Atherogenic Coefficient Research Articles

Lipid profile and atherogenic indices in patients with stable chronic obstructive pulmonary disease

Background and aimsLimited number of studies investigated lipid profile in chronic obstructive pulmonary disease (COPD) with inconsistent results. This study aimed to investigate lipid parameters in sera of patients with stable COPD and their associations with disease severity, smoking, comorbidities and therapy. Methods and resultsThe study included 137 COPD patients and 95 controls. Triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed. Non-HDL-C (NHC), atherogenic coefficient (AC), TG/HDL-C, atherogenic index of plasma (AIP), Castelli's risk index I and II (CRI-I, CRI-II), and monocyte to HDL ratio (MHR) were calculated.HDL-C and MHR were increased, while other lipid parameters and indices were decreased in COPD patients compared to healthy individuals. Smoking did not influence lipid parameters. However, lipid profile was altered only in more severe disease stages. AC, CRI-I and CRI-II showed positive association with lung function parameters in COPD patients, and negative with COPD multicomponent indices (ADO, BODCAT, BODEx, CODEx and DOSE). Combined model that included CRI-II, C-reactive protein, fibrinogen and white blood cells showed great diagnostic performances, and correctly classified 72% of study participants with an AUC of 0.800 (0.742–0.849), P < 0.001. Bronchodilator monotherapy and statins have opposite impact on TC, LDL-C and NHC, while TG, TG/HDL-C and AIP were increased in COPD patients with cardiovascular diseases. ConclusionLipid disbalance is present in COPD, and it seems to occur later as the disease progresses. Further studies are needed to illuminate the underlying mechanism of dyslipidaemia.

Time-Restricted Feeding Improves Body Weight Gain, Lipid Profiles, and Atherogenic Indices in Cafeteria-Diet-Fed Rats: Role of Browning of Inguinal White Adipose Tissue.

Time-restricted feeding (TRF) showed a potent effect in preventing obesity and improving metabolicoutcomes in several animal models of obesity. However, there is, as of yet, scarce evidence concerning its effectiveness against obesogenic challenges that more accurately mimic human Western diets, such as the cafeteria diet. Moreover, the mechanism for its efficacy is poorly understood. White adipose browning has been linked to body weight loss. Herein, we tested whether TRF has the potential to induce browning of inguinal white adipose tissue (iWAT) and to attenuate obesity and associated dyslipidemia in a cafeteria-diet-induced obesity model. Male Wistar rats were fed normal laboratory chow (NC) or cafeteria diet (CAF) for 16 weeks and were subdivided into two groups that were subjected to either ad libitum (ad lib, A) or TRF (R) for 8 h per day. Rats under the TRF regimen had a lower body weight gain and adiposity than the diet-matchedad lib rats, despite equivalent levels of food intake and locomotor activity. In addition, TRF improved the deranged lipid profile (total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c)) and atherogenic indices (atherogenic index of plasma (AIP), atherogenic coefficient (AC), coronary risk index (CRI) in CAF-fed rats. Remarkably, TRF resulted in decreased size of adipocytes and induced emergence of multilocular brown-like adipocytes in iWAT of NC- and CAF-fed rats. Protein expression of browning markers, such as uncoupling protein-1 (UCP1) and peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α), were also up-regulated in the iWAToftime-restricted NC- or CAF-fed rats. These findings suggest that a TRF regimen is an effective strategy to improve CAF diet-induced obesity, probably via a mechanismthe involving WAT browning process.

Biomarkers of Browning in Cold Exposed Siberian Adults.

Cold-exposure promotes energy expenditure by inducing brown adipose tissue (BAT) thermogenesis, which over time, is also sustained by browning, the appearance, or increase, of brown-like cells into white fat depots. Identification of circulating markers reflecting BAT activity and browning is crucial to study this phenomenon and its triggers, also holding possible implications for the therapy of obesity and metabolic diseases. Using RT-qPCR, we evaluated the peripheral blood mononuclear cells (PBMC) expression profile of regulators of BAT activity (CIDEA, PRDM16), white adipocytes browning (HOXC9 and SLC27A1), and fatty acid β-oxidation (CPT1A) in 150 Siberian healthy miners living at extremely cold temperatures compared to 29 healthy subjects living in thermoneutral conditions. Anthropometric parameters, glucose, and lipid profiles were also assessed. The cold-exposed group showed significantly lower weight, BMI, hip circumference, and PBMC expression of CIDEA, but higher expression of HOXC9 and higher circulating glucose compared to controls. Within the cold-exposed group, BMI, total cholesterol, and the atherogenic coefficient were lower in individuals exposed to low temperatures for a longer time. In conclusion, human PBMC expresses the brown adipocytes marker CIDEA and the browning marker HOXC9, which, varying according to cold-exposure, possibly reflect changes in BAT activation and white fat browning.

Alfa2-adrenoblockers attenuate the elevated plasma cholesterol, anxiety levels and restore impaired spatial memory of rats under the chronic noise exposure

Noise is considered one of the environmental hazards that negatively affect health. It can cause damage to the auditory, neurological, hormonal and cardiovascular systems, in addition to impairing psychological and cognitive functions. Considering the significance of vascular disturbances and oxidative stress in the development of the aforementioned negative effects, the purpose of our investigation was to study the level of high density lipoprotein-cholesterol (HDL-Cl), low density lipoprotein-cholesterol (LDL-Cl), and total cholesterol (TCl) in plasma, in addition to the behavioral characteristics of white rats, and the effects of the α2-adrenoblockers beditin and mesedin to reveal their antiatherogenic effect during noise exposure. The “Open field” and “Y-maze” tests were used in order to evaluate the behavioral states of the rats. Investigations were carried out on albino rats divided into 4 groups. The 1st group of rats served as a control. The 2nd, 3rd and 4th groups were exposed to 91 dBA of noise; the duration of exposure was 8 h per day for 60 days. The 3rd group was injected with beditin and the 4th group with mesedin, both intraperitoneally and repeatedly. According to our results, the chronic exposure to high-volume noise leads to the increase of plasma TCl and LDL-Cl concentrations and the decrease of HDL-Cl levels, resulting in increase of the atherogenic coefficient, which is estimated to be one of the main cardiovascular disease risk factors. The “Open field” and “Y-maze” tests revealed that chronic noise exposure caused disturbances in the behavioral activity, a noise duration-dependent delay in movement and orientation, increased anxiety and deficit in the animals’ spatial memory. The administration of α2-adrenoblockers to the noise-exposed animals had a regulatoryeffects of varying intensities, depending on the medication used and the studied parameters under the conditions of chronic acoustic stress.

Re: Comment on "The Clinical Importance of the Plasma Atherogenic Index, Other Lipid Indexes, and Urinary Sodium and Potassium Excretion in Patients with Stroke".

Objective Cardiovascular complications are still the primary reason for high mortality rates worldwide. The determination of risk factors is important to prevent stroke. The aim of the present study was to analyze the importance of serum lipid indexes and urinary sodium (Na)/potassium (K) excretion in patients with stroke together with sex differences. Materials and methods A total of 50 (28 male and 22 female, mean age 65.9±14.6 years) patients with acute stroke were included in the study group, and 32 body mass index-matched healthy subjects were included in the control group. Lipid profiles [(cholesterol, triglyceride, very low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein (HDL)], serum creatinine (Cre), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Na, K, and Cre excretion in spot urine samples of the patients were recorded. Results Systolic blood pressure (p=0.021), ESR (p=0.044), and CRP (p=0.042) were significantly higher in all patients in the stroke group; urinary Tanaka (K) (p=0.033), Kawazaki (K) (p=0.028), urinary spot Cre (p=0.012), and Na excretion (p=0.036) levels were found to be significantly lower in only male patients with stroke. The mean plasma atherogenic indexes were 0.57±0.24 in the study (stroke) group and 0.54±0.22 in the control group (p=0.61). Other lipid indexes, such as Castelli's risk index (CRI)-I (p=0.29), CRI-II (p=0.24), atherogenic coefficient (p=0.29), and non-HDL cholesterol (p=0.69), were not statistically different from the controls. Conclusion Urinary Na, K, and Cre excretion was significantly lower in male patients with stroke, and acute phase reactants were significantly higher in the entire stroke group than in controls. These parameters can be used as auxiliary biomarkers in the risk assessment of stroke.

Castelli risk index-1 and atherogenic coefficient are better predictors of cardiometabolic risk in patients with hypothyroidism

Hypothyroidism resulting from a deficiency of thyroid hormones may be associated with dyslipidaemia. Since altered lipid profile is quite important in predicting CVD risk, therefore the present study aimed to investigate any possible association between the levels of certain lipid indices with thyroid profile and their diagnostic ability of cardiometabolic syndrome in patients with hypothyroidism. A cohort of 40 female patients diagnosed with hypothyroidism was included as cases and thirty age and gender matched healthy females were recruited as controls. Fasting blood samples were collected for analysis of thyroid hormones, cholesterol, triglycerides and high density lipoprotein cholesterol levels by Chemiluminescence immuno-assay, and enzymatic colorimetric methods respectively. Differences in all between groups were tested using parametric independent sample T test. Pearson’s correlation or Spearman rank correlation analysis was done to study the correlations among the parameters as appropriate. Receiver operative characteristic (ROC) curve analysis was performed to study diagnostic utility of parameters.Lipid indices were found to be significantly increased in patients with hypothyroidism when compared to the controls. Castelli risk index-I (CRI-I), CRI-II, atherogenic coefficient (AC) and atherogenic index of plasma (AIP), were found to be significant positively correlated with low density lipoprotein cholesterol (LDL) (r=0.923, p=0.0001, r=0.935, p=0.0001,r=0.970, p=0.0001 and r=0.382, p=0.0001 respectively). The ROC curve analysis of lipid indices for cardiometabolic risk reveals that AUC for CRI-I and AC was high and statistically significant than other lipid parameters.The present study suggests that in addition to routine lipid investigations the inclusion of lipid Indices especially CRI-I, AC, were better indices for screening of early detection of cardiometabolic risk in female patients with hypothyroidism.

The CNIC-polypill improves atherogenic dyslipidemia markers in patients at high risk or with cardiovascular disease: Results from a real-world setting in Mexico.

BackgroundIn many patients, the risk of cardiovascular (CV) events persists despite statin treatment and attaining target LDL–c levels. This residual risk is in part attributed to atherogenic dyslipidemia (AD). We studied the clinical effectiveness of the CNIC-polypill in improving the lipid profile, and lipid ratios and indices indicative of AD that are more accurate in predicting lipid-related CV risk.MethodsPost-hoc analysis of a multicenter, observational, non-comparative, prospective registry in 533 patients in Mexico. We evaluated blood lipids at baseline (usual care) and after 12 months of treatment with the CNIC-polypill (Sincronium®), including total cholesterol (TC), triglycerides (TG), cholesterol low-density lipoproteins (LDL–c), cholesterol high-density lipoproteins (HDL–c), and cholesterol non-high-density lipoproteins (non-HDL–c). We also calculated and compared AD-related lipid ratios and indices, including remnant cholesterol (RC), Castelli's risk index-I (CRI–I), atherogenic index (AI), atherogenic coefficient (AC), a surrogate of insulin resistance (IRS), atherogenic index of plasma (AIP), and lipoprotein combined index (LCI).ResultsAt 1 year of treatment, there was a significant reduction in the levels of TC (−22.6%), TG (−29.2%), LDL–c (−13.8%), and non-HDL–c (−29.2%) (all p < 0.001). The likelihood that patients attained their corresponding target LDL–c and TG levels was almost three-fold and seven-fold higher, respectively (p < 0.001). The values of the AD-related ratios RC, CRI–I, AI, AC, AIP, and LCI were all significantly lower (p < 0.001) after one year of treatment.ConclusionsIn patients with or at high risk of CVD, one-year treatment with the CNIC-polypill significantly lowered lipid ratios indicative of AD compared to baseline.

The efficiency of blackberry loaded AgNPs, AuNPs and Ag@AuNPs mediated pectin in the treatment of cisplatin-induced cardiotoxicity in experimental rats

Cisplatin (cis-Diaminedichloroplatinum) is one of the most effective chemotherapeutic because of its anti-neoplastic properties against various types of tumor. However, it has a wide variety of side effects such as hepato, gastrointestinal, neuro, nephro, and cardiotoxicity (acute and/or chronic) that highly restricted its usage. Thus, research work was planned to detect the role of gold (AuNPs), silver nanoparticles (AgNPs) and their corepshell (Ag@AuNPs) as a carrier for blackberry extract and to enhance its benifit in treatment of cisplatin-induced cardiotoxicity. In our work, solid-state process was used in order to prepare these nanoparticles using pectin as an ecologically friendly-polymer acting as reductant for ions and at the same time as stabilizing agent for the produced nanoparticles. This nominated method for large-scale preparation of nanoparticles is simple, efficient, and convenient. The presence of individual metallic Ag, Au and both has been proven by UV-vis spectroscopy. Transmission electron microscopy (TEM) and particle size analyzer confirmed the preparation of spherical small size with a main diameter <40 nm. The data obtained from zeta potential evaluation displayed the well stabilization for the produced nanoparticles. Transmission electron microscopy (TEM), scanning electron microscopy (SEM) and particle size analyzer have verified that the spherical small size is <40 nm in diameter. Data from zeta potential assessment revealed the good stability of the produced nanoparticles. To this end, fifty sex rats were used in this study and divided into control, cisplatin (cispt), and five treated groups. After the experimental period, lipid profile was estimated and atherogenic coefficient (AC), atherogenic index (AI), and cardiac risk ratio (CRR) were calculated. Oxidant and antioxidant parameters were also estimated. Cardiovascular disease markers were estimated by ELISA. The mean levels of cholesterol, triglycerides, malondialdehyde (MDA), advanced oxidative protein products (AOPP), and cardiovascular markers were significantly increased in cispt group compared to control; whereas these parameters were attenuated in all treated groups in particular that received blackberry (bb) loaded Ag@AuNPs. Based on these results, it can be concluded that bb has antioxidant and antilipidemic effect that help in protecting against cardiovascular disease specially when loaded with Ag@AuNPs.

The correlation between atherogenic indexes and erectile dysfunction

Aside from the ordinary plasma lipid level measurements, the ratios based on individual plasma lipid levels such as atherogenic index of plasma (AIP), Castelli’s risk index 1/2 (CRI-1/2), and atherogenic coefficient (AC) are the novel parameters to evaluate the patients with a high risk of CVD. In this study, we aim to evaluate the relationship between AIP, AC, and CRI-1/2 with increased risk of ED. Between April 2018 and February 2019, 253 patients, who were diagnosed as a vasculogenic ED in our clinic, were enrolled in the study. While the first group (n = 134) consisted of patients with moderate and mild ED (IIEF-EF: 17–30), the second group (n = 119) consisted of patients with severe ED. In addition to the mean values of lipid parameters; CRI-1 (total cholesterol/HDL), CRI-2 (LDL/HDL) AIP (log10(triglycerides/HDL), and AC (non-HDL/HDL) were calculated. The mean age was 44.02 ± 10.41 (24–70), and the mean BMI was 27.80 ± 4.12 (18.52 ± 41.97). However, CRI-1 and AIP values were found to be higher in the severe ED group compared to the mild ED group (CRI-1: 4.50 ± 1.47, 4.88 ± 1.30; p = .039; AIP: 0.489 ± 0.315, 0.617 ± 0.283; p = .007). Our results demonstrated that CR-1 and AIP have a positive correlation with the severity of ED. Moreover, we can suggest that patients with higher CR-1 and AIP values are likely to have more severe ED in the future.

Dietary synbiotic supplementation improves the growth performance, body antioxidant pool, serum biochemistry, meat quality, and lipid oxidative stability in broiler chickens.

The present study investigated the effects of Lactobacillus acidophilus (LBA) and mannan-oligosaccharides (MOS) supplementation on the production performance, serum biochemistry, antioxidant profile, health indices, meat quality, and lipid oxidative stability of broiler chicken. A total of 252 commercial broiler chickens at 1 d old of uniform body weight were randomly allocated to 6 maize-soybean-based dietary treatments: T1 (control diet), T2 ( antibiotic bacitracin methylene di-salicylate [BMD] at 20 mg/kg diet), T3 (MOS at 0.1% + LBA at 106 CFU/g feed), T4 (MOS at 0.1% + LBA at 107 CFU/g feed), T5 (MOS at 0.2% + LBA at 106 CFU/g feed), and T6 (MOS at 0.2% + LBA at 107 CFU/g feed). Each treatment was assigned to 6 replicates of 7 birds. The samples for meat quality and serum biochemistry analysis were taken from 12 birds per treatment (2 birds/replicate). The results revealed better (P < 0.01) growth performance and production efficiency of birds fed either T5 or T6 diet compared to control or BMD supplemented diet and BMD-supplemented birds superseded the control birds. Higher (P < 0.01) serum and liver antioxidant enzyme activities, meat antioxidant capacity (2, 2-azinobis-3-ethylbenzothiazoline-6-sulfonic acid [ABTS] and 1, 1-diphenyl-2-picrylhydrazyl [DPPH] assays], serum total protein, high-density lipoproteins (HDL) cholesterol (P < 0.05), and globulin levels (P < 0.01) were observed in birds fed either T5 or T6 diet compared to control or BMD supplemented birds, whereas, lower lipid oxidation (P < 0.01), cardiac risk ratio, atherogenic coefficient, atherogenic index of plasma, serum glucose, triglyceride, total cholesterol levels (P < 0.01), and serum albumin-to-globulin ratio (P < 0.05) were observed in the chickens. The pH of meat from birds fed T4, T5 or T6 diet was lower (P < 0.01) compared to control and other treatments. The extract release volume (ERV), water holding capacity (WHC), and protein content of meat were higher (P < 0.05) in birds fed either T5 or T6 diet compared to control or BMD supplemented birds. Thus, it was concluded that the supplementation of 0.2% MOS along with LBA at 106 CFU/g is optimum for better growth performance, serum biochemistry, antioxidant profile, health indices, meat quality, and lipid oxidative stability of broiler chickens.

OPPORTUNITIES OF ADJUVANT THERAPY WITH PIOGLITAZONE OF NON-ALCOHOLIC FATТУ LIVER DISEASE СO-OCURRING WITH OBESITY

Relevance. The «Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020» approved by the WHO is dedicated to noncommunicable diseases. Among them - diabetes mellitus, which is a consequence of overweight \ obesity and lack of exercise. Pioglitazone is the only drug on the pharmacological market for the treatment of non-alcoholic steatohepatitis (NASH), regardless of diabetic mellitus status. Currently, the treatment of early NASH in the prevention of both type 2 diabetes and CVD, and amelioration of NASH progression is a priority task.&#x0D; Objective – to study the effectiveness of treatment with pioglitazone in patients with obesity and non-alcoholic fatty liver disease (NAFLD).&#x0D; Materials that methods. 123 patients with obesity 1, 2, 3 classes in combination with NAFLD were included in our research during 3 months. The randomization method of patients was divided into two groups, comparable in age, sex, and body mass index. All patients were offered drug-free treatment that included lifestyle modification: a reduction in diet of 500 kcal from the physiological daily energy expenditure and its physical activity for 150-200 min per week, the problems of adherence to recommendations were additionally discussed during the visits. The patients of the case group adhered to the basic recommendations and received pioglitazone 15 mg / day additionally as a drug treatment. Patients in the control group adhered only to principles of drug-free treatment. Overall, the program consisted of 5 visits over 3 months period. All patients underwent anthropometric measurements, laboratory and instrumental examinations (Ultrasound steatometry) before and after 12 weeks of treatment. Also studied adherence to treatment in two groups of patients using self-report questionnaire.&#x0D; Results. A comparative analysis of the data obtained in patients with obesity and NAFLD from the group of pioglitazone (daily dose of 15 mg) revealed the best major metabolic markers, such as significantly decreased values in waist circumference (p&lt;0,0001), uric acid (p=0,001), thriglycerides (p=0,02) and very low density lipoproteins cholesterol(p=0,003), atherogenic coefficient (p=0,002), fasting insulin (p=0,004) and C-peptide, HOMA-IR index (p=0,01) and increased level of high density lipoproteins cholesterol (p=0,009), respectively. A significant association was found between the target reduction of controlled attenuation parameter and treatment with pioglitazone 15 mg (OR 0,27, 95% CI 0,13–0,56, p=0,001). The dynamics of steatosis had a medium correlation with the final adherence level (r=0,52), regardless of the method of treatment.&#x0D; Conclusions. It was found that in Ukrainians with obesity and NAFLD, moderate steatosis occurs in 73% of cases. Pioglitazone is a significantly highly effective drug for the adjuvant therapy of NAFLD.

Evaluation of the effectiveness of differentiated therapy of non-alcoholic fatty liver disease

Study of the effectiveness of differentiated therapy of non-alcoholic fatty liver disease taking into account the clinical and pathogenetic features of its course. 168 patients with non-alcoholic fatty liver disease were examined, 108 of them were women and 60 men aged from 30 to 70 years. For treatment, depending on the characteristics of the course of the disease, 3 groups of patients were formed. The first group included patients (n=47) with liver steatosis with a high content of lipids in the blood and an increased atherogenic coefficient; they received therapy with ursodeoxycholic acid with atorvastatin. The second group consisted of patients (n=65) with liver steatosis with an increased level of glycemia, insulin and insulin resistance, they were prescribed therapy with ursodeoxycholic acid and metformin. Patients of the third group (n=56) with steatohepatitis with concomitant bacterial overgrowth received еssentiale forte H therapy with rioflora immuno. Clinical data, blood biochemical parameters, insulin and HOMA-IR levels, intestinal microbiota status, as well as regression of liver steatosis and steatohepatitis were evaluated in the dynamics of treatment. In the dynamics of treatment, there was a decrease in the clinical manifestations of the disease in all observed groups of patients, an improvement in lipid metabolism and indicators of the functional state of the liver, a decrease in excessive bacterial growth. On the basis of ultrasound, elastography and fibrotest, the reverse development of liver steatosis was found in 20% and steatohepatitis in 66.6% of patients. The data obtained indicate the feasibility of differentiated treatment of patients with non-alcoholic fatty liver disease depending on thecharacteristics of its course and stage.

Evaluation of Lipid Profile and Atherogenic Indices of Automobile Workers Before and after Green Tea Supplementation

Introduction: The various toxic chemicals automobile workers (AMW) are exposed to may predispose them to some adverse cardiovascular outcomes by alteration of lipids and lipoproteins. However, dietary strategies may be useful in preventing this undesirable outcome. Materials & Methods: The study aimed to assess the lipid profile and atherogenic indices of automobile workers. 78 male subjects aged 18 to 54 years, 33 automobile workers (AMW), and 45 control subjects were recruited for this study. 28 out of the 33 automobile workers received 150 ml of green tea daily for two months. 3ml of fasting blood samples were collected before and after one and two months of intervention. Total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), and triglyceride (TG) were measured enzymatically while low-density lipoprotein cholesterol (LDLc) and atherogenic indices (Castelli’s risk index (CRI) 1 and 2, atherogenic coefficient (AC), atherogenic index of plasma (AIP), non-HDLc (nHDLc) were calculated. Results: The median values of TC, LDLc, TG, CRI-1, CRI-2, AC, AIP, and nHDLc were significantly higher in the automobile workers when compared to the control (p

THE KLOTHO PROTEIN IN BLOOD IN MEN WITH ISCHEMIC HEART DISEASE AND ITS ASSOCIATION WITH A LIPID PROFILE

Purpose of the study was to determine the quantitative content of Klotho protein in the blood of men with coronary heart disease in comparison with the control group and its association with the blood lipid profile. Material and methods. The study included 178 men, including 115 people aged 50-65 years (I age group) and 63 people over 80 years (II age group). The main group included 98 men with coronary heart disease, the average age was 61.1±11.4 years, the control group consisted of 80 men without coronary heart disease, and the average age was 68.1 ± 14.4 years. Klotho protein serum concentration was measured by ELISA. Results. Klotho’s protein level tends to decrease in people with coronary heart disease, its lower level is associated with an increased relative risk of coronary heart disease. In men with coronary heart disease, Kloto protein tends to increase with age, and men without coronary heart disease, on the contrary, decrease. In patients with coronary heart disease, an increase in Klotho protein in the blood is associated with an increase in the level of HDL-C and a decrease in the atherogenic coefficient. Conclusion. Thus, it can be assumed that Klotho protein in men with coronary heart disease exhibits anti-atherogenic properties.

METABOLICALLY HEALTHY AND UNHEALTHY OBESITY IN CHILDREN FROM THE POINT OF VIEW OF EVIDENCE-BASED MEDICINE

Introduction. Childhood obesity and associated metabolic comorbidities is a major global health concern. Metabolic syndrome (MS) is a cluster of metabolic abnormalities that confers a substantial increase in cardiovascular disease risk. In the context of the childhood obesity pandemic, a distinct subgroup of youth with obesity less prone to the development of metabolic disturbances, called “metabolically healthy obese” (MHO), recently has come into focus. However, the diagnostic criteria of both conditions are still controversial in children. Therefore, the purpose of our research is to estimate the prevalence of metabolic syndrome and metabolically healthy obesity in school-age boys using international reference standards and to recognize the most sensitive metabolic markers. Materials and methods. This study was carried out at the Ternopil regional hospital (Western Ukraine) and involved randomly chosen 112 boys from rural and urban population; aged 10–17 years (mean ± SD, 14.6 ± 0.25). Height, weight and waist and hip circumferences were measured by standard methods in each patient. Body mass index (BMI, kg/m2), waist-to-height ratio (WtHR), waist-to-hip ratio (WHR) were calculated by common formulas. Obesity was defined as a BMI ≥ 2SD for age and gender. Blood pressure was measured and estimated according to European Society of Hypertension guidelines (2016). Biomarkers of carbohydrate and lipid metabolism were tested. Discussion. The study identified prominent physical and metabolic differences in groups of patients with MHO and manifested MS, as well as in the high-risk group for the realization of MS. As a result of this project, MHO and MS were confirmed in 49.11 % and 9.82 % surveyed boys, respectively. The rest of teenagers (32.14 %) based on metabolic disturbances, formed a cluster of the high-risk realization of MS. Moreover, fasting hyperglycemia and glucose intolerance were identified only in patients with manifested MS in 10.91 % and 5.45 % cases, respectively. It was found that the waist-to-height ratio &gt; 0.5 is an informative test of obesity in general, and the waist-to-hip ratio &gt; 0.9 is a sensitive screening tool for abdominal obesity in boys in our population. Based on the results, the triglyceride index is the most sensitive biomarker of insulin resistance compared to triglyceride-to-high density lipids cholesterol ratio and atherogenic coefficient in school-age boys. The results can be applied in pediatric practice for early identification of patients with metabolically unhealthy obesity with WHR and the triglyceride index at the early preclinical stage of MS manifestation. Keywords children, metabolically healthy obesity, metabolic syndrome, triglyceride index.

ATHEROGENIC INDICES IN THE ASSESSMENT OF CARDIOVASCULAR DISEASE RISK IN CHILDREN WITH OBESITY AND SUBCLINICAL HYPOTHYROIDISM.

The frequency of subclinical hypothyroidism (SH) in patients with obesity is increased compared with the normal population. However, data on the risk of cardiovascular disease (CVD) in patients with SH are still scarce. Lipid parameters are strong predictors of early CVD. We aimed to investigate the role of lipid indices in predicting CVD risk compared to conventional lipid components. A total of 220 euthyroid obese children (EU) and 90 obese children with SH were included in the study. All data were collected from hospital files. Lipid indices were evaluated. Atherogenic index of plasma (AIP), cardiac risk ratio (CRR) and atherogenic coefficient (AC) were calculated. AIP>0.24, CRR>5 ve AC>3 were considered as cardiovascular risk criteria. The presence of SH increased the risk of higher AIP and the risk of CRR, compared to euthyroid obese children. Subclinical hypothyroidism in obese children may cause dislipidemia carrying a high cardiovascular disease risk.

Associations between B vitamin and amino acid intake, MTHFR genotype, atherogenic indices, and homocysteine levels in postmenopausal women

AbstractIt has been hypothesized that insufficiency of one-carbon metabolism may aggravate lipid metabolism disturbances. Lipid metabolism abnormalities and metabolic syndrome (MetS)—which is associated with abnormally high levels of triglycerides (TG) and low levels of high-density lipoproteins (HDL)—often occur in postmenopausal women. The purpose of this study was thus to determine the relationships between amino acid and B vitamin intake, MTHFR genotype, lipid profile, and atherogenic indices in postmenopausal women.131 postmenopausal women were enrolled for the study. The mean macronutrient, amino acid, and B vitamin intake was evaluated using dietary records. Lipid profile and concentrations of apolipoprotein A1 (ApoA1) and B (ApoB) in serum were measured using the colorimetric method. The total homocysteine (tHcy) and glutathione (GSH) level in plasma were measured using high-performance liquid chromatography. MTHFR genotype (rs1801133) was determined using a single tube TaqMan SNP Genotyping Assay. We calculated atherogenic indices, such as Castelli's risk index I and II (CRI-I and CRI-II), the atherogenic coefficient (AC), and the TG/HDL ratio.No association was found between MetS and tHcy or GSH concentrations. MTHFR genotype and folate intake also did not affect tHcy, GSH, lipid profile, or atherogenic indices. Subjects with tHcy levels over the median had lower total protein intake, lower animal protein/plant protein ratio, lower protein/carbohydrates ratio, and higher amino acid intake (methionine, lysine, arginine, glycine, and tryptophan) than did subjects with lower tHcy levels. Women who failed to meet their vitamin B12 intake needs had almost 40% higher levels of tHcy than women who did met those needs.MTHFR genotype, folate intake, and tHcy levels in plasma are not associated with lipid metabolism in postmenopausal women. tHcy levels may depend on the intake of vitamin B12, and of protein or particular amino acids.The project was financed by the National Science Centre, Poland (grant number 2015/17/N/NZ9/04133).

Metabolic features of elderly patients with multivessel coronary lesions

Peculiarities of the course of coronary heart disease in elderly patients with multivessel lesions of the coronary bed and uncorrected metabolic disorders, in particular lipid profile, are analyzed in the article. The study included 74 patients older than 65 years of both sexes with lesions of the left main coronary artery (LMCA) in combination with a lesion of two or more coronary arteries according to coronary arteriography. The authors found that the negative dynamics of carbohydrate metabolism is a predictor of the deterioration of the course of coronary heart disease (CHD) in elderly patients. An adherence to therapy and glycemic control significantly increase the chances of a favorable course of the disease in elderly patients with multivessel coronary lesions.An elevated level of triglycerides, very low-density lipoproteins cholesterol, and an overall atherogenic coefficient, are a predictor of re-hospitalization associated with coronary insufficiency in elderly patients with multivessel coronary lesions.

Хроническая сердечная недостаточность на фоне ревматоидного артрита: роль воспаления в изменении уровня предсердного натрийуретического пептида и показателей липидограммы

The aim of the research is the analysis of basic clinical laboratory and instrumental parameters of patients suffering from CHF with intermediate left ventricular ejection fraction (LEF), developed as a result of ischemic heart disease and arterial hypertension associated with RA compared to patients without RA; assessment of indicators of morphological and functional parameters of myocardium and possible associations with indicators of RA inflammation activity. Material and methods. The study group included 134 patients with HFFV associated with RA; the comparison group was of 122 patients with HFFV without RA. CHF functional class of patients who took part in the study according to NYHA I-II. RA was diagnosed based on X-ray and serological studies, which included determination of rheumatoid factor (RF), antibodies to cyclic citrullinated peptide (ACCP), C - reactive protein (CRP). Inflammatory process activity was assessed by DAS28 index and visual analogue pain scale (VAS). X-ray RA stage included the studied I-III patients according to Steinbrocker classofication. CHF treatment medications were compared in groups. The basic anti-inflammatory medication for RA treatment is methotrexate. Patients who did not take methotrexate due to side effects and / or individual intolerance took leflunomide at a dosage of 20 mg per day. Moreover, NSAIDs were used (enterally, parenterally, locally). Hematological, biochemical and instrumental studies were carried out. The processing was carried out in STATISTICA 10.0 program. The work presents statistically significant results. The critical level of significance when testing statistical hypotheses is p &lt;0.05. Results. Comparative analysis revealed statistically significant differences in the levels of ESR and CRP, with a predominance of values in the study group, which naturally reflects the intensity of inflammatory process. Furthermore, statistically significant differences in the levels of creatinine and GFR were revealed. It can be due to the influence of chronic inflammation and regular intake of NSAIDs. In the group of patients with CHF on the background of RA, statistically significant decrease in hemoglobin level was found. Statistically significant predominance of TG, LDL-C concentration, as well as a decrease in HDL-C in the study group in relation to the comparison group were obtained. Statistically significant predominance of atherogenic coefficient was revealed in the study group. NT-proBNP concentration in the study groups differed significante: in the group of patients with CHF associated with RA, the level was 306.7 (225; 391) pg / ml; in the CHF group without RA - 488.7 (355; 638) (p = 0.02). A direct association of the DAS28 index and NT-proBNP was found (r = 0.04; p = 0.02). Conclusion. Patients with CHF associated with RA are reasonably recommended to increase the dosage of statins with more frequent monitoring of lipid profile. An assessment of NT-proBNP level is required for more detailed assessment of morphological and functional parameters of myocardium.

Assessment of Lipid Profile and Atherogenic Indexes of Hepatitis B Virus Carriers amongst Volunteer Blood Donors in Nigeria

Introduction: Infectious agents such as hepatitis B virus can constitute major public health problems as ii affects the liver resulting into inflammatory conditions. This study was designed to assess plasma lipid profile and atherogenic indexes of hepatitis B virus carriers among voluntary blood donors in North Central, North East and South-South regions of Nigeria. Materials & Methods: A total of 183 blood samples were collected from subjects in North Central consisting of 137 males and 46 females; 176 blood samples from the North East consisting of 129 males and 47 females and 173 blood samples from subjects in South-South region consisting of 123 males and 50 females. The mean ages of the subjects were 34.89 ± 9.19 years, 39.81 ± 9.60 years and 39.92 ± 9.27 years for North Central, North East and South-South regions respectively. The specimens were tested for hepatitis B surface antigen using enzyme-linked immunosorbent assay. All specimens were analyzed for total cholesterol, HDL-C, LDL-C and triglycerides with standard biochemical procedures. The atherogenic indexes were computed using established ratios. The data was analyzed statistically and p-value 0.05) between the hepatitis B positive carriers and hepatitis B negative subjects across the geo-political zones studied although in some of the parameters the values were on the high normal range between the male and female subjects. The AIP and CRR-1 and CRR-11 of the blood donors in the zones in both the HBsAg positive and negative subjects were within the reference range. The atherogenic coefficient value of >3.0 was obtained for some HBsAg negative and positive subjects in some of the zones. Conclusion: The findings thus indicate that asymptomatic HBV infection may be associated with low risk of dyslipidaemia in the population.