780 research outputs found
Adipocitokinek hatása a HDL mennyiségére és funkciójára az atherosclerosis szempontjából veszélyeztetett betegcsoportokban = The effect of adipocitokines on HDL level and function in atherosclerotic patients
Az adipocitokinek Ă©s a statin kezelĂ©s hatását tanulmányoztuk a HDL funkciĂłira Ă©relmeszesedĂ©s szempontjábĂłl fokozott kockázatĂş betegeken. ElhĂzott gyermekekben Ă©s felnĹ‘ttekben csökkent antioxidáns hatásĂş paraoxonáz (PON1) aktivitást, emelkedett proatherogĂ©n leptin Ă©s alacsonyabb antiatherogĂ©n adiponektin szinteket találtunk. A PON1 aktivitás negatĂvan korrelált a leptin, mĂg pozitĂvan az adiponektin szintekkel. SzĂ©les BMI tartományban a HDL összetĂ©telĂ©t befolyásolĂł LCAT inverz összefĂĽggĂ©st mutatott az elhĂzás mĂ©rtĂ©kĂ©vel, a leptin szintekkel Ă©s a CETP aktivitással. A szĂ©rum rezisztin szint a BMI-vel Ă©s a leptin szinttel negatĂv, mĂg a PON1 aktivitással pozitĂv korreláciĂłt mutatott. Hemodializált Ă©s vesetranszplantált betegekben a veseműködĂ©sre jellemzĹ‘ szĂ©rum Cystatin C szint befolyásolta a PON1 aktivitást. Kimutattuk, hogy a vesefunkciĂł romlásával a vĂ©dĹ‘ hatásĂş PON1 aktivitása csökken. A romlĂł vesefunkciĂłt jellemzĹ‘ emelkedett CysC Ă©s homocisztein szint negatĂvan korrelált a PON1 aktivitással. A vártnál nagyobb mĂ©rtĂ©kű eltĂ©rĂ©st találtunk a PON1 genotĂpus Ă©s fenotĂpus meghatározás eredmĂ©nyei között hemodializált Ă©s vesetranszplantált betegekben. Igazoltuk, hogy a PON1 fenotĂpus mĂłdosĂtja a statin kezelĂ©s PON1 aktivitásra Ă©s lipidparamĂ©terekre kifejtett hatását. EredmĂ©nyeink azt mutatják, hogy az atorvastatin kezelĂ©s megváltoztatja a HDL szubfrakciĂłk arányát, mely a PON1 aktivitás emelĂ©sĂ©n keresztĂĽl fokozza annak antiatherogĂ©n hatását hyperlipidaemiás betegekben. | We investigated the effects of adipokines and statin treatment on HDL function in patients with enhanced risk for atherogenesis. Lower activity of antioxidant paraoxonase(PON1), and a higher proatherogen leptin and a lower antiatherogen adiponectin levels were found in both obese children and adults. PON1 activity showed an inverse correlation with leptin and a positive correlation with adiponectin levels.In a population with a wide range of BMI, HDL composition influencing LCAT, correlated inversely with obesity, leptin levels and CETP activity.Serum levels of resistin were correlated negatively with BMI and serum levels of leptin, but correlated positively with PON1 activity. Serum cystatin C level, a parameter of kidney function, influenced PON1 activity in hemodialyzed and renal transplanted patients.We demonstrated that reduced kidney function was accompanied by a decrease in protective PON1 activity.Increased homocysteine and CysC levels, the indicators of impaired kidney function correlated negatively with PON1 activity.We observed unexpectedly high discordances between PON1 phenotype and genotype assessments in patients with CKD and in renal transplant recipients. We proved that PON1 phenotype modifies the effect of statins on PON1 activity and lipid parameters. Our results showed that atorvastatin treatment alters the proportion of HDL subfractions, which may improve its antiatherogenic effect via enhancement of the PON1 activity in hyperlipidemic patients
Korszerű lipidcsökkentő kezelés
Considerable evidence suggests that "the lower the better" is a reasonable approach for reducing cardiovascular risk by lowering LDL cholesterol levels. Despite the reduction in cardiovascular events and mortality achieved by statin therapy, significant residual risk remains, especially in severe hereditary hypercholesterolemia, such as familial hypercholesterolemia. Some new strategies to achieve even lower LDL levels are now available, including the addition of cholesterol absorption inhibitor ezetimibe, and the recently available Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies. In addition, new LDL drugs may be effectively administrated in those individuals who are unable to tolerate statins. The authors summarize the efficacy and clinical indications of these new agents and review the currently available guidelines
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