High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are strong predictors of atherosclerosis. Statin-induced changes in the ratio of LDL-C to HDL-C (LDL-C/HDL-C) predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the best predictor of subclinical atherosclerosis remains unknown. Our objective was to investigate this issue by measuring changes in carotid intima-media thickness (IMT). A total of 1,920 subjects received health examinations in 1999, and were followed up in 2007. Changes in IMT (follow-up IMT/baseline IMT × 100) were measured by ultrasonography. Our results showed that changes in IMT after eight years were significantly related to HDL-C (inversely, P < 0.05) and to LDL-C/HDL-C ratio (P < 0.05). When the LDL-C/HDL-C ratios were divided into quartiles, analysis of covariance showed that increases in the ratio were related to IMT progression (P < 0.05). This prospective study demonstrated the LDL-C/HDL-C ratio is a better predictor of IMT progression than HDL-C or LDL-C alone.
Abstract-Aldosterone plays a role in hypertension, and hypertension is prevalent in patients with insulin resistance.Cross-sectional studies have reported that plasma aldosterone levels are higher in patients with insulin resistance. However, it is not known whether plasma aldosterone levels predict the development of insulin resistance. Subjects of the present study were 1235 local residents (490 men and 745 women) who participated in health screenings in Japan in 1999. Plasma aldosterone levels were measured by radioimmunoassay. We investigated the cross-sectional relationship between plasma aldosterone levels and insulin resistance (homeostasis model assessment index Ն1.73 according to the diagnostic criteria used in Japan) in 1088 nondiabetic participants. At the 10-year follow-up, 141 subjects had died, and 260 subjects refused re-examination. We performed a prospective analysis of 564 subjects to predict incident insulin resistance. We found a significant (PϽ0.001) cross-sectional relationship between plasma aldosterone and homeostasis model assessment index at baseline. In the prospective analysis, a significantly higher (PϽ0.05) relative risk ( he most important physiological role of aldosterone is to control water homeostasis and electrolytes balance. High levels of adrenal aldosterone secretion cause hypertension, that is, primary aldosteronism, a well-known form of secondary hypertension. Moreover, high plasma aldosterone levels predict the development of hypertension. 1 In view of the fact that aldosterone is a mineral corticosteroid, the association of aldosterone and hypertension is not doubted. Recently, the association between aldosterone and obesity or insulin resistance has attracted much attention. Experimental evidence suggests an interaction between aldosterone and insulin. 2 Aldosterone induces hypokalemia, which may modulate insulin secretion, has direct effects on insulin receptor function, 3,4 causes pancreatic -cell dysfunction or even apoptosis, 5 interferes with insulin signaling pathways, 6 and decreases insulin sensitivity in human adipocytes in vitro. 7 Moreover, aldosterone reduces the expression of insulinsensitizing factors, such as adiponectin and peroxisome proliferator-activated receptor-␥, in obese, diabetic mice. 8 In addition to the above-mentioned in vitro and animal studies, several clinical studies reported an association between plasma aldosterone levels and insulin resistance. Plasma aldosterone levels are elevated in hypertensive obese subjects. 9 Cross-sectional studies have shown an association between plasma aldosterone levels and insulin resistance in hypertensive and normotensive subjects. 10,11 Moreover, insulin resistance was restored by surgical intervention or mineralocorticoid receptor blocker in primary hyperaldosteronism. 12 However, contradictory results were reported by other investigators showing no difference of glucose metabolism in a relatively small number of subjects with primary hyperaldosteronism and essential hypertension 13 and showing no cha...
Our 10-year prospective study suggests that elevated serum HGF levels were significantly associated with the development of IR.
Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ndothelin-1 (ET-1) is an endothelium-derived vasoconstrictor peptide with 21-amino acid residues, originally isolated from culture media conditioned by porcine aortic endothelial cells. 1 ET-1 causes vascular damage 2,3 and is highly expressed in damaged vessels. 4-6 Moreover, the plasma ET-1 level is a predictor of mortality in patients with cardiovascular diseases such as acute myocardial infarction (MI), 7 congestive heart failure 8 and critical leg ischemia. 9 ET-1 is also a potent hypoxia-inducible angiogenic growth factor associated with the development and growth of solid tumors. 10 ET-1 is highly expressed in the tissues of several types of cancers and the plasma level is elevated. 11-14 Moreover, the plasma ET-1 level is a predictor of mortality in patients with several types of cancers. 13,14 However, all previous mortality data have been derived from patients with existing pathological cardiovascular disease and malignancies. Little information is available on the predictive ability of the plasma ET-1 level for cardiovascular and cancer deaths in apparently healthy subjects. Accordingly, we examined whether the plasma ET-1 level would predict 10-year cardiovascular, cancer and all-cause deaths in a general population. Methods Study PopulationA periodic epidemiological survey was performed in 1999 in a small farming community, Tanushimaru (a cohort of the Seven Countries Study 15 ), in southwestern Japan. As reported previously, the demographic background of the subjects in this area is similar to that of the general Japanese population. 16 Of the 1,492 subjects in the original study in 1999, subjects with a history of MI, stroke, or cancer were excluded. Subjects (n=12) with abnormal Q waves (Minnesota codes I1,2) 17 were also censored from the study. Finally, plasma ET-1 levels were obtained from 1,440 subjects (aged over 40 years: 580 men, 860 women) who were followed for 10 years. Background: Endothelin-1 (ET-1) is a potent vasoconstrictor and an elevated plasma level is a prognostic marker in patients with cardiovascular diseases and/or malignancies. We hypothesized that an elevated plasma level might be a prognostic marker even in subjects without apparent cardiovascular disease or malignancy at baseline.
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