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Marais AD, Hoffman A, Blackhurst DM, van der Spuy ZM. Dyslipidaemia in women with polycystic ovary syndrome referred to a teaching hospital in Cape Town, South Africa. J Neuroendocrinol 2024:e13414. [PMID: 38858175 DOI: 10.1111/jne.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/02/2024] [Accepted: 05/11/2024] [Indexed: 06/12/2024]
Abstract
The polycystic ovary syndrome (PCOS) imparts health risks including dyslipidaemia, diabetes and cardiovascular disease that are amenable to lifestyle adjustment and/or medication. We describe dyslipidaemia in women referred to a gynaecological endocrine clinic. Clinical data and endocrine and lipoprotein investigations comprising fasting triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDLC) and calculated low density lipoprotein cholesterol (LDLC) were studied along with electrophoresis patterns of apolipoprotein B-containing lipoproteins. The 1721 participants comprised black, mixed ancestry, white and Indian individuals (9.8%, 83.2%, 5.8% and 1.2%, respectively). The mean ± standard deviation of the age, body mass index (BMI) and waist/hip ratio were 26.0 ± 5.9 years, 32.3 ± 8.3 kg/m2 and waist/hip ratio 0.88 ± 0.11, respectively. Overweight status (BMI 26-30 kg/m2) and obesity (BMI >30 kg/m2) involved 272 (15.8%) and 1010 (58.7%) individuals, respectively. Morbid obesity (BMI >40 kg/m2) was present in 309 (17.9%) individuals. The TG, TC, HDLC and LDLC concentrations were 1.22 ± 0.86, 4.77 ± 1.02, 1.3 ± 0.36, 2.94 ± 0.94 mmol/L, respectively. LDL hypercholesterolaemia occurred in 753 (43.7%) and exceeded 5 mmol/L in 39 (2.3%) women. Low HDLC (<0.9 mmol/L) affected 122 (7%), hypertriglyceridaemia (>1.7 mmol/L) affected 265 (15.4%) and exceeded 2.5 mmol/L in 91 (5.3%) women. Mixed hyperlipidaemia (TG >1.7, TC >5.0 mmol/L) occurred in 176 (10.2%). Electrophoresis revealed small LDL particles in 79 (4.6%) and dysbetalipoproteinaemia in 13 (0.76%) of the cohort. Small LDL associated with obesity, blood pressure, TG and glucose concentration and higher androgenic state. Many women with PCOS had unfavourable lipoprotein results: mostly moderate changes in TG, HDLC and LDLC. Small LDL is not rare, may aid risk assessment and is best determined directly. Incidental monogenic disorders of lipoprotein metabolism included dysbetalipoproteinaemia, familial hypercholesterolaemia and severe hypertriglyceridaemia. Dyslipidaemia in PCOS requires more careful diagnosis, individualised management and research.
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Affiliation(s)
- Adrian David Marais
- Chemical Pathology Division of Department of Pathology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Anne Hoffman
- Department of Obstetrics and Gynaecology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Diane Mary Blackhurst
- Chemical Pathology Division of Department of Pathology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Zephne Margeret van der Spuy
- Department of Obstetrics and Gynaecology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
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Hirano T, Kodera R, Hirashima T, Suzuki N, Aoki E, Hosoya M, Oshima T, Hayashi T, Koba S, Ohta M, Satoh N, Ito Y. Metabolic Properties of Lowdensity Lipoprotein (LDL) Triglycerides in Patients with Type 2 Diabetes, Comparison with Small Dense LDL-Cholesterol. J Atheroscler Thromb 2022; 29:762-774. [PMID: 33952832 PMCID: PMC9135668 DOI: 10.5551/jat.62789] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/15/2021] [Indexed: 11/11/2022] Open
Abstract
AIMS Abnormal compositional changes in low-density lipoprotein (LDL) particles, such as triglyceride (TG) enrichment and size reduction, are common in patients with diabetes. Several cohort studies have demonstrated that LDL-TG and sdLDL-cholesterol (C) are sensitive biomarkers for predicting atherosclerotic cardiovascular diseases beyond LDL-C. Although sdLDL has been extensively studied, little is known about the properties of LDL-TG. We investigated similarities or differences between LDL-TG and sdLDL-C. METHODS Fasting plasma was obtained from 1,085 patients with type 2 diabetes who were enrolled in the diabetes regional cohort study (ViNA Cohort). LDL-TG and sdLDL-C concentrations were measured using a homogeneous assay established by us. In a subset of subjects, LDL-TG and sdLDL-C levels were measured postprandially or after treatment with lipid-lowering drugs. RESULTS In a quartile analysis, higher LDL-TG quartiles were associated with higher frequency of female and fibrate users, whereas sdLDL-C quartiles were associated with frequency of men, drinking, and metabolic syndrome-related measurements. Higher quartiles of LDL-TG/LDL-C were associated with smoking, drinking, fibrate users, and statin users. LDL-TG was significantly correlated with TG, LDL-C, sdLDL-C, and apolipoprotein (apo) B, with apoB being the primary determinant. LDL-TG correlated to high sensitive C-reactive protein (CRP) independently of other lipids. Mean LDL-TG did not change with fasting/non-fasting. Statin treatment reduced LDL-TG, whereas fibrates increased it, but these drugs reduced sdLDL-C equally. CONCLUSIONS LDL-TG levels were more tightly regulated by the number of LDL particles than plasma TG levels were. SdLDL-C was closely associated with metabolic syndrome-related factors, whereas LDL-TG was associated with low-grade systemic inflammation.
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Affiliation(s)
- Tsutomu Hirano
- Diabetes Center, Ebina General Hospital, Kanagawa, Japan
| | - Rieko Kodera
- Diabetes Center, Ebina General Hospital, Kanagawa, Japan
| | | | - Natsuko Suzuki
- Diabetes Center, Ebina General Hospital, Kanagawa, Japan
| | - Ema Aoki
- Diabetes Center, Ebina General Hospital, Kanagawa, Japan
| | - Mitsuru Hosoya
- Diabetes Center, Ebina General Hospital, Kanagawa, Japan
| | - Taito Oshima
- Diabetes Center, Ebina General Hospital, Kanagawa, Japan
| | | | - Shinji Koba
- Division of Comprehensive Internal Medicine, Department of Perioperative Medicine, Showa University School of Dentistry, Tokyo, Japan
| | - Motoko Ohta
- R&D Department, Denka Co., Ltd., Niigata, Japan
| | | | - Yasuki Ito
- R&D Department, Denka Co., Ltd., Niigata, Japan
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Bonilha I, Hajduch E, Luchiari B, Nadruz W, Le Goff W, Sposito AC. The Reciprocal Relationship between LDL Metabolism and Type 2 Diabetes Mellitus. Metabolites 2021; 11:metabo11120807. [PMID: 34940565 PMCID: PMC8708656 DOI: 10.3390/metabo11120807] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes mellitus and insulin resistance feature substantial modifications of the lipoprotein profile, including a higher proportion of smaller and denser low-density lipoprotein (LDL) particles. In addition, qualitative changes occur in the composition and structure of LDL, including changes in electrophoretic mobility, enrichment of LDL with triglycerides and ceramides, prolonged retention of modified LDL in plasma, increased uptake by macrophages, and the formation of foam cells. These modifications affect LDL functions and favor an increased risk of cardiovascular disease in diabetic individuals. In this review, we discuss the main findings regarding the structural and functional changes in LDL particles in diabetes pathophysiology and therapeutic strategies targeting LDL in patients with diabetes.
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Affiliation(s)
- Isabella Bonilha
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
| | - Eric Hajduch
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, F-75006 Paris, France;
| | - Beatriz Luchiari
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
| | - Wilson Nadruz
- Cardiology Division, Cardiovascular Pathophysiology Laboratory, State University of Campinas (Unicamp), Campinas 13083-887, Brazil;
| | - Wilfried Le Goff
- Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Inserm, Sorbonne Université, F-75013 Paris, France;
| | - Andrei C. Sposito
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
- Correspondence: ; Tel.: +55-19-3521-7098; Fax: +55-19-3289-410
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4
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Alizadeh-Fanalou S, Nazarizadeh A, Alian F, Faraji P, Sorori B, Khosravi M. Small dense low-density lipoprotein-lowering agents. Biol Chem 2021; 401:1101-1121. [PMID: 32427116 DOI: 10.1515/hsz-2019-0426] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/06/2020] [Indexed: 02/06/2023]
Abstract
Metabolic disorders, including obesity, diabetes, and hyperlipidemia, as well as cardiovascular diseases (CVD), particularly atherosclerosis, are still leading causes of death worldwide. Plasma levels of low-density lipoprotein (LDL) are currently being considered as a critical risk factor for the diseases mentioned above, especially atherosclerosis. Because of the heterogeneous nature of LDL, many studies have already been conducted on its subclasses, especially small dense LDL (sdLDL). According to available evidence, sdLDL levels can be considered as an ideal alternative to LDL levels for monitoring CVD and early diagnosis of atherosclerosis. Recently, several researchers have focused on factors that are able to decrease sdLDL levels and improve health quality. Therefore, the purpose of this study is to describe the production process of sdLDL particles and review the effects of pharmaceutical and dietary agents as well as lifestyle on sdLDL plasma levels. In brief, their mechanisms of action are discussed. Apparently, cholesterol and LDL-lowering compounds are also effective in the reduction of sdLDL levels. In addition, improving lipid profile, especially the reduction of triglyceride levels, appropriate regimen, and lifestyle can decrease sdLDL levels. Therefore, all the aforementioned parameters should be taken into consideration simultaneously in sdLDL levels reducing strategies.
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Affiliation(s)
- Shahin Alizadeh-Fanalou
- Student Research Committee, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.,Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran1449614535,Islamic Republic of Iran
| | - Ali Nazarizadeh
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran1449614535,Islamic Republic of Iran
| | - Fatemeh Alian
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran131451365,Islamic Republic of Iran
| | - Parisa Faraji
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran131451365,Islamic Republic of Iran
| | - Bahareh Sorori
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran 1449614535, Islamic Republic of Iran
| | - Mohsen Khosravi
- Department of Medicine, Islamic Azad University, Qom Branch, Qom3714668669,Islamic Republic of Iran
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Lin Y, Ye S, He Y, Li S, Chen Y, Zhai Z. Short-term insulin intensive therapy decreases MCP-1 and NF-κB expression of peripheral blood monocyte and the serum MCP-1 concentration in newlydiagnosed type 2 diabetics. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:212-220. [PMID: 29641741 PMCID: PMC10118989 DOI: 10.20945/2359-3997000000029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 12/13/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To observe the effect of short-term insulin intensive treatment on the monocyte chemoattractant protein-1 (MCP-1) as well as on the nuclear factor-kappa B (NF-κB) expression of peripheral blood monocyte. This is also in addition to observing the serum MCP-1 level in newlydiagnosed type 2 diabetic patients and probing its anti-inflammation effects. SUBJECTS AND METHODS Twenty newly-diagnosed type 2 diabetic patients were treated with an insulin intensive treatment for 2 weeks. MCP-1 and NF-κB expression on the monocyte surface were measured with flow cytometry, the serum MCP-1 level was measured by enzyme linked immunosorbent assay (ELISA) during pretreatment and post-treatment. RESULTS After 2 weeks of the treatment, MCP-1 and NF-κB protein expression of peripheral blood monocyte and serum MCP-1 levels decreased significantly compared with those of pre-treatment, which were (0.50 ± 0.18)% vs (0.89 ± 0.26)% (12.22 ± 2.80)% vs (15.53 ± 2.49)% and (44.53 ± 3.97) pg/mL vs (49.53 ± 3.47) pg/mL, respectively (P < 0.01). The MCP-1 expression on monocyte surface had a significant positive relationship with serum MCP-1 levels (r = 0.47, P < 0.01). CONCLUSIONS Short-term insulin intensive therapy plays a role in alleviating the increased inflammation reaction in type 2 diabetics.
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Affiliation(s)
- Yang Lin
- School of Medicine, Shandong University, Jinan, Shandong 250100, China.,Department of Pediatrics, Anhui Provincial Hospital, Hefei, Anhui 230001, China
| | - Shandong Ye
- School of Medicine, Shandong University, Jinan, Shandong 250100, China.,Department of Endocrinology, Anhui Provincial Hospital, Hefei, Anhui 230001, China
| | - Yuanyuan He
- Department of Endocrinology, Anhui Provincial Hospital, Hefei, Anhui 230001, China
| | - Sumei Li
- Department of Endocrinology, Anhui Provincial Hospital, Hefei, Anhui 230001, China
| | - Yan Chen
- Endocrinological Laboratory, Anhui Provincial Hospital, Hefei, Anhui 230001, China
| | - Zhimin Zhai
- Department of Central lab, Anhui Provincial Hospital, Hefei, Anhui 230001, China
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Correlation between Cholesterol, Triglycerides, Calculated, and Measured Lipoproteins: Whether Calculated Small Density Lipoprotein Fraction Predicts Cardiovascular Risks. J Lipids 2017; 2017:7967380. [PMID: 29318047 PMCID: PMC5727838 DOI: 10.1155/2017/7967380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/11/2017] [Accepted: 10/25/2017] [Indexed: 01/07/2023] Open
Abstract
Background Recent literature in lipidology has identified LDL-fractions to be more atherogenic. In this regard, small density LDL-cholesterol (sdLDLc) has been considered to possess more atherogenicity than other LDL-fractions like large buoyant LDL-cholesterol (lbLDLc). Recently, Srisawasdi et al. have developed a method for calculating sdLDLc and lbLDLc based upon a regression equation. Using that in developing world may provide us with a valuable tool for ASCVD risk prediction. Objective (1) To correlate directly measured and calculated lipid indices with insulin resistance, UACR, glycated hemoglobin, anthropometric indices, and blood pressure. (2) To evaluate these lipid parameters in subjects with or without metabolic syndrome, nephropathy, and hypertension and among various groups based upon glycated hemoglobin results. Design Cross-sectional study. Place and Duration of Study. From Jan 2016 to 15 April 2017. Subjects and Methods Finally enrolled subjects (male: 110, female: 122) were evaluated for differences in various lipid parameters, including measured LDL-cholesterol (mLDLc), HDLc and calculated LDL-cholesterol (cLDLc), non-HDLc, sdLDLC, lbLDLC, and their ratio among subjects with or without metabolic syndrome, nephropathy, glycation index, anthropometric indices, and hypertension. Results Significant but weak correlation was mainly observed between anthropometric indices, insulin resistance, blood pressure, and nephropathy for non-HDLc, sdLDLc, and sdLDLc/lbLDLc. Generally lipid indices were higher among subjects with metabolic syndrome [{sdLDLc: 0.92 + 0.33 versus 0.70 + 0.29 (p < 0.001)}, {sdLDLc/lbLDLc: 0.55 + 0.51 versus 0.40 + 0.38 (p = 0.010)}, {non-HDLc: 3,63 + 0.60 versus 3.36 + 0.65 (p = 0.002)}]. The fact that the sdLDLc levels provided were insignificant in Kruskall Wallis Test indicated a sharp increase in subjects with HbA1c > 7.0%. Subjects having nephropathy (UACR > 2.4 mg/g) had higher concentration of non-HDLc levels in comparison to sdLDLc [{non-HDLc: 3.68 + 0.59 versus 3.36 + 0.43} (p = 0.007), {sdLDLc: 0.83 + 0.27 versus 0.75 + 0.35 (p = NS)}]. Conclusion Lipid markers including cLDLc and mLDLc are less associated with traditional ASCVD markers than non-HDLc, sdLDLc, and sdLDLc/lbLDLc in predicting metabolic syndrome, nephropathy, glycation status, and hypertension.
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7
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Ito Y, Ohta M, Ikezaki H, Hirao Y, Machida A, Schaefer EJ, Furusyo N. Development and Population Results of a Fully Automated Homogeneous Assay for LDL Triglyceride. J Appl Lab Med 2017; 2:746-756. [PMID: 33636868 DOI: 10.1373/jalm.2017.024554] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 09/13/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Low-density lipoprotein (LDL) is measured by its cholesterol content (LDL-C), but it has been suggested that LDL triglyceride (LDL-TG) may also be related to coronary artery disease risk. LDL-TG can be measured after ultracentrifugation or electrophoresis, but these are labor intensive methods, indicating the need for an automated homogeneous assay. METHODS TG-rich lipoproteins (TRLs), LDL, and HDL were isolated by ultracentrifugation and used to determine optimal characteristics of surfactants and various enzymes for assay development. We analyzed assay precision and linearity, and compared results with those obtained after ultracentrifugation. Serum samples from a large population study (n = 12284 subjects) were used to generate reference intervals for LDL-TG and to determine levels in various types of hyperlipidemia. RESULTS An assay for LDL-TG has been developed by use of surfactants 1 and 2, and enzymes to measure LDL-TG directly on an automated analyzer. There was an excellent correlation between results obtained with this assay and after isolation of LDL by ultracentrifugation. When the assay was applied to serum samples from normal and hyperlipidemic subjects, median normal values were 0.09 mmol/L, with significant median elevations observed in subjects with increased LDL-C, hypertriglyceridemia, combined hyperlipidemia, and hyperchylomicronemia of 0.19, 0.18, 0.28, and 0.43 mmol/L, respectively, as compared with mean LDL-C values in these subjects of 2.25, 4.01, 2.66, 3.96, and 2.43 mmol/L, respectively. CONCLUSIONS We have developed an automated homogeneous assay for LDL-TG for potential use in research and clinical laboratories, and documented that the TG molar content of LDL is about 5% of its cholesterol content.
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Affiliation(s)
- Yasuki Ito
- R&D Center, Denka Seiken Co., Ltd., Tokyo, Japan
| | - Motoko Ohta
- R&D Center, Denka Seiken Co., Ltd., Tokyo, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.,Cardiovascular Nutrition Laboratory, Human Nutrition Research on Aging at Tufts University School, Boston, MA
| | - Yuhko Hirao
- R&D Center, Denka Seiken Co., Ltd., Tokyo, Japan
| | | | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Human Nutrition Research on Aging at Tufts University School, Boston, MA
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
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Tang S, Wu W, Tang W, Ge Z, Wang H, Hong T, Zhu D, Bi Y. Suppression of Rho-kinase 1 is responsible for insulin regulation of the AMPK/SREBP-1c pathway in skeletal muscle cells exposed to palmitate. Acta Diabetol 2017; 54:635-644. [PMID: 28265821 DOI: 10.1007/s00592-017-0976-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/19/2017] [Indexed: 11/28/2022]
Abstract
AIMS Clinical and experimental data suggest that early insulin therapy could reduce lipotoxicity in subjects and animal models with type 2 diabetes mellitus. However, the underlying mechanisms need to be clarified. Sterol regulatory element-binding protein 1c (SREBP-1c), which is negatively regulated by AMP-activated protein kinase (AMPK), plays a critical role in lipotoxicity and insulin resistance in skeletal muscle cells. Here, we investigated the effect and molecular mechanism of insulin intervention on the AMPK/SREBP-1c pathway in skeletal muscle cells with chronic exposure to palmitic acid (PA). METHODS Male C57BL/6 mice were fed with a high-fat diet for 12 weeks and were then treated with insulin, AMPK inhibitor, or metformin. L6 myotubes incubated with palmitic acid (PA) were treated with insulin or metformin. Dominant-negative AMPKα2 (DN-AMPKα2) lentivirus, AMPKα2 siRNA, or Rho-kinase 1 (ROCK1) siRNA were transfected into PA-treated L6 myotubes. RESULTS We found that the ability of PA to stimulate SREBP-1c and inhibit AMPK was reversed by insulin in L6 cells. Moreover, DN-AMPKα2 lentivirus and AMPKα2 siRNA were transfected into PA-treated L6 myotubes, and the decrease in SREBP-1c expression caused by insulin was blocked by AMPK inhibition independent of the phosphatidylinositol-4,5-biphosphate-3-kinase (PI3K)/AKT pathway. The serine/threonine kinase Rho-kinase (ROCK) 1, a downstream effector of the small G protein RhoA, was activated by PA. Interestingly, knockdown of ROCK1 by siRNA blocked the downregulation of AMPK phosphorylation under PA-treated L6 myotubes, which indicated that ROCK1 mediated the effect of insulin action on AMPK. CONCLUSIONS Our study indicated that insulin reduced lipotoxicity via ROCK1 and then improved AMPK/SREBP-1c signaling in skeletal muscle under PA-induced insulin resistance.
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Affiliation(s)
- Sunyinyan Tang
- Department of Endocrinology, Drum Tower Hospital Affiliated to the Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Wenjun Wu
- Department of Endocrinology, Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, People's Republic of China
| | - Wenjuan Tang
- Department of Endocrinology, Drum Tower Hospital Affiliated to the Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Zhijuan Ge
- Department of Endocrinology, Drum Tower Hospital Affiliated to the Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Hongdong Wang
- Department of Endocrinology, Drum Tower Hospital Affiliated to the Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Ting Hong
- Department of Endocrinology, Drum Tower Hospital Affiliated to the Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Hospital Affiliated to the Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China.
| | - Yan Bi
- Department of Endocrinology, Drum Tower Hospital Affiliated to the Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China.
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Alberty R, Studenčan M, Kovář F. Prevalence of Conventional Cardiovascular Risk Factors in Patients with Acute Coronary Syndromes in Slovakia. Cent Eur J Public Health 2017; 25:77-84. [PMID: 28399360 DOI: 10.21101/cejph.a4351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/07/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acute coronary syndrome (ACS) is a major health problem and the leading cause of death and disability in Slovakia. This is the first study to describe the prevalence rate of conventional cardiovascular risk factors in patients hospitalized for ACS. METHODS Hypertension, diabetes mellitus, hyperlipidemia and cigarette smoking were documented in 1,567 cases (mean age, SD: 66.1±12.0 years, 34.8% of females) enrolled in the SLOVAKS registry from August 2011 through September 2011. RESULTS Overall, 83.5% (95% CI, 81.6-85.2%) of the patients with ACS had hypertension, 65.0% (62.5-67.2%) had a hyperlipidemic profile, 32.6% (30.3-34.9%) were diagnosed with diabetes, and 27.6% (25.1-29.8%) were smokers at the time of a heart-related event. Only 5% of patients with ACS lacked any of the 4 conventional risk factors. Higher prevalence rates of all major risk factors, except smoking, were detected in women than in men, in older (≥65 years of age) than younger patients, and in rural (<2,000 inhabitants) than in urban areas. Premature ACS (<45 years of age) was associated with smoking in men, and smoking and hypertension in women. Smoking, in all risk factor combinations, reduced the age at the time of a heart-related event, on average, by 10.0 years in men and by 12.4 years in women. CONCLUSION The results of this study suggest an appreciable burden of major cardiovascular risk factors and also highlight differences that may aid the targeting of public health interventions.
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Affiliation(s)
- Roman Alberty
- Department of Biology and Ecology, Faculty of Natural Sciences, Matej Bel University, Banská Bystrica, Slovakia
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10
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Hayashi T, Koba S, Ito Y, Hirano T. Method for estimating high sdLDL-C by measuring triglyceride and apolipoprotein B levels. Lipids Health Dis 2017; 16:21. [PMID: 28125987 PMCID: PMC5270205 DOI: 10.1186/s12944-017-0417-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/17/2017] [Indexed: 11/25/2022] Open
Abstract
Background We previously developed an assay to directly measure small dense (sd) low-density lipoprotein cholesterol (LDL-C) levels, which is not widely used in general clinical practice. Therefore, we propose a simpler method, “LDL window,” that uses conventional methods for estimating high sdLDL-C levels. Methods We analyzed our previous studies (2006–2008) on healthy subjects and patients with type 2 diabetes and coronary artery disease (CAD). The sdLDL-C level was measured using the precipitation method, and LDL size was determined using gradient gel electrophoresis. The “LDL window” comprises the estimation of LDL particle number and size. We adopted apolipoprotein B (apoB) for the estimation of the LDL particle number and used 110 mg/dL as the cutoff value for hyper-apoB. Triglycerides (TGs) are a powerful inverse determinant of LDL particle size. Therefore, we adopted TG for the estimation of the LDL particle size and used 150 mg/dL as the cutoff value for hyper-TG. Subjects were stratified into the following four subgroups: normal, hyper-TG, hyper-apoB, and hyper-TG/-apoB. Non-high-density lipoprotein cholesterol (non-HDL-C) is a surrogate marker for apoB; therefore, the “alternative LDL window” comprised non-HDL-C (cutoff, 170 mg/dL) and TG. Results The top quartile (Q4) of sdLDL-C (>31 mg/dL) doubled in patients with diabetes and CAD. The hyper-TG/-apoB group in the “LDL window” represented >90% Q4 and <4% Q1 and Q2, irrespective of the subjects. The sdLDL-C levels in the hyper-TG/-apoB group were 50% higher in patients with diabetes and CAD than those in controls. Similar results were obtained using the “alternative LDL window.” Conclusions Our proposed “LDL window” may help identify patients at high risk of CAD independent of LDL-C. Electronic supplementary material The online version of this article (doi:10.1186/s12944-017-0417-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Toshiyuki Hayashi
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, Shinagawa, Tokyo, Japan
| | - Yasuki Ito
- Reagent R&D Department, Denka Seiken Co., Ltd., Tokyo, Japan
| | - Tsutomu Hirano
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan.
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Bando Y, Tohyama H, Aoki K, Kanehara H, Hisada A, Okafuji K, Toya D. Ipragliflozin lowers small, dense low-density lipoprotein cholesterol levels in Japanese patients with type 2 diabetes mellitus. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2016; 6:1-7. [PMID: 29067237 PMCID: PMC5644427 DOI: 10.1016/j.jcte.2016.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 05/14/2016] [Accepted: 06/13/2016] [Indexed: 02/06/2023]
Abstract
Small dense LDL-C (sd LDL-C) convey cardiovascular risk in type 2 diabetes (T2D). Ipragliflozin reduced sd LDL-C levels in Japanese patients with T2D. Changes in body weight, TG and LDL-C levels contributed to sd LDL-C reduction.
Aims This preliminary randomized, parallel-group comparative study evaluated the efficacy of ipragliflozin for reduction of small dense low-density lipoprotein cholesterol (sd LDL-C) levels in Japanese patients with type 2 diabetes mellitus (T2DM). Methods Sixty-two patients with T2DM (age, 56 ± 8 years; hemoglobin A1c levels, 8.1 ± 0.9%; BMI, 27.5 ± 3.3 kg/m2) were randomly assigned in a 2:1 ratio to receive ipragliflozin (50 mg/day) (treatment group; n = 40) or continued treatment (control group; n = 22) for 12 weeks. The primary endpoints were changes in sd LDL-C levels detected using the LipoPhor AS® system; the secondary endpoints included changes in the sd LDL-C/large buoyant LDL-C (lb LDL-C) ratio, a surrogate marker for LDL particle size, and percent changes in routine lipid parameters. Results The treatment group exhibited a statistically significant reduction from baseline for LDL-C levels (−0.37 mg/dL vs. 14.4 mg/dL, p = 0.038), sd LDL-C levels (−1.28 mg/dL vs. 2.81 mg/dL, p = 0.012), and sd LDL-C/lb LDL-C ratio (−3.20% vs. 4.58%, p = 0.040) compared with the control group. Multiple regression analysis among all subjects revealed change in TG levels (p = 0.011) and LDL-C levels (p = 0.024) as well as change in body weight (p = 0.006) as independent factors contributing to the reduction in sd LDL-C. Conclusions Ipragliflozin may have a potential for lowering sd LDL-C levels associated with increasing LDL particle size in Japanese patients with T2DM.
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Affiliation(s)
- Yukihiro Bando
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Hitomi Tohyama
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Keiko Aoki
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Hideo Kanehara
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Azusa Hisada
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Kazuhiro Okafuji
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Daisyu Toya
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
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The effects of anti-diabetic drugs on LDL subclasses: any role for colesevelam? Cardiovasc Drugs Ther 2014; 28:205-7. [PMID: 24867816 DOI: 10.1007/s10557-014-6521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nishikura T, Koba S, Yokota Y, Hirano T, Tsunoda F, Shoji M, Hamazaki Y, Suzuki H, Itoh Y, Katagiri T, Kobayashi Y. Elevated small dense low-density lipoprotein cholesterol as a predictor for future cardiovascular events in patients with stable coronary artery disease. J Atheroscler Thromb 2014; 21:755-67. [PMID: 24717762 DOI: 10.5551/jat.23465] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The aim of the present study was to investigate how small dense low-density lipoprotein cholesterol (sdLDL-C) compared with LDL-C affect the long-term prognosis in patients with stable coronary artery disease (CAD). METHODS sdLDL-C measured by heparin magnesium precipitation and LDL particle size measured by non-denatured gradient-gel electrophoresis were compared in 190 consecutive CAD patients who underwent coronary arteriography between 2003 and 2004 who did or did not develop cardiovascular events during a seven-year follow-up period. Cardiovascular events were death caused by cardiovascular diseases(CVDs), onset of acute coronary syndrome, need for coronary and peripheral arterial revascularization, hospitalization for heart failure, surgical procedure for any CVDs, and/or hospitalization for stroke. RESULTS First-time cardiovascular events were observed in 72 patients. Those who experienced cardiovascular events were older and had higher prevalence rates of hypertension and diabetes; significantly higher Gensini coronary atherosclerotic scores; significantly higher levels of sdLDL-C, sdLDL-C/LDL-C, and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratios; and greater glycated hemoglobin(Hb)A1c and brain natriuretic peptide (BNP) levels. They also had significantly smaller LDL particle sizes, HDL-C, apolipoprotein A-1, and estimated glomerular filtration rate (GFR) compared with patients without cardiovascular events. Conversely, LDL-C, non-HDL-C, apolipoprotein B, remnantlike particle cholesterol, and high-sensitivity C-reactive protein (hs-CRP) levels were similar between the two groups. A Kaplan-Meyer event-free survival curve demonstrated that patients with sdLDL-C≥35 mg/dL (median level) had significantly poorer prognosis compared with those with lower sdLDL-C levels, while patients with LDL-C ≥100 mg/dL had a non-significantly lower survival rate. CONCLUSION These results confirm that sdLDL-C is a very promising biomarker to predict future cardiovascular events in the secondary prevention of stable CAD.
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Affiliation(s)
- Tenjin Nishikura
- The Department of Medicine, Division of Cardiology, Showa University School of Medicine
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Jakuš V, Sándorová E, Kalninová J, Krahulec B. Monitoring of glycation, oxidative stress and inflammation in relation to the occurrence of vascular complications in patients with type 2 diabetes mellitus. Physiol Res 2014; 63:297-309. [PMID: 24564602 DOI: 10.33549/physiolres.932672] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The study aimed to evaluate if the monitoring of advanced glycation end products (AGEs), advanced oxidation protein products (AOPP), lipoperoxides (LPO) and interleukin-6 (IL-6) in plasma could help to predict development of diabetic complications (DC). Clinical and biochemical parameters including AGEs, AOPP, LPO and IL-6 were investigated in patients with type 2 diabetes mellitus (DM2) with (+DC) and without (-DC) complications. AGEs were significantly higher in both diabetic groups compared to controls. AGEs were also significantly higher in group +DC compared to -DC. AGEs significantly correlated with HbA1c. We observed significantly higher AOPP in both diabetic groups in comparison with controls, but the difference between -DC and +DC was not significant. LPO significantly correlated with BMI. IL-6 were significantly increased in both diabetic groups compared to controls, but the difference between -DC and +DC was not significant. There was no significant correlation between IL-6 and clinical and biochemical parameters. These results do not exclude the association between IL-6 and onset of DC. We suggest that the measurement of not only HbA1c, but also AGEs may be useful to predict the risk of DC development in clinical practice. Furthermore, the measurement of IL-6 should be studied as adjunct to HbA1c monitoring.
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Affiliation(s)
- V Jakuš
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.
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Tani S, Nagao K, Hirayama A. Association between urinary albumin excretion and low-density lipoprotein heterogeneity following treatment of type 2 diabetes patients with the dipeptidyl peptidase-4 inhibitor, vildagliptin: a pilot study. Am J Cardiovasc Drugs 2013; 13:443-50. [PMID: 23990203 DOI: 10.1007/s40256-013-0043-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Few data exist as to whether dipeptidyl peptidase (DPP)-4 inhibitors affect cardio-renal interaction, which is a strong independent prognostic factor for cardiovascular disease (CVD), in diabetic patients. We evaluated the effects of a DPP-4 inhibitor on atherogenic low-density lipoprotein (LDL) heterogeneity and albuminuria in diabetics as an indicator of the severity of diabetic nephropathy. METHODS Type 2 diabetes patients (n = 47) inadequately controlled with diabetes therapy were treated with vildagliptin 50 mg bid for 8 weeks. LDL heterogeneity was evaluated on the basis of the patients' small dense (sd) LDL levels and sd-LDL proportion (sd-LDL/LDL cholesterol [LDL-C]). The level of albuminuria was evaluated on the basis of the urinary albumin-to-creatinine ratio (UACR). RESULTS After 8 weeks of treatment, there was no significant change in serum LDL-C level, but the serum sd-LDL level had decreased significantly by 8.8 %, and the UACR had also decreased significantly by 44.6 %. Triglyceride (TG)-metabolism-related markers (TG, remnant-like particle cholesterol, apolipoprotein [apo] B, apoC-2, and apoC-3) had decreased significantly. The Δ (absolute change from baseline) sd-LDL values correlated positively with ΔTG-metabolism-related markers, but not with the Δ hemoglobin (Hb) A1c or Δ fasting blood sugar (ΔFBS). Furthermore, multivariate regression analysis revealed that Δsd-LDL proportion, but not ΔHbA1c or ΔFBS, was an independent predictor of ΔUACR (β = 0.292, p = 0.0016). CONCLUSIONS Although this was a single-arm study, treatment of type 2 diabetes with vildagliptin might prevent the progression of CVD complicating diabetes by improving LDL heterogeneity, and it might improve renal function by decreasing albuminuria. A randomized controlled trial is warranted.
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Affiliation(s)
- Shigemasa Tani
- Department of Cardiology, Surugadai Nihon University Hospital, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan,
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Meal related glucose monitoring is a method of diagnosing glucose intolerance in pregnancies with high probability of gestational diabetes but normal glucose tolerance by oral glucose tolerance test. Med Hypotheses 2013; 80:816-8. [PMID: 23582888 DOI: 10.1016/j.mehy.2013.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 03/09/2013] [Indexed: 11/24/2022]
Abstract
Gestational diabetes mellitus diagnosed by classical oral glucose tolerance test can result in fetal complications like macrosomia and polyhydramnios. Guidelines exist on management of patients diagnose by abnormal oral glucose tolerance test with diet modification followed by insulin. Even patients with abnormal oral glucose tolerance test maintaining apparently normal blood sugars with diet are advised insulin if there is accelerated fetal growth. But patients with normal oral glucose tolerance test can present with macrosomia and polyhydramnios. These patients are labelled as not having gestational diabetes mellitus and are followed up with repeat oral glucose tolerance test. We hypothesise that these patients may have an altered placental threshold to glucose or abnormal sensitivity of fetal tissues to glucose. Meal related glucose monitoring in these patients can identify minor abnormalities in glucose disturbance and should be treated to targets similar to physiological levels of glucose in non pregnant adults.
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Ribeiro C, Cambri LT, Dalia RA, de Araújo MB, Botezelli JD, Sponton ACDS, de Mello MAR. Effects of physical training with different intensities of effort on lipid metabolism in rats submitted to the neonatal application of alloxan. Lipids Health Dis 2012; 11:138. [PMID: 23067133 PMCID: PMC3532126 DOI: 10.1186/1476-511x-11-138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 10/09/2012] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a chronic disease that is characterized by insulin resistance. Its development is directly connected with the inability of insulin to exert its action, not just on carbohydrate metabolism but also on primarily on lipid metabolism. The present study aimed to compare the effects of continuous, intermittent, and strength training on serum and tissue variables on the lipid metabolism of alloxan rats. METHODS Wistar rats were divided into eight groups: sedentary alloxan (SA), sedentary control (SC), continuous training alloxan (CA), intermittent training alloxan (IA), strength training alloxan (StA), continuous training control (CC), intermittent training control (IC) and strength training control (StC). Alloxan (250 mg/kg bw) was injected into neonatal rats at 6 days of age. The continuous training protocol consisted of 12 weeks of swimming training for 1 uninterrupted hour/day, five days/week, supporting a load that was 5% bw. The intermittent training protocol consisted of 12 weeks of swimming training with 30 s of activity interrupted by 30 s of rest, for a total of 20 min/day, five days/week, supporting a load that was 15% bw. The strength-training protocol consisted of 12 weeks of training, five days/week with 4 sets of 10 jumps in water with 1 min rest between sets, supporting a load that was a 50% bw. RESULTS At 28 days, the alloxan animals exhibited higher insulin resistance as measured by the disappearance of glucose serum (% Kitt/min) during the ITT. At 120 days, the sedentary alloxan animals showed higher FFA values than continuous and intermittent training alloxan. In addition, the alloxan animals that underwent intermittent and strength training showed lower FFA values compared to the corresponding controls. The continuous training protocol was less effective than the strength training protocol for reducing the levels of total cholesterol in the alloxan animals. Serum total lipid values revealed that intermittent training increased serum levels in alloxan animals CONCLUSION Thus, it was concluded that physical training at different intensities of effort is of great importance in attenuation and control of changes in the lipid metabolism in alloxan animals.
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Affiliation(s)
- Carla Ribeiro
- Institute of Biosciences Physical Education Department, São Paulo State University – (Universidade Estadual Paulista- UNESP), Av: 24-A, 1515 Bela Vista, Rio Claro – São Paulo, CEP: 13506-900, Brazil
| | - Lucieli Teresa Cambri
- Institute of Biosciences Physical Education Department, São Paulo State University – (Universidade Estadual Paulista- UNESP), Av: 24-A, 1515 Bela Vista, Rio Claro – São Paulo, CEP: 13506-900, Brazil
| | - Rodrigo Augusto Dalia
- Institute of Biosciences Physical Education Department, São Paulo State University – (Universidade Estadual Paulista- UNESP), Av: 24-A, 1515 Bela Vista, Rio Claro – São Paulo, CEP: 13506-900, Brazil
| | - Michel Barbosa de Araújo
- Institute of Biosciences Physical Education Department, São Paulo State University – (Universidade Estadual Paulista- UNESP), Av: 24-A, 1515 Bela Vista, Rio Claro – São Paulo, CEP: 13506-900, Brazil
| | - José Diego Botezelli
- Institute of Biosciences Physical Education Department, São Paulo State University – (Universidade Estadual Paulista- UNESP), Av: 24-A, 1515 Bela Vista, Rio Claro – São Paulo, CEP: 13506-900, Brazil
| | - Amanda Christine da Silva Sponton
- Institute of Biosciences Physical Education Department, São Paulo State University – (Universidade Estadual Paulista- UNESP), Av: 24-A, 1515 Bela Vista, Rio Claro – São Paulo, CEP: 13506-900, Brazil
| | - Maria Alice Rostom de Mello
- Institute of Biosciences Physical Education Department, São Paulo State University – (Universidade Estadual Paulista- UNESP), Av: 24-A, 1515 Bela Vista, Rio Claro – São Paulo, CEP: 13506-900, Brazil
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Ribeiro C, Cambri LT, Dalia RA, Araújo MB, Ghezzi AC, Moura LP, Araújo GG, Botezelli JD, Mello MAR. Muscle protein metabolism in neonatal alloxan-administered rats: effects of continuous and intermittent swimming training. Diabetol Metab Syndr 2012; 4:5. [PMID: 22309804 PMCID: PMC3292999 DOI: 10.1186/1758-5996-4-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 02/06/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study aimed to examine the effects of intermittent and continuous swimming training on muscle protein metabolism in neonatal alloxan-administered rats. METHODS Wistar rats were used and divided into six groups: sedentary alloxan (SA), sedentary control (SC), continuous trained alloxan (CA), intermittent trained alloxan (IA), continuous trained control (CC) and intermittent trained control (IC). Alloxan (250 mg/kg body weight) was injected into newborn rats at 6 days of age. The continuous training protocol consisted of 12 weeks of swimming training in individual cylinder tanks while supporting a load that was 5% of body weight; uninterrupted swimming for 1 h/day, five days a week. The intermittent training protocol consisted of 12 weeks of swimming training in individual cylinder tanks while supporting a load that was 15% of body weight; 30 s of activity interrupted by 30 s of rest for a total of 20 min/day, five days a week. RESULTS At 28 days, the alloxan animals displayed higher glycemia after glucose overload than the control animals. No differences in insulinemia among the groups were detected. At 120 days, no differences in serum albumin and total protein among the groups were observed. Compared to the other groups, DNA concentrations were higher in the alloxan animals that were subjected to continuous training, whereas the DNA/protein ratio was higher in the alloxan animals that were subjected to intermittent training. CONCLUSION It was concluded that continuous and intermittent training sessions were effective in altering muscle growth by hyperplasia and hypertrophy, respectively, in alloxan-administered animals.
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Affiliation(s)
- Carla Ribeiro
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Lucieli T Cambri
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Rodrigo A Dalia
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Michel B Araújo
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Ana C Ghezzi
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Leandro P Moura
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Gustavo G Araújo
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Jose D Botezelli
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
| | - Maria AR Mello
- São Paulo State University - UNESP, Physical Education Department, Av: 24-A, 1515 Bela Vista. CEP: 13506-900 Rio Claro - São Paulo - Brazil
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Rizzo M, Tomkin GH, Patti AM, Pepe I, Valerio MR, Di Rosa S, Rini GB, Di Fede G. Effects of hypolipidemic and hypoglycemic agents on atherogenic small, dense LDL in Type 2 diabetes. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/clp.11.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Inhaled aerosolized insulin: a "topical" anti-inflammatory treatment for acute lung injury and respiratory distress syndrome? Inflammation 2010; 33:315-9. [PMID: 20186475 DOI: 10.1007/s10753-010-9187-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Acute lung injury (ALI) and the more severe acute respiratory distress syndrome (ARDS) are forms of pulmonary edema that result from robust local and systemic inflammatory states, such as sepsis. The morbidity and mortality associated with ALI and ARDS are significant and the treatment of these conditions presents a formidable challenge. Controlling hyperglycemia with insulin is a core component of patient management in the critically ill. Insulin treatment also exerts beneficial metabolic effects beyond glucose control, as well as non-metabolic effects, in insulin-resistant states. For instance, insulin inhibits NF-kappaB--dependent synthesis of pro-inflammatory factors and attenuates production of ROS. Indeed, intravenous administration of insulin ameliorates pulmonary injury and dysfunction in the LPS model of ALI. Most recently, an inhalable insulin formulation was shown to effectively reduce glucose concentrations with minimal impact on long-term pulmonary function. We propose that administering inhalable insulin to hyperglycemic ALI/ARDS patients could directly reduce alveolar inflammation while reducing circulating glucose levels.
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Biesenbach G, Bodlaj G, Ebner S, Biesenbach P, Pieringer H. Metabolic control and vascular diseases under oral antidiabetic drug versus insulin therapy and/or diet alone during the first year of hemodialysis in type 2 diabetic patients with ESRD. Int Urol Nephrol 2010; 43:1155-60. [PMID: 20640938 DOI: 10.1007/s11255-010-9804-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 07/02/2010] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Uremic type 2 diabetic patients on hemodialysis need various types of antidiabetic therapies. The aim of the present study was to identify differences between patients on oral antidiabetic drug therapy or insulin substitution or diet therapy alone during their first year of hemodialysis. PATIENTS AND METHODS Sixty-four type 2 diabetic patients who had started hemodialysis (HD) at our dialysis center between 2003 and 2007 were included in the study. Kidney-transplanted patients (n = 1) and those with chronic infectious or malignant diseases (n = 4) were excluded. Patients were divided into three groups according to their antidiabetic therapy: group 1 consisted of patients on oral antidiabetic drug therapy (n = 12), group 2 of those on insulin therapy (n = 42), and group 3 of those being treated with diet alone (n = 10). At the start of HD and 12 months later, we measured fasting plasma glucose (FPG), HbA1c, the incidence of hypoglycemia (n/patient/month), cholesterol, triglycerides, body weight, and insulin requirements in the insulin-treated group. C-peptide was only measured at the start of dialysis. We evaluated changes in antidiabetic therapy during the first year on dialysis, and the prevalence of vascular disease in each group at the start of HD. RESULTS FPG and HbA1c values were similar in all groups at the start of HD and after 1 year. Hypoglycemia occurred more frequently in insulin-treated patients; however, the difference was not significant. Cholesterol levels were similar in all groups, whereas triglycerides were significantly lower in insulin-treated patients (138 ± 28 vs. 176 ± 46 mg/dl; P < 0.05). Body weight was similar in all groups. No significant change in body weight was observed in any group after 12 months on dialysis. At the start of HD, C-peptide levels were lower in insulin-treated patients than in the other groups (1.8 ± 0.9 ng/ml vs. 2.2 ± 1.1 and 2.4 ± 1.1 ng/ml; P < 0.05). During the first 12 months on HD, two patients from group 1 were shifted to group 3 (diet alone), while four patients could reduce their drug dosage (33%). However, two subjects became insulin-dependent. In group 2, insulin therapy could be terminated in two cases, while the insulin dose could be reduced in 20 patients (48%). In group 3, one patient was switched to oral antidiabetic therapy. The prevalence of vascular disease was slightly higher in group 3 (NS). CONCLUSION Within 1 year after the start of HD, the dose of sulfonylurea as well as insulin could be reduced in a large majority of patients. Metabolic control was similar in all groups. Only triglycerides were significantly lower in group 2. The frequency of hypoglycemia and the prevalence of vascular disease were just slightly higher in the group on insulin therapy.
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Affiliation(s)
- Georg Biesenbach
- 2nd Department of Medicine, General Hospital Linz, Bismarckstrasse 7, 4020 Linz, Austria.
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Kawano M, Shono N, Yoshimura T, Yamaguchi M, Hirano T, Hisatomi A. Improved cardio-respiratory fitness correlates with changes in the number and size of small dense LDL: randomized controlled trial with exercise training and dietary instruction. Intern Med 2009; 48:25-32. [PMID: 19122353 DOI: 10.2169/internalmedicine.48.1527] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To investigate the correlation between lifestyle improvements, in particular increased cardio-respiratory fitness and changes in the blood lipid profile. METHODS The participants were 217 residents of Fuji and Yamato Towns, Saga City, with mildly abnormal blood pressure, serum lipids or blood glucose detected at health check-ups in 2003. Participants were randomly allocated to an Intervention (108 subjects) or Control group (109 subjects), matched for age and various conditions. The Intervention group was given exercise advice and prescription and dietary instructions. Cardio-respiratory fitness was evaluated using the work rate at double product breaking point. Changes of lipid parameters were compared before and after intervention, and examined the relationship with cardio-respiratory fitness. RESULTS Seventy nine subjects in each group could be followed up for 17 months without requiring pharmacotherapy. Body mass index, waist circumference, systolic blood pressure, homeostasis model assessment insulin resistance, and triglycerides were decreased in the Intervention group. Furthermore, apolipoprotein B levels were lower (p<0.05), and the ratio of LDL cholesterol to apolipoprotein B (LDL/ApoB) was higher (p<0.001). When all subjects were divided into 3 subgroups according to the degree of improvement in cardio-respiratory fitness, LDL/ApoB increased and apolipoprotein B decreased as the degree of improvement increased (p<0.05). CONCLUSION Improvement was seen in atherosclerotic risk factors through lifestyle modification. In particular, improved cardiorespiratory fitness was associated with qualitative and quantitative changes in LDLs.
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Affiliation(s)
- Masayo Kawano
- Department of Internal Medicine, Saga University, Saga.
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Ogita K, Ai M, Tanaka A, Ito Y, Hirano T, Yoshino G, Shimokado K. Serum concentration of small dense low-density lipoprotein-cholesterol during oral glucose tolerance test and oral fat tolerance test. Clin Chim Acta 2007; 387:36-41. [PMID: 17900551 DOI: 10.1016/j.cca.2007.08.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 07/27/2007] [Accepted: 08/29/2007] [Indexed: 11/20/2022]
Abstract
BACKGROUND Small dense low-density lipoprotein (sdLDL) is well known as an atherogenic lipoprotein. We developed a new assay to measure serum concentration of sdLDL-cholesterol (sdLDLC). Using this assay, we reported a unique circadian rhythm of sdLDLC. We determined whether a glucose intake and/or a fat intake affects on serum sdLDLC concentration and determined the modulators of serum sdLDLC concentration. METHODS Ten healthy volunteers were recruited to perform both a 75 g oral glucose tolerance test (OGTT) and an oral fat tolerance test (OFTT) to determine the effects of glucose and fat ingestion separately. Blood was measured for sdLDLC concentration and other valuables. RESULTS Serum concentrations of total cholesterol, LDLC, remnant-like particles-cholesterol (RLPC), and apolipoprotein B significantly decreased during OGTT (p<0.05). SdLDLC also decreased and was a minimum at 2 h after glucose ingestion and increased to the baseline by 3 h. The sdLDLC decrease was seen while serum insulin level was high. The change of sdLDLC during OGTT had greater inverse correlationship with that of serum insulin level (r=-0.74, p<0.01) than that of plasma glucose level (r=-0.69, p=0.04). After fat ingestion, triglyceride and RLPC increased remarkably (p<0.01) but sdLDLC, LDLC, apolipoprotein B, and insulin did not change significantly. CONCLUSIONS Serum concentration of sdLDLC was not affected by a fat intake but by a glucose intake. The change of sdLDLC was associated by that of serum insulin level, suggesting that insulin can be one of the key modulator of serum sdLDLC level as well as LDL metabolism.
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Affiliation(s)
- Kyoko Ogita
- Department of Vascular Medicine and Geriatrics, Tokyo Medical and Dental University, Tokyo, Japan
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Bibliography. Current world literature. Diabetes and the endocrine pancreas II. Curr Opin Endocrinol Diabetes Obes 2007; 14:329-57. [PMID: 17940461 DOI: 10.1097/med.0b013e3282c3a898] [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: 11/25/2022]
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Bibliography. Current world literature. Diabetes and the endocrine pancreas. Curr Opin Endocrinol Diabetes Obes 2007; 14:170-96. [PMID: 17940437 DOI: 10.1097/med.0b013e3280d5f7e9] [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]
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