Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028754 (obesity)
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Three polymorphic sites of the apolipoprotein B gene - the insertion/deletion signal peptide, XbaI and EcoRI sites - were examined in a sample of 107 healthy men and in 46 men with evidence of coronary heart disease selected from a large population survey of South Asians aged 40-69 in London, U.K. There were no significant differences in allele frequencies between cases and controls. Frequencies of the ins (insertion) and X- (absence of XbaI cutting site) alleles were higher in South Asians than in Europeans studied previously (South Asians versus Europeans ins: 0.80 vs. 0.68, P less than 0.025; X-: 0.71 vs. 0.47-0.56, P less than 0.001). The del allele was associated with higher levels of total cholesterol (P less than 0.05) and the X+ allele with lower levels of HDL cholesterol (P less than 0.05), and thus both polymorphisms were associated with differences in the ratio of HDL cholesterol to total cholesterol (ins/del, P less than 0.01; XbaI, P less than 0.001). Mean waist-hip girth ratio was lower in the 10 men homozygous for the X+ allele than in the 42 men with X-/X+ and 55 men with X-/X- genotypes; the means (+/- SEM) were 0.92 +/- 0.02, 0.97 +/- 0.01 and 0.96 +/- 0.01 respectively (P = 0.03). These data suggest that genetic variation in linkage disequilibrium with the XbaI and ins/del polymorphisms of the apo B gene contributes to the determination of total cholesterol and HDL cholesterol levels and possibly to obesity in South Asians.
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PMID:Apolipoprotein B gene polymorphisms are associated with lipid levels in men of South Asian descent. 178 9

Dietary fat intake is often regarded as a major determinant of coronary heart disease (CHD) rate and it has been deemed unnecessary to invoke racial or other factors to explain the differences in CHD rates among different ethnic groups. Despite a high prevalence of CHD risk factors such as hypertension, obesity, and smoking, CHD remains a rarity in westernized black Africans. Cord blood total cholesterol (TC), low density lipoprotein cholesterol (LDLC) and apolipoprotein B (apo B) levels were measured and found to be respectively 12.1%, 18.3% and 22.4% lower in black neonates when compared to white neonates. These differences were again studied in a group of young black African males and a comparable group of age-matched whites who had been exposed to the same environment and western diet for at least 2 years. Although the body mass indices and serum albumin concentrations in the adult males were not significantly different, serum levels of TC, LDLC and apo B were 10.7%, 18.7% and 39.7% lower in the blacks, respectively. Furthermore, high density lipoprotein cholesterol (HDLC) and Apolipoprotein AI were 20.2% and 9.5% higher, homocysteine 45.6% lower and coagulation factor VII 26.6% lower in the adult black Africans. It is concluded that blacks are biochemically less responsive to an atherogenic diet than whites and these differences are already present at birth.
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PMID:Ethnic immunity to coronary heart disease? 179 43

Congestive heart failure (CHF) is a major cause of mortality and morbidity, and has a prognosis similar to that of several malignancies. There are increasing trends in both prevalence and incidence rates of CHF which points towards CHF becoming a major community health problem. Early detection of CHF is dependent upon criteria to define the initial stages of a condition which progresses slowly over many years. In western countries the dominant causes of CHF are hypertension and coronary heart disease, which account for more than 75% of the cases. Other precursors are diabetes and rheumatic heart disease. Independent risk factors for CHF are hypertension, smoking, obesity, and psychological stress. Early detection of CHF through identification of early symptoms such as dyspnea on exertion, treatment of known heart diseases, and treatment of risk factors may prevent its progress. Epidemiological data indicate that primary preventive efforts should be directed against hypertension, smoking and obesity. A multiple risk factor interventional approach seems to yield the best result since these risk factors act synergistically.
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PMID:Epidemiology and prognosis of heart failure. 179 25

The basic mechanisms that initiate and sustain hypertension in the diabetic population are poorly understood. Obesity, insulin, genetic factors, and abnormalities in calcium homeostasis may contribute, and could be related to an elevated Na+/H+ antiport activity. In the first study described in this investigation, hypertensive subjects with insulin-dependent diabetes mellitus (IDDM) who had an elevated Na+/Li+ countertransport activity were found to have a lower whole body glucose utilization, a lower insulin-stimulated forearm carbohydrate oxidation, larger ultrasound kidney volume, and increased left ventricular mass index when compared with hypertensive IDDM subjects with a normal Na+/Li+ countertransport activity or normotensive IDDM subjects. Thus an elevated Na+/Li+ countertransport activity appears to identify a subset of IDDM patients who are more susceptible to the development of the renal and cardiac complications associated with hypertension. This underlines the importance of choosing an appropriate antihypertensive therapy that will not produce a deterioration in glucose and lipid metabolism. In the second part of the report, results are presented for the treatment of hypertensive patients with non-insulin-dependent diabetes mellitus with doxazosin. The selective alpha 1-inhibitor produced a significant reduction in blood pressure, together with favorable changes in the serum lipid profile. As a result, the calculated risk of developing coronary heart disease was significantly reduced. Throughout the study no patients required a dose reduction or discontinuation of doxazosin because of side effects, and no clinically significant changes in laboratory tests were apparent. Thus doxazosin could be considered a useful antihypertensive agent in hypertensive patients with IDDM who are insulin-resistant and who have renal and cardiac abnormalities.
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PMID:Diabetes mellitus and hypertension: a physiologic basis for a rational therapeutic approach. 182 85

This review of the literature focuses on risk factors of smoking, hypertension, obesity, and family history that are associated with the development of coronary heart disease. The prevalence of these cardiac risk factors are incorporated from several Canadian health surveys. Health professionals in cardiovascular settings can use the information to develop cardiac teaching programs to promote awareness and healthy cardiac practices in the Canadian population.
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PMID:Cardiac risk factors of smoking, hypertension, obesity and family history: a review of the literature. 182 93

Three prospective population studies on non-diabetic subjects--the Helsinki Policemen Study, the Busselton Study, and the Paris Prospective Study--have shown that high plasma insulin levels, fasting or after oral glucose load, are associated with an increased risk of coronary heart disease (CHD). The excess of CHD events accumulating in the highest quintiles or deciles for plasma insulin and multivariate analyses suggests that the predictive value of plasma insulin with regard to CHD risk would be independent of blood glucose levels and other major CHD risk factors. Interpretation of the results of multivariate analyses including plasma insulin is, however, complex owing to relatively strong correlations between plasma insulin and several other risk factors. Interaction of the predictive value of plasma insulin with other risk factors, such as obesity, plasma lipids and lipoproteins, and blood pressure also deserves consideration. Analyses of the follow-up data from the Paris Prospective Study have in fact shown that such interaction exists with regard to obesity, high plasma insulin levels being predictive of increased risk of CHD in obese subjects but not in lean subjects. No information is available about the possible relationship between plasma free-insulin levels and atherosclerotic vascular disease (ASVD) in patients with insulin-dependent type diabetes receiving insulin treatment. Information concerning the relationship of plasma insulin to ASVD in subjects with impaired glucose tolerance (IGT) or non-insulin-dependent diabetes (NIDD) is so far fragmentary but suggests that elevated plasma insulin levels would be predictive of increased risk of ASVD in NIDD and its precursor stage, IGT.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hyperinsulinaemia as predictor of atherosclerotic vascular disease: epidemiological evidence. 183 87

The authors investigated the relationship of plasma insulin to some risk factors of ischaemic heart disease (IHD). They examined 79 healthy men--drivers of international truck transport with a normal glucose tolerance. The group comprised 21 men with hyperinsulinaemia. This group was compared with 21 men from the same group with normal insulin levels. The two groups were comparable (matched pairs) for age, occupation, cigarette and alcohol consumption and education. Significantly higher values of the body mass index (BMI), systolic and diastolic blood pressure were found in the group with hyperinsulinaemia. The latter group had a significantly more frequent positive family-history as regards cardiovascular diseases. After 48 months all subjects were checked. Two men from the entire group had died (43 and 48 years) from fatal myocardial infarction, both had hyperinsulinaemia. Manifestations of cardiovascular diseases (IHD and hypertension) developed in 12 subjects from the group with hyperinsulinaemia, as compared with two subjects with hypertension but normal insulin levels. To conclude, it may be stated that healthy subjects with hyperinsulinaemia and a normal glucose tolerance have a higher level of some risk factors of coronary heart disease (hypertension, obesity, positive family-history), as compared with the normoinsulinaemic group, and a poorer prognosis as regards cardiovascular morbidity and mortality.
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PMID:[Risk factors for ischemic heart disease in healthy persons with hyperinsulinemia and normal glucose tolerance]. 184 43

High total cholesterol is an important risk factor for coronary heart disease, and high levels in adulthood can be linked to high levels in childhood. We evaluated total cholesterol and lipoprotein levels and their relationship to body composition and reported family medical history of premature myocardial infarction or high total cholesterol in 800 children, aged 10 to 13, of Hispanic (n = 612), Asian (n = 100), and white or other (n = 88) ethnic descent. Mean total cholesterol levels were similar among boys (168.6 mg/dL; n = 399) and girls (167.5 mg/dL; n = 401) and among ethnic groups; however, high-density lipoprotein cholesterol was highest in boys and in Asian children. Forty-six percent of all children tested had total cholesterol levels of 170 mg/dL or greater (13.4% were 200 mg/dL or higher). Body mass index and skinfold (triceps and subscapular) measurements were least in Asian children. A high prevalence of obesity was noted in white and Hispanic children. Body mass index was positively correlated with total cholesterol in Hispanic children; in all ethnic groups, body mass index was positively associated with triglyceride levels and negatively associated with high-density lipoprotein cholesterol. Skinfold measurements were also significantly correlated with total cholesterol (in Hispanic children) and triglycerides and were negatively associated with high-density lipoprotein cholesterol. Among children with family history data available, only 52% with a low-density lipoprotein cholesterol level of 130 mg/dL or higher had a reported family history of high total cholesterol or myocardial infarction in a parent or grandparent aged 55 or younger, although rates varied substantially by ethnic group. The present study demonstrates the importance of population-based lipid screening in Hispanic, Asian, or multiethnic children, where more than a third of the children have total cholesterol levels in need of dietary management. The majority of children with elevated total or low-density lipoprotein cholesterol levels will not be identified if screening is recommended on the basis of a positive family history alone. Finally, there is evidence that body composition in children may be more closely correlated with total cholesterol or lipoprotein levels in certain ethnic groups.
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PMID:Relationship of blood lipids to anthropometric measures and family medical history in an ethnically diverse school-aged population. 184 49

Increased cholesterol levels above 200 mg/dl, LDL levels above 130 mg/dl and total cholesterol/HDL ratio above 4.5 in males and above 5.0 in females are recognized as indicators of increased risk of atherosclerosis. Risk associated to increased triglyceride levels (above 200 mg/dl) must be judged in relation to associated factors such as family history of coronary heart disease, presence of remnants (type III hyperlipidemia), presence of Lp(a), increased levels of Apo B, reduced levels of HDL2 or Apo A1. VLDL and chylomicron remnants and Lp(a) have an atherogenic power in vitro 2 to 4 times that of LDL. There is a correlation between hypertriglyceridemia and reduced HDL2 and Apo A1 levels. Hypertriglyceridemia is frequently associated to other risk factors like diabetes, obesity, hyperinsulinism, and high blood pressure. Finally, VLDL may elevate levels of plasma plasminogen inhibitor. Thus, hypertriglyceridemia should be investigated when, evaluating risk of atherosclerosis.
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PMID:[Cholesterol and triglycerides in atherosclerosis: epidemiologic and physiopathologic considerations]. 184

Between the years 1979 and 1981, Louisiana ranked 7th in average annual coronary heart disease (CHD) death rate among white women and 6th among black women, age 35 to 74 years. Nationally, death in women due to CHD is 250,000 deaths per year, mainly in women over 50 years of age. That is approximately one half of all deaths due to heart disease in the United States. Risk factors for CHD in women are those which are shared with men, eg, smoking, hypertension, plasma lipoprotein concentrations, obesity, diabetes, and family history, and those which apply solely to women, eg, contraceptive use, menopause, and postmenopausal hormones. The purpose of this manuscript is to review current knowledge regarding CHD in women.
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PMID:Cardiovascular disease in women: an update. 186 Oct 94


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