Abnormal Lipid Levels Research Articles

Prevalence of dyslipidemia and achievement of low-density lipoprotein cholesterol targets in Chinese adults: A nationally representative survey of 163,641 adults

BackgroundElevated serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels are established risk factors for cardiovascular diseases, a leading cause of death in China. We sought to assess the latest levels of serum lipids, prevalence of dyslipidemia and achievement of LDL-C lowering targets among Chinese adults. MethodsData was obtained from a national representative survey recruited 163,641 adults aged >18years in mainland China between 2013 and 2014. Fasting serum total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured by standard methods. Multiple logistic regression was preformed to estimate potential risk factors for dyslipidemias. Proportion of residents not achieve the therapeutic goals for LDL-C by atherosclerotic cardiovascular diseases (ASCVD) risk stratification were evaluated. ResultsNationally, the population-weighted means of TC, HDL-C, and LDL-C, and median of TG were 4.70, 1.35, 2.88, and 1.49mmol/L, respectively. The prevalence of high TC, high LDL-C, low HDL-C and high TG was 6.9%, 8.1%, 20.4% and 13.8%. Among individuals with high ASCVD risk, 74.5% had uncontrolled LDL-C levels (<2.6mmol/L) and 5.5% of them were treated. For very-high-risk individuals, 93.2% didn't achieve their LDL-lowering goals (<1.8mmol/L) and 14.5% of them were treated. ConclusionsChinese adults currently experienced a high prevalence of abnormal serum lipid levels, more common in urban adults or those with obesity or central obesity. A significant proportion of people with high or very high ASCVD risk didn't meet LDL-C targets. Improvements in achievement of lipid-level targets and of LDL-lowering therapy rates based on ASCVD risk stratification were necessary.

Statins in adult patients with HIV: Protocol for a systematic review and network meta-analysis.

Background:Patients with HIV have been found to suffer from lipid abnormalities, including elevated levels of total and LDL-cholesterol as well as triglyceride levels. Abnormal lipid levels are associated with an increased risk of developing cardiovascular diseases, which are significant causes of mortality among the general population. Therefore, the objective of the current study is to conduct a systematic review with network meta-analysis to compare the effects of statins classes on HIV patients.Methods:Randomized clinical trials (RCTs) and observational studies published in English up to 31 December 2017, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching four electronic databases and cross-referencing. Dual selection and abstraction of data will occur. The primary outcome will all-cause mortality, new event of acute myocardial infarction, stroke (hemorrhagic and ischemic), hospitalization for acute coronary syndrome and urgent revascularization procedures and cardiovascular mortality. Secondary outcomes will be assessment of the differences in change of total cholesterol (TC), low-density lipoprotein (LDL-C), apolipoprotein B (ApoB), high density lipoprotein (HDL-C). Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument for RCTs and the Strengthening the Reporting of Observational Studies in Epidemiology instrument for observational studies. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of statins that reduce cardiovascular mortality in HIV patients. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed.Results and Conclusion:Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The evidence will determine which combination of interventions are most promising for current practice and further investigation.Trial registration number:PROSPERO (CRD42017072996).

Prevalence and complications of obesity and overweight among Algerian adolescents

OBJECTIVE: To determine the prevalence of overweight and obesity in Algerian adolescents and investigate the associated cardiometabolic complications. METHODS: The study was conducted in the city of Constantine (Algeria). The population included 1100 schooled adolescent, aged 12–18 years, randomly selected. All had anthropometric measurements, and 989 had blood tests. The BMI was calculated and the prevalence of overweight and obesity was determined using the International Obesity Task Force reference values. RESULTS: 179 (16.3%) adolescents were overweight including 74 boys (13.8%) and 105 girls (18.6%), 51 (4.6%) adolescents were obese including 25 (4.6%) boys vs 26 (4.6%) girls (p = 0.09). Overweight and obese adolescents had higher systolic blood pressure/diastolic blood pressure (p = 0.001/p &lt; 0.0001) and abnormal blood lipid levels. Furthermore, the HOMA index was higher in overweight and obese adolescents (p &lt; 0.0001). CONCLUSION: These findings show a high prevalence of overweight and obesity in a population of Algerian adolescents leading to significant cardiometabolic abnormalities.

Synergistic action of inflammation and lipid dysmetabolism on kidney damage in rats

In kidney disease, inflammation and lipid dysmetabolism are often associated together, however, the effect and mechanism of inflammatory mediators and lipid dysmetabolism on kidney damage is still unclear. In this study, Wistar rats were randomized into four groups: normal diet + saline (Group N), high-fat diet (HF)+ saline (Group HF), normal diet + adriamycin (Group ADR), HF + adriamycin (Group ADR + HF). After 10 weeks of feeding, rats in each group were randomly sacrificed. We found that the protein content of urine in ADR and ADR + HF groups were significantly higher than that of group N and HF while the serum levels of total protein and albumin in the ADR and ADR + HF groups decreased correspondingly. The serum levels of triglyceride, total cholesterol and low-density lipoprotein in the HF, ADR and ADR + HF groups increased. In the treatment groups, mesangial proliferation, matrix accumulation, tubular vacuolization, inflammatory cell infiltration and fat deposition were detected. These pathological changes were the most serious in the ADR + HF group. The expression of tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) were increased in each treatment group, especially in the ADR + HF group. Our results suggested that the inflammatory factors and abnormal lipid levels can activate the inflammatory response in kidney of the Wistar rats, and lead to a series of pathological changes in renal tissue, and inflammatory factors and lipid dysmetabolism can aggravate damage in the kidney.

Abstract P090: Health Informatics Approach to Investigation of Hyperlipidemia in Families

Introduction: West Virginia exhibits pervasive cardiovascular disease (CVD) that may relate to a combination of ancestry and shared environment in families, including vulnerabilities related to diet, physical activity and tobacco use. Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) is a school-based child risk factor screening program that has evaluated over 90,000 WV fifth graders in the past 20 years. Reverse Cascade screening for Familial Hypercholesterolemia (FH) has been difficult with the CARDIAC population. The WVU CTSI Integrated Data Repository (IDR) includes over 2 million records. Hypothesis: Linkage of child CARDIAC data to parent IDR data will allow new information discovery to inform management of CVD. Methods: We used direct demographic data linkage via Oracle with Soundex conversion of names, in the IDR, to find parents of the CARDIAC participants. Data was analyzed in the VMWare SSL environment. Results: 4759 children have a parent(s) identified. 959 mothers and 524 fathers have an LDL level from IDR. Race, BMI and gender was recorded from CARDIAC. 6.8 % of children, 40% of mothers and 44.8% of fathers have an abnormal LDL level &gt;130 mg/dl in IDR. Positive predictive value of the abnormal child lipid level (≥130 mg/dl) is 17% for some parent (56/325) to be abnormal. 4 parents had LDL &gt;190 mg/dl with child &gt; 160, indicating likely FH in the pair (2.7% of pairs or 1 in 371 pairs). Conclusion: Formation of a virtual cohort of CARDIAC children and parents allows Virtual Reverse Cascade Screening to find FH. This project highlights the importance of familial tendency to hyperlipidemia that can aid detection of early lipid abnormality and cardiovascular risk in children and their young parents to promote wellness and potentially avoid early coronary artery disease. We are constructing a virtual longitudinal cohort to study CVD in WV as a part of a Learning Health System in which data management is at the forefront of healthcare improvement.

Cell size is regulated by phospholipids and not by storage lipids in Saccharomyces cerevisiae.

Cell size and morphology are key adaptive features that influence almost all aspects of cellular physiology such as cell cycle and lipid metabolism. Here we report the role of a transcription factor Suppressor Phenotype of Ty elements insertion 10 (SPT10) of Saccharomyces cerevisiae in regulating cell cycle, cell size and lipid metabolism in concert, in addition to its defined role of histone gene expression. Morphological and biochemical analyses of spt10Δ strain show an abnormal cell size, cell cycle and lipid levels. The expression of Spt10p in spt10Δ strain helps the cell revert to typical wild-type phenotypes. SPT10 controls lipid metabolism by negatively regulating the expression of lipid biosynthetic genes, and positively regulating the expression of the lipid hydrolyzing genes. Spt10p helps in maintaining the cell size by regulating the amount of carbon flux into the phospholipid constituents of the cell membranes. On the contrary, storage lipids have no role in regulating the cell size. An exogenous supply of phosphatidic acid increases the cell size, proving the positive impact of the phospholipids on cell size modulation. SPT10 affects cell cycle, cell size and lipid metabolism by an orchestrated transcriptional regulation of the corresponding genes.

Relationship of lipid regulatory gene polymorphisms and dyslipidemia in a pediatric population: the CASPIAN III study.

In this study, we aimed to assess the association between four variants in three genes whose association has been reported in adults but not in children. We evaluated the relationship of the GCKR (rs780094), GCKR (rs1260333), FADS (rs174547), and MLXIPL (rs3812316) polymorphisms with serum lipid levels in Iranian children. This cross-sectional study was conducted in a subpopulation of the CASPIAN III study. During this study, 550 frozen whole blood samples were selected randomly. Using the recorded information of selected cases, those with and without abnormal lipid levels were determined. Allelic and genotypic frequencies of GCKR (rs780094), GCKR (rs1260333), MLXIPL (rs3812316), and FADS (rs174547) polymorphisms were determined and compared in dyslipidemic and normal children. The association between the studied polymorphisms and lipid profiles was determined using logistic regression analysis. Prevalence of hypercholesterolemia, hypertriglyceridemia, high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C) were 24.9, 34.5, 19.0, and 40.7%, respectively. Significant correlations were found between GCKR (rs780094) and GCKR (rs1260333) polymorphisms and cholesterol and triglyceride levels, between FADS (rs174547) polymorphism and level of triglyceride, and also between MLXIPL (rs3812316) and levels of HDL-C. The results of this population-based study provide evidence for a relationship between lipid regulatory gene polymorphisms including GCKR (rs780094), GCKR (rs1260333), FADS (rs174547), and MLXIPL (rs3812316) with dyslipidemia in an Iranian population. These results could provide baseline information on as well as further insight into the genetic makeup of lipid profiles in Iranian children, which could be used for preventative strategies.

The effects of lifestyle changes on serum lipid levels in children in a real life setting.

Studies have shown improvement in lipid levels after institution of lifestyle changes in children enrolled in closely monitored programs. There programs are difficult to mimic in real world clinics. We aim to determine if diet and exercise result in improvement in lipid levels in patients seen in a designated lipid clinic in a real life setting. Retrospective review of patients followed for dyslipidemia at the Texas Children's Hospital Lipid Clinic from May 1, 2012 to May 1, 2015. Patients included were seen more than once, had repeat lipid testing, and abnormal baseline lipid levels. Multivariate analysis using mixed models were performed to compare outcomes in patients who did and did not participate in lifestyle change. Of the 268 patients seen within the study period, 174 (56% male, 44% female) met inclusion criteria. Median age was 11 years. Compared to patients who did not make lifestyle changes: patients who made only diet changes demonstrated significant improvement in weight only (slope = -1.55, P-value = .014), and those who made only exercise changes demonstrated significant improvements in serum cholesterol (slope = -22.8, P-value = .017) and non-HDL cholesterol (slope = -28.7, P-value = < .01) levels. Patients who participated in both diet and exercise demonstrated significant improvement in weight (slope = -1.13, P-value = .011), diastolic blood pressure (slope = -1.82, P-value = < .01), and serum lipid levels: LDL (slope = -10.8, P-value = 0.017), HDL (slope = 1.52, P-value = .24), Triglycerides (slope = -0.11, P-value = .033) compared to those who did not make lifestyle changes. Outpatient management of dyslipidemia is difficult. Only patients who participated in both diet and exercise showed significant improvement in outcomes when compared to those who did not make lifestyle changes.

Erchen Decoction Ameliorates Lipid Metabolism by the Regulation of the Protein CAV-1 and the Receptors VLDLR, LDLR, ABCA1, and SRB1 in a High-Fat Diet Rat Model.

Lipid metabolism disorder is a common metabolic disorder characterized by abnormal lipid levels in blood. Erchen decoction (ECD) is a traditional Chinese medicine prescription, which is used for the treatment of diseases caused by retention of phlegm dampness. It has been reported to ameliorate the disorder of lipid metabolism. The aim of the present study was to investigate the effects and underlying mechanisms of ECD in lipid metabolism disorder induced by a high-fat diet (HFD) in rats. ECD (4.35g/kg/d) and atorvastatin (10mg/kg/d, positive control) were orally administered to HFD-fed rats for four weeks. The parameters, food, water consumption, body weight, body length, liver, and visceral fat weight and the content of serum lipids and lipid transporters were assessed. The effects of ECD on the mRNA and protein expression levels of lipid transport factors were measured by real-time PCR and western blotting. The present study demonstrated that ECD improved the disorders of serum lipid and lipid transporters in HFD-fed rats, TG (0.70±0.08 mmol/L, p<0.01), LDL-C (1.50±0.19 mmol/L, p<0.01), LDL (1.38±0.21 mmol/L, p<0.05), and oxLDL (1.77±0.39 ng/mL, p<0.05) were downregulated, while HDL-C (0.87±0.13 mmol/L, p<0.01), FFA (0.62±0.13 mmol/L, p<0.05), HDL (38.8±4.0 mg/dL, p<0.05), and CETP (903.6±120.0 ng/mL, p<0.05) were upregulated. But ECD obviously had no effects on the indices food/water/energy intake, body/tissue (liver and fat) weight, and BMI (p>0.05). Concomitantly, ECD reversed the abnormal expressions of those lipid transport factors in the liver and visceral fat.

Assessment of Lipid Profile among Children: A Hospital Based Prospective Study

Background: Abnormal lipid level in children leads to cardiovascular diseases. There is increase in rate of cardiovascular diseases among children for past few years. There comes the role of diagnosis and treatment. Examination of lipid profile can help to rule out the disease. The aim of the present study was to study lipid profile of children aged between 8 to 16 years. Methods: A cross sectional study was planned . A total of 200 patients were included for the study. Blood samples were collected from each patient in fasting state. Samples were further examined for lipid profile estimation. Results: 200 students were selected for the present study. Of the 200 children 100 were boys i.e. 50% and 100 were girl’s i.e.50%. Total cholesterol for girls was 165.62±30.48 and for boys it was 162.08±30.16. Mean total cholesterol for girls were 94.2±22.80 and for boys were 92.54±21.14. Conclusions: lipid profile plays a very important role in good health of children. Examination of lipid profile should be done at an early age.

Genetic and microbiome influence on lipid metabolism and dyslipidemia.

Disruption in the metabolism of lipids is broadly classified under dyslipidemia and relates to the concentration of lipids in the blood. Dyslipidemia is a predictor of cardio-metabolic disease including obesity. Traditionally, the large interindividual variation has been related to genetic factors and diet. Genome-wide association studies have identified over 150 loci related to abnormal lipid levels, explaining ~40% of the total variation. Part of the unexplained variance has been attributed to environmental factors including diet, but the extent of the dietary contribution remains unquantified. Furthermore, other factors are likely to influence lipid metabolism including the gut microbiome, which plays an important role in the digestion of different dietary components including fats and polysaccharides. Here we describe the contributing role of host genetics and the gut microbiome to dyslipidemia and discuss the potential therapeutic implications of advances in understanding the gut microbiome to the treatment of dyslipidemia.

Application of atherogenic index of plasma and intima-media thickness of carotid artery in renal arteriolar sclerosis patients with chronic renal failure

Objective To evaluate the application of atherogenic index of plasma (AIP) and intima-media thickness of carotid artery (CA-IMT) in renal arteriolar sclerosis patients with chronic renal failure. Methods One hundred and twenty nine patients with chronic renal failure patients underwent ultrasound-guided percutaneous renal biopsy from October 2013 to June 2014, the biopsy results showed that renal arteriolar sclerosis was identified in 72 patients (atherosclerosis group) and no renal arterioles sclerosis was detected in 57 patients (non-atherosclerosis group); 71 healthy adults were enrolled in the study as controls. The age, height, body weight, systolic and diastolic blood pressure, the indexes of blood lipid and renal function were documented and compared among three groups. The correlation of AIP and CBMmax of common carotid artery and carotid bifurcation with blood lipid level and renal function was analyzed. Results There was significant difference in body weight among patients with atherosclerosis [(70.77±14.27) kg], without atherosclerosis [(60.63±12.12) kg] and the controls [(64.20±8.13) kg] (t=3.071, 3.391, all P<0.05). The TG [(2.43±1.61) mmol/L vs.(1.02±0.37)mmol/L], TC[(7.40±8.80) mmol/L vs.(4.53±0.67)mmol/L], LDL-C[(4.40±2.13) mmol/L vs.(2.85±0.70)mmol/L], AIP[(0.15±0.351)vs.(-0.127±0.184)] of the atherosclerosis group were higher than those of control group (t=5.975, 2.252, 2.614, -5.467, all P<0.05). The HDL-C of atherosclerosis group was lower than that of control group [(0.78±0.16)mmol/L vs.(1.29±0.21)mmol/L, t=4.750, P<0.05]. The Scr[(117.24±94.27)mmol/L vs.(64.16±13.42)mmol/L], BUN[(6.73±3.58)mmol/L vs.(4.66±1.08)mmol/L] of the atherosclerosis group were higher, and the GFR was lower [(65.60±23.00)ml·min-1·1.73 m-2vs.(124.78±24.35)ml·min-11.73 m-2 , t=5.118] than those of control group (t=4.730, 4.702). The Scr of the atherosclerosis group was higher, and the GFR was lower [(65.60±23.00)ml·min-1·1.73 m-2vs.(95.60±53.00)ml·min-1·1.73 m-2, t=3.514] than those of the non-atherosclerosis group [(117.24±94.27)mmol/L vs.(71.35±42.18)mmol/L, t=3.690]. There were positive correlation between TG and LDL-C (r=0.828, 0.323, P<0.05) and negative correlation between AIP and HDL-C (r=-0.489, P<0.05). There was positive correlation of CBMmax with Scr, BUN and AIP (r=0.394, 0.289, 0.528, all P<0.05), and negative correlation between CBMmax and GFR (r=-0.277, P<0.05). Conclusion Body weight, GFR, AIP and CBMmax are useful indicators in evaluation of renal arteriolar sclerosis in patients with chronic renal failure. AIP is a sensitive index for abnormal blood lipid level. AIP and CBMmax are important risk factors in chronic renal failure patients with renal arteriolar sclerosis. Key words: Kidney failure, chronic; Atherogenic index of plasma; Intima-media thickness of carotid artery

US preventive services task force recommendations on obesity in children and adolescents: can evidence translate to impact?

Despite recent plateauing of the prevalence of childhood obesity, nearly 1 in 3 children and adolescents in the United States are overweight or have obesity (1), defined as having a body mass index (BMI) equal or greater than the 85 th percentile for age and sex based on the U.S. Centers for Disease Control and Prevention growth charts. Overweight and obesity—particularly severe obesity (BMI ≥120% of the 95th percentile)—also tended to be more prevalent among certain race-ethnic minorities and lower income communities (2). Obesity during childhood not only predisposes children to obesity and severe obesity as adults, it is also associated with concurrent health issues such as asthma, obstructive sleep apnea, and cardiovascular and metabolic disorders (including high blood pressure, abnormal lipid levels, and insulin resistance). Many children and adolescents with obesity also experience bullying behaviors and negative psychosocial problems (3). While environmental and policy approaches are imperative in providing the conditions where people can easily make healthy choices (4), screening and treating obesity should be part of a comprehensive strategy.

Metabolic Concomitants of Obese and Nonobese Women With Features of Polycystic Ovarian Syndrome.

Context:Polycystic ovarian syndrome (PCOS) is often associated with obesity and diabetes.Objective:The present study measured body fat distribution and metabolic risk factors in women with features of PCOS.Design:Cross-sectional, multiethnic study of cardiovascular risks.Setting:General community.Study Participants:145 PCOS and 344 non-PCOS women.Exposure Measures:Body composition by dual x-ray absorptiometry; abdominal fat masses measured by magnetic resonance imaging and hepatic triglyceride by magnetic resonance spectroscopy.Outcomes Measures:Body composition, liver fat content, homeostatic model assessment for insulin resistance (HOMA-IR), revised, and metabolic syndrome components.Results:PCOS women had a higher free androgen index compared with the non-PCOS women. Nonobese PCOS and non-PCOS women had a similar body fat content and distribution, HOMA-IR, and hepatic triglyceride content. Obese PCOS women had a similar total body fat percentage compared with their non-PCOS counterparts (41.4% and 41.4% respectively). Both obese groups had similar intraperitoneal fat (1.4% of total body mass in PCOS vs 1.4% in non-PCOS). However, obese PCOS women had a greater ratio of truncal/lower body fat (1.42 vs 1.27; P < 0.016). They also had greater insulin resistance (HOMA-IR: PCOS, 2.24% vs non-PCOS, 1.91%; P < 0.016), higher liver triglyceride content (6.96% in PCOS vs 4.44% in non-PCOS; P < 0.016), and a greater incidence of hypertension (33% vs 24%; P < 0.05). No differences were observed in other metabolic risk factors.Conclusions:Both obese and nonobese women with PCOS features had a greater free androgen index compared with non-PCOS women, but neither had greater intraperitoneal fat or abnormal lipid levels. Obese, but not nonobese, women with PCOS had a greater truncal/lower extremity fat ratio, HOMA-IR, and liver triglyceride content.

ADDITION OF MULBERRY LEAF (MORUS ALBA L.) TO A DIET FORMULA IMPEDED ITS HYPOGLYCEMIC EFFECT AND EXACERBATED DYSLIPIDEMIA IN HIGH-FRUCTOSE- AND HIGH-FAT-INDUCED CD-1 MICE

Backgrounds: Morus alba L. (mulberry leaf) is frequently used for therapeutic purposes in China. This study investigated the hypoglycemic and hypolipidemic effects of a reported antidiabetic herbal formula (PLCP) supplemented with mulberry leaves (MPLCP) in high-fructose- and high-fat- (HFF) fed mice. Methods: Six-week-old CD-1 male mice were fed on normal standard diet for 10 weeks. Fat emulsion with or without aqueous/ethanol extracts of PLCP/MPLCP was administrated by gavage daily for HFF groups. The normal group only received vehicle. 15% Fructose drinking water was supplied for HFF groups. Results: MPLCP was less effective than PLCP in hypoglycemic effect. The addition of mulberry leaves impeded not only the decrease in insulin resistance and serum free fatty acid content but also the increase in spleen index. The ethanol extract of MPLCP caused remarkable increase in low-density lipoprotein levels (p &lt; 0.01) and significant increase in total cholesterol level (p &lt; 0.05) compared with model group. Thus the effect of MPLCP was detrimental to abnormal serum lipid levels. Conclusion: The addition of mulberry leaves to PLCP weakened the hypoglycemic effects of the original formula and exacerbated dyslipidemia.

Serum perfluoroalkyl substances and cardiometabolic consequences in adolescents exposed to the World Trade Center disaster and a matched comparison group

BackgroundLarge amounts of various chemical contaminants, including perfluoroalkyl substances (PFASs), were released at the time of the World Trade Center (WTC) disaster. Thousands of children who lived and/or attended school near the disaster site were exposed to these substances but few studies have examined the possible consequences related to these exposures. ObjectivesTo examine the relationship of PFASs serum levels with cardiometabolic profile in children and adolescents enrolled in the World Trade Center Health Registry (WTCHR) and a matched comparison group. MethodsWe evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group consisting of individuals who were ineligible for WTCHR participation upon distance of their home, school or work from the WTC and lack of participation in rescue and recovery activities. Matching was based on date of birth, sex, race, ethnicity, and income. We assessed exposure to PFASs, as measured by serum levels and association with cardiometabolic profile as measured by arterial wall stiffness, body mass index, insulin resistance, fasting total cholesterol, HDL, LDL and triglycerides. ResultsA total of 402 participants completed the study and serum samples were analyzed from 308 participants, 123 in the WTCHR group and 185 in the comparison group. In multivariable regression analysis, after adjusting for relevant confounders, we observed a significant, positive association of perfluorooctanoic acid (PFOA) with triglycerides (beta coefficient=0.14, 95% CI: 0.02, 0.27, 15.1% change), total cholesterol (beta coefficient=0.09, 95% CI: 0.04, 0.14, 9.2% change), and LDL cholesterol (beta coefficient=0.11, 95% CI: 0.03, 0.19, 11.5% change). Perfluorohexanesulfonic acid levels were associated with decreased insulin resistance (beta coefficient=−0.09, 95% CI: −0.18, −0.003, −8.6% change); PFOA and perfluorononanoic acid were associated with increased brachial artery distensibility. ConclusionsThis research adds to our knowledge of the physical health impacts in a large group of children exposed to the WTC disaster. Abnormal lipid levels in young adults might be an early marker of atherosclerosis and cardiovascular diseases and our findings highlight the importance of conducting longitudinal studies in this population.

MDG-1, a Potential Regulator of PPARα and PPARγ, Ameliorates Dyslipidemia in Mice.

Hyperlipidemia is a serious epidemic disease caused by lipid metabolism disorder, which is harmful to human health. MDG-1, a β-d-fructan polysaccharide extracted from Ophiopogon japonicus, has been shown to improve abnormal blood lipid levels and alleviate diabetes. However, the underlying mechanism on hyperlipidemia is largely unknown. In this study, male C57BL/6 mice were randomly separated into three groups, respectively: low-fat diet (Con), high-fat diet (HFD), and high-fat diet plus 5‰ MDG-1 (HFD + MDG-1). Body weight was measured and the serum lipid levels were analyzed. Using gene microarray, various core pathways, together with levels of gene expression within hepatocytes, were analyzed. RT-PCR was used to confirm the identity of the differentially expressed genes. MDG-1 could prevent obesity in HFD-induced mice and improve abnormal serum lipids. Besides, MDG-1 could regulate hyperlipidemia symptoms, specifically, and decrease fasting blood glucose, improve glucose tolerance, and ameliorate insulin resistance. According to results from gene microarray, most of the identified pathways were involved in the digestion and absorption of fat, biosynthesis, and catabolism of fatty acids as well as the secretion and biological synthesis of bile acids. Furthermore, MDG-1 may act upon peroxisome proliferator-activated receptors (PPAR) α and γ, activating PPARα whilst inhibiting PPARγ, thus having a potent hypolipidemic effect.

Integrated Clinical Decision Support Systems Promote Absolute Cardiovascular Risk Assessment: An Important Primary Prevention Measure in Aboriginal and Torres Strait Islander Primary Health Care.

Aboriginal and Torres Strait Islander Australians experience a greater burden of disease compared to non-Indigenous Australians. Around one-fifth of the health disparity is caused by cardiovascular disease (CVD). Despite the importance of absolute cardiovascular risk assessment (CVRA) as a screening and early intervention tool, few studies have reported its use within the Australian Indigenous primary health care (PHC) sector. This study utilizes data from a large-scale quality improvement program to examine variation in documented CVRA as a primary prevention strategy for individuals without prior CVD across four Australian jurisdictions. We also examine the proportion with elevated risk and follow-up actions recorded. We undertook cross-sectional analysis of 2,052 client records from 97 PHC centers to assess CVRA in Indigenous adults aged ≥20 years with no recorded chronic disease diagnosis (2012-2014). Multilevel regression was used to quantify the variation in CVRA attributable to health center and client level factors. The main outcome measure was the proportion of eligible adults who had CVRA recorded. Secondary outcomes were the proportion of clients with elevated risk that had follow-up actions recorded. Approximately 23% (n = 478) of eligible clients had documented CVRA. Almost all assessments (99%) were conducted in the Northern Territory. Within this jurisdiction, there was wide variation between centers in the proportion of clients with documented CVRA (median 38%; range 0-86%). Regression analysis showed health center factors accounted for 48% of the variation. Centers with integrated clinical decision support systems were more likely to document CVRA (OR 21.1; 95% CI 5.4-82.4; p < 0.001). Eleven percent (n = 53) of clients were found with moderate/high CVD risk, of whom almost one-third were under 35 years (n = 16). Documentation of follow-up varied with respect to the targeted risk factor. Fewer than 30% with abnormal blood lipid or glucose levels had follow-up management plans recorded. There was wide variation in CVRA between jurisdictions and between PHC centers. Learnings from successful interventions to educate and support centers in CVRA provision should be shared with stakeholders more widely. Where risk has been identified, further improvement in follow-up management is required to prevent CVD onset and reduce future burden in Australia's Indigenous population.

Prenatal Exposure to Lipopolysaccharide Induces PTX3 Expression and Results in Obesity in Mouse Offspring

This study tested the hypothesis whether inflammation will directly lead to obesity. This study was designed to investigate the relationship between inflammation and obesity by intraperitoneally injecting pregnant mice with lipopolysaccharide (LPS) (75 μg kg−1). The results showed that inflammation during pregnancy could lead to a significant increase in the levels of the inflammatory factor PTX3. The offspring of the LPS-treated mice displayed abnormal levels of fat development, blood lipids, and glucose metabolism, and fat differentiation markers were significantly increased. Our study also confirmed that PTX3 can increase the susceptibility to obesity by regulating the expression of adipogenic markers; this regulatory role of PTX3 is most likely caused by MAPK pathway hyperactivation. Our study is the first to find strong evidence of inflammation as a cause of obesity. We determined that PTX3 was an important moderator of obesity, and we elucidated its mechanism, thus providing new targets and theories for obesity therapy. Moreover, our study provides new ideas and directions for the early intervention of anti-inflammation in pregnancy.

Severe Obesity, Obesity, and Cardiometabolic Risk in Children 0 to 6 Years of Age.

The prevalence of obesity in children has been shown to be plateauing or decreasing in some countries. However, the burden of severe obesity is often not assessed. Children with severe obesity may be at an increased risk for cardiovascular disease and diabetes. The objective is to determine the prevalence of severe obesity in young children and to examine the association with cardiometabolic risk factors. A longitudinal study was conducted through The Applied Research Group for Kids! (TARGet Kids!), a practice-based research network in Toronto, Canada. Healthy children from birth to 6 years of age were recruited and followed through middle childhood. The main outcomes of the study were as follows: total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and non-HDL cholesterol, triglycerides, glucose, systolic blood pressure (SBP), and diastolic blood pressure (DBP). BMI was age and sex standardized based on the WHO growth standards. A BMI z-score >3 was used to define obesity for children <5 years of age, and severe obesity for children ≥5 years of age. Among 5738 children <5 years, 0.8% had a zBMI >3. In 626 children who were 5 and 6 years old, 2.1% had a zBMI >3. In the multivariable analysis adjusted for age, sex, maternal ethnicity, and family history, using repeated measures, children with a zBMI >3 had significantly higher odds of having abnormal SBP [odds ratio (OR) 6.4, 95% confidence interval (CI) 1.5-27.9; p = 0.01] and DBP (OR, 3.6 95% CI 1.2-10.6; p = 0.02), respectively, as compared with healthy-weight children. Trends demonstrating an association between a zBMI >3 and abnormal lipid levels were also identified. Young children with a zBMI >3 have significantly higher blood pressure measures and trends toward worse lipid profiles than children at lower zBMIs.