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Mostaza JM, Pintó X, Armario P, Masana L, Real JT, Valdivielso P, Arrobas-Velilla T, Baeza-Trinidad R, Calmarza P, Cebollada J, Civera-Andrés M, Cuende Melero JI, Díaz-Díaz JL, Espíldora-Hernández J, Fernández Pardo J, Guijarro C, Jericó C, Laclaustra M, Lahoz C, López-Miranda J, Martínez-Hervás S, Muñiz-Grijalvo O, Páramo JA, Pascual V, Pedro-Botet J, Pérez-Martínez P, Puzo J. SEA 2024 Standards for Global Control of Vascular Risk. Clin Investig Arterioscler 2024:S0214-9168(24)00017-2. [PMID: 38490888 DOI: 10.1016/j.arteri.2024.02.001] [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] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/03/2024] [Indexed: 03/17/2024]
Abstract
One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to the knowledge, prevention and treatment of vascular diseases, which are the leading cause of death in Spain and entail a high degree of disability and health expenditure. Atherosclerosis is a multifactorial disease and its prevention requires a global approach that takes into account the associated risk factors. This document summarises the current evidence and includes recommendations for patients with established vascular disease or at high vascular risk: it reviews the symptoms and signs to evaluate, the laboratory and imaging procedures to request routinely or in special situations, and includes the estimation of vascular risk, diagnostic criteria for entities that are vascular risk factors, and general and specific recommendations for their treatment. Finally, it presents aspects that are not usually referenced in the literature, such as the organisation of a vascular risk consultation.
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Affiliation(s)
- José María Mostaza
- Servicio de Medicina Interna, Unidad de Lípidos y Arteriosclerosis, Hospital La Paz-Carlos III, Madrid, España.
| | - Xavier Pintó
- Unidad de Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario Bellvitge, Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Fundación para la Investigación y Prevención de las Enfermedades Cardiovasculares (FIPEC), Universidad de Barcelona, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España
| | - Pedro Armario
- Servicio de Medicina Interna, Área de Atención Integrada de Riesgo Vascular, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral (CSI), Sant Joan Despí, Universidad de Barcelona, Barcelona, España
| | - Luis Masana
- Unidad de Medicina Vascular y Metabolismo (UVASMET), Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universitat Rovira i Virgili, Tarragona, España
| | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Pedro Valdivielso
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand), Universidad de Málaga, Málaga, España
| | - Teresa Arrobas-Velilla
- Laboratorio de Nutrición y RCV, UGC de Bioquímica clínica, Hospital Virgen Macarena, Sevilla, España
| | | | - Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España; Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Jesús Cebollada
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Miguel Civera-Andrés
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España
| | - José I Cuende Melero
- Consulta de Riesgo Cardiovascular, Servicio de Medicina Interna, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - José L Díaz-Díaz
- Sección de Medicina Interna, Unidad de Lípidos y Riesgo Cardiovascular, Hospital Abente y Lago Complejo Hospitalario Universitario A Coruña, La Coruña, España
| | - Javier Espíldora-Hernández
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand), Universidad de Málaga, Málaga, España; Unidad de Lípidos y Unidad Asistencial de Hipertensión Arterial- Riesgo Vascular (HTA-RV), UGC Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Jacinto Fernández Pardo
- Servicio de Medicina Interna, Hospital General Universitario Reina Sofía de Murcia, Universidad de Murcia, Murcia, España
| | - Carlos Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorón, España
| | - Carles Jericó
- Servicio de Medicina Interna, Área de Atención Integrada de Riesgo Vascular, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral (CSI), Sant Joan Despí, Universidad de Barcelona, Barcelona, España
| | - Martín Laclaustra
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Carlos Lahoz
- Servicio de Medicina Interna, Unidad de Lípidos y Arteriosclerosis, Hospital La Paz-Carlos III, Madrid, España
| | - José López-Miranda
- Unidad de Lípidos y Arteriosclerosis, UGC de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Sergio Martínez-Hervás
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Ovidio Muñiz-Grijalvo
- Servicio de Medicina Interna, UCERV, UCAMI, Hospital Virgen del Rocío de Sevilla, Sevilla, España
| | - Juan A Páramo
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España; Servicio de Hematología, Clínica Universidad de Navarra, Navarra, España; Laboratorio Aterotrombosis, CIMA, Universidad de Navarra, Pamplona, España
| | - Vicente Pascual
- Centro de Salud Palleter, Universidad CEU-Cardenal Herrera, Castellón, España
| | - Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España
| | - Pablo Pérez-Martínez
- Unidad de Lípidos y Arteriosclerosis, UGC de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - José Puzo
- Servicio de Bioquímica Clínica, Unidad de Lípidos, Hospital General Universitario San Jorge de Huesca, Huesca, España; Departamento de Medicina, Universidad de Zaragoza, Zaragoza, España
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Martínez-Hervás S, Real JT, Carmena R, Ascaso JF. Cardiovascular prevention in diabetes mellitus. Is it appropriate to speak of moderate or intermediate risk? Clin Investig Arterioscler 2024; 36:80-85. [PMID: 37980242 DOI: 10.1016/j.arteri.2023.10.003] [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] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/20/2023] [Indexed: 11/20/2023]
Abstract
Diabetes, especially type 2, is considered a risk situation for atherosclerotic cardiovascular disease (ASCVD). Subjects with diabetes type 2 have a mortality rate due to ASCVD 3 times higher than that found in the general population, attributed to hyperglycemia and the frequent association of other cardiovascular risk factors, such as atherogenic dyslipidemia. Numerous scientific societies have established a risk classification for ASCVD in diabetes based on 3 degrees (moderate, high and very high). The objectives of dyslipidemia control are clearly defined and accepted, and vary depending on the previously established cardiovascular risk. In moderate or intermediate risk, the guidelines propose a less intensive intervention, maintaining LDL-C levels<100mg/dL and NO-HDL-C levels<130mg/dL, and waiting 10 years until reaching the high-risk category to initiate more intensive treatment. However, during the decade of follow-up recommended in the guidelines, cholesterol deposition in the arterial wall increases, facilitating the development of an unstable and inflammatory atheromatous plaque, and the development of ASCVD. Alternatively, diabetes could be considered from the outset to be a high-risk situation and the goal should be LDL-C<70mg/dL. Furthermore, maintaining LDL-C levels<70mg/dL contributes to reducing and stabilizing atheromatous plaque, avoiding or reducing mortality episodes due to ASCVD during those years of diabetes evolution. Should we maintain the proposed objectives in subjects with diabetes and moderate risk for a decade until reaching the high cardiovascular risk phase or, on the contrary, should we adopt a more intensive stance from the beginning seeking to reduce cardiovascular risk in the majority of patients with diabetes? Is it better to wait or prevent with effective therapeutic measures from the first moment?
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Affiliation(s)
- Sergio Martínez-Hervás
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; Departament de Medicina, Universitat de València, Valencia, España; Instituto de Investigación Sanitaria (INCLIVA), Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, España.
| | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; Departament de Medicina, Universitat de València, Valencia, España; Instituto de Investigación Sanitaria (INCLIVA), Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, España
| | - Rafael Carmena
- Departament de Medicina, Universitat de València, Valencia, España
| | - Juan F Ascaso
- Departament de Medicina, Universitat de València, Valencia, España; Instituto de Investigación Sanitaria (INCLIVA), Valencia, España
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Palanca A, Bartual-Rodrigo A, Cuenca C, Mayo-López OD, Ampudia-Blasco FJ, González-Navarro H, Ascaso JF, García-García AB, Chaves FJ, Real JT, Martínez-Hervás S. Association of carotid atheroma plaque with IL-18 levels and with polymorphisms in the IL-18 receptor gene in a Mediterranean population. Clin Investig Arterioscler 2024:S0214-9168(23)00120-1. [PMID: 38216380 DOI: 10.1016/j.arteri.2023.12.005] [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] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Atherosclerosis is an inflammatory disease. Interleukin 18 (IL-18) is an inflammatory molecule that has been linked to the development of atherosclerosis and cardiovascular disease. OBJECTIVE To evaluate the possible relationship between plasma levels of IL-18 and the presence of atherosclerosis evaluated at the carotid level, as well as to analyze the possible modulation by different polymorphisms in a Mediterranean population. MATERIAL AND METHODS Seven hundred and forty-six individuals from the metropolitan area of Valencia were included, recruited over a period of 2 years. Hydrocarbon and lipid metabolism parameters were determined using standard methodology and IL-18 using ELISA. In addition, carotid ultrasound was performed and the genotype of four SNPs related to the IL-18 signaling pathway was analyzed. RESULTS Patients with higher plasma levels of IL-18 had other associated cardiovascular risk factors. Elevated IL-18 levels were significantly associated with higher carotid IMT and the presence of atheromatous plaques. The genotype with the A allele of the SNP rs2287037 was associated with a higher prevalence of carotid atheromatous plaque. On the contrary, the genotype with the C allele of the SNP rs2293224 was associated with a lower prevalence of atheromatous plaque. CONCLUSIONS High levels of IL-18 were significantly associated with a higher carotid IMT and the presence of atheromatous plaques, which appear to be influenced by genetic factors, as evidenced by associations between SNPs in the IL-18 receptor gene and the presence of atheroma plaque.
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Affiliation(s)
- Ana Palanca
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; INCLIVA, Instituto de Investigación Sanitaria, Valencia, España
| | - Amparo Bartual-Rodrigo
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España
| | - Carolina Cuenca
- INCLIVA, Instituto de Investigación Sanitaria, Valencia, España
| | | | - Francisco Javier Ampudia-Blasco
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; INCLIVA, Instituto de Investigación Sanitaria, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas, Instituto de Salud Carlos III, Madrid, España; Departament de Medicina, Universitat de València, Valencia, España
| | - Herminia González-Navarro
- INCLIVA, Instituto de Investigación Sanitaria, Valencia, España; Departamento de Bioquímica y Biología Molecular, Universitat de València, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas, Instituto de Salud Carlos III, Madrid, España
| | - Juan F Ascaso
- INCLIVA, Instituto de Investigación Sanitaria, Valencia, España; Departament de Medicina, Universitat de València, Valencia, España
| | - Ana Bárbara García-García
- INCLIVA, Instituto de Investigación Sanitaria, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas, Instituto de Salud Carlos III, Madrid, España; Unidad de Genómica y Diabetes, INCLIVA, Instituto de Investigación Sanitaria, Valencia, España
| | - Felipe Javier Chaves
- INCLIVA, Instituto de Investigación Sanitaria, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas, Instituto de Salud Carlos III, Madrid, España; Unidad de Genómica y Diabetes, INCLIVA, Instituto de Investigación Sanitaria, Valencia, España
| | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; INCLIVA, Instituto de Investigación Sanitaria, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas, Instituto de Salud Carlos III, Madrid, España; Departament de Medicina, Universitat de València, Valencia, España
| | - Sergio Martínez-Hervás
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; INCLIVA, Instituto de Investigación Sanitaria, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas, Instituto de Salud Carlos III, Madrid, España; Departament de Medicina, Universitat de València, Valencia, España.
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Palanca A, Ampudia-Blasco FJ, Calderón JM, Sauri I, Martinez-Hervás S, Trillo JL, Redón J, Real JT. Comparison of GLP-1 receptor agonists and other Glucose-Lowering agents on cardiovascular outcomes in individuals with type 2 diabetes and Obesity: A Spanish Real-World Population-Based study. Diabetes Res Clin Pract 2024; 207:111071. [PMID: 38142748 DOI: 10.1016/j.diabres.2023.111071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
AIMS Assess the impact of glucagon-like peptide receptor agonists (GLP-1RA) compared to other glucose-lowering agents on cardiovascular outcomes in individuals with type 2 diabetes and obesity in a Spanish metropolitan area. METHODS A retrospective population-based type 2 diabetes cohort was identified from the Valencia Clinic-Malvarrosa Department electronic databases (2014-2019). Study groups included GLP-1RA, sodium-glucose co-transporter-2 inhibitors (SGLT2i), Insulin, and Miscellany (other glucose-lowering agents). 1:1:1:1 propensity score matching was conducted. The primary outcome was a composite of major adverse cardiovascular events (4-point MACE) comprising myocardial infarction, stroke, all-cause mortality, and heart failure. Secondary outcomes included individual 4-point MACE components. Hazard ratios were estimated using Cox regression analyses against the Miscellany group. RESULTS From 26,944 subjects, 1,848 adults were selected per group. GLP-1RA did not show a significant reduction in 4-point MACE risk (HR 1.05 [95%CI 0.82-1.34]). SGLT2i significantly reduced the risk of heart failure (HR 0.16 [95%CI 0.05-0.54]) and atrial fibrillation (HR 0.58, [95%CI 0.35-0.95]). The Insulin group exhibited a higher risk for 4-point MACE and most individual outcomes compared to GLP-1RA and SGLT2i. CONCLUSIONS Our findings do not provide evidence of a reduced cardiovascular risk, as assessed by 4-point MACE, with GLP-1RA. In contrast, SGLT2i demonstrated protective effects against heart failure and atrial fibrillation.
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Affiliation(s)
- Ana Palanca
- INCLIVA Biomedical Research Institute, Valencia, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain.
| | - F Javier Ampudia-Blasco
- INCLIVA Biomedical Research Institute, Valencia, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain; Department of Endocrinology & Nutrition, Clinic University Hospital of Valencia, Spain; Department of Medicine, Medicine Faculty, University of Valencia (UV), Spain.
| | | | | | - Sergio Martinez-Hervás
- INCLIVA Biomedical Research Institute, Valencia, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain; Department of Endocrinology & Nutrition, Clinic University Hospital of Valencia, Spain; Department of Medicine, Medicine Faculty, University of Valencia (UV), Spain
| | - José Luis Trillo
- Department of Health of Valencia Clínico-Malvarrosa, Valencia, Spain
| | - Josep Redón
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - José T Real
- INCLIVA Biomedical Research Institute, Valencia, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain; Department of Endocrinology & Nutrition, Clinic University Hospital of Valencia, Spain; Department of Medicine, Medicine Faculty, University of Valencia (UV), Spain
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Marco-Benedí V, Cenarro A, Vila À, Real JT, Tamarit JJ, Walther LAAS, Diaz-Diaz JL, Perea V, Civeira F, Vaz AJV. Impact of conducting a genetic study on the management of familial hypercholesterolemia. J Clin Lipidol 2023; 17:717-731. [PMID: 37813710 DOI: 10.1016/j.jacl.2023.08.008] [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: 05/04/2023] [Revised: 07/18/2023] [Accepted: 08/25/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Clinically diagnosed familial hypercholesterolemia (FH) may require a genetic test (GT) to confirm diagnosis. GT availability/accessibility is resource-dependent and usually restricted to specialized clinics. While GT has a diagnostic value, it has not yet defined its impact on long-term management and prognosis of FH. OBJECTIVE The aim was to identify the clinical characteristics associated with the request for a GT in suspected heterozygous FH. METHODS Retrospective study including adult patients with clinically suspected to be FH. Positive GT (GT+) was defined as having a pathogenic/likely pathogenic variant. Patients were stratified based on whether they had a genetic study conducted, and among those with a genetic study, according to those who did or did not have a GT+. RESULTS From 4854 patients included, 3090 were performed a GT (GT+: 2113). Median follow-up: 6.2 years. A younger age, FH-related physical signs, premature coronary disease, higher low-density lipoprotein cholesterol (LDLc) and lower body mass index and triglycerides, associated higher odds of being conducted a genetic study. These patients had higher baseline LDLc (252 mg/dL vs. 211 mg/dL among clinically diagnosed patients) and experienced larger reductions over the follow-up (157.7 mg/dL vs. 113.5 mg/dL, respectively). A similar pattern was observed among patients with GT+ (vs. negative GT). LDLc target attainment was low but increased to 66-95% when a triple combination with statin/ezetimibe/proprotein convertase subtilisin kexin type 9-inhibitor was used. Cardiovascular events occurred in 3.2% and 3.1% of patients who conducted/not conducted a genetic study. Patients conducted a genetic analysis and those with GT+ tended to present the events earlier. CONCLUSIONS Genetic study, vs. having a clinical-only diagnosis, impacts the management of FH. Cardiovascular prognosis was similar in both groups, perhaps as a result of the more intensive management of patients with a genetic study.
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Affiliation(s)
- Victoria Marco-Benedí
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain (Drs Marco-Benedí, Cenarro, Civeira); Universidad de Zaragoza, Zaragoza, Spain (Drs Marco-Benedí, Civeira).
| | - Ana Cenarro
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain (Drs Marco-Benedí, Cenarro, Civeira); Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain (Dr Cenarro)
| | - Àlex Vila
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital de Figueres, Figueres, Spain (Dr Vila)
| | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Departamento de Medicina, Universitat de València, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain (Dr Real)
| | - Juan J Tamarit
- Consorcio Hospital General Universitario, Valencia, Spain (Dr Tamarit)
| | | | - José Luis Diaz-Diaz
- Unidad de Lípidos, Servicio de Medicina Interna, Complexo Hospitalario Universitario de A Coruña, Spain (Dr Diaz-Diaz)
| | - Verónica Perea
- Hospital Universitari Mútua de Terrassa, Spain (Dr Perea)
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain (Drs Marco-Benedí, Cenarro, Civeira); Universidad de Zaragoza, Zaragoza, Spain (Drs Marco-Benedí, Civeira)
| | - Antonio J Vallejo Vaz
- Departmento de Medicina, Universidad de Sevilla, Sevilla, Spain (Dr Vaz); Clinical Epidemiology and Vascular Risk, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/Universidad de Sevilla/CSIC, Seville, Spain (Dr Vaz)
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Francisco V, Ait Eldjoudi D, González-Rodríguez M, Ruiz-Fernández C, Cordero-Barreal A, Marques P, Sanz MJ, Real JT, Lago F, Pino J, Farrag Y, Gualillo O. Metabolomic signature and molecular profile of normal and degenerated human intervertebral disc cells. Spine J 2023; 23:1549-1562. [PMID: 37339697 DOI: 10.1016/j.spinee.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/02/2023] [Accepted: 06/03/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND CONTEXT Intervertebral disc degeneration (IVDD) is an incurable, specific treatment-orphan disease with an increasing burden worldwide. Although great efforts have been made to develop new regenerative therapies, their clinical success is limited. PURPOSE Characterize the metabolomic and gene expression changes underpinning human disc degeneration. This study also aimed to disclose new molecular targets for developing and optimizing novel biological approaches for IVDD. STUDY DESIGN Intervertebral disc cells were obtained from IVDD patients undergoing circumferential arthrodesis surgery or from healthy subjects. Mimicking the harmful microenvironment of degenerated discs, cells isolated from the nucleus pulposus (NP) and annulus fibrosus (AF) were exposed to the proinflammatory cytokine IL-1β and the adipokine leptin. The metabolomic signature and molecular profile of human disc cells were unraveled for the first time. METHODS The metabolomic and lipidomic profiles of IVDD and healthy disc cells were analyzed by high-performance liquid chromatography-mass spectrometry (UHPLC-MS). Gene expression was investigated by SYBR green-based quantitative real-time RT-PCR. Altered metabolites and gene expression were documented. RESULTS Lipidomic analysis revealed decreased levels of triacylglycerols (TG), diacylglycerol (DG), fatty acids (FA), phosphatidylcholine (PC), lysophosphatidylinositols (LPI) and sphingomyelin (SM), and increased levels of bile acids (BA) and ceramides, likely promoting disc cell metabolism changing from glycolysis to fatty acid oxidation and following cell death. The gene expression profile of disc cells suggests LCN2 and LEAP2/GHRL as promising molecular therapeutic targets for disc degeneration and demonstrates the expression of genes related to inflammation (NOS2, COX2, IL-6, IL-8, IL-1β, and TNF-α) or encoding adipokines (PGRN, NAMPT, NUCB2, SERPINE2, and RARRES2), matrix metalloproteinases (MMP9 and MMP13), and vascular adhesion molecules (VCAM1). CONCLUSIONS Altogether, the presented results disclose the NP and AF cell biology changes from healthy to degenerated discs, allowing the identification of promising molecular therapeutic targets for intervertebral disc degeneration. CLINICAL SIGNIFICANCE Our results are relevant to improving current biological-based strategies aiming to repair IVD by restoring cellular lipid metabolites as well as adipokines homeostasis. Ultimately, our results will be valuable for successful, long-lasting relief of painful IVDD.
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Affiliation(s)
- Vera Francisco
- Institute of Health Research INCLIVA and Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Calle Menéndez y Pelayo nº4, 46010 Valencia, Spain; SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Djedjiga Ait Eldjoudi
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - María González-Rodríguez
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Clara Ruiz-Fernández
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Alfonso Cordero-Barreal
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Patrice Marques
- University Clinic Hospital of Valencia and Department of Pharmacology, Faculty of Medicine and Odontology, Institute of Health Research INCLIVA, University of Valencia, Calle Menéndez y Pelayo, nº4, 46010 Valencia, Spain
| | - Maria Jesus Sanz
- University Clinic Hospital of Valencia and Department of Pharmacology, Faculty of Medicine and Odontology, Institute of Health Research INCLIVA, University of Valencia, Calle Menéndez y Pelayo, nº4, 46010 Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain
| | - José T Real
- Institute of Health Research INCLIVA and Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Calle Menéndez y Pelayo nº4, 46010 Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. de Blasco Ibáñez nº15, 46010 Valencia, Spain
| | - Francisca Lago
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), Molecular and Cellular Cardiology Lab, Research Laboratory 7, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Jesus Pino
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain.
| | - Yousof Farrag
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Oreste Gualillo
- SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, Santiago University Clinical Hospital, Tr.ª da Choupana s/n, 15706 Santiago de Compostela, Spain
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Alabadi B, Civera M, De la Rosa A, Martinez-Hervas S, Gomez-Cabrera MC, Real JT. Low Muscle Mass Is Associated with Poorer Glycemic Control and Higher Oxidative Stress in Older Patients with Type 2 Diabetes. Nutrients 2023; 15:3167. [PMID: 37513585 PMCID: PMC10383462 DOI: 10.3390/nu15143167] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/08/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Body composition changes that occur during aging, such as loss of lean mass, are unfavorable at metabolic level and they can explain, in part, the appearance of certain age-associated diseases such as type 2 diabetes (T2D). Separately, T2D is associated with an increase in oxidative stress (OS) which negatively affects skeletal muscle. Our aim was to study the differences in clinical and nutritional parameters, disease control, and OS in a cohort of older patients with T2D classified according to the amount of lean mass they had. We included 100 adults older than 65 years with T2D. We found that women with low fat-free mass and muscle mass have worse T2D metabolic control. Moreover, the patients with a low percentile of muscle mass present a high value of OS. The study shows that the presence of low lean mass (LM) in the geriatric population diagnosed with T2D is associated with poorer glycemic control and greater OS.
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Affiliation(s)
- Blanca Alabadi
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario of Valencia, 46010 Valencia, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, 28029 Madrid, Spain
| | - Miguel Civera
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario of Valencia, 46010 Valencia, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Adrián De la Rosa
- Laboratory of Applied Sciences of Sport and Innovation Research Group (GICED), Unidades Tecnológicas de Santander (UTS), Bucaramanga 680006, Colombia
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario of Valencia, 46010 Valencia, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, 28029 Madrid, Spain
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Mari Carmen Gomez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), ISCIII, 28029 Madrid, Spain
| | - José T Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario of Valencia, 46010 Valencia, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, 28029 Madrid, Spain
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
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Palanca A, Ampudia-Blasco FJ, Calderón JM, Sauri I, Martinez-Hervás S, Trillo JL, Redón J, Real JT. Real-World Evaluation of GLP-1 Receptor Agonist Therapy Persistence, Adherence and Therapeutic Inertia Among Obese Adults with Type 2 Diabetes. Diabetes Ther 2023; 14:723-736. [PMID: 36847952 PMCID: PMC10064368 DOI: 10.1007/s13300-023-01382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/08/2023] [Indexed: 03/01/2023] Open
Abstract
INTRODUCTION In type 2 diabetes (T2D), key barriers to optimal glycaemic control include lack of persistence with treatment, reduced medication adherence and therapeutic inertia. This study aimed to assess the impact of these barriers in obese adults with type 2 diabetes treated with a GLP-1 receptor agonist (GLP-1RA) and compare them against other glucose-lowering agents in a real-world setting. METHODS A retrospective study was conducted using electronic medical records from 2014 to 2019 for adults with T2D at the Valencia Clínico-Malvarrosa Department of Health (Valencia, Spain). Four study groups were established: all GLP-1RA users, SGLT2i users, insulin users and other glucose-lowering agent users (miscellany group). To account for imbalance between groups, propensity score matching (PSM) including age, gender and pre-existing cardiovascular disease was performed. Chi-square tests were used for comparisons between groups. Time to first intensification was calculated using competing risk analysis. RESULTS Among the 26,944 adults with T2D, 7392 individuals were selected following PSM, with 1848 patients in each group. At 2 years, GLP-1RA users were less persistent than non-users (48.4% versus 72.7%, p < 0.0001) but more adherent (73.8% versus 68.9%, respectively, p < 0.0001). A greater proportion of persistent GLP-1RA users than non-persistent users exhibited reduced HbA1c (40.5% versus 18.6%, respectively, p < 0.0001), but no differences in cardiovascular outcomes and death were found. Overall, therapeutic inertia was observed in 38.0% of the study population. The large majority of GLP-1RA users received treatment intensification, whereas only 50.0% of GLP-1RA non-users were intensified. CONCLUSION Under real-life conditions, obese adults with T2D persistently treated with GLP-1RA showed improved glycaemic control. Despite benefits, persistence with GLP-1RA was limited after 2 years. Additionally, therapeutic inertia occurred in two out of three study participants. Strategies to facilitate medication adherence, persistence and treatment intensification in people with T2D should be made a priority in order to achieve and maintain glycaemic targets and improve outcomes in this population. TRAIL REGISTRATION Study registered in clinicaltrials.org with the identifier NCT05535322.
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Affiliation(s)
- Ana Palanca
- Department of Endocrinology and Nutrition, Clinic University Hospital of Valencia, Avda. Blasco Ibáñez nº 17, 46010, Valencia, Spain.
- INCLIVA Biomedical Research Institute, Valencia, Spain.
- CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain.
| | - F Javier Ampudia-Blasco
- Department of Endocrinology and Nutrition, Clinic University Hospital of Valencia, Avda. Blasco Ibáñez nº 17, 46010, Valencia, Spain.
- INCLIVA Biomedical Research Institute, Valencia, Spain.
- CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain.
- Department of Medicine, Medicine Faculty, University of Valencia (UV), Valencia, Spain.
| | | | | | - Sergio Martinez-Hervás
- Department of Endocrinology and Nutrition, Clinic University Hospital of Valencia, Avda. Blasco Ibáñez nº 17, 46010, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
- CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain
- Department of Medicine, Medicine Faculty, University of Valencia (UV), Valencia, Spain
| | - José Luis Trillo
- Department of Health of Valencia Clínico-Malvarrosa, Valencia, Spain
| | - Josep Redón
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - José T Real
- Department of Endocrinology and Nutrition, Clinic University Hospital of Valencia, Avda. Blasco Ibáñez nº 17, 46010, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
- CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Madrid, Spain
- Department of Medicine, Medicine Faculty, University of Valencia (UV), Valencia, Spain
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Hueso L, Marques P, Morant B, Gonzalez-Navarro H, Ortega J, Real JT, Sanz MJ, Piqueras L. CCL17 and CCL22 chemokines are upregulated in human obesity and play a role in vascular dysfunction. Front Endocrinol (Lausanne) 2023; 14:1154158. [PMID: 37124725 PMCID: PMC10130371 DOI: 10.3389/fendo.2023.1154158] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/30/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Background/Aims Chemokines are known to play critical roles mediating inflammation in many pathophysiological processes. The aim of this study was to investigate the role of chemokine receptor CCR4 and its ligands CCL17 and CCL22 in human morbid obesity. Methods Circulating levels of CCL17 and CCL22 were measured in 60 morbidly obese patients (mean age, 45 ± 1 years; body mass index/BMI, 44 ± 1 kg/m2) who had undergone bariatric bypass surgery, and 20 control subjects. Paired subcutaneous (SCAT) and visceral adipose tissue (VCAT) from patients were analysed to measure expression of CCR4 and its ligands by RT-PCR, western blot and immunohistochemical analysis. The effects of CCR4 neutralization ex vivo on leukocyte-endothelial cells were also evaluated. Results Compared with controls, morbidly obese patients presented higher circulating levels of CCL17 (p=0.029) and CCL22 (p<0.001) and this increase was positively correlated with BMI (p=0.013 and p=0.0016), and HOMA-IR Index (p=0.042 and p< 0.001). Upregulation of CCR4, CCL17 and CCL22 expression was detected in VCAT in comparison with SCAT (p<0.05). Using the parallel-plate flow chamber model, blockade of endothelial CCR4 function with the neutralizing antibody anti-CCR4 in morbidly obese patients significantly reduced leucocyte adhesiveness to dysfunctional endothelium, a key event in atherogenesis. Additionally, CCL17 and CCL22 increased activation of the ERK1/2 mitogen-activated protein kinase signalling pathway in human aortic endothelial cells, which was significantly reduced by CCR4 inhibition (p=0.016 and p<0.05). Conclusion Based on these findings, pharmacological modulation of the CCR4 axis could represent a new therapeutic approach to prevent adipose tissue dysfunction in obesity.
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Affiliation(s)
- Luisa Hueso
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | | | - Brenda Morant
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Herminia Gonzalez-Navarro
- INCLIVA Biomedical Research Institute, Valencia, Spain
- Department of Biochemistry, University of Valencia, Valencia, Spain
- CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Joaquin Ortega
- Surgery Service, University Clinic Hospital of Valencia, Valencia, Spain
- Department of Surgery, University of Valencia, Valencia, Spain
| | - José T. Real
- INCLIVA Biomedical Research Institute, Valencia, Spain
- CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain
- *Correspondence: Laura Piqueras, ; María J Sanz, ; José T. Real,
| | - María J Sanz
- INCLIVA Biomedical Research Institute, Valencia, Spain
- CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Pharmacology, University of Valencia, Valencia, Spain
- *Correspondence: Laura Piqueras, ; María J Sanz, ; José T. Real,
| | - Laura Piqueras
- INCLIVA Biomedical Research Institute, Valencia, Spain
- CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Pharmacology, University of Valencia, Valencia, Spain
- *Correspondence: Laura Piqueras, ; María J Sanz, ; José T. Real,
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Martínez-Hervás S, Morales-Suarez-Varela MM, Andrés-Blasco I, Lara-Hernández F, Peraita-Costa I, Real JT, García-García AB, Chaves FJ. Developing a simple and practical decision model to predict the risk of incident type 2 diabetes among the general population: The Di@bet.es Study. Eur J Intern Med 2022; 102:80-87. [PMID: 35570127 DOI: 10.1016/j.ejim.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/08/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
AIMS To develop a simple multivariate predictor model of incident type 2 diabetes in general population. METHODS Participants were recruited from the Spanish Di@bet.es cohort study with 2570 subjects meeting all criteria to be included in the at-risk sample studied here. Information was collected using an interviewer-administered structured questionnaire, followed by physical and clinical examination. CHAID algorithm, which collects the information of individuals with and without type 2 diabetes, was used to develop a decision tree based type 2 diabetes prediction model. RESULTS 156 individuals were identified as having developed type 2 diabetes (6.5% incidence). Fasting plasma glucose (FPG) at the beginning of the study was the main predictive variable for incident type 2 diabetes: FPG ≤ 92 mg/dL (ref.), 92-106 mg/dL (OR = 3.76, 95%CI = 2.36-6.00), > 106 mg/dL (OR = 13.21; 8.26-21.12). More than 25% of subjects starting follow-up with FPG levels > 106 mg/dL developed type 2 diabetes. When FPG <106 mg/dL, other variables (fasting triglycerides (FTGs), BMI or age) were needed. For levels ≤ 92 mg/dL, higher FTGs levels increased risk of incident type 2 diabetes (FTGs > 180 mg/dL, OR = 14.57; 4.89-43.40) compared with the group of FTGs ≤ 97 mg/dL (FTGs = 97-180 mg/dL, OR = 3.12; 1.05-9.24). This model correctly classified 93.5% of individuals. CONCLUSIONS The type 2 diabetes prediction model is based on FTGs, FPG, age, gender, and BMI values. Utilizing commonly available clinical data and a simple blood test, a simple tree diagram helps identify subjects at risk of developing type 2 diabetes, even in apparently low risk subjects with normal FPG.
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Affiliation(s)
- Sergio Martínez-Hervás
- Department of Medicine, University of Valencia, Avenida Blasco Ibañez 15, Valencia 46010, Spain; Service of Endocrinology and Nutrition, Valencia University Clinical Hospital, Avenida Blasco Ibañez 17, Valencia 46010, Spain; INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain; CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain
| | - María M Morales-Suarez-Varela
- Department of Preventive Medicine, Unit of Public Health and Environmental Care, University of Valencia, Vicente Andres Estelles Avenue, Burjassot, Valencia 46100, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Monforte de Lemos 3-5, Madrid 28029, Spain
| | - Irene Andrés-Blasco
- Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain
| | - Francisco Lara-Hernández
- Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain
| | - Isabel Peraita-Costa
- Department of Preventive Medicine, Unit of Public Health and Environmental Care, University of Valencia, Vicente Andres Estelles Avenue, Burjassot, Valencia 46100, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Monforte de Lemos 3-5, Madrid 28029, Spain
| | - José T Real
- Department of Medicine, University of Valencia, Avenida Blasco Ibañez 15, Valencia 46010, Spain; Service of Endocrinology and Nutrition, Valencia University Clinical Hospital, Avenida Blasco Ibañez 17, Valencia 46010, Spain; INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain; CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain.
| | - Ana-Bárbara García-García
- CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain; Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain.
| | - F Javier Chaves
- CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain; Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain
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11
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Palanca A, Ampudia-Blasco FJ, Real JT. The Controversial Role of Vitamin D in Thyroid Cancer Prevention. Nutrients 2022; 14:nu14132593. [PMID: 35807774 PMCID: PMC9268358 DOI: 10.3390/nu14132593] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022] Open
Abstract
Thyroid cancer is the most common endocrine malignancy and exhibits rising incidence. Annual incidence varies by sex, age, and geographical location. It has been reported that impairment of vitamin D signalling promotes thyroid cancer progression. Recent studies have shown that vitamin D, a fat-soluble vitamin that acts as both a nutrient and a hormone, may have utility in the prevention of autoimmune thyroid-related diseases. However, the precise role of vitamin D in the pathobiology of thyroid cancer is controversial. Previous studies have suggested that elevated serum vitamin D levels have a protective role in thyroid cancer. However, there is also evidence demonstrating no inverse relationship between vitamin D levels and the occurrence of thyroid cancer. Furthermore, recent data provide evidence that circulating vitamin D concentration is inversely correlated with disease aggressiveness and poor prognosis, while evidence of an association with tumour initiation remains weak. Nevertheless, a variety of data support an anti-tumorigenic role of vitamin D and its potential utility as a secondary chemopreventive agent. In this review, we highlighted recent findings regarding the association of vitamin D status with the risk of thyroid cancer, prognosis, potential mechanisms, and possible utility as a chemopreventive agent.
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Affiliation(s)
- Ana Palanca
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, 46010 Valencia, Spain;
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBERDEM, CIBER Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain
- Correspondence: (A.P.); (F.J.A.-B.); Tel.: +34-96-197-35-00 (A.P. & F.J.A.-B.)
| | - Francisco Javier Ampudia-Blasco
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, 46010 Valencia, Spain;
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBERDEM, CIBER Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain
- Department of Medicine, Medicine Faculty, University of Valencia (UV), 46010 Valencia, Spain
- Correspondence: (A.P.); (F.J.A.-B.); Tel.: +34-96-197-35-00 (A.P. & F.J.A.-B.)
| | - José T. Real
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, 46010 Valencia, Spain;
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBERDEM, CIBER Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain
- Department of Medicine, Medicine Faculty, University of Valencia (UV), 46010 Valencia, Spain
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Palanca A, Quinones-Torrelo C, Girbés J, Real JT, Ampudia-Blasco FJ. Impact of COVID-19 lockdown on diabetes management and follow-up in a broad population in Spain. Eur J Clin Invest 2022; 52:e13771. [PMID: 35313009 PMCID: PMC9111861 DOI: 10.1111/eci.13771] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/27/2022] [Accepted: 03/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND To evaluate the impact of COVID-19 lockdown on glycaemic control and diabetes follow-up in a Spanish metropolitan area with a total general population of 340,000. METHODS A retrospective real-world study comparing HbA1c testing, an indicator of diabetes control, and mean HbA1c during different COVID-19 restriction periods in 2020 (full lockdown, post-lockdown, partial lockdown) with the same periods in 2019. HbA1c testing was analysed per study period and according to gender, age and clinical setting. Associations between HbA1c testing and different covariables were investigated using logistic regression analysis. Changes in HbA1c were evaluated by repeated measures multivariate analysis of variance (ANOVA). RESULTS During full lockdown, 6847 individuals, of which 56.7% were over 65 and 6.5% below 40, were tested for HbA1c compared to 14,180 in 2019 (OR 0.47, 95% CI:0.46-0.49). Reduction in HbA1c testing was greater among older individuals (OR 0.44, 95% CI:0.42-0.45). No differences were observed for post-lockdown (OR 1.01, 95% CI:0.99-1.04). During partial lockdown, 10,816 individuals had at least one HbA1c measured compared to 12,749 in 2019 (OR 0.84, 95% CI:0.82-0.87). Mean HbA1c during full lockdown was 7.26% (±1.06) compared to 7.50% (±1.14) in 2019 (p < .0001). For gender and across all age groups, HbA1c levels were lower during full lockdown. HbA1c changes were not significantly different during post-lockdown and partial lockdown. CONCLUSIONS COVID-19 restriction measures affected HbA1c testing. During complete lockdown, HbA1c testing decreased by half across all gender and age groups. No deleterious effect on glycaemic control was observed during lockdown and post-lockdown among those tested.
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Affiliation(s)
- Ana Palanca
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,CIBERDEM, CIBER Diabetes and associated metabolic diseases, Madrid, Spain
| | - Carmen Quinones-Torrelo
- Laboratory of Biochemistry and Molecular Pathology, Valencia University Clinic Hospital, Valencia, Spain
| | - Juan Girbés
- Diabetes Unit, Arnau de Vilanova Hospital, Valencia, Spain
| | - José T Real
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,CIBERDEM, CIBER Diabetes and associated metabolic diseases, Madrid, Spain.,Department of Medicine, Medicine Faculty, University of Valencia (UV), Valencia, Spain
| | - F Javier Ampudia-Blasco
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,CIBERDEM, CIBER Diabetes and associated metabolic diseases, Madrid, Spain.,Department of Medicine, Medicine Faculty, University of Valencia (UV), Valencia, Spain
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García-García AB, Martínez-Hervás S, Vernia S, Ivorra C, Pulido I, Martín-Escudero JC, Casado M, Carretero J, Real JT, Chaves FJ. A Very Rare Variant in SREBF2, a Possible Cause of Hypercholesterolemia and Increased Glycemic Levels. Biomedicines 2022; 10:biomedicines10051178. [PMID: 35625914 PMCID: PMC9138625 DOI: 10.3390/biomedicines10051178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023] Open
Abstract
Patients with high cholesterol and glucose levels are at high risk for cardiovascular disease. The Sterol Regulatory Element Binding Protein (SREBP) system regulates genes involved in lipid, cholesterol and glucose pathways. Autosomal Dominant Hypercholesterolemias (ADHs) are a group of diseases with increased cholesterol levels. They affect 1 out of every 500 individuals. About 20–30% of patients do not present any mutation in the known genes (LDLR, APOB and PCSK9). ADHs constitute a good model to identify the genes involved in the alteration of lipid levels or possible therapeutic targets. In this paper, we studied whether a mutation in the SREBP system could be responsible for ADH and other metabolic alterations present in these patients. Forty-one ADH patients without mutations in the main responsible genes were screened by direct sequencing of SREBP system genes. A luciferase reporter assay of the found mutation and an oral glucose tolerance test in carriers and non-carriers were performed. We found a novel mutation in the SREBF2 gene that increases transcription levels and cosegregates with hypercholesterolemia, and we found increased glucose levels in one family. SREBP2 is known to be involved in cholesterol synthesis, plasma levels and glucose metabolism in humans. The found mutation may involve the SREBF2 gene in hypercholesterolemia combined with hyperglycemia.
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Affiliation(s)
- Ana-Bárbara García-García
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), 28029 Madrid, Spain; (A.-B.G.-G.); (S.M.-H.); (J.T.R.)
- Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
| | - Sergio Martínez-Hervás
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), 28029 Madrid, Spain; (A.-B.G.-G.); (S.M.-H.); (J.T.R.)
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
- Endocrinology Service, University Clinical Hospital of Valencia, 46010 Valencia, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Santiago Vernia
- Biomedical Institute of Valencia (IBV-CSIC), 46010 Valencia, Spain; (S.V.); (M.C.)
| | - Carmen Ivorra
- Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
| | - Inés Pulido
- University of Illinois Hospital & Health Sciences System Cancer Center, University of Illinois Chicago, Chicago, IL 60612, USA;
- Department of Physiology, University of Valencia, 46010 Valencia, Spain;
| | | | - Marta Casado
- Biomedical Institute of Valencia (IBV-CSIC), 46010 Valencia, Spain; (S.V.); (M.C.)
- CIBER of Hepatic and Digestive Diseases (CIBEREHD), 28029 Madrid, Spain
| | - Julián Carretero
- Department of Physiology, University of Valencia, 46010 Valencia, Spain;
| | - José T. Real
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), 28029 Madrid, Spain; (A.-B.G.-G.); (S.M.-H.); (J.T.R.)
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
- Endocrinology Service, University Clinical Hospital of Valencia, 46010 Valencia, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Felipe Javier Chaves
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), 28029 Madrid, Spain; (A.-B.G.-G.); (S.M.-H.); (J.T.R.)
- Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
- Correspondence: ; Tel.: +34-96-38-64100 (ext. 51905)
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14
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Marques P, Domingo E, Rubio A, Martinez-Hervás S, Ascaso JF, Piqueras L, Real JT, Sanz MJ. Beneficial effects of PCSK9 inhibition with alirocumab in familial hypercholesterolemia involve modulation of new immune players. Biomed Pharmacother 2021; 145:112460. [PMID: 34864314 DOI: 10.1016/j.biopha.2021.112460] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 09/13/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 12/27/2022] Open
Abstract
Familial hypercholesterolemia (FH) is associated with low-grade systemic inflammation, a key driver of premature atherosclerosis. We investigated the effects of inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9) function on inflammatory state, endothelial dysfunction and cardiovascular outcomes in patients with FH. Fourteen patients with FH were evaluated before and 8 weeks after administration of a PCSK9 blocking monoclonal antibody (alirocumab, 150 mg/subcutaneous/14 days). In vivo and ex vivo analysis revealed that alirocumab blunted the attachment of leukocytes to TNFα-stimulated human umbilical arterial endothelial cells (HUAEC) and suppressed the activation of platelets and most leukocyte subsets, which was accompanied by the diminished expression of CX3CR1, CXCR6 and CCR2 on several leukocyte subpopulations. By contrast, T-regulatory cell activation was enhanced by alirocumab treatment, which also elevated anti-inflammatory IL-10 plasma levels and lowered circulating pro-inflammatory cytokines. Plasma levels of IFNγ positively correlated with levels of total and LDL-cholesterol, whereas circulating IL-10 levels negatively correlated with these key lipid parameters. In vitro analysis revealed that TNFα stimulation of HUAEC increased the expression of PCSK9, whereas endothelial PCSK9 silencing reduced TNFα-induced mononuclear cell adhesion mediated by Nox5 up-regulation and p38-MAPK/NFκB activation, concomitant with reduced SREBP2 expression. PCSK9 silencing also decreased endothelial CX3CL1 and CXCL16 expression and chemokine generation. In conclusion, PCSK9 inhibition impairs systemic inflammation and endothelial dysfunction by constraining leukocyte-endothelium interactions. PCSK9 blockade may constitute a new therapeutic approach to control the inflammatory state associated with FH, preventing further cardiovascular events in this cardiometabolic disorder.
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Affiliation(s)
- Patrice Marques
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain
| | - Elena Domingo
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Arantxa Rubio
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain
| | - Sergio Martinez-Hervás
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Juan F Ascaso
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Laura Piqueras
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - José T Real
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Maria-Jesus Sanz
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
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15
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Cilla A, López-García G, Collado-Díaz V, Amparo Blanch-Ruiz M, Garcia-Llatas G, Barberá R, Martinez-Cuesta MA, Real JT, Álvarez Á, Martínez-Hervás S. Hypercholesterolemic patients have higher eryptosis and erythrocyte adhesion to human endothelium independently of statin therapy. Int J Clin Pract 2021; 75:e14771. [PMID: 34473881 DOI: 10.1111/ijcp.14771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/30/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Phosphatidylserine (PS) externalization out of the membrane facilitates the eryptotic erythrocytes (EE) binding to endothelial cells (EC), potentially leading to atherosclerosis. Thus, the levels of eryptosis and interactions of EE-EC in hypercholesterolemic patients, either non-medicated or medicated, compared with healthy subjects were studied. METHODS A total of 56 subjects clustered into three groups: (control (n = 20), hypercholesterolemic non-treated (HCNT) (n = 15), and statin-treated (HCT) (n = 21)) were enrolled in this cross-sectional study. Biochemical parameters were determined with validated and standard methods. PS exposure was estimated from annexin-V-binding, cell volume from forward scatter (FSC), and GSH from CMFDA fluorescence by flow cytometry. The erythrocyte-EC adhesion assay was performed by using the parallel-plate flow chamber technique. RESULTS Higher PS externalization and adhesion of erythrocytes to EC (P < .05) was found in hypercholesterolemic subjects, regardless of statin treatment, compared with the control group. Although no correlation between FSC and PS externalization with other parameters was found, GSH was inversely correlated with erythrocyte adhesion, which was significantly correlated with total cholesterol, LDL-c, and apolipoprotein B. CONCLUSION The link between hypercholesterolemia and eryptosis suggests a possible detrimental impact of this binomial on endothelial function with possible further development of atherosclerosis and microcirculation problems in hypercholesterolemic patients, independently of statin therapy.
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Affiliation(s)
- Antonio Cilla
- Nutrition and Food Science Area, Faculty of Pharmacy, University of Valencia, Valencia, Spain
| | - Gabriel López-García
- Nutrition and Food Science Area, Faculty of Pharmacy, University of Valencia, Valencia, Spain
| | - Víctor Collado-Díaz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | | | - Guadalupe Garcia-Llatas
- Nutrition and Food Science Area, Faculty of Pharmacy, University of Valencia, Valencia, Spain
| | - Reyes Barberá
- Nutrition and Food Science Area, Faculty of Pharmacy, University of Valencia, Valencia, Spain
| | | | - José T Real
- Endocrinology and Nutrition Department, Hospital Clínico Universitario, Department of Medicine, University of Valencia, Valencia, Spain
| | - Ángeles Álvarez
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
- CIBERehd, Valencia, Spain
| | - Sergio Martínez-Hervás
- Endocrinology and Nutrition Department, Hospital Clínico Universitario, Department of Medicine, University of Valencia, Valencia, Spain
- INCLIVA Institute of Health Research, Valencia, Spain
- CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
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16
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Moreno B, Hueso L, Ortega R, Benito E, Martínez-Hervas S, Peiro M, Civera M, Sanz MJ, Piqueras L, Real JT. Association of chemokines IP-10/CXCL10 and I-TAC/CXCL11 with insulin resistance and enhance leukocyte endothelial arrest in obesity. Microvasc Res 2021; 139:104254. [PMID: 34534571 DOI: 10.1016/j.mvr.2021.104254] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/02/2021] [Revised: 07/20/2021] [Accepted: 09/06/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIMS Obesity is a key contributing factor to incidental type 2 diabetes and cardiovascular disease. CXCR3 receptor and its ligands CXCL 10 and 11 are associated with atherosclerosis and cardiovascular disease. The aim of our study was to analyse the role of the CXCR3 ligands on insulin resistance (IR) and endothelial dysfunction in human obesity. METHODS AND RESULTS We have studied 45 obese patients (mean age 44 ± 6 years, body mass index 45 ± 9 kg/m2) who were selected for Roux-Y-gastric bypass surgery and 21 non obese control subjects with similar age and gender distribution. We measured by ELISA the circulating levels of the CXCR3 ligands interferon-γ inducible protein 10 (IP-10/CXCL10) and interferon-γ-inducible T-cell alpha chemoattractant (I-TAC/CXCL11). Using an ex vivo procedure with the flow chamber assay, we have investigated the effect of such chemokines on endothelial leukocytes arrest under dynamic conditions. Peripheral blood levels of CXCL10 and CXCL11 were significantly higher in obese subjects than in controls (p < 0.001) and significantly correlated with BMI, waist circunference and HOMA-IR. Obese patients with HOMA-IR index above 75th percentile showed highest increase of circulating CXCL10 and CXCL11 values. Under dynamic flow conditions, the enhanced adhesion of patient leukocytes to TNFα-induced human arterial endothelial cells was partly dependent on CXCR3. CONCLUSIONS The study demonstrates that CXCL10 and CXCL11 are associated with IR and enhance leukocyte endothelial arrest in obese subjects. Blockade of CXCR3 signaling might be a new therapeutic approach for the prevention of obesity-associated cardiovascular co-morbidities.
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Affiliation(s)
- Beatriz Moreno
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain
| | - Luisa Hueso
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Rebeca Ortega
- INCLIVA Biomedical Research Institute, Valencia, Spain; Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Esther Benito
- INCLIVA Biomedical Research Institute, Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain; CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain
| | - Sergio Martínez-Hervas
- INCLIVA Biomedical Research Institute, Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain; CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain; Department of Medicine, Faculty of Medicine, University of Valencia, Spain
| | - Marta Peiro
- INCLIVA Biomedical Research Institute, Valencia, Spain; CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain
| | - Miguel Civera
- INCLIVA Biomedical Research Institute, Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain; Department of Medicine, Faculty of Medicine, University of Valencia, Spain
| | - María-Jesús Sanz
- INCLIVA Biomedical Research Institute, Valencia, Spain; Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain; CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain
| | - Laura Piqueras
- INCLIVA Biomedical Research Institute, Valencia, Spain; Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain; CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain.
| | - José T Real
- INCLIVA Biomedical Research Institute, Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain; CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain; Department of Medicine, Faculty of Medicine, University of Valencia, Spain.
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17
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Ascaso P, Palanca A, Martinez-Hervás S, Sanz MJ, Ascaso JF, Piqueras L, Real JT. Peripheral blood levels of CXCL10 are a useful marker for diabetic polyneuropathy in subjects with type 2 diabetes. Int J Clin Pract 2021; 75:e14302. [PMID: 33930221 DOI: 10.1111/ijcp.14302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/19/2020] [Accepted: 04/27/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN) is a chronic complication of diabetes mellitus associated with high morbidity and mortality. Major risk factors for DPN include metabolic changes, duration of diabetes, nerve ischaemia and derangements in regeneration and nerve repair programmes. Chemokines have been previously implicated in the pathogenesis of various neuropathies and neuropathic pain processes. The aim of this pilot study was to evaluate the association between the plasma levels of chemokines (CXCL9, CXCL10 and CXCL11) in the presence of DPN in a cohort of type 2 diabetes (T2D) patients. MATERIALS AND METHODS We studied 73 patients with T2D: 36 with DPN and 37 without DPN. DPN was established through the Semmes-Weinstein test (SW). Plasma levels of circulating chemokines CXCL9, CXCL10 and CXCL11 were determined using DuoSet ELISA kits (Abingdon, UK). RESULTS We found that levels of CXCL10 were significantly higher in patients with DPN than amongst patients without DPN (57.6 ± 38.3 vs 38.1 ± 33.4 pg/mL, respectively; P = .034). Serum levels of chemokine CXCL9 were also higher amongst patients with DPN but did not reach a statistical significance (188.1 ± 72.7 and 150.4 ± 83.6 pg/mL, respectively, P = .06). CONCLUSIONS Increased circulating levels of CXCL10 were associated with DPN in T2D patients, suggesting a role of this chemokine in the DPN. Determination of CXCL10 levels could be used as a marker for the early detection and implementation of therapeutic strategies in order to reverse and prevent the DPN.
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Affiliation(s)
- Pilar Ascaso
- Endocrinology and Nutrition Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Ana Palanca
- Endocrinology and Nutrition Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research-INCLIVA, Valencia, Spain
| | - Sergio Martinez-Hervás
- Endocrinology and Nutrition Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research-INCLIVA, Valencia, Spain
- Centro de Investigación Biomédica en Red - Diabetes y enfermedades metabólicas asociadas (CIBERDEM), Barcelona, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - María Jesús Sanz
- Institute of Health Research-INCLIVA, Valencia, Spain
- Centro de Investigación Biomédica en Red - Diabetes y enfermedades metabólicas asociadas (CIBERDEM), Barcelona, Spain
- Department of Pharmacology, University of Valencia, Valencia, Spain
| | - Juan F Ascaso
- Endocrinology and Nutrition Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research-INCLIVA, Valencia, Spain
- Centro de Investigación Biomédica en Red - Diabetes y enfermedades metabólicas asociadas (CIBERDEM), Barcelona, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Laura Piqueras
- Institute of Health Research-INCLIVA, Valencia, Spain
- Centro de Investigación Biomédica en Red - Diabetes y enfermedades metabólicas asociadas (CIBERDEM), Barcelona, Spain
- Department of Pharmacology, University of Valencia, Valencia, Spain
| | - José T Real
- Endocrinology and Nutrition Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research-INCLIVA, Valencia, Spain
- Centro de Investigación Biomédica en Red - Diabetes y enfermedades metabólicas asociadas (CIBERDEM), Barcelona, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
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18
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Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [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: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
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Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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19
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Real JT, Ascaso JF. Lipid metabolism and classification of hyperlipaemias. Clin Investig Arterioscler 2021; 33 Suppl 1:3-9. [PMID: 33966810 DOI: 10.1016/j.arteri.2020.12.008] [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] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
This chapter summarises, and updates, lipid metabolism. Both pathways, exogenous metabolisms route via the chylomicrons, and the endogenous pathway of very low-density lipoproteins (VLDL) and low-density lipoproteins (LDL). The reverse cholesterol metabolism will also be mentioned. It also includes the current classification of hyperlipidaemias or hyperlipoproteinaemias, with a reminder of the phenotype classification, and further developments of the aetiological classification. Both parts have updated references, with which knowledge of this vast subject can be expanded.
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Affiliation(s)
- José T Real
- Unidad de Lípidos y Prevención Cardiovascular, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; Departamento de Medicina, Universitat de València, Valencia, España; Instituto de Investigación Sanitaria INCLIVA, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas - CIBERDEM, ISCIII, Madrid, España
| | - Juan F Ascaso
- Departamento de Medicina, Universitat de València, Valencia, España; Instituto de Investigación Sanitaria INCLIVA, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas - CIBERDEM, ISCIII, Madrid, España.
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20
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Collado A, Domingo E, Marques P, Perello E, Martínez-Hervás S, Piqueras L, Ascaso JF, Real JT, Sanz MJ. Oral Unsaturated Fat Load Impairs Postprandial Systemic Inflammation in Primary Hypercholesterolemia Patients. Front Pharmacol 2021; 12:656244. [PMID: 33959024 PMCID: PMC8093814 DOI: 10.3389/fphar.2021.656244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/20/2021] [Accepted: 03/18/2021] [Indexed: 12/12/2022] Open
Abstract
Context: Primary hypercholesterolemia (PH) is a lipid disorder characterized by elevated levels of cholesterol and low-density lipoprotein (LDL). Low-grade systemic inflammation is associated with PH, which might explain the higher incidence of cardiovascular diseases in this setting. Objective: To evaluate the effect of an oral unsaturated fat load (OUFL) on different immune parameters and functional consequences in patients with PH in postprandial state. Design: A commercial liquid preparation of long-chain triglycerides (Supracal®; ω6/ω3 ratio >20/1, OUFL) was administered to 20 patients and 10 age-matched controls. Whole blood was collected before (fasting state) and 4 h after administration (postprandial state). Flow cytometry was employed to determine platelet and leukocyte activation, and the levels of circulating platelet-leukocyte aggregates. Soluble markers were determined by ELISA, and the parallel-plate flow chamber was employed to study leukocyte adhesion to the dysfunctional arterial endothelium. Results: The PH group had a lower percentage of activated platelets and circulating type 1 monocytes, and blunted neutrophil activation after the OUFL, accompanied by a significant increase in the percentage of regulatory T lymphocytes. In this group, the OUFL led to a significant impairment of leukocyte adhesion to the dysfunctional [tumor necrosis factor α (TNFα)-stimulated] endothelium and reduced the plasma levels of soluble P-selectin, platelet factor-4 (PF-4)/CXCL4, CXCL8, CCL2, CCL5, and TNFα. Conclusion: The OUFL has a beneficial impact on the pro-thrombotic and pro-inflammatory state of PH patients and might be a promising macronutrient approach to dampen the systemic inflammation associated with PH and the development of further cardiovascular events.
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Affiliation(s)
- Aida Collado
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Elena Domingo
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Patrice Marques
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Eva Perello
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain
| | - Sergio Martínez-Hervás
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Laura Piqueras
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain
| | - Juan F Ascaso
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - José T Real
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Maria-Jesus Sanz
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain
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21
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Bové M, Monto F, Guillem-Llobat P, Ivorra MD, Noguera MA, Zambrano A, Sirerol-Piquer MS, Requena AC, García-Alonso M, Tejerina T, Real JT, Fariñas I, D’Ocon P. NT3/TrkC Pathway Modulates the Expression of UCP-1 and Adipocyte Size in Human and Rodent Adipose Tissue. Front Endocrinol (Lausanne) 2021; 12:630097. [PMID: 33815288 PMCID: PMC8015941 DOI: 10.3389/fendo.2021.630097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/04/2021] [Indexed: 12/11/2022] Open
Abstract
Neurotrophin-3 (NT3), through activation of its tropomyosin-related kinase receptor C (TrkC), modulates neuronal survival and neural stem cell differentiation. It is widely distributed in peripheral tissues (especially vessels and pancreas) and this ubiquitous pattern suggests a role for NT3, outside the nervous system and related to metabolic functions. The presence of the NT3/TrkC pathway in the adipose tissue (AT) has never been investigated. Present work studies in human and murine adipose tissue (AT) the presence of elements of the NT3/TrkC pathway and its role on lipolysis and adipocyte differentiation. qRT-PCR and immunoblot indicate that NT3 (encoded by NTF3) was present in human retroperitoneal AT and decreases with age. NT3 was also present in rat isolated adipocytes and retroperitoneal, interscapular, perivascular, and perirenal AT. Histological analysis evidences that NT3 was mainly present in vessels irrigating AT close associated to sympathetic fibers. Similar mRNA levels of TrkC (encoded by NTRK3) and β-adrenoceptors were found in all ATs assayed and in isolated adipocytes. NT3, through TrkC activation, exert a mild effect in lipolysis. Addition of NT3 during the differentiation process of human pre-adipocytes resulted in smaller adipocytes and increased uncoupling protein-1 (UCP-1) without changes in β-adrenoceptors. Similarly, transgenic mice with reduced expression of NT3 (Ntf3 knock-in lacZ reporter mice) or lacking endothelial NT3 expression (Ntf3flox1/flox2;Tie2-Cre+/0) displayed enlarged white and brown adipocytes and lower UCP-1 expression. Conclusions NT3, mainly released by blood vessels, activates TrkC and regulates adipocyte differentiation and browning. Disruption of NT3/TrkC signaling conducts to hypertrophied white and brown adipocytes with reduced expression of the thermogenesis marker UCP-1.
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Affiliation(s)
- María Bové
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
| | - Fermi Monto
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
| | - Paloma Guillem-Llobat
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
| | - M Dolores Ivorra
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
| | - M Antonia Noguera
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
| | - Andrea Zambrano
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
| | - M Salome Sirerol-Piquer
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
- Departamento de Biología Celular, Biología Funcional y Antropología Física, Universidad de Valencia, Valencia, Spain
- CIBER en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Ana Cristina Requena
- Departamento de Biología Celular, Biología Funcional y Antropología Física, Universidad de Valencia, Valencia, Spain
| | - Mauricio García-Alonso
- Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico San Carlos, Madrid, Spain
| | - Teresa Tejerina
- Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico San Carlos, Madrid, Spain
- Departamento de Farmacología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - José T. Real
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario e INCLIVA, Valencia, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad de Valencia, Valencia, Spain
| | - Isabel Fariñas
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
- Departamento de Biología Celular, Biología Funcional y Antropología Física, Universidad de Valencia, Valencia, Spain
- CIBER en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Pilar D’Ocon
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Estructura de Recerca Interdisciplinar en Biotecnologia i Biomedicina (ERI BIOTECMED), Universidad de Valencia, Valencia, Spain
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Real JT. Diabetes como paradigma del impacto de las enfermedades no transmisibles. Clínica e Investigación en Arteriosclerosis 2020; 32:27-29. [DOI: 10.1016/j.arteri.2019.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ferri J, Perelló E, Lorente RI, Argente C, Rossetti P, Pedro T, Martinez-Hervas S, Real JT. Study of abnormal adrenal receptors in subjects with ACTH-independent Cushing's syndrome and nodular adrenal hyperplasia. ACTA ACUST UNITED AC 2019; 67:245-252. [PMID: 31672533 DOI: 10.1016/j.endinu.2019.07.005] [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: 04/04/2019] [Revised: 07/06/2019] [Accepted: 07/10/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION ACTH-independent Cushing's Syndrome (AICS) accounts for 15-20% of cases of Cushing's syndrome, with <1% due to abnormal receptors. Our aim is to study the presence of abnormal receptors in subjects diagnosed with AICS with nodular adrenal hyperplasia in a 14-year period (2002-2016), as well as its clinical-biological and evolutive characteristics. MATERIAL AND METHODS A multicentre descriptive study of a 15-case series of AICS with nodular adrenal hyperplasia (study period: 2002-2016). In these cases, abnormal receptor screening was performed by means of stimulation tests, with a plasma cortisol increase of ≥ 25% from baseline being considered pathologic. RESULTS Of the 15 cases, 13 were female, with a mean age at diagnosis of 56.8 years. In 12 of the 15 cases studied, positivity was detected with stimulation tests, and, of them, 25% were positive for the meal test, 58.3% for posture walking test, 33.3% for desmopressin; 25% for terlipressin; 33.3% for GnRH; 25% for LH and 50% for metoclopramide. Regarding treatment, bilateral adrenalectomy was performed in 16.7% and unilateral adrenalectomy in 41.7%. The rest continue under observation with periodic follow-up (41.7%). CONCLUSIONS In most of the cases studied with AICS and nodular adrenal hyperplasia (80%), an abnormal cortisol response is detected due to the presence of abnormal receptors. The test with the highest percentage of positivity was the postural walking test (58.3%).
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Affiliation(s)
- Jordi Ferri
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, España
| | - Eva Perelló
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, España
| | - Rosario I Lorente
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, España
| | - Carlos Argente
- Endocrinología y Nutrición, Hospital Marina Baixa, Villajoyosa (Alicante), España
| | - Paolo Rossetti
- Endocrinología y Nutrición, Hospital de Gandía, Gandía (Valencia), España
| | - Teresa Pedro
- Endocrinología y Nutrición, Hospital de Dénia, Dénia (Alicante)
| | - Sergio Martinez-Hervas
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM).
| | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)
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24
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Collado A, Marques P, Escudero P, Rius C, Domingo E, Martinez-Hervás S, Real JT, Ascaso JF, Piqueras L, Sanz MJ. Functional role of endothelial CXCL16/CXCR6-platelet-leucocyte axis in angiotensin II-associated metabolic disorders. Cardiovasc Res 2019; 114:1764-1775. [PMID: 29800106 DOI: 10.1093/cvr/cvy135] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/18/2018] [Indexed: 12/16/2022] Open
Abstract
Aims Angiotensin-II (Ang-II) is the main effector peptide of the renin-angiotensin system (RAS) and promotes leucocyte adhesion to the stimulated endothelium. Because RAS activation and Ang-II signalling are implicated in metabolic syndrome (MS) and abdominal aortic aneurysm (AAA), we investigated the effect of Ang-II on CXCL16 arterial expression, the underlying mechanisms, and the functional role of the CXCL16/CXCR6 axis in these cardiometabolic disorders. Methods and results Results from in vitro chamber assays revealed that CXCL16 neutralization significantly inhibited mononuclear leucocyte adhesion to arterial but not to venous endothelial cells. Flow cytometry and immunofluorescence studies confirmed that Ang-II induced enhanced endothelial CXCL16 expression, which was dependent on Nox5 up-regulation and subsequent RhoA/p38-MAPK/NFκB activation. Flow cytometry analysis further showed that MS patients had higher levels of platelet activation and a higher percentage of circulating CXCR6-expressing platelets, CXCR6-expressing-platelet-bound neutrophils, monocytes, and CD8+ lymphocytes than age-matched controls, leading to enhanced CXCR6/CXCL16-dependent adhesion to the dysfunctional (Ang-II- and TNFα-stimulated) arterial endothelium. Ang-II-challenged apolipoprotein E-deficient (apoE-/-) mice had a higher incidence of AAA, macrophage, CD3+, and CXCR6+ cell infiltration and neovascularization than unchallenged animals, which was accompanied by greater CCL2, CXCL16, and VEGF mRNA expression within the lesion together with elevated levels of circulating soluble CXCL16. Significant reductions in these parameters were found in animals co-treated with the AT1 receptor antagonist losartan or in apoE-/- mice lacking functional CXCR6 receptor (CXCR6GFP/GFP). Conclusion CXCR6 expression on platelet-bound monocytes and CD8+ lymphocytes may constitute a new membrane-associated biomarker for adverse cardiovascular events. Moreover, pharmacological modulation of this axis may positively affect cardiovascular outcome in metabolic disorders linked to Ang-II.
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Affiliation(s)
- Aida Collado
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Patrice Marques
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Paula Escudero
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Cristina Rius
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Elena Domingo
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Sergio Martinez-Hervás
- Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain.,Department of Medicine, Faculty of Medicine, Endocrinology and Nutrition Unit, University Clinic Hospital of Valencia, University of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Spain
| | - José T Real
- Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain.,Department of Medicine, Faculty of Medicine, Endocrinology and Nutrition Unit, University Clinic Hospital of Valencia, University of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Spain
| | - Juan F Ascaso
- Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain.,Department of Medicine, Faculty of Medicine, Endocrinology and Nutrition Unit, University Clinic Hospital of Valencia, University of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Spain
| | - Laura Piqueras
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Maria-Jesus Sanz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
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25
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Ortega R, Collado A, Selles F, Gonzalez-Navarro H, Sanz MJ, Real JT, Piqueras L. SGLT-2 (Sodium-Glucose Cotransporter 2) Inhibition Reduces Ang II (Angiotensin II)-Induced Dissecting Abdominal Aortic Aneurysm in ApoE (Apolipoprotein E) Knockout Mice. Arterioscler Thromb Vasc Biol 2019; 39:1614-1628. [PMID: 31294626 DOI: 10.1161/atvbaha.119.312659] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [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: 12/12/2022]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) is a pathological condition of permanent vessel dilatation that predisposes to the potentially fatal consequence of aortic rupture. SGLT-2 (sodium-glucose cotransporter 2) inhibitors have emerged as powerful pharmacological tools for type 2 diabetes mellitus treatment. Beyond their glucose-lowering effects, recent studies have shown that SGLT-2 inhibitors reduce cardiovascular events and have beneficial effects on several vascular diseases such as atherosclerosis; however, the potential effects of SGLT-2 inhibition on AAA remain unknown. This study evaluates the effect of oral chronic treatment with empagliflozin-an SGLT-2 inhibitor-on dissecting AAA induced by Ang II (angiotensin II) infusion in apoE (apolipoprotein E)-/- mice. Approach and Results: Empagliflozin treatment significantly reduced the Ang II-induced increase in maximal suprarenal aortic diameter in apoE-/- mice independently of blood pressure effects. Immunohistochemistry analysis revealed that empagliflozin diminished Ang II-induced elastin degradation, neovessel formation, and macrophage infiltration at the AAA lesion. Furthermore, Ang II infusion resulted in a marked increase in the expression of chemokines (CCL-2 [chemokine (C-C motif) ligand 2] and CCL-5 [chemokine (C-C motif) ligand 5]), VEGF (vascular endothelial growth factor), and MMP (matrix metalloproteinase)-2 and MMP-9 in suprarenal aortic walls of apoE-/- mice, and all were reduced by empagliflozin cotreatment. Western blot analysis revealed that p38 MAPK (p38 mitogen-activated protein kinase) and NF-κB (nuclear factor-κB) activation was also reduced in the suprarenal aortas of apoE-/- mice cotreated with empagliflozin. Finally, in vitro studies in human aortic endothelial cells and macrophages showed that empagliflozin inhibited leukocyte-endothelial cell interactions and release of proinflammatory chemokines. CONCLUSIONS Pharmacological inhibition of SGLT-2 by empagliflozin inhibits AAA formation. SGLT-2 inhibition might represent a novel promising therapeutic strategy to prevent AAA progression.
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Affiliation(s)
- Rebeca Ortega
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.)
| | - Aida Collado
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.)
| | - Francisca Selles
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.)
| | - Herminia Gonzalez-Navarro
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
| | - Maria-Jesus Sanz
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,Department of Pharmacology, Faculty of Medicine, University of Valencia, Spain (M.J.S., L.P.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
| | - José T Real
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Spain (J.T.R.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
| | - Laura Piqueras
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,Department of Pharmacology, Faculty of Medicine, University of Valencia, Spain (M.J.S., L.P.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
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Marques P, Collado A, Martinez-Hervás S, Domingo E, Benito E, Piqueras L, Real JT, Ascaso JF, Sanz MJ. Systemic Inflammation in Metabolic Syndrome: Increased Platelet and Leukocyte Activation, and Key Role of CX 3CL1/CX 3CR1 and CCL2/CCR2 Axes in Arterial Platelet-Proinflammatory Monocyte Adhesion. J Clin Med 2019; 8:jcm8050708. [PMID: 31109070 PMCID: PMC6572270 DOI: 10.3390/jcm8050708] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 04/15/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Metabolic syndrome is associated with low-grade systemic inflammation, which is a key driver of premature atherosclerosis. We characterized immune cell behavior in metabolic syndrome, its consequences, and the potential involvement of the CX3CL1/CX3CR1 and CCL2/CCR2 chemokine axes. METHODS Whole blood from 18 patients with metabolic syndrome and 21 age-matched controls was analyzed by flow cytometry to determine the leukocyte immunophenotypes, activation, platelet-leukocyte aggregates, and CX3CR1 expression. ELISA determined the plasma marker levels. Platelet-leukocyte aggregates adhesion to tumor necrosis factor-α (TNFα)-stimulated arterial endothelium and the role of CX3CL1/CX3CR1 and CCL2/CCR2 axes was investigated with the parallel-plate flow chamber. RESULTS When compared with the controls, the metabolic syndrome patients presented greater percentages of eosinophils, CD3+ T lymphocytes, Mon2/Mon3 monocytes, platelet-eosinophil and -lymphocyte aggregates, activated platelets, neutrophils, eosinophils, monocytes, and CD8+ T cells, but lower percentages of Mon1 monocytes. Patients had increased circulating interleukin-8 (IL-8) and TNFα levels and decreased IL-4. CX3CR1 up-regulation in platelet-Mon1 monocyte aggregates in metabolic syndrome patients led to increased CX3CR1/CCR2-dependent platelet-Mon1 monocyte adhesion to dysfunctional arterial endothelium. CONCLUSION We provide evidence of generalized immune activation in metabolic syndrome. Additionally, CX3CL1/CX3CR1 or CCL2/CCR2 axes are potential candidates for therapeutic intervention in cardiovascular disorders in metabolic syndrome patients, as their blockade impairs the augmented arterial platelet-Mon1 monocyte aggregate adhesiveness, which is a key event in atherogenesis.
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Affiliation(s)
- Patrice Marques
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
| | - Aida Collado
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
| | - Sergio Martinez-Hervás
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Elena Domingo
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
| | - Esther Benito
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Laura Piqueras
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - José T Real
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Juan F Ascaso
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Maria-Jesus Sanz
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
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Hueso L, Ortega R, Selles F, Wu-Xiong NY, Ortega J, Civera M, Ascaso JF, Sanz MJ, Real JT, Piqueras L. Upregulation of angiostatic chemokines IP-10/CXCL10 and I-TAC/CXCL11 in human obesity and their implication for adipose tissue angiogenesis. Int J Obes (Lond) 2018; 42:1406-1417. [PMID: 29795466 DOI: 10.1038/s41366-018-0102-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS Impaired angiogenesis is linked to adipose tissue (AT) dysfunction, inflammation, and insulin resistance in human obesity. Chemokine (C-X-C motif) receptor. (CXCR3) ligands are important regulators of angiogenesis in different disease contexts such as cancer; however, their role in human morbid obesity is unknown. We investigated the role of the CXCR3 axis in AT angiogenesis in morbidly obese patients. SUBJECTS/METHODS The study group comprised 50 morbidly obese patients (mean age 44 ± 1 years, body mass index 44 ± 1 kg/m2) who had undergone laparoscopic Roux-Y-gastric bypass surgery, and 25 age-matched non-obese control subjects. We measured the circulating levels of the CXCR3 ligands monokine induced by interferon-γ (MIG/CXCL9), interferon-γ inducible protein 10 (IP-10/CXCL10), and interferon-γ-inducible T-cell alpha chemoattractant (I-TAC/CXCL11) in all studied subjects. Additionally, the expression of CXCR3 ligands was analyzed in paired biopsies of subcutaneous and visceral AT obtained during the laparoscopic procedure in morbidly obese patients. Additionally, we explored the functional role of CXCR3 ligands on angiogenesis in AT from morbidly obese patients using an ex vivo assay. RESULTS Plasma levels of CXCL10 and CXCL11 were significantly higher in morbidly obese patients than in controls (p < 0.01). In ex vivo assays, angiogenic growth was markedly lower in visceral AT than in subcutaneous AT (p < 0.05), which was related to significant tissue upregulation of CXCL10, CXCL11 and CXCR3 (p < 0.05). CXCL10 or CXCL11 inhibited AT angiogenesis (p < 0.05), and blockade of CXCR3 function significantly increased capillary sprouting in visceral fat deposits (p < 0.05). Western blot analysis showed that the p38 mitogen-activated protein kinase signaling pathway was implicated in the angiostatic effects of CXCR3 in AT. CONCLUSIONS CXCL10 and CXCL11 may play. deleterious role in obesity as potential inhibitors of AT angiogenesis. Accordingly, pharmacological blockade of CXCR3 could represent. therapy to prevent AT dysfunction in obesity.
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Affiliation(s)
- Luisa Hueso
- Institute of Health Research-INCLIVA, Valencia, Spain
| | - Rebeca Ortega
- Institute of Health Research-INCLIVA, Valencia, Spain.,Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | | | - Ning Yun Wu-Xiong
- Institute of Health Research-INCLIVA, Valencia, Spain.,Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain
| | - Joaquin Ortega
- Surgery Service, University Clinic Hospital of Valencia, Valencia, Spain.,Department of Surgery, University of Valencia, Valencia, Spain
| | - Miguel Civera
- Institute of Health Research-INCLIVA, Valencia, Spain.,Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain
| | - Juan F Ascaso
- Institute of Health Research-INCLIVA, Valencia, Spain.,Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain
| | - Maria-Jesus Sanz
- Institute of Health Research-INCLIVA, Valencia, Spain.,Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - José T Real
- Institute of Health Research-INCLIVA, Valencia, Spain. .,Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain. .,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research- ISCIII, Madrid, Spain.
| | - Laura Piqueras
- Institute of Health Research-INCLIVA, Valencia, Spain. .,Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.
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28
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Sánchez-Hernández RM, Prieto-Matos P, Civeira F, Lafuente EE, Vargas MF, Real JT, Goicoechea FG, Fuentes FJ, Pocovi M, Boronat M, Wägner AM, Masana L. Autosomal recessive hypercholesterolemia in Spain. Atherosclerosis 2018; 269:1-5. [PMID: 29245109 DOI: 10.1016/j.atherosclerosis.2017.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/21/2017] [Accepted: 12/05/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Autosomal recessive hypercholesterolemia (ARH) is a very rare disease, caused by mutations in LDL protein receptor adaptor 1 (LDLRAP1). It is characterized by high levels of low-density lipoprotein cholesterol (LDL-C) and increased risk of premature cardiovascular disease. We aimed to characterize ARH in Spain. METHODS Data were collected from the Dyslipidemia Registry of the Spanish Atherosclerosis Society. A literature search was performed up to June 2017, and all diagnostic genetic studies for familial hypercholesterolemia of Spain were reviewed. RESULTS Seven patients with ARH were identified, 6 true homozygous and one compound heterozygous with a novel mutation: c.[863C>T];p.[Ser288Leu]. High genetic heterogeneity was found in this cohort. True homozygous subjects for LDLRAP1 have more severe phenotypes than the compound heterozygous patient, but similar to patients with homozygous familial hypercholesterolemia (HoFH). Cardiovascular disease was present in 14% of the ARH patients. LDL-C under treatment was above 185 mg/dl and the response to PCSK9 inhibitors was heterogeneous. Finally, the estimated prevalence in Spain is very low, with just 1 case per 6.5 million people. CONCLUSIONS ARH is a very rare disease in Spain, showing high genetic heterogeneity, similarly high LDL-C concentrations, but lower incidence of ASCVD than HoFH.
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Affiliation(s)
- Rosa María Sánchez-Hernández
- Sección de Endocrinología y Nutrición, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS) de la Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - Pablo Prieto-Matos
- Unidad de Endocrinología Pediátrica, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Spain
| | - Fernando Civeira
- Unidad Clínica y de Investigación en Lípidos y Arterioesclerosis, Hospital Universitario Miguel Servet, IIS Aragón, Centro de Investigación Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Universidad de Zaragoza, Zaragoza, Spain
| | - Eduardo Esteve Lafuente
- Servicio Endocrinología y Nutrición, Hospital Universitari de Girona Dr. Josep Trueta, Spain
| | | | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico Valencia, Departamento de Medicina, Universidad de Valencia, INCLIVA, Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Spain
| | | | - Francisco J Fuentes
- Hospital Universitario Reina Sofía, Universidad de Córdoba, Centro de Investigación Biomédica en Red de Fisiopatolgía de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Instituto Maimónedes de Investigación Biomédica de Córdoba (IMIBIC), Spain
| | - Miguel Pocovi
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, IIS Aragón, CIBERCV, Zaragoza, Spain
| | - Mauro Boronat
- Sección de Endocrinología y Nutrición, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS) de la Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ana María Wägner
- Sección de Endocrinología y Nutrición, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS) de la Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Luis Masana
- Unidad de Medicina Vascular y Metabolica, Unidad de Investigación en Lipidos y Arterioesclerosis, Hospital Universitario "Sant Joan", Universitat Rovira i Virgili, IISPV, CIBERDEM, Reus, Madrid, Spain
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29
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Vinué Á, Navarro J, Herrero-Cervera A, García-Cubas M, Andrés-Blasco I, Martínez-Hervás S, Real JT, Ascaso JF, González-Navarro H. The GLP-1 analogue lixisenatide decreases atherosclerosis in insulin-resistant mice by modulating macrophage phenotype. Diabetologia 2017; 60:1801-1812. [PMID: 28608285 DOI: 10.1007/s00125-017-4330-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/10/2017] [Indexed: 12/27/2022]
Abstract
AIMS/HYPOTHESIS Recent clinical studies indicate that glucagon-like peptide-1 (GLP-1) analogues prevent acute cardiovascular events in type 2 diabetes mellitus but their mechanisms remain unknown. In the present study, the impact of GLP-1 analogues and their potential underlying molecular mechanisms in insulin resistance and atherosclerosis are investigated. METHODS Atherosclerosis development was evaluated in Apoe -/- Irs2 +/- mice, a mouse model of insulin resistance, the metabolic syndrome and atherosclerosis, treated with the GLP-1 analogues lixisenatide or liraglutide. In addition, studies in Apoe -/- Irs2 +/- mice and mouse-derived macrophages treated with lixisenatide were performed to investigate the potential inflammatory intracellular pathways. RESULTS Treatment of Apoe -/- Irs2 +/- mice with either lixisenatide or liraglutide improved glucose metabolism and blood pressure but this was independent of body weight loss. Both drugs significantly decreased atheroma plaque size. Compared with vehicle-treated control mice, lixisenatide treatment generated more stable atheromas, with fewer inflammatory infiltrates, reduced necrotic cores and thicker fibrous caps. Lixisenatide-treated mice also displayed diminished IL-6 levels, proinflammatory Ly6Chigh monocytes and activated T cells. In vitro analysis showed that, in macrophages from Apoe -/- Irs2 +/- mice, lixisenatide reduced the secretion of the proinflammatory cytokine IL-6 accompanied by enhanced activation of signal transducer and activator of transcription (STAT) 3, which is a determinant for M2 macrophage differentiation. STAT1 activation, which is essential for M1 phenotype, was also diminished. Furthermore, atheromas from lixisenatide-treated mice showed higher arginase I content and decreased expression of inducible nitric oxide synthase, indicating the prevalence of the M2 phenotype within plaques. CONCLUSIONS/INTERPRETATION Lixisenatide decreases atheroma plaque size and instability in Apoe -/- Irs2 +/- mice by reprogramming macrophages towards an M2 phenotype, which leads to reduced inflammation. This study identifies a critical role for this drug in macrophage polarisation inside plaques and provides experimental evidence supporting a novel mechanism of action for GLP-1 analogues in the reduction of cardiovascular risk associated with insulin resistance.
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Affiliation(s)
- Ángela Vinué
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain
| | - Jorge Navarro
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain
- Clinic Hospital and Department of Medicine, University of Valencia, Institute of Health Research-INCLIVA, Valencia, Spain
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
| | | | - Marta García-Cubas
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain
| | - Irene Andrés-Blasco
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain
| | - Sergio Martínez-Hervás
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain
- Endocrinology and Nutrition Department, Clinic Hospital and Department of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - José T Real
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain
- Endocrinology and Nutrition Department, Clinic Hospital and Department of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Juan F Ascaso
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain
- Endocrinology and Nutrition Department, Clinic Hospital and Department of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Herminia González-Navarro
- Institute of Health Research-INCLIVA, Avda Menéndez Pelayo 4, 46010, Valencia, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.
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30
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Carratala A, Martinez-Hervas S, Rodriguez-Borja E, Benito E, Real JT, Saez GT, Carmena R, Ascaso JF. PAI-1 levels are related to insulin resistance and carotid atherosclerosis in subjects with familial combined hyperlipidemia. J Investig Med 2017; 66:17-21. [PMID: 28822973 DOI: 10.1136/jim-2017-000468] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2017] [Indexed: 01/13/2023]
Abstract
Familial combined hyperlipidemia (FCH) is a primary atherogenic dyslipidemia with insulin resistance and increased cardiovascular risk. Plasminogen activator inhibitor type 1 (PAI-1) and myeloperoxidase (MPO) activity are associated with proinflammatory and atherothrombotic risk. Our aim was to study the role played by PAI-1 and MPO activity in the carotid atherosclerosis prevalence in FCH subjects. 36 FCH unrelated subjects (17 women) were matched by age and body weight with 36 healthy normolipidemic subjects (19 female). Blood lipids, glucose, insulin, insulin resistance (homeostasis model assessment (HOMA)), MPO, and PAI-1 were determined in both groups. Carotid intima media thickness (IMT) was measured by the same investigator by standardized protocol. No differences in age, body mass index (BMI) or waist circumference were observed between the two groups. HOMA and PAI-1 values were higher in the FCH group, reaching statistical significance in those subjects with insulin resistance. In addition, PAI-1 values correlated significantly with metabolic syndrome components and carotid IMT. It is known that the elevated cardiovascular risk that characterizes FCH is frequently associated with insulin resistance. We have detected that two known proinflammatory and proatherothrombotic factors (MPO and PAI-1) are significantly elevated in FCH subjects with insulin resistance. These results could partly explain the high cardiovascular risk present in FCH subjects.
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Affiliation(s)
- Arturo Carratala
- Service of Clinical Biochemistry and Molecular Biology, University Clinical Hospital of Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, University Clinical Hospital of Valencia, INCLIVA, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Enrique Rodriguez-Borja
- Service of Clinical Biochemistry and Molecular Biology, University Clinical Hospital of Valencia, Valencia, Spain
| | - Esther Benito
- Department of Medicine, University of Valencia, Valencia, Spain
| | - José T Real
- Service of Endocrinology and Nutrition, University Clinical Hospital of Valencia, INCLIVA, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Guillermo T Saez
- Department of Biochemistry and Molecular Biology, University of Valencia, INCLIVA, Valencia, Spain.,Service of Clinical Analysis, Dr Peset University Hospital, Valencia, Spain
| | - Rafael Carmena
- Service of Endocrinology and Nutrition, University Clinical Hospital of Valencia, INCLIVA, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Juan F Ascaso
- Service of Endocrinology and Nutrition, University Clinical Hospital of Valencia, INCLIVA, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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31
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Waqas SFH, Hoang AC, Lin YT, Ampem G, Azegrouz H, Balogh L, Thuróczy J, Chen JC, Gerling IC, Nam S, Lim JS, Martinez-Ibañez J, Real JT, Paschke S, Quillet R, Ayachi S, Simonin F, Schneider EM, Brinkman JA, Lamming DW, Seroogy CM, Röszer T. Neuropeptide FF increases M2 activation and self-renewal of adipose tissue macrophages. J Clin Invest 2017; 127:3559. [PMID: 28758905 DOI: 10.1172/jci95841] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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32
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Waqas SFH, Hoang AC, Lin YT, Ampem G, Azegrouz H, Balogh L, Thuróczy J, Chen JC, Gerling IC, Nam S, Lim JS, Martinez-Ibañez J, Real JT, Paschke S, Quillet R, Ayachi S, Simonin F, Schneider EM, Brinkman JA, Lamming DW, Seroogy CM, Röszer T. Neuropeptide FF increases M2 activation and self-renewal of adipose tissue macrophages. J Clin Invest 2017; 127:2842-2854. [PMID: 28581443 DOI: 10.1172/jci90152] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 04/06/2017] [Indexed: 12/30/2022] Open
Abstract
The quantity and activation state of adipose tissue macrophages (ATMs) impact the development of obesity-induced metabolic diseases. Appetite-controlling hormones play key roles in obesity; however, our understanding of their effects on ATMs is limited. Here, we have shown that human and mouse ATMs express NPFFR2, a receptor for the appetite-reducing neuropeptide FF (NPFF), and that NPFFR2 expression is upregulated by IL-4, an M2-polarizing cytokine. Plasma levels of NPFF decreased in obese patients and high-fat diet-fed mice and increased following caloric restriction. NPFF promoted M2 activation and increased the proliferation of murine and human ATMs. Both M2 activation and increased ATM proliferation were abolished in NPFFR2-deficient ATMs. Mechanistically, the effects of NPFF involved the suppression of E3 ubiquitin ligase RNF128 expression, resulting in enhanced stability of phosphorylated STAT6 and increased transcription of the M2 macrophage-associated genes IL-4 receptor α (Il4ra), arginase 1 (Arg1), IL-10 (Il10), and alkylglycerol monooxygenase (Agmo). NPFF induced ATM proliferation concomitantly with the increase in N-Myc downstream-regulated gene 2 (Ndrg2) expression and suppressed the transcription of Ifi200 cell-cycle inhibitor family members and MAF bZIP transcription factor B (Mafb), a negative regulator of macrophage proliferation. NPFF thus plays an important role in supporting healthy adipose tissue via the maintenance of metabolically beneficial ATMs.
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Affiliation(s)
| | - Anh Cuong Hoang
- Institute of Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany
| | - Ya-Tin Lin
- Department of Physiology and Pharmacology and Graduate Institute of Biomedical Sciences, Chang Gung University; Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Grace Ampem
- Institute of Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany
| | - Hind Azegrouz
- Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Lajos Balogh
- National Research Institute for Radiobiology and Radiohygiene, Budapest, Hungary
| | | | - Jin-Chung Chen
- Department of Physiology and Pharmacology and Graduate Institute of Biomedical Sciences, Chang Gung University; Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ivan C Gerling
- Department of Medicine, University of Tennessee, Memphis, Tennessee, USA
| | - Sorim Nam
- Department of Biological Science, Sookmyung Women's University, Seoul, South Korea
| | - Jong-Seok Lim
- Department of Biological Science, Sookmyung Women's University, Seoul, South Korea
| | - Juncal Martinez-Ibañez
- Department of Medicine, Hospital Clínico Universitario de València, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Valencia, Spain
| | - José T Real
- Department of Medicine, Hospital Clínico Universitario de València, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Valencia, Spain
| | - Stephan Paschke
- Department of General and Visceral Surgery, University Hospital Ulm, Ulm, Germany
| | - Raphaëlle Quillet
- Biotechnologie et Signalisation Cellulaire, UMR 7242, Centre National de Recherche Scientifique (CNRS), Université de Strasbourg, Illkirch, France
| | - Safia Ayachi
- Biotechnologie et Signalisation Cellulaire, UMR 7242, Centre National de Recherche Scientifique (CNRS), Université de Strasbourg, Illkirch, France
| | - Frédéric Simonin
- Biotechnologie et Signalisation Cellulaire, UMR 7242, Centre National de Recherche Scientifique (CNRS), Université de Strasbourg, Illkirch, France
| | - E Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Jacqueline A Brinkman
- University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, USA.,William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Dudley W Lamming
- University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, USA.,William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Christine M Seroogy
- University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Tamás Röszer
- Institute of Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany
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33
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Cortes R, Ivorra C, Martínez-Hervás S, Pedro T, González-Albert V, Artero A, Adam V, García-García AB, Ascaso JF, Real JT, Chaves FJ. Postprandial Changes in Chemokines Related to Early Atherosclerotic Processes in Familial Hypercholesterolemic Subjects: A Preliminary Study. Arch Med Res 2016; 47:33-9. [DOI: 10.1016/j.arcmed.2016.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 01/13/2016] [Indexed: 12/01/2022]
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34
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Masana L, Cabré A, Heras M, Amigó N, Correig X, Martínez-Hervás S, Real JT, Ascaso JF, Quesada H, Julve J, Palomer X, Vázquez-Carrera M, Girona J, Plana N, Blanco-Vaca F. Remarkable quantitative and qualitative differences in HDL after niacin or fenofibrate therapy in type 2 diabetic patients. Atherosclerosis 2014; 238:213-9. [PMID: 25528430 DOI: 10.1016/j.atherosclerosis.2014.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 12/01/2014] [Accepted: 12/04/2014] [Indexed: 11/19/2022]
Abstract
HDL-increasing drugs such as fenofibrate and niacin have failed to decrease the cardiovascular risk in patients with type 2 diabetes. Drug-mediated quantitative and qualitative HDL modifications could be involved in these negative results. To evaluate the quantitative and qualitative effects of niacin and fenofibrate on HDL in patients with type 2 diabetes, a prospective, randomised controlled intervention trial was conducted. Thirty type 2 diabetic patients with low HDL were randomised to receive either fenofibrate (FFB) or niacin + laropiprant (ERN/LPR) as an add-on to simvastatin treatment for 12 weeks according to a crossover design. At the basal point and after each intervention period, physical examinations and comprehensive standard biochemical determinations and HDL metabolomics were performed. Thirty nondiabetic patients with normal HDL were used as a basal control group. ERN/LRP, but not FFB, significantly increased HDL cholesterol. Neither ERN/LRP nor FFB reversed the HDL particle size or particle number to normal. ERN/LRP increased apoA-I but not apoA-II, whereas FFB produced the opposite effect. FFB significantly increased Preβ1-HDL, whereas ERN/LRP tended to lower Preβ1-HDL. CETP and LCAT activities were significantly decreased only by ERN/LRP. PAF-AH activity in HDL and plasma decreased with the use of both agents. Despite their different actions on antioxidant parameters, none of the treatments induced detectable antioxidant improvements. ERN/LRP and FFB had strikingly different effects on HDL quantity and quality, as well as on HDL cholesterol concentrations. When prescribing HDL cholesterol increasing drugs, this differential action should be considered.
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Affiliation(s)
- Luís Masana
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, "Sant Joan" University Hospital, Universitat Rovira i Virgili, IISPV, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Reus, Spain.
| | - Anna Cabré
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, "Sant Joan" University Hospital, Universitat Rovira i Virgili, IISPV, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Reus, Spain
| | - Mercedes Heras
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, "Sant Joan" University Hospital, Universitat Rovira i Virgili, IISPV, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Reus, Spain
| | - Núria Amigó
- Metabolomics Platform and Center for Omic Sciences, Universitat Rovira i Virgili, IISPV, CIBERDEM, Reus, Spain
| | - Xavier Correig
- Metabolomics Platform and Center for Omic Sciences, Universitat Rovira i Virgili, IISPV, CIBERDEM, Reus, Spain
| | - Sergio Martínez-Hervás
- Endocrinology and Nutrition Department, Hospital Clinico Universitario, CIBERDEM, INCLIVA, Department of Medicine, University of Valencia, Valencia, Spain
| | - José T Real
- Endocrinology and Nutrition Department, Hospital Clinico Universitario, CIBERDEM, INCLIVA, Department of Medicine, University of Valencia, Valencia, Spain
| | - Juan F Ascaso
- Endocrinology and Nutrition Department, Hospital Clinico Universitario, CIBERDEM, INCLIVA, Department of Medicine, University of Valencia, Valencia, Spain
| | - Helena Quesada
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), CIBERDEM, Barcelona, Spain
| | - Josep Julve
- Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), CIBERDEM, Barcelona, Spain
| | - Xavier Palomer
- Department of Pharmacology and Therapeutic Chemistry, Institut de Biomedicina de la Universitat de Barcelona (IBUB) and CIBERDEM, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - Manuel Vázquez-Carrera
- Department of Pharmacology and Therapeutic Chemistry, Institut de Biomedicina de la Universitat de Barcelona (IBUB) and CIBERDEM, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - Josefa Girona
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, "Sant Joan" University Hospital, Universitat Rovira i Virgili, IISPV, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Reus, Spain
| | - Núria Plana
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, "Sant Joan" University Hospital, Universitat Rovira i Virgili, IISPV, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Reus, Spain
| | - Francisco Blanco-Vaca
- Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), CIBERDEM, Barcelona, Spain
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35
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Molina M, Gonzalez R, Folgado J, Real JT, Martínez-Hervás S, Priego A, Lorente R, Chaves FJ, Ascaso JF. [Correlation between plasma concentrations of homocysteine and diabetic polyneuropathy evaluated with the Semmes-Weinstein monofilament test in patients with type 2 diabetes mellitus]. Med Clin (Barc) 2013; 141:382-6. [PMID: 23332627 DOI: 10.1016/j.medcli.2012.09.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 08/02/2012] [Accepted: 09/06/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Few modifiable risk factors are known to be associated with the presence and progression of diabetic polyneuropathy (DPN). MATERIAL AND METHOD We have analyzed in 405 type 2 diabetic (T2DM) subjects (169 women) the association of plasma homocysteine with the presence of DPN measured with the Semmes-Weinstein (SW) monofilament test. A score below 4 was considered an altered SW monofilament test. Plasma homocysteine, vitamin B12 and folic acid were measured using standard procedures (ELISA). RESULTS Patients with T2DM with altered SW test have significantly higher age, evolution of disease, HbA1c and lower creatinine clearance values. In addition, plasma homocysteine values were independently and significantly higher in T2DM with DPN measured as altered SW test (13.64 ± 4.93 vs. 12.22 ± 4.48 μmol/l, P<.01) with similar vitamin B12 and folic acid values comparing the 2 groups. CONCLUSION Plasma homocysteine and HbA1c values are the 2 modifiable biological factors associated with the presence of DPN evaluated as an altered SW monofilament test in T2DM subjects.
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Affiliation(s)
- Mercedes Molina
- Servicio de Endocrinología, Hospital Clínico Universitario, Valencia, España
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36
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Martinez-Hervas S, Real JT, Priego MA, Carratalá A, Sniderman AD, Carmena R, Ascaso JF. Establishing cut-off values for apolipoprotein B and non-HDL-C according to LDL-C values in a South European population. Int J Clin Pract 2013; 67:81-8. [PMID: 23241052 DOI: 10.1111/j.1742-1241.2012.02998.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Low-density lipoprotein cholesterol (LDL-C) remains the primary target of therapy in most strategies of dyslipidaemia management focused on cardiovascular disease prevention. Different guidelines have identified specific LDL-C cut-off points as targets for therapeutic intervention. Many clinical situations characterised by dyslipidaemia and elevated triglycerides are common in our environment and in overall industrialised countries. Thus, lipid goals based only on LDL-C could misclassify an important percentage of subjects. The objective of the present study was to establish cut-off point values for apoB and non-HDL-C in relation to the identified LDL-C cut-off points for cardiovascular risk in a South European population. METHODS We performed a cross-sectional study including 1501 subjects (770 women and 731 men) between 18 and 80 years of age. Samples were collected after 12-14 h of fasting. Cholesterol, HDL-C, triglycerides and apoB levels were measured using direct methods. LDL-C was calculated by the Friedewald formula. Non-HDL-C was calculated as total cholesterol minus HDL-C. RESULTS The Spearman's rank correlations between apoB and LDL-C (r 0.86, p < 0.0001), and between apoB and non-HDL-C (r 0.91, p < 0.0001) were both significant. The proposed cut-off points for apoB, according to LDL-C goals (70, 100, 130 and 160 mg/dl) in our population are 70, 80, 100 and 115 mg/dl respectively. The proposed cut-off values for non-HDL-C are 100, 120, 150 and 190 mg/dl respectively. CONCLUSION The established LDL-C cut-off values could not be accurate to estimate cardiovascular risk in subjects with mild hypertriglyceridaemia, as frequently occurs in our Mediterranean population. To take into consideration the burden of atherogenic particles and better classify patients at risk we propose cut-off values for apoB or the equivalent for non-HDL-C. Prospective trials including cardiovascular variables are needed to validate our assumption.
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Affiliation(s)
- S Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario, Valencia, Spain CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona,
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Martínez-Hervás S, Priego A, Lorente R, Molina M, Navarro-Hidalgo MI, Real JT, Ascaso JF. [Subclinical carotid atherosclerosis in patients with familial combined hyperlipidemia. Two years follow-up after treatment with high doses of atorvastatin]. Med Clin (Barc) 2011; 138:1-6. [PMID: 21429534 DOI: 10.1016/j.medcli.2010.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 12/08/2010] [Accepted: 12/09/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Familial combined hyperlipidemia (FCH) is a genetic model of atherogenic dyslipidemia with insulin resistance and early coronary disease. Our objective was to evaluate the presence of carotid alterations as a marker of systemic atherosclerosis in subjects with FCH and assess the effect of 80 mg of atorvastatin per day in carotid plaque thickness after 2 years. SUBJECTS AND METHODS 100 non diabetic subjects with FCH in primary prevention were consecutively included. Clinical and biochemical parameters and carotid ultrasonography were performed. Subjects with carotid plaque started treatment with 80 mg of atorvastatin per day for 2 years. RESULTS 29% of subjects had carotid plaques. We did not find significant differences in any of the parameters between subjects with presence or absence of carotid plaques. Twenty subjects with carotid plaques accepted/agreed to participate in the interventional study. Two years follow-up showed a significant reduction in LDLc (30%) and carotid plaque thickness (10%). CONCLUSION Carotid ultrasonography is useful to detect subclinical atherosclerosis in high risk cardiovascular patients such as subjects with FCH. Treatment with high doses of atorvastatin induces the regression of carotid plaque thickness after 2 years follow-up. Our results suggest that intensive treatment with atorvastatin could be useful to reduce the development of cardiovascular disease in this group of patients.
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Affiliation(s)
- Sergio Martínez-Hervás
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Departamento de Medicina, Universidad de Valencia, Valencia, España.
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Navarro I, Molina M, Civera M, Ascaso JF, Real JT, Carmena R. [Catecholamine-induced cardiomyopathy triggered by pheochromocytoma]. ACTA ACUST UNITED AC 2011; 58:204-6. [PMID: 21393076 DOI: 10.1016/j.endonu.2010.11.005] [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] [Received: 10/05/2010] [Revised: 11/21/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022]
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Martinez-Hervas S, Real JT, Ivorra C, Priego A, Chaves FJ, Pallardo FV, Viña JR, Redon J, Carmena R, Ascaso JF. Increased plasma xanthine oxidase activity is related to nuclear factor kappa beta activation and inflammatory markers in familial combined hyperlipidemia. Nutr Metab Cardiovasc Dis 2010; 20:734-739. [PMID: 19765958 DOI: 10.1016/j.numecd.2009.06.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 05/15/2009] [Accepted: 06/02/2009] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIMS Xanthine oxidase (XO) has been described as one of the major enzymes producing free radicals in blood. Oxidative stress and inflammatory processes have been implicated in the pathogenesis of endothelial dysfunction and the progression of atherosclerosis but until now, there is little data about the influence of vascular prooxidant systems and inflammation in familial combined hyperlipidemia (FCH). Our goal was to evaluate whether XO activity was altered in FCH and if it was related to the inflammatory process represented by NFkB, IL-6 and hsCRP, and assessing the correlation between XO activity and insulin resistance (IR). METHOD AND RESULTS 40 Non-related subjects with FCH and 30 control subjects were included, all of them non-diabetic, normotensive and non-smokers. We measured lipid profile, glucose, insulin, uric acid, XO activity, malondialdehyde (MDA), IL-6 and hsCRP in plasma and NFkB activity in circulating mononuclear cells. Patients with FCH showed significantly higher levels of uric acid, XO activity, MDA, NFkB activity, IL-6 and hsCRP than controls. XO activity was independently related to NFkB activity with an odds ratio of 4.082; to IL-6 with an odds ratio of 4.191; and to IR with an odds ratio of 3.830. Furthermore, mean NFkB activity, IL-6 levels, and IR were highest in the highest percentile of XO activity. CONCLUSIONS Subjects with FCH showed increased XO and NFkB activities and low grade inflammatory markers related to atherosclerosis. XO activity was correlated with higher inflammatory activity and IR. These data could explain, in part, the high cardiovascular disease risk present in these patients.
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Affiliation(s)
- S Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario, Department of Medicine, University of Valencia, Valencia, Spain
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Real JT, Martínez-Hervás S, García-García AB, Civera M, Pallardó FV, Ascaso JF, Viña JR, Chaves FJ, Carmena R. Circulating mononuclear cells nuclear factor-kappa B activity, plasma xanthine oxidase, and low grade inflammatory markers in adult patients with familial hypercholesterolaemia. Eur J Clin Invest 2010; 40:89-94. [PMID: 20015244 DOI: 10.1111/j.1365-2362.2009.02218.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Few data are available on circulating mononuclear cells nuclear factor-kappa B (NF-kB) activity and plasma xanthine oxidase (XO) activity in heterozygous familial hypercholesterolaemia (FH). The goal of the study was to analyse circulating mononuclear cells NF-kB and plasma XO activities in FH patients. MATERIALS AND METHODS Thirty FH index patients and 30 normoglycaemic normocholesterolaemic controls matched by age, gender, body mass index, abdominal circumference and homeostasis model assessment index were studied. Plasma XO and inflammatory markers were measured by standard methods. NF-kB was assayed in circulating mononuclear cells. RESULTS Familial hypercholesterolaemia patients showed a significantly higher NF-kB (75.0 +/- 20.7 vs. 42.7 +/- 16.8 relative luminiscence units) and XO (0.44 +/- 0.13 vs. 0.32 +/- 0.09 mU mL(-1)) activities than controls. In addition, interleukin-1, interleukin-6, high sensitivity C reactive protein (hsCRP) and oxidized LDL (LDL-ox) were also significantly higher in FH patients. In the total group (FH and controls), XO was significantly associated with LDL-cholesterol (LDL-C), apolipoprotein B (apoB), NF-kB and hsCPR, and NF-kB activity was significantly associated with XO, hsCPR, LDL-ox, LDL-C and apoB plasma values. Using multiple regression analysis, XO was independently associated with hsCPR and NF-kB, and NF-kB activity in circulating mononuclear cells was independently associated with apoB and LDL-ox plasma values. CONCLUSION Familial hypercholesterolaemia patients show increased activities of NF-kB and XO, and higher values of low grade inflammatory markers related to atherosclerosis. NF-kB activity was independently associated with apoB plasma values. These data could explain in part the high cardiovascular disease risk present in these patients.
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Affiliation(s)
- J T Real
- University of Valencia, Valencia, Spain.
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Martinez-Hervas S, Romero P, Hevilla EB, Real JT, Priego A, Martin-Moreno JM, Carmena R, Ascaso JF. Classical cardiovascular risk factors according to fasting plasma glucose levels. Eur J Intern Med 2008; 19:209-13. [PMID: 18395166 DOI: 10.1016/j.ejim.2007.09.005] [Citation(s) in RCA: 8] [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: 04/24/2007] [Revised: 06/29/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND To compare the prevalence of classical cardiovascular risk factors (CVRF) and metabolic syndrome (MetS) in our population according to fasting plasma glucose levels (FPG). METHODS We have studied 344 subjects between 20-70 years of age, recruited in a Primary Care Clinic. Subjects were divided into four groups according to their fasting plasma glucose (FPG) values: normal plasma glucose (NG) when FPG < 5.6 mmol/L; FPG between 5.6 and 6.0 mmol/L (FPG1); FPG between 6.1-6.9 mmol/L (FPG2); and diabetes (DM) FPG > or = 7 mmol/L or previous diagnosis of diabetes. Cardiovascular risk factors (hypertension, TC/HDL-C index and Apo B values), presence of the MetS and indirect measure of insulin resistance (HOMA) were analyzed. RESULTS Subjects with FPG2 have a prevalence of classic CVRF and MetS similar to that observed in subjects with type 2 diabetes mellitus (T2DM). The TC:HDL-C index > or = 5 in 56% and 57%, Apo B > or = 1.2 g/L in 59% and 57%, hypertension in 60% and 54% of FPG2 and T2DM subjects, respectively. MetS was diagnosed in 79% of FPG2 and 80% of T2DM. We found significant differences with FPG1 group who presented low CVRF and MetS proportion. CONCLUSION In our population FPG2 and T2DM subjects show a similar cardiovascular risk profile. On the other hand, such risk is significantly lower in subjects with FPG between 5.6-6.0 mmol/L. These results might have practical implications.
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Affiliation(s)
- Sergio Martinez-Hervas
- Endocrinology Service, University Clinical Hospital, Department of Medicine-University of Valencia, Spain.
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Pedro T, Martínez-Hervás S, Lorente R, Catalá M, Ortega J, Real JT, Carmena R. [Difficult treatment of amiodarone-induced thyrotoxicosis: a case report]. An Med Interna 2007; 24:543-546. [PMID: 18275264 DOI: 10.4321/s0212-71992007001100007] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Amiodarone causes changes in thyroid function tests in about 15-20% of patients, inducing either hypothyroidism or thyrotoxicosis. The iodine load and the destructive thyroiditis caused by amiodarone produce thyrotoxicosis. We report a case of amiodarone-induced thyrotoxicosis diagnosed when investigating the reason for worsening of cardiac function. Prognosis and treatment of cardiac disorder were determined by thyrotoxicosis. The management needed a closed monitoring of thyroid function. Treatment was based on high doses of propylthiouracil and dexamethasone, but they couldn t control cardiac condition and surgery was warranted. When amiodarone-induced thyrotoxicosis is refractory to medical treatment, we believe surgery should be considered earlier.
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Affiliation(s)
- T Pedro
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Departamento de Medicina, Universidad de Valencia, Valencia.
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Martinez-Hervás S, Real JT, Priego A, Sanz J, Martín JM, Carmena R, Ascaso JF. Hiperlipidemia familiar combinada, síndrome metabólico y enfermedad cardiovascular. Rev Esp Cardiol 2006. [DOI: 10.1157/13095789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Martinez-Hervás S, Real JT, Priego A, Sanz J, Martín JM, Carmena R, Ascaso JF. [Familial combined hyperlipidemia, metabolic syndrome and cardiovascular disease]. Rev Esp Cardiol 2006; 59:1195-8. [PMID: 17144994] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Our aim was to investigate the relationship between metabolic syndrome and cardiovascular disease (i.e., survivors of myocardial infarction) in patients with familial combined hyperlipidemia (FCH). We compared a group of 20 male patients with FCH who had survived a myocardial infarction with two other groups matched for age and body mass index, comprising 20 individuals with FCH who had not had a myocardial infraction and 20 control subjects. Plasma lipid, glucose, and insulin levels were determined. Metabolic syndrome was judged to present on the basis of World Health Organization (WHO) and National Cholesterol Education Program-Adult treatment panel (NCEP-ATPIII) criteria. Differences between the groups were evaluated using non-parametric tests and the association between ischemic coronary disease and other parameters was assessed by logistic regression analysis. According to WHO criteria, the metabolic syndrome was present in 19 FCH patients who had survived a myocardial infarction, in 11 individuals with FCH who had not had a myocardial infraction, and in six control subject (P<.001); the difference between FCH patients with and without myocardial infarction was significant (P<.01). Presence of the metabolic syndrome, as defined by WHO criteria, is a marker of cardiovascular risk in individuals with FCH.
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Affiliation(s)
- Sergio Martinez-Hervás
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain
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Real JT, Romero P, Martínez Hervas S, Pedro T, Carmena R, Ascaso JF. Papel de la dislipemia aterogénica en el desarrollo del síndrome metabólico. Med Clin (Barc) 2006; 127:321-4. [PMID: 16987450 DOI: 10.1157/13092312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Our goal was to know if the diagnosis of metabolic syndrome (MS) as defined by International Diabetes Federation (IDF) criteria 2005 identifies more subjects with atherogenic dyslipidemia and high cardiovascular risk than the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP-III) criteria. PATIENTS AND METHOD Cross-sectional study in an adult population (20-70 years) of 344 subjects (158 males and 186 females), who visited an out-patient clinic in the metropolitan area of Valencia over a period of one year. Opportunistic search method was used. We studied: anthropometrics parameters, blood pressure, plasma lipids -non-high-density lipoprotein cholesterol (no-HDL-c), and total cholesterol:high-density lipoprotein cholesterol index (TC-HDL-c)-, glucose and insulin, and HOMA (Homeostasis Model Assessment) index. RESULTS We have separated the subjects on the basis to the IDF or ATP-III criteria to define the MS. The MS define a group of subjects with important plasma lipids alterations and cardiovascular risk: increase of no-HDL-c, of TC:HDL-c index and of apolipoprotein B. The TC:HDL-c index was > or = 6 in 28.6% of the subjects with MS and only in 9.4% of the subjects without MS (p < 0.0001) by IDF criteria and in 34.6% of the subjects with MS-ATP-III, and in 8.6% without MS-ATP-III (p < 0.0001). The apolipoprotein B > or = 1.2 g/l was observed in 44% of the subjects with MS and only in 26% without MS IDF criteria (p < 0.0001), and only in 47.6% and 28.6%, respectively, by ATP-III criteria (p < 0.0001). CONCLUSIONS The MS defined by the IDF or ATP-III criteria equally identifies subjects with atherogenic dyslipidemia, with increase of no-HDL-c, of the TC: HDL-c index and of the apolipoprotein B and, for this reason, with high cardiovascular risk.
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Affiliation(s)
- José T Real
- Servicio de Endocrinología, Hospital Clínico Universitario, Departamento de Medicina, Universitat de València, Valencia, España
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Ascaso JF, Herreros B, Sanchiz V, Lluch I, Real JT, Minguez M, Mora F, Benages A. Oesophageal motility disorders in type 1 diabetes mellitus and their relation to cardiovascular autonomic neuropathy. Neurogastroenterol Motil 2006; 18:813-22. [PMID: 16918760 DOI: 10.1111/j.1365-2982.2006.00799.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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] [Indexed: 02/08/2023]
Abstract
The relationship between cardiovascular autonomic neuropathy (CVAN) and oesophageal dysfunction in diabetes mellitus has not been well established because reports are contradictory. The aim of this study was to assess oesophageal function and its correlation with CVAN in type 1 diabetic patients without oesophageal symptoms. Forty-six type 1 diabetic patients without oesophageal symptoms (DG) and 34 healthy volunteers (CG) were studied. Both groups underwent CVAN tests and oesophageal manometry and pH-metry. Differences between groups regarding results of cardiovascular autonomic tests and oesophageal studies were statistically analysed. Compared with the CG, the DG group showed insufficient lower oesophageal sphincter (LOS) relaxation and a higher percentage of simultaneous waves (P < 0.01). Patients with CVAN (n = 22) showed a higher prevalence of pathological simultaneous contractions (>10%), and the prevalence of simultaneous waves related to the degree of autonomic neuropathy was: 9% of patients without CVAN, 7% of those suspected to have it and 50% of patients with CVAN (P < 0.001). Factors associated with the presence of pathological simultaneous waves (>10%) were the presence of CVAN and duration of diabetes (P < 0.05, logistic regression analysis). Increase in simultaneous waves and impaired relaxation of LOS are more frequent in diabetic patients with CVAN.
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Affiliation(s)
- J F Ascaso
- Department of Endocrinology, University of Valencia, Valencia, Spain
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Bartual A, González C, Martínez Hervás S, Real JT, García García AB, Castro Cabezas M, Chaves FJ, Priego MA, Ascaso JF, Carmena R. Efecto del género y de la obesidad en la lipemia posprandial en sujetos sanos normolipidémicos no diabéticos y sujetos con hiperlipemia familiar combinada. Rev Clin Esp 2006; 206:213-9. [PMID: 16750103 DOI: 10.1157/13088559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION A new method based on self-measurement of diurnal capillary triglycerides (TG) facilitates the study of postprandial lipemia (PL). The objectives of our study are: to evaluate the effect of gender and obesity on PL measured by self-determination of diurnal capillary TG with Accutrend GCT in normolipidemic non-diabetic subjects and subjects with familial combined hyperlipidemia (FCH). MATERIAL AND METHODS We studied 23 FCH subjects (10 males) and 45 normolipidemic non-diabetic subjects (29 males). All subjects self-determine 3 diurnal capillary TG profiles during a week. RESULTS In normolipidemic non diabetic subjects significantly higher diurnal TG profiles and area under the curve of TG (AUCTGc) (25.25 +/-9.09 vs 19.71 +/- 6.16 mmolh/l) were found in males compared to females. In FCH subjects these differences were not found and the AUCTGc correlated with BMI (r = 0.510, p < 0.05) and waist circumference (r = 0.453, p < 0.05). Obese subjects (BMI >or= 27 kg/m2) showed diurnal TG profiles and AUCTGc significantly higher than the non-obese. DISCUSSION Normolipidemic non diabetic females showed a lower PL compared to males, probably due to the effect of estrogens in PL metabolism. Obesity negatively influences PL in normolipidemic non diabetic subjects and subjects with FCH.
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Affiliation(s)
- A Bartual
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Departamento de Medicina, Universitat de Valencia, España
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González C, Real JT, Bartual A, Chaves FJ, García-García AB, Blesa S, Castro-Cabezas M, Ascaso JF, Carmena R. Determinantes de la lipemia posprandial medida como perfil diurno de triglicéridos en personas no diabéticas con normolipemia. Med Clin (Barc) 2005; 125:448-52. [PMID: 16216199 DOI: 10.1157/13079610] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE We decided to evaluate the clinical and biochemical predictors of postprandial lipemia, measured as daylong capillarly triglycerides (TGc) profiles, in normolipidemic non diabetic subjects. PATIENTS AND METHOD We studied 76 normolipidemic non diabetic subjects (45 premenopausal females). Accutrend was used to measure daylong TGc profiles during 3 days in 6 previously standardized points: fasting, pre and 3 h after dinner and lunch and at bedtime. The area under the curve of TGc (AUC-TGc) was determined as expression of postprandial lipemia. RESULTS Males showed significantly higher AUC-TGc (26.20 [11.00] vs 19.12 [6.57] in females; p < 0.001). Obese showed significantly higher values of AUC-TGc (27.87 [12.47] vs 20.05 [7.04]; p < 0.01). The AUC-TGc correlated with: age (r = 0.242; p < 0.05), body mass index (r = 0.312; p < 0.01), waist circumference (r = 0.394; p < 0.01), fasting plasma triglyceride (r = 0.634; p < 0.001), fasting insulinemia (r = 0.485; p < 0.001) and fasting HOMA (r = 0.484; p < 0.001). The multivariate analysis showed that HOMA (regression coefficient: 0.352; p = 0.02) and waist circumference (regression coefficient: 0.4; p = 0.05) were independent predictors of the AUC-TGc. CONCLUSIONS Independent determinants of postprandial lipemia were waist circumference and HOMA.
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Affiliation(s)
- Cintia González
- Hospital Clínico Universitario de Valencia, Departamento de Medicina, Universidad de Valencia, Valencia, Spain
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Real JT, Merchante A, Gómez JL, Chaves FJ, Ascaso JF, Carmena R. Effects of marathon running on plasma total homocysteine concentrations. Nutr Metab Cardiovasc Dis 2005; 15:134-139. [PMID: 15871862 DOI: 10.1016/j.numecd.2004.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 09/17/2003] [Accepted: 05/25/2004] [Indexed: 11/24/2022]
Abstract
AIMS There is evidence of an excess of acute cardiovascular (CV) events in marathon runners. High plasma total homocysteine (tHcy) concentrations are a recognised risk factor for CV events. Therefore, we investigated the changes in plasma tHcy concentrations 24h before and after a marathon race. METHODS AND RESULTS Twenty-two non-professional male athletes, mean age 35.6 (6.6), range 23-49 years, were studied the day before and 24 h after finishing a marathon race. None of the athletes was a carrier of the MTHFR 677TT genotype and no ingestion of supplements of vitamins (B12, B6, folic acid) was allowed. RESULTS Changes in plasma folate and plasma vitamin B12 concentrations were not detected post-race, but a significant increase in plasma tHcy concentrations was demonstrated. Plasma tHcy increased 19% 24h after the race. Before the race 20% of the subjects had a plasma tHcy concentration > 10 micromol/l (cut-off point for ischaemic heart disease risk), while after the race 50% had plasma tHcy concentrations> 10 micromol/l. CONCLUSION An increase in plasma tHcy concentrations was observed after a marathon race in non-professional not well-trained male athletes performing strong physical activity. The potential physiological or pathological implications of this finding are unknown.
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Affiliation(s)
- J T Real
- Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Spain
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García-García AB, González C, Real JT, Martín de Llano JJ, González-Albert V, Civera M, Chaves FJ, Ascaso JF, Carmena R. Influence of microsomal triglyceride transfer protein promoter polymorphism −493 GT on fasting plasma triglyceride values and interaction with treatment response to atorvastatin in subjects with heterozygous familial hypercholesterolaemia. Pharmacogenet Genomics 2005; 15:211-8. [PMID: 15864113 DOI: 10.1097/01213011-200504000-00004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Familial hypercholesterolaemia (FH) is an autosomal dominant disease characterized by elevated levels of low-density lipoprotein-cholesterol (LDL-C). Phenotypic expression is highly variable, being influenced by diet, age, gender, body mass index, apolipoprotein E genotype and type of LDL-receptor gene mutation. Microsomal triglyceride (TG) transfer protein (MTP) is a protein involved in lipid metabolism. Polymorphism MTP -493 GT has been shown to modulate lipid levels in several populations. To analyse the effect of this polymorphism in the lipid phenotype expression of FH and treatment response, we studied a sample of 222 Spanish FH patients, of whom 147 were studied before and after treatment with 20 mg of atorvastatin daily during 6 weeks. The variant was analysed by polymerase chain reaction amplification and single-strand confirmation polymorphism. Treatment reduced LDL-C, total cholesterol and TGs. Baseline fasting TGs and very-low-density lipoprotein cholesterol levels were lower in female T allele carriers (TG: 111+/-51 mg/dl GG, 89+/-35 mg/dl GT, 83+/-26 mg/dl TT, P=0.022; very-low-density lipoprotein cholesterol: 24+/-13 mg/dl GG, 16+/-5 mg/dl GT, 17+/-5 mg/dl TT, P=0.018). Triglyceride response to atorvastatin was modulated by this polymorphism in men (P=0.009), but not in women, although differences between genotypes were maintained after treatment. In conclusion, the MTP -493 GT polymorphism modulates pre- and post-treatment plasma TG values of FH in Spanish subjects in a gender-specific way. Other environmental and genetic factors likely also modulate this response.
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Affiliation(s)
- Ana B García-García
- Unidad Mixta de Investigación, Hospital Clínico Universitario de Valencia, Spain
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