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Herein, we describe a method to produce yeast-laden hydrogel inks for the direct-write 3D printing of cuboidal lattices for immobilized whole-cell catalysis. A poly(alkyl glycidyl ether)-based triblock copolymer was designed to have three important features for this application: (1) a temperature response, which allowed for facile processing of the material; (2) a shear response, which facilitated the extrusion of the material through a nozzle; and (3) UV light induced polymerization, which enabled the post-extrusion chemical crosslinking of network chains, and the fabrication of robust printed objects. These three key stimuli responses were confirmed via rheometrical characterization. A genetically-engineered yeast strain with an upregulated α-factor production pathway was incorporated into the hydrogel ink and 3D printed. The immobilized yeast cells exhibited adequate viability of 87.5% within the hydrogel. The production of the upregulated α-factor was detected using a detecting yeast strain and quantified at 268 nM (s = 34.6 nM) over 72 h. The reusability of these bioreactors was demonstrated via immersion of the yeast-laden hydrogel lattice in fresh SC media and confirmed by the detection of similar amounts of upregulated α-factor at 259 nM (s = 45.1 nM). These yeast-laden materials represent an attractive opportunity for whole-cell catalysis of other high-value products in a sustainable and continuous manner.

Additive manufacturing allows three-dimensional printing of polymeric materials together with cells, creating living materials for applications in biomedical research and biotechnology. However, understanding the cellular phenotype within living materials is lacking and a key limitation for their wider application. Herein, we present an approach to characterize the cellular phenotype within living materials. We immobilized the budding yeast Saccharomyces cerevisiae in three different photocross-linkable triblock polymeric hydrogels containing F127-bis-urethane methacrylate, F127-dimethacrylate, or poly(alkyl glycidyl ether)-dimethacrylate. Using optical and scanning electron microscopy, we showed that hydrogels based on these polymers were stable under physiological conditions, but yeast colonies showed differences in the interaction within the living materials. We found that the physical confinement, imparted by compositional and structural properties of the hydrogels, impacted the cellular phenotype by reducing the size of cells in living materials compared with suspension cells. These properties also contributed to the differences in immobilization patterns, growth of colonies, and colony coatings. We observed that a composition-dependent degradation of polymers was likely possible by cells residing in the living materials. In conclusion, our investigation highlights the need for a holistic understanding of the cellular response within hydrogels to facilitate the synthesis of application-specific polymers and the design of advanced living materials in the future.

Additive manufacturing allows three-dimensional printing of polymeric materials together with cells, creating living materials for applications in biomedical research and biotechnology. However, an understanding of the cellular phenotype within living materials is lacking, which is a key limitation for their wider application. Herein, we present an approach to characterize the cellular phenotype within living materials. We immobilized the budding yeast Saccharomyces cerevisiae in three different photo-cross-linkable triblock polymeric hydrogels containing F127-bis-urethane methacrylate, F127-dimethacrylate, or poly(alkyl glycidyl ether)-dimethacrylate. Using optical and scanning electron microscopy, we showed that hydrogels based on these polymers were stable under physiological conditions, but yeast colonies showed differences in the interaction within the living materials. We found that the physical confinement, imparted by compositional and structural properties of the hydrogels, impacted the cellular phenotype by reducing the size of cells in living materials compared with suspension cells. These properties also contributed to the differences in immobilization patterns, growth of colonies, and colony coatings. We observed that a composition-dependent degradation of polymers was likely possible by cells residing in the living materials. In conclusion, our investigation highlights the need for a holistic understanding of the cellular response within hydrogels to facilitate the synthesis of application-specific polymers and the design of advanced living materials in the future.

Herein, we describe a yeast-laden hydrogel ink that can be printed using a direct-write 3D printer and used for the production of a peptide. A poly(alkyl glycidyl ether)-based triblock copolymer was synthesized and formulated as a hydrogel that was characterized via rheometry to evaluate the printability of the hydrogel ink. An engineered yeast strain with an upregulated α-factor production pathway was incorporated into the hydrogel ink and 3D printed. The immobilized yeast cells exhibited adequate viability of 87.5% within the hydrogel. The production of the up-regulated α- factor was detected using a detecting yeast strain and quantified at 268 nM (s = 34.6 nM) over 72 h. The reusability of these systems was demonstrated by immersion of the yeast-laden hydrogel lattice in fresh SC media and confirmed by the detection of similar amounts of up-regulated α-factor 259 nM (s = 45.1 nM). These yeast-laden materials represent an attractive opportunity for whole-cell catalysis of other high-value products in a sustainable and continuous manner.

Objective: To compare the costs of treating hypercholesterolaemic patients to a modified European Atherosclerosis Society low density lipoprotein cholesterol (LDL-C) target using atorvastatin, fluvastatin, pravastatin and simvastatin.

Delirium is a frequent cause of hospitalization in the elderly patient, and can be sustained by several factors, which are not always evident. In 1990 Blackburn and Dunn described a clinical picture characterized by the presence of acute urinary retention presenting as delirium, and named it "cystocerebral syndrome". In 1991 Liem and Carter advanced a possible pathophysiological explanation for this phenomenon, suggesting that adrenergic tension might increase in the central nervous system when micturition cannot occur at the usual threshold. The consequent increase in catecholamines level might produce delirium. We report the case of a very old subject with delirium and acute urinary retention, suggestive of the "cystocerebral syndrome", in order to call the attention of geriatricians to acute urinary retention as a possible precipitating factor of delirium.

Postmenopausal modification of the lipid profile plays a major role in the risk of ischemic heart disease. Lifestyle counseling and estrogen replacement therapy have all been proposed as first-line measures, but there is no agreement on the best way to treat climacteric dyslipidemia. Soybean-based diet seems particularly attractive in this context, given its cholesterol lowering potential, its hypothetical anticancerous effects and possible modification of climacteric symptoms.We evaluated the effect of 60 g isolated soy protein (ISP) daily on the lipid profile of 104 postmenopausal women (53.3 +/- 3.3 years) in a double-blind, parallel, placebo-controlled (caseinate) trial, as part of a broader assessment of the effect of ISP on climacteric symptomatology. Serum total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apo A-I, apo B and lipoprotein (a) were determined before and after a 12-week diet modification. Seventy-seven women completed the trial. Both soy and placebo determined a significant reduction in total cholesterol (-0.42 +/- 0.79 and -0.40 +/- 0.57 mmol/L) and LDL-cholesterol (-0.35 +/- 0.72 and -0.31 +/- 0.54 mmol/L), but only soy had a significant lowering effect on apo B and the LDL-cholesterol/HDL-cholesterol ratio (-6% and -8% from baseline respectively); lipoprotein (a) plasma levels were not significantly changed by either treatment. Forty-four women were dyslipidemic at baseline; those with increased LDL concentrations showed a somewhat greater improvement in their lipoprotein profile (LDL-cholesterol and apo B reduction) with soy rather than placebo. No further information emerged when the subjects were divided into three apo E phenotypes.We conclude that diet supplementation with 60 g ISP is slightly better than caseinate in favorably modifying the lipoprotein metabolism of postmenopausal women; this effect is more evident in hypercholesterolemic subjects.

Besides functional impairment, several factors have been associated with mortality in institutionalized older subjects, including advanced age, gender, comorbidity, and malnutrition. We investigated the possible association of a large number of factors, including functional, anthropometric, nutritional, metabolic, clinical, and demographic variables, with two-year all-cause mortality in a sample of 344 institutionalized older subjects (or = 65 years) without evidence of acute illness at the time of observation. Although a number of factors were associated with mortality risk, multivariate analysis showed that only severe disability (6 vs 0-1 lost ADL, O.R.: 3.37, C.I. 95%: 1.76-7.3) and low albumin levels (lowest vs highest tertile: O.R.: 3.0, C.I. 95%: 1.65-5.43) were independent predictors of outcome. Moreover, in the analysis stratified for degree of disability and albumin tertiles, we found a strong gradient in mortality risk with increasing disability and decreasing albumin levels. These results further support the value of these two simple parameters in identifying frail institutionalized older individuals.

In recent years, the use of benzodiazepines has been recognized as an independent risk factor for falls among the elderly. To evaluate the role of different types of benzodiazepines in determining falls in a hospitalized geriatric population, we conducted a prospective study among 7908 patients consecutively admitted in 58 clinical centers of the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA), during an 8-month observation period (1991 and 1993). Over 70% of the patients were older than 65 years, 50% were women, and 23. 6% had a benzodiazepine prescription during hospital stay. The number of patients who experienced one or more falls during follow-up was 174 (2.2%). Sixty falls occurred among patients taking benzodiazepines (3.2%) and 114 (1.9%) among those who did not use benzodiazepines; the crude odds ratio for users versus non-users was 1.7 (95% CI 1.2-2.3). Multivariate logistic regression analysis showed that benzodiazepines with very short (OR 1.9; CI 1.03-3.3) and short half-life (OR 1.8; CI 1.2-2.8) were positively associated with falls during hospital stay. Patients who used other psychotropic agents (OR 2.3; CI 1.7-3.4), antidiabetic agents (OR 1. 5; CI 1.03-2.2), patients with presence of cognitive impairment (OR 1.6; CI 1.08-2.3), high level of comorbidity (OR 1.7; CI 1.05-2.9), more advanced age (80 years, OR 2.7; CI 1.5-4.7) and those who stayed in the hospital for 17 days or more (OR 2.1; CI 1.4-3.3) were also at a greater risk. These findings suggest that benzodiazepines with short and very short half-life are an important and independent risk factor for falls and their prescription to elderly hospitalized patients should be carefully evaluated.

Objectives - Paraoxonase, angiotensin-converting enzyme (ACE), methylenetetrahydrofolate reductase (MTHFR), and apo E gene polymorphisms were evaluated in older patients with vascular dementia (VD) or late-onset Alzheimer's disease (LOAD). Material and methods - Sixty patients with VD, 45 patients with LOAD, and 54 non-demented controls were compared. Results - No differences in the distribution of paraoxonase, ACE, and MTHFR polymorphisms were found. The overall frequency of apo E ε4 allele was "low"; ε4 allele was more frequent in LOAD (17.5%) and VD (13.3%) compared with controls (9.2%), but the difference was not statistically significant. Conclusion - Paraoxonase, ACE, and MTHFR polymorphisms were not associated with VD or LOAD; these common polymorphisms might have a marginal role in the pathogenesis of dementia in older subjects. In spite of a "low" frequency of the apo E ε4 allele in our sample, the frequency of ε4 allele was about double in LOAD compared with controls.

Impaired triglyceride-rich lipoprotein metabolism is most probably related to an enhanced cardiovascular risk, and may be associated with a pro-coagulant state. A double-blind, randomized study was undertaken to evaluate two widely utilized hypolipidemic drugs in the post-prandial phase and their impact on lipid, coagulation and fibrinolytic parameters.Thirty middle-aged men selected according to their low density lipoprotein-cholesterol (LDL-C)or = 160 andor = 240 mg/dl and borderline hypertriglyceridemia (110-220 mg/dl) after at least one month of a lipid-lowering diet received gemfibrozil (600 mg bid) or simvastatin (20 mg qd) and the corresponding placebo. On enrollment and after 2 months of drug treatment, they were tested with a standard oral fat load (OFL) (35 g fat/m2 body surface). On both occasions plasma total-cholesterol, LDL-C, HDL-C, triglycerides, lipoprotein[a] (Lp[a]), tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), antithrombin-III (AT-III), plasminogen and fibrinogen were determined just before the meal (t0) and at times 2 hours, 4 h, 6 h, 8 h after it (t2-t8). A two-factor (time and visit) multivariate analysis for repeated measurements was performed to evaluate the data. Total cholesterol, and LDL-C were significantly diminished 2 months after both gemfibrozil and simvastatin, the latter being more active. Plasma triglycerides showed a marked reduction with gemfibrozil at all times, while simvastatin regimen yielded only minor modifications. HDL-C was only slightly increased by simvastatin; Lp[a] plasma levels were almost unaffected. Small fibrinogen (t0, t2, t6, t8), PAI-1 (t6) and AT III (t0-t8) increases were observed after gemfibrozil, while simvastatin did not significantly modify these parameters.In the post-prandial phase, gemfibrozil and simvastatin induce different metabolic effects that beneficially influence the lipid pattern, whereas fibrinolytic and coagulative parameters display minor variations of undetermined significance.

Several factors, such as disability, malnutrition, weight loss, and the interactive effect of diseases and aging have been associated with morbidity and mortality in the elderly population. Nevertheless, the relationship between disability and biological parameters has not been extensively investigated as a primary focus. In a cross sectional survey, 344 institutionalized elderly subjects were evaluated. Disability was measured according to the Katz index, and patients were divided into three groups: low (0-1 lost ADL), mild (2-4 lost ADL), and severe (5-6 lost ADL). Anthropometric, metabolic, and nutritional parameters were assessed; age, gender, number of pathologies, and number of drugs were also recorded. Data were analyzed by multiple comparison of means according to Scheffé, and by multivariate logistic regression analysis. An impairment in functional status was associated with several modifications in biological parameters. Logistic regression analysis showed that severe disability (5-6 lost ADL) was associated with low waist/hip ratio (0.9 vs0.9, OR: 1.56, CI 95%: 1.08-2.25), high body resistance (625 vs575 omega, OR: 1.39, CI 95%: 1.38-1.39), low plasma albumin levels (3.5 vs4.0 g/dL, OR: 6.02, CI 95%: 5.18-6.85), and low plasma transferrin levels (200 vs250 mg/dL, OR: 5.47, CI 95%: 4.56-4.58) independently of age, gender, comorbidity, and other confounding factors. Our results indicate that severe disability in ADL is strongly associated with anthropometric and biohumoral parameters suggesting the presence of malnutrition. A careful evaluation of the nutritional state appears to be of primary importance, and efforts to improve nutritional status are needed in approaching disabled elderly patients.

Several studies have shown that insulin resistance and hyperinsulinemia are associated with many metabolic disorders predisposing to coronary heart disease (CHD). This syndrome has been termed syndrome X. However, it is not completely known whether these relationships are still present in the elderly, or whether other factors such as age, gender, and body fat distribution modulate them. Therefore, we investigated the relationship between fasting plasma insulin, total and regional adiposity, fasting plasma glucose and lipids, plasma plasminogen activator inhibitor-1 (PAI-1), fibrinogen, and coagulation factor VII in a sample of 100 healthy free-living octogenarians-nonagenarians (52 men and 48 women) who were disability-free according to the Katz index. By univariate analysis, fasting insulin correlated positively with all anthropometric measures except the waist to hip ratio (WHR) in women. There was a positive correlation between fasting insulin and fasting glucose (r=.40, P.01), plasma triglycerides ([TGs] r=.21, P.05), and PAI-1 levels (r=.33, P.01), whereas a negative relation was found with high-density lipoprotein cholesterol (HDL-C) and apolipoprotein, A-I (apo A-I) levels (r=-.22 and =-.24, respectively, P.05). These relationships were weaker and less significant in women. In pooled data, stepwise multiple regression analysis showed an independent relationship of both the body mass index (BMI) and fasting insulin level with TGs (R2=.14), while gender and fasting insulin were the best predictors of HDL-C variance (R2=.17). Furthermore, fasting insulin was the only variable independently related to PAI-1 (R2=.12). Our findings support the existence of a metabolic syndrome even in very old age by showing that high insulin levels are related to various metabolic and hemostatic disorders.

Hypothyroidism is a frequent cause of hyperlipidemia, particularly in women, but its true prevalence, both in the general population and in dyslipidemic subjects, is unknown. It is uncertain if low thyroid function significantly influence HDL metabolism and if sub-clinical disease may cause metabolic abnormalities and increase cardiovascular risk.Three-hundred and three consecutive female patients (mean age 59.2 +/- 0.5 yrs), observed in a metabolic ward because of dyslipidemia, were evaluated.Forty-three women (14.1% of the total) showed sub-clinical hypothyroidism, while in 12 cases (4.0%) overt hypothyroidism was diagnosed; 8 further women (2.6%) had been previously diagnosed to be hypothyroid and were under hormone replacement therapy. On the whole, hypothyroid patients showed higher mean triglyceride levels and lower HDL-cholesterol than dyslipidemic euthyroid women, but the difference did not reach statistical significance. Total cholesterol concentration did not change with impaired thyroid function. Hypothyroid patients reported a clinical history of cardiovascular disease, or had severe atherosclerosis demonstrated, more often than euthyroid subjects (25.0% vs 19.7%, p = n.s.). When only women with arterial disease were considered, HDL plasma levels were significantly lower in the hypothyroid than in the euthyroid group (44.3 +/- 3.1 vs 56.2 +/- 1.7 mg/dl, respectively; p0.01). Hypertriglyceridemia and obesity often coexisted.In conclusion, among dyslipidemic women, unrecognised hypothyroidism is highly prevalent (both sub-clinical and manifest). In hypothyroid subjects atherosclerosis seem to associate with particularly low HDL plasma levels. This might precede atherosclerosis development (reinforced by concomitant thyroid failure) and represent a marker of the polymetabolic syndrome.

Aging is frequently associated with a deterioration in health and functional status, which often induces important modifications in several biological parameters, including plasma lipids; as a consequence, the real "meaning" of lipoprotein parameters in old individuals is complex. A cross sectional study was carried out in order to investigate the lipoprotein profile in very old individuals with or without disability, and evaluate the possible influence of other biological variables on plasma lipids. One hundred selected healthy free-living (FL) and 62 disabled (DIS) subjects aged over 80 were enrolled; 91 healthy adults matched for origin were included as controls. Lipoprotein profile [total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, apoprotein A-I and B], anthropometric parameters, and ADL were measured. The FL octo-nonagenarians featured higher HDL-cholesterol levels than adult controls. DIS octo-nonagenarians showed lower total and HDL-C levels than FL. Discriminant analysis indicated that HDL-cholesterol and apoprotein A-I, but not total cholesterol, strongly discriminated between FL and DIS octo-nonagenarians. Multivariate analysis demonstrated that the waist/hip ratio, an index of visceral adiposity, was negatively associated with HDL-C levels in FL, but not in DIS elderly. We conclude that: 1) in very old individuals, the absence or presence of disability is strongly associated with high or low HDL-cholesterol values, respectively; 2) HDL-C and apo A-I are the parameters which better discriminate between FL and DIS octo-nonagenarians; and 3) the differences in HDL-C levels between FL and DIS are not due to modifications in anthropometric parameters. Prospective studies are needed to better understand the relationship between high-density lipoprotein levels, disability and aging.

Several studies have shown that insulin resistance and hyperinsulinemia are associated with many metabolic disorders predisposing to coronary heart disease (CHD). This syndrome has been termed syndrome X. However, it is not completely known whether these relationships are still present in the elderly, or whether other factors such as age, gender, and body fat distribution modulate them. Therefore, we investigated the relationship between fasting plasma insulin, total and regional adiposity, fasting plasma glucose and lipids, plasma plasminogen activator inhibitor-1 (PAI-1), fibrinogen, and coagulation factor VII in a sample of 100 healthy free-living octogenarians-nonagenarians (52 men and 48 women) who were disability-free according to the Katz index. By univariate analysis, fasting insulin correlated positively with all anthropometric measures except the waist to hip ratio (WHR) in women. There was a positive correlation between fasting insulin and fasting glucose ( r = .40, P r = .21, P r = .33, P r = −.22 and r = −.24, respectively, P R 2 = .14), while gender and fasting insulin were the best predictors of HDL-C variance ( R 2 = .17). Furthermore, fasting insulin was the only variable independently related to PAI-1 ( R 2 = .12). Our findings support the existence of a metabolic syndrome even in very old age by showing that high insulin levels are related to various metabolic and hemostatic disorders.

To compare lipoprotein profile, body composition and diet in a sample of athletes practicing mixed and anaerobic sports activities, and in a group of sedentary controls.Cross selectional study.Twenty professional soccer players (mixed trained), twenty body builders (anaerobic trained) and twenty sedentary subjects, all males and matched for age were studied.No significant differences in total serum cholesterol, triglycerides, HDL-C, LDL-C, apolipoprotein A-I, A-II, B, C-II, C-III, and E levels were found when the three groups were compared. Bioelectrical impendance analysis disclosed significantly lower body fat percentages in both groups of athletes, and increased fat free mass only in body builders. Daily calorie intake was higher, and alcohol intake was lower in the athletes, compared with controls. Body builders had lower carbohydrate, and higher protein and cholesterol intakes, while soccer players had a lower polyunsaturated to saturated fat ratio. None of the apolipoproteins examined was correlated with any body composition of diet parameters. No correlations between lipid parameters and anthropometric or dietary variables were found by multivariate analysis when the subjects were considered as a whole.Our data suggest that in healthy lean normolipemic males, the lipoprotein profile is not modified by mixed or anaerobic sport activities and the respective modifications in body composition and diet.

It has recently been proposed that increased oxidative stress may play a role in the aging process and age-associated degenerative diseases.A cross-sectional study was carried out to assess the relationship of circulating antioxidants, namely vitamins E and C, beta-carotene, proteic thiols (P-SH) and ceruloplasmin, and of lipid peroxides, with both aging and aging with disability, i.e., unsuccessful aging.One hundred healthy free living and 62 disabled octo-nonagenarians and 91 healthy adults were enrolled in the study.Free living and disabled older adults had lower antioxidant and higher lipid peroxide levels than healthy adults, as well as the disabled older adults compared with free living older persons. Using logistic regression, we observed that plasma concentrations of vitamins E and C, P-SH, and lipid peroxides were independently associated with either aging or aging with disability, apparently representing biochemical indicators of patient status. In particular, aging and unsuccessful aging were associated with higher levels of lipid peroxides independently of circulating levels of vitamins C and E, suggesting that the increased oxidative stress was not merely an effect of a lower dietary intake of antioxidants. Serum ceruloplasmin was significantly higher in free living older adults than in healthy adults, and in the disabled compared with free living octo-nonagenarians.Our findings are consistent with the presence of systemic oxidant load in older adults, and this phenomenon is far more evident in unsuccessful aging.

Cardiovascular diseases are the leading cause of disability and mortality in western countries. Lipoprotein(a) [Lp(a)] is now considered an independent risk factor for atherosclerosis, and might consequently be related to longevity and/or disability. In the context of a study on metabolic and anthropometric parameters in a sample of Italian octo-nonagenarians, Lp(a) and apo(a) isoforms were evaluated. One-hundred and fifty Italian octo-nonagenarians were classified as free-living or disabled, according to Katz's index, and compared to 91 healthy control adults. All the study subjects were recruited from a valley (Val Vibrata valley) near Teramo, in the central part of Italy. The median Lp(a) concentration of the whole group was 17 mg/dL (range 1-161 mg/dL), which is much higher than the values observed in Caucasian populations. No differences were detected between the octo-nonagenarian group (median 16 mg/dL, range 1-126 mg/dL) and the control group (median 19.5 mg/dL, range 1-161 mg/dL), nor between the free-living and the disabled groups. Apo(a) isoforms were similarly distributed among free-living, disabled and control subjects. While our findings suggest that Lp(a) plasma levels and apo(a) isoforms are not factors associated with longevity or disability, we cannot exclude that the low incidence of other major risk factors for atherosclerosis in our free-living octo-nonagenarians hampered the full expression of the lipoprotein(a) atherogenic potential, and thus allowed the achievement of a very old age in a good healthy status, even in carriers of high Lp(a) levels or small apo(a) isoforms.

The plasma apolipoprotein concentration furnishes information about the characteristics of the lipoprotein particles transporting them. For example, three main HDL types were characterized on the basis of the constituent apolipoproteins: those containing only apo AI, those containing apo AI and apo AII, and those rich in apo E. The HDL containing only apo AI are preferentially distributed in the HDL2 density range (1.064–1.125g/ml); 4 polypeptides of apo AI go into the constitution of the complex HDL macromolecule. Particles made up of apo AI and apo AII contain 2 polypeptides of each apolipoprotein, and are distributed mainly among the HDL3 (1.125–1.250 g/ml). HDL rich in apo E appear less dense than the HDL2, and even if they are considered important from a metabolic point of view, they are not assayable by common laboratory techniques (Scriver et al 1989, Eisenberg 1984).

To determine the effects of different types of physical training on lipid metabolism, serum lipids, lipoprotein cholesterol, apoproteins A-I and B, hepatic (HTGL), extrahepatic (LPL) and total (PHLA) post-heparin lipoprotein lipase activities were studied in elite athletes engaged in aerobic ("B", no. 13), anaerobic ("C", no. 17) and mixed ("D", no. 9) training programs and in a group of sedentary controls ("A", no. 15). In the aerobic and mixed groups serum triglycerides were significantly lower compared to sedentary controls while total serum cholesterol and LDL cholesterol, as well as serum apoprotein B levels were only slightly lower. HDL cholesterol and HDL2 cholesterol were slightly higher while serum cholesterol/HDL cholesterol (2.89 +/- 0.37 vs 3.6 +/- 0.47, p less than 0.01) and LDL cholesterol/HDL cholesterol (1.69 +/- 0.38 vs 2.23 +/- 0.43, p less than 0.05) ratios were significantly lower only in aerobic athletes compared to the control group. PHLA and LPL activities were slightly higher in the aerobic group than in controls, while PHLA and HTGL were significantly lower in aerobic and mixed athletes. No significant correlations were found between HDL cholesterol and energy expenditure during training, indexes of adipose mass or lipolytic enzyme activities. The results of this cross-sectional study seem to indicate that specialized training programs have a different effect on lipoprotein pattern and lipolytic enzyme activities, and only aerobic exercise has a potentially antiatherogenic effect.

Serum levels of lipids, lipoproteins and apolipoproteins A-I and B were evaluated in 102 patients (75 males and 27 females; ages 58 +/- 8 and 61 +/- 7 years (mean +/- SD), respectively) with arteriosclerosis of the lower limbs of supra-aortic trunks. Compared to findings in 64 healthy, age-matched control subjects, male patients in both groups had significantly higher serum triglyceride levels (+42%, P less than 0.05), while female patients with lower limb arteriosclerosis showed significantly increased cholesterol and triglyceride concentrations (+19%, P less than 0.01 and +82%, P less than 0.05, respectively). LDL-triglycerides were also increased in all patients. HDL-cholesterol was significantly decreased in male patients with arteriosclerosis of the lower limbs (-27%, P less than 0.01) and the supra-aortic trunks (-28%, P less than 0.01), and in females of both groups (-26%, P less than 0.01 and -20%, P less than 0.01, respectively); in terms of percent, HDL2-cholesterol was reduced 2-fold compared to HDL3-cholesterol. Patient apolipoprotein A-I and B levels were unchanged. In male and female patients, correlations between triglycerides and HDL-cholesterol as well as HDL2-cholesterol were negative, but not significant; on the other hand, both correlations were negative and significant in male controls, while only the correlation between triglycerides and HDL2-cholesterol was negative and significant in the female controls. Since HDL-cholesterol, and in particular HDL2-cholesterol, concentrations seem closely related to the intravascular catabolism of triglyceride-rich lipoproteins, the absence of a significant correlation between these parameters in the patients suggests a possible alteration in this metabolic process.

We report on a survey of apolipoprotein A-I and B measurements among 11 laboratories using a lyophilized serum to be evaluated for its possible use as “reference serum” in a large prospective study. Using a single method, radial immunodiffusion (RID), and a common antibody the partecipating laboratories evaluated the apo A-I and apo B concentrations in the proposed reference serum. Analyses were performed in quadruplicate in four consecutive days to estimate the day by day variation in a given laboratory. This value resulted to be 2% for apo A-I and 1.9% for apo B.

Some patients with liver dysfunction show a marked hypertriglyceridaemia, a phenomenon most frequently accompanied by cholestasis. In this report we have identified, isolated and characterized an abnormally large (300–700 A), triglyceride rich, low density lipoprotein, (d 1.019-1.063 g/ml) designated β2-lipoprotein (β2-LP), from the plasma of patients with hypertriglyceridaemia secondary to liver disease. The β2-LP differs significantly in its percent composition and protein moiety from the unique lipoprotein-X (LP-X) specific for cholestasis and also from normal β-lipoproteins, both of which are also present in the patients LDL fraction. Furthermore, some evidence is provided suggesting that the β2-LP is likely to represent an intermediate particle of chylomicron metabolism, which accumulates in this disease due to a markedly diminished hepatic lipase activity.

Analbuminemia or better hypoalbuminemia is a rare disease, first described in 1954 by Bennhold et al. (1), and is characterized by the almost total absence of albumin. This disease is inherited and is probably transmitted by a recessive autosomal gene (2,3). The defect is not complete. The albumin traces present in circulation on Immunoelectrophoresis show the same mobility as normal albumin (4) and no antigenic differences between normal albumin and that in subjects with analbuminemia have been detected (5). In this desease an increased catabolism or loss of this protein may also be ruled out: perfusion of albumin labelled with radioactive iodine has in fact shown a remarkable increase in the half-life of albumin (6,7).

In recent years the study of plasma lipoproteins has significantly broadened our understanding of lipid metabolism and lipid transport1,2.

The aim of this study was the evaluation of some hemorheological and metabolic parameters in a group of patients affected by peripheral artery disease treated with sulodexide. A double-blind with cross-over treatment was used. The results demonstrate that sulodexide reduces blood viscosity and triglyceride levels. This action may have a role in order to modify clinical symptoms and evolution of atherosclerosis.

Numerous clinical and epidemiological studies have shown that various arterial districts (coronary arteries, cerebral arteries, and arteries of the lower limbs) may be simultaneously affected by sclerotic processes in the same patient, confirming that the pathogenetic mechanisms are similar regardless of site. The International Atherosclerosis Project [1], implemented in 19 different geographic areas throughout the world, found a very strong correlation between coronary and aortic lesions. In the Tecumseh study [2] coronary heart disease and absence of peripheral pulses were found to be associated. More recently, the Framingham study [3] showed that claudicatio intermittens was four times more frequent in patients of either sex affected by coronary heart disease (CHD) than in controls. Patients with peripheral artery disease (PAD) were likewise more frequently affected by CHD. Moreover, certain clinical manifestations of CHD, such as angina pectoris and myocardial infarction, seemed to increase the risk of stroke by a factor of 2–4. The Basel prospective study [4] confirmed this reciprocal association between coronary and extracoronary arteriosclerosis, showing that males with PAD presented CHD twice as frequently as controls, and that those with CHD were twice as likely as controls to present PAD. This study also confirmed the findings reported in the Framingham [5] and Seven County studies [6] that arterial hypertension, low-density lipoprotein cholesterol (LDL-C), cigarette smoking, and diabetes mellitus are all risk factors for both CHD and PAD. The most important metabolic risk factors recognized for PAD and cerebrovascular disease (CVD) are reduction of high-density lipoprotein cholesterol (HDL-C), hyperlipidemia, diabetes, and overweight.