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Blokhina AV, Ershova AI, Kiseleva AV, Sotnikova EA, Zharikova AA, Zaicenoka M, Vyatkin YV, Ramensky VE, Kutsenko VA, Shalnova SA, Meshkov AN, Drapkina OM. Applicability of Diagnostic Criteria and High Prevalence of Familial Dysbetalipoproteinemia in Russia: A Pilot Study. Int J Mol Sci 2023; 24:13159. [PMID: 37685967 PMCID: PMC10487848 DOI: 10.3390/ijms241713159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/14/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Familial dysbetalipoproteinemia (FD) is a highly atherogenic genetically based lipid disorder with an underestimated actual prevalence. In recent years, several biochemical algorithms have been developed to diagnose FD using available laboratory tests. The practical applicability of FD diagnostic criteria and the prevalence of FD in Russia have not been previously assessed. We demonstrated that the diagnostic algorithms of FD, including the diagnostic apoB levels, require correction, taking into account the distribution of apoB levels in the population. At the same time, a triglycerides cutoff ≥ 1.5 mmol/L may be a useful tool in identifying subjects with FD. In this study, a high prevalence of FD was detected: 0.67% (one in 150) based on the ε2ε2 haplotype and triglycerides levels ≥ 1.5 mmol/L. We also analyzed the presence and pathogenicity of APOE variants associated with autosomal dominant FD in a large research sample.
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Affiliation(s)
- Anastasia V. Blokhina
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Alexandra I. Ershova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Anna V. Kiseleva
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Evgeniia A. Sotnikova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Anastasia A. Zharikova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 1-73, Leninskie Gory, 119991 Moscow, Russia
| | - Marija Zaicenoka
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Institutskiy per. 9, 141701 Dolgoprudny, Russia;
| | - Yuri V. Vyatkin
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
- Department of Natural Sciences, Novosibirsk State University, 1, Pirogova Str., 630090 Novosibirsk, Russia
| | - Vasily E. Ramensky
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 1-73, Leninskie Gory, 119991 Moscow, Russia
| | - Vladimir A. Kutsenko
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
- Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, 1-73, Leninskie Gory, 119991 Moscow, Russia
| | - Svetlana A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Alexey N. Meshkov
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
- National Medical Research Center for Cardiology, 3–ya Cherepkovskaya Street, 15A, 121552 Moscow, Russia
- Research Centre for Medical Genetics, 1 Moskvorechye St, 115522 Moscow, Russia
- Department of General and Medical Genetics, Pirogov Russian National Research Medical University, 1 Ostrovityanova st., 117997 Moscow, Russia
| | - Oxana M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per. 10, Bld. 3, 101000 Moscow, Russia; (A.I.E.); (A.V.K.); (E.A.S.); (A.A.Z.); (Y.V.V.); (V.E.R.); (V.A.K.); (S.A.S.); (A.N.M.); (O.M.D.)
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Heidemann BE, Wolters FJ, Kavousi M, Gruppen EG, Dullaart RP, Marais AD, Visseren FL, Koopal C. Adiposity and the development of dyslipidemia in APOE ε2 homozygous subjects: A longitudinal analysis in two population-based cohorts. Atherosclerosis 2021; 325:57-62. [PMID: 33892328 DOI: 10.1016/j.atherosclerosis.2021.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/19/2021] [Accepted: 04/01/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Familial dysbetalipoproteinemia (FD), characterized by remnant lipoprotein accumulation and premature cardiovascular disease, occurs in homozygous carriers of the APOE ε2 allele, but genetic predisposition alone does not suffice for the clinical phenotype. Cross-sectional studies suggest that a second metabolic hit - notably adiposity or insulin resistance - is required, but the association between these risk factors and development of FD has not been studied prospectively. METHODS For this study, we evaluated 18,987 subjects from two large prospective Dutch population-based cohorts (PREVEND and Rotterdam Study) of whom 118 were homozygous APOE ε2 carriers. Of these, 69 subjects were available for prospective analyses. Dyslipidemia - likely to be FD - was defined as fasting triglyceride (TG) levels >3 mmol/L in untreated subjects or use of lipid lowering medication. The effect of weight, body mass index (BMI), waist circumference, type 2 diabetes mellitus and non-TG metabolic syndrome on development of dyslipidemia was investigated. RESULTS Eleven of the 69 ε2ε2 subjects (16%) developed dyslipidemia - likely FD - during follow-up. Age-, sex- and cohort-adjusted risk factors for the development of FD were BMI (OR 1.19; 95%CI 1.04-1.39), waist circumference (OR 1.26 95%CI 1.01-1.61) and presence of non-TG metabolic syndrome (OR 4.39; 95%CI 1.04-18.4) at baseline. Change in adiposity during follow-up was not associated with development of dyslipidemia. CONCLUSIONS Adiposity increases the risk of developing an FD-like lipid phenotype in homozygous APOE ε2 subjects. These results stress the importance of healthy body weight in subjects at risk of developing FD.
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Affiliation(s)
- Britt E Heidemann
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Eke G Gruppen
- Department of Endocrinology, University of Groningen and University Medical Center Groningen, University of Groningen, the Netherlands
| | - Robin Pf Dullaart
- Department of Endocrinology, University of Groningen and University Medical Center Groningen, University of Groningen, the Netherlands
| | - A David Marais
- Division of Chemical Pathology, Faculty of Health Sciences, University of Cape Town, South Africa, Cape Town, South Africa
| | - Frank Lj Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, the Netherlands.
| | - Charlotte Koopal
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, the Netherlands
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Terlemez S, Bozdemir E, Kalkan Uçar S, Kabaroğlu C, Habif S, Kayıkçıoğlu M, Çoker M. Insulin resistance in children with familial hyperlipidemia. J Pediatr Endocrinol Metab 2018; 31:1349-1354. [PMID: 30433876 DOI: 10.1515/jpem-2018-0337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/08/2018] [Indexed: 11/15/2022]
Abstract
Background The aim of the study was to investigate whether there is insulin resistance in children with familial hyperlipidemia (FHL) and to determine the factors affecting insulin resistance. Methods Hyperlipidemic children aged between 4 and 18 years and followed up with an FHL diagnosis were included in the study. The children of adults followed up with an FHL diagnosis were also recruited after the screening period. The scanned children were divided into two groups as hyperlipidemic and normolipidemic. A total of 77 patients of whom 52 were hyperlipidemic and 25 were normolipidemic were assessed in the study. Insulin resistance was evaluated (homeostatic model assessment of insulin resistance [HOMA-IR]) by performing the oral glucose tolerance test (OGTT). Results Of the patients, 36 were male and 41 were female; the average age was 11.6±3.9 years, and the body mass index (BMI) was established to be 20.3±4.4. In hyperlipidemic and normolipidemic patients, the following were determined: fasting insulin: 10.6 (±0.89) μU/mL, 4.9 (±0.45) μU/mL (p=0.000); 2-h insulin: 28.7 (±12.7) μU/mL, 18.9 (±10.5) μU/mL (p=0.000); and HOMA-IR: 1.9 (±0.17), 0.86 (±0.7) (p=0.000). No relationship was identified between lipid profiles and insulin resistance. Nevertheless, there was a positive correlation between insulin resistance and apolipoprotein B (Apo B) levels (0.52), and a negative correlation was determined in carnitine levels (-0.64). Conclusions Insulin resistance was established to be higher in children with FHL compared to normolipidemic children. Insulin resistance was not related to lipid phenotypes, but to Apo B levels and carnitine levels. Insulin resistance should be a routine method of evaluation in the follow-up of children with FHL.
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Affiliation(s)
- Semiha Terlemez
- Gazi University Medıcıne Faculty Pediatrıc Cardıology Department, Ankara 06100, Turkey, Phone: 00905327217689
| | - Erkin Bozdemir
- Çiğli Regional Education Hospital Department of Biochemistry, Izmir, Turkey
| | - Sema Kalkan Uçar
- Division of Metabolic Disease, Ege University Medical Faculty, Department of Pediatrics, Izmir, Turkey
| | - Ceyda Kabaroğlu
- Ege University, School of Medicine, Department of Clinical Biochemistry, İzmir, Turkey
| | - Sara Habif
- Ege University School of Medicine, Bornova, Izmir, Turkey
| | - Meral Kayıkçıoğlu
- Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey
| | - Mahmut Çoker
- Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey
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