Cardiovascular diseases(CVDs)are the leading cause of death globally.CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease,cerebrovascular disease and rheumatic heart disease ...Cardiovascular diseases(CVDs)are the leading cause of death globally.CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease,cerebrovascular disease and rheumatic heart disease among other conditions.There are multiple independent risk factors for CVD,including hypertension,age,smoking,insulin resistance,elevated low-density lipoprotein cholesterol(LDL-C)levels,and triglyceride levels.LDL-C levels have traditionally been the target for therapies aimed at reducing CVD risk.High density lipoprotein(HDL)constitutes the only lipoprotein fraction with atheroprotective functions.Early HDL-targeted therapies have focused on increasing HDL-C levels.However,clinical trials have shown that raising HDL-C with niacin failed to achieve CVD reduction.A possible explanation for these findings is that these drugs could interfere with lipid metabolism and cause alterations in HDL structure and composition,leading to loss of functionality.As a result,targeting HDL-C levels would be insufficient to achieve CVD risk reduction,making HDL functionality a more desirable focus for HDL-directed therapies.There are several drugs which show the potential to improve HDL functionality.These drugs include molecules already approved for human use,such as statins and niacin,and particularly,compounds currently undergoing development such as apolipoprotein A-I mimetics and reconstituted HDL preparations.These therapies show promising potential to improve HDL functionality specifically.Future therapeutic strategies should incorporate HDL functionality as a main target of interest.展开更多
AIM To evaluate novel risk factors and biomarkers of car-diovascular disease in celiac disease(CD)patients compared with healthy controls.METHODS Twenty adult patients with recent diagnosis of CD and 20 sex,age and bo...AIM To evaluate novel risk factors and biomarkers of car-diovascular disease in celiac disease(CD)patients compared with healthy controls.METHODS Twenty adult patients with recent diagnosis of CD and 20 sex,age and body mass index-matched healthy controls were recruited during a period of 12 mo.Indicators of carbohydrate metabolism,hematological parameters and high sensitive C reactive protein were determined.Moreover,lipoprotein metabolism was also explored through evaluation of the lipid profile andthe activity of cholesteryl ester transfer protein and lipoprotein associated phospholipase A2,which is also considered a specific marker of vascular inflammation.The protocol was approved by the Ethic Committee from School of Pharmacy and Biochemistry,University of Buenos Aires and from Buenos Aires Italian Hospital,Buenos Aires,Argentina.RESULTS Regarding the indicators of insulin resistance,CD patients showed higher plasma insulin levels[7.2(5.0-11.3)m U/L vs 4.6(2.6-6.7)m U/L,P<0.05],increased Homeostasis Model Assessment-Insulin Resistance[1.45(1.04-2.24)vs 1.00(0.51-1.45),P<0.05]and lower Quantitative Sensitive Check index[0.33(0.28-0.40)vs 0.42(0.34-0.65),P<0.05]indexes.Folic acid concentration[5.4(4.4-7.9)ng/m L vs 12.2(8.0-14.2)ng/m L,P<0.01]resulted to be lower and High-sensitivity C reactive protein levels higher(4.21±6.47 mg/L vs 0.98±1.13 mg/L,P<0.01)in the patient group.With respect to the lipoprotein profile,CD patients showed lower high density lipoprotein-cholesterol(HDL-C)(45±15 mg/d L vs 57±17 mg/d L,P<0.05)and apo A-I(130±31 mg/d L vs 155±29 mg/d L,P<0.05)levels,as well as higher total cholesterol/HDL-C[4.19(3.11-5.00)vs 3.52(2.84-4.08),P<0.05]and apo B/apo A-I(0.75±0.25 vs 0.55±0.16,P<0.05)ratios in comparison with control subjects.No statistically significant differences were detected in lipoprotein-associated lipid transfer protein and enzymes.CONCLUSION The presence and interaction of the detected alterations in patients with CD,would constitute a risk factor for the development of atherosclerotic cardiovascular disease.展开更多
文摘Cardiovascular diseases(CVDs)are the leading cause of death globally.CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease,cerebrovascular disease and rheumatic heart disease among other conditions.There are multiple independent risk factors for CVD,including hypertension,age,smoking,insulin resistance,elevated low-density lipoprotein cholesterol(LDL-C)levels,and triglyceride levels.LDL-C levels have traditionally been the target for therapies aimed at reducing CVD risk.High density lipoprotein(HDL)constitutes the only lipoprotein fraction with atheroprotective functions.Early HDL-targeted therapies have focused on increasing HDL-C levels.However,clinical trials have shown that raising HDL-C with niacin failed to achieve CVD reduction.A possible explanation for these findings is that these drugs could interfere with lipid metabolism and cause alterations in HDL structure and composition,leading to loss of functionality.As a result,targeting HDL-C levels would be insufficient to achieve CVD risk reduction,making HDL functionality a more desirable focus for HDL-directed therapies.There are several drugs which show the potential to improve HDL functionality.These drugs include molecules already approved for human use,such as statins and niacin,and particularly,compounds currently undergoing development such as apolipoprotein A-I mimetics and reconstituted HDL preparations.These therapies show promising potential to improve HDL functionality specifically.Future therapeutic strategies should incorporate HDL functionality as a main target of interest.
基金Supported by CONICET,No.PIP 11220110100516University of Buenos Aires,No.UBACyT 20020150100054BA
文摘AIM To evaluate novel risk factors and biomarkers of car-diovascular disease in celiac disease(CD)patients compared with healthy controls.METHODS Twenty adult patients with recent diagnosis of CD and 20 sex,age and body mass index-matched healthy controls were recruited during a period of 12 mo.Indicators of carbohydrate metabolism,hematological parameters and high sensitive C reactive protein were determined.Moreover,lipoprotein metabolism was also explored through evaluation of the lipid profile andthe activity of cholesteryl ester transfer protein and lipoprotein associated phospholipase A2,which is also considered a specific marker of vascular inflammation.The protocol was approved by the Ethic Committee from School of Pharmacy and Biochemistry,University of Buenos Aires and from Buenos Aires Italian Hospital,Buenos Aires,Argentina.RESULTS Regarding the indicators of insulin resistance,CD patients showed higher plasma insulin levels[7.2(5.0-11.3)m U/L vs 4.6(2.6-6.7)m U/L,P<0.05],increased Homeostasis Model Assessment-Insulin Resistance[1.45(1.04-2.24)vs 1.00(0.51-1.45),P<0.05]and lower Quantitative Sensitive Check index[0.33(0.28-0.40)vs 0.42(0.34-0.65),P<0.05]indexes.Folic acid concentration[5.4(4.4-7.9)ng/m L vs 12.2(8.0-14.2)ng/m L,P<0.01]resulted to be lower and High-sensitivity C reactive protein levels higher(4.21±6.47 mg/L vs 0.98±1.13 mg/L,P<0.01)in the patient group.With respect to the lipoprotein profile,CD patients showed lower high density lipoprotein-cholesterol(HDL-C)(45±15 mg/d L vs 57±17 mg/d L,P<0.05)and apo A-I(130±31 mg/d L vs 155±29 mg/d L,P<0.05)levels,as well as higher total cholesterol/HDL-C[4.19(3.11-5.00)vs 3.52(2.84-4.08),P<0.05]and apo B/apo A-I(0.75±0.25 vs 0.55±0.16,P<0.05)ratios in comparison with control subjects.No statistically significant differences were detected in lipoprotein-associated lipid transfer protein and enzymes.CONCLUSION The presence and interaction of the detected alterations in patients with CD,would constitute a risk factor for the development of atherosclerotic cardiovascular disease.
