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Pihlman J, Magnussen CG, Laitinen TT, Ruohonen S, Pahkala K, Jokinen E, Laitinen TP, Hutri-Kähönen N, Tossavainen P, Taittonen L, Kähönen M, Viikari JSA, Raitakari OT, Juonala M, Nuotio J. Association of number of siblings with preclinical markers of cardiovascular disease. The cardiovascular risk in Young Finns study. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 20:200227. [PMID: 38115890 PMCID: PMC10726240 DOI: 10.1016/j.ijcrp.2023.200227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
To investigate the association of number of siblings with preclinical cardiovascular disease (CVD) markers in adulthood. The sample comprised 2776 participants (54 % female) from the Cardiovascular Risk in Young Finns Study who had CVD risk factor data measured in childhood in 1980 (aged 3-18 years) and markers of preclinical CVD measured in adulthood. Echocardiography was performed in 2011, and carotid intima-media thickness, carotid distensibility, brachial flow-mediated dilatation, and arterial pulse wave velocity were measured in 2001 or 2007. The association between the number of siblings and preclinical CVD was assessed using generalized linear and logistic regression models. Analyses were stratified by sex as associations differed between sexes. Women with 1 sibling had lower E/e'-ratio (4.9, [95%CI 4.8-5.0]) in echocardiography compared with those without siblings (5.1[4.9-5.2]) and those with ≥2 more siblings (5.1[5.0-5.2]) (P for trend 0.01). Men without siblings had the lowest E/A-ratio (1.4[1.3-1.5]) compared with those with 1 sibling (1.5[1.5-1.5]), or ≥2 siblings (1.5[1.5-1.5]) (P for trend 0.01). Women without siblings had highest left ventricular ejection fraction (59.2 %[58.6-59.7 %]) compared with those with 1 sibling (59.1 %[58.8-59.4 %]), or ≥2 siblings (58.4 %[58.1-58.8 %])(P for trend 0.01). In women, brachial flow-mediated dilatation, a measure of endothelial function, was the lowest among participants with ≥2 siblings (9.4 %[9.0-9.8 %]) compared with those with 1 sibling (10.0 %[9.6-10.3 %]) and those without siblings (10.4 %[9.7-11.0 %])(P for trend 0.03). We observed that number of siblings may be associated with increased risk of heart failure in women. As the associations were somewhat inconsistent in males and females, further research is warranted.
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Affiliation(s)
- Jukka Pihlman
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Costan G. Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Tomi T. Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Saku Ruohonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Tomi P. Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Päivi Tossavainen
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, MRC Oulu and Research Unit of Clinical Medicine, University of Oulu, Finland
| | - Leena Taittonen
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, MRC Oulu and Research Unit of Clinical Medicine, University of Oulu, Finland
- Vaasa Central Hospital, Vaasa, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma SA. Viikari
- Department of Internal Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Finland
| | - Markus Juonala
- Department of Internal Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Joel Nuotio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
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2
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Shi L, Bi D, Luo J, Chen W, Yang C, Zheng Y, Hao J, Chang K, Li B, Liu C, Ta D. Associations between electrocardiogram and carotid ultrasound parameters: a healthy chinese group study. Front Physiol 2022; 13:976254. [PMID: 36003640 PMCID: PMC9393264 DOI: 10.3389/fphys.2022.976254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Electrocardiogram (ECG) and carotid ultrasound (CUS) are important tools for the diagnosis and prediction of cardiovascular disease (CVD). This study aimed to investigate the associations between ECG and CUS parameters and explore the feasibility of assessing carotid health with ECG. Methods: This cross-sectional cohort study enrolled 319 healthy Chinese subjects. Standard 12-lead ECG parameters (including the ST-segment amplitude [STA]), CUS parameters (intima-media thickness [IMT] and blood flow resistance index [RI]), and CVD risk factors (including sex, age, and systolic blood pressure [SBP]) were collected for analysis. Participants were divided into the high-level RI group (average RI ≥ 0.76, n = 171) and the normal RI group (average RI < 0.76, n = 148). Linear and stepwise multivariable regression models were performed to explore the associations between ECG and CUS parameters. Results: Statistically significant differences in sex, age, SBP, STA and other ECG parameters were observed in the normal and the high-level RI group. The STA in lead V3 yielded stronger significant correlations (r = 0.27–0.42, p < 0.001) with RI than STA in other leads, while ECG parameters yielded weak correlations with IMT (|r| ≤ 0.20, p < 0.05). STA in lead V2 or V3, sex, age, and SBP had independent contributions (p < 0.01) to predicting RI in the stepwise multivariable models, although the models for IMT had only CVD risk factors (age, body mass index, and triglyceride) as independent variables. The prediction model for RI in the left proximal common carotid artery (CCA) had higher adjusted R2 (adjusted R2 = 0.31) than the model for RI in the left middle CCA (adjusted R2 = 0.29) and the model for RI in the right proximal CCA (adjusted R2 = 0.20). Conclusion: In a cohort of healthy Chinese individuals, the STA was associated with the RI of CCA, which indicated that ECG could be utilized to assess carotid health. The utilization of ECG might contribute to a rapid screening of carotid health with convenient operations.
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Affiliation(s)
- Lingwei Shi
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Dongsheng Bi
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Jingchun Luo
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Wei Chen
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Cuiwei Yang
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Yan Zheng
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Ju Hao
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Ke Chang
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Boyi Li
- Academy for Engineering and Technology, Fudan University, Shanghai, China
- *Correspondence: Boyi Li, ; Chengcheng Liu,
| | - Chengcheng Liu
- Academy for Engineering and Technology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Fudan University, Shanghai, China
- *Correspondence: Boyi Li, ; Chengcheng Liu,
| | - Dean Ta
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
- Academy for Engineering and Technology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Fudan University, Shanghai, China
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3
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Bampatsias D, Mavroeidis I, Tual-Chalot S, Vlachogiannis NL, Bonini F, Sachse M, Mavraganis G, Mareti A, Kritsioti C, Laina A, Delialis D, Ciliberti G, Sopova K, Gatsiou A, Martelli F, Georgiopoulos G, Stellos K, Stamatelopoulos K. Beta-secretase-1 antisense RNA is associated with vascular ageing and atherosclerotic cardiovascular disease. Thromb Haemost 2022; 122:1932-1942. [PMID: 35915966 PMCID: PMC9626031 DOI: 10.1055/a-1914-2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background
The noncoding antisense transcript for β-secretase-1 (
BACE1-AS
) is a long noncoding RNA with a pivotal role in the regulation of amyloid-β (Aβ). We aimed to explore the clinical value of
BACE1-AS
expression in atherosclerotic cardiovascular disease (ASCVD).
Methods
Expression of
BACE1-AS
and its target, β-secretase 1 (
BACE1
) mRNA, was measured in peripheral blood mononuclear cells derived from 434 individuals (259 without established ASCVD [non-CVD], 90 with stable coronary artery disease [CAD], and 85 with acute coronary syndrome). Intima-media thickness and atheromatous plaques evaluated by ultrasonography, as well as arterial wave reflections and pulse wave velocity, were measured as markers of subclinical ASCVD. Patients were followed for a median of 52 months for major adverse cardiovascular events (MACE).
Results
In the cross-sectional arm,
BACE1-AS
expression correlated with
BACE1
expression (
r
= 0.396,
p
< 0.001) and marginally with Aβ1–40 levels in plasma (
r
= 0.141,
p
= 0.008). Higher
BACE1-AS
was associated with higher estimated CVD risk assessed by HeartScore for non-CVD subjects and by European Society of Cardiology clinical criteria for the total population (
p
< 0.05 for both).
BACE1-AS
was associated with higher prevalence of CAD (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.37–2.5), multivessel CAD (OR = 1.36, 95% CI: 1.06–1.75), and with higher number of diseased vascular beds (OR = 1.31, 95% CI: 1.07–1.61, for multiple diseased vascular beds) after multivariable adjustment for traditional cardiovascular risk factors. In the prospective arm,
BACE1-AS
was an independent predictor of MACE in high cardiovascular risk patients (adjusted hazard ratio = 1.86 per ascending tertile, 95% CI: 1.011–3.43,
p
= 0.046).
Conclusion
BACE1-AS
is associated with the incidence and severity of ASCVD.
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Affiliation(s)
- Dimitrios Bampatsias
- Alexandra University Hospital, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Ioannis Mavroeidis
- Alexandra University Hospital, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Simon Tual-Chalot
- Institute of Bioscience, Vascular Biology and Medicine Theme, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Nikolaos L Vlachogiannis
- Biosciences Institute, Vascular Biology and Medicine Theme, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Francesca Bonini
- Department of Cardiovascular Research, European Center for Angioscience (ECAS), Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Germany
| | - Marco Sachse
- Department of Cardiovascular Research, Goethe University Frankfurt Faculty 16 Medicine, Frankfurt am Main, Germany.,Department of Cardiovascular Research, European Center for Angioscience (ECAS), Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Germany
| | - Georgios Mavraganis
- Alexandra University Hospital, Department of Clinical Therapeutics, National and Kapodistrian University of Athens Aiginitio Hospital, Athens, Greece
| | - Alexia Mareti
- Alexandra University Hospital, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Chrysoula Kritsioti
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Ageliki Laina
- Alexandra University Hospital, Department of Clinical Therapeutics,, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Delialis
- National and Kapodistrian University of Athens School of Medicine Therapeutic Clinic, Athens, Greece
| | - Giorgia Ciliberti
- Department of Cardiovascular Research, European Center for Angioscience (ECAS), Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Germany
| | - Kateryna Sopova
- Faculty of Medical Sciences, Newcastle University, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Aikaterini Gatsiou
- , Biosciences Institute, Vascular Biology and Medicine Theme, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Fabio Martelli
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Georgios Georgiopoulos
- National and Kapodistrian University of Athens School of Medicine Therapeutic Clinic, Athens, Greece
| | - Konstantinos Stellos
- Department of Cardiovascular Research, European Center for Angioscience (ECAS), Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Germany.,Department of Cardiology, Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Germany.,Biosciences Institute, Vascular Biology and Medicine Theme, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Kimon Stamatelopoulos
- Alexandra University Hospital, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.,Vascular Biology and Medicine Theme, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
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4
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Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study. PLoS One 2022; 17:e0262831. [PMID: 35171918 PMCID: PMC8849516 DOI: 10.1371/journal.pone.0262831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/12/2021] [Indexed: 11/19/2022] Open
Abstract
Patients with type 2 diabetes who have cardiovascular disease and are receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes. In contrast, glimepiride increases cardiovascular hospitalization when combined with metformin. Here, we assessed the effects of empagliflozin and glimepiride on endothelial function using flow-mediated dilation (FMD). In this prospective, open-label, randomized, parallel-group study, 63 patients with type 2 diabetes received metformin and insulin glargine U100 for 12 weeks. This was followed by additional treatment with empagliflozin or glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (ΔFMDs) at 24 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. The empagliflozin group (n = 33) and glimepiride group (n = 30) showed no significant differences in ΔFMDs (empagliflozin, −0.11 [95%CI: -1.02, 0.80]%; glimepiride, −0.34 [95%CI: -1.28, 0.60]%; P = 0.73). Additionally, changes in glycated hemoglobin were similar between the two groups. However, a significant difference in body weight change was observed (empagliflozin, −0.58 [95%CI: -1.60, 0.43] kg; glimepiride, 1.20 [95%CI: 0.15, 2.26] kg; P = 0.02). Moreover, a body composition analysis revealed that body fluid volume significantly decreased after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, −0.33 ± 0.72 L; P = 0.03). Hence, although empagliflozin did not improve endothelial function compared with glimepiride for patients with type 2 diabetes, it did decrease body fluid volumes. Thus, the coronary-protective effect of empagliflozin is not derived from endothelial function protection, but rather from heart failure risk reduction.
Trial registration: This trial was registered on September 13, 2016; UMIN000024001.
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5
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Rafati M, Zali A, Ghorbanpour A, Sehhati M. Analysis of sequential ultrasound frames for the measurement of hemodynamic stresses, critical bent buckling pressure, and critical buckling torque of human common carotid atherosclerosis. Clin Biomech (Bristol, Avon) 2021; 87:105401. [PMID: 34098148 DOI: 10.1016/j.clinbiomech.2021.105401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 04/01/2021] [Accepted: 05/27/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Structural properties of the arterial wall are important diagnostic parameters. The current study aimed at investigating the hemodynamic properties and intima-media thickness changes of the common carotid artery in human subjects with atherosclerosis in order to determine the relationships between these indices. METHODS This study presented methods to detect instantaneous changes in the lumen diameter, intima media thickness, longitudinal movement and acceleration, and velocity of the left side of common carotid artery. These parameters were measured in 155 male patients, categorized into control (n = 42), mild (n = 39), moderate (n = 37), and severe (n = 37) carotid stenosis groups by B-mode and Doppler ultrasonography. Extracted parameters were used to estimate the biomechanical properties of arteries, including radial strain, arterial stiffness index, Young's elastic modulus, circumferential stress, shear stress, axial stress, critical bent buckling pressure, and critical buckling torque. FINDINGS All biomechanical parameters of common carotid artery were significantly different in patients with mild, moderate, and severe stenosis, compared to the control group (P < 0.05). Moreover, the current results showed a significant correlation between intima media thickness and non-intima media thickness-based biomechanical indices including circumferential strain, stiffness index, and shear stress in different stenosis groups (P < 0.05). INTERPRETATION We concluded that the conventional and new indicators such as axial stress, critical bent buckling pressure, critical buckling torque could be useful for evaluating atherosclerosis development and also, may provide more information for physicians and interventional radiologists in designing strategies for decreasing risk in interventional treatment such as stent replacement and differentiation of vulnerable plaques.
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Affiliation(s)
- Mehravar Rafati
- Department of Medical Physics and Radiology, Faculty of Paramedicine, University of Medical Sciences, Kashan, Iran
| | - Atieh Zali
- Department of Medical Physics and Radiology, Faculty of Paramedicine, University of Medical Sciences, Kashan, Iran
| | - Ali Ghorbanpour
- Department of Mechanical Engineering, Faculty of Engineering, University of Kashan, Kashan, Iran.
| | - Mohammadreza Sehhati
- Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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6
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Konno N, Harada T, Akamatsu D, Goto H, Miki T, Kamei T, Kohzuki M. The area under curve for time-course analysis parameters is associated with abdominal aortic aneurysms and the severity of peripheral artery disease in men. Int J Cardiol Hypertens 2021; 8:100080. [PMID: 33644742 PMCID: PMC7893437 DOI: 10.1016/j.ijchy.2021.100080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/24/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background Abdominal aortic aneurysm (AAA) and peripheral artery disease (PAD) are associated with vascular endothelial dysfunction. To date, flow-mediated vasodilatation (FMD) and nitroglycerin-mediated vasodilatation (NMD) have been used to evaluate vascular function. Recently, parameters of time-course analysis have been proposed as useful evaluations for arteriosclerotic diseases. In this study, the correlation between the parameters of time-course analysis, to the degree of vascular endothelial damage in AAA and PAD, together with their applicability as a vascular function test, was investigated. Methods Brachial artery vasoreactivity was assessed in male patients with AAA (n = 150) and PAD (n = 50). The percentage change in peak diameters (ΔFMD and ΔNMD), the time to diameter change, the time to peak diameter from the diameter change, the blood flow decay time constant, the area under the curve (AUC), the maximum dilation rate and the extended time constant were measured. Results Among the groups of aneurysm diameter in AAA, the FMD-AUC was highly different (p = .01), while the ΔFMD was not significantly different (p = .36). Among the Fontaine stages in PAD, the FMD-AUC was inversely associated with severity (p = .01) although the ΔFMD was not significantly different (p = .71). Among the Fontaine stages, the NMD-AUC was also inversely associated with severity (p = .03) although the ΔNMD was not significantly different (p = .11). Conclusion This study suggests that FMD-AUC and NMD-AUC are useful for estimating vascular endothelial and vascular smooth muscle dysfunction, serving as supplementary markers for the diagnosis and evaluation of PAD and AAA.
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Affiliation(s)
- Nao Konno
- Department of Internal Medicine and Rehabilitation Science, Graduate School of Medicine, Tohoku University.,Department of Clinical Physiological Laboratory Center, Tohoku University
| | - Taku Harada
- Department of Internal Medicine and Rehabilitation Science, Graduate School of Medicine, Tohoku University
| | - Daijirou Akamatsu
- Department of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University
| | - Hitoshi Goto
- Department of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University
| | - Takashi Miki
- Department of Clinical Physiological Laboratory Center, Tohoku University
| | - Takashi Kamei
- Department of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Graduate School of Medicine, Tohoku University
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7
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Thorsteinsdottir H, Christensen JJ, Holven KB, Tveiterås M, Brun H, Åsberg A, Bjerre A. Cardiovascular Risk Factors are Inversely Associated With Omega-3 Polyunsaturated Fatty Acid Plasma Levels in Pediatric Kidney Transplant Recipients. J Ren Nutr 2020; 31:278-285. [PMID: 32792219 DOI: 10.1053/j.jrn.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/08/2020] [Accepted: 06/05/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES High plasma levels of the omega-3 fatty acids eicosapentaenoic acid (EPA), docosahexaenoic acid, and docosapentaenoic acid associates with positive outcomes in adult renal transplant recipients. However, data from pediatric populations are scarce. The aim of the study was to assess the fatty acid profile in a pediatric renal transplantation cohort and to examine the associations between plasma omega-3 fatty acids and cardiovascular disease (CVD) risk factors. METHODS In this cross-sectional study comprising 53 children (median age, 12.2 years; 32 boys) with a renal transplant, we assessed the prevalence of CVD risk factors as well as markers of end organ damage: carotid intima-media thickness (cIMT) and left ventricular mass index. The associations between plasma omega-3 fatty acids and CVD risk factors were assessed. RESULTS Twenty-five (47%) patients were preemptively transplanted. Seventy-six percent had dyslipidemia and 51% had hypertension. The mean left ventricular mass index was 40.4 ± 14.3 g/m2.7, and 14% had left ventricular hypertrophy. The mean cIMT was 0.41 ± 0.04 mm. In a multivariate linear regression, EPA levels were inversely associated to blood pressure (β coeff. = -0.37, P = .007), triglycerides (β coeff. = -0.44, P = .01), and high-density lipoprotein cholesterol (β coeff. = -0.41, P = .01). CONCLUSION EPA levels are inversely associated with components of the metabolic syndrome, which may provide support for specific dietary advice or supplementation in this patient population. cIMT is less pronounced in our cohort than in comparable cohorts with lower rate of preemptive transplantations. Our results need replication in prospective cohorts.
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Affiliation(s)
- Hjørdis Thorsteinsdottir
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Pediatric Research, Oslo University Hospital, Oslo, Norway.
| | - Jacob Juel Christensen
- The Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Department of Nutrition, Institute for Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kirsten B Holven
- The Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Department of Nutrition, Institute for Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Målfrid Tveiterås
- Division of Radiology and Nuclear Medicine, Department of Paediatric Radiology, Oslo University Hospital, Oslo, Norway
| | - Henrik Brun
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Anders Åsberg
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo Norway; Section of Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Anna Bjerre
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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8
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Increased arterial velocity pulse index is an independent factor related to skeletal muscle mass reduction and tissue damage in patients with cardiovascular disease. Hypertens Res 2020; 43:534-542. [DOI: 10.1038/s41440-020-0404-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/09/2019] [Accepted: 12/23/2019] [Indexed: 11/08/2022]
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9
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Nerve conduction velocity is negatively associated with intima-media thickness and brachial-ankle pulse wave velocity in men with type 2 diabetes mellitus. PLoS One 2018; 13:e0209503. [PMID: 30571795 PMCID: PMC6301707 DOI: 10.1371/journal.pone.0209503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022] Open
Abstract
Objective Previous studies suggest that the presence of diabetic peripheral polyneuropathy (DPN) is associated with atherosclerotic diseases; however, little is known about the relationship between diabetic nerve conduction velocity (NCV) versus arterial stiffness and atherosclerosis parameters. Methods The subjects in this study were 292 men with type 2 diabetes mellitus (T2DM). All subjects underwent NCV examination at median and tibial nerves as motor nerve (MCV) as well as median and sural nerves as sensory nerve (SCV). Brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (IMT) were evaluated as arterial stiffness and atherosclerosis parameters. Results Pearson’s correlation coefficient showed that NCV at all sites negatively correlated with baPWV, maximal and mean IMT (IMT-Max and IMT-Mean), and plaque score (all p values p<0.01 at least). Multiple regression analyses adjusted for confounding factors such as age, duration of diabetes, body mass index, HbA1c, fasting C-peptide, systolic blood pressure, HDL-cholesterol, LDL-cholesterol and albuminuria showed that the association of NCV with IMT-Max, ITM-Mean, and plaque score remained significant (all p values p<0.05 at least) except that between SCV at median and IMT-Max. Moreover, SCV at median (forearm) and sural were significantly associated with baPWV (p = 0.023 and p = 0.027, respectively). Conclusion The present study showed that DPN estimated by quantitative NCV is linearly associated with the deterioration of arterial stiffness and atherosclerosis parameters in T2DM independently of various diabetic and atherosclerotic factors.
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Early Effects of Renal Replacement Therapy on Cardiovascular Comorbidity in Children With End-Stage Kidney Disease: Findings From the 4C-T Study. Transplantation 2018; 102:484-492. [PMID: 28926375 DOI: 10.1097/tp.0000000000001948] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The early impact of renal transplantation on subclinical cardiovascular measures in pediatric patients has not been widely investigated. This analysis is performed for pediatric patients participating in the prospective cardiovascular comorbidity in children with chronic kidney disease study and focuses on the early effects of renal replacement therapy (RRT) modality on cardiovascular comorbidity in patients receiving a preemptive transplant or started on dialysis. METHODS We compared measures indicating subclinical cardiovascular organ damage (aortal pulse wave velocity, carotid intima media thickness, left ventricular mass index) and evaluated cardiovascular risk factors in 166 pediatric patients before and 6 to 18 months after start of RRT (n = 76 transplantation, n = 90 dialysis). RESULTS RRT modality had a significant impact on the change in arterial structure and function: compared to dialysis treatment, transplantation was independently associated with decreases in pulse wave velocity (ß = -0.67; P < 0.001) and intima media thickness (ß = -0.40; P = 0.008). Independent of RRT modality, an increase in pulse wave velocity was associated with an increase in diastolic blood pressure (ß = 0.31; P < 0.001). Increasing intima media thickness was associated with a larger increase in body mass index (ß = 0.26; P = 0.003) and the use of antihypertensive agents after RRT (ß = 0.41; P = 0.007). Changes in left ventricular mass index were associated with changes in systolic blood pressure (ß = 1.47; P = 0.01). CONCLUSIONS In comparison with initiating dialysis, preemptive transplantation prevented further deterioration of the subclinical vascular organ damage early after transplantation. Classic cardiovascular risk factors, such as hypertension and obesity are of major importance for the development of cardiovascular organ damage after renal transplantation.
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Kabutoya T, Hoshide S, Kario K. Integrated flow-mediated vasodilation response predicts cardiovascular events in elderly patients with cardiovascular risk factors: the Japan Morning Surge–Home Blood Pressure study. ACTA ACUST UNITED AC 2018; 12:340-345.e2. [DOI: 10.1016/j.jash.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/13/2018] [Accepted: 03/14/2018] [Indexed: 11/15/2022]
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12
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Influence of cardiovascular risk factors on longitudinal motion of the common carotid artery wall. Atherosclerosis 2018; 272:54-59. [DOI: 10.1016/j.atherosclerosis.2018.02.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/08/2018] [Accepted: 02/28/2018] [Indexed: 11/24/2022]
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Shigiyama F, Kumashiro N, Miyagi M, Ikehara K, Kanda E, Uchino H, Hirose T. Effectiveness of dapagliflozin on vascular endothelial function and glycemic control in patients with early-stage type 2 diabetes mellitus: DEFENCE study. Cardiovasc Diabetol 2017; 16:84. [PMID: 28683796 PMCID: PMC5500953 DOI: 10.1186/s12933-017-0564-0] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 06/20/2017] [Indexed: 12/22/2022] Open
Abstract
Background Recent studies reported that sodium glucose cotransporter 2 (SGLT2) inhibitors can potentially reduce the risk of cardiovascular mortality in patients with type 2 diabetes mellitus (T2DM). However, there is little or no information on the therapeutic effects of SGLT2 inhibitors on the progression of atherosclerosis. This dapagliflozin effectiveness on vascular endothelial function and glycemic control (DEFENCE) study was designed to determine the effects of dapagliflozin, a SGLT2 inhibitor, on endothelial function in patients with early-stage T2DM. Methods DEFENCE is a prospective, randomized, open-label, blinded-endpoint, parallel-group, comparative clinical trial. Between October 2015 and August 2016, 80 T2DM patients treated with 750 mg of metformin (hemoglobin A1c ≥6.0 and <8.0%, n = 80) were enrolled and randomized to receive either 1500 mg/day metformin (the metformin group, n = 40), or 750 mg/day metformin supplemented with 5 mg/day dapagliflozin (the dapagliflozin group, n = 40), for 16 weeks. The primary endpoint was a change in flow-mediated dilation (FMD) from baseline to the end of the 16-week treatment period. The secondary outcomes include changes in indexes of glycemic control, lipid metabolism, and oxidative stress, body composition, and safety evaluation. Results Although FMD tended to improve only in the dapagliflozin group, ΔFMD was comparable between the two groups. Analysis of patients with HbA1c >7.0% showed significant improvement of FMD in the dapagliflozin group than metformin group (P < 0.05). HbA1c, fasting plasma glucose, plasma glucagon, and body weight significantly decreased in both groups. Interestingly, urine 8-hydroxy-2′-deoxyguanosin, a biomarker of oxidative stress, was significantly lower in the dapagliflozin group than metformin group at 16 weeks (P < 0.001). Conclusions Dapagliflozin add-on therapy to metformin for 16 weeks improved endothelial function, as assessed by FMD, in patients with inadequately controlled early-stage T2DM. Improvement in oxidative stress may contribute to the improvement in FMD. Trial registration University Hospital Medical Information Network Clinical Trial Registry (UMIN000018754) Electronic supplementary material The online version of this article (doi:10.1186/s12933-017-0564-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fumika Shigiyama
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Naoki Kumashiro
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
| | - Masahiko Miyagi
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Kayoko Ikehara
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Eiichiro Kanda
- Department of Nephrology, Tokyo Kyosai Hospital, Tokyo, Japan.,Life Science and Bioethics Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Uchino
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Takahisa Hirose
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
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Nakahigashi M, Tsukaguchi H, Morimoto S, Nakano C, Ueda H, Someya K, Kusabe M, Kikuchi S, Imada T, Shiojima I. Determinants of the Change in Arterial Stiffness in Peritoneal Dialysis Patients. Int Heart J 2017; 58:915-925. [DOI: 10.1536/ihj.16-624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | | | - Satoshi Morimoto
- Department of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University
| | | | - Hiroko Ueda
- Department of Medicine II, Kansai Medical University
| | | | - Makiko Kusabe
- Department of Medicine II, Kansai Medical University
| | - Sanae Kikuchi
- Department of Medicine II, Kansai Medical University
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Shigiyama F, Kumashiro N, Miyagi M, Iga R, Kobayashi Y, Kanda E, Uchino H, Hirose T. Linagliptin improves endothelial function in patients with type 2 diabetes: A randomized study of linagliptin effectiveness on endothelial function. J Diabetes Investig 2016; 8:330-340. [PMID: 27868359 PMCID: PMC5415473 DOI: 10.1111/jdi.12587] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/02/2016] [Accepted: 10/13/2016] [Indexed: 12/29/2022] Open
Abstract
AIMS/INTRODUCTION The present multicenter, prospective, controlled, open and randomized three-arm parallel study was designed to compare the effects of linagliptin with those of metformin on endothelial function. MATERIALS AND METHODS Type 2 diabetes patients treated with 750 mg of metformin (hemoglobin A1c ≥6.0% and <8.0%, n = 96) were randomized to continue metformin 750 mg/day (control group, n = 29), metformin at 1,500 mg/day (metformin group, n = 26) and metformin 750 mg/day supplemented with linagliptin 5 mg/day (linagliptin add-on group, n = 29) and treated for 16 weeks. Vascular endothelial function was evaluated by flow-mediated dilation. The primary end-point was changes in flow-mediated dilation at 16 weeks relative to baseline. RESULTS Linagliptin significantly improved flow-mediated dilation from baseline (4.9 ± 2.7%) to 16 weeks (6.3 ± 2.7%, P < 0.05), whereas the other groups did not show any changes. Hemoglobin A1c at 16 weeks was significantly lower in the metformin and linagliptin add-on groups compared with the control (6.6 ± 0.6%, 6.5 ± 0.5% and 7.0 ± 0.6%, respectively). Single and multiple regression analyses showed that apolipoprotein B correlated significantly with change in flow-mediated dilation, and apolipoprotein B was decreased only in the linagliptin add-on group (-6.0 ± 11.3 mg/dL, P < 0.01). CONCLUSIONS Linagliptin for 16 weeks improved endothelial function with a modest improvement in glycemic control. This effect was mediated, at least in part, by reduction in apolipoprotein B. Linagliptin has a protective role on endothelial function in patients with type 2 diabetes with moderate hyperglycemia.
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Affiliation(s)
- Fumika Shigiyama
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Naoki Kumashiro
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Masahiko Miyagi
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Ryo Iga
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Yuka Kobayashi
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Eiichiro Kanda
- Department of Nephrology, Tokyo Kyosai Hospital, Tokyo, Japan.,Life Science and Bioethics Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Uchino
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Takahisa Hirose
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan
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Celer O, Akalın A, Oztunali C. Effect of teriparatide treatment on endothelial function, glucose metabolism and inflammation markers in patients with postmenopausal osteoporosis. Clin Endocrinol (Oxf) 2016; 85:556-60. [PMID: 27321876 DOI: 10.1111/cen.13139] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/10/2016] [Accepted: 06/16/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Teriparatide, an anabolic agent used in the treatment of postmenopausal osteoporosis, can induce effects similar to primary hyperparathyroidism. Our objective was to evaluate the effects of teriparatide on endothelial functions, glucose metabolism and inflammation markers in patients diagnosed with postmenopausal osteoporosis. DESIGN, PATIENTS AND MEASUREMENTS This was a single-centre, single-arm, 6-month prospective study. Twenty-three postmenopausal women over 65 years old with a lumbar spine or femoral neck T-score of -4·0 or lower and having at least two compression fractures in thoracic or lumbar spine were studied. Low-dose intermittent teriparatide (20 μg/day) was supplemented with calcium carbonate (1000 mg elemental calcium) and 880 IU cholecalciferol for 6 months. The biochemical parameters for glucose metabolism, inflammation and atherosclerosis were determined. For the assessment of vascular endothelial function, carotid intima-media thickness (CIMT), brachial artery intima-media thickness (BIMT), per cent change in flow-mediated dilation (FMD%) and nitroglycerine-induced dilations (NID%) were measured on ultrasonography. RESULTS The fasting plasma glucose, homoeostatic model assessment of insulin resistance, fibrinogen, homocysteine and high-density lipoprotein cholesterol increased significantly with teriparatide treatment (P < 0·05 for all). Baseline CIMT and BIMT did not change significantly with 6 months of teriparatide treatment (P > 0·05); however, FMD% and NID% showed significant decrease after treatment (P < 0·01 for both). CONCLUSIONS Intermittent teriparatide treatment may adversely affect some parameters of glucose metabolism, inflammation and endothelial function. On the basis of our findings, further large-scale and controlled studies are needed to clarify the exact effect of teriparatide treatment on glucose metabolism, inflammation and endothelial function.
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Affiliation(s)
- Ozgen Celer
- Department of Endocrinology and Metabolism, Eskisehir Osmangazi University, Eskisehir, Turkey.
| | - Aysen Akalın
- Department of Endocrinology and Metabolism, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Cigdem Oztunali
- Department of Radiology, Eskisehir Osmangazi University, Eskisehir, Turkey
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18
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Kondo T, Endo I, Aihara KI, Onishi Y, Dong B, Ohguro Y, Kurahashi K, Yoshida S, Fujinaka Y, Kuroda A, Matsuhisa M, Fukumoto S, Matsumoto T, Abe M. Serum carboxy-terminal telopeptide of type I collagen levels are associated with carotid atherosclerosis in patients with cardiovascular risk factors. Endocr J 2016; 63:397-404. [PMID: 26877258 DOI: 10.1507/endocrj.ej15-0589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Carboxy-terminal telopeptide of type I collagen (ICTP) is generated through matrix metalloproteinase (MMP)-dependent type I collagen digestion, and has been widely utilized as a biomarker for bone turnover. The fact that atherosclerotic lesions are rich in both type I collagen and MMP-producing macrophages led to the hypothesis that serum ICTP concentrations may serve as a non-invasive clinical biomarker for atherosclerosis. Therefore, the association of serum ICTP concentrations with the maximum intima-media thickness (IMT) of carotid arteries, a surrogate index of systemic atherosclerosis, or brachial-ankle pulse wave velocity (baPWV) in patients with atherosclerotic risk factors was evaluated. A total of 52 male and 65 female (mean age: 62.8 yrs) patients without renal failure, malignancies or bone diseases known to affect serum ICTP concentrations were recruited. Patients with max IMTs ≥1.1 mm showed significantly higher serum ICTP concentrations compared with patients with max IMTs <1.1 mm (3.33 ± 0.97 vs 2.82 ± 0.65 ng/mL, p<0.05). Serum ICTP concentration was also positively correlated with max IMT (p<0.001) or baPWV values (p<0.05). Multivariate analyses also revealed that serum ICTP concentrations were correlated with max IMT (p<0.001; 95% CI 0.200 to 0.454). These results suggest that serum ICTP concentrations can be used as a non-invasive biomarker for systemic atherosclerosis.
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Affiliation(s)
- Takeshi Kondo
- Department of Hematology, Endocrinology & Metabolism Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
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Aoi S, Miyake T, Iida T, Ikeda H, Ishizaki F, Chikamura C, Tamura N, Nitta Y, Harada T, Miyaguchi H. Association of Changes in Neck Circumference with Cardiometabolic Risk in Postmenopausal Healthy Women. J Atheroscler Thromb 2016; 23:728-36. [PMID: 26797264 DOI: 10.5551/jat.31963] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Although neck circumference (NC) is thought to predict obesity-related metabolic abnormality, its causal role in cardiometabolic risk is unclear. The aim of this study was to clarify the impact of changes in NC on cardiometabolic risk in healthy postmenopausal women through a community-based longitudinal study. METHODS From a local community in Japan, 63 generally healthy postmenopausal women were recruited. All participants received an assessment of obesity-related anthropometric markers, biochemical parameters, and hemodynamic measures and were followed on average for 3 years. RESULTS At baseline analysis, larger NC was positively associated with atherosclerosis-related markers, brachial-ankle pulse wave velocity (baPWV) and blood pressure, as well as some lipid parameters. After the follow-up period, change in NC was associated with changes in body mass index (BMI), body fat percentage, and waist circumference (WC). Interestingly, significant correlations of change in NC with changes in baPWV and blood pressure were observed, whereas changes in WC and BMI were only associated with changes in low-density lipoprotein cholesterol and/or total cholesterol. In multivariate linear regression analysis, change in NC was significantly associated with changes in baPWV and systolic blood pressure, independent of changes in BMI, WC, and biochemical parameters. In addition, an increase in NC was associated with a 2.69-fold increased odds ratio of accelerated baPWV. CONCLUSIONS Change in NC was independently associated with changes in atherosclerosis-related markers. These observations suggest that NC is an important predictor of the risk of developing obesity-related atherosclerosis in healthy postmenopausal women.
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Affiliation(s)
- Satomi Aoi
- Faculty of Health and Welfare, Prefectural University of Hiroshima
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20
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Taivainen SH, Yli-Ollila H, Juonala M, Kähönen M, Raitakari OT, Laitinen TM, Laitinen TP. Interrelationships between indices of longitudinal movement of the common carotid artery wall and the conventional measures of subclinical arteriosclerosis. Clin Physiol Funct Imaging 2015; 37:305-313. [DOI: 10.1111/cpf.12305] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/03/2015] [Indexed: 01/19/2023]
Affiliation(s)
- S. Helena Taivainen
- Department of Clinical Physiology and Nuclear Medicine; Kuopio University Hospital; Kuopio Finland
- Department of Clinical Physiology and Nuclear Medicine; University of Eastern Finland; Kuopio Finland
| | - Heikki Yli-Ollila
- Department of Clinical Physiology and Nuclear Medicine; Kuopio University Hospital; Kuopio Finland
- Department of Applied Physics; University of Eastern Finland; Kuopio Finland
| | - Markus Juonala
- Department of Medicine; University of Turku; Turku Finland
- Division of Medicine; Turku University Hospital; Turku Finland
- Murdoch Children's Research Institute; Parkville Vic. Australia
| | - Mika Kähönen
- Department of Clinical Physiology; Tampere University Hospital; Tampere Finland
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine; University of Turku; Turku Finland
- Department of Clinical Physiology and Nuclear Medicine; Turku University Hospital; Turku Finland
| | - Tiina M. Laitinen
- Department of Clinical Physiology and Nuclear Medicine; Kuopio University Hospital; Kuopio Finland
| | - Tomi P. Laitinen
- Department of Clinical Physiology and Nuclear Medicine; Kuopio University Hospital; Kuopio Finland
- Department of Clinical Physiology and Nuclear Medicine; University of Eastern Finland; Kuopio Finland
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Tani A, Yamamoto S, Maegawa M, Kunimi K, Matsui S, Keyama K, Kato T, Uemura H, Kuwahara A, Matsuzaki T, Yasui T, Kamada M, Soeki T, Sata M, Irahara M. Arterial stiffness is increased in young women with endometriosis. J OBSTET GYNAECOL 2014; 35:711-5. [PMID: 25543526 DOI: 10.3109/01443615.2014.992871] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Endometriosis is a chronic gynaecological disorder that is accompanied by inflammation and oxidative stress. Atherosclerosis has a long subclinical progression in arteries of children and young adults decades before overt clinical manifestations of the disease. In this study, we determined arterial stiffness by measuring brachial-ankle pulse wave velocity (baPWV) in women with endometriosis to assess the presence of subclinical atherosclerosis. We also measured markers of inflammation and oxidative stress in women with endometriosis. baPWV in women with endometriosis aged over 30 years was significantly higher than that in women without endometriosis aged over 30 years (p < 0.05), but not in women aged less than 30. Serum high-sensitivity C-reactive protein level in women with endometriosis was significantly higher than that in controls (p < 0.05). Young women with endometriosis show significantly increased arterial stiffness, suggesting that women with endometriosis need to be cautious of the future onset of atherosclerosis.
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Affiliation(s)
- A Tani
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - S Yamamoto
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - M Maegawa
- b Department of Obstetrics and Gynecology , Tokushima Prefectural Central Hospital , Tokushima , Japan
| | - K Kunimi
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - S Matsui
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - K Keyama
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - T Kato
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - H Uemura
- c Department of Preventive Medicine , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - A Kuwahara
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - T Matsuzaki
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - T Yasui
- d Department of Reproductive Technology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
| | - M Kamada
- e Department of Obstetrics and Gynecology , Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers , Ehime , Japan
| | - T Soeki
- f Department of Cardiovascular Medicine , Institute of Health Bioscience, The University of Tokushima Graduate School , Tokushima , Japan
| | - M Sata
- f Department of Cardiovascular Medicine , Institute of Health Bioscience, The University of Tokushima Graduate School , Tokushima , Japan
| | - M Irahara
- a Department of Obstetrics and Gynecology , Institute of Health Biosciences, The University of Tokushima Graduate School , Tokushima , Japan
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Miyagi T, Kohagura K, Ishiki T, Kochi M, Kinjyo T, Kinjyo K, Maehara Y, Sakima A, Iseki K, Ohya Y. Interrelationship between brachial artery function and renal small artery sclerosis in chronic kidney disease. Hypertens Res 2014; 37:863-9. [PMID: 24646648 DOI: 10.1038/hr.2014.60] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/06/2014] [Accepted: 01/25/2014] [Indexed: 02/01/2023]
Abstract
Chronic kidney disease (CKD), characterized by senile inflammation, is a risk factor for cardiovascular disease. Conduit artery function and small artery structure relate to cardiovascular disease. We examined the correlations, determinants and interrelationships of arterial indices in association with CKD in a cross-sectional study of 139 patients (60% male; mean age 44 years) with CKD (stages 3-5, 39%) who underwent a renal biopsy. Conduit artery function and small artery sclerosis were assessed by brachial artery flow-mediated dilatation (FMD) and semiquantitative evaluation of small artery intimal thickening (SA-IT), respectively. The estimated glomerular filtration rate correlated with FMD (r=0.31, P=0.0002) and inversely correlated with SA-IT (r=-0.54, P<0.0001). Multiple regression analysis showed that FMD was inversely correlated with SA-IT and vice versa. In addition, high-sensitivity C-reactive protein (hs-CRP) was significantly correlated with SA-IT, but not FMD. Multiple logistic analysis revealed that higher hs-CRP concomitant with decreased FMD was further associated with the risk of severe SA-IT compared with their individual effects. These findings suggest that both conduit artery and small artery disease develop with mutual interaction in parallel with decreased kidney function. Coexistence of inflammation and conduit artery dysfunction may be closely related to renal small artery sclerosis in patients with CKD.
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Affiliation(s)
- Tsuyoshi Miyagi
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Kentaro Kohagura
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Tetsuya Ishiki
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Masako Kochi
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Takanori Kinjyo
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Kojiro Kinjyo
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Yuichi Maehara
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Atsushi Sakima
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Kunitoshi Iseki
- Dialysis Unit, University Hospital of the Ryukyus, Nishihara-cho, Japan
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
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Kabutoya T, Hoshide S, Ogata Y, Eguchi K, Kario K. Masked Hypertension Defined by Home Blood Pressure Monitoring Is Associated With Impaired Flow-Mediated Vasodilatation in Patients With Cardiovascular Risk Factors. J Clin Hypertens (Greenwich) 2013; 15:630-6. [DOI: 10.1111/jch.12155] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/09/2013] [Accepted: 05/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine; Jichi Medical University School of Medicine; Tochigi Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine; Jichi Medical University School of Medicine; Tochigi Japan
| | - Yukiyo Ogata
- Division of Cardiovascular Medicine, Department of Medicine; Jichi Medical University School of Medicine; Tochigi Japan
| | - Kazuo Eguchi
- Division of Cardiovascular Medicine, Department of Medicine; Jichi Medical University School of Medicine; Tochigi Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine; Jichi Medical University School of Medicine; Tochigi Japan
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Watanabe K, Suzuki T, Ouchi M, Suzuki K, Ohara M, Hashimoto M, Yamashita H, Okazaki M, Ishii K, Oba K. Relationship between postprandial glucose level and carotid artery stiffness in patients without diabetes or cardiovascular disease. BMC Cardiovasc Disord 2013; 13:11. [PMID: 23442745 PMCID: PMC3598373 DOI: 10.1186/1471-2261-13-11] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 02/22/2013] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the relationship between postprandial glucose level and atherosclerosis in patients without diabetes and cardiovascular disease by determining carotid ultrasonographic variables and serum levels of 1,5-anhydroglucitol (1,5-AG). METHODS The subjects were 72 patients without diabetes and cardiovascular disease being treated for hypertension or dyslipidemia. The clinical characteristics of all subjects, including the serum level of 1,5-AG, which appears to be well suited for monitoring postprandial hyperglycemia, were evaluated after an overnight fast. The average intima-media thickness (IMT) and the average pulsatility index (PI) of the right and left common carotid arteries were determined with high-resolution ultrasonography and used as ultrasonographic variables. The subjects were divided into a lower 1,5-AG group (n = 36) and a higher 1,5-AG group (n = 36). We evaluated the relationship between clinical characteristics and ultrasonographic variables of the carotid artery in both groups. RESULTS The average PI in the Lower 1,5-AG group was significantly higher than that in the Higher 1,5-AG group, but the average IMT did not differ between the groups. Linear regression analysis, with the ultrasonographic variables as the dependent variables, with 1,5-AG as the independent variable, and adjusted for other clinical characteristics, showed significant correlation between 1,5-AG and the PI but not between 1,5-AG and IMT. CONCLUSION Our results suggest that postprandial hyperglycemia increases carotid artery stiffness, but not morphological change, in patients without diabetes or cardiovascular disease.
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Affiliation(s)
- Kentaro Watanabe
- Department of Internal Medicine, Divisions of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Nippon Medical School, 1-1-5 Sendagi, 113-8603, Bunkyo-ku, Tokyo, Japan.
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Khadilkar S. Hormone Replacement Therapy: An Update. J Obstet Gynaecol India 2012; 62:261-5. [DOI: 10.1007/s13224-012-0269-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lateef A, Petri M. Hormone replacement and contraceptive therapy in autoimmune diseases. J Autoimmun 2012; 38:J170-6. [DOI: 10.1016/j.jaut.2011.11.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 11/12/2011] [Indexed: 12/01/2022]
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Lunder M, Janic M, Kejzar N, Sabovic M. Associations among different functional and structural arterial wall properties and their relations to traditional cardiovascular risk factors in healthy subjects: a cross-sectional study. BMC Cardiovasc Disord 2012; 12:29. [PMID: 22533480 PMCID: PMC3411488 DOI: 10.1186/1471-2261-12-29] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 04/25/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The arterial wall possesses several functional and structural properties that define arterial health. Once they become impaired, cardiovascular risk increases. We aimed to ascertain the pattern of correlations among different arterial wall properties and to explore their relations to traditional risk factors and cardiovascular risk stratification. To allow such an investigation a middle-aged healthy population was recruited. METHODS This cross-sectional study included 100 healthy males (aged 41.9 ± 6.4 years). Pulse wave velocity (PWV), β-stiffness and intima-media thickness (IMT) of the carotid artery, and brachial artery flow-mediated dilation (FMD) were measured by a standardized ultrasound approach. RESULTS No correlation between FMD and IMT was found; only relatively poor correlations between PWV (or β-stiffness) and FMD existed, as well as between PWV (or β-stiffness) and IMT. PWV and β-stiffness highly correlated. Unexpectedly, only weak associations between PWV, β-stiffness, FMD, IMT and traditional risk factors were revealed. Hence, traditional risk factors (mainly age) explained only 10-50% of variability for PWV, β-stiffness, FMD and IMT. Although the subjects had low cardiovascular risk according to their Framingham score, their arterial wall properties were already impaired, particularly FMD. CONCLUSIONS In healthy middle-age males we found: i) absent or poor correlations among arterial stiffness, IMT and endothelial function; ii) a low impact of traditional risk factors on the studied variables, and iii) the presence of impaired arterial wall properties despite low calculated cardiovascular risk. These results provide a deepened understanding of arterial wall properties and could help to improve cardiovascular risk stratification.
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Affiliation(s)
- Mojca Lunder
- Department of Vascular Disease, University of Ljubljana Medical Centre, Zaloška 7, 1000 Ljubljana, Slovenia.
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Suzuki K, Watanabe K, Suzuki T, Ouchi M, Futami-Suda S, Igari Y, Nakano H, Oba K. Sitagliptin improves vascular endothelial function in Japanese type 2 diabetes patients without cardiovascular disease. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/jdm.2012.23053] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Yoshioka E, Saijo Y, Kita T, Okada E, Satoh H, Kawaharada M, Kishi R. Relation between self-reported sleep duration and arterial stiffness: a cross-sectional study of middle-aged Japanese civil servants. Sleep 2011; 34:1681-6. [PMID: 22131605 DOI: 10.5665/sleep.1434] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The aim of this study is to examine the relationship between self-reported sleep duration and arterial stiffness in a large-scale Japanese study. DESIGN Cross-sectional study. SETTING Sapporo City, Hokkaido, Japan. PARTICIPANTS Local government employees aged 35-62 years, who underwent annual health checkups from April 2003 to March 2004. After excluding those with incomplete data, data from 4,268 employees (males: 3,410) participants were analyzed. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Brachial-ankle pulse-wave velocity (baPWV) was investigated as an indicator of arterial stiffness. We used a self-administered questionnaire, which included items on daily sleep duration, lifestyle factors, and occupational factors. Sleep duration was classified into 5 categories; " ≤ 5 h," "6 h," "7 h," "8 h," and " ≥ 9 h." Results of multiple linear regression analysis after fully adjusting the model revealed that subjects with ≥ 9 h of daily sleep had significantly elevated baPWV values compared with the reference group with 7 h of sleep. Stratified analyses by sex showed that there was a significant association among male subjects only. CONCLUSIONS Daily sleep duration ≥ 9 h was found to be associated with elevated values of baPWV. This suggests that there is an association between long sleep duration and arterial stiffness.
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Affiliation(s)
- Eiji Yoshioka
- Department of Public Heath Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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Sandoo A, Veldhuijzen van Zanten JJCS, Metsios GS, Carroll D, Kitas GD. Vascular function and morphology in rheumatoid arthritis: a systematic review. Rheumatology (Oxford) 2011; 50:2125-39. [PMID: 21926155 DOI: 10.1093/rheumatology/ker275] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES RA associates with significantly increased morbidity and mortality from cardiovascular disease (CVD). This may be due to complex interactions between traditional CVD risk factors, systemic rheumatoid inflammation and the vasculature. We reviewed the current literature to answer: (i) whether there is sufficient evidence that patients with RA have altered vascular function and morphology compared with normal controls; (ii) whether there is sufficient evidence to determine if such changes relate predominantly to systemic inflammation; and (iii) whether any changes of vascular function and morphology in RA can be modified with therapy. METHODS The MEDLINE database was searched to identify publications from 1974 to 1 November 2010 pertaining to vascular function and morphology in RA. The total number of articles included in the present review was 93. This included 57 cross-sectional studies, 27 longitudinal studies without randomization and 9 longitudinal studies with randomization. RESULTS Vascular function and morphology was impaired in RA relative to healthy controls. The majority of studies reported no associations between systemic inflammation and vascular function. Treatment with anti-inflammatory medication resulted in both transient and long-term improvements in the vasculature, but only a few studies reported associations between change in inflammation and change in vascular function and morphology. CONCLUSION The link between systemic inflammation and vascular function and morphology is not wholly supported by the available literature. Long-term studies examining specific predictors (including CVD risk factors) on the vasculature in RA are needed.
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Affiliation(s)
- Aamer Sandoo
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Pensnett Road, Dudley, West Midlands DY1 2HQ, UK.
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Lambrinoudaki I, Armeni E, Georgiopoulos G, Kazani M, Kouskouni E, Creatsa M, Alexandrou A, Fotiou S, Papamichael C, Stamatelopoulos K. Subclinical atherosclerosis in menopausal women with low to medium calculated cardiovascular risk. Int J Cardiol 2011; 164:70-6. [PMID: 21737156 DOI: 10.1016/j.ijcard.2011.06.063] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 02/08/2011] [Accepted: 06/10/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND The menopausal status is closely related with cardiovascular disease (CVD). Nevertheless, it is still not included in risk stratification by total cardiovascular risk estimation systems. The present study aimed to evaluate the extent of subclinical vascular disorders in young healthy postmenopausal women. METHODS This cross-sectional study consecutively recruited 120 healthy postmenopausal women without clinically overt CVD or diabetes, aged 41-60 years and classified as not high-risk by the Heartscore (<5%). In addition to risk factors used for Heartscore calculations, years since menopause and associated risk factors (triglycerides (range 37-278 mg/dl), waist circumference (62-114 cm), fasting blood glucose (69-114 mg/dl) and HOMA-IR (0.44-5)) were also assessed. Carotid-femoral pulse wave velocity, carotid and femoral intima-media thickness in the abnormal range as well as atheromatous plaques both in carotid and femoral arteries were used to define the presence of subclinical atherosclerosis. RESULTS Subclinical atherosclerosis and the presence of at least one plaque were identified in 55% and 28% of women, respectively. Subjects with subclinical atherosclerosis had higher age, years since menopause, HOMA-IR and blood pressure. By multivariate analysis years since menopause and systolic blood pressure independently determined subclinical atherosclerosis while 79% of intermediate-risk women (Heartscore 2-4.9%) being in menopause for at least 4 years would be reclassified to a higher risk for the presence of atherosclerosis. CONCLUSION Subclinical atherosclerosis was highly prevalent in postmenopausal women with low to medium Heartscore. Thus our data suggest that menopausal status and associated risk factors should be additionally weighted in risk calculations, regarding primary prevention strategies in this population.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, 76 Vas. Sofias Ave., University of Athens, Aretaieio Hospital, Athens, Greece
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Sandoo A, van Zanten JJCSV, Metsios GS, Carroll D, Kitas GD. The endothelium and its role in regulating vascular tone. Open Cardiovasc Med J 2010; 4:302-12. [PMID: 21339899 PMCID: PMC3040999 DOI: 10.2174/1874192401004010302] [Citation(s) in RCA: 477] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 11/22/2010] [Accepted: 11/23/2010] [Indexed: 12/16/2022] Open
Abstract
The endothelium forms an important part of the vasculature and is involved in promoting an atheroprotective environment via the complementary actions of endothelial cell-derived vasoactive factors. Disruption of vascular homeostasis can lead to the development of endothelial dysfunction which in turn contributes to the early and late stages of atherosclerosis. In recent years an increasing number of non-invasive vascular tests have been developed to assess vascular structure and function in different clinical populations. The present review aims to provide an insight into the anatomy of the vasculature as well as the underlying endothelial cell physiology. In addition, an in-depth overview of the current methods used to assess vascular function and structure is provided as well as their link to certain clinical populations.
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Affiliation(s)
- Aamer Sandoo
- School of Sport and Exercise Sciences, University of Birmingham, Birmingham, West Midlands, United Kingdom
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Cheng DC, Schmidt-Trucksäss A, Liu CH, Liu SH. Automated detection of the arterial inner walls of the common carotid artery based on dynamic B-mode signals. SENSORS 2010; 10:10601-19. [PMID: 22163488 PMCID: PMC3231092 DOI: 10.3390/s101210601] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 11/12/2010] [Accepted: 11/18/2010] [Indexed: 11/25/2022]
Abstract
In this paper we propose a novel scheme able to automatically detect the intima and adventitia of both near and far walls of the common carotid artery in dynamic B-mode RF (radiofrequency) image sequences, with and without plaques. Via this automated system the lumen diameter changes along the heart cycle can be detected. Three image sequences have been tested and all results are compared to manual tracings made by two professional experts. The average errors for near and far wall detection are 0.058 mm and 0.067 mm, respectively. This system is able to analyze arterial plaques dynamically which is impossible to do manually due to the tremendous human workload involved.
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Affiliation(s)
- Da-Chuan Cheng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +886-4-2205-2121 ext. 7625; Fax: +886-4-2233-4175
| | - Arno Schmidt-Trucksäss
- Institute of Exercise and Health Sciences, University of Basel, Basel, Switzerland; E-Mail:
| | - Chung-Hsiang Liu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan; E-Mail:
| | - Shing-Hong Liu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung, Taiwan; E-Mail:
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Seifert-Klauss V, Prior JC. Progesterone and bone: actions promoting bone health in women. J Osteoporos 2010; 2010:845180. [PMID: 21052538 PMCID: PMC2968416 DOI: 10.4061/2010/845180] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 07/31/2010] [Accepted: 08/26/2010] [Indexed: 12/26/2022] Open
Abstract
Estradiol (E(2)) and progesterone (P(4)) collaborate within bone remodelling on resorption (E(2)) and formation (P(4)). We integrate evidence that P(4) may prevent and, with antiresorptives, treat women's osteoporosis. P(4) stimulates osteoblast differentiation in vitro. Menarche (E(2)) and onset of ovulation (P(4)) both contribute to peak BMD. Meta-analysis of 5 studies confirms that regularly cycling premenopausal women lose bone mineral density (BMD) related to subclinical ovulatory disturbances (SODs). Cyclic progestin prevents bone loss in healthy premenopausal women with amenorrhea or SOD. BMD loss is more rapid in perimenopause than postmenopause-decreased bone formation due to P(4) deficiency contributes. In 4 placebo-controlled RCTs, BMD loss is not prevented by P(4) in postmenopausal women with increased bone turnover. However, 5 studies of E(2)-MPA co-therapy show greater BMD increases versus E(2) alone. P(4) fracture data are lacking. P(4) prevents bone loss in pre- and possibly perimenopausal women; progesterone co-therapy with antiresorptives may increase bone formation and BMD.
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Affiliation(s)
- Vanadin Seifert-Klauss
- Frauenklinik der Technischen Universität München (TUM), Klinikum Rechts der Isar, Ismaninger Str., 22 81675 Muenchen, Germany
| | - Jerilynn C. Prior
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of British Columbia and Centre for Menstrual Cycle and Ovulation Research (CeMCOR), 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9
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Pachman DR, Jones JM, Loprinzi CL. Management of menopause-associated vasomotor symptoms: Current treatment options, challenges and future directions. Int J Womens Health 2010; 2:123-35. [PMID: 21072305 PMCID: PMC2971731 DOI: 10.2147/ijwh.s7721] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Indexed: 12/21/2022] Open
Abstract
Hot flashes are one of the most common and distressing symptoms associated with menopause, occurring in more than 75% of postmenopausal women. They are especially problematic in breast cancer patients since some breast cancer therapies can induce hot flashes. For mild hot flashes, it is proposed that behavioral modifications are the first step in management. Hormonal therapies, including estrogens and progestogens, are the most well known effective agents in relieving hot flashes; however, the safety of these agents is controversial. There is an increasing amount of literature on nonhormonal agents for the treatment of hot flashes. The most promising data regard newer antidepressant agents such as venlafaxine, which reduces hot flashes by about 60%. Gabapentin is another nonhormonal agent that is effective in reducing hot flashes. While many complimentary therapies, including phytoestrogens, black cohosh, and dehydroepiandrosterone, have been explored for the treatment of hot flashes; none can be recommended at this time. Furthermore, there is a lack of strong evidence to support exercise, yoga, or relaxation for the treatment of hot flashes. Paced respirations and hypnosis appear to be promising enough to warrant further investigation. Another promising nonpharmacological therapy, currently under investigation, involves a stellate ganglion block.
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Kalyan S, Hitchcock CL, Sirrs S, Pudek M, Prior JC. Cardiovascular and Metabolic Effects of Medroxyprogesterone Acetate versus Conjugated Equine Estrogen After Premenopausal Hysterectomy with Bilateral Ovariectomy. Pharmacotherapy 2010; 30:442-52. [DOI: 10.1592/phco.30.5.442] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Teede HJ, Meyer C, Hutchison SK, Zoungas S, McGrath BP, Moran LJ. Endothelial function and insulin resistance in polycystic ovary syndrome: the effects of medical therapy. Fertil Steril 2010; 93:184-91. [DOI: 10.1016/j.fertnstert.2008.09.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Revised: 09/05/2008] [Accepted: 09/06/2008] [Indexed: 11/15/2022]
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Stamatelopoulos K, Karatzi K, Sidossis LS. Noninvasive methods for assessing early markers of atherosclerosis: the role of body composition and nutrition. Curr Opin Clin Nutr Metab Care 2009; 12:467-73. [PMID: 19571744 DOI: 10.1097/mco.0b013e32832f0d99] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW To present the methodology used to assess early atherosclerosis and its application in assessing the impact of body composition and nutrition on the cardiovascular system. RECENT FINDINGS Accumulating evidence supports the use of noninvasive markers of subclinical atherosclerosis, namely carotid intima-media thickness, flow-mediated dilatation of the brachial artery and augmentation index or pulse wave velocity, in the prediction of cardiovascular risk, especially in primary prevention settings. These markers reflect early initiation of the atherogenetic process, as well as the impact of the treatment currently used. Factors like smoking cessation, exercise and a balanced nutrition have a remarkable effect on these markers and consequently on vascular function. It is interesting to note that individual nutrients such as lipids, vitamins, antioxidants, ethanol, caffeine and isoflavones are capable of manipulating vascular function, which is depicted in these markers of atherosclerosis. SUMMARY A number of noninvasive markers of early atherosclerosis are currently used in order to detect possible initiation of atherosclerotic procedure. Vascular function is greatly affected by nutrition, which might prove to be an alternative to drug therapy for reversing dysfunction of the vessels.
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Stamatelopoulos KS, Kitas GD, Papamichael CM, Chryssohoou E, Kyrkou K, Georgiopoulos G, Protogerou A, Panoulas VF, Sandoo A, Tentolouris N, Mavrikakis M, Sfikakis PP. Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study. Arterioscler Thromb Vasc Biol 2009; 29:1702-8. [PMID: 19608975 DOI: 10.1161/atvbaha.109.190108] [Citation(s) in RCA: 142] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The extent to which atherosclerosis is accelerated in chronic inflammatory diseases is not established. We compared preclinical atherosclerosis in rheumatoid arthritis with diabetes mellitus, a known coronary heart disease equivalent. METHODS AND RESULTS Endothelial function, arterial stiffness, carotid intima-media thickness, and analysis of atheromatous plaques were examined in 84 rheumatoid arthritis patients without cardiovascular disease versus healthy controls matched for age, sex, and traditional cardiovascular disease risk factors, as well as in 48 diabetes patients matched for age, sex, and disease duration with 48 rheumatoid arthritis patients. Rheumatoid arthritis duration associated with arterial stiffening, whereas disease activity associated with carotid plaque vulnerability. All markers of preclinical atherosclerosis were significantly worse in rheumatoid arthritis compared to controls, whereas they did not differ in comparison to diabetes despite a worse cardiovascular risk factor profile in diabetics. Both diseases were associated independently with increased intima-media thickness; rheumatoid arthritis, but not diabetes, was independently associated with endothelial dysfunction. CONCLUSIONS Preclinical atherosclerosis appears to be of equal frequency and severity in rheumatoid arthritis and diabetes of similar duration with differential impact of traditional risk factors and systemic inflammation. Cardiovascular disease risk factors in rheumatoid arthritis may need to be targeted as aggressively as in diabetes.
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Affiliation(s)
- Kimon S Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, 80, Vassilissis Sofias Ave, Athens, Greece.
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Dietary saturated and unsaturated fats as determinants of blood pressure and vascular function. Nutr Res Rev 2009; 22:18-38. [DOI: 10.1017/s095442240925846x] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The amount and type of dietary fat have long been associated with the risk of CVD. Arterial stiffness and endothelial dysfunction are important risk factors in the aetiology of CHD. A range of methods exists to assess vascular function that may be used in nutritional science, including clinic and ambulatory blood pressure monitoring, pulse wave analysis, pulse wave velocity, flow-mediated dilatation and venous occlusion plethysmography. The present review focuses on the quantity and type of dietary fat and effects on blood pressure, arterial compliance and endothelial function. Concerning fat quantity, the amount of dietary fat consumed habitually appears to have little influence on vascular function independent of fatty acid composition, although single high-fat meals postprandially impair endothelial function compared with low-fat meals. The mechanism is related to increased circulating lipoproteins and NEFA which may induce pro-inflammatory pathways and increase oxidative stress. Regarding the type of fat, cross-sectional data suggest that saturated fat adversely affects vascular function whereas polyunsaturated fat (mainly linoleic acid (18 : 2n-6) and n-3 PUFA) are beneficial. EPA (20 : 5n-3) and DHA (22 : 6n-3) can reduce blood pressure, improve arterial compliance in type 2 diabetics and dyslipidaemics, and augment endothelium-dependent vasodilation. The mechanisms for this vascular protection, and the nature of the separate physiological effects induced by EPA and DHA, are priorities for future research. Since good-quality observational or interventional data on dietary fatty acid composition and vascular function are scarce, no further recommendations can be suggested in addition to current guidelines at the present time.
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End-organ dysfunction and cardiovascular outcomes: the role of the microcirculation. Clin Sci (Lond) 2009; 116:175-90. [PMID: 19118490 DOI: 10.1042/cs20080069] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Risk factors for cardiovascular disease mediate their effects by altering the structure and function of wall and endothelial components of arterial blood vessels. A pathological change in the microcirculation plays a pivotal role in promoting end-organ dysfunction that not only predisposes to further organ damage, but also increases the risk for future macrovascular events. The microcirculation is recognized as the site where the earliest manifestations of cardiovascular disease, especially inflammatory responses, occur that may play a pivotal role in driving the atherosclerotic process in conduit vessels. Furthermore, the vast surface area of the endothelium compared with conduit vessels means that the vascular effects of endothelial dysfunction or activation will be most apparent in this section of the vasculature. Current techniques providing indices of vascular health focus on large arteries without providing insight into the structure and function of small vessels. Techniques capable of detecting microvascular damage and monitoring the response to therapeutic interventions, especially in vulnerable target organs of interest, may improve risk stratification and represent a valuable surrogate for future cardiovascular outcome.
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Kang MJ, Kim JH, Chung HR, Lee YA, Shin CH, Yang SW, Kim YY, Jin SM, Noh CI. A study of the development of macrovascular complications and factors related to these complications in young adults with childhood/adolescence-onset type 1 diabetes mellitus. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.2.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Min Jae Kang
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - Joo Hwa Kim
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - Hye Rim Chung
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - Young Ah Lee
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - Sei Won Yang
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - You Yeh Kim
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - Seon Mi Jin
- Department of Pediatrics, Eulji University School of Medicine, Seoul, Korea
| | - Chung Il Noh
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
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Bibliography. Current world literature. Atherosclerosis: cell biology and lipoproteins. Curr Opin Lipidol 2008; 19:525-35. [PMID: 18769235 DOI: 10.1097/mol.0b013e328312bffc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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