138 Tuesday June 27, 2000: Read by 7Ftle Abstracts

T: W7 Fatty Acids: The Link Between Insulin Resistance and Dyslipidaemia

Methods: This study is a cross-sectional one carried out in 1970 Isfabau population aged 30-69 years old. The data was gathered by measuring weight, height, waist and hip griths and also triglyceride (TG), HDL-C and total cholesterol by enzymatic methods and LDL-Cholesterol (LDL-C) by Friede- wald-Fredickson formula. The data was analyzed by stepwise multiregression and logestic tests.

mediated cholesterol transport system in hypertensive patients with abdominal obesity.

Results: Results show a signiliciant relation as 0.1, -0.21 and 0.28 of waist to hip ratio (WHR) with TG, HDL-C and LDL-C/HDL-C, respectively and also high TG/low HDL-C syndrom in high WHR is 3 times more than normal WHR (CI: 2.1-4.8). But there is no significant relation between this dyslipidemia and overall obesity.

) TuT8:W7 ) Prevalence of overweight and obesity in old people

F. Resta, S. Cavaliere, S. Cappetti, A. Innamorato. Dept. of Internal Medicine, Immunology and Infectious Diseases, Section of Geriatrics, University of Bari, Bari, Italy

Objective: The aim of this study was to evaluate the prevalence of overweight and obesity in a free-living old population.

Concl~~~ions: As central obesity, however, predisposes to high TG/low HDL-C syndrom, indepenent of overall level of obesity, it is necessary to control this kind of obesity in our society.

I TuT6 W7 Increased diurnal triglyceridemia in obese insulin resistant subjects is associated to abdominal fat

Methods: We studied 484 subjects (253 M, 231 F), aged 65-84 yr., randomly selected in Casamassima, a rural village of Southern Italy. The nutritional status was assessed with anthropometric variables (BMI, waist cir- cumference, and TSF), serum parameters (albumin, prealbumin, and ApoB), and Mini Nutritional Assessment (MNA).

C.J.M. Halkes, J.l?H. van Wijk, M. Castro Cabezas, D.W. Erkelens. Opts. of Intern. Med. Univ. Hosp. Utrecht, the Netherlands

Background: Metabolic ward studies have shown that abdominal obesity is linked to postprandial triglyceride (TG) metabolism in insulin resistance (IR). We evaluated whether this is also the case for diurnal triglyceridemia.

All

Healthy Hypertens. Diabetes

Underweight (BMI < 24)

15%

25% 10% 6%

NOllllal (2429)

45% 50%

43% 37%

Overweight

(29-34)

26% 20% 31% 36%

Obese P

(>34) (x2)

14% 5% 16% **

21% *** CAD 17% 49% 24% 10% NS Dementia 31% 41% 18% 10% NS

Methods: We compared diurnal capillary TG (TGc) profiles in 30 obese subjects (15 males, BMI 31.0 f 0.8 kg/m*, 47 f 2) with IR (fasting insulin 15.5 f 2.5 mu/L, glucose 6.7 f 0.5 mmol/L) to diurnal triglyceridemia in 30 age and sex matched lean controls (BMI 22.8 f 0.3 kg/m2) without IR (fasting insulin 7.2 f 0.4 mu/L, glucose 5.3 f 0.1 mmo/L). Subjects measured capillary TG on 3 different days, 6 times each day in an out-patient clinic setting. The diurnal TGc profile was calculated as area under the TGc curve (TGc-AUC) and as incremental area (dTGc-AUC). Food intake was recorded and fasting blood was drawn once at the start of the study.

PdiMNl

Comorbid. 29% 37% 29% 5% NS 15% 44% T/6 14% *

*** = P < o.cal5, ** = P < 0.001. * = P < 0.05

Results: Fasting plasma lipids in obese subjects were within normal limits albeit higher than in controls (TG: 1.8 f 0.5 vs 1.0 ZIG 0.1 mmol/L, p < 0.001, cholesterol: 5.5 & 0.2 vs 4.9 f 0.2 mmol/L, p < 0.05). TGc-AUC was elevated in obese subjects (34.6 f 2.9 vs 20.1 f 1.2 h.Mm, p < 0.001, and dTGc-AUC tended to be higher (7.9 f 1.2 vs 5.1 f 0.7 h.mM, p = 0.05). In obese subjects, TGc-AUC and dTGc-AUC were significantly correlated to fasting TGc (r = 0.85 and r = 0.68, respectively), HDL-C (r = -0.66 and r = -0.53) and waist-hip ratio (r = 0.57 and r = 0.72). but not to BMI or self-reported dietary energy intake. In controls, no associations were found with anthropometric parameters, but the best correlations for TGc-AUC and dTGc-AUC were found with fasting TGc (r = 0.88 and r = 0.40) and apo B (r = 0.46 and r = 0.41).

Results: The % prevalences of underweight, normal, overweight, and obese subjects (according to age-adjusted BMI) are shown; the groups of affected and comorbid patients are compared with the healthy group.

Conclusions: In old people, the prevalence of overweight and obesity is elevated in the hypertensive, diabetic, and comorbid patients, while the prevalence of underweight is high in the subjects affected with dementia and Parkinson.

Sponsored by ‘97 MURST-60% and ‘98/‘99 UNIBA grants.

I TuT9.W7 Effect of hezafibrate on relationship between insulin resistance and fatty acids

T. Onuma, S. Kato, N. Takayanagi, K. Abe, Y. Tanaka, R. Kawamori. Dept. of Internal Medicine, Juntendo University, Tokyo, Japan

Conclusion: Increased diurnal triglyceridemia in obese insulin resistant subjects is linked to abdominal obesity, which is in agreement with metabolic ward studies under strictly standardized conditions. We suggest that diurnal triglyceridemia may serve to study the effects of interventions on atherogenic profiles in obese subjects.

Objective: Insulin resistance (IR) is noticed to be an important risk for type 2 diabetes mellitus and atherosclerosis. Bezafibrate (BF) which improves serum lipid-abnormalities seemes to reduce IR. This study is performed to elucidate the effect of BF on the relationship between IR and serum fatty acids in patients with hypertriglyceridemia.

( TuT7.W7 Lipoprotein (a) levels in hypertensive patients with abdominal obesity

Methods: Thirteen patients with hypertriglyceridemia were given 200 mg of BF twice a day for two months. Fasting plasma glucose and insulin levels were measured and calculated HOMA index as an IR before and after the administration of BE Serum fatty acids composition was analysed by using gas-chromatography.

N. Shcheltsina, I. Ozerova, A. Olferiev, 0. Alexandrovich, N. Perova. National Research Center for Preventive Medicine, Moscow, Russia

Objective: To revealed whether serum lipoprotein (a) (Lp(a)) level associated with metabolic disturbances in hypertensive patients with abdominal obesity

(AG). Methods: Seventy hypertensive men aged 35-66 with AO: waist-to-hip

ratio > 0.9 (0.98 + 0.006) and body mass index 2 26 kg/m* (30.8 f 0.4) were included in this study. All patients were grouped according to serum Lp(a) levels: I group (n = 46) with Lp(a) ( 20 mg/dl(6.4 f 0.8). II group (n = 24) with Lp(a) > 20 mddl(65.2 f 8.6). Lp(a) levels were measured by “rocket” immunoelectrophoresis.

Results: Serum TG level was significantly decreased and HDL-C level was significantly increased after the administration of BE TC and free fatty acid levels were slightly but not significantly decreased. Fasting serum insulin and plasma glucose levels were decreased and HOMA index was significantly reduced after BF-administration. Percentage of miristic, linoleic, linolenic and icosenoic acids were significantly decreased and palmitoleic, y-linolenic, arachidic, 5-8-l 1 icosatrienoic, bishomo-y-linolenic, arachidonic, behenic, docosatetraenoic, lignoceric and docosahexaenoic acids were significantly increased after BF-administration. There was significantly positive correlation between the decrease in HOMA index and the decrease in percentage of icosadienoic acid.

Conclusions: These results indicate that the improvement of IR after BF- administration might not be closely associated with the change of serum lipids and fatty acids composition in hypertriglyderidemic patients.

Results: In both groups we obtained glucose/insulin ratio < 6.0 in 2 h post-glucose loading. Total C and LDL C mean vaiues were not different be- tween the two groups. Patients with high Lp(a) levels had lower concentration of Tg (139 vs 195 mg/dl, p < 0.01) and higher HDL C (46 vs 42 mg/dl, p = 0.05). Apo AI levels were similar in both groups, but at high Lp(a) HDL phospholipids (PL) were lower (76 vs 92, p < O.Ol), that was associated with higher HDLC/apo AI ratio (0.36 vs 0.33, p < 0.05) and HDL CYHDL PL ratio (0.64 vs 0.48, p < 0.05).

I TuTl O.W7 Waist to hip ratio as a marker of insulin resistance in healthy subjects

J.T. Real, I. Martinez-Us& P. Ascaso, A. Rodrigo, J.F. Ascaso, R. Carmena. Dpt. of Endocrinology and Nutrition, Hospital Clinic0 Universitario, University of Valencia, Spain

Conclusion: High Lp(a) level is associated with disturbances in HDL- Goals: Our objective was to analyze, in healthy subjects, the relationship of

XIIth International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000

Tuesday June 27, 2000: Read by litle Abstracts

i? W9 Geographic Epidemiology of Atherosclerosis 139

IR and other coronary risk factors with the waist to hip ratio (WHR) in order or = 160/95 mmHg) was 28.5% in men (59.1% of them treated, and 36.7% to identify a possible surrogate marker of IR. controlled), and 25.1% in women (66.9% txeated and 28.1% controlled). 15

Subjects: 30 healthy males, age 3&60 y, non-smokers and non-diabetics to 20% of individuals reported a CVD family history. For all these variables were studied. there were generally differences according to age, sex, and habitat.

Methods: WHR, Blood pressure, TC, TG, HDL-C, glucose and peripheral insulin sensitivity (Si) determined with the minimal model method.

Results: Subjects were divided into two groups: Si > 2 10e4 mU/l/min (No IR) and Si 5 2 10m4 mU/l/min (IR). Si 3.25 l 0.96 vs 1.24 f 0.48*;

Conclusions: Risk factors distributions and prevalences in Hellenic mid- dle-aged individuals rank relatively high. This suggest need of further study and control of them to address CVD prevention properly.

WHR BP To HDL-C FBG

on-IR (20) 0.94 * 0.04 127l74

R(10) 1.03 f 0.05 135/82

TG, HDL-C and FBO in mm&l. p -c 0.05

1.66 * 0.47 I.11 fO.16 5.08 zt 0.41 2.15 + 0.35 0.97 * 0.13 5.28 + 0.50

The Si index correlated with age (r-O.75 pO.OOO), WHR (r-O.76 pO.OOO), TG (r-O.57 p0.005). and BP (r-O.56 pO.006). The logistic regression analysis showed only significantly value (p 0.01) for WHR.

Conclusion: In healthy men subjects, the WHR can be used as a surrogate marker for IR and its associated cardiovascular risk factors.

T: Wt.4 GENE THERAPY AND OTHER NEW TREATMENTS

I TuTl W8 Reperfusion treatment for acute myocardial infarction

Chi Zhao, Shumin Chen, Hao Wang. Department of Cardiology, Dalian Central Hospital, Dalian, China

Objective: To compare outcomes of primary angioplasty with the intravenous urokinase and the intracoronary urokinase intervention for acute myocardial infarction (AMI).

Methods: 110 patients were followed: 1) 45 patients received direct angioplasty, 2) 45 patients were treated by intravenous thrombolysis, 3) 20 pa- tients were treated by intracoronary thrombolysis. Reperfusion rate, mortality, re-infarction rate, and left ventricular ejection fraction were monitored.

Results: The reperfusion rate (92.3%) in the direct angioplasty group was significantly higher than that in intravenous thrombolysis (63.6%) and intracoronruy tbrombolysis (63.2%) groups. The mortality and re-infarction rate in the former markedly lower than the other two groups. Compared with the intravenous and the intracoronary thrombolytic treatments, the patients received direct angioplasty showed higher left ventricular ejection fraction.

Conclusion: The present data suggest that direct angioplasty results in a reduction of short-term mortality and nonfatal reinfarction and therefore advocate the routine use of coronary angioplasty as a primary reperfusion strategy for acute myocardial infarction.

T: W9 GEOGRAPHIC EPIDEMIOLOGY OF ATHEROSCLEROSIS

I TuTl W9 An epidemiological study on cardiovascular risk factors in 35-64 years old Hellenic population

A.K. Zacharof, D. Dandakis, G. Chartzoulakis, G. Drakogiorgos, P. Paziouros, D. Lagoutari, D. Gkortzilas, H. Zacharof, L. Zacharof. 2& Department of Internal Medicine, Hellenic Red Cross Hospital, Athens, Greece

Objective: The purpose of this paper is to estimate the risk factors preva- lence and distribution by age, sex and habitat groups, i.e. tobacco smoking, cholesterolemia, high blood pressure, and obesity in the Hellenic population.

Methods: A random cluster sampling study, stratified by habitat, age and sex, was carried out in our Department on 3972 hospital&d men and women (54% men) of 35 to 64 years of age between 1986-1997. Definition criteria for variables studied were those from WHO and European Atherosclero- sis Society. Additional data for study were treatment and control level of hypertensives, and CVD family history.

Results: Mean cholesterolemia was 25 1.2 mg/dl (250.1 mg/dl in males and 261.9 mg/dl in females). Mean systolic blood pressure was 152.3 mmHg (153.4 and 141.6 mmHg in men and women, respectively). Current smokers were 49.4% of males and 16.7% of females (25.7% and 78.3% were never smokers, respectively). Prevalence of hypercholesterolemia (> or = 250 mg/dl) was 22.6% in men and 23.6% in women, and that of high blood pressure (>

I TuT2.W9 Lifestyle behaviours and coronary risk factors in adolescence

CA. Patemo. For the investigators of FRICELA Study (Factores de RIesgo Coronario En LA Adolescencia = conmary risk factors in adolescence): Society of Cardiology & Society of Pediatrics, Buenos Aires, Argentina

Objective: To know the prevalence of smoking, hypertension, byperc- holesterolemia, the associations among them, and with other variables in adolescence. Lifestyle, behaviours and coronary risk factors detected in the adolescence may result in cardiovascular risk factors in adulthood.

Methods: 2.599 teenager with no previous related desease, between 12 to 19 years, male and female, mean age: 15.07 f 1.87 years old, were studied from August 1994 to July 1997, with a specialized questionnaire pointed to knowing: physiological functions, daily and weekly tasks, recreation, toxic habits, familial history of coronary risk factors and coronary heart disease, and body parameters. An epidemiological, national and multicentric study was developped in 30 medical centres of 12 provinces and the Federal District.

Results: A multivariate analysis adjusted to other risk factors was made, taking into account results statistical significance.

Smoking was inversely associated with hours of study at home and posi- tively associated with nap, with parents smokers, and strongly associated with alcohol intake. Hypertension was directly associated with overweight, obesity; and family history of hypertension, and inversely associated with gym. Hyper- cholesterolemia showed a strong association with hypertension, furthermore, was associated positively with overweight, obesity; and sedentarism.

Conclusion: Lifestyle and behaviours changes (control of overweight, obesity and hypertension; avoidance of sedentarism, tabaquism and alcohol intake) should be performed in the adolescence, in order to reduce the incidence of coronary heart disease in adulthood.

I TuT3.W9 The risk profile of ablebodied Ukrainian male population as a factor of formation of national health Xl-years monitoring

I. Smvmova, 0. Kvasha, I. Gorbas, N. Davydenko, V. Volikov. Research Institute of Cardiology, Kyiv, Ukraine

Objective: The investigation of the risk profile dynamics in ablebodied male population during 20 years as a factor of formation of health.

Methods: Data are presented of 4 cross-sectional epidemiological studies of representative male samples of age 2c59 years executed at 5 years interval. Average number of population was 2ooO.

Results: The received data testify about: 1) the increase in specific gravity of persons with arterial hypertension in population on the whole (by 10.5%) is more vivid in the decades 40-49 (by 6.6%) and 50-59 (by 17.6%) years (p < 0.01); 2) the increase in prevalence of persons with atherogenic range of lipoproteids is more vivid in young decades 20-39 years (by 7.5 and 8.2% accordingly); 3) the stable prevalence of smoking (about 50% in population on the whole); 4) the part of persons without risk factors decreased as related to the age by 4 5; 6.3; 10.1; 2.2% correspondingly as a result of the growth in the associativeness of internal risk factors.

Conclusions: The result obtained not only allow to explain the increase of premature death of ablebodied age men in Ukraine also to point to the priority measures in elaboration of the strategy and policy of action in elaboration of cardiovascular diseases prevention in the health care reforming strategy of health service.

I TuT4.W9 Characteristics of patients with early-onset coronary disease and without smoking habits

A. Batalla’, G.I. Cubero2, J.J.R. Reguero2, S. Hevia2, E. Merino2, S. Braga’, E. Bustillo2, J.C. Sanmartin2, A. Cortina2. Department of Cardiology; ‘Hospital de Cabueries (Gijdn); 2Hospital Central de Asturias (Oviedo), Spain

Purpose: To determine common characteristics of patients under 50 years of age with coronary disease and without smoking habits.

XI&h International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000