Serum apolipoprotein A1 rather than apolipoprotein B is associated with hypertension prevalence in Chinese people with coronary artery disease

How is Obstructive Sleep Apnea Associated with High Blood Pressure and Diabetes Mellitus Type 2? Clues from a Two-Step Mendelian Randomized Study

Background

Obstructive sleep apnea (OSA), high blood pressure (HBP), and type 2 diabetes mellitus (T2DM) have a close clinical relationship, but whether and how OSA affects HBP and T2DM is unclear.

Study Design and Methods

Two-step, two-sample Mendelian randomization techniques were applied using single-nucleotide polymorphisms as genetic instruments for exposure and mediators, thus minimizing bias due to confounding factors and reverse causality. The total effect of OSA on HBP and T2DM was categorized into direct and mediating effects based on the mediating factors.

Results

Two-sample MR analysis showed that OSA increased the risk of HBP (odds ratio [OR] = 1.010, 95% confidence interval [CI], 1.002-1.018; P = 0.0121) and T2DM (OR = 1.140, 95% CI, 1.059-1.228; P = 0.0005). In the process of OSA caused by HBP, sex hormone-binding globulin (SHBG) (female, 4.47% mediation; male, 2.76% mediation), total testosterone (TT) (male, 3.72% mediation), bioavailable testosterone (BioT) (female, 7.74% mediation), high-density lipoprotein cholesterol (HDL-C) (3.25% mediation), and apolipoprotein A1 (ApoA1) (1.31% mediation) were individual contributors. SHBG (female, 4.10% mediation; male, 1.58% mediation), TT (male, 3.69% mediation), BioT (female, 2.58% mediation), HDL-C (3.32% mediation), ApoA1 (2.14% mediation), and omega-6 fatty acids (2.33% mediation) may have mediating roles to varying degrees in the process of OSA caused by T2DM.

Interpretation

This MR study showed that OSA is a risk factor for HBP and T2DM, and the evaluation of mediators may help further reveal the specific mechanism by which OSA causes HBP and T2DM.

The Value of the Apolipoprotein B/Apolipoprotein A1 Ratio in Predicting the Rapid Progression of Non-Culprit Coronary Lesions in Acute Coronary Syndrome in Patients with Diabetes Mellitus after Percutaneous Coronary Intervention

This study aims to assess the predictive value of the apolipoprotein B (ApoB) /apolipoprotein A1 (ApoA1) ratio in acute coronary syndrome (ACS) in patients with diabetes mellitus (DM) for the rapid progression (RP) of non-culprit coronary lesions (NCCLs) after percutaneous coronary intervention (PCI) and observe the effect of the ApoB/ApoA1 ratio on major adverse cardiac events (MACE).A total of 175 patients with DM presenting with ACS who received a PCI and an average 13-month follow-up coronary angiography (CAG) were enrolled from January 2015 to December 2020. According to the CAG, the patients were divided into the RP group and the non-RP group. MACE was defined as a composite of death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization from unstable or progressive angina at the end of a 24-month follow-up.The low-density lipoprotein cholesterol (LDL-C), ApoB, ApoB/ApoA1 ratio, and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio levels at baseline were significantly higher in the RP group than in the non-RP group. The ApoA1 level at baseline in the non-RP group was significantly higher than in the RP group. The predictive significance of the ApoB/ApoA1 ratio (area under the curve (AUC) = 0.712) for the RP of NCCLs was significantly higher than those of ApoA1, ApoB, LDL-C/HDL-C ratio (AUC = 0.628, AUC = 0.640, and AUC = 0.620, respectively). A higher ApoB/ApoA1 ratio and the RP of NCCLs were significantly associated with the occurrence of MACE.The ApoB/ApoA1 ratio was an effective clinical indicator for the RP of NCCLs after PCI in patients with DM presenting with ACS. The high ApoB/ApoA1 ratio and the RP of NCCLs were two risks for MACE.

A Study on Multiple Facets of Apolipoprotein A1 Milano

For several strategies formulated to prevent atherosclerosis, Apolipoprotein A1 Milano (ApoA1M) remains a prime target. ApoA1M has been reported to have greater efficiency in reducing the incidence of coronary artery diseases. Furthermore, recombinant ApoA1M based mimetic peptide exhibits comparatively greater atheroprotective potential, offers a hope in reducing the burden of atherosclerosis in in vivo model system. The aim of this review is to emphasize on some of the observed ApoA1M structural and functional effects that are clinically and therapeutically meaningful that might converge on the basic role of ApoA1M in reducing the chances of glycation assisted ailments in diabetes. We also hypothesize that the nonenzymatic glycation prone arginine amino acid of ApoA1 gets replaced with cysteine residue and the rate of ApoA1 glycation may decrease due to change substitution of amino acid. Therefore, to circumvent the effect of ApoA1M glycation, the related mechanism should be explored at the cellular and functional levels, especially in respective experimental disease model in vivo.

Association of Apolipoprotein A1, High Density Lipoprotein Cholesterol, and Their Ratio with Inflammatory Marker in Chinese Adults with Coronary Artery Disease

Sparse data assessed the association of apolipoprotein A1 (ApoA1) and high density lipoprotein cholesterol (HDL-C) with inflammation. We investigated this association in a hospital-based cross-sectional pilot study that included 7296 patients with coronary artery disease (CAD). In multivariate analysis, negative associations of ApoA1 and HDL-C with C-reactive protein (CRP), high sensitivity CRP (hsCRP), and tumor necrosis factor-α (TNF-α) were shown. The corresponding CRP, hsCRP, and TNF-α values were 5.28 (vs 11.70 mg/L), 4.50 (vs 11.50 mg/L), and 7.68 (vs 10.90 pg/mL) for ApoA1, and 7.13 (vs 10.60 mg/L), 6.27 (vs 9.19 mg/L), and 8.11 (vs 11.86 pg/mL) for HDL-C in the fourth quartiles compared with the first quartiles. ApoA1/HDL-C ratio was inversely associated with hsCRP and interleukin-6 (IL-6). No significant associations of ApoA1 and HDL-C with IL-6 and IL-8, and of ApoA1/HDL-C ratio with CRP, IL-8, and TNF-α were observed. In path analyses, there was no evidence of mediating effects of body mass index on the "ApoA1 and HDL-C-inflammation" relationship. Generally, our study of CAD patients identified graded and inverse associations of ApoA1, HDL-C, and ApoA1/HDL-C ratio with inflammatory marker (CRP, hsCRP, IL-6, IL-8, or TNF-α) levels.

Characteristics of serum lipid levels in patients with hypertension: a hospital-based retrospective descriptive study

BACKGROUND

Dyslipidaemia is different among patients with hypertension in different populations. The serum lipid profiles among Hakka patients with hypertension in southern China are still unclear.

METHODS

35 448 patients with hypertension were enrolled in this study from January 2016 to October 2020, and their serum lipids were analysed.

RESULTS

Low high-density lipoprotein-cholesterol (HDL-C) (29.9%) accounted for the highest proportion in dyslipidaemia, followed by high triglyceride (TG) (20.7%), high total cholesterol (TC) (14.0%) and high low-density lipoprotein-cholesterol (LDL-C) (7.9%) in all subjects. The largest proportion of dyslipidaemia types was independent low HDL-C (12.7%). The proportion of low HDL-C was 15.5% in non-elderly men, 6.4% in non-elderly women, 16.7% in elderly men and 8.5% in elderly women, respectively. The largest proportion of dyslipidaemia types was independent high TG in non-elderly female patients (13.7%) and elderly patients (8.9%). The results showed that higher LDL-C, TC and TG levels in non-elderly patients than elderly patients. TG, TC and LDL-C levels decreasing with the increasing age, the differences were statistically significant. The levels of TG, TC, HDL-C and LDL-C in women were higher than in men among various age groups. Homocysteine level was increasing with increasing age.

CONCLUSIONS

Serum lipid levels varied in different groups according to age and sex in patients with hypertension. Dyslipidaemia is more common in non-elderly patients than elderly. TG, TC and LDL-C levels were higher in female patients than male.