Featured IAS Commentaries
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are not a substitute or replacement for medical advice. If
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a physician or other medical professional. The views expressed
in these Commentaries are those of the authors and are not
necessarily those of IAS.
Metabolic Abnormalities and Prostate Pathologies: the Sub-Saharan African Experience
Author: Chukwunonso E.C.C. Ejike
Urbanization is taking place at different rates
in different parts of sub-Saharan Africa. This has resulted
in a change in the nature of jobs undertaken, foods eaten,
and available machines/energy-sparing devices in the region.
It has also resulted in a change in the disease pattern of
the region, with chronic diseases now competing with communicable
diseases for the often meager health budgets of the countries
in the region. This commentary discusses the diseases associated
with this urbanization-driven change in lifestyle – metabolic
abnormalities –, their rising prevalence with urbanization,
and their relationship with benign prostate hyperplasia (BPH)
and prostate cancer (PC).
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Association between TCF7L2 Polymorphism and Diabetes Mellitus,
Metabolic Syndrome, and Markers of Beta Cell Function and
Insulin Resistance
Authors: Hussein Saadi and Nicolaas Nagelkerke
Type 2 diabetes mellitus (DM) is one of the most
common chronic diseases and affects more than 6% of the world’s
population. The prevalence of DM is on the increase in many
parts of the world and has been estimated to reach 300 million
by the year 2025 [1]. This has been attributed to rising prevalence
of obesity due to an abundance of food and chronic lack of
exercise, acting on genetically susceptible individuals. Inevitably
this will lead to high rates of cardiovascular disease, stroke,
blindness, amputations, and other complications. However, not
all individuals are equally susceptible to diabetes under these
unfavorable environmental conditions. Differences in the genetic
make-up of people, and perhaps also differences in early-life
conditions, must account for this. Finding genes associated
with the development of diabetes potentially offers avenues
for screening, diagnostics, and therapeutics.
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Effect of Nitric Oxide on the Development of Vascular Calcification
Author: Yosuke Kanno
Vascular calcification occurs in many diseases,
including atherosclerosis, diabetes, and uremia [1-3]. Deposition
of calcification in arteries diminishes arterial wall elasticity,
obstructs blood flow, and can lead to heart attacks and stroke
[4]. The presence of calcium deposits in the vessel wall is
indicative of advanced atherosclerosis, and the extent of coronary
calcification adds independent prognostic significance to conventional
risk factors for coronary artery disease. Vascular calcification
is a major independent predictor of cardiovascular morbidity
and mortality [5].
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Can Serum Depletion in the Lower Zone of Extensively Thickened
Plaques in Aortas Initiate Calcification?
Author: Howard H.T. Hsu
The issue of pathological implications and the
underlying causes of arterial calcification remain enigmatic.
The possibility of vascular calcification exerting both beneficial
and/or detrimental
effects on atherosclerosis has been suggested. Doherty and
Detrano [1] proposed that
calcification may stabilize aortic walls weakened by the accumulation
of lipids and inflammatory
substances. Farb et al. [2] provided clinical observations
that advanced calcification can cause
the aortic walls to become brittle with subsequent ruptures.
Other significant clinical effects of
vascular calcification include myocardial infarction [3], failures
of bioprosthetic cardiac valves
[4], and hypertension resulting from inflexibility of the aortic
walls [5].
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ApoB/ApoA1 ratio and Subclinical
Atherosclerosis in a Cypriot Population
Authors:
Andrie Panayiotou, PhD,
Maura Griffin, MSc, DIC,
PhD,
Niki Georgiou, RN,
Dawn Bond, SRN,
Theodosis
Tyllis, MD, MSc., DIC,
Chrysa Chakouri, MD,
Charis
Fessas, MD,
Andrew Nicolaides, MS, FRCS
High concentrations of LDL cholesterol represent
a risk factor for atherosclerotic cardiovascular disease and
mortality [1]. However, they provide no information on other
lipoprotein particles or the atherogenetic ability of the LDL
particles. Apolipoprotein B (apoB) serum concentration is a
measure of the number of LDL, intermediate density lipoprotein,
and VLDL atherosclerotic particles [2] and studies have shown
that apoB is a better candidate risk parameter than non-HDL
cholesterol for identifying subgroups of individuals with elevated
cardiovascular risk [3] as well as predicting carotid intima-media
thickness (IMT) [4]. Apolipoprotein A-1 (apoA1) serum concentration
is a measure of HDL particle number [5]. Epidemiological studies
have shown that serum levels of HDL cholesterol and apoA-1
are inversely correlated with risk of CVD.
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Etiopathology of Atherosclerosis and Type 1 Juvenile Diabetes: Towards a Unifying
Hypothesis?
Authors: Petru Liuba, PhD, MD and Sture Sjöblad, MD, PhD
Type 1 diabetes (T1D) results from destruction
of insulin-producing (ß) cells in the pancreas. It typically
occurs in previously healthy children being one of the most
common childhood diseases. Intriguingly, the diabetes morbidity
continues to rise especially in Europe and USA but the causes
remain elusive [1].
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Pathobiology and Biomarkers of Atherosclerosis
Authors: René R. S. Packard, MD and Peter Libby, MD
Many individuals who experience myocardial infarction
have average or below-average cholesterol levels [1], which
underscores the need for novel strategies of risk stratification
[2]. The involvement of inflammation in all stages of atherosclerosis
[3] has stimulated the evaluation of inflammatory biomarkers
for cardiovascular risk prediction.
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An Approach to the Use
of Peri-Operative Statins to Decrease Cardiac Morbidity Associated
with Non-Cardiac Surgery
Author: B.M. Biccard
In anesthesiology there remains one small randomized
placebo-controlled trial of peri-operative statin therapy for
noncardiac surgery [1]. Recent systematic reviews considering
peri-operative statin therapy suggest that as the majority
of the data is observational, further prospective studies are
needed [2,3]. Adopting a standardized approach to peri-operative
statin use based on an interpretation of the current medical
and surgical data would therefore be desirable.
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