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Guevara-Aguirre J, Mishra A, Canepa M, Guevara C, Villacres Á, Guevara A, Peña G, Lescano D, Kopchick JJ, Balasubramanian P, Longo VD. Normal or improved cardiovascular risk factors in IGF-I-deficient adults with growth hormone receptor deficiency. MED 2024; 5:816-825.e4. [PMID: 38677286 PMCID: PMC11246805 DOI: 10.1016/j.medj.2024.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/26/2023] [Accepted: 03/28/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Human subjects with generalized growth hormone (GH) insensitivity due to GH receptor deficiency (GHRD)/Laron syndrome display a very low incidence of insulin resistance, diabetes, and cancer, as well as delayed age-related cognitive decline. However, the risk of cardiovascular disease (CVD) in these subjects is poorly understood. Here, we have assessed cardiovascular function, damage, and risk factors in GHRD subjects and their relatives. METHODS We measured markers of CVD in two phases: one in a cohort of 30 individuals (GHRD = 16, control relatives = 14) brought to USC (in Los Angeles, CA) and one in a cohort including additional individuals examined in Ecuador (where the subjects live) for a total of 44 individuals (GHRD = 21, control relatives = 23). Data were collected on GHRD and control groups living in similar geographical locations and sharing comparable environmental and socio-economic circumstances. RESULTS Compared to controls, GHRD subjects displayed lower serum glucose, insulin, blood pressure, smaller cardiac dimensions, similar pulse wave velocity, lower carotid artery intima-media thickness, lower creatinine, and a non-significant but major reduction in the portion of subjects with carotid atherosclerotic plaques (7% GHRDs vs. 36%, Controls p = 0.1333) despite elevated low-density lipoprotein cholesterol levels. CONCLUSION The current study indicates that individuals with GHRD have normal or improved levels of cardiovascular disease risk factors as compared to their relatives. FUNDING This study was funded in part by NIH/NIA grant P01 AG034906 to V.D.L.
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Affiliation(s)
- Jaime Guevara-Aguirre
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador; Maastricht University, Maastricht, the Netherlands.
| | - Amrendra Mishra
- Longevity Institute, Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA; Department of Life Sciences, GITAM (Deemed to be University), Bengaluru, India
| | - Marco Canepa
- Cardiovascular Unit, Ospedale Policlinico San Martino IRCCS, Genova, Italy; Department of Internal Medicine and Medical Specialities, University of Genova, Genova, Italy
| | - Carolina Guevara
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador
| | - Álvaro Villacres
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Gabriela Peña
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - Daniela Lescano
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - John J Kopchick
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine and Edison Biotechnology Institute, Ohio University, Athens, OH, USA
| | - Priya Balasubramanian
- Longevity Institute, Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Valter D Longo
- Longevity Institute, Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA; IFOM, AIRC Institute of Molecular Oncology, Milan, Italy.
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Can Y, Uçaroğlu Can N, Akçay Ç, Ulaş SB, Kocayiğit I, Kocayiğit H, Ağaç MT. Increased Cardio-ankle Vascular Index Values in Migraine Patients With Aura. Angiology 2024:33197241228043. [PMID: 38236077 DOI: 10.1177/00033197241228043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Patients with migraine with aura are at an increased risk of cardiovascular disease. There are limited data on arterial stiffness in migraine patients with aura. The present study evaluated arterial stiffness in these patients using the cardio-ankle vascular index (CAVI). This prospective study included 50 patients with migraine with aura (43 female, mean age 38.9 ± 9.9 years). The patient group was matched for age and gender with 50 healthy individuals with no history of migraine (43 female, mean age 39.3 ± 10.3 years). All patients and control subjects underwent a comprehensive clinical evaluation by an experienced neurologist and were interviewed about their headache histories. There was no significant difference in baseline demographic characteristics and echocardiographic parameters between migraine with aura patients and the control group. Both right and left CAVI values were significantly higher in the patients with migraine with aura (6.5 ± 1.2 vs 6.1 ± 0.7, P = .043 and 6.6 ± 1.2 vs 6.1 ± 0.7, P = .009, respectively). Arterial stiffness is an important mediator of cardiovascular diseases. We found that CAVI, a novel marker of the arterial stiffness, is increased in patients with migraine with aura.
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Affiliation(s)
- Yusuf Can
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
| | - Nimet Uçaroğlu Can
- Department of Neurology, Training and Research Hospital, Sakarya University, Turkey
| | - Çağla Akçay
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
| | | | - Ibrahim Kocayiğit
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
| | - Havva Kocayiğit
- Department of Anaesthesiology and Reanimation, School of Medicine, Sakarya University, Turkey
| | - Mustafa Tarık Ağaç
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
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PCSK9 Induces Rat Smooth Muscle Cell Proliferation and Counteracts the Pleiotropic Effects of Simvastatin. Int J Mol Sci 2021; 22:ijms22084114. [PMID: 33923431 PMCID: PMC8073479 DOI: 10.3390/ijms22084114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/17/2022] Open
Abstract
Human atherosclerotic plaque contains smooth muscle cells (SMCs) negative for the contractile phenotype (α-smooth muscle actin) but positive for proprotein convertase subtilisin/kexin type 9 (PCSK9). Thus, we generated rat SMCs which overexpressed human PCSK9 (SMCsPCSK9) with the aim of investigating the role of PCSK9 in the phenotype of SMCs. PCSK9 overexpression in SMCsPCSK9 led to a significant downregulation of the low-density lipoprotein receptor (Ldlr) as well as transgelin (Sm22α), a marker of the contractile phenotype. The cell proliferation rate of SMCsPCSK9 was significantly faster than that of the control SMCs (SMCspuro). Interestingly, overexpression of PCSK9 did not impact the migratory capacity of SMCs in response to 10% FCS, as determined by Boyden's chamber assay. Expression and activity of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (Hmgcr) was significantly increased in the presence of PCSK9, both in SMCPCSK9 and after treatment with recombinant PCSK9. The transcriptional activity of sterol regulatory element-binding protein (SREBP) was also increased in the presence of PSCK9, suggesting a direct role of PCSK9 in the control of SRE-responsive genes, like HMGCR. We also observed that cholesterol biosynthesis is elevated in SMCPCSK9, potentially explaining the increased proliferation observed in these cells. Finally, concentration-dependent experiments with simvastatin demonstrated that SMCsPCSK9 were partially resistant to the antiproliferative and antimigratory effect of this drug. Taken together, these data further support a direct role of PCSK9 in proliferation, migration, and phenotypic changes in SMCs-pivotal features of atherosclerotic plaque development. We also provide new evidence on the role of PCSK9 in the pharmacological response to statins-gold standard lipid-lowering drugs with pleiotropic action.
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Beneficial Effect of Statin Therapy on Arterial Stiffness. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5548310. [PMID: 33860033 PMCID: PMC8026295 DOI: 10.1155/2021/5548310] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/01/2021] [Accepted: 03/17/2021] [Indexed: 12/13/2022]
Abstract
Arterial stiffness describes the increased rigidity of the arterial wall that occurs as a consequence of biological aging and several diseases. Numerous studies have demonstrated that parameters to assess arterial stiffness, especially pulse-wave velocity, are predictive of those individuals that will suffer cardiovascular morbidity and mortality. Statin therapy may be a pharmacological strategy to improve arterial elasticity. It has been shown that the positive benefits of statin therapy on cardiovascular disease is attributable not only to their lipid-lowering capacity but also to various pleiotropic effects, such as their anti-inflammatory, antiproliferative, antioxidant, and antithrombotic properties. Additionally, statins reduce endothelial dysfunction, improve vascular and myocardial remodeling, and stabilize atherosclerotic plaque. The aim of the present review was to summarize the evidence from human studies showing the effects of statins on arterial stiffness.
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Di Minno MND, Gentile M, Di Minno A, Iannuzzo G, Calcaterra I, Buonaiuto A, Di Taranto MD, Giacobbe C, Fortunato G, Rubba POF. Changes in carotid stiffness in patients with familial hypercholesterolemia treated with Evolocumab®: A prospective cohort study. Nutr Metab Cardiovasc Dis 2020; 30:996-1004. [PMID: 32402582 DOI: 10.1016/j.numecd.2020.02.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIM Protein convertase subtilisin kexin type 9 (PCSK-9) inhibitors demonstrated efficacy in cholesterol reduction and in the prevention of cardiovascular events. We evaluated changes in lipid profile and carotid stiffness in patients with familial hypercholesterolemia during 12 weeks of treatment with a PCSK-9 inhibitor, Evolocumab®. METHODS AND RESULTS Patients with familial hypercholesterolemia starting a treatment with Evolocumab® were included. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), small dense LDL (assessed by LDL score) and carotid stiffness were evaluated before starting treatment with Evolocumab® and during 12 weeks of treatment. Twenty-five subjects were enrolled (52% males, mean age 51.5 years). TC and LDL-C were reduced of 38% and 52%, respectively during treatment, with LDL score reduced of 46.1%. In parallel, carotid stiffness changed from 8.8 (IQR: 7.0-10.4) m/sec to 6.6 (IQR: 5.4-7.5) m/sec, corresponding to a median change of 21.4% (p < 0.001), with a significant increase in carotid distensibility (from 12.1, IQR: 8.73-19.3 kPA-1 × 10-3 at T0 to 21.8, IQR: 16.6-31.8 kPA-1 × 10-3 at T12w) corresponding to a median change of 62.8% (p < 0.001). A multivariate analysis showed that changes in LDL score were independently associated with changes in carotid stiffness (β = 0.429, p = 0.041). CONCLUSION Small dense LDL reduction, as assessed by LDL score, is associated with changes in carotid stiffness in patients with familial hypercholesterolemia treated with Evolocumab®.
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Affiliation(s)
| | - Marco Gentile
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Alessandro Di Minno
- Department of Pharmacy, Federico II University, Naples, Italy; Unit of Metabolomics and Cellular Biochemistry of Atherothrombosis, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Ilenia Calcaterra
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Alessio Buonaiuto
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Maria D Di Taranto
- Department of Molecular Medicine e Medical Biotechnologies, Federico II University, Naples, Italy
| | - Carola Giacobbe
- Department of Molecular Medicine e Medical Biotechnologies, Federico II University, Naples, Italy
| | - Giuliana Fortunato
- Department of Molecular Medicine e Medical Biotechnologies, Federico II University, Naples, Italy
| | - Paolo O F Rubba
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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Mandraffino G, Scicali R, Rodríguez-Carrio J, Savarino F, Mamone F, Scuruchi M, Cinquegrani M, Imbalzano E, Di Pino A, Piro S, Rabuazzo AM, Squadrito G, Purrello F, Saitta A. Arterial stiffness improvement after adding on PCSK9 inhibitors or ezetimibe to high-intensity statins in patients with familial hypercholesterolemia: A Two-Lipid Center Real-World Experience. J Clin Lipidol 2020; 14:231-240. [PMID: 32111581 DOI: 10.1016/j.jacl.2020.01.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/29/2019] [Accepted: 01/28/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is characterized by increased cardiovascular risk; despite-high intensity statins, only few patients with FH achieve the recommended low-density lipoprotein cholesterol (LDL-C) targets. OBJECTIVE We aimed to evaluate the effectiveness of six-month add-on therapy with proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9-i) or ezetimibe on lipid profile and pulse wave velocity (PWV) in patients with FH. METHODS In this observational study, we evaluated 98 genetically confirmed patients with FH with an LDL-C off-target despite high-intensity statins with or without ezetimibe; of these, 53 patients (statin plus ezetimibe) added PCSK9-i (PCSK9-i group) and 45 (statin only) added ezetimibe (EZE group) per applicable guidelines and reimbursement rules. All patients obtained biochemical analysis and PWV evaluation at baseline and after six months of optimized treatment. RESULTS After 6 months of add-on therapy, most patients achieving LDL-C targets were in the PCSK9-i group (77.3% PCSK9-i group vs 37.8% EZE group, P < .001). The PCSK9-i group achieved both a greater LDL-C and PWV reduction than the EZE group [-51% vs -22.8%, P < .001 and -15% vs -8.5%, P < .01, respectively]. In a linear regression analysis, we showed a coefficient (r) of 0.334 for the relationship between ΔPWV and ΔLDL (P < .05); moreover, in an exploratory analysis, the relationship appeared to be stronger in patients with FH without cardiovascular events (r = 0.422, P < .01). CONCLUSIONS Lipid and PWV profiles in patients with FH significantly improved after addition of PCSK9-i or ezetimibe to high-intensity statin therapy; moreover, ΔPWV was associated with ΔLDL. Our results are consistent with a beneficial role of these novel therapies in FH subjects.
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Affiliation(s)
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Javier Rodríguez-Carrio
- Department of Functional Biology, Area of Immunology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Area of Metabolism, Instituto de Investigación Sanitaria Del Principado de Asturias (ISPA), Oviedo, Spain; Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, RED in REN Del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Francesca Savarino
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Federica Mamone
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Michele Scuruchi
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Maria Cinquegrani
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | | | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Antonino Saitta
- Department of Clinical and Experimental Medicine, University of Messina, Italy
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Choudhary MK, Eräranta A, Tikkakoski AJ, Koskela J, Hautaniemi EJ, Kähönen M, Mustonen J, Pörsti I. LDL cholesterol is associated with systemic vascular resistance and wave reflection in subjects naive to cardiovascular drugs. Blood Press 2018; 28:4-14. [PMID: 30369274 DOI: 10.1080/08037051.2018.1521263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Low density lipoprotein cholesterol (LDL-C) is a primary risk factor for atherosclerosis, but it is also associated with elevated blood pressure (BP) and future development of hypertension. We examined the relationship between LDL-C and haemodynamic variables in normotensive and never-treated hypertensive subjects. METHODS We recruited 615 volunteers (19-72 years) without lipid-lowering and BP-lowering medication. Supine haemodynamics were recorded using continuous radial pulse wave analysis, whole-body impedance cardiography, and single channel electrocardiogram. The haemodynamic relations of LDL-C were examined using linear regression analyses with age, sex, body mass index (BMI) (or height and weight as appropriate), smoking status, alcohol use, and plasma C-reactive protein, sodium, uric acid, high density lipoprotein cholesterol (HDL-C), triglycerides, estimated glomerular filtration rate, and quantitative insulin sensitivity check index as the other included variables. RESULTS The mean (SD) characteristics of the subjects were: age 45 (12) years, BMI 27 (4) kg/m2, office BP 141/89 (21/13) mmHg, creatinine 74 (14) µmol/l, total cholesterol 5.2 (1.0), LDL-C 3.1 (0.6), triglycerides 1.2 (0.8), and HDL-C 1.6 (0.4) mmol/l. LDL-C was an independent explanatory factor for aortic systolic and diastolic BP, augmentation index, pulse wave velocity (PWV), and systemic vascular resistance index (p < 0.05 for all). When central BP was included in the model for PWV, LDL-C was no longer an explanatory factor for PWV. CONCLUSIONS LDL-C is independently associated with BP via systemic vascular resistance and wave reflection. These results suggest that LDL-C may play a role in the pathogenesis of primary hypertension.
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Affiliation(s)
| | - Arttu Eräranta
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland
| | - Antti J Tikkakoski
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,b Department of Clinical Physiology , Tampere University Hospital , Tampere , Finland
| | - Jenni Koskela
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland
| | - Elina J Hautaniemi
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland
| | - Mika Kähönen
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,b Department of Clinical Physiology , Tampere University Hospital , Tampere , Finland
| | - Jukka Mustonen
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,c Department of Internal Medicine , Tampere University Hospital , Tampere , Finland
| | - Ilkka Pörsti
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,c Department of Internal Medicine , Tampere University Hospital , Tampere , Finland
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