A1 Ratio Research Articles

Effects of Liver Transplantation on Lipids and Cardiovascular Disease in Children With Homozygous Familial Hypercholesterolemia

Homozygous familial hypercholesterolemia (HoFH) is a rare, inherited, life-threatening, metabolic disorder of low-density lipoprotein (LDL) receptor function characterized by elevated serum LDL cholesterol (LDL-C) and rapidly progressive atherosclerotic cardiovascular disease (ACVD). Since LDL receptors are predominantly found on hepatocytes, orthotopic liver transplantation (OLT) has emerged as a viable intervention for HoFH because LDL receptor activity is restored. This study assessed the effects of OLT on ACVD and ACVD risk factors in pediatric patients with HoFH. We analyzed lipids, lipoproteins, body mass index, glucose, blood pressure, and cardiovascular imaging in 8 pediatric patients who underwent OLT for HoFH. Total serum cholesterol, LDL-C, lipoprotein (a), and apolipoprotein B/apolipoprotein A1 ratio decreased to normal values in all subjects (p values <0.001) at 1month after OLT and were maintained for the length of follow-up (2 to 6years). There were few complications related to surgery or immunosuppressive therapy. Two patients developed mild hypertension. In the first 4 subjects monitored for 4 to 6years after OLT, coronary artery disease did not develop or progress except in 1 minor artery in 1 subject and actually regressed in 2 subjects with >50% stenosis. However, aortic valve stenosis progressed in 2 of 4 subjects. In conclusion, OLT is an effective therapeutic option for patients with HoFH with coronary artery disease and persistently elevated serum LDL-C despite maximum medical therapy. Aortic valvular disease may progress. Long-term data are needed to evaluate the true risk-benefit ratio of this surgical approach.

Association of Apo B, Apo A1 and lipid Profile with Early Onset Stroke

Background: Early onset of stroke is a devastating illness and dyslipidaemia are widely accepted risk factors for coronary heart disease (CHD). High Apolipoprotein B (Apo B), low Apolipoprotein A1 (Apo A1) and the Apo B/Apo A1 ratio are used as the predictors of stroke for CHD.Objective: To evaluate the association of Apo B, Apo A1 and lipid profile with early onset stroke.Methods: This case-control study was conducted in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka from Jan’2008 to Dec’2008. Total 100 stroke patients of both sexes were included, diagnosed by CT scan and MRI. Fifty stroke patients of early onset (EOS-P; age d”45 yrs) were included as case and 50 stroke patients of late onset (LOS-P; age &gt;50 yrs) were taken as control. Serum lipid profile (TAG, TC, LDL-C &amp; HDL-C), lipid ratios (TC/HDL-C, LDL-C/HDL-C &amp; TAG/ TC), Apo B, Apo A1, and Apo B/Apo A1 ratio were measured in all patients. Mann Whitney U test, Odds Ratio, unpaired t-test were used for statistical analysis.Results: In this study, serum Apo A1, and TAG were significantly higher in EOS-P than those of LOS-P. Again, with respect of cut off value, odds ratio of 2.29 indicates that high serum Apo B concentration is associated whereas odds ratio of 0.38 indicates that low serum Apo A1 concentration is not associated with EOSConclusion: From this study it can be concluded that, higher level of TAG is a risk factors for early onset stroke and high Apo B is associated with early onset stroke.Bangladesh Soc Physiol. 2015, December; 10(2): 51-55

The status and progress of relationship between dyslipidemia and diabetic retinopathy

Dyslipidemia plays an important role in the pathogenesis of diabetic retinopathy (DR). A preliminary study found that low-density lipoprotein cholesterol, apolipoprotein (Apo) B and Apo B / Apo A1 ratio were positively correlated with DR, while high-density lipoprotein cholesterol, Apo A1 was negatively correlated with DR and proliferative DR. Reducing the blood fats to be helpful to DR control. However, the mechanism of hyperlipidemia in the pathogenesis of DR, the reason of dyslipidemia in diabetic patients and the interaction between hyperglycemia and hyperlipidemia in DR are not clear yet. Moreover, there is no predictive indicators related to blood lipid for DR. Understanding the relationship between dyslipidemia and DR can provide definite evidence for fat-reducing therapy for DR control. Key words: Diabetic retinopathy/etiology; Dyslipidemias; Review

Identification and mating type determination of Phytophthora strains causing blight on two cucurbit crops in South China

To clarify mating types of the pathogen causing phytophthora blight on cucurbit crops, over 400 samples of affected wax gourd and cucumber plants were collected from nine cities in South China during 2007–2010. A total of 198 Phytophthora strains were isolated from the samples and identified as Phytophthora melonis based on their morphological characteristics and rDNA-ITS (internal transcribed spacer) sequences. Mating types of the strains were determined based on mating reactions between a field strain and each of the reference strains of mating types A1 and A2. Five mating types were found in the samples collected. The A0 mating type was predominant in Guilin city, representing 40.9 % of the strains obtained, while the A2 mating type was dominant in the sampling areas with a frequency of 37.5–66.7 %. The A0, A2 and A1A2 mating types were isolated from both hosts. The A1 and A1,A2 mating types were obtained only from the wax gourd and cucumber plants, respectively. The ratio of A1 and A2 mating types isolated from Guilin was close to 1:1, suggesting a possibility for sexual reproduction to occur in South China.

Potential role of apolipoprotein B/A1 ration in obese and non-obese female patients of coronary artery disease

Background: Obesity and hyperlipidemia are considered to be risk factor for cardiovascular diseases. Many patients who develop coronary artery disease (CAD) are non obese and have normal lipoprotein cholesterol. Assessment of apolipoproteins can improve future risk of cardiovascular complications.Aims and Objectives: We have investigated effect of weight in relation with lipoprotein and apolipoprotein levels as efficient marker of CAD in North Indian females.Materials and Methods: The study population consist of 90 subjects categorized into three groups: Group I: Healthy controls; Group 2: Non obese patients of CAD and Group 3: Obese patients of CAD (n= 30 each group). Serum lipid profile along with apolipoprotein B and A1 were measured and apolipoprotein B/A1 ratio were calculated.Result: Total cholesterol and triglycerides levels were significantly high in obese patients as compared to non-obese and controls. LDL-C and HDL-C were altered insignificantly (p&lt;0.1) in Group 2 and Group 3 as compared to Group 1. Apo B and apo A1 were significantly high in obese and non-obese CAD patients as compared to controls whereas insignificant difference was observed (p&lt;0.1) when Group 3 patients were compared with Group 2. ApoB/Apo A1 ratio was increased significantly (p&lt;0.01)) in patient groups as compared to controls. ­­­­­­­­­­­­­­­­­­­­­­­­­Conclusion: Although LDL-C and HDL-C were normal in subjects of CAD, increase in Apo B, A1 and its ratio authenticates the fact that these markers are more efficient in detection of CAD risk in obese and non obese patients than conventional lipid profile parameters.Asian Journal of Medical Sciences Vol. 7(3) 2016 18-22

Effect of Pitavastatin Treatment on ApoB-48 and Lp-PLA₂ in Patients with Metabolic Syndrome: Substudy of PROspective Comparative Clinical Study Evaluating the Efficacy and Safety of PITavastatin in Patients with Metabolic Syndrome.

BackgroundApolipoprotein (Apo) B-48 is an intestinally derived lipoprotein that is expected to be a marker for cardiovascular disease (CVD). Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a vascular-specific inflammatory marker and important risk predictor of CVD. The aim of this study was to explore the effect of pitavastatin treatment and life style modification (LSM) on ApoB-48 and Lp-PLA2 levels in metabolic syndrome (MS) patients at relatively low risk for CVD, as a sub-analysis of a previous multi-center prospective study.MethodsWe enrolled 75 patients with MS from the PROPIT study and randomized them into two treatment groups: 2 mg pitavastatin daily+intensive LSM or intensive LSM only. We measured the change of lipid profiles, ApoB-48 and Lp-PLA2 for 48 weeks.ResultsTotal cholesterol, low density lipoprotein cholesterol, non-high density lipoprotein cholesterol, and ApoB-100/A1 ratio were significantly improved in the pitavastatin+LSM group compared to the LSM only group (P≤0.001). Pitavastatin+LSM did not change the level of ApoB-48 in subjects overall, but the level of ApoB-48 was significantly lower in the higher mean baseline value group of ApoB-48. The change in Lp-PLA2 was not significant after intervention in either group after treatment with pitavastatin for 1 year.ConclusionPitavastatin treatment and LSM significantly improved lipid profiles, ApoB-100/A1 ratio, and reduced ApoB-48 levels in the higher mean baseline value group of ApoB-48, but did not significantly alter the Lp-PLA2 levels.

Evaluation of Lipid Profile and Apolipoproteins in Essential Hypertensive Patients.

Essential hypertension is one of the most common diseases of the Indian population contributing greatly to the morbidity, mortality and economic burden. It has a strong association with cardiovascular disease and abnormal lipid metabolism. Not only the traditional lipid parameters, but also the novel lipid components like Apo A1 and Apo B100 also have been identified to play a role. The present study was done to evaluate serum lipid profile and Apo A1, Apo B 100 in essential hypertensive patients and correlate their values with the degree of hypertension. Fasting samples from 55 age and sex matched controls and 55 essential hypertensives were tested for plasma glucose, serum urea, creatinine, lipid profile, apo A1 and apo B100. The cases were subclassified based on the severity of hypertension according to JNC criteria. The study showed a significantly raised value for serum cholesterol, triacylglycerol, Low Density Lipoprotein (LDL), Very Low-Density Lipoprotein (VLDL) in the hypertensive patients than the control group whereas serum High-Density Lipoprotein (HDL) registered a fall in the cases. Apo A1 revealed a non-significant fall in the hypertensive patients. In contrast, there was a rise in the serum apo B100 in the cases. Apo B100/apo A1 ratio was significantly raised in both stage I and stage II hypertensive patients in comparision to the controls. When correlated, serum apo A1 revealed a negative association where as serum apo B 100 showed a positive association with systolic and diastolic bloood pressure. Both LDL/HDL and apoB100/apo A1 and apo B100 revealed a significant positive association with both SBP and DBP. However, apoB100/apo A1 revealed a more positive association in comparision to LDL/HDL ratio (r=0.749, p<0.001, r=0.756, p<0.001 vs r=0.336, p<0.000, r=0.312, p<0.001). Apo B100/apoA1 has emerged as an important complementary parameter in addition to traditional lipid ratio for evaluation of risk for future cardiovascular disease.

Systemic inflammation, oxidative stress and apolipoprotein B/A1 ratio in active psoriasis: bridging an apparent paradox

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Psoriasis is characterized by systemic increase of inflammation and oxidative stress. In addition, increased incidence of dyslipidemia in dermatological disorders is also in alarming phase. It is conceivable that association of inflammation, oxidative stress and dyslipidemia enhances the future the risk of cardiovascular disease (CVD) in psoriasis patients. The main of the study is to estimate the marker of systemic inflammation, oxidative stress, plasma lipid profile and apolipoprotein levels in psoriasis patients and to determine their role in predicting CVD risk in psoriasis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study population consist of subjects categorized into two groups; Group I: Healthy controls and Group II: Psoriasis patients (n= 25 in each group). Erythrocyte malondialdehyde (MDA), plasma C-reactive protein (CRP) and lipid profile along with apolipoprotein B and A1 were measured and statistically analyzed using standard methods.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Plasma CRP, total cholesterol, triglycerides, LDL-cholesterol and MDA levels were significantly high (p&amp;lt;0.05) in patient group as compared to healthy controls. HDL-cholesterol levels were altered insignificantly (p&amp;lt;0.1) in patient group. Plasma Apo B/Apo A1 ratio were increased significantly (p&amp;lt;0.01) in patient groups as compared to controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Thus, enhanced inflammation, oxidative stress along with increase in Apo B, A1 and its ratio authenticates the fact that these markers are more efficient in prediction of CVD risk in psoriasis patients than conventional lipid profile parameters.&lt;/p&gt;

Hepatic Steatosis and Insulin Resistance, But Not Steatohepatitis, Promote Atherogenic Dyslipidemia in NAFLD.

Patients with nonalcoholic fatty liver disease (NAFLD) are at increased risk of cardiovascular disease, and atherogenic lipoproteins may play an important role. The objective of the study was to determine the contribution of the severity of steatohepatitis to atherogenic dyslipidemia in patients with NAFLD. This was a cross-sectional study. The study was conducted at a university hospital. Patients were recruited from outpatient clinics or from the general population (n = 188). Measurement of hepatic triglyceride content by magnetic resonance spectroscopy, histology (liver biopsy), metabolic profile by means of an oral glucose tolerance test, and lipoprotein analyses were performed. Outcomes measured included standard lipids, lipoprotein subfraction analysis (apolipoprotein B/A1 levels, low-density lipoprotein (LDL) particle size/phenotype, and LDL/high-density lipoprotein subfractions), and insulin resistance. Patients with NAFLD had severe insulin resistance, especially at the level of the adipose tissue, when compared with patients without NAFLD. Despite small differences in triglycerides and high-density lipoprotein-cholesterol, patients with NAFLD had a significantly higher plasma apolipoprotein B to apolipoprotein A1 ratio (0.66 ± 0.02 vs 0.58 ± 0.02, P = .01) and smaller LDL particle size (216.2 ± 0.7 vs 219.4 ± 1.1 Å, P = .01). Of note, these differences between patients with/without NAFLD were independent of the presence of obesity. Severity of steatohepatitis did not significantly influence the lipoprotein profile. Worse atherogenic dyslipidemia was best predicted by the degree of liver fat accumulation and adipose tissue and systemic insulin resistance. NAFLD was associated with a worse atherogenic lipoprotein profile, regardless of similar body mass index and other clinical parameters. We speculate that this lipoprotein profile is driven mostly by liver fat content and insulin resistance and appears not to be worsened by obesity or the severity of liver disease (nonalcoholic steatohepatitis).

Correlation Between Dietary Fat Intake and Atherogenic Indices in Normal, Overweight and Obese Adults with or Without Type 2 Diabetes

Abstract Background and aims: We investigated the association of dietary intake, particularly fat and its constituent fatty acids, with atherogenic indices in adult patients with overweight, obesity and/or type 2 diabetes (T2D). Material and Methods: Two hundred eighty-five outpatients were selected in two cities located in the Northwestern region of Algeria. Anthropometric measurements for body weight, height, body mass index (BMI) and waist circumference were performed. Relationships between dietary intakes, estimated by a 3- days food record, and fasting blood atherogenic indices - total cholesterol-to-high-density lipoprotein cholesterol ratio (TC/HDL-c) and apolipoprotein (apo) B-to-apo A1 ratio, were analysed. Results: Study group included 58.59% overweight/obese T2D patients, 24.91% normal weight T2D patients and 16.49 % overweight/obese patients without diabetes. Higher dietary consumption (p= 0.003) of total fat, saturated fatty acids (SFAs) and polyunsaturated fatty acids (PUFAs), was recorded in the group of overweight/obese T2D patients. Significant positive correlations were observed between apo B/apo A1 and total fat (p= 0.035), total SFAs (p= 0.042) and palmitic acid (p= 0.042) in the group of overweight/obese T2D patients and with ω6 fatty acid (p= 0.030) in the group of overweight/obese patients without diabetes. In the two groups of T2D patients, whether normal weight, overweight/obese, numerous positive correlations with TC/HDL-c were disclosed for PUFAs, ω6 and fatty acids ratios, namely, ω6/ω3, monounsaturated fatty acids (MUFA)/SFAs and (MUFAs+PUFAs)/SFAs. Conclusion: Most adults, whom are either affected by an excess weight or T2D or both together, are prone to cardiovascular risk. Dietary intakes, particularly in fat and its constituent fatty acids, have an important effect on blood lipid atherogenic indices (TC/HDL-c and apo B/apo A1 ratios).

Chronic consumption of a low-fat diet improves cardiometabolic risk factors according to the CLOCK gene in patients with coronary heart disease.

Single nucleotide polymorphisms (SNPs) of the circadian locomotor output cycles kaput (CLOCK) gene have been associated with cardiometabolic conditions such as obesity and dyslipidemia. Our aim was to examine whether the chronic consumption of two healthy diets interacts with SNPs of the CLOCK gene in order to improve lipid metabolism and inflammation status in patients with coronary heart disease (CHD). The diets were low-fat (LF) diet and Mediterranean diet (MedDiet). CLOCK SNPs (rs1801260, rs3749474, rs4580704) and the study procedures were performed in 897 patients from the CORDIOPREV clinical trial. After 12 months of intervention, we found significant gene-diet interactions between rs4580704 SNP and the LF diet. Specifically, major allele carriers C/C displayed a greater decrease in high sensitivity C-reactive protein (p < 0.001) and a significant increase in HDL/apolipoprotein A1 ratio (p = 0.029) than minor G allele carriers (G/G + C/G). No other gene-diet interactions were observed in this research. These results suggest that rs4580704 SNP interacts with the LF diet improving inflammation status and dyslipidemia related with CHD. The shift toward "personalized nutrition" based on gene-nutrient interactions may be suitable for promoting cardiovascular health in patients with CHD.

Apolipoprotein B: novel indicator of elevated intraocular pressure.

Many studies have reported associations between elevated intraocular pressure (IOP) and systemic health parameters, which suggest a common mechanism links IOP elevation and various related cardiometabolic risk factors. Furthermore, according to a recent study, serum apolipoprotein B (APO B) level is a predictor of coronary artery disease. This study was undertaken to analyse the relationship between serum apolipoprotein levels and IOP. Healthy people (28,852) who attended a community hospital for a health checkup between January 2011 and December 2013 were enroled in the study. We measured age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein A1 (APO A1) and APO B, APO B/APO A1 ratios, and IOP. Univariate regression analysis showed IOP was positively correlated with BMI, SBP, DBP, TC, LDL-C, TG, APO B, and APO B/APO A1 (P<0.001), and negatively correlated with HDL-C (P<0.001). On the other hand, multivariate regression analysis adjusted for age, BMI, SBP, and DBP, revealed IOP was positive correlated with TC, TG, LDL-C, APO B, and APO B/APO A1, and negatively correlated with HDL-C (all <0.05). Among the various lipid profiles investigated, APO B was found to be most strongly correlated with IOP, regardless of sex. Additional studies are required to confirm the validity of apolipoprotein level as an index for predicting IOP.

Menopausal stages and serum lipid and lipoprotein abnormalities in middle-aged women

ObjectivesWhether menopausal stage is associated with abnormalities in serum lipid and lipoprotein profiles remains unclear; studies have been conducted mostly in Western populations. This study aimed to examine the prevalence of lipid and lipoprotein abnormalities by recently updated menopausal stages in middle-aged women. Study designThis study was cross-sectional analysis of 1553 women aged 44–56 years, who underwent a comprehensive health screening examination in the Kangbuk Samsung Hospital Total Healthcare Centers, Korea, during 2012–2013. Lipid and lipoprotein profiles including total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), lipoprotein (a) (Lp(a)), apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B) were assessed. Prevalence ratios and 95% confidence intervals for lipid and lipoprotein abnormalities were estimated by menopausal stages as defined by the 2011 Stages of Reproductive Aging Workshop+10 criteria. ResultsIncreased prevalence of lipid and lipoprotein abnormalities were observed across menopausal stages. The increased prevalence of high non-HDL-C was associated with the late menopausal transition and post-menopausal stages and was more pronounced in women with body mass index (BMI) <23kg/m2 than in those with BMI ≥23kg/m2 (P for interaction=0.006). Similarly, there was an interaction between BMI and menopausal stages in relation to high Apo B (P for interaction=0.05) and high Apo B/Apo A1 ratio (P for interaction=0.06). ConclusionsOur findings extend previous results and suggest that the increased prevalence of lipid and lipoprotein abnormalities was associated not only with the post-menopausal stage but also late menopausal transition period.

The impact of interleukin-13 receptor expressions in cell migration of astrocytomas

INTRODUCTION: Astrocytomas are common brain tumors. Increased expression levels of Interleukin-13 Receptor α2 (IL-13RA2) have been reported in astrocytomas. The Interleukin-13 signaling pathway may be associated with cell migration when binding to Interleukin-13 Receptor α1. OBJECTIVE: To investigate Interleukin-13 Receptor α1 (IL-13RA1) and IL13RA2 expression levels in human diffusely infiltrative astrocytomas and test the involvement of Interleukin-13 levels in cell migration in two glioblastoma cell lines. METHODS: IL13RA expression levels were accessed by quantitative real time PCR in 128 samples of astrocytomas and 18 samples of non-neoplastic brain tissues from temporal lobe epilepsy surgery. The impact of IL-13 levels (10 and 20 ng/mL) on cell migration was analyzed by the wound assay in U87MG and A172 cells. RESULTS: Glioblastoma presented higher IL13RA1 and IL13RA2 expression levels compared to lower grades astrocytomas and to non-neoplastic cases. U87MG and A172 cells presented higher expression levels of IL-13RA1 vs. IL-13RA2. A significant difference in migration rate was observed in A172 cells treated with 10 ng/mL of IL-13 vs. control: treated cells presented slower migration than non-treated cells. U87MG cells treated with IL-13 20ng/mL presented slower migration than non-treated cells. This indicates that the IL13Rα1 signaling pathway was not activated, indeed inhibited by the decoy IL-13Rα2, slowing cell migration. This impact occurred with a lesser concentration of IL-13 on the A172 than on the U87MG cell line, because A172 cells have a higher IL-13RA2/A1 ratio. CONCLUSION: The present results suggest IL-13 receptors as possible targets to decrease tumor cell migration.

An ephemeral sexual population of Phytophthora infestans in the Northeastern United States and Canada.

Phytophthora infestans, the causal agent of late blight disease, has been reported in North America since the mid-nineteenth century. In the United States the lack of or very limited sexual reproduction has resulted in largely clonal populations of P. infestans. In 2010 and 2011, but not in 2012 or 2013, 20 rare and diverse genotypes of P. infestans were detected in a region that centered around central New York State. The ratio of A1 to A2 mating types among these genotypes was close to the 50∶50 ratio expected for sexual recombination. These genotypes were diverse at the glucose-6-phosphate isomerase locus, differed in their microsatellite profiles, showed different banding patterns in a restriction fragment length polymorphism assay using a moderately repetitive and highly polymorphic probe (RG57), were polymorphic for four different nuclear genes and differed in their sensitivity to the systemic fungicide mefenoxam. The null hypothesis of linkage equilibrium was not rejected, which suggests the population could be sexual. These new genotypes were monomorphic in their mitochondrial haplotype that was the same as US-22. Through parentage exclusion testing using microsatellite data and sequences of four nuclear genes, recent dominant lineages US-8, US-11, US-23, and US-24 were excluded as possible parents for these genotypes. Further analyses indicated that US-22 could not be eliminated as a possible parent for 14 of the 20 genotypes. We conclude that US-22 could be a parent of some, but not all, of the new genotypes found in 2010 and 2011. There were at least two other parents for this population and the genotypic characteristics of the other parents were identified.

The relationship between apolipoprotein B/ apolipoprotein A1 ratio, high sensitivity C - reactive protein and some components of metabolic syndrome in Bulgarian population

The relationship between apolipoprotein B/ apolipoprotein A1 ratio, high sensitivity C - reactive protein and some components of metabolic syndrome in Bulgarian population

Optimal duration of low molecular weight heparin for the treatment of cancer-related deep vein thrombosis: the Cancer-DACUS Study.

We evaluated the role of residual vein thrombosis (RVT) to assess the optimal duration of anticoagulants in patients with cancer who have deep vein thrombosis (DVT) of the lower limbs. Patients with active cancer and a first episode of DVT treated with low molecular weight heparin (LMWH) for 6 months were eligible. Patients were managed according to RVT findings: those with RVT were randomly assigned to continue LMWH for an additional 6 months (group A1) or to discontinue it (group A2), and patients without RVT stopped LMWH (group B). The primary end point was recurrent venous thromboembolism (VTE) during the 1 year after disconinuation of LMWH, and the secondary end point was major bleeding. Analyses are from the time of random assignment. Between October 2005 and April 2010, 347 patients were enrolled. RVT was detected in 242 patients (69.7%); recurrence occurred in 22 of the 119 patients in group A1compared with 27 of 123 patients in group A2. The adjusted hazard ratio (HR) for group A2 versus A1 was 1.37 (95% CI, 0.7 to 2.5; P = .311). Three of the 105 patients in group B developed recurrent VTE; adjusted HR for group A1 versus B was 6.0 (95% CI, 1.7 to 21.2; P = .005). Three major bleeding events occurred in group A1, and two events each occurred in groups A2 and B. The HR for major bleeding in group A1 versus group A2 was 3.78 (95% CI, 0.77 to 18.58; P = .102). Overall, 42 patients (12.1%) died during follow-up as a result of cancer progression. In patients with cancer with a first DVT, treated for 6 months with LMWH, absence of RVT identifies a population at low risk for recurrent thrombotic events. Continuation of LMWH in patients with RVT up to 1 year did not reduce recurrent VTE.

Relationship Between Alcohol Consumption and Serum Lipid Profiles Among Middle-Aged Population in China: A Multiple-Center Cardiovascular Epidemiological Study.

We assessed the relationship between alcohol consumption and serum lipids in a middle-aged Chinese population. The overall prevalence of drinking among 10 154 participants was 34.07% in males and 3.61% in females. Heavy alcohol drinkers (≥ 30 g/d) tended to be older, smokers, hypertensive, do heavy physical activity, and have a lower body mass index. Levels of high-density lipoprotein cholesterol (HDL-C), apolipoprotein (apo) A1, low-density lipoprotein cholesterol-HDL-C ratio, and apo B-apo A1 ratio rose with increase in alcohol intake in males. An increase of 0.27 mmol/L in triglycerides and a decrease of 2.10 mg/dL in lipoprotein(a), Lp(a), were observed in male alcohol drinkers who consumed ≥30 g alcohol/d compared with abstainers after controlling for all confounders. Levels of total cholesterol, HDL-C, and apo A1 increased with increase in alcohol intake in both genders and Lp(a) decreased with the increase in alcohol intake in males.

Nontraditional risk factors for cardiovascular disease and visceral adiposity index among different body size phenotypes

Background and aimsIncreased cardiovascular disease and mortality risk in metabolically healthy obese (MHO) individuals remain highly controversial. Several studies suggested risk while others do not. The traditional cardiovascular risk factors may be insufficient to demonstrate the complete range of metabolic abnormalities in MHO individuals. Hence, we aimed to compare the prevalence of elevated lipoprotein (a), apolipoprotein B, and uric acid (UA) levels, apolipoprotein B/apolipoprotein A1 ratio, and visceral adiposity index (VAI) scores, and low apolipoprotein A1 levels among 6 body size phenotypes (normal weight with and without metabolic abnormalities, overweight with and without metabolic abnormalities, and obese with or without metabolic abnormalities). Methods and resultsWe conducted a cross-sectional analysis of 7765 Chinese adults using data from the nationwide China Health and Nutrition Survey 2009. MHO persons had intermediate prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low apolipoprotein A1 levels between metabolically healthy normal-weight (MHNW) and metabolically abnormal obese individuals (P < 0.001 for all comparisons). Elevated apolipoprotein B and UA concentrations, apolipoprotein B/apolipoprotein A1 ratio, and VAI scores were all strongly associated with the MHO phenotype (all P < 0.01). ConclusionsPrevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low levels of apolipoprotein A1 was higher among MHO persons than among MHNW individuals. The elevated levels of the nontraditional risk factors and VAI scores in MHO persons could contribute to the increased cardiovascular disease risk observed in long-term studies.

Association of serum 25-hydroxyvitamin D with lifestyle factors and metabolic and cardiovascular disease markers: population-based cross-sectional study (FIN-D2D).

ObjectivesLow serum 25-hydroxyvitamin D (25OHD) level has been associated with an increased risk of several chronic diseases. Our aim was to determine lifestyle and clinical factors that are associated with 25OHD level and to investigate connection of 25OHD level with metabolic and cardiovascular disease markers.DesignIn total, 2868 Finnish men and women aged 45–74 years participated in FIN-D2D population-based health survey in 2007. Participants that had a serum sample available (98.4%; n = 2822) were included in this study. 25OHD was measured with chemiluminescent microparticle immunoassay method.ResultsThe mean 25OHD level was 58.2 nmol/l in men (n = 1348) and 57.1 nmol/l in women (n = 1474). Mean 25OHD level was lower in the younger age groups than in the older ones (p<0.0001 both in men and women). This study confirmed that low physical activity (p<0.0001 both in men and women), smoking (p = 0.0002 in men and p = 0.03 in women) and high BMI (p<0.0001 in women) are factors that independently associate with low 25OHD level. Of the metabolic and cardiovascular disease markers high triglyceride concentration (p = 0.02 in men and p = 0.001 in women) and high apolipoprotein B/apolipoprotein A1 ratio (p = 0.04 in men and p = 0.03 in women) were independently associated with low 25OHD level.ConclusionsHigher age did not predict lower 25OHD level in this study population of aged 45–74 years which may derive from a healthy life-style of “active pensioners”. Low physical activity and smoking came up as independent lifestyle factors associated with low 25OHD level. Defining the molecular mechanisms behind the associations of 25OHD with low physical activity and smoking are important objective in future studies. The association of 25OHD with BMI, high triglyceride concentration and apolipoprotein B/apolipoprotein A1 ratio may be related to the role of vitamin D in inflammation, but more detailed studies are needed.