RESUMO
BACKGROUND: The association of visceral adiposity with mortality in older adults is conflicting. Whether age influences the predicting ability of visceral adiposity (VAI) for mortality remains unknown. This study uncovered the relationship between age-adjusted visceral adiposity index and mortality through the data of NHANES 2011-2014. METHODS: This study obtained data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. The age-adjusted visceral adiposity index (AVAI) scores were expressed as quartiles. Receiver operating characteristics (ROC) curve analysis was also applied to compare the predictive ability for mortality. Multivariate weighted Cox regression models were constructed to explore the association between AVAI and mortality. Kaplan-Meier survival curves were conducted for survival analyses. Smooth curve fittings and two-piecewise linear models were applied to explore the relationships between AVAI and mortality. RESULTS: This study recruited 4281 subjects aged ≥ 18 years from the NHANES 2011-2014. The AUCs of AVAI were 0.82 (0.79, 0.86) and 0.89 (0.85, 0.92) for predicting all-cause mortality and cardiovascular mortality, which were superior to BMI, WC and VAI (all p < 0.05). AVAI is still an independent predictor for mortality adjusted for confounders. The associations of AVAI with all-cause and cardiovascular mortalities were dose-responsive, with higher AVAI scores indicating higher mortality risks. CONCLUSION: Age significantly improves the ability of VAI for predicting all-cause and cardiovascular mortality. Age-adjusted VAI is independently associated with mortality risk, and thus could be considered a reliable parameter for assessing mortality risk.
Assuntos
Adiposidade , Doenças Cardiovasculares , Humanos , Idoso , Inquéritos Nutricionais , Índice de Massa Corporal , Obesidade Abdominal/complicações , Doenças Cardiovasculares/etiologia , Fatores de RiscoRESUMO
BACKGROUND: The relationship between monocyte-to-lymphocyte ratio (MLR) and prognosis in patients with chronic kidney disease (CKD) remains unclear. The aim of this study was to investigate the association between MLR and both all-cause mortality and cardiovascular disease (CVD) mortality in patients with CKD. METHODS: This study analyzed data from National Health and Nutrition Examination Survey 2003-2010. This study included 11262 eligible subjects, and 3015 of them were with CKD. We first compared the differences in clinical characteristics between individuals with and without CKD, and then grouped the CKD population based on quartiles of MLR. The partial correlation analysis was conducted to assess the relationships between MLR and some important clinical features. Cox proportional hazards models were used to investigate the associations between MLR and mortality from all-cause and cardiovascular disease. Restricted cubic spline (RCS) was used to investigate the dose-response relationship between MLR and mortality, the receiver operating characteristic (ROC) curves is used to compare the efficacy of MLR with different clinical biological indicators in assessing the risk of death. RESULTS: During a median follow-up of 10.3 years in CKD population, 1398 (43%) all-cause deaths and 526 (16%) CVD deaths occurred. It has been found that individuals with CKD have higher MLR level. The partial correlation analysis results showed that even after adjusting for age, sex, and race, MLR is still correlated with blood glucose, lipid levels, and kidney function indicators. The results of the cox proportional hazards regression model and Kaplan-Meier curve shown after adjusting for covariates, higher MLR was significantly associated with an increased risk of mortality. Consistent results were also observed when MLR was examined as categorical variable (quartiles). The RCS demonstrated a positive association between MLR and the risk of all-cause mortality and cardiovascular mortality. The ROC results indicate that the predictive efficacy of MLR for all-cause mortality risk is comparable to eGFR, higher than NLR and CRP. The predictive efficacy of MLR for cardiovascular mortality risk is higher than these three indicators. CONCLUSION: Compared to non-CKD population, the CKD population has higher levels of MLR. In the CKD population, MLR is positively correlated with the risk of death. Furthermore, the predictive efficacy of MLR for mortality risk is higher than other clinical indicators. This suggests that MLR can serve as a simple and effective clinical indicator for predicting mortality risk in CKD patients.
Assuntos
Doenças Cardiovasculares , Monócitos , Inquéritos Nutricionais , Insuficiência Renal Crônica , Humanos , Masculino , Feminino , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/complicações , Pessoa de Meia-Idade , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/sangue , Adulto , Prognóstico , Idoso , Linfócitos , Modelos de Riscos Proporcionais , Curva ROC , Causas de Morte , Estados Unidos/epidemiologia , Fatores de Risco , Contagem de Linfócitos , Taxa de Filtração GlomerularRESUMO
The liver is the metabolic core of the whole body. Tools commonly used to study the human liver metabolism include hepatocyte cell lines, primary human hepatocytes, and pluripotent stem cells-derived hepatocytes in vitro, and liver genetically humanized mouse model in vivo. However, none of these systems can mimic the human liver in physiological and pathological states satisfactorily. Liver-humanized mice, which are established by reconstituting mouse liver with human hepatocytes, have emerged as an attractive animal model to study drug metabolism and evaluate the therapeutic effect in "human liver" in vivo because the humanized livers greatly replicate enzymatic features of human hepatocytes. The application of liver-humanized mice in studying metabolic disorders is relatively less common due to the largely uncertain replication of metabolic profiles compared to humans. Here, we summarize the metabolic characteristics and current application of liver-humanized mouse models in metabolic disorders that have been reported in the literature, trying to evaluate the pros and cons of using liver-humanized mice as novel mouse models to study metabolic disorders.
Assuntos
Fígado , Doenças Metabólicas , Animais , Modelos Animais de Doenças , Hepatócitos/metabolismo , Inativação Metabólica , Fígado/metabolismo , Doenças Metabólicas/metabolismo , CamundongosRESUMO
[Figure: see text].
Assuntos
Anticolesterolemiantes , Glicemia , Colesterol , Diabetes Mellitus , Hiperlipidemias , Hipoglicemiantes , Fígado , Metformina , Pró-Proteína Convertase 9 , Adolescente , Adulto , Animais , Humanos , Masculino , Adulto Jovem , Anticolesterolemiantes/uso terapêutico , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/genética , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/metabolismo , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Colesterol/sangue , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/enzimologia , Diabetes Mellitus/genética , Modelos Animais de Doenças , Regulação Enzimológica da Expressão Gênica , Células Hep G2 , Hiperlipidemias/sangue , Hiperlipidemias/tratamento farmacológico , Hiperlipidemias/enzimologia , Hiperlipidemias/genética , Hipoglicemiantes/uso terapêutico , Fígado/efeitos dos fármacos , Fígado/enzimologia , Metformina/uso terapêutico , Camundongos Endogâmicos C57BL , Camundongos Knockout , Pró-Proteína Convertase 9/genética , Pró-Proteína Convertase 9/metabolismo , Receptores para Leptina/deficiência , Receptores para Leptina/genética , Resultado do TratamentoRESUMO
ABSTRACT: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to reduce cardiovascular complications of type-2 diabetes mellitus. However, the beneficial effects of SGLT2 inhibition are mainly associated with decline in hospitalization and death of heart failure. This systematic review will focus on the effect of SGLT2 inhibitors on ischemic events stemming from atherosclerotic coronary diseases, including angina pectoris, angina unstable, and myocardial infarction. We searched PubMed, Scopus, Embase, and Web of Science for relevant publications before October 2020. Twenty-two clinical trials consisting of 56,064 participants were included in the analysis. Cardiovascular effects following treatment with SGLT2 inhibitors were observed for angina pectoris, angina unstable, and myocardial infarction. A random-effects model was chosen, and after analysis of the P values and I2 statistic indices, we concluded that SGLT2 inhibitor treatment did not result in any significant differences in the incidence rate of angina pectoris [relative risk (RR), 0.98; 95% confidence interval (CI), 0.83-1.14; P = 0.92], angina unstable (RR, 0.95; 95% CI, 0.84-1.07; P = 0.84), or myocardial infarction (RR, 0.94; 95% CI, 0.79-1.11; P = 0.98) between the experimental and control groups with firm evidence from sensitivity and trial sequential analyses. This meta-analysis provides evidence that SGLT2 inhibitors have no significant effects on ischemic events stemming from atherosclerotic coronary diseases in patients with type-2 diabetes mellitus.
Assuntos
Doença da Artéria Coronariana/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Angina Pectoris/etiologia , Angina Pectoris/prevenção & controle , Doença da Artéria Coronariana/etiologia , Diabetes Mellitus Tipo 2/complicações , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Inibidores do Transportador 2 de Sódio-Glicose/farmacologiaRESUMO
Increasing evidence shows that obesity is the critical factor in shaping cardio-metabolic phenotypes. However, the pathogenic mechanisms remain incompletely clarified. According to the published reports, adipose tissue communicates with several diverse organs, such as heart, lungs, and kidneys through the secretion of various cytokines named adipokines. The adipocytes isolated from obese mice or humans are dysfunctional with aberrant production of pro-inflammatory adipokines, which subsequently induce both acute and chronic inflammatory reaction and facilitate the process of cardio-metabolic disorder complications. Furthermore, the microenvironment within adipose tissue under obese status also influence the secretion of adipokines. Recently, given that several important adipokines have been completely researched and causally involved in various diseases, we could make a conclusion that adipokines play an essential role in modulating the development of cardio-metabolic disorder diseases, whereas several novel adipokines continue to be explored and elucidated. In the present review, we summarized the current knowledge of the microenvironment of adipose tissue and the published mechanisms whereby adipocytes affects obesity and cardiovascular diseases. On the other hand, we also provide the evidence to elucidate the functions of adipokines in controlling and regulating the inflammatory reactions which contribute to obesity and cardiovascular disease.
Assuntos
Adipocinas/metabolismo , Tecido Adiposo , Doenças Cardiovasculares , Obesidade , Adipócitos/metabolismo , Adipócitos/patologia , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Animais , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Humanos , Camundongos , Obesidade/complicações , Obesidade/metabolismo , Obesidade/patologiaRESUMO
BACKGROUND: There are a variety of causes of left ventricular aneurysm, but it is rarely due to a disturbance in intraventricular hemodynamics. To the best of our knowledge, there have been no reports of ventricular aneurysm at the left ventricular apex caused by an abnormal left ventricular muscle bundle. CASE PRESENTATION: We report two cases of patients with congenital abnormal left ventricular muscle bundles which caused disturbances in intraventricular hemodynamics. This process eventually led to a left ventricular aneurysm at the apex of the heart. In both cases, transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) indicated ventricular aneurysm formation at the apex of the left ventricle. There were also abnormal muscular bundles connecting the ventricular septum and the posterior wall of the left ventricle. The only differences between these two cases were the comorbidities and severity of symptoms. CONCLUSION: Ventricular aneurysm at the apex of the left ventricle is common. However, it is rare for a ventricular aneurysm to form due to intraventricular hemodynamic disturbances caused by an abnormal muscle bundle as opposed to that due to original ventricular wall damage, which is more common. There is currently a lack of relevant studies on the treatment and prognosis of such patients. Whether surgical resection of a ventricular aneurysm leads to a better prognosis remains uncertain.
Assuntos
Circulação Coronária , Aneurisma Cardíaco/etiologia , Cardiopatias Congênitas/complicações , Hemodinâmica , Músculos Papilares/anormalidades , Função Ventricular Esquerda , Adulto , Idoso , Anticoagulantes/uso terapêutico , Procedimentos Cirúrgicos Cardíacos , Feminino , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/fisiopatologia , Aneurisma Cardíaco/terapia , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/fisiopatologia , Cardiopatias Congênitas/terapia , Humanos , Masculino , Músculos Papilares/diagnóstico por imagem , Músculos Papilares/fisiopatologia , Músculos Papilares/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Remnant cholesterol (RC) can partly explain the residual risk in atherosclerotic cardiovascular disease (ASCVD). A consensus method of measuring RC levels has not been established yet. In clinical practice, RC levels are usually calculated from the standard lipid profile, which are not true RC. Nuclear magnetic resonance (NMR) can measure RC levels directly. This study aimed to characterize RC at fasting and non-fasting states in more details and establish the performance of calculated RC and NMR-measured RC. METHODS: Blood samples at fasting state and at 2 h and 4 h postprandial states were collected in 98 subjects. Lipid parameters including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), subfractions 3, 4, and 5 of very low-density lipoprotein cholesterol (VLDL3-C, VLDL4-C, and VLDL5-C, respectively), and intermediate-density lipoprotein cholesterol (IDL-C) were measured by enzymatic method and NMR. RC levels calculated from the standard lipid profile or measured by NMR were referred here as RCe or RCn. RESULTS: The RCe and RCn levels were different, but both of them increased after a meal (P < 0.05), especially at 4 h postprandial state. Low correlations were found between RCe and RCn in the 1st, 2nd, and 3rd quartiles of TG, but RCn showed great correlation with RCe in the highest quartile regardless of the fasting or non-fasting state (R = 0.611, 0.536, and 0.535 for 0 h, 2 h, and 4 h, respectively). However, across the 2nd and 3rd quartiles, RCe levels were nearly close to RCn levels. RCe levels tended to overestimate RCn levels in the 1st quartile of TGe levels with median differences of 0.23(- 0.13, 0.63) and underestimate RCn levels with median differences of - 0.23(- 0.33, 0.07) in the highest quartile of TGe levels. CONCLUSIONS: RC calculated from the standard lipid profile as TC minus LDL-C minus HDL-C is different from the NMR-measured RC. According to different TG levels, RC could overestimate or underestimate the actual RC level. Developing a consensus clinical method to measure RC levels is necessary, so that results from different studies and platforms can be more directly compared. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900020873. Registered in 21 January 2019 - Retrospectively registered.
Assuntos
Análise Química do Sangue/métodos , Colesterol/sangue , Espectroscopia de Ressonância Magnética , Adulto , Idoso , China , HDL-Colesterol/sangue , LDL-Colesterol/sangue , VLDL-Colesterol/sangue , Jejum/sangue , Feminino , Humanos , Lipoproteínas/sangue , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial , Triglicerídeos/sangueRESUMO
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is currently the major cause of chronic liver disease globally. Bile acids (BAs) have emerged as relevant signaling molecules that are associated with NAFLD development. This study was aimed to examine the association of serum total bile acids (TBAs) with NAFLD in a large population of Chinese subjects. METHODS: This cross sectional study recruited 152,336 participants from the Second Xiangya Hospital, China. NAFLD was diagnosed based on the presence of hepatic steatosis on ultrasonography, without significant alcohol consumption and other known causes for chronic liver disease. A multivariate logistic regression model was used to test for the association of serum TBAs with NAFLD, adjusting for conventional risk factors of NAFLD. RESULTS: A total of 27.4% of the participants had NAFLD. Patients with NAFLD had slightly higher TBA levels than those without, 3.4 vs. 3.0 µmol/L (p < 0.001). However, TBA levels were not associated with NAFLD in the multivariate logistic regression model, which adjusted for age, gender and other acknowledged risk factors for NAFLD (OR = 1.00. 95% CI: 1.00-1.00, p = 0.797). CONCLUSIONS: We found that the serum TBA levels were not associated with NAFLD. Future studies in a large population, focusing on serum BA composition may improve the understating of the role of BAs in NAFLD.
Assuntos
Ácidos e Sais Biliares/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/patologia , Fatores de RiscoRESUMO
Low-density lipoprotein cholesterol (LDL-C) has been recommended as the primary treatment target on lipid management in coronary heart disease (CHD) patients for past several decades. However, even by aggressive LDL-C lowering treatment, patients still present a significant residual risk of major adverse cardiovascular events (MACE). Non-high-density lipoprotein cholesterol (non-HDL-C) contained all the atherogenic lipoproteins, such as chylomicron, very-low density lipoprotein (VLDL), LDL, intermediate density lipoprotein (IDL). Many prospective observation studies have found that non-HDL-C was better than LDL-C in predicting risks of MACE. Since non-HDL-C appears to be superior for risk prediction beyond LDL-C, current guidelines have emphasize the importance of non-HDL-C for guiding cardiovascular prevention strategies and have flagged non-HDL-C as a co-primary therapeutic target. The goals of non-HDL-C were recommended as 30 mg/dl higher than the corresponding LDL-C goals, but the value seemed inappropriate. This review provide evidence for changing lipid management strategy to focus on non-HDL-C and appropriate values for adding to LDL-C goals would be proposed.
Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Quilomícrons/uso terapêutico , Doença das Coronárias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/prevenção & controle , HDL-Colesterol/antagonistas & inibidores , LDL-Colesterol/antagonistas & inibidores , Doença das Coronárias/complicações , Doença das Coronárias/patologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Metabolismo dos Lipídeos/efeitos dos fármacos , Lipídeos/antagonistas & inibidores , Lipídeos/genética , Fatores de RiscoRESUMO
Psoriasis is a chronic, systemic, hyper-proliferative immune-mediated inflammatory skin disease. The results of epidemiological investigations have shown that psoriasis affects around 2% of the general population worldwide, and the total number of psoriasis patients is more than 6 million in China. Apart from the skin manifestations, psoriasis has been verified to associate with several metabolic comorbidities, such as insulin resistance, diabetes and obesity. However, the underlying mechanism is still not elucidated. Adipocytes, considered as the active endocrine cells, are dysfunctional in obesity which displays increased synthesis and secretion of adipokines with other modified metabolic properties. Currently, growing evidence has pointed to the central role of adipokines in adipose tissue and the immune system, providing new insights into the effect of adipokines in linking the pathophysiology of obesity and psoriasis. In this review, we summarize the current understanding of the pathological role of adipokines and the potential mechanisms whereby different adipokines link obesity and psoriasis. Furthermore, we also provide evidence which identifies a potential therapeutic target aiming at adipokines for the management of these two diseases.
Assuntos
Adipócitos/imunologia , Adiponectina/imunologia , Citocinas/imunologia , Regulação da Expressão Gênica/efeitos dos fármacos , Lectinas/imunologia , Obesidade/imunologia , Psoríase/imunologia , Adipócitos/efeitos dos fármacos , Adipócitos/patologia , Adiponectina/agonistas , Adiponectina/genética , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/imunologia , Tecido Adiposo/patologia , Citocinas/agonistas , Citocinas/genética , Proteínas Ligadas por GPI/agonistas , Proteínas Ligadas por GPI/genética , Proteínas Ligadas por GPI/imunologia , Regulação da Expressão Gênica/imunologia , Humanos , Sistema Imunitário/efeitos dos fármacos , Fatores Imunológicos/uso terapêutico , Interleucina-1beta/antagonistas & inibidores , Interleucina-1beta/genética , Interleucina-1beta/imunologia , Interleucina-6/antagonistas & inibidores , Interleucina-6/genética , Interleucina-6/imunologia , Lectinas/agonistas , Lectinas/genética , Leptina/antagonistas & inibidores , Leptina/genética , Leptina/imunologia , Terapia de Alvo Molecular/métodos , Obesidade/tratamento farmacológico , Obesidade/genética , Obesidade/fisiopatologia , Psoríase/tratamento farmacológico , Psoríase/genética , Psoríase/fisiopatologia , Transdução de Sinais , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/imunologiaRESUMO
BACKGROUND: Hypertension is a highly prevalent disease and the leading cause of chronic kidney disease (CKD). Metabolic syndrome could also be the risk factor for CKD. We sought to study the association between metabolic syndrome components and the prevalence of CKD in patients with hypertension. METHODS: We carried out a multi-center cross-sectional study from Apr. 2017- Apr. 2018 in 15 cities in China. RESULTS: A total of 2484 patients with hypertension were enrolled. Among them, 56% were male and the average age was 65.12 ± 12.71 years. The systolic BP/diastolic BP was 142 ± 18/83 ± 12 mmHg. Metabolic syndrome components turned out to be highly prevalent in patients with hypertension, ranging from 40 to 58%. The prevalence of chronic kidney disease reached 22.0%. Multi-variate logistic analysis revealed that elevated triglyceride (TG) (OR = 1.81, 95% CI 1.28-2.57, p < 0.01), elevated fasting blood glucose (FBG) (OR = 1.43, 95% CI 1.00-2.07, p = 0.05) and hypertension grades (OR = 1.20, 95% CI 1.00-1.44, p = 0.05) were associated with the prevalence of CKD. In sub-group analysis, elevated TG remained strongly associated with CKD in both diabetes (OR = 2.10, 95%CI 1.22-3.61, p < 0.01) and non-diabetes (OR = 1.53, 95% CI 1.09-2.16, p = 0.01). In sub-group analysis of hypertension grades, there was also a graded trend between elevated TG and CKD from controlled blood pressure (BP) to hypertension grade 2 (OR = 1.81, 95%CI 1.06-3.11, p = 0.03; OR = 1.85, 95%CI 1.00-3.43, p = 0.05; OR = 2.81, 95% CI 1.09-7.28, p = 0.03, respectively). CONCLUSION: Elevated TG, elevated FBG and hypertension grades were significantly associated with the prevalence of CKD in patients with hypertension. Particularly, elevated TG was strongly associated with CKD, independent of diabetes and hypertension grades.
Assuntos
Hipertensão/sangue , Síndrome Metabólica/sangue , Insuficiência Renal Crônica/sangue , Triglicerídeos/sangue , Idoso , Glicemia , Pressão Sanguínea , Complicações do Diabetes/sangue , Complicações do Diabetes/patologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/patologia , Modelos Logísticos , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/patologia , Pessoa de Meia-Idade , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/patologia , Fatores de RiscoRESUMO
Emery-Dreifuss muscular dystrophy (EDMD) is a group of hereditary muscular dystrophy syndrome caused by deficiency of genes encoding nuclear envelope proteins. Patients having EDMD show the triad of muscle dystrophy, joint contracture, and cardiac disease. In almost all patients, cardiac involvement is prevalent and is the most severe aspect of EDMD. Cardiac disease is predominantly shown by conduction defects, atrial fibrillation/flutter, and atrial standstill. Sudden death and heart failure because of left ventricular dysfunction are important causes of mortality, particularly in those patients that have the LMNA mutation. Medical treatment of EDMD is limited to addressing symptoms and ambulation support; moreover, pacemaker implantation is necessary when there are severe conduction defects and bradycardia occurs. Note that automated defibrillation devices may be considered for those patients who have a high risk of sudden death, rate, or rhythm control. Also, anticoagulation should be initiated in those patients who have atrial fibrillation/flutter. Thus, for optimal management, a multidisciplinary approach is required.
Assuntos
Fibrilação Atrial/terapia , Distrofia Muscular de Emery-Dreifuss/genética , Disfunção Ventricular Esquerda/mortalidade , Anormalidades Múltiplas/epidemiologia , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/epidemiologia , Cardiomiopatias/fisiopatologia , Fissura Palatina/complicações , Fissura Palatina/epidemiologia , Contratura/complicações , Contratura/epidemiologia , Morte Súbita/epidemiologia , Feminino , Doenças Genéticas Inatas/fisiopatologia , Átrios do Coração/anormalidades , Átrios do Coração/fisiopatologia , Bloqueio Cardíaco/fisiopatologia , Cardiopatias/complicações , Cardiopatias/epidemiologia , Humanos , Hidrocefalia/complicações , Hidrocefalia/epidemiologia , Comunicação Interdisciplinar , Deformidades Congênitas dos Membros/complicações , Deformidades Congênitas dos Membros/epidemiologia , Masculino , Distrofias Musculares/complicações , Distrofias Musculares/epidemiologia , Distrofia Muscular de Emery-Dreifuss/complicações , Distrofia Muscular de Emery-Dreifuss/diagnóstico , Distrofia Muscular de Emery-Dreifuss/terapia , Marca-Passo Artificial/normas , Disfunção Ventricular Esquerda/epidemiologiaRESUMO
BACKGROUND: It is well known that angiopoietin-like protein 8 (ANGPTL8) exerts its effects on lipid metabolism through the inhibition of lipoprotein lipase and subsequent elevation of plasma triglyceride. However, it is not clear whether ANGPTL8 could affect lipid metabolism via other pathways. The study was aimed to investigate the effects of ANGPTL8 on the function of high-density lipoprotein (HDL), which plays a protective role in atherosclerosis progression. METHODS: Two hundred and ten subjects were recruited. Plasma ANGPTL8 was measured by enzyme-linked immunosorbent assays. Cholesterol efflux capacity was chosen as the biomarker of HDL function and measured via H3-cholesterol loading THP-1 cell models. RESULTS: ANGPTL8 exhibited no significant difference between CAD group and nonCAD group, but ANGPTL8 in DM group was significantly higher than that in the nonDM group [568.3 (406.2-836.8) vs 458.2 (356.8-755.6), P = 0.023]. Compared to controls, subjects in CAD group and DM group exhibited significantly lower cholesterol efflux capacity [CAD: 14.58 ± 2.06 vs 12.51 ± 2.83%, P < 0.0001; DM: 13.62 ± 2.57 vs 12.34 ± 3.16%, P = 0.0099]. ANGPTL8 was inversely correlated with cholesterol efflux capacity (r = - 0.188, P < 0.01). Regression analysis revealed that plasma ANGPTL8 was an independent contributor to cholesterol efflux capacity (standardized ß = - 0.143, P = 0.023). CONCLUSION: ANGPTL8 presents a negative effect on HDL-mediated cholesterol efflux capacity.
Assuntos
Síndrome Coronariana Aguda/sangue , Proteínas Semelhantes a Angiopoietina/sangue , HDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Macrófagos/metabolismo , Hormônios Peptídicos/sangue , Síndrome Coronariana Aguda/diagnóstico , Idoso , Proteína 8 Semelhante a Angiopoietina , Transporte Biológico , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Células THP-1RESUMO
Dyslipidemia, characterized by elevation of plasma low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and reduction of plasma high density lipoprotein cholesterol (HDL-C), has been verified as a causal risk factor for cardiovascular diseases (CVD), leading to a high mortality rate in general population. It is important to understand the molecular metabolism underlying dyslipidemia in order to reduce the risk and to develop effective therapeutic approaches against CVD. ANGPTL3 (human) or Angptl3 (mouse), one member of the angiopoietin-like protein (ANGPTL) family, has been identified as an important regulator of lipid metabolism by inhibiting LPL and EL activity. Results have demonstrated that inactivation of Angptl3 in mice could obviously reduce the level of TG, LDL-C and the atherosclerotic lesion size, leading to a lower risk for dyslipidemia and CVD. Additionally, in humans, carriers with homozygous LOF mutations in ANGPTL3 have lower plasma LDL-C, TG levels and lower risk of atherosclerosis compared to the non-carriers. Here, we collect the latest data and results, giving a new insight into the important role of ANGPTL3 in controlling lipoprotein metabolism. Finally, we introduce two update reports on the antisense oligonucleotide and monoclonal antibody-based inactivation of ANGPTL3 in human clinical trials, to identify that ANGPTL3 could be a novel and effective target for the treatment of dyslipidemia and CVD.
Assuntos
Proteínas Semelhantes a Angiopoietina/metabolismo , Doenças Cardiovasculares/metabolismo , LDL-Colesterol/sangue , Dislipidemias/metabolismo , Triglicerídeos/sangue , Proteína 3 Semelhante a Angiopoietina , Proteínas Semelhantes a Angiopoietina/antagonistas & inibidores , Proteínas Semelhantes a Angiopoietina/genética , Animais , Aterosclerose/tratamento farmacológico , Aterosclerose/genética , Aterosclerose/metabolismo , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/genética , Ensaios Clínicos como Assunto , Dislipidemias/sangue , Dislipidemias/tratamento farmacológico , Dislipidemias/genética , Predisposição Genética para Doença , Humanos , Mutação com Perda de Função , CamundongosRESUMO
Apolipoprotein A5 (apoA5) has been identified to play an important role in lipid metabolism, specifically in triglyceride (TG) and TG-rich lipoproteins (TRLs) metabolism. Numerous evidence has demonstrated for an association between apoA5 and the increased risk of obesity and metabolic syndrome, but the mechanism remains to be fully elucidated. Recently, several studies verified that apoA5 could significantly reduce plasma TG level by stimulating lipoprotein lipase (LPL) activity, and the intracellular role of apoA5 has also been proved since apoA5 is associated with cytoplasmic lipid droplets (LDs) and affects intrahepatic TG accumulation. Furthermore, since adipocytes provide the largest storage depot for TG and play a crucial role in the development of obesity, we could infer that apoA5 also acts as a novel regulator to modulate TG storage in adipocytes. In this review, we focus on the association of gene and protein of apoA5 with obesity and metabolic syndrome, and provide new insights into the physiological role of apoA5 in humans, giving a potential therapeutic target for obesity and associated disorders.
Assuntos
Tecido Adiposo/metabolismo , Apolipoproteína A-V/genética , Fígado/metabolismo , Síndrome Metabólica/metabolismo , Obesidade/metabolismo , Polimorfismo de Nucleotídeo Único , Adipócitos/metabolismo , Adipócitos/patologia , Tecido Adiposo/patologia , Apolipoproteína A-V/metabolismo , VLDL-Colesterol/sangue , Regulação da Expressão Gênica , Hepatócitos/metabolismo , Hepatócitos/patologia , Humanos , Gotículas Lipídicas/metabolismo , Metabolismo dos Lipídeos/genética , Lipase Lipoproteica/genética , Lipase Lipoproteica/metabolismo , Fígado/patologia , Síndrome Metabólica/genética , Síndrome Metabólica/patologia , Obesidade/genética , Obesidade/patologia , Transdução de Sinais , Triglicerídeos/sangueRESUMO
BACKGROUND: Angiopoietin-like protein 8(ANGPTL8) and apolipoprotein CIII (apoCIII) were found to inhibit the activity of lipoprotein lipase (LPL) and disrupt the clearance of triglyceride-rich lipoproteins (TRLs), leading to hypertriglyceridemia. Whether any relationship exists between these two important modulators of triglyceride metabolism has not been reported. Besides, whether ANGPTL8 concentration is altered in the patients with coronary artery disease (CAD) is still unclear. METHODS: A hospital-based case-control study was conducted. Sixty-eight CAD subjects and fifty-two nonCAD controls were recruited. Plasma apoCIII, ANGPTL8 was measured. RESULTS: ANGPTL8 and apoCIII concentration exhibited no significant difference between CAD group and nonCAD group. Both ANGPTL8 and apoCIII were significantly correlated with triglyceride level(r = - 0.243, P = 0.008; r = 0.335, P < 0.001, respectively). Regression analysis revealed that apoCIII was an independent contributor to triglyceride level independent of ANGPTL8 concentration (standardized ß = 0.230, P < 0.01). CONCLUSION: ApoCIII may mediate the effects of ANGPTL8 on triglyceride metabolism.
Assuntos
Proteínas Semelhantes a Angiopoietina/genética , Apolipoproteína C-III/genética , Doença da Artéria Coronariana/genética , Hipertrigliceridemia/genética , Lipase Lipoproteica/genética , Lipoproteínas/genética , Hormônios Peptídicos/genética , Triglicerídeos/sangue , Idoso , Proteína 8 Semelhante a Angiopoietina , Proteínas Semelhantes a Angiopoietina/sangue , Apolipoproteína C-III/sangue , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/patologia , Feminino , Regulação da Expressão Gênica , Humanos , Hipertrigliceridemia/sangue , Hipertrigliceridemia/patologia , Metabolismo dos Lipídeos , Lipase Lipoproteica/sangue , Lipoproteínas/sangue , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Hormônios Peptídicos/sangue , Análise de Regressão , Triglicerídeos/genéticaRESUMO
Aortoesophageal fistula is a rare but life-threatening cause of massive gastrointestinal bleeding. We reported a case of primary aortoesophageal fistula associated with thoracic aortic pseudoaneurysm. Esophagogastroduodenoscopy demonstrated a bulging erosive lesion coated with fibrin. The patient was therefore diagnosed as malignant esophageal mesenchymoma initially. An emergency contrast-enhanced computed tomography revealed an out-pouching saccular aneurysm protruding toward the esophagus at the level of T8-9. The patient expired rapidly due to intractable massive bleeding. Assumptive diagnosis of esophageal malignancy leads to a loss of the most optimal time-point for operation thus negatively affecting the patient survival.
Assuntos
Aorta Torácica , Fístula Esofágica/diagnóstico , Hemorragia Gastrointestinal/etiologia , Fístula Vascular/diagnóstico , Endoscopia do Sistema Digestório , Fístula Esofágica/complicações , Evolução Fatal , Hemorragia Gastrointestinal/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Fístula Vascular/complicaçõesRESUMO
Monocyte chemoattractant protein-1 (MCP-1) has been reported to induce the expression of monocyte chemotactic protein-induced protein 1 (MCPIP1), which undergoes ubiquitination degradation. Therefore, we predict that in vascular smooth muscle (VSMCs), MCPIP1 may be induced by MCP-1 and undergo degradation, which can be inhibited by the proteasome inhibitor, MG132. Our results showed that treatment of human VSMCs with MCP-1 did not increase the expression of MCPIP1. Treatment with MG132, however, elevated MCPIP1 protein levels through stimulation of the gene transcription, but not through increasing protein stability. MCPIP1 expression induced by MG132 was inhibited by α-amanitin inhibition of gene transcription or cycloheximide inhibition of protein synthesis. Our further studies showed that MCPIP1 expression induced by MG132 was inhibited by the inhibitors of AKT and p38 kinase, suggesting a role of the AKT-p38 pathway in MG132 effects. We also found that treatment with MG132 induces apoptosis, but overexpression of MCPIP1 inhibited bromodeoxyuridine (BrdU) incorporation of human VSMCs without induction of significant apoptosis. In summary, MCPIP1 expression is induced by MG132 likely through activation of the AKT-p38 pathway. MCPIP1 inhibits SMC proliferation without induction of apoptosis. J. Cell. Physiol. 232: 122-128, 2017. © 2016 Wiley Periodicals, Inc.
Assuntos
Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Quimiocina CCL2/metabolismo , Leupeptinas/farmacologia , Músculo Liso Vascular/efeitos dos fármacos , Inibidores de Proteassoma/farmacologia , Células Cultivadas , Humanos , Músculo Liso Vascular/citologia , Fatores de Transcrição/metabolismoRESUMO
Apolipoprotein C-III has been referred to as an important participant in the metabolism of triglyceride-rich lipoproteins, leading to hypertriglyceridemia and thereafter cardiovascular disease. Accumulating evidence indicates that apolipoprotein C-III is a multifaceted protein which not only regulates triglyceride metabolism, but also participates in the atherosclerotic lesion formation and several other pathological processes involved in atherosclerosis. Based on data from experiments and clinical trials, some novel therapies such as antisense technology emerge.