RESUMEN
BACKGROUND: Dyslipoproteinemias can be classified by their distinct lipoprotein patterns, which helps determine atherosclerotic cardiovascular disease (ASCVD) risk and directs lipid management but this has required advanced laboratory testing. OBJECTIVE: To develop a new algorithm for classifying lipoprotein disorders that only relies on the standard lipid panel. METHODS: Lipid thresholds for defining the different lipoprotein phenotypes were derived for Non-High-Density Lipoprotein-Cholesterol (NonHDL-C) and Triglycerides (TG) to be concordant when possible with the current US Multi-Society guidelines for blood cholesterol management. RESULTS: The new classification method categorizes patients into all the classical Fredrickson-like phenotypes except for Type III dysbetalipoproteinemia. In addition, a new hypolipidemic phenotype (Type VI) due to genetic mutations in apoB-metabolism is described. The validity of the new algorithm was confirmed by lipid analysis by NMR (N = 11,365) and by concordance with classification by agarose gel electrophoresis/beta-quantification (N = 5504). Furthermore, based on the Atherosclerosis Risk in Communities (ARIC) cohort (N = 14,742), the lipoprotein phenotypes differ in their association with ASCVD (TypeV>IIb > IVb > IIa > IVa > normolipidemic) and can be used prognostically as risk enhancer conditions in the management of patients. CONCLUSIONS: We describe a clinically useful lipoprotein phenotyping system that is only dependent upon the standard lipid panel. It, therefore, can be easily implemented for increasing compliance with current guidelines and for improving the care of patients at risk for ASCVD.
Asunto(s)
Dislipidemias/clasificación , Lípidos/sangre , Adulto , Algoritmos , Dislipidemias/sangre , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Lipoproteínas/sangre , Masculino , Fenotipo , Triglicéridos/sangreRESUMEN
INTRODUCTION: Hypothyroidism has been associated with dyslipidemia. Its treatment with levothyroxine has shown a positive effect on the lipid profile in adults, however, there is a lack of data on the pediatric popu lation. OBJECTIVE: to evaluate the effect of the thyroid profile normalization on the lipid profile in children with primary hypothyroidism. PATIENTS AND METHOD: Retrospective study in children aged from 6 to 16 years, with diagnosis of primary hypothyroidism due to Hashimoto's thyroiditis, in treatment with levothyroxine, and who had an evaluation of serum lipids before and during their treatment. The lipid profile was evaluated in 2 stages: the first one referred to as "before levothyroxine treatment" (at the diagnosis of primary hypothyroidism) and the second one referred to as " thyroid profile normalization" (when normalization of Thyroid-stimulating hormone [TSH] and free T4 [FT4] was achieved during levothyroxine treatment). Sociodemographic and anthropometric data were recorded. The lipid profile evaluation consisted of the serum determination of total cholesterol (TC), high-density cholesterol (HDL-C), and TG. The phenotype of dyslipidemias was determined according to the Fredrickson's classification. RESULTS: 72 patients were included (61% women; age 11.5 ± 2.9 years), out of which 58.3% (n = 42) presented pre-treatment dyslipidemia. In hypothyroid state, it was evident the correlation of TSH with TC (r = 0.36; p = 0.002), LDL-C (r = 0.46; p = 0.01), and HDL-C (r = -0.33; p = 0.004). The thyroid profile normalization showed the reduction of TC [184 mg/dL (IQR 92-322) vs 147 mg/dL (IQR 92-283); p = 0.05], LDL-C [99 mg/dL (IQR 44-232) vs 82 mg/dL (IQR 41-168); p = 0.02], TG [113 mg/dL (IQR 50-483) vs 88 mg/dL (IQR 16-343); p = 0.03], and the frequency of dyslipidemia [58.3% vs 22.2%; p = 0.001), as well as the TC correction with TG (r = 0.35; p = 0.02) and LDL-C (r = 0.88; p = 0.01). Persistent dyslipidemia was associated with obesity (r = 0.27; p = 0.02), overweight (r = 0.58; p = 0.001), and pre-treatment dyslipidemia (r = 0.53; p = 0.001). CONCLUSIONS: There is an association between TSH, TC, LDL-C, and HDL-C in hypothyroidism. When the thyroid profile was normalized, there was a reduction of TC, TG, LDL- C, and dyslipidemia frequency. Persistent dyslipidemia was associated with obesity, overweight, and pre-treatment dyslipidemia.
Asunto(s)
Hipotiroidismo/sangre , Lípidos/sangre , Tirotropina/sangre , Tiroxina/sangre , Adolescente , Niño , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Dislipidemias/sangre , Dislipidemias/clasificación , Dislipidemias/complicaciones , Femenino , Enfermedad de Hashimoto/complicaciones , Humanos , Hipotiroidismo/tratamiento farmacológico , Hipotiroidismo/etiología , Masculino , Obesidad Infantil/etiología , Valores de Referencia , Estudios Retrospectivos , Tiroxina/uso terapéutico , Triglicéridos/sangreRESUMEN
The concept of metabolic syndrome (MetS) as a cluster of cardiovascular risk factors (obesity, altered glucose metabolism, dyslipidemia, and hypertension) has been around for more than 30 years. It is considered to be the result of complex interactions between centrally located fat, insulin resistance, subclinical inflammation, and other factors in genetically predisposed individuals. MetS diagnosis in adults has been linked to increased risk for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). However, MetS in children and adolescents remains a controversial issue despite the extensive research in the field. It is still uncertain which definition should be used for its diagnosis in this age group, what is the clinical significance of such a diagnosis, and how reliably it can predict the future risk of developing CVD and T2D. Even if a child is diagnosed with MetS, management includes addressing each of the syndrome's components individually with weight loss and lifestyle modifications as the basic approach. Co-morbid conditions, such as nonalcoholic fatty liver disease, obstructive sleep apnea, and polycystic ovary syndrome should also be considered. It seems that MetS in children and adolescents should be used clinically as a conceptual framework for the identification of risk factors clustered around obesity and insulin resistance rather than a syndrome that needs to be diagnosed by measuring absolute "all-or-none" criteria.
Asunto(s)
Síndrome Metabólico/diagnóstico , Terminología como Asunto , Adolescente , Factores de Edad , Glucemia/metabolismo , Presión Sanguínea , Composición Corporal , Niño , Dislipidemias/sangre , Dislipidemias/clasificación , Dislipidemias/diagnóstico , Humanos , Hipertensión/clasificación , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Resistencia a la Insulina , Lípidos/sangre , Síndrome Metabólico/sangre , Síndrome Metabólico/clasificación , Síndrome Metabólico/fisiopatología , Obesidad Abdominal/clasificación , Obesidad Abdominal/diagnóstico , Obesidad Abdominal/fisiopatología , Obesidad Infantil/clasificación , Obesidad Infantil/diagnóstico , Obesidad Infantil/fisiopatología , PronósticoRESUMEN
Background and Objectives: Dyslipidaemia and its associated complications have been reported to increase mortality among type 2 diabetes mellitus (T2DM) patients. However, there is a dearth of data on the incidence of dyslipidemia among Ghanaian patients with T2DM. This study evaluated dyslipidemia among newly diagnosed T2DM patients at Dormaa Presbyterian Hospital, Ghana. Materials and Methods: This cross-sectional study recruited a total of 215 participants at the Presbyterian Hospital, Dormaa-Ghana. A well-structured questionnaire was administered to collect demographic data. Predisposing factors of dyslipidemia such as BMI, hypertension, and family history of diabetes were also obtained. Lipid profile was performed on the serum obtained from each respondent. Dyslipidaemia was defined as total cholesterol (TC) >200 mg/dL, triglyceride (TG) >150 mg/dL, low density lipoprotein cholesterol (LDL-c) >100 mg/dL, and high-density lipoprotein cholesterol (HDL-c) <40 in males and <50 mg/dL in females. Combinations of the individual parameters of dyslipidaemia were further evaluated. Results: Of the total (215) participants, 86 (40%) were males and 129 (60%) were females, representing a ratio of 1:1.5. High total cholesterol was more prevalent in females (69.0%) than males (53.5%). Generally, dyslipidaemia was predominant among those aged >40 years, with the exception of increased LDL-c (25.1%), which was higher among the 20-40 years age group. The male participants exhibited significantly (p < 0.001) higher percentages of all combined measures of dyslipidaemia-such as high TG and reduced HDL-c (77.9%), high TG and elevated LDL-c (75.6%) and high LDL and low HDL (65.1%). BMI was significantly associated with HDL levels (p = 0.02), whereas family history of diabetes was associated with TC (p = 0.004) and TG levels (p = 0.019). Conclusion: Combined dyslipidaemia is relatively high among newly diagnosed T2DM patients in Ghana, and in those >40 years. Gender is significantly associated with combined dyslipidaemia in T2DM, and males may be at a higher risk than females. BMI and family history of diabetes are potential risk factors of dyslipidaemia in T2DM.
Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Dislipidemias/clasificación , Lípidos/análisis , Medición de Riesgo/normas , Adulto , Anciano , Algoritmos , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Femenino , Ghana/epidemiología , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/epidemiología , Lípidos/sangre , Masculino , Anamnesis , Persona de Mediana Edad , Prevalencia , Medición de Riesgo/métodos , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
PURPOSE OF REVIEW: DNA copy number variations (CNVs) are large-scale mutations that include deletions and duplications larger than 50âbp in size. In the era when single-nucleotide variations were the major focus of genetic technology and research, CNVs were largely overlooked. However, CNVs clearly underlie a substantial proportion of clinical disorders. Here, we update recent progress in identifying CNVs in dyslipidemias. RECENT FINDINGS: Until last year, only the LDLR and LPA genes were appreciated as loci within which clinically relevant CNVs contributed to familial hypercholesterolemia and variation in Lp(a) levels, respectively. Since 2017, next-generation sequencing panels have identified pathogenic CNVs in at least five more genes underlying dyslipidemias, including a PCSK9 whole-gene duplication in familial hypercholesterolemia; LPL, GPIHBP1, and APOC2 deletions in hypertriglyceridemia; and ABCA1 deletions in hypoalphalipoproteinemia. SUMMARY: CNVs are an important class of mutation that contribute to the molecular genetic heterogeneity underlying dyslipidemias. Clinical applications of next-generation sequencing technologies need to consider CNVs concurrently with familiar small-scale genetic variation, given the likely implications for improved diagnosis and treatment.
Asunto(s)
LDL-Colesterol/sangre , Variaciones en el Número de Copia de ADN , Dislipidemias/genética , Predisposición Genética a la Enfermedad , Proproteína Convertasa 9/genética , Receptores de LDL/genética , Receptores del Ácido Lisofosfatídico/genética , Transportador 1 de Casete de Unión a ATP/sangre , Transportador 1 de Casete de Unión a ATP/genética , Apolipoproteína C-II/sangre , Apolipoproteína C-II/genética , Biomarcadores/sangre , Biología Computacional/métodos , Dislipidemias/sangre , Dislipidemias/clasificación , Dislipidemias/diagnóstico , Expresión Génica , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Lipoproteína Lipasa/sangre , Lipoproteína Lipasa/genética , Mutación , Proproteína Convertasa 9/sangre , Receptores de LDL/sangre , Receptores de Lipoproteína/sangre , Receptores de Lipoproteína/genética , Receptores del Ácido Lisofosfatídico/sangreRESUMEN
RESUMO Objetivo: Avaliar a associação entre história familiar e presença de dislipidemias em crianças. Métodos: Estudo transversal com 257 crianças de 4 a 7 anos de idade do município de Viçosa, Minas Gerais. Foram realizadas avaliações do estado nutricional e do perfil lipídico (colesterol total e frações e triglicerídeos), além do registro de história de dislipidemia dos pais. Para análise estatística, foi utilizado o teste do qui-quadrado de Pearson para identificar associações e teste t de Student para comparação de médias. Foi realizada análise de regressão de Poisson para avaliar a associação independente entre história familiar e a presença de dislipidemia em crianças, sendo adotado o nível de significância estatística de 5%. Resultados: Crianças com pais dislipidêmicos apresentaram maiores concentrações séricas de colesterol total e triglicerídeos. Na análise de regressão após ajuste, a presença de dislipidemia no pai ou na mãe (RP: 2,43; IC95% 1,12-5,27) bem como a presença de dislipidemia no pai e na mãe (RP: 5,62; IC95% 2,27-13,92) estiveram associadas à hipertrigliceridemia nas crianças. Crianças com pais e mães dislipidêmicos apresentaram maior prevalência de lipoproteína de baixa densidade (LDL-c) elevada (RP: 1,52; IC95% 1,18-1,97). Conclusões: A investigação da história familiar de dislipidemia deve fazer parte de protocolos para verificar a presença de hipertrigliceridemia e dislipidemias na infância.
ABSTRACT Objective: To evaluate the association between family history and the presence of dyslipidemia in children. Methods: A cross-sectional study with 257 children aged 4 to 7 years old from Viçosa, Minas Gerais, Southeast Brazil. Nutritional status and lipid profile (total cholesterol, cholesterol fractions, and triglyceride) assessments and an active search for a family history of dyslipidemia in parents were carried out. Pearson's chi-square test was used to identify associations, and Student's t-test was used to compare means. A Poisson regression analysis was performed to assess the independent association between family history and the presence of dyslipidemia in children. A significance level of 5% was adopted. Results: Children of parents with dyslipidemia had higher serum concentrations of total cholesterol and triglycerides. In a regression analysis after adjustments, the presence of dyslipidemia in the father or in the mother (OR: 2.43; 95%CI 1.12-5.27), as well as the presence of dyslipidemia in both the father and the mother (OR: 5.62; 95%CI 2.27-13.92) were associated with hypertriglyceridemia in children. Children of parents with dyslipidemia had a higher prevalence of elevated low-density lipoproteins (LDL-c) (OR: 1.52; 95%CI 1.18-1.97). Conclusions: An investigation of the family history of dyslipidemia should be made as part of the protocol to verify the presence of hypertriglyceridemia and dyslipidemia in children.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adulto , Anamnesis/estadística & datos numéricos , Padres , Brasil/epidemiología , Índice de Masa Corporal , Estado Nutricional , Prevalencia , Estudios Transversales , Evaluación de Necesidades , Dislipidemias/clasificación , Dislipidemias/diagnóstico , Dislipidemias/sangre , Dislipidemias/epidemiología , Lípidos/sangreRESUMEN
OBJECTIVE: To evaluate the association between family history and the presence of dyslipidemia in children. METHODS: A cross-sectional study with 257 children aged 4 to 7 years old from Viçosa, Minas Gerais, Southeast Brazil. Nutritional status and lipid profile (total cholesterol, cholesterol fractions, and triglyceride) assessments and an active search for a family history of dyslipidemia in parents were carried out. Pearson's chi-square test was used to identify associations, and Student's t-test was used to compare means. A Poisson regression analysis was performed to assess the independent association between family history and the presence of dyslipidemia in children. A significance level of 5% was adopted. RESULTS: Children of parents with dyslipidemia had higher serum concentrations of total cholesterol and triglycerides. In a regression analysis after adjustments, the presence of dyslipidemia in the father or in the mother (OR: 2.43; 95%CI 1.12-5.27), as well as the presence of dyslipidemia in both the father and the mother (OR: 5.62; 95%CI 2.27-13.92) were associated with hypertriglyceridemia in children. Children of parents with dyslipidemia had a higher prevalence of elevated low-density lipoproteins (LDL-c) (OR: 1.52; 95%CI 1.18-1.97). CONCLUSIONS: An investigation of the family history of dyslipidemia should be made as part of the protocol to verify the presence of hypertriglyceridemia and dyslipidemia in children.
OBJETIVO: Avaliar a associação entre história familiar e presença de dislipidemias em crianças. MÉTODOS: Estudo transversal com 257 crianças de 4 a 7 anos de idade do município de Viçosa, Minas Gerais. Foram realizadas avaliações do estado nutricional e do perfil lipídico (colesterol total e frações e triglicerídeos), além do registro de história de dislipidemia dos pais. Para análise estatística, foi utilizado o teste do qui-quadrado de Pearson para identificar associações e teste t de Student para comparação de médias. Foi realizada análise de regressão de Poisson para avaliar a associação independente entre história familiar e a presença de dislipidemia em crianças, sendo adotado o nível de significância estatística de 5%. RESULTADOS: Crianças com pais dislipidêmicos apresentaram maiores concentrações séricas de colesterol total e triglicerídeos. Na análise de regressão após ajuste, a presença de dislipidemia no pai ou na mãe (RP: 2,43; IC95% 1,12-5,27) bem como a presença de dislipidemia no pai e na mãe (RP: 5,62; IC95% 2,27-13,92) estiveram associadas à hipertrigliceridemia nas crianças. Crianças com pais e mães dislipidêmicos apresentaram maior prevalência de lipoproteína de baixa densidade (LDL-c) elevada (RP: 1,52; IC95% 1,18-1,97). CONCLUSÕES: A investigação da história familiar de dislipidemia deve fazer parte de protocolos para verificar a presença de hipertrigliceridemia e dislipidemias na infância.
Asunto(s)
Dislipidemias , Anamnesis/estadística & datos numéricos , Adulto , Índice de Masa Corporal , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Dislipidemias/sangre , Dislipidemias/clasificación , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Femenino , Humanos , Lípidos/sangre , Masculino , Evaluación de Necesidades , Estado Nutricional , Padres , PrevalenciaRESUMEN
BACKGROUND: The association between cumulative metabolic syndrome (MS) factors and knee osteoarthritis (KOA) has been highlighted over the past two decades. AIMS: To clarify the relationship between cumulative MS factors and symptomatic KOA. METHODS: A cross-sectional survey involving 119 women aged 45-88 years who were scheduled to undergo knee surgery was conducted. They were stratified into tertiles of symptoms as assessed by the Japanese Orthopedic Association score for KOA. Multinomial logistic regressions were performed using the severity of symptomatic KOA as the dependent variable and each MS factor or the cumulative MS factors as the independent variables. RESULTS: Logistic regression analyses were performed with the upper tertile of stratified symptoms of subjects used as the reference group. After adjustment for confounders, KOA patients who had two (p = 0.004) or three or more (p < 0.0001) MS factors were significantly more likely to have severe symptoms compared to those who had no MS factors. MS factors excluding obesity were similarly analyzed. Even after additional adjustment for body mass index (BMI), KOA patients who had two or more (p = 0.005) MS factors were significantly more likely to have severe symptoms. CONCLUSION: Among KOA female patients diagnosed using radiographic definition, the severity of symptomatic KOA was significantly associated with hypertension, dyslipidemia, and the number of MS factors after adjustment for age, BMI, strength of the knee extensor, and Kellgren-Lawrence grade. The severity of radiographic KOA was not associated with any MS factor or cumulative MS factors.
Asunto(s)
Síndrome Metabólico/etiología , Osteoartritis de la Rodilla/complicaciones , Índice de Severidad de la Enfermedad , Anciano , Anciano de 80 o más Años , Glucemia/análisis , Índice de Masa Corporal , Estudios Transversales , Dislipidemias/clasificación , Femenino , Humanos , Hipertensión/clasificación , Hipertensión/etiología , Articulación de la Rodilla/diagnóstico por imagen , Modelos Logísticos , Síndrome Metabólico/clasificación , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Obesidad/clasificación , Obesidad/epidemiología , Osteoartritis de la Rodilla/clasificación , Osteoartritis de la Rodilla/diagnóstico por imagen , Radiografía , Estudios RetrospectivosRESUMEN
BACKGROUND: Ferritin is associated with various cardiometabolic risk factors such as dyslipidemia, hypertension, obesity, and insulin resistance in adults. We aimed to study the association between serum ferritin levels and dyslipidemia in adolescents, because dyslipidemia is considered an important modifiable cardiovascular risk factor in the young. METHODS: We analyzed 1,879 subjects (1,026 boys and 853 girls) from the 2009-2010 Korean National Health and Nutrition Examination Survey IV. Subjects were categorized into quartiles according to their lipid parameters, which were classified according to age and gender. Those in the highest quartile groups for total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride concentrations were diagnosed as having dyslipidemia. Those in the lowest quartile for high-density lipoprotein cholesterol (HDL-C) values were diagnosed with abnormal levels. RESULTS: In boys, total cholesterol, LDL-C, and triglyceride concentrations were significantly correlated with serum ferritin levels. In both boys and girls, serum ferritin levels were negatively associated with HDL-C values, even after adjusting for all covariates. Furthermore, there was no significant correlation between serum ferritin levels and total cholesterol, LDL, and triglyceride concentrations in girls. CONCLUSION: Serum ferritin levels were significantly associated with major dyslipidemia parameters, more prominently in boys than in girls, and this association represents a cardiometabolic risk factor.
Asunto(s)
Dislipidemias/sangre , Ferritinas/sangre , Adolescente , Niño , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Estudios Transversales , Dislipidemias/clasificación , Femenino , Humanos , Resistencia a la Insulina , Masculino , Encuestas Nutricionales , República de Corea , Factores de Riesgo , Triglicéridos/sangreRESUMEN
Objective To observe changing laws of syndrome types of Chinese medicine (CM) in dyslipidemia patients. Methods Totally 439 dyslipidemia patients were recruited. Their syndrome types of CM and blood lipids were.observed at the baseline (at the first visit) , 1st interview (at week 4), 2nd interview (at week 8), and 3rd interview (at week 12), respectively. Analyses of multilayer latent class analysis model were performed in the 4 interviews. Changes of syndrome types of CM were sum- marized as well. Results Asymptomatic patients accounted for 49. 7% of the total number (218/439) at the baseline. Among symptomatic patients, yin deficiency yang predominance syndrome occupied the top (28.2%, 124/439), and followed by sputum turbidity obstruction syndrome (13. 7%, 60/439). At 1st interview there were still 134 asymptomatic patients. Among symptomatic patients, yin deficiency yang predominance syndrome occupied the top (23. 5%, 103/439), and followed by sputum turbidity obstruc- tion syndrome (17. 3% , 76/439). And 70 patients were lost. At 2nd interview blood stasis phlegm stagna- tion syndrome (21. 4%, 79/369) and yin deficiency yang predominance syndrome (19. 5% , 72)369) were main syndrome types. And 64 patients were lost. At 3rd interview sputum turbidity obstruction syndrome (11. 8%, 36)305) and qi-yin deficiency syndrome (11. 1%, 34)305) were main syndrome types. And 50 patients were lost. Conclusions Syndrome types of CM in dyslipidemia patients showed changing and unstable state along with the prolongation of dyslipidemia. It was insufficient to take syndrome types of CM as main therapeutic indicators for clinical research on dyslipidemia.
Asunto(s)
Dislipidemias , Medicina Tradicional China , Deficiencia Yin , Yin-Yang , Dislipidemias/clasificación , Dislipidemias/diagnóstico , Humanos , SíndromeRESUMEN
Benefit of statin treatment is well established for secondary prevention. For primary prevention, good data exist to support use of statins in high-risk groups. Less data are available for intermediate risk group and very few patients at low risk have been included in clinical trials. In this context, an individual approach based on a risk stratification using PROCAM score adjusted for Switzerland is recommended. Lifestyle measures should be tried first. We also discuss the new American guidelines and their related controversies. Secondary causes and familiar forms of dyslipidemias, for which a risk assessment cannot be performed using risk scores (first cardiovascular event between age 20 and 60), should not be overlooked.
Asunto(s)
Dislipidemias/terapia , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , Dislipidemias/clasificación , Dislipidemias/diagnóstico , Humanos , Guías de Práctica Clínica como AsuntoRESUMEN
AIMS: To study dyslipidemia types in children with metabolic syndrome. MATERIALS AND METHODS: From 1520 children of total population 155 children aged from 9 to 18 years were selected, who formed 2 groups: 1 group--85 children with metabolic syndrome, 2 group--54 children with normal body mass. Anthropometry, blood pressure measurement, estimation of total cholesterol, low density cholesterol, very low density cholesterol, high density cholesterol, tryglicerides in blood were done. RESULTS: The total cholesterol level was 1,1 times higher (p = 0.001), low density cholesterol 1,4 times higher (p = 0.001), very low density cholesterol 1,1 times higher (p= 0.015), tryglicerides 1,1 times higher (p = 0.020) in children with metabolic syndrome than in children of control group. In children with metabolic syndrome sensitively more often IIa, IV dislipidemia types and isolated hypercholesterolemia and less often IIb, III dislipidemia types and high density cholesterol isolated decrease were diagnosed. So children with metabolic syndrome were characterized by atherogenic types of dislipidemias which determine early atherosclerosis development. Children with metabolic syndrome must be examined on the lipid metabolism violation with the aim of its prevention and correction.
Asunto(s)
Dislipidemias/clasificación , Dislipidemias/epidemiología , Síndrome Metabólico/sangre , Síndrome Metabólico/epidemiología , Adolescente , Antropometría , Niño , Colesterol/sangre , LDL-Colesterol/sangre , VLDL-Colesterol/sangre , Dislipidemias/sangre , Femenino , Humanos , Masculino , Obesidad/epidemiología , Triglicéridos/sangreRESUMEN
BACKGROUND: The beneficial effect of statins for cardiovascular disease (CVD) prevention has been well established. However, the effectiveness among different phenotypes of dyslipidemia has not been confirmed. OBJECTIVE: We evaluated the effect of pravastatin on the incidence of CVD in relation to the phenotype of dyslipidemia. METHODS: The MEGA Study evaluated the effect of low-dose pravastatin on primary prevention of CVD in 7832 Japanese patients, who were randomized to diet alone or diet plus pravastatin and followed for more than 5 years. These patients were classified into phenotype IIa (n=5589) and IIb (n=2041) based on the electrophoretic pattern for this post hoc analysis. RESULTS: In the diet group there was no significant difference in the incidence of coronary heart disease (CHD), stroke, CVD, and total mortality between the two phenotypes. Phenotype IIb patients, compared to phenotype IIa, had lower levels of high-density lipoprotein cholesterol (HDL-C) and a significantly higher incidence of CVD in relation to a low HDL-C level (<47.5mg/dL; p=0.02). Furthermore, pravastatin decreased the relative risk for each major endpoint in both type IIa and type IIb dyslipidemia. Significant risk reductions were observed for CHD by 38% (p=0.04) and CVD by 31% (p=0.02) in type IIa dyslipidemia but not in phenotype IIb. CONCLUSION: Pravastatin therapy provided significant risk reductions for CHD and CVD in patients with phenotype IIa dyslipidemia, but not in those with phenotype IIb dyslipidemia.
Asunto(s)
Anticolesterolemiantes/administración & dosificación , Enfermedades Cardiovasculares/prevención & control , Dislipidemias/tratamiento farmacológico , Dislipidemias/genética , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Fenotipo , Pravastatina/administración & dosificación , Análisis de Regresión , Conducta de Reducción del Riesgo , Adulto , Anciano , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , HDL-Colesterol , Dislipidemias/clasificación , Dislipidemias/complicaciones , Electroforesis , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de TiempoAsunto(s)
Enfermedades Cardiovasculares/sangre , Dislipidemias/sangre , Adolescente , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Niño , Dislipidemias/clasificación , Dislipidemias/complicaciones , Dislipidemias/fisiopatología , Humanos , Lipoproteínas HDL/sangre , Lipoproteínas LDL/sangre , Lipoproteínas VLDL/sangre , Factores de Riesgo , Triglicéridos/sangreRESUMEN
OBJECTIVE: To detect the impaired glucose metabolism in dyslipidemic patients and explore whether the type of dyslipidemia affects the type of impaired glucose metabolism. METHODS: In our study, 197 patients without diabetes or cardiovascular disease history were divided into 4 groups according to fasting serum lipid levels: hypercholesterolemic group (HCh group, 45 patients); hypertriglyceridemic group (HTG group, 46 patients); combined dyslipidemic group (58 patients) and control group (48 patients). Serum insulin and glucose levels were detected in fasting situation. HOMA-IR was calculated. And then the patients received 75 g oral glucose tolerance test (OGTT) and their GLU120 levels were detected. RESULTS: The GLU120 levels in HTG group [(10.5±3.2) mmol/L] and combined dyslipidemic group [(12.0±5.4) mmol/L] were significantly higher than those in control group [(8.7±3.5) mmol/L, P=0.045 and 0.024, respectively]. HTG group (39.1%) and combined dyslipidemic group (31.0%) also had higher impaired glucose tolerance (IGT) incidence ratios than those in control group (22.9%, P=0.009 and 0.014, respectively). In subgroup study of patients with fasting glucose levels below 6.1 mmol/L, the incidence ratios of IGT in HTG group and combined dyslipidemic group were 51.4% and 43.9%, respectively, which were significantly higher than those in control group (29.7%, P=0.009 and 0.015, respectively). CONCLUSION: There exists a definite ratio of undiscovered impaired glucose metabolism in dyslipidemic patients who have not suffered from cardiovascular disease, especially in hypertriglyceridemic and combined dyslipidemic group. OGTT is suggested to be brought into effect in order that impaired glucose metabolism would be detected in earlier stage.
Asunto(s)
Dislipidemias/clasificación , Intolerancia a la Glucosa/complicaciones , Trastornos del Metabolismo de la Glucosa/complicaciones , Hiperlipidemias/complicaciones , Anciano , Dislipidemias/sangre , Femenino , Intolerancia a la Glucosa/sangre , Trastornos del Metabolismo de la Glucosa/sangre , Prueba de Tolerancia a la Glucosa , Humanos , Hiperlipidemias/sangre , Hipertrigliceridemia/sangre , Hipertrigliceridemia/complicaciones , Masculino , Persona de Mediana EdadRESUMEN
Cardiovascular disease is the most prevalent cause of death in patients with chronic kidney disease (CKD), even at an early stage of the disease and is considered a coronary heart disease risk equivalent. Therefore, therapeutic efforts to control modifiable additional cardiovascular risk factors such as dyslipidemia in this population seems reasonable. Indeed, abnormalities of lipid metabolism are often encountered in patients with CKD, end stage renal disease or after kidney transplantation. In this review we will summarize the currently available data on etiology, epidemiology, and impact on cardiovascular morbidity in patients with CKD, renal pathologies like the nephrotic syndrome and after kidney transplantation and give a brief overview of the existing guidelines on treating dyslipidemia.
Asunto(s)
Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/fisiopatología , Dislipidemias/tratamiento farmacológico , Hipolipemiantes/uso terapéutico , Fallo Renal Crónico/complicaciones , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/prevención & control , Dislipidemias/clasificación , Humanos , Hipolipemiantes/clasificación , Hipolipemiantes/metabolismo , Fallo Renal Crónico/tratamiento farmacológico , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/terapia , Trasplante de Riñón , Factores de RiesgoRESUMEN
Clinical and epidemiological studies have established a significant correlation between abnormal plasma lipoprotein levels and cardiovascular disease, which remains the leading cause of mortality in the world today. In addition, lipoprotein dysregulation, known as dyslipidemia, is a central feature in disease states, such as diabetes and hypertension, which increases the risk of cardiovascular disease. While a corpus of literature exists on different areas of lipoprotein research, one of the major challenges that researchers face is the difficulties in accessing and integrating relevant information amidst massive quantities of heterogeneous data. Semantic web technologies, specifically ontologies, target these problems by providing an organizational framework of the concepts involved in a system of related instances to support systematic querying of information. In this paper, we identify issues within the lipoprotein research domain and present a preliminary framework for Lipoprotein Ontology, which consists of five specific areas of lipoprotein research: Classification, Metabolism, Pathophysiology, Etiology, and Treatment. By integrating specific aspects of lipoprotein research, Lipoprotein Ontology will provide the basis for the design of various applications to enable interoperability between research groups or software agents, as well as the development of tools for the diagnosis and treatment of dyslipidemia.
Asunto(s)
Lipoproteínas/clasificación , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Biología Computacional , Simulación por Computador , Dislipidemias/clasificación , Dislipidemias/etiología , Dislipidemias/fisiopatología , Dislipidemias/terapia , Humanos , Lipoproteínas/fisiología , Modelos Biológicos , Programas InformáticosRESUMEN
Cardiovascular diseases remain the most important cause of death worldwide. The situation in the Czech Republic is one of the best when compared to the other countries of the former socialist block; on the other hand, we significantly lack behind when the comparison is made to south and southwest European countries. The concept of risk factors (RF) and multifactorial character of atherosclerosis as the main cause of cardiovascular diseases (CVD) is fully accepted at present. Hyperlipoproteinaemia (HLP) and dyslipidemia (DLP) are a group of high incidence metabolic diseases characterised by increased levels of lipids and lipoproteins in plasma or, in case of DLP, by unsuitable, atherogenic composition of lipids and lipoproteins in plasma. HLP and DLP are among the most important RF for the development of CVD. Mainly LDL-cholesterol (LDL-C) is perceived as a very important risk factor; successful reduction of LDL-C is linked to a reduction in cardiovascular risk. Even when LDL-C is decreased and the so-called "target values" achieved, patients are still at risk ofa CV event. This remnant risk is the so called "residual risk". The most important "rival" to LDL-cholesterol among the risk factors is the metabolic syndrome, or rather the DLP associated with the metabolic syndrome, characterised from the perspective of DLP by low levels of HDL-cholesterol and increased triglycerides with concurrent occurrence of "small dense LDL". The issue of heterogeneity and atherogenicity oflipoprotein particles in general then becomes topical. Lipoprotein (a)--Lp(a) is another important lipid risk factor that is getting a significant attention.
Asunto(s)
Enfermedades Cardiovasculares/etiología , Dislipidemias , Hiperlipoproteinemias , Dislipidemias/sangre , Dislipidemias/clasificación , Dislipidemias/complicaciones , Dislipidemias/diagnóstico , Humanos , Hiperlipoproteinemias/sangre , Hiperlipoproteinemias/clasificación , Hiperlipoproteinemias/complicaciones , Hiperlipoproteinemias/diagnóstico , Lipoproteínas/sangre , Factores de RiesgoRESUMEN
La arterioesclerosis, es un proceso complejo y multifactorial que se inicia con la identificación de la estría lipídica a los 3 años de edad, lesión que progresa a placa fibrosa y lesión complicada en los años posteriores. La obesidad, es definida como una deposición excesiva de grasa en el cuerpo, que está asociado con consecuencias adversas para parámetros metabólicos, también consecuencias a corto y largo plazo y usualmente también con problemas psicosociales significativos y el desarrollo de enfermedades crónicas. Las dislipemias son uno conjunto de entidades que afectan al metabolismo lipídico y cuyos efectos nocivos son determinantes en el desarrollo del proceso de arteriosclerosis.
Atherosclerosis is a multifactorial complex process that begins with the identification of lipid streak at 3 years of age, injury progressing to fibrous plaque and complicated lesión in subsequent years. Obesity is defined as an excessive deposition of fat in the body, wich is associated with adverse metabolic parameters, also the short-and long-term and usually also with significant psychosocial problems and chronic disease development. The dyslipidemias are one set of entities that affect lipid metabolism and the harmful effects are crucial in the development of aterosclerosis process.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Arteriosclerosis/clasificación , Arteriosclerosis/diagnóstico , Arteriosclerosis/metabolismo , Obesidad/clasificación , Obesidad/diagnóstico , Obesidad/metabolismo , Dislipidemias/clasificación , Dislipidemias/diagnóstico , Dislipidemias/metabolismo , Metabolismo de los LípidosRESUMEN
Patterns of hypocholesterolemic lipid fractions in 295 patients with liver diseases, malignant tumors, arteriosclerotic and renal diseases with cholesterol (Chol) levels of <30 mg/dl were classified using a simultaneous analytical method for the Chol and triglyceride (TG) fractions (Chol/Trig Combo System). Hypocholesterolemia was classified as follows: IV, Type IV on WHO hyperlipidemia phenotype classification; intermediate density lipoprotein (IDL), cases with appearance of IDL, including appearance of Lp(a); high + low density lipoproteins (HDL+LDL), lipids mostly consisting of HDL and LDL fractions; HDL abnormality, cases with slow alphaHDL or fast HDL; abnormal LDL, both Chol and TG fractions mostly consisting of LDL fraction; normal type, ratios of HDL, very low density lipoproteins (VLD) and LDL fractions were almost normal; and low HDL, HDL-C was <30 mg/dl. Many patients with liver diseases had HDL+LDL (45%), and abnormal LDL was noted in 13% of the cases. In malignant tumors, the frequencies of low HDL, normal type, and HDL+LDL cases were similar (22-30%). In arteriosclerosis, normal type accounted for 46% of the cases, and the frequency of normal type was higher (60%) in renal diseases. Mortality rate (within 1 year after measurement) was then compared among lipid patterns. In liver diseases, mortality rate increased in the following order: abnormal LDL (55%); low HDL (31%); HDL abnormality (25%); and HDL+LDL (21%). No deaths were seen among patients with normal type. In malignant tumors, mortality rate was very high (88%) in patients with HDL+LDL, but low in patients with normal type (22%) and low HDL (9%). Mortality rate was low in patients with arteriosclerosis and renal diseases in the short-term follow-up period (1 year). In the comparisons of distribution, mean, and appearance rate of charge modification frequency (CMF) among lipid patterns, parameters were high in all patterns other than HDL+LDL. Classification of hypocholesterolemia lipid patterns and evaluation of CMF may therefore be clinically useful.