An evaluation of lipid profile and pro-inflammatory cytokines as determinants of cardiovascular disease in those with diabetes: a study on a Mexican American cohort

Abstract

Sedentary life styles coupled with high-calorie diets and unhealthy social habits such as smoking, have put an ever-increasing number of people at risk of cardiovascular disorders (CVD), worldwide. A concomitant increase in the prevalence of type 2-diabetes (hyperglycemia), a risk factor for CVD, has further contributed towards escalating CVD-related mortalities. The increase in number of cases of type 2-diabetes underscores the importance of early diagnosis of cardiovascular disease in those with diabetes. In this work, we have evaluated the sensitivity and specificity of dyslipidemia and proinflammatory cytokines to be used as biomarkers for predicting the risk of CVD in those with diabetes. We hypothesize that interplay between dyslipidemia and diabetes-induced low-grade inflammation in those with type 2-diabetes increases the risk of CVD. A total of 215 participants were randomly recruited from the Cameron County Hispanic Cohort (CCHC). Of these, 99% were Mexican Americans living on Texas-Mexico border. Levels of cytokines, adipokines and lipid profile were measured. Cardiovascular disease (CVD) for this study was defined as prior diagnosis of heart attack, angina and stroke, while diabetes was defined by fasting blood glucose (FBG) of > 100 mg/dL and HbA1c of > 6.5, in accordance with American Diabetes Association (ADA) guidelines. Depending on type and distribution of data, various statistical tests were performed. Our results demonstrated higher rates of heart attack (14% vs 11.8%) and stroke (19.8% vs 10%) in those with diabetes as compared to non-diabetes. The odds of having a heart attack were eight times higher in the presence of elevated triglycerides and pro-inflammatory markers (TNFα and IL6) as compared to presence of pro-inflammatory markers only. The odds for heart attack among those with diabetes, increased by 20 fold in presence of high levels of triglycerides, TNFα, and IL6 when coupled with low levels of high-density lipid cholesterol (HDL-C). Lastly, our analysis showed that poorly controlled diabetes, characterized by HbA1c values of > 6.5 increases the odds of stroke by more than three fold. The study quantifies the role of lipid profile and pro-inflammatory markers in combination with standard risk factors towards predicting the risk of CVD in those with type 2-diabetes. The findings from the study can be directly translated for use in early diagnosis of heart disease and guiding interventions leading to a reduction in CVD-associated mortality in those with type 2-diabetes.

N-acetylcysteine attenuates atherosclerosis progression in aging LDL receptor deficient mice with preserved M2 macrophages and increased CD146

“…Although the exact mechanisms for the development and progression of atherosclerosis are complex and not fully defined, inflammation and related oxidative stress play a critical role in the pathogenesis of atherosclerosis. The levels of inflammatory cytokines including TNF-α, IL-1β, and IL-6 are significantly increased in hyperlipidemic states [30]. These cytokines could activate local and systemic inflammatory responses with increased ROS production and oxidative stress and accelerate the development of atherosclerosis [31,32].…”

Combined Intranasal Insulin/Saxagliptin/Metformin Therapies Ameliorate the Effect of Combined Oral Contraceptive- (COC-) Induced Metabolic Syndrome (MetS) with a Major Target on Glucose Metabolism in Adult Female Wistar Rats

“…Lipid profile analysis, with particular focus on the HDL, LDL, and triglyceride level, has been specifically linked to metabolic syndrome [ 60 ]. Combined oral contraceptive use reduced the level of HDL; this reduction was reversed by intranasal insulin and saxagliptin combined therapy; LDL and total cholesterol levels were reduced by the administration of norethindrone; however, triglyceride levels were not affected by the combined contraceptives.…”

Cardiovascular risk among 6-8-year-old children living in urban and rural communities in Ecuador: A cross-sectional analysis

“…dietary intake, physical inactivity, socioeconomic factors, and urbanization are important risk factors for dyslipidemia and cardiovascular diseases (15)(16)(17). In Latin America, the consumption of energy-dense, nutrition-poor foods has dramatically increased, while the intake of fruit, vegetables, whole grains, cereals, and legumes has decreased (3,4).…”