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de Souza AES, da Silva CHS, de Oliveira RDCS, Guimarães APA, da Silva ANLM, Diniz IG, de Oliveira HSS, de Sousa DS, Figueiredo FADPL, Costa GDLC, Guerreiro JF. Investigation of genetic markers associated to type 2 diabetes mellitus in Santarém-Pará. Genet Mol Biol 2024; 47:e20230107. [PMID: 39133695 PMCID: PMC11308377 DOI: 10.1590/1678-4685-gmb-2023-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 05/22/2024] [Indexed: 08/15/2024] Open
Abstract
Genetic, epigenetic and environmental factors play an important role in the genesis of Type 2 Diabetes Mellitus (T2D). In the genetic context, one of the strategies used to investigate possible associations with diabetes is the search for Single Nucleotide Polymorphisms (SNPs), involving the comparison of alelle frequencies, the phenotypic variations and other relevant factors, such as environmental influences and lifestyle choices, Thus, the aim of this study was to find the relationship of risk variants for T2D in SNPs (rs4994) in the ADRB3 gene; (rs1799854) in the ABCC8 gene; (rs7901695 and rs12255372) in the TCF7L2 gene; and (rs8050136) in the FTO gene in a sample of the population of the municipality of Santarém (PA), Brazilian Amazon, in the northern region of Brazil. ABCC8 (rs1799854 C>T) showed a statistically significant association with T2D. Each chosen gene and SNP has been previously implicated in T2D risk according to existing scientific literature, owing to their roles in glucose regulation and body fat.
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Affiliation(s)
- Adjanny Estela Santos de Souza
- Universidade do Estado do Pará, Faculdade de Medicina, Departamento
de Morfologia e Ciências Fisiológicas, Belém, PA, Brazil
| | - Caio Henrique Silva da Silva
- Universidade do Estado do Pará, Faculdade de Medicina, Departamento
de Morfologia e Ciências Fisiológicas, Belém, PA, Brazil
| | | | - Ana Paula Araújo Guimarães
- Universidade do Estado do Pará, Faculdade de Medicina, Departamento
de Morfologia e Ciências Fisiológicas, Belém, PA, Brazil
| | | | - Isabela Guerreiro Diniz
- Universidade Federal do Pará, Instituto de Ciências Biológicas,
Laboratório de Genética Humana e Médica, Belém, PA, Brazil
| | - Haiala Soter Silva de Oliveira
- Universidade Federal do Pará, Instituto de Ciências Biológicas,
Laboratório de Genética Humana e Médica, Belém, PA, Brazil
| | - Diego Sarmento de Sousa
- Universidade Federal do Oeste do Pará (UFOPA), Santarém, PA,
Brazil
- Centro Universitário da Amazônia (UNAMA), Santarém, PA,
Brazil
| | | | - Greice de Lemos Cardoso Costa
- Universidade Federal do Pará, Instituto de Ciências Biológicas,
Laboratório de Genética Humana e Médica, Belém, PA, Brazil
| | - João Farias Guerreiro
- Universidade Federal do Pará, Instituto de Ciências Biológicas,
Laboratório de Genética Humana e Médica, Belém, PA, Brazil
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Zhang J, Long L, Li J, Zhang H, Yan W, Abulimiti A, Abulajiang N, Lu Q, Nguyen TN, Cai X. Impact of obesity-related indicators on first-pass effect in patients with ischemic stroke receiving mechanical thrombectomy. Neuroradiology 2024; 66:1021-1029. [PMID: 38625617 DOI: 10.1007/s00234-024-03350-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE The first-pass effect (FPE), defined as complete revascularization after a single thrombectomy pass in large vessel occlusion, is a predictor of good prognosis in patients with acute ischemic stroke (AIS) receiving mechanical thrombectomy (MT). We aimed to evaluate obesity-related indicators if possible be predictors of FPE. METHODS We consecutively enrolled patients with AIS who were treated with MT between January 2019 and December 2021 at our institution. Baseline characteristics, procedure-related data, and laboratory test results were retrospectively analyzed. A multivariable logistic regression analysis was performed to evaluate the independent predictors of FPE. RESULTS A total of 151 patients were included in this study, of whom 47 (31.1%) had FPE. After adjusting for confounding factors, the independent predictors of achieving FPE were low levels of body mass index (BMI) (OR 0.85, 95% CI 0.748 to 0.971), non-intracranial atherosclerotic stenosis (OR 4.038, 95% CI 1.46 to 11.14), and non-internal carotid artery occlusion (OR 13.14, 95% CI 2.394 to 72.11). Patients with lower total cholesterol (TC) (< 3.11 mmol/L) were more likely to develop FPE than those with higher TC (≥ 4.63 mmol/L) (OR 4.280; 95% CI 1.24 to 14.74) CONCLUSION: Lower BMI, non-intracranial atherosclerotic stenosis, non-internal carotid artery occlusion, and lower TC levels were independently associated with increased rates of FPE in patients with AIS who received MT therapy. FPE was correlated with better clinical outcomes after MT.
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Affiliation(s)
- Junliu Zhang
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Neurology, the First People's Hospital of Kashi Prefecture, Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, China
| | - Ling Long
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jie Li
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Neurology, the First People's Hospital of Kashi Prefecture, Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, China
| | - Heng Zhang
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Neurology, the First People's Hospital of Kashi Prefecture, Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, China
| | - Wei Yan
- Department of Neurology, the First People's Hospital of Kashi Prefecture, Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, China
| | - Adilijiang Abulimiti
- Department of Neurology, the First People's Hospital of Kashi Prefecture, Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, China
| | - Nuerbiya Abulajiang
- Department of Neurology, the First People's Hospital of Kashi Prefecture, Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, China
| | - Qingbo Lu
- Department of Neurology, the First People's Hospital of Kashi Prefecture, Affiliated Kashi Hospital of Sun Yat-Sen University, Kashi, China.
| | - Thanh N Nguyen
- Department of Neurology, Radiology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, USA.
| | - Xiaodong Cai
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
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3
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Ji LL, Fretwell VS, Escamilla A, Yao W, Zhang T, He M, Zhang JQ. An acute exercise at low to moderate intensity attenuated postprandial lipemia and insulin responses. J Exerc Sci Fit 2024; 22:14-22. [PMID: 38021207 PMCID: PMC10663685 DOI: 10.1016/j.jesf.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Objective The purpose of this study was to investigate the effects of different exercise intensities on postprandial lipemia (PHTG) and insulin resistance in healthy individuals. Methods Participants were 10 adult males with normal fasting triglyceride (TG) concentrations (age = 34 ± 2.8 y, body mass = 72.9 ± 2.4 kg, fasting plasma TG = 1.36 ± 0.18 mmol/l, VO2max = 43.7 ± 3.0 ml/kg/min, fasting glucose = 5.2 ± 0.2 mmol/l and fasting Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR) = 1.7 ± 0.3). In this study, each participant performed a control trial (Ctr, no exercise), and 3 exercise trials at 40 % (40%T), 60 % (60%T), and 70 % (70%T) of their VO2max. In the exercise trials, participant jogged on a treadmill for 1 h at a designated intensity. A fat-rich meal was consumed by each participant 12 h after exercise. Blood samples were taken at 0 h (before the meal), and 2 h, 4 h, 6 h, 8 h, and 24 h after the meal. The plasma TG, area score under TG concentration curve over an 8 h-period (TG tAUC) after the meal, and HOMA2-IR were analyzed. Results Our results showed that at 2 h, 4 h, and 6 h after the meal, TG in all exercise trials were lower than Ctr (p < 0.05) but did not differ from each other. All the exercise trials were lower in TG tAUC scores than Ctr (p < 0.02), but differences were not observed among the exercise trials. In comparison to Ctr, a significant difference in HOMA2-IR in both 60 % T and 70 % T (p < 0.05 and p < 0.01, respectively) was observed, but not in 40 % T. Conclusion The results suggest that exercising at low to moderate exercise intensity for 1 h sufficiently attenuates a fat meal induced PHTG. Moderate exercise intensity also effectively mitigates insulin resistance.
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Affiliation(s)
- Lisa L. Ji
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Vicki S. Fretwell
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Abel Escamilla
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Wanxiang Yao
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Tianou Zhang
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Meizi He
- Department of Public Health, The University of Texas at San Antonio, USA
| | - John Q. Zhang
- Department of Kinesiology, The University of Texas at San Antonio, USA
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4
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Xiao M, Deng H, Mao W, Liu Y, Yang Q, Liu Y, Fan J, Li W, Liu D. U-shaped association between serum triglyceride levels and mortality among septic patients: An analysis based on the MIMIC-IV database. PLoS One 2023; 18:e0294779. [PMID: 38011086 PMCID: PMC10681221 DOI: 10.1371/journal.pone.0294779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Sepsis is characterized by upregulated lipolysis in adipose tissue and a high blood triglyceride (TG) level. It is still debated whether serum TG level is related to mortality in septic patients. The aim of this study is to investigate the association between serum TG level and mortality in septic patients admitted to the intensive care unit (ICU). METHODS Data from adult septic patients (≥18 years) admitted to the ICU for the first time were obtained from the Multiparameter Intelligent Monitoring in Intensive Care IV (MIMIC-IV) database. The patients' serum TG levels that were measured within the first week after ICU admission were extracted for statistical analysis. The endpoints were 28-day, ICU and in-hospital mortality. RESULTS A total of 2,782 septic patients were included. Univariate analysis indicated that the relationship between serum TG levels and the risk of mortality was significantly nonlinear. Both the Lowess smoothing technique and restricted cubic spline analyses revealed a U-shaped association between serum TG levels and mortality among septic patients. The lowest mortality rate was associated with a serum TG level of 300-500 mg/dL. Using 300∼500 mg/dL as the reference range, we found that both hypo-TG (<300 mg/dL) and hyper-TG (≥500 mg/dL) were associated with increased mortality. The result was further adjusted by Cox regression with and without the inclusion of some differential covariates. CONCLUSIONS There was a U-shaped association between serum TG and mortality in septic ICU patients. The optimal concentration of serum TG levels in septic ICU patients is 300-500 mg/dL.
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Affiliation(s)
- Min Xiao
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, China
| | - Hongbin Deng
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenjian Mao
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, China
| | - Yang Liu
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qi Yang
- Department of Critical Care Medicine, Jinling Hospital, Nanjing, China
| | - Yuxiu Liu
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jiemei Fan
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, China
| | - Weiqin Li
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, China
| | - Dadong Liu
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, China
- Department of Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
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5
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Qiu M, Zhou X, Zippi M, Goyal H, Basharat Z, Jagielski M, Hong W. Comprehensive review on the pathogenesis of hypertriglyceridaemia-associated acute pancreatitis. Ann Med 2023; 55:2265939. [PMID: 37813108 PMCID: PMC10563627 DOI: 10.1080/07853890.2023.2265939] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023] Open
Abstract
It is well known, that the inflammatory process that characterizes acute pancreatitis (AP) can lead to both pancreatic damage and systemic inflammatory response syndrome (SIRS). During the last 20 years, there has been a growing incidence of episodes of acute pancreatitis associated with hypertriglyceridaemia (HTAP). This review provides an overview of triglyceride metabolism and the potential mechanisms that may contribute to developing or exacerbating HTAP. The article comprehensively discusses the various pathological roles of free fatty acid, inflammatory response mechanisms, the involvement of microcirculation, serum calcium overload, oxidative stress and the endoplasmic reticulum, genetic polymorphism, and gut microbiota, which are known to trigger or escalate this condition. Future perspectives on HTAP appear promising, with ongoing research focused on developing more specific and effective treatment strategies.
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Affiliation(s)
- Minhao Qiu
- Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Xiaoying Zhou
- Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Maddalena Zippi
- Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy
| | - Hemant Goyal
- Department of Surgery, University of TX Health Sciences Center, Houston, TX, United States
| | | | - Mateusz Jagielski
- Department of General, Gastroenterological and Oncological Surgery, Nicolaus Copernicus University in Toruń, Poland
| | - Wandong Hong
- Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
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6
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Waksman O, Choi D, Mar P, Chen Q, Cho DJ, Kim H, Smith RL, Goonewardena SN, Rosenson RS. Association of blood viscosity and device-free days among hospitalized patients with COVID-19. J Intensive Care 2023; 11:17. [PMID: 37131249 PMCID: PMC10153022 DOI: 10.1186/s40560-023-00665-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Increased estimated whole blood viscosity (eWBV) predicts higher mortality in patients hospitalized for coronavirus disease 2019 (COVID-19). This study assesses whether eWBV is an early predictor of non-fatal outcomes among patients hospitalized for acute COVID-19 infection. METHODS This retrospective cohort study included 9278 hospitalized COVID-19 patients diagnosed within 48 h of admission between February 27, 2020 to November 20, 2021 within the Mount Sinai Health System in New York City. Patients with missing values for major covariates, discharge information, and those who failed to meet the criteria for the non-Newtonian blood model were excluded. 5621 participants were included in the main analysis. Additional analyses were performed separately for 4352 participants who had measurements of white blood cell count, C-reactive protein and D-dimer. Participants were divided into quartiles based on estimated high-shear blood viscosity (eHSBV) and estimated low-shear blood viscosity (eLSBV). Blood viscosity was calculated using the Walburn-Schneck model. The primary outcome was evaluated as an ordinal scale indicating the number of days free of respiratory organ support through day 21, and those who died in-hospital were assigned a value of -1. Multivariate cumulative logistic regression was conducted to evaluate the association between quartiles of eWBV and events. RESULTS Among 5621 participants, 3459 (61.5%) were male with mean age of 63.2 (SD 17.1) years. The linear modeling yielded an adjusted odds ratio (aOR) of 0.68 (95% CI 0.59-0.79, p value < 0.001) per 1 centipoise increase in eHSBV. CONCLUSIONS Among hospitalized patients with COVID-19, elevated eHSBV and eLSBV at presentation were associated with an increased need for respiratory organ support at 21 days. These findings are highly relevant, as they demonstrate the utility of eWBV in identifying hospitalized patients with acute COVID-19 infection at increased risk for non-fatal outcomes in early stages of the disease.
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Affiliation(s)
- Ori Waksman
- Metabolism and Lipids Unit, Cardiovascular Institute, Marie-Josee and Henry R Kravis Center for Cardiovascular Health, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA
| | - Daein Choi
- Metabolism and Lipids Unit, Cardiovascular Institute, Marie-Josee and Henry R Kravis Center for Cardiovascular Health, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA
- Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Phyu Mar
- Metabolism and Lipids Unit, Cardiovascular Institute, Marie-Josee and Henry R Kravis Center for Cardiovascular Health, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA
| | - Qinzhong Chen
- Metabolism and Lipids Unit, Cardiovascular Institute, Marie-Josee and Henry R Kravis Center for Cardiovascular Health, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA
| | | | | | | | - Sascha N Goonewardena
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Robert S Rosenson
- Metabolism and Lipids Unit, Cardiovascular Institute, Marie-Josee and Henry R Kravis Center for Cardiovascular Health, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
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7
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Kiss L, Fűr G, Pisipati S, Rajalingamgari P, Ewald N, Singh V, Rakonczay Z. Mechanisms linking hypertriglyceridemia to acute pancreatitis. Acta Physiol (Oxf) 2023; 237:e13916. [PMID: 36599412 DOI: 10.1111/apha.13916] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/25/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
Hypertriglyceridemia (HTG) is a metabolic disorder, defined when serum or plasma triglyceride concentration (seTG) is >1.7 mM. HTG can be categorized as mild to very severe groups based on the seTG value. The risk of acute pancreatitis (AP), a serious disease with high mortality and without specific therapy, increases with the degree of HTG. Furthermore, even mild or moderate HTG aggravates AP initiated by other important etiological factors, including alcohol or bile stone. This review briefly summarizes the pathophysiology of HTG, the epidemiology of HTG-induced AP and the clinically observed effects of HTG on the outcomes of AP. Our main focus is to discuss the pathophysiological mechanisms linking HTG to AP. HTG is accompanied by an increased serum fatty acid (FA) concentration, and experimental results have demonstrated that these FAs have the most prominent role in causing the consequences of HTG during AP. FAs inhibit mitochondrial complexes in pancreatic acinar cells, induce pathological elevation of intracellular Ca2+ concentration, cytokine release and tissue injury, and reduce the function of pancreatic ducts. Furthermore, high FA concentrations can induce respiratory, kidney, and cardiovascular failure in AP. All these effects may contribute to the observed increased AP severity and frequent organ failure in patients. Importantly, experimental results suggest that the reduction of FA production by lipase inhibitors can open up new therapeutic options of AP. Overall, investigating the pathophysiology of HTG-induced AP or AP in the presence of HTG and determining possible treatments are needed.
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Affiliation(s)
- Lóránd Kiss
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Gabriella Fűr
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Sailaja Pisipati
- Department of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Prasad Rajalingamgari
- Department of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Nils Ewald
- Institute for Endocrinology, Diabetology and Metabolism, University Hospital Minden, Minden, Germany.,Justus-Liebig-Universität Giessen, Giessen, Germany
| | - Vijay Singh
- Department of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Zoltán Rakonczay
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
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8
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Yum KS, Kang SG, Lee JW, Cho YI. Effects of sarpogrelate on blood viscosity. Microvasc Res 2023; 145:104439. [PMID: 36126755 DOI: 10.1016/j.mvr.2022.104439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/30/2022] [Accepted: 09/13/2022] [Indexed: 02/03/2023]
Abstract
The objective of the present study was to evaluate the effects and safety of sarpogrelate hydrochloride (sarpogrelate) in patients with elevated blood viscosity (BV), after 12 and 24 weeks of twice (BID) or thrice (TID) daily administrations of sarpogrelate (100 mg). The participants received oral sarpogrelate administration for 24 weeks and visited the hospital every 12 ± 2 week for blood viscosity measurements at shear rates of 5 and 300 s-1. The BV measured at shear rate of 5 s-1 in male patients decreased significantly from 18.91 cP at the baseline to 16.3 cP after 24 weeks of sarpogrelate administration (13.6 % drop, p < 0.001). The BV measured at 5 s-1 in female decreased more significantly from 17.5 cP at the baseline to 13.4 cP after 24 weeks of sarpogrelate administration (23.0 % drop, p < 0.001). In summary, sarpogrelate may be considered as a possible therapeutic option for improving BV in patients with elevated blood viscosity. In particular, the reduction of the low-shear BV with the help of a viscosity-reducing drug such as sarpogrelate may be considered as a potentially new pharmacological tool for microvascular disease.
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Affiliation(s)
- Keun-Sang Yum
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, Uijeongbu, St. Mary's Hospital, Seoul 11765, Republic of Korea
| | - Sung-Goo Kang
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Seoul 16247, Republic of Korea
| | - Jeong-Won Lee
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, Uijeongbu, St. Mary's Hospital, Seoul 11765, Republic of Korea
| | - Young I Cho
- Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, PA 19104, USA.
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9
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Loh WJ, Bakthavachalam R, Subramaniam T, Pek S, Chua F, Lee L, Watts GF. Chylomicronemia through a burr hole: A case report. Front Cardiovasc Med 2022; 9:1020397. [PMID: 36312279 PMCID: PMC9596755 DOI: 10.3389/fcvm.2022.1020397] [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: 08/16/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Chylomicronemia has either a monogenic or multifactorial origin. Multifactorial chylomicronemia is the more common form and is due to the interaction of genetic predisposition and secondary factors such as obesity, diabetes, unhealthy diet, and medications. We report a case of a 38-year-old man who was diagnosed with multifactorial chylomicronemia following presentation with a subarachnoid hemorrhage requiring emergency surgery through a burr hole; lactescent cerebrospinal fluid mixed with blood was observed through the burr hole. The serum triglyceride concentration was 52⋅4 mmol/L with a detectable triglyceride concentration in the cerebrospinal fluid. Rapid weight gain leading to obesity and related unfavorable lifestyle factors were identified as key secondary causes of chylomicronemia. Gene testing revealed a homozygous variant in APOA5 and a heterozygous common variant in GPIHBP1. Accompanied with secondary causes, the interactions of gene and environmental conditions contribute to chylomicronemia. With aggressive medical treatment including excess weight loss, healthy diet, cessation of alcohol, and combination of anti-lipemic medications, normal plasma triglyceride levels were achieved.
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Affiliation(s)
- Wann Jia Loh
- Department of Endocrinology, Changi General Hospital, Singapore, Singapore,Medical School, University of Western Australia, Perth, WA, Australia,Department of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, WA, Australia,Duke-NUS Medical School, Singapore, Singapore,*Correspondence: Wann Jia Loh, ;
| | | | - Tavintharan Subramaniam
- Diabetes Centre, Admiralty Medical Centre, Singapore, Singapore,Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Sharon Pek
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Fionn Chua
- Department of Dietetics, Changi General Hospital, Singapore, Singapore
| | - Lester Lee
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Gerald F. Watts
- Medical School, University of Western Australia, Perth, WA, Australia,Department of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, WA, Australia
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Association of Blood Viscosity With Mortality Among Patients Hospitalized With COVID-19. J Am Coll Cardiol 2022; 80:316-328. [PMID: 35863848 PMCID: PMC9291270 DOI: 10.1016/j.jacc.2022.04.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 12/18/2022]
Abstract
Background Coronavirus disease-2019 (COVID-19) is characterized by a dysfunctional immune response and abnormal blood rheology that contribute to endothelial dysfunction and thrombotic complications. Whole blood viscosity (WBV) is a clinically validated measure of blood rheology and an established predictor of cardiovascular risk. We hypothesize that increased WBV is associated with mortality among patients hospitalized with COVID-19. Objectives This study sought to determine the association between estimated BV (eBV) and mortality among hospitalized COVID-19 patients. Methods The study population included 5,621 hospitalized COVID-19 patients at the Mount Sinai Health System from February 27, 2020, to November 27, 2021. eBV was calculated using the Walburn-Schneck model. Multivariate Cox proportional hazards models were used to evaluate the association between eBV and mortality. Considered covariates included age, sex, race, cardiovascular and metabolic comorbidities, in-house pharmacotherapy, and baseline inflammatory biomarkers. Results Estimated high-shear BV (eHSBV) and estimated low-shear BV were associated with increased in-hospital mortality. One-centipoise increases in eHSBV and estimated low-shear BV were associated with a 36.0% and 7.0% increase in death, respectively (P < 0.001). Compared with participants in the lowest quartile of eHSBV, those in the highest quartile of eHSBV had higher mortality (adjusted HR: 1.53; 95% CI: 1.27-1.84). The association was consistent among multiple subgroups, notably among patients without any comorbidities (adjusted HR: 1.69; 95% CI: 1.28-2.22). Conclusions Among hospitalized COVID-19 patients, increased eBV is significantly associated with higher mortality. This suggests that eBV can prognosticate patient outcomes in earlier stages of COVID-19, and that future therapeutics aimed at reducing WBV should be evaluated.
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11
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Zhang SJ, Yan ZY, Yuan LF, Wang YH, Wang LF. Multimodal imaging study of lipemia retinalis with diabetic retinopathy: A case report. World J Clin Cases 2022; 10:6736-6743. [PMID: 35979318 PMCID: PMC9294873 DOI: 10.12998/wjcc.v10.i19.6736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/27/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Lipemia retinalis (LR) is a rare disease related to hypertriglyceridemia. However, the symptoms of hypertriglyceridemia are insidious and difficult to detect without blood tests. The fundus is the only site where blood vessels can be observed directly. Understanding the specific performance of LR in multimodal imaging fundus examinations can help diagnose more patients with abnormal hyperlipidemia.
CASE SUMMARY A 29-year-old woman with type 2 diabetes presented to our clinic complaining of a six-day loss of visual acuity in the left eye. The fundus color images showed typical LR: Arteries and veins were the same pink-white color. Infrared images showed hyperinfrared reflections of the arteries and veins. Optical coherence tomography (OCT) showed numerous high point-like reflections in the retinal section, corresponding to different calibers of blood vessel sections. Medium reflections were seen in the big vessels of the choroid. Fundus fluorescein angiography (FFA) and optical coherence tomography angiography (OCTA) showed no significant changes. Laboratory examination found a total cholesterol level of 13.98 mmol/L, triglyceride 20.55 mmol/L, which confirmed the diagnosis of LR. After treatment to lower blood lipids and control blood glucose, the fundus imaging showed that the blood lipids in the patient had returned to normal.
CONCLUSION LR shows specific changes in fundus color photography, infrared photography, and OCT. FFA and OCTA were not sensitive to LR changes.
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Affiliation(s)
- Sheng-Juan Zhang
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Eye Institute, Xingtai 054001, Hebei Province, China
| | - Zhong-Yang Yan
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Eye Institute, Xingtai 054001, Hebei Province, China
| | - Li-Fei Yuan
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Eye Institute, Xingtai 054001, Hebei Province, China
| | - Yan-Hui Wang
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Eye Institute, Xingtai 054001, Hebei Province, China
| | - Li-Fei Wang
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Eye Institute, Xingtai 054001, Hebei Province, China
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12
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Liang HJ, Zhang QY, Hu YT, Liu GQ, Qi R. Hypertriglyceridemia: A Neglected Risk Factor for Ischemic Stroke? J Stroke 2022; 24:21-40. [PMID: 35135057 PMCID: PMC8829486 DOI: 10.5853/jos.2021.02831] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/27/2021] [Indexed: 11/11/2022] Open
Abstract
Hypertriglyceridemia is caused by defects in triglyceride metabolism and generally manifests as abnormally high plasma triglyceride levels. Although the role of hypertriglyceridemia may not draw as much attention as that of plasma cholesterol in stroke, plasma triglycerides, especially nonfasting triglycerides, are thought to be correlated with the risk of ischemic stroke. Hypertriglyceridemia may increase the risk of ischemic stroke by promoting atherosclerosis and thrombosis and increasing blood viscosity. Moreover, hypertriglyceridemia may have some protective effects in patients who have already suffered a stroke via unclear mechanisms. Therefore, further studies are needed to elucidate the role of hypertriglyceridemia in the development and prognosis of ischemic stroke.
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Affiliation(s)
- Hai-jie Liang
- Department of Pharmacology, School of Basic Medical Sciences, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
| | - Qing-yi Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
- State Key Laboratory of Natural and Biomimetic Drugs, Beijing, China
- NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Beijing, China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Peking University Health Science Center, Beijing, China
| | - Yi-tong Hu
- Department of Pharmacology, School of Basic Medical Sciences, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
| | - Guo-qing Liu
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
| | - Rong Qi
- Department of Pharmacology, School of Basic Medical Sciences, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
- State Key Laboratory of Natural and Biomimetic Drugs, Beijing, China
- NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Beijing, China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, Peking University Health Science Center, Beijing, China
- Correspondence: Rong Qi Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China Tel: +86-10-8280-5164 Fax: +86-10-8280-5164 E-mail:
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13
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Armstrong M, Milner E, Nguyen C, Corrigan T, Lee YF. Visualizing and exploring nonlinear behavior, timescales, and mechanical signatures of human blood. Biorheology 2021; 58:1-26. [PMID: 33867354 DOI: 10.3233/bir-201007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Human blood is a thixo-elasto-visco-plastic (TEVP) material that exhibits unique fluctuations in mechanical properties based on physiology, and shear rate. We demonstrate new visual tools to help visualize and characterize these varied mechanical properties. OBJECTIVE Our objective is to demonstrate contemporary visual and numerical tools to help visualize and characterize the varied mechanical properties of human blood. METHODS Using the ARESG2 strain-controlled rheometer with double wall couette geometry and eight human blood donors, with lab test results, elastic and viscous properties are investigated using Series of Physical Processes (SPP) and MITLaos to both analyze and visualize the mechanical signatures of the blood. RESULTS Variations of mechanical properties are shown via SPP generated Cole-Cole plots and MITLaos analysis. These variations are a function of physiological properties of blood on the day of the blood draw based on hematocrit, fibrinogen, cholesterol, triglycerides, and a host of other proteins and constituents. Each rheological experiment with blood is replicated with an analogous experiments with 0.04 wt% xanthan in glycerol, and water to demonstrate that the mechanical properties of the human blood, and its rheological signatures are unique to human blood. CONCLUSIONS Human blood is proven to be a TEVP material, as shown on a series of Cole-Cole plots for eight different donors, at two different frequency and strain amplitude combinations. Variations in Cole-Cole plots for each donor are shown. MITLaos average mechanical properties are calculated and shown. Aggregated elastic and viscous projections and a Cole-Cole plot is shown for Donors 1-8, along with 95% confidence interval.
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Affiliation(s)
- Matthew Armstrong
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, USA
| | - Erin Milner
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, USA
| | - Chi Nguyen
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, USA
| | - Trevor Corrigan
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, USA
| | - Yu-Fan Lee
- Department of Chemical and Biomolecular Engineering, Center for Research in Soft Matter & Polymers, University of Delaware, Newark, DE, USA
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14
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Barzilai-Birenboim S, Yacobovich J, Zalcberg Y, Arad-Cohen N, Avrahami G, Gilad G, Litichever N, Izraeli S, Elitzur S. Bone pain at leukemia diagnosis and other risk factors for symptomatic osteonecrosis in children with acute lymphoblastic leukemia. Pediatr Blood Cancer 2021; 68:e29033. [PMID: 33788395 DOI: 10.1002/pbc.29033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/25/2021] [Accepted: 03/13/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Osteonecrosis is a major cause of acute and long-lasting complications of acute lymphoblastic leukemia (ALL) therapy in children. Our study aimed to evaluate the prevalence, characteristics, risk factors, and outcome of osteonecrosis in children with ALL. PROCEDURE The cohort included 559 children aged 1-20 years diagnosed with ALL between 2003 and 2018 at two tertiary medical centers in Israel and enrolled in two consecutive protocols: ALL-IC BFM 2002 and AIEOP-BFM ALL 2009. Symptomatic osteonecrosis was prospectively captured as an adverse event. RESULTS Osteonecrosis occurred in 51 patients (9.1%). Ninety-four percent of the events were graded as moderate or severe (grades 3-4, Ponte di Legno Toxicity Working Group classification) and multiple bone involvement was common. Full resolution of osteonecrosis was documented in only 16% of the children (median follow-up 4.2 years). Stepwise logistic regression identified five risk factors for osteonecrosis, with a high predictive value (AUC = 0.88): older ageat ALL diagnosis, high-risk ALL group, T-cell immunophenotype, female gender, and a novel risk factor: bone pain at the time of leukemia diagnosis. In addition, osteonecrosis was less common among children of Arab ethnicity. Thrombophilia and an elevated age-adjusted body mass index were not confirmed as risk factors for osteonecrosis. CONCLUSION Due to the low rates of osteonecrosis resolution and its debilitating long-term impact, the identification of patients at high risk for osteonecrosis is important for their inclusion in further studies evaluating potential therapeutic adjustments.
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Affiliation(s)
- Shlomit Barzilai-Birenboim
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joanne Yacobovich
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yair Zalcberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Pediatric Hematology, Oncology, and Bone Marrow Transplantation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Nira Arad-Cohen
- Department of Pediatric Hematology-Oncology, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, and Technion-Israel Institute of Technology, Haifa, Israel
| | - Galia Avrahami
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Gilad
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Litichever
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Shai Izraeli
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sarah Elitzur
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Sanchez RJ, Ge W, Wei W, Ponda MP, Rosenson RS. The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis. Lipids Health Dis 2021; 20:72. [PMID: 34275452 PMCID: PMC8286611 DOI: 10.1186/s12944-021-01488-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022] Open
Abstract
Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.
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Affiliation(s)
| | - Wenzhen Ge
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
| | - Wenhui Wei
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
| | - Manish P Ponda
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
| | - Robert S Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, One Gustav L. Levy Place, Hospital Box 1030, New York, NY, 10029, USA.
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16
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Song K, Yi HJ, Lee DH, Sung JH. Association of blood viscosity with first-pass reperfusion in mechanical thrombectomy for acute ischemic stroke. Clin Hemorheol Microcirc 2021; 77:233-244. [PMID: 33074222 DOI: 10.3233/ch-200979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Elevated blood viscosity has been reported as a risk factor for cerebrovascular disease. OBJECTIVE The relationship between blood viscosity and outcomes of mechanical thrombectomy (MT) for large artery occlusion (LAO) were investigated in the present study. METHODS A total of 238 patients were enrolled and systolic blood viscosity (SBV) and diastolic blood viscosity (DBV) were measured using the scanning capillary tube viscometer. Receiver operating characteristic (ROC) analysis was performed to specify the association of viscosity with the first-pass reperfusion (FPR). Multivariable and regression analyses were performed to evaluate the relationship of viscosity with FPR and various variables. RESULTS Based on ROC analysis, the best DBV cutoff value was 10.55 (cP). In multivariable analysis, high DBV was associated with FPR failure (odds ratio 2.82, 95% confidence interval 1.64-4.22; p = 0.001). Increased DVB could be associated with elevated SBV, hematocrit level, and blood urea nitrogen/creatinine ratio (p = <0.001, 0.004, and 0.002, respectively). CONCLUSIONS Elevated DBV was associated with FPR failure. Patients with high DBV had longer thrombus length and required more stent passages than patients with low DBV.
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Affiliation(s)
- Kyojun Song
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Neurosurgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Jun Yi
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Republic of Korea
| | - Dong Hoon Lee
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae Hoon Sung
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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17
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Lau SCD, Loh CK, Alias H. Case Report: The Use of Intravenous SMOFlipid Infusion to Treat Severe Asparaginase-Induced Hypertriglyceridemia in Two Pediatric Acute Lymphoblastic Leukemia Patients. Front Pediatr 2021; 9:660627. [PMID: 33968859 PMCID: PMC8100240 DOI: 10.3389/fped.2021.660627] [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: 01/29/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022] Open
Abstract
Asparaginase-induced hypertriglyceridemia can have a spectrum of clinical presentations, from being asymptomatic to having life-threatening thrombosis or hyperviscosity syndrome. At present, there is no recommendation on routine lipid monitoring during asparaginase-containing treatment phase, nor a standardized guideline on its management. Two cases are presented here to illustrate the effects of concurrent infection on asparaginase-induced hypertriglyceridemia in patients with high-risk ALL and the use of SMOFlipid infusion as a treatment option in an acute situation.
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Affiliation(s)
- Sie Chong Doris Lau
- Pediatric Hematology and Oncology Unit, Department of Pediatrics, UKM Medical Centre, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - C-Khai Loh
- Pediatric Hematology and Oncology Unit, Department of Pediatrics, UKM Medical Centre, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Hamidah Alias
- Pediatric Hematology and Oncology Unit, Department of Pediatrics, UKM Medical Centre, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
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18
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Wang Y, Wei C, Song Q, Liu J, Cheng Y, Li Y, Wu B, Liu M. Reduction in the Ratio of Low-density Lipoprotein Cholesterol to Highdensity Lipoprotein Cholesterol is Associated with Increased Risks of Hemorrhagic Transformation in Patients with Acute Ischemic Stroke. Curr Neurovasc Res 2020; 16:266-272. [PMID: 31258087 DOI: 10.2174/1567202616666190619151914] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE Hemorrhagic transformation (HT) is a potentially serious complication in patients with acute ischemic stroke (AIS). Whether the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) is associated with HT remains unclear. METHODS Ischemic stroke patients within 7 days of stroke onset from January 2016 to November 2017 were included in this study. Lipid profiles were measured within 24h after admission. HT was determined by a second computed tomography or magnetic resonance imaging within 7 days after admission. Univariate and multivariate logistic regression analysis was used to assess the association between LDL-C/HDL-C and HT. RESULTS We enrolled 1239 patients with AIS (788 males; mean age, 64 ± 15 years), of whom 129 (10.4%) developed HT. LDL-C/HDL-C was significantly lower on admission in patients with HT than those without HT (2.00 ± 0.89 vs. 2.25 ± 1.02, P=0.009). The unadjusted odds ratio (OR) of low LDL-C/HDL-C for HT was 2.07 (95% confidence interval [CI] 1.42-3.01, P<0.001). After adjustment for possible confounders, lower LDL-C/HDL-C (≤1.52) was significantly associated with HT (OR 1.53, 95% CI: 1.02-2.31, P=0.046). Similar results were observed between lower LDL-C (≤ 4 mmol/L) and HT (OR 4.17, 95% CI: 1.25-13.90, P=0.02). However, no significant association was found between HT and high HDL-C, low triglycerides or low total cholesterol. CONCLUSION Lower LDL-C/HDL-C and LDL-C were significantly associated with increased risk of HT after AIS. Further investigations are warranted to confirm these findings and then optimize lipid management in stroke patients with lower LDL/HDL-C or LDL-C.
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Affiliation(s)
- Yanan Wang
- Department of Neurology, Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Chenchen Wei
- Department of Neurology, Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Quhong Song
- Department of Neurology, Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Junfeng Liu
- Department of Neurology, Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Yajun Cheng
- Department of Neurology, Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Yisong Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Bo Wu
- Department of Neurology, Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
| | - Ming Liu
- Department of Neurology, Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China
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19
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Wang Y, Song Q, Cheng Y, Wei C, Ye C, Liu J, Wu B, Liu M. Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke. BMC Neurol 2020; 20:47. [PMID: 32033596 PMCID: PMC7007671 DOI: 10.1186/s12883-020-1615-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/14/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare the predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT. METHODS We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT in multivariate logistic regression analysis. RESULTS A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted odds ratios [ORs] 1.74 [95% confidence interval [CI] 1.09-2.78], 2.01[95% CI 1.26-3.20], and 1.76 [95% CI 1.10-2.83], respectively, P for trend = 0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age (P for interaction = 0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values [Non-HDL-C, net reclassification index (NRI) 0.24, 95%CI 0.17-0.31, P < 0.001; LDL-C, NRI 0.15, 95%CI 0.08-0.22, P = 0.03]. CONCLUSIONS Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT.
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Affiliation(s)
- Yanan Wang
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Quhong Song
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Yajun Cheng
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Chenchen Wei
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Chen Ye
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Junfeng Liu
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Ming Liu
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China.
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20
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Zhang G, Zhang T, Sun X, Tang F, Lin H, Liu Y, Zhang C, Xue F. Whole blood viscosity is an independent early predictor for metabolic syndrome and its components in men: A prospective cohort study in Northern Chinese population. Clin Hemorheol Microcirc 2020; 80:1-8. [PMID: 31929145 DOI: 10.3233/ch-15120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The association between whole blood viscosity (WBV) and metabolic syndrome (MetS) is still scarcely investigated in the population-based prospective cohort. We aim to explore the longitudinal effect of WBV on MetS, and to verify whether WBV measures can be used as early predictors for MetS. The longitudinal cohort consisted of 3,508 adults (2,350 males and 1,158 females) who visited the health check-up system twice. WBV were measured at four shear rate (200, 50, 10 and 1 s-1), and their values were classified into quartiles. Multivariate Cox models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) in men and women, respectively. A total of 444 (12.66%) incident MetS were observed at follow-up period. The incidences of MetS significantly increased with increasing quartiles of WBVs at all of the shear rate in men. After adjusting for baseline age, smoking, obesity, hypertension, hyperglycemia, and hyperlipidemia status, all of the WBV measures were significantly associated with incident MetS in men, and the HRs showed clear increasing trend across the quartiles of baseline WBVs. There were no significant association between WBVs and incident MetS in women. These findings suggest that MetS has a hemodynamic basis, and WBVs could be used as independent early predictor for MetS in men.
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Affiliation(s)
- Guang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Xiubin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Fang Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Haiyan Lin
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Yanxun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Chengqi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China
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21
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Yin Y, Ma L, Xu X, Tian Y, Wen S, Luo J. Thinning of glycerol in the presence of multi-walled carbon nanotubes. J Chem Phys 2019. [DOI: 10.1063/1.5098831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Yanchao Yin
- Department of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China
| | - Liran Ma
- Department of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China
| | - Xuefeng Xu
- School of Technology, Beijing Forestry University, Beijing 100083, China
| | - Yu Tian
- Department of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China
| | - Shizhu Wen
- Department of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China
| | - Jianbin Luo
- Department of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China
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22
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Zhang J, Lei F, Li M, Pan T, Yao L, Chen J. Spectral noise-to-signal ratio priority method with application for visible and near-infrared analysis of whole blood viscosity. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2019; 219:427-435. [PMID: 31063957 DOI: 10.1016/j.saa.2019.04.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/12/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
Whole blood viscosity (WBV) is a group of important clinical indicators of cardio-cerebral vascular diseases. Existing detection methods for WBV are complex, making them inconvenient for large population screening. Blood viscosity is closely related to the deformability and aggregation of erythrocytes, which are associated with haemoglobin. Haemoglobin has obvious near-infrared (NIR) spectral absorption. Scattering occurs when NIR light enters a viscous blood sample, and its scattering degree is correlated with blood viscosity. Based on repeated spectral measurements and spectral similarity, spectral noise-to-signal ratio (NSR) was proposed to quantify the spectral scattering effect in the blood sample. A novel selection method of piecewise-continuous wavelengths, named NSR priority-partial least squares (NSRP-PLS), was proposed and applied for visible-NIR quantitative analysis of WBV with high, medium and low shear rates [WBV(H), WBV(M), WBV(L)]. Modelling was separately performed by gender to allow for systematic gender differences in blood viscosity. For the NIR-predicted and clinically measured values of the three WBV indicators in independent validation, the root mean square errors for prediction (SEP) were 0.498, 0.222 and 0.193 (mPa·s), respectively. And the correlation coefficients (RP) were 0.927, 0.934 and 0.927, respectively. Compared with the three current well-performing methods (MW-PLS, CARS-PLS and SPA-PLS), the proposed NSRP-PLS method achieved better predictive accuracy. Results indicated that visible-NIR spectroscopy combined with the NSRP-PLS method can be used for the quantitative analysis of WBV. The proposed analytical method is rapid, reagent-free and is scientific and meaningful for cardio-cerebral vascular diseases screening in large populations.
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Affiliation(s)
- Jing Zhang
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Fenfen Lei
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Mingliang Li
- Department of Biological Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Tao Pan
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China.
| | - Lijun Yao
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Jiemei Chen
- Department of Biological Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China.
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Burstedt D, Tippett JC. Severe Hypertriglyceridemia During Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth 2019; 33:3418-3422. [PMID: 31076303 DOI: 10.1053/j.jvca.2019.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 01/04/2023]
Affiliation(s)
- David Burstedt
- Baylor Scott & White Healthcare/Texas A&M University Health Science Center College of Medicine, Temple, TX
| | - J Clint Tippett
- Baylor Scott & White Healthcare/Texas A&M University Health Science Center College of Medicine, Temple, TX.
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Wu HC, Lee LC, Wang WJ. Plasmapheresis for hypertriglyceridemia: The association between blood viscosity and triglyceride clearance rate. J Clin Lab Anal 2018; 33:e22688. [PMID: 30320483 DOI: 10.1002/jcla.22688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/03/2018] [Accepted: 09/16/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Several factors in double filtration plasmapheresis (DFPP) were associated with triglyceride (TG) clearance rate. This study examines whether baseline whole blood viscosity was a predictor for efficient TG removal. METHODS Adult subjects who receiving DFPP for hyperlipidemia in Taoyuan General Hospital from January 2015 to March 2018 were classified into efficient and inefficient TG removal according to TG removal rate ≥50% vs <50%. TG removal rate was defined as following formula: (pre-apheresis TG- post-apheresis TG)/pre-apheresis TG. Whole blood viscosity (WBV) was estimated by following equation: WBV = 0.12 × hematocrit +0.17 × (total protein -2.07). Univariate linear regression was used to assess the association between TG removal rate and WBV. Odds ratios (ORs) and 95% confidence interval (95%CI) for associations between variables and efficient TG removal were evaluated by logistic regression model to including univariate and multivariate adjustment. RESULTS From a total of 66 subjects receiving DFPP, 37 subjects reached efficient TG removal. The difference in pre-apheresis TG levels, hematocrit, and WBV between efficient vs. inefficient TG removal groups was 4.1 vs 6.7 mmol/L; 43.1% vs 39.5%; and 6.0cP vs 5.cP (Ps <0.05). After multivariate adjustment, WBC was a significant predictor for efficient TG removal (ORs and 95% CI were 3.192 (1.300-7.838), P < 0.05). The correlation between WBV and extraction of TG was significant (r = -0.255, P = 0.039). CONCLUSION Hyperviscosity reduced the efficiency of TG removal in those receiving DFPP.
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Affiliation(s)
- Hung-Chieh Wu
- Division of Nephrology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.,Institute of Public Health, National Yang Ming University, Taipei, Taiwan
| | - Lin-Chien Lee
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wei-Jie Wang
- Division of Nephrology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.,Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan
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Salvador C, Entenmann A, Salvador R, Niederwanger A, Crazzolara R, Kropshofer G. Combination therapy of omega-3 fatty acids and acipimox for children with hypertriglyceridemia and acute lymphoblastic leukemia. J Clin Lipidol 2018; 12:1260-1266. [PMID: 30055974 DOI: 10.1016/j.jacl.2018.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Lipemic alterations are commonly seen in pediatric patients with acute lymphoblastic leukemia (ALL) treated with corticosteroids and L-asparaginase. OBJECTIVE In these children, hypertriglyceridemia rarely causes symptoms and mostly responds well to a low-fat diet. Only few patients demand further therapy, which is not clearly approved in the literature to date. Therefore, it may be important to compile generally accepted standard procedures for lipid-lowering therapy in the pediatric ALL population. METHODS We performed a study on 119 newly diagnosed pediatric patients with ALL, all treated according to the ALL-BFM 2000 protocol at our institution between the years 2000 and 2009, to evaluate the incidence of hypertriglyceridemia and the efficacy of a combination therapy with omega-3 fatty acids and acipimox in hypertriglyceridemic patients who did not respond to diet. RESULTS We observed hypertriglyceridemia in 34.5% of patients in this collective. In the majority, normalization of triglycerides was successfully managed by administration of a low-fat diet. However, 7.6% of patients (related to total study population) with hypertriglyceridemia did not show diminished lipid levels during diet and/or presented with symptoms such as abdominal pain, dyspnea, or anginal chest pain. In these cases, we performed a lipid-lowering combination therapy with omega-3 fatty acids and acipimox. We observed a prompt decline of serum triglycerides to normal values and an improvement of symptoms within days after onset of this therapy without occurrence of any side effects. CONCLUSION In summary, the combination treatment with omega-3 fatty acids and acipimox could represent an alternative to other reported lipid-lowering therapies without severe adverse reactions.
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Affiliation(s)
- C Salvador
- Division of Pediatric Hematology and Oncology, Department of Pediatrics I, Innsbruck Medical University, Innsbruck, Tyrol, Austria.
| | - A Entenmann
- Division of Gastroenterology and Hepatology, Department of Pediatrics I, Innsbruck Medical University, Innsbruck, Tyrol, Austria
| | | | - A Niederwanger
- Department of Internal Medicine, Innsbruck Medical University, Innsbruck, Tyrol, Austria
| | - R Crazzolara
- Division of Pediatric Hematology and Oncology, Department of Pediatrics I, Innsbruck Medical University, Innsbruck, Tyrol, Austria
| | - G Kropshofer
- Division of Pediatric Hematology and Oncology, Department of Pediatrics I, Innsbruck Medical University, Innsbruck, Tyrol, Austria
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King KS, Sheng M, Liu P, Maroules CD, Rubin CD, Peshock RM, McColl RW, Lu H. Detrimental effect of systemic vascular risk factors on brain hemodynamic function assessed with MRI. Neuroradiol J 2018; 31:253-261. [PMID: 29319396 DOI: 10.1177/1971400917750375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background and purpose Vascular risk factors have been associated with decreased cerebral blood flow (CBF) but this is etiologically nonspecific and may result from vascular insufficiency or a response to decreased brain metabolic activity. We apply new MRI techniques to measure oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen consumption (CMRO2), hypothesizing that decreased CBF related to these vascular risk factors will be associated with increased OEF, confirming a primary vascular insufficiency. Methods 3T MRI was obtained on 70 community-based participants in this IRB-approved study with informed consent, with previous assessment of systolic blood pressure, hypertension medication, elevated serum triglycerides, low serum HDL, and diabetes mellitus. CBF was measured using phase contrast adjusted for brain volume (ml/100 g/min), OEF (%) was obtained from T2-Relaxation-Under-Spin-Tagging (TRUST), and CMRO2 (μmol/100 g/min) was derived using the Fick principle. Stepwise linear regression identified optimal predictors of CBF with age, sex, and hematocrit included for adjustment. This predictive model was then evaluated against OEF and CMRO2. Results Hypertriglyceridemia was associated with low CBF and high OEF. High systolic blood pressure was associated with high CBF and low OEF, which was primarily attributable to those with pressures above 160 mmHg. Neither risk factor was associated with significant differences in cerebral metabolic rate. Conclusion Low CBF related to hypertriglyceridemia was accompanied by high OEF with no significant difference in CMRO2, confirming subclinical vascular insufficiency. High CBF related to high systolic blood pressure likely reflected limitations of autoregulation at higher blood pressures.
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Affiliation(s)
- Kevin S King
- 1 Huntington Medical Research Institutes, USA.,2 Department of Radiology, University of Texas Southwestern Medical Center, USA
| | - Min Sheng
- 3 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, USA
| | - Peiying Liu
- 3 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, USA.,4 Department of Radiology, 1501 Johns Hopkins University , USA
| | | | - Craig D Rubin
- 5 Department of Internal Medicine, University of Texas Southwestern Medical Center, USA
| | - Ron M Peshock
- 2 Department of Radiology, University of Texas Southwestern Medical Center, USA.,5 Department of Internal Medicine, University of Texas Southwestern Medical Center, USA
| | - Roderick W McColl
- 2 Department of Radiology, University of Texas Southwestern Medical Center, USA
| | - Hanzhang Lu
- 3 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, USA.,4 Department of Radiology, 1501 Johns Hopkins University , USA
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27
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Yamada Y, Shima H, Shibata H, Ishii T, Hasegawa T, Shimada H. Severe hypertriglyceridemia during treatment of acute lymphoblastic leukemia associated with type III hyperlipoproteinemia. Pediatr Blood Cancer 2017; 64. [PMID: 28371240 DOI: 10.1002/pbc.26530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/19/2017] [Accepted: 02/23/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Yuji Yamada
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Haruko Shima
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Hironori Shibata
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Shimada
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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28
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Vidanapathirana DM, Rodrigo T, Waidyanatha S, Jasinge E, Hooper AJ, Burnett JR. Lipoprotein Lipase Deficiency in an Infant With Chylomicronemia, Hepatomegaly, and Lipemia Retinalis. Glob Pediatr Health 2017; 4:2333794X17715839. [PMID: 28695157 PMCID: PMC5495498 DOI: 10.1177/2333794x17715839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/11/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
| | | | | | | | - Amanda J Hooper
- Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, Western Australia, Australia.,University of Western Australia, Crawley, Western Australia, Australia
| | - John R Burnett
- Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, Western Australia, Australia.,University of Western Australia, Crawley, Western Australia, Australia
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29
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Mogensen SS, Schmiegelow K, Grell K, Albertsen BK, Wehner PS, Kampmann P, Frandsen TL. Hyperlipidemia is a risk factor for osteonecrosis in children and young adults with acute lymphoblastic leukemia. Haematologica 2017; 102:e175-e178. [PMID: 28209659 PMCID: PMC5477618 DOI: 10.3324/haematol.2016.160507] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Signe Sloth Mogensen
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Medicine, University of Copenhagen, Denmark
| | - Kathrine Grell
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | | | - Peder Skov Wehner
- Department of Pediatric Hematology and Oncology, H. C. Andersen Children's Hospital, Odense University Hospital, Denmark
| | - Peter Kampmann
- Department of Hematology, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Thomas Leth Frandsen
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
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30
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Chen J, Yin Z, Tang Y, Pan T. Vis-NIR spectroscopy with moving-window PLS method applied to rapid analysis of whole blood viscosity. Anal Bioanal Chem 2017; 409:2737-2745. [DOI: 10.1007/s00216-017-0218-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/24/2016] [Accepted: 01/19/2017] [Indexed: 12/01/2022]
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Stojadinović B, Tenne T, Zikich D, Rajković N, Milošević N, Lazović B, Žikić D. Effect of viscosity on the wave propagation: Experimental determination of compression and expansion pulse wave velocity in fluid-fill elastic tube. J Biomech 2015; 48:3969-3974. [PMID: 26454712 DOI: 10.1016/j.jbiomech.2015.09.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 09/09/2015] [Accepted: 09/24/2015] [Indexed: 01/09/2023]
Abstract
The velocity by which the disturbance travels through the medium is the wave velocity. Pulse wave velocity is one of the main parameters in hemodynamics. The study of wave propagation through the fluid-fill elastic tube is of great importance for the proper biophysical understanding of the nature of blood flow through of cardiovascular system. The effect of viscosity on the pulse wave velocity is generally ignored. In this paper we present the results of experimental measurements of pulse wave velocity (PWV) of compression and expansion waves in elastic tube. The solutions with different density and viscosity were used in the experiment. Biophysical model of the circulatory flow is designed to perform measurements. Experimental results show that the PWV of the expansion waves is higher than the compression waves during the same experimental conditions. It was found that the change in viscosity causes a change of PWV for both waves. We found a relationship between PWV, fluid density and viscosity.
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Affiliation(s)
- Bojana Stojadinović
- Biophysics Institute, School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| | - Tamar Tenne
- Raphael Recanati Genetic Institute, Beilinson Hospital, Petah Tikva, Israel
| | - Dragoslav Zikich
- Ella Institute for Melanoma Treatment and Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Nemanja Rajković
- Biophysics Institute, School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| | - Nebojša Milošević
- Biophysics Institute, School of Medicine, Belgrade University, 11000 Belgrade, Serbia
| | - Biljana Lazović
- Clinic of Internal Medicine, Pulmonology Department, University Clinical Hospital Center Zemun, Belgrade, Serbia
| | - Dejan Žikić
- Biophysics Institute, School of Medicine, Belgrade University, 11000 Belgrade, Serbia.
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Soto AG, McIntyre A, Agrawal S, Bialo SR, Hegele RA, Boney CM. Severe Hypertriglyceridemia due to a novel p.Q240H mutation in the Lipoprotein Lipase gene. Lipids Health Dis 2015; 14:102. [PMID: 26337181 PMCID: PMC4559337 DOI: 10.1186/s12944-015-0107-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/26/2015] [Indexed: 11/25/2022] Open
Abstract
Background Lipoprotein Lipase (LPL) deficiency is a rare autosomal recessive disorder with a heterogeneous clinical presentation. Several mutations in the LPL gene have been identified to cause decreased activity of the enzyme. Findings An 11-week-old, exclusively breastfed male presented with coffee-ground emesis, melena, xanthomas, lipemia retinalis and chylomicronemia. Genomic DNA analysis identified lipoprotein lipase deficiency due to compound heterozygosity including a novel p.Q240H mutation in exon 5 of the lipoprotein lipase (LPL) gene. His severe hypertriglyceridemia, including xanthomas, resolved with dietary long-chain fat restriction. Conclusions We describe a novel mutation of the LPL gene causing severe hypertriglyceridemia and report the response to treatment. A review of the current literature regarding LPL deficiency syndrome reveals a few potential new therapies under investigation.
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Affiliation(s)
- Angela Ganan Soto
- Department of Pediatrics, Rhode Island Hospital and Brown University, Providence, RI, USA
| | - Adam McIntyre
- Robarts Research Institute, Western University, London, ON, Canada
| | - Sungeeta Agrawal
- Department of Pediatrics, Rhode Island Hospital and Brown University, Providence, RI, USA
| | - Shara R Bialo
- Department of Pediatrics, Rhode Island Hospital and Brown University, Providence, RI, USA
| | - Robert A Hegele
- Robarts Research Institute, Western University, London, ON, Canada
| | - Charlotte M Boney
- Baystate Children's Hospital, 759 Chestnut Ave S584, Springfield, MA, USA.
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Abstract
This review examines the emerging role of endothelial shear stress (ESS) and blood viscosity on the initiation and progression of atherosclerosis in peripheral arterial disease. Among the variables determining ESS, blood viscosity has to date been the most overlooked by clinical researchers. Blood viscosity is a laboratory assessment that is minimally invasive and modifiable using pharmacologic therapy as well as by hemodilution. Monitoring and controlling blood viscosity not only modulates ESS, but also reduces peripheral vascular resistance and increases blood flow to the lower extremities.
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Bhojwani D, Darbandi R, Pei D, Ramsey LB, Chemaitilly W, Sandlund JT, Cheng C, Pui CH, Relling MV, Jeha S, Metzger ML. Severe hypertriglyceridaemia during therapy for childhood acute lymphoblastic leukaemia. Eur J Cancer 2014; 50:2685-94. [PMID: 25087182 DOI: 10.1016/j.ejca.2014.06.023] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/07/2014] [Accepted: 06/30/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Asparaginase and steroids can cause hypertriglyceridaemia in children with acute lymphoblastic leukaemia (ALL). There are no guidelines for screening or management of patients with severe hypertriglyceridaemia (>1000mg/dL) during ALL therapy. PATIENTS AND METHODS Fasting lipid profiles were obtained prospectively at four time-points for 257 children consecutively enrolled on a frontline ALL study. Risk factors were evaluated by the exact chi-square test. Details of adverse events and management of hypertriglyceridaemia were extracted retrospectively. RESULTS Eighteen of 257 (7%) patients developed severe hypertriglyceridaemia. Older age and treatment with higher doses of asparaginase and steroids on the standard/high-risk arm were significant risk factors. Severe hypertriglyceridaemia was not associated with pancreatitis after adjustment for age and treatment arm or with osteonecrosis after adjustment for age. However, patients with severe hypertriglyceridaemia had a 2.5-3 times higher risk of thrombosis compared to patients without, albeit the difference was not statistically significant. Of the 30 episodes of severe hypertriglyceridaemia in 18 patients, seven were managed conservatively while the others with pharmacotherapy. Seventeen of 18 patients continued to receive asparaginase and steroids. Triglyceride levels normalised after completion of ALL therapy in all 12 patients with available measurements. CONCLUSION Asparaginase- and steroid-induced transient hypertriglyceridaemia can be adequately managed with dietary modifications and close monitoring without altering chemotherapy. Patients with severe hypertriglyceridaemia were not at increased risk of adverse events, with a possible exception of thrombosis. The benefit of pharmacotherapy in decreasing symptoms and potential complications requires further investigation.
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Affiliation(s)
- Deepa Bhojwani
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.
| | - Rashid Darbandi
- Department of Biochemistry, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Deqing Pei
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Laura B Ramsey
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Wassim Chemaitilly
- Department of Pediatrics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - John T Sandlund
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Cheng Cheng
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Mary V Relling
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sima Jeha
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Monika L Metzger
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
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Edahiro R, Sakata Y, Nakatani D, Suna S, Usami M, Matsumoto S, Hara M, Kitamura T, Sato H, Yamashita S, Nanto S, Hikoso S, Sakata Y, Hori M, Hamasaki T, Komuro I. Association of lifestyle-related factors with circadian onset patterns of acute myocardial infarction: a prospective observational study in Japan. BMJ Open 2014; 4:e005067. [PMID: 24907246 PMCID: PMC4054644 DOI: 10.1136/bmjopen-2014-005067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The onset of acute myocardial infarction (AMI) shows characteristic circadian variations involving a definite morning peak and a less-defined night-time peak. However, the factors influencing the circadian patterns of AMI onset and their influence on morning and night-time peaks have not been fully elucidated. DESIGN, SETTING AND PARTICIPANTS An analysis of patients registered between 1998 and 2008 in the Osaka Acute Coronary Insufficiency Study, which is a prospective, multicentre observational study of patients with AMI in the Osaka region of Japan. The present study included 7755 consecutive patients with a known time of AMI onset. MAIN OUTCOMES AND MEASURES A mixture of two von Mises distributions was used to examine whether a circadian pattern of AMI had uniform, unimodal or bimodal distribution, and the likelihood ratio test was then used to select the best circadian pattern among them. The hierarchical likelihood ratio test was used to identify factors affecting the circadian patterns of AMI onset. The Kaplan-Meier method was used to estimate survival curves of 1-year mortality according to AMI onset time. RESULTS The overall population had a bimodal circadian pattern of AMI onset characterised by a high and sharp morning peak and a lower and less-defined night-time peak (bimodal p<0.001). Although several lifestyle-related factors had a statistically significant association with the circadian patterns of AMI onset, serum triglyceride levels had the most prominent association with the circadian patterns of AMI onset. Patients with triglyceride ≥150 mg/dL on admission had only one morning peak in the circadian pattern of AMI onset during weekdays, with no peaks detected on weekends, whereas all other subgroups had two peaks throughout the week. CONCLUSIONS The circadian pattern of AMI onset was characterised by bimodality. Notably, several lifestyle-related factors, particularly serum triglyceride levels, had a strong relation with the circadian pattern of AMI onset. TRIAL REGISTRATION NUMBER UMIN000004575.
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Affiliation(s)
- Ryuya Edahiro
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Biomedical Statistics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Daisaku Nakatani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shinichiro Suna
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masaya Usami
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Sen Matsumoto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiko Hara
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroshi Sato
- School of Human Welfare Studies Health Care Center and Clinic, Kwansei Gakuin University, Nishinomiya, Japan
| | - Shizuya Yamashita
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Community Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shinsuke Nanto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shungo Hikoso
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masatsugu Hori
- Osaka Prefectural Hospital Organization, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Toshimitsu Hamasaki
- Department of Biomedical Statistics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Gaunt TR, Zabaneh D, Shah S, Guyatt A, Ladroue C, Kumari M, Drenos F, Shah T, Talmud PJ, Casas JP, Lowe G, Rumley A, Lawlor DA, Kivimaki M, Whittaker J, Hingorani AD, Humphries SE, Day IN. Gene-centric association signals for haemostasis and thrombosis traits identified with the HumanCVD BeadChip. Thromb Haemost 2013; 110:995-1003. [PMID: 24178511 DOI: 10.1160/th13-02-0087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/05/2013] [Indexed: 01/08/2023]
Abstract
Coagulation phenotypes show strong intercorrelations, affect cardiovascular disease risk and are influenced by genetic variants. The objective of this study was to search for novel genetic variants influencing the following coagulation phenotypes: factor VII levels, fibrinogen levels, plasma viscosity and platelet count. We genotyped the British Women's Heart and Health Study (n=3,445) and the Whitehall II study (n=5,059) using the Illumina HumanCVD BeadArray to investigate genetic associations and pleiotropy. In addition to previously reported associations (SH2B3, F7/F10, PROCR, GCKR, FGA/FGB/FGG, IL5), we identified novel associations at GRK5 (rs10128498, p=1.30x10(-6)), GCKR (rs1260326, p=1.63x10(-6)), ZNF259-APOA5 (rs651821, p=7.17x10(-6)) with plasma viscosity; and at CSF1 (rs333948, p=8.88x10(-6)) with platelet count. A pleiotropic effect was identified in GCKR which associated with factor VII (p=2.16x10(-7)) and plasma viscosity (p=1.63x10(-6)), and, to a lesser extent, ZNF259-APOA5 which also associated with factor VII and fibrinogen (p<1.00x10-²) and plasma viscosity (p<1.00x10(-5)). Triglyceride associated variants were overrepresented in factor VII and plasma viscosity associations. Adjusting for triglyceride levels resulted in attenuation of associations at the GCKR and ZNF259-APOA5 loci. In addition to confirming previously reported associations, we identified four single nucleotide polymorphisms (SNPs) associated with plasma viscosity and platelet count and found evidence of pleiotropic effects with SNPs in GCKR and ZNF259-APOA5. These triglyceride-associated, pleiotropic SNPs suggest a possible causal role for triglycerides in coagulation.
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Affiliation(s)
- Tom R Gaunt
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Delilah Zabaneh
- University College London Genetics Institute, Department of Genetics, Environment and Evolution, Gower St, London WC1E 6BT, UK
| | - Sonia Shah
- University College London Genetics Institute, Department of Genetics, Environment and Evolution, Gower St, London WC1E 6BT, UK
| | - Anna Guyatt
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Christophe Ladroue
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Meena Kumari
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - Fotios Drenos
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, 5 University St, London WC1E 6JF, UK
| | - Tina Shah
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - Philippa J Talmud
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, 5 University St, London WC1E 6JF, UK
| | - Juan Pablo Casas
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Gordon Lowe
- Institute of Cardiovascular & Medical Sciences, Room 335, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Ann Rumley
- Institute of Cardiovascular & Medical Sciences, Room 335, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Debbie A Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Mika Kivimaki
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - John Whittaker
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.,Quantitative Sciences, GlaxoSmithKline, Stevenage, UK
| | - Aroon D Hingorani
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - Steve E Humphries
- University College London Genetics Institute, Department of Genetics, Environment and Evolution, Gower St, London WC1E 6BT, UK.,Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, 5 University St, London WC1E 6JF, UK
| | - Ian N Day
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
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Xu YJ, Zhang M, Ji L, Elimban V, Chen L, Dhalla NS. Suppression of high lipid diet induced by atherosclerosis sarpogrelate. J Cell Mol Med 2013; 16:2394-400. [PMID: 22348587 PMCID: PMC3823433 DOI: 10.1111/j.1582-4934.2012.01554.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Sarpogrelate (SP), a serotonin (5-HT2A) receptor antagonist, is used as an anti-platelet agent for the treatment of some vascular diseases. SP has been reported to inhibit 5-HT induced coronary artery spasm, increase in intracellular calcium and smooth muscle cells proliferation. This study was undertaken to test that SP suppresses the development of atherosclerosis due to high cholesterol diet (HCD) by decreasing blood viscosity and oxidative stress. For this purpose, 29 rabbits were divided into four groups: control group (normal diet); normal diet group with SP at the dose of 5 mg/kg/day; HCD group fed 1% cholesterol; and HCD group with SP at the dose of 5 mg/kg/day. After 90 days of the experiment, blood samples were collected and the animals were killed; the thoracic aorta was stained by the Oil Red O staining method. The results indicate that plasma levels of cholesterol, triglycerides and malondialdehyde were increased in rabbits fed HCD. Plasma viscosity and whole blood viscosity were also higher in the HCD group than that in normal diet group. Treatment with SP prevented these alterations induced by HCD whereas this agent had no significant effect in rabbits fed normal diet. Morphological examination of the aorta revealed that SP treatment prevented the formation of foam cells and atherosclerotic plaque. It is suggested that the beneficial effects of SP in atherosclerosis may be due to actions on blood viscosity, lipid levels and oxidative stress.
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Affiliation(s)
- Yan-Jun Xu
- Institute of Cardiovascular Sciences, St. Boniface Hospital Research, Department of Physiology, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Popat J, Rivero A, Pratap P, Guglin M. What is causing extremely elevated amino terminal brain natriuretic peptide in cancer patients? ACTA ACUST UNITED AC 2012; 19:143-8. [PMID: 23279210 DOI: 10.1111/chf.12018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 10/28/2012] [Accepted: 11/11/2012] [Indexed: 11/30/2022]
Abstract
High levels of B-type natriuretic peptide in cancer patients are poorly studied. Previously published data suggest that they are not related to fluid overload and are encountered mostly in solid cancers. The authors investigated the distribution of amino terminal pro-brain natriuretic peptide (NT-proBNP) between hematologic and solid organ malignancies and the relationship of NT-proBNP with volume status in oncologic patients. A total of 145 consecutive patients with at least one occurrence of NT-proBNP exceeding the upper normal range 10-fold were identified. The authors retrospectively reviewed their records including clinical, laboratory, and radiological data and echocardiograms. More than 70% of patients had hematologic malignancies. Patients with NT-proBNP >50,000 pg/mL had only hematologic malignancies, primarily multiple myeloma. There was no association between M-spike proteins and NT-proBNP. About 80% of patients had signs of fluid overload. The magnitude of NT-proBNP elevation was similar between those with and without heart failure or volume overload, as well as with solid cancers vs hematologic malignancies. Contrary to prior reports, it was found that very high NT-proBNP in cancer patients is usually encountered in the context of fluid overload and most often in hematologic malignancies.
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Affiliation(s)
- Jesal Popat
- Department of Internal Medicine, University of South Florida and Moffitt Cancer Center, Tampa, FL, USA
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Gyawali P, Richards RS, Nwose EU, Bwititi PT. Whole-blood viscosity and metabolic syndrome. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/clp.12.65] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Lashkari HP, Lancaster D, Atra A, Champion MP, Taj MM. Symptomatic severe hypertriglyceridaemia with asparaginase therapy in acute lymphoblastic leukaemia (ALL) and lymphoblastic lymphoma: is rechallenging safe? Int J Hematol 2011; 94:571-5. [DOI: 10.1007/s12185-011-0966-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 10/17/2011] [Accepted: 10/20/2011] [Indexed: 01/19/2023]
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Abstract
IMPORTANCE OF THE FIELD Elevated concentrations of low-density lipoprotein (LDL) cholesterol are associated with increased risk of coronary atherosclerosis, and morbidity and mortality from coronary heart disease (CHD). Lowering of LDL cholesterol leads to a reduction in cardiovascular morbidity and all-cause mortality in individuals at risk for cardiovascular events and patients with established CHD. The mainstays of lipid lowering therapy today are the HMG-CoA reductase inhibitors (statins); however, the residual risk of cardiovascular events amongst individuals treated with statins remains a major healthcare concern. AREAS COVERED IN THIS REVIEW Emerging targets for lipid lowering therapy target pathways that regulate lipoprotein assembly, lipoprotein clearance and pro-atherogenic lipoprotein modification. These emerging drugs have novel mechanisms that include inhibition of lipoprotein assembly (antisense mRNA inhibitors of apolipoprotein B and microsomal transfer protein inhibitors), enhanced lipoprotein clearance (proprotein convertase subtilisin kexin type 9, thyroid hormone analogues), inhibition of pro-atherogenic lipoprotein remodeling (cholesterol ester transfer protein inhibitors (dalcetrapib, anacetrapib) and peroxisome proliferator activator agents (GFT-505, aleglitazar)) and inhibition of lipoprotein modification (heme oxygenase-1 inhibitor (succinobucol), phospholipase A(2) inhibitors (varespladib, darapladib)). WHAT THE READER WILL GAIN A review of the most recent data on emerging drugs in the treatment of hyperlipidemia. TAKE HOME MESSAGE With these medications, we will achieve more effective reductions in cardiovascular morbidity and mortality than achieved with current lipid lowering therapies.
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Cardiovascular Risks of Anemia Correction with Erythrocyte Stimulating Agents: Should Blood Viscosity Be Monitored for Risk Assessment? Cardiovasc Drugs Ther 2010; 24:151-60. [DOI: 10.1007/s10557-010-6239-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cohen H, Bielorai B, Harats D, Toren A, Pinhas-Hamiel O. Conservative treatment of L-asparaginase-associated lipid abnormalities in children with acute lymphoblastic leukemia. Pediatr Blood Cancer 2010; 54:703-6. [PMID: 20063421 DOI: 10.1002/pbc.22305] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To determine the incidence and clinical consequences of asparaginase-associated lipid abnormalities in children with acute lymphoblastic leukemia (ALL). METHODS Sixty-five newly diagnosed children and adolescents aged 0.4-21 years with ALL or lymphoblastic lymphoma were retrospectively evaluated for lipid abnormalities. They were treated according to the ALLIC-BFM 2002 protocol between 2002 and 2005. Fasting cholesterol levels were measured in all patients and triglycerides (TG) in 42/65 patients. RESULTS Prior to treatment, mean cholesterol level was 149 +/- 50 mg/dl, and increased to maximal level 274 +/- 124 mg/dl during treatment. Mean TG level during treatment was 459 +/- 526 mg/dl (range 54-3,009). Twelve patients (28%) had TG levels <200 mg/dl, 18 (43%) had 200-400 mg/dl, 3 (7%) had 400-600 mg/dl, 4 (10%) between 600 and 1,000 mg/dl, and 5 (12%) patients had >1,000 mg/dl. No association was found between TG levels and age or gender. One of the 12 patients with TG >400 mg/dl developed left saggital sinus thrombosis and left frontal lobe infarct. TG level at the time of the event was 2,640 mg/dl. None of the five patients with TG levels >1,000 mg/dl developed pancreatitis. Children with TG levels between 400 and 600 mg/dl were treated by fasting. Fibrates and heparin were added to those with levels >600 mg/dl. Lipid abnormalities normalized in all children upon completion of asparaginase treatment. CONCLUSIONS Abnormalities of lipid profile in children with ALL during asparaginase therapy are relatively common. We recommend measuring TG before and during asparaginase treatment. Initiation of conservative treatment could prevent further increase of TG and decrease the risk of potential complications.
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Affiliation(s)
- Hofit Cohen
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel-Hashomer, Israel.
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Vervita V, Saltamavros AD, Adonakis G, Tsapanos V, Decavalas G, Georgopoulos NA. Obesity and insulin resistance increase plasma viscosity in young women with polycystic ovary syndrome. Gynecol Endocrinol 2009; 25:640-6. [PMID: 19557593 DOI: 10.1080/09513590903015486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To investigate the plasma viscosity in young women with polycystic ovary syndrome (PCOS). DESIGN Patients with PCOS and healthy controls were assessed for plasma viscosity. The acquired data were tested for association with hyperandrogenemia, obesity and insulin resistance (IR) in patients with PCOS. Plasma viscosity was determined by a viscometer Type 53610/I SCHOTT-Instruments, Mainz at 37 degrees C. PATIENTS The study included 96 young women with PCOS and 72 healthy controls. Main outcome measures. Plasma viscosity and IR. RESULTS Plasma viscosity was 1.243 +/- 0.67 mm(2)/s in the control group and 1.252 +/- 0.82 in women with PCOS (p = 0.416). Using multiple regression analysis, total protein (B = 0.348, p = 0.005), area under curve for insulin (B = 0.320, p = 0.011) and BMI (B = 0.315, p = 0.013) were proven to be significantly correlated to plasma viscosity. Plasma viscosity was significantly increased in women with PCOS with IR compared to matched for age and BMI PCOS women without IR (1.300 +/- 0.055 vs. 1.231 +/- 0.049 mm(2)/s) (p = 0.004). CONCLUSION Young women with PCOS presented a plasma viscosity that was increased by obesity and IR. Therefore, clinical management of young overweight women with PCOS with IR should always include a serious reduction in body weight and the use of oral contraceptive treatment with cautious.
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Affiliation(s)
- Vasiliki Vervita
- Division of Reproductive Endocrinology, University of Patras Medical School, Patras 26500, Greece
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Moriarty PM. Association of ApoE and HDL-C with cardiovascular and cerebrovascular disease: potential benefits of LDL-apheresis therapy. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/clp.09.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rosenson RS, Helenowski IB. Fenofibrate abrogates postprandial blood viscosity among hypertriglyceridemia subjects with the metabolic syndrome. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2009. [DOI: 10.1016/j.dsx.2008.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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González-Enríquez GV, Rubio-Benítez MI, García-Gallegos V, Portilla-de Buen E, Troyo-Sanromán R, Leal-Cortés CÁ. Contribution of TNF-308A and CCL2-2518A to Carotid Intima-Media Thickness in Obese Mexican Children and Adolescents. Arch Med Res 2008; 39:753-9. [DOI: 10.1016/j.arcmed.2008.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Accepted: 07/25/2008] [Indexed: 10/21/2022]
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Rasouli M, Kiasari AM, Arab S. INDICATORS OF DEHYDRATION AND HAEMOCONCENTRATION ARE ASSOCIATED WITH THE PREVALENCE AND SEVERITY OF CORONARY ARTERY DISEASE. Clin Exp Pharmacol Physiol 2008; 35:889-94. [DOI: 10.1111/j.1440-1681.2008.04932.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Low HDL levels and the risk of death, sepsis and malignancy. Clin Res Cardiol 2007; 97:227-33. [DOI: 10.1007/s00392-007-0611-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Accepted: 10/18/2007] [Indexed: 01/11/2023]
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50
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Masuda K, Otani K, Asanuma T, Ishikura F, Beppu S. Hypertriglyceridemia Deteriorates Coronary Flow Reserve Even if There is no Coronary Stenosis: Real-Time Myocardial Contrast Echocardiographic Study. J Echocardiogr 2007. [DOI: 10.2303/jecho.5.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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