Lipoprotein Abnormalities Research Articles

Study of common hypertriglyceridaemia genetic variants and subclinical atherosclerosis in a group of women with SLE and a control group

ObjectiveSLE is associated with increased cardiovascular risk (CVR). High serum concentrations of triglyceride-rich lipoproteins and apolipoprotein B-rich particles constitute the characteristic dyslipidaemia of SLE.MethodsA cross-sectional study was conducted to study...

TG/HDL-C ratio predicts in-hospital mortality in patients with acute type A aortic dissection

BackgroundIn recent years, abnormalities in serum lipids and lipoproteins have been shown to be associated with cardiovascular disease risk. However, their prognostic value for acute type A aortic dissection is unclear. This study analyzed the correlation between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and in-hospital mortality in patients with AAAD, and aimed to investigate the clinical significance of preoperative blood lipids and lipoproteins on the prognosis of acute type A aortic dissection.MethodsA total of 361 patients who underwent type A aortic dissection surgery in Fujian Cardiac Medical Center from June 2018 to March 2020 were retrospectively collected. According to the baseline TG/HDL-C ratio, the patients were divided into 3 groups according to the tertile method, the low TG/HDL-C ratio T1 group (< 1.18) and the middle TG/HDL-C ratio T2 group (1.18–1.70). T3 group with high TG/HDL-C ratio (> 1.70). Kaplan–Meier was used for survival analysis, and Cox proportional hazards regression model was used to analyze the factors affecting the prognosis of patients. The receiver operating characteristic (ROC) curve was used for the diagnostic efficacy.ResultsAmong the 361 patients in this study, the mean age was 52.4 ± 11.3 years, 73 (20.2%) were female, and 82 (22.7%) died in hospital. Kaplan–Meier curve showed that with the increase of TG/HDL-C ratio, the risk of in-hospital death gradually increased (P < 0.001). Multivariate Cox regression analysis showed that age (HR = 1.031), body mass index (HR = 1.052), hypertension (HR = 3.491), white blood cells (HR = 1.073), TG/HDL-C ratio (HR = 1.604), MODS (HR = 1.652) was positively correlated with in-hospital mortality (P < 0.05). After adjusting for age, sex, and other risk factors, a significant association was found between the TG/HDL-C ratio and in-hospital mortality for acute type A aortic dissection (HR = 1.472, 95% CI, 1.354–3.451, P = 0.019).ConclusionPatients with type A aortic dissection have obvious abnormal blood lipid metabolism, and serum TG/HDL-C levels are positively correlated with in-hospital mortality in patients with AAAD.

Anti-inflammatory effect of apolipoprotein J in DB/DB mice fed atherogenic diet

Background and Aims : Patients with obesity and type 2 diabetes mellitus (T2DM) show a chronic low grade inflammatory state and an abnormal lipoprotein function. Apolipoprotein J (ApoJ) is a secreted glycoprotein with cardiovascular protective role. We aimed to assess the putative anti-inflammatory action of apoJ treatment in the db/db murine model of obesity and T2DM.

Correlation between Smoking and Dyslipidemia in Elderly Males: An Analytical Cross-Sectional Study

Aim: To investigate the association between smoking and dyslipidemia in elderly males while accounting for age, BMI, and alcohol use. Study design: Analytical cross-sectional study Place and Duration: This study was conducted at Bhitai Dental and Medical College Mirpurkhas from march 2021 to march 2022 Methodology: The research comprised 2,160 participants who were divided into 3 different groups: current smokers, non-smokers, &amp; past smokers. The research excluded those who smoked just sometimes (one cigarette per day). This study separated smokers into four categories: light (26.7 pack-years), medium (426.7-90.5 pack-years), heavy (440.5-75.5 pack-years), and extremely heavy (455.5-165.5 pack-years).On the same day, a survey, physical examination, and laboratory study of blood samples were used to evaluate the study population. The person was assessed while wearing light clothes and no shoes, and anthropometric measures comprised height and body weight. Weight was divided by height squared (kg/m2) to get the BMI. Using established protocols in the clinical laboratory, an automated biochemistry analyzer measured the blood levels of total cholesterol, triglycerides, high-density lipid cholesterol, low- density lipid cholesterol, Apo protein B, and Lipoprotein. Result: When compared to present smokers, the levels of triglycerides and high-density lipid cholesterol among non-smokers and former smokers were statistically significantly different (P=0.001). Other variables, such as Age, body mass index, use of liquor, systolic and diastolic blood pressure, did not significantly differ between non-, past, and present smokers. In comparison to light smokers, moderate, heavy, and very heavy smokers more commonly displayed abnormal levels of TGs, Apo-B, and TC, while very heavy smokers less frequently displayed abnormal levels of low-density lipid cholesterol. It was unexpected to find that among very heavy smokers, aberrant Apo-B levels were seen more frequently than low-density lipid cholesterol levels. The prevalence of abnormal HDL-C and lipoprotein (a) was higher among light smokers. After accounting for alcohol, BMI, and age, smoking remained a significant independent threat fact for dyslipidemia (P = 0.032). Conclusion:The study revealed that smoking caused TGs and apoB levels to rise in elderly males, and HDL-C levels to decrease, making it an independent risk factor for dyslipidemia. Keywords: smoking, dyslipidemia, elderly, males

Progressive, Qualitative, and Quantitative Alterations in HDL Lipidome from Healthy Subjects to Patients with Prediabetes and Type 2 Diabetes

Prediabetes is a clinically silent, insulin-resistant state with increased risk for the development of type 2 diabetes (T2D) and cardiovascular disease (CVD). Since glucose homeostasis and lipid metabolism are highly intersected and interrelated, an in-depth characterization of qualitative and quantitative abnormalities in lipoproteins could unravel the metabolic pathways underlying the progression of prediabetes to T2D and also the proneness of these patients to developing premature atherosclerosis. We investigated the HDL lipidome in 40 patients with prediabetes and compared it to that of 40 normoglycemic individuals and 40 patients with established T2D using Nuclear Magnetic Resonance (NMR) spectroscopy. Patients with prediabetes presented significant qualitative and quantitative alterations, potentially atherogenic, in HDL lipidome compared to normoglycemic characterized by higher percentages of free cholesterol and triglycerides, whereas phospholipids were lower. Glycerophospholipids and ether glycerolipids were significantly lower in prediabetic compared to normoglycemic individuals, whereas sphingolipids were significantly higher. In prediabetes, lipids were esterified with saturated rather than unsaturated fatty acids. These changes are qualitatively similar, but quantitatively milder, than those found in patients with T2D. We conclude that the detailed characterization of the HDL lipid profile bears a potential to identify patients with subtle (but still proatherogenic) abnormalities who are at high risk for development of T2D and CVD.

Novel Surrogate Markers of Cardiovascular Risk in the Setting of Autoimmune Rheumatic Diseases: Current Data and Implications for the Future.

Patients suffering from rheumatologic diseases are known to have an increased risk for cardiovascular disease (CVD). Although the pathological mechanisms behind this excess risk have been increasingly better understood, there still seems to be a general lack of consensus in early detection and treatment of endothelial dysfunction and CVD risk in patients suffering from rheumatologic diseases and in particular in those who haven't yet shown symptoms of CVD. Traditional CVD prediction scores, such as Systematic Coronary Risk Evaluation (SCORE), Framingham, or PROCAM Score have been proposed as valid assessment tools of CVD risk in the general population. However, these risk calculators developed for the general population do not factor in the effect of the inflammatory burden, as well as other factors that can increase CVD risk in patients with rheumatic diseases, such as glucocorticoid therapy, abnormal lipoprotein function, endothelial dysfunction or accelerated atherosclerosis. Thus, their sole use could lead to underestimation of CVD risk in patients with rheumatic diseases. Therefore, there is a need for new biomarkers which will allow a valid and early assessment of CVD risk. In recent years, different research groups, including ours, have examined the value of different CVD risk factors such as carotid sonography, carotid-femoral pulse wave velocity, flow-mediated arterial dilation and others in the assessment of CVD risk. Moreover, various novel CVD laboratory markers have been examined in the setting of autoimmune diseases, such as Paraoxonase activity, Endocan and Osteoprotegerin. Dyslipidemia in rheumatoid arthritis (RA) is for instance better quantified by lipoproteins and apolipoproteins than by cholesterol levels; screening as well as pre-emptive carotid sonography hold promise to identify patients earlier, when prophylaxis is more likely to be effective. The early detection of subtle changes indicating CVD in asymptomatic patients has been facilitated through improved imaging methods; the inclusion of artificial intelligence (AI) shows promising results in more recent studies. Even though the pathophysiology of coronary artery disease in patients with autoimmune rheumatic diseases has been examined in multiple studies, as we continuously gain an increased understanding of this comorbidity, particularly in subclinical cases we still seem to fail in the stratification of who really is at risk—and who is not. A the time being, a multipronged and personalized approach of screening patients for traditional CVD risk factors, integrating modern imaging and further CV diagnostic tools and optimizing treatment seems to be a solid approach. There is promising research on novel biomarkers, likewise, methods using artificial intelligence in imaging provide encouraging data indicating possibilities of risk stratification that might become gold standard in the near future. The present review concentrates on showcasing the newest findings concerning CVD risk in patients with rheumatologic diseases and aims to evaluate screening methods in order to optimize CVD risk evaluation and thus avoiding underdiagnosis and undertreatment, as well as highlighting which patient groups are most at risk.

A Pattern of Lipid Profile Among Saudi Adults With Type 1 Diabetes Mellitus in a Tertiary Hospital: A Retrospective Study.

Objective: Dyslipidemia is prevalent in adults living with type 1 diabetes, and it can worsen the presentation of microvascular complications such as retinopathy. This study aims to identify the pattern coupled with the frequency of dyslipidemia in diabetic adults who followed up at different clinics in King Abdulaziz Medical City, Riyadh, and evaluate the associations with demographic and clinical characteristics.Methods: A cross-sectional, retrospective chart review study of 514 adults with type 1 diabetes was conducted in a tertiary health care facility in the central region of Saudi Arabia. Demographics were retrieved by using the implemented electronic medical records. Fasting lipid profile, glycated hemoglobin (HbA1c), and thyroid-stimulating hormone (TSH) levels were checked for all subjects.Results: Five hundred and fourteen (514) subjects aged 18-65 years were studied (mean age: 26.1 ± 7.1 years). There were 318 (62%) females in the sample, and their mean age was significantly different from the mean age of males (p = 0.01). The mean duration of having diabetes was 12.8 ± 6.9 years. The prevalence of lipid abnormalities included abnormal low-density lipoprotein (LDL) (70%), hypercholesterolemia (23%), abnormal high-density lipoprotein (HDL) (8%), and hypertriglyceridemia (5%). Abnormal HDL was significantly higher in males than in females (p=<0.001). There were no statistically significant differences in the prevalence of other lipid abnormalities between the two genders and the age group < or ≥ 25 years. There was no statistically significant difference in the mean of the tested lipids levels between the two genders. One hundred and forty-three (143) (27.8%) patients had more than one abnormal lipid condition. A statistically significant difference was observed in the mean HbA1c between males and females (p=0.001). Otherwise, there was no significant association of lipid abnormalities with gender, age, diabetes duration, and weight.Conclusion: The most prevalent lipid abnormality was high LDL cholesterol. Nearly a third of the tested individuals had more than one lipid abnormality. Furthermore, poor glycemic control was linked to abnormal lipid profiles. Consequently, local programs must aim to screen and intervene early to delay and prevent future severe vascular complications related to non-treated dyslipidemia.

Normal HDL Cholesterol Efflux and Anti-Inflammatory Capacities in Type 2 Diabetes Despite Lipidomic Abnormalities.

ObjectiveTo assess whether, in type 2 diabetes (T2D) patients, lipidomic abnormalities in high-density lipoprotein (HDL) are associated with impaired cholesterol efflux capacity and anti-inflammatory effect, 2 pro-atherogenic abnormalities.Design and MethodsThis is a secondary analysis of the Lira-NAFLD study, including 20 T2D patients at T0 and 25 control subjects. Using liquid chromatography/tandem mass spectrometry, we quantified 110 species of the main HDL phospholipids and sphingolipids. Cholesterol efflux capacity was measured on THP-1 macrophages. The anti-inflammatory effect of HDL was measured as their ability to inhibit the tumor necrosis factor α (TNFα)-induced expression of vascular cell adhesion molecule-1 (VCAM-1) and intercellular cell adhesion molecule-1 (ICAM-1) on human vascular endothelial cells (HUVECs).ResultsThe cholesterol-to-triglyceride ratio was decreased in HDL from T2D patients compared with controls (-46%, P = 0.00008). As expressed relative to apolipoprotein AI, the amounts of phosphatidylcholines, sphingomyelins, and sphingosine-1-phosphate were similar in HDL from T2D patients and controls. Phosphatidylethanolamine-based plasmalogens and ceramides (Cer) were, respectively, 27% (P = 0.038) and 24% (P = 0.053) lower in HDL from T2D patients than in HDL from controls, whereas phosphatidylethanolamines were 41% higher (P = 0.026). Cholesterol efflux capacity of apoB-depleted plasma was similar in T2D patients and controls (36.2 ± 4.3 vs 35.5 ± 2.8%, P = 0.59). The ability of HDL to inhibit the TNFα-induced expression of both VCAM-1 and ICAM-1 at the surface of HUVECs was similar in T2D patients and controls (-70.6 ± 16.5 vs -63.5 ± 18.7%, P = 0.14; and -62.1 ± 13.2 vs -54.7 ± 17.7%, P = 0.16, respectively).ConclusionDespite lipidomic abnormalities, the cholesterol efflux and anti-inflammatory capacities of HDL are preserved in T2D patients.

Study of Plasma Cholesterol in Adults with Phenylketonuria

Objective: This study was designed to employ the NMR lipoprotein profiling technique to evaluate the spectrum of total cholesterol, LDL cholesterol, and HDL cholesterol. The major aim of this research was to investigate the subclasses of lipoprotein to investigate the pathophysiology of brain damage in PKU cases. However, we were also concerned with the possible cardiovascular risks caused by abnormal lipoprotein profiles. Place and Duration: Pak International Medical College, Hayatabad, Peshawar(PIMC) From Jan 2021 to December 2021 Study type: Case control study Methodology: Patients were asked for an overnight fast to get their plasma samples in the morning. Samples were frozen at − 20 °C to perform analysis by using a 600 MHz Bruker AVANCE IVDr spectrometer. For the statistical analysis, SPSS version 24.0 was used. A student t-test was applied to measure the statistical difference. The significant statistical difference was set as 0.05. Results: In case group total cholesterol was reported as 179.4 while the control group had 200.9 mg/dL with a p value &lt; 0.02. On the other hand, the LDL cholesterol was reported as 104.1 mg/dL in control while 79.5 mg/dL in the case group with p&lt;0.003. Meanwhile, no statistical difference was observed between both groups when comparing triglycerides. No statistical difference was observed between subclasses of lipoprotein. Furthermore in current research correlation was observed between blood PHE levels andPHE control diet. Conclusion: In conclusion, NMR spectroscopy provides unique patterns of lipoprotein profile which were previously seen in patients consuming statins as their treatment Keywords: Plasma cholesterol, LDL cholesterol, phenylketonuria, PKU diet

Prevalence of prediabetes and associated factors in southwest iran: results from Hoveyzeh cohort study

BackgroundIncreasing trend of prediabetes and diabetes is a global public health issue. On the other hand, prediabetes can increase the risk of developing some non-communicable diseases, including type 2 diabetes, cardiovascular disease, hypertension, fatty liver disease, etc. Given that there are modifiable various risk factors for prediabetes, this cross-sectional study aimed to evaluate the prevalence of prediabetes and its risk factors among adults.MethodsThe present study included the baseline data from the Prospective Epidemiological Research Studies of the Iranian Adult and Neonates (PERSIAN), Hoveyzeh Cohort Study (N = 10,009). The demographic data, lifestyle habits, anthropometric data, and clinical and biochemical parameters were gathered. The odds ratio of prediabetes was assessed by logistic regression.ResultsThe final analysis was conducted on 7629 participants. The prevalence of overweight (36.7%), obesity (37.5%), prediabetes (30.29%), abnormal high density lipoprotein (35.4%), cholesterol (33.8%) and triglyceride (39.7%), and HTN (21.3%) were common. In the adjusted analysis, there were higher odds of having prediabetes for overweight (OR = 1.9, 95% CI: (1.19, 3.03), p = 0.007), obesity (OR = 3.18, 95% CI: (1.99, 5.07), p < 0.001), waist circumstance (WC) (OR = 1.024, 95% CI: (1.002, 1.03), p < 0.001), hip circumstance (HC) (OR = 1.01, 95% CI: (1.003, 1.02), p = 0.008), older age (OR = 1.04, 95% CI: (1.04, 1.05), p < 0.001), hypertension (OR = 1.38, 95% CI: (1.21, 1.57), p < 0.001),), glutamic-pyruvic transaminase (OR = 1.013, 95% CI: (1.007, 1.019), p = 0.001), glutamic-oxaloacetic transaminase (OR = 1.01, 95% CI: (1.006, 1.013), p < 0.001), triglyceride = 150–199 mg/dl (OR = 1.32, 95% CI: (1.16, 1.51), p < 0.001), triglyceride ≥ 200 mg/dl (OR = 1.64 (95% CI: 1.44, 1.86), p < 0.001), cholesterol = 200- 239 mg/dl (OR = 1.33, 95% CI: (1.18, 1.49), p < 0.001), and cholesterol ≥ 240 mg/dl (OR = 2.04, 95% CI: (1.72, 2.42), p < 0.001) in general population.ConclusionThe prevalence of prediabetes, overweight, obesity, HTN, and dyslipidemia was common. The greater chances of prediabetes were related to aging, overweight, obesity, HTN, higher liver enzymes, HC, abnormal WC, and dyslipidemia. It seems that practical interventions are necessary to prevent prediabetes.

Non-HDL-cholesterol and atherogenicity in type 2 diabetes mellitus patients

Background: In type 2 diabetes mellitus (DM) lipoprotein abnormalities are the main contributors resulting high atherogenic dyslipidaemia. Non-HDL-cholesterol could be used in screening patients with diabetes, especially in whom LDL-cholesterol levels may not be significantly elevated.

A Tale of Two New Targets for Hypertriglyceridaemia: Which Choice of Therapy?

Angiopoietin-like protein 3 (ANGPTL3) and apolipoprotein C-III (apoC-III) are novel metabolic targets for correcting hypertriglyceridaemia (HTG). As a background to their potential clinical use, we review the metabolic aetiology of HTG, particular abnormalities in triglyceride-rich lipoproteins (TRLs) and their role in atherosclerotic cardiovascular disease (ASCVD) and acute pancreatitis. Molecular and cardiometabolic aspects of ANGPTL3 and apoC-III, as well as inhibition of these targets with monoclonal antibody and nucleic acid therapies, are summarized as background information to descriptions and analyses of recent clinical trials. These studies suggest that ANGPTL3 and apoC-III inhibitors are equally potent in lowering elevated plasma triglycerides and TRLs across a wide range of concentrations, with possibly greater efficacy with inhibition of apoC-III. ANGPTL3 inhibition may, however, have the advantage of greater lowering of plasma LDL cholesterol and could specifically address elevated LDL cholesterol in familial hypercholesterolaemia refractory to standard drug therapies. Large clinical outcome trials in relevant populations are still required to confirm the long-term efficacy, safety and cost effectiveness of these potent agents for mitigating the complications of HTG. Beyond targeting severe chylomicronaemia in the prevention of acute pancreatitis, both agents could be useful in addressing residual risk of ASCVD due to TRLs in patients receiving best standard of care, including behavioural modifications, statins, ezetimibe, fibrates and proprotein convertase subtilisin/kexin type 9 inhibitors.

Profoundly Disturbed Lipoproteins in Cirrhotic Patients: Role of Lipoprotein-Z, a Hepatotoxic LDL-like Lipoprotein.

Detailed information regarding lipoprotein concentrations and subfractions in cirrhotic patients before and after orthotopic liver transplantation (OLT) is lacking. Lipoprotein-Z (LP-Z) is a recently characterised abnormal, hepatotoxic free cholesterol-rich low-density lipoprotein (LDL)-like lipoprotein. We determined the lipoprotein profiles, including LP-Z, in cirrhotic patients and OLT recipients and assessed the prognostic significance of LP-Z on the OLT waiting list. We performed analyses in cirrhotic transplant candidates and non-cirrhotic OLT recipients. A population-based cohort was used as reference. The setting was a University hospital. Lipoprotein particle concentrations and subfractions were measured by nuclear magnetic resonance spectroscopy. In the cirrhotic patients (N = 130), most measures of triglyceride-rich lipoproteins (TRL), LDL, and high-density lipoproteins (HDL) were much lower compared to the OLT recipients (N = 372) and controls (N = 6027) (p < 0.01). In the OLT recipients, many lipoprotein variables were modestly lower, but HDL-cholesterol, triglycerides, and TRL and HDL size were greater vs. the control population. LP-Z was measurable in 40 cirrhotic patients and 3 OLT recipients (30.8% vs. 0.8%, p < 0.001). The cirrhotic patients with measurable LP-Z levels had profoundly lower HDL-cholesterol and particle concentrations (p < 0.001), and worse Child Pugh Turcotte classifications and MELD scores. The presence of LP-Z (adjusted for age, sex, and MELD score) predicted worse survival in cirrhotic patients (HR per 1 LnSD increment: 1.11, 95%CI 1.03–1.19, p = 0.003). In conclusion, cirrhotic patients have considerably lower plasma concentrations of all major lipoprotein classes with changes in lipoprotein subfraction distribution. After OLT, these lipoprotein abnormalities are in part reversed. LP-Z is associated with cirrhosis. Its presence may translate in disturbed HDL metabolism and worse survival.

Incident Stroke and Its Influencing Factors in Patients With Type 2 Diabetes Mellitus and/or Hypertension: A Prospective Cohort Study.

ObjectiveTo understand the incidence of stroke in patients with type 2 diabetes mellitus (T2DM) and/or hypertension (HTN), and provide a basis for the prevention of stroke in these patients.MethodsA prospective cohort study was performed for adults with T2DM and/or HTN. The follow-up period was 1 year. The incidence and recurrence rate of stroke was calculated and a multivariate Cox proportional hazard was used to analyze influencing factors of stroke occurrence and recurrence in the follow-up of patients with T2DM and/or HTN.ResultsOf the 1,650 patients with T2DM and/or HTN, 1,213 patients had no history of stroke. After 1 year of follow-up, 147 new stroke cases occurred, and the incidence rate of stroke was 12.1%. Among the patients who had stroke history (413), there were 116 cases of stroke with a recurrence rate of 26.5%. Seven risk factors were independently associated with stroke occurrence among patients without stroke history, included smoking, abnormal total cholesterol abnormal low-density lipoprotein patients with comorbid T2DM with HTN, physical inactivity, carotid artery stenosis (CAS), and higher scores of National Institutes of Health Stroke Scale (NIHSS). Higher scores of NHISS and CAS were independent risk factors for the recurrence of stroke among patients with stroke history.ConclusionsPatients with T2DM and/or HTN have a higher rate of new stroke and recurrence after 1-year follow-up. Actively identifying the controllable risk factors, such as smoking and physical inactivity, will help reduce the risk of stroke and recurrence in patients with T2DM and HTN.

Coriander Seed Extract ( Coriandum Sativum L ) as an antioxidant

Diabetes mellitus (DM) is a disease characterized by hyperglycemia, lipoprotein abnormalities, increased basal metabolic rate, enzyme deficiency, and high oxidative stress. This research is an experimental study that aims to explore coriander seed extract (Coriandrum sativum L) using Post-Test Only Control Group Design. This study to was conducted to see the antioxidant potential (DPPH, ABTS, LC-MS/MS) of coriander seed extract (Coriandrum sativum L). Based on the test results, coriander seed extract contains very high phytochemicals, one of which is alkaloid compounds, and in vitro test results found DPPH antioxidant with an average IC50 value of 14.33 g/mL and at the lowest concentration (6.25 g/mL). g/mL), CSE also showed the highest antioxidant activity against ABTS trapping with an average IC50 value of 74.07 g/mL and the results of LC-MS/MS obtained samples of coriander extract containing 0.00009% chlorogenic acid and quercetin compounds. of 0.00012%.

Hypertriglyceridemia Induced Acute Pancreatitis Caused by a Novel LIPC Gene Variant in a Pediatric Patient

Hypertriglyceridemia induced acute pancreatitis is a rare cause of pancreatitis in children. Hepatic lipase deficiency is an extremely rare cause of hypertriglyceridemia, reported in only a few families to date. Hepatic lipase is the enzyme involved in the hydrolysis of triglycerides and phospholipids in remnants of triglyceride-rich lipoproteins that have a role in the conversion of very low density lipoprotein remnants to low density lipoproteins. Hepatic lipase deficiency is inherited in an autosomal recessive pattern. Detection of heterozygous carriers of hepatic lipase mutations remains accidental at the population level, as affected persons with a heterozygous state of hepatic lipase mutation do not display specific lipoprotein abnormalities and also patients with complete hepatic lipase deficiency have inconstant phenotype. The proximal promoter of the LIPC gene consists of four polymorphic sites in complete linkage disequilibrium. Five missense mutations in encoding exons have been described and proved to be responsible for hepatic lipase deficiency to date: S267F, T383M, L334F, A174T, and R186H, affecting the activity and secretion of hepatic lipase. We identified a primary disorder of the lipid metabolism as the cause of the acute episode of pancreatitis in a four years old patient, consisting of hepatic lipase deficiency caused by a novel genetic variant of the LIPC gene, a gross deletion of the genomic region encompassing exon 1. This variant was not previously described in the literature in persons with LIPC-related disorders and its significance is currently uncertain, but in the presented clinical and paraclinical context, it has the characteristics of a pathological variant inducing a hepatic lipase deficiency phenotype.

Evinacumab for the treatment of homozygous familial hypercholesterolemia

ABSTRACT Introduction Hypercholesterolemia is mainly caused by abnormal lipoprotein metabolism and can increase the risk of cardiovascular disease. Angiopoietin-like protein 3 (ANGPTL3) can increase low-density lipoprotein cholesterol (LDL-C) and other lipids by inhibiting lipoprotein lipase activity. Evinacumab is a monoclonal antibody against ANGPTL3, it can decrease levels of LDL-C and has shown potential benefit in patients with homozygous familial hypercholesterolemia (HoFH). Areas covered A comprehensive literature search was conducted in PubMed (January 2000 to August 2021). Key search terms included ANGPTL3, evinacumab and HoFH. Other sources were derived from product labeling and ClinicalTrials.gov. All English-language articles identified from the data sources were reviewed and evaluated. Phase 1, 2 and 3 clinical trials were included. The pharmacological characteristics, clinical evidence, and safety of evinacumab were reviewed. Expert opinion Evinacumab is an ANGPTL3 inhibitor. Phase 3 clinical trials found that in patients with HoFH, evinacumab reduced LDL-C by 47%, but placebo increased by 2%. Evinacumab was well-tolerated. Common adverse events included nasopharyngitis, influenza-like illness, dizziness, rhinorrhea, and nausea. It has the potential to become a valuable treatment option for patients with HoFH.

Different types of dyslipidemia in type 2 diabetes and the associated factors

Aim: Diabetes and dyslipidemia are common diseases that can be seen together. In this study, we aimed to investigate factors affecting the type of dyslipidemia in diabetic patients.Methods: The cross-sectional study included a total of 596 patients with type 2 diabetes who visited the outpatient diabetes clinic of the Istanbul Medeniyet University between January 2017 and December 2019. Patient laboratory, clinical, and sociodemographic data were retrieved from medical records. Results: Of all patients, 52% were diagnosed with hypercholesterolemia (total cholesterol ≥200 mg/dL) and 56.4% had a history of hypertriglyceridemia. Four hundred and forty-four (74%) patients had abnormal low-density lipoprotein cholesterol (LDL-C) levels (≥100 mg/dL). Eighty percent of the female patients and 67.4% of the male patients had abnormal LDLC levels, and the difference between the two sexes was statistically significant (p&amp;lt;0.001). Triglyceride levels were higher in the patients with a hemoglobin A1c (HBA1c) level ≥7% (p&amp;lt;0.001). Smokers had significantly higher levels of LDL-C (p=0.03) and lower levels of high-density lipoprotein cholesterol (p=0.038) than non-smokers. The mean body mass index was higher for the group of non-smokers than for the smokers (p&amp;lt;0.001). The rates of hypertriglyceridemia and obesity were significantly higher in patients with hypertension than in those without (p=0.036 and p=0.013, respectively).Conclusion: Dyslipidemia is common in diabetic patients, especially women. A complete examination of the patient should include the consideration of conditions associated with dyslipidemia.

Effect of Carbohydrate-Restricted Dietary Pattern on Insulin Treatment Rate, Lipid Metabolism and Nutritional Status in Pregnant Women with Gestational Diabetes in Beijing, China.

Carbohydrates play an important role in blood glucose control in pregnant women with GDM. Carbohydrate-restricted dietary (CRD) pattern for gestational diabetes mellitus (GDM) has been widely used in clinics, but the change in insulin utilization rate beyond CRD intervention in GDM remains unclear. The aim of the present study was to explore the application of insulin in pregnancy with GDM, as well as the influence of CRD pattern on lipid metabolism and nutritional state. A retrospective study of 265 women with GDM who delivered in Peking University People’s Hospital from July 2018 to January 2020 was conducted using a questionnaire survey. Women were divided into a CRD group or a control group according to whether they had received CRD intervention during pregnancy. There was no statistically significant difference in the rate of insulin therapy between the two groups (p > 0.05), the initial gestational week of the CRD group combined with insulin treatment was significantly higher than that of the control group (p < 0.05), and the risk of insulin therapy was positively correlated with fasting plasma glucose (FPG) in early pregnancy (p < 0.05). The incidence of abnormal low-density lipoprotein cholesterol levels in the CRD group was significantly lower than that in the control group (p < 0.05). There were no significant differences in nutritional indexes between the two groups. The results indicate that CRD intervention may be effective in delaying the use of insulin and improving the blood lipids metabolism during GDM pregnancy, while nutritional status may not be significantly affected under CRD intervention, and a high FPG in early pregnancy with GDM may be a risk factor for combined insulin therapy with CRD intervention.

Modulation activity of Vildagliptin on Hepatic Complications and Lipoprotein Abnormalities Associated with Insulin Resistance in Rats

Modulation activity of Vildagliptin on Hepatic Complications and Lipoprotein Abnormalities Associated with Insulin Resistance in Rats