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Abedi F, Sadeghi M, Omidkhoda N, Kelesidis T, Ramezani J, Samadi S, Mohammadpour AH. HDL-cholesterol concentration and its association with coronary artery calcification: a systematic review and meta-analysis. Lipids Health Dis 2023; 22:60. [PMID: 37158895 PMCID: PMC10165789 DOI: 10.1186/s12944-023-01827-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/29/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Coronary artery calcification (CAC) is a potential risk marker of coronary atherosclerosis that has high specificity and sensitivity. However, the association between high-density lipoprotein cholesterol (HDL-C) concentration and CAC incidence and progression is controversial. METHODS PubMed, Embase, Web of Science, and Scopus were systematically searched to identify relevant observational studies up to March 2023 and assessed the methodological quality using Newcastle-Ottawa Scale (NOS) scale. Random-effects meta-analysis was used to estimate pooled odds ratios (OR) and 95% confidence interval considering heterogeneity across studies. RESULTS Of the 2,411 records, 25 cross-sectional (n = 71,190) and 13 cohort (n = 25,442) studies were included in the systematic review. Ten cross-sectional and eight cohort studies were not eligible and were omitted from the meta-analysis. A total of 15 eligible cross-sectional studies (n = 33,913) were included in the meta-analysis and pooled results revealed no significant association between HDL-C and CAC > 0, CAC > 10, or CAC > 100 [pooled OR: 0.99 (0.97, 1.01)]. Meta-analysis of the 5 eligible prospective cohort studies (n = 10,721) revealed no significant protective effect of high HDL-C against CAC > 0 [pooled OR: 1.02 (0.93, 1.13)]. CONCLUSIONS According to this analysis of observational studies, high HDL-C levels were not found to predict protection against CAC. These results suggest HDL quality rather than HDL quantity is important for certain aspects of atherogenesis and CAC. REGISTRATION NUMBER CRD42021292077.
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Affiliation(s)
- Farshad Abedi
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Sadeghi
- Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Navid Omidkhoda
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Theodoros Kelesidis
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Javad Ramezani
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Samadi
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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Oliveira GMMD, Brant LCC, Polanczyk CA, Malta DC, Biolo A, Nascimento BR, Souza MDFMD, Lorenzo ARD, Fagundes AADP, Schaan BD, Castilho FMD, Cesena FHY, Soares GP, Xavier GF, Barreto JAS, Passaglia LG, Pinto MM, Machline-Carrion MJ, Bittencourt MS, Pontes OM, Villela PB, Teixeira RA, Sampaio RO, Gaziano TA, Perel P, Roth GA, Ribeiro ALP. Estatística Cardiovascular – Brasil 2021. Arq Bras Cardiol 2022; 118:115-373. [PMID: 35195219 PMCID: PMC8959063 DOI: 10.36660/abc.20211012] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023] Open
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Lipopolysaccharide binding protein is associated with CVD risk in older adults. Aging Clin Exp Res 2021; 33:1651-1658. [PMID: 32895891 DOI: 10.1007/s40520-020-01684-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Intestinal (i.e., "gut") permeability may be related to cardiovascular disease (CVD) risk, but biomarkers for gut permeability are limited and associations with CVD risk are unknown-particularly among older adults. AIMS This cross-sectional study aimed to determine if serum biomarkers related to gut permeability [intestinal fatty acid-binding protein (iFABP)] and bacterial toxin clearing [cluster of differentiation 14 (CD14), lipopolysaccharide binding protein (LBP)] are associated with CVD risk among older adults. METHODS Older adults (n = 74, 69.6 ± 6.5-years-old) were stratified by CVD risk category. One-way ANOVAs determined differences in each biomarker by risk category, and associations with risk score were evaluated with Pearson correlations. RESULTS LBP (p = 0.007), but not iFABP and CD14, was significantly different between CVD risk categories. Post-hoc tests indicated LBP was higher in moderate risk and high-moderate risk compared to the high risk category (p < 0.005). Evaluation of LBP and individual components in the risk score demonstrated a moderate, negative correlation of LBP with age and systolic blood pressure (r = - 0.335 and r = - 0.297) and a small positive correlation between LBP and total cholesterol and LDL cholesterol (r = 0.204 and r = 0.220). DISCUSSION/CONCLUSION Lower risk for CVD was associated with higher circulating concentrations of LBP, lower iFABP, and lower systemic inflammation in older adults. Further, there were small positive relationships between total and LDL cholesterol and circulating levels of LBP. These data suggest LBP may be a key component in reducing CVD risk in older adults.
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A cohort study on risk factors of high-density lipoprotein cholesterol hypolipidemia among urban Chinese adults. Lipids Health Dis 2021; 20:20. [PMID: 33618731 PMCID: PMC7898430 DOI: 10.1186/s12944-021-01449-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background High-density lipoprotein cholesterol (HDL-C) hypolipidemia, a major type of dyslipidemia, has been associated with many kinds of diseases, such as stroke, coronary heart disease, obesity and diabetes, and has displayed an increasing prevalence in China. This study explores the risk factors of HDL-C hypolipidemia and makes recommendations for controlling and preventing HDL-C hypolipidemia and the diseases caused by it. Methods Using a retrospective cohort study design, 26,863 urban adults without dyslipidemia, diabetes, cardiovascular and cerebrovascular diseases, hepatosis, renal insufficiency and thyroid diseases were enrolled in the study between 2010 and 2015. Data on each individual were collected at the 2010 baseline year and at a follow-up medical check. A Cox regression model was constructed to evaluate the influence of potential risk factors on the outcome event- HDL-C hypolipidemia. Results The incidence of HDL-C hypolipidemia was 5.7% (1531/26863). Sex, age, body mass index (BMI), HDL-C, triglyceride (TG) and urea nitrogen (UN) were significant risk factors of HDL-C hypolipidemia. Men were more likely to develop HDL-C hypolipidemia than women during follow-up medical checks (HR = 1.258, P = 0.014). The incidence of HDL-C hypolipidemia in the over 65 years old group was higher than that of the ≤65 age group (HR = 1.276, P = 0.009). The incidence of HDL-C hypolipidemia increased with increasing BMI (HR = 1.030, P = 0.002), TG (HR = 1.321, P = 0.001) and UN (HR = 1.054, P = 0.019), while falling with increasing HDL-C in the baseline year (HR = 0.002, P < 0.001). Conclusions Men, aged over 65, with high BMI were at the highest risk of developing HDL-C hypolipidemia. Measures should be taken to prevent HDL-C hypolipidemia even for healthy urban adults whose blood biochemical indicators were in the normal range when their level of TG, UN and HDL-C are closed to the border of the normal value range.
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de Oliveira FF, Berretta JM, de Almeida Junior GV, de Almeida SS, Chen ES, Smith MC, Bertolucci PHF. Pharmacogenetic analyses of variations of measures of cardiovascular risk in Alzheimer's dementia. Indian J Med Res 2020; 150:261-271. [PMID: 31719297 PMCID: PMC6886147 DOI: 10.4103/ijmr.ijmr_1209_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background & objectives: Neurodegeneration affects blood pressure variations, while renal function and cerebral perfusion are impaired by vascular risk factors. This study was aimed to estimate variations of measures of cardiovascular risk in Alzheimer's dementia by pharmacogenetic analyses of the effects of angiotensin-converting enzyme (ACE) inhibitors and statins. Methods: Consecutive patients were prospectively followed to study variations of creatinine clearance and blood pressure for one year, estimated by correlating the effects of ACE inhibitors with the ACE Alu I/D polymorphism and genotypes or haplotypes of rs1800764 or rs4291, and the effects of statins with LDLR (low-density lipoprotein receptor) genotypes or haplotypes of rs11669576 (exon 8) or rs5930 (exon 10), or genotypes of rs2695121 (liver X receptor β gene). Variations of the coronary heart disease (CHD) risk according to these cardiovascular measures were also explored. Results: All polymorphisms of the 193 patients were in Hardy-Weinberg equilibrium. Genetic determinants of cardiovascular effects affected the individual variability of the response to ACE inhibitors and statins. ACE inhibitors, but not statins, reduced blood pressure for all patients. ACE inhibitors protected carriers of alleles that supposedly decrease serum ACE levels (rs1800764-T, rs4291-A, Alu II) regarding creatinine clearance variations (P<0.005), but carriers of Alu DD (P<0.02), rs1800764-C (P<0.05), or rs4291-AT (P<0.04) showed better blood pressure lowering effects. The presence of rs2695121-T (P=0.007) or rs5930-A (P=0.039) was associated with systolic blood pressure lowering, whereas rs5930-AA was protective against decrease in creatinine clearance (P=0.019). Statins lowered creatinine clearance for carriers of rs2695121-CT (P=0.026). Interpretation & conclusions: Pharmacological response of blood pressure and creatinine clearance to ACE inhibitors and statins may be genetically mediated.
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Affiliation(s)
- Fabricio Ferreira de Oliveira
- Department of Neurology & Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Juliana Marília Berretta
- Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | | | - Sandro Soares de Almeida
- Department of Biophysics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Elizabeth Suchi Chen
- Department of Morphology & Genetics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Marilia Cardoso Smith
- Department of Morphology & Genetics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
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A Component Formula of Chinese Medicine for Hypercholesterolemia Based on Virtual Screening and Biology Network. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:1854972. [PMID: 30050582 PMCID: PMC6046189 DOI: 10.1155/2018/1854972] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/18/2018] [Accepted: 06/04/2018] [Indexed: 01/21/2023]
Abstract
Hypercholesterolemia is a risk factor to atherosclerosis and coronary heart disease II. The abnormal rise of cholesterol in plasma is the main symptom. Cholesterol synthesis pathway is an important pathway of the origin of cholesterol, which is an essential pathway for the therapy of hypercholesterolemia. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase), squalene synthase (SQS), and sterol regulatory element binding protein-2 (SREBP-2) are closely connected with the synthesis of cholesterol. The inhibition of these targets can reduce the cholesterol in plasma. This study aimed to build a component formula including three Traditional Chinese Medicines (TCM) components with the inhibition activity of these targets by using virtual screening and biological network. Structure-based pharmacophore models of HMG-CoA reductase and SQS and ligand-based pharmacophore model of SREBP-2 were constructed to screen the Traditional Chinese Medicine Database (TCMD). Molecular docking was used for further screening of components of HMG-CoA reductase and SQS. Then, metabolic network was constructed to elucidate the comprehensive interaction of three targets for lipid metabolism. Finally, three potential active compounds were obtained, which are poncimarin, hexahydrocurcumin, and forsythoside C. The source plants of the compounds were also taken into account, which should have known action of lowering hyperlipidemia. The lipid-lowering effect of hexahydrocurcumin was verified by experiment in vitro. The components that originated from TCMs with lipid-lowering efficacy made up a formula with a synergistic effect through the computer aid drug design methods. The research provides a fast and efficient method to build TCM component formula and it may inspire the study of the explanation of TCM formula mechanism.
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Zimetti F, Freitas WM, Campos AM, Daher M, Adorni MP, Bernini F, Sposito AC, Zanotti I. Cholesterol efflux capacity does not associate with coronary calcium, plaque vulnerability, and telomere length in healthy octogenarians. J Lipid Res 2018; 59:714-721. [PMID: 29436385 DOI: 10.1194/jlr.p079525] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 01/19/2018] [Indexed: 12/23/2022] Open
Abstract
Several studies have revealed that traditional risk factors are less effective in predicting CVD risk in the elderly, suggesting the need to identify new biomarkers. Here, we evaluated the association between serum cholesterol efflux capacity (CEC), an atheroprotective property of HDL recently identified as a novel marker of CVD risk, and atherosclerotic burden in a cohort of very old, healthy individuals. Serum CEC values were not significantly correlated either with calcium score or with markers of vulnerable plaque, such as positive remodeling, hypodensity, spotty calcification, or napking-ring sign. In addition, no association was detected between CEC and telomere length, a marker of biological aging that has been linked to atherosclerosis extent. Interestingly, elderly subjects presented a remarkably higher CEC (+30.2%; P < 0.0001) compared with values obtained from a cohort of sex-matched, cardiovascular event-free, middle-aged individuals. In conclusion, serum CEC is not related to traditional risk factors in very old, cardiovascular event-free subjects, but has significantly higher values compared with a healthy, younger population. Whether this improved HDL functionality may represent a protective factor in CVD onset must be established in future studies.
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Affiliation(s)
| | - Wladimir M Freitas
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Cidade Universitária, Campinas, Brazil
| | - Alessandra M Campos
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Cidade Universitária, Campinas, Brazil
| | - Mauricio Daher
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Cidade Universitária, Campinas, Brazil
| | | | - Franco Bernini
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Andrei C Sposito
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Cidade Universitária, Campinas, Brazil.
| | - Ilaria Zanotti
- Department of Food and Drug, University of Parma, Parma, Italy.
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Rezapour M, Payani E, Taran M, Ghatari AR, Khavanin Zadeh M. Roles of triglyceride and phosphate in atherosclerosis of diabetic hemodialysis patients. Med J Islam Repub Iran 2017; 31:80. [PMID: 29445708 PMCID: PMC5804422 DOI: 10.14196/mjiri.3180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Indexed: 11/18/2022] Open
Abstract
Background: A growing number of patients with End-Stage Renal Disease (ESRD) are undergoing long-term hemodialysis (HD). HD needs a vascular access (VA) and complications of VA account for a sizable proportion of its costs. One of the important cardiovascular diseases (CVD) is atherosclerosis, which is a major cause of premature deaths in the world. So, it is essential to find the risk factors to treat them before they cause an obvious CVD. Methods: We analyzed data from 174 ESRD patients who were candidate for Arterio Venous Fistula (AVF) creation from April 2008 to March 2009 in Hasheminejad Kidney Center by convenient sampling. X-ray images were used and C 4.5 algorithm of data mining techniques revealed the roles of two risk factors for atherosclerosis of diabetic ESRD patients. Pearson coefficient was also used to measure the correlation between the parameters. Results: Diabetic patients had significantly more calcified arteries in their forearm X-ray than other patients (p<0.001). Occurrence of atherosclerotic CVD in diabetic HD patients has an adverse relation compared with the controlled levels of their plasma levels of Triglyceride (TG) and Phosphorus. We found an inverse effect of TG and phosphorus plasma levels on the atherosclerotic involvement of radial and ulnar arteries in diabetic HD patients. We observed that the prevalence of radial and ulnar arteries calcification in these patients is lower when they have higher plasma levels of TG and phosphorous. Conclusion: This study investigates the role of high plasma levels of TG and phosphorous in the development of atherosclerosis in diabetic HD patients. Although many studies showed that hypertriglyceridemia plays a promoting role in the development of CVD, our study also found an inverse effect of plasma levels of TG on the atherosclerotic involvement of radial and ulnar arteries in diabetic patients, and therefore our results support this suspicion that hypertriglyceridemia plays a significant role in developing atherosclerosis.
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Affiliation(s)
- Mohammad Rezapour
- Department of Information Technology Management, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Masoumeh Taran
- Applied Mathematics Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan, Iran
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ST-elevation myocardial infarction risk in the very elderly. BBA CLINICAL 2016; 6:108-12. [PMID: 27635386 PMCID: PMC5024138 DOI: 10.1016/j.bbacli.2016.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 08/24/2016] [Accepted: 09/01/2016] [Indexed: 12/31/2022]
Abstract
Background Despite the high incidence and mortality of ST-segment elevation myocardial infarction (STEMI) among the very elderly, risk markers for this condition remain poorly defined. This study was designed to identify independent markers of STEMI among individuals carefully selected for being healthy or manifesting STEMI in < 24 h. Methods We enrolled participants aged 80 years or older of whom 50 were STEMI patients and 207 had never manifested cardiovascular diseases. Blood tests, medical and psychological evaluations were obtained at study admission. Odds Ratio (OR) and attributed risk (AR) were obtained by multivariate regression models using STEMI as dependent variable. Results Low glomerular filtration rate (GFR) [OR:4.41 (1.78–10.95); p = 0.001], reduced levels of HDL-C [OR:10.70 (3.88–29.46); p = 0.001], male gender [OR:12.08 (5.82–25.08); p = 0.001], moderate to severe depressive symptoms [OR:10.00 (2.82–35.50); p = 0.001], prior smoking [OR:2.00 (1.05–3.80); p = 0.034] and current smoking [OR:6.58 (1.99–21.70); p = 0.002] were significantly associated with STEMI. No association was found between STEMI and age, diabetes, hypertension, mild depressive symptoms, triglyceride or LDL-C. Conclusions This is the first case–control study carried out with very elderlies to assess STEMI risk. Our findings indicate that reduced HDL-C, GFR, male gender, smoking habits and moderate to severe depressive symptoms are markers of STEMI in this age group. General Significance In Individuals aged 80 or more years, a greater attention must be paid to low HDL-C and GFR at the expense of conventional STEMI risk factors for younger adults such as diabetes mellitus, hypertension and high LDL-C or triglyceride. Population aging are rapidly increasing worldwide, especially in developing countries. Incidence and mortality due to cardiovascular diseases is extremely high in the very elderly population. There is no specific algorithm for cardiovascular disease risk estimation for very elderly individuals. Among the very elderly, markers of cardiovascular risk are distinct from younger adults.
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Key Words
- ANCOVA, analysis of covariance
- AR, attributable risk
- Aged
- Aged, 80 and over
- BDI-II, Beck Depression Inventory version II
- BHS, Brasília Heart Study
- BSHA, Brasília Study on Healthy Aging
- CK-MB, MB fraction of creatine kinase
- CRP, C-reactive protein
- CVD, cardiovascular disease
- DBP, diastolic blood pressure
- EDTA, ethylenediamine tetraacetic acid
- GDS, Geriatric Depression Scale
- GFR, glomerular filtration rate
- HDL-C, high-density lipoprotein cholesterol
- HDL-cholesterol
- HbA1c, glycated hemoglobin
- IQR, interquartile range
- LDL-C, low-density lipoprotein cholesterol
- MI, myocardial infarction
- Myocardial infarction
- OR, odds ratio
- SBP, systolic blood pressure
- SD, standard deviation
- STEMI, ST-segment elevation myocardial infarction
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