Serum Lp(a) lipoprotein levels in patients with atherosclerotic occlusive disease of the lower extremities

Objective: to evaluate the association between Lp(a) lipoprotein levels, other serum lipids and the presence of lower limb atherosclerotic occlusive disease. Materials and methods: angiographic findings in 36 patients were related to serum Lp(a). Total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol and Lp(a) levels were compared with those of 73 age- and sex-matched healthy controls. Results: atheromatous lesions were localised in the femoropopliteal (approximate to 60%) and aortoiliac (approximate to 40%) segments. The number of stenosed arteries was greater than or equal to 2 and the range of stenosis severity was between 40% and 100%. There was a significant increase in serum Lp(a) (p = 0.000001) and a decrease in serum HDL (p = 0.000009) levels in patients compared to controls. No difference was observed in total cholesterol, LDL-cholesterol or triglyceride. However, the ratio of total cholesterol/HDL-cholesterol was significantly higher (p = 0.005) in patients. Conclusions: a dyslipidaemic serum profile, characterised by increased Lp(a) levels and decreased HDL-cholesterol levels, is associated with atherosclerotic occlusive disease of the lower extremities

Serum Apolipoprotein AI levels in atherosclerotic and diabetic patients

Objective: to evaluate the association between Apolipoprotein AI (ApoAI), Apolipoprotein B100 (ApoB) and the presence of lower limb atherosclerotic occlusive disease. Materials and methods: serum lipids, lipoprotein fractions, ApoAI, ApoB and Lp(a) were measured in 52 patients (28 diabetics and 24 non-diabetics) with lower limb occlusive disease. They were evaluated according to patients’ glucose and compared with those in 75 healthy controls. Results: there was a significant decrease in HDL-cholesterol and ApoAI serum levels (p = 0.000001) and an increase in Lp(a) (p = 0.000001) in patients as compared to controls. No difference was observed in total cholesterol, non HDL-cholesterol or triglycerides. Multiple regression analysis revealed a significant association between low ApoAI (or HDL) levels and the disease as well as between high Lp(a) levels and the disease. ApoAI (p = 0.0003), HDL-cholesterol (p = 0.00005) and total cholesterol (p = 0.01) levels were significantly lower in diabetic patients compared to non-diabetic patients. Lp(a) levels did not correlate with fasting glucose concentration. Multiple regression analysis revealed a significant association between low ApoAI (or HDL) levels and diabetes. Conclusion: decreased ApoAI appears to be a main component of the dyslipidaemic serum profile observed in patients with atherosclerotic occlusive disease of the lower extremities. Increased Lp(a) levels is an independent risk factor. Decreased HDL-cholesterol is also involved in the dyslipidaemic profile

Association of hyperandrogenemic and metabolic phenotype with carotid intima-media thickness in young women with polycystic ovary syndrome

Polycystic ovary syndrome ( PCOS), a common endocrinopathy of women of reproductive age, is associated with the early appearance of multiple risk factors for cardiovascular disease, such as abdominal obesity, dyslipidemia, and diabetes mellitus. However, premature atherosclerosis of the carotid artery has not yet been demonstrated in young women with PCOS. Measurement of carotid intima-media thickness (IMT) is considered an easy and reliable index of subclinical atherosclerosis, which is predictive of subsequent myocardial infarction and stroke. To evaluate the cardiovascular risk of PCOS and the participation of the hyperandrogenemic and metabolic pattern, we measured carotid IMT by B-mode ultrasound as well as hormonal and several cardiovascular disease-associated parameters in 75 young women with PCOS and 55 healthy, age- and body mass index-matched women. The PCOS women had significantly increased carotid IMT (0.58 vs. 0.47 mm, P < 0.001) and abdominal adiposity; higher levels of androgens, insulin, homeostasis model assessment score of insulin sensitivity, and total and low-density lipoprotein-cholesterol; and significantly lower levels of SHBG and high-density lipoprotein-cholesterol. In the studied population (n = 130), PCOS status, age, body mass index, and parental history of coronary heart disease were strong positive predictors of carotid IMT, whereas dehydroepiandrosterone sulfate was a strong negative predictor. In PCOS patients lower Delta(4)-androstenedione and high-density lipoprotein-cholesterol levels were additionally strong positive predictors of carotid IMT, whereas in control women only total cholesterol was the additional positive predictor of carotid IMT. In conclusion, young women with PCOS have an early increase of cardiovascular risk factors and greater carotid IMT, both of which may be responsible for subclinical atherosclerosis. The hyperandrogenemic phenotype of the syndrome may attenuate the consequences of the dysmetabolic phenotype on the vascular wall