Aging, components of metabolic syndrome and serum C-reactive protein showed significant relationship with carotid atherosclerosis

Levels of TNF-α, IL-6, IL-17, IL-37 cytokines in patients with active vitiligo

OBJECTIVES

Vitiligo is an autoimmune disease, and its pathogenesis involves changes in cytokine levels in the affected patients. Tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-17 from pro-inflammatory cytokines, IL-37 in a recently detected anti-inflammatory activity. The aim of our study was to determine serum TNF-α, IL-6, IL-17, IL-37 levels in patients with vitiligo to understand their possible roles in the disease etiology and to compare the results with the healthy controls.

METHODS

The study included 48 generalized vitiligo patients who were diagnosed with vitiligo, had an increase in the lesions within the last 3 months, and did not receive any systemic or topical treatment during this period; furthermore, 18 healthy controls were included.

RESULTS

Patient group: n = 48, mean age = 30.48 ± 9.86 years; control group: n = 18, mean age = 28.27 ± 9.66 years. Individuals in the patient group had significantly higher serum levels of IL-37(t = 3.90, p < .001), IL-6 (t = 3.39, p < .05), IL-17 (t = 2.08, p < .05), and TNF-α (t = 4.69 p < .001) than in the control group.

CONCLUSION

The high levels of (pro-anti) inflammatory cytokines in vitiligo patients draw attention to the importance of cytokines in the pathogenesis of the disease.

Association between metabolic syndrome, hepatic steatosis, and testosterone deficiency: evidences from studies with men and rodents

Testosterone is the predominant androgen in men and the lack of it can be a trigger to the development of the metabolic syndrome. Here we review the relationship between testosterone deficiency, metabolic syndrome, and hepatic steatosis reported by studies with men and rodents. The prevalence of metabolic syndrome and testosterone deficiency is higher among older subjects. Low total and free testosterone levels were positively associated with disturbs on energy metabolism, changes in body fat distribution, and body composition. Studies reported visceral fat accumulation in men with hypogonadism and castrated rats. Despite some contradictions, the association between higher adiposity, low testosterone, and metabolic syndrome was a common point among the studies. Few studies evaluated the hepatic steatosis and found an association with hypogonadism. Most of the studies with rodents combined the castration with a high-fat diet to study metabolic disturbs. The importance of proper levels of testosterone for energy metabolism homeostasis in men was also underlined by studies that investigated the metabolic effects of testosterone replacement therapy and androgen deprivation therapy.

Lipid profile, random blood glucose and carotid arteries thickness in human male subjects with different ages and body mass indexes

OBJECTIVE

This article investigated the effect of age and body mass index of male humans on the carotid arteries intima media thickness (IMT) and the blood concentration of glucose, triglycerides, total cholesterol and HDL cholesterol.

METHODS

Thirty seven normal male human subjects participated in this study. The participants were classified to three groups depending on their age; 20-29 (11), 30-39 (14) and 40-49 (12). Also, the study subjects were divided to three groups according to their body mass index; normal (13), overweight (13) and obese (11). The Anova test was used for the statistical analysis of the obtained results.

RESULTS

The body mass index significantly affected the blood glucose concentration while its effect on all the other parameters was insignificant. The age significantly affected all the studied parameters except the blood glucose, triglycerides and HDL cholesterol. The total cholesterol/HDL ratio was significantly affected by the age and insignificantly by the body mass index.

CONCLUSIONS

The age was more effective on the studied parameters than the body mass index. Worsening of the lipid profile was seen in the overweight participants rather than the obese ones.

The correlation between atherogenic indexes and erectile dysfunction

Aside from the ordinary plasma lipid level measurements, the ratios based on individual plasma lipid levels such as atherogenic index of plasma (AIP), Castelli's risk index 1/2 (CRI-1/2), and atherogenic coefficient (AC) are the novel parameters to evaluate the patients with a high risk of CVD. In this study, we aim to evaluate the relationship between AIP, AC, and CRI-1/2 with increased risk of ED. Between April 2018 and February 2019, 253 patients, who were diagnosed as a vasculogenic ED in our clinic, were enrolled in the study. While the first group (n = 134) consisted of patients with moderate and mild ED (IIEF-EF: 17-30), the second group (n = 119) consisted of patients with severe ED. In addition to the mean values of lipid parameters; CRI-1 (total cholesterol/HDL), CRI-2 (LDL/HDL) AIP (log10(triglycerides/HDL), and AC (non-HDL/HDL) were calculated. The mean age was 44.02 ± 10.41 (24-70), and the mean BMI was 27.80 ± 4.12 (18.52 ± 41.97). However, CRI-1 and AIP values were found to be higher in the severe ED group compared to the mild ED group (CRI-1: 4.50 ± 1.47, 4.88 ± 1.30; p = .039; AIP: 0.489 ± 0.315, 0.617 ± 0.283; p = .007). Our results demonstrated that CR-1 and AIP have a positive correlation with the severity of ED. Moreover, we can suggest that patients with higher CR-1 and AIP values are likely to have more severe ED in the future.

Carotid Doppler ultrasonographic findings of dapagliflozin use in type 2 diabetic patients

AIM

Sodium-glucose cotransporter 2 inhibitors have been shown to reduce the risk of cardiovascular disease in type 2 diabetes (T2DM) patients. The purpose of this study was to evaluate cardiovascular disease risk indirectly through Doppler ultrasonography (USG) of carotid artery vascular markers in T2DM patients using dapagliflozin.

METHODS

One hundred forty-five patients presenting to our clinic between March 2016 and June 2018 and diagnosed with T2DM were included in the study. These were divided into two groups - a dapagliflozin group of 85 patients and a 60-member non-dapagliflozin control group. Common carotid artery end-diastolic velocity (EDV), peak systolic velocity (PSV), and resistive index (RI) parameters were evaluated using Doppler USG in both groups.

RESULTS

The mean duration of follow-up was 2.2 ± 0.4 years. Mean ages were 45 ± 14 years in the dapagliflozin group and 42 ± 15 in the control group. Mean HbA1c was 7.4 ± 1.6 in the dapagliflozin group and 7.3 ± 2.1 in the control group. Common carotid artery, PSV, and EDV parameters were higher (p = .012/p = .036), while RI was lower (p ˂ .001), in the dapagliflozin group than in the control group.

CONCLUSION

Vascular resistance was lower in the group using dapagliflozin for diabetes management.

Acarbose inhibits the proliferation and migration of vascular smooth muscle cells via targeting Ras signaling

Atherosclerosis involves the proliferation and migration of vascular smooth muscle cells (VSMCs). The migration of VSMCs from the media into the intima and their subsequent proliferation are important processes in neointima formation in atherosclerosis and restenosis after percutaneous coronary interventions. Acarbose, an alpha-glucosidase inhibitor, has been demonstrated to not affect serum levels of glucose and decrease the progression of intima-media thickening in rabbits fed with a high cholesterol diet (HCD). We previously showed that increased Ras protein levels enhanced the migration of TNF-α treated A7r5 cells. The aim of this study was to determine the inhibitory effects of acarbose on Ras expression in A7r5 cells. Acarbose also inhibited the phosphorylation of focal adhesion kinase (FAK) and Akt, activities of the matrix metalloproteinases (MMPs) MMP-2 and MMP-9, and protein expressions of small G proteins (Ras, Cdc42, RhoA, and Rac1) in a dose-dependent manner. We also found that acarbose could effectively inhibit the proliferation and migration of Ras^G12V A7r5 cells by blocking small G proteins and phosphoinositide-3-kinase (PI3K)/Akt signaling. These studies demonstrated that acarbose could theoretically decrease atherosclerosis by targeting Ras signaling.

Serum Immune Mediators Independently Associate with Atherosclerosis in the Left (But Not Right) Carotid Territory of Older Individuals

BACKGROUND AND AIM

Disturbance in the carotid arteries strongly predicts cerebrovascular events and correlates with a systemic inflammatory milieu. We investigated the relationship of a profile of 10 circulating inflammatory mediators with measures of carotid intima-media thickness (cIMT) in elderly subjects, taking traditional risk factors into account.

METHODS

Clinical inspection for present and past chronic conditions and events, as well as biochemical and anthropometric measurements, was performed for patients in ambulatory setting. Scores of cIMT were obtained bilaterally in the distal common carotid artery wall. Serum concentrations of cytokines were assessed by bead-based, multiplexed flow cytometry immunoassays.

RESULTS

Correlation analysis between log-transformed cytokines levels implicated the mediators interleukin-1β (IL1β), IL6, IL8, IL10, and tumor necrosis factor-α (TNFα) (P ≤ .005) with scores of the left cIMT. Stepwise multivariate regression showed that TNFα, IL1β, and IL6 levels accounted for most of the variance in the cIMT scores. Comparison of cytokine levels across increasing tertiles of the left cIMT reproduced the positive association with TNFα and IL1β levels.

CONCLUSION

Five out of ten immune mediators independently correlated with cIMT of older subjects in a territory-sensitive manner. This possible contribution of immune mediators to an atherosclerotic process probably relates to the inflammaging process.

Two-hour post-load plasma glucose levels are associated with carotid intima-media thickness in subjects with normal glucose tolerance

AIMS

Elevated post-load plasma glucose levels may increase the risk of cardiovascular disease, even when they are within the normoglycaemic range. We examined the association of carotid artery intima-media thickness, a marker of early atherosclerosis, with glycaemic variables, including post-load plasma glucose levels, in Japanese subjects with normal glucose tolerance.

METHODS

The study participants were 663 Japanese subjects with normal glucose tolerance (565 men, mean age 47 ± 9 years) who underwent both a 75-g oral glucose tolerance test and carotid artery intima-media thickness measurement by B-mode ultrasonography during a health examination. Associations between maximal common carotid artery intima-media thickness and fasting plasma glucose, 1-h and 2-h plasma glucose during an oral glucose tolerance test, and HbA1c were examined.

RESULTS

The carotid artery intima-media thickness gradually increased across the tertiles of 1-h plasma glucose, 2-h plasma glucose and HbA1c . In multiple linear regression analysis, 2-h plasma glucose (β = 0.09, P = 0.012), as well as age, male gender, hypertension, dyslipidaemia, and current smoking were independent determinants of carotid artery intima-media thickness. In contrast, other glycaemic variables were not independent determinants of carotid artery intima-media thickness. The carotid artery intima-media thickness in hypertensive subjects with the highest tertile of 2-h plasma glucose [0.70 (95% CI 0.64-0.76) mm] was significantly greater than in normotensive subjects, with the lowest tertile of 2-h plasma glucose [0.60 (95% CI 0.58-0.63) mm, P = 0.037], even after adjusting for the multiple potential confounders.

CONCLUSIONS

The 2-h plasma glucose during an oral glucose tolerance test was positively and independently associated with carotid artery intima-media thickness in Japanese subjects with normal glucose tolerance. In particular, the combination of elevated 2-h plasma glucose and hypertension may contribute to an increased carotid artery intima-media thickness.