Lipoprotein(a): Pathophysiology,measurement, indication and treatment in cardiovascular disease. A consensus statement from the Nouvelle Société Francophone d’Athérosclérose (NSFA)

Central Illustration. Pathophysiological pathways providing a causal link between high plasma concentrations of lipoprotein(a) (Lp(a)) and atherosclerotic vascular disease and aortic valve stenosis (AVS). Clinical outcomes are related to accelerated atherosclerosis complicated by atherothrombosis (myocardial infarction, stroke), peripheral artery disease (PAD) or aortic valve replacement (AVR) caused by valve calcification and aortic stenosis. Apo(a): apolipoprotein(a); LDL: low-density lipoprotein; OxPL: oxidized phospholipids; NSFA: Nouvelle Société Francophone d’Athérosclérose; SP: serine-protease domain; V: plasminogen kringle V (reproduced with permission).

     

A seven-year study on an integrated hospital-community diabetes management program in Chinese patients with diabetes

Aims

To assess whether an integrated hospital-community diabetes management program could improve major cardiovascular risk factor control among patients with diabetes in real-world clinical settings.

冠心病患者脂蛋白脂酶活性和载脂蛋白C的变化及意义

观察３０例冠心病、２０例高脂血症患者的血脂含量、载脂蛋白Ｃ及血浆脂蛋白脂酶活性的变化，结果显示：高脂血症患者血浆脂蛋白ＣⅡ水平比正常人高４５．７２％，（Ｐ〈０．００１），且与血甘油三酯值呈明显正相关（ｒ＝０．５９９，Ｐ〈０．００１）；冠心病患者血浆脂蛋白酶性显著低于正常人（Ｐ〈０．０１）。提示：高脂血症患者血浆载脂蛋白ＣⅡ水升高可能是甘油三酯升高的重要原因，冠心病患者的血浆脂蛋白脂酶活性降低，可能     

降脂通脉胶囊联合藻酸双酯钠治疗高脂血症的临床研究

目的探讨降脂通脉胶囊联合藻酸双酯钠片治疗高脂血症的临床疗效。方法选择2018年3月-2019年3月在陕西省荣誉军人康复医院治疗的高脂血症患者86例,根据用药的差别分为对照组(43例)和治疗组(43例)。对照组口服藻酸双酯钠片,50mg/次,3次/d;治疗组在对照组基础上口服降脂通脉胶囊,2.0g/次,3次/d。两组患者经4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、胆固醇(TC)、嗜酸性粒细胞阳离子蛋白(ECP)、摄食抑制因子-1(NSF-1)、硫氧还蛋白相互作用蛋白(TXNIP)、肿瘤坏死因子-α(TFN-α)、白细胞介素-1β(IL-1β)、脂联素(ADP)、超氧化物歧化酶(SOD)、丙二醛(MDA)和谷胱甘肽过氧化物酶(GSH-Px)水平。结果治疗后,对照组临床有效率为81.40%,显著低于治疗组的97.67%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者TC、TG、LDL-C、ECP、IL-1β、TFN-α、TXNIP、NSF-1和MDA水平均显著降低(P<0.05),而HDL-C、ADP、SOD和GSH-Px水平均显著升高(P<0.05),且治疗组患者这些指标明显好于对照组(P<0.05)。结论降脂通脉胶囊联合藻酸双酯钠片治疗高脂血症可有效降低血脂指标,促进机体细胞因子和氧化应激指标的改善,具有一定的临床推广应用价值。     

Reduced plasticity and mild cognitive impairment-like deficits after entorhinal lesions in hAPP/APOE4 mice

Mild cognitive impairment (MCI) is a clinical condition that often precedes Alzheimer disease (AD). Compared with apolipoprotein E-ε3 (APOE3), the apolipoprotein E-ε4 (APOE4) allele is associated with an increased risk of developing MCI and spatial navigation impairments. In MCI, the entorhinal cortex (EC), which is the main innervation source of the dentate gyrus, displays partial neuronal loss. We show that bilateral partial EC lesions lead to marked spatial memory deficits and reduced synaptic density in the dentate gyrus of APOE4 mice compared with APOE3 mice. Genotype and lesion status did not affect the performance in non-navigational tasks. Thus, partial EC lesions in APOE4 mice were sufficient to induce severe spatial memory impairments and synaptic loss in the dentate gyrus. In addition, lesioned APOE4 mice showed no evidence of reactional increase in cholinergic terminals density as opposed to APOE3 mice, suggesting that APOE4 interferes with the ability of the cholinergic system to respond to EC input loss. These findings provide a possible mechanism underlying the aggravating effect of APOE4 on the cognitive outcome of MCI patients.     

ABO blood group in Amerindians from Brazilian Amazon

Background : The Parakanã is a group of Indians with cultural similarities to the extinct Tupi group. They are an isolated native population from East Brazilian Amazon. A number of different O alleles have been found at the blood group ABO locus in populations of several ethnic origins (Caucasians, Blacks, Amerindians). Aim : The present study describes the ABO blood group polymorphism gene of the Parakanã Indians. The Amerindian group was carefully selected for racial background. Subject and methods : The blood group polymorphism was analysed in genomic DNA from 62 Parakanã Indians. We determined the 261G deletion, the T646A and C771T mutations described in O 1variant and the G542A substitution, using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). Results : All Amerindians studied were homozygous for the 261G deletion. The frequencies of the T646A and C771T mutations in Parakanãs (0.65) were lower than that observed in Kayapo, Yanomama and Arara Indians (0.91) ( &#104 2 = 18.24; p-v < 0.001. The G542A substitution in Parakanãs was also lower (0.22) than in other tribes (0.42) ( &#104 2 = 9.73; p-v = 0.001). Conclusions : The different O alleles including the G542A mutation are not distributed homogeneously among all Amazonian Amerindians. Our results are in agreement with other genetic markers studied previously in Parakanã Indians, whose distinct genetic pattern differs from Europeans and even from other Amerindians.     

Effects of interactions between ApoE polymorphisms,alcohol consumption and obesity on age-related trends of blood pressure levels in postmenopausal women: The Bambuì cohort study of aging (1997–2008)

Objectives

To evaluate the effects of interactions between ApoE genotypes, alcohol consumption and obesity on the age-related trends of blood pressure (BP) levels in postmenopausal women.

Study design

A population-based prospective cohort study of all residents in Bambuì, south-eastern Brazil, aged 60 years or older. Repeated BP measurements were obtained in four waves from 851 women who underwent ApoE genotyping at baseline (88.3% of those enrolled), and multi-level random-effects pattern-mixture models were used to evaluate the age-related BP trajectories, while accounting for non-ignorable dropouts/deaths and handling heterogeneities as random parameter variations. The few measurements (2.1%) made during hormone replacement therapy were excluded from the analysis.

Results

Alcohol consumption was associated with high levels of systolic and diastolic BP in an age × genotype-dependent manner only in the non-obese women (BMI < 27 kg/m²). Among those with the ?3/3 genotype, the differences in systolic and diastolic levels between drinkers and non-drinkers estimated at the age of 60 years were respectively 13.7 mmHg (p = 0.022) and 10.7 mmHg (p = 0.002), and disappeared in the older age groups, in which drinking was associated with systolic/diastolic hypertension if the non-obese women were ?4 carriers.

Conclusion

In non-obese postmenopausal women, alcohol consumption is associated with systolic and diastolic hypertension early in those with the ?3/3 ApoE genotype, and late in ?4 carriers. We hypothesize the mediation of androgen hormones and the influence of ApoE genotypes on age at natural menopause. A better understanding of these mechanisms may guide better preventive choices.     

人重组载脂蛋白E在大肠杆菌中的表达和纯化

用含有载脂蛋白EcDNA的PET32a原核表达载体转化大肠杆菌BL21（DE3），使之高效表达载脂蛋白E-thioredoxin融合蛋白，利用融合蛋白上的一段组氨酸序列，用镍离子亲合层析柱进行分离纯化。由于在载脂蛋白E和thioredoxin之间存在凝血酶的识别位点，用凝血酶消化后，经SephacrylS-300凝胶过滤得到人重组载脂蛋白E。用此方法可以从1L大肠杆菌培养液中纯化20-30mg高纯度的各种载脂蛋白E异构体和非自然存原突变体。方法简便，产量高，纯度达95%以上。     

载脂蛋白E基因多态性与高脂血症的相关性研究

选取１３３例高脂血症患者及１２２例正常对照人群，用多聚酶链反应方法快速鉴定其载脂蛋白Ｅ的基因型，结合血脂分析，研究载脂蛋白基因多态性与高脂血症的关系，结果表明，Ｅ３等位基因的分布频率在病例组中明显低于对照且，病例组中Ｅ４等位基因的分布频率明显高于对照组，表明Ｅ４等位基因与高脂血症显著相关。