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Bogaards FA, Gehrmann T, Beekman M, van den Akker EB, van de Rest O, Hangelbroek RWJ, Noordam R, Mooijaart SP, de Groot LCPGM, Reinders MJT, Slagboom PE. PLIS: A metabolomic response monitor to a lifestyle intervention study in older adults. FASEB J 2022; 36:e22578. [PMID: 36183353 DOI: 10.1096/fj.202201037r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/07/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022]
Abstract
The response to lifestyle intervention studies is often heterogeneous, especially in older adults. Subtle responses that may represent a health gain for individuals are not always detected by classical health variables, stressing the need for novel biomarkers that detect intermediate changes in metabolic, inflammatory, and immunity-related health. Here, our aim was to develop and validate a molecular multivariate biomarker maximally sensitive to the individual effect of a lifestyle intervention; the Personalized Lifestyle Intervention Status (PLIS). We used 1 H-NMR fasting blood metabolite measurements from before and after the 13-week combined physical and nutritional Growing Old TOgether (GOTO) lifestyle intervention study in combination with a fivefold cross-validation and a bootstrapping method to train a separate PLIS score for men and women. The PLIS scores consisted of 14 and four metabolites for females and males, respectively. Performance of the PLIS score in tracking health gain was illustrated by association of the sex-specific PLIS scores with several classical metabolic health markers, such as BMI, trunk fat%, fasting HDL cholesterol, and fasting insulin, the primary outcome of the GOTO study. We also showed that the baseline PLIS score indicated which participants respond positively to the intervention. Finally, we explored PLIS in an independent physical activity lifestyle intervention study, showing similar, albeit remarkably weaker, associations of PLIS with classical metabolic health markers. To conclude, we found that the sex-specific PLIS score was able to track the individual short-term metabolic health gain of the GOTO lifestyle intervention study. The methodology used to train the PLIS score potentially provides a useful instrument to track personal responses and predict the participant's health benefit in lifestyle interventions similar to the GOTO study.
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Affiliation(s)
- Fatih A Bogaards
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands.,Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Thies Gehrmann
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands
| | - Marian Beekman
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik Ben van den Akker
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Ondine van de Rest
- Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Roland W J Hangelbroek
- Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Raymond Noordam
- Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Simon P Mooijaart
- Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Marcel J T Reinders
- Leiden Computational Biology Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - P Eline Slagboom
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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2
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Croyal M, Fall F, Ferchaud-Roucher V, Chétiveaux M, Zaïr Y, Ouguerram K, Krempf M, Nobécourt E. Multiplexed peptide analysis for kinetic measurements of major human apolipoproteins by LC/MS/MS. J Lipid Res 2016; 57:509-15. [PMID: 26773160 DOI: 10.1194/jlr.d064618] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Indexed: 11/20/2022] Open
Abstract
A multiplexed assay was developed by MS to analyze, in a single run, six major human Apos involved in lipoprotein metabolism: ApoA-I, ApoA-II, ApoB100, ApoC-II, ApoC-III, and ApoE. This method was validated in vivo in six subjects who received a 14 h constant infusion of [5,5,5-(2)H3]L-leucine at 10 μM/kg/h. Plasma lipoprotein fractions were isolated from collected blood samples and were digested with trypsin. Proteotypic peptides were subsequently analyzed by LC/MS/MS. Enrichment measurement data were compared with those obtained by the standard method using GC/MS. The required time to obtain the LC/MS/MS data was less than that needed for GC/MS. The enrichments from both methods were correlated for ApoA-I (r = 0.994; P < 0.0001) and ApoB100 (r = 0.999; P < 0.0001), and the Bland-Altman plot confirmed the similarity of the two methods. Intra- and inter-assay variability calculated for the six Apos of interest did not exceed 10.7 and 12.5%, respectively, and kinetic parameters were similar and/or in agreement with previously reported data. Therefore, LC/MS/MS can be considered as a useful tool for human Apo kinetic studies using stable isotopes.
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Affiliation(s)
- Mikaël Croyal
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Hôtel-Dieu, F-44000 Nantes, France CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France
| | - Fanta Fall
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Hôtel-Dieu, F-44000 Nantes, France CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France
| | - Véronique Ferchaud-Roucher
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Hôtel-Dieu, F-44000 Nantes, France CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France
| | - Maud Chétiveaux
- CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France
| | - Yassine Zaïr
- CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France
| | - Khadija Ouguerram
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Hôtel-Dieu, F-44000 Nantes, France CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France
| | - Michel Krempf
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Hôtel-Dieu, F-44000 Nantes, France CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France Department of Endocrinology, Metabolic Diseases, and Nutrition, G and R Laennec Hospital, F-44093 Nantes, France
| | - Estelle Nobécourt
- INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Hôtel-Dieu, F-44000 Nantes, France CRNHO, West Human Nutrition Research Center, CHU, F-44093 Nantes, France Department of Endocrinology, Metabolic Diseases, and Nutrition, G and R Laennec Hospital, F-44093 Nantes, France
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3
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Thongtang N, Diffenderfer MR, Ooi EMM, Asztalos BF, Dolnikowski GG, Lamon-Fava S, Schaefer EJ. Linkage between C-reactive protein and triglyceride-rich lipoprotein metabolism. Metabolism 2013; 62:369-75. [PMID: 23018145 PMCID: PMC4315144 DOI: 10.1016/j.metabol.2012.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 08/14/2012] [Accepted: 08/15/2012] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Inflammation plays an important role in atherosclerosis. Elevated C-reactive protein (CRP) levels are associated with a greater risk of cardiovascular disease. Our goal was to study CRP metabolism, and to determine its relationship with lipoprotein metabolism using stable isotope methodology. MATERIAL/METHODS Eight subjects with combined hyperlipidemia underwent a 15-h primed-constant infusion with deuterated leucine. CRP was purified from the plasma density fraction greater than 1.21g/ml by affinity chromatography. Lipoprotein fractions were separated by sequential ultracentrifugation. Isotope enrichment was determined by gas chromatography/mass spectrometry. RESULTS The subjects had mean LDL-C levels of 147.5mg/dl and mean CRP levels of 3.4mg/l. The mean CRP production rate (PR) was 0.050±0.012mg/kg/day and the mean CRP fractional catabolic rate (FCR) was 0.343±0.056 pools/day (residence time 2.92days). CRP pool size (PS) was significantly related to production (r=0.93; p<0.001), but not FCR. CRP PS was also related to body mass index (r=0.79; p=0.02). There was a significant association between CRP FCR and TRL apoB-100 FCR (r=0.74, p=0.04), as well as between CRP PS and TRL apoB-48 FCR (r=-0.90, p=0.002), indicating linkage between CRP and TRL metabolism. CONCLUSION The main determinant of plasma CRP levels was CRP production rate. Moreover a significant linkage between CRP metabolism and both TRL apoB-100 and apoB-48 catabolism was noted.
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Abstract
The prevalence of the metabolic syndrome (MetS) has increased rapidly in North America in recent years. Presently, the MetS is found in 34.3% of the population, and the prevalence is likely to continue to increase in parallel with the obesity epidemic. Losing weight and long-term maintenance of the weight loss are primary targets to beneficially reverse all of the components of the MetS. This paper reviews the clinical and experimental evidence for the reversal of the metabolic complications related to the MetS that follows a sustained weight loss.
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Affiliation(s)
- Annie Ferland
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Anschutz Medical Center, 12801 E. 17th Avenue, Aurora, CO 80045, USA
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5
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Castro-Perez JM, Roddy TP, Shah V, Wang SP, Ouyang X, Ogawa A, McLaren DG, Tadin-Strapps M, Robinson MJ, Bartz SR, Ason B, Chen Y, Previs SF, Wong KK, Vreeken RJ, Johns DG, Hubbard BK, Hankemeier T, Mitnaul L. Attenuation of Slc27a5 gene expression followed by LC-MS measurement of bile acid reconjugation using metabolomics and a stable isotope tracer strategy. J Proteome Res 2011; 10:4683-91. [PMID: 21819150 DOI: 10.1021/pr200475g] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to evaluate the use of high resolution LC-MS together with metabolomics and D(4)-cholic acid (D(4)-CA) as a metabolic tracer to measure the metabolism and reconjugation of bile acids (BAs) in vitro and in vivo. Metabolic tracers are very important because they allow for the direct detection (substrate-to-product) of small and significant biological perturbations that may not be apparent when monitoring "static" endogenous levels of particular metabolites. Slc27a5, also known as fatty acid transport protein 5 (FATP5), is the hepatic BA-CoA ligase involved in reconjugating BAs during enterohepatic BA recycling. Using Slc27a5-cKD mice, silencing of ∼90% gene expression was achieved followed by reduction in the reconjugation of D(4)-CA to D(4)-taurocholic acid (D(4)-TCA), as well as other conjugated BA metabolites in plasma (p = 0.0031). The method described allowed a rapid measure of many D(4) and endogenous BA. Analysis of bile resulted in the detection of 39 BA metabolites from a 13 min analytical run. Finally, the utilization of a novel high resolution mass spectrometry method in combination with metabolomics and a stable isotope metabolic tracer allowed for the detection of targeted and untargeted BAs following silencing of the Slc27a5 gene in primary hepatocytes and in mice.
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6
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Castro-Perez JM, Roddy TP, Shah V, McLaren DG, Wang SP, Jensen K, Vreeken RJ, Hankemeier T, Johns DG, Previs SF, Hubbard BK. Identifying Static and Kinetic Lipid Phenotypes by High Resolution UPLC–MS: Unraveling Diet-Induced Changes in Lipid Homeostasis by Coupling Metabolomics and Fluxomics. J Proteome Res 2011; 10:4281-90. [DOI: 10.1021/pr200480g] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jose M. Castro-Perez
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
- Division of Analytical Biosciences, LACDR, Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
| | - Thomas P. Roddy
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
| | - Vinit Shah
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
| | - David G. McLaren
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
| | - Sheng-Ping Wang
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
| | - Kristian Jensen
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
| | - Rob J. Vreeken
- Division of Analytical Biosciences, LACDR, Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
- Netherlands Metabolomics Centre, LACDR, Leiden University, P.O. Box 9502, 2300RA Leiden, The Netherlands
| | - Thomas Hankemeier
- Division of Analytical Biosciences, LACDR, Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
- Netherlands Metabolomics Centre, LACDR, Leiden University, P.O. Box 9502, 2300RA Leiden, The Netherlands
| | - Douglas G. Johns
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
| | - Stephen F. Previs
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
| | - Brian K. Hubbard
- Department of Cardiovascular Diseases − Atherosclerosis Rahway, Merck Research Laboratories, New Jersey 07065, United States
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7
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Aucott L, Gray D, Rothnie H, Thapa M, Waweru C. Effects of lifestyle interventions and long-term weight loss on lipid outcomes - a systematic review. Obes Rev 2011; 12:e412-25. [PMID: 21371252 DOI: 10.1111/j.1467-789x.2010.00819.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Weight and lipids are critical components of the metabolic syndrome, diabetes and cardiovascular disease. Past reviews considering weight loss on lipid profiles have been for ≤1 year follow-up and/or were for very overweight, obese or morbidly obese participants. This systematic review includes lifestyle interventions for adults (18-65 years), with a mean baseline BMI< 35 kg/m(2) , with weight and lipid differences over 2 years. Between 1990 and 2010, 14 studies were identified. Mean differences for weight and lipids were modest. However, weight loss at 2-3 years follow-up, produced significant beneficial lipid profile changes. These were similar to previous reviews conducted on heavier target groups and/or over shorter follow-up periods; cholesterol (1.3% decrease per kg lost) and triglycerides (1.6% fall per kg). Weight loss sustained longer than 3 years was not associated with beneficial lipid changes, suggesting that other lifestyle changes not just weight loss needs maintaining. Evidence linking lifestyle induced sustained weight loss with lipid profile changes in the long-term for this group is limited. Probable within-group differences (treatment vs prevention), would make further group separation prudent. Individual patient data analysis would facilitate this, uncover baseline, medication and confounding effects, and may identify successful program components enabling more effective obesity prevention and treatment strategies.
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Affiliation(s)
- L Aucott
- Section of Population Health, University of Aberdeen, Aberdeen, UK.
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8
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Pishva H, Mahboob SA, Mehdipour P, Eshraghian MR, Mohammadi-Asl J, Hosseini S, Karimi F. Fatty acid-binding protein-2 genotype influences lipid and lipoprotein response to eicosapentaenoic acid supplementation in hypertriglyceridemic subjects. Nutrition 2010; 26:1117-21. [PMID: 20080390 DOI: 10.1016/j.nut.2009.09.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Revised: 06/22/2009] [Accepted: 09/30/2009] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The blood lipid-lowering effects of eicosapentaenoic acid (EPA) on hypertriglyceridemic subjects with different fatty acid-binding protein-2 (FABP2) genotypes have not, to our knowledge, been previously studied. METHODS Twenty-three FABP2 Ala54 and 23 Thr54 carriers with hypertriglyceridemia (triacylglycerol level >200mg/dL) were enrolled in this study. Participants took 2g of pure EPA daily for 8 wk. Fasting blood lipid and lipoprotein profiles were determined and changes from baseline were measured. RESULTS Blood lipids and lipoprotein responses of the FABP2 genotypes differed after EPA supplementation. Changes from baseline for triacylglycerol (19.2% decrease for Ala54 and 60.5% for Thr54, P<0.001), very low-density lipoprotein (20.0% decrease for Ala54 and 60.5% for Thr54, P<0.001), apolipoprotein CIII (22.8% decrease for Ala54 and 36.4% for Thr54, P<0.01), and high-density lipoprotein cholesterol (17.6% increase for Ala54 and 30.7% for Thr54, P<0.01) differed significantly between the two carrier groups. However, changes in total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were not significant. EPA supplementation increased plasma EPA in Ala54 and Thr54 carriers. Although EPA supplementation increased the level of plasma EPA in both carrier groups, this effect was more pronounced in the Thr54 carriers. CONCLUSION Therefore, EPA consumption has more favorable effects on blood lipids of hypertriglyceridemics with Thr54 genotype rather than those with Ala54. The level of plasma EPA increases after EPA supplementation. Because the FABP2 Thr54 polymorphism appears to be prevalent in hypertriglyceridemic subjects, increasing EPA intake in these subjects could be an effective strategy for reducing blood triacylglycerol concentration.
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Affiliation(s)
- Hamideh Pishva
- Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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9
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Bowden RG, Jitomir J, Wilson RL, Gentile M. Effects of Omega-3 Fatty Acid Supplementation on Lipid Levels in Endstage Renal Disease Patients. J Ren Nutr 2009; 19:259-66. [DOI: 10.1053/j.jrn.2009.01.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Indexed: 11/11/2022] Open
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10
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Truong H, DiBello JR, Ruiz-Narvaez E, Kraft P, Campos H, Baylin A. Does genetic variation in the Delta6-desaturase promoter modify the association between alpha-linolenic acid and the prevalence of metabolic syndrome? Am J Clin Nutr 2009; 89:920-5. [PMID: 19144731 PMCID: PMC2667661 DOI: 10.3945/ajcn.2008.27107] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with protection against components of the metabolic syndrome, but the role of alpha-linolenic acid (ALA), the metabolic precursor of EPA and DHA, has not been studied. The Delta(6)-desaturase enzyme converts ALA into EPA and DHA, and genetic variation in the Delta(6)-desaturase gene (FADS2) may affect this conversion. OBJECTIVES We hypothesize that high ALA is associated with a lower prevalence of the metabolic syndrome and that genetic variation in FADS2 modifies this association. DESIGN We studied 1815 Costa Rican adults. Adipose tissue ALA was used as a biomarker of intake, and metabolic syndrome was identified with the definition from the National Cholesterol Education Program, Adult Treatment Panel III. Prevalence ratios (PRs) and 95% CIs were estimated from binomial regression models, and the likelihood ratio was used to test for effect modification. RESULTS High concentrations of adipose tissue ALA were associated with lower PRs of the metabolic syndrome compared with low ALA (0.81; 95% CI: 0.66, 1.00, for the comparison between the highest and the lowest quintiles; P for trend < 0.02). Higher concentrations of adipose tissue ALA were associated with a lower PR among homozygote (0.67; 95% CI: 0.53, 0.86) and heterozygote (0.84; 95% CI: 0.72, 0.99) carriers of the FADS2 T allele, but not among homozygote carriers of the deletion variant allele (0.99; 95% CI: 0.78, 1.27; P for interaction: 0.08). CONCLUSIONS Elevated ALA concentrations in adipose tissue are associated with lower prevalence of the metabolic syndrome. A lack of association among homozygote carriers of the FADS2 deletion allele suggests that this association may be due in part to the conversion of ALA into EPA.
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Affiliation(s)
- Hong Truong
- Division of Biology and Medicine, Brown University, Providence, RI 02903, USA
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11
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Elbert DL, Mawuenyega KG, Scott EA, Wildsmith KR, Bateman RJ. Stable isotope labeling tandem mass spectrometry (SILT): integration with peptide identification and extension to data-dependent scans. J Proteome Res 2008; 7:4546-56. [PMID: 18774841 DOI: 10.1021/pr800386u] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Quantitation of relative or absolute amounts of proteins by mass spectrometry can be prone to large errors. The use of MS/MS ion intensities and stable isotope labeling, which we term stable isotope labeling tandem mass spectrometry (SILT), decreases the effects of contamination from unrelated compounds. We present a software package (SILTmass) that automates protein identification and quantification by the SILT method. SILTmass has the ability to analyze the kinetics of protein turnover, in addition to relative and absolute protein quantitation. Instead of extracting chromatograms to find elution peaks, SILTmass uses only scans in which a peptide is identified and that meet an ion intensity threshold. Using only scans with identified peptides, the accuracy and precision of SILT is shown to be superior to precursor ion intensities, particularly at high or low dilutions of the isotope labeled compounds or with low amounts of protein. Using example scans, we demonstrate likely reasons for the improvements in quantitation by SILT. The appropriate use of variable modifications in peptide identification is described for measurement of protein turnover kinetics. The combination of identification with SILT facilitates quantitation without peak detection and helps to ensure the appropriate use of variable modifications for kinetics experiments.
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Affiliation(s)
- Donald L Elbert
- Department of Biomedical Engineering and Center for Materials Innovation, Washington University, St. Louis, Missouri, USA.
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12
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Hoenig MR. Implications of the obesity epidemic for lipid-lowering therapy: non-HDL cholesterol should replace LDL cholesterol as the primary therapeutic target. Vasc Health Risk Manag 2008; 4:143-56. [PMID: 18629364 PMCID: PMC2464759 DOI: 10.2147/vhrm.2008.04.01.143] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Obesity, metabolic syndrome and diabetes are conditions with increasing prevalence around the world. Cardiovascular risk in diabetics is often so high as to overlap with event rates observed in those with established coronary disease and this has lead to diabetes being classified as a coronary risk equivalent. However, despite the elevated risk of cardiovascular events associated with diabetes and the metabolic syndrome, these patients often have normal low density lipoprotein (LDL) cholesterol despite frequent increases in apolipoprotein B, triglycerides and nonhigh density lipoprotein (HDL) cholesterol. In contrast to LDL cholesterol, non-HDL cholesterol represents cardiovascular risk across all patient populations but is currently only recommended as a secondary target of therapy by the ATP III report for patients with hypertriglyceridemia. This article provides an overview of the studies that shown non-HDL cholesterol to be superior to LDL cholesterol in predicting cardiovascular events and presents the case for non-HDL cholesterol being the more appropriate primary target of therapy in the context of the obesity pandemic. Adopting non-HDL cholesterol as the primary therapeutic target for all patients will conceivably lead to an appropriate intensification of therapy for high risk patients with low LDL cholesterol.
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Affiliation(s)
- Michel R Hoenig
- Royal Brisbane and Women's Hospital Herston, Queensland, Australia.
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13
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Ramakrishnan R, Ramakrishnan JD. Using mass measurements in tracer studies--a systematic approach to efficient modeling. Metabolism 2008; 57:1078-87. [PMID: 18640385 PMCID: PMC2601710 DOI: 10.1016/j.metabol.2008.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Accepted: 03/27/2008] [Indexed: 10/24/2022]
Abstract
Tracer enrichment data are fitted by multicompartmental models to estimate rate constants and fluxes or transport rates. In apolipoprotein turnover studies, mass measurements are also available, for example, apolipoprotein B levels in very low-density lipoprotein, intermediate-density lipoprotein, and low-density lipoprotein, and are often essential to calculate some of the rate constants. The usual method to use mass measurements is to estimate pool masses along with rate constants. A systematic alternative approach is developed to use flux balances around pools to express some rate constants in terms of the other rate constants and the measured masses. The resulting reduction in the number of parameters to be estimated makes the modeling more efficient. In models that would be unidentifiable without mass measurements, the usual approach and the proposed approach yield identical results. In a simple two-pool model, the number of unknown parameters is reduced from 4 to 2. In a published five-pool model for apolipoprotein B kinetics with three mass measurements, the number of parameters is reduced from 12 to 9. With m mass measurements, the number of responses to be fitted and the number of parameters to be estimated are each reduced by m, a simplification by 1/4 to 1/3 in a typical pool model. Besides a proportionate reduction in computational effort, there is a further benefit because the dimensionality of the problem is also decreased significantly, which means ease of convergence and a smaller likelihood of suboptimal solutions. Although our approach is conceptually straightforward, the dependencies get considerably more complex with increasing model size. To generate dependency definitions automatically, a Web-accessible program is available at http://biomath.info/poolfit/constraints.
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Affiliation(s)
- Rajasekhar Ramakrishnan
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
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14
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Barrett PHR, Chan DC, Watts GF. Thematic review series: Patient-Oriented Research. Design and analysis of lipoprotein tracer kinetics studies in humans. J Lipid Res 2006; 47:1607-19. [PMID: 16728729 DOI: 10.1194/jlr.r600017-jlr200] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Lipoprotein tracer kinetics studies have for many years provided new and important knowledge of the metabolism of lipoproteins. Our understanding of kinetics defects in lipoprotein metabolism has resulted from the use of tracer kinetics studies and mathematical modeling. This review discusses all aspects of the performance of kinetics studies, including the development of hypotheses, experimental design, statistical considerations, tracer administration and sampling schedule, and the development of compartmental models for the interpretation of tracer data. In addition to providing insight into new metabolic pathways, such models provide quantitative information on the effect of interventions on lipoprotein metabolism. Compartment models are useful tools to describe experimental data but can also be used to aid in experimental design and hypothesis generation. The SAAM II program provides an easy-to-use interface with which to develop and test compartmental models against experimental models. The development of a model requires that certain checks be performed to ensure that the model describes the experimental data and that the model parameters can be estimated with precision. In addition to methodologic aspects, several compartment models of apoprotein and lipid metabolism are reviewed.
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Affiliation(s)
- P Hugh R Barrett
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
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Abstract
The metabolic syndrome is defined as the coexistence of 3 or more components, some of which indicate alterations in glucose and lipid metabolism. The prevalence of the metabolic syndrome is rapidly increasing in relation to obesity, and it is considered to be an important predictor of cardiovascular disease. Increased intakes or supplements of n-3 marine fatty acids may improve defects in insulin signaling and prevent alterations in glucose homeostasis and the further development of type 2 diabetes. This is largely mediated through a reduction in fatty acid accumulation in muscle and liver. n-3 Polyunsaturated fatty acids (n-3 PUFAs) reduce plasma triacylglycerols and improve the lipoprotein profile by decreasing the fraction of atherogenic small, dense LDL. However, n-3 PUFAs do not lower LDL cholesterol. These effects are likely mediated through the activity of transcription factors relating to expression of genes involved in lipid oxidation and synthesis. Other pleiotrophic effects of n-3 PUFAs may contribute to decreasing the burden of the metabolic syndrome, such as modulating inflammation, platelet activation, endothelial function, and blood pressure. Although studies comparing the effect of both major n-3 PUFAs are limited, docosahexaenoic acid appears at least as efficient as eicosapentaenoic acid in correcting several risk factors. The use of n-3 PUFAs should be considered in more global strategies including changes in lifestyle, such as adhering to a healthy Mediterranean type of diet and practicing regular physical exercise.
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Affiliation(s)
- Yvon A Carpentier
- L. Deloyers Laboratory of Experimental Surgery, Université Libre de Bruxelles, Brussels, Belgium.
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16
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Parhofer KG, Barrett PHR. Thematic review series: patient-oriented research. What we have learned about VLDL and LDL metabolism from human kinetics studies. J Lipid Res 2006; 47:1620-30. [PMID: 16720894 DOI: 10.1194/jlr.r600013-jlr200] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Lipoprotein metabolism is the result of a complex network of many individual components. Abnormal lipoprotein concentrations can result from changes in the production, conversion, or catabolism of lipoprotein particles. Studies in hypolipoproteinemia and hyperlipoproteinemia have elucidated the processes that control VLDL secretion as well as VLDL and LDL catabolism. Here, we review the current knowledge regarding apolipoprotein B (apoB) metabolism, focusing on selected clinically relevant conditions. In hypobetalipoproteinemia attributable to truncations in apoB, the rate of secretion is closely linked to the length of apoB. On the other hand, in patients with the metabolic syndrome, it appears that substrate, in the form of free fatty acids, coupled to the state of insulin resistance can induce hypersecretion of VLDL-apoB. Studies in patients with familial hypercholesterolemia, familial defective apoB, and mutant forms of proprotein convertase subtilisin/kexin type 9 show that mutations in the LDL receptor, the ligand for the receptor, or an intracellular chaperone for the receptor are the most important determinants in regulating LDL catabolism. This review also demonstrates the variance of results within similar, or even the same, phenotypic conditions. This underscores the sensitivity of metabolic studies to methodological aspects and thus the importance of the inclusion of adequate controls in studies.
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17
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Abstract
PURPOSE OF REVIEW Dyslipoproteinemia is a cardinal feature of the metabolic syndrome that accelerates atherosclerosis. Recent in-vivo kinetic studies of dyslipidemia in the metabolic syndrome are reviewed here. RECENT FINDINGS The dysregulation of lipoprotein metabolism may be caused by a combination of overproduction of VLDL apolipoprotein B-100, decreased catabolism of apolipoprotein B-containing particles, and increased catabolism of HDL apolipoprotein A-I particles. Nutritional modifications and increased physical exercise may favourably alter lipoprotein transport by collectively decreasing the hepatic secretion of VLDL apolipoprotein B and the catabolism of HDL apolipoprotein A-I, as well as by increasing the clearance of LDL apolipoprotein B. Conventional and new pharmacological treatments, such as statins, fibrates and cholesteryl ester transfer protein inhibitors, can also correct dyslipidemia by several mechanisms, including decreased secretion and increased catabolism of apolipoprotein B, as well as increased secretion and decreased catabolism of apolipoprotein A-I. SUMMARY Kinetic studies provide a mechanistic insight into the dysregulation and therapy of lipid and lipoprotein disorders. Future research mandates the development of new tracer methodologies with practicable in-vivo protocols for investigating fatty acid turnover, macrophage reverse cholesterol transport, cholesterol transport in plasma, corporeal cholesterol balance, and the turnover of several subpopulations of HDL particles.
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Affiliation(s)
- Dick C Chan
- Lipoprotein Research Unit, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
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18
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Batista MC, Welty FK, Diffenderfer MR, Sarnak MJ, Schaefer EJ, Lamon-Fava S, Asztalos BF, Dolnikowski GG, Brousseau ME, Marsh JB. Apolipoprotein A-I, B-100, and B-48 metabolism in subjects with chronic kidney disease, obesity, and the metabolic syndrome. Metabolism 2004; 53:1255-61. [PMID: 15375779 DOI: 10.1016/j.metabol.2004.05.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The metabolism of apolipoproteins (apo)B-48, B-100, and A-I was studied with a primed constant infusion of deuterium-labeled leucine in the fed state in 3 male individuals with chronic kidney disease (CKD), a glomerular filtration rate (GFR) of 28 to 57 mL/min/1.73 m2, obesity (body mass index [BMI] 33.1), and the metabolic syndrome. Compared to 5 obese controls (BMI 30.1) and 13 non-obese controls (BMI 25.2), these CKD subjects had high plasma levels of triglycerides (TG) (343 +/- 27.5 mg/dL v 144 +/- 34.4 in the obese controls, P < .001) and low apoA-I (86.7 +/- 3.9 mg/dL). An abnormal high-density lipoprotein (HDL) particle subpopulation pattern was found, with low levels of pre beta-1 and alpha1. Compared to the obese controls, very-low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL) apoB-100 levels were elevated 2- to 3-fold, while LDL apoB-100 levels were slightly lower (-7 %) and apoB-48 levels were comparable. The high TG levels were not associated with statistically significant changes in VLDL apoB-100 kinetics, although the production rate (PR) was higher and the fractional catabolic rate (FCR) was lower. The slightly lower LDL apoB-100 levels were accompanied by a significant 3-fold increase in the FCR and a 2.7-fold increase in the PR. The lower apoA-I levels were accompanied by a 1.6-fold increase in the FCR. Compared to the non-obese controls, the PR of apoA-I was increased by 61% and 38%, respectively (P < .001) in CKD and in obese control subjects. In the control subjects, the PR of apoA-I was significantly correlated with the BMI (r = 0.81, P < .0001). The kinetic results are consistent with these hypotheses: (1) CKD is associated with decreased clearance of the TG-rich lipoproteins (TRLs) and increased catabolism of LDL; (2) obesity increases apoB-100 and apoA-I production; and (3) in CKD, TG transfer to HDL, making HDL more susceptible to catabolism, accounts for the low apoA-I levels.
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Affiliation(s)
- Marcelo C Batista
- Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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19
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Nestel P. Nutritional aspects in the causation and management of the metabolic syndrome. Endocrinol Metab Clin North Am 2004; 33:483-92, v. [PMID: 15262292 DOI: 10.1016/j.ecl.2004.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This article emphasizes the importance of weight reduction in obese individuals as the main nutritional focus relevant to the metabolic syndrome. Although other nutrients influence insulin sensitivity, these effects are modest in comparison with the benefit achievable with weight reduction. This article therefore initially discusses the dramatic rise in the prevalence of the metabolic syndrome,especially in the Asian-Pacific region where insulin resistance and the high conversion rate to type 2 diabetes are almost certainly related to weight gain.
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Affiliation(s)
- Paul Nestel
- Baker Heart Research Institute (Wynn Domain), Commercial Road, Prahan 3181, Melbourne, Victoria, Australia.
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20
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Aguilar-Salinas CA, Assis-Luores-Vale A, Stockins B, Rengifo HM, Filho JD, Neto AA, Rabelo LM, Torres KP, Oliveira JEPD, Machado CA, Reyes E, Saavedra V, Florenzano F, Hernández MV, Jiménez SH, Ramírez E, Vazquez C, Salinas S, Hernández I, Medel O, Moreno R, Lugo P, Alvarado R, Mehta R, Gutierrez V, Gómez Pérez FJ. Ciprofibrate therapy in patients with hypertriglyceridemia and low high density lipoprotein (HDL)-cholesterol: greater reduction of non-HDL cholesterol in subjects with excess body weight (The CIPROAMLAT study). Cardiovasc Diabetol 2004; 3:8. [PMID: 15272932 PMCID: PMC503398 DOI: 10.1186/1475-2840-3-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Accepted: 07/23/2004] [Indexed: 11/30/2022] Open
Abstract
Background Hypertriglyceridemia in combination with low HDL cholesterol levels is a risk factor for cardiovascular disease. Our objective was to evaluate the efficacy of ciprofibrate for the treatment of this form of dyslipidemia and to identify factors associated with better treatment response. Methods Multicenter, international, open-label study. Four hundred and thirty seven patients were included. The plasma lipid levels at inclusion were fasting triglyceride concentrations between 1.6–3.9 mM/l and HDL cholesterol ≤ 1.05 mM/l for women and ≤ 0.9 mM/l for men. The LDL cholesterol was below 4.2 mM/l. All patients received ciprofibrate 100 mg/d. Efficacy and safety parameters were assessed at baseline and at the end of the treatment. The primary efficacy parameter of the study was percentage change in triglycerides from baseline. Results After 4 months, plasma triglyceride concentrations were decreased by 44% (p < 0.001). HDL cholesterol concentrations were increased by 10% (p < 0.001). Non-HDL cholesterol was decreased by 19%. A greater HDL cholesterol response was observed in lean patients (body mass index < 25 kg/m2) compared to the rest of the population (8.2 vs 19.7%, p < 0.001). In contrast, cases with excess body weight had a larger decrease in non-HDL cholesterol levels (-20.8 vs -10.8%, p < 0.001). There were no significant complications resulting from treatment with ciprofibrate. Conclusions Ciprofibrate is efficacious for the correction of hypertriglyceridemia / low HDL cholesterol. A greater decrease in non-HDL cholesterol was found among cases with excess body weight. The mechanism of action of ciprofibrate may be influenced by the pathophysiology of the disorder being treated.
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Affiliation(s)
- Carlos A Aguilar-Salinas
- Departamento de Endocrinología y Metabolismo. Instituto Nacional de la Nutrición, México City, Mexico
| | - Andréia Assis-Luores-Vale
- Hospital Socor. Dept° de Aterosclerose. Rua Tupis, 1540 – 1° andar – Barro Preto – Belo Horizonte/MG-30190-062, Brazil
| | - Benjamín Stockins
- Universidad De La Frontera. Departamento Medicina Interna. Av. Francisco Salazar 01145 Temuco-Chile
| | - Hector Mario Rengifo
- Centro Médico del Pacífico. Departamento de Endocrinología. Calle 5B No. 42-16. Cali – Colombia
| | - José Dondici Filho
- CINDI – Centro de Investigações Diagnósticas Ltda. Dept° de Cardiologia. Rua Rei Alberto, 196 – Centro – Juiz de Fora/MG – 36016-300, Brazil
| | - Abrahão Afiune Neto
- Hospital São Salvador. Dept° de Cardiologia. Avenida A, 333 – Setor Oeste – Goiânia/GO – 74110-020, Brazil
| | - Lísia Marcílio Rabelo
- Fundação Baiana de Cardiologia. Dept° de Lípides. Rua Augusto Viana, S/N° – Canela – Salvador/BA – 40140-060, Brazil
| | - Kerginaldo Paulo Torres
- Prócardio. Dept° de Aterosclerose. Avenida Nascimento de Castro, 1930 – Lagoa Nova – Natal/RN – 59056-450, Brazil
| | - José Egídio Paulo de Oliveira
- Hospital Universitário Clementino Fraga Filho. Dept° de Diabetes/Nutrição. Avenida Brigadeiro Trompowiski, S/N° – Ilha do Fundão – Rio de Janeiro/RJ – 21941-590, Brazil
| | - Carlos Alberto Machado
- Centro de Referência de Hipertensão Arterial Diabetes e Apoio à Saúde do Idoso Dept° de Centro de Referência em Dislipidemia Rua Doutor Clementino, 200 – Belém – São Paulo/SP – 03059-030, Brazil
| | - Eliana Reyes
- Hospital Dipreca. Unidad de Asistencia Nutricional Intensiva.División Medicina Interna Vital Apoquindo 1200. Las Condes.Santiago. Chile
| | - Victor Saavedra
- Consulta Privada. Guardia Vieja 181 of. 405. Providencia. Santiago-Chile
| | - Fernando Florenzano
- Hospital Del Salvador. Sección Cardiología. Av. Salvador 364. Providencia. Santiago-Chile
| | - Ma Victoria Hernández
- Hospital Fuerza Aérea De Chile. Unidad De Cardiología.Av. Las Condes 8631. Las Condes Santiago-Chile
| | - Sergio Hernandez Jiménez
- Departamento de Endocrinología y Metabolismo. Instituto Nacional de la Nutrición, México City, Mexico
| | - Erika Ramírez
- Departamento de Endocrinología y Metabolismo. Instituto Nacional de la Nutrición, México City, Mexico
| | - Cuauhtémoc Vazquez
- Hospital de Cardiología del Centro Médico Nacional Siglo XXI (IMSS).Depto. de Estudios Metabólicos y Clínica de Lípidos.Av. Cuauhtemoc No. 330 Col Doctores.México, D. F
| | - Saul Salinas
- Hospital de Cardiología del Centro Médico Nacional Siglo XXI (IMSS).Depto. de Estudios Metabólicos y Clínica de Lípidos.Av. Cuauhtemoc No. 330 Col Doctores.México, D. F
| | - Ismael Hernández
- Hospital Juárez de México (SSA).Unidad Coronaria.Av. Instituto Politécnico Nacional 5160 Col Magdalena de las Salinas.México, D. F
| | - Octavio Medel
- Hospital Juárez de México (SSA).Unidad Coronaria.Av. Instituto Politécnico Nacional 5160 Col Magdalena de las Salinas.México, D. F
| | - Ricardo Moreno
- Hospital General Regional No. 72 (IMSS).Terapia Intensiva.Filiberto Gómez S/N y Vía Gustavo Baz.Tlalnepantla, Edo. de México, Mexico
| | - Paula Lugo
- Centro Médico Nacional de Occidente (IMSS).Departamento de Cardiología.Belisario Domínguez sin número Col. Centro.Guadalajara, Jal, Mexico
| | - Ricardo Alvarado
- Hospital Dr. Santiago Ramón y Cajal (ISSSTE). Departamento de Cardiología Predio Canoa S/N Col. Los Angeles. Durango, Dgo, Mexico
| | - Roopa Mehta
- Departamento de Endocrinología y Metabolismo. Instituto Nacional de la Nutrición, México City, Mexico
| | | | - Francisco J Gómez Pérez
- Departamento de Endocrinología y Metabolismo. Instituto Nacional de la Nutrición, México City, Mexico
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21
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Issa BG, Hanna FWF. Insulin resistance, the metabolic syndrome and risk of cardiovascular disease: a complex story. Curr Opin Lipidol 2003; 14:405-7. [PMID: 12865741 DOI: 10.1097/00041433-200308000-00013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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