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Terao R, Lee TJ, Colasanti J, Pfeifer CW, Lin JB, Santeford A, Hase K, Yamaguchi S, Du D, Sohn BS, Sasaki Y, Yoshida M, Apte RS. LXR/CD38 activation drives cholesterol-induced macrophage senescence and neurodegeneration via NAD + depletion. Cell Rep 2024:114102. [PMID: 38636518 DOI: 10.1016/j.celrep.2024.114102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/23/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024] Open
Abstract
Although dysregulated cholesterol metabolism predisposes aging tissues to inflammation and a plethora of diseases, the underlying molecular mechanism remains poorly defined. Here, we show that metabolic and genotoxic stresses, convergently acting through liver X nuclear receptor, upregulate CD38 to promote lysosomal cholesterol efflux, leading to nicotinamide adenine dinucleotide (NAD+) depletion in macrophages. Cholesterol-mediated NAD+ depletion induces macrophage senescence, promoting key features of age-related macular degeneration (AMD), including subretinal lipid deposition and neurodegeneration. NAD+ augmentation reverses cellular senescence and macrophage dysfunction, preventing the development of AMD phenotype. Genetic and pharmacological senolysis protect against the development of AMD and neurodegeneration. Subretinal administration of healthy macrophages promotes the clearance of senescent macrophages, reversing the AMD disease burden. Thus, NAD+ deficit induced by excess intracellular cholesterol is the converging mechanism of macrophage senescence and a causal process underlying age-related neurodegeneration.
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Affiliation(s)
- Ryo Terao
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA; Department of Ophthalmology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Tae Jun Lee
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Jason Colasanti
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Charles W Pfeifer
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Joseph B Lin
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrea Santeford
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Keitaro Hase
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA; Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Shinobu Yamaguchi
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel Du
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian S Sohn
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Yo Sasaki
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Mitsukuni Yoshida
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA; Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Rajendra S Apte
- John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA; Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA; Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO, USA.
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2
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Zeng X, Zhao W, Wang S, Xiong H, Wu J, Ren J. L. barbarum (Lycium barbarum L.) supplementation for lipid profiles in adults: A systematic review and meta-analysis of RCTs. Medicine (Baltimore) 2023; 102:e34952. [PMID: 37773857 PMCID: PMC10545344 DOI: 10.1097/md.0000000000034952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/04/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Dyslipidemia is a global health concern with an increasing prevalence worldwide. Lycium barbarum (L. barbarum) is widely used as a medicinal and functional food, and evidence suggests that it may be beneficial for lipid management. In this study, we performed a systematic review and meta-analysis of randomized controlled trials investigating the effects of L. barbarum supplementation on lipid profiles in adults. METHODS PubMed, China National Knowledge Infrastructure, The Cochrane Library, Web of Science, and Wanfang Database were searched from inception until October 2022. The random-effect model was applied, and the pooled effect sizes were expressed as mean differences (MDs) and 95% confidence intervals (CIs). RESULTS The meta-analysis of 5 randomized controlled trials involving 259 subjects indicated that L. barbarum supplementation significantly decreased the triglyceride (TG) concentration (MD: 0.14 mmol/L, 95% CI: 0.08-0.20) and increased the high-density lipoprotein cholesterol concentration (HDL-C) (MD: -0.07 mmol/L, 95% CI: -0.13 to -0.01). However, the reductions in total cholesterol (TC) concentration (MD: 0.11 mmol/L, 95% CI: -0.37 to 0.59) and low-density lipoprotein cholesterol (LDL-C) concentration (MD: 0.21 mmol/L, 95% CI: -0.46 to 0.89) were not statistically significant. CONCLUSION The present study showed that L. barbarum supplementation might have some beneficial effects on TG and HDL-C concentrations in adults, and L. barbarum fruit has an even greater effect on TG and HDL-C concentrations. Considering the sensitivity analyses and limitations of the study included, further large-scale studies are needed to confirm these findings.
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Affiliation(s)
- Xueyuan Zeng
- Traditional Chinese Medicine Academy, Changchun University of Chinese Medicine, Changchun, PR China
| | - Weimin Zhao
- The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, PR China
| | - Siming Wang
- Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, PR China
| | - Huazhong Xiong
- Research Center of Traditional Chinese Medicine, the Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, PR China
| | - Junliang Wu
- Traditional Chinese Medicine Academy, Changchun University of Chinese Medicine, Changchun, PR China
| | - Jixiang Ren
- The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, PR China
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3
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Varkevisser RDM, Birnie E, Vollenbrock CE, Mul D, van Dijk PR, van der Klauw MM, Veeze H, Wolffenbuttel BHR, Aanstoot HJ. Cardiovascular risk management in people with type 1 diabetes: performance using three guidelines. BMJ Open Diabetes Res Care 2022; 10:10/4/e002765. [PMID: 35858715 PMCID: PMC9305824 DOI: 10.1136/bmjdrc-2022-002765] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/07/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Cardiovascular disease (CVD) is the leading cause of mortality in individuals with type 1 diabetes mellitus (T1DM). Cardiovascular risk management is therefore essential in the management of individuals with T1DM. This study describes the performance of lipid and blood pressure management in individuals with T1DM using three guidelines. RESEARCH DESIGN AND METHODS Individuals ≥18 years with T1DM, treated with insulin for ≥1 year, visiting Diabeter or the University Medical Center Groningen between January 1, 2018 and December 31, 2018, were included. Lipid and blood pressure management were examined using the Dutch, American Diabetes Association (ADA) and National Institute for Health and Care Excellence (NICE) guidelines. Concordance of recommended and prescribed lipid-lowering (LLM) or antihypertensive medication (AHM) was assessed per guideline and 10-year age groups. Achievement of treatment targets was assessed for those prescribed medication. RESULTS A total of 1855 individuals with T1DM were included. LLM and AHM was prescribed in 19% and 17%, respectively. In individuals recommended LLM, this was prescribed in 22%-46% according to Dutch, ADA or NICE guideline recommendations. For individuals recommended AHM, this was prescribed in 52%-75%. Recommended and actual prescription of LLM and AHM increased over age for all three guidelines. However, discordance between treatment recommendation and medication prescribed was higher in younger, compared with older, age groups. Low-density lipoprotein-cholesterol targets were achieved by 50% (without CVD) and 31% (with CVD) of those prescribed LLM. The blood pressure target was achieved by 46% of those prescribed AHM. CONCLUSION This study suggests that there is undertreatment of lipid and blood pressure according to guideline recommendations, particularly in younger age groups. Treatment targets are not met by most individuals prescribed medication, while guidelines recommendations differ considerably. We recommend to investigate the factors influencing undertreatment of lipid and blood pressure management in individuals with T1DM.
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Affiliation(s)
| | - Erwin Birnie
- Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Charlotte E Vollenbrock
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - Dick Mul
- Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands
| | - Peter R van Dijk
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - Henk Veeze
- Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - Henk-Jan Aanstoot
- Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands
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4
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Analysis of Coronary Artery Lesion Degree and Related Risk Factors in Patients with Coronary Heart Disease Based on Computer-Aided Diagnosis of Coronary Angiography. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:2370496. [PMID: 34950223 PMCID: PMC8691974 DOI: 10.1155/2021/2370496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/02/2021] [Accepted: 11/13/2021] [Indexed: 12/05/2022]
Abstract
A combination of various risk factors results in the development of coronary heart disease. The earlier that one identifies and deals with reversible risk factors for coronary heart disease, the greater the chance of recovery. The main goal of this research is to learn whether risk variables are associated with greater extent of coronary artery disease in people with coronary heart disease. This article selects 290 patients who had had coronary angiography in our hospital from September 2018 to March 2019 using a retrospective research and analytic methodology. Coronary angiography split the patients into two groups: those with coronary heart disease and those without. To determine the correlation between risk factors and a score related to heart disease, computer-aided statistical analysis of data about the differences in those risk factors was performed. The results were analyzed using the Spearman correlation and partial correlation, and the relationship between risk factors and Gensini score was analyzed by multiple linear regression. For the analysis, binary logistic regression was used to calculate the correlation between the risk factors of coronary heart disease and the probability of developing coronary heart disease. The findings concluded that increased age, smoking, elevated hs-CRP, HbA1c, hypertension, diabetes, and hyperuricemia are all contributors to coronary heart disease. Coronary heart disease is an independent risk factor for this condition. Many of the factors that play a role in the long-term development of the severity of coronary artery disease, such as hypertension, diabetes, smoking, elevated hs-CRP, decreased HDL-C, raised LDL-C, and TG, are commonly found in men. hs-CRP is the primary risk factor for the degree of coronary artery stenosis and could contribute to the progression of the condition by playing a major role in creating more stenosis.
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5
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Chowdhary R, Masarkar N, Khadanga S. Polymorphism in Genes Apolipoprotein C3 (APOC3) and Fatty Acid-Binding Proteins (FABP2) in Nondiabetic Dyslipidemics: A Tertiary Care Hospital-Based Pilot Study. J Lab Physicians 2021; 14:119-124. [PMID: 35982873 PMCID: PMC9381319 DOI: 10.1055/s-0041-1731949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Context
Dyslipidemia is a multifactorial disease in which lipoproteins play an important role as one of the early markers for coronary heart disease (CHD). Mixed dyslipidemia is common in people with diabetes mellitus, but nondiabetic dyslipidemics (NDD) remain unidentified for the risk of developing dyslipidemia and eventually CHD.
Objectives
This pilot study attempts to analyze the genetic basis of lipid metabolism alterations, emphasizing the association between fatty acid-binding protein-2 (FABP2-Ala54Thr) and apolipoprotein-C3 (APOC3-rs5128) genetic polymorphism, as a risk for developing dyslipidemia and CHD in NDD.
Methods and Design
Total 90 subjects—30 DD, 30 NDD, and 30 apparently healthy subjects representing Central India—were included. Biochemical analysis and DNA genotyping were done by polymerase chain reaction restriction fragment length polymorphism.
Statistical Analysis
The biochemical parameters were reported as means ± standard deviation. One-way analysis of variance test was used to compare biochemical parameters of three groups. Chi-squared test was done to compare genotype distributions. The strength of association was assessed by odds ratios (ORs) with 95% confidence intervals (CIs). All statistical analysis was done using SPSS-PC software and Graph Pad.
Results
In NDD, maximum polymorphism was observed followed by DD and least polymorphism was observed in controls. There was a significant association of
APOC3
G allele with occurrence of hypertriglyceridemia (
p
< 0.05); however, no such association was found for FABP2 A allele (
p
> 0.05). Logistic regression analysis revealed APOC3 polymorphism to be significantly associated with dyslipidemia (OR = 2.6667, 95% CI = 1.0510–6.7663,
p
= 0.0341); no such association was found for FABP2 polymorphism (OR = 0.4643, 95% CI = 0.1641–1.3136,
p
= 0.1347). The triglyceride and cholesterol values in individuals with homozygous genotype indicate that genetic study is comparable to the biochemical findings in carriers of polymorphic allele than noncarriers, especially in NDD patients.
Conclusions
Pilot study indicates that the presence of
APOC3
gene polymorphism is associated with pro-atherogenic dyslipidemia in nondiabetic patients and may raise risk of CHD. This information could be used for preventive strategies in NDD group that may otherwise go unnoticed.
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Affiliation(s)
- Rashmi Chowdhary
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Neha Masarkar
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Sagar Khadanga
- Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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6
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Liu Y, Wang X, Han J, Liu L, Jin Y, Jin L, Ye P. PCSK9 positively correlates with plasma sdLDL in community-dwelling population but not in diabetic participants after confounder adjustment. Medicine (Baltimore) 2019; 98:e15062. [PMID: 30946354 PMCID: PMC6456037 DOI: 10.1097/md.0000000000015062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study aimed to investigate the relationship between plasma proprotein convertase subtilisin kexin 9 (PCSK9) and small dense low-density lipoprptein (sdLDL) in diabetic and non-diabetic participants in a community-dwelling cohort.The plasma levels of PCSK9 and sdLDL were detected in 1766 participants (median age: 61.40 years; 733 males vs 1033 females; 383 diabetic vs 1383 non-diabetic patients) from the Pingguoyuan community of Beijing, China.Results showed that Pearson correlation analysis revealed a positive correlation between PCSK9 and sdLDL (r = 0.263, P < .001). Multiple linear regression analysis showed a significant positive correlation between plasma PCSK9 and sdLDL in the whole population study. sdLDL was used as the dependent variable, and the potential cofounders were adjusted. However, any independent relationship was not observed between circulating PCSK9 and sdLDL in the diabetic subpopulation (r = 0.269, P < .05, β = 9.591, P > .05).Thus, there is a positive correlation between plasma PCSK9 and sdLDL in a community-dwelling cohort, but not in type 2 diabetic subpopulation, after confounder adjustment.
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Affiliation(s)
- Yan Liu
- Department of Geriatric Cardiology, Chinese PLA General Hospital
- Critical Care Center, The 302 Hospital, People's Liberation Army
| | - Xiaona Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital
| | - Jie Han
- Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an
| | - Lu Liu
- Department of Geriatric Cardiology, Chinese PLA General Hospital
| | - Ying Jin
- Department of Geriatric Cardiology, Chinese PLA General Hospital
- Geriatric Institute, Chinese PLA Air Force General Hospital, Beijing, China
| | - Liyuan Jin
- Department of Geriatric Cardiology, Chinese PLA General Hospital
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital
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Moccetti F, Weinkauf CC, Davidson BP, Belcik JT, Marinelli ER, Unger E, Lindner JR. Ultrasound Molecular Imaging of Atherosclerosis Using Small-Peptide Targeting Ligands Against Endothelial Markers of Inflammation and Oxidative Stress. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1155-1163. [PMID: 29548756 DOI: 10.1016/j.ultrasmedbio.2018.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/03/2018] [Accepted: 01/08/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study was to evaluate a panel of endothelium-targeted microbubble (MB) ultrasound contrast agents bearing small peptide ligands as a human-ready approach for molecular imaging of markers of high-risk atherosclerotic plaque. Small peptide ligands with established affinity for human P-selectin, VCAM-1, LOX-1 and von Willebrand factor (VWF) were conjugated to the surface of lipid-stabilized MBs. Contrast-enhanced ultrasound (CEUS) molecular imaging of the thoracic aorta was performed in wild-type and gene-targeted mice with advanced atherosclerosis (DKO). Histology was performed on carotid endarterectomy samples from patients undergoing surgery for unstable atherosclerosis to assess target expression in humans. In DKO mice, CEUS signal for all four targeted MBs was significantly higher than that for control MBs, and was three to sevenfold higher than in wild-type mice, with the highest signal achieved for VCAM-1 and VWF. All molecular targets were present on the patient plaque surface but expression was greatest for VCAM-1 and VWF. We conclude that ultrasound contrast agents bearing small peptide ligands feasible for human use can be targeted against endothelial cell adhesion molecules for inflammatory cells and platelets for imaging advanced atherosclerotic disease.
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Affiliation(s)
- Federico Moccetti
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Craig C Weinkauf
- Department of Surgery, University of Arizona, Tucson, Arizona, USA
| | - Brian P Davidson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA; Portland Veterans Affairs Medical Center, Portland, Oregon, USA
| | - J Todd Belcik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| | | | | | - Jonathan R Lindner
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA; Oregon National Primate Research Center, Oregon Health & Science University, Portland, Oregon, USA.
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8
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Volpe M, Battistoni A, Gallo G, Coluccia R, De Caterina R. Aspirin and the Primary Prevention of Cardiovascular Diseases: An Approach Based on Individualized, Integrated Estimation of Risk. High Blood Press Cardiovasc Prev 2017; 24:331-339. [DOI: 10.1007/s40292-017-0213-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/07/2017] [Indexed: 12/12/2022] Open
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9
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Li S, Guo YL, Zhao X, Zhang Y, Zhu CG, Wu NQ, Xu RX, Qing P, Gao Y, Li XL, Sun J, Liu G, Dong Q, Li JJ. Novel and traditional lipid-related biomarkers and their combinations in predicting coronary severity. Sci Rep 2017; 7:360. [PMID: 28336922 PMCID: PMC5428477 DOI: 10.1038/s41598-017-00499-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 03/02/2017] [Indexed: 12/19/2022] Open
Abstract
We investigated simultaneously traditional and novel lipid indices, alone or in combination, in predicting coronary severity assessed by Gensini score (GS) in 1605 non-lipid-lowering-drug-treated patients undergoing coronary angiography. Firstly, levels of triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), non high density lipoprotein cholesterol (non-HDL-C), apolipoprotein (apo) B, lipoprotein (a) [Lp(a)], proprotein convertase subtilisin/kexin type 9 (PCSK9), apoC3, small dense LDL (sdLDL) and large HDL were increased, while HDL-C and apoA1 levels were decreased as GS status (all p for trend <0.05). However, gender stratification analyses showed similar associations between lipids and GS in men but not in women. Secondly, multiple logistic regression analyses indicated that the 12 indices were predictive for high GS (≥24) but not for low GS (1–23) compared with normal coronary (GS = 0) except for TG (neither) and apoB (both). Finally, we found that interactions between two indices with mutually exclusive composition were positively associated with GS status except for couples of TC + apoC3, apoB/PCSK9/apoC3 + sdLDL-C. Concordant elevations in the two showed the highest predictive values for high GS (all p for trend <0.05). Therefore, lipid biomarkers were associated with coronary severity and their adverse changes in combination emerged greater risks in men but not in women.
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Affiliation(s)
- Sha Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Xi Zhao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Yan Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Rui-Xia Xu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Ping Qing
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Xiao-Lin Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Jing Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Geng Liu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
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10
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Abstract
Dementia is a major public health concern, affecting an estimated 7% of the population over 65 and 30% over 80 years of age. There is mounting evidence in the literature from meta-analyses of high-quality prospective cohort studies that statins may have a positive impact in reducing the incidence of dementia. Little is known, however, on whether certain types of statins are more impactful than others. This narrative review specifically explores the various properties of different statin types and whether these differences lead to a clinically significant differential impact on cognitive function. We critically evaluate the literature, emphasizing interesting and important new findings, and overall aim to bring the reader up-to-date on evidence-based recommendations.
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11
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Abstract
Despite the revolutionary advancements in the past 3 decades in the treatment of ventricular tachyarrhythmias with device-based therapy, sudden cardiac death (SCD) remains an enormous public health burden. Survivors of SCD are generally at high risk for recurrent events. The clinical management of such patients requires a multidisciplinary approach from postresuscitative care to a thorough cardiovascular investigation in an attempt to identify the underlying substrate, with potential to eliminate or modify the triggers through catheter ablation and ultimately an implantable cardioverter-defibrillator (ICD) for prompt treatment of recurrences in those at risk. Early recognition of low left ventricular ejection fraction as a strong predictor of death and association of ventricular arrhythmias with sudden death led to significant investigation with antiarrhythmic drugs. The lack of efficacy and the proarrhythmic effects of drugs catalyzed the development and investigation of the ICD through several major clinical trials that proved the efficacy of ICD as a bedrock tool to detect and promptly treat life-threatening arrhythmias. The ICD therapy is routinely used for primary prevention of SCD in patients with cardiomyopathy and high risk inherited arrhythmic conditions and secondary prevention in survivors of sudden cardiac arrest. This compendium will review the clinical management of those surviving SCD and discuss landmark studies of antiarrhythmic drugs, ICD, and cardiac resynchronization therapy in the primary and secondary prevention of SCD.
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Affiliation(s)
- Omair Yousuf
- From the Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Jonathan Chrispin
- From the Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Gordon F Tomaselli
- From the Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ronald D Berger
- From the Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD
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12
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Ezetimibe and simvastatin modulate gut microbiota and expression of genes related to cholesterol metabolism. Life Sci 2015; 132:77-84. [PMID: 25916803 DOI: 10.1016/j.lfs.2015.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/09/2015] [Accepted: 04/15/2015] [Indexed: 12/18/2022]
Abstract
AIMS Hypolipidemic drugs are prescribed in the most of cases for the treatment of cardiovascular diseases. Several studies have showed that the gut microbiota is able to regulate the host cholesterol metabolism. This study aimed to investigate the potential impact of hypolipidemic drugs on the gut microbiota in mice, and to correlate it to the regulation of cholesterol metabolism. MAIN METHODS Male C57Bl/6J mice were divided into four groups fed either a control diet alone (CT), or supplemented with simvastatin (0.1% w/w, Zocor®, MSD), or ezetimibe (0.021% w/w, Ezetrol®, MSD) or a combination of simvastatin and ezetimibe (0.1% and 0.021%, respectively) for one week. KEY FINDINGS The combination of ezetimibe and simvastatin is required to observe a drop in cholesterolemia, linked to a huge activation of hepatic SREBP-2 and the consequent increased expression of genes involved in LDL cholesterol uptake and cholesterol synthesis. The gut microbiota analysis revealed no change in total bacteria, and in major Gram positive and Gram negative bacteria, but a selective significant increase in Lactobacillus spp. in mice treated with the ezetimibe and a decrease by the combination. The changes in lactobacilli level observed in ezetimibe or combination treated-mice are negatively correlated to expression of genes related to cholesterol metabolism. SIGNIFICANCE The present study showed that ezetimibe taken alone is able to modify the composition of gut microbiota in favor of Lactobacillus spp. These results suggest that members of the genus Lactobacillus play an important role in cholesterol metabolism, even in normocholesterolemic mouse model.
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Battistoni A, Mastromarino V, Volpe M. Reducing Cardiovascular and Cancer Risk: How to Address Global Primary Prevention in Clinical Practice. Clin Cardiol 2015; 38:387-94. [PMID: 25873555 DOI: 10.1002/clc.22394] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 01/15/2015] [Accepted: 01/20/2015] [Indexed: 12/11/2022] Open
Abstract
Emerging evidence suggesting the possibility that interventions able to prevent cardiovascular disease (CVD) may also be effective in the prevention of cancer have recently stimulated great interest in the medical community. In particular, data from both experimental and observational studies have demonstrated that aspirin may play a role in preventing different types of cancer. Although the use of aspirin in the secondary prevention of CVD is well established, aspirin in primary prevention is not systematically recommended because the absolute cardiovascular event reduction is similar to the absolute excess in major bleedings. By adding to its cardiovascular prevention benefits, the potential beneficial effect of aspirin in reducing the incidence of mortality and cancer could tip the balance between risks and benefits of aspirin therapy in primary prevention in favor of the latter and broaden the indication for treatment with aspirin in populations at average risk. Prospective and randomized studies are currently investigating the effect of aspirin in prevention of both cancer and CVD; however, clinical efforts at the individual level to promote the use of aspirin in global (or total) primary prevention already could be made on the basis of a balanced evaluation of the benefit/risk ratio.
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Affiliation(s)
- Allegra Battistoni
- Cardiology Department, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy
| | - Vittoria Mastromarino
- Cardiology Department, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy
| | - Massimo Volpe
- Cardiology Department, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed (Volpe), Pozzilli, Italy
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Robinson JG, Rogers WJ, Nedergaard BS, Fialkow J, Neutel JM, Ramstad D, Somaratne R, Legg JC, Nelson P, Scott R, Wasserman SM, Weiss R. Rationale and design of LAPLACE-2: a phase 3, randomized, double-blind, placebo- and ezetimibe-controlled trial evaluating the efficacy and safety of evolocumab in subjects with hypercholesterolemia on background statin therapy. Clin Cardiol 2014; 37:195-203. [PMID: 24481874 DOI: 10.1002/clc.22252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/27/2013] [Indexed: 12/13/2022] Open
Abstract
Low-density lipoprotein cholesterol (LDL-C) levels are significantly associated with atherosclerotic cardiovascular disease (ASCVD) risk, and studies using interventions that lower LDL-C levels have been shown to reduce the risk of ASCVD events and mortality. Statin treatment is the current first-line therapy for lowering LDL-C and reducing ASCVD risk. However, many patients are still unable to reach recommended LDL-C goals on maximally tolerated statin therapy. Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9, including evolocumab (previously AMG 145), dramatically lowered LDL-C in phase 2 clinical trials when administered alone or in combination with a statin. The aim of this phase 3 study is to evaluate the efficacy of 12 weeks of subcutaneous evolocumab (vs placebo) administered every 2 weeks or every month in combination with a statin in patients with hypercholesterolemia and mixed dyslipidemia. This study will also provide comparative efficacy, safety, and tolerability data between evolocumab and ezetimibe when added to background atorvastatin therapy.
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Affiliation(s)
- Jennifer G Robinson
- Departments of Epidemiology and Medicine, College of Public Health, University of Iowa, Iowa, Iowa
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Martin SS, Blaha MJ, Toth PP, Joshi PH, McEvoy JW, Ahmed HM, Elshazly MB, Swiger KJ, Michos ED, Kwiterovich PO, Kulkarni KR, Chimera J, Cannon CP, Blumenthal RS, Jones SR. Very large database of lipids: rationale and design. Clin Cardiol 2013; 36:641-8. [PMID: 24122913 DOI: 10.1002/clc.22214] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/22/2013] [Indexed: 12/23/2022] Open
Abstract
Blood lipids have major cardiovascular and public health implications. Lipid-lowering drugs are prescribed based in part on categorization of patients into normal or abnormal lipid metabolism, yet relatively little emphasis has been placed on: (1) the accuracy of current lipid measures used in clinical practice, (2) the reliability of current categorizations of dyslipidemia states, and (3) the relationship of advanced lipid characterization to other cardiovascular disease biomarkers. To these ends, we developed the Very Large Database of Lipids (NCT01698489), an ongoing database protocol that harnesses deidentified data from the daily operations of a commercial lipid laboratory. The database includes individuals who were referred for clinical purposes for a Vertical Auto Profile (Atherotech Inc., Birmingham, AL), which directly measures cholesterol concentrations of low-density lipoprotein, very low-density lipoprotein, intermediate-density lipoprotein, high-density lipoprotein, their subclasses, and lipoprotein(a). Individual Very Large Database of Lipids studies, ranging from studies of measurement accuracy, to dyslipidemia categorization, to biomarker associations, to characterization of rare lipid disorders, are investigator-initiated and utilize peer-reviewed statistical analysis plans to address a priori hypotheses/aims. In the first database harvest (Very Large Database of Lipids 1.0) from 2009 to 2011, there were 1 340 614 adult and 10 294 pediatric patients; the adult sample had a median age of 59 years (interquartile range, 49-70 years) with even representation by sex. Lipid distributions closely matched those from the population-representative National Health and Nutrition Examination Survey. The second harvest of the database (Very Large Database of Lipids 2.0) is underway. Overall, the Very Large Database of Lipids database provides an opportunity for collaboration and new knowledge generation through careful examination of granular lipid data on a large scale.
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Affiliation(s)
- Seth S Martin
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medicine, Baltimore, Maryland
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Blaha MJ, Michos ED. Niacin--a case study for the role of event-driven versus surrogate endpoint trials. Heart 2013; 99:1631-2. [PMID: 24041650 DOI: 10.1136/heartjnl-2013-304545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Michael J Blaha
- Department of Medicine/Cardiology, The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, , Baltimore, Maryland, USA
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