1
|
Dordonne S, Mergeayfabre M, Hafsi N, Ntoutoum A, Salazar-Cardozo C, Casse O, Hounnou M, Adenis A, Aurelus JM, Misslin-Tristch C, Carod JF, De Toffol B, Lienne JF, Demar M, Nacher M, Sabbah N. Impact of Lipoprotein(a) on Macrovascular Complications of Diabetes in a Multiethnic Population in the French Amazon. J Diabetes Res 2023; 2023:8111521. [PMID: 36776228 PMCID: PMC9918351 DOI: 10.1155/2023/8111521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIMS In French Guiana, the prevalence of diabetes is around 10%, and cardio and neurovascular pathologies are the first medical cause of early mortality. Lipoprotein(a) (Lp(a)) is described in the literature as a risk factor independent of other cardiovascular risk factors, but there are important interindividual differences, especially according to ethnicity. The objective of this study was to investigate the association of Lp(a) and macrovascular complications in a multiethnic population of patients with diabetes in the French Amazon. MATERIALS AND METHODS Since May 2019, 1243 patients were screened 806 of whom had Lp(a) determination. We compared the prevalence of macrovascular complications in three groups according to Lp(a) concentration: between 0 and 75 mg/mL, between 76 and 300 mg/mL, and >300 mg/mL. RESULTS 712 patients in the study had type 2 diabetes (88.34% of the sample). A history of hypertension was significantly associated with greater Lp(a) levels. Lp(a) concentration was greater among Creole ethnic groups. No association was found between Lp(a) levels and macrovascular complications in the Lp(a) > 300 mg/mL group. CONCLUSIONS These results do not replicate findings in mostly Caucasian populations suggesting that the Lp(a) threshold for, or the link with, cardiovascular risk may be different given the predominantly African origin of the French Guianese population. Further studies should study genetic polymorphisms in our population.
Collapse
Affiliation(s)
- Sabrina Dordonne
- Department of Endocrinology and Metabolic Diseases, F-97306 Cayenne, French Guiana
| | - Mayka Mergeayfabre
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424), Cayenne Hospital Center, F-97306 Cayenne, French Guiana
| | - Nezha Hafsi
- Department of Endocrinology and Metabolic Diseases, F-97306 Cayenne, French Guiana
| | - Andre Ntoutoum
- Department of Endocrinology and Metabolic Diseases, F-97306 Cayenne, French Guiana
| | - Clara Salazar-Cardozo
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424), Cayenne Hospital Center, F-97306 Cayenne, French Guiana
| | - Olivier Casse
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424), Cayenne Hospital Center, F-97306 Cayenne, French Guiana
| | - Marianne Hounnou
- Department of Endocrinology and Metabolic Diseases, F-97306 Cayenne, French Guiana
| | - Antoine Adenis
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424), Cayenne Hospital Center, F-97306 Cayenne, French Guiana
| | - Jean-Markens Aurelus
- Department of Endocrinology and Metabolic Diseases, F-97306 Cayenne, French Guiana
| | - Caroline Misslin-Tristch
- Department of General Medicine, Ouest French Guianais Hospital Center, F-97397 Saint-Laurent, French Guiana
| | - Jean-François Carod
- Laboratory of Biology, Ouest French Guianais Hospital Center, F-97397 Saint-Laurent, French Guiana
| | - Bertrand De Toffol
- Department of Neurology, Cayenne Hospital Center, F-97306 Cayenne, French Guiana
| | - Jean François Lienne
- Department of Endocrinology and Metabolic Diseases, F-97306 Cayenne, French Guiana
| | - Magalie Demar
- Laboratory of Parasitology-Mycology (LHUPM), Cayenne Hospital Center, F-97306 Cayenne, French Guiana
- EA3593, Amazon Ecosystems and Tropical Diseases, University of Guiana, French Guiana
| | - Mathieu Nacher
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424), Cayenne Hospital Center, F-97306 Cayenne, French Guiana
- Laboratory of Biology, Ouest French Guianais Hospital Center, F-97397 Saint-Laurent, French Guiana
| | - Nadia Sabbah
- Department of Endocrinology and Metabolic Diseases, F-97306 Cayenne, French Guiana
- Laboratory of Biology, Ouest French Guianais Hospital Center, F-97397 Saint-Laurent, French Guiana
| |
Collapse
|
2
|
Derosa G, Fogari R, Piccinni MN, Peros E, Bertone G, Ciccarelli L, Tinelli C, Geroldi D, Pannacciulli N, De Pergola G. Association between Low-Molecular Weight Apolipoprotein(a) Isoforms and Obesity in Italian Women. ACTA ACUST UNITED AC 2012; 12:1322-6. [PMID: 15340115 DOI: 10.1038/oby.2004.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Low-molecular weight (MW) apolipoprotein(a) [apo(a)] isoforms are closely associated with an increased incidence of atherothrombotic disease, prevalence of which is higher in obese individuals, particularly in women. The hypothesis of this study was to assess whether there are differences in the distribution of apo(a) phenotypes between obese patients and healthy controls. RESEARCH METHODS AND PROCEDURES One hundred three obese Italian women (BMI > or = 30.0 kg/m2) were enrolled in the study, and apo(a) phenotyping was performed in all subjects. The prevalence of low-MW apo(a) isoforms, detected in plasma samples of our obese women, was compared with that found in a control group of 84 normal-weight, never-obese (BMI < 25.0 kg/m(2)), age-matched women. RESULTS The distribution of apo(a) isoforms in the population of obese women was significantly different from that found in normal-weight female subjects. In particular, the percentage of subjects in the obese group with at least one apo(a) isoform of low MW was significantly higher than that in the control group (51.4% vs. 32.1%, p = 0.0079). DISCUSSION Our results seem to suggest the possibility that small-sized apo(a) isoforms may be used together with other traditional risk factors to better assess the overall predisposition to atherothrombotic disease in obese women.
Collapse
Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, Section of Internal Medicine, Vascular and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, University of Pavia, P.le C. Golgi, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Wood RJ, Volek JS, Davis SR, Dell'Ova C, Fernandez ML. Effects of a carbohydrate-restricted diet on emerging plasma markers for cardiovascular disease. Nutr Metab (Lond) 2006; 3:19. [PMID: 16674818 PMCID: PMC1481590 DOI: 10.1186/1743-7075-3-19] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Accepted: 05/04/2006] [Indexed: 12/01/2022] Open
Abstract
Background Increasing evidence supports carbohydrate restricted diets (CRD) for weight loss and improvement in traditional markers for cardiovascular disease (CVD); less is known regarding emerging CVD risk factors. We previously reported that a weight loss intervention based on a CRD (% carbohydrate:fat:protein = 13:60:27) led to a mean weight loss of 7.5 kg and a 20% reduction of abdominal fat in 29 overweight men. This group showed reduction in plasma LDL-cholesterol and triglycerides and elevations in HDL-cholesterol as well as reductions in large and medium VLDL particles and increases in LDL particle size. In this study we report on the effect of this intervention with and without fiber supplementation on plasma homocysteine, lipoprotein (a) [Lp(a)], C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α). Methods Twenty nine overweight men [body mass index (BMI) 25–35 kg/m2] aged 20–69 years consumed an ad libitum CRD (% carbohydrate:fat:protein = 13:60:27) including a standard multivitamin every other day for 12 wk. Subjects were matched by age and BMI and randomly assigned to consume 3 g/d of either a soluble fiber supplement (n = 14) or placebo (n = 15). Results There were no group or interaction (fiber × time) main effects, but significant time effects were observed for several variables. Energy intake was spontaneously reduced (-30.5%). This was accompanied by an increase in protein intake (96.2 ± 29.8 g/d to 107.3 ± 29.7 g/d) and methionine intake (2.25 ± 0.7 g/d, to 2.71 ± 0.78 g/d; P < 0.001). Trans fatty acid intake was significantly reduced (-38.6%) while dietary folate was unchanged, as was plasma homocysteine. Bodyweight (-7.5 ± 2.5 kg) was reduced as was plasma Lp(a) (-11.3%). Changes in plasma Lp(a) correlated with reductions in LDL-cholesterol (r = .436, P < 0.05) and fat loss (r = .385, P < 0,05). At wk 12, both CRP (-8.1%) and TNF-α (-9.3%) were reduced (P < 0.05) independently of weight loss. IL-6 concentrations were unchanged. Conclusion A diet based on restricting carbohydrates leads to spontaneous caloric reduction and subsequent improvement in emerging markers of CVD in overweight/obese men who are otherwise healthy.
Collapse
Affiliation(s)
- Richard J Wood
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Jeff S Volek
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Steven R Davis
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Carly Dell'Ova
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| |
Collapse
|
4
|
Guanche Garcell H, Beatriz Torres M, Martínez Quesada C, Gutiérrez García F, Cañizares Gómez N, Vandama Pinch O. [Effect of weight reduction on lipids and lipoprotein (a) serum levels]. Med Clin (Barc) 2002; 119:730-1. [PMID: 12487968 DOI: 10.1016/s0025-7753(02)73558-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVE A quasi-experimental study to determine the effects of a body weight reduction treatment on lipids and lipoprotein (a) serum levels. PATIENTS AND METHOD Ponderal and lipidogram values were determined in 69 premenopausic obese women before and after treatment. Differences were determined at a given time and at intervals. RESULTS Apart from a high fasting HDLc, a reduction of the lipid values was observed. CONCLUSIONS Our results suggest that weight reduction modifies favourably the lipid profile in premenopausic obese women.
Collapse
Affiliation(s)
- Humberto Guanche Garcell
- Departamento de Epidemiología Hospitalaria. Hospital Universitario Clínico Quirúrgico Joaquín Albarrán. La Habana. Cuba.
| | | | | | | | | | | |
Collapse
|
6
|
Abstract
Obesity is commonly cited as a risk factor for the development of coronary heart disease (CHD). Epidemiologic studies tend to support this contention, particularly those focusing on patients with central obesity. Such studies however, are imprecise and prone to misclassification bias. Angiographic and post mortem studies have demonstrated little or no correlation of total fat mass and coronary atherosclerosis except in those with abdominal obesity. There is a strong association of obesity, particularly central obesity, and traditional risk factors for CHD such as hypertension, type II diabetes mellitus, and dyslipidemia. There may also be an association between obesity and several nontraditional risk factors such as hyperhomocystinemia, elevated Lp(a) levels and factors that increase thrombogenesis. Obesity may also alter endothelial function. Weight loss, although associated with favorable modification of multiple risk factors for CHD, has not been shown to independently and definitively reduce CHD risk.
Collapse
Affiliation(s)
- J K Alexander
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
7
|
Abstract
Strokes are one of the most common causes of mortality and long term severe disability. There is evidence that lipoprotein (a) (Lp(a)) is a predictor of many forms of vascular disease, including premature coronary artery disease. Several studies have also evaluated the association between Lp(a) and ischaemic (thrombotic) stroke. Several cross sectional (and a few prospective) studies provide contradictory findings regarding Lp(a) as a predictor of ischaemic stroke. Several factors might contribute to the existing confusion--for example, small sample sizes, different ethnic groups, the influence of oestrogens in women participating in the studies, plasma storage before Lp(a) determination, statistical errors, and selection bias. This review focuses on the Lp(a) related mechanisms that might contribute to the pathogenesis of ischaemic stroke. The association between Lp(a) and other cardiovascular risk factors is discussed. Therapeutic interventions that can lower the circulating concentrations of Lp(a) and thus possibly reduce the risk of stroke are also considered.
Collapse
Affiliation(s)
- H J Milionis
- Department of Molecular Pathology and Clinical Biochemistry, Royal Free and University College Medical School, University College, London, UK
| | | | | |
Collapse
|
8
|
Abstract
Lipoprotein(a) is a plasma particle which is considered to be a risk factor for the development of coronary heart disease. Plasma levels of lipoprotein(a) are affected by different types of dietary fat and steroid hormones. Two regions upstream of the apolipoprotein(a) promoter have been isolated which could be the site of regulation of apolipoprotein(a) gene transcription.
Collapse
Affiliation(s)
- L Puckey
- Clinical Sciences Centre, Imperial College School of Medicine, Hammersmith Hospital, London, UK
| | | |
Collapse
|