- Email: [email protected]
227: Cardio-metabolic complications of subclinical hypothyroidism in women with metabolic syndrome
Journal of Clinical Lipidology, Vol 2, No 5S, October 2008
statistical significance after controlling for age, BMI, total cholesterol, and creatinine (p=NS). The prevalence of MS increased gradually among groups according to the sex-specific UA quartiles. A multivariate linear regression analysis revealed that SUA level was not an independent variable affecting hfPWV or baPWV both in women and men. This suggests that higher SUA level is independently associated with MS particularly in women, but not with arterial stiffness in Korean subjects.
with euthyroid men (p-values <0.05). Hyperthyroid women had lower LDL-C, TCH and BMI compared with their euthyroid counterparts (p-values <0.05). TSH were correlated with waist circumference among males (r=0.24) and TG concentrations among females (r=0.15). Conclusion: Thyroid dysfunction was present among more than 40% of participants. Hyperthyroid participants had a better metabolic profile in this population than euthyroid participants. Further studies are needed to identify mechanisms behind this observation.
Funding: none Funding: This study was supported by an award from the NIH (T37¨CMD001449) 226 THYROID STIMULATING HORMONE AND COMPONENTS OF METABOLIC SYNDROME AMONG OUTPATIENT CARDIOVASCULAR PATIENTS IN GEORGIA N. Dolidze1, B. Gelaye2, D. Enquobahrie2,3, G. Chapidze1, M. A. Williams2. 1Emergency Cardiology Center, Tbilisi, Georgia, 2University of Washington, Seattle, WA, USA, 3Harvard University, Boston, MA, USA Objective: Thyroid dysfunction and metabolic syndrome (MetS) are associated with increased morbidity and mortality from cardiovascular (CV) diseases. MetS components and thyroid stimulating hormone (TSH) relationships were studied among CV patients. Methods: Male (N=112) and female (N=169) participants were recruited from an outpatient-clinic in Batumi, Georgia. MetS was defined using the Adult Treatment Panel III (ATP III) criteria as the presence of $3 of the following: (1) elevated blood pressure, (2) abdominal obesity, (3) reduced HDL-cholesterol (HDL-C), (4) elevated triglyceride (TG), and 5) elevated fasting glucose (FG). TSH was measured using an ELISA. Results: Females had higher TSH compared with males (mean TSH: 1.31 and 0.95 mg/dl, respectively). 38% of participants were hyperthyroid (46% males and 33% females) and 4% were hypothyroid (3% males and 4% females). Among males, MetS was less common among hyperthyroids compared with euthyroids (53% vs. 69%). Hyperthyroid men had lower LDL-C, total cholesterol (TCH) and FG compared
227 CARDIO-METABOLIC COMPLICATIONS OF SUBCLINICAL HYPOTHYROIDISM IN WOMEN WITH METABOLIC SYNDROME V. Romanov, O. Mitchenko, I. Chulaevskaya, A. Logvinenko. Institution of Cardiology, Department of Dyslipidemia, Kiev, Ukraine Objective: A subclinical hypothyroidism(SH) is the independent factor of cardiovascular diseases for women over 50 years. Methods: 52 women with metabolic syndrom (MS) are surveyed 2 gr.: 1 gr. – 30 pts with MS and SH (thyrotropin (TSH) =8,2± 2,7 IU /ml, FT4 = 2,8±0,1 ng/ml); 2 gr. – 22 pts with MS (ÒSH = 2,1± 0,4 IU/ml, FT4 = 1,9±0,1 ng/ml). Were determined: waist circumference (WC), body mass index (BMI), levels of TSH, free T4, glucose, insulin, leptin and lipids. Results: patients of 1 gr. had authentically large displays of abdominal obesity (WC=102,1±3,4 sm) in comparison with 2 gr. (WC=88,2±2,4 sm) though BMI in both groups did not differ (31,1±1,5 and 33,1±1,5 kg/m2 accordingly).In 1-st group the greatest displays of hyperleptinemia (34,4±4,7) ng/ml were marked, that considerably exceeded norm and can testify to occurrence resistance to leptin. In both groups it were marked normative of glucose and HOMA-index, whereas increased of the cholesterol level (5,4±0,2d mmol/l), hypertriglyceridemia (2,8±0,2) mmol/l and decrease HDL cholesterol (1,0±0,1) mmol/l were marked only in 1-st group.The women of 1 gr. had increase the left ventricular mass index =
S105
Multiple Risk Factors in Cardiovascular Disease—Abstracts
122,9±4,4 g/m2 in comparison to the 2 gr. that testified to presence left ventricular hypertrophy (LVH). Conclusions: the manifestation of SH in women with MS associates with development of abdominal obesity, formation of resistance to leptin, most atherogenic dyslipidemia and prevalence of LVH. We have demonstrated an association between TSH levels with the development of MS and an increased cardiovascular risk in women with SH.
a similar difference was not ob-served for sdLDLC which was lowered by 46% after S&E and by 66% after F&F (p between treatments: n.s.). Conclusions: First: The relative lowering of sdLDL-C was more pronounced than the lowering of total LDL cholesterol after both drug combinations. We suggest that the determination of sdLDL-C yields additional and potentially important information which is independent of total LDL cholesterol.
Funding: none
Funding: none
228
229
THE LOWERING OF SMALL DENSE LDL IN PATIENTS WITH THE METABOLIC SYNDROME BY SIMVASTATIN/EZETIMIBE VERSUS FLUVASTATIN/ FENOFIBRATE S. Westphal1, C. Abletshauser2, K. Borucki1, H. Klima3, C. Luley1. 1Institute of Clinical Chemistry, Magdeburg, Germany, 2Novartis Pharma GmbH, Nuernberg, Germany, 3Roche Diagnostics GmbH, Penzberg, Germany
EXPRESSION OF ADIPONECTIN RECEPTORS IN SUBJECTS WITH IMPAIRED GLUCOSE HOMEOSTASIS – EFFECT OF ACUTE HYPERINSULINEAMIA AND 3-WEEK TELMISARTAN TREATMENT E. Krusinova1, K. Zidkova1, P. Wohl1, P. Mlejnek2, L. Kazdova1, M. Pravenec2, T. Pelikanova1. 1Institute for Clinical and Experimental Medicine, Prague, Czech Republic, 2Academy of Sciences of the Czech Republic, Prague, Czech Republic
Objective: An increased concentration of small dense LDL cholesterol (sdLDL-C) is considered as an emerging cardiovascular risk factor and is commonly encountered in subjects with the metabolic syndrome. Because sdLDL can now be readily quantified by means of a new precipitation method, the objective of this study was to investigate the sdLDL response to two different lipid lowering strategies. The first strategy was the combination of simvastatin with ezetimibe (S&E) The second drug combination was fluvastatin together with fenofibrate (F&F). Methods: To this end 21 patients with the metabolic syndrome were treated in a randomised placebo-controlled crossover study. S&E contained 20 mg simvastatin and 10 mg ezetimibe. F&F contained 80 mg fluvastatin and 200 mg micronized fenofibrate. Both were given once a day for 6 weeks. sdLDLC was determined by means of a new precipitation procedure by Roche Diagnostics. Results: The improvements of triglycerides and HDL cholesterol did not differ between treatments. Total LDL cholesterol, however, was lowered differentially: by 33% after S&E and by 21% after F&F (p between treatments = 0.019). Surprisingly,
S106
Objective: Regulation of adiponectin receptors R1 and R2 in adipose tissue is not clear. We aimed to assess adiponectin (AD) plasma concentrations and expressions of AD and its receptors in subcutaneous adipose tissue (SAT) in subjects with impaired glucose homeostasis (IGH) and to test the effect of hyperinsulinaemia (HI) and telmisartan on their expressions. Methods: 12 subjects with IGH were randomized in double blind cross-over study with 3-week telmisartan 160mg vs. placebo treatment. Each period was terminated by 2-hour hyperinsulinaemic euglycaemic clamp. AD plasma concentrations were measured at 0; 30; 120 min, biopsies of SAT were performed at 0; 30 min of each clamp to assess expressions of AD, R1, R2 using RT-PCR. Results: In IGH, R2 expression in SAT was 2.1 fold higher than R1. Positive correlations were found between expressions of AD and both R1 (p<0.01) and R2 (p<0.05) and between expressions of the receptors (p<0.01). Expressions of AD and R1 were not affected by HI or telmisartan, whereas R2 expression increased during both clamps (p<0.01). Basal plasma AD
statistical significance after controlling for age, BMI, total cholesterol, and creatinine (p=NS). The prevalence of MS increased gradually among groups according to the sex-specific UA quartiles. A multivariate linear regression analysis revealed that SUA level was not an independent variable affecting hfPWV or baPWV both in women and men. This suggests that higher SUA level is independently associated with MS particularly in women, but not with arterial stiffness in Korean subjects.
with euthyroid men (p-values <0.05). Hyperthyroid women had lower LDL-C, TCH and BMI compared with their euthyroid counterparts (p-values <0.05). TSH were correlated with waist circumference among males (r=0.24) and TG concentrations among females (r=0.15). Conclusion: Thyroid dysfunction was present among more than 40% of participants. Hyperthyroid participants had a better metabolic profile in this population than euthyroid participants. Further studies are needed to identify mechanisms behind this observation.
Funding: none Funding: This study was supported by an award from the NIH (T37¨CMD001449) 226 THYROID STIMULATING HORMONE AND COMPONENTS OF METABOLIC SYNDROME AMONG OUTPATIENT CARDIOVASCULAR PATIENTS IN GEORGIA N. Dolidze1, B. Gelaye2, D. Enquobahrie2,3, G. Chapidze1, M. A. Williams2. 1Emergency Cardiology Center, Tbilisi, Georgia, 2University of Washington, Seattle, WA, USA, 3Harvard University, Boston, MA, USA Objective: Thyroid dysfunction and metabolic syndrome (MetS) are associated with increased morbidity and mortality from cardiovascular (CV) diseases. MetS components and thyroid stimulating hormone (TSH) relationships were studied among CV patients. Methods: Male (N=112) and female (N=169) participants were recruited from an outpatient-clinic in Batumi, Georgia. MetS was defined using the Adult Treatment Panel III (ATP III) criteria as the presence of $3 of the following: (1) elevated blood pressure, (2) abdominal obesity, (3) reduced HDL-cholesterol (HDL-C), (4) elevated triglyceride (TG), and 5) elevated fasting glucose (FG). TSH was measured using an ELISA. Results: Females had higher TSH compared with males (mean TSH: 1.31 and 0.95 mg/dl, respectively). 38% of participants were hyperthyroid (46% males and 33% females) and 4% were hypothyroid (3% males and 4% females). Among males, MetS was less common among hyperthyroids compared with euthyroids (53% vs. 69%). Hyperthyroid men had lower LDL-C, total cholesterol (TCH) and FG compared
227 CARDIO-METABOLIC COMPLICATIONS OF SUBCLINICAL HYPOTHYROIDISM IN WOMEN WITH METABOLIC SYNDROME V. Romanov, O. Mitchenko, I. Chulaevskaya, A. Logvinenko. Institution of Cardiology, Department of Dyslipidemia, Kiev, Ukraine Objective: A subclinical hypothyroidism(SH) is the independent factor of cardiovascular diseases for women over 50 years. Methods: 52 women with metabolic syndrom (MS) are surveyed 2 gr.: 1 gr. – 30 pts with MS and SH (thyrotropin (TSH) =8,2± 2,7 IU /ml, FT4 = 2,8±0,1 ng/ml); 2 gr. – 22 pts with MS (ÒSH = 2,1± 0,4 IU/ml, FT4 = 1,9±0,1 ng/ml). Were determined: waist circumference (WC), body mass index (BMI), levels of TSH, free T4, glucose, insulin, leptin and lipids. Results: patients of 1 gr. had authentically large displays of abdominal obesity (WC=102,1±3,4 sm) in comparison with 2 gr. (WC=88,2±2,4 sm) though BMI in both groups did not differ (31,1±1,5 and 33,1±1,5 kg/m2 accordingly).In 1-st group the greatest displays of hyperleptinemia (34,4±4,7) ng/ml were marked, that considerably exceeded norm and can testify to occurrence resistance to leptin. In both groups it were marked normative of glucose and HOMA-index, whereas increased of the cholesterol level (5,4±0,2d mmol/l), hypertriglyceridemia (2,8±0,2) mmol/l and decrease HDL cholesterol (1,0±0,1) mmol/l were marked only in 1-st group.The women of 1 gr. had increase the left ventricular mass index =
S105
Multiple Risk Factors in Cardiovascular Disease—Abstracts
122,9±4,4 g/m2 in comparison to the 2 gr. that testified to presence left ventricular hypertrophy (LVH). Conclusions: the manifestation of SH in women with MS associates with development of abdominal obesity, formation of resistance to leptin, most atherogenic dyslipidemia and prevalence of LVH. We have demonstrated an association between TSH levels with the development of MS and an increased cardiovascular risk in women with SH.
a similar difference was not ob-served for sdLDLC which was lowered by 46% after S&E and by 66% after F&F (p between treatments: n.s.). Conclusions: First: The relative lowering of sdLDL-C was more pronounced than the lowering of total LDL cholesterol after both drug combinations. We suggest that the determination of sdLDL-C yields additional and potentially important information which is independent of total LDL cholesterol.
Funding: none
Funding: none
228
229
THE LOWERING OF SMALL DENSE LDL IN PATIENTS WITH THE METABOLIC SYNDROME BY SIMVASTATIN/EZETIMIBE VERSUS FLUVASTATIN/ FENOFIBRATE S. Westphal1, C. Abletshauser2, K. Borucki1, H. Klima3, C. Luley1. 1Institute of Clinical Chemistry, Magdeburg, Germany, 2Novartis Pharma GmbH, Nuernberg, Germany, 3Roche Diagnostics GmbH, Penzberg, Germany
EXPRESSION OF ADIPONECTIN RECEPTORS IN SUBJECTS WITH IMPAIRED GLUCOSE HOMEOSTASIS – EFFECT OF ACUTE HYPERINSULINEAMIA AND 3-WEEK TELMISARTAN TREATMENT E. Krusinova1, K. Zidkova1, P. Wohl1, P. Mlejnek2, L. Kazdova1, M. Pravenec2, T. Pelikanova1. 1Institute for Clinical and Experimental Medicine, Prague, Czech Republic, 2Academy of Sciences of the Czech Republic, Prague, Czech Republic
Objective: An increased concentration of small dense LDL cholesterol (sdLDL-C) is considered as an emerging cardiovascular risk factor and is commonly encountered in subjects with the metabolic syndrome. Because sdLDL can now be readily quantified by means of a new precipitation method, the objective of this study was to investigate the sdLDL response to two different lipid lowering strategies. The first strategy was the combination of simvastatin with ezetimibe (S&E) The second drug combination was fluvastatin together with fenofibrate (F&F). Methods: To this end 21 patients with the metabolic syndrome were treated in a randomised placebo-controlled crossover study. S&E contained 20 mg simvastatin and 10 mg ezetimibe. F&F contained 80 mg fluvastatin and 200 mg micronized fenofibrate. Both were given once a day for 6 weeks. sdLDLC was determined by means of a new precipitation procedure by Roche Diagnostics. Results: The improvements of triglycerides and HDL cholesterol did not differ between treatments. Total LDL cholesterol, however, was lowered differentially: by 33% after S&E and by 21% after F&F (p between treatments = 0.019). Surprisingly,
S106
Objective: Regulation of adiponectin receptors R1 and R2 in adipose tissue is not clear. We aimed to assess adiponectin (AD) plasma concentrations and expressions of AD and its receptors in subcutaneous adipose tissue (SAT) in subjects with impaired glucose homeostasis (IGH) and to test the effect of hyperinsulinaemia (HI) and telmisartan on their expressions. Methods: 12 subjects with IGH were randomized in double blind cross-over study with 3-week telmisartan 160mg vs. placebo treatment. Each period was terminated by 2-hour hyperinsulinaemic euglycaemic clamp. AD plasma concentrations were measured at 0; 30; 120 min, biopsies of SAT were performed at 0; 30 min of each clamp to assess expressions of AD, R1, R2 using RT-PCR. Results: In IGH, R2 expression in SAT was 2.1 fold higher than R1. Positive correlations were found between expressions of AD and both R1 (p<0.01) and R2 (p<0.05) and between expressions of the receptors (p<0.01). Expressions of AD and R1 were not affected by HI or telmisartan, whereas R2 expression increased during both clamps (p<0.01). Basal plasma AD