The therapeutic modulation of atherogenic dyslipidemia and inflammatory markers in the metabolic syndrome: What is the clinical relevance?
Department of Clinical Medicine and Emerging Diseases, University of Palermo, Palermo, Italy. Acta Diabetologica
(Impact Factor: 2.4).
11/2008; 46(1):1-11. DOI: 10.1007/s00592-008-0057-4
The metabolic syndrome consists of a constellation of clinical and biochemical risk factors that cluster together and heighten the risk for atherogenesis, cardiovascular diseases, and diabetes. Established risk cardiovascular factors like hypertension, atherogenic dyslipidaemia, and glucose intolerance occur in the setting of insulin resistance and central adiposity, with genetic and environmental influences modulating the ultimate risk. Chronic insults to the endothelium take its toll in the form of silent as well as clinically evident cardiovascular events. The cellular and vascular accompaniments have shed some light into the underlying pathophysiology. Heightened, low-grade inflammatory processes as well as a continuum of vascular insults ranging from early endothelial derangements to advanced atherosclerosis have been examined. In recent years there has been an explosion of basic and clinical knowledge related to the metabolic syndrome. Although dyslipidaemia is considered a traditional risk component for the syndrome, its qualitative aspects, genetically determined subfractions, and variation in proatherogenic tendency have generated renewed interest and debate. New targets within the dyslipidaemic spectrum that have differing clinical relevance are being evaluated. The effect of heredity, lifestyle changes, pharmacotherapeutic agents, and supplements is being investigated. Further research into the impact of dyslipidemia and inflammation as both pathophysiologic risk factors and objects for targeted therapy in the metabolic syndrome should deepen our understanding and unravel answers to the underlying dynamics in this global epidemic.
Available from: Maciej Banach
- "Although dyslipidemia is considered as a traditional risk component for the metabolic syndrome, its qualitative aspects, genetically determined subfractions and variation in proatherogenic tendency have generated renewed interest and debate . Different cholesterol concentrations were reported in diabetes caused by single-gene mutations in children and young adults [2, 3]. "
[Show abstract] [Hide abstract]
ABSTRACT: Patients with diabetes caused by single-gene mutations generally exhibit an altered course of diabetes. Those with mutations of the glucokinase gene (GCK-MODY) show good metabolic control and low risk of cardiovascular complications despite paradoxically lowered high-density lipoprotein (HDL) cholesterol levels. In order to investigate the matter, we analyzed the composition of low-density lipoprotein (LDL) and HDL subpopulations in such individuals. The LipoPrint(©) system (Quantimetrix, USA) based on non-denaturing, linear polyacrylamide gel electrophoresis was used to separate and measure LDL and HDL subclasses in fresh-frozen serum samples from patients with mutations of glucokinase or HNF1A, type 1 diabetes (T1DM) and healthy controls. Fresh serum samples from a total of 37 monogenic diabetes patients (21 from GCK-MODY and 16 from HNF1A-MODY), 22 T1DM patients and 15 healthy individuals were measured in this study. Concentrations of the small, highly atherogenic LDL subpopulation were similar among the compared groups. Large HDL percentage was significantly higher in GCK-MODY than in control (p = 0.0003), T1DM (p = 0.0006) and HNF1A-MODY groups (p = 0.0246). Patients with GCK-MODY were characterized by significantly lower intermediate HDL levels than controls (p = 0.0003) and T1DM (p = 0.0005). Small, potentially atherogenic HDL content differed significantly with the GCK-MODY group showing concentrations of that subfraction from control (p = 0.0096), T1DM (p = 0.0193) and HNF1A-MODY (p = 0.0057) groups. Within-group heterogeneity suggested the existence of potential gene-gene or gene-environment interactions. GCK-MODY is characterized by a strongly protective profile of HDL cholesterol subpopulations. A degree of heterogeneity within the groups suggests the existence of interactions with other genetic or clinical factors.
Acta Diabetologica 02/2014; 51(4). DOI:10.1007/s00592-014-0567-1 · 2.40 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: A general problem of supervised remotely. sensed image classification assumes prior knowledge to be available for all thematic classes that are present in the considered data set. However, the ground truth map representing this prior knowledge usually does not really, describe all the land cover typologies in the image and the generation of a complete training set represents a time-consuming, difficult and expensive task. This problem may play a relevant role in remote sensing data analysis, since it affects the classification performances of supervised classifiers, which erroneously assign each sample drawn from an unknown class to one of the known classes. In the present paper, a classification strategy is proposed, which allows the identification of samples drawn from unknown classes, through the application of a suitable Bayesian decision rule. The proposed approach is based on support vector machines (SVMs) for the estimation of probability density, functions and on a recursive procedure to generate prior probabilities estimates for both known and unknown classes. For experimental purposes, both a synthetic data set and two real data sets are employed.
Advances in Techniques for Analysis of Remotely Sensed Data, 2003 IEEE Workshop on; 11/2003
[Show abstract] [Hide abstract]
ABSTRACT: The aims are to examine whether changes in body weight (dBW) are associated with changes in cardiovascular risk factors in Japanese men without abdominal obesity (waist circumference (WC) < 85 cm) and which anthropometric index, dBW or changes in WC (dWC), is more strongly associated with changes in cardiovascular risk factors in men without abdominal obesity. It is a retrospective study in 692 Japanese men without abdominal obesity who took annual health screening tests consecutively over one year. Standardized linear regression coefficients (SRCs) of dBW and dWC were calculated for changes in systolic blood pressure (dSBP), diastolic blood pressure (dDBP), fasting plasma glucose (dFPG), triglycerides (dTG), HDL cholesterol (dHDL), and high-sensitivity C-reactive protein (dCRP). The SRCs of dBW for dFPG and dHDL were significant in all men and in men with each risk factor corresponding to the component of metabolic syndrome (MetS). The SRCs of dWC for dTG and dCRP were significant in all men but not in men with each risk factor corresponding to the MetS component. In conclusions, dBW were significantly associated with dFPG and dHDL in Japanese men without abdominal obesity. Therefore, abdominal obesity should not be considered as a necessary component of MetS in Japanese men. dBW may be more useful than dWC as a marker of changes in cardiovascular risk factors in lifestyle intervention programs.
Acta Diabetologica 11/2010; 48(2):143-8. DOI:10.1007/s00592-010-0238-9 · 2.40 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.