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Arrifano GP, Alvarez-Leite JI, Macchi BM, Campos NFSS, Augusto-Oliveira M, Santos-Sacramento L, Lopes-Araújo A, Souza-Monteiro JR, Alburquerque-Santos R, do Nascimento JLM, Santos S, Ribeiro-dos-Santos Â, Oriá RB, Crespo-Lopez ME. Living in the Southern Hemisphere: Metabolic Syndrome and Its Components in Amazonian Riverine Populations. J Clin Med 2021; 10:3630. [PMID: 34441925 PMCID: PMC8396977 DOI: 10.3390/jcm10163630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022] Open
Abstract
The metabolic syndrome (MetS) epidemic is a global challenge. Although developing countries (including Brazil, India, and South Africa) present a higher proportion of deaths by cardiovascular diseases than developed countries, most of our knowledge is from these developed countries. Amazonian riverine populations (ARP), as well as other vulnerable populations of the Southern Hemisphere, share low-income and traditional practices, among other features. This large cross-sectional study of ARP (n = 818) shows high prevalence of hypertension (51%) and obesity (23%). MetS was diagnosed in 38% of participants (especially in women and 60-69 years-old individuals) without the influence of ancestry. Only 7-8% of adults had no cardio-metabolic abnormalities related to MetS. Atherogenic dyslipidemia (low HDL-cholesterol) was generally observed, including in individuals without MetS. Still, slight differences were detected between settings with a clear predominance of hypertension in Tucuruí. Hypotheses on possible genetic influence and factors (nutrition transition and environmental pollutants -mercury) are proposed for future studies. Moreover, a roadmap to MetS progression based on the most prevalent components is provided for the development of tailored interventions in the Amazon (initially, individuals would present low HDL-cholesterol levels, later progressing to increased blood pressure characterizing hypertension, and ultimately reaching MetS with obesity). Our alarming results support the need to improve our knowledge on these vulnerable populations.
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Affiliation(s)
- Gabriela P. Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (G.P.A.); (N.F.S.S.C.); (M.A.-O.); (L.S.-S.); (A.L.-A.); (R.A.-S.)
| | - Jacqueline I. Alvarez-Leite
- Laboratório de Aterosclerose e Bioquímica Nutricional, Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte 30161-970, Brazil;
| | - Barbarella M. Macchi
- Laboratório de Neuroquímica e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.M.M.); (J.L.M.d.N.)
| | - Núbia F. S. S. Campos
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (G.P.A.); (N.F.S.S.C.); (M.A.-O.); (L.S.-S.); (A.L.-A.); (R.A.-S.)
| | - Marcus Augusto-Oliveira
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (G.P.A.); (N.F.S.S.C.); (M.A.-O.); (L.S.-S.); (A.L.-A.); (R.A.-S.)
| | - Letícia Santos-Sacramento
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (G.P.A.); (N.F.S.S.C.); (M.A.-O.); (L.S.-S.); (A.L.-A.); (R.A.-S.)
| | - Amanda Lopes-Araújo
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (G.P.A.); (N.F.S.S.C.); (M.A.-O.); (L.S.-S.); (A.L.-A.); (R.A.-S.)
| | | | - Raquel Alburquerque-Santos
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (G.P.A.); (N.F.S.S.C.); (M.A.-O.); (L.S.-S.); (A.L.-A.); (R.A.-S.)
| | - José Luiz M. do Nascimento
- Laboratório de Neuroquímica e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.M.M.); (J.L.M.d.N.)
- Programa de Pós-Graduação em Ciências Farmacêuticas, Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá 68903-419, Brazil
| | - Sidney Santos
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (S.S.); (Â.R.-d.-S.)
| | - Ândrea Ribeiro-dos-Santos
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (S.S.); (Â.R.-d.-S.)
| | - Reinaldo B. Oriá
- Laboratório de Biologia da Cicatrização, Ontogenia e Nutrição de Tecidos, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza 60430-160, Brazil;
| | - Maria Elena Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (G.P.A.); (N.F.S.S.C.); (M.A.-O.); (L.S.-S.); (A.L.-A.); (R.A.-S.)
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Abstract
Patients with familial hypercholesterolemia (FH) have early development of atherosclerosis and cardiovascular disease (CVD). Lipid level-lowering medications are not always successful in reducing increased low-density lipoprotein C (LDL-C) levels. Lipoprotein apheresis (LA) therapy has proven its clinical benefit in reducing CVD events for patients with FH with hypercholesterolemia. LA reduces LDL-C levels by more than 60% in patients with FH and reduces CVD events. LA also reduces Lp(a) levels and CVD events. LA reduces inflammatory markers and blood viscosity.
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Affiliation(s)
- Patrick M Moriarty
- Division of Clinical Pharmacology and Atherosclerosis/Lipoprotein-Apheresis Center, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 3008, Kansas City, KS 66160, USA.
| | - Linda Hemphill
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
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