RESUMEN
OBJECTIVE: Metabolic syndrome (MetS) is characterized by low-grade inflammation and confers an increased risk for cardiovascular disease. Endothelial progenitor cells (EPCs) are a measure of vascular health and are decreased in patients with various risk factors for cardiovascular disease (CVD). There is a paucity of data examining the EPC status especially in terms of their functionality in MetS subjects without diabetes or cardiovascular disease. We aimed to enumerate and functionally characterize EPCs in subjects with MetS in comparison to healthy controls. METHODS: The study was performed at the University of California Davis Medical Center. Healthy controls (n=31) and MetS (n=46) subjects were included in the study. EPCs were enumerated in fasting blood by KDR/CD34 dual positivity. Functionality was assessed by the colony forming units (CFU) assay, migration and tubule formation. RESULTS: Subjects with MetS had significantly decreased number of EPCs compared to control subjects. Furthermore, EPCs from MetS subjects depicted significantly impaired clonogenic capacity, i.e., decreased colony forming units, and impaired capacity to incorporate into tubular structures suggesting functional impairment of EPCs from MetS subjects. CONCLUSIONS: We make the novel observation that MetS subjects without diabetes or CVD have decreased EPC number and impaired functionality as compared to control subjects. These findings could contribute to the increased CV risk in this population.
Asunto(s)
Enfermedades Cardiovasculares/etiología , Células Endoteliales/metabolismo , Síndrome Metabólico/fisiopatología , Células Madre/metabolismo , Adulto , Anciano , Recuento de Células , Ensayos de Migración Celular , Ensayo de Unidades Formadoras de Colonias , Femenino , Citometría de Flujo , Humanos , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
In this study, we tested whether 1,200 IU/day of alpha-tocopherol was more potent than 400 and 800 IU of alpha-tocopherol in decreasing low-density lipoprotein (LDL) oxidative susceptibility in a 2-month study. The decrease in LDL oxidation was significantly greater with 1,200 IU/day than 400 IU/day.
Asunto(s)
Antioxidantes/administración & dosificación , Enfermedad de la Arteria Coronaria/prevención & control , Lipoproteínas LDL/metabolismo , Vitamina E/administración & dosificación , Ascorbato Oxidasa/sangre , Ensayos Clínicos como Asunto , Enfermedad de la Arteria Coronaria/sangre , Relación Dosis-Respuesta a Droga , Estudios de Seguimiento , Humanos , Lipoproteínas LDL/efectos de los fármacos , Masculino , Oxidación-Reducción/efectos de los fármacos , beta Caroteno/sangreRESUMEN
The prevalence of coronary heart disease (CHD) and its risk factors in first-generation Asian Indian immigrants to the United States of America (US) were compared with those of the native Caucasian population. A total of 1688 Asian Indian physicians and their family members (1131 men and 557 women, age > or = 20 years) completed a questionnaire and in 580 subjects serum lipoproteins were determined. The age-adjusted prevalence of myocardial infarction and/or angina was approximately three times more in Asian Indian men compared to the Framingham Offspring Study (7.2% versus 2.5%; P < 0.0001) but was similar in women (0.3% versus 1%; p = 0.64). Asian Indians had higher prevalence of noninsulin-dependent diabetes mellitus (NIDDM; 7.6% versus 1%; p < 0.0001) but markedly lower prevalence of cigarette smoking (1.3% versus 27%; p < 0.0001) and obesity (4.2% versus 22%; p < 0.0001). Hypertension was less prevalent in Asian Indian men 14.2% versus 19.1%, p < 0.008) but similar in women (11.3% versus 11.4%). The prevalence of elevated total a low-density lipoprotein (LDL) cholesterol levels was similar in men [17% versus 23.4% (p = 0.24) and 13.7% versus 22.3% (p = 0.22), respectively] but lower in women [15% versus 26.1% (p = 0.018) and 14.3% versus 19.6% (p = 0.047) respectively]. The mean levels of high-density lipoprotein (HDL) cholesterol were less in younger (30-39 years) Asian Indian men (mean: 0.98 versus 1.18 mmol/l; p < 0.001) and middle-aged (30-59 years) women (mean: 1.24 versus 1.45 mmol/l; p < 0.001). The prevalence of hypertriglyceridaemia was similar in men (18.5% versus 11.3%), but higher in Asian Indian women (8.3% versus 4.1%, p = 0.02). To conclude, immigrant Asian Indian men to the US have high prevalence of CHD, NIDDM, low HDL cholesterol levels and hypertriglyceridaemia. All these have "insulin resistance" as a common pathogenetic mechanism and seem to be the most important risk factors.
Asunto(s)
Enfermedad Coronaria/etnología , Emigración e Inmigración , Lípidos/sangre , Adulto , Factores de Edad , Anciano , Enfermedad Coronaria/sangre , Femenino , Humanos , India/etnología , Masculino , Persona de Mediana Edad , Prevalencia , Análisis de Regresión , Factores de Riesgo , Factores Sexuales , Encuestas y Cuestionarios , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND & AIMS: Recent studies suggesting that gastric secretion does not decrease with aging included few elderly individuals and measured only acid secretion. The aims of this study were to measure gastric acid and pepsin output in 206 health Americans (age range, 18-98 years) and to compare secretion rates with gastric histology. METHODS: Immediately after basal and pentagastrin-stimulated acid and pepsin outputs were measured, oxyntic biopsy samples were obtained. RESULTS: Gastric acid and pepsin output rates were similar in young (age range, 18-34 years) and middle-aged (age range, 35-64 years) groups. Stimulated acid output was reduced approximately 30% in the elderly (age range, 65-98 years). However, after adjustment for histology, Helicobacter pylori infection, and other variables, age had no independent effect on acid output. The decline in acid secretion in the elderly was primarily related to a higher prevalence of chronic atrophic gastritis and a lower prevalence of smoking. Pepsin output was reduced by approximately 40% in the elderly. After adjustment for other variables, age remained a robust predictor of reduced pepsin output. CONCLUSION: Although advancing age has no independent effect on gastric acid secretion, it is associated with reduced pepsin output independent of atrophic gastritis, H. pylori infection, and smoking.
Asunto(s)
Envejecimiento/fisiología , Ácido Gástrico/metabolismo , Gastritis/fisiopatología , Pepsina A/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Enfermedad Crónica , Femenino , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patología , Gastritis/complicaciones , Gastritis/patología , Gastritis Atrófica/fisiopatología , Infecciones por Helicobacter/complicaciones , Helicobacter pylori , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Fumar/efectos adversosRESUMEN
OBJECTIVE: To determine the safety and efficacy of long-term dextran sulfate-affinity column low-density lipoprotein (LDL) apheresis for the treatment of children with receptor-negative homozygous familial hypercholesterolemia (HFH). STUDY DESIGN: Two children with HFH (pretreatment cholesterol levels 22.1 to 24.7 mmol/L (ranges 850 to 950 mg/dl) began LDL apheresis treatments at ages 7 and 10 years, respectively. The LDL apheresis treatment interval was generally either 7 or 14 days; for the last 2 years of the study the treatment interval was 7 days. The patients had 167 and 188 LDL apheresis procedures during 64 and 70 months, respectively. RESULTS: Individual procedures decreased total blood cholesterol levels by 63% to 68%. When the treatment interval was 7 days, the patients' time-averaged mean total cholesterol levels decreased to 7.3 +/- 0.65 mmol/L (280 +/- 25 mg/dl) and 6.4 +/- 0.55 mmol/L (247 +/- 22 mg/dl), respectively. Both children remained clinically well with normal growth and development. There was significant regression of xanthomas in both patients. The older patient required heart surgery for preexisting aortic stenosis and coronary ostial stenosis, but neither patient had progression of hypercholesterolemia-related cardiovascular disease. With the exception of iron (deficiency in patient 1), there was no evidence of depletion of serum components. Adverse reactions to LDL apheresis were rare and never severe. CONCLUSIONS: Dextran sulfate-affinity column LDL apheresis is effective long-term treatment for children with receptor-negative HFH.
Asunto(s)
Eliminación de Componentes Sanguíneos/métodos , Proteínas del Sistema Complemento/análisis , Hiperlipoproteinemia Tipo II/sangre , Hiperlipoproteinemia Tipo II/terapia , Lipoproteínas LDL/aislamiento & purificación , Apolipoproteínas/sangre , Eliminación de Componentes Sanguíneos/efectos adversos , Enfermedades Cardiovasculares/etiología , Niño , Desarrollo Infantil/fisiología , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , VLDL-Colesterol/sangre , Femenino , Estudios de Seguimiento , Homocigoto , Humanos , Hiperlipoproteinemia Tipo II/complicaciones , Hiperlipoproteinemia Tipo II/fisiopatología , Pierna , Lipoproteínas LDL/sangre , Masculino , Índice de Severidad de la Enfermedad , Enfermedades de la Piel/etiología , Factores de Tiempo , Triglicéridos/sangre , Vitaminas/sangre , Xantomatosis/etiologíaRESUMEN
Because much data have accrued to support the concept that oxidatively modified LDL (Ox-LDL) can promote atherogenesis, the role of antioxidants in decreasing LDL oxidation has assumed great importance. High-dose alpha-tocopherol supplementation in humans decreases the susceptibility of LDL to oxidation. Hence, the aim of the present study was to ascertain the minimum dose of alpha-tocopherol that would decrease the susceptibility of LDL to oxidation. The effect of alpha-tocopherol in doses of 60, 200, 400, 800, and 1200 IU/d on copper-catalyzed LDL oxidation was tested in a randomized placebo-controlled study over 8 weeks. There were eight subjects in each group. Oxidation of LDL was monitored by measuring the formation of conjugated dienes and lipid peroxides by the thiobarbituric acid-reacting substances (TBARS) assay over an 8-hour time course at baseline and after 8 weeks of supplementation. Neither placebo nor any of the doses of alpha-tocopherol resulted in any side effects or exerted an adverse effect on the plasma lipoprotein profile. However, there was a dose-dependent increase in plasma and lipid-standardized alpha-tocopherol levels with increasing doses of alpha-tocopherol supplementation. LDL alpha-tocopherol appeared to follow a similar trend. When the time-course curves of LDL oxidation and the kinetics of LDL oxidation were examined, there was no significant effect at 8 weeks compared with baseline in the groups that received placebo or alpha-tocopherol 60 or 200 IU/d.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Antioxidantes/administración & dosificación , Lipoproteínas LDL/metabolismo , Vitamina E/administración & dosificación , Adulto , Antioxidantes/farmacología , Relación Dosis-Respuesta a Droga , Ácidos Grasos/sangre , Humanos , Masculino , Oxidación-Reducción/efectos de los fármacos , Vitamina E/farmacologíaRESUMEN
OBJECTIVE: To study effects of variation in carbohydrate content of diet on glycemia and plasma lipoproteins in patients with non-insulin-dependent diabetes mellitus (NIDDM). DESIGN: A four-center randomized crossover trial. SETTING: Outpatient and inpatient evaluation in metabolic units. PATIENTS: Forty-two NIDDM patients receiving glipizide therapy. INTERVENTIONS: A high-carbohydrate diet containing 55% of the total energy as carbohydrates and 30% as fats was compared with a high-monounsaturated-fat diet containing 40% carbohydrates and 45% fats. The amounts of saturated fats, polyunsaturated fats, cholesterol, sucrose, and protein were similar. The study diets, prepared in metabolic kitchens, were provided as the sole nutrients to subjects for 6 weeks each. To assess longer-term effects, a subgroup of 21 patients continued the diet they received second for an additional 8 weeks. MAIN OUTCOME MEASURES: Fasting plasma glucose, insulin, lipoproteins, and glycosylated hemoglobin concentrations. Twenty-four-hour profiles of glucose, insulin, and triglyceride levels. RESULTS: The site of study as well as the diet order did not affect the results. Compared with the high-monounsaturated-fat diet, the high-carbohydrate diet increased fasting plasma triglyceride levels and very low-density lipoprotein cholesterol levels by 24% (P < .0001) and 23% (P = .0001), respectively, and increased daylong plasma triglyceride, glucose, and insulin values by 10% (P = .03), 12% (P < .0001), and 9% (P = .02), respectively. Plasma total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels remained unchanged. The effects of both diets on plasma glucose, insulin, and triglyceride levels persisted for 14 weeks. CONCLUSIONS: In NIDDM patients, high-carbohydrate diets compared with high-monounsaturated-fat diets caused persistent deterioration of glycemic control and accentuation of hyperinsulinemia, as well as increased plasma triglyceride and very-low-density lipoprotein cholesterol levels, which may not be desirable.