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Well-Known and Novel Serum Biomarkers for Risk Stratification of Patients with Non-ischemic Dilated Cardiomyopathy. Int J Mol Sci 2021; 22:ijms22115688. [PMID: 34073616 PMCID: PMC8198011 DOI: 10.3390/ijms22115688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/14/2021] [Accepted: 05/26/2021] [Indexed: 01/02/2023] Open
Abstract
Non-ischemic dilated cardiomyopathy encompasses a wide spectrum of myocardial disorders, characterized by left ventricular dilatation with systolic impairment and increased risk of sudden cardiac death. In spite of all the therapeutic progress that has been made in recent years, dilated cardiomyopathy continues to be an important cause of cardiac transplant, being associated with an enormous cost burden for health care systems worldwide. Predicting the prognosis of patients with dilated cardiomyopathy is essential to individualize treatment. Late gadolinium enhancement-cardiac magnetic resonance imaging, microvolt T-wave alternans, and genetic testing have emerged as powerful tools in predicting sudden cardiac death occurrence and maximizing patient’s selection. Despite all these new diagnostic modalities, additional tests to complement or replace current tools are required for better risk stratification. Therefore, biomarkers are an easy and important tool that can help to detect patients at risk of adverse cardiovascular events. Additionally, identifying potential biomarkers involved in dilated cardiomyopathy can provide us important information regarding the diagnostic, prognostic, risk stratification, and response to treatment for these patients. Many potential biomarkers have been studied in patients with dilated cardiomyopathy, but only a few have been adopted in current practice. Therefore, the aim of our review is to provide the clinicians with an update on the well-known and novel biomarkers that can be useful for risk stratification of patients with non-ischemic dilated cardiomyopathy.
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Martucci G, Pappalardo F, Subramanian H, Ingoglia G, Conoscenti E, Arcadipane A. Endocrine Challenges in Patients with Continuous-Flow Left Ventricular Assist Devices. Nutrients 2021; 13:861. [PMID: 33808026 PMCID: PMC7999433 DOI: 10.3390/nu13030861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/12/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022] Open
Abstract
Heart failure (HF) remains a leading cause of morbidity, hospitalization, and mortality worldwide. Advancement of mechanical circulatory support technology has led to the use of continuous-flow left ventricular assist devices (LVADs), reducing hospitalizations, and improving quality of life and outcomes in advanced HF. Recent studies have highlighted how metabolic and endocrine dysfunction may be a consequence of, or associated with, HF, and may represent a novel (still neglected) therapeutic target in the treatment of HF. On the other hand, it is not clear whether LVAD support, may impact the outcome by also improving organ perfusion as well as improving the neuro-hormonal state of the patients, reducing the endocrine dysfunction. Moreover, endocrine function is likely a major determinant of human homeostasis, and is a key issue in the recovery from critical illness. Care of the endocrine function may contribute to improving cardiac contractility, immune function, as well as infection control, and rehabilitation during and after a LVAD placement. In this review, data on endocrine challenges in patients carrying an LVAD are gathered to highlight pathophysiological states relevant to this setting of patients, and to summarize the current therapeutic suggestions in the treatment of thyroid dysfunction, and vitamin D, erythropoietin and testosterone administration.
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Affiliation(s)
- Gennaro Martucci
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90133 Palermo, Italy; (F.P.); (A.A.)
| | - Federico Pappalardo
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90133 Palermo, Italy; (F.P.); (A.A.)
| | - Harikesh Subramanian
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15201, USA;
| | - Giulia Ingoglia
- Section of Anesthesia Analgesia Intensive Care and Emergency, Department of Surgical, Oncological and Oral Science, University of Palermo, 90133 Palermo, Italy;
| | - Elena Conoscenti
- Infectious Disease and Infection Control Service, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90133 Palermo, Italy;
| | - Antonio Arcadipane
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90133 Palermo, Italy; (F.P.); (A.A.)
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Diaconu R, Donoiu I, Mirea O, Bălşeanu TA. Testosterone, cardiomyopathies, and heart failure: a narrative review. Asian J Androl 2021; 23:348-356. [PMID: 33433530 PMCID: PMC8269837 DOI: 10.4103/aja.aja_80_20] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Testosterone exerts an important regulation of cardiovascular function through genomic and nongenomic pathways. It produces several changes in cardiomyocytes, the main actor of cardiomyopathies, which are characterized by pathological remodeling, eventually leading to heart failure. Testosterone is involved in contractility, in the energy metabolism of myocardial cells, apoptosis, and the remodeling process. In myocarditis, testosterone directly promotes the type of inflammation that leads to fibrosis, and influences viremia with virus localization. At the same time, testosterone exerts cardioprotective effects that have been observed in different studies. There is increasing evidence that low endogenous levels of testosterone have a negative impact in some cardiomyopathies and a protective impact in others. This review focuses on the interrelationships between testosterone and cardiomyopathies and heart failure.
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Affiliation(s)
- Rodica Diaconu
- Department of Cardiology, University of Medicine and Pharmacy, Craiova 200349, Romania
| | - Ionuţ Donoiu
- Department of Cardiology, University of Medicine and Pharmacy, Craiova 200349, Romania
| | - Oana Mirea
- Department of Cardiology, University of Medicine and Pharmacy, Craiova 200349, Romania
| | - Tudor Adrian Bălşeanu
- Department of Physiology, University of Medicine and Pharmacy, Craiova 200349, Romania
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Basualto-Alarcón C, Llanos P, García-Rivas G, Troncoso MF, Lagos D, Barrientos G, Estrada M. Classic and Novel Sex Hormone Binding Globulin Effects on the Cardiovascular System in Men. Int J Endocrinol 2021; 2021:5527973. [PMID: 34335746 PMCID: PMC8318754 DOI: 10.1155/2021/5527973] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 12/16/2022] Open
Abstract
In men, 70% of circulating testosterone binds with high affinity to plasma sex hormone binding globulin (SHBG), which determines its bioavailability in their target cells. In recent years, a growing body of evidence has shown that circulating SHBG not only is a passive carrier for steroid hormones but also actively regulates testosterone signaling through putative plasma membrane receptors and by local expression of androgen-binding proteins apparently to reach local elevated testosterone concentrations in specific androgen target tissues. Circulating SHBG levels are influenced by metabolic and hormonal factors, and they are reduced in obesity and insulin resistance, suggesting that SHBG may have a broader clinical utility in assessing the risk for cardiovascular diseases. Importantly, plasma SHBG levels are strongly correlated with testosterone concentrations, and in men, low testosterone levels are associated with an adverse cardiometabolic profile. Although obesity and insulin resistance are associated with an increased incidence of cardiovascular disease, whether they lead to abnormal expression of circulating SHBG or its interaction with androgen signaling remains to be elucidated. SHBG is produced mainly in the liver, but it can also be expressed in several tissues including the brain, fat tissue, and myocardium. Expression of SHBG is controlled by peroxisome proliferator-activated receptor γ (PPARγ) and AMP-activated protein kinase (AMPK). AMPK/PPAR interaction is critical to regulate hepatocyte nuclear factor-4 (HNF4), a prerequisite for SHBG upregulation. In cardiomyocytes, testosterone activates AMPK and PPARs. Therefore, the description of local expression of cardiac SHBG and its circulating levels may shed new light to explain physiological and adverse cardiometabolic roles of androgens in different tissues. According to emerging clinical evidence, here, we will discuss the potential mechanisms with cardioprotective effects and SHBG levels to be used as an early metabolic and cardiovascular biomarker in men.
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Affiliation(s)
- Carla Basualto-Alarcón
- Departamento de Ciencias de la Salud, Universidad de Aysén, Coyhaique 5951537, Chile
- Departamento de Anatomía y Medicina Legal, Facultad de Medicina, Universidad de Chile, Santiago 8389100, Chile
| | - Paola Llanos
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Gerardo García-Rivas
- Tecnológico de Monterrey, Hospital Zambrano Hellion, TecSalud, Centro de Medicina Funcional, San Pedro Garza García, Nuevo León 66278, Mexico
| | - Mayarling Francisca Troncoso
- Programa de Fisiología y Biofísica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8389100, Chile
| | - Daniel Lagos
- Programa de Fisiología y Biofísica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8389100, Chile
| | - Genaro Barrientos
- Programa de Fisiología y Biofísica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8389100, Chile
| | - Manuel Estrada
- Programa de Fisiología y Biofísica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8389100, Chile
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Kurnaz-Gomleksiz O, Akadam-Teker B, Bugra Z, Omer B, Yilmaz-Aydogan H. Genetic polymorphisms of the SHBG gene can be the effect on SHBG and HDL-cholesterol levels in Coronary Heart Disease: a case-control study. Mol Biol Rep 2019; 46:4259-4269. [PMID: 31111369 DOI: 10.1007/s11033-019-04880-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/14/2019] [Indexed: 12/15/2022]
Abstract
Sex hormone binding globulin (SHBG) level is positively associated with the high-density lipoprotein cholesterol (HDL-C) levels. The aim of this study was to investigate the effects of the SHBG gene variations (D356N, rs1799941, and P156L) on SHBG and HDL-C levels and Coronary Heart Disease (CHD) risk. The SHBG D356 N (rs6259,G > A), P156L (rs6258,C > T), and rs1799941(G > A) polymorphisms were determined in 131 male CHD patients and 55 male controls by PCR-RFLP and real-time PCR techniques. SHGB levels were measured by Electro-chemiluminescence immunoassay (ECLIA). In the patients who had SHBG levels lower than threshold 35 nmol/l value, the risk of being HDL-C levels lower than threshold 0.90 mmol/l value was observed statistically significant (p = 0.017; OR 2.522, 95% CI 1.170-5.438). The rs1799941 GG was associated with increased CHD risk when compared with the A allele carriers (GA + AA) (p = 0.019, OR 2.222, 95% CI 1.130-4.371). In addition, the rs1799941 GG genotype and D356 N N allele were associated with lower SHBG in the CHD group (p < 0.01). The logistic regression analysis also revealed the rs1799941 GG genotype was significantly associated with low SHBG in CHD patients. It was observed that Haplotype-1(rs1799941 G allele-P156L P allele-D356 N D allele) was associated with increased CHD risk, while Haplotype-2 (rs1799941 rare A allele-P156L C allele- D356 N G allele) was correlated with the decreased CHD risk (p = 0.0167). Our findings suggest that there is a positive correlation between SHBG and HDL-C levels in CHD patients, and this association might be affected by SHBG gene variations.
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Affiliation(s)
- Ozlem Kurnaz-Gomleksiz
- Department of Medical Biology, Faculty of Medicine, Altinbas University, Istanbul, Turkey.,Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba C. Çapa, 34093, Istanbul, Turkey
| | - Basak Akadam-Teker
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba C. Çapa, 34093, Istanbul, Turkey.,Department of Medical Genetics, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Zehra Bugra
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Beyhan Omer
- Departments of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hulya Yilmaz-Aydogan
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba C. Çapa, 34093, Istanbul, Turkey.
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6
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Gyawali P, Martin SA, Heilbronn LK, Vincent AD, Jenkins AJ, Januszewski AS, Taylor AW, Adams RJT, O’Loughlin PD, Wittert GA. Cross-sectional and longitudinal determinants of serum sex hormone binding globulin (SHBG) in a cohort of community-dwelling men. PLoS One 2018; 13:e0200078. [PMID: 29995902 PMCID: PMC6040731 DOI: 10.1371/journal.pone.0200078] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 06/19/2018] [Indexed: 12/31/2022] Open
Abstract
Despite its widespread clinical use, there is little data available from population-based studies on the determinants of serum sex hormone binding globulin (SHBG). We aimed to examine multifactorial determinants of circulating SHBG levels in community-dwelling men. Study participants comprised randomly selected 35–80 y.o. men (n = 2563) prospectively-followed for 5 years (n = 2038) in the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. After excluding men with illness or medications known to affect SHBG (n = 172), data from 1786 men were available at baseline, and 1476 at follow-up. The relationship between baseline body composition (DXA), serum glucose, insulin, triglycerides, thyroxine (fT4), sex steroids (total testosterone (TT), oestradiol (E2)), and pro-inflammatory cytokines and serum SHBG level at both baseline & follow-up was determined by linear and penalized logistic regression models adjusting for age, lifestyle & demographic, body composition, metabolic, and hormonal factors. Restricted cubic spline analyses was also conducted to capture possible non-linear relationships. At baseline there were positive cross-sectional associations between age (β = 0.409, p<0.001), TT (β = 0.560, p<0.001), fT4 (β = 0.067, p = 0.019) and SHBG, and negative associations between triglycerides (β = -0.112, p<0.001), abdominal fat mass (β = -0.068, p = 0.032) and E2 (β = -0.058, p = 0.050) and SHBG. In longitudinal analysis the positive determinants of SHBG at 4.9 years were age (β = 0.406, p = <0.001), TT (β = 0.461, p = <0.001), and fT4 (β = 0.040, p = 0.034) and negative determinants were triglycerides (β = -0.065, p = 0.027) and abdominal fat mass (β = -0.078, p = 0.032). Taken together these data suggest low SHBG is a marker of abdominal obesity and increased serum triglycerides, conditions which are known to have been associated with low testosterone and low T4.
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Affiliation(s)
- Prabin Gyawali
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- * E-mail: (PG); (GW)
| | - Sean A. Martin
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Leonie K. Heilbronn
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Andrew D. Vincent
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Alicia J. Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Andrzej S. Januszewski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Anne W. Taylor
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- Population Research and Outcomes Studies, University of Adelaide, Adelaide, South Australia, Australia
| | - Robert J. T. Adams
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The Health Observatory, University of Adelaide, Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | | | - Gary A. Wittert
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- * E-mail: (PG); (GW)
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7
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Goldman AL, Bhasin S, Wu FCW, Krishna M, Matsumoto AM, Jasuja R. A Reappraisal of Testosterone's Binding in Circulation: Physiological and Clinical Implications. Endocr Rev 2017; 38:302-324. [PMID: 28673039 PMCID: PMC6287254 DOI: 10.1210/er.2017-00025] [Citation(s) in RCA: 213] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 06/23/2017] [Indexed: 02/07/2023]
Abstract
In the circulation, testosterone and other sex hormones are bound to binding proteins, which play an important role in regulating their transport, distribution, metabolism, and biological activity. According to the free hormone hypothesis, which has been debated extensively, only the unbound or free fraction is biologically active in target tissues. Consequently, accurate determination of the partitioning of testosterone between bound and free fractions is central to our understanding of how its delivery to the target tissues and biological activity are regulated and consequently to the diagnosis and treatment of androgen disorders in men and women. Here, we present a historical perspective on the evolution of our understanding of the binding of testosterone to circulating binding proteins. On the basis of an appraisal of the literature as well as experimental data, we show that the assumptions of stoichiometry, binding dynamics, and the affinity of the prevailing models of testosterone binding to sex hormone-binding globulin and human serum albumin are not supported by published experimental data and are most likely inaccurate. This review offers some guiding principles for the application of free testosterone measurements in the diagnosis and treatment of patients with androgen disorders. The growing number of testosterone prescriptions and widely recognized problems with the direct measurement as well as the computation of free testosterone concentrations render this critical review timely and clinically relevant.
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Affiliation(s)
- Anna L Goldman
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Frederick C W Wu
- Andrology Research Unit, Centre for Endocrinology and Diabetes, University of Manchester, Manchester M13 9PT, United Kingdom
| | - Meenakshi Krishna
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Alvin M Matsumoto
- Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington 98108
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington 98104
| | - Ravi Jasuja
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115
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Santos MRD, Sayegh ALC, Groehs RVR, Fonseca G, Trombetta IC, Barretto ACP, Arap MA, Negrão CE, Middlekauff HR, Alves MJDNN. Testosterone deficiency increases hospital readmission and mortality rates in male patients with heart failure. Arq Bras Cardiol 2015. [PMID: 26200897 PMCID: PMC4592174 DOI: 10.5935/abc.20150078] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Testosterone deficiency in patients with heart failure (HF) is associated with
decreased exercise capacity and mortality; however, its impact on hospital
readmission rate is uncertain. Furthermore, the relationship between testosterone
deficiency and sympathetic activation is unknown. Objective We investigated the role of testosterone level on hospital readmission and
mortality rates as well as sympathetic nerve activity in patients with HF. Methods Total testosterone (TT) and free testosterone (FT) were measured in 110
hospitalized male patients with a left ventricular ejection fraction < 45% and
New York Heart Association classification IV. The patients were placed into low
testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups.
Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle
sympathetic nerve activity (MSNA) was recorded by microneurography in a
subpopulation of 27 patients. Results Length of hospital stay was longer in the LT group compared to in the NT group (37
± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission
within 1 year was greater in the LT group compared to in the NT group (44% vs.
22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77;
95% confidence interval [CI], 1.58–4.85; p = 0.02) predicted hospital readmission
within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67–8.10; p = 0.009) and
readmission within 90 days (HR, 3.27; 95% CI, 1.23–8.69; p = 0.02) predicted
increased mortality. Neurohumoral activation, as estimated by MSNA, was
significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ±
4 bursts/100 heart beats; p < 0.001). Conclusion These results support the concept that LT is an independent risk factor for
hospital readmission within 90 days and increased mortality in patients with HF.
Furthermore, increased MSNA was observed in patients with LT.
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Affiliation(s)
| | | | | | - Guilherme Fonseca
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, BR
| | | | | | | | | | - Holly R Middlekauff
- Division of Cardiology, David Geffen School of Medicine, University of California, US
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Elevated serum Bisphenol A level in patients with dilated cardiomyopathy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5329-37. [PMID: 25996886 PMCID: PMC4454970 DOI: 10.3390/ijerph120505329] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 05/08/2015] [Indexed: 12/11/2022]
Abstract
Background: This study aimed to determine serum Bisphenol A (BPA) concentrations in patients with dilated cardiomyopathy (DCM) as well as the association between serum BPA and several hormonal parameters in DCM patients compared with a healthy control group. Materials and methods: Eighty-eight DCM patients and 88 age- and gender-matched healthy controls were included. Serum BPA levels and several hormonal parameters (including total testosterone (T), sex hormone-binding globulin (SHBG) and estradiol (E2) were measured by using corresponding ELISA Kits. The free androgen index (FAI) was calculated by the formula: total T in nmol/L × 100/SHBG in nmol/L. Results: BPA levels in the total DCM group were significantly higher compared with that in the controls (6.9 ± 2.7 ng/mL vs. 3.8 ± 1.9 ng/mL, p < 0.001). Significant difference was also observed in SHBG and FAI between DCM patients and controls, (76.9 ± 30.9 nM/L vs. 41.0 ± 15.6 nM/L and 2.9 ± 3.5 vs. 5.3 ± 2.6, respectively, both of p < 0.001). Similar trends were observed in the male and female subgroup. Mean T level was lower in DCM group than in control group (540.8 ± 186.0 pg/mL vs. 656.3 ± 112.9 pg/mL, p < 0.001). Linear regression analysis has shown that increasing serum BPA levels were statistically significantly associated with increased SHBG levels. However, no statistical difference was noted for E2. Conclusion: Our findings firstly demonstrated that BPA exposure increased in DCM patients compared with that in healthy controls, while FAI and T levels decreased. SHBG presented a positive association with BPA. It is concluded that hormone disorder induced by BPA exposure might be an environmental factor in the pathology of DCM.
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Li S, Kievit P, Robertson AK, Kolumam G, Li X, von Wachenfeldt K, Valfridsson C, Bullens S, Messaoudi I, Bader L, Cowan KJ, Kamath A, van Bruggen N, Bunting S, Frendéus B, Grove KL. Targeting oxidized LDL improves insulin sensitivity and immune cell function in obese Rhesus macaques. Mol Metab 2013; 2:256-69. [PMID: 24049738 DOI: 10.1016/j.molmet.2013.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 06/03/2013] [Accepted: 06/05/2013] [Indexed: 12/18/2022] Open
Abstract
Oxidation of LDL (oxLDL) is a crucial step in the development of cardiovascular disease. Treatment with antibodies directed against oxLDL can reduce atherosclerosis in rodent models through unknown mechanisms. We demonstrate that through a novel mechanism of immune complex formation and Fc-γ receptor (FcγR) engagement, antibodies targeting oxLDL (MLDL1278a) are anti-inflammatory on innate immune cells via modulation of Syk, p38 MAPK phosphorylation and NFκB activity. Subsequent administration of MLDL1278a in diet-induced obese (DIO) nonhuman primates (NHP) resulted in a significant decrease in pro-inflammatory cytokines and improved overall immune cell function. Importantly, MLDL1278a treatment improved insulin sensitivity independent of body weight change. This study demonstrates a novel mechanism by which an anti-oxLDL antibody improves immune function and insulin sensitivity independent of internalization of oxLDL. This identifies MLDL1278a as a potential therapy for reducing vascular inflammation in diabetic conditions.
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Affiliation(s)
- Shijie Li
- Genentech Inc., 1 DNA Way, South San Francisco, CA 94080, United States
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Ritchey J, Karmaus W, Sabo-Attwood T, Steck SE, Zhang H. A cross-sectional study of the association of age, race and ethnicity, and body mass index with sex steroid hormone marker profiles among men in the National Health and Nutrition Examination Survey (NHANES III). BMJ Open 2012; 2:bmjopen-2012-001315. [PMID: 23043125 PMCID: PMC3488758 DOI: 10.1136/bmjopen-2012-001315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Since sex hormone markers are metabolically linked, examining sex steroid hormones singly may account for inconsistent findings by age, race/ethnicity and body mass index (BMI) across studies. First, these markers were statistically combined into profiles to account for the metabolic relationship between markers. Then, the relationships between sex steroid hormone profiles and age, race/ethnicity and BMI were explored in multinomial logistic regression models. DESIGN Cross-sectional survey. SETTING The US Third National Health and Nutrition Examination Survey (NHANES III). PARTICIPANTS 1538 Men, >17 years. PRIMARY OUTCOME MEASURE Sex hormone profiles. RESULTS Cluster analysis was used to identify four statistically determined profiles with Blom-transformed T, E, sex hormone binding globulin (SHBG), and 3-α diol G. We used these four profiles with multinomial logistic regression models to examine differences by race/ethnicity, age and BMI. Mexican American men >50 years were associated with the profile that had lowest T, E and 3-α diol G levels compared to other profiles (p<0.05). Non-Hispanic Black, overweight (25-29.9 kg/m(2)) and obese (>30 kg/m(2)) men were most likely to be associated with the cluster with the lowest SHBG (p<0.05). CONCLUSION The associations of sex steroid hormone profiles by race/ethnicity are novel, while the findings by age and BMI groups are largely consistent with observations from single hormone studies. Future studies should validate these hormone profile groups and investigate these profiles in relation to chronic diseases and certain cancers.
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Affiliation(s)
- Jamie Ritchey
- Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Wilfried Karmaus
- Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Tara Sabo-Attwood
- Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Susan E Steck
- Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Hongmei Zhang
- Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
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