Does NO metabolism play a role in the effects of vegetables in health? Nitric oxide formation via the reduction of nitrites and nitrates

A recent attribution of vegetables to human health stems from their effect on the gasotransmitter nitric oxide (NO). This commentary proposes that a major reason for this attribution is that vegetables are rich in nitrates. Recent research has shown that nitrites and nitrates are not only inert end-products of NO oxidation. In addition, they can be recycled back to bioactive NO and this pathway is an important alternative to the classical l-arginine-NO-synthase pathway.Various chronic ailments, e.g., diabetes, obesity, high blood pressure, are symptomatic of NO bioavailability. Because NO deficiency is metabolically complex, natural nitrate-rich nutrients, like green leafy vegetables, can improve these chronic ailments via the alternative nitrate–NO pathway.This commentary implies an added value for vegetables in enhancing health such as cardiac health and in lowering the risks of maladies such as diabetes.     

High-sensitivity C-reactive protein at different stages of atherosclerosis: results of the INVADE study

Evidence on the role of high-sensitivity C-reactive protein (hsCRP) at different stages of atherosclerosis is limited. We therefore analyzed the relationship between hsCRP and measures of subclinical and advanced atherosclerosis in a population-based sample of the INVADE study (n = 3,092, >55 years). The parameters of interest were IMT, ABI, and the stage of atherosclerosis. Differences between participants with normal and pathological hsCRP were analyzed by t test for independent samples or Fishers’ exact test. Differences of hsCRP between IMT quartiles, ABI quartiles, and different stages of atherosclerosis were analyzed by one-way ANOVA. Adjusted stepwise multiple linear regression analysis (IMT and ABI) and adjusted analysis of variance (stage of atherosclerosis) were performed, including significant baseline parameters as covariates. ANOVA showed significant differences of hsCRP among IMT quartiles, ABI quartiles, and patients with and without atherosclerosis. The adjusted analyses confirmed that the effects of IMT, ABI, and atherosclerosis on hsCRP were independent from other significant baseline parameters, but did not yield a significant difference between subclinical and advanced stages of atherosclerosis. The present analysis indicates an independent relationship between hsCRP and both IMT and ABI as measures of subclinical atherosclerosis. The comparison of subclinical and advanced stages of atherosclerosis yielded no significant difference, indicating that hsCRP is sensitive to identify vascular risk patients, but not suited to monitor progression of the disease.     

Determinants of atherosclerosis in an Egyptian cohort of systemic sclerosis: Relation to disease activity and severity

BackgroundSystemic sclerosis (SSc) is a rare multi-system autoimmune disease characterized by vascular abnormalities with an increased prevalence of macrovascular disease.Aim of the workTo evaluate macro-vascular disease (atherosclerosis) in SSc patients and determine its relation to the disease activity and severity.Patients and methodsTwenty-five SSc patients and 20 matched controls were included. The modified Rodnan skin score (mRss) and disease severity by Medsger’s severity score were assessed. Carotid intima-media thickness (IMT) and flow mediated vasodilatation (FMD) of the brachial artery were measured. Traditional vascular risk factors were assessed by thorough history taking and laboratory investigations.ResultsThe age of the patients ranged from 15 to 60 years and they were 22 females and 3 males. 15 had limited and 10 diffuse cutaneous SSc. All SSc patients had an increased IMT (1.24 ± 0.29 mm) which was normal in the control subjects (0.77 ± 0.09 mm) (p < 0.0001). SSc patients had significantly lower HDL, thickened IMT and lower FMD than controls (p = 0.005, p < 0.0001 and p < 0.0001 respectively). The younger age of disease onset was significantly associated with more FMD impairment (r = −0.4, p = 0.04) and Medsger’s severity score (r = 0.5, p = 0.009). The mRss and Medsger’s severity score significantly correlated with the IMT (r = 0.84, p = 0.01 and r = 0.56, p = 0.003 respectively). A significant negative correlation was found between FMD and IMT (r = −0.77, p < 0.0001). Medsger’s severity score significantly correlated with FMD (r = −0.44, p = 0.02).ConclusionSSc is associated with an increased risk of atherosclerosis when compared to age and sex-matched controls. Determinants of this include; younger age of disease onset and more sever disease and low levels of HDL.     

Association of soluble CD40 ligand with carotid atherosclerosis in Japanese type 1 diabetic patients

Aims/hypothesis It has recently been shown that the soluble form of CD40 ligand (sCD40L) interacts with CD40 on vascular cells, leading to a variety of proinflammatory responses, and that serum sCD40L levels can be a predictive marker of cardiovascular events. The aim of this study was to estimate sCD40L levels in type 1 diabetic patients to examine a possible association with carotid atherosclerosis.Subjects and methods Human sCD40L levels in serum and intima–media thickness (IMT) of carotid artery were examined in 80 Japanese type 1 diabetic patients (27 men and 53 women, age 22.8±3.4 years (mean±SD), duration of diabetes 13.2±6.1 years) and 20 healthy age-matched non-diabetic individuals.Results Serum sCD40L levels were significantly (p=0.0185) higher in subjects with type 1 diabetes (2.10±1.33 ng/ml) compared with non-diabetic subjects (1.35±0.88 ng/ml). The greatest IMT (Max-IMT) and averaged IMT (Mean-IMT) were also significantly greater in patients with type 1 diabetes than in control subjects (0.73±0.14 vs 0.64±0.07 mm, p=0.0041, 0.63±0.09 vs 0.57±0.06 mm, p=0.0066, respectively). Levels of sCD40L were statistically significantly associated with Max-IMT (r=0.383, p<0.001) and Mean-IMT (r=0.275, p=0.0058). Furthermore, stepwise multivariate regression analyses demonstrated that sCD40L is a determinant of both Max- and Mean-IMT, independently of conventional risk factors.Conclusions/interpretation It is suggested that increased levels of serum sCD40L are associated with accelerated atherosclerotic change observed in young patients with type 1 diabetes.     

高血压患者双侧颈动脉血流和形态的偏侧差异性分析

目的探讨高血压对双侧颈动脉血流动力学及动脉壁厚度的影响差异。方法纳入原发性高血压患者52例为高血压组,健康体检者46例为健康组。应用彩色多普勒超声分别检测两组患者左右侧颈总动脉搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、动脉血流收缩期峰值(peak systolic velocity,PSV)、舒张末期的谷值(end diastolic velocity,EDV)和内-中膜厚度(intima-media thickness,IMT)。对比两组组内左右侧颈动脉上述指标的差异,以及两组组间同侧颈动脉上述指标的差异。结果高血压组颈总动脉P(IP=0.019)、R(IP=0.012)及IMT(P=0.043)均为左侧大于右侧,而两侧血流速度无显著差异。健康组左右侧颈总动脉上述各项指标均无显著差异。高血压组双侧IMT、RI均显著高于健康组同侧颈总动脉,其中左侧IMT P=0.002,右侧IMT P=0.017,左侧RI P=0.023,右侧RI P=0.024,同时左侧PI高于健康组(P=0.011),而两组间血流速度无显著差异。结论原发性高血压对颈动脉血流动力学及形态学影响左侧大于右侧。     

Anger is associated with subclinical atherosclerosis in low SES but not in higher SES men and women. The Cardiovascular Risk in Young Finns Study

We investigated the associations of anger and cynicism with carotid artery intima-media thickness (IMT) and whether these associations were moderated by childhood or adulthood socioeconomic status (SES). The participants were 647 men and 893 women derived from the population-based Cardiovascular Risk in Young Finns Study. Childhood SES was measured in 1980 when the participants were aged 3–18. In 2001, adulthood SES, anger, cynicism, and IMT were measured. There were no associations between anger or cynicism and IMT in the entire population, but anger was associated with thicker IMT in participants who had experienced low SES in childhood. This association persisted after adjustment for a host of cardiovascular risk factors. It is concluded that the ill health-effects of psychological factors such as anger may be more pronounced in individuals who have been exposed to adverse socioeconomic circumstances early in life.