Influences of gender and age on relationships between alcohol drinking and atherosclerotic risk factors

Background: Alcohol drinking affects atherosclerotic progression mainly through blood pressure and lipid metabolism. The purpose of the present study was to clarify whether effects of alcohol drinking on atherosclerotic risk factors differ by gender and age. Methods: The database of periodic health check-ups for local district workers was used. The subjects were divided into 3 groups according to mean ethanol consumption per day (nondrinkers; light drinkers, less than 30 g per day; moderate-to-heavy drinkers, 30 g or more per day). The mean levels of each atherosclerosis-related variable in the 3 groups were compared. Results: The mean level of body mass index (BMI) was slightly but significantly lower in drinkers than in nondrinkers in the thirties, forties, and fifties age groups in men and in the twenties, thirties, forties, and fifties age groups in women, while this tendency was not found in the sixties age groups of men and women. In men, mean blood pressure was higher in moderate-to-heavy drinkers than in nondrinkers in all age groups and was higher in light drinkers than in nondrinkers only in the age groups after 40 years. Mean blood pressure of women was higher in the moderate-to-heavy drinker group than in the nondrinker group and this difference became higher with advance of age. In women, mean blood pressure was not affected by light drinking in any of the age groups except for the fifties age group. In men, serum total cholesterol was higher in drinkers than in nondrinkers in the twenties age group but was lower in drinkers than in nondrinkers at thirties or older. Serum total cholesterol in women was lower in drinkers than in nondrinkers in the age groups from twenties to forties but tended to be higher in drinkers than in nondrinkers in the sixties age group. Serum HDL cholesterol increased with advance of age from thirties to sixties in men, while it decreased with advance of age from twenties to sixties in women. Serum HDL cholesterol was higher in drinkers than in nondrinkers in all age groups of men and women, and atherogenic index, calculated by using serum total cholesterol and HDL cholesterol concentrations, was lower in drinkers than in nondrinkers in all age groups of men and women. Conclusion: Both in men and women, blood pressure and HDL cholesterol were strongly affected by alcohol drinking: the elevating effect of alcohol drinking on blood pressure was more prominent in the elderly than in the young, while the elevating effect of alcohol drinking on serum HDL cholesterol was not influenced by age. Relationships of drinking with total cholesterol and BMI vary by age and gender.     

阜康市哈族和汉族高血压、血脂异常、糖尿病调查分析

新疆阜康市西距乌鲁木齐市57 km,以哈族和汉族集居为主.随着各族人民生活水平的不断提高,近几年心脑血管疾病成高发态势[1].本次调查旨在了解哈族和汉族两个民族心脑血管主要危险因素高血压、血脂异常、糖尿病患病情况,为科学防治提供依据.     

血脂异常与维持性血液透析患者病死率的关系

目的探讨血总胆固醇的基础水平对维持性血液透析患者全因病死率的预测价值。方法回顾性分析在我院血液透析中心行维持性血液透析（MHD）的患者,记录临床和实验室资料及死亡患者的死亡原因。按总胆固醇水平分为5组,分别计算每组患者的病死率。结果总病死率为11.1%,患者病死率与血胆固醇水平呈U形曲线关系,胆固醇水平≤3.24mmol/L的A组病死率最高。结论 MHD患者血胆固醇水平和病死率的关系与普通人群不同,提示应采取不同的降脂治疗措施。     

中药罗汉果抗血脂紊乱的实验研究

目的观察中药罗汉果对实验性血脂紊乱SD大鼠血清总胆固醇(TC)、低密度脂蛋白(LDL-c)、三酰甘油(TG)及高密度脂蛋白(HDL-c)水平的影响。方法 50只雄性SD大鼠(体质量180g-220g)适应性饲养7d后随机分为空白对照组和造模组,造模组上午8时至下午18时给予普通饲料喂养,18时至次日上午8时高脂饲料喂养,共4周。4周后禁食12h断尾采血测两组空腹血清TC、LDL-c、TG、及HDL-c水平,造模组血脂各指标显著升高具有统计学意义者,确定为模型建立成功。将造模成功的模型组大鼠再随即分为药物实验组(20只,给予含生药4g/(kg d)罗汉果水溶液灌胃)和模型对照组(20只),后者继续高脂饲料喂养。至第八周后测血清TC、LDL-c、TG、及HDL-c水平。结果实验组血清TC)和LDL-c)的水平显著低于对照组(P<0.05);TG水平较对照组有下降趋势,HDL-c水平较对照组有上升趋势。结论中药罗汉果可显著降低实验大鼠血清TC和LDL-c,可通过调节血脂代谢紊乱发挥抗动脉粥样硬化作用。     

Homocysteine Among Renal Transplant Recipients and Its Correlation to the Cyclosporine, GFR and Folate Levels

Hyperhomocysteinemia seems to occur frequently after renal transplantation. It is important to manage cases of hyperhomocysteinemia, aiming to decrease cardiovascular mortality and morbidity in this population. The purpose of this study was to determine the homocysteine level in stable renal transplant recipients and its correlation to the glomerular filtration rate (GFR), cyclosporine level and plasma folate level. Fifty-two stable renal transplant recipients were evaluated, considering age, post-transplant time, renal function tests, lipid profile, total plasma homocysteine, plasma folate and cyclosporine levels. All patients included in the study had hyperhomocysteinemia [34 (65%) mild and 18 (35%) moderate]; hypertriglyceridemia was present in 90% of patients, hypercholesterolemia in 40% of patients and a state of low folate level in all patients. There was a significant positive correlation between the Hcy level and the blood urea and serum creatinine (r = 0.529, r = 0.279, P < 0.05) and a significant negative correlation with plasma folate and GFR (r = −0.416 and r = −0.375; P < 0.05), respectively. Homocysteine is identified as an independent risk factor for CVD, so assessment of the Hcy level should be done for RTRs.     

2型糖尿病血管并发症患者血脂及血浆NO水平的临床研究

目的:评价2型糖尿病(DM)血管并发症患者血脂及血浆NO水平的状况。方法:对203例临床诊断为2型DM的住院患者(男性103例,女性100例)的空腹血脂及血浆NO水平做出分析。结果:A组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、载脂蛋白A1、载脂蛋白B及NO分别为:(4.83±0.87)mmol/L,(2.67±0.42)mmol/L,(1.75±0.65)mmol/L,(1.53±0.19)g/L,(0.88±0.17)g/L及(8.12±1.96)mmol/L。A组高密度脂蛋白胆固醇(HDL-C)的均值为(1.34±0.18)mmol/L,高于C组(P<0.01),NO降低的检出率B组高于C组(P<0.01),血浆NO水平较差的C组显著低于A组(P<0.01)。结论:2型DM患者血糖的控制程度会导致其血脂及NO水平的差异,血糖控制较差会导致血脂代谢紊乱程度增加,并使NO生成减少,要防止血管并发症的发生应该重视及时评价糖代谢问题。     

Insulin: a novel agent in the pathogenesis of prostate cancer

Prostate cancer, the most frequent non-cutaneous malignancy in aging men, is a growing medical problem, representing the second leading cause of male cancer deaths. Despite its high morbidity, the etiology of prostate cancer remains largely unknown. Several studies have documented hormonal imbalance, such as alteration in androgens and estrogens, obesity, family history and growth factors, as risk factors in the pathogenesis of prostate cancer. Insulin is a growth-promoting hormone that is reported to be involved in the pathogenesis of various malignancies, such as breast and bladder cancers. Insulin is known to increase cancer risk through its effect on cell proliferation, differentiation and apoptosis. In the last decade, converging evidence from epidemiological and clinical studies suggests that the insulin is involved in the tumorigenesis and neoplastic growth of the prostate. Several mechanisms have been suggested to explain the possible causal relationship between insulin and prostate cancer, such as the sympathoexcitatory effect of insulin, alteration of sex hormone metabolism, insulin-like growth factor pathway, signal transduction mechanism and dyslipidemia. The present paper reviews relevant existing studies related to the role of insulin in the pathogenesis of prostate carcinoma.     

Unmet needs in the diagnosis and treatment of dyslipidemia in the primary care setting in Germany

OBJECTIVES AND METHODS: DETECT is a cross-sectional study of 55,518 unselected consecutive patients in 3188 representative primary care offices in Germany. In a random subset of 7519 patients, an extensive standardized laboratory program was undertaken. The study investigated the prevalence of cardiovascular disease, known risk factors (such as diabetes, hypertension and dyslipidemia and their co-morbid manifestation), as well as treatment patterns. The present analysis of the DETECT laboratory dataset focused on the prevalence and treatment of dyslipidemia in primary medical care in Germany. Coronary artery disease (CAD), risk categories and LDL-C target achievement rates were determined in the subset of 6815 patients according to the National Cholesterol Education Program (NCEP) ATP III Guidelines. RESULTS: Of all patients, 54.3% had dyslipidemia. Only 54.4% of the NCEP-classified dyslipidemic patients were diagnosed as 'dyslipidemic' by their physicians. Only 27% of all dyslipidemic patients (and 40.7% of the recognized dyslipidemic patients) were treated with lipid-lowering medications, and 11.1% of all dyslipidemic patients (41.4% of the patients treated with lipid-lowering drugs) achieved their LDL-C treatment goals. In conclusion, 80.3% of patients in the sample with dyslipidemia went undiagnosed, un-treated or under-treated.     

Optimal anthropometric factor cutoffs for hyperglycemia, hypertension and dyslipidemia for the Taiwanese population

Background

Optimal cutoffs for obesity indices are rarely studied in Asians. We evaluated these cutoffs for diabetes, hypertension, dyslipidemia and any risk factor for the Taiwanese general population.

Methods

Body mass index (BMI), waist circumference (WC), waist–hip ratio (WHR), waist–height ratio (WHeiR) and other data for 4683 (2280 men and 2403 women) participants of the population-based Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia were used. Areas under curves (AUCs) were analyzed and optimal cutoffs were estimated by maximizing the sums of sensitivity and specificity. Potential confounders included age, smoking, alcohol, betel nut chewing and exercise.

Results

Optimal cutoffs for men and women, respectively, were 23.7–26.3 and 22.1–23.2 kg/m² for BMI; 85.0–87.0 and 74.0–83.0 cm for WC; 0.87–0.90 and 0.78–0.83 for WHR; and 0.48–0.52 and 0.48–0.52 for WHeiR. AUCs were not significantly different among the indices for diabetes in men and for hypertension in women. In men, WHR was significantly inferior to the other indices for predicting hypertension, dyslipidemia and any risk factor. In women, BMI was significantly inferior to the others for diabetes. For dyslipidemia and any risk factor in women, WHeiR showed the largest AUCs and significant differences were seen in the following pairs: WHeiR vs. BMI and WHeiR vs. WHR for dyslipidemia and WC vs. WHR and WHeiR vs. WHR for any risk factor.

Conclusions

WC and WHeiR have similar efficacy and are superior to BMI and WHR. However, WHeiR has the extra benefit of a unisex cutoff within a narrow range.     

Reduced vascular responsiveness to adiponectin in hyperlipidemic rats—mechanisms and significance

Deficiency of adiponectin (APN), an adipocyte-derived vascular protective molecule, contributes to diabetic vascular injury. The current study determined whether obesity/hyperlipidemia may alter the vascular response to APN, and investigated the involved mechanisms and pathologic significance. Adult male Sprague-Dawley rats were fed a regular or high-fat diet (HF) for 4-16 weeks. Circulating APN levels, aortic pAMPK/AMPK, peNOS/eNOS, and APN receptor expression levels were determined. Compared to time-matched animals fed control diet, plasma APN levels in HF-diet animals were significantly increased at 8 weeks, and rapidly declined thereafter. Despite unchanged or elevated circulating APN levels, phosphorylated AMPK and eNOS in vascular tissue were significantly reduced at all observed time points. Recombinant full-length APN (rAPN)-induced AMPK/eNOS phosphorylation and vasodilatation were significantly reduced in 16-week obese/hyperlipidemic aortic segments. Vascular APN receptor 1 (AdipoR1) and receptor 2 (AdipoR2) expression were significantly reduced 16 weeks after HF-diet. Pre-incubation of rAPN with obese/hyperlipidemic plasma, but not with normal plasma, significantly reduced its AMPK and eNOS activation effect, and blunted its protective effect against TNFα-induced HUVEC apoptosis. This study demonstrated for the first time that obesity/hyperlipidemia reduces vascular responsiveness to APN. Modification/inactivation of APN by unidentified factors present in obese/hyperlipidemic plasma, decreased vascular AdipoR1/R2 expression, and reduced circulating APN levels contribute to reduced vascular responsiveness to APN at different stages of the obese condition. Reduced APN bioactivity allows unmitigated TNFα pro-apoptotic and pro-inflammatory actions, contributing to vascular injury in obesity/hyperlipidemia.