Preliminary Evidence for the Association of APOB rs1042034 With Short-Term Statin-Induced Lipid Lowering: An Exploratory Study in Vietnam.

Bariatric surgery improves lipid profile. A still unanswered question is whether this improvement is merely weight-dependent or also results from factors inherent to specificities of the bariatric procedure. We aimed to study lipid profile 1 year after bariatric surgery and compare its changes between the different procedures in patients matched for initial weight and weight loss. We retrospectively analysed patients submitted to Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) or sleeve gastrectomy (SG) between 2010 and 2013. Patients were matched for age (±5 years), sex, pre-surgery body mass index (BMI) (±2 Kg/m(2)) and excess weight loss (EWL) (±5%). Baseline and 1-year lipid profile, its variation and percentage of variation was compared between surgeries. We analysed 229 patients: 72 pairs RYGB-AGB, 47 pairs RYGB-SG and 33 pairs AGB-SG. The median age was 41 (35-52) years and 11.8% were male. Pre-operative BMI was 44.0 ± 4.6 and 32.1 ± 4.4 Kg/m(2) at 1 year. EWL at 1 year was 64.2 ± 18.9%. There were no differences in baseline lipid profile between patients submitted to different types of bariatric surgery. At 1 year, high-density lipoprotein cholesterol (HDL) and triglycerides (TG) improved similarly with all surgeries. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) at 1 year decreased significantly more in patients submitted to RYGB than in weight-matched patients undergoing AGB or SG. RYGB is the only bariatric surgery that reduces TC and LDL in age-, sex-, BMI- and EWL-matched patients. All three procedures improved TG and HDL similarly when the confounding effect of weight loss is eliminated.

Associations of oral contraceptive use with serum lipids and lipoproteins in young women: The Bogalusa Heart Study

BACKGROUNDThe global rise in overweight and obesity has reached alarming levels, substantially increasing the risk of metabolic disorders such as dyslipidemia. We outlined the evolving trends in baseline blood lipid levels among patients experiencing overweight or obesity, as observed in placebo-controlled randomized trials, to address the unmet clinical requirements.AIMTo assess long-term trends in lipid profiles in overweight or obese populations and their association with clinical and treatment factors.METHODSEMBASE, PubMed, Cochrane Library, and Web of Science databases were searched up to October 9, 2024. Randomized placebo-controlled trials of participants with overweight or obesity, with reports of baseline lipid levels, were included. The main outcome was a correlation between pooled baseline levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) with study year. Subgroup analysis was conducted based on characteristics of the populations and intervention types.RESULTSA comprehensive meta-analysis encompassing 866 studies across nearly 60 countries and regions worldwide, involving 3300 participants, revealed significant temporal trends in baseline lipid profiles. The analysis revealed a significant decline in TG (Rs = -0.704, P < 0.001, I2 = 98.6%), TC (Rs = -0.884, P < 0.001, I2 = 99.6%), and LDL-C (Rs = -0.808, P < 0.001, I2 = 96.8%) levels. In contrast, HDL-C (Rs = 0.336, P = 0.041, I2 = 99.2%) levels exhibited a progressive increase over the study period. Subgroup analyses revealed that sex, body mass index, blood pressure, diabetes status, and type of intervention influenced the observed trends, especially with patients receiving pharmacological therapies demonstrating more pronounced improvements (TG: Rs = -0.449, Padj = 0.011; I2 = 98.9%; TC: Rs = -0.650, Padj = 0.001; I2 = 99.4%; HDL-C: Rs = 0.650, Padj = 0.002; I2 = 98.6%; LDL-C: Rs = -0.417, Padj = 0.031; I² = 98.0%).CONCLUSIONDespite rising obesity rates, lipid control has improved over three decades among individuals with overweight or obesity, reflecting the positive impact of public health efforts and effective dyslipidemia treatment strategies.

We conducted a genome-wide scan using variance components linkage analysis to localize quantitative-trait loci (QTLs) influencing triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol, and total cholesterol (TC) levels in 3,071 subjects from 459 families with atherogenic dyslipidemia. The most significant evidence for linkage to TG levels was found in a subset of Turkish families at 11q22 [logarithm of the odds ratio (LOD)=3.34] and at 17q12 (LOD=3.44). We performed sequential oligogenic linkage analysis to examine whether multiple QTLs jointly influence TG levels in the Turkish families. These analyses revealed loci at 20q13 that showed strong epistatic effects with 11q22 (conditional LOD=3.15) and at 7q36 that showed strong epistatic effects with 17q12 (conditional LOD=3.21). We also found linkage on the 8p21 region for TG in the entire group of families (LOD=3.08). For HDL-C levels, evidence of linkage was identified on chromosome 15 in the Turkish families (LOD=3.05) and on chromosome 5 in the entire group of families (LOD=2.83). Linkage to QTLs for TC was found at 8p23 in the entire group of families (LOD=4.05) and at 5q13 in a subset of Turkish and Mediterranean families (LOD=3.72). These QTLs provide important clues for the further investigation of genes responsible for these complex lipid phenotypes. These data also indicate that a large proportion of the variance of TG levels in the Turkish population is explained by the interaction of multiple genetic loci.

Effects of Increasing High-Density Lipoprotein Cholesterol and Decreasing Low-Density Lipoprotein Cholesterol on the Incidence of First Acute Coronary Events (from the Air Force/Texas Coronary Atherosclerosis Prevention Study)

The Clinical Efficacy Assessment Subcommittee of the American College of Physicians–American Society of Internal Medicine acknowledges the scientific validity of this product as a background paper and as a review that captures the levels of evidence in the management of patients with chronic stable angina as of November 17, 2002. The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines regularly reviews existing guidelines to determine when an update or a full revision is needed. This process gives priority to areas in which major changes in text, and particularly recommendations, are merited on the basis of new understanding or evidence. Minor changes in verbiage and references are discouraged. The ACC/AHA/American College of Physicians–American Society of Internal Medicine (ACP-ASIM) Guidelines for the Management of Patients With Chronic Stable Angina, which were published in June 1999, have now been updated. The full-text guideline incorporating the updated material is available on the Internet (www.acc.org or www.americanheart.org) in both a track-changes version showing the changes in the 1999 guideline in strike-out (deleted text) and highlighting …

To determine the relative contributions of triglycerides (TGs) and high-density lipoprotein (HDL) cholesterol in the residual risk of coronary heart disease (CHD) after the reduction of low-density lipoprotein (LDL) cholesterol to guideline-recommended levels, we conducted a hospital-based, case-control study with optimal matching in the strata of LDL cholesterol, gender, ethnicity, and age. The 170 cases and 175 controls were patients at Brigham and Women's Hospital (Boston, Massachusetts) from 2005 to 2008 who had an LDL cholesterol level <130 mg/dl. The cases had incident CHD, and the controls had diagnoses unrelated to CHD. The 170 cases and 175 controls had a mean LDL cholesterol level of 73 and 87 mg/dl, respectively. The association between TG and HDL cholesterol levels and CHD risk was assessed using conditional and unconditional logistic regression analysis. The models investigated accommodated the possibility of an interaction between lipid factors. The odds of CHD increased by approximately 20% per 23-mg/dl increase in TGs and decreased by approximately 40% per 7.5-mg/dl decrease in HDL cholesterol. High TGs and low HDL cholesterol interacted synergistically to increase the odds ratio to 10 for the combined greatest TG (> or =190 mg/dl) and lowest HDL cholesterol quintiles (<30 mg/dl). High TG levels were more strongly associated with CHD when the HDL cholesterol was low than average or high; and low HDL cholesterol levels were more strongly associated with CHD when the TGs were high. TGs and HDL cholesterol were associated with CHD in patients with a LDL cholesterol level of < or =70 mg/dl, with a risk similar to, or greater than, those in the total group. In conclusion, high TG and low HDL cholesterol levels contribute strongly and synergistically to CHD when LDL cholesterol is well controlled. Thus, high TGs might have greater importance in patients with optimal rather than greater LDL cholesterol concentrations.

There is a primary focus in cholesterol management on the elevated low-density lipoprotein cholesterol (LDL-C) component of dyslipidemia and a secondary focus on the other components of dyslipidemia, such as low high-density lipoprotein cholesterol (HDL-C), high triglycerides (TGs), and high non-HDL-C. This was a physician practice analysis to examine the real-world therapeutic management of patients diagnosed with hyperlipidemia and/or hypercholesterolemia according to the guidelines of the National Cholesterol Education Program (NCEP) Adult Treatment Panel Third Report (ATP III) and the American Heart Association (AHA). Additionally, the number of patients who should be diagnosed with mixed hyperlipidemia instead of hyperlipidemia or hypercholesterolemia was estimated. A total of 600 high-volume prescribers of lipid-modifying drugs were identified in 6 metropolitan areas using the IMS Health prescription database. A total of 101 physician prescribers (about 17%) agreed to participate in the study and had the necessary medical records available. The participating prescribers were asked to identify all patients aged between 18 and 79 years who were seen in their practice in the last 2 years having a diagnosis of hyperlipidemia (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 272.4) and/or hypercholesterolemia (ICD-9-CM code 272.0). ICD-9-CM code 272.2 (mixed hyperlipidemia) was purposely excluded from the criteria for patient chart selection in order to estimate the prevalence of mixed hyperlipidemia in patients previously diagnosed with hyperlipidemia and/or hypercholesterolemia. A random number generator was used to select 25 patient medical records from each office. A common instrument was used to collect data on patient demographics; clinical history; comorbid disease states; laboratory test results, including liver function; and 4 values for serum cholesterol (total cholesterol, LDL-C, HDL-C, TG). Total cholesterol was recorded to permit calculation of non-HDL-C. Data collection via patient chart abstraction occurred from March 2004 through August 2004, performed by a staff member in each physician practice who had been trained for this purpose. Drug prescribing was identified from the patient chart. For the physician practice assessment portion of the project, we used patient charts if there was a complete (total cholesterol, TG, HDL-C, and LDL-C) lipid profile for baseline and follow-up, and a minimum of 6 weeks between baseline and follow-up values. At follow-up, the proportion of patients meeting goal lipid values according to the guidelines for LDL-C was 68%, 63% for HDL-C, 59% for TG, and 68% for non-HDL-C. Only 32% of patients met all 3 goals (LDL-C, HDL-C, and TG). The average time between the baseline and follow-up lipid profile was 3.7 years, with a median of 2.9 years, and a minimum of 6 weeks and a maximum of 42 years. Compared with baseline, the most recent follow-up lipid assessment for HDL-C goal attainment showed improvement by an absolute 6%, from 57% to 63% of patients. TG goal attainment improved an absolute 18% (from 41% to 59%), LDL-C goal attainment improved an absolute 45% (from 23% to 68%), non-HDL-C goal attainment improved an absolute 46% (from 22% to 68%), and the combined goals of LDL-C, HDL-C, and TG improved from 8% of patients at baseline to 32% at follow-up. Of the 2,119 patients in the study population, 1,784 (84%) at the time of chart review had been prescribed at least 1 lipid-modifying medication: 1,552 (87%) a single lipid-modifying medication and 232 (13%) combination therapy. The hydroxymethylglutaryl (HMG) coenzyme-A reductase class (statins) accounted for 89% of the monotherapy regimens. Of the patients with baseline LDL-C, HDL-C, and TG readings, 40% could have been diagnosed as having mixed hyperlipidemia, defined as having (a) baseline LDL-C greater than their NCEP ATP III goal and (b) either baseline TG of >150 mg/dL or a baseline HDL-C of <40 mg/dL for males or <50 mg/dL for females. Of the 40% of patients estimated to have mixed hyperlipidemia, 69% were prescribed lipid-modifying monotherapy, 18% were prescribed combination drug therapy, and 14% were not prescribed drug therapy. Attainment of therapeutic goals for serum lipids improved from baseline to follow-up, but approximately one third of patients did not achieve individual lipid goals and two thirds of patients did not attain goal for all 3 targets (LDL-C, HDL-C, and TG).

Conclusions from the VA-HIT study

To examine the relationship between obesity and lipoprotein profiles and compare the effects of total obesity and central adiposity on lipids/lipoproteins in American Indians. Participants were 773 nondiabetic American Indian women and 739 men aged 45 to 74 years participating in the Strong Heart Study. Total obesity was estimated using body mass index (BMI). Central obesity was measured as waist circumference. Lipoprotein measures included triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein AI (apoAI), and apolipoprotein B (apoB). Partial and canonical correlation analyses were used to examine the associations between obesity and lipids/ lipoproteins. Women were more obese than men in Arizona (median BMI 32.1 vs. 29.2 kg/m2) and South Dakota and North Dakota (28.3 vs. 28.0 kg/m2), but there was no sex difference in waist circumference. Men had higher apoB and lower apoAI levels than did women. In women, when adjusted for center, gender, and age, BMI was significantly related to HDL cholesterol (r = -0.24, p < 0.001). There was a significant but weak relation with apoAI (r = -0.14, p < 0.001). Waist circumference was positively related to triglycerides (r = 0.14, p < 0.001) and negatively related to HDL cholesterol (r = -0.23, p < 0.001) and apoAI (r = -0.13, p < 0.001). In men, BMI was positively correlated with triglycerides (r = 0.30, p < 0.001) and negatively correlated with HDL cholesterol (r = -0.35, p < 0.001) and apoAI (r = -0.23, p < 0.001). Triglycerides increased with waist circumference (r = 0.30, p < 0.001) and HDL cholesterol decreased with waist circumference (r = -0.36, p < 0.001). In both women and men there was an inverted U-shaped relationship between obesity and waist with LDL cholesterol and apoB. In canonical correlation analysis, waist circumference received a greater weight (0.86) than did BMI (0.17) in women. However, the canonical weights were similar for waist (0.46) and BMI (0.56) in men. Only HDL cholesterol (-1.02) carried greater weight in women, whereas in men, triglycerides (0.50), and HDL cholesterol (-0.64) carried a large amount of weight. All the correlation coefficients between BMI, waist circumference, and the first canonical variable of lipids/lipoproteins or between the individual lipid/lipoprotein variables and the first canonical variable of obesity were smaller in women than in men. Triglycerides and HDL cholesterol showed clinically meaningful changes with BMI and waist circumference in men. All lipid/lipoprotein changes in women in relation to BMI and waist circumference were minimal. The main lipoprotein abnormality related to obesity in American Indians was decreased HDL cholesterol, especially in men. Central adiposity was more associated with abnormal lipid/lipoprotein profiles than general obesity in women; both were equally important in men.

Exploring Avenues for Raising HDL Cholesterol

Polymorphisms Associated With Cholesterol and Risk of Cardiovascular Events

Classification tree model can properly predict the risk factor of IS, and the most important risk factors are hypertension, hyperglycemia, high LDL-C and smoking.

Objective To investigate the correlation between serum complement C1q tumor necrosis factor related protein (CTRP)-3, cyclophilin A (CyPA) and abnormal metabolism of lipid in patients with preeclampsia (PE). Methods A total of 98 cases of PE patients who admitted to Department of Obstetrics, Qinghai University Affiliated Hospital from January 2017 to June 2018 were selected as study subjects. According to the severity of PE, they were divided into severe PE group (n=48) and mild PE group (n=50). At the same time, another 50 cases of healthy pregnant women who received regular prenatal examination in our hospital during the same period were included in the control group. The serum levels of CTRP-3 and CyPA of three groups were measured by enzyme linked immunosorbent assay. The serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) of three groups were measured by automatic biochemical analyzer. The body mass index (BMI), systolic blood pressure, diastolic blood pressure, and serum levels of TG, TC, LDL-C, HDL-C, CTRP-3 and CyPA in three groups were compared by one-way ANOVA, and the least-significant difference (LSD) method was used for further multiple comparisons. The correlations between serum levels of CTRP-3, CyPA and serum levels of TG, TC, LDL-C and HDL-C in PE patients were analyzed by Pearson correlation analysis. And multiple linear regression analysis was used for multivariate analysis for serum levels of CTRP-3, CyPA and lipid metabolism index in PE patients. The procedures followed in this study met the requirements of World Medical Association Declaration of Helsinki revised in 2013. There were no significant differences among three groups in age and gestational age (P>0.05). Results ①The BMI, systolic blood pressure, diastolic blood pressure and serum levels of TG, TC, LDL-C, HDL-C, CTRP-3 and CyPA were compared among three groups, and all the differences were statistically significant (F=5.138, 6.742, 7.012, 7.436, 6.538, 6.715, 7.213, 27.659, 7.704, P<0.05). Further comparisons showed that BMI, systolic blood pressure, diastolic blood pressure and serum levels of TG, TC, LDL-C and CyPA in severe PE group and mild PE group were significantly higher than those in control group, and all the differences were statistically significant (severe PE group vs control group: LSD-t=7.156, 13.864, 8.664, 14.264, 6.837, 13.875, 28.185, P<0.001; mild PE group vs control group: LSD-t=5.875, 11.673, 7.148, 10.643, 4.184, 11.684, 23.686, P<0.001), while serum levels of HDL-C and CTRP-3 were significantly lower than those in control group, and all the differences also were statistically significant (severe PE group vs control group: LSD-t=12.864, 44.378, P<0.001; mild PE group vs control group: LSD-t=9.547, 31.684, P<0.001). The BMI, systolic blood pressure, diastolic blood pressure and serum levels of TG, TC, LDL-C and CyPA in severe PE group were significantly higher than those in mild PE group, and all the differences were statistically significant (LSD-t=4.738, P<0.001, LSD-t=9.814, P<0.001, LSD-t=4.864, P<0.001, LSD-t=2.326, P=0.042, LSD-t=2.563, P=0.028, LSD-t=2.713, P=0.022, LSD-t=6.145, P<0.001), while serum levels of HDL-C and CTRP-3 were significantly lower than those in mild PE group, and all the differences also were statistically significant (LSD-t=6.258, 16.386, P<0.001). ②Pearson correlation analysis results showed that serum CTRP-3 level was negatively correlated with serum levels of TG, TC and LDL-C in PE patients (r=-0.546, -0.573, -0.601, P<0.001), while positively correlated with serum HDL-C level in PE patients(r=0.531, P<0.001). Serum CyPA level was positively correlated with serum levels of TG, TC and LDL-C in PE patients (r=0.612, 0.637, 0.552, P<0.001), while negatively correlated with serum HDL-C level in PE patients (r=-0.514, P<0.001). ③Multiple linear regression analysis results showed that serum levels of TG, TC, LDL-C and HDL-C were independent influencing factors of serum CTRP-3 and CyPA levels in PE patients (serum CTRP-3 level: t=4.427, P<0.001, t=3.675, P<0.001, t=2.328, P=0.020, t=4.576, P<0.001; serum CyPA level: t=2.788, P=0.005, t=3.332, P=0.001, t=2.429, P=0.015, t=2.140, P=0.032). Conclusions Serum CTRP-3 level in PE patient is lower than normal value, and serum CyPA level is higher than normal value. CTRP-3 and CyPA levels are closely related to the abnormal metabolism of lipid in patients with PE, and may be involved in the occurrence and development process of PE. Key words: Cyclophilin A; Complement C1q tumor necrosis factor related protein 3; Pre-eclampsia; Lipid metabolism; Triglycerides; Cholesterol, HDL; Cholesterol, LDL; Pregnant women

Relation of Clinical Benefit of Raising High-Density Lipoprotein Cholesterol to Serum Levels of Low-Density Lipoprotein Cholesterol in Patients With Coronary Heart Disease (from the Bezafibrate Infarction Prevention Trial)