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Saarinen HJ, Lahtela J, Mähönen P, Palomäki A. The association between inflammation, arterial stiffness, oxidized LDL and cardiovascular disease in Finnish men with metabolic syndrome - a 15-year follow-up study. BMC Cardiovasc Disord 2024; 24:162. [PMID: 38491429 PMCID: PMC10941448 DOI: 10.1186/s12872-024-03818-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/27/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND All-cause mortality and cardiovascular disease are increased in subjects with metabolic syndrome (MetS). Risk scores are used to predict individual risk of heart disease. We performed a long-term follow-up study to investigate whether risk scores and cardiovascular risk factors such as arterial stiffness, high-sensitive C-reactive protein (hs-CRP) and oxidized LDL (OxLDL) can be used to predict cardiovascular events in Finnish men with MetS. METHODS After baseline measurements we followed 105 Finnish men aged 30 to 65 years with MetS for a mean period of 16.4 years. The primary outcome of the study was a composite of myocardial infarction, stroke, symptomatic vascular disease diagnosed with invasive angiography, coronary or peripheral revascularization, amputation due to peripheral vascular disease, cardiovascular death and non-cardiovascular death. The endpoints were retrieved from electronic medical records. RESULTS The number of acute myocardial infarctions and strokes during the first 10 years was lower than estimated by FINRISK score but SCORE predicted cardiovascular death correctly. During the whole follow-up period, 27 of 105 participants (25.8%) had 30 endpoint events. The incidence of the primary composite outcome was significantly lower in subjects with hs-CRP < 1.0 mg/L than in subjects with hs-CRP ≥ 1.0 mg/L (6 of 41 subjects [14.6%] vs. 21 of 64 subjects [32.8%]; p = 0.036). The incidence of the primary composite outcome was higher among subjects with large artery elasticity classified as borderline compared to subjects with normal large artery elasticity (5 of 10 subjects [50%] vs. 22 of 93 subjects [24%]; p = 0.05). There was no difference in the incidence of primary composite outcome in groups with different degrees of small artery elasticity or different level of oxLDL. CONCLUSIONS Men with MetS who had hs-CRP ≥ 1.0 mg/L had higher risk for CVD and all-cause mortality than those with hs-CRP of < 1.0 mg/L. This also applies to subjects with borderline decreased large artery elasticity. The amount of OxLDL had no predictive value on the incidence of CVD and all-cause mortality. Men with MetS participating in the Hämeenlinna Metabolic Syndrome Research Program without lifestyle or drug intervention had better outcome for myocardial infarction or stroke than estimated by the FINRISK score. TRIAL REGISTRATION ClinicalTrials.gov NCT01119404 retrospectively registered 07/05/2010.
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Affiliation(s)
| | - Jorma Lahtela
- Tampere University Central Hospital, Teiskontie 35, Tampere, FI-33521, Finland
| | - Päivi Mähönen
- Vita Laboratories, Laivakatu 5 F, Helsinki, FI-00150, Finland
- Department of Bacteriology & Immunology, University of Helsinki, Yliopistonkatu 4, Helsinki, FI-00100, Finland
| | - Ari Palomäki
- Department of Emergency Medicine, Kanta-Häme Central Hospital, Ahvenistontie 20, Hämeenlinna, FI-13530, Finland
- Cardiometabolic Unit, Linnan Klinikka, Raatihuoneenkatu 10, Hämeenlinna, FI-13100, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampereen Yliopisto, FI-33014, Finland
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Saarinen HJ, Husgafvel S, Pohjantähti-Maaroos H, Wallenius M, Palomäki A. Improved insulin sensitivity and lower postprandial triglyceride concentrations after cold-pressed turnip rapeseed oil compared to cream in patients with metabolic syndrome. Diabetol Metab Syndr 2018; 10:38. [PMID: 29755591 PMCID: PMC5935965 DOI: 10.1186/s13098-018-0340-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 04/23/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The aim of this study was to compare acute effects of turnip rapeseed oil rich with mono- and polyunsaturated fatty acids and cream on postprandial triglyceride levels and post-glucose load measures of insulin sensitivity in population of men with metabolic syndrome. METHODS This open-label balanced crossover study included 37 men with metabolic syndrome. They underwent an oral glucose-fat tolerance test where they ingested 75 g of glucose with either 240 mL of cream or 84 mL of turnip rapeseed oil depending on the study arm. Hourly postprandial blood samples were drawn up to 5 h after this oral glucose-fat tolerance test to determine the changes in triglyceride concentrations and to measure insulin sensitivity. Changes in insulin sensitivity were calculated with different insulin sensitivity indices (OGIS, Stumvoll, Gutt and McAuley scores) derived from measured insulin and glucose concentrations. The oral glucose-fat tolerance test was preceded by a period during which the participants consumed a daily portion of either 35 mL of turnip rapeseed oil or 37.5 g of butter depending on the study arm in addition to their habitual diets. Both dietary periods lasted from 6 to 8 weeks. After an 8-week wash-out period the subjects crossed over to the other study arm and underwent the same process with the other fat adjunct. RESULTS The area under the curve for hourly triglyceride concentrations was 16% smaller after turnip rapeseed oil than after cream (13.86 [interquartile range 8.54] vs. 16.41 [9.09] mmol/l, p < 0.001). The insulin sensitivity markers of OGIS (324 [38.97] vs. 377 [68.38] p < 0.001), Stumvoll score (0.079 [0.029] vs. 0.085 [0.029], p = 0.038) and Gutt score (67.0 ± 2.78 vs. 78.8 ± 4.97 p = 0.001) were higher after turnip rapeseed oil period than after butter period. There was a non-significant change in the McAuley score. CONCLUSION Dietary turnip rapeseed oil improved postprandially measured insulin sensitivity and triglyceride concentrations compared to cream and butter. This provides a possible efficient dietary mean to treat cardiovascular risk factors.Trial registration ClinicalTrials.gov NCT01119690 (05-06-2010).
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Affiliation(s)
| | - Sari Husgafvel
- Central Hospital of Kanta-Häme, Ahvenistontie 20, 13530 Hämeenlinna, Finland
- Linnan Klinikka, Raatihuoneenkatu 10, 13100 Hämeenlinna, Finland
- Central Hospital of Päijät-Häme, Keskussairaalankatu 7, 15850 Lahti, Finland
| | - Hanna Pohjantähti-Maaroos
- Central Hospital of Kanta-Häme, Ahvenistontie 20, 13530 Hämeenlinna, Finland
- Linnan Klinikka, Raatihuoneenkatu 10, 13100 Hämeenlinna, Finland
- Heart Center, Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland
| | - Marja Wallenius
- Linnan Klinikka, Raatihuoneenkatu 10, 13100 Hämeenlinna, Finland
| | - Ari Palomäki
- Central Hospital of Kanta-Häme, Ahvenistontie 20, 13530 Hämeenlinna, Finland
- Linnan Klinikka, Raatihuoneenkatu 10, 13100 Hämeenlinna, Finland
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
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Vilmi-Kerälä T, Koivistoinen T, Palomäki O, Uotila J, Palomäki A. Arterial stiffness in fertile women with metabolic syndrome. Ann Med 2017; 49:636-643. [PMID: 28590772 DOI: 10.1080/07853890.2017.1339907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Although metabolic syndrome (MetS) is evidently associated with the risk of cardiovascular disease (CVD), recently its use has been questioned. We studied the utility of MetS diagnosis when estimating individual CVD risk. METHODS We compared 27 fertile women with MetS and 27 counterparts without the syndrome, matched pairwise according to well-known risk factors of CVD. Pulse wave velocity (PWV) and central blood pressure (cBP) were determined noninvasively via a SphygmoCor device. Arterial compliance was measured noninvasively with an HDI/PulseWaveTMCR-2000 arterial tonometer. RESULTS PWV (7.1 ± 2.5 versus 6.5 ± 1.1 m/s, p = .037), and both systolic (120.9 ± 12.2 versus 111.5 ± 16.0 mmHg, p = .031) and diastolic cBP (81.3 ± 8.5 versus 74.1 ± 11.2 mmHg, p = .035) were higher in the MetS group. Systemic arterial compliance values were lower in both large (15.1 ± 8.0 versus 16.1 ± 4.4 mL/mmHg × 10, p = .034) and small arteries (7.1 ± 2.5 versus 9.3 ± 3.2 mL/mmHg ×100, p = .010) in women with MetS. CONCLUSIONS Fertile women with MetS had increased arterial stiffness, as measured by three different methods. Our results highlight the utility of MetS when revealing increased individual CVD risks in fertile-aged women. Key messages Women with MetS have increased arterial stiffness when measured by different methods. MetS is a useful clinical tool to assess increased cardiovascular risk, particularly among fertile-aged women.
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Affiliation(s)
- Tiina Vilmi-Kerälä
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,b Department of Obstetrics and Gynecology , Tampere University Hospital , Tampere , Finland
| | - Teemu Koivistoinen
- c Department of Emergency Medicine , Kanta-Häme Central Hospital , Hämeenlinna , Finland
| | - Outi Palomäki
- b Department of Obstetrics and Gynecology , Tampere University Hospital , Tampere , Finland
| | - Jukka Uotila
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,b Department of Obstetrics and Gynecology , Tampere University Hospital , Tampere , Finland
| | - Ari Palomäki
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,c Department of Emergency Medicine , Kanta-Häme Central Hospital , Hämeenlinna , Finland.,d Cardiometabolic Unit , Linnan Klinikka , Hämeenlinna , Finland
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Saarinen HJ, Sittiwet C, Simonen P, Nissinen MJ, Stenman UH, Gylling H, Palomäki A. Determining the mechanisms of dietary turnip rapeseed oil on cholesterol metabolism in men with metabolic syndrome. J Investig Med 2017; 66:11-16. [PMID: 28801309 PMCID: PMC5800324 DOI: 10.1136/jim-2017-000495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 07/07/2017] [Accepted: 07/08/2017] [Indexed: 12/17/2022]
Abstract
We have earlier reported the reduction of total cholesterol, low-density lipoprotein (LDL) cholesterol and oxidized LDL caused by short-term modification of diet with cold-pressed turnip rapeseed oil (CPTRO) instead of butter. The aim of this supplementary study was to determine whether the beneficial effects resulted from altered cholesterol metabolism during the intervention.Thirty-seven men with metabolic syndrome (MetS) completed an open, randomized and balanced crossover study. Subjects' usual diet was supplemented with either 37.5 g of butter or 35 mL of CPTRO for 6-8 weeks. Otherwise normal dietary habits and physical activity were maintained without major variations. Serum non-cholesterol sterols were assayed with gas-liquid chromatography and used as surrogate markers of whole-body cholesterol synthesis and absorption efficiency. Serum proprotein convertase subtilisin/kexin type 9 (PCSK9) concentration was analyzed with Quantikine ELISA Immunoassay. Serum cholesterol synthesis markers and serum cholestanol (absorption marker), all as ratios to cholesterol, did not differ between the periods. Serum campesterol and sitosterol ratios to cholesterol were significantly increased after the administration of CPTRO resulting from the increased intake of 217 mg/day of plant sterols in CPTRO. Serum PCSK9 concentration did not differ between CPTRO and butter periods.The reduction in serum cholesterol by 7.2% after consumption of rapeseed oil could not be explained by changes in cholesterol absorption, synthesis or PCSK9 metabolism in MetS.ClinicalTrials.gov NCT01119690.
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Affiliation(s)
| | - Chaiyasit Sittiwet
- University of Helsinki and Helsinki University Central Hospital, Abdominal Center, Helsinki, Finland.,Mahasarakham University, Mahasarakham, Thailand
| | - Piia Simonen
- University of Helsinki and Helsinki University Central Hospital, Heart and Lung Center, Helsinki, Finland
| | - Markku J Nissinen
- University of Helsinki and Helsinki University Central Hospital, Abdominal Center, Helsinki, Finland
| | - Ulf-Håkan Stenman
- University of Helsinki and Helsinki University Central Hospital, Clinical Chemistry, Helsinki, Finland
| | - Helena Gylling
- University of Helsinki and Helsinki University Central Hospital, Internal Medicine, Helsinki, Finland
| | - Ari Palomäki
- Department of Emergency Medicine, Kanta-Häme Central Hospital, Hameenlinna, Finland.,Linnan Klinikka, Cardiometabolic Unit, Hameenlinna, Finland.,University of Tampere, Tampere, Finland
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Hsu JF, Chou TC, Lu J, Chen SH, Chen FY, Chen CC, Chen JL, Elayda M, Ballantyne CM, Shayani S, Chen CH. Low-density lipoprotein electronegativity is a novel cardiometabolic risk factor. PLoS One 2014; 9:e107340. [PMID: 25203525 PMCID: PMC4159324 DOI: 10.1371/journal.pone.0107340] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 08/09/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low-density lipoprotein (LDL) plays a central role in cardiovascular disease (CVD) development. In LDL chromatographically resolved according to charge, the most electronegative subfraction-L5-is the only subfraction that induces atherogenic responses in cultured vascular cells. Furthermore, increasing evidence has shown that plasma L5 levels are elevated in individuals with high cardiovascular risk. We hypothesized that LDL electronegativity is a novel index for predicting CVD. METHODS In 30 asymptomatic individuals with metabolic syndrome (MetS) and 27 healthy control subjects, we examined correlations between plasma L5 levels and the number of MetS criteria fulfilled, CVD risk factors, and CVD risk according to the Framingham risk score. RESULTS L5 levels were significantly higher in MetS subjects than in control subjects (21.9±18.7 mg/dL vs. 11.2±10.7 mg/dL, P:0.01). The Jonckheere trend test revealed that the percent L5 of total LDL (L5%) and L5 concentration increased with the number of MetS criteria (P<0.001). L5% correlated with classic CVD risk factors, including waist circumference, body mass index, waist-to-height ratio, smoking status, blood pressure, and levels of fasting plasma glucose, triglyceride, and high-density lipoprotein. Stepwise regression analysis revealed that fasting plasma glucose level and body mass index contributed to 28% of L5% variance. The L5 concentration was associated with CVD risk and contributed to 11% of 30-year general CVD risk variance when controlling the variance of waist circumference. CONCLUSION Our findings show that LDL electronegativity was associated with multiple CVD risk factors and CVD risk, suggesting that the LDL electronegativity index may have the potential to be a novel index for predicting CVD. Large-scale clinical trials are warranted to test the reliability of this hypothesis and the clinical importance of the LDL electronegativity index.
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Affiliation(s)
- Jing-Fang Hsu
- L5 Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Chieh Chou
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Health Risk Management, China Medical University, Taichung, Taiwan
| | - Jonathan Lu
- Vascular and Medicinal Research, Texas Heart Institute, Houston, Texas, United States of America
| | - Shu-Hua Chen
- Vascular and Medicinal Research, Texas Heart Institute, Houston, Texas, United States of America
| | - Fang-Yu Chen
- L5 Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Chu Chen
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jeffrey L. Chen
- Physical Medicine & Rehabilitation, Department of Orthopedic Surgery, University of California San Diego, San Diego, California, United States of America
| | - MacArthur Elayda
- Biostatistics and Epidemiology, Texas Heart Institute, Houston, Texas, United States of America
| | - Christie M. Ballantyne
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Steven Shayani
- Mount Sinai Medical Center, New York, New York, United States of America
- New York Heart Research Foundation, New York, New York, United States of America
- * E-mail: (SS); (CHC)
| | - Chu-Huang Chen
- L5 Research Center, China Medical University Hospital, Taichung, Taiwan
- Vascular and Medicinal Research, Texas Heart Institute, Houston, Texas, United States of America
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (SS); (CHC)
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