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The purpose of this research study is to assess the presence of metabolic cardiovascular risk factors (lipid dismetabolismul, diabetes mellitus type 2), anthropometric (obesity) and smoking in subjects with and without steatosis (non-viral and non-alcoholic) and the influence of steatosis on cardiovascular risk. Subjects were examined by abdominal ultrasonography under á jeun conditions of at least 5 hours. Abdominal ultrasounding is the most commonly used method for detecting steatosis, is widespread and reproducible. Nonalcoholic fatty liver viewed on ultrasounds shows a bright echostructure (comparable to the kidneys) with a posterior attenuation of the signal and a blurred vascular hepatic drawing. In the light of these recommendations, assessment of non-HDL cholesterol levels contributes to a more accurate stratification of cardiovascular risk than the calculation of LDL cholesterol. The target level of non-HDL-cholesterol is with 30 mg/dL higherr than the corresponding target level of LDL - cholesterol. [ABSTRACT FROM AUTHOR]

Background: The concept of cardio metabolic risk and risk stratification for cardiovascular events are two distinct entities related with different stages of vascular development of the atherogenic process. In our analytical transversal study, we analyzed non-high-density lipoprotein cholesterol behavior and the correlations with traditional cardiovascular risk factors in a subpopulation with coronary pain and indication of angio coronarography. We tried to build a mathematical model in order to predict the non-HDLc, allowing additional cardiovascular risk reassesment., Methods: We included 214 patients hospitalized for symptoms and signs suggestive of coronary artery disease and thus indication of vascular invasive evaluation. The protocol of the vascular evaluation included: assessment of cardiovascular risk for fatal cardiovascular event within the next 10 years, the lipidic risk profile, coronarography and statistical analysis., Results: We found a positive and highly statistically significant association between carotid artery intima-media thickness (c-IMT) and non-HDLc value (p <0.001). The mathematical model of linear regression showed the variability of non-HDLc depending on the following numeric variables: total cholesterol (TC), low density lipoproteins (LDL), triglycerides (TG), metabolic syndrome (MS); 97.5% of the non-HDLc variability was dependent on these variables., Conclusions: Non-HDLc is a useful prognostic factor in cardio-metabolic risk quantification. The interdependent relation between non-HDLc and cardio-metabolic risk factors justifies the inclusion of this parameter in cardio-metabolic risk prediction equation in subjects with metabolic syndrome.

Unlabelled: Normal endothelial function alters physiologically with aging. Intervention of environmental factors precipitates and accelerates endothelial dysfunction progression, correlated with cardiovascular risk., Aim: To study the impact of environmental factors (smoking, nutritional habits, stress, physical activity) on the imbalance of the endothelial commuting threshold., Methods: The questionnaire method was applied in order to identify and quantify the presence of environmental factors; an anthropometrical physical exam was performed; metabolic profile (insulin resistance HOMA-IR, lipid parameters) was assessed. Arterial elasticity was assessed with Complior (Artech Medical)., Results: The studied lot (n=80, 21.16 +/- 2.43 years) comprised young medicine students and showed a high incidence of: smoking (31.25%), unhealthy nutritional habits (60%), stress (60%), sedentary lifestyle (25%). The odds for endothelial function alteration were significant only in subjects who associated stress and smoking (OR=8.18, p=0.0006); in the same group, there was noticed the tendency for metabolic profile alteration, meaning insulin resistance (OR=1.19, p=ns). The association stress-smoking did not significantly influence the unhealthy nutritional habits (p=ns, OR=2.39), lipoprotein anomalies (TC > or = 190 mg/dL: p=ns, OR=0.98; LDL > or = 130 mg/dL: p=ns, OR=3.53), or the sedentary lifestyle (p=ns, OR=0.80)., Conclusions: The main environmental factors which determine endothelial function imbalance in young ages are smoking and occupational stress. It is a positive stress which does not lead to significant metabolic anomalies or lifestyle changes. Though, this kind of stress leads to an unhealthy behavior: smoking. The association stress-smoking is essential in endothelial function alteration in young subjects. Primary cardiovascular prevention must focus drastically on unhealthy behaviors correction to reduce cardiovascular risk in young individuals.

Unlabelled: HDL-cholesterol plays a key role defining the functional state of the arteries and the relation to cardiovascular risk., Aim: To assess the degree of arterial stiffness in asymptomatic subjects with and without cardiovascular risk, depending on lipidic parameters behavior and on the insulin resistance state., Methods: Arterial stiffness was assessed using the carotid-radial pulse wave velocity (PWV-CR) measured with Complior; cardiovascular risk was calculated using the SCORE chart; metabolic risk was quantified by assessing fasting lipidic (TC, TG, HDL, LDL) and glycemic parameters (HOMA-IR >1 defines the insulin resistance state)., Results: 58 asymptomatic subjects, 57.62 +/- 14.40 years: 46.55% with (SCORE > or = 5%) and 53.45% without (SCORE < 5%) cardiovascular risk. In subjects with SCORE < 5% and low HDL (< 40 mg/dL), PWV-CR is influenced by the TG/HDL ratio (R2=0.27, p=0.04); LDL < 115 mg/dL has a powerful influence on PWV-CR (R2=0.58, p=0.02); the association of lipidic alterations is predictive for increased PWV-CR (> or = 9.5 m/s) (R2=0.85, p=0.008). In subjects with SCORE > or = 5%, protective HDL level (> or = 40 mg/dL) and HOMA-IR > 1, PWV-CR is strongly related to the insulin resistance state (R2=0.74, p=0.02), also to the association with LDL levels (R2=0.92, p=0.01)., Conclusions: The association between low HDL levels and other lipidic alterations in asymptomatic subjects with low cardiovascular risk influences the degree of arterial stiffness. Increased HDL levels and the presence of insulin resistance syndrome in high risk asymptomatic subjects are predictive for arterial stiffness. This prediction is amplified by LDL association to the metabolic state of the insulin resistance syndrome. It is necessary to establish target levels for HDL and TG in the cardiovascular disease prevention guidelines.