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Lipid abnormalities as risk factors for cardiovascular disease in CAPD patients
Pre-conglz, ss. Delphi Posters
160
Comparison of Lypanor and Ztvcor efficiency in palients with ish,,:mlc heart desease under short coupe t 14 days) of lreatmenl. Tolal chtqeslerol (mmoHI
Tnglycendes High[ mmol:) ) density Iipoprotems (LDL) 0.
I
6.71±0.60
232±0.32
19.9±1.1
45.4±42
31.6±1.2
2
5.4S±0.57
1.34±0.23
26.3:t: 1.7
4-42±1.7
24.7±2.0
Medton¢
Lypanor
Ztx'or
Lowdensity hpoprolcins (LDL) **
Very Iowdensity lipt~prr, tcms (LDL) %
P
~0 I
<0.01
<0.01
>I}.5
<0.001
A
-18.3",
~.12.2°o
+6.4°0
-12°o
-6.q%
I
7.21±0.50
2.10+0.31
2711±15
42.2+26
2S.9~2.7
2
5.89±1) 41
1.92±[]. I I
26.3±2 1
4 0 8 ± I.S
29.9±2.3
p
<0.05
>0.5
>0.5
>0.5
>0.5
A
-18.3"o
-$6°*
-0.7%
+14%
+1.0%
T H E LONG T E R M EFFICACY OF T H E PREVENTION T R I A L PAVIA 45: A SIGNIFICANT REDUCTION O F THE MORTALITY RATE
We studied the prevalence of lipid disorders and of coronary artery disease and the main factors affecting plasma lipids in CAPD patients. The investigation comparised 40 adult CAPD patients and 50 nornml controls matched Ibr age, sex, race and bodu mass index. Mean values for plasma tipids were witl'dn normal limits in the dialysis group. Total cholesterol (6.15+0.88 vs. 5.16::i:0.19 mrnol/L) LDL-C (4.27+0.76 vs. 3.54+0.89 retool/L) and triglyceride (2.15+0.99 vs 1.59+0.61 mmol/L) were significantly increased in the CAPD patients (p < 0.01 ), whereas HDL-C (0.95+0.23 vs. 1.09+0.27 mmol/L) and Apo A were lower (p < 0.01). C/HDL-C (atherogenic index) was significantly higher 17.96 vs. 5.63) in the CAPD patients with coronary heart disease (p < 0.05}. Increased total cholesterol was observed in 37.5% and trigliceride in 32.5% of the CAPD patients. Age, duration of CAPD, body mass index, and plasma creatinine did not affect plasma lipids. The prevalence of coronary artery disease was 57.5% whill in control group 32% disorders are of predictive value. In conclusion. CAPD patients may be present with multiple lipid abnormalities. Lipid disorders are of predictive value for cardiovascular complications in CAPD patients. THE INCIDENCE OF T H Y R O I D FUNCTION A B N O R M A L I T I E S IN PATIENTS ATTENDING AN OUTPATIENT LIPID CLINIC
1. Richichi, B. Magnani 1 . Cardiology Dept. S. Matteo Ho,wital." IlL AA.
RR. Pavia, Italy
V. Tsimihodimos, H. Milionis, E. Bairaktari 1, C. Tzallas 1. G. Mihiadous. A. Katsaraki, E. Liberopoulos, M. Elisaf. Department qllnternal Medicmc.
The "Project Pavia 45" is a prospectic study for the prevention of Ischemic Cardiopathy addressed to the citiziens living in the city of Pavia from 10 years at least and born in 1941. The Project started in 1986 and finished in 1996. The cohorte so designed was followed for a period of 10 years and it was checked every two years or more frequently (6 months) belonging to the risk levels of each one of the partecipants. Each screening was performed by the compilation of an individual schedule containing all the risk factors collected, the ematochemicals parameters drawed out and the clinical and anamnestic rilevations. Every time, an ECG standard, a thoracic scopy and an oculistic examinations i.e. - Fundus oculi-. were performed. Every two years the participants were called by a wrinen convocation and the whole city was sensibilized throught public meeting {scientifics, culturals or of entertainment): in these occasions the data collected since then were elaborated and showed. At the end of the project we oberved that the main variables studied showed a trend that looks like what is reported in literature, but sometimes, we found the positive effect of the intervention trial. Blood pressure didn't increase in both sex: BMI increased slighhy in males, but it was not statistical significant. Total Cholesterol decreased in the males while increased in the females together with the decrease of HDL (the mean increase of cholesterolemia for both sexes during the 10 years was of 10 mg/dl). Triglycerides increased in more significant way in both sexes (about 15 mg/dl). Glicemia also increased of I8,2 mg/dt for both sexes accompained by a reduction o f sport. Drugs were token for hypertension ( 17. I%). for dyslipemia 14.5%) and for the diabetes (2A%). The ECG showed alterations of heart rythm [ 10.9%), of electric conduction ( 17.4%], aspecific alterations of ventricolar ripolarization in the 44.5% of the cohorte. A significant data that arose is that the percentage of smokers decreased of 9.2 points. The myocardial infarction incidence is very low in the studied group (1.5%); data are missing for the the remnants part of citizients of he same class of age that never came to the control. The difference in the general mortality is great and significant: the total deaths were 41 in the whole population: more in details, I1 (M. R.: 1.8%) died in the followed sample, while, in the other group, the mortality rate was of 10.7% (30). From the comparative analysis made in the U.S.S.L. of Pavia on the sudden death verified during the same 10 years, it has been highlited the decrease of sudden deaths and the increase of the hospitalization rate due to ischemic heart disease, pheraphs
I BioclwmistO' Lahoratm T, Medical School, University ol Ioannina, Ioannina, Greece
LIPID A B N O R M A L I T I E S AS RISK FACTORS FOR CARDIOVASCULAR DISEASE IN CAPD PATIENTS
R. Velffzkovi~:-Radovanovi6, M. Avramovi6, Z. Malobabi6, S. Kosti6, B. Miti~, V. Djordjevi~. Institute of NephroloKv and Haemodialysis.
Clinical center of Nig. Yugoslavia Cardiovascular disease is the leading cause of death in patients with endstage renal disease. Discorders of lipoprotein metabolism may have clinical implications as determinants of cardiovascular risk in uraemic patients on continuous ambulatory peritoneal dialysis (CAPD).
Thyroid
disorders are known to influence lipoprotein metabolism. In the current study we attempted to examine the incidence of thyroid function abnormalities in patients attending our outpatient lipid clinic. During the last two years 248 patients were admitted to our lipid clinic t'or the diagnosis, and management of dyslipidemia. In all cases, a detailed medical history was obtained and a thorough physical examination was perlbrmed with emphasis on the presence o f symptoms/signs indicative of underlying thyroid diseases. Besides lipid parameters, TSH and FT4 levels ,.,,'ere measured in a fasting blood sample. Seven female asymptomatic patients 12.8°o) had frank biochemical hypothyroidism, while II patients 19 female. 2 malel (4.4%~ had the so-called syndrome of subclinical hypothyroidism with TSH level,,, between 5.8-19 mU/L. Following restoration of a euthyroid state v,ith L - thyroxine therapy no significant changes in serum lipid parameters '.,.'ere observed in the whole group of patients with subclinical hypothyroidism. However, in 4 patients with marked TSH levels 1>12 mU/LI relatively small doses of L-thyroxine (75 lag/day) were followed by a significant improvement ofserum lipid profile. Interestingly. 3 patients exhibited clinical or subclinical hyperthyroidism which influenced serum lipid parameters as well as the effectiveness of hypolipidemic treatment. It is concluded that thyroid function abnormalities are relatively common in dyslipidemic patients attending a lipid clinic and could significantly affect the patients" lipid profile as well as the patients' management. INCIDENCE OF DYSLIPIDEMIA IN PATIENTS WITH SUBCLINICAL HYPOTHYROIDISM J. Haddad, A. Avramides, S. Delaroudis, Ch. Balaris, M Somali. E. Papadopoulou, M. Tzoiti, A. Papageorgiou. Department t¢l
Endocrinolog); Hippocration Ho.spital. Thessaloniki. Greece It is still unclear whether subclinical hypothyroidism is a biochemical syndrome or a disease with an increased risk for Coronary Heart Disease due to abnormalities in lipid metabolism. Purpose: The aim of our study was to compare the lipid profile of patients with subclinical hypothyroidism to that of normal subjects, and to analyze the individual lipid profile in such subjects. Patients and Methods: Fifty two patients (49 females and 3 malesL aged 1 5 ~ 0 (mean age 44) with subclinical hypothyroidism were studied. The diagnosis of subclinical hypothyroidism was confirmed by at least two measurements of TSH. Anti-Thyroid Antibodies were positive in 38 out o1 the 52 subjects. Fifty two age and sex-matched subjects from our outpatient department served as controls. They were examined for reasons other than dyslipidemia, and were free from active diseases or diseases which can interfere with lipoprotein metabolism. Results: A high incidence of dyslipidemia (increase in total and LDLcholesterol concentration) was seen in patients with subclinical hypothyroidism compared with matched controls (Table 1 and 11}. There was also positive relationship between the levels of TSH and the degree of dyslipidemia.
7tst EAS Congress and Satellite Symposia
160
Comparison of Lypanor and Ztvcor efficiency in palients with ish,,:mlc heart desease under short coupe t 14 days) of lreatmenl. Tolal chtqeslerol (mmoHI
Tnglycendes High[ mmol:) ) density Iipoprotems (LDL) 0.
I
6.71±0.60
232±0.32
19.9±1.1
45.4±42
31.6±1.2
2
5.4S±0.57
1.34±0.23
26.3:t: 1.7
4-42±1.7
24.7±2.0
Medton¢
Lypanor
Ztx'or
Lowdensity hpoprolcins (LDL) **
Very Iowdensity lipt~prr, tcms (LDL) %
P
~0 I
<0.01
<0.01
>I}.5
<0.001
A
-18.3",
~.12.2°o
+6.4°0
-12°o
-6.q%
I
7.21±0.50
2.10+0.31
2711±15
42.2+26
2S.9~2.7
2
5.89±1) 41
1.92±[]. I I
26.3±2 1
4 0 8 ± I.S
29.9±2.3
p
<0.05
>0.5
>0.5
>0.5
>0.5
A
-18.3"o
-$6°*
-0.7%
+14%
+1.0%
T H E LONG T E R M EFFICACY OF T H E PREVENTION T R I A L PAVIA 45: A SIGNIFICANT REDUCTION O F THE MORTALITY RATE
We studied the prevalence of lipid disorders and of coronary artery disease and the main factors affecting plasma lipids in CAPD patients. The investigation comparised 40 adult CAPD patients and 50 nornml controls matched Ibr age, sex, race and bodu mass index. Mean values for plasma tipids were witl'dn normal limits in the dialysis group. Total cholesterol (6.15+0.88 vs. 5.16::i:0.19 mrnol/L) LDL-C (4.27+0.76 vs. 3.54+0.89 retool/L) and triglyceride (2.15+0.99 vs 1.59+0.61 mmol/L) were significantly increased in the CAPD patients (p < 0.01 ), whereas HDL-C (0.95+0.23 vs. 1.09+0.27 mmol/L) and Apo A were lower (p < 0.01). C/HDL-C (atherogenic index) was significantly higher 17.96 vs. 5.63) in the CAPD patients with coronary heart disease (p < 0.05}. Increased total cholesterol was observed in 37.5% and trigliceride in 32.5% of the CAPD patients. Age, duration of CAPD, body mass index, and plasma creatinine did not affect plasma lipids. The prevalence of coronary artery disease was 57.5% whill in control group 32% disorders are of predictive value. In conclusion. CAPD patients may be present with multiple lipid abnormalities. Lipid disorders are of predictive value for cardiovascular complications in CAPD patients. THE INCIDENCE OF T H Y R O I D FUNCTION A B N O R M A L I T I E S IN PATIENTS ATTENDING AN OUTPATIENT LIPID CLINIC
1. Richichi, B. Magnani 1 . Cardiology Dept. S. Matteo Ho,wital." IlL AA.
RR. Pavia, Italy
V. Tsimihodimos, H. Milionis, E. Bairaktari 1, C. Tzallas 1. G. Mihiadous. A. Katsaraki, E. Liberopoulos, M. Elisaf. Department qllnternal Medicmc.
The "Project Pavia 45" is a prospectic study for the prevention of Ischemic Cardiopathy addressed to the citiziens living in the city of Pavia from 10 years at least and born in 1941. The Project started in 1986 and finished in 1996. The cohorte so designed was followed for a period of 10 years and it was checked every two years or more frequently (6 months) belonging to the risk levels of each one of the partecipants. Each screening was performed by the compilation of an individual schedule containing all the risk factors collected, the ematochemicals parameters drawed out and the clinical and anamnestic rilevations. Every time, an ECG standard, a thoracic scopy and an oculistic examinations i.e. - Fundus oculi-. were performed. Every two years the participants were called by a wrinen convocation and the whole city was sensibilized throught public meeting {scientifics, culturals or of entertainment): in these occasions the data collected since then were elaborated and showed. At the end of the project we oberved that the main variables studied showed a trend that looks like what is reported in literature, but sometimes, we found the positive effect of the intervention trial. Blood pressure didn't increase in both sex: BMI increased slighhy in males, but it was not statistical significant. Total Cholesterol decreased in the males while increased in the females together with the decrease of HDL (the mean increase of cholesterolemia for both sexes during the 10 years was of 10 mg/dl). Triglycerides increased in more significant way in both sexes (about 15 mg/dl). Glicemia also increased of I8,2 mg/dt for both sexes accompained by a reduction o f sport. Drugs were token for hypertension ( 17. I%). for dyslipemia 14.5%) and for the diabetes (2A%). The ECG showed alterations of heart rythm [ 10.9%), of electric conduction ( 17.4%], aspecific alterations of ventricolar ripolarization in the 44.5% of the cohorte. A significant data that arose is that the percentage of smokers decreased of 9.2 points. The myocardial infarction incidence is very low in the studied group (1.5%); data are missing for the the remnants part of citizients of he same class of age that never came to the control. The difference in the general mortality is great and significant: the total deaths were 41 in the whole population: more in details, I1 (M. R.: 1.8%) died in the followed sample, while, in the other group, the mortality rate was of 10.7% (30). From the comparative analysis made in the U.S.S.L. of Pavia on the sudden death verified during the same 10 years, it has been highlited the decrease of sudden deaths and the increase of the hospitalization rate due to ischemic heart disease, pheraphs
I BioclwmistO' Lahoratm T, Medical School, University ol Ioannina, Ioannina, Greece
LIPID A B N O R M A L I T I E S AS RISK FACTORS FOR CARDIOVASCULAR DISEASE IN CAPD PATIENTS
R. Velffzkovi~:-Radovanovi6, M. Avramovi6, Z. Malobabi6, S. Kosti6, B. Miti~, V. Djordjevi~. Institute of NephroloKv and Haemodialysis.
Clinical center of Nig. Yugoslavia Cardiovascular disease is the leading cause of death in patients with endstage renal disease. Discorders of lipoprotein metabolism may have clinical implications as determinants of cardiovascular risk in uraemic patients on continuous ambulatory peritoneal dialysis (CAPD).
Thyroid
disorders are known to influence lipoprotein metabolism. In the current study we attempted to examine the incidence of thyroid function abnormalities in patients attending our outpatient lipid clinic. During the last two years 248 patients were admitted to our lipid clinic t'or the diagnosis, and management of dyslipidemia. In all cases, a detailed medical history was obtained and a thorough physical examination was perlbrmed with emphasis on the presence o f symptoms/signs indicative of underlying thyroid diseases. Besides lipid parameters, TSH and FT4 levels ,.,,'ere measured in a fasting blood sample. Seven female asymptomatic patients 12.8°o) had frank biochemical hypothyroidism, while II patients 19 female. 2 malel (4.4%~ had the so-called syndrome of subclinical hypothyroidism with TSH level,,, between 5.8-19 mU/L. Following restoration of a euthyroid state v,ith L - thyroxine therapy no significant changes in serum lipid parameters '.,.'ere observed in the whole group of patients with subclinical hypothyroidism. However, in 4 patients with marked TSH levels 1>12 mU/LI relatively small doses of L-thyroxine (75 lag/day) were followed by a significant improvement ofserum lipid profile. Interestingly. 3 patients exhibited clinical or subclinical hyperthyroidism which influenced serum lipid parameters as well as the effectiveness of hypolipidemic treatment. It is concluded that thyroid function abnormalities are relatively common in dyslipidemic patients attending a lipid clinic and could significantly affect the patients" lipid profile as well as the patients' management. INCIDENCE OF DYSLIPIDEMIA IN PATIENTS WITH SUBCLINICAL HYPOTHYROIDISM J. Haddad, A. Avramides, S. Delaroudis, Ch. Balaris, M Somali. E. Papadopoulou, M. Tzoiti, A. Papageorgiou. Department t¢l
Endocrinolog); Hippocration Ho.spital. Thessaloniki. Greece It is still unclear whether subclinical hypothyroidism is a biochemical syndrome or a disease with an increased risk for Coronary Heart Disease due to abnormalities in lipid metabolism. Purpose: The aim of our study was to compare the lipid profile of patients with subclinical hypothyroidism to that of normal subjects, and to analyze the individual lipid profile in such subjects. Patients and Methods: Fifty two patients (49 females and 3 malesL aged 1 5 ~ 0 (mean age 44) with subclinical hypothyroidism were studied. The diagnosis of subclinical hypothyroidism was confirmed by at least two measurements of TSH. Anti-Thyroid Antibodies were positive in 38 out o1 the 52 subjects. Fifty two age and sex-matched subjects from our outpatient department served as controls. They were examined for reasons other than dyslipidemia, and were free from active diseases or diseases which can interfere with lipoprotein metabolism. Results: A high incidence of dyslipidemia (increase in total and LDLcholesterol concentration) was seen in patients with subclinical hypothyroidism compared with matched controls (Table 1 and 11}. There was also positive relationship between the levels of TSH and the degree of dyslipidemia.
7tst EAS Congress and Satellite Symposia