The association of vitamin D with common diseases — an appraisal of recent evidence

It has been several years since the discovery of the pleiotropic effects of vitamin D, and there is still hot debate as to the role of vitamin D and attempts to standardise methods of determining 25(OH)D concentrations as well as supplementation with vitamin D. Many studies, both observational and randomised controlled trials, have revealed a whole range of opportunities of active vitamin D metabolite contribution to the treatment of common diseases. A relationship between high concentrations of vitamin D and a low risk of incidence of colorectal cancer, cardiovascular diseases, hypertension, ischaemic stroke, depression,metabolic syndrome and type 2 diabetes has been suggested for a long time, although recently published meta-analyses have created some doubts. There is no consensus regarding vitamin D supplementation and the optimum concentration of serum 25(OH)D. The Institute of Medicine’s 2011 report recommends achieving serum 25(OH)D concentration of 20 ng/mL as optimal, at a dosage of 600 IU of vitamin D per day. International recommendations suggest for individuals at risk a dosage of vitamin D of 2,000 IU per day. Polish experts advise that the optimal concentration of 25(OH)D should be greater than 30 ng/mL for adults

Angiopoietin-like proteins - their role in lipoprotein metabolism and association with atherogenic dyslipidemia

Scientists have been trying to find the best parameter for laboratory assessment of the risk of cardiovasculardiseases (CVD) for decades. Initially, the results of many studies indicated that the analysisof the lipid profile was sufficient to evaluate the risk of CVD. Further studies revealed that more preciselaboratory prediction of cardiovascular risk requires quantification of atherogenic lipoproteins. Recently,angiopoietin-like proteins 3, 4 and 8 (ANGPTLs) have been described as important regulators of plasmalipoprotein metabolism and triglyceride homeostasis. Mutations in ANGPTL3 leading to loss of its functionhave been linked to decreased risk of CVD in humans. Among potential new targets for the managementof dyslipidemia, ANGPTL3 may become a considerably promising one

Occurrence of hyperlipidemia in relation to body mass index in school children aged 9–11

Background. There is a link between lipid disorders and body mass and the occurrence of cardiovascular diseases. This study aimed at establishing the prevalence of lipid abnormalities in relation to body mass in children aged 9–11. Materials and methods. The study involved 232 presumably healthy school children aged 9-11. Fasting venous blood samples were taken from every child to assess the lipid profile: total cholesterol (TC), LDL cholesterol (LDL-C, direct measurement), HDL cholesterol (HDL-C) and triglycerides (TG). Anthropometric measurements were performed including height and weight, followed by calculating the body mass index (BMI) by using an online “OLAF” calculator. Results. The prevalence of hypercholesterolemia and an elevated concentration of LDL-C in the group of children was high and equaled 51.1% and 34.6%, respectively. Hypertriglyceridemia in the respective age groups of 9 and 10–11 years was found to be: 41.6% and 27.7%. Only in 9.5% of children the level of HDL-C was lower than optimal. The percentage of overweight was two-fold higher among boys than in girls (13.6 v. 6.9%), similarly the percentage of obesity was higher in boys compared with that in girls (15.5 v. 10.3%). Conclusions. In school children aged 9–11 the dominant and most frequent lipid abnormality, not associated with an increased body mass, was hypercholesterolemia followed by hypertriglyceridemia. Overweight and obesity were strongly related to gender and much more frequent among boys. There should be more attention paid to dyslipidemia and body weight already in childhood in the context of health policy and prevention

The cut-off values for non-fasting routine lipid parameters in presumably healthy 9–11-year-old children

Disorders of lipid metabolism cause accelerated atherosclerosis and increase cardiovascular risk, which is why lipid profile screening, especially at a young age, should be widely applied.Aim. The aim of the study was to determine the cut-off points for non-fasting lipid parameters in presumably healthy children aged 9-11 years.Material and methods. The study was performed with the use of blood samples taken in non-fasting state from 289 school children of both sexes (152 girls and 137 boys). Routine lipid profile was assessed: TC, LDL-C, HDL-C, and triglycerides. Laboratory measurements were performed in serum samples using abiochemical autoanalyser.Results. In this study we determined the 97.5 percentile values for TC, LDL-C, and triglycerides and the 2.5 percentile values for HDL-C. The upper cut-offs for TC, LDL-C, and triglycerides were found to be 239 mg/dL, 163 mg/dL, and 284 mg/dL, respectively, and the lower cut-off for HDL-C was 37 mg/dL.Conclusions. The upper range of non-fasting total cholesterol was higher by about 30 mg/dL compared to fasting state for a similar age range; the cut-off points in non-fasting children for LDL-C and TG were also higher. The lower cut-off for HDL-C was similar compared to fasting state for the respective age range. The determination of the non-fasting cut-off values for routine lipid profile in the paediatric population is essential for the proper evaluation of the cardiovascular risk because using the reference values for adults may cause an incorrect interpretation of the laboratory results

The impact of metabolic syndrome on the antiplatelet effect of clopidogrel and aspirin in patients with acute coronary syndrome

Aim. The aim of this study was to evaluate the impact of metabolic syndrome and features clustering in this syndrome on the antiplatelet effect of clopidogrel and aspirin in patients with myocardial infarction.Material and methods. The study population comprised 186 consecutive patients treated with primary percutaneous coronary intervention for acute myocardial infarction. Measurements of ADP induced platelet aggregation (ADP-PA) and arachidonic acid induced platelet aggregation (AA-PA) were performed using impedance aggregometry with a Multiplate Analyser. The following factors were analysed as potential determinants of responsiveness to clopidogrel and to aspirin: diagnosed metabolic syndrome, diabetes, hypertension, abdominal obesity, body mass index (BMI), and serum concentrations of triglycerides, HDL-cholesterol and high sensitivity C-reactive protein (hsCRP).Results. The ADP-PA was significantly higher in patients with metabolic syndrome and with diabetes.The AA-PA was significantly higher in subjects with increased levels of hsCRP and in subjects with BMI > 25 kg/m2. The hsCRP was found to be the only independent factor influencing APD-PA (p=0.034). Serum concentrations of hsCRP, HDL-cholesterol and abdominal obesity were independent factors influencing AA-PA (p=0.000004).Conclusion. Metabolic syndrome, diabetes mellitus, obesity and increased hsCRP are determinants of low responsiveness to aspirin and clopidogrel in patients with ACS treated with PCI