Mingfang Li

Queen Mary Hospital, Hong Kong, Hong Kong

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Publications (6)20 Total impact

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    ABSTRACT: In many countries, combination therapy with amlodipine and atorvastatin is indicated for the treatment of patients with hypertension and hypercholesterolemia. The aim of this study was to investigate the impact of this combination therapy on plasma adiponectin levels. Combination therapy with amlodipine and atorvastatin would increase plasma adiponectin levels. A total of 25 patients with coronary artery disease and concomitant hypertension and hypercholesterolemia were evaluated. The combination of amlodipine and atorvastatin in 8 different dosage strengths were flexibly titrated over a period of 14 weeks. Lipid profile and plasma adiponectin were measured. Brachial flow-mediated dilation (FMD) was determined by vascular ultrasound. As compared with baseline, combination therapy with amlodipine and atorvastatin significantly reduced systolic and diastolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol (all P < 0.05). Furthermore, there were significant increases in adiponectin levels (mean [95% confidence interval (CI)], 12.1 [10.7-13.7] vs 8.1 [6.5-10.0] μg/mL; P < 0.001) and brachial FMD (4.4 ± 0.6% vs 5.6 ± 0.5%; P = 0.046) over 14 weeks of treatment. The change in adiponectin levels correlated significantly with the changes in diastolic blood pressure (r = -0.49; P = 0.014) and FMD (r = 0.55; P = 0.007). The results of this study indicate that along with its antihypertensive and cholesterol-lowering effects, combination therapy with amlodipine and atorvastatin appears to increase plasma adiponectin levels and improve endothelial function.
    Postgraduate Medicine 11/2011; 123(6):66-71. DOI:10.3810/pgm.2011.11.2496 · 1.97 Impact Factor
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    ABSTRACT: Type 2 diabetes mellitus (DM) is associated with a decreased level of circulating endothelial progenitor cells (EPCs) and adiponectin. Experimental studies suggest a potential link between hypoadiponectinaemia and the depletion of the EPC level. This study investigated the relationships between adiponectin level and EPC in patients with type 2 DM. A total of 95 type 2 DM patients (58.5 ± 8.8 years, 42 men) and 95 age- and sex-matched healthy controls were recruited. Circulating EPC levels were determined by flow cytometry using CD133(+), CD34(+), CD133(+) /KDR(+) and CD34(+) /KDR(+) as surface markers. Plasma adiponectin levels were measured by enzyme-linked immunosorbent assay. EPC function was studied by in vitro tube formation and migration assay. The levels of CD133(+) (p < 0.001) and CD133(+) /KDR(+) (p < 0.001) EPCs were independently associated with the presence of type 2 DM. The levels of CD34(+) (p = 0.004) and CD34(+) /KDR(+) (p = 0.013) EPCs were independently associated with haemoglobin A(1c). Nevertheless, there was no relationship between the number of EPCs and adiponectin level. Tube formation assay showed impaired pro-angiogenic function of EPC in DM patients compared with controls (p = 0.007). Interestingly, adiponectin supplementation (5 µg/mL) increased tube formation by 17.6% in EPCs from DM patients (p = 0.002). It also significantly enhanced cell migration by 35.9% in EPCs from DM patients (p = 0.01). We detected no relationship between the reduction in the level of EPC and in the level of total adiponectin in blood from patients with type 2 diabetes. EPC from patients with diabetes were stimulated when exposed to adiponectin in the test tube, findings that warrant further study.
    Diabetes/Metabolism Research and Reviews 02/2011; 27(2):185-94. DOI:10.1002/dmrr.1159 · 3.59 Impact Factor
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    ABSTRACT: Low plasma adiponectin level can predict the development of hypertension after 5 years in our population. We therefore investigated whether single-nucleotide polymorphisms (SNPs) in the adiponectin gene influenced plasma adiponectin level and whether they were associated with hypertension. We genotyped 14 tagging SNPs in 1616 subjects with persistent normotensive or hypertensive status during a 6.4-year follow-up period in the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS-2). Plasma adiponectin level was measured in 1385 subjects using in-house sandwich ELISA. The minor G allele of the SNP rs266729 was significantly associated with higher odds of hypertension (odds ratio (95% confidence interval)=1.49 (1.13-1.95), P=0.0044) after adjusting for covariates. In stepwise multiple logistic regression, this SNP (P=0.006) was a significant independent factor of hypertension, together with age (P<0.001), body mass index (P<0.001), triglycerides (P=0.021), and insulin resistance index (P<0.001). Among the 14 SNPs, rs266729 (beta=-0.067, P=0.0037), -10677C>T (beta=0.069, P=0.0027), rs182052 (beta=-0.097, P<0.0001), and rs12495941 (beta=0.103, P<0.0001) were significantly associated with adiponectin level after adjusting for covariates. No significant sex interaction was found for the associations of SNPs with hypertension and adiponectin level. Similar results were obtained in haplotype analysis. In our population, genetic variants in the adiponectin gene influenced plasma adiponectin levels, and one of them was associated with hypertension. This study has provided further evidence for a role of adiponectin in the development of hypertension.
    European Journal of Endocrinology 08/2010; 163(2):251-7. DOI:10.1530/EJE-10-0251 · 3.69 Impact Factor
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    Mingfang Li, Bernard M Y Cheung
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    ABSTRACT: Obesity is associated with increased risk of conditions such as hypertension, dyslipidaemia, diabetes mellitus, and obstructive sleep apnoea. Pharmacotherapy for obesity should be considered in combination with lifestyle changes in obese patients, or overweight patients with other conditions that put them at risk of developing heart disease. Sibutramine and orlistat are the only two anti-obesity medications approved for long-term use. Sibutramine is a serotonergic and adrenergic drug that reduces food intake. Orlistat is a gastrointestinal lipase inhibitor that interferes with fat absorption. However, it commonly causes flatulence and diarrhoea. Rimonabant is the first of a series of endocannabinoid receptor antagonists. It was approved by the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMEA) as an adjunct to diet and exercise in treating obesity in 2006. However, despite the extensive clinical trial data, EMEA announced in 2008 that it has recommended suspension of rimonabant because of its psychiatric side effects. Studies evaluating the long-term safety and efficacy of anti-obesity agents are needed.
    British Journal of Clinical Pharmacology 12/2009; 68(6):804-10. DOI:10.1111/j.1365-2125.2009.03453.x · 3.69 Impact Factor
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    ABSTRACT: We examined the use of lipid lowering medications and control of dyslipidemia among US adults in 1999-2006. Data were extracted from the National Health and Nutrition Examination Survey 1999-2006. The mean low-density lipoprotein-cholesterol (LDL-C) level significantly decreased from 3.25+/-0.03 mmol/L in 1999-2002 to 3.02+/-0.02 mmol/L in 2003-2006 in men, and from 3.11+/-0.03 to 2.98+/-0.03 mmol/L in women (p<0.001). Statins and fibrates were the most commonly used medications. Among those diagnosed with hypercholesterolemia, the proportion on treatment increased from 32.4% to 38.9% (p=0.001) in the 8-year period. The proportion of participants with a history of diabetes treated with a statin increased from 20.9+/-2.2% in 1999-2002 to 37.6+/-2.5% in 2003-2006 (p<0.001). However, only 39.9% of people with diabetes and 45.4% of people with ischemic heart disease (IHD) achieved LDL-C target levels. Between 1999 and 2006, LDL-C level decreased in US adults and use of lipid lowering medications increased. More effort is still needed to detect and treat dyslipidemia in the community, particularly in people at high cardiovascular risk.
    Atherosclerosis 08/2009; 208(2):456-60. DOI:10.1016/j.atherosclerosis.2009.08.001 · 3.71 Impact Factor
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    ABSTRACT: High-density lipoprotein (HDL) cholesterol is a powerful cardiovascular risk factor. Important gender and ethnic differences in plasma HDL levels exist and warrant investigation. Cross-sectional survey in two different general populations. Patients 7700 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2002 and 1944 participants of the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS2) 2000-2004. Plasma HDL levels. Plasma HDL levels were higher in women than in men in both populations. In the United States women, it increased with age, whereas in Chinese women, it declined with age and converged with male HDL levels. In the United States, 37.1 +/- 1.2% men and 38.9 +/- 1.1% women had low HDL levels. In Hong Kong, 34.3 +/- 1.6% men and 34.5 +/- 1.5% women had low HDL levels. In Americans, the independent predictors of low HDL levels were lower age, being non-Mexican Hispanic, waist circumference, triglycerides and not drinking alcohol in men, and lower age, being Hispanic, waist circumference, triglycerides, current smoking and not drinking alcohol in women. In Hong Kong Chinese, the independent predictors of low HDL levels were body mass index, triglycerides, current smoking and not drinking alcohol in men, and lower age, waist circumference, triglycerides, diabetes and former smoking in women. The decline in plasma HDL with age in Chinese women is opposite to that seen in American women. The increased cardiovascular risk in elderly Chinese women requires further study.
    Clinical Endocrinology 09/2008; 70(4):561-8. DOI:10.1111/j.1365-2265.2008.03361.x · 3.35 Impact Factor