ATHEROGENIC INDICES IN THE ASSESSMENT OF CARDIOVASCULAR DISEASE RISK IN CHILDREN WITH OBESITY AND SUBCLINICAL HYPOTHYROIDISM

Protective mechanism of Paeonol on central nervous system

Cerebrovascular diseases involve neuronal damage, resulting in degenerative neuropathy and posing a serious threat to human health. The discovery of effective drug components from natural plants and the study of their mechanism are a research idea different from chemical synthetic medicines. Paeonol is the main active component of traditional Chinese medicine Paeonia lactiflora Pall. It widely exists in many medicinal plants and has pharmacological effects such as anti-atherosclerosis, antiplatelet aggregation, anti-oxidation, and anti-inflammatory, which keeps generally used in the treatment of cardiovascular and cerebrovascular diseases. Based on the therapeutic effects of Paeonol for cardiovascular and cerebrovascular diseases, this article reviewed the pharmacological effects of Paeonol in Alzheimer's disease, Parkinson's disease, stroke, epilepsy, diabetes encephalopathy, and other neurological diseases, providing a reference for the research of the mechanism of Paeonol in central nervous system diseases.

Atherosclerosis Risk Factors in Patients with Reactive Hypoglycemia

PURPOSE

Glucose metabolism disorders are an established risk factor for atherosclerosis. Although reactive hypoglycemia (RH) can be classified as one of these disorders, its role as a potential atherosclerosis risk factor remains unclear. The aim of the study was to assess whether patients with RH have a higher risk of atherosclerosis.

PATIENTS AND METHODS

We recruited 178 patients (N=178) with suspected RH who were hospitalized after 2014 and underwent a prolonged 5-hour oral glucose tolerance test. The study cohort was divided into 2 groups depending on the results of the oral glucose tolerance test: Group 1 - subjects without RH (n=44), Group 2 -subjects with RH (n=134).

RESULTS

The analyzed groups differed significantly in terms of the following risk factors for atherosclerosis: high-density lipoprotein (HDL) cholesterol levels (54.3±18.8 mg/dL vs 63±18.5 mg/dL, p=0.003) and atherogenic indices (Castelli I: 3.7±1.2 vs 3.1±1.3, p=0.004; Castelli II: 2.1±0.9 vs 1.7±0.9, p=0.007; the atherogenic index of plasma: 0.34±0.33 vs 0.18±0.3, p=0.006; and the atherogenic coefficient: 2.7±1.2 vs 2.1±1.3, p=0.004). Univariate logistic regression showed that RH should not be considered to be a predictor of an increased atherogenic index of plasma (odds ratio [OR]=0.3 [95% confidence interval [CI] [0.16-0.7], p=0.002). Multivariate logistic regression revealed triglyceride levels (OR 1.14 [1.07-1.2], p=0.001) and body weight (OR 1.07 [1.03-1.12], p=0.002) to be independent risk factors for atherosclerosis.

CONCLUSION

Atherosclerosis risk factors are no more prevalent in patients with RH. RH does not increase the risk of an abnormal atherogenic index of plasma.

Paeonol suppresses lipid formation and promotes lipid degradation in adipocytes

Paeonol can regulate a variety of physiological and pathological processes such as thrombosis, oxidative stress, inflammation and atherosclerosis. However, its potential role and underlying mechanisms in obesity and lipid metabolism remain to be elucidated. In the present study, 3T3-L1 cells were differentiated and collected on days 4, 6 and 8. The expression levels of fatty-acid-binding protein 4 (FABP4) and microRNA (miR)-21 were detected using reverse transcription-quantitative PCR and western blot analyses. Cell viability was assessed using a Cell Counting Kit-8 assay. A miR-21 mimic was constructed and transfected into 3T3-L1 preadipocytes. Adipocyte differentiation was detected using Oil Red O staining. The proteins CD36, glucose transporter 4, peroxisome proliferator-activated receptor γ (PPAR-γ) and adipocyte protein 2 (Ap2) were detected using western blot analysis. The expression levels of FABP4 and miR-21 were increased in differentiated 3T3-L1 cells. Paeonol exhibited no effects on cell activity, whereas it inhibited the expression levels of miR-21 in the 3T3-L1 differentiated adipocytes. Paeonol suppressed the differentiation of 3T3-L1 adipocytes and its effect was partially reversed by the overexpression of miR-21. In addition, paeonol promoted the lipid degradation of 3T3-L1 adipocytes, increased the expression levels of PPAR-γ and Ap2, and suppressed triglyceride synthesis in these cells. These effects were partially reversed by the overexpression of miR-21. In conclusion, the findings of the present study indicated that paeonol may exert protective effects against lipid formation and promote lipid degradation in adipocytes. These data provide evidence of the regulatory effect of paeonol on adipocyte differentiation and highlight its pathological significance.

Thyroid Function in Adults with Prader-Willi Syndrome; a Cohort Study and Literature Review

Prader–Willi syndrome (PWS) is a complex genetic syndrome combining hypotonia, hyperphagia, a PWS-specific neurocognitive phenotype, and pituitary hormone deficiencies, including hypothyroidism. The low muscle mass associated with PWS causes a low energy expenditure due to a low basal metabolic rate. Combined with increased energy intake due to hyperphagia, this results in a high risk of obesity and associated cardiovascular disease. To reduce the high mortality in PWS (3% yearly), exercise is extremely important. As hypothyroidism can impair exercise tolerance, early detection is crucial. We performed a literature search for articles on hypothyroidism in PWS, measured thyroid hormone (TH) levels in 122 adults with PWS, and performed a medical file search for medication use. Hypothyroidism (low free thyroxin) was present in 17%, and often central in origin (80%). Triiodothyronine levels were lower in patients who used psychotropic drugs, while other TH levels were similar. One in six patients in our cohort of adults with PWS had hypothyroidism, which is more than in non-PWS adults (3%). We recommend yearly screening of free thyroxin and thyroid-stimulating hormone levels to avoid the negative effects of untreated hypothyroidism on basal metabolic rate, body mass index, and cardiovascular risk. Additionally, we recommend measuring TH concentrations 3–4 months after the start of growth hormone treatment.