Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242339 (dyslipidemia)
 13,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Maintenance dialysis patients experience an exceedingly high incidence of arteriosclerotic cardiovascular disease (CVD) events that are poorly predicted by traditional CVD risk factor indices. We evaluated the prevalence of three non-traditional CVD risk factors, i.e. hyperhomocysteinemia, hyperfibrinogenemia, and lipoprotein (a) Lp(a)) excess, and combined hyperhomocysteinemia, hyperfibrinogenemia, and Lp(a) excess, in maintenance dialysis patients. Fasting total plasma homocysteine (Hcy), fibrinogen, Lp(a), glucose, and total and HDL cholesterol levels, and traditional CVD risk factor (i.e. glucose tolerance, smoking, hypertension, dyslipidemia) prevalences were assessed in 71 dialysis patients and 71 age, sex, and race matched Framingham Study controls free of clinical renal disease, with normal serum creatinine (< or = 1.5 mg/dl). Mean plasma Hcy 23.7 vs. 9.9 microM, P = 0.0001), fibrinogen (457 vs. 309 mg/dl, P = 0.0001), and Lp(a) (30 vs. 17 mg/dl, P = 0.0070) levels were substantially increased in the dialysis patients. Matched odds ratios (with 95% confidence intervals), dialysis patients/controls, for hyperhomocysteinemia, hyperfibrinogenemia, and Lp(a) excess, alone or combined, were markedly greater in the dialysis patients, with no evidence of confounding by the traditional CVD risk factors: hyperhomocysteinemia, 105.0 (29.9-368.9); hyperfibrinogenemia, 16.6 (6.6-42.0); Lp(a) excess, 3.5 (1.5-8.4); all three combined 35.0 (5.7-199.8). Given in vitro evidence that Hcy, Lp(a), and fibrinogen interact to promote atherothrombosis, combined hyperhomocysteinemia, hyperfibrinogenemia, and Lp(a) excess may contribute to the high incidence of vascular disease sequelae experienced by dialysis patients, which is inadequately explained by traditional CVD risk factors. Controlled, prospective studies of well-characterized maintenance dialysis cohorts are urgently required to substantiate this hypothesis.
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PMID:Hyperhomocysteinemia, hyperfibrinogenemia, and lipoprotein (a) excess in maintenance dialysis patients: a matched case-control study. 883 31

The potential benefits of correcting identified cardiovascular risk factors in the elderly are substantial. Treatment of hypertension has been shown to reduce morbidity and mortality, and correction of dyslipidemia prevents recurrent coronary events. Other measures (e.g., lowering fibrinogen and homocysteine levels, weight reduction) whose efficacy in the elderly has not been established are nevertheless recommended.
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PMID:Cardiovascular risk factors in the older adult. 894 Nov 64

Niacin (nicotinic acid) in large doses (> 2 g) has been increasingly the choice of lipid-lowering agent by clinicians. However, the potential risks of the use of high doses of the vitamin have not been critically considered in the same way as has the use of other lipid-lowering drugs. The present study provides evidence that pharmacological levels of niacin interfere with the metabolism of methionine, leading to hyperhomocysteinemia and hypocysteinemia. Male Sprague-Dawley rats were fed a semisynthetic diet supplemented with either 400 or 4000 mg niacin/kg (compared with 47 mg/kg diet in the control diet). In Experiment 1, feeding these diets for 3 wk resulted in a dose-related increase in the plasma and urine methionine concentrations while cysteine levels were decreased. This altered methionine metabolism was accompanied by a lower plasma vitamin B-6 concentration in niacin-supplemented rats compared with controls. In Experiment 2, the methionine and cysteine levels in plasma and urine were normalized when vitamin B-6 (10 mg/kg diet) was added to the diet containing 4000 mg niacin/kg and fed for 6 wk. This experiment also showed that plasma and urine homocysteine concentrations were increased by niacin and normalized by vitamin B-6. The hypolipidemic action of niacin was unaffected by the presence of vitamin B-6. These results indicate that niacin at large dosages interferes with methionine metabolism by affecting vitamin B-6 status. The treatment of dyslipidemia with simultaneous administration of niacin and vitamin B-6 could be a better therapy than the use of niacin alone.
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PMID:Vitamin B-6 normalizes the altered sulfur amino acid status of rats fed diets containing pharmacological levels of niacin without reducing niacin's hypolipidemic effects. 904 May 54

There is an excess prevalence of hyperhomocysteinemia in dialysis-dependent end-stage renal disease (ESRD) patients. Cross-sectional studies of the relationship between elevated total homocysteine (tHcy) levels and prevalent cardiovascular disease (CVD) in this patient population suffer from severe methodologic limitations. No prospective investigations examining the association between tHcy levels and the subsequent development of arteriosclerotic CVD outcomes among maintenance dialysis patients have been reported. To assess whether elevated plasma tHcy is an independent risk factor for incident CVD in dialysis-dependent ESRD patients, we studied 73 maintenance peritoneal dialysis or hemodialysis patients who received a baseline examination between March and December 1994, with follow-up through April 1, 1996. We determined the incidence of nonfatal and fatal CVD events, which included all validated coronary heart disease, cerebrovascular disease, and abdominal aortic/lower-extremity arterial disease outcomes. After a median follow-up of 17.0 months, 16 individuals experienced at least one arteriosclerotic CVD event. Cox proportional-hazards regression analyses, unadjusted and individually adjusted for creatinine, albumin, and total cholesterol levels, total/HDL cholesterol ratio, dialysis adequacy/residual renal function, baseline CVD, and the established CVD risk factors (ie, age, sex, smoking, hypertension, diabetes/glucose intolerance, and dyslipidemia) revealed that tHcy levels in the upper quartile (> or = 27.0 mumol/L) versus the lower three quartiles (< 27.0 mumol/L) were associated with relative risk estimates (hazards ratios, with 95% confidence intervals for the occurrence of (pooled) nonfatal and fatal CVD ranging from 3.0 to 4.4; 95% confidence intervals (1.1-8.1) to (1.6-12.2). We conclude that the markedly elevated fasting tHcy levels found in dialysis-dependent ESRD patients may contribute independently to their excess incidence of fatal and nonfatal CVD outcomes.
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PMID:Elevated fasting total plasma homocysteine levels and cardiovascular disease outcomes in maintenance dialysis patients. A prospective study. 940 27

Scepticism about the relevance of preventive measures against cardiovascular disease in the elderly is unjustified because there is evidence that it is possible to assuage the ravages of a lifetime of exposure to risk factors, even beginning late in life. Declines in cardiovascular mortality have occurred in the elderly as well as in the middle-aged. Risk factors that influence the occurrence of cardiovascular disease in the elderly are much the same as those that operate in middle age. The potential and demonstrated benefits of correcting the major cardiovascular risk factors in the older adult are at least as great as for the middle-aged. multivariate risk assessment facilitates the cost-effective targeting of the elderly for treatment. The correction of hypertension and dyslipidemia have been shown to reduce cardiovascular morbidity and mortality in both middle-aged and elderly age-groups. The efficacies of other measures such as lowering homocysteine and fibrinogen levels, quitting smoking, exercising or weight reduction, are not established but nevertheless such measures appear to be warranted.
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PMID:Cardiovascular risk factors in the elderly. 943 86

Cardiovascular disease is the leading cause of death in Louisiana and in the United States. Louisiana women have the second highest mortality rate for cardiovascular disease in the country. The major risk factors in both men and women include cigarette smoking, hypertension, dyslipidemia, diabetes mellitus, obesity, sedentary lifestyle, and poor nutrition. A body of evidence is accumulating to support the existence of nontraditional risk factors such as elevated homocysteine levels and antioxidants. Gender-specific risks and interventions also exist in the form of oral contraceptives and hormone replacement therapy respectively. Raloxifene and other selective estrogen receptive modulators may alter the regimens of hormone replacement therapy in the future. This article reviews cardiac risk factors focusing on gender differences, the arguments for and against hormone replacement therapy as it relates to coronary disease, and some practical aspects of hormone replacement therapy that physicians encounter when considering hormone replacement therapy in the postmenopausal woman.
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PMID:Coronary heart disease risk factors in women: focus on gender differences. 951 Jun 11

HMG reductase inhibitors have significant desirable effects on patients with dyslipidemia. Multiple factors are involved in these desirable effects. Other factors that might play a role in the risk of coronary artery disease are fibrinogen concentration, homocysteine, Lp (a), small dense LDL, insulin resistance, and infection with chlamydia. High-dose reductase inhibitors may be indicated in select patients. The ideal end point may be 150 mg/dL for adults.
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PMID:Present status of HMG reductase inhibitors in treatment of dyslipidemia. 978 44

The Study of Health Assessment and Risk in Ethnic groups (SHARE) is a study to determine the risk factors for atherosclerosis among three ethnic populations in Canada. Three hundred and thirty South Asian Canadian, 320 Chinese Canadian and 320 European Canadian men and women between 35 and 75 years of age are being randomly sampled from communities in Hamilton and Toronto, Ontario and Edmonton, Alberta for assessment of conventional (i.e., smoking, dyslipidemia, diabetes and hypertension) and emerging (i.e., candidate genes for atherosclerosis, homocysteine, fibrinolytic parameters, neurohormones, glucose intolerance, markers of infection, socioeconomic status, psychosocial status and diet) cardiovascular disease risk factors. Subclinical atherosclerosis is measured by quantitative B-mode ultrasonography of the carotid arteries, and other objective measures of vascular disease are a 12-lead electrocardiogram, a two-dimensional echocardiogram, ankle to arm blood pressure ratio and urine microalbumin concentration. The relationship between the conventional and emerging risk factors, and atherosclerosis, vascular disease and markers of end-organ damage will be evaluated between and within ethnic groups.
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PMID:The Study of Health Assessment and Risk in Ethnic groups (SHARE): rationale and design. The SHARE Investigators. 985 15

Diet and exercise are basic measures of treatment of diabetes mellitus. To prevent the development and progression of atherosclerotic disease as well as microangiopathy, diet management should be focused on the reductions of conventional risk factors for atherosclerosis such as hyperglycemia, dyslipidemia, and hypertension. To control the these risk factors, both total energy and fat intake should be reduced. A diet high in mono- and poly-unsaturated fatty acids, and dietary fibers are recommended to diabetic patients, but the ideal ratio of saturated, monounsaturated, and polyunsaturated fatty acids should be determined from clinical and epidemiological studies in the future. A high concentration of plasma homocysteine is a new risk factor for atherosclerotic disease in diabetic patients. To reduce plasma homocysteine, diet enriched in folate and vitamin B12 may be recommended. A high intake of flavonoid, one of antioxidants, may be also recommended in diabetic patients because of its counteraction against increased oxidative stress in diabetes mellitus. Exercise therapy is an effective measure for improving glycemic control in Type 2 diabetic patients. However, the most appropriate kinds and strength of exercise in diabetic patients with complications or elderly diabetic patients still remain unknown. The dietary regimen or exercise of diabetic patients should be determined individually according to the risk factors, complications, and psychological and socioeconomic conditions.
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PMID:[Perspective of dietary management and exercise therapy in diabetes mellitus]. 1019 49

Mild hyperhomocysteinemia, a putative risk factor for atherothrombotic cardiovascular disease morbidity and mortality, may contribute to the excess incidence of atherothrombotic outcomes in the dialysis-dependent end-stage renal disease population. Hemodialysis access (fistula or graft) thrombosis is an unfortunately common and costly morbidity in this patient population. In this study, using a prospective design, the potential relationship between baseline nonfasting, predialysis plasma total homocysteine (tHcy) levels and vascular access-related morbidity was examined in a cohort of 84 hemodialysis patients with a fistula or prosthetic graft as their primary hemodialysis access. Vascular access thrombotic episodes were recorded over a subsequent 18-mo follow-up period. Forty-seven patients (56% of the total) had at least one access thrombosis during the 18-mo follow-up period (median follow-up, 13 mo; rate, 0.6 events per patient-year of follow-up). Proportional hazards modeling revealed that each 1 microM/L increase in the tHcy level was associated with a 4.0% increase in the risk of access thrombosis (95% confidence interval, 1.0 to 6.0%, P = 0.008). This association persisted after adjustment for type of access (fistula versus graft), age, gender, time on dialysis, diabetes, smoking, hypertension, nutritional status, urea reduction ratio, dyslipidemia, and the presence of previous vascular disease. Elevated tHcy levels appear to confer a graded, independent increased risk for hemodialysis access thrombosis. A randomized, controlled trial examining the effect of tHcy-lowering intervention on hemodialysis access thrombosis appears to be justified.
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PMID:Plasma total homocysteine and hemodialysis access thrombosis: a prospective study. 1023 97


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