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Vasantharekha R, Priyanka HP, Swarnalingam T, Srinivasan AV, ThyagaRajan S. Interrelationship between Mini-Mental State Examination scores and biochemical parameters in patients with mild cognitive impairment and Alzheimer's disease. Geriatr Gerontol Int 2016; 17:1737-1745. [PMID: 27921357 DOI: 10.1111/ggi.12957] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 07/30/2016] [Accepted: 09/20/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to provide first-hand information about the prevalence of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in Tamil Nadu, a southern state in India, and examine if there exists a relationship between cognitive functions and biochemical parameters in these patients. METHODS Surveys were collected from adults, older men and women (n = 3126) from different regions of Tamil Nadu, which were followed up after 12 months for 1337 participants. Mini-Mental State Examination (MMSE) scores, lipid profile, and liver function tests were carried out in the elderly, MCI and AD patients. Based on the MMSE scores, the elderly population was classified into old control (28.97 ± 1.49; n = 1868), MCI (19.58 ± 1.17; n = 734) and AD (7.18 ± 1.38; n = 304) groups. Peripheral blood samples were collected after overnight fast from both male and female volunteers (n = 40 per group) who were categorized as young adult control, old control, MCI and AD. RESULTS AD patients showed lower MMSE scores compared with the young adults, old and MCI groups, and MMSE further decreased at follow-up examination a year later. In the serum of AD patients, high-density lipoprotein, alkaline phosphatase activity and bilirubin levels were lower, whereas low-density lipoprotein, total cholesterol and triglycerides levels were higher. MMSE was positively correlated with high-density lipoprotein, and negatively correlated with other lipid parameters in AD. CONCLUSIONS Hypercholesterolemia is a risk factor for AD that might result in neurotoxicity and cognitive impairment. Dysfunction of lipoprotein and heme metabolism might also provide additional targets for AD diagnosis. Geriatr Gerontol Int 2017; 17: 1737-1745.
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Affiliation(s)
- Ramasamy Vasantharekha
- Integrative Medicine Laboratory, Department of Biotechnology, SRM University, Kattankulathur, Tamil Nadu, India
| | - Hannah P Priyanka
- Integrative Medicine Laboratory, Department of Biotechnology, SRM University, Kattankulathur, Tamil Nadu, India
| | - Thangavel Swarnalingam
- Department of Anesthesiology, Tagore Medical College Hospital and Research Center, Tamil Nadu, India
| | | | - Srinivasan ThyagaRajan
- Integrative Medicine Laboratory, Department of Biotechnology, SRM University, Kattankulathur, Tamil Nadu, India
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Kullmann S, Heni M, Hallschmid M, Fritsche A, Preissl H, Häring HU. Brain Insulin Resistance at the Crossroads of Metabolic and Cognitive Disorders in Humans. Physiol Rev 2016; 96:1169-209. [PMID: 27489306 DOI: 10.1152/physrev.00032.2015] [Citation(s) in RCA: 352] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ever since the brain was identified as an insulin-sensitive organ, evidence has rapidly accumulated that insulin action in the brain produces multiple behavioral and metabolic effects, influencing eating behavior, peripheral metabolism, and cognition. Disturbances in brain insulin action can be observed in obesity and type 2 diabetes (T2D), as well as in aging and dementia. Decreases in insulin sensitivity of central nervous pathways, i.e., brain insulin resistance, may therefore constitute a joint pathological feature of metabolic and cognitive dysfunctions. Modern neuroimaging methods have provided new means of probing brain insulin action, revealing the influence of insulin on both global and regional brain function. In this review, we highlight recent findings on brain insulin action in humans and its impact on metabolism and cognition. Furthermore, we elaborate on the most prominent factors associated with brain insulin resistance, i.e., obesity, T2D, genes, maternal metabolism, normal aging, inflammation, and dementia, and on their roles regarding causes and consequences of brain insulin resistance. We also describe the beneficial effects of enhanced brain insulin signaling on human eating behavior and cognition and discuss potential applications in the treatment of metabolic and cognitive disorders.
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Affiliation(s)
- Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Manfred Hallschmid
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
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Abstract
BACKGROUND Research shows that lipid levels may be associated with cognitive function, particularly among women. We aimed to examine total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein (HDL), and HDL/LDL ratio in relation to cognitive performance, measured with six well-established cognitive domains and a composite cognitive score (CCS). METHODS In this cross-sectional study, biomarkers and neuropsychological assessment were available for 141 adults with MMSE scores ≥ 24 (mean age = 69 years, 47% female, mean education = 14.4 years) attending a neuropsychological evaluation. Ordinary least squares regressions were adjusted for age, gender, education, and depressive symptoms in Model 1 and also for apolipoprotein E4 (APOE4) status in Model 2. RESULTS High-density lipoprotein cholesterol (HDL-C) was associated with better CCS (β = 0.24; p = 0.014). This association was significant among women (β = 0.30; p = 0.026) and not among men (β = 0.20; p = 0.124). HDL-C was also related to attention/working memory (β = 0.24; p = 0.021), again only among women (β = 0.37; p = 0.012) and not men (β = 0.15; p = 0.271). Adjusting for APOE4 yielded significance for high HDL-C and CCS (β = 0.24; p = 0.022). CONCLUSIONS HDL-C was the main lipoprotein affecting cognitive function, with results somewhat more pronounced among women. Research should investigate the possibility of finding ways to boost HDL-C levels to potentially promote cognitive function.
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Kullmann S, Callaghan MF, Heni M, Weiskopf N, Scheffler K, Häring HU, Fritsche A, Veit R, Preissl H. Specific white matter tissue microstructure changes associated with obesity. Neuroimage 2015; 125:36-44. [PMID: 26458514 PMCID: PMC4692452 DOI: 10.1016/j.neuroimage.2015.10.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/01/2015] [Accepted: 10/04/2015] [Indexed: 12/14/2022] Open
Abstract
Obesity-related structural brain alterations point to a consistent reduction in gray matter with increasing body mass index (BMI) but changes in white matter have proven to be more complex and less conclusive. Hence, more recently diffusion tensor imaging (DTI) has been employed to investigate microstructural changes in white matter structure. Altogether, these studies have mostly shown a loss of white matter integrity with obesity-related factors in several brain regions. However, the variety of these obesity-related factors, including inflammation and dyslipidemia, resulted in competing influences on the DTI indices. To increase the specificity of DTI results, we explored specific brain tissue properties by combining DTI with quantitative multi-parameter mapping in lean, overweight and obese young adults. By means of multi-parameter mapping, white matter structures showed differences in MRI parameters consistent with reduced myelin, increased water and altered iron content with increasing BMI in the superior longitudinal fasciculus, anterior thalamic radiation, internal capsule and corpus callosum. BMI-related changes in DTI parameters revealed mainly alterations in mean and axial diffusivity with increasing BMI in the corticospinal tract, anterior thalamic radiation and superior longitudinal fasciculus. These alterations, including mainly fiber tracts linking limbic structures with prefrontal regions, could potentially promote accelerated aging in obese individuals leading to an increased risk for cognitive decline. We combined DTI with quantitative multi-parametric mapping (qMPM). Obesity was associated with a reduction in myelin displayed by decreased R1. Obesity was associated with increased water content (decreased R1 and increased PD*). DTI revealed mainly alterations in mean and axial diffusivity with obesity.
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Affiliation(s)
- Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany.
| | - Martina F Callaghan
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, WC1N 3BG London, UK
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Germany
| | - Nikolaus Weiskopf
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, WC1N 3BG London, UK; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Klaus Scheffler
- Department of Biomedical Magnetic Resonance, University of Tübingen, Germany; Department of High-Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Germany
| | - Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Germany; Department Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
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Srinivasa RN, Rossetti HC, Gupta MK, Rosenberg RN, Weiner MF, Peshock RM, McColl RW, Hynan LS, Lucarelli RT, King KS. Cardiovascular Risk Factors Associated with Smaller Brain Volumes in Regions Identified as Early Predictors of Cognitive Decline. Radiology 2015. [PMID: 26218598 DOI: 10.1148/radiol.2015142488] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To determine in a large multiethnic cohort the cardiovascular and genetic risk factors associated with smaller volume in the hippocampus, precuneus, and posterior cingulate, and their association with preclinical deficits in cognitive performance in patients younger and older than 50 years. MATERIALS AND METHODS The institutional review board approved the study and all participants provided written informed consent. Eligible for this study were 1629 participants (700 men and 929 women; mean age, 50.0 years ± 10.2 [standard deviation]) drawn from the population-based Dallas Heart Study who underwent laboratory and clinical analysis in an initial baseline visit and approximately 7 years later underwent brain magnetic resonance imaging with automated volumetry and cognitive assessment with the Montreal Cognitive Assessment (MoCA). Regression analysis showed associations between risk factors and segmental volumes, and associations between these volumes with cognitive performance in participants younger and older than 50 years. RESULTS Lower hippocampal volume was associated with previous alcohol consumption (standardized estimate, -0.04; P = .039) and smoking (standardized estimate, -0.04; P = .048). Several risk factors correlated with lower total brain, posterior cingulate, and precuneus volumes. Higher total (standardized estimate, 0.06; P = .050), high-density lipoprotein (standardized estimate, 0.07; P = .003), and low-density lipoprotein (standardized estimate, 0.04; P = .037) cholesterol levels were associated with larger posterior cingulate volume, and higher triglyceride levels (standardized estimate, 0.06; P = .004) were associated with larger precuneus volume. Total MoCA score was associated with posterior cingulate volume (standardized estimate, 0.13; P = .001) in younger individuals and with hippocampal (standardized estimate, 0.06; P < .05) and precuneus (standardized estimate, 0.08; P < .023) volumes in older adults. CONCLUSION Smaller volumes in specific brain regions considered to be early markers of dementia risk were associated with specific cardiovascular disease risk factors and cognitive deficits in a predominantly midlife multiethnic population-based sample. Additionally, the risk factors most associated with these brain volumes differed in participants younger and older than 50 years, as did the association between brain volume and MoCA score.
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Affiliation(s)
- Rajiv N Srinivasa
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Heidi C Rossetti
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Mohit K Gupta
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Roger N Rosenberg
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Myron F Weiner
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Ronald M Peshock
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Roderick W McColl
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Linda S Hynan
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Richard T Lucarelli
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Kevin S King
- From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390
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Dias IHK, Polidori MC, Li L, Weber D, Stahl W, Nelles G, Grune T, Griffiths HR. Plasma levels of HDL and carotenoids are lower in dementia patients with vascular comorbidities. J Alzheimers Dis 2015; 40:399-408. [PMID: 24448787 DOI: 10.3233/jad-131964] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Elevated serum cholesterol concentrations in mid-life increase risk for Alzheimer's disease (AD) in later life. However, lower concentrations of cholesterol-carrying high density lipoprotein (HDL) and its principal apolipoprotein A1 (ApoA1) correlate with increased risk for AD. As HDL transports oxocarotenoids, which are scavengers of peroxynitrite, we have investigated the hypothesis that lower HDL and oxocarotenoid concentrations during AD may render HDL susceptible to nitration and oxidation and in turn reduce the efficiency of reverse cholesterol transport (RCT) from lipid-laden cells. Fasting blood samples were obtained from subjects with (1) AD without cardiovascular comorbidities and risk factors (AD); (2) AD with cardiovascular comorbidities and risk factors (AD Plus); (3) normal cognitive function; for carotenoid determination by HPLC, analysis of HDL nitration and oxidation by ELISA, and 3H-cholesterol export to isolated HDL. HDL concentration in the plasma from AD Plus patients was significantly lower compared to AD or control subject HDL levels. Similarly, lutein, lycopene, and zeaxanthin concentrations were significantly lower in AD Plus patients compared to those in control subjects or AD patients, and oxocarotenoid concentrations correlated with Mini-Mental State Examination scores. At equivalent concentrations of ApoA1, HDL isolated from all subjects irrespective of diagnosis was equally effective at mediating RCT. HDL concentration is lower in AD Plus patients' plasma and thus capacity for RCT is compromised. In contrast, HDL from patients with AD-only was not different in concentration, modifications, or function from HDL of healthy age-matched donors. The relative importance of elevating HDL alone compared with elevating carotenoids alone or elevating both to reduce risk for dementia should be investigated in patients with early signs of dementia.
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Affiliation(s)
- Irundika H K Dias
- Life and Health Sciences and Aston Research Centre for Healthy Ageing, Aston University, Birmingham, UK
| | - Maria Cristina Polidori
- Institute of Biochemistry and Molecular Biology I, Heinrich-Heine-University, Duesseldorf, Germany Institute of Geriatrics, University of Cologne, Köln, Germany
| | - Li Li
- Life and Health Sciences and Aston Research Centre for Healthy Ageing, Aston University, Birmingham, UK
| | | | - Wilhelm Stahl
- Institute of Biochemistry and Molecular Biology I, Heinrich-Heine-University, Duesseldorf, Germany
| | - Gereon Nelles
- NeuroMed, MedCampus Hohenlind Cologne, Köln, Germany
| | | | - Helen R Griffiths
- Life and Health Sciences and Aston Research Centre for Healthy Ageing, Aston University, Birmingham, UK
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Abstract
Few studies have examined associations between different subcategories of cholesterol and cognitive function. We examined relationships between total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglyceride levels and cognitive performance in the Maine-Syracuse Longitudinal Study, a community-based study of cardiovascular risk factors. Cross-sectional analyses were undertaken on data from 540 participants, aged 60 to 98 years, free of dementia and stroke. TC, HDL, LDL, and triglyceride levels were obtained. Cognitive function was assessed using a thorough neuropsychological test battery, including domains of cognitive function indexed by multiple cognitive tests. The cognitive outcomes studied were as follows: Visual-Spatial Memory and Organization, Verbal and Working Memory, Scanning and Tracking, Abstract Reasoning, a Global Composite score, and the Mini-Mental State Examination (MMSE). Significant positive associations were observed between HDL-cholesterol and the Global Composite score, Working Memory, and the MMSE after adjustment for demographic and cardiovascular risk factors. Participants with desirable levels of HDL (≥60 mg/dL) had the highest scores on all cognitive outcomes. There were no significant associations observed between TC, LDL, or triglyceride concentrations and cognition. In older individuals, HDL-cholesterol was related to a composite of Working Memory tests and for general measures of cognitive ability when adjusted for cardiovascular variables. We speculate that persons over 60 are survivors and thus less likely to show cognitive deficit in relation to TC, LDL-cholesterol, and triglycerides. Longitudinal studies are needed to examine relations between specific cognitive abilities and the different subcategories of cholesterol.
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Prescripciones inconvenientes en el tratamiento del paciente con deterioro cognitivo. Neurologia 2014; 29:523-32. [DOI: 10.1016/j.nrl.2012.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 05/28/2012] [Indexed: 11/22/2022] Open
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Mandas A, Congiu MG, Abete C, Dessi S, Manconi PE, Musio M, Columbu S, Racugno W. Cognitive decline and depressive symptoms in late-life are associated with statin use: evidence from a population-based study of Sardinian old people living in their own home. Neurol Res 2014; 36:247-54. [PMID: 24512018 DOI: 10.1179/1743132813y.0000000287] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This study was designed to provide further insights into the effects of dyslipidemia (Dys-y) and use of statins (St-y) on cognitive functions and mood in older people. METHODS Three hundred and twenty-nine subjects aged > or = 65 years were screened for cognitive dysfunction using mini mental state examination (MMSE). The geriatric depression scale (GDS) was used to detect depression. Interview questionnaires surveyed activities of daily living (ADL) and instrumental ADL (IADL), as well as other functional disabilities. The presence of neutral lipids (NLs) in cytoplasm of peripheral blood mononuclear cells (PBMCs) was determined with the Oil red O (ORO) staining. RESULTS There was no significant difference in MMSE and GDS scores between normal (Dys-n) and Dys-y. However, when Dys-y subjects were divided into St-y and non-statin users (St-n), significant differences emerged in the scores of MMSE and GDS: St-y had lower MMSE and higher GDS than St-n. Multiple correspondence analysis and logistic regression provided further evidence that elderly St-y were much more likely to suffer of cognitive impairment and depression than St-n. Another interesting finding was that the intensity of NL-PBMCs measured by ORO staining was greater in subjects with altered MMSE compared with cognitively normal subjects. In addition St-y had higher ORO score than St-n. DISCUSSION This is an observational study and cannot, therefore, prove a causal relationship between St-y in the elderly and a higher cognitive decline, nevertheless it provides substantial indications that caution should be exercised in the provision of statins in elderly subjects to avoid accelerated memory loss.
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Hottman DA, Chernick D, Cheng S, Wang Z, Li L. HDL and cognition in neurodegenerative disorders. Neurobiol Dis 2014; 72 Pt A:22-36. [PMID: 25131449 DOI: 10.1016/j.nbd.2014.07.015] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 06/26/2014] [Accepted: 07/28/2014] [Indexed: 12/12/2022] Open
Abstract
High-density lipoproteins (HDLs) are a heterogeneous group of lipoproteins composed of various lipids and proteins. HDL is formed both in the systemic circulation and in the brain. In addition to being a crucial player in the reverse cholesterol transport pathway, HDL possesses a wide range of other functions including anti-oxidation, anti-inflammation, pro-endothelial function, anti-thrombosis, and modulation of immune function. It has been firmly established that high plasma levels of HDL protect against cardiovascular disease. Accumulating evidence indicates that the beneficial role of HDL extends to many other systems including the central nervous system. Cognition is a complex brain function that includes all aspects of perception, thought, and memory. Cognitive function often declines during aging and this decline manifests as cognitive impairment/dementia in age-related and progressive neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. A growing concern is that no effective therapy is currently available to prevent or treat these devastating diseases. Emerging evidence suggests that HDL may play a pivotal role in preserving cognitive function under normal and pathological conditions. This review attempts to summarize recent genetic, clinical and experimental evidence for the impact of HDL on cognition in aging and in neurodegenerative disorders as well as the potential of HDL-enhancing approaches to improve cognitive function.
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Affiliation(s)
- David A Hottman
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Dustin Chernick
- Department of Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Shaowu Cheng
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zhe Wang
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ling Li
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA; Department of Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA.
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Abstract
Cholesterol is an essential component of both the peripheral nervous system and central nervous system (CNS) of mammals. Brain cholesterol is synthesized in situ by astrocytes and oligodendrocytes and is almost completely isolated from other pools of cholesterol in the body, but a small fraction can be taken up from the circulation as 27-hydroxycholesterol, or via the scavenger receptor class B type I. Glial cells synthesize native high-density lipoprotein (HDL)-like particles, which are remodelled by enzymes and lipid transfer proteins, presumably as it occurs in plasma. The major apolipoprotein constituent of HDL in the CNS is apolipoprotein E, which is produced by astrocytes and microglia. Apolipoprotein A-I, the major protein component of plasma HDL, is not synthesized in the CNS, but can enter and become a component of CNS lipoproteins. Low HDL-C levels have been shown to be associated with cognitive impairment and various neurodegenerative diseases. On the contrary, no clear association with brain disorders has been shown in genetic HDL defects, with the exception of Tangier disease. Mutations in a wide variety of lipid handling genes can result in human diseases, often with a neuronal phenotype caused by dysfunctional intracellular lipid trafficking.
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Affiliation(s)
- Cecilia Vitali
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, Italy
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Laura Calabresi
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, Italy
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Umegaki H, Kawamura T, Umemura T, Kawano N. Factors associated with cognitive decline in older adults with type 2 diabetes mellitus during a 6-year observation. Geriatr Gerontol Int 2014; 15:302-10. [PMID: 24597930 DOI: 10.1111/ggi.12273] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2014] [Indexed: 11/29/2022]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) is a risk for cognitive decline in older adults. The current study was carried out to determine the factors associated with cognitive decline. METHODS The older T2DM patients (aged ≥65 years, mean age 79.2 ± 5.1 years) were observed for 6 years, and the mean values in clinical indicators of participants with and without cognitive decline over a 6-year period were compared. Then, multiple logistic analysis was carried out to determine the factors associated with cognitive decline. Separate analyses were also carried out for each of five cognitive assessments (Mini-Mental State Examination, word immediate and delayed recall, Stroop test, digit symbol substitution). RESULTS In the composite of several cognitive assessments, higher age and a lower level of high-density lipoprotein cholesterol were associated with cognitive decline in older T2DM patients. Lower systolic blood pressure was associated with a decline in delayed word list recall. Higher plasma insulin level was associated with a decline in the Stroop test performance. CONCLUSION Lower high-density lipoprotein cholesterol was significantly associated with general cognitive decline in older T2DM patients during our 6-year observation. Several other factors were also associated with cognitive assessments of various cognitive domains.
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Affiliation(s)
- Hiroyuki Umegaki
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Chirackal Manavalan AP, Kober A, Metso J, Lang I, Becker T, Hasslitzer K, Zandl M, Fanaee-Danesh E, Pippal JB, Sachdev V, Kratky D, Stefulj J, Jauhiainen M, Panzenboeck U. Phospholipid transfer protein is expressed in cerebrovascular endothelial cells and involved in high density lipoprotein biogenesis and remodeling at the blood-brain barrier. J Biol Chem 2014; 289:4683-98. [PMID: 24369175 PMCID: PMC3931031 DOI: 10.1074/jbc.m113.499129] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Phospholipid transfer protein (PLTP) is a key protein involved in biogenesis and remodeling of plasma HDL. Several neuroprotective properties have been ascribed to HDL. We reported earlier that liver X receptor (LXR) activation promotes cellular cholesterol efflux and formation of HDL-like particles in an established in vitro model of the blood-brain barrier (BBB) consisting of primary porcine brain capillary endothelial cells (pBCEC). Here, we report PLTP synthesis, regulation, and its key role in HDL metabolism at the BBB. We demonstrate that PLTP is highly expressed and secreted by pBCEC. In a polarized in vitro model mimicking the BBB, pBCEC secreted phospholipid-transfer active PLTP preferentially to the basolateral ("brain parenchymal") compartment. PLTP expression levels and phospholipid transfer activity were enhanced (up to 2.5-fold) by LXR activation using 24(S)-hydroxycholesterol (a cerebral cholesterol metabolite) or TO901317 (a synthetic LXR agonist). TO901317 administration elevated PLTP activity in BCEC from C57/BL6 mice. Preincubation of HDL3 with human plasma-derived active PLTP resulted in the formation of smaller and larger HDL particles and enhanced the capacity of the generated HDL particles to remove cholesterol from pBCEC by up to 3-fold. Pre-β-HDL, detected by two-dimensional crossed immunoelectrophoresis, was generated from HDL3 in pBCEC-derived supernatants, and their generation was markedly enhanced (1.9-fold) upon LXR activation. Furthermore, RNA interference-mediated PLTP silencing (up to 75%) reduced both apoA-I-dependent (67%) and HDL3-dependent (30%) cholesterol efflux from pBCEC. Based on these findings, we propose that PLTP is actively involved in lipid transfer, cholesterol efflux, HDL genesis, and remodeling at the BBB.
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Affiliation(s)
| | | | - Jari Metso
- the National Institute for Health and Welfare, Biomedicum, FI-00290 Helsinki, Finland, and
| | - Ingrid Lang
- Institute of Cell Biology, Histology, and Embryology, and
| | | | | | - Martina Zandl
- From the Institute of Pathophysiology and Immunology
| | | | | | - Vinay Sachdev
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria
| | - Dagmar Kratky
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria
| | - Jasminka Stefulj
- the Department of Molecular Biology, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Matti Jauhiainen
- the National Institute for Health and Welfare, Biomedicum, FI-00290 Helsinki, Finland, and
| | - Ute Panzenboeck
- From the Institute of Pathophysiology and Immunology, , To whom correspondence should be addressed: Institute of Pathophysiology and Immunology, Medical University of Graz, Heinrichstrasse 31a, 8010 Graz, Austria. Tel.: 43-316-3801955; Fax: 43-316-3809640; E-mail:
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Taniguchi Y, Shinkai S, Nishi M, Murayama H, Nofuji Y, Yoshida H, Fujiwara Y. Nutritional Biomarkers and Subsequent Cognitive Decline Among Community-Dwelling Older Japanese: A Prospective Study. J Gerontol A Biol Sci Med Sci 2014; 69:1276-83. [DOI: 10.1093/gerona/glt286] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Affiliation(s)
- Federico Oldoni
- From the Departments of Molecular Genetics (F.O., J.A.K.) and Genetics (R.J.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Richard J. Sinke
- From the Departments of Molecular Genetics (F.O., J.A.K.) and Genetics (R.J.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jan Albert Kuivenhoven
- From the Departments of Molecular Genetics (F.O., J.A.K.) and Genetics (R.J.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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AHMADIAN-ATTARI MM, MOSADDEGH M, KAZEMNEJAD A, NOORBALA AA. Comparison between Complementary Dietary Treatment of Alzheimer Disease in Iranian Traditional Medicine and Modern Medicine. IRANIAN JOURNAL OF PUBLIC HEALTH 2013; 42:1414-21. [PMID: 26060643 PMCID: PMC4441938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/10/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dietary notifications have been introduced recently for Alzheimer Disease (AD). In Iranian old medical manuscripts, there are some nutritional recommendations related to Nesyan (AD equivalent). The aim of this article was to compare dietary recommendations of Iranian traditional medicine (ITM) with novel medical outcomes. METHODS 1) Searching for dietary recommendations and abstinences described in ITM credible manuscripts; 2) Extracting fatty components of ITM diet according to the database of the Department of Agriculture of the USA; 3) Statistical analysis of fatty elements of traditionally recommended foods via Mann-Whitney Test in comparison with elements of the abstinent ones; 4) Searching for AD dietary recommendations and abstinences which currently published in medical journals; 5) Comparing traditional and new dietary suggestions with each other. RESULTS 1) Traditionally recommended foods are fattier than abstinent ones (P<0.001). There are meaningful differences between unsaturated fatty acids (UFAs) (P<0.001), saturated fatty acids (P<0.001), and cholesterol (P<0.05) of recommended foods and abstinent ones. 2) Traditionally recommended diet is also fattier than the abstinent diet (4.5 times); UFAs of the recommended diet is 11 times more than that of the abstinent one; it is the same story for cholesterol (1.4 times); 3) Recent studies show that diets with high amounts of UFAs have positive effects on AD; a considerable number of papers emphasizes on probable positive role of cholesterol on AD; 4) Traditional recommended diet is in agreement with recent studies. CONCLUSION ITM recommended diet which is full of unsaturated fatty acids and cholesterol can be utilized for complementary treatment of AD.
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Affiliation(s)
- Mohammad Mahdi AHMADIAN-ATTARI
- 1. Dept. of Traditional Pharmacy, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoud MOSADDEGH
- 1. Dept. of Traditional Pharmacy, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- 2. Traditional Medicine and Material Medical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anooshiravan KAZEMNEJAD
- 3. Dept. of Biostatistics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ahmad Ali NOORBALA
- 4. Psychosomatic Ward Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Cholesterol and copper affect learning and memory in the rabbit. Int J Alzheimers Dis 2013; 2013:518780. [PMID: 24073355 PMCID: PMC3773440 DOI: 10.1155/2013/518780] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 07/31/2013] [Indexed: 12/11/2022] Open
Abstract
A rabbit model of Alzheimer's disease based on feeding a cholesterol diet for eight weeks shows sixteen hallmarks of the disease including beta amyloid accumulation and learning and memory changes. Although we have shown that feeding 2% cholesterol and adding copper to the drinking water can retard learning, other studies have shown that feeding dietary cholesterol before learning can improve acquisition and feeding cholesterol after learning can degrade long-term memory. We explore the development of this model, the issues surrounding the role of copper, and the particular contributions of the late D. Larry Sparks.
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70
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Fiolaki A, Tsamis KI, Milionis HJ, Kyritsis AP, Kosmidou M, Giannopoulos S. Atherosclerosis, biomarkers of atherosclerosis and Alzheimer's disease. Int J Neurosci 2013; 124:1-11. [DOI: 10.3109/00207454.2013.821988] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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71
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Cysique LA, Moffat K, Moore DM, Lane TA, Davies NWS, Carr A, Brew BJ, Rae C. HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1)H MRS study. PLoS One 2013; 8:e61738. [PMID: 23620788 PMCID: PMC3631163 DOI: 10.1371/journal.pone.0061738] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 03/14/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND) in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear. METHODS 92 HIV- infected (HIV+) adults stable on combined antiretroviral therapy (cART) and 30 age-comparable HIV-negative (HIV-) subjects underwent (1)H Magnetic Resonance Spectroscopy (MRS) of the frontal white matter (targeting HIV, normal aging or CVD-related neurochemical injury), caudate nucleus (targeting HIV neurochemical injury), and posterior cingulate cortex (targeting normal/pathological aging, CVD-related neurochemical changes). All also underwent standard neuropsychological (NP) testing. CVD risk scores were calculated. HIV disease biomarkers were collected and cerebrospinal fluid (CSF) neuroinflammation biomarkers were obtained in 38 HIV+ individuals. RESULTS Relative to HIV- individuals, HIV+ individuals presented mild MRS alterations: in the frontal white matter: lower N-Acetyl-Aspartate (NAA) (p<.04) and higher myo-inositol (mIo) (p<.04); in the caudate: lower NAA (p = .01); and in the posterior cingulate cortex: higher mIo (p<.008- also significant when Holm-Sidak corrected) and higher Choline/NAA (p<.04). Regression models showed that an HIV*age interaction was associated with lower frontal white matter NAA. CVD risk factors were associated with lower posterior cingulate cortex and caudate NAA in both groups. Past acute CVD events in the HIV+ group were associated with increased mIo in the posterior cingulate cortex. HIV duration was associated with lower caudate NAA; greater CNS cART penetration was associated with lower mIo in the posterior cingulate cortex and the degree of immune recovery on cART was associated with higher NAA in the frontal white matter. CSF neopterin was associated with higher mIo in the posterior cingulate cortex and frontal white matter. CONCLUSIONS In chronically HIV+ adults with long-term viral suppression, current CVD risk, past CVD and age are independent factors for neuronal injury and inflammation. This suggests a tripartite model of HIV, CVD and age likely driven by chronic inflammation.
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Affiliation(s)
- Lucette A Cysique
- University of New South Wales, St. Vincent's Clinical School, Sydney, Australia.
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72
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Luoma PV. Elimination of endoplasmic reticulum stress and cardiovascular, type 2 diabetic, and other metabolic diseases. Ann Med 2013; 45:194-202. [PMID: 22928964 PMCID: PMC3581057 DOI: 10.3109/07853890.2012.700116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 05/11/2012] [Indexed: 12/21/2022] Open
Abstract
Multiple factors including unhealthy living habits influence the life-maintaining functions of the endoplasmic reticulum (ER) and induce ER stress and metabolic abnormalities. The ER responds to the disturbances by activating mechanisms that increase the capacity to eliminate ER stress. This article elucidates the effects of ER activation that eliminates both ER stress and associated cardiovascular, type 2 diabetic (DM2), and other metabolic diseases. ER-activating compounds eliminate ER stress by lowering elevated cholesterol, regress atherosclerosis, decrease cardiovascular mortality, reduce blood glucose and insulin, and, together with the normalization of glucose-insulin homeostasis, remove insulin resistance, pancreatic β-cell failure, and DM2. A deficient cytochrome P450 activity in hepatic ER leads to cholesterol accumulation that induces stress and xanthoma formation, whereas P450-activating therapy up-regulates apolipoprotein AI and LDLR genes, down-regulates apolipoprotein B gene, and produces an antiatherogenic plasma lipoprotein profile. The ER activation reduces the stress also by eliminating hepatic fat and converting saturated fatty acids (FAs) to unsaturated FAs. Cognitive processes require gene expression modification, and preclinical studies indicate that ER-activating therapy improves cognition. Promotion of healthy lifestyle choices and indicated therapies are key factors in the prevention and elimination of ER stress and associated global health problems.
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Affiliation(s)
- Pauli V. Luoma
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland
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73
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Zhang L, Jin H, Guo X, Yang Z, Zhao L, Tang S, Mo P, Wu K, Nie Y, Pan Y, Fan D. Distinguishing pancreatic cancer from chronic pancreatitis and healthy individuals by (1)H nuclear magnetic resonance-based metabonomic profiles. Clin Biochem 2012; 45:1064-9. [PMID: 22613268 DOI: 10.1016/j.clinbiochem.2012.05.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 04/07/2012] [Accepted: 05/03/2012] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To develop a noninvasive and accessible diagnostic method for pancreatic cancer (PC). DESIGN AND METHODS We presented a metabolomic method, pattern recognition techniques applied to (1)H nuclear magnetic resonance ((1)H NMR) spectra, to investigate the plasma metabolites obtained from 19 patients with PC, 20 patients with chronic pancreatitis (CP) and 20 healthy individuals. RESULTS Metabolic changes associated with PC included abnormal amino acid and lipid metabolism, and possible multiple metabolic syndrome. PC elevated plasma levels of N-acetyl glycoprotein (NAG), dimethylamine (DMA), very low density lipoprotein (VLDL), and acetone, and reduced levels of 3-hydroxybutyrate, lactate, high density lipoprotein (HDL), low density lipoprotein (LDL), citrate, alanine, glutamate, glutamine, histidine, isoleucine, lysine, and valine. These metabolites could be a biomarker group for PC that distinguishes between PC and CP patients and healthy individuals. CONCLUSIONS NMR-based metabonomic strategy appears as a promising approach for distinguishing pancreatic cancer and identifying new strategies for prevention or therapy in the clinical practice.
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Affiliation(s)
- Lin Zhang
- State Key Laboratory of Cancer Biology, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
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Cholesteryl Ester Transfer Protein (CETP) genotype and cognitive function in persons aged 35 years or older. Neurobiol Aging 2012; 33:1851.e7-16. [PMID: 22464147 DOI: 10.1016/j.neurobiolaging.2012.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 01/06/2012] [Accepted: 02/21/2012] [Indexed: 01/25/2023]
Abstract
Common polymorphisms of the Cholestryl Ester Transfer Protein (CETP) gene may predict lower risk of cognitive decline. We investigated the association of cognitive function with CETP genotype in a population-based cohort of 4135 persons aged 35-82 years. Cognitive function was measured with the Ruff Figural Fluency Test (RFFT; worst score, 0 points; best score, 175 points) and CETP I405V and Taq1B genotypes were determined by polymerase chain reaction. RFFT score was not associated with I405V genotype in persons aged 35-64 years. Remarkably, beyond age 65, homozygous valine carriers had higher RFFT scores than heterozygous carriers and noncarriers: RFFT (SD), 52 (21), 49 (18), and 47 (17) points, respectively (p = 0.005). There also was a statistically significant interaction between I405V genotype and age. Beyond age 65, the difference between homozygous valine carriers and noncarriers increased by 0.11 point per year (p = 0.005). RFFT score was not associated with Taq1B genotype. In conclusion, CETP I405V valine homozygosity was associated with better cognitive function in persons aged 65 years or older.
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75
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Umegaki H, Iimuro S, Shinozaki T, Araki A, Sakurai T, Iijima K, Ohashi Y, Ito H. Risk factors associated with cognitive decline in the elderly with type 2 diabetes: Pooled logistic analysis of a 6-year observation in the Japanese elderly diabetes intervention trial. Geriatr Gerontol Int 2012; 12 Suppl 1:110-6. [DOI: 10.1111/j.1447-0594.2011.00818.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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76
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Umegaki H, Iimuro S, Shinozaki T, Araki A, Sakurai T, Iijima K, Ohashi Y, Ito H. Risk factors associated with cognitive decline in the elderly with type 2 diabetes: Baseline data analysis of the Japanese elderly diabetes intervention trial. Geriatr Gerontol Int 2012; 12 Suppl 1:103-9. [DOI: 10.1111/j.1447-0594.2011.00817.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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77
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Khalil A, Berrougui H, Pawelec G, Fulop T. Impairment of the ABCA1 and SR-BI-mediated cholesterol efflux pathways and HDL anti-inflammatory activity in Alzheimer's disease. Mech Ageing Dev 2012; 133:20-9. [DOI: 10.1016/j.mad.2011.11.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/20/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
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78
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Luoma PV. Gene-activation mechanisms in the regression of atherosclerosis, elimination of diabetes type 2, and prevention of dementia. Curr Mol Med 2011; 11:391-400. [PMID: 21568932 PMCID: PMC3282906 DOI: 10.2174/156652411795976556] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 04/04/2011] [Accepted: 04/22/2011] [Indexed: 12/21/2022]
Abstract
Atherosclerotic vascular disease, diabetes mellitus (DM) and dementia are major global health problems. Both endogenous and exogenous factors activate genes functioning in biological processes. This review article focuses on gene-activation mechanisms that regress atherosclerosis, eliminate DM type 2 (DM2), and prevent cognitive decline and dementia. Gene-activating compounds upregulating functions of liver endoplasmic reticulum (ER) and affecting lipid and protein metabolism, increase ER size through membrane synthesis, and produce an antiatherogenic plasma lipoprotein profile. Numerous gene-activators regress atherosclerosis and reduce the occurrence of atherosclerotic disease. The gene-activators increase glucose disposal rate and insulin sensitivity and, by restoring normal glucose and insulin levels, remove metabolic syndrome and DM2. Patients with DM2 show an improvement of plasma lipoprotein profile and glucose tolerance together with increase in liver phospholipid (PL) and cytochrome (CYP) P450. The gene-activating compounds induce hepatic protein and PL synthesis, and upregulate enzymes including CYPs and glucokinase, nuclear receptors, apolipoproteins and ABC (ATP-binding cassette) transporters. They induce reparation of ER structures and eliminate consequences of ER stress. Healthy living habits activate mechanisms that maintain high levels of HDL and apolipoprotein AI, promote health, and prevent cognitive decline and dementia. Agonists of liver X receptor (LXR) reduce amyloid in brain plaques and improve cognitive performance in mouse models of Alzheimer's disease. The gene activation increases the capacity to withstand cellular stress and to repair cellular damage and increases life span. Life free of major health problems and in good cognitive health promotes well-being and living a long and active life.
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Affiliation(s)
- P V Luoma
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.
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79
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Kaffashian S, Dugravot A, Nabi H, Batty GD, Brunner E, Kivimäki M, Singh-Manoux A. Predictive utility of the Framingham general cardiovascular disease risk profile for cognitive function: evidence from the Whitehall II study. Eur Heart J 2011; 32:2326-32. [PMID: 21606085 PMCID: PMC3172575 DOI: 10.1093/eurheartj/ehr133] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Aims Vascular risk factors are associated with cognitive impairment and dementia, although most of the research in this domain focuses on cerebrovascular factors. We examined the relationship between the recently developed Framingham general cardiovascular risk profile and cognitive function and 10-year decline in late midlife. Methods and results Study sample comprised of 3486 men and 1341 women, mean age 55 years [standard deviation (SD)=6], from the Whitehall II study, a longitudinal British cohort study. The Framingham General Cardiovascular Risk profile, assessed between 1997 and 1999, included age, sex, HDL cholesterol, total cholesterol, systolic blood pressure, smoking status, and diabetes status. Measures of cognitive function consisted of tests of reasoning (Alice Heim 4-I), memory, phonemic and semantic fluency, and vocabulary (Mill-Hill), assessed three times (1997–1999, 2002–2004, 2007–2009) over 10 years. In cross-sectional age-adjusted models, 10% point increments in cardiovascular risk were associated with poor performance in all cognitive domains in both men and women (all P-values <0.001). In models adjusted for age, ethnicity, marital status, and education, 10% higher cardiovascular risk was associated with greater overall 10-year cognitive decline in men, reasoning in particular (−0.47; 95% CI: −0.81, −0.11). Conclusion In middle-aged individuals free of cardiovascular disease, an adverse cardiovascular risk profile is associated with poor cognitive function, and decline in at least one cognitive domain in men.
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Affiliation(s)
- Sara Kaffashian
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, 16 Avenue Paul Vaillant Couturier,Villejuif Cedex, France.
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80
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Gonzales MM, Tarumi T, Eagan DE, Tanaka H, Biney FO, Haley AP. Current serum lipoprotein levels and FMRI response to working memory in midlife. Dement Geriatr Cogn Disord 2011; 31:259-67. [PMID: 21494033 PMCID: PMC3085033 DOI: 10.1159/000324713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2011] [Indexed: 11/19/2022] Open
Abstract
AIMS Given that high cholesterol levels at midlife are a risk factor for future cognitive decline, the goal of the current study was to determine if cholesterol-related alterations in the cerebrovascular response to cognition could be detected at midlife. METHODS Forty adults, aged 40-60 years, performed a 2-Back working memory task during fMRI. The associations between serum total cholesterol, HDL-cholesterol, and total cholesterol/HDL-cholesterol concentrations to task-related activation intensity were modeled using multivariate multiple regression (two-tailed p < 0.02). RESULTS Higher levels of total cholesterol/HDL-cholesterol related to reduced working memory-related activation intensity in the left inferior parietal lobe, right superior frontal gyrus, and right middle frontal gyrus. CONCLUSION These data provide preliminary support for a deleterious effect of elevated total cholesterol/HDL-cholesterol ratio on cerebrovascular support for cognition in midlife.
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Affiliation(s)
- Mitzi M. Gonzales
- Department of Psychology, The University of Texas at Austin, Tex., USA
| | - Takashi Tarumi
- Department of Kinesiology and Health Education, The University of Texas at Austin, Tex., USA
| | - Danielle E. Eagan
- Department of Psychology, The University of Texas at Austin, Tex., USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Tex., USA
| | - Fedora O. Biney
- Department of Psychology, The University of Texas at Austin, Tex., USA
| | - Andreana P. Haley
- Department of Psychology, The University of Texas at Austin, Tex., USA,University of Texas Imaging Research Center, Austin, Tex., USA,*Andreana P. Haley, PhD, Department of Psychology, The University of Texas at Austin, 108 E. Dean Keaton, SEA 4.110, Austin, TX 78712 (USA), Tel. +1 512 232 0863, E-Mail
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81
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Gillum RF, Obisesan TO. High-density lipoprotein cholesterol, cognitive function and mortality in a U.S. national cohort. Lipids Health Dis 2011; 10:26. [PMID: 21276232 PMCID: PMC3042961 DOI: 10.1186/1476-511x-10-26] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 01/28/2011] [Indexed: 11/30/2022] Open
Abstract
Low levels of both high density lipoprotein cholesterol (HDL) and cognitive function are associated with increased mortality risk. HDL plays an important role in brain metabolism. We test the hypotheses that the relative protective effect of high HDL level as related to mortality is greater in persons with impaired cognitive function than in others. Data were analyzed from a longitudinal mortality follow-up study of 4911 American men and women aged 60 years and over examined in 1988-1994 followed an average 8.5 yr. Measurements at baseline included HDL, a short index of cognitive function (SICF), socio-demographics, health status, and self-reported leisure-time physical activity. In proportional hazards regression analysis, no significant interaction of HDL with cognitive function was found (p = 0.08); there was a significant age-SICF interaction. After stratifying by age and adjusting for confounding by multiple variables, independent associations of HDL and SICF score with survival were strongest among the oldest persons. Consistent with its association with HDL, cognitive function and survival, controlling in addition for physical activity reduced the associations. In a nationwide cohort of older Americans, analyses demonstrated a lower risk of death independent of confounders among those high HDL and SICF scores, strongest among the oldest persons.
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Affiliation(s)
- Richard F Gillum
- Department of Medicine, Howard University, College of Medicine, Washington, DC, USA.
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82
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Formiga F, Ferrer A, Chivite D, Pinto X, Cuerpo S, Pujol R. Serum high-density lipoprotein cholesterol levels, their relationship with baseline functional and cognitive status, and their utility in predicting mortality in nonagenarians. Geriatr Gerontol Int 2011; 11:358-64. [DOI: 10.1111/j.1447-0594.2010.00681.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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83
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Yamazaki Y, Miwa T, Sakurai H, Hanyu H, Iwamoto T, Odawara M. Clinical backgrounds and morbidity of cognitive impairment in elderly diabetic patients. Endocr J 2011; 58:109-15. [PMID: 21273735 DOI: 10.1507/endocrj.k10e-388] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Despite numerous reports that have linked diabetes with cognitive impairment (CI), there are few studies that have attempted to clarify the morbidity of CI among elderly diabetic patients. The Mini-Mental State Examination (MMSE) was performed on 240 diabetic patients aged 65 years or older who had no diagnosis of dementia. The MMSE scores were 28-30 (normal range) in 151 patients (63%), 24-27 (suspected CI) in 77 (32%), and ≤ 23 (definite CI) in 12 (5%). Eight of the 12 patients with MMSE scores ≤ 23 underwent further detailed examination: the final diagnosis was Alzheimer's disease (AD) (N = 5), vascular dementia (N = 2), and mixed dementia (N = 1). Among 24 of the 77 patients with MMSE scores of 24-27 who were referred for further detailed examination, the final diagnosis was early AD (N = 5), cerebrovascular disease (CVD) (N = 10), and mild CI (N = 7). Only 2 of the patients were judged as being normal. The percentage of patients with a history of CVD, the rate of diuretic use, and the serum levels of non-high-density lipoprotein cholesterol were higher, and the percentage of patients with a history of habitual alcohol consumption was lower in the low MMSE score group than in the normal MMSE score group. Among elderly diabetic patients aged 65 years or older, 5% had evident CI and 32% had suspected CI. Medical staff involved in the care of diabetic patients should be highly aware of possible CI in this patient population.
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Affiliation(s)
- Yasunori Yamazaki
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo, Japan
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McGrowder D, Riley C, Morrison EYSA, Gordon L. The role of high-density lipoproteins in reducing the risk of vascular diseases, neurogenerative disorders, and cancer. CHOLESTEROL 2010; 2011:496925. [PMID: 21490772 PMCID: PMC3065895 DOI: 10.1155/2011/496925] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2010] [Accepted: 11/04/2010] [Indexed: 01/03/2023]
Abstract
High-density lipoprotein (HDL) is one of the major carriers of cholesterol in the blood. It attracts particular attention because, in contrast with other lipoproteins, as many physiological functions of HDL influence the cardiovascular system in favourable ways unless HDL is modified pathologically. The functions of HDL that have recently attracted attention include anti-inflammatory and anti-oxidant activities. High anti-oxidant and anti-inflammatory activities of HDL are associated with protection from cardiovascular disease. Atheroprotective activities, as well as a functional deficiency of HDL, ultimately depend on the protein and lipid composition of HDL. Further, numerous epidemiological studies have shown a protective association between HDL-cholesterol and cognitive impairment. Oxidative stress, including lipid peroxidation, has been shown to be the mediator of the pathologic effects of numerous risk factors of Alzheimer's disease. Lifestyle interventions proven to increase HDL- cholesterol levels including "healthy" diet, regular exercise, weight control, and smoking cessation have also been shown to provide neuro-protective effects. This review will focus on current knowledge of the beneficial effects of HDL-cholesterol as it relates to cardiovascular diseases, breast and lung cancers, non-Hodgkin's lymphoma, as well as its neuroprotective potential in reducing the risk of Alzheimer's disease and dementia.
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Affiliation(s)
- Donovan McGrowder
- Department of Pathology, Faculty of Medical Sciences, University of the West Indies, Mona Campus, Kingston 7, Jamaica
| | - Cliff Riley
- College of Health Sciences, University of Technology, 237 Old Hope Road, Kingston 6, Jamaica
| | | | - Lorenzo Gordon
- Department of Medicine, Faculty of Medical Sciences, University of the West Indies, Kingston 7, Jamaica
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85
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Lewis TL, Cao D, Lu H, Mans RA, Su YR, Jungbauer L, Linton MF, Fazio S, LaDu MJ, Li L. Overexpression of human apolipoprotein A-I preserves cognitive function and attenuates neuroinflammation and cerebral amyloid angiopathy in a mouse model of Alzheimer disease. J Biol Chem 2010; 285:36958-68. [PMID: 20847045 DOI: 10.1074/jbc.m110.127829] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
To date there is no effective therapy for Alzheimer disease (AD). High levels of circulating high density lipoprotein (HDL) and its main protein, apolipoprotein A-I (apoA-I), reduce the risk of cardiovascular disease. Clinical studies show that plasma HDL cholesterol and apoA-I levels are low in patients with AD. To investigate if increasing plasma apoA-I/HDL levels ameliorates AD-like memory deficits and amyloid-β (Aβ) deposition, we generated a line of triple transgenic (Tg) mice overexpressing mutant forms of amyloid-β precursor protein (APP) and presenilin 1 (PS1) as well as human apoA-I (AI). Here we show that APP/PS1/AI triple Tg mice have a 2-fold increase of plasma HDL cholesterol levels. When tested in the Morris water maze for spatial orientation abilities, whereas APP/PS1 mice develop age-related learning and memory deficits, APP/PS1/AI mice continue to perform normally during aging. Interestingly, no significant differences were found in the total level and deposition of Aβ in the brains of APP/PS1 and APP/PS1/AI mice, but cerebral amyloid angiopathy was reduced in APP/PS1/AI mice. Also, consistent with the anti-inflammatory properties of apoA-I/HDL, glial activation was reduced in the brain of APP/PS1/AI mice. In addition, Aβ-induced production of proinflammatory chemokines/cytokines was decreased in mouse organotypic hippocampal slice cultures expressing human apoA-I. Therefore, we conclude that overexpression of human apoA-I in the circulation prevents learning and memory deficits in APP/PS1 mice, partly by attenuating neuroinflammation and cerebral amyloid angiopathy. These findings suggest that elevating plasma apoA-I/HDL levels may be an effective approach to preserve cognitive function in patients with AD.
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Affiliation(s)
- Terry L Lewis
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA
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86
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Ward MA, Bendlin BB, McLaren DG, Hess TM, Gallagher CL, Kastman EK, Rowley HA, Asthana S, Carlsson CM, Sager MA, Johnson SC. Low HDL Cholesterol is Associated with Lower Gray Matter Volume in Cognitively Healthy Adults. Front Aging Neurosci 2010; 2. [PMID: 20725527 PMCID: PMC2914583 DOI: 10.3389/fnagi.2010.00029] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 06/26/2010] [Indexed: 02/05/2023] Open
Abstract
Dyslipidemia is common in adults and contributes to high rates of cardiovascular disease and may be linked to subsequent neurodegenerative and neurovascular diseases. This study examined whether lower brain volumes and cognition associated with dyslipidemia could be observed in cognitively healthy adults, and whether apolipoprotein E (APOE) genotype or family history of Alzheimer's disease (FHAD) alters this effect. T1-weighted magnetic resonance imaging was used to examine regional brain gray matter (GM) and white matter (WM) in 183 individuals (58.4 ± 8.0 years) using voxel-based morphometry. A non-parametric multiple linear regression model was used to assess the effect of high-density lipoprotein (HDL) and non-HDL cholesterol, APOE, and FHAD on regional GM and WM volume. A post hoc analysis was used to assess whether any significant correlations found within the volumetric analysis had an effect on cognition. HDL was positively correlated with GM volume in the bilateral temporal poles, middle temporal gyri, temporo-occipital gyri, and left superior temporal gyrus and parahippocampal region. This effect was independent of APOE and FHAD. A significant association between HDL and the Brief Visuospatial Memory Test was found. Additionally, GM volume within the right middle temporal gyrus, the region most affected by HDL, was significantly associated with the Controlled Oral Word Association Test and the Center for Epidemiological Studies Depression Scale. These findings suggest that adults with decreased levels of HDL cholesterol may be experiencing cognitive changes and GM reductions in regions associated with neurodegenerative disease and therefore, may be at greater risk for future cognitive decline.
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Affiliation(s)
- Michael A Ward
- Geriatric Research, Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital Madison, WI, USA
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87
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Schreurs BG. The effects of cholesterol on learning and memory. Neurosci Biobehav Rev 2010; 34:1366-79. [PMID: 20470821 PMCID: PMC2900496 DOI: 10.1016/j.neubiorev.2010.04.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 04/26/2010] [Accepted: 04/28/2010] [Indexed: 02/07/2023]
Abstract
Cholesterol is vital to normal brain function including learning and memory but that involvement is as complex as the synthesis, metabolism and excretion of cholesterol itself. Dietary cholesterol influences learning tasks from water maze to fear conditioning even though cholesterol does not cross the blood brain barrier. Excess cholesterol has many consequences including peripheral pathology that can signal brain via cholesterol metabolites, pro-inflammatory mediators and antioxidant processes. Manipulations of cholesterol within the central nervous system through genetic, pharmacological, or metabolic means circumvent the blood brain barrier and affect learning and memory but often in animals already otherwise compromised. The human literature is no less complex. Cholesterol reduction using statins improves memory in some cases but not others. There is also controversy over statin use to alleviate memory problems in Alzheimer's disease. Correlations of cholesterol and cognitive function are mixed and association studies find some genetic polymorphisms are related to cognitive function but others are not. In sum, the field is in flux with a number of seemingly contradictory results and many complexities. Nevertheless, understanding cholesterol effects on learning and memory is too important to ignore.
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Affiliation(s)
- Bernard G Schreurs
- Blanchette Rockefeller Neurosciences Institute and Department of Physiology and Pharmacology, West Virginia University School of Medicine, BRNI Building, Morgantown, WV 26505-3409-08, USA.
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88
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Jokela M, Singh-Manoux A, Ferrie JE, Gimeno D, Akbaraly TN, Shipley MJ, Head J, Elovainio M, Marmot MG, Kivimäki M. The association of cognitive performance with mental health and physical functioning strengthens with age: the Whitehall II cohort study. Psychol Med 2010; 40:837-45. [PMID: 19719898 PMCID: PMC3178658 DOI: 10.1017/s0033291709991024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cognitive performance has been associated with mental and physical health, but it is unknown whether the strength of these associations changes with ageing and with age-related social transitions, such as retirement. We examined whether cognitive performance predicted mental and physical health from midlife to early old age. METHOD Participants were 5414 men and 2278 women from the Whitehall II cohort study followed for 15 years between 1991 and 2006. The age range included over the follow-up was from 40 to 75 years. Mental health and physical functioning were measured six times using SF-36 subscales. Cognitive performance was assessed three times using five cognitive tests assessing verbal and numerical reasoning, verbal memory, and phonemic and semantic fluency. Socio-economic status (SES) and retirement were included as covariates. RESULTS High cognitive performance was associated with better mental health and physical functioning. Mental health differences associated with cognitive performance widened with age from 39 to 76 years of age, whereas physical functioning differences widened only between 39 and 60 years and not after 60 years of age. SES explained part of the widening differences in mental health and physical functioning before age 60. Cognitive performance was more strongly associated with mental health in retired than non-retired participants, which contributed to the widening differences after 60 years of age. CONCLUSIONS The strength of cognitive performance in predicting mental and physical health may increase from midlife to early old age, and these changes may be related to SES and age-related transitions, such as retirement.
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Affiliation(s)
- M Jokela
- Department of Epidemiology and Public Health, University College London, UK.
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89
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Sabia S, Ankri J, Singh-Manoux A. Approche « vie entière » dans l’étude du vieillissement cognitif. Med Sci (Paris) 2010; 26:319-24. [DOI: 10.1051/medsci/2010263319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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90
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Rutherford JN, McDade TW, Feranil AB, Adair LS, Kuzawa CW. High prevalence of low HDL-c in the Philippines compared to the US: population differences in associations with diet and BMI. Asia Pac J Clin Nutr 2010; 19:57-67. [PMID: 20199988 PMCID: PMC3152979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of death in the Philippines, although few studies here have examined the lipid profiles underlying disease risk. The isolated low high density lipoprotein cholesterol (HDL-c) phenotype has been implicated as a CVD risk factor, the prevalence of which exhibits significant variation across populations. To assess population variation in individual lipid components and their associations with diet and anthropometric characteristics, we compare lipid profiles in a population of adult Filipino women (n=1877) to US women participating in the National Health and Nutrition Examination Survey (NHANES, n=477). We conducted multiple regression models to assess the relationship between lipid components, body mass index, and dietary variables in the two populations. We measured the prevalence of lipid phenotypes, and logistic regression models determined the predictors of the isolated low HDL-c phenotype. High density lipoprotein cholesterol was lower in the Philippines (40.8+/-0.2 mg/dL) than in NHANES (60.7+/-0.7 mg/dL). The prevalence of the isolated low HDL-c phenotype was 28.8%, compared to 2.10% in NHANES. High prevalence among Filipinos was relatively invariant across all levels of BMI, but was strongly inversely related to BMI in NHANES and exhibited only at the BMI>25 kg/m2 threshold. Diet did not consistently predict the low-HDL phenotype in Filipinos. Filipino women exhibit a high prevalence of the isolated low HDL-c phenotype, which is largely decoupled from anthropometric factors. The relationship of CVD to population variation in dyslipidemia and body composition needs further study, particularly in populations where the burden of cardiovascular and metabolic disease is rapidly increasing.
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Affiliation(s)
- Julienne N Rutherford
- University of Illinois at Chicago, Department of Oral Biology, College of Dentistry, 801 S. Paulina Street, Chicago, IL 60612, USA.
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91
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Murphy AJ, Chin-Dusting J, Sviridov D. Reconstituted HDL: a therapy for atherosclerosis and beyond. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/clp.09.68] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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92
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Pani A, Mandas A, Diaz G, Abete C, Cocco PL, Angius F, Brundu A, Muçaka N, Pais ME, Saba A, Barberini L, Zaru C, Palmas M, Putzu PF, Mocali A, Paoletti F, La Colla P, Dessì S. Accumulation of neutral lipids in peripheral blood mononuclear cells as a distinctive trait of Alzheimer patients and asymptomatic subjects at risk of disease. BMC Med 2009; 7:66. [PMID: 19883495 PMCID: PMC2777188 DOI: 10.1186/1741-7015-7-66] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 11/02/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alzheimer's disease is the most common progressive neurodegenerative disease. In recent years, numerous progresses in the discovery of novel Alzheimer's disease molecular biomarkers in brain as well as in biological fluids have been made. Among them, those involving lipid metabolism are emerging as potential candidates. In particular, an accumulation of neutral lipids was recently found by us in skin fibroblasts from Alzheimer's disease patients. Therefore, with the aim to assess whether peripheral alterations in cholesterol homeostasis might be relevant in Alzheimer's disease development and progression, in the present study we analyzed lipid metabolism in plasma and peripheral blood mononuclear cells from Alzheimer's disease patients and from their first-degree relatives. METHODS Blood samples were obtained from 93 patients with probable Alzheimer's disease and from 91 of their first-degree relatives. As controls we utilized 57, cognitively normal, over-65 year-old volunteers and 113 blood donors aged 21-66 years, respectively. Data are reported as mean +/- standard error. Statistical calculations were performed using the statistical analysis software Origin 8.0 version. Data analysis was done using the Student t-test and the Pearson test. RESULTS Data reported here show high neutral lipid levels and increased ACAT-1 protein in about 85% of peripheral blood mononuclear cells freshly isolated (ex vivo) from patients with probable sporadic Alzheimer's disease compared to about 7% of cognitively normal age-matched controls. A significant reduction in high density lipoprotein-cholesterol levels in plasma from Alzheimer's disease blood samples was also observed. Additionally, correlation analyses reveal a negative correlation between high density lipoprotein-cholesterol and cognitive capacity, as determined by Mini Mental State Examination, as well as between high density lipoprotein-cholesterol and neutral lipid accumulation. We observed great variability in the neutral lipid-peripheral blood mononuclear cells data and in plasma lipid analysis of the subjects enrolled as Alzheimer's disease-first-degree relatives. However, about 30% of them tend to display a peripheral metabolic cholesterol pattern similar to that exhibited by Alzheimer's disease patients. CONCLUSION We suggest that neutral lipid-peripheral blood mononuclear cells and plasma high density lipoprotein-cholesterol determinations might be of interest to outline a distinctive metabolic profile applying to both Alzheimer's disease patients and asymptomatic subjects at higher risk of disease.
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Affiliation(s)
- Alessandra Pani
- Department of Internal Medical Science, University of Cagliari, Italy.
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93
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Reiner Z. How to improve cardiovascular diseases prevention in Europe? Nutr Metab Cardiovasc Dis 2009; 19:451-454. [PMID: 19631516 DOI: 10.1016/j.numecd.2009.06.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 06/15/2009] [Indexed: 11/25/2022]
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94
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Specific loss of brain ABCA1 increases brain cholesterol uptake and influences neuronal structure and function. J Neurosci 2009; 29:3579-89. [PMID: 19295162 DOI: 10.1523/jneurosci.4741-08.2009] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The expression of the cholesterol transporter ATP-binding cassette transporter A1 (ABCA1) in the brain and its role in the lipidation of apolipoproteins indicate that ABCA1 may play a critical role in brain cholesterol metabolism. To investigate the role of ABCA1 in brain cholesterol homeostasis and trafficking, we characterized mice that specifically lacked ABCA1 in the CNS, generated using the Cre/loxP recombination system. These mice showed reduced plasma high-density lipoprotein (HDL) cholesterol levels associated with decreased brain cholesterol content and enhanced brain uptake of esterified cholesterol from plasma HDL. Increased levels of HDL receptor SR-BI in brain capillaries and apolipoprotein A-I in brain and CSF of mutant mice were evident. Cholesterol homeostasis changes were mirrored by disturbances in motor activity and sensorimotor function. Changes in synaptic ultrastructure including reduced synapse and synaptic vesicle numbers were observed. These data show that ABCA1 is a key regulator of brain cholesterol metabolism and that disturbances in cholesterol transport in the CNS are associated with structural and functional deficits in neurons. Moreover, our findings also demonstrate that specific changes in brain cholesterol metabolism can lead to alterations in cholesterol uptake from plasma to brain.
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95
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