![]()
REVIEW
SA JOURNAL OF DIABETES & VASCULAR DISEASE
66
VOLUME 8 NUMBER 2 • JUNE 2011
18. Twigg SM, Kamp MC, Davis TM, Neylon EK, Flack JR, Australian Diabetes Society,
Australian Diabetes Educators Association. Prediabetes: a position statement from
the Australian Diabetes Society and Australian Diabetes Educators Association.
Med J Aust
2007;
186
: 461–5.
19. Pfützner A, Kunt T, Mondok A,
et al
. Fasting intact proinsulin is a highly specific
predictor of insulin resistance in type 2 diabetes.
Diabetes Care
2004;
27
: 682–7.
20. Leonhardt W, Pfützner A, Müller I,
et al
. Effects of pioglitazone and/or simvastatin
on low density lipoprotein subfractions in non-diabetic patients with high
cardiovascular risk: a sub-analysis from the PIOSTAT study.
Atherosclerosis
2008;
201
: 155–62.
21. Forst T, PfütznerA, Lübben G,
et al
. Effect of simvastatin and/or piogliazone
on insulin resistance, insulin secretion, adiponectin, and proinsulin levels in
nondiabetic patients at cardiovascular risk – the PIOSTAT Study.
Metabolism
2007;
56
: 491–6.
22. Hanefeld M, Marx N, Pfützner A,
et al
. Anti-inflammatory effect of pioglitazone
and/or simvastatin in high cardiovascular risk patients with elevated high sensitive
CRP: the PIOSTAT study.
J Am Coll Cardiol
2007;
49
: 291–8.
23. Thrainsdottir IS, Aspelund T, Hardarson T,
et al
. Glucose abnormalities and heart
failure predict poor prognosis in the population-based Reykjavik Study.
Eur J
Cardiovasc Prev Rehabil
2005;
12
: 465–71.
24. Wallander M, Bartnik M, Efendic S,
et al
. Beta cell dysfunction in patients with
acute myocardial infarction but without previously known type 2 diabetes: a
report from the GAMI study.
Diabetologia
2005;
48
: 2229–35.
25. Tamita K, Katayama M, Takagi T,
et al
. Impact of newly diagnosed abnormal
glucose tolerance on long-term prognosis in patients with acute myocardial
infarction.
Circ J
2007;
71
: 834–41.
Book Review
The Sinatra Solution. Metabolic Cardiology
Stephen T Sinatra, MD, FACC
Basic Health Publications Inc, 2005
ISBN 1-59120-158-6
With less self-aggrandisement, this book
might have carried an alternative title
You and
your Mitochondria
, with a subtitle such as
Take
Care of your Mitochondria, and your Body Will
Take Care of the Rest!
The term ‘mitochondrion’ comes from the
Greek [mitos
=
thread, and chondrion
=
gran-
ule]. Every nucleated cell in our bodies contains
mitochondria, sometimes – as in cardiomyo-
cytes – thousands per cell, and these orga-
nelles produce the energy in the form of ATP
for all our vital functions.
The author nicely expresses his gratitude to
all of his patients who allowed him the free-
dom to treat them by means that were, and
probably still are in the eyes of many clinicians,
somewhat experimental, unconventional and
unorthodox. His reported success in terms of
much improved health in many of those of his
patients who were crippled by their poor car-
diovascular status and who were not respond-
ing to conventional pharmacotherapy, provides
much of the raison d’être for the text.
Persons who have had recent senior-school
biology will readily understand most of the
chapters. However the more technical ones
such as Chapter 3, which carries the caption
‘ATP: The Miracle of Life’, and some sections
of the subsequent chapters which deal in
detail with what he has enticingly called the
‘awesome foursome’ i.e. d-ribose, l-carnitine,
coenzyme-Q10 and magnesium, may not be
too digestible for those whose human bio-
chemistry is somewhat rusty! For such persons
the book is a good tutorial.
Nevertheless, the gist of the author’s mes-
sage will emerge very clearly – and I would
compress it along these lines:
• Without mitochondria we would not be
who we are.
• Without healthy mitochondria we are not
what we should be.
• Mitochondria need d-ribose, l-carnitine,
co-enzyme Q10, along with adequate mag-
nesium, as very fundamental essentials for
their proper function/survival.
• Many seriously dysfunctional cardiovascular
conditions, along with a host of other met-
abolic and ‘low-energy’ syndromes, as well
as statin-induced myalgias, are improved
and corrected by ensuring a good intake of
these fundamental mitochondrial nutrients.
• Recommendations for appropriate sup-
plementation with these biochemicals are
provided, and case histories of seriously ill
patients illuminate the benefits of careful
use of these supplemental biochemicals.
• Conventional cardiovascular medications
are by no means eschewed, but while they
address the signs/symptoms of the disor-
ders, the basic energy defect must be cor-
rected. The reminder that cardiac diastole
is far more energy demanding than systole,
helps explain ‘diastolic failure’.
There is no doubt that the current medical
literature supports amply all the major conten-
tions of the author. Big-Pharma doesn’t ‘sell’
these concepts to practitioners, and it is a sad
reflection on our profession that it takes popu-
larisation-type efforts and publications such as
this one to spread such vital messages.
Unfortunately, there is no mention of the
vast population of persons with mitochondrial
cytopathy, particularly those who are HIV posi-
tive, including those receiving ARVs. Indeed
it must be realised that much of the ‘íllness’,
morbidity and mortality of HIV-positive persons
is related to the loss and severely sub-optimal
function of their mitochondria.
In closing, I would without temerity, pro-
pose that in 2010 there is overwhelming jus-
tification to expand the ‘awesome foursome’
to found the ‘livesome fivesome’, by adding
the essentiality of adequate vitamin D to his
regimen, and I doubt that the well-informed
Dr Sinatra would gainsay this. This remains a
readable book for stimulating interest in, and
for providing the rationale for, looking after
our vital mitochondria, so that they may look
after us.
John Straughan
