High cardiovascular risk profile in patients with sleep apnea

Angiotensin converting enzyme (ACE) plays a dominant role in renal and cardiovascular diseases, obesity and diabetes. The somatic ACE (130-190 kDa) is composed of two homologous N- and C- domains. Two soluble N-domain isoforms have been described in human urine with 65 and 90KDa. Studies have supported that N-domain ACE with 90KDa is a biomarker for hypertension, pre-eclampsia and inflammation. We analyzed the expression of somatic and soluble N-domain ACE isoforms in urine of children and adolescents with different nutritional status and cardiovascular risk profile. The volunteers aged from 6 to 19 years were classified into four groups according to their BMI percentile; underweight (n=51), normal weight (n = 53), overweight (n=53) and obese (n=49). Waist-height-ratio (WHtR) was used to assess cardiovascular risk profile dividing the participants into normal risk (n=105) and high risk (n=101). The urines were concentrated 10-fold and dialyzed with Tris-HCl pH 8 and pure water. Then, we performed western blot analysis using 50μg of lyophilized urinary protein, using the ACE polyclonal antibody Y1. Protein detection was performed by chemiluminescent and analysis in Image Lab software utilizing total protein stain for normalization. ACE expression is augmented in obese children when compared with normal weight children ( 0.09 vs 0.53 arbitrary units, p=0,04 ). The higher cardiovascular risk group also presented increased expression of ACE ( 0.27 vs 0.09 arbitrary units, p=0.046 ). The 90KDa N-domain isoform is frequently found in the high cardiovascular risk children ( p= 0.02 ). According to Spearman correlation test, the expression of 90 kDa N-domain ACE correlates positively with waist circumference, WHtR, BMI percentile and Z-score of BMI. Increased ACE expression in obese children contributes to higher cardiovascular risk once this enzyme biosynthesizes Angiotensin II which promotes blood pressure increase, sympathetic nervous system activation and release of glucocorticoids from adrenal gland. ACE expression is also augmented in children with high cardiovascular risk. Presence of 90 KDa N-domain ACE in urine of children and adolescents is a biomarker of poor prognostic for cardiovascular disease in childhood obesity.

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Uric Acid Indicates a High Cardiovascular Risk Profile but Is Not Closely Associated With Insulin Resistance in Obese Adolescents

Diabetes Care ◽

10.2337/dc07-2411 ◽

2008 ◽

Vol 31 (4) ◽

pp. e21-e21 ◽

Cited By ~ 6

Author(s):

H. Mangge ◽

S. Pilz ◽

S. Haj-Yahya ◽

G. Almer

Keyword(s):

Insulin Resistance ◽

Uric Acid ◽

Cardiovascular Risk ◽

Risk Profile ◽

Cardiovascular Risk Profile ◽

High Cardiovascular Risk ◽

Obese Adolescents

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The Independent Impact of Congestive Heart Failure Status and Diuretic Use on Serum Uric Acid Among Men with a High Cardiovascular Risk Profile: A Prospective Longitudinal Study

Seminars in Arthritis and Rheumatism ◽

10.1016/j.semarthrit.2011.02.002 ◽

2011 ◽

Vol 41 (3) ◽

pp. 471-476 ◽

Cited By ~ 13

Author(s):

Devyani Misra ◽

Yanyan Zhu ◽

Yuqing Zhang ◽

Hyon K. Choi

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Uric Acid ◽

Cardiovascular Risk ◽

Longitudinal Study ◽

Risk Profile ◽

Cardiovascular Risk Profile ◽

High Cardiovascular Risk ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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Atrial Natriuretic Peptide Single Nucleotide Polymorphisms in Patients with Nonfamilial Structural Atrial Fibrillation

Clinical Medicine Insights Cardiology ◽

10.4137/cmc.s12239 ◽

2013 ◽

Vol 7 ◽

pp. CMC.S12239 ◽

Cited By ~ 3

Author(s):

Pietro Francia ◽

Agnese Ricotta ◽

Alessandra Frattari ◽

Rosita Stanzione ◽

Anna Modestino ◽

...

Keyword(s):

Cardiovascular Risk ◽

Atrial Natriuretic Peptide ◽

Risk Profile ◽

Left Ventricular ◽

Caucasian Population ◽

Gene Variants ◽

Nucleotide Polymorphisms ◽

Cardiovascular Risk Profile ◽

High Cardiovascular Risk ◽

Single Nucleotide

Background Atrial natriuretic peptide (ANP) has antihypertrophic and antifibrotic properties that are relevant to AF substrates. The -G664C and rs5065 ANP single nucleotide polymorphisms (SNP) have been described in association with clinical phenotypes, including hypertension and left ventricular hypertrophy. A recent study assessed the association of early AF and rs5065 SNPs in low-risk subjects. In a Caucasian population with moderate-to-high cardiovascular risk profile and structural AF, we conducted a case-control study to assess whether the ANP -G664C and rs5065 SNP associate with nonfamilial structural AF. Methods 168 patients with nonfamilial structural AF and 168 age- and sex-matched controls were recruited. The rs5065 and -G664C ANP SNPs were genotyped. Results The study population had a moderate-to-high cardiovascular risk profile with 86% having hypertension, 23% diabetes, 26% previous myocardial infarction, and 23% left ventricular systolic dysfunction. Patients with AF had greater left atrial diameter (44 ± 7 vs. 39 ± 5 mm; P < 0.001) and higher plasma NTproANP levels (6240 ± 5317 vs. 3649 ± 2946 pmol/mL; P < 0.01). Odds ratios (ORs) for rs5065 and -G664C gene variants were 1.1 (95% confidence interval [CI], 0.7-1.8; P = 0.71) and 1.2 (95% CI, 0.3-3.2; P = 0.79), respectively, indicating no association with AF. There were no differences in baseline clinical characteristics among carriers and noncarriers of the −664C and rs5065 minor allele variants. Conclusions We report lack of association between the rs5065 and -G664C ANP gene SNPs and AF in a Caucasian population of patients with structural AF. Further studies will clarify whether these or other ANP gene variants affect the risk of different subpheno-types of AF driven by distinct pathophysiological mechanisms.

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