1
|
Sun F, Zhao W, Shen H, Fan N, Zhang J, Liu Q, Xu C, Luo J, Zhao M, Chen Y, Lam KWK, Yang X, Kwok RTK, Lam JWY, Sun J, Zhang H, Tang BZ. Design of Smart Aggregates: Toward Rapid Clinical Diagnosis of Hyperlipidemia in Human Blood. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2207671. [PMID: 36134528 DOI: 10.1002/adma.202207671] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/10/2022] [Indexed: 06/16/2023]
Abstract
Molecular aggregates with environmental responsive properties are desired for their wide practical applications such as bioprobes. Here, a series of smart near-infrared (NIR) luminogens for hyperlipidemia (HLP) diagnosis is reported. The aggregates of these molecules exhibit a twisted intramolecular charge-transfer effect in aqueous media, but aggregation-induced emission in highly viscous media due to the restriction of the intramolecular motion. These aggregates, which can autonomously respond to different environments via switching the aggregation state without changing their chemical structures are described, as "smart aggregates". Intriguingly, these luminogens demonstrate NIR-II and NIR-III luminescence with ultralarge Stokes shifts (>950 nm). Both in vitro detection and in vivo imaging of HLP can be realized in a mouse model. Linear relationships exist between the emission intensity and multiple pathological parameters in blood samples of HLP patients. Thus, the design of smart aggregate facilitates rapid and accurate detection of HLP and provides a promising attempt in aggregate science.
Collapse
Affiliation(s)
- Feiyi Sun
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Wei Zhao
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, P. R. China
| | - Hanchen Shen
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Ni Fan
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, 999077, P. R. China
| | - Jianyu Zhang
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Qingqing Liu
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, 999077, P. R. China
| | - Changhuo Xu
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Jiaming Luo
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, P. R. China
| | - Mengying Zhao
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Yuyang Chen
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Kristy W K Lam
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Xueqin Yang
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Ryan T K Kwok
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Jacky W Y Lam
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Jianwei Sun
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
| | - Hongfei Zhang
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, P. R. China
| | - Ben Zhong Tang
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Guangdong-Hong Kong-Macau Joint Laboratory of Optoelectronic and Magnetic Functional Materials, Division of Life Science, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, 999077, P. R. China
- School of Science and Engineering, Shenzhen Institute of Aggregate Science and Technology, The Chinese University of Hong Kong, Shenzhen, 518172, P. R. China
- Center of Aggregation-Induced Emission, South China University of Technology, Guangzhou, 510640, P. R. China
| |
Collapse
|
2
|
Langlois MR, Chapman MJ, Cobbaert C, Mora S, Remaley AT, Ros E, Watts GF, Borén J, Baum H, Bruckert E, Catapano A, Descamps OS, von Eckardstein A, Kamstrup PR, Kolovou G, Kronenberg F, Langsted A, Pulkki K, Rifai N, Sypniewska G, Wiklund O, Nordestgaard BG. Quantifying Atherogenic Lipoproteins: Current and Future Challenges in the Era of Personalized Medicine and Very Low Concentrations of LDL Cholesterol. A Consensus Statement from EAS and EFLM. Clin Chem 2018; 64:1006-1033. [PMID: 29760220 DOI: 10.1373/clinchem.2018.287037] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/09/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND The European Atherosclerosis Society-European Federation of Clinical Chemistry and Laboratory Medicine Consensus Panel aims to provide recommendations to optimize atherogenic lipoprotein quantification for cardiovascular risk management. CONTENT We critically examined LDL cholesterol, non-HDL cholesterol, apolipoprotein B (apoB), and LDL particle number assays based on key criteria for medical application of biomarkers. (a) Analytical performance: Discordant LDL cholesterol quantification occurs when LDL cholesterol is measured or calculated with different assays, especially in patients with hypertriglyceridemia >175 mg/dL (2 mmol/L) and low LDL cholesterol concentrations <70 mg/dL (1.8 mmol/L). Increased lipoprotein(a) should be excluded in patients not achieving LDL cholesterol goals with treatment. Non-HDL cholesterol includes the atherogenic risk component of remnant cholesterol and can be calculated in a standard nonfasting lipid panel without additional expense. ApoB more accurately reflects LDL particle number. (b) Clinical performance: LDL cholesterol, non-HDL cholesterol, and apoB are comparable predictors of cardiovascular events in prospective population studies and clinical trials; however, discordance analysis of the markers improves risk prediction by adding remnant cholesterol (included in non-HDL cholesterol) and LDL particle number (with apoB) risk components to LDL cholesterol testing. (c) Clinical and cost-effectiveness: There is no consistent evidence yet that non-HDL cholesterol-, apoB-, or LDL particle-targeted treatment reduces the number of cardiovascular events and healthcare-related costs than treatment targeted to LDL cholesterol. SUMMARY Follow-up of pre- and on-treatment (measured or calculated) LDL cholesterol concentration in a patient should ideally be performed with the same documented test method. Non-HDL cholesterol (or apoB) should be the secondary treatment target in patients with mild to moderate hypertriglyceridemia, in whom LDL cholesterol measurement or calculation is less accurate and often less predictive of cardiovascular risk. Laboratories should report non-HDL cholesterol in all standard lipid panels.
Collapse
Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St-Jan, Brugge, and University of Ghent, Belgium;
| | - M John Chapman
- National Institute for Health and Medical Research (INSERM), and Endocrinology-Metabolism Service, Pitié-Salpetriere University Hospital, Paris, France
| | - Christa Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Samia Mora
- Divisions of Preventive and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Emilio Ros
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, Barcelona and Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain
| | - Gerald F Watts
- Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Jan Borén
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hannsjörg Baum
- Institute for Laboratory Medicine, Blutdepot und Krankenhaushygiene, Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
| | - Eric Bruckert
- Pitié-Salpetriere University Hospital, Paris, France
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | | | | | - Pia R Kamstrup
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Florian Kronenberg
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anne Langsted
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kari Pulkki
- Department of Clinical Chemistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Nader Rifai
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, NC University, Bydgoszcz, Poland
| | - Olov Wiklund
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Børge G Nordestgaard
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | | |
Collapse
|
3
|
Abstract
Accurate lipid and lipoprotein measurements, control of pre-analytical factors and consideration of biological variability are required for the reliable assessment of coronary heart disease (CHD) risk and the management of dyslipidaemia. Inclusion of high density lipoprotein-cholesterol, in addition to total cholesterol, in risk calculations is preferred to attain good sensitivity and specificity. Although the strong and independent association of triglyceride with CHD has been confirmed, its large biological variation limits its utility as a risk factor or primary treatment target. A fasting profile including triglyceride is essential however for consideration of genetic and secondary causes of dyslipidaemia and decisions on therapeutic intervention.
Collapse
Affiliation(s)
- William Richmond
- Chemical Pathology, St Mary's Hospital, Praed Street, Paddington, London, W2 1NY, UK,
| |
Collapse
|
4
|
van den Berg S, Shen Y, Jones SJM, Gibson WT. Genetic counseling in direct-to-consumer exome sequencing: a case report. J Genet Couns 2014; 23:742-53. [PMID: 24954083 PMCID: PMC4156788 DOI: 10.1007/s10897-014-9737-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 06/03/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Saskia van den Berg
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada,
| | | | | | | |
Collapse
|
5
|
Ryoo JH, Park SK. Association of apolipoprotein B and incidence of metabolic syndrome in Korean men: a 5-years' follow-up study. Atherosclerosis 2012; 226:496-501. [PMID: 23273962 DOI: 10.1016/j.atherosclerosis.2012.11.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 11/14/2012] [Accepted: 11/25/2012] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVE There have been reports for the association between elevated serum apolipoprotein B (ApoB) and several cardiometabolic disorders. However, it remains unclear whether serum ApoB level predicts the development of metabolic syndrome (MetS). Accordingly, we carried out a prospective study to evaluate the longitudinal effects of baseline serum ApoB levels on the development of MetS. PATIENTS AND METHODS A cohort of 25,193 healthy Korean men without MetS had been followed up prospectively. Baseline serum ApoB levels were categorized to following quintiles (quintile 1-5: <76.4, 76.4-88.4, 88.4-99.5, 99.5-113.0, ≥113.0). We evaluated the differences in the incidence of MetS according to quintiles of serum ApoB levels. Cox proportional hazards models were used to calculate the adjusted hazard ratios (HRs) for MetS. RESULTS During follow-up, 5407 (21.5%) cases developed MetS between 2006 and 2010. Incidence of MetS increased according to quintiles of serum ApoB levels [quintile 1-5: 9.1%, 16.4%, 22.1%, 27.3%, 36.4%, respectively (P for trend <0.001)]. Even after adjusting for various covariates including non-HDL-cholesterol, the hazard ratios (95% CI) for MetS increased in proportion to the quintiles of serum ApoB levels, compared to quintile 1 [quintile 2-5: 1.64 (1.43-1.89), 1.98 (1.71-2.31), 2.32 (1.96-2.75) and 2.92 (2.37-3.60), respectively (P for trend <0.001)]. These associations were apparent still in the clinically relevant subgroup analyses. CONCLUSIONS Serum ApoB levels predict MetS, independent of baseline confounding variables including non-HDL-cholesterol.
Collapse
Affiliation(s)
- Jae-Hong Ryoo
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | | |
Collapse
|
6
|
Parikh NI, Vasan RS. Assessing the clinical utility of biomarkers in medicine. Biomark Med 2012; 1:419-36. [PMID: 20477384 DOI: 10.2217/17520363.1.3.419] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Biomarkers in medicine have gained immense scientific and clinical interest in recent years. Biomarkers are potentially useful in the contexts of primary, secondary and tertiary prevention. Some of the characteristics of an ideal biomarker include that they are safe and easy to measure, are associated with acceptable costs (including those of the follow-up tests), and there is scientific evidence to suggest that biomarker use/modification influences disease outcomes. Additionally, variation in biomarker levels with gender and ethnicity should be elucidated, and the biomarker should have 'good performance characteristics' (i.e., sensitivity, specificity, positive- and negative-predictive values and positive- and negative-likelihood ratios). Risk prediction scores can combine information from several different biomarkers in order to estimate an individual's risk of developing an outcome, such as disease or death. Three commonly employed methods to test if a biomarker will add to traditional risk prediction models are model discrimination, model calibration and risk reclassification. 'Multimarker' strategies serve to integrate information from multiple biomarkers into risk prediction but may be limited by the presence of highly correlated biomarkers, economic costs and selection bias of biomarker candidates in a particular study sample. In the future, integration of biomarkers identified using emerging technologies from the 'omics fields (including genomics, proteomics, metabolomics, lipomics, ribomics and pharmacogenomics) may be useful for the 'personalization' of treatment/disease prevention.
Collapse
Affiliation(s)
- Nisha I Parikh
- Framingham Heart Study, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803, USA
| | | |
Collapse
|
7
|
|
8
|
Crook MA. A place for assaying serum apolipoprotein AI and B? Ann Clin Biochem 2011; 48:485-6. [DOI: 10.1258/acb.2011.011205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- M A Crook
- Department of Clinical Biochemistry and Metabolic Medicine, University Hospital Lewisham, London SE13 6LH; Department of Chemical Pathology and Metabolic Medicine, Guy's and St Thomas' Hospitals, London; Faculty of Science, University of Greenwich, London SE10 9LS, UK
| |
Collapse
|
9
|
Toth PP. Antisense therapy and emerging applications for the management of dyslipidemia. J Clin Lipidol 2011; 5:441-9. [PMID: 22108147 DOI: 10.1016/j.jacl.2011.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Revised: 08/10/2011] [Accepted: 08/17/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Because a significant percentage of patients who require high-dose statin therapy for dyslipidemia experience treatment-related muscle symptoms and an inconsistent clinical response, alternative or adjunctive approaches to the management of dyslipidemia are needed. One alternative approach, antisense therapy, may offer an effective and well-tolerated option for patients not satisfactorily responsive to or intolerant to standard pharmacologic dyslipidemia therapies. OBJECTIVE This review provides an overview of antisense technology and its potential role in the management of dyslipidemia. METHODS Source material was obtained primarily from the published literature identified through a search of the PubMed database. RESULTS Antisense technology is an evolving approach to therapy that has gone through a series of refinements to enhance molecular stability, potency, and tolerability. Mipomersen is an antisense molecule capable of producing clinically meaningful reductions in low-density lipoprotein cholesterol in patients with severe familial hypercholesterolemia. Further long-term clinical studies are required to more clearly quantify its impact on risk for cardiovascular events and establish whether it increases risk for hepatosteatosis. CONCLUSION Antisense therapy represents a potentially effective and well-tolerated emerging treatment modality for numerous diseases. In the treatment of hypercholesterolemia, the antisense therapy mipomersen may provide a possible treatment option for patients with treatment-resistant dyslipidemia.
Collapse
Affiliation(s)
- Peter P Toth
- Department of Preventive Cardiology, CGH Medical Center, Sterling, IL, USA.
| |
Collapse
|
10
|
Ryoo JH, Ha EH, Kim SG, Ryu S, Lee DW. Apolipoprotein B is highly associated with the risk of coronary heart disease as estimated by the Framingham risk score in healthy Korean men. J Korean Med Sci 2011; 26:631-6. [PMID: 21532853 PMCID: PMC3082114 DOI: 10.3346/jkms.2011.26.5.631] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 03/17/2011] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to examine the association between serum apolipoprotein B (apoB) and the risk of coronary heart disease (CHD) using Framingham risk score (FRS) in healthy Korean men. A total of 13,523 men without medication history of diabetes and hypertension were enrolled in this study. The FRS is based on six coronary risk factors. FRS ≥ 10% was defined as more-than-a-moderate risk group and FRS ≥ 20% as high risk group, respectively. The logistic regression analyses were conducted. When quartile 1 (Q1) set as a reference, in unadjusted analyses, the Q2, Q3, Q4 of apoB level had increased odds ratio (OR) for the risk of CHD in both more-than-a-moderate risk and high risk group, respectively. After adjusting for confounding variables, multivariable-adjusted logistic regression analyses showed a strong relationship between the quartiles of apoB level and more-than-a-moderate risk and high risk group, respectively. These associations were attenuated, but still remained statistically significant. ApoB is found to be independently related to the risk of CHD using FRS in healthy Korean men, and the link between apoB and the risk of CHD is dose-dependent.
Collapse
Affiliation(s)
- Jae-Hong Ryoo
- Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Eun-Hee Ha
- Department of Preventive Medicine, Ewha Womans University, Seoul, Korea
| | - Soo-Geun Kim
- Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Seungho Ryu
- Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Da-Woon Lee
- Department of Family Medicine, Chung-Ang University, School of Medicine, Seoul, Korea
| |
Collapse
|
11
|
Djordjević VB, Cosić V, Stojanović I, Kundalić S, Zvezdanović L, Deljanin-Ilić M, Vlahović P, Popović L. Lipoprotein(a) Is the Best Single Marker in Assessing Unstable Angina Pectoris. Cardiol Res Pract 2011; 2011:175363. [PMID: 21403866 PMCID: PMC3051153 DOI: 10.4061/2011/175363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 11/30/2010] [Accepted: 12/30/2010] [Indexed: 01/17/2023] Open
Abstract
This study evaluated whether statin therapy changed a diagnostic validity of lipid and inflammatory markers in ischemic heart disease (IHD) patients. Levels of lipids, lipoproteins, apolipoproteins, inflammatory markers, and atherogenic indexes were determined in 49 apparently healthy men and women, 82 patients having stable angina pectoris (SAP), 80 patients with unstable angina (USAP), and 106 patients with acute ST-elevation myocardial infarction (STEMI) treated or not treated with statins. Diagnostic accuracy of markers was determined by ROC curve analysis. Significantly lower apoA-I in all statin-treated groups and significantly higher apoB in statin-treated STEMI group compared to non-statin-treated groups were observed. CRP showed the best ROC characteristics in the assessment of STEMI patients. Lp(a) is better in the evaluation of SAP and USAP patients, considering that Lp(a) showed the highest area under the curve (AUC). Regarding atherogenic indexes, the highest AUC in SAP group was obtained for TG/apoB and in USAP and STEMI patients for TG/HDL-c. Statins lowered total cholesterol, LDL-c, and TG but fail to normalize apoA-I in patients with IHD.
Collapse
|
12
|
Affiliation(s)
- H Robert Superko
- Center for Genomics and Human Health, 5669 Peachtree Dunwoody Rd NE, Suite 315, Atlanta, GA 30342, USA.
| |
Collapse
|
13
|
Ballantyne CM, Raichlen JS, Cain VA. Statin Therapy Alters the Relationship Between Apolipoprotein B and Low-Density Lipoprotein Cholesterol and Non–High-Density Lipoprotein Cholesterol Targets in High-Risk Patients. J Am Coll Cardiol 2008; 52:626-32. [DOI: 10.1016/j.jacc.2008.04.052] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 04/07/2008] [Accepted: 04/29/2008] [Indexed: 11/28/2022]
|
14
|
|
15
|
Han JH, Park HS, Kim JA, Kim SM. Apolipoprotein B is a better marker than non-HDL-cholesterol for the metabolic syndrome in Koreans. Atherosclerosis 2008; 197:333-8. [PMID: 17628565 DOI: 10.1016/j.atherosclerosis.2007.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2006] [Revised: 04/11/2007] [Accepted: 05/22/2007] [Indexed: 12/31/2022]
Abstract
Apolipoprotein B (apoB) concentration reflects the number of atherogenic particles and is closely associated with atherosclerosis. Non-HDL-cholesterol (non-HDL-C) has been considered a therapeutic target for patients with hypertriglyceridemia. We compared the predictive values of apoB and non-HDL-C for the metabolic syndrome (MetS) in 3335 Korean adults (mean age, 45.2 years) who participated consecutively in a health examination in a university hospital. Anthropometry, blood pressure, fasting glucose, lipid profiles and apoB were measured. MetS, as defined by a modification of the NCEP-ATP III criteria, was present in 22.1% of men and 16.1% of women. Among the components of the MetS, triglycerides showed the strongest correlation with apoB (r=0.393, P<0.001 in men, and r=0.326, P<0.001 in women) and non-HDL-C (r=0.376, P<0.001 in men, and r=0.349, P<0.001 in women). When apoB and non-HDL-C were mutually adjusted, the ORs for the MetS of non-HDL-C were not significant. As a function of the quartile of apoB levels, the ORs for the MetS were 2.04 (1.26-3.30), 3.54 (2.11-5.93), and 5.38 (3.16-9.17) in men (P for trend <0.001) and 3.75 (1.42-9.87), 5.55 (2.09-14.69), and 13.41 (5.02-35.79) in women (P for trend <0.001), respectively. These findings indicate that apoB is a better marker than non-HDL-C for identifying the MetS among Koreans.
Collapse
Affiliation(s)
- Jee Hye Han
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, South Korea
| | | | | | | |
Collapse
|
16
|
Schuster H, Fagerberg B, Edwards S, Halmos T, Lopatynski J, Stender S, Birketvedt GS, Tonstad S, Gause-Nilsson I, Halldórsdóttir S, Ohman KP. Tesaglitazar, a dual peroxisome proliferator-activated receptor alpha/gamma agonist, improves apolipoprotein levels in non-diabetic subjects with insulin resistance. Atherosclerosis 2007; 197:355-62. [PMID: 17631296 DOI: 10.1016/j.atherosclerosis.2007.05.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2007] [Revised: 05/27/2007] [Accepted: 05/29/2007] [Indexed: 10/23/2022]
Abstract
AIM To determine the effects of the peroxisome proliferator-activated receptor (PPAR) alpha/gamma agonist tesaglitazar on serum levels of apolipoprotein (apo) A-I, apoB, and apoCIII in non-diabetic insulin-resistant subjects. METHODS This randomized, double-blind, multicentre, placebo-controlled trial examined the effect of tesaglitazar (0.1, 0.25, 0.5, and 1mg) once daily for 12 weeks on apolipoprotein levels in 390 abdominally obese subjects with hypertriglyceridaemia. RESULTS Tesaglitazar dose-dependently increased serum concentrations of apoA-I (p<0.009) and decreased concentrations of apoB (p<0.0001), the apoB/apoA-I ratio (p<0.0001), and apoCIII (p<0.0001). Similar improvements were observed in all subgroups of subjects, where individuals were grouped according to age, gender, baseline body mass index, serum triglycerides and high-density lipoprotein cholesterol levels. Low-density lipoprotein particle concentrations were also dose-dependently reduced by tesaglitazar (p<0.0001). CONCLUSION Although tesaglitazar is no longer in clinical development, these data indicate that dual PPARalpha/gamma agonism may be a useful pharmacological approach to improve the atherogenic dyslipidaemia associated with insulin resistance.
Collapse
|
17
|
Davy BM, Davy KP. Comparison of assessment techniques: plasma lipid and lipoproteins related to the metabolic syndrome. Lipids Health Dis 2006; 5:3. [PMID: 16448573 PMCID: PMC1379642 DOI: 10.1186/1476-511x-5-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Accepted: 01/31/2006] [Indexed: 01/01/2023] Open
Abstract
Background The purpose of this investigation was to determine the influence of analytical method on reported concentrations of plasma lipids and lipoproteins, and to determine if there are clinical implications of any potential differences on identification of the metabolic syndrome dyslipidemia, CVD risk stratification and classification of LDL subclass phenotype. Results Plasma triglyceride (TG) concentrations were 1.09 ± 0.06 and 1.17 ± 0.06 mmol/L and plasma high density lipoprotein cholesterol (HDL-C) concentrations were 1.09 ± 0.03 vs 1.19 ± 0.03 mmol/L (both p < 0.05) from 113 duplicate samples sent to two laboratories utilizing different lipid and lipoprotein analytical methods (LABS 1 and 2, respectively). Plasma total cholesterol and low-density lipoprotein cholesterol (LDL-C) concentrations were also significantly different between laboratories. Spearman rho correlations indicate excellent agreement of TG and HDL-C determined by the two laboratories (r = 0.96, TG; r = 0.91, HDL-C, both p < 0.001). Eleven vs. 14 individuals met the TG criteria and 70 vs. 48 met HDL-C metabolic syndrome criteria with LAB 1 and 2, respectively. Apoprotein B concentration (LAB 1) and LDL particle number (LAB 2) were highly correlated. (r = 0.92, P < 0.01). LAB 2 characterized more individuals as LDL pattern B phenotype, as compared to LAB 1 (30 vs. 14%, P < 0.05). Conclusion Different plasma lipid and lipoprotein analytical techniques yield results which are highly correlated, yet significantly different, which suggests a consistent measurement difference. This difference has clinical implications, in that the proportion of individuals identified as meeting the metabolic syndrome dyslipidemia criteria, "at risk" based upon apo B or LDL particle number, and the LDL pattern B phenotype will differ based upon choice of analytical method.
Collapse
Affiliation(s)
- Brenda M Davy
- Dept of Human Nutrition, Foods and Exercise (0430), Virginia Tech, Blacksburg, VA 24061, USA
| | - Kevin P Davy
- Dept of Human Nutrition, Foods and Exercise (0430), Virginia Tech, Blacksburg, VA 24061, USA
| |
Collapse
|
18
|
|
19
|
Tseng CH. Lipid abnormalities associated with urinary albumin excretion rate in Taiwanese type 2 diabetic patients. Kidney Int 2005; 67:1547-53. [PMID: 15780110 DOI: 10.1111/j.1523-1755.2005.00235.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of this study was to examine the lipid abnormalities associated with urinary albumin excretion rate (UAER) in type 2 diabetic patients. METHODS A total of 275 (122 men and 153 women; aged 60.6 +/- 11.1 years) patients were selected with stringent criteria to prevent confounders. Normoalbuminuria (N= 152) and albuminuria (N= 123) were defined as urinary albumin-to-creatinine ratio (ACR) of <30 and > or =30 microg/mg, respectively. Total cholesterol, triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, and apolipoproteins A1 (ApoA1) and B (ApoB) were measured and non-HDL cholesterol calculated. The subjects were divided into four phenotypes based on triglycerides (<1.5 or > or =1.5 mmol/L) and ApoB (<1.2 or > or =1.2 g/L). RESULTS Total cholesterol, ApoB, and non-HDL cholesterol were significantly (P < 0.05) higher in patients with albuminuria. For quartiles of the lipid parameters, prevalences of albuminuria showed significant association with ApoB and non-HDL cholesterol (P trend <0.05). After adjusting for age, systolic blood pressure and hemoglobin A(1c) (HbA(1c)) correlation coefficients between the natural logarithm (ln) ACR and lipid parameters, odds ratios for albuminuria, and standardized regression coefficients for ln ACR, were significant for total cholesterol, ApoB and non-HDL cholesterol in all subjects and in men, but only ApoB was significant in women. For patients with normoalbuminuria, frequencies of normotriglycerides/normo-ApoB, hypertriglycerides/normo-ApoB, normotriglycerides/hyper-ApoB, and hypertriglycerides/hyper-ApoB were 44.7%, 28.9%, 10.5%, and 15.8%, respectively; and were 30.1%, 19.5%, 15.4%, and 35.0% for patients with albuminuria (P < 0.001). The respective adjusted odds ratio for albuminuria for the four phenotypes was 1.00, 1.04 (0.54 to 2.00), 2.25 (1.02 to 5.00), and 3.38 (1.75 to 6.53). CONCLUSION Increased UAER is associated with ApoB-containing lipoproteins and the phenotype of hypertriglycerides/hyper-ApoB is associated with the highest risk of albuminuria. The surrogate marker of non-HDL cholesterol for ApoB is more applicable to the diabetic men.
Collapse
Affiliation(s)
- Chin-Hsiao Tseng
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan.
| |
Collapse
|
20
|
Vaverkova H, Frohlich J, Jackuliakova D, Novotny D. Comparison of apolipoprotein B and plasma lipids as targets for lipid lowering treatment. Clin Biochem 2005; 38:509-13. [PMID: 15885228 DOI: 10.1016/j.clinbiochem.2005.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2004] [Revised: 01/25/2005] [Accepted: 02/17/2005] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To assess the discrepancies between LDL-cholesterol and apo B targets in patients at risk for vascular disease; namely, those with diabetes or hypertriglyceridemia and those with triglycerides <1.7 mmol/L and normal glucose homeostasis. METHODS Lipid clinic patients were divided into two groups: Group 1 consisted of 182 patients whose triglyceride levels were >1.7 mmol/L or who had impaired fasting glucose or type 2 diabetes. In Group 2, there were 42 patients with triglycerides <1.7 mmol/L and normal glucose homeostasis. LDL-cholesterol and apo B were estimated during lipid clinic visits with patients on appropriate lipid lowering therapy. RESULTS 46% of the patients in Group 1 who reached the high risk LDL-cholesterol target of <2.5 mmol/L did not reach apo B target of <0.9 g/L, while in Group 2, only 19% of those who reached the LDL-cholesterol target had apo B >0.9 g/L. CONCLUSION Our findings demonstrate that a large percentage of patients with hypertriglyceridemia or impaired glucose tolerance, treated with lipid lowering agents, reach the LDL-cholesterol but not the apo B treatment targets.
Collapse
Affiliation(s)
- Helena Vaverkova
- 3rd Clinic of Internal Medicine, University Hospital and Medical Faculty of Palacky University, Olomouc, Czech Republic
| | | | | | | |
Collapse
|
21
|
Walldius G, Jungner I. Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets for lipid-modifying therapy. J Intern Med 2004; 255:188-205. [PMID: 14746556 DOI: 10.1046/j.1365-2796.2003.01276.x] [Citation(s) in RCA: 232] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although LDL cholesterol (LDL-C) is associated with an increased risk of coronary heart disease, other lipoproteins and their constituents, apolipoproteins, may play an important role in atherosclerosis. Elevated levels of apolipoprotein (apo) B, a constituent of atherogenic lipoproteins, and reduced levels of apo A-I, a component of anti-atherogenic HDL, are associated with increased cardiac events. Apo B, apo A-I and the apo B/apo A-I ratio have been reported as better predictors of cardiovascular events than LDL-C and they even retain their predictive power in patients receiving lipid-modifying therapy. Measurement of these apolipoproteins could improve cardiovascular risk prediction.
Collapse
Affiliation(s)
- G Walldius
- King Gustaf V Research Institute and Karolinska Institute, Stockholm, Sweden.
| | | |
Collapse
|
22
|
Abstract
The lowering of serum cholesterol is increasingly recognised as essential in the prevention of coronary heart disease and other atherosclerotic disease. The success of statin trials and the need to deploy these drugs effectively in the population has led increasingly to the identification of many people whose serum cholesterol, triglycerides, and HDL-cholesterol require clinical assessment, and frequently treatment. Lipid disorders are mainly straightforward, but some are complex or resistant to simple treatment strategies. I have reviewed the clinical manifestations of disordered lipid metabolism (dyslipidaemia) and its management.
Collapse
Affiliation(s)
- Paul Durrington
- University Department of Medicine, Manchester Royal Infirmary, Oxford Road, M13 9WL, Manchester, UK. >
| |
Collapse
|
23
|
Wägner AM, Pérez A, Zapico E, Ordóñez-Llanos J. Non-HDL cholesterol and apolipoprotein B in the dyslipidemic classification of type 2 diabetic patients. Diabetes Care 2003; 26:2048-51. [PMID: 12832311 DOI: 10.2337/diacare.26.7.2048] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare non-HDL cholesterol (HDLc) and apolipoprotein B (apoB) in the identification of nonconventional high-risk dyslipidemic phenotypes in type 2 diabetic patients. RESEARCH DESIGN AND METHODS Total cholesterol and triglycerides, HDLc, LDL cholesterol, non-HDLc, apolipoprotein B (apoB), and LDL size were determined in 122 type 2 diabetic patients (68% male, aged 59.6 +/- 9.7 years, and HbA(1c) 7.5% [range 5.2-16.0]). They were then classified as normo- and hypertriglyceridemic if their triglyceride concentrations were below/above 2.25 mmol/l, as normo/hyper-non-HDLc if non-HDLc concentrations were below/above 4.13 mmol/l, and as normo- and hyperapoB if apoB concentrations were below/above 0.97 g/l. Both classifications were compared (concordance assessed with the kappa index), and low HDLc and LDL phenotype B were identified in each category. RESULTS A total of 26 patients were hypertriglyceridemic and 96 were normotriglyceridemic. All hypertriglyceridemic subjects had increased non-HDLc, whereas 24 had increased apoB (kappa= 0.95). In the normotriglyceridemic group, 44 had increased non-HDLc, 68 had increased apoB, and 25 of the 52 patients with normal non-HDLc had increased apoB (kappa= 0.587). Low HDLc and LDL phenotype B were similarly distributed into the equivalent categories. CONCLUSIONS Non-HDLc and apoB are equivalent risk markers in hypertriglyceridemic patients, but apoB identifies additional patients with high-risk dyslipidemic phenotypes in normotriglyceridemic type 2 diabetic patients.
Collapse
Affiliation(s)
- Ana Maria Wägner
- Endocrinology and Nutrition Department, Hospital de Sant Pau, Universitat Autònoma, Barcelona, Spain.
| | | | | | | |
Collapse
|
24
|
Ayyobi AF, McGladdery SH, McNeely MJ, Austin MA, Motulsky AG, Brunzell JD. Small, dense LDL and elevated apolipoprotein B are the common characteristics for the three major lipid phenotypes of familial combined hyperlipidemia. Arterioscler Thromb Vasc Biol 2003; 23:1289-94. [PMID: 12750118 DOI: 10.1161/01.atv.0000077220.44620.9b] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Familial combined hyperlipidemia (FCHL) is associated with variable lipid and lipoprotein phenotypes arbitrarily defined as type IIa, IIb, and IV based on plasma total cholesterol and triglyceride levels. This study sought to characterize consistent lipoprotein and lipid abnormalities across the 3 lipoprotein phenotypes in 62 patients with documented FCHL (IIa [n=14], IIb [n=19], and IV [n=29]) and 44 healthy individuals. METHODS AND RESULTS The lipoprotein cholesterol distribution was determined over 38 fractions obtained by density gradient ultracentrifugation. As expected, FCHL patients with hypertriglyceridemia (IIb and IV) had higher cholesterol levels in VLDL than IIa, whereas IIa showed higher cholesterol in the big, buoyant LDL and in HDL. LDL cholesterol was higher in IIb than IV; most of the increase in LDL cholesterol was associated with big, buoyant LDL rather than small, dense LDL (sdLDL). The differences in lipoproteins between phenotypes were attributable to changes in VLDL and big, buoyant LDL levels. Comparison of the FCHL patients with healthy individuals showed a significant elevation in plasma apolipoprotein B levels and sdLDL in all 3 FCHL phenotypes. CONCLUSIONS Although triglyceride and cholesterol levels are variable by lipoprotein phenotype, sdLDL and elevated plasma apolipoprotein B levels are consistent characteristics of FCHL shared by the 3 different lipoprotein phenotypes.
Collapse
Affiliation(s)
- Amir F Ayyobi
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington, Seattle, Wash, USA
| | | | | | | | | | | |
Collapse
|
25
|
Sniderman AD, Furberg CD, Keech A, Roeters van Lennep JE, Frohlich J, Jungner I, Walldius G. Apolipoproteins versus lipids as indices of coronary risk and as targets for statin treatment. Lancet 2003; 361:777-80. [PMID: 12620753 DOI: 10.1016/s0140-6736(03)12663-3] [Citation(s) in RCA: 319] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A D Sniderman
- Mike Rosenbloom Laboratory for Cardiovascular Research, McGill University Health Centre, McGill University, Montreal, QC, Canada.
| | | | | | | | | | | | | |
Collapse
|
26
|
|
27
|
Le NA. Hyperlipidaemia and cardiovascular disease. Curr Opin Lipidol 2002; 13:577-80. [PMID: 12352022 DOI: 10.1097/00041433-200210000-00015] [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: 11/25/2022]
|
28
|
Fielding BA, Frayn KN. Lipid metabolism. Curr Opin Lipidol 2002; 13:573-5. [PMID: 12352021 DOI: 10.1097/00041433-200210000-00014] [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: 11/26/2022]
|
29
|
Durrington PN. Can Measurement of Apolipoprotein B Replace the Lipid Profile in the Follow-up of Patients with Lipoprotein Disorders? Clin Chem 2002. [DOI: 10.1093/clinchem/48.3.401] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Paul N Durrington
- Department of Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, United Kingdom
| |
Collapse
|