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

The insulin resistance syndrome (or syndrome X) is a cluster of symptoms (dyslipidemia, impaired glucose tolerance, overweight, hypertension) associated with a higher risk of atherosclerosis. It has been suggested that hemorheological abnormalities, often found in association with most of these symptoms, may be a part of this syndrome, and possibly play a role in the circulatory abnormalities. In 22 nondiabetic women (20-54 years) presenting a wide range of body mass index (from 20 to 48 kg/m2), insulin sensitivity was assessed with the minimal model procedure, over a 180 min intravenous glucose tolerance test with frequent sampling. The insulin sensitivity index SI (i.e. the slope of the dose-response relationship between insulin increased above baseline and glucose disposal) ranges between 0.1 and 20.1 x 10(-4) min-1/microU/ml) i.e all the range of insulin sensitivity. SI was negatively correlated with blood viscosity (r = -0.530 p < 0.02), body mass index (r = 0.563 p < 0.01) and baseline insulinemia (r = 0.489 p < 0.05). These correlations were independent of each other and were not explained by relationships between SI and fibrinogen or blood lipids. Thus, blood fluidity is correlated with insulin sensitivity when it is measured with an accurate technique, suggesting that blood hyperviscosity is a symptom of insulin resistance that might be involved in the cardiovascular risk of this syndrome.
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PMID:[Blood viscosity is correlated with insulin resistance]. 896 46

In summary, abnormalities in lipid and carbohydrate metabolism, including features of the metabolic risk factor syndrome, are frequently present in patients both before and after renal transplantation. Risk factors of atherosclerosis may not only contribute to increased cardiovascular morbidity and mortality in this patient population, but can also be assumed to contribute to the development and progression of CVR and chronic graft dysfunction. For preventing both early graft losses and the development of graft damage leading to late graft dysfunction and graft loss, it appears to be essential to identify patients at risk early, prior to transplantation. Intervention aiming to reduce overweight, diet and exercise may be of benefit. The role of omega-3 unsaturated fatty acid supplementation remains controversial. Pharmacological intervention by antioxidants or agents to reduce lipids and/or decrease PAI-1 synthesis may prove to be beneficial. Early identification of patients at risk and intervention in due time may improve the results of renal transplantation.
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PMID:Metabolic abnormalities in renal transplant recipients. Risk factors and predictors of chronic graft dysfunction? 902 67

To determine whether skinfold thickness is correlated with degree of overweight, serum levels of cholesterol, and blood pressure in children, 161 boys and 167 girls aged 9 and 10 y underwent physical examinations at three elementary schools in Japan. Triceps skinfold thickness was positively correlated with degree of overweight, atherosclerosis index, and systolic blood pressure, and was negatively correlated with levels of high-density lipoprotein (HDL) cholesterol. Among children who were highly overweight (> or = 30%), those with low triceps skinfold thickness (< 11.2 mm) have lower levels of HDL cholesterol, a higher atherosclerosis index, and higher systolic blood pressure than those with greater triceps skinfold thickness (> or = 11.2 mm). The ratio of degree of overweight to triceps skinfold thickness was significantly correlated with levels of HDL cholesterol in girls but not in boys. These results suggest that, in overweight schoolchildren, skinfold thickness may reflect the risk of future hypercholesterolemia and hypertension. Measurement of triceps skinfold thickness and determination of degree of overweight may be useful for the estimation of obesity in children.
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PMID:Estimation of obesity in schoolchildren by measuring skinfold thickness. 903 21

We assessed the prevalence of coronary heart disease (CHD) risk factors including insulin resistance in 500 (205 males, 295 females) healthy elderly (age > 55 years) indigenous, low socioeconomic group Yorubas residents in either an urban slum (n = 240) or a rural town (n = 260) in southwestern Nigeria. Anthropometric indices, blood pressure and fasting plasma levels of glucose, lipids, insulin and insulin resistance were measured. The results indicated that: (i) gross obesity (4.4%), diabetes (1.6%), hyperlipidaemia (0.2%) and cigarette smoking (4.8%) were relatively uncommon in the population, although the prevalence of hypertension (30%) was higher than previously reported from this population; (ii). the subjects had a relatively high prevalence of multiple CHD risk factors (about 20% had > 4 risk factors), an observation considered paradoxical in view of the reportedly low CHD prevalence in this population; (iii) these CHD risk factors (increased body mass and blood pressure (BP), hyperinsulinaemia and insulin resistance) were more prevalent in the women and in urban residents; (iv) hyperinsulinaemia (20%) and insulin resistance (35%) were common in the population, and were associated, on regression analyses, to such other CHD risk factors as BP and body mass, particularly in women, suggesting, as in Caucasians, that insulin resistance could be an important index of CHD risk; and (v) the excess of multiple CHD risk factors in the women, is due at least in part, to their increased tendency to obesity (8%) and reduced physical activity (83%). This study concludes that: (i) despite the high prevalence of multiple risk factors in this population, CHD prevalence is low, indicating the supremacy of such major risk factors as diabetes and hyperlipidaemia (relatively uncommon here) in the development of CHD; and (ii) potentially the greatest CHD risk is in the elderly women especially if relatively overweight, physically inactive and resident in an urban centre. While further confirmatory studies are necessary in younger subjects and across societal socioeconomic strata, our results nonetheless suggest that attempts to maintain the CHD prevalence at low levels in this population should include efforts directed at reducing excess body weight particularly in women, and advice on maintenance of a traditional diet to keep lipid levels and diabetes prevalence low.
Atherosclerosis 1997 Feb 10
PMID:The prevalence of insulin resistance and other cardiovascular disease risk factors in healthy elderly southwestern Nigerians. 905 Jul 77

Many women in industrialized countries are overweight. Excess body fat is associated with excess morbidity and mortality from atherosclerosis and diabetes. In some cases, overweight/obesity also is implicated with increased incidence of breast cancer, but the results of these studies are not consistent. Human breast cancer is usually distinguished as either premenopausal or postmenopausal. In this review, we focus on literature that presents body mass index (BMI, weight/height2) ranges and identifies menstrual status. The majority of the relevant prospective studies support an inverse relationship between BMI and the relative risk (RR) of developing premenopausal breast cancer. In contrast, a positive relationship between BMI and the RR of developing postmenopausal breast cancer is reported in only half of all prospective studies on this topic. Those studies that do not show a positive RR, in general, have used younger postmenopausal women, and their body weights were obtained prior to menopause. Many case-control studies also report an inverse association between BMI and the RR of developing premenopausal breast cancer, and a positive association between BMI and the RR of developing postmenopausal breast cancer. Other studies do not find these associations, but a number of these studies have used small sample sizes and, for the postmenopausal subjects, have represented populations with low obesity and/or breast cancer rates. Other factors that might play a role in breast cancer development, such as body fat distribution, weight at earlier ages, and weight gain, are also addressed, as well as the effect of obesity in breast cancer prognosis. In addition, limited data available for animal studies related to this topic, as well as potential mechanisms by which body fat may play a role in breast cancer development, are discussed. Finally, the need for better animal models in which to perform controlled dietary and/or drug intervention studies to test rigorously the proposed mechanisms by which body fat may contribute to breast cancer development is addressed.
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PMID:The role of body mass index in the relative risk of developing premenopausal versus postmenopausal breast cancer. 931 8

To elucidate the role of modifiable factors and the apolipoprotein E polymorphism in explaining lipid profiles reflecting low, average and high risk for coronary heart disease, we selected subjects from a large population-based study. Subjects with low total cholesterol (TC) (< 15th percentile) and high HDL-cholesterol levels (> 85th percentile) were randomly selected (n = 99) and represent subjects with a low risk lipid profile. Additionally, 95 subjects with total and HDL-cholesterol levels in the 15% around the population-median (median risk lipid profile) and 100 subjects with high TC (> 85th percentile) and low HDL-cholesterol levels (< 15th percentile) (high risk lipid profile) were selected. Compared with E3/3 subjects, the likelihood for a low risk lipid profile was considerably higher (odds ratio 14.3; 2.6-79) in female, but not in male E2-carriers (1.5; 0.3-6.7). Smoking and alcohol consumption were independently associated with a low risk lipid profile in both genders, physical inactivity only in women. The odds ratio for a high risk lipid profile was elevated in male E4-carriers (4.9; 1.1-23) only. In addition to the E4 isoform, smoking and physical inactivity, overweight was the main determinant for a high risk lipid profile (odds ratio 16.8; 3.4-82). Male overweight E4-carriers had a 50 times higher likelihood of a high risk lipid profile than E3/3 men of normal weight. In women, only overweight was independently associated with a high risk lipid profile. Our results suggest that both modifiable factors and the apolipoprotein E polymorphism contribute to a lipid profile, reflecting low, average and high risk for coronary heart disease, but effects may be gender-specific.
Atherosclerosis 1998 Feb
PMID:Lipid profiles reflecting high and low risk for coronary heart disease: contribution of apolipoprotein E polymorphism and lifestyle. 954 12

Stroke (cerebrovascular accident, CVA) is the third leading cause of death and an important cause of hospital admission and long term disability in Australia. Atherosclerotic lesions at the bifurcation of the common carotid artery are the most common cause of stroke. On occasion these lesions are partially calcified and visible on a conventional panoramic dental radiograph. The atheroma may appear either as a nodular radiopaque mass or as two radiopaque vertical lines within the soft tissues of the neck at the level of the lower margin of the third cervical vertebra (C3). These opacities are separate and distinct from the hyoid bone and variably appear above or below it. Dentists should scrupulously review the panoramic radiographs of all individuals over age 55 with medical histories of hypertension, diabetes mellitus, hypercholesteraemia and coronary artery disease, or whose behaviour includes smoking, ethanol abuse, or dietary indiscretion coupled with overweight and a sedentary lifestyle which are known to be associated with atherosclerosis and stroke.
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PMID:Identification of stroke prone patients by panoramic radiography. 958 27

Current trends in public health provided potential arguments to, first, intensify the recommendations of a physically active lifestyle in the primary prevention of atherosclerosis and, second, to prescribe a supervised outpatient exercise training program for secondary prevention of cardiovascular diseases. Regular physical exercise may positively influence cardiovascular risk factors (overweight, hypertension, hyperlipoproteinaemia, insulin resistance, hemostatic markers). Physical conditioning modifies the body composition in favor of an increased skeletal muscle mass, changes the eating habits, and other life style characteristics. The dietary modifications characterized by a low-fat, more vegetarian food supports the weight control and the adjustment of the other metabolic risk factors. All these changes are suitable to reduce the manifestation of atherosclerosis and to minimize the risk of an acute thromboembolic arterial occlusion. Physical conditioning on one's own initiative in primary prevention or an exercise training program supervised by health professionals in secondary prevention of atherosclerosis should predominantly include a low intensive aerobic endurance exercise training. Lactate concentration in capillary blood can be measured to objectify and regulate exercise intensity. The additional energy turnover should amount to a minimum of 1,000 kcal and a maximum of 3,500 kcal weekly. This energy expenditure could be realized either with an increased physical activity level in daily routine (e.g., stair climbing, go for a walk, gardening) or by a regular leisure-time physical exercise. A turnover of 300 kcal per session should be prescribed. In long-term clinical trials investigating the benefit of primary and secondary cardiovascular prevention a reduction of the cardiovascular mortality of about 20-30% has been demonstrated.
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PMID:[Importance of increased physical activity in ambulatory cardiovascular prevention]. 988 81

A number of studies have shown that fast heart rate is associated with high blood pressure and metabolic disturbances, and that it is a strong precursor of hypertension, atherosclerosis, and cardiovascular events. Subjects with tachycardia often also exhibit increased plasma insulin, overweight, and higher hematocrit. These relationships have been observed also in the elderly and among hypertensive individuals and have held true after controlling for smoking, alcohol intake, and physical activity habits. In three different populations studied with a mixture analysis we demonstrated that the heart rate-blood pressure association was mostly explained by a subpopulation of subjects with high heart rates who had higher levels of blood pressure, total cholesterol, triglycerides, postload glucose, and plasma insulin. The clustering of these risk factors may explain why cardiovascular morbidity is higher in individuals with fast heart rates. Sympathetic overactivity seems to be responsible for both the increase in heart rate and blood pressure, and for the metabolic abnormalities. In addition to being a marker of sympathetic overactivity, tachycardia seems to have a direct action in the induction of risk. Studies in cholesterol-fed monkeys have shown that the reduction of heart rate could retard the development of coronary atherosclerosis. Furthermore, fast heart rate increases the pulsatile nature of the arterial blood flow and increases arterial wall stress. Antihypertensive drugs that lower the heart rate seem to have a good potential for prolonging life expectancy in humans.
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PMID:The physiological determinants and risk correlations of elevated heart rate. 1007 13

Insulin resistance is an early and major feature in the development of non-insulin-dependent diabetes mellitus(NIDDM). It is also associated with hyperlipidemia, hypertension, obesity and cardiovascular disease. It is the clustor of the risk factors for atherosclerosis and recognized as 'insulin-resistance syndrome' (Syndrome X). Central (abdominal) obesity is much more strongly associated with insulin resistance than overall obesity. The increase of both the influx of free fatty acid to liver and the production of TNF-alpha in adipose tissue may play an important role in mechanism of insulin resistance associated with central obesity. Calorie restriction and weight loss improve insulin sensitivity in overweight humans. Exercise training also improves insulin sensitivity via increased oxidative enzymes, glucose transporters (GLUT4) and capillarity in muscle as well as by reducing abdominal fat. The new 'glitazones' (thiazolidinediones) is used clinically to improve insulin sensitivity.
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PMID:[Syndrome X]. 1019 44


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