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Chait A, Eckel RH, Vrablik M, Zambon A. Lipid-lowering in diabetes: An update. Atherosclerosis 2024; 394:117313. [PMID: 37945448 DOI: 10.1016/j.atherosclerosis.2023.117313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/11/2023] [Accepted: 09/22/2023] [Indexed: 11/12/2023]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is accelerated in people with diabetes. Dyslipidemia, hyperglycemia, oxidative stress, and inflammation play a role via a variety of mechanisms operative in the artery wall. In addition, some unique features predispose people with type 1 diabetes to accelerated atherosclerosis. Various organizations have created guidelines that provide advice regarding screening, risk assessment, and roadmaps for treatment to prevent ASCVD in diabetes. Management of dyslipidemia, especially with statins, has proven to be of immense benefit in the prevention of clinical CVD. However, since many patients fail to attain the low levels of low-density lipoproteins (LDL) recommended in these guidelines, supplemental therapy, such as the addition of ezetimibe, bempedoic acid or PCSK9 inhibitors, is often required to reach LDL goals. As a result, the upfront use of combination therapies, particularly a statin plus ezetimibe, is a rational initial approach. The addition to statins of drugs that specifically lower triglyceride levels has not proven beneficial, although the addition of icosapent-ethyl has been shown to be of value, likely by mechanisms independent of triglyceride lowering. Newer treatments in development, including apoC-III and ANGPTL3 inhibitors, seem promising in further reducing apoB-containing lipoproteins.
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Affiliation(s)
- Alan Chait
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, WA, USA
| | - Robert H Eckel
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Michal Vrablik
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alberto Zambon
- Department of Medicine - DIMED, University of Padova, and IRCCS Multimedica Milan, Italy.
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Al Saudi RM, Kasabri V, Naffa R, Bulatova N, Bustanji Y. Glycated LDL-C and glycated HDL-C in association with adiposity, blood and atherogenicity indices in metabolic syndrome patients with and without prediabetes. Ther Adv Endocrinol Metab 2018; 9:311-323. [PMID: 30327717 PMCID: PMC6178372 DOI: 10.1177/2042018818788198] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/19/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The aim of the study was to compare and correlate glycated high-density lipoprotein (GHDL-C) and glycated low-density lipoprotein (GLDL-C) plasma levels with adiposity indices [weight/hip ratio (WHR) and body adiposity index (BAI)], lipid ratios and hematological indices [platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR)]. METHODS This was a cross-sectional study of 30 nondiabetic metabolic syndrome (MetS) patients, 30 prediabetic or type 2 diabetes mellitus (T2DM) patients and 30 normoglycemic controls. RESULTS Remarkably both GHDL-C and GLDL-C levels lacked any intergroup statistically significant discrepancy in either MetS or MetS-pre/T2DM versus control (p > 0.05). Unlike GLDL-C/LDL-C ratios for either MetS groups; there were highly significant intergroup differences in the means of GHDL-C/HDL-C ratios when comparing both nondiabetic MetS and MetS-pre/T2DM groups versus controls (p = 0.001). In MetS patients; GHDL-C and GLDL-C proportionally correlated with WHR (p < 0.05). Also, MetS GHDL-C correlated inversely with MLR and monocytes (p < 0.05). In MetS-pre/T2DM; GLDL-C directly correlated with BAI, platelet count and PLR (p < 0.05). CONCLUSION GLDL-C and GHDL-C are dysfunctional glucolipotoxicity lipoproteins and may present putatively surrogate biomarkers for prediction/prevention of metabolic disturbances.
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Affiliation(s)
| | - Violet Kasabri
- School of Pharmacy, The University of Jordan,
Queen Rania Street, Amman 11942, Jordan
| | - Randa Naffa
- School of Medicine, The University of Jordan,
Queen Rania Street, Amman, Jordan
| | - Nailya Bulatova
- School of Pharmacy, The University of Jordan,
Queen Rania Street, Amman, Jordan
| | - Yasser Bustanji
- School of Pharmacy, The University of Jordan,
Queen Rania Street, Amman, Jordan
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Huang C, Yang W, Wang J, Zhou Y, Geng B, Kararigas G, Yang J, Cui Q. The DrugPattern tool for drug set enrichment analysis and its prediction for beneficial effects of oxLDL on type 2 diabetes. J Genet Genomics 2018; 45:389-397. [PMID: 30054214 DOI: 10.1016/j.jgg.2018.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/18/2018] [Accepted: 07/04/2018] [Indexed: 01/01/2023]
Abstract
Enrichment analysis methods, e.g., gene set enrichment analysis, represent one class of important bioinformatical resources for mining patterns in biomedical datasets. However, tools for inferring patterns and rules of a list of drugs are limited. In this study, we developed a web-based tool, DrugPattern, for drug set enrichment analysis. We first collected and curated 7019 drug sets, including indications, adverse reactions, targets, pathways, etc. from public databases. For a list of interested drugs, DrugPattern then evaluates the significance of the enrichment of these drugs in each of the 7019 drug sets. To validate DrugPattern, we employed it for the prediction of the effects of oxidized low-density lipoprotein (oxLDL), a factor expected to be deleterious. We predicted that oxLDL has beneficial effects on some diseases, most of which were supported by evidence in the literature. Because DrugPattern predicted the potential beneficial effects of oxLDL in type 2 diabetes (T2D), animal experiments were then performed to further verify this prediction. As a result, the experimental evidences validated the DrugPattern prediction that oxLDL indeed has beneficial effects on T2D in the case of energy restriction. These data confirmed the prediction accuracy of our approach and revealed unexpected protective roles for oxLDL in various diseases. This study provides a tool to infer patterns and rules in biomedical datasets based on drug set enrichment analysis. DrugPattern is available at http://www.cuilab.cn/drugpattern.
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Affiliation(s)
- Chuanbo Huang
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Center for Non-Coding RNA Medicine, Peking University, Beijing 100191, China; School of Mathematics Sciences, Huaqiao University, Quanzhou 362021, China
| | - Weili Yang
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Center for Non-Coding RNA Medicine, Peking University, Beijing 100191, China
| | - Junpei Wang
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Center for Non-Coding RNA Medicine, Peking University, Beijing 100191, China
| | - Yuan Zhou
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Center for Non-Coding RNA Medicine, Peking University, Beijing 100191, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Georgios Kararigas
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Gender in Medicine and Center for Cardiovascular Research, DZHK (German Centre for Cardiovascular Research), 10115 Berlin, Germany
| | - Jichun Yang
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Center for Non-Coding RNA Medicine, Peking University, Beijing 100191, China.
| | - Qinghua Cui
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Center for Non-Coding RNA Medicine, Peking University, Beijing 100191, China; Center of Bioinformatics, Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
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4
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Papegay B, Stadler M, Nuyens V, Kruys V, Boogaerts JG, Vamecq J. Short fasting does not protect perfused ex vivo rat liver against ischemia-reperfusion. On the importance of a minimal cell energy charge. Nutrition 2017; 35:21-27. [DOI: 10.1016/j.nut.2016.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 09/28/2016] [Accepted: 10/01/2016] [Indexed: 01/27/2023]
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Megson IL, Treweeke AT, Shaw A, MacRury SM, Setford S, Frias JP, Anhalt H. Continuous subcutaneous insulin infusion in patients with type 2 diabetes: a cohort study to establish the relationship between glucose control and plasma oxidized low density lipoprotein. J Diabetes Sci Technol 2015; 9:573-80. [PMID: 25652563 PMCID: PMC4604536 DOI: 10.1177/1932296815570359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Oxidative stress is a detrimental feature of diabetes implicated in the progression of the disease and its complications. The relationship between insulin therapy and oxidative stress is complex. This study tested the hypothesis that improved glucose control, rather than insulin dose, is central to reduced oxidative stress in patients with type 2 diabetes following continuous subcutaneous insulin infusion (CSII). METHODS In this 16-week, multicenter study, 54 CSII-naïve patients with type 2 diabetes (age 57 ± 10 years, HbA1c 69 ± 15 mmol/mol [8.5 ± 1.4%], diabetes duration 13 ± 6 years) treated with either oral antidiabetic agents (OAD) alone (n = 17), basal insulin ± OAD (n = 17), or multiple daily injections (MDI) ± OAD (n = 20) were the evaluable group. Diabetes medications except metformin were discontinued, and 16 weeks of CSII was initiated. Insulin dose was titrated to achieve optimal glycemic control. A plasma marker of oxidative stress relevant to cardiovascular disease (oxidized low density lipoprotein [ox-LDL]) was assessed at baseline and week 16. RESULTS CSII improved glycemic control (HbA1c -13 ± 2 mmol/mol [-1.2 ± 0.2%]; fasting glucose -36.6 ± 8.4 mg/dL; mean glucose excursion -23.2 ± 6.5 mg/dL, mean ± SE; all P < .001) and reduced ox-LDL (-10.5%; P < .05). The antioxidant effect was cohort-independent (P > .05), but was significantly more pronounced in patients on statins (P = .019). The effect of CSII was more closely correlated to improvements in glucose excursion (P = .013) than to insulin dose (P > .05) or reduction in HbA1c (P > .05). CONCLUSIONS CSII induces depression of plasma ox-LDL associated with change in glucose control, rather than with change in insulin dose. The effect is augmented in patients receiving statins.
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Affiliation(s)
- Ian L Megson
- Free Radical Research Facility, Department of Diabetes & Cardiovascular Science, University of the Highlands & Islands, Inverness, UK
| | - Andrew T Treweeke
- Free Radical Research Facility, Department of Diabetes & Cardiovascular Science, University of the Highlands & Islands, Inverness, UK
| | - Andrew Shaw
- Free Radical Research Facility, Department of Diabetes & Cardiovascular Science, University of the Highlands & Islands, Inverness, UK
| | - Sandra M MacRury
- Free Radical Research Facility, Department of Diabetes & Cardiovascular Science, University of the Highlands & Islands, Inverness, UK
| | | | - Juan P Frias
- National Research Institute, Los Angeles, CA, USA
| | - Henry Anhalt
- Bergen County Pediatric Endocrinology, Hackensack, NJ, USA
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Khorrami A, Ghanbarzadeh S, Ziaee M, Arami S, Vajdi R, Garjani A. Dietary cholesterol and oxidised cholesterol: effects on sperm characteristics, antioxidant status and hormonal profile in rats. Andrologia 2014; 47:310-7. [PMID: 24620776 DOI: 10.1111/and.12262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 11/26/2022] Open
Abstract
Present study was designed to compare the potential effects of high serum levels of LDL and oxidised LDL (OxLDL) on spermatogenesis parameters in male Wistar rats. Animals were allocated into three groups and were fed for 14 weeks with normal, cholesterol-rich and oxidised cholesterol-rich diets. Blood lipid profile, sex hormones level, as well as sex organs weight were evaluated. The sex organs weight in oxidised cholesterol-fed group was significantly reduced (P < 0.05). Spermatozoa count in the group with high serum concentration of OxLDL (64 ± 4.2 × 10(6) ) was markedly lower (P < 0.01) than that of normal rats (87 ± 4.1 × 10(6) ) and rats with high serum level of LDL (90 ± 6.3 × 10(6) ). Similarly, the percentage of viable spermatozoa was significantly (P < 0.001) decreased from 78% to 52% by high level of OxLDL in serum. While, nonoxidised LDL did not have suppressive effects on spermatogenesis and organs weight. Consistent with these effects, the serum concentration of sex hormones including FSH (P < 0.001), LH (P < 0.001) and testosterone (P < 0.01) was significantly decreased only in rats with high level of OxLDL but not in rats with high level of nonoxidised LDL. In conclusion, high OxLDL level showed higher destructive effect on reproductive system compared to the high LDL level.
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Affiliation(s)
- A Khorrami
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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Huang SF, Tsai YA, Wu SB, Wei YH, Tsai PY, Chuang TY. Effects of intravascular laser irradiation of blood in mitochondria dysfunction and oxidative stress in adults with chronic spinal cord injury. Photomed Laser Surg 2012; 30:579-86. [PMID: 22891782 DOI: 10.1089/pho.2012.3228] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE This study investigated the clinical effects of intravascular laser irradiation of blood (ILIB) therapy on oxidative stress and mitochondrial dysfunction in subjects with chronic spinal cord injury (SCI) resulting from trauma. BACKGROUND DATA Little is known about how ILIB may generate antioxidant defenses in humans, and there is still a lack of randomized, sham-control studies to indicate its influence on different metabolic pathways. METHODS Twenty-four chronic SCI subjects (assigned to a sham and a study group), and 12 normal subjects were recruited. The study group underwent 1 h daily of ILIB for 15 days over 3 weeks. The sham group underwent ILIB with no laser power. RESULTS Baseline measurements established higher oxidative stress and mitochondrial dysfunction in the SCI subjects than in the normal subjects. At day 15 of therapy, the study group revealed a significantly higher mitochondrial DNA (mtDNA) copy number, white blood cell adenosine triphosphate (WBC ATP) synthesis, and total antioxidant capacity (TAC) with significantly reduced malondialdehyde (MDA), than did the sham group. The study group intragroup comparison revealed significantly increased mtDNA copy numbers, WBC ATP synthesis, and TAC, with significantly reduced MDA, compared with its baseline measurements. The sham group intragroup comparisons demonstrated no statistical differences. Low-density lipoprotein (LDL) in the study group was significantly reduced at days 10 and 15, with significantly higher high-density lipoprotein (HDL) at day 45. CONCLUSIONS Our study results contribute to the knowledge about the effectiveness of ILIB in alleviating oxidative stress and mitochondrial dysfunction in chronic SCI patients.
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Affiliation(s)
- Shih-Fong Huang
- Department of Neuroregeneration and Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan
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Bahadoran Z, Mirmiran P, Hosseinpanah F, Rajab A, Asghari G, Azizi F. Broccoli sprouts powder could improve serum triglyceride and oxidized LDL/LDL-cholesterol ratio in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Diabetes Res Clin Pract 2012; 96:348-54. [PMID: 22325157 DOI: 10.1016/j.diabres.2012.01.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 12/15/2011] [Accepted: 01/03/2012] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS In this study, broccoli sprout powder (BSP), a good source of bioactive components, was used as supplementary treatment in type 2 diabetic patients. METHODS This randomized clinical trial included 81 patients with type 2 diabetes. Participants were randomly assigned to consume 10g/d BSP (group A), 5g/d BSP (group B), or the placebo (group C), each for 4 weeks. Fasting blood glucose (FBS), total cholesterol (TC), triglyceride concentration (TG), LDL-C, HDL-C, and oxidized-LDL were measured at baseline and 4 weeks after treatment. The ratios of OX-LDL/LDL, atherogenic index of plasma (AIP; log TG/HDL), TC/HDL and LDL/HDL were calculated as cardiovascular risk factors parameters, at baseline and 4 weeks after treatment. RESULTS Seventy-two patients completed the study; n=23, 26 and 23 for groups A, B and C, respectively. After 4 weeks, BSP in dose of 10g/d, significantly decreased serum triglycerides, OX-LDL/LDL ratio and AIP (p<0.05 for treatment effect). HDL-C concentration was significantly higher (p<0.01 for treatment) in group A as compared with group B and placebo. CONCLUSIONS BSP as supplementary treatment in type 2 diabetes could have favorable effects on lipid profiles and OX-LDL/LDL ratio, as risk factors for cardiovascular disease.
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Affiliation(s)
- Zahra Bahadoran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Tang TS, Prior SL, Li KW, Ireland HA, Bain SC, Hurel SJ, Cooper JA, Humphries SE, Stephens JW. Association between the rs1050450 glutathione peroxidase-1 (C > T) gene variant and peripheral neuropathy in two independent samples of subjects with diabetes mellitus. Nutr Metab Cardiovasc Dis 2012; 22:417-425. [PMID: 21185702 DOI: 10.1016/j.numecd.2010.08.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 06/02/2010] [Accepted: 08/02/2010] [Indexed: 12/14/2022]
Abstract
Glutathione peroxidase-1 (GPx-1) is an endogenous anti-oxidant enzyme. The T allele of the GPx-1 rs1050450 (C > T) gene variant is associated with reduced enzyme activity. Our aim was to examine the association between this gene variant and peripheral neuropathy in two cross-sectional samples of subjects with diabetes: (i) 773 Caucasian subjects were genotyped from the UCL Diabetes and Cardiovascular disease Study (UDACS) and (ii) 382 Caucasian subjects from the Ealing Diabetes Study (EDS). Peripheral neuropathy status (and oxidised-LDL [Ox-LDL:LDL] and plasma Total Ant-ioxidant Status [TAOS] in UDACS), were analysed in relation to genotype. We observed that: (i) In UDACS, the odds ratio (OR) for peripheral neuropathy in the T allele carriers compared to the CC genotype was 1.61 [1.10-2.28], p = 0.01. This remained significant after adjustment for other risk factors. Ox-LDL:LDL ratio was significantly elevated in T allele carriers (CC vs. CT/TT: 16.3 ± 2.4 v 18.0 ± 2.9 U/mmol LDL, p = 0.02). (ii) In EDS, the OR for peripheral neuropathy in the T allele carriers compared to the CC genotype was 1.95 [1.11-3.42], p = 0.02. This remained significant after adjustment for other risk factors. In conclusion, we observed a significant association between the T allele and peripheral neuropathy and LDL oxidation. This is the first paper to examine the rs1050450 variant in two samples of Caucasian subjects with diabetes. Prospective analysis of the gene variant is required in diabetic and healthy cohorts with measured plasma markers of oxidative stress to investigate the described association further.
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Affiliation(s)
- T S Tang
- Diabetes Research Group, Institute of Life Sciences, Swansea University, Swansea SA2 8PP, UK
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Kruit JK, Brunham LR, Verchere CB, Hayden MR. HDL and LDL cholesterol significantly influence beta-cell function in type 2 diabetes mellitus. Curr Opin Lipidol 2010; 21:178-85. [PMID: 20463468 DOI: 10.1097/mol.0b013e328339387b] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Patients with type 2 diabetes mellitus (T2DM) display significant abnormalities in both LDL and HDL particles. Recent data suggest that these changes in lipoprotein particles could contribute to the pathogenesis of T2DM. In this review, we focus on these abnormalities and discuss their possible impact on beta-cell function and beta-cell mass. RECENT FINDINGS Infusion of reconstituted HDL in T2DM patients improves beta-cell function, whereas carriers of loss-of-function mutations in the cholesterol transporter ABCA1, who have decreased HDL levels, have impaired beta-cell function. In addition, recent studies show that HDL protects against stress-induced beta-cell apoptosis in vitro. Finally, increasing evidence points to a role for islet inflammation in the pathogenesis of T2DM. ABCA1 and ABCG1 may also modulate these inflammatory responses, suggesting an additional pathway by which HDL may impact T2DM. SUMMARY Recent findings indicate that HDL protects beta-cells from cholesterol-induced beta-cell dysfunction, stress-induced apoptosis and islet inflammation. As the protective properties of HDL are compromised in patients with metabolic syndrome and T2DM, dysfunctional HDL metabolism could contribute to the pathogenesis of T2DM. Therapeutic normalization of both the quantity and quality of HDL particles may be a novel approach to prevent or treat T2DM.
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Affiliation(s)
- Janine K Kruit
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
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An WS, Kim SE, Kim KH, Bae HR, Rha SH. Associations between oxidized LDL to LDL ratio, HDL and vascular calcification in the feet of hemodialysis patients. J Korean Med Sci 2009; 24 Suppl:S115-20. [PMID: 19194540 PMCID: PMC2633196 DOI: 10.3346/jkms.2009.24.s1.s115] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2008] [Accepted: 12/01/2008] [Indexed: 11/20/2022] Open
Abstract
Cardiovascular mortality is associated with vascular calcification (VC) in hemodialysis (HD) patients. The present study was designed to find factors related with medial artery calcification on the plain radiography of feet by comparing C-reactive protein (CRP), plasminogen activator inhibitor type 1 (PAI-1) and lipid profile including oxidized low density lipoprotein (ox-LDL) and to elucidate associations among these factors in HD patients. Forty-eight HD patients were recruited for this study. VC in the feet was detected in 18 patients (37.5%) among total patients and 12 patients (85.7%) among diabetic patients. Diabetes, cardiovascular disease (CVD), pulse pressure, ox-LDL/LDL were higher and high density lipoprotein (HDL) was lower in patients with VC than in patients without VC. Negative associations were found between HDL and CRP, PAI-1. PAI-1 had positive association with ox-LDL/LDL. History of CVD was the only determinant of vascular calcification on the plain radiography of feet. Ox-LDL/LDL, HDL, CRP, and PAI-1 were closely related with one another in HD patients. History of CVD is the most important factor associated with the presence of VC and low HDL and relatively high oxidized LDL/LDL ratio may affect VC formation on the plain radiography in the feet of HD patients.
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Affiliation(s)
- Won Suk An
- Department of Internal Medicine, Dong-A University, Seo-gu, Busan, Korea.
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