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BACKGROUND: In some epidemiological studies, blood lipids are determined at non-fasting state, which may impact cardiovascular risk estimation. The aim of this study was to evaluate postprandial LDL-C changes in men with newly diagnosed metabolic syndrome (MetSy). METHODS: 36 male patients were examined: 12 men with and 24 men without MetSy. The fat tolerance test was performed before and after a three-month hypolipidemic treatment. Serum lipids were measured using routine methods, lipid peroxides (LPO) colorimetrically, apolipoproteins A-I, B, and hsCRP immunoturbidimetrically. RESULTS: The postprandial increase in triglycerides was associated with a decrease in LDL-C and a small decrease in apo B. In men with MetSy, the mean change in LDL-C (-19.5 ± 2.3 mg/dl) was greater than in healthy men (-5.7 ± 3.8 mg/dl). All lipid changes (ΔTG, ΔLDL-C and ΔLPO) were linearly dependent on the postprandial non-LDL-cholesterol. After three months of hypolipidemic treatment, in all men with MetSy, the apoB/apoA-I ratio remained the same as before the therapy. CONCLUSION: In men diagnosed with MetSy, postprandial decreases in LDL-cholesterol may cause underestimation of cardiovascular risk. After three months of hypolipidemic treatment, there was only a partial reduction in this risk, as the apoB/apoA-I ratio remained the same.
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INTRODUCTION: Mechanisms underlying postprandial lipemia in various pathological states remain to be elucidated. OBJECTIVES: The aim of the study was to evaluate lipid homeostasis in men with type 2 diabetes mellitus (DM) after a standard meal. Moreover, the effect of short-term hypolipemic therapy on postprandial lipemia was assessed. PATIENTS AND METHODS: Twenty-six men with DM aged 53 +/-6.7 years, 27 patients with hyperlipemia and no DM (asymptomatic hyperlipemia - AH) and 60 normolipemic subjects aged 46 +/-11 years were included in the study. Treatment with simvastatin (20 mg/d) or fenofibrate (267 mg/d) was initiated in all DM patients due to fasting hyperlipemia, and in the AH group. Blood samples were drawn in the fasting state and 3 h after a meal at three time points, i.e. at baseline, after 6 and 12 weeks of treatment. Triglycerides (TG), glucose, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), HDL2-C, and HDL3-C were assayed by routine laboratory tests; apolipoproteins A and B by immunoturbidimetry, and high-sensitivity C-reactive protein (hsCRP) by immunonephelometry. RESULTS: In men with DM, changes in triglycerides induced by a meal (140 +/-68.0 mg/dl) were higher compared to normolipemic men (62.1 +/-52.5 mg/dl, p <0.001) or AH subjects (76.3 +/-80 mg/dl, p <0.05). There were no linear correlations between the levels of TG (or HDL cholesterol) and HDL3-C, or between TG and hsCRP in the DM group. Hypolipemic treatment decreased fasting lipid and hsCRP levels, significantly reduced postprandial lipemia (p <0.001) and restored some correlations between lipid variables observed in the control group, but not those with hsCRP. CONCLUSIONS: Type 2 DM is associated with increased postprandial lipemia and abnormal lipid homeostasis. Lipid intolerance detected in a postprandial lipemia test may be an indication for hypolipemic therapy.
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Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/metabolismo , Hiperlipidemias/tratamiento farmacológico , Hiperlipidemias/etiología , Hipolipemiantes/administración & dosificación , Lípidos/sangre , Periodo Posprandial , Adulto , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Quimioterapia Combinada , Femenino , Fenofibrato/administración & dosificación , Hemoglobina Glucada/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Simvastatina/administración & dosificación , Triglicéridos/sangreRESUMEN
BACKGROUND: Cardiovascular diseases are one of the most common causes of the prevalence and mortality in the general population. Progressing pollution of the environment, as well as occupational exposure to heavy metals, including lead, may potentially accelerate the development of these disorders. Lead is a well known risk factor of arterial hypertension, and may be involved in atherogenesis. The aim of this study was to assess the influence of occupational lead exposure on the activity of cardiovascular system (CVS). MATERIAL AND METHODS: The study group comprised 153 potentially healthy volunteers, working in a crystal glass foundry. They were examined using ultrasound assessment of carotid arteries, electrocardiograms and ankle-brachial index (ABI). The toxicological assessment of the study group for occupational lead poisoning was performed. Correlations between the degree of intoxication and functional changes in CVS were analyzed. RESULTS: A negative linear correlation between blood lead level or fluorethylenepropylene (FEP) concentration and ABI values was shown, but only in a subgroup with normal lipid pattern. In the persons with higher blood lead levels, the higher values of arterial blood pressure and longer QT-space in electrocardiogram were evidenced. In addition, the right bundle branch block was more frequently observed (in 23% of workers). CONCLUSIONS: Lead may be an independent risk factor of cardiovascular diseases, especially in workers with normal lipid parameters. An increased arterial blood pressure and a decreased ankle-brachial index in the persons with normal cholesterol level can be regarded as a marker of this risk.
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Enfermedades Cardiovasculares/epidemiología , Arterias Carótidas/diagnóstico por imagen , Monitoreo del Ambiente/estadística & datos numéricos , Intoxicación por Plomo/epidemiología , Trastornos del Metabolismo de los Lípidos/epidemiología , Enfermedades Profesionales/epidemiología , Adulto , Anciano , Índice Tobillo Braquial , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/diagnóstico por imagen , Causalidad , Industria Química , Comorbilidad , Contaminantes Ambientales/envenenamiento , Monitoreo Epidemiológico , Femenino , Vidrio , Humanos , Plomo/sangre , Trastornos del Metabolismo de los Lípidos/inducido químicamente , Trastornos del Metabolismo de los Lípidos/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/sangre , Enfermedades Profesionales/inducido químicamente , Polonia/epidemiología , UltrasonografíaRESUMEN
BACKGROUND: Neuropathy can be one of the symptoms of the toxic effect of lead on the nervous system. The aim of this work was to perform clinical and neurophysiological assessment of the peripheral nervous system in workers exposed to lead. MATERIALS AND METHODS: The study included 34 exposed workers and 20 healthy controls. Motor (ulnar, peroneal) and sensory (ulnar, sural) conduction velocity as well as conduction velocity distribution in ulnar n. and EMG from the I. interosseus muscle were assayed. The whole blood value of Pb 400 microg/l was adopted as a borderline between workers with low and increased blood lead concentrations. The FEP value of 70 microg/100 ml erythrocytes was the borderline between those without or with biochemical signs of Pb loading. The workers' age and duration of occupational exposure did not differ significantly between the study and control groups. RESULTS: None of the workers showed clinical signs of neuropathy or abnormalities in routine neurographic examination. As compared with controls, a significantly lowered conduction in slow-conducting motor fibers and neurogenic changes in EMG were observed in workers with the whole blood Pb concentration over 400 microg/l and in workers with FEP level over 70 tig/100 ml erythrocytes. CONCLUSION: Neurotoxic effect of Pb on peripheral nerves is manifested by the damage of slow-conducting motor nerves fibers when overt neuropathy is not yet visible.