Plasma asymmetric dimethylarginine and its association with some of cardiovascular disease risk factors in chronic kidney disease

@#Introduction: Chronic kidney disease (CKD) usually has increase of asymmetric dimethylarginine (ADMA) levels. ADMA is a cardiovascular disease (CVD) risk factor and its elevation associated with other CVD risk factors at CKD leads to increasing risk of death. In this article, we aimed to identify levels and elevation proportion of plasma ADMA in CKD as well as association between ADMA with CVD risk factors. Methods: This cross-sectional study was performed at Hue Central Hospital from 2012-2016 on 176 CKD and 64 control subjects. ADMA levels were measured by using the enzyme linked immunosorbent assay (ELISA) method. Results: Mean ADMA level was markedly higher (p<0.001) in all patients combined (0.73±0.24µmol/L) than in control subjects (0.47±0.13µmol/L). Mean ADMA levels in advanced kidney disease were higher than control subjects. ADMA levels correlated inversely and relatively strictly to estimated glomerular filtration rate (eGFR) (r = -0.689; p<0.001), haemoglobin (r = -0.525; p<0.001) and haematocrit (r = - 0.491; p<0.001); correlated favourably and relatively strictly to serum creatinine (r = 0.569; p<0.001) and serum urea (r = 0.642; p<0.001). ADMA elevation was predicted simultaneously by eGFR<60 mL/min/1.73m2 (p<0.001), anaemia (p=0.002), body mass index (BMI) (p=0.011) and high sensitivity C-reactive protein (hs-CRP) (p=0.041). Cutoff of ≥0.68µmol/L, ADMA levels predict reduction of eGFR<60 mL/min/1.73m2 , sensitivity of 86.9 %, specificity of 82.6%, area under ROC 92.4% (95%CI: 88.6-96.1%).

Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials

BACKGROUND/OBJECTIVES: Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors. MATERIALS/METHODS: We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP). RESULTS: The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively. CONCLUSIONS: This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.

Familial Correlation and Heritability for Cardiovascular Risk Factors

The goal of this study was to describe the overall genetic contribution of phenotypic variation to cardiovascular disease. The study population included 7,589 family members of 1,891 families, derived from Korean Medical Insurance Corporation. The risk factors considered were systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and high serum cholesterol. The levels of cardiovascular disease risk factors were adjusted for age, gender, smoking and alcohol drinking. Heritability was estimated from the slope of the line linear regression of offspring on mid-parent. All risk factors showed positive familial correlations, and correlations were generally lower for spouses than for parent- offspring pairs. Spouse correlations showed increasing patterns with age. Parents-offspring correlations showed little variation with age, suggesting that the observed correlations with CVD risk factors were primarily due to genetic influences rather than environmental effects. Estimated heritabilities were 26% for BMI, 26% for high serum cholesterol, 19% for SBP, and 9% for DBP. These results highlight the importance of considering genetic factors in studies of cardiovascular risk factors.