1
|
Dharmayat KI, Vallejo-Vaz AJ, Stevens CA, Brandts JM, Lyons AR, Groselj U, Abifadel M, Aguilar-Salinas CA, Alhabib K, Alkhnifsawi M, Almahmeed W, Alnouri F, Alonso R, Al-Rasadi K, Ashavaid TF, Banach M, Béliard S, Binder C, Bourbon M, Chlebus K, Corral P, Cruz D, Descamps OS, Drogari E, Durst R, Ezhov MV, Genest J, Harada-Shiba M, Holven KB, Humphries SE, Khovidhunkit W, Lalic K, Laufs U, Liberopoulos E, Roeters van Lennep J, Lima-Martinez MM, Lin J, Maher V, März W, Miserez AR, Mitchenko O, Nawawi H, Panayiotou AG, Paragh G, Postadzhiyan A, Reda A, Reiner Ž, Reyes X, Sadiq F, Sahebkar A, Schunkert H, Shek AB, Stroes E, Su TC, Subramaniam T, Susekov A, Vázquez Cárdenas A, Huong Truong T, Tselepis AD, Vohnout B, Wang L, Yamashita S, Al-Sarraf A, Al-Sayed N, Davletov K, Dwiputra B, Gaita D, Kayikcioglu M, Latkovskis G, Marais AD, Thushara Matthias A, Mirrakhimov E, Nordestgaard BG, Petrulioniene Z, Pojskic B, Sadoh W, Tilney M, Tomlinson B, Tybjærg-Hansen A, Viigimaa M, Catapano AL, Freiberger T, Hovingh GK, Mata P, Soran H, Raal F, Watts GF, Schreier L, Bañares V, Greber-Platzer S, Baumgartner-Kaut M, de Gier C, Dieplinger H, Höllerl F, Innerhofer R, Karall D, Lischka J, Ludvik B, Mäser M, Scholl-Bürgi S, Thajer A, Toplak H, Demeure F, Mertens A, Balligand JL, Stephenne X, Sokal E, Petrov I, Goudev A, Nikolov F, Tisheva S, Yotov Y, Tzvetkov I, Hegele RA, Gaudet D, Brunham L, Ruel I, McCrindle B, Cuevas A, Perica D, Symeonides P, Trogkanis E, Kostis A, Ioannou A, Mouzarou A, Georgiou A, Stylianou A, Miltiadous G, Iacovides P, Deltas C, Vrablik M, Urbanova Z, Jesina P, Tichy L, Hyanek J, Dvorakova J, Cepova J, Sykora J, Buresova K, Pipek M, Pistkova E, Bartkova I, S|ulakova A, Toukalkova L, Spenerova M, Maly J, Benn M, Bendary A, Elbahry A, Ferrières J, Ferrieres D, Peretti N, Bruckert E, Gallo A, Valero R, Mourre F, Aouchiche K, Reynaud R, Tounian P, Lemale J, Boccara F, Moulin P, Charrières S, Di Filippo M, Cariou B, Paillard F, Dourmap C, Pradignac A, Verges B, Simoneau I, Farnier M, Cottin Y, Yelnik C, Hankard R, Schiele F, Durlach V, Sultan A, Carrié A, Rabès JP, Sanin V, Schmieder R, Ates S, Rizos CV, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Doumas M, Skalidis E, Kolovou G, Kolovou V, Garoufi A, Koutagiar I, Polychronopoulos G, Kiouri E, Antza C, Zacharis E, Attilakos A, Sfikas G, Koumaras C, Anagnostis P, Anastasiou G, Liamis G, Adamidis PS, Milionis H, Lambadiari V, Stabouli S, Filippatos T, Mollaki V, Tsaroumi A, Lamari F, Proyias P, Harangi M, Reddy LL, Shah SAV, Ponde CK, Dalal JJ, Sawhney JP, Verma IC, Hosseini S, Jamialahmadi T, Alareedh M, Shaghee F, Rhadi SH, Abduljalal M, Alfil S, Kareem H, Cohen H, Leitersdorf E, Schurr D, Shpitzen S, Arca M, Averna M, Bertolini S, Calandra S, Tarugi P, Casula M, Galimberti F, Gazzotti M, Olmastroni E, Sarzani R, Ferri C, Repetti E, Giorgino F, Suppressa P, Bossi AC, Borghi C, Muntoni S, Cipollone F, Scicali R, Pujia A, Passaro A, Berteotti M, Pecchioli V, Pisciotta L, Mandraffino G, Pellegatta F, Mombelli G, Branchi A, Fiorenza AM, Pederiva C, Werba JP, Parati G, Nascimbeni F, Iughetti L, Fortunato G, Cavallaro R, Iannuzzo G, Calabrò P, Cefalù AB, Capra ME, Zambon A, Pirro M, Sbrana F, Trenti C, Minicocci I, Federici M, Del Ben M, Buonuomo PS, Moffa S, Pipolo A, Citroni N, Guardamagna O, Lia S, Benso A, Biolo GB, Maroni L, Lupi A, Bonanni L, Rinaldi E, Zenti MG, Masuda D, Mahfouz L, Jambart S, Ayoub C, Ghaleb Y, Kasim NAM, Nor NSM, Al-Khateeb A, Kadir SHSA, Chua YA, Razman AZ, Nazli SA, Ranai NM, Latif AZA, Torres MTM, Mehta R, Martagon AJ, Ramirez GAG, Antonio-Villa NE, Vargas-Vazquez A, Elias-Lopez D, Retana GG, Encinas BR, Macias JJC, Zazueta AR, Alvarado RM, Portano JDM, Lopez HA, Sauque-Reyna L, Gomez Herrera LG, Simental Mendia LE, Aguilar HG, Cooremans ER, Aparicio BP, Zubieta VM, Gonzalez PAC, Ferreira-Hermosillo A, Portilla NC, Dominguez GJ, Garcia AYR, Arriaga Cazares HE, Gonzalez Gonzalez JR, Mendez Valencia CV, Padilla Padilla FG, Prado RM, De los Rios Ibarra MO, Arjona Villica~na RD, Acevedo Rivera KJ, Carrera RA, Alvarez JA, Amezcua Martinez JC, Barrera Bustillo MDLR, Vargas GC, Chacon RC, Figueroa Andrade MH, Ortega AF, Alcala HG, Garcia de Leon LE, Guzman BG, Gardu~no Garcia JJ, Garnica Cuellar JC, Gomez Cruz JR, Garcia AH, Holguin Almada JR, Herrera UJ, Sobrevilla FL, Rodriguez EM, Sibaja CM, Medrano Rodriguez AB, Morales Oyervides JC, Perez Vazquez DI, Reyes Rodriguez EA, Osorio MLR, Saucedo JR, Tamayo MT, Valdez Talavera LA, Vera Arroyo LE, Zepeda Carrillo EA, Galema-Boers A, Weigman A, Bogsrud MP, Malik M, Shah S, Khan SA, Rana MA, Batool H, Starostecka E, Konopka A, Lewek J, Bielecka-Dąbrowa A, Gach A, Jóźwiak J, Pajkowski M, Romanowska-Kocejko M, Żarczyńska-Buchowiecka M, Hellmann M, Chmara M, Wasąg B, Parczewska A, Gilis-Malinowska N, Borowiec-Wolna J, Stróżyk A, Michalska-Grzonkowska A, Chlebus I, Kleinschmidt M, Wojtecka A, Zdrojewski T, Myśliwiec M, Hennig M, Medeiros AM, Alves AC, Almeida AF, Lopes A, Guerra A, Bilhoto C, Simões F, Silva F, Lobarinhas G, Gama G, Palma I, Salgado JM, Matos LD, Moura MD, Virtuoso MJ, Tavares M, Ferreira P, Pais P, Garcia P, Coelho R, Ribeiro R, Correia S, Sadykova D, Slastnikova E, Alammari D, Mawlawi HA, Alsahari A, Khudary AA, Alrowaily NL, Rajkovic N, Popovic L, Singh S, Rasulic I, Petakov A, Lalic NM, Peng FK, Vasanwala RF, Venkatesh SA, Raslova K, Fabryova L, Nociar J, Šaligova J, Potočňáková L, Kozárová M, Varga T, Kadurova M, Debreova M, Novodvorsky P, Gonova K, Klabnik A, Buganova I, Battelino T, Bizjan BJ, Debeljak M, Kovac J, Mlinaric M, Molk N, Sikonja J, Sustar U, Podkrajsek KT, Muñiz-Grijalvo O, Díaz-Díaz JL, de Andrés R, Fuentes-Jiménez F, Blom D, Miserez EB, Shipton JL, Ganokroj P, Futema M, Ramaswami U, Alieva RB, Fozilov KG, Khoshimov SU, Nizamov UI, Abdullaeva GJ, Kan LE, Abdullaev AA, Zakirova DV, Do DL, Nguyen MNT, Kim NT, Le TT, Le HA, Santos R, Ray KK. Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study. Lancet 2024; 403:55-66. [PMID: 38101429 DOI: 10.1016/s0140-6736(23)01842-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. METHODS For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. FINDINGS Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. INTERPRETATION Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. FUNDING Pfizer, Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Daiichi Sankyo, and Regeneron.
Collapse
|
2
|
Al Fatly M, Mulder MT, Roeters van Lennep J, Blom HJ, Berk KAC. The effect of diet-induced weight loss on circulating homocysteine levels in people with obesity and type 2 diabetes. Nutr J 2024; 23:2. [PMID: 38167024 PMCID: PMC10763019 DOI: 10.1186/s12937-023-00908-y] [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] [Received: 06/29/2022] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND/AIMS Having type 2 diabetes (T2D) in combination with being overweight results in an additional increase in cardiovascular disease (CVD) risk. In addition, T2D and obesity are associated with increased levels of total homocysteine (tHcy), possibly contributing to the CVD risk. Weight loss dieting has positive effects on several CVD risk factors, but whether it affects tHcy remains unclear. Therefore, the aim of this study was to determine the effect of a calorie restricted diet on tHcy in overweight people with T2D. METHODS In this post-hoc analysis of the POWER study, adults with T2D and a BMI greater than 27 kg/m² were included from the outpatient diabetes clinic of the Erasmus Medical Center, Rotterdam. The patients were subjected to a very low-calorie diet with fortified meal replacements for 20 weeks. Before and after this intervention, blood samples were collected to measure tHcy and other CVD risk factors like glycaemic and lipid parameters. RESULTS 161 overweight participants with T2D were included, with a mean age of 54 years (range 26-74), mean weight of 104.6 ± 19.9 kg and mean HbA1c of 62.7 ± 14.3 mmol/mol. At baseline, men displayed higher tHcy than women, and tHcy level was positively correlated with body weight and triglyceride levels, while it was negatively correlated with renal function and HDL cholesterol. During the intervention, bodyweight was reduced by a mean of 9.7% (from 104.6 ± 19.9 to 94.5 ± 18.1 kg p < 0.001), and all measured glycaemic and lipid blood parameters improved significantly. However, tHcy remained unchanged (from 12.1 ± 4.1 to 12.1 ± 4.2 umol/L, p = 0.880). The change in tHcy during the intervention was negatively associated with the change in weight and BMI (p = 0.01 and p = 0.008, respectively). People who lost < 10 kg (n = 92) had a mean tHcy change of -0.47 umol/L, while people who lost more than ≥ 10 kg (n = 69) had a mean tHcy change of 0.60 umol/L (p = 0.021). CONCLUSION In conclusion, our data show that a calorie restricted diet does not affect tHcy in people with T2D and obesity, despite the use of meal replacements fortified with folic acid and vitamin B12. Our data showed a negative correlation between change in tHcy levels and weight loss, suggesting that people who lost more weight (> 10 kg) showed an increase in tHcy. Future studies should explore the potential increase in tHcy induced by weight loss dieting and target the question if tHcy reduction strategies during weight loss could be clinically beneficial.
Collapse
Affiliation(s)
- Meryem Al Fatly
- Department of Internal Medicine, section of Pharmacology, Vascular and Metabolic Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Monique T Mulder
- Department of Internal Medicine, section of Pharmacology, Vascular and Metabolic Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, section of Pharmacology, Vascular and Metabolic Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Henk J Blom
- Laboratory of Genetic Metabolic Diseases, Department of Clinical Genetics, Center of lysosomal and metabolic disorders, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kirsten A C Berk
- Department of Internal Medicine, section of Pharmacology, Vascular and Metabolic Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands.
- Department of Internal Medicine, section of Dietetics, Erasmus University Medical Center, Rotterdam, The Netherlands.
| |
Collapse
|
3
|
Abstract
Differences between men and women in lipids and lipoproteins are observed in distribution and trajectory from infancy to adulthood in the general population. However, these differences are more pronounced in hereditary lipid disorders such as familial hypercholesterolemia (FH) when absolute cholesterol levels are higher from birth onwards. In the early life course, girls compared to boys have higher low-density lipoprotein cholesterol (LDL-C) levels and total cholesterol, while high-density lipoprotein cholesterol (HDL-C) levels are similar. In early adulthood to middle-age, women have lower LDL-C and higher HDL-C levels, as LDL-C levels increase and HDLC levels decrease in men. In the elderly, all lipids - total cholesterol, LDL-C, HDL-C and triglyceride levels decrease but are more pronounced in men. Lipid levels are also affected by specific transitions in girls/women such as the menstrual cycle, pregnancy, breastfeeding and menopause. Lipid levels fluctuate during the menstrual cycle. During pregnancy a physiological increase of LDL-C and even a larger increase in triglyceride levels are observed. Pregnancy has a double impact on LDL-C accumulation in women with FH as they have to stop statins, and the absolute increase in LDL-C is higher than in women without FH. In the menopausal transition, women develop a more adverse lipid profile. Therefore, it is important to take into account both sex and the life course when assessing a lipid profile.
Collapse
Affiliation(s)
- Kirsten B Holven
- Department of Nutrition, Institute for Basic Medical Science, University of Oslo, Oslo, Norway; National Advisory Unit on FH, Oslo University Hospital, Oslo, Norway.
| | - Jeanine Roeters van Lennep
- Cardiovascular Institute, Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
4
|
Troensegaard H, Khoury J, Westerberg AC, Tonstad S, Roeters van Lennep J, Veierød MB, Iversen PO, Holven KB, Retterstøl K. Protocol for a 20-year follow-up after a randomized controlled trial of a Mediterranean diet in pregnancy: maternal and offspring risk factors for cardiovascular disease. Front Pediatr 2023; 11:1256815. [PMID: 37920793 PMCID: PMC10619653 DOI: 10.3389/fped.2023.1256815] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Background An inadequate maternal diet during pregnancy can impair offspring health and may increase the risk of cardiovascular disease later in life. The purpose of the proposed study is to assess the risk factors associated with cardiovascular disease in both mothers and their offspring 20 years following their participation in a Mediterranean diet intervention trial during pregnancy. Methods The "Cardiovascular Risk Reduction Diet In Pregnancy" (CARRDIP) study was a randomized controlled trial performed between 1999 and 2001. The participants were randomized to adhere to either a Mediterranean diet or their regular diet during pregnancy. An extensive amount of data such as diet information, ultrasound measurements, anthropometry, and biomarkers from these mothers during pregnancy and their offspring in the neonatal period were collected. The mother-offspring pairs (n = 269) from the CARRDIP study will be invited to participate in a clinical examination and blood sample collection. This follow-up study, conducted 20 years after the original CARRDIP study, will investigate cardiovascular risk factors in mothers and offspring. The primary outcome will be the blood pressure of the offspring. In addition, the study will explore various aspects of cardiovascular health, including metabolic and inflammatory status, clinical history, and body composition of the participants. Discussion Previous studies investigating the effects of nutrition during pregnancy on maternal and offspring health have been either observational studies, animal studies, or randomized controlled trials with a follow-up period of less than 5 years. This project aims to study the long-term effects of dietary intervention during pregnancy on maternal and offspring cardiovascular risk markers. Clinical Trial Registration Clinicaltrials.gov, identifier (NCT05030922).
Collapse
Affiliation(s)
- Hannibal Troensegaard
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Janette Khoury
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ane C. Westerberg
- Department of Obstetrics, Division of Obstetrics and Gynaecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital, Oslo, Norway
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, Erasmus MC Cardiovascular Institute, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Marit B. Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Per Ole Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Haematology, Oslo University Hospital, Oslo, Norway
| | - Kirsten B. Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- The Lipid Clinic, Department of Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
5
|
Kavousi M, van Lennep JR. Integration of sex and gender in cardiovascular medicine: a scientific and clinical imperative. Neth Heart J 2023; 31:369-370. [PMID: 37682459 PMCID: PMC10516827 DOI: 10.1007/s12471-023-01817-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
| | - Jeanine Roeters van Lennep
- Cardiovascular Institute, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
6
|
Mulder ST, Omidvari AH, Rueten-Budde AJ, Huang PH, Kim KH, Bais B, Rousian M, Hai R, Akgun C, van Lennep JR, Willemsen S, Rijnbeek PR, Tax DM, Reinders M, Boersma E, Rizopoulos D, Visch V, Steegers-Theunissen R. Dynamic Digital Twin: Diagnosis, Treatment, Prediction, and Prevention of Disease During the Life Course. J Med Internet Res 2022; 24:e35675. [PMID: 36103220 PMCID: PMC9520391 DOI: 10.2196/35675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
A digital twin (DT), originally defined as a virtual representation of a physical asset, system, or process, is a new concept in health care. A DT in health care is not a single technology but a domain-adapted multimodal modeling approach incorporating the acquisition, management, analysis, prediction, and interpretation of data, aiming to improve medical decision-making. However, there are many challenges and barriers that must be overcome before a DT can be used in health care. In this viewpoint paper, we build on the current literature, address these challenges, and describe a dynamic DT in health care for optimizing individual patient health care journeys, specifically for women at risk for cardiovascular complications in the preconception and pregnancy periods and across the life course. We describe how we can commit multiple domains to developing this DT. With our cross-domain definition of the DT, we aim to define future goals, trade-offs, and methods that will guide the development of the dynamic DT and implementation strategies in health care.
Collapse
Affiliation(s)
- Skander Tahar Mulder
- Pattern Recognition Lab, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
| | - Amir-Houshang Omidvari
- Department of Cardiology, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Pei-Hua Huang
- Department of Medical Ethics and Philosophy, Erasmus Medical Center, Rotterdam, Netherlands
| | - Ki-Hun Kim
- Department of Industrial Engineering, Pusan National University, Busan, Republic of Korea
| | - Babette Bais
- Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Melek Rousian
- Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Rihan Hai
- Web Information Systems Group, Mathematics and Computer Science, Technical University of Delft, Delft, Netherlands
| | - Can Akgun
- Web Information Systems Group, Mathematics and Computer Science, Technical University of Delft, Delft, Netherlands
- Bioelectronics Section, Department of Microelectronics, Faculty of Electrical Engineering, Technical University Delft, Delft, Netherlands
| | | | - Sten Willemsen
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands
| | - Peter R Rijnbeek
- Department of Medical Informatics, Erasmus Medical Center, Rotterdam, Netherlands
| | - David Mj Tax
- Pattern Recognition Lab, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
| | - Marcel Reinders
- Pattern Recognition Lab, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Valentijn Visch
- Industrial Design, Mathematics and Computer Science, Technical University Delft, Delft, Netherlands
| | | |
Collapse
|
7
|
Tan L, Wang N, Zee LV, Roeters van Lennep J, Mulder MT, Lu X, Danser AJ, Verdonk K. Abstract 113: Statins, But Not Pcsk9 Inhibitors, Reduce The Adipokine Chemerin In Familial Hypercholesterolemia: Focus On Lipoprotein Subfractions. Hypertension 2022. [DOI: 10.1161/hyp.79.suppl_1.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Familial hypercholesterolemia (FH) is characterized by severe elevations in circulating LDL-cholesterol, and an increase in the risk of dyslipidemia-related cardiovascular disease (CVD). Chemerin, as a newly identified adipokine, is considered as an additional risk factor for CVD. Here we investigated whether it can be modified by cholesterol-lowering therapy.
Methods:
Lipoprotein subfractions were isolated by density gradient ultracentrifugation. Lipids and chemerin concentrations were determined both before and after cholesterol lowering with either a statin (atorvastatin, simvastatin, rosuvastatin, or fluvastatin) or a PCSK9 inhibitor (PCSK9i; alirocumab or evolocumab).
Results:
At baseline chemerin levels were 113±46 (statin group) and 95±44 (PCSK9i group) ng/ml, while triglyceride (TG) levels were 1.9±1.6 and 2.6±1.7 mmol/ml, high-density lipoprotein cholesterol (HDL-c) levels were 1.3±0.4 and 1.2±0.4 mmol/ml, and low-density lipoprotein cholesterol (LDL-c) levels were 5.7±1.5 and 4.9±1.4 mmol/ml (P=ns for difference between 2 groups). Chemerin correlated positively with triglycerides (r=0.45, P<0.005) and negatively with HDL-c (r=-0.33, P<0.01). Both statins and PCSK9i reduced LDL-c (by 41 and 62%, P<0.0001), triglycerides (by 13 and 19%, P<0.01), and increased HDL-c (by 8 and 23%, P<0.01), but only statins additionally reduced chemerin (by 35%, P<0.005). The lipoprotein subfraction profile revealed that chemerin accumulated particularly in the HDL3 fraction (containing >60% of all chemerin in lipoprotein subfractions), with approximately 30% being present in the HDL2 fraction, and approximately 3% in the LDL fraction. Statins reduced HDL3-c and HDL3-TG, and the level of chemerin bound to all subfractions. PCSK9i reduced HDL3-c but did not affect HDL3-TG or the level of chemerin bound to HDL3 and HDL2.
Conclusions:
Circulating chemerin occurs in different lipoprotein subfractions, accumulating particularly in the HDL3 fraction. Statins, but not PCSK9i, lowers chemerin, possibly by interfering with its levels across lipoprotein subfractions. This may represent a novel cardiovascular protective function of statins.
Collapse
Affiliation(s)
| | - Na Wang
- Erasmus MC, Rotterdam, Netherlands
| | | | | | | | - Xifeng Lu
- Shenzhen Technology Univ, Shenzhen, China
| | | | | |
Collapse
|
8
|
Lu Z, Geurts S, Arshi B, Tilly MJ, Aribas E, Roeters van Lennep J, de Groot N, Rizopoulos D, Ikram MA, Kavousi M. Longitudinal Anthropometric Measures and Risk of New-Onset Atrial Fibrillation Among Community-Dwelling Men and Women. Mayo Clin Proc 2022; 97:1501-1511. [PMID: 35691705 DOI: 10.1016/j.mayocp.2021.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/30/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the sex-specific evolution of various anthropometric measures and the association of their longitudinal trajectories with new-onset atrial fibrillation (AF). METHODS Among 5266 men and 7218 women free of AF at baseline from the prospective population-based Rotterdam Study, each anthropometric measure was measured 1 to 5 times from 1989 to 2014. Anthropometric measures were standardized to obtain hazard ratios per 1 SD increase to enable comparison. Joint models were used to assess the longitudinal association between anthropometric measures and incident AF. Use of the joint models is a preferred method for simultaneous analyses of repeated measurements and survival data for conferring less biased estimates. RESULTS Mean (SD) age was 63.9 (8.9) years for men and 64.9 (9.8) years for women. Median follow-up time was 10.5 years. Longitudinal evolution of weight, height, waist circumference, hip circumference, and body mass index was associated with an increased risk of new-onset AF in both men and women. In joint models, larger height in men (hazard ratio [95% credible interval] per 1 SD, 1.27 [1.17 to 1.38]) and weight in women (1.24 [1.16 to 1.34]) showed the largest associations with AF. In joint models, waist to hip ratio was significantly associated with incident AF only in women (1.10 [1.03 to 1.18]). CONCLUSION Considering the entire longitudinal trajectories in joint models, anthropometric measures were positively associated with an increased risk for new-onset AF among men and women in the general population. Increase in measure of central obesity showed a stronger association with increased risk of AF onset among women compared with men.
Collapse
Affiliation(s)
- Zuolin Lu
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Sven Geurts
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Banafsheh Arshi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Martijn J Tilly
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Elif Aribas
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | | | - Natasja de Groot
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Dimitris Rizopoulos
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| |
Collapse
|
9
|
Biskup E, Marra AM, Ambrosino I, Barbagelata E, Basili S, de Graaf J, Gonzalvez-Gasch A, Kaaja R, Karlafti E, Lotan D, Kautzky-Willer A, Perticone M, Politi C, Schenck-Gustafsson K, Vilas-Boas A, Roeters van Lennep J, Gans EA, Regitz-Zagrosek V, Pilote L, Proietti M, Raparelli V. Awareness of sex and gender dimensions among physicians: the European federation of internal medicine assessment of gender differences in Europe (EFIM-IMAGINE) survey. Intern Emerg Med 2022; 17:1395-1404. [PMID: 35604515 PMCID: PMC9352607 DOI: 10.1007/s11739-022-02951-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/15/2022] [Indexed: 11/28/2022]
Abstract
Sociocultural gender is a complex construct encompassing different aspects of individuals' life, whereas sex refers to biological factors. These terms are often misused, although they impact differently on individuals' health. Recognizing the role of sex and gender on health status is fundamental in the pursuit of a personalized medicine. Aim of the current study was to investigate the awareness in approaching clinical and research questions on the impact of sex and gender on health among European internists. Clinicians affiliated with the European Federation of Internal Medicine from 33 countries participated to the study on a voluntary basis between January 1st, 2018 and July 31st, 2019. Internists' awareness and knowledge on sex and gender issues in clinical medicine were measured by an online anonymized 7-item survey. A total of 1323 European internists responded to the survey of which 57% were women, mostly young or middle-aged (78%), and practicing in public general medicine services (74.5%). The majority (79%) recognized that sex and gender are not interchangeable terms, though a wide discrepancy exists on what clinicians think sex and gender concepts incorporate. Biological sex and sociocultural gender were recognized as determinants of health mainly in cardiovascular and autoimmune/rheumatic diseases. Up to 80% of respondents acknowledged the low participation of female individuals in trials and more than 60% the lack of sex-specific clinical guidelines. Internists also express the willingness of getting more knowledge on the impact of sex and gender in cerebrovascular/cognitive and inflammatory bowel diseases. Biological sex and sociocultural gender are factors influencing health and disease. Although awareness and knowledge remain suboptimal across European internists, most acknowledge the underrepresentation of female subjects in trials, the lack of sex-specific guidelines and the need of being more informed on sex and gender-based differences in diseases.
Collapse
Affiliation(s)
- Ewelina Biskup
- Division of Internal Medicine, University Hospital of Basel, Basel, Switzerland
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Alberto M Marra
- Department of Translational Medical Sciences, "Federico II" University of Naples, Naples, Italy
- Center for Pulmonary Hypertension, Thoraxklinic, University Hospital Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | | | - Elena Barbagelata
- Department of Internal Medicine, Lavagna Hospital ASL 4 Chiavarese, Genoa, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Jacqueline de Graaf
- Radboud University Medical Centre, Radboud Health Academy - division of PGME, Nijmegen, Netherlands
| | | | - Risto Kaaja
- Internal Medicine, University of Turku, Turku, Finland
| | - Eleni Karlafti
- 1st Propedeutic Clinic of Internal Medicine, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Dor Lotan
- Division of Cardiology, Columbia University Irving Medical Center, New York, USA
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal MedicineIII, Medical University Vienna, Vienna, Austria
- Gender Institute, Gars am Kamp, Austria
| | - Maria Perticone
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Cecilia Politi
- Internal Medicine, "F. Veneziale" Hospital, Isernia, Italy
| | - Karin Schenck-Gustafsson
- Centre for Gender Medicine, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Andreia Vilas-Boas
- Internal Medicine, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | | | - Emma A Gans
- Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Vera Regitz-Zagrosek
- Charité, University Medicine Berlin, DZHK, Berlin, Germany
- University of Zurich, Zurich, Switzerland
| | - Louise Pilote
- Division of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montreal, Canada
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Via dei Borsari 46, 44121, Ferrara, Italy.
- University Center for Studies On Gender Medicine, University of Ferrara, Ferrara, Italy.
- Faculty of Nursing, University of Alberta, Edmonton, Canada.
| |
Collapse
|
10
|
d'Erasmo L, Steward K, Cefalù AB, Di Costanzo A, Boersma E, Bini S, Arca M, van Lennep JR. EFFICACY AND SAFETY OF LOMITAPIDE IN HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA: THE PAN-EUROPEAN RETROSPECTIVE OBSERVATIONAL STUDY. Eur J Prev Cardiol 2021; 29:832-841. [PMID: 34971394 DOI: 10.1093/eurjpc/zwab229] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 11/25/2021] [Revised: 12/18/2021] [Accepted: 12/27/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Lomitapide is a lipid-lowering agent indicated as adjunct therapy for adult HoFH. OBJECTIVES This study evaluated the medium-term effectiveness and safety of lomitapide in a large cohort of HoFH patients in Europe. METHODS In a multicenter retrospective, observational study including 75 HoFH patients treated with lomitapide in a real-world clinical setting from 9 European countries, LDL-C changes, adverse events (AEs) as well as major adverse cardiovascular events (MACE) were assessed. RESULTS After a median 19 months (IQR 11-41 months) of treatment with a mean dosage of 20 mg of lomitapide. LDL-C decreased by 60%, from baseline 280.5 mg/dL (191.8-405.0 mg/dl) to 121.6 mg/dl (61.0-190.5 mg/dl). At the last visit, 32.0% of patients achieved LDL-C < 100mg/dL and 18.7% <70 mg/dL. At baseline, 38 HoFH patients were receiving LDL apheresis (LA), but after initiation of lomitapide 36.8% of patients discontinued LA. During follow-up, lomitapide was permanently interrupted in 13% of patients. Gastrointestinal (GI) AEs occurred in 40% and liver transaminases increased (3-5 x ULN) in 13% of patients. Among patients with liver ultrasound evaluation (n = 45), a modest increase in hepatic steatosis was noted during treatment; however liver stiffness measured by elastography in 30 of them remained within the normal range. Among HoFH patients exposed to lomitapide for at least 2 years, MACE incident rate was 7.4 per 1000 person-years in the 2 years after as compared to 21.2 per 1000 person-years before treatment with lomitapide. CONCLUSIONS In this medium-term real-world experience, lomitapide proved to be very effective in reducing LDL-C in HoFH. GI AEs were common, but liver safety was reassuring with no sign of increased risk of liver fibrosis. A signal of cardiovascular protection was also observed.
Collapse
Affiliation(s)
- Laura d'Erasmo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Kim Steward
- Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, the Netherlands
| | - Angelo Baldassare Cefalù
- Dipartimento di Promozione della Salute Materno Infantile, Medicina Interna e Specialistica Di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Palermo, Italy
| | - Alessia Di Costanzo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Eric Boersma
- Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, the Netherland
| | - Simone Bini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marcello Arca
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | | | | |
Collapse
|
11
|
Mikolic A, Groeniger JO, Zeldovich M, Wilson L, van Lennep JR, van Klaveren D, Polinder S. Explaining Outcome Differences between Men and Women following Mild Traumatic Brain Injury. J Neurotrauma 2021; 38:3315-3331. [PMID: 34617454 DOI: 10.1089/neu.2021.0116] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Men and women differ in outcomes following mild traumatic brain injury (TBI). In the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we previously found that women had worse 6-month functional outcome (Glasgow Outcome Score Extended [GOSE]), health-related quality of life (HRQoL), and mental health following mild TBI. The aim of this study was to investigate whether those differences were mediated by psychiatric history, gender-related sociodemographic variables, or by care pathways. We analyzed sex/gender differences in 6-month GOSE, generic and TBI-specific HRQoL, and post-concussion and mental health symptoms using three sets of mediators: psychiatric history, sociodemographic variables (living alone, living with children, education and employment status/job category), and care-pathways (referral to study hospital and discharge destination after emergency department); while controlling for a substantial number of potential confounders (pre-injury health and injury-related characteristics). We included 1842 men and 1022 women (16+) with a Glasgow Coma Score 13-15, among whom 83% had GOSE available and about 60% other 6-month outcomes. We used natural effects models to decompose the total effect of sex/gender on the outcomes into indirect effects that passed through the specified mediators and the remaining direct effects. In our study population, women had worse outcomes and these were only partly explained by psychiatric history, and not considerably explained by sociodemographic variables nor by care pathways. Factors other than differences in specified variables seem to underlie observed differences between men and women in outcomes after mild TBI. Future studies should explore more aspects of gender roles and identity and biological factors underpinning sex and gender differences in TBI outcomes.
Collapse
Affiliation(s)
- Ana Mikolic
- Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.,Department of Public Administration and Sociology, Erasmus University, Rotterdam, the Netherlands
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, Georg-August-University, Göttingen, Germany
| | - Lindsay Wilson
- Division of Psychology, University of Stirling, Stirling, United Kingdom
| | | | - David van Klaveren
- Department of Public Administration and Sociology, Erasmus University, Rotterdam, the Netherlands.,Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies/Tufts Medical Center, Boston, Massachusetts, USA
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | | |
Collapse
|
12
|
Klevmoen M, Bogsrud MP, Retterstøl K, Svilaas T, Vesterbekkmo EK, Hovland A, Berge C, Roeters van Lennep J, Holven KB. Loss of statin treatment years during pregnancy and breastfeeding periods in women with familial hypercholesterolemia. Atherosclerosis 2021; 335:8-15. [PMID: 34520888 DOI: 10.1016/j.atherosclerosis.2021.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/22/2021] [Revised: 08/09/2021] [Accepted: 09/02/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Women with heterozygous familial hypercholesterolemia (FH) are recommended to initiate statin treatment at the same age as men (from 8 to 10 years of age). However, statins are contraindicated when pregnancy is planned, during pregnancy and breastfeeding. The aim of the study was to determine the duration of pregnancy-related off-statin periods and breastfeeding in FH women. METHODS A cross-sectional study using an anonymous online self-administered questionnaire was conducted. Women with FH were recruited through Lipid Clinics in Norway and Netherlands and national FH patient organizations. RESULTS 102 women with FH (n = 70 Norwegian and n = 32 Dutch) were included in the analysis. Total length of pregnancy-related off-statin periods was estimated for 80 women where data were available, and was median (min-max) 2.3 (0-14.2) years. Lost statin treatment time was estimated for 67 women where data were available, and was median (min-max) 18 (0-100)% at mean (SD) age of 31 (4.3) years at last pregnancy. More women breastfed in Norway (83%) and for longer time [8.5 [1-42] months] compared to the Netherlands [63%, p = 0.03; 3.6 (0-14) months, p < 0.001]. Eighty-six percent of the women reported need for more information on pregnancy and breastfeeding in relation to FH. CONCLUSIONS Young FH women lose years of treatment when discontinuing statins in relation to pregnancy and breastfeeding periods and should be closely followed up to minimize the duration of these off-statin periods. Whether these periods of interrupted treatment increase the cardiovascular risk in FH women needs to be further elucidated.
Collapse
Affiliation(s)
- Marianne Klevmoen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Norway
| | - Martin P Bogsrud
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Norway; Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Lipid Clinic, Oslo University Hospital, Norway
| | | | - Elisabeth K Vesterbekkmo
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anders Hovland
- Department of Cardiology, Nordland Hospital, Norway; Department of Clinical Medicine, University of Tromsø, Norway
| | - Christ Berge
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Norway.
| |
Collapse
|
13
|
Ambrož M, de Vries ST, Vart P, Dullaart RPF, Roeters van Lennep J, Denig P, Hoogenberg K. Sex Differences in Lipid Profile across the Life Span in Patients with Type 2 Diabetes: A Primary Care-Based Study. J Clin Med 2021; 10:jcm10081775. [PMID: 33921745 PMCID: PMC8072568 DOI: 10.3390/jcm10081775] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/11/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022] Open
Abstract
We assessed sex differences across the life span in the lipid profile of type 2 diabetes (T2D) patients treated and not treated with statins. We used the Groningen Initiative to ANalyze Type 2 diabetes Treatment database, which includes T2D patients from the north of the Netherlands. Patients with a full lipid profile determined between 2010 and 2012 were included. We excluded patients treated with other lipid-lowering drugs than statins. Sex differences in low- and high-density lipoprotein cholesterol (LDL-c and HDL-c) and triglyceride (TG) levels across 11 age groups stratified by statin treatment were assessed using linear regression. We included 26,849 patients (51% women, 55% treated with statins). Without statins, women had significantly lower LDL-c levels than men before the age of 45 years, similar levels between 45 and 49 years, and higher levels thereafter. With statins, similar LDL-c levels were shown up to the age of 55, and higher levels in women thereafter. Women had significantly higher HDL-c levels than men, regardless of age or statin treatment. Men had significantly higher TG levels up to the age of 55 and 60, depending on whether they did not take or took statins, respectively, and similar levels thereafter. When managing cardiovascular risk in patients with T2D, attention is needed for the menopausal status of women and for TG levels in younger men.
Collapse
Affiliation(s)
- Martina Ambrož
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
- Correspondence:
| | - Sieta T. de Vries
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
| | - Priya Vart
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
| | - Robin P. F. Dullaart
- Department of Internal Medicine-Endocrinology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands;
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, 3015GD Rotterdam, The Netherlands;
| | - Petra Denig
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
| | - Klaas Hoogenberg
- Department of Internal Medicine, Martini Hospital, 9728NT Groningen, The Netherlands;
| |
Collapse
|
14
|
Johansen AK, Bogsrud MP, Roeters van Lennep J, Narverud I, Langslet G, Retterstøl K, Holven KB. Long term follow-up of children with familial hypercholesterolemia and relatively normal LDL-cholesterol at diagnosis. J Clin Lipidol 2021; 15:375-378. [PMID: 33608220 DOI: 10.1016/j.jacl.2021.01.007] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/22/2020] [Accepted: 01/19/2021] [Indexed: 11/18/2022]
Abstract
Familial hypercholesterolemia (FH) is a genetic disorder with high low-density lipoprotein cholesterol (LDL-C) levels and high risk of cardiovascular disease. The long-term importance of carrying an FH mutation despite having relatively normal LDL-C levels in childhood is not known. We investigated the development of LDL-C levels and need of statin therapy in children with an FH mutation, with pretreatment LDL-C ≤ 4.1 mmol/L (~160 mg/dL), followed-up at lipid clinics in Oslo, Norway and Rotterdam, The Netherlands. Of 742 FH children, 109 (15%) had pretreatment LDL-C ≤ 4.1 mmol/L (~160 mg/dL) [mean (SD) 3.5 (0.5) mmol/L; (~130 (19) mg/dL)] measured at 11.8 (3.9) years of age [mean age (SD)]. After 8.2 (5.2) years [mean (SD)] of follow-up, 71.6% had started statin treatment. Therefore, all children carrying an FH mutation, independent of cholesterol levels, should receive follow-up at specialized lipid clinics for optimal and individualized treatment.
Collapse
Affiliation(s)
- Anja K Johansen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O Box 1046 Blindern 0317 Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Rikshospitalet, P.O Box 4950, Nydalen, Oslo, Norway
| | - Martin P Bogsrud
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Rikshospitalet, P.O Box 4950, Nydalen, Oslo, Norway; Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Oslo, Norway
| | | | - Ingunn Narverud
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O Box 1046 Blindern 0317 Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Rikshospitalet, P.O Box 4950, Nydalen, Oslo, Norway
| | - Gisle Langslet
- Lipid Clinic, Oslo University Hospital, P.O Box 4950 Nydalen, 0424 Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O Box 1046 Blindern 0317 Oslo, Norway; Lipid Clinic, Oslo University Hospital, P.O Box 4950 Nydalen, 0424 Oslo, Norway
| | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O Box 1046 Blindern 0317 Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Rikshospitalet, P.O Box 4950, Nydalen, Oslo, Norway.
| |
Collapse
|
15
|
Futema M, Ramaswami U, Tichy L, Bogsrud MP, Holven KB, Roeters van Lennep J, Wiegman A, Descamps OS, De Leener A, Fastre E, Vrablik M, Freiberger T, Esterbauer H, Dieplinger H, Greber-Platzer S, Medeiros AM, Bourbon M, Mollaki V, Drogari E, Humphries SE. Comparison of the mutation spectrum and association with pre and post treatment lipid measures of children with heterozygous familial hypercholesterolaemia (FH) from eight European countries. Atherosclerosis 2021; 319:108-117. [PMID: 33508743 DOI: 10.1016/j.atherosclerosis.2021.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 02/10/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolaemia (FH) is commonly caused by mutations in the LDLR, APOB or PCSK9 genes, with untreated mean low density lipoprotein-cholesterol (LDL-C) concentrations being elevated in APOB mutation carriers, even higher in LDLR mutation and highest in those with a PCSK9 mutation. Here we examine this in children with FH from Norway, UK, The Netherlands, Belgium, Czech Republic, Austria, Portugal and Greece. METHODS Differences in characteristics and pre- and post-treatment lipid concentrations in those with different molecular causes were compared by standard statistical tests. RESULTS Data were obtained from 2866 children, of whom 2531 (88%) carried a reported LDLR/APOB/PCSK9 variant. In all countries, the most common cause of FH was an LDLR mutation (79% of children, 297 different), but the prevalence of the APOB p.(Arg3527Gln) mutation varied significantly (ranging from 0% in Greece to 39% in Czech Republic, p < 2.2 × 10-16). The prevalence of a family history of premature CHD was significantly higher in children with an LDLR vs APOB mutation (16% vs 7% p=0.0005). Compared to the LDLR mutation group, mean (±SD) concentrations of pre-treatment LDL-C were significantly lower in those with an APOB mutation (n = 2260 vs n = 264, 4.96 (1.08)mmol/l vs 5.88 (1.41)mmol/l, p < 2.2 × 10-16) and lowest in those with a PCSK9 mutation (n = 7, 4.71 (1.22)mmol/l). CONCLUSIONS The most common cause of FH in children from eight European countries was an LDLR mutation, with the prevalence of the APOB p.(Arg3527Gln) mutation varying significantly across countries. In children, LDLR-FH is associated with higher concentrations of LDL-C and family history of CHD compared to those with APOB-FH.
Collapse
Affiliation(s)
- Marta Futema
- Centre for Heart Muscle Disease, Institute for Cardiovascular Science, University College London, London, United Kingdom
| | - Uma Ramaswami
- Lysosomal Disorders Unit, Royal Free Hospital, London, United Kingdom
| | - Lukas Tichy
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno, Brno, Czech Republic
| | - Martin P Bogsrud
- National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway; Unit for Cardiac and Cardiovascular Genetics, Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | | | | | - Albert Wiegman
- Department of Pediatrics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Anne De Leener
- Centre de Génétique Humaine, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Elodie Fastre
- Centre de Génétique Humaine, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Michal Vrablik
- Third Department of Internal Medicine, General University Hospital and First Faculty of Medicine, Charles University, U Nemocnice 1, Prague 2, 128 08, Czech Republic
| | - Tomas Freiberger
- Centre for Cardiovascular Surgery and Transplantation, Czech Republic, and Medical Faculty, Masaryk University, Pekarska 53, 656 91 Brno, Brno, Czech Republic
| | - Harald Esterbauer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Hans Dieplinger
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Schöpfstraße 41, 6020, Innsbruck, Austria
| | - Susanne Greber-Platzer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center Pediatrics, Medical University Vienna, Austria
| | - Ana M Medeiros
- Cardiovascular Research Group, Research and Development Unit, Department of Health Promotion and Chronic Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal and University of Lisboa, Faculty of Sciences, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - Mafalda Bourbon
- Cardiovascular Research Group, Research and Development Unit, Department of Health Promotion and Chronic Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal and University of Lisboa, Faculty of Sciences, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - Vasiliki Mollaki
- First Department of Pediatrics, National and Kapodistrian University of Athens, Greece
| | - Euridiki Drogari
- First Department of Pediatrics, National and Kapodistrian University of Athens and Department of Inborn Errors of Metabolism and Inherited Dyslipidemias, "MITERA" Children's Hospital, Athens, Greece
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, Institute for Cardiovascular Science, University College London, London, United Kingdom.
| |
Collapse
|
16
|
Neuman RI, Figaroa AMJ, Nieboer D, Saleh L, Verdonk K, Danser AHJ, Duvekot HJJ, van den Meiracker AH, Roeters van Lennep J, Visser W. Angiogenic markers during preeclampsia: Are they associated with hypertension 1 year postpartum? Pregnancy Hypertens 2020; 23:116-122. [PMID: 33321329 DOI: 10.1016/j.preghy.2020.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/10/2020] [Accepted: 11/27/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Preeclampsia is associated with hypertension in later life, but the underlying pathophysiological mechanisms remain uncertain. We aimed to explore whether the angiogenic markers soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) measured in women with preeclampsia could be associated with hypertension 1 year after delivery. METHODS This is a secondary analysis of a prospective cohort study, originally aimed to evaluate the use of sFlt-1/PlGF ratio to predict adverse outcome in women with (suspected) preeclampsia. Office blood pressure (BP) was evaluated at 1 year postpartum in women who had a confirmed diagnosis of preeclampsia within one week of biomarker measurement. RESULTS Eighty women were included with a median (interquartile range) gestational age (GA) at biomarker measurement of 30 (27-33) weeks. Twenty-three (29%) women had hypertension 1 year postpartum. These women showed higher median SBP during their pregnancy and lower GA at PE diagnosis compared to women without hypertension. Median PlGF levels were lower in women with hypertension 1 year postpartum compared to women without hypertension (23 vs. 48 pg/mL, p = 0.017), while no differences in sFlt-1 or sFlt-1/PlGF ratio were observed. Multivariable analysis adjusted for GA did not show significant association between PlGF (nor sFlt-1, sFlt-1/PlGF ratio) and hypertension 1 year postpartum (OR [95% CI] 0.9 [0.2-4.4], p = 0.97). CONCLUSION Our data indicate that sFlt-1, PlGF or their ratio measured during pregnancy are not suitable for the prediction of hypertension 1 year postpartum and hence guiding follow-up of women with previous preeclampsia.
Collapse
Affiliation(s)
- Rugina I Neuman
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Gynecology and Obstetrics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Aveline M J Figaroa
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Gynecology and Obstetrics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Daan Nieboer
- Department of Public Health, Rotterdam, The Netherlands
| | - Langeza Saleh
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Gynecology and Obstetrics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Verdonk
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A H Jan Danser
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Hans J J Duvekot
- Department of Gynecology and Obstetrics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anton H van den Meiracker
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Willy Visser
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Gynecology and Obstetrics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
| |
Collapse
|
17
|
Hovland A, Narverud I, Lie Øyri LK, Bogsrud MP, Aagnes I, Ueland T, Mulder M, Leijten F, Langslet G, Wium C, Svilaas A, Arnesen KE, Roeters van Lennep J, Aukrust P, Halvorsen B, Retterstøl K, Holven KB. Subjects with familial hypercholesterolemia have lower aortic valve area and higher levels of inflammatory biomarkers. J Clin Lipidol 2020; 15:134-141. [PMID: 33358307 DOI: 10.1016/j.jacl.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Reduction of the aortic valve area (AVA) may lead to aortic valve stenosis with considerable impact on morbidity and mortality if not identified and treated. Lipoprotein (a) [Lp(a)] and also inflammatory biomarkers, including platelet derived biomarkers, have been considered risk factor for aortic stenosis; however, the association between Lp(a), inflammatory biomarkers and AVA among patients with familial hypercholesterolemia (FH) is not clear. OBJECTIVE We aimed to investigate the relation between concentration of Lp(a), measurements of the aortic valve including velocities and valve area and circulating inflammatory biomarkers in adult FH subjects and controls. METHODS In this cross-sectional study aortic valve measures were examined by cardiac ultrasound and inflammatory markers were analyzed in non-fasting blood samples. The study participants were 64 FH subjects with high (n = 29) or low (n = 35) Lp(a), and 14 healthy controls. RESULTS Aortic valve peak velocity was higher (p = 0.02), and AVA was lower (p = 0.04) in the FH patients compared to controls; however, when performing multivariable linear regression, there were no significant differences. Furthermore, there were no significant differences between the high and low FH Lp(a) groups regarding the aortic valve. FH subjects had higher levels of platelet-derived markers CD40L, PF4, NAP2 and RANTES compared to controls (0.003 ≤ P ≤ 0.03). This result persisted after multiple linear regression. CONCLUSIONS Middle-aged, intensively treated FH subjects have higher aortic valve velocity, lower AVA, and higher levels of the platelet-derived markers CD40L, PF4, NAP2 and RANTES compared to healthy control subjects. The aortic valve findings were not significant after multiple linear regression, whereas the higher levels of platelet-derived markers were maintained.
Collapse
Affiliation(s)
- Anders Hovland
- Division of Internal Medicine, Nordland Hospital, Norway; Department of Clinical Medicine, University of Tromsø, Norway.
| | - Ingunn Narverud
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| | - Linn Kristin Lie Øyri
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Martin Prøven Bogsrud
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway; Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Norway
| | - Inger Aagnes
- Division of Internal Medicine, Nordland Hospital, Norway
| | - Thor Ueland
- Research Institute for Internal Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway; K.G. Jebsen Thrombosis Research and Expertise Centre, University of Tromsø, Norway
| | - Monique Mulder
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Frank Leijten
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Gisle Langslet
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| | - Cecilie Wium
- Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Arne Svilaas
- Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| | - Kjell Erik Arnesen
- Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| | | | - Pål Aukrust
- Research Institute for Internal Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Norway
| | - Bente Halvorsen
- Research Institute for Internal Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| |
Collapse
|
18
|
Meun C, Gunning MN, Louwers YV, Peters H, Roos‐Hesselink J, Roeters van Lennep J, Rueda Ochoa O, Appelman Y, Lambalk N, Boersma E, Kavousi M, Fauser BCJM, Laven JSE. The cardiovascular risk profile of middle-aged women with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2020; 92:150-158. [PMID: 31638273 PMCID: PMC7003818 DOI: 10.1111/cen.14117] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/14/2019] [Accepted: 10/21/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Contradictory results have been reported regarding the association between polycystic ovary syndrome (PCOS) and cardiovascular disease (CVD). We assessed the cardiometabolic phenotype and prevalence of CVD in middle-aged women with PCOS, compared with age-matched controls from the general population, and estimated 10-year CVD risk and cardiovascular health score. DESIGN A cross-sectional study. PARTICIPANTS 200 women aged >45 with PCOS, and 200 age-matched controls. MEASUREMENTS Anthropometrics, insulin, lipid levels, prevalence of metabolic syndrome and type II diabetes. Ten-year Framingham risk score and the cardiovascular health score were calculated, and carotid intima-media thickness (cIMT) was measured. RESULTS Mean age was 50.5 years (SD = 5.5) in women with PCOS and 51.0 years (SD = 5.2) in controls. Increased waist circumference, body mass index and hypertension were more often observed in women with PCOS (P < .001). In women with PCOS, the prevalence of type II diabetes and metabolic syndrome was not significantly increased and lipid levels were not different from controls. cIMT was lower in women with PCOS (P < .001). Calculated cardiovascular health and 10-year CVD risk were similar in women with PCOS and controls. CONCLUSIONS Middle-aged women with PCOS exhibit only a moderately unfavourable cardiometabolic profile compared to age-matched controls, even though they present with an increased BMI and waist circumference. Furthermore, we found no evidence for increased (10-year) CVD risk or more severe atherosclerosis compared with controls from the general population. Long-term follow-up of women with PCOS is necessary to provide a definitive answer concerning long-term risk for CVD.
Collapse
Affiliation(s)
- Cindy Meun
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynaecologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Marlise N Gunning
- Department of Reproductive Medicine & GynecologyUniversity Medical Center Utrecht, University of UtrechtUtrechtthe Netherlands
| | - Yvonne V Louwers
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynaecologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Henrike Peters
- Department of Obstetrics and GynecologyAmsterdam UMC – location VUmcAmsterdamThe Netherlands
| | | | | | - Oscar‐Leonel Rueda Ochoa
- Department of EpidemiologyErasmus Medical CenterRotterdamThe Netherlands
- School of MedicineUniversidad Industrial de SantanderBucaramangaColombia
| | - Yolande Appelman
- Department of CardiologyAmsterdam UMC – location VUmcAmsterdamThe Netherlands
| | - Nils Lambalk
- Department of Obstetrics and GynecologyAmsterdam UMC – location VUmcAmsterdamThe Netherlands
| | - Eric Boersma
- Department of CardiologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Maryam Kavousi
- Department of EpidemiologyErasmus Medical CenterRotterdamThe Netherlands
| | - Bart CJM Fauser
- Department of Reproductive Medicine & GynecologyUniversity Medical Center Utrecht, University of UtrechtUtrechtthe Netherlands
| | - Joop SE Laven
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynaecologyErasmus University Medical CenterRotterdamThe Netherlands
| | | |
Collapse
|
19
|
Hoogendoorn A, den Hoedt S, Hartman EMJ, Krabbendam-Peters I, Te Lintel Hekkert M, van der Zee L, van Gaalen K, Witberg KT, Dorst K, Ligthart JMR, Drouet L, Van der Heiden K, van Lennep JR, van der Steen AFW, Duncker DJ, Mulder MT, Wentzel JJ. Variation in Coronary Atherosclerosis Severity Related to a Distinct LDL (Low-Density Lipoprotein) Profile: Findings From a Familial Hypercholesterolemia Pig Model. Arterioscler Thromb Vasc Biol 2019; 39:2338-2352. [PMID: 31554418 PMCID: PMC6818985 DOI: 10.1161/atvbaha.119.313246] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE In an adult porcine model of familial hypercholesterolemia (FH), coronary plaque development was characterized. To elucidate the underlying mechanisms of the observed inter-individual variation in disease severity, detailed lipoprotein profiles were determined. Approach and Results: FH pigs (3 years old, homozygous LDLR R84C mutation) received an atherogenic diet for 12 months. Coronary atherosclerosis development was monitored using serial invasive imaging and histology. A pronounced difference was observed between mildly diseased pigs which exclusively developed early lesions (maximal plaque burden, 25% [23%-34%]; n=5) and advanced-diseased pigs (n=5) which developed human-like, lumen intruding plaques (maximal plaque burden, 69% [57%-77%]) with large necrotic cores, intraplaque hemorrhage, and calcifications. Advanced-diseased pigs and mildly diseased pigs displayed no differences in conventional risk factors. Additional plasma lipoprotein profiling by size-exclusion chromatography revealed 2 different LDL (low-density lipoprotein) subtypes: regular and larger LDL. Cholesterol, sphingosine-1-phosphate, ceramide, and sphingomyelin levels were determined in these LDL-subfractions using standard laboratory techniques and high-pressure liquid chromatography mass-spectrometry analyses, respectively. At 3 months of diet, regular LDL of advanced-diseased pigs contained relatively more cholesterol (LDL-C; regular/larger LDL-C ratio 1.7 [1.3-1.9] versus 0.8 [0.6-0.9]; P=0.008) than mildly diseased pigs, while larger LDL contained more sphingosine-1-phosphate, ceramides, and sphingomyelins. Larger and regular LDL was also found in plasma of 3 patients with homozygous FH with varying LDL-C ratios. CONCLUSIONS In our adult FH pig model, inter-individual differences in atherosclerotic disease severity were directly related to the distribution of cholesterol and sphingolipids over a distinct LDL profile with regular and larger LDL shortly after the diet start. A similar LDL profile was detected in patients with homozygous FH.
Collapse
Affiliation(s)
- Ayla Hoogendoorn
- From the Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands (A.H., E.M.J.H., K.v.G., K.V.d.H., A.F.W.v.d.S., J.J.W.)
| | - Sandra den Hoedt
- Department of Internal Medicine, Laboratory of Vascular Medicine, Division of Pharmacology, Vascular & Metabolic Disease (S.d.H., L.v.d.Z., K.D., J.R.v.L., M.T.M.), Erasmus MC, Rotterdam, the Netherlands
| | - Eline M J Hartman
- From the Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands (A.H., E.M.J.H., K.v.G., K.V.d.H., A.F.W.v.d.S., J.J.W.)
| | - Ilona Krabbendam-Peters
- Department of Cardiology, Experimental Cardiology (I.K.-P., M.t.L.H., D.J.D.), Erasmus MC, Rotterdam, the Netherlands
| | - Maaike Te Lintel Hekkert
- Department of Cardiology, Experimental Cardiology (I.K.-P., M.t.L.H., D.J.D.), Erasmus MC, Rotterdam, the Netherlands
| | - Leonie van der Zee
- Department of Internal Medicine, Laboratory of Vascular Medicine, Division of Pharmacology, Vascular & Metabolic Disease (S.d.H., L.v.d.Z., K.D., J.R.v.L., M.T.M.), Erasmus MC, Rotterdam, the Netherlands
| | - Kim van Gaalen
- From the Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands (A.H., E.M.J.H., K.v.G., K.V.d.H., A.F.W.v.d.S., J.J.W.)
| | - Karen Th Witberg
- Department of Cardiology, Interventional Cardiology (K.T.W., J.M.R.L.), Erasmus MC, Rotterdam, the Netherlands
| | - Kristien Dorst
- Department of Internal Medicine, Laboratory of Vascular Medicine, Division of Pharmacology, Vascular & Metabolic Disease (S.d.H., L.v.d.Z., K.D., J.R.v.L., M.T.M.), Erasmus MC, Rotterdam, the Netherlands
| | - Jurgen M R Ligthart
- Department of Cardiology, Interventional Cardiology (K.T.W., J.M.R.L.), Erasmus MC, Rotterdam, the Netherlands
| | - Ludovic Drouet
- Department of Angiohematology, Hospital Lariboisiere, Paris, France (L.D.)
| | - Kim Van der Heiden
- From the Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands (A.H., E.M.J.H., K.v.G., K.V.d.H., A.F.W.v.d.S., J.J.W.)
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, Laboratory of Vascular Medicine, Division of Pharmacology, Vascular & Metabolic Disease (S.d.H., L.v.d.Z., K.D., J.R.v.L., M.T.M.), Erasmus MC, Rotterdam, the Netherlands
| | - Antonius F W van der Steen
- From the Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands (A.H., E.M.J.H., K.v.G., K.V.d.H., A.F.W.v.d.S., J.J.W.)
| | - Dirk J Duncker
- Department of Cardiology, Experimental Cardiology (I.K.-P., M.t.L.H., D.J.D.), Erasmus MC, Rotterdam, the Netherlands
| | - Monique T Mulder
- Department of Internal Medicine, Laboratory of Vascular Medicine, Division of Pharmacology, Vascular & Metabolic Disease (S.d.H., L.v.d.Z., K.D., J.R.v.L., M.T.M.), Erasmus MC, Rotterdam, the Netherlands
| | - Jolanda J Wentzel
- From the Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands (A.H., E.M.J.H., K.v.G., K.V.d.H., A.F.W.v.d.S., J.J.W.)
| |
Collapse
|
20
|
Yahya R, Berk K, Verhoeven A, Bos S, van der Zee L, Touw J, Erhart G, Kronenberg F, Timman R, Sijbrands E, Roeters van Lennep J, Mulder M. Statin treatment increases lipoprotein(a) levels in subjects with low molecular weight apolipoprotein(a) phenotype. Atherosclerosis 2019; 289:201-205. [PMID: 31327478 DOI: 10.1016/j.atherosclerosis.2019.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 10/26/2018] [Revised: 05/20/2019] [Accepted: 07/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND AIMS We aimed to evaluate the effect of statin treatment initiation on lipoprotein(a) [Lp(a)] levels in patients with dyslipidemia, and the interactions with the apolipoprotein(a) [apo(a)] phenotype, LPA single nucleotide polymorphisms (SNPs) and change in LDL cholesterol. METHODS The study population consisted of patients with dyslipidemia, predominantly familial hypercholesterolemia, who first initiated statin treatment (initiation group; n = 39) or were already on stable statin treatment for at least 4 months (control group; n = 42). Plasma Lp(a) levels were determined with a particle-enhanced immunoturbidimetric assay before and at least 2 months after start of statin treatment in individuals of the initiation group, and at two time points with an interval of at least 2 months in the control group. High and low molecular weight (HMW and LMW, respectively) apo(a) phenotype was determined by immunoblotting, and the common LPA SNPs rs10455872, rs3798220 and rs41272110 by Taqman assay. RESULTS Plasma Lp(a) levels did not increase significantly in the initiation group (median 20.5 (IQR 10.9-80.7) to 23.3 (10.8-71.8) mg/dL; p = 0.09) nor in the control group (30.9 (IQR 9.2-147.0) to 31.7 (IQR 10.9-164.0) mg/dL; p = 0.61). In patients with the LMW apo(a) phenotype, Lp(a) levels increased significantly from 66.4 (IQR 23.5-148.3) to 97.4 (IQR 24.9-160.4) mg/dL (p = 0.026) in the initiation group, but not in the control group and not in patients characterized by the HMW apo(a) phenotype. Interactions with common LPA SNPs and change in LDL cholesterol were not significant. CONCLUSIONS Statins affect Lp(a) levels differently in patients with dyslipidemia depending on the apo(a) phenotype. Statins increase Lp(a) levels exclusively in patients with the LMW apo(a) phenotype.
Collapse
Affiliation(s)
- Reyhana Yahya
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Kirsten Berk
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Dietetics and Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Adrie Verhoeven
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Sven Bos
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Leonie van der Zee
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jeanette Touw
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Gertraud Erhart
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Reinier Timman
- Department of Psychiatry, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Eric Sijbrands
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Monique Mulder
- Department of Internal Medicine, division of Vascular Medicine and Pharmacology, Division of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands.
| |
Collapse
|
21
|
Moulin P, Dufour R, Averna M, Arca M, Cefalù AB, Noto D, D'Erasmo L, Di Costanzo A, Marçais C, Walther LAAS, Banach M, Borén J, Cramb R, Gouni-Berthold I, Hughes E, Johnson C, Pintó X, Reiner Ž, van Lennep JR, Soran H, Stefanutti C, Stroes E, Bruckert E. Characterisation of patients with familial chylomicronaemia syndrome (FCS) and multifactorial chylomicronaemia syndrome (MCS): Establishment of an FCS clinical diagnostic score. Data Brief 2018; 21:1334-1336. [PMID: 30456254 PMCID: PMC6231039 DOI: 10.1016/j.dib.2018.10.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/24/2018] [Accepted: 10/24/2018] [Indexed: 11/27/2022] Open
Abstract
Data presented in this article are supplementary material to our article entitled “Identification and diagnosis of patients with familial chylomicronaemia syndrome (FCS): expert panel recommendations and proposal of an “FCS Score” (Moulin et al., 2018, in press). The data describe the genotypes of patients with familial chylomicronaemia syndrome (FCS) and multifactorial chylomicronaemia syndrome (MCS), from the validation and replication cohorts.
Collapse
Affiliation(s)
- Philippe Moulin
- Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, INSERM UMR 1060 Carmen, Université Claude Bernard Lyon 1, Lyon, France
| | - Robert Dufour
- Institut de Recherches Cliniques de Montréal, Montréal, Canada
| | - Maurizio Averna
- Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), University of Palermo, Palermo, Italy
| | - Marcello Arca
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Angelo B Cefalù
- Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), University of Palermo, Palermo, Italy
| | - Davide Noto
- Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), University of Palermo, Palermo, Italy
| | - Laura D'Erasmo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Alessia Di Costanzo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Christophe Marçais
- Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, INSERM UMR 1060 Carmen, Université Claude Bernard Lyon 1, Lyon, France
| | - Luis Antonio Alvarez-Sala Walther
- Hospital General Universitario Gregorio Marañón, IiSGM, Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Jan Borén
- University of Gothenburg, Gothenburg, Sweden
| | - Robert Cramb
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Elizabeth Hughes
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | | | | | | | - Handrean Soran
- Central Manchester University Hospital NHS Foundation Trust, Manchester, UK
| | - Claudia Stefanutti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Erik Stroes
- Academic Medical Center, Amsterdam, the Netherlands
| | - Eric Bruckert
- Endocrinologie Métabolisme et Prévention Cardiovasculaire, Institut E3M et IHU Cardiométabolique (ICAN), Hôpital Pitié Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| |
Collapse
|
22
|
Benschop L, Schalekamp-Timmermans S, van Lennep JR, Jaddoe V, Steegers E, Ikram K. 52. Cardiovascular risk factors track from mother to child. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
23
|
Benschop L, Schalekamp-Timmermans S, Schelling S, Jaddoe V, van Lennep JR, Steegers E. 50. Cardiovascular health in early pregnancy and hypertensive disorders of pregnancy. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
24
|
Moulin P, Dufour R, Averna M, Arca M, Cefalù AB, Noto D, D'Erasmo L, Di Costanzo A, Marçais C, Alvarez-Sala Walther LA, Banach M, Borén J, Cramb R, Gouni-Berthold I, Hughes E, Johnson C, Pintó X, Reiner Ž, van Lennep JR, Soran H, Stefanutti C, Stroes E, Bruckert E. Identification and diagnosis of patients with familial chylomicronaemia syndrome (FCS): Expert panel recommendations and proposal of an “FCS score”. Atherosclerosis 2018; 275:265-272. [DOI: 10.1016/j.atherosclerosis.2018.06.814] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/23/2018] [Accepted: 06/13/2018] [Indexed: 12/31/2022]
|
25
|
Davidson M, Hsieh A, Ahmad Z, van Lennep JR, Stevenson M. Examining the High Disease Burden and Impact on Quality of Life in Familial Chylomicronemia Syndrome. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.04.199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
26
|
Holven KB, Narverud I, van Lennep JR, Versmissen J, Øyri LK, Galema-Boers A, Langslet G, Ulven SM, Veierød MB, Retterstøl K, Bogsrud MP. Sex differences in cholesterol levels from birth to 19 years of age may lead to increased cholesterol burden in females with FH. J Clin Lipidol 2018; 12:748-755.e2. [DOI: 10.1016/j.jacl.2018.02.021] [Citation(s) in RCA: 9] [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] [Received: 12/17/2017] [Revised: 02/08/2018] [Accepted: 02/28/2018] [Indexed: 10/17/2022]
|
27
|
Davidson M, Stevenson M, Hsieh A, Ahmad Z, Roeters van Lennep J, Crowson C, Witztum JL. The burden of familial chylomicronemia syndrome: Results from the global IN-FOCUS study. J Clin Lipidol 2018; 12:898-907.e2. [PMID: 29784572 DOI: 10.1016/j.jacl.2018.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/30/2018] [Accepted: 04/18/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Familial chylomicronemia syndrome (FCS) is a rare genetic disorder characterized by a deficiency of lipoprotein lipase leading to extreme hypertriglyceridemia. Patients' burden of illness and quality of life have been poorly addressed in the literature. OBJECTIVE To understand the ways in which FCS impacts patients' lives. METHODS Investigation of Findings and Observations Captured in Burden of Illness Survey (IN-FOCUS) was a global web-based survey open to patients with FCS. Survey questions captured information on diagnostic experience, symptoms, comorbidities, disease management, and impact on multiple life dimensions. RESULTS Of 166 patients in 10 countries, 62% were from the United States and 70% were male. Median age at the time of the survey was 33 years, and median age at diagnosis was 9 years. Patients saw a mean of 5 physicians from different specialties before their FCS diagnosis and experienced multiple physical, emotional, and cognitive symptoms on a daily to monthly basis; 40% were admitted to the hospital in the past year. A lifetime mean of 13 episodes occurred in the 40% of patients with FCS-related acute pancreatitis. Most patients (>90%) found managing fat intake to be difficult, and 53% experienced symptoms despite adherence to their diets. FCS impacted employment status (94%), emotional/mental well-being (58%-66%), and social relationships (68%-82%). CONCLUSIONS Patients with FCS experience significant clinical and psychosocial burdens that reduce their quality of life and limit employment and social interactions. Increased awareness among healthcare professionals of the multifaceted nature of the FCS disease burden may help expedite diagnosis and timely institution of treatment and broaden management considerations.
Collapse
Affiliation(s)
- Michael Davidson
- Department of Medicine, University of Chicago, Chicago, IL, USA.
| | | | | | - Zahid Ahmad
- Division of Nutrition and Metabolic Disease, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | - Joseph L Witztum
- Division of Endocrinology and Metabolism, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
28
|
|
29
|
Affiliation(s)
- Luis Masana
- Research Unit of Lipids and Atherosclerosis, University Rovira i Virgili, C. Sant Llorenç 21, 43201, Reus, Spain.
| | | |
Collapse
|
30
|
Heida K, Bots M, Cohen M, Dunné FV, Groot CD, Hammoud N, Hoek A, Laven J, Maas A, van Lennep JR, Velthuis B, Franx A. O119. Cardiovascular risk management after reproductive and pregnancy related disorders: A Dutch multidisciplinary evidence-based guideline. Pregnancy Hypertens 2015. [DOI: 10.1016/j.preghy.2015.07.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
31
|
Sjouke B, Kusters D, Kindt I, Besseling J, Defesche J, Sijbrands E, van Lennep JR, Stalenhoef A, Wiegman A, de Graaf J, Fouchier S, Kastelein J, Hovingh GK. HOMOZYGOUS AUTOSOMAL DOMINANT HYPERCHOLESTEROLEMIA IN THE NETHERLANDS: PREVALENCE, GENOTYPE-PHENOTYPE RELATIONSHIP AND CLINICAL OUTCOME. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)62053-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
32
|
Yahya R, Van Lennep HR, Jainandunsing S, Biharie R, Touw J, Boon M, Rensen P, de Rooy F, Sijbrands E, Verhoeven A, van Lennep JR, Mulder M. PM317 Lipoprotein(a) and CETP in South Asians and Caucasians at risk for cardiovascular disease. Glob Heart 2014. [DOI: 10.1016/j.gheart.2014.03.1676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
33
|
ten Kate GJR, Neefjes LA, Dedic A, Nieman K, Langendonk JG, Galema-Boers AJ, Roeters van Lennep J, Moelker A, Krestin GP, Sijbrands EJ, de Feyter PJ. The effect of LDLR-negative genotype on CT coronary atherosclerosis in asymptomatic statin treated patients with heterozygous familial hypercholesterolemia. Atherosclerosis 2013; 227:334-41. [DOI: 10.1016/j.atherosclerosis.2012.12.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 12/11/2012] [Accepted: 12/13/2012] [Indexed: 10/27/2022]
|
34
|
Affiliation(s)
- Jeanine Roeters van Lennep
- Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, Netherlands.
| | - Johannes A Romijn
- Department of Endocrinology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, Netherlands
| | - Hubertus Ij Harinck
- Department of Intensive Care Unit, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, Netherlands
| |
Collapse
|