Applying apoB to the diagnosis and therapy of the atherogenic dyslipoproteinemias: a clinical diagnostic algorithm

Sniderman, Allan D.

doi:10.1097/01.mol.0000137220.39031.3b

Cited by 52 publications

(29 citation statements)

References 24 publications

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“…It had been proved that the amount of small dense LDL increases with TG concentration 1.5 mmol/L (ref. 9,11 ). A value 1.2 g/L for apoB was chosen, because at this level the cardiovascular risk rapidly increased 9,12 .…”

Section: Study Design and Subjectsmentioning

confidence: 99%

“…9,11 ). A value 1.2 g/L for apoB was chosen, because at this level the cardiovascular risk rapidly increased 9,12 . This value corresponds to the 75 th percentile of the North American population, the level chosen to define an elevated LDL-C (ref.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

“…The dyslipidemias represent heterogenic metabolic disorders. Sniderman suggested an algorithm of dyslipidemia classification based on apolipoprotein B (apoB) and triglyceride (TG) concentrations 9 . The classification divides dyslipidemias into four dyslipidemic phenotypes (DLP) on the basis of apoB and TG concentrations: DLP 1 (normo-apoB / normo-TG), DLP 2 (normo-apoB / hyper-TG), DLP 3 (hyper-apoB / normo-TG) and DLP 4 (hyper-apoB / hyper-TG).…”

Section: Introductionmentioning

confidence: 99%

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Prehypertension in dyslipidemic individuals; relationship to metabolic parameters and intima-media thickness

Karásek

Vaverková²,

Halenka³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Introduction. Like hypertension, prehypertension is associated with cardiovascular disease. Aims. The aim of this study was to evaluate: a) the prevalence of prehypertension/hypertension in individuals with various dyslipidemic phenotypes; b) the relation between blood pressure (BP) and other risk factors for atherosclerosis; c) atherogenic potential of prehypertension by the assessment of intima-media thickness of the arteria carotis communis (IMT). Methods. 667 clinically asymptomatic subjects were divided into four dyslipidemic phenotypes (DLP) according to apolipoprotein B (apoB) and triglycerides (TG): DLP1 (n=198, normo-apoB/normo-TG), DLP2 (n=179, normo-apoB/ hyper-TG), DLP3 (n=87, hyper-apoB/normo-TG), DLP4 (n=203, hyper-apoB/hyper-TG). DLP1 served as a control group. Results. There was significantly higher prevalence of prehypertension and hypertension in subjects with dyslipidemia (DLP2 43.0%, 41.3%; DLP3 42.5%, 29.9%; DLP4 42.4%, 47.8%) than in normolipidemic individuals (DLP1 32.8%, 20.2%). Systolic and diastolic blood pressure (SBP + DBP) correlated with age, total cholesterol, TG, non-HDL-cholesterol, body mass index and waist circumference; SBP additionally with C-peptide, fasting glycemia; DBP additionally with apoB, homeostasis model assessment (HOMA) and plasminogen activator inhibitor-1. The IMT of hypertensive and of prehypertensive subjects was higher than that of subjects with normal BP in all DLPs. Conclusions. The prevalence of prehypertension was higher in all dyslipidemic patients. The common prevalence of prehypertension/hypertension was highest in the hypertriglyceridemic subjects. Prehypertensive and hypertensive patients had higher IMT than normotensive individuals in all DLPs.

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Section: Study Design and Subjectsmentioning

confidence: 99%

Section: Study Design and Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prehypertension in dyslipidemic individuals; relationship to metabolic parameters and intima-media thickness

Karásek

Vaverková²,

Halenka³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…In recent years, six changes have occurred that strongly impact on approaches to the prevention of CVD in women: 1) newer methods of measuring lipoproteins and inflammatory markers; (11,12) 2) noninvasive imaging of arteries, especially the coronary, aortic and carotid; (13) 3) substantial reduction in the amount of saturated fat and cholesterol in the U.S. diet; (14,15) 4) increase in the prevalence of obesity, especially central obesity (16); 5) substantial decrease in the prevalence of cigarette smoking; (17) and 6) a marked increase in the extent of sedentary behavior. (18) The WOMAN study has attempted to utilize or impact on most of these factors.…”

Section: Introductionmentioning

confidence: 99%

The clinical trial of Women On the Move through Activity and Nutrition (WOMAN) study

Kuller

Kriska

Kinzel

et al. 2007

Contemporary Clinical Trials

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The Women On the Move through Activity and Nutrition (WOMAN) Study is the first randomized clinical trial of nonpharmacological intervention designed to modify lipoproteins, weight loss and exercise among postmenopausal women using noninvasive measures of atherosclerosis as the primary endpoint. The trial was initially designed to test whether intervention as compared to health education would be more effective in slowing progression of subclinical atherosclerosis among women on hormone therapy (HT), estrogen or estrogen+progestin. It was designed and implemented prior to the results of the Women's Health Initiative (WHI). The trial was since modified to include women who had been on HT but went off after the results of the WHI were reported. Eligible women were between the ages of 52-62, had waist circumference ≥80 cm, low density lipoprotein cholesterol between 100-160 mg% and controlled blood pressure. The intervention is low in total and saturated fat, trans fats, higher in fiber and promotes loss of 7-10% of body weight and includes at least 150 minutes of physical activity per week. The study has recruited 508 women. The primary endpoints are change in extent of carotid intima media wall thickness as measured by carotid ultrasound, pulse wave velocity as a measure of vascular stiffness and coronary artery calcium using electron beam computed tomography. Body composition is measured by dual-energy x-ray absorptiometry.

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“…The study was reviewed and approved by institutional Ethics Committee of the Medical Faculty and University Hospital Olomouc and informed consent was obtained from all participants. Individuals who met the above criteria (n=234), were divided into four dyslipidemic phenotypes (DLP) according to Sniderman classification based on apolipoprotein B and triglycerides 27 : DLP 1 (n=58, apoB<1.2 g/l and TG<1.5 mmol/l), DLP 2 (n=47, apoB<1.2 g/l and TG≥1.5 mmol/l), DLP 3 (n=31, apoB≥1.2 g/l and TG<1.5 mmol/l), DLP 4 (n=98, apoB≥1.2 g/l and TG≥1.5 mmol/l). A value 1.5 mmol/l for TG was chosen in this classification, because it is at this level that small dense LDL particles become common.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

Total Adiponectin Levels in Dyslipidemic Individuals: Relationship to Metabolic Parameters and Intima-Media Thickness

Karásek¹,

Vaverková²,

Halenka³

et al. 2011

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Introduction. Adiponectin is adipocytokin with anti-inflammatory and anti-atherogenic effects. However, studies examining the relationship between adiponectin and cardiovascular diseases have shown inconsistent results.Aims. The aim of this study was to evaluate the plasma levels of adiponectin in clinically asymptomatic subjects with various dyslipidemic phenotypes. The associations between adiponectin and risk factors for atherosclerosis, markers of insulin resistance, and the intima-media thickness of the common carotid artery (IMT) were also evaluated.Methods. 234 asymptomatic subjects were divided into four dyslipidemic phenotypes (DLP) according to apolipoprotein B (apoB) and triglycerides (TG): DLP1 (n=58, apoB<1.2 g/l and TG<1.5 mmol/l), DLP2 (n=47, apoB<1.2 g/l and TG≥1.5 mmol/l), DLP3 (n=31, apoB≥1.2 g/l and TG<1.5 mmol/l) and DLP4 (n=98, apoB≥1.2 g/l and TG≥1.5 mmol/l). DLP1 (normo-apoB/normo-TG) served as a control group.Results. Significant differences in adiponectin levels between normolipidemic phenotype -DLP1 (16.1[10.3-20.8] mg/l) and hypertriglyceridemic phenotypes -DLP2 (9.5[6.8-13.0] mg/l, p<0.01) and ] mg/l, p<0.01) after adjustment for age, sex and body mass index were found. Adiponectin correlated positively with highdensity lipoprotein cholesterol and apolipoprotein A1 (apoA1), negatively with triglycerides, apoB/apoA1, highsensitivity C-reactive protein, insulin, homeostasis model assessment and waist circumference. ApoA1 and insulin were detected as independent predictors for adiponectin levels in multivariate regression analysis. Adiponectin did not correlate with IMT.Conclusions. Individuals with hypertriglyceridemic phenotypes showed decreased adiponectin levels in comparison with normolipidemic subjects. Adiponectin was associated with lipid parameters, markers of insulin resistance, chronic inflammation and visceral obesity. But no association between adiponectin and IMT was found.

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Applying apoB to the diagnosis and therapy of the atherogenic dyslipoproteinemias: a clinical diagnostic algorithm

Abstract: The evidence supporting the clinical use of apoB is solid, its measurement is standardized, and automated, inexpensive laboratory testing could easily be widely available. However, clinical benefit will only follow clinical application.

Cited by 52 publications

References 24 publications

Prehypertension in dyslipidemic individuals; relationship to metabolic parameters and intima-media thickness

Prehypertension in dyslipidemic individuals; relationship to metabolic parameters and intima-media thickness

The clinical trial of Women On the Move through Activity and Nutrition (WOMAN) study

Total Adiponectin Levels in Dyslipidemic Individuals: Relationship to Metabolic Parameters and Intima-Media Thickness

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