Association of serum adipocyte fatty acid-binding protein and apolipoprotein B /apolipoprotein A1 ratio with intima media thickness of common carotid artery in dyslipidemic patients.

BACKGROUND: Diseases caused by atherosclerosis play the most important role in mortality and morbidity worldwide. Serum adipocyte fatty acid binding protein (A-FABP) seems to be a new promising marker to determine the risk of atherosclerosis. OBJECTIVE: The aim of this study was to evaluate relationships between serum A-FABP levels in studied individuals and to assess the possibility of modeling the intima media thickness of the common carotid artery (C-IMT) using A-FABP levels and other observed characteristics. METHODS: Seventy two Caucasian individuals were enrolled and divided into 3 groups: dyslipidemic patients with or without metabolic syndrome (MetS+, n=17; MetS-, n= 34) and controls (n=21). RESULTS: There was confirmed the well-established risk profile of individuals with MetS (unfavorable lipid and lipoprotein profile, as well as increased parameters of insulin resistence and C-IMT). A-FABP concentrations in this group were significantly higher in comparison with both MetS- and controls. CONCLUSION: Using multiple linear regression models of C-IMT values for all individual data, healthy controls and dyslipidemic patients without metabolic syndrome (MetS-) A-FABP levels were not revealed as an important predictor of C-IMT in our model. In contrast, age, gender, waist circumference, nonHDL cholesterol levels and ApoB/ApoA1 ratio were important repressors of C- IMT in study individuals. This finding may be attributed to the overwhelming effect of other more robust risk factors for atherosclerosis in these individuals.

Multianalyte Determination of NOACs Using LC-MS/MS and Comparison with Functional Coagulation Assays.

BACKGROUND: Detection of new oral anticoagulant (NOAC) levels by screening, special and global tests, and liquid chromatography-coupled tandem mass spectrometry (LC-MS/MS) is important in clinical situations when the cause of bleeding needs to be determined. METHODS: We compared a routine coagulation test, special function test for NOACs, global coagulation test, and an LC-MS/MS method that enables simultaneous determination of apixaban, dabigatran and rivaroxaban in human plasma within one analysis to determine the optimal indication of the comparison methods, including their limitations and interferences. RESULTS: This study was conducted on a set of blood samples from 116 patients treated with NOACs. The results of both specific dilute thrombin time (dTT) tests for dabigatran provided the same results as the activated partial thromboplastin time (aPTT) screening test in comparison with LC-MS/MS as a reference. The dTT assay HemosIL® showed better results for low concentrations when compared to LC-MS/MS than dTT HYPHEN® as HemosIL® uses a non-linear calibration curve. Results of the specific anti-Xa assay yielded better results than the prothrombin time test in comparison with LC-MS/MS as a reference, especially for apixaban, but also for rivaroxaban. Our LC MS/MS method is simply feasible, but only in a specialized laboratory. The method is easy-to-use for the simultaneous determination of all dabigatran, apixaban and rivaroxaban by LC-MS/MS within three minutes with a concentration range of 1 to 500 µg/L without dilution. CONCLUSIONS: In the normal practice of the coagulation laboratory, it is advisable to use specific tests for NOAC determination as screening and global assays are not sufficiently specific. The dTT test is the optimal choice for dabigatran determination and for xabans to determine anti-Xa activity. The LC-MS/MS method is suitable as an arbitration method for serious conditions.

The introduction of simple cardiorespiratory fitness testing in overweight/obese type 2 diabetics: a pilot study.

BACKGROUND: Low level of cardiorespiratory fitness has been recognized as an important independent and modifiable risk factor of increased morbidity and mortality. However, in standard outpatient settings, patients are not routinely screened for fitness and advantages of such testing for the management of type 2 diabetes have not been defined.AimTo describe the toleration of a fast, simple and practicable fitness test (2-min step-in-place test) by overweight/obese type 2 diabetics and their performance indicated by 2-min step-in-place test score (STS). To study short-term anthropometric, functional and metabolic changes following the implementation of the test in the selected population. METHODS: A total of 33 overweight/obese type 2 diabetics underwent, besides routine examination at the outpatient clinic, the fitness test (group A). Patients were asked to increase their regular physical activity with focus on walking without change in diet and chronic medication. Three to four months later, the subjects were tested again. An identical number of age- and sex-matched obese diabetics followed in our outpatient clinic (without fitness testing), was randomly selected from the Hospital Information System (control group B).FindingsAll patients subjected to fitness testing completed the protocol successfully. STS score was found to have a considerable range with differences between males and females at the borderline of statistical significance. The data are compliant with lower aerobic endurance of obese diabetics compared with healthy population. Within study period, the tested group presented with improvements in STS (referring especially to the males) as well as in several laboratory parameters of glucose and lipid homeostasis, glomerular function and subclinical inflammation with no reflection in anthropometry. Group B demonstrated no significant change. In conclusion, 2-min step-in-place test is fast, undemanding and well-tolerated by patients and personnel. Following its validation based on cardiopulmonary exercise testing, the test may prove recommendable for screening or self-monitoring purposes.

Apolipoprotein B versus LDL-cholesterol: Association with other risk factors for atherosclerosis.

OBJECTIVE: To characterize the differences in various risk factors for atherosclerosis between individuals with apoB higher (H) and lower (L) than predicted from regression equation apoB vs LDL-C. METHODS: We evaluated 391 dyslipidemic subjects not treated with hypolipidemic drugs. The measured parameters included lipid profile, apolipoproteins A-1 and B, markers of insulin resistance and inflammation/hemostasis. RESULTS: Correlation coefficient between apoB and LDL-C was 0.9 (p<0.0001). Individuals with H apoB compared to L apoB had significantly higher sex and age adjusted BMI, waist circumference, insulin, HOMA (fasting insulinglucose/22.5), C-peptide, proinsulin, PAI-1, sICAM-1, sVCAM-1, t-PA, vWF, frequency of metabolic syndrome and lower values of TC, LDL-C and HDL-C (p<0.05 to <0.001 for all parameters). CONCLUSION: Individuals with apoB higher than predicted by their LDL-C levels are more insulin resistant and have more atherogenic risk profile. Thus, at least for dyslipidemic patients with high cardiometabolic risk, apoB is a more appropriate marker of risk than LDL-C.

Positive association of adiponectin with soluble vascular cell adhesion molecule sVCAM-1 levels in patients with vascular disease or dyslipidemia.

The aim of our study was to evaluate the relationship of adiponectin to soluble forms of vascular cell adhesion molecule-1 (sVCAM-1) and intercellular cell adhesion molecule-1 (sICAM-1) in patients with cardiovascular disease or dyslipidemia. Two hundred and sixty-four patients (134 men/130 women, mean age 43.8+/-14.8/46.0+/-14.9 years) of Lipid Center, University Hospital Olomouc, off hypolipidemic therapy for at least 6 weeks, participated in the study. In multiple regression analysis, adiponectin was independently positively associated with serum HDL-cholesterol (p<0.0001) and sVCAM-1 (p<0.0001), female gender (p<0.0001) and negatively with hs-CRP (p=0.014). Serum concentration of adiponectin and sICAM-1 did not correlate but sICAM-1 was independently, positively associated with sVCAM-1 (p<0.0001) and negatively with markers of insulin resistance and inflammation, namely atherogenic index log[triglycerides/HDL-cholesterol] (p<0.0001), hs-CRP (p<0.001) and HOMA (p<0.05). Positive association of adiponectin with HDL-C and negative association with hs-CRP indicate anti-atherogenic properties of adiponectin. The finding of the positive association of adiponectin with sVCAM-1 in patients at risk is unexpected. We hypothesize that adiponectin may be involved (directly or indirectly) in shedding of ectodomains of VCAM-1 from endothelial surface and in this way down-regulates their effects. This process may be protective in the initial stages of atherosclerosis.