Microalbuminuria is not associated with cardiovascular disease in patients with homozygous familial hypercholesterolaemia

Zouvanis, Michael; Raal, Frederick J.; Joffe, B. I.; Seftel, H. C.

doi:10.1016/0021-9150(94)05443-m

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…FH subjects, on the other hand, have normal or only mildly elevated triglyceride levels, normal postprandial lipaemia [34] and large, rather than small, LDL particles [35], and thus have few, if any, features of the metabolic syndrome. This is also supported by the findings in a previous study in which we found no association between microalbuminuria, another proposed marker of the metabolic syndrome which is also considered to be a predictor of cardiovascular disease, and atherosclerosis in subjects with homozygous FH [36]. Our study also shows that leptin levels are not influenced by the degree of hyperlipidaemia, and that BMI is also the major determinant of leptin levels in FH patients.…”

Section: Discussionsupporting

confidence: 92%

Atherosclerosis seems not to be associated with hyperinsulinaemia in patients with familial hypercholesterolaemia

Raal

Panz

Pilcher

et al. 1999

Journal of Internal Medicine

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Objective. To study the relationship between hyperinsulinaemia, insulin resistance, leptin and atherosclerosis in subjects with familial hypercholesterolaemia (FH). Design. Case-control cross-sectional study. Setting. Lipid clinic, Johannesburg Hospital, South Africa. Subjects and methods. Fasting serum lipid, glucose, insulin and leptin levels were measured in 24 homozygous FH subjects; 20 FH heterozygotes without coronary artery disease (CAD); 22 heterozygotes with documented CAD; and 20 healthy normocholesterolaemic subjects. Insulin resistance was calculated using the homeostasis model assessment (HOMA) formula. Results. Mean glucose and insulin levels were similar in all 4 groups. There was no significant difference in calculated insulin resistance between any of the groups. There was also no relationship between the degree of insulin resistance and total or LDL-cholesterol levels. Using Spearman's correlation coefficient (R s ) calculated insulin resistance correlated with triglyceride (R s = 0.27; P , 0.05) and inversely with HDL-cholesterol (R s = ] 0.26; P , 0.05). Fasting insulin concentrations and calculated insulin resistance were similar in FH subjects with overt CAD compared to those without. Leptin levels were higher in the FH subjects with CAD. However, these subjects were older and had a larger body mass index (BMI), and when adjusted for age and BMI, only BMI correlated with leptin levels (multiple r = 0.65; P , 0.001). Conclusions. In the absence of other causes of insulin resistance, FH subjects have normal fasting insulin levels and, in general, they are not insulin resistant. Insulin resistance appears to play little role in the pathogenesis of accelerated atherosclerosis in FH.

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Section: Discussionsupporting

confidence: 92%

Atherosclerosis seems not to be associated with hyperinsulinaemia in patients with familial hypercholesterolaemia

Raal

Panz

Pilcher

et al. 1999

Journal of Internal Medicine

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“…Patients with higher albumin excretion, regardless of the limit for microalbuminuria, had significantly higher cholesterol levels and higher evening neopterin. The results presented here differ from the report by Zouvanis et al (50), who found no microalbuminuria in 15 familial hypercholesterolemia patients and concluded that there is no association between microalbuminuria and coronary artery disease (CAD) in homozygous familial hypercholesterolemia. The authors hypothesized that microalbuminuria in combination with atherosclerosis and CAD is associated with insulin resistance.…”

Section: Discussioncontrasting

confidence: 57%

Urinary Neopterin and Microalbuminuria in Patients Treated by Low-density Lipoprotein Apheresis

Cermanová¹,

Melichar²,

Solichová³

et al. 2005

Pteridines

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ΊΙ. Interni klinika,; Klinika onkologie a radioterapie, -'Klinika gerontologická a metabolická, 4 Katedra lékarské biofyziky, Lékarská fakulta University Karlovy a Fakultní nemocnice Hradee Králové, Czech republic. AbstractLow-density lipoprotein (LDL)-apheresis is a method of extracorporeal elimination of LDL-cholesterol in patients with severe primary lipoprotein disorders. LDL-cholesterol activates macrophages, which play an important role in atheromatous plaque formation. In the present study, we have investigated urinary neopterin, a specific marker of macrophage activation and microalbuminuria, an indicator of generalized vascular dysfunction, after a single LDL-apheresis procedure in 10 patients with severe primary lipoprotein disorder. The urinary neopterin/creatinine ratio was increased in patients compared to controls. No significant changes of the neopterin/creatinine and albumin/creatinine ratios were observed after LDL-apheresis, except a significant (p < 0.006) decrease of urinary neopterin/creatinine ratio in the evening after the apheresis. This decrease showed significant negative correlation with the pre-apheretic levels of atherogenic cholesterol fractions (p < 0.05) and with cholesterol decrease during the apheresis (p < 0.05). Urinary albumin/creatinine ratio correlated positively with total and LDL-cholesterol levels before the apheresis and with the evening urinary neopterin/creatinine ratio after the apheresis, but did not correlate with glycemia and triacylglycerides. Elevated urinary neopterin in the patients with severe primary lipoprotein disorders reflects the presence of atherosclerosis. A single LDL-apheresis procedure did not significantly affect microalbuminuria. The decrease of urinary neopterin in the evening after the apheresis corresponds with the diurnal rhythm of neopterin excretion and was less pronounced in patients with more severe hypercholesterolemia. The correlations between microalbuminuria, neopterin and pre-apheretic cholesterol concentrations indicate a possible connection between microvascular dysfunction, macrophage activity and severity of hyperlipidemia, but these results should be interpreted with caution because of small number of subjects evaluated.

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“…However, previous studies show different results. In a study, 36 there was no association between microalbuminuria and cardiovascular disease in patients with hypercholesterolemia. Similarly, we did not find a relation between properties of coronary arteriosclerosis and microalbuminuria in patients with ACS in this study.…”

Section: Discussionmentioning

confidence: 86%

Microalbuminuria is not associated with endothelial dysfunction and coronary atherosclerosis in patients with acute coronary syndromes

et al. 2010

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Background: Microalbuminuria is associated with atherosclerosis and it is a strong and independent predictor of increased risk for cardiovascular morbidity and mortality. However, the underlying mechanisms of the association of albuminuria and cardiovascular disease are not well understood. We examined the association of endothelial dysfunction with microalbuminuria in non-diabetic and non-hypertensive patients with acute coronary syndromes (ACS). Methods: We compared endothelial function by flow-mediated dilatation (FMD) and glyceryl trinitrate-mediated dilatation (GTN) and angiographic properties among 27 microalbuminuric and 106 normoalbuminuric patients. Severity of coronary arteriosclerosis was evaluated using the Gensini score and number of diseased vessels. Results: We evaluated 133 patients (106 males; mean age 59 ± 11 years). Microalbuminuria was present in 27 (20.3%) subjects. Patients with microalbuminuria and normoalbuminuria had similar baseline characteristics. FMD and GTN responses were not different in microalbuminuric patients compared with normoalbuminuric patients (FMD 8.2 ± 5.3 vs. 7.9 ± 6.5%, p = 0.54 and GTN 9.3 ± 5.4 vs. 10.2 ± 6.9%, p = 0.82). Microalbuminuria was not associated with endothelial dysfunction (p = 0.49). Morphological properties of coronary lesion were not different. Conclusion: The presence of microalbuminuria is not associated with endothelial dysfunction and severity of angiographic coronary atherosclerosis in non-diabetic and non-hypertensive patients with ACS.

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Microalbuminuria is not associated with cardiovascular disease in patients with homozygous familial hypercholesterolaemia

Cited by 7 publications

References 10 publications

Atherosclerosis seems not to be associated with hyperinsulinaemia in patients with familial hypercholesterolaemia

Atherosclerosis seems not to be associated with hyperinsulinaemia in patients with familial hypercholesterolaemia

Urinary Neopterin and Microalbuminuria in Patients Treated by Low-density Lipoprotein Apheresis

Microalbuminuria is not associated with endothelial dysfunction and coronary atherosclerosis in patients with acute coronary syndromes

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