1
|
Khoja A, Andraweera PH, Lassi ZS, Ali A, Zheng M, Pathirana MM, Aldridge E, Wittwer MR, Chaudhuri DD, Tavella R, Arstall MA. Risk Factors for Early-Onset Versus Late-Onset Coronary Heart Disease (CHD): Systematic Review and Meta-Analysis. Heart Lung Circ 2023; 32:1277-1311. [PMID: 37777398 DOI: 10.1016/j.hlc.2023.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 10/02/2023]
Abstract
AIM We aimed to systematically compare literature on prevalence of modifiable and non-modifiable risk factors for early compared to late-onset coronary heart disease (CHD). METHODS PubMed, CINAHL, Embase, and Web of Science databases were searched (review protocol registered in PROSPERO CRD42020173216). Study quality was assessed using the National Heart, Lung and Blood Institute tool for observational and case-control studies. Review Manager 5.3 was used for meta-analysis. Effect sizes were expressed as odds ratio (OR) and mean differences (MD)/standardised MD (SMD) with 95% confidence intervals (CI) for categorical and continuous variables. RESULTS Individuals presenting with early-onset CHD (age <65 years) compared to late-onset CHD had higher mean body mass index (MD 1.07 kg/m2; 95% CI 0.31-1.83), total cholesterol (SMD 0.43; 95% CI 0.23-0.62), low-density lipoprotein (SMD 0.26; 95% CI 0.15-0.36) and triglycerides (SMD 0.50; 95% CI 0.22-0.68) with lower high-density lipoprotein-cholesterol (SMD 0.26; 95% CI -0.42--0.11). They were more likely to be smokers (OR 1.76, 95% CI 1.39-2.22) and have a positive family history of CHD (OR 2.08, 95% CI 1.74-2.48). They had lower mean systolic blood pressure (MD 4.07 mmHg; 95% CI -7.36--0.78) and were less likely to have hypertension (OR 0.47, 95% CI 0.39-0.57), diabetes mellitus (OR 0.56, 95% CI 0.51-0.61) or stroke (OR 0.31, 95% CI 0.24-0.42). CONCLUSION A focus on weight management and smoking cessation and aggressive management of dyslipidaemia in young adults may reduce the risk of early-onset CHD.
Collapse
Affiliation(s)
- Adeel Khoja
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia.
| | - Prabha H Andraweera
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Zohra S Lassi
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Mingyue Zheng
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maleesa M Pathirana
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Emily Aldridge
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Melanie R Wittwer
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Debajyoti D Chaudhuri
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Rosanna Tavella
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Margaret A Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia; Medical Specialties, Faculty of Health Sciences, The University of Adelaide, SA, Australia
| |
Collapse
|
2
|
Šuran D, Završnik T, Kokol P, Kokol M, Sinkovič A, Naji F, Završnik J, Blažun Vošner H, Kanič V. Lipoprotein(a) As a Risk Factor in a Cohort of Hospitalised Cardiovascular Patients: A Retrospective Clinical Routine Data Analysis. J Clin Med 2023; 12:jcm12093220. [PMID: 37176660 PMCID: PMC10178911 DOI: 10.3390/jcm12093220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION Lipoprotein(a) (Lp(a)) is a well-recognised risk factor for ischemic heart disease (IHD) and calcific aortic valve stenosis (AVS). METHODS A retrospective observational study of Lp(a) levels (mg/dL) in patients hospitalised for cardiovascular diseases (CVD) in our clinical routine was performed. The Lp(a)-associated risk of hospitalisation for IHD, AVS, and concomitant IHD/AVS versus other non-ischemic CVDs (oCVD group) was assessed by means of logistic regression. RESULTS In total of 11,767 adult patients, the association with Lp(a) was strongest in the IHD/AVS group (eβ = 1.010, p < 0.001), followed by the IHD (eβ = 1.008, p < 0.001) and AVS group (eβ = 1.004, p < 0.001). With increasing Lp(a) levels, the risk of IHD hospitalisation was higher compared with oCVD in women across all ages and in men aged ≤75 years. The risk of AVS hospitalisation was higher only in women aged ≤75 years (eβ = 1.010 in age < 60 years, eβ = 1.005 in age 60-75 years, p < 0.05). CONCLUSIONS The Lp(a)-associated risk was highest for concomitant IHD/AVS hospitalisations. The differential impact of sex and age was most pronounced in the AVS group with an increased risk only in women aged ≤75 years.
Collapse
Affiliation(s)
- David Šuran
- Department of Cardiology and Angiology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Tadej Završnik
- Department of Cardiology and Angiology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Peter Kokol
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor Koroška cesta 46, 2000 Maribor, Slovenia
| | - Marko Kokol
- Faculty of Electrical Engineering and Computer Science, University of Maribor Koroška cesta 46, 2000 Maribor, Slovenia
- Semantika Research, Semantika d.o.o., Zagrebška ulica 40a, 2000 Maribor, Slovenia
| | - Andreja Sinkovič
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
- Department of Medical Intensive Care, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
| | - Franjo Naji
- Department of Cardiology and Angiology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Jernej Završnik
- Community Healthcare Center Dr. Adolf Drolc Maribor, Ulica talcev 9, 2000 Maribor, Slovenia
- Alma Mater Europaea, Slovenska ulica 17, 2000 Maribor, Slovenia
| | - Helena Blažun Vošner
- Community Healthcare Center Dr. Adolf Drolc Maribor, Ulica talcev 9, 2000 Maribor, Slovenia
- Alma Mater Europaea, Slovenska ulica 17, 2000 Maribor, Slovenia
- Faculty of Health and Social Sciences Slovenj Gradec, Glavni trg 1, 2380 Slovenj Gradec, Slovenia
| | - Vojko Kanič
- Department of Cardiology and Angiology, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| |
Collapse
|
3
|
Chu W, Lynskey N, Iain-Ross J, Pell JP, Sattar N, Ho FK, Welsh P, Celis-Morales C, Petermann-Rocha F. Identifying the Biomarker Profile of Pre-Frail and Frail People: A Cross-Sectional Analysis from UK Biobank. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2421. [PMID: 36767787 PMCID: PMC9915970 DOI: 10.3390/ijerph20032421] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This study aimed to compare the biomarker profile of pre-frail and frail adults in the UK Biobank cohort by sex. METHODS In total, 202,537 participants (67.8% women, aged 37 to 73 years) were included in this cross-sectional analysis. Further, 31 biomarkers were investigated in this study. Frailty was defined using a modified version of the Frailty Phenotype. Multiple linear regression analyses were performed to explore the biomarker profile of pre-frail and frail individuals categorized by sex. RESULTS Lower concentrations of apoA1, total, LDL, and HDL cholesterol, albumin, eGFRcys, vitamin D, total bilirubin, apoB, and testosterone (differences ranged from -0.30 to -0.02 per 1-SD change), as well as higher concentrations of triglycerides, GGT, cystatin C, CRP, ALP, and phosphate (differences ranged from 0.01 to 0.53 per 1-SD change), were identified both in pre-frail and frail men and women. However, some of the associations differed by sex. For instance, higher rheumatoid factor and urate concentrations were identified in pre-frail and frail women, while lower calcium, total protein, and IGF-1 concentrations were identified in pre-frail women and frail women and men. When the analyses were further adjusted for CRP, similar results were found. CONCLUSIONS Several biomarkers were linked to pre-frailty and frailty. Nonetheless, some of the associations differed by sex. Our findings contribute to a broader understanding of the pathophysiology of frailty as currently defined.
Collapse
Affiliation(s)
- Wenying Chu
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Nathan Lynskey
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - James Iain-Ross
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Jill P. Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Naveed Sattar
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Frederick K. Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Paul Welsh
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Carlos Celis-Morales
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3466706, Chile
| | - Fanny Petermann-Rocha
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
| |
Collapse
|
4
|
Klesareva EA, Afanasieva OI, Sherstyuk EE, Tmoyan NA, Razova OA, Tyurina AV, Afanasieva MI, Ezhov MV, Pokrovsky SN. The relationship between the level of Lр(а) and the prevalence of atherosclerosis among young patients. TERAPEVT ARKH 2022; 94:479-484. [DOI: 10.26442/00403660.2022.04.201454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Indexed: 11/22/2022]
Abstract
Background. Hyperlipoproteinemia (a) is an independent and cause risk factor for atherosclerotic cardiovascular diseases (ASCVD). The correlation between lipoprotein (a) Lp(a) and inflammation in the vessel wall was actively studied during the past few years. C-reactive protein (CRP) plays an important role in ASCVD.
Aim. To analyze the relationship between hyperlipoproteinemia (a), inflammatory markers, and the early development of stenosing atherosclerosis (AS) in several vascular pools.
Materials and methods. 76 patients, 55 men aged 18 to 55 years and 21women 18 to 60 years, with the results of instrumental examination of coronary, carotid and lower extremities vascular pools were enrolled. Three groups: with stenosing (50%) AS of only one (group 1, n=29); two or three (group 2, n=21) vascular pools. 26 patients without coronary heart disease and AS were included in the control group. All patients in groups 1 and 2 and 65% of those in the control group took statins. The concentrations of Lp(a), CRP, lipids and blood count were determined.
Results. The patients of the three groups did not differ in age. In the groups with AS (79% in group 1 and 85% in group 2), there were more men (relative to 54% in the control group). Diabetes mellitus was more common only in patients with multifocal AS. The absolute number of blood monocytes and leukocytes, the neutrophil-lymphocyte ratio, as well as Lp(a) level were higher in patients of groups 1 and 2 relative to the control. The maximum Lp(a) level (median [25%; 75%]) was observed in patients with lesions of two or more vascular pools vs the control group (49 [4; 96] mg/dL, vs 10 [4; 21] mg/dL, p=0.02). The CRP level was significant elevated in patients from group 2 7.2 [4.0; 9.7] mg/L, relative to group 1 2.5 [1.0; 4.7] mg/L, and the control group 2.9 [1.2; 4.9] mg/L, p0.05. The Lp(a) and CRP concentration, or the presence of diabetes mellitus in patients, regardless of other risk factors, were associated with severe stenosing AS in young and middle age.
Conclusion. An elevated concentration of Lp(a) (30 mg/dL) determines the presence of both isolated and multifocal stenosing AS in the examined patients. A simultaneous increase in the concentration of both Lp(a) and CRP, as well as the presence of diabetes mellitus, are associated with the premature development of stenosing atherosclerotic lesions in several vascular regions at once. Measurement of these predictors in young and middle-aged patients makes it possible to use them as biochemical markers to assess the likelihood of multifocal lesions of the vascular pool.
Collapse
|
5
|
Kar S. Elevated Lipoprotein A in South Asians and the Associated Risk of Cardiovascular Disease: A Systematic Review. Curr Probl Cardiol 2020; 46:100581. [PMID: 32295712 DOI: 10.1016/j.cpcardiol.2020.100581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 03/11/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND South Asians have a premature risk of cardiovascular disease and increased lipoprotein A which enhances their risk. METHODS This systematic review evaluates the role of elevated lipoprotein A in cardiovascular disease risk for South Asians. It discusses the pathophysiology, clinical studies, and treatment of elevated lipoprotein A using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. RESULTS A total of 72 articles was incorporated which consisted of clinical studies, case-control and cohort studies, meta-analysis, reviews, and editorials. Cardiovascular disease and myocardial infarction occurs prematurely in South Asians, which is further enhanced with an elevated lipoprotein A. CONCLUSIONS South Asians with an elevated lipoprotein A have an increased risk of coronary artery disease so they should have early enactment of lifestyle modification and aggressive medical management.
Collapse
|
6
|
Hoover-Plow J, Huang M. Lipoprotein(a) metabolism: potential sites for therapeutic targets. Metabolism 2013; 62:479-91. [PMID: 23040268 PMCID: PMC3547132 DOI: 10.1016/j.metabol.2012.07.024] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/03/2012] [Accepted: 07/11/2012] [Indexed: 11/20/2022]
Abstract
Lipoprotein(a) [Lp(a)] resembles low-density lipoprotein (LDL), with an LDL lipid core and apolipoprotein B (apoB), but contains a unique apolipoprotein, apo(a). Elevated Lp(a) is an independent risk factor for coronary and peripheral vascular diseases. The size and concentration of plasma Lp(a) are related to the synthetic rate, not the catabolic rate, and are highly variable with small isoforms associated with high concentrations and pathogenic risk. Apo(a) is synthesized in the liver, although assembly of apo(a) and LDL may occur in the hepatocytes or plasma. While the uptake and clearance site of Lp(a) is poorly delineated, the kidney is the site of apo(a) fragment excretion. The structure of apo(a) has high homology to plasminogen, the zymogen for plasmin and the primary clot lysis enzyme. Apo(a) interferes with plasminogen binding to C-terminal lysines of cell surface and extracellular matrix proteins. Lp(a) and apo(a) inhibit fibrinolysis and accumulate in the vascular wall in atherosclerotic lesions. The pathogenic role of Lp(a) is not known. Small isoforms and high concentrations of Lp(a) are found in healthy octogenarians that suggest Lp(a) may also have a physiological role. Studies of Lp(a) function have been limited since it is not found in commonly studied small mammals. An important aspect of Lp(a) metabolism is the modification of circulating Lp(a), which has the potential to alter the functions of Lp(a). There are no therapeutic drugs that selectively target elevated Lp(a), but a number of possible agents are being considered. Recently, new modifiers of apo(a) synthesis have been identified. This review reports the regulation of Lp(a) metabolism and potential sites for therapeutic targets.
Collapse
Affiliation(s)
- Jane Hoover-Plow
- J. J. Jacobs Center for Thrombosis and Vascular Biology, Department of Cardiovascular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44139, USA.
| | | |
Collapse
|
7
|
Mirza SM, Haller NA, Dalia A, Cho D. 21-Year-old male with severe coronary atherosclerosis. J Cardiol Cases 2013; 7:e153-e154. [PMID: 30533149 DOI: 10.1016/j.jccase.2013.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/22/2013] [Accepted: 02/02/2013] [Indexed: 11/24/2022] Open
Abstract
Coronary heart disease (CHD) is not limited to middle-aged and elderly individuals; when premature CHD develops in the younger population, it has distinct characteristics in terms of lipid profile, risk factors, and clinical presentation. The following describes a 21-year-old male who presented with stable angina, underwent a full cardiac workup, and was ultimately found to have multivessel CHD. In summary, the presence of mild dyslipidemia, high blood pressure, cigarette smoking, obesity, and a family history was sufficient to induce ischemic heart disease at such a young age. <Learning objective: This case report reveals an exceptionally young Caucasian man presenting with stable angina and found to have multivessel coronary disease. The patient received a coronary artery bypass surgery at just 21 years of age. He exhibits traditional risk factors of CHD; hypertension, dyslipidemia, cigarette smoking, and obesity. CHD may be more prevalent in the younger population than once was thought, and it is important that risk factor reduction starts in early in life.>.
Collapse
Affiliation(s)
| | - Nairmeen Awad Haller
- Northeast Ohio Medical University, Rootstown, OH 44272, USA.,Akron General Medical Center, Akron, OH 44307, USA
| | - Adam Dalia
- Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Donald Cho
- Northeast Ohio Medical University, Rootstown, OH 44272, USA.,Akron General Medical Center, Akron, OH 44307, USA
| |
Collapse
|
8
|
Mishra MN, Kalra R, Rohatgi S. Clinical profile, common thrombophilia markers and risk factors in 85 young Indian patients with arterial thrombosis. SAO PAULO MED J 2013; 131:384-8. [PMID: 24346777 PMCID: PMC10871819 DOI: 10.1590/1516-3180.2013.1316369] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/16/2012] [Accepted: 03/06/2013] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Arterial thrombosis may occur consequent to hereditary thrombophilia and increased lipoprotein(a) [Lp(a)] and fibrinogen. Our aim was to study the prevalence of common thrombophilia markers in 85 consecutive cases of arterial thrombosis. DESIGN AND SETTING A retrospective study was conducted from 85 consecutive young patients treated as outpatients or admitted due to stroke or myocardial infarction at a tertiary care hospital. METHODS Eighty-five Indian patients (age < 45 years) presenting ischemic stroke (n = 48) or myocardial infarction (n = 37) and 50 controls were studied for seven thrombophilia markers including antithrombin (AT), factor V, protein C, protein S, activated protein C resistance (APC-R), fibrinogen and Lp(a). Functional assays for protein C, protein S, factor V and APC-R were performed using clotting-based methods. Semi-quantitative estimation of fibrinogen was done using Clauss's method and Lp(a) using immunoturbidimetry. Statistical analysis was done using the Epi Info 6 software. RESULTS Thirty-three samples (38.8%) tested positive for one or more thrombophilia markers. The three commonest abnormalities were elevated Lp(a) (20%), fibrinogen (17.6%) and low APC-R (14.2%). Low levels of protein C, protein S and AT were present in 4.7, 9.4 and 7% of the patients, respectively. Overall, the risk factor profile was: smoking (33%), positive family history (15.3%), hyperlipidemia (7%), hypertension, diabetes mellitus and obesity (2.3% each). CONCLUSIONS An association was found between low levels of protein C, protein S and AT and arterial thrombosis, but only elevated fibrinogen levels, smoking, positive family history and hyperlipidemia showed statistical significance.
Collapse
Affiliation(s)
- Mahendra Narain Mishra
- MD. Specialist in Pathology and Immunopathology, Department of Pathology, Dr. Lal Path Labs Pvt Ltd., New Delhi, India
| | - Ravi Kalra
- MD, PhD. Department of Cardiology, Indian Naval Hospital Ship Asvini, Colaba, Mumbai, Maharashtra, India
| | - Shalesh Rohatgi
- MD, PhD. Department of Neurology, Command Hospital (WC), Chandimandir, Haryana, India
| |
Collapse
|
9
|
|
10
|
Pietrzak A, Kadzielewski J, Janowski K, Roliński J, Krasowska D, Chodorowska G, Paszkowski T, Kapeć E, Jastrzebska I, Tabarkiewicz J, Lotti T. Lipoprotein (a) in patients with psoriasis: associations with lipid profiles and disease severity. Int J Dermatol 2009; 48:379-87. [PMID: 19335423 DOI: 10.1111/j.1365-4632.2009.03994.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lipoprotein (a) [Lp(a)] is a genetically determined molecule whose role has been implied in cardiovascular pathology, and whose levels have been reported to be elevated in patients with psoriasis. Aim To assess the serum levels of Lp(a) in patients with psoriasis, and to investigate the associations of Lp(a) with other lipids and with psoriasis severity. METHODS Thirty-four patients with psoriasis and 26 healthy control subjects took part in the study. Serum levels of Lp(a) and total, high density lipoprotein (HDL), low density lipoprotein (LDL), and very low density lipoprotein (VLDL) cholesterol fractions were measured in all participants. The levels of triglycerides and total cholesterol were measured using enzymatic colorimetric tests; HDL and LDL cholesterol concentrations were determined by precipitation methods; the VLDL concentration was calculated according to the formula: VLDL cholesterol = triglycerides/5. RESULTS Patients with psoriasis showed significantly higher serum levels of Lp(a) relative to controls. Even when controlling for normolipidemic vs. hyperlipidemic status, abnormal levels of Lp(a) (> 30 mg/dL) were observed significantly more often in patients than in controls. In both patients and controls, Lp(a) levels correlated positively with total and HDL cholesterol levels. In patients, Lp(a) levels correlated positively with psoriasis severity. CONCLUSIONS Lp(a) may be a factor contributing to an increased cardiovascular risk in patients with psoriasis. A pathogenetic link may exist between this lipoprotein and psoriatic pathophysiology.
Collapse
Affiliation(s)
- Aldona Pietrzak
- Department of Dermatology, Medical University of Lublin, Lublin, Poland
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|