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Zhang Y, Wu X, Liu G, Feng X, Zhang W, Jiang H, Zhang X. Association between cardiometabolic index and erectile dysfunction among US adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey 2001-2004. Int J Impot Res 2024; 36:422-429. [PMID: 38123844 DOI: 10.1038/s41443-023-00801-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
The aim of this study was to assess the association between a new metabolic index, the cardiometabolic index (CMI) and erectile dysfunction (ED). The data for this study relied on the National Health and Nutrition Examination Survey (NHANES), a cross-sectional database, between 2001 and 2004. The CMI was calculated as the following formula: Triglyceride (TG) (mmol/L)/ High density lipid-cholesterol (HDL-C) (mmol/L) ×waist-height ratio (WHtR). The multivariate logistic regression analyses were conducted to assess the association between CMI and ED, supplemented by subgroup analysis and dose-response curves. Finally, a total of 1367 adult male participants were identified, and the mean CMI was 0.83 ± 0.02. Multivariate logistic regression analysis showed that in model 2 controlling for all potential confounders, CMI was significantly associated with ED (OR = 1.49, 95% CI: 1.09, 2.04) (p = 0.017). Subsequently, we convert the CMI from a continuous variable to a categorical variable (Tertiles). The results showed that male participants in CMI Tertile 3 group had a higher risk of ED than those in Tertile 1 group in model 2 (OR = 2.07, 95% CI: 1.12, 3.83, P = 0.024). The subgroup analysis of model 2 demonstrated that CMI was significantly associate with ED in participants aged ≥50 y (OR = 2.31, 95% CI: 1.35, 3.95, P = 0.005), body mass index (BMI) > 30 kg/m2 (OR = 1.78, 95% CI: 1.10, 2.90, P = 0.023), with hypertension (OR = 1.89, 95% CI: 1.63, 3.45, P = 0.020), with diabetes mellitus (OR = 1.67, 95% CI: 1.13, 2.47, P = 0.015), with cardiovascular disease (CVD) (OR = 1.54, 95% CI: 1.12, 2.10, P = 0.011) and smoking (OR = 2.07, 95% CI: 1.26, 3.39, P = 0.007). This study demonstrates a strong association between CMI and ED and an increased risk of ED with higher CMI levels. More prospective studies with large samples and good designs are needed to validate our results in the future.
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Affiliation(s)
- Yuyang Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Xu Wu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Guodong Liu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
- Department of Urology, The First People's Hospital of Changzhou, Changzhou, Jiangsu, China.
| | - Wei Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing, China
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China.
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Fu C, Xu J, Chen SL, Chen CB, Liang JJ, Liu Z, Huang C, Wu Z, Ng TK, Zhang M, Liu Q. Profile of Lipoprotein Subclasses in Chinese Primary Open-Angle Glaucoma Patients. Int J Mol Sci 2024; 25:4544. [PMID: 38674129 PMCID: PMC11050298 DOI: 10.3390/ijms25084544] [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: 03/19/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
To investigate the plasma lipoprotein subclasses in patients with primary open-angle glaucoma (POAG), a total of 20 Chinese POAG patients on intraocular pressure (IOP)-lowering treatment and 20 age-matched control subjects were recruited. Based on the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), the study subjects were divided into elevated- and normal-level subgroups. The plasma lipoprotein, lipoprotein subclasses, and oxidized LDL (oxLDL) levels were quantitatively measured. The discrimination potential of the lipoproteins was evaluated using the area under the receiver operating characteristic curve (AUC), and their correlation with clinical parameters was also evaluated. Compared to the control subjects with elevated TC and/or LDL-C levels, the levels of TC, LDL-C, non-high-density lipoprotein cholesterol (non-HDL), LDL subclass LDL3 and small dense LDL (sdLDL), and oxLDL were significantly higher in POAG patients with elevated TC and/or LDL-C levels. No differences in any lipoproteins or the subclasses were found between the POAG patients and control subjects with normal TC and LDL-C levels. Moderate-to-good performance of TC, LDL-C, non-HDL, LDL3, sdLDL, and oxLDL was found in discriminating between the POAG patients and control subjects with elevated TC and/or LDL-C levels (AUC: 0.710-0.950). Significant negative correlations between LDL3 and sdLDL with retinal nerve fiber layer (RNFL) thickness in the superior quadrant and between LDL3 and average RNFL thickness were observed in POAG patients with elevated TC and/or LDL-C levels. This study revealed a significant elevation of plasma lipoproteins, especially the LDL subclasses, in POAG patients with elevated TC and/or LDL-C levels, providing insights on monitoring specific lipoproteins in POAG patients with elevated TC and/or LDL-C.
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Affiliation(s)
- Changzhen Fu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Jianming Xu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Shao-Lang Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Chong-Bo Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Jia-Jian Liang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Zibo Liu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Chukai Huang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Zhenggen Wu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
| | - Qingping Liu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China; (C.F.); (J.X.); (S.-L.C.); (C.-B.C.); (J.-J.L.); (Z.L.); (C.H.); (Z.W.); (T.K.N.)
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Mahmood T, Miles JR, Minnier J, Tavori H, DeBarber AE, Fazio S, Shapiro MD. Effect of PCSK9 inhibition on plasma levels of small dense low density lipoprotein-cholesterol and 7-ketocholesterol. J Clin Lipidol 2024; 18:e50-e58. [PMID: 37923663 PMCID: PMC10957330 DOI: 10.1016/j.jacl.2023.10.009] [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: 06/18/2023] [Revised: 09/19/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Oxidized forms of cholesterol (oxysterols) are implicated in atherogenesis and can accumulate in the body via direct absorption from food or through oxidative reactions of endogenous cholesterol, inducing the formation of LDL particles loaded with oxidized cholesterol. It remains unknown whether drastic reductions in LDL-cholesterol (LDL-C) are associated with changes in circulating oxysterols and whether small dense LDL (sdLDL) are more likely to carry these oxysterols and susceptible to the effects of PCSK9 inhibition (PCSK9i). OBJECTIVE We investigate the effect of LDL-C reduction accomplished via PCSK9i on changes in plasma levels of sdLDL-cholesterol (sdLDL-C) and a common, stable oxysterol, 7-ketocholesterol (7-KC), among 134 patients referred to our Preventive Cardiology clinic. METHODS Plasma lipid panel, sdLDL-C, and 7-KC measurements were obtained from patients before and after initiation of PCSK9i. RESULTS The intervention caused a significant lowering of LDL-C (-55.4 %). The changes in sdLDL-C levels (mean reduction 51.4 %) were highly correlated with the reductions in LDL-C levels (R = 0.829, p < 0.001). Interestingly, whereas changes in plasma free 7-KC levels with PCSK9i treatment were much smaller than (-6.6 %) and did not parallel those of LDL-C and sdLDL-C levels, they did significantly correlate with changes in triglycerides and very low-density lipoprotein-cholesterol (VLDL-C) levels (R = 0.219, p = 0.025). CONCLUSION Our findings suggest a non-preferential clearance of LDL subparticles as a consequence of LDL receptor upregulation caused by PCSK9 inhibition. Moreover, the lack of significant reduction in 7-KC with PCSK9i suggests that 7-KC may be in part carried by VLDL and lost during lipoprotein processing leading to LDL formation.
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Affiliation(s)
- Tahir Mahmood
- Oregon Health & Science University, Knight Cardiovascular Institute, Center for Preventive Cardiology, Portland, OR, USA (Dr Mahmood, Miles, Minnier, Tavori and Fazio)
| | - Joshua R Miles
- Oregon Health & Science University, Knight Cardiovascular Institute, Center for Preventive Cardiology, Portland, OR, USA (Dr Mahmood, Miles, Minnier, Tavori and Fazio)
| | - Jessica Minnier
- Oregon Health & Science University, Knight Cardiovascular Institute, Center for Preventive Cardiology, Portland, OR, USA (Dr Mahmood, Miles, Minnier, Tavori and Fazio); Oregon Health & Science University, OHSU-PSU School of Public Health, Portland, OR, USA (Dr Minnier)
| | - Hagai Tavori
- Oregon Health & Science University, Knight Cardiovascular Institute, Center for Preventive Cardiology, Portland, OR, USA (Dr Mahmood, Miles, Minnier, Tavori and Fazio)
| | - Andrea E DeBarber
- Oregon Health & Science University, University Shared Resources, Portland, OR, USA (Dr DeBarber)
| | - Sergio Fazio
- Oregon Health & Science University, Knight Cardiovascular Institute, Center for Preventive Cardiology, Portland, OR, USA (Dr Mahmood, Miles, Minnier, Tavori and Fazio)
| | - Michael D Shapiro
- Wake Forest University School of Medicine, Section on Cardiovascular Medicine, Center for Prevention of Cardiovascular Disease, Winston-Salem, NC, USA (Dr Shapiro).
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4
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Balling M, Nordestgaard BG, Varbo A, Langsted A, Kamstrup PR, Afzal S. Small Dense Low-Density Lipoprotein Cholesterol and Ischemic Stroke. Ann Neurol 2023; 93:952-964. [PMID: 36606557 DOI: 10.1002/ana.26598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
OBJECTIVE For decades, it has been suggested that small dense low-density lipoprotein (sdLDL) may be particularly atherogenic. High levels of sdLDL are associated with an increased risk of ischemic heart disease; however, the association of sdLDL with ischemic stroke has not been explored in a large prospective study on the general population. We tested the hypothesis that high sdLDL cholesterol levels are associated with an increased risk of ischemic stroke. METHODS This prospective study included 38,319 individuals from the Copenhagen General Population Study with fresh sample measurements of sdLDL cholesterol. Median follow-up time was 3.1 years. We observed 302 and 74 ischemic and hemorrhagic strokes from baseline in 2013 to 2017 to the end of follow-up in 2018. For comparison, we included estimates for large buoyant LDL cholesterol and total LDL cholesterol. RESULTS Higher levels of sdLDL cholesterol were log-linearly associated with increased risk of ischemic stroke. Compared with individuals with sdLDL cholesterol in the lowest tertile (≤0.60 mmol/l; ≤23 mg/dl) the multivariable adjusted hazard ratio for ischemic stroke was 1.79 (95% confidence interval = 1.31-2.43) for the highest tertile (≥0.86 mmol/l; ≥33 mg/dl). Multivariable adjusted hazard ratios for ischemic stroke per 1 mmol/l (38.7 mg/dl) higher levels were 1.69 (1.28-2.22) for sdLDL cholesterol, 0.95 (0.78-1.16) for large buoyant LDL cholesterol, and 1.08 (0.93-1.25) for total LDL cholesterol. Hazard ratios were similar when further adjusting for body mass index (BMI) and diabetes mellitus in the biological pathway in combination with related lipids and lipoproteins. INTERPRETATION Higher sdLDL cholesterol levels were robustly associated with increased risk of ischemic stroke. ANN NEUROL 2023.
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Affiliation(s)
- Mie Balling
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anette Varbo
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pia R Kamstrup
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Shoaib Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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5
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Bonilha I, Hajduch E, Luchiari B, Nadruz W, Le Goff W, Sposito AC. The Reciprocal Relationship between LDL Metabolism and Type 2 Diabetes Mellitus. Metabolites 2021; 11:metabo11120807. [PMID: 34940565 PMCID: PMC8708656 DOI: 10.3390/metabo11120807] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes mellitus and insulin resistance feature substantial modifications of the lipoprotein profile, including a higher proportion of smaller and denser low-density lipoprotein (LDL) particles. In addition, qualitative changes occur in the composition and structure of LDL, including changes in electrophoretic mobility, enrichment of LDL with triglycerides and ceramides, prolonged retention of modified LDL in plasma, increased uptake by macrophages, and the formation of foam cells. These modifications affect LDL functions and favor an increased risk of cardiovascular disease in diabetic individuals. In this review, we discuss the main findings regarding the structural and functional changes in LDL particles in diabetes pathophysiology and therapeutic strategies targeting LDL in patients with diabetes.
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Affiliation(s)
- Isabella Bonilha
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
| | - Eric Hajduch
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, F-75006 Paris, France;
| | - Beatriz Luchiari
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
| | - Wilson Nadruz
- Cardiology Division, Cardiovascular Pathophysiology Laboratory, State University of Campinas (Unicamp), Campinas 13083-887, Brazil;
| | - Wilfried Le Goff
- Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Inserm, Sorbonne Université, F-75013 Paris, France;
| | - Andrei C. Sposito
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
- Correspondence: ; Tel.: +55-19-3521-7098; Fax: +55-19-3289-410
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6
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Pregnancy is accompanied by larger high density lipoprotein particles and compositionally distinct subspecies. J Lipid Res 2021; 62:100107. [PMID: 34416270 PMCID: PMC8441201 DOI: 10.1016/j.jlr.2021.100107] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 08/03/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022] Open
Abstract
Pregnancy is accompanied by significant physiological changes, which can impact the health and development of the fetus and mother. Pregnancy-induced changes in plasma lipoproteins are well documented, with modest to no impact observed on the generic measure of high density lipoprotein (HDL) cholesterol. However, the impact of pregnancy on the concentration and composition of HDL subspecies has not been examined in depth. In this prospective study, we collected plasma from 24 nonpregnant and 19 pregnant women in their second trimester. Using nuclear magnetic resonance (NMR), we quantified 11 different lipoprotein subspecies from plasma by size, including three in the HDL class. We observed an increase in the number of larger HDL particles in pregnant women, which were confirmed by tracking phospholipids across lipoproteins using high-resolution gel-filtration chromatography. Using liquid chromatography-mass spectrometry (LC-MS), we identified 87 lipid-associated proteins across size-speciated fractions. We report drastic shifts in multiple protein clusters across different HDL size fractions in pregnant females compared with nonpregnant controls that have major implications on HDL function. These findings significantly elevate our understanding of how changes in lipoprotein metabolism during pregnancy could impact the health of both the fetus and the mother.
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7
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Froyen E. The effects of fat consumption on low-density lipoprotein particle size in healthy individuals: a narrative review. Lipids Health Dis 2021; 20:86. [PMID: 34362390 PMCID: PMC8348839 DOI: 10.1186/s12944-021-01501-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/12/2021] [Indexed: 11/30/2022] Open
Abstract
Cardiovascular disease (CVD) is the number one contributor to death in the United States and worldwide. A risk factor for CVD is high serum low-density lipoprotein cholesterol (LDL-C) concentrations; however, LDL particles exist in a variety of sizes that may differentially affect the progression of CVD. The small, dense LDL particles, compared to the large, buoyant LDL subclass, are considered to be more atherogenic. It has been suggested that replacing saturated fatty acids with monounsaturated and polyunsaturated fatty acids decreases the risk for CVD. However, certain studies are not in agreement with this recommendation, as saturated fatty acid intake did not increase the risk for CVD, cardiovascular events, and/or mortality. Furthermore, consumption of saturated fat has been demonstrated to increase large, buoyant LDL particles, which may explain, in part, for the differing outcomes regarding fat consumption on CVD risk. Therefore, the objective was to review intervention trials that explored the effects of fat consumption on LDL particle size in healthy individuals. PubMed and Web of Science were utilized during the search process for journal articles. The results of this review provided evidence that fat consumption increases large, buoyant LDL and/or decreases small, dense LDL particles, and therefore, influences CVD risk.
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Affiliation(s)
- Erik Froyen
- Department of Nutrition and Food Science, Huntley College of Agriculture, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA, 91768, USA.
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8
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Effects of lipoproteins on endothelial cells and macrophages function and its possible implications on fetal adverse outcomes associated to maternal hypercholesterolemia during pregnancy. Placenta 2021; 106:79-87. [PMID: 33706211 DOI: 10.1016/j.placenta.2021.02.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/03/2021] [Accepted: 02/25/2021] [Indexed: 11/23/2022]
Abstract
Hypercholesterolemia is one of the main risk factors associated with atherosclerosis and cardiovascular disease, the leading cause of death worldwide. During pregnancy, maternal hypercholesterolemia develops, and it can occur in a physiological (MPH) or supraphysiological (MSPH) manner, where MSPH is associated with endothelial dysfunction and early atherosclerotic lesions in the fetoplacental vasculature. In the pathogenesis of atherosclerosis, endothelial activation and endothelial dysfunction, characterized by an imbalance in the bioavailability of nitric oxide, contribute to the early stages of this disease. Macrophages conversion to foam cells, cholesterol efflux from these cells and its differentiation into a pro- or anti-inflammatory phenotype are also important processes that contribute to atherosclerosis. In adults it has been reported that native and modified HDL and LDL play an important role in endothelial and macrophage function. In this review it is proposed that fetal lipoproteins could be also relevant factors involved in the detrimental vascular effects described in MSPH. Changes in the composition and function of neonatal lipoproteins compared to adults has been reported and, although in MSPH pregnancies the fetal lipid profile does not differ from MPH, differences in the lipidomic profiles of umbilical venous blood have been reported, which could have implications in the vascular function. In this review we summarize the available information regarding the effects of lipoproteins on endothelial and macrophage function, emphasizing its possible implications on fetal adverse outcomes associated to maternal hypercholesterolemia during pregnancy.
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9
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Zinöcker MK, Svendsen K, Dankel SN. The homeoviscous adaptation to dietary lipids (HADL) model explains controversies over saturated fat, cholesterol, and cardiovascular disease risk. Am J Clin Nutr 2021; 113:277-289. [PMID: 33471045 DOI: 10.1093/ajcn/nqaa322] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/09/2020] [Indexed: 12/16/2022] Open
Abstract
SFAs play the leading role in 1 of the greatest controversies in nutrition science. Relative to PUFAs, SFAs generally increase circulating concentrations of LDL cholesterol, a risk factor for atherosclerotic cardiovascular disease (ASCVD). However, the purpose of regulatory mechanisms that control the diet-induced lipoprotein cholesterol dynamics is rarely discussed in the context of human adaptive biology. We argue that better mechanistic explanations can help resolve lingering controversies, with the potential to redefine aspects of research, clinical practice, dietary advice, public health management, and food policy. In this paper we propose a novel model, the homeoviscous adaptation to dietary lipids (HADL) model, which explains changes in lipoprotein cholesterol as adaptive homeostatic adjustments that serve to maintain cell membrane fluidity and hence optimal cell function. Due to the highly variable intake of fatty acids in humans and other omnivore species, we propose that circulating lipoproteins serve as a buffer to enable the rapid redistribution of cholesterol molecules between specific cells and tissues that is necessary with changes in dietary fatty acid supply. Hence, circulating levels of LDL cholesterol may change for nonpathological reasons. Accordingly, an SFA-induced raise in LDL cholesterol in healthy individuals could represent a normal rather than a pathologic response. These regulatory mechanisms may become disrupted secondarily to pathogenic processes in association with insulin resistance and the presence of other ASCVD risk factors, as supported by evidence showing diverging lipoprotein responses in healthy individuals as opposed to those with metabolic disorders such as insulin resistance and obesity. Corresponding with the model, we suggest alternative contributing factors to the association between elevated LDL cholesterol concentrations and ASCVD, involving dietary factors beyond SFAs, such as an increased endotoxin load from diet-gut microbiome interactions and subsequent chronic low-grade inflammation that interferes with fine-tuned signaling pathways.
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Affiliation(s)
| | - Karianne Svendsen
- Department of Nutrition, University of Oslo, Oslo, Norway.,The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Simon Nitter Dankel
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
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10
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Neutrophils as a Novel Target of Modified Low-Density Lipoproteins and an Accelerator of Cardiovascular Diseases. Int J Mol Sci 2020; 21:ijms21218312. [PMID: 33167592 PMCID: PMC7664187 DOI: 10.3390/ijms21218312] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 12/17/2022] Open
Abstract
Neutrophil extracellular traps (NETs) significantly contribute to various pathophysiological conditions, including cardiovascular diseases. NET formation in the vasculature exhibits inflammatory and thrombogenic activities on the endothelium. NETs are induced by various stimulants such as exogenous damage-associated molecular patterns (DAMPs). Oxidatively modified low-density lipoprotein (oxLDL) has been physiologically defined as a subpopulation of LDL that comprises various oxidative modifications in the protein components and oxidized lipids, which could act as DAMPs. oxLDL has been recognized as a crucial initiator and accelerator of atherosclerosis through foam cell formation by macrophages; however, recent studies have demonstrated that oxLDL stimulates neutrophils to induce NET formation and enhance NET-mediated inflammatory responses in vascular endothelial cells, thereby suggesting that oxLDL may be involved in cardiovascular diseases through neutrophil activation. As NETs comprise myeloperoxidase and proteases, they have the potential to mediate oxidative modification of LDL. This review summarizes recent updates on the analysis of NETs, their implications for cardiovascular diseases, and prospects for a possible link between NET formation and oxidative modification of lipoproteins.
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Jakubauskas D, Jansen M, Lyngsø J, Cheng Y, Pedersen JS, Cárdenas M. Toward reliable low-density lipoprotein ultrastructure prediction in clinical conditions: A small-angle X-ray scattering study on individuals with normal and high triglyceride serum levels. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2020; 31:102318. [PMID: 33091569 DOI: 10.1016/j.nano.2020.102318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/23/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
Atherosclerosis is the main killer in the west and therefore a major health challenge today. Total serum cholesterol and lipoprotein concentrations, used as clinical markers, fail to predict the majority of cases, especially between the risk scale extremes, due to the high complexity in lipoprotein structure and composition. In particular, low-density lipoprotein (LDL) plays a key role in atherosclerosis development, with LDL size being a parameter considered for determining the risk for cardiovascular diseases. Determining LDL size and structural parameters is challenging to address experimentally under physiological-like conditions. This article describes the biochemistry and ultrastructure of normolipidemic and hypertriglyceridemic LDL fractions and subfractions using small-angle X-ray scattering. Our results conclude that LDL particles of hypertriglyceridemic compared to healthy individuals 1) have lower LDL core melting temperature, 2) have lower cholesteryl ester ordering in their core, 3) are smaller, rounder and more spherical below melting temperature, and 4) their protein-containing shell is thinner above melting temperature.
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Affiliation(s)
- Dainius Jakubauskas
- Biofilms - Research center for Biointerfaces, Dept. of Biomedical Science, Faculty of Health and Society, Malmo University, Malmo, Sweden.
| | - Martin Jansen
- Institute of Clinical Chemistry and Laboratory Medicine, Medical Centre, University of Freiburg, Freiburg im Breisgau, Germany.
| | - Jeppe Lyngsø
- Department of Chemistry and Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Aarhus, Denmark.
| | - Yuanji Cheng
- Department of Materials Science and Applied Mathematics, Faculty of Technology and Society, Malmo University, Malmo, Sweden.
| | - Jan Skov Pedersen
- Department of Chemistry and Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Aarhus, Denmark.
| | - Marité Cárdenas
- Biofilms - Research center for Biointerfaces, Dept. of Biomedical Science, Faculty of Health and Society, Malmo University, Malmo, Sweden.
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Charles-Messance H, Mitchelson KA, De Marco Castro E, Sheedy FJ, Roche HM. Regulating metabolic inflammation by nutritional modulation. J Allergy Clin Immunol 2020; 146:706-720. [DOI: 10.1016/j.jaci.2020.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022]
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Abstract
PURPOSE OF REVIEW To describe lipid abnormalities in diabetes, when they occur and the evidence base for lipid management with established and new drugs to prevent diabetes complications. We also discuss how to manage statin intolerance. RECENT FINDINGS Statins remain first-line therapy in patients with diabetes, though newer therapies to reduce LDL-C have emerged, including ezetimibe as an add-on therapy to statins, and injectable PCSK9 inhibitors, both of which are safe and effective in diabetes. Emerging evidence suggests a need to consider lipid-lowering therapies more often in younger patients with both type 1 and type 2 diabetes. Statins remain the cornerstone of lipid management in diabetes but other options are increasing. There is also now evidence for better managing apparent statin intolerance. Notably, younger patients lose the most life years from their diabetes, an observation that future guidelines need to consider.
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Affiliation(s)
- Anne Sillars
- The Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, G12 8TA UK
| | - Naveed Sattar
- The Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, G12 8TA UK
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Wakabayashi I, Daimon T. Comparison of discrimination for cardio-metabolic risk by different cut-off values of the ratio of triglycerides to HDL cholesterol. Lipids Health Dis 2019; 18:156. [PMID: 31351479 PMCID: PMC6661090 DOI: 10.1186/s12944-019-1098-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/11/2019] [Indexed: 12/21/2022] Open
Abstract
Background The ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio) is known as a good predictor for cardiovascular disease. The purpose of this study was to compare discrimination for cardiovascular risk by different cut-off values of the TG/HDL-C ratio. Methods Receiver operating characteristic (ROC) analysis was performed for the relationship between TG/HDL-C ratio and accumulation of cardio-metabolic risk factors including visceral obesity, hypertension and diabetes. Logistic regression analysis was performed for the relationships of TG/HDL-C ratio with cardio-metabolic risk factors using the cut-off values obtained by ROC analysis and conventional cut-off values (men, 3.75; women, 3.00). Results In ROC analysis, the optimal cut-off values for TG/HDL-C ratio were 2.967 in men and 2.237 in women, which were much smaller than the conventional cut-of values. Odds ratios for multiple cardio-metabolic risk factors of subjects with vs. subjects without a high TG/HDL-C ratio in men and women were 5.75 (4.43–7.46) and 18.76 (10.32–34.13), respectively, by using the new cut-off values and they were 5.03 (3.96–6.39) and 16.11 (9.20–28.20), respectively, by using the conventional cut-off values. The odds ratios for visceral obesity, hypertension and diabetes were comparable when using these two different cut-off values. Conclusion Cut-off values should be ideally calculated by ROC analysis. However, the discrimination power of cut-off values for the TG/HDL-C ratio calculated by ROC analysis for cardio-metabolic risk was similar to those by using the conventional cut-off values. Further studies using cardiovascular events as outcomes in the analysis may be needed to determine more suitable cut-off values of the TG/HDL-C ratio.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Takashi Daimon
- Division of Biostatistics, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
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Effect of Evolocumab on Lipoprotein Particles. Am J Cardiol 2018; 121:308-314. [PMID: 29221604 DOI: 10.1016/j.amjcard.2017.10.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/24/2017] [Accepted: 10/25/2017] [Indexed: 11/20/2022]
Abstract
The level of low-density lipoprotein cholesterol (LDL-C) reflects the cholesterol carried mainly by low-density lipoprotein particles (LDL-P). LDL-C, however, does not always correlate with LDL-P because of the variable amounts of cholesterol per particle. Consideration of LDL-P concentrations in addition to LDL-C may help guide therapeutic decisions in a select number of patients. Evolocumab is a fully human monoclonal antibody directed against proprotein convertase subtilisin-kexin type 9 that lowers both LDL-C and cardiovascular events. To evaluate the effect of evolocumab on serum levels and size of lipoprotein particles, we conducted a post hoc subanalysis of 619 patients from the Durable Effect of PCSK9 Antibody Compared with Placebo Study or DESCARTES trial, a 52-week, randomized, double-blind, placebo-controlled, global study of patients with hyperlipidemia. At baseline, mean LDL-P concentration was 1077 nmol/L for the placebo group and 1100 nmol/L for the evolocumab group. In patients receiving evolocumab, week 52 total LDL-P concentration decreased to 610 nmol/L, a treatment difference of 50% versus placebo. Evolocumab also reduced concentrations of medium very low-density lipoprotein particles (VLDL-P), small VLDL-P, and intermediate-density lipoprotein particle: median (Q1, Q3) changes were -15.2% (-48, 48), -29% (-54, 18), and -36% (-70, 22), respectively. Mean (95% confidence interval) % changes in total LDL particle size in the evolocumab group was -1.7 (-2.0, -1.4); % changes in HDL and VLDL particle sizes were 1.1 (0.7, 1.5) and 8.7 (7.0, 10.5), respectively. Changes in total LDL, HDL, and VLDL particle sizes (vs placebo) were all significant (p <0.001). In conclusion, evolocumab significantly lowers atherogenic lipoprotein particles including low-density and remnant lipoproteins.
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Teeman CS, Kurti SP, Cull BJ, Emerson SR, Haub MD, Rosenkranz SK. Postprandial lipemic and inflammatory responses to high-fat meals: a review of the roles of acute and chronic exercise. Nutr Metab (Lond) 2016; 13:80. [PMID: 27891165 PMCID: PMC5112627 DOI: 10.1186/s12986-016-0142-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/09/2016] [Indexed: 12/18/2022] Open
Abstract
Postprandial lipemia is an independent risk factor for development of cardiovascular disease. Postprandial inflammation following the prolonged elevation of triglycerides occurring subsequent to ingestion of high-fat meals, provides a likely explanation for increased disease risk. Substantial evidence has shown that acute exercise is an effective modality for attenuation of postprandial lipemia following a high-fat meal. However, much of the evidence pertaining to exercise intensity, duration, and overall energy expenditure for reducing postprandial lipemia is inconsistent. The effects of these different exercise variables on postprandial inflammation is largely unknown. Long-term, frequent exercise, however, appears to effectively reduce systemic inflammation, especially in at-risk or diseased individuals. With regard to an acute postprandial response, without a recent bout of exercise, high levels of chronic exercise do not appear to reduce postprandial lipemia. This review summarizes the current literature on postprandial and inflammatory responses to high-fat meals, and the roles that both acute and chronic exercise play. This review may be valuable for health professionals who wish to provide evidence-based, pragmatic advice for reducing postprandial lipemia and cardiovascular disease risk for their patients. A brief review of proposed mechanisms explaining how high-fat meals may result in pro-inflammatory and pro-atherosclerotic environments is also included.
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Affiliation(s)
- Colby S. Teeman
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, 66506 Manhattan, KS USA
- Physical Activity and Nutrition-Clinical Research Consortium (PAN-CRC), College of Human Ecology, Kansas State University, 1105 Sunset Ave, 66502 Manhattan, KS USA
| | - Stephanie P. Kurti
- Department of Kinesiology, Kansas State University, 1A Natatorium, 920 Denison Ave, 66506 Manhattan, KS USA
- Physical Activity and Nutrition-Clinical Research Consortium (PAN-CRC), College of Human Ecology, Kansas State University, 1105 Sunset Ave, 66502 Manhattan, KS USA
| | - Brooke J. Cull
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, 66506 Manhattan, KS USA
- Physical Activity and Nutrition-Clinical Research Consortium (PAN-CRC), College of Human Ecology, Kansas State University, 1105 Sunset Ave, 66502 Manhattan, KS USA
| | - Sam R. Emerson
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, 66506 Manhattan, KS USA
- Physical Activity and Nutrition-Clinical Research Consortium (PAN-CRC), College of Human Ecology, Kansas State University, 1105 Sunset Ave, 66502 Manhattan, KS USA
| | - Mark D. Haub
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, 66506 Manhattan, KS USA
- Physical Activity and Nutrition-Clinical Research Consortium (PAN-CRC), College of Human Ecology, Kansas State University, 1105 Sunset Ave, 66502 Manhattan, KS USA
| | - Sara K. Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, 66506 Manhattan, KS USA
- Physical Activity and Nutrition-Clinical Research Consortium (PAN-CRC), College of Human Ecology, Kansas State University, 1105 Sunset Ave, 66502 Manhattan, KS USA
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Di Meo S, Reed TT, Venditti P, Victor VM. Role of ROS and RNS Sources in Physiological and Pathological Conditions. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:1245049. [PMID: 27478531 PMCID: PMC4960346 DOI: 10.1155/2016/1245049] [Citation(s) in RCA: 756] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/04/2016] [Accepted: 05/23/2016] [Indexed: 12/19/2022]
Abstract
There is significant evidence that, in living systems, free radicals and other reactive oxygen and nitrogen species play a double role, because they can cause oxidative damage and tissue dysfunction and serve as molecular signals activating stress responses that are beneficial to the organism. Mitochondria have been thought to both play a major role in tissue oxidative damage and dysfunction and provide protection against excessive tissue dysfunction through several mechanisms, including stimulation of opening of permeability transition pores. Until recently, the functional significance of ROS sources different from mitochondria has received lesser attention. However, the most recent data, besides confirming the mitochondrial role in tissue oxidative stress and protection, show interplay between mitochondria and other ROS cellular sources, so that activation of one can lead to activation of other sources. Thus, it is currently accepted that in various conditions all cellular sources of ROS provide significant contribution to processes that oxidatively damage tissues and assure their survival, through mechanisms such as autophagy and apoptosis.
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Affiliation(s)
- Sergio Di Meo
- Dipartimento di Biologia, Università di Napoli “Federico II”, 80126 Napoli, Italy
| | - Tanea T. Reed
- Department of Chemistry, Eastern Kentucky University, Richmond, KY 40475, USA
| | - Paola Venditti
- Dipartimento di Biologia, Università di Napoli “Federico II”, 80126 Napoli, Italy
| | - Victor Manuel Victor
- Service of Endocrinology, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46010 Valencia, Spain
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The "cardiometabolic index" as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin Chim Acta 2014; 438:274-8. [PMID: 25199852 DOI: 10.1016/j.cca.2014.08.042] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/13/2014] [Accepted: 08/29/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patients with type 2 diabetes are prone to have obesity and dyslipidemia. The purpose of this study was to evaluate the usefulness of cardiometabolic index (CMI), a new index calculated as the product of waist-to-height ratio and triglycerides-to-HDL cholesterol ratio, for discrimination of diabetes. METHODS Subjects were 10,196 Japanese women and men who had received annual health checkups at their workplaces. Receiver-operating characteristic (ROC) analysis and logistic regression analysis were performed to determine relationships of CMI with hyperglycemia and diabetes. RESULTS In women and men, hemoglobin A1c was significantly higher in the highest quartile of CMI than in the other lower quartiles. By using ROC analysis, the cutoff values of CMI for hyperglycemia and diabetes were determined to be 0.799 and 0.800, respectively, in women and to be 1.625 and 1.748, respectively, in men. When these cutoff values were used in logistic regression analysis, there were strong associations of CMI with hyperglycemia and diabetes in women and men (odds ratio with 95% confidence interval of subjects with vs. subjects without high CMI: 6.98 [4.68-10.42] for hyperglycemia and 14.61 [5.95-35.88] for diabetes in women; 4.42 [3.66-5.35] for hyperglycemia and 5.38 [3.89-7.44] for diabetes in men). CONCLUSION The results suggest that CMI is a useful new index, reflecting both adiposity and blood lipids, for discrimination of diabetes.
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Tellis CC, Moutzouri E, Elisaf M, Wolfert RL, Tselepis AD. The elevation of apoB in hypercholesterolemic patients is primarily attributed to the relative increase of apoB/Lp-PLA₂. J Lipid Res 2013; 54:3394-402. [PMID: 24092915 DOI: 10.1194/jlr.m041806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is a risk factor of cardiovascular disease. Plasma Lp-PLA₂ is mainly associated with apolipoprotein (apo)B-containing lipoproteins, primarily with low density lipoproteins (LDLs). Importantly, only a proportion of circulating lipoproteins contain Lp-PLA₂. We determined the plasma levels of Lp-PLA₂-bound apoB (apoB/Lp-PLA₂) in patients with primary hypercholesterolemia. The effect of simvastatin therapy was also addressed. The plasma apoB/Lp-PLA₂ concentration in 50 normolipidemic controls and 53 patients with primary hypercholesterolemia at baseline and at 3 months posttreatment with simvastatin (40 mg/day) was determined by an enzyme-linked immunosorbent assay. The concentration of the apoB-containing lipoproteins that do not bind Lp-PLA₂ [apoB/Lp-PLA₂⁻] was calculated by subtracting the apoB/Lp-PLA₂ from total apoB. The apoB/Lp-PLA₂ levels were 3.6-fold higher, while apoB/Lp-PLA₂⁻ were 1.3-fold higher in patients compared with controls. After 3 months of simvastatin treatment apoB/Lp-PLA₂ and apoB/Lp-PLA₂⁻ levels were reduced by 52% and 33%, respectively. The elevation in apoB-containing lipoproteins in hypercholesterolemic patients is mainly attributed to the relative increase in the proatherogenic apoB/Lp-PLA₂, while simvastatin reduces these particles to a higher extent compared with apoB/Lp-PLA₂⁻. Considering that Lp-PLA₂ is proatherogenic, the predominance of apoB/Lp-PLA₂ particles in hypercholesterolemic patients may contribute to their higher atherogenicity and incidence of cardiovascular disease.
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Affiliation(s)
- Constantinos C Tellis
- Laboratory of Biochemistry, Department of Chemistry University of Ioannina, Ioannina, Greece
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Torimoto K, Okada Y, Mori H, Hajime M, Tanaka K, Kurozumi A, Narisawa M, Yamamoto S, Arao T, Matsuoka H, Inokuchi N, Tanaka Y. Efficacy of combination of Ezetimibe 10 mg and rosuvastatin 2.5 mg versus rosuvastatin 5 mg monotherapy for hypercholesterolemia in patients with type 2 diabetes. Lipids Health Dis 2013; 12:137. [PMID: 24053480 PMCID: PMC3849617 DOI: 10.1186/1476-511x-12-137] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/18/2013] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Statins are used to treat hypercholesterolemia in patients with type 2 diabetes mellitus, but many of these patients fail to achieve the target LDL-C level. Recent reports have suggested that a synergistic effect can be obtained by concomitant administration of the cholesterol absorption inhibitor ezetimibe and a statin. However, in patients with type 2 diabetes who are already being treated with satins, it remains unclear whether it is more effective to add ezetimibe or to increase the statin dose. Therefore, this study was performed to examine the effects of these two regimens on LDL-C and lipoproteins. METHODS The subjects were type 2 diabetic patients under treatment with rosuvastatin (2.5 mg daily), who had LDL-C levels ≥80 mg/dL. They were randomly allocated to a group that received add-on therapy with ezetimibe at 10 mg/day (combination group, n = 40) or an increase of the rosuvastatin dose to 5 mg/day (dose escalation group, n = 39). These two groups were compared at baseline and after 12 weeks of treatment. RESULTS The percent change of LDL-C was -31% in the combination group and -12% in the dose escalation group. Both groups showed a significant decrease, but the decrease was greater in the combination group. In both groups, there was a significant decrease in the levels of small dense LDL-C, oxidized LDL and remnant-like lipoprotein cholesterol. For all of these parameters, the percent changes were greater in the combination group. Only the combination group showed a significant decrease of triglycerides. Multivariate analysis was performed to identify factors associated with reaching an LDL-C level <80 mg/dL. As a result, add-on therapy with ezetimibe was extracted as a factor related to improvement of LDL-C. CONCLUSIONS Compared with increasing the dose of rosuvastatin, the combination of rosuvastatin and ezetimibe not only achieves quantitative but also qualitative improvement of serum lipid levels in type 2 diabetic patients, suggesting that this combination could suppress the progression of atherosclerosis. TRIAL REGISTRATION UMIN000011005.
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Affiliation(s)
- Keiichi Torimoto
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Hiroko Mori
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Maiko Hajime
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Kenichi Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Akira Kurozumi
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Manabu Narisawa
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Sunao Yamamoto
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | - Tadashi Arao
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
| | | | | | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan
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Li M, Zheng Y, Shan FY, Zhou J, Gong T, Zhang ZR. Development of ionic-complex-based nanostructured lipid carriers to improve the pharmacokinetic profiles of breviscapine. Acta Pharmacol Sin 2013; 34:1108-15. [PMID: 23770990 DOI: 10.1038/aps.2013.43] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 03/27/2013] [Indexed: 01/09/2023] Open
Abstract
AIM Breviscapine isolated from the Chinese herb Erigeron breviscapus (Vant) Hand-Mazz is widely used to treat cardiovascular and cerebrovascular diseases. The aim of this study was to improve the pharmacokinetic profiles of breviscapine using nanostructured lipid carrier based on an ionic complex formation. METHODS Breviscapine nanostructured lipid carrier (Bre-NLC) was prepared using the thin film homogenization method. The morphology of Bre-NLCs was determined using transmission electron microscopy. The mean particle size, polydispersity index, zeta-potential analysis and entrapment efficiency were analized. In vitro release was studied using the dialysis method. In vitro stability was studied in fresh plasma and liver slurry of rats. In vivo pharmacokinetics was analyzed in rats after intravenous injection of a dose equivalent to breviscapine (10 mg/kg). RESULTS The Bre-NLCs were spherical with a mean particle size of ~170 nm, a zeta potential of ∼20 mV and a high entrapment efficiency of ~89%. Compared with a commercially available solution, a substantial decrease in the cumulative release of breviscapine was found for the Bre-NLCs. The NLC has a significantly protective effect against the liver enzyme degradation of breviscapine. After intravenous administration in rats, the Bre-NLCs exhibited a 32 times increase in the AUC0-t and a 12 times increase in T1/2 as compared to the commercially available breviscapine solution. CONCLUSION The results demonstrate that the NLC has great potential to use as a novel sustained release system for breviscapine.
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Wakabayashi I. Alcohol intake and triglycerides/high-density lipoprotein cholesterol ratio in men with hypertension. Am J Hypertens 2013; 26:888-95. [PMID: 23519165 DOI: 10.1093/ajh/hpt033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio has been proposed to be a good predictor of cardiovascular disease. The relationship between alcohol consumption and TG/HDL-C ratio in patients with hypertension is unknown. METHODS Subjects were normotensive and hypertensive men aged 35-60 years who were divided by daily ethanol intake into non-, light (<22g/day), heavy (≥22 but <44g/day), and very heavy (≥44g/day) drinkers. RESULTS The TG/HDL-C ratio was significantly higher in the hypertensive group than in the normotensive group. Both in the normotensive and hypertensive groups, TG/HDL-C ratio was significantly lower in light, heavy, and very heavy drinkers than in nondrinkers and was lowest in light drinkers. In the hypertensive group, odds ratios (ORs) for high TG/HDL-C ratio (≥3.75) in light, heavy, and very heavy drinkers vs. nondrinkers were significantly lower (P < 0.01) than a reference level of 1.00 (light drinkers: OR = 0.49, 95% confidence interval (CI) = 0.40-0.59; heavy drinkers: OR = 0.59, 95% CI = 0.52-0.67; very heavy drinkers: OR = 0.70, 95% CI = 0.61-0.80) and were significantly lower than the corresponding ORs in the normotensive group. The ORs for hypertension in subjects with vs. subjects without high TG/HDL-C ratio were significantly higher than the reference level in all the alcohol groups and were significantly lower in light, heavy, and very heavy drinkers than in nondrinkers. CONCLUSIONS The results suggest that there is an inverted J-shaped relationship between alcohol and TG/HDL-C ratio in individuals with hypertension and that alcohol weakens the positive association between TG/HDL-C ratio and hypertension.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
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Tsunoda T, Nozue T, Yamada M, Mizuguchi I, Sasaki M, Michishita I. Effects of ezetimibe on atherogenic lipoproteins and glucose metabolism in patients with diabetes and glucose intolerance. Diabetes Res Clin Pract 2013; 100:46-52. [PMID: 23369229 DOI: 10.1016/j.diabres.2012.12.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 11/08/2012] [Accepted: 12/20/2012] [Indexed: 02/07/2023]
Abstract
AIM To evaluate the effects of ezetimibe on atherogenic lipoproteins and glucose metabolism in patients with diabetes and glucose intolerance. METHODS Seventy-six patients with diabetes and glucose intolerance were enrolled in this study. At baseline and 12 weeks after treatment with ezetimibe 10mg/day, we measured the levels of lipid and glucose parameters. RESULTS Ezetimibe reduced the mean levels of low-density lipoprotein cholesterol (LDL-C) (-20%, P<0.001), remnant-like particle cholesterol (-22%, P<0.001), small dense-LDL (-19%, P<0.001), apolipoprotein B-48 (-2%, P<0.01), malondialdehyde modified-LDL (-15%, P<0.001), and serum immunoreactive insulin (IRI) (-4%, P<0.01). In the insulin resistance subgroup, ezetimibe reduced the abdominal circumference (-1%, P<0.05) and mean levels of fasting plasma glucose (-7%, P<0.05), IRI (-36%, P<0.01), s-CPR (-27%, P<0.01), HOMA-IR (-39%, P<0.01) and HbA1c tended to decrease (-2%, P=0.06). CONCLUSIONS Ezetimibe reduced atherogenic lipoproteins in patients with diabetes and glucose intolerance; besides, it improved glucose metabolism in patients with insulin resistance.
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Affiliation(s)
- Tetsuji Tsunoda
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama, Japan.
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Wakabayashi I. Influence of age and gender on triglycerides-to-HDL-cholesterol ratio (TG/HDL ratio) and its association with adiposity index. Arch Gerontol Geriatr 2012; 55:729-34. [PMID: 22878061 DOI: 10.1016/j.archger.2012.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Revised: 07/04/2012] [Accepted: 07/08/2012] [Indexed: 11/16/2022]
Abstract
TG/HDL ratio has been proposed to be a good predictor of cardiovascular disease. The aim of this study was to determine whether TG/HDL ratio and its association with adiposity index are modified by age and gender. Subjects were younger (35-40 years) and older (60-70 years) Japanese men and women (n=16,825) receiving health checkup examinations. TG/HDL ratio and its relationship with adiposity index such as waist-to-height ratio (WHtR) were compared between the age pair and between the gender pair. Log-transformed TG/HDL ratio was significantly higher in older women than in younger women, while log-transformed TG/HDL ratio was comparable in younger and older men. The odds ratio (OR) for high TG/HDL ratio in subjects with vs. subjects without high WHtR was significantly lower in older men and women than in younger men and women, respectively. The OR was significantly lower in younger men than in younger women [4.08 (3.63-4.58) (younger men) vs. 8.42 (5.55-12.78) (younger women), p<0.01], whereas the OR was significantly lower in older women than in older men [3.36 (2.87-3.93) (older men) vs. 1.93 (1.31-2.85) (older women), p<0.01]. The results suggest that TG/HDL ratio is comparable in younger and older men but that TG/HDL ratio is higher in older women than in younger women and that the association between obesity and high TG/HDL ratio declines with age and is stronger in younger women than in younger men, while the association is weaker in older women than in older men.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
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25
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Bulum T, Kolarić B, Duvnjak L. Insulin sensitivity modifies the relationship between thyroid function and lipid profile in euthyroid type 1 diabetic patients. Endocrine 2012; 42:139-45. [PMID: 22246849 DOI: 10.1007/s12020-012-9598-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 12/29/2011] [Indexed: 12/19/2022]
Abstract
It has been suggested that association between hypothyroidism with dyslipidemia might be present already at the stage of normal thyroid function through altered insulin sensitivity. We analyzed the role of insulin sensitivity as a mediator of thyroid-induced lipid changes in euthyroid type 1 diabetic patients. Study included 304 patients with type 1 diabetes and normal thyroid function. Insulin sensitivity was measured with estimated glucose disposal rate calculated using the equation: eGDR = 24.31 - (12.22 × WHR) - (3.29 × HT) - (0.57 × HbA1c); WHR = waist-to-hip ratio, HT = hypertension. TSH, FT4, FT3, and serum lipids were measured. Correlations and multiple linear regressions analysis were performed to identify relationships between thyroid status and serum lipid parameters after stratifying patients in quartiles of eGDR. After adjustment for age, sex, BMI, duration of diabetes and insulin dose TSH, FT3, and FT4 was not significantly associated with serum lipids in all patients, independently of level of insulin sensitivity. However, after stratifying patients for the degree of insulin sensitivity in subjects in the lowest quartile of insulin sensitivity TSH was independently associated with LDL cholesterol (β = 0.210, p = 0.02). The independent relation of eGDR with TSH and LDL cholesterol suggests that the influence of thyroid function on lipid metabolism might extend into euthyroid range through altered insulin sensitivity.
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Affiliation(s)
- Tomislav Bulum
- Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Dugi dol 4a, Zagreb, Croatia.
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26
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Soška V, Jarkovský J, Ravčuková B, Tichý L, Fajkusová L, Freiberger T. The logarithm of the triglyceride/HDL-cholesterol ratio is related to the history of cardiovascular disease in patients with familial hypercholesterolemia. Clin Biochem 2012; 45:96-100. [DOI: 10.1016/j.clinbiochem.2011.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 11/02/2011] [Accepted: 11/08/2011] [Indexed: 10/15/2022]
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27
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Waluś-Miarka M, Sanak M, Idzior-Waluś B, Miarka P, Witek P, Małecki MT, Czarnecka D. A novel mutation (Cys308Phe) of the LDL receptor gene in families from the South-Eastern part of Poland. Mol Biol Rep 2011; 39:5181-6. [PMID: 22160468 PMCID: PMC3310989 DOI: 10.1007/s11033-011-1314-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 11/30/2011] [Indexed: 11/30/2022]
Abstract
The purpose of this investigation was to characterize a new mutation in the LDL-receptor (LDLR) gene in three families with clinically diagnosed familial hypercholesterolemia (FH) from the South-Eastern part of Poland. Mutational screening with exon by exon sequencing analysis was performed in all probands. The novel mutation c986G>T (Cys308Phe) in the exon 7 of LDLR gene was found in three apparently unrelated probands with FH. Analysis of the receptor activity of peripheral blood lymphocytes by binding and uptake of DiL-LDL showed a significant reduction (by 24% versus healthy control) of the fluorescent label in the lymphocytes of patients heterozygous for this mutation. Concentrations of serum LDL-C in probands before treatment were between 9.5 and 10.5 mmol/l. All patients had corneal arcus and tendon xanthoma. Clinically, families were characterized by premature coronary artery disease. This mutation occurred relatively frequently in our group of patients with FH, but this could be explained by a founder effect since we demonstrated their common ancestors.
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Affiliation(s)
- Małgorzata Waluś-Miarka
- Department of Metabolic Diseases, Jagiellonian University, Medical School, Kopernika 15, 31-501, Kraków, Poland.
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Gu X, Zhang W, Liu J, Shaw JP, Shen Y, Xu Y, Lu H, Wu Z. Preparation and characterization of a lovastatin-loaded protein-free nanostructured lipid carrier resembling high-density lipoprotein and evaluation of its targeting to foam cells. AAPS PharmSciTech 2011; 12:1200-8. [PMID: 21927961 PMCID: PMC3225525 DOI: 10.1208/s12249-011-9668-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 07/28/2011] [Indexed: 11/30/2022] Open
Abstract
This study was designed to investigate whether a non-protein nanostructured lipid carrier (NLC) resembling high-density lipoprotein (HDL) could deliver a hydrophobic anti-atherogenic drug, lovastatin, to foam cells. Lovastatin-loaded NLC (LT-NLC) was prepared by a nanoprecipitation/solvent diffusion method. The LT-NLC-apoprotein (LT-NLC-apo) was prepared by incubating LT-NLC with native HDL. The physicochemical parameters of LT-NLC were characterized in terms of particle size, zeta potential, morphology, entrapment efficiency, and crystallization behavior. Targeting behavior and mechanism were demonstrated by the incubation of LT-NLC-apo with a RAW 264.7 macrophage-derived foam cell model in the presence or absence of very-low-density lipoprotein (VLDL) and lipase. The results showed that LT-NLC was solid spherical or oval in shape with an average diameter of 13.8 ± 2.2 nm, zeta potential of −29.3 ± 0.2 mV and entrapment efficiency of 96.2 ± 1.3%. Phagocytosis studies showed that uptake of LT-NLC-apo by macrophages was significantly lower than LT-NLC (p < 0.01), suggesting that LT-NLC-apo could possibly escape recognition from macrophages in vivo. The uptake was increased twofold when LT-NLC-apo was incubated with transfected foam cells containing VLDL and lipase. These results indicated that non-protein NLC resembling HDL could be a useful tool to deliver lipophilic anti-atherogenic drugs to foam cells, and that uptake could be enhanced by the VLDL receptor pathway.
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Peddie MC, Rehrer NJ, Perry TL. Physical activity and postprandial lipidemia: are energy expenditure and lipoprotein lipase activity the real modulators of the positive effect? Prog Lipid Res 2011; 51:11-22. [PMID: 22123195 DOI: 10.1016/j.plipres.2011.11.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 11/04/2011] [Accepted: 11/04/2011] [Indexed: 10/15/2022]
Abstract
Historically, the link between elevated cholesterol and increased risk of cardiovascular disease has been based on fasting measurements. This is appropriate for total, low-density lipoprotein and high-density lipoprotein cholesterol. However, triglyceride concentrations vary considerably throughout the day in response to the regular consumption of food and drink. Recent findings indicate that postprandial triglyceride concentrations independently predict future cardiovascular risk. Potential modulators of postprandial lipidemia include meal composition and physical activity. Early cross sectional studies indicated that physically active individuals had a lower postprandial lipidemic response compared to inactive individuals. However, the effect of physical activity on postprandial lipidemia is an acute phenomenon, which dissipates within 60 h of a single bout of exercise. Total exercise induced energy expenditure, rather than duration or intensity of the physical activity is commonly reported to be a potent modulator of postprandial lipidemia. However, the pooled results of studies in this area suggest that energy expenditure exerts most of its influence on fasting triglyceride concentrations rather than on the incremental change in triglyceride concentrations seen following meal consumption. It seems more likely that energy expenditure is one component of a multifactorial list of mediators that may include local muscle contractile activity, and other yet to be elucidated mechanisms.
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Affiliation(s)
- Meredith C Peddie
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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30
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Subramanian S, Chait A. Hypertriglyceridemia secondary to obesity and diabetes. Biochim Biophys Acta Mol Cell Biol Lipids 2011; 1821:819-25. [PMID: 22005032 DOI: 10.1016/j.bbalip.2011.10.003] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 09/09/2011] [Accepted: 10/03/2011] [Indexed: 02/04/2023]
Abstract
Hypertriglyceridemia is a common lipid abnormality in persons with visceral obesity, metabolic syndrome and type 2 diabetes. Hypertriglyceridemia typically occurs in conjunction with low HDL levels and atherogenic small dense LDL particles and is associated with increased cardiovascular risk. Insulin resistance is often an underlying feature and results in increased free fatty acid (FFA) delivery to the liver due to increased peripheral lipolysis. Increased hepatic VLDL production occurs due to increased substrate availability via FFAs, decreased apolipoprotein B100 degradation and increased lipogenesis. Postprandial hypertriglyceridemia also is a common feature of insulin resistance. Small dense LDL that coexist with decreased HDL particles in hypertriglyceridemic states are highly pro-atherogenic due to their enhanced endothelial permeability, proteoglycan binding abilities and susceptibility to oxidation. Hypertriglyceridemia also occurs in undertreated individuals with type 1 diabetes but intensive glucose control normalizes lipid abnormalities. However, development of visceral obesity in these patients unravels a similar metabolic profile as in patients with insulin resistance. Modest hypertriglyceridemia increases cardiovascular risk, while marked hypertriglyceridemia should be considered a risk for pancreatitis. Lifestyle modification is an important therapeutic strategy. Drug therapy is primarily focused on lowering LDL levels with statins, since efforts at triglyceride lowering and HDL raising with fibrates and/or niacin have not yet been shown to be beneficial in improving cardiovascular risk. Fibrates, however, are first-line agents when marked hypertriglyceridemia is present. This article is part of a Special Issue entitled Triglyceride Metabolism and Disease.
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Affiliation(s)
- Savitha Subramanian
- Diabetes Obesity Center of Excellence, Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA, USA
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Didangelos A, Stegemann C, Mayr M. The -omics era: proteomics and lipidomics in vascular research. Atherosclerosis 2011; 221:12-7. [PMID: 22024275 DOI: 10.1016/j.atherosclerosis.2011.09.043] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 09/21/2011] [Accepted: 09/21/2011] [Indexed: 10/17/2022]
Abstract
A main limitation of the current approaches to atherosclerosis research is the focus on the investigation of individual factors, which are presumed to be involved in the pathophysiology and whose biological functions are, at least in part, understood. These molecules are investigated extensively while others are not studied at all. In comparison to our detailed knowledge about the role of inflammation in atherosclerosis, little is known about extracellular matrix remodelling and the retention of individual lipid species rather than lipid classes in early and advanced atherosclerotic lesions. The recent development of mass spectrometry-based methods and advanced analytical tools are transforming our ability to profile extracellular proteins and lipid species in animal models and clinical specimen with the goal of illuminating pathological processes and discovering new biomarkers.
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Goldberg IJ, Eckel RH, McPherson R. Triglycerides and heart disease: still a hypothesis? Arterioscler Thromb Vasc Biol 2011; 31:1716-25. [PMID: 21527746 DOI: 10.1161/atvbaha.111.226100] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The purpose of this article is to review the basic and clinical science relating plasma triglycerides and cardiovascular disease. Although many aspects of the basic physiology of triglyceride production, its plasma transport, and its tissue uptake have been known for several decades, the relationship of plasma triglyceride levels to vascular disease is uncertain. Are triglyceride-rich lipoproteins, their influence on high-density lipoprotein and low-density lipoprotein, or the underlying diseases that lead to defects in triglyceride metabolism the culprit? Animal models have failed to confirm that anything other than early fatty lesions can be produced by triglyceride-rich lipoproteins. Metabolic products of triglyceride metabolism can be toxic to arterial cells; however, these studies are primarily in vitro. Correlative studies of fasting and postprandial triglycerides and genetic diseases implicate very-low-density lipoprotein and their remnants and chylomicron remnants in atherosclerosis development, but the concomitant alterations in other lipoproteins and other risk factors obscure any conclusions about direct relationships between disease and triglycerides. Genes that regulate triglyceride levels also correlate with vascular disease. Human intervention trials, however, have lacked an appropriately defined population and have produced outcomes without definitive conclusions. The time is more than ripe for new and creative approaches to understanding the relationship of triglycerides and heart disease.
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Affiliation(s)
- Ira J Goldberg
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
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Zhang X, Hurng J, Rateri DL, Daugherty A, Schmid-Schönbein GW, Shin HY. Membrane cholesterol modulates the fluid shear stress response of polymorphonuclear leukocytes via its effects on membrane fluidity. Am J Physiol Cell Physiol 2011; 301:C451-60. [PMID: 21525434 DOI: 10.1152/ajpcell.00458.2010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Continuous exposure of polymorphonuclear leukocytes (PMNLs) to circulatory hemodynamics points to fluid flow as a biophysical regulator of their activity. Specifically, fluid flow-derived shear stresses deactivate leukocytes via actions on the conformational activities of proteins on the cell surface. Because membrane properties affect activities of membrane-bound proteins, we hypothesized that changes in the physical properties of cell membranes influence PMNL sensitivity to fluid shear stress. For this purpose, we modified PMNL membranes and showed that the cellular mechanosensitivity to shear was impaired whether we increased, reduced, or disrupted the organization of cholesterol within the lipid bilayer. Notably, PMNLs with enriched membrane cholesterol exhibited attenuated pseudopod retraction responses to shear that were recovered by select concentrations of benzyl alcohol (a membrane fluidizer). In fact, PMNL responses to shear positively correlated (R(2) = 0.96; P < 0.0001) with cholesterol-related membrane fluidity. Moreover, in low-density lipoprotein receptor-deficient (LDLr(-/-)) mice fed a high-fat diet (a hypercholesterolemia model), PMNL shear-responses correlated (R(2) = 0.5; P < 0.01) with blood concentrations of unesterified (i.e., free) cholesterol. In this regard, the shear-responses of PMNLs gradually diminished and eventually reversed as free cholesterol levels in blood increased during 8 wk of the high-fat diet. Collectively, our results provided evidence that cholesterol is an important component of the PMNL mechanotransducing capacity and elevated membrane cholesterol impairs PMNL shear-responses at least partially through its impact on membrane fluidity. This cholesterol-linked perturbation may contribute to dysregulated PMNL activity (e.g., chronic inflammation) related to hypercholesterolemia and causal for cardiovascular pathologies (e.g., atherosclerosis).
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Affiliation(s)
- Xiaoyan Zhang
- Center for Biomedical Engineering, University of Kentucky, Lexington, KY 40506-0070, USA
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Albers JJ, Kennedy H, Marcovina SM. Evaluation of a new homogenous method for detection of small dense LDL cholesterol: Comparison with the LDL cholesterol profile obtained by density gradient ultracentrifugation. Clin Chim Acta 2011; 412:556-61. [DOI: 10.1016/j.cca.2010.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 11/30/2010] [Accepted: 12/01/2010] [Indexed: 10/18/2022]
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Underappreciated opportunities for low-density lipoprotein management in patients with cardiometabolic residual risk. Atherosclerosis 2010; 213:1-7. [PMID: 20451205 DOI: 10.1016/j.atherosclerosis.2010.03.038] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 03/22/2010] [Accepted: 03/29/2010] [Indexed: 11/24/2022]
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Zhang WL, Gu X, Bai H, Yang RH, Dong CD, Liu JP. Nanostructured lipid carriers constituted from high-density lipoprotein components for delivery of a lipophilic cardiovascular drug. Int J Pharm 2010; 391:313-21. [PMID: 20214958 DOI: 10.1016/j.ijpharm.2010.03.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 01/26/2010] [Accepted: 03/02/2010] [Indexed: 12/27/2022]
Abstract
To investigate the possibility of reconstituted protein-free high-density lipoprotein (HDL) being a carrier for delivering a lipophilic cardiovascular drug, Tanshinone IIA-loaded HDL-like nanostructured lipid carriers (TA-NLC) were prepared by a nanoprecipitation/solvent diffusion method. The physicochemical parameters of TA-NLC were characterized in terms of particle size, zeta potential, morphology, entrapment efficiency, differential scanning calorimetry (DSC) and stability. A novel two-step method has been employed to determine entrapment efficiency of TA-NLC. The binding properties of TA-NLC to apolipoproteins were investigated by in vitro incubation competition assay in the presence of native HDL and electrophoresis test. Phagocytosis and cytotoxicity was evaluated using mouse macrophage cell line RAW 264.7 with TA-NLC and incubated TA-NLC with native HDL (TA-NLC-apo). The results showed that TA-NLC had an average diameter of 8.0+/-1.2 nm, zeta potential of -29.0+/-0.0 mV, drug loading of 6.17+/-0.3% and entrapment efficiency of 97.84+/-1.2%. TA-NLC were demonstrated spheres with drug incorporated in lipid core forming a shell-core structure. DSC analysis showed that TA was dispersed in NLC in an amorphous state. The incorporation of glycerol trioleate to NLC led to crystal order disturbance. Agarose gel electrophoresis and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-SPAGE) patterns indicated that TA-NLC could bind to apolipoprotein A-I (apoA-I) specifically in vitro. Phagocytosis studies showed significant differences in uptake between TA-NLC and TA-NLC-apo and demonstrated that TA-NLC incubated with native HDL could turn endogenous by association to apolipoproteins, which cannot trigger immunological responses and could escape from recognition by macrophages.
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Affiliation(s)
- Wen-Li Zhang
- Department of Pharmaceutics, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, PR China
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37
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Ghassab RK, Gohari LH, Firoozray M, Yegane MN. Determination of Low Density Lipoprotein Particle Size by Polyacrylamide Gradient Gel Electrophoresis in Patients with Coronary Artery Stenosis. Lab Med 2010. [DOI: 10.1309/lmr1mwbggi3kxzei] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Yamashita S, Kawase R, Nakaoka H, Nakatani K, Inagaki M, Yuasa-Kawase M, Tsubakio-Yamamoto K, Sandoval JC, Masuda D, Ohama T, Nakagawa-Toyama Y, Matsuyama A, Nishida M, Ishigami M. Differential reactivities of four homogeneous assays for LDL-cholesterol in serum to intermediate-density lipoproteins and small dense LDL: Comparisons with the Friedewald equation. Clin Chim Acta 2009; 410:31-8. [DOI: 10.1016/j.cca.2009.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 09/04/2009] [Accepted: 09/04/2009] [Indexed: 11/25/2022]
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Kolovou GD, Anagnostopoulou KK, Damaskos DS, Bilianou HI, Mihas C, Milionis HJ, Kostakou PM, Cokkinos DV. Gender differences in the lipid profile of dyslipidemic subjects. Eur J Intern Med 2009; 20:145-51. [PMID: 19327602 DOI: 10.1016/j.ejim.2008.06.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Revised: 05/26/2008] [Accepted: 06/09/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We evaluated the gender-associated differences in lipid profile of subjects intended to receive lipid-lowering therapy with emphasis on the associations between triglycerides (TG) and other plasma lipid variables. DESIGN Lipid profiles of 1385 patients [aged 55+/-11 years, 549 women (40%)] were evaluated. Eligible subjects fulfilled one or more of the following criteria: total cholesterol (TC)>or=6.2 mmol/l, TG>or=1.7 mmol/l, and high-density lipoprotein cholesterol (HDL-C)<1.0 mmol/l. Patients were divided into subgroups according to TG and HDL-C levels. RESULTS Women aged on average 3.5 years older, had higher TC and HDL-C, lower TG and a correspondingly lower TC/HDL-C ratio than men. High TG and low HDL-C in tandem appeared twice more frequently in men. Inverse correlations between HDL-C and TG levels were found to exist in the entire cohort (r=-0.354, p<0.001) and in all various subgroups. In the subgroup with TG<1.7 mmol/l, women had higher TC and HDL-C, lower TG levels and lower TC/HDL-C ratio compared with men. In the subgroup with TG>or=1.7 mmol/l, women had higher TC and HDL-C levels and lower TC/HDL ratio compared with men. In the subgroup with HDL-C>or=1.0 mmol/l women had higher HDL-C, lower TG levels and lower TC/HDL-C ratio compared with men. CONCLUSIONS Elevated TG levels and low HDL-C in tandem are common lipid abnormalities in the clinical setting of primary and secondary preventions. Gender-associated differences in the lipid profile are evident in subjects presenting with dyslipidemia and might be of potential relevance for diagnostics and therapy for the prevention of atherosclerosis.
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Prassl R, Pregetter M, Amenitsch H, Kriechbaum M, Schwarzenbacher R, Chapman JM, Laggner P. Low density lipoproteins as circulating fast temperature sensors. PLoS One 2008; 3:e4079. [PMID: 19114995 PMCID: PMC2603587 DOI: 10.1371/journal.pone.0004079] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Accepted: 11/28/2008] [Indexed: 11/18/2022] Open
Abstract
Background The potential physiological significance of the nanophase transition of neutral lipids in the core of low density lipoprotein (LDL) particles is dependent on whether the rate is fast enough to integrate small (±2°C) temperature changes in the blood circulation. Methodology/Principal Findings Using sub-second, time-resolved small-angle X-ray scattering technology with synchrotron radiation, we have monitored the dynamics of structural changes within LDL, which were triggered by temperature-jumps and -drops, respectively. Our findings reveal that the melting transition is complete within less than 10 milliseconds. The freezing transition proceeds slowly with a half-time of approximately two seconds. Thus, the time period over which LDL particles reside in cooler regions of the body readily facilitates structural reorientation of the apolar core lipids. Conclusions/Significance Low density lipoproteins, the biological nanoparticles responsible for the transport of cholesterol in blood, are shown to act as intrinsic nano-thermometers, which can follow the periodic temperature changes during blood circulation. Our results demonstrate that the lipid core in LDL changes from a liquid crystalline to an oily state within fractions of seconds. This may, through the coupling to the protein structure of LDL, have important repercussions on current theories of the role of LDL in the pathogenesis of atherosclerosis.
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Affiliation(s)
- Ruth Prassl
- Institute of Biophysics and Nanosystems Research, Austrian Academy of Sciences, Graz, Austria.
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41
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Cefalu WT. Diabetic dyslipidemia and the metabolic syndrome. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2008. [DOI: 10.1016/j.dsx.2008.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Stalenhoef AFH, de Graaf J. Association of fasting and nonfasting serum triglycerides with cardiovascular disease and the role of remnant-like lipoproteins and small dense LDL. Curr Opin Lipidol 2008; 19:355-61. [PMID: 18607182 DOI: 10.1097/mol.0b013e328304b63c] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The magnitude of the contribution of serum triglycerides to cardiovascular disease risk and the mechanisms by which triglyceride-rich lipoproteins exert their effect on the vascular wall are largely unknown. Postprandial lipemia likewise has been linked to atherosclerosis, but large prospective studies assessing the magnitude of this association are also lacking. Hypertriglyceridemia is characterized by the presence of cholesterol-rich remnant-like lipoproteins and small dense LDL particles, both of which are believed to contribute to cardiovascular disease risk. RECENT FINDINGS Several large prospective cohort studies and a meta-analysis have been published recently, investigating the association of fasting and nonfasting serum triglycerides with cardiovascular disease. Fasting triglycerides increase the adjusted hazard ratios for cardiovascular disease risk 1.7 x (comparing upper with lower tertile), and nonfasting levels around 2.0 x. Measurement of nonfasting triglycerides may be more feasible and more informative, but standardization of a test meal is necessary. For clinical practice, the concentration of the atherogenic lipoprotein subfractions in hypertriglyceridemia may be reflected best by measuring apolipoprotein B. SUMMARY Nonfasting triglyceride levels may replace fasting levels in assessing cardiovascular disease risk once standard reference values have been developed. Several atherogenic lipoprotein subfractions can be measured by including apolipoprotein B in addition to HDL, (nonfasting) triglycerides and LDL cholesterol.
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Affiliation(s)
- Anton F H Stalenhoef
- Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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43
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McNeal C, Wilson DP. Metabolic syndrome and dyslipidemia in youth. J Clin Lipidol 2008; 2:147-55. [PMID: 21291733 DOI: 10.1016/j.jacl.2008.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 04/07/2008] [Accepted: 04/09/2008] [Indexed: 01/22/2023]
Abstract
Obesity is a well-known risk factor for metabolic syndrome. Although the cause or causes of metabolic syndrome are debated, insulin resistance, dyslipidemia, and hypertension are increasingly recognized in children and adolescents, especially those who are overweight or obese. Although adoption of a healthy lifestyle early in life offers the best long-term solution, many children and adolescents are currently at risk for future cardiovascular disease. Although long-term outcome data are lacking, the dyslipidemic triad commonly seen in youth with metabolic syndrome (elevated triglycerides, low high-density lipoprotein, and small dense low-density lipoprotein) is likely to significantly contribute to future vascular disease. Surrogate markers (carotid intima-media thickness and flow-mediated vasodilatation) for the precursors of cardiovascular disease are increased in obese youth, consistent with early vascular damage. In this work, we review the features of metabolic syndrome in children and adolescents, including age- and gender-specific norms for lipid values. Diagnostic criteria and modifications of screening guidelines unique to youth are discussed. Although recommendations for lifestyle modification are suggested for all, many youth at high risk of future cardiovascular risk may need more aggressive medical interventions to improve insulin sensitivity, achieve a less atherogenic lipid profile, and lower blood pressure.
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Affiliation(s)
- Catherine McNeal
- Department of Pediatrics, Scott and White Hospital, Texas A&M University Health Science Center College of Medicine, 2401 South 31st Street, Temple, TX 76508, USA; Department of Internal Medicine, Scott and White Hospital, Texas A&M University Health Science Center College of Medicine, 2401 South 31st Street, Temple, TX 76508, USA
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44
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Rufail ML, Schenkein HA, Koertge TE, Best AM, Barbour SE, Tew JG, van Antwerpen R. Atherogenic lipoprotein parameters in patients with aggressive periodontitis. J Periodontal Res 2008; 42:495-502. [PMID: 17956461 DOI: 10.1111/j.1600-0765.2007.00973.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Certain types of chronic infection increase the plasma level of very-low-density lipoprotein, leading to formation of the particularly atherogenic low-density lipoprotein subclass, small dense low-density lipoprotein. In the present study, we examined whether aggressive forms of periodontitis are associated with these atherogenic lipoprotein parameters. MATERIAL AND METHODS Twelve healthy control subjects without periodontitis, 12 subjects with localized aggressive periodontitis and 12 subjects with generalized aggressive periodontitis were studied. Lipoprotein subclass levels were determined using nuclear magnetic resonance methodology. RESULTS Healthy control subjects, localized aggressive periodontitis subjects and generalized aggressive periodontitis subjects had progressively higher plasma levels of very-low-density lipoprotein and progressively smaller average low-density lipoprotein size (p < 0.05, one-way analysis of variance). In pairwise comparisons, differences were only significant between healthy controls and generalized aggressive periodontitis subjects (p < 0.05, Tukey's post test). After adjustment for body mass index, the mean periodontal pocket depth correlated positively with plasma very-low-density lipoprotein levels (p = 0.047). Very-low-density lipoprotein concentrations correlated positively with small dense low-density lipoprotein levels and negatively with average low-density lipoprotein size. Prevalence of the atherogenic lipoprotein pattern-B in healthy controls, localized aggressive periodontitis subjects and generalized aggressive periodontitis subjects was 8.3%, 33.3% and 66.6%, respectively. CONCLUSION These results indicate that periodontal infection is associated with elevated plasma levels of atherogenic lipoprotein species. This association may account for the increased risk of periodontitis patients for cardiovascular disease.
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Affiliation(s)
- M L Rufail
- Department of Biochemistry, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298, USA
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45
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Abstract
Vascular complications associated with type 2 diabetes confer significant morbidity and mortality. Atherosclerosis develops much earlier and progresses more rapidly than in subjects without diabetes. The clustering of cardiovascular risk factors associated with type 2 diabetes is mainly responsible for accelerated atherosclerotic disease. While statins remain the primary lipid-modifying therapy, the pharmacological profile of the fibrates suggests potential as an alternative or additional treatment for reducing the risk of atherosclerotic vascular complications in type 2 diabetes.
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Affiliation(s)
- George Steiner
- University of Toronto, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada, M5G 2C4.
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46
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Godsland IF, Johnston DG, Chaturvedi N. Mechanisms of disease: lessons from ethnicity in the role of triglyceride metabolism in ischemic heart disease. ACTA ACUST UNITED AC 2007; 3:530-8. [PMID: 17581622 DOI: 10.1038/ncpendmet0530] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 12/29/2006] [Indexed: 11/09/2022]
Abstract
Mean risk factor levels in various ethnic groups illustrate the potential importance of triglyceride metabolism in the risk for ischemic heart disease (IHD). Serum triglyceride concentrations are a surrogate for a range of potentially atherogenic disturbances in lipoprotein species, including increased concentrations of remnants of VLDL and chylomicron metabolism, increased small, dense LDL concentrations and reduced HDL concentrations. Differences between at-risk groups in lipoprotein profiles reflect alterations in the metabolism of triglycerides that might be greater than differences observed when only circulating triglyceride concentrations are measured. This atherogenic lipoprotein profile is typically found in association with increased visceral fat, insulin resistance and type 2 diabetes and might be a characteristic of Asian Indian ethnicity. By contrast, despite being relatively insulin resistant, Afro-Caribbean men in the UK have a low risk of IHD and lack the adverse lipoprotein profile. This could result from secretion of relatively large proportions of their VLDL as small, triglyceride-poor particles, levels of which are not augmented in response to loss of insulin action. These considerations re-endorse the potential importance of triglyceride metabolism in IHD and present opportunities for identifying useful areas in which drug targets for reducing IHD risk can be sought.
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Affiliation(s)
- Ian F Godsland
- Endocrinology and Metabolic Medicine, Imperial College London, St Mary's Hospital, London, UK.
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47
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Gazi IF, Tsimihodimos V, Tselepis AD, Elisaf M, Mikhailidis DP. Clinical importance and therapeutic modulation of small dense low-density lipoprotein particles. Expert Opin Biol Ther 2006; 7:53-72. [PMID: 17150019 DOI: 10.1517/14712598.7.1.53] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The National Cholesterol Education Programme Adult Treatment Panel III accepted the predominance of small dense low-density lipoprotein (sdLDL) as an emerging cardiovascular disease (CVD) risk factor. Most studies suggest that measuring low-density lipoprotein (LDL) particle size, sdLDL cholesterol content and LDL particle number provides additional assessment of CVD risk. Therapeutic modulation of small LDL size, number and distribution may decrease CVD risk; however, no definitive causal relationship is established, probably due to the close association between sdLDL and triglycerides and other risk factors (e.g., high-density lipoprotein, insulin resistance and diabetes). This review addresses the formation and measurement of sdLDL, as well as the relationship between sdLDL particles and CVD. The effect of hypolipidaemic (statins, fibrates and ezetimibe) and hypoglycaemic (glitazones) agents on LDL size and distribution is also discussed.
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Affiliation(s)
- Irene F Gazi
- Royal Free Hospital (and University College of Medicine), Department of Clinical Biochemistry, Pond St, London, NW3 2QG, UK
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48
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Kwon SW, Yoon SJ, Kang TS, Kwon HM, Kim JH, Rhee J, Lee SJ, Park JK, Lim JY, Yoon YW, Hong BK. Significance of small dense low-density lipoprotein as a risk factor for coronary artery disease and acute coronary syndrome. Yonsei Med J 2006; 47:405-14. [PMID: 16807992 PMCID: PMC2688162 DOI: 10.3349/ymj.2006.47.3.405] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Small dense LDL (sd-LDL) has recently emerged as an important coronary artery disease (CAD) risk factor. This study was performed to investigate how LDL particle size is related to CAD and acute coronary syndrome (ACS). Blood samples were collected from 504 patients that underwent coronary angiography to evaluate chest pain. The LDL particle size of these samples was measured. The mean LDL particle size was smaller in patients with angiographically proven CAD than in the controls (26.41 +/- 0.95 vs 26.73 +/- 0.64 nm, p < 0.001), and was negatively correlated with the Framingham risk score (r=-0.121, p=0.007). Patients with more extensive CAD had smaller LDL particles. LDL particle size was also smaller in patients with acute coronary syndrome as compared to non-ACS patients (26.09 +/- 1.42 vs 26.54 +/- 0.63 nm, p=0.011). These results suggest that sd-LDL is independently associated with the incidence and extent of CAD, and can be a risk factor for the development of ACS in the Korean population.
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Affiliation(s)
- Sung Woo Kwon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Jung Yoon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Soo Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuck Moon Kwon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Ho Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jihyuk Rhee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Ju Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Kwan Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Yun Lim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young Won Yoon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Bum Kee Hong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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De Spirito M, Brunelli R, Mei G, Bertani FR, Ciasca G, Greco G, Papi M, Arcovito G, Ursini F, Parasassi T. Low density lipoprotein aged in plasma forms clusters resembling subendothelial droplets: aggregation via surface sites. Biophys J 2006; 90:4239-47. [PMID: 16533854 PMCID: PMC1459520 DOI: 10.1529/biophysj.105.075788] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In early phases of atherogenesis, droplets and vesicles accumulate in the subendothelial extracellular space of arterial intima. There is much evidence to suggest that these droplets, ranging between 100 and 400 nm, derive from modified low-density lipoprotein (LDL). In investigations of the formation mechanism of these droplets, LDL fusion was previously induced in vitro by proteolysis, lipolysis, oxidation, and vigorous shaking, but all treatments failed to reproduce the size distribution range of in vivo droplets, mostly resulting, instead, in particles with a diameter intermediate between that of one and two LDL. Our approach was meant to mimic LDL aging in plasma. LDL isolated from plasma that was incubated overnight at 37 degrees C is slightly modified in the secondary structure of its protein component and is primed to form very large aggregates according to a reaction-limited mechanism. This mechanism requires interactions between selected surface sites, whereas massive fusion is ruled out. In the frame of the general theory for colloids, the aggregation of LDL aged in plasma fulfills all the requirements of the reaction-limited mechanism, encompassing 1), exponential growth; 2), fractal structure, with the dimension of elementary constituent still consistent with a single LDL; and 3), extreme polydispersity of aggregates, with shape and dimension very close to that of droplets observed in vivo.
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Affiliation(s)
- Marco De Spirito
- Istituto di Fisica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
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Rufail ML, Schenkein HA, Barbour SE, Tew JG, van Antwerpen R. Altered lipoprotein subclass distribution and PAF-AH activity in subjects with generalized aggressive periodontitis. J Lipid Res 2005; 46:2752-60. [PMID: 16179738 DOI: 10.1194/jlr.m500389-jlr200] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In this study, we examined whether the documented increase of plasma triglycerides in patients with generalized aggressive periodontitis (GAgP) is associated with changes in lipoprotein subclass distribution and/or LDL-associated platelet-activating factor acetylhydrolase (PAF-AH) activity. Lipoprotein subclasses were analyzed in whole plasma samples using nuclear magnetic resonance methods. Compared with subjects without periodontitis (NP subjects; n = 12), GAgP subjects (n = 12) had higher plasma levels of large, medium, and small VLDL (35.0 +/- 6.7 vs. 63.1 +/- 9.6 nmol/l; P = 0.025), higher levels of intermediate density lipoprotein (24.8 +/- 11.6 vs. 87.2 +/- 16.6 nmol/l; P = 0.006), lower levels of large LDL (448.3 +/- 48.5 vs. 315.8 +/- 59.4 nmol/l; P = 0.098), and higher levels of small LDL (488.2 +/- 104.2 vs. 946.7 +/- 151.6 nmol/l; P = 0.021). The average size of LDL from NP and GAgP subjects was 21.4 +/- 0.2 and 20.6 +/- 0.3 nm, respectively (P = 0.031). Compared with NP subjects, GAgP subjects had a greater number of circulating LDL particles (961.3 +/- 105.3 vs. 1,349.0 +/- 133.2 nmol/l; P = 0.032). Differences in the plasma levels of large, medium, and small HDL were not statistically significant. NP and GAgP subjects had similar plasma levels of total LDL-associated PAF-AH activity; however, LDL of GAgP subjects contained less PAF-AH activity per microgram of LDL protein (1,458.0 +/- 171.0 and 865.2 +/- 134 pmol/min/microg; P = 0.014). These results indicate that, in general, GAgP subjects have a more atherogenic lipoprotein profile and lower LDL-associated PAF-AH activity than NP subjects. These differences may help explain the increased risk of GAgP subjects for cardiovascular disease.
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Affiliation(s)
- Miguel L Rufail
- Department of Biochemistry, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298, USA
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