Complete Lipid Profile Research Articles

Anti-hyperglycemic activity of Centella asiatica is partly mediated by carbohydrase inhibition and glucose-fiber binding

BackgroundCentella asiatica (C. asiatica) was previously reported to have anti-hyperglycemic effects in animal diabetic model rats. However, its activity on organ and tissue level remains unstudied. Our study aims at exploring the possible effects, C. asiatica extract and insoluble fiber has on carbohydrate absorption, insulin secretion, insulin sensitivity and glucose utilization.MethodsFor primary evaluation of anti-hyperglycemic activity, we measured Fasting Blood Glucose and performed Glucose Tolerance Test, in type 2 diabetic rats. To further study the pancreatic effect and glucose utilization, plasma insulin concentration, insulin secreted from isolated rat islets and liver glycogen were assayed. Effect on carbohydrate break down was assayed using intestinal disaccharidase enzyme, α-amylase inhibition assays and Six-Segment study of the GI tract. Effect of C. asiatica on glucose absorption was studied by an in-situ, perfused, intestinal model in rats and by glucose-fiber binding assay. Gastrointestinal motility was seen by a BaSO4 milk traverse test. Additionally, a complete lipid profile assay, after a chronic study, was conducted.ResultsC. asiatica showed no significant change in insulin secretion in-vivo and in isolated rat islets. Additionally, no effect of the extract was seen on liver glycogen deposition. Retarded glucose absorption was seen in the in-situ perfused rat intestinal model at a dose. The extract was also found to inhibit action of both intestinal disaccharidase and α-amylase. This was confirmed, yet again, via the Six Segment study, where sucrose digestion was found to be inhibited throughout the length of the GI Tract. Significant glucose-fiber binding was demonstrated in the in-vitro models. During the chronic study, body mass of C. asiatica treated Type 2 diabetic rats returned to normal and their polydipsic and polyphagic conditions were also improved. Chronic treatment of C. asiatica also improved subject’s lipid profile.ConclusionA combination of in-vitro, in-vivo and in-situ tests confirmed the anti-hyperglycemic activity of C. asiatica and its tissue level mechanism. Further study is required to fully elucidate the effect this extract or the active compounds have on the individual glucose transporters and the precise mechanism of glucose-fiber binding.

Visceral fat rating is a useful indicator in risk assessment among coronary artery disease patients treated with aggressive lipid lowering therapy

BackgroundVisceral fat rating (VFR), calculated by bioelectrical impedance, is a new parameter associated with obesity and Coronary Artery Diseases (CAD). We have attempted to assess population of treated CAD patients classified based on VFR. MethodsWe enrolled consecutive patients having documented CAD who had received prior treatment along with high-dose lipid lowering drugs for a minimum of 6 wks and compared with healthy controls. CAD patients with VFR >12 were labeled as High Visceral fat CAD (HVC) while those with VFR ≤12 were grouped as Low Visceral fat CAD (LVC). Established anthropometric indices like waist circumference (WC) and Body Mass Index (BMI) were measured. We used bioelectrical impedance to measure VFR using a device called InnerScanV (TANITA, Tokyo). A complete lipid profile was recorded. Groups were compared by chi-square, t-test and one-way analysis of variance. Multivariate analysis was done for identifying risk factors. Results303 subjects were enrolled, including 150 CAD patients and 153 healthy controls. Among CAD group, there were 74 (49.3%) HVC and 76 (51.7%) LVC patients. On comparing treated HVC and treated LVC patients, HVC patients had expectedly higher WC, BMI and higher Triglycerides (TG), total cholesterol (TC) and LDL cholesterol. On comparing the patients with healthy controls, HVC group again had higher WC, BMI, LDL, TC:HDL ratio, LDL:HDL ratio and lower HDL levels. On the other hand, LVC patients had a lower BMI than the healthy controls and there was no difference in the lipid parameters, apart from lower HDL in LVC patients, between the two groups. VFR along with WC, HDL, LDL:HDL and TC:HDL were independent risk factors among treated CAD patients. WC, HDL, LDL:HDL and TC:HDL ratios were risk factors among LVC patients while in addition to these, BMI and LDL were extra risk factors among HVC patients and thus associated with VFR. ConclusionHigh visceral fat is associated with deranged anthropometric measurements and lipid profile. We hypothesize that HVC patients might be resistant to conventional treatment, while LVC patients respond well to aggressive lipid lowering therapy. HVC patients are also associated with more risk factors than LVC patients.

Prevalence of insulin resistance in siblings of type 2 diabetics of north west punjabi population.

Insulin resistance a physiological condition is marked by hyperglycemia and failure of cells to respond to normal action thus hyperinsulinemia. It is prevalent in individuals having genetic predisposition and family history of type 2 diabetes mellitus. Physically inactive individuals having sedentary life style are also at a risk of developing insulin resistance. The present study was planned to observe the prevalence of insulin resistance or pre diabetes in various age groups of North West Punjabi population. A total of 400 families comprising of 1159 offsprings of diabetic patients and siblings amongst each were included in the present study. All these 400 families had history of type 2 diabetes mellitus in the present or past generation. Written consent was taken from the head of the family for inclusion in the study. Fasting samples were collected and analysed for Glucose, Glycosylated Hb, complete lipid profile, Insulin and c-peptide. Body mass index, waist hip ratio and HOMA-IR were calculated. Comparison of mean of various parameters was done using student t-test. Analysis of variance (ANOVA) was applied for comparison between groups followed by Bonferroni post hoc analysis. Pearson's correlation method was used for quantitative variables. Statistical significance was defined as p<0.05 (two tailed). Prevalence of impaired fasting glucose both in males and females increased with advancing age. Hyperglycemia along with hyperinsulinemia, hypercholesterolemia and hypertriglyceridemia was observed in individuals having impaired fasting glucose. Individuals belonging to age group of >18-35 years were more prone to insulin resistance as compared to other age groups. Insulin resistance at a young age of 18-35 years predisposes these individuals to coronary events. Females in reproductive years are more prone to insulin resistance or pre diabetes as compared to males of the same age group.

Estimation of serum lipids in patients with Oral Submucous Fibrosis in India.

Objectives: Oral submucous fibrosis (OSMF) is the most prevalent precancerous condition in India. Low levels of lipids serves as a marker and prognostic indicator in the early detection of oral precancerous and cancerous states. In spite of the high prevalence and its potential to undergo malignant transformation, this condition has not widely been investigated with respect to the serum lipid levels. In the present study, an attempt was made to analyze the complete serum lipid profile, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) cholesterol in OSMF and controls. Material and Methods: The study was conducted in 45 clinically and histopathologically diagnosed cases of OSMF and 45 age and sex matched controls. The complete lipid profile including TC, TG, HDL cholesterol, LDL cholesterol and VLDL cholesterol was analyzed. Results: The serum lipid levels were significantly lower in the patients with OSMF than in the controls. When the values were compared between different disease stages, the maximum reduction of lipids was evident for stage 3 OSMF. From the present results, it is evident that the level of serum lipids decreases with progression of the disease. Conclusions: From these findings, it appears that the decrease in the lipid levels may be considered as a useful marker in the early diagnosis of oral premalignant condition like OSMF. Key words:Oral submucous fibrosis, lipids, premalignant condition.

Lifestyle modifications in an adolescent dormitory: a clinical trial.

PurposeChildhood obesity is an increasing public health issue worldwide. We examined dietary patterns among adolescents in a dormitory school, identified obese adolescents and tried to intervene to improve food habits and physical activity.MethodsWe conducted an experimental prospective longitudinal study based on 36 obese (body mass index [BMI]≥95th percentile) adolescents (aged 12-18 years) compared with controls (healthy children: normal age-appropriate BMI (BMI≤85th percentile). Six months' intervention included lifestyle-modification counseling (once a week by a clinical dietician), and an exercise regimen twice a week, 60 minutes each time, instructed by a professional pediatric trainer). Both groups underwent baseline measurements at the beginning of the study and 6 months later (arterial stiffness, blood pressure, pulse, weight and height, hemoglobin, creatinine, liver enzymes, highly sensitive C-reactive protein and complete lipid profile).ResultsTwenty-one participants completed the study. Low compliance from participants, school staff and parents was observed (participation in planned meetings; 71%-83%). BMI significantly decreased from 32.46±3.93 kg/m2 to 30.32±3.4 kg/m2 (P=0.002) in the study group. Arterial stiffness was not significantly different between the 2 groups and did not change significantly after 6 months' intervention (P=0.494). No significant changes in CRP and lipid profile were observed after the intervention.ConclusionMaking lifestyle modifications among adolescents in a dormitory school is a complex task. Active intervention indeed ameliorates BMI parameters. However, in order to maximize the beneficial effects, a multidisciplinary well-trained team is needed, with emphasis on integrating parents and the school environment.

Investigating the Physiological Changes in the Cardiovascular System Across Ages 25 to 75 Years

The aim of the present study was to investigate the physiological changes that occur in the cardiovascular system with advancing age. 50 males and females, in the age group of 25–75 years, participated in the study. Clinical evaluation included assessment of heart rate, blood pressure, complete lipid profile and blood glucose in addition to details of medical history and personal habits, with particular regard to smoking habits and alcohol intake. Results showed that VO2max, sub-maximal heart rate and maximal heart rate were significantly negatively correlated to age (r = -0.523, -0.745 and -0.824 respectively), whereas blood pressure was significantly positively correlated to age (r =0.383). The study concluded that aging has a depreciatory effect on the cardiovascular functions causing a decline in the various physiological parameters of the cardiovascular system across ages 25 to 75 years, with an increased tendency of occurrence after 45 years of age.

Bone mineral density and factors influencing it in Asian Indian population with type 2 diabetes mellitus.

Objective:To assess bone mineral density (BMD) in type 2 diabetes mellitus (T2DM) patients and its relation, if any, to clinical, hormonal and metabolic factors.Materials and Methods:A prospective evaluation of 194 T2DM patients (97 men and 97 women) was carried out. BMD was done with dual energy X-ray absorptiometry (DXA) at the lumbar spine and total hip. Physical activity, nutritional intake and sunlight exposure were calculated. Biochemical and hormonal tests included serum 25 hydroxy vitamin D [25(OH) D], parathyroid hormone, estrogen, testosterone and urinary calcium-creatinine ratio. Glycosylated hemoglobin and complete lipid profiles were done in patients with diabetes. Five hundred and seventy one non-diabetic controls (262 males and 309 females) were evaluated for BMD alone.Results:BMD was normal (Z score > -2) in 156 (80.5%) and low (Z score ≤ -2) in 38 (19.5%) patients in the diabetes study group. BMD in the diabetes group was significantly higher than the control group in both sexes at the hip and spine. The difference was no longer significant on analysis of a BMI matched control subgroup. Weight and BMI showed significant correlation to BMD. Duration of T2DM, degree of glycemic control, use of drugs like statins and thiazolidinediones, 25(OH) D levels, calcium intake, sunlight exposure and physical activity did not significantly affect BMD in this cohort of individuals with diabetes.Conclusions:Bone mineral density of Asian Indian T2DM subjects was similar to that of healthy volunteers in this study.

RAMADAN FASTING EFFECTS ON METABOLIC PARAMETERS IN ELDERLY PERSONS WITH CARDIOVASCULAR RISK FACTORS

Objective: Our study aims was to evaluate the effect of Ramadan fasting on routine biochemical parameters in elderly subjects with cardiovascular risk factors. Design : Cohort study. Setting: Subjects were prospectively recruited and screened at nine primary care clinics, three outpatients specialized clinics and an emergency departement. Participants: subjects aged ≥ 65 years (n=87) recruted in Ramadan month in 2010, 2011 and 2012. Measurements: Dietary intake using a 24 hour recall, biochemical tests including complete lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), renal function tests, serum uric acid, serum electrolytes (sodium, potassium, chloride and protein), glycaemia, and glycated hemoglobin (HbA1C). All data related to dietary intake and biochemical tests were performed one month before Ramadan, during the last week of Ramadan and one month after Ramadan. Comparison between the three time groups were made using standard statistical tests. Results: We showed a significant decrease of creatinine clearance and an increase of serum triglycerides and blood glucose during Ramadan. After Ramadan, we observed a significant increase in HDL-C was and a significant decrease in serum triglycerides and HbA1c. No correlation was found between glycaemia and total energy intake, neither between LDL-C/HDL-C ratio and total energy intake. Conclusion: In elderly subjects with cardiovascular risk factors, Ramadan seems to induce dual effects. During the fasting period, there is a potential risk of renal function decrease and an increase of glycaemia. In contrast, after Ramadan, our findings support the potential beneficial effect of fasting on lipid regulation and glycemic control.

Differences in lipid profiles in two Hispanic ischemic stroke populations.

The study aims to compare lipid profiles among ischemic stroke patients in a predominantly Caribbean-Hispanic population in Miami and a Mestizo Hispanic population in Mexico City. We analyzed ischemic stroke Hispanic patients with complete baseline fasting lipid profile enrolled contemporaneously in the prospective registries of two tertiary care teaching hospitals in Mexico City and Miami. Demographic characteristics, risk factors, medications, ischemic stroke subtype, and first fasting lipid profile were compared. Vascular risk factor definitions were standardized. Multiple linear regression analysis was performed to compare lipid fractions. A total of 324 patients from Mexico and 236 from Miami were analyzed. Mexicans were significantly younger (58 · 1 vs. 67 · 4 years), had a lower frequency of hypertension (53 · 4% vs. 79 · 7%), and lower body mass index (27 vs. 28 · 5). There was a trend toward greater prevalence of diabetes in Mexicans (31 · 5 vs. 24 · 6%, P = 0 · 07). Statin use at the time of ischemic stroke was more common in Miami Hispanics (18 · 6 vs. 9 · 4%). Mexicans had lower total cholesterol levels (169 · 9 ± 46 · 1 vs. 179 · 9 ± 48 · 4 mg/dl), lower low-density lipoprotein (92 · 3 ± 37 · 1 vs. 108 · 2 ± 40 · 8 mg/dl), and higher triglyceride levels (166 · 9 ± 123 · 9 vs. 149 · 2 ± 115 · 2 mg/dl). These differences remained significant after adjusting for age, gender, hypertension, diabetes, body mass index, smoking, ischemic stroke subtype, and statin use. We found significant differences in lipid fractions in Hispanic ischemic stroke patients, with lower total cholesterol and low-density lipoprotein, and higher triglyceride levels in Mexicans. These findings highlight the heterogeneity of dyslipidemia among the Hispanic race-ethnic group and may lead to different secondary prevention strategies.

Association ofInterleukin-6 −174 G&gt;CPromoter Polymorphism with Increased Risk of Type 2 Diabetes Mellitus Patients with Diabetic Nephropathy in Turkey

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus. We aimed to evaluate the interleukin (IL)-6 gene polymorphisms in type 2 DN and control subjects. The patients selected from the Department of Endocrinology and Metabolism Diseases included 43 type 2 diabetes mellitus patients without DN and 43 type 2 diabetes mellitus patients with DN and 340 healthy normal controls. All subjects underwent venous blood drawing for complete hormonal assays, lipid profile, glucose, and insulin and Il-6 gene polymorphism genetic analysis. IL-6 -174 G>C genotype distribution was different between the control group and the type 2 diabetes mellitus patients (p=0.004). The higher frequency of the polymorphic G allele was also similar for the group with type 2 diabetes mellitus as for the control group. The frequency of the polymorphic G allele was 83.9% in diabetic patients with nephropathy versus 70.9% in those without nephropathy (p=0.039). We suggest that the -174 G>C polymorphism of the IL-6 gene is an independent risk factor for DN in Turkish type 2 diabetes mellitus patients.

Identification of small compound biomarkers of pituitary adenoma: a bilateral inferior petrosal sinus sampling study

Evaluation of the pathogenic mechanisms underlying Cushing disease (CD) is limited partly by the inaccessibility of the pituitary gland for biopsy. We used bilateral inferior petrosal sinus sampling (BIPSS), the...

Fatty nodules of the dermis of the upper eyelids: a new entity

Dear Editor,Acquiredyellowishlesionsofvarioushuesinvolvingonlytheskin of the eyelids are generally caused by lipidized histio-cytes (xanthelasma, xanthoma) [1, 2] or lipidized epithelialcells (sebaceous tumors) [ 3, 4]. We report an extraordinarycase of a late middle aged woman with bilateral nasal uppereyelid, yellow–orange, mildly elevated nodules due to acomplete focal replacement of an involved segment of thedermis by mature adipocytes.A62-year-oldwomanfirstnotedpainless,yellowish,upperinner eyelid discolorations in 2008. They slowly enlarged tobecome mildly elevated, and focally marginated nodules.They were soft and compressible. On ophthalmic examina-tion, performed on March 5, 2013, each lesion was oval andsoft with irregular borders (Fig. 1a). Visual acuity was 20/40in each eye. There was no ptosis. The eye examination wasremarkable for bilateral posterior chamber intraocular lenseswith Descemet’s stripping endothelial keratoplasties (DSEK)for Fuchs’ dystrophy. The patient denied using makeup(exceptforaneyebrowpencil),anyinjectionsaroundtheeyes,skin conditions including similar lesions elsewhere, systemicmedicines or diseases, and a diet with excessive fruit orvegetable intake. A recent complete blood count and lipidprofile obtained as part of a thorough clinical checkup werewithinnormallimits.Becauseofslowenlargement,thepatientwantedthelesionsexcised.Atbilateralsurgery,theorbicularismuscle was clearly observed and noted to be free of dehis-cences; the medial fat pads were not encountered. After5 months of follow-up, the lesions have not recurred.Thegrossspecimensmeasured0.9×0.4cmand0.7×0.5cm,with 0.2 cm of thickness. Microscopically, the dermis of botheyelid specimens was dominated by well-developed, large,univacuolar lipocytes that extended throughout its full thick-ness, sparing only a thin lamina of collagen beneath a non-disturbed epidermis. Hair structures and sweat glands werepreserved (Fig. 1b, top and bottom panels). The fat cells wereS-100 positive (Fig. 1c) and there were many thin trichrome-positive strands of surviving dermal collagen (Fig. 1d). Alcianblue staining was negative. Rare multinucleated histiocytescontainingeither delicate granules or fine lipidic vacuoles wereobserved (Fig. 1e). CD68 confirmed the presence of a lightdispersion of small, non-activated histiocytes (Fig. 1f).Thecurrentpatient’soval,palpable,yellow-orange,elevat-edlesionswithfocallywell-definedmargins(“puddlesoffat”)differ from the flat or placoid, creamy-yellow appearance ofxanthelasma with ill-defined edges [1]. Abundant ectopicdermal lipocytes constituted the main pathologic feature, andprobably arose from metaplasia of dermalfibroblast-like stro-mal cells. Lipocytes can occur among dermal nevus cells;osteomas of the dermis [5] and osteolipomas are additionalexamples of metaplastic phenomena [6]. An intramuscularlipoma of the orbicularis has been described [7], but eyeliddermal involvement by a solitary lipoma or polypoidal nevuslipomatosus has not been reported [6]. The underlyingorbicularis muscle in the current case did not display a dehis-cence that might have permitted prolapse of more deeplylocatedfat.Injectionsoffat,paraffin,orsiliconeandentrappedointment create multiloculated, extracellular lipogranulomashistopathologicallythatarerimmedbymononucleatedepithe-lioid cells and multinucleated giant cells [8, 9].There is one relevant report in the dermatology literature[10] of a group of 27 French patients with flat, superonasal

CARDIOVASCULAR MANIFESTATIONS AMONG WORKERS IN MEAT PRODUCTION EXPOSED TO COLD ENVIRONMENT

Introduction: Several mechanisms were suggested to describe the relationship between cold exposure and coronary heart disease (CHD). Aim of the work: Our aim is studying the prevalence of cardiovascular manifestations encountered in cold exposure and, to investigate some of the hemodynamic variables that affect the biochemical parameters especially the coagulation and the lipid profile. Subjects and Methods: This study was conducted on 81 subjects in one of the leading factories in meat production in Egypt and twenty subjects as control group. All the personnel were subjected to a full history taking with special questionnaire, clinical examination, and investigations involving, complete blood picture, bleeding time, plasma fibrinogen, plasma thrombin, clotting time, cryoglobulin, complete lipid profile, resting ECG and Rt.upper limb Colored Doppler. Results: Clinical examination showed significant prevalence in chest manifestations which was (42.2%), cardiac (47.5%) and Peripheral vascular manifestations (37.7%) among the exposed group. Investigations revealed low Hemoglobin, low platelet, low bleeding time and higher total cholesterol level among the studied groups. Cryoglobulins showed one positive case among the exposed subjects. There was a prevalence of abnormal ECG findings in 28% of the exposed group. Colored Doppler showed complete normal findings among the exposed subjects. Conclusions and Recommendations: We concluded that exposure to cold environment during work puts the workers in a serious risk of having clinical manifestations’ changes and altered biochemical parameters in which it can lead to serious pathological disturbances. Preplacement and Periodic medical examination are recommended. Using personnel protective equipments (PPE), exposure limits schedules and establishing the work place according to the international standards of occupational health and safety is highly recommended to minimize the exposure effects.

Effect of tomato consumption on high-density lipoprotein cholesterol level: a randomized, single-blinded, controlled clinical trial

IntroductionEpidemiologic evidence suggests that tomato-based products could reduce the risk of cardiovascular diseases. One of the main cardiovascular risk factors is low levels of high-density lipoprotein cholesterol (HDL-C). This study aimed to prospectively evaluate the effect of tomato consumption on HDL-C levels.Subject and methodsWe conducted a randomized, single-blinded, controlled clinical trial. We screened 432 subjects with a complete lipid profile. Those individuals with low HDL-C (men <40 mg/dL and women <50 mg/dL) but normal triglyceride levels (<150 mg/dL) were included. Selected participants completed a 2-week run-in period on an isocaloric diet and then were randomized to receive 300 g of cucumber (control group) or two uncooked Roma tomatoes a day for 4 weeks.ResultsA total of 50 individuals (women = 41; 82%) with a mean age of 42 ± 15.5 years and a mean body mass index of 27.6 ± 5.0 kg/m2 completed the study. A significant increase in HDL-C levels was observed in the tomato group (from 36.5 ± 7.5 mg/dL to 41.6 ± 6.9 mg/dL, P < 0.0001 versus the control group). After stratification by gender, the difference in HDL-C levels was only significant in women. The mean HDL-C increase was 5.0 ± 2.8 mg/dL (range 1–12 mg/dL). Twenty patients (40%) finished the study with levels >40 mg/dL. A linear regression model that adjusted for those parameters that impact HDL-C levels (age, gender, waist-to-hip ratio, body mass index, fasting triglyceride concentration, simple sugars, alcohol, physical activity, and omega-3 consumption) showed an independent association between tomato consumption and the increase in HDL-C (r2 = 0.69; P < 0.0001).ConclusionRaw tomato consumption produced a favorable effect on HDL-C levels in overweight women.

Standard strategies for acute ischemic stroke within the rtPA therapeutic window: UNITED STATES.

A 63-year-old hypertensive, diabetic man called 911 at 8:00 pm complaining of right-sided weakness that started at 6:30 pm after dinner. The ambulance arrived at the patient's house at 8:05 pm and he was brought to the nearest stroke center. While en route, the paramedic alerted the stroke center emergency department. The patient arrived at the emergency room at 8:30 pm and was immediately evaluated by the physician. A stroke code was called and the neurologist was at the bedside at 8:40 pm. An 18-gauge IV was inserted by the nurse and blood test for basic metabolic panel, complete blood count, coagulopathy panel, and lipid profile were sent. The NIH Stroke Scale was performed, showing a total score of 10. The time of onset was verified with the patient's wife, who witnessed the event. A noncontrast CT was done at 8:50 pm and officially read at 8:55 pm, showing absence of signs of hemorrhage or acute infarct. After reviewing the inclusion and exclusion criteria, the patient was deemed eligible for thrombolysis and IV tissue plasminogen activator (tPA) was ordered. The IV tPA was initiated at 9:15 pm, 45 minutes from the time the patient entered the emergency room door, 2 hours and 45 minutes from symptom onset. This scenario is increasingly becoming a routine exercise in many primary stroke centers across the United States.

AB0271 Beneficial effect of anti-tnf therapy in the lipoprotein atherogenic risk profile in comparison with dmard standard therapy in ra patients

BackgroundRA patients portend a greater risk of cardio-vascular complications than general population. Although most probably diverse mechanisms are implicated, quantity and quality changes in the lipoproteins appear to have an...

Serum Lipid Profile in Nigerian Patients with Ischaemic Cerebrovascular Accident

Ischaemic Cerebrovascular Accident (CVA) has been shown to be associated with abnormal lipid profile (dyslipidaemia) as a risk factor. There is paucity of data regarding this in this environment hence this study. In this study, a total number of 63 subjects were recruited comprised of 33 patients with cerebrovascular accident (stroke) and 30 apparently healthy volunteers as control. A complete lipid profile which included Total serum Cholesterol (TC), serum Triglyceride (TG), High Density Lipoprotein cholesterol (HDL-c) and Low Density Lipoprotein cholesterol (LDL-c) were assayed for both patients and controls. The lipid profile was determined using standard methods. The TC for both patients and control were 212±53 and 196±46 mg/dL respectively, TG for both patients and controls were 159±9 and 79±13 mg/dL respectively, HDL-c was 55±9 mg/dL for patients and 61±7 mg/dL for controls and LDL-c was 151±34 mg/dL for patients and 117±51 mg/dL for control subjects. TC, TG and LDL-c were higher in the ischaemic CVA patients than the controls; however only TG showed a significant increase while HDL-c although not significant was lower than control. The study therefore showed that ischaemic CVA is associated with hypercholesterolaemia, hypertriglyceridaemia and high LDL-cholesterol. We thus suggest preventive and management strategies that will reduce lipid levels (TC, TG and LDL) and enhance HDL-cholesterol in Nigeria patients that are prone to or diagnosed of ischaemic CVA.

Abstract P255: Decrease in Serum Lipids among 5th Grade CARDIAC Participants, 2002-2012

The presence of multiple cardiovascular risk factors such as elevations in body mass index (BMI), systolic blood pressure (SBP), serum low-density lipoprotein (LDL) cholesterol, and the related non high-density lipoprotein (non-HDL) cholesterol in children is predictive of later cardiovascular disease. LDL and non-HDL have recent decreases in the US adult and youth population despite increases in obesity rates. The purpose of this study was to assess these trends among Appalachian 5 th grade children. Methods: 47,198 children, mostly between 10-11 years old, participated in a cross-sectional statewide CARDIAC (Coronary Artery Risk Detection In Appalachian Communities) screening between 2002-2012 and had a complete fasting lipid profile (FLP). Consistent with state demographics, 92.6% were Caucasian and 53.6% female. LDL (Mean = 92.9, sd = 25.5) and non-HDL (M=111, sd = 28.9) cholesterol levels were normally distributed. Covariates included race, gender, age, SBP and BMI (M = 21.36, sd = 5.2). Generalized Linear Models (GLM) and orthogonal contrast matrices were used to test the hypothesis of a linear (v. non-linear) trend over time for LDL and non-HDL values. Results: Models predicting LDL and non-HDL were significant and fit a linear trend (p-value &lt; 0.0001) attributable to the explanatory variables (race was not significant and excluded from the final models). For LDL, year of screening was significant (p&lt;0.0001) as was gender, age and BMI (all p &lt; 0.0001). For non-HDL, year of screening was also significant (p&lt;0.0001), as was gender (p=0.0194), age (p&lt;0.0001), BMI (p&lt;0.0001), and SBP (p=0.0013). There was a decreasing trend in LDL (dot) and non-HDL (broken line) over time (Figure 1). Although some non-linear trends were also significant (e.g., a quartic trend, p &lt; 0.001), the linear trend provided the best fit for both models. Conclusion: The mean values for LDL and non-HDL of a cross-sectional sample of children in 5 th grade Appalachia has decreased over time even after adjusting for age, BMI, gender, race and SBP.

Atherogenic changes in low-density lipoprotein particle profiles were not observed in non-obese women with polycystic ovary syndrome

Is a preponderance of small dense low-density lipoprotein-cholesterol (LDL-C) observed in non-obese women with polycystic ovary syndrome (PCOS)? Non-obese Korean women with PCOS have no quantitative or qualitative changes in LDL-C profiles. Small dense LDL particles (sd-LDL) are more atherogenic than large buoyant ones and are strongly associated with coronary artery disease independent of other risk factors. Many investigators have found an increased proportion of atherogenic sd-LDL or a decreased mean LDL particle size in women with PCOS, but all of these studies have been based primarily on obese or overweight women with PCOS. This was a case-control study evaluating complete lipid and lipoprotein profiles in 64 PCOS patients and 64 age- and BMI-matched controls. All women with PCOS in our study population were not obese. To determine the differences in the LDL particle profiles between PCOS phenotypes, the patients with PCOS were divided into two subgroups according to the presence of clinical or biochemical hyperandrogenism. Using the Rotterdam criteria, we recruited 64 women (18-40 years) with PCOS who were attending a tertiary university hospital. A total of 64 premenopausal control women were matched with patients based on exact age and BMI (± 1.0 kg/m(2)). All the participants fell within the non-obese range of the BMI (<25 kg/m(2)) according to the definition of obesity for Asians. The LDL subfraction was analyzed by 3% polyacrylamide gel tube electrophoresis. Seven LDL subclasses were quantified and LDL subclasses 3-7 were small LDL subfractions. LDL subfraction scores were calculated based on the following weighted scoring system developed by the manufacturer: scores of <5.5 were categorized as phenotype A (large, buoyant LDLs), and those >5.5 were categorized as non-A phenotype (sd-LDLs). The system also determined the mean LDL particle size diameter. There were no differences in the absolute level of LDL-C, mean LDL diameter or percentage of atherogenic sd-LDLs between PCOS patients and controls or between hyperandrogenic and non-hyperandrogenic PCOS subgroups. Also, none of the subjects showed a non-A LDL phenotype. The most notable finding of our study was the difference in the lipoprotein (a) levels and prevalence of its elevation in PCOS patients versus controls (P = 0.002 and P = 0.004, respectively), and between PCOS subgroups (P = 0.030 and P = 0.047, respectively). Inclusion of only non-obese subjects, small sample size and lack of information on other potential confounding factors, such as differences in diet and/or exercise patterns. Although our findings suggest that non-obese women with PCOS have no significant quantitative or qualitative changes in LDL-C profile, data on obese Korean women with PCOS could offer complementary findings about the possible relationship between the magnitude of obesity and LDL phenotype. Further investigations are needed to determine whether a change in lipoprotein (a) in non-obese women with PCOS is also found in other ethnic groups. No conflict of interest exists. This study was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A100624). N/A.

Visfatin and adiponectin as novel markers for evaluation of metabolic disturbance in recently diagnosed rheumatoid arthritis patients

The aim is to assess metabolic disturbance in early rheumatoid arthritis patients and its relation to the clinical characteristics of patients. Forty recently diagnosed untreated rheumatoid arthritis (RA) patients with disease duration less than 1 year (group I) along with age- and sex-matched forty healthy volunteers who served as controls (group II) were studied. Disease activity score was used to assess disease activity. Blood pressure, BMI, glucose, insulin and complete lipid profile, visfatin, and adiponectin were measured. Insulin resistance (IR) was estimated by the homeostasis model assessment for insulin resistance (HOMA-IR). Beta-cell function was estimated by the homeostasis model assessment (HOMA-B). Also, rheumatoid factor, anticyclic citrullinated peptide antibodies were measured. Group I had significantly higher fasting insulin, HOMA-(IR, B), visfatin, lipid profile (except HDL), and lower adiponectin versus group II (p = 0.000). There were significant positive correlations between visfatin and the following biochemical parameters: insulin, HOMA-IR, HOMA-B, cholesterol, triglycerides, LDL-C (p = 0.05, 0.029, 0.005, 0.001, 0.002, 0.045, respectively). Also, the disease activity score was positively correlated with visfatin (p = 0.003). Meanwhile, there were significant negative correlations between adiponectin and the following biochemical parameters: insulin, HOMA-IR, HOMA-B, cholesterol, triglycerides, LDL-C, visfatin (p = 0.031, 0.023, 0.001, 0.000, 0.000, 0.016, 0.000, respectively). Also, the disease activity score was negatively correlated with adiponectin (p = 0.001). The findings of the present study showed that recently diagnosed untreated RA patients are characterized by a severe metabolic disturbance state that is driven primarily by disease activity.