Linkage analysis in a large pedigree ascertained due to essential familial hypercholesterolemia

Sib-pair linkage analysis was used to screen a large pedigree, ascertained through four members with hypercholesterolemia, for evidence of linkage between 12 quantitative traits and 15 genetic marker loci. Traits were analyzed on the untransformed, natural log and square root-transformed scales. After adjusting for multiple tests, there is a suggestion of linkage between height and the Kidd blood group on chromosome 18 and between VLDL cholesterol, and possibly triglyceride, and KM on chromosome 2. © 1993 Wiley-Liss, Inc.     

Risk factors for atherosclerosis in twins

We performed multivariate genetic analyses of cardiovascular risk factors from two sets of data on US and Australian female twins. Similar models for body-mass index (BMI), serum low density (LDL) and high density (HDL) lipoproteins, including age as a covariate, were fitted successfully to both groups. These suggested that BMI, or genes responsible for a significant proportion of the variance of BMI, explained correlations between lipid subfractions, as well as those between blood pressure and lipid subfractions, especially HDL. © 1993 Wiley-Liss, Inc.     

Association between polymorphic blood markers and risk factors for cardiovascular disease in a large pedigree

A large pedigree with high prevalence of heart disease is investigated to analyse the association between polymorphic blood markers and quantitative risk factors for cardiovascular disease. The analysis incorporates a familial correlation structure among the individuals in the pedigree and a generalized power transformation to induce approximate residual normality of the risk factors. A total of 380 marker/risk factor combinations are analysed, and at the normal 1% significance level, positive associations are found between the A antigen of the ABO locus and both serum total cholesterol and low-density lipoprotein cholesterol, and negative associations are found between the B antigen of the ABO locus and serum total cholesterol, and between the B allele of acid phosphatase (AP) locus and systolic blood pressure.     

Plasma concentrations of plant sterols: physiology and relationship with coronary heart disease

Recently, it has been questioned whether elevated levels of circulating plant sterols increase the risk of coronary heart disease (CHD). To date, no definitive conclusions regarding such a relationship have been reached, nor have there been any studies summarizing the factors that contribute to the observed elevations in plant sterol concentrations in plasma. Thus, the purpose of this review is to systematically compare the plant sterol levels of subjects from the general population and to describe factors that contribute to the variations observed. The question of whether elevated plasma concentrations of plant sterols are associated with an increased risk of CHD was also assessed. Results indicate that the key factors accounting for variations in circulating plant sterol concentrations include: apolipoprotein E phenotypes, ATP-binding cassette transporter polymorphisms, use of statin drugs, presence of metabolic syndrome, dietary intake of plant sterols, gender, and analytical techniques used in the measurement of plant sterols in the plasma. An analysis of the studies examining the relationship between circulating levels of plant sterols and CHD risk in non-sitosterolemic populations revealed no clear associations. Furthermore, it was shown that the above-mentioned factors play an important role in determining the levels of plant sterols in plasma. Since these factors may act as potential confounders, they must be controlled for before more solid conclusions can be reached.     

The Silent Killer

Summary

High blood pressure or hypertension continues as a major medical problem in the United States and the world. Hypertension leads to stroke, heart attack, and other coronary diseases. Generally, except for those past age 70, it is a much greater problem for males than for females. Half of those with high blood pressure are not even aware of it and for over 90%, the cause is unknown. Blood pressure, and the resulting coronary problems, can be reduced significantly with lifestyle and health choices. The information presented at most of the medical Web sites applies to both men and women. Many of the behavioral changes are relatively simple to accomplish, but men need to be aware of those healthy lifestyle choices if they are to reduce their risks of later coronary disease.     

低聚果糖对小鼠血糖和血脂作用的影响

目的观察低聚果糖(FOS)对小鼠血糖(G IU)、血甘油三酯(Tg)和血胆固醇(Ch)的影响。方法FOS 0.1g/kg和1g/kg.bw.天,分组ig(灌服)小鼠连续14天后,分别测定血糖、甘油三酯、胆固醇。结果和正常对照组相比,iglg/kg的小鼠Tg、Ch含量下降,G IU含量上升(P<0.01);ig0.1g/kg的小鼠Tg、Ch含量上升(P<0.05),G IU含量上升。结论FOS1g/kg.bw.天×14天的用量,实验小鼠的血脂水平下降,血糖升高。     

全血铬与冠心病及血脂关系的研究

全血铬与冠心病及血脂关系的研究崔金山，张玉敏，王薛君，张宝珍（沈阳医学院预防医学系，沈阳１１００３１）刘道荣，冯丰（沈阳医学院附属二院，沈阳１１０００１）关键词：血铬，冠心病，血脂ＳｔｕｄｉｅｓｏｎｔｈｅＲｅｌａｔｉｏｎｓｈｉｐＢｅｔｗｅｅｎＢｌｏｏ...     

Unscrambling the research: Eggs, serum cholesterol and coronary heart disease

The role of dietary cholesterol in raising plasma cholesterol levels has been debated over the past 25 years. Consequently, eggs, as a food high in dietary cholesterol, have been targeted as a food to limit when advising patients on a diet to lower serum cholesterol levels. The aim of the present review was to evaluate the literature to address the effects of dietary cholesterol from eggs on serum cholesterol levels and risk of coronary heart disease. An increase in dietary cholesterol from eggs by 100 mg daily, equivalent to half a medium egg or three to four eggs a week, results in an increase of approximately 0.05 mmol/L in LDL cholesterol. Adding 100 mg of cholesterol per day (equivalent to three to four eggs a week) to a high saturated fat diet caused an increase in LDL cholesterol of 0.061 ± 0.006 mmol/L, whereas adding the same quantity of cholesterol to a low saturated fat diet caused an increase in LDL cholesterol of only 0.036 ± 0.004 mmol/L (P = 0.03). Despite the small increase in LDL‐cholesterol levels with increasing egg intake, most epidemiological studies have shown little or no association between egg intake and risk of coronary heart disease. However, the impact of dietary cholesterol for people with type 2 diabetes has been poorly studied. In conclusion, in a healthy Western population, there is insufficient evidence to excessively restrict egg intake as part of a healthy diet. Eggs should be considered in a similar way as other protein‐rich foods and selected as part of a varied diet that is low in saturated fat and contains a variety of cardio‐protective foods such as fish, wholegrains, fruits, vegetables, legumes and nuts.     

简易智能心率血压监测仪对老年难治性高血压合并冠心病患者血压控制的效果观察

目的：分析简易智能心率血压监测仪在老年难治性高血压合并冠心病患者中对血压控制效果的作用。方法：抽取2018年1月～2020年1月在本院接收的90例老年难治性高血压合并冠心病患者作为研究对象,根据抽签法进行分组,将患者分为观察组（n=45）和对照组（n=45）。对照组患者实施随机固定某时段监测,观察组采用简易智能心率血压监测仪进行全天候动态监测,观察比较两组患者的血压控制效果及心率改变情况。比较观察组和对照组患者日夜血压水平变化异常率及晨峰出现率。比较两组患者对于血压检查的满意度及舒适度。结果：观察组患者的全天血压、日间血压、夜间血压与全天血压总负荷水平均较对照组高,组间比较有较大的差别（P<0.05）,同时观察组患者的日夜水平变化异常分型中非杓型较对照组低,而晨峰出现概率较对照组更高,组间比较有较大的差别（P<0.05）,此外观察组患者对于血压检查的满意度及舒适度均明显高于对照组,组间比较有较大的差别（P<0.05）。结论：简易智能心率血压监测仪进行血压监测能够更好地发现血压异常状况,指导临床调整用药方案,有助于提高血压控制效果。     

Testing for developmental changes in gene expression on resemblance for quantitative traits in kinships of twins: application to height, weight, and blood pressure

Height, weight, and blood pressure measurements on identical and fraternal twins and their families were analyzed to assess the degree to which genetic effects may change with age. The blood pressure data were based on the total sample of 1,767 individuals, while height and weight were available on 1,640 individuals in 204 monozygotic twin kinships. The results of testing alternative hypotheses about developmental changes in gene expression indicate that different mechanisms may be operative for these traits. While there was no evidence that developmental effects are a significant source of the observed variation in systolic or diastolic blood pressure, there was strong evidence that genetically determined developmental changes are an important factor in the determination of body weight. Age-related changes in weight appeared to be best explained by the cumulative developmental effects of a single set of genes, rather than by the expression of new genes at different stages of development.     

Lipid-lowering medication and risk of injury

Meta-analyses of early primary prevention trials of lipid-lowering therapies suggested increased risk of injury deaths among treated persons. Our population-based case-control study examined the association of lipid-lowering medication use with fatal and nonfatal injuries in 298 cases and 332 controls. No increased injury risk was observed among current (OR = 0.46, 95% CI 0.18–1.21) or past users (OR = .92, 95% CI 0.44–1.95), after adjustment for behavioral disorders, medical conditions, and health status. Stratified analyses did not reveal sub-groups at significantly increased risk. These results, consistent with recent clinical trials and meta-analyses, suggest no increased injury risk associated with lipid-lowering medications.     

Cost-effectiveness of dietary treatment of hypercholesterolemia in Spain

Background: Dietary treatment of hypercholesterolemia is one of the most frequently proposed measures to prevent cardiovascular disease. In this study cost-effectiveness of dietary treatment in Spain was assessed.Methods: Cost-effectiveness ratio was measured in terms of cost per life years gained, comparing net programme cost to its effectiveness. Effectiveness was estimated using a model that incorporates the Framingham multiple logistic equation to obtain the number of coronary events prevented and life years gained according to age, sex and initial cholesterol concentration. In this study it was assumed that dietary treatment could reduce cholesterol concentration by 5% in the group of participants. Net programme cost was estimated as total programme cost less averted cardiovascular disease treatment costs due to disease prevention. Costs and benefits were estimated for 1990 using a 5% discount rate.Results: Cost per life year gained ranged from $6,270 to 61,439 in men and $28,067 to 171, 459 in women, according to age and initial cholesterol concentration. The lowest cost-effectiveness ratio was obtained in individuals with a cholesterol concentration of 9.7 mmol/l (380 mg/dl) aged 45–49 years in men and 50–54 years in women, and the highest one was obtained in those men and women with a cholesterol concentration of 5.7 mmol/l (220 mg/dl) aged 60–65 years. Cost per life year gained was lower than $25,000 in men aged 35 to 64 years with a cholesterol concentration higher than 6.2 mmol/l (240 mg/dl) and it was lower than $35,000 in women aged 35 to 64 years with a cholesterol concentration higher than 9.3 mmol/l (360 mg/dl).Conclusion: Individual dietary treatment of hypercholesterolemia could be considered an efficient use of health resources. Programmes for dietary treatment of hypercholesterolemia should be recommended in men aged 35–64 years with hypercholesterolemia (>6.2 mmol/1) and in women aged 35–64 years with very high cholesterol concentrations.     

Changing from a mixed to self-selected vegetarian diet – influence on blood lipids

Objective To observe any changes in serum concentrations of lipids, when UK meat‐eaters switch to a self selected vegetarian diet for 6 months. Design Observational study using capillary blood samples and 3‐day estimated dietary diary. Setting Free‐living subjects in the North‐West of England. Subjects Twelve male and 31 female adult volunteers aged between 18 and 42 years. Outcome measures Serum lipids; nutrient intake and anthropometric measurements at baseline and 6 months after switching to a self‐selected vegetarian diet. Results Total energy intake and amount of energy derived from saturated fatty acids decreased significantly after changing to a vegetarian diet (P < 0.05) whereas energy derived from carbohydrate, and intakes of nonstarch polysaccharide intake increased. On switching to a vegetarian diet, total cholesterol and triacylglycerol concentrations were not significantly changed, but HDL‐C was 21% higher than at baseline (1.21 mmol L^?1 vs. 1.47 mmol L^?1; P = 0.001). Conclusions These results suggest that beneficial changes to diet occurred on changing to a self‐selected vegetarian diet. Changing to a self‐selected vegetarian diet appears to be one way of achieving a better blood lipid profile.     

Effect of high-chromium brewer's yeast on human serum lipids.

A group of 11 normolipidemic and a group of 16 hyperlipidemic adult subjects were given orally 20 gm daily of a high-chromium brewer's yeast (2.4 micrograms Cr+++/gm, ie, 48 micrograms Cr+++ daily) for 8 weeks. A significant decrease in total cholesterol in both groups of subjects was observed (24-26 mg/dl). High density lipoprotein cholesterol (HDL-C) was significantly increased (5-6 mg/dl) in normo- and hyperlipidemic subjects by brewer's yeast supplementation. However, following supplementation, the triglyceride blood levels were not changed in either the normo- or hyperlipidemic group. When the multiple complex risk factor (total cholesterol/HDL-C) was calculated, 84% of all subjects receiving brewer's yeast showed a decrease in this ratio, and the mean decrease in this ratio in all subjects was significant at P less than 0.01. A second group of 19 normolipidemic, predominantly male, adult subjects was given orally 10 gm of a high-chromium brewer's yeast (2.4 micrograms/gm, ie, 24 micrograms Cr+++ daily) for 8 weeks. The total circulating serum cholesterol was significantly decreased by a modest amount in this group after supplementation. The HDL-C levels were significantly increased (4 mg/dl). The total cholesterol/HDL ratio was decreased in 79% of the subjects, and the mean TC/HDL-C decrease of the entire group was significant at P less than 0.01.     

孕前不同BMI孕妇孕早期及孕晚期血脂水平的变化

目的 探讨孕前不同体质指数(BMI)孕妇妊娠不同时期的血脂水平变化情况,为有效避免孕妇妊娠期出现高血脂症状提供依据.方法 选取绍兴市中心医院2014年12月至2015年11月500例进行常规检查的孕妇作为研究对象,并根据孕前BMI分为正常组(BMI ＜25)、超重组(BMI≥25).对孕妇进行妊娠期随访调查,比较不同BMI孕妇妊娠早期、晚期血脂水平变化情况,同时对两组孕妇一般资料进行比较.结果 超重组较正常组孕妇文化程度低(x2=8.196,P＜0.05)、年龄大(t=3.178,P＜0.05)、孕前BMI高(t=20.855,P＜0.05)、孕期体重增长少(t=4.270,P＜0.05),差异有统计学意义;超重组与正常组妊娠晚期血脂指标水平均高于妊娠早期,超重组孕妇妊娠早期血脂指标HDL-C含量低于正常组,甘油三酯、胆固醇、LDL-C含量高于正常组(t值分别为3.267、2.679、2.507、2.041,均P＜0.05),同时超重组孕妇妊娠晚期血脂指标HDL-C、胆固醇、LDL-C水平低于正常组,甘油三酯含量高于正常组(t值分别为1.743、2.636、1.992、1.874;均P＜0.05).结论 妊娠早期超重孕妇的血脂HDL-C水平低于BMI正常者,妊娠晚期超重孕妇甘油三酯含量高于BMI正常者,同时孕妇的文化程度低、年龄与患者出现高血脂有关.     

血压与身体发育指标关系的分析研究

本文分析了1593名10～15岁男女学生的血压与身高、体重、皮下脂肪、血红蛋白、脉搏等发育指标的关系。经调查发现,血压值与体重的相关系数最大,与皮脂及身高的关系次之。但血压与血红蛋白及脉搏的关系不大。同年龄组体重≥90百分位儿童的血压值明显较10～90百分位间者高。故身高高者、体重重者,其血压也相应较高。据此,建议对体重较重(>90百分位)、血压较高(>95百分位)的儿童加强医学观察,以及早发现和预防高血压的发生。     

MORTALITY FROM CORONARY HEART DISEASE IS INVERSELY RELATED TO FISH CONSUMPTION IN THE NETHERLANDS

Mortality from coronary heart disease was more than 50 percent lower among Netherlands men who consumed at least 30 grams of fish per day than among those who did not eat fish.     

Apolipoprotein genetic variation in the assessment of atherosclerosis susceptibility

Apolipoproteins are the protein constituents of lipoproteins, the particles that transport cholesterol and triglycerides in the plasma. Numerous epidemiologic studies have associated variations in plasma levels of lipoproteins and apolipoproteins with the development of atherosclerosis. Furthermore, genetic variations in lipoproteins and apolipoproteins have been associated with disorders of lipid metabolism. Recent advances in biochemical and molecular genetic methods have resulted in an increased understanding of interindividual variations in lipoprotein metabolism and of their relationship to atherosclerosis and the dyslipoproteinemias. In particular, certain DNA restriction fragment length polymorphisms of the apolipoprotein genes have, in the last few years, been associated with atherosclerotic diseases and dyslipoproteinemias. We believe that genetic markers, when used in conjunction with traditional clinical and biochemical determinations, may one day be useful in predicting atherosclerosis susceptibility in the general population.     

The babel of the ABCs: novel transporters involved in the regulation of sterol absorption and excretion

Hypercholesterolaemia is a major risk factor for coronary heart disease (CHD). Therefore, the reduction of low-density lipoprotein (LDL) cholesterol is one of the primary targets of the current recommendations to decrease CHD risk in the population. Whereas, the mechanisms involved in de novo cholesterol synthesis and its uptake by cells via the LDL receptor are well known, we still need better understanding about the mechanisms involved in intestinal cholesterol absorption and excretion. The recent discovery of ABCG5 and ABCG8 transporters will significantly improve our understanding of cholesterol trafficking and it will lead to better and new therapeutic strategies to maintain cholesterol homeostasis.