oronary heart disease (CHD) is still one of the major causes of deaths in Japan. 1 Moreover, CHD mortality is expected to increase in the near future because the lifestyles of the Japanese, such as their dietary habits, have become westernized. 2 Indeed, it has been reported that young Japanese patients with CHD who have multiple coronary risk factors, including hypertension, hyperlipidemia, and obesity, all of which might be associated with their lifestyles, have been increasing. 3 Therefore, it is important in the field of cardiovascular preventive medicine to identify those at risk of CHD in general populations.Increased arterial stiffness has been shown to be associated not only with several coronary risk factors, 4-11 but also with the future development of CHD. [12][13][14][15][16][17][18] Recently, the second derivative of the finger photoplethysmogram (SDPTG) has been developed as one of the non-invasive and convenient methods for pulse-wave analysis. [19][20][21] The SDPTG is obtained from double differentiation of the finger photoplethysmogram (PTG) and is thought to provide structural and functional properties of both central and peripheral arteries. 19 Indeed, an index calculated from the SDPTG showed a significant association with age, 19,20,[22][23][24] carotid arterial distensibility, 25 and the aortic augmentation index (AIx). 19,21 In addition, the SDPTG indices were independently influenced by several risk factors for atherosclerosis in patients with hypertension 23 and in the general population. 24 However, it is still unclear as to whether the SDPTG indices are related to the coronary risk factors, or moreover, the risk for the future development of CHD in apparently healthy individuals.Thus, we conducted a cross-sectional study in a Japanese community to assess the relationship between the SDPTG indices and coronary risk factors in subjects with no apparent atherosclerotic disorders. Furthermore, we calculated the Framingham risk score, 26 which has been used to estimate an individual's risk of CHD, and determined the optimal cut-off points of the SDPTG indices to discriminate individuals at risk of CHD. Methods Study PopulationIn the present study, 211 subjects (age: 63±15 years, range: 21-91 years, 93 males) who underwent both SDPTG recording and blood sampling after an overnight fast were recruited from the annual health examination in a community, Yamanashi, Japan, in 2004 and. Subjects with a history or presence of atherosclerotic disorders, such as CHD, stroke, and peripheral obstructive arterial disease, were excluded from the study. We also excluded subjects with renal dysfunction (serum creatinine ≥1.3 mg/dl) or patients who had taken medications for hypertension, hyperlipidemia, or diabetes mellitus. Subjects with abnormal Q-waves on the 12-lead electrocardiogram at rest were also excluded. This study protocol was approved by the
SUMMARYIt has been reported that green tea consumption reduces the risk of coronary artery disease and cardiac events. Catechin is a major constituent of Japanese green tea and an antioxidant. Lipids and oxidization of low-density lipoprotein cholesterol (LDL-C) play important roles in atherosclerosis. Therefore, we evaluated the effect of catechin intake on the lipid profile and plasma oxidized LDL. The study population consisted of 40 healthy adult volunteers (10 men, 30 women). Catechin was extracted from green tea leaves. The subjects were randomly divided into two groups, a catechin group (n = 29) and a control group (n = 11). In the catechin group, catechin (500 mg: equivalent to 6 or 7 cups of green tea) was administered orally. Venous blood samples were obtained before eating a meal at the start and after 4 weeks without any lifestyle modification. Plasma oxidized LDL assay was performed with a sandwich-type enzyme immunoassay using anti-oxidized phosphatidylcholine monoclonal antibody. The baseline lipid profiles and tea consumptions were similar between the two groups. Plasma oxidized LDL was significantly decreased after catechin administration (from 9.56 ± 9.2 to 7.76 ± 7.7 U/mL, P = 0.005), while plasma LDL-C, triglyceride, and HDL-C concentrations did not change. Catechin decreased the plasma oxidized LDL concentration without significant change in plasma LDL concentration. The mechanism of the beneficial effects of green tea on coronary artery disease might result from a decrease in plasma oxidized LDL. (Int Heart J 2007; 48: 725-732)
OBJECTIVETo determine if prediabetes is associated with atherosclerosis of coronary arteries, we evaluated the degree of coronary atherosclerosis in nondiabetic, prediabetic, and diabetic patients by using coronary angioscopy to identify plaque vulnerability based on yellow color intensity.RESEARCH DESIGN AND METHODSSixty-seven patients with coronary artery disease (CAD) underwent angioscopic observation of multiple main-trunk coronary arteries. According to the American Diabetes Association guidelines, patients were divided into nondiabetic (n = 16), prediabetic (n = 28), and diabetic (n = 23) groups. Plaque color grade was defined as 1 (light yellow), 2 (yellow), or 3 (intense yellow) based on angioscopic findings. The number of yellow plaques (NYPs) per vessel and maximum yellow grade (MYG) were compared among the groups.RESULTSMean NYP and MYG differed significantly between the groups (P = 0.01 and P = 0.047, respectively). These indexes were higher in prediabetic than in nondiabetic patients (P = 0.02 and P = 0.04, respectively), but similar in prediabetic and diabetic patients (P = 0.44 and P = 0.21, respectively). Diabetes and prediabetes were independent predictors of multiple yellow plaques (NYPs ≥2) in multivariate logistic regression analysis (odds ratio [OR] 10.8 [95% CI 2.09–55.6], P = 0.005; and OR 4.13 [95% CI 1.01–17.0], P = 0.049, respectively).CONCLUSIONSCoronary atherosclerosis and plaque vulnerability were more advanced in prediabetic than in nondiabetic patients and comparable between prediabetic and diabetic patients. Slight or mild disorders in glucose metabolism, such as prediabetes, could be a risk factor for CAD, as is diabetes itself.
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