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Masquio DCL, Campos RMDS, Netto BDM, de Carvalho-Ferreira JP, Bueno CR, Alouan S, Poletto GT, Ganen ADP, Tufik S, de Mello MT, Nardo N, Dâmaso AR. Interdisciplinary Therapy Improves the Mediators of Inflammation and Cardiovascular Risk in Adolescents with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7114. [PMID: 38063544 PMCID: PMC10706419 DOI: 10.3390/ijerph20237114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/21/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023]
Abstract
Obesity is associated with inflammation and an increased risk of cardiovascular disease and premature mortality, as well as a range of other conditions. Obesity is a growing global problem, not only in adults, but also in children and adolescents. Therefore, the present study aimed to assess the effects of a one-year interdisciplinary intervention on the cardiometabolic and inflammatory profiles of adolescents with obesity. Twenty-two adolescents completed the intervention, which included clinical, nutritional, psychological and physical exercise counselling. Body composition, and metabolic, inflammatory, and cardiovascular risk biomarkers were analyzed before and after one year of intervention. Visceral and subcutaneous fat were determined ultrasonographically. The homeostasis model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) equation were used to estimate insulin resistance and insulin sensitivity, respectively. A reduction in body mass, adiposity, glucose, and insulin and an improved lipid profile were observed after the therapy. Hyperleptinemia was reduced from 77.3% to 36.4%. Plasminogen activator inhibitor-1 (PAI-1), intercellular adhesion molecule 1 (ICAM-1), leptin, the leptin/adiponectin ratio, and the adiponectin/leptin ratio were also significantly improved. Metabolic changes were associated with a reduction in visceral fat and waist circumference, and adiponectin and the leptin/adiponectin ratio were associated with HOMA-IR. The interdisciplinary therapy promoted improvements in hyperleptinemia and metabolic, inflammatory, and cardiovascular biomarkers.
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Affiliation(s)
- Deborah Cristina Landi Masquio
- Programa de Pós-Graduação em Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, São Paulo 04023-061, SP, Brazil;
- Programa de Mestrado Profissional em Nutrição: do Nascimento à Adolescência, Curso de Nutrição, Centro Universitário São Camilo (CUSC), São Paulo 05025-010, SP, Brazil;
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
| | - Raquel Munhoz da Silveira Campos
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos 11010-150, SP, Brazil;
| | - Bárbara Dal Molin Netto
- Programa de Pós-Graduação em Alimentação e Nutrição, Departamento de Nutrição, Universidade Federal do Paraná (UFPR), Curitiba 80210-170, PR, Brazil;
| | - Joana Pereira de Carvalho-Ferreira
- Laboratório Multidisciplinar em Alimentos e Saúde, Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas (UNICAMP), Limeira 13484-350, SP, Brazil;
| | - Carlos Roberto Bueno
- Escola de Educação Física e Esporte de Ribeirão Preto (EEFERP), Universidade de São Paulo (USP), Ribeirão Preto 14040-900, SP, Brazil;
| | - Stella Alouan
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
| | - Gabriela Tronca Poletto
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
| | - Aline de Piano Ganen
- Programa de Mestrado Profissional em Nutrição: do Nascimento à Adolescência, Curso de Nutrição, Centro Universitário São Camilo (CUSC), São Paulo 05025-010, SP, Brazil;
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo 04724-000, SP, Brazil;
| | - Marco Túlio de Mello
- Escola de Educação Física, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 31310-250, MG, Brazil;
| | - Nelson Nardo
- Departamento de Educação Física, Universidade Estadual de Maringá (UEM), Maringá 87020-900, PR, Brazil;
| | - Ana R. Dâmaso
- Programa de Pós-Graduação em Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, São Paulo 04023-061, SP, Brazil;
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
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Drożdż D, Drożdż M, Wójcik M. Endothelial dysfunction as a factor leading to arterial hypertension. Pediatr Nephrol 2023; 38:2973-2985. [PMID: 36409370 PMCID: PMC10432334 DOI: 10.1007/s00467-022-05802-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/22/2022]
Abstract
Hypertension remains the main cause of cardiovascular complications leading to increased mortality. The discoveries of recent years underline the important role of endothelial dysfunction (ED) in initiating the development of arterial hypertension. The endothelium lines the interior of the entire vascular system in the body and acts as a physical barrier between blood and tissues. Substances and mediators produced by the endothelium exhibit antithrombotic and anti-inflammatory properties. Oxidative stress and inflammation are conditions that damage the endothelium and shift endothelial function from vasoprotective to vasoconstrictive, prothrombotic, and pro-apoptotic functions. A dysfunctional endothelium contributes to the development of hypertension and further cardiovascular complications. Reduced nitric oxide (NO) bioavailability plays an essential role in the pathophysiology of ED-associated hypertension. New technologies provide tools to identify pathological changes in the structure and function of the endothelium. Endothelial dysfunction (ED) contributes to the development of arterial hypertension and should be considered in therapeutic strategies for children with hypertension.
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Affiliation(s)
- Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland.
| | - Monika Drożdż
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland
| | - Małgorzata Wójcik
- Deapartment of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland
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Abo El-Asrar M, Ismail EAR, Elnhrawy AM, Thabet RA. Fatty acid binding protein 1 (FABP1) and fatty acid binding protein 2 (FABP2) as a link between diabetic nephropathy and subclinical atherosclerosis in children and adolescents with type 1 diabetes. J Diabetes Complications 2023; 37:108414. [PMID: 36758511 DOI: 10.1016/j.jdiacomp.2023.108414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/13/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diabetic nephropathy is a major cause of morbidity and mortality in type 1 diabetes mellitus (T1DM). Fatty acid binding proteins (FABP1 and FABP2) play a role in the development and progression of chronic kidney disease including type 2 diabetes mellitus. AIM We assessed serum FABP1 and FABP2 levels in children and adolescents with T1DM as potential markers for diabetic nephropathy and their relation to carotid intima media thickness (CIMT). METHODS Sixty patients with T1DM were divided into 2 groups according to the presence of nephropathy and compared with 30 healthy controls. CIMT, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), urinary albumin creatinine ratio (UACR), fasting lipid profile and serum FABP1 and FABP2 levels were assessed. RESULTS FABP1 and FABP2 levels were significantly higher among type 1 diabetic patient with and without nephropathy compared with healthy controls with the highest levels among patients with nephropathy (p < 0.001). There were significant positive correlations between FABP1 and FABP2 and each of systolic blood pressure, CIMT, FBG, HbA1c and total cholesterol among T1DM patients. FABP1 was negatively correlated to glomerular filtration rate. Multivariable linear regression analysis showed that systolic blood pressure, CIMT, FBG and HbA1c were the significant independent variables related to FABP1 levels in type 1 diabetic patients with nephropathy. ROC curve analysis was performed to determine the cutoff value of FABP1 and FABP2 that could detect nephropathy. CONCLUSION FABP1 and FABP2 levels are elevated in children and adolescents with T1DM and could represent a link between diabetic nephropathy and subclinical atherosclerosis.
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Affiliation(s)
| | | | | | - Rasha Adel Thabet
- Pediatric Departments, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Shoji M, Matsui T, Tanaka H, Nomura K, Tsujita H, Kodama Y, Koba S, Kobayashi Y, Shinke T. Fibrinolytic markers could be useful predictors of severity in patients with pulmonary arterial hypertension: a retrospective study. Thromb J 2021; 19:78. [PMID: 34736457 PMCID: PMC8567565 DOI: 10.1186/s12959-021-00332-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background The severity of pulmonary arterial hypertension (PAH) is classified based on mean pulmonary artery pressure (mPAP) levels. However, other markers have not been elucidated. Fibrinolytic markers, such as total plasminogen activator inhibitor-1 (tPAI-1) and thrombomodulin (TM), are known to reflect arterial endothelial function. However, the relationship between serum tPAI-1, TM and pulmonary circulation has not been completely determined. Methods This study included 100 consecutive patients (38 men), with a mean age of 68.9 ± 12.0 years, with cardiac diseases who underwent right heart catheterization. Serum coagulation and fibrinolytic marker levels were measured. Results The average mPAP value was 25.1 ± 13.1 mmHg for all patients. The mPAP levels revealed a significant positive correlation with serum tPAI-1 (ρ = 0.24, p = 0.042) and uric acid (ρ = 0.29, p = 0.0031) levels. In the group with mPAP levels less than 25 mmHg (n = 58, ave. 17.3 ± 4.3 mmHg), mPAP levels showed a significant positive correlation with serum tPA-1 (ρ = 0.34, p = 0.034) and TM (ρ = 0.34, p = 0.043) values. The mean tPAI-1 (29.8 ± 23.3 ng/ml, p = 0.047) and uric acid (5.7 ± 1.8 mg/dl, p = 0.026) levels were significantly less in those with lower mPAP levels. A multivariate analysis revealed that tPAI-1 alone was a significant independent characteristic marker of PAH (odds ratio 1.02, 95%CI 1.000–1.036, p = 0.034). Conclusions These results indicate that serum tPAI-1 and TM may be useful predictors of severity, similar to mPAP in patients with PAH. They could be beneficial in predicting PAH among patients in the early stage of the disease.
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Affiliation(s)
- Makoto Shoji
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
| | - Taiju Matsui
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Hideaki Tanaka
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kosuke Nomura
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Hiroaki Tsujita
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yusuke Kodama
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Youichi Kobayashi
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Toshiro Shinke
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
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Laryushina Y, Parakhina V, Turgunova L, Sheryazdanova D, Dosmagambetova R, Turmukhambetova A, Ponamareva O, Orbetzova M. Association of Plasminogen Activator Inhibitor-1 and Cardiovascular Events Development in Patients with Prediabetes. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background. Plasminogen activator inhibitor-1(PAI-1) is a marker of endothelial dysfunction(ED) and a predictor of both the development of type 2 diabetes mellitus, and a cardiovascular event(CVE). Its role in the CVE development was sufficiently studied in patients without carbohydrate metabolism disorders, and understudied in patients with prediabetes.
Aim: the research interest is the study of PAI-1 in patients with prediabetes and its effect on the CVE development.
Materials and methods. The case-control study of 168 patients aged from 18 to 65 was carried out among the local population from January to December 2019.After clinical examination, patients were divided into 3 groups: group 1 (n=55)– patients with prediabetes and with CVE; group 2 (n=93) - patients with prediabetes and without CVE; the control group n=20.
Results. Differences in PAI-1 level were found in groups 1 (Me=30718.6 pg/ml) and 2 (Me=24692.0 pg/ml; p≤0.001), even greater differences were found in both groups compared to the control one (p≤0.001).
The correlation analysis has found in both group influence such IR indicators as fasting glucose, IR-HOMA index, glucagon, C-peptide to elevation of PAI-1. These findings indicate that with an elevation of the PAI-1 level, the concentration of fasting glucose, glucagon, C-peptide and scores of IR-HOMA index increase in both group.
The Binary regression analysis has demonstrated, that an elevation of the PAI-1 biomarker increases the likelihood of CVE by 3.3 fold in patients with prediabetes (p≤0.01). In addition to, a model has been derived for assessing the risk of cardiovascular events in patients with prediabetes.
Conclusions. Elevation of PAI-1 concentration is associated with insulin resistance which leads to ED, and further development risk of CVE in patients with prediabetes.
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Aleman MN, Díaz EI, Luciardi MC, Mariani AC, Bazán MC, Abregu AV. Hemostatic state of children with type 1 diabetes. Ann Pediatr Endocrinol Metab 2021; 26:99-104. [PMID: 34218631 PMCID: PMC8255861 DOI: 10.6065/apem.2040142.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Hyperglycemia is one of the factors responsible for the molecular alterations that modify hemostasis. The aim of this study was to determine the levels of circulating molecules that have a prothrombotic impact on the child and adolescent population with type 1 diabetes mellitus. METHODS There were 35 patients with type 1 diabetes mellitus (11.0±2.5 years of age and a median 3.7±2.0 years of the disease) with no vascular complications and 20 healthy controls with similar age, sex, and body mass index included in the study. The evaluated parameters were fibrinogen, plasminogen activator inhibitor-1 (PAI1), von Willebrand factor antigen, and standard coagulation tests (platelet count, prothrombin time, and activated partial thromboplastin time). Glycemic control was evaluated by hemoglobin A1c and fasting blood glucose tests, and the presence of retinopathy and nephropathy was ruled out. The data obtained were analyzed by IBM SPSS Statistics ver. 20.0 and expressed as mean±standard deviation. The Pearson correlation coefficient was applied to investigate correlations between variables. RESULTS Diabetic patients showed significantly higher levels of fibrinogen (308±66 mg/dL vs. 246±18 mg/dL, P=0.0001), PAI-1 (41.6±12 ng/mL vs. 11.7±1.0 ng/mL, P=0.0001), and von Willebrand factor antigen (284%±55% vs. 121%±19%, P=0.0001). However, standard coagulation tests did not show differences between the 2 groups. PAI-1 was correlated with glycemia, hemoglobin A1c, fibrinogen, and von Willebrand factor antigen. CONCLUSION Elevated levels of fibrinogen, PAI-1, and von Willebrand factor antigen were found in the pediatric and adolescent population with type 1 diabetes mellitus, which suggests a prothrombotic state.
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Affiliation(s)
- Mariano Nicolás Aleman
- Departamento de Bioquímica Aplicada, Facultad de Bioquímica, Universidad Nacional de Tucumán, Tucumán, Argentina,Address for correspondence: Mariano Nicolás Áleman Departamento de Bioquímica Aplicada, Facultad de Bioquímica, Universidad Nacional de Tucumán, Balcarce 747, San Miguel de Tucumán, Tucumán 4000, Argentina
| | - Elba Irma Díaz
- Departamento de Bioquímica Aplicada, Facultad de Bioquímica, Universidad Nacional de Tucumán, Tucumán, Argentina
| | - Maria Constanza Luciardi
- Departamento de Bioquímica Aplicada, Facultad de Bioquímica, Universidad Nacional de Tucumán, Tucumán, Argentina
| | - Ana Carolina Mariani
- Departamento de Bioquímica Aplicada, Facultad de Bioquímica, Universidad Nacional de Tucumán, Tucumán, Argentina
| | - Maria Cristina Bazán
- Departamento de Endocrinología, Hospital del Niño Jesús de Tucumán, Tucumán, Argentina
| | - Adela Victoria Abregu
- Departamento de Bioquímica Aplicada, Facultad de Bioquímica, Universidad Nacional de Tucumán, Tucumán, Argentina
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Jasser‐Nitsche H, Haidl H, Cvirn G, Pohl S, Gallistl S, Fröhlich‐Reiterer E, Schlagenhauf A. Increased tissue factor activity promotes thrombin generation at type 1 diabetes onset in children. Pediatr Diabetes 2020; 21:1210-1217. [PMID: 32691481 PMCID: PMC7589270 DOI: 10.1111/pedi.13086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/09/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE In type 1 diabetes (T1D), a prothrombotic status due to elevated coagulation factors coincides with metabolic derailment. In a previous study, we discovered altered thrombin generation profiles in children with T1D. These alterations are potentially most pronounced at T1D onset and ameliorated after insulin treatment. We tested this hypothesis in a longitudinal study, measuring thrombin generation together with coagulation parameters in children at T1D onset and during follow-up. MATERIALS AND METHODS Twenty-three children (12 female, age: 9.4 [2.7-17.3] years; median [range]) were tested at T1D onset and after long-term insulin treatment. Thrombin generation was measured using calibrated automated thrombography. Tissue factor (TF) activity and tissue factor pathway inhibitor (TFPI) activity were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS A procoagulant shift was observed in thrombin generation traces at T1D onset compared to follow-up (time to peak: 5.67 [4.11-7.67] min vs 6.39 [4.89-10.44] min, P < .001). These alterations at T1D onset coincided with increased TF activity (5.18 [0.01-12.97] pmol/L vs 2.67 [0.04-10.41] pmol/L, P < .05) and increased TFPI activity (0.051 [0.038-0.074] U/mL vs 0.035 [0.026-0.056] U/mL, P < .05). CONCLUSION The procoagulant shift in thrombin generation at T1D onset is a result of increased TF activity, but this effect is partially counterbalanced by increased TFPI levels. Elevated TF and TFPI levels hint to a fragile hemostatic balance at the endothelial lining of blood vessels. Additional prothrombotic stimuli may tip over this balance explaining the increased thrombotic risk of children with T1D.
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Affiliation(s)
- Hildegard Jasser‐Nitsche
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Harald Haidl
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Gerhard Cvirn
- Otto Loewi Research Center, Physiological ChemistryMedical University of GrazGrazAustria
| | - Sina Pohl
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Siegfried Gallistl
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Elke Fröhlich‐Reiterer
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Axel Schlagenhauf
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
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Sobczak AIS, Phoenix FA, Pitt SJ, Ajjan RA, Stewart AJ. Reduced Plasma Magnesium Levels in Type-1 Diabetes Associate with Prothrombotic Changes in Fibrin Clotting and Fibrinolysis. Thromb Haemost 2020; 120:243-252. [PMID: 31942750 PMCID: PMC6997031 DOI: 10.1055/s-0039-3402808] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/11/2019] [Indexed: 12/28/2022]
Abstract
Individuals with type-1 diabetes mellitus (T1DM) have a higher risk of thrombosis and low plasma magnesium concentrations. As magnesium is a known regulator of fibrin network formation, we investigated potential associations between fibrin clot properties and plasma magnesium concentrations in 45 individuals with T1DM and 47 age- and sex-matched controls without diabetes. Fibrin clot characteristics were assessed using a validated turbidimetric assay and associations with plasma magnesium concentration were examined. Plasma concentrations of fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and lipids were measured and fibrin fiber diameters assessed using scanning electron microscopy. Fibrin clot maximum absorbance was unchanged in subjects with T1DM compared with controls, while lysis time was prolonged (p = 0.0273). No differences in fibrin fiber diameters or in lipid profile were observed between T1DM and controls. PAI-1 concentration was lower in the T1DM group compared with the controls (p = 0.0232) and positively correlated with lysis time (p = 0.0023). Plasma magnesium concentration was lower in the T1DM group compared with controls (p < 0.0001). Magnesium concentration negatively correlated with clot maximum absorbance (p = 0.0215) and lysis time (p = 0.0464). A turbidimetric fibrin clot lysis assay performed in a purified system that included PAI-1 and 0 to 3.2 mM Mg2+ showed a shortening of lysis time with increasing Mg2+ concentrations (p = 0.0004). Our findings reveal that plasma magnesium concentration is associated with changes in fibrin clot and lysis parameters.
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Affiliation(s)
| | - Fladia A. Phoenix
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Samantha J. Pitt
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Ramzi A. Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Alan J. Stewart
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
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Shen T, Xing G, Zhu J, Cai Y, Zhang S, Xu G, Feng Y, Li D, Rao J, Shi R. Effects of 12-Week Supplementation of a Polyherbal Formulation in Old Adults with Prehypertension/Hypertension: A Randomized, Double-Blind, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:7056872. [PMID: 31391860 PMCID: PMC6662493 DOI: 10.1155/2019/7056872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/24/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Uncontrolled blood pressure is the leading cause of mortality and disability due to associated cerebral and cardiovascular diseases and kidney failure. More than one-third of the old adult population have hypertension or prehypertension and many of their blood pressure are poorly controlled. OBJECTIVE We hypothesized that plant extracts-based antioxidants may benefit those with prehypertension/hypertension. METHOD One hundred age- and gender-matched healthy older adults were randomly assigned to receive HyperBalance capsules (n=50) or placebo (n=50) at Tang-Qiao Community Health Service Center, Shanghai. Blood pressure and severity scores of hypertension treatment-related symptoms (dizziness, headache, ringing/buzzing in ears, rapid heart rate, and chest tightness) were evaluated before and after the 12-week intervention. RESULTS Ninety-eight people completed the study, with 2 dropouts in the placebo group before the end of the study. Forty-one subjects (82%) of the HyperBalance group and 40 subjects (83.3%) of the placebo group had prehypertension (systolic blood pressures (SBP) between 130-139 and diastolic blood pressure (DBP) between 85-89mmHg), and 9 subjects (18%) in the HyperBalance group and 8 subjects (16.7%) in the placebo group had hypertension (≥140/90mmHg) before the intervention. HyperBalance significantly (P<0.01) reduced SBP from 136.18±4.38 to 124.14±3.96 mmHg and reduced DBP from 82.45±2.91 to 80.24±2.41mmHg, respectively, and reversed all 9 hypertension people to normotension or prehypertension state, whereas the placebo moderately reduced SBP from 135.79±4.22 to 132.35±4.656mmHg and reduced DBP from 82.90±3.07 to 82.27±3.01mmHg. All symptom severity scores became significantly lower in the HyperBalance group than in the placebo group after HyperBalance intervention: dizziness (0.82±0.44; vs 2.02±0.64, P<0.01); headache (0.46±0.50; vs 1.81±0.61, P<0.01); ringing/buzzing in ears (0.44±0.50; vs 1.04±0.29, P<0.01); and rapid heart rate and chest tightness (0.30±0.46; vs 0.92±0.28, P<0.01). CONCLUSION Polyherbal supplementation such as HyperBalance could benefit old adults with prehypertension/hypertension and improve treatment-related symptoms. Further studies are needed to validate the current findings.
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Affiliation(s)
- Tian Shen
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Guoqiang Xing
- The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, China
- Lotus Biotech.com LLC, John Hopkins University-MCC, 9601 Medical Center Drive, Rockville, MD 20850, USA
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Shuxian Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Gang Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yi Feng
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Donghua Li
- Tang Qiao Community Health Service Center, Pudong New District, Shanghai 200127, China
| | - Jianyu Rao
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Rong Shi
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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10
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Corban MT, Prasad A, Nesbitt L, Loeffler D, Herrmann J, Lerman LO, Lerman A. Local Production of Soluble Urokinase Plasminogen Activator Receptor and Plasminogen Activator Inhibitor-1 in the Coronary Circulation Is Associated With Coronary Endothelial Dysfunction in Humans. J Am Heart Assoc 2018; 7:e009881. [PMID: 30371230 PMCID: PMC6201458 DOI: 10.1161/jaha.118.009881] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/21/2018] [Indexed: 01/11/2023]
Abstract
Background Soluble urokinase plasminogen activator receptor (su PAR ) is a proinflammatory biomarker associated with immune activation and fibrinolysis inhibition. Plasminogen activator inhibitor ( PAI -1) is associated with excessive fibrin accumulation, thrombus formation, and atherosclerosis. The relationship between cross-coronary su PAR and PAI -1 production and endothelial dysfunction remains unknown. Methods and Results Seventy-nine patients (age 53±10 years, 75% women) with angina and normal coronary arteries or mild coronary artery disease (<40% stenosis) on angiogram underwent acetylcholine assessment of epicardial endothelial dysfunction (mid-left anterior descending coronary artery diameter decrease >20% after acetylcholine) and mircovascular endothelial dysfunction (coronary blood flow change <50% after acetylcholine). Simultaneous left main and coronary sinus su PAR and PAI -1 levels were measured in each patient before acetylcholine administration, and cross-coronary su PAR and PAI -1 production rates were calculated. Patients' characteristics, except for age (51±10 versus 57±9, P=0.02), and resting coronary hemodynamics were not significantly different between patients with (26%) versus without (74%) epicardial endothelial dysfunction. Patients' characteristics and resting coronary hemodynamics were not significantly different between those with (62%) and those without (38%) mircovascular endothelial dysfunction. Patients with mircovascular endothelial dysfunction demonstrated local coronary su PAR production versus su PAR extraction in patients with normal microvascular function (median 25.8 [interquartile range 121.6, -23.7] versus -12.7 [52.0, -74.8] ng/min, P=0.03). Patients with epicardial endothelial dysfunction had higher median coronary PAI -1 production rates compared with those with normal epicardial endothelial function (1224.7 [12 940.7, -1915.4] versus -187.4 [4444.7, -4535.8] ng/min, P=0.03). Conclusions su PAR is released in coronary circulation of patients with mircovascular endothelial dysfunction and extracted in those with normal microvascular function. Cross-coronary PAI -1 release is higher in humans with epicardial endothelial dysfunction.
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Affiliation(s)
- Michel T. Corban
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Abhiram Prasad
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Lisa Nesbitt
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Darrell Loeffler
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Joerg Herrmann
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
| | - Lilach O. Lerman
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
- Division of Nephrology and HypertensionDepartment of MedicineMayo Clinic College of Medicine and ScienceRochesterMN
| | - Amir Lerman
- Department of Cardiovascular DiseasesMayo Clinic College of Medicine and ScienceRochesterMN
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11
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Simanenkova AV, Makarova MN, Vasina LV, Butomo MI, Dora SV, Shlyakhto EV. Glucagon-like peptide-1 receptor agonist diminishes endothelial dysfunction in type 2 diabetic patients. ACTA ACUST UNITED AC 2018. [DOI: 10.24884/1682-6655-2018-17-2-57-63] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective. To evaluate liraglutide (LIR) endothelial protective action. Material and methods. Type 2 diabetic patients with HbA1C 7.5-9.0 % had metformin (MET) dose titrated for 3 months. Patients with HbA1C less than 7.5 % comprised group 1 (MET), more than 7.5 % - group 2 (MET+LIR). Blood concentrations of tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), endothelin-1 (E) were evaluated at baseline, in 3, 6 and 9 months. Results. PAI-1 was increased in both groups and gradually decreased. T-PA was normal. E was primarily increased only in group 2. E was normal in group 1 in general, but enlarged with glycaemia increase. E decreased in group 2 with glycaemia improvement and worsening. Conclusions. Glycaemia control improvement decreases endothelial dysfunction. LIR improves vasomotor endothelial function, independently on its influence on glycaemia.
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Affiliation(s)
- A. V. Simanenkova
- Federal State Budgetary Educational Institution of Higher Education «Pavlov First Saint Petersburg State Medical University»
| | - M. N. Makarova
- Federal State Budgetary Educational Institution of Higher Education «Pavlov First Saint Petersburg State Medical University»
| | - L. V. Vasina
- Federal State Budgetary Educational Institution of Higher Education «Pavlov First Saint Petersburg State Medical University»; Federal State Budgetary Institution «Almazov National Medical Research Centre» of the Ministry of Health of the Russian Federation
| | - M. I. Butomo
- Federal State Budgetary Educational Institution of Higher Education «Pavlov First Saint Petersburg State Medical University»
| | - S. V. Dora
- Federal State Budgetary Educational Institution of Higher Education «Pavlov First Saint Petersburg State Medical University»
| | - E. V. Shlyakhto
- Federal State Budgetary Educational Institution of Higher Education «Pavlov First Saint Petersburg State Medical University»; Federal State Budgetary Institution «Almazov National Medical Research Centre» of the Ministry of Health of the Russian Federation
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12
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Rupérez AI, Olza J, Gil-Campos M, Leis R, Bueno G, Aguilera CM, Gil A, Moreno LA. Cardiovascular risk biomarkers and metabolically unhealthy status in prepubertal children: Comparison of definitions. Nutr Metab Cardiovasc Dis 2018; 28:524-530. [PMID: 29571590 DOI: 10.1016/j.numecd.2018.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/31/2018] [Accepted: 02/08/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS The early onset of cardio-metabolic abnormalities, known as metabolically unhealthy (MU) status, is highly associated with obesity and cardiovascular disease (CVD), as well as with increased morbidity and mortality later in life. Given the lack of a consensus MU classification for prepubertal children, we aimed to compare available MU definitions in terms of their association with CVD risk biomarkers. METHODS AND RESULTS A total of 930 prepubertal children (622 with overweight/obesity, 462 males) aged 5-10.9 years were recruited, anthropometric measures were taken and biomarkers were analyzed. Children were classified using eight MU definitions based on different cut-offs for blood pressure, triacylglycerides, high-density lipoprotein cholesterol, glucose and homeostasis model assessment for insulin resistance (HOMA-IR). MU prevalence in children with overweight/obesity ranged between 30% and 60% across definitions. Plasma concentrations of resistin, leptin, myeloperoxidase (MPO) and total plasminogen activator inhibitor 1 (tPAI-1) were higher, and those of adiponectin were lower, in MU compared to MH children with overweight/obesity. Linear regression analyses confirmed the contribution of MPO and tPAI-1 concentrations to MU status, with most significant results derived from definitions that use age and sex-specific criteria and that account for HOMA-IR. CONCLUSION Plasma concentrations of MPO and tPAI-1 are increased in prepubertal MU children irrespective of having normal-weight or overweight/obesity. Inclusion of age and sex-specific cut-offs for cardio-metabolic components as well as insulin resistance criteria increases the quality of MU definitions as seen by their stronger association with CVD biomarkers concentrations.
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Affiliation(s)
- A I Rupérez
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, Food and Agriculture Institute of Aragón (IA2), Health Research Institute of Aragón (ISS Aragón), Zaragoza, Spain.
| | - J Olza
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, University of Granada, Biomedical Research Institute ibs, Granada, Spain; CIBER Obesity and Nutrition Physiopathology (CIBEROBN), Madrid, Spain
| | - M Gil-Campos
- CIBER Obesity and Nutrition Physiopathology (CIBEROBN), Madrid, Spain; Paediatric Research and Metabolism Unit, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMBIC), Córdoba, Spain
| | - R Leis
- CIBER Obesity and Nutrition Physiopathology (CIBEROBN), Madrid, Spain; Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Paediatric Department, Health Research Institute of Santiago (IDIS), University of Santiago de Compostela, Galicia, Spain
| | - G Bueno
- CIBER Obesity and Nutrition Physiopathology (CIBEROBN), Madrid, Spain; Paediatric Department, Lozano Blesa University Hospital, University of Zaragoza, Food and Agriculture Institute of Aragón (IA2), Health Research Institute of Aragón (ISS Aragón), Zaragoza, Spain
| | - C M Aguilera
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, University of Granada, Biomedical Research Institute ibs, Granada, Spain; CIBER Obesity and Nutrition Physiopathology (CIBEROBN), Madrid, Spain
| | - A Gil
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, University of Granada, Biomedical Research Institute ibs, Granada, Spain; CIBER Obesity and Nutrition Physiopathology (CIBEROBN), Madrid, Spain
| | - L A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, University of Zaragoza, Food and Agriculture Institute of Aragón (IA2), Health Research Institute of Aragón (ISS Aragón), Zaragoza, Spain; CIBER Obesity and Nutrition Physiopathology (CIBEROBN), Madrid, Spain
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13
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Abo El-Asrar M, Ismail EAR, Thabet RA, Kamel AS, NehmedAllah S. Osteopontin as a marker of vasculopathy in pediatric patients with type 1 diabetes mellitus: Relation to vascular structure. Pediatr Diabetes 2018; 19:1107-1115. [PMID: 29687557 DOI: 10.1111/pedi.12686] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is associated with serious micro-vascular and macro-vascular complications. Osteopontin (OPN) has emerged as a strong predictor of incipient diabetic nephropathy and a first-ever cardiovascular event in adults with T1DM. OPN is linked to coronary atherosclerosis in type 2 diabetes. The aim of the study was to test the hypothesis that OPN could be a potential marker for micro-vascular complications in children and adolescents with T1DM and we assessed its relation to carotid and aortic intima media thickness (CIMT and AIMT) as non-invasive index for subclinical atherosclerosis. METHODS Eighty patients with T1DM ≤18 years were divided into 2 groups according to the presence of micro-vascular complications and compared with 40 age- and sex-matched healthy controls. Fasting blood glucose, high sensitivity C-reactive protein (hs-CRP), HbA1c, urinary albumin creatinine ratio (UACR), OPN, CIMT, and AIMT were assessed. RESULTS Both CIMT and AIMT were significantly higher in patients with and without micro-vascular complications compared with healthy controls (P < .001). OPN concentrations were significantly elevated in all diabetic patients compared with controls (P = .002). OPN was also significantly higher in patients with micro-vascular complications than patients without (P < .001) but levels were comparable among those without complications and controls (P = .322). Receiver operating characteristic curve analysis revealed that OPN cut-off value 90 ng/mL could differentiate patients with and without micro-vascular complications with 81.7% sensitivity and 95.8% specificity. Significant positive correlations were found between OPN and HbA1c, UACR, CIMT, and AIMT. CONCLUSIONS OPN could be considered a marker of vasculopathy and subclinical atherosclerosis in pediatric T1DM.
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Affiliation(s)
| | | | | | - Ashraf Sayed Kamel
- Pediatric Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
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14
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El-Samahy MH, Tantawy AAG, Adly AAM, Habeeb NM, Ismail EAR, Hamed GM, Eladawy R. Expression of CD4 + CD28 null T lymphocytes in children and adolescents with type 1 diabetes mellitus: Relation to microvascular complications, aortic elastic properties, and carotid intima media thickness. Pediatr Diabetes 2017; 18:785-793. [PMID: 28102614 DOI: 10.1111/pedi.12484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cardiovascular risk in type 1 diabetes mellitus (T1DM) is associated with endothelial dysfunction, inflammation, and altered immunity. CD4+ CD28null T-cells are a subset of long-lived cytotoxic CD4+ T-lymphocytes with proatherogenic and plaque-destabilizing properties. We hypothesized that the frequency of CD4+ CD28null T-cells may be altered in T1DM and related to vascular complications. AIM To assess the percentage of CD4+ CD28null T-lymphocytes in children and adolescents with T1DM and their relation to vascular structure and glycemic control. METHODS Totally 100 patients with T1DM were divided into 2 groups according to the presence of microvascular complications and compared with 50 healthy controls. CD4+ CD28null T-lymphocytes were analyzed using flow cytometry. Aortic elastic properties and carotid intima media thickness (CIMT) were assessed. RESULTS Aortic stiffness index and CIMT were significantly higher among patients compared with healthy controls while aortic strain and distensibility were decreased. The percentage of CD4+ CD28null T-cells was significantly higher in patients with and without microvascular complications compared with controls. High frequency of CD4+ CD28null T-cells was found among patients with microalbuminuria or peripheral neuropathy. Patients with CD4+ CD28null T-cells ≥10% had higher HbA1c, urinary albumin creatinine ratio, aortic stiffness, and CIMT. CD4+ CD28null T-cells were positively correlated to HbA1c, aortic stiffness index, and CIMT. CONCLUSIONS Changes in aortic elastic properties and increased CIMT among young patients with T1DM may enable the recognition of preclinical cardiac impairment. The correlation between CD4+ CD28null T-cells and assessed parameters of vascular structure highlights the role of altered immune response in the occurrence of diabetic vascular complications.
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Affiliation(s)
- Mona H El-Samahy
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Azza A G Tantawy
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amira A M Adly
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nevin M Habeeb
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman A R Ismail
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Gehan M Hamed
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rasha Eladawy
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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15
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Sun K, Song J, Liu K, Fang K, Wang L, Wang X, Li J, Tang X, Wu Y, Qin X, Wu T, Gao P, Chen D, Hu Y. Associations between homocysteine metabolism related SNPs and carotid intima-media thickness: a Chinese sib pair study. J Thromb Thrombolysis 2017; 43:401-410. [PMID: 27822905 PMCID: PMC5337241 DOI: 10.1007/s11239-016-1449-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Carotid intima-media thickness (CIMT) is a good surrogate for atherosclerosis. Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. We aim to investigate the relationships between homocysteine (Hcy) related biochemical indexes and CIMT, the associations between Hcy related SNPs and CIMT, as well as the potential gene–gene interactions. The present study recruited full siblings (186 eligible families with 424 individuals) with no history of cardiovascular events from a rural area of Beijing. We examined CIMT, intima-media thickness for common carotid artery (CCA-IMT) and carotid bifurcation, tested plasma levels for Hcy, vitamin B6 (VB6), vitamin B12 (VB12) and folic acid (FA), and genotyped 9 SNPs on MTHFR, MTR, MTRR, BHMT, SHMT1, CBS genes. Associations between SNPs and biochemical indexes and CIMT indexes were analyzed using family-based association test analysis. We used multi-level mixed-effects regression model to verify SNP-CIMT associations and to explore the potential gene–gene interactions. VB6, VB12 and FA were negatively correlated with CIMT indexes (p < 0.05). rs2851391 T allele was associated with decreased plasma VB12 levels (p = 0.036). In FABT, CBS rs2851391 was significantly associated with CCA-IMT (p = 0.021) and CIMT (p = 0.019). In multi-level mixed-effects regression model, CBS rs2851391 was positively significantly associated with CCA-IMT (Coef = 0.032, se = 0.009, raw p < 0.001) after Bonferoni correction (corrected α = 0.0056). Gene–gene interactions were found between CBS rs2851391 and BHMT rs10037045 for CCA-IMT (p = 0.011), as well as between CBS rs2851391 and MTR rs1805087 for CCA-IMT (p = 0.007) and CIMT (p = 0.022). Significant associations are found between Hcy metabolism related genetic polymorphisms, biochemical indexes and CIMT indexes. There are complex interactions between genetic polymorphisms for CCA-IMT and CIMT.
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Affiliation(s)
- Kexin Sun
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Kuo Liu
- Department of Epidemiology and Biostatistics, Capital Medical University, 10 You'anmenwai Xitoutiao, Beijing, 100069, China
| | - Kai Fang
- Beijing Center for Disease Prevention and Control, No.16 He Pingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Ling Wang
- Pingshan New District Center for Disease Control and Prevention, Shenzhen, 518118, Guangdong, China
| | - Xueyin Wang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Xun Tang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China.
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16
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Kupfer R, Larrúbia MR, Bussade I, Pereira JRD, Lima GAB, Epifanio MA, Schettino CDS, Momesso DP. Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:115-121. [PMID: 28225861 PMCID: PMC10118868 DOI: 10.1590/2359-3997000000255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 08/10/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the occurrence and clinical predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM. SUBJECTS AND METHODS The study included 45 women with type 1 diabetes mellitus (DM) (aged 36 ± 9 years) who underwent carotid Doppler ultrasound evaluation to determine the carotid artery intima-media thickness (CIMT) and to assess the occurrence of carotid artery plaques. Insulin sensitivity was assessed by estimated glucose disposal rate (eGDR), and metabolic syndrome (MS) was defined by the World Health Organization criteria. RESULTS The cohort had a mean age of 36 ± 9 years, diabetes duration of 18.1 ± 9.5 years, and body mass index (BMI) of 24.6 ± 2.4 kg/m2. MS was present in 44.4% of the participants. The CIMT was 0.25 ± 0.28 mm, and the prevalence of carotid artery plaques was 13%. CIMT correlated positively with hypertension (p = 0.04) and waist-to-hip ratio (r = 0.37, p = 0.012). The presence of carotid artery plaques correlated positively with age (p = 0.018) and hypertension (p = 0.017). eGDR correlated negatively with CIMT (r = -0.39, p = 0.009) and carotid plaques (p = 0.04). Albuminuria showed a correlation trend with CIMT (p = 0.06). Patients with carotid artery plaques were older, had a higher prevalence of hypertension, and lower eGDR. No correlation was found between CIMT and carotid plaques with diabetes duration, MS, BMI, cholesterol profile, glycated hemoglobin, high-sensitivity C-reactive protein, or fibrinogen. CONCLUSION Insulin resistance, central obesity, hypertension, and older age were predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM.
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Affiliation(s)
- Rosane Kupfer
- Pontifícia Universidade Católica do Rio de Janeiro, Brasil
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17
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Fedoseeva LA, Klimov LO, Ershov NI, Alexandrovich YV, Efimov VM, Markel AL, Redina OE. Molecular determinants of the adrenal gland functioning related to stress-sensitive hypertension in ISIAH rats. BMC Genomics 2016; 17:989. [PMID: 28105924 PMCID: PMC5249038 DOI: 10.1186/s12864-016-3354-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background The adrenals are known as an important link in pathogenesis of arterial hypertensive disease. The study was directed to the adrenal transcriptome analysis in ISIAH rats with stress-sensitive arterial hypertension and predominant involvement in pathogenesis of the hypothalamic-pituitary-adrenal and sympathoadrenal systems. Results The RNA-Seq approach was used to perform the comparative adrenal transcriptome profiling in hypertensive ISIAH and normotensive WAG rats. Multiple differentially expressed genes (DEGs) related to different biological processes and metabolic pathways were detected. The discussion of the results helped to prioritize the several DEGs as the promising candidates for further studies of the genetic background underlying the stress-sensitive hypertension development in the ISIAH rats. Two of these were transcription factor genes (Nr4a3 and Ppard), which may be related to the predominant activation of the sympathetic-adrenal medullary axis in ISIAH rats. The other genes are known as associated with hypertension and were defined in the current study as DEGs making the most significant contribution to the inter-strain differences. Four of them (Avpr1a, Hsd11b2, Agt, Ephx2) may provoke the hypertension development, and Mpo may contribute to insulin resistance and inflammation in the ISIAH rats. Conclusions The study strongly highlighted the complex nature of the pathogenesis of stress-sensitive hypertension. The data obtained may be useful for identifying the common molecular determinants in different animal models of arterial hypertension, which may be potentially used as therapeutic targets for pharmacological intervention. Electronic supplementary material The online version of this article (doi:10.1186/s12864-016-3354-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Larisa A Fedoseeva
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Leonid O Klimov
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Nikita I Ershov
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Yury V Alexandrovich
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Vadim M Efimov
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russian Federation.,Novosibirsk State University, Novosibirsk, Russian Federation
| | - Arcady L Markel
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russian Federation.,Novosibirsk State University, Novosibirsk, Russian Federation
| | - Olga E Redina
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russian Federation.
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18
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El-Asrar MA, Elbarbary NS, Ismail EAR, Bakr AA. Circulating angiopoietin-2 levels in children and adolescents with type 1 diabetes mellitus: relation to carotid and aortic intima-media thickness. Angiogenesis 2016; 19:421-31. [PMID: 27236773 DOI: 10.1007/s10456-016-9517-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Angiopoietin-2 is a growth factor involved in the pathophysiology of vascular and inflammatory diseases such as arteriosclerosis. Carotid or aortic scans provide noninvasive screening tools for assessment of preclinical atherosclerosis in high-risk children. AIM We assessed serum angiopoietin-2 in children and adolescents with type 1 diabetes mellitus as a potential marker for vascular complications in relation to glycemic control, inflammation and vascular structure. METHODS Sixty patients with type 1 diabetes were divided into 2 groups according to the presence of micro-vascular complications and compared with 30 healthy controls. High-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), urinary albumin/creatinine ratio, serum angiopoietin-2, carotid and aortic intima-media thickness (CIMT and AIMT) were measured. RESULTS CIMT, AIMT and serum angiopoietin-2 levels were significantly increased in patients with and without micro-vascular complications compared with controls, and the highest levels were in patients with complications (p < 0.001). Angiopoietin-2 was higher in patients with microalbuminuria than normoalbuminuric group (p < 0.001). Fasting blood glucose, HbA1c, hs-CRP, CIMT and AIMT were independently related to angiopoietin-2 in multiple regression analysis. Disease duration, hyperglycemia, poor glycemic control, hypercholesterolemia, inflammation and angiopoietin-2 were independent factors contributing to atherosclerosis risk. CONCLUSION The relation between angiopoietin-2 and assessed parameters of vascular structure in type 1 diabetes reflects a state of endothelial injury and highlights the role of disturbed angiogenesis and vascular inflammation in the occurrence of diabetic complications.
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Affiliation(s)
| | | | | | - AlShaimaa Abo Bakr
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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19
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Kim DH, Choi BH, Ku SK, Park JH, Oh E, Kwak MK. Beneficial Effects of Sarpogrelate and Rosuvastatin in High Fat Diet/Streptozotocin-Induced Nephropathy in Mice. PLoS One 2016; 11:e0153965. [PMID: 27097221 PMCID: PMC4838298 DOI: 10.1371/journal.pone.0153965] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/06/2016] [Indexed: 01/18/2023] Open
Abstract
Chronic kidney disease (CKD) is a major complication of metabolic disorders such as diabetes mellitus, obesity, and hypertension. Comorbidity of these diseases is the factor exacerbating CKD progression. Statins are commonly used in patients with metabolic disorders to decrease the risk of cardiovascular complications. Sarpogrelate, a selective antagonist of 5-hydroxytryptamine (5-HT) 2A receptor, inhibits platelet aggregation and is used to improve peripheral circulation in diabetic patients. Here, we investigated the effects of sarpogrelate and rosuvastatin on CKD in mice that were subjected to a high fat diet (HFD) for 22 weeks and a single low dose of streptozotocin (STZ, 40 mg/kg). When mice were administrated sarpogrelate (50 mg/kg, p.o.) for 13 weeks, albuminuria and urinary cystatin C excretion were normalized and histopathological changes such as glomerular mesangial expansion, tubular damage, and accumulations in lipid droplets and collagen were significantly improved. Sarpogrelate treatment repressed the HFD/STZ-induced CD31 and vascular endothelial growth factor receptor-2 expressions, indicating the attenuation of glomerular endothelial proliferation. Additionally, sarpogrelate inhibited interstitial fibrosis by suppressing the increases in transforming growth factor-β1 (TGF-β1) and plasminogen activator inhibitor-1 (PAI-1). All of these functional and histological improvements were also seen in rosuvastatin (20 mg/kg) group and, notably, the combinatorial treatment with sarpogrelate and rosuvastatin showed additive beneficial effects on histopathological changes by HFD/STZ. Moreover, sarpogrelate reduced circulating levels of PAI-1 that were elevated in the HFD/STZ group. As supportive in vitro evidence, sarpogrelate incubation blocked TGF-β1/5-HT-inducible PAI-1 expression in murine glomerular mesangial cells. Taken together, sarpogrelate and rosuvastatin may be advantageous to control the progression of CKD in patients with comorbid metabolic disorders, and particularly, the use of sarpogrelate as adjunctive therapy with statins may provide additional benefits on CKD.
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Affiliation(s)
- Dong-hyun Kim
- College of pharmacy, The Catholic University of Korea, Bucheon, Gyeonggi-do, 420-743, Republic of Korea
| | - Bo-hyun Choi
- College of pharmacy, The Catholic University of Korea, Bucheon, Gyeonggi-do, 420-743, Republic of Korea
| | - Sae-Kwang Ku
- College of Korean Medicine, Daegu Haany University, Gyeongsan, Gyeonsangbuk-do, 712-715, Republic of Korea
| | - Jeong-hyeon Park
- College of pharmacy, The Catholic University of Korea, Bucheon, Gyeonggi-do, 420-743, Republic of Korea
| | - Euichaul Oh
- College of pharmacy, The Catholic University of Korea, Bucheon, Gyeonggi-do, 420-743, Republic of Korea
| | - Mi-Kyoung Kwak
- College of pharmacy, The Catholic University of Korea, Bucheon, Gyeonggi-do, 420-743, Republic of Korea
- * E-mail:
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El-Beblawy NMS, Andrawes NG, Ismail EAR, Enany BES, El-Seoud HSA, Erfan MA. Serum and Urinary Orosomucoid in Young Patients With Type 1 Diabetes: A Link Between Inflammation, Microvascular Complications, and Subclinical Atherosclerosis. Clin Appl Thromb Hemost 2016; 22:718-726. [PMID: 26975878 DOI: 10.1177/1076029616637185] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Orosomucoid is an acute-phase serum protein that is upregulated in urine samples of patients with diabetic nephropathy. We assessed serum and urinary orosomucoid levels in children and adolescents with type 1 diabetes and their relation to microvascular complications and carotid intima-media thickness (CIMT). Sixty patients with type 1 diabetes were divided into 2 groups according to the presence of microvascular complications and compared with 60 healthy controls. High-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), urinary albumin-creatinine ratio (UACR), serum and urinary orosomucoid, and CIMT were assessed. Both serum and urinary orosomucoid levels were significantly increased in patients with and without microvascular complications compared with controls, and the highest levels were in patients with complications (P < .001). Serum and urinary orosomucoid were higher in patients with microalbuminuria than normoalbuminuric group (P < .001). The cutoff value of urinary orosomucoid at 2825 ng/mL could differentiate patients with and without microvascular complications. Serum and urinary orosomucoid were positively correlated. Multiple regression analysis showed that HbA1c, UACR, hs-CRP, and CIMT were independently related to orosomucoid. We suggest that orosomucoid is a significant independent factor for diabetic microvascular complications and can be considered as an early marker of renal injury. High orosomucoid levels in type 1 diabetes reflect endothelial dysfunction and subclinical atherosclerosis.
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Affiliation(s)
| | | | | | | | | | - Marwa A Erfan
- Department of Pediatrics, Ain Shams University, Cairo, Egypt
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Bhat UG, Watanabe K. Serpine1 Mediates Porphyromonas gingivalis Induced Insulin Secretion in the Pancreatic Beta Cell Line MIN6. ACTA ACUST UNITED AC 2015. [PMID: 26213716 DOI: 10.13188/2377-987x.1000008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Periodontitis is an inflammatory disease resulting in destruction of gingiva and alveolar bone caused by an exuberant host immunological response to periodontal pathogens. Results from a number of epidemiological studies indicate a close association between diabetes and periodontitis. Results from cross-sectional studies indicate that subjects with periodontitis have a higher odds ratio of developing insulin resistance (IR). However, the mechanisms by which periodontitis influences the development of diabetes are not known. Results from our previous studies using an animal model of periodontitis suggest that periodontitis accelerates the onset of hyperinsulinemia and IR. In addition, LPS from a periodontal pathogen, Porphyromonas gingivalis (Pg), stimulates Serpine1 expression in the pancreatic beta cell line MIN6. Based on these observations, we hypothesized that a periodontal pathogen induces hyperinsulinemia and Serpine1 may be involved in this process. To test this hypothesis, we co-incubated Pg with the pancreatic beta cell line MIN6 and measured the effect on insulin secretion by MIN6 cells. We further determined the involvement of Serpine1 in insulin secretion by downregulating Serpine1 expression. Our results indicated that Pg stimulated insulin secretion by approximately 3.0 fold under normoglycemic conditions. In a hyperglycemic state, Pg increased insulin secretion by 1.5 fold. Pg significantly upregulated expression of the Serpine1 gene and this was associated with increased secretion of insulin by MIN6 cells. However, cells with downregulated Serpine1 expression were resistant to Pg stimulated insulin secretion under normoglycemic conditions. We conclude that the periodontal pathogen, Pg, induced insulin secretion by MIN6 cells and this induction was, in part, Serpine1 dependent. Thus, Serpine1 may play a pivotal role in insulin secretion during the accelerated development of hyperinsulinemia and the resulting IR in the setting of periodontitis.
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Sun YP, Cai YY, Li HM, Deng SM, Leng RX, Pan HF. Increased carotid intima-media thickness (CIMT) levels in patients with type 1 diabetes mellitus (T1DM): A meta-analysis. J Diabetes Complications 2015; 29:724-30. [PMID: 25890843 DOI: 10.1016/j.jdiacomp.2015.03.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 03/18/2015] [Accepted: 03/23/2015] [Indexed: 01/28/2023]
Abstract
AIM To derive a more precise estimation of carotid intima-media thickness (CIMT) levels in patients with type 1 diabetes mellitus (T1DM) by meta-analysis. METHODS PubMed and Embase databases were searched to identify all available studies comparing CIMT levels between T1DM group and control group. Meta-analysis was performed to compare the difference of overall mean CIMT levels between the two groups. Publication bias was evaluated by funnel plot, Begg' test and Egger' test. Meta-regression analysis was conducted to investigate the influential factors on CIMT difference. The meta-analysis was conducted by STATA 12.0 software. RESULTS A total of 1840 articles were obtained after searching databases; 47 studies were finally included in the meta-analysis. Significant heterogeneity was observed among these studies (Q = 768.75, P < 0.001, I(2) = 94.0%). Compared with the control group, the T1DM group had significantly higher CIMT levels (standardized mean difference: 1.01, 95% CI: 0.75-1.28; P < 0.001). A likely source of heterogeneity was Newcastle-Ottawa Scale (NOS) scores and sample size ratio of patents and controls. The funnel plot did not show a skewed or asymmetrical shape, and the result of Begg' test and Egger' test was P = 0.178 and P = 0.145 respectively. Accordingly, it could be assumed that publication bias was not present. CONCLUSION T1DM patients have significantly increased CIMT levels compared to control subjects.
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Affiliation(s)
- Yi-Peng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yuan-Yuan Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Faculty of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hong-Miao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Sen-Miao Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Rui-Xue Leng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Effects of adenotonsillectomy on plasma inflammatory biomarkers in obese children with obstructive sleep apnea: A community-based study. Int J Obes (Lond) 2015; 39:1094-100. [PMID: 25801692 PMCID: PMC4496251 DOI: 10.1038/ijo.2015.37] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/23/2015] [Accepted: 03/15/2015] [Indexed: 12/30/2022]
Abstract
Background Obesity and obstructive sleep apnea syndrome (OSA) are highly prevalent and frequently overlapping conditions in children that lead to systemic inflammation, the latter being implicated in the various end-organ morbidities associated with these conditions. Aim To examine the effects of adenotonsillectomy (T&A) on plasma levels of inflammatory markers in obese children with polysomnographically diagnosed OSA who were prospectively recruited from the community. Methods Obese children prospectively diagnosed with OSA, underwent T&A and a second overnight polysomnogram (PSG) after surgery. Plasma fasting morning samples obtained after each of the 2 PSG were assayed for multiple inflammatory and metabolic markers including interleukin-6 (IL-6), IL-18, plasminogen activator inhibitor-1 (PAI-1), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase- (MMP-9), adiponectin, apelin C, leptin and osteocrin. Results Out of 122 potential candidates, 100 obese children with OSA completed the study with only 1/3 exhibiting normalization of their PSG after T&A (i.e., AHI≤1/hrTST). However, overall significant decreases in MCP-1, PAI-1, MMP-9, IL-18 and IL-6, and increases in adropin and osteocrin plasma concentrations occurred after T&A. Several of the T&A responsive biomarkers exhibited excellent sensitivity and moderate specificity to predict residual OSA (i.e., AHI≥/hrTST). Conclusions A defined subset of systemic inflammatory and metabolic biomarkers is reversibly altered in the context of OSA among community-based obese children, further reinforcing the concept on the interactive pro-inflammatory effects of sleep disorders such as OSA and obesity contributing to downstream end-organ morbidities.
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Functional stability of plasminogen activator inhibitor-1. ScientificWorldJournal 2014; 2014:858293. [PMID: 25386620 PMCID: PMC4214104 DOI: 10.1155/2014/858293] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/17/2014] [Indexed: 12/23/2022] Open
Abstract
Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of plasminogen activators, such as tissue-type plasminogen activator (t-PA) and urokinase-type plasminogen activator (u-PA), and a major regulator of the fibrinolytic system. PAI-1 plays a pivotal role in acute thrombotic events such as deep vein thrombosis (DVT) and myocardial infarction (MI). The biological effects of PAI-1 extend far beyond thrombosis including its critical role in fibrotic disorders, atherosclerosis, renal and pulmonary fibrosis, type-2 diabetes, and cancer. The conversion of PAI-1 from the active to the latent conformation appears to be unique among serpins in that it occurs spontaneously at a relatively rapid rate. Latency transition is believed to represent a regulatory mechanism, reducing the risk of thrombosis from a prolonged antifibrinolytic action of PAI-1. Thus, relying solely on plasma concentrations of PAI-1 without assessing its function may be misleading in interpreting the role of PAI-1 in many complex diseases. Environmental conditions, interaction with other proteins, mutations, and glycosylation are the main factors that have a significant impact on the stability of the PAI-1 structure. This review provides an overview on the current knowledge on PAI-1 especially importance of PAI-1 level and stability and highlights the potential use of PAI-1 inhibitors for treating cardiovascular disease.
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von Hundelshausen P, Schmitt MMN. Platelets and their chemokines in atherosclerosis-clinical applications. Front Physiol 2014; 5:294. [PMID: 25152735 PMCID: PMC4126210 DOI: 10.3389/fphys.2014.00294] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 07/22/2014] [Indexed: 12/22/2022] Open
Abstract
The concept of platelets as important players in the process of atherogenesis has become increasingly accepted due to accumulating experimental and clinical evidence. Despite the progress in understanding the molecular details of atherosclerosis, particularly by using animal models, the inflammatory and thrombotic roles of activated platelet s especially in the human system remain difficult to dissect, as often only the complications of atherosclerosis, i.e., stroke and myocardial infarction are definable but not the plaque burden. Platelet indices including platelet count and mean platelet volume (MPV) and soluble mediators released by activated platelets are associated with atherosclerosis. The chemokine CXCL4 has multiple atherogenic activities, e.g., altering the differentiation of T cells and macrophages by inhibiting neutrophil and monocyte apoptosis and by increasing the uptake of oxLDL and synergizing with CCL5. CCL5 is released and deposited on endothelium by activated platelets thereby triggering atherogenic monocyte recruitment, which can be attenuated by blocking the corresponding chemokine receptor CCR5. Atheroprotective and plaque stabilizing properties are attributed to CXCL12, which plays an important role in regenerative processes by attracting progenitor cells. Its release from luminal attached platelets accelerates endothelial healing after injury. Platelet surface molecules GPIIb/IIIa, GP1bα, P-selectin, JAM-A and the CD40/CD40L dyade are crucially involved in the interaction with endothelial cells, leukocytes and matrix molecules affecting atherogenesis. Beyond the effects on the arterial inflammatory infiltrate, platelets affect cholesterol metabolism by binding, modifying and endocytosing LDL particles via their scavenger receptors and contribute to the formation of lipid laden macrophages. Current medical therapies for the prevention of atherosclerotic therapies enable the elucidation of mechanisms linking platelets to inflammation and atherosclerosis.
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Affiliation(s)
- Philipp von Hundelshausen
- Institute for Cardiovascular Prevention, Ludwig-Maximilians-University of Munich Munich, Germany ; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance Munich, Germany
| | - Martin M N Schmitt
- Institute for Cardiovascular Prevention, Ludwig-Maximilians-University of Munich Munich, Germany
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Inflammatory markers and obstructive sleep apnea in obese children: the NANOS study. Mediators Inflamm 2014; 2014:605280. [PMID: 24991089 PMCID: PMC4058796 DOI: 10.1155/2014/605280] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 04/17/2014] [Accepted: 05/01/2014] [Indexed: 11/30/2022] Open
Abstract
Introduction. Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities. Aim. To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4–15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers. Results. 204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI) of 3 events/hour total sleep time (TST). BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P < 0.01), while MCP-1 levels were associated with more prolonged nocturnal hypercapnia (P < 0.001). Conclusion. IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.gov NCT01322763.
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