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Pituitary adenylate cyclase-activating polypeptide/vasoactive intestinal peptide [Part 1]: biology, pharmacology, and new insights into their cellular basis of action/signaling which are providing new therapeutic targets
Purpose of review To discuss recent advances of vasoactive intestinal peptide (VIP)/pituitary adenylate cyclase-activating polypeptide (PACAP) receptors in pharmacology, cell biology, and intracellular signaling in cancer. Recent findings Recent studies provide new insights into the pharmacology, cell biology of the VIP/PACAP system and show they play important roles in a number of human cancers, as well as in tumor growth/differentiation and are providing an increased understanding of their signaling cascade that is suggesting new treatment targets/approaches. Summary Recent insights from studies of VIP/...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Editorial: Gastrointestinal regulatory peptides
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Novel therapies for familial hypercholesterolemia
Purpose of review Familial hypercholesterolemia is a genetic disorder of defective clearance and subsequent increase in serum LDL cholesterol (LDL-C) with a resultant increased risk of premature atherosclerotic cardiovascular disease. Despite treatment with traditional lipid-lowering therapies (LLT), most patients with familial hypercholesterolemia are unable to achieve target LDL-C. We review current and future novel therapeutic options available for familial hypercholesterolemia. Recent findings The use of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors are effective in lowering LDL-C in patie...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Lipoprotein (a) and diabetes mellitus: causes and consequences
Purpose of review This review provides an update on the role of lipoprotein (a) [Lp(a)] in diabetes, including its impact as a risk factor as well as its contribution to the development of cardiovascular disease. Recent findings Although a specific role for Lp(a) has not yet been conclusively established, it appears to have an inverse association with risk of diabetes. Several population-based studies have demonstrated associations between low levels of Lp(a) and increased risk of type 2 diabetes, but Mendelian randomization studies do not consistently support causality. Conversely, in patients with type 2 diabe...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Novel behavioural approaches and implementation science for mitigating genetic risk of cardiovascular disease due to elevated lipoprotein(a)
Purpose of review Elevated lipoprotein(a) [Lp(a)] is a genetic trait that indicates higher risk of atherosclerotic cardiovascular disease (ASCVD). We review novel strategies to mitigate behavioural risk-factors in this genetic condition. Recent findings Pharmacological and biological interventions are available for lowering Lp(a). However, the acceptability and feasibility of these approaches are questionable due to cost and lack of clinical evidence for their efficacy. A number of low-cost, minimal patient contact interventions are available for modifying behavioural risk-factors that are associated with increa...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Expert position statements: comparison of recommendations for the care of adults and youth with elevated lipoprotein(a)
Purpose of review Summarize recent recommendations on clinical management of adults and youth with elevated lipoprotein(a) [Lp(a)] who are at-risk of or affected by cardiovascular disease (CVD). Recent findings There is ample evidence to support elevated Lp(a) levels, present in approximately 20% of the general population, as a causal, independent risk factor for CVD and its role as a significant risk enhancer. Several guidelines and position statements have been published to assist in the identification, treatment and follow-up of adults with elevated levels of Lp(a). There is growing interest in Lp(a) screenin...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Dyslipidemia in childhood and adolescence: from screening to management
Purpose of review To summarize types of dyslipidemia frequently encountered during childhood and adolescence, with a focus on screening, diagnosis, and management. Recent findings It is important that screening for atherosclerotic cardiovascular disease (ASCVD) begin in childhood. Genetic testing allows for increased awareness of dyslipidemia and more targeted intervention. Pharmacologic treatment of pediatric dyslipidemias has a good safety profile and can reduce adult ASCVD risk. Summary Much of what is known about pediatric dyslipidemia has been extrapolated from adult data, but recently, there have be...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Advances in the management of statin myopathy
Purpose of review Statins are highly effective therapies for reducing low-density lipoprotein cholesterol and preventing cardiovascular events. However, many patients taking statins experience statin-associated muscle symptoms. In the current manuscript, we review algorithms to define statin intolerance and approaches to optimize cardiovascular risk reduction and reduce the nocebo effect among individuals reporting statin-associated muscle pain. Recent findings Patients with statin intolerance have a higher cardiovascular event risk. These data underscore the need to apply clinical strategies that improve treatm...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Dietary management of cardiovascular risk including type 2 diabetes
Purpose of review Recent changes or confirmations linking patterns of eating and specific dietary interventions in the management of cardiovascular risk factors including associations with prevalent and incident type 2 diabetes. Recent findings Recently published guidance for dietary management of cardiovascular risk and type 2 diabetes have mostly common features. Major findings include a trend to replace strict quantitative advice on nutrients with qualitative advice on food consumption with exceptions for diabetes, global advice to increase intake of plant foods, confirmation to substitute mono and polyunsatu...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Use of cardiovascular imaging in risk restratification of the diabetic patient
Purpose of review Diabetes mellitus is no longer considered a cardiovascular disease (CVD) risk equivalent, but the optimal methods of risk stratification are a matter of debate. The coronary calcium score (CCS) is a measure of the burden of atherosclerosis and is widely used for CVD risk stratification in the general population. We review recently published data to describe the role of the CCS in people with diabetes mellitus. Recent findings People with diabetes mellitus have 10-year event rates for CVD and CVD mortality that are considered high, at a much lower level of CCS than the general population. Differ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Transatlantic guidelines on dyslipidemia and cardiovascular risk: key differences across the pond
Purpose of review The purpose of this review is to compare and contrast the key messages from the 2018 American Heart Association (AHA)/American College of Cardiology (ACC) Multisociety Guideline on the Management of Blood Cholesterol and the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) Guidelines for the Management of Dyslipidemias. We also review some of the evidence that served as the basis for these guidelines and share our opinion regarding these guidelines. Recent findings Patients with atherosclerotic cardiovascular disease (ASCVD), severe hypercholesterolemia, familial...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Best practice for treating dyslipidaemia in patients with diabetes based on current international guidelines
Purpose of review Dyslipidaemia is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD) in type 2 diabetes. We provide an in-context overview of recent trials of lipid-lowering pharmacotherapies and of recommendations from international guidelines for managing dyslipidaemia in patients with diabetes. Recent findings Clinical trials have demonstrated that patients with diabetes derive greater benefits from ezetimibe and proprotein convertase subtilisin–kexin type 9 inhibitors owing to the higher absolute ASCVD risk compared with patients without diabetes. Pure eicosapentaenoic acid ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Assessing the dyslipidemias: to fast or not to fast?
Purpose of review Nonfasting lipid testing has been introduced into several guidelines over the past decade or so however, the uptake into clinical practice has not been universal. This review highlights some of the prevalent reasons for provider reluctance to use nonfasting testing and the evidence to support nonfasting testing for routine screening in most patients. Recent findings Several studies have found nonfasting lipids to be as, or more, strongly associated with cardiovascular disease (CVD) risk prediction. In particular, nonfasting tests improve system efficiency, are safe for patients with diabetes, t...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Apolipoprotein B: the Rosetta Stone of lipidology
Purpose of review This review summarizes the evidence that apolipoprotein B (apoB) integrates the conventional lipid markers – total cholesterol, triglycerides, LDL-cholesterol, and non-HDL-cholesterol – into a single index that accurately and simply quantitates the atherogenic risk due to the apoB lipoprotein particles. Recent findings Marked hypertriglyceridemia remains the essential signal for hyperchylomicronemia and potential pancreatitis. However, with the exception of Lp(a) and the abnormal cholesterol-enriched remnant particles that are the hallmark of type III hyperlipoproteinemia, recent evidence f...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease risk: current status and treatments
Purpose of review The role of triglyceride-rich lipoproteins (TRLs) in the development of atherosclerotic cardiovascular disease (ASCVD) is at the forefront of current research and treatment development programs. Despite extreme lowering of LDL-cholesterol there remains a high risk of cardiovascular disease and mortality. Recent large epidemiological, genomic wide association studies and Mendelian randomization studies have identified novel mechanisms and targets regulating TRL. This review will focus on recent and ongoing clinical trials that aim to reduce cardiovascular risk by decreasing plasma levels of TRL. Rec...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research