Impaired HDL cholesterol efflux capacity in systemic lupus erythematosus patients is related to subclinical carotid atherosclerosis

Rheumatology ◽  
2020 ◽  
Vol 59 (10) ◽  
pp. 2847-2856 ◽  
Author(s):  
Hiurma Sánchez-Pérez ◽  
Juan Carlos Quevedo-Abeledo ◽  
Laura de Armas-Rillo ◽  
Íñigo  Rua--Figueroa ◽  
Beatriz Tejera-Segura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Cardiovascular Risk Factors ◽  
Cholesterol Efflux ◽  
Carotid Atherosclerosis ◽  
Vitro Assay ◽  
Carotid Plaques ◽  
Cholesterol Efflux Capacity ◽  
Related Data

Abstract Objectives Lipid profiles appear to be altered in SLE patients due to disease activity and inflammation. Cholesterol efflux capacity (CEC) is the ability of high-density lipoprotein cholesterol to accept cholesterol from macrophages. CEC has been linked to cardiovascular events in the general population and is impaired in SLE patients. The aim of this study was to establish whether CEC is related to subclinical carotid atherosclerosis in SLE patients. Methods The present report is of a cross-sectional study that encompassed 418 individuals: 195 SLE patients and 223 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. Carotid intima-media thickness and carotid plaques were evaluated in SLE patients. A multivariable analysis was performed to study the relationship of CEC to SLE-related data, lipid profile and subclinical carotid atherosclerosis. Results CEC was downregulated in SLE patients [8.1  (4.2) % vs 16.9 (10.4) %, P = 0.004). This occurred independently of traditional cardiovascular risk factors, statin use or other variations in the lipid profile related to the disease. Traditional cardiovascular risk factors, both in patients and controls, and SLE-related data such as activity, severity or damage were not associated with CEC. After multivariable regression analysis including lipid profile–related molecules, CEC was inversely and independently associated with the presence of carotid plaques in SLE patients [odds ratio 0.87 (95% CI: 0.78, 0.97), P = 0.014]. Conclusion CEC is impaired in SLE patients independently of other inflammation-related lipid profile modifications that occur during the disease. CEC is associated with carotid plaques in SLE patients.

scholarly journals HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients with Systemic Sclerosis.

2020 ◽  
Author(s):  
Iván Ferraz-Amaro ◽  
Esmeralda Delgado-Frías ◽  
Vanesa Hernández-Hernández ◽  
Hiurma Sánchez-Pérez ◽  
Laura de Armas-Rillo ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Systemic Sclerosis ◽  
Lipid Profile ◽  
Cholesterol Efflux ◽  
Hdl Cholesterol ◽  
Skin Thickness ◽  
Vitro Assay ◽  
Cholesterol Efflux Capacity ◽  
Related Data ◽  
Beta Coefficient

Abstract Objective. It is well established that patients with systemic sclerosis (SSc) have a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC), the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages has been linked to cardiovascular events. The aim of this study was to establish whether CEC and lipid profile were impaired in SSc patients respect to controls and whether these changes were associated with disease-related data. Methods. Cross-sectional study encompassed 188 individuals: 73 SSc patients and 115 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SSc-related data could explain such differences. Results. The multivariate analysis adjusted for demographic characteristics, cardiovascular risk factors and lipid-related molecules showed that total cholesterol (beta coefficient: -22 [95%CI -37- -7], p=0.004), triglycerides (beta coefficient: 24 [95%CI 2-47], p=0.033), lipoprotein A (beta coefficient: 22 [95%CI 2-43], p=0.033) and CEC (beta coefficient: -6 [95%CI -10- -2]%,p=0.002) were significantly differences between patients and controls. Skin thickness, as assessed by modified Rodnan skin score, was independently associated with a lower CEC (beta coefficient: -0.21 [95%CI -0.37- -0.05]%, p=0.011) after multivariable adjustment. Conclusion. SSc patients show an abnormal lipid profile with respect to controls including CEC. Skin thickness is independent and inversely associated with CEC in SSc patients.

scholarly journals HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients With Systemic Sclerosis

2020 ◽  
Author(s):  
Iván Ferraz-Amaro ◽  
Esmeralda Delgado-Frías ◽  
Vanesa Hernández-Hernández ◽  
Hiurma Sánchez-Pérez ◽  
Laura de Armas-Rillo ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Systemic Sclerosis ◽  
Lipid Profile ◽  
Cholesterol Efflux ◽  
Hdl Cholesterol ◽  
Skin Thickness ◽  
Vitro Assay ◽  
Cholesterol Efflux Capacity ◽  
Related Data ◽  
Beta Coefficient

Abstract Objective. It is well established that patients with systemic sclerosis (SSc) have a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC), the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages has been linked to cardiovascular events. The aim of this study was to establish whether CEC and lipid profile were impaired in SSc patients respect to controls and whether these changes were associated with disease-related data.Methods. Cross-sectional study encompassed 188 individuals: 73 SSc patients and 115 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SSc-related data could explain such differences. Results. The multivariate analysis adjusted for demographic characteristics, cardiovascular risk factors and lipid-related molecules showed that total cholesterol (beta coefficient: -22 [95%CI -37- -7], p=0.004), triglycerides (beta coefficient: 24 [95%CI 2-47], p=0.033), lipoprotein A (beta coefficient: 22 [95%CI 2-43], p=0.033) and CEC (beta coefficient: -6 [95%CI -10- -2]%,p=0.002) were significantly differences between patients and controls. Skin thickness, as assessed by modified Rodnan skin score, was independently associated with a lower CEC (beta coefficient: -0.21 [95%CI -0.37- -0.05]%, p=0.011) after multivariable adjustment.Conclusion: SSc patients show an abnormal lipid profile respect to controls including CEC, a finding that could be involved in the increased cardiovascular burden suffered by these patients. Skin thickness is independent and inversely associated with CEC in SSc patients.

Abstract WP241: Prevalence of Subclinical Extracranial Carotid Atherosclerosis Detected by Ultrasound Among Amerindians: A Population Study in Rural Ecuador

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Victor J Del Brutto ◽  
Jose G Romano ◽  
Robertino M Mera ◽  
Jonathan P Amodio ◽  
Tatjana Rundek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
High Blood Pressure ◽  
Carotid Atherosclerosis ◽  
Male Gender ◽  
Rural Setting ◽  
Carotid Plaques ◽  
The Mean

Background: Epidemiological information on extracranial carotid atherosclerosis (ECA) among Amerindians is limited. We aim to determine the prevalence of subclinical ECA and its correlation with cardiovascular risk factors in community-dwelling adults of Amerindian ancestry living in a rural Ecuadorian village. Methods: Utilizing a population-based design, stroke-free individuals aged ≥40 years were invited to undergo carotid ultrasound. Subclinical ECA was defined as an intima-media thickness (cIMT) >1mm and/or the presence of carotid plaques (focal intima thickening >1.5mm that protrudes into the lumen). Degree of luminal stenosis was calculated and considered significant if >50%. We investigated the association between these biomarkers and cardiovascular risk factors. Results: Of 728 candidates, 559 (77%) stroke-free individuals underwent carotid sonographic evaluation and were included. The mean age was 62.3 ±12.5 and 238 (43%) were men. The mean value of the cIMT was 0.85 ± 0.17mm (median cIMT: 0.83mm; IQ range: 0.74-0.92 mm). The prevalence of increased cIMT, carotid plaques, and increased cIMT and/or carotid plaques were 14%, 23.8%, and 26.1%, respectively. Table depicts the association of these biomarkers with cardiovascular risk factors. A multinomial logistic regression model, using individuals with normal carotids as the referent category, showed significant associations of ECA with increasing age, male gender, smoking and high blood pressure. Significant carotid stenosis was found in 19 subjects (3.4%). Conclusions: About one-fourth of Amerindians living in a rural setting have subclinical ECA. Increasing age, male gender, smoking and high blood pressure were independent determinants of the burden of ECA, while elevated glucose and total cholesterol showed no significant association. Obesity was inversely associated with ECA in univariate analysis, but such association disappeared in the multivariate model.

scholarly journals The Predictive Value of Carotid Ultrasonography With Cardiovascular Risk Factors—A “SPIDER” Promoting Atherosclerosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongwei Li ◽  
Xiaolin Xu ◽  
Baoming Luo ◽  
Yuling Zhang
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Cardiovascular Risk Factors ◽  
Carotid Atherosclerosis ◽  
Clinical Use ◽  
Cvd Risk ◽  
Carotid Ultrasonography ◽  
Carotid Plaques

Insufficient recommendations do not support the clinical use of carotid ultrasonography for further risk stratification in moderate-to-high risk patients with cardiovascular disease (CVD). A literature review was performed to assess six aspects of the research progress and limitations of carotid ultrasonography and carotid atherosclerosis-related risk factors: (1) structures of the carotid intima and media; (2) plaques; (3) inflammation; (4) dynamics of carotid blood flow; (5) early detection and intervention; and (6) risk factors for CVD. Although carotid intima-media thickness and carotid plaques are well-acknowledged independent predictors of CVD risk, normative and cut-off values are difficult to define due to the heterogeneous measurements reported in previous studies. Plaque properties, including location, number, density, and size, become more important risk predictors for cardiovascular disease, but a better approach for clinical use needs to be further established. Three-dimensional ultrasound and contrast-enhanced ultrasound are promising for promoting risk stratification with more details on plaque morphology. Moreover, inflammatory diseases and biomarkers should be evaluated for a full assessment of the inflammatory burden for atherosclerosis. Carotid flow velocity is not only an indicator for stenosis but also a potential risk predictor. Carotid atherosclerosis should be detected and treated early, and additional clinical trials are needed to determine the efficacy of these measures in reducing CVD risk. Cardiovascular risk factors tend to affect carotid plaques, and early treat-to-target therapy might yield clinical benefits. Based on the aforementioned six aspects, we consider that these six important factors act like a “SPIDER” spinning the web of atherosclerosis; a timely comprehensive assessment and intervention may halt the progression to CVD. Carotid ultrasound results should be combined with other atherosclerotic factors, and a comprehensive risk assessment may help to guide cardiovascular prevention decisions.

scholarly journals HDL cholesterol efflux capacity and lipid profile in patients with systemic sclerosis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Iván Ferraz-Amaro ◽  
Esmeralda Delgado-Frías ◽  
Vanesa Hernández-Hernández ◽  
Hiurma Sánchez-Pérez ◽  
Laura de Armas-Rillo ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Systemic Sclerosis ◽  
Lipid Profile ◽  
Cholesterol Efflux ◽  
Multivariable Analysis ◽  
Hdl Cholesterol ◽  
Skin Thickness ◽  
Cholesterol Efflux Capacity ◽  
Related Data ◽  
Beta Coefficient

Abstract Objective It is well established that patients with systemic sclerosis (SSc) have a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC), the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages, has been linked to cardiovascular events. The aim of this study was to establish whether CEC and lipid profile were impaired in SSc patients with respect to controls and whether these changes were associated with disease-related data. Methods Cross-sectional study encompassed 188 individuals: 73 SSc patients and 115 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SSc-related data could explain such differences. Results The multivariable analysis adjusted for demographic characteristics, cardiovascular risk factors, and lipid-related molecules showed that total cholesterol (beta coefficient: − 22 [95%CI – 37 to – 7], p = 0.004), triglycerides (beta coefficient: 24 [95%CI 2–47], p = 0.033), lipoprotein A (beta coefficient: 22 [95%CI 2–43], p = 0.033), and CEC (beta coefficient: – 6 [95%CI − 10 to – 2]%,p = 0.002) were significantly different between patients and controls. Skin thickness, as assessed by modified Rodnan skin score, was independently associated with a lower CEC (beta coefficient: – 0.21 [95%CI – 0.37 to – 0.05]%, p = 0.011) after multivariable adjustment. Conclusion SSc patients show an abnormal lipid profile with respect to controls including CEC. Skin thickness is independent and inversely associated with CEC in SSc patients.

scholarly journals HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients with Systemic Sclerosis.

2021 ◽  
Author(s):  
Iván Ferraz-Amaro ◽  
Esmeralda Delgado-Frías ◽  
Vanesa Hernández-Hernández ◽  
Hiurma Sánchez-Pérez ◽  
Laura de Armas-Rillo ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Systemic Sclerosis ◽  
Lipid Profile ◽  
Cholesterol Efflux ◽  
Multivariable Analysis ◽  
Hdl Cholesterol ◽  
Skin Thickness ◽  
Cholesterol Efflux Capacity ◽  
Related Data ◽  
Beta Coefficient

Abstract Objective. It is well established that patients with systemic sclerosis (SSc) have a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC), the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages has been linked to cardiovascular events. The aim of this study was to establish whether CEC and lipid profile were impaired in SSc patients respect to controls and whether these changes were associated with disease-related data.Methods. Cross-sectional study encompassed 188 individuals: 73 SSc patients and 115 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SSc-related data could explain such differences. Results. The multivariable analysis adjusted for demographic characteristics, cardiovascular risk factors and lipid-related molecules showed that total cholesterol (beta coefficient: -22 [95%CI -37- -7], p=0.004), triglycerides (beta coefficient: 24 [95%CI 2-47], p=0.033), lipoprotein A (beta coefficient: 22 [95%CI 2-43], p=0.033) and CEC (beta coefficient: -6 [95%CI -10- -2]%,p=0.002) were significantly differences between patients and controls. Skin thickness, as assessed by modified Rodnan skin score, was independently associated with a lower CEC (beta coefficient: -0.21 [95%CI -0.37- -0.05]%, p=0.011) after multivariable adjustment.Conclusion: SSc patients show an abnormal lipid profile with respect to controls including CEC. Skin thickness is independent and inversely associated with CEC in SSc patients.

scholarly journals SAT0317 HDL-CHOLESTEROL EFFLUX CAPACITY IS DOWNREGULATED IN PATIENTS WITH SYSTEMIC SCLEROSIS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1104.2-1104
Author(s):  
I. Ferraz-Amaro ◽  
D. F. Esmeralda ◽  
V. Hernández-Hernández ◽  
H. Sánchez-Pérez ◽  
L. De Armas-Rillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Systemic Sclerosis ◽  
Lipid Profile ◽  
Cholesterol Efflux ◽  
Hdl Cholesterol ◽  
Skin Thickness ◽  
Research Support ◽  
Related Data ◽  
Beta Coefficient

Background:It is well established that patients with systemic sclerosis (SS) show a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC) is the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages. CEC has been linked to cardiovascular events in the general population and to subclinical atherosclerosis in patients with rheumatoid arthritis and systemic lupus erythematosus.Objectives:The main purpose of our study was to assess, for the first time, whether CEC is disrupted in patients with SS compared to controls. We also aimed to identify patients’ characteristics that could explain such potential CEC disturbance.Methods:Cross-sectional study that encompassed 188 individuals; 73 SS patients and 115 age- and sex-matched controls. CEC, using anin vitroassay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SS-related data could explain CEC differences.Results:CEC was downregulated in SS patients as compared to controls (beta coefficient -6 [95%CI -10- -2] %, p=0.002). This occurred independently of traditional cardiovascular risk factors, statin use or other variations in the lipid profile produced by the disease. Demographics and lipid profile were, in general, not related with CEC in both patients and controls. In this sense, only abdominal circumference showed a positive association with CEC in patients (beta coefficient 0.09 [95%CI 0.03-0.14], p=0.002) but not in controls. Similarly, no traditional cardiovascular risk factors were related with CEC in both populations. Regarding lipid profile, no correlations were identified between the standard lipid profile molecules and CEC. Remarkably, the use of statins was not related to CEC in both patients and controls. Lastly, concerning SS related data, a negative association between mRSS and CEC was identified (beta coef. -1.08 [95%CI -2.03- -0.12] %, p=0.028).Skin thickness through modified Rodnan (mRSS) was positively related to age and the presence of hypertension, but negatively associated with apolipoprotein B, apo B:A1 ratio, and CEC when univariate correlations were assessed (Table 4). When the relation of mRSS to these lipid-related molecules was adjusted for traditional CV risk factors, the statistical significance of mRSS with those molecules was maintained. Moreover, when the relation between mRSS and CEC was additionally adjusted for other lipid-related molecules, its significance was conserved (beta coef. -1.35 [95%CI -2.62- -0.08]) %, p=0.038)Conclusion:CEC is downregulated in SS patients independently of other inflammation-related lipid profile modifications that occur in the disease. Skin thickness is independent and inversely associated with CEC in SS patients.Disclosure of Interests:Iván Ferraz-Amaro Grant/research support from: Pfizer, Abbvie, Speakers bureau: Pfizer, Abbvie, MSD., delgado frias esmeralda Speakers bureau: Pfizer, Abbvie, MSD, Vanessa Hernández-Hernández Speakers bureau: Pfizer, Abbvie, MSD, Hiurma Sánchez-Pérez: None declared, Laura de Armas-Rillo: None declared, Estefania Armas González: None declared, Jose David Machado: None declared, Federico Díaz-González Grant/research support from: Abbvie, Pfizer, MSD, Speakers bureau: Abbvie, Pfizer, MSD

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