1
|
Stanciulescu LA, Scafa-Udriste A, Dorobantu M. Exploring the Association between Low-Density Lipoprotein Subfractions and Major Adverse Cardiovascular Outcomes—A Comprehensive Review. Int J Mol Sci 2023; 24:ijms24076669. [PMID: 37047642 PMCID: PMC10095470 DOI: 10.3390/ijms24076669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Cardiovascular disease (CVD) impacts hundreds of millions of people each year and is the main cause of death worldwide, with atherosclerosis being its most frequent form of manifestation. Low-density lipoproteins (LDL) have already been established as a significant cardiovascular risk factor, but more recent studies have shown that small, dense LDLs are the ones more frequently associated with a higher overall risk for developing atherosclerotic cardiovascular disease. Ever since atherogenic phenotypes were defined for the first time, LDL subfractions have been continuously analyzed in order to identify those with a higher atherogenic profile that could further become not only high-accuracy, effective prognostic biomarkers, but also treatment targets for novel lipid-lowering molecules. This review sets out to comprehensively evaluate the association between various LDL-subfractions and the risk of further developing major adverse cardiovascular events, by assessing both genetical and clinical features and focusing on their physiopathological characteristics, chemical composition, and global ability to predict long-term cardiovascular risk within the general population. Further research is required in order to establish the most beneficial range of LDL-C levels for both primary and secondary prevention, as well as to implement LDL subfraction testing as a routine protocol, separately from the general assessment of the other traditional cardiovascular risk factors.
Collapse
Affiliation(s)
- Laura Adina Stanciulescu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Cardiology Department, Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania
| | - Alexandru Scafa-Udriste
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Cardiology Department, Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania
| | - Maria Dorobantu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Romanian Academy, 010071 Bucharest, Romania
| |
Collapse
|
2
|
Dai R, Zhao X, Zhuo H, Wang W, Xu Y, Hu Z, Zhang T, Zhao J. CYP2C19 metabolizer phenotypes may affect the efficacy of statins on lowering small dense low-density lipoprotein cholesterol of patients with coronary artery disease. Front Cardiovasc Med 2022; 9:1016126. [PMID: 36601065 PMCID: PMC9806256 DOI: 10.3389/fcvm.2022.1016126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background Dyslipidemia is a major cause of arteriosclerotic cardiovascular disease (ASCVD), and low-density lipoprotein cholesterol (LDL-C) is the profile to be reduced to prevent disease progression. Small dense low-density lipoprotein cholesterol (sdLDL-C) has been proven to be a more effective biomarker than LDL-C for ASCVD primary and secondary prevention. CYP2C19 is an important drug metabolism gene. This study aimed to investigate the relationship between sdLDL-C and coronary artery disease (CAD) risk factors and explore the influence of CYP2C19 metabolizer phenotypes on the sdLDL-C lowering efficacy of statins. Methods This study recruited 182 patients with CAD and 200 non-CAD controls. Baseline laboratory indices of fasting blood were detected, including blood lipids, glucose, and creatinine. In addition, LDL-C subfractions were separated and quantified. Gene polymorphisms of SLCO1B1 and CYP2C19 were detected in patients with CAD. The LDL-C subfractions levels of patients with CAD were followed up after statin drug treatment. Results Total cholesterol, LDL-C, LDLC-2, LDLC-3, LDLC-4, LDLC-5, LDLC-6, LDLC-7, and sdLDL-C levels of patients with CAD were significantly higher than those in non-CAD controls. Meanwhile, sdLDL-C (AUC = 0.838) and LDLC-4 (AUC = 0.835) performed outstandingly in distinguishing patients with CAD from controls. Based on CYP2C19 metabolizer phenotypes, 113 patients with CAD were divided into the extensive metabolizer (EM, n = 49), intermediate metabolizer (IM, n = 52), and poor metabolizer (PM, n = 12) groups. The patients with IM and PM metabolizer phenotypes had better sdLDL-C lowering efficacy after taking statin drugs than patients with EM phenotype (P = 0.0268, FDR = 0.0536). The SLCO1B1 genotype had no significant impact on the efficacy of statins (P = 0.1611, FDR = 0.1611). Conclusion sdLDL-C and LDLC-4 outperformed other blood lipids such as LDL-C for CAD risk screening. CYP2C19 metabolizer phenotypes had the potential to predict the efficacy of statins in lowering sdLDL-C.
Collapse
Affiliation(s)
- Ruozhu Dai
- Department of Cardiology, Quanzhou First Hospital Afliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Xiaoyu Zhao
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Huilin Zhuo
- Department of Cardiology, Quanzhou First Hospital Afliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Wei Wang
- Department of Cardiology, Quanzhou First Hospital Afliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Yue Xu
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Zixin Hu
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China,Artificial Intelligence Innovation and Incubation Institute, Fudan University, Shanghai, China,Fudan Zhangjiang Institute, Shanghai, China,*Correspondence: Zixin Hu ✉
| | - Tiexu Zhang
- Department of Cardiovascular Medicine, The First People's Hospital of Pingdingshan, Pingdingshan, Henan, China,Tiexu Zhang ✉
| | - Jiangman Zhao
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China,Jiangman Zhao ✉
| |
Collapse
|
3
|
Lipoproteins and Cardiovascular Disease: An Update on the Clinical Significance of Atherogenic Small, Dense LDL and New Therapeutical Options. Biomedicines 2021; 9:biomedicines9111579. [PMID: 34829807 PMCID: PMC8615620 DOI: 10.3390/biomedicines9111579] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/15/2022] Open
Abstract
Dyslipidemia is a potent risk factor for the genesis and progression of cardiovascular disease (CVD), and both the concentration and type of low-density lipoproteins (LDL) augment this association. The small, dense LDL (sdLDL) subfraction is the subtype which is most strongly predictive of atherosclerosis and cardiovascular events. In addition to the traditionally available lipid-lowering treatment options, certain novel therapies have been shown to favorably impact sdLDL, among them the antidiabetic class of agents known as glucagon-like peptide 1 receptor agonists (GLP1-RAs). These drugs seem to alter the pathophysiologic mechanisms responsible for the formation and accumulation of atherogenic lipoprotein particles, thus potentially reducing cardiovascular outcomes. They represent a uniquely targeted therapeutic approach to reduce cardiometabolic risk and warrant further study for their beneficial nonglycemic actions.
Collapse
|
4
|
Wu D, Yang Q, Su B, Hao J, Ma H, Yuan W, Gao J, Ding F, Xu Y, Wang H, Zhao J, Li B. Low-Density Lipoprotein Cholesterol 4: The Notable Risk Factor of Coronary Artery Disease Development. Front Cardiovasc Med 2021; 8:619386. [PMID: 33937355 PMCID: PMC8085268 DOI: 10.3389/fcvm.2021.619386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/23/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Coronary artery disease (CAD) is the leading cause of death worldwide, which has a long asymptomatic period of atherosclerosis. Thus, it is crucial to develop efficient strategies or biomarkers to assess the risk of CAD in asymptomatic individuals. Methods: A total of 356 consecutive CAD patients and 164 non-CAD controls diagnosed using coronary angiography were recruited. Blood lipids, other baseline characteristics, and clinical information were investigated in this study. In addition, low-density lipoprotein cholesterol (LDL-C) subfractions were classified and quantified using the Lipoprint system. Based on these data, we performed comprehensive analyses to investigate the risk factors for CAD development and to predict CAD risk. Results: Triglyceride, LDLC-3, LDLC-4, LDLC-5, LDLC-6, and total small and dense LDL-C were significantly higher in the CAD patients than those in the controls, whereas LDLC-1 and high-density lipoprotein cholesterol (HDL-C) had significantly lower levels in the CAD patients. Logistic regression analysis identified male [odds ratio (OR) = 2.875, P < 0.001], older age (OR = 1.018, P = 0.025), BMI (OR = 1.157, P < 0.001), smoking (OR = 4.554, P < 0.001), drinking (OR = 2.128, P < 0.016), hypertension (OR = 4.453, P < 0.001), and diabetes mellitus (OR = 8.776, P < 0.001) as clinical risk factors for CAD development. Among blood lipids, LDLC-3 (OR = 1.565, P < 0.001), LDLC-4 (OR = 3.566, P < 0.001), and LDLC-5 (OR = 6.866, P < 0.001) were identified as risk factors. To predict CAD risk, six machine learning models were constructed. The XGboost model showed the highest AUC score (0.945121), which could distinguish CAD patients from the controls with a high accuracy. LDLC-4 played the most important role in model construction. Conclusions: The established models showed good performance for CAD risk prediction, which can help screen high-risk CAD patients in asymptomatic population, so that further examination and prevention treatment might be taken before any sudden or serious event.
Collapse
Affiliation(s)
- Dongmei Wu
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Qiuju Yang
- Department of Cardiovascular Medicine, The First People's Hospital of Pingdingshan, Pingdingshan, China
| | - Baohua Su
- Department of Cardiovascular Medicine, Mianxian Hospital, Hanzhong, China
| | - Jia Hao
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Huirong Ma
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Weilan Yuan
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Junhui Gao
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Feifei Ding
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Yue Xu
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Huifeng Wang
- Department of Cardiovascular Medicine, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Shanxi, China
| | - Jiangman Zhao
- Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Bingqiang Li
- Department of Cardiovascular Medicine, The First People's Hospital of Pingdingshan, Pingdingshan, China
| |
Collapse
|
5
|
Gu C, Wang N, Ren P, Wu X, Pang B, Zhang S, Hou X, Xu D, Yuan Y, Liu G. Association between postprandial lipoprotein subclasses and Framingham cardiovascular disease risk stratification. Clin Biochem 2020; 89:51-57. [PMID: 33359967 DOI: 10.1016/j.clinbiochem.2020.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 12/18/2020] [Accepted: 12/20/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the ability of postprandial lipoprotein subclass concentrations to stratify patients with respect to their risk for cardiovascular disease (CVD). METHODS Using the Framingham cardiovascular disease risk score (FRS) algorithm, a total of 112 consecutive patients referred for community health screening were stratified into two groups: (a) low-risk (FRS < 10%) and (b) intermediate/high-risk (FRS ≥ 10%). Serum lipoprotein subclass concentrations were determined by Vertical Auto Profile (VAP-II). RESULTS Fasting and postprandial levels of LDL4, HDL2, VLDL1 + 2, VLDL3, and RLP, as well as fasting levels of ApoB and postprandial levels of LDL3 and IDL1, were significantly different in the intermediate/high risk FRS group vs. the low-risk group (P < 0.05). Correlations between Framingham CVD risk and LDL3, LDL4, IDL1, VLDL1 + 2, VLDL3, RLP, and ApoB were positive while negative for HDL2 in both the fasting and postprandial states. Intermediate/high risk for CVD was shown to be significantly associated with both fasting and postprandial levels of VLDL1 + 2 and RLP, as well as with postprandial LDL4 and VLDL3, as determined using forward conditional logistic regression analysis. Postprandial levels of VLDL1 + 2 were better at identifying patients in the intermediate/high-risk FRS group than fasting levels, although the differences were not significant due to overlapping reference intervals. In addition, the association between RLP and VLDL subclasses relative to Framingham CVD risk increased significantly in the postprandial state (ΔR2 = 0.023; ΔF = 7.178; ΔP = 0.025) but not in the fasting state. CONCLUSIONS The use of postprandial lipoprotein subclass concentrations is not inferior to the use of fasting levels in identifying intermediate/high-risk FRS individuals. In addition, changes in RLP and VLDL subclass concentrations in fasting vs. postprandial states may reveal lipid metabolic mechanisms associated with CVD.
Collapse
Affiliation(s)
- Chun Gu
- Department of Laboratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Na Wang
- Department of Laboratory, Southern District of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Peng Ren
- Department of Laboratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Xuemei Wu
- Department of Laboratory, Southern District of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Bo Pang
- Department of Laboratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Shuying Zhang
- Department of Laboratory, Southern District of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Xueyun Hou
- Department of Laboratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Dan Xu
- Department of Laboratory, Southern District of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Yuliang Yuan
- Department of Laboratory, Southern District of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China.
| | - Guijian Liu
- Department of Laboratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China.
| |
Collapse
|
6
|
Duan R, Xue W, Wang K, Yin N, Hao H, Chu H, Wang L, Meng P, Diao L. Estimation of the LDL subclasses in ischemic stroke as a risk factor in a Chinese population. BMC Neurol 2020; 20:414. [PMID: 33183255 PMCID: PMC7664065 DOI: 10.1186/s12883-020-01989-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/30/2020] [Indexed: 01/09/2023] Open
Abstract
Background Acute ischemic stroke (AIS) is one of the leading causes of mortality and long-term disability worldwide. Our study aims to clarify the role of low-density lipoproteins (LDL) subclasses in the occurrence of AIS and develop a risk xprediction model based on these characteristics to identify high-risk people. Methods Five hundred and sixty-six patients with AIS and 197 non-AIS controls were included in this study. Serum lipids and other baseline characteristics including fasting blood glucose (GLU), serum creatinine (Scr), and blood pressure were investigated in relation to occurrence of AIS. The LDL subfractions were classified and measured with the Lipoprint System by a polyacrylamide gel electrophoresis technique. Results Levels of LDL-3, LDL-4 and LDL-5 subclasses were significantly higher in the AIS group compared to the non-AIS group and lower level of LDL-1 was prevalent in the AIS patients. Consistently, Spearman correlation coefficient demonstrated that sd-demonevels, especially LDL-3 and LDL-4 levels, were significantly positively correlated with AIS. Furthermore, there is a significant positive correlation between small dense LDL (sd-LDL, that is LDL-3 to 7) levels and serum lipids including total cholesterol (TC), Low density lipoprotein cholesterol (LDL-C), and Triglyceride (TG). Increased LDL-3 and LDL-4 as well as decreased LDL-1 and LDL-2 were correlated to the occurrence of AIS, even in the people with normal LDL-C levels. A new prediction model including 12 variables can accurately predict the AIS risk in Chinese patients (AUC = 0.82 ± 0.04). Conclusions Levels of LDL subclasses should be considered in addition to serum LDL-C in assessment and management of AIS. A new prediction model based on clinical variables including LDL subtractions can help clinicians identify high of AIS, even in the people with norm.
Collapse
Affiliation(s)
- Ruisheng Duan
- Department of Neurology, Hebei General Hospital, Shijiazhuang, 050000, Hebei, China.
| | - Wenjun Xue
- Department of Neurology, the First People's Hospital of Pingdingshan, Henan, 467000, Pingdingshan, China
| | - Kunpeng Wang
- Department of Neurosurgery, the Affiliated Hospital of Chengde Medical University, Chengde, 067000, Hebei, China
| | - Nan Yin
- Department of Neurology, Hebei General Hospital, Shijiazhuang, 050000, Hebei, China
| | - Hongyu Hao
- Department of Neurology, Hebei General Hospital, Shijiazhuang, 050000, Hebei, China
| | - Hongshan Chu
- Department of Neurology, Hebei General Hospital, Shijiazhuang, 050000, Hebei, China
| | - Lijun Wang
- Department of Medicine, Shanghai Zhangjiang institute of Medical innovation, Biotecan Pharmaceuticals co., ltd., Shanghai, 201204, China
| | - Peng Meng
- Department of Medicine, Shanghai Zhangjiang institute of Medical innovation, Biotecan Pharmaceuticals co., ltd., Shanghai, 201204, China.
| | - Le Diao
- Department of Medicine, Shanghai Zhangjiang institute of Medical innovation, Biotecan Pharmaceuticals co., ltd., Shanghai, 201204, China.
| |
Collapse
|
7
|
Grundler F, Mesnage R, Goutzourelas N, Tekos F, Makri S, Brack M, Kouretas D, Wilhelmi de Toledo F. Interplay between oxidative damage, the redox status, and metabolic biomarkers during long-term fasting. Food Chem Toxicol 2020; 145:111701. [PMID: 32858131 PMCID: PMC7446623 DOI: 10.1016/j.fct.2020.111701] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022]
Abstract
Obesity and its related metabolic disorders, as well as infectious diseases like covid-19, are important health risks nowadays. It was recently documented that long-term fasting improves metabolic health and enhanced the total antioxidant capacity. The present study investigated the influence of a 10-day fasting on markers of the redox status in 109 subjects. Reducing power, 2,2’-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt radical cation(ABTS) radical scavenging capacity, and hydroxyl radical scavenging capacity increased significantly, and indicated an increase of circulating antioxidant levels. No differences were detected in superoxide scavenging capacity, protein carbonyls, and superoxide dismutase when measured at baseline and after 10 days of fasting. These findings were concomitant to a decrease in blood glucose, insulin, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) and triglycerides as well as an increase in total cholesterol/high-density lipoprotein (HDL) ratio. In addition, the well-being index as well as the subjective energy levels increased, documenting a good tolerability. There was an interplay between redox and metabolic parameters since lipid peroxidation baseline levels (thiobarbituric acid reactive substances [TBARS]) affected the ability of long-term fasting to normalize lipid levels. A machine learning model showed that a combination of antioxidant parameters measured at baseline predicted the efficiency of the fasting regimen to decrease LDL levels. In conclusion, it was demonstrated that long-term fasting enhanced the endogenous production of antioxidant molecules, that act protectively against free radicals, and in parallel improved the metabolic health status. Our results suggest that the outcome of long-term fasting strategies could be depending on the baseline values of the antioxidative and metabolic status of subjects. Long-term fasting increases the antioxidant capacity and decreases oxidative damage. It improves the metabolic health status. High TBARS levels at baseline limit the LDL reduction during long-term fasting. The antioxidant status is related with the lipid lowering effect of long-term fasting.
Collapse
Affiliation(s)
- Franziska Grundler
- Buchinger Wilhelmi Clinic, 88662, Überlingen, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117, Berlin, Germany.
| | - Robin Mesnage
- Gene Expression and Therapy Group, King's College London, Faculty of Life Sciences & Medicine, Department of Medical and Molecular Genetics, 8th Floor, Tower Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
| | - Nikolaos Goutzourelas
- Department of Biochemistry-Biotechnology, School of Health Sciences, University of Thessaly, Viopolis, 41500, Larissa, Greece.
| | - Fotios Tekos
- Department of Biochemistry-Biotechnology, School of Health Sciences, University of Thessaly, Viopolis, 41500, Larissa, Greece.
| | - Sotiria Makri
- Department of Biochemistry-Biotechnology, School of Health Sciences, University of Thessaly, Viopolis, 41500, Larissa, Greece.
| | - Michel Brack
- The Oxidative Stress College Paris, 75007, Paris, France.
| | - Demetrios Kouretas
- Department of Biochemistry-Biotechnology, School of Health Sciences, University of Thessaly, Viopolis, 41500, Larissa, Greece.
| | | |
Collapse
|
8
|
Producing high-oleic acid beef and the impact of ground beef consumption on risk factors for cardiovascular disease: A review. Meat Sci 2020; 163:108076. [PMID: 32066000 DOI: 10.1016/j.meatsci.2020.108076] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 02/06/2023]
Abstract
This review summarizes the effects of high-oleic acid oil and high-oleic acid ground beef interventions on risk factors for cardiovascular disease (CVD) in human trials, and also summarizes studies designed to increase the amount of oleic acid (18:1n-9) in beef. In three human trials, high-oleic acid oils and high-oleic acid ground beef increased plasma high-density lipoprotein cholesterol over baseline values or over high-carbohydrate diets. Neither low-oleic acid nor high-oleic acid ground beef increased risk factors for CVD, confirming earlier studies that used high-oleic acid oils. High-oleic acid beef can be obtained from cattle fed a corn-based finishing diet to USDA Grade of USDA Choice or greater; from beef from cattle with Japanese genetics; and from the brisket. Beef from grass-fed cattle contains more n-3 fatty acids than beef from conventionally-fed cattle, but also contains greater amounts of saturated and trans-fatty acids.
Collapse
|
9
|
Ferrari F, Stein R, Motta MT, Moriguchi EH. PCSK9 Inhibitors: Clinical Relevance, Molecular Mechanisms, and Safety in Clinical Practice. Arq Bras Cardiol 2019; 112:453-460. [PMID: 30843929 PMCID: PMC6459431 DOI: 10.5935/abc.20190029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/01/2018] [Indexed: 12/13/2022] Open
Abstract
Coronary artery disease (CAD) is one of the leading causes of mortality. High circulating levels of low-density lipoprotein (LDL) in the blood are associated with cardiovascular mortality, whether through an etiological role or through its association with the progression of CAD per se. Randomized clinical trials have shown that, when LDL levels are reduced, cardiovascular risk is also reduced, which reinforces this association. The first major trial involving a hypolipidemic agent of the statin family, the Scandinavian Simvastatin Survival Study (4S), was published in 1994 and found a significant reduction in mortality in patients at high cardiovascular risk. However, even in subsequent studies with different statins, a residual risk persisted, and this seems not to have changed over time; it is speculated that this risk may be due to statin intolerance. In this scenario, the potential exists for novel hypolipidemic agents to drive a true revolution in the therapy of dyslipidemia. The recent discovery of PCSK9 inhibitors (PCSK9i), a class of hypolipidemic monoclonal antibodies, is extremely promising. PCSK9 inhibition is capable of promoting a mean LDL reduction of up to 60%, with potential for very significant clinical repercussions, as every 38 mg/dL reduction in LDL appears to be associated with a 22% reduction in cardiovascular risk. This review addresses a brief history of PCSK9i, major trials of these drugs, cardiovascular outcomes, and aspects related to their efficacy and safety. Finally, the molecular mechanisms and possible pleiotropic effects of PCSK9i are also discussed.
Collapse
Affiliation(s)
- Filipe Ferrari
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares - Hospital de Clínicas de Porto Alegre (HCPA) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil.,Grupo de Pesquisa em Cardiologia do Exercício (CardioEx) - Hospital de Clínicas de Porto Alegre (HCPA) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil
| | - Ricardo Stein
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares - Hospital de Clínicas de Porto Alegre (HCPA) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil.,Grupo de Pesquisa em Cardiologia do Exercício (CardioEx) - Hospital de Clínicas de Porto Alegre (HCPA) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil.,Faculdade de Medicina - Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil.,Vitta Centro de Bem-Estar Físico, Porto Alegre, RS - Brazil.,Divisão de Medicina Interna - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil
| | | | - Emilio Hideyuki Moriguchi
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares - Hospital de Clínicas de Porto Alegre (HCPA) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil.,Divisão de Medicina Interna - Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil.,Departamento de Medicina Interna - Escola de Medicina - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil
| |
Collapse
|
10
|
Teer E, Joseph DE, Driescher N, Nell TA, Dominick L, Midgley N, Deshpande G, Page MJ, Pretorius E, Woudberg NJ, Lecour S, Glashoff RH, Essop MF. HIV and cardiovascular diseases risk: exploring the interplay between T-cell activation, coagulation, monocyte subsets, and lipid subclass alterations. Am J Physiol Heart Circ Physiol 2019; 316:H1146-H1157. [PMID: 30768357 DOI: 10.1152/ajpheart.00797.2018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Although rollout of combined antiretroviral treatment (cART) has blunted human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) onset, there is increased development of cardiovascular diseases (CVDs) in HIV-infected individuals. While most HIV-infected individuals on cART achieve viral suppression, this may not necessarily result in complete immunological recovery. This study therefore evaluated T-cell-mediated changes and coagulation markers in HIV-positive individuals to ascertain their potential to increase CVD risk. Eighty participants were recruited (Worcester, South Africa), and fasted blood was collected to evaluate: 1) immune activation (CD38 expression on CD4+ and CD8+ T cells) and thrombus formation [tissue factor (CD142)] on CD4+ and CD8+ T cells; 2) monocyte subpopulations (nonclassical, intermediate, and classical); and 3) classical regulatory T (Treg) cells with activation markers [glycoprotein A repetitions predominant (GARP) and special AT-rich sequence-binding protein 1 (SATB-1)]. High- and low-density lipoprotein subclasses (Lipoprint) were also determined. This study revealed four key findings for HIV-positive patients: 1) coexpression of the CD142 coagulation marker together with immune activation on both CD4+ and CD8+ T cells during chronic infection stages; 2) Treg cell activation and upregulated GARP and SATB-1 contributing to Treg dysfunction in chronic HIV; 3) proatherogenic monocyte subset expansion with significant correlation between T-cell activation and macrophage activation (marker: CD163); and 4) significant correlation between immune activation and lipid subclasses, revealing crucial changes that can be missed by traditional lipid marker assessments (LDL and HDL). These data also implicate lipopolysaccharide-binding protein as a crucial link between immune activation, lipid alterations, and increased CVD risk. NEW & NOTEWORTHY With combined antiretroviral treatment rollout, HIV-AIDS patients are increasingly associated with cardiovascular diseases onset. This study demonstrated the significant interplay between adaptive immune cell activation and monocyte/macrophage markers in especially HIV-positive individuals with virological failure and on second line treatment. Our data also show a unique link between immune activation and lipid subclass alterations, revealing important changes that can be missed by traditional lipid marker assessments (e.g., LDL and HDL).
Collapse
Affiliation(s)
- Eman Teer
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Danzil E Joseph
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Natasha Driescher
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Theo A Nell
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Leanne Dominick
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Natasha Midgley
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Gaurang Deshpande
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Martin J Page
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Etheresia Pretorius
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| | - Nicholas J Woudberg
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town , Cape Town , South Africa
| | - Sandrine Lecour
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town , Cape Town , South Africa
| | - Richard H Glashoff
- Division of Medical Microbiology and Immunology, Department of Pathology, Stellenbosch University and National Health Laboratory Service , Cape Town , South Africa
| | - M Faadiel Essop
- Cardio-Metabolic Research Group, Department of Physiological Sciences, Stellenbosch University , Stellenbosch , South Africa
| |
Collapse
|
11
|
Liu M, Jiang S, Ma Y, Ma J, Hassan W, Shang J. Peripheral-blood gene expression profiling studies for coronary artery disease and its severity in Xinjiang population in China. Lipids Health Dis 2018; 17:154. [PMID: 30021655 PMCID: PMC6052538 DOI: 10.1186/s12944-018-0798-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/11/2018] [Indexed: 12/19/2022] Open
Abstract
Background Alterations in gene expression in peripheral blood cells play a curtail role in the presence and extent of coronary artery disease (CAD), but its severity reflected by gene expression alterations in peripheral blood cells is still unknown in Xinjiang population in China. Methods Global gene expression profiling in peripheral blood was used to explore differentially expressed genes in coronary artery stenosis patients. RNA was extracted from peripheral blood of 9 controls without coronary stenosis and 21 cases with angiographically CAD. The extent of CAD severity was categorized angiographically as no CAD, mild CAD (20 to 50% luminal diameter stenosis [LDS]), moderate CAD (50 to 75% LDS) and severe CAD (≥75% LDS). Differentially expressed genes related with CAD severity from peripheral blood cells were screened by linear mixed effects analysis using the lme4 package in R. Then the differentially expressed genes that gradually up-regulated or down-regulated were enriched by Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Results The most significantly enrichments were toll-like receptor signaling pathway, immune responses, translational processes, cellular growth, inflammation and metabolic processes. Combined with NCBI-GeneRIF and PubMed analysis, we focused on the 12 genes associated with toll-like receptor signaling pathway in the extent of coronary artery stenosis patients. Receiver operating characteristic (ROC) analysis of 12 genes associated with toll-receptor signaling pathway in the 236 CAD patients from GEO database demonstrated that 12 genes expression could predict severe CAD with an area under the curve of 0.67, sensitivity of 77.65% and specificity of 51.52%. Conclusion These results suggest that 12 genes associated with toll-like receptor signaling pathway in peripheral-blood cells reflect the presence and extent of CAD severity in Xinjiang population in China. Electronic supplementary material The online version of this article (10.1186/s12944-018-0798-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Meng Liu
- Cancer Prevention and Research Institute, The affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, 830011, Xinjiang, China
| | - Shubin Jiang
- Department of Coronary Care Unit, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi, 830000, Xinjiang, China
| | - Yu Ma
- Department of Clinical Laboratory, The Fourth People' Hospital of Urumqi, Urumqi, 830002, Xinjiang, China
| | - Jun Ma
- Department of Coronary Care Unit, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi, 830000, Xinjiang, China
| | - Waseem Hassan
- Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Jing Shang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, Jiangsu, China. .,Jiangsu Key Laboratory of TCM Evaluation and Translational Research, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China.
| |
Collapse
|