There is extensive evidence showing that insulin resistance (IR) is associated with chronic low-grade inflammation. Furthermore, IR has been shown to increase the risk for cardiovascular disease (CVD), even in nondiabetic patients, and is currently considered as a “nontraditional” risk factor contributing to CVD by promoting hypertension, oxidative stress, endothelial dysfunction, dyslipidemia, and type 2 diabetes mellitus. However, chronic kidney disease (CKD) is also considered a state of low-grade inflammation. In addition, CKD is considered an IR state and has been described as an independent risk factor for the development of CVD, as even early-stage CKD is associated with an estimated 40% to 100% increase in CVD risk. There is also strong evidence indicating that inflammation per se plays a crucial role in both the initiation and progression of CVD. Given the above, the combined effect of IR and CKD may significantly increase the risk of inflammation and CVD. This review aims to focus on the complex interplay between IR, CKD, inflammation, and CVD and will present and discuss the current clinical and scientific data pertaining to the impact of IR and CKD on inflammation and CVD.

ABSTRACT:The role of low-density lipoprotein cholesterol (LDL-C) in the pathophysiology of atherosclerosis is well recognized, and statin therapy represents the standard of care for LDL-C lowering and reduction of cardiovascular risk. However, many patients fail to achieve LDL-C goals, whereas others are intolerant to statins due to side effects. Unfortunately, until recently, the efficacy of other nonstatin LDL-C-lowering agents was limited, achieving an LDL-C reduction of no more than 20%. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors represent a new class of LDL-lowering agents, producing large reductions in LDL-C. Alirocumab is a PCSK9 inhibitor, which was recently approved by the Food and Drug Administration as an adjunct to diet and maximally tolerated statin therapy for treatment of adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C levels. This review aims to provide the current clinical and scientific data pertaining to the treatment of hypercholesterolemia with alirocumab.

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Neurofibromatosis type 1 or von Recklinghausen disease is a systemic hereditary disease characterized by disorders regarding the skin, neural and skeletal systems. Osteoporosis is one of the skeletal manifestations of neurofibromatosis type 1, being associated with increased fracture risk. Neurofibromatosis type 1 is associated with a propensity for the development of cancer, breast cancer in particular being associated with neurofibromatosis type 1.

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