|
1
|
Rezaee M, Kamrani F, Imannezhad M, Shahri HH, Saihood WK, Rezvani A, Far PM, Mahaki H, Esmaily H, Moohebati M, Shariati M, Ghayour-Mobarhan M, Darroudi S. Beyond traditional metrics: evaluating the triglyceride-total cholesterol-body weight index (TCBI) in cardiovascular risk assessment. BMC Cardiovasc Disord 2025; 25:39. [PMID: 39849378 PMCID: PMC11756170 DOI: 10.1186/s12872-025-04500-6] [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: 11/11/2024] [Accepted: 01/14/2025] [Indexed: 01/25/2025] Open
Abstract
BACKGROUND Cardiovascular disease (CVD), a non-communicable condition, stands as the primary cause of death globally. This study seeks to evaluate the predictive power of atherogenic indices, which are recognized for their influence on CVD, alongside a newly developed index encompassing all three principal risk factors for CVD, referred to as the triglyceride-total cholesterol-body weight index (TCBI). The primary outcomes evaluated include both the incidence and mortality rates associated with CVD. METHODS A prospective cohort study was conducted on Mashhad stroke and heart atherosclerotic disorder (MASHAD) study data, involving 9704 healthy participants. Baseline variables were measured, and TCBI, Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC), Castelli risk index I and II (CRI-I & II) were calculated using specific formulas. RESULTS Following a 10-year follow-up period, a significant positive relationship was observed between TCBI (HR: 1.078, 95% CI: 1.012-1.15), CRI-I (HR: 1.16, 95% CI: 1.007-1.337), and CRI-II (HR: 1.199, 95% CI: 1.001-1.437) with CVD mortality. However, no significant relationship was identified between TCBI and atherogenic indices related to CVD incidence, and neither AIP nor AC was associated with CVD mortality. CONCLUSION In conclusion, TCBI, in contrast to AC and AIP, was linked to increased CVD mortality. However, the more substantial predictive capabilities of CRI-I and CRI-II compared to TCBI emphasize the importance of traditional atherogenic indices for accurate risk assessment. These findings underscore the necessity of enhancing the TCBI formula to improve its effectiveness in assessing CVD risk.
Collapse
Affiliation(s)
- Mohsen Rezaee
- Student Research Committee, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Farzam Kamrani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mobina Imannezhad
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Hashemi Shahri
- Department of Clinical Pharmacy, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Waleed Khaled Saihood
- Department of Biochemistry and Biophysics, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Alireza Rezvani
- Metabolic syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran
| | - Parsa Mearaji Far
- Metabolic syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran
| | - Hanie Mahaki
- Metabolic syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Metabolic syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran
- Department of Cardiovascular, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Shariati
- Blood Burn Infections Research Center, Academic Center for Education, Culture and Research (ACECR, Vascular and Endovascular Surgery Research Center, Mashhad University of medical sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran.
| | - Susan Darroudi
- Vascular and Endovascular Surgery Research Center, Mashhad University of medical sciences, Mashhad, 99199-91766, Iran.
| |
Collapse
|
|
2
|
Bertolín-Boronat C, Merenciano-González H, Marcos-Garcés V, Martínez-Mas ML, Climent Alberola JI, Pérez N, López-Bueno L, Esteban-Argente MC, Valls Reig M, Arizón Benito A, Payá Rubio A, Ríos-Navarro C, de Dios E, Gavara J, Sanchis J, Bodi V. Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program. Rev Cardiovasc Med 2025; 26:25399. [PMID: 39867202 PMCID: PMC11759968 DOI: 10.31083/rcm25399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 09/17/2024] [Accepted: 09/23/2024] [Indexed: 01/28/2025] Open
Abstract
Background Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we analyze the dynamics and predictors of HDL-C increase during CRP in patients following ST-segment elevation myocardial infarction or occlusion myocardial infarction. Methods We conducted a prospective study of myocardial infarction patients who completed exercise-based Phase 2 CRP. Data was collected on clinical variables, cardiovascular risk factors, treatment goals, pharmacological therapy, and health outcomes through questionnaires at the beginning and at the end of Phase 2 CRP. Lipid profile analysis was performed before discharge, 4 to 6 weeks after discharge, and at the end of Phase 2 CRP. Changes in lipid profiles were evaluated, and predictors of failure to increase HDL-C levels were identified by binary logistic regression analysis. Results Our cohort comprised 121 patients (mean age 61.67 ± 10.97 years, 86.8% male, and 47.9% smokers before admission). A significant decrease in total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were noted, along with an increase in HDL-C (43.87 ± 9.18 vs. 39.8 ± 10.03 mg/dL, p < 0.001). Patients achieving normal HDL-C levels (>40 mg/dL in men and >50 mg/dL in women) significantly increased from 34.7% at admission to 52.9% the end of Phase 2. Multivariable analysis revealed smoking history (hazard ratio [HR] = 0.35, 95% confidence interval [CI], 0.11-0.96, p = 0.04), increased reduction in total cholesterol (HR = 0.94, 95% CI, 0.89-0.98, p = 0.004), and increased reduction in LDL-C (HR = 0.94, 95% CI, 0.89-0.99, p = 0.01) were inversely associated with failure to increase HDL-C levels. Conversely, higher HDL-C before CRP (HR = 1.15, 95% CI, 1.07-1.23, p < 0.001) and increased lipoprotein (a) (HR = 1.01, 95% CI, 1-1.02, p = 0.04) predicted failure to increase HDL-C levels. No significant correlations were found with Mediterranean diet adherence, weekly physical activity, training modalities, or physical fitness parameters. Conclusions Participation in an exercise-based Phase 2 CRP led to mild but significant increases in HDL-C. Smoking history and patients experiencing substantial reductions in total cholesterol and LDL-C were more likely to experience HDL-C increases, unlike those with higher HDL-C and lipoprotein (a) levels before CRP.
Collapse
Affiliation(s)
- Carlos Bertolín-Boronat
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- INCLIVA Health Research Institute, 46010 Valencia, Spain
| | - Héctor Merenciano-González
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- INCLIVA Health Research Institute, 46010 Valencia, Spain
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain
| | - Víctor Marcos-Garcés
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- INCLIVA Health Research Institute, 46010 Valencia, Spain
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain
| | - María Luz Martínez-Mas
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | | | - Nerea Pérez
- INCLIVA Health Research Institute, 46010 Valencia, Spain
| | - Laura López-Bueno
- Department of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | | | - María Valls Reig
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | | | - Alfonso Payá Rubio
- Department of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | | | - Elena de Dios
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain
| | - Jose Gavara
- Centre for Biomaterials and Tissue Engineering, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Juan Sanchis
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- INCLIVA Health Research Institute, 46010 Valencia, Spain
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Vicente Bodi
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- INCLIVA Health Research Institute, 46010 Valencia, Spain
- Network Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| |
Collapse
|
|
3
|
Romero-Jiménez MJ. HDL and cardiovascular risk. Atherosclerosis 2025; 400:119050. [PMID: 39551681 DOI: 10.1016/j.atherosclerosis.2024.119050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Accepted: 11/07/2024] [Indexed: 11/19/2024]
|
|
4
|
Bea AM, González-Guerrero A, Cenarro A, Lamiquiz-Moneo I, Climent E, Jarauta E, Gracia-Rubio I, Benaiges D, Laclaustra M, Tejedor T, Pedro-Botet J, Civeira F, Marco-Benedí V. Association of HDL cholesterol with all-cause and cardiovascular mortality in primary hypercholesterolemia. Atherosclerosis 2025; 400:118617. [PMID: 39368903 DOI: 10.1016/j.atherosclerosis.2024.118617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 09/09/2024] [Accepted: 09/24/2024] [Indexed: 10/07/2024]
Abstract
BACKGROUND AND AIMS Recent reports have shown that subjects with high high-density lipoprotein cholesterol (HDLc) levels are paradoxically at increased risk for all-cause and cardiovascular mortality. The aim was to study the association of HDLc concentration with mortality in subjects with high cholesterol. METHODS We analyzed total mortality, cardiovascular mortality, and non-cardiovascular mortality in a cohort of 2992 subjects with primary hypercholesterolemia, who were followed for 10.2 years (range 1-25 years), with a total of 30,602 subject-years of follow-up. RESULTS During follow-up, 168 subjects died, with 52 (13.7 %), 105 (4.80 %), and 11 (2.60 %) in the low, normal, and high HDLc groups, respectively (p < 0.001). The risk of death was 2.89 times higher (95 % confidence interval (CI), 1.50-5.57, p < 0.001) in subjects in the low HDLc group compared to those in the high HDLc group and 1.48 times higher (95 % CI 0.80-2.76, p = 0.214) in the normal HDLc group compared to the high HDLc group. However, HDLc concentration and HDLc groups based on HDLc concentration were not independently associated with mortality in Cox regression analysis. Cardiovascular and non-cardiovascular mortalities showed similar results. CONCLUSIONS All types of mortality were lower in subjects with primary hypercholesterolemia and with high HDLc in univariate analysis. Elevated HDLc was not associated with total, cardiovascular, and non-cardiovascular mortality when adjusted for major cardiovascular risk factors.
Collapse
Affiliation(s)
- Ana M Bea
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain
| | - Anton González-Guerrero
- School of Medicine, Universitat Autónoma de Barcelona/Universitat Pompeu Fabre, Barcelona, Spain
| | - Ana Cenarro
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Instituto Aragonés de Ciencias de La Salud (IACS), Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Universidad de Zaragoza, Zaragoza, Spain
| | - Elisenda Climent
- Lipid and Vascular Risk Unit, Department of Endocrinology and Nutrition, Hospital Del Mar, Barcelona, Spain
| | - Estibaliz Jarauta
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Universidad de Zaragoza, Zaragoza, Spain
| | - Irene Gracia-Rubio
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Universidad de Zaragoza, Zaragoza, Spain
| | - David Benaiges
- Lipid and Vascular Risk Unit, Department of Endocrinology and Nutrition, Hospital Del Mar, Barcelona, Spain
| | - Martín Laclaustra
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Universidad de Zaragoza, Zaragoza, Spain
| | - Teresa Tejedor
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Universidad de Zaragoza, Zaragoza, Spain
| | - Juan Pedro-Botet
- Lipid and Vascular Risk Unit, Department of Endocrinology and Nutrition, Hospital Del Mar, Barcelona, Spain
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Universidad de Zaragoza, Zaragoza, Spain.
| | - Victoria Marco-Benedí
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Spain; Universidad de Zaragoza, Zaragoza, Spain
| |
Collapse
|
|
5
|
Wen W, Fan H, Zhang S, Hu S, Chen C, Tang J, You Y, Wang C, Li J, Luo L, Cheng Y, Zhou M, Zhao X, Tan T, Xu F, Fu X, Chen J, Dong P, Zhang X, Wang M, Feng Y. Associations between metabolic dysfunction-associated fatty liver disease and atherosclerotic cardiovascular disease. Am J Med Sci 2024; 368:557-568. [PMID: 38944203 DOI: 10.1016/j.amjms.2024.06.022] [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: 07/29/2023] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is closely related to metabolic syndrome and remains a major global health burden. The increased prevalence of obesity and type 2 diabetes mellitus (T2DM) worldwide has contributed to the rising incidence of NAFLD. It is widely believed that atherosclerotic cardiovascular disease (ASCVD) is associated with NAFLD. In the past decade, the clinical implications of NAFLD have gone beyond liver-related morbidity and mortality, with a majority of patient deaths attributed to malignancy, coronary heart disease (CHD), and other cardiovascular (CVD) complications. To better define fatty liver disease associated with metabolic disorders, experts proposed a new term in 2020 - metabolic dysfunction associated with fatty liver disease (MAFLD). Along with this new designation, updated diagnostic criteria were introduced, resulting in some differentiation between NAFLD and MAFLD patient populations, although there is overlap. The aim of this review is to explore the relationship between MAFLD and ASCVD based on the new definitions and diagnostic criteria, while briefly discussing potential mechanisms underlying cardiovascular disease in patients with MAFLD.
Collapse
Affiliation(s)
- Wen Wen
- Department of Cardiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, 313000, Zhejiang, China
| | - Hua Fan
- School of Clinical Medicine, The First Affiliated Hospital of Henan University of Science and Technology, Henan University of Science and Technology, Luoyang 471003, Henan, China
| | - Shenghui Zhang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Siqi Hu
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Chen Chen
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Jiake Tang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Yao You
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Chunyi Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Jie Li
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Lin Luo
- Hangzhou Ruolin Hospital Management Co. Ltd, Hangzhou, 310007, China
| | - Yongran Cheng
- School of Public Health, Hangzhou Medical College, Hangzhou, 311300, China
| | - Mengyun Zhou
- Department of Molecular & Cellular Physiology, Shinshu University School of Medicine, 3900803, Japan
| | - Xuezhi Zhao
- Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang, China
| | - Tao Tan
- Faculty of Applied Science, Macao Polytechnic University, Macao SAR, 999078, China
| | - Fangfang Xu
- Strategy Research and Knowledge Information Center, SAIC Motor Group, 200030, Shanghai, China
| | - Xinyan Fu
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Juan Chen
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Peng Dong
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Xingwei Zhang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China
| | - Mingwei Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China.
| | - Yan Feng
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Hangzhou, 310015, Hangzhou Lin'an Fourth People's Hospital, Hangzhou 311321, China.
| |
Collapse
|
|
6
|
Akiyama T, Ikegami R, Kubota N, Takano T, Yoneyama S, Okubo T, Hoyano M, Ozaki K, Inomata T. Serum Apolipoprotein-A2 Levels Are a Strong Predictor of Future Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention. Circ J 2024; 88:1770-1777. [PMID: 38897974 DOI: 10.1253/circj.cj-24-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND Because apolipoprotein-A2 (ApoA2), a key component of high-density lipoprotein cholesterol (HDL-C), lacks clear clinical significance, we investigated its impact on cardiovascular events in patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS We examined 638 patients who underwent PCI with a new-generation drug-eluting stent for acute or chronic coronary syndrome and had their apolipoprotein levels measured between 2016 and 2021. The patients were divided into 2 groups based on the median serum ApoA2 values, and the incidence of major adverse cardiovascular events (MACE) was assessed. Of the 638 patients, 563 (88%) received statin treatment, with a median serum LDL-C level of 93 mg/dL. Furthermore, 137 patients (21.5%) experienced MACE, and Kaplan-Meier analysis revealed that the higher ApoA2 group had a significantly lower incidence of MACE than the lower ApoA2 group (30.9% vs. 41.6%). However, the other apolipoproteins, including ApoA1, ApoB, ApoC2, ApoC3, and ApoE, showed no significant differences in MACE. Multivariable Cox hazard analysis indicated that ApoA2 was an independent predictor of MACEs (hazard ratio, 0.666; 95% confidence interval, 0.465-0.954). Furthermore, ApoA2 levels exhibited the strongest inverse association with high-sensitivity C-reactive protein levels (rs=-0.479). CONCLUSIONS Among all the apolipoproteins, the serum ApoA2 level may be the strongest predictor of future cardiovascular events and prognosis in patients undergoing PCI.
Collapse
Affiliation(s)
- Takumi Akiyama
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Ryutaro Ikegami
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Naoki Kubota
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Toshiki Takano
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Shintaro Yoneyama
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Takeshi Okubo
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Makoto Hoyano
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Kazuyuki Ozaki
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Takayuki Inomata
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| |
Collapse
|
|
7
|
Ray S, Saikia D, Vashisht Y, Sharma S, Meena RK, Kumar M. Dyslipidemia and atherogenic indexes in children with transfusion-dependent thalassemia. Hematol Transfus Cell Ther 2024; 46:345-351. [PMID: 37147168 PMCID: PMC11451368 DOI: 10.1016/j.htct.2023.02.006] [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: 09/17/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVE This study endeavored to assess the lipid profile and atherogenic lipid indexes in children with transfusion-dependent thalassemia (TDT) and to compare them with matched healthy children. METHOD The study group consisted of a total of 72 TDT patients aged 3 to14 years, while the control group had 83 age- and sex-matched healthy children. The fasting lipid profile and lipid indexes were estimated and the atherogenic index of plasma (AIP), Castelli's risk indexes I and II, atherogenic coefficient were calculated and compared between the two groups. RESULT Compared to the control group, the mean LDL, HDL and cholesterol levels were significantly lower among the case group (p-value < 0.001). The mean VLDL and triglycerides were significantly higher in the case group (p-value < 0.001). Lipid indexes, including the atherogenic index of plasma (AIP), Castelli's risk indexes I and II and atherogenic coefficients were significantly higher in TDT children. CONCLUSION Dyslipidemia and increased risk of atherosclerosis were found in TDT children, as they had elevated atherogenic lipid indexes. Our study underlines the importance of the routine use of these indexes in TDT children. Future studies should focus on lipid indexes in this high-lipid group of children so that preventive strategies can be planned accordingly.
Collapse
Affiliation(s)
| | - Diganta Saikia
- Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India
| | | | - Shikha Sharma
- Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India
| | | | - Manish Kumar
- Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India
| |
Collapse
|
|
8
|
Meneguelli TS, Kravchychyn ACP, Wendling AL, Dionísio AP, Bressan J, Martino HSD, Tako E, Hermsdorff HHM. Cashew nut ( Anacardium occidentale L.) and cashew nut oil reduce cardiovascular risk factors in adults on weight-loss treatment: a randomized controlled three-arm trial (Brazilian Nuts Study). Front Nutr 2024; 11:1407028. [PMID: 38988854 PMCID: PMC11234893 DOI: 10.3389/fnut.2024.1407028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/15/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction Cashew nut contains bioactive compounds that modulate satiety and food intake, but its effects on body fat during energy restriction remains unknown. This study aimed to assess the effects of cashew nut and cashew nut oil on body fat (primary outcome) as well as adiposity, cardiometabolic and liver function markers (secondary outcomes). Materials and methods An eight-week (8-wk) randomized controlled-feeding study involved 68 adults with overweight/obesity (40 women, BMI: 33 ± 4 kg/m2). Participants were randomly assigned to one of the energy-restricted (-500 kcal/d) groups: control (CT, free-nuts), cashew nut (CN, 30 g/d), or cashew nut oil (OL, 30 mL/d). Body weight, body composition, and blood collection were assessed at the baseline and endpoint of the study. Results After 8-wk, all groups reduced significantly body fat (CT: -3.1 ± 2.8 kg; CN: -3.3 ± 2.7 kg; OL: -1.8 ± 2.6 kg), body weight (CT: -4.2 ± 3.8 kg; CN: -3.9 ± 3.1 kg; OL: -3.4 ± 2.4 kg), waist (CT: -5.1 ± 4.6 cm; CN: -3.9 ± 3.9 cm; OL: -3.7 ± 5.3 cm) and hip circumferences (CT: -2.9 ± 3.0 cm; CN: -2.7 ± 3.1 cm; OL: -2.9 ± 2.3 cm). CN-group reduced liver enzymes (AST: -3.1 ± 5.3 U/L; ALT: -6.0 ± 9.9 U/L), while the OL-group reduced LDL-c (-11.5 ± 21.8 mg/dL) and atherogenic index (-0.2 ± 0.5). Both intervention groups decreased neck circumference (CN: -1.0 ± 1.2 cm; OL: -0.5 ± 1.2 cm) and apo B (CN: -6.6 ± 10.7 mg/dL; OL: -7.0 ± 15.3 mg/dL). Conclusion After an 8-wk energy-restricted intervention, all groups reduced body fat (kg), weight, and some others adiposity indicators, with no different effect of cashew nut or cashew nut oil. However, participants in the intervention groups experienced additional reductions in atherogenic marker, liver function biomarkers, and cardiovascular risk factors (neck circumference and apo B levels), with these effects observed across the OL group, CN group, and both intervention groups, respectively.Clinical trial registration:https://ensaiosclinicos.gov.br/rg/RBR-8xzkyp2, identifier 8xzkyp2.
Collapse
Affiliation(s)
- Talitha Silva Meneguelli
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Ana Claudia Pelissari Kravchychyn
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Aline Lage Wendling
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Ana Paula Dionísio
- Brazilian Agricultural Research Corporation (Embrapa) Agroindústria Tropical-CNPAT, Brasília, Brazil
| | - Josefina Bressan
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Hercia Stampini Duarte Martino
- Laboratory of Experimental Nutrition, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Elad Tako
- Trace Minerals and Nutrition Lab, Department of Food Science, Cornell University, Ithaca, NY, United States
| | - Helen Hermana Miranda Hermsdorff
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| |
Collapse
|
|
9
|
Sharma A, Sharma C, Sharma L, Wal P, Mishra P, Sachdeva N, Yadav S, Vargas De-La Cruz C, Arora S, Subramaniyan V, Rawat R, Behl T, Nandave M. Targeting the vivid facets of apolipoproteins as a cardiovascular risk factor in rheumatoid arthritis. Can J Physiol Pharmacol 2024; 102:305-317. [PMID: 38334084 DOI: 10.1139/cjpp-2023-0259] [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] [Indexed: 02/10/2024]
Abstract
Mostly, cardiovascular diseases are blamed for casualties in rheumatoid arthritis (RA) patients. Customarily, dyslipidemia is probably the most prevalent underlying cause of untimely demise in people suffering from RA as it hastens the expansion of atherosclerosis. The engagement of inflammatory cytokines like tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6), etc., is crucial in the progression and proliferation of both RA and abnormal lipid parameters. Thus, lipid abnormalities should be monitored frequently in patients with both primary and advanced RA stages. An advanced lipid profile examination, i.e., direct role of apolipoproteins associated with various lipid molecules is a more dependable approach for better understanding of the disease and selecting suitable therapeutic targets. Therefore, studying their apolipoproteins is more relevant than assessing RA patients' altered lipid profile levels. Among the various apolipoprotein classes, Apo A1 and Apo B are primarily being focused. In addition, it also addresses how calculating Apo B:Apo A1 ratio can aid in analyzing the disease's risk. The marketed therapies available to control lipid abnormalities are associated with many other risk factors. Hence, directly targeting Apo A1 and Apo B would provide a better and safer option.
Collapse
Affiliation(s)
- Aditi Sharma
- Department of Pharmacology, School of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, India
| | - Chakshu Sharma
- Department of Pharmacology, School of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, India
| | - Lalit Sharma
- Department of Pharmacology, School of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, India
| | - Pranay Wal
- Pranveer Singh Institute of Technology, Pharmacy, Kanpur, Uttar Pradesh, India
| | - Preeti Mishra
- Raja Balwant Singh Engineering Technical Campus, Bichpuri, Agra, India
| | - Nitin Sachdeva
- Department of Anesthesia, Mediclinic Aljowhara Hospital, Al Ain, United Arab Emirates
| | - Shivam Yadav
- School of Pharmacy, Babu Banarasi Das University, Lucknow, Uttar Pradesh, India
| | - Celia Vargas De-La Cruz
- Department of Pharmacology, Bromatology and Toxicology, Faculty of Pharmacy and Biochemistry, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru
- E-Health Research Center, Universidad de Ciencias y Humanidades, Lima 15001, Peru
| | - Sandeep Arora
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh, India
| | - Vetriselvan Subramaniyan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Selangor Darul Ehsan, Malaysia
- Centre for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu 600077, India
| | - Ravi Rawat
- School of Health Sciences and Technology, University of Petroleum and Energy Studies, Bidholi, Dehradun, Uttarakhand, India
| | - Tapan Behl
- Amity School of Pharmaceutical Sciences, Amity University, Mohali, Punjab, India
| | - Mukesh Nandave
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, Delhi, India
| |
Collapse
|
|
10
|
Chary A, Tohidi M, Hasheminia M, Golmohammadi M, Haji Hosseini R, Hedayati M, Azizi F, Hadaegh F. Association Between HDL2-C and HDL3-C with Cardiovascular Disease: A Nested Case-Control Study in an Iranian Population. Int J Endocrinol Metab 2024; 22:e141550. [PMID: 38665147 PMCID: PMC11041996 DOI: 10.5812/ijem-141550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/18/2023] [Accepted: 11/28/2023] [Indexed: 04/28/2024] Open
Abstract
Background The contribution of high-density lipoprotein cholesterol (HDL-C) subclasses to incident cardiovascular disease (CVD) and coronary heart disease (CHD) remains a subject of debate. Objectives The objective of this study was to investigate these associations in a population with a high prevalence of dyslipidemia and CVD. Methods In a nested case-control study, HDL-C and its subclasses (HDL2-C and HDL3-C) in 370 age and gender-matched case and control subjects were determined. This study employed multivariable-adjusted conditional logistic regression to calculate the odds ratios (ORs) for the associations between HDL-C, HDL2-C, HDL3-C, and HDL2-C/HDL3-C (both as continuous and categorical variables) with incident CVD and CHD. The present study models were adjusted for a comprehensive set of confounders, including body mass index, current smoking, hypertension, type 2 diabetes mellitus, use of lipid-lowering drugs, family history of premature CVD, non-HDL-C, and triglycerides. Results In multivariate analysis, when considering lipoprotein parameters as continuous variables, a 1-unit increase in HDL-C and HDL3-C was associated with a reduced risk of incident CVD and CHD. For CVD, the ORs (95% confidence intervals [CI]) were 0.95 (0.92 - 0.98) and 0.95 (0.93 - 0.98) for HDL-C and HDL3-C, respectively. The corresponding values for CHD were 0.94 (0.91 - 0.97) and 0.94 (0.91 - 0.97). In the categorical approach to lipoprotein parameters, higher quartiles of HDL-C and HDL3-C, compared to the first quartile, were significantly associated with a lower risk of incident CVD and CHD. The ORs (95% CI) for the fourth quartiles were 0.43 (0.25 - 0.74, P for trend = 0.003) and 0.46 (0.27 - 0.78, P for trend = 0.005) for HDL-C and HDL3-C regarding CVD and 0.32 (0.17 - 0.59) and 0.32 (0.18 - 0.59) (all P for trend = 0.001) regarding CHD, respectively. Paradoxically, across quartiles of HDL2-C/HDL3-C, this lipid ratio was associated with a higher risk of CHD (92% higher risk in the fourth quartile). Conclusions The results showed that HDL3-C, but not HDL2-C, was primarily responsible for the protective effect of HDL-C against CVD, particularly CHD, in Iranian adults.
Collapse
Affiliation(s)
- Abdolreza Chary
- Department of Biology, Payame Noor University, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Melika Golmohammadi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
11
|
Hu JJ, Dong YM, Ding R, Yang JC, Odkhuu E, Zhang L, Ye DW. Health burden of unbalanced fatty acids intake from 1990 to 2019: A global analysis. MED 2023; 4:778-796.e3. [PMID: 37683637 DOI: 10.1016/j.medj.2023.08.002] [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: 02/21/2023] [Revised: 06/01/2023] [Accepted: 08/15/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Unbalanced fatty acids intake is associated with a range of health outcomes; however, the impact on human health remains unclear globally. We aim to provide a comprehensive assessment of the health effect of unbalanced fatty acids intake on a global scale. METHODS We analyzed the trends of summary exposure value (SEV) and the attributable burden of unbalanced fatty acids intake, including diet low in polyunsaturated fatty acids (low PUFAs), diet low in seafood omega-3 fatty acids (low seafood-(ω-3)-PUFAs), and diet high in trans fatty acids (high TFAs) from 1990 to 2019 using data from Global Burden of Disease Study 2019. FINDINGS The global fatty acids intake was far from the optimal level. High-income North America had the highest SEV of diet of high TFAs, while less-developed regions located in Saharan Africa had the highest SEVs of low PUFAs and low seafood-(ω-3)-PUFAs. The attributable burden was unequally distributed to less-developed regions. Males had lower SEVs but higher attributable burden than females and this gender gap was particularly pronounced before the age of 59. The young population had a higher SEV of diet of low PUFAs, comparable SEV of low seafood-(ω-3)-PUFAs but lower SEV of high TFAs than the elderly population. CONCLUSIONS This study underpinned the high prevalence of unbalanced fatty acids intake worldwide and provided evidence-based guidance for identifying at-risk populations and developing effective strategies to improve fatty acids intake in the future. FUNDING The study was funded by Shanxi Province "136" Revitalization Medical Project Construction Funds and the Fundamental Research Funds for the Central Universities.
Collapse
Affiliation(s)
- Jun-Jie Hu
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yi-Min Dong
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Rong Ding
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jin-Cui Yang
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Erdenezaya Odkhuu
- Department of Anatomy, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Lei Zhang
- Department of Hepatobiliary Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Medical University, Shanxi Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Taiyuan, Shanxi, China; Key Laboratory of Hepatobiliary and Pancreatic Diseases of Shanxi Province (Preparatory), Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Medical University, Shanxi Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Taiyuan, Shanxi, China; Hepatic Surgery Center, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Da-Wei Ye
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Department of Hepatobiliary Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Medical University, Shanxi Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Taiyuan, Shanxi, China; Key Laboratory of Hepatobiliary and Pancreatic Diseases of Shanxi Province (Preparatory), Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Shanxi Medical University, Shanxi Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Taiyuan, Shanxi, China; Professor Ye Zhewei's Intelligent Medical Research Laboratory, Macau, China.
| |
Collapse
|
|
12
|
Schoch L, Alcover S, Padró T, Ben-Aicha S, Mendieta G, Badimon L, Vilahur G. Update of HDL in atherosclerotic cardiovascular disease. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:297-314. [PMID: 37940388 DOI: 10.1016/j.arteri.2023.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023]
Abstract
Epidemiologic evidence supported an inverse association between HDL (high-density lipoprotein) cholesterol (HDL-C) levels and atherosclerotic cardiovascular disease (ASCVD), identifying HDL-C as a major cardiovascular risk factor and postulating diverse HDL vascular- and cardioprotective functions beyond their ability to drive reverse cholesterol transport. However, the failure of several clinical trials aimed at increasing HDL-C in patients with overt cardiovascular disease brought into question whether increasing the cholesterol cargo of HDL was an effective strategy to enhance their protective properties. In parallel, substantial evidence supports that HDLs are complex and heterogeneous particles whose composition is essential for maintaining their protective functions, subsequently strengthening the "HDL quality over quantity" hypothesis. The following state-of-the-art review covers the latest understanding as per the roles of HDL in ASCVD, delves into recent advances in understanding the complexity of HDL particle composition, including proteins, lipids and other HDL-transported components and discusses on the clinical outcomes after the administration of HDL-C raising drugs with particular attention to CETP (cholesteryl ester transfer protein) inhibitors.
Collapse
Affiliation(s)
- Leonie Schoch
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; Faculty of Medicine, University of Barcelona (UB), 08036 Barcelona, Spain
| | - Sebastián Alcover
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain
| | - Teresa Padró
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain
| | | | - Guiomar Mendieta
- Cardiology Unit, Cardiovascular Clinical Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Lina Badimon
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; Cardiovascular Research Chair, UAB, 08025 Barcelona, Spain; CiberCV, Institute of Health Carlos III, Madrid, Spain
| | - Gemma Vilahur
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; CiberCV, Institute of Health Carlos III, Madrid, Spain.
| |
Collapse
|
|
13
|
Wasniewska M, Pepe G, Aversa T, Bellone S, de Sanctis L, Di Bonito P, Faienza MF, Improda N, Licenziati MR, Maffeis C, Maguolo A, Patti G, Predieri B, Salerno M, Stagi S, Street ME, Valerio G, Corica D, Calcaterra V. Skeptical Look at the Clinical Implication of Metabolic Syndrome in Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040735. [PMID: 37189984 DOI: 10.3390/children10040735] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/25/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative review of the literature and a summary of the main observations, conclusions, and perspectives raised in the literature and the study projects of the Working Group of Childhood Obesity (WGChO) of the Italian Society of Paediatric Endocrinology and Diabetology (ISPED) on MetS in childhood obesity. Although there is an agreement on the distinctive features of MetS, no international diagnostic criteria in a pediatric population exist. Moreover, to date, the prevalence of MetS in childhood is not certain and thus the true value of diagnosis of MetS in youth as well as its clinical implications, is unclear. The aim of this narrative review is to summarize the pathogenesis and current role of MetS in children and adolescents with particular reference to applicability in clinical practice in childhood obesity.
Collapse
Affiliation(s)
- Malgorzata Wasniewska
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Giorgia Pepe
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Tommaso Aversa
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Simonetta Bellone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Luisa de Sanctis
- Department of Public Health and Pediatric Sciences, University of Torino, 10126 Turin, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, "Santa Maria delle Grazie" Hospital, 80078 Pozzuoli, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Nicola Improda
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy
| | - Maria Rosaria Licenziati
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
| | - Alice Maguolo
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
| | - Giuseppina Patti
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genova, 16128 Genova, Italy
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Largo del Pozzo, 71, 41124 Modena, Italy
| | - Mariacarolina Salerno
- Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Stefano Stagi
- Health Sciences Department, University of Florence and Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Maria Elisabeth Street
- Unit of Paediatrics, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43126 Parma, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Napoli "Parthenope", 80133 Napoli, Italy
| | - Domenico Corica
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, 20157 Milano, Italy
| |
Collapse
|
|
14
|
Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population. Sci Rep 2022; 12:13769. [PMID: 35962047 PMCID: PMC9374724 DOI: 10.1038/s41598-022-17961-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/03/2022] [Indexed: 11/08/2022] Open
Abstract
The best obesity index for myocardial infarction or angina pectoris (MIAP) risk assessment remains controversial. Furthermore, the association between biochemical indices and these diseases is unclear. This study examined associations of obesity and biochemical indices with MIAP in the Korean population. This large-scale cross-sectional study was based on the Korea National Health and Nutrition Survey dataset from 2010 to 2019. A total of 22,509 subjects (9452 men and 13,057 women) aged ≥ 50 years were included. Participants consisted of 21,426 individuals without MIAP (men = 8869, women = 12,557) and 1083 with MIAP (men = 583, women = 500). Binary logistic regression was performed to examine the association of MIAP with obesity and biochemical indices. The prevalence of MIAP in Korean adults aged ≥ 50 years was 4.81% (6.57% among men, 3.98% among women). MIAP was more strongly associated with total cholesterol than other variables in men (adjusted OR = 0.436 [0.384-0.495], adjusted p < 0.001) and women (adjusted OR = 0.541 [0.475-0.618], adjusted p < 0.001). The waist-to-height ratio (adjusted OR = 1.325 [1.082-1.623], adjusted p = 0.007) and waist circumference (adjusted OR = 1.290 [1.072-1.553], adjusted p = 0.007) showed a significant association with MIAP in men, with no association between obesity indices and MIAP in women after adjustment. The association between biochemical indices and MIAP differed slightly according to sex. Only total cholesterol, creatinine, and platelets were associated with MIAP in both men and women.
Collapse
|
|
15
|
Sirtori CR, Corsini A, Ruscica M. The Role of High-Density Lipoprotein Cholesterol in 2022. Curr Atheroscler Rep 2022; 24:365-377. [PMID: 35274229 PMCID: PMC8913032 DOI: 10.1007/s11883-022-01012-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE OF THE REVIEW High-density lipoproteins (HDL) are responsible for the transport in plasma of a large fraction of circulating lipids, in part from tissue mobilization. The evaluation of HDL-associated cholesterol (HDL-C) has provided a standard method for assessing cardiovascular (CV) risk, as supported by many contributions on the mechanism of this arterial benefit. The present review article will attempt to investigate novel findings on the role and mechanism of HDL in CV risk determination. RECENT FINDINGS The most recent research has been aimed to the understanding of how a raised functional capacity of HDL, rather than elevated levels per se, may be responsible for the postulated CV protection. Markedly elevated HDL-C levels appear instead to be associated to a raised coronary risk, indicative of a U-shaped relationship. While HDL-C reduction is definitely related to a raised CV risk, HDL-C elevations may be linked to non-vascular diseases, such as age-related macular disease. The description of anti-inflammatory, anti-oxidative and anti-infectious properties has indicated potential newer areas for diagnostic and therapeutic approaches. In the last two decades inconclusive data have arisen from clinical trials attempting to increase HDL-C pharmacologically or by way of recombinant protein infusions (most frequently with the mutant A-I Milano); prevention of stent occlusion or heart failure treatment have shown instead significant promise. Targeted clinical studies are still ongoing.
Collapse
Affiliation(s)
- Cesare R Sirtori
- Department of Pharmacological and Biomolecular Sciences, Università Degli Studi Di Milano, Milan, Italy.
| | - Alberto Corsini
- Department of Pharmacological and Biomolecular Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università Degli Studi Di Milano, Milan, Italy.
| |
Collapse
|
|
16
|
Matsuo M. ABCA1 and ABCG1 as potential therapeutic targets for the prevention of atherosclerosis. J Pharmacol Sci 2022; 148:197-203. [DOI: 10.1016/j.jphs.2021.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/28/2022] Open
|
|
17
|
Alfhili MA, Aljuraiban GS. Lauric Acid, a Dietary Saturated Medium-Chain Fatty Acid, Elicits Calcium-Dependent Eryptosis. Cells 2021; 10:cells10123388. [PMID: 34943896 PMCID: PMC8699421 DOI: 10.3390/cells10123388] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/20/2021] [Accepted: 11/28/2021] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular diseases (CVD) are a leading cause of mortality worldwide, and dietary habits represent a major risk factor for dyslipidemia; a hallmark of CVD. Saturated fatty acids contribute to CVD by aggravating dyslipidemia, and, in particular, lauric acid (LA) raises circulating cholesterol levels. The role of red blood cells (RBCs) in CVD is increasingly being appreciated, and eryptosis has recently been identified as a novel mechanism in CVD. However, the effect of LA on RBC physiology has not been thoroughly investigated. RBCs were isolated from heparin-anticoagulated whole blood (WB) and exposed to 50-250 μM of LA for 24 h at 37 °C. Hemoglobin was photometrically examined as an indicator of hemolysis, whereas eryptosis was assessed by Annexin V-FITC for phosphatidylserine (PS) exposure, Fluo4/AM for Ca2+, light scatter for cellular morphology, H2DCFDA for oxidative stress, and BODIPY 581/591 C11 for lipid peroxidation. WB was also examined for RBC, leukocyte, and platelet viability and indices. LA caused dose-responsive hemolysis, and Ca2+-dependent PS exposure, elevated erythrocyte sedimentation rate (ESR), cytosolic Ca2+ overload, cell shrinkage and granularity, oxidative stress, accumulation of lipid peroxides, and stimulation of casein kinase 1α (CK1α). In WB, LA disrupted leukocyte distribution with elevated neutrophil-lymphocyte ratio (NLR) due to selective toxicity to lymphocytes. In conclusion, this report provides the first evidence of the pro-eryptotic potential of LA and associated mechanisms, which informs dietary interventions aimed at CVD prevention and management.
Collapse
Affiliation(s)
- Mohammad A. Alfhili
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
- Correspondence: ; Tel.: +966-504-262-597
| | - Ghadeer S. Aljuraiban
- Department of Community Health Sciences, King Saud University, Riyadh 12372, Saudi Arabia;
| |
Collapse
|
|
18
|
Doğan K, Şeneş M, Karaca A, Kayalp D, Kan S, Gülçelik NE, Aral Y, Yücel D. HDL subgroups and their paraoxonase-1 activity in the obese, overweight and normal weight subjects. Int J Clin Pract 2021; 75:e14969. [PMID: 34626508 DOI: 10.1111/ijcp.14969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/10/2021] [Accepted: 10/07/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Obesity and overweight are significant public health problems because of higher risk for coronary artery disease (CAD). It is very important to determine new predictive markers to identify the CAD risk in obese and overweight. To aim this, we analysed HDL-C subgroups (HDL2-C and HDL3-C) and their paraoxonase-1 (PON-1) activity in obese, overweight and normal weight subjects. METHOD 71 obese, 40 overweight and 30 healthy subjects as a control group were enrolled the study. Serum lipids levels were determined with enzymatic colorimetric method. Further, PON-1 activities and HDL-C levels were determined by spectrophotometric methods. Non-HDL3-C concentrations were calculated with the subtraction of HDL3-C from total HDL-C. RESULTS The mean serum levels of total HDL-C, HDL3-C, Non-HDL3-C and ApoA1 were higher in control group than obese and overweight groups. There were a statistically significant difference between obese and control group in terms of Lp(a), hsCRP and HOMA index. Higher total PON-1, non-HDL3 PON-1 and HDL3 PON-1 activities were found in the control group compared with obese and overweight groups. Total HDL was weakly negative correlated with the HOMA index, BMI and waist circumference. There was a weak negative correlation between non-HDL3-C and waist circumference. CONCLUSION Altered HDL-subgroups pattern and decreased PON-1 activities may cause increased risk for CVD in obese and overweight individuals. Therefore determination of HDL subgroups and their PON-1 activity may improve risk prediction compared with measuring total HDL-C levels and its PON-1 activity alone. Body weight and insulin resistance appear to have a role in the decreased HDL-C levels and PON-1activity in obese. Further studies should be conducted to shed more light on impacts of these markers in CVD.
Collapse
Affiliation(s)
- Kübra Doğan
- Department of Clinical Biochemistry, Sivas Numune State Hospital, Ministry of Health, Sivas, Turkey
| | - Mehmet Şeneş
- Department of Clinical Biochemistry, Ankara Training and Research Hospital, Ministry of Health Ankara, Turkey
| | - Anara Karaca
- Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ministry of Health Ankara, Turkey
| | - Damla Kayalp
- Department of Clinical Biochemistry, Yozgat City Hospital, Ministry of Health, Yozgat, Turkey
| | - Seyfullah Kan
- Department of Endocrinology and Metabolism, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Neşe Ersöz Gülçelik
- Department of Endocrinology and Metabolism, Gülhane Training and Research Hospital, Ministry of Health Ankara, Turkey
| | - Yalçın Aral
- Department of Endocrinology and Metabolism, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Doğan Yücel
- Department of Clinical Biochemistry, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey
| |
Collapse
|
|
19
|
Wang Z, Li M, Xie J, Gong J, Liu N. Association between remnant cholesterol and arterial stiffness: A secondary analysis based on a cross-sectional study. J Clin Hypertens (Greenwich) 2021; 24:26-37. [PMID: 34750951 PMCID: PMC8783357 DOI: 10.1111/jch.14384] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 12/15/2022]
Abstract
The relationship between conventional lipid parameters and arterial stiffness (AS) has been verified by previous studies. However, it remains unknown whether non‐conventional lipid parameters have certain predictive effect on AS represented by brachial‐ankle pulse wave velocity (baPWV). Therefore, the study was to explore the relationship between remnant cholesterol (RC) and other non‐conventional lipid parameters and AS in the general population free from cardiovascular disease. The study included 912 participants aged 24–84 years from a medical health checkup center of Murakami Memorial Hospital. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to examine the association between non‐conventional lipid parameters and AS. The results showed that compared with non‐AS group, the AS group had higher RC, non‐high‐density lipoprotein cholesterol (Non‐HDL‐C), atherogenic index of plasma (AIP), lipoprotein combine index (LCI), atherosclerosis index (AI), triglycerides/HDL‐C (TG/HDL‐C), Castelli's risk index I (CRI‐I) and Castelli's risk index II (CRI‐II). Then, the authors divided participants into two groups by the optimal cutoff point of 23.6 of RC determined by Youden index. The baPWV was significantly higher in higher RC group compared with lower RC group, and RC was positively correlated with baPWV. Multivariate Logistic regression analysis showed that, regarding lower RC as reference, higher RC was independently associated with higher risk of AS, independent of other risk factors (OR = 1.794, 95% CI: 1.267‐2.539, p = .001). The area under the curve of AS predicted by RC was higher than that of other non‐conventional lipid parameters (almost all p < .05). The findings indicated that increased RC was a significant predictor of AS.
Collapse
Affiliation(s)
- Zhenwei Wang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Min Li
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jing Xie
- College of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jing Gong
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Naifeng Liu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| |
Collapse
|
|
20
|
Haji Aghajani M, Madani Neishaboori A, Ahmadzadeh K, Toloui A, Yousefifard M. The association between apolipoprotein A-1 plasma level and premature coronary artery disease: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14578. [PMID: 34181800 DOI: 10.1111/ijcp.14578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/25/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Apolipoprotein A-1 (Apo A-1) is a constituent of high-density lipoprotein (HDL) and emerging evidences put forward a potential association between Apo A-1 plasma levels and premature coronary artery disease (pCAD). The aim of the present study is to gather relative literature and perform a systematic review and meta-analysis regarding the association between serum ApoA-1 levels and pCAD. METHODS Medline (via PubMed), Scopus, Embase and Web of Science databases were searched from the inception of databases until December 7, 2020. All articles reporting the plasma levels of ApoA-1 in patients with pCAD and the control group were included. A meta-analysis with pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) was reported. Subgroup analyses were done based on the observed heterogeneity in results. RESULTS Seventeen case-control studies were included. ApoA-1 plasma level was calculated to be lower in pCAD patients compared with the control group (SMD: -0.67; 95% CI: -0.48 to -0.86; P < .001). The subgroup analysis and meta-regression showed that the variation in gender distribution, the development level of the target population's country and quality score of included studies were the main sources of heterogeneity. It was observed that the relationship was only significant in the developed countries (P < .001). Also, the heterogeneity was reduced when the analysis was limited to males (I2 = 57.2%) and females only (I2 = 26.0%). CONCLUSION In conclusion, there seems to be a significant association between the serum levels of ApoA-1 and pCAD. However, all of the included studies had a case-control design and since there is no good quality and prospective cohort studies included, reliability of the current evidence is debatable. Therefore, further well-designed cohort studies are required to assess the impact of serum ApoA-1 reduction on pCAD onset.
Collapse
Affiliation(s)
- Mohammad Haji Aghajani
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Koohyar Ahmadzadeh
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Toloui
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
21
|
Fernández-Aparicio Á, Perona JS, Schmidt-RioValle J, Padez C, González-Jiménez E. Assessment of Different Atherogenic Indices as Predictors of Metabolic Syndrome in Spanish Adolescents. Biol Res Nurs 2021; 24:163-171. [PMID: 34689601 DOI: 10.1177/10998004211050887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Inconsistent results due to age, ethnic, and geographic differences have been found on the predictive capacity of atherogenic indices in previous studies. The aim of this study was to assess the predictive value of 6 atherogenic indices for MetS in a Spanish adolescent population. Methods: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2y) that were randomly recruited from schools in Southeastern Spain. Anthropometric and biochemical parameters were evaluated to identify the presence of MetS. The following atherogenic indices were calculated: triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL cholesterol, triglycerides to HDL-cholesterol ratio (TG/HDL-c), LDL-cholesterol to HDL-cholesterol ratio (LDL-c/HDL-c), and total cholesterol to HDL-cholesterol ratio (TC/HDL-c). Results: The area under the curve (AUC) of receiver operating characteristic curves was used for discrimination purposes. AIP was the atherogenic index most strongly associated with MetS with an unadjusted odds ratio (OR) of 37.98 in boys and of 28.75 in girls. A high OR was maintained after adjustment by different factors. AUC values for all atherogenic indices were above 0.83 and 0.88 in boys and in girls, respectively. Conclusions: Among the 6 atherogenic indices studied, AIP was the one most strongly associated with MetS in Spanish adolescents. The AUC values obtained from ROC analyses suggest that all atherogenic indices have the ability to predict MetS. These atherogenic indices are interesting and useful predictive indicators for MetS. However, more studies are needed to explore in-depth this predictive capacity.
Collapse
Affiliation(s)
| | - Javier S Perona
- Department of Food and Health, Instituto de la Grasa-CSIC, 54444Campus of the University Pablo de Olavide, Seville, Spain
| | | | - Cristina Padez
- Department of Life Sciences, Research Centre for Anthropology and Health, 37829University of Coimbra, Coimbra, Portugal
| | - Emilio González-Jiménez
- Department of Nursing, Faculty of Health Sciences, 71041University of Granada, Granada, Spain
| |
Collapse
|
|
22
|
Schoch L, Badimon L, Vilahur G. Unraveling the Complexity of HDL Remodeling: On the Hunt to Restore HDL Quality. Biomedicines 2021; 9:805. [PMID: 34356869 PMCID: PMC8301317 DOI: 10.3390/biomedicines9070805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/26/2022] Open
Abstract
Increasing evidence has cast doubt over the HDL-cholesterol hypothesis. The complexity of the HDL particle and its proven susceptibility to remodel has paved the way for intense molecular investigation. This state-of-the-art review discusses the molecular changes in HDL particles that help to explain the failure of large clinical trials intending to interfere with HDL metabolism, and details the chemical modifications and compositional changes in HDL-forming components, as well as miRNA cargo, that render HDL particles ineffective. Finally, the paper discusses the challenges that need to be overcome to shed a light of hope on HDL-targeted approaches.
Collapse
Affiliation(s)
- Leonie Schoch
- Cardiovascular Program, Institut de Recerca, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain; (L.S.); (L.B.)
- Faculty of Medicine, University of Barcelona (UB), 08036 Barcelona, Spain
| | - Lina Badimon
- Cardiovascular Program, Institut de Recerca, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain; (L.S.); (L.B.)
- CiberCV, 08025 Barcelona, Spain
- Cardiovascular Research Chair, UAB, 08025 Barcelona, Spain
| | - Gemma Vilahur
- Cardiovascular Program, Institut de Recerca, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain; (L.S.); (L.B.)
- CiberCV, 08025 Barcelona, Spain
| |
Collapse
|
|
23
|
Ebrahim S. Cohort Profiles: what are they good for? Int J Epidemiol 2021; 50:367-370. [PMID: 33837386 DOI: 10.1093/ije/dyab054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 01/12/2023] Open
Affiliation(s)
- Shah Ebrahim
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| |
Collapse
|
|
24
|
Malin R, Lehtinen S, Luoma P, Näyhä S, Hassi J, Koivula T, Lehtimäki T. Serum Lipid Levels and M/L55 Allele Distribution of HDL Paraoxonase Gene in Saami and Finnish Men. Int J Circumpolar Health 2021. [DOI: 10.1080/22423982.2001.12112993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Riikka Malin
- University of Tampere, Medical School, Department of Medical Biochemistry, Tampere
- Tampere University Hospital, Centre for Laboratory Medicine, Department of Clinical Chemistry, Laboratory of Atherosclerosis Genetics, Tampere
| | - Saara Lehtinen
- University of Tampere, Medical School, Department of Medical Biochemistry, Tampere
- Tampere University Hospital, Centre for Laboratory Medicine, Department of Clinical Chemistry, Laboratory of Atherosclerosis Genetics, Tampere
| | - Pauli Luoma
- Oulu Regional Institute of Occupational Heath, Oulu, Finland
| | - Simo Näyhä
- Oulu Regional Institute of Occupational Heath, Oulu, Finland
| | - Juhani Hassi
- Oulu Regional Institute of Occupational Heath, Oulu, Finland
| | - Timo Koivula
- Tampere University Hospital, Centre for Laboratory Medicine, Department of Clinical Chemistry, Laboratory of Atherosclerosis Genetics, Tampere
| | - Terho Lehtimäki
- University of Tampere, Medical School, Department of Medical Biochemistry, Tampere
- Tampere University Hospital, Centre for Laboratory Medicine, Department of Clinical Chemistry, Laboratory of Atherosclerosis Genetics, Tampere
| |
Collapse
|
|
25
|
Li JY, Xu WJ, Zhou Z, Zhang RL, Sun T, Xu H, Wu J. Evaluation of atherogenic lipoprotein-cholesterol to HDL cholesterol ratio as a prognostic test for ST-segment elevation myocardial infarction. Int J Med Sci 2021; 18:2897-2904. [PMID: 34220316 PMCID: PMC8241770 DOI: 10.7150/ijms.44801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/24/2021] [Indexed: 11/05/2022] Open
Abstract
Background: The detectable component of triglyceride-rich lipoproteins (TGRLs), remnant lipoprotein cholesterol (RLP-c), has been proven being correlated with the progression of atherosclerosis and myocardial infarction. However, when taken as a risk predictor, the prognostic and diagnostic potential of RLP-c remains controversial in studies. In this study, we evaluated the hypothesis that atherogenic lipoprotein-cholesterol (AL-c), representing the sum of RLP-c and the sd-LDL-c, to the HDL-c ratio, could represent a better predictive indicator than RLP-c alone in ST-segment elevation myocardial infarction (STEMI). Methods: The 316 consecutive patients suffering from persistent chest discomfort admitted to the Shanghai General Hospital between January 2018 and June 2018 were enrolled. 149 STEMI patients (62% men, mean age 69.6 ± 13.3 years) were included as the study cohort. The AL-c/HDL-c ratio was calculated on admission in a cohort of electrocardiogram-confirmed STEMI patients and compared to other lipid profiles as a predictive indicator. Results: The AL-c/HDL-c ratio was significantly increased in STEMI patients compared with apparently healthy adults (0.93; IQR [0.71-1.18] vs 0.70; IQR [0.45-1.04]; p < 0.001). Gender dependency existed, and the male and female patients had median AL-c/HDL-c ratios of 1.01 and 0.79, respectively (p < 0.001). Compared to RLP-c, the AL-c/HDL-c ratio had a better prognostic value to predict STEMI risk in both sexes (AUC of 0.672 with a sensitivity of 0.794 in males and 0.613 with a sensitivity of 0.684 in females). Conclusions: The AL-c/HDL-c ratio could represent a convenient and sensitive biomarker for screening and predicting STEMI risk.
Collapse
Affiliation(s)
- Jia-Yong Li
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Jun Xu
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhe Zhou
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Clinical Laboratory Medicine Center, Shanghai Children's Hospital, Shanghai, China
| | - Ru-Lin Zhang
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Sun
- Department of Cardiology, Shanghai Ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Xu
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Wu
- Department of Laboratory Medicine, Shanghai General Hospital Jiading Branch, Shanghai, China
| |
Collapse
|
|
26
|
Abstract
Earlier epidemiological studies have shown an inverse correlation between high-density lipoprotein cholesterol (HDLc) and coronary heart disease (CHD). This observation along with the finding that reverse cholesterol transport is mediated by HDL, supported the hypothesis that the HDL molecule has a cardioprotective role. More recently, epidemiological data suggest a U-shaped curve correlating HDLc and CHD. In addition, randomized clinical trials of drugs that significantly increase plasma HDLc levels, such as nicotinic acid and cholesterol ester transfer protein (CETP) inhibitors failed to show a reduction in major adverse cardiovascular events. These observations challenge the hypothesis that HDL has a cardioprotective role. It is possible that HDL quality and function is optimal only when de novo synthesis of apo A-I occurs. Inhibition of turnover of HDL with currently available agents yields HDL molecules that are ineffective in reverse cholesterol transport. To test this hypothesis, newer therapeutic drugs that increase de novo production of HDL and apo A-I should be tested in clinical trials.
Collapse
Affiliation(s)
- Julien J Feghaly
- Department of Medicine, School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Arshag D Mooradian
- Department of Medicine, University of Florida College of Medicine, 653-1 West 8th Street, 4th Floor-LRC, Jacksonville, FL, 32209, USA.
| |
Collapse
|
|
27
|
Matsushima-Nagata K, Sugiuchi H, Anraku K, Takao T, Kondo Y, Ishitsuka Y, Irikura M, Irie T, Matsumura T, Araki E, Sumida M, Katayama Y, Kayahara N. A homogeneous assay to determine high-density lipoprotein subclass cholesterol in serum. Anal Biochem 2020; 613:114019. [PMID: 33189705 DOI: 10.1016/j.ab.2020.114019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
Existing methods to measure high-density lipoprotein cholesterol (HDL-C) subclasses (HDL2-C and HDL3-C) are complex and require proficiency, and thus there is a need for a convenient, homogeneous assay to determine HDL-C subclasses in serum. Here, cholesterol reactivities in lipoprotein fractions [HDL2, HDL3, low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL)] toward polyethylene glycol (PEG)-modified enzymes were determined in the presence of varying concentrations of dextran sulfate and magnesium nitrate. Particle sizes formed in the lipoprotein fractions were measured by dynamic light scattering. We optimized the concentrations of dextran sulfate and magnesium nitrate before assay with PEG-modified enzymes to provide selectivity for HDL3-C. On addition of dextran sulfate and magnesium nitrate, the sizes of particles of HDL2, LDL, and VLDL increased, but the size of HDL3 fraction particles remained constant, allowing only HDL3-C to participate in coupled reactions with the PEG-modified enzymes. In serum from both healthy volunteers and patients with type 2 diabetes, a good correlation was observed between the proposed assay and ultracentrifugation in the determination of HDL-C subclasses. The assay proposed here enables convenient and accurate determination of HDL-C subclasses in serum on a general automatic analyzer and enables low-cost routine diagnosis without preprocessing.
Collapse
Affiliation(s)
| | | | | | - Takako Takao
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuki Kondo
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoichi Ishitsuka
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mitsuru Irikura
- Laboratory of Evidence-Based Pharmacotherapy, Daiichi University of Pharmacy, Fukuoka, Japan
| | - Tetsumi Irie
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takeshi Matsumura
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mizuki Sumida
- Research Center, Hitachi Chemical Diagnostics Systems Co., Ltd., Shizuoka, Japan
| | - Yuki Katayama
- Research Center, Hitachi Chemical Diagnostics Systems Co., Ltd., Shizuoka, Japan
| | | |
Collapse
|
|
28
|
Sacks FM, Liang L, Furtado JD, Cai T, Davidson WS, He Z, McClelland RL, Rimm EB, Jensen MK. Protein-Defined Subspecies of HDLs (High-Density Lipoproteins) and Differential Risk of Coronary Heart Disease in 4 Prospective Studies. Arterioscler Thromb Vasc Biol 2020; 40:2714-2727. [PMID: 32907368 PMCID: PMC7577984 DOI: 10.1161/atvbaha.120.314609] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/26/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE HDL (high-density lipoprotein) contains functional proteins that define single subspecies, each comprising 1% to 12% of the total HDL. We studied the differential association with coronary heart disease (CHD) of 15 such subspecies. Approach and Results: We measured plasma apoA1 (apolipoprotein A1) concentrations of 15 protein-defined HDL subspecies in 4 US-based prospective studies. Among participants without CVD at baseline, 932 developed CHD during 10 to 25 years. They were matched 1:1 to controls who did not experience CHD. In each cohort, hazard ratios for each subspecies were computed by conditional logistic regression and combined by meta-analysis. Higher levels of HDL subspecies containing alpha-2 macroglobulin, CoC3 (complement C3), HP (haptoglobin), or PLMG (plasminogen) were associated with higher relative risk compared with the HDL counterpart lacking the defining protein (hazard ratio range, 0.96-1.11 per 1 SD increase versus 0.73-0.81, respectively; P for heterogeneity <0.05). In contrast, HDL containing apoC1 or apoE were associated with lower relative risk compared with the counterpart (hazard ratio, 0.74; P=0.002 and 0.77, P=0.001, respectively). CONCLUSIONS Several subspecies of HDL defined by single proteins that are involved in thrombosis, inflammation, immunity, and lipid metabolism are found in small fractions of total HDL and are associated with higher relative risk of CHD compared with HDL that lacks the defining protein. In contrast, HDL containing apoC1 or apoE are robustly associated with lower risk. The balance between beneficial and harmful subspecies in a person's HDL sample may determine the risk of CHD pertaining to HDL and paths to treatment.
Collapse
Affiliation(s)
- Frank M. Sacks
- Corresponding author: Frank M. Sacks, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115; ; 617-432-1420
| | | | | | - Tianxi Cai
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - W. Sean Davidson
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Zeling He
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Robyn L. McClelland
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Eric B. Rimm
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| | - Majken K. Jensen
- Departments of Nutrition (FMS, JFD, MKJ, EBR), Epidemiology (MKJ and EBR) and Biostatistics (ZH, TC, LL), Harvard T.H. Chan School of Public Health; Department of Pathology and Laboratory Medicine, University of Cincinnati (WSD); Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA (EBR, FMS); and University of Washington, Seattle, WA (RLM)
| |
Collapse
|
|
29
|
Sahraoui A, Dewachter C, Vegh G, Mc Entee K, Naeije R, Bouguerra SA, Dewachter L. High fat diet altered cardiac metabolic gene profile in Psammomys obesus gerbils. Lipids Health Dis 2020; 19:123. [PMID: 32493392 PMCID: PMC7271448 DOI: 10.1186/s12944-020-01301-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 05/22/2020] [Indexed: 01/18/2023] Open
Abstract
Background In metabolic disorders, myocardial fatty infiltration is critically associated with lipotoxic cardiomyopathy. Methods Twenty Psammomys obesus gerbils were randomly assigned to normal plant or high fat diet. Sixteen weeks later, myocardium was sampled for pathobiological evaluation. Results A sixteen-week high fat diet resulted in myocardial structure disorganization, with collagen deposits, lipid accumulation, cardiomyocyte apoptosis and inflammatory cell infiltration. Myocardial expressions of glucose transporter GLUT1 and pyruvate dehydrogenase (PDH) inhibitor, PDH kinase (PDK)4 increased, while insulin-regulated GLUT4 expression remained unchanged. Myocardial expressions of molecules regulating fatty acid transport, CD36 and fatty acid binding protein (FABP)3, were increased, while expression of rate-controlling fatty acid β-oxidation, carnitine palmitoyl transferase (CPT)1B decreased. Myocardial expression of AMP-activated protein kinase (AMPK), decreased, while expression of peroxisome proliferator activated receptors (PPAR)-α and -γ did not change. Conclusion In high fat diet fed Psammomys obesus, an original experimental model of nutritionally induced metabolic syndrome mixing genetic predisposition and environment interactions, a short period of high fat feeding was sufficient to induce myocardial structural alterations, associated with altered myocardial metabolic gene expression in favor of lipid accumulation.
Collapse
Affiliation(s)
- Abdelhamid Sahraoui
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 808, Lennik Road, 1070, Brussels, Belgium.,Team of Cellular and Molecular Physiopathology, Faculty of Biological Sciences, Houari Boumediene University of Sciences and Technology, El Alia, Algiers, Algeria.,Faculté des Sciences de la Nature et de la Vie & des Sciences de la Terre, University Djilali Bounaama of Khemis Miliana, 44225, Khemis Miliana, Algeria
| | - Céline Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 808, Lennik Road, 1070, Brussels, Belgium.,Department of Cardiology, Cliniques Universitaires de Bruxelles, Hôpital Académique Erasme, Bruxelles, Belgium
| | - Grégory Vegh
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 808, Lennik Road, 1070, Brussels, Belgium
| | - Kathleen Mc Entee
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 808, Lennik Road, 1070, Brussels, Belgium
| | - Robert Naeije
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 808, Lennik Road, 1070, Brussels, Belgium
| | - Souhila Aouichat Bouguerra
- Team of Cellular and Molecular Physiopathology, Faculty of Biological Sciences, Houari Boumediene University of Sciences and Technology, El Alia, Algiers, Algeria
| | - Laurence Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 808, Lennik Road, 1070, Brussels, Belgium.
| |
Collapse
|
|
30
|
Mortality and cardiovascular and respiratory morbidity in individuals with impaired FEV 1 (PURE): an international, community-based cohort study. LANCET GLOBAL HEALTH 2020; 7:e613-e623. [PMID: 31000131 DOI: 10.1016/s2214-109x(19)30070-1] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 01/06/2019] [Accepted: 02/11/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The associations between the extent of forced expiratory volume in 1 s (FEV1) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary across populations is unknown. METHODS In this international, community-based cohort study, we prospectively enrolled adults aged 35-70 years who had no intention of moving residences for 4 years from rural and urban communities across 17 countries. A portable spirometer was used to assess FEV1. FEV1 values were standardised within countries for height, age, and sex, and expressed as a percentage of the country-specific predicted FEV1 value (FEV1%). FEV1% was categorised as no impairment (FEV1% ≥0 SD from country-specific mean), mild impairment (FEV1% <0 SD to -1 SD), moderate impairment (FEV1% <-1 SD to -2 SDs), and severe impairment (FEV1% <-2 SDs [ie, clinically abnormal range]). Follow-up was done every 3 years to collect information on mortality, cardiovascular disease outcomes (including myocardial infarction, stroke, sudden death, or congestive heart failure), and respiratory hospitalisations (from chronic obstructive pulmonary disease, asthma, pneumonia, tuberculosis, or other pulmonary conditions). Fully adjusted hazard ratios (HRs) were calculated by multilevel Cox regression. FINDINGS Among 126 359 adults with acceptable spirometry data available, during a median 7·8 years (IQR 5·6-9·5) of follow-up, 5488 (4·3%) deaths, 5734 (4·5%) cardiovascular disease events, and 1948 (1·5%) respiratory hospitalisation events occurred. Relative to the no impairment group, mild to severe FEV1% impairments were associated with graded increases in mortality (HR 1·27 [95% CI 1·18-1·36] for mild, 1·74 [1·60-1·90] for moderate, and 2·54 [2·26-2·86] for severe impairment), cardiovascular disease (1·18 [1·10-1·26], 1·39 [1·28-1·51], 2·02 [1·75-2·32]), and respiratory hospitalisation (1·39 [1·24-1·56], 2·02 [1·75-2·32], 2·97 [2·45-3·60]), and this pattern persisted in subgroup analyses considering country income level and various baseline risk factors. Population-attributable risk for mortality (adjusted for age, sex, and country income) from mildly to moderately reduced FEV1% (24·7% [22·2-27·2]) was larger than that from severely reduced FEV1% (3·7% [2·1-5·2]) and from tobacco use (19·7% [17·2-22·3]), previous cardiovascular disease (5·5% [4·5-6·5]), and hypertension (17·1% [14·6-19·6]). Population-attributable risk for cardiovascular disease from mildly to moderately reduced FEV1 was 17·3% (14·8-19·7), second only to the contribution of hypertension (30·1% [27·6-32·5]). INTERPRETATION FEV1 is an independent and generalisable predictor of mortality, cardiovascular disease, and respiratory hospitalisation, even across the clinically normal range (mild to moderate impairment). FUNDING Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, Ontario Ministry of Health and Long-Term Care, AstraZeneca, Sanofi-Aventis, Boehringer Ingelheim, Servier, and GlaxoSmithKline, Novartis, and King Pharma. Additional funders are listed in the appendix.
Collapse
|
|
31
|
Panarello G, Calianno G, De Baz H, Signori D, Cappelletti P, Tesio F. Does Continuous Ambulatory Peritoneal Dialysis Induce Hypercholesterolemia? Perit Dial Int 2020. [DOI: 10.1177/089686089301302s106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hypercholesterolemia has been recognized as a significant risk factor for atherosclerosis and coronary artery disease. The aim of this study was to evaluate the prevalence of hypercholesterolemia and the role, if any, of type of dialysis. In 19 hemodialysis (HD) and 20 continuous ambulatory peritoneal dialysis (CAPD) subjects, body weight, body mass index (BMI), arm muscle area (AMA), total choles terol (C), HDL and LDL fractions, triglycerldes, C/HDL ratio, glycosilated hemoglobin, and apolipoproteins AI, All, B, CII, CllI, and E were evaluated. Hypercholesterolemia was defined as cholesterol greater than 220 mg/dL and LDL greater than 150 mg/dL. Body weight, body mass index, and arm muscle area were higher (p<0.05) in CAPD as compared with HD; so were total cholesterol, LDL, C/HDL ratio, and glycosllated hemoglobin (Hbalc). Hypercholesterolemia prevalence was 3/19 in HD and 11/20 in CAPD (p<0.05). A relationship between Hbalc and C/HDL ratio was found in the CAPD group (r=0.48; p<0.05). We are greatly concerned about these metabolic effects of CAPD; therefore, we should carefully select patients to be treated by CAPD. Aggressive nutritional and pharmacological treatment for glucose Intolerance and hypercholesterolemia In CAPD patients must be performed in order to reduce the incidence of coronary artery disease (CAD).
Collapse
Affiliation(s)
- Giacomo Panarello
- Nephrology and Clinical Chemistry Services, Civil Hospital, Pordenone, Italy
| | - Giuseppina Calianno
- Nephrology and Clinical Chemistry Services, Civil Hospital, Pordenone, Italy
| | - Hamurabi De Baz
- Nephrology and Clinical Chemistry Services, Civil Hospital, Pordenone, Italy
| | - Daniela Signori
- Nephrology and Clinical Chemistry Services, Civil Hospital, Pordenone, Italy
| | - Piero Cappelletti
- Nephrology and Clinical Chemistry Services, Civil Hospital, Pordenone, Italy
| | - Franco Tesio
- Nephrology and Clinical Chemistry Services, Civil Hospital, Pordenone, Italy
| |
Collapse
|
|
32
|
German CA, Shapiro MD. Assessing Atherosclerotic Cardiovascular Disease Risk with Advanced Lipid Testing: State of the Science. Eur Cardiol 2020; 15:e56. [PMID: 32742310 PMCID: PMC7387892 DOI: 10.15420/ecr.2019.18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/17/2020] [Indexed: 11/06/2022] Open
Abstract
Cardiovascular disease is the number one cause of death and disability worldwide. While substantial gains have been made in reducing cardiovascular mortality, future projections suggest that we have reached a nadir and may be at an inflection point, given the rising tide of obesity and diabetes. Evaluation and management of plasma lipids is central to the prevention of atherosclerotic cardiovascular disease. Although the standard lipid panel represents a well-established platform to assess risk, this test alone can be insufficient and/or misleading. Advances in our understanding of atherosclerosis have led to the development of lipid-based biomarkers that help to discriminate the risk of cardiovascular disease when it is unclear. While these biomarkers provide novel information, their implementation into clinical medicine remains difficult given discrepancies in the literature, lack of assay standardisation, poor accessibility and high cost. However, additional measures of atherogenic lipoproteins or their surrogates may offer insight beyond the standard lipid panel, providing a more precise assessment of risk and more accurate assessment of lipid-lowering therapy.
Collapse
Affiliation(s)
- Charles Amir German
- Division of Cardiovascular Disease, Center for Preventive Cardiology, Wake Forest Baptist Medical Center Winston-Salem, NC, US
| | - Michael David Shapiro
- Division of Cardiovascular Disease, Center for Preventive Cardiology, Wake Forest Baptist Medical Center Winston-Salem, NC, US
| |
Collapse
|
|
33
|
Wiegmann C, Mick I, Brandl EJ, Heinz A, Gutwinski S. Alcohol and Dementia - What is the Link? A Systematic Review. Neuropsychiatr Dis Treat 2020; 16:87-99. [PMID: 32021202 PMCID: PMC6957093 DOI: 10.2147/ndt.s198772] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Dementia is a globally increasing health issue and since no cure is currently available, prevention is crucial. The consumption of alcohol is a controversially discussed risk factor for dementia. While many previously published epidemiological studies reported a risk reduction by light to moderate alcohol consumption, there is no persuasive model of an underlying biochemical mechanism. The purpose of this article is to review current models on alcohol neurotoxicity and dementia and to analyze and compare studies focusing on the epidemiological link between alcohol consumption and the risk of dementia. METHODS The electronic database Pubmed was searched for studies published between 1994 and 2019 concerning the topic. RESULTS Available epidemiological studies are not sufficient to verify a protective effect of alcohol on dementia development.
Collapse
Affiliation(s)
- Caspar Wiegmann
- Department of Psychiatry and Psychotherapy, Psychiatric Hospital of Charité at St. Hedwig Hospital, Berlin, Germany
| | - Inge Mick
- Department of Psychiatry and Psychotherapy, Psychiatric Hospital of Charité at St. Hedwig Hospital, Berlin, Germany
| | - Eva J Brandl
- Department of Psychiatry and Psychotherapy, Psychiatric Hospital of Charité at St. Hedwig Hospital, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Psychiatric Hospital of Charité at St. Hedwig Hospital, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
| | - Stefan Gutwinski
- Department of Psychiatry and Psychotherapy, Psychiatric Hospital of Charité at St. Hedwig Hospital, Berlin, Germany
| |
Collapse
|
|
34
|
Sacanella Anglés I, Casas Rodríguez R, Viñas Esmel E, Castro Barquero S, Sacanella Meseguer E. [Prevention of cardiovascular disease and fermented alcoholic beverages. Reality or fiction?]. NUTR HOSP 2019; 36:58-62. [PMID: 31368340 DOI: 10.20960/nh.02811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION A large evidence-based reports a J-shaped association among moderate alcohol consumption and cardiovascular health. Low-moderate alcohol intake has been related to lower all-cause mortality (20%) and ischemic heart events (40%) compared to abstainers. The dose that is allegedly beneficial varies between 10-20 gr/day for women and men respectively. Moreover, the drinking pattern seems to be significant in order to get healthy effects. Moderate alcohol consumption hinders atherogenesis by several mechanisms mainly improving lipid profile and reducing thrombogenesis. Nevertheless, it is still unclear whether high-polyphenol alcoholic beverages, such as wine and beer, confer a greater cardiovascular protection than spirits, which have much less polyphenol content.
Collapse
|
|
35
|
Mirza E. Atherogenic indices in pseudoexfoliation syndrome. Eye (Lond) 2019; 33:1911-1915. [PMID: 31278384 DOI: 10.1038/s41433-019-0506-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/14/2019] [Accepted: 05/22/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Evaluation of atherogenic indices in patients with pseudoexfoliation syndrome (PEXS) by traditional serum lipid profiles [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and non-HDL-c] and non-traditional serum lipid ratios [TC/HDL-c, TG/HDL-c, LDL-c/HDL-c and non-HDL-c/HDL-c]. METHODS A total of 100 patients were included in the study. Fifty patients diagnosed with PEXS were regarded as group 1 and 50 patients without PEXS were regarded as group 2, respectively. RESULTS The median TC, TG, LDL-c, HDL-c and non-HDL-c values were significantly higher in group 1 compared to group 2 (p = 0.007, p = 0.025, p = 0.016, p = 0.015 and p = 0.042, respectively). But there were no significant differences in the TC/HDL-c, TG/HDL-c, LDL-c/HDL-c and non-HDL-c/HDL-c ratios among the two groups (p = 0.581, p = 0.617, p = 0.292 and p = 0.583, respectively). CONCLUSIONS Non-traditional serum lipid ratios are superior to traditional serum lipid profiles for identifying the risk of vascular disease and this study did not demonstrate a complete relationship between PEXS and increased risk of vascular disease.
Collapse
Affiliation(s)
- Enver Mirza
- Department of Ophthalmology, University of Health Sciences, Konya Education and Research Hospital, 42090, Konya Meram, Turkey.
| |
Collapse
|
|
36
|
Stamenkovic A, Ganguly R, Aliani M, Ravandi A, Pierce GN. Overcoming the Bitter Taste of Oils Enriched in Fatty Acids to Obtain Their Effects on the Heart in Health and Disease. Nutrients 2019; 11:E1179. [PMID: 31137794 PMCID: PMC6566568 DOI: 10.3390/nu11051179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/13/2019] [Accepted: 05/22/2019] [Indexed: 01/18/2023] Open
Abstract
Fatty acids come in a variety of structures and, because of this, create a variety of functions for these lipids. Some fatty acids have a role to play in energy metabolism, some help in lipid storage, cell structure, the physical state of the lipid, and even in food stability. Fatty acid metabolism plays a particularly important role in meeting the energy demands of the heart. It is the primary source of myocardial energy in control conditions. Its role changes dramatically in disease states in the heart, but the pathologic role these fatty acids play depends upon the type of cardiovascular disease and the type of fatty acid. However, no matter how good a food is for one's health, its taste will ultimately become a deciding factor in its influence on human health. No food will provide health benefits if it is not ingested. This review discusses the taste characteristics of culinary oils that contain fatty acids and how these fatty acids affect the performance of the heart during healthy and diseased conditions. The contrasting contributions that different fatty acid molecules have in either promoting cardiac pathologies or protecting the heart from cardiovascular disease is also highlighted in this article.
Collapse
Affiliation(s)
- Aleksandra Stamenkovic
- Institute of Cardiovascular Sciences, St Boniface Hospital, Winnipeg, MB R2H2A6, Canada.
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E0W3, Canada.
| | - Riya Ganguly
- Institute of Cardiovascular Sciences, St Boniface Hospital, Winnipeg, MB R2H2A6, Canada.
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E0W3, Canada.
| | - Michel Aliani
- Canadian Centre for Agri-Food Research in Health and Medicine (CCARM), Albrechtsen Research Centre, St Boniface Hospital, University of Manitoba, Winnipeg, MB R2H2A6, Canada.
- Department of Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB R2H2A6, Canada.
| | - Amir Ravandi
- Institute of Cardiovascular Sciences, St Boniface Hospital, Winnipeg, MB R2H2A6, Canada.
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E0W3, Canada.
- Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E0W3, Canada.
| | - Grant N Pierce
- Institute of Cardiovascular Sciences, St Boniface Hospital, Winnipeg, MB R2H2A6, Canada.
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E0W3, Canada.
- Canadian Centre for Agri-Food Research in Health and Medicine (CCARM), Albrechtsen Research Centre, St Boniface Hospital, University of Manitoba, Winnipeg, MB R2H2A6, Canada.
| |
Collapse
|
|
37
|
Abstract
PURPOSE OF REVIEW This review of the literature aims to discuss the evidence linking different lipid and apolipoprotein measures to peripheral artery disease. RECENT FINDINGS Measures of atherogenic dyslipidemia, including elevations in total cholesterol and total cholesterol/high-density lipoprotein cholesterol as well as low levels of high-density lipoprotein cholesterol, are strongly associated with future risk of peripheral artery disease. Compared to coronary artery disease, there are fewer data showing an association between low-density lipoprotein cholesterol and future risk of peripheral artery disease. Novel lipid measures, including nuclear magnetic resonance-derived lipoproteins and oxidized lipids, may lead to better assessments of future peripheral artery disease risk. These data highlight the important differences between lipid risk factors for peripheral and coronary artery disease. Improved understanding of these distinctions may lead to new therapeutic options for patients with peripheral artery disease.
Collapse
Affiliation(s)
- Aaron W Aday
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave. Suite 300, Nashville, TN, 37203, USA
| | - Brendan M Everett
- Divisions of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
|
38
|
Plasma Levels of Preβ1-HDL Are Significantly Elevated in Non-Dialyzed Patients with Advanced Stages of Chronic Kidney Disease. Int J Mol Sci 2019; 20:ijms20051202. [PMID: 30857306 PMCID: PMC6429079 DOI: 10.3390/ijms20051202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 01/29/2023] Open
Abstract
In chronic kidney disease (CKD), the level of high-density lipoprotein (HDL) decreases markedly, but there is no strong inverse relationship between HDL-cholesterol (HDL-C) and cardiovascular diseases. This indicates that not only the HDL-C level, but also the other quantitative changes in the HDL particles can influence the protective functionality of these particles, and can play a key role in the increase of cardiovascular risk in CKD patients. The aim of the present study was the evaluation of the parameters that may give additional information about the HDL particles in the course of progressing CKD. For this purpose, we analyzed the concentrations of HDL containing apolipoprotein A-I without apolipoprotein A-II (LpA-I), preβ1-HDL, and myeloperoxidase (MPO), and the activity of paraoxonase-1 (PON-1) in 68 patients at various stages of CKD. The concentration of HDL cholesterol, MPO, PON-1, and lecithin-cholesterol acyltransferase (LCAT) activity were similar in all of the analyzed stages of CKD. We did not notice significant changes in the LpA-I concentrations in the following stages of CKD (3a CKD stage: 57 ± 19; 3b CKD stage: 54 ± 15; 4 CKD stage: 52 ± 14; p = 0.49). We found, however, that the preβ1-HDL concentration and preβ1-HDL/LpA-I ratio increased along with the progress of CKD, and were inversely correlated with the estimated glomerular filtration rate (eGFR), even after adjusting for age, gender, triacylglycerols (TAG), HDL cholesterol, and statin therapy (β = −0.41, p < 0.001; β = −0.33, p = 0.001, respectively). Our results support the earlier hypothesis that kidney disease leads to the modification of HDL particles, and show that the preβ1-HDL concentration is significantly elevated in non-dialyzed patients with advanced stages of CKD.
Collapse
|
|
39
|
The consumption of 12 Eggs per week for 1 year does not alter fasting serum markers of cardiovascular disease in older adults with early macular degeneration. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2019. [DOI: 10.1016/j.jnim.2018.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
|
40
|
Campos RMDS, Masquio DCL, Corgosinho FC, Caranti DA, Ganen ADP, Tock L, Oyama LM, Dâmaso AR. Effects of magnitude of visceral adipose tissue reduction: Impact on insulin resistance, hyperleptinemia and cardiometabolic risk in adolescents with obesity after long-term weight-loss therapy. Diab Vasc Dis Res 2019; 16:196-206. [PMID: 30688518 DOI: 10.1177/1479164118825343] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM To investigate the association between visceral adipose tissue loss and insulin resistance and hyperleptinemia in adolescents with obesity submitted to interdisciplinary weight-loss therapy. METHODS A total of 172 post-pubertal adolescents (body mass index greater than the 95th percentile of the Centers for Disease Control and Prevention reference growth charts) were recruited for the study. The adolescents were assigned to long-term weight-loss therapy. Body composition, visceral and subcutaneous fat, glucose metabolism, lipid profile, hepatic enzymes and leptin concentration were measured. After the therapy, the adolescents were allocated to three different groups according to the tertile of visceral fat reduction. RESULTS Positive effects on body composition were observed in all analysed groups independent of visceral fat reduction. It was found that visceral fat was an independent predictor of insulin resistance in the investigated population. Obese adolescents who lost a higher proportion of visceral adipose tissue (>1.8 cm) demonstrated improved metabolic and inflammatory parameters twice as much than those who presented smaller losses. Positive correlations between visceral fat reduction and glucose metabolism, lipid profile, hepatic enzymes and homeostasis model assessment of insulin resistance index were demonstrated. CONCLUSION The magnitude of the reduction in visceral fat was an independent predictor of insulin resistance, hyperleptinemia and metabolic disorders related to obese adolescents.
Collapse
Affiliation(s)
- Raquel Munhoz da Silveira Campos
- 1 Department of Physiotherapy, Therapeutic Resources Laboratory, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
- 5 Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil
| | | | | | - Danielle Arisa Caranti
- 4 Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil
- 5 Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil
| | | | | | - Lila Missae Oyama
- 7 Post Graduate Program of Nutrition, Paulista School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- 8 Department of Physiology, Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ana Raimunda Dâmaso
- 7 Post Graduate Program of Nutrition, Paulista School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| |
Collapse
|
|
41
|
Félix-Redondo FJ, Lozano Mera L, Alvarez-Palacios Arrighi P, Grau Magana M, Ramírez-Romero JM, Fernández-Bergés D. [Impact of cardiovascular risk factors in the Extremadura population: HERMEX cohort contributions for a preventive strategy]. Aten Primaria 2019; 52:3-13. [PMID: 30638699 PMCID: PMC6938985 DOI: 10.1016/j.aprim.2018.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/30/2018] [Accepted: 11/12/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To determine the population attributable fraction (PAF) of the major risk factors (RF) for the occurrence of cardiovascular disease in an Extremadura population cohort and therefore recommend priority preventive measures in health. METHODS Design, Cohort study. LOCATION Representative population sample of a health area of Extremadura (Spain) PARTICIPANTS: 2833 individuals, from 25 to 79 years old, randomly selected and recruited between 2007 and 2009. Antecedents and clinical parameters were recorded, a follow up until December 31, 2015 were done. MEASUREMENTS Explanatory variables: Age, sex, obesity, current smoking, arterial hypertension, diabetes mellitus (DM) and hypercholesterolemia. OUTCOME VARIABLE First event of the combined variable of myocardial infarction, angina pectoris, stroke, peripheral arterial disease and cardiovascular death. Fully adjusted hazard ratios (HR) were calculated by Cox regression. The PAFs were calculated using Levin's formula. RESULTS 2669 subjects were included, 103 had history of cardiovascular disease and 61 were lost. The follow-up was 6.9 years (IR 6.5-7.5). 134 events were recorded. Incidence rate 7.42/1,000 people-year. Adjusted HR (95% CI) were: hypertension 2.26 (1.40-3.67), hypercholesterolemia 2.23 (1.56-3.18), DM 1.79 (1.24-2.58) and current smoking 1.72 (1.11-2.69). The PAF (95% CI) were: hypertension: 31.1 (12.4-48.8), hypercholesterolemia 27.0% (14.8-40.6), smoking 18.8% (3.3-35.0) and DM 7.9% (2.6-15.2). CONCLUSIONS Hypertension confers the greatest burden of cardiovascular disease in the population of Extremadura, followed by hypercholesterolemia and smoking. These RF are priority objectives for a population-based preventive strategy.
Collapse
Affiliation(s)
| | - Luis Lozano Mera
- Centro de Salud Urbano I, Servicio Extremeño de Salud, Mérida, Badajoz, España
| | - Paula Alvarez-Palacios Arrighi
- Unidad de Investigación Área de Salud Don Benito-Villanueva de la Serena. FUNDESALUD, Villanueva de la Serena, Badajoz, España
| | | | | | - Daniel Fernández-Bergés
- Unidad de Investigación Área de Salud Don Benito-Villanueva de la Serena. FUNDESALUD, Villanueva de la Serena, Badajoz, España
| |
Collapse
|
|
42
|
Fu W, Gao XP, Zhang S, Dai YP, Zou WJ, Yue LM. 17β-Estradiol Inhibits PCSK9-Mediated LDLR Degradation Through GPER/PLC Activation in HepG2 Cells. Front Endocrinol (Lausanne) 2019; 10:930. [PMID: 32082252 PMCID: PMC7002320 DOI: 10.3389/fendo.2019.00930] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 12/20/2019] [Indexed: 12/22/2022] Open
Abstract
Plasma levels of PCSK9 are significantly higher in postmenopausal women. Pharmacologically increased estrogen levels have been shown to lower PCSK9 and LDL-C levels in animals and humans. The action of estrogen suggests that it has the ability to prevent PCSK9-mediated LDLR degradation in liver cells. However, little is known about how estrogen alters PCSK9-mediated LDLR degradation. Here, we report that 17β-estradiol (βE2) reduces PCSK9-mediated LDLR degradation by a mechanism that involves activation of the G protein-coupled estrogen receptor (GPER). In cultured HepG2 cells, βE2 prevented the internalization of PCSK9, which subsequently lead to PCSK9-mediated LDLR degradation. The altered LDLR levels also resulted in an increase in LDL uptake that was not observed in the absence of PCSK9. In addition, we showed that clathrin was rapidly increased in the presence of PCSK9, and this increase was blocked by βE2 incubation, suggesting rapid recruitment of clathrin in HepG2 cells. PLCγ activation and intracellular Ca2+ release were both increased due to the rapid effect of estrogen. By using a GPER antagonist G15, we demonstrated that the GPER mediates the action of estrogen. Together, the data from this in vitro study demonstrate that estrogen can regulate LDLR levels mainly through GPER activation, which prevents PCSK9-dependent LDLR degradation in HepG2 cells.
Collapse
Affiliation(s)
- Wei Fu
- Department of Physiology, West China School of Basic Medical and Forensic Medicine, Sichuan University, Chengdu, China
| | - Xiao-Ping Gao
- College of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sheng Zhang
- Department of Physiology, West China School of Basic Medical and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yan-Ping Dai
- College of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wen-Jun Zou
- College of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li-Min Yue
- Department of Physiology, West China School of Basic Medical and Forensic Medicine, Sichuan University, Chengdu, China
- *Correspondence: Li-Min Yue
| |
Collapse
|
|
43
|
Efficacy of Exercise Time Models in Weight-Loss and Coronary Risk Panel of Middle-Aged Females. ACTA ACUST UNITED AC 2018. [DOI: 10.5812/hmj.86318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
|
44
|
Romano S, Salustri E, Ruscitti P, Carubbi F, Penco M, Giacomelli R. Cardiovascular and Metabolic Comorbidities in Rheumatoid Arthritis. Curr Rheumatol Rep 2018; 20:81. [DOI: 10.1007/s11926-018-0790-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
|
45
|
Estrada-Luna D, Ortiz-Rodriguez MA, Medina-Briseño L, Carreón-Torres E, Izquierdo-Vega JA, Sharma A, Cancino-Díaz JC, Pérez-Méndez O, Belefant-Miller H, Betanzos-Cabrera G. Current Therapies Focused on High-Density Lipoproteins Associated with Cardiovascular Disease. Molecules 2018; 23:molecules23112730. [PMID: 30360466 PMCID: PMC6278283 DOI: 10.3390/molecules23112730] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/20/2018] [Accepted: 10/21/2018] [Indexed: 02/06/2023] Open
Abstract
High-density lipoproteins (HDL) comprise a heterogeneous family of lipoprotein particles divided into subclasses that are determined by density, size and surface charge as well as protein composition. Epidemiological studies have suggested an inverse correlation between High-density lipoprotein-cholesterol (HDL-C) levels and the risk of cardiovascular diseases and atherosclerosis. HDLs promote reverse cholesterol transport (RCT) and have several atheroprotective functions such as anti-inflammation, anti-thrombosis, and anti-oxidation. HDLs are considered to be atheroprotective because they are associated in serum with paraoxonases (PONs) which protect HDL from oxidation. Polyphenol consumption reduces the risk of chronic diseases in humans. Polyphenols increase the binding of HDL to PON1, increasing the catalytic activity of PON1. This review summarizes the evidence currently available regarding pharmacological and alternative treatments aimed at improving the functionality of HDL-C. Information on the effectiveness of the treatments has contributed to the understanding of the molecular mechanisms that regulate plasma levels of HDL-C, thereby promoting the development of more effective treatment of cardiovascular diseases. For that purpose, Scopus and Medline databases were searched to identify the publications investigating the impact of current therapies focused on high-density lipoproteins.
Collapse
Affiliation(s)
- Diego Estrada-Luna
- Instituto Nacional de Cardiología "Ignacio Chávez" Juan Badiano No. 1, Belisario Domínguez Sección 16, 14080 Tlalpan, Mexico City, Mexico.
| | - María Araceli Ortiz-Rodriguez
- Facultad de Nutrición, Universidad Autónoma del Estado de Morelos, UAEM, Calle Río Iztaccihuatl S/N, Vista Hermosa, 62350 Cuernavaca, Morelos, Mexico.
| | - Lizett Medina-Briseño
- Universidad de la Sierra Sur, UNSIS, Miahuatlán de Porfirio Díaz, 70800 Oaxaca, Mexico.
| | - Elizabeth Carreón-Torres
- Instituto Nacional de Cardiología "Ignacio Chávez" Juan Badiano No. 1, Belisario Domínguez Sección 16, 14080 Tlalpan, Mexico City, Mexico.
| | - Jeannett Alejandra Izquierdo-Vega
- Área Académica de Medicina, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Carretera Actopan-Tilcuautla, Ex-Hacienda La Concepción S/N, San Agustín Tlaxiaca, 42160 Hidalgo, Mexico.
| | - Ashutosh Sharma
- Tecnologico de Monterrey, School of Engineering and Sciences, Campus Queretaro, Epigmenio Gonzalez 500, 76130 Queretaro, Mexico.
| | - Juan Carlos Cancino-Díaz
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas del Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico.
| | - Oscar Pérez-Méndez
- Instituto Nacional de Cardiología "Ignacio Chávez" Juan Badiano No. 1, Belisario Domínguez Sección 16, 14080 Tlalpan, Mexico City, Mexico.
| | | | - Gabriel Betanzos-Cabrera
- Área Académica de Medicina, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Carretera Actopan-Tilcuautla, Ex-Hacienda La Concepción S/N, San Agustín Tlaxiaca, 42160 Hidalgo, Mexico.
| |
Collapse
|
|
46
|
Wan GX, Xia WB, Ji LH, Qin HL, Zhang YG. Triglyceride to high density lipoprotein cholesterol ratio may serve as a useful predictor of major adverse coronary event in female revascularized ST-elevation myocardial infarction. Clin Chim Acta 2018; 485:166-172. [PMID: 29969621 DOI: 10.1016/j.cca.2018.06.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Elevated triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio has been identified as a surrogate marker of insulin resistance and an independent predictor for cardiovascular events in the general population. However, the prognostic value of TG/HDL-C ratio in revascularized ST-elevation myocardial infarction(STEMI) patients remains unclear. We examined the association between TG/HDL-C ratio and clinical outcome of revascularized STEMI patients in the Chinese population. METHODS 464 STEMI patients who underwent successful revascularization were enrolled to determine the relationship between TG/HDL-C ratio and major adverse coronary events(MACEs) with a 30-month follow-up. The Kaplan-Meier analysis and Cox regression proportional hazard model were applied to assess the prognostic value of TG/HDL-C ratio. RESULTS TG/HDL-C ratio was found to be significantly associated with age (p = 0.017), history of diabetes(p = 0.017), heart rate(p = 0.011), TG(p < 0.001), HDL-C(p < 0.001) and Gensini score(p = 0.034). The multivariate Cox regression analysis revealed that elevated TG/HDL-C ratio was an independent prognostic factor for MACE in female patients (HR = 2.624,95%CI = 1.211-5.687,p = 0.014) but not in male patients(HR = 0.756, 95%CI = 0.484-1.179,p = NS) after adjustment with other MACE-related prognostic factors. CONCLUSION The TG/HDL-C ratio may be independently associated with MACEs in female revascularized STEMI patients in the Chinese population.
Collapse
Affiliation(s)
- Guo-Xing Wan
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Wen-Bin Xia
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Li-Hua Ji
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Hai-Lun Qin
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Yong-Gang Zhang
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China.
| |
Collapse
|
|
47
|
Marino A, Sakamoto T, Tang XH, Gudas LJ, Levi R. A Retinoic Acid β2-Receptor Agonist Exerts Cardioprotective Effects. J Pharmacol Exp Ther 2018; 366:314-321. [PMID: 29907698 PMCID: PMC6041952 DOI: 10.1124/jpet.118.250605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/04/2018] [Indexed: 12/20/2022] Open
Abstract
We previously discovered that oral treatment with AC261066, a synthetic selective agonist for the retinoic acid β2-receptor, decreases oxidative stress in the liver, pancreas, and kidney of mice fed a high-fat diet (HFD). Since hyperlipidemic states are causally associated with myocardial ischemia and oxidative stress, we have now investigated the effects of AC261066 in an ex vivo ischemia/reperfusion (I/R) injury model in hearts of two prototypic dysmetabolic mice. We found that a 6-week oral treatment with AC261066 in both genetically hypercholesterolemic (ApoE-/-) and obese (HFD-fed) wild-type mice exerts protective effects when their hearts are subsequently subjected to I/R ex vivo in the absence of added drug. In ApoE-/- mice this cardioprotection ensued without hyperlipidemic changes. Cardioprotection consisted of attenuation of infarct size, diminution of norepinephrine (NE) spillover, and alleviation of reperfusion arrhythmias. This cardioprotection was associated with a reduction in oxidative stress and mast cell (MC) degranulation. We suggest that the reduction in myocardial injury and adrenergic activation, and the antiarrhythmic effects, result from decreased formation of oxygen radicals and toxic aldehydes known to elicit the release of MC-derived renin, promoting the activation of the local renin-angiotensin system leading to enhanced NE release and reperfusion arrhythmias. Because these beneficial effects of AC261066 occurred at the ex vivo level following oral drug treatment, our data suggest that AC261066 could be viewed as a therapeutic means to reduce I/R injury of the heart, and potentially also be considered in the treatment of other cardiovascular ailments such as chronic arrhythmias and cardiac failure.
Collapse
Affiliation(s)
- Alice Marino
- Department of Pharmacology, Weill Cornell Medicine, New York, New York
| | - Takuya Sakamoto
- Department of Pharmacology, Weill Cornell Medicine, New York, New York
| | - Xiao-Han Tang
- Department of Pharmacology, Weill Cornell Medicine, New York, New York
| | - Lorraine J Gudas
- Department of Pharmacology, Weill Cornell Medicine, New York, New York
| | - Roberto Levi
- Department of Pharmacology, Weill Cornell Medicine, New York, New York
| |
Collapse
|
|
48
|
Akadam-Teker B, Ozkara G, Kurnaz-Gomleksiz O, Bugra Z, Teker E, Ozturk O, Yilmaz-Aydogan H. BMP1 5'UTR + 104 T/C gene variation: can be a predictive marker for serum HDL and apoprotein A1 levels in male patients with coronary heart disease. Mol Biol Rep 2018; 45:1269-1276. [PMID: 30062502 DOI: 10.1007/s11033-018-4283-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/25/2018] [Indexed: 12/16/2022]
Abstract
Apolipoprotein A1 (Apo A1), the major protein of HDL, is secreted as a proprotein and then is cleaved by C-terminal procollagen endoproteinase/bone morphogenetic protein-1 (BMP1). BMP1 stimulates the conversion of newly secreted proapo A1 to its phospholipid-binding form. Therefore, genetic variations of BMP1 gene may affect serum ApoA1 and HDL levels. We aimed to investigate the effects of the functional 5'UTR + 104 (T/C) variant of BMP1 on serum ApoA1 and HDL levels and risk of coronary heart disease (CHD) in this study. The BMP1 5'UTR + 104 (T/C) (rs143383) variation was determined in 131 male patients with CHD and 51 male controls by real-time polymerase chain reaction technique. ApoA1 levels were measured by immunoturbidimetry. The serum Apo-A1 levels were found higher in controls with the BMP1-CC genotype than those with the T-allele (p < 0.001). Our findings show the association of this variation with serum ApoA1 and HDL-C levels which increase in the order of CT < TT < CC in the controls. No effect was found on ApoA1 and HDL-C levels in CHD patients, as it was observed in the controls. However, the BMP1-TT genotype was associated with higher triglyceride (TG) levels as compared to C-allele (p = 0.009). These discrepancies could be due to statin therapy which has dominant effects on lowering cholesterol levels comparing to TG levels. Our results indicated that the BMP1 5'UTR + 104 (T/C) variation may affect the serum ApoA1 and lipoprotein levels depending on statin therapy so that contributes to the development of CHD.
Collapse
Affiliation(s)
- Basak Akadam-Teker
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba c. Çapa, 34093, Istanbul, Turkey.,Department of Medical Genetics, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Gulcin Ozkara
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba c. Çapa, 34093, Istanbul, Turkey
| | - Ozlem Kurnaz-Gomleksiz
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba c. Çapa, 34093, Istanbul, Turkey.,Department of Medical Biology, Faculty of Medicine, Altinbas University, Istanbul, Turkey
| | - Zehra Bugra
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erhan Teker
- Departments of Cardiology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Oguz Ozturk
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba c. Çapa, 34093, Istanbul, Turkey
| | - Hulya Yilmaz-Aydogan
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakıf Gureba c. Çapa, 34093, Istanbul, Turkey.
| |
Collapse
|
|
49
|
The Association of Dietary Cholesterol and Fatty Acids with Dyslipidemia in Chinese Metropolitan Men and Women. Nutrients 2018; 10:nu10080961. [PMID: 30044444 PMCID: PMC6115945 DOI: 10.3390/nu10080961] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/08/2018] [Accepted: 07/23/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The associations between dietary cholesterol and fatty acids and serum lipids are controversial. This study is to examine the association of dietary cholesterol and fatty acids with serum lipids and dyslipidemia in Chinese metropolitan male and female adults. METHODS 3850 participants in the Shanghai Diet and Health Survey were investigated during the period 2012⁻2013. Information was obtained on dietary intake, anthropometric and blood laboratory measurements. Dyslipidemia was determined by US National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). RESULTS Dietary cholesterol was in line with serum TC, LDL-C and the LDL-C to HDL-C ratio in general and the partial correlation coefficients were 0.64 (95% CI: 0.13⁻1.15, p = 0.015), 0.73 (95% CI: 0.21⁻1.24, p = 0.006) and 0.01 (95% CI: 0.00⁻0.02, p = 0.018), respectively. The partial correlation coefficients were greater in women. Dietary fatty acids were not associated with serum lipids. The highest quintile of dietary cholesterol intake (≥538.0 mg/day) was associated with an approximate 1.6-fold risk for high TC and high HDL-C compared with the lowest quintile (<193.1 mg/day) generally. CONCLUSIONS Dietary cholesterol was associated with serum cholesterol in Chinese metropolitan adults and a higher risk of dyslipidemia was observed at a high level of dietary cholesterol intake. Whether there should be an upper limit on dietary cholesterol in the Chinese population warrants further study.
Collapse
|
|
50
|
Mahdavi S, Jenkins DJA, Borchers CH, El-Sohemy A. Genetic Variation in 9p21 and the Plasma Proteome. J Proteome Res 2018; 17:2649-2656. [DOI: 10.1021/acs.jproteome.8b00117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Sara Mahdavi
- Department of Nutritional Sciences, University of Toronto, 150 College Street, Room 310, Toronto, Ontario M5S 3E2, Canada
| | - David J. A. Jenkins
- Department of Nutritional Sciences, University of Toronto, 150 College Street, Room 310, Toronto, Ontario M5S 3E2, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, Ontario M5B 1T8, Canada
- Risk Factor Modification Centre and Division of Endocrinology and Metabolism, St. Michael’s Hospital, St. Michael’s Health Centre, 61 Queen Street East, Toronto, Ontario M5C 2T2, Canada
| | - Christoph H. Borchers
- University of Victoria−Genome British Columbia Proteomics Centre, University of Victoria, Victoria, British Colombia V8Z 7X8, Canada
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
- Gerald Bronfman Department of Oncology, Jewish General Hospital, McGill University, Montreal, Quebec H4A 3T2, Canada
- Proteomics Centre, Segal Cancer Centre, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Quebec H3T 1E2, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, 150 College Street, Room 310, Toronto, Ontario M5S 3E2, Canada
| |
Collapse
|