Cholesterol Levels In Adults Research Articles

Management of Supplemental Therapy with Tomato Juice (Lycopersicon Esculentum) to Reduce Cholesterol Levels in Adults in the Franciscan Community

High blood cholesterol levels (hypercholesterolemia) can cause harm to the body, including increasing the risk of coronary heart disease, stroke, hypertension, and obesity. Preventing high cholesterol involves pharmacological and non-pharmacological therapies, including consuming tomato juice due to its high lycopene content. Lycopene is known for its antioxidant properties that may affect high cholesterol levels. This study was conducted to analyze the effects of supplement therapy with tomato juice on cholesterol levels in adults in the Franciscan Community of Santa Elisabeth in Medan 2023. The study used a quantitative research design with a pre-experimental method and a post-test group design approach. Purposive sampling was used to select 12 respondents who were given tomato juice for 14 days. The data was analyzed using the Wilcoxon test, and the results showed a p-value of 0.534 (p<0.05), indicating that tomato juice supplementation therapy had no significant effect on reducing cholesterol levels in adults in the Franciscan Community of Santa Elisabeth population in Medan. However, four respondents reported reduced cholesterol levels due to the complementary therapy with tomato juice, while eight did not experience the same effects. In conclusion, the utilization of tomato juice as a complementary therapy did not show a significant impact on reducing adult cholesterol levels. This prompts exploring other potential strategies for addressing this health concern.

Effects of PFAS on human liver transporters: implications for health outcomes.

Per- and polyfluoroalkyl substances (PFAS) have become internationally recognized over the past three decades as persistent organic pollutants used in the production of various consumer and industrial goods. Research efforts continue to gauge the risk that historically used, and newly produced, PFAS may cause to human health. Numerous studies report toxic effects of PFAS on the human liver as well as increased serum cholesterol levels in adults. A major concern with PFAS, also dubbed "forever chemicals," is that they accumulate in the liver and kidney and persist in serum. The mechanisms responsible for their disposition and excretion in humans are poorly understood. A better understanding of the interaction of PFAS with liver transporters, as it pertains to the disposition of PFAS and other xenobiotics, could provide mechanistic insight into human health effects and guide efforts toward risk assessment of compounds in development. This review summarizes the current state of the literature on the emerging relationships (eg, substrates, inhibitors, modulators of gene expression) between PFAS and specific hepatic transporters. The adaptive and toxicological responses of hepatocytes to PFAS that reveal linkages to pathologies and epidemiological findings are highlighted. The evidence suggests that our understanding of the molecular landscape of PFAS must improve to determine their impact on the expression and function of hepatocyte transporters that play a key role in PFAS or other xenobiotic disposition. From here, we can assess what role these changes may have in documented human health outcomes.

Real world study on elexacaftor-tezacaftor-ivacaftor impact on cholesterol levels in adults with cystic fibrosis.

The introduction of the highly effective modulator therapy elexacaftor-tezacaftor-ivacaftor (ETI) has revolutionized the care of persons with cystic fibrosis (PwCF) with major improvements seen in lung function and body mass index. The effects of ETI therapy in real-world cohorts on other parameters such as cholesterol levels are largely unknown. A single-center, retrospective chart review study was conducted to assess the change in lipid panels before and after ETI initiation. The study investigated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels using both a univariate and multivariate mixed-effects model to evaluate the change after initiation of ETI in a cohort of PwCF. There were 128 adult PwCF included in the analysis. Statistically significant changes were seen in both univariate and multivariate analyses for TC, LDL-C, and HDL-C. On multivariate analysis, TC increased by an average of 15.0 mg/dL after ETI initiation (p < 0.0001), LDL-C increased by an average of 9.3 mg/dL (p < 0.001), and HDL-C increased by an average of 3.8 mg/dL (p < 0.001) after ETI initiation. In this real-world cohort of PwCF, cholesterol parameters increased after initiation with ETI therapy. Further consideration may need to be given for PwCF in regards to screening for cardiometabolic risk factors as PwCF age as well as the potential need for cholesterol-lowering therapies.

Low-Density Lipoprotein Cholesterol Levels in Adults With Coronary Artery Disease in the US, January 2015 to March 2020

This study uses National Health and Nutrition Examination Survey data to examine lipid control among adults in the US with coronary artery disease from January 2015 to March 2020.

Overweight Management through Mild Caloric Restriction in Multigenerational Long-Tailed Macaque Breeding Groups.

Caloric restriction (CR) is an effective method to reduce overweight in captive non-human primates (NHPs). CR has been applied to individually- and pair-housed NHPs, but whether applying CR can be effective and safe in group-housed NHPs has not yet been assessed. This study investigates the effect of mild (20%) CR on adult overweight and biochemical parameters, immature growth, veterinary consultations, and reproductive success in multigenerational long-tailed macaque (Macaca fascicularis) breeding groups. Data were derived from anthropometric measurements and blood samples during yearly health checks, complemented with retrospective data on veterinary consultations and reproductive success. Adult body measures decreased after CR, with heavier individuals and females losing more weight compared to leaner individuals and males. CR lowered cholesterol levels in adults but had no overall effect on other biochemical parameters. Yet, biochemical parameters of individuals with high baseline values were reduced more compared to individuals with low baseline values. Immature growth, veterinary consultations and reproductive success were not influenced by CR. Thus, CR targeted the right individuals, i.e., overweight adults, and had no adverse effects on the variables examined in this study. This implies that mild CR can be a valuable overweight management strategy in group-housed NHPs.

Optimal Low-Density Lipoprotein Cholesterol Levels in Adults Without Diabetes Mellitus: A Nationwide Population-Based Study Including More Than 4 Million Individuals From South Korea.

BackgroundAlthough the strong association between low-density lipoprotein cholesterol (LDL-C) and cardiovascular disease (CVD) is well-known, the threshold LDL-C level at which the risk of CVD begins to increase in individuals without diabetes mellitus (DM) remains unknown. We aimed to evaluate the association between incident CVD and serum LDL-C levels with or without statin use in individuals without DM.MethodsWe identified 4,182,117 individuals without previous CVD who underwent a health screening examination in 2009 and 2011 from the Korean National Health Insurance Cohort database. The primary endpoint was a composite of cardiovascular deaths, myocardial infarction (MI) cases, and ischemic stroke cases.ResultsDuring the median follow-up of 6 years, there were 51,961 CVD events that included 17,392 MI cases, 33,779 ischemic stroke cases, and 2,039 cardiovascular deaths. The LDL-C levels that were associated with an increased risk of CVD were ≥100 mg/dL in non-statin users and ≥130 mg/dL in statin users. However, even in individuals with lower LDL-C levels, all those with fasting plasma glucose (FPG) levels ≥110 mg/dL had a significantly higher risk of CVD.ConclusionsWe demonstrated that LDL-C levels ≥100 mg/dL were correlated with an increased risk of CVD in individuals without DM and a history of CVD. We found that a glucose, cholesterol interaction increased CVD risk, and modestly elevated FPG levels (110–125 mg/dL) were associated with a higher CVD risk even in individuals with well-controlled LDL-C levels.

Use of Restaurant Nutrition Information and Hyperlipidemia Among U.S. Adults Based on NHANES 2013–2014 Data (P18-120-19)

ObjectivesConsumption of energy-dense meals from restaurants may increase the risk of cardiovascular disease. In the past 40 years, consumption of away-from-home meals has nearly doubled, and restaurants with more than 20 locations are now federally mandated to display the nutrition information on menus. As Americans continue to consume a large number of their daily meals from restaurants, it is important to evaluate the association between the use of restaurant-provided nutrition information and health outcomes. No study has reported such association in a representative sample of Americans. Therefore, the objective of this analysis was to evaluate the association between the use of nutrition information in restaurants and cholesterol levels in adults. MethodsA cross-sectional analysis of NHANES 2013–2014 data was completed using responses to the question on the use of nutrition information in restaurants to make purchasing decisions. This was associated with the risk of high cholesterol (levels > 200 mg/dL) by using multiple logistic regression and adjusting for medical conditions, energy intake, and weight history. ResultsA total of 1238 adults (18–65y) responded to the question about viewing nutrition information in restaurants; 43% reported using this information to make purchasing decisions. However, using such information was not associated with a lower risk of high cholesterol (OR: 1.014, 95% CI: 0.797, 1.290). Similar results were seen in the adjusted model (OR: 0.924, 95% CI 0.719, 1.187). ConclusionsNo significant associations were found between the use of nutrition information in restaurants to make purchasing decisions and a lower risk of high cholesterol. This could be explained by the possibility that individuals with high cholesterol are more aware of their eating patterns and use more than just nutrition information to make purchasing decisions to help lower their cholesterol. Longitudinal studies are needed to confirm these results. Funding SourcesFIU Internal funds.

Current trends in non–HDL cholesterol and LDL cholesterol levels in adults with atherosclerotic cardiovascular disease

Low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) are targets for prevention of atherosclerotic cardiovascular disease (ASCVD). The American Heart Association and American College of Cardiology recently modified recommendations for clinical management of cholesterol in secondary and primary prevention. Accordingly, the present article examines the need for cholesterol-lowering drugs in the U.S. population with ASCVD. This study examines trends in non-HDL-C and LDL-C levels in a free living population of ASCVD subjects between 1999 and2016. National Health and Nutrition Examination Surveys database included 4920 adults with ASCVD aged 40 to 85years. Complete data were available for 4226. Trend analysis of changes in lipids is shown in box plots. Mean age was 67years with 57% males. Over 17 years, LDL-C decreased significantly by 24% and non-HDL-C by 21%. Over the period of study, reported intake of cholesterol-lowering drugs rose from 37% in 1999-2000 to 69% in 2015 to 2016. Over this same period, serum triglycerides decreased by 29% (P<.001) and HDL-C rose by 6%. The changes in LDL-C and non-HDL-C in patients with ASCVD over a 17-year period probably are related to increased treatment with statins. However, the changes are too small to be explained by widespread use of high-intensity statins, which is the current recommendation for patients with ASCVD. These findings pose a challenge for professional education to support implementation of current guidelines for cholesterol-lowering therapies.

Cynanchum wilfordii Etanolic Extract Controls Blood Cholesterol: A Double-blind, Randomized, Placebo-Controlled, Parallel Trial.

We evaluated the effects of Cynanchum wilfordii (CW) ethanolic extract on blood cholesterol levels in adults with high low-density lipoprotein cholesterol (LDL-C) levels. In a double-blind, randomized, placebo-controlled, parallel trial, 84 subjects were recruited. Participants were randomly divided into two groups with a low-dose (300 mg/d) or high-dose (600 mg/d) of CW. Levels of very low-density lipoprotein (p = 0.022) and triglycerides (p = 0.022) were significantly lower in the low-dose CW group than in the placebo group after 8 weeks. In a subgroup of participants with LDL-C≥ 150 mg/dL (n = 33), there was a significant decrease in total cholesterol (low-dose, p = 0.012; high-dose, p = 0.021), apolipoprotein B (low-dose, p = 0.022; high-dose, p = 0.016), and cholesteryl ester transfer protein (low-dose, p = 0.037; high-dose, p = 0.016) after 8 weeks of CW. The correlation between changes in total cholesterol and baseline LDL-C levels was significant in the groups that received both doses of CW (low-dose, p = 0.010; high-dose, p = 0.015). These results show that the CW ethanolic extract can regulate blood cholesterol in subjects with LDL-C≥ 150 mg/dL.

Study protocol for a double-blind randomised controlled trial investigating the impact of 12 weeks supplementation with a Fucus vesiculosus extract on cholesterol levels in adults with elevated fasting LDL cholesterol who are overweight or have obesity

IntroductionHyperlipidaemia, hyperglycaemia and chronic inflammation are risk factors for chronic diseases cardiovascular disease and type 2 diabetes. Polyphenols are bioactive compounds found in marine algae with potential antihyperlipidaemic, antihyperglycaemic and...

Change in nonhigh-density lipoprotein cholesterol levels in adults with prediabetes.

This study aimed to observe the change in nonhigh-density lipoprotein cholesterol (non-HDL-C) levels and analyzed its related factors in adults with prediabetes (impaired fasting glucose and/or impaired glucose tolerance).This case-controlled study included 56 adults with normal glucose tolerance (NGT) and 74 adults with prediabetes. The cases and controls were age and gender-matched. Anthropometric measurements including height, weight, waist circumference, and blood pressure were performed. All patients underwent an oral glucose tolerance test (OGTT) after 8 hours of fasting, and the levels of glucose, insulin, lipids, and uric acid were measured.The levels of non-HDL-C (3.63 ± 0.92 vs 3.27 ± 1.00 mmol/L) were significantly higher in prediabetic subjects than in NGT subjects (P < .05). Non-HDL-C positively correlated with HOMA-IR (r = 0.253, P = .004), triglyceride (r = 0.204, P = .020), and uric acid (r = 0.487, P = .000). After multivariate analysis, uric acid continued to be significantly associated with non-HDL-C (β = 0.006, P = .000).Non-HDL-C is elevated in adults with prediabetes. A relationship between non-HDL-C and uric acid was observed.

Practice nurse involvement in the management of adults with type 2 diabetes mellitus attending a general practice: results from a systematic review.

Using the methodology of the Joanna Briggs Institute, a systematic review of current research was performed to determine if the addition of management by nurses had been more effective in improving clinical outcomes of patients with type 2 diabetes attending a general practice compared with standard care. A three-step literature search was conducted for suitable English studies with quantitative clinical outcomes that had been published from January 1990 to May 2014. Randomised controlled trials (RCTs) were particularly sought after; however, other research designs were considered. Articles were assessed by two independent reviewers for methodological validity, prior to inclusion in the review, using standardised critical appraisal instruments from the Joanna Briggs Institute. When possible, quantitative data were pooled in statistical meta-analysis. Seven studies were of suitable quality and relevance for the review: these included three randomised control trials; two cluster- RCTs; a cluster, nonrandomised, controlled before-after study; and a cluster observational cohort study. These studies yield evidence that nurse management in addition to standard general practitioner care leads to modest improvements in blood pressure and total cholesterol levels in adults with type 2 diabetes attending a general practice. Meta-analysis identified modest, significant improvements amongst participants in nurse management interventions (NMIs) in the following clinical outcomes: mean SBP, mean DBP and mean total cholesterol. The majority of outcomes studied did not show any advantage to adding NMIs to general practitioner care. Two studies reported significant improvements of participants with poor control in mean haemoglobin A1c. An RCT that investigates the effect of NMIs on patients, with poor control in regard to clinical outcomes and cost effectiveness, is recommended.

Chronic consumption of conventional and saturated-fat reduced dairy products have differential effects on low-density lipoprotein cholesterol levels in adults at moderate cardiovascular disease risk

Reducing the intake of dietary saturated fatty acids (SFA) to ⩽10 % of total energy intake is a key public health strategy aimed at lowering current cardiovascular disease (CVD) incidence. Consumption of dairy products (including butter) represents approximately 35 % of total dietary SFA intake(1). Supplementation of the bovine diet with oleic acid-rich plant oil has been reported to depress SFA and increase cis-monounsaturated fatty acids levels in milk, providing a strategy to lower total dietary SFA intake (2). This human intervention study aimed to investigate whether consumption of SFA-reduced, compared with conventional dairy products, would impact on the fasting lipid profile, glucose and insulin concentrations of adults at moderate CVD risk. Fifty-four adults (mean age 53 (SD 13) years, BMI 26 (SD 3) kg/m2), completed a double blind, randomised, controlled 12-week cross-over study with an 8-week washout period between treatment arms. Participants replaced habitual dairy foods/snacks with SFA-reduced or conventional UHT milk, Cheddar cheese and butter (fatty acid (FA) composition of SFA-reduced vs. conventional dairy products: total SFA: -7·0 g/d, C18:1cis: 3·0 g/d, C18:1trans: 2·4 g/d), achieving an isoenergetic daily dietary exchange (41 g/d total fat). At the beginning and end of each treatment period, fasting blood samples were collected for biochemical analysis. LDL-C was estimated using the Friedewald formula. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the glucose and insulin data.

Low-density lipoprotein cholesterol levels in adults with type 2 diabetes: an alternative equation for accurate estimation and improved cardiovascular risk classification.

Low-density lipoprotein cholesterol (LDL-C) is a major risk factor for atherosclerotic disease. Despite its limitations, Friedewald-calculated LDL-C (F-LDL-C) remains widely used for LDL-C determination. In this observational study of 1999 adults with type 2 diabetes mellitus (T2DM), we compare the accuracy of F-LDL-C to directly measured LDL-C (M-LDL-C) and derived and validated a new [SMART2D (Singapore Study of MAcro-angiopathy and Micro-Vascular Reactivity in Type 2 Diabetes)] formula to estimate LDL-C. From 1000 randomly selected patients, M-LDL-C was compared to F-LDL-C. Using multiple linear regression to identify independent predictors for M-LDL-C, the SMART2D equation was derived and subsequently validated in the next 981 patients. F-LDL-C was 0.367 (0.216) mmol/L lower than M-LDL-C. This difference was -0.009 (0.189) for SMART2D-LDL-C. Using F-LDL-C, 27% with M-LDL-C ≥2.6 mmol/L were classified as LDL-C <2.6 mmol/L, reduced to 2.1% when using SMART2D-LDL-C. With F-LDL-C, misclassification was greater when triglycerides were ≥2.2 mmol/L, especially for the lower LDL-C cut-offs (1.8 and 2.6 mmol/L), and this was markedly improved with SMART2D-LDL-C. In conclusion, in T2DM, F-LDL-C underestimates M-LDL-C, with misclassifications that may potentially have an impact on therapeutic decisions in T2DM. The SMART2D equation improves accuracy of estimate, reducing misclassifications. Trials will be needed to ascertain the clinical significance of these findings.

Pitavastatin: a guide to its use in hypercholesterolaemia and mixed dyslipidaemia

Pitavastatin (Livazo®; Livalo®), an HMG-CoA reductase inhibitor (statin), is an effective and well tolerated option to reduce elevated total cholesterol and low-density lipoprotein cholesterol levels in adults with primary hypercholesterolaemia and mixed dyslipidaemia, including those considered to be at high risk.

OP09 Life-Course Body Mass Index, Birthweight And Lipid Levels in Mid-Adulthood: A Nationwide Birth Cohort Study

BackgroundCardiovascular disease (CVD) is a major public health problem. Clinical trials have shown that lowering total- and/or low-density lipoprotein (LDL)-cholesterol reduces the risk of CVD. Therefore, to reduce the burden...

Breast-feeding and cardiovascular risk factors and outcomes in later life: evidence from epidemiological studies

This paper considers the body of observational evidence examining the association of being breast-fed to cardiovascular risk factors and outcomes in later life, and whether any potentially advantageous findings are causal. Early cardiovascular consequences/correlates of breast-feeding, compared to being formula fed, include markedly higher levels of total blood cholesterol, lower levels of pre-prandial blood glucose and insulin and lower levels of adiposity. However, a key issue is whether these early differences at a period of rapid development programme/influence cardiovascular risk factors and outcomes in later life. Evidence of long-term effects of early feeding, largely from observational studies, has shown that those breast-fed have lower levels of blood total cholesterol, lower risk of type-2 diabetes and marginally lower levels of adiposity and blood pressure in adult life. There is no strong evidence to suggest effects of early feeding on adult levels of blood glucose, blood insulin and CHD outcomes, although further data are needed. However, the influence of confounding factors, such as maternal body size, maternal smoking and socio-demographic factors, and exclusivity of early feeding on these potentially beneficial associations needs to be considered before inferring any causal effects. Moreover, fewer studies have examined whether duration of exclusive breast-feeding has a graded influence on these risk factors and outcomes; such data would help further in deciding upon causal associations. While strong observational evidence suggests nutritional programming of adult cholesterol levels, associations with other markers of cardiometabolic risk and their consequences in later life need to be confirmed in well-conducted observational and experimental studies.

Impact of Electronic Health Record Clinical Decision Support on Diabetes Care: A Randomized Trial

We wanted to assess the impact of an electronic health record-based diabetes clinical decision support system on control of hemoglobin A(1c) (glycated hemoglobin), blood pressure, and low-density lipoprotein (LDL) cholesterol levels in adults with diabetes. We conducted a clinic-randomized trial conducted from October 2006 to May 2007 in Minnesota. Included were 11 clinics with 41 consenting primary care physicians and the physicians' 2,556 patients with diabetes. Patients were randomized either to receive or not to receive an electronic health record (EHR)-based clinical decision support system designed to improve care for those patients whose hemoglobin A(1c), blood pressure, or LDL cholesterol levels were higher than goal at any office visit. Analysis used general and generalized linear mixed models with repeated time measurements to accommodate the nested data structure. The intervention group physicians used the EHR-based decision support system at 62.6% of all office visits made by adults with diabetes. The intervention group diabetes patients had significantly better hemoglobin A(1c) (intervention effect -0.26%; 95% confidence interval, -0.06% to -0.47%; P=.01), and better maintenance of systolic blood pressure control (80.2% vs 75.1%, P=.03) and borderline better maintenance of diastolic blood pressure control (85.6% vs 81.7%, P =.07), but not improved low-density lipoprotein cholesterol levels (P = .62) than patients of physicians randomized to the control arm of the study. Among intervention group physicians, 94% were satisfied or very satisfied with the intervention, and moderate use of the support system persisted for more than 1 year after feedback and incentives to encourage its use were discontinued. EHR-based diabetes clinical decision support significantly improved glucose control and some aspects of blood pressure control in adults with type 2 diabetes.

Sex differences in the association between infant feeding and blood cholesterol in later life: the Newcastle thousand families cohort study at age 49–51 years

Previous studies have suggested an association between being breastfed and later cholesterol levels. We investigated whether duration of total and exclusive breastfeeding were related to circulating total, HDL and LDL cholesterol and triglyceride measures at age 50, and whether such associations differ between men and women. Members of the Newcastle thousand families study were followed from birth in 1947. Men (n = 179) and 226 women (n = 226) with blood cholesterol and triglyceride measures at age 50 and with prospectively recorded duration of both total and exclusive breastfeeding were included. Neither total duration nor duration of exclusive breastfeeding were associated with the outcome measures when analysing both sexes together. However, in sex specific analyses significant associations between duration of exclusive breastfeeding and both total and LDL cholesterol (adjusted regression coefficient (r) per 30 days = 0.12 mmol/l (95% CI 0.04-0.20) P = 0.004 for total cholesterol and adjusted r per 30 days = 0.10 mmol/l (95% CI 0.02-0.18) P = 0.016 for LDL cholesterol) were seen for women with no significant associations observed in men. Significant interactions between duration of exclusive breastfeeding and sex were seen for total and LDL cholesterol (P = 0.02 and P = 0.03, respectively) with a near-significant interaction for HDL cholesterol (P = 0.06). In all cases, greater increases in cholesterol with increasing duration of exclusive breastfeeding were seen for women than for men. In conclusion, the association between breastfeeding and adult cholesterol levels differs between men and women and in women remains a significant association even after adjustment for potential confounders. However, our findings may not reflect the situation in younger generations.

Heart Disease and Stroke Statistics—2009 Update

Heart Disease and Stroke Statistics—2009 Update