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1.
Gene ; 762: 145019, 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-32755657

RESUMO

Dyslipidemia is a well-established risk factor for cardiovascular disease. Experimental studies have reported that peroxisome proliferator-activated receptor γ (PPAR-γ) regulates adipocyte differentiation, lipid storage, and glucose metabolism. Therefore, we examined the associations between PPAR-γ polymorphisms (rs1801282, rs3856806, rs12497191, rs1151999, and rs1152003) and serum lipids in two cross-sectional studies. In the Shizuoka area of the Japan Multi-Institutional Collaborative Cohort Study, we examined 4,952 participants (3,356 men and 1,596 women) in a baseline survey and 2,245 participants (1,550 men and 695 women) in a second survey 5 years later. Outcome measures were the prevalence of dyslipidemia (low-density lipoprotein-cholesterol [LDL-C] ≥ 140 mg/dl, high-density lipoprotein-cholesterol < 40 mg/dl, triglycerides ≥ 150 mg/dl, and/or use of cholesterol-lowering drugs) and the prevalence of high LDL-C (LDL-C ≥ 140 mg/dl and/or use of cholesterol-lowering drugs). Multivariate odds ratios (ORs) were estimated by using unconditional logistic regression models. A total of 2,114 and 1,431 individuals (42.7% and 28.9%) had dyslipidemia and high LDL-C in the baseline survey, respectively, as did 933 and 716 (41.6% and 31.9%), respectively, in the second survey. In the baseline study, compared with major allele homozygotes, minor allele homozygotes of rs3856806 and rs12497191 had a 42% (OR, 0.58; 95% confidence interval (CI), 0.39-0.85) and 23% (OR, 0.77; 95% CI, 0.60-0.99) lower risk of dyslipidemia, respectively, after adjustment for potential confounding factors. In addition, minor allele homozygotes of rs3856806 had a 45% (OR, 0.55; 95% CI, 0.35-0.86) lower risk of high LDL-C. Similar risk reductions were found in the second survey. In conclusion, rs3856806 and rs12497191 polymorphisms may be related to a lower risk of dyslipidemia and high LDL-C.


Assuntos
Dislipidemias/genética , PPAR gama/genética , Polimorfismo de Nucleotídeo Único , Adulto , Idoso , Colesterol/sangue , Dislipidemias/sangue , Feminino , Humanos , Vida Independente , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade
2.
Arterioscler Thromb Vasc Biol ; 40(9): 1970-1981, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32762461

RESUMO

Dyslipidemias include both rare single gene disorders and common conditions that have a complex underlying basis. In London, ON, there is fortuitous close physical proximity between the Lipid Genetics Clinic and the London Regional Genomics Centre. For >30 years, we have applied DNA sequencing of clinical samples to help answer scientific questions. More than 2000 patients referred with dyslipidemias have participated in an ongoing translational research program. In 2013, we transitioned to next-generation sequencing; our targeted panel is designed to concurrently assess both monogenic and polygenic contributions to dyslipidemias. Patient DNA is screened for rare variants underlying 25 mendelian dyslipidemias, including familial hypercholesterolemia, hepatic lipase deficiency, abetalipoproteinemia, and familial chylomicronemia syndrome. Furthermore, polygenic scores for LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol, and triglycerides are calculated for each patient. We thus simultaneously document both rare and common genetic variants, allowing for a broad view of genetic predisposition for both individual patients and cohorts. For instance, among patients referred with severe hypertriglyceridemia, defined as ≥10 mmol/L (≥885 mg/dL), <1% have a mendelian disorder (ie, autosomal recessive familial chylomicronemia syndrome), ≈15% have heterozygous rare variants (a >3-fold increase over normolipidemic individuals), and ≈35% have an extreme polygenic score (a >3-fold increase over normolipidemic individuals). Other dyslipidemias show a different mix of genetic determinants. Genetic results are discussed with patients and can support clinical decision-making. Integrating DNA testing into clinical care allows for a bidirectional flow of information, which facilitates scientific discoveries and clinical translation.


Assuntos
Dislipidemias/genética , Variação Genética , Lipídeos/sangue , Biomarcadores/sangue , Variações do Número de Cópias de DNA , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/história , Predisposição Genética para Doença , Testes Genéticos , Sequenciamento de Nucleotídeos em Larga Escala , História do Século XX , História do Século XXI , Humanos , Herança Multifatorial , Fenótipo , Prognóstico , Medição de Risco , Fatores de Risco
3.
PLoS One ; 15(6): e0234433, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511269

RESUMO

BACKGROUND: Several previous studies have suggested that Helicobacter pylori (H. pylori) infection affects the serum lipid profile. However, it remains controversial and the mechanism has not been elucidated. The purpose of this study is to use an epidemiological perspective to evaluate the association between H. pylori infection and the serum lipid profile. METHODS: Multivariate analysis was performed using the data of serum lipid profile, infection status of H. pylori, fitness/lifestyle habits, and various subjects' characteristics which were derived from the 15,679 generally healthy individuals in Japan. The average treatment effects (ATEs) of H. pylori infection on the serum lipid profile were estimated using augmented inverse probability weighting (AIPW). A meta-analysis was also performed using the 27 studies worldwide in which the status of H. pylori infection and at least one serum examination value (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), or triglyceride (TG)) were described. RESULTS: The ATEs determined with AIPW showed that H. pylori infection has significant positive effects on LDL-C and TC (ATE (95% confidence interval [95%CI]) = 3.4 (2.36-4.49) and 1.7 (0.58-2.88), respectively) but has significant negative effects on HDL-C and TG (ATE (95%CI) = -1.2 (-1.74 to -0.72) and -3.5 (-5.92 to -1.06), respectively). The meta-analysis to estimate the association between H. pylori infection and the serum lipid profile revealed that H. pylori infection is positively associated with LDL-C, TC, and TG (standardized mean difference [SMD] (95%CI) = 0.11 (0.09-0.12), 0.09 (0.07-0.10) and 0.06 (0.05-0.08), respectively) and negatively associated with HDL-C (SMD = -0.13 (-0.14 to -0.12)). CONCLUSION: Both our multivariate analyses and meta-analysis showed that H. pylori infection significantly affects the serum lipid profile, which might lead to various dyslipidemia-induced severe diseases like coronary thrombosis or cerebral infarction.


Assuntos
Dislipidemias/epidemiologia , Infecções por Helicobacter/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/etiologia , Feminino , Infecções por Helicobacter/sangue , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Japão/epidemiologia , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Pontuação de Propensão , Fatores de Risco , Triglicerídeos/sangue , Adulto Jovem
4.
Cardiovasc Diabetol ; 19(1): 89, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32539832

RESUMO

BACKGROUND: Fatty acid-binding protein 4 (FABP4) acts as a novel adipokine, and elevated FABP4 concentration is associated with obesity, insulin resistance and atherosclerosis. Dipeptidyl peptidase-4 (DPP-4) inhibitors, a class of antidiabetic drugs, have distinct structures among the drugs, possibly leading to a drug class effect and each drug effect. Sitagliptin, a DPP-4 inhibitor, has been reported to decrease FABP4 concentration in drug-naïve and sulfonylurea-treated patients with type 2 diabetes mellitus. Anagliptin, another DPP-4 inhibitor, was shown to decrease low-density lipoprotein cholesterol (LDL-C) level to a greater extent than that by sitagliptin in the Randomized Evaluation of Anagliptin vs. Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) trial. AIM AND METHODS: As a sub-analysis study using data obtained from the REASON trial, we investigated the effects of treatment with anagliptin (n = 148, male/female: 89/59) and treatment with sitagliptin (n = 159, male/female: 93/66) for 52 weeks on FABP4 concentration in patients with type 2 diabetes mellitus at a high risk for cardiovascular events who were receiving statin therapy. RESULTS: The DPP-4 inhibitor had been administered in 82% of the patients in the anagliptin group and 81% of the patients in sitagliptin group prior to randomization. Serum FABP4 level was significantly decreased by 7.9% by treatment with anagliptin (P = 0.049) and was not significantly decreased by treatment with sitagliptin (P = 0.660). Change in FABP4 level was independently associated with basal FABP4 level and changes in waist circumference and creatinine after adjustment of age, sex and the treatment group. CONCLUSION: Anagliptin decreases serum FABP4 concentration independent of change in hemoglobin A1c or LDL-C in patients with type 2 diabetes mellitus and dyslipidemia who are on statin therapy. Trial registration ClinicalTrials.gov number NCT02330406. Registered January 5, 2015, https://clinicaltrials.gov/ct2/show/NCT02330406.


Assuntos
Glicemia/efeitos dos fármacos , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Dislipidemias/tratamento farmacológico , Proteínas de Ligação a Ácido Graxo/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pirimidinas/uso terapêutico , Idoso , Biomarcadores/sangue , Glicemia/metabolismo , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Inibidores da Dipeptidil Peptidase IV/efeitos adversos , Regulação para Baixo , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Pessoa de Meia-Idade , Pirimidinas/efeitos adversos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
5.
Cardiovasc Diabetol ; 19(1): 93, 2020 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-32560724

RESUMO

BACKGROUND: The potential for PPAR agonists to positively affect risk of cardiovascular disease in patients with type 2 diabetes (T2DM) is of persistent attention. The PRESS XII study primarily aimed to evaluate the efficacy and safety of saroglitazar (2 mg and 4 mg) as compared to pioglitazone 30 mg on glycemic control in patients with type 2 diabetes mellitus. METHODS: In this randomized double-blind study, patients with T2DM [glycosylated hemoglobin (HbA1c) ≥ 7.5%] were enrolled from 39 sites in India. Patients received once-daily doses of either saroglitazar or pioglitazone (1:1:1 allocation ratio) for a total of 24 weeks. Patients were continued in a double blind extension period for an additional 32 weeks. Efficacy evaluations of glycemic parameters [HbA1c (Primary endpoint at week 24), FPG and PPG] and other lipid parameters (TG, LDL-C, VLDL-C, HDL-C, TC, Non HDL-C, Apo A1 and Apo B) were conducted at week 12, 24 and 56 and compared to the baseline levels. The efficacy analyses were performed by using paired t-test and ANCOVA model. RESULTS: A total of 1155 patients were enrolled in this study. The baseline characteristics were similar between the three treatment groups. The within group mean (± SD) change in HbA1c (%) from baseline of the saroglitazar (2 mg and 4 mg) and pioglitazone treatment groups at week 24 were: - 1.38 ± 1.99 for saroglitazar 2 mg; - 1.47 ± 1.92 for saroglitazar 4 mg and - 1.41 ± 1.86 for pioglitazone, respectively. Statistically significant reduction from baseline in HbA1c was observed in each treatment group at week 24 with p-value < 0.016. There was a significant reduction in TG, LDL-C, VLDL-C, TC and Non HDL-C with a significant increase in HDL-C from baseline levels (< 0.016). Most of the AE's were 'mild' to 'moderate' in severity and were resolved by the completion of the study. CONCLUSIONS: Saroglitazar effectively improved glycemic control and lipid parameters over 56 weeks in patients of T2DM receiving background metformin therapy and has a promising potential to reduce the cardiovascular risk in T2DM patients. Trial registration CTRI/2015/09/006203, dated 22/09/2015.


Assuntos
Glicemia/efeitos dos fármacos , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Dislipidemias/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Lipídeos/sangue , Fenilpropionatos/administração & dosagem , Pioglitazona/administração & dosagem , Pirróis/administração & dosagem , Biomarcadores/sangue , Glicemia/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Método Duplo-Cego , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Hemoglobina A Glicada/metabolismo , Humanos , Hipoglicemiantes/efeitos adversos , Índia/epidemiologia , Fenilpropionatos/efeitos adversos , Pioglitazona/efeitos adversos , Estudos Prospectivos , Pirróis/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
7.
Medicine (Baltimore) ; 99(23): e20621, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32502038

RESUMO

BACKGROUND: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in reproductive-aged women. In addition to the reproductive consequences, PCOS is also characterized by a metabolic disorder, which may play a part in the etiology of anovulation and has important implications for long-term health as well. Vitamin D deficiency is prevalent in PCOS and there is a close relationship between metabolic dysfunction and vitamin D status in women with PCOS. The purpose of this systematic analysis is to evaluate the effect of vitamin D supplementation on serum lipid profiles in patients with PCOS. METHODS: We will search five databases for relative studies: Medline, the Cochrane Library, EMBASE, Web of Science, and ClinicalTrials.gov and identified all reports of randomized controlled trials published prior to July 2020. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by discussion among authors. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Fixed-effects model or random-effects model was used to calculate pooled estimates of weighted mean difference (WMD) with 95% confidence intervals. RESULTS: This review will be to assess the effect of vitamin D supplementation on serum lipid profiles in patients with PCOS. The results of the study will be published in a scientific journal after peer-review. CONCLUSIONS: These findings will provide guidance to clinicians and patients on the use of vitamin D for PCOS with dyslipidemia. ETHICS AND DISSEMINATION: This study is a protocol for a systematic review of vitamin D as a treatment of dyslipidemia in PCOS patients. SYSTEMATIC REVIEW REGISTRATION: INPLASY202050007.


Assuntos
Dislipidemias/tratamento farmacológico , Síndrome do Ovário Policístico/complicações , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Dislipidemias/sangue , Dislipidemias/complicações , Feminino , Humanos , Metanálise como Assunto , Síndrome do Ovário Policístico/sangue , Revisões Sistemáticas como Assunto , Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico
8.
Internist (Berl) ; 61(6): 573-586, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32394074

RESUMO

The treatment of elevated plasma lipids plays an important role in atherosclerosis prevention. Low-density lipoprotein (LDL) cholesterol lowering with statins and, if required, additional inhibition is of the utmost importance. Lifestyle modification plays only a minor role in LDL cholesterol lowering. Absolute cardiovascular risk determines whether and at what intensity lipid lowering therapy should be implemented. Thus, in patients at very high risk, an LDL cholesterol level <55 mg/dl (<1.4 mmol/l) and a 50% reduction from baseline should be achieved. With respect to elevated triglyceride concentrations, treatment goals are less clearly defined, despite the fact that elevated triglyceride concentrations are causally linked to atherosclerotic events. Lifestyle modification can significantly reduce triglyceride concentrations and are often more effective than specific triglyceride lowering medications. New lipid lowering drugs still need to prove their clinical benefit in endpoint trials.


Assuntos
Dislipidemias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipolipemiantes/uso terapêutico , LDL-Colesterol , Dislipidemias/sangue , Medicina Baseada em Evidências/tendências , Humanos , Hipercolesterolemia/sangue , Hiperlipoproteinemias/sangue , Hipertrigliceridemia/sangue , Triglicerídeos/sangue
9.
Intern Med ; 59(9): 1155-1162, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32378655

RESUMO

Objective To examine the degree of metabolic abnormalities and their association with the sociodemographic background or mental illness/cognitive disability among homeless men in Nagoya, Japan. Methods We interviewed 106 homeless men (aged 54.2±12.7 years) and measured their metabolic parameters. Mental illness and cognitive disability were diagnosed using the Mini-International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale-III test, respectively. Associations between metabolic abnormalities and the sociodemographic background or mental illness/cognitive disability were analyzed. Results There were significant correlations of liver dysfunction (AST≥35 IU, ALT≥35 IU, γ-GTP≥75 IU), hypertension [systolic/diastolic blood pressure (BP) ≥140/90 mmHg], and dyslipidemia (HDL <40 mg/dL) with the history/duration of homelessness (over 2 times/year) and residence status (living on the streets). Although the mean body mass index (BMI), BP, HbA1c, and LDL in participants living in temporary residences were similar to those obtained from the general population data from National Health Nutrition Survey (NHNS) 2016, the systolic/diastolic BP in those living on the street was significantly higher than in the general population, and the HDL in those living in temporary residences was significantly lower than in those reported in the NHNS 2016 data. In the group with cognitive disability, the ALT, TG, and BMI values were significantly higher and the HDL level significantly lower in those living in temporary residences than in those living on the streets. Conclusion Stressful conditions while living on the streets may exacerbate hypertension and liver dysfunction, and unhealthy food habits when living in a temporary residence may exacerbate low HDL levels. In addition, an inability to self-manage due to cognitive disability may increase the ALT, TG, and BMI values. The provision of homeless people with the skills to sustain independent living conditions and ensure a healthy diet is required.


Assuntos
Pessoas em Situação de Rua , Saúde do Homem , Doenças não Transmissíveis/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Demografia , Dislipidemias/sangue , Humanos , Hipertensão/fisiopatologia , Japão/epidemiologia , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Doenças não Transmissíveis/psicologia , Prevalência , Psicometria , Fatores Socioeconômicos , Adulto Jovem
10.
Cardiovasc Diabetol ; 19(1): 67, 2020 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-32416728

RESUMO

BACKGROUND: We evaluated the effect of statin use on new-onset type 2 diabetes among individuals without atherosclerotic cardiovascular disease (ASCVD) using nationally representative South Korean claims data (2002-2013, N = 1,016,820). METHODS: A total of 13,698 patients (statin users 5273, non-statin users 5273) aged 40-74 years, newly diagnosed with dyslipidemia but without any history of diabetes or ASCVD, were selected in 2005. We followed up the final sample until 2013 and evaluated the cumulative incidence of type 2 diabetes. We used extended Cox regression models to estimate the time-varying adjusted hazard ratios of statin use on new-onset type 2 diabetes. We performed further analyses based on the cumulative defined daily dose of statin received per year to evaluate the degree of risk compared to non-statin users. RESULTS: Over the mean follow-up period of 7.1 years, 3034 patients developed type 2 diabetes; the number of statin users exceeded that of non-users, demonstrating that statin use significantly increased the risk of new-onset type 2 diabetes. The risk of new-onset type 2 diabetes differed among statin users according to cDDD per year (adjusted HR = 1.31 [95% CI 1.18-1.46] for less than 30 cDDD per year; 1.58 [1.43-1.75] for 30-120 cDDD per year; 1.83 [1.62-2.08] for 120-180 cDDD per year; and 2.83 [2.51-3.19] for more than 180 cDDD per year). The diabetogenic effect of pitavastatin was not statistically significant, but the risk was the largest for atorvastatin. Long-term exposure (≥ 5 years) to statins was associated with a statistically significant increase in the risk of new onset type 2 diabetes in all statin subtypes explored, with the highest magnitude for simvastatin (HR = 1.916, 95% CI 1.647-2.228) followed by atorvastatin (HR = 1.830, 95% CI 1.487-2.252). CONCLUSIONS: Statin use was significantly associated with an increased risk of new-onset type 2 diabetes. We also found a dose-response relationship in terms of statin use duration and dose maintenance. Periodic screening and monitoring for incident type 2 diabetes may be warranted in long-term statin users.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Dislipidemias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Lipídeos/sangue , Adulto , Idoso , Biomarcadores/sangue , Bases de Dados Factuais , Diabetes Mellitus Tipo 2/diagnóstico , Relação Dose-Resposta a Droga , Dislipidemias/sangue , Dislipidemias/epidemiologia , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
11.
Cardiovasc Ther ; 2020: 3987065, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32411300

RESUMO

Objective: The drug efficacy may differ among different statins, and evidence from head-to-head comparisons is sparse and inconsistent. The study is aimed at comparing the lipid-lowering/increasing effects of 7 different statins in patients with dyslipidemia, cardiovascular diseases, or diabetes mellitus by conducting systematic review and network meta-analyses (NMA) of the lipid changes after certain statins' use. Methods: In this study, we searched four electronic databases for randomized controlled trials (RCTs) published through February 25, 2020, comparing the lipid-lowering efficacy of no less than two of the included statins (or statin vs. placebo). Three reviewers independently extracted data in duplicate. Firstly, mixed treatment overall comparison analyses, in the form of frequentist NMAs, were conducted using STATA 15.0 software. Then, subgroup analyses were conducted according to different baseline diseases. At last, sensitivity analyses were conducted according to age and follow-up duration. The trial was registered with PROSPERO (number CRD42018108799). Results: As a result, seven statin monotherapy treatments in 50 studies (51956 participants) were used for the analyses. The statins included simvastatin (SIM), fluvastatin (FLU), atorvastatin (ATO), rosuvastatin (ROS), lovastatin (LOV), pravastatin (PRA), and pitavastatin (PIT). In terms of LDL-C lowering, rosuvastatin ranked 1st with a surface under cumulated ranking (SUCRA) value of 93.1%. The comparative treatment efficacy for LDL-C lowering was ROS>ATO>PIT>SIM>PRA>FLU>LOV>PLA. All of the other ranking and NMA results were reported in SUCRA plots and league tables. Conclusions: According to the NMAs, it can be concluded that rosuvastatin ranked 1st in LDL-C, ApoB-lowering efficacy and ApoA1-increasing efficacy. Lovastatin ranked 1st in TC- and TG-lowering efficacy, and fluvastatin ranked 1st in HDL-C-increasing efficacy. The results should be interpreted with caution due to some limitations in our review. However, they can provide references and evidence-based foundation for drug selection in both statin monotherapies and statin combination therapies.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Dislipidemias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Lipídeos/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Regulação para Baixo , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Pessoa de Meia-Idade , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Adulto Jovem
12.
Cardiovasc Diabetol ; 19(1): 45, 2020 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245386

RESUMO

BACKGROUND: Elevation in small dense low-density lipoprotein (sdLDL) is common in patients with diabetes mellitus (DM), which has already been reported to be associated with incidence of coronary artery disease (CAD). The aim of the present study was to investigate the prognostic value of plasma sdLDL level in patients with stable CAD and DM. METHODS: A total of 4148 consecutive patients with stable CAD were prospectively enrolled into the study and followed up for major cardiovascular events (MACEs) up to 8.5 years. Plasma sdLDL level was measured in each patient by a direct method using automated chemistry analyzer. The patients were subsequently divided into four groups by the quartiles of sdLDL and the association of sdLDL level with MACEs in different status of glucose metabolism [DM, Pre-DM, normal glycaemia regulation (NGR)] was evaluated. RESULTS: A total of 464 MACEs were documented. Both Kaplan-Meier analysis and Cox regression analysis indicated that the patients in quartile 4 but not quartile 2 or 3 of sdLDL level had significantly higher rate of MACEs than that in lowest quartile. When the prognostic value of high sdLDL was assessed in different glucose metabolism status, the results showed that the high sdLDL plus DM was associated with worse outcome after adjustment of confounding risk factors (hazard ratio: 1.83, 95% confident interval: 1.24-2.70, p < 0.05). However, no significant association was observed for high sdLDL plus Pre-DM or NGR. CONCLUSIONS: The present study firstly indicated that elevated levels of plasma sdLDL were associated with increased risk of MACEs among DM patients with proven CAD, suggesting that sdLDL may be useful for CAD risk stratification in DM.


Assuntos
Glicemia/metabolismo , LDL-Colesterol/sangue , Doença da Artéria Coronariana/sangue , Diabetes Mellitus/sangue , Dislipidemias/sangue , Idoso , Pequim/epidemiologia , Biomarcadores/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho da Partícula , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Regulação para Cima
13.
PLoS One ; 15(4): e0231622, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298352

RESUMO

OBJECTIVES: Nonthyroidal illness syndrome (NTIS), also known as low triiodothyronine (T3) syndrome, frequently affects patients with systemic lupus erythematosus (SLE) and may affect lipid metabolism. Dyslipidemia is highly prevalent and associated with the long-term prognosis of SLE. The aim of the present study was to explore the clinical significance of NTIS on disease activity and dyslipidemia in patients with SLE. METHODS: Clinical and laboratory data were collected retrospectively from 223 patients with SLE. The correlation between free triiodothyronine (FT3), SLE disease activity, and lipid profiles were estimated. The correlation coefficient (r) was calculated using a Pearson's regression model. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for dyslipidemia in SLE. RESULTS: Serum FT3 levels were negatively correlated with the levels of 24 h urine protein (UP), blood urea nitrogen (BUN), creatinine (Cr) and SLE disease activity index (SLEDAI) (all p < 0.001) in NTIS patients but not in euthyroid patients. ApoB/ApoA1 was significantly correlated with SLEDAI (p < 0.01) in NTIS patients and CRP (p < 0.001) and ESR (p < 0.01) in euthyroid patients. A multivariate analysis revealed that only FT3 exhibited an independent negative association with dyslipidemia (P = 0.01; OR = 0.48; 95% CI 0.27-0.85). CONCLUSION: NTIS frequently occurs in patients with SLE. Low FT3 is associated with disease activity in SLE patients complicated with NTIS. Low FT3 is an independent risk factor for dyslipidemia in patients with SLE.


Assuntos
Dislipidemias/complicações , Síndromes do Eutireóideo Doente/complicações , Lúpus Eritematoso Sistêmico/complicações , Adulto , Apolipoproteína A-I/sangue , Apolipoproteínas B/sangue , Dislipidemias/sangue , Síndromes do Eutireóideo Doente/sangue , Feminino , Humanos , Lipídeos/sangue , Lúpus Eritematoso Sistêmico/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tri-Iodotironina/sangue , Adulto Jovem
14.
Prog Cardiovasc Dis ; 63(3): 228-232, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32224114

RESUMO

OBJECTIVE: To explore the sex-specific association of non-statin classes of drugs in reducing cardiovascular outcomes. METHODS: Published data search up to November 2019 reporting primary outcomes that approximate with major vascular events (MVEs) after treatment with non-statin group of drugs was performed. The primary outcome was the sex-specific association with MVEs. Random-effects meta-analysis was performed to estimate relative risk (RR) of the individual classes of therapies. RESULTS: Seven Randomized Clinical Trials (RCTs) including 122,164 patients were included in our analysis. Four studies compared the Triglyceride (TG)-lowering group of drugs with placebo and 3 studies compared low-density lipoprotein cholesterol (LDL-c) lowering drugs with placebo. Overall, with non-statin drugs, there was no difference in the risk reduction of cardiovascular (CV) events between men (RR 0.86; 95% CI 0.79-0.94, p-value <0.001) and women (RR 0.88; 95% CI 0.83-0.93, p-value 0.91). However, TG targeting interventions showed no cardiovascular outcome benefits in men (RR 0.85; 95% CI 0.71-1.02, p-value <0.001) while no significant benefit was seen in women (RR 0.87; 95% CI 0.77-0.98, p value = 0.85). No such difference existed in non-statin LDL-c lowering group of drugs in between men (RR 0.88; 95% CI 0.81-0.94, p value = 0.18) and women (RR 0.88; 95% CI 0.82-0.94, p value = 0.46). However, lowering of TG was only associated with a higher risk reduction of CV events (RR 0.86; 95% CI 0.77-0.95, p value = 0.03) in the entire study population. CONCLUSION: Non-statin group of drugs was effective in reducing adverse CV outcomes for both sexes. Lowering TG was associated with higher risk reduction in CV events in general.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dislipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Lipídeos/sangue , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Dislipidemias/sangue , Dislipidemias/epidemiologia , Feminino , Humanos , Hipolipemiantes/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Fatores Sexuais , Resultado do Tratamento
15.
Adv Exp Med Biol ; 1177: 133-148, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246446

RESUMO

Coronary artery disease (CAD) is one of the leading causes of death worldwide. It is well known that dyslipidemia is a major pathogenic risk factor for atherosclerosis and CAD, which results in cardiac ischemic injury and myocardial infarction. Lipid-modifying drugs can effectively improve lipid abnormalities including reducing low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) or increasing high-density lipoprotein cholesterol (HDL-C), and eventually decrease the incidence of cardiovascular events. This chapter will review basic principles of lipid metabolism and focus on the therapeutic strategies of lipids modifying drugs (statins, proprotein convertase subtilisin/kexin type 9 inhibitors, ezetimibe, niacin, polyunsaturated fatty acids, and so on) in patients with arteriosclerotic cardiovascular disease. Meanwhile, the challenges and perspectives of the lipid-lowering agents currently in clinical practice as well as their limitations will be outlined.


Assuntos
Hipolipemiantes/farmacologia , Lipídeos/sangue , Aterosclerose/sangue , Aterosclerose/tratamento farmacológico , LDL-Colesterol/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/tratamento farmacológico , Dislipidemias/sangue , Dislipidemias/tratamento farmacológico , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia
16.
Ann Palliat Med ; 9(2): 414-419, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32233629

RESUMO

BACKGROUND: Dyslipidemia is common among the general population, and its prevention is urgently needed particularly for the health of students. The purpose of our study was to explore the relationship between serum iron level and blood lipids. METHODS: A sample of 290 university students was collected in this cross-section study. The blood lipids and serum iron levels were determined. Pearson's correlation coefficient was used to determine the correlation between serum iron level and blood lipids. RESULTS: The prevalence of dyslipidemia was 8.8% among male students and 5.4% among female students. The overall prevalence of dyslipidemia was7.2% among the total students. The results showed that serum iron level was negatively correlated with triglyceride (TG), but was positively correlated with high-density lipoprotein cholesterol (HDL)-cholesterol, low-density lipoprotein cholesterol (LDL)-cholesterol, and total cholesterol (TC) in female students. Female students with serum iron less than 15 mmol/L had higher levels of serum TG than female students with serum iron 15 mmol/L or above (P<0.05). CONCLUSIONS: These findings suggest that lower serum iron levels may be a risk factor of high serum TG in female students. Supplementation of iron may be a strategy for prevention of high serum TG in female students.


Assuntos
Dislipidemias/sangue , Ferro/sangue , Estudantes/estatística & dados numéricos , Triglicerídeos/sangue , Anemia Ferropriva/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Dislipidemias/diagnóstico , Feminino , Humanos , Masculino , Fatores Sexuais , Universidades , Adulto Jovem
17.
Nutr Metab Cardiovasc Dis ; 30(5): 777-787, 2020 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-32131987

RESUMO

BACKGROUND AND AIMS: Dyslipidemia has been identified as a major risk factor for cardiovascular disease. We aimed to identify metabolites and metabolite modules showing novel association with lipids among Bogalusa Heart Study (BHS) participants using untargeted metabolomics. METHODS AND RESULTS: Untargeted ultrahigh performance liquid chromatography-tandem mass spectroscopy was used to quantify serum metabolites of 1 243 BHS participants (816 whites and 427 African-Americans). The association of single metabolites with lipids was assessed using multiple linear regression models to adjust for covariables. Weighted correlation network analysis was utilized to identify modules of co-abundant metabolites and examine their covariable adjusted correlations with lipids. All analyses were conducted according to race and using Bonferroni-corrected α-thresholds to determine statistical significance. Thirteen metabolites with known biochemical identities showing novel association achieved Bonferroni-significance, p < 1.04 × 10-5, and showed consistent effect directions in both whites and African-Americans. Twelve were from lipid sub-pathways including fatty acid metabolism (arachidonoylcholine, dihomo-linolenoyl-choline, docosahexaenoylcholine, linoleoylcholine, oleoylcholine, palmitoylcholine, and stearoylcholine), monohydroxy fatty acids (2-hydroxybehenate, 2-hydroxypalmitate, and 2-hydroxystearate), and lysoplasmalogens [1-(1-enyl-oleoyl)-GPE (P-18:1) and 1-(1-enyl-stearoyl)-GPE (P-18:0)]. The gamma-glutamylglutamine, peptide from the gamma-glutamyl amino acid sub-pathway, were also identified. In addition, four metabolite modules achieved Bonferroni-significance, p < 1.39 × 10-3, in both whites and African-Americans. These four modules were largely comprised of metabolites from lipid sub-pathways, with one module comprised of metabolites which were not identified in the single metabolite analyses. CONCLUSION: The current study identified 13 metabolites and 4 metabolite modules showing novel association with lipids, providing new insights into the physiological mechanisms regulating lipid levels.


Assuntos
Doenças Cardiovasculares/sangue , Cromatografia Líquida de Alta Pressão , Dislipidemias/sangue , Lipídeos/sangue , Metabolômica , Espectrometria de Massas em Tandem , Adulto , Afro-Americanos , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Estudos Transversais , Dislipidemias/diagnóstico , Dislipidemias/etnologia , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Louisiana/epidemiologia , Masculino , Pessoa de Meia-Idade , Fenótipo , Valor Preditivo dos Testes , Fatores Raciais , Fatores de Risco
18.
Open Heart ; 7(1): e001003, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32201580

RESUMO

Spirulina, a cyanobacteria commonly referred to as a blue-green algae, is one of the oldest lifeforms on Earth. Spirulina grows in both fresh and saltwater sources and is known for its high protein and micronutrient content. This review paper will cover the effects of spirulina on weight loss and blood lipids. The currently literature supports the benefits of spirulina for reducing body fat, waist circumference, body mass index and appetite and shows that spirulina has significant benefits for improving blood lipids.


Assuntos
Fármacos Antiobesidade/uso terapêutico , Suplementos Nutricionais , Dislipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Lipídeos/sangue , Obesidade/tratamento farmacológico , Spirulina , Perda de Peso/efeitos dos fármacos , Animais , Fármacos Antiobesidade/efeitos adversos , Biomarcadores/sangue , Suplementos Nutricionais/efeitos adversos , Dislipidemias/sangue , Dislipidemias/diagnóstico , Humanos , Hipolipemiantes/efeitos adversos , Obesidade/diagnóstico , Obesidade/fisiopatologia , Resultado do Tratamento
19.
Cardiovasc Diabetol ; 19(1): 33, 2020 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-32169071

RESUMO

The proprotein convertase subtilisin/kexin type 9 (PCSK9) acts via a canonical pathway to regulate circulating low-density lipoprotein-cholesterol (LDL-C) via degradation of the LDL receptor (LDLR) on the liver cell surface. Published research has shown that PCSK9 is involved in atherosclerosis via a variety of non-classical mechanisms that involve lysosomal, inflammatory, apoptotic, mitochondrial, and immune pathways. In this review paper, we summarized these additional mechanisms and described how anti-PCSK9 therapy exerts effects through these mechanisms. These additional pathways further illustrate the regulatory role of PCSK9 in atherosclerosis and offer an in-depth interpretation of how the PCSK9 inhibitor exerts effects on the treatment of atherosclerosis.


Assuntos
Aterosclerose/enzimologia , LDL-Colesterol/sangue , Diabetes Mellitus/enzimologia , Dislipidemias/enzimologia , Inflamação/enzimologia , Pró-Proteína Convertase 9/metabolismo , Animais , Anticorpos Monoclonais/uso terapêutico , Anticolesterolemiantes/uso terapêutico , Aterosclerose/sangue , Aterosclerose/tratamento farmacológico , Aterosclerose/patologia , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Dislipidemias/sangue , Dislipidemias/tratamento farmacológico , Dislipidemias/patologia , Células Endoteliais/enzimologia , Células Endoteliais/patologia , Humanos , Inflamação/sangue , Inflamação/patologia , Macrófagos/enzimologia , Macrófagos/patologia , Placa Aterosclerótica , Pró-Proteína Convertase 9/antagonistas & inibidores , Inibidores de Serino Proteinase/uso terapêutico
20.
Maturitas ; 135: 82-88, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32209279

RESUMO

INTRODUCTION: Dyslipidemias are common and increase the risk of cardiovascular disease. The menopause transition is associated with an atherogenic lipid profile, with an increase in the concentrations of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein B (apoB) and potentially lipoprotein (a) [Lp(a)], and a decrease in the concentration of high-density lipoprotein cholesterol (HDL-C). AIM: The aim of this clinical guide is to provide an evidence-based approach to management of menopausal symptoms and dyslipidemia in postmenopausal women. The guide evaluates the effects on the lipid profile both of menopausal hormone therapy and of non-estrogen-based treatments for menopausal symptoms. MATERIALS AND METHODS: Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS: Initial management depends on whether the dyslipidemia is primary or secondary. An assessment of the 10-year risk of fatal cardiovascular disease, based on the Systematic Coronary Risk Estimation (SCORE) system, should be used to set the optimal LDL-C target. Dietary changes and pharmacological management of dyslipidemias should be tailored to the type of dyslipidemia, with statins constituting the mainstay of treatment. With regard to menopausal hormone therapy, systemic estrogens induce a dose-dependent reduction in TC, LDL-C and Lp(a), as well as an increase in HDL-C concentrations; these effects are more prominent with oral administration. Transdermal rather than oral estrogens should be used in women with hypertriglyceridemia. Micronized progesterone or dydrogesterone are the preferred progestogens due to their neutral effect on the lipid profile. Tibolone may decrease TC, LDL-C, TG and Lp(a), but also HDL-C concentrations. Low-dose vaginal estrogen and ospemifene exert a favorable effect on the lipid profile, but data are scant regarding dehydroepiandrosterone (DHEA). Non-estrogen-based therapies, such as fluoxetine and citalopram, exert a more favorable effect on the lipid profile than do sertraline, paroxetine and venlafaxine. Non-oral testosterone, used for the treatment of hypoactive sexual desire disorder/dysfunction, has little or no effect on the lipid profile.


Assuntos
Dislipidemias/terapia , Menopausa , Dislipidemias/sangue , Dislipidemias/diagnóstico , Feminino , Humanos , Lipídeos/sangue , Programas de Rastreamento
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