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The objective of this study was to evaluate the effect of a high fat or high carbohydrate breakfast on postprandial lipid profile in healthy subjects with or without family history of type 2 diabetes mellitus. A single blind, controlled clinical trial with parallel groups was performed in 20 healthy subjects; 10 subjects with family history of type 2 diabetes mellitus and 10 individuals without that background. Each group was randomized to receive a high fat or high carbohidrate breakfast. A metabolic profile that included fasting and postprandial lipids, as well as, the assessment of insulin sensitivity were performed. Lower high-lipoprotein cholesterol (p < 0.02) and apolipoprotein A1 (p < 0.03) concentrations were found in subjects with family history of type 2 diabetes mellitus than those without that background. In this same above mentioned group with the high carbohydrate breakfast, there were significant increments in apoliprotein B at minute 300 (p < 0.03) and in triglycerides at minute 360 (p < 0.03). In the group without family history of diabetes that received the high fat breakfast, there were increments in triglycerides (p < 0.03) and very-low density lipoprotein concentrations at minute 180 (p < 0.03). In conclusion, healthy subjects with family history of type 2 diabetes showed some atherogenic characteristics in their metabolic profile, and the high carbohydrate breakfast produced in them increments in apolipoprotein B and in triglycerides, meanwhile that, in those subjects without such background the high fast breakfast produced unfavorable effects on their lipid concentrations.
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PMID:[Effect of a high fat or high carbohydrate breakfast on postprandial lipid profile in healthy subjects with or without family history of type 2 diabetes mellitus]. 1580 1

Effect of single bout of dynamic physical exercise on parameters of lipid-transport system and carbohydrate metabolism and hormones (insulin, cortisol) in the blood was studied in patients with coronary heart disease with class I-III angina and type 2 diabetes. Intensity of exercise was limited by severity of stable effort angina and was > 95, 80 and 70% of predicted maximum in patients with class I (n=10), II (n=12) and III (n=14) angina, respectively. High intensity exercise provoked development of atherogenic dyslipidemia: elevation of levels of total cholesterol, low density lipoprotein cholesterol, triglycerides, apolipoprotein B and apolipoprotein B/A1 ratio, and lowering of levels of high density lipoprotein cholesterol and apolipoprotein A1. Patients with diabetes responded to high intensity exercise by elevation of blood glucose and insulin levels and lowering of sensitivity of tissues of the periphery to insulin (glucose/insulin ratio). On the contrary exercise of moderate intensity did not affect negatively metabolism of blood lipids and carbohydrates. Six months course of physical training in patients with diabetes (n=10) corrected exogenous atherogenic dyslipidemia and derangements of carbohydrate metabolism, which developed after acute dynamic effort of high intensity.
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PMID:[Physical activity and atherosclerosis: effect of dynamic activity of various intensity on parameters of lipid-transport system and carbohydrate metabolism in patients with coronary heart disease and type 2 diabetes]. 1635 62

An international, standardised case-control study was established to assess the importance of risk factors for coronary heart disease worldwide. From 52 countries representing every inhabited continent 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension and/or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins and psychosocial factors to myocardial infarction was reported. Odds ratios and their 99% confidence limits for the association of risk factors to acute myocardial infarction and their population attributable risks were calculated. Smoking (odds ratio 2.87 for current vs never, population attributable risk 35.7% for current and former smoker vs never), raised apolipoprotein B / apolipoprotein A1 ratio (3.25 for top vs lowest quintile, population attributable risk 49.2 for top four quintiles vs lowest quintile), history of hypertension (1.91, 17.9%), diabetes (2.37, 9.9%), abdominal obesity (1.12 for top vs lowest tertile and 1.62 for middle vs lowest tertile, 20.1% for top two tertiles vs lowest tertile), psychosocial factors (2.67, 32.5), daily consumption of fruits and vegetables (0.70, 13.7% for lack of daily consumption), regular alcohol consumption (0.91, 6.7%), and regular physical activity (0.86, 12.2%) were all significantly related to acute myocardial infarction (p < 0.0001 for all risk factors, and p = 0.03 for alcohol). These associations were noted in men and women, old and young and in all regions of the world. Collectively these nine risk factors accounted for 90% of the population attributable risk in men and 94% in women. This finding suggests that approaches to prevention can be based on similar principles worldwide.
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PMID:[Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries in a case-control study based on the INTERHEART study]. 1673 79

The anti-inflammatory effects of high-density lipoproteins (HDL) are well documented and include inhibition of low-density lipoprotein (LDL) oxidation, reduction of inflammatory cytokines and vascular leukocyte adhesion molecules, and participation in innate immunity. However, certain conditions, including coronary disease, diabetes mellitus, systemic inflammation, and a diet high in saturated fat, are associated with modification of HDL such that it paradoxically enhances LDL oxidation and/or vascular inflammation. Treatment with statins and/or apolipoprotein A1 mimetic peptides improves HDL's anti-inflammatory functions, and these as well as other medications may represent a novel pathway through which to target atherosclerosis.
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PMID:Modifying the anti-inflammatory effects of high-density lipoprotein. 1716 48

The International Diabetes Federation (IDF) proposed a new definition for metabolic syndrome (MS) in 2005. We conducted this study to compare the association of MS by IDF and ATP III definition to various metabolic variables. In 2005, we enrolled 654 Chinese people in a screening program in Taiwan. Anthropometric and biochemical profiles, including high-sensitivity C-reactive protein (hsCRP), were measured. Serum hsCRP levels were higher in those with MS by IDF definition (2.4+/-1.9mg/l versus 1.3+/-1.4mg/l, p<0.0001). Serum hsCRP levels increase with the number of components of MS they met (p for trend<0.001). Serum LDL levels were higher in those with MS by IDF definition (131+/-39 versus 125+/-32, p<0.05) but not in those with MS by ATP III definition (p=0.2). Serum hsCRP levels correlate significantly to MS by ATP III definition, after adjusting for age, sex, smoking, body mass index, serum apolipoprotein A1 and LDL levels. Adding MS status by IDF definition in this model significantly increased model fitness in men (MS by IDF definition, partial r=0.18, p<0.05, MS by ATP III definition, partial r=0.12, p=0.071). In conclusion, IDF definition of MS has a stronger relationship with serum hsCRP than ATP III definition in men.
Diabetes Res Clin Pract 2007 Aug
PMID:Serum C-reactive protein levels correlates better to metabolic syndrome defined by International Diabetes Federation than by NCEP ATP III in men. 1723 98

South Asians have high rates of diabetes and the highest rates of premature coronary artery disease in the world, both occurring about 10 years earlier than in other populations. The metabolic syndrome (MS), which appears to be the antecedent or "common soil" for both of these conditions, is also common among South Asians. Because South Asians develop metabolic abnormalities at a lower body mass index and waist circumference than other groups, conventional criteria underestimate the prevalence of MS by 25% to 50%. The proposed South Asian Modified National Cholesterol Education Program criteria that use abdominal obesity as an optional component and the South Asian-specific waist circumference recommended by the International Diabetes Federation appear to be more appropriate in this population. Furthermore, Asian Indians have at least double the risk of coronary artery disease than that of whites, even when adjusted for the presence of diabetes and MS. This increased risk appears to be due to South Asian dyslipidemia, which is characterized by high serum levels of apolipoprotein B, lipoprotein (a), and triglycerides and low levels of apolipoprotein A1 and high-density lipoprotein (HDL) cholesterol. In addition, the HDL particles are small, dense, and dysfunctional. MS needs to be recognized as a looming danger to South Asians and treated with aggressive lifestyle modifications beginning in childhood and at a lower threshold than in other populations.
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PMID:The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. 1805 10

Previous studies of leptin with cardiovascular disease (CVD) risk factors have been limited by clinical samples or lack of representation of the general population. This cross-sectional study, designed to examine whether leptin or insulin may mediate the endogenous relation of obesity with metabolic, inflammatory, and thrombogenic cardiovascular risk factors, included 522 men and 514 women aged >or=40 years who completed a physical examination during the third National Health and Nutrition Examination Survey. Participants were free of existing CVD, cancer (except non-melanoma skin cancer), diabetes, or respiratory disease. In multivariable analyses adjusted for race/ethnicity and lifestyle factors, waist circumference (WC) was positively associated with blood pressure, triglyceride, LDL cholesterol, total cholesterol:HDL ratio, apolipoprotein B, C-reactive protein (CRP), and fibrinogen concentrations, and negatively associated with HDL cholesterol and apolipoprotein A1 levels. The associations of WC with the metabolic CVD risk factors were largely attenuated after adjustment for insulin levels, while the associations of WC with the inflammatory and thrombogenic factors (CRP and fibrinogen, respectively) were largely explained by adjustment for leptin concentrations. However, leptin levels were not independently associated with CRP and fibrinogen in men and CRP in women when adjusted for WC. Positive associations of leptin and insulin with fibrinogen in women, independent of WC, were noted. These results suggest that insulin may be an important mediator of the association of obesity with metabolic but not inflammatory or thrombogenic CVD risk factors, while leptin does not appear to influence cardiovascular risk through a shared association with these risk factors. However, we cannot rule out the possibility that leptin and insulin influence cardiovascular risk in women through independent effects on fibrinogen concentrations.
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PMID:The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults. 1816 70

Today, eggs with an increased content of -3 fatty acids are available but there are few publications on the effects of consumption of such eggs on the lipoproteins and acute phase markers in humans. The aim of the present study was to evaluate the effects of consumption of standard eggs and -3 enriched eggs on lipoproteins, glucose and inflammation markers. Nineteen healthy volunteers consumed one extra egg per day of either standard eggs or omega-3 enriched eggs in a double-blind, cross-over study. The duration of each period was 1 month. The effects of the different egg diets on apolipoprotein A1 and B (Apo A1 and B), lipoprotein (a), creatinine, cystatin C, C-reactive protein, serum amyloid protein A, interleukin 6, triglycerides, glucose, total-, high-density lipoprotein and low-density lipo-protein cholesterol concentrations were analyzed. Addition of one regular egg per day to the normal diet had no negative impact on blood lipids or inflammation markers. Consumption of omega-3 enriched eggs resulted in higher levels of ApoA1, lower ApoB/ApoA1 ratio and lower plasma glucose. These effects have been associated in previous studies with a reduced risk for cardiovascular mortality and diabetes.
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PMID:Biochemical effects of consumption of eggs containing omega-3 polyunsaturated fatty acids. 1899 Dec 44

This study was performed to evaluate the relationship between serum phosphate levels and cardiovascular risk factors and metabolic syndrome components in a cross-sectional survey. Plasma phosphate was measured by immunoturbidimetry in 46,798 subjects over 20 years of age with an estimated GFR>or=60 mL/(min 1.73 m(2)) who participated in a health-check survey at the Kangbuk Samsung Hospital in South Korea. The median plasma phosphate level was 3.49+/-0.44 mg/dL and the mean estimated GFR was 77.46+/-8.51 mL/(min 1.73 m(2)). We found that serum phosphate levels had a positive correlation with total cholesterol, HDL-C, lipoprotein a, apolipoprotein A1, calcium, and albumin. In addition, serum phosphate levels had a negative correlation with age, body mass index, uric acid, fasting glucose, insulin, HOMA-IR, HS-CRP, triglyceride levels, systolic blood pressure, diastolic blood pressure, and waist circumference (P<0.001). In conclusion, we found that a high phosphate level is correlated with cardiovascular disease while a lower phosphate level is correlated with metabolic syndrome. Serum phosphate levels that were too high or too low correlated with cardiovascular risk factors and elements of metabolic syndrome, respectively, showing that it may be important to maintain an appropriate level of phosphate for the prevention of cardiovascular events and metabolic syndrome.
Diabetes Res Clin Pract 2009 Jan
PMID:Serum phosphate levels and the risk of cardiovascular disease and metabolic syndrome: a double-edged sword. 1910 Oct 54

Several polymorphisms in apolipoprotein A1 (APOA1) gene have been associated with metabolic diseases. Increased transcription efficiency was observed in -75A allele carriers compared to -75G allele homozygotes. +83C allele was associated with higher body mass index and waist-to-hip ratio in type II diabetes subjects. -75G/A and +83C/T polymorphisms were analyzed by RFLP-PCR in 334 individuals from a Brazilian elderly cohort. APOA1 polymorphisms were associated with age-related morbidities, as well as with triglycerides, total cholesterol, HDL, VLDL, LDL, creatinine, urea, albumin, glycated hemoglobin and fasting glucose serum levels. Allele frequencies were 0.102 and 0.21, respectively, for -75A and +83T. -75G allele showed significant association with hypertension (P = 0.001). An association between +83C allele and obesity was observed (P = 0.040) and this allele also showed an association with hypertension in the presence of cardiovascular disease (P = 0.047). Moreover, +83T allele was associated with lower glycated hemoglobin values (P = 0.026). To our knowledge, there is no data associating this polymorphism with glycated hemoglobin. Furthermore, individuals carrying AT haplotype have lower risk for developing hypertension (P = 0.0002), while GT haplotype carriers present decreased risk to develop obesity comparing to GC haplotype (P = 0.025). APOA1 polymorphisms analysis may be a useful tool to identify risk factors for subjects and families and clarify the physiopathological role of these polymorphisms in age-related diseases, such as hypertension and obesity.
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PMID:Apolipoprotein A1 gene polymorphisms as risk factors for hypertension and obesity. 1940 98


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