Cholesterol Measurements Research Articles

Small Dense Low-Density Lipoprotein Cholesterol and Ischemic Stroke.

For decades, it has been suggested that small dense low-density lipoprotein (sdLDL) may be particularly atherogenic. High levels of sdLDL are associated with an increased risk of ischemic heart disease; however, the association of sdLDL with ischemic stroke has not been explored in a large prospective study on the general population. We tested the hypothesis that high sdLDL cholesterol levels are associated with an increased risk of ischemic stroke. This prospective study included 38,319 individuals from the Copenhagen General Population Study with fresh sample measurements of sdLDL cholesterol. Median follow-up time was 3.1 years. We observed 302 and 74 ischemic and hemorrhagic strokes from baseline in 2013 to 2017 to the end of follow-up in 2018. For comparison, we included estimates for large buoyant LDL cholesterol and total LDL cholesterol. Higher levels of sdLDL cholesterol were log-linearly associated with increased risk of ischemic stroke. Compared with individuals with sdLDL cholesterol in the lowest tertile (≤0.60 mmol/l; ≤23 mg/dl) the multivariable adjusted hazard ratio for ischemic stroke was 1.79 (95% confidence interval=1.31-2.43) for the highest tertile (≥0.86 mmol/l; ≥33 mg/dl). Multivariable adjusted hazard ratios for ischemic stroke per 1 mmol/l (38.7mg/dl) higher levels were 1.69 (1.28-2.22) for sdLDL cholesterol, 0.95 (0.78-1.16) for large buoyant LDL cholesterol, and 1.08 (0.93-1.25) for total LDL cholesterol. Hazard ratios were similar when further adjusting for body mass index (BMI) and diabetes mellitus in the biological pathway in combination with related lipids and lipoproteins. Higher sdLDL cholesterol levels were robustly associated with increased risk of ischemic stroke. ANN NEUROL 2023;93:952-964.

Sex and income inequalities in preventive services in diabetes

BackgroundCancer preventive services (gynaecological cancer screening, colon cancer screening) and cardiometabolic screening are recommended by guidelines to individuals. People with diabetes were less likely to receive them than those without diabetes in some studies.ObjectivesTo analyse differences in the coverage of preventive services in people with diabetes compared to non-diabetic individuals and in people with diabetes according to sex and household income.MethodsWe analysed data collected from the European Health Interview Survey 2013–2015, including individuals aged 40–74 (n = 179,318), 15,172 with diabetes from 29 countries. The income of a household (HHI) was described in quintiles. The relationship between the coverage of preventive services (cardiometabolic, vaccination, cancer screening) and sociodemographic characteristics was analysed with multiple logistic regression.ResultsWomen comprised 53.8% of the total and 40% were 60–74 years. People with diabetes compared to those without diabetes had higher reported coverage of cardiometabolic screening (98.4% vs. 90.0% in cholesterol measurement; 97.0% vs. 93.6% in blood pressure measurement), colorectal cancer screening (27.1% vs. 24.6%) but lower coverage of gynaecological cancer screening (mammography: 29.2% vs. 33.5%, pap smear test: 28.3% vs. 37.9%). Among diabetic patients, women were less likely to receive cholesterol screening (OR = 0.81; 95% CI: 0.72–0.91) and colon cancer screening (OR = 0.79; 95% CI: 0.73–0.86) compared to men. Being affluent was positively associated with receiving cardiometabolic screening and mammography in diabetic patients.ConclusionPeople with diabetes reported higher coverage of preventive services except gynaecological cancer screening. Disparities were found in diabetes among women and less affluent individuals.

6-gingerol ameliorates weight gain and insulin resistance in metabolic syndrome rats by regulating adipocytokines

Metabolic syndrome (MetS) can lead to increase of insulin resistance (IR) and visceral adipose tissue production of adipocytokines. 6-gingerol is known to have antioxidant and anti-inflammatory activities. Aim of this study is to investigate the effects of 6-gingerol on high-fat high-fructose (HFHF) diet-induced weight gain and IR in rats through modulation of adipocytokines. To induce MetS, male Sprague-Dawley rats were fed with a HFHF diet for 16 weeks and at Week 8, single-dose low-dose streptozotocin (22 mg/kg) were intraperitoneally injected. After 8 weeks of HFHF diet feeding, the rats were treated orally with 6-gingerol (50, 100, and 200 mg/kg/day) once daily for 8 weeks. At the end of the study, all animals were terminated, serum, liver, and visceral adipose tissues were harvested for biochemical analysis including the measurements of total cholesterol, triglycerides, HDL-cholesterol, fasting plasma glucose, insulin, leptin, adiponectin, proinflammatory cytokines (TNF-α and IL-6) and liver and adipose tissue histopathology. Biochemical parameters namely serum total cholesterol (243.7 ± 127.6 vs 72.6 ± 3 mg/dL), triglycerides (469.2 ± 164.9 vs 49.3 ± 6.3 mg/dL), fasting plasma glucose (334 ± 49.5 vs 121 ± 8.5 mg/dL), HOMA-IR (0.70 ± 0.24 vs 0.32 ± 0.06), and leptin (6.19 ± 1.24 vs 3.45 ± 0.33 ng/mL) were significantly enhanced, whereas HDL-cholesterol (26.2 ± 5.2 vs 27.9 ± 1.1 mg/dL) and adiponectin level (14.4 ± 5.5 vs 52.8 ± 10.7 ng/mL) were lowered in MetS vs normal control. Moreover, MetS were marked a significant increase in body weight and proinflammatory cytokines. Treatment with 6-gingerol dose-dependently restored all of those alterations towards normal values as well as the accumulation of lipid in liver and adipose tissues. These findings demonstrate that 6-gingerol, in a dose-dependent mode, showed capability of improving weight gain and IR in MetS rats through modulation of adipocytokines.

Correlation between Serum CD36 Level and Lipid Profile in Patients with Type 2 Diabetes Mellitus, Khartoum State, Sudan

Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia. DM-related dyslipidemia are associated with complications resulting from progressive damage of various organs. CD36 is 88-kD, class B scavenger receptor, expressed on different types of cells. In diabetic patients, LDL particles are glycated with strong level; this increases CD36 expression, initiates foam cell formation and accelerates atherosclerosis. Objective: This study aimed to determine the correlation between serum CD36 level and lipid profile among patients with type 2 diabetes mellitus in Zeenam Specialized center, Khartoum State, Sudan, in a period between 2019 and 2022. Methodology: Hundred participants at different ages were included in this study; 70 were type 2 diabetic patients (cases) and 30 apparently healthy individual (control). 3 ml of venous blood were collected from the participants by using a sterile needle and syringe into a labeled plain container. Each sample was stood until complete clot occurs. Clotted blood sample was then centrifuged to obtain the serum. Then they were used for measurement of total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride and soluble CD36 levels. Total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were measured using Biosystem chemistry analyzer BTS-302. Serum CD36 was measured using Microplate Reader (URIT-660). Results: The results revealed that serum total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels were significantly higher in patients with type 2 diabetes mellitus compared with control (P = 0.03, P = 0.031, P = 0.000, P = 0.000) respectively, while there is no statistically significant differences in serum CD36 level between cases and control (P = 0.129). Also this study showed that there is no statistically significant correlation between serum CD36 level and total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, age and body mass index. Conclusion: This study concluded that there is no statistically significant difference in serum CD36 level between cases and control. And sCD36 level was not correlated with total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, body mass index, and age.

Correlation of LDL Cholesterol Calculated by Friedewald’s, Puavilai’s, Vujovic’s, de Cordova’s and Martin’s Formulae with Directly Measured LDL Cholesterol: A Cross-sectional Study

Introduction: Measurement of Low Density Lipoprotein Cholesterol (LDL-C) carries high importance in the management of Cardiovascular Disease (CVD). Direct LDL-C measurement is preferred method but this is expensive and inconvenient for the routine laboratories. To date, various types of formulae have been introduced. However, accurate estimation of LDL-C by formula is a challenge. Aim: To determine that which of these calculated formulae (Friedewald’s, Puavilai’s, Vujovic’s, de Cordova’s and Martin’s formulae) show maximum correlation with directly measured LDL-C at different serum triglyceride levels. Materials and Methods: The present cross-sectional study was conducted in the Department of Biochemistry, KLE Centenary Charitable Hospital and Medical Research Centre, Belgaum, Karnataka, India, from December 2020 to December 2021. A total of 280 outpatient fasting complete lipid profiles of patients, aged between 18-50 years were included in the study. LDL-C measured by Friedewald’s formula, Puavilai’s formula, Vujovic’s formula, de Cordova’s formula and Martin’s formula were compared with directly measured LDL-C. Comparison of calculated LDL-C with directly measured LDL-C was done at following Triglyceride (TG) ranges as group 1: <200 mg/dL, group 2: 200-300 mg/dL, group 3: 300-400 mg/dL and group 4: >400 mg/dL. Data analysis was done using Pearson’s correlation coefficient and two paired t-test. Results: Of total 280 samples, 124 participants were in group 1, 91 participants in group 2, 36 participants in group 3 and 29 participants in group 4, and there were 130 males and 150 females. The mean age in group 1, 2, 3 and 4 was 40.9±8.0 years, 38.8±9.2 years, 39.1±10.0 years and 39.8±8.2 years, respectively. Martin’s formula showed maximum correlation with r-value of 0.9979 compared to Friedewald’s, Puavilai’s formula, Vujovic’s formula and de Cordova’s formula. The mean difference was least for Martin’s formula 0.31±3.53 compared to other formulas. Percentage of error was least for Martin’s formula (0.23%) in total study sample and in all groups. Martin’s LDL-C shows highest concordance (90.90%) compared to Frielwald’s (79.60%), Puavilai’s (86.00%), Vujovic’s (83.88%) and de Cordova’s formula (82.76%). Conclusion: In the present study, Martin’s formula showed highest correlation, least mean difference, highest concordance and low percentage of errors in all the groups compared to Frieldwald’s formula, Puavilai’s formula, Vujovic’s formula and de Cordova’s formula.

The Effect of Individual Education on the Participation of Relatives of Cancer Patients in General Health and Cancer Screenings: A One Group Pretest-Post Test Study

Objective: The aim of this study was to evaluate whether or not there were changes in the behaviors of relatives of cancer patients such as learning the warning signs of cancer, engaging in cancer prevention strategies, and participating in screenings after education sessions in the clinic. Methods: This one-group pretest-posttest study was conducted with 238 relatives in a medical oncology clinic in Antalya, Turkey. Individual education sessions were conducted as an intervention, banners were hung about cancer, and general health information on checkups in the form of leaflets were distributed to each relative regarding cancer screenings. Reminder messages were sent to individuals to participate in screenings one and two months after the first interview. The posttest data were collected by phone in the third month. Four questionnaires were prepared based on the literature and national cancer screening standards. The face validity of the tools was evaluated by three experts and 15 relatives who not included as participants. Results: The rate of having a mammography increased from 19.8% to 33.9%, rates of having the fecal occult blood test increased from 16.9% to 23.8%, and rates of having the HPV test increased from 43.5% to 49.6%. The rate of having blood pressure checks within the last 12 months increased from 75.8% to 83.1%, rates of blood cholesterol measurement increased from 68.5% to 79%, and rates of blood glucose measurement increased from 70.2% to 79%. Conclusion: Education provided to the relatives increased participation in screenings.

Recommended and observed statin use among U.S. adults – National Health and Nutrition Examination Survey, 2011-2018

The American College of Cardiology/American Heart Association Blood Cholesterol Guideline was published in 2013 (2013 Cholesterol Guideline) and the Multi-society Guideline on the Management of Blood Cholesterol in 2018 (2018 Cholesterol Guideline). To compare differences in population level estimates for statin recommendations and use between guidelines. Using four 2-year cycles from the National Health and Nutrition Examination Survey (2011-2018), we analyzed data from 8,642 non-pregnant adults aged ≥20 years with complete information for blood cholesterol measurements and other cardiovascular risk factors used to define treatment recommendations in the 2013 or 2018 Cholesterol Guidelines. We compared the prevalence of statin recommendations and use between the guidelines, overall and among patient management groups. Under the 2013 Cholesterol Guideline, an estimated 77.8 million (33.6%) adults would be recommended statins, compared to 46.1 million (19.9%) recommended and 50.1 million (21.6%) considered for statins by the 2018 Cholesterol Guideline. Statin use among those recommended treatment was similar utilizing the 2018 Cholesterol Guideline (47.4%) compared to the 2013 Cholesterol Guideline (47.0%). Differences were observed across demographic and patient management groups. Compared to the 2013 Cholesterol Guideline, the prevalence of statin recommendations decreased utilizing the 2018 Cholesterol Guideline algorithm, though additional persons would be considered for treatment after risk factor assessment and patient-clinician discussion under the 2018 Cholesterol Guideline. Statin use was suboptimal (<50%) for those recommended treatment under either guideline. Optimizing patient-clinician risk discussions and shared decision making may be needed to improve treatment rates.

Shared Activities With Parents During Adolescence Predicts Health Risk Across Multiple Biological Systems 22 Years Later.

Although affectively focused dimensions of social relationships are associated with differences in health risk, less research has considered nonaffective features of relationships, such as engaging in shared activities. This study sought to test whether adolescents who engaged in more shared activities with their parents had lower health risk in early midlife across multiple biological markers. Using data from a nationally representative study ( N = 4801), prospective associations between shared activities with parents during adolescence and health risk classifications for measures of inflammation, renal function, glucose homeostasis, and cholesterol 22 years later were examined, along with the potentially confounding roles of childhood socioeconomic status and parent-child relationship satisfaction. Exploratory analyses considered possible indirect effects of cigarette use, alcohol use, and body mass index in adulthood. Engaging in more shared activities with parents was associated with a reduced likelihood of being classified in a high-risk health category for markers of inflammation ( B = -0.02, standard error [SE] = 0.01, p = .040), renal function ( B = -0.08, SE = 002, p = .001), glucose ( B = -0.06, SE = 0.23, p = .011), and high-density lipoprotein ( B = - 0.03, SE = 0.01, p = .021), and overall allostatic load ( B = - 0.02, SE = 0.02, p = .001), beyond demographic and health covariates. Controlling for parental income and relationship satisfaction largely did not affect observed associations. Exploratory tests of indirect effects imply that health behaviors in adulthood may partially account for observed associations. Engaging in more shared activities predicted more optimal health classifications 22 years later, suggesting that the amount of contact between parents and teenagers may have long-lasting beneficial health effects. Furthermore, consideration of nonaffective dimensions of family relationships may provide additional insight into associations between social relationships and health.

Identification of Secondary Prevention Patients Eligible for PCSK9 Inhibitors Therapy According to the Routine Clinical Practice in Spain.

Many patients at very high risk of cardiovascular (CV) events would benefit from lipid-lowering therapies (LLT) intensification to decrease their risk. This study aimed to identify the real-world secondary prevention patients potentially eligible for proprotein convertase subtilisin-kexin type9 inhibitors (PCSK9i) in Spain. This retrospective cohort study included adult patients registered in the IQVIA Spanish Electronic Medical Records outpatient database (2014-2020), diagnosed with myocardial infarction (MI), unstable angina (UA), ischaemic stroke (IS), transient ischaemic attack (TIA) or peripheral artery disease (PAD) and with ≥ 1 low-density lipoprotein cholesterol (LDL-C) or total cholesterol measurements. Longitudinal data were collected from the initial diagnosis to the end of the study period or follow-up loss. The study included 9516 patients, 63.9% male, mean (SD) age 67.7 (12.5) years and mean LDL-C 117.3 (38.8) mg/dL. MI, IS and PAD were the most severe events reported during the study period (28.5%, 18.7% and 29.3% of patients, respectively). At the time of last available LDL-C assessment (≥ 3months post-event), 64.4% patients were on LLT. Of those, 45.4%, 46.9% and 7.7% were on high-, moderate- and low-intensity LLT. Overall, 9.6% patients achieved LDL-C < 55mg/dL (24.2% LDL-C < 70mg/dL). Furthermore, 17.9% patients receiving optimized oral LLT showed LDL-C > 100mg/dL (LDL-C reimbursement threshold for PCSK9i in Spain). Up to 82% of patients with atherosclerotic CV disease do not achieve LDL-C levels recommended by the 2019 ESC/EAS guidelines despite being on optimized oral LLT therapy. In 17.9% of these patients LDL-C levels exceed 100mg/dL, being eligible for PCSK9i in Spain.

Low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol measurement in Familial Dysbetalipoproteinemia

AimTo compare LDL-C concentrations using the Friedewald formula, the Martin-Hopkins formula, a direct assay and polyacrylamide gradient gel electrophoresis (PGGE) to the reference standard density gradient ultracentrifugation in patients with Familial Dysbetalipoproteinemia (FD) patients. We also compared non-HDL-cholesterol concentrations by two methods. MethodsFor this study data from 28 patients with genetically confirmed FD from the placebo arm of the EVOLVE-FD trial were used. Four different methods for determining LDL-C were compared with ultracentrifugation. Non-HDL-C was measured with standard assays and compared to ultracentrifugation. Correlation coefficients and Bland-Altman plots were used to compare the methods. ResultsMean age of the 28 FD patients was 62 ± 9 years, 43 % were female and 93 % had an ɛ2ɛ2 genotype. LDL-C determined by Friedewald (R2 = 0.62, p <0.01), Martin-Hopkins (R2 = 0.50, p = 0.01) and the direct assay (R2 = 0.41, p = 0.03) correlated with density gradient ultracentrifugation. However, Bland-Altman plots showed considerable over- or underestimation by the four methods compared to ultracentrifugation. Non-HDL-C showed good correlation and agreement. ConclusionIn patients with FD, all four methods investigated over- or underestimated LDL-C concentrations compared with ultracentrifugation. In contrast, standard non-HDL-C assays performed well, emphasizing the use of non-HDL-C in patients with FD.

Is the cholesterol-perfluoroalkyl substance association confounded by dietary fiber intake?: a Bayesian analysis of NHANES data with adjustment for measurement error in fiber intake

BackgroundSerum concentrations of total cholesterol and related lipid measures have been associated with serum concentrations of per- and polyfluoroalkyl substances (PFAS) in humans, even among those with only background-level exposure to PFAS. Fiber is known to decrease serum cholesterol and a recent report based on National Health and Nutrition Examination Survey (NHANES) showed that PFAS and fiber are inversely associated. We hypothesized that confounding by dietary fiber may account for some of the association between cholesterol and PFAS.MethodsWe implemented a Bayesian correction for measurement error in estimated intake of dietary fiber to evaluate whether fiber confounds the cholesterol-PFAS association. The NHANES measure of diet, two 24-h recalls, allowed calculation of an estimate of the “true” long-term fiber intake for each subject. We fit models to the NHANES data on serum cholesterol and serum concentration of perfluorooctanoic acid (PFOA) and two other PFAS for 7,242 participants in NHANES.ResultsThe Bayesian model, after adjustment for soluble fiber intake, suggested a decrease in the size of the coefficient for PFOA by 6.4% compared with the fiber-unadjusted model.ConclusionsThe results indicated that the association of serum cholesterol with PFAS was not substantially confounded by fiber intake.

Temporal Association of Total Serum Cholesterol and Pancreatic Cancer Incidence.

Previous studies have suggested a "cholesterol-lowering effect" of preclinical pancreatic cancer, suggesting lower total cholesterol as a potential diagnostic marker. Leveraging repeated measurements of total cholesterol, this study aims to examine the temporal association of total cholesterol and pancreatic cancer incidence. We conducted a nested case-control study based on a Korean National Health Insurance Service-Health Screening Cohort, including 215 pancreatic cancer cases and 645 controls matched on age and sex. Conditional logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the associations of pancreatic cancer incidence with total cholesterol levels across different time windows over 11 years before pancreatic cancer diagnosis (recent, mid, distant). We found that, compared to participants with total cholesterol &lt; 200 mg/dL in the recent 3 years prior to diagnosis, those having total cholesterol ≥ 240 mg/dL showed a significantly lower pancreatic cancer incidence (OR = 0.50 (0.27-0.93)). No significant association was found in relation to total cholesterol measured in the mid and distant past. When changes in total cholesterol over the three time periods were analyzed, compared with those with total cholesterol levels consistently below 240 mg/dL over the entire period, the OR of pancreatic cancer was 0.45 (0.20-1.03) for participants with recent-onset hypercholesterolemia, 1.89 (0.95-3.75) for recent-resolved hypercholesterolemia, and 0.71 (0.30-1.66) for consistent hypercholesterolemia. In conclusion, while high total cholesterol in the recent past may indicate a lower pancreatic cancer incidence, a recent decrease in total cholesterol may suggest an elevated incidence of pancreatic cancer.

Lipoprotein(a) levels in children with suspected familial hypercholesterolaemia: a cross-sectional study.

Familial hypercholesterolaemia (FH) predisposes children to the early initiation of atherosclerosis and is preferably diagnosed by DNA analysis. Yet, in many children with a clinical presentation of FH, no mutation is found. Adult data show that high levels of lipoprotein(a) [Lp(a)] may underlie a clinical presentation of FH, as the cholesterol content of Lp(a) is included in conventional LDL cholesterol measurements. As this is limited to adult data, Lp(a) levels in children with and without (clinical) FH were evaluated. Children were eligible if they visited the paediatric lipid clinic (1989-2020) and if Lp(a) measurement and DNA analysis were performed. In total, 2721 children (mean age: 10.3 years) were included and divided into four groups: 1931 children with definite FH (mutation detected), 290 unaffected siblings/normolipidaemic controls (mutation excluded), 108 children with probable FH (clinical presentation, mutation not detected), and 392 children with probable non-FH (no clinical presentation, mutation not excluded). In children with probable FH, 32% were found to have high Lp(a) [geometric mean (95% confidence interval) of 15.9 (12.3-20.6) mg/dL] compared with 10 and 10% [geometric means (95% confidence interval) of 11.5 (10.9-12.1) mg/dL and 9.8 (8.4-11.3) mg/dL] in children with definite FH (P = 0.017) and unaffected siblings (P = 0.002), respectively. Lp(a) was significantly higher and more frequently elevated in children with probable FH compared with children with definite FH and unaffected siblings, suggesting that high Lp(a) may underlie the clinical presentation of FH when no FH-causing mutation is found. Performing both DNA analysis and measuring Lp(a) in all children suspected of FH is recommended to assess possible LDL cholesterol overestimation related to increased Lp(a).

Abstract 10103: Polygenic Scores and Longitudinal Trajectories of Cardiometabolic Phenotypes

Introduction: Genetic predisposition via polygenic scores (PGS) is strongly associated with single measurements of systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C), but it is unclear how PGS are associated with their longitudinal trajectories and how these trajectories are associated with risk of coronary heart disease (CHD). Hypothesis: PGS are associated with classes of longitudinal trajectories, and these trajectories are associated with CHD. Methods: Analyses were conducted in 8,453 white participants from the Atherosclerosis Risk in Communities study. SBP and LDL-C measurements were adjusted for medication use. Latent class models were used to group participants into longitudinal trajectory classes based on SBP and LDL-C values from 3-5 visits over up to 27 years. PGS were created by multiplying publicly available weights with participant genotype dosages. The association between PGS and trajectory classes for SBP and LDL-C was examined using logistic regression. We then examined the association of trajectory classes with incident myocardial infarction (MI) and CHD using cox proportional hazard models. Results: Participants were assigned to 4 classes of SBP and 2 classes of LDL-C trajectories ( Figure ). The SBP PGS was significantly associated with SBP classes 2 (OR = 1.28 per standard deviation change in the PGS, P = 4.8E-7) and 4 (OR = 1.7, P &lt; 2E-16) relative to class 3, and with class 4 relative to class 2 (OR= 1.3, P = 2.0E-6). The LDL-C PGS was significantly associated with class 2 (OR = 1.63, P &lt; 2E-16). There were 147 CHD and 102 MI events during 7 additional years of follow up. SBP class 2 and LDL-C class 2 were significantly associated with greater risk of incident MI. Conclusions: Our results highlight longitudinal trajectory classes as a tool for contextualizing the genomics of cardiometabolic phenotypes and the association of these phenotypes with CHD.

COMPARISON OF LIPID PARAMETERS IN MATERNAL SERUM AND NEWBORN CORD BLOOD

Background: One of the leading causes of morbidity and mortality in the modern period is coronary heart disease. The fetal origin concept has shown that the origins of this epidemic can be found as early as fetal life. A few research have compared the lipid profiles of cord blood from pre-term and term newborns, opening the door to early chronic disease prevention. Aim: The aim of the study was to compare lipid parameters in pre-term and term maternal serum and neonatal cord blood. Methods: In 300 newborns cord blood and 300 maternal serum samples, a cross-sectional research was performed. The placental side of the umbilical cord was used to collect cord blood samples, which were then examined for their lipid profiles, which included measurements of serum cholesterol, triglycerides, low density lipoprotein (LDL), high density lipoprotein (HDL), and apolipoproteins including ApoA and ApoB. Results: When lipid parameters from maternal serum and neonatal cord blood were compared, maternal serum had statistically significant higher values for the apolipoproteins, atherogenic index (AI), and lipid profile. Lipid parameters (TC, TG, LDL, very low density lipoprotein, Apolipoprotein B, and AI) were higher in mothers of pre-term babies and also in cord blood of pre-term neonates. Comparison of lipid parameters of pre-term and term mothers and neonatal cord blood was highly significant. Conclusion: There was a significant association of cord blood and maternal lipid parameters; hence, change in maternal lipid levels might influences the lipid levels in the cord blood of neonates.

Effects of Medicare Advantage on preventive care use and health behavior.

To examine the effects of Medicare Advantage (MA) enrollment on preventive care use and health behavior. The Medicare Current Beneficiary Survey, the Area Health Resources File, the Geographic Variation Public Use File, and the Centers for Medicare and Medicaid Services annual risk and ratebook files for 2012-2016. Outcomes included 11 measures of preventive care use and six measures of health behavior. My primary independent variable was MA enrollment. For each outcome, I first conducted linear regression analysis while adjusting for individual-level and county-level characteristics. Then, I conducted the following alternative analyses to account for differences in observed and/or unobserved characteristics between MA and traditional Medicare (TM) enrollees: propensity score (PS) matching analysis and instrumental variable (IV) analysis. I extracted 9399 MA enrollees and 15,543 TM enrollees. Linear regression and PS matching analyses showed that MA enrollment was statistically significantly associated with higher likelihood of having blood pressure measurement, cholesterol measurement, and influenza vaccine, lower likelihood of receiving an HbA1C test, and higher likelihood of currently smoking. However, the magnitude of the associations was small. There were no statistically significant associations in other measures. IV analyses also found no or limited evidence that MA enrollment led to statistically significant changes in preventive care use and health behavior. Specifically, MA enrollment led to statistically significant improvements in the likelihood of doing any physical activities (1.29 [95% CI: 0.51-2.07]) or doing muscle-strengthening activities (0.72 [95% CI: 0.03-1.41]). No statistically significant changes were observed in other measures. MA plans may not necessarily increase the use of preventive services and improve health behaviors. As improvements in preventive services and health behavior may have the potential to achieve better outcomes while lowering costs, policy makers should consider developing targeted interventions for MA to achieve those improvements.

Development of minimal resource pre-screening tools for chronic kidney disease in people with type 2 diabetes

Regular chronic kidney disease (CKD) screening can facilitate earlier diagnosis of CKD and preventative action to reduce the risk of CKD progression. People with type 2 diabetes are at a higher risk of developing CKD; hence, it is recommended that they undergo annual screening. However, resources may be limited, particularly in lower-to-middle income countries, and those at the highest risk of having an abnormal CKD screening result should be prioritised for screening. We have developed models to determine which patients are at a high risk of renal impairment. We have shown that, for people with type 2 diabetes and no previous diagnosis of CKD stage 3-5, it is possible to use age, gender, body mass index, duration of type 2 diabetes and blood pressure information to detect those at a higher risk of a reduced glomerular filtration rate. When blood measurements are available, triglyceride and cholesterol measurements can be used to improve the estimate of the risk. Even though risk factors were associated with an increased urine albumin:creatinine ratio, we found no clinical benefit of using the model over a screen-all approach.

Effects of COVID-19 Pandemic and Lockdown on Monitoring and Treatment Balance of Finnish Coronary Heart Disease and Type 2 Diabetes Patients.

We aimed to examine the effect of the COVID-19 pandemic and lockdown on monitoring and treatment balance of Finnish coronary heart disease (CHD) and type 2 diabetes (T2D) patients. We used data from the electronic health records on 1604 CHD and 10,136 T2D patients aged 18‒85 years in Eastern Finland. Measurement and levels of low-density lipoprotein cholesterol (LDL) of CHD patients and glycated haemoglobin (HbA1c) of T2D patients were assessed monthly during January 2019-June 2021. Interrupted time-series analysis design was utilized to examine the effect of the lockdown on proportion of patients monitored and treatment balance. Reductions in frequencies of LDL testing of CHD and HbA1c testing of T2D patients were observed during the national lockdown. Downward trend in average LDL was observed from January 2019 until June 2021. Average HbA1c values increased from January 2019 to March 2020 with an additional increase by 2.04 mmol/mol (0.80 to 3.29) in April 2020. However, there was a downward trend in monthly average HbA1c during the lockdown until June 2021 with an additional change in level by 0.61 mmol/mol (95% CI 0.06 to 1.16) in July 2020. The lockdown decreased the frequency of monitoring among both CHD and T2D patients. Meanwhile, monthly average LDL had a steadily improving pattern in CHD patients during the follow-up while temporary worsening in HbA1c in patients with T2D was observed at the time of the lockdown. The lockdown may have introduced selection in patients who had their treatment outcomes monitored. Better self-management of risk factors among patients is also possible.

Evaluation of visceral adiposity index with cardiovascular risk factors, biomarkers in postmenopausal women to predict cardiovascular disease: A 10 year study

Background and aimVisceral adiposity index (VAI) is reportedly beneficial in predicting cardiovascular disease (CVD) and metabolic syndrome (MetS). However, long-term studies analyzing the efficacy of VAI in the prediction of CVD risk are limited. The relationship between VAI and electrolytes is unclear. This study aimed to determine if VAI can be used as a predictor of CVD and provide early diagnosis possibility for future CVD patients. Moreover, the impact of biomarkers and electrolytes on VAI therefore indirect relation to CVD was analyzed. MethodsPostmenopausal women (aged >40 years) admitted to our hospital in 2011 were included and categorized into two groups according to their VAI scores: mild/moderate and severe. Groups were compared with insulin resistance, biochemical parameters, and anthropometric measurements. Patients have been reached out after 10 years and questioned for additional disease and cardiovascular risk. Statistical Package for Social Sciences (SPSSv22.0) was used for data analysis. The p < 0.05 value was considered significant. ResultsMean VAI score of patients with MetS (7.30 ± 4.75) was significantly higher than without MetS (2.95 ± 1.05) (p < 0.01). Serum magnesium level was found significantly lower in the severe group. Serum zinc (Zn) and hsCRP levels were higher in the severe group. Correlation analysis showed significant positive correlations between VAI scores and total cholesterol (r = 0.289, p < 0.05), Zn (r = 0.397, p < 0.01), fasting insulin (r = 0.455, p < 0.01) and no significant association with the 10-year CVD incidence (OR: 1.034 (0.888–1.203); p = 0.668). ConclusionPrevious VAI results cannot assist in predicting the 10-year CVD risk. Additionally, including measurements of serum Zn, total cholesterol, fasting insulin, and FBG levels are reasonable approach for managing postmenopausal women with unfavorable CVD risk profiles.

Particle Size Distribution of Plasma Lipoproteins in Donkeys from Death Valley Compared to a Sampling of Horses.

Simple SummaryDonkeys, like horses, belong to the Equidae family. Though they share some physical attributes, much of their physiology is quite different from horses. Both horses and donkeys can develop clinical issues associated with obesity; insulin dysregulation; and altered lipid metabolism, often termed equine metabolic syndrome or donkey metabolic syndrome, respectively. Unlike large breed horses, however, donkeys, ponies, and miniature horses are more susceptible to developing dyslipidemias. This study aimed to use a novel Lipoprint® assay to compare the lipid profiles of apparently healthy donkeys and large-breed horses to establish a baseline for future work that may lead to the use of this test methodology for the evaluation and monitoring of equids with endocrine disorders.The clinical evaluation of lipid metabolism in equids is often limited to the measurement of total cholesterol and triglyceride concentrations. This provides a limited picture of metabolic state and general health, given the continuous exchange of lipid species between various lipoproteins. Major lipoprotein classes in equids include high-density lipoprotein (HDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and chylomicrons (CM). Unlike large breed horses, donkeys are highly susceptible to hepatic lipidosis. Currently, serum triglyceride concentrations serve as a surrogate marker of hepatic lipid exportation. Both VLDL, indicative of hepatic exportation, and its metabolic end-product, LDL, are rich in triglycerides, and contribute to this value. Diagnostic assays that distinguish VLDL from LDL could be useful in better recognizing the hepatic pathology in donkeys. The compositional differences of lipoproteins across species limit the use of commercially available assays developed for the measurement of human lipoproteins in domestic animals. In this study, we evaluated a high-resolution polyacrylamide gel electrophoresis method (Lipoprint®) for separating major lipoprotein classes and sub-fractionating LDL and HDL based on particle size in a large group of donkeys, and compared the pattern to a representative set of horses. Donkeys proved an HDL-rich species, with HDL accounting for the bulk of all lipoproteins (average 78.45%, SD 6.6%, range 92.2–55%). VLDL accounted for a large portion of the total (average 21.6%, SD 6.6%, range 37.1–7.8%), with minimal amounts of LDL detected. The horses tested had higher proportions of VLDL as compared to donkeys (31.7% and 21.6%, respectively p = 0.00008). The later finding draws into question the purported relationship between VLDL, high triglycerides, and hepatic lipidosis, given the incidence of the disease in donkeys is far higher than in horses.