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Hypertriglyceridemia  [PDF]
Amanda Brahm,Robert A. Hegele
Nutrients , 2013, DOI: 10.3390/nu5030981
Abstract: Hypertriglyceridemia (HTG) is commonly encountered in lipid and cardiology clinics. Severe HTG warrants treatment because of the associated increased risk of acute pancreatitis. However, the need to treat, and the correct treatment approach for patients with mild to moderate HTG are issues for ongoing evaluation. In the past, it was felt that triglyceride does not directly contribute to development of atherosclerotic plaques. However, this view is evolving, especially for triglyceride-related fractions and variables measured in the non-fasting state. Our understanding of the etiology, genetics and classification of HTG states is also evolving. Previously, HTG was considered to be a dominant disorder associated with variation within a single gene. The old nomenclature includes the term “familial” in the names of several hyperlipoproteinemia (HLP) phenotypes that included HTG as part of their profile, including combined hyperlipidemia (HLP type 2B), dysbetalipoproteinemia (HLP type 3), simple HTG (HLP type 4) and mixed hyperlipidemia (HLP type 5). This old thinking has given way to the idea that genetic susceptibility to HTG results from cumulative effects of multiple genetic variants acting in concert. HTG most is often a “polygenic” or “multigenic” trait. However, a few rare autosomal recessive forms of severe HTG have been defined. Treatment depends on the overall clinical context, including severity of HTG, concomitant presence of other lipid disturbances, and the patient's global risk of cardiovascular disease. Therapeutic strategies include dietary counselling, lifestyle management, control of secondary factors, use of omega-3 preparations and selective use of pharmaceutical agents.
The effect of aerobic training on endothelium-dependent vasodilatation in patients with coronary artery disease who were revascularized and young men  [PDF]
Seyed Masoud Seyedian, Farzaneh Ahmadi, Babak Hamidian, Ebrahim Hajizadeh, Afshin Rezazadeh, Ahmad Reza Asare, Mohammad Hasan Adel, Mohammad Nourizadeh
Health (Health) , 2013, DOI: 10.4236/health.2013.510230
Abstract:

Aim: The aim of this study was to determine the effect of training on endothelium-dependent vasodilatation in patients with coronary artery disease (CAD) after revascularization and healthy young men. Background: Impaired endothelial function has been observed in patients with CAD and those with CAD risk factors. Studies have shown that exercise can enhance endothelial function. Methods: This experimental cross-sectional study was conducted on patients with CAD (3 months after CABG and PCI) and students of medical school in 2011. Endothelium dependent dilation of the brachial artery was determined by using high-resolution vascular ultrasonography through flow-mediated vasodilatation (FMD) after induction of ischemia, and the data were analyzed using SPSS, dependent t-test and ANCOVA. Findings: The findings showed that at baseline, FMD was reduced in revascularized patients, when compared with healthy young men, after 8 weeks, and exercise training significantly improved FMD in patients underwent training group [from 4.31 ± 1.45 (SD)% to 6.15 ± 0.773 (SD)%, p < 0.05] and substantially increased the same in healthy young men [from 9.18% ± 1.45% to 11.72% ± 1.72%, p < 0.05] However, in the control group, the FMD remained unchanged, and even after aerobic training, it did not significantly modify the brachial artery diameter in these groups. Conclusion: Our study demonstrates that endothelial dysfunction persisting in CAD patients after revascularization and aerobic training can improve endothelial function in different vascular beds in CAD patients and healthy young men. This may contribute to the benefit of regular exercise in preventing and restricting cardiovascular disease.

Factors associated with overweight and central adiposity in urban workers covered by the Workers Food Program of the Brazilian Amazon Region
Araújo, Marília S.;Costa, Teresa H.M. da;Schmitz, Bethsáida A.S.;Machado, Liliane M.M.;Santos, Wallace R.A. dos;
Revista Brasileira de Epidemiologia , 2010, DOI: 10.1590/S1415-790X2010000300006
Abstract: objective: to investigate factors associated with overweight and abdominal obesity in male and female workers. methods: this is a cross-sectional population-based study. a representative sample of 1,054 workers ranging from 18 to 74 years of age, selected among individuals covered by the workers′ food program living in the metropolitan region of belém, northern brazil. health-related behavior and anthropometry were assessed. fasting blood samples were collected. results: overweight prevalence was 38.0% among women and 50.4% among men. among overweight subjects, there were 6.1% obese women and 10.7% obese men. multivariate analysis was used to identify social behavior and clinical-biochemical factors associated with increased body adiposity (bmi > 25 kg/m2 and increased waist circumference: > 80 cm for women and > 94 cm for men). variables positively and significantly associated with overweight and abdominal obesity in men according to prevalence ratio (pr) values were: age (1.02), high family income (1.05), smoking (1.36), hypertension (systolic blood pressure, 1.41; diastolic blood pressure, 1.85) and hypertriglyceridemia (2.29). in women, the pr of increased body adiposity was associated with: age (1.02), alcohol intake (1.42), hypertriglyceridemia (1.44), diastolic blood pressure (1.65) and hyperglycemia (1.71). conclusions: the association of overweight and abdominal obesity with social behavior variables should be corrected with preventive and educational measures. furthermore, association of overweight and abdominal obesity with clinical and biochemical variables places the urban workers from the amazon region assisted by the workers′ food program at a possible risk for morbidity and mortality from increased body adiposity.
Use of Plasmapheresis in Managing the Diagnostic Dilemma of Symptomatic Hypertriglyceridemia  [PDF]
Nigel Gordon Maher,Hariharan Ramaswamykanive
Case Reports in Gastrointestinal Medicine , 2012, DOI: 10.1155/2012/501373
Abstract: We present a case study of a 29-year-old male who presented with abdominal pain typical for pancreatitis. Detailed history and investigations revealed that the cause of abdominal pain was secondary to the raised triglyceride levels. It was difficult to distinguish whether he had hypertriglyceridemia-induced abdominal pain or acute pancreatitis, given that he had only a mildly raised lipase and a normal contrast computed tomography scan of the pancreas. The abdominal pain resolved with the fall in the triglyceride levels following plasmapheresis. Plasmapheresis is an underevaluated modality of the treatment of hypertriglyceridemia due to its cost and availability. 1. Introduction Severe hypertriglyceridemia is known to cause abdominal pain and acute pancreatitis [1]. Amylase and lipase serum levels, both diagnostic markers for pancreatitis [2], may be spuriously normal or only mildly raised in the setting of hypertriglyceridemia [3–5], obscuring a diagnosis of pancreatitis. Management of hypertriglyceridemia is generally conservative, such as dietary advice, fasting, lipid lowering medications, and noncaloric intravenous fluids [1, 3]. Plasmapheresis has emerged as an effective, yet underevaluated, technique for rapidly lowering triglyceride levels, helping to prevent and treat acute pancreatitis [6, 7]. No reports have documented its use in the symptomatic management of abdominal pain, independent of pancreatitis, induced by severe hypertriglyceridemia. 2. Case Report A 29-year-old indigenous Australian male presented to the emergency department of a rural hospital complaining upper abdominal pain radiating to the back. His heart rate was 64 beats per minute, blood pressure 138/83?mmHg, respiratory rate 11 per minute, saturating 99% on room air, and he had a temperature of 36.5°C. He had 8 out of 10 on visual analogue pain score (VAS). His past medical history included asthma, type II diabetes, obesity, and hypertriglyceridemia. He was diagnosed to have hypertriglyceridemia-induced pancreatitis three years ago when he presented with severe abdominal pain. His triglyceride level then was 39?mmol/L. The computed tomography (CT) scan at that time confirmed a diagnosis of focal pancreatitis, along with hepatosplenomegaly. He was lost to further follow-up, postconservative management. He was a current smoker and denied recent alcohol consumption. At admission he was clinically very dry. His blood tests were not fully analysable due to excessive lipemia. He was resuscitated with three litres of crystalloid fluid and on repeat blood testing, he was found to
Women with overweight, mixed hyperlipidemia, intolerance to glucose and diastolic hypertension  [PDF]
Ruth-Maria Korth
Health (Health) , 2014, DOI: 10.4236/health.2014.65064
Abstract: Primarily healthy women who attended a practice of General Medicine were examined and coded data were evaluated using two statistical methods (n = 248, aged 36 ± 14 years). It was found that participants with LDL-related (mixed) hyperlipidemia showed higher blood pressure, a higher proportion of alcohol problems and/or smoking compared to normolipidemic women (p ≤ 0.05). These hyperlipidemic women who reported alcohol problems and/or smoking more often showed proteinuria and/or hematuria, rise of LDL/HDL, critical fasting blood glucose and lower HDL-cholesterol compared to hyperlipidemic women reporting healthy lifestyle (p ≤ 0.05). Likewise, high triglycerides were associated with rise of blood pressure and intolerance to glucose (p ≤ 0.05) and also with elevated total cholesterol. Alcohol-related hypertriglyceridemia overlapped with diastolic hypertension, rise of body weight and urine pathology, lowering of HDL-cholesterol and critical fasting blood glucose. The motivating message was that women with mixed hyperlipidemia and healthy lifestyle had functionally renal endothelium and healthy HDL-related baseline measures. Altogether, LDL-related hyperlipidemia and/or high triglycerides were correlated with diastolic hypertension whereby critical alcohol consumption declined renal endothelium and lowered HDL-cholesterol implicating baseline strategies to neutralize early risk factors.
Targeting the Endothelium  [cached]
JOSE A. ADAMS
Signa Vitae , 2010,
Abstract: The endothelium is an active organ with paracrine-endocrine capabilities that directs a multitude of physiological actions both locally and remotely. Cardiac arrest and resuscitation is a model of whole body ischemia reperfusion injury, interventions that have their basis in cytoprotection, reduction of the inflammatory cascade, fibrinolysis and improvement of microvasculature blood flow target the endothelium. This presentation will review pharmacologic, cell targeted therapies and periodic acceleration (pGz) interventions that have the endothelium in part as the target organ. The clinical potential of such interventions as preconditioning, conditioning and postconditioning strategies associated with cardiac arrest will be defined.
Effect of smoking on postprandial hypertriglyceridemia  [cached]
Mansour Salesi,Homeira Rashidi,Farid Fatahi
Zahedan Journal of Research in Medical Sciences , 2010,
Abstract: Background: Smokers have recently been shown to be insulin resistant and to exhibit several characteristics of the insulin resistance syndrome that could increase postprandial triglyceridemia. Postprandial hypertriglyceridemia could increase coronary artery disease (CAD) risk. In this study, we assessed fasting and postprandial triglyceride levels in healthy, normolipidaemic, chronic smokers and a matched group of nonsmoking individuals. Methods and Materials: We evaluated 78 subjects with simple sampling in case-control study. 39 were smoker and 39 nonsmokers. All of them had normal lipid and glycemic profile and had BMI between 19 and 29.9. The subjects didn’t have history of CAD or previously elevated fasting TG>150mg/dl, FBS>100mg/dl, age>60or<30, or alcoholic drinking. Then we give them 60 gm butter and triglyceride level was checked one and six hours postprandial. Between these times the subjects should not eat anything except water and smokers were allowed to smoke. All data analyzed with T-test and for repeated data ANOVA with SPSS software. Results: In our study was shown that TG levels among women and men had no significant difference (p=0.403). There was a significant difference among fasting TG, one hour postprandial and six hours postprandial in both groups(p<0.001). Also the changing rate of lipid from fasting state to one and six hours postprandial, among smokers and nonsmokers was significantly different (p<0.001).Conclusion: We concluded that smoking can change lipid profile in normolipemic subjects; and smokers with normal fasting triglyceride have more elevated levels of postprandial triglyceride in compared to nonsmokers. Postprandial hypertriglyceridemia has been an important factor for cardiovascular disease, then smoking can increase cardiovascular disease risk in this way
Perinatal and early adulthood factors associated with adiposity
Sim?es, Vanda Maria Ferreira;Barbieri, Marco Antonio;Silva, Antonio Augusto Moura da;Batista, Rosangela Fernandes Lucena;Alves, Maria Teresa Seabra Soares de Britto e;Cardoso, Viviane Cunha;Veloso, Helma Jane Ferreira;Bettiol, Heloisa;
Cadernos de Saúde Pública , 2012, DOI: 10.1590/S0102-311X2012000700016
Abstract: we used body mass index (bmi) and waist circumference (wc) as fat indicators to assess whether perinatal and early adulthood factors are associated with adiposity in early adulthood. we hypothesized that risk factors differ between men and women and are also different when wc is used for measuring adiposity as opposed to bmi. we conducted a longitudinal study based on a sample of 2,063 adults from the 1978/1979 ribeir?o preto birth cohort. adjustment was performed using four sequential multiple linear regression models stratified by sex. both perinatal and early adulthood variables influenced adulthood bmi and wc. the associations differed between men and women and depending on the measure of abdominal adiposity (bmi or wc). living with a partner, for both men and women, and high fat and alcohol intake in men were factors that were consistently associated with higher adulthood bmi and wc levels. the differences observed between sexes may point to different lifestyles of men and women, suggesting that prevention policies should consider gender specific strategies.
Pathology of digestive organs at adiposity (review)  [PDF]
Anisimova E.V.,Kozlova I.V.,Volkov S.V.,Meshcherjakov V.L.
Saratov Journal of Medical Scientific Research , 2011,
Abstract: The review is devoted demonstration of communication of adiposity with occurrence of diseases of digestive organs. The problem urgency is caused by steady increase in number of patients with adiposity, involving in pathological process of vitals. Clinical changes from digestive organs at patients with adiposity can be the diversified, presence two-dimensional syndromes , caused multiorgans a pathology is characteristic
Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis  [cached]
Li-Hui Deng, Ping Xue, Qing Xia, Xiao-Nan Yang, Mei-Hua Wan
World Journal of Gastroenterology , 2008,
Abstract: AIM: To investigate the effect of admission hypertriglyceridemia (HTG) on the episodes of severe acute pancreatitis (SAP).METHODS: One hundred and seventy-six patients with SAP were divided into HTG group (n = 45) and control group (n = 131) according to admission triglyceride (TG) ≥ 5.65 mmol/L and < 5.65 mmol/L, respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson’ s score, acute physiology and chronic heath evaluation II (APACHE II) score, Balthazar’s computed tomography (CT) score, complications and mortality were compared. Correlation between admission TG and 24-h APACHE II score was analyzed.RESULTS: SAP patients with HTG were younger (40.8 ± 9.3 years vs 52.6 ± 13.4 years, P < 0.05) with higher etiology rate of overeating, high-fat diet (40.0% vs 14.5%, P < 0.05) and alcohol abuse (46.7% vs 23.7%, P < 0.01), incidence rate of hypocalcemia (86.7% vs 63.4%, P < 0.01) and hypoalbuminemia (84.4% vs 60.3%, P < 0.01), 24-h APACHE II score (13.6 ± 5.7 vs 10.7 ± 4.6, P < 0.01) and admission serum glucose (17.7 ± 7.7 vs 13.4 ± 6.1, P < 0.01), complication rate of renal failure (51.1% vs 16.8%, P < 0.01), shock (37.9% vs 14.5%, P < 0.01) and infection (37.4% vs 18.3%, P < 0.01) and mortality (13.1% vs 9.1%, P < 0.01). Logistic regression analysis showed a positive correlation between admission TG and 24-h APACHE II score (r = 0 .509, P = 0.004).CONCLUSION: The clinical features of SAP patients with HTG are largely consistent with previous studies. HTG aggravates the episodes of SAP.
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