Novel and traditional lipid profiles in Metabolic Syndrome reveal a high atherogenicity

Paredes, Sílvia; Fonseca, Liliana; Ribeiro, Laura; Ramos, Helena; Oliveira, José Carlos; Palma, Isabel

doi:10.1038/s41598-019-48120-5

Cited by 41 publications

(31 citation statements)

References 43 publications

(57 reference statements)

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“…Elevated triglycerides are common in MetS and correlate with elevated cardiovascular risk [ 10 ]. Triglycerides are primarily carried by very low density lipoprotein (VLDL) in circulation [ 11 ]. In the postprandial state, the triglyceride level varies greatly and is affected largely by VLDL-related metabolism [ 12 – 14 ]; therefore, hypertriglyceridemia is preferentially defined by fasting triglyceride values [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

The role of postprandial very-low-density lipoprotein in the development of atrial remodeling in metabolic syndrome

et al. 2020

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Background Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and remodeling of left atrium. Methods Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 h after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrium diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P < 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P < 0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-h postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm. Conclusions Postprandial VLDL-χ is associated with atrial remodeling particularly in the MetS group. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients. Trial registration ISRCTN 69295295. Retrospectively registered 9 June 2020.

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Section: Introductionmentioning

confidence: 99%

The role of postprandial very-low-density lipoprotein in the development of atrial remodeling in metabolic syndrome

et al. 2020

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“…Accordingly, the 2019 guidelines update have also highlighted the importance of ApoB and non-HDL-c measurements in patients with diabetes. In fact,ApoB is also recommended to assess CV risk, particularly in individuals with hypertriglyceridemia, diabetes, obesity, metabolic syndrome and very low LDL-c levels and it can be used as an alternative to LDL-c for screening, diagnosis and management(6,13). The present study shows that in type 2 diabetes individuals there are several atherosclerotic lipoproteins that remain elevated even when patients present an optimal LDL-c level.…”

mentioning

confidence: 99%

Apolipoprotein B and non-high-density lipoprotein cholesterol reveal a high atherogenicity in individuals with type 2 diabetes and controlled low-density lipoprotein-cholesterol

Fonseca

Paredes

Ramos

et al. 2020

Preprint

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Purpose: Lipid-lowering therapy is guided by Low-density-lipoprotein cholesterol (LDL-c), although the CVD risk could be better reflected by other lipid parameters. This study aimed the evaluation of a comprehensive lipid profile in patients with type 2 diabetes mellitus (T2DM) and comparation of those achieving and not achieving LDL-c control in respect to other non-conventional lipid parameters. Methods: We characterized a comprehensive lipid profile in 96 T2DM patients. ESC/EAS 2016 and 2019 Guidelines for the Management of Dyslipidemias were used to define LDL-c targets. Atherogenic lipoprotein profile was compared in patients with LDL-c within and above the target. Results: Only 28.1% and 16.7% of patients had mean LDL-c levels within the 2016 and 2019 guidelines, respectively. In patients with LDL-c within target by the 2016 guidelines, 22%, 25% and 44% presented levels above the recommended range for non-HDL-c, ApoB and oxidized LDL-c, respectively, whereas accordingly to the 2019 guidelines, 50%, 39% and 44% had elevated levels of -HDL-c, ApoB and oxidized LDL-c, respectively. There was a significant strong association of LDL-c and non-HDL-c (r=0.850), ApoB (r=0.656) and oxidized LDL-c (r=0.508). Similarly, non-HDL-c was significantly strongly correlated with ApoB (r=0.808) and oxidized LDL-c (r=0.588). Conclusions: These findings emphasize the limitations of a sole LDL-c measurement for CV risk assessment. Targeting only LDL-c could result in missed opportunities for CV risk reduction in T2DM individuals. Our data suggest that non-HDL-c, ApoB and oxidized LDL-c could be considered as part of these patients’ evaluation allowing a more accurate estimation of CV risk and treatment among these high-risk patients.

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“…A cluster of health-related conditions occurs due to altered metabolisms, including modified lipid profiles with decreased high-density lipoproteins (HDLs) and increased very low-density lipoproteins (VLDLs), increased triglycerides as well as blood glucose levels and high blood pressure, which advances to metabolic syndromes such as obesity and type 2 diabetes and are independently associated with an increased risk for cardiovascular diseases, such as CAD and stroke [187]. These circulating blood cholesterols provoke crater-like defects and balloon-like protrusions on the surfaces of blood vessels, indicating endothelial cell damage, which leads to auto-oxidation and results in the generation of atherogenic oxidative derivatives [188].…”

Section: Implication Of Pd-1/pd-l1 Axis In the Altered Metabolism Durmentioning

confidence: 99%

Delicate Role of PD-L1/PD-1 Axis in Blood Vessel Inflammatory Diseases: Current Insight and Future Significance

Veluswamy

Wacker

Scherner

et al. 2020

IJMS

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Immune checkpoint molecules are the antigen-independent generator of secondary signals that aid in maintaining the homeostasis of the immune system. The programmed death ligand-1 (PD-L1)/PD-1 axis is one among the most extensively studied immune-inhibitory checkpoint molecules, which delivers a negative signal for T cell activation by binding to the PD-1 receptor. The general attributes of PD-L1’s immune-suppressive qualities and novel mechanisms on the barrier functions of vascular endothelium to regulate blood vessel-related inflammatory diseases are concisely reviewed. Though targeting the PD-1/PD-L1 axis has received immense recognition—the Nobel Prize in clinical oncology was awarded in the year 2018 for this discovery—the use of therapeutic modulating strategies for the PD-L1/PD-1 pathway in chronic inflammatory blood vessel diseases is still limited to experimental models. However, studies using clinical specimens that support the role of PD-1 and PD-L1 in patients with underlying atherosclerosis are also detailed. Of note, delicate balances in the expression levels of PD-L1 that are needed to preserve T cell immunity and to curtail acute as well as chronic infections in underlying blood vessel diseases are discussed. A significant link exists between altered lipid and glucose metabolism in different cells and the expression of PD-1/PD-L1 molecules, and its possible implications on vascular inflammation are justified. This review summarizes the most recent insights concerning the role of the PD-L1/PD-1 axis in vascular inflammation and, in addition, provides an overview exploring the novel therapeutic approaches and challenges of manipulating these immune checkpoint proteins, PD-1 and PD-L1, for suppressing blood vessel inflammation.

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Novel and traditional lipid profiles in Metabolic Syndrome reveal a high atherogenicity

Cited by 41 publications

References 43 publications

The role of postprandial very-low-density lipoprotein in the development of atrial remodeling in metabolic syndrome

The role of postprandial very-low-density lipoprotein in the development of atrial remodeling in metabolic syndrome

Apolipoprotein B and non-high-density lipoprotein cholesterol reveal a high atherogenicity in individuals with type 2 diabetes and controlled low-density lipoprotein-cholesterol

Delicate Role of PD-L1/PD-1 Axis in Blood Vessel Inflammatory Diseases: Current Insight and Future Significance

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