. Association Between Bone Mineral Density, Bone Turnover Markers, and Serum Cholesterol Levels in Type 2 Diabetes. Front Endocrinol (Lausanne) 2018; 9:646. [PMID: 30459714 PMCID: PMC6232230 DOI: 10.3389/fendo.2018.00646] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 10/12/2018] [Indexed: 11/13/2022] Open
Abstract
Purpose: The association between bone mineral density (BMD), bone turnover markers, and serum cholesterol in healthy population has already been proved. However, in patients with type 2 diabetes mellitus (T2D), it has not been adequately analyzed. In this study, we investigated the correlation between BMD, bone turnover markers, and serum cholesterol levels in people with T2D. Methods: We enrolled 1,040 men and 735 women with T2D from Zhongshan Hospital between October 2009 and January 2013. Their general condition, history of diseases and medication, serum markers, and BMD data were collected. We used logistic regression analysis to identify the association between serum cholesterol levels and BMD as well as bone turnover markers. Results: In multivariate regression analysis, we observed that in men with T2D, high high-density lipoprotein-cholesterol and total cholesterol levels were significantly associated with low total lumbar, femur neck, and total hip BMD, while low-density lipoprotein-cholesterol level was only inversely associated with total lumbar and femur neck BMD. Total cholesterol and low-density lipoprotein-cholesterol levels were also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps. In women with T2D, high-density lipoprotein-cholesterol level was observed to be negatively correlated with total lumbar, femur neck, and total hip BMD, while total cholesterol and low-density lipoprotein-cholesterol levels were only associated with BMD at the total lumbar. Furthermore, total cholesterol was also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps; high-density lipoprotein-cholesterol was only related to osteocalcin and parathyroid hormone, while low-density lipoprotein-cholesterol was only related to β-crosslaps in women. Conclusion: Our study suggests a significantly negative correlation between serum cholesterol levels and BMD in both men and women with T2D. The associations between serum cholesterol levels and bone turnover markers were also observed in T2D patients.
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Affiliation(s)
- Yinqiu Yang
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guangwang Liu
- Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Yao Zhang
- Department of Endocrinology, Department of Infectious Disease, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guiping Xu
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
- VIP Clinical Department, Fujian Provincial Hospital, Fuzhou, China
| | - Xilu Yi
- Department of Endocrinology, Zhongshan Hospital, Songjiang Central Hospital, Fudan University, Shanghai, China
| | - Jing Liang
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chenhe Zhao
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jun Liang
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Chao Ma
- Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Yangli Ye
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mingxiang Yu
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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梁 青, 陈 燕, 李 传, 陆 立. [Quercetin attenuates Ox-LDL-induced calcification in vascular smooth muscle cells by regulating ROS-TLR4 signaling pathway]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:980-985. [PMID: 30187880 PMCID: PMC6744032 DOI: 10.3969/j.issn.1673-4254.2018.08.13] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether quercetin inhibits oxidized low-density lipoprotein (Ox-LDL)-induced osteogenic differentiation and calcification of vascular smooth muscle cells (VSMCs) and understand the underlying mechanism. METHODS The calcification of human VSMCs following Ox-LDL treatment was assessed using alizarin red staining and by detecting ALP activity. The mRNA expressions of the bone-related genes including Msx2, BMP2 and Osterix, and the contractile proteins including SMA and SM22a were analyzed using qPCR. The effects of quercetin were investigated on OxLDL-induced VSMC calcification and changes in ALP activity, expressions of Msx2, BMP2, Osterix, SMA and SM22a, ROS levels and SOD activity. The effect of Toll like receptor 4 (TLR4) silencing mediated by siRNA transfection on cell calcification, ALP activity, gene expressions and ROS levels were investigated. RESULTS Ox-LDL treatment promoted VSMC calcification and up-regulated TLR4 expression. Quercetin treatment significantly attenuated Ox-LDL-induced VSMC calcification, reduced ALP activity, down-regulated the expression levels of Msx2, BMP2 and Osterix, and up-regulated the expressions of vascular smooth muscle contractile proteins SMA and SM22a. In addition, Quercetin treatment markedly increased SOD activity, reduced ROS levels and TLR4 expression in VSMCs. Silencing TLR4 expression using TLR4 siRNA also significantly decreased calcification of the VSMCs. CONCLUSIONS Quercetin inhibits Ox-LDL-induced VSMC calcification in VSMCs possibly by targeting the ROS/TLR4 signaling pathway.
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Affiliation(s)
- 青春 梁
- 南方医科大学第三附属医院麻醉科,广东 广州 510630Department of Anesthesiology, Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China
| | - 燕亭 陈
- 中山大学中山医学院病理生理学教研室,广东 广州 510080Department of Pathophysiology, Zhongshan Medical School, Sun Yat-Sen University, Guangzhou 510080, China
| | - 传翔 李
- 南方医科大学第三附属医院麻醉科,广东 广州 510630Department of Anesthesiology, Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China
| | - 立鹤 陆
- 中山大学中山医学院病理生理学教研室,广东 广州 510080Department of Pathophysiology, Zhongshan Medical School, Sun Yat-Sen University, Guangzhou 510080, China
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Li B, Li Y, Zhang T, Song L, Lei C, Zhao Y, He B, Zhao Y, Yin B, Jin X, Li T. Preptin is a new predictor of coronary artery calcification. Clin Chim Acta 2018; 485:133-138. [PMID: 29958889 DOI: 10.1016/j.cca.2018.06.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND We aimed to assess whether an elevated preptin level is associated with coronary artery calcification (CAC). METHODS Two hundred and twenty participants with suspected cardiovascular disease were recruited. CAC was measured using 320-row-detector dynamic volume CT, and the patients were divided into 2 groups: the non-CAC group (with an Agatston score = 0) and the CAC group (with an Agatston score > 0). RESULTS The serum preptin level was significantly elevated in the CAC group compared with the non-CAC group. In logistic regression analysis, preptin, as well as age, gender, hypertension history and history of β-blocker use, were independent predictors of a positive CAC score. The highest preptin quintile of patients had a higher CAC level compared with other quintiles. Binary logistic regression analyses showed that the highest preptin quintile had a 2.9-time increased odds ratio of an elevated CAC level than the other 4 quintile patients. CONCLUSIONS This study demonstrated that serum preptin was associated with coronary artery calcification.
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Affiliation(s)
- Bo Li
- Department of Cardiology, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Yuhua Li
- Department of Imaging, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Tongtong Zhang
- Department of Clinical Laboratory, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Litao Song
- Department of Imaging, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Chengbin Lei
- Department of Clinical Laboratory, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Yan Zhao
- Department of Clinical Laboratory, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Bing He
- Department of Imaging, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Yunhe Zhao
- Department of Cardiology, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Bo Yin
- Department of Cardiology, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China
| | - Xiaodong Jin
- Department of Geriatrics, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China.
| | - Tao Li
- Center of Translational Medicine, Central Hospital of Zibo, NO, 54, Gong Qing Tuan Xi Road, Zibo 255036, PR China.
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Ambrogini E, Que X, Wang S, Yamaguchi F, Weinstein RS, Tsimikas S, Manolagas SC, Witztum JL, Jilka RL. Oxidation-specific epitopes restrain bone formation. Nat Commun 2018; 9:2193. [PMID: 29875355 PMCID: PMC5990540 DOI: 10.1038/s41467-018-04047-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/26/2018] [Indexed: 12/14/2022] Open
Abstract
Atherosclerosis and osteoporosis are epidemiologically linked and oxidation specific epitopes (OSEs), such as phosphocholine (PC) of oxidized phospholipids (PC-OxPL) and malondialdehyde (MDA), are pathogenic in both. The proatherogenic effects of OSEs are opposed by innate immune antibodies. Here we show that high-fat diet (HFD)-induced bone loss is attenuated in mice expressing a single chain variable region fragment of the IgM E06 (E06-scFv) that neutralizes PC-OxPL, by increasing osteoblast number and stimulating bone formation. Similarly, HFD-induced bone loss is attenuated in mice expressing IK17-scFv, which neutralizes MDA. Notably, E06-scFv also increases bone mass in mice fed a normal diet. Moreover, the levels of anti-PC IgM decrease in aged mice. We conclude that OSEs, whether produced chronically or increased by HFD, restrain bone formation, and that diminished defense against OSEs may contribute to age-related bone loss. Anti-OSEs, therefore, may represent a novel therapeutic approach against osteoporosis and atherosclerosis simultaneously.
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Affiliation(s)
- Elena Ambrogini
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, 4301W. Markham, Little Rock, AR, 72205, USA.
| | - Xuchu Que
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, CA, 92093-0682, USA
| | - Shuling Wang
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, CA, 92093-0682, USA
| | - Fumihiro Yamaguchi
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, CA, 92093-0682, USA
| | - Robert S Weinstein
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, 4301W. Markham, Little Rock, AR, 72205, USA
| | - Sotirios Tsimikas
- Department of Medicine, Cardiololgy, University of California San Diego, 9500 GilmanDrive, La Jolla, CA, 92093-0682, USA
| | - Stavros C Manolagas
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, 4301W. Markham, Little Rock, AR, 72205, USA
| | - Joseph L Witztum
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, CA, 92093-0682, USA
| | - Robert L Jilka
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, 4301W. Markham, Little Rock, AR, 72205, USA
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Ohgi K, Kajiya H, Goto-T K, Okamoto F, Yoshinaga Y, Okabe K, Sakagami R. Toll-like receptor 2 activation primes and upregulates osteoclastogenesis via lox-1. Lipids Health Dis 2018; 17:132. [PMID: 29859535 PMCID: PMC5985062 DOI: 10.1186/s12944-018-0787-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 05/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lectin-like oxidized low-density-lipoprotein receptor 1 (Lox-1) is the receptor for oxidized low-density lipoprotein (oxLDL), a mediator in dyslipidemia. Toll-like receptor (TLR)-2 and - 4 are receptors of lipopolysaccharide (LPS) from Porphyromonas gingivalis, a major pathogen of chronic periodontitis. Although some reports have demonstrated that periodontitis has an adverse effect on dyslipidemia, little is clear that the mechanism is explained the effects of dyslipidemia on osteoclastogenesis. We have hypothesized that osteoclast oxLDL has directly effect on osteoclasts (OCs), and therefore alveolar bone loss on periodontitis may be increased by dyslipidemia. The present study aimed to elucidate the effect of Lox-1 on osteoclastogenesis associated with TLRs in vitro. METHODS Mouse bone marrow cells (BMCs) were stimulated with macrophage colony-stimulating factor into bone marrow macrophages (BMMs). The cells were also stimulated with synthetic ligands for TLR2 (Pam3CSK4) or TLR4 (Lipid A), with or without receptor activator of nuclear factor kappa-B ligand (RANKL), and assessed for osteoclastogenesis by tartrate-resistant acid phosphatase (TRAP) staining, immunostaining, western blotting, flow activated cell sorting (FACS) analysis, real-time polymerase chain reaction (PCR), and reverse transcription PCR. RESULTS Lox-1 expression was significantly upregulated by Pam3CSK4 and Lipid A in BMCs (p < 0.05), but not in BMMs. FACS analysis identified that Pam3CSK4 upregulated RANK and Lox-1 expression in BMCs. TRAP-positive cells were not increased by stimulation with Pam3CSK4 alone, but were increased by stimulation with combination combined Pam3CSK and oxLDL. Expression of both Lox-1 and myeloid differentiation factor 88 (MyD88), an essential adaptor protein in the TLR signaling pathway, were suppressed by inhibitors of TLR2, TLR4 and mitogen-activated protein kinase (MAPK). CONCLUSIONS This study supports that osteoclastogenesis is promoted under the coexistence of oxLDL by TLR2-induced upregulation of Lox-1 in BMCs. This indicates that periodontitis could worsen with progression of dyslipidemia.
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Affiliation(s)
- Kimiko Ohgi
- Department of Odontology, Fukuoka Dental College, Fukuoka, 8140193, Japan
| | - Hiroshi Kajiya
- Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka, 8140193, Japan.
| | - Kazuko Goto-T
- Department of Dental Hygiene, Fukuoka College of Health Sciences, Fukuoka, 8140193, Japan
| | - Fujio Okamoto
- Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka, 8140193, Japan
| | - Yasunori Yoshinaga
- Department of Odontology, Fukuoka Dental College, Fukuoka, 8140193, Japan
| | - Koji Okabe
- Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka, 8140193, Japan
| | - Ryuji Sakagami
- Department of Odontology, Fukuoka Dental College, Fukuoka, 8140193, Japan
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Price TR, Moncada K, Leyva-Jimenez H, Park KW, Tontonoz P, Walzem RL. Phenamil, an amiloride derivative, restricts long bone growth and alters keeled-sternum bone architecture in growing chickens. Poult Sci 2018; 96:2471-2479. [PMID: 28340021 DOI: 10.3382/ps/pex034] [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: 09/13/2016] [Accepted: 01/23/2017] [Indexed: 11/20/2022] Open
Abstract
"Broiler-type" chickens are fast-grow-ing, heavy-bodied birds with high demands on bone quality. Phenamil increased mineralization in cultured murine mesenchymal stem cells. Phenamil effects were tested in 2 groups of weight and gender matched day-old broiler chickens (n = 13). Oral administration of 30 mg phenamil/kg body weight d 1 to 13 reduced growth of chicks d 5 to 14 (P = 0.002); with phenamil-treated (PT) chick body weight being 84% of vehicle-treated (VT) chicks' body weight on d 14. Tissues collected on d 15 showed that femur lengths and widths did not differ, but tibias from PT chicks were 6% shorter (P = 0.002) and 13% narrower (P = 0.012) with 18% thinner tibial cross-sections (P < 0.008) than in VT chicks. Angles of the caudal aspect of the anterior surface of keeled-sternums were 166° in PT chicks, flatter than the 148° found in VT chicks (P = 0.000). Total mineral content of both tibia and femur were lower in PT chicks (P = 0.005 for both). Bone Ca, P, and Mg (ppm) in ash were similar, but Ca:P was lower (1.70 vs 1.75) in PT versus VT chicks (P < 0.05). Osteocalcin was ∼20% lower (P = 0.020), PINP was ∼45% higher (P = 0.000) in PT chicks. Carboxy-terminal telopeptide type I collagen (ICTP) and cross-linked N-telopeptide of type I collagen (NTX1) were similar in the 2 groups. Phenamil had unexpected and detrimental effects on bone formation in growing broiler chicks, reducing linear skeletal growth and markedly changing bone architecture.
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Affiliation(s)
- Tara R Price
- Department of Nutrition and Food Science, Texas A&M University, College Station, TX 77843
| | - Kristin Moncada
- Department of Poultry Science, Texas A&M University, College Station, TX 77843
| | | | - Kye Won Park
- Department of Food Science and Biotechnology, Sungkyunkwan University, Suwon, Korea 16419
| | - Peter Tontonoz
- Department of Pathology and Laboratory Medicine, University of California - Los Angeles, Los Angeles, CA 90095
| | - Rosemary L Walzem
- Department of Poultry Science, Texas A&M University, College Station, TX 77843.,Graduate Faculty of Nutrition, Texas A&M University, College Station, TX 77843
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Abstract
PURPOSE OF REVIEW As the incidence of calcific aortic valve stenosis increases with the aging of the population, improved understanding and novel therapies to reduce its progression and need for aortic valve replacement are urgently needed. RECENT FINDINGS Lipoprotein(a) is the only monogenetic risk factor for calcific aortic stenosis. Elevated levels are a strong, causal, independent risk factor, as demonstrated in epidemiological, genome-wide association studies and Mendelian randomization studies. Lipoprotein(a) is the major lipoprotein carrier of oxidized phospholipids, which are proinflammatory and promote calcification of vascular cells, two key pathophysiological drivers of aortic stenosis. Elevated plasma lipoprotein(a) and oxidized phospholipids predict progression of pre-existing aortic stenosis and need for aortic valve replacement. The failure of statin trials in pre-existing aortic stenosis may be partially due to an increase in lipoprotein(a) and oxidized phospholipid levels caused by statins. Antisense oligonucleotides targeted to apo(a) are in Phase 2 clinical development and shown to lower both lipoprotein(a) and oxidized phospholipids. SUMMARY Lipoprotein(a) and oxidized phospholipids are key therapeutic targets in calcific aortic stenosis. Strategies aimed at potent lipoprotein(a) lowering to normalize levels and/or to suppress the proinflammatory effects of oxidized phospholipids may prevent progression of this disease.
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67
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Degenerative Aortic Stenosis, Dyslipidemia and Possibilities of Medical Treatment. ACTA ACUST UNITED AC 2018; 54:medicina54020024. [PMID: 30344255 PMCID: PMC6037252 DOI: 10.3390/medicina54020024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 12/20/2022]
Abstract
Degenerative aortic stenosis (DAS) is the most frequently diagnosed heart valve disease in Europe and North America. DAS is a chronic progressive disease which resembles development of atherosclerosis. Endothelial dysfunction, lipid infiltration, calcification and ossification are evidenced in both diseases. The same risk factors such as older age, male sex, smoking, and elevated levels of lipids are identified. The effect of smoking, visceral obesity, metabolic syndrome, hypercholesterolemia, low-density lipoprotein, high-density lipoprotein, lipoprotein(a), adiponectin and apolipoprotein(a) on development of DAS are being studied. The search for genetic ties between disorders of lipid metabolism and DAS has been started. DAS is characterized by a long symptom-free period which can last for several decades. Aortic valve replacement surgery is necessary when the symptoms occur. The lipid-lowering therapy effect on stopping or at least slowing down the progression of DAS was studied. However, the results of the conducted clinical trials are controversial. In addition, calcium homeostasis, bone metabolism and calcinosis-reducing medication are being studied. Although prospective randomized clinical trials have not demonstrated any positive effect of statins used for slowing progression of the disease, statins are still recommended for patients with dyslipidemia. Recent study has suggested that a specific modification of treatment, based on severity of disease, may have a beneficial effect in patients with aortic sclerosis and mild DAS. New clinical studies analyzing new treatment possibilities which could correct the natural course of the disease and reduce the need for aortic valve replacement by surgery or transcatheter treatment interventions are needed.
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68
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Jung MH, Youn HJ, Ihm SH, Jung HO, Hong KS. Heart Rate and Bone Mineral Density in Older Women with Hypertension: Results from the Korea National Health and Nutritional Examination Survey. J Am Geriatr Soc 2018; 66:1144-1150. [PMID: 29608214 DOI: 10.1111/jgs.15359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To determine whether high heart rate is associated with low bone mineral density (BMD) in older women with hypertension. DESIGN Retrospective cohort study. SETTING Population-based study conducted in Korea (Korea National Health and Nutritional Examination Survey 2009-10). PARTICIPANTS Postmenopausal women aged 60 and older with hypertension (N=981) divided into 2 groups according to resting heart rate, with a cut-off value of 80 bpm, which has been found to be associated with osteoporosis. MEASUREMENTS BMD profiles and clinical and laboratory data were collected. Osteoporosis was defined as a T-score of -2.5 or less, according to World Health Organization criteria. RESULTS BMD was significantly lower in participants with a high heart rate, even after adjustment for age, diabetes mellitus, white blood cell count, and fasting glucose and triglyceride levels. The prevalence of osteoporosis was also significantly higher in those participants. In multivariate logistic regression analysis, the group with high heart rate was 1.7 times as likely (95% confidence interval=1.2-2.3) to have osteoporosis as those with a lower heart rate, independent of age, body mass index, comorbidities, and laboratory findings. CONCLUSION High heart rate is independently associated with lower BMD in older women with hypertension; proactive surveillance of BMD could be helpful when managing older women with hypertension and a high heart rate.
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Affiliation(s)
- Mi-Hyang Jung
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hae Ok Jung
- Division of Cardiology, Department of Internal Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Soon Hong
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Hortells L, Sur S, St Hilaire C. Cell Phenotype Transitions in Cardiovascular Calcification. Front Cardiovasc Med 2018; 5:27. [PMID: 29632866 PMCID: PMC5879740 DOI: 10.3389/fcvm.2018.00027] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 03/14/2018] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular calcification was originally considered a passive, degenerative process, however with the advance of cellular and molecular biology techniques it is now appreciated that ectopic calcification is an active biological process. Vascular calcification is the most common form of ectopic calcification, and aging as well as specific disease states such as atherosclerosis, diabetes, and genetic mutations, exhibit this pathology. In the vessels and valves, endothelial cells, smooth muscle cells, and fibroblast-like cells contribute to the formation of extracellular calcified nodules. Research suggests that these vascular cells undergo a phenotypic switch whereby they acquire osteoblast-like characteristics, however the mechanisms driving the early aspects of these cell transitions are not fully understood. Osteoblasts are true bone-forming cells and differentiate from their pluripotent precursor, the mesenchymal stem cell (MSC); vascular cells that acquire the ability to calcify share aspects of the transcriptional programs exhibited by MSCs differentiating into osteoblasts. What is unknown is whether a fully-differentiated vascular cell directly acquires the ability to calcify by the upregulation of osteogenic genes or, whether these vascular cells first de-differentiate into an MSC-like state before obtaining a “second hit” that induces them to re-differentiate down an osteogenic lineage. Addressing these questions will enable progress in preventative and regenerative medicine strategies to combat vascular calcification pathologies. In this review, we will summarize what is known about the phenotypic switching of vascular endothelial, smooth muscle, and valvular cells.
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Affiliation(s)
- Luis Hortells
- Division of Cardiology, Department of Medicine, and the Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Swastika Sur
- Division of Cardiology, Department of Medicine, and the Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Cynthia St Hilaire
- Division of Cardiology, Department of Medicine, and the Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
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70
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FRAX® Fracture Risks Are Associated with Coronary Artery Calcification Score. DISEASE MARKERS 2017; 2017:1592598. [PMID: 29422704 PMCID: PMC5750485 DOI: 10.1155/2017/1592598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/20/2017] [Accepted: 12/05/2017] [Indexed: 11/29/2022]
Abstract
Purpose To examine the association between fracture risk assessment tool (FRAX) scores and coronary artery calcification (CAC) score in adults. Methods The medical records of 81 adults who underwent both coronary computed tomography and bone mineral density (BMD) studies in a package during their health exams were reviewed at a regional hospital in Southern Taiwan. Data collected included health history, anthropomorphic characteristics, clinical laboratory results, and BMD. Fracture risk was determined using FRAX. Univariate and multivariate linear regression analysis were used to assess the association between CAC score and 10-year probability of hip fracture (HF) and major osteoporotic fracture (MOF) determined by FRAX. Results The mean age of the patients was 55.8 years, and 63.0% were male. Univariate linear regression analysis showed that increases in MOF and HF risks, as measured by FRAX, were significantly and positively associated with CAC score. Multiple linear regression analysis adjusting for potential confounders showed that CAC score remained significantly associated with four FRAX indicators, including right MOF (r = 0.45, P < 0.001), left MOF (r = 0.31, P = 0.021), right HF (r = 0.38, P = 0.001), and left HF (r = 0.23, P = 0.049). Conclusions Increased risks of MOF and HF as determined by FRAX were significantly and independently associated with CAC score.
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Zhang N, Zhang Y, Lin J, Qiu X, Chen L, Pan X, Lu Y, Zhang J, Wang Y, Li D, Wang L. Low-density lipoprotein receptor deficiency impaired mice osteoblastogenesis in vitro. Biosci Trends 2017; 11:658-666. [PMID: 29269714 DOI: 10.5582/bst.2017.01267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Postmenopausal osteoporosis affected most elderly women with co-existence of lipid and bone metabolism disorders. However, the cellular and molecular mechanisms underlying the parallel progression and cross-talk of these systems remained unclear. In the present study, low-density lipoprotein receptor knockout (LDLR-/-) mice were chosen to elucidate the effect of LDLR in regulating the differentiation of osteoblasts, which were responsible for bone formation and modulation of osteoclastogenesis. Primary osteoblasts were isolated from the calvarium of newborn LDLR-/- or wild-type mice followed by osteoblastic differentiation culture in vitro. Alkaline phosphatase activity was significantly decreased in LDLR-/- osteoblasts compared to wild-type controls, combined with calcium deposit formation delay, implying impaired osteoblastogenesis in vitro. Consistent with these findings, the expression of runt-related transcription factor 2 (Runx2) was decreased 3 days after differentiation in LDLR-/- osteoblasts compared to wild-type controls. Moreover, the expression of Osterix was decreased 7 days after differentiation in LDLR-/- osteoblasts compared to wild-type controls, later than Runx2.However, the osteoclastogenesis modulation role of osteoblasts was unaffected by the LDLR deficiency, evidenced by the same level of osteoprotegerin (OPG)/receptor activator of nuclear factor-κ B ligand (RANKL) axis between LDLR-/- and wild-type control osteoblasts. Our results provide a novel insight into the role of LDLR during osteoblastic differentiation and improve understanding of cross-talk between bone and lipid metabolisms.
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Affiliation(s)
- Na Zhang
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Yang Zhang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine
| | - Jing Lin
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Xuemin Qiu
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Lanting Chen
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Xinyao Pan
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Youhui Lu
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Jiali Zhang
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Yan Wang
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Dajin Li
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
| | - Ling Wang
- Hospital & Institute of Obstetrics and Gynecology, Fudan University.,The Academy of Integrative Medicine of Fudan University.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases
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Akahori H, Tsujino T, Masuyama T, Ishihara M. Mechanisms of aortic stenosis. J Cardiol 2017; 71:215-220. [PMID: 29258711 DOI: 10.1016/j.jjcc.2017.11.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 11/08/2017] [Indexed: 12/22/2022]
Abstract
The pathobiology of degenerative aortic valve stenosis (AS) is complex and involves multiple features such as fibrosis, inflammation, oxidative stress, angiogenesis, hemorrhage, and osteogenic differentiation. We summarize the mechanism of valve calcification and angiogenesis which is necessary for calcifying processes. A promising therapeutic target is nuclear factor (NF)-κB which activates bone morphogenetic protein (BMP)2 via interleukin-6. BMP2 activates Wnt signaling via msh homeobox 2 causing osteogenic differentiation. BMP2 also activates Runx2/Cbfa1 which is an osteoblast-specific transcription factor. Signals in the hypoxia-inducible factor-2 axis activated by the NF-κB signaling pathway also play important role in calcifying processes including angiogenesis. The reason why angiogenesis takes place in avascular valves is still unknown, but it is likely angiogenesis and angiogenesis-related hemorrhage play critical roles in the progression of AS.
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Affiliation(s)
- Hirokuni Akahori
- Division of Cardiovascular Medicine and Coronary Artery Disease, Hyogo College of Medicine, Nishinomiya, Japan.
| | - Takeshi Tsujino
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe, Japan
| | - Tohru Masuyama
- Division of Cardiovascular Medicine and Coronary Artery Disease, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masaharu Ishihara
- Division of Cardiovascular Medicine and Coronary Artery Disease, Hyogo College of Medicine, Nishinomiya, Japan
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73
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Massera D, Xu S, Bartz TM, Bortnick AE, Joachim H, Chonchol M, Owens DS, Barasch E, Gardin JM, Gottdiener JS, Robbins JR, Siscovick DS, Kizer JR. Relationship of bone mineral density with valvular and annular calcification in community-dwelling older people: The Cardiovascular Health Study. Arch Osteoporos 2017; 12:52. [PMID: 28560501 PMCID: PMC5537624 DOI: 10.1007/s11657-017-0347-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 05/06/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Associations between bone mineral density and aortic valvular, aortic annular, and mitral annular calcification were investigated in a cross-sectional analysis of a population-based cohort of 1497 older adults. Although there was no association between continuous bone mineral density and outcomes, a significant association between osteoporosis and aortic valvular calcification in men was found. INTRODUCTION The process of cardiac calcification bears a resemblance to skeletal bone metabolism and its regulation. Experimental studies suggest that bone mineral density (BMD) and valvular calcification may be reciprocally related, but epidemiologic data are sparse. METHODS We tested the hypothesis that BMD of the total hip and femoral neck measured by dual-energy X-ray absorptiometry (DXA) is inversely associated with prevalence of three echocardiographic measures of cardiac calcification in a cross-sectional analysis of 1497 older adults from the Cardiovascular Health Study. The adjusted association of BMD with aortic valve calcification (AVC), aortic annular calcification (AAC), and mitral annular calcification (MAC) was assessed with relative risk (RR) regression. RESULTS Mean (SD) age was 76.2 (4.8) years; 58% were women. Cardiac calcification was highly prevalent in women and men: AVC, 59.5 and 71.0%; AAC 45.1 and 46.7%; MAC 42.8 and 39.5%, respectively. After limited and full adjustment for potential confounders, no statistically significant associations were detected between continuous BMD at either site and the three measures of calcification. Assessment of WHO BMD categories revealed a significant association between osteoporosis at the total hip and AVC in men (adjusted RR compared with normal BMD = 1.24 (1.01-1.53)). In graded sensitivity analyses, there were apparent inverse associations between femoral neck BMD and AVC with stenosis in men, and femoral neck BMD and moderate/severe MAC in women, but these were not significant. CONCLUSION These findings support further investigation of the sex-specific relationships between low BMD and cardiac calcification, and whether processes linking the two could be targeted for therapeutic ends.
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Affiliation(s)
- Daniele Massera
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Shuo Xu
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | | | - Anna E. Bortnick
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - H. Joachim
- University of California San Diego, San Diego, CA
| | | | | | | | | | | | | | | | - Jorge R. Kizer
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
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Liu H, Xu H, Huang K. Selenium in the prevention of atherosclerosis and its underlying mechanisms. Metallomics 2017; 9:21-37. [PMID: 28009916 DOI: 10.1039/c6mt00195e] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Atherosclerosis and related cardiovascular diseases (CVDs) represent the greatest threats to human health worldwide. Selenium, an essential trace element, is incorporated into selenoproteins that play a crucial role in human health and disease. Although findings from a limited number of randomized trials have been inconsistent and cannot support a protective role of Se supplementation in CVDs, prospective observational studies have generally shown a significant inverse association between selenium or selenoprotein status and CVD risk. Furthermore, a benefit of selenium supplementation in the prevention of CVDs has been seen in population with low baseline selenium status. Evidence from animal studies shows consistent results that selenium and selenoproteins might prevent experimental atherosclerosis, which can be explained by the molecular and cellular effects of selenium observed both in animal models and cell cultures. Selenoproteins of particular relevance to atherosclerosis are glutathione peroxidases, thioredoxin reductase 1, selenoprotein P, selenoprotein S. The present review is focusing on the existing evidence that supports the concept that optimal selenium intake can prevent atherosclerosis. Its underlying mechanisms include inhibiting oxidative stress, modulating inflammation, suppressing endothelial dysfunction, and protecting vascular cells against apoptosis and calcification. However, the benefit of selenium supplementation in the prevention of atherosclerosis remains insufficiently documented so far. Future studies with regard to the effects of selenium supplementation on atherosclerosis should consider many factors, especially the baseline selenium status, the dose and forms of selenium supplementation, and the selenoprotein genotype. Additionally, much more studies are needed to confirm the roles of selenoproteins in atherosclerosis prevention and clarify the underlying mechanisms.
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Affiliation(s)
- Hongmei Liu
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China. and Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, Wuhan 430074, People's Republic of China
| | - Huibi Xu
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China. and Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, Wuhan 430074, People's Republic of China
| | - Kaixun Huang
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China. and Hubei Key Laboratory of Bioinorganic Chemistry & Materia Medica, Wuhan 430074, People's Republic of China
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Caffarelli C, Montagnani A, Nuti R, Gonnelli S. Bisphosphonates, atherosclerosis and vascular calcification: update and systematic review of clinical studies. Clin Interv Aging 2017; 12:1819-1828. [PMID: 29133976 PMCID: PMC5669782 DOI: 10.2147/cia.s138002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Epidemiologic and clinical data have suggested the existence of a biologic linkage between the bone system and the vascular system. Bisphosphonates (BPs) are effective inhibitors of bone resorption and are currently considered the drugs of choice for the prevention and treatment of osteoporosis and related fractures. Data from several publications have suggested that BPs may also be effective in reducing the atherosclerotic process and vascular calcification, but the results of these studies are contrasting. This review aimed to allow a better understanding of the relationships between BPs and atherosclerosis in humans. Materials and methods Electronic databases of Pubmed-Medline, Cochrane Library and SCOPUS from inception to June 30, 2016 were searched. The full texts of the articles potentially eligible were carefully assessed and reviewed. Finally, 20 studies were found to be eligible and were included in the systematic review. All included studies were published between 2000 and 2014. Results In several studies, etidronate limited the progression of aortic and coronary calcification in hemodialysis patients, whereas the nitrogen-containing-BPs given orally did not significantly reduce vascular calcifications in patients with chronic kidney disease, kidney trasplant or in those with osteoporosis. Nitrogen-containing-BPs present favorable effects both on vessel wall thickness and on arterial elasticity due to both a reduction in serum lipids and the interaction of BPs with the bone tissue, with the consequent release of bone turnover markers and cytokines into the bloodstream. Conclusion To sum up, the BPs seem to have the potential of influencing atherosclerosis and calcium homeostasis at the level of vascular walls with several possible mechanisms which may differ according to the type, potency, dosage and administration route of BPs. Additional studies are needed to specifically address the mechanism by which BP use could influence cardiovascular morbidity and mortality.
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Affiliation(s)
- Carla Caffarelli
- Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Andrea Montagnani
- Division of Internal Medicine, General Hospital Misericordia, Grosseto, Italy
| | - Ranuccio Nuti
- Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Stefano Gonnelli
- Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
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Metabolically healthy/unhealthy components may modify bone mineral density in obese people. Arch Osteoporos 2017; 12:95. [PMID: 29082431 DOI: 10.1007/s11657-017-0381-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/20/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Link between obesity and bone health is controversial. It seems that maybe the difference in metabolic status leads to this difference. We studied relation between metabolically healthy/unhealthy components with bone mineral density. Results showed metabolically unhealthy obesity (MUHO) phenotypes have better bone status at hip site than metabolically healthy obesity (MHO). Also, component metabolic can effect on BMD in different sites. PURPOSE/INTRODUCTION This cross-sectional study aimed to compare total BMD and L-L4 BMD in MHO and MUHO base on Karelis criteria. METHODS We enrolled 272 Iranian obese women and men (BMI ≥ 30). According to Karelis criteria, the participants were grouped base to MHO and MUHO. The body composition and BMD were assessed for all cases. Serum HDL-C, LDL-C, total cholesterol, triglyceride (TG), fasting blood glucose, homeostatic model assessment-insulin resistance (HOMA-IR), and hypersensitive C-reactive protein (hs-CRP) levels were quantified by ELISA method. RESULTS Our results demonstrate MUHO phenotype have high total BMD more than MHO (P = 0.01, CI = 0.12 to 0.21). Also, the results of logistic regression analysis showed MUHO have strongly associated with total BMD (β = -0.42, CI = - 0.31 to - 0.04, P = 0.009), but did not affected L2-L4 BMD (β = - 0.09, CI = - 0.14 to 0.08, P = 0.578); this represents that there was discordance in MUHO subjects. Our evidence implicated that HOMA-IR, high level serum TG, hs-CRP, and low level serum HDL had mediatory effect on relationship between obesity and high BMD at the hip region in MUHO subjects (P < 0.05). CONCLUSION Present evidence indicates that, could be a novel link between difference in MUH phenotype and MH phenotype with bone status. Also, component metabolic can effect on BMD in different sites.
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Panh L, Lairez O, Ruidavets JB, Galinier M, Carrié D, Ferrières J. Coronary artery calcification: From crystal to plaque rupture. Arch Cardiovasc Dis 2017; 110:550-561. [DOI: 10.1016/j.acvd.2017.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/14/2017] [Accepted: 04/18/2017] [Indexed: 12/31/2022]
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Torzewski M, Ravandi A, Yeang C, Edel A, Bhindi R, Kath S, Twardowski L, Schmid J, Yang X, Franke UFW, Witztum JL, Tsimikas S. Lipoprotein(a) Associated Molecules are Prominent Components in Plasma and Valve Leaflets in Calcific Aortic Valve Stenosis. ACTA ACUST UNITED AC 2017; 2:229-240. [PMID: 29147686 PMCID: PMC5685511 DOI: 10.1016/j.jacbts.2017.02.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The LPA gene is the only monogenetic risk factor for CAVS, and OxPL and lysophosphatidic acid, generated by autotaxin from OxPL, are pro-inflammatory. Both autotaxin–apolipoprotein B and autotaxin–apo(a) were measureable in plasma. Immunohistochemistry revealed a strong presence of apo(a), OxPL, malondialdehyde-lysine, autotaxin, and macrophages, particularly in advanced lesions rich in cholesterol crystals and calcification. Six species of OxPL and lysophosphatidic acid, with aldehyde-containing phosphocholine-based OxPL most abundant, were identified and quantified after extraction from valve leaflets. We demonstrate the presence of a constellation of pathologically linked, Lp(a)-associated molecules in plasma and in aortic valve leaflets of patients with CAVS. These data are consistent with the hypothesis that Lp(a) is a key etiologic factor in patients with CAVS.
The LPA gene is the only monogenetic risk factor for calcific aortic valve stenosis (CAVS). Oxidized phospholipids (OxPL) and lysophosphatidic acid generated by autotaxin (ATX) from OxPL are pro-inflammatory. Aortic valve leaflets categorized pathologically from both ATX–apolipoprotein B and ATX–apolipoprotein(a) were measureable in plasma. Lipoprotein(a) (Lp[a]), ATX, OxPL, and malondialdehyde epitopes progressively increased in immunostaining (p < 0.001 for all). Six species of OxPL and lysophosphatidic acid were identified after extraction from valve leaflets. The presence of a constellation of pathologically linked, Lp(a)-associated molecules in plasma and in aortic valve leaflets of patients with CAVS suggest that Lp(a) is a key etiologic factor in CAVS.
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Affiliation(s)
| | - Amir Ravandi
- Cardiac Sciences Program, University of Manitoba and Institute of Cardiovascular Sciences, St. Boniface Hospital
| | - Calvin Yeang
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Andrea Edel
- Cardiac Sciences Program, University of Manitoba and Institute of Cardiovascular Sciences, St. Boniface Hospital
| | - Rahul Bhindi
- Cardiac Sciences Program, University of Manitoba and Institute of Cardiovascular Sciences, St. Boniface Hospital
| | - Stefan Kath
- Department of Laboratory Medicine, Robert-Bosch-Hospital, Germany
| | - Laura Twardowski
- Department of Laboratory Medicine, Robert-Bosch-Hospital, Germany
| | - Jens Schmid
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Xiaohong Yang
- Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, La Jolla CA
| | - Ulrich F W Franke
- Department of Cardiovascular Surgery, Robert-Bosch-Hospital, Germany
| | - Joseph L Witztum
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla CA
| | - Sotirios Tsimikas
- Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, La Jolla CA
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Helin-Toiviainen M, Rönkkö S, Kaarniranta K, Puustjärvi T, Rekonen P, Ollikainen M, Uusitalo H. Oxidized low-density lipoprotein, lipid and calcium aggregates reveal oxidative stress and inflammation in the conjunctiva of glaucoma patients. Acta Ophthalmol 2017; 95:378-385. [PMID: 28139882 DOI: 10.1111/aos.13380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 12/08/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE Conjunctival specimens from primary open-angle glaucoma (POAG), exfoliation glaucoma (ExG) patients and controls were histologically analysed for oxidized low-density lipoprotein (ox-LDL), lipid and calcium aggregates. Our goal was to use them as biomarkers of oxidative stress and inflammation and to evaluate their correlation with glaucoma and impact on surgical outcome. METHODS Conjunctival samples were obtained from POAG (n = 14) and ExG (n = 17) patients and from control subjects (n = 11) operated for macular hole, retinal detachment or strabismus. Immunohistochemistry was performed using the antibody against ox-LDL. Lipids and calcium were analysed by histochemical stainings with Nile red and Alizarin red S, respectively. RESULTS Immunoreaction for ox-LDL was significantly increased in POAG (p = 0.049) and the number of lipid aggregates was significantly higher in ExG (p = 0.009) when compared to control. When POAG and ExG patients were grouped according to the outcome of deep sclerectomy (DS) surgery, the number of lipid (p < 0.001) and calcium aggregates (p = 0.014) were significantly higher in the conjunctival stroma of patients whose surgery failed within a three-year follow-up period. CONCLUSIONS The lipid-mediated alterations suggested the presence of oxidative stress and inflammation in the conjunctiva of glaucoma patients. The present data further support the role of oxidative stress and inflammation in the wound healing process leading to excessive scarring and failure in DS surgery.
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Affiliation(s)
- Minna Helin-Toiviainen
- Department of Ophthalmology; Institute of Clinical Medicine; University of Eastern Finland; Kuopio Finland
| | - Seppo Rönkkö
- Faculty of Health Sciences; School of Pharmacy; Pharmaceutical Technology; University of Eastern Finland; Kuopio Finland
| | - Kai Kaarniranta
- Department of Ophthalmology; Institute of Clinical Medicine; University of Eastern Finland; Kuopio Finland
- Department of Ophthalmology; Kuopio University Hospital; Kuopio Finland
| | - Tuomo Puustjärvi
- Department of Ophthalmology; Kuopio University Hospital; Kuopio Finland
| | - Petri Rekonen
- Department of Ophthalmology; Institute of Clinical Medicine; University of Eastern Finland; Kuopio Finland
- Department of Ophthalmology; Kuopio University Hospital; Kuopio Finland
| | - Minna Ollikainen
- Department of Ophthalmology; Kuopio University Hospital; Kuopio Finland
| | - Hannu Uusitalo
- Department of Ophthalmology; University of Tampere; Tampere Finland
- Tampere University Hospital Eye Center; Medical School; University of Tampere; Tampere Finland
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Kamstrup PR, Hung MY, Witztum JL, Tsimikas S, Nordestgaard BG. Oxidized Phospholipids and Risk of Calcific Aortic Valve Disease: The Copenhagen General Population Study. Arterioscler Thromb Vasc Biol 2017; 37:1570-1578. [PMID: 28572160 DOI: 10.1161/atvbaha.116.308761] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 05/17/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Lipoprotein(a) is causally associated with calcific aortic valve disease (CAVD). Lipoprotein(a) carries proinflammatory and procalcific oxidized phospholipids (OxPL). We tested whether the CAVD risk is mediated by the content of OxPL on lipoprotein(a). APPROACH AND RESULTS A case-control study was performed within the Copenhagen General Population Study (n=87 980), including 725 CAVD cases (1977-2013) and 1413 controls free of cardiovascular disease. OxPL carried by apoB (apolipoprotein B-100; OxPL-apoB) or apolipoprotein(a) (OxPL-apo(a)) containing lipoproteins, lipoprotein(a) levels, LPA kringle IV type 2 repeat, and rs10455872 genetic variants were measured. OxPL-apoB and OxPL-apo(a) levels correlated with lipoprotein(a) levels among cases (r=0.75 and r=0.95; both P<0.001) and controls (r=0.65 and r=0.93; both P<0.001). OxPL-apoB levels associated with risk of CAVD with odds ratios of 1.2 (95% confidence interval [CI]:1.0-1.6) for 34th to 66th percentile levels, 1.6 (95% CI, 1.2-2.1) for 67th to 90th percentile levels, 2.0 (95% CI, 1.3-3.0) for 91st to 95th percentile levels, and 3.4 (95% CI, 2.1-5.5) for levels >95th percentile, versus levels <34th percentile (trend, P<0.001). Corresponding odds ratios for OxPL-apo(a) were 1.2 (95% CI, 1.0-1.5), 1.2(95% CI, 0.9-1.6), 2.1(95% CI, 1.4-3.1), and 2.9(95% CI, 1.9-4.5; trend, P<0.001) and were similar for lipoprotein(a). LPA genotypes associated with OxPL-apoB, OxPL-apo(a), and lipoprotein(a) levels and explained 34%, 46%, and 39%, respectively, of the total variation in levels. LPA genotypes associated with risk of CAVD; a doubling in genetically determined OxPL-apoB, OxPL-apo(a), and lipoprotein(a) levels associated with odds ratio of CAVD of 1.18 (95% CI, 1.10-1.27), 1.09 (95% CI, 1.05-1.13), and 1.09 (95% CI, 1.05-1.14), respectively, comparable to the corresponding observational estimates of 1.27 (95% CI, 1.16-1.39), 1.13 (95% CI, 1.08-1.18), and 1.11 (95% CI, 1.06-1.17). CONCLUSIONS OxPL-apoB and OxPL-apo(a) are novel genetic and potentially causal risk factors for CAVD and may explain the association of lipoprotein(a) with CAVD.
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Affiliation(s)
- Pia R Kamstrup
- From the Department of Clinical Biochemistry (P.R.K., B.G.N.) and the Copenhagen General Population Study (P.R.K., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Department of Medicine, University of California San Diego, La Jolla (M.-Y.H., J.L.W., S.T.); Department of Internal Medicine, School of Medicine, College of Medicine (M.-Y.H.) and Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital (M.-Y.H.), Taipei Medical University, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan (M.-Y.H.); and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (B.G.N.).
| | - Ming-Yow Hung
- From the Department of Clinical Biochemistry (P.R.K., B.G.N.) and the Copenhagen General Population Study (P.R.K., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Department of Medicine, University of California San Diego, La Jolla (M.-Y.H., J.L.W., S.T.); Department of Internal Medicine, School of Medicine, College of Medicine (M.-Y.H.) and Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital (M.-Y.H.), Taipei Medical University, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan (M.-Y.H.); and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (B.G.N.)
| | - Joseph L Witztum
- From the Department of Clinical Biochemistry (P.R.K., B.G.N.) and the Copenhagen General Population Study (P.R.K., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Department of Medicine, University of California San Diego, La Jolla (M.-Y.H., J.L.W., S.T.); Department of Internal Medicine, School of Medicine, College of Medicine (M.-Y.H.) and Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital (M.-Y.H.), Taipei Medical University, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan (M.-Y.H.); and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (B.G.N.)
| | - Sotirios Tsimikas
- From the Department of Clinical Biochemistry (P.R.K., B.G.N.) and the Copenhagen General Population Study (P.R.K., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Department of Medicine, University of California San Diego, La Jolla (M.-Y.H., J.L.W., S.T.); Department of Internal Medicine, School of Medicine, College of Medicine (M.-Y.H.) and Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital (M.-Y.H.), Taipei Medical University, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan (M.-Y.H.); and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (B.G.N.).
| | - Børge G Nordestgaard
- From the Department of Clinical Biochemistry (P.R.K., B.G.N.) and the Copenhagen General Population Study (P.R.K., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Department of Medicine, University of California San Diego, La Jolla (M.-Y.H., J.L.W., S.T.); Department of Internal Medicine, School of Medicine, College of Medicine (M.-Y.H.) and Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital (M.-Y.H.), Taipei Medical University, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan (M.-Y.H.); and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (B.G.N.)
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Beloqui O, Moreno MU, San José G, Pejenaute Á, Cortés A, Landecho MF, Díez J, Fortuño A, Zalba G. Increased phagocytic NADPH oxidase activity associates with coronary artery calcification in asymptomatic men. Free Radic Res 2017; 51:389-396. [PMID: 28427294 DOI: 10.1080/10715762.2017.1321745] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Vascular calcification is a common feature in atherosclerosis and associates with cardiovascular events. Oxidative stress may be involved in the pathogenesis of vascular calcification. Previous studies have shown that the phagocytic NADPH oxidase is associated with atherosclerosis. The objective of the present study was to investigate the association between phagocytic NADPH oxidase-mediated superoxide production and coronary artery calcium (CAC). NADPH oxidase-mediated superoxide production was determined by chemiluminescence and CAC by computed tomography in 159 asymptomatic men free of overt clinical atherosclerosis. Multivariate linear regression analyses were used to assess the relationship between CAC and NADPH oxidase-mediated superoxide production. Compared with individuals in the lowest score of CAC (= 0 Agatston units), those in the upper score (>400 Agatston units) showed higher superoxide production (p < 0.05). In correlation analysis, superoxide production positively (p < 0.01) correlated with CAC, which in multivariate analysis remained significant after adjusting for age, HDL-cholesterol, triglycerides, body mass index, smoking, arterial hypertension and diabetes mellitus. In conclusion, in a population of men without clinically overt atherosclerotic disease, increased NADPH oxidase-mediated superoxide production associated with enhanced CAC. Albeit descriptive, these findings suggest a potential involvement of phagocytic NADPH oxidase-mediated oxidative stress in CAC.
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Affiliation(s)
- Oscar Beloqui
- a Department of Internal Medicine , Clínica Universidad de Navarra , Pamplona , Spain.,b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain
| | - María U Moreno
- b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Division of Cardiovascular Pathophysiology , Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra , Pamplona , Spain
| | - Gorka San José
- b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Division of Cardiovascular Pathophysiology , Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra , Pamplona , Spain
| | - Álvaro Pejenaute
- d Department of Biochemistry and Genetics , University of Navarra , Pamplona , Spain
| | - Adriana Cortés
- d Department of Biochemistry and Genetics , University of Navarra , Pamplona , Spain
| | - Manuel F Landecho
- a Department of Internal Medicine , Clínica Universidad de Navarra , Pamplona , Spain.,b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain
| | - Javier Díez
- b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Division of Cardiovascular Pathophysiology , Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra , Pamplona , Spain.,e Deparment of Cardiology and Cardiac Surgery , Clínica Universidad de Navarra , Pamplona , Spain
| | - Ana Fortuño
- b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Division of Cardiovascular Pathophysiology , Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra , Pamplona , Spain
| | - Guillermo Zalba
- b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Division of Cardiovascular Pathophysiology , Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra , Pamplona , Spain.,d Department of Biochemistry and Genetics , University of Navarra , Pamplona , Spain
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Abstract
PURPOSE OF REVIEW Lipoprotein(a) [Lp(a)] is the strongest independent genetic risk factor for both myocardial infarction and aortic stenosis. It has also been associated with other forms of atherosclerotic cardiovascular disease (CVD) including ischemic stroke. Its levels are genetically determined and remain fairly stable throughout life. Elevated Lp(a), above 50 mg/dl, affects one in five individuals worldwide. RECENT FINDINGS Herein, we review the recent epidemiologic and genetic evidence supporting the causal role of Lp(a) in CVD, highlight recommendations made by European and Canadian guidelines regarding Lp(a) and summarize the rapidly evolving field of Lp(a)-lowering therapies including antisense therapies and Proprotein Convertase Subtilisin/Kexin Type 9 inhibitors. SUMMARY With novel therapies on the horizon, Lp(a) is poised to gain significant clinical relevance and its lowering could have a significant impact on the burden of CVD. VIDEO ABSTRACT.
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Affiliation(s)
- Mehdi Afshar
- aDepartment of Medicine, McGill University bPreventive and Genomic Cardiology, McGill University Health Center and Research Institute cDepartment of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada
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Okafor ON, Farrington K, Gorog DA. Allopurinol as a therapeutic option in cardiovascular disease. Pharmacol Ther 2017; 172:139-150. [DOI: 10.1016/j.pharmthera.2016.12.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Jin ES, Jeong JH, Lee B, Im SB. Association factor analysis between osteoporosis with cerebral artery disease: The STROBE study. Medicine (Baltimore) 2017; 96:e6164. [PMID: 28248870 PMCID: PMC5340443 DOI: 10.1097/md.0000000000006164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The purpose of this study was to determine the clinical association factors between osteoporosis and cerebral artery disease in Korean population. Two hundred nineteen postmenopausal women and men undergoing cerebral computed tomography angiography were enrolled in this study to evaluate the cerebral artery disease by cross-sectional study. Cerebral artery disease was diagnosed if there was narrowing of 50% higher diameter in one or more cerebral vessel artery or presence of vascular calcification. History of osteoporotic fracture was assessed using medical record, and radiographic data such as simple radiography, MRI, and bone scan. Bone mineral density was checked by dual-energy x-ray absorptiometry. We reviewed clinical characteristics in all patients and also performed subgroup analysis for total or extracranial/ intracranial cerebral artery disease group retrospectively. We performed statistical analysis by means of chi-square test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon's rank sum test for continuous variables. We also used univariate and multivariate logistic regression analyses were conducted to assess the factors associated with the prevalence of cerebral artery disease. A two-tailed p-value of less than 0.05 was considered as statistically significant. All statistical analyses were performed using R (version 3.1.3; The R Foundation for Statistical Computing, Vienna, Austria) and SPSS (version 14.0; SPSS, Inc, Chicago, Ill, USA). Of the 219 patients, 142 had cerebral artery disease. All vertebral fracture was observed in 29 (13.24%) patients. There was significant difference in hip fracture according to the presence or absence of cerebral artery disease. In logistic regression analysis, osteoporotic hip fracture was significantly associated with extracranial cerebral artery disease after adjusting for multiple risk factors. Females with osteoporotic hip fracture were associated with total calcified cerebral artery disease. Some clinical factors such as age, hypertension, and osteoporotic hip fracture, smoking history and anti-osteoporosis drug use were associated with cerebral artery disease.
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Affiliation(s)
- Eun-Sun Jin
- Department of Internal Medicine, College of Medicine, Kyung Hee University
| | - Je Hoon Jeong
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital
| | - Bora Lee
- Department of Biostatistic Consulting, Soon Chun Hyang Medical Center, Bucheon, Republic of Korea
| | - Soo Bin Im
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital
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86
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Casado-Díaz A, Túnez-Fiñana I, Mata-Granados JM, Ruiz-Méndez MV, Dorado G, Romero-Sánchez MC, Navarro-Valverde C, Quesada-Gómez JM. Serum from postmenopausal women treated with a by-product of olive-oil extraction process stimulates osteoblastogenesis and inhibits adipogenesis in human mesenchymal stem-cells (MSC). Exp Gerontol 2017; 90:71-78. [PMID: 28167238 DOI: 10.1016/j.exger.2017.01.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 12/23/2022]
Abstract
Aging may enhance both oxidative stress and bone-marrow mesenchymal stem-cell (MSC) differentiation into adipocytes. That reduces osteoblastogenesis, thus favoring bone-mass loss and fracture, representing an important worldwide health-issue, mainly in countries with aging populations. Intake of antioxidant products may help to retain bone-mass density. Interestingly, a novel olive-pomace physical treatment to generate olive oil also yields by-products rich in functional antioxidants. Thus, diet of postmenopausal women was supplemented for two months with one of such by-products (distillate 6; D6), being rich in squalene. After treatment, serum from such women showed reduced both lipidic peroxidation and oxidized low-density lipoprotein (LDL). Besides, vitamin E and coenzyme Q10 levels increased. Furthermore, culture medium containing 10% of such serum both increased osteoblastogenesis and reduced adipogenesis in human MSC from bone marrow. Therefore, highly antioxidant by-products like D6 may represent a relevant source for development of functional products, for both prevention and treatment of degenerative pathologies associated with aging, like osteoporosis.
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Affiliation(s)
- Antonio Casado-Díaz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; RETICEF & CIBER de Fragilidad y Envejecimento Saludable (CIBERFES), Spain
| | - Isaac Túnez-Fiñana
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; Dep. Bioquímica y Biología Molecular, Facultad de Medicina y Enfermería, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
| | - José María Mata-Granados
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
| | - María Victoria Ruiz-Méndez
- Instituto de la Grasa, Consejo Superior de Investigaciones Científicas (CSIC), Campus Universitario Pablo de Olavide E46, Ctra. de Utrera km 1, 41013 Sevilla, Spain
| | - Gabriel Dorado
- Dep. Bioquímica y Biología Molecular, Universidad de Córdoba, Campus de Excelencia Internacional Agroalimentario (ceiA3), Campus Rabanales C6-1-E17, 14071 Córdoba, Spain; RETICEF & CIBER de Fragilidad y Envejecimento Saludable (CIBERFES), Spain
| | - María Concepción Romero-Sánchez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; RETICEF & CIBER de Fragilidad y Envejecimento Saludable (CIBERFES), Spain
| | | | - José Manuel Quesada-Gómez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; RETICEF & CIBER de Fragilidad y Envejecimento Saludable (CIBERFES), Spain.
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87
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Nicoll R, Henein M. Arterial calcification: A new perspective? Int J Cardiol 2017; 228:11-22. [DOI: 10.1016/j.ijcard.2016.11.099] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/06/2016] [Indexed: 12/19/2022]
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88
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Matsuzaki M, Kulkarni B, Kuper H, Wells JC, Ploubidis GB, Prabhakaran P, Gupta V, Walia GK, Aggarwal A, Prabhakaran D, Davey Smith G, Radhakrishna KV, Ben-Shlomo Y, Kinra S. Association of Hip Bone Mineral Density and Body Composition in a Rural Indian Population: The Andhra Pradesh Children and Parents Study (APCAPS). PLoS One 2017; 12:e0167114. [PMID: 28060826 PMCID: PMC5217858 DOI: 10.1371/journal.pone.0167114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/09/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Fat mass is variably associated with bone mass, possibly due to differential mechanical and biological effects of fat mass. We examined the association of fat mass with bone mass in a lean population. OBJECTIVE To investigate association between hip bone mineral density and fat and lean mass in a cross-sectional study from southern India. DESIGN The Andhra Pradesh Children and Parents Study is a prospective cohort study in Hyderabad, India. In 2009-2012, the study collected data on anthropometric measures, bone mineral density (BMD), fat mass, and lean mass measured by dual-energy x-ray absorptiometry, and socioeconomic data of the adult participants (n = 1760; mean age = 34.9 years old for women; 2130 and 32.3 for men). RESULTS The median BMI (kg/m2) was 20.1 kg/m2. Women had relatively higher fat mass as compared to men. In models adjusted for lean mass, there was an association between hip bone mineral density and fat mass in women (β (95% confidence interval): premenopausal 0.025 (0.006 to 0.045); postmenopausal 0.045 (0.014 to 0.076)) but not in men (0.001 (-0.012 to 0.0014)). The association between hip BMD and fat mass was stronger in postmenopausal than premenopausal women. Hip BMD was consistently associated with lean mass, in both men and women. CONCLUSIONS In this relatively lean population, lean mass was more consistently associated with hip BMD than fat mass. Weight gain through lean mass improvement may be a more reliable public health strategy for strengthening bone health in transitional settings.
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Affiliation(s)
- Mika Matsuzaki
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Bharati Kulkarni
- National Institute of Nutrition, Indian Council of Medical Research Tarnaka, Jamai-Osmania, Hyderabad, India
| | - Hannah Kuper
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonathan C. Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom
| | - George B. Ploubidis
- Department of Population Health and Statistics Centre for Longitudinal Studies, Institute of Education, University of London, London, United Kingdom
| | | | - Vipin Gupta
- Department of Anthropology, University of Delhi, Delhi, India
| | | | | | | | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | | | - Yoav Ben-Shlomo
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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89
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Shamsuzzaman S, Onal M, St John HC, Jeffery JJ, Pike JW. Absence of the Vitamin D Receptor Inhibits Atherosclerotic Plaque Calcification in Female Hypercholesterolemic Mice. J Cell Biochem 2017; 118:1050-1064. [PMID: 27567005 DOI: 10.1002/jcb.25679] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 01/06/2023]
Abstract
Epidemiological and clinical data suggest adverse cardiovascular outcomes with respect to vitamin D deficiency. Here, we explored the effects of vitamin D in atherosclerotic plaque calcification in vivo by utilizing vitamin D receptor (Vdr)-deficient mice in an Apoe-/- background. Animals were fed a high-fat diet (HFD) for either 12 or 18 weeks and then examined for atherosclerotic plaque development. In order to prevent calcium deficiency, Vdr-/- and Apoe-/- ;Vdr-/- animals were fed a high-calcium rescue diet prior to initiation of the HFD feeding and supplemented with high-calcium water during HFD feeding. Although calcium supplementation improved bone mass in Vdr-/- and Apoe-/- ;Vdr-/- mice, neither strain was fully rescued. Systemic inflammatory responses observed in the absence of VDR were exaggerated in Apoe-/- mice. Whereas, hyperlipidemic profiles seen in Apoe-/- mice were ameliorated in the absence of VDR. Micro-computed tomography (µCT) analysis revealed that six out of eight Apoe-/- animals developed atherosclerotic plaque calcification following 12 weeks of HFD feeding and 100% of the mice developed plaque calcification after 18 weeks. In contrast, although atherosclerotic lesions were evident in Apoe-/- ;Vdr-/- mice at 12 and 18 weeks of HFD challenge, none of these animals developed plaque calcification at either time point. The active vitamin D hormone, 1,25(OH)2 D3 likely increased calcification in aortic smooth muscle cells perhaps by directly modulating expression of Alpl, Rankl, and Opg. Our data suggest that the absence of VDR inhibits atherosclerotic plaque calcification in hypercholesterolemic Apoe-/- mice, providing additional insight into the role of vitamin D in atherosclerotic plaque calcification. J. Cell. Biochem. 118: 1050-1064, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sohel Shamsuzzaman
- Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin, 53706
| | - Melda Onal
- Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin, 53706
| | - Hillary C St John
- Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin, 53706
| | - Justin J Jeffery
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, 53706
| | - John W Pike
- Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin, 53706
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90
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Xu M, Liu L, Song C, Chen W, Gui S. Ghrelin improves vascular autophagy in rats with vascular calcification. Life Sci 2016; 179:23-29. [PMID: 27916732 DOI: 10.1016/j.lfs.2016.11.025] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/25/2016] [Accepted: 11/26/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUNDS This study aimed to investigate whether ghrelin ameliorated vascular calcification (VC) through improving autophagy. METHODS VC model was induced by nicotine plus vitamin D3 in rats and β-glycerophosphate in vascular smooth muscle cell (VSMC). Calcium deposition was detected by von Kossa staining or alizarin red S staining. ALP activity was also detected. Western blot was used to assess the protein expression. RESULTS Ghrelin treatment attenuated the elevation of calcium deposition and ALP activity in VC model both in vivo and in vitro. Interesting, the protein levels of autophagy markers, LC3 and beclin1 were significantly upregulated by ghrelin in VC model. An autophagy inhibitor, 3-methyladenine blocks the ameliorative effect of ghrelin on VC. Furthermore, protein expressions of phosphate-AMPK were increased by ghrelin treatment both in calcified aorta and VSMC. The effect of ghrelin on autophagy induction and VC attenuation was prevented by AMPK inhibitor, compound C. CONCLUSIONS Our results suggested that ghrelin improved autophagy through AMPK activation, which was resulted in VC amelioration. These data maybe throw light on prevention and therapy of VC.
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Affiliation(s)
- Mingming Xu
- Department of Geriatric Medicine, Affiliated Nanshan Hospital of Guangdong Medical University, China.
| | - Lin Liu
- Department of Geriatric Medicine, Affiliated Nanshan Hospital of Guangdong Medical University, China
| | - Chenfang Song
- Department of Geriatric Medicine, Affiliated Nanshan Hospital of Guangdong Medical University, China
| | - Wei Chen
- Department of Geriatric Medicine, Affiliated Nanshan Hospital of Guangdong Medical University, China
| | - Shuyan Gui
- Department of Endocrine, Affiliated Nanshan Hospital of Guangdong Medical University, China
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91
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Baldwin MJ, Policha A, Maldonado T, Hiramoto JS, Honig S, Conte MS, Berger J, Rockman CB. Novel association between bone mineral density scores and the prevalence of peripheral artery disease in both sexes. Vasc Med 2016; 22:13-20. [PMID: 27799423 DOI: 10.1177/1358863x16672740] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of the current study was to investigate the association between bone mineral density (BMD) scores and the prevalence of peripheral artery disease (PAD) in a large cohort of subjects who underwent arterial Doppler assessments and calcaneal bone densitometry. The study was performed using data obtained from Life Line Screening Inc. Subjects were self-selected and paid for screening tests. The prevalence of PAD was significantly higher in men with osteopenia (4.5%) and osteoporosis (10.9%) compared to men with normal BMD (3.0%) ( p<0.001). Osteopenia (odds ratio (OR) 1.3) and osteoporosis (OR 2.3) were found to be independent risk factors for the presence of PAD in men. The prevalence of PAD was significantly higher in women with osteopenia (4.8%) and osteoporosis (11.8%) compared to women with normal BMD (3.3%) ( p<0.001). Osteopenia (OR 1.15) and osteoporosis (OR 1.8) were found to be independent risk factors for the presence of PAD in women. The current study reports a strong association of abnormal BMD analysis with the prevalence of PAD, which persists even when controlling for age and associated atherosclerotic risk factors. Although the mechanism by which these two disease processes is related is not completely elucidated, the presence of osteoporosis should make clinicians aware of the possibility of occult PAD or associated atherosclerotic disease in appropriate patients.
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Affiliation(s)
- Melissa J Baldwin
- 1 Division of Vascular & Endovascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Aleksandra Policha
- 1 Division of Vascular & Endovascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Thomas Maldonado
- 1 Division of Vascular & Endovascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Jade S Hiramoto
- 2 Division of Vascular & Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, CA, USA
| | - Stephen Honig
- 1 Division of Vascular & Endovascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Michael S Conte
- 2 Division of Vascular & Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, CA, USA
| | - Jeffrey Berger
- 1 Division of Vascular & Endovascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Caron B Rockman
- 1 Division of Vascular & Endovascular Surgery, New York University Langone Medical Center, New York, NY, USA
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92
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Koike S, Yano S, Tanaka S, Sheikh AM, Nagai A, Sugimoto T. Advanced Glycation End-Products Induce Apoptosis of Vascular Smooth Muscle Cells: A Mechanism for Vascular Calcification. Int J Mol Sci 2016; 17:ijms17091567. [PMID: 27649164 PMCID: PMC5037835 DOI: 10.3390/ijms17091567] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/27/2016] [Accepted: 09/08/2016] [Indexed: 02/08/2023] Open
Abstract
Vascular calcification, especially medial artery calcification, is associated with cardiovascular death in patients with diabetes mellitus and chronic kidney disease (CKD). To determine the underlying mechanism of vascular calcification, we have demonstrated in our previous report that advanced glycation end-products (AGEs) stimulated calcium deposition in vascular smooth muscle cells (VSMCs) through excessive oxidative stress and phenotypic transition into osteoblastic cells. Since AGEs can induce apoptosis, in this study we investigated its role on VSMC apoptosis, focusing mainly on the underlying mechanisms. A rat VSMC line (A7r5) was cultured, and treated with glycolaldehyde-derived AGE-bovine serum albumin (AGE3-BSA). Apoptotic cells were identified by Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. To quantify apoptosis, an enzyme-linked immunosorbent assay (ELISA) for histone-complexed DNA fragments was employed. Real-time PCR was performed to determine the mRNA levels. Treatment of A7r5 cells with AGE3-BSA from 100 µg/mL concentration markedly increased apoptosis, which was suppressed by Nox inhibitors. AGE3-BSA significantly increased the mRNA expression of NAD(P)H oxidase components including Nox4 and p22phox, and these findings were confirmed by protein levels using immunofluorescence. Dihydroethidisum assay showed that compared with cBSA, AGE3-BSA increased reactive oxygen species level in A7r5 cells. Furthermore, AGE3-induced apoptosis was significantly inhibited by siRNA-mediated knockdown of Nox4 or p22phox. Double knockdown of Nox4 and p22phox showed a similar inhibitory effect on apoptosis as single gene silencing. Thus, our results demonstrated that NAD(P)H oxidase-derived oxidative stress are involved in AGEs-induced apoptosis of VSMCs. These findings might be important to understand the pathogenesis of vascular calcification in diabetes and CKD.
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Affiliation(s)
- Sayo Koike
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
| | - Shozo Yano
- Department of Laboratory Medicine, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
| | - Sayuri Tanaka
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
| | - Abdullah M Sheikh
- Department of Laboratory Medicine, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
| | - Atsushi Nagai
- Department of Laboratory Medicine, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
| | - Toshitsugu Sugimoto
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
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93
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Byon CH, Heath JM, Chen Y. Redox signaling in cardiovascular pathophysiology: A focus on hydrogen peroxide and vascular smooth muscle cells. Redox Biol 2016; 9:244-253. [PMID: 27591403 PMCID: PMC5011184 DOI: 10.1016/j.redox.2016.08.015] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 08/23/2016] [Indexed: 02/07/2023] Open
Abstract
Oxidative stress represents excessive intracellular levels of reactive oxygen species (ROS), which plays a major role in the pathogenesis of cardiovascular disease. Besides having a critical impact on the development and progression of vascular pathologies including atherosclerosis and diabetic vasculopathy, oxidative stress also regulates physiological signaling processes. As a cell permeable ROS generated by cellular metabolism involved in intracellular signaling, hydrogen peroxide (H2O2) exerts tremendous impact on cardiovascular pathophysiology. Under pathological conditions, increased oxidase activities and/or impaired antioxidant systems results in uncontrolled production of ROS. In a pro-oxidant environment, vascular smooth muscle cells (VSMC) undergo phenotypic changes which can lead to the development of vascular dysfunction such as vascular inflammation and calcification. Investigations are ongoing to elucidate the mechanisms for cardiovascular disorders induced by oxidative stress. This review mainly focuses on the role of H2O2 in regulating physiological and pathological signals in VSMC.
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Affiliation(s)
| | - Jack M Heath
- Department of Pathology, Birmingham, AL 35294, USA
| | - Yabing Chen
- Department of Pathology, Birmingham, AL 35294, USA; University of Alabama at Birmingham, and the Birmingham Veterans Affairs Medical Center, Birmingham, AL 35294, USA.
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94
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Hsu JJ, Lim J, Tintut Y, Demer LL. Cell-matrix mechanics and pattern formation in inflammatory cardiovascular calcification. Heart 2016; 102:1710-1715. [PMID: 27406839 DOI: 10.1136/heartjnl-2016-309667] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/20/2016] [Indexed: 12/24/2022] Open
Abstract
Calcific diseases of the cardiovascular system, such as atherosclerotic calcification and calcific aortic valve disease, are widespread and clinically significant, causing substantial morbidity and mortality. Vascular cells, like bone cells, interact with their matrix substrate through molecular signals, and through biomechanical signals, such as traction forces transmitted from cytoskeleton to matrix. The interaction of contractile vascular cells with their matrix may be one of the most important factors controlling pathological mineralisation of the artery wall and cardiac valves. In many respects, the matricrine and matrix mechanical changes in calcific vasculopathy and valvulopathy resemble those occurring in embryonic bone development and normal bone mineralisation. The matrix proteins provide a microenvironment for propagation of crystal growth and provide mechanical cues to the cells that direct differentiation. Small contractions of the cytoskeleton may tug on integrin links to sites on matrix proteins, and thereby sense the stiffness, possibly through deformation of binding proteins causing release of differentiation factors such as products of the members of the transforming growth factor-β superfamily. Inflammation and matrix characteristics are intertwined: inflammation alters the matrix such as through matrix metalloproteinases, while matrix mechanical properties affect cellular sensitivity to inflammatory cytokines. The adhesive properties of the matrix also regulate self-organisation of vascular cells into patterns through reaction-diffusion phenomena and left-right chirality. In this review, we summarise the roles of extracellular matrix proteins and biomechanics in the development of inflammatory cardiovascular calcification.
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Affiliation(s)
- Jeffrey J Hsu
- Department of Medicine, Division of Cardiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Jina Lim
- Department of Pediatrics, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Yin Tintut
- Department of Medicine, Division of Cardiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Physiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Orthopaedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Linda L Demer
- Department of Medicine, Division of Cardiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Physiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Bioengineering, University of California, Los Angeles (UCLA), Los Angeles, California, USA
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95
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Lee SN, Cho JY, Eun YM, Song SW, Moon KW. Associations between osteoporosis and coronary artery disease in postmenopausal women. Climacteric 2016; 19:458-62. [PMID: 27397609 DOI: 10.1080/13697137.2016.1200550] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Coronary artery disease (CAD) and osteoporosis are major causes of mortality and morbidity in postmenopausal women. We aimed to investigate the association between osteoporosis and CAD in asymptomatic postmenopausal women at a single center. METHODS This study included 863 postmenopausal women without histories of cardiovascular diseases who visited the Health Promotion Center from June 1, 2004 to May 31, 2015. All subjects were screened for bone mineral density (BMD) by dual-energy X-ray absorptiometry and for the degree of CAD by multidetector computed tomography. RESULTS Low BMD including osteopenia and osteoporosis was found to be significantly associated with old age, low body mass index, and a higher prevalence of diabetes mellitus. The incidences of CAD including a high coronary artery calcium score (≥100), obstructive coronary artery disease, and multivessel disease were significantly higher in subjects with low BMD. After adjusting for age and cardiovascular risk factors, osteoporosis was associated with a high coronary artery calcium score (p = 0.015) and with obstructive coronary artery disease (p = 0.002). There was a trend toward significance with multivessel disease (p = 0.052). CONCLUSIONS High coronary artery calcium score and obstructive coronary artery disease, as revealed by multidetector computed tomography, were associated with osteoporosis in asymptomatic postmenopausal women, independent of cardiovascular risk factors and age.
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Affiliation(s)
- S N Lee
- a Department of Internal Medicine , St. Vincent's Hospital, The Catholic University of Korea , Suwon , South Korea
| | - J-Y Cho
- a Department of Internal Medicine , St. Vincent's Hospital, The Catholic University of Korea , Suwon , South Korea
| | - Y-M Eun
- b Department of Family Medicine , St. Vincent's Hospital, The Catholic University of Korea , Suwon , South Korea
| | - S-W Song
- b Department of Family Medicine , St. Vincent's Hospital, The Catholic University of Korea , Suwon , South Korea
| | - K-W Moon
- a Department of Internal Medicine , St. Vincent's Hospital, The Catholic University of Korea , Suwon , South Korea
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96
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[Aortic valve calcification prevalence and association with coronary risk factors and atherosclerosis in Mexican population]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2016; 87:108-115. [PMID: 27389533 DOI: 10.1016/j.acmx.2016.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/25/2016] [Accepted: 05/30/2016] [Indexed: 11/21/2022] Open
Abstract
OBJETIVE The prevalence of aortic valve calcification (AVC), strongly influenced by ethnicity, is unknown in Mexican population. The aim of this study was to investigate the prevalence of AVC and its associations with cardiovascular risk factors and coronary artery calcification (CAC), in Mexican subjects. METHODS In 1,267 subjects (53% women) without known coronary heart disease, aged 35 to 75 years, AVC and CAC were assessed by multidetector-computed tomography using the Agatston score. Cardiovascular risk factors were documented in all participants. The associations of AVC with CAC and risk factors were assessed by multivariable logistic regression analyses. RESULTS The overall prevalence of AVC and CAC was 19.89% and 26.5%, respectively. AVC and CAC increased with age and were found more frequently in men (25.5% and 37.1%, respectively) than in women (14.9% and 13.0%, respectively). AVC was observed in only 8.5% of subjects without CAC, while those with CAC 1-99, 100-399, and >400 Agatston units had AVC prevalences of 36.8%, 56.8%, and 84.0%, respectively. The multivariable logistic regression analyses, adjusted for age, gender, obesity, physical inactivity, hypertension, dyslipidemia and high insulin levels, showed that the presence of CAC (OR [CI95%]: 3.23 [2.26-4.60]), obesity (1.94 [1.35-2.79]), male gender (1.44 [1.01-2.05]) and age (1.08 [1.03-1.10]), were significant independent predictors of AVC. CONCLUSION Prevalence of AVC is high and significantly associated with atherosclerotic risk factors and CAC in this Mexican population.
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Li X, Lim J, Lu J, Pedego TM, Demer L, Tintut Y. Protective Role of Smad6 in Inflammation-Induced Valvular Cell Calcification. J Cell Biochem 2016; 116:2354-64. [PMID: 25864564 DOI: 10.1002/jcb.25186] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 04/01/2015] [Indexed: 12/23/2022]
Abstract
Calcific aortic vascular and valvular disease (CAVD) is associated with hyperlipidemia, the effects of which occur through chronic inflammation. Evidence suggests that inhibitory small mothers against decapentaplegic (I-Smads; Smad6 and 7) regulate valve embryogenesis and may serve as a mitigating factor in CAVD. However, whether I-Smads regulate inflammation-induced calcific vasculopathy is not clear. Therefore, we investigated the role of I-Smads in atherosclerotic calcification. Results showed that expression of Smad6, but not Smad7, was reduced in aortic and valve tissues of hyperlipidemic compared with normolipemic mice, while expression of tumor necrosis factor alpha (TNF-α) was upregulated. To test whether the effects are in response to inflammatory cytokines, we isolated murine aortic valve leaflets and cultured valvular interstitial cells (mVIC) from the normolipemic mice. By immunochemistry, mVICs were strongly positive for vimentin, weakly positive for smooth muscle α actin, and negative for an endothelial cell marker. TNF-α upregulated alkaline phosphatase (ALP) activity and matrix mineralization in mVICs. By gene expression analysis, TNF-α significantly upregulated bone morphogenetic protein 2 (BMP-2) expression while downregulating Smad6 expression. Smad7 expression was not significantly affected. To further test the role of Smad6 on TNF-α-induced valvular cell calcification, we knocked down Smad6 expression using lentiviral transfection. In cells transfected with Smad6 shRNA, TNF-α further augmented ALP activity, expression of BMP-2, Wnt- and redox-regulated genes, and matrix mineralization compared with the control cells. These findings suggest that TNF-α induces valvular and vascular cell calcification, in part, by specifically reducing the expression of a BMP-2 signaling inhibitor, Smad6.
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Affiliation(s)
- Xin Li
- Department of Medicine, University of California, Los Angeles, California
| | - Jina Lim
- Departments of Pediatrics, University of California, Los Angeles, California
| | - Jinxiu Lu
- Department of Physiology, University of California, Los Angeles, California
| | - Taylor M Pedego
- Department of Medicine, University of California, Los Angeles, California
| | - Linda Demer
- Department of Medicine, University of California, Los Angeles, California.,Department of Physiology, University of California, Los Angeles, California.,Department of Bioengineering, University of California, Los Angeles, California
| | - Yin Tintut
- Department of Medicine, University of California, Los Angeles, California
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98
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Low serum testosterone level was associated with extensive coronary artery calcification in elderly male patients with stable coronary artery disease. Coron Artery Dis 2016; 26:437-41. [PMID: 25968306 DOI: 10.1097/mca.0000000000000260] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Coronary artery calcification (CAC) is a pandemic condition in elderly patients with coronary artery disease (CAD) and associated with a worse prognosis. Although available data have shown an association between testosterone levels in men and CAD, the association between testosterone and CAC in elderly male patients with CAD remains unknown. METHODS A total of 211 consecutive male patients (age ≥ 65 years) who underwent first multidetector computed tomography and following angiography were enrolled from our institution between March 2009 and September 2014. CAD was angiographically documented as significant stenoses (reduction ≥ 50% of the lumen diameter) on any major coronary vessel. The standard Agatston calcium score was calculated. The relationship of serum testosterone level with the CAC score measured by multidetector computed tomography in elderly male patients with stable CAD was evaluated. For data analyses, the CAC score was divided into four categories: ≤ 10, 11-99, 100-399, and ≥ 400, corresponding to minimal, moderate, increased, and extensive calcification. RESULTS Patients with higher CAC scores had significantly lower testosterone levels than patients with lower CAC scores (P = 0.048). In logistic regression analysis, testosterone level remained an independent predictor of extensive CAC (odds ratio 0.997, 95% confidence interval 0.994-0.999, P = 0.043). CONCLUSION Our findings indicate an inverse association between testosterone level and the susceptibility to extensive CAC in elderly men with stable CAD.
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99
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Tsang HG, Rashdan NA, Whitelaw CBA, Corcoran BM, Summers KM, MacRae VE. Large animal models of cardiovascular disease. Cell Biochem Funct 2016; 34:113-32. [PMID: 26914991 PMCID: PMC4834612 DOI: 10.1002/cbf.3173] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 12/12/2022]
Abstract
The human cardiovascular system is a complex arrangement of specialized structures with distinct functions. The molecular landscape, including the genome, transcriptome and proteome, is pivotal to the biological complexity of both normal and abnormal mammalian processes. Despite our advancing knowledge and understanding of cardiovascular disease (CVD) through the principal use of rodent models, this continues to be an increasing issue in today's world. For instance, as the ageing population increases, so does the incidence of heart valve dysfunction. This may be because of changes in molecular composition and structure of the extracellular matrix, or from the pathological process of vascular calcification in which bone-formation related factors cause ectopic mineralization. However, significant differences between mice and men exist in terms of cardiovascular anatomy, physiology and pathology. In contrast, large animal models can show considerably greater similarity to humans. Furthermore, precise and efficient genome editing techniques enable the generation of tailored models for translational research. These novel systems provide a huge potential for large animal models to investigate the regulatory factors and molecular pathways that contribute to CVD in vivo. In turn, this will help bridge the gap between basic science and clinical applications by facilitating the refinement of therapies for cardiovascular disease.
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Affiliation(s)
- H G Tsang
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - N A Rashdan
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - C B A Whitelaw
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - B M Corcoran
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - K M Summers
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - V E MacRae
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
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100
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Kuipers AL, Miljkovic I, Evans R, Bunker CH, Patrick AL, Zmuda JM. Optimal serum cholesterol concentrations are associated with accelerated bone loss in African ancestry men. Osteoporos Int 2016; 27:1577-1584. [PMID: 26602914 PMCID: PMC4792711 DOI: 10.1007/s00198-015-3416-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/09/2015] [Indexed: 01/14/2023]
Abstract
UNLABELLED We tested if serum lipid and lipoprotein cholesterol levels are associated with longitudinal measures of bone mineral density (BMD) in 1289 African ancestry men. After 6 years of mean follow-up, men with clinically optimal levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), or triglycerides at baseline experienced the greatest BMD loss, independent of potential confounding factors (all p < 0.05). INTRODUCTION Studies of lipid and lipoprotein cholesterol associations with bone mineral density (BMD) and bone loss have been inconclusive, and longitudinal data are sparse. Therefore, the aim of this study was to test if fasting serum lipid and lipoprotein cholesterol levels are associated with areal and volumetric BMD and BMD change. METHODS We determined the association of serum triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol concentrations with cross-sectional and longitudinal (mean follow-up, 6.1 years) measures of BMD in a cohort of 1289 in African ancestry men (mean age, 56.4 years). Fasting serum triglycerides, HDL, and LDL were measured at baseline concurrent with BMD assessments. Dual-energy X-ray absorptiometry was used to quantify integral hip BMD, and peripheral quantitative computed tomography at the radius and tibia was used to quantify volumetric BMD. Men were categorized as optimal, borderline, or high risk for triglyceride, HDL, and LDL concentrations based on Adult Treatment Panel III guidelines. RESULTS Lower serum triglyceride or LDL and higher HDL concentrations were associated with lower trabecular BMD at baseline (all p < 0.05). Similarly, men classified as having optimal levels of LDL, HDL, or triglycerides at baseline experienced the greatest integral BMD loss at the hip and trabecular BMD loss at the tibia (all p < 0.05), independent of potential confounding factors. CONCLUSIONS We found that clinically optimal serum lipid and lipoprotein cholesterol concentrations were associated with accelerated bone loss among Afro-Caribbean men. Further studies are needed to better understand the mechanisms involved and potential clinical significance of these findings.
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Affiliation(s)
- A L Kuipers
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A543 Crabtree Hall, Pittsburgh, PA, 15261, USA.
| | - I Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A543 Crabtree Hall, Pittsburgh, PA, 15261, USA
| | - R Evans
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A543 Crabtree Hall, Pittsburgh, PA, 15261, USA
| | - C H Bunker
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A543 Crabtree Hall, Pittsburgh, PA, 15261, USA
| | - A L Patrick
- Tobago Health Studies Office, Jerningham Court, James Park, Scarborough, Tobago, Trinidad and Tobago
| | - J M Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A543 Crabtree Hall, Pittsburgh, PA, 15261, USA
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