Allan Sniderman

..The Medusa Hypothesis puts forward a common pathophysiology for the complex and biologically diverse array of factors that have been associated with vascular disease...

..Accordingly, to understand the impact of any intervention on energy storage and release by adipocytes, the effects of both insulin and ASP must be taken into account...

..Getting it right means getting the target for therapy right, however. The article examines the criteria that should be used to make this choice...

..The second is to present a diagnostic algorithm for the apolipoprotein B100 dyslipidemias based on triglyceride and apoB...

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..0%. Thus, using the conventional cholesterol ratios rather than the apoB/apoA-I ratio results in frequent and substantial error in the estimation of the lipoprotein-related risk of vascular disease...

..The conclusion that follows, based on the evidence in hand, is that although these programs were appropriate at the time statins were introduced, they are not appropriate now...

..Measurment of apolipoprotein B is the key to diagnosis and such patients should be considered for statin therapy...

..In particular, there are few data on apoB levels in these patients. Moreover, most reports have focused on mean lipoprotein levels and consequently there is little information on the frequencies of the various dyslipidemic phenotypes...

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..They also point to physiologically important, although still only partially understood, metabolic relationships amongst hepatic apoB-100 secretion, cholesterol efflux, and bile acid synthesis...

..42, P = 0.004 and R = 0.48, P = 0.003) and Indian women (R = 0.46, P = 0.05 and R = 0.59, P = 0.01). CONCLUSION: Visfatin concentrations may be related to HDL metabolism in Asian Indian immigrants...

..The objective of this study was to demonstrate the additional information that can be acquired by comparing the major plasma lipids and apolipoproteins amongst adult male and female Swedes, Iranians and Americans...

..Rather, non-HDL-C appears to be an indirect way of estimating apoB. We argue that we should integrate the information from non-HDL-C and apoB for better risk assessment and a better target of therapy...

..Here, we review the diagnostic algorithm for apoB dyslipoproteinemias and provide, for the first time, a treatment plan on the basis of a reduction of atherogenic lipoprotein particles rather than plasma lipids...

..Canada has chosen to do so. What Europe and America decide remains to be seen...

..Therefore, the MS score provides a clinically useful index of MS severity and the associated atherosclerotic risk factor profile. It also correlates with the angiographic severity of CAD and its clinical complications...

..The conventional approach is restricted to a comparison of in-trial data. Although essential, this overlooks the issue as to which marker better identifies residual risk after any particular treatment regimen...

..The present article represents the 2009 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult...

..It also relates differences in body fat distribution to differences in the apoB/apoA-I ratio, providing at least part of the answer as to why South Asians may be at increased risk of vascular disease...

..It follows that definitive evidence supporting maximal lowering of LDL-C or maximal dose of statins is still lacking and guidelines, if they are to be evidence-based, should acknowledge this uncertainty...

..These examples establish that apoB and non-HDL-C are not clinical equivalents...

..This hypothesis may explain a variety of previously unanswered clinical puzzles such as the vulnerability of many peoples from South East Asia to the adverse metabolic consequences of obesity...

..Plasma ASP may be useful as a fasting variable that will provide additional information regarding ppTG and NEFA clearance...

..It suggests that the characteristics of the valve are more critical than the patient's level of LDL-C...

..Our objective was to develop a simple algorithm that could be applied in routine clinical practice to diagnose type III hyperlipoproteinemia based on plasma total cholesterol, triglyceride and apolipoprotein (Apo) B...

..Management of severe ischemic mitral regurgitation remains difficult with disappointing early and intermediate-term surgical results of valve repair...

..The key feature of this model of common complex disease is that it posits testable faults in definable metabolic pathways, which supply the genetic underpinning of the disorder...

..Our data suggest that apoB is a better candidate risk parameter than NHDLC for identifying a subgroup of individuals with or without MetS with elevated cardiovascular risk...

..Appreciating these distinctions should allow appropriate use of the apoB/apoA-I ratio as a simple, single, summary index of the lipoprotein-related risk of vascular disease...

..The strongest single lipoprotein-related risk factor was the apo-B/apo-A-I ratio. In conclusion, these results provide further confirmation of the importance of determining apo-B and apo-A-I in routine clinical practice...

..This may provide new insight into why apoB is a better predictor of vascular risk than LDLC...

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..It follows that correlation is not adequate as a sole judge of equivalence of laboratory parameters...

..CONCLUSIONS: The S323I variant may alter C5L2 function and might be one molecular basis contributing to familial combined hyperlipidemia...

..To examine the relationship between plasma triglycerides (TG) to HDL-cholesterol (HDL-C) or HDL apo A-I...

..However, aging-related post-maturation increases in adipose tissue mass also appear to contribute to an aggravation and/or modulation of this genetically determined apoB overproduction...

..Therefore, our objective is to elucidate how apolipoprotein B and apolipoprotein A-I amplify evidence of the interactions amongst metabolic syndrome, insulin resistance, abdominal obesity, and vascular risk...

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..In conclusion, it appears that not all of the effects of age are irreversible. therefore, outcomes with early prevention might be much more favorable than usually assumed...

..Moreover, we examined whether any lipids, lipoproteins or cholesterol ratios add significant predictive information beyond that provided by the apoB/apoA-I ratio...

..9 ml/h; ob/ob, 102 +/- 4.5 ml/h; p < 0.01; wild type, 144 +/- 8.9 ml/h). These results suggest that the ASP regulation of energy storage may influence energy expenditure and dynamic metabolic balance...

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..After ingestion of fat without glucose, the lack of insulin response may lead to C3-mediated peripheral FFA trapping, which probably serves as a backup system in case of insufficient or inefficient insulin-dependent FFA trapping...

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