Increased ApoB/ApoA1 ratio is associated with excess weight, body adiposity, and altered lipid profile in children / A razão ApoB/ApoA1 aumentada está associada ao excesso de peso, de adiposidade corporal e ao perfil lipídico alterado em crianças

Abstract Objective: To investigate ApoB/ApoA1 ratio and its association with cardiovascular risk factors in children. Methods: Cross-sectional study with 258 children aged 8 and 9 years old, enrolled in all urban schools in the city of Viçosa-MG. Anthropometric and body composition assessment, as well as biochemical profile of the children was performed. Socioeconomic variables and sedentary lifestyle were evaluated through a semi-structured questionnaire. Results: Many children had excess weight (35.2%), abdominal adiposity (10.5%), and body fat (15.6%), as well as increased ApoB/ApoA1 ratio (14.7%), total cholesterol (51.8%), and triglycerides (19.8%). Children with excess weight and total and central fat had a higher prevalence of having a higher ApoB/ApoA1 ratio, as well as those with atherogenic lipid profile (increased LDL-c and triglycerides and low HDL-c). A direct association was found between the number of cardiovascular risk factors and the ApoB/ApoA1 ratio (p = 0.001), regardless of age and income. Conclusion: The increased ApoB/ApoA1 ratio was associated with excess weight, body adiposity (total and central), and altered lipid profile in children. Children with a higher number of cardiovascular risk factors had higher ApoB/ApoA1 ratio, in both genders.

Resumo Objetivo: Investigar a razão ApoB/ApoA1 e sua relação com fatores de risco cardiovascular em crianças. Métodos: Estudo transversal com 258 crianças de 8 e 9 anos, matriculadas em todas as escolas urbanas de Viçosa-MG. Foi feita avaliação antropométrica, da composição corporal e bioquímica das crianças. As variáveis socioeconômicas e o sedentarismo foram avaliados por questionário semiestruturado. Resultados: Muitas crianças apresentaram excesso de peso (35,2%), de adiposidade abdominal (10,5%) e de gordura corporal (15,6%), bem como a razão ApoB/ApoA1 (14,7%), colesterol-total (51,8%) e triglicerídeos (19,8%) aumentados. Crianças com excesso de peso e de gordura total e central apresentaram maiores prevalências de maior razão ApoB/ApoA1, bem como as com perfil lipídico aterogênico (LDL-c e triglicerídeos aumentados e baixo HDL-c). Foi encontrada associação direta entre o número de fatores de risco cardiovascular e a razão ApoB/ApoA1 (p = 0,001), independente da idade e renda. Conclusão: A razão ApoB/ApoA1 aumentada esteve associada ao excesso de peso, de adiposidade corporal (total e central) e ao perfil lipídico alterado nas crianças. As crianças com maior número de fatores de risco cardiovascular apresentaram maior razão ApoB/ApoA1, em ambos os sexos.

Association of postalimentary lipemia with atherosclerotic manifestations

We identified different lipemic and metabolic responses after the ingestion of a standardized meal by healthy adults and related them to atherosclerotic markers. Samples from 60 normolipidemic adults were collected before and after a liquid meal (40 g fat/m² body surface) at 0, 2, 4, 6, and 8 h for measurements of lipids, free fatty acids (FFA), insulin, cholesteryl ester transfer protein (CETP), autoantibodies to epitopes of oxidized LDL (oxLDL Ab), lipolytic activities, and apolipoprotein E polymorphism. Mean carotid intima-media thickness (cIMT) was determined by Doppler ultrasound. The volunteers were classified into early (N = 39) and late (N = 31) triacylglycerol (TAG) responders to the test meal. Late responders showed lower HDL cholesterol concentration at fasting and in the TAG peak, lower insulin and higher FFA concentrations compared to early responders. Multivariate regression analyses showed that mean cIMT was associated with gender (male) and age in early responders and by cholesterol levels at the 6th hour in late responders. oxLDL Ab were explained by lipoprotein lipase and negatively by hepatic lipase and oxLDL Ab (fasting period) by CETP (negative) and FFA (positive). This study is the first to identify a postalimentary insulin resistance state, combined with a reduced CETP response exclusively among late responders, and the identification of the regulators of postalimentary atherogenicity. Further research is required to determine the metabolic mechanisms described in the different postalimentary phenotypes observed in this study, as well as in different pathological states, as currently investigated in our laboratory.

C-reactive Protein and Carotid Intima-media Thickness in a Population of Middle-aged Koreans / 예방의학회지

OBJECTIVES: This study was performed to evaluate the relationship between C-reactive protein (CRP) and carotid intima-media thickness (carotid IMT) in a population of middle-aged Koreans. METHODS: A total of 1,054 men and 1,595 women (aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause (women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. RESULTS: Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women (p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men (p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women (p for trend=0.017), but not in men (p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55 (95% CI=1.06-2.26) in women, but only 1.05 (95% CI=0.69-1.62) in men. CONCLUSIONS: CRP and carotid IMT levels appear to be directly related in women, but not in men.

Aislamiento de bacterias periodontop ticas desde hemocultivos y ateromas obtenidos de pacientes con aterosclerosis y periodontitis / Isolation of periodontal bacteria from blood samples and atheromas in patients with atherosclerosis and periodontitis

Background: Periodontitis is a common oral disease produced by bacterial species that reside in the subgingival plaque. These microorganisms have been associated to atherosclerosis and it is suggested that periodontitis is a cardiovascular risk factor. Aim: To isolate periodontal bacteria from blood and atheroma samples, from patients with atherosclerosis and periodontitis. Material and methods: Twelve patients with periodontitis and a clinical diagnosis of atherosclerosis and 12 patients with periodontitis but without atherosclerosis were studied. Blood samples were obtained immediately before and after scaling and root planing. The samples were incubated in aerobic and anaerobic conditions. One week after scaling, atheromatous plaques were obtained during endarterectomy in the 12 patients with atherosclerosis. These were homogenized and cultured for aerobic and anaerobic bacteria. Microorganisms were identified by means ofPCR. Results: Five patients with and two without atherosclerosis, had bacteremia after scaling and root planing. Bacterial species isolated from blood samples were the same found in periodontic pockets. Four atheromatous plaques of patients with bacteremia yielded positive cultures. The isolated bacteria were the same found in blood samples and periodontal pockets. Conclusions: Bacteremia occurred in seven of 24 patients after scaling and root planing. In four patients, the same species found in periodontic pockets and blood cultures were detected in atherosclerotic plaques obtained one week after the dental procedure.

The significance of plasma high density lipoprotein cholesterol (hdlc).

High Density Lipoprotein (HDL) transports in plasma, phospholipids, cholesterol, and triacylglycerol. The cholesterol associated with HDL (HDLc) is cholesterol that is scavenged from peripheral tissues back to liver. The liver converts this cholesterol into bile acids, bile salts, and esterifies the rest and secretes them into bile. Low HDLc is a risk factor for atherogenesis. Higher levels of HDLc in plasma are therefore an index of safety from coronary heart disease and atherosclerosis. Regular physical exercise, and changes in life style like cessation of smoking, lowered alcohol consumption, modified dietary fat intake and certain medications can improve the level of HDLc in plasma.

Lípides séricos em criancas e adolescentes de Florianópolis, SC: Estudo Floripa saudável 2040 / Serum lipids in school kids and adolescents from Florianópolis, SC, Brazil: Healthy Floripa 2040 study

OBJETIVO: Determinar a distribuicão dos lipídeos séricos em criancas e adolescentes de Florianópolis, SC. Determinar a associacão entre colesterol não-desejável (>170 mg/dL) e outros fatores de risco para aterosclerose. MÉTODOS: Amostra aleatória estratificada (por idade e tipo de escola) de alunos da rede escolar de Florianópolis. Dados sobre fatores de risco, antropometria, pressão arterial e concentracão sérica de lípides foram coletados. RESULTADOS: Participaram 1.053 indivíduos com idade entre 7 e 18 anos. A concentracão sérica do colesterol (médianDP) foi 162n28 mg/dL; dos triglicerídeos 93n47 mg/dL; do HDL-colesterol 53n10 mg/dL; do LDL-colesterol 92n24 mg/dL e do colesterol não-HDL 109n 26 mg/dL. As médias das relacões CT/HDL e LDL/HDL foram, respectivamente, 3,1n0,6 e 1,8n0,5. Os lípides foram mais elevados nas criancas de escola privada, nos menores de 10 anos, no sexo feminino e nos de cor negra. O modelo de regressão logística que melhor previu os níveis de colesterol anormal incluía: obesidade, história familiar de acidente vascular cerebral ou infarto do miocárdio, sexo feminino, idade inferior a 10 anos e a imagem corporal definida pelo médico como sobrepeso/obesidade. CONCLUSAO: As concentracões de lipídeos em criancas e adolescentes mostraram valores intermediários quando comparados a estudos semelhantes. Uma grande parcela dos indivíduos apresenta níveis de colesterol sérico classificados como não-desejáveis para idade. Pela significância da associacão do colesterol com o excesso de peso, o controle deste fator na infância deve ser tomado como prioridade nos programas de prevencão primordial com o objetivo de reduzir a incidência das doencas relacionadas à aterosclerose na idade adulta.

Fatores de risco para aterosclerose em crianças e adolescentes com história familiar de doença arterial coronariana prematura / Risk factors for atherosclerosis in children and adolescents with family history of premature coronary artery disease

OBJETIVOS: Analisar a prevalência de dislipidemia em 109 crianças e adolescentes com história familiar de doença arterial coronariana prematura e a associação com outros fatores de risco para aterosclerose. MÉTODOS: Foram determinados valores séricos de colesterol total, de lipoproteínas de baixa densidade (LDL-C), alta densidade (HDL-C), triglicérides, índice de massa corpórea e pressão arterial. Foram também avaliados: prática de atividade física, tabagismo, renda familiar e escolaridade da mãe. RESULTADOS: Do total, 27,5 e 19,3 por cento apresentaram, respectivamente, valores de colesterol total e LDL-C acima do normal, 13,8 por cento valores de HDL-C diminuídos e 13,0 por cento trigliceridemia elevada. Excesso de peso (obesidade e sobrepeso) foi detectado em 25,7 por cento dos casos; destes, 57,1 por cento apresentavam valores anormais de lipídios. A prevalência de dislipidemia, isolada ou concomitante com outros fatores de risco, foi de 38,5 por cento. Hábito de fumar ocorreu em 3,6 por cento dos casos, hipertensão arterial em 2,7 por cento, e 72,5 por cento não praticavam atividade física. Não houve associação entre as variáveis renda familiar, escolaridade da mãe e prática de atividade física e dislipidemia. Entretanto, observou-se associação significativa entre dislipidemia e excesso de peso (p = 0,02; odds ratio = 2,82; IC 95 por cento = 1,16-6,81). CONCLUSAO: Fatores de risco para aterosclerose em crianças e adolescentes com história familiar de doença arterial coronariana prematura devem ser identificados o mais cedo possível para que sejam adotados programas preventivos de saúde.

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.

Antiatherogenic effect of taurine in high fat diet fed rats.

The role of taurine on atherogenesis induced by high fat diet in rats, a species which depends entirely on taurine for conjugation of bile acids has been investigated. Wistar male rats were fed on (p.o.) taurine in addition to high fat diet (11% coconut oil w/w) for 6 months. High fat diet caused significant increase of serum total cholesterol (2 fold), serum triglycerides (92.6%), LDL cholesterol (92.3%) and body weight gain (2.8 fold). Taurine administration significantly reduced serum cholesterol (37%), triglycerides (94.5%), LDL cholesterol (34%), body weight (46%). It also significantly reduced aortic cholesterol and thiobarbituric acid reactive substances and there was a significant increase of reduced glutathione. Taurine significantly increased fecal bile acids which may have resulted in significant decrease of serum cholesterol. Aortic lesion index was significantly decreased in the taurine administered group suggesting the antiatherogenic effect of taurine. It is concluded that taurine attenuated the atherogenesis possibly by its hypocholesterolemic and antioxidant property.

Circulating adhesion molecules as predictors of atherosclerosis and coronary heart disease

Adhesion of leukocytes to endothelial cells via cell adhesion molecules is thought to be pivotal in the initiation of atherosclerosis. This study was designed to determine the value of circulating cell adhesion molecules as a predictors of coronary heart disease and atherosclerosis. This study was conducted on 25 patients with coronary heart disease [CHD], 21 patients with carotid artery atherosclerosis [CAA] and 20 healthy individuals served as control group. The levels of serum soluble[s] adhesion molecules: E-selectin [sE-selectin], intracellular adhesion molecule-l [sICAM-1] and vascular cell adhesion molecule-l [sVCAM-1] were measured in addition to the serum lipids, total cholesterol and triglyceride, HDL-c and LDL-c. The concentration of sE-selectin was significantly higher in the patient groups when compared with the control subjects [CHD 34.9 +/- 19.2 ng/ml; CAA 43.0 +/- 16.7 ng/ml vs. control 18.5 +/- 7.4 ng/ml, p<0.05 and p< 0.001 respectivly]. While there were non significant statistical difference between CHD and CAA [p> 0.05]. The serum level of sICAM-1 was significantly higher in CHD than control [p< 0.05], while there were non significant changes in their values in CAA and control [CHD 318 +/- 85.1 ng/ml, CAA 292.3 +/- 64.2 ng/ml vs. control 240 +/- 68.1 ng/ml]. A significant increase was found in sVCAM-1 among the patient groups when compared with the control [CHD 535 + 227.1ng/ml, CAA 445 + 139.6 ng/ml, control 115+19.7 ng/ml p < 0.001 and p< 0.01 for CHD and CAA respectivly]. The levels of the studied serum lipids were significantly increased in the patient groups when compared with the control [p < 0.001]. When these serum lipids were correlated with the studied adhesion molecules, there were positive correlation between the sE-selectin and LDL-c [r = 0.5, p < 0.02], between sICAM-1 and both of LDL-c [r = 0.51, p< 0.02] and TG [r = 0.39, p<0.05] and between sVCAM-1 and TG [r = 0.62, p< 0.01]. In conclusion, the increase of sE-selectin, sICAM-1 and sVCAM-I levels in patients with CHD and CAA suggests that they would be of beneficial value as markers for preclinical prediction of atherosclerosis and CHD

Determinación de lipoproteína (a) por electroinmunodifusión / Electroimmunodifusion method for Lp (a) in serum

Los aumentos de la lipoproteína (a) sérica , (Lp(a)), están asociados a un incremento del riesgo para la aterosclerosis a través de su papel atero-trombótico. Para su dosaje en sangre, se desarrolló un método por electroinmunodifusión. Se utilizó un soporte de agarosa al 1,5 por ciento con 30 por ciento de agar (p/p), disuelto en un buffer tris-glicina-veronal sódico, con antisuero específico anti apo (a) y calibrador liofilizado comerciales. El CV por ciento intra-ensayos fue 6,9 por ciento y el CV por ciento inter-ensayos fue 8,8 por ciento. La linealidad se mantuvo entre 5 y 120 mg/dl. Se midió la Lp(a) en 134 sujetos "aparentemente sanos" de ambos sexos. La distribución de valores no fue gaussiana y tuvo una mediana de 10 mg/dl. El percentil 75 fue 33 mg/dl el cual se consideró "valor de corte", para la detección de sujetos en riesgo; el percentil 90 fue 72 mg/dl. Los valores hallados por este método correlacionaron bien con otro método por ELISA, obteniéndose r = + 0,896, P < 0,000001. El congelamiento de los sueros por 45 días a -20ºC no modificó significativamente los valores, hallándose r = + 0,963, P < 0,000001. Se concluye que el método propuesto puede ser utilizado para la determinación de Lp(a) sérica

Hypocholesterolemic activity of nut shell extract of Semecarpus anacardium (Bhilawa) in cholesterol fed rabbits.

Administration of S. anacardium nut shell extract to cholesterol fed rabbits resulted in a significant reduction in serum cholesterol (-73.3%) and serum LDL-Chol. (-80%). The extract feeding also prevented the accumulation of cholesterol/triglycerides in liver, heart muscle and aorta and caused a regression of plaques (75.3-83.5%). These results indicate that S. anacardium is hypocholesterolemic in action and prevents cholesterol induced atheroma. Possible mechanism of action is discussed.

Effects of peroxidized oil on the development of experimental atherosclerosis in rabbits.

Ingestion of peroxidized oil under hypercholesterolemic dietary conditions resulted in a number of biochemical and pathological changes in rabbits. Total lipids, cholesterol and glyceride levels of plasma, liver and aorta were significantly higher in peroxidized oil fed rabbits, compared to the ones receiving normal oil. The degree of atherosclerosis and the severity of histopathological changes were significantly higher in rabbits fed with peroxidized oil.

Plasma estradiol and lipid profile in perimenopausal women.

This study was conducted to examine the estradiol level and plasma lipid profile in perimenopausal women. The estradiol and HDL levels were higher and LDL levels lower in premenopausal women than in postmenopausal women of the same age group. Higher HDL and lower LDL levels in premenopausal women are likely to protect them against atherosclerosis, and the difference may be casually related to estradiol levels.

Lipid patterns and fibrinogen levels of smokers and non-smokers.

Hypercholesterolaemia, smoking and elevated levels of fibrinogen are independent risk factors for cardiovascular disease (CVD). The aim of this study was to determine whether smoking indirectly affects the other risk factors, namely cholesterol and fibrinogen levels. Serum lipid patterns and fibrinogen levels were determined in 67 cigarette or beedi smokers and 51 non-smokers in the age group 18 to 50 years. Serum thiocyanate levels were measured as an indirect indicator or smoking exposure. Smokers had significantly higher serum thiocyanate levels than non-smokers. The serum total cholesterol levels in smokers was significantly higher than in non-smokers, but there was no association with the degree of smoking. In contrast, smokers had significantly elevated fibrinogen levels which were positively related to thiocyanate levels, indicating that plasma fibrinogen levels increase in smoking exposure. These results suggest that smoking may increase the risk of CVD by elevating plasma fibrinogen levels.

Role of circulating immune complexes and platelet aggregation in the development of experimentally induced atherosclerosis in monkeys with normal intact vas deferens and following vasectomy.

The study was undertaken in normal and vasectomized monkeys to elucidate the relationship of circulating immune complexes and platelet aggregability with experimental aortic and coronary atherosclerosis. Four groups of animals, viz. sham-vasectomized stock diet fed, vasectomized stock diet fed, sham-vasectomized atherogenic diet fed, were studied for a period of 1 year. An increased incidence of atherosclerosis was noted with high levels of circulating immune complexes in vasectomized monkeys. Platelets obtained from atherogenic diet fed monkeys had a clear tendency of increased aggregation and agglutination in the presence of ADP, epinephrine and ristocetin respectively. Vasectomy produced a significant enhancement in platelet aggregation response with ADP and epinephrine in atherogenic diet fed animals. The aortic and coronary atherosclerosis was also significantly increased in atherogenic diet fed groups both with and without vasectomy.

Effect of a new herbo-mineral hypolipidemic agent on plasma lipoprotein pattern in rat atherosclerosis.

Hyperlipidemia was induced in rats by feeding an atherogenic diet for 5 months. The effect of administration of an indigenous hypolipidemic agent, Anna Kaara Raaja Sindhooram (AKRS) on the plasma lipoprotein profile was studied in the presence and absence of dietary lipid stimuli. Hyperlipidemia produced an enormous increase in the cholesterol and triglyceride contents of the low density (LDL) and very low density (VLDL) lipoprotein fractions and reduced the level of the putative non-atherogenic high density cholesterol (HDL-C). The agarose gel electrophoretic pattern showed a decrease in alpha-lipoproteins and an increase in beta-lipoproteins in the hyperlipidemic rats. AKRS treatment for 5 months altered the lipoprotein pattern favourably by raising HDL-C and lowering LDL-C in the treated rats.