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Editorial 2012; 33(Suppl 3): 41-47 PubMed PMID: 23353836 Citation  Keywords:  Congresses as Topic, Humans, Neuroendocrinology:trends, Toxicology:trends,.   

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Journal Article 2012; 33(Suppl 2): 102-107 PubMed PMID: 23183520 Citation  Keywords:  Adult, Cardiovascular Diseases:epidemiology, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prevalence, Retrospective Studies, Risk Factors, Risk Reduction Behavior, Smoking Cessation.   

OBJECTIVES: Smoking cessation is an essential part of cardiovascular disease (CVD) prevention. At the Center for Tobacco-Dependent (CTD), clients are screened to identify and reduce cardiovascular (CV) risk factors. In our study we have focused on the role of the CTD in reducing global CV risk.

METHODS: 1,334 CTD patients aged 25-64 years (52.2% men, mean age 44±12 years, Fagerström Test for Cigarette Dependence 6±2) were included in a retrospective cross-sectional survey. Medical history, blood samples and physical examination were analysed. Blood pressure, weight and exhaled CO were measured at each visit (12-months-follow-up). Patients' CV risk was scored. CO-verified abstinence according to CV risk and prevalence of detected CV risk factors were examined.

RESULTS: Among patients who had attended at least their first visit and a visit after one year, 37.9% (506/1,334) had stopped smoking. Among patients with a SCORE of <5%, the success rate was 44.3% (254/574) and 41.2% for patients at high CV risk (105/255, p=0.41). There was a trend towards a lower success rate among patients with CVD, but this difference was not significant. The smoking cessation rate among low and high CV risk patients at the baseline visit was identical (46.2%, resp. 47.3%, p=0.81). 3.1% (42/1,334) of patients were referred to a specialist for hypertension. 62.5% (223/357), without a prior history, were found to have dyslipidemia.

CONCLUSIONS: High CV risk patients have the same chance to stop smoking as low risk patients....

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Controlled Clinical Trial 2012; 33(Suppl 2): 87-92 PubMed PMID: 23183517 Citation  Keywords:  Adult, Aged, Atherosclerosis:drug therapy, Drug Therapy, Combination, Dyslipidemias:drug therapy, Fatty Acids, Omega-3:administration & dosage, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors:administration & dosage, Hypertriglyceridemia:dr.   

BACKGROUND: Atherogenic dyslipidemia contributes substantially to the residual cardiovascular risk. The aim of this study was to examine the effects of therapeutic doses of n-3 polyunsaturated fatty acids on the three major lipid abnormalities of atherogenic dyslipidemia, i.e. hypertriacylglycerolemia, low HDL cholesterol, and increased levels of small dense LDL particles, as well as on some new risk factors.

MATERIALS AND METHODS: A total of 60 hypertriacylglycerolemic patients were included in the study. Group S consisted of 36 patients who were already treated with statins, Group N of 24 patients not yet treated. Each patient was examined after six weeks on placebo and six weeks of treatment with n-3 PUFA (eicosapentaenoic and docosahexaenoic acid ethyl esters, 3.0 g/d).

RESULTS: Treatment with n-3 PUFA caused a decrease in plasma triacylglycerols (28%, p<0.001), and VLDL (-27%, p<0.001), an increase in HDL-C (+4%, p<0.01), and a decrease in sdLDL cholesterol (-16%, p<0.05). These changes were accompanied by a decrease in microalbuminuria (-30%, p<0.05), as well as in several parameters of oxidative stress. Analysis of the fatty acids composition of plasma phospholipids showed a significant increase in all n-3 PUFAs examined, accompanied by a decrease in n-6 PUFAs, as well as in monounsaturated acids. No significant differences in the effects of n-3 PUFA were found between the Groups S and N.

CONCLUSION: Our results support the opinion that hypertriacylglycerolemic patients benefit from the treatment with n-3 PUFA which improves several important metabolic factors of cardiovascular risk....

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Journal Article 2012; 33(Suppl 2): 83-86 PubMed PMID: 23183516 Citation  Keywords:  Adult, Aged, Cardiovascular Diseases:epidemiology, Cholesterol Esters:blood, Depressive Disorder:epidemiology, Diabetes Mellitus, Type 2:epidemiology, Fatty Acids, Monounsaturated:blood, Fatty Acids, Unsaturated:blood, Female, Humans, Insulin Resistance:p.   

BACKGROUND: Depressive disorder is related to an increased risk of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). Insulin resistance (IR), connected with altered fatty acid (FA) composition, namely with decreased proportion of polyunsaturated FA could participate in these associations. The aim of the study was to investigate the composition of FA in plasma cholesterol esters (CE) and phosphatidylcholine (PC) as well as indices of insulin resistance and oxidative stress in the patients with depressive disorder.

MATERIALS AND METHODS: Parameters of lipid and glucose homeostasis, concentrations of FA in plasma cholesteryl esters (CE) and phosphatidylcholine (PC) and conjugated dienes in LDL were investigated in a group of 47 patients (9M/38F) with depression and compared with 47 control persons (16M/31F). Delta-9 desaturase (D9D) and D6D desaturase were estimated as product to precursor fatty acid ratios.

RESULTS: In depressive patients increased concentrations of palmitoleic acid and total monounsaturated FA with decreased proportion of total polyunsaturated FA n-6 (PUFA n-6) (all p<0.05) in CE were found, while in PC increased proportion of saturated FA was observed (p<0.05). Moreover, index of D6D activity was significantly increased in PC and CE (p<0.05). Concomitantly, in depressive patients higher levels of plasma triacylglycerols (p<0.05), conjugated dienes in LDL (p<0.001) and HOMA index of IR (p<0.05) were found.

CONCLUSIONS: Esterified FA composition of depressive patients revealed changes, similar to those, usually observed in insulin resistance. Dysregulation of FA could participate in the pathogenesis of depression and be associated with an increased risk of CVD and DM2....

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Journal Article 2012; 33(Suppl 2): 73-77 PubMed PMID: 23183514 Citation  Keywords:  Adult, Antigens, CD11a:metabolism, Antigens, CD14:metabolism, Antigens, CD18:metabolism, Cross-Over Studies, Diabetes Mellitus, Type 2:drug therapy, Dyslipidemias:drug therapy, Female, Fenofibrate:administration & dosage, Humans, Hypolipidemic Agents:admi.   

BACKGROUND: Mixed hyperlipidemia is often associated with type 2 diabetes mellitus and contributes to atherosclerosis progression in diabetes patients. Leukocyte activation plays an important role in atherogenesis. Both statins and fibrates are used in the treatment of mixed dyslipidemia, but their specific effect on leukocyte function remains to be elucidated. We have therefore compared the effect of simvastatin and fenofibrate on several leukocyte activation markers in diabetes patients.

METHODS: Twenty patients with type 2 diabetes and mixed hyperlipidemia were sequentially treated with simvastatin (20 mg/day) and fenofibrate (200 mg/day) in a randomized cross-over study (12 weeks each treatment). We measured adhesion molecules LFA-1, VLA-4 and CD18; in addition, lipopolysaccharide receptor CD14 on monocytes was analyzed as a marker of innate immunity. Leukocyte expression of these molecules was quantified using flow cytometry. Laboratory examinations were done at baseline and at the end of each treatment. Baseline values were compared to those of 29 healthy controls.

RESULTS: Expression of integrin CD18 (in all leukocyte populations), lipopolysaccharide receptor and VLA-4 (on lymphocytes only) was significantly higher in patients than in controls. Both treatments resulted in significant decrease in CD18 and CD14 expression; LFA-1 and VLA-4 were not influenced.

CONCLUSIONS: Both simvastatin and fenofibrate had similar favorable effect on leukocyte activation markers. This result supports the use of both statins and fibrates for the treatment of mixed hyperlipidemia in patients with type 2 diabetes mellitus....

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Journal Article 2012; 33(Suppl 2): 55-59 PubMed PMID: 23183511 Citation  Keywords:  Adult, Aged, Aged, 80 and over, Cohort Studies, Coronary Artery Disease:blood, Dyslipidemias:blood, Female, Humans, Hypolipidemic Agents:therapeutic use, Lipoprotein(a):blood, Logistic Models, Male, Middle Aged, Risk Factors, Severity of Illness Index,.   

OBJECTIVES: Lipoprotein (a) [Lp(a)], together with other serum lipoproteins have an important role in the pathogenesis of coronary heart disease. The objective of the study was to assess the association between plasma levels of Lp(a) with the extent of angiographically defined coronary artery disease (CAD).

PATIENTS AND METHODS: A total of 518 consecutive patients (66 % males) underwent coronary angiography in connection with lipids and lipoprotein determinations between 1st January and 31st May 2010. Most of the patients were treated with lipid lowering therapy (77 % statins). Modified angiographic Gensini Score (GS) and adjusted angiographic score (AS) were used to reflect the extent of coronary atherosclerosis.

RESULTS: Both GS and AS angiographic scores correlated significantly with age, male gender, statin therapy and inversely with left ventricular ejection fraction (p<0.05-0.01 for all). The results showed significant inverse correlation of HDL cholesterol levels with GS and AS (r=-0.16, p<0.001), and apolipoprotein A levels with GS and AS (r=-0.20, p<0.0001) and a positive correlation of Lp(a) levels with angiographic score (r=0.13, p<0.01) and with adjusted angiographic score (r=0.16, p<0.01). Regression analysis showed only Lp(a) concentration was an independent lipid factor that correlated with the extent of CAD.

CONCLUSION: Only Lp(a) levels correlated with the extent of coronary artery disease as assessed with coronary angiography in patients treated with lipid lowering therapy....

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Journal Article 2012; 33(Suppl 2): 43-49 PubMed PMID: 23183509 Citation  Keywords:  Animals, Animals, Congenic, Chromosomes, Mammalian, Disease Models, Animal, Glucose Intolerance:drug therapy, Hypertension:drug therapy, Lipids:blood, Male, Metabolic Syndrome X:drug therapy, Ondansetron:pharmacology, Polydactyly:genetics, Rats, Rats, Inb.   

OBJECTIVES: Ondansetron is an antagonist of 5-HT3 receptors mostly used as an antiemetic yet known to modulate metabolism and appetite. We tested the metabolic effects of ondansetron in newly derived congenic rat strain, carrying limited chromosome 8 regions of (PD) Brown Norway (BN) and polydactylous (PD) strain origins (including variant serotonin receptor Htr3b gene) within the genomic background of highly inbred model of metabolic syndrome, the spontaneously hypertensive rat (SHR).

METHODS: Adult, standard diet-fed male rats of SHR and the congenic SHR.(PD/BN)8 strains received ondansetron (2mg/kg body weight/day) or vehicle (n=6/strain/treatment) via oral gavage for 14 days while we followed their metabolic and morphometric profiles including glucose tolerance and triacylgycerol and cholesterol concentrations in 20 lipoprotein fractions.

RESULTS: We fine-mapped the chromosome 8 differential segment in the new SHR.(PD/BN)8 congenic strain: it comprises BN-derived region together with an adjacent 422kb stretch of PD origin. The SHR.(PD/BN)8 rats were heavier than SHR, the fasting glucose was significantly higher in ondansetron-treated congenic than in SHR (post-hoc Tukey's HSD p=0.02). Compared to SHR, ondansetron induced significantly more robust increases of cholesterol and triacylglycerol concentrations in total, chylomicron, VLDL and HDL particles in the SHR.(PD/BN)8 congenic strain.

CONCLUSION: We established new congenic model with distinct pharmacogenetic profile related to metabolic effects of ondansetron, facilitating thus the search for responsible genetic variants within the limited genomic region demarcated by the differential segment....

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Journal Article 2012; 33(Suppl 2): 32-37 PubMed PMID: 23183507 Citation  Keywords:  Aged, Aged, 80 and over, Ankle Brachial Index, Cerebrovascular Disorders:epidemiology, Coronary Artery Disease:epidemiology, Cross-Sectional Studies, Czech Republic:epidemiology, Dyslipidemias:epidemiology, Female, Humans, Hypertension:epidemiology, Male,.   

OBJECTIVES: It has been demonstrated that the deleterious effect of smoking on the cardiovascular system is mediated through a decrease in protective HDL cholesterol. In addition, women are more sensitive to the negative effects of smoking, although the exact mechanism underlying this phenomenon is currently unknown. In this study, we evaluated whether smoking habits could modify the association of HDL cholesterol and apolipoprotein A1 (ApoA1) with reverse cholesterol transport (RCT), as measured by cholesterol efflux (CHE), in middle-aged women.

DESIGN: The study group consisted of 39 healthy middle-aged women, 21 non-smokers (age 51.8±2.5 years, BMI 25.1±2.8 kg/m2) and 18 smokers (age 50.5±3.2 years, BMI 24.8±3.5 kg/m2). In addition to all traditional cardiovascular risk factors, CHE from macrophages, labelled during a 48-hour incubation in a medium containing [14C] cholesterol, to plasma acceptors in study subjects was established as a marker of reverse cholesterol transport.

RESULTS: CHE was significantly higher in non-smokers than in smokers (14.22±1.75% vs. 13.17±1.33%; p<0.05). Smoking habit had no effect on the association of HDL with ApoA1 or HDL with CHE. However, in contrast to the strong association of ApoA1 with CHE in non-smokers (r=0.62; p<0.01), no such strong association was found in smokers (r=0.38; n.s.).

MAIN FINDINGS AND CONCLUSION: Based on our results, smoking can alter ApoA1-mediated reverse cholesterol transport in women....

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