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Zhu Y, Cai SS, Ma J, Cheng L, Wei C, Aggarwal A, Toh WH, Shin C, Shen R, Kong J, Mao SA, Lao YH, Leong KW, Mao HQ. Optimization of lipid nanoparticles for gene editing of the liver via intraduodenal delivery. Biomaterials 2024; 308:122559. [PMID: 38583366 PMCID: PMC11099935 DOI: 10.1016/j.biomaterials.2024.122559] [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: 01/13/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/09/2024]
Abstract
Lipid nanoparticles (LNPs) have recently emerged as successful gene delivery platforms for a diverse array of disease treatments. Efforts to optimize their design for common administration methods such as intravenous injection, intramuscular injection, or inhalation, revolve primarily around the addition of targeting ligands or the choice of ionizable lipid. Here, we employed a multi-step screening method to optimize the type of helper lipid and component ratios in a plasmid DNA (pDNA) LNP library to efficiently deliver pDNA through intraduodenal delivery as an indicative route for oral administration. By addressing different physiological barriers in a stepwise manner, we down-selected effective LNP candidates from a library of over 1000 formulations. Beyond reporter protein expression, we assessed the efficiency in non-viral gene editing in mouse liver mediated by LNPs to knockdown PCSK9 and ANGPTL3 expression, thereby lowering low-density lipoprotein (LDL) cholesterol levels. Utilizing an all-in-one pDNA construct with Strep. pyogenes Cas9 and gRNAs, our results showcased that intraduodenal administration of selected LNPs facilitated targeted gene knockdown in the liver, resulting in a 27% reduction in the serum LDL cholesterol level. This LNP-based all-in-one pDNA-mediated gene editing strategy highlights its potential as an oral therapeutic approach for hypercholesterolemia, opening up new possibilities for DNA-based gene medicine applications.
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Affiliation(s)
- Yining Zhu
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA
| | - Shuting Sarah Cai
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
| | - Jingyao Ma
- Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Leonardo Cheng
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA
| | - Christine Wei
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA
| | - Ataes Aggarwal
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Computer Science, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Wu Han Toh
- Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Computer Science, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Biology, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Charles Shin
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Ruochen Shen
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA
| | - Jiayuan Kong
- Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Shuming Alan Mao
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Department of Computer Science, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Yeh-Hsing Lao
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
| | - Kam W Leong
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA; Department of Systems Biology, Columbia University Medical Center, New York, NY, 10032, USA.
| | - Hai-Quan Mao
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, 21218, USA; Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA; Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
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Faridi KF, Lahan S, Budoff MJ, Cury RC, Feldman T, Pan AP, Fialkow J, Nasir K. Serum Lipoproteins Are Associated With Coronary Atherosclerosis in Asymptomatic U.S. Adults Without Traditional Risk Factors. JACC. ADVANCES 2024; 3:101049. [PMID: 39129991 PMCID: PMC11312344 DOI: 10.1016/j.jacadv.2024.101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/27/2024] [Accepted: 04/16/2024] [Indexed: 08/13/2024]
Abstract
Background The relationship between atherogenic lipoproteins and subclinical coronary atherosclerosis has not been thoroughly evaluated in low-risk adults. Objectives The purpose of this study was to assess the association of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C), and apolipoprotein B (apoB) with coronary atherosclerosis in adults without traditional risk factors. Methods We assessed atherosclerosis on coronary computed tomography angiography among asymptomatic adults in the Miami Heart Study not taking lipid-lowering therapy and without hypertension, diabetes, or active tobacco use. Prevalence of atherosclerosis was evaluated based on serum LDL-C, non-HDL-C, and apoB, and multivariable logistic regression with forward selection was used to assess variables associated with coronary plaque. Results Among 1,033 adults 40 to 65 years of age, 55.0% were women and 86.3% had estimated 10-year atherosclerotic cardiovascular disease risk <5%. Coronary atherosclerosis prevalence was 35.9% (50.6% in men; 23.8% in women) and 3.4% had ≥1 high-risk plaque feature. Atherosclerosis prevalence increased with LDL-C, ranging from 13.2% in adults with LDL-C <70 mg/dL up to 48.2% with ≥160 mg/dL. Higher LDL-C (adjusted OR [aOR]: 1.13 [95% CI: 1.08-1.18] per 10 mg/dL), age (aOR: 1.43 [95% CI: 1.28-1.60] per 5 years), male sex (aOR: 3.81 [95% CI: 2.86-5.10]), and elevated lipoprotein(a) (aOR: 1.46 [95% CI: 1.01-2.09]) were associated with atherosclerosis. Higher serum non-HDL-C and apoB were similarly associated with atherosclerosis. In adults with optimal risk factors, 21.2% had atherosclerosis with greater prevalence at higher lipoprotein levels. Conclusions Among asymptomatic middle-aged adults without traditional risk factors, coronary atherosclerosis is common and increasingly prevalent at higher levels of atherogenic lipoproteins. These findings emphasize the importance of lipid-lowering strategies to prevent development and progression of atherosclerosis regardless of risk factors.
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Affiliation(s)
- Kamil F. Faridi
- Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Shubham Lahan
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Matthew J. Budoff
- Division of Cardiology, Harbor UCLA Medical Center, Torrance, California, USA
| | - Ricardo C. Cury
- Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida, USA
| | - Theodore Feldman
- Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida, USA
| | - Alan P. Pan
- Center for Health Data Science and Analytics, Houston Methodist Research Institute, Houston, Texas, USA
| | - Jonathan Fialkow
- Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
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Grejtakova D, Boronova I, Bernasovska J, Bellosta S. PCSK9 and Lipid Metabolism: Genetic Variants, Current Therapies, and Cardiovascular Outcomes. Cardiovasc Drugs Ther 2024:10.1007/s10557-024-07599-5. [PMID: 38907775 DOI: 10.1007/s10557-024-07599-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 06/24/2024]
Abstract
Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a crucial role in the modulation of lipid metabolism as a critical negative regulator of hepatic low-density lipoprotein receptor (LDLR) levels and circulating low-density lipoprotein (LDL) clearance. Numerous gain-of-function (GOF) mutations in PCSK9 have been identified as causing familial hypercholesterolemia (FH) by reducing LDLR levels, and loss-of-function (LOF) mutations associated with a hypercholesterolemia phenotype protective against atherosclerosis. PCSK9 represents an example of successful translational research resulting in the identification of PCSK9 as a major drug target for a lipid-lowering therapy. To explore the genetic constitution of PCSK9 and its biologic role, in this review, we summarize the current evidence of clinically significant PCSK9 genetic variants involved in lipid metabolism as well as emphasize the importance of PCSK9 inhibition for the improvement of cardiovascular outcomes by conducting a meta-analysis of the available data on the incidence of cardiovascular disease events.
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Affiliation(s)
- Daniela Grejtakova
- Laboratory of Molecular Genetics, Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, 17 November 1, Presov, 08001, Slovakia.
| | - Iveta Boronova
- Laboratory of Molecular Genetics, Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, 17 November 1, Presov, 08001, Slovakia
| | - Jarmila Bernasovska
- Laboratory of Molecular Genetics, Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, 17 November 1, Presov, 08001, Slovakia
| | - Stefano Bellosta
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università Degli Studi di Milano, Via Balzaretti 9, 20133, Milan, Italy
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Rasmussen KL, Luo J, Nordestgaard BG, Tybjærg-Hansen A, Frikke-Schmidt R. APOE and vascular disease: Sequencing and genotyping in general population cohorts. Atherosclerosis 2023; 385:117218. [PMID: 37586954 DOI: 10.1016/j.atherosclerosis.2023.117218] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/14/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND AIMS The apolipoprotein E(APOE) ϵ2/ϵ3/ϵ4 polymorphism plays a central role in lipid metabolism, vascular disease and dementia. The impact of the full range of structural genetic variation in APOE for lipids, lipoproteins and apolipoproteins and for vascular disease in the general population is not known. METHODS We systematically sequenced APOE in 10,296 individuals from the Copenhagen City Heart Study and genotyped nine rare variants (frequency≥2/10,296) in 95,227 individuals from the Copenhagen General Population Study. The UK Biobank was used for validation of common APOE variants. RESULTS Rare mutations in APOE, predicted to be deleterious, are present in 1 in 257 individuals in the general population. In the meta-analysis, multifactorially adjusted hazard ratios (95% confidence intervals) for ϵ44 and ϵ22 versus ϵ33 were 1.15 (1.04-1.26) and 1.02 (0.83-1.24) for ischemic cerebrovascular disease (ICVD), 1.11 (1.04-1.19) and 0.94 (0.83-1.08) for ischemic heart disease (IHD) and 1.03 (0.89-1.17) and 1.49 (1.20-1.87) for peripheral arterial disease (PAD). A multifactorially and ϵ2/ϵ3/ϵ4 adjusted weighted allele score on the continuous scale including all common and rare structural variants showed that for individuals with genetically predicted high plasma apoE and remnant cholesterol the risk for PAD was increased. CONCLUSIONS APOE variants with high apoE, triglycerides, and remnant cholesterol are associated with PAD, whereas common APOE variants with high LDL cholesterol, triglycerides and remnant cholesterol are associated with IHD. APOE variants with low apoE are associated with increased risk of ICVD. These findings highlight that both rare and common structural variations in APOE play a role in vascular disease.
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Affiliation(s)
- Katrine L Rasmussen
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark; Department of Clinical Biochemistry, Nordsjællands Hospital, Dyrehavevej 29, DK-3400 Hillerød, Denmark.
| | - Jiao Luo
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark
| | - Børge G Nordestgaard
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark; The Copenhagen City Heart Study, Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark; Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark
| | - Anne Tybjærg-Hansen
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark; The Copenhagen City Heart Study, Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
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Roeters van Lennep JE, Tokgözoğlu LS, Badimon L, Dumanski SM, Gulati M, Hess CN, Holven KB, Kavousi M, Kayıkçıoğlu M, Lutgens E, Michos ED, Prescott E, Stock JK, Tybjaerg-Hansen A, Wermer MJH, Benn M. Women, lipids, and atherosclerotic cardiovascular disease: a call to action from the European Atherosclerosis Society. Eur Heart J 2023; 44:4157-4173. [PMID: 37611089 PMCID: PMC10576616 DOI: 10.1093/eurheartj/ehad472] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Cardiovascular disease is the leading cause of death in women and men globally, with most due to atherosclerotic cardiovascular disease (ASCVD). Despite progress during the last 30 years, ASCVD mortality is now increasing, with the fastest relative increase in middle-aged women. Missed or delayed diagnosis and undertreatment do not fully explain this burden of disease. Sex-specific factors, such as hypertensive disorders of pregnancy, premature menopause (especially primary ovarian insufficiency), and polycystic ovary syndrome are also relevant, with good evidence that these are associated with greater cardiovascular risk. This position statement from the European Atherosclerosis Society focuses on these factors, as well as sex-specific effects on lipids, including lipoprotein(a), over the life course in women which impact ASCVD risk. Women are also disproportionately impacted (in relative terms) by diabetes, chronic kidney disease, and auto-immune inflammatory disease. All these effects are compounded by sociocultural components related to gender. This panel stresses the need to identify and treat modifiable cardiovascular risk factors earlier in women, especially for those at risk due to sex-specific conditions, to reduce the unacceptably high burden of ASCVD in women.
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Affiliation(s)
- Jeanine E Roeters van Lennep
- Department of Internal Medicine, Cardiovascular Institute, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Lale S Tokgözoğlu
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Lina Badimon
- Cardiovascular Science Program-ICCC, IR-Hospital de la Santa Creu I Santa Pau, Ciber CV, Autonomous University of Barcelona, Barcelona, Spain
| | - Sandra M Dumanski
- Department of Medicine, Cumming School of Medicine, University of Calgary, Libin Cardiovascular Institute, and O’Brien Institute for Public Health, Calgary, Canada
| | - Martha Gulati
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Connie N Hess
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora and CPC Clinical Research Aurora, CO, USA
| | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, and National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Meral Kayıkçıoğlu
- Department of Cardiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Esther Lutgens
- Cardiovascular Medicine and Immunology, Mayo Clinic, Rochester, MN, USA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eva Prescott
- Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Jane K Stock
- European Atherosclerosis Society, Mässans Gata 10, SE-412 51 Gothenburg, Sweden
| | - Anne Tybjaerg-Hansen
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, The Copenhagen General Population Study, Copenhagen University Hospital-Herlev and Gentofte Hospital, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marieke J H Wermer
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology at University Medical Center Groningen, Groningen, The Netherlands
| | - Marianne Benn
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, The Copenhagen General Population Study, Copenhagen University Hospital-Herlev and Gentofte Hospital, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Ruscica M, Macchi C, Giuliani A, Rizzuto AS, Ramini D, Sbriscia M, Carugo S, Bonfigli AR, Corsini A, Olivieri F, Sabbatinelli J. Circulating PCSK9 as a prognostic biomarker of cardiovascular events in individuals with type 2 diabetes: evidence from a 16.8-year follow-up study. Cardiovasc Diabetol 2023; 22:222. [PMID: 37620933 PMCID: PMC10464486 DOI: 10.1186/s12933-023-01948-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality, being twofold to fourfold more common in patients with type 2 diabetes mellitus (T2DM) than in individuals without diabetes. However, despite this decade-old knowledge, the identification of a specific prognostic risk biomarker remains particularly challenging. METHODS Taking advantage of a large sample of Caucasian patients (n = 529) with a diagnosis of T2DM followed for a median of 16.8 years, the present study was aimed at testing the hypothesis that fasting serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels could be prognostic for major adverse cardiovascular events (MACE) and all-cause mortality. RESULTS Median levels of PCSK9 were 259.8 ng/mL, being higher in women compared to men and increasing even more in the presence of a complication (e.g., diabetic kidney disease). PCSK9 positively correlated with markers of blood glucose homeostasis (e.g., HbA1c, fasting insulin and HOMA-IR) and the atherogenic lipid profile (e.g., non-HDL-C, apoB and remnant cholesterol). Serum PCSK9 predicted new-onset of MACE, either fatal or non-fatal, only in women (Odds Ratio: 2.26, 95% CI 1.12-4.58) and all-cause mortality only in men (Hazard Ratio: 1.79, 95% CI 1.13-2.82). CONCLUSIONS Considering that up to two-thirds of individuals with T2DM develop ASCVD in their lifetime, the assessment of circulating PCSK9 levels can be envisioned within the context of a biomarker-based strategy of risk stratification. However, the sex difference found highlights an urgent need to develop sex-specific risk assessment strategies. TRIAL REGISTRATION It is a retrospective study.
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Affiliation(s)
- Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy.
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Chiara Macchi
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
| | - Angelica Giuliani
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | | | - Deborah Ramini
- Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy
| | - Matilde Sbriscia
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Stefano Carugo
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | | | - Alberto Corsini
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
| | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
- Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy
| | - Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy.
- Laboratory Medicine Unit, Azienda Ospedaliero Universitaria Delle Marche, Ancona, Italy.
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Kujawowicz K, Mirończuk-Chodakowska I, Witkowska AM. Sirtuin 1 as a potential biomarker of undernutrition in the elderly: a narrative review. Crit Rev Food Sci Nutr 2023:1-22. [PMID: 37229564 DOI: 10.1080/10408398.2023.2214208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Undernutrition and inflammatory processes are predictors of early mortality in the elderly and require a rapid and accurate diagnosis. Currently, there are laboratory markers for assessing nutritional status, but new markers are still being sought. Recent studies suggest that sirtuin 1 (SIRT1) has the potential to be a marker for undernutrition. This article summarizes available studies on the association of SIRT1 and undernutrition in older people. Possible associations between SIRT1 and the aging process, inflammation, and undernutrition in the elderly have been described. The literature suggests that low SIRT1 levels in the blood of older people may not be associated with physiological aging processes, but with an increased risk of severe undernutrition associated with inflammation and systemic metabolic changes.
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Affiliation(s)
- Karolina Kujawowicz
- Department of Food Biotechnology, Medical University of Bialystok, Bialystok, Poland
| | | | - Anna Maria Witkowska
- Department of Food Biotechnology, Medical University of Bialystok, Bialystok, Poland
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8
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Devi K, Bhargave A, Ahmad I, Yadav A, Gupta R. Association study of PCSK9 SNPs (rs505151 & rs562556) and their haplotypes with CVDs in Indian population. Ann Hum Biol 2023; 50:56-62. [PMID: 36695028 DOI: 10.1080/03014460.2023.2171121] [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: 01/26/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) has emerged as the most prevalent cause of death in India. Pro-protein Convertase Subtilisin/Kexin Type 9 (PCSK9) gene has been found to be associated with lipid levels and a biomarker for susceptibility of CVD. AIM To study the association of PCSK9 SNPs rs505151 & rs562556 and their haplotypes with CVDs in the Indian population. SUBJECTS & METHODS The present study comprised of 102 angiographically proven CVD patients & 100 healthy subjects. To study polymorphism, Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) method was used. Biochemical parameters were analysed by enzymatic methods or automated analysers. Haplotype analysis was done using SHEsis software. RESULTS The dominant genetic model with an odds ratio (confidence interval) of 4.71 (2.59 - 8.5), (p value = .0001), shows the risk of CVDs. However, rs562556 (I474V) variant was not found to be associated with clinical parameters and risk of CVDs (p value >.05). Out of four haplotypes, H3 (G-A) was found to be associated with the CVDs (OR- 3.137, p value = .0001). CONCLUSION This study concludes that G allele of rs505151 SNP (PCSK9) and the H3 (G-A) haplotype of rs505151 & rs562556 were found to be risk factors for CVDs in the Indian population.
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Affiliation(s)
- Kiran Devi
- Department of Biochemistry, Kurukukshetra University, Kurukshetra, India
| | - Archna Bhargave
- Department of Biochemistry, Kurukukshetra University, Kurukshetra, India
| | - Imteyaz Ahmad
- Department of Biochemistry, Kurukukshetra University, Kurukshetra, India
| | - Anita Yadav
- Department of Biotechnology, Kurukukshetra University, Kurukshetra, India
| | - Ranjan Gupta
- Department of Biochemistry, Kurukukshetra University, Kurukshetra, India
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9
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Hu YX, You HM, Zhu RF, Liang YL, Li FF, Qin YW, Zhao XX, Liang C, Jing Q. Establishment of a lipid metabolism disorder model in ApoEb mutant zebrafish. Atherosclerosis 2022; 361:18-29. [PMID: 36306655 DOI: 10.1016/j.atherosclerosis.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/21/2022] [Accepted: 10/14/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS ApoEb is a zebrafish homologous to mammalian ApoE, whose deficiency would lead to lipid metabolism disorders (LMDs) like atherosclerosis. We attempted to knock out the zebrafish ApoEb, then establish a zebrafish model with LMD. METHODS ApoEb was knocked out using the CRISPR/Cas9 system, and the accumulation of lipids was confirmed by Oil Red O staining, confocal imaging, and lipid measurements. The lipid-lowering effects of simvastatin (SIM), ezetimibe (EZE) and Xuezhikang (XZK), an extract derived from red yeast rice, were evaluated through in vivo imaging in zebrafish larvae. RESULTS In the ApoEb mutant, significant vascular lipid deposition occurred, and lipid measurement performed in the whole-body homogenate of larvae and adult plasma showed significantly increased lipid levels. SIM, EZE and XZK apparently relieved hyperlipidemia in ApoEb mutants, and XZK had a significant inhibitory effect on the recruitment of neutrophils and macrophages. CONCLUSIONS In this study, an LMD model has been established in ApoEb mutant zebrafish. We suggest that this versatile model could be applied in studying hypercholesterolemia and related vascular pathology in the context of early atherosclerosis, as well as the physiological function of ApoE.
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Affiliation(s)
- Yang-Xi Hu
- Department of Cardiology, Changzheng Hospital, Shanghai, 200003, China
| | - Hong-Min You
- Department of Cardiology, Changhai Hospital, Shanghai, 200433, China
| | - Rong-Fang Zhu
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yu-Lai Liang
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Fang-Fang Li
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yong-Wen Qin
- Department of Cardiology, Changhai Hospital, Shanghai, 200433, China
| | - Xian-Xian Zhao
- Department of Cardiology, Changhai Hospital, Shanghai, 200433, China
| | - Chun Liang
- Department of Cardiology, Changzheng Hospital, Shanghai, 200003, China.
| | - Qing Jing
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China.
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Effect of High-Intensity Strength and Endurance Training in the Form of Small Circuits on Changes in Lipid Levels in Men Aged 35–40 Years. J Clin Med 2022; 11:jcm11175146. [PMID: 36079074 PMCID: PMC9457363 DOI: 10.3390/jcm11175146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Blood lipid profiles consist of total cholesterol (TC) and its fractions, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG). For several decades, studies have examined the effects of various factors on lipid status and its association with the risk of developing arteriosclerosis and cardiovascular disease. The beneficial effects of increased physical activity on cardiovascular health have been demonstrated by appropriate modulation of lipid profiles. For individuals with low physical activity, the literature recommends engaging in various forms of training that can improve physical fitness and resting lipid status. The aim of the study was to examine whether a specific original training program improves lipid profiles to the levels recommended for the male population. Methods: The study involved two equal (n = 15) groups of men (experimental and control groups, aged 35–40 years). The experimental group performed 60-min training sessions for 8 weeks (3 times a week) including a set of strength and endurance exercises. Before and after the training program, blood was drawn from both groups for serum determination of TC, HDL, LDL non-HDL, and TG, and a battery of four field physical performance tests was administered. Results: Statistically significant decreases (TC by 19.3%, TG by 23.7%, LDL by 15%), a non-significant decrease (10% for non-HDL), and no change for HDL were found in the experimental group. Control group showed a statistically significant decrease, by 7.4% for TC. The results confirm the effectiveness of the proposed training in improving health indices. Conclusions: The 8-week training program met the health-related fitness paradigm recommended for physical activity in men aged 35–40 years. After the completion of the program, all the participants expressed their satisfaction from participating in a health-promoting experiment.
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Iwagami M, Qizilbash N, Gregson J, Douglas I, Johnson M, Pearce N, Evans S, Pocock S. Blood cholesterol and risk of dementia in more than 1·8 million people over two decades: a retrospective cohort study. THE LANCET HEALTHY LONGEVITY 2021; 2:e498-e506. [DOI: 10.1016/s2666-7568(21)00150-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/10/2021] [Accepted: 06/16/2021] [Indexed: 01/27/2023]
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PCSK9: A Multi-Faceted Protein That Is Involved in Cardiovascular Biology. Biomedicines 2021; 9:biomedicines9070793. [PMID: 34356856 PMCID: PMC8301306 DOI: 10.3390/biomedicines9070793] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 12/29/2022] Open
Abstract
Pro-protein convertase subtilisin/kexin type 9 (PCSK9) is secreted mostly by hepatocytes and to a lesser extent by the intestine, pancreas, kidney, adipose tissue, and vascular cells. PCSK9 has been known to interact with the low-density lipoprotein receptor (LDLR) and chaperones the receptor to its degradation. In this manner, targeting PCSK9 is a novel attractive approach to reduce hyperlipidaemia and the risk for cardiovascular diseases. Recently, it has been recognised that the effects of PCSK9 in relation to cardiovascular complications are not only LDLR related, but that various LDLR-independent pathways and processes are also influenced. In this review, the various LDLR dependent and especially independent effects of PCSK9 on the cardiovascular system are discussed, followed by an overview of related PCSK9-polymorphisms and currently available and future therapeutic approaches to manipulate PCSK9 expression.
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Hu D, Guo Y, Wu R, Shao T, Long J, Yu B, Wang H, Luo Y, Lu H, Zhang J, Chen YE, Peng D. New Insight Into Metformin-Induced Cholesterol-Lowering Effect Crosstalk Between Glucose and Cholesterol Homeostasis via ChREBP (Carbohydrate-Responsive Element-Binding Protein)-Mediated PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) Regulation. Arterioscler Thromb Vasc Biol 2021; 41:e208-e223. [PMID: 33535788 DOI: 10.1161/atvbaha.120.315708] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Die Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
- Department of Internal Medicine, University of Michigan, Ann Arbor (D.H., Y.G., H.W., Y.L., H.L., J.Z., Y.E.C.)
| | - Yanhong Guo
- Department of Internal Medicine, University of Michigan, Ann Arbor (D.H., Y.G., H.W., Y.L., H.L., J.Z., Y.E.C.)
| | - Renrong Wu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (R.W., T.S.)
| | - Tiannan Shao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (R.W., T.S.)
| | - Junke Long
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
| | - Bilian Yu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
| | - Huilun Wang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
- Department of Internal Medicine, University of Michigan, Ann Arbor (D.H., Y.G., H.W., Y.L., H.L., J.Z., Y.E.C.)
| | - Yonghong Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
- Department of Internal Medicine, University of Michigan, Ann Arbor (D.H., Y.G., H.W., Y.L., H.L., J.Z., Y.E.C.)
| | - Haocheng Lu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
- Department of Internal Medicine, University of Michigan, Ann Arbor (D.H., Y.G., H.W., Y.L., H.L., J.Z., Y.E.C.)
| | - Jifeng Zhang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
- Department of Internal Medicine, University of Michigan, Ann Arbor (D.H., Y.G., H.W., Y.L., H.L., J.Z., Y.E.C.)
| | - Y Eugene Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
- Department of Internal Medicine, University of Michigan, Ann Arbor (D.H., Y.G., H.W., Y.L., H.L., J.Z., Y.E.C.)
| | - Daoquan Peng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (D.H., J.L., B.Y., Y.L., D.P.)
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Daghlas I, Gill D. Low-density lipoprotein cholesterol and lifespan: A Mendelian randomization study. Br J Clin Pharmacol 2021; 87:3916-3924. [PMID: 33704808 DOI: 10.1111/bcp.14811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/21/2021] [Accepted: 02/26/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS It is unknown whether long-term low-density lipoprotein cholesterol (LDL-c) lowering increases lifespan and longevity in a general population not selected for elevated cardiovascular risk. The present study aimed to investigate the overall and gene-specific effect of circulating LDL-c levels on lifespan and longevity in a general population. METHODS Leveraging data from the Global Lipids Genetics Consortium (n = 173 082), we identified genetic variants to proxy LDL-c levels generally, and also through perturbation of particular drug targets (HMGCR, NPC1L1 and PCSK9). We investigated their association with lifespan (n = 1 012 240) using Mendelian randomization, and replicated results using the outcome of longevity to the 90th vs. 60th percentile age (11 262 cases/25 483 controls). RESULTS A 1-standard deviation increase in genetically proxied LDL-c was associated with 1.2 years lower lifespan (95% confidence interval [CI] -1.55, -0.87; P = 3.83 × 10-12 ). Findings were consistent in statistical sensitivity analyses, and when considering the outcome of longevity (odds ratio for survival to the 90th vs 60th percentile age 0.72, 95% CI 0.64, 0.81, P = 7.83 × 10-8 ). Gene-specific Mendelian randomization analyses showed a significant effect of LDL-c modification through PCSK9 on lifespan (-0.99 years, 95% CI -1.43, 0.55, P = 6.80 × 10-6 ); however, estimates for HMGCR and NPC1L1 were underpowered. CONCLUSIONS This genetic evidence supports that higher LDL-c levels reduce lifespan and longevity. In a general population that is not selected for increased cardiovascular risk, there is likely to be a net lifespan benefit of LDL-c lowering therapies, particularly for PCSK9 inhibitors, although randomized controlled trials are necessary before modification of clinical practice.
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Affiliation(s)
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Clinical Pharmacology and Therapeutics Section, Institute of Medical and Biomedical Education and Institute for Infection and Immunity, St George's, University of London, London, UK.,Clinical Pharmacology Group, Pharmacy and Medicines Directorate, St George's University Hospitals NHS Foundation Trust, London, UK.,Novo Nordisk Research Centre Oxford, Old Road Campus, Oxford, UK
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15
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Yu Y, Li M, Huang X, Zhou W, Wang T, Zhu L, Ding C, Tao Y, Bao H, Cheng X. A U-shaped association between the LDL-cholesterol to HDL-cholesterol ratio and all-cause mortality in elderly hypertensive patients: a prospective cohort study. Lipids Health Dis 2020; 19:238. [PMID: 33183311 PMCID: PMC7659118 DOI: 10.1186/s12944-020-01413-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/02/2020] [Indexed: 12/22/2022] Open
Abstract
Background The low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking the LDL-C/HDL-C ratio to mortality have yielded inconsistent results and been limited by short follow-up periods. Therefore, the aim of the present study was to determine whether the LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients. Methods A total of 6941 hypertensive patients aged 65 years or older who were not treated with lipid-lowering drugs were selected from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between the LDL-C/HDL-C ratio and all-cause mortality was determined using multivariate Cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve analysis. Results During a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between the LDL-C/HDL-C ratio and all-cause mortality. Patients were divided according to the quintiles of the LDL-C/HDL-C ratio. Compared to the reference group (Q3: 1.67–2.10), patients with both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios had higher all-cause mortality (< 1.67: HR 1.81, 95% CI: 1.08–3.03; ≥2.10: HR 2.00, 95% CI: 1.18–3.39). Compared with the lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratios of 1.67–2.10 had a significantly higher survival probability (log-rank P = 0.038). Conclusions The results suggest that there is a U-shaped association between the LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-020-01413-5.
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Affiliation(s)
- Yu Yu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Minghui Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Congcong Ding
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Yu Tao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Zambon A, Mello e Silva A, Farnier M. The burden of cholesterol accumulation through the lifespan: why pharmacological intervention should start earlier to go further? EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 7:435-441. [DOI: 10.1093/ehjcvp/pvaa123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022]
Abstract
Abstract
Among the cardiovascular risk factors, cholesterol-rich atherogenic lipoproteins play a central role in the pathogenesis of atherosclerosis. In middle-aged adults, the size of the total atherosclerotic plaque burden is influenced by both the concentration of circulating atherogenic lipoproteins and the total duration of exposure to these lipoproteins. This review describes the evidence supporting a causal link between lifelong elevations in atherogenic lipoproteins and future risk of atherosclerosis; evidence strengthened by recent epidemiological, genetic, and clinical data. By consequence, adolescence and early adulthood are a crucial time for determining later cardiovascular disease risk. Arguments showing that early optimal lipid control leads to improved outcomes will be presented and suggestions put forward for how those most at risk should be identified and managed.
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Affiliation(s)
- Alberto Zambon
- Department of Medicine – DIMED, School of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | | | - Michel Farnier
- PEC2, EA 7460, University of Bourgogne Franche-Comté, Besançon, France
- Cardiology Department, University Hospital Dijon Bourgogne, Dijon, France
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Ferreira JP, Xhaard C, Lamiral Z, Borges‐Canha M, Neves JS, Dandine‐Roulland C, LeFloch E, Deleuze J, Bacq‐Daian D, Bozec E, Girerd N, Boivin J, Zannad F, Rossignol P. PCSK9 Protein and rs562556 Polymorphism Are Associated With Arterial Plaques in Healthy Middle-Aged Population: The STANISLAS Cohort. J Am Heart Assoc 2020; 9:e014758. [PMID: 32208829 PMCID: PMC7428603 DOI: 10.1161/jaha.119.014758] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/02/2020] [Indexed: 02/06/2023]
Abstract
Background PCSK9 (Proprotein convertase subtilisin/kexin type 9) binds low-density lipoprotein receptor, preventing its recycling. PCSK9 is a risk predictor and a biotarget in atherosclerosis. The PCSK9-rs562556 variant has been reported as a gain-of-function mutation. The aim of this study was to determine whether the PCSK9-low-density lipoprotein receptor-rs562556 axis is associated with carotid artery plaques between 2 visits separated by almost 20 years in a longitudinal population cohort. Methods and Results The STANISLAS (Suivi Temporaire Annuel Non-Invasif de la Santé des Lorrains Assurés Sociaux) cohort is a longitudinal familial cohort from the Lorraine region of France. Participants attending 2 visits (visit 1 and visit 4) separated by 18.5 years (mean) were included (n=997). Carotid artery plaques were determined with standardized vascular echography. The mean age of the adult population at visit 1 was 42±5 years. At visit 4, 203 (20.4%) participants had arterial plaques. Participants who developed arterial plaques were older (42.7±5.4 versus 41.7±4.7 years), more often male (60% versus 49%), smokers (29% versus 18%), with diabetes mellitus (6% versus 3%), and higher cholesterol levels (low-density lipoprotein cholesterol, 1.6±0.4 versus 1.5±0.3 g/L) (all P<0.05). The independent factors associated with arterial plaques were age, smoking, and low-density lipoprotein cholesterol. Higher PCSK9 levels were associated with arterial plaques on top of the clinical model (odds ratio, 2.14; 95% CI,= 1.28-3.58); the missense mutation coding the single-nucleotide polymorphism rs562556 was associated with both higher PCSK9 concentration and incident carotid arterial plaques. Conclusions Higher PCSK9 concentration was associated with the development of arterial plaques almost 20 years in advance in a healthy middle-aged population. Mutations of the single-nucleotide polymorphism rs562556 associated with both PCSK9 levels and arterial plaques reinforce the potential causality of our findings. PCSK9 inhibitors could be useful for primary cardiovascular prevention.
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Affiliation(s)
- João Pedro Ferreira
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
| | - Constance Xhaard
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
| | - Zohra Lamiral
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
| | - Marta Borges‐Canha
- Department of Physiology and Cardiothoracic SurgeryCardiovascular Research and Development UnitFaculty of MedicineUniversity of PortoPortugal
| | - João Sérgio Neves
- Department of Physiology and Cardiothoracic SurgeryCardiovascular Research and Development UnitFaculty of MedicineUniversity of PortoPortugal
| | - Claire Dandine‐Roulland
- Centre National de Recherche en Génomique HumaineInstitut François Jacob, CEAUniversité Paris‐SaclayEvryFrance
| | - Edith LeFloch
- Centre National de Recherche en Génomique HumaineInstitut François Jacob, CEAUniversité Paris‐SaclayEvryFrance
| | - Jean‐François Deleuze
- Centre National de Recherche en Génomique HumaineInstitut François Jacob, CEAUniversité Paris‐SaclayEvryFrance
| | - Delphine Bacq‐Daian
- Centre National de Recherche en Génomique HumaineInstitut François Jacob, CEAUniversité Paris‐SaclayEvryFrance
| | - Erwan Bozec
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
| | - Nicolas Girerd
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
| | - Jean‐Marc Boivin
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
| | - Faiez Zannad
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
| | - Patrick Rossignol
- InsermCentre d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Université de LorraineNancyFrance
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Descamps OS, Verhaegen A, Demeure F, Langlois M, Rietzschel E, Mertens A, De Sutter J, Wallemacq C, Lancellotti P, De Backer G. Evolving concepts on the management of dyslipidaemia. Acta Clin Belg 2020; 75:80-90. [PMID: 31846601 DOI: 10.1080/17843286.2019.1702823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
It has been well established that low-density lipoproteins (LDL) and other apolipoprotein B-containing lipoproteins are causally related to atherosclerotic cardiovascular disease (ASCVD) and that lowering these lipoproteins reduces the risk of ASCVD. By lowering LDL particles as much as possible, ASCVD can be prevented. There seems to be no LDL-cholesterol (LDL-C) threshold below which no further ASCVD prevention can be achieved. Furthermore, a low (an even very low) LDL-C appears to be safe. The new ESC/EAS guidelines based on these concepts are a step towards a benefit-based strategy by focusing on the clinical benefit that can be achieved by treating the cause of ASCVD. It is recommended to lower LDL-C as much as possible to prevent ASCVD, especially in high and very high-risk patients. With these new recommendations come recognition of the importance of combination therapies in high and very high-risk patients, first with statins and ezetimibe, and if needed with a PCSK9 inhibitor. The present paper is a review of some new concepts arising during the past 10 years in the field of lipidology and the description of what is new in the 2019 EAS/ESC guidelines.
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Affiliation(s)
- Olivier S. Descamps
- Department of internal medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul and department of cardiology, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Ann Verhaegen
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerpen, Belgium
| | - Fabien Demeure
- Department of Cardiology, CHU UCL Namur site de Godinne, Yvoir, Belgium
| | - Michel Langlois
- department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Jan, Brugge, Belgium
| | - Ernst Rietzschel
- department of Cardiology, University Hospital Ghent and Ghent University, Ghent, Belgium
| | - Ann Mertens
- Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Aging (CHROMETA), KU Leuven, Leuven, Belgium
| | - Johan De Sutter
- Department of Cardiology, AZ Maria Middelars Ghent and University Ghent, Belgium
| | - Caroline Wallemacq
- department of Diabetes, Nutrition and Metabolic diseases, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, department of Cardiology, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium
| | - Guy De Backer
- Gent Department of public health and primary care, Ghent University, Gent, Belgium
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Familial hypercholesterolaemia: evolving knowledge for designing adaptive models of care. Nat Rev Cardiol 2020; 17:360-377. [DOI: 10.1038/s41569-019-0325-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2019] [Indexed: 01/05/2023]
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20
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Guo S, Xia XD, Gu HM, Zhang DW. Proprotein Convertase Subtilisin/Kexin-Type 9 and Lipid Metabolism. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1276:137-156. [DOI: 10.1007/978-981-15-6082-8_9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Abstract
PURPOSE OF REVIEW Cardiovascular disease prevention trials of lipid lowering with statins have shown unexpected long-term benefits after the formal randomized treatment stopped. This finding needs further exploration because it raises the possibility that the trajectory of the disease can be modified. RECENT FINDINGS Extended follow up data are now available from further major primary prevention studies and from meta-analyses of the legacy effect of statin trials. New outcome studies have been proposed and launched to test the ability of early intervention to slow or regress atherosclerosis. SUMMARY Legacy effects are apparent in trials of LDL lowering in hypercholesterolemic and hypertensive patient cohorts. Over follow up periods of decades, both cardiovascular mortality and all-cause mortality are reduced in individuals who received 3 to 5 years of statin therapy. The phenomenon is observed also in studies of intensive glycemic control suggesting that it is possible to impact plaque development with long-term beneficial consequences. Novel strategies for primary prevention are being devised that include the early use of both prolonged-moderate and short-term aggressive LDL lowering.
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Affiliation(s)
- Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland
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22
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Stock J. News from ESC congress 2019: New ESC/EAS guidelines for dyslipidaemia management published. Atherosclerosis 2019; 291:124-126. [PMID: 31668350 DOI: 10.1016/j.atherosclerosis.2019.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Jane Stock
- European Atherosclerosis Society, World Trade Center Göteborg, Mässans Gata 10, SE-412 51, Göteborg, Sweden.
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23
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Santos RD, Chacra AP. Update on genetics and molecular biology. Curr Opin Lipidol 2019; 30:414-416. [PMID: 31460946 DOI: 10.1097/mol.0000000000000633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Raul D Santos
- Heart Institute (InCor), University of São Paulo Medical School Hospital
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Ana P Chacra
- Heart Institute (InCor), University of São Paulo Medical School Hospital
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24
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Dixon DL, Virani SS. Mortality reduction with PCSK9 inhibition: A case of cautious optimism. J Clin Lipidol 2019; 13:712-713. [PMID: 31371269 DOI: 10.1016/j.jacl.2019.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 06/25/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Dave L Dixon
- Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA
| | - Salim S Virani
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations, Houston, TX, USA; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine, Houston, TX, USA.
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25
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Schwartz GG, Taylor MRG. PCSK9 Function and Cardiovascular Death: The Knot Tightens. J Am Coll Cardiol 2019; 73:3115-3117. [PMID: 31221260 DOI: 10.1016/j.jacc.2019.03.518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 03/18/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Gregory G Schwartz
- Cardiology Division, Rocky Mountain Regional VA Medical Center, Aurora, Colorado; University of Colorado School of Medicine, Aurora, Colorado.
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