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Background: Coronary artery disease (CAD) is the leading cause of mortality in Australian women. We identified gender differences in healthy lifestyle adherence in patients treated with percutaneous coronary intervention (PCI) for CAD. Method(s): Consecutive patients were prospectively recruited from three Australian institutions (2016-2017). The primary endpoint at 1 year follow-up was healthy lifestyle adherence defined as 3/3 of: a heart-healthy diet, being physically active and not smoking. Secondary endpoints included cardiac rehabilitation attendance, medication use and lipid levels. Result(s): From 729 participants (n=192, 26.3% women) 56% were adherent to all three lifestyle measures with no gender difference overall. Compared to men, women were less likely to smoke (7.7% versus 12.2%, p<0.001) to be physically active (61.5% versus 78.2%; p<0.0001), attend cardiac rehabilitation (58.2% versus 66.4%; p<0.045), and take statin therapy (85.4% versus 94.7%; p<0.0001). Female gender independently predicted physical inactivity (OR 2.41, 95% CI 1.57-3.68, p<0.001). Conclusion(s): Important gender differences exist in patients treated with PCI for CAD, namely, significant lower physical activity, cardiac rehabilitation attendance and statin use in women. These all represent key targets for gender-specific secondary prevention interventions.Copyright © 2020

Background: Coronary artery disease (CAD) is the leading cause of mortality in Australian women. We identified gender differences in healthy lifestyle adherence in patients treated with percutaneous coronary intervention (PCI) for CAD. Method(s): Consecutive patients were prospectively recruited from three Australian institutions (2016-2017). The primary endpoint at 1 year follow-up was healthy lifestyle adherence defined as 3/3 of: a heart-healthy diet, being physically active and not smoking. Secondary endpoints included cardiac rehabilitation attendance, medication use and lipid levels. Result(s): From 729 participants (n=192, 26.3% women) 56% were adherent to all three lifestyle measures with no gender difference overall. Compared to men, women were less likely to smoke (7.7% versus 12.2%, p<0.001) to be physically active (61.5% versus 78.2%; p<0.0001), attend cardiac rehabilitation (58.2% versus 66.4%; p<0.045), and take statin therapy (85.4% versus 94.7%; p<0.0001). Female gender independently predicted physical inactivity (OR 2.41, 95% CI 1.57-3.68, p<0.001). Conclusion(s): Important gender differences exist in patients treated with PCI for CAD, namely, significant lower physical activity, cardiac rehabilitation attendance and statin use in women. These all represent key targets for gender-specific secondary prevention interventions.Copyright © 2020

Background: Impaired postprandial remnant cholesterol (RC) metabolism results in high triglyceride (TG) in plasma and may intensify the risk of atherosclerotic cardiovascular disease (ASCVD) in familial hypercholesterolaemia (FH). However, routine assessment of postprandial lipaemia in FH has not been previously investigated. Objective(s): We aimed to assess postprandial lipaemia and chylomicron metabolism by implicating a simplified oral fat tolerance test (OFTT). Method(s): Thirty consecutive subjects with phenotypical FH (N1 = 20 with ASCVD and N2 = 10 without ASCVD) prospectively underwent a simplified OFTT (0,4 h) using a dietary supplement containing 75.0 g monosaturated fat, 41.9 g carbohydrate and 7.2 g protein. FH was diagnosed using the Dutch Lipid Clinic Network criteria. Total cholesterol, TG and high-density lipoprotein (HDL)-cholesterol were measured with enzymatic, colorimetric assays on a Beckman Coulter AU 5800 analyser. RC was calculated as (Total cholesterol-LDL cholesterol-HDL cholesterol). Result(s): Delta plasma TG for cases [mean age 49.9 +/- 11.6yr, median LDL 2.3 (1.7-4.4), median TG 1.2 (0.95-1.40) mmol/L], and 10 FH patients without ASCVD [mean age 46.4 +/- 13.8 yr, LDL 3.5 (2.4-4.5), TG 1.0 (0.60-1.30)] was measured. In cases with ASCVD, there was significant increased postprandial delta TG [1.50 (0.75-2.0) vs 0.35 (0.18-1.56), p = 0.01] and RC [1.2 (0.85-1.55) vs 0.35 (0.18-1.56), p = 0.01]. Postprandial dyslipidaemia in FH with and without ASCVD was independent to conventional risk factors, lipoprotein (a) level [0.18 (0.06-1.14) vs 0.23 (0.15-0.40) p = 0.54], body mass index [(27.3 (3.7) vs 24.4 (4.2), p = 0.06], HbA1C [5.8 (0.4) vs 5.6 (0.8), p = 0.29] and insulin plasma level [(11.5 (6.3) vs 7.0 (2.4), P = 0.06]. Conclusion(s): Our results suggest that postprandial lipaemia is significantly higher in FH subjects with ASCVD. Further trial is required to evaluate implications for additional lipid lowering therapy for further reduction

Background: Impaired postprandial remnant cholesterol (RC) metabolism results in high triglyceride (TG) in plasma and may intensify the risk of atherosclerotic cardiovascular disease (ASCVD) in familial hypercholesterolaemia (FH). However, routine assessment of postprandial lipaemia in FH has not been previously investigated. Objective(s): We aimed to assess postprandial lipaemia and chylomicron metabolism by implicating a simplified oral fat tolerance test (OFTT). Method(s): Thirty consecutive subjects with phenotypical FH (N1 = 20 with ASCVD and N2 = 10 without ASCVD) prospectively underwent a simplified OFTT (0,4 h) using a dietary supplement containing 75.0 g monosaturated fat, 41.9 g carbohydrate and 7.2 g protein. FH was diagnosed using the Dutch Lipid Clinic Network criteria. Total cholesterol, TG and high-density lipoprotein (HDL)-cholesterol were measured with enzymatic, colorimetric assays on a Beckman Coulter AU 5800 analyser. RC was calculated as (Total cholesterol-LDL cholesterol-HDL cholesterol). Result(s): Delta plasma TG for cases [mean age 49.9 +/- 11.6yr, median LDL 2.3 (1.7-4.4), median TG 1.2 (0.95-1.40) mmol/L], and 10 FH patients without ASCVD [mean age 46.4 +/- 13.8 yr, LDL 3.5 (2.4-4.5), TG 1.0 (0.60-1.30)] was measured. In cases with ASCVD, there was significant increased postprandial delta TG [1.50 (0.75-2.0) vs 0.35 (0.18-1.56), p = 0.01] and RC [1.2 (0.85-1.55) vs 0.35 (0.18-1.56), p = 0.01]. Postprandial dyslipidaemia in FH with and without ASCVD was independent to conventional risk factors, lipoprotein (a) level [0.18 (0.06-1.14) vs 0.23 (0.15-0.40) p = 0.54], body mass index [(27.3 (3.7) vs 24.4 (4.2), p = 0.06], HbA1C [5.8 (0.4) vs 5.6 (0.8), p = 0.29] and insulin plasma level [(11.5 (6.3) vs 7.0 (2.4), P = 0.06]. Conclusion(s): Our results suggest that postprandial lipaemia is significantly higher in FH subjects with ASCVD. Further trial is required to evaluate implications for additional lipid lowering therapy for further reduction

Polycystic ovary syndrome (PCOS) is a common condition characterised by both reproductive and metabolic features (obesity, insulin resistance, diabetes risk). Some evidence suggests that women with PCOS have lower vitamin D levels compared to healthy controls. Vitamin D binding protein (DBP) is the main carrier of vitamin D in circulation and plays an important role in regulating vitamin D concentration and bioavailability for target tissues. To our knowledge, no previous studies have examined DBP, bioavailable and free 25-hydroxyvitamin D (25(OH)D) in women with PCOS. The primary aim of this study was to compare DBP, bioavailable and free 25(OH)D concentrations in women with PCOS and controls. The secondary aim was to investigate relationships between DBP, bioavailable and free 25(OH)D and metabolic features (anthropometric measures, insulin resistance, and lipid profile). In a cross sectional study using bio-banked samples, we measured 25(OH)D, DBP and albumin. Bioavailable and free 25(OH)D were calculated using previously validated formula. BMI, body composition (dual X-ray absorptiometry, DXA), insulin resistance (homeostatic model assessment of insulin resistance (HOMA-IR)) and glucose infusion rate (GIR) from hyperinsulinaemic euglycaemic clamp and serum lipids (ELISA) were also measured in a physically and biochemically well-characterised cohort of women with and without PCOS. We studied 90 women with PCOS and 59 controls aged 18-48 years. DBP concentrations were lower in PCOS compared to controls (median [IQR]: 443.40 [314.4] vs 482.4 [156.8] mug/ml, p = 0.02). No significant differences were found in bioavailable or free 25(OH)D concentrations between groups. DBP was not associated with BMI, percent body fat or markers of insulin resistance (all p > 0.2). High-density lipoprotein (HDL) was the main determinant of DBP in the overall cohort (beta = -0.12, p = 0.02), after adjusting for covariates including PCOS/control status, age, BMI, total 25(OH)D and HOMA

Polycystic ovary syndrome (PCOS) is a common condition characterised by both reproductive and metabolic features (obesity, insulin resistance, diabetes risk). Some evidence suggests that women with PCOS have lower vitamin D levels compared to healthy controls. Vitamin D binding protein (DBP) is the main carrier of vitamin D in circulation and plays an important role in regulating vitamin D concentration and bioavailability for target tissues. To our knowledge, no previous studies have examined DBP, bioavailable and free 25-hydroxyvitamin D (25(OH)D) in women with PCOS. The primary aim of this study was to compare DBP, bioavailable and free 25(OH)D concentrations in women with PCOS and controls. The secondary aim was to investigate relationships between DBP, bioavailable and free 25(OH)D and metabolic features (anthropometric measures, insulin resistance, and lipid profile). In a cross sectional study using bio-banked samples, we measured 25(OH)D, DBP and albumin. Bioavailable and free 25(OH)D were calculated using previously validated formula. BMI, body composition (dual X-ray absorptiometry, DXA), insulin resistance (homeostatic model assessment of insulin resistance (HOMA-IR)) and glucose infusion rate (GIR) from hyperinsulinaemic euglycaemic clamp and serum lipids (ELISA) were also measured in a physically and biochemically well-characterised cohort of women with and without PCOS. We studied 90 women with PCOS and 59 controls aged 18-48 years. DBP concentrations were lower in PCOS compared to controls (median [IQR]: 443.40 [314.4] vs 482.4 [156.8] mug/ml, p = 0.02). No significant differences were found in bioavailable or free 25(OH)D concentrations between groups. DBP was not associated with BMI, percent body fat or markers of insulin resistance (all p > 0.2). High-density lipoprotein (HDL) was the main determinant of DBP in the overall cohort (beta = -0.12, p = 0.02), after adjusting for covariates including PCOS/control status, age, BMI, total 25(OH)D and HOMA

Evidence from observational studies indicates a role for vitamin D in kidney function and progression to chronic kidney disease. Findings from animal studies have proposed underlying mechanisms including increased activation of the renin-angiotensin system, increased blood pressure, insulin resistance and chronic low-grade inflammation. However, human studies are limited by confounders arising from heterogeneous samples of participants. We examined the relationship between 25(OH)D and estimated glomerular filtration rate (eGFR) in a predominantly obese otherwise healthy and drug-naive population with no history of chronic kidney disease (CKD). One hundred and twenty one non-diabetic (75 g oral glucose tolerance test; OGTT) volunteers (70 males and 51 females), aged 18-57 years participated in the study. Median 25(OH)D level was 37 nmol/L with no difference by sex. Twenty six participants (21.5%) had 25(OH)D <25 nmol/L, 75 participants (62%) had 25(OH)D of 25-49.99 nmol/L, and 20 participants (16.5%) had 25(OH)D >=50 nmol/L. In univariate analysis, 25(OH)D was related negatively to percent body fat and 2-h glucose level post OGTT. Mean (SD) eGFR was 113.1 (14.9) mL/min/1.73 m2, and in the multivariable analysis, it was related to age, sex, percent body fat and 2-h glucose level post OGTT, but not to 25(OH)D. Furthermore, there was no relationship between eGFR and 25(OH)D across BMI categories. Our data suggest that measuring 25(OH)D in predominantly obese otherwise healthy individuals with no history of CKD may not be beneficial in early recognition of kidney disease.Copyright © 2016 Elsevier Ltd

Evidence from observational studies indicates a role for vitamin D in kidney function and progression to chronic kidney disease. Findings from animal studies have proposed underlying mechanisms including increased activation of the renin-angiotensin system, increased blood pressure, insulin resistance and chronic low-grade inflammation. However, human studies are limited by confounders arising from heterogeneous samples of participants. We examined the relationship between 25(OH)D and estimated glomerular filtration rate (eGFR) in a predominantly obese otherwise healthy and drug-naive population with no history of chronic kidney disease (CKD). One hundred and twenty one non-diabetic (75 g oral glucose tolerance test; OGTT) volunteers (70 males and 51 females), aged 18-57 years participated in the study. Median 25(OH)D level was 37 nmol/L with no difference by sex. Twenty six participants (21.5%) had 25(OH)D <25 nmol/L, 75 participants (62%) had 25(OH)D of 25-49.99 nmol/L, and 20 participants (16.5%) had 25(OH)D >=50 nmol/L. In univariate analysis, 25(OH)D was related negatively to percent body fat and 2-h glucose level post OGTT. Mean (SD) eGFR was 113.1 (14.9) mL/min/1.73 m2, and in the multivariable analysis, it was related to age, sex, percent body fat and 2-h glucose level post OGTT, but not to 25(OH)D. Furthermore, there was no relationship between eGFR and 25(OH)D across BMI categories. Our data suggest that measuring 25(OH)D in predominantly obese otherwise healthy individuals with no history of CKD may not be beneficial in early recognition of kidney disease.Copyright © 2016 Elsevier Ltd