Update on medical management of dyslipidemia and atherosclerosis.

Scientific achievements revealing the pathogenesis of atherosclerosis resulted in the second half of the 20th century in major improvement in prevention and therapy of cardiovascular disorders (CVD). Essential became the understanding of a critical pathogenetic role of the low-density lipoproteins (LDL), mainly their oxidized form (oxLDL) and also the protective potential of the high-density lipoproteins (HDL). CVD is now regarded to be an inflammatory disease in which a systemic inflammatory reaction is combined with an accumulation of immune cells in atherosclerotic plaques.

New promising potential in fighting atherosclerosis: HDL and reverse cholesterol transport.

Atherogenesis and cardiovascular disease (CVD) mortality remain an outstanding population health risk. Its importance grows with rising affluence leading to obesity in the developing countries. Inspite of an enormous initial enthusiasm related to the breakthrough success with the statins, there remains a substantial residual risk of CVD.

Type 2 diabetes mellitus, pandemic in 21st century.

In the second half of the 20th century it became obvious that a relentless increase in Type 2 diabetes mellitus (T2DM), affecting the economically affluent countries, is gradually afflicting also the developing world. This chapter shows the threat that the T2DM epidemic represents to mankind, with the astonishing recent discoveries on the role of obesity and of body fat in this metabolic disorder. Presently, the highest prevalence of T2DM is in Saudi Arabia.

Global prevalence and future of diabetes mellitus.

This chapter addresses the prevalence of diabetes mellitus (DM) in various countries according to geographic regions, as designated in an atlas publishedby the International Diabetes Federation in 2011. These include countries and territories in Europe, Africa, Middle East, North Africa, North America and Caribbean islands, South and Central America, South-East Asia and the Western Pacific Islands. Actual prevalence of DM (cases per 100 population) is expressed not only specifically for each individual country (national value) but more importantly, corrected by the population, age structure (comparative value) and also as an estimate of DM trend in 2030.

Women live longer than men.

In most parts of the world women live longer. This gender gap in life expectancy (LE) is remarkable and it has challenged scientific research for decades. Closer analysis of geographic differences related to such gender gap and attempts to recognize its cause may provide a powerful tool to understand the basic process of aging and to device preventive health care strategies.

Dramatic decline of ischaemic heart disease mortality in post communist central Europe: recovery from totality.

After 1970 the preexisting gap in population health between democratic Europe and communist countries became even more prominent. While in the democratic Europe there was a progressive rise in life expectancy associated with the decline in ischaemic heart disease (IHD), the trend on the other side of the iron curtain was exactly reverse. After the fall of communism in 1989 population health in the post-communist central Europe (CE) rapidly signalled a favourable recovery.

Plant polyphenols in prevention of heart disease.

Polyphenols (PPH) are a group of chemical substances found in plants, characterized by the presence of more than one phenol unit . The largest and best studied polyphenols are the flavonoids, which include several thousand compounds. PPH are the most abundant antioxidants in human diets.

Mediterranean diet and cardiovascular disease: the penalty for neglecting the benefit.

This brief review strongly suggests that the traditional mediterranean diet with its pyramid of nutrients, high fish consumption and an adequate physical activity is a desirable component of a life style model for the world being rapidly transformed by the effects of globalization (Fig. 1, Ref. 7).

Brown fat tissue - a potential target to combat obesity.

From the global population perspective, the epidemic of "globesity" (more than one billion adults being overweight) represents one of the largest public health problems (1). Traditional reasoning related to the dysbalance between caloric intake and energy expenditure does not provide a satisfying explanation for a complexfailure to combat obesity. The brown adipose tisue (BAT) has a unique chemical structure and a specific metabolic role.

Health differences between populations of the United States of America and the European Union.

This review documents health care outcome in relation to health expenditure in the US and in the European Union (EU) and it attempts to interpret the root cause of observed differences. In comparison with the US where the per capita expenditure for health care is close to 8,000 international dollars, health expenditure in the Western European Countries (WEC) (France, Germany, Britain, Italy) is approximately only half of that in the US. In the Central and Eastern European Countries (CEEC) it is 20 per cent or less of the US health care budget.

Enigmatic lipoprotein (a) and cardiovascular disease.

Lipoprotein (a), (LPA) consists of a low density lipoprotein (LDL)-like particle with a lipid core encircled by a large protein, the apo-B-100. A very large glycoprotein, the apoprotein (a) (apoA) is firmly linked to apo-B-100 by two covalent disulfide bonds. The metabolic role of LPA until very recently has been shrouded in mystery.

Garlic (Allium sativum L.) and cardiovascular diseases.

Garlic is an important component in the complementary and alternative medicine. Large segments of population believe in and utilize herbal products even when these have not been as thoroughly researched as garlic. Experimental and clinical studies confirm that the ancient experience with beneficial effects of garlic holds validity even in prevention of cardiovascular disorders and other metabolic ills.

Health of Europeans twenty years after the fall of Berlin wall.

The failure of central planning in the totalitarian systems of the USSR and its satellites adversely affected not only the economy and social relations but also the population health. While in the countries with established democracy (DEM) the general health and the life expectancy (LE) steadily improved, in countries declaring socialism (SOC) the LE was stagnant and in the USSR even decreased. Dramatic changes in Russia after the demise of Soviet Union resulted in an extraordinary destabilization of LE that reached a minimum in 1994.

Diabetes type 2 pandemic in 21st century.

In the second half of the 20th century it became obvious that a relentless increase in diabetes type 2 (DM) affecting the economically affluent countries, is gradually afflicting also the developing world. This review juxtaposes the threat that the DM epidemic represents to mankind, with the astonishing recent discoveries on the role of obesity and of the body fat in this metabolic disorder. Presently, the highest prevalence of DM is in Saudi Arabia, a country deep in riches generated by its oil wells.

Statins: the drugs for the 21st century?

This review summarizes the current evidence on beneficial effect of statins on the atherogenesis and the preventive potential of coenzyme Q 10 to avoid statin-induced myopathy. Statins, originally discovered in molds are the most effective medication to decrease the low-density cholesterol (LDL-C) which is the key participant in atherogenesis. Statins accomplish this by inhibiting the hydroxymethyl glutaryl coenzyme A reductase, an enzyme that is rate limiting for cholesterol biosynthesis.

Alcoholism: recent advances in epidemiology, biochemistry and genetics.

Countries traditionally consuming beer and wine have high alcohol consumption as compared to East Asia, where the fact of low alcoholism prevalence can be attributed to a defect in metabolic degradation of ethanol. Dependence on alcohol is multifactorial and is related to a complex interplay of metabolic, genetic, social and environmental factors. Repetitive alcohol ingestion and its resulting dependence is associated with false euphoria triggered by an inhibition of glutamate receptors and other brain neurotransmitters, namely dopamine and serotonine.

Paradoxes in medicine: an access to new knowledge?

The analysis of health and nutrition data from various countries shows many surprising and seemingly incomprehensible facts and paradoxical relationships. Health status of a country is the result of long-term factors and therefore it cannot be changed from day to day. For example in Central European countries there was a sudden increase in life expectancy after the fall of Soviet hegemony.

Vitamin D deficiency, atherosclerosis and cancer.

Abstract: Recently there has been intense interest to find if vitamin D deficiency may be related to cardiovascular disease, cancer and infection. Inadequate saturation with vitamin D may adversely affect immune and metabolic functions, causing non-skeletal medical disorders. Sunlight exposure induces vitamin D synthesis in the skin from a precursor, 7-dehydrocholesterol.

Adult obesity at the beginning of the 21st century: epidemiology, pathophysiology and health risk.

Obesity is defined as increased body weight caused by excessive accumulation of fat. Due to a very long period of undernutrition in human history, the contemporary human body regulation mechanisms seem to be biased in favor of preserving fat rather to eliminate it. At the highest risk are populations that suddenly gained wealth.

Ethanol and cardiovascular diseases: epidemiological, biochemical and clinical aspects.

The effects of alcoholic beverages on the cardiovascular system can take opposite forms, depending on how much of ethanol is consumed. The negative effects of alcoholism are well established. Alcoholism is a cause of cardiomyopathy, cardiac arrhythmias and hypertension.

Y-STR variation among Slavs: evidence for the Slavic homeland in the middle Dnieper basin.

A set of 18 Y-chromosomal microsatellite loci was analysed in 568 males from Poland, Slovakia and three regions of Belarus. The results were compared to data available for 2,937 Y chromosome samples from 20 other Slavic populations. Lack of relationship between linguistic, geographic and historical relations between Slavic populations and Y-short tandem repeat (STR) haplotype distribution was observed.

Cadmium blood concentrations in relation to nutrition.

Cadmium is a toxic element ubiquitous in the environment, which damages biological systems in various ways. The major source of cadmium exposure is food. High cadmium content in the soil leads to high cadmium concentrations in certain plants such as grains (above all surface layers and germs), oil or non-oil seeds, fruit and vegetables.

The relationship between micronuclei in human lymphocytes and selected micronutrients in vegetarians and non-vegetarians.

A vegetarian diet results in higher intake of vitamins and micronutrients, which - although providing antioxidant defence - may lead to deficiency in other micronutrients involved in DNA metabolism and stability (such as vitamins belonging to the B group). The principal difference among various vegetarian diets is the extent to which animal products are avoided. We have performed a pilot study to determine the relationship between the micronucleus frequency in lymphocytes and diet, and we compared the levels of Vitamins C and E, beta-carotene, B(12), folic acid, homocysteine and total antioxidant capacity in healthy vegetarians and non-vegetarians.

Possible involvement of XPA in repair of oxidative DNA damage deduced from analysis of damage, repair and genotype in a human population study.

Participants in a study of occupational exposure to mineral fibres in Slovakia were analysed for the polymorphism 23A-->G in the DNA repair gene XPA. Of the 388 subjects, 239 were exposed to asbestos, stonewool or glass fibre; the rest were unexposed controls. Levels of DNA base alterations (oxidation and alkylation) in lymphocytes were measured using the comet assay with lesion-specific endonucleases.