Evaluación del lipidograma y ciertos factores de riesgo de ateroesclerosis en niños cuyos padres tuvieron arteriopatía coronaria de inicio temprano / Assessment of lipid profile and some risk factors of atherosclerosis in children whose parents had early onset coronary artery disease

Antecedentes/Objetivo. El objetivo de nuestro estudio fue analizar el lipidograma y ciertos factores de riesgo de ateroesclerosis, tales como las lipoproteínas de baja densidad oxidadas (ox-LDL, por su sigla en inglés) y las lipoproteínas de baja densidad pequeñas y densas (sdLDL, por su sigla en inglés) en los hijos de pacientes con cardiopatía coronaria (CC) prematura. Población y métodos. Hijos de padres con CC de inicio temprano emparejados con pares de su misma edad y mismo sexo. Se analizaron las concentraciones de lípidos, apolipoproteínas (ApoA, B, E), ox-LDL, sdLDL y lipoproteína (a) [Lp(a)] en los niños de estudio y de referencia. Los datos se evaluaron con el programa SPSS, junto con la prueba t de Student y la prueba U de Mann-Whitney. Resultados. Los niños del grupo de estudio (n: 43) tenían niveles más elevados de LDL, Lp(a) y ox-LDL y cocientes mayores de CT/HDL, ApoB/ApoA, LDL/HDL y ox-LDL/HDL (p < 0,05) que los del grupo de referencia. Conclusión. Con base en estos hallazgos, se sugiere que la dislipidemia y las concentraciones elevadas de LDL, Lp(a) y ox-LDL son frecuentes en los hijos de pacientes con CC de inicio temprano y representan gran parte de la predisposición familiar a tener CC

Background/Aim: The objective of our study was to analyze the lipid profile and some risk factors of atherosclerosis such as oxidized-low density lipoprotein (ox-LDL), small dense LDL (sd LDL) in the offspring of patients with premature coronary heart disease (CHD). Population and Methods: Children whose parents had early onset CHD were matched with age and sex pairs. Study and controls were analyzed for lipid levels, apolipoproteins (Apo- A,B,E), ox-LDL, sd LDL and lipoprotein (a) [Lp(a)]. The data were evaluated with SPSS using "Student tand Mann-Whitney U" tests. Results: Thestudy group children (n: 43) had higher LDL, Lp(a) and ox-LDL levels, ratios of TC/HDL, Apo-B/A, LDL/HDL and ox-LDL/HDL (p<0.05) than control group. Conclusion: These findings suggest that dyslipidemia and increased LDL, Lp(a) and ox-LDL levels are common in the offspring of patients with early onset CHD and account largely for their familial predisposition for CHD.

Specific alterations in plasma proteins during depressed, manic, and euthymic states of bipolar disorder

Bipolar disorder (BD) is a common psychiatric mood disorder affecting more than 1-2% of the general population of different European countries. Unfortunately, there is no objective laboratory-based test to aid BD diagnosis or monitor its progression, and little is known about the molecular basis of BD. Here, we performed a comparative proteomic study to identify differentially expressed plasma proteins in various BD mood states (depressed BD, manic BD, and euthymic BD) relative to healthy controls. A total of 10 euthymic BD, 20 depressed BD, 15 manic BD, and 20 demographically matched healthy control subjects were recruited. Seven high-abundance proteins were immunodepleted in plasma samples from the 4 experimental groups, which were then subjected to proteome-wide expression profiling by two-dimensional electrophoresis and matrix-assisted laser desorption/ionization-time-of-flight/time-of-flight tandem mass spectrometry. Proteomic results were validated by immunoblotting and bioinformatically analyzed using MetaCore. From a total of 32 proteins identified with 1.5-fold changes in expression compared with healthy controls, 16 proteins were perturbed in BD independent of mood state, while 16 proteins were specifically associated with particular BD mood states. Two mood-independent differential proteins, apolipoprotein (Apo) A1 and Apo L1, suggest that BD pathophysiology may be associated with early perturbations in lipid metabolism. Moreover, down-regulation of one mood-dependent protein, carbonic anhydrase 1 (CA-1), suggests it may be involved in the pathophysiology of depressive episodes in BD. Thus, BD pathophysiology may be associated with early perturbations in lipid metabolism that are independent of mood state, while CA-1 may be involved in the pathophysiology of depressive episodes.

Reassessing lipid metabolism and its potentialities in the prediction of cardiovascular risk

There are numerous particles, enzymes, and mechanisms in the lipid metabolism that are involved in the genesis of cardiovascular disease (CVD). Given its prevalence in populations and its impact on mortality, it is relevant to review the lipid metabolism as it may potentially provide subsidies to better prediction. This article reviews the importance of traditional cardiovascular risk factors and comments on the potential of novel lipid biomarkers involved in the physiopathology of CVD. The Framingham cohorts proved the role of traditional risk factors (physical inactivity, smoking, blood pressure, total cholesterol, LDL-C, HDL-C, plasma glucose) in the prediction of cardiovascular events. However, a significant number of individuals that suffer from a cardiovascular event has few or none of these factors. Such finding indicates the need for new biomarkers able to identify plaques that are more susceptible to rupture. Some of bloodstream biomarkers related to lipid metabolism are modified LDL particles, apolipoprotein AI (apo AI), apolipoprotein B, lipoprotein (a) [Lp (a)], cholesteryl ester transfer protein (CETP), subtypes of LDL and HDL particles, and lipoprotein-associated phospholipase A2 (Lp-PLA2). These factors participate in the atherosclerotic process, and are abnormal in individuals at high risk, or in those who suffered from a cardiovascular event. Lp (a) determination is already employed in clinical practice and should be included as a reference parameter for CVD monitoring. Furthermore, there are expectations for wider use of apo B, non-HDL cholesterol and total cholesterol / HDL-C determination to improve cardiovascular risk assessment.

Pressao Arterial na Adolescencia, Adipocinas e Inflamacao no Adulto Jovem. Estudo do Rio de Janeiro / Blood Pressure in Adolescence, Adipokines and Inflammation in Young Adults. The Rio de Janeiro Study

Fundamento: O impacto pressão arterial (PA) na adolescência sobre outros fatores de risco cardiovascular em adultos jovens é importante para a prevenção primária. Objetivo: Avaliar a PA, índices antropométricos, perfil metabólico e inflamatório de jovens estratificados pelo comportamento da sua PA obtida há 18 anos. Métodos: Avaliaram-se 116 indivíduos, sendo 63 homes, pertencentes ao estudo do Rio de Janeiro (seguimento 17,76 ± 1,63 anos) em dois momentos: A1 (12,40 ± 1,49 anos) e A2 (30,09 ± 2,01 anos). Os 116 indivíduos foram divididos em dois grupos: GN (n = 71), PA normal em A1; e GH (n = 45): PA anormal em A1. A PA, o peso, a altura e o índice de massa corporal (IMC) foram obtidos em A1 e A2. Em A2, acrescentaram-se a circunferência abdominal (CA) e variáveis laboratoriais, metabólicas e inflamatórias. Resultados: 1) Os grupos não diferiram quanto à idade e sexo; 2) Em A2, GH apresentou maiores médias de peso, IMC, PA, insulina, HOMA-IR (p < 0,001), leptina (p < 0,02), Apolipoproteína B100 e A1 (p < 0,02), relação Apolipoproteína B100 / Apolipoproteína A1 (p < 0,010), maiores prevalências de sobrepeso/obesidade (p < 0,001), da CA aumentada (p < 0,001) e de hipertensão arterial (p < 0,02); 3) Não houve diferença entre os grupos para as variáveis inflamatórias; 4) Houve correlação positiva da PA em A1 com a PA, o IMC, e com a insulina, a leptina e o HOMA-IR em A2 (p < 0,05). Conclusões: A PA na adolescência se associou a maiores valores de PA, variáveis antropométricas e metabólicas na fase adulta jovem, mas não a variáveis inflamatórias. .

Background: The impact of blood pressure (BP) during adolescence on other cardiovascular risk factors in young adults is important for the primary prevention. Objective: To evaluate BP, anthropometric indexes, metabolic and inflammatory profiles in young individuals stratified by their BP behavior recorded for 18 years. Methods: A total of 116 individuals, of whom 63 were males, from the Rio de Janeiro study (follow-up of 17.76 ± 1.63 years), were assessed at two moments: A1 (12.40 ± 1.49 years) and A2 (30.09 ± 2.01 years). The 116 individuals were divided into two groups: GN (n = 71), of participants with normal BP at A1; and GH (n = 45), of those with abnormal BP at A1. BP, weight, height and body mass index (BMI) were measured at A1 and A2. At A2, abdominal circumference (AC) and laboratory, metabolic and inflammatory variables were included. Results: 1) No difference was observed between the groups as regards age and gender; 2) At A2, GH showed higher mean weight, BMI, BP, insulin, HOMA-IR (p < 0.001), leptin (p < 0.02), apolipoprotein B100 and A1 (p < 0.02), apolipoprotein B100 / apolipoprotein A1 ratio (p < 0.010); and higher prevalences of overweight/obesity (p < 0.001), of increased AC (p < 0.001) and of hypertension (p < 0.02); 3) No difference was observed between the groups as regards the inflammatory variables; 4) There was a positive correlation of BP at A1 with BP, BMI, insulin, leptin and HOMA-IR at A2 (p < 0.05). Conclusion: BP in adolescence was associated with higher values of BP, and anthropometric and metabolic variables in young adulthood, but not with inflammatory variables. .

Effects of R219K polymorphism of ATP-binding cassette transporter 1 gene on serum lipids ratios induced by a high-carbohydrate and low-fat diet in healthy youth

BACKGROUND: Diets are the important players in regulating plasma lipid profiles. And the R219K polymorphism at the gene of ATP-binding cassette transporter 1(ABCA1) was reported to be associated with the profiles. However, no efforts have been made to investigate the changes of lipid profiles after a high-carbohydrate and low-fat diet in different subjects with different genotypes of this polymorphism. This study was to evaluate the effects of ABCA1 R219K polymorphism on serum lipid and apolipoprotein (apo) ratios induced by a high-carbohydrate/low-fat (high-CHO) diet. After a washout diet of 54.1% carbohydrate for 7 days, 56 healthy young subjects (22.89 ± 1.80 years old) were given a high-CHO diet of 70.1% carbohydrate for 6 days. Height, weight, waist circumference, hip circumference, glucose (Glu), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apoA-1 and apoB-100 were measured on the 1st, 8th and 14th days of this study. Body mass index (BMI), waist-to-hip ratios (WHR), log(TG/HDL-C), TC/HDL-C, LDL-C/HDL-C and apoA-1/apoB-100 were calculated. ABCA1 R219K was analyzed by a PCR-RFLP method. RESULTS: The results indicate that the male subjects of all the genotypes had higher WHR than their female counterparts on the 1st, 8th and 14th days of this study. The male K carriers had higher log(TG/HDL-C) and TC/HDL-C than the female carriers on the 1st and 14th days, and higher LDL-C/HDL-C on the 14th day. When compared with that on the 8th day, TC/HDL-C was decreased regardless of the genotypes and genders on the 14th day. Log(TG/HDL-C) was increased in the males with the RR genotype and the female K carriers. Lowered BMI, Glu and LDL-C/HDL-C were found in the male K carriers, but only lowered BMI in the female K carriers and only lowered LDL-C/HDL-C in the females with the RR genotype. CONCLUSIONS: These results suggest that ABCA1 R219K polymorphism is associated differently in males and females with elevated log(TG/HDL-C) and decreased LDL-C/HDL-C induced by the high-CHO diet.

Factores de riesgo cardiovascular y perfil apolipoprotéico en un grupo de adultos atendidos en un centro público de salud del estado Carabobo, Venezuela / Cardiovascular risk factors and apolipoproteic profile in a group of adults treated in a public health center in Carabobo state, Venezuela

Objetivos. Comparar los niveles séricos de las apolipoproteínas A-I y B así como las relaciones Apo B/Apo A-I y HDL colesterol/Apo A-I según edad, sexo y factores de riesgo cardiovascular en individuos atendidos en un centro público de salud venezolano. Materiales y métodos. Se determinó la presión arterial, la circunferencia de cintura (CC), el perfil lipídico y las apolipoproteínas A-I y B en 221 individuos (44,0±15,5 años) de ambos sexos; también se calculó el índice de masa corporal (IMC) a partir del peso y la talla y se estableció hábito al tabaco, la ingesta de bebidas alcohólicas y el patrón de su consumo. Resultados. El 27,5 por ciento presentó concentraciones bajas de Apo A-I, 45,2 por ciento Apo B elevada y 60,6 por ciento relación Apo B/Apo A-I alta. Los niveles séricos de las apolipoproteínas y la relación Apo B/Apo A-I no variaron con la edad o sexo, mientras que la relación HDL colesterol/Apo A-I disminuyó al elevarse la edad. Los individuos obesos, fumadores, hipertensos, hipercolesterolémicos, hipertrigliceridémicos o con HDL colesterol bajo mostraron cifras más elevadas de Apo B y Apo B/Apo A-I. La relación HDL colesterol/Apo A-I disminuyó con la edad, el nivel de habito al tabaco y el aumento de LDL-C y triglicéridos. El consumo de tres o más bebidas alcohólicas/día se asoció con disminución de Apo B. Conclusiones. Se demostró alta prevalencia de perfil apolipoprotéico alterado, lo cual se asoció con los principales factores de riesgo cardiovascular. Los resultados del estudio apoyan la inclusión de las apolipoproteínas evaluadas en las determinaciones de laboratorio realizadas en los centros públicos de atención de salud venezolanos.

Objectives. To compare serum levels of apolipoproteins A-I and B as well as Apo B/Apo A-I and HDL cholesterol/Apo A-I ratios by age, gender and cardiovascular risk factors in individuals treated at a Venezuelan public health center. Materials and methods. We determined in 221 individuals (44.0 ± 15.5 years) of both genders blood pressure, waist circumference (WC), lipid profile and apolipoproteins A-I and B; body mass index (BMI) was calculated from weight and height; smoking habit, alcohol intake and consumption pattern were established. Results. 27.5 percent of individuals had low levels of Apo A-I, 45.2 percent high Apo B and 60.6 percent high Apo B/Apo A-I ratio. Serum levels of apolipoproteins and Apo B/Apo A-I ratio did not vary with age or gender, while the ratio HDL cholesterol/Apo A-I decreased with the age. Obese individuals, smokers, hypertensive, hypercholesterolemics, hypertriglyceridemics or with low HDL cholesterol showed higher Apo B and Apo B/Apo A-I ratio. Older individuals, smokers or individuals with increased LDL cholesterol and triglycerides showed lower HDL cholesterol/Apo A-I ratio. Consumption of three or more alcoholic drinks/day was associated with decreased Apo B. Conclusions. These results show high prevalence of altered apolipoprotein profile, which is associated with major cardiovascular risk factors. The results support the inclusion of the evaluated apolipoproteins in laboratory determinations made in public health centers in Venezuela.

Susceptibility of Mice to Trypanosoma evansi Treated with Human Plasma Containing Different Concentrations of Apolipoprotein L-1

The aim of this study was to test the susceptibility of mice to Trypanosoma evansi treated with human plasma containing different concentrations of apolipoprotein L-1 (APOL1). For this experiment, a strain of T. evansi and human plasma (plasmas 1, 2, and 3) from 3 adult males clinically healthy were used. In vivo test used 50 mice divided in 5 groups (A to E) with 10 animals in each group. Animals of groups B to E were infected, and then treated with 0.2 ml of human plasma in the following outline: negative control (A), positive control (B), treatment with plasma 1 (C), treatment with plasma 2 (D), and treatment with plasma 3 (E). Mice treated with human plasma showed an increase in longevity of 40.9+/-0.3 (C), 20+/-9.0 (D) and 35.6+/-9.3 (E) days compared to the control group (B) which was 4.3+/-0.5 days. The number of surviving mice and free of the parasite (blood smear and PCR negative) at the end of the experiment was 90%, 0%, and 60% for groups C, D, and E, respectively. The quantification of APOL1 was performed due to the large difference in the treatments that differed in the source plasma. In plasmas 1, 2, and 3 was detected the concentration of 194, 99, and 115 mg/dl of APOL1, respectively. However, we believe that this difference in the treatment efficiency is related to the level of APOL1 in plasmas.

Apolipoproteins and vitamin C intake in healthy Saudi adults

Vitamin C has been shown to he an effective therapy for reducing total serum cholesterol, but recent studies have determined that low-density lipoprotein cholesterol [LDL-C] and high density lipoprotein cholesterol [HDL-C] as well as their apolipoprotein Apo B and Apo A-1 respectively are actually better predictive measures of coronary heart disease risk, therefore, the purpose of this study was to investigate the relationship between vitamin C intakes and the serum concentration of vitamin C, LDL-C, HDL-C, triglycerides, Apo B and Apo A. 1 in healthy Saudi subjects. The results show that vitamin C intake had a significant positive association with serum concentrations of vitamin C, HDL-C and Apo A-1, but an inverse association with serum concentrations of LDL-C, Apo B and triglyceride, after adjusting for age, body mass index and gender. Vitamin C intake was inversely related to the mean LDL/HDL and triglyceridef HDL ratios. So it is concluded that increase vitamin C intake could play an important role in lipoprotein concentrations as well as their apolipoproteins and could play a potential role in the prevention of atherogenic disease in healthy Saudi men

Relationship between rheumatoid arthritis activity and serum levels of lipid profile

Rheumatoid arthritis [RA] is characterized by inflammation and an increased cardiovascular risk. It was recently shown that active early rheumatoid arthritis is associated with dyslipidaemia, which may partially explain the enhanced cardiovascular risk. However, it is unknown when this dyslipidaemia starts. Changes in lipid profiles, lipoprotein [Lp] and acute phase reactants are associated with early atherosclerosis in RA. The associations of Lp levels with atherosclerotic disorders, diabetes, RA and renal diseases suggest that Lp might be involved in autoimmune reactions. To evaluate the change of lipid profile in rheumatoid arthritis and its association with the disease activity. This was a prospective study with 21 female patients who had rheumatoid arthritis and whose progress was accompanied for 1 year. Total cholesterol [TC], low density lipoprotein-cholestero [LDL-C], high density lipoprotein-cholesterol [HDL-C], triglycerides [TG], apolipoproteins A [apo-A] and apo-B, Lp, erythrocytic sedimentation sate [ESR], as well as health assessment questionnaire [HAQ] and disease activity through disease activity index 28-joint score [DAS28] were evaluated. After 1 year, the TC level was increased in 66.6% of the patients [p=0.019] and the LDL-C level was also elevated in 80.9% of the patients [p=0.008]. In contrast, the Lp level was reduced in 33.33% of the cases [p=0.003]. A significant decrease also occurred in ESR, HAQ and DAS28. However, there was no association between the alteration of the lipid profile and the disease activity. Although the reduction in the disease activity [DAS28] was significant, the lipid profile worsened

Non-invasive fibrosis seromarkers as a predictor of liver fibrosis in chronic hepatitis C and/or non-alcoholic steatohepatitis

In patients with chronic hepatitis C, the precise stage of hepatic fibrosis is the most important predictor of disease progression and it determines the need for antiviral therapy. Although liver biopsy is acknowledged as the gold standard for evaluating fibrosis, it is occasionally prone to sampling error and complications. We aimed to correlate an index of biochemical markers with histological features of fibrosis to predict hepatic fibrosis in patients with chronic hepatitis C virus, patients with combined hepatitis C virus and non-alcoholic steatohepatitis and those with non-alcoholic steatohepatitis, aiming to reduce the use of the liver biopsy. Out of those attending our out patient clinic for clinical, haematological, biochemical, virological, histological and ultrasonographic assessment prior to interferon therapy for hepatitis C virus, we enrolled 41 patients and grouped them according to histopathological examination of their liver biopsies into: Group I: 21 chronic hepatitis C virus patients as defined by positive 3rd generation ELISA; Group II: 20 patients with combined hepatitis C virus and NASH. We added a third group [Group III] of 15 patients having non alcoholic steatohepatitis as defined clinically, biochemically and through diagnostic percutanous liver biopsy. There were 33 male 23 female patients; 35 [62.5%] of them were from rural areas and 21 [37.5%] were from urban areas; the mean ages were 40.5 +/- 9, 46.6 +/- 7.7 and 42.13 +/- 11.06 in Group I, II and III respectively. Twenty apparently healthy individuals served as the control group. All the patients and the control group were submitted to full clinical history and examination, abdominal ultrasonography, CBC, liver biochemical profile and fibrosis biomarkers [apolipoprotein A1, haptoglobin, alpha2 marcoglobulin, GGT]. Liver biopsy was done for suitable patients after taking a consent and the results of fibrosis seromarkers were compared with the results of liver biopsy using the Metavir scoring system, We also estimated patients' body mass index, fasting and post prandial blood glucose. We excluded patients with other causes of chronic liver disease and co-morbidities that could confound the results of the non-invasive markers adopted, including schistosomiasis which was excluded by serological test. 43% of Group I and 40% of Group II had advanced fibrosis. None of Group III had advanced fibrosis; mild fibrosis was detected in 80% of them. gamma-GT was found positively correlated to the degree of hepatic fibrosis in Groups I, II and III [r = 0.667, 0.656 and 0.121, respectively] with P values of 0.001, 0.002, 0.668, respectively. alpha2 macroglobulin was found to be a reliable predictor of fibrosis [r = 0.30, P = 0.02] with ROC curve [area under the curve = 0.70] best cutoff value 2.55 g/L with sensitivity of 0.80 and specificity of 0.50. The results of haptoglobin were negatively related to the degree of hepatic fibrosis in Group I and II with ROC curve area under the curve of 0.33 and P value of 0.04. Significant direct correlation was seen in Group III [r = 0.55, P = 0.03], so by regression analysis, haptoglobin can be used as a good predictor for fibrosis in Group III [r = 0.54, P=0.04]. Apolipoprotein A1 has negative correlation to the stage of fibrosis in Groups I and II although the results were statistically insignificant. APRI index was found significantly directly correlated to the fibrosis stage and the grade of inflammation of all studied groups [r= 0.57, P< 0.01 and r = 0.36, P< 0.01, respectively] with a best cutoff value of 0.62, with sensitivity of 0.86 and specificity of 0.57. In patients with advanced fibrosis the best cutoff value was found to be 0.72 with sensitivity of 0.94 and specificity of 0.67. Mordified APRI test showed AUC of 0.79 [P<0.01] with a best cutoff value of 0.067 at which sensitivity and specificity were 0.82 and 0.61, respectively. Alpha macroglobulin, haptoglobin, apolipoprotein A1, APRI index and a modified APRI index, were found be significant predictors of hepatic fibrosis and were reprocessed by stepwise logistic regression

Effects of omega-3 fatty acid supplements on serum lipids, apolipoproteins and malondialdehyde in type 2 diabetes patients

In order to test whether hyperlipidaemia and glycaemic control can be improved among diabetes patients by dietary supplementation with purified omega-3 fatty acids, we carried out a doubleblind, placebo-controlled trial on 50 type 2 diabetes patients randomized to 2 g/day purified omega-3 fatty acids or placebo for 10 weeks. Fasting triglycerides decreased significantly with supplementation relative to placebo [P = 0.01]. There was a significant decrease in ApoB-100 and malondialdehyde compared to baseline values and compared to the control group. Omega-3 fatty acids had no significant effect on serum lipid levels, ApoA-I, glucose, insulin and HbA1[c]

Uso de tabaco e perfil lipídico-lipoprotéico plasmático em adolescentes / Tobacco use and plasma lipid-lipoprotein profile in adolescents

OBJETIVO: Analisar o impacto quanto ao uso de tabaco no perfil lipídico-lipoprotéico plasmático em amostra representativa de adolescentes. MÉTODOS: A amostra foi constituída por 452 sujeitos (246 moças e 206 rapazes) com idades entre 15 e 18 anos. Os participantes completaram questionário estruturado auto-administrado com relação ao uso de tabaco. As concentrações de lipídeos-lipoproteínas plasmáticas foram estabelecidas mediante procedimentos laboratoriais. Os procedimentos da análise de covariância, controlando a participação da ingestão de gordura saturada e de colesterol dietético, foram empregados para identificar as diferenças entre os valores médios. As estimativas de odds ratio foram utilizadas para estabelecer o risco relativo dos adolescentes fumantes apresentarem perfil lipídico-lipoprotéico de risco aterogênico. RESULTADOS: A proporção de fumantes foi de 20,9 por cento entre os rapazes e 15,4 por cento entre as moças. O consumo médio de cigarros por dia foi de 9,2 ± 4,7 nos rapazes e 5,6 ± 3,1 nas moças. Quando comparados com não fumantes, rapazes e moças fumantes apresentaram níveis séricos de colesterol total, LDL-colesterol, triglicerídeos e apolipoproteína B100 significativamente mais elevados, e níveis séricos de HDL-colesterol significativamente menores. Adolescentes fumantes tenderam a demonstrar risco de níveis de lipídeos-lipoproteinas plasmáticas alterados duas vezes maior que não fumantes. CONCLUSÃO: Intervenções direcionadas à adoção de um estilo de vida saudável, incluindo abstenção do uso de tabaco, deverão iniciar-se em idades precoces na tentativa de prevenir ou retardar o desenvolvimento de lesões ateroscleróticas e minimizar o aparecimento de coronariopatias prematuras na idade adulta.

OBJECTIVE: To analyze the impact of tobacco use on plasma lipid lipoprotein profile in representative sample of adolescents. METHODS: A sample of 452 subjects (246 girls and 206 boys) 15 to 18 years old were included in the study. Each participant completed a structured and self-administered questionnaire concerning tobacco use. Plasma lipid-lipoprotein concentrations were measured by standard procedures. Differences between mean values were evaluated by analysis of covariance, controlling for saturated fat and cholesterol intake. Odds ratio was used to estimate the relative risk of the smokers being classified with an undesirable level of a plasma lipidlipoprotein parameter. RESULTS: The proportion of smokers was 20.9 percent for boys and 15.4 percent for girls. The average consumption of cigarettes per day was 9.2 ± 4.7 for boys and 5.6 ± 3.1 for girls. When compared with non-smokers, boy and girl smokers showed a significantly higher serum levels of total cholesterol, LDL-cholesterol, triglycerides and apolipoprotein B100, and significantly lower serum levels of HDL-cholesterol. Adolescent smokers tended to show a two-fold higher risk of altered lipid-lipoprotein levels than non-smokers. CONCLUSION: The present data could imply that intervention promoting a healthy lifestyle, including non smoking, should start at an early age to prevent or delay development of atherosclerotic lesions and ultimately to minimize the appearance of premature coronary heart disease in adults.

Cigarette smoking as an acute threat for the cardiovascular system

Cigarette smoking is one of the major risk factors for cardiovascular disease as well as hyperlipidemia. Lecithin: Cholesterol acyl transferase [LCAT] activity represented a key factor in the esterification of serum cholesterol and reverse cholesterol transport. Leptin, the protein product of the ob gene, seems to regulate body fat stores. The present study was carried out to evaluate changes in the circulating levels of leptin, LCAT activity, insulin, glucose, cotinine and lipid profile [total cholesterol TC, triglycerides TG, HDLC, LDL-C], free fatty acids [FFA5] and apolipoprotiens [Apo Al and Apo B] in healthy smokers [n=48] and non smokers [n=32] group. The results showed remarkable increase in the levels of LDL-C, FFAs, cotinine, leptin [p<.000], TC[P<0.01] and glucose [p<0.05] in healthy smokers than non smokers group. However, the activity of LCAT and levels of HDL-C and Apo Al, were significantly reduced [p<.000] in smokers subjects than non smokers group. Present results showed, the significant increase in levels of leptin, FFAs, LDL-C and the significant decrease in HDL-C and LCAT activity during cigarette smoking which may implicate high risk for further vascular complications

Atherogenic lipid profile of Brazilian near-term newborns

Cardiovascular disease is the primary cause of death in Brazil. Recent studies have shown that low birth weight and preterm birth are linked to a higher prevalence of cardiovascular disease. The aim of the present study was to compare the levels of lipids and apolipoproteins and atherogenic indexes between term and near-term newborn infants. A sample of umbilical cord blood was obtained from 135 newborns (66 males) divided into two groups: 25 near-term neonates (35-36.6 weeks of gestational age) and 110 term neonates (37-42 weeks of gestational age). The total cholesterol concentrations were higher in the near-term neonates than in the term group (94.04 ± 8.02 vs 70.42 ± 1.63 mg/dl, P < 0.01), due to an increase in the LDL-cholesterol fraction in the near-term group (57.76 ± 6.39 vs 34.38 ± 1.29 mg/dl, P < 0.001). The atherogenic indexes (total cholesterol/HDL-cholesterol, LDL-cholesterol/HDL-cholesterol and apolipoprotein B/apolipoprotein A-I) were higher in the near-term group (P < 0.001, P < 0.001, and P < 0.05, respectively). The gestational age of the newborns was inversely correlated with total cholesterol and LDL-cholesterol, and also with the total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol indexes. These findings demonstrate that the lipid profile is worse in the group of near-term neonates compared with the term group. Future studies are needed to determine if this atherogenic profile in near-term neonates can affect body metabolism, increasing the risk for cardiovascular diseases in adult life.

Assessment of lipoprotein[a]groups of Syrian population

Lipoprotein [a] LP[a] consists of two components: LDL particle and apo[a] molecule, which resembles plasminogen. Many studies found that high levels of LP[a] are considered as an independent risk factor of atherosclerotic disease, whereas others did not find this correlation. 203 healthy Syrian subjects were recruited for the study. They were divided into 8 groups according to geographic and ethnic distribution as follows: 35 from Damascus and mid Syrian, 24 from Sauida, 22 from Hasakee, 28 from Palestinian refugee camp, 21 from Der El-Zor, 29 from Syrian coast, as for the ethnic group they were 22 from Kurds, 22 from Sarkasian. LP[a] level was determined by ELISA method. Whereas apo[a] phenotyping was performed by Electrophoresis on SDS-Agarose Gel 1, 5%. No significant differences in LP[a] levels among the 8 groups were found. Whereas there was a significant difference in apo[a] phenotype [applying Utermann et aL, 1998] among different groups. We found that the group from Hasake had the highest percentage of apo[a] phenotype with high molecular weight [HMW], which makes them the least of the 8 groups susceptible to Cardiovascular disease [CVD]. Whereas in the ethnic group of Kurds the low molecular weight [LMW] apo[a] prevailed which makes them the most group susceptible to [CVD]

Apolipoproteins: correlation with carotid intimamedia thickness and coronary artery disease.

BACKGROUND: Lower levels of plasma apolipoprotein AI (Apo A-I) and higher levels of ApoB, and the ratio of ApoB to ApoA-I are considered to be independent risk factors for coronary heart disease, and may assume importance in the definite subset of Indian patients with normal levels of traditional lipid risk factors and an early-onset of coronary artery disease (CAD). Carotid intima-media thickness is considered as a marker of atherosclerosis and in prediction of clinical coronary events and coronary artery disease. With increasing interest in the role of non-traditional lipid risk factors in CAD and few studies reported in Indian subjects, we undertook this study to correlate the apolipoprotein levels with CAD and their impact on arterial thickening utilizing the carotid intima-media thickness as a surrogate marker. METHODS AND RESULTS: Traditional lipid profile, apolipoprotein A-I and B and carotid artery Intima-media thickness (IMT) with a B-mode scan were measured in 309 patients recruited for the study (age group 36-64 years), which included 193 males and 116 females. Mean of maximal IMT exceeding 0.8 mm at the far wall of common carotid artery, excluding plaques, was selected as the higher values for comparison. One hundred and twenty two subjects had evidence for CAD as diagnosed by documented hospitalization with myocardial infarction or acute coronary syndrome, coronary angiography when feasible or noninvasive cardiac evaluation. Prevalence of subjects with increased IMT was higher among subjects with an apolipoprotein B: apolipoprotein A-I ratio exceeding one compared to those with a ratio less than one (30.6% vs 16.5%, p = 0.005). Prevalence of CAD was significantly higher among subjects with apolipoprotein B: apolipoprotein A-I ratio exceeding one as compared to those with a ratio less than one (53.7% vs 30.3%, p = 0.0002). Subjects with apolipoprotein B: apolipoprotein A-I ratio exceeding one and carotid IMT more than 0.8 mm had a 2.7-fold prevalence for CAD as against those with a ratio less than one and IMT less than 0.8 mm. On multivariate logistic regression analysis, apolipoprotein B: apolipoprotein A-I ratio exceeding one was significantly associated with increased IMT (odds ratio 2.27) and CAD (odds ratio 2.50) even after inclusion of sex, smoking, body mass index, total cholesterol, LDL-cholesterol, HDL-cholesterol, total cholesterol:HDL-cholesterol ratio and serum triglycerides into the model. CONCLUSIONS: We conclude that apolipoprotein B to A-I ratio shows a strong association with carotid intimal medial thickening and coronary artery disease in this Western Indian population and may play an important role is assessment of coronary risk in addition to traditional coronary risk factors.

Phospholipid transfer protein activity in two cholestatic patients

CONTEXTO: A proteína de transferência de fosfolípides é responsável pela transferência de fosfolípides de lipoproteínas ricas em triglicérides, as lipoproteínas de muito baixa densidade e também para lipoproteínas de baixa densidade para as lipoproteínas de alta densidade, processo este também bastante eficiente entre partículas de lipoproteínas de alta densidade. Esta proteína promove a transferência líquida de fosfolípides gerando partículas pequenas, pobres em apolipoproteínas AI, subfrações estas que são excelentes aceptoras de efluxo celular de colesterol. CASE REPORT: A atividade da proteína de transferência de fosfolípides foi avaliada em dois pacientes com colestase hepática assumindo-se que alterações na sua atividade possam ocorrer em plasma de pacientes que apresentam lipoproteína X. Ambos pacientes apresentavam grave hipercolesterolemia, altos níveis de colesterol nas lipoproteínas de baixa densidade e fosfolípides e, em um deles, baixos níveis de colesterol em lipoproteínas de alta densidade. A atividade da proteína de transferência de fosfolípides detectada em ambos encontrava-se no limite inferior. Não são de nosso conhecimento resultados semelhantes na literatura. Nossa hipótese seria a de que a atividade da proteína de transferência de fosfolípides estaria reduzida na colestase hepática devido a alterações na composição química das lipoproteínas de alta densidade, como por exemplo, aumento de fosfolípides da partícula. A lipoproteína X, rica em fosfolípides, também poderia competir com a lipoproteína de alta densidade como substrato para a ação da proteína de transferência de fosfolípides.

The relationship between leptin and lipids in atherosclerosis.

BACKGROUND: This study aimed to examine the extent to which leptin, alone or in combination with other risk factors, may be an independent marker for myocardial infarction in a region with a high incidence of cardiovascular disease. METHODS AND RESULTS: Leptin levels were measured by the ELISA method, while plasma lipids and lipoproteins were measured by conventional methods. Leptin levels were significantly higher in the patient than in the control group. Serum total cholesterol, low-density lipoprotein, lipoprotein (a) and apolipoprotein B showed a significant correlation with leptin, while high-density lipoprotein showed an inverse relation. CONCLUSIONS: Our results suggest that leptin may be one factor operating in the metabolic alteration taking place during myocardial infarction, and is a possible risk factor.

Partículas lipoproteicas LpA-I, LpA-I: A-II y LpB en enfermedad coronaria / Lipoprotein particles LpA-I, LpA-I: A-II and LpB in patients with coronary artery disease

Background: High density lipoproteins are an heterogeneous population of particles. Two main subpopulations have been identified, one contains Apo A-I and Apo A-II and is denominated LpA-I:A-II and another one contains only Apo A-I and is denominated LpA-I. Aim: To measure the concentrations of these particles in patients with stable coronary artery disease. Patients and Methods: Serum lipids, A-I and B apolipoproteins, LpA-I, LpA-I:A-II and LpB particles were measured in 73 men aged 33 to 82 years with angiographically documented coronary artery disease (CAD) and 33 control subjects aged 39 to 76 years. LpA-I, LpA-I:A-II and LpB were measured by a noncompetitive enzyme linked immunoassay using previously characterized monoclonal antibodies against ApoA-I, ApoA-II and apoB. Results: Patients with CAD had significantly higher mean levels of LDL cholesterol than the control group (p= 0.038). The mean concentration of LpA-I particles in patients with CAD was significantly lower (p= 0.031) than in control subjects, while the concentration of LpA-I:A-II particles was significantly higher (p=0.016). The percentage of coronary stenosis correlated negatively with LpA-I and positively with LpA-I:A-II. The best relative risk (RR) indicator in these patients was LDL-cholesterol. The relative risk increases 2.5 fold when LpA-I falls below the cut-off level. Likewise, the relative risk increases 3-fold when LpA-I:A-II raises over the cut-off level. Conclusions: Our findings indicate that the quantification of LpA-I and LpA-I:A-II particles might allow a more accurate evaluation of the CAD risk than HDL cholesterol. LpA-I might represent the antiatherogenic fraction of HDL