scholarly journals Psoriasis and Cardiovascular Risk—Do Promising New Biomarkers Have Clinical Impact?

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Sirje Kaur ◽  
Külli Kingo ◽  
Mihkel Zilmer

Epidemiological studies suggest an increased prevalence of cardiovascular disease (CVD) in patients with psoriasis (PS). Therefore, emphasis has lately been laid on the necessity for clinical evaluation of the risk of CVD in these patients. The systemic inflammatory markers C-reactive protein (CRP) and interleukin- (IL-) 6, which have long been used to predict future CVD in the general population, are increased manyfold in patients with PS. Lipid abnormalities characterized by elevated triglycerides, low HDL cholesterol, and higher concentrations of LDL cholesterol and its oxidized form are also prevalent in patients. There is a need for additional laboratory markers for the assessment of cardiovascular status of patients with PS. Due to frequent comorbid overweight and obesity, biologically active compounds produced by adipocytes may have an impact on monitoring the status of the cardiovascular system of patients with PS. For this purpose, two adipokines, adiponectin and leptin, have been most extensively studied. The review focuses on some inflammatory and oxidative stress aspects in patients with PS through the analysis of the impact of prominent adipokines and oxidized low-density lipoprotein (oxLDL) to assess their eligibility for clinical practice as markers of CVD risk in patients with PS.

1981 ◽  
Author(s):  
W B Kannel

Coronary heart disease is a common, highly lethal, disease which frequently attacks without warning and too often presents with sudden death as the first symptom. Chances of an American male developing CHD before age 60 are one in five.Most angina, infarctions and sudden deaths represent medical failures which should have been forecasted and prevented. About 30% of first MI's will shortly develop angina and experience a per annum death rate, half of which will be sudden deaths. Reinfarctions will occur at 6% per year and half the recurrences will be fatal.No major innovations are needed to identify coronary candidates or to establish their risk from the joint effect of known risk factors. However, all have much to learn about motivating changes in behavior required to control the major risk factors such as cigarette smoking, faulty diet, overweight, sedentary living, abnormal lipids, hypertension and impaired glucose tolerance.Low density lipoprotein cholesterol promotes atherogenesis whereas HDL-cholesterol is protective, and the net effect is judged by their ratio. Hypertension, systolic or diastolic, labile or fixed, at any age in either sex is a powerful contributor to CHD. The impact of diabetes is greater for women, diminishes with age and varies depending on coexisting risk factors.Optimal risk evaluation requires quantitative combination of risk factors so as to include persons with multiple marginal risk factor abnormalities who are at high risk.


2008 ◽  
Vol 2 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Stavroulla Xenophontos ◽  
Marilena Hadjivassiliou ◽  
Alexandros Karagrigoriou ◽  
Nafsika Demetriou ◽  
George Miltiadous ◽  
...  

This study was carried out in Greek Cypriot males to identify risk factors that predispose to myocardial infarction (MI). Genetic and lipid risk factors were investigated for the first time in a Greek Cypriot male case-control study.Contrary to other studies, mean low density lipoprotein cholesterol did not differ between cases and controls. High density lipoprotein cholesterol on the other hand, although within normal range in cases and controls, was significantly higher in the control population. In agreement with many other studies, smoking was significantly more prevalent in cases compared with controls. In pooled cases and controls, smokers had a significantly lower HDL-C level compared with non-smokers. The frequency of the IL-13 R130Q homozygotes for the mutation (QQ), as well as the mutant allele were significantly higher in cases compared with controls. The IL-13 R130Q variant, or another locus, linked to it, may increase the risk of MI.


Author(s):  
Heinz Drexel

Lipid metabolism has gained cardiological interest only after statins were demonstrated to reduce cardiovascular disease in secondary and primary prevention. Therefore, this chapter first introduces the physiological and atherogenic properties of lipoproteins, before focusing on interventions. Both the efficacy and safety of statins have been proven in numerous randomized clinical trials. Because there is a considerable residual risk in statin-treated patients, additional approaches have been investigated. The focus is now on further reductions in low-density lipoprotein (LDL) cholesterol levels. First, high-intensity statin regimens were shown to reduce residual risk. Subsequently, ezetimibe was demonstrated, for the first time, to have a beneficial effect as a non-statin lipid intervention. More recently, inhibitors of the enzyme PCSK9 have demonstrated a very high efficacy in reducing LDL cholesterol levels. Although the causality of LDL for atherosclerotic cardiovascular disease has been proven in epidemiological studies, including Mendelian randomization studies, as well as interventional trials, adherence to statins and other therapies is far from optimal. In contrast, interventions to increase high-density lipoprotein (HDL) cholesterol levels could not proven to have further benefits when combined with statins.


2015 ◽  
Vol 1 (2) ◽  
pp. 2
Author(s):  
Ronald Barbaras

For a number of years, high-density lipoprotein (HDL) has been recognized to have an athero-protective role by promoting reverse lipid transport, a process facilitating the cholesterol efflux from atherosclerotic plaques in the artery wall and its elimination by the liver via biliary excretion. On the contrary, low-density lipoprotein (LDL) particles carry cholesterol to the organs and tissues where it can be used to produce hormones or maintain cell metabolism. When an imbalance develops, as a result of either an excess level of cholesterol associated with LDL (LDL-C) or a less effective cholesterol elimination by HDL (HDL-C), this causes an excess of cholesterol to be transported to the tissues and promotes the deposition of cholesterol. This often occurs in the artery walls, particularly in the coronary arteries. There is no approved medical treatment for directly suppressing or treating the atherosclerotic plaque once it is formed. Epidemiological studies have shown that the risk of developing cardio-vascular disease (CVD) is higher in patients with low levels of HDL-C regardless of LDL-C levels, even in patients optimally treated with LDL-C-lowering therapies. These data highlight that low HDL-C and low HDL particle number is an important target of therapies aiming to reduce the residual risk of CVD.


2020 ◽  
Vol 8 (1) ◽  
pp. 20-29
Author(s):  
Valentina Vorobyeva ◽  
Irina Vorobyeva ◽  
Alla Kochetkova ◽  
Vladimir Mazo ◽  
Sergey Zorin ◽  
...  

Introduction. Overweight and obesity are leading risk factors for metabolic syndrome (MS). From 20 to 35% of Russian people have this condition, depending on their age. MS is a precursor of cardiovascular disease, diabetes mellitus, diabetic nephropathy, and nonalcoholic steatohepatitis. Specialized foods (SFs) with hypocholesteremic effects are an important component of the diet therapy for MS patients. Creating local SFs to optimize the nutritional status of MS patients and prevent related diseases is a highly promising area of research. The aim of our study was to develop the formulation and technology of SFs and evaluate their effectiveness in MS treatment. Study objects and methods. The objects of the study were food ingredients and SFs. Safety indicators and micronutrient contents were determined by standard methods, whereas nutritional and energy values and amino acid contents were determined by calculation. Results and discussion. Based on medical requirements, we selected functional ingredients and developed a formulation and technology of SFs with an optimized protein, fat, and carbohydrate composition. The formulation included essential micronutrients and biologically active substances with a desirable physiological effect. Clinical trials involved 15 MS patients aged from 27 to 59. For two weeks, they had a low-calorie standard diet with one serving of SFs in the form of a drink instead of a second breakfast. The patients showed a significant improvement in anthropometric indicators. Blood serum tests revealed decreased contents of total cholesterol (by 16.9%), low-density lipoprotein cholesterol (by 15.3%), and triglycerides (by 27.9%). Conclusion. We developed technical specifications and produced a pilot batch of SFs. The trials showed an improvement of lipid metabolism in the MS patients who were taking SFs as part of their diet therapy.


2014 ◽  
Vol 31 (4) ◽  
pp. 199-203
Author(s):  
M Saiedullah ◽  
S Begum ◽  
S Hayat ◽  
SM Kamahuddin ◽  
MR Rahman ◽  
...  

Objective: Serum low density lipoprotein (LDL) cholesterol is considered as the primary target of lipid lowering therapy and non-high density lipoprotein (HDL) cholesterol is the recommended second target. Recent studies claimed that non-HDL cholesterol is a better predictor of cardiovascular diseases (CVD) than LDL cholesterol. In this study we aimed to compare non-HDL cholesterol and LDL cholesterol as a CVD risk factor in confirmed diabetic subjects. Materials and methods: In this cross-sectional observational study, 1042 confirmed diabetic subjects selected randomly were included. HbA1cResults: In the total subjects, 767 (74%) subjects had LDL cholesterol > 100 mg/dL and 822 (79%) subjects had non- HDL cholesterol > 130 mg/dL. HbA1c values were different (p<0.02) in five groups and showed upward trend (p<0.01). All the lipid parameters studied were significantly different in five groups (p<0.0001) and TC, TG and non-HDL cholesterol showed upward trend (p<0.0001), but HDL cholesterol and LDL cholesterol showed downward trend (p<0.0001). Odds ratio (OR) of likelihood of risk individuals regarding non-HDL cholesterol compared to LDL cholesterol were 0.50 (p<0.001), 1.32 (p>0.05), 2.96 (p<0.001), 6.49 (p<0.001) and 9.37 (p<0.001) for TG concentrations of up to 150 mg/dL, 151-200 mg/dL, 201-250 mg/dL, 251-300 mg/dL and 301-400 mg/dL respectively with relative risk of 0.60, 1.24, 2.43, 4.83, 5.10. Conclusion: LDL cholesterol is a better tool for the detection of high-risk individuals than non-HDL cholesterol at TG concentration up to 150 mg/dL, whereas non-HDL cholesterol is better than LDL cholesterol at TG concentration above 200 mg/dL as a CVD risk factor. DOI: http://dx.doi.org/10.3329/jbcps.v31i4.21004 J Bangladesh Coll Phys Surg 2013; 31: 199-203


2010 ◽  
Vol 42 (3) ◽  
pp. 331-341 ◽  
Author(s):  
Jefferson C. Frisbee ◽  
Adam G. Goodwill ◽  
Phoebe A. Stapleton ◽  
Stephanie J. Frisbee ◽  
Alexandre C. d'Audiffret

One clinical intervention against the negative outcomes associated with atherothrombotic vascular disease (AVD) is low-dose, chronic aspirin therapy. However, epidemiological studies suggest that recurrence of adverse vascular events with aspirin therapy is growing and associated with therapy duration. The contributors to this outcome are unclear and include poor patient compliance and aspirin-resistant platelet thromboxane A2 (TxA2) production. Based on previous results in hypercholesterolemic mice, we hypothesized that elevated aspirin-insensitive arachidonic acid (AA)-induced TxA2 production by the vascular endothelium contributes to aspirin resistance in AVD independent of platelet behavior. AA-induced dilation was blunted in aortic rings and in arterioles from apolipoprotein E (ApoE) and low-density lipoprotein receptor (LDLR) gene deletion mice (vs. C57/Bl6/J), partially due to elevated TxA2 production. Acute inhibition of cyclooxygenases or TxA2 synthase attenuated the increased TxA2 production in ApoE and LDLR and improved AA-induced dilation, responses that were mirrored by chronic treatment with low-dose aspirin of 16 wk duration. However, this effect was not temporally stable, and, with longer-duration therapy, the beneficial impact of aspirin on outcomes diminished. A similar, though less robust, pattern to the impact of chronic aspirin therapy on vascular outcomes was identified with chronic antioxidant treatment (TEMPOL). These results suggest that in dyslipidemic mice, the beneficial impact of chronic aspirin therapy on improving vascular outcomes decay with time and that a contributing element to subsequent negative vascular events may be the development of aspirin-resistant TxA2 production by the vasculature itself.


2015 ◽  
Vol 36 (2) ◽  
pp. 146-153 ◽  
Author(s):  
Yeoungjee Cho ◽  
Janine Büchel ◽  
Sonja Steppan ◽  
Jutta Passlick-Deetjen ◽  
Carmel M. Hawley ◽  
...  

Background The longitudinal trends of lipid parameters and the impact of biocompatible peritoneal dialysis (PD) solutions on these levels remain to be fully defined. The present study aimed to a) evaluate the influence of neutral pH, low glucose degradation product (GDP) PD solutions on serum lipid parameters, and b) explore the capacity of lipid parameters (total cholesterol [TC], triglyceride [TG], high density lipoprotein [HDL], TC/HDL, low density lipoprotein [LDL], very low density lipoprotein [VLDL]) to predict cardiovascular events (CVE) and mortality in PD patients. Methods The study included 175 incident participants from the balANZ trial with at least 1 stored serum sample. A composite CVE score was used as a primary clinical outcome measure. Multilevel linear regression and Poisson regression models were fitted to describe the trend of lipid parameters over time and its ability to predict composite CVE, respectively. Results Small but statistically significant increases in serum TG (coefficient 0.006, p < 0.001), TC/HDL (coefficient 0.004, p = 0.001), and VLDL cholesterol (coefficient 0.005, p = 0.001) levels and a decrease in the serum HDL cholesterol levels (coefficient -0.004, p = 0.009) were observed with longer time on PD, whilst the type of PD solution (biocompatible vs standard) received had no significant effect on these levels. Peritoneal dialysis glucose exposure was significantly associated with trends in TG, TC/HDL, HDL and VLDL levels. Baseline lipid parameter levels were not predictive of composite CVEs or all-cause mortality. Conclusion Serum TG, TC/HDL, and VLDL levels increased and the serum HDL levels decreased with increasing PD duration. None of the lipid parameters were significantly modified by biocompatible PD solution use over the time period studied or predictive of composite CVE or mortality.


2020 ◽  
Vol 26 (4) ◽  
pp. 399-406
Author(s):  
Ruolin Li ◽  
Shumin Yang ◽  
Rufei Gao ◽  
Yin Deng ◽  
Jiahuan Liu ◽  
...  

Objective: To investigate whether serum bisphenol A (BPA) concentration is related to the occurrence of dyslipidemia. Methods: A total of 574 adults were enrolled at baseline and followed up for 5 years. Concentrations of serum BPA, triglycerides (TGs), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol were measured. Dyslipidemia was defined as the existence of one or more of the following conditions: high-LDL-cholesterolemia (LDL ≥140 mg/dL), hypertriglyceridemia (TGs ≥150 mg/dL), or low-HDL-cholesterolemia (HDL <40 mg/dL). Participants were stratified into tertiles according to low, median, and high baseline serum BPA levels. Multivariable linear and logistic regression models were used. Data from baseline and follow-up were used for cross-sectional and longitudinal analyses, respectively. Results: In the cross-sectional analysis, compared to subjects in the low BPA tertile, those in the high BPA tertile showed a higher level of LDL cholesterol (108.1 ± 24.4 mg/dL versus 119.5 ± 26.9 mg/dL; P<.05) and a lower level of HDL cholesterol (46.2 ± 11.7 mg/dL versus 39.5 ± 7.5 mg/dL; P<.05). In multivariable linear regression models, Z-transformed BPA was positively associated with LDL cholesterol (β= 0.13, P = .002) and negatively associated with HDL cholesterol (β= −0.28; P<.001). After cross-sectionally adjusting for confounders, subjects in higher BPA exposure was associated with a higher prevalence of low-HDL-cholesterolemia. Longitudinally, in subjects without low-HDL-cholesterolemia at baseline, each SD increment in baseline BPA was associated with a higher incidence of low-HDL-cholesterolemia after adjustment for confounders (odds ratio [95% confidence interval; CI] 2.76, 95% CI 1.21, 6.29). Conclusion: Cross-sectionally, higher BPA exposure is associated with a higher prevalence of low-HDL-cholesterolemia. Longitudinally, baseline BPA is an independent predictor of the 5-year incidence of low-HDL-cholesterolemia. Abbreviations: BMI = body mass index; BPA = bisphenol A; CI = confidence interval; CVD = cardiovascular disease; EIMDS = environment, inflammation and metabolic diseases study; HDL = high density lipoprotein; LDL = low density lipoprotein; OR = odds ratio; PPAR = peroxisome proliferator-activated receptor; SBP = systolic blood pressure; TG = triglyceride; Z-BPA = Z-transformed bisphenol A


Author(s):  
Nazli Azabdaftari ◽  
Reza Amani ◽  
Mohammad Taha Jalali

Aim Limited cardiovascular disease (CVD) risk data are available for firefighters worldwide. This comparative study was aimed at investigating the biochemical and nutritional indices of firefighters in Iran. Materials and methods Individuals’ anthropometric measurements, including weight, height, and waist and hip circumferences, were measured and the percent of body fat (BF%) was also obtained. Blood sampling was done in order to determine lipid profile, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), lipoprotein a (Lp(a)) and fasting blood sugar (FBS) concentrations. Systolic and diastolic blood pressures (SBP and DBP) were also measured. Results The mean ages of firefighters and administrative staff were 42.45 ± 6.75 and 44.64 ± 5.83 y, respectively. The prevalence of overweight and obesity was 45% and 24% in firefighters and 54% and 23% in administrative staff, respectively. High waist-to-hip and waist-to-stature ratios were detected in 26.4% and 81.3% of firefighters versus 33.3% and 89.7% of the control group, respectively. No significant differences were observed between the mean of TC, TG, HDL-C, LDL-C and FBS concentrations. The mean of Lp(a) was significantly higher among firefighters ( P<0.05). About half of the subjects in both groups had TC >5.17, TG >1.69, HDL-C <1.03 nmol/L and Lp(a) >25 mg/dL. There were no significant differences between the SBP and DBP of subjects. There was no significant difference in smoking habits between the two groups. Conclusions Considering the high prevalence of overweight and obesity, high TC, TG and Lp(a) and low HDL-C concentrations among all firefighters, it seems necessary to provide fitness-promotion and nutritional education programs for the prevention of obesity-related chronic diseases such as CVD.


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