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Tanaka M, Sato T, Endo K, Inyaku M, Mori K, Hosaka I, Mikami T, Akiyama Y, Ohnishi H, Hanawa N, Furuhashi M. An increase in calculated small dense low-density lipoprotein cholesterol predicts new onset of hypertension in a Japanese cohort. Hypertens Res 2023; 46:2635-2645. [PMID: 37532953 DOI: 10.1038/s41440-023-01392-x] [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: 04/04/2023] [Revised: 07/04/2023] [Accepted: 07/08/2023] [Indexed: 08/04/2023]
Abstract
A disorder of lipid metabolism is involved in cardiovascular diseases including hypertension. A high level of small dense low-density lipoprotein cholesterol (sdLDL-C) is a strong risk factor for atherosclerotic cardiovascular disease. However, the association between sdLDL-C and hypertension has not been fully investigated. We investigated the associations between the development of hypertension during a 10-year period and levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, triglycerides (TG), and LDL-C and sdLDL-C calculated by using the Sampson equations in 28,990 Japanese subjects who received annual health examinations. After exclusion of subjects with missing data, those with hypertension, and those with TG ≥ 800 mg/dL at baseline, a total of 15,177 subjects (men/women: 9374/5803, mean age: 46 years) were recruited. During the 10-year period, 2379 men (25.4%) and 724 women (12.5%) had new onset of hypertension. Multivariable Cox proportional hazard model analyses showed that levels of HDL-C, non-HDL-C, TG and sdLDL-C, but not levels of TC and LDL-C, were independent risk factors for the development of hypertension after adjustment of age, sex, family history of hypertension, systolic blood pressure, obesity, current smoking habit, alcohol drinking habit, estimated glomerular filtration rate, diagnosis of diabetes mellitus and use of lipid-lowering drugs and that the adjusted risk of sdLDL-C (per 1-standard deviation) was highest (hazard ratio [95% confidence interval: 1.09 [1.05-1.13]). The addition of sdLDL-C to traditional risk factors for hypertension significantly improved the discriminatory capability, which was better than that of other lipid fractions. In conclusion, a high level of calculated sdLDL-C predicts the development of hypertension.
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Affiliation(s)
- Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Tanaka Medical Clinic, Yoichi, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Keisuke Endo
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masafumi Inyaku
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazuma Mori
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takuma Mikami
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yukinori Akiyama
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nagisa Hanawa
- Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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Ikezaki H, Furusyo N, Ai M, Okazaki M, Kohzuma T, Hayashi J, Shimono N, Schaefer EJ. Relationship between the cholesterol and triglyceride content of lipoprotein subclasses and carotid intima-media thickness: A cross-sectional population-based study. Clin Chim Acta 2023; 548:117521. [PMID: 37597644 DOI: 10.1016/j.cca.2023.117521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND The association between lipoprotein subclasses and carotid intima-media thickness (cIMT) progression has yet to be fully evaluated. We assessed which lipoprotein subclasses were associated with maximum cIMT levels in the general population. METHODS In this study, cholesterol and triglyceride content of 20 lipoprotein subclasses were analyzed using gel permeation high-performance liquid chromatography (GP-HPLC) in 864 Japanese women and men (mean age 57 y, free of chronic liver or kidney diseases and off lipid-lowering, hormone replacement, or adrenocorticosteroid medications). Univariate and multivariate regression analyses and univariate and partial correlation analyses were performed to examine the relationships between lipoprotein subclasses and maximum cIMT levels. RESULTS After adjusting for age, sex, systolic blood pressure, smoking, diabetes, and anti-hypertensive agents, elevated low-density lipoprotein (LDL)-2 and -3 cholesterol (particle diameter 25.5 nm and 23.0 nm, respectively; medium and small LDL) were associated with higher maximum cIMT levels in both women and men (all p for trend < 0.05). These associations were significant even after participants taking anti-diabetic or anti-hypertensive agents were excluded. No significant associations were found between any triglyceride subclasses and maximum cIMT levels. CONCLUSIONS Smaller LDL particle cholesterol values are the most atherogenic lipoprotein parameter.
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Affiliation(s)
- Hiroaki Ikezaki
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan; Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, and Tufts University School of Medicine, Boston, MA, United States; Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan.
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan
| | - Masumi Ai
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, and Tufts University School of Medicine, Boston, MA, United States; Department of Insured Medical Care Management, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mitsuyo Okazaki
- Professor emeritus of Tokyo Medical and Dental University, Tokyo, Japan
| | - Takuji Kohzuma
- Diagnostics Department, Asahi Kasei Pharma Corporation, Tokyo, Japan
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan
| | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, and Tufts University School of Medicine, Boston, MA, United States
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Prognostic Implication of Small Dense LDL-Cholesterol Levels following Acute Coronary Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010158. [PMID: 36676782 PMCID: PMC9861894 DOI: 10.3390/medicina59010158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
Background and Objectives: Small dense LDL cholesterol is a strong risk factor for atherosclerosis. However, few studies have investigated the impacts of this specific lipid profile on the incident risk of adverse cardiovascular events in patients with acute coronary syndrome. Materials and Methods: Patients with acute coronary syndrome, who underwent revascularization, were included and followed for 2 years. The levels of small dense LDL cholesterol were measured at index discharge (day 0) in the setting of newly administered therapies for secondary prevention, including aspirin and statins, during the index hospitalization. The prognostic impact of small dense LDL-cholesterol levels on the risk of a primary composite endpoint, including cardiac death, non-fatal myocardial infarction, unstable angina pectoris, stroke, and heart failure, was investigated. Results: In total, 46 patients (median 75 (59, 83) years old, 63% men) were included. Median small dense LDL cholesterol was 19.4 (13.5, 23.8) mg/dL at index discharge. All patients initiated statin treatment before the index discharge, with a median LDL-cholesterol level of 77 (64, 109) mg/dL. Small dense LDL-cholesterol level was independently associated with an incremental risk for the primary endpoint (p < 0.05 by adjusting for several potential risk factors, including LDL cholesterol) with a cutoff of 32.6 mg/dL. Conclusions: Small dense LDL-cholesterol level was a significant risk factor for cardiovascular events following presentations of acute coronary syndrome.
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Zhang M, Wan ZC, Lv YM, Huang YC, Hu L, Xu H, Lei XM. Ten-year Time-trend Analysis of Dyslipidemia Among Adults in Wuhan. Curr Med Sci 2022; 42:1099-1105. [PMID: 36245027 PMCID: PMC9573792 DOI: 10.1007/s11596-022-2630-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 06/02/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Dyslipidemia is associated with an increased risk of cardiovascular disease, the major cause of death in an aging population. This study aimed to estimate the prevalence of dyslipidemia for the past decade among adults in Wuhan, China. METHODS We performed a serial cross-sectional study that recruited 705 219 adults from the Health Management Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from 2010 to 2019. The diagnosis of dyslipidemia was based on the 2016 Chinese Guidelines for the Management of Dyslipidemia in Adults. Fixed effects and random effects models were applied to adjust the confounding variables (gender and age). RESULTS The overall prevalence of dyslipidemia was 33.1% (46.2% in men and 14.7% in women) in 2019. The prevalence of dyslipidemia was significantly increased over 10 years [from 28.6% (95% CI: 28.2%-29.1%) in 2010 to 32.8 % (95% CI:32.6%-33.1%) in 2019;. P-0.001], especially for hypo-high-density lipoprotein cholesterolemia [from 18.4% (95% CI: 18.0%-18.8%) in 2010 to 24.5% (95% CI: 24.3%-24.7%) in 2019; P-0.001]. In 2019, the prevalence of dyslipidemia was higher in participants with comorbidities, including overweight/obesity, hypertension, diabetes, hyperuricemia, or chronic kidney disease, and dyslipidemia was the most significant among participants aged 30-39 years. CONCLUSION This study demonstrated that dyslipidemia is on the rise in men, and more emphasis should be provided for the screening of dyslipidemia in young males for the primary prevention of cardiovascular and renal diseases.
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Affiliation(s)
- Man Zhang
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng-Ce Wan
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong-Man Lv
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuan-Cheng Huang
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Liu Hu
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hui Xu
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Mei Lei
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Shen Y, Wang XQ, Dai Y, Wang YX, Zhang RY, Lu L, Ding FH, Shen WF. Diabetic dyslipidemia impairs coronary collateral formation: An update. Front Cardiovasc Med 2022; 9:956086. [PMID: 36072863 PMCID: PMC9441638 DOI: 10.3389/fcvm.2022.956086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Coronary collateralization is substantially impaired in patients with type 2 diabetes and occlusive coronary artery disease, which leads to aggravated myocardial ischemia and a more dismal prognosis. In a diabetic setting, altered serum lipid profiles and profound glycoxidative modification of lipoprotein particles induce endothelial dysfunction, blunt endothelial progenitor cell response, and severely hamper growth and maturation of collateral vessels. The impact of dyslipidemia and lipid-lowering treatments on coronary collateral formation has become a topic of heightened interest. In this review, we summarized the association of triglyceride-based integrative indexes, hypercholesterolemia, increased Lp(a) with its glycoxidative modification, as well as quantity and quality abnormalities of high-density lipoprotein with impaired collateral formation. We also analyzed the influence of innovative lipid-modifying strategies on coronary collateral development. Therefore, clinical management of diabetic dyslipidemia should take into account of its effect on coronary collateralization in patients with occlusive coronary artery disease.
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Affiliation(s)
- Ying Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Qun Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Dai
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Xuan Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Yan Zhang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Lin Lu
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Hua Ding
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Feng Hua Ding,
| | - Wei Feng Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wei Feng Shen,
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Jin X, Yang S, Lu J, Wu M. Small, Dense Low-Density Lipoprotein-Cholesterol and Atherosclerosis: Relationship and Therapeutic Strategies. Front Cardiovasc Med 2022; 8:804214. [PMID: 35224026 PMCID: PMC8866335 DOI: 10.3389/fcvm.2021.804214] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/02/2021] [Indexed: 12/14/2022] Open
Abstract
Low-density lipoprotein cholesterol (LDL-C) plays an important role in the formation, incidence, and development of atherosclerosis (AS). Low-density lipoproteins can be divided into two categories: large and light LDL-C and small, dense low-density lipoprotein cholesterol (sdLDL-C). In recent years, an increasing number of studies have shown that sdLDL-C has a strong ability to cause AS because of its unique characteristics, such as having small-sized particles and low density. Therefore, this has become the focus of further research. However, the specific mechanisms regarding the involvement of sdLDL-C in AS have not been fully explained. This paper reviews the possible mechanisms of sdLDL-C in AS by reviewing relevant literature in recent years. It was found that sdLDL-C can increase the atherogenic effect by regulating the activity of gene networks, monocytes, and enzymes. This article also reviews the research progress on the effects of sdLDL-C on endothelial function, lipid metabolism, and inflammation; it also discusses its intervention effect. Diet, exercise, and other non-drug interventions can improve sdLDL-C levels. Further, drug interventions such as statins, fibrates, ezetimibe, and niacin have also been found to improve sdLDL-C levels.
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Affiliation(s)
- Xiao Jin
- General Department of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shengjie Yang
- General Department of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Lu
- Beijing University of Chinese Medicine, Beijing, China
| | - Min Wu
- General Department of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Ikezaki H, Furusyo N, Nakashima R, Umemoto M, Yamamoto K, Matsumoto Y, Ohta A, Yamasaki S, Hiramine S, Takayama K, Ogawa E, Toyoda K, Murata M, Shimono N, Hayashi J. Kyushu and Okinawa Population Study (KOPS): a large prospective cohort study in Japan. BMJ Open 2021; 11:e053763. [PMID: 34933862 PMCID: PMC8693098 DOI: 10.1136/bmjopen-2021-053763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The Kyushu and Okinawa Population Study (KOPS) was established to investigate gene-environmental interactions in non-communicable diseases in Japan. Besides collecting blood samples and anthropometric measurements, we also obtained medical histories, psychological status and lifestyle habits, including physical activities and dietary patterns. PARTICIPANTS KOPS is a community-based prospective cohort study and consists of participants from four southwestern areas in Japan. Baseline surveys were conducted between 2004 and 2007 (wave 1), and 2009 and 2012 (wave 2) at the sites of municipality-based health check-ups. A total of 17 077 participants were included, comprising 10 697 participants of wave 1 and 6380 participants of wave 2; the median age in both groups was 61 years. Among them, 3006 individuals participated in both wave 1 and wave 2 surveys. FINDINGS TO DATE We have focused on either risk or confounding factors for non-communicable diseases. We have assessed the clinical utility of the newly developed biomarkers for impaired glucose tolerance, such as urinary myo-inositol and glycated albumin, and atherosclerosis, such as small dense low-density lipoprotein cholesterol. We have conducted an international collaborative study with Framingham Offspring Study to investigate ethnic differences in impaired glucose tolerance and cardiovascular diseases. We have found that insulin resistance and deficiency might account for the ethnic differences in impaired glucose tolerance and cardiovascular disease risks. As gene-environmental interaction analyses, we found a synergic effect of interleukin 28B single nucleotide polymorphisms (SNPs) and gender on the spontaneous elimination of hepatitis C, and a beneficial interaction of SNPs of high-density lipoprotein cholesterol and gender on the impact of physical activity. In addition, we reported eight novel loci contributing to the development and severity of coronary artery disease from a large genome-wide association study. FUTURE PLANS We plan to investigate further the clinical utility of the newly developed biomarkers and the gene-environmental interactions using prospective data.
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Affiliation(s)
- Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Taihaku Avenue Clinic, Fukuoka, Japan
| | - Ryoko Nakashima
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Makiko Umemoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Ken Yamamoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yuji Matsumoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Azusa Ohta
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Sho Yamasaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Satoshi Hiramine
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Takayama
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan
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Liu H, Liu K, Pei L, Li S, Zhao J, Zhang K, Zong C, Zhao L, Fang H, Wu J, Sun S, Song B, Xu Y, Gao Y. Atherogenic Index of Plasma Predicts Outcomes in Acute Ischemic Stroke. Front Neurol 2021; 12:741754. [PMID: 34707558 PMCID: PMC8542679 DOI: 10.3389/fneur.2021.741754] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/02/2021] [Indexed: 11/25/2022] Open
Abstract
Aim: The atherogenic index of plasma (AIP) was significantly related to adverse outcomes in patients with cardiovascular disease. Our aim was to investigate the association between AIP and adverse outcomes in acute ischemic stroke. Methods: Patients with acute ischemic stroke (AIS) admitted between 2015 and 2018 were prospectively enrolled in this study. Functional outcomes were evaluated by the modified Rankin Scale (mRS). Poor outcomes were defined as mRS 3–6. The relationship of AIP with the risk of outcomes was analyzed by multivariate logistic regression models. Results: A total of 1,463 patients with AIS within 24 h of symptom onset were enrolled. The poor outcome group had a significantly higher level of AIP [0.09 (−0.10 to 0.27) vs. 0.04 (−0.09 to 0.18), p < 0.001] compared with the good outcome group. Multivariable logistic regression analysis showed that higher AIP was associated with poor outcomes in all the stroke patients (OR 1.84, 95% CI, 1.23–2.53, p = 0.007), which was more evident in patients with large-artery atherosclerosis subtype (OR 1.90, 95% CI, 1.53–2.62, p = 0.002), but not in the other subtypes. Receiver operating curve (ROC) analysis revealed that the best predictive cutoff value of AIP was 0.112, with a sensitivity of 70.8% and a specificity of 59.2%, and the area under the ROC curves for AIP was 0.685. Conclusion: AIP may be an important and independent predictor of the outcome of dysfunction in patients with AIS, especially the stroke subtype of large-artery atherosclerosis.
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Affiliation(s)
- Hongbing Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kai Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lulu Pei
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shen Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiawei Zhao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ke Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ce Zong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lu Zhao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Fang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun Wu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shilei Sun
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Selected 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors. A look into their use and potential in pre-diabetes and type 2 diabetes. Endocr Regul 2021; 55:182-192. [PMID: 34523296 DOI: 10.2478/enr-2021-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objectives. This review assesses the comparative safety and efficacy of selected 3-hydroxy-3-methylglutaric acid coenzyme A inhibitors (statins, cinnamic acids. 3-hydroxy-3-methyl glutaric acid) on the pre-onset type 2 diabetes (PT2D) and post-onset type 2 diabetes (T2D)-related cluster of seven features (central obesity, hyperglycemia, hypertension, dyslipidemia, pro-thrombosis, oxidation and inflammation). Methods. Google scholar and PubMed were searched for statin*, flaxseed lignan complex (FLC), cinnamic acid (CA)*, and 3-hydroxy-3-methylglutaric acid (HMGA) in conjunction with each of PT2D, T2D and the cluster of seven. An introduction was followed by findings or absence thereof on the impacts of each of statins, FLC, CAs and HMGA on each member of the cluster of seven. Results. Pravastatin manages three features in PT2D, while a number of the statins improve five in T2D. FLC is negative in PT2D but controls four in T2D; it is not clear if the CAs and HMGA in FLC play a role in this success. CAs have potential in six and HMGA has potential in three of the cluster of seven though yet CAs and HMGA are untested in PT2D and T2D in humans. There are safety concerns with some statins and HMGA but FLC and CAs appear safe in the doses and durations tested. Conclusions. Selected statins, FLC, CAs and HMGA can manage or have a potential to manage at least three features of the cluster of seven. Most of the literature-stated concerns are with select statins but there are concerns (one actual and two potential) with HMGA.
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Elevated Serum Small Dense Low-Density Lipoprotein Cholesterol May Increase the Risk and Severity of Coronary Heart Disease and Predict Cardiovascular Events in Patients with Type 2 Diabetes Mellitus. DISEASE MARKERS 2021; 2021:5597028. [PMID: 34046097 PMCID: PMC8128552 DOI: 10.1155/2021/5597028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/27/2021] [Indexed: 11/26/2022]
Abstract
Background Coronary heart disease (CHD) is a common and severe complication in type 2 diabetes mellitus (T2DM) patients. Increased amount of circulatory small dense low-density lipoprotein cholesterol (sdLDL-C) particles is known to be a sign of dyslipidemia and can result in atherosclerosis. However, the association between serum sdLDL-C levels and CHD in T2DM patients remains unclear. Methods A total of 3684 T2DM patients who received selective coronary angiography (CAG) were selected. For analyzing the association between sdLDL-C and CHD severity in T2DM, the patients with CHD were further divided into four subgroups according to the quartiles of sdLDL-C. A multivariate logistic regression was used for analyzing the risks and severity of CHD. A total of 3427 patients with continuous stable CHD were recruited and followed up for 5 years. Results Serum sdLDL-C levels in the CHD group were significantly increased compared with those in the non-CHD group [0.80 (0.49) mmol/L vs. 0.70 (0.30) mmol/L, p < 0.001]. The results from CHD subgroup analysis indicated that the sdLDL-C levels in patients with multiple-vessel disease and high Gensini score (GS) were significantly increased. By adjusting the confounding factors and analyzing with multiple logistic regression, we found that sdLDL-C independently correlated with the presence and severity of CHD (CHD: OR = 2.257; multiple-vessel disease: OR = 3.288; high GS: OR = 2.554). A total of 484 major cardiovascular events (MACEs) were documented. After Kaplan-Meier analysis and chi-squared analysis, the incidence of MACEs in the high sdLDL-C group was higher than that in the low sdLDL-C group (16.04% vs. 12.25%, p = 0.002). Conclusion In T2DM patients, elevated serum sdLDL-C may increase the severity of CHD and predict cardiovascular events in the future. Therefore, serum sdLDL-C may be a potential biomarker for the surveillance of CHD in T2DM patients.
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Iannuzzi A, Rubba P, Gentile M, Mallardo V, Calcaterra I, Bresciani A, Covetti G, Cuomo G, Merone P, Di Lorenzo A, Alfieri R, Aliberti E, Giallauria F, Di Minno MND, Iannuzzo G. Carotid Atherosclerosis, Ultrasound and Lipoproteins. Biomedicines 2021; 9:biomedicines9050521. [PMID: 34066616 PMCID: PMC8148516 DOI: 10.3390/biomedicines9050521] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
Carotid artery plaques are considered a measure of atherosclerosis and are associated with an increased risk of atherosclerotic cardiovascular disease, particularly ischemic strokes. Monitoring of patients with an elevated risk of stroke is critical in developing better prevention strategies. Non-invasive imaging allows us to directly see atherosclerosis in vessels and many features that are related to plaque vulnerability. A large body of evidence has demonstrated a strong correlation between some lipid parameters and carotid atherosclerosis. In this article, we review the relationship between lipids and atherosclerosis with a focus on carotid ultrasound, the most common method to estimate atherosclerotic load.
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Affiliation(s)
- Arcangelo Iannuzzi
- Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy; (A.B.); (G.C.)
- Correspondence:
| | - Paolo Rubba
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Marco Gentile
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Vania Mallardo
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Ilenia Calcaterra
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Alessandro Bresciani
- Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy; (A.B.); (G.C.)
| | - Giuseppe Covetti
- Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy; (A.B.); (G.C.)
| | - Gianluigi Cuomo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Pasquale Merone
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Anna Di Lorenzo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Roberta Alfieri
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Emilio Aliberti
- North Tees University Hospital, Stockton-on Tees TS19 8PE, UK;
| | - Francesco Giallauria
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Matteo Nicola Dario Di Minno
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Gabriella Iannuzzo
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
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Wang X, Wang L, Cao R, Yang X, Xiao W, Zhang Y, Ye P. Correlation between small and dense low-density lipoprotein cholesterol and cardiovascular events in Beijing community population. J Clin Hypertens (Greenwich) 2021; 23:345-351. [PMID: 33481346 PMCID: PMC8029841 DOI: 10.1111/jch.14150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 11/28/2022]
Abstract
The relationship between small dense low‐density lipoprotein cholesterol (sdLDL‐C) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross‐sectional or longitudinal follow‐up study on sdLDL‐C in the Chinese hypertension population. We analyzed the association of plasma sdLDL‐C levels with major adverse cardiovascular events in 1325 subjects from a longitudinal follow‐up community‐based population in Beijing, China. During the follow‐up period, a total of 191 subjects had MACEs. Cox regression analysis showed that sdLDL‐C is a major risk factor for MACEs independent of sex, age, BMI, hypertension, diabetes, smoking, SBP, DBP, FBG, eGFR in the general community population (1.013 (1.001 −1.025, P < .05)), but the correlation disappeared after adjusting for TC and HDL‐C in Model 3. Cox analysis showed that hypertension combined with high level of sdLDL‐C was still the risk factor for MACEs ((2.079 (1.039‐4.148)). Our findings in the Chinese cohort support that sdLDL‐C is a risk factor for major adverse cardiovascular events in hypertension subjects.
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Affiliation(s)
- Xiaona Wang
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Liang Wang
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ruihua Cao
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xu Yang
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Wenkai Xiao
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yun Zhang
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ping Ye
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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