Abstract
Low-density lipoprotein cholesterol has been positively associated to an increase of cardiovascular risk by a large number of epidemiological studies. On the contrary, high-density lipoprotein cholesterol results inversely related to cardiovascular risk. In this contest plasma total cholesterol and low-density lipoprotein cholesterol concentration, and the total cholesterol – high-density lipoprotein cholesterol ratio seems to be able to predict cardiovascular risk. Diet and its composition affects various plasma cholesterol concentration and their ratios. Particularly, a reduction of saturated fat acids dietary intake is strictly related to both improve of blood lipid profile and reduction of cardiovascular events incidence. On the other hand, the evidences from epidemiologic and clinical studies are consistent in finding that the reduction of cardiovascular risk depends by nutrients used for replacing saturated fat acids. Specifically it has been demonstrated that replacement of saturated fat acids with unsaturated fat acids, either monounsaturated or polyunsaturated ones, is effective in improving cardiovascular risk. On the contrary, saturated fat acids replacement with high glycemic index refined carbohydrate actually increases cardiovascular risk. Despite that, many dietary guidelines do not give any tips about nutrients to use in replacement of saturated fat acids, underestimating the significance. In this perspective Mediterranean diet, represents an attractive dietary pattern for the improvement of blood lipid profile and the reduction of the cardiovascular risk.
References
Riemann D, Spiegelhalder K, Feige B, et al. The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Med Rev 2010; 14: 19-31. http://dx.doi.org/10.1016/j.smrv.2009.04.002
Le’ger D, Bayon V. societal costs of insomnia. Sleep Med Rev 2010; 14: 379-89. http://dx.doi.org/10.1016/j.smrv.2010.01.003
Bonnet MH, Arand DL. Hyperarousal and insomnia: State of the science. Sleep Med Rev 2010; 14: 9-15. http://dx.doi.org/10.1016/j.smrv.2009.05.002
Wang Y, Zhu GX. The clinical characteristics of chronic primary insomnia in China. Chinese J Clin Neurosci 2011; 19: 601-605.
Zhang Y, Jiang XH, Hu Y. Analysis of psychological and physiological insomnia accompanied by emotional disorders and depressive insomnia PSG. Chinese J Clin Neurosci 2008; 16: 361-63.
Cortoos A, Verstraeten E, Cluydts R. Neurophysiological aspects of primary insomnia: Implications for its treatment. Sleep Med Rev 2006; 10: 255-66. http://dx.doi.org/10.1016/j.smrv.2006.01.002
Buysse DJ, Germain A, Hall M, et al. A neurobiological model of insomnia. Drug Discov Today Dis Models 2011; 8: 129-37. http://dx.doi.org/10.1016/j.ddmod.2011.07.002
Jiang XH, Xu ZQ, Liu J. The GABA changes of encephalofluetuograph in intrinsic insomnias. Chinese J Clin Neurosci 2005, 13: 236-38.
Saper CB, Scammell TE, Jun L. Hypothalamic regulation of sleep and circadian rhythms. Nature 2005; 437: 1257-63. http://dx.doi.org/10.1038/nature04284
Berridge CW, Schmeichel BE, España RA. Noradrenergic modulation of wakefulness/arousal. Sleep Med Rev 2012; 16: 187-97. http://dx.doi.org/10.1016/j.smrv.2011.12.003
Perlis ML, Smith MT, Andrews PJ, et al. Beta/Gamma EEG activity in patients with primary and secondary insomnia and good sleeper controls. Sleep 2001; 24: 110-17.
Bastien CH. Insomnia: Neurophysiological and neuropsychological approaches. Neuropsychol Rev 2011; 21: 22-40. http://dx.doi.org/10.1007/s11065-011-9160-3
Pavlova M, Berg O, Gleason R, et al. Self-reported hyperarousal traits among insomnia patients. J Psychosom Res 2001; 51: 435-41. http://dx.doi.org/10.1016/S0022-3999(01)00189-1
Morin CM, Benca R. Chronic insomnia. Lancet 2012; 379: 1129-41. http://dx.doi.org/10.1016/S0140-6736(11)60750-2
Bastien CH, LeBlanc M, Carrier J. Sleep EEG power spectra, insomnia, and chronic use of benzodiazepines. Sleep 2003; 26: 313-17.
Nelson LE, Jun L, Tianzhi G. The 2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiol 2003; 98: 428-36. http://dx.doi.org/10.1097/00000542-200302000-00024
Gilsbach R, Albarrán-Juárez J, Hein L. Pre-versus postsynaptic signalling by 2-adrenoceptors. Curr Top Membr 2011; 67: 139-60. http://dx.doi.org/10.1016/B978-0-12-384921-2.00007-0
Roth T, Roehrs T, Pies R. Insomnia: Pathophysiology and implications for treatment. Sleep Med Rev 2007; 11: 71-79. http://dx.doi.org/10.1016/j.smrv.2006.06.002
Insomnia definition, diagnosis and medication treatment consensus experts group. Insomnia definition, diagnosis and medication treatment consensus. Chinese J Neurol 2006; 39: 141-43.
Backhaus J, Junghanns K, Broocks A, et al. Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 2002; 53: 734-40. http://dx.doi.org/10.1016/S0022-3999(02)00330-6
Wang C, Chu YM, Zhang YL, et al. Factorial structure of HAMA in the Chinese patients with depressive disorder. J Clin Psychiatry 2011; 21: 299-301.
Iber C, Ancoli-Israel S, Andrew L, et al. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Westchester: Am Acad Sleep Med 2007; 24-30.
Mantz J, Josserand J, Hamada S. Dexmedetomidine: New insights. Eur J Anaesthesiol 2011; 28: 3-6. http://dx.doi.org/10.1097/EJA.0b013e32833e266d
Huupponen E, Maksimow A, Lapinlampi P, et al. Electroencephalogram spindle activity during dexmedetomidine sedation and physiological sleep
[J]. Acta Anaesthesiol 2008; 52(2): 289-94. http://dx.doi.org/10.1111/j.1399-6576.2007.01537.x
Venn RM, Bradshaw CJ, Spencer R. Preliminary UK experience of dexmedetormidine, a novel agent for postoperative sedation in the intensive care unit. Anesthesia 1999; 54: 1136-42. http://dx.doi.org/10.1046/j.1365-2044.1999.01114.x
Gilsbach R, Albarrán-Juárez J, Hein L. Pre- versus postsynaptic signaling by 2-adrenoceptors
[J]. Curr Top Membr 2011; 67: 139-60. http://dx.doi.org/10.1016/B978-0-12-384921-2.00007-0
Hsu YW, Cortinez LI, Robertson KM, et al. Dexmedetomidine pharmacodynamics: Part I crossover comparison of the respiratory effects of Dexmedetomidine and remifentanil in healthy volunteers. Anesthesiol 2004; 101: 1066-67. http://dx.doi.org/10.1097/00000542-200411000-00005
Schramm NL, McDonald MP, Limbird LE. The alpha(2a)adrenergic receptor plays a protective role in mouse behavioral models of depression and anxiety. J Neurosci 2001; 21: 4875-82.
Bellville G, Cousineau H, Levrier K, et al. Meta-analytic review of the impact of cognitive-behavior therapy for insomnia on concomitant anxiety. Clin Psychol Rev 2011; 31: 638-52. http://dx.doi.org/10.1016/j.cpr.2011.02.004
Gauthier A-K, Chevrette T, Bouvier H, et al. Evening vs. morning wake EEG activity in adolescents with anxiety disorders
[J]. J Anxiety Disord 2009; 23(1): 112-17. http://dx.doi.org/10.1016/j.janxdis.2008.04.005
Uhde TW, Cortese BM, Vedeniaphin A. The brainstem noradrenergic systems in stress, anxiety and depression
[J]. Curr Psychiatry Rep 2009; 11(4): 269-76. http://dx.doi.org/10.1007/s11920-009-0039-4
Sachs G, Anderer P, Dantendorfer K, et al. EEG mapping in patients with social phobia
[J]. Psychiatry Res 2004; 131(3): 237-47. http://dx.doi.org/10.1016/j.pscychresns.2003.08.007
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.