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Identifying pseudohypertriglyceridemia in clinical practice 在临床实践中识别假性高甘油三酯血症
Q Medicine Pub Date : 2014-12-01 DOI: 10.2217/clp.14.52
J. Backes, T. Dayspring, D. Hoefner, J. Contois, J. Mcconnell, P. Moriarty
Abstract Isolated asymptomatic glycerol kinase deficiency (GKD) or ‘pseudohypertriglyceridemia’, is an X-linked recessive disorder resulting in hyperglyceroluria and hyperglycerolemia. Patients typically present with hypertriglyceridemia, which is unresponsive to therapy. The falsely elevated triglycerides are a result of clinical laboratories utilizing glycerol levels to report triglyceride concentrations. Glycerol blanking will account for the excess glycerol and provide accurate triglyceride measures. Pseudohypertriglyceridemia is linked to glucose impairment and other forms of GKD involving childhood metabolic crises and developmental limitations. Identifying patients with pseudohypertriglyceridemia prevents overestimation of cardiovascular risk and exposure to unnecessary lipid-altering agents; and heightens the awareness of the potential for symptomatic GKD in male offspring. We urge clinical labs to provide a glycerol-blanked triglyceride measurement for known or suspected pseudohypertriglyceridemia.
孤立性无症状甘油激酶缺乏症(GKD)或“假性高甘油三酯血症”,是一种x连锁隐性疾病,导致高甘油尿症和高甘油血症。患者通常表现为高甘油三酯血症,对治疗无反应。错误升高的甘油三酯是临床实验室利用甘油水平报告甘油三酯浓度的结果。甘油空白将说明多余的甘油和提供准确的甘油三酯测量。假性高甘油三酯血症与葡萄糖损伤和其他形式的GKD有关,涉及儿童代谢危机和发育限制。识别假性高甘油三酯血症患者可以防止高估心血管风险和暴露于不必要的脂质改变药物;并提高了对男性后代可能出现症状性GKD的认识。我们敦促临床实验室提供甘油空白甘油三酯测量已知或可疑的假性高甘油三酯血症。
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引用次数: 13
Biosynthesis, metabolism and function of protectins and resolvins 保护蛋白和溶解蛋白的生物合成、代谢和功能
Q Medicine Pub Date : 2014-12-01 DOI: 10.2217/clp.14.44
J. Demarquoy, F. L. Borgne
Abstract N-3 polyunsaturated long chain fatty acids and especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are known to limit inflammation and to improve its resolution. The benefits resulting from the use of EPA and DHA are numerous, they are used for treating asthma and arthritis, for controlling blood pressure and vascular reactivity and have been shown to have antitumor effect. While the effects of these polyunsaturated fatty acids on improving the resolution of inflammation are well evidenced, the mechanisms involved in this process remained unclear until the discovery of protectins and resolvins. The goal of this paper is to give an overview on the biosynthesis, the metabolism and the biochemical and physiological functions of these molecules derived from EPA and DHA.
N-3多不饱和长链脂肪酸,特别是二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)具有限制炎症和提高其分辨率的作用。使用EPA和DHA带来的好处是很多的,它们被用于治疗哮喘和关节炎,控制血压和血管反应性,并已被证明具有抗肿瘤作用。虽然这些多不饱和脂肪酸在改善炎症消退方面的作用已得到充分证明,但在发现保护和消退机制之前,这一过程所涉及的机制仍不清楚。本文就EPA和DHA衍生分子的生物合成、代谢及其生化生理功能等方面的研究进展进行综述。
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引用次数: 16
Lowering LDL-C with alirocumab, an investigational PCSK9 inhibitor alirocumab降低LDL-C,一种实验性PCSK9抑制剂
Q Medicine Pub Date : 2014-12-01 DOI: 10.2217/clp.14.55
J. Edelberg
Jay Edelberg is an MD PhD graduate of Duke University in Durham, North Carolina, USA and trained in clinical cardiology at the Beth Israel Deaconess Medical Center in Boston. From 1999 to 2006, Dr Edelberg served as CCU cardiologist and led the Cardiac Vascular Biology Research Laboratory at Weill-Cornell Medical Center, with a specific research focus on cardiovascular stem cells and biomarkers of cardiac aging. In 2006, Dr Edelberg became Director of Cardiovascular Urogenital Biomarker research at GlaxoSmithKline. Two years later, he moved to Bristol-Myers Squibb and progressed to become the US medical lead for Eliquis (apixaban). He joined Sanofi in 2012 as Vice President and Head of the newly formed PCSK9 Development & Launch Unit, reporting to Elias Zerhouni, President, Global R&D and Hanspeter Spek, President, Global Operations, Sanofi. Over the years, Dr Edelberg has published more than 75 peer-reviewed publications and has participated in numerous research and peer-review committees, including those of the National Institutes of Health (NIH), American Heart Association (AHA) and the California Institute for Regenerative Medicine (CIRM). He currently sits on the American Federation for Aging Research Board of Directors and is a Section Editor for the journal Aging Cell.
Jay Edelberg博士毕业于美国北卡罗来纳州达勒姆的杜克大学,曾在波士顿Beth Israel Deaconess医疗中心接受临床心脏病学培训。从1999年到2006年,Edelberg博士担任CCU心脏病专家,并领导威尔-康奈尔医学中心的心血管生物学研究实验室,专门研究心血管干细胞和心脏衰老的生物标志物。2006年,Edelberg博士成为葛兰素史克(GlaxoSmithKline)心血管泌尿生殖生物标志物研究主任。两年后,他跳槽到百时美施贵宝(Bristol-Myers Squibb),并成为Eliquis(阿哌沙班)的美国医学负责人。他于2012年加入赛诺菲,担任新成立的PCSK9开发和发布部门的副总裁兼主管,向赛诺菲全球研发总裁Elias Zerhouni和全球运营总裁Hanspeter Spek汇报。多年来,Edelberg博士发表了超过75篇同行评议的出版物,并参加了许多研究和同行评议委员会,包括美国国立卫生研究院(NIH)、美国心脏协会(AHA)和加州再生医学研究所(CIRM)。他目前是美国老龄化研究委员会的成员,也是《衰老细胞》杂志的编辑。
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引用次数: 0
Harnessing the power of yeast to elucidate the role of sphingolipids in metabolic and signaling processes pertinent to psychiatric disorders. 利用酵母的力量阐明鞘脂在与精神疾病相关的代谢和信号过程中的作用。
Q Medicine Pub Date : 2014-11-01 DOI: 10.2217/clp.14.47
Shyamalagauri Jadhav, Miriam L Greenberg

The development of therapies for neuropsychiatric disorders is hampered by the lack of understanding of the mechanisms underlying their pathologies. While aberrant sphingolipid metabolism is associated with psychiatric illness, the role of sphingolipids in these disorders is not understood. The genetically tractable yeast model can be exploited in order to elucidate the cellular consequences of sphingolipid perturbation. Hypotheses generated from studies in yeast and tested in mammalian cells may contribute to our understanding of the role of sphingolipids in psychiatric disorders and to the development of new treatments. Here, we compare sphingolipid metabolism in yeast and mammalian cells, discuss studies implicating sphingolipids in psychiatric disorders and propose approaches that utilize yeast in order to elucidate sphingolipid function and identify drugs that target sphingolipid synthesis.

由于缺乏对其病理机制的理解,神经精神疾病治疗的发展受到阻碍。虽然神经鞘脂代谢异常与精神疾病有关,但神经鞘脂在这些疾病中的作用尚不清楚。遗传上可处理的酵母模型可以用来阐明鞘脂扰动的细胞后果。酵母研究和哺乳动物细胞测试产生的假设可能有助于我们理解鞘脂在精神疾病中的作用,并有助于开发新的治疗方法。在这里,我们比较了酵母和哺乳动物细胞中的鞘脂代谢,讨论了鞘脂与精神疾病有关的研究,并提出了利用酵母来阐明鞘脂功能和鉴定靶向鞘脂合成药物的方法。
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引用次数: 3
Association of leptin gene polymorphism G-2548A with metabolic and anthropometric parameters in obese patients in a Serbian population: pilot study 瘦素基因多态性G-2548A与塞尔维亚人群肥胖患者代谢和人体测量参数的关联:初步研究
Q Medicine Pub Date : 2014-10-01 DOI: 10.2217/clp.14.42
Sanja Soskić, E. Stokic, M. Obradović, Emina Sudar, Nasta Tanić, A. Kupusinac, J. Djordjevic, E. Isenovic
Abstract Aim: The aim of this pilot study was to investigate possible associations of LEP promoter polymorphism LEP G-2548A and obesity-associated metabolic and antropometric parameters in obese population. Materials & methods: Group of 31 patients with hyperalimentary type of obesity (mean age: 39.26 ± 11.45 years; BMI: 41.51 ± 9.22 kg/m2) and 36 healthy, nonobese, normal weight subjects (mean age: 33.55 ± 6.46 years; BMI: 22.63 ± 1.94 kg/m2) were studied. Blood samples were collected for DNA isolation, serum leptin and serum lipids measurements. LEP G-2548A genotypes were determined by PCR restriction fragment length polymorphism based analyses. Results: No significant differences in genotype and allele frequencies of the LEP G-2548A polymorphism were detected between obese and normal weight subjects. No association was found between this polymorphism and BMI. Obese subjects had statistically significant increase in serum leptin levels compared with control, while no association between leptin concentration and LEP polymorphism LEP G-2548A was found. There is a statistically significant association of LEP G-2548A genotypes with LDL (p < 0.05), LDL/HDL ratio (p < 0.001), apoB (p < 0.01), body weight (p < 0.001) and waist circumference (p < 0.001). Conclusion: Our findings indicate that there is an association between LEP G-2548A polymorphism and metabolic and anthropometric parameters in obese patients in a Serbian population.
摘要目的:本初步研究的目的是探讨肥胖人群中LEP启动子多态性LEP G-2548A与肥胖相关的代谢和心率参数的可能关联。材料与方法:31例高消化型肥胖患者(平均年龄:39.26±11.45岁;BMI: 41.51±9.22 kg/m2)和36名健康、非肥胖、体重正常的受试者(平均年龄:33.55±6.46岁;BMI: 22.63±1.94 kg/m2)。采集血样进行DNA分离、血清瘦素和血脂测定。LEP G-2548A基因型采用PCR限制性片段长度多态性分析。结果:肥胖者与正常体重者LEP G-2548A多态性基因型及等位基因频率无显著差异。没有发现这种多态性与BMI之间的关联。肥胖组血清瘦素水平较对照组有统计学意义升高,而瘦素浓度与LEP多态性LEP G-2548A无相关性。LEP G-2548A基因型与LDL (p < 0.05)、LDL/HDL比值(p < 0.001)、apoB (p < 0.01)、体重(p < 0.001)、腰围(p < 0.001)有统计学意义。结论:我们的研究结果表明,LEP G-2548A多态性与塞尔维亚人群肥胖患者的代谢和人体测量参数之间存在关联。
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引用次数: 2
Sphingolipid regulators of cellular dysfunction in Type 2 diabetes mellitus: a systems overview 2型糖尿病细胞功能障碍的鞘脂调节:系统综述
Q Medicine Pub Date : 2014-10-01 DOI: 10.2217/clp.14.37
Jessica S Ross, S. Russo, Georgia C Chavis, L. Cowart
Abstract Climbing obesity rates have contributed to worldwide increases in obesity-associated diseases, including the metabolic syndrome and Type 2 diabetes mellitus (T2DM). Sphingolipids, an important class of structural and signaling lipids, have emerged as key players in the development and pathogenesis of insulin resistance and T2DM. More specifically, sphingolipids have been demonstrated to play integral roles in lipotoxicity and other aspects of pathogenesis in T2DM, although the cellular mechanisms by which this occurs and by which sphingolipid metabolism is dysregulated in T2DM remain under investigation. This review summarizes current knowledge of sphingolipid metabolism and signaling in key organs and tissues affected by T2DM, including the pancreas, adipose tissue, skeletal muscle, cardiovascular system and liver, and highlights areas that ripe for future investigation.
肥胖率的上升导致全球范围内肥胖相关疾病的增加,包括代谢综合征和2型糖尿病(T2DM)。鞘脂是一类重要的结构脂和信号脂,在胰岛素抵抗和T2DM的发展和发病机制中起着关键作用。更具体地说,鞘脂已被证明在2型糖尿病的脂肪毒性和其他发病机制中起着不可或缺的作用,尽管这种作用发生的细胞机制以及鞘脂代谢失调在2型糖尿病中仍在研究中。本文综述了T2DM影响的关键器官和组织(包括胰腺、脂肪组织、骨骼肌、心血管系统和肝脏)鞘脂代谢和信号传导的现有知识,并强调了未来研究的成熟领域。
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引用次数: 11
Hypertriglyceridemic waist increased risk of inappropriate glucose control in patients with coronary heart disease 高甘油三酯血症腰增加冠心病患者血糖控制不当的风险
Q Medicine Pub Date : 2014-10-01 DOI: 10.2217/clp.14.49
O. Mayer, J. Seidlerová, J. Bruthans, Katarína Timoracká, Petra Vágovičová, J. Vaněk, P. Wohlfahrt, J. Filipovský, R. Cífková
Abstract Aim: The definition of metabolic syndrome (MetSy) in patients with coronary heart disease (CHD) remains problematic because of concomitant treatment. We speculate, which definition is suitable in terms of long-term glycemic status. Methods: We analyzed 979 patients with stable CHD. Four different MetSy definitions were used: ‘standard Adult Treatment Panel III (ATP)’, ‘modified ATP’ (not using antihypertensive treatment as an alternative criterion), ‘atherogenic dyslipidemia’ or ‘hypertriglyceridemic waist’. Results: The presence of ‘hypertriglyceridemic waist’ was associated with almost twofold higher risk (OR 1.79; 95% CI: 1.19 – 2.68) of hemoglobin A1c ≥48. Predictive power of standard or modified ATP definitions diminished after adjustment. Conclusion: In CHD patients, the simplified MetSy definition using ‘hypertriglyceridemic waist’ provides better prediction for glycemic control than ATP definition.
摘要目的:冠心病(CHD)患者代谢综合征(MetSy)的定义由于伴随治疗而存在问题。我们推测,哪个定义适合长期血糖状态。方法:对979例稳定期冠心病患者进行分析。使用了四种不同的MetSy定义:“标准成人治疗组III (ATP)”、“改良ATP”(不使用降压治疗作为替代标准)、“动脉粥样硬化性血脂异常”或“高甘油三酯血症腰”。结果:“高甘油三酯血症腰”的存在与几乎两倍的高风险相关(OR 1.79;95% CI: 1.19 ~ 2.68),血红蛋白A1c≥48。标准或修改后的ATP定义的预测能力在调整后降低。结论:在冠心病患者中,使用“高甘油三酯血症腰”的简化MetSy定义比ATP定义更能预测血糖控制。
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引用次数: 1
The effects of mipomersen, a secondgeneration antisense oligonucleotide, on atherogenic (apoB-containing) lipoproteins in the treatment of homozygous familial hypercholesterolemia 第二代反义寡核苷酸mipomersen对纯合子家族性高胆固醇血症治疗中致动脉粥样硬化(含载脂蛋白)脂蛋白的影响
Q Medicine Pub Date : 2014-10-01 DOI: 10.2217/clp.14.43
M. McGowan, P. Moriarty, J. Backes
Abstract Mipomersen (Kynamro® [mipomersen sodium injection]; Genzyme, a Sanofi Company, MA, USA) is indicated as an adjunct to lipid-lowering medications and diet to reduce LDL-C, apoB, total cholesterol and non-HDL cholesterol in patients with homozygous familial hypercholesterolemia. In a 6-month Phase III trial (n = 51), mean percent change in LDL-C was -25% (95% CI: -32 to -18) versus placebo -3% (95% CI: -12 to 5; p < 0.001). The absolute mean LDL-C reduction was 113 mg/dl (2.92 mmol/l). Lipoprotein(a) was also significantly lowered by -31% (95% CI: -39 to -23) versus placebo -8% (95% CI: -19 to 3; p < 0.01). Some patients experienced transient and generally reversible hepatic effects, mild-to-moderate injection site reactions and flu-like symptoms. The mechanism of action and metabolism of mipomersen makes drug–drug interactions unlikely.
Mipomersen (Kynamro®[Mipomersen钠注射液];Genzyme, Sanofi Company, MA, USA)作为降脂药物和饮食的辅助药物,用于降低纯合子家族性高胆固醇血症患者的LDL-C、载脂蛋白ob、总胆固醇和非高密度脂蛋白胆固醇。在一项为期6个月的III期试验(n = 51)中,LDL-C的平均百分比变化为-25% (95% CI: -32至-18),而安慰剂的平均百分比变化为-3% (95% CI: -12至5;P < 0.001)。绝对平均LDL-C降低为113 mg/dl (2.92 mmol/l)。脂蛋白(a)也显著降低了-31% (95% CI: -39至-23),而安慰剂-8% (95% CI: -19至3;P < 0.01)。一些患者出现短暂且通常可逆的肝脏反应,轻度至中度注射部位反应和流感样症状。mipomersen的作用机制和代谢使药物-药物相互作用不太可能发生。
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引用次数: 7
Potential of nanoliposomes for the therapy and/or diagnosis of Alzheimer’s disease: recent progress 纳米脂质体在阿尔茨海默病治疗和/或诊断中的潜力:最新进展
Q Medicine Pub Date : 2014-10-01 DOI: 10.2217/clp.14.33
S. Antimisiaris
Abstract “...the nanoliposomes developed have the potental to be used for the therapy/ diagnosis of Alzheimer’s disease, providing that future in vivo studies verify the in vitro results.”
摘要“…开发的纳米脂质体具有用于治疗/诊断阿尔茨海默病的潜力,提供未来的体内研究验证体外结果。”
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引用次数: 4
Genetic screening to improve the diagnosis of familial hypercholesterolemia 遗传筛查提高家族性高胆固醇血症的诊断
Q Medicine Pub Date : 2014-10-01 DOI: 10.2217/clp.14.32
Fathimath Faiz, L. Nguyen, F. M. Bockxmeer, A. Hooper
Abstract Familial hypercholesterolemia (FH) is a common inherited disorder that causes premature atherosclerosis due to defective clearance of LDL. With current mutation screening strategies, the success rate of finding a causative LDLR or other mutation in a clinically diagnosed FH patient is approximately 70–80%. High-throughput next-generation sequencing approaches are now being introduced to not only identify mutations in genes not previously suspected to be important to FH, but also to screen the currently known gene variants more comprehensively with greater success. Where conventional methods have failed to disclose a causative mutation in one of the known genes, a polygenic mode of inheritance has been proposed to account for FH in these ‘mutation-negative’ patients. Identifying the precise molecular basis of the disorder is important for family cascade screening as well as to optimize treatment and clinical management, thereby preventing the otherwise fatal consequences of undiagnosed and untreated FH.
家族性高胆固醇血症(FH)是一种常见的遗传性疾病,由于LDL清除缺陷导致过早动脉粥样硬化。在目前的突变筛查策略下,在临床诊断为FH的患者中发现致病性LDLR或其他突变的成功率约为70-80%。高通量新一代测序方法现在被引入,不仅可以识别以前未被怀疑对FH重要的基因突变,还可以更全面地筛选目前已知的基因变异,并取得更大的成功。在传统方法无法揭示已知基因之一的致病突变的情况下,已经提出了一种多基因遗传模式来解释这些“突变阴性”患者的FH。确定该疾病的精确分子基础对于家庭级联筛查以及优化治疗和临床管理非常重要,从而防止未确诊和未经治疗的FH的其他致命后果。
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引用次数: 2
期刊
Clinical Lipidology
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