Highlighted Articles - Atherosclerosis April 2015 Issue
27 April 2015
Using a cross-sectional analysis of 3976 participants from the Multi-Ethnic Study of Atherosclerosis (MESA), Al Rifai et al characterized the association of the metabolic conditions: non-alcoholic fatty liver disease (NAFLD), obesity and metabolic syndrome with increased inflammation and subclinical atherosclerosis. From their results they were able to conclude that NAFLD is independently associated with increased inflammation and coronary artery calcium (CAC) and that there is a graded association between obesity, metabolic syndrome and NAFLD with inflammation and CAC. Miname & Santos observe in their invited commentary, that Al Rifai et al’s findings reinforce the view that the liver may have additional and independent roles in atherogenesis. However, they highlight two significant limitations of this study, namely the cross sectional design and the fact that NAFLD stages were not identified, although clearly diagnosis of staging would be impractical in such a large cohort. They conclude that prospective studies will be needed to demonstrate an independent role of NAFLD as a marker of future cardiovascular disease.
Rizza et al outline the development of a RECPAM (Recursive Partitioning and Amalgamation) model to create a quantitative risk score based on ADAM17 (A Disintegrin and Metallo Protease Domain 17) substrates. Rizza and colleagues tested the ADAM-17 risk score on a cohort of 298 subjects, participating to the Athero-Vascular Diabetes (AVD) study and were able to reveal that increased ADAM-17 activity and/or expression was associated with severity or complications of atherosclerosis. In her invited commentary Marta Letizia Hribal discusses the method used by Rizza et al to generate the ADAM-17 risk score and points out that although this work has some limitations the results appear promising and may be employed to achieve a more accurate risk prediction in the future.
The review by Taskinen & Borén summarises recent advances in our understanding of the pathophysiology of diabetic dyslipidemia. It discusses the relationship between diabetes and cardiovascular disease, and the role of hepatic overproduction of large triglycerides-rich VLDL1 together with delayed clearance of triglycerides. The underlying mechanisms of diabetic dyslipidaemia described by the authors suggest that drugs specifically aimed at reducing triglycerides could provide efficient treatment.
Tompra et al explored the efficacy of upper extremity exercise training, in patients with intermittent claudication by performing a systematic review of the literature related to this topic. The analysis of findings from 6 randomized controlled trials suggests that upper extremity exercise is equally effective as lower extremity exercise.
Papers in this issue include: