Lipids in Health and Disease - Latest Comments

Paramount Inherited Functional Mitochondrial Cytopathy, Pre-Metabolic and Metabolic Syndrome are based on.

Sergio Stagnaro — 2008-10-04T00:00:00Z

Sirs,

this paper is really intriguing and interesting. However, in Primary Prevention as well as early bedside diagnosis of Metabolic Syndrome, physicians have necessarily to know Biophysical-Semeiotic Constitutions, fundamental ground of Single Patient Based Medicine, which fortunately completes EBM! (1, 2).

Really, the constitutions exist and are based on inherited mitochondrial functional cytopathy, I discovered and described - for the first time - about 30 years ago, and termed as Congenital Acidosic Enzyme Metabolic Histangiopathy (1-15).

Notoriously, Metabolic Syndrome (i.e., all its components) is preceded by the related biophysical-semeiotic constitutions, their corresponding inherited Real Risk, and then by Biophysical Semeiotic Pre-Metabolic Syndrome (See www.semeioticabiofisica.it and the linked Microangiologia) (2-4).

Generally, the metabolic syndrome is characterized by a group of "so-called" metabolic risk factors in one person:

A) Abdominal obesity (excessive fat tissue in and around the abdomen);

B) Atherogenic dyslipidemia (blood fat disorders - high triglycerides, low

HDL cholesterol and high LDL cholesterol - that foster plaque buildups in artery walls);

C) Elevated blood pressure;

D) Insulin resistance or glucose intolerance (the body can't properly use

insulin or blood sugar);

E) Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor-1 in the blood) Proinflammatory state (e.g., elevated C-reactive protein in the blood).

As I referred previously, also recently (15), all these components of Metabolic Syndrome may occur exclusively in individuals involved by Congenital Acidosic Enzyme Metabolic Histangiopathy as well as by either "some" or all biophysical-semeiotic constitutions.

In a few words, not all patients with Metabolic Syndrome are equal!

Interestingly, such as important data, gathered bedside with the aid of Biophysical Semeiotics, since last November Quantum Biophysical Semeiotics, proved to be reliable in my long well-established clinical experience.

In fact, they highlight intriguing aspects of metabolic syndrome, until now unexplained: for instance, only 50% of this syndrome is associated with impairment of glucose metabolism, e.g., type 2 diabetes! In fact, no one authors all around the world has been able to give full explanation about what accounts for the reason that glucose metabolism is altered only in an half of patients with Metabolic Syndrome. In addition, CAD primary prevention have to be performed exclusively in those patients involved by CAD inherited Real Risk, based on coronary micorcirculatory remodelling, wherein newborn-pathological, type I, subtype b), aspecific, Endoarteriolar Blocking Devices play a central role (8, 9, 16)

References

1) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. http://www.travelfactory.it

2) Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Ed. Travel Factory, Roma, 2005

3) Stagnaro SergioBiophysical Semeiotic Constitutions, Genomics, and Cardio-Vascular Diseases. BMC Cardiovascular Disorders

http://www.biomedcentral.com/1471-2261/4/20/comments#95454 2004

4) Stagnaro Sergio. Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science. http://medicine.plosjournals.org/perlserv/?request=read-response 2005

5) Stagnaro Sergio. Bedside diagnosing diabetic and dyslipidaemic constitutions and diabetes real risk. 2 October 2006, Brit. Col. Med. Journal. http://www.cmaj.ca/cgi/eletters/175/7/733 2006

6) Stagnaro Sergio. Hypertensive Constitution accounts for the existence

of diabetics with and without Hypertension. Cardiovascular Diabetology

2006, 5:19 http://www.cardiab.com/content/5/1/19/comments

7) Stagnaro Sergio. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr. 2007 Feb 7; [MEDLINE]

8) Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices

in Diabetic and Dislipidaemic Constitution and Diabetes Primary

Prevention. The Lancet. March 06 2007

http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?action=view&totalComments=1

9) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic

men and women. 21 June 2007. http://www.annals.org/cgi/eletters/0000605-200708070-00167v1

10) Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma. 2006

11) Stagnaro S. Pivotal role of Biophysical Semeiotic Constitutions in

Primary Prevention. Cardiovascular Diabetology, 2:1,

http://www.cardiab.com/content/2/1/13/comments#5753 2003

12) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica

condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz.

Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28

Settembre-1 Ottobre, 1983, Bellagio.

13) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X

Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7

Novembre, 1981. Siena.

14) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica.

Gazz Med. It. - Asch. Sci, Med. 144, 423, 1985.

15) Stagnaro Sergio. Epidemiological evidence for the non-random

clustering of the components of the metabolic syndrome: multicentre study

of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr.

2007 Feb 7; [PubMed]

16) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php

Pre-Metabolic and Metabolic Syndrome are based on Inherited Mitochondrial Cytopathy.

Sergio Stagnaro — 2008-10-04T00:00:00Z

Sirs,

I find this paper really interesting and useful in preventing rather than recognizing metabolic syndrome. However, in Primary Prevention as well as early bedside diagnosis of Metabolic Syndrome, physicians have at the best to know Biophysical-Semeiotic Constitutions, fundamental ground of Single Patient Based Medicine, which fortunately completes EBM! (1, 2).

Really, these constitutions exist and are based on inherited mitochondrial functional cytopathy, I discovered and described - for the first time - about 30 years ago, and termed as Congenital Acidosic Enzyme Metabolic Histangiopathy (1-15).

Generally, the metabolic syndrome is characterized by a group of "so-called" metabolic risk factors in one person:

A) Abdominal obesity (excessive fat tissue in and around the abdomen);

B) Atherogenic dyslipidemia (blood fat disorders - high triglycerides, low

HDL cholesterol and high LDL cholesterol - that foster plaque buildups in artery walls);

C) Elevated blood pressure;

D) Insulin resistance or glucose intolerance (the body can't properly use

insulin or blood sugar);

E) Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor-1 in the blood) Proinflammatory state (e.g., elevated C-reactive protein in the blood).

In a few words, not all patients with Metabolic Syndrome are equal!

References

1) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-

Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la

definizione della Single Patient Based Medicine. Travel Factory, Roma,

2004. http://www.travelfactory.it

2) Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Ed. Travel Factory, Roma, 2005

3) Stagnaro SergioBiophysical Semeiotic Constitutions, Genomics, and

Cardio-Vascular Diseases. BMC Cardiovascular Disorders

http://www.biomedcentral.com/1471-2261/4/20/comments#95454 2004

4) Stagnaro Sergio. Single Patient Based Medicine: its paramount role in

Future Medicine. Public Library of Science.

http://medicine.plosjournals.org/perlserv/?request=read-response 2005

5) Stagnaro Sergio. Bedside diagnosing diabetic and dyslipidaemic

constitutions and diabetes real risk. 2 October 2006, Brit. Col. Med.

Journal. http://www.cmaj.ca/cgi/eletters/175/7/733 2006

6) Stagnaro Sergio. Hypertensive Constitution accounts for the existence

of diabetics with and without Hypertension. Cardiovascular Diabetology

2006, 5:19 doi:10.1186/1475-2840-5-19 2006

7) Stagnaro Sergio. Biophysical-Semeiotic Diabetic "and" Dyslipidaemic

Constitutions and Primary Prevention. Annals of Family Medicine

http://www.annfammed.org/cgi/eletters/4/5/427 2006

8) Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices

in Diabetic and Dislipidaemic Constitution and Diabetes Primary

Prevention. The Lancet. March 06 2007

http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?action=view&totalComments=1

9) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic

men and women. 21 June 2007. http://www.annals.org/cgi/eletters/0000605-200708070-00167v1

10) Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma. 2006

11) Stagnaro S. Pivotal role of Biophysical Semeiotic Constitutions in

Primary Prevention. Cardiovascular Diabetology, 2:1,

http://www.cardiab.com/content/2/1/13/comments#5753 2003

12) Stagnaro Sergio. Bedside Recognizing CAD Inherited Real Risk and silent CAD with Biophysical Semeiotics. Lipid in Health and Disease. (29 May 2008) http://www.lipidworld.com/content/7/1/19/comments#299588

13) Stagnaro Sergio. Alzheimer's Disease Byophysical Semeiotics supports the pathophysiology of Koudinov's theory.11 January 2002. Clin. Med. & Health Research http://clinmed.netprints.org/cgi/eletters/2001100005v1#9

14) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica.

Gazz Med. It. - Asch. Sci, Med. 144, 423, 1985.

15) Stagnaro Sergio. Epidemiological evidence for the non-random

clustering of the components of the metabolic syndrome: multicentre study

of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr.

2007 Feb 7; [PubMed]

16) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. 2007 http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php

17) Stagnaro Sergio. Renin-angiotensin blockade and kidney disease inherited real risk. The Lancet.com, September 23, 2008.

http://www.thelancet.com/journals/lancet/article/PIIS014067360861212X/comments?action=view&totalComments=2#1841

Bedside Recognizing CAD Inherited Real Risk and silent CAD with Biophysical Semeiotics.

Sergio Stagnaro — 2008-05-29T00:00:00Z

Editors,

nowadays physicians could be able to recognize CLINICALLY, quickly and easily, coronary artery disease, even in earliest stage, i.e., INHERITED Real Risk of CAD, and obviously overt CAD, even silent, by means of Biophysical Semeiotics (1-9) (See www.semeioticabiofisica.it, Practical Applications). , Thanks to a few open-minded, farsighted physicians and "peer-reviewers" , bedside methods reliable in diagnosing CAD real risk is now-a-days an efficacious clinical tool, which proved to be of paramount importance in CAD Primary Prevention (1-9).

As a matter of facts, not all hypertensive or diabetic or dyslipidaemic patients are neither suffering of ouvert CAD, nor at real risk of CAD (4, 8). A large number of well-known randomized trials report the benefits of both diuretics and exercise training in prehypertensive and hypertensive subjects, without recognizing individuals with CAD INHERITED Real Risk. The same consideration is valid for diabetics, independent from treatment results. To the best of my knowledge, neither the exact effects in healthy subjects at “real risk” for CAD, nor the real action mechanisms in patient involved by CAD are now-a-days completely known, ignoring the vast majority of doctors around the world what does it means such as original medical concept, i.e.,"microvascular remodelling", CAD real risk is based on, characterized principally by INHERITED newborn-pathological, type I, subtype b), CORONARY Endoarteriolar Blocking Devices, I discovered some years ago, identical to those we observe in diabetic pancreas ... since BIRTH, of course(7-9). In fact, as I illustrated in previous papers (1-9), physical training, such as walking, 120 paces/min.for 1 h., brings about three important effects also in “healthy” individual, involved by diabetic and/or hypertensive and/or arteriosclerotic (especially coronary) constitution: first of all, it ameliorates endothelial cells functions (2, 3, 4), improving “gradient shear stress”, and, in turn, causing physiological distribution of endothelial membrane “adhesion points”, which play notoriously a primary role in normal endothelial cell functioning. Moreover, the above-illustrated exercise training stimulates ubidecarenone synthesis, activating CoQ10 mithocondrial cycle, in both endothelial and scheletric muscle cells (5).

Finally, doctors can bedside evaluate natriuretic peptides at rest as well as immediately after dynamic tests, described also in above-cited website, in Practical Applications, among them hearth preconditoning plays a central role. For further information, please See Bibliography in above website.

References.

1) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

2) Stagnaro S., Diagnosi percusso-ascoltatoria delle alterazioni emoreologiche precoci nelle arteriopatie periferiche clinicamente silenti. I Congr. Naz. Soc. It. di Emoreologia. Atti, pag. 51. 30 Giugno-2 Luglio, 1982, Siena.

3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 14, 1989.

4) Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997.

5) Stagnaro Sergio. Biophysical-Semeiotic Bed-Side Detecting CAD,

even silent, and Coronary Calcification. 4to Congreso International de Cardiologia por Internet, 2005, http://www.fac.org.ar/ccvc/marcoesp/marcos.php.

6) Stagnaro S.-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617 (Medline)

7) Stagnaro S. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. http://www.thelancet.com/journals/lancet/article/

PIIS0140673607603316/comments?totalcomments=1

8) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php

9) Stagnaro S. New bedside way in reducing mortality in diabetic men and women. Ann. Int. Med. http://www.annals.org/cgi/eletters/0000605-200708070-00167v1

Cissus quadrangularis, fat loss and competing interests

Anssi Manninen — 2008-05-07T00:00:00Z

The lead author of this study has a patent on Cissus quadrangularis as a fat loss agent. A competing interest exists when professional judgement concerning a primary interest may be influenced by a secondary interest (e.g., financial gain). While there is nothing inherently unethical about a competing interest, they should be acknowledged and openly stated.

Anssi Manninen

Manninen Nutraceuticals Oy

Oulu, Finland

Question from a non-professional

Susan Williams — 2008-02-02T00:00:00Z

Is there any real help available at this time for those people with high cholesterol who clearly cannot tolerate statins-- or are they doomed ? Thank you. Goldysue@mindspring.com

Pivotal Role of Liver PPARs Activity Bed-side Evaluation in Monitoring glucidic and lipidic Metabolism.

Sergio Stagnaro — 2007-06-02T00:00:00Z

Sirs,

in my view, in the primary prevention of all components of metabolic syndrome, and particularly hyperinsulinaemia-insulinresistance, IGT, and type 2 diabetes, first of all, doctors have to recognize on very large scale Pre-Metabolic syndrome, classic and variant, I described earlier (See web site www.semeioticabiofisica.it/microangiologia.it, Pre-Metabolic Syndrome, URL http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%20engl.doc After that, doctors have to monitor at the bed-side pre-metabolic syndrome initial evolution to metabolic syndrome, since the well-known diabetes complications begin notoriously years or decades before diabetes onset. Among a lot of biophysical-semeiotic methods, different in technical difficulty, but similarly reliable and useful, peroxisome proliferator-activated receptors (PPARs) clinical evaluation proved to be really efficacious. Regarding such as assessment, I suggest two methods, based on melatonin and respectively thyroide hormone secretion, which allow doctors to evaluate at the bed-side the activity of these nuclear receptors in individuals involved by Pre-Metabolic Syndrome (1). In a few words, PPARs are members of the nuclear receptor family that regulates the expression of genes that control fatty acid synthesis, storage, catabolism, as well as glucose homeostasis and insulin sensitivity. PPARs, as heterodimers acting with another member of the nuclear receptor family, the retinoid X receptor (RXR-ROR), stimulated also by melatonin (2, 3, 4), hooking onto peroxisome proliferator response elements (PPREs), binding finally the P450 4A1 and 4A6 genes. In addition, recent data suggest that PPAR alpha and gamma activation decreases atherosclerosis progression not only by correcting metabolic disorders, but also through direct effects on the vascular wall (ibidem). PPARs modulate the recruitment of leukocytes to endothelial cells, control the inflammatory response and lipid homeostasis of monocytes/macrophages and regulate inflammatory cytokine production by smooth muscle cells. In conclusion, Biophysical-Semeiotic Evaluating PPARs activity, described for the first time from clinical view-point, represents a paramount event in Preventive Medicine.

1) Stagnaro Sergio. Bed-Side Biophysical-Semeiotic Evaluation of PPARs Activity.

http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/PPARs%20BS%20Evaluation%

2) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

3) Stagnaro S., Stagnaro-Neri M., La Melatonina nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. Ediz. Travel Factory, Roma, 2004.

4) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ediz. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

Nice

Ferdinand Novak — 2006-08-02T00:00:00Z

Nice, comprehensive author`s opinion.

But, the principal question is - do we need lab entity we cannot in daily practice measure valid ?

Names error

Demosthenes Panagiotakos — 2005-09-06T00:00:00Z

There is an error in the 1st author name that cannot be changed via your website ..pls change it into Evangelos Polychronopoulos as it appears in the manuscript. Also the CONCLUSION of the abstract does not looks good ... and I cannot change it from your web ...

Positive

Diane Bison — 2004-12-07T00:00:00Z

Well written, comprehensive.