High-density lipoprotein lipid peroxidation as a diagnostics biomarker in coronary artery disease.

This study aimed at evaluating the serum High-density lipoprotein lipid peroxidation (HDLox) levels and their association with coronary artery disease (CAD). This case-control study comprised 572 patients with stable CAD and 281 healthy subjects with no history of cardiovascular disease (control group). Based on the results of coronary angiography, the patient group was divided into two groups: CAD- and CAD+. HDLox was measured using a fluorimetric method. The ability of HDLox and serum high-density lipoprotein cholesterol (HDL-C) to detect CAD and coronary artery stenosis ≥50% was also compared using the receiver operating characteristic (ROC) curve analysis. The CAD patients showed significantly higher serum HDLox levels, compared to the control group [1.15 (1.01-1.31) vs. 0.85 (0.62-1.06), no units, p < 0.001]. Moreover, serum HDLox levels were significantly lower in CAD- patients, compared to the CAD+ patients [1.05 (0.92-1.22) vs. 1.24 (1.12-1.35), no units, p < 0.001]. According to the results of univariate and multivariate logistic regression, the HDLox showed association with the presence of CAD (odds ratio [OR]: 1.754; 95% confidence interval [CI]: 1.564-1.968; p < 0.001) and coronary artery stenosis ≥50% (OR: 1.729; 95% CI: 1.534-1.949; p < 0.001). The results obtained from the area under the ROC curve revealed that the HDLox could better detect the risk of CAD and coronary artery stenosis ≥50% compared to serum HDL-C level. The oxidation of HDL leads to a reduction in its antioxidant function and it has a crucial role in the development of atherosclerosis. HDLox is suggested as a diagnostics biomarker for CAD.

Association of body mass index with serum calcium and phosphate levels.

OBJECTIVE: It has been shown that several environmental and physiological factors can affect on the serum levels of calcium and phosphate. The objective of the present study was explored the relationship between serum calcium and phosphate levels with anthropometric and hematological markers. METHODS: 908 subjects were recruited from the Mashhad stroke and heart atherosclerosis disorder (MASHHAD) program. Anthropometric parameters, liver/kidney function tests (e.g., Urea nitrogen, creatinine, urea and uric acid, creatinine, AST, ALT) were determined in all participants. Serum concentrations of calcium and phosphate were measured using Autoanalyzer BT3000P (Pars Azmoon kit, Tehran, Iran). SPSS software was used for statistical analyses. RESULTS: We observed that obese subjects had a lower level of serum calcium (p˂0.05). Moreover, a relationship was detected between serum phosphate level and different menopausal status (p˂0.05). Serum calcium and phosphate did not change by increasing age in the population. Additionally, there was a correlation between lymphocyte count with serum phosphate level (p˂0.05). No statistically different were detected for the levels of calcium/phosphate with respect to smoking status, physical activity, lipid profile, liver and renal function markers. CONCLUSION: We found an association between serum calcium and BMI as well as with serum phosphate and menopausal status.

Protective and hypoglycemic effects of celery seed on streptozotocin-induced diabetic rats: experimental and histopathological evaluation.

AIMS: Diabetes mellitus is a major manifestation of metabolic disorder which presents with hyperglycemia (high levels of serum blood sugar). In the present study, we aimed to investigate the effects of celery seed extract on different biochemical factors and histopathological changes in normal and streptozotocin (STZ)-induced diabetic rats. METHODS: A total of 35 male Wistar rats were divided into five groups (one normal and four diabetic groups). STZ was injected intraperitoneally to induce diabetes. The effects of hexane extract of celery seed and glibenclamide (as a positive control) were compared. Blood samples were analyzed on days 0, 18, and 33, and histopathological evaluations were performed at the end of the study. RESULTS: Glucose, triglycerides, and cholesterol levels significantly decreased, whereas insulin and high-density lipoprotein (HDL) levels increased in the extract-administered groups, as compared to the negative diabetic control group (P < 0.0001). The concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum of the extract-administered groups were significantly less than the negative control group (P < 0.0001). Histopathological reports revealed significantly less atrophy, necrosis, and inflammation in the rats receiving celery seed extract compared to the negative control group. CONCLUSIONS: The results indicated that celery seed extract can be effective in controlling hyperglycemia and hyperlipidemia in diabetic rats, and demonstrated its protective effects against pancreatic toxicity resulting from STZ-induction.

Cardiovascular Risk Factors and Nutritional Intake are not Associated with Ultrasound-defined Increased Carotid Intima Media Thickness in Individuals Without a History of Cardiovascular Events.

BACKGROUND: Carotid ultrasound appears to be useful in the assessment of cardiovascular risk. In this study, we have assessed the carotid intima-media thickness (CIMT) in a group of individuals without a history of cardiovascular events. METHODS: A sample of 431subjects (189 [43.9%] males and 242 [56.1%] females) was obtained from an urban population using a stratified-cluster method in Mashhad stroke and heart atherosclerosis disorder study. None of the subjects had a history of the cardiovascular event. Carotid artery duplex ultrasound was used to determine the CIMT in all subjects, and to identify those with an abnormal value (CIMT [+]; i.e., CIMT ≥ 0.8 mm). Dietary intake of participants was assessed using a questionnaire for 24-h dietary recall. The relationship between anthropometric, biochemical and dietary data and CIMT were assessed. RESULTS: The mean age of subjects was 48.7 ± 8.0 years. Of the 431 patients, 118 (27.4%) were found to be CIMT (+). Of the cardiovascular parameters assessed, only age (odds ratio [OR] [95% confidence interval (CI)], 1.11 [0.56-4.34]; P < 0.01) and male gender (OR [95% CI], 1.14 [0.63-2.23]; P < 0.05) were significant independent predictors of ultrasound defined CIMT. Crude and total energy adjusted intake were not associated with the presence of CIMT (+). CONCLUSIONS: It appears that within a relatively young Iranian population of individuals without a history of cardiovascular event, the presence of CIMT (+) defined by duplex ultrasound cut-off value of ≥0.8 mm, did not associate with several modifiable cardiovascular risk factors or measures of dietary intake.

Effects of simvastatin treatment on serum adiponectin concentrations in patients with dislipidemia.

BACKGROUND: Adiponectin is an adipose tissue-derived protein with anti-inflammatory properties. Statins are a class of cholesterol-lowering drugs, widely used for treatment of cardiovascular diseases. OBJECTIVES: In the current study, we aimed to assess the effects of simvastatin on serum levels of adiponectin in patients with dyslipidemia, recruited from Ghaem Hospital, Mashhad, Iran. MATERIALS AND METHODS: A total of 102 patients with dyslipidemia were treated with simvastatin or placebo during a double-blind, cross-over, placebo-controlled trial. The adiponectin levels were measured before and after each treatment period. Seventy seven participants completed the study. RESULTS: There was a significant reduction in serum total cholesterol (approxmately 21%), low density lipoprotein-cholesterol (LDL-C) (approxmately 28%), and triglycerides (approxmately 11%), after four weeks of treatment with simvastatin (P < 0.001). CONCLUSIONS: No significant change in serum adiponectin concentrations was observed after treatment with simvastatin. This may be because of the relatively short duration of treatment and longer treatment duration may be necessary to investigation in future studies.

Changes in small dense low-density lipoprotein levels following acute coronary syndrome.

Low-density lipoprotein (LDL), especially small dense LDL (sdLDL), plays a role in atherogenesis. We compared baseline sdLDL levels between healthy controls and patients with acute coronary syndrome (ACS). Blood samples were taken from patients diagnosed with myocardial infarction ([MI] n = 104) and unstable angina ([UA] n = 100). Both sdLDL and high-sensitivity C-reactive protein (hsCRP) levels were determined on admission and in the next 24 hours after the onset of symptoms. Baseline concentration of sdLDL was significantly higher in patients presenting with ACS than controls (P < .05). In the 24 hours following ACS, the sdLDL levels decreased insignificantly in both groups of patients with ACS (P > .05). The changes in sdLDL values were not significantly different between MI and UA participants (P > .05). Patients with ACS have higher concentration of sdLDL compared with the controls.

Serum small dense low-density lipoprotein concentrations are elevated in patients with significant coronary artery stenosis and are related to features of the metabolic syndrome.

Serum small dense low-density lipoprotein (sd-LDL) concentrations were measured in patients with angiographically defined coronary artery disease (CAD) and compared to concentrations in healthy subjects. Five hundred and seventy patients with stable CAD were divided into CAD- and CAD+ based on angiography. Patients in whom stenosis was <50 % in diameter were classified as having a 'normal' angiogram (CAD-), otherwise the patients were allocated to the CAD+ group. The CAD+ group was further subcategorized into single-, double- and triple-vessel disease (VD). Serum sd-LDL concentrations were significantly lower in controls compared with CAD+ and CAD- patients (P < 0.001). Moreover, CAD+ patients had higher concentrations of sd-LDL than CAD- patients (P < 0.01). sd-LDL levels were not significantly associated with severity of CAD defined by the number of stenosed coronary arteries (P = 0.245). All participants were also categorized into subgroups with or without metabolic syndrome. Subjects with metabolic syndrome had higher levels of sd-LDL than subjects without metabolic syndrome (P < 0.01). Multiple linear regressions showed that in CAD patients, triacylglycerol, total-cholesterol, body mass index, and waist circumferences were the most important determinants of serum sd-LDL concentrations. We found that sd-LDL levels were significantly higher in patients presenting with symptoms of CAD. Moreover, patients with significant stenosis of their coronary arteries (>50 % stenosis) had higher levels of sd-LDL compared to patients without significant lesions.

Effects of auricular acupuncture on anthropometric, lipid profile, inflammatory, and immunologic markers: a randomized controlled trial study.

OBJECTIVES: A randomized controlled clinical trial was performed to examine the effectiveness of auricular acupuncture on body weight loss and its impact on lipid profile, and immunologic and inflammatory markers in obese subjects. METHODS: Participants (n=204) were randomized to therapeutic acupuncture and control groups. Subjects received authentic (cases) or sham (controls) acupuncture for 6 weeks (first period) in combination with a low-calorie diet. In the next 6 weeks (second period), the low-calorie diet was used on its own. Subjects were assessed at the beginning and 6 and 12 weeks later. In addition to anthropometric and lipid parameters, serum anti-heat shock protein (Hsp)-27, 60, 65, 70 and high sensitive C-reactive protein (hs-CRP) levels were assessed. RESULTS: In the first period, anthropometric parameters and hs-CRP changed significantly in both groups, while significant changes in anti-Hsp antibodies were only observed in case subjects. In the second period, which shows the sustainable effects of acupuncture, changes in anthropometric parameters were more prominent in controls, while significant reductions in the group receiving authentic acupuncture were maintained for anti-Hsp antibodies. A comparison between the first and second period in both groups showed that the changes for most of the parameters were more significant in the first period. Comparison between cases and controls showed that authentic acupuncture was more effective in reducing the levels of anthropometric factors and anti-Hsp antibodies but not hs-CRP. CONCLUSIONS: Auricular acupuncture in combination with diet restriction was effective for weight loss and dyslipidemia. Moreover, it was found that it has immunomodulatory but not anti-inflammatory effects on the immune system by regulation of the levels of anti-Hsp antibodies.

The effects of body acupuncture on obesity: anthropometric parameters, lipid profile, and inflammatory and immunologic markers.

A randomized controlled clinical trial in 196 obese subjects was performed to examine the effectiveness of body acupuncture on body weight loss, lipid profile and immunogenic and inflammatory markers. Subjects received authentic (cases) or sham (controls) acupuncture for 6 weeks in combination with a low-calorie diet. In the following 6 weeks, they received the low-calorie diet alone. Subjects were assessed at the beginning, 6 and 12 weeks later. Heat shock protein (Hsps)-27, 60, 65, 70 antibody titers and high sensitivity C-reactive protein (hs-CRP) levels were also assessed. A significant reduction in measures of adiposity and improvement in lipid profile were observed in both groups, but the levels of anti-Hsp-antibodies decreased in cases only. A reduction in anthropometric and lipid profile in cases were sustained in the second period, however, only changes in lipid profile were observed in the control group. Anti-Hsp-antibodies and hs-CRP levels continued to be reduced in cases but in controls only the reduction in hs-CRP remained. Changes in anthropometric parameters, lipid profile, and anti-Hsp-antibodies were more evident in cases. Body acupuncture in combination with diet restriction was effective in enhancing weight loss and improving dyslipidemia.

Effect of Ganoderma lucidum hydroalcoholic extract on insulin release in rat-isolated pancreatic islets.

OBJECTIVE: Ganoderma Lucidum (G. Lucidum) has been suggested to increase serum insulin level. This study was undertaken to investigate its direct effect on the islets of Langerhans. MATERIAL AND METHODS: Male albino Wistar rats were anesthetized and the islets were isolated after digestion of the pancreas with collagenase. The islets were incubated for 60 min in Krebs bicarbonate buffer containing 3 or 10 mM glucose in the presence of hydroalcoholic extract of G. Lucidum (1 mg/ml), 3-isobutyl-1-methylxanthine (IBMX, 100 µM) or vehicle. RESULTS: Exposure of islets to the extract increased insulin secretion at basal (3 mM) glucose concentration. Increase of glucose concentration to 10 mM resulted in a significant increase in the rate of insulin secretion. While the IBMX could augment insulin release evoked by 10 mM glucose, the extract failed to modify it. CONCLUSION: Our results demonstrate that G. lucidum acts directly on the Langerhans islets to increase basal insulin release.

Prooxidant-anti-oxidant balance is not associated with extent of coronary artery disease.

OBJECTIVE: We have measured the pro-oxidant-antioxidant-balance (PAB) levels in patients with defined coronary artery disease (CAD) and compared them with concentrations in healthy subjects. DESIGN AND METHODS: Based on angiography results, 400 patients with stable CAD were divided into CAD- and CAD+, this being further subcategorized into groups with single-, double- and triple-vessel disease (VD). RESULTS: The mean PAB values in the healthy subjects, was significantly lower than for other groups (P<0.001). In CAD- patients, PAB levels were 123.2 ± 43.9, which was not statistically different compared to groups with SVD, 2VD and 3VD (P>0.05). In the CAD+ group, PAB values in 1VD, 2VD and 3VD were not significantly different among patients with SVD, 2VD and 3VD (P>0.05). CONCLUSIONS: In conclusion, we found higher levels of oxidative stress in CAD+ patients compared to healthy subjects. The oxidation level was not related to measures of the extent of CAD such as number of stenosed vessels.

Changes in pro-oxidant-antioxidant balance after bare metal and drug eluting stent implantation in patients with stable coronary disease.

OBJECTIVES: In this study we aimed to assess the changes in pro-oxidant-antioxidant balance (PAB) after the placement of either a drug-eluting-stent (DES) or bare-metal-stent (BMS) in patients with stable coronary artery disease. DESIGN AND METHODS: Percutaneous coronary interventions (PCI) with either BMS or DES were undertaken for 152 patients (82 in the BMS and 70 in the DES groups respectively). PAB values were measured 24h before and after PCI. RESULTS: Baseline PAB values were 80.68 (64.98-99.37) and 98.86 (64.70-140.62) for BMS and DES group, respectively, which were not significantly different between the 2 groups (P>0.05). Following PCI, median PAB values decreased to 72.10 (61.40-96.13) and 81.40 (54.15-121.90) in BMS and DES groups, respectively. The reduction was significant in both BMS and DES groups (P<0.05). The changes in PAB values were -2.81 (-12.76 to 2.31) for BMS and -2.82 (-29.88 to 8.93) for DES group, which were not significantly different between the 2 groups (P>0.05). CONCLUSION: We found that the reported difference in clinical outcomes following DES or BMS implantation cannot be attributed to differences in early changes in oxidative stress induction as assessed by changes in PAB values.

Serum inflammatory and immune marker response after bare-metal or drug-eluting stent implantation following percutaneous coronary intervention.

We assessed the changes in serum antiheat shock protein (HSP)-27 antibody and high-sensitivity C-reactive protein (hsCRP) levels, following the placement of a drug-eluting stent (DES) or bare-metal stent (BMS) in patients with stable coronary artery disease. Either a BMS or DES was implanted in 137 patients (82 BMS; 55 DES). Anti-HSP27 and hsCRP levels were measured 24 hours before and 24 hours after stenting. Median hsCRP serum levels increased significantly to 60.78 (10.13-84.87) and 77.80 (50.00-84.84) mg/L for BMS and DES groups (P = .006 and P = .000, respectively); this increase did not differ significantly between the 2 groups. Median anti-HSP27 antibody levels decreased to 0.26 (0.17-0.49) and 0.21 (0.16-0.29) absorbency units in BMS and DES groups (P = .045 and P = < 0.001, respectively). The changes in anti-HSP27 antibody titers were significant between the 2 groups (P = .015). Bare-metal stent and DES differ in stimulation of immune rather than inflammatory responses. Less stent restenosis after DES compared with BMS implantation could, in part, be attributed to differences in immune responses.

Determination of prooxidant--antioxidant balance after acute coronary syndrome using a rapid assay: a pilot study.

The purpose of the current study was to investigate a novel measure of oxidative stress in patients with acute coronary syndrome (ACS) using a pro-oxidant-antioxidant balance (PAB) assay, which is simple and rapid. Blood samples were taken from 94 patients admitted with ACS. Pro-oxidant-antioxidant balance values were determined in the first and second 12 hours after the onset of symptoms and compared with values for 81 age- and sex-matched controls. The mean PAB values in the first and second 12-hour samples of patients were both significantly higher than that of controls (P < .001). Among patients, PAB values were also significantly higher in the second samples compared with the first samples (P < .001). These findings indicate a heightened state of oxidative stress following ACS and suggest that the PAB value may be considered as a cardiovascular risk predictor to estimate the extent of oxidative stress.

Serum selenium and glutathione peroxidase concentrations in Iranian patients with angiography-defined coronary artery disease.

This study investigated the relationship between serum selenium (Se) and glutathione peroxidase (GPx) levels and the presence of coronary artery disease (CAD) among Iranian patients. Three groups were compared: patients undergoing angiography with angiographically defined CAD, individuals with a normal angiogram, and apparently healthy controls with no evidence of overt CAD. Anthropometric measurements, blood pressure, fasting blood glucose and lipid profiles, serum Se and GPx measurements, and angiographic assessment were carried out using standard protocols. Mean serum Se concentrations were not significantly different between patients with and without CAD and the control group. The mean value of serum GPx in the control group was significantly higher than in patients with or without CAD. Selenium status did not differentiate between patients with and without CAD, which may be related to the fact that angiography is not a very sensitive index of global atherosclerosis, and it is possible that patients who were CAD negative by angiogram still have significant disease. It may also be that Se is not a good marker of CAD.

Antibody titres to heat shock protein 27 are elevated in patients with acute coronary syndrome.

IgG antibody titres to heat shock protein 27 (anti-Hsp27) were measured to determine whether these titres were affected in patients admitted with acute coronary syndrome. Blood samples were taken from 94 patients admitted with acute coronary syndrome. Anti-Hsp27 IgG titres were determined using an in-house enzyme-linked immunosorbent assay (ELISA) in the first and second 12 h after the onset of symptoms and compared with values for 81 age- and sex-matched control subjects. Median antibody titres to Hsp27 in the first sample from patients whose diagnosis was a myocardial infarction (n = 42) was 0.41 absorbancy units (range 0.28-0.57) and for those with unstable angina (n = 52) was 0.31 (range 0.20-0.42), both being significantly higher than for controls (n = 81), which was 0.08 (range 0.05-0.15) (P < 0.05). However, titres fell in the second samples collected in the coronary syndrome patients and were then no longer significantly different from controls (P > 0.05). Myocardial infarction patients also had significantly higher anti-Hsp27 titres in the first 12 h than patients with unstable angina (P < 0.05), but again the difference in the second sample did not reach statistical significance (P > 0.05). Serum antibody titres to Hsp27 rise and fall rapidly after the onset of acute coronary syndrome, and may be an early marker of myocardial ischaemia as patients with myocardial infarction or unstable angina both had high titres.