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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Microorganisms infection was thought to be associated with atherosclerosis (AS), but the results of trials investigating antibiotic therapy in patients with coronary artery disease were controversial. Recently, a series of studies explored the relationship between gut flora and obesity, which showed that western-style diet (high fat) could induce imbalanced ratio of the Firmicutes versus the Bacteroidetes in the gut of germ-free mice and human beings, and gut flora could promote obesity through several novel pathways, such as inhibition of fasting-induced adipocyte factor. Meanwhile, data from some studies confirm that some link exists between the abdominal obesity and satiety centers (hindbrain and hypothalamus) with neurotransmitters and hormones. All of the above showed some connection between western-style diet, gut flora, visceral fat, and satiety centers, but until now, no study has shown us the exact mechanism about it. It is proposed that the vicious cycle composed of gut flora and visceral fat may initiate and promote AS. Attempts to confirm this hypothesis may lead to new directions in the study of the pathogenesis of AS and the development of novel strategies for the treatment of AS.
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PMID:Vicious cycle composed of gut flora and visceral fat: a novel explanation of the initiation and progression of atherosclerosis. 1792 Feb 7

The prevalence of the metabolic syndrome among developed countries is rising, and this is largely driven by increasing obesity rates. Central obesity plays a key role in the pathogenesis of the metabolic syndrome: it promotes inflammation, hypertension and dyslipidaemia, and leads to the development of type 2 diabetes mellitus and atherosclerosis. Clinical management should be focused on multifactorial intervention to address all the associated cardiovascular risk factors. The atherogenic mixed dyslipidaemic profile associated with the metabolic syndrome is an important target for intervention to reduce the risk of type 2 diabetes and premature cardiovascular disease.
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PMID:Clinical implications of the metabolic syndrome. 1793 57

Type 2 diabetes is usually associated with a number of metabolic and cardiovascular (or cardiometabolic) risk factors that contribute to a high rate of vascular events in these patients. Adipose tissue is now known to secrete a number of pro-inflammatory adipokines that are thought to mediate the link between obesity, insulin resistance and atherosclerosis. Therefore, not only is abdominal obesity a major cardiometabolic risk factor per se, it has the potential to give rise to other emerging risk factors. Plasma concentrations of inflammatory markers, such as C-reactive protein, may provide additional information to guide management and may even represent therapeutic targets. Reducing the risk of cardiovascular events in patients with Type 2 diabetes will involve targeting traditional risk factors and probably novel cardiometabolic factors.
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PMID:The importance of treating multiple cardiometabolic risk factors in patients with Type 2 diabetes. 1800 Dec 59

In spite of its prevalence, age-related androgen deficiency has not been studied in full. Androgen deficiency is associated with a lot of age-related diseases (coronary artery disease, arterial hypertension, obesity, diabetes mellitus, osteoporosis etc). The level of testosterone in men gradually decreases beginning at the age of 30 to 40 years. Age-related hypogonadism results in an increase in the frequency of cardiovascular diseases and cardiovascular mortality. Low testosterone level is associated with dyslipidemia, atherosclerosis, reduction of fibrinolysis, insulinoresistance, and abdominal obesity. Physiological doses of androgen preparations are supposed to have a positive effect on various chains of metabolism and improve the course of diseases in men.
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PMID:[Correction of androgen deficiency in elderly patients]. 1803 61

Parameters of HDL (concentrations of cholesterol, apoprotein A1, and phospholipids and phospholipid composition) determining their functional properties were studied in patients with arterial hypertension in combination with other components of metabolic syndrome (abdominal obesity, hyperlipidemia, and impaired glucose tolerance). Patients with isolated arterial hypertension did not differ from the control group by the concentration of apoprotein A1 and HDL cholesterol, but had lower content of HDL phospholipids and changed phospholipid composition: lower ratio of phosphatidylcholine and higher relative contents of lysophosphatidylcholine, sphingomyelin, and phosphatidylethanolamine. Parameters of HDL in patients with arterial hypertension associated with other components of metabolic syndrome did not differ from those in patients with isolated arterial hypertension. The observed changes in HDL in patients with arterial hypertension alone or in combination with other components of metabolic syndrome can impair functional capacity of HDL in reverse cholesterol transport, which increases the risk of atherosclerosis.
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PMID:Parameters of high-density lipoproteins in patients with arterial hypertension in combination with other components of metabolic syndrome. 1822 52

1. The worldwide epidemic of obesity in adults has been mirrored in children in developed and developing countries. 2. Central obesity appears to be driving a cluster of abnormalities often referred to as the metabolic syndrome. 3. The definition of the metabolic syndrome in children is not suited to arbitrary cut-offs and a definition using the significant clustering of risk factors that is already evident in childhood and adolescent populations may be preferable. 4. An Australian population study showed that 25% of 8-year-olds and 29% of 14-year-olds could be described by the high risk cluster with features similar to adult metabolic syndrome. 5. The high risk cluster was significantly linked to high and low birthweight, shorter duration of breast-feeding, larger postnatal weight gains after 12 months of age and raised C-reactive protein, gamma glutamyl transferase and alanine transaminase levels. At-risk young adults have also been shown to have macroscopic atherosclerosis in post-mortem studies. 6. Identification of at-risk children has obvious benefits for the individual and as well, for prevention of a future cohort with raised cardiovascular morbidity and mortality; however, complexities and controversies exist in doing so. Familial, genetic and lifestyle risk factors aggregate and labelling children with predisease may be problematic. Committed political and societal changes are necessary to reduce childhood obesity and subsequent adult cardiovascular disease.
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PMID:Childhood obesity, hypertension, the metabolic syndrome and adult cardiovascular disease. 1830 30

Worldwide, the rates of obesity are rapidly rising. Abdominal obesity in particular is associated with increased cardiovascular risk factors, namely increased triglycerides, low high-density lipoprotein (HDL) cholesterol, elevated blood pressure and increased plasma glucose. The cluster of these obesity-related metabolic disorders identifies individuals with the cardiometabolic syndrome, who are at particular risk for cardiovascular disease and type 2 diabetes. The accumulation of intra-abdominal fat and the subsequent development of visceral obesity rely on the body's mechanisms to store energy and to stimulate appetite. The endocannabinoid system has been implicated in the regulation of energy balance and has emerged as a critical target for the modulation of visceral obesity and insulin resistance. Its overactivity appears to be associated with the development of obesity. The current review examines the role of the endocannabinoid system in cardiometabolic disease and its basis as a target for modulating cardiovascular risk.
Atherosclerosis 2008 Aug
PMID:The endocannabinoid system and cardiometabolic risk. 1844 May 38

Risk reduction in patients with clinically manifest vascular disease focuses on preventing new vascular events and not on prevention of type 2 diabetes. However, given the common pathophysiological pathways involved in the development of atherosclerosis and type 2 diabetes, it is probable that people with atherosclerotic vascular disease have an elevated risk of type 2 diabetes. The present prospective cohort study investigated the incidence of type 2 diabetes and the effect of the presence of metabolic syndrome on the incidence of type 2 diabetes in 4,022 patients with clinically manifest atherosclerosis, included in the study from September 1996 to June 2006. Patients who died (n=456), who were lost to follow-up (n=84) and those with diabetes at baseline (n=558) were excluded, leaving 2,924 patients for analysis. The incidence of diabetes was assessed by questionnaire (self-reported diabetes). During 13,726 person-years of follow-up (median follow-up 4.3 years, range 2.4-7.0 years), there were 152 type 2 diabetes cases (5.2%), corresponding to an incidence rate of 11.1 (95% CI 9.4-13.0) per 1,000 person-years. Patients with metabolic syndrome were at increased risk of incident type 2 diabetes compared to those without metabolic syndrome, with an adjusted hazard ratio of 5.7 (95% CI 3.7-8.9) for Revised National Cholesterol Education Program, 6.0 (4.1-9.0) for National Cholesterol Education Program and 4.0 (2.7-6.1) for International Diabetes Federation definitions of metabolic syndrome. Of all metabolic syndrome components, abdominal obesity was most strongly associated with incident type 2 diabetes (94% higher risk of type 2 diabetes for 1 standard deviation (11.3 cm) increase in waist circumference). In conclusion, patients with manifest atherosclerosis are at high risk of developing type 2 diabetes. Metabolic syndrome identifies those at the highest risk and is an easy to use clinical tool. Abdominal obesity is a strong individual predictor of type 2 diabetes. Patients with manifest atherosclerosis and metabolic syndrome may derive particular benefit from lifestyle interventions focusing on weight reduction.
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PMID:Metabolic syndrome and incidence of type 2 diabetes in patients with manifest vascular disease. 1853 99

The relationship between uric acid and cardiovascular disease has been known since the 19th century, after that many authors reported the classical association of gout, hypertension, obesity and cardiovascular disease. With the exception of specific genetic defects in purine metabolism, increased uric acid is generally associated with important risk factors for atherosclerosis like hypertension, abdominal obesity, insulin resistance, the metabolic syndrome and renal failure. Studies have clearly shown an association between increased uric acid concentrations with oxidative stress, endothelial dysfunction, inflammation, subclinical atherosclerosis and an increased risk of cardiovascular events. Increased uric acid levels are independent markers of cardiovascular disease risk. Prospective studies are necessary to show that reduction of uric acid levels prevent cardiovascular events.
Atherosclerosis 2009 Jan
PMID:Uric acid: A marker of increased cardiovascular risk. 1858 21

Insulin resistance syndrome is characterized by hyperglycemia, atherogenic dyslipidemia, hypertension, and abdominal obesity. Hyperglycemia is the major risk factor for microvascular complications in type 2 diabetes. However, 70% to 80% of patients with type 2 diabetes will die of macrovascular disease. Atherogenic dyslipidemia-characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol (HDL-c) levels, and a preponderance of small, dense, low-density lipoprotein (LDL) particles-is the major cause of atherosclerosis in individuals with type 2 diabetes. Therefore, treatment of type 2 diabetes must address hyperglycemia to prevent microvascular disease (retinopathy, neuropathy, and nephropathy) and atherogenic dyslipidemia to prevent macrovascular complications. Emerging evidence indicates lipid and glucose homeostasis are interrelated via bile acid-activated nuclear hormone receptor signaling pathways. Agents that act on these pathways could simultaneously address hyperglycemia and dyslipidemia in patients with type 2 diabetes. Recent studies have shown that bile acid sequestrants, including cholestyramine, colestimide, and colesevelam HCl, significantly improve glycemic control and reduce LDL cholesterol levels in patients with type 2 diabetes. This paper will review the effects of bile acid sequestrants on both glucose and lipid metabolism in patients with type 2 diabetes.
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PMID:Reducing cardiovascular complications of type 2 diabetes by targeting multiple risk factors. 1867 Mar 66


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