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)

The obese state has been recognized to accentuate the known risk factors for atherosclerotic disease as dyslipidemia, hypertension, glucose intolerance and insulin resistance. Among other risk factors, obesity is characterized by a series of lipid disturbances, such as hypercholesterolemia, high fasting (and postprandial) triglyceride levels, low HDL cholesterol, high apolipoprotein B, high small dense lipoprotein particles and alterations of serum and tissue LPL-activity. Although obesity is associated with such cluster of lipid abnormalities, these factors do not explain the complete process of atherogenesis in the obese subject. Other risk factors belonging to the polymetabolic syndrome-cluster, insulin resistance, hypertension, fibrinogen, add substantial but not full explanation to the atherothrombotic process. Over the last decade, a series of excellent studies have provided the background for a more indepth mechanism of atherosclerosis; the role of lipid peroxidation in particular has been one of the focuses of this current research. There exists a lot of evidence suggesting a major role for oxidized LDL and VLDL particles in the pathogenesis of atherosclerosis. Although obesity is characterized by dyslipidemia, less is known about the oxidation capacity of lipoproteins in obese subjects. We measured the oxidizability in vitro in 21 premenopausal women and compared them to 18 age-matched controls. The oxidizability of the non-HDL fraction is evaluated by measuring the fluorescence and thiobarbituric acid reactive substances (TBARS: MDA nM/mg non-HDL) at different time intervals of incubation. TBARS formation increased linearly with the increase of lipids both in non-obese and obese subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
Int J Obes Relat Metab Disord 1995 Sep
PMID:Human obesity: from lipid abnormalities to lipid oxidation. 858 Oct 73

There is good evidence that central (visceral) adiposity is important in the development of the insulin resistance or metabolic syndrome (obesity, hyperinsulinemia, dyslipidemia, glucose intolerance, hypertension, and coronary heart disease). It is proposed that some non-Caucasian populations are especially susceptible to development of this syndrome, and that lifestyle changes may play important etiologic roles. We postulate that this is due to the presence in these populations of a genetic predisposition to weight gain, perhaps related to a "thrifty" genotype, leading to the concentration of weight gain in visceral fat depots, when there is exposure to conditions associated with westernization.
Obes Res 1995 Sep
PMID:Susceptibility to development of central adiposity among populations. 858 74

We retrospectively analyzed the courses of 37 non-insulin dependent diabetics (hemodialyzed:HD group) with end-stage renal disease (ESRD), to identify factors predisposing to renal failure. The factors analyzed were: diabetic (non-proliferative and proliferative) retinopathy, family histories of diabetes and hypertension, smoking, dyslipidemia, first examination proteinuria and non-compliance. These factors were statistically compared in 37 NIDDM without renal failure (non-HD group). There were no significant differences in age or duration of diabetes between the two groups. Significant differences (P < 0.001) were, however, recognized in diabetic proliferative retinopathy and hypertension between the two groups. Hypertension was present in 35/36 (97.2%) HD patients and in 21/36 (58.3%) non-HD patients. A family history of hypertension was recognized in 16/37 HD (43.2%) and in 7/33 (21.2%) non-HD (P < 0.05). Differences were recognized in HDL-cholesterol, LDL-cholesterol and TG levels (38.2 +/- 12.5 mg/dl and 56.7 +/- 18.5 mg/dl, 140.4 +/- 57.1 mg/dl and 115.6 +/- 33.6 mg/dl, 169.9 +/- 89.4 mg/dl and 115.7 +/- 75.1 mg/dl, in HD and non-HD, respectively, P < 0.05). First visit proteinuria was found in all HD patients, and in 6/34 (17.6%) non-HD. The difference in previous treatment refusal, for 7 or more years, was significant with 23/36 (58.9%) HD patients and only 1/25 (4.0%) non-HD patients (P < 0.001) having a history of prolonged non-compliance with diabetic treatment. Diabetic retinopathy, non-proliferative and proliferative, hypertension and a family history of hypertension, elevated triglyceride and LDL-cholesterol, low HDL-cholesterol, first visit proteinuria, and prolonged non-compliance correlated with progression to ESRD. We advocate expanding diabetic education to include prevention of complications such as diabetic nephropathy.
Diabetes Res Clin Pract 1995 Sep
PMID:Retrospective analysis of hemodialyzed diabetic patients in Japan. 859 10

Hyperlipidemia occurs frequently after heart transplantation, and accelerated coronary artery disease remains the major cause of morbidity and mortality in patients who survive more than 1 year after heart transplantation. However, the risks and benefits of lipid-lowering therapy after heart transplantation remain poorly defined, and national guidelines for lipid-lowering drug therapy do not specifically address treatment of dyslipidemia in transplant recipients. Since the initial reports in the 1980s of rhabdomyolysis in heart transplant patients receiving high-dosage lovastatin, results of 11 post-transplantation series that used lovastatin, simvastatin, or pravastatin at lower dosages as drug monotherapy have been published. These studies have shown an overall 1% incidence of rhabdomyolysis, defined as creatine kinase > 10 times the upper limit of normal plus muscle symptoms. One randomized, controlled prospective trial has investigated the effects of lipid-lowering pharmacotherapy on patient outcome in cardiac transplant recipients. At 1-year follow-up in this nonblinded, single-center trial, patients treated with pravastatin (20 or 40 mg/day) initiated within 2 weeks of transplantation had a significant reduction in mortality rate and a significantly lower incidence of transplant arteriopathy. A number of important issues remain unanswered regarding treatment guidelines in patients with hyperlipidemia after heart transplantation. In January 1995 we began the Heart Transplant Lipid Registry, with 12 participant centers, to gather data prospectively on the efficacy and safety of lipid-lowering drugs in the treatment of dyslipidemia after heart transplantation.
Am J Cardiol 1996 Sep 01
PMID:Treatment of hyperlipidemia after heart transplantation and rationale for the Heart Transplant Lipid Registry. 880 37

The maximum tolerated dose and pharmacokinetics of a drug is usually determined in healthy human volunteers and animals. This data is then used to define the dosing recommendation for the diseased patient population. However, in the case of some hydrophobic drugs, the dose which is deemed nontoxic becomes ineffective and/or toxic when administered to the diseased patient. This observation might be explained by several lines of evidence which indicate that binding of drugs such as amphotericin B (AmpB) and cyclosporine (CSA) to plasma low-density lipoprotein- (LDL) cholesterol is involved in the development of kidney toxicity. Our preliminary studies have suggested that this phenomena might be due to increase lipid transfer protein (LTP 1) activity which promotes the transfer of AmpB from high-density lipoproteins to LDL. In addition, since LTP 1 function is regulated by the lipid content of plasma lipoproteins, we suggest that changes in lipoprotein composition that occur in dyslipidemia regulate the distribution of these and other hydrophobic drugs (i.e., annamycin and nystatin). The impact of these studies on hydrophobic drug therapy could have broad implications on how we evaluate and determine dosing of hydrophobic drugs in dyslipidemic patients. By understanding the mechanism(s) responsible for the distribution of hydrophobic compounds in the bloodstream, we are trying to define the effect of dyslipidemias on the plasma clearance and therapeutic index of hydrophobic compounds.
J Pharmacol Toxicol Methods 1996 Sep
PMID:Modifications in plasma lipoprotein concentration and lipid composition regulate the biological activity of hydrophobic drugs. 887 13

The aim of this review is to assess the prevalence of complications and responses to various antihypertensive drug therapies in ethnic minority groups in the United States. In some instances, these comments are extended to responses of citizens in their countries of origin. The incidence of hypertension, mortality from hypertensive heart disease, stroke, and hypertensive renal disease are higher in African Americans. Although some Hispanic Americans have a lesser risk for hypertension, they have a greater risk for other risk factors such as diabetes and dyslipidemia. There is a similar association between income and mortality for both African Americans and Hispanic Americans. When compared to European Americans and other ethnic minorities, African Americans respond less favorably to beta blockers and angiotensin-converting enzyme (ACE) inhibitors. Nevertheless, the observed response in African Americans to ACE inhibitors and beta blockers is clinically significant. The available literature indicates that Asian American responses to calcium antagonists seem to be more favorable than responses to ACE inhibitors and equivalent to their responses to diuretic and beta blocker therapy. Although there are few published studies of drug efficacy in Hispanic Americans, there appears to be no hierarchy in response to the various antihypertensive drug classes. Ethnicity is not an accurate criterion for predicting poor response to any class of antihypertensive therapy. Thus, there is little justification to use racial profiling as a criterion for the avoidance of selected drug classes because of presumed lack of efficacy. Observed differences in the incidence of hypertension and its poor outcomes have led some investigators to postulate that the etiology of hypertension in ethnic minority groups is intrinsically different from whites. Awareness of racial differences in hypertension outcomes evolved in the United States within a historical context that does not fully appreciate that race is often a surrogate for many social and economic factors that influence health status and healthcare delivery. Poor outcomes in ethnic minority groups occur in many diseases, not only hypertension. The goal of ethnicity-related research should be to describe the diversity of disease expression in humans and to target at-risk groups for prevention and early intervention. The use of racial descriptors to explain genetic differences in ethnic groups should take a lesser priority.
Am J Med 1996 Sep 30
PMID:The impact of ethnicity on response to antihypertensive therapy. 887 72

Obesity, diabetes mellitus, and hypertension are common and interrelated medical problems in Westernized, industrialized societies. These medical conditions are associated with an increased risk of cardiovascular disease and are more prevalent among minorities, such as African-American and Hispanic populations. The associated cardiovascular risks of these problems are more thoroughly addressed in another review in this supplement. Obesity markedly enhances the development of type II diabetes. Moreover, it enhances the cardiovascular risk associated with other risk factors, such as hypertension and dyslipidemia. Weight reduction in association with an aerobic exercise program improves metabolic abnormalities and reduces blood pressure in individuals with diabetes and hypertension. Frequently, however, pharmacologic treatment is required to lower blood pressure. Individual therapy with an angiotensin-converting enzyme (ACE) inhibitor is preferred initially in these individuals, with the addition of either a low dose diuretic or a nondihydropyridine calcium antagonist if additional blood pressure reduction is required. These additive agents are recommended, since each has been shown individually to reduce cardiovascular morbidity and to preserve renal function among diabetic patients. Other issues, such as aggressive therapy of lipids and adequate glycemic control, are also important strategies for reducing cardiovascular and renal morbidity and mortality in this very high-risk population.
Am J Med 1996 Sep 30
PMID:Therapeutic challenges in the obese diabetic patient with hypertension. 887 73

Serum lipid profiles were determined in 2,703 male and 792 female officials of the Electricity Generating Authority of Thailand (EGAT), aged 35-54 yrs, and 519 Ramathibodi Hospital Staff (RHS) consisting of 66 men and 453 women, aged 19-61 yrs. They are affluent-urban Thais. Mean serum total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and triglyceride (TG) levels in EGAT officials were higher than those in RHS with the same sex, whereas the opposite result was observed for their serum high density lipoprotein-cholesterol (HDL-C) levels. Men also showed higher serum TC, LDL-C, and TG but lower HDL-C levels than women. The major type of dyslipidemia in EGAT officials and RHS was hypercholesterolemia due to elevated serum LDL-C levels, but the elevated LDL-C level in RHS was less severe than that in EGAT officials. Besides, the prevalence of serum HDL-C level of 1.55 mmol/L, a negative risk factor for coronary heart disease, in RHS was higher than that in EGAT officials. The mean percentages of dietary fat-calories consumed by EGAT officials and RHS were 39% and 31%, respectively. Thus it is plausible that dietary fat intake influences their serum lipid levels. The beneficial effects of linoleate intake on serum lipoprotein profiles are illustrated in RHS.
Biomed Environ Sci 1996 Sep
PMID:Dyslipidemia in urban Thais. 888 31

Resistance to insulin-stimulated glucose uptake is associated with several cardiovascular disease risk factors, including hypertension, dyslipidemia, and alterations of the blood clotting cascade that accentuate thrombosis. This constellation of risk factors may be recognized at young ages and is at least in part heritable. Recognition of this syndrome dictates that preventive and therapeutic strategies should address overall cardiovascular disease risk. In patients with hypertension or diabetes, additional clinical trials are required to identify those interventions that will most effectively reduce not only overall risk but also definitive cardiovascular disease endpoints.
Curr Opin Cardiol 1996 Sep
PMID:Insulin and hypertensive cardiovascular disease. 888 74

Obesity is strongly associated with cardiac risk factors including elevated blood pressure, glucose intolerance, and dyslipidemia. Clinical trials have indicated that weight loss significantly improves these risk profiles. Epidemiologic studies consistently have shown that obesity is a strong risk factor for coronary heart disease in both men and women. In addition, abdominal adiposity may confer added risk for coronary heart disease. Although obesity is a modifiable and preventable cardiac risk factor, management of this disorder remains both challenging and vexing to clinicians. To prevent cardiovascular disease we must find ways to decrease the rising prevalence of obesity and to help overweight individuals achieve and sustain weight loss.
Curr Opin Cardiol 1996 Sep
PMID:Obesity and cardiovascular disease. 888 75


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