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Oshima S, Shiiya S, Nakamura Y. Serum Uric Acid-Lowering Effects of Combined Glycine and Tryptophan Treatments in Subjects with Mild Hyperuricemia: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study. Nutrients 2019; 11:E564. [PMID: 30845731 PMCID: PMC6471320 DOI: 10.3390/nu11030564] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/01/2019] [Accepted: 03/03/2019] [Indexed: 12/29/2022] Open
Abstract
We determined the serum uric acid-lowering effects of combined daily supplementation of glycine and tryptophan in patients with mild hyperuricemia using a randomized, double-blind, placebo-controlled, crossover clinical trial design. Japanese healthy adult males and females with mild hyperuricemia (fasting serum uric acid of 6.6⁻7.9 mg/dL) ingested a powder mixture containing 3.0 g of glycine and 0.2 g of tryptophan or a placebo powder once daily at bedtime for 6 weeks. Combined supplementation with glycine and tryptophan significantly decreased serum uric acid levels (from 7.1 mg/dL to 6.7 mg/dL, p = 0.004) before and after the trial. Serum uric acid concentrations significantly decreased in the subjects supplemented with the amino acid mixture compared with those in placebo-treated subjects (p = 0.028). In addition, the combination treatment with glycine and tryptophan decreased serum triglyceride levels (from 119 mg/dL to 86 mg/dL, p = 0.002). Increased solubility of uric acid caused by urinary pH were likely contributors to the serum uric acid-lowering effects of the amino acid mixture.
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Affiliation(s)
- Shunji Oshima
- Core Technology Laboratories, Asahi Group Holdings, Ltd., 1-21, Midori 1-Chome, Moriya-shi 302-0106, Japan.
| | - Sachie Shiiya
- Core Technology Laboratories, Asahi Group Holdings, Ltd., 1-21, Midori 1-Chome, Moriya-shi 302-0106, Japan.
| | - Yasunori Nakamura
- Core Technology Laboratories, Asahi Group Holdings, Ltd., 1-21, Midori 1-Chome, Moriya-shi 302-0106, Japan.
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Brito AKDS, Lima GDM, Farias LMD, Rodrigues LARL, Carvalho VBLD, Pereira CFDC, Frota KDMG, Conde-Júnior AM, Silva AMO, Rizzo MDS, Fonseca CMB, Moura RCD, Santos RCD, Leite JRDSDA, Santos MAPD, Nunes PHM, Arcanjo DDR, Martins MDCDCE. Lycopene-Rich Extract from Red Guava ( Psidium guajava L.) Decreases Plasma Triglycerides and Improves Oxidative Stress Biomarkers on Experimentally-Induced Dyslipidemia in Hamsters. Nutrients 2019; 11:nu11020393. [PMID: 30781884 PMCID: PMC6412966 DOI: 10.3390/nu11020393] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/02/2019] [Accepted: 02/06/2019] [Indexed: 12/28/2022] Open
Abstract
This work assessed the effects of a 28-day treatment with lycopene-rich extract (LRE) from red guava fruit (Psidium guajava L.) on the lipid profile and oxidative stress in an experimental model of dyslipidemia. Male hamsters (116.5 ± 2.16 g) were fed with the AIN 93G diet containing casein (20%), coconut fat (13.5%) and cholesterol (0.1%). The animals were divided into four groups: normolipidemic control (standard feed; NC, n = 7); hypercholesterolemic control (HC, n = 7); LRE 25 mg/kg/day (LRE-25, n = 7) and LRE 50 mg/kg/day (LRE-50, n = 9). After treatment, plasma concentrations of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol (LDL-c), high-density lipoprotein (HDL) cholesterol (HDL-c), malondialdehyde (MDA-p) and myeloperoxidase (MPO), as well as erythrocytic superoxide dismutase (SOD-e) and the atherogenic index, were determined. Malondialdehyde (MDA-h), catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD-h) levels were assessed. Feed intake (FI) and weight gain (WG) were also determined. The LRE-25 group presented significantly lower TG levels and atherogenic index than did the HC group (p < 0.05). Both LRE-25 and LRE-50 groups presented lower levels of MDA-p and MPO than did the HC group (p < 0.05). LRE demonstrated a promising effect against dyslipidemia and oxidative stress.
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Affiliation(s)
| | - Geovanni de Morais Lima
- Medicinal Plants Research Center, Federal University of Piaui, Teresina, PI 64.049-550, Brazil.
| | - Luciana Melo de Farias
- Department of Nutrition, Federal University of Piaui, SG-13, Ininga. Teresina, PI 64.049-550, Brazil.
| | | | | | | | | | | | - Ana Mara Oliveira Silva
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, SE 49100-000, Brazil.
| | | | | | - Rayane Carvalho de Moura
- Department of Nutrition, Federal University of Piaui, SG-13, Ininga. Teresina, PI 64.049-550, Brazil.
| | - Raimunda Cardoso Dos Santos
- Biodiversity and Biotechnology Research Center, Federal University of Piaui, Parnaiba, PI 64202-020, Brazil.
| | | | | | - Paulo Humberto Moreira Nunes
- Medicinal Plants Research Center, Federal University of Piaui, Teresina, PI 64.049-550, Brazil.
- Department of Biophysics and Physiology, Federal University of Piaui, 64049-550. Teresina, PI 64.049-550, Brazil.
| | - Daniel Dias Rufino Arcanjo
- Medicinal Plants Research Center, Federal University of Piaui, Teresina, PI 64.049-550, Brazil.
- Department of Biophysics and Physiology, Federal University of Piaui, 64049-550. Teresina, PI 64.049-550, Brazil.
| | - Maria do Carmo de Carvalho E Martins
- Medicinal Plants Research Center, Federal University of Piaui, Teresina, PI 64.049-550, Brazil.
- Department of Biophysics and Physiology, Federal University of Piaui, 64049-550. Teresina, PI 64.049-550, Brazil.
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53
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Hannon BA, Thompson SV, Edwards CG, Skinner SK, Niemiro GM, Burd NA, Holscher HD, Teran-Garcia M, Khan NA. Dietary Fiber Is Independently Related to Blood Triglycerides Among Adults with Overweight and Obesity. Curr Dev Nutr 2019; 3:nzy094. [PMID: 30820489 PMCID: PMC6389638 DOI: 10.1093/cdn/nzy094] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 10/19/2018] [Accepted: 11/26/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), a cluster of visceral adiposity-related risk factors, affects approximately 35% of the United States population. Although improvement in diet quality is an important approach to reducing MetS risk, the role of particular dietary components remains unclear, especially among younger adults. Individual dietary components have been implicated in ameliorating or exacerbating MetS risk; however, the extent to which these factors contribute to MetS prevention has received little attention. OBJECTIVE This cross-sectional study aimed to assess relations between diet and individual MetS components in young to middle-aged adults who are overweight and/or obese. METHODS Participants aged 25-45 y (N = 117) with overweight and obesity, but no other diagnosed metabolic disease, recorded dietary intake over 7 d. MetS components (waist circumference, blood pressure, glucose, triglycerides [TGs], and high-density lipoprotein cholesterol [HDL]) were measured. Visceral adipose tissue was measured by dual-energy X-ray absorptiometry. Linear regression was used to assess relations between diet and MetS risk factors, adjusting for age, sex, and visceral adipose tissue. RESULTS MetS prevalence in this sample was 32%. Energy-adjusted total fiber intake (β = -0.21, P = 0.02) was inversely associated with TG concentrations. No significant relations were observed between other dietary factors and MetS components. These findings indicate that among MetS components, TG concentrations are potentially sensitive to fiber consumption. CONCLUSIONS These results provide cross-sectional evidence supporting the protective influence of dietary fiber on MetS components among young to middle-aged adults. Additional, well-designed clinical trials are needed to assess the causal relations between various types of dietary fiber and metabolic disease.
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Affiliation(s)
- Bridget A Hannon
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
| | - Sharon V Thompson
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
| | - Caitlyn G Edwards
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
| | - Sarah K Skinner
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL
| | - Grace M Niemiro
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL
| | - Nicholas A Burd
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL
| | - Hannah D Holscher
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL
| | - Naiman A Khan
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL
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54
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Gutgsell AR, Ghodge SV, Bowers AA, Neher SB. Mapping the sites of the lipoprotein lipase (LPL)-angiopoietin-like protein 4 (ANGPTL4) interaction provides mechanistic insight into LPL inhibition. J Biol Chem 2018; 294:2678-2689. [PMID: 30591589 DOI: 10.1074/jbc.ra118.005932] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/21/2018] [Indexed: 12/29/2022] Open
Abstract
Cardiovascular disease has been the leading cause of death throughout the world for nearly 2 decades. Hypertriglyceridemia affects more than one-third of the population in the United States and is an independent risk factor for cardiovascular disease. Despite the frequency of hypertriglyceridemia, treatment options are primarily limited to diet and exercise. Lipoprotein lipase (LPL) is an enzyme responsible for clearing triglycerides from circulation, and its activity alone can directly control plasma triglyceride concentrations. Therefore, LPL is a good target for triglyceride-lowering therapeutics. One approach for treating hypertriglyceridemia may be to increase the amount of enzymatically active LPL by preventing its inhibition by angiopoietin-like protein 4 (ANGPTL4). However, little is known about how these two proteins interact. Therefore, we used hydrogen-deuterium exchange MS to identify potential binding sites between LPL and ANGPTL4. We validated sites predicted to be located at the protein-protein interface by using chimeric variants of LPL and an LPL peptide mimetic. We found that ANGPTL4 binds LPL near the active site at the lid domain and a nearby α-helix. Lipase lid domains cover the active site to control both enzyme activation and substrate specificity. Our findings suggest that ANGPTL4 specifically inhibits LPL by binding the lid domain, which could prevent substrate catalysis at the active site. The structural details of the LPL-ANGPTL4 interaction uncovered here may inform the development of therapeutics targeted to disrupt this interaction for the management of hypertriglyceridemia.
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Affiliation(s)
- Aspen R Gutgsell
- From the Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 and
| | - Swapnil V Ghodge
- the Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
| | - Albert A Bowers
- the Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
| | - Saskia B Neher
- From the Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 and
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55
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Gao Z, Lai Q, Yang Q, Xu N, Liu W, Zhao F, Liu X, Zhang C, Zhang J, Jia L. The characteristic, antioxidative and multiple organ protective of acidic-extractable mycelium polysaccharides by Pleurotus eryngii var. tuoliensis on high-fat emulsion induced-hypertriglyceridemic mice. Sci Rep 2018; 8:17500. [PMID: 30504780 PMCID: PMC6269502 DOI: 10.1038/s41598-018-35706-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 11/09/2018] [Indexed: 12/26/2022] Open
Abstract
The antioxidant and multiple organ protection effects of acid- extracted mycelia polysaccharides (Ac-MPS) from Pleurotus eryngii var. tuoliensis on HFE-induced hypertriglyceridemic mice were investigated. The results showed that Ac-MPS have potential ability to relieve the hypertriglyceridemia and preventing oxidative stress by decreasing levels of TG, TC LDL-C, elevating contents of HDL-C in serum, increasing the activities of SOD, GSH-Px, CAT and T-AOC, and the down regulating MDA and LPO contents in liver, heart, kidney and spleen. And the histopathological observations also displayed that Ac-MPS could alleviate organ damage. Moreover, the GC, HPGPC, FT-IR and AFM analyses revealed the Ac-MPS possessed the typical polysaccharides structure with the molecular weights (Mw) of 2.712 × 105 Da. These conclusions indicated that the Ac-MPS had the potential to develop new drugs for hypertriglyceridemia-induced multiple organ failure.
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Affiliation(s)
- Zheng Gao
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China
| | - Qiangqiang Lai
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China
| | - Qihang Yang
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China
| | - Nuo Xu
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China
| | - Wenbo Liu
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China
| | - Fulan Zhao
- The First People's Hospital of Taian, Taian, 271000, PR China
| | - Xinchao Liu
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China
| | - Chen Zhang
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China
| | - Jianjun Zhang
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China.
| | - Le Jia
- College of Life Science, Shandong Agricultural University, Taian, 271018, PR China.
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56
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Jung JY, Choi Y, Suh CH, Yoon D, Kim HA. Effect of fenofibrate on uric acid level in patients with gout. Sci Rep 2018; 8:16767. [PMID: 30425304 PMCID: PMC6233215 DOI: 10.1038/s41598-018-35175-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022] Open
Abstract
Gout is a chronic disease associated with deposition of monosodium urate crystals and accompanied by diabetes, hypertension, and dyslipidemia. Hypertriglyceridemia is common among patients with gout, and fenofibrate is usually used to reduce triglyceride levels. The aim of this study is to determine the effect of uric acid reduction by fenofibrate in patients with gout administered uric acid lowering agents (viz., the xanthine oxidase inhibitors allopurinol and febuxostat). Data from 863 patients with gout were collected from electronic medical records comprising information on underlying diseases, laboratory findings, and drug histories. Among all the patients, 70 (8.11%) took fenofibrate with allopurinol or febuxostat. Male and young patients took fenofibrate more frequently, and hypertension was less frequent in patients administered xanthine oxidase inhibitors and fenofibrate than in those administered only xanthine oxidase inhibitors. After the treatment, serum uric acid levels more significantly decreased (−1.81 ± 2.41 vs. −2.40 ± 2.28 mg/dL, p = 0.043) in patients with fenofibrate cotreatment, than in those administered allopurinol or febuxostat alone. The effect of uric acid reduction was larger (b = −1.098, p < 0.001) in patients taking glucocorticoids than in those administered other treatments. There was no difference in the levels of creatinine, blood urea nitrogen, and aminotransferases between patients treated with and without fenofibrate. Fenofibrate additionally reduced uric acid levels without showing any change in the results of renal or liver function tests, suggesting that the addition of fenofibrate is a reasonable option for treating gout in patients having high triglyceride levels.
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Affiliation(s)
- Ju-Yang Jung
- Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea
| | - Young Choi
- Department of Biomedical Informatics, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.,Department of Biomedical Science, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea
| | - Chang-Hee Suh
- Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea
| | - Dukyong Yoon
- Department of Biomedical Informatics, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea. .,Department of Biomedical Science, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
| | - Hyoun-Ah Kim
- Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
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57
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A case-control study of the determinants for cervicocerebral artery dissection. J Neurol 2018; 266:119-123. [PMID: 30421338 DOI: 10.1007/s00415-018-9096-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cervicocerebral artery dissection (CAD) is a major cause of ischemic stroke in young adults. There are many existing studies on determinants for CAD; however, they are still not totally defined. We conduct the study to further investigate the determinants for CAD based on ischemic stroke patients. METHODS 81 ischemic stroke patients with CAD were enrolled in the CAD stroke group and 84 ischemic stroke patients without CAD were enrolled in the non-CAD stroke group. Their clinical data, such as age, gender, vascular risk factors, headache and neck pain and clinical laboratory data, were collected to analyze the differences between the two groups. RESULTS A total of 165 ischemic stroke patients were included. The mean age of CAD stroke group was (51.6 ± 12.4) years, and (55.5 ± 8.1) years in non-CAD stroke group, with a statistically significant difference (P = 0.017). The average level of triglycerides in CAD stroke group was (1.3 ± 0.7) mmol/L, and (1.7 ± 1.1) mmol/L in non-CAD stroke group, with a statistically significant difference (P = 0.012). There were 42.0% (34/81) of headache and neck pain in CAD stroke group and 22.6% (19/84) in non-CAD stroke group, with a statistically significant difference (P = 0.008). The key findings with significant difference were stratified and multivariate logistic regression analysis showed that age < 50 years old (OR 2.98, 95% CI 1.43-6.21, P = 0.004), triglycerides < 1.6 mmol/L (OR 3.51, 95% CI 1.69-7.27, P = 0.001) and headache and neck pain (OR 2.94, 95% CI 1.39-6.20, P = 0.005) showed a positive correlation with CAD. CONCLUSION In the process of diagnosis and treatment of ischemic stroke, for patients with age < 50 years old, headache and neck pain and triglycerides < 1.6 mmol/L, the cervicocerebral artery dissection should be considered, and vascular imaging examination needs to be performed in time.
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58
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Liu X, Li M, Wang X, Dang Z, Jiang Y, Wang X, Yang Z. Effect of serum triglyceride level on the prognosis of patients with hepatocellular carcinoma in the absence of cirrhosis. Lipids Health Dis 2018; 17:248. [PMID: 30400953 PMCID: PMC6220457 DOI: 10.1186/s12944-018-0898-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 10/23/2018] [Indexed: 02/08/2023] Open
Abstract
Background The liver plays an important role in the metabolism of lipid and lipoprotein. Dyslipidemia has been demonstrated to be related with several cancers, but the association between serum lipid and hepatocellular carcinoma (HCC) in the absence of cirrhosis remains unclear. Methods A total of 2528 patients with HCC at the Beijing Ditan Hospital between February 2008 and December 2017 were retrospectively included in the study. We identified 200 patients with HCC without cirrhosis by histopathology, imaging, endoscopic findings, and laboratory tests. Multivariate regression analysis was performed to determine the independent characteristics associated with HCC without cirrhosis and its prognosis. Results In the logistics regression analysis, compared to patients with HCC with cirrhosis, patients with HCC without cirrhosis were more likely to have elevated triglyceride (TG) levels (OR = 2.66; 95% CI, 1.18–6.01; P = 0.019). The Kaplan-Meier analysis revealed that a lower TG level was a risk factor regardless of the presence of cirrhosis. The results of the Cox proportional hazard regression analysis showed that a decreased TG level was significantly related to a worse overall survival (HR = 0.51; 95% CI, 0.29–0.89; P = 0.017). Conclusion Serum TG level may be an independent factor to predict the prognosis of patients with HCC in the absence of cirrhosis. Electronic supplementary material The online version of this article (10.1186/s12944-018-0898-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoli Liu
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China
| | - Mengge Li
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China
| | - Xinhui Wang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China
| | - Zhibo Dang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China
| | - Yuyong Jiang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China
| | - Xianbo Wang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China
| | - Zhiyun Yang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China.
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La Fountaine MF, Cirnigliaro CM, Hobson JC, Dyson-Hudson TA, Mc Kenna C, Kirshblum SC, Spungen AM, Bauman WA. Establishing a threshold to predict risk of cardiovascular disease from the serum triglyceride and high-density lipoprotein concentrations in persons with spinal cord injury. Spinal Cord 2018; 56:1051-1058. [PMID: 30089895 PMCID: PMC6219899 DOI: 10.1038/s41393-018-0187-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/20/2022]
Abstract
STUDY DESIGN Retrospective cohort. OBJECTIVE This report identified the serum triglyceride (TG) concentrations in persons with spinal cord injury (SCI) and able-bodied (AB) individuals that the serum high-density lipoprotein cholesterol (HDL-C) equaled 40 mg/dl, a concentration below which is an independent risk factor for coronary artery disease. METHODS Retrospective analysis was performed on 578 participants: 223 with SCI at or proximal to the 4th thoracic vertebrae (↑T4), 178 with SCI at or distal to the 5th thoracic vertebrae (↓T5), and 177 AB. Different statistical modeling approaches identified the intersecting serum TG concentration with a serum HDL-C concentration equal to 40 mg/dl. Participants were dichotomized into subgroups by TG concentration exceeding (supra) or falling below (sub) the intersecting value and the TG/HDL-C ratios were compared. RESULTS Linear regression analysis revealed that the serum TG concentration that intersects with serum HDL-C concentration at 40 mg/dl was 121 mg/dl in SCI ↑T4 and 137 mg/dl in SCI ↓T5 group. A ROC curve identified the optimal TG concentration as 115 mg/dl in SCI ↑T4 and 137 mg/dl in SCI ↓T5 group with the latter concentration being similar to the AB group (e.g., 137 mg/dl). The TG/HDL-C ratios in the respective ↑T4, ↓T5, and AB supra and subgroups were similar within each group. CONCLUSIONS A lower TG concentration appears to be associated with dyslipidemia in persons with SCI than AB individuals. These findings should prompt clinicians to screen for and consider instituting lifestyle or pharmacological interventions at lower TG concentrations to reduce risk of CVD.
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Affiliation(s)
- Michael F La Fountaine
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, USA.
- The Institute for Advanced Study of Rehabilitation and Sports Science, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, USA.
- Departments of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA.
| | - Christopher M Cirnigliaro
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Joshua C Hobson
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Trevor A Dyson-Hudson
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Cristin Mc Kenna
- Kessler Foundation, West Orange, NJ, USA
- Kessler Institute for Rehabilitation, West Orange, NJ, USA
| | - Steven C Kirshblum
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
- Kessler Institute for Rehabilitation, West Orange, NJ, USA
| | - Ann M Spungen
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William A Bauman
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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60
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Jin JL, Sun D, Cao YX, Guo YL, Wu NQ, Zhu CG, Gao Y, Dong QT, Zhang HW, Liu G, Dong Q, Li JJ. Triglyceride glucose and haemoglobin glycation index for predicting outcomes in diabetes patients with new-onset, stable coronary artery disease: a nested case-control study. Ann Med 2018; 50:576-586. [PMID: 30207490 DOI: 10.1080/07853890.2018.1523549] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIM Previous studies have shown that both triglyceride glucose (TyG) and haemoglobin glycation indexes (HGI) are predictors of cardiovascular risk. However, the prognostic value of TyG index and HGI in patients with type 2 diabetes mellitus (T2DM) and stable coronary artery disease (CAD) is not determined. METHODS We conducted a nested case-control study among 1282 T2DM patients with stable CAD. Patients were followed up for 3846 person-years. A total of 160 patients with events (12.5%) were identified and matched individually on age, gender, previous use of lipid lowering agents and duration of follow-up with 640 controls. RESULTS In Kaplan-Meier analysis, the upper tertiles of TyG index and HGI had a significant lower event-free survival (p = .002; p = .036, respectively). Of the note, both TyG index and HGI were associated with increased risk of MACCEs after adjusting for confounding risk factors [adjusted HR (95% CI): 1.693 (1.238-2.316); 1.215 (1.046-1.411), respectively]. Moreover, adding TyG index to the Cox model increased the C-statistic to 0.638 (95%CI: 0.595-0.683, p = .002) while the C-statistic was not statistically improved when HGI was included (p = .240). CONCLUSIONS Both TyG index and HGI could predict cardiovascular outcomes in T2DM patients with new-onset, stable CAD while TyG index might be better. Key messages Both TyG and HGI are predictors of cardiovascular risk. The prognostic value of TyG index and HGI in T2DM patients with stable coronary artery disease is not determined. Our study firstly indicates that TyG index might have better prognostic value than HGI in T2DM patients with new-onset, stable CAD.
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Affiliation(s)
- Jing-Lu Jin
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Di Sun
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Ye-Xuan Cao
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Yuan-Lin Guo
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Na-Qiong Wu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Cheng-Gang Zhu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Ying Gao
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Qiu-Ting Dong
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Hui-Wen Zhang
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Geng Liu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Qian Dong
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Jian-Jun Li
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
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Jin JL, Cao YX, Wu LG, You XD, Guo YL, Wu NQ, Zhu CG, Gao Y, Dong QT, Zhang HW, Sun D, Liu G, Dong Q, Li JJ. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis 2018; 10:6137-6146. [PMID: 30622785 DOI: 10.21037/jtd.2018.10.79] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals. However, the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined. Methods We conducted a nested case-control study among 3,745 patients with stable CAD. Patients were followed up for 11,235 person-years. The cardiovascular events (CVEs) were defined as all-cause death, non-fatal myocardial infarction (MI), stroke and post-discharge revascularization [percutaneous coronary intervention (PCI) coronary artery bypass grafting (CABG)]. In total, 290 (7.7%) patients with CVEs and 1,450 controls were matched according to age, gender, previous history of PCI or CABG and the duration of follow-up. TyG index was calculated as formula: ln[fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results Multivariable Cox proportional hazards models revealed that TyG index was positively associated with CVEs risk (hazard ratio: 1.364, 95% confidence interval: 1.100-1.691, P=0.005). The Kaplan-Meier analysis indicated that patients within the highest quartile of TyG index presented the lowest event-free survival (P=0.029). Moreover, a 1-standard deviation (SD) increment in TyG index was associated with 23.2% [hazard ratio (HR): 1.232, 95% confidence interval (95% CI): 1.084-1.401] higher risk of CVEs, which was superior to other triglyceride or glycemic related markers. Conclusions The present study, firstly, showed that TyG index was positively associated with future CVEs, suggesting that TyG may be a useful marker for predicting clinical outcomes in patients with CAD.
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Affiliation(s)
- Jing-Lu Jin
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Ye-Xuan Cao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Li-Guo Wu
- Department of Cardiology, TangXian People's Hospital, Baoding 072350, China
| | - Xiang-Dong You
- Department of Cardiology, TangXian People's Hospital, Baoding 072350, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Qiu-Ting Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Hui-Wen Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Di Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Geng Liu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
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Hannon BA, Khan NA, Teran-Garcia M. Nutrigenetic Contributions to Dyslipidemia: A Focus on Physiologically Relevant Pathways of Lipid and Lipoprotein Metabolism. Nutrients 2018; 10:E1404. [PMID: 30279335 PMCID: PMC6213032 DOI: 10.3390/nu10101404] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 09/19/2018] [Accepted: 09/27/2018] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease (CVD) remains the number one cause of death worldwide, and dyslipidemia is a major predictor of CVD mortality. Elevated lipid concentrations are the result of multiple genetic and environmental factors. Over 150 genetic loci have been associated with blood lipid levels. However, not all variants are present in pathways relevant to the pathophysiology of dyslipidemia. The study of these physiologically relevant variants can provide mechanistic understanding of dyslipidemia and identify potential novel therapeutic targets. Additionally, dietary fatty acids have been evidenced to exert both positive and negative effects on lipid profiles. The metabolism of both dietary and endogenously synthesized lipids can be affected by individual genetic variation to produce elevated lipid concentrations. This review will explore the genetic, dietary, and nutrigenetic contributions to dyslipidemia.
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Affiliation(s)
- Bridget A Hannon
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL 61801, USA.
| | - Naiman A Khan
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL 61801, USA.
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL 61801, USA.
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL 61801, USA.
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL 61801, USA.
- Department of Human Development and Family Studies, Cooperative Extension, University of Illinois at Urbana-Champaign, Carle Illinois College of Medicine, Urbana-Champaign, IL 61801, USA.
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Del Carpio E, Hernández L, Ciangherotti C, Villalobos Coa V, Jiménez L, Lubes V, Lubes G. Vanadium: History, chemistry, interactions with α-amino acids and potential therapeutic applications. Coord Chem Rev 2018; 372:117-140. [PMID: 32226092 PMCID: PMC7094547 DOI: 10.1016/j.ccr.2018.06.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 06/03/2018] [Indexed: 12/11/2022]
Abstract
In the last 30 years, since the discovery that vanadium is a cofactor found in certain enzymes of tunicates and possibly in mammals, different vanadium-based drugs have been developed targeting to treat different pathologies. So far, the in vitro studies of the insulin mimetic, antitumor and antiparasitic activity of certain compounds of vanadium have resulted in a great boom of its inorganic and bioinorganic chemistry. Chemical speciation studies of vanadium with amino acids under controlled conditions or, even in blood plasma, are essential for the understanding of the biotransformation of e.g. vanadium antidiabetic complexes at the physiological level, providing clues of their mechanism of action. The present article carries out a bibliographical research emphaticizing the chemical speciation of the vanadium with different amino acids and reviewing also some other important aspects such as its chemistry and therapeutical applications of several vanadium complexes.
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Key Words
- 2,2′-bipy, 2,2-bipyridine
- 6-mepic, 6-methylpicolinic acid
- Ad, adenosine
- Ala, alanine
- Ala-Gly, alanylglycine
- Ala-His, alanylhistidine
- Ala-Ser, alanylserine
- Amino acids
- Antidiabetics
- Antitumors
- Asp, aspartic acid
- BEOV, bis(ethylmaltolate)oxovanadium(IV)
- Chemical speciation
- Cys, cysteine
- Cyt, citrate
- DMF, N,N-dimethylformamide
- DNA, deoxyribonucleic acid
- EPR, Electron Paramagnetic Resonance
- G, Gauss
- Glu, glutamic acid
- Gly, glycine
- GlyAla, glycylalanine
- GlyGly, glycylglycine
- GlyGlyCys, glycylglycylcysteine
- GlyGlyGly, glycylglycylglycine
- GlyGlyHis, glycylglycylhistidine
- GlyPhe, glycylphenylalanine
- GlyTyr, glycyltyrosine
- GlyVal, glycylvaline
- HIV, human immunodeficiency virus
- HSA, albumin
- Hb, hemoglobin
- His, histidine
- HisGlyGly, histidylglycylglycine
- Ig, immunoglobulins
- Im, imidazole
- L-Glu(γ)HXM, l-glutamic acid γ-monohydroxamate
- LD50, the amount of a toxic agent (such as a poison, virus, or radiation) that is sufficient to kill 50 percent of population of animals
- Lac, lactate
- MeCN, acetonitrile
- NADH and NAD+, nicotinamide adenine dinucleotide
- NEP, neutral endopeptidas
- NMR, Nuclear Magnetic Resonance
- Ox, oxalate
- PI3K, phosphoinositide 3-kinase
- PTP1B, protein tyrosine phosphatase 1B
- Pic, picolinic acid
- Pro, proline
- Pro-Ala, prolylalanine
- RNA, ribonucleic acid
- SARS, severe acute respiratory syndrome
- Sal-Ala, N-salicylidene-l-alaninate
- SalGly, salicylglycine
- SalGlyAla, salicylglycylalanine
- Ser, serine
- T, Tesla
- THF, tetrahydrofuran
- Thr, threonine
- VBPO, vanadium bromoperoxidases
- VanSer, Schiff base formed from o-vanillin and l-serine
- Vanadium complexes
- acac, acetylacetone
- dhp, 1,2-dimethyl-3-hydroxy-4(1H)-pyridinone
- dipic, dipicolinic acid
- dmpp, 1,2-dimethyl-3-hydroxy-4-pyridinonate
- hTf, transferring
- hpno, 2-hydroxypyridine-N-oxide
- l.m.m., low molecular mass
- mal, maltol
- py, pyridine
- sal-l-Phe, N-salicylidene-l-tryptophanate
- salGlyGly, N-salicylideneglycylglycinate
- salSer, N-salicylideneserinate
- salTrp, N-salicylidene-L tryptophanate
- salVal, N-salicylidene-l-valinate
- salophen, N,N′-bis(salicylidene)-o-phenylenediamine
- saltrp, N-salicylidene-l-tryptophanate
- γ-PGA, poly-γ-glutamic acid
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Affiliation(s)
- Edgar Del Carpio
- Laboratorio de Equilibrios en Solución, Universidad Simón Bolívar (USB), Apartado 89000, Caracas 1080 A, Venezuela
- Unidad de Química Medicinal, Facultad de Farmacia, Escuela “Dr. Jesús María Bianco”, Universidad Central de Venezuela, Venezuela
| | - Lino Hernández
- Laboratorio de Equilibrios en Solución, Universidad Simón Bolívar (USB), Apartado 89000, Caracas 1080 A, Venezuela
- Escuela de Quimica, Facultad de Ciencias, Universidad Central de Venezuela, Venezuela
| | - Carlos Ciangherotti
- Laboratorio de Neuropéptidos, Facultad de Farmacia, Escuela “Dr. Jesús María Bianco”, Universidad Central de Venezuela, Venezuela
- Laboratorio de Bioquímica, Facultad de Farmacia, Escuela “Dr. Jesús María Bianco”, Universidad Central de Venezuela, Venezuela
| | - Valentina Villalobos Coa
- Laboratorio de Equilibrios en Solución, Universidad Simón Bolívar (USB), Apartado 89000, Caracas 1080 A, Venezuela
| | - Lissette Jiménez
- Facultad de ingeniería Química, Universidad de Carabobo, Venezuela
| | - Vito Lubes
- Laboratorio de Equilibrios en Solución, Universidad Simón Bolívar (USB), Apartado 89000, Caracas 1080 A, Venezuela
| | - Giuseppe Lubes
- Laboratorio de Equilibrios en Solución, Universidad Simón Bolívar (USB), Apartado 89000, Caracas 1080 A, Venezuela
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Nichols GA, Philip S, Reynolds K, Granowitz CB, Fazio S. Increased Cardiovascular Risk in Hypertriglyceridemic Patients With Statin-Controlled LDL Cholesterol. J Clin Endocrinol Metab 2018; 103:3019-3027. [PMID: 29850861 DOI: 10.1210/jc.2018-00470] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/23/2018] [Indexed: 02/04/2023]
Abstract
CONTEXT Real-world evidence of the relationship between high triglyceride (TG) levels and cardiovascular (CV) disease (CVD) risk among statin-treated patients with low-density lipoprotein cholesterol (LDL-C) control is lacking. OBJECTIVE We aimed to compare CVD and mortality risk between patients with high vs normal TGs. DESIGN Longitudinal observational cohort study. SETTING Integrated delivery system. PATIENTS Patients aged ≥45 years whose TG level was either <150 mg/dL (normal) or between 200 and 499 mg/dL (high) in 2010, were taking only statins, had LDL-C values 40 to 100 mg/dL, and had diagnosed CVD. OUTCOME MEASURES Patients were followed through December 2016. Our primary outcomes were a composite of nonfatal myocardial infarction (MI), nonfatal stroke, unstable angina, coronary revascularization, and all-cause mortality and a second composite adding peripheral revascularization and aneurysm repair. We compared multivariable-adjusted incidence rates and rate ratios (RRs) of the outcomes and their components. RESULTS A total of 14,481 patients comprised the normal TG group, and 2702 patients were in the high TG group. Multivariable-adjusted incidence of the second composite was 10% greater in the high TG group [50.9/1000 person-years, 95% CI 47.0 to 55.2 vs 46.5, 44.8 to 48.2, RR 1.10, 95% CI 1.00 to 1.20, P = 0.041]. The difference was driven by nonfatal MI (RR 1.20, 95% CI 1.00 to 1.45, P = 0.045), coronary revascularization (RR 1.18, 95% CI 1.00 to 1.40, P = 0.045), and peripheral revascularization (RR 1.56, 95% CI 1.14 to 2.13, P = 0.006). CONCLUSIONS CVD risk in high-risk statin-treated patients with atherosclerotic CVD was associated with high TG levels.
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Affiliation(s)
| | | | | | | | - Sergio Fazio
- Oregon Health & Science University, Portland, Oregon
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Metabolomics-Based Clinical Efficacy and Effect on the Endogenous Metabolites of Tangzhiqing Tablet, a Chinese Patent Medicine for Type 2 Diabetes Mellitus with Hypertriglyceridemia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:5490491. [PMID: 30140295 PMCID: PMC6081579 DOI: 10.1155/2018/5490491] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/29/2018] [Accepted: 06/27/2018] [Indexed: 01/27/2023]
Abstract
Tangzhiqing tablet (TZQ) is derived from Tangzhiqing formula, which has been used to regulate glucose and lipid metabolism in China for hundreds of years. However, as a new Chinese patent medicine, its clinical indication is not clear. To explore the clinical indication and effect on the patients with type 2 diabetes mellitus (T2DM), a pilot clinical trial and metabolomics study were carried out. In the clinical study, T2DM patients were divided into three groups and treated with TZQ, placebo, or acarbose for 12 weeks, respectively. The metabolomic study based on UPLC Q-TOF MS was performed including patients with hypertriglyceridemia in TZQ and placebo groups and healthy volunteers. The clinical results showed that TZQ could reduce glycosylated hemoglobin (HbA1c) and fasting insulin. For patients with hypertriglyceridemia in TZQ group, the levels of HbA1c all decreased and were correlated with the baseline level of triglyceride. Metabonomics data showed a significant difference between patients and healthy volunteers, and 17 biomarkers were identified. After 12-week treatment with TZQ, 11 biomarkers decreased significantly (p<0.05), suggesting that TZQ could improve the metabolomic abnormalities in these participants. In conclusion, the clinical indication of TZQ was T2DM with hypertriglyceridemia, and its target was related to glycerophospholipid metabolism.
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Zheng T, Ge B, Liu H, Chen B, Qin L, Xiao L, Song J. Triglyceride-mediated influence of serum angiopoietin-like protein 8 on subclinical atherosclerosis in type 2 diabetic patients: results from the GDMD study in China. Cardiovasc Diabetol 2018; 17:84. [PMID: 30007407 PMCID: PMC6046091 DOI: 10.1186/s12933-018-0687-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/17/2018] [Indexed: 01/12/2023] Open
Abstract
Background Hypertriglyceridemia, insulin resistance and hyperglycemia are risk factors for atherosclerosis in type 2 diabetes. Angiopoietin-like protein 8 (ANGPTL8) is a newly identified liver-derived hormone related to these risk factors. Hence, we aimed to explore the correlations between serum levels of ANGPTL8 and subclinical atherosclerosis in type 2 diabetes. Methods We measured serum ANGPTL8, blood lipids, blood glucose, common carotid artery Intima-Media Thickness (c-IMT) and calculated homeostasis model assessment of insulin resistance in (1) control subjects (n = 100), (2) type 2 diabetic patients without subclinical atherosclerosis (n = 100), and (3) type 2 diabetic patients with subclinical atherosclerosis (n = 100). Results Serum levels of ANGPTL8 and triglyceride (TG) were significantly increased in type 2 diabetic patients with subclinical atherosclerosis as compared with type 2 diabetic patients without subclinical atherosclerosis and control subjects (P < 0.001). ANGPTL8 was positively associated with age, TG, diabetes duration, and c-IMT in type 2 diabetes. Logistic regression analysis revealed that ANGPTL8 had higher odds of having subclinical atherosclerosis [odds ratio (OR) 2.90, 95% confidence interval (CI) 1.48–5.70, P = 0.002] in type 2 diabetes. Mediation analysis indicated that TG acted as a partial mediator in the relationship between ANGPTL8 and c-IMT. Conclusions TG partially mediates the positive relationship between ANGPTL8 and c-IMT. Our data provide the first evidence for a strong link between ANGPTL8 and subclinical atherosclerosis, suggesting ANGPTL8 to be a new biomarker for subclinical atherosclerosis in type 2 diabetes.
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Affiliation(s)
- Tianpeng Zheng
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Guilin Medical University, 212 Renmin Road, Guilin, 541199, Guangxi, People's Republic of China.
| | - Bo Ge
- Department of Urology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China
| | - Hongbo Liu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China
| | - Bo Chen
- Department of Human Anatomy, Southwest Medical University, Luzhou, Sichuan, People's Republic of China
| | - Linyuan Qin
- Department of Epidemiology and Health Statistics, Guilin Medical University, Guilin, Guangxi, People's Republic of China
| | - Liuping Xiao
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Guilin Medical University, 212 Renmin Road, Guilin, 541199, Guangxi, People's Republic of China
| | - Jianfei Song
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China
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Jiao ZY, Li XT, Li YB, Zheng ML, Cai J, Chen SH, Wu SL, Yang XC. Correlation of triglycerides with myocardial infarction and analysis of risk factors for myocardial infarction in patients with elevated triglyceride. J Thorac Dis 2018; 10:2551-2557. [PMID: 29997915 DOI: 10.21037/jtd.2018.04.132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background This study aims to investigate the associations of different (low/medium/high) levels of fasting triglyceride (TG) levels with cardiovascular endpoints. Methods This cohort study comprised of in-service and retired employees of the Kailuan Coal Mine Group, who participated in the health examination conducted in 11 hospitals in the Kailuan region from June 2006 to October 2007 (n=100,271). The study population was divided into five groups according to different TG levels. Logistic regression analysis was used to analyze the risk factors for myocardial infarction (MI) in patients with elevated TG, and Cox proportional hazards regression analysis was used to analyze the effects of different TG levels on endpoint events. Results After a median follow-up of 7 years, 961 patients developed MI and 3,142 subjects died. The multivariate logistic regression analysis revealed that elevated TG, an age of ≥65 years old, body mass index (BMI) >25 kg/m2, fasting blood glucose (FBG) ≥6.1 mmol/L and high density lipoprotein cholesterol (HDL-C) <1.5 mmol/L were all risk factors for MI (P<0.05). Furthermore, Cox proportional hazards regression model revealed that after controlling for gender, age and other factors, with the increase in TG level, the relative risk of MI also increased. Compared to the TG1 group, the risk of MI increased to 1.32 folds in the TG4 group (95% CI: 1.05-1.66, P=0.018) and 1.61 folds in the TG5 group (95% CI: 1.21-1.93, P=0.004). Furthermore, the risk of MI combined with all-cause death and all-cause death also increased, but the differences were not all statistically significant. Conclusions In the study population of the Kailuan region, elevated fasting TG increases the risk of MI, particularly in populations with an age of ≥65 years old, BMI >25 kg/m2, FBG ≥6.1 mmol/L and HDL-C <1.5 mmol/L.
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Affiliation(s)
- Zhen-Yu Jiao
- The Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Xiao-Tao Li
- Department of Senile Disease, Beijing Wujing Zongdui Hospital, Beijing 100027, China
| | - Yan-Bing Li
- The Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Mei-Li Zheng
- The Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jun Cai
- The Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Shuo-Hua Chen
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan 063000, China
| | - Shou-Ling Wu
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan 063000, China
| | - Xin-Chun Yang
- The Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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Protein N-Glycosylation in Cardiovascular Diseases and Related Risk Factors. CURRENT CARDIOVASCULAR RISK REPORTS 2018. [DOI: 10.1007/s12170-018-0579-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Menni C, Gudelj I, Macdonald-Dunlop E, Mangino M, Zierer J, Bešić E, Joshi PK, Trbojević-Akmačić I, Chowienczyk PJ, Spector TD, Wilson JF, Lauc G, Valdes AM. Glycosylation Profile of Immunoglobulin G Is Cross-Sectionally Associated With Cardiovascular Disease Risk Score and Subclinical Atherosclerosis in Two Independent Cohorts. Circ Res 2018. [PMID: 29535164 PMCID: PMC5970566 DOI: 10.1161/circresaha.117.312174] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Supplemental Digital Content is available in the text. Rationale: One measure of protein glycosylation (GlycA) has been reported to predict higher cardiovascular risk by reflecting inflammatory pathways. Objective: The main objective of this study is to assess the role of a comprehensive panel of IgG glycosylation traits on traditional risk factors for cardiovascular disease and on presence of subclinical atherosclerosis in addition to GlycA. Methods and Results: We measured 76 IgG glycosylation traits in 2970 women (age range, 40–79 years) from the TwinsUK cohort and correlated it to their estimated 10-year atherosclerotic cardiovascular disease risk score and their carotid and femoral plaque measured by ultrasound imaging. Eight IgG glycan traits are associated with the 10-year atherosclerotic cardiovascular disease risk score after adjusting for multiple tests and for individual risk factors—5 with increased risk and 3 with decreased risk. These glycans replicated in 967 women from ORCADES cohort (Orkney Complex Disease Study), and 6 of them were also associated in 845 men. A linear combination of IgG glycans and GlycA is also associated with presence of carotid (odds ratio, 1.55; 95% confidence interval, 1.25–1.93; P=7.5×10-5) and femoral (odds ratio, 1.32; 95% confidence interval, 1.06–1.64; P=0.01) plaque in a subset of women with atherosclerosis data after adjustment for traditional risk factors. One specific glycosylation trait, GP18-the percentage of FA2BG2S1 glycan in total IgG glycans, was negatively correlated with very-low-density lipoprotein and triglyceride levels in serum and with presence of carotid plaque (odds ratio, 0.60; 95% confidence interval, 0.50–0.71; P=5×10-4). Conclusions: We find molecular pathways linking IgG to arterial lesion formation. Glycosylation traits are independently associated with subclinical atherosclerosis. One specific trait related to the sialylated N-glycan is negatively correlated with cardiovascular disease risk, very-low-density lipoprotein and triglyceride serum levels, and presence of carotid plaque.
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Affiliation(s)
- Cristina Menni
- From the Department of Twin Research and Genetic Epidemiology (C.M., M.M., J.Z., T.D.S., A.M.V.)
| | - Ivan Gudelj
- King's College London, United Kingdom; Genos Glycoscience Research Laboratory, Zagreb, Croatia (I.G., I.T.-A., G.L.)
| | - Erin Macdonald-Dunlop
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics (E.M.-D., P.K.J., J.F.W.)
| | - Massimo Mangino
- From the Department of Twin Research and Genetic Epidemiology (C.M., M.M., J.Z., T.D.S., A.M.V.).,University of Edinburgh, Scotland; National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' Foundation Trust, London, UK (M.M.)
| | - Jonas Zierer
- From the Department of Twin Research and Genetic Epidemiology (C.M., M.M., J.Z., T.D.S., A.M.V.).,Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Neuherberg, Germany (J.Z.)
| | - Erim Bešić
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Croatia (E.B., G.L.)
| | - Peter K Joshi
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics (E.M.-D., P.K.J., J.F.W.)
| | - Irena Trbojević-Akmačić
- King's College London, United Kingdom; Genos Glycoscience Research Laboratory, Zagreb, Croatia (I.G., I.T.-A., G.L.)
| | - Phil J Chowienczyk
- Department of Clinical Pharmacology, British Heart Foundation Centre (P.J.C.)
| | - Tim D Spector
- From the Department of Twin Research and Genetic Epidemiology (C.M., M.M., J.Z., T.D.S., A.M.V.)
| | - James F Wilson
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics (E.M.-D., P.K.J., J.F.W.).,Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, Western General Hospital (J.F.W.)
| | - Gordan Lauc
- King's College London, United Kingdom; Genos Glycoscience Research Laboratory, Zagreb, Croatia (I.G., I.T.-A., G.L.).,Faculty of Pharmacy and Biochemistry, University of Zagreb, Croatia (E.B., G.L.)
| | - Ana M Valdes
- From the Department of Twin Research and Genetic Epidemiology (C.M., M.M., J.Z., T.D.S., A.M.V.) .,School of Medicine, Nottingham City Hospital, United Kingdom (A.M.V.).,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, United Kingdom (A.M.V.)
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Arca M, Borghi C, Pontremoli R, De Ferrari GM, Colivicchi F, Desideri G, Temporelli PL. Hypertriglyceridemia and omega-3 fatty acids: Their often overlooked role in cardiovascular disease prevention. Nutr Metab Cardiovasc Dis 2018; 28:197-205. [PMID: 29397253 DOI: 10.1016/j.numecd.2017.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/12/2017] [Accepted: 11/06/2017] [Indexed: 01/12/2023]
Abstract
AIMS This review aims to describe the pathogenic role of triglycerides in cardiometabolic risk, and the potential role of omega-3 fatty acids in the management of hypertriglyceridemia and cardiovascular disease. DATA SYNTHESIS In epidemiological studies, hypertriglyceridemia correlates with an increased risk of cardiovascular disease, even after adjustment for low density lipoprotein cholesterol (LDL-C) levels. This has been further supported by Mendelian randomization studies where triglyceride-raising common single nucleotide polymorphisms confer an increased risk of developing cardiovascular disease. Although guidelines vary in their definition of hypertriglyceridemia, they consistently define a normal triglyceride level as <150 mg/dL (or <1.7 mmol/L). For patients with moderately elevated triglyceride levels, LDL-C remains the primary target for treatment in both European and US guidelines. However, since any triglyceride level in excess of normal increases the risk of cardiovascular disease, even in patients with optimally managed LDL-C levels, triglycerides are an important secondary target in both assessment and treatment. Dietary changes are a key element of first-line lifestyle intervention, but pharmacological treatment including omega-3 fatty acids may be indicated in people with persistently high triglyceride levels. Moreover, in patients with pre-existing cardiovascular disease, omega-3 supplements significantly reduce the risk of sudden death, cardiac death and myocardial infarction and are generally well tolerated. CONCLUSIONS Targeting resistant hypertriglyceridemia should be considered as a part of clinical management of cardiovascular risk. Omega-3 fatty acids may represent a valuable resource to this aim.
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Affiliation(s)
- M Arca
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Roma, Italy.
| | - C Borghi
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Ospedale Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - R Pontremoli
- Dipartimento di Medicina Interna, Università di Genova, Ospedale Policlinico San Martino, Genova, Italy
| | - G M De Ferrari
- Unità Coronarica e Laboratori Sperimentazione e Ricerca, Centro Clinico di Ricerca Cardiovascolare, IRCCS Fondazione Policlinico San Matteo, Dipartimento di Medicina Molecolare, Università degli Studi di Pavia, Pavia, Italy
| | - F Colivicchi
- UOC Cardiologia, Ospedale S. Filippo Neri, ASL ROMA 1, Roma, Italy
| | - G Desideri
- Facoltà di Medicina e Chirurgia, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - P L Temporelli
- Divisione di Cardiologia Riabilitativa, ICS Maugeri, IRCCS, Veruno-NO, Italy
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72
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Boursier G, Sultan A, Molinari N, Maimoun L, Boegner C, Picandet M, Kuster N, Bargnoux AS, Badiou S, Dupuy AM, Cristol JP, Avignon A. Triglycerides and glycated hemoglobin for screening insulin resistance in obese patients. Clin Biochem 2017; 53:8-12. [PMID: 29225096 DOI: 10.1016/j.clinbiochem.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/22/2017] [Accepted: 12/07/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Assessment of insulin resistance (IR) is essential in non-diabetic patients with obesity. Thus study aims to identify the best determinants of IR and to propose an original approach for routine assessment of IR in obesity. DESIGN AND PATIENTS All adult with obesity defined by a body mass index ≥30kg/m2, evaluated in the Nutrition Department between January 2010 and January 2015 were included in this cross-sectional study. Patients with diabetes were excluded. IR was diagnosed according to the HOMA-IR. Based on a logistic regression, we determined a composite score of IR. We then tested the variables with a principal component analysis and a hierarchical clustering analysis. RESULTS A total of 498 patients with obesity were included. IR was associated with grade III obesity (OR=2.6[1.6-4.4], p<0.001), HbA1c≥5.7% (OR=2.6[1.7-4.0], p<0.001), hypertriglyceridemia >1.7mmol/l (OR=3.0[2.0-4.5], p<0.001) and age (OR=0.98[0.96-0.99], p=0.002). Exploratory visual analysis using factor map and clustering analysis revealed that lipid and carbohydrates metabolism abnormalities were correlated with insulin resistance but not with excessive fat accumulation and low-grade inflammation. CONCLUSIONS Our results highlight the interest of simple blood tests such as HbA1c and triglyceride determination, which associated with BMI, may be widely available tools for screening IR in obese patients.
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Affiliation(s)
- Guilaine Boursier
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Biochemistry and Hormonology, CHU Montpellier, Montpellier, France
| | - Ariane Sultan
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Nutrition and Diabetes, CHU Montpellier, Montpellier, France
| | - Nicolas Molinari
- MISTEA, INRA, Univ Montpellier, Department of Statistics, CHU Montpellier, Montpellier, France
| | - Laurent Maimoun
- Department of Nuclear Medicine, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Catherine Boegner
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Nutrition and Diabetes, CHU Montpellier, Montpellier, France
| | - Marion Picandet
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Nutrition and Diabetes, CHU Montpellier, Montpellier, France
| | - Nils Kuster
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Biochemistry and Hormonology, CHU Montpellier, Montpellier, France
| | - Anne-Sophie Bargnoux
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Biochemistry and Hormonology, CHU Montpellier, Montpellier, France
| | - Stéphanie Badiou
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Biochemistry and Hormonology, CHU Montpellier, Montpellier, France
| | - Anne-Marie Dupuy
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Biochemistry and Hormonology, CHU Montpellier, Montpellier, France
| | - Jean-Paul Cristol
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Biochemistry and Hormonology, CHU Montpellier, Montpellier, France.
| | - Antoine Avignon
- PHYMEDEXP, CNRS, INSERM, Univ Montpellier, Department of Nutrition and Diabetes, CHU Montpellier, Montpellier, France
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Mărginean CO, Meliţ LE, Dobreanu M, Mărginean MO. Type V hypertriglyceridemia in children, a therapeutic challenge in pediatrics: A case report and a review of the literature. Medicine (Baltimore) 2017; 96:e8864. [PMID: 29390422 PMCID: PMC5758124 DOI: 10.1097/md.0000000000008864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RATIONALE Hypertriglyceridemia is defined as a level of triglycerides above 150 mg/dL. The complex causes and classification of hypertriglyceridemia lead to difficulties in the diagnosis and management of this condition. PATIENT CONCERNS We present the case of a 15 years and 6 months old female teenager, admitted in our clinic for the following complaints: severe abdominal pain predominantly in the lateral left quadrant, nausea, vomiting, and the lack of stools for 2 days. The clinical exam showed: impaired general status, painful abdomen at superficial and deep palpation in the left and upper abdominal quadrants, the absence of stools for 2 days. DIAGNOSES The laboratory parameters revealed leukocytosis with neutrophilia, thrombocytopenia, high level of serum amylase and triglycerides, and increased inflammatory biomarkers. The imagistic investigations showed ascites and paralytic ileus. INTERVENTIONS The management was burdened by the side-effects of hypolipidemic drugs impairing the liver function and leading to rhabdomyolysis, but eventually the patient's outcome was good. OUTCOMES Type V hyperlipoproteinemia is a rare condition accounting for approximately 5% of the cases. The risk for acute pancreatitis is well-known to be associated with hypertriglyceridemia, even though in rare cases. LESSONS The prognosis of hypertriglyceridemia is pediatrics is burdened not only by the long-term risk factors associated to the diseases itself, but also by the negative effects of long-term hypolipidemic treatment.
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Affiliation(s)
| | - Lorena Elena Meliţ
- Department of Pediatrics I, University of Medicine and Pharmacy Tirgu Mureş, Romania
| | - Minodora Dobreanu
- Department of Laboratory Medicine, University of Medicine and Pharmacy Tirgu Mureş, Romania
| | - Maria Oana Mărginean
- Department of Pediatrics I, University of Medicine and Pharmacy Tirgu Mureş, Romania
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Malinska H, Škop V, Trnovska J, Markova I, Svoboda P, Kazdova L, Haluzik M. Metformin attenuates myocardium dicarbonyl stress induced by chronic hypertriglyceridemia. Physiol Res 2017; 67:181-189. [PMID: 29137475 DOI: 10.33549/physiolres.933606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Reactive dicarbonyls stimulate production of advanced glycation endproducts, increase oxidative stress and inflammation and contribute to the development of vascular complications. We measured concentrations of dicarbonyls - methylglyoxal (MG), glyoxal (GL) and 3-deoxyglucosone (3-DG) - in the heart and kidney of a model of metabolic syndrome - hereditary hypertriglyceridemic rats (HHTg) and explored its modulation by metformin. Adult HHTg rats were fed a standard diet with or without metformin (300 mg/kg b.w.) and dicarbonyl levels and metabolic parameters were measured. HHTg rats had markedly elevated serum levels of triacylglycerols (p<0.001), FFA (p<0.01) and hepatic triacylglycerols (p<0.001) along with increased concentrations of reactive dicarbonyls in myocardium (MG: p<0.001; GL: p<0.01; 3-DG: p<0.01) and kidney cortex (MG: p<0.01). Metformin treatment significantly reduced reactive dicarbonyls in the myocardium (MG: p<0.05, GL: p<0.05, 3-DG: p<0.01) along with increase of myocardial concentrations of reduced glutathione (p<0.01) and glyoxalase 1 mRNA expression (p<0.05). Metformin did not have any significant effect on dicarbonyls, glutathione or on glyoxalase 1 expression in kidney cortex. Chronically elevated hypertriglyceridemia was associated with increased levels of dicarbonyls in heart and kidney. Beneficial effects of metformin on reactive dicarbonyls and glyoxalase in the heart could contribute to its cardioprotective effects.
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Affiliation(s)
- H Malinska
- Department of Cardio-Metabolic Research, Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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Eicosapentaenoic Acid Inhibits Oxidation of ApoB-containing Lipoprotein Particles of Different Size In Vitro When Administered Alone or in Combination With Atorvastatin Active Metabolite Compared With Other Triglyceride-lowering Agents. J Cardiovasc Pharmacol 2017; 68:33-40. [PMID: 26945158 PMCID: PMC4936437 DOI: 10.1097/fjc.0000000000000379] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Eicosapentaenoic acid (EPA) is a triglyceride-lowering agent that reduces circulating levels of the apolipoprotein B (apoB)-containing lipoprotein particles small dense low-density lipoprotein (sdLDL), very–low-density lipoprotein (VLDL), and oxidized low-density lipoprotein (LDL). These benefits may result from the direct antioxidant effects of EPA. To investigate this potential mechanism, these particles were isolated from human plasma, preincubated with EPA in the absence or presence of atorvastatin (active) metabolite, and subjected to copper-initiated oxidation. Lipid oxidation was measured as a function of thiobarbituric acid reactive substances formation. EPA inhibited sdLDL (IC50 ∼2.0 μM) and LDL oxidation (IC50 ∼2.5 μM) in a dose-dependent manner. Greater antioxidant potency was observed for EPA in VLDL. EPA inhibition was enhanced when combined with atorvastatin metabolite at low equimolar concentrations. Other triglyceride-lowering agents (fenofibrate, niacin, and gemfibrozil) and vitamin E did not significantly affect sdLDL, LDL, or VLDL oxidation compared with vehicle-treated controls. Docosahexaenoic acid was also found to inhibit oxidation in these particles but over a shorter time period than EPA. These data support recent clinical findings and suggest that EPA has direct antioxidant benefits in various apoB-containing subfractions that are more pronounced than those of other triglyceride-lowering agents and docosahexaenoic acid.
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Abstract
Hypertriglyceridemia is increasingly identified in children and adolescents, owing to improved screening and higher prevalence of childhood obesity. Hypertriglyceridemia can result from either increased triglyceride (TG) production or reduced TG clearance. The etiologic origin can be primary (genetic) or secondary, but it is often multifactorial. Management is challenging because of the interplay of genetic and secondary causes and lack of evidence-based guidelines. Lifestyle changes and dietary interventions are most important, especially in hypertriglyceridemia associated with obesity. Dietary restriction of fat remains the mainstay of management in primary hypertriglyceridemia. When fasting TG concentration is increased above 500 mg/dL (5.65 mmol/L), fibrates may be used to prevent pancreatitis. Omega-3 fatty acids are often used as an adjunctive therapy. When the fasting TG concentration is less than 500 mg/dL (5.65 mmol/L) and if the non-high-density lipoprotein cholesterol level is above 145 mg/dL (3.76 mmol/L), statin treatment can be considered.
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Affiliation(s)
- Badhma Valaiyapathi
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Bhuvana Sunil
- Department of Pediatrics, Harlem Hospital Center, New York, NY
| | - Ambika P Ashraf
- Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL
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Oleszko A, Hartwich J, Wójtowicz A, Gąsior-Głogowska M, Huras H, Komorowska M. Comparison of FTIR-ATR and Raman spectroscopy in determination of VLDL triglycerides in blood serum with PLS regression. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2017; 183:239-246. [PMID: 28454077 DOI: 10.1016/j.saa.2017.04.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/13/2017] [Accepted: 04/16/2017] [Indexed: 06/07/2023]
Abstract
Hypertriglyceridemia, related with triglyceride (TG) in plasma above 1.7mmol/L is one of the cardiovascular risk factors. Very low density lipoproteins (VLDL) are the main TG carriers. Despite being time consuming, demanding well-qualified staff and expensive instrumentation, ultracentrifugation technique still remains the gold standard for the VLDL isolation. Therefore faster and simpler method of VLDL-TG determination is needed. Vibrational spectroscopy, including FT-IR and Raman, is widely used technique in lipid and protein research. The aim of this study was assessment of Raman and FT-IR spectroscopy in determination of VLDL-TG directly in serum with the isolation step omitted. TG concentration in serum and in ultracentrifugated VLDL fractions from 32 patients were measured with reference colorimetric method. FT-IR and Raman spectra of VLDL and serum samples were acquired. Partial least square (PLS) regression was used for calibration and leave-one-out cross validation. Our results confirmed possibility of reagent-free determination of VLDL-TG directly in serum with both Raman and FT-IR spectroscopy. Quantitative VLDL testing by FT-IR and/or Raman spectroscopy applied directly to maternal serum seems to be promising screening test to identify women with increased risk of adverse pregnancy outcomes and patient friendly method of choice based on ease of performance, accuracy and efficiency.
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Affiliation(s)
- Adam Oleszko
- Wrocław University of Science and Technology, Faculty of Fundamental Problems of Technology, Department of Biomedical Engineering, 27 Stanisława Wyspiańskiego St., 50-370 Wrocław, Poland.
| | - Jadwiga Hartwich
- Jagiellonian University Medical College, Department of Analytical Biochemistry, 9 Medyczna St., 30-688 Kraków, Poland
| | - Anna Wójtowicz
- Jagiellonian University, Kraków, Department of Obstetrics & Perinatology, 23 Kopernika St., 31-501 Krakow, Poland
| | - Marlena Gąsior-Głogowska
- Wrocław University of Science and Technology, Faculty of Fundamental Problems of Technology, Department of Biomedical Engineering, 27 Stanisława Wyspiańskiego St., 50-370 Wrocław, Poland
| | - Hubert Huras
- Jagiellonian University, Kraków, Department of Obstetrics & Perinatology, 23 Kopernika St., 31-501 Krakow, Poland
| | - Małgorzata Komorowska
- Wrocław University of Science and Technology, Faculty of Fundamental Problems of Technology, Department of Biomedical Engineering, 27 Stanisława Wyspiańskiego St., 50-370 Wrocław, Poland
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Hypertriglyceridemia, an Underestimated Cardiovascular Risk Factor: An Epidemiological Study of the Rome Area. High Blood Press Cardiovasc Prev 2017; 24:401-404. [DOI: 10.1007/s40292-017-0222-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022] Open
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Naqvi S, Naveed S, Ali Z, Ahmad SM, Asadullah Khan R, Raj H, Shariff S, Rupareliya C, Zahra F, Khan S. Correlation between Glycated Hemoglobin and Triglyceride Level in Type 2 Diabetes Mellitus. Cureus 2017; 9:e1347. [PMID: 28713663 PMCID: PMC5509244 DOI: 10.7759/cureus.1347] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Context Dyslipidemia is quite prevalent in non-insulin dependent diabetes mellitus. Maintaining tight glycemic along with lipid control plays an essential role in preventing micro- and macro-vascular complications associated with diabetes. Purpose The main purpose of the study was to highlight the relationship between glycosylated hemoglobin (HbA1c) and triglyceride levels. This may in turn help in predicting the triglyceride status of type 2 diabetics and therefore identifying patients at increased risk from cardiovascular events. Hypertriglyceridemia is one of the common risk factors for coronary artery disease in type 2 diabetes mellitus (DM). Careful monitoring of the blood glucose level can be used to predict lipid status and can prevent most of the complications associated with the disease. Method This is a cross-sectional study using data collected from the outpatient diabetic clinic of Jinnah Postgraduate Medical Centre (JPMC) Karachi, Pakistan. Patients of age 18 years and above were recruited from the clinic. A total of consenting 509 patients of type 2 diabetes mellitus were enrolled over a period of 11 months. For statistical analysis, SPSS Statistics for Windows, Version 17.0 ( IBM Corp, Armonk, New York) was used and Chi-square and Pearson’s correlation coefficient was used to find the association between triglyceride and HbA1c. The HbA1c was dichotomized into four groups on the basis of cut-off. Chi-square was used for association between HbA1c with various cut-off values and high triglyceride levels. Odds-ratio and its 95% confidence interval were calculated to estimate the level of risk between high triglyceride levels and HbA1c groups. The p-value < 0.05 was considered statistically significant for all the tests applied for significance. Result The association of high triglyceride was evaluated in four different groups of HbA1c, with a cut-off seven, eight, nine and 10 respectively. With HbA1c cut-off value of 7%, 74% patients had high triglycerides and showed a significant association with high triglyceride levels at p < 0.001 and odds ratio was 2.038 (95% confidence interval: 1.397 – 2.972). Logistic regression models were adjusted for demographic factors (age, race, gender), lifestyle factors (smoking, body mass index, lifestyle) and health status factors (blood pressure, physician-rated health status). Conclusion After adjusting for relevant covariates, glycated hemoglobin was positively correlated with high triglyceride. Hence, HbA1c can be an indicator of triglyceride level and can be one of the predictors of cardiovascular risk factors in type 2 diabetes mellitus.
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Affiliation(s)
- Syeda Naqvi
- Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)
| | - Shabnam Naveed
- Internal Medicine, Jinnah Sindh Medical University (SMC)
| | - Zeeshan Ali
- Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC)
| | | | | | - Honey Raj
- Jinnah Postgraduate Medical Centre, Baqai Medical College
| | | | | | | | - Saba Khan
- Internal Medicine, Jinnah Sindh Medical University (SMC)
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No Effect of Omega-3 Carboxylic Acids on Pharmacokinetics/Pharmacodynamics of Warfarin or on Platelet Function When Co-administered with Acetylsalicylic Acid: Results of Two Phase I Studies in Healthy Volunteers. Am J Cardiovasc Drugs 2017; 17:251-260. [PMID: 28197979 DOI: 10.1007/s40256-017-0217-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Omega-3 carboxylic acids (OM3-CA) can lower triglyceride levels. OBJECTIVE Our objective was to assess the effects of OM3-CA on warfarin pharmacokinetics and pharmacodynamics and on acetylsalicylic acid (ASA)-dependent and independent platelet activation when co-administered with ASA in two phase I studies. METHODS In ECLIPSE II (NCT01431690), 26 participants received warfarin 25 mg on days 1 and 22 and OM3-CA 4 g once daily from day 8 to day 28. In OM-EPA-007 (NCT01486433), 52 participants received simvastatin 40 mg plus ASA 81 mg once daily for 14 days, with or without OM3-CA 4 g. Lack of a drug-drug interaction was indicated when 90% confidence intervals (CIs) fell entirely within the range 80-125% for least-squares mean (LSM) ratios of area under the concentration-time curve (AUC), maximum observed plasma concentration (C max), international normalized ratio (INR) AUC to 168 h and maximum INR. RESULTS In ECLIPSE II, 90% CIs for LSM ratios of with:without OM3-CA fell within 80-125% for AUC and C max of S- and R-warfarin enantiomers. The 90% CIs for LSM ratios of with:without OM3-CA fell within 80-125% for INR AUC to 168 h after dosing and for maximum INR of warfarin. In OM-EPA-007, no significant effect of OM3-CA was observed on ASA-dependent or ASA-independent platelet activation. No deaths or serious adverse events occurred in either study. CONCLUSION OM3-CA did not affect the pharmacokinetics or pharmacodynamics of warfarin or the pharmacodynamic effects of ASA. OM3-CA did not affect platelet function when co-administered with ASA.
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Paalvast Y, de Boer JF, Groen AK. Developments in intestinal cholesterol transport and triglyceride absorption. Curr Opin Lipidol 2017; 28:248-254. [PMID: 28338522 DOI: 10.1097/mol.0000000000000415] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW To discuss recent advances in research focused on intestinal lipid handling. RECENT FINDINGS An important strategy in reducing atherosclerosis and risk of cardiovascular events is to increase the rate of reverse cholesterol transport, including its final step; cholesterol excretion from the body. The rate of removal is determined by a complex interplay between the factors involved in regulation of intestinal cholesterol absorption. One of these factors is a process known as transintestinal cholesterol excretion. This pathway comprises transport of cholesterol directly from the blood, through the enterocyte, into the intestinal lumen. In humans, this pathway accounts for 35% of cholesterol excretion in the feces. Mechanistic studies in mice revealed that, activation of the bile acid receptor farnesoid X receptor increases cholesterol removal via the transintestinal cholesterol excretion pathway as well as decreases plasma cholesterol and triglyceride providing an interesting target for treatment of dyslipidemia in humans. The physical chemical properties of bile acids are under control of farnesoid X receptor and determine intestinal cholesterol and triglyceride solubilization as well as absorption, providing a direct link between these two important factors in the pathogenesis of cardiovascular disease. Besides bile acids, intestinal phospholipids are important for luminal lipid solubilization. Interestingly, phospholipid remodeling through LPCAT3 was shown to be pivotal for uptake of fatty acids by enterocytes, which may provide a mechanistic handle for therapeutic intervention. SUMMARY The importance of the intestine in control of cholesterol and triglyceride homeostasis is increasingly recognized. Recently, novel factors involved in regulation of cholesterol excretion and intestinal triglyceride and fatty acid uptake have been reported and are discussed in this short review.
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Affiliation(s)
- Yared Paalvast
- aDepartment of Pediatrics bDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen cDepartment of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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82
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Arterial function parameters in patients with metabolic syndrome and severe hypertriglyceridemia. J Clin Lipidol 2017; 11:901-907. [PMID: 28595894 DOI: 10.1016/j.jacl.2017.04.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/10/2017] [Accepted: 04/25/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Hypertriglyceridemia (hTG) is 1 of the dyslipidemia manifestations in patients with metabolic syndrome (MetS). However, for several decades, the role of hTG in cardiovascular risk was not well established. OBJECTIVE The aim of this study was to assess the parameters of the vascular structure and function in patients with MetS and different degree of hTG. METHODS Patients (aged 40-65 years) with MetS were divided into 3 groups by triglyceride (TG) levels according to National Cholesterol Education Program Adult Treatment Panel III Guidelines: severe hTG (TG ≥ 500 mg/dL), moderate hTG (TG 200-499 mg/dL), and a control (TG < 150 mg/dL) groups. Noninvasive assessment of vascular parameters (aortic augmentation index adjusted for heart rate 75 bpm [AixHR75], pulse wave velocity [PWV], flow-mediated dilatation, and common carotid artery intima-media thickness (IMT)) were performed. RESULTS Among the 1938 patients analyzed, 1041 had hTG. Moderate hTG was observed in 90.40% (n = 941), whereas severe TG was observed in 9.6% (n = 100) of patients. Overall TG concentration was 231.17 ± 184.23 mg/dL; in severe hTG group, TG concentration was 795.36 ± 368.45 mg/dL, in moderate hTG group 285.20 ± 70.86 mg/dL, and 112.48 ± 24.80 mg/dL in control group. AIxHR75 and IMT were the lowest in the severe hTG group (P < .001 for both). Mean arterial pressure, carotid-radial PWV (9.25 ± 1.13 vs 9.24 ± 1.28 vs 8.91 ± 1.28; P < .001) as well as carotid-femoral PWV (8.63 ± 1.65 vs 8.75 ± 1.58 vs 8.51 ± 1.6; P = .006) were the higher in hTG groups compared with control. There were no significant differences between groups in flow-mediated dilatation (3.39 ± 2.01 vs 3.26 ± 2.43 vs 3.45 ± 2.61, P = .283). CONCLUSIONS Patients with MetS and severe hTG have lower IMT and AIxHR75 and higher PWV and mean arterial pressure. Many factors could affect arterial parameters, and more research are needed to investigate arterial parameters and hTG connection.
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83
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Assessment of pharmacokinetic interaction between omega-3 carboxylic acids and the statins rosuvastatin and simvastatin: Results of 2 phase I studies in healthy volunteers. J Clin Lipidol 2017; 11:739-748. [DOI: 10.1016/j.jacl.2017.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 03/28/2017] [Indexed: 11/19/2022]
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84
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Sayar F, Akhondi N, Fallah S, Moalemnia AA, Cheraghi A. Association of Serum Triglyceride Level and Gemfibrozil Consumption With Periodontal Status. J Periodontol 2017; 88:457-463. [DOI: 10.1902/jop.2016.160366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ferena Sayar
- Department of Periodontics, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
| | - Nasrin Akhondi
- Department of Mathematics, South Tehran Branch, Islamic Azad University
| | | | | | - Azra Cheraghi
- Department of Periodontics, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
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85
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Chang Y, Robidoux J. Dyslipidemia management update. Curr Opin Pharmacol 2017; 33:47-55. [DOI: 10.1016/j.coph.2017.04.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/27/2017] [Accepted: 04/19/2017] [Indexed: 12/11/2022]
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86
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Abstract
: Since the introduction of HMG-CoA reductase inhibitors, also known as statins, as an adjunct to diet in the treatment of hyperlipidemia and the greater emphasis placed on reducing low-density lipoprotein (LDL) cholesterol levels in the prevention of atherosclerosis and cardiovascular disease (CVD), there has been less focus on the value of lowering serum triglyceride levels. Many patients are aware of their "good" and "bad" cholesterol levels, but they may not be aware of their triglyceride level or of the association between high triglycerides and the development of CVD. In recent years, however, in light of the increasing incidences of obesity, insulin resistance, and type 2 diabetes, lowering triglyceride levels has gained renewed interest. In addition to the focus on lowering LDL cholesterol levels in CVD prevention, clinicians need to be aware of the role of triglycerides-their contribution to CVD, and the causes and treatment of hypertriglyceridemia.
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87
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Abstract
An elevated serum level of LDL cholesterol is a well-known risk factor for cardiovascular disease (CVD), but the role of elevated triglyceride levels is debated. Controversies regarding hypertriglyceridaemia as an independent risk factor for CVD have occurred partly because elevated triglyceride levels are often a component of atherogenic dyslipidaemia - they are associated with decreased levels of HDL cholesterol and increased levels of small dense LDL particles, which are highly atherogenic. Findings from several large studies indicate that elevated levels of triglycerides (either fasting or nonfasting) or, more specifically, triglyceride-rich lipoproteins and their remnants, are independently associated with increased risk of CVD. Possible mechanisms for this association include excessive free fatty acid release, production of proinflammatory cytokines, coagulation factors, and impairment of fibrinolysis. Therapeutic targeting of hypertriglyceridaemia could, therefore, reduce CVD and cardiovascular events, beyond the reduction achieved by LDL-cholesterol lowering. Elevated triglyceride levels are reduced with lifestyle interventions and fibrates, which can be combined with omega-3 fatty acids. Some new drugs are on the horizon, such as volanesorsen (which targets apolipoprotein C-III), pemafibrate, and others. However, CVD outcome studies with triglyceride-lowering agents have produced inconsistent results, meaning that no convincing evidence is available that lowering triglycerides by any approach can reduce mortality.
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88
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Systemic Bioavailability and Dose Proportionality of Omega-3 Administered in Free Fatty Acid Form Compared With Ethyl Ester Form: Results of a Phase 1 Study in Healthy Volunteers. Eur J Drug Metab Pharmacokinet 2017; 42:815-825. [DOI: 10.1007/s13318-016-0398-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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89
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Autosomal dominant familial dysbetalipoproteinemia: A pathophysiological framework and practical approach to diagnosis and therapy. J Clin Lipidol 2017; 11:12-23.e1. [DOI: 10.1016/j.jacl.2016.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/26/2016] [Accepted: 10/02/2016] [Indexed: 11/18/2022]
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90
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Włodarczyk M, Wrzosek M, Nowicka G, Jabłonowska-Lietz B. Impact of variants in CETP and apo AI genes on serum HDL cholesterol levels in men and women from the Polish population. Arch Med Sci 2016; 12:1188-1198. [PMID: 27904507 PMCID: PMC5108385 DOI: 10.5114/aoms.2016.60870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/03/2015] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Polymorphisms in the cholesterol ester transfer protein (CETP) gene and apolipoprotein AI (apo AI) gene are identified as the most common genetic factors influencing high-density lipoprotein cholesterol (HDL cholesterol) levels. Low HDL cholesterol is an important risk factor for cardiovascular disease. We investigated the effect of the TaqIB polymorphism of the CETP gene and the 75G/A polymorphism of the apo AI gene on the HDL cholesterol concentration in a sample of Polish adults. MATERIAL AND METHODS A total of 621 subjects, 414 women and 207 men, were included in this study. Lipid levels were measured using standard protocols, and apolipoprotein AI was determined by immunoturbidimetric assay. CETP and apo AI genotyping was performed using a restriction fragment length polymorphism based method. RESULTS Significantly lower HDL cholesterol concentrations were found in B1B1 homozygotes than in carriers of the B2 allele of the TaqIB polymorphism in the CETP gene among both men and women. In GG homozygotes of the 75G/A polymorphism in the apo AI gene lower HDL cholesterol levels were observed, but the difference did not reach statistical significance. A statistically significant association of low HDL cholesterol (< 25th percentile) with CETP genotypes was found in women (p < 0.0001) and in men (p = 0.0368). CONCLUSIONS These data demonstrate a significant impact of the TaqIB polymorphism in the CETP gene on HDL cholesterol levels in the studied Polish population, while the effect of the 75G/A polymorphism in the apo AI gene appears not to be significant.
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Affiliation(s)
- Marta Włodarczyk
- Department of Pharmacogenomics, Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Małgorzata Wrzosek
- Department of Pharmacogenomics, Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Grażyna Nowicka
- Department of Pharmacogenomics, Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Beata Jabłonowska-Lietz
- Center of Promotion of Healthy Nutrition and Physical Activity, National Food and Nutrition Institute, Warsaw, Poland
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91
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Akyol S, Lu J, Akyol O, Akcay F, Armutcu F, Ke LY, Chen CH. The role of electronegative low-density lipoprotein in cardiovascular diseases and its therapeutic implications. Trends Cardiovasc Med 2016; 27:239-246. [PMID: 28040327 DOI: 10.1016/j.tcm.2016.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/01/2016] [Accepted: 11/15/2016] [Indexed: 11/30/2022]
Abstract
Cardiovascular disease (CVD) is a health problem of great concern to both the public and medical authorities. Low-density lipoprotein (LDL) has been reported to play an important role in both the development and progression of CVD, but studies are underway to determine how LDL exerts its effects. In recent years, it has been found that LDL has several subfractions, each of which affects endothelial function differently; L5, the most electronegative fraction, has been shown to be unique in that it induces an atherogenic response. This review examines the current knowledge concerning the relationships between L5 and CVD and highlights the role of L5 in the pathophysiology of CVD, especially with regards to atherosclerosis.
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Affiliation(s)
- Sumeyya Akyol
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA; Department of Medical Biology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey.
| | - Jonathan Lu
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA
| | - Omer Akyol
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA; Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatih Akcay
- Department of Medical Biochemistry, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ferah Armutcu
- Department of Medical Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Liang-Yin Ke
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chu-Huang Chen
- Vascular & Medicinal Research, Texas Heart Institute, 6770 Bertner Avenue, MC 2-255, Houston, TX 77030, USA; Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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92
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Siegmund LA, Naylor J, Bena J, McClelland M. The relationship between Metabolic Syndrome and adherence to cardiac rehabilitation. Physiol Behav 2016; 169:41-45. [PMID: 27840095 DOI: 10.1016/j.physbeh.2016.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/09/2016] [Accepted: 11/09/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Lee Anne Siegmund
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States.
| | - Jonathan Naylor
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States
| | - James Bena
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States
| | - Mark McClelland
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States
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93
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Han T, Cheng Y, Tian S, Wang L, Liang X, Duan W, Na L, Sun C. Changes in triglycerides and high-density lipoprotein cholesterol may precede peripheral insulin resistance, with 2-h insulin partially mediating this unidirectional relationship: a prospective cohort study. Cardiovasc Diabetol 2016; 15:154. [PMID: 27814764 PMCID: PMC5095985 DOI: 10.1186/s12933-016-0469-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/26/2016] [Indexed: 12/31/2022] Open
Abstract
Background Results of longitudinal researches regarding the temporal relationship between dyslipidemia and insulin resistance (IR) are inconsistent. This study assessed temporal relationships of blood lipids with IR and determined whether there are any mediating effects existed in these temporal relationships. Methods This study examined a longitudinal cohort of 3325 subjects aged 20–74 years from China with an average of 4.2 years follow-up. Measurements of fasting blood lipids, as well as fasting and 2-h serum glucose and insulin, were obtained at two time points. The Gutt index and HOMA-IR were calculated as indicators of peripheral IR and hepatic IR. A cross-lagged path analysis was performed to examine the temporal relationships between blood lipids and IR. A mediation analysis was used to examine mediating effect. Results After adjusting for covariates, the cross-lagged path coefficients from baseline TG and HDL-C to follow-up Gutt index were significantly greater than those from baseline Gutt index to follow-up TG and HDL-C (β1 = −0.131 vs β2 = −0.047, P < 0.001 for TG; β1 = 0.134 vs β2 = 0.023, P < 0.001 for HDL-C). The path coefficients from baseline TG and HDL-C to follow-up 2-h insulin were significantly greater than those from baseline 2-h insulin to follow-up TG and HDL-C (β1 = 0.125 vs β2 = 0.040, P < 0.001 for TG; β1 = −0.112 vs β2 = −0.026, P < 0.001 for HDL-C). 2-h insulin partially mediated the effect of TG/HDL-C on Gutt index with a 59.3% mediating effect for TG and 61.0% for HDL-C. Conclusions These findings provide strong evidence that dyslipidemia probably precede peripheral IR and that 2-h insulin partially mediates this unidirectional temporal relationship. Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0469-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tianshu Han
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Yu Cheng
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Shuang Tian
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Li Wang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Xi Liang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Wei Duan
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Lixin Na
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China.
| | - Changhao Sun
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China.
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94
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Younis A, Younis A, Tzur B, Peled Y, Shlomo N, Goldenberg I, Fisman EZ, Tenenbaum A, Klempfner R. Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease. Cardiovasc Diabetol 2016; 15:149. [PMID: 27793156 PMCID: PMC5084328 DOI: 10.1186/s12933-016-0466-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/20/2016] [Indexed: 02/06/2023] Open
Abstract
Background Data regarding long-term association of metabolic syndrome (MetS) with adverse outcomes are conflicting. We aim to determine the independent association of MetS (based on its different definitions) with 20 year all-cause mortality among patients with stable coronary artery disease (CAD). Methods Our study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction Prevention registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014. MetS was defined according to two definitions: The International Diabetes Federation (IDF); and the National Cholesterol Education Program–Third Adult Treatment Panel (NCEP). Results According to the IDF criteria 2122 (14%) patients had MetS, whereas according to the NCEP definition 7446 (48%) patients had MetS. Kaplan–Meier survival analysis showed that all-cause mortality was significantly higher among patients with MetS defined by both the IDF (67 vs. 61%; log rank-p < 0.001) as well as NCEP (67 vs. 54%; log rank-p < 0.001) criteria. Multivariate adjusted mortality risk was 17% greater [Hazard Ratio (HR) 1.17; 95% Confidence Interval (CI) 1.07–1.28] in patients with MetS according to IDF and 21% (HR 1.21; 95% CI 1.13–1.29) using the NCEP definition. Subgroup analysis demonstrated that long-term increased mortality risk associated with MetS was consistent among most clinical subgroups excepted patients with renal failure (p value for interaction < 0.05). Conclusions Metabolic syndrome is independently associated with an increased 20-year all-cause mortality risk among patients with stable CAD. This association was consistent when either the IDF or NCEP definitions were used. Trial registration retrospective registered Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0466-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Arwa Younis
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.
| | - Anan Younis
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Boaz Tzur
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Yael Peled
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Nir Shlomo
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel
| | - Ilan Goldenberg
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel.,Heart Research Follow-up Program, University of Rochester, Rochester, NY, USA
| | - Enrique Z Fisman
- Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel.,Cardiovascular Diabetology Research Foundation, Holon, Israel
| | - Alexander Tenenbaum
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel.,Cardiovascular Diabetology Research Foundation, Holon, Israel
| | - Robert Klempfner
- The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.,Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel
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95
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Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Fernando R, Marti R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos R, Gomez-Marcos MA. Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial. Cardiovasc Diabetol 2016; 15:148. [PMID: 27776526 PMCID: PMC5078926 DOI: 10.1186/s12933-016-0465-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 10/06/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV) can reflect both central and peripheral arterial stiffness. Metabolic syndrome (MetS) and its components may increase arterial stiffness and the risk of cardiovascular diseases. However, the correlation of MetS and its components with arterial stiffness is still not clear. The primary aim of this study is thus the relationship using baPWV and CAVI in Caucasian adults with intermediate cardiovascular risk. The secondary aim is to analyze sex differences. METHODS This study analyzed 2351 subjects aged 35-74 years (mean, 61.4 ± 7.7 years) comprising 61.7 % males and enrolled in the improving interMediAte Risk management (MARK) study. CAVI was measured using a VaSera VS-1500 ® device, and baPWV was calculated using a validated equation. MetS was defined based on the Joint Scientific Statement National Cholesterol Education Program III. Waist circumference, blood pressure, fasting plasma glucose, and lipid profile were measured. RESULTS MetS was found in 51.9 % of the subjects. All MetS components except reduced HDL-cholesterol (p = 0.578) were associated with CAVI. High density lipoprotein cholesterol (p = 0.075) and waist circumference (p = 0.315) were associated with baPWV. The different MetS components that assess dyslipidemia using the stiffness measures show different associations according to patient sex. The high blood pressure component had a greater odds ratio (OR) for both baPWV ≥ 17.5 m/sec (OR = 6.90, 95 % CI 3.52-13.519) and CAVI ≥ 9 (OR = 2.20, 95 % CI 1.63-1.90). CONCLUSIONS MetS and all its components (except HDL-cholesterol with baPWV and CAVI and WC with baPWV) were associated with baPWV and CAVI. However, there were sex differences in the association of MetS and its components with baPWV and CAVI. Data from this study suggest a greater association of CAVI and baPWV values with MetS components in males than in females and indicate greater arterial stiffness in the event of simultaneously elevated blood pressure, fasting plasma glucose, and waist circumference. Trial Registration Clinical Trials.gov Identifier: https://clinicaltrials.gov/ct2/show/ NCT01428934. Registered 2 September 2011. Last updated September 8, 2016.
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Affiliation(s)
| | - Luis Garcia-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, 37003, Salamanca, Spain.,Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Biomedical and Diagnostic Sciences Department, University of Salamanca, Salamanca, Spain
| | - M Carmen Patino-Alonso
- Primary Care Research Unit, The Alamedilla Health Center, 37003, Salamanca, Spain.,Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Statistics Department, University of Salamanca, Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Primary Care Research Unit, The Alamedilla Health Center, 37003, Salamanca, Spain.,Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Rigo Fernando
- San Agustín Health Center, Illes Balears Health Service (IBSALUT), Palma of Mallorca, Spain
| | - Ruth Marti
- Unitat of Suport a the Recerca of Girona, Institut Universitari D'Investigació in Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDBGI), Girona, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, 37003, Salamanca, Spain.,Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, 37003, Salamanca, Spain.,Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- Primary Care Research Unit, The Alamedilla Health Center, 37003, Salamanca, Spain.,Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Rafel Ramos
- Unitat of Suport a the Recerca of Girona, Institut Universitari D'Investigació in Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDBGI), Girona, Spain.,Departament of Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain
| | - Manuel A Gomez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, 37003, Salamanca, Spain.,Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Medicine, University of Salamanca, Salamanca, Spain
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96
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Grasgruber P, Sebera M, Hrazdira E, Hrebickova S, Cacek J. Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries. Food Nutr Res 2016; 60:31694. [PMID: 27680091 PMCID: PMC5040825 DOI: 10.3402/fnr.v60.31694] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/12/2016] [Accepted: 08/09/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this ecological study was to identify the main nutritional factors related to the prevalence of cardiovascular diseases (CVDs) in Europe, based on a comparison of international statistics. DESIGN The mean consumption of 62 food items from the FAOSTAT database (1993-2008) was compared with the actual statistics of five CVD indicators in 42 European countries. Several other exogenous factors (health expenditure, smoking, body mass index) and the historical stability of results were also examined. RESULTS We found exceptionally strong relationships between some of the examined factors, the highest being a correlation between raised cholesterol in men and the combined consumption of animal fat and animal protein (r=0.92, p<0.001). The most significant dietary correlate of low CVD risk was high total fat and animal protein consumption. Additional statistical analyses further highlighted citrus fruits, high-fat dairy (cheese) and tree nuts. Among other non-dietary factors, health expenditure showed by far the highest correlation coefficients. The major correlate of high CVD risk was the proportion of energy from carbohydrates and alcohol, or from potato and cereal carbohydrates. Similar patterns were observed between food consumption and CVD statistics from the period 1980-2000, which shows that these relationships are stable over time. However, we found striking discrepancies in men's CVD statistics from 1980 and 1990, which can probably explain the origin of the 'saturated fat hypothesis' that influenced public health policies in the following decades. CONCLUSION Our results do not support the association between CVDs and saturated fat, which is still contained in official dietary guidelines. Instead, they agree with data accumulated from recent studies that link CVD risk with the high glycaemic index/load of carbohydrate-based diets. In the absence of any scientific evidence connecting saturated fat with CVDs, these findings show that current dietary recommendations regarding CVDs should be seriously reconsidered.
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Affiliation(s)
- Pavel Grasgruber
- Faculty of Sports Studies, Masaryk University, Brno, Czech Republic;
| | - Martin Sebera
- Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Eduard Hrazdira
- Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Sylva Hrebickova
- Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Jan Cacek
- Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
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97
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Girona J, Ibarretxe D, Plana N, Guaita-Esteruelas S, Amigo N, Heras M, Masana L. Circulating PCSK9 levels and CETP plasma activity are independently associated in patients with metabolic diseases. Cardiovasc Diabetol 2016; 15:107. [PMID: 27488210 PMCID: PMC4973048 DOI: 10.1186/s12933-016-0428-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/22/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND PCSK9 inhibition is a new powerful cholesterol-lowering strategy. Recently, it was reported that CETP inhibitors influence PCSK9 levels as an off-target effect. We explored the relationship between circulating PCSK9 levels and CETP activity in patients with metabolic disease who were not on lipid-lowering therapy. METHODS Plasma CETP activity and PCSK9 levels were measured in 450 participants (median age, 58 years; 49 % women) who attended the metabolism unit because of metabolic syndrome (MetS) (78 %), atherogenic dyslipidemia (32 %), obesity (50 %), type 2 diabetes mellitus (72 %), and other risk factors (13 %). A 6 week lipid-lowering drug wash-out period was established in treated patients. RESULTS Both PCSK9 levels and CETP activity were higher in patients with an increasing number of MetS components. PCSK9 levels were positively correlated with CETP activity in the entire cohort (r = 0.256, P < 0.0001) independent of age, gender, body mass index (BMI), systolic blood pressure (SBP), LDL cholesterol (LDL-C), triglycerides and glucose. Individuals with the loss-of-function PCSK9 genetic variant rs11591147 (R46L) had lower levels of PCSK9 (36.5 %, P < 0.0001) and LDL-C (17.8 %, P = 0.010) as well as lower CETP activity (10.31 %, P = 0.009). This association remained significant in the multiple regression analysis even after adjusting for gender, age, BMI, LDL-C, triglycerides, glucose, lecithin-cholesterol acyltransferase, SBP and MetS (P = 0.003). CONCLUSIONS Our data suggest a metabolic association between PCSK9 and CETP independent of lipid-lowering treatment. The clinical implications of this metabolic relationship could be relevant for explaining the effect of PCSK9 and CETP inhibition on overall lipid profiles.
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Affiliation(s)
- Josefa Girona
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, C Sant Llorenç, 21, 43201, Reus, Spain.,Spanish Biomedical Research Centre in Diabetes and AssociatedMetabolic Disorders (CIBERDEM), Madrid, Spain
| | - Daiana Ibarretxe
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, C Sant Llorenç, 21, 43201, Reus, Spain.,Spanish Biomedical Research Centre in Diabetes and AssociatedMetabolic Disorders (CIBERDEM), Madrid, Spain
| | - Nuria Plana
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, C Sant Llorenç, 21, 43201, Reus, Spain.,Spanish Biomedical Research Centre in Diabetes and AssociatedMetabolic Disorders (CIBERDEM), Madrid, Spain
| | - Sandra Guaita-Esteruelas
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, C Sant Llorenç, 21, 43201, Reus, Spain.,Spanish Biomedical Research Centre in Diabetes and AssociatedMetabolic Disorders (CIBERDEM), Madrid, Spain
| | - Nuria Amigo
- Biosfer Teslab, Reus and Department of Electronic Engineering, Universitat Rovira i Virgili, IISPV, Tarragona, Spain.,Spanish Biomedical Research Centre in Diabetes and AssociatedMetabolic Disorders (CIBERDEM), Madrid, Spain
| | - Mercedes Heras
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, C Sant Llorenç, 21, 43201, Reus, Spain.,Spanish Biomedical Research Centre in Diabetes and AssociatedMetabolic Disorders (CIBERDEM), Madrid, Spain
| | - Luis Masana
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, C Sant Llorenç, 21, 43201, Reus, Spain. .,Spanish Biomedical Research Centre in Diabetes and AssociatedMetabolic Disorders (CIBERDEM), Madrid, Spain.
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98
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Katsiki N, Mikhailidis DP, Mantzoros CS. Non-alcoholic fatty liver disease and dyslipidemia: An update. Metabolism 2016; 65:1109-23. [PMID: 27237577 DOI: 10.1016/j.metabol.2016.05.003] [Citation(s) in RCA: 383] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/02/2016] [Accepted: 05/05/2016] [Indexed: 11/21/2022]
Abstract
Non-alcoholic fatty liver (NAFLD) is the most common liver disease worldwide, progressing from simple steatosis to necroinflammation and fibrosis (leading to non-alcoholic steatohepatitis, NASH), and in some cases to cirrhosis and hepatocellular carcinoma. Inflammation, oxidative stress and insulin resistance are involved in NAFLD development and progression. NAFLD has been associated with several cardiovascular (CV) risk factors including obesity, dyslipidemia, hyperglycemia, hypertension and smoking. NAFLD is also characterized by atherogenic dyslipidemia, postprandial lipemia and high-density lipoprotein (HDL) dysfunction. Most importantly, NAFLD patients have an increased risk for both liver and CV disease (CVD) morbidity and mortality. In this narrative review, the associations between NAFLD, dyslipidemia and vascular disease in NAFLD patients are discussed. NAFLD treatment is also reviewed with a focus on lipid-lowering drugs. Finally, future perspectives in terms of both NAFLD diagnostic biomarkers and therapeutic targets are considered.
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Affiliation(s)
- Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK.
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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99
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Valensi P, Avignon A, Sultan A, Chanu B, Nguyen MT, Cosson E. Atherogenic dyslipidemia and risk of silent coronary artery disease in asymptomatic patients with type 2 diabetes: a cross-sectional study. Cardiovasc Diabetol 2016; 15:104. [PMID: 27450534 PMCID: PMC4957891 DOI: 10.1186/s12933-016-0415-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/30/2016] [Indexed: 01/02/2023] Open
Abstract
Background To investigate whether atherogenic dyslipidemia, a dyslipidemic profile combining elevated triglycerides and low high-density lipoprotein (HDL) cholesterol, is predictive of risk of silent myocardial ischemia (SMI) or angiographic coronary artery disease (CAD) in asymptomatic patients with type 2 diabetes. Methods Cohort study in 1080 asymptomatic patients with type 2 diabetes with a normal resting electrocardiogram, at least one additional cardiovascular risk factor and low density lipoprotein (LDL) cholesterol <3.35 mmol/L. Patients initially underwent screening for SMI by stress myocardial scintigraphy. Patients with SMI underwent coronary angiography. Results Overall, 60 (5.5 %) patients had atherogenic dyslipidemia (triglycerides ≥2.26 mmol/L and HDL cholesterol ≤0.88 mmol/L). In multivariate analyses taking into account the parameters associated in univariate analyses with SMI and then CAD, atherogenic dyslipidemia was associated with SMI (odds ratio 1.8[1.0–3.3]), as were male gender (OR 2.1[1.5–2.9]), BMI (OR 0.97[0.94–0.997]), retinopathy (OR 1.4[1.1–1.9]), peripheral occlusive arterial disease (POAD: OR 2.5[1.6–3.8]) and mean blood pressure (OR 1.01[1.00–1.03]); atherogenic dyslipidemia was associated with CAD (OR 4.0[1.7–9.2]), as were male gender (OR 3.0[1.6–5.6]), BMI (OR 0.94[0.90–0.995]), retinopathy (OR 1.7[1.0–2.9], POAD (OR 4.0[2.1–7.4]) and mean blood pressure (OR 1.03[1.01–1.05]). In the subgroup of 584 patients with LDL cholesterol <2.6 mmol/L, atherogenic dyslipidemia was also associated with CAD (OR 3.6[1.5–9.0]). Conclusions Atherogenic dyslipidemia was associated with an increased risk of SMI and silent CAD in patients with type 2 diabetes and LDL cholesterol levels <3.35 mmol/L. Specific management of atherogenic dyslipidemia might help reducing the high residual burden of cardiovascular disease.
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Affiliation(s)
- Paul Valensi
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, Avenue du 14 Juillet, 93143, Bondy Cedex, France.
| | - Antoine Avignon
- Department of Endocrinology-Diabetology-Nutrition, CHRU Montpellier, 34295, Montpellier Cedex 5, France.,PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295, Montpellier Cedex 5, France
| | - Ariane Sultan
- Department of Endocrinology-Diabetology-Nutrition, CHRU Montpellier, 34295, Montpellier Cedex 5, France.,PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295, Montpellier Cedex 5, France
| | - Bernard Chanu
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, Avenue du 14 Juillet, 93143, Bondy Cedex, France
| | - Minh Tuan Nguyen
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, Avenue du 14 Juillet, 93143, Bondy Cedex, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, Avenue du 14 Juillet, 93143, Bondy Cedex, France.,Unité de Recherche Epidémiologique Nutritionnelle, UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, 93000, Bobigny, France
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100
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Rosenblit PD. Common medications used by patients with type 2 diabetes mellitus: what are their effects on the lipid profile? Cardiovasc Diabetol 2016; 15:95. [PMID: 27417914 PMCID: PMC4946113 DOI: 10.1186/s12933-016-0412-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 06/14/2016] [Indexed: 12/11/2022] Open
Abstract
Dyslipidemia is the most fundamental risk factor for atherosclerotic cardiovascular disease (ASCVD). In clinical practice, many commonly prescribed medications can alter the patient's lipid profile and, potentially, the risk for ASCVD-either favorably or unfavorably. The dyslipidemia observed in type 2 diabetes mellitus (T2DM) can be characterized as both ominous and cryptic, in terms of unrecognized, disproportionately elevated atherogenic cholesterol particle concentrations, in spite of deceptively and relatively lower levels of low-density lipoprotein cholesterol (LDL-C). Several factors, most notably insulin resistance, associated with the unfavorable discordance of elevated triglyceride (TG) levels and low levels of high-density lipoprotein cholesterol (HDL-C), have been shown to correlate with an increased risk/number of ASCVD events in patients with T2DM. This review focuses on known changes in the routine lipid profile (LDL-C, TGs, and HDL-C) observed with commonly prescribed medications for patients with T2DM, including antihyperglycemic agents, antihypertensive agents, weight loss medications, antibiotics, analgesics, oral contraceptives, and hormone replacement therapies. Given that the risk of ASCVD is already elevated for patients with T2DM, the use of polypharmacy may warrant close observation of overall alterations through ongoing lipid-panel monitoring. Ultimately, the goal is to reduce levels of atherogenic cholesterol particles and thus the patient's absolute risk.
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Affiliation(s)
- Paul D Rosenblit
- Diabetes/Lipid Management & Research Center, 18821 Delaware St, Suite 202, Huntington Beach, CA, 92648, USA.
- Division of Endocrinology, Diabetes, Metabolism, Department of Medicine, University of California, Irvine (UCI) School of Medicine, Irvine, CA, USA.
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