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Andreani GA, Mahmood S, Patel MS, Rideout TC. Maternal pea fiber supplementation to a high calorie diet in obese pregnancies protects male offspring from metabolic dysfunction in adulthood. J Dev Orig Health Dis 2023; 14:711-718. [PMID: 38234128 DOI: 10.1017/s2040174423000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
We investigated the influence of maternal yellow-pea fiber supplementation in obese pregnancies on offspring metabolic health in adulthood. Sixty newly-weaned female Sprague-Dawley rats were randomized to either a low-calorie control diet (CON) or high calorie obesogenic diet (HC) for 6-weeks. Obese animals were then fed either the HC diet alone or the HC diet supplemented with yellow-pea fiber (HC + FBR) for an additional 4-weeks prior to breeding and throughout gestation and lactation. On postnatal day (PND) 21, 1 male and 1 female offspring from each dam were weaned onto the CON diet until adulthood (PND 120) for metabolic phenotyping. Adult male, but not female, HC offspring demonstrated increased body weight and feed intake vs CON offspring, however no protection was offered by maternal FBR supplementation. HC male and female adult offspring demonstrated increased serum glucose and insulin resistance (HOMA-IR) compared with CON offspring. Maternal FBR supplementation improved glycemic control in male, but not female offspring. Compared with CON offspring, male offspring from HC dams demonstrated marked dyslipidemia (higher serum cholesterol, increased number of TG-rich lipoproteins, and smaller LDL particles) which was largely normalized in offspring from HC + FBR mothers. Male offspring born to obese mothers (HC) had higher hepatic TG, which tended to be lowered (p = 0.07) by maternal FBR supplementation.Supplementation of a maternal high calorie diet with yellow-pea fiber in prepregnancy and throughout gestation and lactation protects male offspring from metabolic dysfunction in the absence of any change in body weight status in adulthood.
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Affiliation(s)
- Gabriella A Andreani
- Departments of Exercise and Nutrition Sciences, School of Public Health and Health Professions, Buffalo, NY, USA
| | - Saleh Mahmood
- Departments of Exercise and Nutrition Sciences, School of Public Health and Health Professions, Buffalo, NY, USA
| | - Mulchand S Patel
- Biochemistry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Todd C Rideout
- Departments of Exercise and Nutrition Sciences, School of Public Health and Health Professions, Buffalo, NY, USA
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Rabizadeh S, Seyedi SA, Nabipoorashrafi SA, Omidvar Siahkalmahalleh M, Yadegar A, Mohammadi F, Rajab A, Esteghamati A, Nakhjavani M. The lack of association between different LDL-C levels and oxidized LDL in patients with type 2 diabetes. Chronic Dis Transl Med 2023; 9:329-335. [PMID: 37915391 PMCID: PMC10617302 DOI: 10.1002/cdt3.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 11/03/2023] Open
Abstract
Background High concentrations of low-density lipoprotein cholesterol (LDL-C) have been a known risk factor for cardiovascular diseases. Also, the role of oxidized LDL (ox-LDL) in forming atherosclerosis plaque has been proven. However, it has not yet been proven that atherogenic LDL-C by-products like ox-LDL will decrease by keeping the LDL levels at the desired level. This study aimed to examine the relationship between LDL-C and ox-LDL in different LDL-C values in patients with type 2 diabetes (T2D). Methods In this cross-sectional study, 347 patients with T2D who received statins were enrolled. LDL-C values were defined into four groups as LDL-C < 55 mg/dL, 55 mg/dL ≤ to <70 mg/dL, 70 mg/dL ≤ to <100 mg/dL and LDL-C ≥ 100 mg/dL. Total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and ox-LDL were studied in the four defined groups. Results Ox-LDL levels were not different among the four groups (p = 0.30). In addition, LDL-C and ox-LDL levels had no significant correlation (r = 0.480, p = 0.376). Additionally, based on this study analysis, ox-LDL levels were significantly correlated with TG levels (r = 0.119, p < 0.05) and TG/HDL ratio (r = 0.390, p < 0.01). Conclusions It is concluded that ox-LDL levels were not associated with different LDL-C level categories from <55 mg/dL to >100 mg/dL in patients with T2D. However, the revealed association of ox-LDL with TG level and TG/HDL ratio may be considered in the clinic.
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Affiliation(s)
- Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
| | - Seyed Arsalan Seyedi
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
| | - Seyed Ali Nabipoorashrafi
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
| | | | - Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
| | - Fatemeh Mohammadi
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
| | - Armin Rajab
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr Hospital, School of MedicineTehran University of Medical SciencesTehranIran
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Gholami Chahkand MS, Esmaeilpour Moallem F, Qezelgachi A, Seifouri K, Pesaran Afsharian A, sheikhzadeh F, poursalehi A, Fani Sadrabadi FS, Saghab Torbati M, Ramezanzade M, Alishiri G, Ansari A, Zare Dehabadi E, Karimi Matloub S, Sheikh Z, Deravi N, Mehrtabar S, Chichagi F, Faal Hamedanchi N, Arzaghi M, Asadi M, Alsadat Dadkhah P, Ansari A. Lipoprotein (a) as a predictor of diabetic retinopathy in patients with type 2 diabetes: A systematic review. Diab Vasc Dis Res 2023; 20:14791641231197114. [PMID: 38018132 PMCID: PMC10685788 DOI: 10.1177/14791641231197114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Lipoprotein a (LP(a)), an LDL-like lipoprotein, known as a risk factor for cardiovascular diseases, has a controversial association with diabetic retinopathy in patients with type 2 diabetes-the current systematic review aimed to critically assess the association between LP(a) and diabetic retinopathy. METHODS A systematic review of relevant studies was conducted after a thorough search in PubMed, Scopus, and Google Scholar electronic databases. We used English observational, case-control, and prospective cohort studies published up to August 2022, including type 2 diabetic patients as the population, diabetic retinopathy as the outcome, and LP(a) as the intervention. RESULT 17 relevant studies, including 4688 patients with diabetes, were included in this systematic review. While in 13 studies, Lipoprotein(a) was recognized as a risk factor for diabetic retinopathy, only three studies reported no evidence of a relationship between the two. Also, another study showed a mixed outcome of the relationship between LP(a) and diabetic retinopathy. CONCLUSION High serum lipoprotein(a) in patients with type 2 diabetes is considered a risk factor for diabetic retinopathy. However, further large-scaled cohort studies are still required to validate this finding.
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Affiliation(s)
| | | | - Abolfazl Qezelgachi
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Kiana Seifouri
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Farzad sheikhzadeh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Atefe poursalehi
- Student Research Committee, School of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | - Goharsharieh Alishiri
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Arina Ansari
- Student Research Committee, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Emad Zare Dehabadi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Sheikh
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Mehrtabar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Chichagi
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Faal Hamedanchi
- Faculty of Medicine, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran
| | | | - Mahla Asadi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Akram Ansari
- Medical College, Shantou University, Shantou, China
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Soedarman S, Kurnia KH, Prasetya ADB, Sasongko MB. Cholesterols, Apolipoproteins, and Their Associations with the Presence and Severity of Diabetic Retinopathy: A Systematic Review. Vision (Basel) 2022; 6:vision6040077. [PMID: 36548939 PMCID: PMC9785692 DOI: 10.3390/vision6040077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/28/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Serum apolipoproteins have been reported as a more significant marker for diabetic retinopathy (DR) compared with serum cholesterols. This article aims to review the associations between serum cholesterols and apolipoproteins, and the presence and severity of DR. The protocol of this systematic review was registered at the PROSPERO registry (CRD42022303331). We conducted a systematic search of literature published between 2011 to 2022 using the search terms "serum cholesterol" AND/OR "lipoprotein" AND/OR "apolipoprotein" AND/OR "diabetic retinopathy". Fifteen studies were included in this review. Six studies assessed the association between serum cholesterols, apolipoproteins, and the presence of DR. Three studies reported lower levels of apolipoprotein A1, and one study reported higher levels of apolipoprotein B in patients with DR. The remaining nine studies compared serum cholesterol and apolipoprotein levels according to DR severity. Patients with more severe grades of DR presented with lower apolipoprotein A1 in six (66.7%) studies, higher apolipoprotein B levels in seven (77.8%) studies, and a higher apolipoprotein B/apolipoprotein A1 ratio in six out of seven (85%) studies. In conclusion, serum apolipoproteins, in particular the apolipoprotein B/apolipoprotein A1 ratio, were a more consistent marker for DR severity compared with serum cholesterols.
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Affiliation(s)
- Soefiandi Soedarman
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- JEC Eye Hospitals & Clinics, Jakarta 10310, Indonesia
| | | | | | - Muhammad Bayu Sasongko
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Sardjito Eye Center, Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia
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Makover ME, Shapiro MD, Toth PP. There is urgent need to treat atherosclerotic cardiovascular disease risk earlier, more intensively, and with greater precision: A review of current practice and recommendations for improved effectiveness. Am J Prev Cardiol 2022; 12:100371. [PMID: 36124049 PMCID: PMC9482082 DOI: 10.1016/j.ajpc.2022.100371] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/10/2022] [Accepted: 08/05/2022] [Indexed: 12/12/2022] Open
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is epidemic throughout the world and is etiologic for such acute cardiovascular events as myocardial infarction, ischemic stroke, unstable angina, and death. ASCVD also impacts risk for dementia, chronic kidney disease peripheral arterial disease and mobility, impaired sexual response, and a host of other visceral impairments that adversely impact the quality and rate of progression of aging. The relationship between low-density lipoprotein cholesterol (LDL-C) and risk for ASCVD is one of the most highly established and investigated issues in the entirety of modern medicine. Elevated LDL-C is a necessary condition for atherogenesis induction. Basic scientific investigation, prospective longitudinal cohorts, and randomized clinical trials have all validated this association. Yet despite the enormous number of clinical trials which support the need for reducing the burden of atherogenic lipoprotein in blood, the percentage of high and very high-risk patients who achieve risk stratified LDL-C target reductions is low and has remained low for the last thirty years. Atherosclerosis is a preventable disease. As clinicians, the time has come for us to take primordial and primary prevention more serously. Despite a plethora of therapeutic approaches, the large majority of patients at risk for ASCVD are poorly or inadequately treated, leaving them vulnerable to disease progression, acute cardiovascular events, and poor aging due to loss of function in multiple visceral organs. Herein we discuss the need to greatly intensify efforts to reduce risk, decrease disease burden, and provide more comprehensive and earlier risk assessment to optimally prevent ASCVD and its complications. Evidence is presented to support that treatment should aim for far lower goals in cholesterol management, should take into account many more factors than commonly employed today and should begin significantly earlier in life.
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Santamaria-Juarez C, Atonal-Flores F, Diaz A, Sarmiento-Ortega VE, Garcia-Gonzalez M, Aguilar-Alonso P, Lopez-Lopez G, Brambila E, Treviño S. Aortic dysfunction by chronic cadmium exposure is linked to multiple metabolic risk factors that converge in anion superoxide production. Arch Physiol Biochem 2022; 128:748-756. [PMID: 32067514 DOI: 10.1080/13813455.2020.1726403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT The chronic exposure to Cadmium (Cd) constitute an risk to develop hypertension and cardiovascular diseases associated with the increase of oxidative stress. OBJECTIVE In this study, we investigate the role of metabolic changes produced by exposure to Cd on the endothelial dysfunction via oxidative stress. METHODS Male Wistar rats were exposed to Cd (32.5-ppm) for 2-months. The zoometry and blood pressure were evaluated, also glucose and lipids profiles in serum and vascular reactivity evaluated in isolated aorta rings. RESULTS Rats exposed to Cd showed an increase of blood pressure and biochemical parameters similar to metabolic syndrome. Additionally, rats exposed to Cd showed a reduced relaxation in aortic rings, which was reversed after the addition of SOD and apocynin an inhibitor of NADPH. CONCLUSION The Cd-exposition induced hypertension and endothelial injury by that modifying the vascular relaxation and develop oxidative stress via NADPH oxidase, superoxide and loss nitric oxide bioavailability.
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Affiliation(s)
- Celeste Santamaria-Juarez
- Department of Pharmacy, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
| | - Fausto Atonal-Flores
- Department of Physiology, Faculty of Medicine, University Autonomous of Puebla, The Volcano, Mexico
| | - Alfonso Diaz
- Department of Pharmacy, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
| | - Victor E Sarmiento-Ortega
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
| | - Miguel Garcia-Gonzalez
- Department of Pharmacy, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
| | - Patricia Aguilar-Alonso
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
| | - Gustavo Lopez-Lopez
- Department of Pharmacy, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
| | - Eduardo Brambila
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
| | - Samuel Treviño
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla, Puebla, Mexico
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Hu F, Lu F, Huang X, Cheng X. Relationship Between Plasma Total Homocysteine Levels and Mean Corrected TIMI Frame Count in Patients with Acute Myocardial Infarction. Int J Gen Med 2021; 14:8161-8172. [PMID: 34815690 PMCID: PMC8604641 DOI: 10.2147/ijgm.s338938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022] Open
Abstract
Objective To explore the relationship between the plasma total homocysteine (tHcy) levels and slow coronary flow (SCF) measured by mean corrected TIMI frame count (CTFC) in patients with acute myocardial infarction (AMI). Methods Ninety-one patients with primary myocardial infarction were enrolled in this study. The quantitative measurement of coronary blood flow was performed using the mean CTFC method. Plasma tHcy levels were determined using enzymatic assay from venous blood samples. Multivariable linear regression models indicated were used to estimate the effect size (β) of plasma tHcy levels on mean CTFC levels. Results Compared with patients with the mean CTFC ≤23.61 frames per second (FPS) group, there were increased plasma tHcy levels in patients of the second, third and highest mean CTFC quartiles (P < 0.001). Linear regression models indicated that plasma tHcy levels were positively associated with mean CTFC levels (adjusted-β per SD increase: 1.96, 95% CI 1.20 to 2.73, P < 0.001). Compared to the tHcy ≤12.30 μmol/L group, the third and highest tHcy-quartile groups had higher mean CTFC levels (adjusted-β: 2.52, 95% CI 0.39 to 4.65, P = 0.023; adjusted-β: 5.07, 95% CI 2.98 to 7.16, P < 0.001, respectively; P for trend <0.001). Moreover, this positive relationship was modified by diabetes mellitus (P-value for interaction was 0.046). Conclusion We found a positive relationship between plasma tHcy levels and mean CTFC levels in patients with AMI. Moreover, diabetes mellitus played an interactive role in this positive association between the plasma tHcy levels and mean CTFC levels.
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Affiliation(s)
- Feng Hu
- The Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Feng Lu
- The Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Xiao Huang
- The Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Xiaoshu Cheng
- The Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
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Dimitriou E, Sergentanis TN, Lambadiari V, Theodossiadis G, Theodossiadis P, Chatziralli I. Correlation between Imaging Morphological Findings and Laboratory Biomarkers in Patients with Diabetic Macular Edema. J Diabetes Res 2021; 2021:6426003. [PMID: 34423046 PMCID: PMC8378977 DOI: 10.1155/2021/6426003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/15/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate the potential association between peripheral blood biomarkers and morphological characteristics of retinal imaging in patients with diabetic macular edema (DME). METHODS Participants in this cross-sectional study were 36 consecutive patients (36 eyes) with treatment-naïve DME, who underwent spectral domain-optical coherence tomography (SD-OCT), fundus photography, and fundus fluorescein angiography (FFA). In addition, peripheral blood samples were taken to evaluate full blood count and biochemical parameters. Correlation between imaging characteristics and laboratory parameters was examined. RESULTS Eyes with central subfield thickness greater than 405 μm presented significantly higher neutrophils/lymphocytes (p = 0.043) and higher lipoprotein (a) compared to eyes with CST < 405 μm (p = 0.003). Presence of hyperreflective foci on SD-OCT was associated with significantly higher white blood cell count (p = 0.028). Ellipsoid zone disruption was associated with significantly lower hematocrit (p = 0.012), hemoglobin (p = 0.009), and red blood cell count (p = 0.026), as well as with higher lipoprotein (a) (p = 0.015). Macular ischemia on FFA was associated with significantly higher monocytes (p = 0.027) and monocytes/HDL (p = 0.019). No significant associations were found between laboratory parameters and subretinal fluid, intraretinal fluid, exudates, cysts, disorganization of inner retinal layers, epiretinal membrane, and external limiting membrane condition. CONCLUSION Specific imaging morphological characteristics were found to be associated with laboratory parameters in patients with DME. These findings may shed light on the pathophysiology of DME and its correlation with the development of specific clinical signs.
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Affiliation(s)
- Eleni Dimitriou
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros N. Sergentanis
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vaia Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Athens, Greece
| | - George Theodossiadis
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Irini Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
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Singh P, Goncalves I, Tengryd C, Nitulescu M, Persson AF, To F, Bengtsson E, Volkov P, Orho-Melander M, Nilsson J, Edsfeldt A. Reduced oxidized LDL in T2D plaques is associated with a greater statin usage but not with future cardiovascular events. Cardiovasc Diabetol 2020; 19:214. [PMID: 33317535 PMCID: PMC7737372 DOI: 10.1186/s12933-020-01189-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
Background Type 2 diabetes (T2D) patients are at a greater risk of cardiovascular events due to aggravated atherosclerosis. Oxidized LDL (oxLDL) has been shown to be increased in T2D plaques and suggested to contribute to plaque ruptures. Despite intensified statin treatment during the last decade the higher risk for events remains. Here, we explored if intensified statin treatment was associated with reduced oxLDL in T2D plaques and if oxLDL predicts cardiovascular events, to elucidate whether further plaque oxLDL reduction would be a promising therapeutic target. Methods Carotid plaque OxLDL levels and plasma lipoproteins were assessed in 200 patients. Plaque oxLDL was located by immunohistochemistry. Plaque cytokines, cells and scavenger receptor gene expression were quantified by Luminex, immunohistochemistry and RNA sequencing, respectively. Clinical information and events during follow-up were obtained from national registers. Results Plaque oxLDL levels correlated with markers of inflammatory activity, endothelial activation and plasma LDL cholesterol (r = 0.22-0.32 and p ≤ 0.01 for all). T2D individuals exhibited lower plaque levels of oxLDL, sLOX-1(a marker of endothelial activation) and plasma LDL cholesterol (p = 0.001, p = 0.006 and p = 0.009). No increased gene expression of scavenger receptors was identified in T2D plaques. The lower oxLDL content in T2D plaques was associated with a greater statin usage (p = 0.026). Supporting this, a linear regression model showed that statin treatment was the factor with the strongest association to plaque oxLDL and plasma LDL cholesterol (p < 0.001 for both). However, patients with T2D more frequently suffered from symptoms and yet plaque levels of oxLDL did not predict cardiovascular events in T2D (findings are summarized in Fig. 1a). Conclusions This study points out the importance of statin treatment in affecting plaque biology in T2D. It also implies that other biological components, beyond oxLDL, need to be identified and targeted to further reduce the risk of events among T2D patients receiving statin treatment.
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Affiliation(s)
- Pratibha Singh
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Isabel Goncalves
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden.,Dept. of Cardiology, Skåne University Hospital, Lund/Malmö, Sweden
| | - Christoffer Tengryd
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Mihaela Nitulescu
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Ana F Persson
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Fong To
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Eva Bengtsson
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Petr Volkov
- Diabetes Center Bioinformatics Unit, Lund University, Malmö, Sweden
| | - Marju Orho-Melander
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Jan Nilsson
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
| | - Andreas Edsfeldt
- Dept. of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden. .,Dept. of Cardiology, Skåne University Hospital, Lund/Malmö, Sweden. .,Wallenberg Center for Molecular Medicine, Lund University, Malmö, Sweden.
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10
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Moosaie F, Davatgari RM, Firouzabadi FD, Esteghamati S, Deravi N, Meysamie A, Khaloo P, Nakhjavani M, Esteghamati A. Lipoprotein(a) and Apolipoproteins as Predictors for Diabetic Retinopathy and Its Severity in Adults With Type 2 Diabetes: A Case-Cohort Study. Can J Diabetes 2020; 44:414-421. [PMID: 32205075 DOI: 10.1016/j.jcjd.2020.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/15/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Our aim in this study was to assess the relationship between serum lipoprotein(a) [Lp(a)] and apolipoproteins and the risk of developing diabetic retinopathy (DR). METHODS One thousand fifty-seven patients with type 2 diabetes were divided into 2 main groups and followed for 5 years: 637 patients without DR and 420 patients with DR. A group of patients with DR were then divided into 2 subgroups: 162 patients with nonproliferative DR (NPDR) and 163 patients with proliferative DR (PDR). The association between serum Lp(a) and apolipoproteins with NPDR and PDR was assessed using univariate and multivariate regression analyses. Receiver-operating characteristic curve analysis was performed based on the new cutoff values. RESULTS There was a positive relationship between Lp(a) and the presence of DR as well as a negative correlation between ApoA and DR (p<0.001 and p=0.03, respectively). We also found a positive association between ApoB and the severity of DR (p=0.008). ApoA1 had an area under the curve of 55.0% for the prediction of DR. The calculated cutoff values of ApoB/ApoA1 ratio (0.58 g/L) and ApoB (77.5 g/L) in detection of DR were lower than their standard cutoff values of 0.8 and 90 g/L, respectively. Also, the sensitivity of new cutoff values for ApoB and ApoB/ApoA1 ratio was higher than the standard value, but the specificity of the standard cutoff values for both was higher than our new cutoff value. CONCLUSIONS Serum Lp(a) and ApoA1 levels were independently associated with DR, and serum ApoB correlated with severity of DR. These measurements can be used for assessment and early treatment of this vision-threatening complication of diabetes.
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Affiliation(s)
- Fatemeh Moosaie
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mohamadhosseinzadeh Davatgari
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Dehghani Firouzabadi
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf Esteghamati
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alipasha Meysamie
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Khaloo
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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11
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Fujii N, Meade RD, McNeely BD, Nishiyasu T, Sigal RJ, Kenny GP. Type 2 diabetes specifically attenuates purinergic skin vasodilatation without affecting muscarinic and nicotinic skin vasodilatation and sweating. Exp Physiol 2018; 103:212-221. [DOI: 10.1113/ep086694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/28/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Naoto Fujii
- Faculty of Health and Sport Sciences; University of Tsukuba; Tsukuba Japan
- Human and Environmental Physiology Research Unit; University of Ottawa; Ottawa Ontario Canada
| | - Robert D. Meade
- Human and Environmental Physiology Research Unit; University of Ottawa; Ottawa Ontario Canada
| | - Brendan D. McNeely
- Human and Environmental Physiology Research Unit; University of Ottawa; Ottawa Ontario Canada
| | - Takeshi Nishiyasu
- Faculty of Health and Sport Sciences; University of Tsukuba; Tsukuba Japan
| | - Ronald J. Sigal
- Human and Environmental Physiology Research Unit; University of Ottawa; Ottawa Ontario Canada
- Department of Medicine; Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
- Clinical Epidemiology Program; Ottawa Hospital Research Institute; Ottawa Ontario Canada
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit; University of Ottawa; Ottawa Ontario Canada
- Clinical Epidemiology Program; Ottawa Hospital Research Institute; Ottawa Ontario Canada
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12
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Kibel A, Selthofer-Relatic K, Drenjancevic I, Bacun T, Bosnjak I, Kibel D, Gros M. Coronary microvascular dysfunction in diabetes mellitus. J Int Med Res 2017; 45:1901-1929. [PMID: 28643578 PMCID: PMC5805190 DOI: 10.1177/0300060516675504] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 09/30/2016] [Indexed: 12/16/2022] Open
Abstract
The significance, mechanisms and consequences of coronary microvascular dysfunction associated with diabetes mellitus are topics into which we have insufficient insight at this time. It is widely recognized that endothelial dysfunction that is caused by diabetes in various vascular beds contributes to a wide range of complications and exerts unfavorable effects on microcirculatory regulation. The coronary microcirculation is precisely regulated through a number of interconnected physiological processes with the purpose of matching local blood flow to myocardial metabolic demands. Dysregulation of this network might contribute to varying degrees of pathological consequences. This review discusses the most important findings regarding coronary microvascular dysfunction in diabetes from pre-clinical and clinical perspectives.
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Affiliation(s)
- Aleksandar Kibel
- Department for Heart and Vascular
Diseases, Clinic of Internal Medicine, Osijek University Hospital, Osijek,
Croatia
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
| | - Kristina Selthofer-Relatic
- Department for Heart and Vascular
Diseases, Clinic of Internal Medicine, Osijek University Hospital, Osijek,
Croatia
- Department of Internal Medicine, Faculty
of Medicine, University of Osijek, Osijek, Croatia
| | - Ines Drenjancevic
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
| | - Tatjana Bacun
- Department of Internal Medicine, Faculty
of Medicine, University of Osijek, Osijek, Croatia
- Department of Endocrinology, Clinic of
Internal Medicine, Osijek University Hospital, Osijek, Croatia
| | - Ivica Bosnjak
- Department for Heart and Vascular
Diseases, Clinic of Internal Medicine, Osijek University Hospital, Osijek,
Croatia
| | - Dijana Kibel
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
- Department of Diagnostic and
Interventional Radiology, Osijek University Hospital, Osijek, Croatia
| | - Mario Gros
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
- Department of Diagnostic and
Interventional Radiology, Osijek University Hospital, Osijek, Croatia
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13
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Tu WJ, Liu H, Liu Q, Cao JL, Guo M. Association Between Serum Lipoprotein(a) and Diabetic Retinopathy in Han Chinese Patients With Type 2 Diabetes. J Clin Endocrinol Metab 2017; 102:2525-2532. [PMID: 28472352 DOI: 10.1210/jc.2016-4015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 04/25/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT Contrasting observations have been made on the relationship between lipoprotein(a) [Lp(a)] concentration and diabetic retinopathy (DR) in patients with type 2 diabetes (T2D). OBJECTIVE To measure serum Lp(a) concentrations in patients with T2D to investigate whether Lp(a) affects risk for DR. DESIGN AND PATIENTS Serum Lp(a) was determined in 377 Han Chinese patients with T2D. Demographic and clinical information, including presence of DR and vision-threatening DR (VTDR), were collected on admission. The relationship between serum Lp(a) and DR or VTDR was evaluated using univariate and multivariate regression analyses. RESULTS Patients with DR or VTDR had significantly higher serum Lp(a) concentrations on admission (P < 0.001). The distribution across Lp(a) quartiles ranged from 11.7% (DR) and 4.3% (VTDR) in the first quartile to 47.9% (DR) and 19.1% (VTDR) in the fourth quartile (P for trend < 0.001). Multivariate logistic regression analysis adjusted for common DR and VTDR risk factors showed that the third and fourth Lp(a) quartiles were significantly associated with DR and VTDR compared with the first Lp(a) quartile (P < 0.001). The patient group with highest concentrations of both Lp(a) (fourth quartile) and hemoglobin A1c (≥7%) had an odds ratio for DR of 5.15 [95% confidence interval (CI), 2.78 to 9.55; P < 0.001] and for VTDR of 5.32 (95% CI, 2.92 to 10.15; P < 0.001) compared with patients with lower concentrations of both factors. CONCLUSIONS Lp(a) concentration was independently associated with DR in patients with T2D. More frequent retinal examinations should be recommended for patients with T2D and high Lp(a) concentrations.
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Affiliation(s)
- Wen-Jun Tu
- Institute of Radiation Medicine, China Academy of Medical Science & Peking Union Medical College, Tianjin 300192, China
- Department of Laboratory, China Rehabilitation Research Center, Beijing 100068, China
| | - Huan Liu
- Department of Endocrinology and Metabolic Disease, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Qiang Liu
- Institute of Radiation Medicine, China Academy of Medical Science & Peking Union Medical College, Tianjin 300192, China
| | - Jian-Lei Cao
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Min Guo
- Department of Endocrinology and Metabolic Disease, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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14
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Kubo M, Miyoshi T, Oe H, Ohno Y, Nakamura K, Ito H. Prognostic significance of endothelial dysfunction in patients undergoing percutaneous coronary intervention in the era of drug-eluting stents. BMC Cardiovasc Disord 2015; 15:102. [PMID: 26399321 PMCID: PMC4580289 DOI: 10.1186/s12872-015-0096-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 09/14/2015] [Indexed: 12/31/2022] Open
Abstract
Background Endothelial function is a prognostic predictor in patients undergoing percutaneous coronary intervention (PCI). However, in an era with widespread use of drug-eluting stents, the clinical relevance of endothelial dysfunction on restenosis in patients undergoing PCI has not been fully evaluated. Methods This study included 80 patients with stable angina pectoris. Flow-mediated dilation (FMD) of the brachial artery was examined 1 week after PCI. Patients were retrospectively followed-up for an average of 21 months after PCI. The primary endpoints included cardiac death, nonfatal myocardial infarction, stroke, coronary revascularization, and critical limb ischemia. Results A drug-eluting stent was used in 58 patients and a cardiovascular event was recorded in 34 patients during follow-up. The incidence of all cardiovascular diseases was significantly greater in the low FMD (median FMD <4.2 %) than the high FMD (median FMD ≥4.2 %) group (60 % vs. 25 %, p <0.01). Furthermore, the incidence of coronary revascularization was significantly higher in the low than the high FMD group (p = 0.02), while the incidence of in-stent restenosis did not differ between the two groups. Cox regression analysis showed that low FMD was an independent predictor of cardiovascular events (hazard ratio: 2.77, 95 % confidence interval: 1.23 to 6.19, p = 0.01). Conclusions Impaired brachial artery FMD independently predicts long-term cardiovascular events after PCI in the era of drug-eluting stents.
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Affiliation(s)
- Motoki Kubo
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Hiroki Oe
- Center of Ultrasonography, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Yuko Ohno
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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15
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Schwimmer JB, Zepeda A, Newton KP, Xanthakos SA, Behling C, Hallinan EK, Donithan M, Tonascia J. Longitudinal assessment of high blood pressure in children with nonalcoholic fatty liver disease. PLoS One 2014; 9:e112569. [PMID: 25419656 PMCID: PMC4242611 DOI: 10.1371/journal.pone.0112569] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/01/2014] [Indexed: 12/12/2022] Open
Abstract
Objective Nonalcoholic fatty liver disease (NAFLD) affects 9.6% of children and may put these children at elevated risk of high blood pressure and subsequent cardiovascular morbidity and mortality. Therefore, we sought to determine the prevalence of and risk factors for high blood pressure in children with NAFLD. Methods Cohort study performed by the NIDDK NASH Clinical Research Network. There were 484 children with NAFLD ages 2 to 17 at enrollment; 382 children were assessed both at enrollment and 48 weeks afterwards. The main outcomes were high blood pressure at baseline and persistent high blood pressure at both baseline and 48 weeks. Results Prevalence of high blood pressure at baseline was 35.8% and prevalence of persistent high blood pressure was 21.4%. Children with high blood pressure were significantly more likely to have worse steatosis than children without high blood pressure (mild 19.8% vs. 34.2%, moderate 35.0% vs. 30.7%, severe 45.2% vs. 35.1%; P = 0.003). Higher body mass index, low-density lipoprotein, and uric acid were independent risk factors for high blood pressure (Odds Ratios: 1.10 per kg/m2, 1.09 per 10 mg/dL, 1.25 per mg/dL, respectively). Compared to boys, girls with NAFLD were significantly more likely to have persistent high blood pressure (28.4% vs.18.9%; P = 0.05). Conclusions In conclusion, NAFLD is a common clinical problem that places children at substantial risk for high blood pressure, which may often go undiagnosed. Thus blood pressure evaluation, control, and monitoring should be an integral component of the clinical management of children with NAFLD.
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Affiliation(s)
- Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego, School of Medicine, San Diego, California, United States of America
- Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego, California, United States of America
- Liver Imaging Group, Department of Radiology, University of California San Diego, School of Medicine, San Diego, California, United States of America
- * E-mail:
| | - Anne Zepeda
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego, School of Medicine, San Diego, California, United States of America
- University of California San Diego, Master of Advanced Studies in Clinical Research, San Diego, California, United States of America
| | - Kimberly P. Newton
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego, School of Medicine, San Diego, California, United States of America
- Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego, California, United States of America
| | - Stavra A. Xanthakos
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Cynthia Behling
- Department of Pathology, Sharp Medical Center, San Diego, California, United States of America
| | - Erin K. Hallinan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Michele Donithan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - James Tonascia
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Montero D, Walther G, Pérez-Martin A, Vicente-Salar N, Roche E, Vinet A. Vascular smooth muscle function in type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetologia 2013; 56:2122-33. [PMID: 23864267 DOI: 10.1007/s00125-013-2974-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 06/05/2013] [Indexed: 01/22/2023]
Abstract
AIMS/HYPOTHESIS In type 2 diabetes, in contrast to the well-documented endothelial dysfunction, studies assessing vascular smooth muscle (VSM) function have yielded discrepant results over the last two decades. We therefore sought to determine whether or not VSM function is impaired in individuals with type 2 diabetes. METHODS We conducted a systematic search of MEDLINE, Cochrane, Scopus and Web of Science databases, from their respective inceptions until December 2012, for articles evaluating VSM function in individuals with type 2 diabetes. A meta-analysis was performed to compare the standardised mean difference (SMD) in VSM function between individuals with type 2 diabetes and age-matched controls. Subgroup analyses and meta-regression were used to identify sources of heterogeneity. RESULTS Twenty-seven articles (1,042 individuals with type 2 diabetes and 601 control subjects) were included in this analysis. VSM function was significantly impaired in diabetic compared with control subjects (SMD -0.68, 95% CI -0.84, -0.52; p < 0.001). Although moderate heterogeneity among studies was found (I (2) = 52%), no significant publication bias was detected. Subgroup analyses showed a further decline in VSM function assessed in the microcirculation compared with the macrocirculation of individuals with type 2 diabetes (p = 0.009). In meta-regression, VSM function in the microcirculation was inversely associated with BMI and triacylglycerols and was positively associated with HDL-cholesterol. CONCLUSIONS/INTERPRETATION In addition to the endothelium, the VSM is a source of vascular dysfunction in type 2 diabetes. An exacerbation of VSM function in the microcirculation may be a distinctive feature in type 2 diabetes.
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Affiliation(s)
- David Montero
- LAPEC EA4278, Avignon University, 33 rue Louis Pasteur, F-84000, Avignon, France.
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17
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Nakhjavani M, Morteza A, Meysamie A, Esteghamati A, Khalilzadeh O, Esfahanian F, Khajeali L, Feiz F. Serum heat shock protein 70 and oxidized LDL in patients with type 2 diabetes: does sex matter? Cell Stress Chaperones 2011; 16:195-201. [PMID: 20872261 PMCID: PMC3059792 DOI: 10.1007/s12192-010-0232-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 09/11/2010] [Accepted: 09/13/2010] [Indexed: 11/30/2022] Open
Abstract
Several studies suggest that the response to various stressors differs between the sexes. We aimed to study serum HSP70 and levels of oxidized-LDL (ox-LDL) as markers of oxidative stress in men and women with type 2 diabetes. We quantified serum HSP70 and levels of ox-LDL in three cohorts; patients with newly diagnosed diabetes, patients with long-standing diabetes and normal controls. The cohort of patients with newly diagnosed diabetes was followed up for 3 months under glucose-lowering therapy with metformin. Our findings showed that serum HSP70 level was increased in women with long-standing diabetes in comparison with men. HSP70 did not decrease after glucose lowering therapy in women with newly diagnosed diabetes, but it did decrease in men. There was no significant difference on ox-LDL between men and women in any of the studied cohorts. It decreased significantly in the cohort of patients with newly diagnosed diabetes after treatment, regardless of sex. There was no significant correlation between HSP70 and ox-LDL in any of the studied cohorts except among normal women. We suggest that diabetes induces an immune response and impairs cellular defense mechanisms against oxidative stress more commonly in women with type 2 diabetes than in men.
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Affiliation(s)
- Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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18
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Nakhjavani M, Asgharani F, Khalilzadeh O, Esteghamati A, Ghaneei A, Morteza A, Anvari M. Oxidized Low-Density Lipoprotein Is Negatively Correlated With Lecithin-Cholesterol Acyltransferase Activity in Type 2 Diabetes Mellitus. Am J Med Sci 2011; 341:92-5. [DOI: 10.1097/maj.0b013e3181f3ce10] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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19
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Nakhjavani M, Khalilzadeh O, Khajeali L, Esteghamati A, Morteza A, Jamali A, Dadkhahipour S. Serum Oxidized-LDL is Associated with Diabetes Duration Independent of Maintaining Optimized Levels of LDL-Cholesterol. Lipids 2010; 45:321-7. [DOI: 10.1007/s11745-010-3401-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 02/23/2010] [Indexed: 12/11/2022]
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Abstract
Pioglitazone, a thiazolidinedione, has established efficacy in improving glycaemic control in patients with type 2 diabetes. Pioglitazone also improves components of the mixed dyslipidaemia profile common in these patients, as typified by raised levels of plasma triglycerides, low levels of HDL cholesterol (HDL-C) and a raised proportion of LDL cholesterol (LDL-C) occurring as the small dense subfraction. In head-to-head trials, pioglitazone has consistently shown superior benefits on LDL-C and HDL-C as well as triglycerides compared with rosiglitazone and sulphonylureas. Pioglitazone used as monotherapy or combination therapy reduces levels of small dense LDL3 particles while raising levels of larger and less atherogenic LDL fractions. In addition, pioglitazone reduces cholesterol load and particle numbers of LDL3. Importantly, the differential effects of pioglitazone on LDL subfractions are complimentary and additive to those of simvastatin. Pioglitazone increases total HDL-C levels by 10-20%, mainly because of an increase in the larger HDL2 subfraction. Pioglitazone also significantly reduces plasma triglyceride levels by 10-25%. In recent studies, pioglitazone significantly reduced carotid and coronary atherosclerosis compared with the sulphonylurea glimepiride. The antidyslipidaemic effects of pioglitazone--in particular, improvements in HDL-C and reduction of small dense LDL3--may have contributed to these effects.
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Affiliation(s)
- M Hanefeld
- GWT-TUD GmbH, Centre for Clinical Studies, Department of Metabolic Research and Endocrinology, Dresden Technical University, Dresden, Germany.
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21
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Ford MA, McConnell JP, Lavi S, Rihal CS, Prasad A, Sandhu GS, Hartman SJ, Lerman LO, Lerman A. Coronary artery endothelial dysfunction is positively correlated with low density lipoprotein and inversely correlated with high density lipoprotein subclass particles measured by nuclear magnetic resonance spectroscopy. Atherosclerosis 2009; 207:111-5. [PMID: 19515370 DOI: 10.1016/j.atherosclerosis.2009.04.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/20/2009] [Accepted: 04/26/2009] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The association between cholesterol and endothelial dysfunction remains controversial. We tested the hypothesis that lipoprotein subclasses are associated with coronary endothelial dysfunction. METHODS AND RESULTS Coronary endothelial function was assessed in 490 patients between November 1993 and February 2007. Fasting lipids and nuclear magnetic resonance (NMR) lipoprotein particle subclasses were measured. There were 325 females and 165 males with a mean age of 49.8+/-11.6 years. Coronary endothelial dysfunction (epicardial constriction>20% or increase in coronary blood flow<50% in response to intracoronary acetylcholine) was diagnosed in 273 patients, the majority of whom (64.5%) had microvascular dysfunction. Total cholesterol and LDL-C (low density lipoprotein cholesterol) were not associated with endothelial dysfunction. One-way analysis and multivariate methods adjusting for age, gender, diabetes, hypertension and lipid-lowering agent use were used to determine the correlation between lipoprotein subclasses and coronary endothelial dysfunction. Epicardial endothelial dysfunction was significantly correlated with total (p=0.03) and small LDLp (LDL particles) (p<0.01) and inversely correlated with total and large HDLp (high density lipoprotein particles) (p<0.01). CONCLUSIONS Epicardial, but not microvascular, coronary endothelial dysfunction was associated directly with LDL particles and inversely with HDL particles, suggesting location-dependent impact of lipoprotein particles on the coronary circulation.
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22
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Nakhjavani M, Esteghamati A, Asgarani F, Khalilzadeh O, Nikzamir A, Safari R. Association of oxidized low-density lipoprotein and transforming growth factor-beta in type 2 diabetic patients: a cross-sectional study. Transl Res 2009; 153:86-90. [PMID: 19138653 DOI: 10.1016/j.trsl.2008.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2008] [Revised: 11/06/2008] [Accepted: 11/18/2008] [Indexed: 11/23/2022]
Abstract
Recent in vitro evidence suggests that oxidized low-density lipoprotein (ox-LDL) stimulates the expression of transforming growth factor-beta (TGF-beta) by human glomerular epithelial cells. An elevated level of TGF-beta, which is a multifunctional growth cytokine, is also reported in diabetic patients. This study aimed to determine the association between ox-LDL and TGF-beta in healthy and type 2 diabetic participants. A total of 80 type 2 diabetic patients, who were referred to the outpatient diabetes clinic of a university general hospital, and 80 healthy controls matched for sex, age, and body mass index (BMI) were recruited. Fasting blood samples were obtained, and fasting plasma glucose, cholesterol, high-density lipoprotein-cholesterol (HDL-c), LDL-cholesterol, triglycerides, creatinine, HbA1C, ox-LDL, and TGF-beta were measured. Ox-LDL and TGF-beta were significantly greater in diabetic patients than healthy controls (72.66 +/- 3.11, 46.02 +/- 1.64, P < 0.001 and 4.75 +/- 0.43, 2.06 +/- 0.31, P < 0.001, respectively). Ox-LDL was significantly correlated to TGF-beta in diabetic patients (r = 0.318, P = 0.004). This significant association was not observed in healthy controls (r = 0.148, P = 0.191). In multivariate linear regression analysis after adjustment for age, sex, BMI, and creatinine, ox-LDL was a significant independent predictor of TGF-beta (beta = 0.308, P = 0.007). In conclusion, this study demonstrated that ox-LDL is significantly correlated to TGF-beta in type 2 diabetic patients.
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23
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Abstract
The role of low-density lipoprotein cholesterol (LDL-C) in the pathogenesis of cardiovascular disease (CVD) and the clinical benefit of lowering LDL-C in high-risk patients is well established. What remains controversial is whether we are using the best measure(s) of LDL characteristics to identify all individuals who are at CVD risk or if they would benefit from specific therapies. Despite the successful LDL-C reduction trials, substantial numbers of patients continue to have clinical events in the treatment groups. The size of LDL particles and assessment of the number of LDL particles (LDL-Num) have been suggested as a more reliable method of atherogenicity. Each LDL particle has one apoprotein B-100 measure attached; therefore, determination of whole plasma apoprotein B can be considered the best measure of LDL-Num. Because the cholesterol content per LDL particle exhibits large interindividual variation, the information provided by LDL-C and LDL-Num is not equivalent. Individuals with the same level of LDL-C may have higher or lower numbers of LDL particles and, as a result, may differ in terms of absolute CVD risk. LDL particle size and number provide independent measures of atherogenicity and are strong predictors of CVD.
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Abstract
Insulin has an exercise-like action to increase microvascular perfusion of skeletal muscle and thereby enhance delivery of hormone and nutrient to the myocytes. With insulin resistance, insulin's action to increase microvascular perfusion is markedly impaired. This review examines the present status of these observations and techniques available to measure such changes as well as the possible underpinning mechanisms. Low physiological doses of insulin and light exercise have been shown to increase microvascular perfusion without increasing bulk blood flow. In these circumstances, blood flow is proposed to be redirected from the nonnutritive route to the nutritive route with flow becoming dominant in the nonnutritive route when insulin resistance has developed. Increased vasomotion controlled by vascular smooth muscle may be part of the explanation by which insulin mediates an increase in microvascular perfusion, as seen from the effects of insulin on both muscle and skin microvascular blood flow. In addition, vascular dysfunction appears to be an early development in the onset of insulin resistance, with the consequence that impaired glucose delivery, more so than insulin delivery, accounts for the diminished glucose uptake by insulin-resistant muscle. Regular exercise may prevent and ameliorate insulin resistance by increasing "vascular fitness" and thereby recovering insulin-mediated capillary recruitment.
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Affiliation(s)
- Michael G Clark
- Menzies Research Institute, University of Tasmania, Private Bag 58, Hobart 7001, Australia.
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25
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Gazi IF, Tsimihodimos V, Tselepis AD, Elisaf M, Mikhailidis DP. Clinical importance and therapeutic modulation of small dense low-density lipoprotein particles. Expert Opin Biol Ther 2006; 7:53-72. [PMID: 17150019 DOI: 10.1517/14712598.7.1.53] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The National Cholesterol Education Programme Adult Treatment Panel III accepted the predominance of small dense low-density lipoprotein (sdLDL) as an emerging cardiovascular disease (CVD) risk factor. Most studies suggest that measuring low-density lipoprotein (LDL) particle size, sdLDL cholesterol content and LDL particle number provides additional assessment of CVD risk. Therapeutic modulation of small LDL size, number and distribution may decrease CVD risk; however, no definitive causal relationship is established, probably due to the close association between sdLDL and triglycerides and other risk factors (e.g., high-density lipoprotein, insulin resistance and diabetes). This review addresses the formation and measurement of sdLDL, as well as the relationship between sdLDL particles and CVD. The effect of hypolipidaemic (statins, fibrates and ezetimibe) and hypoglycaemic (glitazones) agents on LDL size and distribution is also discussed.
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Affiliation(s)
- Irene F Gazi
- Royal Free Hospital (and University College of Medicine), Department of Clinical Biochemistry, Pond St, London, NW3 2QG, UK
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Abstract
PURPOSE OF REVIEW This review discusses whether the relationship of small dense low-density lipoprotein to cardiovascular risk is direct, due to the atherogenic properties of the particle, or a reflection of concomitant abnormalities in high-density lipoprotein and plasma triglyceride. RECENT FINDINGS Recent studies have examined whether low-density lipoprotein size distribution or concentration of small low-density lipoprotein is related more strongly to risk. It appears that the latter is a better predictor in major surveys, although in smaller cohort studies particle size shows a strong association with atherosclerosis burden. While the main causes of the formation of small dense low-density lipoprotein are relatively well understood, novel metabolic factors may also play a role, and pharmacologic interventions such as glitazones may have a direct regulatory impact. SUMMARY Evidence links abnormalities in low-density lipoprotein structure to cardiovascular risk. The plasma concentration of small dense low-density lipoprotein is likely to be more informative than relative low-density lipoprotein particle size, and although methods are available for quantitation of this subfraction, there is considerable room for improvement. It is not yet clear how knowledge of the small dense low-density lipoprotein concentration may add to risk prediction.
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Affiliation(s)
- Chris J Packard
- Department of Vascular Biochemistry, University of Glasgow, Scotland, UK.
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