Association between Periodontitis and Myocardial Infarction: Systematic Review and Meta-Analysis

Abstract The association between periodontitis and myocardial infarction remains unclear in the literature. Few studies have addressed periodontitis exposure as a predisposing factor for the development of myocardial infarction. Therefore, the present systematic review aims to analyze the association between periodontitis and myocardial infarction. This meta-analysis systematically searched MEDLINE, EMBASE, The Cochrane Controlled Trials Register, SCIELO, LILACS, CINAHL, Scopus, Web of Science and grey literature for studies estimating the association between periodontitis and myocardial infarction. Quality of evidence was assessed for all studies. The meta-analysis was conducted using random-effects models. Four of the six studies selected were included in the meta-analysis, including 1,035,703 subjects. The association between periodontitis and myocardial infarction was: RR: 5.99 (95% CI: 1.17-30.68), but with high heterogeneity (I2 = 100%; p <0.01). The results including only the highest quality articles, was lower: RR: 2.62 (95% CI: 1.47-4.70 3.83), but with lower heterogeneity (I2 = 85.5%; p < 0.01).The present systematic review with meta-analysis showed an association between periodontitis and acute myocardial infarction, but with a high level of heterogeneity.

Dislipidemia Diabética / Diabetic Dyslipidemia

O Diabetes mellitus é uma doença com elevada prevalência global, associada à mortalidade cardiovascular e complicações microvasculares, que conferem o caráter crônico a essa patologia. No diabetes tipo II, o processo aterosclerótico tem início antes mesmo do diagnóstico, daí a importância do reconhecimento dos fatores de risco implicados na fisiopatologia da doença vascular nessa população. A dislipidemia no diabético é caracterizada por lipoproteínas ricas em triglicérides, LDL pequenas, densas e muito aterogênicas e HDL-c baixo. As estatinas são os medicamentos de escolha para tratar a dislipidemia e reduzir de forma significativa o risco cardiovascular nesses pacientes. Apesar do controle glicêmico intensivo não reduzir eventos cardiovasculares nos estudos randomizados, alguns hipoglicemiantes apresentam efeito favorável sobre o perfil lipídico, com redução de futuros eventos

Diabetes mellitus is a disease with high global prevalence, associated with cardiovascular mortality and microvascular complications, which give this disease its chronic nature. In type II diabetes, the atherosclerotic process begins even before diagnosis, hence the importance of recognizing the risk factors involved in pathophysiology of vascular disease in this population. Dyslipidemia in the diabetic patient is characterized by triglyceride-rich lipoproteins; small-dense and very atherogenic LDLs and low HDL-c. Statins are the drugs of choice for treating dyslipidemia and significantly reducing the cardiovascular risk in these patients. Although intensive glycemic control did not reduce cardiovascular events in randomized trials, some hypoglycemic drugs have demonstrated a favorable effect on the lipid profile, and may reduce future events

Relationship between C -reactive protein and other cardiovascular risk factors in hypercholesterolemic individ alsa / Relação entre a proteína C reativa e os fatores de risco para doenças cardiovasculares em indivíduos hipercolesterolêmicos

Objective: To evaluate the correlation between ultrasensitive C-reactive protein (us-CRP) and markers of cardiovascular risk in hypercholesterolemic adults of differing nutritional status. Methods: Forty-six hypercholesterolemic subjects (7 men: 30 to 70 years; 39 women: 45 to 70 years) with total cholesterol >240 mg/dL were studied. Anthropometric variables (weight, height, and waist and hip circumference) were measured, as well as us-CRP, total cholesterol (TC), HDL-C, LDL-C, VLDL-C, triglycerides, apolipoprotein AI, apolipoprotein B, glucose and fasting insulin, and homeostasis model assessment (HOMA-IR) of insulin resistance. Spearman correlations and multiple linear regression analysis were performed at a level of significance of 5%. Results: Plasma levels of triglycerides, VLDL-C, glucose, HDL-C and us-CRP were higher in overweight subjects (p<0.05). Ultrasensitive CRP was positively correlated with body mass index (r=0.32) and hip circumference (r=0.30), as well as with TC (r=0.33), apolipoprotein B (r=0.36) and glucose (r=0.42). Regression analysis showed that us-CRP concentration was positively associated with TC, glucose, and waist-hip ratio. These parameters explained 41% of the variability in us-CRP. Conclusion: Obese individuals present a higher concentration of us-CRP, fasting glucose, triglycerides, and VLDL-C. Excess weight is associated with us-CRP, a finding highlighting the importance of this biomarker for the detection of individuals at cardiovascular risk.

Objetivo: Avaliar a correlação entre a proteína C reativa ultrasensível (PCR-us) e os marcadores clássicos de risco cardiovascular em adultos hipercolesterolêmicos em diferentes estados nutricionais. Métodos: Amostra de 46 indivíduos hipercolesterolêmicos (7 homens: 30 a 70 anos e 39 mulheres: 45 a 70 anos) com colesterol total (CT) >240 mg/dL. Realizou-se determinações antropométricas como peso, altura, circunferência da cintura (CC) e do quadril (CQ), além de medidas plasmáticas de PCR-us, CT, HDL-C, LDL-C, VLDL-C, triglicerídeos (TG), apolipoproteína AI (Apo AI), apolipoproteína B (Apo B), glicose e insulina de jejum e HOMA-IR. Realizou-se correlações de Spearman e análise de regressão linear múltipla ao nível de significância de 5%. Resultados: Os níveis plasmáticos de TG, VLDL-C, glicose, HDL-C e PCR-us foram maiores em indivíduos com sobrepeso (p<0,05). A PCR-us foi positivamente correlacionada com o índice de massa corporal (r=0,32) e com a CQ (r=0,30), bem como com o CT (r=0,33), Apo B (r=0,36) e glicose (r=0,42). A análise de regressão mostrou que a concentração de PCR-us foi positivamente associada ao CT, glicose e razão cintura-quadril. Esses parâmetros explicam a variabilidade da PCR-us em 41%. Conclusão: Os indivíduos obesos têm maior concentração plasmática de PCR-us, glicose, TG e VLDL-C. O excesso de peso está correlacionado com a PCR-us, mostrando a importância deste biomarcador para triagem de indivíduos de risco cardiovascular.

Serum lipoprotein ratios as markers of insulin resistance: A study among non-diabetic acute coronary syndrome patients with impaired fasting glucose.

Background & objectives: Recent data suggest that insulin resistance can predict cardiovascular disease independently of the other risk factors, such as hypertension, visceral obesity or dyslipidaemia. However, the majority of available methods to evaluate insulin resistance are complicated to operate, expensive, and time consuming. This study was undertaken to assess whether serum lipoprotein ratios could predict insulin resistance in non-diabetic acute coronary syndrome (ACS) patients. Methods: Ninety non-diabetic patients with impaired fasting glucose admitted with a diagnosis of ACS were included in the study. At the time of admission fasting glucose and insulin concentrations were measured. The homeostatic model assessment-insulin resistance (HOMA-IR) was used for insulin resistance. The fasting serum total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) levels were checked, and then TC/HDL-C and TG/HDL-C ratios were calculated. The areas under the curves (AUC) of the receiver operating characteristic (ROC) curves were used to compare the power of these serum lipoprotein ratios as markers. Results: Lipoprotein ratios were significantly higher in patients with HOMA-IR index > 2.5 as compared to patients with index <2.5 (P < 0.05). Both TG/HDL-C and TC/HDL-C ratios were significantly correlated with HOMA-IR (P<0.05). The area under the ROC curve of the TG/HDL-C and TC/HDL-C ratio for predicting insulin resistance was 0.80 (95% CI, 0.67 to 0.93), 0.78 (95% CI, 0.65 to 0.91), respectively. Interpretation & conclusions: The findings of this study demonstrate that serum lipoprotein ratios can provide a simple means of identifying insulin resistance and can be used as markers of insulin resistance and cardiovascular diseases risk in adult non-diabetic patients.

Niveles séricos de lipoproteína (a), apoproteínas A1 y B100 y otros factores de riesgo cardiovascular en una población de adultos del área urbana de san josé, Costa Rica / Serum levels of lipoprotein (a), apolipoproteins A1 and B100, and other cardiovascular risk factors in an adult population of the urban area of san jose, Costa Rica

Introducción y objetivos: La enfermedad cardiovascular es la primera causa de muerte en Costa Rica, razón por la cual seplantea el estudio de nuevos factores de riesgo en una población adulta de la provincia de San José.Métodos: Este estudio evaluó las concentraciones séricas del perfil lipídico, glucosa, lipoproteína (a), apoproteínas A1, B100y otros factores de riesgo de enfermedad cardiovascular en una población de 430 adultos con edades entre los 20 y 60años del área metropolitana de San José, Costa Rica.Resultados: La prevalencia de hiperlipoproteinemia (a) (≥ 0,3 g/L), hiperapoproteinemia B (> 0,65 g/L), hipercolesterolemia(> 5,17mmol/L), intolerancia a la glucosa (5,55-6,98 mmol/L) y diabetes mellitus (≥ 6,99 mmol/L) en la población es de67,8%, 87,4%, 46,3%, 14,2% y 5,7% respectivamente, sin diferencias significativas por sexo. La prevalencia de hipertrigliceridemia(>1,69 mmol/L) en la población es de 45,3%, siendo significativamente mayor en hombres que en mujeres (53,4%vs 37,2%; p = 0,001). Un porcentaje considerable de la población estudiada con niveles elevados de lipoproteína (a) (n =313) mostró simultáneamente uno o varios parámetros del perfil lipídico y la glucosa elevados. El 52,1 % presentó colesteroltotal ≥ 5,17 mmol/L; 44,4% triglicéridos ≥ 1,69 mmol/L; 25,2% HDL-colesterol < 1,03 mmol/L; 67,4 % LDL-colesterol ≥2,58 mmol/L, 45,0 % índice de Castelli ≥ 4,5, 17,9% glucosa ≥ 5,55 mmol/L y 88,8% apoproteína B > 0,65g/L. La prevalenciade síndrome metabólico en la población en estudio y según los criterios diagnósticos establecidos por la OrganizaciónMundial de la Salud es de 4,2%, fue mayor entre el género masculino (7,3% vs 1,7%; p = 0,008)...

Introduction and objectives: Cardiovascular disease is the first death cause in Costa Rica. This investigation proposes thestudy of new risk factors in an adult population of the province of San José.Methods: This study evaluated the lipid profile, glucose and other related cardiovascular risk factors in 430 adults aged20 to 60 years, residents of the metropolitan area of San José, Costa Rica.Results: The prevalences of hyperlipoprotein (a) (≥ 0,3 g/L), hyperapoprotein B (> 0,65 g/L), hypercholesterolemia (> 5,17mmol/L), impaired glucose tolerance (5,55-6,98 mmol/L) and diabetes mellitus (≥ 6,99 mmol/L) were 67,8%, 87,4%, 46,3%, 14,2% and 5,7% respectively, without significant differences between genders. The prevalence of hypertriglyceridemia(>1, 69 mmol/L) was 45,3%, being higher among the male population (53,4% vs. 37,2%; p = 0,001). A significantpercentage of the people included in this study had simultaneously high levels of lipoprotein (a) (n =313) and high levelsof another coronary risk factors such as: high cholesterol (52,1% had levels ≥ 5,17 mmol/L); high triglycerides (44,4% hadlevels ≥ 1,69 mmol/L); low HDL-cholesterol (25,2% had levels < 1,03 mmol/L); high LDL-cholesterol (67,4% had levels ≥2,58 mmol/L), high Castelli Index (45,0% had levels ≥ 4,5) , high glucose (17,9% had levels ≥ 5,55 mmol/L) and finally highlevels of apoprotein B (88,8% had levels > 0,65 g/L). The prevalence of metabolic syndrome in the studied population,according to the World Health Organization diagnostic criteria, was 4,2%, being higher among the male group (7,3% vs.1,7%; p = 0,008)...

Inflamação subclínica em mulheres que utilizam contraceptivo oral / Subclinical inflammation in women taking oral contraceptives

Fundamentos: Estudos recentes mostram que mulheres em uso de contraceptivo oral (CO) apresentam triglicerídeos e lipoproteínas de baixa densidade mais elevados quando comparadas a mulheres que não utilizam CO. Embora ainda sejam desconhecidas as consequências clínicas desse aumento em longo prazo, estudos sugerem que níveis mais elevados das lipoproteínas de baixa densidade contribuam diretamente para o processo inflamatório vascular. Uma das formas mais eficientes de se determinar a inflamação vascular é através da proteína C-reativa de alta sensibilidade (PCR).Objetivo: Verificar se a PCR de mulheres que utilizam CO é maior que a de mulheres que não utilizam CO. Métodos: Estudo realizado na Faculdade Social da Bahia, Salvador, BA – Brasil no período de julho a dezembro 2012. Incluídas mulheres aparentemente sadias, com idade entre 18-28 anos, eutróficas, classificadas como irregularmente ativas e com triglicerídeos de jejum <150 mg/dL. A amostra foi estratificada em dois grupos: grupo SCO formado por mulheres que não utilizavam nenhum tipo de contraceptivo a base de hormônios e grupo CO formado por mulheres que estavam em uso continuado de CO de baixa dosagem há no mínimo um ano. Após jejum de 12 horas foram coletados 5 mL de sangue para dosagem da PCR. Resultados: Selecionadas 44 mulheres distribuídas igualmente entre os grupos, idade 24,0±2,9 anos, IMC 21,0±3,2 kg/m2. A mediana e o desvio interquartil da PCR do grupo SCO e do grupo CO foram respectivamente 0,5 mg/L (0,0-0,9) e 2,1 mg/L (0,9-3,2), apresentando diferença estatística significativa (p=0,002).Conclusão: Neste estudo a PCR das mulheres que utilizam CO foi significativamente maior que a das mulheres que não utilizam CO.

Background: Recent studies show that women taking oral contraceptives (OC) have higher triglyceride and low-density lipoprotein levels than women not taking CO. Although the long-term clinical consequences of this increase are still unknown, studies suggest that higher levels of low-density lipoproteins contribute directly to vascular inflammation. One of the most effective ways of measuring vascular inflammation is through high sensitivity C-reactive protein (CRP).Objective: To examine whether the CRP levels of women taking OC are higher than those of women not taking OC.Methods: Study conducted at the Bahia Social Work College, Salvador, Bahia State – Brazil between July and December 2012, including apparently healthy women between 18 and 28 years old, eutrophic, classified as irregularly active and with fasting triglycerides below 150mg/dL. The sample was divided into two groups: an NOC group of women who not taking any type of hormone-based contraceptive and an OC group of women taking continuous low-dose OC for at least one year. After fasting for 12 hours, 5mL of blood were collected to measure their CRP levels. Results: 44 women were selected and divided equally between the groups, aged 24.0±2.9, BMI 21.0±3.2kg/m2. The median and interquartile CRP deviations in the NOC group and the OC group were respectively 0.5mg/L (0.0 to 0.9) and 2.1mg/L (0.9 to 3.2), with a statistically significant difference (p=0.002).Conclusion: In this study, the CRP levels of women taking oral contraceptives were significantly higher than those of women not taking oral contraceptives.

Cardiovascular risk in carotid disease: assessment of doppler sonography and biomarker results / Risco cardiovascular e doença carotídea: avaliação de resultados de doppler e biomarcadores

INTRODUCTION: Atherosclerosis and correlated cardiovascular problems, whose mechanical and physiological disorders cause thickening and hardening of blood vessels, are among the main causes of death worldwide. OBJECTIVE: To assess plasma concentrations of biomarkers from the lipid metabolism and carotid doppler sonography results by correlating them with atherogenic carotid disease. METHODS: the study comprised 66 patients aged 57.5 ± 15.5 years (20-77), from which 63% were female. Serum markers and doppler sonography images were used to evaluate the association with atherogenic carotid disease (ACD). RESULTS: There was a higher prevalence of ACD among females (33% vs. 15%), age range 56-65, showing a relative risk (RR) of 1.56 among females (p < 0.002; Fisher, Katz). Concerning high density lipoprotein cholesterol (HDL-C) and carotid stenosis classification, North American Symptomatic Carotid Endarterectomy Trial (NASCET), 76% of patients showed HDL-C within the protection range, from which 31 individuals presented level I (normal). 81% of them showed HDL-C > 40 mg/dl and 19% had HDL-C ≥ 40 mg/dl. The prevalence of HDL-C > 40 mg/dl at levels II, III and IV was considerable. There was no difference in HDL-C among the groups (p = 0.4910; unpaired t test). Furthermore, there was no difference in paraoxonase (PON1) activity when stratified to HDL-C > and < 40 mg/dl (p > 0.05). CONCLUSION: The female group displayed higher ACD prevalence at 56-65 age range, with RR of 1.56 times higher. These findings substantiate the importance of analyzing this group and age range carefully, inasmuch as the absence of hormonal protection may increase ACD risk and ultimately influence HDL antioxidant activity due to its direct action on PON1. Triglycerides (TG)/HDL-C ratio indicates cardiovascular risk and impaired reverse cholesterol transport.

INTRODUÇÃO: Complicações da aterosclerose agregam as principais causas de morte no mundo por problemas cardiovasculares relativos a distúrbio da condição mecânica e fisiológica que promove espessamento e endurecimento nas artérias. OBJETIVO: Avaliar as concentrações plasmáticas de biomarcadores do metabolismo lipídico e os resultados de doppler de carótidas, relacionando-os com a doença aterogênica de carótidas. MÉTODOS: Foram acompanhados 66 pacientes, com a média de idade entre 57,5 ± 15,5 anos, (20 a 77), sendo 63% mulheres. Utilizaram-se biomarcadores séricos e imagens (doppler) para avaliar a associação com a doença aterogênica carotídea (DCA). RESULTADOS E DISCUSSÃO: A DCA foi mais prevalente no gênero feminino (33% vs. 15%) entre as idades de 56-65 anos, risco relativo (RR) 1,56 nas mulheres (p < 0,002; Fisher, Katz). Em relação ao colesterol da lipoproteína de alta densidade (HDL-C) e à classificação da estenose de carótidas, North American Symptomatic Carotid Endarterectomy Trial (NASCET), observamos que 76% dos indivíduos apresentavam HDL-C na faixa protetora, sendo 31 grau I (normal); 81% possuíam lipoproteína de alta densidade (HDL) sérica > 40 mg/dl em comparação com 19% que tinham concentração de HDL-C ≥ 40 mg/dl. A prevalência de HDL-C > 40 mg/dl nos graus II, III e IV foi significativa. Não houve diferença de HDL-C entre os grupos (p = 0,4910, teste t não pareado). Não foi observada diferença entre as atividades de paraoxonase (PON1) quando estratificada para HDL-C > e < que 40 mg/dl (p > 0,05). CONCLUSÃO: O gênero feminino teve maior prevalência de DCA entre 56-65 anos, RR 1,56 vezes maior. Esse achado revela a importância de atenção nesse gênero e nessa faixa etária, uma vez que a ausência de proteção hormonal agrava o risco de DCA, podendo influenciar na atividade antioxidante da HDL por atuar diretamente na PON1. A razão triglirecídeos (TG)/HDL-C aponta para risco cardiovascular e deficiências no transporte reverso do colesterol.

Perfil lipídico y malonilaldehído en preeclámpticas / Malonaldehyde and lipid profile in preeclamptic patients

Determinar las concentraciones séricas de lípidos, lipoproteínas, apolipoproteínas y malonilaldehído en preeclámpticas. Estudio descriptivo y prospectivo. Setenta pacientes que asistieron a la emergencia de obstetricia fueron seleccionadas y divididas en dos grupos mediante un muestreo no probabilístico. Ambos grupos consistieron en preeclámpticas (grupo A) y embarazadas normotensas (grupo B), consideradas como controles. Se midieron las concentraciones de colesterol total, triglicéridos, apolipoproteína A-I y B, lipoproteínas de alta densidad (HDL-C), baja densidad (LDL-C), muy baja densidad (VLDL) y malonilaldehído. Hospital Central “Dr. Urquinaona”. Maracaibo, Estado Zulia. No se encontraron diferencias en la edad materna y en el promedio de peso materno entre las preeclámpticas y los controles (P = ns). Se evidenciaron diferencias estadísticamente significativas en la edad gestacional al momento del estudio, presión arterial sistólica y diastólica, peso del recién nacido y presencia de proteinuria (P < 0,05). Se encontraron diferencias estadísticamente significativas en las concentraciones de triglicéridos, lipoproteinas de alta densidad y de muy baja densidad, apolipoproteína B y malonilaldehído (P < 0,05). No se encontraron diferencias estadísticamente significativas en las concentraciones plasmáticas de colesterol, lipoproteínas de baja densidad y apolipoproteína A-I (P = ns). Se observaron correlaciones significativas negativas en las preeclámpticas entre las concentraciones de lipoproteínas de alta densidad y de muy baja densidad y entre las concentraciones de lipoproteínas de alta densidad y apolipoproteína B (P < 0,05). Existen diferencias significativas en las concentraciones de triglicéridos, lipoproteínas de alta densidad y de muy baja densidad, apolipoproteína B y malonilaldehído en las preeclámpticas.

To determine lipids, lipoproteins, apolipoproteins and malonilaldehyde concentrations in preeclamptic and normotensive patients. Seventy patients who assisted to obstetric emergency were selected and divided in two groups using a non-probabilistic sampling method. Both groups consisted in preeclamptic patients (group A) and normotensive pregnant women (group B), considered as controls. Plasma total cholesterol, triglycerides, apolipoproteins A-I and B, high density lipoprotein (HDL-C), low density (LDL-C), very low density (VLDL) and malonilaldehyde were measured. Hospital Central "Dr. Urquinaona". Maracaibo, Estado Zulia. There were not significant statically differences in mean maternal age and weight between preeclamptic patients and controls (P = ns) There were found significant differences in gestational age at the moment of delivery, systolic and diastolic blood pressure, newborn weight and presence of proteinuria (P > 0.05). There were statically significant differences in concentrations of triglycerides, HDL-C, VLDL, apolipoprotein B and malonilaldehyde (P < 0.05). There were not found significant differences in plasma concentrations of cholesterol, LDL-C and apolipoprotein A-I (P = ns). There were negative significant correlations in preeclamptic between HDL-C and LDL-C and between HDL-C and apolipoprotein B (P < 0,05). There are significant differences in triglycerides, HDL-C, VLDL, apolipoprotein B and malonilaldehyde in preeclamptic patients.

Ácido linoleico conjugado e exercício físico: efeitos na aterosclerose de camundongos apoe (-/-) / Conjugated linoleic acid and exercise: effects on atherosclerosis of apo e(-/-) Mice

Fundamento: Nenhum estudo foi encontrado em relação aos efeitos da combinação de ácido linoleico conjugado (CLA) e exercício físico na progressão de aterosclerose de camundongos APO E (-/-). Objetivo: Avaliar os efeitos da combinação de exercício físico e ácido linoleico conjugado (CLA) na progressão de aterosclerose de camundongos knockout para o gene da Apo E alimentados com dietas normo e hiperlipídica. Métodos: Camundongos knockout para Apo E foram alocados em quatro grupos/dieta: NS - dieta normolipídica e sedentário (n=5), HS - dieta hiperlipídica e sedentário (n=5), NECLA - dieta normolipídica com CLA e exercitado (n=8) e HECLA - dieta hiperlipídica com CLA e exercitado (n=8). O colesterol total e o HDL-C foram determinados através do método enzimático-colorimétrico. O LDL-C foi calculado pela fórmula de Friedewald. O fígado foi pesado e as lesões ateroscleróticas foram analisadas por fotomicrografia representativa da aorta. Utilizou-se ANOVA e Tukey ao nível de significância de 5%. Resultados: O grupo HECLA apresentou maiores valores de colesterol total e LDL-c que os grupos NECLA e NS (p<0,05). Em relação ao HDL-c, o grupo HS apresentou maior concentração que o grupo HECLA (p=0,019). O peso do fígado foi maior no grupo HECLA comparado com o NECLA (p=0,003). Em relação à progressão da aterosclerose, não foi encontrado diferenças significativas entre os grupos (p>0,05). Conclusões: A combinação exercício físico e CLA, independente do tipo de dieta, não foi eficiente na redução da progressão de aterosclerose de camundongos Knockout para o gene que expressa a apolipoproteina E.

Background: No studies were found regarding the effects of the combination of conjugated linoleic acid (CLA) and physical exercise in the progression of atherosclerosis in mice APO E (-/-). Objective: To evaluate the effects of the combination of exercise and conjugated linoleic acid (CLA) on the progression of atherosclerosis in mice knockout for the gene Apo E fed diets with normal and hyperlipidemic. Methods: Apo E knockout mice were divided into four groups / diet: NS - normolipídica diet and sedentary (n = 5), HS - high fat diet and sedentary (n = 5), NECLA - normolipídica diet with CLA and exercised (n = 8) and HECLA - High fat diet with CLA and exercised (n = 8). Total cholesterol and HDL-C were determined by enzymatic-colorimetric method. LDL-C was calculated using the Friedewald formula. The liver was weighed and atherosclerotic lesions were analyzed by representative photomicrographs of aorta. We used ANOVA and Tukey tests at a significance level of 5%. Results: The HECLA group had higher total cholesterol and LDL-C than groups NECLA and NS (p <0,05). In relation to HDL-C, the HS group had a higher concentration than the group HECLA (p = 0,019). Liver weight was higher in the group HECLA compared with NECLA (p = 0,003). Regarding the progression of atherosclerosis, was not found significant differences between groups (p> 0.05). Conclusions: The combination of exercise and CLA, regardless of the diet was not effective in reducing the progression of atherosclerosis Knockout mice for the gene that expresses the apolipoprotein E.

Efeitos do treinamento resistido na lipoproteína de baixa densidade: [revisão] / Effects of resistance training on low density lipoprotein

Os benefícios da prática regular do exercício físico estão claramente estabelecidos na literatura. Entretanto, a escolha do tipo de exercício ideal pode ser mais salutar para indivíduos com doenças específicas e patologias associadas. O propósito desta revisão foi verificar se o treinamento resistido (TR) exerce alguma alteração no colesterol da lipoproteína de baixa densidade (LDL-C). Foram observadas grandes diferenças na literatura, dificultando uma conclusão em relação aos benefícios do TR nesta revisão. No entanto, foi visto que o TR pode ser promissor na redução dos níveis de LDL-C, principalmente em homens e mulheres adultos, em pacientes com diabetes mellitus tipo 1 e tipo 2 e em mulheres pré-menopausa, não mostrando diferenças na população idosa. Os autores concluem que o TR é uma boa opção de exercício físico para indivíduos, principalmente quando o treinamento aeróbio (TA) é contraindicado.

The benefits of exercise regular practice are clearly established in the literature. However, the choice of the ideal exercise may be more beneficial for individuals with specific diseases and associated pathologies. The aim of this review was to determine whether resistance training (RT) promotes any change on low density lipoprotein cholesterol. Important differences were observed in research protocols, making it difficult to define the benefits of RT in this review. However, it was noticed that RT may be promising in reducing LDL-C levels mainly in adult men and women, in patients with diabetes mellitus type 1 and type 2 and in pre-menopausal women, not presenting differences in the elderly population. It was concluded that the RT is an option good of physical exercise for individuals, especially when the aerobic training (AT) is contra-indicated.

Efecto de los ácidos grasos trans sobre las lipoproteínas del plasma / Effect of trans fatty acids on plasma lipoproteins

Estudios clínicos y epidemiológicos indican que un consumo elevado de ácidos grasos trans (AGtrans) aumenta el riesgo de enfermedad cardio-vascular (ECV). Los ácidos grasos trans provenientes de los aceites parcialmente hidrogenados han sido asociados a muertes por ECV, pero estos efectos negativos sobre la salud humana no son atribuibles a los isómeros trans-11 C18:1 ó al cis-9, trans-11 del ácido linoleico conjugado (CLA) presentes en la carne o leche de ganado vacuno u ovino. El objetivo de esta revisión es presentar las evidencias disponibles a la fecha, sobre los diferentes aspectos químicos de los ácidos grasos con isomería trans, sobre el proceso de hidrogenación usado por la industria de alimentos y de biohidrogenación, así como de los posibles efectos del consumo de los AG trans sobre los factores de riesgo de ECV asociados con las lipoproteínas del plasma.

Tratamiento agresivo hipolipemiante en las enfermedades cardiovasculares / Aggresive lipid lowering therapy on cardiovascular disease

A 3 los factores de riesgo cardiovascular (CV) tradicionales hipercolesterolemia, hipertensión y tabaquismo, se agregó la diabetes mellitus. Hay muchos otros como la homocisteína y la lipoproteína (a), aunque de los beneficios de su tratamiento están por aclararse. También hay interés en los factores inflamatorios de riesgo CV, como la proteína C-reactiva ultra sensible (PCR-us) y la lipasa A, asociada a las lipoproteínas (Lp-PLA) cuyo dosaje está disponible comercialmente pero no es claro su rol en la práctica clínica de rutina. Sin embargo, todavía las lipoproteínas de baja densidad (LDL) representan el estándar de oro para predecir el riesgo CV. Con las dislipidemias de lipoproteínas específicas y los pacientes de difícil manejo, es importante individualizar su tratamiento con dietas y fármacos alternativos. Existieron percepciones erróneas como la creencia que solamente los caucásicos del mundo occidental y los varones tenían riesgo CV significativo. Ahora se sabe que muchos otros grupos étnicos también sufren enfermedades CV, especialmente los que viven en población urbana y que las mujeres incluso tienen peor pronóstico si se presentan antes de los 50 años de edad. Quizás el problema médico más importante en este momento es el síndrome metabólico, que en combinación junto a los demás factores de riesgo CV multiplica el riesgo total. Los tratamientos futuros involucrarán a la genética pero, por ahora, el uso agresivo de medicamentos puede modificar favorablemente el riesgo CV, más no eliminarlo.

Efectos del estradiol y acetato de noretisterona sobre los lípidos y la lipoproteína (a) sérica en posmenopáusicas ooforectomizadas / Effects del estradiol and norethisterone acetate on lipids and serum lipoprotein (a) in oophorectomized postmenopausal women

Determinar los efectos del estradiol y acetato de noretisterona sobre el perfil lipídico y la lipoproteína (a) en posmenopáusicas sanas ooforestomizadas. Se incluyeron treinta y seis mujeres sometidas a histerectomía y salpingo-ooforectomía bilateral con sintomas climatéricos. Las posmenopáusicas fueron tratadas con 2 mg de estradiol y 1 mg de acetato de noretisterona diario por 12 meses. Se midieron las concentraciones séricas de triglicéridos, HDL colesterol. LDL colesterol y colesterol y lipoproteína (a) al inicio del estudio y a los 3, 6, 9 y 12 meses de tratamiento. Hospital Central "Dr. Urquinaona", Maracaibo. No se observaron cambios estadísticamente significativos de colesterol, triglicéridos y LDL colesterol después de 3, 6, 9 y 12 meses de tratamiento cuando se comparó con los valores iniciales (P = ns). Desde los primeros 3 meses de tratamiento se observo un incremento en los valores de HDL colesterol (P < 0,05). Durante los primeros 3 meses de tratamiento los niveles de lipoprotéina (a) no variaron en forma significativa (P = ns). A partir de los 6 meses de tratamiento y a los 9 y 12 meses, estos niveles séricos se incrementaron en forma estadísticamente significativa cuando se compararon con los valores iniciales (P < 0,05). La administración oral de estradiol y acetato de noretisterona produce cambios significativos en los niveles de HDL colesterol y lipoprotéina, sin afectar las concentraciones séricas de colesterol, triglicéridos y LDL colesterol en pomenopáusicas ooforectomizadas

Classificação das dislipidemias / Classification of dyslipidaemia

Os autores ressaltam a importância de uma classificação das dislipidemias aceita pela comunidade científica, o que facilita o estabelecimento do diagnóstico e a melhor terapêutica, bem como o prognóstico das mesmas. Além da propedêutica dos distúrbios lipoprotéicos, são abordados aspectos genéticos das principais dislipidemias.

Phenotypic & genotypic conservation of ompL1 & lipL41 among leptospiral isolates of Andaman Islands.

BACKGROUND & OBJECTIVES: The leptospiral antigens that are conserved among the diverse pathogenic leptospires have potential importance in the development of new serodiagnostic and immunoprotective strategies. The present study was therefore carried out to find out the phenotypic conservation of the leptospiral proteins OmpL1 and LipL41, and the genetic conservation of ompL1 and lipL41 genes among the leptospiral isolates of Andaman Islands and among the reference strains. METHODS: In one dimensional SDS-PAGE the leptospiral samples prepared from strains of various leptospiral serovars were run and transferred on to nitrocellulose paper and probed with pooled convalescent phase human sera to find out the phenotypic conservation of the protein fragments at 31 and 41 kDa. Further, the proteins were indirectly confirmed as OmpL1 and LipL41 by using specific rabbit hyperimmune sera. Specific primers were utilized to amplify the fragments to study the genetic conservation of ompL1 and lipL41. Further, these two fragments were sequenced and BLAST analysis was done with the whole genome of Leptospira interrogans serovar Lai for comparison. RESULTS: Analysis of individual immunoblots using patient sera showed that the OmpL1 and LipL41 were conserved among all the isolates used in the study. Further, these two proteins were probed with specific rabbit hyperimmune sera of OmpL1 and LipL41 for confirming the fragments and it was found to be conserved among all the isolates. The PCR based amplification further showed that the genes ompL1 and lipL41 were conserved among the leptospiral isolates studied. Sequencing followed by BLAST analysis of these showed 97 per cent similarity with the whole genome sequence and low score values in comparison with other bacterial species. INTERPRETATION & CONCLUSION: The antigenic and genetic conservation of the two proteins, OmpL1 and LipL41, indicated that these could be potential candidates for development of diagnostic test systems for leptospirosis.

Current concepts of the relationship between cholesterol fed rats and endogenous amino acids

The effect of long term feeding of cholesterol 100 mg/kg/day for 20 weeks on free amino acid patterns in plasma and liver contents in rats was investigated using LKB-amino acid analyzer [Biochrom Ltd., Cambridge, England] and correlated these results with their effects on plasma levels of cholesterol, triglyceride, lipoprotein and Gamma Glutamyl Transferase [yGT]. indicate that all amino acid contents in the liver were significantly decreased in the cholesterol feed animal group. The amplitude of reductions varied between 40-100%. Glutamine and tryptophan were not detected in the liver of cholesterol feed group. The plasma concentrations of taurine, glutamate, alanine, valine and phenylalanine were elevated whose mean percentage increases were 48 +/- 4, 40 +/- 3, 25 +/- 3 and 35 +/- 4 respectively. These increases were associated with significant decrease in the concentration of ornithine [37%]. Meanwhile proline was not detected in the plasma of treated animals. Also, plasma cholesterol, triglyceride, lipoproteins and yGT were determined by colorimetric methods using Kits from Boehringer Mannheim [GmbH]. Results indicated that feeding cholesterol significantly increased the plasma yGT activity. In these experimental conditions the chronic intake of cholesterol had no significant effects on plasma cholesterol or other plasma lipids parameters tested except plasma triglyceride which was significantly increased, these results indicated that there are interactions between cholesterol intake and hepatic glutamine and tryptophan as well as plasma proline and these interaction mechanisms may be considered the factor generating metabolic events, which play physiological functions in the regulation of plasma cholesterol. Thus, under pathological conditions there is an imbalance between these interaction mechanisms which cause an increase in the circulating levels of cholesterol, leading to pathological processes such as hyperlipidemias, atherosclerosis and bile stones

Niveles de lipoproteina (a) y perfil lipidico en un grupo de individuos sanos en Bogota / Lipoprotein (a) levels and lipid profile in normal persons in Bogota

Objetivo: esta investigación tuvo como objetivo la determinación de los niveles de lipoproteína (a) (Lp(a)) y perfil lipídico en un grupo de individuos sanos. Material y métodos: Doscientos sujetos aparentemente sanos seleccionados al azar (hombres n=78; mujeres n=122) residentes en Bogotá O.C. a los cuales se les determinó colesterol total (Klosses y Shumberger, Lab. Bayer), triglicéridos (Wahlefildwl, Lab. Bayer S.A.), colesterol HDL (Finley, Warnik, Lab. Bayer S.A.), colesterol LDL (Burstein y Samoillee, Lab. Bayer S.A.), apo Al y B (Brustolini D y Maiernam M, por métodos enzimáticos colorimétricos; la Lp(a) por nefelometría y las apoproteínas por turbidimetría. Resultados: los resultados no mostraron una relación directa entre el perfil lipídico y los niveles de Lp(a), observándose que esta es un factor de riesgo independiente que puede inducir enfermedad cardiovascular. Este estudio permitió clasificar los individuos en cuatro grupos según la frecuencia de la distribución de la Lp(a) mostrando que el 85 por ciento exhibían valores < 26 mg/dL. Conclusiones: probabilísticamente se encontró que valores superiores pueden convertirse eventualmente en un factor de riesgo, o por lo menos de alerta, para enfermedad cardiovascular en la población bogotana.

Avaliaçäo dos níveis de lipídios, lipoproteínas, apoproteínas e o papel da lipoproteína(a) na desenvolvimento de aterosclerose e alterações fibrinolíticas nos pacientes portadores de hanseníase virchoviana / Avaliation of lipidis levels, lipoproteins, apoproteins and lixoproteins paper at atherosclerosis development and altering fibrinolitics

Muitos portadores de hanseníase virchoviana, após longo tempo de evoluçäo, apresentam alterações dérmicas muito semelhantes aos xantonas e seus exames histológicos mostram numerosos macrófagos carregados de material lipídico. Esses fatos, associados a alteraçöes humorais dos lipídios descritas na literatura, sugerindo alteraçöes no metabolismo dos mesmos, levou-nos a estudos, visando a estabelecer valores médios em pacientes, utilizando-se de novas determinaçöes lipoprotêicas e de apoproteínas muito mais precisas. A lipoproteína(a) apresentou valor médio acima de 20 mg/dl em 64,6(por cento) dos pacientes, contra 33,3(por cento) no grupo controle. O encontro de lipoproteína(a) aumentada em pacientes portadores de hanseníase virchoviana é importante, porque existe uma comprovada relaçäo entre esta lipoproteína e alteraçöes vasculares tipo ateroscleróticas e distúrbios na fibrinólise

Effect of selenium supplementation on plasma lipid and lipoprotein cholesterol levels in adult rats

Selenium is an antioxidant nutrient that prevents lipid peroxidation. The objective of the study was to investigate long-term effects of selenium supplementation on plasma lipid profile in rats. To investigate the effect of this micronutrient on plasma lipid levels, adult rats supplemented with selenium [20 micro g/Kg body weight] for 16 weeks were studied. Plasma selenium levels were found to be 167.9 +/- 4.8 micro g/1 and 193.9 +/- 3.8 micro.g/1 in control and selenium treated rats, respectively. Selenium supplementation significantly lowered the concentrations of plasma triglycerides by 21% and low density lipoprotein cholesterol [LDL-cho] by 42%. Also, the ratio of LDL-cho to either high density lipoprotein cholesterol [HDL-cho] or to total-cho was significantly lowered. On the other hand, selenium did not influence HDL-cho and total-cho concentrations although their relative ratio to each other was significantly increased [p<0.001]. Plasma selenium levels in the examined rats were negatively correlated with plasma triglycerides [r = -0.3479] and LDL-cho [r = -0.3177] concentrations. Therefore, the food supplementation with selenium might be beneficial in improving lipid profile, the major risk factor for coronary heart disease [CHD]