Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Alzheimer's disease is a devastating condition that is increasing in prevalence. No known prevention or cure exists for Alzheimer's disease. Cardiovascular risk factors are prevalent and increase in the elderly, and there have been conflicting reports of associations between modifiable cardiovascular risk factors and Alzheimer's disease. The mechanisms for these associations are uncertain, but they are likely to be the result of a combination of direct and cerebrovascular disease-related mechanisms. From this standpoint, diabetes and hyperinsulinemia seem to have the strongest evidence from laboratory, clinical, and epidemiologic studies. Studies have also indicated that hypertension, hyperlipidemia, hyperhomocysteinemia, and smoking are potentially important risk factors for Alzheimer's disease.
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PMID:Cardiovascular risk factors and Alzheimer's disease. 1519 99

The inheritance of the apolipoprotein E4 (APOE4) allele has been shown to increase the plasma cholesterol level, but little information is as concerns the association of the APOE genotype and hyperlipidaemia and the activities of two serum enzymes, acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). Blood samples from 55 type IIb hyperlipidaemic, non-demented patients and 55 age- and sex-matched controls were therefore examined in this pilot study. A significantly increased BChE activity was found in the serum of type IIb hyperlipidaemic patients, but the AChE activity did not differ significantly as compared with that in the control group. The APOE4 allele was significantly overrepresented among the hyperlipidaemic probands, but neither serum cholinesterase activity was affected by the dosage of the APOE4 gene. Our results point to a possible association between an abnormal lipid metabolism and the BChE activity and might have implications as regards the pathomechanism of both Alzheimer's and vascular dementias and the cholinesterase inhibitor therapy of dementing disorders.
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PMID:Increased serum butyrylcholinesterase activity in type IIb hyperlipidaemic patients. 1521 7

The circulation constitutes a potential source of the beta-amyloid (A beta) protein deposited cerebrally in Alzheimer's disease (AD). Cardiovascular risk factors, including hyperlipidaemia, may be involved in the pathogenesis of AD. Plasma A beta 40 was measured by radioimmunoassay in normal and hyperlipidaemic subjects with the aim of determining if plasma lipid content and/or age correlated with circulating A beta 40 concentration. Plasma A beta 40 levels in hyperlipidaemics were elevated by 20.3% compared to normal subjects. A beta 40 did not correlate with plasma lipids in normal subjects. Age, however, correlated positively with A beta 40 in these individuals and with total cholesterol, low-density lipoprotein (LDL) and triglycerides. No correlations were observed in hyperlipidaemic patients or when the data for the two groups were combined. These data are consistent with ageing, the primary risk factor for AD, but not hyperlipidaemia influencing circulating A beta 40 levels.
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PMID:Plasma beta-amyloid (A beta) 40 concentration, lipid status and age in humans. 1530 95

Apolipoprotein E (ApoE) is the major lipid-carrier protein in the brain, and several studies provided evidence that ApoE epsilon4 allele can be considered a genetic risk factor for vascular diseases. Findings indicate that Alzheimer disease (AD) and vascular dementia (VaD) may have common risk factors and/or pathogenesis, but their interrelationships still need to be clearly defined. Since ApoE4 imparts risk for both hyperlipidemia and AD, it seemed worthwhile to investigate the possible role of ApoE in the pathogenesis of AD and VaD. To this task, we examined in healthy volunteers, and AD and VaD patients: i) the frequency of ApoE isoforms; and ii) the influence of ApoE genotype on serum lipid levels. Our findings suggest that epsilon4 allele is an important risk factor for the development not only of the Alzheimer type, but also of the vascular type of dementia. In contrast, epsilon2 allele could have a protective role in AD dementia. These results confirm the hypothesis that serum ApoE concentration is dependent on ApoE genotype, but do not support the view that it has to be considered a relevant biochemical marker for AD and VaD.
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PMID:Apolipoprotein E as vascular risk factor in neurodegenerative dementia. 1537 90

We investigated the influence of brain atrophy and white matter lesions on cognitive function in elderly people. We selected 33 subjects (mean age, 79.2 +/- 5.1yrs) with a MMSE score from 14 to 30 who had no previous history of stroke from the outpatients in the Memory Clinic of our hospital. These subjects were divided into four groups on the basis of their MMSE score as follows: 14-20; moderate dementia (Moderate-D, n = 9), 21-23; mild dementia (Mild-D, n = 9), 24-27; mild cognitive impairment (MCI, n = 10), 28-30; normal (Normal, n = 5). Among these four groups, we compared the frequency of the associated risk factors for cerebral infarction (hypertension, diabetes mellitus, hyperlipidemia, heart disease), and the severity of brain atrophy and cerebral white matter lesion which were visually evaluated by MRI technique. Brain atrophy and white matter lesions were assessed by reviewing the cerebral cortex and hippocampus, and deep white matter lesion (DWML) and periventricular hyperintensity (PVH), respectively. Brain atrophy was divided into three grades (mild, moderate, severe) and white matter lesions were classified into four grades (0-3) using Fazekas's criteria. We performed statistical analysis to detect t parameters which correlate with and influence MMSE scores from among the MRI findings. The cases with dementia were all diagnosed as Alzheimer's disease. There were no significant differences among the four groups in mean age, the incidence of individual associated risk factors, the severity of cortical atrophy, or the grade of DWML (< or = 2) and PVH (< or = 2). However, the frequency of hippocampal atrophic change greater than a moderate grade increased in parallel with the exacerbation of reduced cognitive function (Normal; 20%, MCI: 40%, Mild-D; 56%, Moderate-D 89%), and approximately 76% with such a change were AD cases. Statistical analysis showed a significant negative correlation between the grade of hippocampal atrophy and MMSE score (r = -0.518, p < 0.005) and a great influence of hippocampal atrophy on that score (step-wise regression analysis: r = 0.518, p < 0.005). From the above results, it was suggested that more than moderate atrophic change in the hippocampus might possibly be related with cognitive impairment and that both DWML and PVH less than the second grade had little influence on the decline of brain function.
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PMID:[A neuroradiological study on the influence of cerebral atrophy and white matter lesion on cognitive function in the elderly]. 1551 34

Significant progress in the field of VaD resulted from publication of the NINIDS-AIREN Diagnostic Criteria for VaD (G.C. Roman, T.K. Tatemichi, T. Erkinjuntti, et al., Vascular dementia (VaD): diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 43 (1993) 250-260). Epidemiological studies confirmed the importance of VaD as the second most common cause of dementia in the elderly, representing 15-20% of all cases of dementia. In Europe and North America, Alzheimer's disease (AD) predominates over VaD in a 2:1 ratio; in contrast, in Japan and China VaD accounts for almost 50% of all dementias. Case-control studies have identified risk factors for VaD including ageing, hypertension, diabetes mellitus, hyperlipidemia, recurrent stroke, cardiac disease, smoking, sleep apnea, and more recently, hyperhomocysteinemia, among others. Hypertension treatment may prevent VaD and AD. This finding has enormous importance from the Public Health viewpoint to decrease the future number of patients with dementia in the elderly. Along with advances in the field of VaD came a number of controversies and damaging misconceptions and myths. Myth no. 1--Vascular dementia is a non-entity: The false idea that VaD does not exist is particularly destructive because it creates the perspective that VaD is unworthy of study or research. A condition that either does not exist or represents only a minute proportion of all cases of dementia in the elderly, lacks public health relevance and becomes a low priority for research by funding agencies and industry. In fact, vascular brain lesions are the commonest and most important component of dementia in the elderly. Myth no. 2--Vascular dementia is so difficult to diagnose that only experts can recognize and identify it accurately: VaD does exist and the diagnosis of post-stroke VaD, in particular is straightforward. Most cases fulfill NINDS-AIREN criteria for probable VaD; i.e., (1) there is acute onset of dementia demonstrated by impairment of memory and two other cognitive domains, such as orientation, praxis or executive dysfunction; (2) relevant cerebrovascular lesions are demonstrated by neuroimaging; and (3) a temporal relation between stroke and cognitive loss is evident. In the donepezil trials on VaD, post-stroke dementia represented about 75% of the >1,200 patients enrolled. Myth no. 3--Improvement in clinical trials of cholinergics in VaD is due to underlying AD, not to the vascular lesions. Experimental, clinical and pathological evidence has demonstrated cholinesterase deficits in VaD (independently of any concomitant AD pathology), including low acetylcholine in cerebrospinal fluid, and reduced choline acetyltransferase (ChAT) in the brain.
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PMID:Facts, myths, and controversies in vascular dementia. 1553 19

Apolipoprotein E (apoE) associates with lipoproteins and mediates their interaction with members of the LDL receptor family. ApoE exists as three common isoforms that have important distinct functional and biological properties. Two apoE isoforms, apoE3 and apoE4, are recognized by the LDL receptor, whereas apoE2 binds poorly to this receptor and is associated with type III hyperlipidemia. In addition, the apoE4 isoform is associated with the common late-onset familial and sporadic forms of Alzheimer's disease. Although the interaction of apoE with the LDL receptor is well characterized, the specificity of other members of this receptor family for apoE is poorly understood. In the current investigation, we have characterized the binding of apoE to the VLDL receptor and the LDL receptor-related protein (LRP). Our results indicate that like the LDL receptor, LRP prefers lipid-bound forms of apoE, but in contrast to the LDL receptor, both LRP and the VLDL receptor recognize all apoE isoforms. Interestingly, the VLDL receptor does not require the association of apoE with lipid for optimal recognition and avidly binds lipid-free apoE. It is likely that this receptor-dependent specificity for various apoE isoforms and for lipid-free versus lipid-bound forms of apoE is physiologically significant and is connected to distinct functions for these receptors.
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PMID:The apoE isoform binding properties of the VLDL receptor reveal marked differences from LRP and the LDL receptor. 1586 33

Dementia is the development of multiple cognitive deficits that includes memory impairment and at least one of the following--Aphasia, apraxia, agnosia or disturbances in executive functioning. The common causes of dementia among the elderly are Alzheimer's disease, vascular dementia, mixed dementia and Lewy body disease. The concept of reversible dementia was introduced in 1980 when a task force sponsored by National Institute of Ageing found 10-12% of dementia cases in older group to have reversible causes such as metabolic-nutritional, drugs, infections, psychiatric disorders etc. In our series of 76 patients in the presenile age group (<65 years), 34.21% (26/76) had a reversible condition underlying the dementia. 43.42% (33/76) had vascular dementia, 13.15% (10/76) had Alzheimer's disease and 9.21% (7/76) had mixed dementia. Hypertension, hyperlipidemia and diabetes mellitus were commoner in the vascular dementia group as compared to the Alzheimer's group. Evaluation of MRI as a tool in diagnosis of dementia showed increased sensitivity of MRI towards detecting lacunes. The potentially reversible dementias comprised infections 14.47% (11/76), metabolic-nutritional 14.47% (11/76) and autoimmune diseases 3.94% (3/76). These were characterized by a subcortical dementia. Four month follow up of MMSE in this group showed significant and sustained improvement in the metabolic nutritional group.
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PMID:Presenile dementia--etiology, clinical profile and treatment response at four month follow up. 1588 51

Although hyperlipidemia is known to contribute to vascular disease and it may play a role in dementia, specific studies for elderly are limited. The aim of this study is to examine the relationship between dyslipidemia and dementia. In this study, 1251 patients admitted to the Hacettepe University Division of Geriatric Medicine were enrolled. On the basis of the mini mental state examination (MMSE), the clock drawing test (CDT) scores, the APA DSM-IV and the NINCDS-ADRDA criteria and the Hachinski ischemic score (HIS), the subjects were divided into four groups: Alzheimer's disease (AD), vascular dementia (VD), mild cognitive impairment (MCI) and normal cognitive status (NCS). The lipoprotein levels were measured, and we analyzed the data using chi2 and the one-way analysis of variance methods. Among the subjects, 14.8% had low high-density lipoproteins (HDL), 58.5% had high triglyceride (TG), 73.6% had high low-density lipoproteins (LDL), and 21.6% had high lipoprotein-a (Lp(a)) of our study population. There was no difference between the dementia subgroups and the NCS group in the lipoprotein levels. The only significant relationship was between high TG levels and the AD, as well as the MCI groups. Low HDL and high LDL are important problems in elderly. Although serum lipid levels, especially of Lp(a), has recently been thought to be related with dementia, our study suggests the absence of such a relationship. The national data regarding the elderly population should be evaluated on the basis of genetic and environmental factors in each country. The present study showing no significant relationship between Lp(a) and the cognitive status adds new information to the available literature.
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PMID:Are serum lipid and lipoprotein levels related to dementia? 1591 Oct 36

Having in mind the fact that cerebrovascular disease (CVB) takes today in medicine, in spite of diagnostic and therapeutic modernisation, the third place of mortality causes in the world (behind cordial and malignant diseases, but in front of depressions), and the second place of invalidity cause (right after trauma) as well as the second place of dementia cause (after Alzheimer disease), it urges primary prophylaxis. Developing countries, but before all countries of East and Middle Europe, where is our country, are highly risked areas where CV disease has trend of incidence and total frequency increase. In the neighbouring Croatia today CV disease is at the first place of mortality causes. In the world today 5 million people annually suffer CV disease, in Europe about 700.000, but frequency of suffering on Balkan is about 5 prom. Age of CV disease effecting unfortunately moved towards young age, and today 49% of effected by CV disease are of 46 to 59 years of age. Early detection and treatment of risk factors (before hypertension, smoking, diabetes mellitus, hyperlipidaemia, stress and physical non-activities) are the first aspect of CV disease prophylaxis. Together with this aspect of primary prophylaxis is early detection of complications of mentioned risk factors on the walls of blood vessels, before all changing in sense of arteriosclerosis, with consequence of disorder of cerebral haemodynamics. With that objective - verification of circulator and total haemodynamic disorders, there is obvious disclose of non-invasive diagnostic methods, and one of them is Transcranial Doppler Sonography (TCD). TCD is method comfortable for patient, reliable and rather precise, dynamic, and can be repeated several times, without side effects and in comparison with others rather cheap.
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PMID:Transcranial Doppler sonography as diagnostic method. 1621 70


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