Elena Casals
University of Barcelona
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Featured researches published by Elena Casals.
Circulation | 2004
Emilio Ros; Isabel Núñez; Ana Pérez-Heras; Mercè Serra; Rosa Gilabert; Elena Casals; Ramón Deulofeu
Background—Epidemiological studies suggest that nut intake decreases coronary artery disease (CAD) risk. Nuts have a cholesterol-lowering effect that partly explains this benefit. Endothelial dysfunction is associated with CAD and its risk factors and is reversed by antioxidants and marine n-3 fatty acids. Walnuts are a rich source of both antioxidants and &agr;-linolenic acid, a plant n-3 fatty acid. Methods and Results—To test the hypothesis that walnut intake will reverse endothelial dysfunction, we randomized in a crossover design 21 hypercholesterolemic men and women to a cholesterol-lowering Mediterranean diet and a diet of similar energy and fat content in which walnuts replaced ≈32% of the energy from monounsaturated fat. Participants followed each diet for 4 weeks. After each intervention, we obtained fasting blood and performed ultrasound measurements of brachial artery vasomotor function. Eighteen subjects completing the protocol had suitable ultrasound studies. Compared with the Mediterranean diet, the walnut diet improved endothelium-dependent vasodilation and reduced levels of vascular cell adhesion molecule-1 (P <0.05 for both). Endothelium-independent vasodilation and levels of intercellular adhesion molecule-1, C-reactive protein, homocysteine, and oxidation biomarkers were similar after each diet. The walnut diet significantly reduced total cholesterol (−4.4±7.4%) and LDL cholesterol (−6.4±10.0%) (P <0.05 for both). Cholesterol reductions correlated with increases of both dietary &agr;-linolenic acid and LDL &ggr;-tocopherol content, and changes of endothelium-dependent vasodilation correlated with those of cholesterol-to-HDL ratios (P <0.05 for all). Conclusions—Substituting walnuts for monounsaturated fat in a Mediterranean diet improves endothelium-dependent vasodilation in hypercholesterolemic subjects. This finding might explain the cardioprotective effect of nut intake beyond cholesterol lowering.
Maturitas | 2000
Camil Castelo-Branco; Juan J. Vicente; Francesc Figueras; A. Sanjuán; María J. Martínez de Osaba; Elena Casals; Francesca Pons; Juan Balasch; Juan A. Vanrell
BACKGROUND The main goals of estrogen replacement therapy (ERT) are the prevention of osteoporosis and cardioprotection and the improvement of quality of life (QL). Androgens and tibolone therapy may increase bone mineral density (BMD) to a greater extent than ERT and offer an increase in QL. Lipid and cardiovascular effects, however, are still a major concern. AIM To evaluate whether the addition of a weak androgen to ERT may improve postmenopausal bone loss and sexual activity without adverse effects on lipid pattern and to compare these effects with those observed after tibolone therapy. SUBJECTS AND METHODS This prospective study enrolled 120 surgical postmenopausal women; of these, 96 completed the 1-year follow-up. Patients were allocated to one of four groups. The first group (A; n = 23) received 4 mg of estradiol valerate plus 200 mg of enanthate of dihydroandrosterone im monthly. The second group (E; n = 26) received 50 microg/day of transdermal 17-b-estradiol continuously; the third (T; n = 23) received 2.5 mg of tibolone every day; and finally, the fourth group (C; n = 24) constituted a treatment-free control group. Bone mass (dual X-ray absorptiometry), serum total cholesterol, HDL, LDL, triglycerides, apolipoproteins A1 and B and sexual activity were evaluated before starting therapy and at the end of follow-up. RESULTS All active treatment groups showed an increase in BMD. This increase was higher in the A treatment group (4.08% P < 0.01). Sexuality improved significantly with therapy; however, tibolone and androgens increased scores to a greater extent than ERT. Androgen therapy was associated with significant increases in total cholesterol, LDL and triglycerides. Cholesterol and LDL fall into groups E and T, HDL into groups A and T and triglycerides in group T only. CONCLUSION The combined regimen of androgens and ERT increased vertebral bone mass and enhance sexual activity in postmenopausal women equal to that of tibolone and to a greater extent than ERT alone; its effects on lipids, however, are clearly adverse.
Acta Obstetricia et Gynecologica Scandinavica | 1996
Eduard Gratacós; Elena Casals; Carolina Sanllehy; V. Cararach; Pedro L. Alonso; Albert Fortuny
Objectives. To evaluate the levels of serum lipids (cholesterol and triglycerides) in pregnant women with different types of hypertension, at the first, second and third trimesters of pregnancy.
Gastroenterology | 1996
Antonia Bertomeu; Emilio Ros; Daniel Zambón; María Vela; Rm Perez-Ayuso; Targarona Em; M. Trías; Carolina Sanllehy; Elena Casals; Josep M. Ribó
BACKGROUND & AIMS Apolipoprotein (apo) E is a genetically polymorphic protein influencing lipoprotein metabolism and the risk of both atherosclerosis and Alzheimers disease. As opposed to common apo E3, apo E2 decreases and apo E4 increases hepatic lipoprotein uptake; hence, apo E4 could promote gallstone formation by increasing hepatic and biliary cholesterol concentrations. This study was designed to evaluate whether apo E polymorphism is related to gallstone risk. METHODS apo E phenotype was determined in subjects older than 40 years of age (160 with and 125 without gallstones) and in 61 patients with cholesterol gallstones who underwent cholecystectomy. Bile composition, nucleation time, and gallstone features were analyzed in surgical patients. RESULTS The E4/3 phenotype was enriched in both patients with gallstones and those who underwent cholecystectomy, with significantly (P < 0.006) higher epsilon 4 allele frequencies than in gallstone-free subjects (odds ratio, 2.67 [95% confidence limits, 1.23-5.93] and 3.62 [95% confidence limits, 1.49-8.91], respectively); women, but not men, accounted for these differences. The prevalence of the epsilon 4 allele increased with age in patients with gallstones, whereas the opposite occurred in gallstone-free subjects. Biliary lipid and gallstone cholesterol content tended to increase in the sequence E4 > E3 > E2 in patients who underwent cholecystectomy. CONCLUSIONS Carrying the apo E4 isoform is a genetic risk factor for cholelithiasis in humans, thus adding another adverse effect of apo E polymorphism on health.
Diabetic Medicine | 2004
Camino Rodríguez-Villar; Ana Pérez-Heras; I. Mercadé; Elena Casals; Emilio Ros
Aims To compare the effects of a high‐carbohydrate (CHO) diet and a high‐monounsaturated fatty acid (MUFA) diet on LDL oxidative resistance in free‐living individuals with Type 2 diabetes mellitus.
American Journal of Obstetrics and Gynecology | 1998
Eduard Gratacós; Elena Casals; Ramón Deulofeu; V. Cararach; Pedro L. Alonso; Albert Fortuny
OBJECTIVES We sought to evaluate the circulating levels of lipid peroxides and vitamin E and the placental levels of lipid peroxides in pregnant women with different types of hypertension. STUDY DESIGN Lipid peroxides were measured in serum and placental tissue by the thiobarbituric acid method and high-pressure liquid chromatography, and vitamin E was measured by high-pressure liquid chromatography. The patients studied were 36 healthy pregnant women and 92 women with hypertension classified as having mild gestational hypertension (n = 28), severe gestational hypertension (n = 10), preeclampsia (n = 34), and chronic hypertension (n = 20). RESULTS Lipid peroxides in serum and placental tissue were significantly increased, and vitamin E levels in serum were significantly decreased in women with severe gestational hypertension and preeclampsia compared with controls. The groups of mild gestational hypertension or chronic hypertension had similar values of lipid peroxides or vitamin E as controls. CONCLUSIONS Our results suggest that the category of gestational hypertension may be composed of at least two entities with different pathophysiology and support the concept of nonproteinuric preeclampsia.
Metabolism-clinical and Experimental | 1998
Carolina Sanllehy; Elena Casals; Camino Rodríguez-Villar; Daniel Zambón; Julia Ojuel; Antonio M. Ballesta; Emilio Ros
The magnitude of serum lipid changes in response to hypolipidemic drugs varies considerably between individuals. These differences may be due to interactions between genetic and environmental factors that effect drug bioavailability or the capacity of the lipid-regulating enzyme and receptor targets to be affected. The apolipoprotein E (apoE) gene locus has been examined in this regard, but reports are conflicting on the effect of its variability on the response to hypolipidemic drugs. We investigated the effect of apoE polymorphism on the serum lipid response to the hepatic hydroxymethyl glutaryl coenzyme A (HMG CoA) reductase inhibitor lovastatin and the fibric acid derivative gemfibrozil. Lipoprotein changes were assessed after 12 weeks of therapy in 106 patients with primary hypercholesterolemia and combined hyperlipidemia treated with lovastastin and in 63 given gemfibrozil therapy. No significant effect of the apoE phenotypes E3/2, E3/3, or E4/3 on the heterogeneity of lipid responses to either drug was found.
British Journal of Obstetrics and Gynaecology | 2003
Eduard Gratacós; Elena Casals; O. Gómez; Elisa Llurba; Imma Mercader; V. Cararach; Lluıacute; s Cabero
Objectives To evaluate the susceptibility to oxidation of low density lipoprotein (LDL) in women with a history of pre‐eclampsia.
Atherosclerosis | 2011
Rosa Solà; Montserrat Fitó; Ramón Estruch; Jordi Salas-Salvadó; Dolores Corella; Rafael de la Torre; Miguel A. Muñoz; María del Carmen López-Sabater; M. A. Martínez-González; Fernando Arós; Valentina Ruiz-Gutiérrez; Miquel Fiol; Elena Casals; Julia Wärnberg; Pilar Buil-Cosiales; Emilio Ros; Valentini Konstantinidou; José Lapetra; Lluis Serra-Majem; María-Isabel Covas
OBJECTIVES Apolipoprotein (Apo)B, ApoA-I, and their ratio could predict coronary heart disease (CHD) risk more accurately than conventional lipid measurements. Our aim was to assess the effect of a traditional Mediterranean diet (TMD) on apolipoproteins. METHODS High-cardiovascular risk subjects (n=551, 308 women and 243 men), aged 55-80 years, were recruited into a large, multicenter, randomized, controlled, parallel-group, clinical trial (The PREDIMED Study) aimed at testing the efficacy of TMD on primary cardiovascular disease prevention. Participants assigned to a low-fat diet (control) (n=177), or TMDs (TMD+virgin olive oil (VOO), n=181 or TMD+nuts, n=193) received nutritional education and either free VOO (ad libitum) or nuts (dose: 30 g/day). A 3-month evaluation was performed. RESULTS Both TMDs promoted beneficial changes on classical cardiovascular risk factors. ApoA-I increased, and ApoB and ApoB/ApoA-I ratio decreased after TMD+VOO, the changes promoting a lower cardiometabolic risk. Changes in TMD+VOO versus low-fat diet were -2.9 mg/dL (95% CI, -5.6 to -0.08), 3.3mg/dL (95% CI, 0.84 to 5.8), and -0.03 mg/dL (-0.05 to -0.01) for ApoB, ApoA-I, and ApoB/ApoA-I ratio, respectively. CONCLUSIONS Individuals at high-cardiovascular risk who improved their diet toward a TMD pattern rich in virgin olive oil, reduced their Apo B and ApoB/ApoA-I ratio and improved ApoA-I concentrations.
Metabolism-clinical and Experimental | 1999
Daniel Zambón; Emilio Ros; Camino Rodríguez-Villar; Juan C. Laguna; Manual Vázquez; Carolina Sanllehy; Elena Casals; Josep M. Sol; Gonzalo Hernández
The most appropriate therapy for combined hyperlipidemia remains to be determined. We compared the lipid-regulating effects of gemfibrozil and lovastatin in 30 patients with familial combined hyperlipidemia (FCHL) in a randomized, double-blind, placebo-controlled crossover study including 8-week courses of one drug followed by a washout period and a crossover phase to the alternate drug. After completion of the trial, open-label combination therapy was given for up to 12 months. Lovastatin was more efficacious than gemfibrozil in the reduction of total cholesterol (23% v. 9%, P<.001) and low-density lipoprotein (LDL) cholesterol (28% v. 2%, P<.001), whereas gemfibrozil surpassed lovastatin in the reduction of triglycerides (48% v. 0%, P<.001) and very-low-density lipoprotein (VLDL) cholesterol (50% v. 19%, P = .005) and the increase of high-density lipoprotein (HDL) cholesterol (18% v. 4%, P = .005). Lovastatin caused a greater decline in total apolipoprotein B (apo B) and LDL apo B than gemfibrozil, whereas VLDL apo B decreased only after gemfibrozil therapy. Drug-induced changes in lipoprotein composition indicated that gemfibrozil reduced both the number and size of VLDL particles and lovastatin decreased the number of LDL particles. Combined treatment was safe and had additive effects on lipids, causing significant (P<.001) reductions in total cholesterol (32%), triglycerides (51%), LDL cholesterol (34%), and apo B (26%) and an increase in HDL cholesterol (19%). Target LDL cholesterol levels were achieved only in 11% of patients given gemfibrozil alone and triglycerides decreased to target levels in 22% after lovastatin alone, whereas combined therapy normalized both lipid fractions in 96% of patients. Thus, in FCHL, gemfibrozil has no effect on LDL cholesterol levels but favorably influences the putative atherogenic alterations of lipoprotein composition that are related to hypertriglyceridemia. Conversely, lovastatin markedly decreases LDL cholesterol but has little effect on triglyceride-rich lipoproteins. Combination treatment safely corrects all of the lipid abnormalities in most patients.