Navegando por Palavras-chave "Lipoproteins"
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- ItemSomente MetadadadosCaracterização do perfil de subtrações LDL e HDL em pacientes com artrite psoriásica(Universidade Federal de São Paulo (UNIFESP), 2019-01-31) Scherer, Daniele [UNIFESP]; Pinheiro, Marcelo De Medeiros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Cardiovascular diseases represent the main cause of death worldwide, with dyslipidemia being one of the main risk factors. Several studies have shown a higher rate of dyslipidemia and findings of subclinical atherosclerosis in patients with psoriatic arthritis (APs), but the lipoprotein pattern and its subfractions in this population is still poorly investigated Objectives: To characterize the profile of LPs (LDL and HDL subfractions) in patients with APs, as well as analyzing the associations with clinical variables. Methods: a total of 91 patients with APs, according to the CASPAR criteria (Classification Criteria for Psoriatic Arthritis), were included in this cross-sectional study, through a global clinical evaluation, including measures of outcome of cutaneous and joint disease activity, as well as as analysis of LDL and HDL subfractions, using automated LP electrophoresis (LIPOPRINT®). LDL subfractions were classified as non-atherogenic, atherogenic and highly atherogenic and HDL subfractions were grouped as small, intermediate and large according to the Lipoprint® methodology. P less than 0.05 was considered significant. Results: Most patients (n = 56, 62%) had an atherogenic or highly atherogenic pattern. And, in those patients with normal plasma LDL concentration (below 100 mg / dL), thirty-two (35%) of them were categorized with a high-risk lipoprotein pattern. Male gender, current use of glucocorticosteroids, shorter disease duration and higher BMI were associated with the atherogenic or highly atherogenic profile. In contrast, the vast majority of patients with APs (n = 72, 75%) had adequate HDL values (above 40 mg / dL), although the most protective subfraction (large molecules) was found in only 10% sample, especially in those with low disease activity. Conclusion: Our data showed that LDL subfractions are altered in the vast majority of patients with APs, regardless of the absolute value of total LDL, suggesting that the identification of the most atherogenic profile through the evaluation of lipoprotein subfractions may have a greater impact to assess cardiovascular risk in this scenario, to the detriment of the isolated dosage of HDL and LDL.
- ItemAcesso aberto (Open Access)Comparação dos efeitos de duas estratégias hipolipemiantes sobre subclasses de lipoproteínas em pacientes com infarto agudo do miocárdio(Universidade Federal de São Paulo (UNIFESP), 2020-06-25) Pinto, Leticia Carolinni Dos Santos [UNIFESP]; Fonseca, Francisco Antonio Helfenstein [UNIFESP]; Universidade Federal de São PauloBACKGROUND: Increased levels of low density lipoprotein-cholesterol (LDL-C) are related to cardiovascular disease. Prospective, randomized and controlled studies showed that statin treatment may decrease morbidity and mortality from atherosclerosis, specially from coronary disease. However, similar values of LDL-C can be distributed on many subclasses of LDL and intermediate lipoproteins (IDL) with possible implications for the residual cholesterol risk. OBJECTIVES: This study aimed to compare the effects of two highly effective lipid-lowering strategies on lipoprotein subclasses in subjects with acute myocardial infarction. In addition, associations between lipoprotein subclasses and the amount of myocardial infarction mass, as well as left ventricular function were evaluated by cardiac 3T magnetic resonance imaging (cMRI). METHODS: Prospective, randomized, open label study with blinded endpoints included 101 subjects with ST segment elevation myocardial infarction (STEMI) from nine hospitals of the city of São Paulo. All patients received tenecteplase in the first 6 h of STEMI and were hospitalized in the Hospital São Paulo of the Universidade Federal de São Paulo, in the first 24 h for coronary angiography (pharmacoinvasive strategy). At the hospital arrival, a written informed consent was obtained and the patients were randomized to receive a daily dose of rosuvastatin 20 mg or the combined simvastatin 40 mg/ezetimibe 10 mg. Blood samples were collected at admission and after 30 days of STEMI. Subclasses of lipoproteins were examined by polyacrylamid gel electroforesis. cMRI parameters were performed after 30 days of STEMI. RESULTS: Study population was composed predominantly by overweight males, smokers, and hypertensives. The two groups of patients had comparable coronary angiography with higher prevalence of the left anterior descending as culprit artery. After 30 days, cMRI revealed similar findings for both groups. The classical lipid profile (cholesterol, LDL-C, HDL-C, non-HDL-C, and triglycerides) was comparable between groups at baseline and after 30 days. Furthermore, both lipid-lowering strategies promoted similar changes on IDL and LDL subclasses. However, their effects were more pronounced on the less atherogenic lipoproteins (LDL 1-2), not changing the profile of small dense LDL particles (LDL3-7). There was an improvement with both therapies on the pattern of IDL subclasses. Finally, there was an association between baseline IDL subclasses and the amount of infarcted mass, especially IDL type C. CONCLUSIONS: Despite expressive decrease in the LDL-C levels, and improvement of IDL particles, both treatments did not improve the pattern of more atherogenic LDL particles. The infarcted myocardial mass seems related to the most atherogenic IDL subclass.
- ItemSomente MetadadadosEfeitos da suplementação de fitosteróis nas subfrações lipoproteícas: estudo de prevenção primaria(Universidade Federal de São Paulo (UNIFESP), 2021) Machado, Valeria Arruda [UNIFESP]; Izar, Maria Cristina De Oliveira [UNIFESP]; Universidade Federal de São PauloBackground: Compared with the general population, military police has unhealthy lifestyle. Further, the impaired physical and psychological health to what they are exposed place them under higher risk for cardiovascular diseases (CVD). Though, it is particularly relevant for this population the adoption of a healthier lifestyle, with the use of food supplements with bioactive properties, an additional option to achieve goals, including LDL-cholesterol (LDL-c) reduction. Among those, phytosterols possess the capacity of competing with intestinal cholesterol absorption, thus reducing their plasma levels. However, the effects of phytosterols on lipoprotein subfractions are less reported. Objectives: To evaluate the effects of phytosterol supplementation to the diet on plasma lipids, and on subfractions of LDL and HDL of patients in primary prevention of CVD without drug therapy. The secondary objectives were to assess modifications in food consumption and anthropometric parameters. Methods: Sixty male subjects, military police from the ROTA (Rondas Ostensivas Tobias de Aguiar), with hypercholesterolemia in primary prevention were recruited. Of those, 27 individuals did not have all inclusion criteria, and 10 were excluded for not following the protocol. The final sample consisted of 23 individuals. The study design was prospective, open label, randomized, crossover, where subjects were randomized to diet alone or diet plus phytosterols (2.6 g divided in two doses, with meals) during 12 weeks, followed by a 7-day washout period, and after this period the treatments were inverted and maintained for another 12 weeks. At the end of each intervention period, blood sample collection, was obtained and the same laboratory tests were performed. Anthropometric parameters, food consumption and the classic lipid profile were evaluated every 12 weeks. Lipoprotein size (HDL and LDL) were analised by the electrophoresis system in polyacrylamide gel (Lipoprint System®). We identified large buoyant (1-3), intermediate (4-7) and small (8-10) HDLs, as well as the non-atherogenic IDL A, and the atherogenic IDL B and C, VLDL, and large (1 and 2), and small-dense (3-7) LDL. Results: The phytosterol supplementation to the diet reduced total cholesterol (p= 0.04) and increased HDL-c (p=0.02), compared with baseline, whereas diet alone promoted increase in intermediate HDL subfraction (p=0.007). Diet alone (p=0.02) or added to phytosterol reduced IDL B (p=0.03). Abdominal circumference was reduced after diet (p=0.01) and diet + phytosterols (p= 0.03). Conclusions: Phytosterols supplemented to the diet have proven beneficial to improve the classic lipid profile; diet alone or with phytosterols promoted reduction of the atherogenic lipoprotein subfraction IDL. There was a small additional benefit of both interventions on waist circumference.
- ItemAcesso aberto (Open Access)Efeitos do treinamento de alta intensidade de corredores profissionais na saúde cardiovascular(Universidade Federal de São Paulo (UNIFESP), 2016-12-21) Bittencourt, Celia Regina de Oliveira [UNIFESP]; Fonseca, Francisco Antonio Helfenstein [UNIFESP]; http://lattes.cnpq.br/2393476657163442; http://lattes.cnpq.br/2334390725647030; Universidade Federal de São Paulo (UNIFESP)Introduction: Physical activity has been universally recommended for cardiovascular disease prevention. However, the effects of intensive physical activity on cardiovascular protection are less reported. Objectives : To examine biochemical, nutritional, and ergo-respiratory parameters, and, particularly, to quantify the percentage of circulating endothelial progenitor cells (EPC) and amount of endothelial (EMP) and platelet (PMP) microparticles among professional runners. These parameters were compared with healthy non-athlete controls. Methods: Case control study includes professional runners and age and gender matched controls. Circulating EPC, EMP and PMP were quantified by flow-cytometry using specific antibodies. Lean and fat corporal mass were estimated by bioimpedance. Biochemical parameters were obtained fast after routine exercise in the day before. Results: Athletes had lower BMI, better metabolic and lipid profile (all p<0.05 vs. controls). Higher CEP (%) was observed in athletes (CD34/KDR+, p=0.038 vs. controls; CD133+/KDR+, p=0.018 vs. controls; but did not differ for CD34+/CD133+, p=0.51). Microparticles (EMP and PMP) were similar between athletes and controls. Athletes had higher mean (SE) VO2 peak group [59 (4) vs 48 (3) ml/kg.min, p<0.05). Conclusions: Intensive exercise is associated with increased circulating EPC without increase in microparticles. This favorable balance of vascular biomarkers is still associated with better anthropometric and biochemical parameters.
- ItemSomente MetadadadosEstudo dos glicosaminoglicanos aórticos: sua importância funcional e interação com lipoproteinas plasmáticas(Universidade Federal de São Paulo (UNIFESP), 1981) Toledo, Olga Maria Szymanski [UNIFESP]; Mourão, Paulo Antonio de Souza [UNIFESP]
- ItemAcesso aberto (Open Access)Lipid levels and risk of venous thrombosis: results from the MEGA-study(Springer, 2017) Morelli, Vania M. [UNIFESP]; Lijfering, Willem M.; Bos, Mettine H. A.; Rosendaal, Frits R.; Cannegieter, Suzanne C.The relationship between lipid levels and risk of venous thrombosis is not well established. We aimed to assess the association between several lipids and risk of venous thrombosis using data from a population-based case-control study, and to evaluate the underlying mechanism, considering confounding by common risk factors and mediation via hemostatic factors and C-reactive protein. From the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA) study, 2234 patients with a first venous thrombosis and 2873 controls were included. Percentile categories of total/low-density lipoprotein/high-density lipoprotein cholesterol, triglycerides, and apolipoproteins B and A1 were established in controls (< 10th, 10th-25th, 25th-75th [reference], 75th-90th, > 90th percentile). In age- and sex-adjusted models, decreasing levels of apolipoproteins B and A1 were dose-dependently associated with increased thrombosis risk, with odds ratios of 1.35 (95% confidence interval 1.12-1.62) and 1.50 (95% confidence interval 1.25-1.79) for the lowest category versus the reference category, respectively. The dose-response relation remained with further adjustment for body mass index, estrogen use, statin use, and diabetes. Although apolipoproteins B and A1 were associated with several hemostatic factors and C-reactive protein, none explained the increased risk in mediation analyses. The other lipids were not associated with venous thrombosis risk. In conclusion, decreasing levels of apolipoproteins B and A1 were associated with increased risk of venous thrombosis. Our findings are consistent with experimental data on the anticoagulant properties of apolipoproteins B and A1. These findings need to be confirmed and the underlying mechanism further investigated.
- ItemAcesso aberto (Open Access)Nefrolitíase e risco cardiovascular : avaliação da aterosclerose nos pacientes litiásicos(Universidade Federal de São Paulo (UNIFESP), 2017-11-30) Freitas, Augustus Cesar Pinto de [UNIFESP]; Schor, Nestor [UNIFESP]; Casarini, Dulce Elena [UNIFESP]; Torres, Leuridan Cavalcante [UNIFESP]; Duarte, Maria do Carmo Menezes Bezerra; Dulce Elena Casarini : http://lattes.cnpq.br/0534906942293338; Maria do Carmo Menezes Bezerra Duarte : http://lattes.cnpq.br/4973562538598237; Leuridan Cavalcante Torres : http://lattes.cnpq.br/2047142717269426; http://lattes.cnpq.br/8276708741672261; http://lattes.cnpq.br/5318231956041552; Universidade Federal de São Paulo (UNIFESP)Nephrolithiasis is considered a multifactorial disease, which prevalence has been increasing in the world. Many studies have been established a link between nephrolithiasis and systemic disease, including cardiovascular disease (CVD), metabolic syndrome (MS) and atherosclerosis. The main theories about the pathogenesis of early calculi’s matrix describe it like a biomineralization pathological and inflammatory process, with involvement of reactive oxygen species (ROS). Thereby, the calculi’s formation shares pathophysiological mechanisms suchlike that involved with another systemic disorders, which have high mortality and begins with atherosclerosis. Studies have shown the presence of ROS and your products in atherosclerosis, like oxidized low-density lipoprotein (LDLox), which is considered a marker of that disease. High levels of LDLox correlate significantly with CVD, including coronary and femoral artery disease. The antibody of LDLox (Ac Anti-LDLox) correlates less clearly with atherosclerosis. However, despite both, nephrolithiasis and atherosclerosis, exhibit pathophysiological mechanisms related to oxidative stress, we have not studies about LDLox in nephrolithiasis’ patients. This study aims to evaluate the serum levels of LDLox, antibory LDLox and others atherosclerosis markers in nephrolithiasis’ patients, according to the severity of the disease. It’s an translational cross-sectional study conducted between October 2015 and February 2017, involving 94 lithiasic patients, asymptomatic from the cardiovascular point of view, between 30-70 years old, watched in renal calculi clinic of Instituto de Medicina Integral Professor Fernando Figueira (IMIP) and 21 healthy controls. They were excluded when any anatomical abnormalities, chronic renal disease or cardiovascular disease were found or if they use statins. Pregnant women were also excluded. There were realized 24 hour urine measurements, serum measurements of atherosclerosis markers, like enzyme immunoassay to LDLox (Human Oxidized Low Density Lipoprotein (OxLDL) ELISA Kit; Elabscience Biotechnology Co., Wuhan, China) and Ac Anti-LDLox (OLAB IgG - Antioxidized LDL autoantibodies - ELISA Kit; Biomedica Medizinprodukte GmbH, Viena, Austria), following the manufacturer’s instructions. This study was approved by the Ethics Committee on Human Research of IMIP. Patients with nephrolithiasis were divided into group 1 (≥ 3 kidney stones) and group 2 (1-2 kidney stones). Both showed significantly higher LDLox levels (group 1: p= 0,02; group 2: 0,003) and higher LDLox/HDL (group 1: p=0,005; group 2: p=0,004) than controls. Patients in group 1 evidenced lower levels of Ac Anti-LDLox (p= 0,03) in relation to the control group. C-reactive protein were higher in patients with more severe disease (group 1; p=0,02). Our findings suggest that patients with renal stone disease have higher levels of LDLox, LDLox/HDL and PCR than healthy individuals. These findings indicate that this may be the link between nephrolithiasis, atherosclerosis and cardiovascular disease, more prevalent in patients with calculi.
- ItemAcesso aberto (Open Access)PCSK9 and its clinical importance with the new therapeutic targets against dyslipidemia(Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2012-12-01) Ferreira, Carlos Eduardo dos Santos [UNIFESP]; Fonseca, Francisco Antonio Helfenstein [UNIFESP]; Mangueira, Cristóvão Luis Pitangueiras; Hospital Israelita Albert Einstein; Universidade Federal de São Paulo (UNIFESP)This is a remarkable progress; since the finding of statins, there was no new way of reducing, significantly, cholesterol and LDL fraction. It is also clear that this decrease, by statins, is related to future cardiovascular lesions, being useful in its primary and secondary prophylaxis. The authors presented studies on research to promote the falling of blood cholesterol by means of antibodies, which inhibit the pro-protein PCSK9, as well as agents that act performing the RNA interference. We had two advantages immediately: for patients with myopathy associated with statins, and the fact of being injected every 15 days, that may contribute to better treatment adherence.
- ItemAcesso aberto (Open Access)Reverse Cholesterol Transport: Molecular Mechanisms and the Non-medical Approach to Enhance HDL Cholesterol(Frontiers Media Sa, 2018) Marques, Leandro Ribeiro; Diniz, Tiego Aparecido; Antunes, Barbara Moura; Rossi, Fabricio Eduardo; Caperuto, Erico Chagas; Lira, Fabio Santos de [UNIFESP]; Gonçalves, Daniela Caetano [UNIFESP]Dyslipidemia (high concentrations of LDL-c and low concentrations of HDL-c) is a major cause of cardiovascular events, which are the leading cause of death in the world. On the other hand, nutrition and regular exercise can be an interesting strategy to modulate lipid profile, acting as prevention or treatment, inhibiting the risk of diseases due to its anti-inflammatory and anti-atherogenic characteristics. Additionally, the possibility of controlling different training variables, such as type, intensity and recovery interval, can be used to maximize the benefits of exercise in promoting cardiovascular health. However, the mechanisms by which exercise and nutrients act in the regulation of cholesterol and its fractions, such as reverse cholesterol transport, receptors and transcription factors involved, such as PPARs and their role related to exercise, deserve further discussion. Therefore, the objective of this review is to debate about non-medical approaches to increase HDL-c, such as nutritional and training strategies, and to discuss the central mechanisms involved in the modulation of lipid profile during exercise, as well as that can be controlled by physical trainers or sports specialists in attempt to maximize the benefits promoted by exercise. The search for papers was performed in the databases: Medline (Pubmed), Science Direct, Scopus, Sport Discus, Web of Science, Scielo and Lilacs until February 2016.