LDL-cholesterol versus HDL-cholesterol in the atherosclerotic plaque: inflammatory resolution versus thrombotic chaos

Impact of Bempedoic acid on LDL-C reduction and cardiovascular outcomes: A comprehensive meta-analysis of randomized controlled trials

BACKGROUND

The management of LDL-C levels is pivotal in the prevention of cardiovascular morbidity, particularly among patients at high risk or those intolerant to statins. Bempedoic acid emerges as a novel agent in this therapeutic arena.

OBJECTIVES

This systematic review and meta-analysis endeavor to quantify the effectiveness of Bempedoic acid in attenuating LDL-C levels and explore its impact on cardiovascular morbidity, emphasizing its role as an adjunctive or alternative therapy in statin-intolerant or high-risk patients.

METHODS

A comprehensive search spanning PubMed, Google Scholar, and Cochrane Library databases furnished studies for this review. The inclusion was critiqued based on predefined PICOS parameters, ensuring a robust analytical framework.

RESULTS

Bempedoic acid showcased a significant plunge in LDL-C levels (MD -20.69 %, 95 % CI [-23.20, -18.19]), outperforming placebo and ezetimibe monotherapy. The cardioprotective effect was further echoed with a reduced risk of major adverse cardiac events (MACE) in the Bempedoic acid cohort (RR 0.86, 95 % CI [0.80, 0.94]). However, a dive into the safety profile revealed no substantial augmentation in adverse events, affirming its tolerance and efficacy.

CONCLUSIONS

Bempedoic acid represents a potent therapeutic ally, affirming its capacity to significantly pare down LDL-C levels and curtail cardiovascular events. Its favorable safety profile underscores its suitability, especially among those with statin intolerance or individuals categorized within the high-risk vascular bracket, necessitating a paradigm shift in current lipid management strategies.

Lifestyle and clinical factors as predictive indicators of cardiometabolic multimorbidity in Chinese adults: Baseline findings of the Beijing Health Management Cohort (BHMC) study

BACKGROUND

Cardiometabolic multimorbidity (CMM) is increasing globally as a result of lifestyle changes and the aging population. Even though previous studies have examined risk factors associated with CMM, there is a shortage of prediction models that can accurately identify high-risk individuals for early prevention.

METHODS

In the baseline survey of the Beijing Health Management Cohort, a total of 77,752 adults aged 18 years or older were recruited from 2020 to 2021. Data on lifestyle factors, clinical profiles, and diagnoses of diabetes, coronary heart disease, and stroke were collected. Logistic regression models were used to identify risk factors for CMM. Nomograms were developed to estimate an individual's probability of CMM based on the identified risk factors. The performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC).

RESULTS

In men, the top three risk factors for CMM were hypertension (OR: 3.52, 95 % CI: 2.97-4.18), eating very fast (3.43, 2.27-5.16), and dyslipidemia (2.59, 2.20-3.06). In women, hypertension showed the strongest association with CMM (3.62, 2.90-4.52), followed by night sleep duration less than 5 h per day (2.41, 1.67-3.50) and dyslipidemia (1.91, 1.58-2.32). The ORs for holding passive and depressed psychological traits were 1.49 (95%CI: 1.08-2.06) in men and 1.58 (1.03-2.43) in women. Prediction models incorporating these factors demonstrated good discrimination in the test set, with AUC 0.84 (0.83-0.86) for men and 0.90 (0.89-0.91) for women. The sex-specific nomograms were established based on selected predictors.

CONCLUSIONS

Modifiable lifestyle factors, metabolic health and psychological trait are associated with the risk of CMM. The developed prediction models and nomograms could facilitate early identification of individuals at high-risk of CMM.

Acute effect of proprotein convertase subtilisin/kexin type 9 inhibitor on oxidized low-density lipoprotein and lipid profile in patients at cardiovascular risk

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new class of potent lipid-lowering drugs. Oxidized low-density lipoprotein (ox-LDL) is the key pathogenic factor leading to atherosclerosis. However, its effect on ox-LDL levels has not been clinically reported. The clinical data of 290 very high-risk atherosclerotic cardiovascular disease (ASCVD) patients diagnosed in the First Affiliated Hospital of Zhengzhou University from May 2022 to October 2022 were collected retrospectively. According to whether evolocumab (a PCSK9 inhibitor) was used after percutaneous coronary intervention (PCI), they were divided into evolocumab group (153 cases) and statin monotherapy group (137 cases). At hospital admission, ox-LDL, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoproteinA1 (apoA1), apolipoprotein B-100 (apoB), lipoprotein (a) [Lp(a)], and high-sensitivity reactive protein (hs-CRP) levels were collected and used as baseline data. After two weeks of treatment, ox-LDL in the evolocumab group and statin monotherapy group were significantly lower than those before treatment (p<0.05). The decrease of ox-LDL in the evolocumab group was more than in the stain monotherapy group (p<0.05). In conclusion, PCSK9 inhibitors reduce ox-LDL levels in very high-risk ASCVD patients in a short time.

The Impact of Statin Therapy on Cardiovascular Outcomes in Patients With Diabetes: A Systematic Review

Cardiovascular disease (CVD) is the primary cause of death all over the world, especially due to myocardial ischemia caused by atherosclerosis that blocks cardiac arteries and leads to arrhythmia and other cardiac diseases. Meanwhile, diabetes mellitus (DM) and elevated cholesterol level are the risk factors for cardiovascular (CV) disease. This noncommunicable disease has become a main concern for us as cardiovascular disease develops in a slow manner without any symptoms in the early stage. Early prevention and intervention have a major impact on improving the outcome of cardiovascular health in diabetic patients. Controlling cholesterol level by administering statin has shown some beneficial impacts in reducing the risk of cardiovascular disease in patients with DM. This study used a systematic literature review (SLR) approach to give an overview of the current literature and to analyze the effects of statin therapy on cardiovascular outcomes in patients with DM. The literature search was conducted in PubMed and Google Scholar databases. The total number of articles included in the present review is six, obtained from reputable journals published between 2013 and 2023, and we only focused on reviewing six articles for in-depth analysis. The evidence we collected showed a positive outcome in terms of cardiovascular health in persons with DM after statin therapy. However, there are several risk factors that interfere with the effectiveness of statin in diabetic patients.

Dietary ω3 Fatty Acids and Phytosterols in the Modulation of the HDL Lipidome: A Longitudinal Crossover Clinical Study

High-density lipoproteins (HDLs) are complex particles composed of a wide range of lipids, proteins, hormones and vitamins that confer to the HDL particles multiple cardiovascular protective properties, mainly against the development of atherosclerosis. Among other factors, the HDL lipidome is affected by diet. We hypothesized that diet supplementation with ω3 (docosahexaenoic acid: DHA and eicosapentaenoic acid: EPA) and phytosterols (PhyS) would improve the HDL lipid profile. Overweight subjects (n = 20) were enrolled in a two-arm longitudinal crossover study. Milk (250 mL/day), supplemented with either ω3 (EPA + DHA, 375 mg) or PhyS (1.6 g), was administered to the volunteers over two consecutive 28-day intervention periods, followed by HDL lipidomic analysis. The comprehensive lipid pattern revealed that the HDL lipidome is diet-dependent. ω3-milk supplementation produced more changes than PhyS, mainly in cholesteryl esters (CEs). After ω3-milk intake, levels of DHA and EPA within phosphatylcholines, triglycerides and CE lipids in HDLs increased (p < 0.05). The correlation between lipid species showed that lipid changes occur in a coordinated manner. Finally, our analysis revealed that the HDL lipidome is also sex-dependent. The HDL lipidome is affected by diet and sex, and the 4 weeks of ω3 supplementation induced HDL enrichment with EPA and DHA.

Effect of Atherogenic Index of Plasma on Pre-Percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow in Patients With ST Elevation Myocardial Infarction

Dyslipidemia is an important risk factor for cardiovascular morbidity and mortality. Although low-density lipoprotein (LDL) is primarily responsible, the importance of triglyceride (TG) and high-density lipoprotein (HDL) has also been recognized. The present study investigated the effect of the atherogenic index of plasma (AIP), in which atherogenic and protective lipoproteins were evaluated together, on the initial flow in patients with ST elevation myocardial infarction. AIP was calculated as log(TG/HDL-cholesterol). Patients included in the study (n = 1535) were divided into Thrombolysis in Myocardial Infarction (TIMI) flow grade 0 and >0. AIP was found to be significantly different between 2 groups (.55 ± .23 vs .67 ± .21; P < .001). AIP was an independent predictor for pre-intervention TIMI flow (Odds Ratio: 2.778). A moderate correlation was found between TIMI frame count measurements, calculated in patients with TIMI 2-3, and AIP (Pearson correlation coefficient: .63, P < .001). In the receiver operating characteristic analysis, AIP showed the highest area under curve (AUC) compared with other lipid parameters for predicting vascular patency. The AUC of AIP was .634, the cut-off value was .59, and the sensitivity and specificity were 67.6% and 68.4%, respectively (P < .001). In conclusion, AIP was found to be an important marker affecting pre-percutaneous coronary intervention TIMI flow.

Association between axial length and HDL in children: a hospital-based cross-sectional study

BACKGROUND

To analyze the relationship between axial length and levels of high-density lipoprotein (HDL) cholesterol in children.

METHODS

A retrospective, hospital-based cross-sectional research with 69 right eyes from 69 children who underwent health examination by Zhejiang Provincial People's Hospital was carried out. The participants were split into three groups: Group A (axial length < = 23 mm), Group B (axial length 23-24 mm), and Group C (axial length > 24 mm). Demographic epidemiological information, blood biochemical parameters and ophthalmic characteristics including refractive status and ocular geometric parameters were obtained and analyzed.

RESULTS

69 right eyes from 69 patients (25 males and 44 females) with a median age of 10.00 years old (IQR: 8.00-11.00 years) were included in the study. Within Group A, there were a total of 17 individuals; Group B consisted of 22 individuals; Group C included 30 individuals. The mean axial length of three groups was 22.148(0.360), 23.503(0.342) and 24.770(0.556) mm, respectively (p < 0.0001). The mean HDL levels were significantly different in three groups are 1.824(0.307), 1.485(0.253) and 1.507 (0.265) mmol/L, respectively. By applying a Pearson Coefficient, we evaluated the association between axial length and HDL and discovered that there was a statistically significant (p = 0.00025) and adverse (R = -0.43) association between axial length and HDL.

CONCLUSIONS

We concluded from our study that there was a significantly inverse relationship between axial length and the levels of HDL in children.

HDL Function and Size in Patients with On-Target LDL Plasma Levels and a First-Onset ACS

Patients admitted for acute coronary syndrome (ACS) usually have high cardiovascular risk scores with low levels of high-density lipoprotein cholesterol (HDL-C) and high low-density lipoprotein cholesterol (LDL-C) levels. Here, we investigated the role of lipoprotein functionality as well as particle number and size in patients with a first-onset ACS with on-target LDL-C levels. Ninety-seven patients with chest pain and first-onset ACS with LDL-C levels of 100 ± 4 mg/dL and non-HDL-C levels of 128 ± 4.0 mg/dL were included in the study. Patients were categorized as ACS and non-ACS after all diagnostic tests were performed (electrocardiogram, echocardiogram, troponin levels and angiography) on admission. HDL-C and LDL-C functionality and particle number/size by nuclear magnetic resonance (NMR) were blindly investigated. A group of matched healthy volunteers (n = 31) was included as a reference for these novel laboratory variables. LDL susceptibility to oxidation was higher and HDL-antioxidant capacity lower in the ACS patients than in the non-ACS individuals. ACS patients had lower HDL-C and Apolipoprotein A-I levels than non-ACS patients despite the same prevalence of classical cardiovascular risk factors. Cholesterol efflux potential was impaired only in the ACS patients. ACS-STEMI (Acute Coronary Syndrome—ST-segment-elevation myocardial infarction) patients, had a larger HDL particle diameter than non-ACS individuals (8.4 ± 0.02 vs. 8.3 ± 0.02 and, ANOVA test, p = 0.004). In conclusion, patients admitted for chest pain with a first-onset ACS and on-target lipid levels had impaired lipoprotein functionality and NMR measured larger HDL particles. This study shows the relevance of HDL functionality rather than HDL-C concentration in ACS patients.

Combination model of neutrophil to high-density lipoprotein ratio and system inflammation response index is more valuable for predicting peripheral arterial disease in type 2 diabetic patients: A cross-sectional study

BACKGROUND

Neutrophil/high-density lipoprotein (HDL) ratio (NHR), monocyte/HDL ratio (MHR), lymphocyte/HDL ratio (LHR), platelet/HDL ratio (PHR), systemic immune-inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) have been recently investigated as novel inflammatory markers. Herein, the correlation was investigated between these inflammatory biomarkers and peripheral arterial disease (PAD) in type 2 diabetes mellitus (T2DM) patients.

METHODS

In this retrospective observational study, the hematological parameter data of 216 T2DM patients without PAD (T2DM-WPAD) and 218 T2DM patients with PAD (T2DM-PAD) at Fontaine stages II, III or IV stage had been collected. Differences in NHR, MHR, LHR, PHR, SII, SIRI, and AISI were analyzed, and receiver operating characteristic (ROC) curves were used to analyze the diagnostic potential of these parameters.

RESULTS

The levels of NHR, MHR, PHR, SII, SIRI and AISI in T2DM-PAD patients were significantly higher than in T2DM-WPAD patients (P < 0.001). They were correlated with disease severity. Further, multifactorial logistic regression analyses showed that higher NHR, MHR, PHR, SII, SIRI, and AISI might be independent risk factors for T2DM-PAD (P < 0.001). The areas under the curve (AUCs) of the NHR, MHR, PHR, SII, SIRI, and AISI for T2DM-PAD patients was 0.703, 0.685, 0.606, 0.648, 0.711, and 0.670, respectively. The AUC of the NHR and SIRI combined model was 0.733.

CONCLUSION

The levels of NHR, MHR, PHR, SII, SIRI, and AISI were higher in T2DM-PAD patients, and they were independently linked with its clinical severity. The combination model of NHR and SIRI was most valuable for predicting T2DM - PAD.

Serum zinc levels are associated with obesity and low-density lipoprotein cholesterol in Mexican adults

PURPOSE

Little is known about the association between serum zinc (Zn) levels and obesity in the Mexican population. Therefore, we tested the association between serum Zn levels, obesity status, and serum lipid levels in a sample of Mexican adults.

METHODS

Anthropometric data and serum levels of total cholesterol, high- and low-density lipoprotein cholesterol (HDL-C and LDL-C, respectively), and triglycerides were analyzed in 96 Mexican adults. Serum Zn was measured with inductively coupled plasma mass spectrometry. An individual data meta-analysis of the association between serum Zn, overweight, and obesity status was performed in 172 adults from two different provinces in Mexico.

RESULTS

Serum Zn was negatively associated with body mass index (BMI, β = -0.034 ± 0.013, p = 2.0 ×10^-6) and obesity (odds ratio [OR]= 0.990, 95% confidence interval [CI]= 0.980-0.999, p = 3.4 ×10^-5). The association between Zn level and obesity in Mexican adults was confirmed with an individual data meta-analysis (OR= 0.977, 95% CI= 0.966-0.988, p = 3.4 ×10^-5). In addition, a significant interaction effect between serum Zn level and sex was observed on LDL-C level (β = 7.010 ± 3.295, p = 0.037). Serum Zn was negatively associated with LDL-C levels in women (β = -0.188 ± 0.074, p = 0.016).

CONCLUSION

Our results confirm the negative association of serum Zn level with obesity. For the first time, we show a sex-specific association between serum Zn and LDL-C levels in a Mexican population. However, further studies are needed in larger and more varied Mexican cohorts to replicate and confirm our findings.

Preventive Potential of the Aqueous Extract of the Mixture of Bidens pilosa (Asteraceae) and Cymbopogon citratus (Poaceae) Aerial Parts on Hypertension Induced by a Chronic Salt and Alcohol Consumption on the Rats

High blood pressure (HBP) is currently one of the main risk factors for cardiovascular and kidney diseases. Nowadays, populations make extensive use of alternative medicine for their health problems. Bidens pilosa (B. pilosa) and Cymbopogon citratus (C. citratus) are used individually in the traditional treatment of cardiovascular disorders. This study assessed the effects of the mixture of these two plants aqueous extract on HBP in rats. Male rats (42) were divided into 7 groups of 6 rats each. Normotensive rats received only distilled water and formed group 1. The other animals received ethanol + salt preceded by distilled water (10 mL/kg; group 2) and spironolactone (10 mg/kg; group 3); the aqueous extracts of the mixture (100 and 200 mg/kg; groups 4 and 5) isolated plants B. pilosa (200 mg/kg; group 6) and C. citratus (200 mg/kg; group 7). Animals were treated for 7 weeks during which water consumption and urine volume were assessed; then, hemodynamic parameters were recorded, and rats were sacrificed. Serum and some organs (liver, kidney, heart, and aorta) were used to evaluate biochemical parameters. Ingestion of ethanol + salt leads to a significant increase in urinary volume and water intake that were significantly prevented by the extracts from the mixture and isolated plants. Ethanol + salt solution significantly increased the blood pressure, heart rate, triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-chol), very-low-density lipoprotein cholesterol (VLDL-chol), atherogenic indices, liver and kidney function parameters, and malondialdehyde (MDA) levels. However, the levels of high-density lipoprotein cholesterol (HDL-chol), albumin, reduced glutathione (GSH), catalase, and superoxide dismutase (SOD) activity were significantly reduced. The extracts of the mixture and isolated plants significantly prevented all these variations with a more pronounced action for the lowest dose of the mixture on the lipid profile, oxidative stress, and kidney function. These observations confirm the beneficial effects of B. pilosa and C. citratus to manage hypertension.

Profile of cardiovascular disease risk in type 2 diabetes mellitus patients receiving statin therapy: A cross-sectional study

Background

Cardiovascular disease is still the number 1 cause of death globally. Meanwhile, type 2 diabetes mellitus (T2DM) is a risk factor for atherosclerosis vascular disease (ASCVD), so an assessment using Framingham Risk Score (FRS) is needed to predict the risk of ASCVD in the future.

Objective

Analyzing the risk factor of ASCVD using the Framingham Risk Score (FRS) in T2DM patients.

Methods

This study was conducted from July 2020 to July 2021, which the participants were measured for FRS including age, gender, current smoking, diabetes, blood pressure (systolic), high-density lipoprotein (HDL) cholesterol, total cholesterol (TC), and ASCVD risk score. The analysis employed multiple linear tests and ANOVA tests with p < 0.05.

Results

Several ASCVD risk factors in T2DM patients were found, including gender (t = 6.015; p < 0.001), age (t = 6.901; p < 0.001), HDL level (t = 2.287; p = 0.024), CT level (t = 5.273; p < 0.001), blood pressure (t = 5.850; p < 0.001), and current smoking (t = 2.638; p = 0.009). The results of analysis between ASCVD risk factor and level of ASCVD risk obtained a significant association (F = 36,642; p < 0.001).

Conclusion

Risk factors of ASCVD in T2DM patients such as gender, age, HDL level, CT level, blood pressure, and current smoking.

•

Risk factors of ASCVD include gender, age, HDL level, CT level, blood pressure, and current smoking in T2DM patients.

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Significant ASCVD risk factors are age, gender, TC level, and blood pressure.

•

The Framingham Risk Score is used to predict ASCVD in T2DM patients in the next 10 years.

The association between elevated lipid profile and liver enzymes: a study on Bangladeshi adults

Dyslipidemia, a major contributor to cardiovascular diseases, is rapidly increasing in Asian countries including Bangladesh. In addition to the cardiovascular system, abnormal lipid levels are also known to cause complications in renal and hepatic systems. The data regarding dyslipidemia and its relationship with liver enzymes are scarce for the Bangladeshi population. Therefore, this study was conducted to estimate the prevalence of dyslipidemia and determine the relationship between lipid profile and liver enzymes in Bangladeshi adults. A total of 405 participants (318 males and 87 females) were enrolled in the study. Serum levels of TG, TC, LDL, HDL and liver enzymes including ALT, AST, GGT and ALP were analyzed using standard methods. Dyslipidemia and liver function tests abnormalities were defined according to the international standard guidelines. The association between elevated lipid profile markers and liver enzyme abnormalities was assessed by logistic regression analysis. Overall, the prevalence of elevated TG, TC, LDL and low HDL were 30.9%, 23.7%, 26.2% and 78.8%, respectively. On the other hand, the prevalence of elevated liver enzymes ALT, AST, GGT and ALP were 18.8%, 21.6%, 12.9% and 21.9%, respectively. Dyslipidemia and liver enzyme abnormalities were higher in diabetic and hypertensive participants than in the healthy participants. About 61% of participants with dyslipidemia had at least one or more elevated liver enzymes. In regression analysis, an independent association was observed between serum GGT and all lipid components. In conclusion, a high prevalence of dyslipidemia and liver enzyme abnormalities were observed among the study participants. Of the four liver enzymes, the serum levels of GGT showed an independent association with all lipid components. Moreover, this study indicates that subjects with dyslipidemia often have a higher chance of having liver diseases than subjects with no dyslipidemia. However, large-scale prospective studies are needed to understand the underlying mechanisms of lipid-induced hepatic dysfunction in the Bangladeshi population.

Identification of dyslipidemia as a risk factor for sudden sensorineural hearing loss: A multicenter case-control study

Background

Recently, several studies have reported an association between lipid profiles and sudden sensorineural hearing loss (SSNHL), yet there is considerable variability between the individual studies in defining the precise association between serum lipids levels and SSNHL. This study sought to identify a possible relationship between dyslipidemia and the prevalence and prognosis of SSNHL.

Methods

A case‐control study was carried out at two independent medical centers, including 2,288 SSNHL patients and 2,288 healthy controls. Clinical characteristics and serum lipid parameters were assessed, including total cholesterol (CHOL), high‐density lipoprotein (HDL), low‐density lipoprotein (LDL), triglycerides (Trig), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB), and lipoprotein a (Lpa). Multivariate logistic regression analysis was performed to assess the relationship between lipid profiles and SSNHL in the 4,576 subjects.

Results

Significant differences were identified in several conventional serum lipid markers including CHOL, Trig, HDL, LDL, ApoAI, ApoB, and Lpa, between SSNHL patients and healthy controls. Serum ApoAI levels were significantly lower in patients with bilateral SSNHL compared to unilateral SSNHL. Binary logistic regression analysis revealed that higher levels of ApoB, LDL, Trig, and lower levels of ApoAI and HDL were all associated with an increased risk of SSNHL. After clinical characterization, multivariate analysis showed that only low levels of ApoB predicted likelihood of a recovery of more than 30 dB among patients with SSNHL.

Conclusions

Serum lipids are associated with the incidence and prognosis of SSNHL. Identification of dyslipidemia may improve early evaluation and management of SSNHL risks.

Expression of miRNAs Targeting ATP Binding Cassette Transporter 1 (ABCA1) among Patients with Significant Carotid Artery Stenosis

Background: Carotid artery stenosis is a dynamic process associated with an increased risk of cardiovascular events. However, knowledge of biomarkers useful for identifying and quantifying high-risk carotid plaques associated with the increased incidence of cerebrovascular events is insufficient. Therefore, the objectives of this study were to evaluate the expression of ATP binding cassette transporter 1 (ABCA1) and validate its target microRNA (miRNA) candidates in human carotid stenosis arteries to identify its potential as a biomarker. Methods: In human carotid stenosis arterial tissues and plasma, the expression of ABCA1 and its target miRNAs (miRNA-33a-5p, 33b-5p, and 148a-3p) were evaluated by quantitative real time-polymerase chain reaction (qRT-PCR), immunohistochemistry, and enzyme-linked immunosorbent assay (ELISA). Results: The expression of ABCA1 was significantly decreased in the plasma of stenosis patients, but its expression was not different in arterial tissues (p < 0.05). However, significantly more target miRNAs were secreted by stenosis patients than normal patients (p < 0.05). Interestingly, lipotoxicity induced by the oleic and palmitic acid (OAPA) or lipopolysaccharide (LPS) treatment of human umbilical vein endothelial cells (HUVECs) dramatically enhanced the gene expression of adipogenic and inflammatory factors, whereas ABCA1 expression was significantly decreased. Conclusions: Therefore, miRNA-33a-5p, 33b-5p, and 148a-3p represent possible biomarkers of carotid artery stenosis by directly targeting ABCA1.

Unraveling the Complexity of HDL Remodeling: On the Hunt to Restore HDL Quality

Increasing evidence has cast doubt over the HDL-cholesterol hypothesis. The complexity of the HDL particle and its proven susceptibility to remodel has paved the way for intense molecular investigation. This state-of-the-art review discusses the molecular changes in HDL particles that help to explain the failure of large clinical trials intending to interfere with HDL metabolism, and details the chemical modifications and compositional changes in HDL-forming components, as well as miRNA cargo, that render HDL particles ineffective. Finally, the paper discusses the challenges that need to be overcome to shed a light of hope on HDL-targeted approaches.

Synergistic effect of Betulinic acid, Apigenin and Skimmianine (BASk) in high cholesterol diet rabbit: Involvement of CD36-TLR2 signaling pathway

BACKGROUND

Progression of chronic inflammatory disease, atherosclerosis is a multifactorial process. Cluster of differentiation 36 (CD36) mediated downstream activation of Toll like receptor 2 (TLR2) and NLRP3 (Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3) inflammasome signaling pathway actively participates during chronic inflammation. Nowadays, synergistic combinations of bioactive compounds attained priority in the field of drug discovery and development as therapeutic agents. An investigation regarding the anti-inflammatory potential of a novel drug formulation, BASk which is a combination of three bioactive compounds Betulinic acid (B):Apigenin (A):Skimmianine (Sk) remains the focus area of this research study. We also elucidate the molecular mechanism behind the therapeutic potential of BASk through CD36 mediated activation TLR2-NLRP3 signaling pathway.

METHODS

OxLDL induced hPBMCs used to screen out a suitable combination of BASk via MTT, COX, LOX, NOS and MPO assays. Hypercholesterolemia is induced in rabbits by supplementing with 1% cholesterol + 0.5% cholic acid and treated with BASk (2:2:1) (5 mg/Kg) and atorvastatin (10 mg/Kg) for 60 days. CD36, TLR2, NLRP3, NFκB, cytokines, endothelial damage were quantified by reverse transcription, real time PCR, ELISA, flow cytometry and histopathology.

RESULTS

hPBMCs pretreated with BASk at 2:2:1 ratio significantly decreased the activities of COX, 15-LOX, NOS and MPO on OxLDL induction than quercetin. Down regulation of CD36, TLR2, MyD88, TRAF6 by BASk further buttressed NLRP3 inflammasome activation mediated by the transcription factor NFκB. This is in correlation with the effect of BASk by balancing pro (IL-1β, IL-18) and anti-inflammatory (TGF-β) mediators in the aortic endothelial cells.

CONCLUSION

BASk exerted its anti-inflammatory potential by reducing pro-inflammatory mediators during cholesterol supplementation via down regulating CD36 mediated TLR2 - NLRP3 inflammasome cascade. This deciphers a synergistic combination named BASk (2:2:1) as a novel drug formulation against chronic inflammatory disease, atherosclerosis.

Modulatory effect of pigeon pea-wheat biscuits on lipid profile, lipid peroxidation level, α-glucosidase, and butyrylcholinesterase activities in type-2 diabetic patients

This study examined the modulatory effect of pigeon pea-wheat biscuits on lipid profile, lipid peroxidation level, α-glucosidase, and butyrylcholinesterase activities in type-2 diabetic patients. Composite flours were formulated using pigeon pea (PP) and wheat flour (WF) in ratio 100:0, 75:25, 50:50, 25:75, and 0:100. Sixty diabetic patients (DP) were treated with biscuit samples and the effect of the biscuits on the serum lipid profile, α-glucosidase, and butyrylcholinesterase (BChE) activities were evaluated. The result revealed that total cholesterol ranged from [100-PP (13.94 ± 1.05 mg/dl)-REF (40.46 ± 3.09 mg/dl)]; triglyceride [100-PP (28.00 ± 1.14)-REF (115.00 ± 7.05)], low-density lipoprotein (LDL-C) [100-PP (0.75 ± 0.30)-REF (13.30 ± 2.04)], high-density lipoprotein level(HDL-C) [REF (4.16 ± 0.49)-100-PP (7.59 ± 1.62)], LDL-C/HDL-C [100-PP (0.098 ± 0.01)-REF (8.72 ± 1.20)]. Alanine aminotransferase [CAB (3.10 ± 0.51 U/L)-REF (6.90 ± 0.84 U/L)]; aspartate aminotransferase [100-PP (9.50 ± 0.61 U/L)-REF (19.75 ± 1.50 U/L)]; alkaline phosphate (ALP) [CAB (26.99 ± 2.13 U/L)-BASELINE (UT) (92.40 ± 5.41 U/L]. α-glucosidase [100-PP (1.20 ± 0.07)-REF (0.37 ± 0.02)] and BChE [100-PP (1.12 ± 0.09)-REF (1.30 ± 0.01)] and Malondialdehyde [100-PP (0.33 ± 0.08)-REF (0.37 ± 0.04)]. 100-PP had an outstanding antihyperlipidemic potentials, not injurious to liver and might serve as good functional food that could help in preventing the risk of developing heart coronary disease, atherosclerosis, and stroke. PRACTICAL APPLICATIONS: This study provides vital information on the possible effect of pigeon pea-wheat biscuits on the serum lipid profile and peroxidation levels, α-glucosidase and butyrylcholinesterase of diabetic patients. The biscuits produced had lowering effect on cholesterol and low-density lipoprotein but improved high-density lipoprotein. All the biscuits have good lipid profile which may lower the risk of developing coronary heart diseases and vascular heart diseases in diabetes. However, 100-PP biscuit had an outstanding antihyperlipidemia action on the serum lipid levels of the patients. Also, it had the highest α-glucosidase, MDA, and BChE inhibitory potential. ALT, AST, and ALP serum activities of the patient's serum were greatly improved after treatment with the biscuits. 100-PP could lower the risk of developing heart coronary disease, atherosclerosis, and stroke.

Insights into interplay of immunopathophysiological events and molecular mechanistic cascades in psoriasis and its associated comorbidities

Psoriasis is an inflammatory skin disease with complex pathogenesis and multiple etiological factors. Besides the essential role of autoreactive T cells and constellation of cytokines, the discovery of IL-23/Th17 axis as a central signaling pathway has unraveled the mechanism of accelerated inflammation in psoriasis. This has provided insights into psoriasis pathogenesis and revolutionized the development of effective biological therapies. Moreover, genome-wide association studies have identified several candidate genes and susceptibility loci associated with this disease. Although involvement of cellular innate and adaptive immune responses and dysregulation of immune cells have been implicated in psoriasis initiation and maintenance, there is still a lack of unifying mechanism for understanding the pathogenesis of this disease. Emerging evidence suggests that psoriasis is a high-mortality disease with additional burden of comorbidities, which adversely affects the treatment response and overall quality of life of patients. Furthermore, changing trends of psoriasis-associated comorbidities and shared patterns of genetic susceptibility, risk factors and pathophysiological mechanisms manifest psoriasis as a multifactorial systemic disease. This review highlights the recent progress in understanding the crucial role of different immune cells, proinflammatory cytokines and microRNAs in psoriasis pathogenesis. In addition, we comprehensively discuss the involvement of various complex signaling pathways and their interplay with immune cell markers to comprehend the underlying pathophysiological mechanism, which may lead to exploration of new therapeutic targets and development of novel treatment strategies to reduce the disastrous nature of psoriasis and associated comorbidities.

High-density lipoprotein remodelled in hypercholesterolaemic blood induce epigenetically driven down-regulation of endothelial HIF-1α expression in a preclinical animal model

AIMS

High-density lipoproteins (HDLs) are circulating micelles that transport proteins, lipids, and miRNAs. HDL-transported miRNAs (HDL-miRNAs) have lately received attention but their effects on vascular cells are not fully understood. Additionally, whether cardiovascular risk factors affect HDL-miRNAs levels and miRNA transfer to recipient cells remains equally poorly known. Here, we have investigated the changes induced by hypercholesterolaemia on HDL-miRNA levels and its effect on recipient endothelial cells (ECs).

METHODS AND RESULTS

Pigs were kept on a high-fat diet (HC; n = 10) or a normocholesterolaemic chow (NC; n = 10) for 10 days reaching cholesterol levels of 321.0 (229.7-378.5) mg/dL and 74.0 (62.5-80.2) mg/dL, respectively. HDL particles were isolated, purified, and quantified. HDL-miRNA profiling (n = 149 miRNAs) of HC- and NC-HDLs was performed by multipanel qPCR. Cell cultures of porcine aortic ECs were used to determine whether HDL-miRNAs were delivered to ECs. Potential target genes modulated by miRNAs were identified by bioinformatics and candidate miRNAs were validated by molecular analysis. In vivo effects in the coronary arteries of normocholesterolaemic swine administered HC- or NC-HDLs were analysed. Among the HDL-miRNAs, four were found in different amounts in HC- and NC-HDL (P < 0.05). miR-126-5p and -3p and miR-30b-5p (2.7×, 1.7×, and 1.3×, respectively) were found in higher levels and miR-103a-3p and miR-let-7g-5p (-1.6×, -1.4×, respectively) in lower levels in HC-HDL. miR-126-5p and -3p were transferred from HC-HDL to EC (2.5×; P < 0.05), but not from NC-HDL, by a SRB1-mediated mechanism. Bioinformatics revealed that HIF1α was the miR-126 target gene with the highest predictive value, which was accordingly found to be markedly reduced in HC-HDL-treated ECs and in miR126 mimic transfected ECs. In vivo validation confirmed that HIF1α was diminished in the coronary endothelial layer of NC pigs administered HC-HDL vs. those administered NC-HDL (P < 0.05).

CONCLUSION

Hypercholesterolaemia induces changes in the miRNA content of HDL enhancing miR126 and its delivery to ECs with the consequent down-regulation of its target gene HIF1α.

Eight sessions of endurance training decrease fasting glucose and improve glucose tolerance in middle-aged overweight males

Exercise improves metabolic regulation and reduces the risk of developing type 2 diabetes and other metabolic diseases. The recommendations for exercise are rather general and the health benefits of controlled training studies are important to make better recommendations. In the present study, we report that eight endurance training sessions over 3 weeks reduced fasting glucose, and improved glucose tolerance and plasma lipids in sedentary middle-aged males (44-64 years) with overweight or obesity (BMI: 27-38). The decrease in fasting glucose was substantial (from 5.3 ± 0.3 to 4.8 ± 0.2 mM; p < .001). The training sessions consisted of 60-min indoor-cycling at ∼83% of peak heart rate divided in four blocks of 15 min cycling, with 2-min rest between blocks. Maximal oxygen uptake did not increase (38.8 ± 1.8 vs. 39.0 ± 1.6 ml kg^-1 min^-1). In conclusion, 3-weekly sessions of moderate-/high-intensity endurance training can be recommended for untrained males with overweight or obesity to improve glucose homeostasis.

Differential RNA expression profiles and competing endogenous RNA-associated regulatory networks during the progression of atherosclerosis

Aim: To identify differential mRNA and ncRNA expression profiles and competing endogenous RNA-associated regulatory networks during the progression of atherosclerosis (AS). Materials & methods: We systematically analyzed whole-transcriptome sequencing of samples from different stages of AS to evaluate their long noncoding RNA (lncRNA), circular RNA (circRNA), miRNA and mRNA profiles. Results: We constructed three AS-related competing endogenous RNA regulatory networks of differentially expressed circRNAs, lncRNAs, miRNAs and mRNAs. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses revealed that the circRNAs in the network were enriched in lipid metabolic processes and participated in the PPAR signaling pathway. Furthermore, lncRNAs were related to receptor activity, myofibrils and cardiovascular system development. Conclusion: The current findings further clarified the regulatory mechanisms at different stages of AS and may provide new ideas and targets for AS.

Synthetic high-density lipoproteins loaded with an antiplatelet drug for efficient inhibition of thrombosis in mice

Antiplatelet agents offer a desirable approach to thrombosis prevention through the reduction of platelet reactivity. However, major bleeding events greatly attenuate the clinical outcomes of most antithrombotic agents. Therefore, the development of safer and more effective strategies to prevent vascular occlusion and avoid bleeding is urgently needed. A reconstituted nanoparticle, synthetic high-density lipoprotein (sHDL), which mimics the native HDL, has been established as clinically safe and is easily manufactured on a large scale. In this study, we propose that the delivery of the antiplatelet drug ML355, a selective inhibitor of 12(S)-lipoxygenase (12-LOX), by sHDL will efficiently inhibit thrombosis by targeting ML355 to the intended site of action, improving the pharmaceutical profile and harnessing the innate antithrombotic efficacy of the sHDL carrier. Our data show that ML355-sHDL exhibits more potent inhibition of thrombus formation in both small arterioles and larger arteries in mice without impairing the normal hemostasis in vivo.

Comparative effects of commonly used commercially available non-nutritive sweeteners on diabetes-related parameters in non-diabetic rats

Studies of non-nutritive sweeteners (NNS) in diabetes models have been limited to their pure forms or NNS-sweetened products. Hence, we conducted a comparative study on the effects of commercial table-top NNS on diabetes-related parameters in non-diabetic rats. Normal animals were fed for 5 weeks with aqueous solutions of aspartame-, sucralose-, stevia-, sodium cyclamate- and saccharin-based commercial NNS at concentrations equivalent to the sweetness of 10% sucrose solution and thereafter food intake, blood glucose, lipid profile, and biochemical parameters were measured. Aspartame adversely affected blood cholesterols, while cyclamate increased food intake and weight gain. Stevia reduced weight gain and exhibited insulinotropic effects. These data in normal rats hypothetically suggest that stevia-based NNS may help in glycemic control and body weight management, while cyclamate- and aspartame-based NNS may increase body weight and risk of cardiovascular diseases. Further clinical studies are, however, required to confirm the results of this study. PRACTICAL APPLICATIONS: The use of NNS is becoming more popular, especially for individuals with diabetes. However, while there are several commercial table-top NNS available in the market, little is known about how they affect most diabetes-related parameters of consumers, as most of the previous studies on NNS have been limited to their pure forms or NNS-sweetened products. Therefore, we comparatively studied the effects of some commercially available table-top forms of the different NNS (aspartame, sucralose, cyclamate, saccharin, and stevia) on diabetes-related parameters in normal rats. These findings in normal rats suggested that some commercially available NNSs like stevia-based NNS may be suitable for glycemic control and body weight management, while cyclamate- and aspartame-based NNS may increase body weight and risk of cardiovascular diseases. However, these finding in normal rats is subject to additional corroborative clinical studies.

HDL (High-Density Lipoprotein) Remodeling and Magnetic Resonance Imaging-Assessed Atherosclerotic Plaque Burden: Study in a Preclinical Experimental Model

OBJECTIVE

HDL (high-density lipoprotein) role in atherosclerosis is controversial. Clinical trials with CETP (cholesterylester transfer protein)-inhibitors have not provided benefit. We have shown that HDL remodeling in hypercholesterolemia reduces HDL cardioprotective potential. We aimed to assess whether hypercholesterolemia affects HDL-induced atherosclerotic plaque regression. Approach and Results: Atherosclerosis was induced in New Zealand White rabbits for 3-months by combining a high-fat-diet and double-balloon aortic denudation. Then, animals underwent magnetic resonance imaging (basal plaque) and randomized to receive 4 IV infusions (1 infusion/wk) of HDL isolated from normocholesterolemic (NC-HDL; 75 mg/kg; n=10), hypercholesterolemic (HC-HDL; 75 mg/Kg; n=10), or vehicle (n=10) rabbits. Then, animals underwent a second magnetic resonance imaging (end plaque). Blood, aorta, and liver samples were obtained for analyses. Follow-up magnetic resonance imaging revealed that NC-HDL administration regressed atherosclerotic lesions by 4.3%, whereas, conversely, the administration of HC-HDLs induced a further 6.5% progression (P<0.05 versus basal). Plaque characterization showed that HC-HDL administered animals had a 2-fold higher lipid and cholesterol content versus those infused NC-HDL and vehicle (P<0.05). No differences were observed among groups in CD31 levels, nor in infiltrated macrophages or smooth muscle cells. Plaques from HC-HDL administered animals exhibited higher Casp3 (caspase 3) content (P<0.05 versus vehicle and NC-HDL) whereas plaques from NC-HDL infused animals showed lower expression of Casp3, Cox1 (cyclooxygenase 1), inducible nitric oxide synthase, and MMP (metalloproteinase) activity (P<0.05 versus HC-HDL and vehicle). HDLs isolated from animals administered HC-HDL displayed lower antioxidant potential and cholesterol efflux capacity as compared with HDLs isolated from NC-HDL-infused animal and vehicle or donor HDL (P<0.05). There were no differences in HDL-ApoA1 content, ABCA1 (ATP-binding cassette transporter A1) vascular expression, and SRB1 (scavenger receptor B1) and ABCA1 liver expression.

CONCLUSIONS

HDL particles isolated from a hypercholesterolemic milieu lose their ability to regress and stabilize atherosclerotic lesions. Our data suggest that HDL remodeling in patients with co-morbidities may lead to the loss of HDL atheroprotective functions.

Clinacanthus nutans Leaves Extract Reverts Endothelial Dysfunction in Type 2 Diabetes Rats by Improving Protein Expression of eNOS

Diabetes mellitus is associated with endothelial dysfunction; it causes progressive vascular damage resulting from an impaired endothelium-dependent vasorelaxation. In the diabetes state, presence of hyperglycemia and insulin resistance predisposes to endothelial dysfunction. Clinacanthus nutans, widely used as a traditional medicine for diabetes is reported to have hypoglycemic, hypolipidemic, antioxidant, and anti-inflammatory properties. However, the possibility of C. nutans affecting the vascular endothelial function in diabetes remains unclear. This study was aimed at evaluating the effects of C. nutans methanolic leaves extract (CNME) on endothelial function in a type 2 diabetes (T2DM) rat model. Sixty male Sprague-Dawley rats were divided into five groups (n = 12 per group): nondiabetic control, nondiabetic treated with four weeks of CNME (500 mg/kg/daily), untreated diabetic rats, diabetic treated with metformin (300 mg/kg/daily), and diabetic treated with CNME (500 mg/kg/daily). T2DM was induced by a single intraperitoneal injection of low-dose streptozotocin (STZ) to rats fed with high-fat diet (HFD). Endothelial-dependent and endothelial-independent relaxations and contractions of the thoracic aorta were determined using the organ bath. Aortic endothelial nitric oxide synthase (eNOS) expression was determined using Western blotting. Endothelial-dependent relaxation was reduced in diabetic rats. Both diabetic groups treated with CNME or metformin significantly improved the impairment in endothelium-dependent vasorelaxation; this was associated with increased expression of aortic eNOS protein. CNME- and metformin-treated groups also reduced aortic endothelium-dependent and aortic endothelium-independent contractions in diabetics. Both of these diabetic-treated groups also reduced blood glucose levels and increased body weight compared to the untreated diabetic group. In conclusion, C. nutans improves endothelial-dependent vasodilatation and reduces endothelial-dependent contraction, thus ameliorating endothelial dysfunction in diabetic rats. This may occur due to its effect on increasing eNOS protein expression.

Lipoprotein ability to exchange and remove lipids from model membranes as a function of fatty acid saturation and presence of cholesterol

Lipoproteins play a central role in the development of atherosclerosis. High and low-density lipoproteins (HDL and LDL), known as 'good' and 'bad' cholesterol, respectively, remove and/or deposit lipids into the artery wall. Hence, insight into lipid exchange processes between lipoproteins and cell membranes is of particular importance in understanding the onset and development of cardiovascular disease. In order to elucidate the impact of phospholipid tail saturation and the presence of cholesterol in cell membranes on these processes, neutron reflection was employed in the present investigation to follow lipid exchange with both HDL and LDL against model membranes. Mirroring clinical risk factors for the development of atherosclerosis, lower exchange was observed in the presence of cholesterol, as well as for an unsaturated phospholipid, compared to faster exchange when using a fully saturated phospholipid. These results highlight the importance of membrane composition on the interaction with lipoproteins, chiefly the saturation level of the lipids and presence of cholesterol, and provide novel insight into factors of importance for build-up and reversibility of atherosclerotic plaque. In addition, the correlation between the results and well-established clinical risk factors suggests that the approach taken can be employed also for understanding a broader set of risk factors including, e.g., effects of triglycerides and oxidative stress, as well as local effects of drugs on atherosclerotic plaque formation.

Melatonin inhibits high glucose-induced ox-LDL/LDL expression and apoptosis in human umbilical endothelial cells

BACKGROUND

Cardiovascular disease (CVD) is one of the major cause of mortality in diabetic patients. Evidence suggests that hyperglycemia in diabetic patients contributes to increased risk of CVD. This study is to investigate the therapeutic effects of melatonin on glucose-treated human umbilical vein endothelial cells (HUVEC) and provide insights on the underlying mechanisms.

MATERIALS AND METHODS

Cell viability was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Reactive oxygen species (ROS) and membrane potential was detected using 2',7'-dichlorofluorescein diacetate and 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolcarbocyanine iodide (JC-1) dye staining, respectively. While, cell apoptosis was determined by Annexin-V staining and protein expression was measured using Western blot.

RESULTS

Our results suggested that melatonin inhibited glucose-induced ROS elevation, mitochondria dysfunction and apoptosis on HUVEC. Melatonin inhibited glucose-induced HUVEC apoptosis via PI3K/Akt signaling pathway. Activation of Akt further activated BcL-2 pathway through upregulation of Mcl-1 expression and downregulation Bax expression in order to inhibit glucose-induced HUVEC apoptosis. Besides that, melatonin promoted downregulation of oxLDL/LOX-1 in order to inhibit glucose-induced HUVEC apoptosis.

CONCLUSIONS

In conclusion, our results suggested that melatonin exerted vasculoprotective effects against glucose-induced apoptosis in HUVEC through PI3K/Akt, Bcl-2 and oxLDL/LOX-1 signaling pathways.

APOL1 Genetic Variants Are Associated with Serum-Oxidized Low-Density Lipoprotein Levels and Subclinical Atherosclerosis in South African CKD Patients

INTRODUCTION

Apolipoprotein L1 (APOL1) plays an important role in cholesterol metabolism and attenuation of low-density lipoprotein (LDL) oxidation. While protecting against Trypanosoma brucei rhodesiense infection, APOL1 risk alleles confer greater risk for CKD and cardiovascular disease among patients of African descent.

OBJECTIVES

We investigated whether APOL1 risk variants are associated with atherosclerosis and oxidized LDL (OxLDL) levels among black South African CKD patients.

METHODS

A cross-sectional study of 120 adult CKD patients and 40 controls was undertaken. DNA samples of participants were genotyped for APOL1 G1 and G2 variants. High-sensitivity C-reactive protein, serum lipids, and OxLDL levels were measured, and carotid doppler ultrasonography was performed on all participants.

RESULTS

APOL1 alleles rs73885319, rs60910145, and rs71785313 had minor allele frequencies of 9.2, 8.8, and 17.5%, respectively, in the patients, and 8.8, 8.8, and 13.8%, respectively, in the controls. Of the 9 patients with 2 APOL1 risk alleles, 77.8% were compound G1/G2 heterozygotes and 22.2% were G2 homozygotes. Carriers of at least 1 APOL1 risk allele had a 3-fold increased risk of subclinical atherosclerosis (odds ratio 3.19; 95% confidence interval: 1.64-6.19; p = 0.01) compared to individuals with no risk alleles. Patients with 1 or 2 APOL1 risk alleles showed a significant increase in OxLDL levels when compared with those without the APOL1 risk allele.

CONCLUSION

These findings suggest an increased risk for atherosclerosis in carriers of a single APOL1 risk variant, and the presence of APOL1 risk variants was associated with increased serum OxLDL levels in black South African CKD patients.

Expression and clinical significance of serum cystatin C in patients with hypertension and coronary heart disease

The aim of this study is to explore the potential association between cystatin C (Cys-c) and coronary heart disease (CHD) in hypertensive patients.In this study, circulating levels of Cys-c in 62 essential hypertension (EH) patients, 147 hypertension with coronary heart disease (EH + CHD) patients, and 60 healthy volunteers were investigated using immunoturbidimetry. Then, we analyzed the correlations between Cys-C and other clinical parameters.Serum Cys-C level was significantly higher in the EH and EH + CHD groups than in the control group, and higher in the EH + CHD group than in the EH group. Receiver operating characteristic curve (ROC) analysis showed that the diagnostic value of Cys-C for patients with hypertension combined CHD was 0.871(95% CI: 0.818-0.913). Serum Cys-C level was significantly higher in the double-vessel disease group and multi-vessel disease group than in the single-vessel disease group, and higher in the multi-vessel disease group than in the double-vessel disease group. Urinary albumin and CRP correlated positively with Cys-C, and HDL correlated negatively with Cys-C. Cys-C was an independent risk factor for CHD in hypertensive patients.Our results suggested that circulating Cys-C levels was up-regulated in patients with hypertension and CHD, and had correlation with the severity of coronary artery disease. As one of the important risk factors for CHD, Cys-C can predict the occurrence of CHD in patients with hypertension.

Myricitrin exhibits anti-atherosclerotic and anti-hyperlipidemic effects in diet-induced hypercholesterolemic rats

The present study investigated the anti-atherosclerotic potential of myricitrin in hypercholesterolemic rats. Rats were divided into the following groups: sham (standard food), control [1% high-cholesterol diet (HCD)], 1 μM myricitrin + 1% HCD, 10 μM myricitrin + 1% HCD, 100 μM myricitrin + 1% HCD, and the positive control (10 mg/kg body weight atorvastatin). The dose was given to rats via oral gavage for 45 consecutive days. Feeding of rats with 1% HCD caused substantial increases in the levels of LDL, cholesterol, and triglycerides (TG), while high-density lipoprotein (HDL) was reduced. However, rats supplemented with myricitrin had reduced levels of cholesterol, LDL, and TG to near-normal levels, whereas HDL was increased. Catalase, superoxide dismutase (SOD), glutathione peroxidase (Gpx), and reduced glutathione (GSH) levels were substantially reduced in the HCD-fed rats compared with sham rats. However, the rats supplemented with 100 μM myricitrin showed > 50% increases in these levels. Lipid peroxidation and reactive oxygen species (ROS) levels were reduced following myricitrin treatment. The aortic cell wall area was significantly increased by 14.5% in HCD-fed rats. However, rats supplemented with 1, 10, and 100 μM myricitrin showed significant reductions in the aortic cell wall area of 2.3%, 4%, and 27.5%, respectively. This is the first report of the anti-atherosclerotic and hypolipidemic effects of myricitrin in hypercholesterolemic rats. Myricitrin decreased the level of total serum cholesterol and the role of aortic atherosclerosis in hypercholesterolemic rats.

Regulatory Factor X1 Downregulation Contributes to Monocyte Chemoattractant Protein-1 Overexpression in CD14+ Monocytes via Epigenetic Mechanisms in Coronary Heart Disease

Monocyte chemoattractant protein 1 (MCP1) affects the chemotaxis of monocytes and is a key chemokine closely related to the development of atherosclerosis (AS). Compared with healthy controls, coronary heart disease (CAD) patients show significantly upregulated plasma concentrations and mRNA expression of MCP1 in CD14+ monocytes. However, the specific regulatory mechanism of MCP1 overexpression in AS is still unclear. Our previous research indicated that there was no significant difference in the H3K4 and H3K27 tri-methylation of the MCP1 promoter in CD14+ monocytes from CAD versus non-CAD patients, but the H3 and H4 acetylation of the MCP1 promoter was increased in CD14+ monocytes from CAD patients. We further found that the H3K9 tri-methylation of the MCP1 promoter in CD14+ monocytes from CAD patients was decreased, but the DNA methylation levels did not differ markedly from those in non-CAD patients. Our previous work showed that the level of regulatory factor X1 (RFX1) was markedly reduced in CD14+ monocytes from CAD patients and played an important role in the progression of AS by regulating epigenetic modification. In this study, we investigated whether RFX1 and epigenetic modifications mediated by RFX1 contribute to the overexpression of MCP1 in activated monocytes in CAD patients. We found that the enrichment of RFX1, histone deacetylase 1 (HDAC1), and suppressor of variegation 3–9 homolog 1 (SUV39H1) in the MCP1 gene promoter region were decreased in CD14+ monocytes from CAD patients and in healthy CD14+ monocytes treated with low-density lipoprotein (LDL). Chromatin immunoprecipitation (ChIP) assays identified MCP1 as a target gene of RFX1. Overexpression of RFX1 increased the recruitments of HDAC1 and SUV39H1 and inhibited the expression of MCP1 in CD14+ monocytes. In contrast, knockdown of RFX1 in CD14+ monocytes reduced the recruitments of HDAC1 and SUV39H1 in the MCP1 promoter region, thereby facilitating H3 and H4 acetylation and H3K9 tri-methylation in this region. In conclusion, our results indicated that RFX1 expression deficiency in CD14+ monocytes from CAD patients contributed to MCP1 overexpression via a deficiency of recruitments of HDAC1 and SUV39H1 in the MCP1 promoter, which highlighted the vital role of RFX1 in the pathogenesis of CAD.

Site-Specific Glycoprofiles of HDL-Associated ApoE are Correlated with HDL Functional Capacity and Unaffected by Short-Term Diet

Since high-density lipoprotein (HDL) glycoprofiles are associated with HDL functional capacity, we set out to determine whether diet can alter the glycoprofiles of key HDL-associated proteins, including ApoE, a potent driver of chronic disease risk. Ten healthy subjects consumed a fast food (FF) and a Mediterranean (Med) diet for 4 days in randomized order, with a 4-day wash-out between treatments. A multiple reaction monitoring method was used to characterize the site-specific glycoprofiles of HDL proteins, and HDL functional capacity was analyzed. We describe for the first time that ApoE has 7 mucin-type O-glycosylation sites, which were not affected by short-term diet. The glycoprofiles of other HDL-associated proteins were also unaffected, except that a disialylated ApoC-III glycan was enriched after Med diet, and a nonsialylated ApoC-III glycan was enriched after FF diet. Twenty-five individual glycopeptides were significantly correlated with cholesterol efflux capacity and 21 glycopeptides were correlated with immunomodulatory capacity. Results from this study indicate that the glycoprofiles of HDL-associated proteins including ApoE are correlated with HDL functional capacity but generally unaffected by diet in the short term, except ApoC-III sialylation. These results suggest that HDL protein glycoprofiles are affected by both acute and long-term factors and may be useful for biomarker discovery.

Overexpression of PID1 reduces high density lipoprotein level and functionality in swine

Phosphotyrosine interaction domain 1 (PID1), a protein with a phosphotyrosine-binding (PTB) domain, interacts with the lipoprotein receptor-related protein 1 (LRP1) to reduce the insulin sensitivity of adipocyte. Considering the role of LRP1 in lipid metabolism, we investigated the effect of PID1 on the content and biological activities of serum lipoproteins in pigs. PID1-transgenic pigs were genetated by sperm and magnetic nanoparticles-mediated method. The levels of PID1 in PID1-transgenic pig's liver were higher than that in the wild-type pig's liver. We found that serum levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apoA-I) were significantly reduced in PID1-transgenic pigs. On the other hand, PID1-transgenic pigs displayed increased non-HDL-C levels. Serum levels of total cholesterol and triglycerides were comparable between the PID1-transgenic and the wild-type pigs. Further, the HDL isolated from PID1-transgenic pigs showed a significant reduction in cholesterol efflux ability. In addition, serum superoxide dismutase activity of PID1-transgenic pigs was also obviously lowered compared with that of wild type pigs. In conclusion, these results suggest that PID1 might be able to adjust HDL-C levels in serum and HDL cholesterol efflux ability.

Serum lipid, homocysteine, and platelet derived growth factor in patients with hypertension

Purpose

The purpose of this paper is to study serum lipids, lipoproteins, homocysteine (Hcy) and platelet-derived growth factor (PDGF), and to evaluate the relationship between serum lipids, lipoproteins, Hcy and PDGF in patients with hypertension.

Design/methodology/approach

In total, 85 patients with hypertension (34 males, 51 females) were recruited from October to December 2015 at Saraphi Hospital, Chiang Mai Province using purposive sampling. PDGF mRNA levels of the patients were analyzed using the RT-PCR method. Hcy was analyzed by high-performance liquid chromatography. An enzymatic-colorimetric method was used to measure serum cholesterol, high-density lipoprotein cholesterol and triglyceride. A low-density lipoprotein cholesterol (LDL-C) level was calculated using Friedewald’s formula. Descriptive statistics and the Pearson product moment were also used in the analysis.

Findings

Among the patients with hypertension, hypercholesterolemia, high levels of LDL-C, hypertriglyceridemia and hyperhomocysteinemia were found in 54.1, 70.7, 25.9 and 44.7 percent, respectively. In addition, PDGF was significantly correlated with Hcy (r=0.705; p<0.005). There was no association between serum lipids or lipoproteins and Hcy or PDGF in patients with hypertension.

Practical implications

The results of this study provide direction on how serum lipids, lipoproteins, Hcy and PDGF can be used as a guide to improving dietary management as a means of reducing cardiovascular disease, and stroke in patients with hypertension.

Originality/value

This manuscript is not currently under consideration, in press or published elsewhere. This manuscript is truthful original work without fabrication, fraud or plagiarism. The authors have made important scientific contributions to this study. The authors are familiar with the primary data, and have read the entire manuscript and take responsibility for it content. No benefits were received by the authors or any member of the authors’ family or the research team, from any commercial source, directly or indirectly related to this work. Moreover, no one affiliated with has any financial interest related to the subject matter of this manuscript.

Molecular Dynamics Simulations of Water-Mediated Cholesterol Capture within an Open-Ended Single-Walled Carbon Nanotube

The excess concentration of cholesterol in the bloodstream can be brought down to a safer level by utilizing a potential cholesterol-binding agent such as a carbon nanotube (CNT). Here, we have probed solvent-mediated interactions between cholesterol and CNT by performing molecular dynamics simulations and potential-of-mean force (PMF) calculations. Simulations predict favorable interactions between water-mediated cholesterol and CNT owing to strong mutual interactions between them, whereas water plays an opposing role in the association. The breakdown of PMF into its enthalpic and entropic contributions indicates that contrary to traditional entropy-driven hydrophobic association, the cholesterol encapsulation within a CNT is primarily driven by enthalpy.

Decreasing serum homocysteine and hypocholesterolemic effects of Bovine lactoferrin in male rat fed with high-cholesterol diet

Introduction: Lipid metabolism disorder or hyperlipidemia is known as a risk factor for cardiovascular disease, the increase in serum homocysteine and leptin are associated with atherosclerotic disease. The purpose of the present study was to examine the effects of bovine lactoferrin (bLF) on serum homocysteine (Hcy), apolipoproteinA-I (ApoA-I) and B (ApoB), leptin and lipid profile changes in high-cholesterol-diet (HCD) fed rats.

Methods: The Healthy Adult Sprague-Dawley (SD) male rats were randomly assigned into three experimental groups. Each group consisted of eleven male rats including control group, HCD rats and hypercholesterolemic rats, which were treated with bLF (HCD+bLF). bLF was given by gavage (200 mg/kg/d). After 4 weeks of feeding and overnight fasting, total blood samples were collected.

Results: The results showed the elevated level of Hcy, leptin, total cholesterol, low density lipoprotein cholesterol (LDL-C), ApoB and decrease in ApoA-I in non-treated HCD group compared to the control rats. Administration of bLF significantly ameliorated the Hcy and leptin levels with decrease in LDL-C and total cholesterol in rats fed with a high-cholesterol diet. bLF also tended to increase low serum concentration of ApoA-I and high density lipoprotein cholesterol (HDL-C) in HCD rats. Meanwhile, upon bLF-treated rats, there was a significant decrease in ApoB in HCD group.

Conclusion: The findings indicated that bLF can improve the alteration of serum Hcy, leptin, apolipproteins and lipid changes in male rats fed with high-cholesterol diet. So, bLF can counteract with HCD elicited hyper-homocysteinemia and hyper-leptinemia, suggesting it to have the useful therapeutic potential in patients with atherosclerosis and lipid disorder.

Endoplasmic reticulum stress mediates inflammatory response triggered by ultra-small superparamagnetic iron oxide nanoparticles in hepatocytes

Ultra-small superparamagnetic iron oxide nanoparticles (USPIO-NPs) are widely used as clinical magnetic resonance imaging contrast agents for hepatic diseases diagnosis. USPIO-NPs often damage the hepatocytes and affect the function of liver but its mechanism of action remains unclear. In the present study, USPIO-NPs caused higher cytotoxicity and lactate dehydrogenase (LDH) leakage in hepatic L02 cells than SPIO-NPs. Subsequently, USPIO-NPs affected more genes' expression than SPIO-NPs analyzed through microarray and bioinformatics analysis. The affected genes were involved in several biological processes, including calcium ion homeostasis, inflammatory response-related leukocyte chemotaxis, and migration. In addition, the level of endoplasmic reticulum (ER) calcium ion was increased by USPIO-NPs. USPIO-NPs also upregulated the genes related to acute-phase inflammation, including IL1B, IL6, IL18, TNFSF12, TNFRSF12, SAA1, SAA2, JAK1, STAT5B, and CXCL14. Furthermore, interleukin-6 (IL-6) secretion was elevated by USPIO-NPs as detected using ELISA. On the other hand, USPIO-NPs changed the morphology of ER and triggered the ER stress and unfolded protein response PERK/ATF4 pathway. Furthermore, blocking ER stress with inhibitor or ATF4 small interfering RNA counteracted IL-6-related acute-phase inflammation and cytotoxicity caused by USPIO-NPs. Taken together, we found that the USPIO-NPs could trigger stronger IL-6-related acute-phase inflammation than SPIO-NPs in hepatocytes. We demonstrated, for the first time, that IL-6-related acute-phase inflammation caused by NPs was regulated by PERK/ATF4 signaling. The PERK/ATF4 pathway explored in this study could be a candidate for diagnostic and therapeutic target against NPs-induced liver injury and cytotoxicity, which would be helpful for USPIO-NPs medical application.

Evolution of 29 Anthropometric, Nutritional, and Cardiometabolic Parameters Among Morbidly Obese Adolescents 2 Years Post Sleeve Gastrectomy

Background

Laparoscopic sleeve gastrectomy (LSG) is a popular treatment for adolescent morbid obesity. Research on LSG outcomes among adolescents assessed a narrow range of anthropometric, nutritional, or cardiometabolic parameters, leading to an incomplete picture of these changes. We examined a wide variety of anthropometric, nutritional, and cardiometabolic parameters among adolescents before and after LSG.

Methods

We retrospectively reviewed medical charts of all obese adolescents who underwent LSG at Hamad Medical Corporation, Qatar, between January 2011 and June 2015 (N = 102). We assessed preoperative levels and postoperative changes in 4 anthropometric, 15 nutritional, and 10 cardiometabolic parameters.

Results

The study sample comprised 79 patients with complete information (36 males, mean age 15.99 ± 1.1 years). At a mean of 24.2 months post-LSG, we observed (1) significantly reduced mean weight and body mass index by 51.82 ± 28.1 kg and 17 ± 6.24 kg/m², respectively; (2) the highest prevalence of post-LSG deficiencies pertained to vitamin D, albumin, and ferritin (89.3, 38, and 33.3%, respectively); (3) low hemoglobin levels (29.3%) only in females; (4) trace elements were not deficient; (4) significant reductions in percentage of adolescents with elevated low-density lipoprotein (from 66.1 to 38.9%), alanine aminotransferase (from 45.3 to 10.9%), and aspartate aminotransferase (from 24.1 to 8.6%) levels; (5) 100% remission of prediabetes cases; and (6) 80% remission of type 2 diabetes cases.

Conclusions

LSG achieved significant weight loss and improvement of cardiometabolic risk factors among adolescents. However, the slight worsening of preexisting nutritional deficiencies warrants careful preoperative surveillance and appropriate postoperative nutritional supplementation.

Low-density lipoprotein level on admission is not associated with postintravenous thrombolysis intracranial hemorrhage in patients with acute ischemic stroke

Intravenous thrombolysis with the tissue plasminogen activator (tPA) is the gold standard for acute ischemic stroke. However, its application is limited because of the concern of the post-tPA intracranial hemorrhage (ICH). Low low-density lipoprotein (LDL) has been speculated to increase the risk of hemorrhagic transformation after ischemic stroke. However, whether LDL is associated with post-tPA ICH remains controversial. The present study obtained the medical records from Shuang Ho Hospital and retrospectively reviewed for the period between August 2009 and December 2016 to investigate the association between LDL and the risk of post-tPA ICH. The differences were analyzed using the Student's t-test, Fisher's exact test, the univariate and stepwise multiple regression model, and p<0.05 was considered statistically significant. Among 218 patients, post-tPA ICH was noted in 23 (10.5%) patients. Patients with post-tPA ICH tended to have a lower LDL level (ICH group: 102.00±24.56, non-ICH group: 117.02±37.60 mg/dL, p=0.063). However, after adjustment for the factors might affect the risk of post-tPA ICH, such as stroke severity, onset-to-treatment time interval, and atrial fibrillation (AF), LDL level was not associated with post-tPA ICH whereas AF was the only significant factor increased the risk of post-tPA ICH (adjusted OR: 1.177, 95% CI 1.080 to 1.283). In addition, patients with AF had significant lower LDL level and for patients without AF, LDL was not associated with the post-tPA ICH. In conclusion, LDL level is not associated with the risk of post-tPA ICH in Taiwanese patients with stroke.

Does dyslipidemia worsen the hearing level in diabetics?

Objective

To identify the effect of dyslipidemia on auditory function detected by Pure Tone Audiometry. To check if dyslipidemia worsens the hearing level in diabetics.

Design

This was a comparative study where 120 subjects between the age group of 20 and 50 years underwent pure tone audiometry, lipid profile and blood sugars. Group 1 consisted of 30 subjects with type 2 diabetes and dyslipidemia; Group 2 had 30 subjects with isolated diabetes; Group 3 had 30 with isolated dyslipidemia and Group 4 included 30 normal subjects as control.

Results

Significant hearing loss was seen only in the group with isolated diabetes (63%). The most common type of hearing loss was high frequency sensorineural hearing loss. When comparison was made between the combinations of different lipid profiles, no association was found to the level of hearing.

Conclusions

Diabetics are more prone to high frequency hearing loss. Altered lipid profile has no role in causing hearing loss.

Tβ4 Increases Neovascularization and Cardiac Function in Chronic Myocardial Ischemia of Normo- and Hypercholesterolemic Pigs

Translations of new therapeutic options for cardiovascular disease from animal studies into a clinical setting have been hampered, in part by an improper reflection of a relevant patient population in animal models. In this study, we investigated the impact of thymosin β4 (Tβ4), which promotes collateralization and capillarization, during hypercholesterolemia, a known risk factor of coronary artery disease. Initial in vitro results highlighted an improved endothelial cell function upon Tβ4 treatment under control conditions and during hypercholesterolemic stress (scratch area [pixels]: oxidized low-density lipoprotein [oxLDL], 191,924 ± 7,717; and oxLDL + Tβ4, 105,621 ± 11,245). To mimic the common risk factor of hypercholesterolemia in vivo, pigs on regular (NC) or high-fat (HC) diet underwent chronic myocardial ischemia followed by recombinant adeno-associated virus (rAAV)-mediated transduction of Tβ4 or LacZ as a control. We show that Tβ4 overexpression improves capillarization and collateralization (collaterals: NC + rAAV.LacZ, 2.1 ± 0.5; NC + rAAV.Tβ4, 6.7 ± 0.5; HC + rAAV.LacZ, 3.0 ± 0.3; and HC + rAAV.Tβ4, 6.0 ± 0.4), ultimately leading to an improved myocardial function in both diet groups (ejection fraction [EF] at day 56 [%]: NC + rAAV.LacZ, 26 ± 1.1; NC + rAAV.Tβ4, 45 ± 1.5; HC + rAAV.LacZ, 26 ± 2.5; and HC + rAAV.Tβ4, 41 ± 2.6). These results demonstrate the potency of Tβ4 in a patient-relevant large animal model of chronic myocardial ischemia.

ALUminating the Path of Atherosclerosis Progression: Chaos Theory Suggests a Role for Alu Repeats in the Development of Atherosclerotic Vascular Disease

Atherosclerosis (ATH) and coronary artery disease (CAD) are chronic inflammatory diseases with an important genetic background; they derive from the cumulative effect of multiple common risk alleles, most of which are located in genomic noncoding regions. These complex diseases behave as nonlinear dynamical systems that show a high dependence on their initial conditions; thus, long-term predictions of disease progression are unreliable. One likely possibility is that the nonlinear nature of ATH could be dependent on nonlinear correlations in the structure of the human genome. In this review, we show how chaos theory analysis has highlighted genomic regions that have shared specific structural constraints, which could have a role in ATH progression. These regions were shown to be enriched with repetitive sequences of the Alu family, genomic parasites that have colonized the human genome, which show a particular secondary structure and are involved in the regulation of gene expression. Here, we show the impact of Alu elements on the mechanisms that regulate gene expression, especially highlighting the molecular mechanisms via which the Alu elements alter the inflammatory response. We devote special attention to their relationship with the long noncoding RNA (lncRNA); antisense noncoding RNA in the INK4 locus (ANRIL), a risk factor for ATH; their role as microRNA (miRNA) sponges; and their ability to interfere with the regulatory circuitry of the (nuclear factor kappa B) NF-κB response. We aim to characterize ATH as a nonlinear dynamic system, in which small initial alterations in the expression of a number of repetitive elements are somehow amplified to reach phenotypic significance.

The expression of hSR-B1 on platelets of patients with coronary artery disease (CAD)

INTRODUCTION

The human scavenger receptor class B type 1 (hSR-B1), which serves as a high affinity receptor for HDL, is expressed on platelet surface and mediates various anti-atherogenic functions. Based on the anti-thrombotic effect of HDL and the importance of HDL-SR-B1 in the formation of atherosclerotic plaque, the present study was aimed to investigate and compare the expression level of hSR-B1on platelets of CAD patients with that of normal controls.

METHODS

The expression of the hSR-B1 on platelets of 31 CAD patients with atherosclerotic plaque and 20 healthy controls were detected using flowcytometry and western blotting. Moreover, platelet function in response to the agonists was examined by aggregometry, and the lipid panel tests were assayed using chemistry autoanalyzer.

RESULTS

Our findings showed that the expression of hSR-B1 was significantly reduced on the surface of platelets from CAD patients with atherosclerotic disease, as compared with healthy controls (6/8% vs. 13/6%) (P < 0,001). Of particular of interest, we also found that the formation of aggregates after stimulation of the platelets with ADP was higher in patients with atherosclerotic disease than the controls; indicating an inverse relationship between hSR-B1 expression and the function of human platelets.

CONCLUSION

Taken together, the results of the present study raise the possibility that the measurement of hSR-B1 expression on human platelets may provide a valuable insight that reflects the status of RCT in patients with atherosclerosis.

A Population-Based Cross-Sectional Study of the Association between Liver Enzymes and Lipid Levels

BACKGROUND

To examine the association between low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels and liver enzyme functions.

METHODS

The National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2012 was used to examine the association between liver enzymes and lipid levels amongst adults in the United States.

RESULTS

Sixteen percent adults had ALT > 40 U/L, 11% had AST > 40 U/L, and 96% had ALP > 120 U/L. Age, gender, and race/ethnicity showed significant association with LDL, HDL, and triglycerides levels. LDL greater than borderline high was associated with little over two times higher odds of elevated ALT (OR: 2.33, 95% CI: 2.17, 2.53, p ≤ 0.001) and AST (OR: 2.79, 95% CI: 2.55, 3.06, p ≤ 0.001). High HDL was associated with 50% higher odds for elevated ALT (OR: 1.51, 95% CI: 1.39, 1.64, p ≤ 0.001) and over two-and-half fold elevated AST (OR: 2.77, 95% CI: 2.47, 3.11, p ≤ 0.001). LDL-C, HDL-C, and triglycerides were found to be good predictor of elevated ALT, AST, and ALP levels. Similarly, old age and female gender were significant predictor of elevated ALT and AST (p ≤ 0.001).

CONCLUSIONS

Underlying hepatic pathophysiology from dyslipidemia deserves further exploration due to its potential effects on hepatic drug metabolism/detoxification.

Protective effect of atorvastatin meditated by HMGCR gene on diabetic rats with atherosclerosis: An in vivo and in vitro study

BACKGROUND

Accelerated atherosclerosis in patients suffering from diabetes represents a major cause of morbidity and mortality. The aim of present study was to investigate the protective effects conferred by atorvastatin (AVT) meditated by the HMGCR gene in diabetic rats with atherosclerosis.

METHODS

Serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FBG) and serum insulin (INS) were all determined by means of in vivo experiments. Following the establishment of the diabetic model of atherosclerosis, the expressions of HMGCR, low density lipoprotein receptor (LDLR), fatty acid synthase (FASN) were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blot analysis in the vitro experiments. Flow cytometry was adopted in order to detect cell cycle and apoptosis.

RESULTS

The in vivo experiments results indicated that FBG and INS among the diabetic arteriosclerosis rats exhibited markedly higher levels; after injected with AVT and HMGCR, decreased contents of TC, TG, LDL-C and VLDL-C, while increased contents of HDL-C as well as an increased positive rate of HMGCR protein expression were observed. In vitro experiment, the mRNA and protein expression of LDLR were increased and FASN were decreased in cells transfected with HMGCR and AVT; with a greater number of cells arrested at the S phase and less in the G0/G1 phase, as well as data indicating the rate of apoptosis was inhibited after HMGCR and AVT transfection processes.

CONCLUSION

The key findings of the present study suggested that the protective effect conferred by AVT in diabetic rats with atherosclerosis was associated with the overexpression of the HMGCR gene, thus presenting a novel target for atherosclerosis treatment.