Interrelations of lipids and lipoproteins with coronary artery disease mortality in 19 countries

doi:10.1016/0002-9149(86)90659-4

The American Journal of Cardiology

Volume 57, Issue 14, 30 May 1986, Pages G5-G10

https://doi.org/10.1016/0002-9149(86)90659-4 Get rights and content

Abstract

Coronary risk factors differ in importance from country to country, but a proportion of interpopulation differences in coronary artery disease (CAD) mortality is probably closely related to interpopulation differences in total serum cholesterol levels. Interpopulation differences in high density lipoprotein (HDL) cholesterol levels supposedly do not explain interpopulation differences in CAD mortality, although HDL cholesterol may be an important negative risk factor within a population. Age- and sex-specific serum cholesterol, triglyceride and HDL cholesterol levels have been sought for 27 industrialized countries for which the World Health Organization has reliable mortality data. At least partially complete information was obtained from 19 countries, derived from national or regional studies in middle-aged subjects, and this has been related to CAD mortality rates. In men, 45% of the interpopulation variation in CAD mortality was explained by variation in serum cholesterol levels; 32% by variation in HDL cholesterol; and 55% by variation in the ratio of total serum cholesterol/HDL cholesterol. CAD mortality in men did not correlate with a population's serum triglyceride levels. In women, the only significant correlate of interpopulation variation in CAD mortality was the ratio of total serum cholesterol/HDL cholesterol, which explained 31 % of the variation in CAD mortality. These findings highlight the contributions of total serum cholesterol and the ratio of total serum cholesterol/HDL cholesterol to CAD mortality in men at the international level and have implications for individual members of a population. Similar analyses in women were not particularly informative.

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La incidencia de las enfermedades arterioscleróticas ha aumentado en los países desarrollados. La dislipemia es un factor de riesgo cardiovascular mayor y el descenso del LDLc es el objetivo terapéutico. Hay que individualizar los objetivos en cada paciente y las estatinas han demostrado ser un tratamiento coste-efectivo tanto en prevención primaria como en secundaria. La aparición de los inhibidores de PSCK9, más potentes y por tanto consiguiendo un mayor descenso de las cifras de LDLc, son un avance en el tratamiento de la enfermedad cardiovascular. La publicación en 2019 de las Guías de Dislipemias (Sociedad Europea de Cardiología /Sociedad Europea de Arteriosclerosis) con el nivel de evidencia y fuerza de recomendación, pueden ayudar en la toma de decisiones y beneficios para nuestros pacientes en la práctica clínica diaria.
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Association of Interleukin-10 –592 C > A gene polymorphism with coronary artery disease: A case-control study and meta-analysis
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Atherosclerosis is the major underlying cause of cardiovascular disease. Inflammatory mechanisms play a pivotal role in the pathogenesis and progression of atherosclerosis [4-7]. Interleukin-10 (IL-10) is an anti-inflammatory cytokine that has been demonstrated to be a modifying risk factor for both atherosclerosis and acute coronary events[8-10].
Coronary-artery-disease (CAD) is the leading cause of death worldwide, and hence there is a need to identify reliable markers for identifying individuals at high risk of developing CAD. Interleukin-10 (IL-10) is an anti-inflammatory cytokine that is associated with an increased risk of developing both atherosclerosis and acute coronary events. The study aimed to explore the association of a genetic variant in IL-10 with the risk of developing CAD and the severity of the disease. To further explore, a systematic review and meta-analysis was performed. The cumulative results of the relationship between IL and 10 –592 C > A polymorphism and CAD in Iranian population have also been presented.
In this cross sectional study, a total of 948 individuals including 307 healthy controls and 641 patients that among cases, four hundred and fifty-five of the patients had > 50% stenosis (angiogram positive group) and 186 patients had < 50% stenosis (angiogram negative group) were recruited from the Mashhad-Stroke and Heart-Atherosclerotic-Disorders cohort. Genotyping for the IL-10 –592 C > A polymorphism was performed using a PCR-RFLP technique, and statistical analysis undertaken by univariate and multivariate analyses. PubMed, Google Scholar and Scopus were searched for papers related to this polymorphism up to October 2019. The Meta-analysis was done based on the random effect model using a Meta-analysis.
In our study, the frequency of the variant A allele of the IL-10 –592 C > A was significantly higher in CAD patients than the control group (P value = 0.043). Moreover, subjects carrying AA genotype had a significantly higher risk of CAD (OR: 1.8, 95%CI: 1.04–3.16), p = 0.03), compared to those with the wild type genotype. The results of meta-analysis of 9336 cases and 8461 controls did not also show any significant association between IL and 10 –592 C > A and CAD in dominant and recessive genetic models but only in co-dominant model when fix effect was applied.
Although our research findings support a significant association of genetic polymorphism in the IL10 gene with cardiovascular diseases, this finding cannot be confirmed in meta-analysis. Further functional analysis and evaluation of this marker in a multicenter setting are needed to establish its value as a risk stratification marker.
LDL as a therapeutic objective
2019, Clinica e Investigacion en Arteriosclerosis
La incidencia de las enfermedades arterioscleróticas ha aumentado en los países desarrollados. La dislipemia es un factor de riesgo cardiovascular mayor y el descenso del cLDL es el objetivo terapéutico. Hay que individualizar los objetivos en cada paciente y las estatinas han demostrado ser un tratamiento coste-efectivo tanto en prevención primaria como en secundaria. La aparición de los inhibidores de PSCK9, más potentes y por tanto consiguiendo un mayor descenso de las cifras de cLDL, son un avance en el tratamiento de la enfermedad cardiovascular. La publicación en 2019 de las guías de dislipemias (Sociedad Europea de Cardiología/Sociedad Europea de Arteriosclerosis), con el nivel de evidencia y fuerza de recomendación, pueden ayudar en la toma de decisiones y beneficios para nuestros pacientes en la práctica clínica diaria.
The incidence of atherosclerotic cardiovascular disease has increased in the developed countries. Dyslipidemia is a primary major risk factor for atherosclerotic cardiovascular disease and LDL lowering is one of the main objectives. Although treatment goals for dyslipidemias should be personalized in every patient, statins are cost-effective in primary and secondary prevention of atherosclerotic cardiovascular disease. New treatments with higher power and greater decreases in LDL, PSCK9 inhibitors, have made a new breakthrough in atherosclerotic cardiovascular disease treatment. The 2019 guidelines for de management of dyslipidemias: lipid modification to reduce cardiovascular risk (European Society of Cardiology/European Atherosclerosis Society) with the level of evidence and the strength of the recommendations can facilitate the best decisions and benefits to our patients in clinical practice.
Applications of Gum Arabic in Medical and Health Benefits
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Gum Arabic (GA) is a mixture of polysaccharides and glycoproteins secreted from Acacia senegal, Acacia seyal, and Acacia nilotica trees’ stems. The high spot of this chapter was to review the application of GA in human health and medicine. GA has been applied to relieve the opposing effects of chronic renal failure and has a positive effect on nephrotoxicity; raises creatinine clearance from the body; improves renal excretion of ADH, Mg²⁺, and Ca²⁺; decreases plasma urea and plasma phosphate, urinary flow rate, phosphaturia, natriuresis, glucosuria, proteinuria as well as urinary excretion of Na⁺ and phosphate; and it reduces the blood pressure and plasma cholesterol concentrations. It is a good antioxidant, which protects against cardiac and hepatic toxicities. It has pro-absorptive properties, which can be an effective substitute medication for diarrhea. It is effective in dental remineralization. GA has antimicrobial action and is known to be used as an effective prebiotic as good as inulin, which increases the numbers of Lactobacilli, Bifidobacteria, and Bacteroides without significant drawbacks. GA has an opposing effect of vitamin D and electrolyte balance, and in some cases, it causes hypersensitivity.
Association assessment of Interleukine-10 gene polymorphism and its expression status with susceptibility to coronary artery disease in Iran
2018, Egyptian Journal of Medical Human Genetics
The cytokines are potent inflammatory factors that regulate each stage of atherosclerosis leading to the disease development. Interleukin-10 (IL-10) as an anti-inflammatory cytokine can develop atherosclerosis by inhibiting the synthesis of metalloproteinase. Moreover, IL-10 promotes the plaque stability by preserving the extracellular matrix and fibrous cap.
We evaluated the association of the two IL-10 promoter gene polymorphisms with susceptibility to coronary artery disease (CAD) in Iranian population.
We used the Sequence Specific Primer-Polymerase Chain Reaction method to determine genotypes. We also studied mRNA expression of the IL-10 gene in Iranian CAD patients using quantitative real-time PCR.
There was a significant association between IL-10(−819) T allele and IL-10(−819) T/T genotype, and CAD (p = 0.041 and p = 0.042 respectively). There also was a significant association between IL-10(−1082) G allele and IL-10(−1082) G/G genotype, and CAD (p = 0.017 and p = 0.020 respectively). Genotype T/T of IL-10(−819) polymorphism significantly associated with the two vessel disease type (p = 0.017). In addition, there was a significant association between IL-10(−1082) G/G genotype and the three vessel disease type (p = 0.009). IL-10 mRNA expression was significantly decreased 3.36-fold in samples with IL-10(−819) polymorphism and 1.98-fold in individuals with IL-10(−1082) polymorphism.
Our results suggest that IL-10 gene promoter polymorphisms may influence both coronary artery disease risks and severity in Iranian patients.
Association between interleukin-6 gene -174 G/C polymorphism and the risk of coronary heart disease: A meta-analysis of 20 studies including 9619 cases and 10,919 controls
2012, Gene
Interleukin-6 (IL-6) gene − 174 G/C polymorphism has been reported to be associated with coronary heart disease (CHD), but the results remain inconclusive. The present meta-analysis was therefore designed to clarify these controversies. This meta-analysis was performed by searching PubMed, Embase and Web of Science databases. A total of 20 studies including 9619 CHD cases and 10,919 controls were combined showing no evidence of association between IL-6 gene − 174 G/C polymorphism and CHD risk (for C/C + C/G vs. G/G: OR = 1.10, 95% CI = 0.99–1.22, p = 0.07; for C/C vs. C/G + G/G: OR = 1.08, 95% CI = 0.93–1.24, p = 0.33; for C/C vs. G/G: OR = 1.16, 95% CI = 0.97–1.39, p = 0.11; for C allele vs. G allele: OR = 1.10, 95% CI = 1.00–1.21, p = 0.06). Moreover, we also did not find significant association between IL-6 gene − 174 G/C polymorphism and myocardial infarction (MI) risk. However, in the subgroup analysis by ethnicity, significant association was found among Asians (for C/C + C/G vs. G/G: OR = 1.35, 95% CI = 1.05–1.63, p = 0.02). In summary, the present meta-analysis suggests that IL-6 gene − 174 G/C polymorphism is associated with increased CHD risk among Asians. However, due to the small subjects included in the subgroup analysis of Asians, the results should be interpreted with caution.

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Interrelations of lipids and lipoproteins with coronary artery disease mortality in 19 countries

Abstract

Atherosclerosis

Atherosclerosis

J Chronic Dis

The recent decline in ischemic heart disease mortality

Ann Intern Med

Cholesterol in the prediction of atherosclerotic disease