Increased concentration of uric acid (UA) is positively associated with the clinical severity but negatively associated with the prognosis of heart failure (HF). However, data related to the association between UA concentration and N-terminal pro brain natriuretic peptide (NT-proBNP) are still lacking. The aim of the study was to analyze the relationships between UA, NT-proBNP, clearance of creatinine and NYHA function class and echocardiographic variables in the Slovak population of primary care patients diagnosed with HF. The association between UA and NT-proBNP was assessed by multivariate analysis. 848 patients (402 men, 446 women) with HF were included in the study. NT-proBNP correlated with UA in both men and women after adjustment based on age, BMI and glomerular filtration rate (r=0.263, p<0.0001; r=0.293, p<0.0001). UA concentration rose with the severity of the NYHA class and was significantly higher in patients with moderate and severe systolic dysfunctions as well as with diastolic dysfunction in the multivariate analysis. In conclusion, our study in Slovak population with HF has revealed a positive correlation between the concentration of UA and NT-proBNP, and the independency of this association on confounding factors. The results support the role of UA as a biochemical marker of HF severity and prognosis.
- MeSH
- biologické markery krev MeSH
- diastola MeSH
- faktory vyvracející (epidemiologie) MeSH
- funkce levé komory srdeční MeSH
- kyselina močová krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- natriuretický peptid typu B krev MeSH
- peptidové fragmenty krev MeSH
- prognóza MeSH
- průřezové studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání diagnostické zobrazování krev patofyziologie MeSH
- stupeň závažnosti nemoci MeSH
- systola MeSH
- tepový objem MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Slovenská republika MeSH
Prítomnosť diabetes mellitus 2. typu výrazne zvyšuje riziko kardiovaskulárnych príhod a smrti z kardiovaskulárnych príčin. Na indikácii aterosklerózy a jej komplikácií u diabetikov sa významne podieľajú poruchy metabolizmu lipoproteínov. Dyslipidémia u diabetikov je typická vysokou koncentráciu triacylglycerolu (TAG) a nízkou koncentráciu lipoproteínu s vysokou hustotou (HDL). Na úrovni lipoproteínových tried a podtried je takmer konštantným javom akumulácia malých denzných LDL a VLDL a remnantných častíc. V liečbe dyslipidémie u diabetikov sa uplatňujú režimové opatrenia a farmakoterapia, ktorej základom sú aj naďalej statíny. Ak samotným statínom nie je možné dosiahnuť požadovanú cieľovú koncentráciu LDL, odporúčaná je kombinovaná liečba. Dôkazy o efektivite má kombinácia statínu s ezetimibom alebo PCSK9-inhibítorom. Použitie fibrátov má svoje opodstatnenie len u vybraných skupín diabetikov, ako sú napríklad pacienti s dyslipidémiou a diabetickou retinopatiou, pripadne pacienti s veľmi vysokou koncentráciou TAG.
Presence of type 2 diabetes mellitus (T2DM) significantly increases risk of cardiovascular events and cardiovascular death. Lipoprotein metabolism disorders in patients with T2DM are significantly contributing to this risk. For a diabetic dyslipidemia, high concentration of triacylglycerol (TAG) and low concentration of high density lipoprotein (HDL) is typical. On the level of lipoprotein subclasses, high concentration of small dense low-density lipoproteins (LDL) and very low-density lipoproteins and remnant particles are almost constant findings in patients with diabetes. The dyslipidemia in T2DM should treated by combination of non-pharmacologic and pharmacologic therapy. Mainstay of pharmacologic therapy are statins. If statin monotherapy is not sufficient to achieve target levels of LDL, combination therapy is recommended. There is sufficient evidence about effectivity of statin combination with ezetimibe or PCSK9 inhibitor. Fibrates are recommended only in selected patients like those with retinopathy or very high TAG levels
BACKGROUND: Our goal was to investigate the effect of short term exercise on fasting and postprandial lipoprotein profile. METHODS: Healthy sedentary men exercised 20 min for four days. The intensity of exercise was modulated to maintain 75-80 % of a calculated HRmax. Before and after the exercise program, fasting and postprandial (4 h after standard meal) concentrations of lipoprotein subfractions were measured by an electrophoresis in polyacrylamide gel and total concentrations of TAG, LDL and HDL by enzymatic colorimetric method. After 2 days of rest, fasting and postprandial concentrations of lipoprotein fractions and subfractions were measured to determine a persistency of a changes in the lipoprotein profile. RESULTS: 4 days of physical exercise led to statistically significant decrease of concentration of triacylglycerol in fasting (76.29 ± 20.07, 53.92 ± 10.90, p < 0.05) and postprandial state (139.06 ± 23.72, 96.55 ± 25.21, p < 0.05) VLDL in fasting (21.88 ± 3.87, 18.00 ± 3.93, p < 0.05) and postprandial state (23.88 ± 3.52, 19.25 ± 3.62, p < 0.05), total cholesterol in fasting (162.26 ± 23.38, 148.91 ± 17.72, p < 0.05) and postprandial state (163.73 ± 23.02, 150.08 ± 18.11, p < 0.05). Atherogenic medium LDL decreased also in fasting (9.89 ± 3.27, 6.22 ± 2.55, p < 0.001) and postprandial state (8.88 ± 6.51, 6.88 ± 5.57, p < 0.001). However decrease of large IDL (25.38 ± 3.54, 23.88 ± 3.91, p < 0.05) and large LDL particles (42.89 ± 11.40, 38.67 ± 9.30) was observed only in postprandial state. Total HDL concentration remained unchanged but we observed statistically significant decrease of small HDL particles in fasting (6.11 ± 2.89, 4.22, p < 0.05) and postprandial state (6.44 ± 3.21, 4.56 ± 1.33, p < 0.05). Concentration of these particles are associated with progression of atherosclerosis. All changes of fasting and postprandial lipoprotein profile disappeared after 2 days of rest. CONCLUSION: Just 4 daily settings of 20 min of physical exercise can lead to significant positive changes of fasting and postprandial lipoprotein profile.
- MeSH
- cholesterol krev MeSH
- cvičení MeSH
- dospělí MeSH
- lidé MeSH
- lipoproteiny krev MeSH
- mladý dospělý MeSH
- omezení příjmu potravy krev MeSH
- postprandiální období MeSH
- sedavý životní styl MeSH
- triglyceridy krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Odporúčania kardiologických odborných spoločností v oblasti primárnej prevencie kardiovaskulárnych chorôb kladú dôraz na pravidelnú aeróbnu fyzickú aktivitu. Jej pozitívny efekt na kardiovaskulárnu ako aj celkovú mortalitu bol opakovane podložený pozorovaniami z prospektívnych a prierezových epidemiologických štúdií. Jedným z možných vysvetlení tohto priaznivého efektu je zmena koncentrácie lipoproteínových tried a taktiež ich podtried, čo sa prejaví zmenou ich priemernej veľkosti. V nami sledovanej skupine mladých zdravých mužov a žien so sedavým spôsobom života sme sledovali vplyv aeróbnej fyzickej námahy strednej intenzity v trvaní 30 min po dobu 14 dní v podobe pomalého behu. Koncentrácie lipoproteínových tried a podtried boli stanovené metódou lineárnej elektroforézy v polyakrylamidovom géle. V sledovanom súbore sme zaznamenali štatisticky významný pokles VLDL, veľkých IDL častíc, LDL strednej veľkosti, malých denzných LDL a HDL častíc strednej veľkosti. Všetky tieto lipoproteínové častice sú vo svetle súčasných poznatkov považované za aterogénne. Už 14 dní pravidelného cvičenia teda prináša pozitívny vplyv na koncentrácie plazmatických lipoproteínov, čo zdôrazňuje rolu pravidelnej fyzickej aktivity v primárnej prevencii kardiovaskulárnych chorôb.
Recommendations from the cardiological professional companies working in the area of primary prevention of cardiovascular diseases put an emphasis on regular aerobic physical activity. Its positive effect on both cardiovascular and overall mortality has repeatedly been proven by the observations of prospective and cross‑sectional epidemiological studies. One of the possible explanations of this positive effect is a change in the concentration of lipoprotein classes and their sub‑classes, which is expressed as a change in their average size. In a group of young healthy men and women with a sedentary lifestyle we observed the effect of medium intensive physical exercise in the form of a 30-minute slow run per day lasting for 14 days. The concentration of lipoprotein classes and sub‑classes were determined through the method of a linear electrophoresis in polyacrylamide gel. In the observed group we found a statistically significant decrease of VLDL, large IDL particles, medium sized LDL, small dense LDL, and medium sized HDL particles. In the light of current knowledge all these lipoprotein particles are deemed as atherogenic. Thus, as little as 14 days of regular exercising has a positive effect on the concentration of plasmatic lipoproteins, and emphasises the role of regular physical activity in the primary prevention of cardiovascular diseases.
- MeSH
- biochemická analýza krve MeSH
- dospělí MeSH
- kardiovaskulární nemoci * prevence a kontrola MeSH
- lidé MeSH
- lipoproteiny HDL MeSH
- lipoproteiny LDL MeSH
- lipoproteiny * fyziologie krev MeSH
- mladý dospělý MeSH
- průzkumy a dotazníky MeSH
- studenti lékařství MeSH
- tělesná výchova * MeSH
- zátěžový test MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
BACKGROUND: Majority of studies that focused on the influence of abdominal obesity on lipoprotein profile, were conducted in the fasting conditions. The effects of visceral fat accumulation on postprandial lipoprotein concentrations have not yet been studied in details. We therefore focused on the postprandial lipoprotein profile in otherwise healthy men and women with abdominal obesity and their comparison with the control group of volunteers with normal waist circumference. The concentration of lipoprotein classes and subclasses was measured before and 4 hours after a standard meal by linear polyacrylamide gel electrophoresis. RESULTS: A statistically significant postprandial rise in triacylglycerol concentration occurred in all subjects. VLDL increased 4 hours after meal in all subjects except the women with normal waist circumference. The concentration of large IDL particles increased in both non-obese men and women. In women with abdominal obesity, however, it decreased, while in obese men there was no statistically significant change. The concentration of small and medium-sized IDL particles decreased in all volunteers. Analyzing subclasses changes of large, medium-sized and small LDL particles we saw no significant shift in their concentrations except the subclass of large LDL particles, which decreased in men. Concentrations of medium and small HDL particles decreased postprandially in all volunteers with normal waist circumference. However, they remained unchanged in subjects with abdominal obesity. CONCLUSIONS: We observed significant postprandial changes of the lipoprotein profile, but the nature and extent of these changes depended on gender and presence of abdominal obesity.
- MeSH
- abdominální obezita krev MeSH
- dospělí MeSH
- HDL-cholesterol krev MeSH
- LDL-cholesterol krev MeSH
- lidé MeSH
- obvod pasu MeSH
- postprandiální období MeSH
- sexuální faktory MeSH
- triglyceridy krev MeSH
- velikost částic MeSH
- VLDL-cholesterol krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
