Pediatric chronic kidney disease: blood cell count indexes as inflammation markers / Doença renal crônica pediátrica: índices de contagem de células sanguíneas como marcadores de inflamação

Abstract Introduction: Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. Aim: To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). Methods: We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. Results: Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. Conclusion: The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

Resumo Introdução: Doença renal crônica (DRC) é definida como um declínio progressivo das funções renais. Na infância, os principais fatores desencadeantes são anomalias congênitas dos rins e trato urinário (CAKUT) e glomerulopatias. Respostas inflamatórias apresentam desafios para diagnóstico e estadiamento, o que justifica estudos sobre biomarcadores/índices. Objetivo: Definir índices de contagem de células sanguíneas e verificar sua associação com etiologia e estadiamento da DRC pediátrica. Os índices incluídos foram: Razão Neutrófilo-Linfócito (NLR), Razão Neutrófilo-Linfócito Derivada (dNLR), Razão Linfócito-Monócito (LMR), Índice de Resposta à Inflamação Sistêmica (SIRI), Índice Agregado de Inflamação Sistêmica (AISI) e Índice de Inflamação Imune Sistêmica (SII). Métodos: Determinamos índices em 52 pacientes pediátricos com DRC e 33 controles saudáveis por cálculo matemático. Pacientes com DRC foram separados em cinco grupos conforme etiologia e estadiamento: Grupo IA: glomerulopatias em estágio 1 ou 2; IB: glomerulopatias em estágio 3 ou 4; IIA: CAKUT em estágio 1 ou 2; IIB: CAKUT em estágio 3 ou 4; e III: estágios 3 ou 4 de outras etiologias. Além disso, combinamos todos os pacientes com DRC em um grupo (IV). Grupo V foi um grupo controle saudável. Resultados: Observamos valores menores de LMR nos grupos IB e IIB comparados ao grupo V (p=0,047; p=0,031, respectivamente). Encontramos valores maiores de SIRI para o grupo III versus grupo V (p=0,030). Não houve diferença para outros índices quando os grupos foram comparados dois a dois. Conclusão: Os índices LMR e SIRI apresentaram resultados promissores na avaliação da inflamação, pois correlacionaram-se com as etiologias da DRC e, principalmente, com o estadiamento desses pacientes.

Pediatric chronic kidney disease: blood cell count indexes as inflammation markers.

INTRODUCTION: Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. AIM: To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). METHODS: We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. RESULTS: Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. CONCLUSION: The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

Adiponectin and Stnfr2 peripheral levels are associated with cardiovascular risk in patients with schizophrenia.

OBJECTIVES: To investigate the association between cytokine peripheral levels and the risk of cardiovascular disease in patients with schizophrenia and controls. METHODS: A sample of 40 patients and 40 control subjects participated in the study. Psychiatric diagnosis was established following structured clinical assessment. The Framingham Score was used to assess cardiovascular risk (CVR). Serum levels of the cytokines IL-1ß, IL-6, IL-8, IL-10, IL-12p70 and TNF-α were determined by cytometric bead array (CBA) technique, and the serum levels of IL-33, sST2, sTNFR1, sTNFR2, Leptin and Adiponectin by Enzyme-Linked Immunosorbent assay (ELISA). RESULTS: Patients with schizophrenia showed greater frequency of moderate CVR when compared with controls (p = 0.14). In addition, patients showed higher levels of sTNFR2 and Adiponectin compared to controls (p = 0.007 and p < 0.001, respectively). Adiponectin and sTNFR2 were associated with CVR only in patients (p = 0.0002 and p = 0.033, respectively). In multivariate analysis controlling for socio-demographic and clinical confounders, illness duration (r = 0.492; p < 0.002) and sTNFR2 (r = 0.665; p < 0.004) were independent predictors of CVR. CONCLUSION: Our results reinforce the concept that patients with schizophrenia are at greater risk to develop cardiovascular diseases, and suggest that the associated chronic low-grade inflammation might play a role in this process.

Chia seed (Salvia hispanica L.) consumption and lipid profile: a systematic review and meta-analysis.

Chia (Salvia hispanica L.) is an annual herbaceous plant, originally from southern Mexico and northern Guatemala - nowadays grown all over the world. In recent years, there has been an increase in demand for plant foods with health-promoting properties, and chia is a main actor in this process due to its high nutritional and functional value and its chemical composition rich in PUFAs, mainly ω-3, as well as protein, dietary fiber, and bioactive compounds. Chia has been explored in different research models for health and the prevention of human diseases. Evidence has suggested potential for improving insulin resistance, disordered lipid profiles, glucose tolerance and even adiposity. The aim of this study was to evaluate the effect of consumption of chia seeds on the lipid profile, triglycerides, and serum ω-3 fatty acids in adults. This systematic review included all randomized controlled trials (parallel or crossover design) published up to August 2020 in the main databases Medline, Embase, Scopus, Web of Science, and Scielo. Two independent authors selected and extracted data from those articles. After the selection process, 10 clinical trials were included. Forest plots and summary tables were constructed to present data and sensitivity subgroup analyses were performed for some of the outcomes. The results showed that chia consumption suggests a protective effect on the lipid profile, decreasing TC (MD = -2.98, 95% CI = [-9.98; 4.02]), TG (MD = -14.09 mg dL-1, 95% CI = [-33.46; 5.28]), and LDL (MD = 2.07 mg dL-1; 95% CI = [-5.05; 9.19]) and increasing HDL (MD = -2.92 mg dL-1, 95% CI = [-5.91; 0.06]). Regarding serum fatty acids, chia reduced FFA and SFA and increased PUFAs, ALA, EPA, and LA. It has also reduced DHA while not changing DPA. The intake of chia appears to have a neutral or beneficial effect on some markers of the lipid and fatty acid profile.

Atrial Fibrillation and Use of Rivaroxaban: Performance of the Prothrombin Time / INR as a Function of Time After Blood Collection

Abstract Background Traditionally, the most effective therapy in the prevention of stroke in patients with atrial fibrillation (AF) has been oral anticoagulation with vitamin K inhibitors, particularly warfarin, whose disadvantages and adverse effects have led to their replacement by "direct oral anticoagulants", as factor X inhibitor. Objectives This study aimed to conduct a brief approach on atrial fibrillation (AF) and use of Rivaroxaban, and to comparatively evaluate the prothrombin time / International Normalized Ratio (PT/INR) in patients with AF in use of this oral anticoagulant, depending on the time elapsed between the last administration of the drug and the time of blood sample venipuncture. Methods We evaluated 34 patients with AF in use of Rivaroxaban by using PT / INR, distributed into a subgroup with blood collection time ≤ 12 hours (n = 7) and > 12 hours after the last drug intake (n = 27). Mann-Whitney test was used to compare the groups and p < 0.05 was considered significant. Results An analysis as a function of time between the Rivaroxaban intake and blood collection, revealed that PT / INR suffers the greatest effect up to 12 hours after ingestion of the drug, dropping to levels close to normal in subsequent hours before the next dose. Conclusion We concluded that, in contrast to warfarin, the knowledge of the time interval between drug intake and blood collection from patients taking Rivaroxaban is essential to properly interpret a laboratory test to assess hemostasis, particularly PT and its derivatives. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

TNF, IL-6, and IL-10 cytokines levels and their polymorphisms in renal function and time after transplantation.

Cytokine polymorphisms can influence their plasma levels and thus affect the immune response in renal transplantation. A total of 146 renal transplant recipients (RTR) were classified into groups according to the estimated glomerular filtration rate (R1: < 60 and R2: ≥ 60 mL/min/1.73 m2) and time after transplantation (T1: 1 to 24, T2: 25 to 60, T3: 61 to 120, and T4: > 120 months after transplantation). The polymorphisms were genotyped by single specific primer-polymerase chain reaction. IL-10 was measured by ELISA and IL-6, and TNF levels were determined using Miliplex®. A higher frequency of the - 308G allele and the - 308G/G genotype, low-producer, was observed in the R1 group compared with R2. In addition, a higher frequency of the - 308A carriers, high-producer, was found in the R2 group. However, no significant difference was observed in cytokine levels when both groups were compared. Higher levels of IL-6 were observed in T1 compared with T2 and T4 groups. Lower IL-6 levels were found in T2 compared with T3 group. Lower levels of IL-10 were also found in T1 group in relation to T2, while higher levels of this cytokine were observed in T2 group compared with T3. The results suggest that the - 308G > A polymorphism in the TNF gene is associated with filtration function after renal transplantation, and IL-6 and IL-10 levels change according to the time after transplantation. Thus, the joint evaluation of - 308G > A polymorphism in TNF gene and IL-6 and IL-10 levels would provide a broader and effective view on the clinical monitoring of RTR.

Estrogen receptor-alpha gene XbaI A > G polymorphism influences short-term cognitive decline in healthy oldest-old individuals.

METHODS: The individuals were categorized in two groups according to the presence or absence of cognitive decline. Cognitive data were related to genetic information. RESULTS: The XbaI -351 AA genotype was more common among cognitive decliners, while -351G allele carriers showed cognitive stability or improvement. CONCLUSION: These results suggest that ESR-1 could be associated with one-year cognitive decline in healthy oldest-old individuals, since the estrogen pathway may be involved with neuroprotection, even in healthy brain aging.

Estrogen receptor-alpha gene XbaI A > G polymorphism influences short-term cognitive decline in healthy oldest-old individuals / Polimorfismo XbaI A > G no gene do receptor do estrogênio-alfa influencia o declínio cognitivo em curto prazo em idosos muito idosos saudáveis

ABSTRACT This prospective study aimed to evaluate the influence of the -351A/G XbaI polymorphism in the estrogen receptor-alpha (ESR-1) gene on global cognitive scores of a community sample of healthy oldest-old individuals within one year of follow up. Methods The individuals were categorized in two groups according to the presence or absence of cognitive decline. Cognitive data were related to genetic information. Results The XbaI -351 AA genotype was more common among cognitive decliners, while -351G allele carriers showed cognitive stability or improvement. Conclusion These results suggest that ESR-1 could be associated with one-year cognitive decline in healthy oldest-old individuals, since the estrogen pathway may be involved with neuroprotection, even in healthy brain aging.

RESUMO Neste estudo prospectivo foi avaliada a influência do polimorfismo -351A/G XbaI do gene do receptor de estrogênio alfa (ESR-1) sobre o desempenho cognitivo global em idosos muito idosos (≥ 75 anos) saudáveis durante um ano. Métodos Os indivíduos foram divididos em dois grupos de acordo com a presença ou ausência de declínio cognitivo. Dados cognitivos foram relacionados à informação genética. Resultados O genótipo XbaI -351 AA foi mais comum entre indivíduos que apresentaram declínio cognitivo, enquanto carreadores do alelo -351G demonstraram estabilidade ou melhora cognitiva. Conclusão Estes resultados sugerem que ESR-1 poderia estar associado ao declínio cognitivo em curto prazo em idosos saudáveis, possivelmente por meio de propriedades neuroprotetoras do estrogênio, mesmo em cérebros idosos saudáveis.

Vasoactive intestinal peptide reduces the inflammatory profile in mice infected with Trypanosoma cruzi.

Vasoactive intestinal peptide (VIP) has gained great prominence because of its therapeutic potential, which is ascribed to its ability to regulate innate immunity, inhibit antigen-specific Th1 cell responses, and generate T regulatory cells. Additionally, VIP may act as a natural antimicrobial peptide, killing bacteria, fungi, and infective forms of Trypanosoma brucei. Despite the possible relevance of VIP during the course of Chagas disease, studies regarding this in human and experimental Trypanosoma cruzi infections remain poorly characterized. In this work, we evaluated the effects of VIP on systemic and cardiac immune responses during experimental acute infection. C57BL/6 mice were infected with 5000 trypomastigotes of the VL-10 strain of T. cruzi and treated with intraperitoneal VIP injection every other day for one month. After 30 days, we observed no reduction in parasitemia levels. However, we observed a reduction in serum levels of IFN-gamma and IL-2 and an increase in that of IL-4. These data suggest that VIP treatment modified immune responses to favor the Th2 response, which had no impact on parasitemia levels although the serum level of IFN-gamma was reduced. However, this change in immune balance reduced heart damage, as noted by the smaller cardiac volume and the moderate inflammatory infiltrate observed in VIP-treated mice. Our results indicate that VIP treatment reduced the inflammatory response at the cardiac site of mice that were experimentally infected with T. cruzi. These data suggest a protective role for VIP in the heart of infected mice.

Hemostatic Parameters according to Renal Function and Time after Transplantation in Brazilian Renal Transplanted Patients.

Kidney transplantation is the key for patients with end-stage renal disease, improving quality of life and longer survival. However, kidney transplant triggers an intense inflammatory response and alters the hemostatic system, but the pathophysiological mechanisms of these changes are not completely understood. The aim of this cross-sectional cohort study was to investigate hemostatic biomarkers in Brazilian renal transplanted patients according to renal function and time after transplantation. A total of 159 renal transplanted patients were enrolled and D-Dimer (D-Di), Thrombomodulin (TM), von Willebrand Factor (VWF), and ADAMTS13 plasma levels were assessed by ELISA. An increase of D-Di was observed in patients with higher levels of creatinine. ADAMTS13 levels were associated with creatinine plasma levels and D-Di levels with Glomerular Filtration Rate. These results suggested that D-Di and ADAMTS13 can be promising markers to estimate renal function. ADAMTS13 should be investigated throughout the posttransplant time to clarify the participation of this enzyme in glomerular filtration and acceptance or rejection of the graft in Brazilian transplanted patients.

Asymmetric Dimethylarginine (ADMA) in cardiovascular and renal disease.

BACKGROUND: Asymmetric Dimethylarginine (ADMA) is a modified amino acid formed when intracellular arginine is methylated by methyltransferases that are widely distributed throughout the body. Nitric oxide (NO) is produced from l-arginine in a reaction catalyzed by three distinct isoforms of NO synthase (NOS). NO has emerged as a mediator involved in maintenance of vascular tonus, blood pressure regulation, inhibition of platelet aggregation, leukocyte and endothelial cell interaction and vascular permeability. ADMA is an important inhibitor that competes with NOS and compromises NO synthesis. OBJECTIVE: This review aims to compile articles involving renal and cardiovascular diseases in which plasma ADMA was assessed in order to clarify its role in these diseases. CONCLUSION: Although current knowledge suggests that ADMA has a role in the onset of cardiovascular and renal diseases, its actions are poorly understood. Clarifying its biochemical mechanisms is essential for improving disease management and promoting better quality of life for these patients.

Cytokines signatures in short and long-term stable renal transplanted patients.

Despite the evidences showing the relevance of regulatory immune-mediated mechanisms to guarantee the stable graft function in renal transplanted patients, studies focusing on the immune response observed over a long-term period after renal transplantation are still limited. Several efforts have been done to establish novel biomarkers with relevant predictive values that could be used as prognostic laboratorial tools to monitor the complex network triggered through time after kidney transplantation. In this study, we have evaluated the pro-inflammatory and regulatory patterns of plasma cytokines in a group of 120 renal transplanted patients with stable graft function ranging from 1 to 160 months. Our data demonstrated an overall predominance of regulatory cytokines short-term after renal transplantation (1-24 months) with peaks of IL-4, IL-5 and IL-10. Moreover, a slight peak of TNF-α was observed 25-60 months after renal transplantation. Following a gap of stable cytokine profile (61-120 months), peaks of pro-inflammatory cytokines IL-8, IL-6, IL1ß, TNF-α and IL-12 were observed later on (>120 months) after renal transplantation. Additionally, the categorical analysis of "low" or "high" cytokine producers re-enforce the occurrence of an overall regulatory status early-after stable renal graft function with a predominant pro-inflammatory pattern later on long-term renal transplantation. Taken together, our data suggest that IL-5 is a good biomarker associated with short-term stable renal function, whereas IL-12 seems to be a relevant pro-inflammatory element in long-term renal transplanted patients.

Polymorphism in the methylenetetrahydrofolate reductase (C677T) gene and homocysteine levels: a comparison in Brazilian patients with coronary arterial disease, ischemic stroke and peripheral arterial obstructive disease.

This study aimed to compare plasma levels of total homocysteine (tHcy) in different arterial events as well as to investigate an association between homocysteine levels and C677T polymorphism in Brazilian patients. A total of 145 subjects were enrolled in this study including 43 patients with coronary arterial disease (CAD), 21 with ischemic stroke (IS), 44 with peripheral arterial obstructive disease (PAOD) and 37 control subjects. A preliminary analysis showed significant difference for tHcy plasma levels between patients with CAD (P = 0.003) or PAOD (P = 0.03) compared to controls. However, after adjustment for sex, age, total cholesterol, LDL, diabetes, tabagism or C677T polymorphism, no significant differences were detected in tHcy levels among patients groups and controls. No significant correlation was demonstrated for C677T polymorphism and homocysteine levels. These results indicate that increased Hcy levels may not be considered an independent risk factor for atherothrombotic diseases in Brazilian patients.

Hypercoagulability markers in patients with peripheral arterial disease: association to ankle-brachial index.

Peripheral arterial disease is diagnosed by measuring the ankle-brachial index. Values lower than 0.90 define the disease being usually related to its severity. Patients with peripheral arterial disease may show a hypercoagulability state. The aim of this study was to assess hemostatic variables and to correlate them with the presence of peripheral arterial disease and its severity as assessed by ankle-brachial index values. Plasma levels of D dimer, plasminogen, prothrombin fragment 1+2, plasminogen activator inhibitor and thrombomodulin were measured in 36 patients with peripheral arterial disease (group 1) and 30 without disease (group 2). Significant differences for D dimer, plasminogen, prothrombin fragment 1+2 and plasminogen activator inhibitor type 1 between the 2 groups were found (P<0.05). Significant and inverse correlations were also observed (Pearson correlation, P<0.05) between ankle-brachial index values and levels of both plasminogen and plasminogen activator inhibitor type 1. Although there was no significant correlation between ankle-brachial index and levels of D dimer, higher D dimer values were observed in patients with lower ankle-brachial index values. The results confirm a trend to hypercoagulability and hypofibrinolysis in patients with peripheral arterial disease. Increased levels of plasminogen activator inhibitor type 1 seem to be associated with the severity of the disease, considering the inverse correlation between this inhibitor and ankle-brachial index.

Lipoproteína (a) em pacientes portadores de doença arterial obstrutiva periférica e/ou diabetes mellitus tipo 2 / Lipoprotein (a) in patients with peripheral arterial obstructive disease and/or type 2 diabetes mellitus

INTRODUÇÃO: A doença arterial obstrutiva periférica (DAOP) constitui um excelente marcador para a aterosclerose sistêmica. Entre os fatores de risco para essa doença está o diabetes mellitus tipo 2 (DM2). Acredita-se que a lipoproteína (a) [Lp(a)] esteja ligada a risco aumentado de aterosclerose, embora os mecanismos que levem a esse aumento não sejam completamente conhecidos. Níveis elevados de Lp(a) parecem estar associados a risco aumentado de doença arterial coronariana (DAC), assim como DAOP e doença cerebrovascular. OBJETIVO: Avaliar os níveis plasmáticos de Lp(a) e outras variáveis lipídicas em um grupo de pacientes com DAOP e/ou DM2. MATERIAL E MÉTODOS: Níveis plasmáticos de Lp(a), colesterol total (CT), colesterol da lipoproteína de alta densidade (HDL-c), colesterol da lipoproteína de baixa densidade (LDL-c), triglicérides (TG) e apolipoproteínas A-I e B foram medidos em amostras de sangue de 12 indivíduos comprovadamente não-portadores de DAOP e DM2 (controles), 17 pacientes portadores de DAOP, 18 pacientes com DM2 e 19 pacientes portadores de DAOP e DM2 simultaneamente. Os participantes desse estudo foram selecionados buscando-se homogeneidade e semelhança estatística em relação às variáveis sexo, idade e nível socioeconômico. RESULTADOS: A Lp(a) apresentou tendência a elevação tanto no grupo de pacientes com DAOP quanto naquele com DM2 + DAOP. Foram encontradas diferenças significativas entre os grupos para as dosagens de HDL-c e Apo A-I, inclusive com correlação positiva entre esses parâmetros. A relação CT/HDL-c apresentou diferença estatística significativa entre os grupos. Foram observadas correlações positiva entre Lp(a) e LDL-c, e negativa entre o índice tornozelo-braquial (ITB) e a Lp(a). CONCLUSÃO: Para as variáveis lipídicas estudadas foram observadas diferenças estatísticas significativas apenas entre os níveis plasmáticos de HDL-c e Apo A-I. Para o parâmetro Lp(a) foram observados níveis plasmáticos mais elevados...

BACKGROUND: Peripheral arterial obstructive disease (PAOD) constitutes an excellent marker for systemic atherosclerosis and type 2 diabetes mellitus (DM2) is among the greatest risk factors for this disease. It is believed that lipoprotein (a) [Lp(a)] is linked to increased risk of atherosclerosis, although the mechanisms responsible for that are not widely known. Elevated levels of Lp(a) seem to be associated with a higher risk of coronary artery disease (CAD), as well as PAOD and cerebrovascular disease. OBJECTIVES: To assess the plasma levels of Lp(a) and other lipid parameters in patients with PAOD and/or DM2. Material and methods: Plasma levels of Lp(a), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG) and apolipoproteins A-I and B were measured in blood samples of 12 subjects carrying neither PAOD nor DM2 (control group), 17 patients with PAOD, 18 with DM2 and 19 with both PAOD and DM2. The subjects selected for this study showed homogeneity and no statistical difference for gender, age, and socioeconomic status. RESULTS: The Lp(a) showed a tendency to elevation both in groups PAOD only and PAOD + DM2 simultaneously. Significant differences were observed among the groups as to HDL-c and apolipoprotein A-I levels, with positive correlation between these two parameters. TC/HDL-c ratio showed significant difference among the groups. Positive correlation was found between Lp(a) and LDL-c, and negative one, between the ankle-arm index and LP(a). CONCLUSION: As to the lipid parameters studied, significant statistical differences were found between HDL-c and apolipoprotein A-I plasma levels only. For Lp(a) parameter, higher plasma levels were observed in PAOD and PAOD + DM2, which have also shown concomitant and significant HDL-c reduction.

Increased serum levels of lipoprotein(a) correlated with the severity of coronary artery disease in patients submitted to angiography.

OBJECTIVE: To determine serum levels of lipoprotein(a) and lipid profile of a group of individuals submitted to coronary angiography, with the aim of establishing the possible correlation between these parameters and the severity of coronary artery disease. METHODS: Serum levels of total cholesterol, HDLC, LDLC, triglycerides, lipoprotein(a), apolipoproteins A-I and B were measured in blood samples of 17 subjects with absence of atheromatosis in the coronary arteries (control), 12 subjects presenting mild/moderate atheromatosis and 28 subjects presenting severe atheromatosis. RESULTS: No significant statistical differences were found between the means of the three groups for the parameters assessed, except for lipoprotein(a) serum levels which presented significant differences between the means of the control, mild/moderate atheromatosis and severe atheromatosis groups (p<0.001). CONCLUSION: The means obtained in the three groups for Lp(a) indicate a progressive increase in the serum levels of this parameter according to the severity of coronary atheromatosis. These findings suggest the need of additional studies in order to obtain enough evidence to support the introduction of routine assessment of Lp(a) levels in clinical laboratories in the monitoring of patients at risk for coronary artery disease (CAD).

Níveis plasmáticos elevados de lipoproteína(a) correlacionados com a gravidade da doença arterial coronariana em pacientes submetidos à angiografia / Increased serum levels of lipoprotein(a) correlated with the severity of coronary artery disease in patients submitted to angiography / Increased serum levels of lipoprotein(a) correlated with the severity of coronary artery disease in patients submitted to angiography

OBJETIVO: Determinar os níveis plasmáticos de lipoproteína(a) e perfil lipídico de um grupo de indivíduos submetidos à angiografia coronariana, buscando estabelecer a possível correlação entre estes parâmetros e a gravidade da doença coronariana. MÉTODOS: Níveis plasmáticos de colesterol total, HDL C, LDL C, triglicérides, lipoproteína(a), apolipoproteínas A-I e B foram medidos em amostras de sangue de 17 indivíduos com ausência de ateromatose nas coronárias (controles), 12 indivíduos apresentando ateromatose leve/moderada e 28 indivíduos apresentando ateromatose grave. RESULTADOS: Não foram encontradas diferenças estatisticamente significativas entre as médias dos três grupos para os parâmetros avaliados, exceto para os níveis plasmáticos de lipoproteína(a) que apresentaram diferenças significativas entre as médias dos grupos controle, ateromatose leve/moderada e ateromatose grave (p<0,001). CONCLUSÃO: As médias obtidas nos três grupos para Lp(a) sinalizam um aumento progressivo nos níveis plasmáticos deste parâmetro, de acordo com a gravidade da ateromatose coronariana. Estes achados sugerem a necessidade de estudos adicionais, visando obter suficiente evidência para a introdução rotineira da avaliação dos níveis de Lp(a) em laboratórios clínicos, no monitoramento de pacientes apresentando risco para doença arterial coronariana (DAC).

OBJECTIVE: To determine serum levels of lipoprotein(a) and lipid profile of a group of individuals submitted to coronary angiography, with the aim of establishing the possible correlation between these parameters and the severity of coronary artery disease. METHODS: Serum levels of total cholesterol, HDL C, LDL C, triglycerides, lipoprotein(a), apolipoproteins A-I and B were measured in blood samples of 17 subjects with absence of atheromatosis in the coronary arteries (control), 12 subjects presenting mild/moderate atheromatosis and 28 subjects presenting severe atheromatosis. RESULTS: No significant statistical differences were found between the means of the three groups for the parameters assessed, except for lipoprotein(a) serum levels which presented significant differences between the means of the control, mild/moderate atheromatosis and severe atheromatosis groups (p<0.001). CONCLUSION: The means obtained in the three groups for Lp(a) indicate a progressive increase in the serum levels of this parameter according to the severity of coronary atheromatosis. These findings suggest the need of additional studies in order to obtain enough evidence to support the introduction of routine assessment of Lp(a) levels in clinical laboratories in the monitoring of patients at risk for coronary artery disease (CAD).