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Almeda-Valdes P, Cuevas-Ramos D, Mehta R, Muñoz-Hernandez L, Cruz-Bautista I, Perez-Mendez O, Tusie-Luna MT, Gomez-Perez FJ, Pajukanta P, Matikainen N, Taskinen MR, Aguilar-Salinas CA. Factors associated with postprandial lipemia and apolipoprotein A-V levels in individuals with familial combined hyperlipidemia. BMC Endocr Disord 2014; 14:90. [PMID: 25425215 PMCID: PMC4253986 DOI: 10.1186/1472-6823-14-90] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 11/17/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Alterations in postprandial metabolism have been described in familial combined hyperlipidemia (FCH); however, their underlying mechanisms are not well characterized. We aimed to identify factors related to the magnitude of postprandial lipemia and apolipoprotein (apo) A-V levels in subjects with FCH. METHODS FCH cases (n = 99) were studied using a standardized meal test. Abdominal obesity was assessed using the waist to hip ratio (WHR). A linear regression model was performed to investigate the variables associated with the triglycerides incremental area under the curve (iAUC). Independent associations between metabolic variables and apo A-V iAUC were also investigated in a randomly selected subgroup (n = 44). The study sample was classified according to the presence of fasting hypertriglyceridemia (≥150 mg/dL) and abdominal obesity (WHR ≥0.92 in men and ≥0.85 in women) to explore differences in parameters. RESULTS The fasting apo B-48 levels (r = 0.404), and the WHR (r = 0.359) were independent factors contributing to the triglycerides iAUC (r2 = 0.29, P < 0.001). The triglycerides iAUC was independently associated with the apo A-V iAUC (r2 = 0.54, P < 0.01). Patients with both hypertriglyceridemia and abdominal obesity showed the most robust triglycerides and apo A-V postprandial responses. CONCLUSIONS In patients with FCH the fasting apo B-48 level is the main factor associated with postprandial lipemia. Abdominal obesity also contributes to the magnitude of the postprandial response.The triglycerides postprandial increment is the principal factor associated with the apo A-V postprandial response.
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Affiliation(s)
- Paloma Almeda-Valdes
- />Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Daniel Cuevas-Ramos
- />Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Roopa Mehta
- />Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Liliana Muñoz-Hernandez
- />Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Ivette Cruz-Bautista
- />Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Oscar Perez-Mendez
- />Department of Molecular Biology, Instituto Nacional de Cardiologia Ignacio A. Chavez, Mexico City, Mexico
| | - Maria Teresa Tusie-Luna
- />Molecular Biology and Genomic Medicine Units. Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran. Biomedical Investigation Institute, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Francisco J Gomez-Perez
- />Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Päivi Pajukanta
- />Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Niina Matikainen
- />Diabetes and Obesity Units, Heart and Lung Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Marja-Riitta Taskinen
- />Diabetes and Obesity Units, Heart and Lung Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Carlos A Aguilar-Salinas
- />Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
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Hung YP, Lee NY, Lin SH, Chang HC, Wu CJ, Chang CM, Chen PL, Lin HJ, Wu YH, Tsai PJ, Tsai YS, Ko WC. Effects of PPARγ and RBP4 gene variants on metabolic syndrome in HIV-infected patients with anti-retroviral therapy. PLoS One 2012; 7:e49102. [PMID: 23145084 PMCID: PMC3492303 DOI: 10.1371/journal.pone.0049102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 10/03/2012] [Indexed: 11/23/2022] Open
Abstract
Background PPARγ and RBP4 are known to regulate lipid and glucose metabolism and insulin resistance. The influences of PPARγ (C1431T and Pro12Ala) and RBP4 (−803GA) polymorphisms on metabolic syndrome in HIV-infected patients receiving anti-retroviral therapy were examined in this study. Materials and Methods A cross-sectional study of HIV-1 infected adults with antiretroviral therapy for more than one year in the National Cheng Kung University Hospital was conducted. The gene polymorphisms were determined by quantitative PCR. Results Ninety-one patients were included in the study. Eighty-two (90.1%) patients were males with a mean age of 44.4 years. For the C1431T polymorphism in PPARγ, while patients with the T allele (48.4%) had trends toward lower rate of hypertriglyceridemia, the borderline significance together with insignificant power did not support the protective effect of the T allele against development of hypertriglyceridemia. For the Pro12Ala polymorphism in PPARγ, although patients with the Pro/Ala genotype (8.8%) had a higher level of serum LDL (138.0 vs. 111.5 mg/dl, P = 0.04) and trends toward higher rates of hypercholesterolemia and serum LDL>110 mg/dl, these variables were found to be independent of the Pro/Ala genotype in the multivariate analysis. For the −803GA polymorphism in RBP4, patients with the A allele (23.1%) more often had insulin resistance (HOMA>3.8; 33.3 vs. 8.7%, P = 0.01) and more often received anti-hypoglycemic drugs (14.3 vs. 1.4%, P = 0.04). The detrimental effect of the A allele in RBP4 −803GA polymorphism on development of insulin resistance was supported by the multivariate analysis adjusting for covariates. Conclusion The impacts of PPARγ C1431T and Pro12Ala polymorphisms on metabolism in HIV-infected patients are not significant. RBP4 −803GA polymorphism has increased risk of insulin resistance in HIV-infected patients with anti-retroviral therapy.
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Affiliation(s)
- Yuan-Pin Hung
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Internal Medicine, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan
| | - Nan-Yao Lee
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ho-Ching Chang
- Department of Nutrition, Chi-Mei Hospital, Tainan, Taiwan
| | - Chi-Jung Wu
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
- Division of Clinical Research, National Health Research Institutes, Tainan, Taiwan
| | - Chia-Ming Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Po-Lin Chen
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hsiao-Ju Lin
- Department of Internal Medicine, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yi-Hui Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Internal Medicine, Pingtung Christian Hospital, Pingtung, Taiwan
| | - Pei-Jane Tsai
- Department of Medical Laboratory Science and Biotechnology, National Cheng Kung University, Tainan, Taiwan
- Research Center of Infectious Disease and Signaling, National Cheng Kung University, Tainan, Taiwan
| | - Yau-Sheng Tsai
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
- Research Center of Infectious Disease and Signaling, National Cheng Kung University, Tainan, Taiwan
- * E-mail: (WCK); (YST)
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
- Research Center of Infectious Disease and Signaling, National Cheng Kung University, Tainan, Taiwan
- Department of Medicine, National Cheng Kung University, Tainan, Taiwan
- * E-mail: (WCK); (YST)
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Sniderman AD. Applying apoB to the diagnosis and therapy of the atherogenic dyslipoproteinemias: a clinical diagnostic algorithm. Curr Opin Lipidol 2004; 15:433-8. [PMID: 15243216 DOI: 10.1097/01.mol.0000137220.39031.3b] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The first objective is to present the most recent evidence relating to the efficacy of apolipoprotein B as a diagnostic index of the risk of vascular disease and a therapeutic target for statin therapy. The second is to present a diagnostic algorithm for the apolipoprotein B100 dyslipidemias based on triglyceride and apoB. RECENT FINDINGS The results from several recent prospective epidemiological studies demonstrate apoB to be superior to any of the cholesterol indices to estimate the risk of vascular disease. Similarly, the results of several of the major statin clinical trials demonstrate that apoB is a more adequate index of the adequacy of statin therapy than any of the cholesterol indices. Recent studies of lipoprotein subclass distribution in subjects with familial combined hyperlipidemia are reviewed. They demonstrate the limitations of the original lipid-based criteria and point to the necessity of using apoB as a fundamental diagnostic criterion for the disorder. A diagnostic algorithm for an apoB100 atherogenic dyslipoproteinemias is presented and the limitations of the lipid-based system described. SUMMARY The evidence supporting the clinical use of apoB is solid, its measurement is standardized, and automated, inexpensive laboratory testing could easily be widely available. However, clinical benefit will only follow clinical application.
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Affiliation(s)
- Allan D Sniderman
- Laboratory for Cardiovascular Research, Royal Victoria Hospital, Montreal, Quebec, Canada.
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Veerkamp MJ, de Graaf J, Hendriks JCM, Demacker PNM, Stalenhoef AFH. Nomogram to Diagnose Familial Combined Hyperlipidemia on the Basis of Results of a 5-Year Follow-Up Study. Circulation 2004; 109:2980-5. [PMID: 15184285 DOI: 10.1161/01.cir.0000130646.93255.86] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Familial combined hyperlipidemia (FCH) is traditionally diagnosed by total plasma cholesterol and/or triglyceride levels above the 90th percentile adjusted for age and gender. In a recent study, we showed that the diagnosis of FCH on the basis of these diagnostic criteria was inconsistent in 26% of the subjects over a 5-year period. This result emphasizes the need for reevaluation of the diagnostic criteria for FCH.
Methods and Results—
A total of 32 families (299 subjects) were studied in 1994 and 1999. A subject was defined “truly” FCH when diagnosed FCH in 1994 and/or 1999 on the basis of traditional plasma lipid criteria. Additional lipid and lipoprotein parameters, including apolipoprotein B (apoB) and small, dense LDL, were measured at both time points. In total, 121 subjects (40%) were defined as truly FCH. Multivariate analysis revealed that absolute apoB values combined with triglyceride and total cholesterol levels adjusted for age and gender best predicted truly FCH. A nomogram including these parameters is provided to simply and accurately calculate the probability to be affected by FCH. Furthermore, it is shown that when percentiles of triglyceride and total cholesterol adjusted for age and gender are not available in a population, the definition of FCH can be established on the basis of hypertriglyceridemia (>1.5 mmol/L) and hyper-apoB (>1200 mg/L).
Conclusions—
The diagnosis of FCH is best predicted by absolute apoB levels combined with triglyceride and total cholesterol levels adjusted for age and gender and can accurately be calculated by a nomogram. This definition is also a good predictor of cardiovascular risk in FCH.
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Affiliation(s)
- Mario J Veerkamp
- Department of Medicine, Division of General Internal Medicine, University Medical Center Nijmegen, Nijmegen, The Netherlands
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