Cholesterol Articles and Abstracts

For medical practitioners and the general public - Cholesterol Journal Article Catalog.

Cholesterol Journal Articles



Record 1121 to 1140
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Association of serum tumour necrosis factor-alpha with serum low-density lipoprotein-cholesterol and blood pressure in apparently healthy Japanese women
Ito, H., A. Ohshima, et al. (2001), Clin Exp Pharmacol Physiol 28(3): 188-92.
Abstract: 1. The pro-inflammatory cytokine tumour necrosis factor (TNF)-alpha is considered to be involved in the development of atherosclerosis by inducing local inflammatory responses in the vascular wall. Because TNF-alpha is also known to affect lipid and glucose metabolism, the association between the circulating concentration of TNF-alpha and atherogenic risk factors was examined in 82 apparently healthy Japanese women (aged 19-69 years; mean age 48.5 years). 2. The mean (+/-SD) serum TNF-alpha concentration was 2.7+/-0.9 pg/mL (range 1.4-5.9 pg/mL). The TNF-alpha concentration showed significant correlations with age (r = 0.28; P = 0.01), body mass index (r = 0.27; P = 0.01), the waist-hip ratio (r = 0.41; P = 0.0002), percentage body fat (r = 0.30; P = 0.006), systolic (r = 0.32; P = 0.004) and diastolic (r = 0.24; P = 0.03) blood pressure, total cholesterol (r = 0.27; P = 0.02) and low-density lipoprotein-cholesterol (LDL-C; r = 0.36; P = 0.001), while the correlations with high-density lipoprotein-cholesterol (r = -0.20; P = 0.08) and insulin resistance estimated by the homeostasis model assessment (HOMA(IR); r = 0.16; P = 0.15) were not statistically significant. 3. When adjusted for age and menopause, TNF-alpha was significantly associated with systolic blood pressure (r = 0.25; P = 0.02) and LDL-C (r = 0.27; P = 0.02). The association between TNF-alpha and LDL-C remained significant when adjustment was made for age, menopause and the waist-hip ratio (r = 0.24; P = 0.03). 4. Our results indicate that TNF-alpha may play a role in modulating blood pressure and LDL-C.

Association of skin cholesterol content, measured by a noninvasive method, with markers of inflammation and Framingham risk prediction
Mancini, G. B., S. Chan, et al. (2002), Am J Cardiol 89(11): 1313-6.

Association of the A-204C polymorphism in the cholesterol 7alpha-hydroxylase gene with variations in plasma low density lipoprotein cholesterol levels in the Framingham Offspring Study
Couture, P., J. D. Otvos, et al. (1999), J Lipid Res 40(10): 1883-9.
Abstract: The first reaction of the catabolic pathway of cholesterol is catalyzed by CYP7 and serves as the rate-limiting step and major site of regulation of bile acid synthesis in the liver. A common A to C substitution at position -204 of the promoter of CYP7 gene has been associated with variations in plasma LDL-cholesterol concentrations but the effect of this polymorphism is unknown in the general population. The aim of the present study was therefore to investigate the association of this polymorphism to lipoprotein levels in a population-based sample of 1139 male and 1191 female Framingham Offspring participants. In men, the C variant was associated with higher plasma concentrations of LDL-cholesterol and this association remained significant after adjustment for familial relationship, age, BMI, smoking, alcohol intake, the use of beta-blockers, and apoE genotype. The C variant was also associated with an increased TC/HDL ratio in men. Variance components analysis indicated that allelic variability at nucleotide -204 of the CYP7 gene and polymorphism of the apoE gene accounted for 1 and 5% of the variation of plasma LDL-cholesterol concentrations, respectively. In women, however, there was no relationship between LDL-cholesterol and the A-204C polymorphism but subjects homozygous for the CC genotype had significantly lower triglyceride levels than heterozygotes. Moreover, no significant relationship was found between the A-204C variants and lipoprotein particle diameter or the prevalence of coronary heart disease in both genders. Thus, our results show that the A-204C polymorphism in the CYP7 gene is associated with statistically significant variations in LDL-C and triglyceride concentrations in men and women, respectively, but the cumulative effects of these variations on atherosclerotic risk remain uncertain.

Association of the apolipoprotein B gene polymorphisms with cholesterol levels and response to fluvastatin in Brazilian individuals with high risk for coronary heart disease
Guzman, E. C., M. H. Hirata, et al. (2000), Clin Chem Lab Med 38(8): 731-6.
Abstract: The influence of genetic polymorphism of the apolipoprotein B on lipid metabolism and coronary heart disease (CHD) risk has been demonstrated in different populations, but few studies have shown the contribution of this risk factor in individuals from Brazil. The Ins/del, Xbal and EcoRI polymorphisms of apo B were evaluated in 93 controls and in 104 Caucasian individuals presenting with a high risk lipid profile (HR1) for CHD; 54 of these subjects (HR2) were treated with fluvastatin during 16 weeks. DNA polymorphisms of the apo B gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism. The X(-)X(-) genotype for Xbal polymorphism was associated with higher serum concentrations of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) (p<0.01) in women of the HR1 group. The Ins/del and EcoRI polymorphisms were not associated with variation of lipid profile. After treatment with fluvastatin, TC and LDL-C levels of HR2 individuals were reduced by 23% and 30%, respectively. Individuals with II genotype had significantly greater reduction (34%) of LDL-C than those with ID/DD genotypes (27%). These results indicate that the Xbal polymorphism is associated with variation of serum TC and LDL-C levels in Brazilian women with lipid profile of risk for CHD and the Ins/del polymorphism is associated with the therapeutic response to fluvastatin.

Association of the human Y chromosome with cholesterol levels in the general population
Charchar, F. J., M. Tomaszewski, et al. (2004), Arterioscler Thromb Vasc Biol 24(2): 308-12.
Abstract: OBJECTIVE: Males are at higher risk of cardiovascular diseases than females. The aim of the study was to test whether the potential of the Y chromosome to affect cardiovascular risk could be attributed to its influence on lipids. METHODS AND RESULTS: 1288 Polish men (1157 subjects from young healthy cohort and 131 individuals from middle-aged hypertensive population) were phenotyped for determinants of cardiovascular risk including BMI, blood pressures, lipids, and testosterone. Each subject was genotyped for the HindIII(+/-) polymorphism within the nonrecombining region of the Y chromosome. Men with the HindIII(-) variant exhibited significantly higher total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) levels than subjects with the HindIII(+) genotype in both populations. The differences between the genotypes were 0.15 mmol/L (P=0.0107) and 0.45 mmol/L (P=0.0377) in TC and 0.15 mmol/L (P=0.0059) and 0.41 mmol/L (P=0.0432) in LDL among young apparently healthy men and middle-aged hypertensive men, respectively. The HindIII(+) was associated with a significant increase in blood pressure of the middle-aged men. Testosterone serum concentrations correlated positively with HDL-cholesterol levels, and this association was independent of the Y chromosome. CONCLUSIONS: The results indicate that a locus/loci on the Y chromosome may influence LDL levels, independent of testosterone levels.

Association of the serotonin transporter gene with serum cholesterol levels and heart disease
Comings, D. E., J. P. MacMurray, et al. (1999), Mol Genet Metab 67(3): 248-53.
Abstract: In a study of a group of elderly athletes we observed an unexpected association between serum cholesterol levels and the HTTLPR insertion/deletion polymorphism of the promoter region of the serotonin transporter gene (HTT, SLC6A4). As a follow-up we examined the potential association of this polymorphism with cholesterol and triglyceride levels, or heart disease, in two other groups of subjects. We examined the possible association between cholesterol levels and heart disease and genotypes of the HTTLPR insertion/deletion polymorphism of the promoter region of the HTT gene, in three independent study populations ranging from 42 to 90 years of age. For subjects 55 to 70 years of age in Group 1, cholesterol levels were significantly greater in the LS heterozygotes than either LL or SS homozygotes, indicating a heterosis effect (P 70 years of age. While these studies are preliminary and exploratory, they are consistent with a relationship of the HTT gene in cholesterol levels and a risk for heart disease. Replication of these findings in independent, epidemiologically based studies is required.

Association of triglyceride-to-HDL cholesterol ratio with heart rate recovery
Shishehbor, M. H., B. J. Hoogwerf, et al. (2004), Diabetes Care 27(4): 936-41.
Abstract: OBJECTIVE: Insulin resistance is associated with autonomic dysfunction. An attenuated decrease in heart rate after exercise (or heart rate recovery HRR) predicts all-cause mortality and is believed to reflect decreased parasympathetic activity. Utilizing triglyceride/HDL cholesterol concentration as a marker of insulin resistance, we sought to assess the association between insulin resistance and HRR. RESEARCH DESIGN AND METHODS: Our study population included 4,963 healthy adults who participated in the Lipid Research Clinics Prevalence Study and underwent exercise testing. HRR was considered abnormal if it did not drop > or = 42 bpm 2 min after completion of exercise. Fasting blood specimens were drawn. RESULTS: Individuals in the highest quartile of triglyceride/HDL cholesterol had a significantly higher prevalence of abnormal HRR (40 vs. 30%, multivariable-adjusted prevalence ratio 1.18, 95% CI 1.01-1.39; P = 0.04). As a continuous variable, an increase in 1 SD of triglyceride-to-HDL cholesterol ratio was associated with a greater likelihood of an abnormal HRR, even after adjusting for >20 covariates (adjusted OR 1.16, 95% CI 1.07-1.25; P < 0.001). During 12 years of follow-up, there were 284 deaths. In age- and sex-adjusted analysis, participants with an abnormal HRR and high triglyceride-to-HDL cholesterol ratio had significantly higher mortality than those with a normal HRR and high triglyceride-to-HDL cholesterol ratio (hazard ratio = 1.49, 95% CI 1.08-2.04; P = 0.015). CONCLUSIONS: HRR is associated with triglyceride-to-HDL cholesterol ratio and identifies patients with insulin resistance who are at increased risk of death.

Association of two apolipoprotein A-I gene MspI polymorphisms with high density lipoprotein (HDL)-cholesterol levels and indices of obesity in selected healthy Chinese subjects and in patients with early-onset type 2 diabetes
Ma, Y. Q., G. N. Thomas, et al. (2003), Clin Endocrinol (Oxf) 59(4): 442-9.
Abstract: OBJECTIVE: Previous studies have reported associations between two apolipoprotein A-I (apoA-I) gene MspI polymorphisms (G-75A and C83T) and high density lipoprotein (HDL)-cholesterol and/or apoA-I levels, but have not investigated the relationship with obesity. METHODS: We determined the distribution of these polymorphisms in 482 early-onset (< or = 40 years) Type 2 Chinese diabetics and 167 Chinese selected healthy controls. RESULTS: The -75A and 83T allele frequencies were similar in the diabetic and healthy subjects. In the healthy control subjects, HDL-cholesterol levels were significantly higher in the AA homozygotes than in the GG/GA carriers (1.74 +/- 0.58 vs. 1.45 +/- 0.58 mmol/l, P<0.001). Furthermore, analyses showed a significant relationship between increasing HDL-cholesterol tertiles and the AA genotype frequency in the selected healthy subjects (3.6, 8.9 and 16.1%, P=0.026). For the C83T polymorphism, healthy male CT carriers had higher HDL-cholesterol levels than CC homozygotes (1.71 +/- 0.57 vs. 1.25 +/- 0.30 mmol/l, P=0.001), but this was not found in females. No relationship between these polymorphisms and lipid levels was found in the diabetics, who had a more adverse lipid profile than the selected controls. In the diabetics, but not the controls, in CT carriers compared to CC homozygotes there were lower levels of body mass index (BMI; 23.8 +/- 3.9 vs. 25.4 +/- 4.7 kg/m2, P=0.048) and waist-to-height ratio (0.49 +/- 0.06 vs. 0.52 +/- 0.07, P=0.023), and this relationship was supported by tertile analysis. CONCLUSIONS: The -75AA genotype was associated with higher HDL-cholesterol levels in the selected healthy, but not diabetic, subjects. The 83T allele was associated with greater indices of obesity in the diabetic patients, and with higher HDL-cholesterol in heterozygous healthy male subjects.

Associations between body height, body composition and cholesterol levels in middle-aged men. the coronary risk factor study in southern Sweden (CRISS)
Henriksson, K. M., U. Lindblad, et al. (2001), Eur J Epidemiol 17(6): 521-6.
Abstract: BACKGROUND: Short body height is associated with increased risk for coronary heart disease; however, mechanisms are not fully explained. In this study, associations between body height and serum cholesterol, non-high-density lipoprotein (non-HDL cholesterol) and high-density lipoprotein (HDL cholesterol) were investigated. METHODS: Prospective cohort study of middle-aged men from Helsingborg, Sweden starting 1990. Two birth-year cohorts were invited at 37, 40 and 43 years of age; participation at baseline was 991 (68%). Serum and HDL cholesterol, systolic and diastolic blood pressure, weight, height, waist and hip circumferences were measured. Non-HDL cholesterol, body mass index (BMI) and waist/ hip ratio (WHR) were calculated. The participants completed a questionnaire covering lifestyle variables. RESULTS: There were statistically significant inverse correlations between body height and serum cholesterol (-0.11) and non-HDL cholesterol (-0.12). One standard deviation, 6.7 cm, taller body height was associated with a lower serum cholesterol (-0.12 mmol/l) and a lower non-HDL cholesterol (-0.13 m mol/l; p < 0.001). These associations remained when adjusted for BMI and WHR. Men with serum cholesterol equal to or above 6.5 mmol/l were significantly shorter (mean 178.71 cm) than men with serum cholesterol below 6.5 mmol/l (mean 179.71 cm). In addition, BMI and WHR were positively associated with serum and non-HDL cholesterol and inversely associated with HDL cholesterol. The change in cholesterol levels over the six-year follow-up was significantly associated to the change in BMI and WHR. CONCLUSIONS: Body height had an independent and inverse relation to serum cholesterol and non-HDL cholesterol in middle-aged men, and the lipid pattern suggests that the underlying mechanism might be different from the traditional association between lipids and the metabolic syndrome. Although the direct clinical implication is limited, our results may help to explain the association between short height and risk of myocardial infarction.

Associations between breast cancer, plasma triglycerides, and cholesterol
Potischman, N., C. E. McCulloch, et al. (1991), Nutr Cancer 15(3-4): 205-15.
Abstract: A case-control study investigating the association between plasma lipids and breast cancer was conducted among women aged 30-80 in Buffalo, NY. All eligible women from a large breast clinic and two area physicians' offices were requested to participate over a one-year period. Subjects completed a health questionnaire and donated a fasting blood sample prior to diagnostic breast biopsies. The 83 women found to have breast cancer (cases) had significantly higher plasma triglyceride values than did the 113 women found not to have breast cancer (controls). Lower plasma beta-carotene values were associated with breast cancer, but only in those women with elevated triglyceride or cholesterol. Plasma cholesterol values were lower in those breast cancer cases presenting with more advanced stages of cancer, suggesting that metabolic effects of clinical and preclinical breast cancer may lower cholesterol levels. Although the limitations of case-control studies are well-recognized, these data suggest an etiologic role for plasma triglycerides and beta-carotene or for related dietary factors.

Associations between dietary intakes and blood cholesterol concentrations at 31 months
Cowin, I. S. and P. M. Emmett (2001), Eur J Clin Nutr 55(1): 39-49.
Abstract: OBJECTIVE: The initial stages of atherosclerosis have been shown to occur in children as young as 3. Elevated total and LDL cholesterol concentrations and low HDL concentrations are a well-established risk factor for atherosclerosis. The objective of this study was to investigate the dietary determinants of blood lipid concentrations at 31 months of age. SUBJECTS: A randomly selected group of children (214 boys, 175 girls) in south-west England forming part of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) cohort. DESIGN: Three-day dietary records were obtained at 18 months. At 31 months a non-fasting blood sample was taken and analysed for total and HDL cholesterol and triglyceride, and measures of height and weight were taken. RESULTS: Among boys, total cholesterol concentrations were positively associated with the intake of total fat (r=0.209, P=0.002) and saturated fatty acids (r=0.211, P=0.002). Among girls, HDLC was positively associated with energy intake (r=0.204, P=0.018), and negatively associated with intakes of polyunsaturated fat, saturated fat and sugar in multivariate analysis. There were no associations between the intakes of non-starch polysaccharides (fibre) or dietary cholesterol and total or HDL cholesterol concentrations in either sex. Among boys, higher intakes of breakfast cereals were associated with lower total cholesterol (r=-0.187, P=0.008). Among girls, higher intakes of biscuits and meat and meat products were associated with higher HDLC concentrations. CONCLUSIONS: These data suggest that the dietary determinants of blood lipid concentrations differ between boys and girls. Reducing saturated fat intake in boys would be likely to lead to an improvement in blood lipid profiles. In this study there is no evidence to suggest that an increase in the intake of polyunsaturated fat by pre-school children would result in improved blood lipid profiles.

Associations between lipoproteins and the progression of coronary and vein-graft atherosclerosis in a controlled trial with gemfibrozil in men with low baseline levels of HDL cholesterol
Syvanne, M., M. S. Nieminen, et al. (1998), Circulation 98(19): 1993-9.
Abstract: BACKGROUND: Lipid-lowering secondary-prevention trials of coronary artery disease (CAD) have implicated triglyceride-rich lipoproteins as the main determinants of angiographic progression after elevated LDL cholesterol levels have been lowered with therapy. The present study focuses on the lipoprotein determinants of angiographic CAD progression in men with low HDL cholesterol concentration as their main baseline lipid abnormality who underwent 32 months of randomized therapy with gemfibrozil or placebo. METHODS AND RESULTS: Men who had undergone coronary bypass surgery (n=372) completed a randomized, placebo-controlled study with gemfibrozil 1200 mg/d. They were selected primarily for HDL cholesterol levels that corresponded to the lowest third for middle-aged men. Average baseline lipid and lipoprotein levels were serum triglyceride, 1.60; serum cholesterol, 5.17; ultracentrifugally separated LDL cholesterol, 3.43; HDL2 cholesterol, 0.41; and HDL3 cholesterol, 0. 61 mmol/L. In the gemfibrozil group, these levels were reduced on average by 40%, 9%, and 6% or increased by 5% and 9%, respectively. On-trial IDL and LDL triglyceride and cholesterol levels significantly predicted global angiographic progression, taking into account changes in native segments and in bypass grafts. HDL3 but not HDL2 cholesterol concentration was associated with protection against progression, especially focal disease in native coronary lesions. VLDL was the lipoprotein most predictive of new lesions in vein grafts; IDL was also significantly related. CONCLUSIONS: This study expands the previous evidence of the triglyceride-rich lipoproteins, especially IDL, as predictors of angiographic progression of CAD but does not negate the significance of mildly elevated LDL levels. Of the HDL subfractions, only HDL3 was protective in this group of men selected for their low initial HDL levels.

Associations between serum high-density lipoprotein cholesterol or apolipoprotein AI levels and common genetic variants of the ABCA1 gene in Japanese school-aged children
Yamakawa-Kobayashi, K., H. Yanagi, et al. (2004), Metabolism 53(2): 182-6.
Abstract: ATP-binding cassette transporter A1 (ABCA1) plays an important role in apolipoprotein AI (apoAI)-mediated cholesterol efflux from peripheral cells. The mild changes in ABCA1 activity due to genomic variation might be associated with interindividual variations in serum high-density lipoprotein cholesterol (HDL-C) and apoAI levels, or primary hypoalphalipoproteinemia in the general population. In the present study, we analyzed the relationships between 5 single nucleotide polymorphisms (SNPs) and 2 insertion/deletion polymorphisms in the 5' flanking region and 5 missense polymorphisms of the ABCA1 gene and serum lipid levels in healthy school-aged children. We detected significant associations between the K219R and V771M polymorphisms, and HDL-C or apoAI levels. The present data support the proposition that the K219 allele is an anti-atherogenic allele with increased cholesterol efflux activity. Similarly, the M771 allele appears to be anti-atherogenic, although the frequency of the M771 allele is low.

Associations of B- and C-Raf with cholesterol, phosphatidylserine, and lipid second messengers: preferential binding of Raf to artificial lipid rafts
Hekman, M., H. Hamm, et al. (2002), J Biol Chem 277(27): 24090-102.
Abstract: The serine/threonine kinase C-Raf is a key mediator in cellular signaling. Translocation of Raf to membranes has been proposed to be facilitated by Ras proteins in their GTP-bound state. In this study we provide evidence that both purified B- and C-Raf kinases possess lipophilic properties and associate with phospholipid membranes. In the presence of phosphatidylserine and lipid second messengers such as phosphatidic acid and ceramides these associations were very specific with affinity constants (K(D)) in the range of 0.5-50 nm. Raf association with liposomes was accompanied by displacement of 14-3-3 proteins and inhibition of Raf kinase activities. Interactions of Raf with cholesterol are of particular interest, since cholesterol has been shown to be involved, together with sphingomyelin and glycerophospholipids in the formation of specialized lipid microdomains called rafts. We demonstrate here that purified Raf proteins have moderate binding affinity for cholesterol. However, under conditions of lipid raft formation, Raf association with cholesterol (or rafts) increased dramatically. Since ceramides also support formation of rafts and interact with Raf we propose that Raf may be present at the plasma membrane in two distinct microdomains: in raft regions via association with cholesterol and ceramides and in non-raft regions due to interaction with phosphatidylserine and phosphatidic acid. At either location Raf kinase activity was inhibited by lipid binding in the absence or presence of Ras. Ras-Raf interactions with full-length C-Raf were studied both in solution and in phospholipid environment. Ras association with Raf was GTP dependent as previously demonstrated for C-Raf-RBD fragments. In the presence of liposomes the recruitment of C-Raf by reconstituted Ras-farnesyl was only marginal, since almost 70% of added C-Raf was bound by the lipids alone. Thus Ras-Raf binding in response to activation of Ras-coupled receptors may utilize Raf protein that is already present at the membrane.

Associations of cholesterol lowering by statins with anger and hostility in hypercholesterolemic men
Strandberg, T. E., K. Raikkonen, et al. (1994), Biol Psychiatry 35(8): 575-7.

Associations of fasting blood glucose with cholesterol absorption and synthesis in nondiabetic middle-aged men
Stranberg, T. E., V. Salomaa, et al. (1996), Diabetes 45(6): 755-61.
Abstract: NIDDM and the metabolic syndrome are characterized by a low serum, HDL cholesterol content and a high triglyceride level, whereas total and LDL cholesterol concentrations are not necessarily elevated. Variable results have been reported on cholesterol absorption, elimination, and synthesis in NIDDM, but no studies are available on subjects within the normal range of blood glucose. From serum samples collected in 1985 from 203 nondiabetic men aged 51-66 years, we examined lipids, cholesterol precursors (reflecting cholesterol synthesis), and plant sterols and cholestanol (reflecting cholesterol absorption) in relation to fasting blood glucose. The findings prompted us (in 1993) to further examine 11 men from the highest and lowest glucose thirds of 203 nondiabetic men by additional dietary, serum, and fecal analyses for absorption, elimination, and synthesis of cholesterol and insulin sensitivity. In 1985, blood glucose was significantly related to LDL apolipoprotein B (P = 0.05) but not to LDL cholesterol (P = 0.19). Significantly higher serum lathosterol and desmosterol-to-cholesterol proportions and lower plant sterol and cholestanol proportions in the highest rather than the lowest glucose thirds suggested that the subjects with high normal blood glucose had decreased absorption and enhanced synthesis of cholesterol. In 1993, men with the lowest glucose versus those with the highest glucose had a lower waist-to-hip ratio, plasma HbA1c, fasting and postload insulin and glucose values, and a higher insulin sensitivity index. In agreement with the 1985 non-cholesterol sterol data, direct analyses of cholesterol metabolism showed further higher cholesterol absorption efficiency (P = 0.03) and serum plant sterol and cholestanol proportions (P < 0.001). Despite a slightly lower dietary cholesterol intake, cholesterol synthesis (P = 0.02) and serum lathosterol (P < 0.01) and desmosterol (P < 0.01) proportions were lowest in men with the lowest glucose third. We conclude that noncholesterol sterols in serum exhibits a long-lasting correlation with blood glucose level in a nondiabetic male population. Low intestinal absorption and high synthesis of cholesterol characterize men with high normal blood glucose. Differences in cholesterol metabolism could be due to underlying insulin effects associated with obesity-like fat distribution and may thus imply novel aspects in the metabolic interrelation between insulin and cholesterol in humans.

Associations of fat and cholesterol intake with serum lipid levels and cardiovascular disease: the EURODIAB IDDM Complications Study
Toeller, M., A. E. Buyken, et al. (1999), Exp Clin Endocrinol Diabetes 107(8): 512-21.
Abstract: The EURODIAB IDDM Complications Study, a cross-sectional, clinic-based study examined the fat and cholesterol intakes of European individuals with type 1 diabetes for possible relations to serum lipid levels (total cholesterol, HDL- and LDL-cholesterol, fasting triglycerides) and to the prevalence of cardiovascular disease (past history or electrocardiogram abnormalities). Fat intake (total fat, saturated fat, cholesterol) from 2,868 subjects with type 1 diabetes (mean age 32.9 +/- 10.2 years (range: 14-61 years), mean diabetes duration 14.7 +/- 9.4 years (range: 1-56 years)) was assessed by a standardized 3-day dietary record at the Nutrition Co-Ordinating Centre (Dusseldorf). Serum lipid levels were determined in the central laboratory (London) by standard enzymatic methods. Energy-adjusted total and LDL-cholesterol levels increased significantly with higher intakes of total fat, saturated fat and cholesterol. However, these relations were largely explained by concomitant decreases in dietary fibre intake. For levels of HDL-cholesterol and triglycerides no independent associations were observed with fat or cholesterol intake. Increased intakes of total fat, saturated fat and cholesterol were also related to higher prevalences of cardiovascular disease. These associations were, however, no longer significant after adjustment for dietary fibre intake for which we previously demonstrated independent associations with the serum cholesterol pattern and CVD. Since higher fat intakes are commonly accompanied by lower carbohydrate and fibre intakes we conclude that restricted intakes of cholesterol, saturated fat and total fat combined with higher fibre intakes beneficially affect both the levels of total and LDL-cholesterol and the risk for cardiovascular disease in European individuals with type 1 diabetes.

Associations of HDL, HDL(2), and HDL(3) cholesterol and apolipoproteins A-I and B with lifestyle factors in healthy women and men: the Stanford Five City Project
Gardner, C. D., D. L. Tribble, et al. (2000), Prev Med 31(4): 346-56.
Abstract: BACKGROUND: Measures of the two major high-density lipoprotein (HDL) subfractions, HDL(2) and HDL(3), and the major apolipoproteins of HDL and low-density lipoprotein (LDL), Apo A-I and Apo B, may be etiologically important factors in the development of coronary artery disease. The association of lifestyle factors with these lipoprotein-related variables remains unclear. METHODS: HDL-C, HDL(2)-C, HDL(3)-C, Apo A-I, and Apo B levels were determined in a population-based sample of 1,027 healthy women and men aged 25-64 years, from four California cities who participated in the 1989/1990 survey of the Stanford Five City Project. In this cross-sectional study we examined the independent associations of these lipoprotein-related variables with body mass index (BMI), cigarette smoking, daily energy expenditure, alcohol intake, dietary intake, and hormone use (oral contraceptives and estrogen replacement therapy). RESULTS: In general, BMI and alcohol intake were the strongest independent predictors of the lipoprotein-related variables. The negative association of BMI with HDL-C was attributable primarily to the association with the HDL(2)-C subfraction, while for alcohol intake the positive association with HDL-C was attributable primarily to the association with HDL(3)-C, particularly in men. Among men, but not women, energy expenditure was a significant independent predictor of each of the lipoprotein-related variables, with positive associations observed for HDL-C, HDL(2)-C, HDL(2)-C, and Apo A-I and a negative association observed for Apo B (P < 0.005). CONCLUSIONS: Data from this population-based sample suggest that specific lifestyle factors are more strongly associated with some lipoprotein-related variables than with others, with notable gender differences.

Associations of obesity markers, insulin, and sex hormones with HDL-cholesterol levels in Turkish and German individuals
Hergenc, G., H. Schulte, et al. (1999), Atherosclerosis 145(1): 147-56.
Abstract: Turkish men and women have about 20% lower mean levels of HDL-C and apoA-I than German individuals. To obtain some information on the metabolic basis of this difference, we compared anthropometric data as well as serum levels of leptin, insulin, testosterone (T), estradiol (E2), and sex hormone binding globuline (SHBG) in 289 German and 120 Turkish men as well as in 108 German and 182 Turkish women aged 20-60. Individuals who smoke, take hormones, have overt diabetes mellitus, BMI > 30 kg/m2, triglycerides > 400 mg/dl, or LDL-cholesterol > 200 mg/dl were excluded. In both sexes, Turks had significantly lower levels of HDL-C, apoA-I, Lp(a), and SHBG than Germans. Moreover, German men had a larger waist circumference, lower levels of E2 and a lower ratio of T/SHBG. German women also had a lower BMI, smaller waist circumference, lower insulin levels and higher T levels. Mean values of age, waist-hip-ratio (WHR), leptin, triglycerides, LDL-C, and apoB did not differ significantly among Germans and Turks. Upon univariate analysis HDL-C had inverse correlations with BMI, waist circumference, WHR, leptin, and insulin as well as positive correlations with SHBG in both sexes. Upon multivariate analysis, most of the different levels of HDL-C and apoA-I between Germans and Turks were explained by ethnicity, independently of obesity markers, insulin, and sex hormones.

Associations of serum total cholesterol, different types of stroke, and stenosis distribution of cerebral arteries. The Akita Pathology Study
Konishi, M., H. Iso, et al. (1993), Stroke 24(7): 954-64.
Abstract: BACKGROUND AND PURPOSE: The relation between serum total cholesterol levels and stroke is controversial. The Akita Pathology Study provides data on the association of serum total cholesterol, different types of stroke, and distribution of stenosis in cerebral arteries. METHODS: The data are based on 750 autopsied men aged 30 years and older who were admitted to a local hospital in northeast Japan between 1966 and 1984. The overall autopsy rate was 88%. The grade of stenosis in the cerebral arteries was determined blindly by one pathologist using Baker's method for basal cerebral arteries (atherosclerosis scores) and using microscopic examination of a single basal ganglion slide for the intracerebral penetrating arteries (arteriolosclerosis scores). RESULTS: The age-adjusted mean value of serum total cholesterol concentration was 164 mg/dL for cerebral hemorrhage, 177 mg/dL for infarction in penetrating artery regions, and 200 mg/dL for infarction in cortical artery regions. Mean serum cholesterol was lower in deaths caused by cerebral hemorrhage than in those caused by myocardial infarction and other cardiovascular disease. Mean atherosclerosis score of basal cerebral arteries was low for cerebral hemorrhage, intermediate for penetrating artery infarction, and high for cortical artery infarction. Stenosis of both basal and penetrating arteries was minimum or absent in cases of cerebral hemorrhage. Only the basal arteries were stenotic in cases of cortical artery infarction, whereas both basal and penetrating arteries were stenosed in cases of penetrating artery infarction. There were positive associations of serum cholesterol with stenosis of basal and penetrating arteries. Among cases of cerebral hemorrhage, serum total cholesterol levels were even lower in men with no significant stenosis in either basal or penetrating arteries than in men with stenosis in either type of artery. CONCLUSIONS: The association of serum cholesterol with pathogenesis varies among stroke types. Elevated serum cholesterol levels were associated with the presence of cortical artery infarction, while low serum cholesterol levels were associated with cerebral hemorrhage.


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