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1.
N Engl J Med ; 382(3): 244-255, 2020 01 16.
Artículo en Inglés | MEDLINE | ID: mdl-31893580

RESUMEN

BACKGROUND: Lipoprotein(a) levels are genetically determined and, when elevated, are a risk factor for cardiovascular disease and aortic stenosis. There are no approved pharmacologic therapies to lower lipoprotein(a) levels. METHODS: We conducted a randomized, double-blind, placebo-controlled, dose-ranging trial involving 286 patients with established cardiovascular disease and screening lipoprotein(a) levels of at least 60 mg per deciliter (150 nmol per liter). Patients received the hepatocyte-directed antisense oligonucleotide AKCEA-APO(a)-LRx, referred to here as APO(a)-LRx (20, 40, or 60 mg every 4 weeks; 20 mg every 2 weeks; or 20 mg every week), or saline placebo subcutaneously for 6 to 12 months. The lipoprotein(a) level was measured with an isoform-independent assay. The primary end point was the percent change in lipoprotein(a) level from baseline to month 6 of exposure (week 25 in the groups that received monthly doses and week 27 in the groups that received more frequent doses). RESULTS: The median baseline lipoprotein(a) levels in the six groups ranged from 204.5 to 246.6 nmol per liter. Administration of APO(a)-LRx resulted in dose-dependent decreases in lipoprotein(a) levels, with mean percent decreases of 35% at a dose of 20 mg every 4 weeks, 56% at 40 mg every 4 weeks, 58% at 20 mg every 2 weeks, 72% at 60 mg every 4 weeks, and 80% at 20 mg every week, as compared with 6% with placebo (P values for the comparison with placebo ranged from 0.003 to <0.001). There were no significant differences between any APO(a)-LRx dose and placebo with respect to platelet counts, liver and renal measures, or influenza-like symptoms. The most common adverse events were injection-site reactions. CONCLUSIONS: APO(a)-LRx reduced lipoprotein(a) levels in a dose-dependent manner in patients who had elevated lipoprotein(a) levels and established cardiovascular disease. (Funded by Akcea Therapeutics; ClinicalTrials.gov number, NCT03070782.).


Asunto(s)
Enfermedades Cardiovasculares/tratamiento farmacológico , Hipolipemiantes/administración & dosificación , Lipoproteína(a)/sangre , Oligonucleótidos/administración & dosificación , Adulto , Anciano , Enfermedades Cardiovasculares/sangre , Colesterol/sangre , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Hipolipemiantes/efectos adversos , Hipolipemiantes/uso terapéutico , Análisis de los Mínimos Cuadrados , Masculino , Persona de Mediana Edad , Oligonucleótidos/efectos adversos , Factores de Riesgo
2.
J Zoo Wildl Med ; 50(4): 927-936, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31926525

RESUMEN

Seabirds have been widely used for monitoring the health of the oceans in diverse marine regions. Among low-cost survey strategies, systematic surveys of seabirds beached on coasts have been developed since the 20th century. However, these studies do not always address blood aspects. The assessment of the health status of birds based on the analysis of hematological and plasma chemistry is crucial to evaluate the overall health status profile of live organisms. Here, the authors study the variability of blood parameters by sex, age class, and year of beached Magellanic Penguin during the nonreproductive period in northern Argentina. Of 44 penguins, 77% were categorized as younger juveniles and the rest as older juveniles, and were captured and studied in coastal areas of Buenos Aires Province during the summers of 2017 and 2018. The mean body weight of beached penguins was affected by the age class of the individuals; most of the younger juveniles showed poor condition in terms of body mass (1,761 ± 235 g). No significant differences were observed in body weight between years and sex. Still, there were significant differences between years for alkaline phosphatase (ALP) and creatine phosphokinase (CPK) values. Twelve of the 20 blood parameters analyzed differ significantly with the age class of the beached penguins; younger juveniles were in a state of inanition. Our results may serve as a necessary first step in improving the conservation status of the Magellanic Penguin in nonbreeding grounds of Argentina, and call for a better knowledge of the health status of the species along its annual cycle.


Asunto(s)
Recuento de Eritrocitos/veterinaria , Hematócrito , Recuento de Leucocitos/veterinaria , Estaciones del Año , Spheniscidae/sangre , Envejecimiento , Fosfatasa Alcalina/sangre , Animales , Animales Salvajes , Anticuerpos Heterófilos , Argentina , Glucemia , Proteínas Sanguíneas , Colesterol/sangre , Creatina Quinasa/sangre , Femenino , Hemoglobinas , Recuento de Linfocitos/veterinaria , Masculino , Fósforo/sangre , Transaminasas/sangre , Urea/sangre , Ácido Úrico/sangre
3.
Clin Sci (Lond) ; 134(2): 273-287, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31957803

RESUMEN

The current main treatment for coronary artery disease (CAD) is to reduce low-density lipoprotein cholesterol (LDL-C) by statins, which could decrease the incidence of major adverse cardiovascular events (MACEs) by 30%. However, many residual risks still remain. To clarify the mechanism involved, we studied patients with acute myocardial infarction (AMI) with low LDL-C levels. Lymphocytes were isolated, and it was found that despite no difference in plasma LDL-C level, the lymphocyte cholesterol content was higher in AMI patient than those in non-CAD patients; thus, the decrease in intracellular cholesterol content was inconsistent with that in the plasma. Additionally, [3H]-cholesterol efflux rates were lower and mRNA levels of the inflammatory factors tumour necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) higher in AMI lymphocytes. It was found that sulphotransferase 2B1b (SULT2B1b) expression was higher in AMI lymphocytes. Further research using Jurkat T lymphocytes confirmed that SULT2B1b knockdown increased cholesterol efflux capacity and decreased mRNA levels of TNF-α and IFN-γ by increasing liver X receptor (LXR)-ß levels. Furthermore, the degree of CpG island methylation in the SULT2B1b promoter was reduced in cells from AMI patients. In conclusion, SULT2B1b up-regulation due to hypomethylation of its promoter promotes cholesterol accumulation and inflammation by inhibiting LXR-ß in lymphocytes of AMI patients with low LDL-C levels. Therefore, reducing intracellular cholesterol is also important as plasma cholesterol levels. Therapeutic approaches to decrease SULT2B1b expression might be potentially beneficial for CAD prevention by decreasing intracellular cholesterol.


Asunto(s)
Colesterol/metabolismo , Interferón gamma/metabolismo , Linfocitos/metabolismo , Sulfotransferasas/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Transporte Biológico , Colesterol/sangre , LDL-Colesterol/metabolismo , Enfermedad de la Arteria Coronaria/genética , Enfermedad de la Arteria Coronaria/metabolismo , Enfermedad de la Arteria Coronaria/prevención & control , Metilación de ADN , Humanos , Mediadores de Inflamación/metabolismo , Interferón gamma/genética , Células Jurkat , Receptores X del Hígado/genética , Receptores X del Hígado/metabolismo , Infarto del Miocardio/genética , Infarto del Miocardio/metabolismo , Infarto del Miocardio/prevención & control , Regiones Promotoras Genéticas/genética , Sulfotransferasas/genética , Factor de Necrosis Tumoral alfa/genética
4.
Zhonghua Nei Ke Za Zhi ; 59(1): 18-22, 2020 Jan 01.
Artículo en Chino | MEDLINE | ID: mdl-31887831

RESUMEN

The prevalence of dyslipidemia in Chinese adult is increasing dramatically, which poses a severe challenge to the prevention and treatment of atherosclerotic cardiovascular diseases. In recent years, a series of new research results have been published, providing a lot of new information for the management strategy of dyslipidemia. In order to apply these new research results to clinical practice for the further prevention and treatment of dyslipidemia more reasonably and effectively, the China Cholesterol Education Program (CCEP) Working Committee organized joint expert meeting and revised the "Expert Advice on Prevention and Treatment of Dyslipidemia in China Cholesterol Education Program 2014", in which a new classification standard for cardiovascular risk stratification has been proposed, and the target value of lipid-lowering therapy has been updated.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Colesterol/sangre , Dislipidemias , Guías de Práctica Clínica como Asunto , Adulto , China , Dislipidemias/prevención & control , Dislipidemias/terapia , Humanos , Factores de Riesgo
5.
Gene ; 7242020 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-30898706

RESUMEN

AIM: The long noncoding RNAs (lncRNAs) have gradually been reported to be an important class of RNAs with pivotal roles in the development and progression of myocardial infarction (MI). In this study, we hypothesized that genetic variant of cyclin-dependent kinase inhibitor 2B antisense RNA (ANRIL) and metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) may affect the prognosis of MI patients. METHODS: The study included 401 Han Chinese MI patients and 409 controls. Four lncRNA tag single nucleotide polymorphisms (SNPs)-ANRIL rs9632884 and rs1537373, MALAT1 rs619586 and rs3200401-were selected. SNP genotyping was performed by an improved multiplex ligation detection reaction assay. RESULTS: rs9632884 and rs3200401 SNPs were significantly associated with lipid levels in both controls and MI patients (P < 0.003-0.046). Several SNPs interacted with sex and age to modify total cholesterol, low-density lipoprotein cholesterol, and creatinine levels to modify the risk of MI. No association between the lncRNAs SNPs and susceptibility to MI was found (P > 0.05 for all). CONCLUSIONS: Taken together, this study provides additional evidence that genetic variation of the ANRIL rs9632884 and MALAT1 rs3200401 can mediate lipid levels in MI patients.


Asunto(s)
Colesterol/sangre , Infarto del Miocardio/genética , ARN Largo no Codificante/genética , Triglicéridos/sangre , Anciano , Grupo de Ascendencia Continental Asiática/genética , Estudios de Casos y Controles , Colesterol/genética , Enfermedad de la Arteria Coronaria/genética , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Hipertensión/genética , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Polimorfismo de Nucleótido Simple , Fumar/genética , Triglicéridos/genética
6.
J Sci Food Agric ; 100(2): 705-713, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-31599967

RESUMEN

BACKGROUND: Despite the growing importance of probiotics apparent health benefits, an impediment to the use of new probiotic cultures is their safety. Hence there is a need to strictly examine the biosafety as well as health benefits of probiotics in in vivo model systems. RESULTS: In this study, two lactic acid bacterial (LAB) cultures Lactobacillus fermentum NCMR 2826 and FIX proven for their in vitro probiotic properties were investigated for their in vivo safety in Wistar rats. An acute toxicity study (14 days) with a high dose of biomass (1016 colony-forming units (CFU) mL-1 ) followed by a subchronic test for 13 weeks with oral feeding of the probiotic cultures in three different doses (107 , 108 and 1010 CFU mL-1 ) on a daily basis revealed the safety of the L. fermentum cultures. The probiotic feeding had no toxic effects on survival, body weight and food consumption with any of the dosages used throughout the treatment period. No statistically significant changes in relative organ weights and serum biochemical and hematological indices were found between the control and the probiotic fed animals. In addition to the safety attributes, the L. fermentum culture fed rats showed reduced serum cholesterol levels, macrovesicular steatosis and hepatocyte ballooning compared with control animals. Further, quantification of intestinal microbiota using real-time polymerase chain reaction (PCR) analysis from animal feces indicated a significant increase and stability of Lactobacillus and Bifidobacterium counts but a decrease of Escherichia coli numbers. CONCLUSION: This study of safety and beneficial features highlights the use of the two native L. fermentum isolates as potential probiotic food supplements. © 2019 Society of Chemical Industry.


Asunto(s)
Anticolesterolemiantes/administración & dosificación , Colesterol/metabolismo , Microbioma Gastrointestinal/efectos de los fármacos , Lactobacillus fermentum/metabolismo , Probióticos/administración & dosificación , Animales , Anticolesterolemiantes/metabolismo , Bacterias/clasificación , Bacterias/efectos de los fármacos , Bacterias/genética , Bacterias/aislamiento & purificación , Colesterol/sangre , Intestinos/efectos de los fármacos , Intestinos/microbiología , Lactobacillus fermentum/crecimiento & desarrollo , Masculino , Probióticos/metabolismo , Ratas , Ratas Wistar
7.
An Bras Dermatol ; 94(6): 691-697, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31789271

RESUMEN

BACKGROUND: Different strategies have been proposed for the cardiovascular risk management of patients with psoriasis. OBJECTIVE: To estimate the cardiovascular risk and evaluate two cardiovascular prevention strategies in patients with psoriasis, analyzing which proportion of patients would be candidates to receive statin therapy. METHODS: A retrospective cohort was selected from a secondary database. All patients >18 years with psoriasis without cardiovascular disease or lipid-lowering treatment were included. The atherosclerotic cardiovascular disease calculator (2018 American College of Cardiology/American Heart Association guidelines) and the Systematic Coronary Risk Evaluation risk calculator (2016 European Society of Cardiology/European Society of Atherosclerosis guidelines) were calculated. The SCORE risk value was adjusted by a multiplication factor of 1.5. The recommendations for the indication of statins suggested by both guidelines were analyzed. RESULTS: A total of 892 patients (mean age 59.9±16.5 years, 54.5% women) were included. The median atherosclerotic cardiovascular disease calculator and Systematic Coronary Risk Evaluation values were 13.4% (IQR 6.1-27.0%) and 1.9% (IQR 0.4-5.2), respectively. According to the atherosclerotic cardiovascular disease calculator, 20.1%, 11.0%, 32.9%, and 36.4% of the population was classified at low, borderline, moderate, or high risk. Applying the Systematic Coronary Risk Evaluation, 26.5%, 42.9%, 20.8%, and 9.8% of patients were stratified as having low, moderate, high, or very high risk, respectively. The proportion of subjects with statin indication was similar using both strategies: 60.1% and 60.9% for the 2018 American College of Cardiology/American Heart Association and 2016 European Society of Cardiology/European Society of Atherosclerosis guidelines, respectively. STUDY LIMITATIONS: This was a secondary database study. Data on the severity of psoriasis and pharmacological treatments were not included in the analysis. CONCLUSION: This population with psoriasis was mostly classified at moderate-high risk and the statin therapy indication was similar when applying the two strategies evaluated.


Asunto(s)
Anticolesterolemiantes/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Psoriasis/prevención & control , Adulto , Anciano , Enfermedades Cardiovasculares/etiología , Colesterol/sangre , Complicaciones de la Diabetes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Psoriasis/complicaciones , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Triglicéridos/sangre
8.
Zhonghua Nei Ke Za Zhi ; 58(11): 823-825, 2019 Nov 01.
Artículo en Chino | MEDLINE | ID: mdl-31665858

RESUMEN

This study was aimed to investigate the association between dyslipidemia and thyroid associated ophthalmopathy (TAO). We evaluated the relationship between dyslipidemia and TAO in 218 patients with Graves' disease (GD) and found that the serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in the GD subjects with TAO (n=110) were significantly increased [(5.32±1.39) mmol/L vs. (3.18±2.12) mmol/L, (2.98±0.75) mmol/L vs. (1.25±0.98) mmol/L] than those in the GD subjects without TAO (n=108). TC and LDL-C were positively correlated with the Clinical disease activity score (CAS) [TC (r=0.7, P=0.03),LDL-C (r=0.82, P=0.03)], and the levels of TC (OR=2.56, P=0.02) and LDL-C(OR=2.01, P=0.015) were positively associated with TAO. These suggested that high serum cholesterol level is a novel risk factor for TAO, and management of blood lipids should be included in the treatment of TAO.


Asunto(s)
Colesterol/sangre , Oftalmopatía de Graves/diagnóstico , Hipercolesterolemia/diagnóstico , LDL-Colesterol , Oftalmopatía de Graves/sangre , Humanos , Hipercolesterolemia/sangre , Factores de Riesgo
9.
Biomed Khim ; 65(5): 403-406, 2019 Aug.
Artículo en Ruso | MEDLINE | ID: mdl-31666413

RESUMEN

An imidazole derivative cramizol, has lipid-lowering and anti-atherogenic effects. Cramizol reduces blood levels of cholesterol and triglycerides, and also reduces the atherogenic index in animals with acute hyperlipidemia induced by Triton WR-1339. Cramizol and the lipid-lowering drug fenofibrate exhibited similar effectiveness as hypolipidemic agents. Cramizol also restores the expression of the Apoa1 gene in rats with experimentally induced hyperlipidemia to normal values. This may be a basis of its hypolipidemic and anti-atherogenic action.


Asunto(s)
Apolipoproteína A-I/genética , Hiperlipidemias/tratamiento farmacológico , Hipolipemiantes/farmacología , Imidazoles/farmacología , Animales , Colesterol/sangre , Fenofibrato , Hiperlipidemias/genética , Ratas , Triglicéridos/sangre
10.
Methodist Debakey Cardiovasc J ; 15(3): 192-199, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31687098

RESUMEN

The extract of red yeast rice (RYR) is the most effective cholesterol-lowering nutraceutical on the market. In particular, its effectiveness is directly related to the amount of monacolin K within the extract (up to 10 mg/day). Consuming monacolin K on a daily basis reduces low-density lipoprotein (LDL) cholesterol plasma levels between 15% and 25% within 6 to 8 weeks. Certainly, the decrease in LDL-cholesterol is accompanied by a similar reduction in total cholesterol, non-high-density lipoprotein cholesterol, plasma apolipoprotein B, matrix metalloproteinases 2 and 9, and high-sensitivity C-reactive protein. Furthermore, the RYR lipid-lowering effect is associated with significant improvements in pulse wave velocity and endothelial function, which are validated and reliable biomarker tools able to detect vascular aging. Although it has a mechanism of action similar to statins, a daily consumption of between 3 and 10 mg monacolin K has only minimal associated risks, and mild myalgias are seen only in the frailest patients (those who also cannot tolerate minimal dosages of statin). The monacolin K found in RYR is a safe and effective supplement for managing mild to moderate hypercholesterolemia in people with no additional cardiovascular risk factors.


Asunto(s)
Productos Biológicos/uso terapéutico , Colesterol/sangre , Suplementos Dietéticos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Hipercolesterolemia/tratamiento farmacológico , Lovastatina/uso terapéutico , Animales , Productos Biológicos/efectos adversos , Biomarcadores/sangre , Suplementos Dietéticos/efectos adversos , Regulación hacia Abajo , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Hipercolesterolemia/sangre , Hipercolesterolemia/diagnóstico , Lovastatina/efectos adversos , Resultado del Tratamiento
11.
Prog Cardiovasc Dis ; 62(5): 375-383, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31733217

RESUMEN

The authors review more than three decades of progress in providing clinicians and patients with guidance on risk assessment, patient evaluation and cholesterol management. Beginning with the National Cholesterol Education Program's Initial Adult Treatment Panel report, the cholesterol guidelines increasingly reflect the progress made in understanding the benefits of improved lifestyle and nutrition to improve lipid profiles, major risk factors and reduce ASCVD risk. Moreover, they now provide qualitative and quantitative assessment tools to guide appropriate risk reduction LDL-C lowering therapy. Use of the Pooled Cohort Equations to determine Low, Borderline, Intermediate and High 10-year ASCVD risk is now joined by recognition of conditions and biomarkers that enhance ASCVD risk. This personalizes the risk discussion for the patient. An important addition is the selective use of coronary artery calcium (CAC) scoring to reclassify risk in patients at borderline or intermediate risk, but for whom a risk decision regarding statin therapy is uncertain. In secondary prevention, current guidelines provide criteria for determining a "very high" risk group in whom risk is especially high and in whom aggressive LDL-C lowering can be shown to provide increased absolute benefit. Current guidelines provide a comprehensive look at children and adolescents, young adults, elderly, women and issues specific to women through the life course. They provide guidance for those adults at risk due to severe hypercholesterolemia, persistent hypertriglyceridemia after secondary causes have been addressed, those with inflammatory disorders and HIV, those adults with chronic kidney disease, and those affected by issues of race/ethnicity. They conclude with a brief summary of recommendations emphasizing important concepts for providing safety with LDL-C lowering therapy. This combination of best external evidence and clinical expertise from the expert panel should provide a solid foundation for lipid management of patients at risk for or with clinical ASCVD.


Asunto(s)
Anticolesterolemiantes/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , Colesterol/sangre , Dislipidemias/tratamiento farmacológico , Medicina Basada en la Evidencia , Guías de Práctica Clínica como Asunto , Anticolesterolemiantes/efectos adversos , Biomarcadores/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Difusión de Innovaciones , Dislipidemias/sangre , Dislipidemias/epidemiología , Dislipidemias/historia , Medicina Basada en la Evidencia/historia , Medicina Basada en la Evidencia/tendencias , Predicción , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Factores Protectores , Factores de Riesgo , Resultado del Tratamiento
13.
Medicine (Baltimore) ; 98(48): e18065, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31770223

RESUMEN

Previous studies have indicated that muscle RAS oncogene homolog (MRAS) gene played an important role in cardiovascular diseases. However, the effect of MRAS genetic variations on ischemic stroke (IS) is still not clear. The aim of the current study was to investigate the association between the MRAS polymorphism and IS risk in Han populations.Three SNPs (rs40593, rs751357, rs6782181) at MRAS were selected for genotyping in a sample of 240 IS patients and 430 controls. Logistic regression was performed to evaluate the association of 3 SNPs with IS and IS subgroups.No association of MRAS SNPs with IS risk was observed, while G allele of rs40593 was associated with increased risk of cerebral infarction area. Compared with carriers of the AA genotype, the risk of carriers of the AG+GG genotype increased, with an OR (95%CI) of 2.337 (1.175-4.647), P = .016. In relation to lipid profile, rs40593, rs751357, rs6782181 were associated with increased total cholesterol (TC) levels.Summarily, this study suggested that MRAS rs40593 may contribute to the increased risk of area of cerebral infarction of IS in Han population. rs40593, rs751357, and rs6782181 were associated with higher serum TC levels.


Asunto(s)
Grupo de Ascendencia Continental Asiática/genética , Isquemia Encefálica/genética , Colesterol/sangre , Accidente Cerebrovascular/genética , Proteínas ras/genética , Adulto , Alelos , Isquemia Encefálica/sangre , China , Grupos Étnicos/genética , Femenino , Genotipo , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Accidente Cerebrovascular/sangre , Adulto Joven
14.
Prog Cardiovasc Dis ; 62(5): 384-389, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31669499

RESUMEN

The 2018 AHA/ACC cholesterol guideline builds on the 2013 ACC/AHA cholesterol guideline statin recommendations to provide more detailed recommendations for the use of nonstatin therapy risk stratification for primary prevention statin use. New information has become available after the development of the 2018 AHA/ACC cholesterol guideline that can further inform clinical practice. Proprotein convertase subtilisin kexin type-9 (PCSK9) monoclonal antibodies are now a reasonable or even good value following over 60% reductions in their acquisition price, and the identification of high risk patient groups most likely to benefit from further low-density lipoprotein cholesterol (LDL-C) lowering. Meta-analyses and clinical trial data now show that patients with LDL-C ≥ 100 mg/dl are more likely to experience progressively greater reductions in the risk of cardiovascular and total mortality and coronary heart disease events for progressively higher LDL-C levels. Icosapent ethyl, a highly concentrated form of modified EPA has been shown to reduce cardiovascular events in high risk patients with moderate hypertriglyceridemia on statin therapy. Comparisons with other statin guidelines revealed that statin initiation for those with ≥7.5% 10-year atherosclerotic cardiovascular disease (ASCVD) risk is the most effective strategy for reducing the most ASCVD events for the proportion of the population treated. Data from younger populations finally became available for coronary artery calcium (CAC) scoring (mean age of 51 years) which confirmed the value of CAC > 0 for identifying individuals at increased ASCVD risk most likely to benefit from statin initiation. This analysis also found that statins could keep CAC = 0 in those with risk factors. Epidemiologic pooling studies now clearly show that LDL-C and non-high-density lipoprotein cholesterol levels in young adulthood confer excess risk for ASCVD later in life. Accumulating data support earlier risk factor intervention trials as the next research priority.


Asunto(s)
Anticolesterolemiantes/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , Colesterol/sangre , Dislipidemias/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Anticolesterolemiantes/efectos adversos , Biomarcadores/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Humanos , Factores Protectores , Factores de Riesgo , Resultado del Tratamiento
15.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 619-621, 2019 Jul.
Artículo en Chino | MEDLINE | ID: mdl-31642246

RESUMEN

OBJECTIVE: To explore the serum homocysteine (Hcy) level and its influence factors in systemic lupus erythematosus (SLE) patients. METHODS: 90 SLE patients were included in the study. According to the systemic lupus erythematosus disease activity index (SLEDAI) score, 41 patients were in active stage (> 9 scores), 49 patients were in inactive stage (≤9 scores), while 46 healthy individuals were selected as controls. Total cholesterol (TC), triacylglyceride (TG), serum creatinine (Ser), C-reactive protein (CRP), serum cystatin (cystin c, CysC) and Hcy level were measured. Analysis on the relationship between Hcy level and SLEDAI score, as well as serum indicators was conducted. RESULTS: The levels of Hcy, TG, TC, CRP and CysC in SLE patients were higher than healthy controls (P < 0.05), and the serum level in active SLE patients was higher than inactive SLE patients (P < 0.05). There was no significant difference in Ser level among the active SLE patients, inactive SLE patients and healthy controls (P>0.05). There was a positive correlation between Hcy level and SLEDAI score (r=0.698 3, P < 0.01), as well as CysC (r=0.597 5, P < 0.01). There was no significant correlation between Hcy level and CRP, TC, TG and Ser levels (P>0.05). CONCLUSIONS: The Hcy level in SLE patients was higher than healthy controls. The level of Hcy was positively correlated with the degree of disease activity. The Hcy level and SLEDAI score can be used as indicators to evaluate the activity of SLE.


Asunto(s)
Homocisteína/sangre , Lupus Eritematoso Sistémico/sangre , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Colesterol/sangre , Creatinina/sangre , Cistatina C/sangre , Humanos , Lupus Eritematoso Sistémico/diagnóstico , Triglicéridos/sangre
16.
Medicine (Baltimore) ; 98(43): e17353, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31651840

RESUMEN

BACKGROUND: Patients with simple obesity suffer from poor quality of life, as well as high risk of hypertension, diabetes, cardiovascular, and cerebrovascular accidents. Lots of Clinical trials suggested that acupuncture is beneficial for simple obesity, and it aims to gather solid evidence in order to provide reliable reference in establishing guidelines for acupuncture treatment of simple obesity in this study. METHODS: Relevant databases including Cochrane Library, PubMed, Cochrane Central Register of Controlled Trials, Medline University Resource Center, Chinese Biomedical Literature Service System, and China National Knowledge Infrastructure will be retrieved from January 1950 to November 2018. Two authors will screen studies independently according to the inclusion and exclusion criteria and extract the data in a form of sheet. Quality evaluations and bias risk assessments will be performed for the methodology of included studies. Dichotomous data will be analyzed using odds ratio (OR), and continuous data using mean differences. Network meta-analysis will be conducted by using Stata 14.0. The Development and Evaluation approach will be used to rate the certainty of the evidence of estimates derived from meta-analysis. The primary outcome is body mass index (BMI), and the secondary outcomes are triglycerides, total cholesterol, low-density lipoprotein-cholesterol, effective rate, adverse effects, and recurrence rate. Trial registration number is CRD42019117387. RESULTS: Based on current evidence, this review will rank the efficacy and safety of the various acupuncture regimen in decreasing BMI, triglycerides, total cholesterol of patients with simple obesity, and to summarize a prioritization regimen. CONCLUSION: This evidence may be useful for clinicians, patients, and guideline-makers to select the optimum proposal of acupuncture for the simple obesity treatment.


Asunto(s)
Terapia por Acupuntura/métodos , Obesidad/terapia , Adulto , Índice de Masa Corporal , Colesterol/sangre , Protocolos Clínicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metaanálisis en Red , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento , Triglicéridos/sangre
17.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): e190002.supl.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596373

RESUMEN

INTRODUCTION: This article aims to estimate reference values for laboratory tests of cholesterol, glycosylated hemoglobin and creatinine for the Brazilian adult population. METHODS: A descriptive study carried out with laboratory data from the National Health Survey (Pesquisa Nacional de Saúde - PNS). Samples of blood and urine were collected in a PNS subsample of 8,952 individuals aged 18 years old or older. To determine the reference values, exclusion criteria were applied: presence of previous diseases and outliers, defined by values outside the range estimated by the mean ± 1.96 × standard deviation. Subsequently, reference values were calculated according to gender, age group and race/skin color. RESULTS: Differences in reference values according to gender were observed. Women had higher values of total cholesterol, LDL-c and HDL-c. Glycosylated hemoglobin showed similar values in relation to gender, and creatinine was higher among men. The mean reference values were higher in the elderly population, aged 60 years old or older. The mean, lower and upper limits of total cholesterol and fractions of non-white people were slightly lower. There was no difference according to race/skin color for glycosylated hemoglobin and creatinine. CONCLUSION: The establishment of national reference parameters for laboratory tests, adapted to the sociodemographic and geographic characteristics, provides relevant information for evaluation of diagnosis and treatment of chronic diseases in Brazil.


Asunto(s)
Colesterol/sangre , Técnicas de Laboratorio Clínico/normas , Creatinina/análisis , Hemoglobina A Glucada/análisis , Adolescente , Adulto , Grupo de Ascendencia Continental Africana , Brasil , Grupo de Ascendencia Continental Europea , Femenino , Encuestas Epidemiológicas/métodos , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , Adulto Joven
18.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190004.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596375

RESUMEN

INTRODUCTION: This article aims at describing the National Health Survey (Pesquisa Nacional de Saúde- PNS) methodology of collecting laboratory exams data. METHODOLOGY: A subsample of 25% of the census tracts was selected, according to the stratification of the PNS sample, with a probability inversely proportional to the difficulty of collection. The collection of blood and urine was done in the households by a laboratory agent, among residents selected for individual interview. Due to the difficulties found in the field work, the sample did not reach the minimum expected number in some strata, and a post-stratification procedure was proposed for the data analysis. RESULTS: The collection of biospecimens was performed in 8,952 individuals. Laboratory tests were: glycated hemoglobin; total cholesterol; LDL cholesterol; HDL cholesterol; serology for dengue; red blood cell count (erythrogram) and white series count (leukogram); high performance liquid chromatography (HPLC) for diagnosis of hemoglobinopathies; creatinine. Theexcretion of potassium, salt and sodium and creatinine was estimated in the urine. The database of laboratory exams was weighed and made publicly available on the Oswaldo Cruz Foundation's PNS website and can be accessed without prior authorization. CONCLUSION: The total subsample of laboratory exams is of great value, since it allowed us to establish national reference parameters adequate to sociodemographic and geographic characteristics of the Brazilian population, providing relevant and complementary information for the analysis of the health situation of Brazil.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Recolección de Datos/métodos , Bases de Datos Factuales , Encuestas Epidemiológicas/métodos , Adolescente , Adulto , Recolección de Muestras de Sangre/métodos , Brasil , Colesterol/sangre , Cromatografía Líquida de Alta Presión , Dengue/sangre , Recuento de Eritrocitos , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Toma de Muestras de Orina/métodos , Adulto Joven
19.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190005.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596376

RESUMEN

OBJECTIVE: To analyze the prevalence of altered total cholesterol and fractions levels in the Brazilian population, according to biochemical data from the National Health Survey. METHODS: A descriptive study, using data from the National Health Survey, collected between 2014 and 2015. Total cholesterol and fractions were analyzed and population prevalences of altered values according to socio-demographic variables were calculated. The cutoff points considered were: total cholesterol ≥ 200mg/dl; low-density lipoprotein LDL ≥ 130mg/dL and high-density lipoprotein HDL < 40mg/dL. RESULTS: The prevalence of total cholesterol ≥200mg/dL in the population was 32.7%, and higher in women (35.1%). The prevalence of altered HDL was 31.8%, 22.0% in females and 42.8% in males. LDL ≥ 130mg/dL was found in 18.6% and was higher in women (19.9%). The population aged 45 years old and older and those with low levels of education presented a higher prevalence of altered cholesterol. CONCLUSION: Altered values of total cholesterol and fractions were frequent in the Brazilian population, especially among women, the elderly and people with low levels of education. These results may guide control and preventative actions such as healthy eating, physical activity and treatment, all of which aim to prevent coronary diseases.


Asunto(s)
HDL-Colesterol/sangre , LDL-Colesterol/sangre , Colesterol/sangre , Encuestas Epidemiológicas/métodos , Hipercolesterolemia/epidemiología , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Brasil/epidemiología , Estudios Epidemiológicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Valores de Referencia , Distribución por Sexo , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
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