Dyslipidemia Status Research Articles

Kidney Function as a Determinant of HDL and Triglyceride Concentrations in the Australian Population.

Background: Chronic kidney disease (CKD) is a potent risk factor for cardiovascular disease (CVD). CVD risk increases in a stepwise manner with increasing kidney impairment and is significantly reduced by kidney transplantation, suggesting a causal relationship. Dyslipidemia, a well recognised CVD risk factor, is highly prevalent in CKD. While dyslipidemia is a risk factor for CKD, kidney impairment can also induce a dyslipidemic state that may contribute to the excess burden of CVD in CKD. We utilised a multipronged approach to determine whether a causal relationship exists. Materials and Methods: Retrospective case-control analysis of 816 patients admitted to the Royal Hobart Hospital in 2008–2009 with different degrees of kidney impairment and retrospective before-after cohort analysis of 60 patients who received a transplanted kidney between 1999 and 2009. Results: Decreased estimated GFR (eGFR) was independently associated with decreased high density lipoprotein (HDL, p < 0.0001) and increased triglyceride concentrations (p < 0.01) in multivariate analysis. There was no significant relationship between eGFR and low density lipoprotein (LDL) or total cholesterol in multivariate analysis. Kidney transplantation increased HDL (p < 0.0001) and decreased triglyceride (p = 0.007) concentration, whereas there was no significant change in LDL and total cholesterol. These effects were dependent on maintenance of graft function, statin therapy (those who were on) if graft failure occurred then HDL again decreased and triglycerides increased. Conclusions: Kidney transplantation ameliorated alterations in plasma lipoprotein profile associated with kidney impairment, an effect that was dependent on the maintenance of graft function. These data suggest that kidney function is a determinant of HDL and triglyceride concentrations in patients with CKD.

The prevalence of metabolic syndrome among chronic disease patients in Alwazarat health center at Prince Sultan Military Medical City, Riyadh, Saudi Arabia, 2014

Background: The presence of metabolic syndrome (MS) results in heart attacks twice the time in people with MS and in thrice the time the chances of experiencing a heart attack or stroke in those with MS when compared with normal individuals. Identifying individuals with MS appropriately and managing them at early stages are important. Objective: To measure the prevalence of MS using the NECP/ATP III and the WHO criteria and compare the differences between the two criteria in assessing the prevalence of disease in addition to identifying the different factors associated with MS among chronic disease patients in primary health care. Materials and Methods: A cross-sectional study was carried out at chronic disease clinics in Alwazarat primary care center during the period between February and March 2014. It included a sample of 250 patients attending the chronic disease clinics. A questionnaire was designed to interview the patients and collect the information regarding their socioeconomic status, smoking habits, physical activity, and history of diabetes mellitus (DM), hypertension, and dyslipidemia. Information about their body mass index, blood pressure measurement, and the laboratory tests were recorded in a different checklist. Result: The prevalence of MS among the patients based on the NECP/ATP III and the WHO criteria was 36% and 39.1%, respectively. On the basis of both the criteria together (NECP/ATP III and the WHO), the prevalence of MS was 29.3%. High fasting blood sugar was the highest prevalent component of MS based on the NECP/ATP III criteria (96.3%), followed by low HDL-cholesterol level (82.7%) and abdominal obesity (76.5%), while the highest prevalent component of MS based on the WHO criteria, in addition to impaired glucose level, was obesity (59.1%), followed by high triglycerides level (53.2%), and low HDL-cholesterol level (40.9%). Obesity, ex-smoking, and history of DM, hypertension, and dyslipidemia together were significantly associated with MS. Conclusion: This study showed that there is no significant difference between the WHO criteria and NECP/ATP III criteria for the diagnosis of MS. The approach to the management of all cardiovascular risk factors as MS must be considered.

Automated Multiplex LC-MS/MS Assay for Quantifying Serum Apolipoproteins A-I, B, C-I, C-II, C-III, and E with Qualitative Apolipoprotein E Phenotyping.

Direct and calculated measures of lipoprotein fractions for cardiovascular risk assessment suffer from analytical inaccuracy in certain dyslipidemic and pathological states, most commonly hypertriglyceridemia. LC-MS/MS has proven suitable for multiplexed quantification and phenotyping of apolipoproteins. We developed and provisionally validated an automated assay for quantification of apolipoprotein (apo) A-I, B, C-I, C-II, C-III, and E and simultaneous qualitative assessment of apoE phenotypes. We used 5 value-assigned human serum pools for external calibration. Serum proteins were denatured, reduced, and alkylated according to standard mass spectrometry-based proteomics procedures. After trypsin digestion, peptides were analyzed by LC-MS/MS. For each peptide, we measured 2 transitions. We compared LC-MS/MS results to those obtained by an immunoturbidimetric assay or ELISA. Intraassay CVs were 2.3%-5.5%, and total CVs were 2.5%-5.9%. The LC-MS/MS assay correlated (R = 0.975-0.995) with immunoturbidimetric assays with Conformité Européenne marking for apoA-I, apoB, apoC-II, apoC-III, and apoE in normotriglyceridemic (n = 54) and hypertriglyceridemic (n = 46) sera. Results were interchangeable for apoA-I ≤3.0 g/L (Deming slope 1.014) and for apoB-100 ≤1.8 g/L (Deming slope 1.016) and were traceable to higher-order standards. The multiplex format provides an opportunity for new diagnostic and pathophysiologic insights into types of dyslipidemia and allows a more personalized approach for diagnosis and treatment of lipid abnormalities.

Status of Dyslipidemia in Vitamin D Supplemented Argentinean Indigenous Children Versus A Non-supplemented Mixed Population Group.

Epidemiological studies have suggested an inverse association between circulating levels of vitamin D and cardiovascular disease risk biomarkers, including an atherogenic lipid profile. To compare the prevalence and the distribution of lipid levels among vitamin D supplemented Argentinean indigenous San Antonio de los Cobres (SAC) children with a nonsupplemented Buenos Aires (BA) mixed population group. A group of indigenous children from SAC with hypovitaminosis D supplemented with vitamin D; and a nonsupplemented group from a BA mixed population were compared via a cross sectional study. Anthropometric measures, glucose, lipids, vitamin D, and insulin were measured. The mean ages were 10.3 + 2.3 in SAC and 8.7 ± 1.8 years in BA children. There was a lower prevalence of overweight 7.9%(15/192) vs 17.8% (23/129); and of obesity 1.6% (3/192) vs 30.2% (39/129) in SAC vs. BA respectively. Approximately half of the SAC children versus 30% from BA had optimal vitamin D levels (≥30ng/mL). There was a significantly higher prevalence of high triglycerides (TG) (27.6%vs 4.6%) and low HDL-C (21.3% vs 5.4%) in SAC vs BA children, respectively. In separate linear regression models, we found that despite effective vitamin D repletion, SAC children had higher TG and TG/HDL-C values, whereas HDL-C levels were lower than those of BA children adjusted for age, gender, BMI, and insulin levels. Indigenous Argentinean children have a higher risk for dyslipidemia in comparison with BA children, even after vitamin D treatment, suggesting that dyslipidemia could be related to diet or ethnic backgrounds.

Antidiabetic and Antihyperlipidemic Properties of a Triterpenoid Compound, Dehydroeburicoic Acid, from Antrodia camphorata in Vitro and in Streptozotocin-Induced Mice.

The aim of this study was to examine the effects of dehydroeburicoic acid (TT) on type 1 diabetes mellitus and dyslipidemia in streptozotocin (STZ)-induced diabetic mice. STZ-induced diabetic mice were randomly divided into six groups and given orally by gavage TT (at three dosages), metformin (Metf), fenfibrate (Feno), or vehicle for 4 weeks. STZ-induced diabetic mice showed elevations in blood glucose levels (P < 0.001). TT treatment markedly decreased blood glucose levels by 42.6-46.5%. Moreover, STZ-induced diabetic mice displayed an increase in circulating triglyceride (TG) and total cholesterol (TC) levels (P < 0.001 and P < 0.01, respectively) but a decrease in blood insulin and adiponectin levels (P < 0.01 and P < 0.05, respectively). These substances are also reversed by TT treatment, indicating TT ameliorated diabetes and dyslipidemia. Membrane skeletal muscular expression levels of glucose transporter 4 (GLUT4) and expression levels of AMPK phosphorylation (phospho-AMPK) in both liver and skeletal muscle were reduced in STZ-induced diabetic mice, which normalized upon TT treatment and correction of hyperglycemia accompanied with a decrease in mRNA levels of phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6 Pase), which was related to the inhibition of hepatic glucose production and attenuating diabetic state. In addition, TT also showed hypolipidemic effect by increasing hepatic expression levels of peroxisome proliferator-activated receptor α (PPARα) and mRNA levels of carnitine palmitoyl transferase Ia (CPT-1a) but decreasing expression levels of fatty acid synthase (FAS), which further contributed to a decrease in circulating TG levels. TT-treated mice displayed decreased SREBP2 mRNA levels and reduced blood TC levels. These findings strongly support that TT prevents diabetic and dyslipidemic states in STZ-induced diabetic mice evidenced by regulation of GLUT4, PPARα, FAS, and phosphorylation of AMPK.

CD68GFP/APOE-/- mouse: A novel model to study macrophage biology in atherosclerosis

CD68GFP/APOE-/- mouse: A novel model to study macrophage biology in atherosclerosis

Abstract 273: Myocardial Infarction with Non Obstructive Coronary Artery Disease: Prevalence, Clinical Features and Outcomes

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is an enigma that is being increasingly recognized with the frequent use of angiography following Acute Myocardial Infarction (AMI). The current study is a prospective, contemporary analysis of MINOCA vs. Myocardial Infarction with obstructive coronary artery disease (MI-CAD) in regards to prevalence, clinical features, and in-hospital outcomes. Methods: All consecutive patients undergoing coronary angiography for AMI (as per the Third Universal AMI Definition) in South Australian public hospitals from January 2012 - December 2013 were included. Data was captured by Coronary Angiogram Database of South Australia (CADOSA), a comprehensive registry compatible with the NCDR® CathPCI® Registry. The AMI patients were classified as MI-CAD or MINOCA on the basis of the presence or absence of a significant stenosis (≥50%) on angiography. Results: From 4,189 angiography procedures undertaken for AMI, 468 (11%) were classified as MINOCA. Patients with MINOCA were younger (59±15 vs. 64±13 years, p &lt;0.01) and more likely to be female (53% vs. 26%, p &lt;0.01), compared to those with MI-CAD. Age-adjusted analysis comparing patients with MINOCA to MI-CAD revealed differences in: (1) cardiovascular risk factors including hypertension (52% vs. 66%, p&lt;0.01), diabetes (19% vs. 32%, p&lt;0.01), dyslipidemia (46% vs. 62%, p&lt;0.01), and current smoker status (27% vs. 37% p&lt;0.01); (2) AMI type and size with fewer ST elevation myocardial infarcts (27% vs. 41%, p&lt;0.01) and lower peak troponin values (180 ng/L, IQR 353 vs. 264 ng/L, IQR 680, p&lt;0.01) amongst MINOCA patients. Furthermore, the GRACE Score for acute coronary syndrome risk stratification was lower for the MINOCA patients compared to MICAD (150±34 versus 160±35, p &lt;0.01). Despite fewer cardiovascular risk factors, the absence of obstructive coronary artery disease, smaller infarcts, and a lower GRACE score, the in-hospital mortality was similar for MINOCA and MI-CAD patients (2.2% vs. 3.0%, p=0.22). Moreover, MINOCA patients were less likely to receive secondary prevention therapies at discharge including antiplatelet therapy (60% vs. 92%, p&lt;0.01) beta-blockers (41% vs. 65%, p&lt;0.01), statin (55% vs. 88%, p&lt;0.01), ACE-inhibitor/angiotensin receptor blocker (59% versus 81%, p&lt;0.01), or referral to cardiac rehabilitation (15% versus 52%, p&lt;0.01). Conclusions: In contemporary cardiology practice, MINOCA may be more frequent than previously appreciated and has a guarded prognosis despite its apparent lower risk profile. Improving the use of secondary prevention therapies in these patients may improve their prognosis.

Use of Ophiocordyceps sinensis (syn. Cordyceps sinensis) combined with angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) versus ACEI/ARB alone in the treatment of diabetic kidney disease: a meta-analysis

Ophiocordyceps sinensis (O. sinensis; syn. Cordyceps sinensis) has been used in clinical therapy for diabetic kidney disease (DKD) for more than 15 years. O. sinensis is a household name in china and it is available even in supermarket. However, the precise role of O. sinensis has not been fully elucidated with meta-analysis. The aim of this study was to review existing evidence on the effectiveness of O. sinensis for the treatment of DKD. We identified 60 trials involving 4288 participants. Overall, O. sinensis combined with ACEI/ARB had a better effect when compared to ACEI/ARB alone on 24 h UP (MD = −0.23 g/d, 95% CI: − 0.28 to −0.19, p < 0.00001), UAER (MD = −19.71 μg/min, 95% CI: −22.76 to −16.66, p < 0.00001), MAU (MD = −45.09 mg/d, 95% CI: −55.68 to −34.50, p < 0.00001), BUN (MD = −0.70 mmol/L, 95% CI: −1.02 to −0.39, p < 0.0001), SCr (MD = −8.37 μmol/L, 95% CI: −12.41 to −4.32, p < 0.0001), CRP (MD = −1.32 mg/L; 95% CI: −1.78 to −0.86; p < 0.00001), TG (MD = −0.51 mmol/L; 95% CI: −0.69 to −0.34, p < 0.00001), TC (MD = −0.64 mmol/L; 95% CI: −0.91 to −0.37, p < 0.00001), and SBP (MD = −2.01 mmHg; 95% CI: −3.45 to −0.58, p = 0.006). However, no effects were found for DBP, FBG, and HbA1C. This meta-analysis suggested that use of O. sinensis combined with ACEI/ARB may have a more beneficial effect on the proteinuria, inflammatory, dyslipidemia status as compared to ACEI/ARB alone in DKD III–IV stage patients, while there is no evidence that O. sinensis could improve the hyperglycemia status. However, with regard to low-quality and significant heterogeneity of included trials, to further verify the current results from this meta-analysis, long-term and well-designed RCTs with high-quality study are warranted to ascertain the long-term efficacy of O. sinensis.

Effect of Wheatgrass (Triticum aestivum) Juice on High Density Lipoprotein (HDL) Level in Experimentally Induced Dyslipidaemic Male Long Evans Rat

Background: Evidence shows that high density lipoproteins (HDLs) may exert multiple anti-atherogenic and anti-thrombotic effects that together decrease the risk of cardiovascular morbidity in hyperlipidaemic state. Experimental studies showed that fresh wheatgrass (Triticum aestivum Linn.) juice exerts lipid lowering effect as well as increases HDL-cholesterol level in rats. Objective: The present study was done to observe the effect of wheatgrass juice on serum HDL-cholesterol on experimentally induced dyslipidaemic rats evident by reduced HDL-cholesterol level. Materials and method: This experimental study was carried out in the Department of Pharmacology &amp; Therapeutics, Dhaka Medical College, Dhaka, from July 2009 to June 2010. A total number of 48 healthy adult male Long Evans rats, age ranging from 2-3 months, and weighing from 140-200 grams were used for the present study. Six rats were taken in each group of total 8 groups treated differently with 1 control group. Rats of the first 5 groups were sacrificed at 29th day and their lipid profile was measured. Rests of the rats were sacrificed at 57th day and their lipid profile was measured. Results: Mean HDL-cholesterol of the group of rats treated with 10 mL/kg grass juice and 1% cholesterol diet, with 10 mL/kg grass juice and with 20 mL/kg grass juice were significantly increased (P&lt;0.05, P&lt;0.05, P&lt;0.01 respectively). The mean HDL-cholesterol of the group treated with Atorvastatin for 28 days were also significantly increased (P&lt;0.001).Conclusion: The present experiment showed that HDL-cholesterol level is increased by ingestion of wheat grass juice in experimental animals. Therefore, it provides the initial step for demonstrating cardio-protective effect of wheatgrass juice by increasing HDL-cholesterol level in blood in dyslipidaemic state. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22235 Delta Med Col J. Jan 2015; 3(1): 18-24

Effects of vitamin E-coated dialysis membranes on anemia, nutrition and dyslipidemia status in hemodialysis patients: a meta-analysis

Background: This was controversial whether vitamin E-coated dialyzer therapy was beneficial for the complications associated with hemodialysis. Therefore, we performed this systematic review to evaluate the effects of vitamin E-coated dialyzer. Methods: Related trials were searched from multiple electronic databases. We conducted meta-analysis to assess changes in the predefined outcomes using RevMan 5.3 software. Results: Meta-analysis showed vitamin E-coated dialyzer therapy could decrease erythropoietin (EPO) resistance index (SMD, −0.24; 95% CI, −0.47 to −0.01; p = 0.04). However, pooled-analysis showed vitamin E-coated dialyzer therapy could not decrease weekly EPO dose (SMD, −0.11; 95% CI, −0.32 to 0.09; p = 0.28) and intima–media thickness (IMT) of the carotid artery (MD, −0.09; 95% CI, −0.2 to 0.01; p = 0.09), and vitamin E-coated dialyzer therapy did not improve the serum hemoglobin (MD, −0.03; 95% CI, −0.18 to 0.13; p = 0.74), albumin levels (SMD, −0.64; 95% CI, −1.62 to 0.34; p = 0.2), in addition, there was no significant difference in serum cholesterol (SMD, −0.07; 95% CI, −0.45 to 0.31; p = 0.71), triglycerides (MD, −2.77; 95% CI, −32.42 to 26.87; p = 0.85), high density lipoprotein (HDL) (SMD, 0.24; 95% CI, −0.14 to 0.62; p = 0.22) and low density lipoprotein (LDL) (SMD, 0.00; 95% CI, −0.38 to 0.37; p = 0.98) levels. Conclusions: Vitamin E-coated dialyzer may reduce the EPO resistance, but there is no conclusive evidence that vitamin E-coated dialyzer can improve the renal anemia, malnutrition, dyslipidemia and atherosclerosis status in hemodialysis (HD) patients. However, high-quality trials with hard clinical endpoints are required to fully elucidate the clinical value of vitamin E-coated dialyzer therapy.

Effects of Bofu-Tsusho-San on diabetes and hyperlipidemia associated with AMP-activated protein kinase and glucose transporter 4 in high-fat-fed mice.

This study was undertaken to examine the effect and mechanism of Bofu-tsusho-san formula (BO) on hyperglycemia and hyperlipidemia and in mice fed with a high-fat (HF) diet. The C57BL/6J mice were received control/HF diet for 12 weeks, and oral administration of BO (at three doses) or rosiglitazone (Rosi) or vehicle for the last 4 weeks. Blood, skeletal muscle and tissues were examined by means of measuring glycaemia and dyslipidaemia-associated events. BO treatment effectively prevented HF diet-induced increases in the levels of triglyceride (TG), free fatty acid (FFA) and leptin (p < 0.01, p < 0.01, p < 0.01, respectively). BO treatment exhibited reduced both visceral fat mass and hepatic triacylglycerol content; moreover, BO treatment displayed significantly decreased both the average area of the cut of adipocytes and ballooning of hepatocytes. BO treatment exerted increased the protein contents of glucose transporter 4 (GLUT4) in skeletal muscle, and caused lowered blood glucose levels. BO treatment displayed increased levels of phosphorylated AMP-activated protein kinase (AMPK) in both skeletal muscle and liver tissue. Furthermore, BO reduced the hepatic expression of glucose-6-phosphatase (G6Pase) and phosphenolpyruvate carboxykinase (PEPCK) and glucose production. Therefore, it is possible that the activation of AMPK by BO leads to diminished gluconeogenesis in liver tissue. BO increased hepatic expressions of peroxisome proliferator-activated receptor α (PPARα), whereas down-regulating decreasing expressions of fatty acid synthesis, including sterol regulatory element binding protein 1c (SREBP1c) and fatty acid synthase (FAS), resulting in a decrease in circulating triglycerides. This study originally provides the evidence that amelioration of dyslipidemic and diabetic state by BO in HF-fed mice occurred by regulation of GLUT4, SREBP1c, FAS, PPARα, adiponectin and AMPK phosphorylation.

Osteoporosis is less frequent in endometrial cancer survivors with hypertriglyceridemia.

We previously reported an association between dyslipidemia and endometrial cancers. Osteoporosis is also reported to relate with some cancers. A common etiologic event has been proposed between dyslipidemia and osteoporosis. However, the pattern of interrelationships among dyslipidemia, osteoporosis and endometrial cancer is not well understood. To improve the quality of life of endometrial cancer survivors, these relationships should be determined. This study included 179 Japanese menopausal women who underwent bilateral salpingo-oophorectomy, including 114 women with incident endometrial cancer and 65 without endometrial cancer. The women were categorized according to dyslipidemia status. Bone mineral density was measured and compared between groups. Osteoporosis was statistically more frequent in women with hypertriglyceridemia who did not have endometrial cancer. In contrast, osteoporosis was statistically less frequent in women with hypertriglyceridemia who had endometrial cancer. In this cross-sectional study in a Japanese population, osteoporosis was associated with hypertriglyceridemia in post-menopausal women without endometrial cancer, but was less frequent in endometrial cancer survivors with hypertriglyceridemia.

Examining controversies and new frontiers in lipid management

Over the course of the last three decades our approach to the management of dyslipidemia has intensified on the basis of randomized controlled trials demonstrating reduction in cardiovascular events. However, the presence of a substantial residual risk and complex dyslipidemic states presents an ongoing challenge in clinical practice. The current controversies and opportunities in the management of both atherogenic and protective lipid factors will be reviewed.

Caffeamide 36-13 Regulates the Antidiabetic and Hypolipidemic Signs of High-Fat-Fed Mice on Glucose Transporter 4, AMPK Phosphorylation, and Regulated Hepatic Glucose Production.

This study was to investigate the antidiabetic and antihyperlipidemic effects of (E)-3-[3, 4-dihydroxyphenyl-1-(piperidin-1-yl)prop-2-en-1-one] (36-13) (TS), one of caffeic acid amide derivatives, on high-fat (HF-) fed mice. The C57BL/6J mice were randomly divided into the control (CON) group and the experimental group, which was firstly fed a HF diet for 8 weeks. Then, the HF group was subdivided into four groups and was given TS orally (including two doses) or rosiglitazone (Rosi) or vehicle for 4 weeks. Blood, skeletal muscle, and tissues were examined by measuring glycaemia and dyslipidemia-associated events. TS effectively prevented HF diet-induced increases in the levels of blood glucose, triglyceride, insulin, leptin, and free fatty acid (FFA) and weights of visceral fa; moreover, adipocytes in the visceral depots showed a reduction in size. TS treatment significantly increased the protein contents of glucose transporter 4 (GLUT4) in skeletal muscle; TS also significantly enhanced Akt phosphorylation in liver, whereas it reduced the expressions of phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase). Moreover, TS enhanced phosphorylation of AMP-activated protein kinase (phospho-AMPK) both in skeletal muscle and liver tissue. Therefore, it is possible that the activation of AMPK by TS resulted in enhanced glucose uptake in skeletal muscle, contrasting with diminished gluconeogenesis in liver. TS exhibits hypolipidemic effect by decreasing the expressions of fatty acid synthase (FAS). Thus, antidiabetic properties of TS occurred as a result of decreased hepatic glucose production by PEPCK and G6Pase downregulation and improved insulin sensitization. Thus, amelioration of diabetic and dyslipidemic state by TS in HF-fed mice occurred by regulation of GLUT4, G6Pase, and FAS and phosphorylation of AMPK.

Antidiabetic and Antihyperlipidemic Effects of Clitocybe nuda on Glucose Transporter 4 and AMP‐Activated Protein Kinase Phosphorylation in High‐Fat‐Fed Mice

The objective of this study was to evaluate the antihyperlipidemic and antihyperglycemic effects and mechanism of the extract of Clitocybe nuda (CNE), in high-fat- (HF-) fed mice. C57BL/6J was randomly divided into two groups: the control (CON) group was fed with a low-fat diet, whereas the experimental group was fed with a HF diet for 8 weeks. Then, the HF group was subdivided into five groups and was given orally CNE (including C1: 0.2, C2: 0.5, and C3: 1.0 g/kg/day extracts) or rosiglitazone (Rosi) or vehicle for 4 weeks. CNE effectively prevented HF-diet-induced increases in the levels of blood glucose, triglyceride, insulin (P < 0.001, P < 0.01, P < 0.05, resp.) and attenuated insulin resistance. By treatment with CNE, body weight gain, weights of white adipose tissue (WAT) and hepatic triacylglycerol content were reduced; moreover, adipocytes in the visceral depots showed a reduction in size. By treatment with CNE, the protein contents of glucose transporter 4 (GLUT4) were significantly increased in C3-treated group in the skeletal muscle. Furthermore, CNE reduces the hepatic expression of glucose-6-phosphatase (G6Pase) and glucose production. CNE significantly increases protein contents of phospho-AMP-activated protein kinase (AMPK) in the skeletal muscle and adipose and liver tissues. Therefore, it is possible that the activation of AMPK by CNE leads to diminished gluconeogenesis in the liver and enhanced glucose uptake in skeletal muscle. It is shown that CNE exhibits hypolipidemic effect in HF-fed mice by increasing ATGL expression, which is known to help triglyceride to hydrolyze. Moreover, antidiabetic properties of CNE occurred as a result of decreased hepatic glucose production via G6Pase downregulation and improved insulin sensitization. Thus, amelioration of diabetic and dyslipidemic states by CNE in HF-fed mice occurred by regulation of GLUT4, G6Pase, ATGL, and AMPK phosphorylation.

Validation of the Antidiabetic and Hypolipidemic Effects of Clitocybe nuda by Assessment of Glucose Transporter 4 and Gluconeogenesis and AMPK Phosphorylation in Streptozotocin‐Induced Mice

The study was designed to investigate the effects of extract of Clitocybe nuda (CNE) on type 1 diabetes mellitus and dyslipidemia in streptozotocin- (STZ-) induced diabetic mice. Diabetes was induced by injection of STZ. Diabetic mice were randomly divided into five groups and given orally CNE (C1: 0.2, C2: 0.5, and C3: 1.0 g/kg body weight) or metformin (Metf) or vehicle for 4 weeks. STZ induction decreased in the levels of insulin, body weight, and the weight of skeletal muscle, whereas the levels of blood glucose, hemoglobin nonenzymatically (percent HbA1c), and circulating triglyceride (P < 0.001, P < 0.001, and P < 0.01, resp.) were increased. CNE decreased the levels of blood glucose, HbA1c, and triglyceride levels, whereas it increased the levels of insulin and leptin compared with the vehicle-treated STZ group. STZ induction caused a decrease in the protein contents of skeletal muscular and hepatic phosphorylation of AMP-activated protein kinase (phospho-AMPK) and muscular glucose transporter 4 (GLUT4). Muscular phospho-AMPK contents were increased in C2-, C3-, and Metf-treated groups. CNE and Metf significantly increased the muscular proteins of GLUT4. Liver phospho-AMPK showed an increase in all CNE- and Metf-treated groups combined with the decreased hepatic glucose production by decreasing phosphenolpyruvate carboxykinase (PEPCK), glucose-6-phosphatase (G6Pase), and 11beta hydroxysteroid dehydroxygenase (11β-HSD1) gene, which contributed to attenuating diabetic state. The study indicated that the hypoglycemic properties of CNE were related to both the increased muscular glucose uptake and the reduction in hepatic gluconeogenesis. CNE exerts hypolipidemic effect by increasing gene expressions of peroxisome proliferator-activated receptor α (PPARα) and decreasing expressions of fatty acid synthesis, including acyl-coenzyme A: diacylglycerol acyltransferase (DGAT) 2. Therefore, amelioration of diabetic and dyslipidemic state by CNE in STZ-induced diabetic mice occurred by regulation of GLUT4, PEPCK, DGAT2, and AMPK phosphorylation.

Influence of breastfeeding on blood‐cell transcript‐based biomarkers of health in children

The expression of specific genes in peripheral blood cells (PBCs) may be used as biomarkers of the metabolic status. High levels of expression of CPT1A, SLC27A2, INSR, LEPR, FASN and PPARα in PBCs are indicative of a lower risk for the insulin resistant or dyslipidaemic state associated with obesity in children. Breastfeeding seems to confer protective effects against obesity and its related metabolic problems. Children who had been breastfed showed higher expression levels of SLC27A2, FASN, PPARα and INSR in PBCs compared with formula-fed subjects. The relationship of the PBC transcript levels of SLC27A2, INSR, FASN and PPARα with insulin resistance and dyslipidaemia may be dependent on the type of infant feeding (breast vs. formula). The transcript levels of the mentioned biomarkers could be useful to distinguish the formula-fed children who are at higher risk of metabolic alterations. Blood-cell transcripts have showed to be good biomarkers of metabolic alterations and their use in early detection and prevention of future disorders is promising. This study aimed to examine the relation between previously proposed transcriptional biomarkers of metabolic health (SLC27A2, CPT1A, FASN, PPARα, INSR, LEPR) in peripheral blood cells and the type of infant feeding in a subset of children from the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants) cohort. A total of 237 children aged 2-9 years from eight European countries were studied. Breastfed children showed higher expression levels of SLC27A2, FASN, PPARα and INSR, and lower risk of being overweight and of having high plasma triglyceride levels vs. formula-fed children. Besides, overweight formula-fed children presented higher HOMA-index than overweight breastfed children (1.90 vs. 1.62); however, this negative effect was absent in formula-fed children with high expression of SLC27A2. Moreover, formula-fed children with low expression of SLC27A2, FASN, PPARα and INSR presented higher triglyceride levels than subjects with high expression of these genes (77.7 mg dL(-1) vs. 44.8 mg dL(-1) ). This difference was absent in breastfed children. Protective effects of breastfeeding are reflected in higher expression levels of SLC27A2, FASN, PPARα and INSR in blood cells. These biomarkers may also serve to discriminate the formula-fed children that are at higher risk of metabolic alterations.

Relationship between hypertension and selected cardiovascular risk factors and all cause mortality in patients with alzheimer's disease

Purpose: To evaluate the relationship between hypertension (HT) and other selected cardiovascular risk factors (age, gender, smoking, lipid profile) and the all cause mortality in patients with Alzheimer's Disease (AD). Methods: We evaluated 1083 patients with AD (390M, 693F, mean age 76,6±7,0 range 50-94 ys) referred to the Department of Neurology in Warsaw through years 2000-2006.The AD was diagnosed on the basis of Mini Mental Scale (MMSE), NINCDS –ADRDA criteria for AD, DSM-IV criteria for AD and neurological and neuropsychological assessment. The level of cognitive impairment was assessed based on the MMSE score. All patients also underwent through evaluation including: assessment of cardiovascular risk factors, antihypertensive treatment and the results of laboratory tests.All cause mortality was estimated on the basis of data on deaths from the Central Statistical Office. Results: After the mean follow-up of 4,86 ys (range 0 – 13 ys) all cause mortality was 66,1% (714 patients of mean age 77,3 ys (range 50-96ys)). The patients who have died were characterized by older age (77,3,1±6,73 vs 74,1±7,12ys, p<0,01) and more severe cognitive impairment (median MMSE score 17 vs 20, p <0,01) as compared to the patients who stayed alive during follow-up. There was no difference in the gender distribution between presented groups (frequency of female 62,5% vs 67,7%, p=0,09). Multivariate Cox model including age, gender, hypertension presence, dyslipidemia status, smoking status, level of education and the degree of cognitive impairment showed that male gender (Exp(B) = 0,796, ps<0,05), smoking (Exp(B) = 1,363, ps<0,05), older age (Exp(B) = 1,055, ps<0,0r), and lower score in MMSE ((Exp(B) = 0,950, ps<0,01) increased the risk of death in one year. Conclusions: , Our results show that in patients with AD, among analysed cardiovascular risk factors, only age, gender and smoking, but not the presence of hypertension and dyslipidemia status was associated with higher all cause mortality.

The evolving landscape of endocrine pathology practice

The effect of the interaction between type 2 diabetes and dyslipidemia on inflammation and lipid peroxidation (LPO) has not been assessed.To investigate whether diabetes coupled with dyslipidemia alters oxidative metabolism leading to increased LPO products and inflammatory status.100 patients were divided into four groups based upon diabetic and dyslipidemic status: poorly controlled diabetes with dyslipidemia (DM-PC/D), well-controlled diabetes with dyslipidemia (DM-WC/D), normoglycemic individuals with dyslipidemia (NG/D), and normoglycemic individuals without dyslipidemia (NG/ND). Plasma was evaluated for an LPO product (MDA), antioxidant levels and inflammatory cytokines.Diabetics presented significantly higher levels of LPO (p < 0.05) and the DM-PC/D had higher levels of proinflammatory cytokines and MDA in the plasma in comparison with normoglycemics (p < 0.05). Interestingly IL1-β, IL-6, and TNF-α in DM-WC/D were not statistically different from those in DM-PC/D. Normoglycemic individuals with dyslipidemia presented significantly increased levels of IL-6 and TNF-α when compared to normoglycemic without dyslipidemia (p < 0.05). MDA levels were also positively correlated with the presence of DM complications (r = 0.42, p < 0.01).These findings show that dyslipidemia is associated with an increased inflammatory status, even in well-controlled diabetics and in normoglycemics. Our results suggest that lipid metabolism and peroxidation are important for the development of inflammation, which is elevated in several complications associated with diabetes.

Pattern of Lipid Profile among Type 2 Diabetic Patients

Diabetes mellitus is recognized as a serious global health problem and frequently associated with disabling and lifethreatening complications related to some modifiable risk factors. One of the modifiable factors is dyslipidemia. This study addressed the dyslipidemic status of 124 subjects with type 2 diabetes mellitus (T2DM) attending the outpatient department, Ibrahim General Hospital and Diabetic Care and Education Center Dhanmondi, Dhaka during the period from January to June 2010. The diagnosed diabetic subjects were interviewed and the biochemical investigation data were collected from record review. Three fourth of the respondents were female and majority (24.2%) of them were 46 to 50 years of age. Most of the respondents were graduates having neuclear families. The mean total cholesterol and triglyceride were found 181.7±43.0 mg/dl and 161.0±112.5 mg/dl respectively. According to NCEP ATP III (2001), 59.7% of the participants had high level of low density lipoproteins (LDL) and only 18% had desired level of high density lipoproteins (HDL). The mean (±SD) of LDL and HDL were 109.8±37.0 mg/dl and 41.0±7.9 mg/dl respectively. Men had elevated level of mean TG with wide variation (185.98±179.56 mg/dl) than women (151.63±72.16 mg/dl). The mean (±SD) of HDL was found lower in men than women (35.8 ± 6.3 vs. 42.9 ± 7.5 mg/dl, p&lt; 0.05) though not significant. The study revealed that dyslipidemia (high TC, TG, LDL and low HDL) was prevalent among the T2DM subjects, which needs attention of equal importance to maintain within normal limit as with the control of hyperglycemia and hypertension. DOI: http://dx.doi.org/10.3329/imcj.v6i1.14712 Ibrahim Med. Coll. J. 2012; 6(1): 12-17