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Background: The clinical value and the interrelationship of HDL and the metabolic syndrome were studied using plasma levels of TNF-α, IL 6, IL 10, IL 8, IL 1beta, IL 2R in patients with cardiovascular stenosis. Methods: On the basis of exclusion criteria, we recruited 198 male and female patients aged 45 to 75 years with CVD and 43 patients with MS. Patients were subdivided into %stenosis according to the CASS guidelines. Lipids were measured on an Olympus AU640 analyzer. Ox-LDL was measured by the immunosorbent assay and MDA by HPLC. Cytokines were analysed with DPC Immulite 1000. Statistical tests were performed using SPSS for Windows, 14.0 & Medcalc. Results: Ox-LDL and apoB were significantly higher in the MS(+) patient group (88.7 U/L) compared to the MS(-) group (77.5 U/L). Ox-LDL showed a positive correlation (P=0.001) with LDL-C, apoB and MDA. There was a higher concentration of HDL in the patient group MS(-), which was confirmed by a non-significant (P=0.849) change of apoA(I) from 1.267 g/L in the MS(+) to 1.275 g/L in the MS(-) group. A light significant increase of IL 10 (P=0.05) in MS(+) patients was observed, and the other analysed inflammation markers were mostly unchanged. MS has no direct association with the cytokine production. Conclusions: Ox-LDL and apoB were significantly higher in the MS(+) patient group. In a multiple regression analysis for ox-LDL, apoB (P=0.003) emerged as a strong predictor of the ox-LDL concentration, independent of age, gender, BMI and smoking.

Medical laboratories play a vital role in modern healthcare, and qualified specialists in Clinical Chemistry and Laboratory Medicine are essential for the pro vision of high-quality preanalytical, analytical and consultative services. Laboratory medicine has undergone major transformations during the last decade. Ongoing technological developments have considerably improved the productivity of clinical laboratories. Information on laboratory services is globally available, and clinical laboratories worldwide face international competition and there is a huge pressure to reduce costs. To be prepared for the future, clinical laboratories should enhance efficiency and reduce the cost increases by forming alliances and networks, consolidating, integrating or outsourcing, and more importantly create additional value by providing know ledge services related to in vitro diagnostics. Therefore, business models that increase efficiency such as horizontal and vertical integration are proposed, based on collaborative networks for the delivery of clinical laboratory services. Laboratories should cooperate, consolidate and form strategic alliances to enhance efficiency and reduce costs. There is a growing conflict between the science and the art of clinical practice and on the role of the biomedical sciences in medical practice. We have a dehumanizing effect on medical care. Disease is defined at the level of sick molecules and cells and curative medicine is being replaced by the preventive care of the disease. Undoubtedly all those questions will raise considerable problems and challenges for the medical educators.

The observation that obesity, dyslipidemia, diabetes and hypertension occur simultaneously in many people was first made by Crepaldi in 1967. In the late 1970s this clustering of conditions was termed "metabolic syndrome" by German researchers. Since then the syndrome has been described under a number of guises as "Insulin resistance syndrome", "Syndrome X", "Plurimetabolic syndrome" and the "Metabolic syndrome". The syndrome is a multi-component disease brought on by combination of lifestyle and environmental factors, with some populations exhibiting a genetic susceptibility for its development. Metabolic syndrome increases the risk of cardiovascular disease and type 2 diabetes. The National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) has recognized the metabolic syndrome as a cluster of abnormalities increasing the risk for both cardiovascular disease (CVD) and type 2 diabetes. The NCEP-ATP III guidelines have also underlined the central role of abdominal obesity in the development of this syndrome. The escalating prevalence of the syndrome has important health implications. Each component of the metabolic syndrome is an established cardiovascular disease risk factor, and the presence of multiple components confer greater risk than the sum of the risks associated with the individual ones. For instance, it has been shown that men with the simultaneous presence of fasting hyperinsulinemia, elevated apolipoprotein B concentration and an increased proportion of small LDL particles were characterized by a 20-fold increase in the risk for developing CVD over the 5-year follow-up period of the study, compared with men without this cluster of non-traditional risk markers. In addition, the risk of CVD associated with the atherogenic metabolic triad remained significant even after adjustment for traditional risk factors such as LDL-cholesterol, triglyceride and HDL-cholesterol levels. Risk assessment includes a list of biological parameters wherein lipids play an important role, especially triglycerides and HDL-particles. The traditional factors associated with the syndrome are obesity, insulin resistance, hyperglycemia, dyslipemia, hypertension and microalbuminuria. [ABSTRACT FROM AUTHOR]

The purpose of this study was to establish a relationship between self-association and phospholipid binding of the human and the baboon apoA-1 protein. The enthalpy changes on binding dimyristoyl lecithin and lysolecithin to etther the human or the baboon native apoA-I protein were measured in a microcalorimeter. An endothermal process, most pronounced for the human apoprotein, was observed at low phospholipid levels. At higher phospholipid to protein ratios the binding was exothermal. Gel filtration experiments on Sephadex G-200 showed that the native apoprotein of both species consists of dimers and tetramers. The baboon native apoA-I protein contained a higher amount of dimers. After preincubation of the apoA-I protein with lysolecithin, the enthalpy changes measured on subsequent binding of dimyristoyl lecithin were shifted towards more exotherrnal values compared to the curve for the native apoprotein. The amplitude of this shift corresponds to that of the endothermal process observed on binding dimyristoyl lecithin to the native apoprotein. This process was attributed to a phospholipid-induced disaggregation of the apoA-I protein. Gel filtration data showed a decreased extent of aggregation in the apoA-I protein preincubated with lysolecithin. This sample consisted exclusively of dimers. Ultracentrifugal flotation of the complexes formed between the apoA-I protein, and respectively dimyristoyl lecithin and spbingomyelin indicated that preincubation with lysolecithin increased the extent of complex formation. These results suggest that the dimeric form of the apoA-I protein possesses the highest affinity for phospholipids. Any dissociation of higher polymers enhances the phospholipid-binding capacity of the human and the baboon apoA-I protein. [ABSTRACT FROM AUTHOR]