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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Wei L, Sun J, Xie H, Zhuang Q, Wei P, Zhao X, Chen Y, Dong J, Li M, Chen C, Yang S, Shen C. Interaction Analysis of Abnormal Lipid Indices and Hypertension for Ischemic Stroke: A 10-Year Prospective Cohort Study. Front Cardiovasc Med 2022; 9:819274. [PMID: 35360026 PMCID: PMC8962740 DOI: 10.3389/fcvm.2022.819274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/18/2022] [Indexed: 01/23/2023] Open
Abstract
BackgroundDyslipidemia and hypertension are two important independent risk factors for ischemic stroke (IS); however, their combined effect on IS remains uncertain.ObjectivesThis present study aimed to evaluate the interaction effect of hypertension and abnormal lipid indices on IS in a 10-year prospective cohort in Chinese adults.MethodsThe cohort study of 4,128 participants was conducted in May 2009 and was followed up to July 2020. All qualified participants received a questionnaire survey, physical examination, and blood sample detection. Cox regression was used to evaluate the association of dyslipidemia and hypertension with IS, and calculate the hazard ratio (HR) and 95% confidence interval (CI). The relative excess risk of interaction (RERI) and the HR (95%CI) of interaction terms were used to examine additive and multiplicative interactions.ResultsIn the hypertensive population, Non-HDL-C ≥190 mg/dl, LDL-C/HDL-C ≥2 and HDL-C ≥60 mg/dl were statistically associated with IS, and after adjusting for covariates, HRs (95%CIs) were 1.565 (1.007–2.429), 1.414 (1.034–1.933) and 0.665 (0.450–0.983), respectively. While in the non-hypertension population, no significant association of Non-HDL-C ≥190 mg/dl, LDL-C/HDL-C ≥2, and HDL-C ≥60 was detected with IS (P > 0.05). There was a significant association between TC/HDL-C ≥ 3.6 and the decreased risk of IS in the non-hypertension population, and the HR (95%CI) was 0.479 (0.307–0.750). Whereas, a similar association was not observed in the hypertensive population. HDL-C ≥ 60 mg/dl, Non-HDL-C ≥ 190 mg/dl, TC/HDL-C ≥ 3.6, and TG/HDL-C ≥ 1 have additive and multiplicative interactions with hypertension (P < 0.05). The RERIs (95% CIs) of the additive interaction are −0.93 (−1.882–0.044), 1.394 (0.38–2.407), 0.752 (0.354–1.151) and 0.575 (0.086–1.065), respectively. The HRs (95% CIs) of the multiplicative interaction terms were 0.498 (0.272–0.911), 4.218 (1.230–14.464), 2.423 (1.437–4.086) and 1.701 (1.016–2.848), respectively.ConclusionHigh concentration of HDL-C reduces the impact of hypertension on IS, while the high concentration of Non-HDL-C, TC/HDL-C, and TG/HDL-C positively interact with hypertension affecting the incidence of IS. This study provides useful evidence for the combined effects of dyslipidemia and hypertension in predicting IS.
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Affiliation(s)
- Lai Wei
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Junxiang Sun
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Hankun Xie
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qian Zhuang
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Pengfei Wei
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Xianghai Zhao
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Yanchun Chen
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Jiayi Dong
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mengxia Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Changying Chen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Song Yang
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
- Song Yang
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- *Correspondence: Chong Shen
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Caselli C, De Caterina R, Ragusa R, Liga R, Gimelli A, Scholte AJHA, Clerico A, Knuuti J, Neglia D. Association of Circulating Heme Oxygenase-1, Lipid Profile and Coronary Disease Phenotype in Patients with Chronic Coronary Syndrome. Antioxidants (Basel) 2021; 10:antiox10122002. [PMID: 34943105 PMCID: PMC8698632 DOI: 10.3390/antiox10122002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/21/2022] Open
Abstract
Background. The NF-E2–related factor 2 (Nrf2)/Heme Oxygenase-1 (HO-1) pathway has an emerging role in atherosclerosis. Activated by oxidative stress, it is deemed to exert athero-protective effects. We aimed at evaluating the relationships between plasma HO-1, clinical/molecular profiles and coronary disease patterns in patients with chronic coronary syndromes (CCS). Methods. HO-1 was measured in 526 patients (60 ± 9 years, 318 males) with CCS. Coronary computed tomography angiography (CTA) and stress imaging were used to assess the disease phenotype (coronary atherosclerosis and myocardial ischemia) in a subgroup of 347 patients. Results. In the overall population, HO-1 median value (25–75 percentile) was 5.195 (1.75–8.25) ng/mL. Patients with higher HO-1 were more frequently male, had a higher BMI and lower LVEF%, but otherwise similar risk factors than the other patients. Their bio-humoral profile was characterized by higher markers of endothelial/myocardial dysfunction, but lower levels of cholesterol lipoproteins. Coronary artery disease was characterized by more diffuse atherosclerosis, with mainly non-obstructive and calcified plaques, and a higher prevalence of functional ischemia. Conclusion: In patients with CCS, higher plasma HO-1 levels are associated with lower cholesterol and a more diffuse but mainly non-obstructive coronary atherosclerosis, confirming a potential role for the Nrf2/HO-1 pathway as a protective feedback.
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Affiliation(s)
- Chiara Caselli
- Institute of Clinical Physiology, National Research Council (IFC-CNR), Via Moruzzi, 1, 56124 Pisa, Italy;
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (A.G.); (A.C.); (D.N.)
- Correspondence: ; Tel.: +39-050-315-3551; Fax: 39-050-315-2166
| | - Raffaele De Caterina
- Institute of Cardiology, University of Pisa, 56124 Pisa, Italy; (R.D.C.); (R.L.)
| | - Rosetta Ragusa
- Institute of Clinical Physiology, National Research Council (IFC-CNR), Via Moruzzi, 1, 56124 Pisa, Italy;
- Scuola Superiore Sant’Anna, 56124 Pisa, Italy
| | - Riccardo Liga
- Institute of Cardiology, University of Pisa, 56124 Pisa, Italy; (R.D.C.); (R.L.)
| | - Alessia Gimelli
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (A.G.); (A.C.); (D.N.)
| | | | - Aldo Clerico
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (A.G.); (A.C.); (D.N.)
- Scuola Superiore Sant’Anna, 56124 Pisa, Italy
| | - Juhani Knuuti
- Turku University Hospital, University of Turku, 20520 Turku, Finland;
| | - Danilo Neglia
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (A.G.); (A.C.); (D.N.)
- Scuola Superiore Sant’Anna, 56124 Pisa, Italy
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Zeng C, Yan C, Guo S, Zhu H, Chen Y, Zhan X. High-density lipoprotein cholesterol to apolipoprotein A1 ratio and all-cause mortality among incident peritoneal dialysis patients. Nutr Metab Cardiovasc Dis 2021; 31:3457-3463. [PMID: 34656383 DOI: 10.1016/j.numecd.2021.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/22/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS The ratio of high-density lipoprotein cholesterol to apolipoprotein A1 (HAR) is associated with all-cause mortality in nonchronic kidney disease patients, but its role in predicting all-cause mortality in patients undergoing peritoneal dialysis (PD) is still unclear. The purpose of this study was to investigate the relationship between HAR and all-cause mortality in patients with PD. METHODS AND RESULTS The medical records of 1199 patients with PD from November 1, 2005, to August 31, 2019, were collected retrospectively. The main outcome was defined as all-cause mortality. The HAR was divided into three groups by X-tile software. The association between HAR and all-cause mortality was evaluated by Cox models. The Kaplan-Meier method was used for the survival curve. The median follow-up period was 35 months (interquartile range: 20-57 months), with a total of 326 deaths recorded. After multiple adjustments, the risk of all-cause mortality in the high HAR group was 1.96-fold higher than that in the low HAR group (hazard ratio: 1.96; 95% CI, 1.22 to 3.15; P = 0.005). The restricted cubic splines showed that the risk of all-cause mortality increased gradually when HAR was >0.37. In the stratified analysis, a high HAR was linked to a high risk of all-cause mortality in males, patients under 55 years old, and patients without diabetes or cardiovascular disease (CVD). CONCLUSION This study suggests that HAR is independently related to all-cause mortality in PD patients, especially in males, patients under 55 years old, and patients without diabetes or CVD.
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Affiliation(s)
- Chuanfei Zeng
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Caixia Yan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Shan Guo
- Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330006, China
| | - Hengmei Zhu
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Yanbing Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Xiaojiang Zhan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China.
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Li L, Cai G, Lu W, Li F, Yu L, Xiao J. The ratio of HDL-C to apoA-I interacts with free triiodothyronine to modulate coronary artery disease risk. BMC Cardiovasc Disord 2021; 21:504. [PMID: 34666674 PMCID: PMC8524928 DOI: 10.1186/s12872-021-02316-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE In the present work, research was carried out to explore the correlation between the high-density lipoprotein cholesterol (HDL-C)/apolipoprotein A-I (apoA-I) ratio and serum free triiodothyronine (FT3) and their interaction on the risk of coronary artery disease (CAD). METHODS A total of 1686 patients who underwent selective coronary angiography were enrolled in the present study, including 1279 patients with CAD and 407 controls. The subjects were divided into three groups according to tertiles of the HDL-C/apoA-I ratio. Binary logistic regression analysis was used to evaluate the interaction of the HDL-C/apoA-I ratio and FT3 level with the risk of CAD. RESULTS The group with the highest HDL-C/apoA-I ratio had the lowest levels of FT3. Multiple linear regression analysis showed that the HDL-C/apoA-I ratio was negatively associated with FT3 after adjusting for age, sex, body mass index (BMI), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), FT4 and TSH. A logistic regression model showed that a high HDL-C/apoA-I ratio (> 0.89 mmol/g) and high FT3 levels (> 4.5 pmol/l) were protective factors for CAD. Patients with a lower HDL-C/apoA-I ratio (≤ 0.89 mmol/g) and lower FT3 level (≤ 4.5 pmol/l) had an increased risk of CAD (OR = 2.441, P = 0.000, S = 1.13, AP = 0.068, AP* = 0.116, RERI = 0.168). CONCLUSIONS The HDL-C/apoA-I ratio was negatively associated with FT3, and there was a significant interaction between the HDL-C/apoA-I ratio and FT3 with the risk of CAD.
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Affiliation(s)
- Li Li
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China.
| | - Gaojun Cai
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China.
| | - Wei Lu
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Feng Li
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Lei Yu
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Jianqiang Xiao
- Department of Cardiology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of XuZhou Medical University, Changzhou, 213017, Jiangsu, China
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Huang H, Wang J, Xu L, Miao M, Xu C. Association between High-Density Lipoprotein Cholesterol to Apolipoprotein A-I Ratio and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study. Int J Endocrinol 2021; 2021:6676526. [PMID: 34194492 PMCID: PMC8203372 DOI: 10.1155/2021/6676526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/22/2021] [Accepted: 05/29/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study aimed to explore the association between high-density lipoprotein cholesterol to apolipoprotein A-I ratio (HDL-C/apo A-I) and nonalcoholic fatty liver disease (NAFLD). METHODS A total of 9025 Chinese adults were enrolled in this cross-sectional study, who presented their annual health checkups at Zhenhai Lianhua Hospital, Ningbo, during 2017. RESULTS The NAFLD prevalence was 33.7%, and HDL-C/apo A-I was significantly decreased in NAFLD patients, as well as in lean NAFLD and in patients with NAFLD-related advanced fibrosis (all P < 0.001). The prevalence of NAFLD and components of metabolic syndrome are inversely associated with HDL-C/apo A-I (P < 0.001). Multivariate logistic regression analysis show that HDL-C/apo A-I is inversely associated with the risk of NAFLD (odds ratio: 0.353, 95% confidence interval: 0.257-0.486; P < 0.001). CONCLUSIONS Our results suggested that increased HDL-C/apo A-I is significantly associated with a decreased risk of NAFLD.
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Affiliation(s)
- Hangkai Huang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jinghua Wang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Lei Xu
- Department of Gastroenterology, Zhejiang University Ningbo Hospital, Ningbo 315010, China
| | - Min Miao
- Department of Internal Medicine, Zhenhai Lianhua Hospital, Ningbo 315207, China
| | - Chengfu Xu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Proatherogenic Sialidases and Desialylated Lipoproteins: 35 Years of Research and Current State from Bench to Bedside. Biomedicines 2021; 9:biomedicines9060600. [PMID: 34070542 PMCID: PMC8228531 DOI: 10.3390/biomedicines9060600] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/05/2021] [Accepted: 05/23/2021] [Indexed: 12/20/2022] Open
Abstract
This review summarizes the main achievements in basic and clinical research of atherosclerosis. Focusing on desialylation as the first and the most important reaction of proatherogenic pathological cascade, we speak of how desialylation increases the atherogenic properties of low density lipoproteins and decreases the anti-atherogenic properties of high density lipoproteins. The separate sections of this paper are devoted to immunogenicity of lipoproteins, the enzymes contributing to their desialylation and animal models of atherosclerosis. In addition, we evaluate the available experimental and diagnostic protocols that can be used to develop new therapeutic approaches for atherosclerosis.
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HDL-C/apoA-I Ratio Is Associated with the Severity of Coronary Artery Stenosis in Diabetic Patients with Acute Coronary Syndrome. DISEASE MARKERS 2021; 2021:6689056. [PMID: 34055102 PMCID: PMC8149224 DOI: 10.1155/2021/6689056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/30/2021] [Accepted: 04/15/2021] [Indexed: 01/01/2023]
Abstract
Background Emerging evidence demonstrates that the lipid metabolism in acute coronary syndrome (ACS) patients with type 2 diabetes mellitus (T2DM) differs from nondiabetic patients. However, the distinct lipid profiles and their relationships with the severity of coronary artery stenosis and prognosis in patients with T2DM remain elusive. Method and Result This single-center, prospective cohort study enrolled 468 patients diagnosed with ACS undergoing coronary angiography, consisting of 314 non-DM and 154 DM patients. The HDL-C/apoA-I ratio was significantly higher in DM patients with a multivessel (≥3 affected vessels) lesion than a single-vessel (1-2 affected vessels) lesion. Regression analyses showed that the HDL-C/apoA-I ratio was positively correlated to the number of stenotic coronary arteries in DM patients but not non-DM patients. However, Kaplan-Meier survival analysis revealed no significant difference in the major adverse cardiovascular event rate regarding different HDL-C/apoA-I levels in DM or non-DM ACS patients at the end of the 2-year follow-up. Conclusion A higher HDL-C/apoA-I ratio is associated with increased severity of coronary artery stenosis in DM patients with ACS but not with the rate of major adverse cardiovascular events at the end of the 2-year follow-up.
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Baek J, Lee H, Lee HH, Heo JE, Cho SMJ, Kim HC. Thirty-six Year Trends in Mortality from Diseases of Circulatory System in Korea. Korean Circ J 2021; 51:320-332. [PMID: 33821581 PMCID: PMC8022022 DOI: 10.4070/kcj.2020.0424] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/24/2020] [Accepted: 12/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Understanding the trends in cardiovascular disease (CVD) mortality is important for developing burden reduction strategies. Based on the Cause of Death Statistics, we examined the changing patterns of CVD mortality in Korea between 1983 and 2018. METHODS Causes of death were coded according to the International Classification of Disease, 10th revision. Deaths from all diseases of circulatory system (I00-I99) and the following 6 subcategories were analyzed: total heart diseases (I00-I13 and I20-I51), hypertensive heart diseases (I10-I13), ischemic heart diseases (I20-I25), myocardial infarction (I21-I23), heart failure (I50), and cerebrovascular diseases (I60-I69). Crude, age-standardized, and age-stratified rates were calculated to assess temporal trends in CVD mortality. RESULTS The number of deaths and crude mortality rate for all diseases of circulatory system increased recently mainly due to the population ageing. Specifically, total heart diseases showed increasing trend, whereas cerebrovascular diseases showed decreasing trend. Between 1983 and 2018, age-standardized mortality rates significantly declined for all diseases of circulatory system, total heart diseases, hypertensive heart diseases, and cerebrovascular diseases. Age-standardized mortality rates for ischemic heart diseases and myocardial infarction peaked in the early 2000s then decreased thereafter. However, age-standardized mortality rate for heart failure rapidly increased, especially in recent years. CONCLUSIONS CVD mortality in Korea has remarkably decreased over the last 36 years. However, the recent rise in the absolute number of deaths from heart diseases, especially from heart failure, calls for attention in prevention and management of CVD and its sequelae.
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Affiliation(s)
- Jongmin Baek
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeok Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Eun Heo
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - So Mi Jemma Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
- Integrative Research Center for Cerebrovascular and Cardiovascular diseases, Yonsei University College of Medicine, Seoul, Korea.
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Yan YQ, Chen J, Huang YQ. A Non-Linear Association of High-Density Lipoprotein Cholesterol with All-Cause and Cause-Specific Mortality in Diabetic Patients. Diabetes Metab Syndr Obes 2021; 14:2851-2862. [PMID: 34188508 PMCID: PMC8235948 DOI: 10.2147/dmso.s313006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The association between high-density lipoprotein cholesterol (HDL-C) and the risk of death among people with diabetes remains to be verified. METHODS This was a nationwide, population-based cohort study in United States. A total of 6549 diabetes patients were included from the National Health and Nutrition Examination Surveys (NHANES). HDL-C concentration was divided into quintiles, and the lowest risk group (Q4: 1.32 to 1.53 mmol/L) was used as reference. Multivariate Cox proportional hazards models and restrictive cubic curves were performed to estimate hazard ratios (HRs) with 95% confidence interval (CI) for all-cause and cause-specific mortality. RESULTS During a median follow-up of 82.36 ± 50.11 months, 1546 (23.61%) cases of all-cause, 389 (5.94%) cardiovascular and 262 (4.00%) cancer mortality have occurred, respectively. After adjusting for potential covariates, a U-shaped association was found between HDL-C and all-cause mortality (minimum mortality risk at 1.37 mmol/L); the risk for all-cause mortality was significantly higher in the groups with HDL-C concentration <0.96 mmol/L (HR: 1.30; 95% CI: 1.09, 1.56; P=0.0046) and with HDL-C concentration ≥1.55 mmol/L (HR: 1.20; 95% CI: 1.00, 1.44; P=0.0481) than participants with HDL-C concentrations ranging from 1.32 to 1.53mmol/L. Nonlinear associations of HDL-C levels with both cardiovascular and cancer mortality were also observed. CONCLUSION A non-linear association was observed association of HDL-C with all-cause, cardiovascular and cancer mortality among diabetic patients.
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Affiliation(s)
- Yu-qin Yan
- Department of Cardiology, People’s Hospital of Shenzhen Baoan District, Shenzhen, 518100, People’s Republic of China
| | - Jun Chen
- Department of Cardiology, People’s Hospital of Shenzhen Baoan District, Shenzhen, 518100, People’s Republic of China
| | - Yu-qing Huang
- Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China
- Correspondence: Yu-qing Huang Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, People’s Republic of ChinaTel/Fax +86-20-83827812 Email
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11
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Chen CL, Liu XC, Liu L, Lo K, Yu YL, Huang JY, Huang YQ, Chen JY. U-Shaped Association of High-Density Lipoprotein Cholesterol with All-Cause and Cardiovascular Mortality in Hypertensive Population. Risk Manag Healthc Policy 2020; 13:2013-2025. [PMID: 33116982 PMCID: PMC7549655 DOI: 10.2147/rmhp.s272624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/12/2020] [Indexed: 12/30/2022] Open
Abstract
Purpose Whether the paradox of high-density lipoprotein cholesterol (HDL-C) and elevated mortality risk extends to hypertensive patients is unclear. We aimed to investigate the association between HDL-C and all-cause and cardiovascular disease mortality in adults with hypertension. Methods In the National Health and Nutrition Examination Surveys, 11,497 hypertensive participants aged ≥18years old and examined at baseline between 1999 and 2014 were followed up until December 2015. We categorized the HDL-C concentration as ≤30, 31–40, 41–50, 51–60 (reference), 61–70, >70 mg/dL and examined their associations with all-cause and cardiovascular mortality, respectively. Multivariate Cox regression was used to calculated hazard ratio (HR) and 95% confidence interval (CI) for mortality risk. Results During follow-up (median: 9.2 ± 3.8 years), 3012 deaths and 713 cardiovascular deaths were observed. In the restrictive cubic curves, associations of HDL-C levels and all-cause and cardiovascular mortality were detected to be U-shaped. After multivariable adjustment, HRs for all-cause mortality were for the lowest HDL-C concentration (≤30 mg/dL) 1.29 (95% CI, 1.07–1.56) and the highest (>70 mg/dL) 1.20 (1.06–1.37), comparing with the reference group. For cardiovascular mortality, HRs were 1.31 (0.83–1.48) and 1.09 (0.83–1.43), respectively. Similar results were obtained in subgroups stratified by age, gender, race, and taking lipid-lowering drugs. The lowest all-cause mortality risk was observed at HDL-C 66 mg/dL (concentration) and 51–60 mg/dL (range). Conclusion Both lower and higher HDL-C concentration appeared to be associated with higher mortality in hypertensive population. Further investigation is warranted to clarify the underlying mechanisms.
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Affiliation(s)
- Chao-Lei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Xiao-Cong Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Kenneth Lo
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Yu-Ling Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Jia-Yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Yu-Qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Ji-Yan Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
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12
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Zhong GC, Huang SQ, Peng Y, Wan L, Wu YQL, Hu TY, Hu JJ, Hao FB. HDL-C is associated with mortality from all causes, cardiovascular disease and cancer in a J-shaped dose-response fashion: a pooled analysis of 37 prospective cohort studies. Eur J Prev Cardiol 2020; 27:1187-1203. [PMID: 32283957 DOI: 10.1177/2047487320914756] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective The association between high-density lipoprotein cholesterol (HDL-C) levels and mortality remains controversial. We aimed to investigate the potential dose–response associations between HDL-C levels and mortality from all causes, cardiovascular disease and cancer in the general population. Methods PubMed and Embase were searched through April 2019. Prospective cohort studies reporting risk estimates of HDL-C levels and mortality were included. Linear and non-linear dose–response analyses were conducted. A random-effects model was employed to calculate pooled hazard ratio. Results Thirty-seven studies, involving 3,524,505 participants and more than 612,027 deaths, were included. HDL-C level was found to be associated with mortality from all causes, cardiovascular disease and cancer in a J-shaped dose–response pattern, with the lowest risk observed at HDL-C levels of 54–58 mg/dL, 68–71 mg/dL and 64–68 mg/dL, respectively. Compared with HDL-C level of 56 mg/dL, the pooled hazard ratios for all-cause mortality were 1.03 (95% confidence interval (CI) 1.01, 1.05) and 1.10 (95% CI 1.09, 1.12) for each 10-mg/dL increase and decrease in HDL-C levels, respectively; furthermore, compared with the reference category, the pooled hazard ratios for all-cause mortality were 1.21 (95% CI 1.09, 1.36) and 1.36 (95% CI 1.21, 1.53) for the highest and the lowest categories of HDL-C levels, respectively. Similar results were obtained for cardiovascular and cancer mortality. Conclusions In the general population, HDL-C level is associated with mortality from all causes, cardiovascular disease and cancer in a J-shaped dose–response manner; both extremely high and low HDL-C levels are associated with an increased risk of mortality.
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Affiliation(s)
- Guo-Chao Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Su-Qun Huang
- Emergency Department, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Yang Peng
- Department of Geriatrics, The Fifth People’s Hospital of Chengdu, China
| | - Lun Wan
- Department of Hepatobiliary Surgery, The People’s Hospital of Dazu District, China
| | - You-Qi-Le Wu
- School of Public Health and Management, Research Centre for Medicine and Social Development, Innovation Centre for Social Risk Governance in Health, Chongqing Medical University, China
| | - Tian-Yang Hu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Jie-Jun Hu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, China
| | - Fa-Bao Hao
- Paediatric Surgery Centre, Qingdao Women and Children’s Hospital, Qingdao University, China *These two authors should be considered joint corresponding authors
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13
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Mutual Influences between Nitric Oxide and Paraoxonase 1. Antioxidants (Basel) 2019; 8:antiox8120619. [PMID: 31817387 PMCID: PMC6943684 DOI: 10.3390/antiox8120619] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 12/13/2022] Open
Abstract
One of the best consolidated paradigms in vascular pharmacology is that an uncontrolled excess of oxidizing chemical species causes tissue damage and loss of function in the endothelial and subendothelial layers. The fact that high-density lipoproteins play an important role in preventing such an imbalance is integrated into that concept, for which the expression and activity of paraoxonases is certainly crucial. The term paraoxonase (aryldialkyl phosphatase, EC 3.1.8.1) encompasses at least three distinct isoforms, with a wide variation in substrate affinity, cell and fluid localization, and biased expression of polymorphism. The purpose of this review is to determine the interactions that paraoxonase 1 has with nitric oxide synthase, its reaction product, nitric oxide (nitrogen monoxide, NO), and its derived reactive species generated in an oxidative medium, with a special focus on its pathological implications.
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14
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Ye J, Luo QY, Wang XP, Liu ZY, Chen MX, Huang H, Zhang L. Serum Apolipoprotein A-I Combined With C-Reactive Protein Serves As A Novel Prognostic Stratification System For Colorectal Cancer. Cancer Manag Res 2019; 11:9265-9276. [PMID: 31802946 PMCID: PMC6826184 DOI: 10.2147/cmar.s215599] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background and objective Noninvasive prognostic tools for colorectal cancer (CRC) are urgently needed. This study was designed to investigate the prognostic value of preoperative serum lipid and lipoprotein concentrations (including ApoA-I, Apo-B, HDL-C, LDL-C, TC and TG) and CRP levels retrospectively in CRC patients. Methods Preoperative serum lipid and lipoprotein concentrations (including ApoA-I, Apo-B, HDL-C, LDL-C, TC and TG) and CRP levels were analyzed retrospectively in 250 patients with CRC. The prognostic significance of these indexes was determined by univariate and multivariate Cox hazard models. Results CRC patients with higher levels of ApoA-I and HDL-C and lower levels of CRP had significantly longer overall survival (OS, log rank test, p<0.05). Based on univariate analysis, ApoA-I levels (p=0.002), CRP levels (p=0.007), HDL-C levels (p=0.005), pT classification (p=0.005), pN classification (p<0.001), pM classification (p<0.001) and pTNM stage (p<0.001) were significantly associated with OS. Multivariate Cox proportional hazards regression analysis indicated that ApoA-I levels (HR: 1.52, p=0.023), CRP levels (HR: 1.85, p=0.035) and pTNM stage (HR: 2.53, p< 0.001) were independent predictors of CRC survival. The included patients were then stratified into three tiers based on the ApoA-I and CRP levels. In the whole cohort, the OS and disease-free survival differed significantly between the low-risk (ApoA-I≥1.08 mg/dL and CRP<3.04 mg/dL), medium-risk (ApoA-I≥1.08 mg/dL or CRP<3.04 mg/dL), and high-risk (ApoA-I<1.08 mg/dL and CRP ≥3.04 mg/dL) groups (p=0.001 and p=0.004). Conclusion Decreased levels of ApoA-I and HDL-C and increased levels of CRP were predictive of poor prognosis among patients with CRC. In addition, the combination of ApoA-I and CRP can serve as a novel prognostic stratification system for more accurate clinical staging of CRC.
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Affiliation(s)
- Juan Ye
- Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.,Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, People's Republic of China.,Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
| | - Qiu-Yun Luo
- Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Xue-Ping Wang
- Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Zhen-Yi Liu
- Department of Blood Transfusion, Peking University Shenzhen Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Mei-Xian Chen
- Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Hao Huang
- Department of Laboratory Science, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
| | - Lin Zhang
- Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.,Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
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15
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Hermans MP, Valensi P, Ahn SA, Rousseau MF. [HDL-C/apoA-I]: A multivessel cardiometabolic risk marker in women with T2DM. Diabetes Metab Res Rev 2018; 34. [PMID: 28921828 DOI: 10.1002/dmrr.2950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/25/2017] [Accepted: 09/06/2017] [Indexed: 01/15/2023]
Abstract
AIMS Although women have higher high-density lipoprotein cholesterol (HDL-C) than have men, their HDL particles are also prone to become small, dense, and dysfunctional in case of type 2 diabetes mellitus (T2DM). To assess the vascular risk related to HDLs of different sizes/densities without direct measurement, we adjusted HDL-C to its main apolipoprotein (apoA-I) as [HDL-C/apoA-I]. This ratio estimates HDL sizes and provides indices as to their number, cholesterol load, and density. METHODS We stratified 280 Caucasian T2DM women according to [HDL-C/apoA-I] quartiles (Q) to determine how they are segregated according to cardiometabolic risk, β-cell function, glycaemic control, and vascular complications. Five parameters were derived from combined determination of HDL-C and apoA-I: HDL size, HDL number, cholesterol load per particle (pP), apoA-I pP, and HDL density. RESULTS An adverse cardiometabolic profile characterized QI and QII patients whose HDLs were denser and depleted in apoA-I, whereas QIII patients had HDLs with characteristics closer to those of controls. QIV patients had HDLs of supernormal size/composition and a more favourable phenotype in terms of fat distribution; insulin sensitivity (64% vs 41%), metabolic syndrome, and β-cell function (32% vs 23%); exogenous insulin (44 vs 89 U·d-1 ); and glycaemic control (glycated haemoglobin, 56 vs 61 mmol·mol-1 ), associated with lower prevalence of microvascular/macrovascular complications: all-cause microangiopathy 47% vs 61%; retinopathy 22% vs 34%; all-cause macroangiopathy 19% vs 31%; and coronary artery disease 6% vs 24% (P < .05). CONCLUSION [HDL-C/apoA-I] can stratify T2DM women according to metabolic phenotype, macrovascular and coronary damage, β-cell function, microangiopathic risk, and retinopathy. This ratio is a versatile and readily available marker of cardiometabolic status and vascular complications in T2DM women.
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Affiliation(s)
- Michel P Hermans
- Division of Endocrinology & Nutrition, Cliniques universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Paul Valensi
- Service d'Endocrinologie-Diabétologie-Nutrition, CRNH-IdF, CINFO, AP-HP, Hôpital Jean Verdier, Université Paris 13, Bondy, France
| | - Sylvie A Ahn
- Division of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Michel F Rousseau
- Division of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
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16
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Katzke VA, Sookthai D, Johnson T, Kühn T, Kaaks R. Blood lipids and lipoproteins in relation to incidence and mortality risks for CVD and cancer in the prospective EPIC-Heidelberg cohort. BMC Med 2017; 15:218. [PMID: 29254484 PMCID: PMC5735858 DOI: 10.1186/s12916-017-0976-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 11/11/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Circulating concentrations of lipid biomarkers are associated with risk of cardiovascular diseases (CVD). The evidence for a relationship with cancer risk, however, is not entirely consistent. This study aims to assess the relationships of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), apolipoprotein (a) (apo(a)), apoB-100, and lipoprotein(a) (Lp(a)) with risk of common cancer forms and total cancer mortality in comparison to incidence and mortality of CVD. METHODS We selected a case-cohort sample out of the prospective EPIC-Heidelberg study, including a random subcohort (n = 2739), and cases of cancer (n = 1632), cancer mortality (n = 761), CVD (n = 1070), and CVD mortality (n = 381). Concentrations of lipid biomarkers were measured in pre-diagnostic blood samples. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Prentice-weighted Cox regression models. RESULTS High levels of circulating apoB-100 and TG were inversely associated and high HDL-C levels were positively associated with breast cancer risk (highest vs. lowest quartile (Q4 vs. Q1), HRapoB 0.71, 95% CI 0.52-0.98; HRTG 0.65, 0.46-0.92; and HRHDL 1.39, 1.01-1.93). Higher levels of Lp(a) were associated with an increase in prostate cancer risk (Q4 vs. Q1, HRLp(a) 1.43, 1.02-2.03) and high levels of apo(a) were associated with a decrease in lung cancer risk (Q4 vs. Q1, HRapo(a) 0.52, 0.30-0.91). High TC, HDL-C, apo(a), and Lp(a) levels were associated with a reduction in total cancer mortality (Q4 vs. Q1, HRTC 0.71, 0.54-0.94; HRHDL 0.67, 0.50-0.91; HRapo(a) 0.71, 0.54-0.93; and HRLp(a) 0.74, 0.57-0.98). All lipid biomarkers were associated with risk of myocardial infarction, whereby TC, apoB-100, TG, and Lp(a) were positively and HLD-C and apo(a) inversely associated with risk. Only high levels of TG were associated with an increased risk of stroke. None of the lipids were associated with risk of colorectal cancer and with risk of CVD mortality after multivariable adjustments. CONCLUSIONS This prospective study demonstrates inverse associations of lipid biomarkers with cancer incidence and mortality, with the exception of positive associations of HDL-C and Lp(a) with breast and prostate cancer risk, respectively. Thus, the observed cancer risk pattern clearly differs from the CVD risk pattern.
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Affiliation(s)
- Verena Andrea Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
| | - Disorn Sookthai
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Theron Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.,Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany
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17
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Tani S, Matsuo R, Kawauchi K, Yagi T, Atsumi W, Hirayama A. A cross-sectional and longitudinal study between association of n-3 polyunsaturated fatty acids derived from fish consumption and high-density lipoprotein heterogeneity. Heart Vessels 2017; 33:470-480. [PMID: 29159568 PMCID: PMC5911278 DOI: 10.1007/s00380-017-1082-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/10/2017] [Indexed: 01/07/2023]
Abstract
Decreased high-density lipoprotein (HDL) particle size, cholesterol poor, apolipoprotein A-I-rich HDL particles leading to smaller HDL particle size, may be associated with an anti-atherosclerotic effect. The data are sparse regarding the relationship between n-3 polyunsaturated fatty acids [n-3 PUFAs: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)] and HDL particle size. This study was designed as a hospital-based cross-sectional study to investigate the relationship between the serum levels of n-3 PUFAs and the HDL-cholesterol/apolipoprotein A-1 ratio, as estimated by the HDL particle size, in patients with the presence of one or more risk factors for atherosclerotic cardiovascular disease (ASCVD). Six hundred and forty sequential patients were enrolled in this study. The serum levels of EPA and DHA showed a strong correlation (r = 0.736, p < 0.0001). However, in a multivariate regression analysis after adjustment for ASCVD risk factors, increased serum DHA (β = - 0.745, p = 0.021), but not serum EPA (β = - 0.414, p = 0.139) or EPA + DHA (β = 0.330, p = 0.557) level, was identified as an independent indicator of decreased HDL particle size. In 476 patients followed up for at least 6 months, the absolute change (Δ) in the HDL-cholesterol/apolipoprotein A-1 ratio decreased significantly as the quartile of the Δ DHA level increased (p = 0.014), whereas no significant difference in the Δ HDL-cholesterol/apolipoprotein A-1 ratio was noted with the increase in the quartile of the Δ EPA level. Moreover, a multivariate regression analysis identified increased DHA level and decreased estimated low-density lipoprotein (LDL) particle size measured relative to the mobility value of LDL with polyacrylamide gel electrophoresis (i.e., relative LDL migration: LDL-Rm value), as independent predictors of decreased HDL-cholesterol/apolipoprotein A-1 ratio (β = - 0.171, p = 0.0003 and β = - 0.142, p = 0.002). The results suggest that increased serum DHA level, but not EPA level, might be associated with decreased HDL-cholesterol/apolipoprotein A-1 ratio, an indicator of estimated HDL particle size. Further studies are needed to investigate the useful clinical indices and outcomes of these patients. Clinical Trial Registration Information UMIN ( http://www.umin.ac.jp/ ), Study ID: UMIN000010603.
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Affiliation(s)
- Shigemasa Tani
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan. .,Department of Cardiology, Nihon University Hospital, Tokyo, Japan. .,Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
| | - Rei Matsuo
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan.,Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kenji Kawauchi
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan.,Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Tsukasa Yagi
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan.,Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Wataru Atsumi
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan.,Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Atsushi Hirayama
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
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18
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Zhang Y, Guo F, Li S, Wang F, Meng Z, Zhao J, Liu Z, Wang B, Fan P, Wang C, Wu H. Decreased high density lipoprotein cholesterol is an independent predictor for persistent organ failure, pancreatic necrosis and mortality in acute pancreatitis. Sci Rep 2017; 7:8064. [PMID: 28808236 PMCID: PMC5556036 DOI: 10.1038/s41598-017-06618-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 06/19/2017] [Indexed: 12/15/2022] Open
Abstract
High density lipoprotein cholesterol (HDL-C) has been reported as a significant indicator of systemic inflammation. The association underlying HDL-C and persistent organ failure (POF), pancreatic necrosis (PNec) and mortality in acute pancreatitis (AP) has not been evaluated. From 2007 to 2016, consecutive AP patients with admission lipid profiles assessment were included in this study. The association of HDL-C value and other lipids with outcomes was explored with Cox proportional regression models, which were adjusted for confounding factors. 1131 consecutive AP patients were clinically eligible. Overall, 17.9% of the patients developed with POF, 27.1% experienced PNec, and 6.7% died during hospitalization. Lower HDL-C median (<1.06 mmol/L) was identified as an independent prognostic factor of the outcomes. Moreover, there was a positive trend for the association across increasing HDL-C quartiles and POF, PNec and mortality after multivariable analysis (p values were <0.001, <0.001 and 0.043, respectively). The AUC of HDL-C for the outcomes were comparable to that of Ranson score for diagnosing POF (0.778 vs. 0.678; P < 0.001), PNec (0.734 vs. 0.701; P = 0.143) and mortality (0.768 vs. 0.745; P = 0.516). Decreased HDL-C value is an independent risk factor for the incidence of POF, PNec and in-hospital mortality in AP.
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Affiliation(s)
- Yushun Zhang
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Feng Guo
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shoukang Li
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Feiyang Wang
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zibo Meng
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jingyuan Zhao
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhiqiang Liu
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Bo Wang
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Ping Fan
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Chunyou Wang
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Heshui Wu
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Hernáez Á, Castañer O, Elosua R, Pintó X, Estruch R, Salas-Salvadó J, Corella D, Arós F, Serra-Majem L, Fiol M, Ortega-Calvo M, Ros E, Martínez-González MÁ, de la Torre R, López-Sabater MC, Fitó M. Mediterranean Diet Improves High-Density Lipoprotein Function in High-Cardiovascular-Risk Individuals: A Randomized Controlled Trial. Circulation 2017; 135:633-643. [PMID: 28193797 DOI: 10.1161/circulationaha.116.023712] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 12/05/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND The biological functions of high-density lipoproteins (HDLs) contribute to explaining the cardioprotective role of the lipoprotein beyond quantitative HDL cholesterol levels. A few small-scale interventions with a single antioxidant have improved some HDL functions. However, to date, no long-term, large-scale, randomized controlled trial has been conducted to assess the effects of an antioxidant-rich dietary pattern (such as a traditional Mediterranean diet [TMD]) on HDL function in humans. METHODS This study was performed in a random subsample of volunteers from the PREDIMED Study (Prevención con Dieta Mediterránea; n=296) after a 1-year intervention. We compared the effects of 2 TMDs, one enriched with virgin olive oil (TMD-VOO; n=100) and the other enriched with nuts (TMD-Nuts; n=100), with respect to a low-fat control diet (n=96). We assessed the effects of both TMDs on the role of HDL particles on reverse cholesterol transport (cholesterol efflux capacity, HDL ability to esterify cholesterol, and cholesteryl ester transfer protein activity), HDL antioxidant properties (paraoxonase-1 arylesterase activity and total HDL antioxidant capacity on low-density lipoproteins), and HDL vasodilatory capacity (HDL ability to induce the release of nitric oxide in endothelial cells). We also studied the effects of a TMD on several HDL quality-related characteristics (HDL particle oxidation, resistance against oxidative modification, main lipid and protein composition, and size distribution). RESULTS Both TMDs increased cholesterol efflux capacity relative to baseline (P=0.018 and P=0.013 for TMD-VOO and TMD-Nuts, respectively). The TMD-VOO intervention decreased cholesteryl ester transfer protein activity (relative to baseline, P=0.028) and increased HDL ability to esterify cholesterol, paraoxonase-1 arylesterase activity, and HDL vasodilatory capacity (relative to control, P=0.039, P=0.012, and P=0.026, respectively). Adherence to a TMD induced these beneficial changes by improving HDL oxidative status and composition. The 3 diets increased the percentage of large HDL particles (relative to baseline, P<0.001). CONCLUSIONS The TMD, especially when enriched with virgin olive oil, improved HDL atheroprotective functions in humans. CLINICAL TRIAL REGISTRATION URL: http://www.controlled-trials.com. Unique identifier: ISRCTN35739639.
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Affiliation(s)
- Álvaro Hernáez
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Olga Castañer
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Roberto Elosua
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Xavier Pintó
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Ramón Estruch
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Jordi Salas-Salvadó
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Dolores Corella
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Fernando Arós
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Lluis Serra-Majem
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Miquel Fiol
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Manuel Ortega-Calvo
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Emilio Ros
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Miguel Ángel Martínez-González
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Rafael de la Torre
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - M Carmen López-Sabater
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.)
| | - Montserrat Fitó
- From Cardiovascular Risk and Nutrition Research Group (A.H., O.C., R.d.l.T, M. Fitó) and Cardiovascular Epidemiology and Genetics Research Group (R. Elosua), REGICOR Study Group, and Human Pharmacology and Neurosciences Research Group (R.d.l.T.), Hospital del Mar Medical Research Institute, Barcelona, Spain; PhD Program in Food Sciences and Nutrition (A.H.) and Department of Nutrition and Bromatology, Faculty of Pharmacy (M.C.L.-S.), Universitat de Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (A.H., O.C., X.P., R. Estruch, J.S.-S., D.C., F.A., L.S.-M., M. Fiol, M.O.-C., E.R., M.A.M.-G., R.d.l.T., M.C.L.-S., M. Fitó); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Spain (R. Estruch, E.R.); Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.S.-S.); Department of Preventive Medicine, Universidad de Valencia, Spain (D.C.); Department of Cardiology, Hospital Universitario de Álava, Vitoria, Spain (F.A.); Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Hospital Son Espases, and Institute of Health Sciences (IUNICS), Palma de Mallorca, Spain (M. Fiol); Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud Las Palmeritas, Spain (M.O.-C.); and Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain (M.A.M.-G.).
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Rhee EJ, Byrne CD, Sung KC. The HDL cholesterol/apolipoprotein A-I ratio: an indicator of cardiovascular disease. Curr Opin Endocrinol Diabetes Obes 2017; 24:148-153. [PMID: 28099205 DOI: 10.1097/med.0000000000000315] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW In multiple studies, the HDL cholesterol (HDL-C) concentration has been shown to be inversely associated with cardiovascular disease (CVD) and CVD risk. Based on this observation, increasing the plasma HDL-C concentration is thought to be a desirable strategy, in the 21st century, for decreasing the burden of CVD. RECENT FINDINGS Recent studies have shown that powerful HDL-C concentration-increasing drugs are ineffective for decreasing CVD. Increasing evidence now shows that HDL is an unstable and heterogeneous particle, and that 'HDL particle functionality' is far more important in atheroprotection than is the HDL-C level, alone. Apolipoprotein A-I (apoA-I) is the major protein component of HDL, and increasing evidence suggests that the ratio of HDL-C to apoA-I may give additional insight as a risk marker not just for CVD but also for all-cause and cancer mortality. SUMMARY In this review, we discuss the importance of HDL composition, apoA-I levels, and the HDL-C/apoA-I ratio for predicting CVD and mortality outcomes.
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Affiliation(s)
- Eun-Jung Rhee
- aDivision of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea bEndocrinology and Metabolism Unit, Southampton General Hospital, University of Southampton, Southampton, UK cDivision of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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21
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Streja D. Progress toward newer guidelines of lipid management. Curr Opin Endocrinol Diabetes Obes 2017; 24:119-121. [PMID: 28107249 DOI: 10.1097/med.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dan Streja
- UCLA Medical School, Los Angeles, California, USA
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Sharif S, van der Graaf Y, Nathoe HM, de Valk HW, Visseren FLJ, Westerink J. HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes. Diabetes Care 2016; 39:1424-30. [PMID: 27222511 DOI: 10.2337/dc16-0155] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/01/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate whether low HDL cholesterol (HDL-c) levels are a risk factor for cardiovascular disease and mortality in patients with type 2 diabetes and whether it remains a residual risk factor when attaining low LDL cholesterol (LDL-c) treatment goals or when LDL-c is treated with intensive lipid-lowering therapy. RESEARCH DESIGN AND METHODS We performed a prospective cohort study of 1,829 patients with type 2 diabetes included in the Second Manifestations of ARTerial disease (SMART) cohort. Cox proportional hazard models were used to evaluate the risk of HDL-c on cardiovascular events and all-cause mortality. Analyses were performed in strata of LDL-c levels (<2.0, 2.0-2.5, and >2.5 mmol/L) and lipid-lowering therapy intensity and were adjusted for age, sex, BMI, smoking, alcohol, LDL-c, triglycerides, systolic blood pressure, estimated glomerular filtration rate, glucose, and HbA1c. RESULTS A total of 335 new cardiovascular events and 385 deaths occurred during a median follow-up of 7.0 years (interquartile range 3.9-10.4). No relation was found between plasma HDL-c and cardiovascular events (hazard ratio [HR] 0.97, 95% CI 0.93-1.01) or all-cause mortality (HR 0.99, 95% CI 0.96-1.03). Subgroup analysis supported effect modification by plasma LDL-c levels. In patients with LDL-c levels <2.0 mmol/L, higher HDL-c was related to higher risk for all-cause mortality (HR 1.14, 95% CI 1.07-1.21). Higher HDL-c was also related to higher risk for cardiovascular events in patients with LDL-c levels <2.0 mmol/L (HR 1.10, 95% CI 1.07-1.21) in contrast to patients with LDL-c levels between 2.0 and 2.5 mmol/L (HR 0.85, 95% CI 0.75-0.95) and >2.5 mmol/L (HR 0.96, 95% CI 0.91-1.00). CONCLUSIONS In high-risk patients with type 2 diabetes with LDL-c levels <2.0 mmol/L, higher HDL-c at baseline is unexpectedly related to a higher risk for cardiovascular events and all-cause mortality in contrast to high-risk patients with type 2 diabetes with LDL-c levels between 2.0 and 2.5 mmol/L.
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Affiliation(s)
- Shahnam Sharif
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hendrik M Nathoe
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Harold W de Valk
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan Westerink
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
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23
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Wang XP, Li XH, Zhang L, Lin JH, Huang H, Kang T, Mao MJ, Chen H, Zheng X. High level of serum apolipoprotein A-I is a favorable prognostic factor for overall survival in esophageal squamous cell carcinoma. BMC Cancer 2016; 16:516. [PMID: 27444612 PMCID: PMC4957343 DOI: 10.1186/s12885-016-2502-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/04/2016] [Indexed: 12/28/2022] Open
Abstract
Background Noninvasive prognostic tools for esophageal squamous cell carcinoma (ESCC) are urgently needed. Serum lipids and lipoproteins are used for the prognosis of certain diseases; however, the prognostic value of serum apolipoprotein A-I (ApoA-I) in ESCC has not been described. Methods Pre-treatment serum lipids and lipoprotein concentrations (including ApoA-I, Apo-B, HDL-C, LDL-C, TC and TG) were analyzed retrospectively and compared between 210 patients with ESCC and 219 healthy controls. The prognostic significance of serum lipids and lipoproteins was determined by univariate and multivariate Cox hazard models in ESCC. Results Clinical characteristics (age, sex, pT status, pN status, pM status, pTNM status, histological differentiation or alcohol index) had no influence on baseline ApoA-I level. Serum ApoA-I, HDL-C, LDL-C, and TC levels were significantly lower and Apo-B was significantly higher in ESCC patients than in normal controls. On univariate analysis, ApoA-I, alcohol index, pT status, pN status and pTNM status were associated with significantly poor survival, and ApoA-I (p = 0.039), alcohol index (p = 0.037) and pTNM status (p = 0.000) were identified as prognostic factors associated with shorter survival in the multivariate analysis. Conclusions Overall survival was shorter in ESCC patients with decreased pre-treatment ApoA-I levels. Our findings suggest that serum ApoA-I level should be evaluated as a predictor of survival in patients with ESCC.
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Affiliation(s)
- Xue-Ping Wang
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiao-Hui Li
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Lin Zhang
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.,Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, China
| | - Jian-Hua Lin
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Hao Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ting Kang
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Min-Jie Mao
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Hao Chen
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.
| | - Xin Zheng
- Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.
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Ghasemzadeh Z, Abdi H, Asgari S, Tohidi M, Khalili D, Valizadeh M, Moeini S, Eidkhani V, Azizi F, Hadaegh F. Divergent pathway of lipid profile components for cardiovascular disease and mortality events: Results of over a decade follow-up among Iranian population. Nutr Metab (Lond) 2016; 13:43. [PMID: 27346994 PMCID: PMC4919865 DOI: 10.1186/s12986-016-0102-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/19/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Data regarding the impact of different lipid measures on cardiovascular diseases (CVD) and mortality events is not consistent. We aimed to evaluate the relationship between different lipid parameters and incident CVD and mortality events in an Iranian population over a median follow-up of 11.9 years. METHODS The study was conducted on 2532 men and 2986 women aged ≥ 40 years. Multivariate adjusted hazard ratios (HRs), using age as time scale, were calculated for every 1 standard deviation (SD) increase in total cholesterol (TC), logarithm-transformed triglycerides (ln-TGs), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), non-HDL-C, TC/HDL-C and ln-TGs/HDL-C. Covariates included gender (female as reference), body mass index, education status, low physical activity, smoking, blood pressure status (normotension, prehypertension and hypertension), glucose tolerance status (normal glucose tolerance, prediabetes and diabetes) and lipid lowering drugs. The same analyses were also repeated for tertiles of all lipid measures. Considering the absence of interaction between gender and lipid parameters, we used a sex-adjusted analysis. For analyses of mortality events, prevalent CVD was adjusted as well (All p for interactions > 0.1). RESULTS A total of 789 new CVD events, 279 cardiovascular (CV) and 270 non-CV deaths occurred. In multivariate analysis, all lipid measures except HDL-C showed significant risk for new CVD events with HRs ranged from 1.14 to 1.27 for ln-TGs/HDL-C and LDL-C, respectively (all p-values ≤ 0.001). Considering CV mortality, there were significant positive associations between TC, LDL-C, non-HDL-C, TC/HDL-C and CV mortality events in sex-adjusted analysis; however after multivariate analysis, these associations attenuated and reached to null. Applying lipid measures as categorical variables, only TC displayed a positive association with CV mortality in multivariate analysis [TC ≥ 6.14 mmol/L: HR 1.43 (1.04-1.98)]. In multivariate analysis, there were negative significant associations between all lipid measures except HDL-C and non-CV mortality; every 1-SD increase in TC, LDL-C, non-HDL-C, ln-TGs ,TC/HDL-C and ln-TGs/HDL-C was associated with 24, 25, 27, 19, 23 and 17 % decreased risk in non-CV mortality (all p-values ≤ 0.01). CONCLUSIONS These findings indicate divergent associations of TC, LDL-C, non-HDL-C, TC/HDL-C, TGs and TGs/HDL-C with CVD vs non-CV mortality, demonstrating a higher risk for the former and lower risk for the latter.
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Affiliation(s)
- Zahra Ghasemzadeh
- />Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran
| | - Hengameh Abdi
- />Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- />Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran
| | - Maryam Tohidi
- />Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran
| | - Davood Khalili
- />Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran
| | - Majid Valizadeh
- />Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siamak Moeini
- />Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran
| | - Vahid Eidkhani
- />Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran
| | - Fereidoun Azizi
- />Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- />Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-476, Tehran, Iran
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Ikenaga M, Higaki Y, Saku K, Uehara Y. High-Density Lipoprotein Mimetics: a Therapeutic Tool for Atherosclerotic Diseases. J Atheroscler Thromb 2016; 23:385-94. [PMID: 26830201 DOI: 10.5551/jat.33720] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Clinical trials and epidemiological studies have revealed a negative correlation between serum high-density lipoprotein (HDL) cholesterol levels and the risk of cardiovascular events. Currently, statin treatment is the standard therapy for cardiovascular diseases, reducing plasma low-density lipoprotein (LDL) cholesterol levels. However, more than half of the patients have not been able to receive the beneficial effects of this treatment.The reverse cholesterol transport pathway has several potential anti-atherogenic properties. An important approach to HDL-targeted therapy is the optimization of HDL cholesterol levels and function in the blood to enhance the removal of circulating cholesterol and to prevent or mitigate inflammation that causes atherosclerosis. Cholesteryl ester transfer protein inhibitors increase HDL cholesterol levels in humans, but whether they reduce the risk of atherosclerotic diseases is unknown. HDL therapies using HDL mimetics, including reconstituted HDL, apolipoprotein (Apo) A-IMilano, ApoA-I mimetic peptides, or full-length ApoA-I, are highly effective in animal models. In particular, the Fukuoka University ApoA-I-mimetic peptide (FAMP) effectively removes cholesterol via the ABCA1 transporter and acts as an anti-atherosclerotic agent by enhancing the biological functions of HDL without elevating HDL cholesterol levels.Our literature review suggests that HDL mimetics have significant atheroprotective potential and are a therapeutic tool for atherosclerotic diseases.
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Krishnan S, Huang J, Lee H, Guerrero A, Berglund L, Anuurad E, Lebrilla CB, Zivkovic AM. Combined High-Density Lipoprotein Proteomic and Glycomic Profiles in Patients at Risk for Coronary Artery Disease. J Proteome Res 2015; 14:5109-18. [DOI: 10.1021/acs.jproteome.5b00730] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | - Lars Berglund
- Department
of Veterans Affairs, Northern California Health Care System, Sacramento, California 95655, United States
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