This review presents existing evidence of the influence of saturated and unsaturated fatty acids on cardiovascular diseases (CVD). Data are discussed regarding the roles of the most relevant fatty acids, such as myristic (C14:0), palmitic (C16:0), stearic (C18:0), palmitoleic (C16:1), oleic (C18:1), linoleic (C18:2), α-linolenic (C18:3, ω-3), γ-linolenic (C18:3, ω-6), arachidonic (C20:4), eicosapentaenoic (C20:5), docosahexaenoic (C22:6), and docosapentaenoic (C22:5) acid. The accumulated knowledge has expanded the understanding of the involvement of fatty acids in metabolic processes, thereby enabling the transition from basic exploratory studies to practical issues of application of these biomolecules to CVD treatment. In the future, these findings are expected to facilitate the interpretation and prognosis of changes in metabolic lipid aberrations in CVD.

Adipose tissue is considered one of the endocrine organs in the body because of its ability to synthesize and release a large number of hormones, cytokines, and growth and vasoactive factors that influence a variety of physiological and pathophysiological processes, such as vascular tone, inflammation, vascular smooth muscle cell migration, endothelial function, and vascular redox state. Moreover, genetic factors substantially contribute to the risk of obesity. Research into the biochemical effects of molecules secreted by visceral adipocytes as well as their molecular genetic characteristics is actively conducted around the world mostly in relation to pathologies of the cardiovascular system, metabolic syndrome, and diabetes mellitus. Adipokines could be developed into biomarkers for diagnosis, prognosis, and therapeutic targets in different diseases. This review describes the relevance of secretory activity molecules of visceral adipocytes in cardiovascular disease associated abdominal obesity.

We studied associations of osteocalcin, osteoprotegerin, and calcitonin with markers of inflammation in atherosclerotic plaques in coronary arteries and assessed the influence of these biomolecules on calcification of atherosclerotic plaques. The initial stage of calcification of atherosclerotic plaques is characterized by activation of inflammatory processes, which is seen from increased levels of proinflammatory biomarkers (IL-6, IL 8, TNF-α, and IL-1β). Progressive calcification of atherosclerotic plaques is accompanied by insignificant accumulation of calcitonin and osteoprotegerin. The exception is osteocalcin, its concentration significantly increased during calcification. The results suggest that severe vascular calcification can be regarded as non-specific marker of atherosclerosis. Instability of atherosclerotic plaques is associated with higher level of calcification.

SummaryBackgroundThe objective of this work was to study the profile of fatty acids and to search for associations of fatty acids with oxidative-antioxidant parameters and an oxidative-inflammatory biomarker (lipoprotein-associated phospholipase A2) in men with coronary atherosclerosis and coronary heart disease.MethodsAnalysis of 20 fatty acids was performed in 60 men with angiographically confirmed coronary atherosclerosis and coronary heart disease and in a control group of men without coronary heart disease. Serum fatty-acid content was evaluated by high-performance gas-liquid chromatography. The blood levels of oxidative stress, total antioxidative defence, and lipoprotein-associated phospholipase 2 were analyzed.ResultsIn the group of men with coronary atherosclerosis the levels of myristic and palmitic fatty acids were higher by 59% and 22%, respectively. An increase in the weight percentage of monounsaturated fatty acids was noted, such as palmitoleic, oleic, and octadecenic. Significantly lower levels of polyunsaturated fatty acids, such as linolic, eicosadienoic, eicosatrienoic, arachidonic, eicosapentaenoic, γ-linolenic, docosapentaenoic, and docosahexaenoic were detected in the group with coronary atherosclerosis. The lipoprotein-associated phospholipase A2 level was higher by 48%. Oxidative stress was higher by 17%, and the total antioxidant defence in serum was lower by 45%. We found correlations between fatty acids and oxidative-antioxidative alterations. The relative risk of vulnerable atherosclerotic plaques correlated with increased levels of palmitic, stearic, oleic, and linolic fatty acids.ConclusionsSignificant alterations in the profile of fatty acids are associated with oxidative-antioxidative alterations and are accompanied by an increase in free-radical formation, which can probably serve as a risk factor of atherosclerosis.

We studied the balance of fatty acids and their correlation with parameters of lipid metabolism and inflammation markers in men with coronary atherosclerosis. In the blood of patients and healthy men, the content of myristic (C14:0), pentadecanoic (C15:0), palmitic (C16:0), stearic (C18:0), arachidic (C20:0) and docosanic (C22:0), TNFα, IL-1β, IL-6, IL-8, C-reactive protein, cholesterol, triglycerides, HDL, and LPO intensity were measured. In patients with coronary atherosclerosis, increased concentrations of saturated fatty acids, triglycerides, LPO products, IL-6, IL-8, and C-reactive protein were found. Correlation analysis revealed multiple correlations between the studied fatty acids, correlation of C16:0, C18:0, and C20:0 with inflammation markers, C14:0, C16:0, and C18:0 with triglyceride level, C16:0, C18:0, and C20:0 with cholesterol. The contents of C14:0, C15:0, C16:0, and C18:0 correlated with the presence of coronary atherosclerosis. Lipid metabolism disturbances in coronary atherosclerosis were accompanied by changes in not only lipid spectrum and inflammation markers, but also fatty acids balance.

Inflammatory biomarkers and chemoattractants characteristic and important for different types (lipid; inflammatory erosive; degenerative necrotic) of unstable plaques in coronary arteries were identified and studied in male patients with coronary atherosclerosis without acute coronary syndrome we studied. Among the three types of unstable plaques, elevated concentrations of IL-1β, IL-6, IL-8, IL-18 and monocyte chemotactic protein-1 were characteristic of not only inflammatory erosive type, but also lipid type compared with degenerative necrotic type. Thus, intensification of the inflammatory process plays an important role in the development of not only inflammatory and destructive, but also of lipid type of unstable atherosclerotic plaques.

The concentrations of LPO products (including those present in LDL), oxidative modification of proteins, paraoxonase activity, concentrations of antioxidants, lipid values and biomarkers of endothelial dysfunction were studied in the blood and coronary artery intima/media of male patients with coronary atherosclerosis without acute coronary syndrome. Blood levels of LDL oxidized apolipoproteins and lipoprotein (a) were higher, while the content of NO metabolites, sVCAM endothelial adhesion molecules, and LDL oxidation resistance were lower in men with mainly unstable atherosclerotic plaques in the coronary arteries in comparison with men with mainly stable plaques in the coronary arteries. Of these blood biomarkers, only NO metabolites, oxidized proteins, and sVCAM correlated with the presence of unstable atherosclerotic plaques. A significant correlation between the levels of biomarkers in the vascular wall and blood was detected only for LPO parameters.

Резюме Цель исследования. Изучить диагностически значимые для стабильных и нестабильных атеросклеротических бляшек (АСБ) разных типов показатели активности матриксных металлопротеиназ-ММП-3, ММП-7, ММП-9 в гомогенатах и тканевую экспрессию ММП-2, ММП-9 и коллагена 4-го типа. Материалы и методы. В исследование включены 54 мужчины с коронарным атеросклерозом без острого коронарного синдрома, у которых в ходе операции коронарного шунтирования проведена эндартерэктомия из коронарной артерии. В полученных образцах методом иммуноферментного анализа определяли уровни ММП-3, ММП-7 и ММП-9; выявляли тканевую экспрессию ММП-2, ММП-9 и коллагена 4-го типа. Результаты. В нестабильных АСБ повышена активность ММП-7 и ММП-9, отмечаются значительное увеличение тканевой экспрессии ММП-2 и ММП-9, снижение экспрессии коллагена 4-го типа. Из 3 типов нестабильных АСБ наибольшая тканевая экспрессия ММП-9 выявлена в АСБ липидного типа в сравнении с дистрофически-некротическим и воспалительно-эрозивным, а экспрессия коллагена 4-го типа преобладала в дистрофически-некротических АСБ. Заключение. Проведенное исследование определяет тканевую экспрессию коллагена как маркер стабильности фиброзной покрышки, а наличие металлопротеиназ в некротическом детрите, структурах внеклеточного матрикса и клеточных элементах может характеризовать АСБ как нестабильную либо находящуюся в переходном структурном состоянии. Иммуногистохимический метод позволяет выявить структурные элементы, характеризующие нестабильность в АСБ различных типов.