Atherothrombosis is a multifactorial disease and risk factors for atherothrombosis are now estimated to be in the hundreds. In addition to classical risk factors like serum lipids (total cholesterol and triglycerides), lipoproteins, and apolipoproteins, a variety of inflammatory molecules such as C-reactive protein and serum amyloid A, hemostatic factors and various specific cell types have been also considered for risk and/or require management. In a collaborative study, we searched for predictors of endothelial function and potential association with cardiovascular risk in women with sedentary occupations, in whom obesity-associated risk factors may contribute to excess morbidity and mortality. Ninety consecutive women (age 22-63 years, 22 overweight and 42 obese) had vital signs and a variety of laboratory parameters (lipids, insulin, glucose, high-sensitivity C-reactive protein, and sex hormones) measured along with assessment of endothelial function. We found that endothelial function was significantly associated with cardiovascular risk in these women with sedentary occupations, who were commonly overweight or obese. Even in the absence of routine exercise, cardiorespiratory fitness, rather than conventional risk factors or body mass, was the dominant predictor of endothelial function and suggested a modifiable approach to risk. In another collaborative study, we investigated predictors of endothelial function in employees with sedentary occupations in a worksite exercise program. Since a sedentary work force may be at increased risk of future cardiovascular disease, our purpose was to determine whether risk could be reduced with nutritional guidance and daily exercise at worksite facilities. Seventy-two sedentary employees (aged 22-62 years; 26 overweight) completed 3 months of participation in the Keep the Beat program of the National Heart, Lung and Blood Institute, with determination of endothelial function, vital signs, laboratory data and peak oxygen consumption during treadmill exercise. Results of this study showed that daily exercise achievable in the workplace, along with nutritional information, have measurable health benefits, including improved endothelial function, regardless of adiposity or weight loss, which may decrease cardiovascular risk, if sustained. In a third collaborative study, we found that a previously described receptor on human cells, CD36, also functions as a phagocytic receptor for a variety of bacteria and hence plays an important role in bacterial infections. Along with identification of a new role for this receptor, we also identified the intracellular biochemical pathways that are activated during interaction of human cells with bacteria. These findings are potentially important for atherosclerosis because it is now considered as an inflammatory disease and toxic components called lipopolysaccharides or endotoxins present in the wall of gram-negative bacteria have been implicated in the atherosclerotic process.
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