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Ceruloplasmin and the extent of heart failure in ischemic and nonischemic cardiomyopathy patients. Mediators Inflamm 2013; 2013:348145. [PMID: 23781119 PMCID: PMC3679757 DOI: 10.1155/2013/348145] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 05/01/2013] [Accepted: 05/12/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Ceruloplasmin was elevated in patients with coronary heart disease, but the relationship between ceruloplasmin and heart failure was still unknown. We aimed to evaluate ceruloplasmin in heart failure patients and assess association between ceruloplasmin and the extent of heart failure. METHODS AND RESULTS 202 heart failure patients were divided into ischemic (78 with coronary stenosis) and nonischemic groups (124 without coronary stenosis). 94 subjects without heart failure were included as controls. The extent of heart failure was defined according to NYHA classification. Ceruloplasmin levels in ischemic (P < 0.001) and nonischemic groups (P < 0.001) were higher than those in control group. Ceruloplasmin had a positive linear correlation with C-reactive protein (P < 0.01) and a negative linear correlation with LVEF (P < 0.05). In nonischemic group, CP levels were significantly different among different NYHA subgroups (P < 0.05). The correlation between ceruloplasmin and extent of heart failure was calculated by binary logistic regression. Ceruloplasmin showed an independent association with the extent of heart failure in nonischemic cardiomyopathy patients (P < 0.05). CONCLUSIONS Ceruloplasmin was significantly elevated in patients with ischemic or nonischemic cardiomyopathy and had linear correlation with C-reactive protein and LVEF. In nonischemic cardiomyopathy patients, the ceruloplasmin value was an independent biomarker associated with the extent of heart failure.
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Wang X, Dong Y, Qi X, Huang C, Hou L. Cholesterol levels and risk of hemorrhagic stroke: a systematic review and meta-analysis. Stroke 2013; 44:1833-9. [PMID: 23704101 DOI: 10.1161/strokeaha.113.001326] [Citation(s) in RCA: 226] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Cholesterol levels are inconsistently associated with the risk of hemorrhagic stroke. The purpose of this study is to assess their relationships using a meta-analytic approach. METHODS We searched PubMed and Embase for pertinent articles published in English. Only prospective studies that reported effect estimates with 95% confidential intervals (CIs) of hemorrhagic stroke for ≥3 categories of cholesterol levels, for high and low comparison, or for per 1 mmol/L increment of cholesterol concentrations were included. We used the random-effects model to pool the study-specific results. RESULTS Twenty-three prospective studies were included, totaling 1 430 141 participants with 7960 (5.6%) hemorrhagic strokes. In high versus low analysis, the summary relative risk of hemorrhagic stroke was 0.69 (95% CI, 0.59-0.81) for total cholesterol, 0.98 (95% CI, 0.80-1.19) for high-density lipoprotein cholesterol, and 0.62 (95% CI, 0.41-0.92) for low-density lipoprotein cholesterol. In dose-response analysis, the summary relative risk of hemorrhagic stroke for 1 mmol/L increment of total cholesterol was 0.85 (95% CI, 0.80-0.91), for high-density lipoprotein cholesterol was 1.11 (95% CI, 0.99-1.25), and for low-density lipoprotein cholesterol was 0.90 (95% CI, 0.77-1.05). The pooled relative risk for intracerebral hemorrhage was 1.17 (95% CI, 1.02-1.35) for high-density lipoprotein cholesterol. CONCLUSIONS Total cholesterol level is inversely associated with risk of hemorrhagic stroke. Higher level of low-density lipoprotein cholesterol seems to be associated with lower risk of hemorrhagic stroke. High-density lipoprotein cholesterol level seems to be positively associated with risk of intracerebral hemorrhage.
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Affiliation(s)
- Xiang Wang
- Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Safavi SM, Ziaei R, Maracy MR. Association of serum ceruloplasmin level with obesity: some components of metabolic syndrome and high-sensitive C-reactive protein in Iran. J Obes 2012; 2012:951093. [PMID: 23365726 PMCID: PMC3549357 DOI: 10.1155/2012/951093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 12/18/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND One of the mechanisms that has been suggested for obesity related metabolic disturbances is obesity-induced inflammation. Pro-inflammatory cytokines generated in adipose tissue can increase hepatic synthesis of inflammation-sensitive plasma proteins (ISPs) including ceruloplasmin (Cp). In this study we aimed to investigate the relation between serum Cp level and obesity. METHODS 61 persons with body mass index (BMI) ≥ 25 kg/m² (case group) and 61 persons with BMI < 25 kg/m² (control group) were included in this study with a case-control design. Serum Cp levels, triglyceride level, fating blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and hsCRP were measured in both groups. RESULTS We did not observe any significant association between serum Cp level and BMI in all subjects [OR: 1.02 (CI, 0.967 to 1.07)] and in case (β = 0.012, P = 0.86) and control groups (β = 0.49, P = 0.07) separately. However, in control group, this positive association was marginally significant. We found a positive correlation between serum Cp level and serum triglyceride level. CONCLUSION Serum Cp level was not related to obesity in this group of subjects. None of the baseline variables could predict obesity in this group of subjects, including serum Cp level, FBS, total cholesterol, LDL and HDL- cholesterols and hsCRP.
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Affiliation(s)
- Seyyed Morteza Safavi
- School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan 81745, Iran
| | - Rahele Ziaei
- School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan 81745, Iran
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Ganini D, Canistro D, Jang J, Stadler K, Mason RP, Kadiiska MB. Ceruloplasmin (ferroxidase) oxidizes hydroxylamine probes: deceptive implications for free radical detection. Free Radic Biol Med 2012; 53:1514-21. [PMID: 22824865 PMCID: PMC3448871 DOI: 10.1016/j.freeradbiomed.2012.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 06/22/2012] [Accepted: 07/16/2012] [Indexed: 11/25/2022]
Abstract
Ceruloplasmin (ferroxidase) is a copper-binding protein known to promote Fe(2+) oxidation in plasma of mammals. In addition to its classical ferroxidase activity, ceruloplasmin is known to catalyze the oxidation of various substrates, such as amines and catechols. Assays based on cyclic hydroxylamine oxidation are used to quantify and detect free radicals in biological samples ex vivo and in vitro. We show here that human ceruloplasmin promotes the oxidation of the cyclic hydroxylamine 1-hydroxy-3-carboxy-2,2,5,5-tetramethylpyrrolidine hydrochloride (CPH) and related probes in Chelex-treated phosphate buffer and rat serum. The reaction is suppressed by the metal chelators DTPA, EDTA, and desferal, whereas heparin and bathocuproine have no effect. Catalase or superoxide dismutase additions do not interfere with the CPH-oxidation yield, demonstrating that oxygen-derived free radicals are not involved in the CPH oxidation mediated by ceruloplasmin. Plasma samples immunodepleted of ceruloplasmin have lower levels of CPH oxidation, which confirms the role of ceruloplasmin (ferroxidase) as a biological oxidizing agent of cyclic hydroxylamines. In conclusion, we show that the ferroxidase activity of ceruloplasmin is a possible biological source of artifacts in the cyclic hydroxylamine-oxidation assay used for reactive oxygen species detection and quantification.
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Affiliation(s)
- Douglas Ganini
- Free Radical Metabolism Section, Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Donatella Canistro
- Department of Pharmacology, Molecular Toxicology Unit, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - JinJie Jang
- Free Radical Metabolism Section, Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Krisztian Stadler
- Oxidative Stress and Disease Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Ronald P. Mason
- Free Radical Metabolism Section, Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Maria B. Kadiiska
- Free Radical Metabolism Section, Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
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Shahabi P, Siest G, Herbeth B, Ndiaye NC, Visvikis-Siest S. Clinical necessity of partitioning of human plasma haptoglobin reference intervals by recently-discovered rs2000999. Clin Chim Acta 2012; 413:1618-24. [DOI: 10.1016/j.cca.2012.04.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 04/23/2012] [Accepted: 04/29/2012] [Indexed: 11/28/2022]
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Gong WH, Zheng WX, Wang J, Chen SH, Pang B, Hu XM, Cao XL. Coexistence of hyperlipidemia and acute cerebral ischemia/reperfusion induces severe liver damage in a rat model. World J Gastroenterol 2012; 18:4934-43. [PMID: 23002367 PMCID: PMC3447277 DOI: 10.3748/wjg.v18.i35.4934] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 04/13/2012] [Accepted: 05/06/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the correlation of hyperlipemia (HL) and acute cerebral ischemia/reperfusion (I/R) injury on liver damage and its mechanism.
METHODS: Rats were divided into 4 groups: control, HL, I/R and HL+I/R. After the induction of HL via a high-fat diet for 18 wk, middle cerebral artery occlusion was followed by 24 h of reperfusion to capture I/R. Serum alanine transaminase (ALT) and aspartate aminotransferase (AST) were analyzed as part of liver function tests and liver damage was further assessed by histological examination. Hepatocyte apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. The expression of genes related to apoptosis (caspase-3, bcl-2) was assayed by immunohistochemistry and Western blotting. Serum tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1) and liver mitochondrial superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA) and Ca2+ levels were measured to determine inflammatory and oxidative/antioxidative status respectively. Microsomal hydroxylase activity of the cytochrome P450 2E1 (CYP2E1)-containing enzyme was measured with aniline as the substrate, and CYP2E1 expression in the liver tissue and microsome was determined by immunohistochemistry and Western blotting respectively.
RESULTS: HL alone induced by high-fat diet for 18 wk resulted in liver damage, indicated by histopathological analysis, and a considerable increase in serum ALT (25.13 ± 16.90 vs 9.56 ± 1.99, P < 0.01) and AST levels (18.01 ± 10.00 vs 11.33 ± 4.17, P < 0.05) compared with control. Moreover, HL alone induced hepatocyte apoptosis, which was determined by increased TUNEL-positive cells (4.47 ± 0.45 vs 1.5 ± 0.22, P < 0.01), higher caspase-3 and lower bcl-2 expression. Interestingly, compared with those in control, HL or I/R groups, massive increases of serum ALT (93.62 ± 24.00 vs 9.56 ± 1.99, 25.13 ± 16.90 or 12.93 ± 6.14, P < 0.01) and AST (82.32 ± 26.92 vs 11.33 ± 4.17, 18.01 ± 10.00 or 14.00 ± 6.19, P < 0.01) levels in HL+I/R group were observed suggesting severe liver damage, which was confirmed by liver histology. In addition, HL combined with I/R also caused significantly increased hepatocyte apoptosis, as evidenced by increased TUNEL-positive cells (6.20 ± 0.29 vs 1.5 ± 0.22, 4.47 ± 0.45 or 1.97 ± 0.47, P < 0.01), elevated expression of caspase-3 and lower expression of bcl-2. Furthermore, when compared to HL or I/R alone, HL plus I/R enhanced serum TNF-α, IL-1, liver mitochondrial MDA and Ca2+ levels, suppressed SOD and GSH-Px in liver mitochondria, and markedly up-regulated the activity (11.76 ± 2.36 vs 4.77 ± 2.31 or 3.11 ± 1.35, P < 0.01) and expression (3.24 ± 0.38 vs 1.98 ± 0.88 or 1.72 ± 0.58, P < 0.01) of CYP2E1 in liver.
CONCLUSION: The coexistence of HL and acute cerebral I/R induces severe liver damage, suggesting that cerebral ischemic stroke would exaggerate the damage of liver caused by HL. This effect is possibly due to enhanced CYP2E1 induction which further promotes oxidative damage, inflammation and hepatocyte apoptosis.
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Yiallouros PK, Savva SC, Kolokotroni O, Behbod B, Zeniou M, Economou M, Chadjigeorgiou C, Kourides YA, Tornaritis MJ, Lamnisos D, Middleton N, Milton DK. Low serum high-density lipoprotein cholesterol in childhood is associated with adolescent asthma. Clin Exp Allergy 2012; 42:423-32. [PMID: 22356143 DOI: 10.1111/j.1365-2222.2011.03940.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Whilst emerging evidence from animal and cell experiments has shown high-density lipoprotein cholesterol to have anti-inflammatory effects consistent with a protective role in asthma, human studies investigating the relationship of high-density lipoprotein cholesterol with asthma have produced conflicting results. OBJECTIVE To examine the association between serum lipids among Cypriot children aged 11-12 years and prevalence of asthma at age 15-17 years. METHODS In 3982 children, we assessed serum lipids, body mass index and maximal oxygen consumption at baseline (2001-2003) and explored associations with respiratory health at follow-up (2007) using multiple logistic regression models. RESULTS Lower levels of high-density lipoprotein cholesterol at age 11-12 years were found in subjects who reported ever asthma (58.2 vs. 60.0 mg/dL, P = 0.005) and active asthma (57.5 vs. 59.9 mg/dL, P = 0.010) in adolescence, in comparison with their respective reference groups. Total cholesterol, low-density lipoprotein and triglycerides had no association with any of the asthma outcomes. In contrast, with estimated odds ratios of 1.89 (95% CI 1.19-3.00) and 1.89 (95% CI 1.02-3.53), ever asthma and active asthma respectively appeared particularly pronounced among those who at baseline had high-density lipoprotein cholesterol <40 mg/dL, even after adjusting for potential confounders including body mass index and maximal oxygen consumption. CONCLUSIONS & CLINICAL RELEVANCE Low-serum high-density lipoprotein cholesterol in childhood is associated with an increased risk for asthma in adolescence, suggesting a potential role of this lipoprotein in the pathogenesis of paediatric asthma.
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Affiliation(s)
- P K Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.
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Oliveira-Filho J, Dias JDS, Jesus PA, Neto NJ, Aras R, Reis FJ, Furie KL. Clinical assessment, neuroimaging and immunomarkers in Chagas disease study (CLINICS): Rationale, study design and preliminary findings. Dement Neuropsychol 2012; 6:180-187. [PMID: 29213794 PMCID: PMC5618967 DOI: 10.1590/s1980-57642012dn06030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 05/20/2012] [Indexed: 11/21/2022] Open
Abstract
Chagas disease (CD) is an important cause of cardiomyopathy and stroke in Brazil. Brain infarcts and atrophy seem to occur independently of cardiomyopathy severity and cognitive impairment is understudied. OBJECTIVE Compare the prevalence of brain magnetic resonance imaging abnormalities between patients with or without CD; determine if inflammatory biomarkers are increased in CD; and determine the efficacy of aspirin in reducing the rate of microembolization in these patients. METHODS 500 consecutive patients with heart failure will undergo a structured cognitive evaluation, biomarker collection and search for microembolic signals on transcranial Doppler. The first 90 patients are described, evaluated with cognitive tests and brain magnetic resonance imaging to measure N-acetyl aspartate (NAA), choline (Cho), myo-inositol (MI) and creatine (Cr). RESULTS Mean age was 55±11 years, 51% female, 38 (42%) with CD. Mean NAA/Cr ratio was lower in patients with CD as compared to other cardiomyopathies. Long-term memory and clock-drawing test were also significantly worse in CD patients. In the multivariable analysis correcting for ejection fraction, age, sex and educational level, reduced NAA/Cr (p=0.006) and cognitive dysfunction (long-term memory, p=0.023; clock-drawing test, p=0.015) remained associated with CD. CONCLUSION In this preliminary sample, CD was associated with cognitive impairment and decreased NAA/Cr independently of cardiac function or educational level.
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Affiliation(s)
- Jamary Oliveira-Filho
- From the Stroke and Cardiomyopathy Clinics of the Hospital Universitario
Professor Edgard Santos, Federal University of Bahia, BA, Brazil; and the Stroke
Service of Massachusetts General Hospital, Harvard University, USA
| | - Jesângeli de S. Dias
- From the Stroke and Cardiomyopathy Clinics of the Hospital Universitario
Professor Edgard Santos, Federal University of Bahia, BA, Brazil; and the Stroke
Service of Massachusetts General Hospital, Harvard University, USA
| | - Pedro A.P. Jesus
- From the Stroke and Cardiomyopathy Clinics of the Hospital Universitario
Professor Edgard Santos, Federal University of Bahia, BA, Brazil; and the Stroke
Service of Massachusetts General Hospital, Harvard University, USA
| | - Nestor J.S.B. Neto
- From the Stroke and Cardiomyopathy Clinics of the Hospital Universitario
Professor Edgard Santos, Federal University of Bahia, BA, Brazil; and the Stroke
Service of Massachusetts General Hospital, Harvard University, USA
| | - Roque Aras
- From the Stroke and Cardiomyopathy Clinics of the Hospital Universitario
Professor Edgard Santos, Federal University of Bahia, BA, Brazil; and the Stroke
Service of Massachusetts General Hospital, Harvard University, USA
| | - Francisco J.F.B. Reis
- From the Stroke and Cardiomyopathy Clinics of the Hospital Universitario
Professor Edgard Santos, Federal University of Bahia, BA, Brazil; and the Stroke
Service of Massachusetts General Hospital, Harvard University, USA
| | - Karen L. Furie
- From the Stroke and Cardiomyopathy Clinics of the Hospital Universitario
Professor Edgard Santos, Federal University of Bahia, BA, Brazil; and the Stroke
Service of Massachusetts General Hospital, Harvard University, USA
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Maan A, Shaikh AY, Mansour M, Ruskin JN, Heist EK. Stroke and Death Prediction with the Impact of Vascular Disease in Patients with Atrial Fibrillation. J Atr Fibrillation 2012; 5:586. [PMID: 28496751 DOI: 10.4022/jafib.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 05/15/2012] [Accepted: 05/15/2012] [Indexed: 12/22/2022]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia encountered in the U.S. and the growing burden of AF has profound health implications due to the association of AF with an increased risk of stroke, heart failure, and mortality. AF is a significant risk factor for thromboembolic stroke; and also independently increases total mortality in patients with and without cardiovascular disease. Various risk stratification schemes such as CHADS2 and CHA2DS2-VASc have been implemented in clinical practice to determine the risk of cardio-embolic stroke, and need for thrombo-prophylaxis in patients with AF. AF is also closely related to the pathophysiology of other cardiovascular and peripheral vascular disease. Many patients with AF have associated atherosclerosis given that many risk factors for atherosclerosis also predispose to AF. Myocardial infarction (MI) is also closely related to AF and its clinical course is affected by new onset AF. This review elucidates the impact of AF on major adverse cardiovascular events and mortality outcomes in relation to stroke, coronary artery disease and peripheral vascular disease.
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Affiliation(s)
- Abhishek Maan
- Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA 01655
| | - Amir Y Shaikh
- Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA 01655
| | - Moussa Mansour
- Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, GRB 109, 55 Fruit St, Boston MA 02115
| | - Jeremy N Ruskin
- Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, GRB 109, 55 Fruit St, Boston MA 02115
| | - E Kevin Heist
- Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, GRB 109, 55 Fruit St, Boston MA 02115
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Tajik N, Golpaie A, Keshavarz SA, Djalali M, Sehat M, Masoudkabir F, Ahmadivand Z, Fatehi F, Zare M, Yazdani T. Decreased plasma levels of ceruloplasmin after diet-induced weight loss in obese women. J Endocrinol Invest 2012; 35:566-9. [PMID: 21795842 DOI: 10.3275/7878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Plasma ceruloplasmin (Cp) has been shown to be a risk factor for cardiovascular disease and also to be associated with obesity. However, it is not known whether weight loss could decrease the plasma Cp levels. AIM To investigate the effect of diet-induced weight loss on plasma Cp in obese women. SUBJECTS AND METHODS Sixty-seven healthy obese women [age =33.4±8.7 yr, body mass index (BMI) =36.0±4.8 kg/m2] were entered into a medically supervised program aimed at reducing body weight by 10% or more. Weight loss was achieved through a diet providing a daily energy deficit of 500-1000 kcal/day. In addition, all patients were prescribed to use 50 g of a fiber supplement per day. For all subjects, assessment of dietary intake, anthropometric indices, and plasma levels of C-reactive protein and Cp was performed at the first visit and repeated at 12th week of follow-up. RESULTS By completing the program, weight (Δ=-9.5%, p<0.0001), BMI (Δ=-9.7%, p<0.0001), waist-circumference (Δ=-6.1%, p<0.0001), and triceps skinfold thickness (Δ=-14.9%, p<0.0001) significantly decreased. Plasma Cp significantly decreased after 12 weeks of dietary intervention (33.6±5.6 mg/dl vs 25.2±5.8 mg/dl, p<0.0001). Percent change in Cp was correlated with percent change in waist-circumference (r=446, p=0.015). CONCLUSION Our study suggests that an improved body composition induced by restriction of energy intake is associated with decreased serum concentrations of Cp in obese women which in turn might have reduced the subjects' risk of developing cardiovascular disease.
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Affiliation(s)
- N Tajik
- Nutrition and Biochemistry Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Mallipattu SK, He JC, Uribarri J. Role of advanced glycation endproducts and potential therapeutic interventions in dialysis patients. Semin Dial 2012; 25:529-38. [PMID: 22548330 DOI: 10.1111/j.1525-139x.2012.01081.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
It has been nearly 100 years since the first published report of advanced glycation end products (AGEs) by the French chemist Maillard. Since then, our understanding of AGEs in diseased states has dramatically changed. Especially in the last 25 years, AGEs have been implicated in complications related to aging, neurodegenerative diseases, diabetes, and chronic kidney disease. Although AGE formation has been well characterized by both in vitro and in vivo studies, few prospective human studies exist demonstrating the role of AGEs in patients on chronic renal replacement therapy. As the prevalence of end-stage renal disease (ESRD) in the United States rises, it is essential to identify therapeutic strategies that either delay progression to ESRD or improve morbidity and mortality in this population. This article reviews the role of AGEs, especially those of dietary origin, in ESRD patients as well as potential therapeutic anti-AGE strategies in this population.
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Affiliation(s)
- Sandeep K Mallipattu
- Division of Nephrology, Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA
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Wu W, Wang M, Sun Z, Wang X, Miao J, Zheng Z. The predictive value of TNF-α and IL-6 and the incidence of macrovascular complications in patients with type 2 diabetes. Acta Diabetol 2012; 49:3-7. [PMID: 20495833 DOI: 10.1007/s00592-010-0198-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 05/05/2010] [Indexed: 11/28/2022]
Abstract
Some inflammation factors have been shown to accelerate type 2 diabetes macrovascular complication (T2DMC). The study investigates the variation of TNF-α and IL-6 levels during the progression of T2DMC to explore their predictive value in the incidence of T2DMC. All participants were divided into two groups, type 2 diabetes mellitus (T2DM) and non-diabetes (ND) group. TNF-α and IL-6 were analyzed with enzyme immunoassay. All participants were followed up by carotid Doppler, Doppler of lower extremities, head CT and 64-row multislice spiral CTA. The incidence of macrovascular atherosclerosis in T2DM was significantly higher than that in ND group (P < 0.05). The levels of TNF-α and IL-6 in both groups with atherosclerosis increased annually. In patients who had atherosclerosis with diabetes, measured levels of TNF-α and IL-6 were significantly higher than those in patients with atherosclerosis without diabetes (P < 0.05). The levels of TNF-α and IL-6 in T2DMC and ND group with atherosclerosis was significantly higher than that in two groups without atherosclerosis (P < 0.05). Patients with T2DM were divided into four groups according to their HbA1C level. There was a strong positive correlation between the levels of TNF-α and IL-6 and HbA1C (P > 0.05). The TNF-α and IL-6 levels can be used as predictors for atherosclerosis development. Compared with non-diabetic atherosclerosis, TNF-α and IL-6 have stronger predictive value in diabetic atherosclerosis development. One reason for hyperglycemia increasing atherosclerosis is to activate inflammatory cells and relives of inflammatory factors. Hyperglycemia can trigger inflammation, which is a quality-effect relationship reaction.
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Affiliation(s)
- Weihua Wu
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, China.
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Degraba TJ, Hoehn GT, Nyquist PA, Wang H, Kenney R, Gonzales DA, Kern SJ, Ying SX, Munson PJ, Suffredini AF. Biomarker discovery in serum from patients with carotid atherosclerosis. Cerebrovasc Dis Extra 2011; 1:115-29. [PMID: 22566989 PMCID: PMC3343755 DOI: 10.1159/000334477] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Blood-based biomarkers of atherosclerosis have been used to identify patients at high risk for developing stroke. We hypothesized that patients with carotid artery disease would have a distinctive proteomic signature in blood as compared to a healthy control population without carotid artery disease. In order to discover protein biomarkers associated with increased atherosclerotic risk, we used two different strategies to identify biomarkers from patients with clinically defined atherosclerosis who were undergoing endarterectomy for atherosclerotic carotid artery disease. These patients were compared with healthy matched controls. METHODS Serum was obtained from patients undergoing endarterectomy (EA; n = 38) and compared to a group of age-matched healthy controls (n = 40). Serum was fractionated using anion exchange chromatography and three different surface-enhanced laser desorption/ionization (SELDI) chip surfaces and then evaluated with mass spectrometry (MS) and two-dimensional difference gel electrophoresis (2D-DIGE). RESULTS A random forest (RF) analysis of the SELDI-MS protein peak data distinguished these two groups with 69.2% sensitivity and 73.2% specificity. Four unique SELDI peaks (4.2, 4.4, 16.7 and 28 kDa, all p< 0.01) showed the greatest influence in the RF model. The EA patients with a history of prior clinical atherosclerotic plaque rupture manifested as either stroke or transient ischemic attack (symptomatic; n = 16) were compared to patients with carotid atherosclerosis but no clinical evidence of plaque rupture (asymptomatic; n = 22). Analysis of the SELDI spectra did not separate these two patient subgroups. A subgroup analysis using 2D-DIGE images obtained from albumin-depleted serum comparing symptomatic (n = 10) to asymptomatic EA patients (n = 10) found 4 proteins that were differentially expressed (p < 0.01) in the symptomatic patients. These proteins were identified as α(1)-antitrypsin, haptoglobin and vitamin D binding protein that were downregulated and α(2)-glycoprotein precursor that was upregulated in the symptomatic EA group. CONCLUSIONS SELDI-MS data analysis of fractionated serum suggests that a distinct protein signature exists in patients with carotid atherosclerosis compared to age-matched healthy controls. Identification of 4 proteins in a subset of patients with symptomatic and asymptomatic carotid atherosclerosis suggests that these and other protein biomarkers may assist in identifying high-risk patients with carotid atherosclerosis.
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Affiliation(s)
- Thomas J Degraba
- Neurology Department, National Naval Medical Center, Bethesda, Md., USA
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Adamsson Eryd S, Smith JG, Melander O, Hedblad B, Engström G. Incidence of coronary events and case fatality rate in relation to blood lymphocyte and neutrophil counts. Arterioscler Thromb Vasc Biol 2011; 32:533-9. [PMID: 22116095 DOI: 10.1161/atvbaha.111.240416] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Elevated levels of blood leukocytes have been associated with acute coronary events (CEs), but data on leukocyte subclasses are limited. This study aimed to explore whether blood lymphocyte and neutrophil counts are associated with incidence of CEs and with fatal outcome in subjects who subsequently experienced a first CE. METHODS AND RESULTS Neutrophil and lymphocyte counts were measured in 27 419 subjects from the general population without a history of CEs, heart failure, or atrial fibrillation. Incidence of CEs was studied in relation to leukocyte counts during a mean follow-up of 13.6 years. Neutrophil but not lymphocyte counts were significantly associated with incidence of CEs. After adjustments for confounding factors, the hazard ratios (95% confidence interval) were 1.00 (reference), 1.07 (0.94-1.23), 1.09 (0.95-1.25), and 1.39 (1.22-1.59) for subjects with neutrophils in the first, second, third, and fourth (highest) sex-specific quartiles, respectively (P for trend <0.001). Of the 1965 subject who had a CE, 471 subjects died on the first day of the CE, in- or outside hospital. The proportions of subjects who died the first day were 19%, 21%, 25%, and 28%, respectively in the first, second, third, and fourth quartiles (P for trend <0.001). CONCLUSIONS Increased neutrophil counts are associated with incidence of CEs and increased case-fatality rate after a CE.
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Affiliation(s)
- Samuel Adamsson Eryd
- Cardiovascular Epidemiology Research Group, Department of Clinical Sciences Lund University, Skåne University Hospital, Entrance 72, Bldg 60, Floor 13, 20205 Malmö, Sweden.
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Higashimoto Y, Yamagata T, Honda N, Satoh R, Sano H, Iwanaga T, Miyhara T, Muraki M, Tomita K, Tohda Y, Fukuda K. Clinical and inflammatory factors associated with body mass index in elderly patients with chronic obstructive pulmonary disease. Geriatr Gerontol Int 2011; 11:32-8. [PMID: 20609004 DOI: 10.1111/j.1447-0594.2010.00629.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Body mass index (BMI) is closely associated with mortality in chronic obstructive pulmonary disease (COPD). Systemic inflammation has been suggested as one of the mechanisms of malnutrition in COPD. This study investigated the relationships of clinical variables and inflammatory biomarkers with BMI in COPD in an aging population. METHODS Baseline levels of serum biomarkers were determined for 69 patients with stable male COPD. Multivariate logistic regression was used to evaluate associations between clinical variables, including emphysema scores, and biomarkers with BMI. RESULTS Twenty eight patients were categorized as low BMI (<20 kg/m2). BMI was inversely correlated with serum α1-antitrypsin (α1-AT) concentration and emphysema scores, and was positively correlated with forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Multivariate logistic regression analysis showed that α1-AT was independently associated with BMI. CONCLUSION Low BMI was associated with the severity of emphysema and systemic inflammation reflected by elevated α1-AT level.
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Affiliation(s)
- Yuji Higashimoto
- Department of Rehabilitation Medicine, Kinki University School of Medicine, Osaka, Japan.
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Piguet O. Eating disturbance in behavioural-variant frontotemporal dementia. J Mol Neurosci 2011; 45:589-93. [PMID: 21584651 DOI: 10.1007/s12031-011-9547-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Accepted: 05/06/2011] [Indexed: 12/13/2022]
Abstract
Behavioural-variant frontotemporal dementia (bvFTD) is a progressive neurodegenerative brain disorder, clinically characterised by changes in cognition, personality and behaviour. Marked disturbances in eating behaviour, such as overeating and preference for sweet foods, are also commonly reported. This paper reviews the current literature on eating abnormalities in bvFTD, their clinical characteristics and biological correlates, and the contribution of hypothalamus to eating regulation. Existing literature shows that disturbance in an orbitofrontal-insular-striatal brain network underlies the emergence of eating disturbance in bvFTD. In addition, recent evidence indicates that degeneration and consequent dysregulation within the hypothalamus relates to significant feeding disturbance in this disease. These findings could provide a basis for the development of therapeutic models in bvFTD.
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Affiliation(s)
- Olivier Piguet
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW, 2031, Australia.
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67
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Inflammation-sensitive proteins and risk of atrial fibrillation: a population-based cohort study. Eur J Epidemiol 2011; 26:449-55. [DOI: 10.1007/s10654-011-9565-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
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de las Fuentes L, de Simone G, Arnett DK, Dávila-Román VG. Molecular determinants of the cardiometabolic phenotype. Endocr Metab Immune Disord Drug Targets 2011; 10:109-23. [PMID: 20384572 DOI: 10.2174/187153010791213119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Accepted: 04/04/2010] [Indexed: 12/25/2022]
Abstract
The metabolic syndrome represents a clustering of risk factors that has been shown to predict adverse cardiovascular outcomes. Although the precise mechanisms contributing to the cardiometabolic syndrome (CMS) remain poorly defined, accumulating evidence identifies two intersecting candidate pathways responsible for inflammation and energy homeostasis in the pathophysiology that underlie cardiometabolic traits. Although currently no pharmacologic interventions specifically target CMS, future drug development efforts should attempt to capitalize on molecular nodes at the intersections of these pathways in the CMS.
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Affiliation(s)
- Lisa de las Fuentes
- Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University School of Medicine, St. Louis, MO 63110, USA.
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69
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Plasma ceruloplasmin as a biomarker for obesity: a proteomic approach. Clin Biochem 2011; 44:351-6. [PMID: 21291874 DOI: 10.1016/j.clinbiochem.2011.01.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 01/18/2011] [Accepted: 01/19/2011] [Indexed: 01/02/2023]
Abstract
OBJECTIVES This study aimed to investigate new biomarkers of obesity particularly in relation with inflammation-associated proteins using protein differential display techniques. DESIGN AND METHODS Comparison of protein expression in plasma between non-obese (n=109, body mass index, BMI<25kg/m(2)) and obese (n=32, BMI≥25kg/m(2)) groups was carried out using two-dimensional gel electrophoresis (2-DE) analysis. ELISA was also performed for validation. RESULTS Among six differentially expressed protein spots, ceruloplasmin (Cp) and fibrinogen were over-expressed in obese group. Plasma Cp levels were significantly higher in obese group than non-obese group (34.0 ± 8.6 vs. 41.3 ± 12.7mg/dL, p<0.001) and positively correlated with age (r=0.253, p<0.005), BMI (r=0.265, p<0.001) and hsCRP (r=0.385, p<0.001). In stepwise multiple linear regression analysis, plasma Cp along with hsCRP were found predictors for obesity (adjusted β-coefficient=0.266, p<0.01). CONCLUSION Elevated plasma Cp levels were significantly associated with obesity, which may be suggested to be a marker of obesity.
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Puerta A, Díez-Masa JC, Martín-Álvarez PJ, Martín-Ventura JL, Barbas C, Tuñón J, Egido J, de Frutos M. Study of the capillary electrophoresis profile of intact α-1-acid glycoprotein isoforms as a biomarker of atherothrombosis. Analyst 2011; 136:816-22. [DOI: 10.1039/c0an00320d] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Inflammatory markers, lipoprotein components and risk of major cardiovascular events in 65,005 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). Atherosclerosis 2010; 213:299-305. [DOI: 10.1016/j.atherosclerosis.2010.08.049] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 06/28/2010] [Accepted: 08/03/2010] [Indexed: 11/18/2022]
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Comparative analysis of serum proteomes of patients with cardiovascular disease. Clin Biochem 2010; 44:178-84. [PMID: 20934420 DOI: 10.1016/j.clinbiochem.2010.09.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2010] [Revised: 09/27/2010] [Accepted: 09/28/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To monitor increases or decreases in cardiovascular disease (CVD)-related proteins that will be released from the deposits or plaque on the inner wall of blood vessels. DESIGN AND METHODS Protein profiles of sera from healthy subjects and CVD patients were determined via 2-DE. Differentially expressed spots in CVD patients were identified by ESI-Q-TOF MS/MS. Retinol binding protein 4 (RBP4), ceruloplasmin, and hemopexin were confirmed by Western blotting and RBP4 was further verified by ELISA. RESULTS Approximately, 400 spots were detected in each gel via comparisons of the serum proteome. Among these spots, 19 spots were selected and identified by ESI-Q-TOF MS/MS (P<0.05). The expression levels of RBP4 and ceruloplasmin were higher in CVD patients by Western blotting. The level of immunoreactive RBP4 in CVD patients was higher than that in healthy subjects. CONCLUSIONS The three proteins identified in the present study may constitute potential biomarkers for the diagnosis of CVD in patients.
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Nordestgaard BG, Adourian AS, Freiberg JJ, Guo Y, Muntendam P, Falk E. Risk factors for near-term myocardial infarction in apparently healthy men and women. Clin Chem 2010; 56:559-67. [PMID: 20185621 DOI: 10.1373/clinchem.2009.139964] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Limited information is available regarding risk factors for the near-term (4 years) onset of myocardial infarction (MI). We evaluated established cardiovascular risk factors and putative circulating biomarkers as predictors for MI within 4 years of measurement. METHODS We conducted a matched, nested case-control study (252 cases and 499 controls) drawing on 45 735 men and women participating in the Copenhagen City Heart Study and the Copenhagen General Population Study. Established risk factors and 17 putative biomarkers, including inflammation-sensitive plasma proteins (C-reactive protein, fibrinogen, alpha(l)-antitrypsin, complement 3), apolipoproteins (A1, B, E, B/A1 ratio), markers of iron overload (iron, transferrin, transferrin saturation), creatinine, alkaline phosphatase, gamma-glutamyl transpeptidase, and leukocytes (lymphocyte count, neutrophil count, neutrophil/lymphocyte ratio) were assessed. RESULTS Among women and men, only 13% and 50%, respectively, of those with near-term MI were classified as high risk by Framingham risk score at baseline. After adjustment for established risk factors, odds ratios for near-term MI, which compared highest to lowest quintiles, were 2.87(95% CI 1.51-5.48; P = 0.001) for alpha(l)-antitrypsin, 2.84(1.42-5.67; P = 0.003) for C-reactive protein, 1.97(1.09-3.57; P = 0.03) for creatinine, 1.99(1.09-3.65; P = 0.03) for fibrinogen, and 0.37(0.19-0.73; P = 0.004) for iron. The corresponding odds ratio for all biomarkers combined was 7.24 (3.28-16.0; P < 0.001). CONCLUSIONS We identified 5 biomarkers associated with increased near-term risk of MI independently of established risk factors. All putative biomarkers combined explained a 7-fold increase in the odds of near-term MI.
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Affiliation(s)
- Børge G Nordestgaard
- Department of Clinical Biochemistry and The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark.
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Houck PD, Linz WJ. Multivessel myocardial infarction: a window to future treatments of myocardial infarction. HEART ASIA 2010; 2:82-8. [PMID: 27325951 DOI: 10.1136/ha.2009.001545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Philip D Houck
- Division of Cardiology, Department of Medicine, Scott & White Healthcare, Temple, Texas, Texas A&M Health Science Center College of Medicine, College Station, Texas, USA
| | - Walter J Linz
- Department of Pathology, Scott & White Healthcare, Temple, Texas, Texas A&M Health Science Center College of Medicine, College Station, Texas, USA
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Langlois MR, De Buyzere ML, Delanghe JR. Plasma vitamin C for predicting cardiovascular disease: more than a nutritional biomarker. Acta Clin Belg 2009; 64:341-3. [PMID: 19810422 DOI: 10.1179/acb.2009.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M R Langlois
- Department of Clinical Chemistry, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium
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Kim J, Lee S, In K, Kim J, You S, Kang K, Sim J, Lee S, Yoon D, Lee J, Shin C. Increase in serum haptoglobin and apolipoprotein M in patients with obstructive sleep apnoea. J Sleep Res 2009; 18:313-20. [PMID: 19566894 DOI: 10.1111/j.1365-2869.2008.00725.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Obstructive sleep apnoea (OSA) is a common syndrome, which is associated with a number of medical problems that impact morbidity and mortality. Although the precise mechanisms that underlie these associations are not fully understood, previous studies have suggested that patients with OSA show elevations of several biomarkers that are associated with cardiovascular risk. This study was undertaken to identify serum proteins associated with OSA by using a proteomics technique and to examine changes in identified protein levels after continuous positive airway pressure treatment. The study participants consisted of 40 male patients (aged 40-49 years) with severe OSA and 34 male control subjects matched for age and body mass index. All subjects underwent polysomnography. Using a proteomics approach, we identified nine proteins that were differentially expressed in patients with severe OSA and controls. Three of these nine proteins, haptoglobin, paraoxonase-1 and apolipoprotein M, were quantified by using enzyme-linked immunosorbent assays, kinetic assays and by using Western blotting. Multiple regression analysis showed that haptoglobin and apolipoprotein M levels are independently related to apnoea-hypopnoea index (P < 0.01). A further study is required to determine the nature of associations between these identified proteins and OSA in a large population.
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Affiliation(s)
- Jinkwan Kim
- Pulmonary Sleep Disorder Center, Ansan Hospital, Korea University Medical Center, Ansan, Gyeonggi-do 425-707, South Korea
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Chang HH, Chen CS, Lin JY. Dietary perilla oil lowers serum lipids and ovalbumin-specific IgG1, but increases total IgE levels in ovalbumin-challenged mice. Food Chem Toxicol 2009; 47:848-54. [DOI: 10.1016/j.fct.2009.01.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Altamura C, Squitti R, Pasqualetti P, Gaudino C, Palazzo P, Tibuzzi F, Lupoi D, Cortesi M, Rossini PM, Vernieri F. Ceruloplasmin/Transferrin system is related to clinical status in acute stroke. Stroke 2009; 40:1282-8. [PMID: 19228837 DOI: 10.1161/strokeaha.108.536714] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE In acute stroke, Iron (Fe) may amplify reperfusion injury by catalyzing the conversion of superoxide and hydrogen peroxide into highly reactive radicals. Transferrin (Tf) is the main protein regulating Fe homeostasis, whereas Ceruplasmin (CP) is a circulating ferroxidase enzyme able to oxidize ferrous ions to less toxic ferric forms. This study aims at investigating whether CP, Copper (Cu), Tf, and Fe play a role in the pathophysiology of acute stroke. METHODS We enrolled 35 acute stroke patients and 44 controls. All patients underwent: neurological examination assessed by National Institutes of Health Stroke Scale (NIHSS), ultrasound evaluation of carotid atherosclerosis, brain MRI to quantify ischemic lesion volume and measurement of serum levels of CP, Cu, Tf, Fe, hydro-peroxides, and Total plasmatic antioxidant capacity. RESULTS In patients, NIHSS scores were associated with Tf (r=-0.48, P=0.004), hydro-peroxides (r=0.34, P=0.046), CP (r=0.43, P=0.012), and lesion volume (r=0.50, P=0.004). Lesion volume was inversely associated with Tf (r=-0.44, P=0.012). CP and hydro-peroxides were also largely related (r=0.81, P<0.001). The model multiple R was 0.57, resulting in a 32.5% of explained NIHSS variance with Tf accounting for 23.4% and CP for 9.1%. CONCLUSIONS CP and Tf levels are representative of clinical status in acute stroke patients. Our findings suggest a protective role of Tf in acute stroke and a possible ambivalent role of CP.
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Affiliation(s)
- Claudia Altamura
- Neurologia Clinica, Università Campus Bio-Medico di Roma, Roma, Italy.
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79
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Koenig W. Update on integrated biomarkers for assessment of long-term risk of cardiovascular complications in initially healthy subjects and patients with manifest atherosclerosis. Ann Med 2009; 41:332-43. [PMID: 19291518 DOI: 10.1080/07853890902769675] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Risk stratification for cardiovascular diseases (CVD) remains suboptimal even after the introduction of global risk assessment by various scores. This has prompted the search for additional biomarkers which might help to improve risk stratification. Basically, there are blood biomarkers representing various pathophysiological pathways of atherosclerosis, and markers of subclinical disease. Since inflammatory processes accompany all stages of atherosclerosis, measurement of plasma/serum concentrations of circulating inflammatory biomarkers have received great attention. Such biomarkers can be measured systemically by sensitive assays, and elevated concentrations in the circulation have been shown to be associated with future CVD events. Thus, they might add to the predictive value of the atherogenic lipoprotein phenotype to further improve CVD risk assessment. In addition, several non-invasive imaging techniques are available for which also a predictive value for CVD could be established. However, for most of these biomarkers the clinical utility has not yet been firmly established. This review attempts to give an update on the potential use of biomarkers for risk stratification in initially healthy subjects and patients with manifest, chronic atherosclerosis, particularly focusing on the integrated value of the combination of these markers.
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Affiliation(s)
- Wolfgang Koenig
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Albert-Einstein-Allee 23, Ulm, Germany.
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Holme I, Aastveit AH, Hammar N, Jungner I, Walldius G. Haptoglobin and risk of myocardial infarction, stroke, and congestive heart failure in 342,125 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). Ann Med 2009; 41:522-32. [PMID: 19657769 DOI: 10.1080/07853890903089453] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Few studies have analysed the importance of haptoglobin (Hp) as a risk factor for acute myocardial infarction (AMI), stroke, and heart failure (HF) in large healthy populations. AIMS We examined Hp as risk factor for AMI, stroke, and HF in the Apolipoprotein MOrtality RISk (AMORIS) Study and compared its predictive strength with that of total serum cholesterol (TC). METHODS Prospective study (11.8 years) of AMI, stroke, and HF through linkage with Swedish hospital discharge and mortality registers with measurements of Hp in 342,125 subjects. RESULTS Hp is a significant risk factor of AMI, stroke, and HF. Relationships were stronger for men than women with regard to stroke and HF, but not AMI. Hp was almost as predictive as TC for AMI and about equally predictive of stroke with a stronger relationship to ischaemic than haemorrhagic stroke. A 4.2-fold increase in risk of AMI was observed comparing subjects in the joint lower quartiles of TC and Hp to those in the upper. For stroke, the risk increase was 2-fold, and 1.5-fold for HF. INTERPRETATION The inflammation marker Hp carried as much additional predictive information value on AMI and stroke as TC. Hp was also a risk factor of HF.
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Affiliation(s)
- Ingar Holme
- Department of Preventive Cardiology, Centre of Preventive Medicine, Oslo University Hospital, Ulleval, Oslo, Norway.
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Anand AV, Chandrasek M, Kalavathy S, Uma K, Saravanan M, Gani AMS, Kumar KV, Senthil R, Kumar PS. The Influencing Aspects of Atorvastatin on C-Reactive Protein and Lipid Profile in Patients with Stroke. INTERNATIONAL JOURNAL OF BIOLOGICAL CHEMISTRY 2008; 3:30-34. [DOI: 10.3923/ijbc.2009.30.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
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Meng QH, Zhu S, Sohn N, Mycyk T, Shaw SA, Dalshaug G, Krahn J. Release of cardiac biochemical and inflammatory markers in patients on cardiopulmonary bypass undergoing coronary artery bypass grafting. J Card Surg 2008; 23:681-7. [PMID: 18778302 DOI: 10.1111/j.1540-8191.2008.00701.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Determination of cardiac markers can assess cardiac injury induced by cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG). However, the markers and their release pattern are not well defined. This study was aimed at assessing the release and timing of cardiac biochemical and inflammatory markers in patients undergoing elective CABG with CPB. METHODS Forty patients undergoing elective CABG were included in this study. Blood samples were collected for biochemical measurements at the following time points: immediately prior to the induction of anesthesia, one, six, 12, and 24 hours after initiation of CPB. RESULTS Increased release of cardiac troponin I was observed one hour after initiation of CPB (p < 0.05) and reached the maximum at 12 hours after CPB (p < 0.01). Serum CK-MB enzyme activity and CK-MB mass both were highly elevated starting at one hour after initiation of CPB, peaked at six hours, and remained elevated until 24 hours after CPB. Both lactate and lactate dehydrogenase were highly elevated six hours after CPB and peaked at 12 hours after CPB (p < 0.01). Serum levels of interleukin-6 and tumor necrosis factor-alpha increased significantly one hour after initiation of CPB and peaked at six hours (p < 0.01), while serum high sensitivity C-reactive protein levels started to elevate 12 hours after CPB (p < 0.01). CONCLUSION Monitoring of these markers could help to determine implementation of protective interventions during CABG with CPB to prevent myocardial deterioration and to predict the risk and prognosis.
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Affiliation(s)
- Qing H Meng
- Department of Pathology and Laboratory Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. mail:
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83
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Acute phase proteins activation in subjects with coronary atherosclerosis and micro-vessel coronary circulation impairment. J Thromb Thrombolysis 2008; 28:50-6. [DOI: 10.1007/s11239-008-0248-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Accepted: 06/23/2008] [Indexed: 10/21/2022]
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Engström G, Hedblad B, Tydén P, Lindgärde F. Inflammation-sensitive plasma proteins are associated with increased incidence of heart failure: a population-based cohort study. Atherosclerosis 2008; 202:617-22. [PMID: 18599061 DOI: 10.1016/j.atherosclerosis.2008.05.038] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Revised: 05/18/2008] [Accepted: 05/23/2008] [Indexed: 01/27/2023]
Abstract
BACKGROUND Although inflammation has been associated with different cardiovascular diseases, the relationships with future heart failure (HF) are unclear. This population-based study explored whether elevated plasma levels of inflammatory proteins are associated with incidence of HF. METHODS Five inflammation-sensitive plasma proteins (ISPs, fibrinogen, ceruloplasmin, haptoglobin, orosomucoid, and alpha1-antitrypsin) was measured in 6071 men (mean age 46 years) without history of myocardial infarction (MI) or stroke. Incidence of hospitalizations due to HF (primary diagnosis) was monitored over 22 years of follow-up, in relation to the number of elevated ISPs (i.e., in the 4th quartile). Subjects with myocardial infarction during follow-up were censored. RESULTS During the follow-up, 159 men were hospitalized due to HF. Baseline levels of all ISPs, except for haptoglobin, were significantly higher in men who developed HF. After adjustments for confounding factors, the hazard ratios (HR) of HF were 1.00 (reference), 1.7 (95% CI: 1.1-2.7), 2.0 (CI: 1.2-3.3) and 2.6 (CI: 1.6-4.1), respectively, in men with none, one, two and three or more ISPs in the 4th quartile (trend: p<0.001). Of the individual ISPs, fibrinogen, ceruloplasmin and alpha1-antitrypsin showed significant relationships with incidence of HF after adjustment for risk factors. CONCLUSION Plasma levels of inflammatory markers are associated with long-term incidence of hospitalizations due to HF in middle-aged men.
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Affiliation(s)
- Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö University Hospital, Sweden.
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85
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CD36/fatty acid translocase, an inflammatory mediator, is involved in hyperlipidemia-induced exacerbation in ischemic brain injury. J Neurosci 2008; 28:4661-70. [PMID: 18448643 DOI: 10.1523/jneurosci.0982-08.2008] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hyperlipidemia with accompanying increase in peripheral inflammation is a risk factor for stroke. The effect of excess lipids on stroke-induced injury and the mechanism by which lipid-mediated inflammatory responses contribute to stroke are not known. We investigated these uncertainties by subjecting normal and hyperlipidemic mice to transient middle cerebral artery occlusion, followed by measurement of stroke severity and inflammatory response. Infarct size, swelling, and lipid contents were significantly increased in the high-fat fed ApoE knock-out mice, as was the expression of the inflammatory mediators CD36 and monocyte chemoattractant protein 1 (MCP-1) in the brain and periphery. Furthermore, the hyperlipidemic mice exhibited numerous foam cells, a probable cause of increased swelling and postischemic inflammation, in the peri-infarct area. Genetic deletion of cd36 in the hyperlipidemic condition reduced proinflammatory chemokine/receptor and cytokines (MCP-1, CC chemokine receptor 2, and interleukins 1beta and 6), in the brain 6 h after ischemia. The reduced proinflammatory response also resulted in smaller ischemic injury, less swelling, and fewer foam cells at 3 d after ischemia. The results show that hyperlipidemia-induced inflammation is a negative factor for stroke outcomes and indicate that downregulating CD36 may be an effective therapeutic strategy for reducing the impact of stroke in hyperlipidemic subjects.
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86
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Sherva R, Miller MB, Pankow JS, Hunt SC, Boerwinkle E, Mosley TH, Weder AB, Curb JD, Luke A, Morrison AC, Fornage M, Arnett DK. A whole-genome scan for stroke or myocardial infarction in family blood pressure program families. Stroke 2008; 39:1115-20. [PMID: 18323513 DOI: 10.1161/strokeaha.107.490433] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Atherothrombotic diseases, including stroke and myocardial infarction, share a common pathogenesis. Chromosomal regions have been linked to atherothrombotic diseases in family studies, and association studies have identified candidate gene polymorphisms that affect the risk of stroke and/or myocardial infarction. Using data from the Family Blood Pressure Program, we tested for chromosomal regions linked to the composite phenotype of stroke or myocardial infarction in a large set of hypertensive families. METHODS Nonparametric linkage analysis was implemented in MERLIN, which tests for excess allele-sharing among affected siblings. Empirical distributions based on gene dropping simulations were constructed for each test statistic, and the -log(10) of the associated probability values were compared. RESULTS Analyses were based on 9607 individuals in 226 black, 395 Hispanic, and 207 white families; 106 families had multiple affected individuals. Several regions showed linkage to stroke or myocardial infarction, most significantly in Hispanics on chromosomes 2p21 (-log(10) P=3.0) and 7q21.1 (-log(10) P=2.8), 9q32 in blacks and Hispanics (-log(10) P=3.0), 11p13 in blacks (-log(10) P=2.1), and 12q24.33 in whites (-log(10) P=3.0). CONCLUSIONS There is statistically significant evidence for loci affecting stroke or myocardial infarction on chromosomes 2, 9, and 12.
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Affiliation(s)
- Richard Sherva
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA
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87
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Abstract
Coronary Artery Disease is the major cause of mortality and morbidity worldwide. Traditional risk factors account for only half of the morbidity and mortality from coronary artery disease. There is substantial evidence that oxidative stress plays the major role in the atherosclerotic process. The present study was undertaken to evaluate the level of lipid peroxidation (by measuring malondialdehyde) and antioxidant enzymes (ceruloplasmin, glutathione, superoxide dismutase) in coronary artery disease. Serum malondialdehyde levels and serum ceruloplasmin levels were significantly raised in all the subgroups of study group as compared to control group (p<0.001). Whole blood glutathione levels and hemolysate superoxide dismutase activity was significantly decreased in all the subgroups of study group as compared to control group (p<0.001). Above results suggests that the patients of coronary artery disease show increased oxidative stress and decreased levels of antioxidant enzymes. So it is recommended that the management protocol for coronary artery disease patients should include antioxidant supplementation along with simultaneous lowering of lipid peroxidation.
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88
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Reiss AB, Wirkowski E. Role of HMG-CoA reductase inhibitors in neurological disorders : progress to date. Drugs 2008; 67:2111-20. [PMID: 17927279 DOI: 10.2165/00003495-200767150-00001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Inhibitors of HMG-CoA reductase (statins) are cholesterol-lowering agents that dramatically reduce morbidity and mortality in patients with established cardiovascular disease. In addition, they exhibit pleiotropic effects that operate independently of lipid modification. Statin administration results in greater nitric oxide bioavailability, improved endothelial function, enhanced cerebral blood flow, immune modulation with anti-inflammatory action, decreased platelet aggregation and antioxidant activity. Some or all of these effects may improve outcome or ameliorate symptoms in neurological disorders. This article examines the potential role of statins in treating stroke, Alzheimer's disease, multiple sclerosis and Parkinson's disease. Studies are ongoing in this controversial area, but there are no firm conclusions. The appropriateness of initiating statin therapy for neurological disorders is not established at this time. The exception is stroke, in which recurrence is significantly reduced by statin therapy.
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Affiliation(s)
- Allison B Reiss
- SUNY Stony Brook School of Medicine, Vascular Biology Institute, Winthrop-University Hospital, Mineola, NY 11501, USA.
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89
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Brunetti ND, Pellegrino PL, Correale M, De Gennaro L, Cuculo A, Di Biase M. Acute phase proteins and systolic dysfunction in subjects with acute myocardial infarction. J Thromb Thrombolysis 2007; 26:196-202. [PMID: 18038115 DOI: 10.1007/s11239-007-0088-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 08/06/2007] [Indexed: 08/30/2023]
Abstract
AIM To investigate correlations between plasmatic concentrations of acute phase proteins (APPs) and left ventricular systolic function during the early phase of acute myocardial infarction. METHODS Plasmatic concentrations of alpha-1-anti-trypsin (A1AT), alpha 1 glyco-protein (A1GP), haptoglobin (HG), caeruloplasmin (CP) and C-reactive protein (CRP) were evaluated in 123 patients with ST elevation acute myocardial infarction (STEMI) within 12 h after onset of chest pain. Systolic function was assessed with bi-dimensional echography and incidence of in-hospital adverse events was compared to APPs levels. RESULTS A1AT, A1GP, HG and CP showed a statistically significant correlation with admission CRP concentrations (P < 0.001). Left ventricular ejection fraction inversely correlated with plasmatic concentrations of A1GP, A1AT, CP and HG. Incidence of acute heart failure correlated with values of APPs and, in a stepwise analysis, CP values were the most significant markers of acute heart failure. CONCLUSIONS Systolic dysfunction in STEMI patients seems to be associated with an inflammatory response featured by a rise in plasmatic concentration of APPs; increase in APPs concentrations seems to own a short-term prognostic relevance.
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90
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Youssef MYZ, Mojiminiyi OA, Abdella NA. Plasma concentrations of C-reactive protein and total homocysteine in relation to the severity and risk factors for cerebrovascular disease. Transl Res 2007; 150:158-63. [PMID: 17761368 DOI: 10.1016/j.trsl.2007.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Revised: 02/11/2007] [Accepted: 02/14/2007] [Indexed: 11/26/2022]
Abstract
Higher C-reactive protein (CRP) and plasma homocysteine (tHcy) concentrations have been shown to indicate increased risk of coronary heart disease and cerebrovascular disease (CVD), but the mechanisms by which they increase the risk of atherothrombotic disease are under investigation. This study evaluates the associations of high-sensitivity C-reactive protein (hs-CRP) and tHcy with the risk factors, severity, and outcome on discharge in patients with CVD. hs-CRP, fasting tHcy, and lipid profile were determined in 50 patients with CVD and 20 healthy control subjects. Clinical data, National Institutes of Health stroke scale (NIHSS) on admission and disability Rankin scale on discharge, were recorded. Based on epidemiologic studies, cutoff points of 1.5 mg/L (hs-CRP) and 15mumol/L (tHcy) were used to indicate increased risk. Univariate and multivariate logistic regression analyses were used to relate tHcy with other CVD risk factors, NIHSS on admission and the disability Rankin scale on discharge. Overall, 38% of patients had increased hs-CRP and 26% had elevated tHcy. hs-CRP (P = 0.005) and tHcy (P < 0.0001) concentrations were significantly higher in patients compared with controls, and these differences remained significant after correction for age and sex. tHcy showed significant correlations with hs-CRP (rs = 0.35; P = 0.003) and low-density lipoprotein-cholesterol (LDL-C; rs = 0.49; P = 0.005). Logistic regression analysis with CVD as the dependent variable showed significant association with hs-CRP (P = 0.01) and tHcy (P < 0.0001) after adjustment for potential confounders. hs-CRP showed increased trend with disease severity and significant association with the disability Rankin scale (P = 0.033). These data support 4 main conclusions: (1) Elevation of hs-CRP and tHcy are common in CVD; (2) the significant relationship between tHcy and hs-CRP suggests that the association of tHcy with CVD risk may be dependent on inflammation-related mechanisms; (3) increased hs-CRP and tHcy show that patients with CVD may be at greater risk of subsequent coronary heart disease; and (4) admission hs-CRP could be used as an indicator of prognosis.
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Affiliation(s)
- Maged Y Z Youssef
- Ministry of Health, Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait
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91
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Kobusiak-Prokopowicz M, Orzeszko J, Mazur G, Mysiak A, Orda A, Poreba R, Mazurek W. Chemokines and left ventricular function in patients with acute myocardial infarction. Eur J Intern Med 2007; 18:288-94. [PMID: 17574102 DOI: 10.1016/j.ejim.2007.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2005] [Revised: 11/10/2006] [Accepted: 02/09/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Leukocytes are activated in the inflammatory process involving locally atherosclerotic lesions through adhesive molecules attaching to the surface of endothelial cells, especially during acute myocardial infarction. The aim of the study was to assess MCP-1, MIP-1alpha, and RANTES serum levels in patients with STEMI and to correlate them with the severity of left ventricle (LV) dysfunction. METHODS Forty patients were initially divided into two groups, with group 1 having an ejection fraction (EF) above 40% and group 2 an EF of 40% or less. Next, the patients were divided on the basis of wall motion score index (WMSI): group 3 had a WMSI of 1.3 or lower and group 4 had a WMSI above 1.3. A control group of ten volunteers was also included in the study. Serum samples were taken at admission as well as 3, 24, 48, 72 h, and 7 days after. RESULTS The baseline serum levels of MCP-1 and RANTES in group 1 were significantly higher than in the controls (p<0.05 and p<0.005, respectively). The highest concentrations of chemokines were observed 3 h after admission. The serum levels of MIP-1alpha on admission and 3 h later were significantly higher in group 1 than in group 2 (p<0.03 and p<0.01, respectively). Maximum MIP-1 concentrations were observed 3 h after admission in group 3 and 24 h after admission in group 4 (p<0.006). In group 1, MIP-1alpha 3 h after admission correlated positively with the EF (r=0.444, p<0.05). In group 1 there was a negative correlation between MIP-1alpha concentration 3 h after admission and LV end-diastolic dimension (r=-0.492, p<0.02). CONCLUSIONS Patients with myocardial infarction with an elevated ST segment had a significant increase in MCP-1, MIP-1alpha, and RANTES serum levels.
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Abstract
PURPOSE OF REVIEW Inflammation is implicated in ischaemic stroke as a general cardiovascular risk factor, a possible immediate trigger, a component (and possible exacerbating factor) of the response to tissue injury, a marker of future risk, and as a therapeutic target. Each aspect is reviewed. RECENT FINDINGS Evidence of epidemiological association of inflammatory markers, particularly C-reactive protein, has accrued, but the independence of inflammation from more conventional risk indicators is under question. Other inflammatory markers are associated with intermediate phenotypes such as hypertension. Tissue inflammation in atherosclerotic plaque is of probable relevance in identifying recently symptomatic carotid disease. Both humoral and cellular inflammation are evident following stroke, with evidence that these responses may exacerbate tissue injury. Blockade of interleukin-1, or of neutrophil chemotaxis, has reduced infarct volume in models of stroke but has yet to show benefit in clinical trials. Other anti-inflammatory strategies are promising. SUMMARY Inflammation is implicated in several aspects of acute ischaemic stroke. It remains to be established whether the inflammatory response is a truly independent risk factor in general, or whether specific anti-inflammatory interventions are beneficial either in prevention or acute treatment.
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Affiliation(s)
- Keith W Muir
- Division of Medicine and Neurosciences, University of Manchester, Hope Hospital, Salford, UK.
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93
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Nowik M, Nowacki P, Grabarek J, Drechsler H, Białecka M, Widecka K, Stankiewicz J, Safranow K. Can We Talk about CD4+CD28– Lymphocytes as a Risk Factor for Ischemic Stroke? Eur Neurol 2007; 58:26-33. [PMID: 17483582 DOI: 10.1159/000102163] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Accepted: 12/06/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND CD4+CD28- lymphocytes are implicated in the destabilization of atheromatous plaque, leading to acute coronary episodes. One may ask whether these cells play a similar role in ischemic stroke pathogenesis with an atherosclerotic background. METHODS Flow cytometry was applied to determine the percentage of CD4+CD28- lymphocytes in the peripheral blood of patients during the acute phase of their first ischemic stroke (group I) and in patients without a history of stroke but with two of the most important risk factors (hypertension, diabetes) for atherosclerosis-related ischemic stroke (group II). The results were compared with healthy controls. RESULTS The median percentages of CD4+CD28- lymphocytes in groups I and II did not differ significantly, but for each of these groups the percentage was higher than in the control group. The time of blood sampling from onset of stroke, presence of the ischemic focus in the CT brain scan and severity of neurological deficits did not correlate with the percentage of CD4+CD28- lymphocytes. CONCLUSIONS We conclude that CD4+CD28- lymphocytes are implicated in mechanisms enhancing the risk of acute ischemic stroke and not a consequence of stroke.
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Affiliation(s)
- M Nowik
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland.
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94
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Brunetti ND, Correale M, Pellegrino PL, Cuculo A, Biase MD. Acute phase proteins in patients with acute coronary syndrome: Correlations with diagnosis, clinical features, and angiographic findings. Eur J Intern Med 2007; 18:109-17. [PMID: 17338962 DOI: 10.1016/j.ejim.2006.07.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Revised: 05/18/2006] [Accepted: 07/06/2006] [Indexed: 11/17/2022]
Abstract
BACKGROUND C-reactive protein (CRP) plasma levels increase in patients with acute coronary syndrome (ACS). The role and implications of increased plasma concentrations of other acute phase proteins (APPs), such as alpha-1-antitrypsin (A1AT), alpha-1 glycoprotein (A1GP), haptoglobin (HG), ceruloplasmin (CP), and C3c and C4 complement fraction, in patients with ACS are still not completely defined. METHODS A total of 218 consecutive patients with ACS were included in the study, 185 with acute myocardial infarction (AMI) and 33 with unstable angina (UA). In all patients, A1AT, A1GP, HG, CP, C3c and C4 complement fraction, and CRP were evaluated within 12 h after the onset of symptoms. Sixty-two patients with AMI underwent coronary angiography. RESULTS APPs showed a significant correlation with CRP concentrations. Patients with AMI had higher concentrations of A1AT and HG than UA patients. Cholesterol levels were correlated with APPs in patients with AMI. Patients with three coronary vessel disease or LAD disease had significantly higher C3c concentrations. Coronary collateral flow was associated with higher A1GP and CP concentrations, and total coronary occlusion with A1AT and CP. CONCLUSIONS APPs were correlated with CRP concentrations in subjects with ACS. The increase in APPs in patients with ACS seems to be linked to the entity of myocardial damage and coronary atherosclerotic burden.
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95
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Engström G, Hedblad B, Janzon L, Lindgärde F. Long-Term Change in Cholesterol in Relation to Inflammation-Sensitive Plasma Proteins: A Longitudinal Study. Ann Epidemiol 2007; 17:57-63. [PMID: 17178329 DOI: 10.1016/j.annepidem.2006.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 03/02/2006] [Accepted: 03/06/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE The nature of the relationship between inflammation and elevated serum lipid levels is incompletely understood. This longitudinal study explores whether elevated levels of inflammation-sensitive plasma proteins (ISPs) are a risk factor for developing increased cholesterol and triglyceride levels. METHODS Five ISPs (fibrinogen, orosomucoid, alpha1-antitrypsin, haptoglobin, and ceruloplasmin) were measured in a population-based cohort of nondiabetic healthy men aged 38 to 50 years at baseline. Subjects were reexamined after a mean of 6.2 years. The development of hypercholesterolemia (cholesterol>or=6.5 mmol/L [>or=251 mg/dL]) and hypertriglyceridemia (triglycerides>or=2.3 mmol/L [>or=204 mg/dL]) during follow-up was studied in relation to the number of elevated levels of ISPs (i.e., in the top quartile). RESULTS Of men with initially normal cholesterol levels (<6.5 mmol/L; n=2224), proportions of men with no, one, two, and three or more elevated ISP levels at baseline who developed hypercholesterolemia were 12%, 13%, 16%, and 20%, respectively (p for trend=0.0002). This relationship remained significant after adjustments for cholesterol level at baseline and other confounding factors. The relationship between ISP levels and future hypertriglyceridemia was attenuated and nonsignificant after adjustments for confounding factors. CONCLUSION In apparently healthy men with initially normal cholesterol levels, elevated ISP levels are a risk factor for development of hypercholesterolemia.
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Affiliation(s)
- Gunnar Engström
- Department of Clinical Science, Section for Epidemiology, Lund University, Malmö University Hospital, Sweden.
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96
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Engström G, Hedblad B, Berglund G, Janzon L, Lindgärde F. Plasma levels of complement C3 is associated with development of hypertension: a longitudinal cohort study. J Hum Hypertens 2006; 21:276-82. [PMID: 17167524 DOI: 10.1038/sj.jhh.1002129] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hypertension has been associated with raised plasma levels of complement factor 3 and 4 (C3 and C4). The nature of this association is unclear. This population-based longitudinal study explored whether C3 or C4 is associated with development of hypertension. Blood pressure and plasma levels of C3 and C4 were determined in 2178 healthy men, aged 35-50 years, initially without treatment for hypertension. Incidence of hypertension and blood pressure increase over 15.7 (+/-2.2) years follow-up was studied in relation to C3 and C4 at baseline. Among men with initially normal blood pressure (<160/95 mm Hg), incidence of hypertension (>or=160/95 mm Hg or treatment) was 32, 42, 37 and 47%, respectively, for men with C3 in the first, second, third and fourth quartile (trend: P=0.001). This relationship remained significant after adjustment for confounding factors. Among men without blood pressure treatment, systolic BP increase (mean+standard error, adjusted for age, initial blood pressure and follow-up time) was 17.5+0.8, 19.6+0.9, 19.8+0.8 and 20.8+0.8 mm Hg, respectively, in the C3 quartiles (trend: P=0.004). C3 was not associated diastolic blood pressure at follow-up. Although C4 was associated with blood pressure at the baseline examination, there was no relationship between C4 and development of hypertension or future blood pressure increase. It is concluded that C3 in plasma is associated with future blood pressure increase and development of hypertension.
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Affiliation(s)
- G Engström
- Department of Clinical Science, Malmö University Hospital, Lund University, Malmö, Sweden.
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97
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Engström G, Hedblad B, Janzon L. Reduced lung function predicts increased fatality in future cardiac events. A population-based study. J Intern Med 2006; 260:560-7. [PMID: 17116007 DOI: 10.1111/j.1365-2796.2006.01718.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Moderately reduced lung function in apparently healthy subjects has been associated with incidence of coronary events. However, whether lung function is related to the fatality of the future events is unknown. This study explored whether reduced forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) in initially healthy men is related to the fatality of the future coronary events. DESIGN Prospective cohort study. SETTING Population-based study from Malmö, Sweden. SUBJECTS A total of 5452 healthy men, 28-61 years of age. MAIN OUTCOME MEASURES Incidence of first coronary events was monitored over a mean follow-up of 19 years. The fatality of the future events was studied in relation to FEV and FVC. RESULTS A total of 589 men suffered a coronary event during follow-up, 165 of them were fatal during the first day. After risk factors adjustment, low FEV or FVC were associated with incidence of coronary events (fatal or nonfatal) and this relationship was most pronounced for the fatal events. Amongst men who subsequently had a coronary event, the case-fatality rates were higher in men with low FEV or FVC. Adjusted for risk factors, the odds ratio for death during the first day was 1.00 (reference), 1.63 (95% CI: 0.9-3.1), 1.86 (1.0-3.5) and 2.06 (1.1-3.9), respectively, for men with FVC in the 4th, 3rd, 2nd, and lowest quartiles (trend: P < 0.05). FEV showed similar relationships with the fatality rates. CONCLUSION Apparently healthy men with moderately reduced lung function have higher fatality in future coronary events, with a higher proportion of coronary heart disease deaths and less nonfatal myocardial infarction.
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Affiliation(s)
- G Engström
- Department of Clinical Sciences, Malmö University Hospital, Lund University, Malmö, Sweden.
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98
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Coimbra S, Santos-Silva A, Rocha-Pereira P, Rocha S, Castro E. Green tea consumption improves plasma lipid profiles in adults. Nutr Res 2006. [DOI: 10.1016/j.nutres.2006.09.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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99
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Boncoraglio GB, Bodini A, Brambilla C, Carriero MR, Ciusani E, Parati EA. An Effect of the PAI-1 4G/5G Polymorphism on Cholesterol Levels May Explain Conflicting Associations with Myocardial Infarction and Stroke. Cerebrovasc Dis 2006; 22:191-5. [PMID: 16735791 DOI: 10.1159/000093604] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2005] [Accepted: 02/21/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE The gene-encoding plasminogen activator inhibitor type 1 (PAI-1) has a common 4G/5G 'functional' polymorphism, and people homozygous for the 4G allele have higher PAI-1 plasma concentrations. The 4G/4G genotype is associated with increased risk of myocardial infarction but paradoxically protects against stroke. We hypothesized that this paradox may be explained via an effect of the PAI-1 polymorphism on plasma lipids. METHODS We studied 71 consecutive Italian patients referred to our Institute for first stroke or vascular cognitive impairment. PAI-1 gene 4G/5G polymorphism, total plasma cholesterol, plasma triglycerides, sex, age, smoking, oral contraceptive use, statin therapy, hypertension, diabetes, and history of myocardial infarction were examined. RESULTS The 4G/4G genotype was significantly associated with high cholesterol (p = 0.003) but not with triglycerides (p = 0.39). Adjusted odds ratios were: 5.8 for 4G/4G vs. 4G/5G (95% CI, 3.1-23.0), and 15.9 for 4G/4G vs. 5G/5G (95% CI, 2.4-105.0). CONCLUSIONS This finding may explain the involvement of the PAI-1 polymorphism in the clustering of atherothrombotic risk factors, and why people with the 4G/4G genotype are at increased risk for myocardial infarction. Stroke is not so clearly related to hypercholesterolemia and other effects of the 4G/4G genotype (perhaps increased PAI-1 expression) may protect against stroke.
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Affiliation(s)
- Giorgio B Boncoraglio
- Cerebrovascular Diseases Unit, Istituto Nazionale Neurologico Carlo Besta, Milano, Italy
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100
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Al-Shawwa B, Al-Huniti N, Titus G, Abu-Hasan M. Hypercholesterolemia is a potential risk factor for asthma. J Asthma 2006; 43:231-3. [PMID: 16754527 DOI: 10.1080/02770900600567056] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The effect of hyperlipidemia on asthma has never been addressed. Recent literature implicates a pro-inflammatory role for hypercholesterolemia. This study evaluates the effect of serum cholesterol level on asthma frequency. METHODS Factors associated with asthma risk were examined in a retrospective study design. Study subjects were between the 4 and 20 years of age who presented to a rural pediatric clinic and whose total serum cholesterol level was obtained. Diagnosis of asthma was determined by the treating physician. Multivariable logistic regression was performed to identify variables that were related to the odds of having asthma. RESULTS A total of 188 patients were included. Asthma was present in 50 patients. Total serum cholesterol (mean +/- SD) for the asthma group was 176.7 +/- 39.8 compared to 162.9 +/- 12.8 in the non-asthma group (P = 0.028). A total of 21 of the 50 (42%) asthma patients were obese compared to 31 of the 138 (22%) non-asthma patients (p = 0.014). There was no difference between both groups regarding age and gender. Hypercholesterolemia and obesity were identified by logistic regression analysis to increase the probability of asthma independently. CONCLUSION Hypercholesterolemia is a potential risk factor for asthma independent of obesity.
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