1
|
Zierfuss B, Höbaus C, Herz CT, Koppensteiner R, Stangl H, Schernthaner GH. HDL particle subclasses in statin treated patients with peripheral artery disease predict long-term survival. Thromb Haemost 2022; 122:1804-1813. [PMID: 35436798 DOI: 10.1055/a-1827-7896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Low-density lipoprotein-cholesterol (LDL-C) reduction showed a strong reduction of cardiovascular (CV) event rates in CV disease. However, the residual risk of future CV events remains high, which especially extends to peripheral arterial disease (PAD). Nuclear magnetic resonance (NMR)-spectroscopy offers a novel method for analyses of the lipoprotein spectrum. This study investigates lipoprotein subclasses using NMR-spectroscopy and assesses implications for long-term survival in PAD. NMR-spectroscopy was performed by Nightingale Inc. in 319 patients with stable PAD and well-controlled CV risk factors. Patients were followed-up for ten years. During that period 123 patients (38.5%) died, of those 68 (21.3%) were defined as CV-deaths. Outcome data were analyzed by the Kaplan-Meier method and multivariable Cox regression for lipoprotein particles. Small and medium high-density lipoprotein-particles (S-HDL-P and M-HDL-P) showed a significant inverse association with all-cause mortality in Cox-regression analyses after multivariable adjustment (S-HDL-P hazard ratio 0.71, 95% confidence interval 0.57-0.88; M-HDL-P 0.72, 0.58-0.90) for each increase of 1 standard deviation. In contrast, cholesterol-rich x-large HDL-particles (XL-HDL-P) showed a positive association with all-cause mortality (1.51, 1.20-1.89). Only the association between XL-HDL-P and CV-death sustained multivariable adjustment (1.49, 1.10-2.02), whereas associations for S-HDL-P and M-HDL-P were attenuated (0.76, 0.57-1.01; 0.80, 0.60-1.06). This study shows a novel association for a beneficial role of S-HDL-P and M-HDL-P but a negative association with higher cholesterol-rich XL-HDL-P for long-term outcome in well-treated patients with PAD. Thus, these results provide evidence that NMR-measured HDL particles identify patients at high CV residual risk beyond adequate lipid-lowering therapy.
Collapse
Affiliation(s)
- Bernhard Zierfuss
- Department of Medicine 2, Division of Angiology, Medical University of Vienna, Wien, Austria
| | - Clemens Höbaus
- Department of Medicine 2, Division of Angiology, Medical University of Vienna, Wien, Austria
| | - Carsten Thilo Herz
- Department of Medicine 3, Division of Nephrology and Dialysis, Medical University of Vienna, Wien, Austria
| | - Renate Koppensteiner
- Department of Medicine 2, Division of Angiology, Medical University of Vienna, Wien, Austria
| | - Herbert Stangl
- Center for Pathobiochemistry and Genetics, Institute for Medical Chemistry, Medical University of Vienna, Wien, Austria
| | | |
Collapse
|
2
|
Enrichment of HDL proteome and phospholipidome from human serum via IMAC/MOAC affinity. Biomed Chromatogr 2020; 34:e4693. [DOI: 10.1002/bmc.4693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/17/2019] [Accepted: 08/23/2019] [Indexed: 12/19/2022]
|
3
|
McGuinn LA, Schneider A, McGarrah RW, Ward-Caviness C, Neas LM, Di Q, Schwartz J, Hauser ER, Kraus WE, Cascio WE, Diaz-Sanchez D, Devlin RB. Association of long-term PM 2.5 exposure with traditional and novel lipid measures related to cardiovascular disease risk. ENVIRONMENT INTERNATIONAL 2019; 122:193-200. [PMID: 30446244 PMCID: PMC6467069 DOI: 10.1016/j.envint.2018.11.001] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) exposure is associated with increased morbidity and mortality, particularly for cardiovascular disease. The association between long-term exposure to PM2.5 and measures of lipoprotein subfractions remains unclear. Therefore, we examined associations between long-term PM2.5 exposure and traditional and novel lipoprotein measures in a cardiac catheterization cohort in North Carolina. METHODS This cross-sectional study included 6587 patients who had visited Duke University for a cardiac catheterization between 2001 and 2010 and resided in North Carolina. We used estimates of daily PM2.5 concentrations on a 1 km-grid based on satellite measurements. PM2.5 predictions were matched to the address of each patient and averaged for the year prior to catheterization date. Serum lipids included HDL, LDL, and triglyceride-rich particle, and apolipoprotein B concentrations (HDL-P, LDL-P, TRL-P, and apoB, respectively). Linear and quantile regression models were used to estimate change in lipoprotein levels with each μg/m3 increase in annual average PM2.5. Models were adjusted for age, sex, race/ethnicity, history of smoking, area-level education, urban/rural status, body mass index, and diabetes. RESULTS For a 1-μg/m3 increment in PM2.5 exposure, we observed increases in total and small LDL-P, LDL-C, TRL-P, apoB, total cholesterol, and triglycerides. The percent change from the mean outcome level was 2.00% (95% CI: 1.38%, 2.64%) for total LDL-P and 2.25% (95% CI: 1.43%, 3.06%) for small LDL-P. CONCLUSION Among this sample of cardiac catheterization patients residing in North Carolina, long-term PM2.5 exposure was associated with increases in several lipoprotein concentrations. This abstract does not necessarily reflect U.S. EPA policy.
Collapse
Affiliation(s)
- Laura A McGuinn
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | - Robert W McGarrah
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Cavin Ward-Caviness
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, USA
| | - Lucas M Neas
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, USA
| | - Qian Di
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elizabeth R Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Wayne E Cascio
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, USA
| | - David Diaz-Sanchez
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, USA
| | - Robert B Devlin
- National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, USA
| |
Collapse
|
4
|
Muhlestein JB, May HT, Galenko O, Knowlton KU, Otvos JD, Connelly MA, Lappe DL, Anderson JL. GlycA and hsCRP are independent and additive predictors of future cardiovascular events among patients undergoing angiography: The intermountain heart collaborative study. Am Heart J 2018; 202:27-32. [PMID: 29803983 DOI: 10.1016/j.ahj.2018.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/02/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND GlycA is an inflammatory marker that is raised in patients with cardiometabolic diseases and associated with cardiovascular (CV) events. We sought to determine if GlycA adds independent value to hsCRP for CV risk prediction. METHODS Patients in the Intermountain Heart Collaborative Study who underwent coronary angiography and had plasma GlycA and hsCRP levels were studied (n = 2996). Patients were followed for 7.0 ± 2.8 years. GlycA and hsCRP were moderately correlated (r = 0.46, P < .0001). GlycA and hsCRP concentrations were stratified into high and low categories by their median values. Multivariable cox hazard regression was utilized to determine the associations of GlycA quartiles, as well as high and low categories of GlycA and hsCRP, with major adverse cardiovascular events (MACE) defined as the composite of death, myocardial infarction (MI), heart failure (HF) hospitalization, and stroke. RESULTS The highest GlycA quartile was associated with future MACE [HR: 1.43; 95% CI: 1.22-1.69; P < .0001]. Patients with high GlycA and high hsCRP had more diabetes, hyperlipidemia, hypertension, HF, renal failure and MI, but not coronary artery disease. High GlycA and hsCRP (H/H) versus low GlycA and hsCRP (L/L) was associated with MACE, death and HF hospitalization, but not MI or stroke. Combined MACE rates were 33.5%, 41.3%, 35.7% and 49.1% for L/L, L/H, H/L and H/H categories of GlycA/hsCRP, respectively (P-trend < .0001). The interaction between GlycA and hsCRP was significant for the outcome of death (P = .03). CONCLUSION In this study, levels of GlycA and hsCRP were independent and additive markers of risk for MACE, death and HF hospitalization.
Collapse
Affiliation(s)
- Joseph B Muhlestein
- Intermountain Medical Center, Murray, UT; University of Utah, Salt Lake City, UT.
| | | | | | - Kirk U Knowlton
- Intermountain Medical Center, Murray, UT; University of California San Diego, San Diego, CA
| | - James D Otvos
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, NC
| | | | | | - Jeffrey L Anderson
- Intermountain Medical Center, Murray, UT; University of Utah, Salt Lake City, UT
| |
Collapse
|
5
|
Rodriguez-Garcia E, Ruiz-Nava J, Santamaria-Fernandez S, Fernandez-Garcia JC, Vargas-Candela A, Yahyaoui R, Tinahones FJ, Bernal-Lopez MR, Gomez-Huelgas R. Implications of the Mediterranean diet and physical exercise on the lipid profile of metabolically healthy obese women as measured by nuclear magnetic resonance spectroscopy ( 1 H NMR). Chem Phys Lipids 2018; 213:68-75. [DOI: 10.1016/j.chemphyslip.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/08/2018] [Accepted: 03/22/2018] [Indexed: 01/28/2023]
|
6
|
Bhanpuri NH, Hallberg SJ, Williams PT, McKenzie AL, Ballard KD, Campbell WW, McCarter JP, Phinney SD, Volek JS. Cardiovascular disease risk factor responses to a type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at 1 year: an open label, non-randomized, controlled study. Cardiovasc Diabetol 2018; 17:56. [PMID: 29712560 PMCID: PMC5928595 DOI: 10.1186/s12933-018-0698-8] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/02/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of death among adults with type 2 diabetes mellitus (T2D). We recently reported that glycemic control in patients with T2D can be significantly improved through a continuous care intervention (CCI) including nutritional ketosis. The purpose of this study was to examine CVD risk factors in this cohort. METHODS We investigated CVD risk factors in patients with T2D who participated in a 1 year open label, non-randomized, controlled study. The CCI group (n = 262) received treatment from a health coach and medical provider. A usual care (UC) group (n = 87) was independently recruited to track customary T2D progression. Circulating biomarkers of cholesterol metabolism and inflammation, blood pressure (BP), carotid intima media thickness (cIMT), multi-factorial risk scores and medication use were examined. A significance level of P < 0.0019 ensured two-tailed significance at the 5% level when Bonferroni adjusted for multiple comparisons. RESULTS The CCI group consisted of 262 participants (baseline mean (SD): age 54 (8) year, BMI 40.4 (8.8) kg m-2). Intention-to-treat analysis (% change) revealed the following at 1-year: total LDL-particles (LDL-P) (- 4.9%, P = 0.02), small LDL-P (- 20.8%, P = 1.2 × 10-12), LDL-P size (+ 1.1%, P = 6.0 × 10-10), ApoB (- 1.6%, P = 0.37), ApoA1 (+ 9.8%, P < 10-16), ApoB/ApoA1 ratio (- 9.5%, P = 1.9 × 10-7), triglyceride/HDL-C ratio (- 29.1%, P < 10-16), large VLDL-P (- 38.9%, P = 4.2 × 10-15), and LDL-C (+ 9.9%, P = 4.9 × 10-5). Additional effects were reductions in blood pressure, high sensitivity C-reactive protein, and white blood cell count (all P < 1 × 10-7) while cIMT was unchanged. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score decreased - 11.9% (P = 4.9 × 10-5). Antihypertensive medication use was discontinued in 11.4% of CCI participants (P = 5.3 × 10-5). The UC group of 87 participants [baseline mean (SD): age 52 (10) year, BMI 36.7 (7.2) kg m-2] showed no significant changes. After adjusting for baseline differences when comparing CCI and UC groups, significant improvements for the CCI group included small LDL-P, ApoA1, triglyceride/HDL-C ratio, HDL-C, hsCRP, and LP-IR score in addition to other biomarkers that were previously reported. The CCI group showed a greater rise in LDL-C. CONCLUSIONS A continuous care treatment including nutritional ketosis in patients with T2D improved most biomarkers of CVD risk after 1 year. The increase in LDL-cholesterol appeared limited to the large LDL subfraction. LDL particle size increased, total LDL-P and ApoB were unchanged, and inflammation and blood pressure decreased. Trial registration Clinicaltrials.gov: NCT02519309. Registered 10 August 2015.
Collapse
Affiliation(s)
| | - Sarah J. Hallberg
- Virta Health, San Francisco, CA USA
- Medically Supervised Weight Loss, Indiana University Health Arnett, Lafayette, IN USA
| | | | | | - Kevin D. Ballard
- Department of Kinesiology and Health, Miami University, Oxford, OH USA
| | - Wayne W. Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN USA
| | - James P. McCarter
- Virta Health, San Francisco, CA USA
- Department of Genetics, Washington University School of Medicine, St. Louis, MO USA
| | | | - Jeff S. Volek
- Virta Health, San Francisco, CA USA
- Department of Human Sciences, The Ohio State University, Columbus, OH USA
| |
Collapse
|