Vegetovascular dysfunction as an integral parameter of high risk for cardiovascular diseases development in young subjects

AIM: To study manifestations of vegetative dystonia in children of probands from families with hereditary IHD load regarding the main risk factors. MATERIALS AND METHODS: 44 individuals aged 21 +/- 0.7 years were selected out of 111 children from 103 examined families the fathers of which had transmural or macrofocal myocardial infarction at the age under 50. 22 of 44 examinees had syndrome of vegetovascular dystonia (VVD). RESULTS: Children of probands with family history of cardiovascular disease and having VVD had levels of cholesterol, triglycerides and apoB higher, but HDLP cholesterol lower than those free of VVD. In daughters of the probands insulin and hydrocortisone levels were high whereas sons with VVD had only insulin levels higher. CONCLUSION: Children of probands of both sexes had high coefficients of hormonal and metabolic adaptation dependent on the severity of VVD syndrome.     

Effects of plant stanol and sterol esters on serum phytosterols in a family with familial hypercholesterolemia including a homozygous subject

We studied the concentrations and ratios to cholesterol of noncholesterol sterols reflecting absorption (eg, campesterol) or synthesis (eg, lathosterol) of cholesterol off and on plant sterol and stanol ester spreads in serum and in different lipoproteins of a family with familial hypercholesterolemia, including heterozygous parents receiving no treatment and their homozygous offspring undergoing long-term treatment with statins and apheresis. Serum cholesterol levels were similar in the homozygous and heterozygous individuals, but the concentrations of sterols reflecting cholesterol absorption were as much as 10 times greater in the homozygous child than in the heterozygous parents, whereas the respective markers of cholesterol synthesis only tended to be higher. About 70% of squalene in the homozygous individual (60% in the heterozygous family members) and 85% to 90% of noncholesterol sterols (60%-80% in the heterozygous subjects) were transported by low-density lipoprotein. The ratios of absorption sterols to cholesterol were higher in high-density lipoprotein (HDL) than in very low-density lipoprotein (VLDL), whereas those of synthesis markers and plant stanols were highest in VLDL. The ratios of absorption sterols in serum were mostly lower than those in HDL but higher than in VLDL, whereas the ratios of synthesis sterols in serum were lower than they were in VLDL. Both spreads reduced serum total cholesterol by about 14% in the heterozygous family members and 9% in the homozygous individual. The sterol ester spread increased serum plant sterol concentrations (eg, campesterol in the homozygous family member increased from 5 to 9 mg/dL) and the ratios to cholesterol, but the stanol ester spread decreased them. Plant sterol esters seemed to similarly decrease serum cholesterol in this family with familial hypercholesterolemia, but the clinical role of increased plant sterol concentrations, almost doubled in the LDL of homozygous individuals, is not known.     

Hyperlipoproteinemia with albumin-lipid complex: a novel type of hyperlipoproteinemia associated with insulin-resistant diabetes mellitus

We describe a new phenotype of hyperlipoproteinemia in two members of a family with a high degree of consanguinity. Both have a history of uncontrolled diabetes mellitus without ketoacidosis, and a family history of coronary artery disease at a relatively early age. A high degree of insulin resistance was found. The abnormal lipoprotein(s) has alpha-lipoprotein mobility on cellulose acetate electrophoresis and has a relative density of less than 1.006 as determined by ultracentrifugation of serum collected after a short fast. The fraction isolated by ultracentrifugation contains about half of the serum cholesterol and triglycerides and most of the phospholipids; the major protein component is albumin. Immunoelectrophoresis showed low concentrations of beta-lipoproteins in both sera, and two abnormal precipitin bands against monospecific antiserum to antilipoprotein A; a third member of the family showed only one abnormal precipitin band against the same antibody. We tentatively propose an abnormal gene(s) as the underlying mechanism. The insulin-resistant diabetes mellitus, probably inherited separately, may aggravate the hyperlipidemia.     

Characterization of hereditary partial myeloperoxidase deficiency

We studied a family with a partial myeloperoxidase deficiency. The myeloperoxidase in the neutrophils and monocytes of the parents and their two sons had normal spectral properties (determined optically and by EPR). Enzymic characteristics (oxidation of iodide) were indistinguishable from those of normal myeloperoxidase; moreover, immunological identity between the myeloperoxidase in the leukocytes of the family members and normal myeloperoxidase was found. No differences in heat stability were observed. The neutrophils and monocytes of the sons contained 9% to 18% of the myeloperoxidase content of normal cells; the neutrophils and monocytes of the parents contained 45% to 58%. These data suggest either that the parents are heterozygous and the sons homozygous for hereditary partial myeloperoxidase deficiency or that each parent is heterozygous for a different type of myeloperoxidase deficiency and the sons combine both deficiencies. The oxidative metabolism of the neutrophils during phagocytosis was not affected by the myeloperoxidase deficiency. The killing of Staphylococcus aureus was apparently normal. The perforation of Escherichia coli by the neutrophils of the sons, however, was retarded in comparison with normal neutrophils.     

Serum lipid concentrations correlate with the progression of chronic renal failure.

OBJECTIVE: To explore the distribution pattern for serum lipid concentrations among patients with different degrees of chronic renal failure; to study the characteristics of abnormal lipid metabolism for chronic renal failure patients when the disease progress further. SETTING: No. 255 Hospital of PLA, Tangshan, Hebei, China; No. 281 Hospital of PLA, Beidanhe, Hebei, China; and the General Hospital of Beijing Military Region, Beijing, China. PRACTICE DESCRIPTION: A total of 240 serum/urine samples from 50 healthy volunteers and from 190 patients with different degrees of chronic renal failure, which fall into four groups according to their glomerular filtration rates, were measured for serum levels of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and for urine albumin concentrations; the levels of these criteria were compared between the control group and diseased groups; the mean concentrations of different lipid variables were paired and subjected to linear regression analysis. MAIN OUTCOME MEASUREMENTS: Glomerular filtration rates were estimated by the iohexol clearance method, in which plasma content of iohexol was measured with high performance liquid chromatography; concentrations of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and albumin were assayed according to standard protocols. RESULTS: Serum levels of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, and urine albumin contents were significantly higher, whereas those of high density lipoprotein cholesterol were lower, in diseased groups than that of the control (p < 0.05, p < 0.01). When the disease progressed, concentrations of these criteria increased or decreased further (p < 0.01, p < 0.05). Significant correlations were found between a few lipid criteria for their mean concentrations in diseased groups. CONCLUSION: The study demonstrates a correlation between abnormalities of lipid metabolism and the degrees of kidney insufficiency, and a correlation within certain kinds of lipid criteria in patients with different degrees of renal damage. The results suggest the existence of multi-correlations in vivo in catabolism and metabolism of lipid, lipoprotein, apolipoprotein, and protein in the patients. The exact mechanism responsible for the association and correlation remains to be clarified.     

Genetic analysis of a kindred with familial hypobetalipoproteinemia. Evidence for two separate gene defects: one associated with an abnormal apolipoprotein B species, apolipoprotein B-37; and a second associated with low plasma concentrations of apolipoprotein B-100.

In 1979 Steinberg and colleagues recognized a unique kindred with normotriglyceridemic hypobetalipoproteinemia (1979. J. Clin. Invest. 64:292-301). We have undertaken an intensive reexamination of this kindred and have studied 41 family members in three generations. In this family we document the presence of two distinct apo B alleles associated with low plasma concentrations of apolipoprotein (apo) B and low density lipoprotein (LDL) cholesterol and we trace the inheritance of these two alleles over three generations. One of the alleles resulted in the production of an abnormal, truncated apo B species, apo B-37. The other apo B allele was associated with reduced plasma concentrations of the normal apo B species, apo B-100. H.J.B., the proband, and two of his siblings had both abnormal apo B alleles and were therefore compound heterozygotes for familial hypobetalipoproteinemia. Their average LDL-cholesterol level was 6 +/- 9 mg/dl. All of the offspring of the three compound heterozygotes had hypobetalipoproteinemia, and each had evidence of only one of the abnormal apo B alleles. In the entire kindred, we identified six heterozygotes for familial hypobetalipoproteinemia who had only the abnormal apo B-37 allele and their average LDL cholesterol was 31 +/- 12 mg/dl. We identified 10 heterozygotes who had only the allele for reduced plasma concentrations of apo B-100 and their LDL cholesterol level was 31 +/- 15 mg/dl. Unaffected family members (n = 22) had LDL cholesterol levels of 110 +/- 27 mg/dl. This report describes the first kindred in which two distinct abnormal apo B alleles have been identified, both of which are associated with familial hypobetalipoproteinemia.     

Sexual differences in lipoprotein composition in a family with dyslipidemic hypertension with premature atheroschlerosis: deficiency of high-density lipoprotein-L and high-density lipoprotein-M "apolipoprotein-I alone" particle.

This article describes a family with a high incidence of premature atherosclerosis and primary hypertriglyceridemia in the women. The lipoprotein composition of this family was investigated with a new methodology that combines gradient ultracentrifugation to isolate lipoprotein subfractions with high-performance liquid chromatography to quantitate apolipoproteins. The major lipoprotein abnormalities that were identified in the hyperlipidemic women in this family were (1) an increased mass of very low density lipoprotein (VLDL) and intermediate density lipoprotein (IDL) with triglyceriderich VLDL but normal IDL composition; (2) triglyceride-rich low-density lipoprotein (LDL) with normal cholesterol and apolipoprotein B concentrations; (3) a relatively normal total mass of high-density lipoprotein (HDL)-L and HDL-M but with a reduction in the apolipoprotein A-I/A-II ratio and a decrease in the cholesterol to triglyceride ratio; (4) an elevation of HDL-D apolipoprotein A-I. The reduction in the apolipoprotein A-I/A-II ratio was also seen in the hyperlipidemic men and in most of nonhyperlipidemic family members and was the most common lipoprotein abnormality that was identified in this family (9 of 11 family members who were not on lipid-lowering medications were affected). The hypertriglyceridemic women appeared to have an increase in the "A-I + A-II" HDL particles in all subfractions and an increase in the "A-I alone" particles in HDL-D. These increases provided the apparently normal total mass of HDL that was observed in these women. These increases in HDL were not seen in the hypertriglyceridemic men. We conclude that a deficiency of the "A-I alone" particle in HDL-L and HDL-M may contribute to the premature atherosclerosis that was seen in this family and that it appears to precede the appearance of hypertriglyceridemia. The increase in the "A-I + A-II" HDL particles did not appear to provide the same protection as would be expected from "A-I alone" HDL.     

Lipoprotein cholesterol concentrations in patients with Beh?et's disease

Serum cholesterol concentrations among very low, low, and high density lipoproteins (VLDL, LDL and HDL) in 12 male patients with Beh?et's disease were compared with those of 12 normal male subjects. Serum lipoproteins were separated by a combination of ultracentrifugation and gel filtration chromatography. The patients had significantly (p less than 0.001) lower concentrations of HDL-cholesterol than the control subjects (356 +/- 62 mg/l vs. 573 +/- 108 mg/l, means +/- SD). The cholesterol concentrations in apolipoprotein B-containing lipoproteins (VLDL and LDL) from the patients tended to be reciprocally higher than those of the controls, though not statistically significant. There was no difference in serum total cholesterol concentrations. The chemical composition of HDL from the patient group was characterized by higher protein and lower cholesterol (both esterified and free) contents compared with the control HDL.     

Cholesterol concentrations in patients with Anorexia Nervosa and in healthy controls

Argentinean women have one of the highest international mortality rates for cardiovascular disease and they are particularly vulnerable to eating pathologies. Cardiovascular risk is exacerbated in women with Anorexia Nervosa (AN), since high cholesterol concentrations have been widely reported. OBJECTIVES: To compare blood cholesterol concentrations in AN patients with controls, and to correlate cholesterol with the body mass index (BMI), patient age, vomiting and tobacco. DESIGN AND METHOD: Cholesterol measurements documented at diagnosis from the clinical notes of patients were recorded from the Association Against Bulimia and Anorexia (ALUBA). Comparison was carried out with data of the general Argentinean public. RESULTS: Total cholesterol, LDL and HDL concentrations were higher in patients compared with controls. Total cholesterol in patients decreased during treatment and it was correlated with the patient age, but with no other variable. CONCLUSION: The abnormal lipid profile places patients at risk for cardiovascular disease. Older and untreated patients may be at particular higher risk of suffering from the consequences of elevated cholesterol concentrations.     

Elevated cholesterol and bile acid synthesis in an adult patient with homozygous familial hypercholesterolemia. Reduction by a high glucose diet.

Elevated levels of cholesterol synthesis are reported for several young children with homozygous familial hypercholesterolemia (HFH) and are considered to contribute directly to their hypercholesterolemia. In contrast, increased cholesterol production has not previously been found in adult patients with HFH. Using the fecal steroid balance technique, we studied rates of cholesterol and bile acid synthesis in a 24-yr-old man who had severe hypercholesterolemia typical of HFH and who lacked skin fibroblast low density lipoprotein (LDL) receptor activity. On an average diet (45% carbohydrate, 40% fat, 15% protein) mean +/- SEM cholesterol (24.8 +/- 1.4 mg/kg per d) and bile acid (11.1 +/- 1.6 mg/kg per d) excretion were approximately threefold higher than normal. When an isocaloric high carbohydrate, low fat diet (90.5% glucose oligosaccharides, 1.3% safflower oil, 8.2% crystalline amino acids was substituted, mean cholesterol (13.0 +/- 0.5 mg/kg per d) and bile acid (8.6 +/- 0.4 mg/kg per d) fell markedly. The decline in fecal steroid excretion was accompanied by modest reductions in plasma total and LDL cholesterol concentrations and by a softening of cutaneous xanthomata. Although the patient phenotypically and biochemically resembled the HFH state, his family pedigree was not noteable for hypercholesterolemia. While the patient's father had premature cardiovascular disease, his mother had no evidence of heart disease, had normal plasma total and LDL cholesterol levels, and had normal fibroblast LDL receptor activity. Likewise, the plasma cholesterol levels of three other members of the patient's family were normal. Despite the unusual genotypic background of this individual, however, the fecal balance data shows that elevated cholesterol and bile acid synthesis may occur in adult, as well as juvenile, patients with HFH and may be responsive to dietary control.     

Serum adipokines are associated with cholesterol metabolism in the metabolic syndrome

BACKGROUND: The purpose of this study was to investigate whether cholesterol metabolism is associated with serum adipokines and inflammatory markers. METHODS: In fifty-eight subjects with impaired fasting glucose or impaired glucose tolerance and features of the metabolic syndrome cholesterol metabolism was assayed with serum non-cholesterol sterol ratios to cholesterol, surrogate markers of synthesis (cholesterol precursors) and dietary absorption % of cholesterol (cholestanol and plant sterols) and related them to serum adiponectin, leptin, high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). RESULTS: Adiponectin was negatively related to synthesis markers (e.g. desmosterol r=-0.371, P<0.01), and positively to absorption markers (e.g. cholestanol r=0.269, P<0.05). Leptin was associated with synthesis markers (e.g. desmosterol r=0.271, P<0.05) and negatively with absorption markers (e.g. sitosterol r=-0.278, P<0.05). Hs-CRP was negatively associated with absorption markers (e.g. sitosterol r=-0.407, P<0.001). IL-6 and TNF-alpha were not related to cholesterol metabolism. When dividing the subjects into tertiles by the serum desmosterol/cholestanol ratio, the I tertile (high synthesis/low absorption) was associated with low adiponectin concentrations, high BMI and serum leptin concentrations (P<0.05 for all). CONCLUSIONS: Adiponectin, leptin and hs-CRP were associated with variables of cholesterol metabolism. A high ratio of cholesterol synthesis to absorption is characterized by high serum leptin and low adiponectin concentrations.     

Serum lipid concentrations correlate more strongly with total body fat than with body mass index in obese humans

BACKGROUND: To investigate the associations of body mass index (BMI) and total body fat (TBF) vs. blood lipid concentrations, we measured six anthropometric parameters, body fat mass, and serum lipid profiles in 1529 apparently healthy adults. METHODS: TBF was assessed using a body fat analyzer. Serum concentrations of triglyceride, total cholesterol, and low- or high-density lipoprotein cholesterol (LDL-C or HDL-C) were determined by standard enzymatic procedures. RESULTS: Serum lipid concentrations were more strongly correlated with TBF than with BMI or waist circumference in both men and women. The mean concentrations of total cholesterol in the subjects with high fatness (TBF>95th percentile) were significantly higher than those for the subjects with low fatness (TBF<5th percentile; p<0.01), but no significant differences were observed in serum lipid levels between overweights (BMI>95th percentile) and underweights (BMI<5th percentile). The incidence of hypercholesterolemia was significantly higher in the subjects with high fatness (TBF>95th percentile) than the corresponding overweight subjects (BMI>95th percentile; p<0.01). CONCLUSION: TBF is more strongly associated with serum lipid concentrations in adults, at least as compared to BMI.     

Quantification of lipoprotein cholesterol in serum from children with different lipoprotein profiles: heparin-calcium precipitation and ultracentrifugation compared

We compared the serum lipoprotein cholesterol concentrations in subgroups of children (n = 360), ages 5-17 years, as measured by the heparin-Ca2+ and preparative ultracentrifugation methods. Children were grouped from the total population on the basis of their previous results for serum beta- and pre-beta-lipoprotein cholesterol (Group I: low beta- and low pre-beta-; Group II: high beta- and low pre-beta; Group III: high beta- and high pre-beta-; Group IV: low beta- and high pre-beta-). The values for very-low-density (VLDL) cholesterol by ultracentrifugation method were 44, 53, 15, and 10 mg/L greater than the values for pre-beta-lipoprotein cholesterol by the heparin-Ca2+ method in Groups I, II, III, and IV, respectively; the differences were not significant in Group IV. The values of low-density (LDL) cholesterol were 64, 137, 144, and 73 mg/L less than the values for beta-lipoprotein cholesterol in Groups I, II, III, and IV, respectively (p less than 0.005). On the other hand, high-density (HDL) cholesterol concentrations in the respective four groups were 10, 37, 93, and 52 mg/L greater than alpha-lipoprotein cholesterol concentrations; the differences were significant for Groups II, III, and IV (p less than 0.005). Overall, the values for LDL-cholesterol correlated highly with beta-lipoprotein cholesterol (r = 0.94), whereas correlations for VLDL- and HDL-cholesterol values with pre-beta-lipoprotein cholesterol (r = 0.76) and alpha-lipoprotein cholesterol (r = 0.77) were somewhat lower. The differences between these two methods may result from their different operational definitions for measuring serum lipoproteins and the possibility that without appropriate corrections the values obtained by preparative ultracentrifugation do not serve as reference values.     

Living with prostate cancer: a critical review of relatives' experiences

The aim was to review the existing qualitative research literature on the perspectives of the spouse, sons and daughters on life in a family where the male partner/father has prostate cancer. PubMed and CINAHL were searched using the MESH words: prostatic neoplasm, spouse, family, adult children, son, daughter and qualitative research. The search was limited from December 1960 to January 2008. The search returned 560 papers; only six qualitative research papers were relevant and included in the study. The main results of the perspectives of spouses, daughters and sons are presented in relation to the following four stages: diagnosis, pretreatment decision-making, awaiting treatment and treatment/post-treatment. The studies reviewed indicate that the spouse, sons and daughters were all markedly affected by the man's serious diagnosis. Some studies highlights the methodological problem of non-independent informants: in a couple or focus group interview, the different individuals interviewed will always be influenced by the statements or presence of others, or the couple will act as a system and their individual views cannot be identified. This paper concludes that there is a lack of European research through all stages of the illness. In order to learn about the individual, perspective studies should only include either the spouse or the son or daughter as informants. Further research on all stages of the illness is needed. The studies should have a longitudinal design.     

超声诊断弥漫性胰腺脂肪浸润的临床意义

目的探讨超声诊断弥漫性胰腺脂肪浸润的临床意义,分析弥漫性脂肪浸润与血脂、血糖浓度的关系。 方法选取2016年6月~11月在扬州大学附属医院进行健康体检的64 155位受检者,超声诊断为弥漫性胰腺脂肪浸润的共1030例,随机选取同期无胰腺脂肪浸润的4229例受检者作为无胰腺脂肪浸润组,整理所选受检者的体检报告资料,通过χ²检验分析弥漫性胰腺脂肪浸润组与无胰腺脂肪浸润组间高血脂、高血糖发生率的差异,并采用独立样本t检验探讨弥漫性胰腺脂肪浸润与血脂、血糖浓度的关系。 结果弥漫性胰腺脂肪浸润组空腹高血糖、高胆固醇、高甘油三酯的发生率分别为23.7%、14.1%及62.1%,无胰腺脂肪浸润组空腹高血糖、高胆固醇、高甘油三酯的发生率分别为11.1%、10.2%及34.5%,弥漫性胰腺脂肪浸润组空腹高血糖、高胆固醇、高甘油三酯的发生率显著高于无胰腺脂肪浸润组,差异均有统计学意义（χ²=112.74、13.00、259.36,P均<0.001）。弥漫性胰腺脂肪浸润组空腹血糖、胆固醇、甘油三酯的平均浓度分别为（5.86±1.91）mmol/L、（4.72±0.94）mmol/L及（2.45±2.03）mmol/L;无胰腺脂肪浸润组空腹血糖、胆固醇、甘油三酯的平均浓度分别为（5.30±1.31）mmol/L、（4.54±0.90）mmol/L及（1.74±1.80）mmol/L,弥漫性胰腺脂肪浸润组空腹血糖、胆固醇及甘油三酯浓度显著高于无胰腺脂肪浸润组,差异均有统计学意义（t=11.12、5.48、11.74,P均<0.001）。 结论超声诊断弥漫性胰腺脂肪浸润对于提示无症状的高血脂、高血糖有重要的临床价值,可为临床早期进行干预治疗提供依据。     

Interaction of high density lipoprotein with adipocytes in a new patient with Tangier disease

A 56-year-old man, the offspring of a consanguineous first cousin marriage, presented with clinical, morphological, and biochemical features of familial deficiency of high-density lipoproteins (Tangier disease). Of 8 first- and second-degree relatives examined, 4 had either plasma apo A-I or HDL cholesterol concentrations 2 standard deviations below normal population mean on at least 1 occasion. The patient and a majority of his relatives also had high plasma apo B concentrations relative to their levels of cholesterol. Adipose tissue biopsy was undertaken to study HDL interaction with the patients' cells. Specific uptake of HDL3 was demonstrated in adipocytes of this patient, but was decreased relative to a control of similar fat cell size. However, no marked difference in fat cell cholesterol content was observed between the Tangier patient and the control. Thus it appears unlikely that adipocytes play a role in the etiology of Tangier disease.     

Consequences of a family history of type 1 and type 2 diabetes on the phenotype of patients with type 2 diabetes

OBJECTIVE: To investigate the impact of a family history of type 1 and type 2 diabetes on the phenotype of patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: In a population-based study, we compared the phenotype in 3 groups of patients with type 2 diabetes. The first group had no family history of diabetes (FH-, n = 148); the second group had a family history of type 2 diabetes only (FH+(TYPE2), n = 1,211); and the third group had a family history of both type 1 and type 2 diabetes (FH+(MIXED), n = 240). Furthermore, we studied the frequency of GAD antibodies (GADabs), HLA-DQB1 risk genotypes, and the presence of coronary heart disease (CHD) according to family history in unrelated patients with type 2 diabetes from 787 families (148 FH-, 546 FH+(TYPE2) and 93 FH+(MIXED)). RESULTS: Patients with no family history of diabetes were older at the onset of the disease, had a better beta-cell function (P = 0.004), and had higher HDL cholesterol concentrations (P = 0.006) than patients with a family history of diabetes. Patients with a family history of only type 2 diabetes had higher BMI and fasting C-peptide concentrations (P = 0.031) but lower frequency of GADab (11 vs. 23%, P = 0.001) and DQB1 risk genotypes (37 vs. 54%, P = 0.003) compared with patients with a family history of both type 1 and type 2 diabetes. In addition, hypertension (P = 0.05) and CHD (P = 0.031) were more common in FH+(TYPE2) than in FH+(MIXED) patients. In patients <60 years old, a family history of type 1 diabetes was associated with a reduced risk of CHD independent of age, hypertension, and HDL cholesterol concentrations. The results were similar when the GADab+ patients were excluded from the analysis. CONCLUSIONS: A family history of both type 1 and type 2 diabetes had a profound influence on the phenotype of patients with type 2 diabetes, which suggests a genetic interaction between type 1 and type 2 diabetes.     

Enhanced nitric oxide production is closely associated with serum lipid concentrations in adolescents

BACKGROUND: To investigate whether nitric oxide (NO) production is associated with serum lipid concentrations and body mass index (BMI), we measured serum nitrate and nitrites (NOx) concentrations, serum lipid profiles, and anthropometric parameters in 319 adolescents. METHODS: Serum NOx concentrations were determined using the Griess reaction. Serum concentrations of triglyceride, total cholesterol, and low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured by standard enzymatic procedures. RESULTS: Subjects with increased serum cholesterol or triglyceride concentrations exhibited remarkably high NOx levels. Total cholesterol and triglyceride averaged 161.5+/-27.4 and 205.9+/-107.8 mg/dl in males with NOx >92.8 micromol/l (upper 20%), which were significantly above the values (132.4+/-17.2 and 58.1+/-20.3 mg/dl) in those with NOx <15.6 micromol/l (lower 20%). The prevalences of male adolescents with increased concentrations of cholesterol and triglyceride were significantly higher in the subjects with NOx > or =51.2 micromol/l than in those with NOx <51.2 micromol/l (8.9% and 22.2% vs. 1.6% and 2.3%, p<0.05, respectively). Correlation coefficients of serum lipid concentrations and anthropometric parameters vs. serum NOx concentrations were higher in males than in females for cholesterol (r=0.28 vs. 0.23), triglyceride (r=0.51 vs. 0.42), HDL-C (r=-0.25 vs. -0.16), and BMI (r=0.39 vs. 0.27). CONCLUSIONS: NO production is closely associated with serum lipid concentrations in adolescents, and these associations are stronger in males than in females.     

A screening procedure for dyslipoproteinemia in the newborn. Apoprotein quantitadon on dried blood spots

A new screening procedure for the detection of dyslipoproteinemia in the newborn is proposed, based on apoprotein quantitation. Blood is collected by heel-prick in infants 5–7 days after birth-when apoprotein and lipids have reached stable values-and adsorbed on filter paper. Blood spots are eluted with a detergent and apoprotein A-I and B are assayed by inununonephelometry. The apo A-I/B ratio is used as a screening parameter, given its high discriminative power between normals and individuals with cardiovascular disease. The quantitation of the apo A-I/B ratio in blood spots is independent of the volume of the blood spot and of the newborn hematocrit. In a follow-up study, plasma lipid and apoprotein concentrations were assayed in the infants with an apo A-I/B ratio lower than 1.0 at 5 days, and a family study was carried out. On screening 1500, 30 infants gave positive results at birth, and were controlled between 2 and 8 months. In eight families studied, six children had abnormally high cholesterol and apo B values and five children had abnormally low HDL cholesterol and apo A-I concentrations. This screening procedure is a new approach to the detection of familial dyslipoproteinemia in the newborn, as it is based on the quantitation of the apo A-I/B protein ratio, instead of cholesterol, LDL cholesterol or β-lipoprotein quantitation. It enables a differentiation to be made between various forms of dyslipoproteinemia, leads to a better characterization of various diseases, and decreases the percentage of false positive cases.     

Plasma concentration of IGF-I is independently associated with insulin sensitivity in subjects with different degrees of glucose tolerance

OBJECTIVE: We studied the relationships between plasma IGF-I concentrations and insulin sensitivity in subjects with various degrees of glucose tolerance. RESEARCH DESIGN AND METHODS: A total of 357 nondiabetic subjects, 54 subjects with impaired glucose tolerance and 98 newly diagnosed type 2 diabetic subjects, were consecutively recruited, and anthropometric and biochemical characteristics were collected. RESULTS: IGF-I concentrations were negatively correlated with age, BMI, waist-to-hip ratio, triglyceride levels, and systolic and diastolic blood pressure. IGF-I concentrations were positively correlated with HDL cholesterol and homeostasis model assessment of insulin sensitivity (HOMA-S). The correlations remained significant after adjusting for sex, age, and BMI. Correlations for HOMA-S with these metabolic and anthropometric variables were of a similar degree and direction to those for IGF-I concentrations. Stepwise linear regression analysis in a model, which included well-known modulators of insulin sensitivity such as sex, age, BMI, glucose tolerance status, family history of diabetes, waist-to-hip ratio, systolic and diastolic blood pressure, HDL cholesterol, and triglyceride levels, revealed that IGF-I concentrations were independently associated with insulin sensitivity accounting for 10.8% of its variation (P < 0.0001). IGF-I concentrations were significantly lower in subjects with World Health Organization (WHO)-defined metabolic syndrome compared with subjects without metabolic syndrome (P < 0.0001). Logistic regression analysis showed that each unit increase in log-transformed IGF-I concentrations was associated with a 90.5% reduction in the risk of WHO-defined metabolic syndrome. CONCLUSIONS: These data indicate that IGF-I has the characteristics to be a marker for the insulin resistance syndrome. This suggests that low IGF-I levels may be a useful marker for identifying subjects at risk for cardiovascular disease.