scholarly journals HDL Cholesterol Efflux Capacity and Concentration in Patients With Rheumatoid Arthritis: a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Binbin Xie ◽  
Jiang He ◽  
Yong Liu ◽  
Ting Liu ◽  
Chaoqun Liu
Keyword(s):  
Cholesterol Efflux ◽  
Meta Analysis ◽  
Large Population ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cochrane Library ◽  
Cholesterol Efflux Capacity ◽  
Reactive Protein ◽  
Predictive Role ◽  
Stratified Analysis

Abstract Background: HDL cholesterol efflux capacity has been proposed as an independent risk factor of cardiovascular diseases. However, the presented data has been less than convincing in RA. This meta-analysis aimed to identify whether CEC was impaired in RA or altered by drug therapy.Methods: PubMed, Embase, and Cochrane library databases were searched to identify studies for CEC in RA patients. The primary outcomes were CEC, high-density lipoprotein cholesterol and C-reactive protein.Results: A total of 11 eligible articles including 6 observational and 5 intervention studies. Pooled results showed there was no significantly decrease in the CEC of RA patients comparing with the healthy controls (SMD: -0.22, 95% CI: -0.65 to 0.20), whereas the plasma HDL-C levels was decreased in RA patients (WMD: -5.21, 95% CI: -7.69 to -2.72). Furthermore, in the before-after studies, CEC of RA patients (SMD: 0.20, 95% CI: 0.03 to 0.38) was increased but the plasma HDL-C levels (WMD: 3.26, 95% CI: -0.17 to 6.69) was similar after anti-rheumatic treatment comparing to the baseline. In addition, stratified analysis suggested that DAS28 could be potential sources of heterogeneity for CEC. The funnel plot was relatively symmetric and was not suggestive of presence of publication bias.Conclusion The current meta-analysis demonstrated a slight, nonsignificant, decrease in the CEC among RA patients as compared with healthy individuals, but it can be improved substantially following anti-rheumatic treatment. More large population studies evaluating the predictive role of CEC on cardiovascular risk in RA are needed.

scholarly journals HDL cholesterol efflux capacity and concentration in patients with rheumatoid arthritis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Binbin Xie ◽  
Jiang He ◽  
Yong Liu ◽  
Ting Liu ◽  
Chaoqun Liu
Keyword(s):  
Rheumatoid Arthritis ◽  
Cholesterol Efflux ◽  
Human Subjects ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cochrane Library ◽  
Future Research ◽  
Cholesterol Efflux Capacity ◽  
Beneficial Effects

Abstract Background: Poor cholesterol efflux capacity (CEC) has been proposed to be an independent risk factor for cardiovascular diseases. However, the current evidences in the literature are inconsistent. This meta-analysis aimed to identify whether CEC is impaired or altered by drug therapy in individuals with rheumatoid arthritis (RA).Methods: The PubMed, Embase, and Cochrane library databases were searched to identify studies on CEC in RA patients. The searches were focused on studies in human subjects that were published before 10 June 2020, without language restrictions. The primary outcomes were CEC and the high-density lipoprotein cholesterol (HDL-C) and C-reactive protein levels (CRP) levels.Results: A total of 11 eligible articles, including 6 observational and 5 intervention studies, were retrieved. The pooled results showed that CEC is not significantly lower in RA patients than in healthy controls (SMD: -0.22, 95% CI: -0.65 to 0.20), whereas the plasma HDL-C level is not significantly (WMD: -3.98, 95% CI: -8.32 to 0.37, I² = 54%, P for heterogeneity = 0.050) but is significantly decreased in the RA patients with moderate body mass index (BMI) (WMD: -5.46, 95% CI: -9.40 to -1.52, I² = 37%, P for heterogeneity = 0.175). Furthermore, in the before-after studies, the CEC of RA patients (SMD: 0.20, 95% CI: 0.03 to 0.38) increased, but the plasma HDL-C level (WMD: 3.26, 95% CI: -0.17 to 6.69) remained at a similar level after anti-rheumatic treatment compared to the baseline. In addition, stratified analysis suggested that the Disease Activity Score for 28 joints could be a potential source of heterogeneity for CEC. The funnel plot was relatively symmetric and did not suggest the presence of publication bias.Conclusion：The current meta-analysis demonstrated that HDL-mediated CEC can be improved by the early control of inflammation and anti-rheumatic treatment in RA patients, which is independent of HDL-C levels. Future research is needed to determine whether therapeutic strategies to enhance CEC in RA patients have beneficial effects for preventing CVD.

A Meta-Analysis of HDL Cholesterol Efflux Capacity and Concentration in Patients With Rheumatoid Arthritis

2020 ◽  
Author(s):  
Binbin Xie ◽  
Jiang He ◽  
Yong Liu ◽  
Ting Liu ◽  
Chaoqun Liu
Keyword(s):  
Rheumatoid Arthritis ◽  
Cholesterol Efflux ◽  
Human Subjects ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cochrane Library ◽  
Future Research ◽  
Cholesterol Efflux Capacity ◽  
Beneficial Effects

Abstract Background: Poor cholesterol efflux capacity (CEC) has been proposed to be an independent risk factor for cardiovascular diseases. However, the current evidences in the literature are inconsistent. This meta-analysis aimed to identify whether CEC is impaired or altered by drug therapy in individuals with rheumatoid arthritis (RA).Methods: The PubMed, Embase, and Cochrane library databases were searched to identify studies on CEC in RA patients. The searches were focused on studies in human subjects that were published before 10 Sep 2020, without language restrictions. The primary outcomes were CEC and the high-density lipoprotein cholesterol (HDL-C) and C-reactive protein levels (CRP).Results: A total of 11 eligible articles, including 6 observational and 5 intervention studies, were retrieved. The pooled results showed that CEC is not significantly lower in RA patients than in healthy controls (SMD: -0.34, 95% CI: -0.83 to 0.14), whereas the plasma HDL-C level is not significantly lower HDL-C levels (WMD: -3.91, 95% CI: -7.15 to -0.68). Furthermore, in the before-after studies, the CEC of RA patients (SMD: 0.20, 95% CI: 0.02 to 0.37) increased, but the plasma HDL-C level (WMD: 3.63, 95% CI: -0.13 to 7.39) remained at a similar level after anti-rheumatic treatment compared to the baseline. In addition, the funnel plot was relatively symmetric and did not suggest the presence of publication bias.Conclusion: The current meta-analysis demonstrated that HDL-mediated CEC can be improved by the early control of inflammation and anti-rheumatic treatment in RA patients, which is independent of HDL-C levels. Future research is needed to determine whether therapeutic strategies to enhance CEC in RA patients have beneficial effects for preventing CVD.

scholarly journals High Density Lipoprotein Cholesterol Efflux Capacity and Atherosclerosis in Cardiovascular Disease: Pathophysiological Aspects and Pharmacological Perspectives

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 574
Author(s):  
Maria Pia Adorni ◽  
Nicoletta Ronda ◽  
Franco Bernini ◽  
Francesca Zimetti
Keyword(s):  
High Density Lipoprotein ◽  
Cholesterol Efflux ◽  
Current Knowledge ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
High Density ◽  
Current Evidence ◽  
Endocrine Disorders ◽  
Lifestyle Modifications ◽  
Cholesterol Efflux Capacity

Over the years, the relationship between high-density lipoprotein (HDL) and atherosclerosis, initially highlighted by the Framingham study, has been revealed to be extremely complex, due to the multiple HDL functions involved in atheroprotection. Among them, HDL cholesterol efflux capacity (CEC), the ability of HDL to promote cell cholesterol efflux from cells, has emerged as a better predictor of cardiovascular (CV) risk compared to merely plasma HDL-cholesterol (HDL-C) levels. HDL CEC is impaired in many genetic and pathological conditions associated to high CV risk such as dyslipidemia, chronic kidney disease, diabetes, inflammatory and autoimmune diseases, endocrine disorders, etc. The present review describes the current knowledge on HDL CEC modifications in these conditions, focusing on the most recent human studies and on genetic and pathophysiologic aspects. In addition, the most relevant strategies possibly modulating HDL CEC, including lifestyle modifications, as well as nutraceutical and pharmacological interventions, will be discussed. The objective of this review is to help understanding whether, from the current evidence, HDL CEC may be considered as a valid biomarker of CV risk and a potential pharmacological target for novel therapeutic approaches.

Abstract 540: Correlation of Improved Cholesterol Efflux Capacity of High Density Lipoprotein With Survival and Allograft Vasculopathy in Cardiac Transplant Recipients

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Ali Javaheri ◽  
Payman Zamani ◽  
Maria Molina ◽  
Amrith Rodrigues ◽  
Susan Chambers ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cholesterol Efflux ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cardiac Transplant ◽  
Transplant Recipients ◽  
Single Center ◽  
Allograft Vasculopathy ◽  
Cholesterol Efflux Capacity ◽  
Transplant Patients

Background: Coronary allograft vasculopathy (CAV) is an important cause of mortality after cardiac transplantation. High density lipoprotein (HDL) cholesterol efflux capacity has been inversely associated with coronary artery disease and is impaired in cardiac transplant recipients. We performed a single center case-cohort study to test the hypothesis that reduced efflux capacity is a risk factor for mortality and a second, multi-center retrospective study to test if efflux capacity is associated with CAV progression. Methods: We designed a single center case-cohort study in which we identified cardiac transplant patients who died between 2009-2012 (cases, n=34) and controls as cardiac transplant patients who were alive as of the fourth quarter of 2013 (n=57). Efflux capacity was measured by incubating apolipoprotein B-depleted serum with macrophages in a validated ex vivo system. In a second study, we utilized pre-transplant samples from the Clinical Trials in Organ Transplantation 5 (CTOT5) study to determine the association between ATP-binding-cassette (ABC) A1-dependent cholesterol efflux and CAV progression at 1 year. Results: In our single center study, the average time from transplant to study entry was well-matched between cases and controls (7.6±1.0 vs 7.7±0.8 years, respectively, p=0.48). Multivariable Cox proportional hazard ratios demonstrated that higher levels of HDL cholesterol efflux capacity were associated with survival (HR 0.61, 95% CI 0.43-0.85), even after adjustment for HDL cholesterol mass. To determine whether excess mortality observed in subjects with reduced efflux could be attributable to CAV progression, we tested the relationship between intravascular ultrasound (IVUS) progression of CAV and cholesterol efflux capacity using linear regression. ABCA1-dependent efflux and IVUS progression were significantly associated (β = -0.90, 95% CI [-1.73 - -0.07], p = 0.037, R2 = 0.37). Conclusion: Reduced efflux capacity is an important mediator of CAV progression and mortality in cardiac transplant recipients. This finding suggests that interventions to increase HDL cholesterol efflux capacity may provide clinical benefit in cardiac transplant recipients.

scholarly journals Usefulness of apolipoprotein B-depleted serum in cholesterol efflux capacity assays using immobilized liposome-bound gel beads

2019 ◽  
Vol 39 (4) ◽  
Author(s):  
Yuna Horiuchi ◽  
Ryunosuke Ohkawa ◽  
Shao-Jui Lai ◽  
Shitsuko Shimano ◽  
Michio Hagihara ◽  
...  
Keyword(s):  
Serum Protein ◽  
Cholesterol Efflux ◽  
Serum Proteins ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cholesterol Concentration ◽  
Precipitation Method ◽  
Serum Samples ◽  
Apo B ◽  
Cholesterol Efflux Capacity

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.

scholarly journals Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

Biomedicines ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 524
Author(s):  
Andreas Ritsch ◽  
Angela Duerr ◽  
Patrick Kahler ◽  
Monika Hunjadi ◽  
Tatjana Stojakovic ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Cardiovascular Mortality ◽  
Cholesterol Efflux ◽  
Cardiovascular Health ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Reactive Protein ◽  
Amyloid A ◽  
Artery Disease

(1) Background and Aims: Efforts to reduce coronary artery disease (CAD) by raising high-density lipoprotein (HDL) cholesterol (HDL-C) have not been uniformly successful. A more important factor than HDL-C may be cellular cholesterol efflux mediated by HDL, which has been shown to be associated with CAD. In this report, we analyzed the influence of cardiovascular biomarkers and risk factors on cholesterol efflux in a prospective observational study of patients referred to coronary angiography. (2) Methods: HDL-mediated efflux capacity was determined for 2468 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study who were referred to coronary angiography at baseline between 1997 and 2000. Median follow-up time was 9.9 years. Primary and secondary endpoints were cardiovascular and all-cause mortality, respectively. (3) Results: Cholesterol efflux strongly correlated with HDL-related markers including HDL cholesterol, HDL phospholipids, and apolipoproteins AI and AII, as well as HDL particle concentration, which was not seen for low density lipoprotein (LDL) markers including LDL cholesterol and apoB. Cholesterol efflux was associated negatively with C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6), and serum amyloid A. Cardiovascular mortality was higher in patients in the lowest cholesterol efflux quartile. This association was weakened, but not fully abolished, after adjustment for HDL cholesterol. (4) Conclusions: We demonstrate that cholesterol efflux was associated with HDL-composition as well as inflammatory burden in patients referred for coronary angiography, and that this inversely predicts cardiovascular mortality independently of HDL cholesterol.

Abstract 622: High-density Lipoprotein Cholesterol Efflux Does Not Predict Cardiovascular Risk in Hemodialysis Patients

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Sanam Ebtehaj ◽  
Chantal Kopecky ◽  
Bernd Genser ◽  
Christiane Drechsler ◽  
Vera Krane ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Density Lipoprotein ◽  
Primary Endpoint ◽  
Cholesterol Efflux ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
High Density ◽  
Cardiac Events ◽  
Cholesterol Efflux Capacity ◽  
All Cause Mortality

The cardioprotective effect of HDL (High-Density Lipoprotein) is largely determined by its cholesterol efflux capacity, which was shown to correlate inversely with atherosclerotic cardiovascular disease in populations with normal kidney function. Patients with end-stage renal disease suffer an exceptionally high cardiovascular risk not fully explained by traditional risk factors. Here, we investigated in a post-hoc analysis in 1147 patients with type 2 diabetes mellitus on hemodialysis participating in the 4D Study (The German Diabetes Dialysis Study), if the HDL cholesterol efflux capacity is predictive of cardiovascular risk. Efflux capacity was quantified by incubating human macrophage foam cells with apolipoprotein B-depleted serum. During a median follow-up of 4.1 years n=423 patients reached the combined primary endpoint (composite of cardiac death, nonfatal myocardial infarction and stroke), n=410 experienced cardiac events and n=561 died (all-cause mortality). Strikingly, in Cox regression analysis we found no association of efflux capacity with the combined primary endpoint (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.88 – 1.06, p =0.417), cardiac events (HR, 0.92; CI, 0.83-1.02; p =0.108) or all-cause mortality (HR 0.96; 95% CI, 0.88-1.05; p =0.390). In conclusion, HDL cholesterol efflux capacity is not a prognostic cardiovascular risk marker in diabetic patients on hemodialysis.

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