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2.
Am J Med Sci ; 359(5): 281-286, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32245567

RESUMO

BACKGROUND: The monocyte to high-density lipoprotein ratio (MHR) has been used to predict adverse clinical outcomes in patients with acute coronary syndrome (ACS). This meta-analysis aimed to evaluate the prognostic utility of MHR in patients with ACS. MATERIALS AND METHODS: We comprehensively searched for relevant studies in Pubmed, Embase, CNKI, WanFang and VIP databases until March 12, 2019. Epidemiologic studies investigating the association between MHR and major adverse cardiovascular events (MACE) or all-cause mortality in patients with ACS were included. Pooled effect was expressed as risk ratios (RR) with 95% confidence intervals (CI) for the highest versus the reference lower MHR group. RESULTS: Eight studies involving 6,480 patients with ACS were included and analyzed. Meta-analysis indicated that the highest MHR was significantly associated with higher risk of MACE (RR 1.65; 95%CI 1.36-2.02) and all-cause mortality (RR 2.61; 95%CI 1.29-4.89) after adjusting for the conventional confounders. The prognostic values of MACE with the highest MHR caused no significant changes in the in-hospital follow-up (RR 1.76; 95%CI 1.34-2.32) and >6 months follow-up (RR 1.68; 95%CI 1.08-2.62) subgroups. Furthermore, ST elevation myocardial infarction patients with the highest MHR had a 2.07-fold higher risk of in-hospital MACE (RR 2.07; 95%CI 1.52-2.80). CONCLUSIONS: Elevated MHR is independently associated with an increased risk of MACE and all-cause mortality in patients with ACS. MHR may serve as a potential prognostic indicator for ACS prognosis.


Assuntos
Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/diagnóstico , Lipoproteínas HDL/sangue , Monócitos/citologia , Feminino , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Prognóstico , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico
3.
PLoS One ; 15(4): e0231927, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32343751

RESUMO

Metabolic Syndrome (MS) is characterized by a low-grade inflammatory state causing an alteration of non-invasive indexes derived from blood count, namely monocyte-to-HDL ratio (MHR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR). We analyse a population of 771 subjects (394 controls and 377 MS patients) to evaluate the best predictive index of MS. The diagnosis of MS was made according to the 2006 criteria of the International Diabetes Federation (IDF). We performed ROC curve analyses to evaluate the best predictor index of MS. MHR cut-off value was used to classify the population in two different groups and to create the outcome variable of the Recursive Partitioning and Amalgamation (RECPAM) analysis. This method is a tree-structured approach that defines "risk profiles" for each group of dichotomous variables. We showed that MHR index is significantly linked to body mass index (BMI), waist circumference, creatinine, C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR). ROC curve defined an MHR cut-off value of 6.4, which was able to identify two patient groups with significant differences in waist circumference, blood pressure, creatinine, estimated glomerular filtration rate and fasting plasma glucose. RECPAM analysis demonstrated that gender, BMI categorization and hyperglycaemia were the most important risk determinants of increased MHR index that can be considered bona fide a useful and easily obtainable tool to suggest the presence of peculiar metabolic features that predict MS.


Assuntos
Glicemia/análise , Índice de Massa Corporal , Lipoproteínas HDL/sangue , Síndrome Metabólica/patologia , Monócitos/citologia , Adulto , Idoso , Área Sob a Curva , Sedimentação Sanguínea , Proteína C-Reativa/análise , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Curva ROC , Fatores Sexuais , Fumantes , Circunferência da Cintura
4.
PLoS Negl Trop Dis ; 14(3): e0008138, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32226013

RESUMO

The changes in host lipid metabolism during leprosy have been correlated to fatty acid alterations in serum and with high-density lipoprotein (HDL) dysfunctionality. This is most evident in multibacillary leprosy patients (Mb), who present an accumulation of host lipids in Schwann cells and macrophages. This accumulation in host peripheral tissues should be withdrawn by HDL, but it is unclear why this lipoprotein from Mb patients loses this function. To investigate HDL metabolism changes during the course of leprosy, HDL composition and functionality of Mb, Pb patients (paucibacillary) pre- or post-multidrug therapy (MDT) and HC (healthy controls) were analyzed. Mb pre-MDT patients presented lower levels of HDL-cholesterol compared to HC. Moreover, Ultra Performance Liquid Chromatography-Mass Spectrometry lipidomics of HDL showed an altered lipid profile of Mb pre-MDT compared to HC and Pb patients. In functional tests, HDL from Mb pre-MDT patients showed impaired anti-inflammatory and anti-oxidative stress activities and a lower cholesterol acceptor capacity compared to other groups. Mb pre-MDT showed lower concentrations of ApoA-I (apolipoprotein A-I), the major HDL protein, when compared to HC, with a post-MDT recovery. Changes in ApoA-I expression could also be observed in M. leprae-infected hepatic cells. The presence of bacilli in the liver of a Mb patient, along with cell damage, indicated hepatic involvement during leprosy, which may reflect on ApoA-I expression. Together, altered compositional and functional profiles observed on HDL of Mb patients can explain metabolic and physiological changes observed in Mb leprosy, contributing to a better understanding of its pathogenesis.


Assuntos
Hanseníase/patologia , Lipoproteínas HDL/sangue , Adolescente , Adulto , Idoso , Cromatografia Líquida de Alta Pressão , Feminino , Humanos , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Plasma/química , Adulto Jovem
5.
Arterioscler Thromb Vasc Biol ; 40(5): 1182-1194, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32131613

RESUMO

OBJECTIVE: To characterize the fate of protein and lipid in nascent HDL (high-density lipoprotein) in plasma and explore the role of interaction between nascent HDL and mature HDL in promoting ABCA1 (ATP-binding cassette transporter 1)-dependent cholesterol efflux. Approach and Results: Two discoidal species, nascent HDL produced by RAW264.7 cells expressing ABCA1 (LpA-I [apo AI containing particles formed by incubating ABCA1-expressing cells with apo AI]), and CSL112, human apo AI (apolipoprotein AI) reconstituted with phospholipids, were used for in vitro incubations with human plasma or purified spherical plasma HDL. Fluorescent labeling and biotinylation of HDL were employed to follow the redistribution of cholesterol and apo AI, cholesterol efflux was measured using cholesterol-loaded cells. We show that both nascent LpA-I and CSL112 can rapidly fuse with spherical HDL. Redistribution of the apo AI molecules and cholesterol after particle fusion leads to the formation of (1) enlarged, remodeled, lipid-rich HDL particles carrying lipid and apo AI from LpA-I and (2) lipid-poor apo AI particles carrying apo AI from both discs and spheres. The interaction of discs and spheres led to a greater than additive elevation of ABCA1-dependent cholesterol efflux. CONCLUSIONS: These data demonstrate that although newly formed discs are relatively poor substrates for ABCA1, they can interact with spheres to produce lipid-poor apo AI, a much better substrate for ABCA1. Because the lipid-poor apo AI generated in this interaction can itself become discoid by the action of ABCA1, cycles of cholesterol efflux and disc-sphere fusion may result in net ABCA1-dependent transfer of cholesterol from cells to HDL spheres. This process may be of particular importance in atherosclerotic plaque where cholesterol acceptors may be limiting.


Assuntos
Transportador 1 de Cassete de Ligação de ATP/metabolismo , HDL-Colesterol/sangue , Macrófagos/metabolismo , Transportador 1 de Cassete de Ligação de ATP/genética , Animais , Apolipoproteína A-I/sangue , Transporte Biológico , HDL-Colesterol/química , Humanos , Cinética , Lipoproteínas HDL/sangue , Camundongos , Tamanho da Partícula , Células RAW 264.7
6.
BMC Cancer ; 20(1): 200, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164586

RESUMO

BACKGROUND: Existing data from several reports on the association between lipid profile and ovarian tumour (OT) suggests divergent conclusions. Our aim was to examine whether circulating lipid profile: total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) differed between cases and non-cases of OT. METHODS: Electronic repositories; PUBMED, EMBASE and Cochrane library were explored through December 2019 to retrieve published articles for inclusion in the meta-analysis after quality assessment. Heterogeneity was assessed using I2 statistics, the effect of individual studies on the overall effect size was tested using sensitivity analysis and funnel plot was used to evaluate publication bias. RESULTS: Twelve studies, involving 1767 OT cases and 229,167 non-cases of OT were included in this meta-analysis and I2 statistics ranged between 97 and 99%. Mean circulating TC (- 16.60 [- 32.43, - 0.77]mg/dL; P = 0.04) and HDL (- 0.25[- 0.43, - 0.08]mmol/L; P = 0.005) were significantly lower among OT cases compared to non-OT cases. CONCLUSION: Decreased TC and HDL profiles were observed among subjects with OT in this collection of reports. The implications of TC and HDL in tumour manifestations and growth need to be validated in a large multi-ethnic longitudinal cohort adjusting for relevant confounders.


Assuntos
Lipoproteínas HDL/sangue , Neoplasias Ovarianas/sangue , Triglicerídeos/sangue , Colesterol/sangue , Feminino , Humanos , Lipoproteínas LDL/sangue , Masculino , Fatores de Risco
7.
Lipids Health Dis ; 19(1): 49, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32178676

RESUMO

BACKGROUND: Inflammatory cytokines contribute to proatherogenic changes in lipid metabolism by reduction of HDL-cholesterol (HDL-C) levels, impairment of its antiinflammatory and antioxidant functions. Therefore, the protective actions of HDL-C can be limited in chronic inflammatory diseases such as multiple sclerosis (MS). The aim of this study was to assess the association between lipoprotein subfractions and inflammatory status in early stages of multiple sclerosis. METHODS: Polyacrylamide gel electrophoresis Lipoprint© System was used for lipoprotein profile analysis in 19 newly diagnosed MS patients, and in matched 19 healthy controls. Serum levels of interleukin (IL) 1ß, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12 (p70), IL-13, IL-17, granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor, interferon-γ and TNF-α were measured by multiplex bead assay. RESULTS: Concentrations of the measured cytokines and lipoprotein subclasses were comparable between MS patients and controls. Male, but not female MS patients had significantly higher total HDL-C and small HDL-C subfraction than healthy controls. Large HDL-C negatively correlated with all measured cytokines except IL-17 in MS but not in controls. Intermediate HDL-C subfractions correlated positively with all measured cytokines except G-CSF in MS females but not in MS males or controls. CONCLUSION: Our results of higher HDL-C and mainly its small HDL-C subfraction suggest that male MS patients are at higher risk of atherosclerosis and the subtle dyslipidemia is present in early stages of the disease. The correlations between specific HDL-C subfractions and the inflammatory cytokines demonstrate mutual links between systemic inflammation and lipid metabolism in MS. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT03052595 Registered on Feb 14, 2017.


Assuntos
Inflamação/imunologia , Inflamação/metabolismo , Lipoproteínas HDL/metabolismo , Esclerose Múltipla/imunologia , Esclerose Múltipla/metabolismo , Adulto , HDL-Colesterol/sangue , HDL-Colesterol/metabolismo , Eletroforese em Gel de Poliacrilamida , Feminino , Humanos , Inflamação/sangue , Interleucina-10/sangue , Interleucina-10/metabolismo , Interleucina-17/sangue , Interleucina-17/metabolismo , Interleucina-1beta/sangue , Interleucina-1beta/metabolismo , Interleucina-2/sangue , Interleucina-2/metabolismo , Interleucina-4/sangue , Interleucina-4/metabolismo , Interleucina-6/sangue , Interleucina-6/metabolismo , Interleucina-7/sangue , Interleucina-7/metabolismo , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Lipoproteínas LDL/metabolismo , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/sangue
8.
Bratisl Lek Listy ; 121(2): 151-153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115969

RESUMO

BACKGROUND: Mitral valve prolapse (MVP) is a common disorder, afflicting 2 % to 3 % of the general population. Despite the general belief of a benign disorder, there is an increasing awareness of an association between mitral valve prolapse and sudden cardiac death from arrhythmia and also atherosclerosis. Monocyte to high density lipoprotein ratio (MHR) is a new tool for predicting inflammation, which plays a major role in atherosclerosis. OBJECTIVE:   To evaluate the relationship between MHR and the presence of MVP. METHODS: The study population consisted of 82 patients with MVP and the control group of 78 normal individuals. Transthoracic echocardiograpy was performed for all of the study population and peripheral venous blood samples were drawn for measuring MHR and other haemotological parameters. RESULTS: The patients with MVP were more likely to have higher MHR values (15.82±6.01 in MVP patients and 13.30 ± 6.43 in controls; p=0.011). Monocyte counts and MHR of the MVP group were significantly higher than the control group and MHR values were directly proportional with the regurgitation area. CONCLUSION: The MHR is strongly associated with MVP and regurgitation area and might be a prognostic factor for patients with MVP (Tab. 3, Fig. 1, Ref. 15).


Assuntos
Lipoproteínas HDL , Prolapso da Valva Mitral , Monócitos , Estudos de Casos e Controles , Morte Súbita Cardíaca , Humanos , Lipoproteínas HDL/sangue , Prolapso da Valva Mitral/sangue , Prolapso da Valva Mitral/diagnóstico , Prognóstico
9.
Horm Metab Res ; 52(2): 95-103, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32053842

RESUMO

The aim of this study was to explore the association of the triglyceride to high-density lipoprotein ratio (TG/HDL) and the visceral adiposity index (VAI) with metabolic syndrome (Mets) in high-risk populations of diabetic patients. Patients were recruited from the Endocrinology Clinic of Hebei General Hospital from April 2018 to April 2019,according to the "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 Edition)". A total of 824 patients participated in the study. The association between TG/HDL or VAI and Mets in these patients was assessed using a multivariate logistic regression model. Receiver operating characteristic (ROC) curve analysis was used to evaluate the ability of TG/HDL and VAI to predict Mets in the diabetic susceptible population. The prevalence of Mets gradually increased in males and females with advancing tertiles of TG/HDL or VAI. After adjusting for the relevant risk factors, TG/HDL and VAI were positively correlated with Mets in men and women. Both of them showed a better the area under the ROC curve (AUC) for Mets in females than body mass index, waist circumference, TG and homeostatic model assessment of insulin resistance. In females, the cut-off point of 1.67 for VAI showed a higher accuracy for Mets (sensitivity 0.756, specificity 0.705, Youden index 0.461), the same relationship not significant in men. TG/HDL and VAI provide a high predictive value for Mets in a diabetic susceptible population, especially in females.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Lipoproteínas HDL/sangue , Síndrome Metabólica/sangue , Triglicerídeos/sangue , Adiposidade , Adulto , China/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Humanos , Gordura Intra-Abdominal/fisiopatologia , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Curva ROC
10.
Nutrients ; 12(2)2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32023922

RESUMO

Angelica gigas Nakai, Korean dang-gui, has long been widely used in traditional treatment methods. There have been a number of studies of the health effects of A. gigas and related compounds, but studies addressing effects on blood triglycerides (TG) are lacking. To investigate the effects of A. gigas Nakai extract (AGNE) on TG in Korean subjects, we carried out a 12-week, randomized, double-blind, placebo-controlled clinical trial. Subjects who met the inclusion criterion (130 mg/dL ≤ fasting blood TG ≤ 200 mg/dL) were recruited for this study. One hundred subjects were assigned to the AGNE group (n = 50) or the placebo group (n = 50), who were given 1 g/day of AGNE (as a gigas Nakai extract 200 mg/d) in capsules and the control group for 12 weeks. Outcomes were efficacy TG, lipid profiles, atherogenic index, and safety parameters were assessed initially for a baseline measurement and after 12 weeks. After 12 weeks of supplementation, TG and very low-density lipoprotein cholesterol (VLDL-C) concentration and TG/HDL-C ratio in the AGNE group were significantly reduced compared to the placebo group (p < 05). No significant changes in any safety parameter were observed. These results suggest that the ingestion of AGNE may improve TG and be useful to manage or prevent hypertriglyceridemia.


Assuntos
Angelica , Hipertrigliceridemia/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Extratos Vegetais/uso terapêutico , Triglicerídeos/sangue , Adulto , VLDL-Colesterol/sangue , Método Duplo-Cego , Feminino , Humanos , Hipertrigliceridemia/sangue , Lipoproteínas HDL/sangue , Masculino , Pessoa de Meia-Idade , República da Coreia , Resultado do Tratamento
11.
BMC Pregnancy Childbirth ; 20(1): 61, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000699

RESUMO

BACKGROUND: While many risk factors for preeclampsia, such as increased body mass index, advanced maternal age, chronic hypertension, diabetes, are now established in clinical practice, maternal lipid profile has not been included in the risk assessment for preeclampsia. We aim to characterize the serum levels of Total Cholesterol (TC), High density lipoprotein (HDL), Low density lipoprotein (LDL), Triglycerides (TG), Apolipoprotein A1, Apolipoprotein B and their ratios TC/HDL and ApoB/ApoA1 in the maternal and fetal circulations of normal pregnancy, preeclampsia (PE), fetal growth restriction (FGR) and PE + FGR. METHODS: A prospective cross-sectional case control study was conducted measuring maternal and fetal lipid levels by enzymatic analysis and immune-turbidimetric enzymatic assays. FGR was defined by elevated umbilical artery Doppler resistance in association with estimated fetal weight < 10%. Kruskal Wallis non-parametric analysis of variance was used to test for homogeneity across the clinical groups for each of the variables, Mann-Whitney tests for pairwise comparisons and Spearman rank correlation were used to quantify gestational age-related changes. RESULTS: (1) TG levels were elevated in maternal PE and cord blood PE + FGR groups compared to normal pregnancies. (2) A statistically significant elevation of fetal ApoB levels was observed in PE, FGR and PE + FGR compared to normal pregnancies. Apolipoprotein levels A1 and B were not different between maternal groups. (3) TC, HDL, LDL and TC/HDL levels did not show any significant gestational variation or between clinical groups in the maternal or fetal circulation. CONCLUSIONS: Elevation in maternal TG levels may have a role in the pathogenesis of PE. The implications of elevated maternal and fetal TG levels and elevated fetal Apolipoprotein B levels deserves further exploration of their role in long term cardiovascular risk in the mother as well as the offspring.


Assuntos
Retardo do Crescimento Fetal/sangue , Lipídeos/sangue , Pré-Eclâmpsia/sangue , Adulto , Apolipoproteína A-I/sangue , Apolipoproteínas B/sangue , Austrália/epidemiologia , Estudos de Casos e Controles , Colesterol/sangue , Estudos Transversais , Ensaios Enzimáticos , Feminino , Sangue Fetal , Humanos , Imunoturbidimetria , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Circulação Placentária , Gravidez , Estudos Prospectivos , Triglicerídeos/sangue , Adulto Jovem
12.
Zhonghua Er Ke Za Zhi ; 58(2): 101-106, 2020 Feb 02.
Artigo em Chinês | MEDLINE | ID: mdl-32102145

RESUMO

Objective: To analyze the genetic characteristics of a five generations pedigree with homozygous familial hypercholesterolemia (HoFH). Methods: Prospective study. Twenty family members included a proband diagnosed as familial hyperlipidemia at the cardiology Department of Xi'an Children's Hospital in October 2018 were research object. Clinical data were collected. Genome DNAs were extracted. Whole exons sequencing was performed on the proband using target capture next generation sequencing. Candidate gene mutation sites identified by bioinformatics were verified by Sanger sequencing in the family members. The genotype-phenotype correlation of the pedigree was analyzed between heterozygous mutation carriers and non-carriers. Results: The proband was a 7-years and 10-month-old boy. He was born with a roundgreen bean size yellow skin protuberance in the skin of the coccyx. Since the age of 3-4 years old, xanthoma-like lesions with a diameter of 0.5-1.5 cm gradually appeared in the skin of bilateral elbow joints, knee joints and Achilles tendon. The height, weight and intellectual development of the child were the same as those of normal children at the same age. No similar xanthoma-like lesion was found in the other family members. The proband's total cholesterol (TC) reached 18.16-21.24 mmol/L, and his low density lipoproteincholesterol (LDL-C) was 14.08-15.51 mmol/L. Carotid ultrasonography showed diffuse sclerotic plaques in bilateral carotid and vertebral arteries, and color Doppler echocardiography revealed aortic valve thickening and calcification. Gene testing identified that the proband carried a homozygous mutation C. 418G>A (p. E140K) in LDLR gene inherited from his parents who had a consanguineous marriage and carried a heterozygous mutation of LDLR-E140K, respectively.The TC, LDL-C and apolipoproteinB (ApoB) of LDLR-E140K gene heterozygous carriers ((8.40±0.13), (6.79±0.01) and (1.95±0.05) mmol/L, respectively) were significantly higher than those of non-carriers ((4.59±0.28), (3.35±0.39) and (0.86±0.10) mmol/L, t=7.269, 4.595, 6.311, respectively, P<0.05). Conclusions: LDLR-E140K gene homozygous mutation is first reported to be associated with most severe phenotype HoFH. The genotype-phenotype analysis of the pedigree shows that the clinical phenotype of the proband with homozygous mutation is the most serious, and all the heterozygous mutation carriers present with hypercholesterolemia phenotype. The investigation confirms that LDLR-E140K is the pathogenic variation of familial hyperlipidemia.


Assuntos
LDL-Colesterol/sangue , DNA/genética , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo I/genética , Receptores de LDL/genética , Valva Aórtica/diagnóstico por imagem , Sequência de Bases , Criança , Pré-Escolar , Análise Mutacional de DNA , Ecocardiografia Doppler , Feminino , Predisposição Genética para Doença , Heterozigoto , Homozigoto , Humanos , Hiperlipoproteinemia Tipo I/diagnóstico , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/diagnóstico , Lactente , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Proteínas de Membrana , Mutação , Linhagem , Fenótipo , Estudos Prospectivos
13.
Circulation ; 141(6): 444-453, 2020 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-31941372

RESUMO

BACKGROUND: Studies have failed to establish a clear link between high-density lipoprotein (HDL) cholesterol and cardiovascular disease, leading to the hypothesis that the atheroprotective role of HDL lies in its biological activity rather than in its cholesterol content. However, to date, the association between HDL functional characteristics and acute coronary syndrome has not been investigated comprehensively. METHODS: We conducted a case-control study nested within the PREDIMED (Prevención con Dieta Mediterránea) cohort, originally a randomized trial in which participants followed a Mediterranean or low-fat diet. Incident acute coronary syndrome cases (N=167) were individually matched (1:2) to control patients by sex, age, intervention group, body mass index, and follow-up time. We investigated 2 individual manifestations (myocardial infarction, unstable angina) as secondary outcomes. We measured the following functional characteristics: HDL cholesterol concentration (in plasma); cholesterol efflux capacity; antioxidant ability, measured by the HDL oxidative-inflammatory index; phospholipase A2 activity; and sphingosine-1-phosphate, apolipoproteins A-I and A-IV, serum amyloid A, and complement 3 protein (in apolipoprotein B-depleted plasma). We used conditional logistic regression models adjusted for HDL cholesterol levels and cardiovascular risk factors to estimate odds ratios (ORs) between 1-SD increments in HDL functional characteristics and clinical outcomes. RESULTS: Low values of cholesterol efflux capacity (OR1SD, 0.58; 95% CI, 0.40-0.83) and low levels of sphingosine-1-phosphate (OR1SD, 0.70; 95% CI, 0.52-0.92) and apolipoprotein A-I (OR1SD, 0.58; 95% CI, 0.42-0.79) were associated with higher odds of acute coronary syndrome. Higher HDL oxidative inflammatory index values were marginally linked to acute coronary syndrome risk (OR1SD, 1.27; 95% CI, 0.99-1.63). Low values of cholesterol efflux capacity (OR1SD, 0.33; 95% CI, 0.18-0.61), sphingosine-1-phosphate (OR1SD: 0.60; 95% CI: 0.40-0.89), and apolipoprotein A-I (OR1SD, 0.59; 95% CI, 0.37-0.93) were particularly linked to myocardial infarction, whereas high HDL oxidative-inflammatory index values (OR1SD, 1.53; 95% CI, 1.01-2.33) and low apolipoprotein A-I levels (OR1SD, 0.52; 95% CI, 0.31-0.88) were associated with unstable angina. CONCLUSIONS: Low cholesterol efflux capacity values, pro-oxidant/proinflammatory HDL particles, and low HDL levels of sphingosine-1-phosphate and apolipoprotein A-I were associated with increased odds of acute coronary syndrome and its manifestations in individuals at high cardiovascular risk. CLINICAL TRIAL REGISTRATION: URL: https://www.controlled-trials.com/ISRCTN35739639. Unique identifier: ISRCTN35739639.


Assuntos
Síndrome Coronariana Aguda/sangue , Apolipoproteína A-I/sangue , Lipoproteínas HDL/sangue , Lisofosfolipídeos/sangue , Esfingosina/análogos & derivados , Síndrome Coronariana Aguda/dietoterapia , Idoso , Estudos de Casos e Controles , Dieta Mediterrânea , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Esfingosina/sangue
14.
Artigo em Inglês | MEDLINE | ID: mdl-31954174

RESUMO

Perinatal and long-term offspring morbidities are strongly dependent on the preservation of placental vascular homeostasis during pregnancy. In adults, the HDL-apoM-S1P complex protects the endothelium and maintains vascular integrity. However, the metabolism and biology of cord blood-derived HDLs (referred to as neonatal HDL, nHDL) strikingly differ from those in adults. Here, we investigate the role of neonatal HDLs in the regulation of placental vascular function. We show that nHDL is a major carrier of sphingosine-1-phosphate (S1P), which is anchored to the particle through apoM (rs = 0.90, p < 0.0001) in the fetal circulation. Furthermore, this complex interacts with S1P receptors on the feto-placental endothelium and activates specifically extracellular signal-regulated protein kinases 1 and 2 (ERK) and phospholipase C (PLC) downstream signaling, promotes endothelial cell proliferation and calcium flux. Notably, the nHDL-S1P complex triggers actin filaments reorganization, leading to an enhancement of placental endothelial barrier function. Additionally, nHDL induces vasorelaxation of isolated placental chorionic arteries. Taken together, these results suggest that circulating nHDL exerts vasoprotective effects on the feto-placental endothelial barrier mainly via S1P signaling.


Assuntos
Sangue Fetal/metabolismo , Lipoproteínas HDL/metabolismo , Lisofosfolipídeos/metabolismo , Placenta/irrigação sanguínea , Esfingosina/análogos & derivados , Apolipoproteínas M/sangue , Apolipoproteínas M/metabolismo , Células Cultivadas , Endotélio Vascular/metabolismo , Feminino , Humanos , Lipoproteínas HDL/sangue , Lisofosfolipídeos/sangue , Sistema de Sinalização das MAP Quinases , Gravidez , Esfingosina/sangue , Esfingosina/metabolismo , Fosfolipases Tipo C/metabolismo
15.
Cir Cir ; 88(1): 1-6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31967611

RESUMO

Background: Alterations in the lipid profile are part of the acute phase response, this corresponds to the so-called lipemia of sepsis. Objective: To determine if the serum level of high density lipoprotein (HDL) is related to severity and mortality. Method: Retrospective, descriptive, cross-sectional study of patients diagnosed with abdominal sepsis. During the period from April 2016 to February 2017. The severity was determined by APACHE II, SOFA, Mannheim, CONUT, the presence of organic faults and mortality. Results: We included 154 cases, 59 female and 95 male; The main organ causing abdominal sepsis was the appendix 41.6%. The overall mortality was 14.3%. The presence of organic faults was 35.1%. The mean HDL level was 37.64 mg/dl (SD ± 16.16). The findings, subjected to statistical verification by Student's t-test, showed significance among the cases with SOFA > 4 (p = 0.01) and Mannheim > 26 (p = 0.001), CONUT > 6 (p = 0.001), presence of organic failures (p = 0.001), and mortality (p = 0.003). Conclusions: HDL levels are related to severity, with the development of organic failures and mortality in sepsis.


Assuntos
Gastroenteropatias/sangue , Lipoproteínas HDL/sangue , Sepse/sangue , Índice de Gravidade de Doença , APACHE , Reação de Fase Aguda/sangue , Biomarcadores/sangue , Estudos Transversais , Feminino , Gastroenteropatias/etiologia , Gastroenteropatias/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Escores de Disfunção Orgânica , Peritonite/sangue , Peritonite/complicações , Peritonite/mortalidade , Estudos Retrospectivos , Sepse/etiologia , Sepse/mortalidade
16.
Am Heart J ; 221: 60-66, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31927126

RESUMO

BACKGROUND: High-density lipoprotein cholesterol (HDL-C) concentration is inversely related to risk of major adverse cardiovascular events (MACE) in epidemiologic studies but is a poorer predictor of MACE in patients with established coronary heart disease. HDL particle concentration (HDLP) has been proposed as a better predictor of risk. We investigated whether HDLP is associated with risk of MACE after acute coronary syndrome (ACS). METHODS: The dal-Outcomes trial compared the CETP inhibitor dalcetrapib with placebo in patients with recent ACS. In a nested case-cohort analysis, total, large, medium, and small HDLPs were measured by nuclear magnetic resonance spectroscopy at baseline (4-12 weeks after ACS) in 476 cases with MACE and 902 controls. Hazard ratios (HRs; case-control) for 1-SD increment of HDLP or HDL-C at baseline were calculated with and without adjustment for demographic, clinical, laboratory, and treatment variables. Similarly, HRs for MACE were calculated for changes in HDLP or HDL-C from baseline to month 3 of assigned treatment. RESULTS: Over median follow-up of 28 months, the risk of MACE was not associated with baseline HDLP (adjusted HR = 0.98, 95% CI = 0.84-1.15, P = .81), any HDLP subclass, or HDL-C. Dalcetrapib increased HDL-C and total, medium, and large HDLP and decreased small HDLP but had no effect on MACE compared with placebo. There were no association of risk of MACE with change in HDLP or HDL-C and no interaction with assigned study treatment. CONCLUSIONS: Neither baseline HDLP nor the change in HDLP on treatment with dalcetrapib or placebo was associated with risk of MACE after ACS.


Assuntos
Síndrome Coronariana Aguda/sangue , Angina Instável/epidemiologia , Doença das Coronárias/mortalidade , Hospitalização/estatística & dados numéricos , Lipoproteínas HDL/sangue , Infarto do Miocárdio/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Síndrome Coronariana Aguda/tratamento farmacológico , Idoso , Anticolesterolemiantes/uso terapêutico , Estudos de Casos e Controles , HDL-Colesterol/sangue , Feminino , Humanos , Espectroscopia de Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Compostos de Sulfidrila/uso terapêutico
17.
An Bras Dermatol ; 95(1): 40-45, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31889591

RESUMO

BACKGROUND: Psoriasis is a chronic immune-mediated inflammatory skin disease that is associated with cardiovascular comorbidities. OBJECTIVES: The objective of this retrospective study is to assess the C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio as inflammatory markers in patients with psoriasis and to search for a relationship between these parameters and psoriasis severity, as defined by the psoriasis area and severity index. METHODS: There were 94 patients with psoriasis and 118 healthy controls enrolled in the study. The C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio values of two groups were retrospectively evaluated. RESULTS: Statistically significant differences were observed in terms of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio between the patient and control groups (p=0.001, p=0.003, p=0.038, and p=0.007, respectively). Positive correlations were found between the psoriasis area and severity index and the values of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio (r: 0.381; p<0.01, r: 0.203; p<0.05, r: 0.268; p<0.01, r: 0.374; p<0.01, r: 0.294; p<0.01, respectively). STUDY LIMITATIONS: The small sample size and the retrospective design of the study are limitations. CONCLUSION: Elevated C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were significantly associated with psoriasis. A positive correlation between C-reactive protein and monocyte-to-high-density-lipoprotein ratio leads to the suggestion that monocyte-to-high-density-lipoprotein ratio might be a reliable parameter in psoriasis during the follow-up. The relationship between the diasease and inflammatory parameters might provide early detection of cardiovascular morbidities in psoriasis patients.


Assuntos
Plaquetas , Proteína C-Reativa/análise , Lipoproteínas HDL/sangue , Linfócitos , Monócitos , Neutrófilos , Psoríase/sangue , Adulto , Análise de Variância , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Psoríase/complicações , Valores de Referência , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Adulto Jovem
18.
Int J Gynaecol Obstet ; 148(3): 375-380, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31811728

RESUMO

OBJECTIVE: To investigate associations between pre-gestational dyslipidemia, expressed as the ratio between triglycerides (TG) and high-density lipoprotein cholesterol (HDL), and adverse maternal and neonatal outcomes. METHODS: A retrospective cohort analysis included women with TG and HDL measurements available up to 52 weeks before conception who delivered a singleton, non-anomalous infant. The study population was stratified according to a TG/HDL ratio cutoff of 3. Primary maternal outcomes included gestational diabetes or hypertensive disorders of pregnancy and neonatal outcomes after delivery before 37 weeks. RESULTS: Among 5226 women included, 4446 (85.1%) had TG/HDL <3 and 780 (14.9%) ≥3. TG/HDL ratio ≥3 vs <3 was associated with higher rates of gestational diabetes (13.1% vs 5.2%, P<0.0001) and hypertensive disorders of pregnancy (5.3% vs 2.2%, P<0.0001). Larger babies (3229.7 ± 520.7 g vs 3181.7 ± 504.4 g, P=0.015) with higher birth weight percentile (59.0 ± 26.4 vs 55.1 ± 26.6, P<0.0001) and increased rates of large-for-gestational-age (14.5% vs 10.8%, P=0.007) and macrosomia (5.6% vs 3.9%, P=0.026) were found. In multivariate analysis, TG/HDL ≥3 remained an independent risk-factor for gestational diabetes (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.02-2.39) and pre-eclampsia (aOR 3.02, 95% CI 1.82-5.01). CONCLUSIONS: An increase in adverse pregnancy outcomes was reported, mainly gestational diabetes and pre-eclampsia, when TG/HDL ratio up to 1 year before pregnancy was ≥3.


Assuntos
Diabetes Gestacional/epidemiologia , Lipoproteínas HDL/sangue , Resultado da Gravidez/epidemiologia , Triglicerídeos/sangue , Adulto , Feminino , Macrossomia Fetal/epidemiologia , Humanos , Recém-Nascido , Pré-Eclâmpsia/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco
19.
Ocul Immunol Inflamm ; 28(3): 463-467, 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30966842

RESUMO

Purpose: The purpose of this article was to evaluate monocyte count and high-density lipoprotein (HDL) cholesterol levels and their ratio (monocyte/HDL ratio [MHR]) in patients with branch retinal vein occlusion (BRVO).Materials and Methods: A total of 50 participants were included in the study. Participants were divided into two groups: Twenty-five patients diagnosed with BRVO and 25 participants as the control group. Ocular examination findings and hematologic parameters were accessed from the file records and database, retrospectively.Results: The mean MHR was significantly higher in BRVO group compared to the control group (13.4 ± 5.2 vs. 8.1 ± 2.2, p < 0.001). In receiver operating characteristics analysis, the area under the curve for MHR was 0.862, and an MHR of >9.5 predicted BRVO with a sensitivity of 76% and specificity of 70.8%.Conclusion: The present study showed that elevated MHR is significantly associated with BRVO. Therefore, MHR may be a useful marker for the emergence of BRVO.


Assuntos
Biomarcadores/sangue , Lipoproteínas HDL/sangue , Monócitos/metabolismo , Oclusão da Veia Retiniana/sangue , Vasos Retinianos/diagnóstico por imagem , Acuidade Visual , Idoso , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Contagem de Leucócitos , Masculino , Prognóstico , Oclusão da Veia Retiniana/diagnóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Microscopia com Lâmpada de Fenda , Tomografia de Coerência Óptica
20.
Biomed Chromatogr ; 34(1): e4693, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31465544

RESUMO

High-density lipoproteins (HDLs) have anti-inflammatory and antioxidant properties and are potentially cardio-protective. Defective HDL function is caused by alterations in both the proteome and lipidome of HDL particles. As potential biomarkers, the development of analytical methods is necessary for the enrichment of HDLs. Therefore, a method for selective enrichment of HDLs using immobilized metal ion affinity chromatography (IMAC) and metal oxide affinity chromatography (MOAC) is presented. SPE-based isolation of HDLs from whole serum is adopted as an alternative to traditional ultracentrifugation methods followed by SDS-PAGE. The enrichment mechanism relies on isoelectric points of lipoproteins and metal oxide. Negatively charged lipoprotein particles interact with positively charged metal oxides and IMAC affinity, which acts as a cation. Identified proteins from HDL through MALDI-MS analysis are apo AI, AII, AIV, CI, CIII, E, J, M, H, serum amyloid A and other nonapoproteins that are part of HDL particles and perform cellular functions. This serum-based proteomics approach gives insight into the functional role of HDL. HDL-associated phospholipids have also been analyzed by LDI-MS. Results suggest that the adopted analytical strategy is a feasible idea to extract lipoproteins from serum. A comparative study of healthy and diseased samples using this approach will provide valuable information in future.


Assuntos
Cromatografia de Afinidade/métodos , Lipoproteínas HDL/sangue , Fosfolipídeos/sangue , Proteoma/análise , Humanos , Lipoproteínas HDL/isolamento & purificação , Fosfolipídeos/isolamento & purificação , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
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