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Alfadda AA, Youssef AM, Al-Sofiani ME, Amin HS, AlOtaibi O, Mohamed N, Algohani HA, Isnani A, Rafiullah M. Medication Adherence and Treatment Satisfaction With Lipid-Lowering Drugs Among Patients With Diabetes and Dyslipidemia. Ann Pharmacother 2024:10600280241262513. [PMID: 39054790 DOI: 10.1177/10600280241262513] [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: 07/27/2024] Open
Abstract
BACKGROUND Poor adherence to lipid-lowering drugs in diabetic patients with dyslipidemia increases has been linked with an increased cardiovascular risk. A better understanding of the determinants of adherence to lipid-lowering drugs and treatment satisfaction among people with diabetes and dyslipidemia is crucial. OBJECTIVE We aimed to assess the prevalence of adherence to lipid-lowering drugs, identify its determinant factors, and evaluate treatment satisfaction among users of lipid-lowering drugs who have diabetes and dyslipidemia. METHODS We surveyed 398 adult patients with diabetes and dyslipidemia, using a validated medication adherence survey (Adherence to Refills and Medications Scale) and a validated treatment satisfaction survey (Treatment Satisfaction Questionnaire for Medication, TSQM). Sociodemographic and medical history data were collected through questionnaires. RESULTS The prevalence of poor medication adherence was 36%. Factors associated with poor adherence included adverse reactions to medications, lack of medication availability, and lack of family support. Adherent patients reported lower low-density lipoprotein-cholesterol (LDL-C) and total cholesterol levels, higher treatment satisfaction, and a higher prevalence of cardiovascular disease and comorbidities. Having a family history of dyslipidemia was negatively associated with adherence, while the number of comorbidities positively influenced it. The scores of TSQM components such as effectiveness, global satisfaction, and convenience were significantly higher in people who were adherent or achieved the LDL-C target. CONCLUSION AND RELEVANCE Our findings highlight the need for interventions targeting several factors impacting adherence to lipid-lowering drugs in patients with diabetes and dyslipidemia. Managing adverse effects, leveraging family support, and ensuring medication access represent crucial aspects of improving adherence and potentially mitigating cardiovascular risks in this high-risk population.
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Affiliation(s)
- Assim A Alfadda
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amira M Youssef
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed E Al-Sofiani
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hussein Saad Amin
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Obeed AlOtaibi
- University Diabetes Center, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Nourhan Mohamed
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hossam Ayed Algohani
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Arthur Isnani
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Rafiullah
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Divković A, Karasalihović Z, Rumora Samarin I, Sabitović D, Radić K, Golub N, Vujić L, Rajković MG, Vitali Čepo D. Effect of Alpha Lipoic Acid Supplementation on Oxidative Stress and Lipid Parameters in Women Diagnosed with Low-Grade Squamous Intraepithelial Lesions (LSILs): A Double-Blind, Randomized, Placebo-Controlled Trial. Antioxidants (Basel) 2023; 12:1670. [PMID: 37759972 PMCID: PMC10525309 DOI: 10.3390/antiox12091670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Limited scientific evidence shows that alpha lipoic acid (ALA) can induce regression rates of low-grade squamous intraepithelial lesions (LSILs), but the mechanisms of these effects have not been elucidated. To gain a broader insight into its therapeutic potential and mechanisms of action, the effects of 3 months of supplementation with 600 mg of ALA on antioxidant and lipid status parameters in 100 patients with LSILs were investigated in a randomized, placebo-controlled study. The obtained results are discussed in terms of patients' initial metabolic status and diet quality (particularly nutritional intake of antioxidants). The obtained results showed that oxidative status biomarkers were not significantly affected by ALA supplementation. However, serum superoxide dismutase (SOD) activity was positively affected in the subgroup of patients with higher dietary antioxidant intake. Surprisingly, ALA supplementation resulted in a small but statistically significant increase in serum low density lipoprotein (LDL), and the observed effect was significantly affected by the initial lipid status of the participants. Larger studies are necessary to gain additional insights on the clinical significance of ALA as an antioxidant and hypolipemic agent and to optimize its potential application in LSIL treatment.
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Affiliation(s)
- Anja Divković
- University Clinical Centre Tuzla, 75000 Tuzla, Bosnia and Herzegovina; (A.D.); (Z.K.)
| | - Zinaida Karasalihović
- University Clinical Centre Tuzla, 75000 Tuzla, Bosnia and Herzegovina; (A.D.); (Z.K.)
| | - Ivana Rumora Samarin
- University of Zagreb, Faculty of Food Technology and Biotechnology, 10000 Zagreb, Croatia;
| | - Damir Sabitović
- University Clinical Centre Tuzla, 75000 Tuzla, Bosnia and Herzegovina; (A.D.); (Z.K.)
| | - Kristina Radić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Nikolina Golub
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Lovorka Vujić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Marija Grdić Rajković
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Dubravka Vitali Čepo
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
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Wu DF, Lin D, Lu F, Liao QC, Wu YJ, Wang Z, Yu K, Li WJ, Deng JL. Sex-Specific Influence of the SCARB1 Rs5888 SNP on the Serum Lipid Response to Atorvastatin in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2020; 13:553-561. [PMID: 33154658 PMCID: PMC7605962 DOI: 10.2147/pgpm.s273346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022]
Abstract
Background Epidemiological studies have shown that there are sex differences in blood lipid levels and lipid responses to statins. Previous studies have shown that the rs5888 single nucleotide polymorphism (SNP) in the scavenger receptor class B type 1 (SCARB1) gene is associated with serum lipid levels in a sex-specific manner. The present study was undertaken to detect the sex-specific influence of the SCARB1 rs5888 SNP on the serum lipid response to atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods A total of 158 unrelated ACS patients (108 males, 50 females) were enrolled, and all patients received atorvastatin 20 mg/daily after PCI. Genotyping of the rs5888 SNP was performed by polymerase chain reaction and direct sequencing. Serum lipid profiles were determined before treatment and after an average follow-up time of one year. Results The baseline serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (Apo)AI levels were higher in females than in males (P<0.05). After treatment with atorvastatin, serum TC, LDL-C, and ApoB were decreased, and ApoAI was increased (P<0.05). The effects of atorvastatin on serum lipid levels were different between males and females, and females had greater decreases in TC, LDL-C and ApoB levels than males (P<0.05). The genotypic frequencies of the rs5888 SNP were not different between males and females. The atorvastatin response was not associated with the rs5888 SNP in males (P > 0.05). Nonetheless, in female individuals carrying the rs5888 T-allele, we observed a greater reduction in TC, LDL-C, and ApoB levels after the use of 20 mg/day atorvastatin (P<0.05). Conclusion This study indicates that the SCARB1 rs5888 T-allele was associated with a greater reduction in serum TC, LDL-C, and ApoB after atorvastatin treatment in female patients with ACS undergoing PCI.
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Affiliation(s)
- Dong-Feng Wu
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
| | - Dan Lin
- Department of the First Comprehensive Clinic, The Affiliated Stomatology Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Feng Lu
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
| | - Qin-Chen Liao
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
| | - Yu-Juan Wu
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
| | - Zhou Wang
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
| | - Kun Yu
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
| | - Wei-Jun Li
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
| | - Jin-Long Deng
- Department of the Geriatric Cardiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, People's Republic of China
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The Gut Microbiota-Produced Indole-3-Propionic Acid Confers the Antihyperlipidemic Effect of Mulberry-Derived 1-Deoxynojirimycin. mSystems 2020; 5:5/5/e00313-20. [PMID: 33024047 PMCID: PMC7542557 DOI: 10.1128/msystems.00313-20] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Hyperlipidemia is a worldwide epidemic with an obvious gender disparity in incidence. Modulations on gut microbiota by traditional Chinese medicines (TCM) are emerging as a potential rationale governing the profitable effects of drugs on hyperlipidemia. However, it is unclear how gut microbes regulate the progression of hyperlipidemia. Here, we found that mulberry leaf extract (MLE) and its active component 1-deoxynojirimycin (DNJ) diminished hyperglycemia and hypertriglyceridemia with similar efficacy in male and female mice but preferentially alleviated hypercholesterolemia in female mice. Further investigations showed that DNJ sex-specifically downregulated the expression of lipogenic genes, especially cholesterol-biosynthetic genes. Oral administration of DNJ imposed more profound modulation on gut microbiota in female mice than in male ones, as estimated by 16S rRNA metatranscriptomic analysis. DNJ markedly enriched Akkermansia and Clostridium group XIVa and promoted the production of indole-3-propionic acid (IPA) in a sexually dimorphic way. Importantly, IPA tightly associates with the antihyperlipidemic effect of DNJ and exhibited a potent lipid-lowering effect both in vitro and in vivo Together, our results have established a regulatory mechanism by which DNJ sex-specifically improves hyperlipidemia, offering an in-depth theoretical basis for therapeutic exploitation of DNJ as a sex-specific intervention against hyperlipidemia.IMPORTANCE Hyperlipidemia has been intensively focused on by researchers around the world owing to its major contribution to cardiovascular diseases. Various evidence reveals that women are more susceptible than male counterparts to dyslipidemia, making sex-dependent therapeutic strategies and drugs urgently needed. In the present work, we demonstrate that DNJ, the main active component of mulberry leaves, exerts an obvious female-preferential antihyperlipidemic effect through specifically enriching Akkermansia and Clostridium XIVa and elevating an active microbial metabolite, indole-3-propionic acid (IPA), in female mice. Moreover, we have corroborated the potent lipid-lowering efficacy of IPA both in vitro and in vivo These findings not only indicate a potential mechanism by which gut microbes and their metabolites confer the beneficial role of DNJ in ameliorating hyperlipidemia but also provide an in-depth theoretical basis for therapeutic exploitation of DNJ as a female-specific intervention against hyperlipidemia.
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Michaud TL, Siahpush M, King KM, Ramos AK, Robbins RE, Schwab RJ, Clarke MA, Su D. Program completion and glycemic control in a remote patient monitoring program for diabetes management: Does gender matter? Diabetes Res Clin Pract 2020; 159:107944. [PMID: 31765684 DOI: 10.1016/j.diabres.2019.107944] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 02/06/2023]
Abstract
AIMS To examine gender differences in program completion and glycemic outcomes for patients with type 2 diabetes (T2D) in a remote patient monitoring (RPM) program for diabetes management. METHODS Based on data from an RPM program that enrolled post-discharge T2D patients (n = 1645) in 2014-2017, logistic regression models were estimated to assess gender difference in the likelihood of completing the three-month RPM program; whereas ordinary least squares (OLS) regression models were used to examine gender difference in post-RPM hemoglobin A1c (HbA1c), controlling for demographics, baseline health status, including HbA1c, patient activation scores, and physiological data upload frequency for patients who had completed the program. RESULTS Among enrolled participants, men had lower odds of completing the three-month RPM program than women (adjusted odds ratio, 0.61; 95% confidence interval [CI], 0.39-0.95). However, among those who completed the program, men had lower post-RPM HbA1c than women (-0.18; 95% CI, -0.33, -0.03) after controlling for baseline HbA1c and other covariates. CONCLUSIONS While female patients with T2D were more likely to complete the RPM program, they showed a higher glycemic level at the end of the program compared to male patients. To close gender disparities in health, interventions through telemedicine tailored towards women's diabetes outcomes and men's engagement level are warranted.
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Affiliation(s)
- Tzeyu L Michaud
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Mohammad Siahpush
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Keyonna M King
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Athena K Ramos
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Regina E Robbins
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Robert J Schwab
- Division of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Martina A Clarke
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dejun Su
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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Wang Y, Dai Y, Zheng J, Xie Y, Guo R, Guo X, Sun G, Sun Z, Sun Y, Zheng L. Sex difference in the incidence of stroke and its corresponding influence factors: results from a follow-up 8.4 years of rural China hypertensive prospective cohort study. Lipids Health Dis 2019; 18:72. [PMID: 30909919 PMCID: PMC6434616 DOI: 10.1186/s12944-019-1010-y] [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] [Received: 01/31/2019] [Accepted: 03/08/2019] [Indexed: 02/08/2023] Open
Abstract
Background Few studies investigate sex difference in stroke incidence in rural China hypertensive population. Methods A total of 5097 hypertensive patients aged ≥35 years (mean age, 56.3 ± 11.2 years; 43.8% men) were included in our analysis with a median follow-up 8.4 years in Fuxin county of Liaoning province in China. Cox proportional hazard models were used to analyze the association between the potential factors and incident stroke. Results We observed 501 new strokes (310 ischemic, 186 hemorrhagic, and 5 unclassified stroke) during the follow-up. The overall incidence of stroke was 1235.21 per 100,000 person-years; for men, the rates were 1652.51 and 920.80 for women. This sex difference in all stroke can be explained by approximately 25% through age, systolic blood pressure, body mass index, low-density lipoprotein-cholesterol, current smoking, current drinking, antihypertensive drugs, education and physical activity. Subgroup analysis indicated that in hemorrhagic stroke this sex difference was more remarkable (63.89% can be explained). Conclusions The incidence of stroke was higher in men than that in women and this difference was partly explained by several traditional cardiovascular risk factors.
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Affiliation(s)
- Yali Wang
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yue Dai
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Jia Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yanxia Xie
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Rongrong Guo
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
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Al-Zakwani I, Al-Mahruqi F, Al-Rasadi K, Shehab A, Al Mahmeed W, Arafah M, Al-Hinai AT, Al Tamimi O, Al Awadhi M, Santos RD. Sex disparity in the management and outcomes of dyslipidemia of diabetic patients in the Arabian Gulf: findings from the CEPHEUS study. Lipids Health Dis 2018; 17:25. [PMID: 29402296 PMCID: PMC5800019 DOI: 10.1186/s12944-018-0667-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/22/2018] [Indexed: 01/02/2023] Open
Abstract
Background Little is known about sex gap in the management and outcomes of dyslipidemia among diabetics in the Arabian Gulf. The aim if this study was to determine sex differences in the management and outcomes of dyslipidemia in diabetic patients in the Arabian Gulf. Methods This study was derived from the Centralized Pan-Middle-East Survey on the management of hypercholesterolemia. Patients recruited were aged ≥18 years on lipid lowering drugs for ≥3 months (stable medication for ≥6 weeks). Outcomes were based on the joint Consensus Statement of the American Diabetes Association and American College of Cardiology Foundation. Analyses were performed using univariate and multivariate logistic regression techniques. Results The mean age of the cohort (n = 3336) was 57 ± 11 years and 45% (n = 1486) were females. Females were less likely to be on rosuvastatin (7.6% vs 12%; P < 0.001), atorvastatin (41% vs 46%; P = 0.005) and combination hypolipidemic therapy (5.6% vs 2.8%; P < 0.001) but more likely to be on simvastatin (51% vs 39%; P < 0.001) than males. Females, especially those with very high atherosclerotic cardiovascular disease (ASCVD) risk status, were also less likely to achieve LDL-cholesterol [adjusted odds ratio (aOR), 0.58; 95% confidence interval (CI): 0.40–0.86; P = 0.006], non-HDL-cholesterol [aOR, 0.68; 95% CI: 0.46–0.99; P = 0.048] and apolipoprotein B [aOR, 0.64; 95% CI: 0.44–0.92; P = 0.016] lipid targets. Conclusions Diabetic women were less likely to be on optimal hypolipemic therapy and consequently less likely to attain lipid goals compared to men. This shows a sex gap on dyslipidemia treatment in the region. Diabetic women with very high ASCVD risk status need to be aggressively treated to lower their risk of cardiovascular events.
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Affiliation(s)
- Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, PO Box 38, PC-123, Al-Khodh, Sultanate of Oman. .,Gulf Health Research, Muscat, Oman.
| | - Fatma Al-Mahruqi
- College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Khalid Al-Rasadi
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Wael Al Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, UAE
| | | | | | | | | | - Raul D Santos
- Lipid Clinic Heart Institute (InCor), University of Sao Paulo Medical School Hospital, Sao, Paulo, Brazil
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Zhang X, Ji L, Ran X, Su B, Ji Q, Hu D. Gender Disparities in Lipid Goal Attainment among Type 2 Diabetes Outpatients with Coronary Heart Disease: Results from the CCMR-3B Study. Sci Rep 2017; 7:12648. [PMID: 28978912 PMCID: PMC5627285 DOI: 10.1038/s41598-017-13066-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 09/13/2017] [Indexed: 02/05/2023] Open
Abstract
Our study was aimed to investigate the gender disparities in lipid goal attainment among type 2 diabetes outpatients with concomitant coronary heart disease (CHD) and explore potential risk factors. We performed the present analysis using data from a nationally representative epidemiologic study. The therapeutic goal was defined as achieving a low-density lipoprotein cholesterol (LDL-C) <1.8 mmol/L. A total of 1721 male and 2072 female type 2 diabetes outpatients with established CHD were identified. Compared with men, women had higher levels of total cholesterol (4.98 vs. 4.46 mmol/L; p < 0.001), LDL-C (2.82 vs. 2.54 mmol/L; p < 0.001), and triglycerides (2.02 vs. 1.79 mmol/L; p < 0.001), but not hemoglobin A1c (7.47% vs. 7.50%; p = 0.597). The proportion of women received lipid-lowering therapy was lower (38.1% vs. 48.2%; p < 0.001). The percentages of patients who achieved the LDL-C goal were higher among men. Multivariable regression analysis indicated that the odds ratio for lipid goal attainment due to the gender difference was 0.61 after adjusting confounders. The inability to achieve LDL-C goals in women with type 2 diabetes and CHD is apparently greater than that in men. This finding underscores the importance of initiatives to establish a more aggressive lipid management strategy for women to overcome gender imbalances.
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Affiliation(s)
- Xiaomei Zhang
- Peking University International Hospital, Department of Endocrinology and Metabolism, Beijing, 102206, China
| | - Linong Ji
- Peking University People's Hospital, Department of Endocrinology and Metabolism, Beijing, 100044, China.
| | - Xingwu Ran
- West China Hospital, Sichuan University, Department of Endocrinology and Metabolism, Chengdu, 610041, China
| | - Benli Su
- The Second Affiliated Hospital of Dalian Medical University, Department of Endocrinology, Dalian, 116027, China
| | - Qiuhe Ji
- Xijing Hospital, Forth Military Medical University, Department of Endocrinology, Xi'an, 710032, China
| | - Dayi Hu
- Peking University People's Hospital, Department of Cardiology, Beijing, 100044, China
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Kautzky-Willer A, Harreiter J. Sex and gender differences in therapy of type 2 diabetes. Diabetes Res Clin Pract 2017; 131:230-241. [PMID: 28779681 DOI: 10.1016/j.diabres.2017.07.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/09/2017] [Accepted: 07/07/2017] [Indexed: 12/11/2022]
Abstract
Clinical guidelines for the management of type 2 diabetes recommend individual therapy considering age, duration of disease, presence of complication and risk of hypoglycaemia. However, at present, the patient's sex has no impact on clinical decisions. Yet, there is mounting data pointing at biological and psychosocial differences between men and women with great impact on progression of disease and complications. Moreover, choices and preferences of therapeutic strategies as well as adherence to lifestyle and pharmacological interventions differ in both sexes. In addition, drug therapy may have sex-specific side effects. Therefore, there is need of more research on biological differences and of evidence-based individualised targeted sex-sensitive therapeutic concepts. Clinical guidelines must consider relevant sex-differences. Development and implementation of sex-specific programs may help to improve adherence to therapy and to reduce progression of disease and development of complications. A more gender-sensitive clinical approach may improve quality of life and increase health and life expectancy in men and women with type 2 diabetes.
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Affiliation(s)
- Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Gender Medicine Institute, Gars am Kamp, Austria.
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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10
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En route to precision medicine through the integration of biological sex into pharmacogenomics. Clin Sci (Lond) 2017; 131:329-342. [PMID: 28159880 DOI: 10.1042/cs20160379] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/15/2016] [Accepted: 11/07/2016] [Indexed: 12/14/2022]
Abstract
Frequently, pharmacomechanisms are not fully elucidated. Therefore, drug use is linked to an elevated interindividual diversity of effects, whether therapeutic or adverse, and the role of biological sex has as yet unrecognized and underestimated consequences. A pharmacogenomic approach could contribute towards the development of an adapted therapy for each male and female patient, considering also other fundamental features, such as age and ethnicity. This would represent a crucial step towards precision medicine and could be translated into clinical routine. In the present review, we consider recent results from pharmacogenomics and the role of sex in studies that are relevant to cardiovascular therapy. We focus on genome-wide analyses, because they have obvious advantages compared with targeted single-candidate gene studies. For instance, genome-wide approaches do not necessarily depend on prior knowledge of precise molecular mechanisms of drug action. Such studies can lead to findings that can be classified into three categories: first, effects occurring in the pharmacokinetic properties of the drug, e.g. through metabolic and transporter differences; second, a pharmacodynamic or drug target-related effect; and last diverse adverse effects. We conclude that the interaction of sex with genetic determinants of drug response has barely been tested in large, unbiased, pharmacogenomic studies. We put forward the theory that, to contribute towards the realization of precision medicine, it will be necessary to incorporate sex into pharmacogenomics.
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Li M, Li S, Du X, Wu T, Li X, Ma C, Huo Y, Hu D, Gao R, Wu Y. Factors attributed to the higher in-hospital mortality of ST elevation myocardial infarction patients admitted during off-hour in comparison with those during regular hour. PLoS One 2017; 12:e0175485. [PMID: 28388683 PMCID: PMC5384766 DOI: 10.1371/journal.pone.0175485] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 03/27/2017] [Indexed: 11/18/2022] Open
Abstract
Background In-hospital mortality of patients with ST elevation myocardial infarction (STEMI) admitted during off-hour was reported higher than those admitted during regular hour, but which factors cause the difference remains largely unknown though the difference in medical resources was often accused. Methods and results This registry-based study recruited 7456 STEMI patients prospectively from 99 level two hospitals across China. Generalized linear mixed models were applied to quantify the risk of in-hospital death attributed to admission time and the explainers of its change, accounting for the clustering of patients within hospitals. There were 45.2% patients admitted during regular hour and 54.8% during off-hour. In-hospital mortality was 7.0% for patients admitted during regular hour and 8.3% for those during off-hour (p<0.05). Generalized linear mixed models adjusting for age, gender and education showed that patients’ disease severity at admission and medical treatments received after admission could explain the risk difference attributed to admission time by 55% and 20%, respectively. After all factors accounted, the residual relative risk difference left only 6% (adjusted OR = 0.94) and became no longer significant. Conclusions The regular-and-off-hour mortality difference exists among STEMI patients in Chinese level two hospitals, which could be attributed primarily to disease severity at admission and secondly to the poorer medical treatments. These results call for public attention to the more severity of STEMI patients admitted during off-hour in addition to improving medical resources for STEMI at off-hour.
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Affiliation(s)
- Min Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shenshen Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Xin Du
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Tao Wu
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Xian Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Changsheng Ma
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yong Huo
- Peking University First Hospital, Beijing, China
| | - Dayi Hu
- Peking University People’s Hospital, Beijing, China
| | - Runlin Gao
- The Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Bejing, China
| | - Yangfeng Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
- * E-mail:
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12
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The Prevalence of Metabolic Syndrome and Its Components among People with Type 2 Diabetes in the Ho Municipality, Ghana: A Cross-Sectional Study. Int J Chronic Dis 2017; 2017:8765804. [PMID: 28293668 PMCID: PMC5331170 DOI: 10.1155/2017/8765804] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 01/20/2017] [Accepted: 01/24/2017] [Indexed: 01/10/2023] Open
Abstract
The cooccurrence of diabetes mellitus and metabolic syndrome potentiates the cardiovascular risk associated with each of the conditions; therefore characterizing metabolic syndrome among people with type 2 diabetes is beneficial for the purpose of cardiovascular disease prevention. This study aims at evaluating the prevalence of metabolic syndrome and its components among 162 patients with type 2 diabetes attending the diabetic clinic of the Ho Municipal Hospital, Ghana. Data obtained included anthropometric indices, blood pressure, serum lipids, glucose, and sociodemographics and clinical information. The overall prevalence of metabolic syndrome among the study population was 43.83%, 63.58%, and 69.14% using the NCEP-ATP III, the WHO, and the IDF criteria, respectively. The most predominant component among the study population was high blood pressure using the NCEP-ATP III (108 (66.67%)) and WHO (102 (62.96)) criteria and abdominal obesity (112 (69.14%)) for IDF criteria. High blood pressure was the most prevalent component among the males while abdominal obesity was the principal component among the females. In this population with type 2 diabetes, high prevalence of metabolic syndrome exists. Gender vulnerability to metabolic syndrome and multiple cluster components were skewed towards the female subpopulation with type 2 diabetes.
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13
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Rodriguez F, Olufade TO, Ramey DR, Friedman HS, Navaratnam P, Heithoff K, Foody JM. Gender Disparities in Lipid-Lowering Therapy in Cardiovascular Disease: Insights from a Managed Care Population. J Womens Health (Larchmt) 2016; 25:697-706. [PMID: 26889924 DOI: 10.1089/jwh.2015.5282] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Numerous studies have documented the strong inverse relationship between low-density lipoprotein cholesterol (LDL-C) levels and atherosclerotic cardiovascular disease (ASCVD). However, women are less likely to be screened for hypercholesterolemia, receive lipid-lowering therapy (LLT), and achieve optimal LDL-C levels. MATERIALS AND METHODS Data were extracted from a U.S. administrative claims database between January 2008 and December 2012 for patients with established ASCVD. The earliest date of valid LDL-C value was defined as the index date. Patients were followed for ±12 months from the index date and were stratified by gender, by baseline LDL-C level, and whether they were initially treated with a LLT then propensity score matched by gender using demographic and clinical characteristics. Both descriptive statistics and logistic regression models were used to explore the association of gender with the frequency of LDL-C monitoring, LLT treatment initiation in initially untreated patients, and prescribing patterns in initially treated patients. RESULTS A total of 76,414 subjects with established ASCVD were identified; 42% of the sample was women. In the unmatched cohort, 50.3% of men and 32.0% of women were prescribed a preindex statin (p < 0.0001). Among matched patients (n = 51,764), women initially treated with LLT were significantly less likely to receive a prescription for a higher potency LLT. Even among those with LDL-C levels above 160 mg/dL, women were more likely to discontinue LLT, odds ratio (95% confidence interval) 1.8 (1.2-2.3). Female gender and older age were significant predictors of discontinuation, and the potency of the index medication was the strongest predictor of dose titration. Initially untreated women were less likely to initiate LLT treatment than men, irrespective of index LDL-C levels (p < 0.0001). CONCLUSIONS The observed disparities further reinforce the need for targeted efforts to reduce the gender gap for secondary prevention in women at high risk of cardiovascular disease.
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Affiliation(s)
- Fatima Rodriguez
- 1 Division of Cardiovascular Medicine, Stanford University , Stanford, California
| | | | - Dena R Ramey
- 2 Merck Sharp & Dohme Corp. , North Wales, Pennsylvania
| | | | | | - Kim Heithoff
- 2 Merck Sharp & Dohme Corp. , North Wales, Pennsylvania
| | - JoAnne M Foody
- 4 Division of Cardiovascular Medicine, Brigham and Women's Hospital , Boston, Massachusetts
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14
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Chiang CE, Ferrières J, Gotcheva NN, Raal FJ, Shehab A, Sung J, Henriksson KM, Hermans MP. Suboptimal Control of Lipid Levels: Results from 29 Countries Participating in the Centralized Pan-Regional Surveys on the Undertreatment of Hypercholesterolaemia (CEPHEUS). J Atheroscler Thromb 2015; 23:567-87. [PMID: 26632163 DOI: 10.5551/jat.31179] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Five multicentre, cross-sectional Centralized Pan-Regional Surveys on the Undertreatment of Hypercholesterolaemia (CEPHEUS) were conducted in 29 countries across Asia, Western Europe, Eastern Europe, the Middle East, and Africa. The surveys assessed the current use and efficacy of lipid-lowering drugs (LLDs) worldwide and identified possible patient and physician characteristics associated with failure to attain low-density lipoprotein cholesterol (LDL-C) goals. The aim of this analysis was to consolidate the global results from these surveys. METHODS The surveys involved patients aged ≥18 years who had been prescribed LLDs for at least 3 months without dose changes for at least 6 weeks. A single visit was scheduled for data collection, including fasting plasma lipid and glucose levels. Cardiovascular risk profile and LDL-C goal attainment were assessed according to the 2004 updated US National Cholesterol Education Program Adult Treatment Panel III guidelines. RESULTS In total, 35 121 patients (mean age: 60.4 years) were included, and 90.3% had been prescribed statin monotherapy. Overall, only 49.4% of patients reached their recommended LDL-C level. LDL-C goals were attained in 54.8% (5084/9273) and 22.8% (3287/14 429) of patients were at high and very high cardiovascular risk, respectively. Factors associated with an increased likelihood of LDL-C goal attainment were lower baseline cardiovascular risk; presence of diabetes mellitus, hypertension, or history of cardiovascular disease; and treatment with simvastatin, atorvastatin, or rosuvastatin (vs. all other LLDs). CONCLUSION LDL-C goal attainment in patients taking LLDs is suboptimal worldwide, particularly in patients at high and very high cardiovascular risk.
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Affiliation(s)
- Chern-En Chiang
- General Clinical Research Center, Division of Cardiology, Taipei Veterans General Hospital and National Yang-Ming University
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15
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Pavanello C, Mombelli G. Considering gender in prescribing statins: what do physicians need to know? ACTA ACUST UNITED AC 2015. [DOI: 10.2217/clp.15.39] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Yu B, Zhao S, Hu D, Ambegaonakr BM, DYSIS-China Study Investigators, Jia Er BA, Guiwen C, Buxing C, Hong C, Jin C, Jing C, Liefeng C, Min C, Qiong C, Shaoliang C, Tielong C, Xiaofei C, Xiaohong C, You C, Guoli C, Mei C, Hongliang C, Qin C, Shiwei C, Yong C, Shudong D, Henghua D, Xiaomei D, Yirong D, Xiaoyan D, Birong D, Yumei D, Yugang D, Ping D, Lei D, Limei F, Ningyuan F, Lixia F, Lie F, Jun G, GeWeihong, Hongmin G, Minxia G, Qinghua H, Fengchang H, Dayi H, Lingzhi H, Xueqiang H, Yaojun H, Yiming H, Zhiping H, Fei H, Qi H, Dejia H, Gewen H, Hongman H, Liming H, Qiong H, Ruowen H, Taifu H, Bin J, Kai J, Hui J, Huigen J, Jinsong K, Bao L, Chengjiang L, Hongjuan L, Jun(Xinjiang) L, Jun(Jiangsu) L, Nanfang L, Qifu L, Qiang L, Xin L, Xueyou L, Yanbing L, Yanping L, Yansheng L, Yong L, Yuling L, Zhanquan L, Zhengfang L, Li L, Yongxue L, Zerong L, Yuhua L, Fan L, Hong L, Hui L, Minling L, Qiang L, Qingsong L, Shaokui L, Weidong L, Xueping L, Xinjian L, Benyan L, Shaonian L, Suxin L, Hong L, LvYun, Aiqun M, Jianhua M, Qiang M, Yan M, Changsheng M, Yide M, Yiming M, NieXiaoli, NiuXiaoyuan, Hongtao P, Mingkang P, Qiaoqing P, Huifen Q, Qiumin Q, Lijie Q, Liqun R, Jingshan S, Qiang S, Jing H, Xiuyun S, Yongquan S, Liangyi S, Zhi S, Zhiyuan S, Yufeng S, Chunyan T, TengXiaochun, Haoming T, Wenhua T, Qinwei T, TuQiuyun, Keying W, Aihong W, Chaohui W, Chunning W, Dezhao W, Guixia W, Hanqiao W, Jianan W, Jianjun W, Lan W, Xiaoming W, Yaping W, Yangwei W, Yongjun W, Meifang W, Yidong W, Hongyun W, Chun W, Dongmei W, Jiang W, Jun W, Xiaolin W, Zonggui W, XiGuangxia, Yi X, Qian X, Xiaoping X, Yulong X, Anding X, XueYuanming, Chuanzhu Y, Tao Y, Xiaowei Y, Gangyi Y, Jian Y, Wangpingm Y, Xiaosu Y, Xinchun Y, Yifang Y, Yu Y, Mingyu Y, Min Y, Ping Y, Bo Y, Jiangyi Y, Jinming Y, Yan Y, Ling Z, Longyi Z, Xiaoyun Z, Baorong Z, Bei Z, Chaoxin Z, Xuelian Z, Dadong Z, Dongping Z, Fuchun Z, Hong Z, Huifang Z, Liping Z, Liyang Z, Rufu Z, Saidan Z, Weijuan Z, Dong Z, Gang Z, Shuiping Z, Xiuxin Z, Qiangsun Z, Yang Z, Xiaohui Z, Yali Z, Yujie Z, Yi Z, Yulan Z, Xiangping Z. Gender differences in lipid goal attainment among Chinese patients with coronary heart disease: insights from the DYSlipidemia International Study of China. Eur Heart J Suppl 2015. [DOI: 10.1093/eurheartj/suv018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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17
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Mombelli G, Bosisio R, Calabresi L, Magni P, Pavanello C, Pazzucconi F, Sirtori CR. Gender-related lipid and/or lipoprotein responses to statins in subjects in primary and secondary prevention. J Clin Lipidol 2015; 9:226-33. [DOI: 10.1016/j.jacl.2014.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 11/26/2014] [Accepted: 12/04/2014] [Indexed: 11/27/2022]
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18
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Guo T, Yin RX, Chen X, Bin Y, Nie RJ, Li H. Sex-specific association of the SPTY2D1 rs7934205 polymorphism and serum lipid levels. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:665-681. [PMID: 25755761 PMCID: PMC4348833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 12/24/2014] [Indexed: 06/04/2023]
Abstract
The objective of the present study was to detect the association of the rs7934205 single nucleotide polymorphism (SNP) near the Suppressor of Ty, domain containing 1 gene (SPTY2D1) and serum lipid levels between males and females in the Mulao and Han populations. Genotyping of SPTY2D1 rs7934205 SNP was performed in 933 of Mulao and 865 of Han participants using polymerase chain reaction and restriction fragment length polymorphism. The T allele frequency was different between Mulao males and females (23.2% vs. 27.9%, P = 0.018). The genotype and allele frequencies were also different between Han males and females (P = 0.020 and P = 0.004; respectively). Serum levels of apolipoprotein (Apo) A1 in Mulao males; and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), ApoA1 and ApoB in Mulao females were different between the CC and CT/TT genotypes (P < 0.05). Serum TC, ApoB levels in Han males, and ApoB levels in Han females were different between the CC and CT/TT genotypes (P < 0.05). The subjects with CT/TT genotype in both Mulao and Han males and females have more favorable lipid profiles than those with CC genotype. These findings suggest that the association between the SPTY2D1 rs7934205 SNP and serum lipid levels might have ethnic- and/or sex-specificity.
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Affiliation(s)
- Tao Guo
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Rui-Xing Yin
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Xia Chen
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Yuan Bin
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Rong-Jun Nie
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Hui Li
- Clinical Laboratory of The Affiliated Cancer Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
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Ruggieri A, Gambardella L, Maselli A, Vona R, Anticoli S, Panusa A, Malorni W, Matarrese P. Statin-induced impairment of monocyte migration is gender-related. J Cell Physiol 2014; 229:1990-8. [PMID: 24777636 DOI: 10.1002/jcp.24657] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 04/25/2014] [Indexed: 11/07/2022]
Abstract
Statins, widely used for treatment of hypercholesterolemia, have been demonstrated to exert pleiotropic beneficial effects independently of their cholesterol-lowering action, such as anti-inflammatory activity. A gender disparity has been observed in their cholesterol lowering activity as well as in response to these "off label" effects. Monocytes play a central role in atherosclerotic disease and, more in general, in inflammatory responses, through their chemotactic function and cytokine production. On these bases, in the present work, we examined the effect of statins on homeostasis and migration properties of freshly isolated monocytes from male and female healthy donors. Two prototypic natural and synthetic statins with different polarity, that is, type 1 and type 2 statins, have been considered: simvastatin and atorvastatin. Freshly isolated monocytes from peripheral blood of male and female healthy donors were treated with these drugs in the absence or presence of lipopolysaccharide (LPS) stimulation. Results obtained indicated that the polar statin efficiently inhibited chemotaxis of monocytes more than the apolar statin and that this effect was more significantly induced in cells from females than in cells from males. Dissecting the mechanisms involved, we found that these results could mainly be due to differential effects on: (i) the release of key cytokines, for example, MCP-1 and TNF-α; (ii) the maintenance of the redox homeostasis; (iii) a target activity on microfilament network integrity and function. All in all these results could suggest a reappraisal of "off-label" effects of statins taking into account either their chemical structure, that is, molecular polarity, or the gender issue.
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Affiliation(s)
- Anna Ruggieri
- Department of Infectious, Parasitic and Immune Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
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Chen CY, Chuang SY, Fang CC, Huang LC, Hsieh IC, Pan WH, Yeh HI, Wu CC, Yin WH, Chen JW. Gender disparities in optimal lipid control among patients with coronary artery disease. J Atheroscler Thromb 2014; 21 Suppl 1:S20-8. [PMID: 24452112 DOI: 10.5551/jat.21_sup.1-s20] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Coronary heart disease(CHD) is the leading cause of death worldwide in both men and women. Hypercholesterolemia is a major factor contributing to the incidence of CHD. Many lipid-lowering trials have shown statins to be effective medications for the primary and secondary prevention of CHD. Some studies have suggested that statins are as or more effective in women than in men. However, there is a substantial gender gap in lipid goal attainment with respect to primary care guidelines, as reported in observational studies. In this article, we attempt to explain gender differences in lipid control in individuals with or at risk of CHD in order to improve awareness of and narrow gaps in gender disparities in lipid management.
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Affiliation(s)
- Chun-Yen Chen
- Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College
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21
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Chen CY, Chuang SY, Fang CC, Huang LC, Hsieh IC, Pan WH, Yeh HI, Wu CC, Yin WH, Chen JW. Gender Difference in Statin Intervention on Blood Lipid Control among Patients with Coronary Heart Disease. INT J GERONTOL 2013. [DOI: 10.1016/j.ijge.2013.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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