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Bamba H, Singh G, John J, Inban P, Prajjwal P, Alhussain H, Marsool MDM. Precision Medicine Approaches in Cardiology and Personalized Therapies for Improved Patient Outcomes: A systematic review. Curr Probl Cardiol 2024; 49:102470. [PMID: 38369209 DOI: 10.1016/j.cpcardiol.2024.102470] [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: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
Personalized medicine is a novel and rapidly evolving approach to clinical practice that involves making decisions about disease prediction, prevention, diagnosis, and treatment by utilizing modern technologies. The concepts of precision medicine have grown as a result of ongoing developments in genomic analysis, molecular diagnostics, and technology. These advancements have enabled a deeper understanding and interpretation of the human genome, allowing for a personalized approach to clinical care. The primary objective of this research is to assess personalized medicine in terms of its indications, advantages, practical clinical uses, potential future directions, problems, and effects on healthcare. An extensive analysis of the scientific literature regarding this topic demonstrated the new medical approach's relevance and usefulness, as well as the fact that personalized medicine is becoming increasingly prevalent in various sectors. The online, internationally indexed databases PubMed and Cochrane Reviews were used to conduct searches for and critically evaluate the most relevant published research including original papers and reviews in the scientific literature. The findings suggest that precision medicine has a lot of potential and its implementation lowers the incidence of stroke as well as coronary heart disease and improves patient health in cardiology.
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Affiliation(s)
- Hyma Bamba
- Cardiology, Government Medical College and Hospital, Chandigarh, India
| | - Gurmehar Singh
- Cardiology, Government Medical College and Hospital, Chandigarh, India
| | - Jobby John
- Cardiology, Dr. Somervell Memorial CSI Medical College and Hospital Karakonam, Trivandrum, India
| | | | | | - Haitham Alhussain
- Public Health and Infection Control dept, King Fahad Hospital, Alhofuf, Saudi Arabia
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Fu C, Liu D, Liu Q, Wang X, Ma X, Pan H, Feng S, Sun Z, Qiao W, Yang M, Gao S, Ding H, Huang X, Hou J. Revisiting an old relationship: the causal associations of the ApoB/ApoA1 ratio with cardiometabolic diseases and relative risk factors-a mendelian randomization analysis. Cardiovasc Diabetol 2024; 23:51. [PMID: 38310324 PMCID: PMC10838437 DOI: 10.1186/s12933-024-02140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND It has been confirmed that the ApoB/ApoA1 ratio is closely associated with the incidence of cardiometabolic diseases (CMD). However, due to uncontrolled confounding factors in observational studies, the causal relationship of this association remains unclear. METHODS In this study, we extracted the ApoB/ApoA1 ratio and data on CMD and its associated risk factors from the largest European Genome-Wide Association Study. The purpose was to conduct Mendelian Randomization (MR) analysis. The causal relationship between the ApoB/ApoA1 ratio and CMD was evaluated using both univariable and multivariable MR analyses. Furthermore, bidirectional MR analysis was performed to estimate the causal relationship between the ApoB/ApoA1 ratio and risk factors for CMD. The final verification confirmed whether the ApoB/ApoA1 ratio exhibits a mediating effect in CMD and related risk factors. RESULTS In terms of CMD, a noteworthy correlation was observed between the increase in the ApoB/ApoA1 ratio and various CMD, including ischemic heart disease, major adverse cardiovascular events, aortic aneurysm, cerebral ischemic disease and so on (all PFDR<0.05). Meanwhile, the ApoB/ApoA1 ratio was significantly associated with CMD risk factors, such as hemoglobin A1c, fasting insulin levels, waist-to-hip ratio, sedentary behavior, and various others, demonstrating a notable causal relationship (all PFDR<0.05). Additionally, the ApoB/ApoA1 ratio played a mediating role in CMD and relative risk factors. CONCLUSIONS This MR study provides evidence supporting the significant causal relationship between the ApoB/ApoA1 ratio and CMD and its risk factors. Moreover, it demonstrates the mediating effect of the ApoB/ApoA1 ratio in CMD and its risk factors. These findings suggest that the ApoB/ApoA1 ratio may serve as a potential indicator for identifying the risk of developing CMD in participants.
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Affiliation(s)
- Chao Fu
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Dongbo Liu
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Qi Liu
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Xuedong Wang
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Xiaoxue Ma
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Hong Pan
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Shi Feng
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Zhao Sun
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Weishen Qiao
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Mengyue Yang
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Shuang Gao
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Hongyu Ding
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China
| | - Xingtao Huang
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China.
| | - Jingbo Hou
- Department of Cardiology, The Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, Heilongjiang Province, China.
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Pirillo A, Catapano AL. How to Handle Elevated Triglycerides: Life after PROMINENT. Curr Atheroscler Rep 2023; 25:921-929. [PMID: 38114852 DOI: 10.1007/s11883-023-01175-2] [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] [Accepted: 11/18/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE OF REVIEW Hypertriglyceridaemia (HTG) is a common condition characterised by elevated levels of plasma triglycerides (TG), which are transported in the blood mainly by TG-rich lipoproteins (TRL). Elevated TG levels (150-400 mg/dL) are associated with increased cardiovascular risk. Severe HTG (>880 mg/dL) is associated with a risk of acute pancreatitis only. Randomised clinical trials investigating the clinical benefit of TG-lowering drugs in patients with elevated TG levels have provided conflicting results. RECENT FINDINGS Elevated TG levels are only one marker of altered lipid/lipoprotein metabolism and indeed reflect altered concentrations of one or more classes or subfractions of TRL, which in turn may have a different association with CV risk. Fibrates, the drugs most commonly used to treat HTG, provide cardiovascular benefits to only a specific subgroup of patients. The lack of clinical benefit from pemafibrate has emphasised the concept that lowering TG levels is not sufficient to reduce the CV risk unless it is accompanied by a reduction in the number of circulating atherogenic lipoproteins, which can be assessed by determining apolipoprotein B levels. Treatment with omega-3 fatty acids was also ineffective in reducing CV risk, with the exception of icosapent ethyl, which, however, appears to have beneficial effects beyond lipids. New drugs are currently being developed that aim to lower TG levels by targeting apolipoprotein C-III or angiopoietin-like-3, both of which are involved in the metabolism of TGs. TG reduction can be achieved by various drugs, but most of them are ineffective in reducing CV risk. The results of outcome studies on new TG-lowering drugs will clarify whether lowering apoB levels is critical to achieve clinical benefit.
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Affiliation(s)
- Angela Pirillo
- Center for the Study of Atherosclerosis, E. Bassini Hospital, Cinisello Balsamo, Milan, Italy
| | - Alberico L Catapano
- IRCCS MultiMedica, Sesto S. Giovanni, Milan, Italy.
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
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Raja V, Aguiar C, Alsayed N, Chibber YS, ElBadawi H, Ezhov M, Hermans MP, Pandey RC, Ray KK, Tokgözoglu L, Zambon A, Berrou JP, Farnier M. Non-HDL-cholesterol in dyslipidemia: Review of the state-of-the-art literature and outlook. Atherosclerosis 2023; 383:117312. [PMID: 37826864 DOI: 10.1016/j.atherosclerosis.2023.117312] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023]
Abstract
Dyslipidemia refers to unhealthy changes in blood lipid composition and is a risk factor for atherosclerotic cardiovascular diseases (ASCVD). Usually, low-density lipoprotein-cholesterol (LDL-C) is the primary goal for dyslipidemia management. However, non-high-density lipoprotein cholesterol (non-HDL-C) has gained attention as an alternative, reliable goal. It encompasses all plasma lipoproteins like LDL, triglyceride-rich lipoproteins (TRL), TRL-remnants, and lipoprotein a [Lp(a)] except high-density lipoproteins (HDL). In addition to LDL-C, several other constituents of non-HDL-C have been reported to be atherogenic, aiding the pathophysiology of atherosclerosis. They are acknowledged as contributors to residual ASCVD risk that exists in patients on statin therapy with controlled LDL-C levels. Therefore, non-HDL-C is now considered an independent risk factor or predictor for CVD. The popularity of non-HDL-C is attributed to its ease of estimation and non-dependency on fasting status. It is also better at predicting ASCVD risk in patients on statin therapy, and/or in those with obesity, diabetes, and metabolic disorders. In addition, large follow-up studies have reported that individuals with higher baseline non-HDL-C at a younger age (<45 years) were more prone to adverse CVD events at an older age, suggesting a predictive ability of non-HDL-C over the long term. Consequently, non-HDL-C is recommended as a secondary goal for dyslipidemia management by most international guidelines. Intriguingly, geographical patterns in recent epidemiological studies showed remarkably high non-HDL-C attributable mortality in high-risk countries. This review highlights the independent role of non-HDL-C in ASCVD pathogenesis and prognosis. In addition, the need for a country-specific approach to dyslipidemia management at the community/population level is discussed. Overall, non-HDL-C can become a co-primary or primary goal in dyslipidemia management.
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Affiliation(s)
- Vikrama Raja
- Abbott Products Operations AG, Basel, Switzerland
| | - Carlos Aguiar
- Department of Cardiology, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | | | | | - Hussein ElBadawi
- Internal Medicine Department, Wayne State University, Detroit, MI, USA; Metabolic Unit, My Clinic International, Jeddah, Saudi Arabia
| | - Marat Ezhov
- National Medical Research Center of Cardiology n.a. ac. E.I. Chazov, Moscow, Russia
| | | | | | - Kausik K Ray
- Imperial Centre for Cardiovascular Disease Prevention, Imperial College London, UK
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Sviridov D, Dasseux A, Reimund M, Pryor M, Drake SK, Jarin Z, Wolska A, Pastor RW, Remaley AT. Short hydrocarbon stapled ApoC2-mimetic peptides activate lipoprotein lipase and lower plasma triglycerides in mice. Front Cardiovasc Med 2023; 10:1223920. [PMID: 37547254 PMCID: PMC10403075 DOI: 10.3389/fcvm.2023.1223920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Defects in lipolysis can lead to hypertriglyceridemia, which can trigger acute pancreatitis and is also associated with cardiovascular disease. Decreasing plasma triglycerides (TGs) by activating lipoprotein lipase (LPL) with ApoC2 mimetic peptides is a new treatment strategy for hypertriglyceridemia. We recently described a dual ApoC2 mimetic/ApoC3 antagonist peptide called D6PV that effectively lowered TG in several mouse models but has limitations in terms of drug development. The aim of this study was to create the next generation of ApoC2 mimetic peptides. Methods We employed hydrocarbon staples, as well as select amino acid substitutions, to make short single helical mimetic peptides based on the last helix of ApoC2. Peptides were first tested for their ability to activate LPL and then in hypertriglyceridemia mouse models. All-atom simulations of peptides were performed in a lipid-trilayer model of TG-rich lipoproteins to discern their possible mechanism of action. Results We designed a single stapled peptide called SP1 (21 residues), and a double stapled (stitched) peptide called SP2 (21 residues) and its N-terminal acylated analogue, SP2a. The hydrocarbon staples increased the amphipathicity of the peptides and their ability to bind lipids without interfering with LPL activation. Indeed, from all-atom simulations, the conformations of SP1 and SP2a are restrained by the staples and maintains the proper orientation of the LPL activation motif, while still allowing their deeper insertion into the lipid-trilayer model. Intraperitoneal injection of stapled peptides (1-5 umoles/kg) into ApoC2-hypomorphic mice or human ApoC3-transgenic resulted in an 80%-90% reduction in plasma TG within 3 h, similar to the much longer D6PV peptide (41 residues). Other modifications (replacement L-Glu20, L-Glu21 with their D-isomers, N-methylation of Gly19, Met2NorLeu and Ala1alpha-methylAla substitutions, N-terminal octanoylation) were introduced into the SP2a peptide. These changes made SP2a highly resistant to proteolysis against trypsin, pepsin, and Proteinase K, while maintaining similar efficacy in lowering plasma TG in mice. Conclusion We describe a new generation of ApoC2 mimetic peptides based on hydron carbon stapling that are at least equally potent to earlier peptides but are much shorter and resistant to proteolysis and could be further developed into a new therapy for hypertriglyceridemia.
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Affiliation(s)
- Denis Sviridov
- Laboratory of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Amaury Dasseux
- Laboratory of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Mart Reimund
- Laboratory of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Milton Pryor
- Laboratory of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Steven K. Drake
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Zack Jarin
- Laboratory of Computational Biology, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Anna Wolska
- Laboratory of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Richard W. Pastor
- Laboratory of Computational Biology, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Alan T. Remaley
- Laboratory of Lipoprotein Metabolism, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
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Associations of Cardiorespiratory Fitness With Estimated Remnant Cholesterol and Non-High-Density Lipoprotein Cholesterol in Healthy Men. Am J Cardiol 2023; 186:170-175. [PMID: 36307347 DOI: 10.1016/j.amjcard.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/05/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022]
Abstract
Remnant cholesterol (RC) and non-high-density lipoprotein cholesterol (non-HDL-C) may contribute to the residual risk for atherosclerotic cardiovascular disease. High cardiorespiratory fitness (CRF) is associated with favorable traditional lipid profiles, but its relation with RC and non-HDL-C remains unclear. We analyzed cross-sectional data on 4,613 healthy men (mean age 49 years). CRF was measured using peak oxygen uptake during incremental exercise testing and categorized into quartiles. RC was estimated as total cholesterol minus HDL-C and low-density lipoprotein cholesterol, and elevated RC was defined as ≥38 mg/100 ml (90 percentile). Non-HDL-C was calculated as total cholesterol minus HDL-C, and high non-HLD-C was defined as ≥190 mg/100 ml. CRF was inversely associated with RC (β -0.31, 95% confidence interval [CI] -0.39 to -0.24) and non-HDL-C (β -0.34, 95% CI -0.57 to -0.11) after adjustment for several risk factors. Each metabolic equivalent increment in CRF was associated with lower odds of having elevated RC (odds ratio [OR] 0.85, 95% CI 0.77 to 0.93) and non-HDL-C (OR 0.93, 95% CI 0.85 to 1.00) in multivariable analysis. Compared with the bottom quartile, the top quartile of CRF had significantly lower odds of elevated RC (OR 0.63, 95% CI 0.45 to 0.88) and non-HDL-C (OR 0.68, 95% CI 0.51 to 0.91). In conclusion, higher CRF was independently associated with lower levels of RC and non-HDL-C and lower odds of the prevalence of elevated RC and non-HDL-C in healthy men.
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Olivieri O, Turcato G, Cappellari M, Stefanoni F, Osti N, Pizzolo F, Friso S, Bassi A, Castagna A, Martinelli N. High Plasma Concentration of Apolipoprotein C-III Confers an Increased Risk of Cerebral Ischemic Events on Cardiovascular Patients Anticoagulated With Warfarin. Front Cardiovasc Med 2022; 8:781383. [PMID: 35187103 PMCID: PMC8854278 DOI: 10.3389/fcvm.2021.781383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Apolipoprotein C-III (Apo CIII) is a crucial regulator of triglyceride-rich lipoproteins (TRLs) and influences the risk of cardiovascular diseases. High levels of Apo CIII have been also associated with cerebrovascular events and earlier works showed procoagulant effects of Apo CIII. The main aim was to assess whether the plasma concentration of Apo CIII could confer an increased risk of cerebral ischemic events in anticoagulated patients at high-risk of cardioembolism. Methods We systematically checked medical records and quantified cerebral ischemic events in a selected cohort of 118 subjects [median age 68 with interquartile range (IQR) 59–75 years, 66.9% males, 52.5% with coronary artery disease (CAD)], taking anticoagulant therapy with warfarin because of atrial fibrillation (AF) and/or mechanical prosthetic heart valves. All the subjects, enrolled between May 1999 and December 2006, were prospectively followed until death or July 31, 2018. Assessments of complete plasma lipid and apolipoprotein profiles, including Apo A-I, B, CIII, and E, were available for all subjects at enrollment. Results After a median follow-up of 109 months (IQR, 58–187), 24 subjects (20.3%) had cerebral ischemic events: stroke (n = 15) and TIA (n = 9). Subjects with plasma concentration of Apo CIII above the median value (10.3 mg/dL) had an about three-fold increased risk of stroke/TIA than those with lower levels of Apo C-III [hazard ratio 3.08 (95%CI, 1.22–7.77)]. This result was confirmed in multiple Cox regression models adjusted for gender, age, CAD, AF, diabetes, hypertension, plasma lipids, and CHA2DS2-VASc score. By stratifying the sample on the basis of Apo CIII level and CHA2DS2-VASc score, an additive effect was observed with the highest risk in subjects with both high Apo C-III concentration and CHA2DS2-VASc score. Conclusion High Apo CIII plasma levels may be associated with an increased risk of ischemic stroke/TIA in high-risk cardiovascular patients anticoagulated with warfarin.
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Affiliation(s)
- Oliviero Olivieri
- Unit of Internal Medicine, Department of Medicine, University of Verona, Verona, Italy
- *Correspondence: Oliviero Olivieri
| | - Gianni Turcato
- Department of Emergency Medicine, Franz Tappeiner Hospital, Merano, Italy
| | | | - Filippo Stefanoni
- Unit of Internal Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Nicola Osti
- Unit of Internal Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Francesca Pizzolo
- Unit of Internal Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Simonetta Friso
- Unit of Internal Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Antonella Bassi
- Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy
| | - Annalisa Castagna
- Unit of Internal Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Nicola Martinelli
- Unit of Internal Medicine, Department of Medicine, University of Verona, Verona, Italy
- Nicola Martinelli
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Chi G, Lee JJ, Kazmi SHA, Fitzgerald C, Memar Montazerin S, Kalayci A, Korjian S, Heise M, Deckelbaum LI, Libby P, Bhatt DL, Gibson CM. Early and late recurrent cardiovascular events among high-risk patients with an acute coronary syndrome: Meta-analysis of phase III studies and implications on trial design. Clin Cardiol 2022; 45:299-307. [PMID: 35019162 PMCID: PMC8922536 DOI: 10.1002/clc.23773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/12/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background Despite low‐density lipoprotein cholesterol‐lowering therapies and other standard‐of‐care therapy, there remains a substantial residual atherosclerotic risk among patients with an acute coronary syndrome (ACS). This study aims to estimate the risk of early and late recurrent major adverse cardiovascular events (MACE) and address its implications on trial design. Methods A literature search was performed to collect phase III interventional trials on high‐risk ACS patients. Pooled event rates at 90 and 360 days were estimated by fitting random‐effects models using the DerSimonian–Laird method. Under the assumption of a total sample size of 10,000 and 1:1 allocation at a one‐sided alpha of 0.025 using the log‐rank test, the relationship between power and relative risk reduction (RRR) or absolute risk reduction (ARR) was explored for early versus late MACE endpoint. Results Seven trials representing 82,727 recent ACS patients were analyzed. The pooled rates of recurrent MACE were 4.1% and 8.3% at 90 and 360 days. Approximately 49% of events occurred within the first 90 days. Based on the estimated risks at 90 and 360 days, to attain 90% statistical power, a lower magnitude of RRR is required for late MACE than early MACE (22% vs. 30%), whereas a lower magnitude of ARR is required for early MACE than late MACE (1.2% vs. 1.8%). Conclusion The initial 90‐day window after ACS represents a vulnerable period for recurrent events. From a trial design perspective, determining a clinically important benefit by RRR versus ARR may influence the decision between early and late MACE as the study endpoint.
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Affiliation(s)
- Gerald Chi
- Department of Medicine, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jane J Lee
- Baim Institute for Clinical Research, Boston, Massachusetts, USA
| | - Syed H A Kazmi
- Department of Medicine, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Clara Fitzgerald
- Department of Medicine, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Sahar Memar Montazerin
- Department of Medicine, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Arzu Kalayci
- Department of Medicine, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Serge Korjian
- Department of Medicine, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark Heise
- CSL Behring, King of Prussia, Pennsylvania, USA
| | | | - Peter Libby
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Deepak L Bhatt
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - C Michael Gibson
- Department of Medicine, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Wei D, Marrachelli VG, Melgarejo JD, Liao CT, Janssens S, Verhamme P, Vanassche T, Van Aelst L, Monleon D, Redón J, Zhang ZY. Lipoprotein profiles of fat distribution and its association with insulin sensitivity. Front Endocrinol (Lausanne) 2022; 13:978745. [PMID: 36387872 PMCID: PMC9640977 DOI: 10.3389/fendo.2022.978745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fat deposition is associated with adverse outcomes. Waist-to-hip (WHR) ratio is a simple feasible index to assess fat distribution. Lipoprotein particle composition in relation to WHR and to what extent their association is mediated by insulin sensitivity are less investigated. METHODS In 504 randomly recruited Flemish (mean age: 48.9 years; women: 51.6%), we analyzed the lipoprotein particle constitutions using nuclear magnetic resonance spectroscopy. WHR obesity described a WHR of ≥ 0.85 for women or 0.9 for men. Insulin sensitivity was evaluated by the homeostasis model assessment-estimated insulin resistance (HOMA-IR). SCORE-2 risk algorithm was applied to estimate 10-year cardiovascular risk. Statistical methods included multivariable-adjusted linear regression analysis, logistic regression analysis, and mediation analysis. RESULTS The prevalence of WHR obesity was 54.6%, approximately 3 times of BMI-determined obesity (19.1%). Individuals with WHR obesity had significantly higher metabolic complications, such as hypertension (57.1%), dyslipidemia (61.8%), and insulin resistance (14.2%). WHR and WHR obesity were positively associated with total very-low-density lipoprotein (VLDL) particle concentration, remnant cholesterol, and triglycerides, but were negatively associated with VLDL particle size (P ≤ 0.027), independent of body mass index and other covariates. WHR was inversely associated with total high-density lipoprotein (HDL) particle concentration, whereas WHR obesity was inversely associated with HDL cholesterol (P ≤ 0.039). Neither WHR nor WHR obesity was associated with the concentration of total low-density lipoprotein (LDL) particles, LDL particle size, and LDL cholesterol (P ≥ 0.089). In the mediation analysis, insulin sensitivity significantly mediated the effect of WHR on total VLDL particle concentration (mediation percentage: 37.0%), remnant cholesterol (47.7%), and HDL cholesterol (41.1%). Individuals with WHR obesity were at increased cardiovascular risk, regardless of LDL cholesterol (P ≤0.028). In WHR obesity, higher total VLDL particle concent36ration and remnant cholesterol, and lower HDL cholesterol were associated with an increased cardiovascular risk (P≤ 0.002). CONCLUSIONS Upper-body fat deposition was independently associated with an unfavorable lipoprotein profile, and insulin sensitivity significantly mediated this association. LDL cholesterol might underestimate lipid abnormality for people with upper-body obesity and lowering VLDL particles and remnant cholesterol might potentially reduce the residual cardiovascular risk.
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Affiliation(s)
- Dongmei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Vannina González Marrachelli
- Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Jesus D. Melgarejo
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Chia-Te Liao
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Stefan Janssens
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Peter Verhamme
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Thomas Vanassche
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Lucas Van Aelst
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Daniel Monleon
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
- Department of Pathology, University of Valencia, Valencia, Spain
| | - Josep Redón
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- *Correspondence: Zhen-Yu Zhang,
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10
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Amadi CE, Mbakwem AC, Duro DC, Udenze IC, Akinsola CM, Ajuluchukwu JN, Wale Oke DA. Prevalence, patterns and predictors of metabolic abnormalities in Nigerian hypertensives with hypertriglyceridemic waist phenotype: A cross sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001203. [PMID: 36962833 PMCID: PMC10021371 DOI: 10.1371/journal.pgph.0001203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Simultaneous presence of elevated waist circumference and hypertriglyceridemia (HTGW) is a simple and low-cost measure of visceral obesity, and it is associated with a plethora of cardio-metabolic abnormalities that can increase the risk of cardiovascular diseases and incident Type 2 diabetes mellitus. We decided to study the prevalence, patterns, and predictors of metabolic abnormalities in Nigerian hypertensives with the HTGW phenotype. METHODS The medical records of 582 hypertensives with complete data of interest were retrieved and analyzed for the study. Their socio-demographic data, anthropometric data, and booking blood pressure values were retrieved. The results of their fasting plasma glucose, lipid profile, uric acid and serum creatinine were also retrieved for analysis. RESULTS The mean age of the study population was 56.2 ±13.6, with 53.1% being males. The prevalence of smoking and use of alcohol was 4.3% and 26.5% respectively. The prevalence of the HTGW phenotype was 23.4% and were predominantly males (61%). Subjects with the HTGW phenotype were more obese assessed by waist circumference (WC) and body mass index (BMI). Mean serum total cholesterol, triglyceride, very low-density lipoprotein, uric acid, and creatinine were significantly higher in the HTGW phenotype (p = 0.003; <0.001; <0.001; 0.002 and <0.001 respectively). The prevalence of newly diagnosed Type 2 diabetes was 28.7%. There was also a preponderance of cardio-metabolic abnormalities (obesity, dyslipidaemia, hyperuricemia) in the HTGW phenotype. In both males and females, the HGTW phenotype was significantly associated with elevated Tc, TG, VLDL, hyperuricemia and atherogenic index of plasma. CONCLUSION The HTGW phenotype is common amongst Nigerian hypertensives, and it is associated with metabolic abnormalities.
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Affiliation(s)
- Casmir E Amadi
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Amam C Mbakwem
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Ifeoma C Udenze
- Department of Chemical Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Clement M Akinsola
- Department of Community Health, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Jayne N Ajuluchukwu
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - David A Wale Oke
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
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11
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Arikawa R, Kanda D, Ikeda Y, Tokushige A, Sonoda T, Anzaki K, Ohishi M. Prognostic impact of malnutrition on cardiovascular events in coronary artery disease patients with myocardial damage. BMC Cardiovasc Disord 2021; 21:479. [PMID: 34615478 PMCID: PMC8493704 DOI: 10.1186/s12872-021-02296-9] [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: 05/31/2021] [Accepted: 09/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stable coronary artery disease (CAD) patients with myocardial damage have a poor prognosis compared to those without myocardial damage. Recently, malnutrition has been reported to affect the prognosis of cardiovascular diseases. However, the effects of malnutrition on prognosis of CAD patients with myocardial damage remains uncertain. We investigated the effects of malnutrition on prognosis of CAD patients with myocardial damage who received percutaneous coronary intervention (PCI). METHODS Subjects comprised 241 stable CAD patients with myocardial damage due to myocardial ischemia or infraction. Patients underwent successful revascularization for the culprit lesion by PCI using second-generation drug-eluting stents and intravascular ultrasound. The geriatric nutritional risk index (GNRI), which is widely used as a simple method for screening nutritional status using body mass index and serum albumin, was used to assess nutritional status. Associations between major cardiovascular and cerebrovascular events (MACCE) and patient characteristics were assessed. RESULTS Mean GNRI was 100 ± 13, and there were 55 malnourished patients (23%; GNRI < 92) and 186 non-malnourished patients (77%). MACCE occurred within 3 years after PCI in 42 cases (17%), including 34 deaths (14%), and the malnourished group showed a higher rate of MACCE (38%) compared with the non-malnourished group (11%, p < 0.001). Univariate Cox proportional hazards analyses showed that MACCE was associated with age [hazard ratio (HR), 1.04; 95% confidence interval (CI), 1.04-1.07; p = 0.004], prior heart failure (HR 2.35; 95% CI 1.10-5.01; p = 0.027), high-sensitivity C-reactive protein (HR 1.08; 95% CI 1.03-1.11; p < 0.001), hemodialysis (HR 2.63; 95% CI 1.51-4.58; p < 0.001) and malnutrition (HR 3.69; 95% CI 2.11-6.42; p < 0.001). Multivariate Cox proportional hazards analysis revealed hemodialysis (HR 2.17; 95% CI 1.19-3.93; p = 0.011) and malnutrition (HR 2.30; 95% CI 1.13-4.67; p = 0.020) as significantly associated with MACCE. Furthermore, Cox proportional hazards models using malnutrition and hemodialysis revealed that patients with malnutrition and hemodialysis were at greater risk of MACCE after PCI than patients with neither malnutrition nor hemodialysis (HR 6.91; 95% CI 3.29-14.54; p < 0.001). CONCLUSIONS In CAD patients with myocardial damage, malnutrition (GNRI < 92) represents an independent risk factor for MACCE. Assessment of nutritional status may help stratify the risk of cardiovascular events and encourage improvements in nutritional status.
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Affiliation(s)
- Ryo Arikawa
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Daisuke Kanda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan.
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Akihiro Tokushige
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Takeshi Sonoda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Kazuhiro Anzaki
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
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12
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Association between chronic kidney disease and new-onset dyslipidemia: The Japan Specific Health Checkups (J-SHC) study. Atherosclerosis 2021; 332:24-32. [PMID: 34375910 DOI: 10.1016/j.atherosclerosis.2021.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/02/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Dyslipidemias are common among patients with chronic kidney disease (CKD) and are a major risk factor for cardiovascular disease. This study aimed to investigate the association between early-stage CKD and new-onset dyslipidemia for each lipid profile. METHODS This nationwide longitudinal study included data from the Japan Specific Health Checkups (J-SHC) Study. New-onset dyslipidemia was indicated by hypertriglyceridemia (High-TG; ≥150 mg/dL), hyper-LDL cholesterolemia (High-LDL-C; ≥140 mg/dL), or hypo-HDL chelesterolemia (Low-HDL-C; <40 mg/dL) levels according to the guideline of Japan Atherosclerosis Society, or High-TG/HDL-C ratio (≥3.5) which was a good predictor of atherosclerosis. The incidence of new-onset dyslipidemia was compared between participants with and without CKD. Survival curves were used to analyze the incidence of each dyslipidemia. RESULTS Of 289,462 participants with a median follow-up period of 3 years, the incidence of High-TG, High-LDL-C, Low-HDL-C, and High-TG/HDL-C ratios were 64.4/1000 person-years, 83.1/1000 person-years, 14.5/1000 person-years, and 39.6/1000 person-years, respectively. The adjusted hazard ratios (95% confidence intervals) for High-TG, High-LDL-C, Low-HDL-C, and High-TG/HDL-C ratio were 1.09 (1.05-1.13), 0.99 (0.95-1.04), 1.12 (1.05-1.18), and 1.14 (1.09-1.18), respectively, in CKD participants as compared to non-CKD participants. Decreased eGFR and presence of proteinuria were independently associated with higher risks for new-onset of High-TG, Low-HDL-C, and High-TG/HDL-C ratios. CONCLUSIONS CKD was associated with a higher risk of new-onset High-TG, Low-HDL-C, and High-TG/HDL-C ratios, but not High-LDL-C, in the general population. These CKD-specific lipid abnormalities may explain the residual risk for CKD-related cardiovascular disease.
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13
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Colivicchi F, Di Fusco SA, Arca M, Leggio M, Caldarola P, Murrone A, Valente S, Urbinati S, Roncon L, Amodeo V, Aspromonte N, Cipriani M, Domenicucci S, Francese GM, Imazio M, di Uccio FS, Di Lenarda A, Gulizia MM, Gabrielli D. Non-high-density lipoprotein cholesterol versus low-density lipoprotein cholesterol in clinical practice: ANMCO position paper. J Cardiovasc Med (Hagerstown) 2021; 22:609-617. [PMID: 33651721 DOI: 10.2459/jcm.0000000000001175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Bloodstream cholesterol is a central contributor to atherosclerotic cardiovascular diseases. For several decades, low-density lipoprotein cholesterol (LDL-C) has been the main biomarker for the prediction of cardiovascular events and therapeutic target of lipid-lowering treatments. More recently, several findings have supported the greater reliability of non-high-density lipoprotein cholesterol (non-HDL-C) as a predictive factor and possible therapeutic target in refining antiatherogenic treatments, especially among patients with lower LDL-C and higher triglyceride values. This article discusses the limits of current standard methods for assessing LDL-C levels and emphasizes the persistent residual cardiovascular risk in patients treated with lipid-lowering agents on the basis of recommended LDL-C targets. It highlights that patients with controlled LDL-C and non-targeted non-HDL-C have a higher cardiovascular risk. The article focuses on the role of non-HDL-C as a better predictor of atherosclerotic disease as compared with LDL-C and as a therapeutic target. Finally, this article includes an executive summary aimed at refining preventive approaches in atherosclerotic cardiovascular disease.
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Affiliation(s)
- Furio Colivicchi
- Clinical and Rehabilitative Cardiology Unit, San Filippo Neri Hospital ASL Roma 1, Rome
| | | | - Marcello Arca
- Department of Translational and Precision Medicine, Sapienza University of Roma, Rome
| | - Massimo Leggio
- Clinical and Rehabilitative Cardiology Unit, San Filippo Neri Hospital ASL Roma 1, Rome
| | | | - Adriano Murrone
- Cardilogy-Intensive Care Unit, Ospedali di Città di Castello e Gubbio - Gualdo Tadino, Azienda USL Umbria 1, Perugia
| | | | | | - Loris Roncon
- Cardiology Unit, Ospedale Santa Maria della Misericordia, Rovigo
| | - Vincenzo Amodeo
- Cardilogy-Intensive Care Unit, Santa Maria degli Ungheresi Hospital, Polistena, Reggio Calabria
| | - Nadia Aspromonte
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Manlio Cipriani
- Cardiology Unit 2, ASST Grande Ospedale Metropolitano Niguarda Cà Granda, Milan
| | | | - Giuseppina Maura Francese
- Cardiology Division, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione 'Garibaldi' Catania, Catania
| | - Massimo Imazio
- Cardilogy Unit, Presidio Molinette, A.O.U. Città della Salute e della Scienza di Torino, Torino
| | | | - Andrea Di Lenarda
- Cardiovascular Center, University Hospital and Health Services of Trieste, Trieste
| | - Michele Massimo Gulizia
- Cardiology Division, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione 'Garibaldi' Catania, Catania
- Presidente Fondazione per il Tuo cuore, Heart Care Foundation, Florence
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14
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Ma S, Xia M, Gao X. Biomarker Discovery in Atherosclerotic Diseases Using Quantitative Nuclear Magnetic Resonance Metabolomics. Front Cardiovasc Med 2021; 8:681444. [PMID: 34395555 PMCID: PMC8356911 DOI: 10.3389/fcvm.2021.681444] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/02/2021] [Indexed: 12/23/2022] Open
Abstract
Despite great progress in the management of atherosclerosis (AS), its subsequent cardiovascular disease (CVD) remains the leading cause of morbidity and mortality. This is probably due to insufficient risk detection using routine lipid testing; thus, there is a need for more effective approaches relying on new biomarkers. Quantitative nuclear magnetic resonance (qNMR) metabolomics is able to phenotype holistic metabolic changes, with a unique advantage in regard to quantifying lipid-protein complexes. The rapidly increasing literature has indicated that qNMR-based lipoprotein particle number, particle size, lipid components, and some molecular metabolites can provide deeper insight into atherogenic diseases and could serve as novel promising determinants. Therefore, this article aims to offer an updated review of the qNMR biomarkers of AS and CVD found in epidemiological studies, with a special emphasis on lipoprotein-related parameters. As more researches are performed, we can envision more qNMR metabolite biomarkers being successfully translated into daily clinical practice to enhance the prevention, detection and intervention of atherosclerotic diseases.
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Affiliation(s)
- Shuai Ma
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.,Fudan Institute for Metabolic Diseases, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China
| | - Mingfeng Xia
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.,Fudan Institute for Metabolic Diseases, Shanghai, China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.,Fudan Institute for Metabolic Diseases, Shanghai, China
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15
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Comparing dietary score associations with lipoprotein particle subclass profiles: A cross-sectional analysis of a middle-to older-aged population. Clin Nutr 2021; 40:4720-4729. [PMID: 34237699 DOI: 10.1016/j.clnu.2021.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/21/2021] [Accepted: 06/08/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Lipoprotein particle concentrations and size are associated with increased risk for atherosclerosis and premature cardiovascular disease. Studies also suggest that certain dietary behaviours may be cardioprotective. Limited comparative data regarding any dietary score/index-lipoprotein particle subclass associations exist. Thus, our objective was to assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Health Eating Index-2015 (HEI-2015), Mediterranean Diet (MD) and Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and plasma lipids and lipoprotein profiles to test the hypothesis that healthier diet (better quality and more anti-inflammatory) would be associated with a more favourable lipoprotein profile. MATERIALS AND METHODS This was a cross-sectional study of 1862 men and women aged 46-73 years, randomly selected from a large primary care centre in Ireland. DASH, HEI-2015, MD and E-DII scores were derived from food frequency questionnaires. Lipoprotein subclass particle concentrations and size were determined using nuclear magnetic resonance spectroscopy. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with lipoprotein particle subclasses. RESULTS In fully adjusted models, higher diet quality or a more anti-inflammatory diet was associated with less large and medium very low-density lipoprotein (VLDL) (DASH and HEI-2015), intermediate-density lipoprotein (IDL) (DASH, MD and E-DII) and small high-density lipoprotein (HDL) (DASH, HEI-2015 and E-DII) particles. After accounting for multiple testing, relationships with large VLDL (DASH: β = -0.102, p = .037), IDL (DASH: β = -0.089, p = .037) and small HDL (DASH: β = -0.551, p = .014 and E-DII: β = 0.483, p = .019) concentrations persisted. CONCLUSIONS These findings provide evidence that better diet quality, determined by the DASH score, may be more closely associated with a more favourable lipoprotein particle subclass profile in middle-to older-aged adults than the HEI-2015, MD and E-DII scores. A less pro-atherogenic lipoprotein status may be a potential mechanism underlying the cardioprotective effects of higher dietary quality.
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16
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Hübel C, Herle M, Santos Ferreira DL, Abdulkadir M, Bryant-Waugh R, Loos RJF, Bulik CM, Lawlor DA, Micali N. Childhood overeating is associated with adverse cardiometabolic and inflammatory profiles in adolescence. Sci Rep 2021; 11:12478. [PMID: 34127697 PMCID: PMC8203659 DOI: 10.1038/s41598-021-90644-2] [Citation(s) in RCA: 3] [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: 09/22/2020] [Accepted: 05/07/2021] [Indexed: 12/15/2022] Open
Abstract
Childhood eating behaviour contributes to the rise of obesity and related noncommunicable disease worldwide. However, we lack a deep understanding of biochemical alterations that can arise from aberrant eating behaviour. In this study, we prospectively associate longitudinal trajectories of childhood overeating, undereating, and fussy eating with metabolic markers at age 16 years to explore adolescent metabolic alterations related to specific eating patterns in the first 10 years of life. Data are from the Avon Longitudinal Study of Parents and Children (n = 3104). We measure 158 metabolic markers with a high-throughput (1H) NMR metabolomics platform. Increasing childhood overeating is prospectively associated with an adverse cardiometabolic profile (i.e., hyperlipidemia, hypercholesterolemia, hyperlipoproteinemia) in adolescence; whereas undereating and fussy eating are associated with lower concentrations of the amino acids glutamine and valine, suggesting a potential lack of micronutrients. Here, we show associations between early behavioural indicators of eating and metabolic markers.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Moritz Herle
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diana L Santos Ferreira
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mohamed Abdulkadir
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, Michael Rutter Centre for Children and Young People, Maudsley Hospital, London, UK
| | - Ruth J F Loos
- Icahn School of Medicine At Mount Sinai, New York, NY, USA
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Deborah A Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol National Institute of Health Research Biomedical Research Centre, Bristol, UK
| | - Nadia Micali
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Great Ormond Street Institute of Child Health, University College London, London, UK.
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17
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Lawler PR, Kotrri G, Koh M, Goodman SG, Farkouh ME, Lee DS, Austin PC, Udell JA, Ko DT. Real-world risk of cardiovascular outcomes associated with hypertriglyceridaemia among individuals with atherosclerotic cardiovascular disease and potential eligibility for emerging therapies. Eur Heart J 2021; 41:86-94. [PMID: 31733058 DOI: 10.1093/eurheartj/ehz767] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/09/2019] [Accepted: 10/26/2019] [Indexed: 02/06/2023] Open
Abstract
AIMS Hypertriglyceridaemia in patients with atherosclerotic cardiovascular disease (ASCVD) has been in focus following the REDUCE-IT trial showing benefit with icosapent ethyl. Among individuals with prevalent ASCVD, we sought to quantify the contemporary, real-world risk of ASCVD events associated with hypertriglyceridaemia, as well as estimate icosapent ethyl eligibility and compare trial participants with REDUCE-IT-like individuals in the population. METHODS AND RESULTS We examined data from 2 424 865 adults with lipid panels in the Ontario population. Among those with prevalent ASCVD, we examined adjusted associations between triglyceride (TG) and ASCVD events (first occurrence of myocardial infarction, unstable angina, stroke or transient ischaemic attack, coronary revascularization, or cardiovascular death). The proportion of patients with ASCVD potentially eligible for icosapent ethyl was estimated as those with TG 135-499 mg/dL (1.52-5.63 mmol/L) and low-density lipoprotein cholesterol (LDLc) 41-100 mg/dL (1.06-2.59 mmol/L), similar to the lipid cut-offs in REDUCE-IT, and their demographics and event rates examined. Among 196 717 individuals with ASCVD, median age was 69 years and 30% were female. A total of 24 097 composite ASCVD events occurred over a mean (standard deviation) 2.9 (0.5) years of follow-up. Increasing TG was associated with a graded, progressively higher hazard of ASCVD events. Twenty-five percent (49 886) of individuals with ASCVD had hypertriglyceridaemia and controlled LDLc; these patients were demographically similar to those in REDUCE-IT with comparable event rates. CONCLUSIONS Among patients with ASCVD, hypertriglyceridaemia is common, and is associated with higher ASCVD risk across a range of TG. It is possible that as many as one in four patients with ASCVD may be candidates for emerging therapies.
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Affiliation(s)
- Patrick R Lawler
- Peter Munk Cardiac Centre, University Health Network, 200 Elizabeth St, Toronto, Ontario, Canada.,University of Toronto, 27 King's College Cir, Toronto, Ontario, Canada.,Ted Rogers Centre for Heart Research, 661 University Avenue, 14th Floor, Toronto, Ontario, Canada
| | - Gynter Kotrri
- University of Toronto, 27 King's College Cir, Toronto, Ontario, Canada
| | - Maria Koh
- ICES, 2075 Bayview Avenue, Toronto, Ontario, Canada
| | - Shaun G Goodman
- University of Toronto, 27 King's College Cir, Toronto, Ontario, Canada.,St Michael's Hospital, 30 Bond St, Toronto, Ontario, Canada
| | - Michael E Farkouh
- Peter Munk Cardiac Centre, University Health Network, 200 Elizabeth St, Toronto, Ontario, Canada.,University of Toronto, 27 King's College Cir, Toronto, Ontario, Canada
| | - Douglas S Lee
- Peter Munk Cardiac Centre, University Health Network, 200 Elizabeth St, Toronto, Ontario, Canada.,University of Toronto, 27 King's College Cir, Toronto, Ontario, Canada.,Ted Rogers Centre for Heart Research, 661 University Avenue, 14th Floor, Toronto, Ontario, Canada.,ICES, 2075 Bayview Avenue, Toronto, Ontario, Canada
| | | | - Jacob A Udell
- Peter Munk Cardiac Centre, University Health Network, 200 Elizabeth St, Toronto, Ontario, Canada.,University of Toronto, 27 King's College Cir, Toronto, Ontario, Canada.,ICES, 2075 Bayview Avenue, Toronto, Ontario, Canada.,Women's College Hospital, 76 Grenville St, Toronto, Ontario, Canada
| | - Dennis T Ko
- Peter Munk Cardiac Centre, University Health Network, 200 Elizabeth St, Toronto, Ontario, Canada.,University of Toronto, 27 King's College Cir, Toronto, Ontario, Canada.,ICES, 2075 Bayview Avenue, Toronto, Ontario, Canada
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18
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Zhao Q, Wang J, Miao Z, Zhang NR, Hennessy S, Small DS, Rader DJ. A Mendelian randomization study of the role of lipoprotein subfractions in coronary artery disease. eLife 2021; 10:e58361. [PMID: 33899735 PMCID: PMC8163505 DOI: 10.7554/elife.58361] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 04/23/2021] [Indexed: 12/26/2022] Open
Abstract
Recent genetic data can offer important insights into the roles of lipoprotein subfractions and particle sizes in preventing coronary artery disease (CAD), as previous observational studies have often reported conflicting results. We used the LD score regression to estimate the genetic correlation of 77 subfraction traits with traditional lipid profile and identified 27 traits that may represent distinct genetic mechanisms. We then used Mendelian randomization (MR) to estimate the causal effect of these traits on the risk of CAD. In univariable MR, the concentration and content of medium high-density lipoprotein (HDL) particles showed a protective effect against CAD. The effect was not attenuated in multivariable analyses. Multivariable MR analyses also found that small HDL particles and smaller mean HDL particle diameter may have a protective effect. We identified four genetic markers for HDL particle size and CAD. Further investigations are needed to fully understand the role of HDL particle size.
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Affiliation(s)
- Qingyuan Zhao
- Statistical Laboratory, University of CambridgeCambridgeUnited Kingdom
| | - Jingshu Wang
- Department of Statistics, University of ChicagoChicagoUnited States
| | - Zhen Miao
- Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
| | - Nancy R Zhang
- Department of Statistics, University of PennsylvaniaPhiladelphiaUnited States
| | - Sean Hennessy
- Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
| | - Dylan S Small
- Department of Statistics, University of PennsylvaniaPhiladelphiaUnited States
| | - Daniel J Rader
- Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUnited States
- Department of Medicine, University of PennsylvaniaPhiladelphiaUnited States
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19
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Johansen MØ, Vedel-Krogh S, Nielsen SF, Afzal S, Davey Smith G, Nordestgaard BG. Per-Particle Triglyceride-Rich Lipoproteins Imply Higher Myocardial Infarction Risk Than Low-Density Lipoproteins: Copenhagen General Population Study. Arterioscler Thromb Vasc Biol 2021; 41:2063-2075. [PMID: 33827253 DOI: 10.1161/atvbaha.120.315639] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Mia Ø Johansen
- Department of Clinical Biochemistry (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, CopenhagenUniversity Hospital, Denmark.,The Copenhagen General Population Study (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.)
| | - Signe Vedel-Krogh
- Department of Clinical Biochemistry (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, CopenhagenUniversity Hospital, Denmark.,The Copenhagen General Population Study (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.)
| | - Sune F Nielsen
- Department of Clinical Biochemistry (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, CopenhagenUniversity Hospital, Denmark.,The Copenhagen General Population Study (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.)
| | - Shoaib Afzal
- Department of Clinical Biochemistry (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, CopenhagenUniversity Hospital, Denmark.,The Copenhagen General Population Study (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.)
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, United Kingdom (G.D.S.).,Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom (G.D.S.)
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, CopenhagenUniversity Hospital, Denmark.,The Copenhagen General Population Study (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (M.O.J., S.V.-K., S.F.N., S.A., B.G.N.)
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20
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Inflammageing in the cardiovascular system: mechanisms, emerging targets, and novel therapeutic strategies. Clin Sci (Lond) 2021; 134:2243-2262. [PMID: 32880386 DOI: 10.1042/cs20191213] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022]
Abstract
In the elderly population, pathological inflammation has been associated with ageing-associated diseases. The term 'inflammageing', which was used for the first time by Franceschi and co-workers in 2000, is associated with the chronic, low-grade, subclinical inflammatory processes coupled to biological ageing. The source of these inflammatory processes is debated. The senescence-associated secretory phenotype (SASP) has been proposed as the main origin of inflammageing. The SASP is characterised by the release of inflammatory cytokines, elevated activation of the NLRP3 inflammasome, altered regulation of acetylcholine (ACh) nicotinic receptors, and abnormal NAD+ metabolism. Therefore, SASP may be 'druggable' by small molecule therapeutics targeting those emerging molecular targets. It has been shown that inflammageing is a hallmark of various cardiovascular diseases, including atherosclerosis, hypertension, and adverse cardiac remodelling. Therefore, the pathomechanism involving SASP activation via the NLRP3 inflammasome; modulation of NLRP3 via α7 nicotinic ACh receptors; and modulation by senolytics targeting other proteins have gained a lot of interest within cardiovascular research and drug development communities. In this review, which offers a unique view from both clinical and preclinical target-based drug discovery perspectives, we have focused on cardiovascular inflammageing and its molecular mechanisms. We have outlined the mechanistic links between inflammageing, SASP, interleukin (IL)-1β, NLRP3 inflammasome, nicotinic ACh receptors, and molecular targets of senolytic drugs in the context of cardiovascular diseases. We have addressed the 'druggability' of NLRP3 and nicotinic α7 receptors by small molecules, as these proteins represent novel and exciting targets for therapeutic interventions targeting inflammageing in the cardiovascular system and beyond.
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21
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Bornfeldt KE. Triglyceride lowering by omega-3 fatty acids: a mechanism mediated by N-acyl taurines. J Clin Invest 2021; 131:147558. [PMID: 33720044 DOI: 10.1172/jci147558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Interest in omega-3 fatty acids (colloquially known as fish oils) to lower residual cardiovascular risk in statin-treated patients has increased markedly in the wake of recent cardiovascular outcome trials. The triglyceride-lowering effects of omega-3 fatty acids are generally thought to occur by reduced hepatic VLDL production. In this issue of the JCI, Grevengoed et al. used mouse models and human plasma samples to reveal an additional mechanism whereby these polyunsaturated fatty acids can lower plasma triglycerides. Their findings indicate that omega-3 fatty acid-derived N-acyl taurines (NATs) greatly accumulate in bile and also in plasma following omega-3 supplementation. The authors further show that one of these NATs (C22:6 NAT) inhibited intestinal triglyceride hydrolysis and lipid absorption, which resulted in lower plasma triglycerides and protection against hepatic triacylglycerol accumulation in mice fed a high-fat diet. The findings open a potential avenue for triglyceride lowering by omega-3 fatty acids conjugated to taurine.
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22
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Akoumianakis I, Zvintzou E, Kypreos K, Filippatos TD. ANGPTL3 and Apolipoprotein C-III as Novel Lipid-Lowering Targets. Curr Atheroscler Rep 2021; 23:20. [PMID: 33694000 DOI: 10.1007/s11883-021-00914-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Despite significant progress in plasma lipid lowering strategies, recent clinical trials highlight the existence of residual cardiovascular risk. Angiopoietin-like protein 3 (ANGPTL3) and apolipoprotein C-III (Apo C-III) have been identified as novel lipid-lowering targets. RECENT FINDINGS Apo C-III and ANGPTL3 have emerged as novel regulators of triglyceride (TG) and low-density lipoprotein-cholesterol (LDL-C) levels. ANGPTL3 is an inhibitor of lipoprotein lipase (LPL), reducing lipolysis of Apo B-containing lipoproteins. Loss-of-function ANGPLT3 mutations are associated with reduced plasma cholesterol and TG, while novel ANGPLT3 inhibition strategies, including monoclonal antibodies (evinacumab), ANGPLT3 antisense oligonucleotides (IONIS-ANGPTL3-LRx), and small interfering RNA (siRNA) silencing techniques (ARO-ANG3), result in increased lipolysis and significant reductions of LDL-C and TG levels in phase I and II clinical trials. Similarly, Apo C-III inhibits LPL while promoting the hepatic secretion of TG-rich lipoproteins and preventing their clearance. Loss-of-function APOC3 mutations have been associated with reduced TG levels. Targeting of Apo C-III with volanesorsen, an APOC3 siRNA, results in significant reduction in plasma TG levels but possibly also increased risk for thrombocytopenia, as recently demonstrated in phase I, II, and III clinical trials. ARO-APOC3 is a novel siRNA-based agent targeting Apo C-III which is currently under investigation with regard to its lipid-lowering efficiency. ANGPTL3 and Apo C-III targeting agents have demonstrated striking lipid-lowering effects in recent clinical trials; however, more thorough safety and efficacy data are required. Here, we evaluate the role of ANGPLT3 and Apo C-III in lipid metabolism, present the latest clinical advances targeting those molecules, and outline the remaining scientific challenges on residual lipid-associated cardiovascular risk.
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Affiliation(s)
- Ioannis Akoumianakis
- Department of Internal Medicine, School of Medicine, University Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece.,Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Evangelia Zvintzou
- Department of Medicine, Pharmacology Laboratory, School of Health Sciences, University of Patras, Achaias, Rio, Greece
| | - Kyriakos Kypreos
- Department of Medicine, Pharmacology Laboratory, School of Health Sciences, University of Patras, Achaias, Rio, Greece.,Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Theodosios D Filippatos
- Department of Internal Medicine, School of Medicine, University Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece. .,Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Sciences, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece.
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23
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Izumida T, Nakamura Y, Sato Y, Ishikawa S. Association among age, gender, menopausal status and small dense low-density lipoprotein cholesterol: a cross-sectional study. BMJ Open 2021; 11:e041613. [PMID: 33542041 PMCID: PMC7925934 DOI: 10.1136/bmjopen-2020-041613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Small dense low-density lipoprotein cholesterol (sdLDL-C) might be a better cardiovascular disease (CVD) indicator than low-density lipoprotein cholesterol (LDL-C); however, details regarding its epidemiology remain elusive. The present study aimed at evaluating the association between the demographic factors, such as age, gender and menopausal status, and sdLDL-C levels and sdLDL-C/LDL-C ratio in the Japanese population. DESIGN This was a cross-sectional study. SETTING 13 rural districts in Japan, 2010-2017. PARTICIPANTS This study included 5208 participants (2397 men and 2811 women), who underwent the health mass screening that was conducted in accordance with the medical care system for the elderly and obtained informed consent for this study. RESULTS In total, 517 premenopausal women (mean age ±SD, 45.1±4.2 years), 2294 postmenopausal women (66.5±8.8 years) and 2397 men (64.1±11.2 years) were analysed. In men, the sdLDL-C levels and sdLDL-C/LDL-C ratio increased during younger adulthood, peaked (36.4 mg/dL, 0.35) at 50-54 years, and then decreased. In women, relatively regular increasing trends of sdLDL-C level and sdLDL-C/LDL-C ratio until approximately 65 years (32.7 mg/dL, 0.28), followed by a downward or pleated trend. Given the beta value of age, body mass index, fasting glucose and smoking and drinking status by multiple linear regression analysis, standardised sdLDL-C levels and sdLDL-C/LDL-C ratio in 50-year-old men, premenopausal women and postmenopausal women were 26.6, 22.7 and 27.4 mg/dL and 0.24, 0.15 and 0.23, respectively. The differences between premenopausal and postmenopausal women were significant (p<0.001). CONCLUSIONS SdLDL-C and sdLDL-C/LDL-C ratios showed different distributions by age, gender and menopausal status. A subgroup-specific approach would be necessary to implement sdLDL-C for CVD prevention strategies, fully considering age-related trends, gender differences and menopausal status.
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Affiliation(s)
- Toshihide Izumida
- Division of Community Medicine, Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan
| | - Yosikazu Nakamura
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Yukihiro Sato
- Internal Medicine, Kamiichi General Hospital, Toyama, Japan
| | - Shizukiyo Ishikawa
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
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24
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Athinarayanan SJ, Hallberg SJ, McKenzie AL, Lechner K, King S, McCarter JP, Volek JS, Phinney SD, Krauss RM. Impact of a 2-year trial of nutritional ketosis on indices of cardiovascular disease risk in patients with type 2 diabetes. Cardiovasc Diabetol 2020; 19:208. [PMID: 33292205 PMCID: PMC7724865 DOI: 10.1186/s12933-020-01178-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/15/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We have previously reported that in patients with type 2 diabetes (T2D) consumption of a very low carbohydrate diet capable of inducing nutritional ketosis over 2 years (continuous care intervention, CCI) resulted in improved body weight, glycemic control, and multiple risk factors for cardiovascular disease (CVD) with the exception of an increase in low density lipoprotein cholesterol (LDL-C). In the present study, we report the impact of this intervention on markers of risk for atherosclerotic cardiovascular disease (CVD), with a focus on lipoprotein subfraction particle concentrations as well as carotid-artery intima-media thickness (CIMT). METHODS Analyses were performed in patients with T2D who completed 2 years of this study (CCI; n = 194; usual care (UC): n = 68). Lipoprotein subfraction particle concentrations were measured by ion mobility at baseline, 1, and 2 years and CIMT was measured at baseline and 2 years. Principal component analysis (PCA) was used to assess changes in independent clusters of lipoprotein particles. RESULTS At 2 years, CCI resulted in a 23% decrease of small LDL IIIb and a 29% increase of large LDL I with no change in total LDL particle concentration or ApoB. The change in proportion of smaller and larger LDL was reflected by reversal of the small LDL subclass phenotype B in a high proportion of CCI participants (48.1%) and a shift in the principal component (PC) representing the atherogenic lipoprotein phenotype characteristic of T2D from a major to a secondary component of the total variance. The increase in LDL-C in the CCI group was mainly attributed to larger cholesterol-enriched LDL particles. CIMT showed no change in either the CCI or UC group. CONCLUSION Consumption of a very low carbohydrate diet with nutritional ketosis for 2 years in patients with type 2 diabetes lowered levels of small LDL particles that are commonly increased in diabetic dyslipidemia and are a marker for heightened CVD risk. A corresponding increase in concentrations of larger LDL particles was responsible for higher levels of plasma LDL-C. The lack of increase in total LDL particles, ApoB, and in progression of CIMT, provide supporting evidence that this dietary intervention did not adversely affect risk of CVD.
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Affiliation(s)
| | - Sarah J Hallberg
- Virta Health, 501 Folsom Street, San Francisco, CA, 94105, USA.,Indiana University Health Arnett, Lafayette, IN, USA.,Indiana University, School of Medicine, Indianapolis, IN, USA
| | - Amy L McKenzie
- Virta Health, 501 Folsom Street, San Francisco, CA, 94105, USA
| | - Katharina Lechner
- Department of Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Sarah King
- School of Medicine, University of California, San Francisco, CA, 94143, USA
| | - James P McCarter
- Abbott Diabetes Care, Alameda, CA, 94502, USA.,Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Jeff S Volek
- Virta Health, 501 Folsom Street, San Francisco, CA, 94105, USA.,Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | | | - Ronald M Krauss
- School of Medicine, University of California, San Francisco, CA, 94143, USA.
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25
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Abstract
BACKGROUND ABO blood group is associated with differences in lifespan, cardiovascular disease, and some cancers, for reasons which are incompletely understood. To gain sex-specific additional insight about potential mechanisms driving these common conditions for future interventions, we characterized associations of ABO blood group antigen across the phenotype sex-specifically. METHODS We performed a phenome-wide association study (PheWAS) assessing the association of tag single nucleotide polymorphisms (SNPs) for ABO blood group antigens (O, B, A1, and A2) with 3873 phenotypes. RESULTS The tag SNP for the O antigen was inversely associated with diseases of the circulatory system (particularly deep vein thrombosis (DVT)), total cholesterol, low-density lipoprotein cholesterol (LDL-C), and ovarian cancer, and positively associated with erythrocyte traits, leukocyte counts, diastolic blood pressure (DBP), and healthy body composition; the tag SNP for the A1 antigen tended to have associations in reverse to O. Stronger associations were more apparent for men than women for DVT, DBP, leukocyte traits, and some body composition traits, whereas larger effect sizes were found for women than men for some erythrocyte and lipid traits. CONCLUSION Blood group has a complex association with cardiovascular diseases and its major risk factors, including blood pressure and lipids, as well as with blood cell traits and body composition, with some differences by sex. Lower LDL-C may underlie some of the benefits of blood group O, but the complexity of associations with blood group antigen suggests overlooked drivers of common chronic diseases.
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Affiliation(s)
- Shun Li
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Rd, Pokfulam, Hong Kong, Special Administrative Region, China
| | - C M Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Rd, Pokfulam, Hong Kong, Special Administrative Region, China.
- School of Public Health and Health Policy, The City University of New York, 55 W 125 St, New York, NY, 10027, USA.
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26
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Olivieri O, Speziali G, Castagna A, Pattini P, Udali S, Pizzolo F, Liesinger L, Gindlhuber J, Tomin T, Schittmayer M, Birner-Gruenberger R, Cecconi D, Girelli D, Friso S, Martinelli N. The Positive Association between Plasma Myristic Acid and ApoCIII Concentrations in Cardiovascular Disease Patients Is Supported by the Effects of Myristic Acid in HepG2 Cells. J Nutr 2020; 150:2707-2715. [PMID: 32710763 DOI: 10.1093/jn/nxaa202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/06/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In the settings of primary and secondary prevention for coronary artery disease (CAD), a crucial role is played by some key molecules involved in triglyceride (TG) metabolism, such as ApoCIII. Fatty acid (FA) intake is well recognized as a main determinant of plasma lipids, including plasma TG concentration. OBJECTIVES The aim was to investigate the possible relations between the intakes of different FAs, estimated by their plasma concentrations, and circulating amounts of ApoCIII. METHODS Plasma samples were obtained from 1370 subjects with or without angiographically demonstrated CAD (mean ± SD age: 60.6 ± 11.0 y; males: 75.8%; BMI: 25.9 ± 4.6 kg/m2; CAD: 73.3%). Plasma lipid, ApoCIII, and FA concentrations were measured. Data were analyzed by regression models adjusted for FAs and other potential confounders, such as sex, age, BMI, diabetes, smoking, and lipid-lowering therapies. The in vitro effects of FAs were tested by incubating HepG2 hepatoma cells with increasing concentrations of selected FAs, and the mRNA and protein contents in the cells were quantified by real-time RT-PCR and LC-MS/MS analyses. RESULTS Among all the analyzed FAs, myristic acid (14:0) showed the most robust correlations with both TGs (R = 0.441, P = 2.6 × 10-66) and ApoCIII (R = 0.327, P = 1.1 × 10-31). By multiple regression analysis, myristic acid was the best predictor of both plasma TG and ApoCIII variability. Plasma TG and ApoCIII concentrations increased progressively at increasing concentrations of myristic acid, independently of CAD diagnosis and gender. Consistent with these data, in the in vitro experiments, an ∼2-fold increase in the expression levels of the ApoCIII mRNA and protein was observed after incubation with 250 μM myristic acid. A weaker effect (∼30% increase) was observed for palmitic acid, whereas incubation with oleic acid did not affect ApoCIII protein or gene expression. CONCLUSIONS Plasma myristic acid is associated with increased ApoCIII concentrations in cardiovascular patients. In vitro experiments indicated that myristic acid stimulates ApoCIII expression in HepG2 cells.
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Affiliation(s)
| | | | | | | | - Silvia Udali
- Department of Medicine, University of Verona, Verona, Italy
| | | | - Laura Liesinger
- Institute of Chemical Technologies and Analytics, Vienna University of Technology, Vienna, Austria.,Diagnostic and Research Institute of Pathology, Diagnostic and Research Center of Molecular Medicine, Medical University of Graz, Graz, Austria.,Omics Center Graz, BioTechMed-Graz, Graz, Austria
| | - Juergen Gindlhuber
- Institute of Chemical Technologies and Analytics, Vienna University of Technology, Vienna, Austria.,Diagnostic and Research Institute of Pathology, Diagnostic and Research Center of Molecular Medicine, Medical University of Graz, Graz, Austria.,Omics Center Graz, BioTechMed-Graz, Graz, Austria
| | - Tamara Tomin
- Institute of Chemical Technologies and Analytics, Vienna University of Technology, Vienna, Austria.,Diagnostic and Research Institute of Pathology, Diagnostic and Research Center of Molecular Medicine, Medical University of Graz, Graz, Austria.,Omics Center Graz, BioTechMed-Graz, Graz, Austria
| | - Matthias Schittmayer
- Institute of Chemical Technologies and Analytics, Vienna University of Technology, Vienna, Austria.,Diagnostic and Research Institute of Pathology, Diagnostic and Research Center of Molecular Medicine, Medical University of Graz, Graz, Austria.,Omics Center Graz, BioTechMed-Graz, Graz, Austria
| | - Ruth Birner-Gruenberger
- Institute of Chemical Technologies and Analytics, Vienna University of Technology, Vienna, Austria.,Diagnostic and Research Institute of Pathology, Diagnostic and Research Center of Molecular Medicine, Medical University of Graz, Graz, Austria.,Omics Center Graz, BioTechMed-Graz, Graz, Austria
| | - Daniela Cecconi
- Department of Biotechnology, University of Verona, Verona, Italy
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27
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Gentile M, Iannuzzi A, Giallauria F, D’Andrea A, Venturini E, Pacileo M, Covetti G, Panico C, Mattiello A, Vitale G, Sarullo FM, Rubba P, Vigorito C, Panico S, Iannuzzo G. Association between Very Low-Density Lipoprotein Cholesterol (VLDL-C) and Carotid Intima-Media Thickness in Postmenopausal Women Without Overt Cardiovascular Disease and on LDL-C Target Levels. J Clin Med 2020; 9:jcm9051422. [PMID: 32403373 PMCID: PMC7290892 DOI: 10.3390/jcm9051422] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 01/06/2023] Open
Abstract
Background: atherosclerotic process inexorably advances in patients reaching low-density lipoprotein cholesterol (LDL-C) targets. An attractive hypothesis is that lipoprotein particles (very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL)), could contribute to residual risk. The present study aims to investigate the relationship between carotid intima-media thickness (IMT) and different lipoprotein subfractions in a cohort of healthy postmenopausal women. Methods: 75 postmenopausal women, at LDL-C target levels without overt cardiovascular disease, underwent biochemical analyses (including subfraction assay of plasma lipoproteins) and carotid ultrasound examination. Results: a statistically significant correlation between VLDL and carotid IMT (p < 0.001) was found. No significant correlation was found between carotid IMT and LDL-C (p = 0.179), IDL-C (p = 0.815), high-density lipoprotein (HDL) (p = 0.855), and LDL score (p = 0.240). Moreover, IMT is significantly correlated to LDL particle diameter (p = 0.044). After adjusting for age, systolic blood pressure, body mass index, smoking habits, glucose plasma concentration, and Lipoprotein(a) (Lpa) levels, multivariate analysis showed that women in the third tertile of VLDL-C, compared with those in the first tertile, were significantly associated to the highest IMT (p = 0.04). Conclusions: in this cohort of postmenopausal women, VLDL-C was significantly associated to carotid IMT, independent of main cardiovascular risk factors. These findings pave the way for targeting circulating concentrations of VLDL-C to reduce cardiovascular events in patients with target LDL-C levels.
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Affiliation(s)
- Marco Gentile
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (C.P.); (A.M.); (P.R.); (S.P.); (G.I.)
- Correspondence:
| | - Arcangelo Iannuzzi
- Department of Medicine and Medical Specialties, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (A.I.); (G.C.)
| | - Francesco Giallauria
- “Federico II” University of Naples, Department of Translational Medical Sciences, 80131 Naples, Italy; (F.G.); (C.V.)
| | - Antonello D’Andrea
- Cardiology and Intensive Care Units, “Umberto I” Hospital, Viale San Francesco, 84014 Nocera Inferiore (Salerno), Italy; (A.D.); (M.P.)
| | - Elio Venturini
- Cardiac Rehabilitation Unit, Azienda USL Toscana Nord-Ovest, Cecina Civil Hospital, 57023 Cecina (LI), Italy;
| | - Mario Pacileo
- Cardiology and Intensive Care Units, “Umberto I” Hospital, Viale San Francesco, 84014 Nocera Inferiore (Salerno), Italy; (A.D.); (M.P.)
| | - Giuseppe Covetti
- Department of Medicine and Medical Specialties, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (A.I.); (G.C.)
| | - Camilla Panico
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (C.P.); (A.M.); (P.R.); (S.P.); (G.I.)
| | - Amalia Mattiello
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (C.P.); (A.M.); (P.R.); (S.P.); (G.I.)
| | - Giuseppe Vitale
- Cardiovascular Rehabilitation Unit, “Buccheri La Ferla Fatebenefratelli” Hospital, 90123 Palermo, Italy; (G.V.); (F.M.S.)
| | - Filippo Maria Sarullo
- Cardiovascular Rehabilitation Unit, “Buccheri La Ferla Fatebenefratelli” Hospital, 90123 Palermo, Italy; (G.V.); (F.M.S.)
| | - Paolo Rubba
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (C.P.); (A.M.); (P.R.); (S.P.); (G.I.)
| | - Carlo Vigorito
- “Federico II” University of Naples, Department of Translational Medical Sciences, 80131 Naples, Italy; (F.G.); (C.V.)
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (C.P.); (A.M.); (P.R.); (S.P.); (G.I.)
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (C.P.); (A.M.); (P.R.); (S.P.); (G.I.)
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28
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Fernández-Cidón B, Candás-Estébanez B, Ribalta J, Rock E, Guardiola-Guionnet M, Amigó N, Padró-Miquel A, Alía-Ramos P, Pintó-Sala X. Precipitated sdLDL: An easy method to estimate LDL particle size. J Clin Lab Anal 2020; 34:e23282. [PMID: 32198796 PMCID: PMC7370712 DOI: 10.1002/jcla.23282] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/16/2020] [Accepted: 02/04/2020] [Indexed: 11/10/2022] Open
Abstract
Background LDL‐C lowering is the main measure in cardiovascular disease prevention but a residual risk of ischemic events still remains. Alterations of lipoproteins, specially, increase in small dense LDL (sdLDL) particles are related to this risk. Objective To investigate the potential use of sdLDL cholesterol concentration (sdLDL‐C) isolated by an easy precipitation method and to assess the impact of a set of clinical and biochemical variables determined by NMR on sdLDL concentration. Methods sdLDL‐C and NMR lipid profile were performed in 85 men samples. Association among them was evaluated using Pearson coefficients (rxy). A multivariate regression was performed to identify the influence of NMR variables on sdLDL‐C. Results A strong association between sdLDL‐C and LDLLDL‐P (rxy = 0.687) and with LDL‐Z (rxy = −0.603) was found. The multivariate regression explained a 56.8% in sdLDL‐C variation (P = 8.77.10‐12). BMI, ApoB, triglycerides, FFA, and LDL‐Z showed a significant contribution. The most important ones were ApoB and LDL‐Z; a 1nm increase (LDL‐Z) leads to decrease 126 nmol/L in sdLDL‐C. Conclusion The association between sdLDL‐C, LDL‐Z, and LDL‐P is clear. From a large number of variables, especially LDL‐Z and apoB influence on sdLDL‐C. Results show that the smaller the LDL size, the higher their cholesterol concentration. Therefore, sdLDL‐C determination by using this easy method would be useful to risk stratification and to uncover cardiovascular residual risk.
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Affiliation(s)
- Bárbara Fernández-Cidón
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.,Department of Biochemistry, Molecular Biology and Biomedicine, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | | | - Josep Ribalta
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Edmond Rock
- French National Institute for Agricultural Research, Paris, France
| | | | - Núria Amigó
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | | | - Pedro Alía-Ramos
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Xavier Pintó-Sala
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
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Hedayatnia M, Asadi Z, Zare-Feyzabadi R, Yaghooti-Khorasani M, Ghazizadeh H, Ghaffarian-Zirak R, Nosrati-Tirkani A, Mohammadi-Bajgiran M, Rohban M, Sadabadi F, Rahimi HR, Ghalandari M, Ghaffari MS, Yousefi A, Pouresmaeili E, Besharatlou MR, Moohebati M, Ferns GA, Esmaily H, Ghayour-Mobarhan M. Dyslipidemia and cardiovascular disease risk among the MASHAD study population. Lipids Health Dis 2020; 19:42. [PMID: 32178672 PMCID: PMC7075010 DOI: 10.1186/s12944-020-01204-y] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 02/18/2020] [Indexed: 12/23/2022] Open
Abstract
Introduction Dyslipidemia may be defined as increased levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), or a decreased serum high-density lipoprotein cholesterol (HDL-C) concentration. Dyslipidemia is an established risk factor for cardiovascular disease (CVD). We aimed to investigate the association of dyslipidemia and CVD events among a population sample from Mashhad, in northeastern Iran. Material and methods This prospective cohort study comprised a population of 8698 men and women aged 35–65 years who were recruited from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. Socioeconomic and demographic status, anthropometric parameters, laboratory evaluations, lifestyle factors, and medical history were gathered through a comprehensive questionnaire and laboratory and clinical assessment for all participants. Cox regression model and 95% confidence interval (CI) were used to evaluate the association of dyslipidemia and its components with CVD incidence. Results After 6 years of follow-up, 233 cases of CVD (including 119 cases of unstable angina [US], 74 cases of stable angina [SA], and 40 cases of myocardial infarction [MI]) were identified in the study population. Unadjusted baseline serum LDL-C, TC, and TG levels were positively associated with the risk of total CVD events among the entire population (HR: 1.54, 95% CI: 1.19–2; P-value< 0.01; HR: 1.53; 95% CI: 1.18–1.98; P < 0.01; HR: 1.57; 95% CI: 1.27–2.03; P < 0.01, respectively). However, after adjusting for confounding factors (age, body mass index [BMI], family history of CVD, smoking status [non-smoker, ex-smoker and current smoker], lipid lowering drug treatment, anti-hypertensive drug treatment, hypertension, healthy eating index [HEI], total energy intake, and presence of diabetes mellitus), a significant direct association only remained between TC and MI risk in men (HR: 2.71; 95%CI: 1.12–6.57; P-value< 0.05). Conclusion In the present study, TC baseline level was significantly associated with the risk of MI among men.
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Affiliation(s)
- Mahshad Hedayatnia
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Asadi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zare-Feyzabadi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdiyeh Yaghooti-Khorasani
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ghazizadeh
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roshanak Ghaffarian-Zirak
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Nosrati-Tirkani
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mohammadi-Bajgiran
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohadese Rohban
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Sadabadi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid-Reza Rahimi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marzieh Ghalandari
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Asa Yousefi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elnaz Pouresmaeili
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, UK
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. .,International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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30
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Sparks JR, Porter RR, Youngstedt SD, Bowyer KP, Durstine JL, Wang X. Effects of moderate sleep restriction during 8-week calorie restriction on lipoprotein particles and glucose metabolism. SLEEP ADVANCES 2020; 1:zpab001. [PMID: 33644759 PMCID: PMC7898726 DOI: 10.1093/sleepadvances/zpab001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/08/2021] [Indexed: 11/15/2022]
Abstract
Abstract
Study Objectives
This study examined how glucose, glucose regulatory hormones, insulin sensitivity, and lipoprotein subclass particle concentrations and sizes change with sleep restriction during weight loss elicited by calorie restriction.
Methods
Overweight or obese adults were randomized into an 8-week calorie restriction intervention alone (CR, n = 12; 75% female; body mass index = 31.4 ± 2.9 kg/m2) or combined with sleep restriction (CR+SR, n = 16; 75% female; body mass index = 34.5 ± 3.1 kg/m2). Participants in both groups were given the same instructions to reduce calorie intake. Those in the CR+SR group were instructed to reduce their habitual time-in-bed by 30–90 minutes 5 days each week with 2 ad libitum sleep days. Fasting venous blood samples were collected at pre- and post-intervention.
Results
Differential changes were found between the two groups (p = 0.028 for group × time interaction) in glucagon concentration, which decreased in the CR group (p = 0.016) but did not change in CR+SR group. Although changes in mean HDL particle (HDL-P) size and visfatin concentration were not statistically different between groups (p = 0.066 and 0.066 for group×time interaction, respectively), mean HDL-P size decreased only in the CR+SR group (Cohen’s d = 0.50, p = 0.022); visfatin concentrations did not change significantly in either group but appeared to decrease in the CR group (Cohen’s d = 0.67, p = 0.170) but not in the CR+SR group (Cohen’s d = 0.43, p = 0.225).
Conclusion
These results suggest that moderate sleep restriction, despite the presence of periodic ad libitum sleep, influences lipoprotein subclass particles and glucose regulation in individuals undergoing calorie restriction.
Clinical trial registration: ClinicalTrials.gov (NCT02413866, Weight Outlooks by Restriction of Diet and Sleep)
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Affiliation(s)
- Joshua R Sparks
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Ryan R Porter
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Shawn D Youngstedt
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Kimberly P Bowyer
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - J Larry Durstine
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Xuewen Wang
- Department of Exercise Science, University of South Carolina, Columbia, SC
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Tikkanen E, Minicocci I, Hällfors J, Di Costanzo A, D'Erasmo L, Poggiogalle E, Donini LM, Würtz P, Jauhiainen M, Olkkonen VM, Arca M. Metabolomic Signature of Angiopoietin-Like Protein 3 Deficiency in Fasting and Postprandial State. Arterioscler Thromb Vasc Biol 2020; 39:665-674. [PMID: 30816800 DOI: 10.1161/atvbaha.118.312021] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective- Loss-of-function (LOF) variants in the ANGPTL3 (angiopoietin-like protein 3) have been associated with low levels of plasma lipoproteins and decreased coronary artery disease risk. We aimed to determine detailed metabolic effects of genetically induced ANGPTL3 deficiency in fasting and postprandial state. Approach and Results- We studied individuals carrying S17X LOF mutation in ANGPTL3 (6 homozygous and 32 heterozygous carriers) and 38 noncarriers. Nuclear magnetic resonance metabolomics was used to quantify 225 circulating metabolic measures. We compared metabolic differences between LOF carriers and noncarriers in fasting state and after a high-fat meal. In fasting, ANGPTL3 deficiency was characterized by similar extent of reductions in LDL (low-density lipoprotein) cholesterol (0.74 SD units lower concentration per LOF allele [95% CI, 0.42-1.06]) as observed for many TRL (triglyceride-rich lipoprotein) measures, including VLDL (very-low-density lipoprotein) cholesterol (0.75 [95% CI, 0.45-1.05]). Within most lipoprotein subclasses, absolute levels of cholesterol were decreased more than triglycerides, resulting in the relative proportion of cholesterol being reduced within TRLs and their remnants. Further, β-hydroxybutyrate was elevated (0.55 [95% CI, 0.21-0.89]). Homozygous ANGPTL3 LOF carriers showed essentially no postprandial increase in TRLs and fatty acids, without evidence for adverse compensatory metabolic effects. Conclusions- In addition to overall triglyceride- and LDL cholesterol-lowering effects, ANGPTL3 deficiency results in reduction of cholesterol proportion within TRLs and their remnants. Further, ANGPTL3 LOF carriers had elevated ketone body production, suggesting enhanced hepatic fatty acid β-oxidation. The detailed metabolic profile in human knockouts of ANGPTL3 reinforces inactivation of ANGPTL3 as a promising therapeutic target for decreasing cardiovascular risk.
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Affiliation(s)
- Emmi Tikkanen
- From the Nightingale Health, Ltd, Helsinki, Finland (E.T., J.H., P.W.)
| | - Ilenia Minicocci
- Department of Internal Medicine and Medical Specialties (I.M., A.D.C., L.D., M.A.), Sapienza University of Rome, Italy
| | - Jenni Hällfors
- From the Nightingale Health, Ltd, Helsinki, Finland (E.T., J.H., P.W.)
| | - Alessia Di Costanzo
- Department of Internal Medicine and Medical Specialties (I.M., A.D.C., L.D., M.A.), Sapienza University of Rome, Italy
| | - Laura D'Erasmo
- Department of Internal Medicine and Medical Specialties (I.M., A.D.C., L.D., M.A.), Sapienza University of Rome, Italy
| | - Eleonora Poggiogalle
- Department of Experimental Medicine (E.P., L.M.D.), Sapienza University of Rome, Italy
| | - Lorenzo Maria Donini
- Department of Experimental Medicine (E.P., L.M.D.), Sapienza University of Rome, Italy
| | - Peter Würtz
- From the Nightingale Health, Ltd, Helsinki, Finland (E.T., J.H., P.W.)
| | - Matti Jauhiainen
- Minerva Foundation Institute for Medical Research, Biomedicum 2U, Helsinki, Finland (M.J., V.M.O.)
| | - Vesa M Olkkonen
- Minerva Foundation Institute for Medical Research, Biomedicum 2U, Helsinki, Finland (M.J., V.M.O.)
- Department of Anatomy, University of Helsinki, Finland (V.M.O.)
| | - Marcello Arca
- Department of Internal Medicine and Medical Specialties (I.M., A.D.C., L.D., M.A.), Sapienza University of Rome, Italy
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Dissimilar Effects of Anagliptin and Sitagliptin on Lipoprotein Subclass in Standard or Strong Statin-Treated Patients with Type-2 Diabetes Mellitus: A Subanalysis of the REASON (Randomized Evaluation of Anagliptin versus Sitagliptin on Low-Density LipoproteiN Cholesterol in Diabetes) Trial. J Clin Med 2019; 9:jcm9010093. [PMID: 31905896 PMCID: PMC7019317 DOI: 10.3390/jcm9010093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 12/25/2022] Open
Abstract
The effects of antidiabetic agents on lipoprotein subclasses are assumed to be pivotal, but this assumption has not been studied. We evaluated lipoprotein subclasses in patients, randomly selected from REASON (Randomized Evaluation of Anagliptin versus Sitagliptin On low-density lipoproteiN cholesterol in diabetes) Trial participants, with type-2 diabetes treated with either anagliptin or sitagliptin. We measured total cholesterol (TC) and triglycerides (TG) in 4 (chylomicron (CM), very low-density lipoprotein (VLDL), low density lipoprotein (LDL), and high-density lipoprotein (HDL)) lipoprotein classes and 20 (2 CM, 5 VLDL, 6 LDL, and 7 HDL) lipoprotein subclasses. Between 0 and 52 weeks, TC and TG in lipoprotein and the lipoprotein subclass were distributed differently in patients treated with anagliptin and sitagliptin. The preferable changes in TC and TG levels were observed dominantly in the anagliptin-treated group under standard statin therapy, but the benefits were observed in both the anagliptin- and sitagliptin-treated groups, at least partially under strong statin therapy. In future studies, the atherogenic properties of lipoprotein subclasses might be considered when employing antidiabetic dipeptidyl peptidase-4 (DPP-4) inhibitors, especially in patients with type-2 diabetes who are at risk of atherosclerotic cardiovascular disease (ASCVD) or are undergoing statin treatment.
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33
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Hirowatari Y, Yoshida H. Innovatively Established Analysis Method for Lipoprotein Profiles Based on High-Performance Anion-Exchange Liquid Chromatography. J Atheroscler Thromb 2019; 26:1027-1040. [PMID: 31548491 PMCID: PMC6927812 DOI: 10.5551/jat.rv17037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 08/20/2019] [Indexed: 12/15/2022] Open
Abstract
Separation analysis of lipoprotein classes have various methods, including ultracentrifugation, electrophoresis, and gel permeation chromatography (GPC). All major lipoprotein classes can be separated via ultracentrifugation, but performing the analysis takes a long time. Low-density lipoprotein (LDL), intermediate-density lipoprotein (IDL), and very low-density lipoprotein (VLDL) in patient samples cannot be sufficiently separated via electrophoresis or GPC. Thus, we established a new method [anion-exchange high-performance liquid chromatography (AEX-HPLC)] by using HPLC with an AEX column containing nonporous gel and an eluent containing chaotropic ions. AEX-HPLC can separate five lipoprotein fractions of high-density lipoprotein (HDL), LDL, IDL, VLDL, and others in human serum, which can be used in substitution for ultracentrifugation method. The method was also approved for clinical use in the public health-care insurance in Japan in 2014. Furthermore, we developed an additional method to measure cholesterol levels of the four leading lipoprotein fractions and two subsequent fractions (i.e., chylomicron and lipoprotein(a)). We evaluated the clinical usefulness of AEX-HPLC in patients with coronary heart disease (CHD), diabetes, and kidney disease and in healthy volunteers. Results indicate that the cholesterol levels in IDL and VLDL measured by AEX-HPLC may be useful risk markers of CHD or diabetes. Furthermore, we developed another new method for the determination of alpha-tocopherol (AT) in lipoprotein classes, and this method is composed of AEX-HPLC for the separation of lipoprotein classes and reverse-phase chromatography to separate AT in each lipoprotein class. The AT levels in LDL were significantly correlated with the lag time to copper ion-induced LDL oxidation, which is an index of oxidation resistance. The application of AEX-HPLC to measure various substances in lipoproteins will be clinically expected in the future.
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Affiliation(s)
- Yuji Hirowatari
- Laboratory Science, Department of Health Science, Saitama Prefectural University Saitama, Japan
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital, Chiba, Japan
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34
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Toth PP, Bays HE, Brown WV, Catapano AL, Davidson MH, Farnier M, Tomassini JE, Jensen E, Polis AB, Tershakovec AM. Comparing remnant lipoprotein cholesterol measurement methods to evaluate efficacy of ezetimibe/statin vs statin therapy. J Clin Lipidol 2019; 13:997-1007.e8. [PMID: 31629703 DOI: 10.1016/j.jacl.2019.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/30/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Elevated remnant lipoprotein cholesterol (RLP-C) levels increase cardiovascular disease risk. However, RLP-C measurement methods are not standardized, leading to variations across studies. OBJECTIVE To evaluate the effect of ezetimibe (Eze) + statins vs statin monotherapy on RLP-C using immunoseparation (IM), vertical auto profile (VAP) ultracentrifugation, and calculated RLP-C measurement methods. METHODS This post hoc analysis evaluated data pooled from 3 first-line (all-statin [simvastatin 10/20/40/80 mg] vs Eze + statin [Eze 10 mg + simvastatin]) and 2 second-line (statin [atorvastatin uptitrated to 40/80 mg] vs statin + Eze [atorvastatin 20/40 mg + Eze 10 mg]) studies. Similarity of RLP-C methods was evaluated using Pearson correlation coefficients and Bland-Altman plots. RLP-C changes and percent changes from baseline were measured by all 3 methods in first-line and VAP and calculated methods in second-line studies. RESULTS Correlations between methods were generally moderate to strong for RLP-C levels, changes, and percent changes across treatment groups (r = 0.29-0.79) but with little evidence of agreement by Bland-Altman plots. Baseline RLP-C levels for Eze + statin vs all-statin groups were lower by IM (14.0 vs 14.0) compared with VAP (36.9 vs 35.9) and calculated (32.8 vs 33.3) methods. RLP-C changes (mg/dL) and percent changes from baseline were significantly greater (P < .01) with Eze + statins vs statins by VAP, calculated, and IM methods (between-treatment differences: -5.0 and -12.0, -2.0 and -5.4, and -1.5 and -12.1, respectively) in first-line, and VAP and calculated methods (between-treatment differences: -5.0 and -19.9 and -2.0 and -7.3) in second-line studies. CONCLUSION Although the 3 methods showed little agreement, each supported Eze + statins for achieving greater RLP-C reductions vs statin monotherapy; variability of results reinforces urgent need to standardize RLP-C measurements.
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Affiliation(s)
- Peter P Toth
- CGH Medical Center, Sterling, IL, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Harold E Bays
- Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, USA
| | - W Virgil Brown
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Multimedica IRCCS, Milan, Italy
| | - Michael H Davidson
- The University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Michel Farnier
- Lipid Clinic, Point Médical, and Departement of Cardiology, CHU Dijon-Bourgogne, Dijon, France
| | - Joanne E Tomassini
- Global Clinical Development, Merck Research Laboratories, Merck & Co, Inc, Kenilworth, NJ, USA
| | - Erin Jensen
- Global Clinical Development, Merck Research Laboratories, Merck & Co, Inc, Kenilworth, NJ, USA
| | - Adam B Polis
- Global Clinical Development, Merck Research Laboratories, Merck & Co, Inc, Kenilworth, NJ, USA
| | - Andrew M Tershakovec
- Global Clinical Development, Merck Research Laboratories, Merck & Co, Inc, Kenilworth, NJ, USA
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Sex differences in postprandial responses to different dairy products on lipoprotein subclasses: a randomised controlled cross-over trial. Br J Nutr 2019; 122:780-789. [PMID: 31208475 DOI: 10.1017/s0007114519001429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Men have earlier first-time event of CHD and higher postprandial TAG response compared with women. The aim of this exploratory sub-study was to investigate if intake of meals with the same amount of fat from different dairy products affects postprandial lipoprotein subclasses differently in healthy women and men. A total of thirty-three women and fourteen men were recruited to a randomised controlled cross-over study with four dairy meals consisting of butter, cheese, whipped cream or sour cream, corresponding to 45 g of fat (approximately 60 energy percent). Blood samples were taken at 0, 2, 4 and 6 h postprandially. Lipoprotein subclasses were measured using NMR and analysed using a linear mixed model. Sex had a significant impact on the response in M-VLDL (P=0·04), S-LDL (P=0·05), XL-HDL (P=0·009) and L-HDL (P=0·001) particle concentration (P), with women having an overall smaller increase in M-VLDL-P, a larger decrease in S-LDL-P and a larger increase in XL- and L-HDL-P compared with men, independent of meal. Men showed a decrease in XS-VLDL-P compared with women after intake of sour cream (P<0·01). In men only, XS-VLDL-P decreased after intake of sour cream compared with all other meals (v. butter: P=0·001; v. cheese: P=0·04; v. whipped cream: P=0·006). Meals with the same amount of fat from different dairy products induce different postprandial effects on lipoprotein subclass concentrations in men and women.
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36
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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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Mackey RH, Kuller LH, Moreland LW. Inflammatory joint diseases and atherosclerosis: time to look beyond the 'lipid paradox'. Curr Opin Lipidol 2019; 30:342-349. [PMID: 31145122 DOI: 10.1097/mol.0000000000000620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Uncertainty persists about the contribution of lipids to the increased risk of cardiovascular disease (CVD) among rheumatoid arthritis and other inflammatory joint disease (IJD) patients. In reviewing recent research, we consider potential insights gained by quantifying lipoprotein particles directly, rather than by their lipid content. RECENT FINDINGS Although inflammation often decreases LDL cholesterol (LDL-C), and anti-inflammatory medications often increase LDL-C, both inflammation and anti-inflammatory medications can increase atherogenic Apolipoprotein B (ApoB)-containing lipoprotein particles, attenuated by statins. CVD risk factors, that is, smoking, obesity, ApoB, may increase years prior to IJD diagnosis. Increased risks of nonatherosclerotic myocardial and pulmonary disease, heart failure and mortality may be directly related to disease activity, inflammation, and possibly to HDL particles and function. SUMMARY For IJD patients, higher cumulative lifetime exposure to CVD risk factors accelerates atherosclerosis and subsequent CVD risk that is underestimated by current risk factor levels. CVD risk reduction in IJD requires aggressive and earlier reduction in CVD risk factors (ApoB lipoproteins, smoking, hypertension, diabetes, lack of physical activity), in addition to control of disease activity and inflammation. Lipid-lowering medications can attenuate anti-inflammatory medication-induced increases in ApoB and LDL-C, but can also reduce CVD risk due to cumulative lifetime exposure.
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Affiliation(s)
- Rachel H Mackey
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, University of Pittsburgh
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, University of Pittsburgh
| | - Larry W Moreland
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Farukhi Z, Mora S. A little more time around the track may go a long way: Implications of increasing moderate to vigorous physical activity in pre-adolescents. Atherosclerosis 2019; 288:160-162. [PMID: 31337493 DOI: 10.1016/j.atherosclerosis.2019.06.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 06/27/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Zareen Farukhi
- Center for Lipid Metabolomics, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Samia Mora
- Center for Lipid Metabolomics, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Ruscica M, Tokgözoğlu L, Corsini A, Sirtori CR. PCSK9 inhibition and inflammation: A narrative review. Atherosclerosis 2019; 288:146-155. [PMID: 31404822 DOI: 10.1016/j.atherosclerosis.2019.07.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/06/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality despite excellent pharmacological and revascularization approaches. Low-density lipoproteins (LDL) are undoubtedly the most significant biochemical variables associated with atheroma, however, compelling data identify inflammation as critical for the maintenance of the atherosclerotic process, underlying some of the most feared vascular complications. Although its causal role is questionable, high-sensitivity C-reactive protein (hs-CRP) represents a major biomarker of inflammation and associated risk in CVD. While statin-associated reduced risk may be related to the lowering of both LDL-C and hs-CRP, PCSK9 inhibitors leading to dramatic LDL-C reductions do no alter hs-CRP levels. On the other hand, hs-CRP levels identify groups of patients with a high risk of CV disease achieving better ASCVD prevention in response to PCSK9 inhibition. In the FOURIER study, even in patients with extremely low levels of LDL-C, there was a stepwise risk increment according to the values of hs-CRP: +9% (<1 mg/L), +10.8% (1-3 mg/L) and +13.1% (>3 mg/L). Likewise, in the SPIRE-1 and -2 studies, bococizumab patients with hs-CRP> 3 mg/L had a 60% greater risk of future CV events. Most of the patients enrolled in the PCSK9 trials were on maximally tolerated statin therapy at baseline, and an elevated hs-CRP may reflect residual inflammatory risk after standard LDL-C lowering therapy. Moreover, data on changes in inflammation markers in carriers of PCSK9 loss-of-function mutations are scanty and not conclusive, thus, evidence from the effects of anti-inflammatory molecules on PCSK9 levels might help unravel this hitherto complex tangle.
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Affiliation(s)
- Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Lale Tokgözoğlu
- Department of Cardiology, Hacettepe University, Ankara, Turkey
| | - Alberto Corsini
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy; Multimedica IRCCS, Milan, Italy
| | - Cesare R Sirtori
- Centro Dislipidemie, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Postprandial Circulating miRNAs in Response to a Dietary Fat Challenge. Nutrients 2019; 11:nu11061326. [PMID: 31200481 PMCID: PMC6627817 DOI: 10.3390/nu11061326] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 12/19/2022] Open
Abstract
Postprandial lipemia has many physiopathological effects, some of which increase the risk of cardiovascular disease. MicroRNAs (miRNAs) can be found in almost all biological fluids, but their postprandial kinetics are poorly described. We aimed to profile circulating miRNAs in response to a fat challenge. In total, 641 circulating miRNAs were assessed by real-time PCR in plasmas from mice two hours after lipid gavage. Mice with intestine-specific loss of Dicer were screened to identify potential miRNAs released by the intestine. A total of 68 miRNAs were selected for further validation. Ten circulating miRNAs were finally validated as responsive to postprandial lipemia, including miR-206-3p, miR-543-3p, miR-466c-5p, miR-27b-5p, miR-409-3p, miR-340-3p, miR-1941-3p, miR-10a-3p, miR-125a-3p, and miR-468-3p. Analysis of their possible tissues of origin/target showed an enrichment of selected miRNAs in liver, intestine, brain, or skeletal muscle. miR-206, miR-27b-5p, and miR-409-3p were validated in healthy humans. Analysis of their predicted target genes revealed their potential involvement in insulin/insulin like growth factor (insulin/IGF), angiogenesis, cholecystokinin B receptor signaling pathway (CCKR), inflammation or Wnt pathways for mice, and in platelet derived growth factor (PDGF) and CCKR signaling pathways for humans. Therefore, the current study shows that certain miRNAs are released in the circulation in response to fatty meals, proposing them as potential novel therapeutic targets of lipid metabolism.
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Rosenson RS, Daviglus ML, Handelsman Y, Pozzilli P, Bays H, Monsalvo ML, Elliott-Davey M, Somaratne R, Reaven P. Efficacy and safety of evolocumab in individuals with type 2 diabetes mellitus: primary results of the randomised controlled BANTING study. Diabetologia 2019; 62:948-958. [PMID: 30953107 PMCID: PMC6509076 DOI: 10.1007/s00125-019-4856-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/18/2019] [Indexed: 01/24/2023]
Abstract
AIMS/HYPOTHESIS The study aimed to examine the efficacy of 12 weeks of monthly evolocumab or placebo in lowering LDL-cholesterol (LDL-C) in individuals with type 2 diabetes and hypercholesterolaemia or mixed dyslipidaemia and on a maximum-tolerated statin of at least moderate intensity. METHODS For this randomised, placebo-controlled outpatient study, eligible individuals were ≥18 years old with type 2 diabetes, HbA1c <10% (86 mmol/mol), had been on stable pharmacological therapy for diabetes for ≥6 months and were taking a maximum-tolerated statin dose of at least moderate intensity. Lipid eligibility criteria varied by history of clinical cardiovascular disease. Participants were randomised 2:1 to evolocumab 420 mg s.c. or placebo. Randomisation was performed centrally via an interactive web-based or voice recognition system. Allocation was concealed using the centralised randomisation process. Treatment assignment was blinded to the sponsor study team, investigators, site staff and patients throughout the study. Co-primary endpoints were mean percentage change in LDL-C from baseline to week 12 and to the mean of weeks 10 and 12. Additional endpoints included LDL-C <1.81 mmol/l, LDL-C reduction ≥50% and other lipids. Exploratory analyses included percentage changes in fasting and post mixed-meal tolerance test (MMTT) lipoproteins and lipids, glucose metabolism variables and inflammatory biomarkers. RESULTS In total, 421 individuals were randomised and analysed, having received evolocumab (280 participants) or placebo (141 participants) (mean [SD] age 62 [8] years; 44% women; 77% white). Evolocumab decreased LDL-C by 54.3% (1.4%) at week 12 (vs 1.1% [1.9%] decrease with placebo; p < 0.0001) and by 65.0% (1.3%) at the mean of weeks 10 and 12 (vs 0.8% [1.8%] decrease with placebo; p < 0.0001); it also decreased non-HDL-cholesterol (HDL-C) by 46.9% (1.3%) at week 12 (vs 0.6% [1.8%] decrease with placebo) and by 56.6% (1.2%) at the mean of weeks 10 and 12 (vs 0.1% [1.6%] decrease with placebo). Evolocumab significantly improved levels of other lipids and allowed more participants to reach LDL-C <1.81 mmol/l or a reduction in LDL-C levels ≥50%. After an MMTT (120 min), there were favourable changes (p < 0.05; nominal, post hoc, no multiplicity adjustment) in chylomicron triacylglycerol (triglycerides), chylomicron cholesterol, VLDL-C and LDL-C. Evolocumab had no effect on glycaemic variables and was well tolerated. CONCLUSIONS/INTERPRETATION In statin-treated individuals with type 2 diabetes and hypercholesterolaemia or mixed dyslipidaemia, evolocumab significantly reduced LDL-C and non-HDL-C. Favourable changes (p < 0.05) were observed in postprandial levels of chylomicrons, VLDL-C and LDL-C. TRIAL REGISTRATION ClinicalTrials.gov NCT02739984 FUNDING: This study was funded by Amgen Inc. DATA AVAILABILITY Qualified researchers may request data from Amgen clinical studies. Complete details are available at www.amgen.com/datasharing .
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Affiliation(s)
- Robert S Rosenson
- Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, MC Level, New York, NY, 10029, USA.
| | - Martha L Daviglus
- University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | | | | | - Harold Bays
- Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, USA
| | | | | | | | - Peter Reaven
- University of Arizona College of Medicine, Phoenix VA Health Care System, Phoenix, AZ, USA
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May HT, Muhlestein JB, Ma Y, López JAG, Coll B, Nelson J. Effects of Evolocumab on the ApoA1 Remnant Ratio: A Pooled Analysis of Phase 3 Studies. Cardiol Ther 2019; 8:91-102. [PMID: 30852766 PMCID: PMC6525215 DOI: 10.1007/s40119-019-0133-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Indexed: 12/05/2022] Open
Abstract
Introduction The apolipoprotein A1 (apoA1) remnant ratio has been identified as an independent cardiovascular (CV) risk factor. Higher apoA1 remnant ratios may predict lower CV risk in some patients. This analysis aimed to evaluate the effects of evolocumab on the change from baseline in the apoA1 remnant ratio compared with placebo. Methods This pooled post hoc analysis included 2464 patients with mixed dyslipidemia treated with evolocumab 140 mg every 2 weeks (Q2W) or 420 mg once monthly (QM) in three phase 3 evolocumab trials. The apoA1 remnant ratio was calculated by dividing apoA1 by the difference between non-high-density lipoprotein cholesterol (non-HDL-C) and low-density lipoprotein cholesterol (LDL-C). ApoA1 remnant ratio strata were generated using previously published tertile (< 4.7, 4.7–6.8, and > 6.8) and partitioning categories (< 3.6, 3.6–6.0, and > 6.0). Results The baseline apoA1 remnant ratio in evolocumab and placebo treatment arms was 7.1 and 7.3, respectively. At week 12, evolocumab 140 mg Q2W and 420 mg QM increased the apoA1 remnant ratio by 25.0% and 33.6%, respectively, versus placebo (p < 0.0001 for both groups). When patients were categorized by week 12 apoA1 remnant ratio thresholds (< 3.6 vs. > 3.6, and < 4.7 vs. > 4.7), those with higher week 12 apoA1 remnant ratios were significantly more likely to have also achieved a target non-HDL-C level of < 100 mg/dl. In the subset of women > 50 years of age, the proportion of patients at apoA1 remnant ratio thresholds < 3.6, 3.6–6.0, and > 6.0 at baseline shifted toward or remained at higher thresholds at week 12. Conclusions This post hoc analysis suggests that evolocumab increases the apoA1 remnant ratio. Funding Amgen Inc. Plain Language Summary Plain language summary available for this article. Electronic supplementary material The online version of this article (10.1007/s40119-019-0133-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heidi T May
- Intermountain Heart Institute, Intermountain Medical Center, Murray, UT, USA.
| | - Joseph B Muhlestein
- Intermountain Heart Institute, Intermountain Medical Center, Murray, UT, USA.,Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Yuhui Ma
- Amgen Inc., Thousand Oaks, CA, USA
| | | | | | - John Nelson
- California Cardiovascular Institute, Fresno, CA, USA
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Al Rifai M, Cainzos-Achirica M, Blaha MJ, Arps K, Wood DA, Blumenthal RS, McEvoy JW. Health Factors Associated with Cardiovascular Wellness. Curr Atheroscler Rep 2019; 21:10. [PMID: 30747344 DOI: 10.1007/s11883-019-0771-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE OF REVIEW In this review, we discuss a new paradigm for atherosclerotic cardiovascular disease (ASCVD) prevention that is focused on cultivating cardiovascular wellness through the promotion of "health factors." RECENT FINDINGS Cardiovascular prevention efforts have contributed to falling rates of ASCVD over the past five decades. However, contemporary increases in obesity and diabetes have led to a recent slowing in the annual decline of ASCVD death rates. This slowing represents an opportunity for new thinking to change the current ASCVD prevention paradigm, i.e., the identification and treatment or control of risk factors for disease. Indeed, a new paradigm focusing on cultivating cardiovascular wellness in addition to preventing disease is gaining increased traction. With this approach, the goal of ASCVD prevention is shifting to include consideration of both treating "risk factors" and cultivating health factors. Importantly, cardiovascular wellness is more than just the absence of disease and, therefore, risk factors and health factors are not always mere opposites. We review healthy lifestyle tools such as the American Heart Association Life's simple 7 and Fuster-BEWAT score. We summarize landmark studies of interventions aimed at improving adherence to health factors. We highlight the inherent limitations of current studies to adequately examine cardiovascular wellness. We propose new study designs that are required to identify novel health factors and measures of wellness. We conclude with recommendations regarding the utility of health factors and cardiovascular wellness in current practice.
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Affiliation(s)
- Mahmoud Al Rifai
- Department of Internal Medicine, University of Kansas School of Medicine, Wichita, KS, USA.,Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Miguel Cainzos-Achirica
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.,Bellvitge University Hospital and Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Kelly Arps
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - David A Wood
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.,National University of Ireland, Galway Campus, Galway, Ireland.,National Institute for Preventive Cardiology; and Saolta University Healthcare Group, University College Hospital Galway, Newcastle Rd, Galway, Ireland
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - John W McEvoy
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA. .,National University of Ireland, Galway Campus, Galway, Ireland. .,National Institute for Preventive Cardiology; and Saolta University Healthcare Group, University College Hospital Galway, Newcastle Rd, Galway, Ireland.
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Sliz E, Kettunen J, Holmes MV, Williams CO, Boachie C, Wang Q, Männikkö M, Sebert S, Walters R, Lin K, Millwood IY, Clarke R, Li L, Rankin N, Welsh P, Delles C, Jukema JW, Trompet S, Ford I, Perola M, Salomaa V, Järvelin MR, Chen Z, Lawlor DA, Ala-Korpela M, Danesh J, Davey Smith G, Sattar N, Butterworth A, Würtz P. Metabolomic consequences of genetic inhibition of PCSK9 compared with statin treatment. Circulation 2018; 138:2499-2512. [PMID: 30524137 PMCID: PMC6254781 DOI: 10.1161/circulationaha.118.034942] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/22/2018] [Indexed: 12/22/2022]
Abstract
Background Both statins and PCSK9 inhibitors lower blood low-density lipoprotein cholesterol (LDL-C) levels to reduce risk of cardiovascular events. To assess potential differences between metabolic effects of these two lipid-lowering therapies, we performed detailed lipid and metabolite profiling of a large randomized statin trial and compared the results with the effects of genetic inhibition of PCSK9, acting as a naturally occurring trial. Methods 228 circulating metabolic measures were quantified by nuclear magnetic resonance spectroscopy, including lipoprotein subclass concentrations and their lipid composition, fatty acids, and amino acids, for 5,359 individuals (2,659 on treatment) in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) trial at 6-months post-randomization. The corresponding metabolic measures were analyzed in eight population cohorts (N=72,185) using PCSK9 rs11591147 as an unconfounded proxy to mimic the therapeutic effects of PCSK9 inhibitors. Results Scaled to an equivalent lowering of LDL-C, the effects of genetic inhibition of PCSK9 on 228 metabolic markers were generally consistent with those of statin therapy (R2=0.88). Alterations in lipoprotein lipid composition and fatty acid distribution were similar. However, discrepancies were observed for very-low-density lipoprotein (VLDL) lipid measures. For instance, genetic inhibition of PCSK9 had weaker effects on lowering of VLDL-cholesterol compared with statin therapy (54% vs. 77% reduction, relative to the lowering effect on LDL-C; P=2x10-7 for heterogeneity). Genetic inhibition of PCSK9 showed no significant effects on amino acids, ketones, or a marker of inflammation (GlycA) whereas statin treatment weakly lowered GlycA levels. Conclusions Genetic inhibition of PCSK9 had similar metabolic effects to statin therapy on detailed lipid and metabolite profiles. However, PCSK9 inhibitors are predicted to have weaker effects on VLDL lipids compared with statins for an equivalent lowering of LDL-C, which potentially translate into smaller reductions in cardiovascular disease risk.
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Affiliation(s)
- Eeva Sliz
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
| | - Johannes Kettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Computational Medicine, Faculty of Medicine, University of Oulu, Finland
| | - Michael V Holmes
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- National Institute for Health Research, Oxford Biomedical Research Centre, Oxford University Hospital, Oxford, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Clare Oliver Williams
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Homerton College, University of Cambridge, Cambridge, UK
| | - Charles Boachie
- Robertson Centre for Biostatistics, Boyd Orr Building, University of Glasgow, Glasgow, UK
| | - Qin Wang
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Computational Medicine, Faculty of Medicine, University of Oulu, Finland
- Systems Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Minna Männikkö
- Northern Finland Birth Cohorts, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Department of Genomics of Complex Diseases, School of Public Health, Imperial College London, UK
| | - Robin Walters
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kuang Lin
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robert Clarke
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Chinese Academy of Medical Sciences, 9 Dongdan San Tiao, Beijing, China
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Naomi Rankin
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | | | - Stella Trompet
- Leiden University Medical Centre, Leiden, The Netherlands
- Department of Internal Medicine, section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Ian Ford
- Robertson Centre for Biostatistics, Boyd Orr Building, University of Glasgow, Glasgow, UK
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Debbie A Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mika Ala-Korpela
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Computational Medicine, Faculty of Medicine, University of Oulu, Finland
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Systems Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, The Alfred Hospital, Monash University, Melbourne, VIC, Australia
| | - John Danesh
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, United Kingdom
- Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Adam Butterworth
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, United Kingdom
| | - Peter Würtz
- Diabetes and Obesity Research Program, University of Helsinki, Helsinki, Finland
- Nightingale Health Ltd, Helsinki, Finland
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Fuertes-Martín R, Taverner D, Vallvé JC, Paredes S, Masana L, Correig Blanchar X, Amigó Grau N. Characterization of 1H NMR Plasma Glycoproteins as a New Strategy To Identify Inflammatory Patterns in Rheumatoid Arthritis. J Proteome Res 2018; 17:3730-3739. [PMID: 30353728 DOI: 10.1021/acs.jproteome.8b00411] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease associated with a high index of morbidity and mortality from cardiovascular diseases. We used 1H NMR to characterize the plasma glycoprotein and lipoprotein profiles of a cohort of patients with RA ( n = 210) versus healthy individuals ( n = 203) to associate them with the RA disease and its severity. Using 1H NMR, we developed a line-shape method to characterize the two peaks associated with glycoproteins (GlycA and GlycB) and its derived variables: areas of GlycB (Area GlycB) and GlycA (Area GlycA), shape factors of these two peaks (H/W = height/width), and the distance between them (Distance GlycB-GlycA). We also used the advanced lipoprotein test Liposcale (CE) to characterize the lipoprotein subclasses. The standard lipid panel and traditional inflammatory markers such as C-reactive protein, the erythrocyte sedimentation rate, fibrinogen, the rheumatoid factor, anticitrullinated peptide antibodies, and the DAS28 index have also been determined. RA patients presented a significant 10.65% increase in the GlycA associated area compared with the control group ( p = 2.21 × 10-10). They also presented significantly higher H/W GlycA and GlycB ratios than the control population (H/W GlycB p = 7.88 × 10-8; H/W GlycA p = 5.61 × 10-8). The prediction model that uses the traditional inflammatory variables and the 1H NMR-derived parameters presented an AUC that was almost 10% higher than the model that only uses the traditional inflammatory variables (from 0.7 to 0.79 AUC). We have demonstrated that GlycA and GlycB variables derived from 1H NMR, along with classic inflammatory parameters, help to improve the classification of individuals with high RA disease activity.
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Affiliation(s)
- Rocío Fuertes-Martín
- Biosfer Teslab SL; DEEEA, Metabolomics Platform , Universitat Rovira i Virgili, IISPV; CIBERDEM , 43007 Tarragona , Spain
| | - Dèlia Taverner
- Unitat de Recerca en Lipids i Arteriosclerosi , Hospital Universitari Sant Joan de Reus; IISPV; CIBERDEM , 43204 Reus , Spain
| | - Joan-Carles Vallvé
- Unitat de Recerca en Lipids i Arteriosclerosi , Hospital Universitari Sant Joan de Reus; IISPV; CIBERDEM , 43204 Reus , Spain
| | - Silvia Paredes
- Unitat de Recerca en Lipids i Arteriosclerosi , Hospital Universitari Sant Joan de Reus; IISPV; CIBERDEM , 43204 Reus , Spain
| | - Lluis Masana
- Unitat de Recerca en Lipids i Arteriosclerosi , Hospital Universitari Sant Joan de Reus; IISPV; CIBERDEM , 43204 Reus , Spain
| | | | - Núria Amigó Grau
- Biosfer Teslab SL; DEEEA, Metabolomics Platform , Universitat Rovira i Virgili, IISPV; CIBERDEM , 43007 Tarragona , Spain
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Novikova OA, Laktionov PP, Karpenko AA. The roles of mechanotransduction, vascular wall cells, and blood cells in atheroma induction. Vascular 2018; 27:98-109. [PMID: 30157718 DOI: 10.1177/1708538118796063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND This paper describes and analyzes the cellular and molecular mechanisms underlying atherosclerosis development. In particular, the roles of monocytes/macrophages, smooth muscle cells, and vascular endothelium in the formation of stable/unstable atheromatous plaques, and the contributions of some processes to atheroma formation. METHODS AND RESULTS In this study we analyzed endothelium: function, dysfunction, and involvement into atherogenesis; cell proteins mediating mechanotransduction; proatherogenic role of monocytes; the role of macrophages in the development of unstable atheromatous plaques and smooth muscle cell origin in atherosclerosis. Smooth muscle cell phenotypic switching; their functioning; the ability to retain cholesterol and lipoproteins as well as secretion of pro- and anti-inflammatory molecules and extracellular matrix proteins, their response to extracellular stimuli secreted by other cells, and the effect of smooth muscle cells on the cells surrounding atheromatous plaques are fundamentally important for the insight into atherosclerosis molecular basis. CONCLUSION Atheromatous plaque transcriptome studies will be helpful in the identification of the key genes involved in atheroma transformation and development as well as discovery of the new targets for diagnosis and therapy.
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Affiliation(s)
- Olga A Novikova
- 1 Department of Vascular and Hybrid Surgery, National Medical Research Institute Academician E.N. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
| | - Pavel P Laktionov
- 2 Laboratory of Molecular Medicine, SB RAS Institute of Chemical Biology and Fundamental Medicine; E.N. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation.,3 E.N. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
| | - Andrey A Karpenko
- 1 Department of Vascular and Hybrid Surgery, National Medical Research Institute Academician E.N. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
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Langlois MR, Nordestgaard BG. Which Lipids Should Be Analyzed for Diagnostic Workup and Follow-up of Patients with Hyperlipidemias? Curr Cardiol Rep 2018; 20:88. [PMID: 30120626 DOI: 10.1007/s11886-018-1036-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW To summarize and discuss the clinical use of lipid and apolipoprotein tests in the settings of diagnosis and therapeutic follow-up of hyperlipidemia. RECENT FINDINGS The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently produced recommendations on the measurement of atherogenic lipoproteins, taking into account the strengths and weaknesses of analytical and clinical performances of the tests. Total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol (= LDL + remnant cholesterol) constitute the primary lipid panel for hyperlipidemia diagnosis and cardiovascular risk estimation. LDL cholesterol is the primary target of lipid-lowering therapies. Non-HDL cholesterol or apolipoprotein B should be used as secondary therapeutic target in patients with mild-to-moderate hypertriglyceridemia, 2-10 mmol/l (175-880 mg/dl). Lipoprotein (a) is included in LDL cholesterol and should be measured at least once in all patients at cardiovascular risk, including to explain poor response to statin treatment.
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Affiliation(s)
- Michel R Langlois
- AZ St.-Jan Hospital, Department of Laboratory Medicine, Ruddershove 10, 8000, Brugge, Belgium. .,University of Ghent, Ghent, Belgium.
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
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Wada H, Dohi T, Miyauchi K, Jun S, Endo H, Doi S, Konishi H, Naito R, Tsuboi S, Ogita M, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H. Relationship between the prognostic nutritional index and long-term clinical outcomes in patients with stable coronary artery disease. J Cardiol 2018; 72:155-161. [DOI: 10.1016/j.jjcc.2018.01.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/17/2018] [Accepted: 01/23/2018] [Indexed: 12/23/2022]
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Packard CJ. Determinants of Achieved LDL Cholesterol and "Non-HDL" Cholesterol in the Management of Dyslipidemias. Curr Cardiol Rep 2018; 20:60. [PMID: 29904807 DOI: 10.1007/s11886-018-1003-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW The advent of combination therapy to provide LDL lowering beyond that achieved with statins necessitates the development of greater understanding of how drugs work together, what changes occur in key lipoprotein fractions, and what residual risk remains. RECENT FINDINGS Clinical trials of agents that, when added to statins, generate profound LDL lowering have been successful in reducing further the risk of cardiovascular disease. LDL cholesterol can be now decreased to unprecedented levels, so the focus of attention then shifts to other apolipoprotein B-containing, atherogenic lipoprotein classes such as lipoprotein(a) and remnants of the metabolism of triglyceride-rich particles. "Non-HDL cholesterol" is used increasingly (especially if measured in the non-fasting state) as a more comprehensive index of risk. Metabolic studies reveal how current drugs act in combination to achieve profound lipid lowering. However, care is needed in interpreting achieved LDLc and non-HDLc levels in the emerging treatment paradigm.
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Affiliation(s)
- Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Ground Floor, Room G31, McGregor Building, University Avenue, Glasgow, G12 8QQ, UK.
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50
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Langlois MR, Chapman MJ, Cobbaert C, Mora S, Remaley AT, Ros E, Watts GF, Borén J, Baum H, Bruckert E, Catapano A, Descamps OS, von Eckardstein A, Kamstrup PR, Kolovou G, Kronenberg F, Langsted A, Pulkki K, Rifai N, Sypniewska G, Wiklund O, Nordestgaard BG. Quantifying Atherogenic Lipoproteins: Current and Future Challenges in the Era of Personalized Medicine and Very Low Concentrations of LDL Cholesterol. A Consensus Statement from EAS and EFLM. Clin Chem 2018; 64:1006-1033. [PMID: 29760220 DOI: 10.1373/clinchem.2018.287037] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/09/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND The European Atherosclerosis Society-European Federation of Clinical Chemistry and Laboratory Medicine Consensus Panel aims to provide recommendations to optimize atherogenic lipoprotein quantification for cardiovascular risk management. CONTENT We critically examined LDL cholesterol, non-HDL cholesterol, apolipoprotein B (apoB), and LDL particle number assays based on key criteria for medical application of biomarkers. (a) Analytical performance: Discordant LDL cholesterol quantification occurs when LDL cholesterol is measured or calculated with different assays, especially in patients with hypertriglyceridemia >175 mg/dL (2 mmol/L) and low LDL cholesterol concentrations <70 mg/dL (1.8 mmol/L). Increased lipoprotein(a) should be excluded in patients not achieving LDL cholesterol goals with treatment. Non-HDL cholesterol includes the atherogenic risk component of remnant cholesterol and can be calculated in a standard nonfasting lipid panel without additional expense. ApoB more accurately reflects LDL particle number. (b) Clinical performance: LDL cholesterol, non-HDL cholesterol, and apoB are comparable predictors of cardiovascular events in prospective population studies and clinical trials; however, discordance analysis of the markers improves risk prediction by adding remnant cholesterol (included in non-HDL cholesterol) and LDL particle number (with apoB) risk components to LDL cholesterol testing. (c) Clinical and cost-effectiveness: There is no consistent evidence yet that non-HDL cholesterol-, apoB-, or LDL particle-targeted treatment reduces the number of cardiovascular events and healthcare-related costs than treatment targeted to LDL cholesterol. SUMMARY Follow-up of pre- and on-treatment (measured or calculated) LDL cholesterol concentration in a patient should ideally be performed with the same documented test method. Non-HDL cholesterol (or apoB) should be the secondary treatment target in patients with mild to moderate hypertriglyceridemia, in whom LDL cholesterol measurement or calculation is less accurate and often less predictive of cardiovascular risk. Laboratories should report non-HDL cholesterol in all standard lipid panels.
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Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St-Jan, Brugge, and University of Ghent, Belgium;
| | - M John Chapman
- National Institute for Health and Medical Research (INSERM), and Endocrinology-Metabolism Service, Pitié-Salpetriere University Hospital, Paris, France
| | - Christa Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Samia Mora
- Divisions of Preventive and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Emilio Ros
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, Barcelona and Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain
| | - Gerald F Watts
- Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Jan Borén
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hannsjörg Baum
- Institute for Laboratory Medicine, Blutdepot und Krankenhaushygiene, Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
| | - Eric Bruckert
- Pitié-Salpetriere University Hospital, Paris, France
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | | | | | - Pia R Kamstrup
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Florian Kronenberg
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anne Langsted
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kari Pulkki
- Department of Clinical Chemistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Nader Rifai
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, NC University, Bydgoszcz, Poland
| | - Olov Wiklund
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Børge G Nordestgaard
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
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