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Kounatidis D, Tentolouris N, Vallianou NG, Mourouzis I, Karampela I, Stratigou T, Rebelos E, Kouveletsou M, Stamatopoulos V, Tsaroucha E, Dalamaga M. The Pleiotropic Effects of Lipid-Modifying Interventions: Exploring Traditional and Emerging Hypolipidemic Therapies. Metabolites 2024; 14:388. [PMID: 39057711 PMCID: PMC11278853 DOI: 10.3390/metabo14070388] [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: 06/18/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Atherosclerotic cardiovascular disease poses a significant global health issue, with dyslipidemia standing out as a major risk factor. In recent decades, lipid-lowering therapies have evolved significantly, with statins emerging as the cornerstone treatment. These interventions play a crucial role in both primary and secondary prevention by effectively reducing cardiovascular risk through lipid profile enhancements. Beyond their primary lipid-lowering effects, extensive research indicates that these therapies exhibit pleiotropic actions, offering additional health benefits. These include anti-inflammatory properties, improvements in vascular health and glucose metabolism, and potential implications in cancer management. While statins and ezetimibe have been extensively studied, newer lipid-lowering agents also demonstrate similar pleiotropic effects, even in the absence of direct cardiovascular benefits. This narrative review explores the diverse pleiotropic properties of lipid-modifying therapies, emphasizing their non-lipid effects that contribute to reducing cardiovascular burden and exploring emerging benefits for non-cardiovascular conditions. Mechanistic insights into these actions are discussed alongside their potential therapeutic implications.
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Affiliation(s)
- Dimitris Kounatidis
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.K.); (N.T.); (E.R.); (M.K.)
| | - Nikolaos Tentolouris
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.K.); (N.T.); (E.R.); (M.K.)
| | - Natalia G. Vallianou
- First Department of Internal Medicine, Sismanogleio General Hospital, 15126 Athens, Greece;
| | - Iordanis Mourouzis
- Department of Pharmacology, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Irene Karampela
- Second Department of Critical Care, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Theodora Stratigou
- Department of Endocrinology and Metabolism, Evangelismos General Hospital, 10676 Athens, Greece;
| | - Eleni Rebelos
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.K.); (N.T.); (E.R.); (M.K.)
| | - Marina Kouveletsou
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.K.); (N.T.); (E.R.); (M.K.)
| | | | - Eleni Tsaroucha
- First Department of Internal Medicine, Sismanogleio General Hospital, 15126 Athens, Greece;
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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Klement M, Drexel H, Saely CH. Impact of ezetimibe on markers of inflammation in patients treated with statins: a systematic review. Inflammopharmacology 2023:10.1007/s10787-023-01209-w. [PMID: 37261626 DOI: 10.1007/s10787-023-01209-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/22/2023] [Indexed: 06/02/2023]
Abstract
Statins are the primary pharmacological intervention to reduce LDL cholesterol; they significantly reduce inflammatory markers. Ezetimibe also reduces LDL cholesterol and reduces cardiovascular events when given on top of statin therapy. Whether ezetimibe, like statins, reduces markers of inflammation is less clear. We, therefore, conducted a systematic literature research addressing the impact of ezetimibe on CRP, TNFα and IL-6 when given on top of statin therapy. Our work indicates that overall ezetimibe reduces inflammation on top of statin treatment. However, available data are limited for CRP and even more so for TNFα and IL-6.
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Affiliation(s)
- Margaretha Klement
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Heinz Drexel
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, 6800, Feldkirch, Austria
- Department of Medicine, Academic Teaching Hospital Bregenz, Bregenz, Austria
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Christoph H Saely
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Carinagasse 47, 6800, Feldkirch, Austria.
- Department of Medicine, Academic Teaching Hospital Bregenz, Bregenz, Austria.
- Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
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3
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Tapdıgova R, Bayrak G, Yılmaz BC, Aytan H. Antilipidemic ezetimibe induces regression of endometriotic explants in a rat model of endometriosis with its anti-inflammatory and anti-angiogenic effects. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2022; 395:673-680. [PMID: 35294604 DOI: 10.1007/s00210-022-02226-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/05/2022] [Indexed: 10/18/2022]
Abstract
To assess the potential therapeutic role of antilipidemic ezetimibe on endometriosis in an experimental rat model. A standard experimental endometriosis model was created with 18 Whistar-Albino rats, and after 1 month, the sizes of the endometriotic explants were measured. The rats were randomized as study and control groups. A total of 1 mg/kg/day ezetimibe and 1 ml/kg/day saline were administered orally to the study and control groups respectively for 28 days. At the end of 28 days, the explants were measured again, excised, and sent for histopathologic assessment for expression of tumor necrosis factor-alpha (TNF-α) and vascular endothelial growth factor (VEGF) and number of mast cells. At the end of the study period, the size of the endometriotic explants decreased significantly in the study group; but not in the control group (from 145.3 ± 120.5 to 89.8 ± 60.1 vs 174.72 ± 88.3 to 87.65 ± 27.1 cm3 respectively); however, the amount of post- and pretreatment differences in explant sizes was similar in the groups. The median TNF-α and VEGF levels were significantly lower in the ezetimibe group when compared to the control group (4 [3-4] vs 2 [1-3], p 0.029; 4 [3-4] vs 2 [2-3], p 0.002; respectively). And numbers of mast cells in all uterine layers were also lower in the ezetimibe group. Ezetimibe decreased the size of the endometriotic explants with its anti-inflammatory and anti-angiogenic properties. This agent alone or with combination of other agents may have a potential role in the treatment of endometriosis.
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Affiliation(s)
- Raziyya Tapdıgova
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Gülsen Bayrak
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Banu Coşkun Yılmaz
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Hakan Aytan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mersin University, Mersin, Turkey.
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Ugovšek S, Zupan J, Rehberger Likozar A, Šebeštjen M. Influence of lipid-lowering drugs on inflammation: what is yet to be done? Arch Med Sci 2022; 18:855-869. [PMID: 35832698 PMCID: PMC9266870 DOI: 10.5114/aoms/133936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/04/2021] [Indexed: 12/17/2022] Open
Abstract
Atherosclerosis is a chronic inflammatory disease that is associated with risk of cardiovascular events. The best-characterised and well-standardised clinical indicator of inflammation is C-reactive protein. Current evidence-based drug therapies for prevention and treatment of cardiovascular diseases are mainly focused on reduction of low-density lipoprotein cholesterol. However, these drugs do not provide sufficient protection against recurrent cardiovascular events. One of the possible mechanisms behind this recurrence might be the persistence of residual inflammation. For the most commonly used lipid-lowering drugs, the statins, their reduction of cardiovascular events goes beyond lowering of low-density lipoprotein cholesterol. Here, we review the effects of these lipid-lowering drugs on inflammation, considering statins, ezetimibe, fibrates, niacin, proprotein convertase subtilisin/kexin type 9 inhibitors, bempedoic acid, ethyl eicosapentaenoic acid and antisense oligonucleotides. We focus in particular on C-reactive protein, and discuss how the effects of the statins might be related to reduced rates of cardiovascular events.
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Affiliation(s)
- Sabina Ugovšek
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Janja Zupan
- Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | | | - Miran Šebeštjen
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia
- University Medical Centre Ljubljana, Department of Cardiology, Slovenia
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Aparecida Silveira E, Vaseghi G, de Carvalho Santos AS, Kliemann N, Masoudkabir F, Noll M, Mohammadifard N, Sarrafzadegan N, de Oliveira C. Visceral Obesity and Its Shared Role in Cancer and Cardiovascular Disease: A Scoping Review of the Pathophysiology and Pharmacological Treatments. Int J Mol Sci 2020; 21:E9042. [PMID: 33261185 PMCID: PMC7730690 DOI: 10.3390/ijms21239042] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022] Open
Abstract
The association between obesity, cancer and cardiovascular disease (CVD) has been demonstrated in animal and epidemiological studies. However, the specific role of visceral obesity on cancer and CVD remains unclear. Visceral adipose tissue (VAT) is a complex and metabolically active tissue, that can produce different adipokines and hormones, responsible for endocrine-metabolic comorbidities. This review explores the potential mechanisms related to VAT that may also be involved in cancer and CVD. In addition, we discuss the shared pharmacological treatments which may reduce the risk of both diseases. This review highlights that chronic inflammation, molecular aspects, metabolic syndrome, secretion of hormones and adiponectin associated to VAT may have synergistic effects and should be further studied in relation to cancer and CVD. Reductions in abdominal and visceral adiposity improve insulin sensitivity, lipid profile and cytokines, which consequently reduce the risk of CVD and some cancers. Several medications have shown to reduce visceral and/or subcutaneous fat. Further research is needed to investigate the pathophysiological mechanisms by which visceral obesity may cause both cancer and CVD. The role of visceral fat in cancer and CVD is an important area to advance. Public health policies to increase public awareness about VAT's role and ways to manage or prevent it are needed.
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Affiliation(s)
- Erika Aparecida Silveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Goiás, Brazil; (A.S.d.C.S.); (M.N.)
| | - Golnaz Vaseghi
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran;
| | - Annelisa Silva de Carvalho Santos
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Goiás, Brazil; (A.S.d.C.S.); (M.N.)
- United Faculty of Campinas, Goiânia 74525-020, Goiás, Brazil
| | - Nathalie Kliemann
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, 69372 Lyon, France;
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1416753955, Iran;
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran
| | - Matias Noll
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Goiás, Brazil; (A.S.d.C.S.); (M.N.)
- Instituto Federal Goiano, Ceres 76300-000, Goiás, Brazil
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran;
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
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Kollia C, Antonopoulos AS, Siasos G, Konsola T, Oikonomou E, Gouliopoulos N, Tsigkou V, Papapanagiotou A, Kassi E, Tentolouris N, Katsiki N, Vavuranakis M, Papavassiliou AG, Tousoulis D. Associations between Adiponectin Gene Variability, Proinflammatory and Angiogenetic Markers: Implications for Microvascular Disease Development in Type 2 Diabetes Mellitus? Curr Vasc Pharmacol 2020; 17:204-208. [PMID: 29308741 DOI: 10.2174/1570161116666180108113825] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/15/2017] [Accepted: 12/21/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Adiponectin gene (ADIPOQ) variability may affect the risk for type 2 diabetes mellitus (T2DM) but it remains unclear whether it is involved in microvascular complications. OBJECTIVE To explore the impact of ADIPOQ variability on markers of inflammation and angiogenesis in T2DM. METHODS Overall, 220 consecutive T2DM patients from our outpatient diabetic clinic were genotyped for G276T (rs1501299) and T45G (rs2241766) single nucleotide polymorphisms of ADIPOQ gene. Serum levels of interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), vascular endothelial growth factor (VEGF) were measured by enzyme-linked immunosorbent assay and high sensitivity Creactive protein (hsCRP) by immunonephelometry. RESULTS Homozygosity for the G allele on rs2241766 was associated with significantly lower serum VEGF and ICAM-1 levels compared with other genotype groups, but had no effect on IL-6. Genetic variability on rs1501299 was not associated with either VEGF or ICAM-1 levels, but T homozygotes for rs1501299 had significantly lower IL-6 concentrations compared with G carriers. Furthermore, the presence of the G allele on rs2241766 was associated with significantly lower HbA1c, whereas no associations were observed for both body mass index and hsCRP with either rs2241766 or rs1501299. CONCLUSION Genetic variability on adiponectin gene was associated with serum levels of inflammatory and angiogenetic markers. Further research is required to elucidate the role of adiponectin in the development and/or progression of microvascular disease in T2DM patients.
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Affiliation(s)
- Christina Kollia
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,First Department of Propaedeutic and Internal Medicine, Division of Diabetes, Laiko University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Alexios S Antonopoulos
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Theodosia Konsola
- First Department of Propaedeutic and Internal Medicine, Division of Diabetes, Laiko University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Nikolaos Gouliopoulos
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Vasiliki Tsigkou
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Aggeliki Papapanagiotou
- Department of Biological Chemistry, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Eva Kassi
- First Department of Propaedeutic and Internal Medicine, Division of Diabetes, Laiko University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Nicholas Tentolouris
- First Department of Propaedeutic and Internal Medicine, Division of Diabetes, Laiko University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Niki Katsiki
- Second Department of Internal Medicine, Hipokration University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Manolis Vavuranakis
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athanasios G Papavassiliou
- Department of Biological Chemistry, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Bagheri R, Rashidlamir A, Ashtary‐Larky D, Wong A, Alipour M, Motevalli MS, Chebbi A, Laher I, Zouhal H. Does green tea extract enhance the anti-inflammatory effects of exercise on fat loss? Br J Clin Pharmacol 2020; 86:753-762. [PMID: 31747468 PMCID: PMC7098875 DOI: 10.1111/bcp.14176] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 08/19/2019] [Accepted: 11/10/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS Green tea extract (GTE) can exert antiobesity and anti-inflammatory effects. Our study determined whether the benefits of GTE are summative with exercise-induced changes in anthropometric indices, and the levels of inflammatory cytokines, adiponectin and irisin in inactive overweight women. METHODS Thirty overweight female participants were randomized to 3 groups: endurance training + placebo (ET + P); endurance training + GTE (ET + GTE); and Control (no exercise) + placebo (Control, n = 10). The exercise intervention consisted of an 8-week endurance-training programme of 3 sessions per week (aerobics, aerobic circuit training, and fast walking or jogging at a moderate intensity of 40-59% of the heart rate reserve). The dose of GTE used was 500 mg/day in the form of a green tea capsule. RESULTS Body weight, body mass index, waist to hip ratio and body fat percentage were decreased in both ET + P and ET + GTE interventions (P < .001 for both interventions). The reduction of anthropometric values in the ET + GTE group was significantly higher than ET + P interventions (P < .001). Both exercise interventions also significantly (P < .001) increased adiponectin (ET + GTE = 5.28 mg/mL [95% confidence interval {CI}, 4.48 to 6.08] and ET + P = 3.34 mg/mL [95% CI, 2.76 to 3.92]) and decreased high-sensitivity C-reactive protein (hs-CRP; ET + GTE = -0.95 mg/L [95% CI, -1.15 to -0.75] and ET + P = -0.35 mg/L [95% CI, -0.46 to -0.24]). Changes in adiponectin and hs-CRP were greater (P < .05) in ET + GTE compared to ET + P. There were no significant differences in irisin, interleukin-6 or tumour necrosis factor-α between the 3 groups (P > .05). CONCLUSIONS GTE improves exercise-induced body composition by further decreasing exercise-induced changes in weight, body mass index, waist to hip ratio and body fat percentage. The combination of GTE and exercise also produced greater changes in anti-inflammatory (increases in adiponectin) and metabolic (decreases in hs-CRP) markers than exercise alone.
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Affiliation(s)
- Reza Bagheri
- Department of Exercise PhysiologyUniversity of IsfahanIsfahanIran
| | - Amir Rashidlamir
- Department of Exercise PhysiologyFerdowsi University of MashhadMashhadIran
| | - Damoon Ashtary‐Larky
- Nutrition and Metabolic Diseases Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Alexei Wong
- Department of Health and Human PerformanceMarymount UniversityArlingtonVAUSA
| | - Meysam Alipour
- Alimentary Tract Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | | | - Amel Chebbi
- Faculty of Medicine of TunisUniversity of TunisTunisTunisia
| | - Ismail Laher
- Department of Pharmacology and Therapeutics, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé)RennesFrance
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8
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Shaposhnik II, Genkel VV. [Pleiotropic effects of ezetimibe]. KARDIOLOGIIA 2019; 59:12-17. [PMID: 31995721 DOI: 10.18087/cardio.n875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/13/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
The article discusses in detail the question of the additional positive effects of ezetimibe in addition to direct hypolipidemic action. The data of experimental and clinical studies in which the effect of ezetimibe on carbohydrate metabolism, inflammation, endothelial dysfunction, and liver is studied. The article also discusses the results of clinical studies that examined the effect of ezetimibe on atherosclerotic plaque.
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Affiliation(s)
- I I Shaposhnik
- Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation
| | - V V Genkel
- Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation
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9
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Beneficial Effects of Adiponectin on Glucose and Lipid Metabolism and Atherosclerotic Progression: Mechanisms and Perspectives. Int J Mol Sci 2019; 20:ijms20051190. [PMID: 30857216 PMCID: PMC6429491 DOI: 10.3390/ijms20051190] [Citation(s) in RCA: 262] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 12/14/2022] Open
Abstract
Circulating adiponectin concentrations are reduced in obese individuals, and this reduction has been proposed to have a crucial role in the pathogenesis of atherosclerosis and cardiovascular diseases associated with obesity and the metabolic syndrome. We focus on the effects of adiponectin on glucose and lipid metabolism and on the molecular anti-atherosclerotic properties of adiponectin and also discuss the factors that increase the circulating levels of adiponectin. Adiponectin reduces inflammatory cytokines and oxidative stress, which leads to an improvement of insulin resistance. Adiponectin-induced improvement of insulin resistance and adiponectin itself reduce hepatic glucose production and increase the utilization of glucose and fatty acids by skeletal muscles, lowering blood glucose levels. Adiponectin has also β cell protective effects and may prevent the development of diabetes. Adiponectin concentration has been found to be correlated with lipoprotein metabolism; especially, it is associated with the metabolism of high-density lipoprotein (HDL) and triglyceride (TG). Adiponectin appears to increase HDL and decrease TG. Adiponectin increases ATP-binding cassette transporter A1 and lipoprotein lipase (LPL) and decreases hepatic lipase, which may elevate HDL. Increased LPL mass/activity and very low density lipoprotein (VLDL) receptor and reduced apo-CIII may increase VLDL catabolism and result in the reduction of serum TG. Further, adiponectin has various molecular anti-atherosclerotic properties, such as reduction of scavenger receptors in macrophages and increase of cholesterol efflux. These findings suggest that high levels of circulating adiponectin can protect against atherosclerosis. Weight loss, exercise, nutritional factors, anti-diabetic drugs, lipid-lowering drugs, and anti-hypertensive drugs have been associated with an increase of serum adiponectin level.
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10
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D'Elia L, Strazzullo P, Iacone R, Russo O, Galletti F. Leptin levels predict the development of insulin resistance in a sample of adult men-The Olivetti Heart Study. Nutr Metab Cardiovasc Dis 2019; 29:39-44. [PMID: 30527422 DOI: 10.1016/j.numecd.2018.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Leptin (LPT) is associated with unfavourable cardio-metabolic risk profile. Although a number of studies have found a positive association between LPT and insulin resistance (IR), no observational study has evaluated a prospective association to detect a predictive role of LPT in IR. Therefore, the aim of this study was to estimate the role of LPT on the incidence of IR in an 8-year follow-up of a sample of adult men (The Olivetti Heart Study). METHODS AND RESULTS The study included 527 not diabetic men without IR (homeostasis model assessment - HOMA index < 2.77 UI) at baseline. Baseline LPT was significantly and positively associated with HOMA index, body mass index (BMI), waist circumference and blood pressure. At the end of the 8-year follow-up period, a positive and significant association was detected between baseline LPT and changes in HOMA index (r = 0.25, p < 0.01) and incidence of IR (OR: 2.6, 95%CI: 1.9-3.4). This trend was also confirmed after adjustment for potential confounders. In addition, the predictive value of LPT was found in subjects who had not experienced any weight increase over the years, and for normal weight and excess body weight participants, separately. CONCLUSIONS The results of this prospective study suggest a predictive role of circulating LPT levels on a reduction of insulin sensitivity over time, independently of main potential confounders, in non-diabetic men without IR at baseline. In addition, in normal weight individuals, LPT levels were associated with development of IR.
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Affiliation(s)
- L D'Elia
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy
| | - P Strazzullo
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy
| | - R Iacone
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy
| | - O Russo
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy
| | - F Galletti
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy.
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11
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Sahebkar A, Simental-Mendía LE, Pirro M, Banach M, Watts GF, Sirtori C, Al-Rasadi K, Atkin SL. Impact of ezetimibe on plasma lipoprotein(a) concentrations as monotherapy or in combination with statins: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 2018; 8:17887. [PMID: 30552391 PMCID: PMC6294784 DOI: 10.1038/s41598-018-36204-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/06/2018] [Indexed: 02/06/2023] Open
Abstract
The aim of this meta-analysis of randomized placebo-controlled clinical trials was to assess the effect of ezetimibe on plasma lipoprotein(a) concentrations. Only randomized placebo-controlled trials investigating the impact of ezetimibe treatment on cholesterol lowering that include lipoprotein(a) measurement were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (from inception to February 26th, 2018). A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate the impact of potential confounders on lipoprotein concentrations. This meta-analysis of data from 10 randomized placebo-controlled clinical trials (15 treatment arms) involving a total of 5188 (3020 ezetimibe and 2168 control) subjects showed that ezetimibe therapy had no effect on altering plasma Lp(a) concentrations (WMD: -2.59%, 95% CI: -8.26, 3.08, p = 0.370; I2 = 88.71%, p(Q) < 0.001). In the subgroup analysis, no significant alteration in plasma Lp(a) levels was observed either in trials assessing the impact of monotherapy with ezetimibe versus placebo (WMD: -4.64%, 95% CI: -11.53, 2.25, p = 0.187; I2 = 65.38%, p(Q) = 0.005) or in trials evaluating the impact of adding ezetimibe to a statin versus statin therapy alone (WMD: -1.04%, 95% CI: -6.34, 4.26, p = 0.700; I2 = 58.51%, p(Q) = 0.025). The results of this meta-analysis suggest that ezetimibe treatment either alone or in combination with a statin does not affect plasma lipoprotein(a) levels.
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Affiliation(s)
- Amirhossein Sahebkar
- Halal Research Center of IRI, FDA, Tehran, Iran.
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Matteo Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113, Lodz, Poland
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Gerald F Watts
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Lipid Disorders Clinic, Cardiometabolic Services, Department of Cardiology, Royal Perth Hospital, GPO Box X2213, Perth, Australia
| | - Cesare Sirtori
- Centro Dislipidemie, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Khalid Al-Rasadi
- Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
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12
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Guimarães ES, Cerda A, Dorea EL, Bernik MMS, Gusukuma MC, Pinto GA, Fajardo CM, Hirata MH, Hirata RDC. Effects of short-term add-on ezetimibe to statin treatment on expression of adipokines and inflammatory markers in diabetic and dyslipidemic patients. Cardiovasc Ther 2017; 35. [DOI: 10.1111/1755-5922.12307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/14/2017] [Accepted: 09/18/2017] [Indexed: 01/05/2023] Open
Affiliation(s)
- Elizandra Silva Guimarães
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences; University of Sao Paulo; Sao Paulo Brazil
| | - Alvaro Cerda
- Center of Excellence in Translational Medicine, CETM-BIOREN, Department of Basic Sciences; Universidad de La Frontera; Temuco Chile
| | | | | | | | | | - Cristina Moreno Fajardo
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences; University of Sao Paulo; Sao Paulo Brazil
| | - Mario Hiroyuki Hirata
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences; University of Sao Paulo; Sao Paulo Brazil
| | - Rosario Dominguez Crespo Hirata
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences; University of Sao Paulo; Sao Paulo Brazil
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13
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Stelmach E, Hołownia O, Słotwiński M, Gerhant A, Olajossy M. Hiponatremia in the practice of a psychiatrist. Part 1: SIADH syndrome and drug-induced hyponatremia. CURRENT PROBLEMS OF PSYCHIATRY 2017. [DOI: 10.1515/cpp-2017-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction. Hyponatremia is an important part of psychiatric practice. In order to analyze its causes and symptoms, the literature on hyponatremia in psychiatric patients has been reviewed. The work has been divided into two separate manuscripts. In the first one the authors discuss the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and hyponatremia occurring with the use of psychotropic drugs (antidepressants, antipsychotics, normotimics), while the second paper discusses research on psychogenic polydipsia. The causes of hyponatremia in patients treated in psychiatric wards include: water intoxication associated with polydipsia, somatic comorbidities, side effect of internal medicine and psychiatric drugs. The most common mechanism leading in these cases to hyponatremia is the syndrome of inappropriate secretion of vasopressin (SIADH). The SIADH syndrome is a group of symptoms, first described in 1967 by Schwartz and Bartter in The American Journal of Medicine, which results from the hypersecretion of antidiuretic hormone, also called vasopressin, which causes patients to develop normovolemic hyponatremia. The phenomenon of drug-induced hyponatremia in psychiatric practice is generally observed with the use of antidepressants, antipsychotics and anti-epileptic drugs (used in psychiatry as normotimic drugs).
Aim and method. The first manuscript includes a review of literature on the syndrome of inappropriate secretion of vasopressin (SIADH) and hyponatremia occurring after the use of psychotropic drugs, and is divided into two subsections: 1. The syndrome of inappropriate secretion of vasopressin (SIADH), 2. Hyponatremia and psychotropic drugs (antidepressants, antipsychotics, normotimics).
Conclusion. In the view of the reviewed literature it is extremely important to control the natremia level during pharmacotherapy using the above mentioned drugs, especially in the initial period of therapy.
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Affiliation(s)
- Ewa Stelmach
- 2 Department of Psychiatry and Psychiatric Rehabilitation , Medical University of Lublin
| | - Olga Hołownia
- 2 Department of Psychiatry and Psychiatric Rehabilitation , Medical University of Lublin
| | - Maciej Słotwiński
- 2 Department of Psychiatry and Psychiatric Rehabilitation , Medical University of Lublin
| | - Aneta Gerhant
- 2 Department of Psychiatry and Psychiatric Rehabilitation , Medical University of Lublin
| | - Marcin Olajossy
- 2 Department of Psychiatry and Psychiatric Rehabilitation , Medical University of Lublin
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14
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Dolezelova E, Stein E, Derosa G, Maffioli P, Nachtigal P, Sahebkar A. Effect of ezetimibe on plasma adipokines: a systematic review and meta-analysis. Br J Clin Pharmacol 2017; 83:1380-1396. [PMID: 28166606 DOI: 10.1111/bcp.13250] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 01/22/2017] [Accepted: 01/27/2017] [Indexed: 12/11/2022] Open
Abstract
AIMS Statins are known to influence the status of adipokines, which play a key role in the pathophysiology of cardiometabolic diseases. As the effect of ezetimibe as an add-on to statin therapy on the impact of statins on plasma adipokines levels is currently unclear, the aim of the present study was to investigate this through a meta-analysis of controlled trials. METHODS A systematic review was performed, followed by a bibliographic search in PubMed, Medline, SCOPUS, Web of Science and Google Scholar databases. Quantitative data synthesis was performed using a fixed- or random-effects model (based on the level of interstudy heterogeneity) and the generic inverse variance weighting method. Effect sizes were expressed as standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS Meta-analysis of 23 controlled trials did not suggest any significant effect of adding ezetimibe on top of statin therapy on plasma concentrations of adiponectin (SMD 0.34, 95% CI -0.28, 0.96; P = 0.288), leptin (SMD -0.75, 95% CI: -2.35, 0.85; P = 0.360), plasminogen activator inhibitor 1 (SMD -1.06, 95% CI: -2.81, 0.69; P = 0.236) and interleukin 6 (SMD 0.30, 95% CI: -0.08, 0.67; P = 0.124). However, significantly greater reductions in plasma concentrations of tumour necrosis factor α (TNF-α) (SMD -0.48, 95% CI -0.87, -0.08; P = 0.018) were achieved with ezetimibe/statin combination therapy. CONCLUSIONS The results suggested that ezetimibe add-on to statin therapy is associated with an enhanced TNF-α-lowering effect compared with statin monotherapy. Owing to the emerging role of TNF-α in the pathogenesis of metabolic disorders, further investigations are required to unveil the translational relevance of this TNF-α-lowering effect.
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Affiliation(s)
- Eva Dolezelova
- Faculty of Pharmacy in Hradec Kralove, Department of Biological and Medical Sciences, Charles University, Hradec Kralove, Czech Republic
| | - Evan Stein
- Metabolic and Atherosclerosis Research Center, Cincinnati, OH, USA
| | - Giuseppe Derosa
- Centre of Diabetes and Metabolic Diseases, Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy.,Molecular Medicine Laboratory, University of Pavia, Pavia, Italy
| | - Pamela Maffioli
- Centre of Diabetes and Metabolic Diseases, Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,PhD School in Experimental Medicine, University of Pavia, Pavia, Italy
| | - Petr Nachtigal
- Faculty of Pharmacy in Hradec Kralove, Department of Biological and Medical Sciences, Charles University, Hradec Kralove, Czech Republic
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Medicine, University of Western Australia, Perth, WA, Australia
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