Impaired Reverse Cholesterol Transport is Associated with Changes in Fatty Acid Profile in Children and Adolescents with Abdominal Obesity.

BACKGROUND: Abdominal obesity is an important cardiovascular disease risk factor. Plasma fatty acids display a complex network of both pro and antiatherogenic effects. High density lipoproteins (HDL) carry out the antiatherogenic pathway called reverse cholesterol transport (RCT), which involves cellular cholesterol efflux (CCE), and lecithin:cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) activities. OBJECTIVES: Our aim was to characterize RCT and its relation to fatty acids present in plasma in pediatric abdominal obesity. METHODS: Seventeen children and adolescents with abdominal obesity and 17 healthy controls were studied. Anthropometric parameters were registered. Glucose, insulin, lipid levels, CCE employing THP-1 cells, LCAT and CETP activities, plus fatty acids in apo B-depleted plasma were measured. RESULTS: The obese group showed a more atherogenic lipid profile, plus lower CCE (Mean±Standard Deviation) (6 ± 2 vs. 7 ± 2%; P < 0.05) and LCAT activity (11 ± 3 vs. 15 ±5 umol/dL.h; P < 0.05). With respect to fatty acids, the obese group showed higher myristic (1.1 ± 0.3 vs. 0.7 ± 0.3; P < 0.01) and palmitic acids (21.5 ± 2.8 vs. 19.6 ± 1.9; P < 0.05) in addition to lower linoleic acid (26.4 ± 3.3 vs. 29.9 ± 2.6; P < 0.01). Arachidonic acid correlated with CCE (r = 0.37; P < 0.05), myristic acid with LCAT (r = -0.37; P < 0.05), palmitioleic acid with CCE (r = -0.35; P < 0.05), linoleic acid with CCE (r = 0.37; P < 0.05), lauric acid with LCAT (r = 0.49; P < 0.05), myristic acid with LCAT (r = -0.37; P < 0.05) ecoisatrienoic acid with CCE (r = 0.40; P < 0.05) and lignoseric acid with LCAT (r = -0.5; P < 0.01). CONCLUSIONS: Children and adolescents with abdominal obesity presented impaired RCT, which was associated with modifications in proinflammatory fatty acids, such as palmitoleic and myristic, thus contributing to increased cardiovascular disease risk.

Nutritional status in patients with HIV infection and AIDS.

The aim of this study was to evaluate the nutritional status of adults with HIV infection or with AIDS through the use of biochemical parameters. The study was performed on 43 patients (19 HIV+ and 24 AIDS patients), between 26 and 44 years of age, from low and medium socioeconomic status, with access to health care services; 35 patients were under highly active antiretroviral therapy (HAART) treatment. Body weight and height were determined, and the Body Mass Index calculated (kg/m2). Blood samples were collected from fasting patients. Plasma cholesterol (total, HDL and LDL), triacylglycerol, total protein, apolipoproteins A-I and B, albumin, transthyretin, retinol binding protein, and ceruloplasmin concentrations were determined. Plasma levels of zinc, copper, and selenium were determined in a haemolysis-free sample by flame atomic absorption spectrometry. Statistical analyses were performed with the Student's t-test. AIDS patients showed changes in biochemical parameters, particularly an increase in fibrinogen and a trend to decreased transthyretin levels. These findings stress the importance of the inclusion of functional biochemical parameters in the periodic evaluation of these patients. This would allow an early assessment of the need for appropriate nutritional support, implemented along with the specific retroviral treatment. This would aim at delaying the progression of the disease, and might improve the prospects of survival and quality of life.