Abstract 499: Lipoprotein(A) and Carotid Intimal Medial Thickness

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Hiroaki Ikezaki ◽  
Yuya Yokota ◽  
Ernst J Schaefer ◽  
Katalin V Horvath ◽  
Bela F Asztalos ◽  
...  
Keyword(s):  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Men And Women ◽  
Lipoprotein A ◽  
Intimal Medial Thickness ◽  
Carotid Intimal Medial Thickness ◽  
History Of ◽  
The Common ◽  
Ascvd Risk

Introduction: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of death and disability in both Japan and the United States. Carotid intimal medial thickness (CIMT) has been used as a marker of ASCVD risk. We examined various specialized lipoprotein parameters to determine their utilities for predictor of CIMT progression. Methods: Using plasma samples obtained from fasting men and women (n=2245) living in the Fukuoka area of Japan, (median age 59 years), at baseline we measured direct high density lipoprotein cholesterol (HDL-C), HDL2-C, HDL3-C, low density lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C), triglycerides (TG), LDL-triglycerides (LDL-TG), lipoprotein(a) or Lp(a), and adiponectin. All assays were measured on an automated high throughput platform (Olympus AU400) using assay kits from the Denka Seiken Corporation (Niigata, Japan) and had within and between run coefficients of variations of < 5%. Blood pressure, body mass index, use of medications, and history of hypertension, dyslipidemia and diabetes were also assessed. CIMT of the common carotid artery was assessed bilaterally at baseline and after 5 years of follow up used trained technicians with analysis coefficients of variation of < 10%. Participants using statin therapy at baseline and during follow up were excluded. Results: After controlling for age and gender, only Lp(a) was significantly associated with change in CIMT over a 5 year period in this population. The data indicated that for every 1 log unit higher Lp(a) level at baseline, there was a 0.06 mm increase in CIMT over 5 years (p=0.02). While relationships were seen with other parameters and CIMT change, none of these other relationships reached statistical significance at p<0.05. We also observed significant relationships (p<0.05) between CIMT progression and age, gender, current smoking, history of hypertension, treatment of hypertension. Conclusions: Our data indicate that lipoprotein (a) as measured by immunoassay in an important predictor of the progression of atherosclerosis in the common carotid arteries of middle aged and elderly Japanese men and women, and serves as a valuable marker of ASCVD risk.

scholarly journals Lifetime duration of lactation and chronic inflammation among middle-aged women with a history of gestational diabetes

2020 ◽  
Vol 8 (2) ◽  
pp. e001229
Author(s):  
Sylvia H Ley ◽  
Jorge E Chavarro ◽  
Stefanie N Hinkle ◽  
Mengying Li ◽  
Michael Y Tsai ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Chronic Inflammation ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Health Study ◽  
Gamma Glutamyl Transferase ◽  
Middle Aged ◽  
History Of ◽  
Glutamyl Transferase

IntroductionLonger duration of lactation is associated with lower cardiometabolic disease risk, but pathogenic pathways involved in the disease progression are unclear, especially among high-risk women. We aimed to examine the associations of lifetime lactation duration with cardiometabolic biomarkers among middle-aged women with a history of gestational diabetes (GDM).Research design and methodsWomen with a history of GDM participating in the Nurses’ Health Study II, a prospective cohort study, were identified and followed through biennial questionnaires beginning in 1991. Lactation history was asked in three follow-up questionnaires to calculate lifetime duration. In 2012–2014, fasting blood samples were collected through the Diabetes & Women’s Health Study to measure inflammatory (C-reactive protein (CRP), interleukin (IL) 6), liver enzyme (alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase), and lipid biomarkers (total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol).ResultsAt follow-up blood collection, women were at median age 58.2 (95% CI 51 to 65) years and 26.3 (95% CI 15.7 to 34.1) years since GDM index pregnancy. After multiple adjustment including prepregnancy body mass index (BMI), longer duration of lactation was significantly associated with lower CRP (least squares (LS) mean 1.90 mg/L (95% CI 1.47 to 2.45) for 0-month lactation, 1.98 mg/L (95% CI 1.68 to 2.32) for up to 12-month lactation, 1.67 mg/L (95% CI 1.42 to 1.97) for 12–24 month lactation, and 1.39 mg/L (95% CI 1.19 to 1.62) for >24-month lactation; p trend=0.003) and IL-6 (1.25 pg/L (95% CI 0.94 to 1.68), 1.19 pg/L (95% CI 0.99 to 1.42), 1.04 pg/L (95% CI 0.87 to 1.25), and 0.93 pg/L (95% CI 0.78 to 1.11); p trend=0.04). Longer duration of lactation was associated with lower risk for chronic inflammation using CRP 3 mg/L cut-off in middle-aged women (OR 0.81 (95% CI 0.69 to 0.940 per 1-year increase) with multiple adjustment.ConclusionsLonger lifetime duration of lactation was associated with favorable inflammatory biomarker concentrations in middle-aged women with a history of GDM. Chronic inflammatory pathways may be responsible for previously reported associations between lactation and long-term risk for cardiometabolic diseases.

scholarly journals Small Dense Low‐Density Lipoprotein Cholesterol Is the Most Atherogenic Lipoprotein Parameter in the Prospective Framingham Offspring Study

2021 ◽  
Author(s):  
Hiroaki Ikezaki ◽  
Elise Lim ◽  
L. Adrienne Cupples ◽  
Ching‐Ti Liu ◽  
Bela F. Asztalos ◽  
...  
Keyword(s):  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Lipoprotein A ◽  
Remnant Lipoprotein ◽  
Triglyceride Rich Lipoprotein ◽  
Ascvd Risk

Background Elevated plasma levels of direct low‐density lipoprotein cholesterol (LDL‐C), small dense LDL‐C (sdLDL‐C), low‐density lipoprotein (LDL) triglycerides, triglycerides, triglyceride‐rich lipoprotein cholesterol, remnant lipoprotein particle cholesterol, and lipoprotein(a) have all been associated with incident atherosclerotic cardiovascular disease (ASCVD). Our goal was to assess which parameters were most strongly associated with ASCVD risk. Methods and Results Plasma total cholesterol, triglycerides, high‐density lipoprotein cholesterol, direct LDL‐C, sdLDL‐C, LDL triglycerides, remnant lipoprotein particle cholesterol, triglyceride‐rich lipoprotein cholesterol, and lipoprotein(a) were measured using standardized automated analysis (coefficients of variation, <5.0%) in samples from 3094 fasting subjects free of ASCVD. Of these subjects, 20.2% developed ASCVD over 16 years. On univariate analysis, all ASCVD risk factors were significantly associated with incident ASCVD, as well as the following specialized lipoprotein parameters: sdLDL‐C, LDL triglycerides, triglycerides, triglyceride‐rich lipoprotein cholesterol, remnant lipoprotein particle cholesterol, and direct LDL‐C. Only sdLDL‐C, direct LDL‐C, and lipoprotein(a) were significant on multivariate analysis and net reclassification after adjustment for standard risk factors (age, sex, hypertension, diabetes mellitus, smoking, total cholesterol, and high‐density lipoprotein cholesterol). Using the pooled cohort equation, many specialized lipoprotein parameters individually added significant information, but no parameter added significant information once sdLDL‐C (hazard ratio, 1.42; P <0.0001) was in the model. These results for sdLDL‐C were confirmed by adjusted discordance analysis versus calculated non–high‐density lipoprotein cholesterol, in contrast to LDL triglycerides. Conclusions sdLDL‐C, direct LDL‐C, and lipoprotein(a) all contributed significantly to ASCVD risk on multivariate analysis, but no parameter added significant risk information to the pooled cohort equation once sdLDL‐C was in the model. Our data indicate that small dense LDL is the most atherogenic lipoprotein parameter.

scholarly journals Visit-to-Visit Variability of Lipids Measurements and the Risk of Stroke and Stroke Types: A Prospective Cohort Study

2020 ◽  
Vol 22 (1) ◽  
pp. 119-129 ◽  
Author(s):  
Anxin Wang ◽  
Haibin Li ◽  
Jinhuan Yuan ◽  
Yingting Zuo ◽  
Yijun Zhang ◽  
...  
Keyword(s):  
Hemorrhagic Stroke ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
History Of ◽  
Variability Index ◽  
Stroke Type ◽  
Average Real Variability ◽  
Adjusted Model

Background and Purpose Previous studies suggested increased visit-to-visit variability of total cholesterol (TC) is associated with stroke. This study aimed to investigate the associations of various lipids measurements variability and the risk of stroke and stroke type (ischemic and hemorrhagic stroke).Methods Fifty-one thousand six hundred twenty participants in the Kailuan Study without history of myocardial infarction, stroke, and cancer who underwent three health examinations during 2006 to 2010 were followed for incident stroke. Variability in TC, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) measurements were measured using the coefficient of variation (CV), standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV).Results During a median of 6.04 years of follow-up, 1,189 incident stroke (1,036 ischemic and 160 hemorrhagic stroke) occurred. In the multivariable-adjusted model, the hazard ratio (HR) comparing participants in the highest versus lowest quartile of CV of HDL-C were 1.21 (95% confidence interval [CI], 1.02 to 1.45; <i>P</i> for trend=0.013) for ischemic stroke. The highest quartile of CV of LDL-C was associated with 2.17-fold risk of hemorrhagic stroke (HR, 2.17; 95% CI, 1.25 to 3.75; <i>P</i> for trend=0.002) compared with the lowest quartile. We did not observe any significant association between TC and triglycerides variability with any of stroke. Consistent results were obtained when calculating variability index using SD, VIM, or ARV.Conclusions These findings suggest the high visit-to-visit HDL-C and LDL-C variability were associated with an increased incidence of ischemic and hemorrhagic stroke, respectively.

Abstract P493: Small Dense Low-density Lipoprotein Cholesterol and Carotid Intimal Medial Thickness Progression

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Hiroaki Ikezaki ◽  
Yuya Yokota ◽  
Masumi Ai ◽  
Bela F Asztalos ◽  
Masayuki Murata ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Cvd Risk ◽  
Intimal Medial Thickness ◽  
Carotid Intimal Medial Thickness

Introduction: Carotid intimal medical thickness (cIMT) is associated with cardiovascular disease (CVD). The association between atherogenic lipoproteins including small dense low-density lipoprotein cholesterol (sdLDL-C) and carotid intimal medial thickness (cIMT) progression has not been fully evaluated in a prospective cohort study. Hypothesis: We assessed the hypothesis that sdLDL-C is the most atherogenic lipoproteins with regard to cIMT progression. Methods: Kyushu and Okinawa Population Study (KOPS) is a community-based, prospective, and observational study in Japan which has been underway since 2004 and a total of 18,762 participants have been enrolled. For this study, we included 2,030 male and female participants (median age 59 years at baseline) who were free of CVD and off cholesterol lowering medication, and had cIMT measured at both baseline and after 5 years follow-up survey. Using plasma samples obtained from those subjects after overnight fast, we measured total cholesterol, direct low-density lipoprotein cholesterol (LDL-C), sdLDL-C, LDL-triglycerides (LDL-TG), high-density lipoprotein cholesterol (HDL-C), HDL2-C, HDL3-C, triglycerides, Lp(a), adiponectin and high sensitivity C reactive protein (hs CRP). Their cIMT levels were measured by B-mode ultrasonography with a 10 MHz probe at far walls of their both right and left common carotid arteries. Results: Median cIMT at baseline was 0.63 mm and median 5 year progression was 0.18 mm. After adjustment for standard CVD risk factor including age, gender, systolic blood pressure, total cholesterol, HDL-C, smoking, diabetes, and hypertension treatment, only LDL-C, sdLDL-C, and the sdLDL-C/LDL-C ratio were associated with cIMT progression. Even in subjects with direct LDL-C < 100 mg/dL, considered to be at low CVD risk, elevated sdLDL-C were associated with cIMT progression ( P for trend = 0.009) in a model with established CVD risk factors, although the sdLDL-C/LDL-C ratio did not. Conclusions: In conclusion, both sdLDL-C and direct LDL-C are significantly associated with cIMT progression. Moreover sdLDL-C has stronger relationship with cIMT progression than does LDL-C; therefore, measurement of sdLDL-C may allow for the formulation of optimal therapy to cIMT progression.

scholarly journals Maternal Cardiovascular Risk Assessment 3-to-11 Years Postpartum in Relation to Previous Occurrence of Pregnancy-Related Complications

2019 ◽  
Vol 8 (4) ◽  
pp. 544 ◽  
Author(s):  
Ilona Hromadnikova ◽  
Katerina Kotlabova ◽  
Lenka Dvorakova ◽  
Ladislav Krofta
Keyword(s):  
Uric Acid ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Lipoprotein Cholesterol ◽  
Lipoprotein A ◽  
Cholesterol Levels ◽  
Delivery Date ◽  
History Of ◽  
Severity Of The Disease ◽  
Previous Occurrence

The aim of the present study was to assess the long-term outcomes of women 3-to-11 years postpartum in relation to the previous occurrence of pregnancy-related complications such as gestational hypertension (GH), preeclampsia (PE) and fetal growth restriction (FGR). Body mass index (BMI), waist circumference values, the average values of systolic (SBP) and diastolic (DBP) blood pressures and heart rate, total serum cholesterol levels, serum HDL (high-density lipoprotein) cholesterol levels, serum LDL (low-density lipoprotein) cholesterol levels, serum triglycerides levels, serum lipoprotein A levels, serum CRP (C-reactive protein) levels, plasma homocysteine levels, serum uric acid levels, individual and relative risks of having a heart attack or stroke over the next ten years were compared between groups (50 GH, 102 PE, 34 FGR and 90 normal pregnancies) and correlated with the severity of the disease with regard to clinical signs (25 PE without severe features, 77 PE with severe features), and delivery date (36 early PE, 66 late PE). The adjustment for potential covariates was made, where appropriate. At 3–11 years follow-up women with a history of GH, PE regardless of the severity of the disease and the delivery date, PE without severe features, PE with severe features, early PE, and late PE had higher BMI, waist circumferences, SBP, DBP, and predicted 10-year cardiovascular event risk when compared with women with a history of normotensive term pregnancy. In addition, increased serum levels of uric acid were found in patients previously affected with GH, PE regardless of the severity of the disease and the delivery date, PE with severe features, early PE, and late PE. Higher serum levels of lipoprotein A were found in patients previously affected with early PE. The receiver operating characteristic (ROC) curve analyses were able to identify a substantial proportion of women previously affected with GH or PE with a predisposition to later onset of cardiovascular diseases. Women with a history of GH and PE represent a risky group of patients that may benefit from implementation of early primary prevention strategies.

scholarly journals Cardiovascular events and effectiveness of hypolipidemic therapy in patients with familial hypercholesterolemia and patients of very high cardiovascular risk: 3-year follow-up of the RENAISSANCE Registry

2020 ◽  
pp. 27-36
Author(s):  
У.В. Чубыкина ◽  
М.В. Ежов
Keyword(s):  
Cardiovascular Risk ◽  
Familial Hypercholesterolemia ◽  
Cardiovascular Events ◽  
Density Lipoprotein ◽  
High Cardiovascular Risk ◽  
Lipoprotein A ◽  
History Of ◽  
Male Sex ◽  
Very High

Цель. Целью исследования явилась оценка эффективности и приверженности гиполипидемической терапии, частоты развития сердечно<со< судистых осложнений в течение 3<летнего периода наблюдения в рамках регистра РЕНЕССАНС (Регистр пациентов с СГХС и пациентов очень высокого сЕрдечно<Сосудистого риска с недоСтАточной эффективНоСтью проводимой гиполипидемической терапии). Материал и методы. РЕНЕССАНС является открытым национальным наблюдательным исследованием и включает больных с семейной ги< перхолестеринемией (СГХС), а также пациентов очень высокого сердечно<сосудистого риска (ОВССР). Учитывали наличие факторов риска атеросклероза, анамнез сердечно<сосудистых заболеваний, гиполипидемическую терапию. В каждом центре выполняли определение концен< трации: общего холестерина (ОХС), триглицеридов (ТГ), холестерина липопротеидов высокой плотности (ХС ЛВП) в сыворотке крови. Содер< жание холестерина липопротеидов низкой плотности (ХС ЛНП) рассчитывали по формуле Фридвальда. Уровень липопротеида(а) измеряли методом иммуноферментного анализа в некоторых центрах. При оценке частоты конечной точки, включавшей фатальные и нефатальные сердечно<сосудистых осложнения (ССО), проводили анализ Каплана — Майера. Результаты. В регистр включено 1570 (средний возраст 54,0±14,6 лет) пациентов с СГХС и 121 (63,5±10,9 лет) больной с ОВССР. В группе СГХС динамическое наблюдение проведено у 594 пациентов (38%) в течение 23,6±14,6 месяцев, конечная точка зарегистрирована у 9% больных. Мужской пол (относительный риск 2,1; 95% доверительный интервал 1,13–3,66; p<0,01), гипертония (2,8; 1,4–5,2; p<0,01), ишеми< ческая болезнь сердца (6,8; 3,5–13,2; p<0,0001), отягощенный анамнез по сердечно<сосудистым заболеваниям (ССЗ) (2,1; 1,1–3,9; p<0,05) и концентрация липопротеида(а) ≥ 30 мг/дл (2,8; 1,1–7,7; p<0,05) явились предикторами развития ССО. В группе СГХС отмечено снижение уровня ОХС от исходного на 19%, ХС ЛНП на 25% (р<0,001 для обоих), целевых значений ХС ЛНП достигли 2% больных. В группе ОВССР динамическое наблюдение проведено у 72 (60%) пациентов в течение 19,7±5,8 месяцев. Ни один больной не достиг целевого уровня ХС ЛНП менее 1,4 ммоль/л. Заключение. Трехлетнее наблюдение за участниками регистра РЕНЕССАНС демонстрирует усиление приверженности гиполипидемической терапии. С увеличением риска развития сердечно<сосудистых осложнений при СГХС ассоциированы мужской пол, наличие гипертонии, ише< мической болезни сердца, отягощенного анамнеза по ССЗ и высокий уровень липопротеида(а). The aim of the study was to evaluate the effectiveness and adherence to hypolipidemic therapy, the frequency of cardiovascular events (CVE) during the 3!year follow!up in the RENAISSANCE registry (Registry of patients with familial hypercholesterolemia and very high cardiovascular risk with insufficient effect of hypolipidemic therapy). Methods. The RENAISSANCE registry is an open, national, observational study and includes patients with familial hypercholesterolemia (FH), as well as patients of very high cardiovascular risk (VHR). We took into consideration atherosclerosis risk factors and history of cardiovascular diseases (CVD), adherence to hypolipidemic therapy. Concentrations of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL!C) were measured in blood serum in all centers. Low density lipoprotein cholesterol (LDL!C) level was defined according to Friedewald formula. The concentration of lipoprotein(a) was measured by enzyme!linked immunosorbent assay in serum in some centers. Kaplan!Mayer analysis was performed to assess the frequency of fatal and nonfatal CVE. Results. The Registry consisted of 1570 (mean age 54.0±14.6 years) FH patients and 121 (63.5±10.9 years) VHR patients. Data of 594 patients (38%) who had follow!up visits were obtained in FH patients, follow!up duration 23.6±14.6 months, 54 (9%) patients experienced CVE. Male sex (hazard ratio 2.1; 95% confidence interval 1.13!3.66, p<0.01), hypertension (2.8;1.4–5.2; p<0.01), ischemic heart disease (6.8;3.5!13.2; p<0.0001), family history of CVD (2.1;1.1–3.9, p<0.05) and lipoprotein(a) level ≥30 mg/dl (2.8;1.1–7.7; p<0.05) were predictors of CVE. In FH patients the level of TC decreased by 19%, LDL!C by 25% (p<0.001 for both). Data on 72 VHR patients (60%) were obtained with follow!up duration of 19.7±5.8 months. No patient achieved the target LDL!C level of less than 1.4 mmol/L. Conclusion. Three!year follow!up of participants in the RENAISSANCE registry shows an enhanced adherence to hypolipidemic therapy. In FH patients the increased risk of new CVE is associated with male sex, hypertension, CHD, family history of CVD and lipoprotein(a) level ≥30 mg/dl

scholarly journals Prediction of subclinical coronary atherosclerosis in patients with high and very high cardiovascular risk

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
N Pogosova ◽  
NP Kachanova ◽  
YM Yufereva ◽  
OY Sokolova ◽  
IE Koltunov ◽  
...  
Keyword(s):  
Family History ◽  
Ct Angiography ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diagnostic Model ◽  
History Of ◽  
Hs Crp ◽  
Very High

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary atherosclerosis has a long subclinical period. It’s early detection may offer a possibility of timely initiation of preventive interventions Purpose To develop a diagnostic rule for detection of patients (pts) with high probability of subclinical atherosclerosis among those with high or very high cardiovascular (CV) risk. Methods This cross-sectional study enrolled 52 pts (32 men [62%]), aged 40 to 65 years [mean age 54.6 ± 8.0]) with high or very high CV risk (5-9 and ≥10% by The Systematic Coronary Risk Estimation Scale [SCORE], respectively). All participants underwent cardiac computed tomography (CT) angiography and calcium scoring. Traditional risk factors (RFs) (family history of premature CVD, smoking, overweight/obesity and abdominal obesity, hypertension, type 2 diabetes mellitus, lipids parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) and lipids-related markers (apolipoprotein A1, apolipoprotein B, ApoB/ApoA1 ratio), biomarkers of inflammation (high-sensitivity C-reactive protein [hs CRP], fibrinogen), indicator carbohydrate metabolism (glucose),  ankle-brachial index,  stress-test, carotid plaques according to ultrasound were evaluated in all pts. Psychological RFs were evaluated using Hospital Anxiety and Depression Scale and DS-14 for type D personality. Results All pts were divided into 2 groups according to the CT angiography results: pts in the main group (n = 21) had any non-obstructive lesions or calcium score &gt;0, pts in the control group (n = 31) had intact coronary arteries. The groups did not differ in age or gender. 26 multiple linear logistic models for any subclinical atherosclerosis were developed based on obtained diagnostic features. Taking into account R-square = 0.344 (p = 0.0008), the best fitting model was follows:  subclinical coronary atherosclerosis= -1.576 + 0.234 x SCORE ≥5%  + 0.541 x hs CRP &gt;2 g/l + 0.015 x heart rate  (bpm) + 0.311 family history of premature CVD.  The developed algorithm had sensitivity of 63% and  specificity of 80%. Conclusions The created diagnostic model diagnostic model suggests the presence of subclinical coronary atherosclerosis in patients with high / very high CV risk with a high degree of probability. This easy-to-use method can be used in routine clinical practice to improve risk stratification and management choices in high-risk pts.

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