Castelli Index Research Articles

Effects of a Sorghum Beverage with Lacticaseibacillus paracasei on Body Composition, Lipid Profiles, and Intestinal Health in Overweight and Obese Adults: A Randomized Single-Blind Pilot Study.

(1) Background: This study aimed to evaluate the effect of an extruded whole-grain sorghum beverage containing L. paracasei on body composition, lipid profiles, and intestinal health in overweight and obese adults. (2) Methods: A chronic, single-blind randomized controlled pilot study was conducted with 30 volunteers allocated to three groups (n = 10/group): extruded sorghum beverage (ESB), extruded sorghum beverage with L. paracasei (ESPB), and control beverage (CB) (waxy maize starch). The chemical composition of the beverages was analyzed. Volunteers consumed the beverages for ten weeks at breakfast, along with individual dietary prescriptions. Body composition, biochemical markers, gastrointestinal symptoms, stool consistency, intestinal permeability, short-chain fatty acids, fecal pH, and stool L. paracasei DNA concentration were analyzed at the beginning and end of the intervention period. (3) Results: The ESB showed better composition than the CB, particularly in terms of resistant starch content, total phenolic compounds, condensed tannins, and antioxidant capacity. Both the ESB and the ESPB had an effect on body composition (estimated total visceral fat and waist volume), biochemical markers (Castelli index I), and intestinal health (Bristol scale, diarrhea score, valeric acid, and L. paracasei DNA concentration). No changes were observed in the CB group after the intervention. (4) Conclusions: Whole-grain sorghum beverages demonstrated good nutritional value, and consumption of these beverages, with or without L. paracasei, provided health benefits, including improvements in body composition, Castelli index I scores, and intestinal health, in overweight and obese adults.

Correlations of Remnant Cholesterol and Atherogenic Index of Plasma as Predictors of Cardiovascular Accidents in Obese and Overweight Individuals in Nigeria

Obesity is one of the indices of metabolic syndrome and has been implicated in cardiovascular incidents. Atherogenic index of plasma (AIP) has been associated as a biomarker in the predictor of cardiovascular diseases, with remnant cholesterol (RC) suggested as a link to the development of cardiovascular incidents irrespective of body mass index. Objective: The main aim of this current study was to investigate the correlation between AIP and RC among the participants. Materials: A total of 90 participants with average age of 36.05± for normal weight, 36.54±0.7 for overweight and 37.85±2.1 for obese, were enrolled into the study, the participants were categorized based on their BMI. AIP was calculated as Log10 (TG/HDLc), RC was calculated as (TC-HDLc-LDLc), fasting blood was collected for analysis of lipid profile, and fasting blood sugar by standard methods. Data obtained were analyzed using statistical packages for social sciences (SPSS) version 22.0. Results: The values of basic lipid profile and their mathematical derivatives except HDLc were significantly higher in obese and overweight subject when compared to the control (normal weight). In the regression analysis, we found out that subjects with higher AIP shows a tendency of increased risk for the development of obesity and its related complications (OR=2.74, <P 0.001). AIP showed to be a better predictive value for obesity with AUC of 0.8, than other lipid components and derivatives. The Pearson correlation analysis indicates that AIP positively and significantly correlated with RC, BMI, Castelli index I and II, non-HDLc and VLDL and negatively correlated with HDLc across the group. In this study, the analyzed Cardiovascular risk indices were indicative of atherogenicity risk which might help in identifying individuals with abnormal lipid composition at risk of cardiovascular diseases. Our findings suggested that lipid profile derivatives such as Remnant Cholesterol (RC), Atherogenic Index of Plasma (AIP) and Castelli index, could serve as more sensitive cardiovascular risk predictors in the presence of normal value of basic lipid panel test.

Association of c.+677 C>T (rs1801133) and c.+1298 A>C (rs1801131) MTHFR genetic variants with cardiometabolic and disease risk in systemic lupus erythematosus patients: A cross-sectional study.

Systemic lupus erythematosus (SLE) patients present a high prevalence of cardiometabolic risk, associated with worse clinical manifestations and mortality. Folate, an essential micronutrient that participates in vital immune cellular functions, could positively affect the cardiometabolic and disease risk in SLE, through the methylenetetrahydrofolate reductase (MTHFR) enzyme, which participates in the folate metabolism, where single nucleotide variants (SNVs) have been described as a potential genetic risk factor for SLE. The aim of this study was to determine the association of the c.+677C>T (rs1801133) and c.+1298 A>C (rs1801131) MTHFR genetic variants with cardiometabolic risk and clinical disease variables in SLE patients. A case-control study was conducted on 394 unrelated Mexican-mestizo women: 199 with SLE according to the 1997 SLE-ACR criteria and 196 control subjects (CS). Folic acid and homocysteine levels were evaluated by immunoassays. Genotyping of MTHFR genetic variants was carried out by allelic discrimination. No significant differences were found for folic acid (p = .15) and homocysteine serum levels (p = .59) between groups. According to the CC c.+677 MTHFR genotype, this was associated with low cardiovascular disease (CVD) risk by the Castelli index (OR = 0.42; p = .03) in SLE patients. The TC (OR = 1.3; p = .03) and the TA (OR = 1.6; p < .01) haplotypes from c.+677C>T plus c.+1298 MTHFR were associated with SLE risk, while the CC MTHFR haplotype (OR = 0.5; p = .01) was found as a non-risk factor for the disease. In conclusion, the TC and the TA MTHFR haplotypes are associated with disease risk; meanwhile, the CC c.+677 MTHFR genotype confers lower cardiometabolic risk in Mexican-mestizo SLE patients.

Correlation between bone density, bone metabolism markers with lipid metabolism markers and body mass index

PurposeWe aimed to explore the relationship between bone mineral density (BMD), bone metabolism markers, and blood lipid-related indicators, body mass index (BMI) in elderly individuals.MethodsA retrospective analysis was conducted on 710 patients. Patients’ gender, age, height, weight, bone density values, T-scores, bone metabolism markers (including serum N-terminal propeptide of type I collagen (s-PINP), serum C-terminal telopeptide of type I collagen (s-CTX) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and lipid-related indicators (including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and Castelli index 1 (TC/HDL-C index) and Castelli index 2 (LDL-C/HDL-C index) were recorded. Correlations between variables were analyzed, and patients were grouped according to gender and T-score for intergroup comparisons.ResultsHDL-C negatively correlates with BMD and s-CTX. TG, Castelli index, and BMI positively correlate with BMD. BMI negatively correlates with s-PINP. 1,25(OH)2D3 negatively correlates with TC, LDL-C, and Castelli index. LDL-C positively correlates with BMD in males, and TC negatively correlates with s-PINP. In females, HDL-C negatively correlates with BMD, and s-CTX positively correlates with Castelli index. 1,25(OH)2D3 negatively correlates with TC, LDL-C, and Castelli index. TG and Castelli index were higher in normal bone mass group, while HDL-C is higher in the osteoporosis group. TG and BMI positively predicted bone mass density, while HDL-C negatively predicted bone mass density.ConclusionsHDL-C may have a predictive role in osteoporosis, particularly in women. The likelihood of osteoporosis is lower in individuals with high BMI or hyperlipidemia. Some lipid metabolism markers can be used to predict osteoporosis, and further research is needed.

Differences in Chronic Low-Grade Inflammation and Metabolic Disturbances between VDR Genotypes in an Ethnically Homogenous Postmenopausal Female Population from Poland.

(1) Vitamin D deficiency and changes in the endocrine system may stimulate systemic inflammation. VDR expression and the vitamin D concentration decrease with age, which is important in postmenopausal women for whom estrogen deficiency causes rapid bone loss. This group is, moreover, particularly at risk of developing atherosclerosis and its adverse consequences, such as chronic inflammation. The aim of this study was to assess the differentiation by the VDR genotype of the risk factors for so-called chronic low-grade inflammation and metabolic disorders. (2) We studied the differences between the anthropometric, metabolic, and inflammation parameters of VDR genotypes for Apa-I, Bsm-I, Fok-I, and Taq-I in a sample of 321 women aged 50-60 from an ethnically homogeneous urban population in Poland. (3) The TT Taq-I genotype presented a significantly higher rate of insulin resistance (HOMA) and lower serum levels of adiponectin than the other two genotypes. The AA genotype of the Bsm-I polymorphism was associated with a more atherogenic serum profile and significantly higher LDL and LDL/HDL values and Castelli Index. (4) Chronic low-grade inflammation was associated with the TT Taq-I genotype and presented a higher rate of insulin resistance. The AA genotype of the Bsm-I polymorphism presented a more atherogenic serum lipid profile and, therefore, a higher risk of developing cardiovascular disease.

RELACIÓN ENTRE EL NIVEL DE ACTIVIDAD FÍSICA Y EL RIESGO CORONARIO DEL PERSONAL ADMINISTRATIVO DE LA UNIVERSIDAD NACIONAL DE TRUJILLO, 2022

The objective was to identify the relationship between the level of physical activity and the coronary risk of the administrative staff of the Universidad Nacional de Trujillo, 2022. Observational, relational and cross-sectional study. 111 administrative workers participated in the research to whom a survey was applied to determine their level of physical activity and height and weight were measured. In the lipidprofile assay, a fasting blood sample was taken. The IBM SPSS Statistics version 26 software was then used to calculate the mean, standard deviation, and 95% confidence intervals for the factors: BMI, total cholesterol, LDL, VLDL, and TC/HDL-cholesterol (Castelli index). Subsequently, Pearson's Chi-square analysis was performed. A sedentary lifestyle was mainly associated with twice the coronary risk (α&lt; 0.05). The Castelli index is useful for the diagnosis of dyslipidemia and as a predictor of cardiovascular risk in patients with metabolic syndrome.

Anti-atherogenic and cardio-protective properties of sweet melon (Cucumis melo. L. Inodorus) seed extract on high fat diet induced obesity in male wistar rats

BackgroundCucumis melon is a medicinal plant with multiple pharmacological properties such as anti-inflammatory, antioxidant, and diuretic effects. An increasing body of scientific evidence established the anti-diabetic/anti-obesity effects of Cucumis melo in humans, mice, and hamster models. However, there are no tangible reports on its ability to prevent cardiovascular complications following diet-induced obesity. The anti-atherogenic and cardioprotective effects of the Methanolic extract of Cucumis melo. L. Inodorus seeds on a high-fat diet (HFD)-induced obese rats was assessed in this study. MethodsForty male Wistar rats were randomly divided into five groups, (n = 8/group); i.e., Normal (N), HFD, HFD + 50 mg/kg b.w. of MCMs (Methanolic extract of Cucumis melon seeds), HFD + 100 mg/Kg b.w. of MCMs and HFD + 200 mg/kg b.w. of MCMs. The experimental animals were anaesthetized and sacrificed after 10 weeks, and blood samples and heart tissue were collected for further analysis. Using the Graph Pad Prism version 5.0, the results expressed as Mean ± SD was tested using the one-way ANOVA to show intergroup differences, followed by Bonferonni ‘s post hoc test. The level of significance was determined at P ≤ 0.05.ResultsMCMs significantly (P < 0.05) reduced body weight, adiposity index, total fat mass, low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC) compared with the HFD obese groups MCMs caused a significant reduction in the body weight, total fat mass, adiposity index, low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC) when compared to the animals in HFD obese groups. Also, the Atherogenic index of plasma (AIP), Castelli index and, malondialdehyde (MDA) significantly (P < 0.05) decreased in MCMs treated groups compared to the HFD obese group. The catalase, protein, and HDL levels were significantly increased in MCMs treated groups compared to HFD-obese animals. Expression of nitric oxide in the form of nitrite in the heart tissue significantly increased in the MCMs treated compared to the HFD-obese rats, with the majority of the positive results recorded at 100 mg/Kg b.w. of MCMs.ConclusionsMCMs have anti-atherogenic and Cardio-protective properties on High Fat Diet-Induced Obesity in Male rats via an antioxidant and nitric oxide-dependent mechanism. Further study is recommended to evaluate the molecular mechanisms to which these anti-atherogenic and cardio-protective actions can be attributed and exploit the GCMS result in the development of drug candidates.

TLR4 polymorphism and haplotype are associated with obesity and lipid profile in young population: a pilot study.

The single nucleotide polymorphisms in the TLR4 gene can decrease or increase the response to lipopolysaccharide, increasing the susceptibility to inflammatory diseases, affecting the expression or receptor function by inducing a low-grade chronic inflammatory response. The objective of this study was to evaluate the association of SNPs -2570 A > G (rs2737190), -2081 G > A (rs10983755), 896 A > G (rs 4986790), and 1196 C > T (rs4986791) of the TLR4 gene with obesity and metabolic alterations in the young population. In this study, it was found that the carriers of the heterozygous genotype of the SNPs -2081 G > A, 896 A > G, and 1196 C > T confer a higher risk of developing obesity (OR=3.73, p=0.018; OR=5.66, p=0.014, and OR=8.95, p=0.014, respectively). Also, with the lipid profile, the SNP -2081 G > A was associated with total cholesterol (TC)≥ 200mg/dL (OR=3.91, p=0.020) and Kannel index >3% (OR=4.00, p=0.008). The SNP 896 A>G was associated with LDL-c ≥100 mg/dL (OR=3.64, p=0.040) and Kannel index >3% (OR=4.33, p=0.016), and the SNP 1196 C>T was associated with TC≥200mg/dL (OR=4.37, p=0.048), Castelli index >4.5/>5% (OR=5.33, p=0.016), and Kannel index >3% (OR=16.00, p=0.001). Finally, the AGGT haplotype was associated with Castelli index >4.5/>5% (OR=5.40, p=0.015) and Kannel index >3% (OR=10.46, p<0.001), and the AAAC haplotype was associated with obesity (OR=3.56, p=0.020), TC≥200mg/dL (OR=4.04, p=0.007), LDL-c≥100mg/dL (OR=2.98, p=0.030) and Kannel index >3% (OR=4.20, p=0.002). The heterozygous genotype of the SNPs -2081 G > A, 896 A > G and 1196 C > T of the TLR4 gene was associated with altered lipid profile and development of obesity in young university students of Guerrero State, Mexico.

The Role of Oxidative Stress in the Risk of Cardiovascular Disease and Identification of Risk Factors Using AIP and Castelli Atherogenicity Indicators in Patients with PCOS.

Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies in females of reproductive age and may affect 5–14% of women. In women with PCO syndrome, metabolic disorders such as insulin resistance, hyperinsulinemia, obesity, diabetes mellitus, and other elements of metabolic syndrome may occur. Patients with PCOS often have overweight and obesity, especially abdominal obesity, which is one of the risk factors for developing atherosclerosis. The atherogenicity indicators of AIP (atherogenic index of plasma) and Castelli’s index are used to assess the risk of developing atherosclerosis. Studies have shown an increase in the concentration and activity of oxidative stress markers in patients with PCOS compared to women without the disease. The aim of the present study was to evaluate oxidative stress parameters in patients with PCOS in relation to insulin resistance, BMI, and hyperandrogenemia and to correlate them with cardiovascular risk parameters. Conclusions: The severity of oxidative stress in women with PCOS correlates with exposure to cardiovascular diseases. The assessment of additional cardiovascular disease (CVD) parameters is useful in identifying the risk groups for cardiometabolic disease among PCOS patients. When additional risk factors such as hyperandrogenism and insulin resistance (IR) are present in patients with PCOS, it is reasonable to include preventive examinations early. It is also important to evaluate lipidograms, which will make it possible to determine indicators of atherogenicity. Patients with PCOS and IR are at particular risk for cardiovascular complications. PCOS should be considered an important risk factor for CVD, which occurs independently of the occurrence of obesity. This factor is related to the important role of insulin resistance, which occurs independently of obesity. Atherogenic factors (AIP and Castelli index) are useful additional parameters to assess the risk of cardiometabolic disease in PCOS patients, especially among groups with insulin resistance. The early detection of risk factors should be an integral part of the care of PCOS patients. In laboratory studies of women with PCOS, TG, TChol, HDL-c and LDL-c levels, and glutathione peroxidase (GPx) activity were most clearly correlated with exposure to cardiovascular disease.

A STUDY TO EVALUATE THE IMPORTANCE OF FASTING LIPID PROFILE ESTIMATION AS THE PART OF INITIAL EVALUATION OF HIV POSITIVE PATIENTS BEFORE STARTING HAART

BACKGROUND:-There is evidence that ART is associated with lipodystrophy syndrome, a disturbance of lipid metabolism characterised by insulin resistance, dyslipidaemia, and fat maldistribution, metabolic bone disease (osteopenia and/or osteoporosis), and lactic acidosis. ART- associated dyslipidaemia is characterized by elevated serum concentrations of total cholesterol, triglycerides, low density lipoprotein 2(LDL-c), very low-density lipoprotein (VLDL), and Apo lipoprotein B (apoB) and low levels of high density lipoprotein (HDL-c) constituting an atherogenic lipid 1 prole . In this study 143 young patients who were attending the Antiretroviral Therapy PlusMATERIAL AND METHODS:- Centre &amp; Medicine Wards, ACSR GMC NELLORE were included randomly. 5mlSample preparation and Biochemical assay :- of venous blood sample was collected by venipuncture from 12 hours overnight fast and centrifuged at 3000 cycles per minute and serum was separated for lipid prole measurement within one hour of blood collection. The serum levels of TC, HDL-C, LDL-C, VLDL and TG were measured using AU480 BECKMANS random access fully automated auto analyzer at Biochemistry laboratory, ACSR GMC, NELLORE. TC, LDL and TC/HDL lipid proles are signicant. F-Signicant values areRESULTS;- &lt;0.05, reject null hypothesis. It means that the difference among the lipid proles of TC, LDL and TC/HDL in the study group is statistically signicant with respect to regimen groups. HDL, TG and VLDL lipid proles are not signicant. F-Signicant values are &gt;0.05, no evidence to reject null hypothesis. It means that the no signicant difference among the lipid proles of HDL, TG, and VLDL in the study group is not statistically signicant with respect to regimen groups. SignicantCONCLUSIONS:- metabolic and morphological alterations occur in HIV infected patients especially in patients on HAART. The patients on HAART had an elevated Castelli Index I, indicating an increased risk for atherosclerotic cardiovascular disease in this population. There is need to assess lipid proles at baseline before initiation of HAART treatment and lipid prole monitoring during therapy to monitor any rising trends. New medications with more lipid friendly proles within existing drugs such as darunavir (PI), etravirine (NNRTI), new classes of drugs such as integrase inhibitors (raltegravir) and CCR5 inhibitors (maraviroc) can be used to avoid dyslipidaemia.

A STUDY TO ASSESS ANTHROPOMETRIC PARAMETERS AND SERUM LIPID VARIATIONS IN HIV PATIENTS RECEIVING HAART

Background:- There is evidence that ART is associated with lipodystrophy syndrome, a disturbance of lipid metabolism characterised by insulin resistance, dyslipidaemia and fat maldistribution, usually presenting as visceral abdominal obesity and cervical fat pad accumulation (buffalo hump)1,metabolic bone disease (osteopenia and/or osteoporosis) and lactic acidosis. ART- associated dyslipidaemia is characterized by elevated serum concentrations of total cholesterol, triglycerides, low density lipoprotein 2(LDL-c), very low-density lipoprotein (VLDL), Apo lipoprotein B (apoB) and low levels of high density lipoprotein (HDL-c) constituting an atherogenic lipid profile2. Materials And Methods:- In this study 100 young patients who were attending the Antiretroviral Therapy Plus Centre &amp; Medicine Wards, ACSR GMC, NELLORE were included randomly. Anthropometric Measurement :- Body weights were measured (to the nearest 0.5 kilogram) with the subject standing on a weighing scale after it was adjusted to zero kg. Heights were measured (to the nearest 1.0 centimeter) with the subject standing in an erect position against a vertical scale of portable standiometer and a L-square placed on the head and the head positioned to a level with the inferior margin of the bony orbit. The waist measurements were taken from the middle point between the iliac crest and the last rib as recommended by the WHO. Hip circumference was measured as the maximal circumference over the buttocks. BMIs were then calculated as weight in kilograms divided by the height in meter squared. Results:- The results of the study showed that the Anthropometric parameters on analysis showed a normal range BMI in 59% of patients. Waist-to-hip ratio which have been shown to be better reflector of body fat distribution and is significantly elevated in the HIV-infected patients on HAART. Waist-Hip ratio value analysis showed normal in 18.19% and abnormal in 81.81% of cases. The mean value in males is 0.9578 and in females is 0.9204. This showed a significant correlation to Waist/ hip ratio and the gender. Conclusions:- Significant metabolic and morphological alterations occur in HIV infected patients especially in patients on HAART. The patients on HAART had an elevated Castelli Index I, indicating an increased risk for atherosclerotic cardiovascular disease in this population. Waist-to-hip ratio which are the key indices for assessing body fat distribution were significantly raised in HAART-experienced patients in this study implying that HAART could result to lipodystrophy.

Cardiovascular risk among people of all ages during the recovery period after COVID-19 (1-3 months) in the background of morbid obesity of the first stage

The aim of our study is to determine the correlation between obesity and overweight with COVID-19 among people aged over 40 years, in the period from 1 to 3 months after COVID-19 disease. Materials and methods: the group of subjects after COVID-19 consisted of 10 people, including 5 people at the age 40-59 years and 5 people at the age 60 years and older. The control group consisted of 21 individuals without COVID-19 and had a negative PCR test at the time of the survey: 5 individuals aged 40-59 years and 16 individuals aged 60 years and older. The subjects in both groups had cardiovascular risk factors and signs of metabolic syndrome. The subjects have been measured body weight (in kg), height (in cm), body mass index (BMI, in kg / m2), waist circumference (WC, in cm), hip circumference (HC, in cm) with the calculation of the ratio between WC and HC. For the assessment of the state of lipid metabolism, the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low - density lipoprotein cholesterol (LDL-C), triglycerides (TG) in serum venous blood were determined by standard biochemical methods with the help of automatic biochemical analyzer "Autolab" by "Boehringer Mannheim" using the reagents from company "BIO SYSTEMS" (Spain). Cardiovascular risk indicators were calculated - Castelli index (TC/ HDL-C) and Boizel index (TG to HDL-C), and an updated SCORE-2 scale was used. The composition of the physique was determined using the device "OMRON". To exclude organic cardiac pathology, arrhythmias, and conduction, a standard ECG recording on a Ucard 200 device (Ukraine) was used. The microcirculation of the bulbar conjunctiva (slit lamp, "Zeiss", Germany) has been studied. Statistical data processing was performed using the program Statistica 10.0 (USA). Results: in the subjects included in the study, the indicators of general blood tests, which could indicate the presence of inflammation, were without any pathological changes. In accordance with the results of standard ECG, the subjects had no organic cardiac pathology, arrhythmia, and conduction. Younger patients with metabolic syndrome (MS) after COVID-19 had a statistically significantly higher BMI compared with the subgroup without COVID-19. Within each age group, the subjects of both subgroups (excluding COVID-19 and after COVID-19) have had general and visceral obesity rates that were combined with the other markers of metabolic syndrome, including dyslipidemia. It is shown that the calendar age of the patients with overweight after COVID-19 is statistically significantly higher than the calendar age of the patients with the overweight without COVID-19 in the anamnesis. The calendar age of the patients with the obesity of the 1-st grade after COVID-19 was significantly lower than the age of the patients without COVID-19. The indicator of very high cardiovascular risk is determined among the individuals of the senior age group, especially after COVID-19. Patients with high cardiovascular risk have more probabilities for the development of vascular disorders. A close correlation between the number of functioning capillaries and the atherogenicity index (r = 0.99, p &lt;0.05), as well as with the Castelli index (r = 0.99, p &lt;0.05) was found. As conclusions, we have found a connection between obesity and an increase of the indicators of cardiovascular risk 3 months later after past COVID-19. It is obvious that among people with obesity a more severe course of COVID-19 is possible at a younger age than among overweight patients. It is likely that COVID-19 may be the cause of accelerated aging in middle-aged individuals with obesity. However, to verify this assumption, it is necessary to conduct additional examinations to determine the biological age. The detected changes among the people with MS in 1-3 months after COVID-19 may be the basis for the development of post - COVID syndrome and justify the necessity for comprehensive pathogenetic treatment. Key words: morbid obesity; COVID-19; cardiovascular risk; Castelli index; Boizel index; SCORE-2 scale; capillaroscopy of the bulbar conjunctiva.

Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting.

Background and Objectives: Coronary artery disease is still a major cause of death in developed countries. Low-density lipoprotein cholesterol (LDL-C) lowering with statin therapy is a key strategy in major acute coronary events’ prevention. The aim of the study was to establish if there is a cardioprotective effect of pre-operative LDL lowering therapy on perioperative myocaridal injury in patients undergoing off-pump coronary artery bypass grafting (CABG). Moreover, the impact of pre-operative LDL level on long term outcome was analysed. Materials and Methods: The retrospective single center analysis included 662 consecutive patients (431 (65%) males and 231 (35%) female, mean age of 65 ± 8) referred for cardiac surgery due to stable chronic coronary syndrome between 2012–2018. The follow up was 9 years. Results: A statistically significant difference was found in postoperative serum Troponin-I for LDL thresholds of 1.8 mmol/L (p = 0.009), 2.6 mmol/L (p = 0.03) and 3.0 mmol/L (p = 0.001). The results indicate that cardioprotective role of LDL is achieved within LDL concentration rate below 1.8 mmol/L (<70 mg/dL). Five patients died perioperatively, whereas 1-year and 9-year overall mortality rates were 4% (n = 28) and 18.6% (n = 123), respectively. Comparing the survival group with diseased, Mann-Whitney U test showed a statistically significant difference in HDL-C (p = 0.007), Troponin (p = 0.009), Castelli index (p = 0.001) and atherogenic index (p = 0.004). Preoperative levels of total cholesterol, LDL-C and HDL-C did not significantly differ between survivors and diseased. The 9-year mortality risk did not differ significantly between subgroups divided according to LDL-C thresholds of 1.4 mmol/L (55 mg/dL), 1.8 mmol/L (70 mg/dL), 2.6 mmol/L (100 mg/dL) and 3.0 mmol/L (116 mg/dL). Conclusions: Preoperative low level of LDL-C cholesterol (below 1.83 mmol/L, 70 mg/dL) has a cardioprotective effect on perioperative myocardial injury in off-pump coronary artery bypass grafting.

Synergic effects of ultrasound and laser therapies on mesentery for management of obesity and diabetes in rats.

Nowadays, the mesentery as a new organ was discovered. Mesenteric events may play an important role in the pathophysiology of several diseases. The aim of our study was investigate the synergic effects of ultrasound (US) and laser therapies on mesentery in obese-hyperglycemic rats. The 25 male Wistar rats were randomized into five groups. Obese nondiabetic (OND) group: obese rats without diabetes and no treatment conditions; SHAM group: obese-hyperglycemic rats treated with placebo; US group: obese-hyperglycemic rats treated with US; LASER group: obese-hyperglycemic rats treated with laser and; US+LASER group: obese-hyperglycemic rats treated with US plus laser. An animal model of type 2 diabetes based on a hyperlipidemic diet combined with a low dose of streptozotocin was used in this study. Body mass and biochemical measurements were performed. GOT and GPT level showed a significant reduction in the treated groups than SHAM. The total cholesterol, triglycerides and very low-density lipoprotein (VLDL) levels showed significantly lower values for the US+LASER group. There was also reduced risk of cardiovascular diseases evidenced by Castelli index in the treated groups than SHAM. This study showed that the US and laser treatment on mesentery resulted to an improvement in biochemical measurements of the obese-hyperglycemic rats, especially the total cholesterol, triglycerides and VLDL levels.

The value of lipid profile in asthma-obstructive sleep apnea overlap

The asthma obstructive sleep apnea overlap is a clinical entity relatively new and the association with a dysfunctional plasma lipid profile is not known. Aim. In this study, we compared the serum lipid profile in asthma-obstructive sleep apnea overlap syndrome to those in asthma and obstructive sleep apnea patients. Methods. A cross-sectional study of 97 cases of which 26 patients had only asthma, 51 were diagnosed with OSA, and 20 were identified with A-OSA overlap. The lipid profile included the total cholesterol, HDL-cholesterol, triglycerides, the LDLcholesterol. The Casteli indexes I and II and the atherogenic plasma index were calculated. Results. The patients with asthma- obstructive apnea overlap were older (55.55 years vs 53,73 years in obstructive sleep apnea and 51,04 years in asthmatics), mostly obese (95%), and had a significantly higher average of BMI (38.11 vs. 35.64 and 28.8, respectively). Asthma- obstructive apnea overlap was at higher risk of cardiovascular disease than asthmatics, in respect to the lipid profile: the levels of HDL-cholesterol were lower, triglycerides were higher, and the values of Castelli index I and II were higher. Conclusions. Based on our results, we confirm that age and BMI contribute to the risk of A-OSA overlap. The major differences in the common markers of the serum lipid profile are lower HDL-C and higher triglycerides. As a clinical implication, both Castelli indexes could provide additional value for cardiovascular risk and should be monitored in A-OSA overlap.

Relationship between spectral indicators of heart rate variability and fasting glucose level in healthy persons and elderly patients with discirculatory atherosclerotic encephalopathy

Objective — to establish the peculiarities and relationship of spectral indicators of heart rate variability (HRV), fasting glucose level and lipid profile indicators in practically healthy persons and in elderly patients with dyscirculatory atherosclerotic encephalopathy (DEP). Materials and methods. The study involved 77 subjects of various age, who were divided into two groups: group 1 consisted of apparently healthy persons (19 subjects of middle age and 27 elderly subjects) and group 2 that included patients with DAP manifestations (15 subjects of middle age and 16 elderly persons). In the groups of elderly persons, the subgroups were extracted based on the fasting glucose levels: lower than 6.1 mmol/l and 6.1 mmol/l. The measurements of systolic and diastolic blood pressure were performed in a sitting position after at least 10 min of rest. Plasma glucose levels were determined by a standard glucoseoxidase method, lipid profile was determined by using the automatic analyzer. To assess the risk of cardiovascular disease development, calculations were performed for the indices of the cardiovascular risk: Castelli index and Boizel index. All patients with DEP manifestations underwent 24‑hour Holter ECG monitoring, and healthy people underwent 5 min ECG. Results. The incidence of fasting hyperglycemia in patients with 1 — 2 stage DEP manifestations was in 3.4 times higher (p &lt; 0.05) vs healthy subjects of the same age. The significant correlation has been reveled between age and HDL‑C (r = 0.47, р &lt; 0.05), atherogenic index (r = –0.40, р &lt; 0.05), heart rate (r = –0.45, р &lt; 0.05), Castelli index (r = –0.40, р &lt; 0.05), Boizel index (r = –0.31, р &lt; 0.05), heart rate (r = –0.45, р &lt; 0.05). Moreover, correlation has been established between Boizel index and heart rate (r = +0.44, р &lt; 0.05), heart rate and LF/HF (r = +0.57, р &lt; 0.05), between TG and heart rate (r = +0.43, р &lt; 0.05), LF/HF (r = +0.53, р &lt; 0.05) and between levels of very low density lipoprotein cholesterol and heart rate (r = +0.44 р &lt; 0.05), LF/HF (r = +0.53, р &lt; 0. 05). It has been established that hyperglycemia and dyslipidemia significantly affected spectral heart rate variability indices in patients with encephalopathy manifestations. Conclusions. With ageing, the frequency of fasting hyperglycemia in patients with 1 — 2 stage DEP manifestations was significantly higher in 3.4 times in comparison with practically healthy individuals of the same age. In the group of practically healthy persons over 60 years old, the tendency has been revealed towards a decrease in the spectral parameters of HRV LF and HF, which indicates HRV decrease. With the development of 1 — 2 stages DEP, even in the middle age, a significant decrease in the value of HF (parasympathetic influence) and a significant increase in the value of LF (sympathetic activity) were revealed. In elderly people with signs of 1 — 2 stage DEP with normoglycemia and fasting hyperglycemia against the background of dyslipidemia, the sympathetic link of the autonomic nervous system is activated, accompanied by an increase in the index of vascular complications. In patients with 1 — 2 stages DEP and fasting hyperglycemia, this tendency was even more pronounced. This fact can serve as confirmation that in the development of pre‑diabetic disorders (fasting hyperglycemia) one of the pathogenic mechanisms is the violation of the central regulatory mechanisms, which in turn leads to the violation of the autonomic balance with the prevalence of sympathicotonia, and a decrease in the parasympathetic effect on the heart, which leads to development of autonomous cardiac neuropathy.

Adverse effects of perinatal protein restriction on regulators of lipid metabolism and hepatic function in offspring of sprague-dawley rats

Background: Adequate evidence suggests that a poor in utero environment produced by early-life dietary disturbance may predispose offspring to chronic diseases in later life. It remains to be defined which of the windows of early exposure due to perinatal protein restriction (PPR) (gestation, lactation, and/or both) is more detrimental to the regulators of lipid metabolism and hepatic functions of the offspring in later life. Hence, the current study investigated the role of PPR on regulators of lipid metabolism and hepatic functions in adult offspring. Materials and Methods: Twenty-four pregnant Sprague-Dawley rats were used and fed either a control (CONT) diet containing 20% protein or protein-restricted (PR) diet with 8% protein. The dams were given PR diet up to parturition (in utero group, in utero protein restriction [IUPR]), or from birth to postnatal day (PND) 21 (lactation group, lactational protein restriction [LPR]) or for a period covering both (combined protein restriction [CPR]). On PND 126, triglycerides (TG), cholesterol (CHOL), low density lipoprotein (LDL), and high density lipoprotein (HDL) were determined and Castelli indices I and II were calculated. Hepatic lipase (HL) and lipoprotein lipase (LPL), aspartate aminotransferase (AST), alanine amino transferase (ALT), alkaline phosphatase (ALP), and serum albumin were also assessed. Results: There was a significant decrease (P < 0.01) in HDL with a significant increase (P < 0.01) in TG and LDL in IUPR and CPR offspring compared with CONT. The Castelli index I was significantly increased (P < 0.01) in all PR offspring with a significant increase (P < 0.01) in Castelli index II in LPR offspring compared with CONT. HL and LPL activities reduced significantly (P < 0.01) in all PR offspring. PPR produced a significant reduction (P < 0.01) in AST with a significant elevation in ALT in all PR, while ALT heightened significantly (P < 0.01) in CPR offspring. A significant decrease (P < 0.01) was observed in albumin level in CPR offspring compared with CONT. Conclusion: In conclusion, it is evidenced that PPR at critical periods of early-life exposure blunted remarkably the actions of HL and LPL which consequently led to impairment of lipid metabolism and hepatic dysfunction.

SUN-269 THE UTILITY AND RELATIONSHIP OF LIPOPROTEIN MARKERS TO ATHEROSCLEROTIC VASCULAR DISEASEIN BLACK CKD AND KIDNEY TRANSPLANT RECIPIENTS IN SOUTH AFRICA

Dyslipidaemia is a well-recognized risk factor for cardiovascular disease (CVD) in chronic kidney disease (CKD). We evaluated the relationship of lipoprotein biomarkers to AsVD among stage 3 CKD and ESKD patients on renal replacement therapy (peritoneal dialysis (PD) and haemodialysis (HD) and KTRs) This was a cross-sectional study of 40 adult (18-65 years) non-diabetic stage 3 CKD patients, 40 PD and 40 HD patients, 41 KTRs and 41 age- and sex-matched healthy controls. An interviewer-administered questionnaire was used to obtain information on participants’ sociodemographic and cardiovascular risk factors. Serum was analysed for creatinine, albumin, lipid profile, lipoprotein markers including lipoprotein(a) Lp-PLA2 and apolipoprotein A1 and inflammatory markers such as hsCRP, pentraxin-3, TNF-α and EN-RAGE. Lipoprotein ratios including Castelli indices 1 and 2, atherogenic coefficient (AC), atherogenic index of plasma (AIP), non-HDL-C and lipoprotein combined index (LCI) were calculated. Echocardiography was performed on all patients and carotid intima media thickness (CIMT) was assessed The levels of Lp(a) and Lp-PLA2 were increased in all kidney disease groups. Significantly higher levels of Lp(a) were seen in PD, HD, KTRs and the combined kidney disease group, compared to controls (p < 0.02) while lower levels of APO A1 were seen in all kidney disease groups. Significantly higher values of Castelli index 1, AC and non-HDL-C were seen in PD patients when compared to controls and CKD stage 3, (p < 0.031). Castelli 1 and 2 and AC correlated positively with CIMT in the combined kidney disease patients. Age (> 40 years) [OR 5.00, p < 0.001], male gender [OR 3.24, p = 0.005], low HDL-C levels [OR 3.14, p = 0.008] and elevated Lp (a) levels [OR 2.23, p = 0.048] independently predicted AsVD. Lipoprotein (a) predicted AsVD better than other lipid markers evidenced by higher AUC on ROC curve. The burden of abnormal lipid biomarkers was greater among ESKD patients and the highest burden was in PD patients while lipoprotein ratios were increased in the kidney disease patients. KTRs had a more favourable lipid biomarker profile compared to dialysis patients. Lipoprotein(a) was a better surrogate marker for AsVD among female kidney disease patients when compared with other lipoprotein biomarkers, and lipid profile parameters. Therapeutic efforts directed at lowering Lp(a) levels may be beneficial in CKD patients

Assessment of cardiovascular risk in post-menopausal women in Ghana

Background: Cardiovascular diseases (CVD) continue to be a major cause of death among post-menopausal women. We sought to assess cardiovascular risk among pre- and post-menopausal women living within the Cape Coast Municipality by comparing the lipid profiles and other emerging biomarkers of CVD, i.e. the atherogenic index of plasma (AIP), visceral adiposity index (VAI), body adiposity index (BAI) and Castelli index I (CRI-I). Methods: A comparative cross-section of 150 women (75 pre-menopausal women and 75 post-menopausal women) visiting the University of Cape Coast hospital for regular checkups were randomly recruited into the study. Socio-demographic and clinical characteristics of participants were obtained with the aid of a structured questionnaire. Blood pressure (BP) was measured and lipid profile was estimated using fasting blood samples. Other markers of cardiovascular risk such as BMI, AIP, VAI, BAI and CRI-I were estimated. Results: We report elevated levels of total cholesterol (TC) (p&lt;0.0001), low density lipoprotein (LDL) (p&lt;0.0001), very low-density lipoprotein (VLDL) (p=0.0021), triglycerides (TG) (p&lt;0.0001) and non-high-density lipoprotein (non-HDL-C) cholesterol (p&lt;0.0001) in post-menopausal women compared with pre-menopausal women. High-density lipoprotein (HDL) (p&lt;0.0001) was, however, decreased in post-menopausal women. Mean AIP (p&lt; 0.0001), VAI (p&lt; 0.0001), BAI (p&lt; 0.0038) and CRI-I (p&lt;0.0001) were significantly increased in post-menopausal women compared to pre-menopausal women. We also report a positive correlation of TC, TG, VLDL and non-HDL with atherogenic markers AIP, VAI and CRI-I in post-menopausal women. A negative correlation of HDL with AIP, VAI, and CR in post-menopausal women was also observed. Conclusions: Menopause could lead to changes in lipid profile to atherogenicity with associated increase in the risk of CVD. Atherogenic markers such as AIP, VAI, BAI, and CR can serve as potential biomarkers for predicting CVD.

HDL-C and non-HDL-C levels are associated with anthropometric and biochemical parameters.

Background Dyslipidemias are associated with atherosclerosis and cardiovascular diseases. Recently, non-high-density lipoprotein cholesterol (non-HDL-c) has emerged as a new target for assessment and prediction of risk of cardiovascular disease (CVD) and is closely associated with atheroma plaque progression. Objectives To evaluate associations between HDL-c and non-HDL-c levels and anthropometric and biochemical parameters and with the Castelli risk indexes I and II. Methods 300 randomly selected people were subdivided into two groups: patients with normal values for non-HDL-c and patients with altered values for non-HDL-c. These parameters were analyzed for associations with glycemia, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-c), Castelli Index I (CI-I), Castelli Index II (CI-II), waist circumference (WC), body mass index (BMI) and presence of metabolic syndrome (MS). Results Glycemia, TC, TG, LDL-c, CI-I, CI-II, WC and BMI were all significantly different between subjects with normal and altered values of HDL-c and non-HDL-c. TC and WC both exhibited significantly higher values among patients with abnormal non-HDL-c when compared to patients with abnormal HDL-c. A significant difference was observed in occurrence of MS among patients with altered values of HDL-c and non-HDL-c. Conclusions Our results show that both HDL-c and non-HDL-c are associated with insulin resistance, dyslipidemia, atherogenic indices, and obesity. There is therefore a need for randomized clinical intervention trials examining the potential role of non-HDL-c as a possible primary therapeutic target.