Abnormal Total Cholesterol Research Articles

Patterns and Factors Associated with Dyslipidemia Among Patients with Diabetes Mellitus Attending Hoima Regional Referral Hospital, Uganda.

Dyslipidemia in Sub-Saharan Africa has been on the disproportionate rise among diabetes patients across various contextual settings due to its patterns and associated factors. This study determined the patterns and factors associated with dyslipidemia among diabetes patients attending Hoima Regional Referral Hospital (HRRH). This was a hospital-based cross-sectional study conducted at HRRH between October 2022 and January 2023, enrolled 375 adult diabetes patients consecutively from diabetic outpatient clinic. Data on socio-demographic, behavioral, medical history, physical examination, and laboratory diagnoses were collected and summarized using descriptive statistics. Patterns of dyslipidemia were presented as a proportion of each lipid profile either singly or in combination expressed as a percentage. In the bivariate analysis, variables with p-values <0.2, crude odds ratios of ≥2 or ≤0.5, or those with biological plausibility were included in a multiple logistic regression model. Factors with p-values <0.05 were considered statistically significant. All analyses were conducted using Stata version 17. Of the 375 diabetes patients, 260 (69.3%) had abnormal total cholesterol (TC), and 185 (49.3%) had two lipid profile abnormalities. The majority of the patients were female, 235 (62.7%), and 38 (10.1%) had a diagnosis of coronary heart disease (CHD). Additionally, 134 (35.7%) were overweight, and 39 (10.4%) were obese. Female patients had higher odds of dyslipidemia (Adjusted Odds Ratio [AOR] = 2.2, 95% CI: 1.02-4.86, p = 0.045). Those with coronary heart disease (CHD) had increased odds of dyslipidemia (AOR = 4.1, 95% CI: 1.51-11.07, p = 0.006). All diabetes patients who were overweight or obese had dyslipidemia (p < 0.001). The most common pattern of dyslipidemia in patients with diabetes was elevated total cholesterol, followed by high low-density lipoprotein, associated with overweight, obesity, female gender, and CHD. Routine screening of lipid profiles, BMI, and CHD in diabetic clinics is crucial for early intervention and improved outcomes.

Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study

BackgroundFew studies have reported hyperglycemia and diabetic ketoacidosis in patients on dolutegravir (DTG) treatment. This study determined the effect of DTG on fasting blood glucose levels in a cohort of persons living with HIV (PLHIV) in Ghana and initiating DTG regimens.MethodsA two-year observational longitudinal cohort study conducted from 12th October 2020 to 31st December 2022. Fasting blood glucose was measured at baseline, 12, 24, 36 and 72 weeks for patients after a 12 h overnight fast. The Kaplan-Meier estimator was used to estimate the risk of developing type 2 diabetes mellitus (T2DM). Cox proportional hazard model was used in estimating hazard ratios.ResultsA total of 1334 non-diabetic patients were enrolled with 78% (1039) females and 83% (1104) were antiretroviral therapy experienced. The incidence proportion and rate of T2DM at 72 weeks were 11.8% (95%CI: 10.2–13.7) and 98.1 cases per 1000 PY (95%CI: 83.9-114.6) respectively. The median time to development of T2DM was 24 weeks post DTG initiation. Male sex (aHR 2.9 [95%CI: 1.9–4.3]), abnormal waist-hip ratio (1.67 [95% CI: 1.15–2.43]) and abnormal total serum cholesterol (aHR 1.6 [95%CI: 1.1–2.3]) were found to be significant determinants of T2DM.ConclusionIncidence of T2DM is high among non-diabetic PLHIV within 72 weeks of initiating DTG based therapy with males having a higher risk. Longitudinal changes in waist-hip ratio and serum cholesterol among patients initiated on DTG needs to be monitored regularly.

The potential benefits of extra screening for glycated haemoglobin, total cholesterol and low-density lipoprotein cholesterol on donor health management and retention.

An extra health screening, including glycated haemoglobin (HbA1c), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), was initiated for regular donors aged over 40 in Taiwan in November 2015. This study aimed to determine its benefits on donor health management and retention. A stratified random mail survey was conducted among donors who received HbA1c, TC and LDL-C screening between November 2015 and June 2017 to investigate their awareness of the screening, medical histories and post-screening behaviours. Their subsequent screening results and donation records from 3 years before and after the initial screening were obtained up to December 2021. In total, 2070 donors participated in the mail survey, with participation rates ranging 15.7%-23.2% across study groups. The screening newly detected hyperglycaemia in 1.6% (95% confidence interval [CI]: 1.2%-2.0%) and hyperlipidaemia in 1.0% (95% CI: 0.7%-1.4%) of participants, with 42.7% (95% CI: 40.3%-45.2%) of participants unaware of the screening. Participants with initially abnormal or borderline TC or LDL-C results showed significant decreases in the subsequent screening (all p values<0.05). No difference was found in participants' awareness of the screening. However, those who sought medical consultation or made specific lifestyle changes tended to show greater improvements. Awareness of the screening was associated with increased whole blood donations and donated units. The extra health screening has limited benefits for donor health management without additional interventions, but it may motivate donors to donate more frequently. Raising donors' awareness of the screening is also crucial to maximize its benefits.

Maternal Lipids in Pregnancy and Later Life Dyslipidemia: The POUCHmoms Longitudinal Cohort Study.

Maternal lipid levels increase in normal pregnancies. Here, we examine whether pregnancies with the highest total cholesterol, low-density lipoprotein (LDL) or triglyceride levels or the lowest high-density lipoprotein (HDL) levels predict future dyslipidemia post-pregnancy. Longitudinal cohort study. Five communities in Michigan, USA. Pregnant women (n = 649) with blood lipid levels measured at mid-pregnancy in the Pregnancy Outcomes and Community Health (POUCH) Study and at the POUCHmoms Study follow-up, 7-15 years later. Maternal mid-pregnancy lipid levels were defined as 'high' (upper quartile of triglycerides ≥ 216 mg/dL, LDL ≥ 145 mg/dL and total cholesterol ≥ 256 mg/dL) or 'low' (lower quartile, HDL < 58 mg/dL) using whole sample lipid distributions. At follow-up, dyslipidemia was classified by the clinical cutoffs of triglycerides and total cholesterol ≥ 200 mg/dL, LDL ≥ 130 mg/dL and HDL < 50 mg/dL. Weighted regression models estimated the risk of dyslipidemia at follow-up in relation to pregnancy lipid levels, adjusted for baseline confounders. Dyslipidemia later in life. Mid-pregnancy triglycerides, LDL, and total cholesterol levels at the upper quartile were associated with at least threefold increase in the risk of abnormal triglycerides, LDL and total cholesterol levels later in life. Women with low mid-pregnancy HDL levels had just over a twofold increased risk of abnormally low HDL levels at follow-up. These associations persisted following adjustment for covariates, i.e. demographics, lifestyle, and years of follow-up. Higher mid-pregnancy LDL, total cholesterol and triglycerides and lower levels of HDL may signal future dyslipidemia risk and the need for closer lipid monitoring to ensure timely interventions that can attenuate cardiovascular disease risk.

EFFECT OF VIGOROUS INTENSITY AEROBIC EXERCISE REGIMEN ON PLASMA CHOLESTEROLS OF ADULTS IN BENUE STATE UNIVERSITY, MAKURDI-NIGERIA

Background: Abnormal plasma cholesterols are major risk factors for stroke, coronary heart disease and peripheral vascular diseases globally. Efforts are currently ongoing to come up with the best approach for health promotion and disease prevention, as well as clinical management of abnormal plasma cholesterol. Vigorous intensity aerobic exercise regimen is presently being investigated in this direction.. Methodology: This study investigated the effect of vigorous intensity aerobic exercise regimen on plasma total cholesterol and high density lipoprotein-cholesterol of adults in Benue State University, Makurdi. The design of the study was guided by two research questions. Two hypotheses were formulated and tested at 0.05 level of significance. The study adopted two group pretest posttest quasi experimental design. The study population comprises twenty-one (21) Benue State University staff in the experimental group, and another twenty-one (21) for the control group. The proforma used for the data collection was validated by three experts, one from Measurement and Evaluation, one from the Department of Human Kinetics and Health Education and one from College of Health Sciences all in Benue State University, Makurdi. Data generated were analyzed using Statistical Package for Social Sciences (SPSS Version 25). A descriptive statistics, mean and standard deviation were used to answer the research questions, and an inferential statistics, Analysis of Covariance (ANCOVA) and Paired Samples Test were used to test the hypotheses at 0.05 level of significance. Results: The findings revealed that out of the 21 participants in the two groups, 12(57.14%) were males, while 9(42.86%) were females. The age range in the control group was between 28 to 65years, while that of the experimental group was between 36-68years. Vigorous intensity aerobic exercise regimen was found to have statistically significant effect on plasma total cholesterol (P = 0.000&lt;0.05). Even though high density lipoprotein-cholesterol was found to be elevated by vigorous intensity aerobic exercise regimen, the level of the elevation was discovered not to be statistically significant (P = 0.110 &gt; 0.05). Conclusion: The study concluded that public health education experts as well as other healthcare workers should henceforth incorporate vigorous intensity aerobic exercise regimen prescription in public health awareness on health promotion and disease prevention, as well as clinical management of patients with abnormal plasma total cholesterol.

Impact of Isotretinoin on Blood Lipids and Liver Enzymes: A Retrospective Cohort Study in Saudi Arabia.

Isotretinoin is an effective treatment for acne but can cause side effects such as changes in blood lipids and liver enzymes. Laboratory monitoring is essential during treatment, but there is variation in monitoring practices. This study aims to investigate the relationship between isotretinoin therapy and its effects on complete blood count in Saudi Arabia to improve patient outcomes. The study was a retrospective cohort study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, between January 2016 and December 2020. Following the inclusion and exclusion criteria, 515 patients were randomly selected for the study. The data was analyzed using SPSS, and descriptive statistics and paired samples t-tests were employed to analyze the data. In this study, 515 patients were enrolled. Of these participants, 76.7% (n=395) were females and 23.3% (n=120) were males. The mean age of the study participants was 23.98±7.4 years and ranged between 16 and 65 years. The mean dose of Isotretinoin administered was 27.65±9.6 mg/day, with a range of 10-60 mg/day. The mean BMI of the study participants was 24.3±4.1 kg/m2, ranging from 14.3 to 44.8 kg/m2. Regarding the effect of Isotretinoin on laboratory measures, significant statistical differences were found in hemoglobin measurements (t=-3.379, p=0.001), platelets (t=-3.169, p=0.002), neutrophils (%) (t=3.107, p=0.002), total cholesterol (t=-13.017, p=0.000), AST (t=-6.353, p=0.000), ALT (t=-4.352, p=0.000), HDL (t=2.446, p=0.015), and LDL (t=-12.943, p=0.000). However, there were no significant statistical differences in the measurements of WBC, neutrophils (count), or triglycerides. In the Chi-square analysis and Fisher's Exact test to identify the interaction between BMI, dose, and gender on abnormal lab results, significant interaction was found between participants' BMI and abnormal HDL measurements (p=0.006). Furthermore, there were significant interactions between Isotretinoin dose (either less than 30 mg/day or 30 mg/day or more) and abnormal neutrophil count (p=0.04), abnormal HDL measurements (p=0.010), and abnormal triglycerides measurements (p=0.020). Moreover, a statistically significant interaction was found between participants' gender and abnormal hemoglobin measurements (p=0.006), abnormal total cholesterol (p=0.016), abnormal AST measurements (p=0.001), abnormal ALT measurements (p=0.000), abnormal HDL measurements (p=0.000), and abnormal triglycerides measurements (p=0.007). In conclusion, the study found that isotretinoin therapy has significant effects on several laboratory measures, including hemoglobin, platelets, neutrophils, total cholesterol, AST, ALT, HDL, and LDL. The study also revealed significant interactions between BMI, dose, gender, and abnormal lab results.

Ten-Year Review of the Postpartum Maternal Health Clinic at the Kingston Health Sciences Centre

ObjectivesThe postpartum Maternal Health Clinic (MHC) sees patients who have experienced pregnancy complications identified as pregnancy-related cardiovascular disease (CVD) risk indicators (hypertensive disorders of pregnancy, gestational diabetes, placental abruption, idiopathic preterm delivery, and intrauterine growth restriction) at 6 months postpartum for CVD risk screening. This project aimed to summarise the past 10 years of the MHC and identify trends in patient characteristics, patient CVD risk assessments, and clinic attendance over time. MethodsPatients included in this study have experienced 1 or more pregnancy-related CVD risk indicator(s) and have delivered between April 2011 and April 2021. MHC patient data and the Better Outcomes Registry Network database were utilised to compare eligible and participating patient data during clinically significant time periods. ResultsThe clinic has seen 1030 patients in the last 10 years and their characteristics have remained largely consistent. However, there has been an increase in the proportion of patients seen because of a hypertensive disorder and an increase in the proportion of patients with obesity, abnormal total cholesterol, and elevated fasting glucose. Additionally, CVD risk scores and the prevalence of metabolic syndrome have remained consistent over the years. Regarding the clinic’s outreach, patient eligibility for the MHC has been increasing while attendance has been decreasing over time. ConclusionsOverall, there remains a need to screen these patients for CVD risk and counsel them on risk reduction. There is also an opportunity to increase patient recruitment to improve attendance and to address the increased need for CVD risk screening and counselling in the community.

Microalbuminuria and lipid variations in adolescents diagnosed with type 1 diabetes

ObjectiveThis study investigates the prevalence of lipid abnormalities among adolescents diagnosed with Type 1 Diabetes Mellitus (T1DM) and explores potential associations with microalbuminuria and cardiovascular disease (CVD) risk factors.Research Design and Methods: A retrospective study analyzed lipid profiles, microalbuminuria, and CVD risk in adolescents with T1DM. Six hundred individuals were assessed for lipid levels, BMI, and microalbuminuria. ResultsDyslipidemia prevalence was 59.7 %, with 22.7 % exhibiting abnormal total cholesterol (TC) and triglycerides (TG), and 15.8 % with elevated TC alone. A2 microalbuminuria was found in 59.2 %, with 14.6 % showing A3. Females had higher A2 prevalence and mild eGFR decrease (P = 0.02). Lipid levels correlated significantly with microalbuminuria (TC: r = 0.761; TG: r = 0.572, P = 0.03 and 0.04, respectively). The prevalence of high total cholesterol (TC) + high triglycerides (TG), as well as the high TG alone, was considerably higher in patients belonging to the A2 Microalbuminuria group. AIP, HbA1c, and UACR showed a strong positive correlation (r = 0.542, P = 0.04; r = 0.621, P = 0.02). ConclusionOur study highlights the prevalence of elevated or borderline lipid levels among adolescents with Type 1 Diabetes Mellitus (T1DM), indicating a heightened risk of dyslipidemia in this population. Particularly concerning is the significantly increased incidence of dyslipidemia among young individuals with T1DM, with females exhibiting a notable susceptibility to cardiovascular disease (CVD) due to dyslipidemia's impact on the Atherogenic Index of Plasma (AIP). Furthermore, Microalbuminuria, specifically type A2 and A3, was prevalent among our study participants, with females showing a significantly higher occurrence of A2 microalbuminuria compared to males. The association between microalbuminuria and dyslipidemia, especially the combination of high total cholesterol (TC) and high triglycerides (TG), emphasizes the importance of comprehensive screening protocols for both microalbuminuria and dyslipidemia in managing the cardiovascular risk profile of individuals with T1DM.

Association between lipid profiles and cigarette smoke among adults in the Persian cohort (Shahedieh) study

ObjectivesExposure to cigarette smoke introduces a large amount of nicotine into the bloodstream through the lungs. So, smoking can be a risk factor for many diseases. The present study was conducted to investigate the effect of active and passive cigarette smoke on the blood lipid profile and dyslipidemia.MethodsThis cross-sectional study was performed on 5052 individuals who participated in the recruitment phase of the Shahedieh cohort study. A logistic regression model was used to investigate the relationship between smoking exposure status and lipid profiles.ResultsThe prevalence of abnormal low-density lipoprotein-cholesterol (LDL-C), abnormal HDL-C, abnormal total cholesterol (TC), abnormal triglyceride (TG), and dyslipidemia were 254 (5.00%), 562 (11.10%), 470 (9.30%), 1008 (20.00%), and 1527 (30.20%), respectively. Adjusting for confounders, it was observed that current smokers had higher odds of having abnormal HDL-C [OR (95% CI), 2.90 (2.28–3.69)], abnormal TG [OR (95% CI), 1.71 (1.38–2.13)] and dyslipidemia [OR (95% CI), 1.86 (1.53–2.25)]. Ex-smokers also had greater odds of abnormal HDL-C [OR (95% CI), 1.51 (1.06–2.16)] compared to non-smokers who were not exposed to cigarette smoke.ConclusionsThe findings indicated that current smokers had higher TG and lower HDL. So, necessary measures should be taken to reduce smoking. The findings also showed that the prevalence of abnormal TG and HDL in ex-smokers was lower than in current smokers. Therefore, the existence of incentive policies to quit smoking seems necessary.

Abstract P427: Vitamin D Deficiency and Cardiovascular Disease (CVD) Risk Factors in American Indian Adolescents: The Strong Heart Family Study

Introduction: Vitamin D deficiency (VDD) may be associated with CVD risk factors, such as obesity, diabetes, and dyslipidemia and is amenable to successful interventions through changes in diet and vitamin supplementation. Aims: To describe the prevalence of VDD among American Indian adolescents from SHFS and determine its association with obesity, diabetes, and dyslipidemia incidence in follow-up exams. Methods: We included adolescents (&lt;20 years) from the SHFS, who had serum vitamin D measured on stored samples collected at the baseline examination, 2001-2003 (n=307). We defined VDD as ≤20ng/mL and obesity as baseline Body Mass Index (BMI) ≥95%, follow-up BMI ≥30kg/m 2 , waist-hip-ratio (WHR) ≥0.9 for males, or WHR ≥0.85 for females. Diabetes was defined as measured fasting plasma glucose level ≥126 mg/dL or taking hypoglycemic medication. We defined dyslipidemia as abnormal total cholesterol, LDL-C, HDL-C, non-HDL-C, triglycerides, or taking medication. We used log binomial generalized estimating equations to determine if the prevalence or incidence of obesity, diabetes, or dyslipidemia differed according to VDD, while controlling for age, gender, and center (Arizona, Oklahoma, or Dakotas). Results: VDD prevalence was 50.8% in AI adolescents, and it was associated with the prevalence of BMI≥95%, high WHR, and dyslipidemia. By the first follow-up, 28.8% developed a BMI≥30kg/m 2 , 58.8% developed high WHR, 6.2% developed diabetes, and 62.6% developed dyslipidemia. By the second follow-up, 11.4% developed diabetes. The risk of high WHR (RR=1.28, CI=1.04-1.58, follow-up=5.8 years), and the risk of diabetes (RR=2.32, CI=1.05-5.12, follow-up=13.3 years) was higher in those with baseline VDD while controlling for covariates (Table 1). Conclusions: These data suggest that VDD in adolescence may contribute to the development of high WHR and diabetes later in life, which are strongly associated with CVD. Thus, the results of this analysis may provide a critical step toward reducing or controlling CVD at an early age.

A novel predictive method for risk stratification in acne patients receiving isotretinoin: an analysis of laboratory abnormalities and changes in inflammatory parameters

Introduction Isotretinoin is a widely used, effective medication for moderate to severe acne. It is typically used for several months, which necessitates regular laboratory monitoring. However, consensus on the optimal assessment frequency is lacking. Method This is a single-center retrospective study on 1182 patients who received isotretinoin for acne at the Dermatology Clinic in Jordan University Hospital over 5 years. Results Of the 1182 patients, 892 (76.57% females) met the inclusion criteria. An increase in the proportion of patients with abnormal triglycerides and total cholesterol levels from baseline to the sixth month was observed (p < 0.05). Conversely, differences in the number of patients with abnormal AST, ALT, and CBC were not found throughout treatment (p > 0.05). Moreover, there was a decrease in the neutrophil-to-lymphocyte ratio (NLR) ratio and systemic inflammatory index (SII) after the sixth month of isotretinoin treatment compared to the baseline (p = 0.012 and p = 0.021, respectively). Conclusions We found that a baseline cholesterol level of 163.9 mg/dl and a baseline triglycerides level of 85.5 mg/dL are highly specific and sensitive in detecting grade 1 abnormalities at the one-month follow-up. This novel prediction approach serves as an effective risk stratification method for isotretinoin acne patients.

The effect of hyperuricemia and its interaction with hypertension towards chronic kidney disease in patients with type 2 diabetes: evidence from a cross- sectional study in Eastern China.

This study aimed to explore the synergistic interaction effect between hyperuricemia and hypertension towards chronic kidney disease in patients with type 2 diabetes. This research originates from a cross-sectional study performed in Zhejiang Province, Eastern China, between March and November 2018. The correlation between serum uric acid levels and the risk of chronic kidney disease was assessed using a restricted cubic spline model. An unconditional multivariable logistic regression model, along with an interaction table, was utilized to explore the potential interaction effect of hyperuricemia and hypertension towards chronic kidney disease. 1,756 patients with type 2 diabetes were included in this study, the prevalence of chronic kidney disease (CKD) was 27.62% in this population. A U-shaped non-linear pattern emerged correlating serum uric acid (SUA) levels and CKD risk, indicating that both low and high SUA levels were linked to an increased CKD risk. This risk achieved its lowest point (nadir) at SUA approximately equals to 285μmol/L (p for trend <0.05). Once adjustments for age, gender, education level, abnormal fasting plasma glucose (FPG), abnormal hemoglobin A1c (HbA1c), abnormal total cholesterol (TC), abnormal high-density lipoprotein cholesterol (HDL-C), alcohol consumption and duration of diabetes were factored in, it was found that patients with both hyperuricemia and hypertension demonstrated a 5.42-fold (95% CI: 3.72-7.90) increased CKD risk compared to the reference group. The additive interaction between hyperuricemia and hypertension was statistically significant, as manifested by the following values: a relative excess risk due to interaction (RERI) of 2.57 (95% CI: 0.71-4.71), an attributable proportion due to interaction (AP) of 0.47 (95% CI: 0.14-0.64), and a synergy index (SI) of 2.39 (95% CI: 1.24-4.58). In contrast, there was no significant interaction effect in multiplicative scale. Hyperuricemia and hypertension may contribute additively to CKD, beyond their isolated impacts. Evaluating the risk of CKD in type 2 diabetes patients necessitates considering this potential interaction.

Mildly elevated serum bilirubin and its correlations with lipid levels among male patients undergoing health checkups

BackgroundBilirubin’s ability to lower lipid levels was confirmed by several studies, but those studies mainly focused on total bilirubin (TBil). The present study aimed to elucidate the correlations of the two subtypes of bilirubin with lipid levels.MethodsA total of 1732 male patients undergoing health checkups were categorized into three groups according to the levels of direct bilirubin (DBil) and indirect bilirubin (IBil). The differences in medical characteristics among the three groups were analysed.ResultsSubjects in the elevated DBil group had the lowest serum alanine aminotransferase (ALT), total cholesterol (TC), blood urea nitrogen (BUN), γ-glutamyl transpeptidase (γ-GT), fasting blood glucose (FBG), haemoglobin (HGB), and triglyceride (TG) levels in contrast to the other groups (P < 0.01), while subjects in the elevated IBil group had the highest ALT, γ-GT, BUN, serum creatinine (SCR), HGB, TC, and TG levels among the three groups (P < 0.01). DBil levels exhibited a significant negative correlation with TC (r = -0.777, P < 0.01) and TG (r = -0.397, P < 0.01) levels, while IBil levels exhibited a significant positive correlation with TC (r = 0.790, P < 0.01) and TG (r = 0.302, P < 0.01) levels. The frequencies of abnormal TC, TG, HGB and BUN levels were the lowest in the elevated DBil group, while the levels of these four variables were the highest in the elevated IBil group. Mildly elevated DBil levels were related to lower TG (OR = 0.112, 95% CI = 0.027–0.458) and TC (OR = 0.097, 95% CI = 0.013–0.700), and mildly elevated IBil levels were connected with increased TC (OR = 3.436, 95% CI = 2.398–4.924) and TG (OR = 1.636, 95% CI = 1.163–2.303). DBil was an independent protective factor against increased TC (OR = 0.702, 95% CI = 0.602–0.817, P < 0.01) and TG (OR = 0.632, 95% CI = 0.541–0.739, P < 0.01) levels, and IBil was an independent risk factors for increased TC (OR = 1.251, 95% CI = 1.176–1.331, P < 0.01).ConclusionsDBil was an independent protective factor against high TC and TG levels. IBil was an independent risk factors for elevated TC levels. The prognostic value of IBil levels warrants further attention.

Frequency of Deranged Lipid Profile in Patients with Stroke

Objective: This study aims to find out the frequency of patients with strokes at Lady Reading Hospital in Peshawar have abnormal lipid profiles. Materials &amp; Methods: The Department of Medicine at Lady Reading Hospital in Peshawar conducted this cross-sectional, descriptive study. There were 96 patients in all, both genders, who presented with a stroke between the ages of 30 and 70. Individuals with CRF (chronic renal failure), CLD (chronic liver disease), or medications that reduce cholesterol were not included. Blood samples were collected and transferred to the laboratory to measure the lipid profile. Results: In this study, the age range was 30 to 70 years old, with a mean age of 53 years. The majority of the patients (54.17%) ranged in age from 51 to 70. There were 58.33% males and 41.67% females. 40 (41.67%) stroke patients had a disordered lipid profile. Of the stroke patients, 41.67% had abnormal total cholesterol, 53.13% abnormal LDL cholesterol, 25.0% abnormal triglyceride levels, and 21.88% abnormal HDL cholesterol. Conclusion: This study concluded that the frequency of dyslipidemia in stroke patients is very high. With this knowledge, specialized statin drugs could be created, leading to better disease control. Patients with ischemic stroke were more likely than those with hemorrhagic stroke to have abnormalities in their lipid levels. Keywords: Stroke, Cholesterol level, Dyslipidaemia, Lipid Profile, Cerebrovascular Accidents.

Comparison of Serum Lipid Levels between Ischemic and Haemorrhagic Stroke Patients: An Observational Study

Stoke is the leading cause of adult disability and the second leading cause of mortality. The incidence of stroke has decreased in the developed world but increased in developing countries like Bangladesh. Association between serum lipid levels and stroke is controversial and regional data is limited. In this study, we aimed to compare the difference in serum lipid levels among ischemic stroke (IS) and hemorrhagic stroke (HS) patients. This cross-sectional observational study was conducted at Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, from February to June, 2021. Admitted 50 consecutive IS patients, and 50 HS patients were enrolled. After clinical and radiological confirmation, detailed history was taken and 8 hours of fasting blood sample for serum lipid profiling were collected. Data were analyzed to observe the difference in lipid levels between the two groups. Among the 100 stroke patients mean age of the IS and HS groups was 67.62 ± 8.33 and 65.14 ± 9.43 years, respectively. Males were predominant in both groups, and the majority of them had a history of hypertension. Mean serum total cholesterol (TC) was above the normal range in IS group (5.28 ± 2.18 mmol/L), and serum high density lipoprotein (HDL) was lower in IS group (0.82 ± 0.28 mml/L), and both differences were statistically significant between the IS and HS groups. This study found that patients with IS had a higher incidence of abnormal TC and HDL levels. Preventive measures using lipid-lowering agents can be considered for high-risk patients. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(2):83-87

Association between oral contraceptives with lipid profile: results from Hoveyzeh cohort study (HCS)

BackgroundOral contraceptives (OCs) affect lipid metabolism, which can cause hyperlipidemia, a risk factor for cardiovascular diseases. The study was designed to evaluate the possible changes in lipid profile due to using OCs.MethodsA cross-sectional study was conducted from April 2016 to August 2018 among women from the baseline phase Hoveyzeh cohort study (HCS). Sociodemographic data, anthropometric measurements, physical activity, and biochemical blood tests were measured for every participant. Multiple logistic regression was used to adjust the potential confounders.ResultsAmong 2272 participants, 1549 women were OC users, and 723 women were non-user OCs. The mean lipid profile levels were higher in OC users than in non-user OCs. Odds of abnormal Total cholesterol (TC) in OC users were significantly higher than those of non-users OCs [OR = 1.29 (95% CI;1.05 to 1.58)]. Also, the Odds of abnormal low-density lipoprotein (LDL) in OC users was 12% higher than in non-user OCs. However, no significant relationship between abnormal LDL with Oral Contraceptive Pills (OCPs) was observed.ConclusionsThe mean lipid profile was higher in OC users compared to non-user OCs. This finding highlights the need for public health strategies to prevent and detect hyperlipidemia in user OCs.

Diet quality indices and their relationship with dyslipidemia in adults: A cross-sectional study

Food habits may influence a range of modifiable risk factors of cardiovascular diseases (CVDs) including dyslipidemia. This study was conducted to find whether healthy eating index (HEI) and dietary quality index-international (DQI-I) were associated with the risk of dyslipidemia among the Iranian adults in Shiraz. In this study, 236 participants with the age of 20-50 years were recruited from Shiraz medical centers through random cluster sampling. The HEI-2015 and DQI-I scores were computed using dietary intakes based on a 168-item food frequency questionnaire (FFQ). Logistic regression was utilized to estimate the relation between HEI-2015 and DQI-I score and lipid profile. Individuals in the greatest adherence to the HEI-2015 was associated with reduced odds ratio (OR) of total cholesterol (TC) and low-density lipoprotein (LDL) in the crude model (OR: 0.46 and OR: 0.30). This association was significant after adjustment for potential confounders (OR: 0.40 and OR: 0.31). Also, we observed significant association between DQI-I with TC and LDL in crude model (OR: 0.42 and OR: 0.45). In the adjusted model, participants in the last tertile of DQI-I were 55%, 58% and 57% less likely to have abnormal TC (OR: 0.45), LDL (OR: 0.42) and high-density lipoprotein (HDL) (OR: 0.43), compared those in the first tertile. In conclusion, higher adherence to DQI-I score was related to lower LDL and total cholesterol and higher HDL levels. Furthermore, in participants with higher adherence of HEI-2015 score, LDL and total cholesterol level were lower.

Association between total cholesterol and all-cause mortality in geriatric patients with hip fractures: A prospective cohort study with 339 patients.

Total cholesterol (TC) levels represent the comprehensive level of human cholesterol metabolism, which is closely related to the nutritional status, metabolic level, disease development, and aging of the human body. Total cholesterol plays an important role in the maintenance of bodily functions, regulation of sexual function, immune regulation, and in the development of organisms. Abnormal TC levels are an important risk factor for cardiovascular disease (CVD), and TC is closely related to the development of many diseases, and is used as an important indicator of human blood lipid levels and overall health status. However, the relationship between serum TC levels and the prognosis of patients with hip fractures remains unclear. To evaluate the association between TC levels and all-cause mortality in patients with geriatric hip fractures. Elderly patients with hip fractures were screened between January 2015 and September 2019. Patient demographic and clinical characteristics were recorded. Linear multivariate Cox regression models were used to identify the association between TC levels and all-cause mortality. Analyses were performed using Empower Stats and R software. Three hundred and thirty-nine patients were enrolled. The mean follow-up period was 34.18 months. There were 99 (29.20%) cases of all-cause mortality. Total cholesterol levels after hip fracture were linearly associated with all-cause mortality in the elderly. Linear multivariate Cox regression models showed that TC levels were associated with mortality (hazard ratio (HR) = 0.67; 95% confidence interval (95% CI): 0.53-0.85; p = 0.001 after adjusting for confounding factors). Each 1 mmol/L increase in TC levels was associated with a 33% reduction in morbidity and mortality. Compared with the low-TC group, mortality was significantly lower in the middle-TC group (HR = 0.58; 95% CI: 0.35-0.94; p = 0.027) and high-TC group (HR = 0.45; 95% CI: 0.27-0.75; p = 0.002). Total cholesterol levels were associated with mortality in geriatric hip fracture patients and could be considered a protective factor for all-cause mortality.

One-step integrated coronary–carotid–cerebral computed tomography angiography to evaluate cardiovascular and cerebrovascular atherosclerosis

PurposeThis study aims to develop a low-radiation dose, one-step integrated coronary–carotid–cerebral computed tomography angiography (ICCC-CTA) technique to analyze the relationship between cardiovascular and cerebrovascular atherosclerosis and evaluate the risk factors of plaque to provide an early-stage treatment to patients and reduce vascular events.MethodsA total of 300 consecutive asymptomatic patients with cardiovascular risk factors who underwent ICCC-CTA were enrolled in this prospective study. The association between coronary and carotid-cerebrovascular atherosclerosis was assessed. The primary cardiovascular risk factors for various plaque types in cardiovascular or cerebrovascular disease were evaluated using multivariate analysis.ResultsAmong 300 patients, 189 (63%) had plaques in their coronary and cerebral arteries. The presence of calcified and mixed plaques in the carotid-cerebral and coronary arteries was strongly correlated (χ2 = 20.71, P = 0.001; χ2 = 8.96, P = 0.003, respectively). Multivariate logistic regression analysis revealed that abnormal blood glucose [OR = 1.44, 95% CI 0.12–0.62, P = 0.01] and abnormal total cholesterol [OR = 1.28, 95% CI 0.07–0.46, P = 0.01] are risk factors in all the models in the coronary artery, non-calcified plaque group. Abnormal blood glucose [OR = 1.43, 95% CI 0.11–0.61, P = 0.01] and abnormal systolic blood pressure [OR = 1.02, 95% CI 0.01–0.04, P = 0.02] are risk factors in all the models in the coronary artery calcified plaque group. Abnormal blood glucose level [OR = 1.44, 95% CI = 0.12–0.62, P = 0.01] was only a risk factor in the non-calcified plaque carotid–cerebral artery group.ConclusionsWe confirm that elevated blood glucose and total cholesterol levels are associated with coronary and carotid-cerebrovascular plaques using the novel one-step low dose cerebral-carotid-cardiac CTA technique. These findings will provide insights for further studies focusing on developing low-radiation dose one-step ICCC-CTA to screen cardiovascular/cerebrovascular plaques in general population with cardiovascular risk factors.Advances in knowledgeWe developed a low–radiation dose, one-step ICCC-CTA technique to detect cardiovascular and cerebrovascular atherosclerosis. We evaluated the risk factors for plaque burden for the early treatment and reduction of vascular events. These findings supported the development of low–radiation dose one-step ICCC-CTA to screen for cardiovascular/cerebrovascular disease in general population with cardiovascular risk factors.

Ziziphus mauritiana Leaves Normalize Hormonal Profile and Total Cholesterol in Polycystic Ovarian Syndrome Rats.

In the present study, the beneficial effect of leaves of Ziziphus mauritiana on testosterone, estradiol, progesterone, LH hormones, blood glucose, and total cholesterol levels in the experimentally induced polycystic ovaries of female Sprague Dawley rats were evaluated. Letrozole was used to induce PCOS in rats, and clomiphene citrate was used as a standard control. This study was carried out in vivo on 30 female rats where group I received normal saline and group II to V were treated with letrozole (1 mg/kg/day), which was dissolved in normal saline orally for 21 days to induce PCOS. After PCOS induction, test groups III and IV were orally treated with ZMME at a dose of 100 mg/kg and 200 mg/kg for 14 days, respectively, and group V was treated with clomiphene citrate (2 mg/kg) orally for 14 days. At the end of the experimental period, the animals were sacrificed by cervical dislocation, and blood samples were collected by cardiac puncture. After blood collection, the ovaries were removed and weighed. The results showed that Ziziphus mauritiana normalized all hormones and total cholesterol levels. The HPTLC profile showed the presence of gallic acid, rutin, quercetin, and ursolic acid. Many studies have reported that quercetin is effective against PCOS and its complications; it suppresses insulin resistance and reduces testosterone and LH levels. The present study showed an improvement in the inflammatory microenvironment of the ovarian tissue in the PCOS rat model. This research concluded that the leaves of Ziziphus mauritiana have potential efficacy in the treatment of PCOS by normalizing abnormal hormones and total cholesterol levels, which could be due to the presence of quercetin in the leaves.