Small Dense Low-Density Lipoprotein Cholesterol Levels in Breakfast Skippers and Staple Foods Skippers

AIMS

Skipping breakfast is known as a cardiovascular disease (CVD) risk. Recently, eating and dietary patterns have been varied in many countries, however, the mechanisms of promoting CVD are still unclear. Our goal was to assess the effects of eating and dietary patterns on CVD risk factors, with a focus on lipid parameters including serum concentration of small dense low-density lipoprotein cholesterol (sdLDL-C).

METHODS

Subjects consisted of 27,997 Japanese men and women, who had medical check-up. Lipid parameters including sdLDL-C levels in breakfast skippers were compared with those in breakfast eaters. Lipid parameters in staple foods skippers were also compared with those in staple foods eaters.

RESULTS

Breakfast skippers had significantly (p＜0.01) higher serum levels of median sdLDL-C than breakfast eaters in both genders (34.7 versus 32.0 mg/dL in men, 25.4 versus 24.9 mg/dL in women, respectively), and the same was true for sdLDL-C/LDL-C ratio (0.276 versus 0.260 in men, 0.218 versus 0.209 in women, respectively). Similarly, staple foods skippers had significantly higher sdLDL-C level than staple foods eaters in both genders (34.1 versus 31.6 mg/dL in men, 25.8 versus 24.7 mg/dL in women), and the same went for sdLDL-C/LDL-C ratio (0.278 versus 0.256 in men, 0.215 versus 0.208 mg/dL in women, respectively).

CONCLUSION

Our data indicate that both skipping breakfast and having meals without staple foods increase serum sdLDL-C concentration and cause unfavorable lipid profiles, and then may promote CVD. These finding provide evidence for the importance of having breakfast and meals with staple foods for preventing CVD.

Reference interval for serum concentration of small dense low-density lipoprotein cholesterol in the healthy Japanese population

BACKGROUND

Small dense low-density lipoprotein a smaller and denser subfraction among whole low density lipoprotein particles is known to be highly atherogenic. The reference interval (RI) is not strictly defined for serum concentration of sdLDL-cholesterol (sdLDL-C) in Japan. The purpose of this study is to set the reference interval for sdLDL-C in healthy subjects.

METHODS

The population of this cross-sectional study was consisted of 40,862 individuals who had annual health checkups, and healthy subjects were extracted based on exclusion criteria such as medical history, social history, and blood sampling test results. Their serum sdLDL-C values were statistically analyzed and the RIs were set in men, premenopausal women, and postmenopausal women separately.

RESULTS

The mean values of serum sdLDL-C in healthy subjects were 23.9 mg/dL in men, 20.0 mg/dL in premenopausal women and 23.7 mg/dL in postmenopausal women, and the RIs were 12.6-45.3 mg/dL in men, 11.4-35.1 mg/dL in premenopausal women and 14.6-38.6 mg/dL in postmenopausal women. Serum sdLDL-C values were significantly higher in men than in women. Besides, sdLDL-C values were significantly higher in postmenopausal women than in premenopausal women. In both genders, sdLDL-C values tended to increase with age.

CONCLUSION

These results suggest that the RIs for sdLDL-C are recommended as follows: 13-45 mg/dL in men, 11-35 mg/dL in premenopausal women, and 15-39 mg/dL in postmenopausal women, respectively. Aside from these RIs, it is also necessary to define clinical cutoff values graded according to individual risk levels for atherosclerotic cardiovascular diseases.

Relationships between Smoking Status, Cardiovascular Risk Factors, and Lipoproteins in a Large Japanese Population

Aims: Smoking is a major risk factor for cardiovascular disease (CVD), a leading cause of death and disability. Other CVD risk factors include age, gender, hypertension, diabetes, increased low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C). Our goal was to assess relationships between smoking status and CVD risk factors, with a focus on direct LDL-C, HDL-C, triglycerides (TG) and small dense LDL-C (sdLDL-C).

Methods: A total of 34,497 Japanese men and women, mean age 51 years, had their CVD risk factors including fasting serum total cholesterol, TG, HDL-C, sdLDL-C, and direct LDL-C assessed. One-way ANOVA and multiple linear regression analyses were carried to assess the interrelationships of these parameters with smoking.

Results: In both men and women, current smokers had significantly ( p ＜0.001) higher median TG (+19.6%, +16.9%) and sdLDL-C levels (+12.7%, +4.2%) levels, and significantly ( p ＜0.001) lower HDL-C levels (-7.3%, -4.3%) than non-smokers. They were also significantly ( p ＜0.05) more likely to have TG values ＞150 mg/dL (+56.8%, +116.3%), sdLDL-C ＞40.1 mg/dL (+28.8%, +44.9%), and HDL-C ＜40 mg/dL (+89.8%, +114.3%). Ex-smokers generally had lipid values that were intermediate between non-smokers and current smokers. Multivariate analysis confirmed the significance of these relationships.

Conclusion: Our data indicate that current cigarette smoking is associated with increased TG and sdLDL-C levels, as well as decreased HDL-C levels. Furthermore, smoking effect on lipid profiles remain after cessation. These data provide further justification for smoking cessation.

A prospective multicenter observational study evaluating the risk of periendoscopic events in patients using anticoagulants: the Osaka GIANT Study

Background and study aims  An increasing number of patients have been using anticoagulants including anti-vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs); however, in patients using anticoagulants, limited data are available with regard to the risks of gastrointestinal bleeding and thromboembolic events during the peri-endoscopic period. We aimed to evaluate the peri-endoscopic bleeding and thrombotic risks in patients administered VKAs or DOACs. Patients and methods  Consecutive patients using anticoagulants who underwent endoscopic biopsy, mucosal resection, or submucosal dissection were prospectively enrolled across 11 hospitals. The primary outcome assessed was difference in incidence of post-procedural gastrointestinal bleeding in patients using VKAs and DOACs. Duration of hospitalization and peri-procedural thromboembolic events were also compared. Results  We enrolled 174 patients using VKAs and 37 using DOACs. In total, 16 patients using VKA were excluded from the analysis because of cancellation of endoscopic procedures and contraindications to the use of DOACs; 128 (81 %) patients using VKAs and 17 (46 %) using DOACs received heparin-bridging therapy (HB). The rate of post-procedural gastrointestinal bleeding in DOAC users was similar to that in VKA users (16.2 % vs. 16.4 %, P  = 1.000). Duration of hospitalization was significantly longer in patients using VKAs than in those using DOACs (median 15 vs. 7 days, P  < 0.0001). Myocardial infarction occurred during pre-endoscopic HB in one patient using VKAs. Conclusion  DOAC administration showed similar post-procedural gastrointestinal bleeding risk to VKA administration in patients undergoing endoscopic procedures, but it shortened the hospital stay.

HuR is exported to the cytoplasm in oral cancer cells in a different manner from that of normal cells

HuR, a ubiquitously expressed member of the Hu protein family that binds and stabilizes an AU-rich element (ARE)-containing mRNAs, is known to shuttle between the nucleus and the cytoplasm via several export pathways. When normal cells were treated with heat shock, HuR was exported to the cytoplasm in a chromosome maintenance region 1 (CRM1)-dependent manner. However, in this study, we demonstrate that HuR is exported to the cytoplasm in oral cancer cells even if the cells were treated with the inhibitor of the CRM1-independent export pathway. Immunohistochemical and biochemical analyses showed that HuR existed in both the cytoplasm and the nucleus in oral cancer cells, such as HSC-3 and Ca9.22, but existed entirely inside the nucleus in normal cells. AU-rich element-mRNAs were also exported to the cytoplasm and stabilised in the oral cancer cells, which were inhibited by HuR knockdown. This export of HuR was not affected by at least 7 h of treatment of leptomycin B (LMB), which is an inhibitor of the CRM1-dependent export pathway. These findings suggest that HuR is exported to the cytoplasm in oral carcinoma cells in a different manner from that of normal cells, and is likely to occur through the perturbation of a normal export pathway.

Vacuum phenomenon in non-open fracture of the mandibular condyle: report of three cases

Gas in the joint space was observed in three patients with condylar fracture who were referred for CT examinations of the mandible. CT showed that the condylar fractures were non-open fractures. The gas was only observed in the intrajoint capsule of the temporomandibular joint (TMJ). Follow-up CT, 4 days after the initial CT, showed that the gas in the joint space was absorbed in one of three cases. In the non-open condylar fractures, the gas collection in the TMJ was considered to be a vacuum phenomenon due to the intact joint capsule of the TMJ on CT.

A possible indicator of urinary NH2-terminal big gastrin immunoreactivity for gastrin secretion

Urinary and plasma gastrin immunoreactivities in normal subjects were studied by radioimmunoassays using three region-specific antisera. Urinary excretion of NH2-terminal big gastrin immunoreactivity (NT G-34-IR) in the fasting state (0.79 +/- 0.17 pmol/kg/h, mean +/- SE) was several hundred times as much as that of either COOH-terminal gastrin or gastrin/cholecystokinin immunoreactivity. Urinary NT G-34-IR increased significantly after feeding, and correlated closely with integrated plasma NT G-34-IR. Renal clearance of NT G-34-IR was 62.4 +/- 7.9 ml/min and about one hundred times greater than that of any other gastrin immunoreactivities, indicating that there exist different catabolic pathways of gastrin peptides in the kidney. Gel filtration of urine extract revealed that a single giant peak of NT G-34-IR eluted in a later position than NH2-terminal heptadecapeptide of big gastrin. These results suggest that most of plasma NT G-34-IR is excreted in urine, and urinary excretion of NT G-34-IR reflects well-integrated plasma NT G-34-IR. Therefore, urinary NT G-34-IR may serve as a feasible indicator for gastrin secretion.

Marked secretion of pyruvate in human duodenal juice stimulated with pancreozymin or secretin

Pyruvate and lactate in duodenal aspirates were investigated to determine whether they are excreted from human pancreas as substrates for alkaline secretion as is bicarbonate. Secretion of these acids was compared with that of another organic acid, citrate, which is thought to be excreted in close relationship to digestive enzymes. All acids were assayed in the fluid obtained from 11 subjects without pancreatic diseases, before and after sequential intravenous injections of 1 unit/kg pancreozymin and 1 unit/kg secretin. Pyruvate concentrations were markedly increased by each stimulation, especially by secretin, and the cumulative excretions of pyruvate and bicarbonate after secretin stimulation were significantly correlated among the subjects. In contrast, lactate concentrations, although high just after administration of pancreozymin, declined to a considerable extent following each injection, rather similar to those of protein or citrate. These data suggest that pyruvate may be secreted from human pancreatic duct cells similar to bicarbonate secretion through mechanisms related to alkaline secretion.

Prostaglandin D2 diminishes transmucosal potential difference in rat colonic mucosa in vitro in contrast to the increasing effect of prostaglandin E1

The effect of Prostaglandin D2 (PGD2) on ion transport was investigated in the rat colon in vitro. Ion transport across the intestinal mucosa was estimated by transmucosal potential difference (PD) and short circuit current (Isc) in the Ussing chamber. PGD2 added to the serosal reservoir induced a sustained reduction in PD and Isc at the concentration of higher than 10(-7)M, producing the maximal decrease at 10(-5)M. PGD2 at 10(-5)M completely blocked the increase in PD elicited by prostaglandin E1 (PGE1), theophylline, dibutyryl cAMP or serotonin. Adenylate cyclase activity was determined in the colonic mucosal homogenates after addition of PGD2 and PGE1. Treatment with PGD2 or PGE1 caused a significant increase in the enzyme activity. Combined treatment with both prostaglandins induced no more increase than that elicited by PGE1 alone. These results suggest that PGD2 has an anti-secretory effect on the rat colon and it may regulate the ion transport process through other mechanism than the modification of cyclic AMP concentration in mucosal cells.

Mutagenic activation of biliary metabolites of benzo(a)pyrene by beta-glucuronidase-positive bacteria in human faeces

Human faeces hydrolysed synthetic beta-D-glucuronides of both p-nitrophenol and phenolphthalein. The origin of this activity in faeces was localised in the bacterial pellet fraction after centrifugation. Ninety-seven bacterial strains with beta-glucuronidase activity isolated from fresh human faeces were identified as species of Bacteroides, Peptostreptococcus, Fusobacterium, Propionibacterium, Clostridium, Eubacterium and Bifidobacterium. They were classified into two groups according to their activity against two synthetic beta-D-glucuronides. One group hydrolysed p-nitrophenyl glucuronide and phenolphthalein glucuronide to the same extent and the other hydrolysed p-nitrophenyl glucuronide much more strongly than phenolphthalein glucuronide. The bile of rats given benzo(a)pyrene by mouth was tested for mutagenicity in the presence and absence of cell-free extracts of human faeces and bacteria. Extracts of beta-glucuronidase-positive bacteria increased the mutagenicity of metabolites of benzo(a)pyrene, as did faecal extracts, but extracts of beta-glucuronidase-negative bacteria did not. D-Saccharic acid-1,4-lactone inhibited the increase in mutagenicity produced by the faecal extracts and extracts of beta-glucuronidase-positive bacteria except for Peptostreptococcus strains 204 and 952. These results indicate that some intestinal bacteria have beta-glucuronidases heterogenous in substrate specificity and that they may be involved in mutagenicity of benzo(a)pyrene in the intestinal tract.

Secretion of pyruvate and lactate in pancreatic juice induced by acetazolamide or secretin

In vivo studies using pentobarbital sodium-anesthesized dogs were performed to investigate whether a transport pathway for pyruvate and lactate is present in the exocrine pancreas. Concentrations of both acids were measured in peripheral blood and pancreatic juice before and after intravenous 15-min administration of 2.25 mmol/kg DL-lactate, superimposed on continuous intravenous infusion of 3 U X kg-1 X h-1 secretin. The concentration ratio of lactate to pyruvate in pancreatic juice was found to be approximately 1, a lower value than found in other tissues or body fluids. D-lactate, not detected in either blood or juice during basal periods, rapidly appeared in both fluids in parallel with the physiological isomer L-lactate, after the infusion of DL-lactate. Further addition of acetazolamide or a high dose of secretin caused a marked secretory response of pyruvate and lactate with no increase in juice bicarbonate levels. We conclude that these acids can be transported from blood to lumen when the transmembrane pH gradient across the duct cell membranes is augmented by stimulants via a proton pump mechanism involving a CO2-HCO3-buffer system.

Marked prolongation in disappearance half-time of plasma cholecystokinin-octapeptide in patients with hepatic cirrhosis

For exploration on the elimination of cholecystokinin from the circulation, the disappearance half-time of cholecystokinin-octapeptide was estimated with cholecystokinin specific radioimmunoassay in normal subjects and patients with chronic renal failure and with hepatic cirrhosis. With a brief infusion of 30.4 ng/kg of cholecystokinin-octapeptide for 2 min, plasma cholecystokinin level rose from 16.1 +/- 3.6 pg/ml (mean +/- SE) to 216.5 +/- 6.1 pg/ml at 3 min after starting infusion, and decreased rapidly in a single exponential fashion for 10 min in hepatic cirrhosis. The disappearance half-time of cholecystokinin-octapeptide in patients with hepatic cirrhosis was 2.45 +/- 0.07 min, and it was significantly longer than that in normal subjects (1.30 +/- 0.07) or patients with chronic renal failure (1.70 +/- 0.11). These findings suggest that the liver plays a major role in cholecystokinin-octapeptide elimination in humans.

Release of vasoactive intestinal peptide by intraduodenal infusion of HCl or fat and intramuscular injection of neostigmine in man

A highly sensitive radioimmunoassay system for plasma vasoactive intestinal peptide (VIP) was developed to examine the effect of intraduodenal infusion of HCl or fat on the plasma VIP levels in healthy subjects, and the effect of intramuscular injection of neostigmine in patients with irritable bowel syndrome (IBS). Intraduodenal infusion of 100 ml of 0.1 N HCl or 10 g fat caused a significant rise in plasma VIP level. Neostigmine (12.5 micrograms/kg) produced a significant rise in plasma VIP level, and the plasma VIP response to neostigmine was significantly greater in the IBS group than in the normal group. These results suggest that VIP might play a role in the pathophysiology of IBS.

Changes in serum levels of pancreatic isoamylase, lipase, trypsin, and elastase 1 after endoscopic retrograde pancreatography

To compare the behavior of pancreatic enzymes in the circulation, serum levels of pancreatic isoamylase activity, lipase activity, immunoreactive trypsin (IRT), and immunoreactive elastase 1 (IRE) were measured in the same serum samples taken serially from 29 subjects undergoing endoscopic retrograde pancreatography (ERP). A striking correlation between the maximal increments of serum pancreatic enzyme levels after ERP and the degrees of opacification of pancreatic duct system was observed, except in 6 subjects with chronic pancreatitis. In 13 out of 19 subjects whose main pancreatic duct (MPD) and branches were opacified, serum pancreatic enzyme levels reached a peak within 2 hours after ERP and decreased thereafter. The mean maximal rise of serum levels of lipase, IRT, pancreatic isoamylase, and IRE in the 13 subjects was 32, 21, 10, and 4 times the basal value, respectively. A delay of peaking in serum levels of pancreatic isoamylase and IRE as compared with those of lipase and IRT was observed in the 13 subjects. The mean disappearance half-time of serum lipase, IRT, pancreatic isoamylase, and IRE in the 13 subjects was 2.8, 4.6, 8.0 and 16.0 hours, respectively.

Plasma cholecystokinin responses after ingestion of liquid meal and intraduodenal infusion of fat, amino acids, or hydrochloric acid in man: analysis with region specific radioimmunoassay

A highly sensitive and precise radioimmunoassay system for plasma cholecystokinin (CCK) was developed with the anti-CCK-8 specific antiserum which raised against N-terminal amino acids residue of sulfated CCK-8 and reacted with CCK-8, CCK-33, and CCK-39 but not with gastrin and its related peptides. Mean concentration of the fasting plasma CCK determined with this method using CCK-8 as standard was 12.9 +/- 5.9 pg/ml in normal subjects (n = 26), and in patients with hepatic cirrhosis it was significantly higher (36.7 +/- 16.9 pg/ml, n = 9, p less than 0.01) than in normal subjects. In six young healthy volunteers, intraduodenal infusion of fat caused a significant increase (p less than 0.05) of plasma CCK from a basal level of 8.0 pg/ml to a peak of 43.0 +/- 12.0 pg/ml at 20 min after starting of infusion. In the same subjects, a significant increase of plasma CCK was also observed by amino acids infusion, but no elevation of plasma CCK level was found during intraduodenal acidification.

Forskolin-induced cyclic AMP production and gastric acid secretion in dispersed rabbit parietal cells: novel evidence for a major role of cyclic AMP in acid release

Forskolin, a unique diterpine which is a direct activator of cyclic AMP-generating systems, stimulated both cyclic AMP and acid production in dispersed rabbit parietal cells. This agent was also capable of augmenting the action of histamine on both cyclic AMP and acid production at a low concentration. These findings provided novel evidence for a major role of cyclic AMP in gastric acid secretion.

Serological relationships among some Pichia species

Antigenic analyses of five species of the genus Pichia were carried out for taxonomic study by the slide agglutination method using monospecific and absorbed antisera and the agglutinin absorption technique. Comparative studies were also performed with a few strains of each of the same species and their classifications are discussed with respect to the antigenic structures and the patterns of proton magnetic resonance (PMR) spectra of their cell wall polysaccharides. ichia delftensis and Pichia zaruensis possessed thermostable antigens 1,2,5 and 11, and the former had also thermoabile antigen m. Both species were closely related to Candida krusei. Pichia toletana possessed thermostable antigens 1,2,5,11,17 and 49. Pichia bovis contained thermostable antigens 1,2,14,15,16,20 and 21, and it was related to most species of the genus Hansenula, although assimilation of potassium nitrate was negative. Finally, Pichia etchellsii possessed thermostable antigens 1,2,3,4,9 and 14, and was closely related to Pichia vini. Patterns of PMR spectra of mannans of these species also supported their serological relationships. Therfore, P. delftensis, P. zaruensis and P. etchellsii are considered to be the synonyms of Pichia fluxuum, Pichia dispora and P. vini respectively, although P. toletanan and P. bovis are independent species.