scholarly journals Why does Russia have such high cardiovascular mortality rates? Comparisons of blood-based biomarkers with Norway implicate non-ischaemic cardiac damage

2020 ◽  
pp. jech-2020-213885 ◽  
Author(s):  
Olena lakunchykova ◽  
Maria Averina ◽  
Tom Wilsgaard ◽  
Hugh Watkins ◽  
Sofia Malyutina ◽  
...  

BackgroundRussia has one of the highest rates of mortality from cardiovascular disease (CVD). At age 35–69 years, they are eight times higher than in neighbouring Norway. Comparing profiles of blood-based CVD biomarkers between these two populations can help identify reasons for this substantial difference in risk.MethodsWe compared age-standardised mean levels of CVD biomarkers for men and women aged 40–69 years measured in two cross-sectional population-based studies: Know Your Heart (KYH) (Russia, 2015–2018; n=4046) and the seventh wave of the Tromsø Study (Tromsø 7) (Norway, 2015–2018; n=17 646). A laboratory calibration study was performed to account for inter-laboratory differences.ResultsLevels of total, low-density lipoprotein-, high-density lipoprotein-cholesterol and triglycerides were comparable in KYH and Tromsø 7 studies. N-terminal pro-b-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT) and high-sensitivity C-reactive protein (hsCRP) were higher in KYH compared with Tromsø 7 (NT-proBNP was higher by 54.1% (95% CI 41.5% to 67.8%) in men and by 30.8% (95% CI 22.9% to 39.2%) in women; hs-cTnT—by 42.4% (95% CI 36.1% to 49.0%) in men and by 68.1% (95% CI 62.4% to 73.9%) in women; hsCRP—by 33.3% (95% CI 26.1% to 40.8%) in men and by 35.6% (95% CI 29.0% to 42.6%) in women). Exclusion of participants with pre-existing coronary heart disease (279 men and 282 women) had no substantive effect.ConclusionsDifferences in cholesterol fractions cannot explain the difference in CVD mortality rate between Russia and Norway. A non-ischemic pathway to the cardiac damage reflected by raised NT-proBNP and hs-cTnT is likely to contribute to high CVD mortality in Russia.

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Daniel Budiono

Abstract: Atherosclerosis is the leading cause of mortality in the developed countries and in the future, it is predicted to be the leading cause of mortality in the developing countries. Low density lipoprotein, high sensitivity C-reactive protein, and obesity have been identified as risk factors of atherosclerosis. Obesity during childhood and adolescents tends to occur during adults life. The aim of this study is to know the levels of low density lipoprotein and high sensitivity C-reactive protein and the correlation between those two levels in obese adolescents. This observational cross sectional study design involved 17 obese adolescents and analyzed using Spearman Correlation Test. The results showed the mean levels of LDL was 123,0 mg/dL, and hs-CRP was 1,618 mg/L. Spearman correlation test showed significance value (p) was 0,024 and correlation significance value coefficient was 0,544. From the results can be concluded that the levels of low density lipoprotein levels in obese adolescents is in normal range, obese adolescents are associated with a moderate risk of cardiovascular disease at the future and there is a significant positive correlation between low density lipoprotein cholestrol levels and high sensitivity C-reactive protein levels in obese adolescents. Keywords : low density lipoprotein, high sensitivity c-reactive protein, obese adolescents   Abstrak: Aterosklerosis merupakan penyebab kematian utama di negara maju saat ini, dan diprediksi akan menjadi penyebab kematian utama di negara berkembang di masa mendatang. Peningkatan kadar low density lipoprotein dan kadar high sensitivity C-reactive protein (hs-CRP) serta obesitas telah diidentifikasi sebagai faktor risiko aterosklerosis. Remaja yang mengalami obesitas cenderung tetap mengalami obesitas pada saat dewasa. Tujuan dari penelitian ini untuk mengetahui gambaran kadar kolestrol low density lipoprotein dan kadar high sensitivity C-reactive protein pada remaja obes, serta hubungan kadar low density lipoprotein dengan kadar high sensitivity C-reactive protein pada remaja obes. Penelitian ini menggunakan desain penelitian analitik observasional dengan pendekatan cross sectional terhadap 17 remaja obes. Nilai rerata kadar LDL pada remaja obes 123,00 mg/dL, dan nilai rerata kadar hs-CRP pada remaja obes 1,618 mg/L. Berdasarkan hasil penelitian, dapat disimpulkan remaja obes memiliki kadar LDL dalam rentang normal, remaja obes memiliki risiko sedang terkena penyakit kardiovaskular di masa mendatang dan terdapat hubungan positif yang signifikan antara kadar low density lipoprotein dengan kadar high sensitivity c-reactive protein pada remaja obes. Kata Kunci: low density lipoprotein, high sensitivity c-reactive protein, remaja obes


2018 ◽  
Vol 108 (6) ◽  
pp. 1283-1290 ◽  
Author(s):  
Eke G Gruppen ◽  
Stephan J L Bakker ◽  
Richard W James ◽  
Robin P F Dullaart

ABSTRACT Background Paraoxonase-1 (PON-1) is a high-density lipoprotein (HDL)-associated enzyme with antioxidative properties, which may protect against the development of cardiovascular disease. Alcohol consumption increases HDL cholesterol, but the extent to which alcohol consumption gives rise to higher serum PON-1 activity is uncertain. Objective In a population-based study, we determined the relation of serum PON-1 activity with alcohol consumption when taking account of HDL cholesterol and apolipoprotein A-I (apoA-I), its major apolipoprotein. Design A cross-sectional study was performed in 8224 participants of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort. Alcohol consumption was categorized as 1) no/rarely (25.3%); 2) 0.1–10 g/d (49.3%); 3) 10–30 g/d (20.1%); and 4) >30 g/d (5.2%) with 1 drink equivalent to 10 g alcohol. Serum PON-1 activity was measured as its arylesterase activity (phenyl acetate as substrate). Results Median serum PON-1 activity was 50.8, 53.1, 54.4, and 55.7 U/L in the 4 categories of alcohol consumption, respectively (P < 0.001). Its increase paralleled the increments in HDL cholesterol and apoA-I. Notably, there was no further increase in PON-1 activity, HDL cholesterol, and apoA-I when alcohol consumption was increased from 10–30 g/d to >30 g/d. Multivariable linear regression analysis demonstrated that PON-1 activity was related to alcohol consumption independently from clinical covariates, high sensitivity C-reactive protein, and lipid concentrations, including HDL cholesterol (P < 0.001 for each category of alcohol consumption with no alcohol consumption as the reference category). Notably, as inferred from standardized β-coefficients, there was no difference in PON-1 activity between 10–30 g alcohol/d and >30 g alcohol/d. Conclusions Alcohol consumption is associated with an increase in serum PON-1 activity, but its effect seems to reach a plateau with alcohol consumption of 10–30 g/d.


2020 ◽  
Vol 5 (3) ◽  
pp. 676
Author(s):  
Rama Dhanivita Djamin

<p><em>Obesitas terjadi karena akumulasi lemak berlebih di dalam tubuh. Akumulasi lemak menimbulkan low grade inflammation pada jaringan adiposa, menyebabkan peningkatan sitokin inflamasi seperti tumor necrosis factor-alpha, interleukin-1 beta, dan interleukin-6 (IL-6). Peningkatan sekresi IL-6 merangsang hepar meningkatkan produksi protein fase akut. High sensitivity C-reactive protein (hs-CRP) sebagai penanda inflamasi merupakan protein fase akut. Low density lipoprotein (LDL-kolesterol) adalah lipoprotein yang paling banyak mengandung kolesterol. Peningkatan kadar hs-CRP dan kadar LDL-kolesterol pada obesitas diidentifikasi sebagai faktor risiko aterosklerosis. Penelitian ini bertujuan menganalisis hubungan hs-CRP dengan LDL-kolesterol pada penyandang obes, merupakan penelitian analitik rancangan potong lintang dilakukan  September 2018 sampai Agustus 2019. Kadar hs-CRP diperiksa dengan metode enzyme linked immunoassay (ELISA), sedangkan kadar LDL-kolesterol dengan metode kalkulasi (rumus Friedewald). Uji korelasi Spearman digunakan untuk menganalisi data, jika didapatkan nilai p&lt;0,05 korelasi dinyatakan bermakna. Subjek penelitian berjumlah 26 penyandang obes terdiri dari 6 laki-laki (23,1%) dan 20 perempuan (76,9%). Rerata umur subjek penelitian adalah 36,46(7,68) tahun. Rerata kadar hs-CRP dan kadar LDL-kolesterol adalah 5,08(1,28) mg/L dan  154,69(45,8) mg/dL. Analisis korelasi menunjukkan korelasi positif lemah dan tidak bermakna secara statistik antara kadar hs-CRP dengan kadar LDL-kolesterol (r= 0,333, p=0,096). Simpulan: Terdapat korelasi positif lemah antara kadar hs-CRP dengan kadar LDL-kolesterol pada penyandang obes.</em></p><p><strong><em>Kata kunci</em></strong><em>: </em><em>Obesitas, High Sensitivity C-Reactive, Low Density Lipoprotein</em><em></em></p>


Author(s):  
Adam M. Lubert ◽  
Tarek Alsaied ◽  
Joseph J. Palermo ◽  
Nadeem Anwar ◽  
Elaine M. Urbina ◽  
...  

Background Hypocholesterolemia is a marker of liver disease, and patients with a Fontan circulation may have hypocholesterolemia secondary to Fontan‐associated liver disease or inflammation. We investigated circulating lipids in adults with a Fontan circulation and assessed the associations with clinical characteristics and adverse events. Methods and Results We enrolled 164 outpatients with a Fontan circulation, aged ≥18 years, in the Boston Adult Congenital Heart Disease Biobank and compared them with 81 healthy controls. The outcome was a combined outcome of nonelective cardiovascular hospitalization or death. Participants with a Fontan (median age, 30.3 [interquartile range, 22.8–34.3 years], 42% women) had lower total cholesterol (149.0±30.1 mg/dL versus 190.8±41.4 mg/dL, P <0.0001), low‐density lipoprotein cholesterol (82.5±25.4 mg/dL versus 102.0±34.7 mg/dL, P <0.0001), and high‐density lipoprotein cholesterol (42.8±12.2 mg/dL versus 64.1±16.9 mg/dL, P <0.0001) than controls. In those with a Fontan, high‐density lipoprotein cholesterol was inversely correlated with body mass index ( r =−0.30, P <0.0001), high‐sensitivity C‐reactive protein ( r =−0.27, P =0.0006), and alanine aminotransferase ( r =−0.18, P =0.02) but not with other liver disease markers. Lower high‐density lipoprotein cholesterol was independently associated with greater hazard for the combined outcome adjusting for age, sex, body mass index, and functional class (hazard ratio [HR] per decrease of 10 mg/dL, 1.37; 95% CI, 1.04–1.81 [ P =0.03]). This relationship was attenuated when log high‐sensitivity C‐reactive protein was added to the model (HR, 1.26; 95% CI, 0.95–1.67 [ P =0.10]). Total cholesterol, low‐density lipoprotein cholesterol, and triglycerides were not associated with the combined outcome. Conclusions The Fontan circulation is associated with decreased cholesterol levels, and lower high‐density lipoprotein cholesterol is associated with adverse outcomes. This association may be driven by inflammation. Further studies are needed to understand the relationship between the severity of Fontan‐associated liver disease and lipid metabolism.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christina M Parrinello ◽  
Morgan E Grams ◽  
David Couper ◽  
Christie M Ballantyne ◽  
Ron C Hoogeveen ◽  
...  

Background: Comparability of laboratory measures over time is important for studies of disease prevalence and progression. While a small amount of bias may seem negligible on an individual level, it can result in substantial misclassification of disease in the population. We conducted a calibration study of important biomarkers across five study visits (25 years) in ARIC. Methods: We re-measured 15 analytes in 200 blood samples to calibrate original measurements at each time point using Bland-Altman plots and Deming regression. We also assessed the impact of calibration on the prevalence of chronic kidney disease (CKD), defined by estimated glomerular filtration rate using creatinine (eGFRcr), and on trends over time. Results: Assays in samples frozen 12-27 years were highly correlated with original values (median r=0.95) after removing outliers (median 4% of values). The range of bias (% difference in means) across visits for each original analyte compared to its reference were: creatinine: 13-49%; uric acid: 3-24%; C-reactive protein: 3-9%; total cholesterol: 1-6%; high density lipoprotein cholesterol: 4-8% (but new methods differed); low density lipoprotein cholesterol: 1-5%; triglycerides: 2-4%; glucose: 1-4%; N-terminal prohormone of brain natriuretic peptide: 2-12%; high sensitivity cardiac troponin T: 1-9%; alanine transaminase (ALT): 21%; aspartate transaminase (AST): 17%; gamma glutamyl transpeptidase: 0.2%; ß2-microglobulin: 1%; beta-trace protein: 13%. Four analytes met calibration criteria: creatinine, uric acid, ALT and AST. The impact on CKD prevalence was substantial and similar to previous statistical calibration (22% uncalibrated, 1.9% previously and 1.3% current laboratory calibration). Trends in eGFRcr over time were better aligned after calibration ( Figure ). Conclusions: Repeat assay of samples shows high correlation with original values. Calibration enables application of absolute cutoffs (required for defining CKD and other conditions) and improves longitudinal analyses.


2020 ◽  
Vol 9 (12) ◽  
pp. 3838
Author(s):  
Soo Ji Jeon ◽  
Hyung Bin Hwang ◽  
Na Young Lee

The purpose of this study was to investigate the function of the renin–angiotensin–aldosterone system (RAAS) in normal tension glaucoma (NTG) patients by measuring the level of renin and angiotensin II (AngII) in the plasma. Twenty-four patients with NTG and 38 control subjects were included in this study. Renin and AngII were measured in the blood samples of all subjects by enzyme-linked immunosorbent assay (ELISA). No significant differences were found in the complete blood count, fasting glucose, low-density lipoprotein (LDL), and high-sensitivity C-reactive protein (hs-CRP) levels between the control and NTG groups. The systemic concentration and variability of the renin concentration in the blood was significantly higher in the NTG group (p = 0.005 and 0.005, respectively). According to multivariate logistic regression analysis, the variability of the renin concentration was associated with NTG (p = 0.006). In conclusion, the systemic concentration and variability of renin levels were elevated in NTG patients. An altered renin concentration could represent a difference in RAAS function in NTG patients.


2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Myung Han Hyun ◽  
Yuchang Lee ◽  
Byoung Geol Choi ◽  
Jin Oh Na ◽  
Cheol Ung Choi ◽  
...  

In statin therapy, the prognostic role of achieved low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hsCRP) in cardiovascular outcomes has not been fully elucidated. A total of 4,803 percutaneous coronary intervention (PCI)-naïve patients who prescribed moderate intensity of statin therapy were followed up. Total and each component of major adverse cardiovascular events (MACE) according to LDL-C and hsCRP quartiles were compared. The incidence of 5-year total MACEs in the highest quartile group according to the followed-up hsCRP was higher than that in the lowest quartile (hazard ratio (HR) = 2.16, p<0.001). However, there was no difference between the highest and lowest quartiles of the achieved LDL-C (HR = 0.95, p=0.743). After adjustment of potential confounders, the incidence of total death, de novo PCI, atrial fibrillation, and heart failure in the highest quartile of followed-up hsCRP, was higher than that in the lowest quartile (all p<0.05). However, other components except for de novo PCI in the highest quartile by achieved LDL-C was not different to that in the lowest quartile. These results suggest that followed-up hsCRP can be more useful for predicting future cardiovascular outcome than achieved LDL-C in PCI-naïve patients with statin therapy.


Sign in / Sign up

Export Citation Format

Share Document