INTERNE GENEESKUNDE there is a considerable incidence of viral pathogens in pulmonary exacerbations in adult CF patients. Newly identified viruses such as pandemic influenza A/H1N1, human metapneumovirus, human bocavirus, and human coronavirus NL63 were not detected in our population, except for 1 human coronavirus NL63. Novel aspects of nonfasting lipemia in relation to vascular biology. Castro Cabezas M, Botham KM, Mamo JCL, Proctor SD. Int J Vasc Med 2012; volume 2012: doi: 10.1155/2012/419015. PMID:22548177. No Abstract. A physician’s guide for the management of hypertriglyceridemia: the etiology of hypertiglyceridemia determines treatment strategy. Klop B, Jukema JW, Rabelink TJ, Castro Cabezas M. Panminerva Med 2012; 54: 91-103. PMID: 22525564. Hypertriglyceridemia is a common lipid disorder associated to different, highly prevalent metabolic derangements like diabetes mellitus, the metabolic syndrome and obesity. The choice of treatment depends on the underlying pathogenesis and the consequences for atherosclerosis or pancreatitis. A family history, physical examination and analysis of the lipid profile including measurement of apolipoprotein B or non-HDL-C are necessary to establish the underlying primary or secondary cause. Due to physiological diurnal variations of triglycerides (TG), the time of measurement (fasting or postprandial) should be taken into account when evaluating TG values. Increased awareness arises concerning the impact of postprandial hypertriglyceridemia on the development of atherosclerosis. Hypertriglyceridemia is strongly associated to postprandial hyperlipidemia, remnant accumulation, increased small dense LDL concentrations, low HDL-C, increased oxidative stress, endothelial dysfunction, leukocyte activation and insulin resistance. All these factors are strongly linked to the development of atherosclerosis. Treatment should be aimed at reducing the secretion of triglyceride-rich lipoproteins, increasing intravascular lipolysis and reducing the number of circulating remnants. The main intervention is a change of lifestyle with decreased alcohol consumption, increased physical activity, dietary changes and, if applicable, adaptation of used medication. Fibrates, fish oil and nicotinic acid are the first choice of treatment in sporadic and familial hypertriglyceridemia to reduce the risk of pancreatitis, whereas high dose statins, sometimes in combination with fibrates, nicotinic acid, or fish oil capsules, are indicated for familial combined hyperlipidemia. Statins are necessary to reach low LDL-C concentrations in patients with type 2 diabetes mellitus and statin dosage should be increased when hypertriglyceridemia is present to reach secondary treatment targets for apolipoprotein B or non-HDL-C. Finally, family screening is mandatory to detect familial lipid disorders for early intervention in other family members. Skin autofluorescence and risk of micro- and macrovascular complications in patients with type 2 diabetes mellitus: a multicenter study. Noordzij MJ, Mulder DJ, Oomen PHN, Brouwer T, Jager J, Castro Cabezas M, Lefrandt JD, Smit AJ. Diabetic Medicine 2012; 29; 1556-1561. PMID: 22937960. Skin autofluorescence is a non-invasive marker of advanced glycation end product accumulation. In a previous study, skin autofluorescence correlated with and predicted 35 WETENSCHAPPELIJK jaarverslag 2012 Pagina 34
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