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Soluble Receptor for Advanced Glycation End Products and Its Correlation with Vascular Damage in Adolescents with Obesity.
Rodríguez-Mortera, R, Luevano-Contreras, C, Solorio-Meza, S, Gómez-Ojeda, A, Caccavello, R, Bains, Y, Gugliucci, A, Garay-Sevilla, ME
Hormone research in paediatrics. 2019;(1):28-35
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Abstract
OBJECTIVE The aim of this study was to evaluate soluble receptor for advanced glycation end products (sRAGE) and advanced glycation end products (AGEs) in adolescents with and without obesity (OB) and their correlation with vascular damage. METHODS This is a cross-sectional study with 15-19 years old adolescents: 33 with OB and 33 with normal weight (NW), each group included 17 male and 16 female. Lipid profile, insulin, carboxymethylysine (CML), sRAGE, total AGEs, and dietary AGEs intake (dAGEs) were evaluated. Vascular damage was measured by flow-mediated vasodilation (FMD) and arterial stiffness index (Iβ). Homeostatic model assessment-insulin (HOMA-IR) and atherogenic index (AI) were calculated. RESULTS The group with OB had higher triglycerides (TG; p < 0.0001), AI (p < 0.001), HOMA-IR (p < 0.0001), dAGEs intake (p < 0.0001), lower CML (p = 0.05), total AGEs (p < 0.01), sRAGE (p < 0.001), and FMD (p < 0.002). In the total group, sRAGE correlated with AI (r = -0.26 p = 0.037); in the NW group, CML correlated with Iβ (r = -0.36; p = 0.037); and in the group of adolescents with OB, sRAGE correlated with FMD (r = -0.37; p = 0.037) and Iβ (r = 0.47; p = 0.006), while CML and total AGEs correlated with AI, p = 0.007 and p < 0.01, respectively). CONCLUSIONS The group of adolescents with OB showed higher cardiometabolic risk as shown by higher TG, AI, HOMA-IR, and lower sRAGE and FMD. sRAGE correlated negatively with FMD and positively with Iβ, so it could be suggested as a biochemical marker of impaired endothelial function.
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A pilot-study to identify the feasibility of an Internet-based coaching programme for changing the vascular risk profile of high-risk patients.
Goessens, BM, Visseren, FL, de Nooijer, J, van den Borne, HW, Algra, A, Wierdsma, J, van der Graaf, Y, ,
Patient education and counseling. 2008;(1):67-72
Abstract
OBJECTIVE To evaluate the feasibility of a web-based coaching programme for vascular risk factor treatment, to describe the patterns of use and to measure changes in risk factors. METHODS Patients with a clinical manifestation of arterial disease and Internet access were asked to participate in the nurse-led Internet-based risk factor management programme. At the first clinic visit, a personalized action plan was made for the treatment of risk factors. Patients were instructed on communication with a specialized nurse through Internet and encouraged to enter self-measured risk factor levels at their personalized website. The nurse practitioner replied on working days and gave feedback, support, and recommendations on lifestyle and medical treatment. After 6 months, risk factors were re-measured. RESULTS Fifty patients participated, 70% were overweight, 64% had hypertension, 42% hyperlipidemia, and 24% smoked at baseline. During 6 months, the log-in average at the individual website was 35 times per patient (1.3 log-ins/week); while the nurse practitioner logged-in at the overall website 23 times/week. The website was hardly used by five patients. Most e-mail messages were sent by patients for hypertension (211 times) and obesity (203 times), whereas the nurse practitioner sent nearly twice as many e-mail messages for hypertension (400 times) and obesity (455 times). The level of most risk factors decreased and the fraction of achieved treatment goals increased (blood pressure from 36 to 58%, LDL-cholesterol from 58 to 64%, glucose from 64 to 82%). CONCLUSIONS A web-based vascular risk factor intervention programme is feasible; it is frequently used by patients and suitable to decrease the level of several risk factors. It has the promise of being an efficacious intervention for risk factor sanitation in patients with symptomatic vascular disease. PRACTICE IMPLICATIONS An Internet-based individualised risk management programme could make patients aware of their self-management capability and may contribute to risk factor reduction.
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Vascular events in the Multiple Outcomes of Raloxifene Evaluation (MORE) trial: incidence, patient characteristics, and effect of raloxifene.
Duvernoy, CS, Kulkarni, PM, Dowsett, SA, Keech, CA
Menopause (New York, N.Y.). 2005;(4):444-52
Abstract
OBJECTIVE To determine the incidence of arterial and venous thromboembolic (VTE) events, to determine the effect of raloxifene on the incidence of combined vascular (arterial and VTE) events, and to identify patient characteristics associated with these vascular events, in women participating in the MORE trial. DESIGN In a post hoc analysis using MORE data, arterial, VTE, and combined vascular event rates were compared between participants receiving placebo (n = 2,576) and those receiving 60 mg/d of raloxifene (n = 2,557). Baseline characteristics were compared between those who did and did not experience an arterial event. The same analysis was performed for VTE events. RESULTS Overall, during a mean follow-up time of 41 months, 178 women experienced an arterial event and 40 experienced a VTE event. In the placebo group, the incidence of arterial events exceeded VTE events by at least sevenfold. Raloxifene had no significant effect on the incidence of combined vascular events in the overall cohort (hazard ratio 0.95, 95% CI, 0.73-1.24). In a subset of women retrospectively determined to be at increased cardiovascular risk, raloxifene was associated with a lower incidence of combined vascular events (hazard ratio 0.63, 95% CI, 0.40-0.97). Baseline characteristics differed between those who did and those who did not experience an arterial event, but this was generally not the case for VTE events. CONCLUSIONS Arterial events were more common than VTE events. The characteristics of women experiencing an arterial event differed from those experiencing a VTE event. Raloxifene had a neutral effect on the risk of combined vascular events in the overall population, and was associated with a reduced combined vascular event rate in women at increased cardiovascular risk. Additional studies are needed to confirm the effect of raloxifene on overall vascular outcomes.
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Acute effect of amino acid peritoneal dialysis solution on vascular function.
Vychytil, A, Födinger, M, Pleiner, J, Müllner, M, Konner, P, Skoupy, S, Röhrer, C, Wolzt, M, Sunder-Plassmann, G
The American journal of clinical nutrition. 2003;(5):1039-45
Abstract
BACKGROUND Oral ingestion of proteins or amino acids is associated with endothelial dysfunction. The effect of commercial amino acid peritoneal dialysis solutions on vascular function is unknown. OBJECTIVE We compared the acute effect of intraperitoneal amino acid administration with that of intraperitoneal glucose administration on vascular function in peritoneal dialysis patients. DESIGN In an open-label randomized, controlled, crossover and observer-blinded trial, we examined the acute effect of an intraperitoneal application of 2 L commercial 1.1% amino acid solution compared with that of a 2.27% glucose solution in 13 peritoneal dialysis patients. The primary endpoint was the change in forearm reactive hyperemia 6 h after instillation of either dialysis solution. RESULTS After 6 h of dwell time, reactive hyperemia was substantially impaired after administration of the amino acid solution compared with the glucose solution (median difference: 202%; 95% CI: 57%, 368%; P = 0.007). In a comparison of differences between values at 6 h and those before treatment, reactive hyperemia significantly decreased during the dwell with the amino acid dialysis solution compared with that with the glucose dialysis solution (median difference: 242%; 95% CI: 53%, -457%; P = 0.013). In an analysis of smoking and nonsmoking patients separately, the difference in forearm blood flow between the 2 treatments was still statistically significant. CONCLUSIONS One 6-h dwell with a commercial amino acid dialysis solution acutely impairs forearm reactive hyperemia in smoking and nonsmoking peritoneal dialysis patients. Because endothelial dysfunction is associated with increased morbidity and mortality, the long-term use of these solutions may increase the risk of cardiovascular disease.
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Modifications of magnesium and copper concentrations in serum and arterial wall of patients with vascular diseases related to ageing, atherosclerosis and aortic aneurysm.
Iskra, M, Majewski, W, Piorunska-Stolzmann, M
Magnesium research. 2002;(3-4):279-85
Abstract
Relationship between concentration of Mg and Cu in serum and the arterial wall was studied in patients with atherosclerosis obliterans (AO), aortic aneurysm (AA) and in the control group. The effect of ageing was also evaluated. The results showed increased serum concentration of Cu in the eldest control group (50-59 years) when compared to the younger (20-29 years). Serum concentration of Mg was decreased in AO and AA, and that in the arterial wall was lower in AA, than in controls. Concentration of Cu in serum and the arterial wall was higher in AO than in controls. Lower limb ischaemia results in decreased serum Mg and increased Cu in the critical degree as compared with the moderate degree of ischaemia. The ratio Mg/Cu was found lower both in serum and the arterial wall in AO and AA, as a result of ageing and vascular disease, and it could be better marker of ischaemia than individual element concentrations.
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Fluvastatin prevents development of arterial stiffness in haemodialysis patients with type 2 diabetes mellitus.
Ichihara, A, Hayashi, M, Ryuzaki, M, Handa, M, Furukawa, T, Saruta, T
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2002;(8):1513-7
Abstract
BACKGROUND Arterial stiffness assessed by pulse wave velocity (PWV) predicts all-cause and cardiovascular mortality in diabetic patients with end-stage renal disease. We studied the preventive effects of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, fluvastatin, on arterial PWV values in this population. METHODS Twenty-two patients with normal serum lipid levels received fluvastatin (20 mg/day p.o.) or a placebo for 6 months. Their serum lipid levels, serum levels of C-reactive protein (CRP), arterial PWV, and ankle brachial indexes (ABI) were determined before, and 3 and 6 months after taking the medication to evaluate arterial stiffness. RESULTS At the beginning of the follow-up, there were no differences in age, blood pressure, body mass index, serum haemoglobin A1c level, serum CRP level, serum lipid levels, PWV or ABI between the placebo- (n=10) and the fluvastatin-treated patients (n=12). After 6 months, the PWV and the serum oxidized low-density lipoprotein cholesterol (LDL-C) level increased significantly (from 1969+/-140 to 2326+/-190 cm/s and 70.4+/-13.8 to 91.8+/-15.5 U/l, respectively) in the placebo-treated patients. However, the fluvastatin group had a significantly reduced PWV (from 1991+/-162 to 1709+/-134 cm/s), oxidized LDL-C serum levels (from 89.0+/-9.6 to 73.0+/-5.8 U/l) and CRP serum levels (from 0.97+/-0.32 to 0.26+/-0.16 mg/dl) compared with those in the placebo group. CONCLUSIONS Long-term administration of fluvastatin prevents further worsening of arterial biomechanics in haemodialysis patients with type 2 diabetes mellitus, even in the presence of serum lipid levels in the normal range.
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Decreasing plasma endothelin-1 and unchanged plasma neopterin during folate supplementation in hyperhomocysteinemia.
Gottsäter, A, Forsblad, J, Mattiasson, I, Lindgärde, F
International angiology : a journal of the International Union of Angiology. 2002;(2):158-64
Abstract
BACKGROUND Hyperhomocysteinemia is a risk factor for atherosclerosis and venous thrombosis, probably exerting its effects through endothelial function. Homocysteine levels are lowered by folate supplementation, and such treatment improves endothelial function. However, whether folate supplementation decreases vascular risk and improves survival is unknown. The aim of this study was to evaluate endothelial function and mononuclear leukocyte inflammatory activity during homocysteine lowering in patients with hyperhomocysteinemia and vascular disease. METHODS Endothelial function assessed as plasma (p-)endothelin(ET)-1 and intraplatelet cGMP and cAMP, and mononuclear leukocyte inflammatory activity, assessed as p-neopterin were studied during homocysteine lowering in 50 patients with hyperhomocysteinemia and vascular disease, randomized to folate supplementation or no treatment for 3 months. RESULTS P-homocysteine decreased during the 3 months not only in patients on folate supplementation (from 27 [21-52] to 14 [8-41] micromol/l; p<0.001), but also in the untreated group (from 23 [20-35] to 19 [4-31] micromol/l; p<0.001). P-ET-1 decreased during folate supplementation (from 5.7 [2.7-11.6] to 4.1 [1.8-9.0] pg/ml; p<0.01), but was unchanged in the untreated group 4.1 [2.0-9.5] pg/ml and 4.5 [2.7-7.1] pg/ml). P-neopterin was unchanged in patients on folate supplementation (9.7 [5.1-54.4] and 7.6 [5.7-73.0] nmol/l), but increased in the untreated group (from 8.2 [4.7-19.5] to 8.6 [4.6-24.6] nmol/l; p<0.05). Intraplatelet cGMP decreased in patients on folate supplementation (from 0.86 [0.21-2.00] platelets to 0.56 [0.17-1.42] pmol/10(9) platelets; p<0.05), but was unchanged in the untreated group. No significant differences concerning intraplatelet cAMP occurred in either group. CONCLUSIONS Folate supplementation in hyperhomocysteinemia is associated with decreasing levels of both ET-1 and intraplatelet cGMP, and the absence of an increase in the levels of the inflammatory mediator neopterin.