LDL receptor expression on T lymphocytes in old patients with Down syndrome

BACKGROUND: In Down syndrome patients several metabolic abnormalities have been reported, some involving the lipid metabolism. The level of LDL in plasma is the major determinant of the risk of vascular disease. There appear to be no studies on the LDL receptor in Down syndrome patients. METHODS: Flow cytometric methods for measuring the LDL receptor in peripheral blood mononuclear cells (PBMC) can identify patients with hypercholesterolemia. We applied this method in 19 old patients with Down syndrome and 23 healthy controls. RESULTS: Down syndrome patients had high levels of triglycerides and low levels of HDL, and high levels of CRP. We also found a down-regulation of LDL receptor expression. CONCLUSIONS: Down syndrome patients show no increase in the frequency of cardiovascular disease. The low incidence in cardiovascular disease despite the low level of HDL, high levels of CRP and reduction of LDL receptor expression lead to the conclusion that either these are not risk factors in these patients or that other risks factors – not yet identified – are considerably lower

Awareness and knowledge about weight status and management: results from the 1 d sensitization campaign 'Obesity Day' in northern Italy.

AbstractObjectiveTo evaluate the awareness and knowledge about weight status and its management.DesignA 1 d cross-sectional survey. Basic anthropometric assessments (weight, height, BMI and waist circumference) and a self-administered questionnaire were considered.SettingNineteen Clinical Nutrition or Endocrinology and Metabolic Disorders Units or Dietetics Services in the Italian region of Lombardy.SubjectsAll adults attending the 'Obesity Day' initiative.ResultsA total of 914 participants (605 female and 309 male) were recruited. Although most of the participants (83·5 %) considered obesity to be a disease, 38·5 % were likely to misperceive their weight status. In particular, 38·8 % of normal-weight adults believed themselves to be overweight, whereas 71·1 % and 37·5 % of classes I and II/III obese adults classified themselves as being overweight and mildly obese, respectively. However, most of the overweight (90·2 %), mildly (96·8 %) and moderately/severely obese adults (99·1 %) recognized the need to lose weight. In all, 37·8 % of the sample underestimated the role of physical activity in weight management. Interestingly, only 17·2 % of dieters (previous or current) declared being advised by their doctor to lose weight. Multivariate models revealed that higher age, low education and higher BMI were important determinants of poor weight control and management. In addition, previous dieting appeared not to provide better knowledge, whereas the role of physical activity was recognized mainly by those practising it.ConclusionsThe present study suggests that in Italy knowledge about weight management should be improved not only in the general population but also among health-care professionals. To confirm this finding, there is now the rationale for a nationally representative survey. New educational programmes can be designed on the basis of the information collected

Natural zeolites chabazite/phillipsite/analcime increase blood levels of antioxidant enzymes

Imbalance between reactive oxygen species generation and antioxidant capacity induces a condition known as oxidative stress which is implicated in numerous pathological processes. In this study we evaluated whether natural zeolites chabazite/phillipsite/analcime may affect the levels of different antioxidant enzymes (gluthatione peroxidase, superoxide dismutase, gluthatione reductase), total antioxidant status and oxidative stress in 25 clinically healthy men, both non-smokers and smokers. Measurements were performed on whole blood or on plasma samples before (T0) and after 4-weeks zeolites intake (T1). At T1, gluthatione peroxidase, superoxide dismutase and gluthatione reductase increased compared to T0 levels, both considering all subjects as joint and after subdivision in non-smokers and smokers. Differently, a reduction in total antioxidant status was observed at T1. Anyway, total antioxidant status resulted higher than the reference values in both groups at each time point. A decrease in lipid peroxidation, a major indicator of oxidative stress assessed by monitoring thiobarbituric acid reactive substances, was also observed in all subjects at T1. Our results suggested that chabazite/phillipsite/analcime may help to counteract oxidative stress in apparently healthy subjects exposed to different oxidative stress risk factors, such as smoking, thus representing a particular kind of food with potential antioxidant properties

Bariatric surgery to reduce mortality in US adults. A public health perspective from the Analysis of the American National Health and Nutrition Examination Survey linked to the US mortality register

Background Type II obesity represents a major pandemic and public health threat in high-income countries. Type II obesity increases the risk of all-cause and specific-cause mortality, and it is widely acknowledged that bariatric surgery represents the only effective therapeutic option in these patients. The aim of the present study was to estimate US population attributable risk for all-cause and cause-specific mortality in type II obese subjects undergoing weight loss as resulting from bariatric surgery alone and supplemented with behavioral intervention. Methods The American National Health and Nutrition Examination Survey linked to the US death registry updated to 2011 was used to estimate type II obesity prevalence and all-cause and specific cause of death for type II obese adults undergoing weight loss. Multivariate adjusted proportional hazard Cox models were used to estimate mortality risks. Statistical analyses were performed on the most updated version of the database (June 2017). Results A monotone positive trend for type II obesity was observed during the period 1999–2014 (p < 0.001). According to trend analysis, the rate of type II obesity in US adults is expected to rise up to 8.5%. Two- to sevenfold increased risk of all-cause and specific-cause mortality was observed for type II obese participants when compared to type I obese and overweight participants. Population attributable risk for all-cause and specific-cause mortality for type II obese subjects undergoing weight loss was ranging between 6 and 34%. Conclusions Bariatric surgery supplemented with behavioral intervention can result in a relevant reduction of mortality if extensively applied to the US populatio

N-terminal pro-B-type natriuretic peptide and echocardiographic abnormalities in severely obese patients: correlation with visceral fat

To gain further information on the utility of NT-proBNP as an indicator of possible preclin. cardiac disease in normotensive, severely obese individuals, we measured NT-proBNP concns. in 27 severely obese women with no complications and 15 normal-wt. patients. Serum NT-proBNP concns. were measured by the proBNP (Roche) assay. Obese patients showed impairment of several echocardiog. characteristics compared with lean individuals, and some of these differences correlated significantly with the s.c. adipose tissue (VAT) area. The most novel finding in our study is the significant correlation between NT-proBNP and echocar-diqgraphic characteristics (left ventricular mass indexed for height, left ventricular mass, end-diastolic posterior wall, end-diastolic septum thickness, myocardial performance index, early diastolic filling wave velocity) in a homogeneous population. This may indicate that NT-proBNP itself could serve as an indicator of left ventricular morpho-functional changes. NT-proBNP appears to offer possibilities for identifying preclin. cardiac disease, particularly in obese women with large amts. of visceral fat. [on SciFinder (R)

Epicardial fat thickness in type 2 diabetes outpatient care

Visceral fat is an independent predictor of the cardiovascular risk in subjects with type 2 diabetes (T2DM), but it is rarely assessed during an outpatient visit. Epicardial fat (EAT), the visceral fat of the heart, plays a role in coronary artery disease (CAD). EAT thickness can be clinically assessed with standard ultrasound. In this study we sought to evaluate the association of ambulatory ultrasound measured EAT thickness with CAD in asymptomatic well controlled T2DM subjects on metformin monotherapy during outpatient visits. This was single center, pragmatic study in 142 T2DM patients. Each subject underwent baseline ultrasound EAT thickness measurement, anthropometric and biomarkers. The incidence of CAD was detected after 1 year. At baseline, HbA1c was 6.7 % and BMI 34.9 kg/m2, EAT thickness was 8.3 ± 2.3 in women and 9.4 ± 2.4 mm in men, higher than threshold values for high cardiovascular risk. In multivariate models, EAT was the only statistically significant correlate of CAD at 1-year f/u (p = 0.04). Conclusions Point of care ultrasound measured EAT thickness is a good correlate of CAD in well controlled and asymptomatic T2DM subjects on metformin monotherapy. EAT thickness predicted CAD better than traditional risk factors, such as BMI, HbA1c, age, blood pressure or duration of diabetes. •Visceral fat plays a major role in diabetes-related cardiovascular risk. However visceral fat is not routinely assessed during outpatient visit.•Patients risk is often based on traditional parameters such as A1c, BMI.•Epicardial fat is strongly associated with diabetes related cardiovascular diseases.•Epicardial fat thickness can be easily and not invasively measured with ultrasound in an outpatient visit. Epicardial fat is marker of visceral fat.•In this real world study we found that ultrasound measured epicardial fat thickness was the best predictor of CAD in patients with well controlled type 2 diabetes and obesity on Metformin monotherapy.•Ultrasound assessment of visceral fat during outpatient visit can provide a better stratification of the cardiovascular risk than traditional markers in type 2 patients who would have been considered at low risk based only on A1c