• MeSH
• HDL-cholesterol MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• LDL-cholesterol MeSH
• rizikové faktory MeSH
• Publikační typ
• kongresy MeSH
• sborníky MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• kardiologie
• angiologie
• vnitřní lékařství

• MeSH
• ateroskleróza prevence a kontrola   MeSH
• HDL-cholesterol * MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• komentáře MeSH

Whether national guidelines should incorporate apolipoprotein B (apoB) into clinical practice is one of the most important and contentious decisions they must face. Canada has chosen to do so. What Europe and America decide remains to be seen. RECENT FINDINGS: Obviously, the results of the major epidemiological studies and clinical trials should be major drivers of decisions about guidelines. Such evidence clearly indicates that apoB is superior to LDL C as a marker of risk and an index of the adequacy of therapy but is mixed as to whether apoB is superior to non-HDL C. In this paper, we demonstrate that the issue is more complicated than it appears: that even if non-HDL C and apoB are equal predictors of vascular risk (which we do not believe is the case), this is not due to the VLDL C that is included in non-HDL C but rather reflects the fact that non-HDL C is a 'backwards' measure of apoB - that is, non-HDL C provides an indirect estimate of LDL particle number. Moreover, equal predictive power in groups does not mean that markers have equal predictive power in individuals. We also list multiple clinical circumstances when non-HDL C and apoB lead to different clinical decisions because the real test of markers is when they differ, not when they agree. SUMMARY: Thus, our conclusion is that apoB and non-HDL C are equal - except when they are not. Because apoB allows greater specificity of diagnosis and therapy, it re-establishes the primacy of individuals over groups as the objects of our study and our care and that may be its most important contribution to clinical lipidology. Dyslipidemias/physiopathology Dyslipidemias/therapy* Humans Hypolipidemic Agents/therapeutic use Individualized Medicine Lipid Metabolism Practice Guidelines as Topic Risk Factors Sensitivity and Specificity Substances Apolipoproteins B Biological Markers Cholesterol, HDL Cholesterol, LDL Cholesterol, VLDL Hypolipidemic Agents LinkOut - more resourcesFull Text Sources Lippincott Williams & Wilkins Ovid Technologies, Inc. Swets Information Services Other Literature Sources Labome Researcher Resource - ExactAntigen/Labome

• MeSH
• apolipoproteiny B krev   MeSH
• biologické markery krev   MeSH
• diferenciální diagnóza MeSH
• dyslipidemie diagnóza   patofyziologie   terapie   MeSH
• HDL-cholesterol krev   MeSH
• hypolipidemika terapeutické užití   MeSH
• individualizovaná medicína MeSH
• kardiovaskulární nemoci patofyziologie   prevence a kontrola   terapie   MeSH
• klinické zkoušky jako téma MeSH
• LDL-cholesterol krev   MeSH
• lidé MeSH
• metabolismus lipidů MeSH
• rizikové faktory MeSH
• senzitivita a specificita MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• VLDL-cholesterol krev   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Kanada MeSH

Recent studies emphasize the importance of low-density lipoprotein cholesterol (LDL-C) in altering the hematopoietic cell compartment of bone marrow and of high-density lipoprotein cholesterol (HDL-C) in inhibiting metabolic endotoxemia-induced inflammation. The data suggest that these lipoproteins may exert their inflammatory or anti-inflammatory roles by modulating innate immune memory. Targeting specific LDL-C and HDL-C subfractions could therefore potentially reduce the residual risk in hepatic and cardiometabolic disease.

• MeSH
• HDL-cholesterol * MeSH
• imunologická paměť * MeSH
• LDL-cholesterol * MeSH
• lidé MeSH
• přirozená imunita * MeSH
• zánět MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• anticholesteremika MeSH
• HDL-cholesterol MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• Publikační typ
• kongresy MeSH
• sborníky MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• kardiologie

• MeSH
• hodnocení rizik MeSH
• koronární nemoc patofyziologie   prevence a kontrola   MeSH
• lipoproteiny HDL krev   metabolismus   účinky léků   MeSH
• lipoproteiny LDL krev   metabolismus   účinky léků   MeSH
• niacin aplikace a dávkování   farmakologie   MeSH
• statiny aplikace a dávkování   farmakologie   MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Spojené státy americké MeSH

Přes velmi úspěšnou terapii hypercholesterolemie a hypertenze připadá v rozvinutých společnostech stále asi 50 % úmrtí na kardiovaskulární nemoci. To může být vysvětleno vlivem sterilního zánětu v tukové tkáni a následně proinflamačního stavu celého organizmu. Metoda vysoce senzitivního stanovení C-reaktivního proteinu (hsCRP) umožnila v rozsáhlých epidemiologických studiích prokázat, že jeho mírně zvýšená koncentrace odhaluje individuální zvýšené riziko infarktu myokardu. Skutečnost je ale poněkud složitější, protože koncentrace hsCRP významně souvisí s hlavními rizikovými faktory kardiovaskulárních nemocí - věkem, BMI a kouřením. Prokázalo se, že zvýšená proporce proinflamačních makrofágů ve viscerální tukové tkáni vzrůstá s věkem (rozdílně u mužů a žen), se zvýšeným obsahem tělesného tuku a s koncentrací non-HDL-cholesterolu. Předpokládá se, že takto indukovaný proinflamační stav a zmnožení proinflamačních makrofágů v tukové tkáni působí v rozvoji aterosklerózy synergně s věkem, BMI a hypercholesterolemií.

Although current treatment of hypertension and hypercholesterolemia is most effective, cardiovascular mortality still remains at 50 % in industrialized countries. This could be explained by the rather high contribution of the inflammatory process to atherogenesis development. Use of high-sensitivity C-reactive protein (hsCRP) determination in several large epidemiological studies has made it possible to document increased risk of myocardial infarction in individuals with slightly increased hsCRP concentrations, which could thus serve as a discriminatory factor in cardiovascular disease risk assessment. However, the situation is not that simple since hsCRP concentrations correlate significantly with BMI, age and smoking as major cardiovascular risk factors. Increased proportion of pro-inflammatory macrophages in visceral adipose tissue has also been shown to rise with BMI, age (differently in men and women) and non-HDL-cholesterol levels. It has been suggested that the pro-inflammatory status induced by a higher proportion of pro-inflammatory macrophages in visceral adipose tissue acts synergistically in atherogenesis development.

• Klíčová slova
• inkrustační teorie,
• MeSH
• ateroskleróza * etiologie   imunologie   patologie   MeSH
• C-reaktivní protein MeSH
• HDL-cholesterol MeSH
• kardiovaskulární nemoci mortalita   patologie   MeSH
• LDL-cholesterol MeSH
• lidé MeSH
• pěnové buňky MeSH
• rizikové faktory MeSH
• sexuální faktory MeSH
• věkové faktory MeSH
• zánět * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

• MeSH
• C-reaktivní protein diagnostické užití   MeSH
• HDL-cholesterol nedostatek   metabolismus   MeSH
• koronární nemoc etiologie   prevence a kontrola   MeSH
• rizikové faktory MeSH
• statiny terapeutické užití   MeSH
• zánět diagnóza   MeSH
• Publikační typ
• kongresy MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• kardiologie
• angiologie
• vnitřní lékařství

The atherogenic impact and functional capacity of LCAT was studied and discussed over a half century. This review aims to clarify the key points that may affect the final decision on whether LCAT is an anti-atherogenic or atherogenic factor. There are three main processes involving the efflux of free cholesterol from peripheral cells, LCAT action in intravascular pool where cholesterol esterification rate is under the control of HDL, LDL and VLDL subpopulations, and finally the destination of newly produced cholesteryl esters either to the catabolism in liver or to a futile cycle with apoB lipoproteins. The functionality of LCAT substantially depends on its mass together with the composition of the phospholipid bilayer as well as the saturation and the length of fatty acyls and other effectors about which we know yet nothing. Over the years, LCAT puzzle has been significantly supplemented but yet not so satisfactory as to enable how to manipulate LCAT in order to prevent cardiometabolic events. It reminds the butterfly effect when only a moderate change in the process of transformation free cholesterol to cholesteryl esters may cause a crucial turn in the intended target. On the other hand, two biomarkers - FER(HDL) (fractional esterification rate in HDL) and AIP [log(TG/HDL-C)] can offer a benefit to identify the risk of cardiovascular disease (CVD). They both reflect the rate of cholesterol esterification by LCAT and the composition of lipoprotein subpopulations that controls this rate. In clinical practice, AIP can be calculated from the routine lipid profile with help of AIP calculator www.biomed.cas.cz/fgu/aip/calculator.php.

• MeSH
• ateroskleróza krev   metabolismus   MeSH
• biologické markery metabolismus   MeSH
• cholesterol metabolismus   MeSH
• esterifikace MeSH
• lecitincholesterolacyltransferasa metabolismus   MeSH
• lidé MeSH
• lipoproteiny HDL metabolismus   MeSH
• mastné kyseliny metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Paraoxonase 1 is believed to play a role in preventing lipid oxidation and, thus, limiting production of proinflammatory mediators. Systemic inflammatory response in sepsis increases oxidative stress and decreases high-density lipoprotein (HDL) concentrations. The objective of this study was to investigate serum paraoxonase 1 activities in critically ill patients with sepsis and after recovery. Serum paraoxonase 1 arylesterase/paraoxonase activities, concentration of total cholesterol, HDL cholesterol (HDL-C) and serum C-reactive protein (CRP) in septic patients of a medical intensive care unit (n = 30) and age/sex-matched outpatient controls without sepsis (n = 30) were analyzed. Paired convalescent samples were also taken 1 week after recovery (n = 11). In septic patients, both arylesterase (88.3 +/- 36.5 vs. 162.1 +/- 44.8 kU/l, P < 0.001) and paraoxonase (75.2 +/- 50.0 vs. 125.2 +/- 69.4 U/l, P < 0.01) paraoxonase 1 activities decreased as compared to controls. Both activities normalized after recovery. Negative correlation was found between CRP and both arylesterase (r = -0.676, P < 0.001) and paraoxonase (r = -0.401, P < 0.01) as well as positive correlation between HDL-C and both arylesterase (r = 0.585, P < 0.001) and paraoxonase (r = 0.405, P < 0.01) paraoxonase 1 activities. The decreased activity of paraoxonase 1 in negative correlation with CRP offers a potentially useful marker of sepsis progress and recovery in critically ill patients.

• MeSH
• aryldialkylfosfatasa krev   MeSH
• biologické markery MeSH
• C-reaktivní protein analýza   MeSH
• cholesterol krev   MeSH
• dospělí MeSH
• HDL-cholesterol krev   MeSH
• kritický stav MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• sepse diagnóza   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH