Volume 5, Issue 3

Provident News

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Announcements

Mickey Rubin and his wife Kristen welcomed their daughter Sydney Lane on July 18th.  Mom, dad and baby are all doing well.  Congratulations to the Rubin family!

Ana Diaz, and her husband Omar welcomed their daughter Lila on August 4th.  Big brother Benjamin could not be happier and all are doing well.  Congratulations to the Diaz family!

Tia Kartsanov has joined the Glen Ellyn staff in the accounting department. Welcome Tia!

Tracey Resuali has joined the Glen Ellyn staff as our administrative assistant.  Welcome Tracey!

Linda Derrig has transferred to the Data Management Department where she has assumed the responsibilities of Data Analyst.  Congratulations Linda!

Brian Alvarado has joined the Bloomington team in lab services.  Welcome Brian!

Dr. Mano Patri has left the Addison staff to move closer to family in St. Louis.  We will miss her and wish her all the best.

Dr. Kathy Kelley will be joining the Addison staff as Principal Investigator.  We welcome Dr. Kelley to the Provident team.

Kristen Taggart was promoted to Clinical Research Coordinator at the Addison site.  Congratulations Kristen!

Karen Thursby has transitioned from a contract employee to a Provident employee as a Clinical Research Associate for both the Bloomington and Addison sites.  We are excited to have her on board.  Welcome Karen!

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Recent and Upcoming Publications and Presentations

Publications

Davidson MH, Maki KC, Bays HE, Carter R, Ballantyne CM.  Effects of prescription omega-3-acid ethyl esters on lipoprotein particle concentrations, Apolipoprotein AI and CIII, and lipoprotein associated phospholipase A2 mass in statin-treated subjects with hypertriglyceridemia.  J Clin Lipidol.  2009 (in press).  

Maki KC, Beiseigel JM, Jonnalagadda SS, Gugger CK, Reeves MS, Farmer MV, Kaden VN, Rains TM.  Whole grain ready-to-eat cereal, as part of a dietary program for weight loss, reduces low density lipoprotein particles in statin-treated subjects with hypertriglyceridemia.  J Am Diet Assoc. 2009. (in press).   

Rains TM, Anderson B, Maki KC.  Green Tea Catechins and Abdominal Fat Loss.  SCAN’s Pulse: A Publication for Sports, Cardiovascular and Wellness Nutritionists from the Sports, Cardiovascular and Wellness Nutrition Practice Group within the American Dietetic Association 2009 (in press).   

Maki KC, Rubin MR, Wong LG, McManus JF, Jensen CD, Marshall JW, Lawless A.  Serum 25-hydroxyvitamin D is independently associated with high-density cholesterol and the metabolic syndrome in men and women.  J Clin Lipidol. 2009;3:289-296.   

Maki KC, Sanders LM, Reeves MS, Kaden VN, Rains TM, Cartwright Y.  Beneficial effects of resistant starch on laxation in healthy adults. Int J Food Sci Nutr. 2009;17:1-10.   

Maki KC, Carson ML, Anderson WHK, Geohas J, Reeves MS, Farmer MV, Turowski M, Miller M, Kaden VN, Dicklin MR, Rains TM.  Lipid altering effects of different formulations of hydroxymethylcellulose. J Clin Lipidol.  2009;3:159-166.

Maki KC, Dicklin MR, Lawless A, Reeves MS.  Omega-3 fatty acids for the treatment of elevated triglycerides.  Clinical Lipidology.  2009;4:425-437.

Roth EM, Bays HE, Forker AD, Maki KC, Carter R, Doyle RT, Stein EA. Prescription omega-3 fatty acids as an adjunct to fenofibrate therapy in hypertriglyceridemic subjects. J Cardiovasc Pharmacol. 2009.  [Epub ahead of print].

Maki KC, McKenney JM, Farmer MV, Reeves MS, Dicklin MR.  Indices of insulin sensitivity and secretion from a standard liquid meal test in subjects with type 2 diabetes, impaired or normal fasting glucose.  Nutrition J. 2009;28:8-22.  

Davidson MH, Maki KC, Dicklin MR, Feinstein SB, Witchger MS, Bell M, McGuire DK, Provost JC, Liker H, Aviram M.  Effects of consumption of pomegranate juice on carotid intima-media thickness in men and women at moderate risk for coronary heart disease.  Am J Cardiol. 2009. (in press).

 

 

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Abstracts/Presentations

Obesity Society’s Annual Scientific Sessions. Maki KC, Rains TM, Reeves MS, Farmer MV.  Repeatability of insulin sensitivity and secretion indices from liquid meal tolerance tests in subjects with normal fasting glucose, impaired fasting glucose, or type 2 diabetes mellitus. October, 2009.   

European Society for Clinical Nutrition and Metabolism: 31st  ESPEN Congress.  Alish CJ, Garvey W, Maki KC, Sacks GS, Hustead DS, Mustad VA.  Continuous feeding with a diabetic-specific formula improves glycemic variability and reduces insulin requirements in tube fed patients with type 2 diabetes managed with insulin. August, 2009.  

Southeast Lipid Association. Maki KC. Epidemiology and Statistics: Masters in Lipidology Advanced Training & Board Review Course.  April, 2009.
 
Northeast Lipid Association. Maki KC. Epidemiology and Statistics: Masters in Lipidology Advanced Training & Board Review Course.  June, 2009.
 
Southwest Lipid Association. Maki KC. Epidemiology and Statistics: Masters in Lipidology Advanced Training & Board Review Course.  July, 2009.
 
Southwest Lipid Association. Maki KC. Lipid Regulating Drug Therapies-Pharmacology, Efficacy and Safety: Masters in Lipidology Advanced Training & Board Review Course.  July, 2009.
 
Southwest Lipid Association Annual Scientific Forum. Maki KC. Vitamin D Status and Metabolic Syndrome.  July 2009.
 
Midwest Lipid Association. Maki KC. Epidemiology and Statistics: Masters in Lipidology Advanced Training & Board Review Course.  September, 2009. 
 
Midwest Lipid Association. Maki KC. Lipid Regulating Drug Therapies-Pharmacology, Efficacy and Safety: Masters in Lipidology Advanced Training & Board Review Course. September, 2009.
 
Midwest Lipid Association. Maki KC. Vitamin D Status and Metabolic Syndrome.  September, 2009. 
 
National Lipid Association. Maki KC.  Epidemiology and Statistics: Masters in Lipidology Advanced Training & Board Review Course.  August, 2009.  
 
National Lipid Association. Maki KC. Vitamin D Status and Metabolic Syndrome.  August, 2009.

XV International Symposium on Atherosclerosis.   Bays HE, Maki KC, McKenney J, Doyle RT, Stein E.  Long-term efficacy of prescription omega-3 fatty acids co-administered with simvastatin in hypertriglyceridemic patients.  June, 2009.

American Diabetes Association: 69th Scientific Sessions.  Bays HE, Maki KC, Carter RN, Doyle RT, Stein E.  Effects of prescription omega-3 fatty acids on body weight in patients with very high triglyceride levels.  June, 2009.   

 

 

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In the Literature

Serum 25-hydroxyvitamin D is independently associated with high-density lipoprotein cholesterol and the metabolic syndrome in men and women. J Clin Lipidol, 2009; 3: 289-296.

Objective and Methods:  

The objective of this cross-sectional study was to assess the relationship between serum 25-hydroxyvitamin D [25 (OH)D] level and selected markers for cardiovascular disease (CVD) risk, particularly the metabolic syndrome and it’s components. The study sample included 257 predominantly non-Hispanic white subjects (93.7%), including 71 men and 186 women. A majority of study participants (n = 222, 86.4%) were vitamin D supplement users, including those who took a multivitamin containing vitamin D. Questionnaires were used to assess medical history, use of medications and dietary supplements, physical activity, dietary intake (Harvard Food Frequency), and sun exposure. Clinical measurements obtained during a period of 6 weeks in August and September of 2008 included body weight, blood pressure, waist circumference and the following laboratory values: serum levels of 25(OH)D, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, triglycerides (TG) and glucose.   

Results:   

The logistic regression model, adjusted for age and sex, indicated that each 1 ng/mL increase in 25(OH)D was associated with a 5% reduction in the relative odds for metabolic syndrome.  When additional variables were included (non metabolic syndrome components), each 1 ng/mL increase in 25(OH)D led to a 7% reduction in the relative odds for metabolic syndrome.  

Several components of the metabolic syndrome were associated with lower 25(OH)D concentration, including increased values for waist circumference, triglycerides, HDL-C and glucose.  Only waist circumference and HDL-C remained statistically significant in multivariate analyses.  

Most notably, each 1 ng/dL increment in 25(OH)D concentration was associated with a 0.52 mg/dL increase in HDL-C.  After adjusting for age, sex, waist circumference, physical activity score, alcohol consumption, and smoking status, the strong association between serum 25(OH)D and HDL-C remained statistically significant (regression coefficient = 0.42 mg/dL, p < 0.001).   

Conclusions: 

These findings suggest a lower serum 25(OH)D level is associated with the metabolic syndrome and less favorable values for some metabolic syndrome risk factors, particularly HDL-C concentration.  The most notable finding from the present study was the strong relationship between serum concentrations of 25(OH)D and HDL -C concentrations.  Each 10 ng/mL increment in 25(OH)D was associated with an increase of ~4 mg/dL in HDL -C after adjustment for established determinants of the HDL -C concentration.  This is of considerable potential importance given that each 1 mg/dL increment in HDL -C is associated with a 3-6% reduction in coronary heart disease (CHD) risk.  Research is warranted to assess whether increasing vitamin D intake will improve the metabolic cardiovascular risk factor profile and, ultimately, aid in the prevention of CHD.   

Dr. Maki’s Commentary:  
Results from a number of cohort studies have suggested that higher blood levels of 25(OH)D are associated with lower risk for cardiovascular events, as well as lower total and cardiovascular mortality (1-3). Most published reports of the relationships between vitamin D status and cardiovascular risk factors have assessed these relationships in population segments with relatively low levels of 25(OH)D. The group studied here is notable because the levels of 25(OH)D were much higher than those in the general population, owing to the high prevalence of vitamin D supplement use and the fact that data collection was performed at the end of the summer months when recent sun exposure was likely above average. The prevalence of vitamin D insufficiency [25(OH)D < 30ng/mL] was only 11.6%, compared to ~50% in the US population.
 
The most surprising finding was that even among those with 25(OH)D levels in the normal range, there was a strong association between 25(OH)D and the HDL-C concentration in both men and women.  After adjusting for various determinants of the HDL-C concentration, each 10 ng/mL increase in 25(OH)D was associated with an increase of ~4 mg/dL in HDL-C.  The clinical implications of this relationship are uncertain, but deserve further investigation.  The finding that greater adiposity was associated with lower 25(OH)D confirms results from many previous studies. Since vitamin D is fat soluble, greater sequestration of vitamin D in fat cells may result in a lower blood level of 25(OH)D for given levels of vitamin D intake and sun exposure among heavier individuals.

The results from this and other studies suggesting that lower vitamin D status is associated with various metabolic disturbances and adverse health outcomes indicate that substantial potential exists for improving public health through efforts to increase vitamin D intake if these relationships are causal.  Additional research is warranted to better define optimal levels of circulating 25(OH)D and vitamin D intake.  In addition, clinical trials are warranted to directly assess the influence of increasing 25(OH)D concentration on metabolic parameters and health outcomes.    

 

Citations:  

1.  Heaney RP. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr. 2004;80(Suppl):1706S-1709S. 

2.  Giovannucci E. Can vitamin D reduce mortality? Arch Intern Med. 2007;167:1709-1710.

3.  Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117:503-511.

 

 

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Books and Book Chapters

 
  • Maki KC, Rubin M. Cardiovascular Epidemiology and Characterization of Atherosclerotic Disease Risk Factors.  In: Toth PP, Cannon CP (eds).  Comprehensive Cardiovascular Care in the Primary Care Setting, Humana Press, 2009 (in press).

 

                     

 

 

  • Toth PP, Maki KC. Practical Lipid Management: London: John Wiley & Sons.  Practical Lipid Management: Concepts and Controversies, is a text on the clinical management of dyslipidemias. As its title suggests, the book provides a straightforward and practical approach to the identification and treatment of abnormalities in lipid metabolism. The target audience consists of family physicians, internists, nurse practitioners, physician assistants, cardiologists, endocrinologists and allied health professionals involved in the care of patients with lipid disorders.  The book is available for purchase at Amazon.com.

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  • The book Therapeutic Lipidology edited by Drs. Michael Davidson, Peter Toth and Kevin Maki is available for purchase at Amazon.com.

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  • Maki KC, Matsuo N, Dicklin MR. Clinical studies evaluating the benefits of diacylglycerol for managing excess adiposity. In: Katsuragi Y, Yasukawa T, Matsuo N, Flickinger BD, Tokimitusu I, and Matlock MG. (eds) Chapter 10. Diacylglycerol Oil, AOCS Press, 2nd ed. 2008.

     

  • Maki, KC and Dicklin M. How well do various lipids and lipoprotein measures predict cardiovascular disease morbidity and mortality. In: Toth PP, Sica D. (eds). Clinical Challenges in Lipid Disorders. Oxford: Clinical Publishing. June, 2008.

     

  • Huth PJ, Rains TM, Yang Yifan, Philips SM. Current and emerging role of whey protein on muscle accretion. In: Onwulata CI and Huth PJ. (eds) Chapter 13. Whey Processing, Functionality and Health Benefits. Wiley-Blackwell. 2008.

 

 

About Provident

Provident has a team of research professionals with extensive experience in the design and conduct of clinical trials to evaluate pharmaceuticals, medical and functional foods, dietary supplements and medical devices.

For more information, visit our web site: http://www.providentcrc.com.

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