Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adipose tissue (AT) is not considered anymore as a passive depot for storing excess energy in the form of triglycerides but as an active organ secreting several hormones or adipokines. With the exception of adiponectin the serum levels of adipokines are increased in obesity. Leptin regulates food intake, reproductive and immune system. Adiponectin decreases insulin resistance and has antiinflammatory properties. On the contrary, resisting, tumor necrosis factor and Interleukin-6 are diabetogenic and induce inflammatory reactions. It is believed that atherosclerosis is due to the inflammation induced by oxydized LDL-cholesterol in vessels. Abdominal obesity is associated with increased incidence of metabolic disorders and insulin resistance. The role of adipokines in these disorders is described as well as their role in the antidiabetic effect of thiazo-linedinediones. AT contains also enzymes responsible for the aromatization of androstenedione into estrone, which could explain an increase of breast and uterus cancer in obese people.
 ...
PMID:[Adipose tissue: a real endocrine gland synthesizing hormones and cytokines: clinical implications]. 1509 64

About 60% of patients with mild and moderate hypertension have insulin resistance and half of them have clinically manifest metabolic syndrome which comprises abdominal obesity, hyperlipidemia, impaired glucose tolerance, hypertension and insulin resistance. In a framework of metabolic syndrome hypertension is characterized by disturbed circadian profile without nocturnal blood pressure lowering and concentric left ventricular hypertrophy. There exist 2 mechanisms of linkage between hypertension and metabolic syndrome: impaired ion transport and neurohormonal and humoral activation. Antihypertensive drugs for correction of hypertension in metabolic syndrome should be long acting, provide protection of target organs, and induce positive or neutral metabolic effect. Together with normalization of blood pressure these actions can cause lowering of risk of atherosclerosis development. Representatives of the following classes of antihypertensive agents can be used as drugs of choice: angiotensin converting enzyme inhibitors, long-acting calcium antagonists, selective beta1-adrenoblockers, and thiazide diuretics.
 ...
PMID:[Arterial hypertension in a framework of metabolic syndrome: special features and principles of drug correction]. 1511 79

Eighteen million Americans have type 2 Diabetes Mellitus (DM) while another 40 million have impaired glucose tolerance. Atherosclerotic heart disease is the leading cause of death in patients with diabetes mellitus. In addition to the increased risk for CardioVascular Disease (CVD), patients with diabetes have a worse prognosis than nondiabetics when they suffer an ischemic event. Insulin resistance is increasingly recognized as a chronic, low-level, inflammatory state. Hyperinsulinemia has been proposed as the forerunner of hypertension, low high-density lipoprotein cholesterolemia, hypertriglyceridemia, abdominal obesity, and altered glucose tolerance, linking all these abnormalities to the development of coronary vascular disease. Atherosclerosis and insulin resistance share similar pathophysiological mechanisms, due to the actions of proinflammatory cytokines. The dynamic inflammatory milieu found in diabetes explains the susceptibility of diabetics to CVD and the potential mechanism by which aspirin may prevent CVD in diabetics. Aspirin decreases the risk for CVD in diabetic patients by a variety of established and novel mechanisms. Therapeutic strategies that lesson the CVD risk in diabetic patients, including the use of aspirin for primary and secondary prevention, are potentially very important. This review article addresses the antiatherosclerotic effects of aspirin, the potential anti-diabetic effects of aspirin, and the clinical trial evidence for CVD prevention by aspirin in diabetics. We also present recommendations for the use of aspirin in the diabetic population and the current guidelines put forth by the American Heart Association and by the American Diabetes Association.
 ...
PMID:Prevention of cardiovascular complications of diabetes mellitus by aspirin. 1549 69

A group of 247 middle-aged men and women with diabetes lasting mostly for less than 5 years, treated by diet alone and oral antidiabetics resp. is followed up in the surgeries of nine general practitioners, with special attention to early detection and prevention of macroangiopathies. In the submitted paper the authors focus their attention on the body build of patients and the importance of assessment of abdominal adipose tissue by available anthropometric methods. The patients were obese, mostly with abdominal accumulation of adipose tissue. As to indicators of abdominal obesity in particular the waist circumference and waist/hip ratio proved useful as they correlated significantly with insulin secretion assessed by C peptide, triacylglycerols, HDL-cholesterol, blood pressure, with ECG signs of ischaemia and a reduced blood flow in the lower limbs, evaluated from the ankle indexes (ABP). Determining factors for the waist circumference included the C peptide concentration, ABP index, HDL-cholesterol level and treatment of hypertension. With regard to the relatively high incidence of subclinical signs of vascular injury in these diabetics the authors draw attention to the practical impact of the demonstrated correlations between waist circumference and risk factors of atherosclerosis which is a threat for insulinresistant diabetics already at the time of is onset.
 ...
PMID:[Abdominal obesity and cardiovascular risk in type 2 diabetics]. 1564 38

Elevated C-reactive protein concentration, measured by an ultrasensitive method (hsCRP), has been proved to be a risk factor for atherosclerosis progression and its complications (myocardial infarction and stroke) in otherwise healthy men and women. In patients with already diagnosed atherosclerotic disease elevated concentration of hsCRP predicts prognosis. There are multiple causes of elevated hsCRP concentration: metabolic changes (e.g. as a part of metabolic syndrome), genetic background and chronic infections. Proinflammatory effect of adipose tissue in obese individuals seems to play an important role, hsCRP levels correlate with markers of abdominal obesity. Elevated hsCRP concentrations can be lowered both pharmacologically and by a lifestyle change. This review covers current knowledge of pathophysiology of elevated hsCRP concentration and possible use of this method in clinical medicine.
 ...
PMID:[An ultrasensitive C-reactive protein assay--a new parameter in cardiovascular risk]. 1564 58

Polycystic ovary syndrome (PCOS), a common endocrinopathy of women of reproductive age, is associated with the early appearance of multiple risk factors for cardiovascular disease, such as abdominal obesity, dyslipidemia, and diabetes mellitus. However, premature atherosclerosis of the carotid artery has not yet been demonstrated in young women with PCOS. Measurement of carotid intima-media thickness (IMT) is considered an easy and reliable index of subclinical atherosclerosis, which is predictive of subsequent myocardial infarction and stroke. To evaluate the cardiovascular risk of PCOS and the participation of the hyperandrogenemic and metabolic pattern, we measured carotid IMT by B-mode ultrasound as well as hormonal and several cardiovascular disease-associated parameters in 75 young women with PCOS and 55 healthy, age- and body mass index-matched women. The PCOS women had significantly increased carotid IMT (0.58 vs. 0.47 mm, P < 0.001) and abdominal adiposity; higher levels of androgens, insulin, homeostasis model assessment score of insulin sensitivity, and total and low-density lipoprotein-cholesterol; and significantly lower levels of SHBG and high-density lipoprotein-cholesterol. In the studied population (n = 130), PCOS status, age, body mass index, and parental history of coronary heart disease were strong positive predictors of carotid IMT, whereas dehydroepiandrosterone sulfate was a strong negative predictor. In PCOS patients lower delta4-androstenedione and high-density lipoprotein-cholesterol levels were additionally strong positive predictors of carotid IMT, whereas in control women only total cholesterol was the additional positive predictor of carotid IMT. In conclusion, young women with PCOS have an early increase of cardiovascular risk factors and greater carotid IMT, both of which may be responsible for subclinical atherosclerosis. The hyperandrogenemic phenotype of the syndrome may attenuate the consequences of the dysmetabolic phenotype on the vascular wall.
 ...
PMID:Association of hyperandrogenemic and metabolic phenotype with carotid intima-media thickness in young women with polycystic ovary syndrome. 1574 Dec 56

The metabolism of apoB-containing lipoproteins was investigated in the fasted state in three complete and three partial hepatic lipase (HL)-deficient subjects as well as in seven normotriglyceridemic (NTG) and two hypertriglyceridemic (HTG) controls using a 12 h primed-constant infusion of L-[5,5,5-D(3)]-leucine. Two males with complete HL deficiency had increased plasma pool sizes of VLDL and IDL apoB-100 due to substantial reductions in fractional catabolic rate (FCR) of VLDL and IDL apoB-100 compared with both NTG and HTG controls. Reductions in LDL apoB-100 production rate (PR) were also observed in these two patients compared with NTG and HTG controls. Complete HL deficiency in the female proband was associated with normal VLDL apoB-100 kinetics, while plasma IDL apoB-100 pool size was increased by 124% due to an 82% decrease in the FCR of IDL apoB-100. The FCR and PR of LDL apoB-100 were reduced by 64 and 51%, respectively, in the proband compared with sex-matched controls. Partial HL-deficient patients were characterized by apoB-containing lipoprotein metabolism similar to that of controls. These results indicate that complete HL deficiency is associated with a potentially atherogenic apoB-containing lipoprotein metabolism that can be modulated considerably by secondary factors such as gender and abdominal obesity.
Atherosclerosis 2005 Jun
PMID:Plasma metabolism of apoB-containing lipoproteins in patients with hepatic lipase deficiency. 1591 Aug 63

Metabolic syndrome is widely spread in population especially among subjects with risk factors of atherosclerosis related diseases. Since 1988 criteria of metabolic syndrome have undergone substantial transformation. Technical difficulties related to detection of insulin resistance created obstacles to application of the term "metabolic syndrome" in clinical practice. In 2001 experts of National Cholesterol Education Program in USA suggested new set of criteria. The presence of 3 or more of the following 5 components (abdominal obesity, hypertriglyceridemia, low level of high density lipoprotein cholesterol, hypertension and high fasting blood glucose) allows to diagnose metabolic syndrome. These worldwide used criteria do not imply detection of insulin resistance. Feasibility of this approach has been confirmed by analysis of correlation between presence of markers of insulin resistance and that of metabolic syndrome according to novel criteria. This analysis has shown that combination of 3 or more components is significantly associated with insulin resistance.
 ...
PMID:[Is it necessary to detect insulin resistance for diagnosis of metabolic syndrome in clinical practice?]. 1594 Feb 4

Metabolic syndrome affects approximately one quarter of population in developed countries. Its presence is a major risk for development of both type 2 diabetes (T2DM) and atherosclerosis. The prevalence of cardiovascular disease is 2-3 times higher in individuals with metabolic syndrome than in age-matched controls. Most important components of metabolic syndrome are insulin resistance with or without glucose intolerance, abdominal obesity, atherogenic dyslipidaemia, hypertension, prothrombotic state and proinflammatory state. Early identification of subjects with metabolic syndrome is very important, since they represent a target group for multiple lifestyle and pharmacological interventions. Lifestyle interventions, antiobesity drugs and drugs increasing insulin sensitivity prevented development of T2DM in subjects with impaired glucose tolerance in randomized trials. Treatment of atherogenic dyslipidaemia to the therapeutic goals defined for diabetic patients seems reasonable and both statins and fibrates could be used based on evidence from clinical trials. Treatment of hypertension should also aim for target levels similar to those in diabetic patients. Using drugs affecting renin-angiotensin II axis, as first choice seems reasonable based on evidence from clinical trials showing the ability of these drugs to prevent T2DM and decrease albuminuria.
 ...
PMID:Metabolic syndrome in relationship to type 2 diabetes and atherosclerosis. 1595 70

Obesity and overweight are linked with a cluster of metabolic and vascular disorders that have been termed the metabolic syndrome. Although there is not yet a universally-accepted set of diagnostic criteria, most expert groups agree that the syndrome is characterised by impaired insulin sensitivity and hyperglycaemia, dyslipidaemia (elevated blood triacyglycerols with depressed HDL-cholesterol), abdominal obesity and hypertension. Based on existing published criteria estimates suggest that the syndrome affects a substantial percentage of the middle-aged and elderly populations of most European countries (10-20%) and confers increased risk of type 2 diabetes (2-8.8-fold) and CVD (1.5-6-fold), as well as having a marked effect on morbidity. Although the pathophysiology is incompletely understood, insulin resistance and abdominal obesity are central to subsequent abnormalities in circulating glucose and lipoproteins, and vascular function that lead to type 2 diabetes, atherosclerosis and CVD. The link between metabolic syndrome, type 2 diabetes and CVD, as well as inability to reverse the present rising rates of obesity, will lead to economically-unsustainable costs of health care in the next 10-20 years. Preventative strategies for metabolic syndrome are required to slow rates of progression and to reduce dependence on costly medical management. A notable development is recent evidence that shows that diet and exercise are more effective than drug treatment in preventing the development of type-2 diabetes in high-risk individuals. The LIPGENE project will investigate dietary fat quality as a strategy for the prevention of metabolic syndrome and identify food chain approaches that can support consumer attempts to alter their dietary patterns.
 ...
PMID:Metabolic syndrome: what is it and what are the implications? 1604 68


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>