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  • 1
    In: Diabetes Care, American Diabetes Association, Vol. 37, No. 9 ( 2014-09-01), p. 2548-2556
    Abstract: To assess the relative impact of an intensive lifestyle intervention (ILI) on use and costs of health care within the Look AHEAD trial. RESEARCH DESIGN AND METHODS A total of 5,121 overweight or obese adults with type 2 diabetes were randomly assigned to an ILI that promoted weight loss or to a comparison condition of diabetes support and education (DSE). Use and costs of health-care services were recorded across an average of 10 years. RESULTS ILI led to reductions in annual hospitalizations (11%, P = 0.004), hospital days (15%, P = 0.01), and number of medications (6%, P & lt; 0.001), resulting in cost savings for hospitalization (10%, P = 0.04) and medication (7%, P & lt; 0.001). ILI produced a mean relative per-person 10-year cost savings of $5,280 (95% CI 3,385–7,175); however, these were not evident among individuals with a history of cardiovascular disease. CONCLUSIONS Compared with DSE over 10 years, ILI participants had fewer hospitalizations, fewer medications, and lower health-care costs.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2014
    detail.hit.zdb_id: 1490520-6
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  • 2
    Online Resource
    Online Resource
    Elsevier BV ; 2010
    In:  Journal of Lipid Research Vol. 51, No. 2 ( 2010-02), p. 297-308
    In: Journal of Lipid Research, Elsevier BV, Vol. 51, No. 2 ( 2010-02), p. 297-308
    Type of Medium: Online Resource
    ISSN: 0022-2275
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2010
    detail.hit.zdb_id: 1466675-3
    SSG: 12
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  • 3
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. suppl_1 ( 2012-05)
    Abstract: Cholesteryl ester transfer protein (CETP) mediates the transfer of neutral lipids, including cholesteryl esters (CEs) and triglycerides (TGs), between HDL, LDL and VLDL. Lipoprotein particles contain a neutral lipid core composed of CE and TG surrounded by a surface monolayer of phospholipids (PL), free cholesterol (FC), and apolipoproteins, most notably, apo B-100 in LDL and VLDL and apo A-I in HDL. An elevated level of LDL-cholesterol (LDL-C) and/or a low level of HDL-cholesterol (HDL-C) in human plasma are major risk factors for cardiovascular disease (CVD). Since increased CETP can reduce HDL-C concentration and CETP deficiency is associated with elevated HDL-C levels, CETP inhibitors, including torcetrapib, anacetrapib and dalcetrapib have been investigated in clinical trials for treating CVD. Despite the intense clinical interest in CETP inhibition, little is known concerning the molecular mechanisms of CETP-mediated lipid transfer among lipoproteins, or even how CETP interacts with lipoproteins. CETP is a hydrophobic glycoprotein of 476 amino acids (∼53 kDa, before posttranslational modification). Its crystal structure reveals a banana-shaped molecule with N- and C-terminal β-barrel domains, a central β-sheet, and a ∼60 Å-long hydrophobic central cavity. Three CETP neutral lipid transfer hypotheses were proposed more than two decades ago: 1) a shuttle mechanism that involves CETP collecting CEs from one lipoprotein and delivering them through the aqueous phase to another lipoprotein; 2) a tunnel mechanism in which CETP bridges two lipoproteins forming a ternary complex, with lipids flowing from the donor to acceptor lipoprotein through the CETP molecule; and 3) a modified tunnel mechanism implicating a CETP dimer. One difficulty in investigating CETP mechanisms using structural methods is that interaction with CETP can alter the size, shape, and composition of lipoproteins, especially HDL. We validated an optimized negative-staining electron microscopy (NS-EM) protocol in which flash-fixation of lipoprotein particles preserves a near native-state conformation for direct visualization of individual molecular or macromolecular particles. We applied this protocol to study the mechanisms by which CETP interacts with spherical HDL, LDL and VLDL. Three-dimensional (3D) reconstructions of CETP, free and HDL-bound, were obtained by single-particle techniques. In addition, we used inhibitory CETP antibodies to identify the regions of CETP that interact with HDL and LDL. Finally molecular dynamics (MD) simulation was used to assess the molecular mobility of CETP and predict the likely conformational changes that are associated with lipid transfer. We discovered that CETP bridges a ternary complex with its N-terminal β-barrel domain penetrating into HDL and its C-terminal domain interacting with LDL or VLDL. In our mechanistic model, the CETP lipoprotein-interacting regions, which are highly mobile, form pores that connect to a hydrophobic central cavity, thereby forming a tunnel for transfer of neutral lipids from donor to acceptor lipoproteins. These new insights into CETP transfer provide a molecular basis for analyzing mechanisms for CETP inhibition.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 1494427-3
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 33, No. suppl_1 ( 2013-05)
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. suppl_1 ( 2013-05)
    Abstract: Plasma concentrations of HDL-cholesterol (C) are negatively correlated with atherosclerotic cardiovascular disease. Nevertheless, current evidence suggests that this correlation is not axiomatic and that some forms of HDL are dysfunctional and atherogenic. Moreover, clinical trials of interventions that raise HDL-C have not been uniformly successful suggesting that mechanisms by which HDL-C is increased determine its anti atherogenic potency. Additionally, mice overexpressing the HDL receptor, SR-BI, have lower plasma HDL-C concentrations and less atherosclerosis. Thus, new strategies that reduce HDL-C while promoting reverse cholesterol transport (RCT) may have therapeutic value. Serum opacity factor (SOF) disrupts HDL and forms three products_lipid-free apo A-I, a CE-depleted remnant neo HDL, and a cholesteryl ester-rich microemulsion (CERM) containing apo E and the CE of up to ~400,000 HDL particles. Hepatic CE uptake in Huh7 and HepG2 cells is faster when delivered by CERM than from the parent HDL, and cleared in vitro , in part, via the LDL-receptor (LDLR). We investigated the therapeutic potential of SOF in promoting RCT by comparing the uptake of HDL-, LDL- and CERM-CE in the final RCT steps_hepatocyte uptake, CE metabolism to cholesterol and bile salts, and their secretion and transfer to bile. HDL and LDL with [ 14 C]CE were labeled with [ 14 C]CE by incubation with lipoprotein deficient serum and the lipoproteins recovered by ultracentrifugation. CERM-labeled with [ 14 C]CE was obtained from SOF activity vs. HDL labeled with [ 14 C]CE. Incorporation efficiencies for HDL and LDL were 67% and 52% while [ 14 C]CE specific activities were 3.93 x 10 -4 and 3.04 x 10 -4 mCi/mg CE, respectively. [ 14 C]Metabolites from the hepatic uptake of HDL, LDL, and CERM were quantified by a two-solvent TLC system that resolves CE, C, and the major bile salts. The [ 14 C]CE of all three particles was taken up by cells and converted to free cholesterol with half-times of 2.7, 3.8, and 3.7 h respectively from HDL, CERM and LDL. Rates of bile salt synthesis and secretion are currently being investigated. These data show that SOF diverts potentially toxic HDL-CE to the hepatic LDLR pathway where it is hydrolyzed.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1494427-3
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 33, No. 7 ( 2013-07), p. 1714-1721
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 7 ( 2013-07), p. 1714-1721
    Abstract: HIV patients on antiretroviral therapy (HIV/ART) exhibit a unique atherogenic dyslipidemic profile with hypertriglyceridemia (HTG) and low plasma concentrations of high-density lipoprotein (HDL) cholesterol. In the Heart Positive Study of HIV/ART patients, a hypolipidemic therapy of fenofibrate, niacin, diet, and exercise reduced HTG and plasma non–HDL cholesterol concentrations and raised plasma HDL cholesterol and adiponectin concentrations. We tested the hypothesis that HIV/ART HDL have abnormal structures and properties and are dysfunctional. Approach and Results— Hypolipidemic therapy reduced the TG contents of low-density lipoprotein and HDL. At baseline, HIV/ART low-density lipoproteins were more triglyceride (TG)-rich and HDL were more TG- and cholesteryl ester-rich than the corresponding lipoproteins from normolipidemic (NL) subjects. Very-low-density lipoproteins, low-density lipoprotein, and HDL were larger than the corresponding lipoproteins from NL subjects; HIV/ART HDL were less stable than NL HDL. HDL-[ 3 H]cholesteryl ester uptake by Huh7 hepatocytes was used to assess HDL functionality. HIV/ART plasma were found to contain significantly less competitive inhibition activity for hepatocyte HDL-cholesteryl ester uptake than NL plasma were found to contain ( P 〈 0.001). Conclusions— Compared with NL subjects, lipoproteins from HIV/ART patients are larger and more neutral lipid-rich, and their HDL are less stable and less receptor-competent. On the basis of this work and previous studies of lipase activity in HIV, we present a model in which plasma lipolytic activities or hepatic cholesteryl ester uptake are impaired in HIV/ART patients. These findings provide a rationale to determine whether the distinctive lipoprotein structure, properties, and function of HIV/ART HDL predict atherosclerosis as assessed by carotid artery intimal medial thickness.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1494427-3
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 33, No. suppl_1 ( 2013-05)
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. suppl_1 ( 2013-05)
    Abstract: Reverse cholesterol transport (RCT), the transfer of cholesterol from peripheral tissues, including the subendothelial space of the arterial wall, to the liver for disposal, is a current model of HDL atheroprotection. The final RCT step, selective hepatic HDL-cholesteryl ester (CE) uptake, is mediated by scavenger receptor class B type I (SR-BI). The net receptor reaction of SR-BI vs. HDL is distinct from that of LDL vs. the LDL receptor. LDL holo particle uptake is succeeded by steps that breakdown apo B-100 and hydrolyze and recycle the CE. In contrast, HDL-CE uptake is selective, occurring without a concomitant net uptake of the major HDL protein, apo A-I and even though apo E and apo A-I bind equally well to SR-BI, apoA-I-containing particles mediate 2-fold more selective CE uptake. The reaction of HDL with SR-BI is similar to the activity of a streptococcal serum opacity factor (SOF) against HDL_both reactions selectively remove CE from HDL leaving remnants. In addition, SOF catalyzes the displacement of apo A-I leaving an apo A-II-rich neo HDL, an effect that was assigned to the greater lipophilicity of apo A-II vs. apo A-I. Thus, we tested the hypothesis that the same occurs during the interaction of HDL with SR-BI, i.e., that apo A-II vs. apo A-I is selectively excluded from cellular uptake via SR-BI. Herein, we compare the selective uptake of HDL-CE vs. HDL-apo A-I and apo A-II. Cellular uptake of HDL-[ 3 H]CE labeled with [ 125 I]apo A-I or [ 125 I]apo A-II was compared in CHO-K1 and CHO-ldlA7 cells (LDL-R -/- ) with and without over expression of mouse SR-BI, and Huh7 human hepatocytes. Cell-associated 125 I and 3 H were determined by γ- and β-counting respectively. Uptake of CE, apo A-I, and apo A-II SR-BI-over expressing CHO cells was 32,800 ± 4800, 9.3 ± 2.7, and 2.5 ± 0.2 nmol/mg cell protein. The corresponding values for Huh7 cells were 9,700 ± 1,800, 15 ± 2.4, and 7.6 ± 0.9 nmol/mg cell protein. Relative to CE, both apo A-I and apo A-II were excluded from uptake by all cells. However, relative to the apo A-I and apo A-II contents of HDL, uptake of apo A-I was twice that of apo A-II, thus supporting the hypothesis that the more lipophilic apo A-II is selectively excluded from cellular uptake via SR-BI and retained in the neo HDL remnant.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1494427-3
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  • 7
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 32, No. suppl_1 ( 2012-05)
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. suppl_1 ( 2012-05)
    Abstract: Background: Microsolubilization of dimyristoyl phosphatidylcholine (DMPC) by human apolipoprotein A-I is a frequently used model system for the identification of determinants of macrophage cholesterol efflux, the first step in reverse cholesterol transport (RCT) to hepatic disposal. Although many studies have focused on microsolubilization of DMPC, most have been conducted under stoichiometric conditions resulting in ∼9 nm rHDL, and few have included free cholesterol (FC), a key lipid in RCT. Methods: Various rHDL species (excess DMPC + FC), were prepared and analyzed by size exclusion chromatography (SEC), differential scanning calorimetry (DSC) and circular dichroism (CD) spectroscopy as a function of temperature. Results: At each mol% of FC/DMPC, multiple rHDL species differing in size from ∼10 to ∼25 nm were formed. In SEC, rHDL size increased with the mol% FC in the microsolubilization reaction and in a given reaction mixture the large rHDL were always more FC-rich than the small rHDL. In DSC, the DMPC transition range of rHDL was broader than that of pure DMPC and although the transition temperature moderately increases with increasing mol% FC, the apparent enthalpy of the transition is diminished. The thermal dependence of the CD spectra showed that increasing mol% FC and rHDL size moderately increases the stability of apo A-I. Conclusion: Although large FC-rich and small FC-poor domains coexist on DMPC surfaces; the size of these domains increases with mol% FC. This effect of FC on rHDL size decreases the overall cooperativity of the DMPC phase transition and reduces the number of acyl chain interactions. Physiologically, these data suggest that increased FC-loading of macrophages should increase the size of nascent HDL produced by the interaction of apo A-I with cellular ABCA1. The lower stability of FC-poor HDL would likely make it release more lipid-free apo A-I in response to important plasma proteins including LCAT, PLTP, and CETP and in response to serum opacity factor.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 1494427-3
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  • 8
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 96, No. 7 ( 2011-07), p. 2236-2247
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    RVK:
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2011
    detail.hit.zdb_id: 2026217-6
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  • 9
    In: Atherosclerosis, Elsevier BV, Vol. 223, No. 2 ( 2012-08), p. 342-349
    Type of Medium: Online Resource
    ISSN: 0021-9150
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2012
    detail.hit.zdb_id: 1499887-7
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  • 10
    Online Resource
    Online Resource
    American Chemical Society (ACS) ; 2010
    In:  Biochemistry Vol. 49, No. 50 ( 2010-12-21), p. 10656-10665
    In: Biochemistry, American Chemical Society (ACS), Vol. 49, No. 50 ( 2010-12-21), p. 10656-10665
    Type of Medium: Online Resource
    ISSN: 0006-2960 , 1520-4995
    RVK:
    Language: English
    Publisher: American Chemical Society (ACS)
    Publication Date: 2010
    detail.hit.zdb_id: 1472258-6
    SSG: 12
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