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Elevated interleukin-10: a new cause of dyslipidemia leading to severe HDL deficiency.
Moraitis, AG, Freeman, LA, Shamburek, RD, Wesley, R, Wilson, W, Grant, CM, Price, S, Demosky, S, Thacker, SG, Zarzour, A, et al
Journal of clinical lipidology. 2015;(1):81-90
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Abstract
BACKGROUND Low high-density lipoprotein cholesterol (HDL-C) is a risk factor for coronary artery disease. Investigating mechanisms underlying acquired severe HDL deficiency in noncritically ill patients ("disappearing HDL syndrome") could provide new insights into HDL metabolism. OBJECTIVE To determine the cause of low HDL-C in patients with severe acquired HDL deficiency. METHODS AND RESULTS Patients with intravascular large B-cell lymphoma (n = 2), diffuse large B-cell lymphoma (n = 1), and autoimmune lymphoproliferative syndrome (n = 1) presenting with markedly decreased HDL-C, low low-density lipoprotein cholesterol (LDL-C), and elevated triglycerides were identified. The abnormal lipoprotein profile returned to normal after therapy in all 4 patients. All patients were found to have markedly elevated serum interleukin-10 (IL-10) levels that also normalized after therapy. In a cohort of autoimmune lymphoproliferative syndrome patients (n = 93), IL-10 showed a strong inverse correlation with HDL-C (R(2) = 0.3720, P < .0001). A direct causal role for increased serum IL-10 in inducing the observed changes in lipoproteins was established in a randomized, placebo-controlled clinical trial of recombinant human IL-10 in psoriatic arthritis patients (n = 18). Within a week of initiating subcutaneous recombinant human IL-10 injections, HDL-C precipitously decreased to near-undetectable levels. LDL-C also decreased by more than 50% (P < .0001) and triglycerides increased by approximately 2-fold (P < .005). All values returned to baseline after discontinuing IL-10 therapy. CONCLUSION Increased IL-10 causes severe HDL-C deficiency, low LDL-C, and elevated triglycerides. IL-10 is thus a potent modulator of lipoprotein levels, a potential new biomarker for B-cell disorders, and a novel cause of disappearing HDL syndrome.
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[Low HDL-cholesterol, high triglycerides--well known but often ignored].
Benz, R, Suter, PM
Praxis. 2004;(46):1911-6
Abstract
A reduced HDL-Cholersterol and increased triglyzerides are an often seen laboratory abnormality. They are known risk factors for arteriosclerosis. However the small influence of a pharamcologic treatment on the two reduced the interest in them. We therefore want to show the relation of the triglyzerides with the HDL-Cholesterol and the nonpharmacologic treatment of these two factors. Some clinical examples are illustrating the topic.
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Intervention in shift scheduling and changes in biomarkers of heart disease in hospital wards.
Bøggild, H, Jeppesen, HJ
Scandinavian journal of work, environment & health. 2001;(2):87-96
Abstract
OBJECTIVES The effect of introducing regularity, few consecutive night shifts, more weekends off, and only 2 different types of shifts (day-evening or day-night) into shift scheduling on biomarkers of heart disease was studied. METHODS Ergonomic shift criteria were introduced in a quasi-experimental controlled intervention in 4 hospital wards. Six wards participated as controls. Altogether 101 nurses and nurses' aides were followed for 6 months with measurements of cholesterol and triglycerides. The intervention led to more regular schedules and more staff having 2 shifts in 2 of the intervention wards 1 year after the intervention. The schedules among the controls became less regular and less predictable. The number of consecutive night shifts remained unchanged. RESULTS After 6 months the high-density lipoprotein (HDL) cholesterol level had increased in the intervention group, and the total cholesterol and low-density lipoprotein (LDL) cholesterol levels and the total:HDL cholesterol ratio had decreased. Regardless of the intervention, changes in regularity were associated with the triglyceride and HDL cholesterol levels and also with the total:HDL cholesterol ratio. More ergonomic changes were associated with lower LDL cholesterol levels, a lower total:HDL cholesterol ratio, and higher HDL cholesterol levels. CONCLUSIONS Increased ergonomic scheduling was possible. Lipids and lipoproteins changed as predicted, both when the changes were assessed in respect to the changes in schedules that resulted from the intervention and the changes that occurred regardless of the intervention. The study suggests that scheduling based on ergonomic criteria is a possible means for reducing the risk of heart disease among shift workers.