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Winckel T, Friedrich N, Zylla S, Fenzlaff M, Schöpfel J, Gauß KF, Petersmann A, Nauck M, Völzke H, Hannemann A. Bone turnover: the role of lipoproteins in a population-based study. Lipids Health Dis 2024; 23:302. [PMID: 39300501 DOI: 10.1186/s12944-024-02290-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 09/09/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Dyslipidemia has been associated with reduced bone mineral density and osteoporotic fractures, but the relation between lipid and bone metabolism remains poorly understood. Analysing the effects of lipoprotein subclasses on bone turnover may provide valuable insights into this association. We therefore examined whether lipoprotein subclasses, measured by proton nuclear magnetic resonance (1H-NMR) spectroscopy, are associated with bone turnover markers (BTMs) and with the ultrasound-based bone stiffness index. METHODS Data from 1.349 men and 1.123 women, who participated in the population-based Study of Health in Pomerania-TREND were analysed. Serum intact amino-terminal propeptide of type I procollagen (P1NP, bone formation) and carboxy-terminal telopeptide of type I collagen (CTX, bone resorption) concentrations were measured. Associations between the lipoprotein data and the BTMs or the stiffness index were investigated using linear regression models. RESULTS The triglyceride or cholesterol content in very-low-density lipoprotein and intermediate-density lipoprotein particles was inversely associated with both BTMs, with effect estimates being slightly higher for CTX than for P1NP. The triglyceride content in low-density lipoprotein and high-density lipoprotein particles and the Apo-A2 content in high-density lipoprotein particles was further inversely associated with the BTMs. Associations with the ultrasound-based bone stiffness index were absent. CONCLUSIONS Consistent inverse associations of triglycerides with bone turnover were observed, which argue for a protective effect on bone health, at least in the normal range. Yet, the presented associations did not translate into effects on the ultrasound-based bone stiffness. Further, there was no relevant gain of information by assessing the lipoprotein subclasses. Nevertheless, our study highlights the close relations between lipid and bone metabolism in the general population.
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Affiliation(s)
- Todd Winckel
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Stephanie Zylla
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Marc Fenzlaff
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
| | - Juliane Schöpfel
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
| | - Karen Friederike Gauß
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
| | - Astrid Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, D-17475, Greifswald, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.
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Xu Q, Li C, Jing P, Li H, Tian X, Xia X, Zhang Y, Zhang X, Wang Y, Wang A, Meng X. Low-Density Lipoprotein Cholesterol to Triglyceride Ratio and Clinical Outcomes after Acute Ischaemic Stroke or Transient Ischaemic Attack. J Atheroscler Thromb 2024; 31:1162-1178. [PMID: 38382995 PMCID: PMC11300661 DOI: 10.5551/jat.64704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/14/2024] [Indexed: 02/23/2024] Open
Abstract
AIMS Studies showed that low-density lipoprotein cholesterol (LDL-C) to triglyceride (TG) ratio could be used as a predictive parameter of low-density lipoprotein oxidation in vivo and the level of small dense LDL-C. However, whether LDL-C/TG ratio is associated with stroke prognosis remains unclear. We investigated the associations of LDL-C/TG ratio with outcomes in patients with acute ischaemic stroke (AIS) or transient ischaemic attacks (TIA) and explored whether it produced more predictive value than LDL-C and TG. METHODS Data were derived from the Third China National Stroke Registry (CNSR-III). Multivariable Cox regression for stroke recurrence, composite vascular events and all-cause death and logistic regression for the poor functional outcome (modified Rankin Scale score 3-6) were used. RESULTS A total of 14123 patients were included. After adjusting for confounding factors, quartile 4 of LDL-C/TG ratio was associated with an increased risk of recurrent stroke (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.03-1.56), composite vascular events (HR,1.23; 95% CI, 1.00-1.52), death (HR,1.70; 95% CI, 1.13-2.54) and poor functional outcome (odds ratio, 1.34; 95% CI, 1.12-1.61) at 3 months follow-up compared with quartile 1. We also found that quartile 4 of LDL-C and TG was positively and negatively associated with poor functional outcome at 3 months, respectively. LDL-C/TG ratio performed better than LDL-C or TG in predicting clinical outcomes. CONCLUSIONS LDL-C/TG ratio was associated with the risk of stroke recurrence, composite vascular events, death and poor functional outcome in patients with AIS or TIA.
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Affiliation(s)
- Qin Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Changjun Li
- Department of Neurology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Jing
- Department of Neurology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Tian
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xue Xia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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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: 15] [Impact Index Per Article: 15.0] [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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Zhang F, Zhang Y, Zhang J, Wang X, Li Y, Wang W. Small dense low density lipoprotein predominance in patients with type 2 diabetes mellitus using Mendelian randomization. PLoS One 2024; 19:e0298070. [PMID: 38330008 PMCID: PMC10852223 DOI: 10.1371/journal.pone.0298070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Patients with T2DM often suffer from CVD-related complications, significantly impacting morbidity and mortality rates. The upsurge in CVD prevalence among them is partly linked to sd LDL particles. Understanding the mechanisms behind elevated sd LDL levels is critical for preventing and managing cardiovascular complications in diabetes. METHODS MR was employed to identify instrumental variables and establish causality, exploring underlying mechanisms. RESULTS Notably, T2DM itself, insulin resistance, and fasting glucose seemingly do not directly impact sd LDL levels. Instead, the presence of T2DM or insulin resistance, leading to reduced HDL cholesterol or elevated TG levels, directly contributes to subsequent sd LDL increases, indicating a comprehensive mediating effect. While LDL cholesterol levels correlate positively with sd LDL, they appear unaffected by T2DM or insulin resistance. Importantly, hypertension induced by T2DM or insulin resistance exhibits a positive effect on sd LDL reversal. Unlike T2DM or insulin resistance, blood glucose levels show no significant impact on all processes. CONCLUSIONS It is hoped that these insights might influence the treatment of patients with diabetes and the management of blood parameters in clinical practice. Examining the effect of T2DM or insulin resistance on sd LDL within HDL cholesterol and triglycerides pathways might provide valuable insights for targeted cardiovascular treatments. Additionally, the study's exploration of the potential positive effects of elevated blood pressure on sd LDL reversal may introduce novel considerations for blood pressure management in patients with diabetes.
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Affiliation(s)
- Fengyi Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Yufeng Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Jiayi Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Xin Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Yujie Li
- Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Wenbo Wang
- Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
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Hirano T, Hayashi T, Sugita H, Tamasawa A, Goto S, Tomoyasu M, Yamamoto T, Ohara M, Terasaki M, Kushima H, Ito Y, Yamagishi S, Mori Y. Prospective randomized comparative study of the effect of pemafibrate add-on or double statin dose on small dense low-density lipoprotein-cholesterol in patients with type 2 diabetes and hypertriglyceridemia on statin therapy. J Diabetes Investig 2023; 14:1401-1411. [PMID: 37647503 PMCID: PMC10688129 DOI: 10.1111/jdi.14076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/23/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
AIMS/INTRODUCTION Small dense low-density lipoprotein (sdLDL) is a more potent atherogenic lipoprotein than LDL. As sdLDL-cholesterol (C) levels are determined by triglyceride and LDL-C levels, pemafibrate and statins can reduce sdLDL-C levels. However, it remains unclear whether adding pemafibrate or increasing statin doses would more effectively reduce sdLDL-C levels in patients receiving statin therapy. MATERIALS AND METHODS A total of 97 patients with type 2 diabetes and hypertriglyceridemia who were treated with statins were randomly assigned to the pemafibrate 0.2 mg/day addition or statin dose doubled, and followed for 12 weeks. sdLDL-C was measured by our established homogenous assay. RESULTS The percentage and absolute reductions of sdLDL-C levels were significantly greater in the pemafibrate add-on group than the statin doubling group (-32.8 vs -8.1%; -16 vs -3 mg/dL, respectively). Triglyceride levels were reduced only in the pemafibrate add-on group (-44%), and LDL-C levels were reduced only in the statin doubling group (-8%), whereas levels of non-high-density lipoprotein-C and apolipoprotein B were similarly decreased (7-9%) in both groups. The absolute reductions of sdLDL-C levels were closely associated with decreased triglyceride, LDL-C, non-high-density lipoprotein-C and apolipoprotein B. In the subgroup analysis, the effect of pemafibrate add-on on sdLDL-C reductions was observed irrespective of baseline lipid parameters or statin type. No serious adverse effects were observed in both groups. CONCLUSIONS In patients with type 2 diabetes and hypertriglyceridemia, the addition of pemafibrate to a statin is superior to doubling a statin in reducing sdLDL-C without increasing adverse effects.
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Affiliation(s)
- Tsutomu Hirano
- Diabetes CenterEbina General HospitalEbinaJapan
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Toshiyuki Hayashi
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
- Yurakubashi ClinicTokyoJapan
| | - Hiroe Sugita
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | | | - Satoshi Goto
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
- Goto IinNaraJapan
| | - Masako Tomoyasu
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Takeshi Yamamoto
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Makoto Ohara
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Michishige Terasaki
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Hideki Kushima
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Yasuki Ito
- Clinical Diagnostics DepartmentDenka Co., Ltd.TokyoJapan
| | - Sho‐ichi Yamagishi
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Yusaku Mori
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
- Anti‐Glycation Research Section, Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
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Hida Y, Imamura T, Kinugawa K. Impact of Pemafibrate Therapy on Reducing Small Dense Low-Density-Lipoprotein-Cholesterol Levels in Patients with Hypertriglyceridemia. J Clin Med 2023; 12:6915. [PMID: 37959379 PMCID: PMC10648094 DOI: 10.3390/jcm12216915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/22/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Small dense LDL-cholesterol is a recently discovered cardiovascular risk factor beyond LDL-cholesterol. Pemafibrate is a novel selective peroxisome proliferator-activated receptor-α modulator that reduces triglyceride levels. Given the significant association between triglycerides and small dense LDL-cholesterol levels, pemafibrate may reduce the levels of small dense LDL-cholesterol. METHODS Patients with hypertriglyceridemia who started pemafibrate therapy and continued it for >3 months between 2018 and 2022 were included in this retrospective study. The levels of small dense LDL-cholesterol, which was estimated using Sampson's equation, consisting of the LDL-cholesterol and triglyceride levels, were compared between baseline and 3-month follow-up. RESULTS A total of 98 patients receiving pemafibrate therapy (median age: 63 years, 69 male) were eligible, including 33 patients (34%) who received concomitant statins. Small dense LDL-cholesterol levels decreased significantly during the course of 3-month pemafibrate therapy from 48.9 (IQR: 35.7, 57.9) mg/dL to 38.8 (IQR: 30.0, 45.1) mg/dL, regardless of the concomitant administration of statins (p < 0.001). The rate of cardiovascular events decreased significantly from the pre-treatment 1-year period to the treatment 1-year period (from 13 to 2 events, from 0.133 to 0.021 events per year, incidence rate ratio: 0.16, 95% confidence interval: 0.14-0.17, p < 0.001). CONCLUSIONS Pemafibrate therapy may mitigate the concentrations of small dense LDL-cholesterol autonomously in patients manifesting hypertriglyceridemia within the authentic clinical milieu. The clinical importance of the diminishment in small dense LDL-cholesterol instigated via pemafibrate merits further scrutiny.
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Affiliation(s)
| | - Teruhiko Imamura
- Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan
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Hirano T. Hypertriglyceridemia contributes significantly to high prevalence of small dense LDL-cholesterol in patients with type 2 diabetes, even when LDL-C targets are achieved. Diabetol Int 2023; 14:288-293. [PMID: 37397906 PMCID: PMC10307935 DOI: 10.1007/s13340-023-00634-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/08/2023] [Indexed: 07/04/2023]
Abstract
Background Small-dense (sd)LDL-cholesterol (C) is a potent risk factor for atherosclerotic cardiovascular disease (ASCVD) beyond LDL-C, and 35 mg/dL has been proposed as a cut-off value for high-sdLDL-C. sdLDL-C levels are strongly regulated by triglycerides (TG) and LDL-C levels. LDL-C has detailed targets for the prevention of ASCVD, while TG is only defined as abnormal at ≥ 150 mg/dL. We investigated the effect of hypertriglyceridemia on the prevalence of high-sdLDL-C in patients with type 2 diabetes and explored the optimal TG levels that would suppress high-sdLDL-C. Methods Fasting plasma was obtained from 1569 patients with type 2 diabetes who were enrolled in the regional cohort study. sdLDL-C concentrations were measured by the homogeneous assay established by us. High-sdLDL-C was defined as ≤ 35 mg/dL according to the Hisayama Study. Hypertriglyceridemia was defined as ≥ 150 mg/dL. Results All lipid parameters except HDL-C were higher in the high-sdLDL-C group than in the normal-sdLDL-C group. The receiver operating characteristic (ROC) curves revealed that high sdLDL-C was identified sensitively by TG and LDL-C, with cut-off values of 115 mg/dL for TG and 110 mg/dL for LDL-C. The presence of hypertriglyceridemia increased the prevalence of high-sdLDL-C sixfold more than the normotriglyceridemic counterpart, regardless of statin use. This substantial influence of hypertriglyceridemia was found even within the control target of LDL-C levels (70-120 mg/dL) for diabetic subjects. Conclusions The TG cut-off for high-sdLDL-C was well below 150 mg/dL in a diabetic population. Amelioration of hypertriglyceridemia is needed even when LDL-C targets for diabetes are achieved.
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Affiliation(s)
- Tsutomu Hirano
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
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Itabe H, Obama T. The Oxidized Lipoproteins In Vivo: Its Diversity and Behavior in the Human Circulation. Int J Mol Sci 2023; 24:ijms24065747. [PMID: 36982815 PMCID: PMC10053446 DOI: 10.3390/ijms24065747] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
A high concentration of low-density lipoproteins (LDLs) in circulation has been well-known as a major risk factor for cardiovascular diseases. The presence of oxidized LDLs (oxLDLs) in atherosclerotic lesions and circulation was demonstrated using anti-oxLDL monoclonal antibodies. The so-called “oxLDL hypothesis”, as a mechanism for atherosclerosis development, has been attracting attention for decades. However, the oxLDL has been considered a hypothetical particle since the oxLDL present in vivo has not been fully characterized. Several chemically modified LDLs have been proposed to mimic oxLDLs. Some of the subfractions of LDL, especially Lp(a) and electronegative LDL, have been characterized as oxLDL candidates as oxidized phospholipids that stimulate vascular cells. Oxidized high-density lipoprotein (oxHDL) and oxLDL were discovered immunologically in vivo. Recently, an oxLDL-oxHDL complex was found in human plasma, suggesting the involvement of HDLs in the oxidative modification of lipoproteins in vivo. In this review, we summarize our understanding of oxidized lipoproteins and propose a novel standpoint to understand the oxidized lipoproteins present in vivo.
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Schaefer EJ, Ikezaki H, Diffenderfer MR, Lim E, Liu CT, Hoogeveen RC, Guan W, Tsai MY, Ballantyne CM. Atherosclerotic cardiovascular disease risk and small dense low-density lipoprotein cholesterol in men, women, African Americans and non-African Americans: The pooling project. Atherosclerosis 2023; 367:15-23. [PMID: 36724690 DOI: 10.1016/j.atherosclerosis.2023.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/22/2022] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Elevated small dense low-density lipoprotein-cholesterol (sdLDL-C) has been reported to be associated with increased atherosclerotic cardiovascular disease (ASCVD) risk. Our aims were to determine whether direct and calculated sdLDL-C were significant independent ASCVD risk factors in sex and race subgroups. METHODS In a total of 15,933 participants free of ASCVD at baseline (median age 62 years, 56.7% female, 19.7% African American) fasting plasma lipids and sdLDL-C were measured by standardized automated methods. All subjects were followed for 10 years for incident ASCVD, which developed in 9.7% of subjects. SdLDL-C values were also calculated. Univariate and multivariate analyses were carried out to assess for independent associations with incident ASCVD after adjustment for all standard risk factors. RESULTS All standard risk factors were significantly associated with incident ASCVD on univariate analysis, as were direct and calculated sdLDL-C. These latter parameters were also significant when added to the pooled cohort risk equation. However, associations were significantly stronger for direct sdLDL-C and were not significant for calculated values once direct values were in the model. In contrast to calculated values, top quartile direct sdLDL-C was significantly independently associated with incident ASCVD versus bottom quartile values in all subjects and subgroups, except African Americans (hazard ratios ≥1.50, p < 0.01). Subjects with direct values ≥ 50 mg/dL versus <25 mg/dL had significantly higher independent ASCVD risk in all groups (hazard ratios >1.49, all p < 0.01). CONCLUSIONS Having a direct small dense low-density lipoprotein cholesterol value ≥ 50 mg/dL is a significant independent ASCVD risk-enhancer.
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Affiliation(s)
- Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Department of Medicine, Tufts University School of Medicine, Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA; Boston Heart Diagnostics, Framingham, MA, USA.
| | - Hiroaki Ikezaki
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Department of Medicine, Tufts University School of Medicine, Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA
| | - Margaret R Diffenderfer
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Department of Medicine, Tufts University School of Medicine, Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA; Boston Heart Diagnostics, Framingham, MA, USA
| | - Elise Lim
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; The Framingham Heart Study, National Heart, Lung, Blood Institute, Framingham, MA, USA
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; The Framingham Heart Study, National Heart, Lung, Blood Institute, Framingham, MA, USA
| | - Ron C Hoogeveen
- Cardiovascular Research Section, Baylor College of Medicine, Houston, TX, USA
| | - Weihua Guan
- Department of Laboratory Medicine and Pathology, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Christie M Ballantyne
- Cardiovascular Research Section, Baylor College of Medicine, Houston, TX, USA; Cardiology Division, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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10
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Hori M, Imamura T, Narang N, Onoda H, Tanaka S, Ushijima R, Sobajima M, Fukuda N, Ueno H, Kinugawa K. Triglyceride and Small Dense LDL-Cholesterol in Patients with Acute Coronary Syndrome. J Clin Med 2021; 10:jcm10194607. [PMID: 34640624 PMCID: PMC8509760 DOI: 10.3390/jcm10194607] [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: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Small dense LDL-cholesterol is an established risk factor for atherosclerosis but is not routinely measured in daily practice. The association between small dense LDL-cholesterol and triglyceride, which in turn is routinely measured, in patients with acute coronary syndrome remains unknown. METHODS Consecutive patients with acute coronary syndrome who were admitted to our institute were prospectively included, and serum samples were obtained on admission. The association between small dense LDL-cholesterol and triglyceride was investigated. RESULTS Among 55 patients (median 71 years old, 64% men), median (interquartile range) small dense LDL-cholesterol was 23.6 (17.0, 36.0) and triglyceride was 101 (60, 134) mg/dL. Triglyceride level correlated with small dense LDL-cholesterol (r = 0.67, p < 0.001) and was an independent determinant of small dense LDL-cholesterol together with body mass index (p = 0.010 and p = 0.008, respectively). Those with high triglyceride and high body mass index had a 3-fold level of small dense LDL-cholesterol compared with those with low triglyceride and low body mass index (45.8 [35.0, 54.0] mg/dL versus 15.0 [11.6, 23.7] mg/dL, p = 0.001). CONCLUSIONS Triglyceride level was a major determinant of small dense LDL-cholesterol in patients with acute coronary syndrome. Triglyceride level might be a useful and practical biomarker for risk stratification for patients with acute coronary syndrome together with body mass index.
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Affiliation(s)
- Masakazu Hori
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
| | - Teruhiko Imamura
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
- Correspondence: ; Tel.: +81-76-434-2246; Fax: +81-76-434-5026
| | - Nikhil Narang
- Advocate Christ Medical Center, Oak Lawn, IL 60453, USA;
| | - Hiroshi Onoda
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
| | - Shuhei Tanaka
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
| | - Ryuichi Ushijima
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
| | - Mitsuo Sobajima
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
| | - Nobuyuki Fukuda
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
| | - Hiroshi Ueno
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
| | - Koichiro Kinugawa
- The Second Department of Internal Medicine, University of Toyama, Toyama 9300072, Japan; (M.H.); (H.O.); (S.T.); (R.U.); (M.S.); (N.F.); (H.U.); (K.K.)
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11
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Singh A, Puhan R, Pradhan A, Ali W, Sethi R. Small Dense Low-Density Lipoprotein for Risk Prediction of Acute Coronary Syndrome. Cardiol Res 2021; 12:251-257. [PMID: 34349867 PMCID: PMC8297045 DOI: 10.14740/cr1254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/27/2021] [Indexed: 02/05/2023] Open
Abstract
Background Elevated Low density Lipoprotein (LDL) levels have been traditionally associated with development of atherosclerotic coronary artery disease (CAD). As LDL-cholesterol levels are not always raised in acute coronary syndrome (ACS) patients, sd-LDL is an emerging risk factor. The purpose of the present study was tri-fold. Firstly, it aimed to investigate the association of sd-LDL as a risk factor in ACS patients. Secondly, it aimed to correlate the presence of sd-LDL with severity of coronary artery disease as determined by coronary angiography. Lastly, it aimed to correlate the presence of sd-LDL with short-term outcomes. Methods This was a prospective, hospital-based, cross-sectional, case-control study conducted over a 1-year study duration. Patients above the age of 18 years diagnosed with ACS within 24 h of admission were studied. Blood samples were collected after all patients had undergone coronary angiography and sd-LDL levels were measured. Results ACS patients had significantly higher sd-LDL levels than non-ACS patients (16.10 ± 1.42 mg/dL vs. 12.67 ± 0.71 mg/dL, P = 0.036). Males had significantly higher sd-LDL levels than females (16.79 ± 1.55 mg/dl vs. 10.77 ± 2.62 mg/dl, P=0.047). Patients with non-left anterior descending coronary artery (LAD) involvement had significantly higher sd-LDL levels compared to patients with LAD involvement (21.92 ± 3.55 mg/dL vs. 14.03 ± 1.35 mg/dL, P = 0.007). Conclusion These results suggest that sd-LDL is a risk factor for the development of ACS in an Indian population.
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Affiliation(s)
- Abhishek Singh
- Department of Internal Medicine, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Rajendra Puhan
- Department of Internal Medicine, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Akshyaya Pradhan
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Wahid Ali
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Rishi Sethi
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
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12
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Alizadeh-Fanalou S, Nazarizadeh A, Alian F, Faraji P, Sorori B, Khosravi M. Small dense low-density lipoprotein-lowering agents. Biol Chem 2021; 401:1101-1121. [PMID: 32427116 DOI: 10.1515/hsz-2019-0426] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/06/2020] [Indexed: 02/06/2023]
Abstract
Metabolic disorders, including obesity, diabetes, and hyperlipidemia, as well as cardiovascular diseases (CVD), particularly atherosclerosis, are still leading causes of death worldwide. Plasma levels of low-density lipoprotein (LDL) are currently being considered as a critical risk factor for the diseases mentioned above, especially atherosclerosis. Because of the heterogeneous nature of LDL, many studies have already been conducted on its subclasses, especially small dense LDL (sdLDL). According to available evidence, sdLDL levels can be considered as an ideal alternative to LDL levels for monitoring CVD and early diagnosis of atherosclerosis. Recently, several researchers have focused on factors that are able to decrease sdLDL levels and improve health quality. Therefore, the purpose of this study is to describe the production process of sdLDL particles and review the effects of pharmaceutical and dietary agents as well as lifestyle on sdLDL plasma levels. In brief, their mechanisms of action are discussed. Apparently, cholesterol and LDL-lowering compounds are also effective in the reduction of sdLDL levels. In addition, improving lipid profile, especially the reduction of triglyceride levels, appropriate regimen, and lifestyle can decrease sdLDL levels. Therefore, all the aforementioned parameters should be taken into consideration simultaneously in sdLDL levels reducing strategies.
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Affiliation(s)
- Shahin Alizadeh-Fanalou
- Student Research Committee, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.,Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran1449614535,Islamic Republic of Iran
| | - Ali Nazarizadeh
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran1449614535,Islamic Republic of Iran
| | - Fatemeh Alian
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran131451365,Islamic Republic of Iran
| | - Parisa Faraji
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran131451365,Islamic Republic of Iran
| | - Bahareh Sorori
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran 1449614535, Islamic Republic of Iran
| | - Mohsen Khosravi
- Department of Medicine, Islamic Azad University, Qom Branch, Qom3714668669,Islamic Republic of Iran
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13
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Structure and Dynamics of Oxidized Lipoproteins In Vivo: Roles of High-Density Lipoprotein. Biomedicines 2021; 9:biomedicines9060655. [PMID: 34201176 PMCID: PMC8229488 DOI: 10.3390/biomedicines9060655] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 01/30/2023] Open
Abstract
Oxidative modification of lipoproteins is implicated in the occurrence and development of atherosclerotic lesions. Earlier studies have elucidated on the mechanisms of foam cell formation and lipid accumulation in these lesions, which is mediated by scavenger receptor-mediated endocytosis of oxidized low-density lipoprotein (oxLDL). Mounting clinical evidence has supported the involvement of oxLDL in cardiovascular diseases. High-density lipoprotein (HDL) is known as anti-atherogenic; however, recent studies have shown circulating oxidized HDL (oxHDL) is related to cardiovascular diseases. A modified structure of oxLDL, which was increased in the plasma of patients with acute myocardial infarction, was characterized. It had two unique features: (1) a fraction of oxLDL accompanied oxHDL, and (2) apoA1 was heavily modified, while modification of apoB, and the accumulation of oxidized phosphatidylcholine (oxPC) and lysophosphatidylcholine (lysoPC) was less pronounced. When LDL and HDL were present at the same time, oxidized lipoproteins actively interacted with each other, and oxPC and lysoPC were transferred to another lipoprotein particle and enzymatically metabolized rapidly. This brief review provides a novel view on the dynamics of oxLDL and oxHDL in circulation.
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14
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Ikezaki H, Lim E, Cupples LA, Liu CT, Asztalos BF, Schaefer EJ. Small Dense Low-Density Lipoprotein Cholesterol Is the Most Atherogenic Lipoprotein Parameter in the Prospective Framingham Offspring Study. J Am Heart Assoc 2021; 10:e019140. [PMID: 33586462 PMCID: PMC8174280 DOI: 10.1161/jaha.120.019140] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Elevated plasma levels of direct low‐density lipoprotein cholesterol (LDL‐C), small dense LDL‐C (sdLDL‐C), low‐density lipoprotein (LDL) triglycerides, triglycerides, triglyceride‐rich lipoprotein cholesterol, remnant lipoprotein particle cholesterol, and lipoprotein(a) have all been associated with incident atherosclerotic cardiovascular disease (ASCVD). Our goal was to assess which parameters were most strongly associated with ASCVD risk. Methods and Results Plasma total cholesterol, triglycerides, high‐density lipoprotein cholesterol, direct LDL‐C, sdLDL‐C, LDL triglycerides, remnant lipoprotein particle cholesterol, triglyceride‐rich lipoprotein cholesterol, and lipoprotein(a) were measured using standardized automated analysis (coefficients of variation, <5.0%) in samples from 3094 fasting subjects free of ASCVD. Of these subjects, 20.2% developed ASCVD over 16 years. On univariate analysis, all ASCVD risk factors were significantly associated with incident ASCVD, as well as the following specialized lipoprotein parameters: sdLDL‐C, LDL triglycerides, triglycerides, triglyceride‐rich lipoprotein cholesterol, remnant lipoprotein particle cholesterol, and direct LDL‐C. Only sdLDL‐C, direct LDL‐C, and lipoprotein(a) were significant on multivariate analysis and net reclassification after adjustment for standard risk factors (age, sex, hypertension, diabetes mellitus, smoking, total cholesterol, and high‐density lipoprotein cholesterol). Using the pooled cohort equation, many specialized lipoprotein parameters individually added significant information, but no parameter added significant information once sdLDL‐C (hazard ratio, 1.42; P<0.0001) was in the model. These results for sdLDL‐C were confirmed by adjusted discordance analysis versus calculated non–high‐density lipoprotein cholesterol, in contrast to LDL triglycerides. Conclusions sdLDL‐C, direct LDL‐C, and lipoprotein(a) all contributed significantly to ASCVD risk on multivariate analysis, but no parameter added significant risk information to the pooled cohort equation once sdLDL‐C was in the model. Our data indicate that small dense LDL is the most atherogenic lipoprotein parameter.
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Affiliation(s)
- Hiroaki Ikezaki
- Cardiovascular Nutrition Laboratory Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University Boston MA.,Tufts University School of Medicine Boston MA.,Friedman School of Nutrition Science and Policy at Tufts University Boston MA.,Department of General Internal Medicine Kyushu University Hospital Fukuoka Japan
| | - Elise Lim
- Department of Biostatistics Boston University School of Public Health Boston MA.,FHS (Framingham Heart Study)National Heart, Lung, and Blood Institute Framingham MA
| | - L Adrienne Cupples
- Department of Biostatistics Boston University School of Public Health Boston MA.,FHS (Framingham Heart Study)National Heart, Lung, and Blood Institute Framingham MA
| | - Ching-Ti Liu
- Department of Biostatistics Boston University School of Public Health Boston MA.,FHS (Framingham Heart Study)National Heart, Lung, and Blood Institute Framingham MA
| | - Bela F Asztalos
- Cardiovascular Nutrition Laboratory Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University Boston MA.,Tufts University School of Medicine Boston MA.,Friedman School of Nutrition Science and Policy at Tufts University Boston MA
| | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University Boston MA.,Tufts University School of Medicine Boston MA.,Friedman School of Nutrition Science and Policy at Tufts University Boston MA
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15
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Sawada N, Obama T, Koba S, Takaki T, Iwamoto S, Aiuchi T, Kato R, Kikuchi M, Hamazaki Y, Itabe H. Circulating oxidized LDL, increased in patients with acute myocardial infarction, is accompanied by heavily modified HDL. J Lipid Res 2020; 61:816-829. [PMID: 32291330 PMCID: PMC7269762 DOI: 10.1194/jlr.ra119000312] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 03/13/2020] [Indexed: 12/13/2022] Open
Abstract
Oxidized LDL (oxLDL) is a known risk factor for atherogenesis. This study aimed to reveal structural features of oxLDL present in human circulation related to atherosclerosis. When LDL was fractionated on an anion-exchange column, in vivo-oxLDL, detected by the anti-oxidized PC (oxPC) mAb, was recovered in flow-through and electronegative LDL [LDL(-)] fractions. The amount of the electronegative in vivo-oxLDL, namely oxLDL in the LDL(-) fraction, present in patients with acute MI was 3-fold higher than that observed in healthy subjects. Surprisingly, the LDL(-) fraction contained apoA1 in addition to apoB, and HDL-sized particles were observed with transmission electron microscopy. In LDL(-) fractions, acrolein adducts were identified at all lysine residues in apoA1, with only a small number of acrolein-modified residues identified in apoB. The amount of oxPC adducts of apoB was higher in the LDL(-) than in the L1 fraction, as determined using Western blotting. The electronegative in vivo-oxLDL was immunologically purified from the LDL(-) fraction with an anti-oxPC mAb. The majority of PC species were not oxidized, whereas oxPC and lysoPC did not accumulate. Here, we propose that there are two types of in vivo-oxLDL in human circulating plasma and the electronegative in vivo-oxLDL accompanies oxidized HDL.
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Affiliation(s)
- Naoko Sawada
- Division of Biological Chemistry, Department of Pharmaceutical Sciences Showa University School of Pharmacy, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Takashi Obama
- Division of Biological Chemistry, Department of Pharmaceutical Sciences Showa University School of Pharmacy, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Shinji Koba
- Division of Cardiology, Department of Medicine Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Takashi Takaki
- Division of Electron Microscopy Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Sanju Iwamoto
- Division of Physiology and Pathology, Department of Pharmacology, Toxicology, and Therapeutics Showa University School of Pharmacy, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Toshihiro Aiuchi
- Division of Biological Chemistry, Department of Pharmaceutical Sciences Showa University School of Pharmacy, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Rina Kato
- Division of Biological Chemistry, Department of Pharmaceutical Sciences Showa University School of Pharmacy, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Masaki Kikuchi
- Division of Biological Chemistry, Department of Pharmaceutical Sciences Showa University School of Pharmacy, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Yuji Hamazaki
- Division of Cardiology, Department of Medicine Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Hiroyuki Itabe
- Division of Biological Chemistry, Department of Pharmaceutical Sciences Showa University School of Pharmacy, Shinagawa-ku, Tokyo 142-8555, Japan. mailto:
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16
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Wu B, Yu Z, Tong T, Tong X, Yang Y, Tang Y, Ren H, Liao Y, Liao J. Evaluation of small dense low-density lipoprotein concentration for predicting the risk of acute coronary syndrome in Chinese population. J Clin Lab Anal 2020; 34:e23085. [PMID: 31696980 PMCID: PMC7083486 DOI: 10.1002/jcla.23085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/31/2019] [Accepted: 09/18/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Acute coronary syndrome (ACS) is the leading cause of death in developing and developed countries, yet assessing the risk of its development remains challenging. Several lines of evidence indicate that small, dense low-density lipoproteins (sd-LDL) are associated with increased cardiovascular disease risk. We aim to evaluate sd-LDL concentration for predicting the risk of ACS in Chinese population. METHODS Baseline characteristics of 121 patients with ACS and 172 healthy controls were obtained. Plasma sd-LDL-C was measured using homogeneous assay, and the proportion of sd-LDL-C in LDL-C was detected. RESULTS There was gender and age effect on the sd-LDL-C concentration and sd-LDL-C/LDL-C ratio among healthy subjects. Elevated sd-LDL-C concentrations and sd-LDL-C/LDL-C ratio were observed in ACS patients with unstable angina pectoris (UAP), non-ST-segment elevation myocardial infarction (STEMI), and ST-segment elevation myocardial infarction (NSTEMI) compared with healthy controls (P < .05); however, there were no differences among ACS groups. According to Pearson's correlation coefficient analyses, sd-LDL-C concentration and sd-LDL-C/LDL-C ratio were positively correlated with triglyceride (TG) and LDL-C concentrations (P < .05) and negatively correlated with high-density lipoprotein (HDL) concentration (P < .05). Based on the receiver operating characteristic (ROC) curves, the cutoff values of sd-LDL-C and sd-LDL-C/LDL-C ratio for the prediction of ACS were 1.06 mmol/L and 34.55%, respectively. Multivariate logistic regression analysis demonstrated that the sd-LDL-C/LDL-C ratio, but not sd-LDL-C concentration, was significantly associated with ACS events [OR (95% CI): 1.24, 1.11-1.38, P < .001]. CONCLUSIONS The sd-LDL-C/LDL-C ratio may be associated with an increased risk of developing ACS in Chinese population.
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Affiliation(s)
- Bin Wu
- Department of Laboratory MedicineGuangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouChina
| | - Zhiwu Yu
- Division of Laboratory ScienceAffiliated Cancer Hospital & Institute of Guangzhou Medical UniversityGuangzhouChina
| | - Tong Tong
- Department of PharmacyAnhui Provincial HospitalThe First Affiliated Hospital of University of Science and Technology of ChinaAnhuiChina
| | - Xinxin Tong
- Department of Blood TransfusionGuangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouChina
| | - Yinmei Yang
- Department of Laboratory MedicineGuangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouChina
| | - Yongcai Tang
- Department of Laboratory MedicineGuangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouChina
| | - Huiming Ren
- Department of Laboratory MedicineWuxi Fourth People's HospitalAffiliated Hospital of Jiangnan UniversityWuxiChina
| | - Yike Liao
- Peking University Health Science CentreBeijingChina
| | - Jun Liao
- Department of Laboratory MedicineGuangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouChina
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17
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Tanaka M, Kanasaki A, Hayashi N, Iida T, Murao K. Safety and efficacy of a 48-week long-term ingestion of D-allulose in subjects with high LDL cholesterol levels. ACTA ACUST UNITED AC 2020. [DOI: 10.2131/fts.7.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Misuzu Tanaka
- Research and Development, Matsutani Chemical Industry Co., Ltd
| | - Akane Kanasaki
- Research and Development, Matsutani Chemical Industry Co., Ltd
| | - Noriko Hayashi
- Research and Development, Matsutani Chemical Industry Co., Ltd
| | - Tetsuo Iida
- Research and Development, Matsutani Chemical Industry Co., Ltd
| | - Koji Murao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Kagawa University
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18
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Izumida T, Nakamura Y, Hino Y, Ishikawa S. Combined Effect of Small Dense Low-Density Lipoprotein Cholesterol (sdLDL-C) and Remnant-Like Particle Cholesterol (RLP-C) on Low-Grade Inflammation. J Atheroscler Thromb 2019; 27:319-330. [PMID: 31462603 PMCID: PMC7192812 DOI: 10.5551/jat.49528] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims: Small dense low-density lipoprotein cholesterol (sdLDL-C) and remnant-like particle cholesterol (RLP-C) are the novel atherosclerotic risk factors and might be strongly associated with inflammation. The basic evidence supports that sdLDL and RLP have some different mechanisms inducing an inflammatory response. Many studies have focused on the mechanism of inflammation of sdLDL-C or RLP-C per se, with limited data on the association between sdLDL-C and RLP-C in the real-world, population-based setting. Thus, the aim of this study was to investigate the association between sdLDL-C and RLP-C with inflammation. Methods: We examined the baseline cross-sectional data of participants from the Jichi Medical School-II Cohort Study. In total, 5,305 participants (2,439 men and 2,866 women) were included in this study. Results: Of all quartiles of sdLDL-C, the fourth had the highest high-sensitivity C-reactive protein (hs-CRP) level. Once adjusted for age, sex, smoking status, homeostasis model assessment of insulin resistance, antidyslipidemic and antihyperglycemic medication use, and RLP-C, sdLDL-C was significantly and positively associated with hs-CRP (geometric mean, 95% confidence interval (CI), 0.36 mg/L (0.34–0.38 mg/L), 0.37 mg/L (0.35–0.39 mg/L), 0.40 mg/L (0.37–0.42 mg/L) versus 0.44 mg/L (0.42–0.47 mg/L), P < 0.001 for trend). After stratifying the participants into four sdLDL-C×four RLP-C categories, the group in the fourth sdLDL-C quartile and the forth RLP-C quartile had the highest hs-CRP level (geometric mean, 95% CI, 0.52 mg/L, 0.48–0.57 mg/L, interaction P = 0.75). Conclusions: SdLDL-C and RLP-C had different associations with inflammation. Our results support sdLDL-C as the potential novel factor of cardiovascular disease, independently of RLP-C.
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Affiliation(s)
| | - Yosikazu Nakamura
- Division of Public Health, Center for Community Medicine, Jichi Medical University
| | | | - Shizukiyo Ishikawa
- Division of Public Health, Center for Community Medicine, Jichi Medical University
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Non-HDL as a Valid Surrogate Marker of Small Dense LDL in a Young Indian Population. Indian J Clin Biochem 2019; 34:263-271. [PMID: 31391715 DOI: 10.1007/s12291-018-0758-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 05/02/2018] [Indexed: 10/17/2022]
Abstract
Small dense (sd) LDL is a significant independent risk factor for premature coronary artery disease (CAD). Unfortunately, its estimation is not popular, due to the limited availability of specialized equipment, high cost and time-consuming technique. Non-HDL is a calculated, single index measure of all atherogenic apolipoprotein-B containing lipoproteins. This study aimed at identifying non-HDL as a superior surrogate marker of sdLDL cholesterol in a young Indian population. 161 healthy subjects < 45 years were tested for lipid profile, apolipoproteins A1 and B, and sdLDL particle size. sdLDL particles showed negative correlation with non-HDL (r = - 0.283, p < 0.001), LDL (r = - 0.195, p = 0.013) and apoB/apo A1 (r = - 0.175, p = 0.026), the significance being greatest with non-HDL. ROC showed AUC for non-HDL, LDL and apoB/apo A1 as 0.704, 0.686, and 0.596 respectively. For LDL < 130 mg/dL, sdLDL showed a more significant negative correlation with non-HDL (r = - 0.291, p < 0.001) as compared with apoB/apoA1 (r = - 0.172, p = 0.037). For triglycerides < 200 mg/dL, sdLDL particle size showed higher significant negative correlation with non-HDL (r = - 0.213, p = 0.015) than with LDL (r = - 0.176, p = 0.045) while for triglycerides between 200 and 400 mg/dL, significant negative correlation was observed only with non-HDL (r = - 0.372, p = 0.043). Hence, our study suggested that non-HDL is a superior surrogate marker of sdLDL particle size as compared to LDL and apoB/A1 ratio in a young healthy Indian population and should be used for optimum assessment of dyslipidemias and CAD risk.
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20
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Summerhill VI, Grechko AV, Yet SF, Sobenin IA, Orekhov AN. The Atherogenic Role of Circulating Modified Lipids in Atherosclerosis. Int J Mol Sci 2019; 20:E3561. [PMID: 31330845 PMCID: PMC6678182 DOI: 10.3390/ijms20143561] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/21/2019] [Accepted: 07/19/2019] [Indexed: 02/08/2023] Open
Abstract
Lipid accumulation in the arterial wall is a crucial event in the development of atherosclerotic lesions. Circulating low-density lipoprotein (LDL) is the major source of lipids that accumulate in the atherosclerotic plaques. It was discovered that not all LDL is atherogenic. In the blood plasma of atherosclerotic patients, LDL particles are the subject of multiple enzymatic and non-enzymatic modifications that determine their atherogenicity. Desialylation is the primary and the most important atherogenic LDL modification followed by a cascade of other modifications that also increase blood atherogenicity. The enzyme trans-sialidase is responsible for the desialylation of LDL, therefore, its activity plays an important role in atherosclerosis development. Moreover, circulating modified LDL is associated with immune complexes that also have a strong atherogenic potential. Moreover, it was shown that antibodies to modified LDL are also atherogenic. The properties of modified LDL were described, and the strong evidence indicating that it is capable of inducing intracellular accumulation of lipids was presented. The accumulated evidence indicated that the molecular properties of modified LDL, including LDL-containing immune complexes can serve as the prognostic/diagnostic biomarkers and molecular targets for the development of anti-atherosclerotic drugs.
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Affiliation(s)
- Volha I Summerhill
- Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow 121609, Russia.
| | - Andrey V Grechko
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 14-3 Solyanka Street, Moscow 109240, Russia
| | - Shaw-Fang Yet
- Institute of Cellular and System Medicine, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County 35053, Taiwan
| | - Igor A Sobenin
- Laboratory of Medical Genetics, National Medical Research Center of Cardiology, 15A 3-rd Cherepkovskaya Street, Moscow 121552, Russia
| | - Alexander N Orekhov
- Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow 121609, Russia.
- Institute of Human Morphology, 3 Tsyurupa Street, Moscow 117418, Russia.
- Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, Moscow 125315, Russia.
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21
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Dansinger ML, Williams PT, Superko HR, Schaefer EJ. Effects of weight change on apolipoprotein B-containing emerging atherosclerotic cardiovascular disease (ASCVD) risk factors. Lipids Health Dis 2019; 18:154. [PMID: 31311555 PMCID: PMC6636168 DOI: 10.1186/s12944-019-1094-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/01/2019] [Indexed: 01/05/2023] Open
Abstract
Background and aims Non-high-density (HDL)-cholesterol, low-density lipoprotein (LDL)-particle number, apolipoprotein B, lipoprotein(a) (Lp(a)), and small-dense (sdLDL) and large-buoyant (lbLDL) LDL-subfractions are emerging apo B-containing atherosclerotic cardiovascular disease (ASCVD) risk factors. Current guidelines emphasize lifestyle, including weight loss, for ASCVD risk management. Whether weight change affects these emerging risk factors beyond that predicted by traditional triglyceride and LDL-cholesterol measurements remains to be determined. Method Regression analyses of fasting ∆apo B-containing lipoproteins vs. ∆BMI were examined in a large anonymized clinical laboratory database of 33,165 subjects who did not report use of lipid-lowering medications. Regression slopes (±SE) were estimated as: *∆mmol/L per ∆kg/m2, †∆g/L per ∆kg/m2, ‡∆% per ∆kg/m2, and §∆μmol/L per ∆kg/m2. Results When adjusted for age, ∆BMI was significantly related to ∆nonHDL-cholesterol (males: 0.0238 ± 0.0041, P = 7.9 × 10− 9; females: 0.0330 ± 0.0037, P < 10− 16)*, ∆LDL-particles (males: 0.0128 ± 0.0024, P = 2.1 × 10− 7; females: 0.0114 ± 0.0022, P = 3.2 × 10− 7)*, ∆apo B (males: 0.0053 ± 0.0010, P = 7.9 × 10− 8; females: 0.0073 ± 0.0009, P = 2.2 × 10− 16)†, ∆sdLDL (males: 0.0125 ± 0.0015, P = 2.2 × 10− 16; females: 0.0128 ± 0.0012, P < 10− 16)*, ∆percent LDL carried on small dense particles (%sdLDL, males: 0.296 ± 0.035, P < 10− 16; females: 0.221 ± 0.023, P < 10− 16)‡, ∆triglycerides (males: 0.0358 ± 0.0049, P = 2.0 × 10− 13; females: 0.0304 ± 0.0029, P < 10− 16)*, and ∆LDL-cholesterol (males: 0.0128 ± 0.0034, P = 0.0002; females: 0.0232 ± 0.0031, P = 1.2 × 10− 13)* in both males and females. Age-adjusted ∆BMI was significantly related to ∆lbLDL in females (0.0098 ± 0.0024, P = 3.9 × 10− 5)* but not males (0.0007 ± 0.0026, P = 0.78)*. Female showed significantly greater increases in ∆LDL-cholesterol (P = 0.02) and ∆lbLDL (P = 0.008) per ∆BMI than males. ∆BMI had a greater effect on ∆LDL-cholesterol measured directly than indirect estimate of ∆LDL-cholesterol from the Friedewald equation. When sexes were combined and adjusted for age, sex, ∆triglycerides and ∆LDL-cholesterol, ∆BMI retained residual associations with ∆nonHDL-cholesterol (0.0019 ± 0.0009, P = 0.03)*, ∆LDL-particles (0.0032 ± 0.0010, P = 0.001)*, ∆apo B (0.0010 ± 0.0003, P = 0.0008)†, ∆Lp(a) (− 0.0091 ± 0.0021, P = 1.2 × 10− 5)§, ∆sdLDL (0.0001 ± 0.0000, P = 1.6 × 10− 11)* and ∆%sdLDL (0.151 ± 0.018, P < 10− 16) ‡. Conclusions Emerging apo B-containing risk factors show associations with weight change beyond those explained by the more traditional triglyceride and LDL-cholesterol measurements. Electronic supplementary material The online version of this article (10.1186/s12944-019-1094-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael L Dansinger
- Boston Heart Diagnostics, 175 Crossing Boulevard, Suite 100, Framingham, MA, 01702, USA. .,Tufts Medical Center, 800 Washington St, Boston, MA, 02111, USA.
| | - Paul T Williams
- Boston Heart Diagnostics, 175 Crossing Boulevard, Suite 100, Framingham, MA, 01702, USA
| | - H Robert Superko
- Boston Heart Diagnostics, 175 Crossing Boulevard, Suite 100, Framingham, MA, 01702, USA
| | - Ernst J Schaefer
- Boston Heart Diagnostics, 175 Crossing Boulevard, Suite 100, Framingham, MA, 01702, USA.,Cardiovascular Nutrition Laboratory, USDA Human Nutrition Research Center at Tufts University, 711 Washington St., Boston, MA, 02111, USA
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22
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Ichikawa T, Miyaaki H, Miuma S, Motoyoshi Y, Narita S, Toda S, Takahashi Y, Honda T, Yajima H, Uehara R, Hino N, Hori T, Hirata R, Taura N, Nakao K. Carotid Intima-media Thickness and Small Dense Low-density Lipoprotein Cholesterol Increase after One Year of Treatment with Direct-acting Antivirals in Patients with Hepatitis C Virus Infection. Intern Med 2019; 58:1209-1215. [PMID: 30626818 PMCID: PMC6543209 DOI: 10.2169/internalmedicine.1514-18] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective Direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV) infection exert a significantly high sustained viral response (SVR), and patients experience a rebound increase in low-density lipoprotein cholesterol (LDL) and total cholesterol levels. Carotid intima-media thickness (IMT) is a highly reproducible and non-invasive parameter for assessing the atherosclerotic process, and the small dense (sd) LDL level is useful for clinically evaluating the atherogenic risk. Methods A total of 48 patients with chronic HCV infection were treated with DAAs. All patients exhibited an SVR 24 weeks later. We compared the metabolic profiles of the patients, including the sdLDL and IMT values, at the start of DAA treatment with those after one year of treatment. We verified whether the HCV clearance after the administration of DAAs is associated with the development of atherosclerosis. Results The sdLDL, %sdLDL (sdLDL/LDL), and LDL values were exacerbated after a year of treatment; however, the triglyceride level, glycated hemoglobin level, insulin resistance, and body weight remained unaltered. The max-IMT was increased after a year compared to that at the start of treatment. Differences in the max-IMT (dmax-IMT) were greater in men than in women; however, no correlation was observed between the dmax-IMT and genotype, fibrosis, hypertension, hyperlipidemia, diabetes, obesity, and dialysis status. The %sdLDL at the start and a year later was positively correlated with the dmax-IMT. No correlation was observed among various factors including the LDL, triglyceride, body mass index, insulin resistance and dmax-IMT. In uni- and multivariate analyses, a significant correlation was observed between %sdLDL≥16% at the start of treatment and the sex and dmax-IMT. Conclusion Because the sdLDL and IMT values were exacerbated after a year of DAA treatment, atherosclerosis must be evaluated in patients achieving an SVR.
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Affiliation(s)
- Tatsuki Ichikawa
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
- Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
- Department of Comprehensive Community Care Systems, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Hisamitsu Miyaaki
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Satoshi Miuma
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | | | - Syouhei Narita
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
| | - Satomi Toda
- Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
| | - Youichi Takahashi
- Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
| | - Tetsurou Honda
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
| | - Hiroyuki Yajima
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
| | - Ryouhei Uehara
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
| | - Naoyuki Hino
- Department of Comprehensive Community Care Systems, Graduate School of Biomedical Sciences, Nagasaki University, Japan
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Tomoko Hori
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
| | - Ryousuke Hirata
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
| | - Naota Taura
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
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Association between plasma essential amino acids and atherogenic lipid profile in a Chinese population: A cross-sectional study. Atherosclerosis 2019; 286:7-13. [PMID: 31071661 DOI: 10.1016/j.atherosclerosis.2019.04.225] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 04/09/2019] [Accepted: 04/24/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS The association between amino acids and small dense low-density lipoprotein cholesterol (sdLDL-C) and remnant-like particle cholesterol (RLP-C) remains poorly understood. This study aims to investigate the association between plasma essential amino acids (EAAs) and atherogenic lipid profiles. METHODS Plasma amino acid levels of 475 individuals were measured using liquid chromatography-mass spectrometry. SdLDL-C, RLP-C, and other lipid components were evaluated. Associations between EAAs and lipid components or dyslipidemia were determined using correlation analysis and multivariate logistic regression. RESULTS Concentrations of plasma branched-chain amino acid (BCAA) were positively correlated with sdLDL-C, RLP-C, and triglycerides (TG) levels, but inversely correlated with high-density lipoprotein cholesterol (HDL-C). In contrast, threonine concentration was inversely correlated with sdLDL-C, RLP-C, and TG. Compared with the lowest tertile, individuals in the highest tertile of plasma total BCAAs level had an odds ratio (OR) of 2.33 (95% confidence interval [CI]: 1.35, 4.03) for the risk of high sdLDL-C, 3.63 (95%CI: 1.69, 7.80) for the risk of high RLP-C, 3.10 (95%CI: 1.66, 5.80) for the risk of high TG, and 3.67 (95%CI: 2.00, 6.73) for atherogenic lipid triad (all p < 0.01). In contrast, compared with the lowest tertile, individuals in the highest plasma threonine tertile had a 43% lower OR for high sdLDL-C, 56% lower OR for high TG, and 55% lower OR for lipid triad risk (all p < 0.05). CONCLUSIONS Among the EAAs evaluated, elevated plasma BCAAs were significantly associated with increased risk of atherogenic lipid profile. In contrast, elevated threonine was associated with reduced risk of atherogenic lipid profile.
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Roehl K, Falco-Walter J, Ouyang B, Balabanov A. Modified ketogenic diets in adults with refractory epilepsy: Efficacious improvements in seizure frequency, seizure severity, and quality of life. Epilepsy Behav 2019; 93:113-118. [PMID: 30867113 DOI: 10.1016/j.yebeh.2018.12.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study evaluates the efficacy of a modified ketogenic diet (MKD) on seizure frequency, severity, and quality of life (QOL), as well as potential complications of MKD therapy among adults with drug-resistant epilepsy (DRE). METHODS Changes in seizure frequency, severity, QOL, and side effects were retrospectively examined among adults, ≥17 years of age, with DRE (≥2 antiepileptic drugs [AEDs]), after 3 months of MKD therapy. Attention was paid to medication or vagus nerve stimulator (VNS) changes as well to evaluate potential confounders. RESULTS A total of 60% (n = 33) of the 55 individuals reported ≥50% seizure frequency improvement, 42 (76%) reported improvement in seizure severity, and 48 (87%) reported improvement in QOL. More patients following a modified ketogenic diet - 15 g net carbohydrate daily (MKD-15) (95%) compared with a MKD-50 (69%) reported improvement in QOL (p = 0.02). Weight among the entire sample declined from 77.5 (20) kg to 73.9 (19.0) kg (p < 0.0001), and total cholesterol (TC), low density lipoprotein (LDL), and total cholesterol:high density lipoprotein (TC:HDL) increased significantly (p = 0.03, p = 0.04, and p = 0.02, respectively). Free carnitine values were available for a select number of patients, 26 (47%) at baseline, and 7 (13%) at follow-up, of which 8 (31%) at baseline, and 2 (29%) at follow-up had carnitine deficiency (<25 nmol/mL). Constipation was noted in 5 patients (9%), and no kidney stones were reported during the study period. There were no statistical differences in number or dose changes for AED or VNS during the study period. SIGNIFICANCE Modified ketogenic diet therapies reduce seizure frequency and severity and improve QOL among adults with DRE with few side effects outside of weight loss, a desired outcome among many adults with DRE. More restrictive MKDs may offer improved seizure severity and QOL. Modified ketogenic diet therapy increases LDL cholesterol, which may be cardioprotective if related to an increase in LDL particle size with high saturated fat intake; however, more research is needed examining LDL particle size changes among those receiving MKD therapy.
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Affiliation(s)
- Kelly Roehl
- Rush University Medical Center, 1725 West Harrison Street, Suite 885, Chicago, IL 60612, United States of America.
| | - Jessica Falco-Walter
- Rush University Medical Center, 1725 West Harrison Street, Suite 885, Chicago, IL 60612, United States of America; Stanford University, 213 Quarry Road, 4th Floor, Palo Alto, CA 94304, United States of America.
| | - Bichun Ouyang
- Rush University Medical Center, 1725 West Harrison Street, Suite 885, Chicago, IL 60612, United States of America.
| | - Antoaneta Balabanov
- Rush University Medical Center, 1725 West Harrison Street, Suite 885, Chicago, IL 60612, United States of America.
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25
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Preston Mason R. New Insights into Mechanisms of Action for Omega-3 Fatty Acids in Atherothrombotic Cardiovascular Disease. Curr Atheroscler Rep 2019; 21:2. [PMID: 30637567 PMCID: PMC6330561 DOI: 10.1007/s11883-019-0762-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Treatment of hypercholesterolemia with statins results in significant reductions in cardiovascular risk; however, individuals with well-controlled low-density lipoprotein cholesterol (LDL-C) levels, but persistent high triglycerides (TG), remain at increased risk. Genetic and epidemiologic studies have shown that elevated fasting TG levels are associated with incident cardiovascular events. At effective doses, omega-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower TG levels but may have additional atheroprotective properties compared to other TG-lowering therapies such as niacin and fibrates. The purpose of this review is to evaluate mechanisms related to the potential benefits of omega-3 fatty acids in atherothrombotic disease. RECENT FINDINGS Large randomized clinical trials are currently under way to test the cardiovascular benefits of omega-3 fatty acids at a pharmacologic dosage (4 g/day). A large randomized trial with a prescription EPA-only formulation was shown to reduce a composite of cardiovascular events by 25% in statin-treated patients with established cardiovascular disease or diabetes and other CV risk factors. EPA and DHA have distinct tissue distributions as well as disparate effects on membrane structure and lipid dynamics, rates of lipid oxidation, and signal transduction pathways. Compared to other TG-lowering therapies, EPA has been found to inhibit cholesterol crystal formation, inflammation, and oxidative modification of atherogenic lipoprotein particles. The anti-inflammatory and endothelial benefits of EPA are enhanced in combination with a statin. Omega-3 fatty acids like EPA only at a pharmacologic dose reduce fasting TG and interfere with mechanisms of atherosclerosis that results in reduced cardiovascular events. Additional mechanistic trials will provide further insights into their role in reducing cardiovascular risk in subjects with well-managed LDL-C but elevated TG levels.
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Affiliation(s)
- R Preston Mason
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
- Elucida Research LLC, Beverly, MA, 01915, USA.
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26
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Incel-Uysal P, Akdogan N, Alli N, Oktem A, Candar T, Topcuoglu C, Turhan T. Assessment of Metabolic Profile and Ischemia-modified Albumin Level in Patients with Alopecia Areata: A Case-Control Study. Indian J Dermatol 2019; 64:12-18. [PMID: 30745629 PMCID: PMC6340238 DOI: 10.4103/ijd.ijd_238_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Alopecia areata (AA) is an autoimmune-mediated hair follicle disorder. In the literature, there is no study evaluating metabolic syndrome and levels of ischemia-modified albumin (IMA) which is proposed as an oxidative stress biomarker in patients with AA. Aims: The aim was to investigate the presence of metabolic syndrome and the levels of IMA, small dense low-density lipoprotein (sd-LDL), and visfatin levels in AA patients. Settings and Design: A hospital-based cross-sectional study was undertaken among AA patients and controls. Subjects and Methods: Thirty-five patients with AA and 35 sex-, age-, and body mass index-matched healthy controls were enrolled. Clinical and laboratory parameters of metabolic syndrome were examined in all participants. Furthermore, IMA, sd-LDL, and visfatin levels were assessed and analyzed with regard to disease pattern, severity and extent, severity of alopecia tool score, duration, and recurrence. Results: The median IMA and adjusted IMA levels were significantly increased compared with controls (P<0.05 and P=0.002, respectively). Patients with pull test positivity displayed higher levels of adjusted IMA levels (P<0.05). In AA group, there was a positive correlation between adjusted IMA and waist circumference (r=0.443, P=0.008), adjusted IMA and triglyceride levels (r=0.535, P=0.001), and adjusted IMA and sd-LDL levels (r=0.46, P<0.05). We observed no statistically significant difference in fasting blood glucose and lipid profile, sd-LDL, and visfatin levels of the patients and healthy controls. Conclusions: AA patients and controls have similar metabolic profile. Raised levels of adjusted IMA levels may be associated with antioxidant/oxidant imbalance and with risk of cardiovascular disease.
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Affiliation(s)
- Pinar Incel-Uysal
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Neslihan Akdogan
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Nuran Alli
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Ayse Oktem
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Tuba Candar
- Department of Medical Biochemistry, Ufuk University Faculty of Medicine, Ankara, Turkey
| | - Canan Topcuoglu
- Department of Medical Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Turan Turhan
- Department of Medical Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
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27
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Kinoshita M, Yokote K, Arai H, Iida M, Ishigaki Y, Ishibashi S, Umemoto S, Egusa G, Ohmura H, Okamura T, Kihara S, Koba S, Saito I, Shoji T, Daida H, Tsukamoto K, Deguchi J, Dohi S, Dobashi K, Hamaguchi H, Hara M, Hiro T, Biro S, Fujioka Y, Maruyama C, Miyamoto Y, Murakami Y, Yokode M, Yoshida H, Rakugi H, Wakatsuki A, Yamashita S. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017. J Atheroscler Thromb 2018; 25:846-984. [PMID: 30135334 PMCID: PMC6143773 DOI: 10.5551/jat.gl2017] [Citation(s) in RCA: 511] [Impact Index Per Article: 85.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Koutaro Yokote
- Department of Diabetes, Metabolism and Endocrinology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yasushi Ishigaki
- Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Seiji Umemoto
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Hirotoshi Ohmura
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shinji Kihara
- Biomedical Informatics, Osaka University, Osaka, Japan
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Isao Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan
| | - Kazuhisa Tsukamoto
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama, Japan
| | - Seitaro Dohi
- Chief Health Management Department, Mitsui Chemicals Inc., Tokyo, Japan
| | - Kazushige Dobashi
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine, Kanagawa, Japan
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University, Hyogo, Japan
| | - Chizuko Maruyama
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University, Tokyo, Japan
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Masayuki Yokode
- Department of Clinical Innovative Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan
| | - Shizuya Yamashita
- Department of Community Medicine, Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Rinku General Medical Center, Osaka, Japan
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28
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Abstract
Accumulating clinical evidence has suggested serum triglyceride (TG) is a leading predictor of atherosclerotic cardiovascular disease, comparable to low-density lipoprotein (LDL)-cholesterol (C) in populations with type 2 diabetes, which exceeds the predictive power of hemoglobinA1c. Atherogenic dyslipidemia in diabetes consists of elevated serum concentrations of TG-rich lipoproteins (TRLs), a high prevalence of small dense low-density lipoprotein (LDL), and low concentrations of cholesterol-rich high-density lipoprotein (HDL)2-C. A central lipoprotein abnormality is an increase in large TG-rich very-low-density lipoprotein (VLDL)1, and other lipoprotein abnormalities are metabolically linked to increased TRLs. Insulin critically regulates serum VLDL concentrations by suppressing hepatic VLDL production and stimulating VLDL removal by activation of lipoprotein lipase. It is still debated whether hyperinsulinemia compensatory for insulin resistance is causally associated with the overproduction of VLDL. This review introduces experimental and clinical observations revealing that insulin resistance, but not hyperinsulinemia stimulates hepatic VLDL production. LDL and HDL consist of heterogeneous particles with different size and density. Cholesterol-depleted small dense LDL and cholesterol-rich HDL2 subspecies are particularly affected by insulin resistance and can be named “Metabolic LDL and HDL,” respectively. We established the direct assays for quantifying small dense LDL-C and small dense HDL(HDL3)-C, respectively. Subtracting HDL3-C from HDL-C gives HDL2-C. I will explain clinical relevance of measurements of LDL and HDL subspecies determined by our assays. Diabetic kidney disease (DKD) substantially worsens plasma lipid profile thereby potentiated atherogenic risk. Finally, I briefly overview pathophysiology of dyslipidemia associated with DKD, which has not been so much taken up by other review articles.
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Affiliation(s)
- Tsutomu Hirano
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine
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Mason RP, Dawoud H, Jacob RF, Sherratt SCR, Malinski T. Eicosapentaenoic acid improves endothelial function and nitric oxide bioavailability in a manner that is enhanced in combination with a statin. Biomed Pharmacother 2018; 103:1231-1237. [PMID: 29864903 DOI: 10.1016/j.biopha.2018.04.118] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/04/2018] [Accepted: 04/16/2018] [Indexed: 11/27/2022] Open
Abstract
The endothelium exerts many vasoprotective effects that are largely mediated by release of nitric oxide (NO). Endothelial dysfunction represents an early but reversible step in atherosclerosis and is characterized by a reduction in the bioavailability of NO. Previous studies have shown that eicosapentaenoic acid (EPA), an omega-3 fatty acid (O3FA), and statins individually improve endothelial cell function, but their effects in combination have not been tested. Through a series of in vitro experiments, this study evaluated the effects of a combined treatment of EPA and the active metabolite of atorvastatin (ATM) on endothelial cell function under conditions of oxidative stress. Specifically, the comparative and time-dependent effects of these agents on endothelial dysfunction were examined by measuring the levels of NO and peroxynitrite (ONOO-) released from human umbilical vein endothelial cells (HUVECs). The data suggest that combined treatment with EPA and ATM is beneficial to endothelial function and was unique to EPA and ATM since similar improvements could not be recapitulated by substituting another O3FA docosahexaenoic acid (DHA) or other TG-lowering agents such as fenofibrate, niacin, or gemfibrozil. Comparable beneficial effects were observed when HUVECs were pretreated with EPA and ATM before exposure to oxidative stress. Interestingly, the kinetics of EPA-based protection of endothelial function in response to oxidation were found to be significantly different than those of DHA. Lastly, the beneficial effects on endothelial function generated by combined treatment of EPA and ATM were reproduced when this study was expanded to an ex vivo model utilizing rat glomerular endothelial cells. Taken together, these findings suggest that a combined treatment of EPA and ATM can inhibit endothelial dysfunction that occurs in response to conditions such as hyperglycemia, oxidative stress, and dyslipidemia.
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Affiliation(s)
- R Preston Mason
- Elucida Research LLC, Beverly, MA, 01915, United States; Cardiovascular Division, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
| | - Hazem Dawoud
- Nanomedical Research Laboratory, Ohio University, Athens, OH, 45701, United States
| | | | | | - Tadeusz Malinski
- Nanomedical Research Laboratory, Ohio University, Athens, OH, 45701, United States
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Inaku KO, Ogunkeye OO, Abbiyesuku FM, Chuhwak EK, Isichei CO, Imoh LC, Amadu NO, Abu AO. Elevation of small, dense low density lipoprotein cholesterol-a possible antecedent of atherogenic lipoprotein phenotype in type 2 diabetes patients in Jos, North-Central Nigeria. BMC Clin Pathol 2017; 17:26. [PMID: 29225514 PMCID: PMC5718080 DOI: 10.1186/s12907-017-0065-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/27/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The global prevalence of type 2 diabetes is increasing. Dyslipidaemia is a known complication of diabetes mellitus manifesting frequently as cardiovascular diseases and stoke. Elevation of small, dense low density lipoprotein has been recognised as a component of the atherogenic lipoprotein phenotype associated with cardiovascular complications. We speculate that the elevation of this lipoprotein particle may be the antecedent of the atherogenic lipoprotein phenotype. This study therefore aims to determine the pattern of dyslipidaemia among diabetes mellitus patients in Jos, North-Central Nigeria. METHODS One hundred and seventy-six patients with type 2 diabetes and 154 age-matched controls were studied. The patients with diabetes were regular clinic attenders and had stable glycaemic control. None were on lipid-lowering therapy. Anthropometric indices, blood pressure, and lipids (including total cholesterol, high density lipoprotein cholesterol, and triglyceride) were measured by chemical methods using the Hitachi 902 analyzer. Low density lipoprotein cholesterol was calculated using the Friedewald's equation. Small, dense low density lipoprotein cholesterol, -sdLDL-C was measured using the precipitation method by Hirano et al. Means of the different groups were compared using EPI Info and a P-value of <0.05 was accepted as significant difference. RESULTS Total cholesterol, low density lipoprotein cholesterol, triglyceride and small, dense lipoprotein cholesterol were all significantly higher in diabetes patients than controls except high density lipoprotein cholesterol. The percentage of LDL-C as sdLDL-C among the diabetes versus control group was 45% ± 17.79 v 32.0% ± 15.93. Serum sdLDL-C concentration was determined to be 1.45 ± 0.64 among diabetes patients and 0.8 ± 0.54 among control subjects. 75% of diabetes patients had hypertension and were taking blood pressure lowering medications. CONCLUSION The classical atherogenic lipoprotein phenotype was not demonstrated among subjects with type 2 diabetes mellitus in this study, but the elevation of serum small dense low density lipoprotein cholesterol in patients with sustained hypertension suggests the establishment of atherogenic complications among our diabetes patients.
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Affiliation(s)
- Kenneth O. Inaku
- Department of Chemical Pathology, Faculty of Medicine, College of Medical Sciences, University of Calabar, Calabar, Cross River State Nigeria
| | - Obasola O. Ogunkeye
- Department of Chemical Pathology, Faculty of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Fayeofori M. Abbiyesuku
- Department of Chemical Pathology, Faculty of Medicine, University of Ibadan, Ibadan, Oyo State Nigeria
| | - Evelyn K. Chuhwak
- Department of Internal Medicine, Faculty of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Christian O. Isichei
- Department of Chemical Pathology, Faculty of Medical Sciences, University of Jos, Jos, Plateau State Nigeria
| | - Lucius C. Imoh
- Department of Chemical Pathology, University of Jos Teaching Hospital, Jos, Plateau State Nigeria
| | - Noel O. Amadu
- Department of Chemical Pathology, University of Jos Teaching Hospital, Jos, Plateau State Nigeria
| | - Alexander O. Abu
- Department of Chemical Pathology, University of Jos Teaching Hospital, Jos, Plateau State Nigeria
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Eicosapentaenoic Acid Inhibits Oxidation of ApoB-containing Lipoprotein Particles of Different Size In Vitro When Administered Alone or in Combination With Atorvastatin Active Metabolite Compared With Other Triglyceride-lowering Agents. J Cardiovasc Pharmacol 2017; 68:33-40. [PMID: 26945158 PMCID: PMC4936437 DOI: 10.1097/fjc.0000000000000379] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Eicosapentaenoic acid (EPA) is a triglyceride-lowering agent that reduces circulating levels of the apolipoprotein B (apoB)-containing lipoprotein particles small dense low-density lipoprotein (sdLDL), very–low-density lipoprotein (VLDL), and oxidized low-density lipoprotein (LDL). These benefits may result from the direct antioxidant effects of EPA. To investigate this potential mechanism, these particles were isolated from human plasma, preincubated with EPA in the absence or presence of atorvastatin (active) metabolite, and subjected to copper-initiated oxidation. Lipid oxidation was measured as a function of thiobarbituric acid reactive substances formation. EPA inhibited sdLDL (IC50 ∼2.0 μM) and LDL oxidation (IC50 ∼2.5 μM) in a dose-dependent manner. Greater antioxidant potency was observed for EPA in VLDL. EPA inhibition was enhanced when combined with atorvastatin metabolite at low equimolar concentrations. Other triglyceride-lowering agents (fenofibrate, niacin, and gemfibrozil) and vitamin E did not significantly affect sdLDL, LDL, or VLDL oxidation compared with vehicle-treated controls. Docosahexaenoic acid was also found to inhibit oxidation in these particles but over a shorter time period than EPA. These data support recent clinical findings and suggest that EPA has direct antioxidant benefits in various apoB-containing subfractions that are more pronounced than those of other triglyceride-lowering agents and docosahexaenoic acid.
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Small Dense Low-Density Lipoprotein as Biomarker for Atherosclerotic Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:1273042. [PMID: 28572872 PMCID: PMC5441126 DOI: 10.1155/2017/1273042] [Citation(s) in RCA: 232] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/12/2017] [Indexed: 01/11/2023]
Abstract
Low-density lipoprotein (LDL) plays a key role in the development and progression of atherosclerosis and cardiovascular disease. LDL consists of several subclasses of particles with different sizes and densities, including large buoyant (lb) and intermediate and small dense (sd) LDLs. It has been well documented that sdLDL has a greater atherogenic potential than that of other LDL subfractions and that sdLDL cholesterol (sdLDL-C) proportion is a better marker for prediction of cardiovascular disease than that of total LDL-C. Circulating sdLDL readily undergoes multiple atherogenic modifications in blood plasma, such as desialylation, glycation, and oxidation, that further increase its atherogenicity. Modified sdLDL is a potent inductor of inflammatory processes associated with cardiovascular disease. Several laboratory methods have been developed for separation of LDL subclasses, and the results obtained by different methods can not be directly compared in most cases. Recently, the development of homogeneous assays facilitated the LDL subfraction analysis making possible large clinical studies evaluating the significance of sdLDL in the development of cardiovascular disease. Further studies are needed to establish guidelines for sdLDL evaluation and correction in clinical practice.
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Thongtang N, Diffenderfer MR, Ooi EMM, Barrett PHR, Turner SM, Le NA, Brown WV, Schaefer EJ. Metabolism and proteomics of large and small dense LDL in combined hyperlipidemia: effects of rosuvastatin. J Lipid Res 2017; 58:1315-1324. [PMID: 28392500 DOI: 10.1194/jlr.m073882] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/17/2017] [Indexed: 11/20/2022] Open
Abstract
Small dense LDL (sdLDL) has been reported to be more atherogenic than large buoyant LDL (lbLDL). We examined the metabolism and protein composition of sdLDL and lbLDL in six subjects with combined hyperlipidemia on placebo and rosuvastatin 40 mg/day. ApoB-100 kinetics in triglyceride-rich lipoproteins (TRLs), lbLDL (density [d] = 1.019-1.044 g/ml), and sdLDL (d = 1.044-1.063 g/ml) were determined in the fed state by using stable isotope tracers, mass spectrometry, and compartmental modeling. Compared with placebo, rosuvastatin decreased LDL cholesterol and apoB-100 levels in TRL, lbLDL, and sdLDL by significantly increasing the fractional catabolic rate of apoB-100 (TRL, +45%; lbLDL, +131%; and sdLDL, +97%), without a change in production. On placebo, 25% of TRL apoB-100 was catabolized directly, 37% was converted to lbLDL, and 38% went directly to sdLDL; rosuvastatin did not alter these distributions. During both phases, sdLDL apoB-100 was catabolized more slowly than lbLDL apoB-100 (P < 0.01). Proteomic analysis indicated that rosuvastatin decreased apoC-III and apoM content within the density range of lbLDL (P < 0.05). In our view, sdLDL is more atherogenic than lbLDL because of its longer plasma residence time, potentially resulting in more particle oxidation, modification, and reduction in size, with increased arterial wall uptake. Rosuvastatin enhances the catabolism of apoB-100 in both lbLDL and sdLDL.
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Affiliation(s)
- Nuntakorn Thongtang
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Margaret R Diffenderfer
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Esther M M Ooi
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - P Hugh R Barrett
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | | | - Ngoc-Anh Le
- Atlanta Veterans Affairs Medical Center, Decatur, GA; and; Emory University School of Medicine, Atlanta, GA
| | - W Virgil Brown
- Atlanta Veterans Affairs Medical Center, Decatur, GA; and; Emory University School of Medicine, Atlanta, GA
| | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA;.
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Hayashi T, Koba S, Ito Y, Hirano T. Method for estimating high sdLDL-C by measuring triglyceride and apolipoprotein B levels. Lipids Health Dis 2017; 16:21. [PMID: 28125987 PMCID: PMC5270205 DOI: 10.1186/s12944-017-0417-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/17/2017] [Indexed: 11/25/2022] Open
Abstract
Background We previously developed an assay to directly measure small dense (sd) low-density lipoprotein cholesterol (LDL-C) levels, which is not widely used in general clinical practice. Therefore, we propose a simpler method, “LDL window,” that uses conventional methods for estimating high sdLDL-C levels. Methods We analyzed our previous studies (2006–2008) on healthy subjects and patients with type 2 diabetes and coronary artery disease (CAD). The sdLDL-C level was measured using the precipitation method, and LDL size was determined using gradient gel electrophoresis. The “LDL window” comprises the estimation of LDL particle number and size. We adopted apolipoprotein B (apoB) for the estimation of the LDL particle number and used 110 mg/dL as the cutoff value for hyper-apoB. Triglycerides (TGs) are a powerful inverse determinant of LDL particle size. Therefore, we adopted TG for the estimation of the LDL particle size and used 150 mg/dL as the cutoff value for hyper-TG. Subjects were stratified into the following four subgroups: normal, hyper-TG, hyper-apoB, and hyper-TG/-apoB. Non-high-density lipoprotein cholesterol (non-HDL-C) is a surrogate marker for apoB; therefore, the “alternative LDL window” comprised non-HDL-C (cutoff, 170 mg/dL) and TG. Results The top quartile (Q4) of sdLDL-C (>31 mg/dL) doubled in patients with diabetes and CAD. The hyper-TG/-apoB group in the “LDL window” represented >90% Q4 and <4% Q1 and Q2, irrespective of the subjects. The sdLDL-C levels in the hyper-TG/-apoB group were 50% higher in patients with diabetes and CAD than those in controls. Similar results were obtained using the “alternative LDL window.” Conclusions Our proposed “LDL window” may help identify patients at high risk of CAD independent of LDL-C. Electronic supplementary material The online version of this article (doi:10.1186/s12944-017-0417-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Toshiyuki Hayashi
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, Shinagawa, Tokyo, Japan
| | - Yasuki Ito
- Reagent R&D Department, Denka Seiken Co., Ltd., Tokyo, Japan
| | - Tsutomu Hirano
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan.
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Cho Y, Lee SG, Jee SH, Kim JH. Hypertriglyceridemia is a major factor associated with elevated levels of small dense LDL cholesterol in patients with metabolic syndrome. Ann Lab Med 2016; 35:586-94. [PMID: 26354346 PMCID: PMC4579102 DOI: 10.3343/alm.2015.35.6.586] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 04/22/2015] [Accepted: 08/13/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We aimed to determine the major contributing component of metabolic syndrome (MetS) that results in an elevated small dense LDL cholesterol (sdLDL-C) concentration and sdLDL-C/LDL-C ratio. METHODS Four hundred and forty-seven subjects (225 men; 222 women) with MetS were randomly selected from the Korean Metabolic Syndrome Research Initiatives-Seoul cohort study. Age- and sex-matched healthy controls (181 men; 179 women) were also randomly selected from the same cohort. RESULTS A comparison of the median values of the sdLDL-C concentration between subgroups, divided according to whether subjects met or did not meet the criteria for each MetS component in patients with MetS, revealed a significant difference in the sdLDL-C concentration only between subgroups divided according to whether subjects met or did not meet the triglyceride (TG) criteria (P<0.05 for each gender). The TG level showed a good correlation with sdLDL-C concentration (correlation coefficients [r]=0.543 for men; 0.653 for women) and the sdLDL-C/LDL-C ratio (r=0.789 for men; 0.745 for women). Multiple linear regression analyses conducted for the MetS group concordantly identified TG as one of the most significant contributors to sdLDL-C concentration (β=0.1747±0.0105, P<0.0001) and the sdLDL-C/LDL-C ratio (β=6.9518±0.3011, P<0.0001). CONCLUSIONS Among five MetS components, only the abnormal TG level was a differentiating factor for sdLDL-C concentration and sdLDL-C/LDL-C ratio. These results were reproducible in both genders, with or without MetS.
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Affiliation(s)
- Yonggeun Cho
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Guk Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Ho Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Do HDL and LDL subfractions play a role in atherosclerosis in end-stage renal disease (ESRD) patients? Int Urol Nephrol 2016; 49:155-164. [PMID: 27942970 DOI: 10.1007/s11255-016-1466-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/17/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Significantly increased cardiovascular mortality in patients with chronic kidney (CKD) disease cannot be explained by traditional risk factors. Recent studies revealed that the quality of HDL and LDL cholesterol may be more important than their serum levels. The aim of this study was to assess which LDL and HDL subfractions were more abundant in end-stage renal disease (ESRD) patients and to analyse whether subfraction distribution could be associated with accelerated atherosclerotic processes. METHODS This study included 50 ESRD patients undergoing dialysis and 20 healthy volunteers. LDL and HDL subfractions were analysed in serum with the use of Lipoprint system. All patients had intima-media thickness (IMT) measured. RESULTS Statistically significant differences in subfractions between control and study group were observed in case of: HDL1 (p < 0.0001), HDL2 (p = 0.009), HDL3 (p < 0.0001), HDL4 (p = 0.003), HDL5 (p = 0.01), HDL7 (p < 0.0001), HDL8 (p < 0.0001), HDL9 (p < 0.0001), HDL10 (p < 0.0001), large HDL (p < 0.0001), HDL Small (p < 0.0001) as well as IDL-B (p = 0.014), IDLA (p = 0.011), LDL2 (p = 0.007). Significant differences were also observed in HDL and LDL subfraction distribution between haemodialysis patients with normal and increased IMT: HDL6 (p = 0.020), HDL Large (HDL1-3) (p = 0.017), HDL Intermediate (HDL4-7) (p = 0.017). CONCLUSIONS This study revealed that ESRD influenced HDL subfractions. In HD patients, large HDL subfractions are more abundant while small HDL fraction is more frequent in healthy persons. It failed to show the influence of end-stage disease on LDL subfraction levels. Shift in HDL subfractions might be responsible for the increased risk of atherosclerosis in CKD patients.
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Anti-arthritogenic and cardioprotective action of hesperidin and daidzein in collagen-induced rheumatoid arthritis. Mol Cell Biochem 2016; 423:115-127. [PMID: 27704466 DOI: 10.1007/s11010-016-2830-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/22/2016] [Indexed: 12/12/2022]
Abstract
Atherosclerosis has been linked to chronic inflammatory processes. Changes in the levels of lipoproteins, especially low-density lipoprotein or its variants, as well as inflammatory markers are risk factors for the atherosclerosis. In the present study, an experimental model of rheumatoid arthritis was developed by administrating collagen suspension intradermally in the tail region of Wistar albino rats. At the same time, a suspension of hesperidin (50 mg/kg body weight) and daidzein (20 mg/kg body weight) was orally administrated. The compounds were given in the morning and evening for 21 days. Levels of inflammatory markers in the homogenate of knee joints of experimental rats as well as plasma lipoproteins were investigated. The administration of hesperidin and daidzein caused significant (p < 0.001) decrease in articular elastase activity, TNF-α, and malondialdehyde levels. Further, arthritis scoring and histological findings supported the anti-inflammatory actions of the test compounds. Interestingly, the test compounds also lowered the plasma low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, and triglyceride but increased the level of high-density lipoprotein cholesterol. The test compounds thus ameliorated the risk factors of atherosclerosis. Furthermore, antioxidant roles of hesperidin as well as daidzein were evident from decrease in free radical load demonstrated as increase in total antioxidant level in plasma of arthritic animals treated with hesperidin and daidzein. In a separate in vitro experiment, enhanced free radical scavenging activity of hesperidin was demonstrated against 2,2-diphenyl-1-picrylhydrazyl and 2,2-azinobis-3-ethylbenzothiazoline-6-sulfonic acid. The anti-inflammatory, hypolipidemic, and antioxidant actions of the naturally occurring test compounds, particularly hesperidin, seem to be quite effective against rheumatoid arthritis and atherosclerosis. Thus, their consumption may be helpful in prevention or at least delaying the onset of these diseases in susceptible individuals.
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Bando Y, Tohyama H, Aoki K, Kanehara H, Hisada A, Okafuji K, Toya D. Ipragliflozin lowers small, dense low-density lipoprotein cholesterol levels in Japanese patients with type 2 diabetes mellitus. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2016; 6:1-7. [PMID: 29067237 PMCID: PMC5644427 DOI: 10.1016/j.jcte.2016.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 05/14/2016] [Accepted: 06/13/2016] [Indexed: 02/06/2023]
Abstract
Small dense LDL-C (sd LDL-C) convey cardiovascular risk in type 2 diabetes (T2D). Ipragliflozin reduced sd LDL-C levels in Japanese patients with T2D. Changes in body weight, TG and LDL-C levels contributed to sd LDL-C reduction.
Aims This preliminary randomized, parallel-group comparative study evaluated the efficacy of ipragliflozin for reduction of small dense low-density lipoprotein cholesterol (sd LDL-C) levels in Japanese patients with type 2 diabetes mellitus (T2DM). Methods Sixty-two patients with T2DM (age, 56 ± 8 years; hemoglobin A1c levels, 8.1 ± 0.9%; BMI, 27.5 ± 3.3 kg/m2) were randomly assigned in a 2:1 ratio to receive ipragliflozin (50 mg/day) (treatment group; n = 40) or continued treatment (control group; n = 22) for 12 weeks. The primary endpoints were changes in sd LDL-C levels detected using the LipoPhor AS® system; the secondary endpoints included changes in the sd LDL-C/large buoyant LDL-C (lb LDL-C) ratio, a surrogate marker for LDL particle size, and percent changes in routine lipid parameters. Results The treatment group exhibited a statistically significant reduction from baseline for LDL-C levels (−0.37 mg/dL vs. 14.4 mg/dL, p = 0.038), sd LDL-C levels (−1.28 mg/dL vs. 2.81 mg/dL, p = 0.012), and sd LDL-C/lb LDL-C ratio (−3.20% vs. 4.58%, p = 0.040) compared with the control group. Multiple regression analysis among all subjects revealed change in TG levels (p = 0.011) and LDL-C levels (p = 0.024) as well as change in body weight (p = 0.006) as independent factors contributing to the reduction in sd LDL-C. Conclusions Ipragliflozin may have a potential for lowering sd LDL-C levels associated with increasing LDL particle size in Japanese patients with T2DM.
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Affiliation(s)
- Yukihiro Bando
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Hitomi Tohyama
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Keiko Aoki
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Hideo Kanehara
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Azusa Hisada
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Kazuhiro Okafuji
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Daisyu Toya
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
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Moriyama K, Takahashi E. Non-HDL Cholesterol is a More Superior Predictor of Small-Dense LDL Cholesterol than LDL Cholesterol in Japanese Subjects with TG Levels <400 mg/dL. J Atheroscler Thromb 2016; 23:1126-37. [PMID: 27001003 PMCID: PMC5090818 DOI: 10.5551/jat.33985] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aim: The Japan Atherosclerosis Society (JAS) guidelines for the diagnosis and treatment of hyperlipidemia in Japanese adults recommend using low-density lipoprotein cholesterol (LDL-C) calculated by Friedewald formula (F_LDL-C) for subjects with triglyceride (TG) levels <400 mg/dL and non-high-density lipoprotein cholesterol (non-HDL-C) levels for subjects with TG levels ≥400 mg/dL. Because small-dense LDL particles are more atherogenic than large LDL particles, we sought the better lipid parameter which was more reflective of the high small-dense LDL-C (sdLDL-C) levels in subjects with TG levels <400 mg/dL. Methods: This study included 769 Japanese subjects who met our inclusion criteria and underwent an annual health examination, including sdLDL-C analyses. Results: The correlation coefficient of non-HDL-C for sdLDL-C (r = 0.760) was significantly higher than that of F_LDL-C (r = 0.601). The area under the curve (95% confidence interval) was 0.771 (0.731, 0.811) for F_LDL-C and 0.871 (0.842, 0.901) for non HDL-C, which showed significantly higher predictive value for more than fourth quartile value of sdLDL-C (46 mg/dL). The optimal cut-off point of non-HDL-C was 158 mg/dL. Even in subjects stratified by waist circumstance, homeostasis model assessment of insulin resistance, TG, and F_LDL-C levels and non-HDL-C showed stronger relationships with sdLDL-C than F_LDL-C. Moreover, non-HDL-C showed a better relationship with sdLDL-C than total cholesterol (TC), TC/HDL-C, and non-HDL-C/HDL-C. Conclusion: Our data suggested that non-HDL-C is superior to F_LDL-C and one of the reliable surrogate lipid markers of sdLDL-C in Japanese subjects with TG levels <400 mg/dL.
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Affiliation(s)
- Kengo Moriyama
- Department of Clinical Health Science, Tokai University School of Medicine, Tokyo, Japan
| | - Eiko Takahashi
- Department of Clinical Health Science, Tokai University School of Medicine, Tokyo, Japan
- Address for correspondence: Eiko Takahashi, Department of Clinical Health Science, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan (Health Evaluation and Promotion Center, Tokai University Hachioji Hospital) E-mail:
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Shimada A, Kimura H, Oida K, Kanehara H, Bando Y, Sakamoto S, Wakasugi T, Saga T, Ito Y, Kamiyama K, Mikami D, Iwano M, Hirano T, Yoshida H. Serum CETP status is independently associated with reduction rates in LDL-C in pitavastatin-treated diabetic patients and possible involvement of LXR in its association. Lipids Health Dis 2016; 15:57. [PMID: 26984517 PMCID: PMC4794860 DOI: 10.1186/s12944-016-0223-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 03/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Statins decrease cholesteryl ester transfer protein (CETP) levels, which have been positively associated with hepatic lipid content as well as serum low density lipoproteins-cholesterol (LDL-C) levels. However, the relationship between the CETP status and statin-induced reductions in LDL-C levels has not yet been elucidated in detail. We herein examined the influence of the CETP status on the lipid-reducing effects of pitavastatin in hypercholesterolemic patients with type 2 diabetes mellitus as well as the molecular mechanism underlying pitavastatin-induced modifications in CETP levels. METHODS Fifty-three patients were treated with 2 mg of pitavastatin for 3 months. Serum levels of LDL-C, small dense (sd) LDL-C, and CETP were measured before and after the pitavastatin treatment. The effects of pitavastatin, T0901317, a specific agonist for liver X receptor (LXR) that reflects hepatic cholesterol contents, and LXR silencing on CETP mRNA expression in HepG2 cells were also examined by a real-time PCR assay. RESULTS The pitavastatin treatment decreased LDL-C, sdLDL-C, and CETP levels by 39, 42, and 23%, respectively. Despite the absence of a significant association between CETP and LDL-C levels at baseline, baseline CETP levels and its percentage change were an independent positive determinant for the changes observed in LDL-C and sdLDL-C levels. The LXR activation with T0901317 (0.5 μM), an in vitro condition analogous to hepatic cholesterol accumulation, increased CETP mRNA levels in HepG2 cells by approximately 220%, while LXR silencing markedly diminished the increased expression of CETP. Pitavastatin (5 μM) decreased basal CETP mRNA levels by 21%, and this was completely reversed by T0901317. CONCLUSION Baseline CETP levels may predict the lipid-reducing effects of pitavastatin. Pitavastatin-induced CETP reductions may be partially attributed to decreased LXR activity, predictable by the ensuing decline in hepatic cholesterol synthesis. TRIAL REGISTRATION UMIN Clinical Trials Registry ID UMIN000019020.
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Affiliation(s)
- Akihiro Shimada
- Department of Clinical Laboratory and Nephrology, University of Fukui Hospital, 23-3 Matsuoka-shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan
| | - Hideki Kimura
- Department of Clinical Laboratory and Nephrology, University of Fukui Hospital, 23-3 Matsuoka-shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan.
| | - Koji Oida
- Division of Internal Medicine, Fukui Chuo Clinic, 4-5-10, Matsumoto, Fukui, 910-0003, Japan
| | - Hideo Kanehara
- Division of Endocrinology, Fukui-ken Saiseikai Hospital, 7-1, Funahashi, Wadanaka, 918-8503, Japan
| | - Yukihiro Bando
- Division of Endocrinology, Fukui-ken Saiseikai Hospital, 7-1, Funahashi, Wadanaka, 918-8503, Japan
| | - Shinobu Sakamoto
- Division of Internal Medicine, Yasukawa Hospital, 2-108, Owada, Fukui, 910-0005, Japan
| | - Takanobu Wakasugi
- Division of Endocrinology, Fukui Prefectural Hospital, 2-8-1, Yotsui, Fukui, 910-8526, Japan
| | - Takashi Saga
- Division of Internal Medicine, Tanaka Hospital, 2-3-1 Ohte, Fukui, Fukui, 910-0005, Japan
| | - Yasuki Ito
- Research and Development Department, Denka Seiken Co. Ltd, Tokyo, Japan
| | - Kazuko Kamiyama
- Division of Nephrology, Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan
| | - Daisuke Mikami
- Division of Nephrology, Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan
| | - Masayuki Iwano
- Division of Nephrology, Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan
| | - Tsutomu Hirano
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Haruyoshi Yoshida
- Division of Nephrology, Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan.,Division of Nephrology, Obama Municipal Hospital, 2-2 Ohte, Obama, Fukui, 917-8567, Japan
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Brinton EA. Management of Hypertriglyceridemia for Prevention of Atherosclerotic Cardiovascular Disease. Endocrinol Metab Clin North Am 2016; 45:185-204. [PMID: 26893005 DOI: 10.1016/j.ecl.2015.09.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mendelian randomization data strongly suggest that hypertriglyceridemia (HTG) causes atherosclerotic cardiovascular disease (ASCVD), and so triglyceride (TG) level-lowering treatment in HTG is now more strongly recommended to address the residual ASCVD risk than has been the case in (generally earlier) published guidelines. Fibrates are the best-established agents for TG level lowering and are generally used as first-line treatment of TG levels greater than 500 mg/dL. Statins are the best-established agents for ASCVD prevention, and so are usually used as first-line treatment of TG levels less than 500 mg/dL.
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Affiliation(s)
- Eliot A Brinton
- Atherometabolic Research, Utah Foundation for Biomedical Research, 419 Wakara Way, Suite 211, Salt Lake City, UT 84108, USA.
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Bando Y, Toyama H, Kanehara H, Hisada A, Okafuji K, Toya D, Tanaka N. Switching from atorvastatin to rosuvastatin lowers small, dense low-density lipoprotein cholesterol levels in Japanese hypercholesterolemic patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2016; 111:66-73. [PMID: 26589368 DOI: 10.1016/j.diabres.2015.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 10/09/2015] [Accepted: 10/09/2015] [Indexed: 11/21/2022]
Abstract
AIMS This open-label, randomized, parallel-group comparative study compared the efficacy of rosuvastatin (5mg/day) and atorvastatin (10mg/day) for reduction of small dense low-density lipoprotein cholesterol (sd LDL-C) levels in Japanese patients with type 2 diabetes mellitus (T2DM). METHODS Patients with T2DM and hypercholesterolemia with detectable sd LDL-C after receiving 10mg/day atorvastatin for ≥ 24 weeks were randomly assigned to receive rosuvastatin (5mg/day; switched treatment) or atorvastatin (10mg/day; continued treatment) for 12 weeks. The primary endpoints were changes in sd LDL-C levels and sd LDL-C/total LDL-C ratio evaluated using the LipoPhor AS(®) system. RESULTS There were no significant percent changes from baseline for LDL-C levels between the switched (n=55) and the continued treatment group (n=56). However, the former group exhibited a statistically significant reduction from baseline of sd LDL-C levels, sd LDL-C/total LDL-C ratio compared with the latter group (-3.8 mg/dL vs. -1.4 mg/dL, p=0.014; -2.3% vs. -0.6%, p=0.004, respectively). Multiple regression analysis among all subjects revealed that independent factors contributing to the reduction in sd LDL-C levels were a change in LDL-C (p=0.003) and triglyceride (TG) levels (p=0.006), treatment group (the switched group=1, the continued group=0; standard coefficient=-1.2, p=0.034) and baseline glycated hemoglobin A1c (HbA1c) (p=0.045), respectively. CONCLUSION Switching from 10mg atorvastatin to 5mg rosuvastatin may be a useful therapeutic option to reduce sd LDL-C levels in Japanese hypercholesterolemic patients with T2DM.
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Affiliation(s)
- Yukihiro Bando
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan.
| | - Hitomi Toyama
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Hideo Kanehara
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Azusa Hisada
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Kazuhiro Okafuji
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Daisyu Toya
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
| | - Nobuyoshi Tanaka
- Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Fukui Prefecture, Japan
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Tsujita K, Sugiyama S, Shimomura H, Yamanaga K, Kaikita K, Hokimoto S, Ogawa H. Reply: Intriguing Off-Target Effects of Ezetimibe. J Am Coll Cardiol 2015; 66:2808-2809. [PMID: 26700842 DOI: 10.1016/j.jacc.2015.09.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/08/2015] [Indexed: 11/15/2022]
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Shen H, Xu L, Lu J, Hao T, Ma C, Yang H, Lu Z, Gu Y, Zhu T, Shen G. Correlation between small dense low-density lipoprotein cholesterol and carotid artery intima-media thickness in a healthy Chinese population. Lipids Health Dis 2015; 14:137. [PMID: 26510458 PMCID: PMC4625741 DOI: 10.1186/s12944-015-0143-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 10/23/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Small dense low-density lipoprotein cholesterol (sdLDL-C) concentration was useful in the assessment of the presence of cardiovascular diseases (CVD) and its severity. We examined whether SdLDL-C is more closely associated with carotid artery intima-media thickness (CA-IMT), a surrogate measure of atherosclerosis, than LDL-C and traditional CVD risk factors in Chinese healthy subjects. METHODS We measured CA-IMT, blood pressure (BP), sdLDL-C, glucose metabolism and lipid in 183 native Chinese healthy subjects. CA-IMT was assessed by ultrasonography, and sdLDL-C concentrations were measured by a homogenous assay. Pearson's correlation coefficient analyses and Multiple regression analyses were used to examine the relationships between CA-IMT values and other clinical variables. RESULTS The sdLDL-C level was significantly higher in males than in females (p <0.05) and there was an age effect on sdLDL-C (p <0.05). When the effects of age, gender and other traditional CVD risk factors were adjusted using multiple regression analysis. CA-IMT remained significantly associated with sdLDL-C(β = 0.437, p <0.001). CONCLUSIONS There are gender and age differences in sdLDL-C levels among a healthy Chinese population. Moreover, we found adjusted traditional CVD risk factors such as higher age, male sex, and other traditional CVD risk factors, the association between CA-IMT and SdLDL-C remained significant. sdLDL-C is may be a useful predictor in the assessment of CA-IMT in Chinese population.
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Affiliation(s)
- Hao Shen
- Department of Clinical Laboratory Medicine, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Li Xu
- Department of General Surgery, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Jingfen Lu
- Department of Clinical Laboratory Medicine, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Tianbo Hao
- Department of Clinical Laboratory Medicine, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Chunfang Ma
- Department of Clinical Laboratory Medicine, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Honglin Yang
- Department of Clinical Laboratory Medicine, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Zhaoyang Lu
- Department of Ultrasonography, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Yongchun Gu
- Department of Central Laboratory, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Tonghua Zhu
- Department of Clinical Laboratory Medicine, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
| | - Guorong Shen
- Department of Clinical Laboratory Medicine, The First People's Hospital of Wujiang, Affliated Wujiang Hospital of Nantong University, Suzhou, China.
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Sakamoto K, Kawamura M, Kohro T, Omura M, Watanabe T, Ashidate K, Horiuchi T, Hara H, Sekine N, Chin R, Tsujino M, Hiyoshi T, Tagami M, Tanaka A, Mori Y, Inazawa T, Hirano T, Yamazaki T, Shiba T. Effect of Ezetimibe on LDL-C Lowering and Atherogenic Lipoprotein Profiles in Type 2 Diabetic Patients Poorly Controlled by Statins. PLoS One 2015; 10:e0138332. [PMID: 26398887 PMCID: PMC4580589 DOI: 10.1371/journal.pone.0138332] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 08/28/2015] [Indexed: 12/30/2022] Open
Abstract
Background There exists a subpopulation of T2DM in whom first-line doses of statin are insufficient for optimally reducing LDL-C, representing a major risk of CVD. The RESEARCH study focuses on LDL-C reduction in this population along with modifications of the lipid profiles leading to residual risks. Methods Lipid changes were assessed in a randomized, multicenter, 12-week, open-label study comparing a high-potency statin (10mg of atorvastatin or 1mg of pitavastatin) plus ezetimibe (EAT: n = 53) with a double dose of statin (20mg of atorvastatin or 2mg of pitavastatin) (DST: n = 56) in DM subjects who had failed to achieve the optimal LDL-C targets. Lipid variables were compared with a primary focus on LDL-C and with secondary focuses on the percentage of patients who reached the LDL-C targets and changes in the levels of RLP-C (remnant like particle cholesterol) and sd-LDL-C, two characteristic atherogenic risks of DM. Results The reduction of LDL-C (%), the primary endpoint, differed significantly between the two groups (-24.6 in EAT vs. -10.9 in DST). In the analyses of the secondary endpoints, EAT treatment brought about significantly larger reductions in sd-LDL-C (-20.5 vs. -3.7) and RLP-C (-19.7 vs. +5.5). In total, 89.4% of the patients receiving EAT reached the optimized treatment goal compared to 51.0% of the patients receiving DST. The changes in TC (-16.3 vs. -6.3) and non-HDL-C (-20.7 vs. -8.3) differed significantly between the two groups. Conclusion Ezetimibe added to high-potency statin (10 mg of atorvastatin or 1 mg of pitavastatin) was more effective than the intensified-dose statin (20 mg of atorvastatin or 2 mg of pitavastatin) treatment not only in helping T2DM patients attain more LDL-C reduction, but also in improving their atherogenic lipid profiles, including their levels of sd-LDL-C and RLP-C. We thus recommend the addition of ezetimibe to high-potency statin as a first line strategy for T2DM patients with insufficient statin response. Trial Registration The UMIN Clinical Trials Registry UMIN000002593
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Affiliation(s)
- Kentaro Sakamoto
- Toho University Ohashi Medical Center, Department of Diabetes and Metabolism, Tokyo, Japan
| | - Mitsunobu Kawamura
- Tokyo Teishin Hospital, Division of Endocrinology and Metabolism Department of Internal Medicine, Tokyo, Japan
| | - Takahide Kohro
- Jichi Medical University, Department of Medical Informatics / Cardiology, Tochigi, Japan
| | - Masao Omura
- Yokohama Rosai Hospital, Department of Endocrinology and Metabolism, Kanagawa, Japan
| | - Takayuki Watanabe
- Yokohama City Minato Red Cross Hospital, Department of Internal Medicine, Kanagawa, Japan
| | - Keiko Ashidate
- Kudanzaka Hospital, Department of Internal Medicine, Tokyo, Japan
| | - Toshiyuki Horiuchi
- Tokyo Metropolitan Health Medical Treatment Corporation Toshima Hospital, Department of Endocrinology and Metabolism, Tokyo, Japan
| | - Hidehiko Hara
- Toho University Ohashi Medical Center, Department of Cardiology, Tokyo, Japan
| | - Nobuo Sekine
- Tokyo Koseinenkin Hospital, Department of Internal Medicine, Tokyo, Japan
| | - Rina Chin
- Tokyo Kyosai Hospital, Department of Internal Medicine, Tokyo, Japan
| | - Motoyoshi Tsujino
- Tokyo Metropolitan Tama Medical Center, Department of Internal Medicine, Tokyo, Japan
| | | | - Motoki Tagami
- Sanraku Hospital, Life-style related Disease Clinic, Tokyo, Japan
| | - Akira Tanaka
- Kagawa Nutrition University, Nutrition Clinic, Tokyo, Japan
| | - Yasumichi Mori
- Toranomon Hospital, Department of Endocrinology and Metabolism, Tokyo, Japan
| | | | - Tsutomu Hirano
- Showa University School of Medicine, Department of Medicine Division of Diabetes Metabolism and Endocrinology, Tokyo, Japan
| | - Tsutomu Yamazaki
- The University of Tokyo Hospital, Clinical Research Support Center, Tokyo, Japan
| | - Teruo Shiba
- Toho University Ohashi Medical Center, Department of Diabetes and Metabolism, Tokyo, Japan
- Mitsui Memorial Hospital, Division of Diabetes and Metabolism, Tokyo Japan
- * E-mail:
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Okada K, Hibi K, Gohbara M, Kataoka S, Takano K, Akiyama E, Matsuzawa Y, Saka K, Maejima N, Endo M, Iwahashi N, Tsukahara K, Kosuge M, Ebina T, Fitzgerald PJ, Honda Y, Umemura S, Kimura K. Association between blood glucose variability and coronary plaque instability in patients with acute coronary syndromes. Cardiovasc Diabetol 2015; 14:111. [PMID: 26289581 PMCID: PMC4546046 DOI: 10.1186/s12933-015-0275-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 08/08/2015] [Indexed: 11/10/2022] Open
Abstract
Background Blood glucose variability is receiving considerable attention as a new risk factor for coronary artery disease. This study aimed to investigate the association between blood glucose variability and coronary plaque tissue characteristics. Methods In 57 patients with acute coronary syndrome, integrated backscatter intravascular ultrasound (IB-IVUS) and gray-scale IVUS were performed before balloon dilatation or stent implantation in the culprit vessels. Standard IVUS indices were evaluated for volume index (volume/length), and plaque components were measured by IB-IVUS for percent tissue volume. In addition to conventional glucose indicators, blood glucose variability in a stable state was determined by calculating the mean amplitude of glycemic excursions (MAGE) using a continuous glucose monitoring system. Results Higher MAGE values were significantly correlated with larger percent plaque volumes (r = 0.32, p = 0.015), and increased lipid (r = 0.44, p = 0.0006) and decreased fibrous (r = −0.45, p = 0.0005) plaque components. In contrast, HbA1c or fasting plasma glucose values were not significantly correlated with plaque volumes and percent plaque components. Homeostasis model assessment of insulin resistance values were positively correlated with vessel (r = 0.35, p = 0.007) and plaque (r = 0.27, p = 0.046) volumes, but not with percent plaque components. In multiple regression analysis, higher MAGE values were independently associated with increased lipid (β = 0.80, p = 0.0035) and decreased fibrous (β = -0.79, p = 0.0034) contents in coronary plaques. Conclusions Among all glucose indicators studied, only higher blood glucose variability was an independent determinant of increased lipid and decreased fibrous contents with larger plaque burden, suggesting blood glucose variability as one of the important factors related to coronary plaque vulnerability.
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Affiliation(s)
- Kozo Okada
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Masaomi Gohbara
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Shunsuke Kataoka
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Keiko Takano
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Eiichi Akiyama
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Yasushi Matsuzawa
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Kenichiro Saka
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Nobuhiko Maejima
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Mitsuaki Endo
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Noriaki Iwahashi
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Kengo Tsukahara
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Toshiaki Ebina
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Peter J Fitzgerald
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, USA.
| | - Yasuhiro Honda
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, USA.
| | - Satoshi Umemura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
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Manabe Y, Morihara R, Matsuzono K, Nakano Y, Takahashi Y, Narai H, Omori N, Abe K. Estimation of the Presence of Small Dense Lipoprotein Cholesterol in Acute Ischemic Stroke. Neurol Int 2015; 7:5973. [PMID: 26294946 PMCID: PMC4508545 DOI: 10.4081/ni.2015.5973] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 05/13/2015] [Indexed: 12/04/2022] Open
Abstract
Small dense low-density lipoprotein (sdLDL) is an established risk factor in ischemic heart disease. However, its clinical significance in acute ischemic stroke (AIS) is uncertain. This study evaluates the prognostic value of the presence of sdLDL in patients with AIS by determining whether it contributes to clinical outcome or not. We studied 530 consecutive patients admitted within the first 48 hours after onset of ischemic stroke and 50 corresponding controls. Serum lipid parameters were measured on admission by standard laboratory methods. The percentage of AIS patients with sdLDL was significantly higher than the one of matched controls with sdLDL. Concerning comparisons between AIS patients with or without sdLDL, the percentages of males and patients with histories of smoking, hypertension, and cardiovascular disease were significantly higher in AIS patients with sdLDL. Concerning the grade of severity, modified Rankin Scale (mRS) on discharge was significantly higher in AIS patients with sdLDL. On logistic regression analysis, age (OR=2.29, P<0.001), male gender (OR=0.49, P<0.01), history of atrial fibrillation (OR=3.46, P<0.001), and the presence of sdLDL (OR=1.59, P<0.05) were significantly associated with poor prognosis (mRS on discharge >3). Our study showed that the presence of sdLDL might be independently associated with a poor prognosis after AIS.
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Affiliation(s)
- Yasuhiro Manabe
- Department of Neurology, National Hospital Organization Okayama Medical Center , Japan
| | - Ryuta Morihara
- Department of Neurology, National Hospital Organization Okayama Medical Center , Japan
| | - Kosuke Matsuzono
- Department of Neurology, National Hospital Organization Okayama Medical Center , Japan
| | - Yumiko Nakano
- Department of Neurology, National Hospital Organization Okayama Medical Center , Japan
| | - Yoshiaki Takahashi
- Department of Neurology, National Hospital Organization Okayama Medical Center , Japan
| | - Hisashi Narai
- Department of Neurology, National Hospital Organization Okayama Medical Center , Japan
| | - Nobuhiko Omori
- Department of Neurology, National Hospital Organization Okayama Medical Center , Japan
| | - Koji Abe
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science , Japan
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Oztas E, Caglar GS, Kaya C, Karadag D, Demirtas S, Kurt M, Pabuccu R. Association of anti-Mullerian hormone and small-dense low-density lipoprotein cholesterol with hepatosteatosis in young lean women with and without polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2015; 182:240-6. [PMID: 25632415 DOI: 10.1016/j.ejogrb.2014.09.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To study the association of anti-Mullerian hormone (AMH) and small-dense low-density lipoprotein cholesterol (sd-LDL) with hepatosteatosis among young, lean, polycystic ovary patients. STUDY DESIGN A prospective, case control study was carried out including 79 young lean women. Fifty-eight women with polycystic ovary syndrome (PCOS) and 21 age-and BMI-matched healthy controls were recruited. Anthropometric variables, biochemical and hormonal parameters, insulin-resistance indices, lipid profiles including sd-LDL levels and serum AMH levels were determined. Hepatic lipid content was evaluated by abdominal ultrasonography (USG). Determining the best predictor(s) which discriminate normal USG and hepatosteatosis was analyzed by multiple logistic regression analyses. Adjusted odds ratios and 95% confidence intervals were also calculated. RESULTS PCOS patients had an increased prevalence of hepatosteatosis by 41.4% (P = 0.006) and they had significantly higher levels of sd-LDL and AMH when compared with the control group (P < 0.001). AMH and sd-LDL levels were positively and significantly associated with hepatosteatosis in young lean women with and without PCOS (OR: 2.877, 95%CI: 1.453-5.699, P: 0.02 and OR: 1.336, 95%CI: 1.083-1.648, P: 0.007, respectively). AMH and sd-LDL levels were positively correlated in PCOS patients (r = 0.626, P < 0.001). Both sd-LDL and AMH levels were the most predictive parameters for the determination of hepatosteatosis within the PCOS group. (OR: 3.347, 95%CI: 1.348-8.313, P = 0.009 and OR: 1.375, 95%CI: 1.072-1.764, P = 0.012, respectively). Statistically significant higher levels of AMH were associated with hepatosteatosis both in insulin resistance (IR) positive and IR negative PCOS patients (P < 0.001). CONCLUSION Hepatosteatosis is common in young lean PCOS patients. Increased AMH and sd-LDL levels may independently predict hepatosteatosis in young lean women with and without PCOS.
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Brinton EA. Management of Hypertriglyceridemia for Prevention of Atherosclerotic Cardiovascular Disease. Cardiol Clin 2015; 33:309-23. [DOI: 10.1016/j.ccl.2015.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hirose T, Teramoto T, Abe K, Taneyama T. Determinants of Bezafibrate-induced Improvements in LDL Cholesterol in Dyslipidemic Patients with Diabetes. J Atheroscler Thromb 2015; 22:676-84. [PMID: 25752494 DOI: 10.5551/jat.27425] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Our previous "J-BENEFIT (Japan BEzafibrate cliNical EFfectIveness and Tolerability)" study demonstrated that bezafibrate improves blood lipid profiles and glucose control in dyslipidemic patients with diabetes. However, bezafibrate did not significantly improve low-density lipoprotein cholesterol (LDL-C), although some patients showed decreases while others showed increases in the LDL-C levels. Therefore, a subgroup analysis of the J-BENEFIT study was conducted to identify factors influencing the bezafibrate-induced changes in the LDL-C levels. METHODS Of the 3,316 patients in the J-BENEFIT study, 2,116 not treated with other lipid-lowering drugs were enrolled in the current study, and the effects of 24-week treatment with bezafibrate on the LDL-C levels were analyzed. A reduction in the LDL-C level of ≥ 25% occurred in 253 patients, and a logistic-regression analysis was used to identify factors associated with this improvement. RESULTS Among the 2,116 overall patients, bezafibrate treatment significantly increased the LDL-C levels from 123.9±36.7 to 125.7±31.3 mg/dL. The subanalysis showed that the treatment responses varied according to the baseline LDL-C level, with significant decreases in the ≥ 160 and ≥ 140-<160 mg/dL groups, no significant decrease in the ≥ 120-<140 mg/dL group and a significant increase in the <120 mg/dL group. A multivariate logistic-regression analysis of the data for the patients with an LDL-C of ≥ 25% identified a female sex, the use of anti-hypertensive and hypoglycemic agents and a high baseline LDL-C level to be significant determinants of the LDL-C response to bezafibrate. CONCLUSIONS Our results showed that treatment with bezafibrate improves the LDL-C levels and lipid profiles in dyslipidemic diabetic patients, especially women, subjects co-treated with anti-hypertensive or hypoglycemic agents and those with high baseline LDL-C levels.
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Affiliation(s)
- Takahisa Hirose
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University School of Medicine
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