Acquired Hypolipoproteinemia

1992 ◽  
Vol 38 (5) ◽  
pp. 776-781 ◽  
Author(s):  
M De Buyzere ◽  
J Delanghe ◽  
C Labeur ◽  
L Noens ◽  
Y Benoit ◽  
...  

Abstract We present a six-year follow-up of a boy with a novel type of hypolipoproteinemia, with clinical and biochemical features distinct from classical hypoalphalipoproteinemias. There were abnormally low concentrations of total and high-density lipoprotein (HDL) cholesterol, apolipoprotein (apo) B, apo A-I, and apo A-II, and the phospholipids were decreased. The most striking abnormality was an extra fraction containing mainly phospholipids and apo A-I in the HDL3 subfraction. This fraction is reminiscent of concentric 20- to 50-nm-diameter lamellar phospholipid liposomes. Plasma lecithin:cholesterol acyltransferase activity was strongly decreased. We noted a persisting polyclonal hypergammaglobulinemia, hematological abnormalities (hemolytic anemia and thrombocytopenia), and a progressive splenomegaly. After the five-year follow-up, the patient had recurrent severe infections; moderate hematuria and proteinuria developed gradually. Treatment with corticosteroids and immunoglobulins improved thrombocytopenia and hypolipoproteinemia. These clinical and biochemical findings differ from those in the known primary and secondary hypo-alpha-lipoproteinemia syndromes. Although investigation of the relatives suggests a familial predisposition for hypo-alpha-lipoproteinemia, the subject's condition can be regarded as acquired.

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Catherine Rahilly-Tierney ◽  
Howard D Sesso ◽  
J. Michael Gaziano ◽  
Luc Djousse

BACKGROUND: Few studies have examined prospectively the relationship between baseline high-density lipoprotein (HDL) cholesterol and longevity. OBJECTIVES: We sought to examine whether higher HDL levels were associated with lower risk of all-cause, cardiovascular (CVD), and non-CVD mortality prior to age 90 in the Physicians’ Health Study (PHS). METHODS: We considered a baseline cohort of 1351 PHS participants who provided bloods between 1997 and 2001 and were old enough to reach age 90 by March 4, 2009. Included subjects had complete baseline data on HDL and total cholesterol; lifestyle factors including smoking, exercise, alcohol consumption, and BMI; and comorbidities including hypertension, diabetes mellitus, congestive heart failure, cancer, and stroke. We used Cox proportional hazards to determine the HRs and 95% CIs for all-cause, CVD, and non-CVD mortality prior to age 90, adjusting for baseline age, co-morbidities, and non-HDL cholesterol. RESULTS: At baseline, the cohort had a mean (SD) age of 81.9 (2.9) years and a mean (SD) HDL cholesterol of 44.8(16.5) mg/dL. After a mean follow-up of 6.8 years (maximum 12.3 years), 501 (37.1%) of men died prior to age 90. In multi-variable adjusted analyses, men in the highest HDL-C quartile (≥54.1 mg/dL) had a 28% lower risk (HR 0.72, 95% CI 0.55-0.95) of all-cause mortality prior to age 90 compared to men in the lowest HDL-C quartile (<32.8 mg/dL). From the lowest to highest HDL quartile, age-adjusted HR(95%CI) for CVD mortality prior to age 90 were 0.66 (0.44-0.99), 0.58 (0.38-0.90), and 0.53 (0.34-0.82) (p for trend 0.004). There was no significant association between baseline HDL cholesterol and non-CVD death. CONCLUSION: In a cohort of older male physicians with long-term follow-up, baseline HDL cholesterol was inversely associated with the risk of dying prior to age 90, largely explained by an inverse association between HDL and CVD mortality.


1994 ◽  
Vol 40 (4) ◽  
pp. 574-578 ◽  
Author(s):  
S M Marcovina ◽  
V P Gaur ◽  
J J Albers

Abstract Biological variability is a major contributor to the inaccuracy of cardiovascular risk assessments based on measurement of lipids, lipoproteins, or apolipoproteins. We obtained estimates of biological variation (CVb) for 20 healthy adults and calculated the percentiles of CVb as an expression of the variability of CVb among individuals for cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein (apo) A-I, apo B, and lipoprotein(a) [Lp(a)] by four biweekly measurements of these analytes. The CVb for the group was approximately 6-7% for cholesterol, HDL cholesterol, apo A-I, and apo B; approximately 9% for LDL cholesterol; and 28% for triglyceride. However, for each analyte, there was a considerable variation of CVb among individuals. For all analytes except Lp(a), there was no relation between the individual's CVb and the analyte concentration. Lp(a) was inversely related to CVb, and there was a very wide variation in the CVb for Lp(a) among the participants, ranging from 1% to 51%. The number of independent analyses to perform to accurately assess an individual's risk for coronary artery disease should be determined on the basis of the individual CVb for a given analyte rather than the average CVb.


1993 ◽  
Vol 39 (3) ◽  
pp. 477-480 ◽  
Author(s):  
J C Vella ◽  
E Jover

Abstract We studied several risk factors in relation to parental cardiovascular heart disease: total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein (apo) A-I, apo B, and lipoprotein(a) [Lp(a)] were determined in 322 serum samples (43 from subjects with and 279 without parental cardiovascular heart disease). The distribution of Lp(a) concentrations in our young population was similar to that of other white populations, i.e., markedly skewed, with higher frequencies at low values. As compared with children whose parents did not report cardiovascular heart disease, those with affected parents had a higher mean Lp(a) (0.23 vs 0.18 g/L; P &lt; 0.05). Moreover, 42% of the children with parental cardiovascular heart disease, but only 19% of those with no parental cardiovascular heart disease, exhibited Lp(a) values &gt; 0.30 g/L. These results suggest not only that Lp(a) is an important risk factor for cardiovascular heart disease, but also that Lp(a) is more strongly related to the risk of cardiovascular heart disease than are HDL- and LDL-cholesterol and apo A-I and B.


Author(s):  
Jos Twisk ◽  
Isabel Ferreira

The incidence of morbidity and mortality related to CVD is rather low in a paediatric population. Studies investigating the relationship between physical activity, physical fitness, and cardiovascular health in children and adolescents are therefore mostly limited to CVD risk factors as outcome measures. For this reason, this chapter will focus on the association of physical activity and physical fitness with CVD risk factors in children and adolescents. These risk factors can be divided into the so-called traditional CVD risk factors; that is, lipoproteins [total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (TG)], blood pressure, body fatness, and diabetes, and ‘new’ CVD risk factors; that is, other lipoproteins [lipoprotein(a) (Lp(a)), apolipoprotein (apo)B, and apoA-1], coagulation and inflammation markers [fibrinogen, C-reactive protein (CRP)], homocysteine, and heart rate variability.


2019 ◽  
Vol 8 (5) ◽  
pp. 599
Author(s):  
Ji Hye Huh ◽  
Tae Woong Yoon ◽  
Dae Ryong Kang ◽  
Jang Young Kim

We investigated whether changes in adiponectin levels over time predict incident metabolic syndrome (MetS) in a population-based prospective study. In total, 1110 subjects were categorized into four groups according to their sex-specific median baseline adiponectin levels and the change in adiponectin levels at follow-up: low baseline adiponectin and decreased adiponectin during follow-up (LB&DF), low baseline adiponectin and increased adiponectin during follow-up (LB&IF), high baseline adiponectin and decreased adiponectin during follow-up (HB&DF), and high baseline adiponectin and increased adiponectin during follow-up (HB&IF). During the median 2.4-year follow-up period, 180 (16.2%) subjects developed MetS. Compared to the LB&DF group, the fully adjusted hazard ratio (95% confidence interval) for incident MS was the lowest in the HB&IF group (0.33, (0.17–0.63)), followed by the HB&DF group (0.58, (0.40–0.84)) and LB&IF group (0.63, (0.41–0.93)). This phenomenon was more prominent in men than in women. Among the individual MetS components, increased adiponectin levels during follow-up were significantly associated with lower risks of incident low high density lipoprotein (HDL) cholesterol and incident high blood pressure. This finding suggests that a change in adiponectin level, as well as the baseline adiponectin level, might have a clinical role in the development of MetS among men.


Author(s):  
Johanna E. Emmens ◽  
Congzhuo Jia ◽  
Leong L. Ng ◽  
Dirk J. van Veldhuisen ◽  
Kenneth Dickstein ◽  
...  

Background We recently showed that, in patients with heart failure, lower high‐density lipoprotein (HDL) cholesterol concentration was a strong predictor of death or hospitalization for heart failure. In a follow‐up study, we suggested that this association could be partly explained by HDL proteome composition. However, whether the emerging concept of HDL function contributes to the prognosis of patients with heart failure has not been addressed. Methods and Results We measured 3 key protective HDL function metrics, namely, cholesterol efflux, antioxidative capacity, and anti‐inflammatory capacity, at baseline and after 9 months in 446 randomly selected patients with heart failure from BIOSTAT‐CHF (A Systems Biology Study to Tailored Treatment in Chronic Heart Failure). Additionally, the relationship between HDL functionality and HDL proteome composition was determined in 86 patients with heart failure. From baseline to 9 months, HDL cholesterol concentrations were unchanged, but HDL cholesterol efflux and anti‐inflammatory capacity declined (both P <0.001). In contrast, antioxidative capacity increased ( P <0.001). Higher HDL cholesterol efflux was associated with lower mortality after adjusting for BIOSTAT‐CHF risk models and log HDL cholesterol (hazard ratio, 0.81; 95% CI, 0.71–0.92; P =0.001). Other functionality measures were not associated with outcome. Several HDL proteins correlated with HDL functionality, mainly with cholesterol efflux. Apolipoprotein A1 emerged as the main protein associated with all 3 HDL functionality measures. Conclusions Better HDL cholesterol efflux at baseline was associated with lower mortality during follow‐up, independent of HDL cholesterol. HDL cholesterol efflux and anti‐inflammatory capacity declined during follow‐up in patients with heart failure. Measures of HDL function may provide clinical information in addition to HDL cholesterol concentration in patients with heart failure.


2019 ◽  
Vol 39 (4) ◽  
Author(s):  
Yuna Horiuchi ◽  
Ryunosuke Ohkawa ◽  
Shao-Jui Lai ◽  
Shitsuko Shimano ◽  
Michio Hagihara ◽  
...  

Abstract Cholesterol efflux capacity (CEC) in atherosclerotic lesions is the main anti-atherosclerotic function of high-density lipoprotein (HDL). In recent studies, apolipoprotein (apo) B-depleted serum (BDS) obtained with the polyethylene glycol (PEG) precipitation method is used as a cholesterol acceptor (CA) substitution for HDL isolated by ultracentrifugation. However, the suitability of BDS as a CA is controversial. In the present study, CEC obtained from BDS (BDS-CEC) was evaluated based on a parameter, defined as whole-CEC, which was calculated by multiplying CEC obtained using fixed amounts of HDL by cholesterol concentration to HDL-cholesterol (HDL-C) levels in the serum. Significant correlation (r = 0.633) was observed between both CECs. To eliminate systematic errors from possible contamination with serum proteins and low-density lipoprotein (LDL) or very-LDL (VLDL) in BDS-CEC, the deviation of each CEC-BDS from the regression equation was compared with serum protein, LDL, and triglyceride (TG) levels. No correlation was observed between the deviation and the levels of each of these serum components, indicating that the deviations do not derive from systematic error. Further, to evaluate the effects of serum protein on the results, we measured BDS-CEC of reconstituted serum samples prepared using combinations of five levels of serum proteins with five levels of HDL-C. No significant change in BDS-CEC was observed in any combination. These results indicate that BDS-CEC reflects not only the function of HDL but also its concentration in serum.


1996 ◽  
Vol 42 (4) ◽  
pp. 524-530 ◽  
Author(s):  
R Siekmeier ◽  
P Wülfroth ◽  
H Wieland ◽  
W Gross ◽  
W März

Abstract We analyzed the susceptibility of low-density lipoproteins (LDL) to oxidation in 17 healthy smokers (43.3 +/- 16.8 pack-years) and 19 healthy nonsmokers, matched for age (smokers: 52 +/- 7 years; nonsmokers: 53 +/- 7 years), gender, and relative body mass. Cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, and apolipoprotein (apo) B were not different between smokers and nonsmokers; apo A-I was slightly lower in smokers (one-tailed P = 0.066). To study whether LDL from smokers were prone to in vitro oxidation than LDL from nonsmokers, we measured the time kinetics of diene formation and the production of malondialdehyde during oxidation of LDL in vitro. In smokers and nonsmokers, respectively, the mean (+/-SD) lag times (tinh) of diene formation were 111 +/- 26 and 100 +/- 27 min, the peak rates of diene formation (Vmax) were 5.99 +/- 2.34 and 6.34 +/- 2.30 mmol x min-1 x g-1, and the amounts of dienes produced during the propagation phase (dmax) were 250 +/- 264 and 248 +/- 56 mmol x g-1. Neither the malondialdehyde content of LDL (measured as thiobarbituric acid-reactive substances) before oxidation nor the amount of malondialdehyde generated during oxidation (smokers: 57.0 +/- 14.2 micromol x g-1; nonsmokers: 63.2 +/- 15.2 micromol x g-1 indicated any statistically significant effect of smoking. When nonsmokers and smokers were considered together, the amount of malondialdehyde generated during oxidation correlated with age (nonparametric rs = 0.405), body mass index (r2 = 0.573), and concentrations of apo B (rs = 0.480), cholesterol (rs = 0.448), triglycerides (rs = 0.436), and LDL cholesterol (rs = 0.398). Our data show that smoking is not associated with increased oxidizability of LDL in healthy men and women at ages 42-63 years.


2018 ◽  
Vol 67 (3) ◽  
pp. 663-668
Author(s):  
May Yang ◽  
Joseph Rigdon ◽  
Sandra A Tsai

Electronic medical records (EMRs) offer a potential opportunity to identify patients at high risk for cardiometabolic disease, which encompasses type 2 diabetes and cardiovascular disease (CVD). The objective of this retrospective cohort study is to use information gathered from EMR to investigate the association between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and cardiometabolic outcomes in a general population of subjects over 50 years of age during a follow-up period of 8–9 years. TG/HDL-C was recorded for each of 1428 subjects in 2008, and diagnoses of type 2 diabetes and CVD were recorded through chart review until 2017. Cox proportional hazards models controlling for demographic characteristics and other risk factors demonstrated that high TG/HDL-C (>2.5 in women or >3.5 in men) was significantly associated with increased incidence of type 2 diabetes (HR 1.66; 95% CI 1.07 to 2.57; p=0.0230). There was also a suggested association between high TG/HDL-C and incidence of CVD (HR 1.51; 95% CI 0.98 to 2.35; p=0.0628). These findings suggest that using TG/HDL-C, which can be easily calculated from data in an EMR, should be another tool used in identifying patients at high cardiometabolic risk.


1988 ◽  
Vol 75 (2) ◽  
pp. 135-142 ◽  
Author(s):  
G. Franceschini ◽  
Y. Moreno ◽  
P. Apebe ◽  
L. Calabresi ◽  
E. Gatti ◽  
...  

1. Serum lipid and apolipoprotein levels, distribution and composition of high-density lipoprotein (HDL) sub-fractions and lecithin:cholesterol acryltransferase activity were analysed in nine normolipidaemic subjects, in whom a hypertriglyceridaemic state was induced by the acute administration of ethanol (40 g) plus fat (70 g) or of fat only. 2. Triglyceride (TG) levels increased by 180% 4–6 h after fat plus ethanol intake, the hypertriglyceridaemic response being inversely correlated with the basal HDL2 mass (r = −0.82). Serum apolipoprotein (apo) B levels rose by 8%, HDL–cholesterol decreased by 10% and HDL–TG increased by 57% at 6–8 h. 3. When ethanol was omitted, serum cholesterol and TG rose by 6% and 70%, respectively; both apo AI and apo B levels went up by 8%, whereas HDL-cholesterol rose progressively (15%) at 12 h. 4. The flotation rates of both HDL2 and HDL, increased, reaching a maximum 6–8 h after ethanol plus fat intake. These changes were due to an increase in TG and phospholipid contents, whereas cholesteryl esters and proteins decreased. 5. The alterations in HDL are attributable to the increase in TG-rich lipoproteins, to the stimulated cholesterol esterification (+ 15%) and to an enhanced transfer of newly formed cholesteryl esters to apo-B-containing lipoproteins in exchange for TG. 6. Changes in HDL properties were evident only when ethanol was given concomitantly with fat. 7. These findings suggest that in the postprandial phase lipoprotein changes may occur, which facilitate an improved removal of cholesterol from tissues.


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