Control Of Dyslipidemia Research Articles

Hypertriglyceridemia and its impact on mitotane monitoring in adrenocortical carcinoma.

Mitotane is used for treatment of advanced adrenocortical carcinoma. It is administered when the carcinoma is unresectable, metastasized, or at high-risk of recurrence after resection. In addition, mitotane is considered to have direct adrenolytic effects. Because of its narrow therapeutic-toxic range, therapeutic drug monitoring (TDM) is warranted. In 2020, a left-sided adrenal gland tumor was found (5.8 cm) in a 38-year-old man. Considering the size of this lesion and inability to exclude an adrenocortical carcinoma on imaging, a laparoscopic adrenalectomy was performed. Histopathologic examination determined presence of an adrenocortical carcinoma (pT2N0M0 ENSAT stadium II; ki67 10-15%). There was no evidence for residual or metastatic disease but given the high risk of recurrence, adjuvant therapy with mitotane was initiated. During TDM, a sudden and spuriously high level of mitotane was observed but without signs or symptoms of toxicity. After exploration, it was found that this high concentration was completely due to uncontrolled hypertriglyceridemia. After correction thereof, mitotane levels were again in the therapeutic range. This observation underscores the importance of TDM sampling in a fasting state with concurrent control of prevalent or incident dyslipidemia. TDM of mitotane is advocated to achieve therapeutic levels while avoiding toxicity. For correct TDM, sampling should be done at least 12 h after last intake of mitotane. Although sampling in fasting conditions in not explicitly mentioned in the guidelines, fasting state should be considered as elevated serum triglyceride levels might cause spuriously high mitotane levels. In patients undergoing treatment with mitotane and presenting with too high or unexplained fluctuating mitotane levels without signs or symptoms of toxicity, hypertriglyceridemia as a possible cause should be investigated. If dyslipidemia occurs in patients under mitotane treatment, other causes than mitotane (e.g. alcohol abuse and diabetes) should be considered and appropriate treatment should be initiated.

Cardiovascular Risk Scores among Asymptomatic Adults with Haemophilia.

The mortality rate of Brazilian people with haemophilia (PwH) is decreasing, but the relative incidence of deaths associated with cardiovascular disease (CVD) is increasing. We aimed to describe the CVD risk score of PwH according to Pooled Cohort Equations Risk (PCER) Calculator tool and its treatment recommendations. We also compared the PCER estimates with the respective Framingham Risk Score (FRS). This cross-sectional study included male PwH ≥ 40 years treated at the Comprehensive Haemophilia Treatment Centre of Pernambuco (Recife/Brazil). PwH with a previous CVD event or a low-density lipid cholesterol ≥ 5.0 mmol/L were excluded. Interviews, medical file reviews, and blood tests were performed. The PCER tool was used to estimate the CVD risk and compare it with the respective FRS. A p-value < 0.05 was accepted as statistically significant. Thirty PwH were included. Median age was 51.5 [interquartile range-IQR; 46.0-59.5] years. The prevalence of obesity, systemic arterial hypertension, diabetes mellitus, hypertriglyceridaemia, hypercholesterolaemia, and hypoHDLaemia were 20%, 67%, 24%, 14%, 47%, and 23%, respectively. The median PCER score was 6.9% [IQR; 3.1-13.2], with 50% having a high risk (PCER ≥ 7.5%). Statin use was suggested for 54% of PwH. Blood pressure was poorly controlled in 47% of PwH. The agreement between PCER and FRS was 80% (κ = 0.60; p = 0.001). Half of the male people with haemophilia aged 40 years or older had a 10-year high risk of developing CVD with strong recommendations to improve control of dyslipidaemia and blood pressure.

Hypercholesterolaemia control in Spain: The same situation with different regional realities

Introduction and objectivesThe cardiovascular prevention strategy by autonomous communities can be variable since the competences in health are transferred. The objective of the study was to determine the degree of dyslipidaemia control and the lipid-lowering pharmacological therapy used in patients at high/very high cardiovascular risk (CVR) by autonomous communities. MethodsObservational, cross-sectional, descriptive study based on a consensus methodology. Information on the clinical practice of 145 health areas belonging to 17 Spanish autonomous communities was collected through face-to-face meetings and questionnaires administered to the 435 participating physicians. Furthermore, aggregate non-identifiable data were compiled from 10 consecutive dyslipidaemic patients that each participant had recently visited. ResultsOf the 4,010 patients collected, 649 (16%) had high and 2,458 (61%) very high CVR. The distribution of the 3,107 high/very high CVR patients was balanced across regions, but there were inter-regional differences (P < 0.0001) in the achievement of target LDL-C<70 and <55 mg/dL, respectively. High-intensity statins in monotherapy or in combination with ezetimibe and/or PCSK9 inhibitors were used in 44, 21 and 4% of high CVR patients, while in those at very high CVR it rose to 38, 45 and 6%, respectively. The use of these lipid-lowering therapies at national level was significantly different between regions (P = 0.0079). ConclusionsEven though the distribution of patients at high/very high CVR was similar between autonomous communities, inter-territorial differences were identified in the degree of achievement of LDL cholesterol therapeutic goal and use of lipid-lowering therapy.

Poor control of modifiable cardiovascular risk factors among Congolese patients in the acute and sequelae phase of stroke : A cross-sectional study

PurposeTo assess the level of the control of the cardiovascular risk factors in patients with a history of stroke in the Democratic Republic of the Congo. MethodsThe level of the control of arterial hypertension, diabetes mellitus, and dyslipidemias was analyzed in two hundred and seventy-four (274) patients followed for stroke. ResultsAmong 188 patients with a prior diagnosis of arterial hypertension, only 100 (53.2%) were treated, 27 (27.0%) had their blood pressure well controlled [12.3% in acute stroke vs. 46.5% in sequelae phase; p = 0.0002]. Among 42 (71.2%) diabetics treated, 23 (63.9%) had glycaemia levels > 200 mg/dl, 60.0% in acute phase and 83.3% in sequelae phase (p = 0.28). Finally, 87.0% of the patients had a non-HDL-C > 85 mg/dl. ConclusionsThis study shows a poor control of modifiable cardiovascular risk factors in patients with very high cardiovascular risk due to stroke. There is a need for an effective program to combat non-communicable diseases in our environment.

Gliflozins, Erythropoietin, and Erythrocytosis: Is It Renal Normoxia- or Hypoxia-Driven?

The introduction of gliflozins in the management of type 2 diabetes mellitus leads to a better control of hyperglycemia, obesity, hypertension, dyslipidemia, and fluid retention. Most importantly, it also improves renal survival and reduces major cardiovascular events and mortality. Gliflozins were also found to induce erythropoietin (EPO) synthesis, leading to reticulocytosis and erythropoiesis. The mechanism(s) by which gliflozins induce erythropoiesis is a matter of debate. Although the canonical pathway of triggering EPO synthesis is through renal tissue hypoxia, it has been suggested that improved renal oxygenation may facilitate EPO synthesis via non-canonical routes. The latter proposes that the recovery of peritubular interstitial fibroblasts producing erythropoietin (EPO) is responsible for enhanced erythropoiesis. According to this hypothesis, enhanced glucose/sodium re-uptake by proximal tubules in uncontrolled diabetes generates cortical hypoxia, with injury to these cells. Once transport workload declines with the use of SGLT2i, they recover and regain their capacity to produce EPO. In this short communication, we argue that this hypothesis may be wrong and propose that gliflozins likely induce EPO through the documented intensification of renal hypoxia at the corticomedullary junction, related to the translocation of tubular transport from cortical segments to medullary thick ascending limbs. We propose that gliflozins, through intensified hypoxia in this region, trigger local EPO synthesis in peritubular interstitial cells via the canonical pathway of blocking HIF-prolyl hydroxylases (that initiate HIF alpha degradation), with the consequent stabilization of HIF-2 signal and an apocrinic induction of EPO in these same cells.

Prevalence, awareness, treatment, and control of dyslipidemia in Chinese adults: a systematic review and meta-analysis.

Researchers have conducted a considerable number of epidemiological studies on dyslipidemia in China over recent years. Nevertheless, a representative study to comprehensively appraise for the epidemiological status of dyslipidemia is still lacked. This meta-analysis is intended to explore the pooled prevalence, rates of awareness, treatment, and control of dyslipidemia among adults in Chinese Mainland. A systematic review was performed on relevant cross-sectional studies published since January 2012 by searching six authoritative literature databases. Meta-analyses were conducted in included studies based on a random-effect model to summarize the epidemiological status of dyslipidemia in China. A potential source of heterogeneity was detected by subgroup analysis and meta-regression. Publication bias was assessed by Egger's test and funnel plots. A sensitivity analysis was conducted to examine the study quality's influence on the pooled estimate of prevalence and rates of awareness, treatment, and control. Forty-one original researches with a total of 1,310,402 Chinese participants were finally included in the meta-analysis. The prevalence, rates of awareness, treatment, and control of dyslipidemia were 42.1%, 18.2%, 11.6%, and 5.4%, respectively. With a pooled prevalence estimate at 24.5%, low HDL-C was the most prevalent among various dyslipidemia types, followed by hypertriglyceridemia (TG) (15.4%), hypercholesterolemia (TC) (8.3%), and high LDL-C (7.1%). The pooled prevalence of elevated serum lipoprotein(a) [Lp(a)] was 19.4%. By gender, the prevalence of dyslipidemia was 47.3% in males and 38.8% in females. Subgroup analyses revealed that the prevalence in southern and urban areas were higher than their counterparts. Females and population in urban areas tended to possess higher rates of awareness, treatment, and control. Meta-regression analyses suggested that the year of screening influenced prevalence estimates for dyslipidemia. The impact of the study's quality on the pooled estimates is insignificant. Our study suggested a severe epidemic situation of dyslipidemia among adults in Chinese Mainland. More importantly, the awareness, treatment, and control rates were extremely low, revealing that dyslipidemia is a grave health issue. Consequently, we should attach more importance to the management of dyslipidemia, especially in economically underdeveloped areas. PROSPERO [CRD42022366456].

THE MEDITERRANEAN DIET AND GLYCEMIC REGULATION IN PATIENTS WITH DYSLIPIDEMIA AND DIABETES MELLITUS TYPE 2

Objective: The Mediterranean diet is considered a cornerstone in the regulation of the person with dyslipidemia and diabetes mellitus. The aim of the study is to record the eating habits of patients with dyslipidemia and type 2 diabetes mellitus and to correlate these habits with their regulation. Design and method: This study involved 948 patients (490 men and 458 women with an average age of 61.6±7 years). A registration questionnaire was used for their demographic, somatometric data, their eating habits, their medication and patients’ compliance with them was reassessed with a review after six months. Results: The duration of dyslipidemia was 12.7±14.2 years and DM2 was 12.8±14.4 years. The mean value of glycosylated hemoglobin was (HbA1c) 6.73±2.55%, with 57.1% of patients having HbA1c less than 7%. The body mass index (BMI) was 32.6±6.85 in both sexes (p = 0.440). 66.8% of patients were overweight, and obese with women having higher rates. 87.1% of patients consume breakfast, fruits more than 7 times a week consume 33.1%, vegetables at least 2 times 53.6%, meat 2 times 42%, fish 1 time 46.8%, legumes 65%, chicken 2 times 29.1% and sweets consume 16.6% of patients. A positive association with the regulation of dyslipidemia and DM2 is shown by the consumption of balanced breakfast (p = 0.001) and the presence of 2 main meals in the daily schedule (p = 0.008). The high consumption of junk food (p = 0.009), the consumption of soft drinks (p = 0.056) and the consumption of sweets (p&lt; 0.001) had a negative impact. 27% of patients were in higher education, 43.5% in secondary education, and 31.5% in basic education. Insufficient control of dyslipidemia was in 60,5% of patients. The prevalence of metabolic syndrome was found to be less in those who followed the Mediterranean diet. Conclusions: The eating habits of people with dyslipidemia and DM2 affect their regulation having a positive effect especially on glycemic regulation. The adoption of the Mediterranean diet is accompanied by a reduction in the risk of developing metabolic syndrome.

The effects of high-load and low-load resistance training on insulin resistance, lipids and inflammation in coronary artery disease patients

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Javna agencija za raziskovalno dejavnost Republike Slovenije. Background Prevalence of diabetes and dysmetabolism is high in patients with coronary artery disease (CAD), therefore, the combination of resistance training (RT) and aerobic training (AT) is advised to provide optimal control of insulin metabolism, dyslipidaemia, and inflammation. Since previous studies examined only the effects of low load (LL) to moderate load resistance training (RT) (&amp;lt;60% of one repetition maximum [1-RM]), the effects of high load (HL) RT remains to be investigated. Purpose This study aimed to examine the effects of HL-RT and LL-RT combined with AT in comparison to solely AT on insulin resistance, lipids, and inflammation in patients with CAD. Methods Seventy-nine patients with CAD were randomised to combined AT and LL-RT (30%-40% of 1-RM), combined AT and HL-RT (70%-80% of 1-RM) or AT alone (50%-80% of peak power output). The study was completed by 59 patients, with [mean (SD)] age = 61 (8) years, height = 172.1 (8.4) cm, weight = 85.47 (15.43) kg and left ventricular ejection fraction = 53 (9) %. Patients in all three groups performed the same progressive AT consisted of 3-5 min of work-load interval cycling separated by 2 min of unloaded cycling progressing from 50% to 80% maximal workload achieved at baseline cardiopulmonary exercise test. In RT groups, the training load progressed from 70% of 1-RM (6–11 reps/set) to 80% of 1-RM (6–8 reps/set) in HL-RT group and from 35% of 1-RM (12–22 reps/set) to 40% of 1-RM (12–16 reps/set) in LL-RT group in the first seven weeks of the intervention. After 1-RM re-evaluation, training load progressed from 70% 1-RM (11 reps/set) to 80% 1-RM (6–8 reps/set) in HL-RT group, and from 35% 1-RM (22 reps/set) to 40% 1-RM (12–16 reps/set) in LL-RT group. We collected blood samples after overnight fast (≥10 hours) at baseline (prior to first training session) and post-training (prior to last training session) for analysis of glucose, insulin, homeostatic model of insulin resistance, total cholesterol, triglycerides, HDL and LDL cholesterol and C-reactive protein levels. Results Two-way analysis of variance showed only significant time effect on total cholesterol and LDL cholesterol (both p &amp;lt; 0.001) and C-reactive protein (p = 0.017), while there was no significant effect of time x group interaction on any of the blood biomarkers. When compared with baseline, total cholesterol and LDL levels were significantly lower after AT (total cholesterol: -0.4 mmol/l, p = 0.013; LDL: -0.4 mmol/l, p = 0.006) and HL-RT (total cholesterol: -0.5 mmol/l, p = 0.002; LDL: -0.5 mol/l, p = 0.002). In addition, there was a borderline decrease in triglycerides (AT group: -0.18 mmol/l, p = 0.053), glucose (LL-group: -0.6 mmol/l, p = 0.065) and C-reactive protein (HL-RT group: -0.9 mmol/l, p = 0.069) levels. Conclusions The combination of AT and RT, regardless of the RT load, was not superior to AT alone in improvement of insulin and lipids metabolism, and inflammation in patients with CAD.

Trends and determinants of prevalence, awareness, treatment and control of dyslipidaemia in canton of Geneva, 2005–2019: Potent statins are underused

We assessed 1) trends in prevalence, awareness, treatment and control rates of dyslipidaemia and associated factors, 2) the effect of statin generation/potency on control levels and 3) the effect of ESC lipid guidelines, on lipid management. Data from multiple cross-sectional, population-based surveys conducted between 2005 and 2019 in the canton of Geneva, Switzerland, were used. Prevalence, awareness, treatment and control rates of dyslipidaemia were 46.0% and 34.9% (p < 0.001), 67.0% and 77.3% (p = 0.124), 40.0% and 19.9% (p < 0.001), and 68.0% and 84.0% (p = 0.255), in 2005 and 2019, respectively. After multivariable adjustment, only the decrease in treatment rates was significant. Increasing age, higher BMI, history of hypertension or diabetes were positively associated with prevalence, while female sex was negatively associated. Female sex, history of diabetes or CVD were positively associated with awareness, while increasing age was negatively associated. Increasing age, smoking, higher BMI, history of hypertension, diabetes or CVD were positively associated with treatment, while female sex was negatively associated. Female sex was positively associated with control, while increasing age was negatively associated. Highly potent statins increased from 50.0% to 87.5% and third generation statins from 0% to 47.5% in 2009 and 2015, respectively. Increased statin potency was borderline (p = 0.059) associated with dyslipidaemia control. ESC guidelines had no effect regarding the prescription of more potent or higher generation statins. We conclude that in the canton of Geneva, treatment of diagnosed dyslipidaemia is low, but control is adequate. Women are undertreated but better controlled than men. The most potent hypolipidemic drugs are underused.

Geographic Variations in the Prevalence, Awareness, Treatment, and Control of Dyslipidemia among Chinese Adults in 2018–2019: A Cross-sectional Study

ObjectiveTo investigate the spatial patterns of the prevalence, awareness, treatment, and control rates of dyslipidemia at the provincial level in China. MethodsA national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in mainland China in 2018–2019, using a multi-stage, stratified, cluster-randomized sampling design. Subjects, as households, were selected, followed by a home visit to collect information. Both descriptive and linear regression procedures were applied in the analyses. ResultsThe overall prevalence of dyslipidemia was 35.6%, and wide geographic variations of prevalence, treatment, and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1 ± 13.8 years. The highest-lowest difference regarding the provincial level prevalence rates were 19.7% vs. 2.1% for high low-density lipoprotein cholesterol, 16.7% vs. 2.5% for high total cholesterol, 35.9% vs. 5.4% for high triglycerides, and 31.4% vs. 10.5% for low high-density lipoprotein cholesterol. The treatment rate of dyslipidemia was correlated with the socio-demographic index (P < 0.001), urbanization rate (P = 0.01), and affordable basic technologies and essential medicines (P < 0.001). ConclusionPrevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence, treatment, and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.

Clinical effect of carotid stenting on cognitive abilities - possible evaluation using candidates for biomarkers.

Micro- and macrovascular consequences of atherosclerosis, arterial hypertension, dyslipidemia, and smoking can affect neurotransmission and markers for neuronal activity. The potential direction and specifics are under study. It is also known that optimal control of hypertension, diabetes, and dyslipidemia in midlife may positively affect cognitive functioning later in life. However, the role of hemodynamically significant carotid stenoses in neuronal activity markers and cognitive functioning is still being debated. With the increased use of interventional treatment for extracranial carotid disease, the question of whether it might affect neuronal activity indicators and whether we can stop or even reverse the path of cognitive deterioration in patients with hemodynamically severe carotid stenoses naturally emerges. The existing state of knowledge provides us with ambiguous answers. We sought the literature for possible markers of neuronal activity that can explain any potential difference in cognitive outcomes and guide us in the assessment of patients throughout carotid stenting. The combination of biochemical markers for neuronal activity with neuropsychological assessment and neuroimaging may be important from practical point of view and may provide the answer to the question for the consequences of carotid stenting for long-term cognitive prognosis.

Control de la hipercolesterolemia en España: una misma situación con diferentes realidades autonómicas

Introduction and objectiveThe cardiovascular prevention strategy by autonomous communities can be variable since the competences in health are transferred. The objective of the study was to determine the degree of dyslipidaemia control and the lipid-lowering pharmacological therapy used in patients at high/very high cardiovascular risk (CVR) by autonomous communities. MethodsObservational, cross-sectional, descriptive study based on a consensus methodology. Information on the clinical practice of 145 health areas belonging to 17 Spanish autonomous communities was collected through face-to-face meetings and questionnaires administered to the 435 participating physicians. Furthermore, aggregate non-identifiable data were compiled from 10 consecutive dyslipidaemic patients that each participant had recently visited. ResultsOf the 4010 patients collected, 649 (16%) had high and 2458 (61%) very high CVR. The distribution of the 3107 high/very high CVR patients was balanced across regions, but there were inter-regional differences (P<.0001) in the achievement of target LDL-C <70 and <55mg/dL, respectively. High-intensity statins in monotherapy or in combination with ezetimibe and/or PCSK9 inhibitors were used in 44, 21 and 4% of high CVR patients, while in those at very high CVR it rose to 38, 45 and 6%, respectively. The use of these lipid-lowering therapies at national level was significantly different between regions (P=.0079). ConclusionsEven though the distribution of patients at high/very high CVR was similar between autonomous communities, inter-territorial differences were identified in the degree of achievement of LDL cholesterol therapeutic goal and use of lipid-lowering therapy.

Investigation of risk factors associated with impaired glucose regulation: Using the momentum equation to assess the impact of risk factors on community residents.

To identify risk factors for impaired glucose regulation (IGR) and assess their impact on community residents, this study used a questionnaire to conduct cross-sectional surveys and analysis. Overall, 774 residents of an urban community in northern China (Jian city) participated in this study. Trained investigators conducted surveys using questionnaires. Based on their medical history, respondents were divided into three glucose status groups as follows: normal (NGT), IGR, and diabetes mellitus (DM). Statistical analysis of survey data was performed using SPSS v. 22.0. Age, hypertension, family history of diabetes (FHD), dyslipidemia, obesity, and cardiovascular and cerebral disease (CVD) were positively correlated with IGR in men and women. IGR was negatively correlated with a sedentary lifestyle in men and positively correlated with being overweight in women. The number of type 2 diabetes mellitus (T2D) risk factors per subject was positively correlated with age in the NGT group. Glucose status deteriorated with increasing age and the number of risk factors. FHD was the strongest risk factor in both men and women. Prevention of IGR includes weight control, physical activity, and prevention of hypertension and dyslipidemia, especially in subjects with FHD.

Control of diabetes, hypertension, and dyslipidemia in Jordan: a cross-sectional study

A cross-sectional study of 1200 Jordanian type 2 DM patients was included in this study during the period of December 2017-December 2018. We reviewed the charts of these patients until January 2020. Data obtained from medical records included information about sociodemographic variables, anthropometric measurements, glycated hemoglobin (HbA1c), BP, low-density lipoprotein (LDL), the presence of DM complications, and treatment. The percentage of subjects who had HbA1c values of less than 7% was 41.7%. BP targets (<140/90 and 130/80 mmHg) were achieved in 61.9 and 22% of our patients, respectively. LDL targets less than 100 and 70 mg/dl or less were achieved in 52.2 and 15.9% of our studied population. Only 15.4% of our patients could have simultaneous control of HbA1c less than 7%, BP less than 140/90 mmHg, and LDL less than 100 mg/dl. Factors associated with poor glycemic control were obesity [odds ratio (OR)=1.9], DM duration between 5 and 10 years or more than 10 years (OR=1.8 and 2.5, respectively), and the use of a combination of oral hypoglycemic agent plus insulin or insulin alone (OR=2.4 and 6.2, respectively). Moreover, factors associated with uncontrolled BP (≥140/90) were male gender (OR=1.4), age 50-59 years or at least 60 years (OR=3.3 and 6.6, respectively), overweight and obesity (OR=1.6 and 1.4, respectively), insulin use (OR=1.6), and LDL at least 100 mg/dl (OR=1.4). The overall prevalence of poor glycemic control was high and alarming. Future research should focus on capturing all variables that may impact glycemic, BP, and dyslipidemia control, with special emphasis on a healthy lifestyle that would be of great benefit in this control.

THE INHIBITION EFFECT OF MORINGA (Moringa oleifera L.) LEAVES AND RED GINGER RHIZOME (Zingiber officinale Rosc.) PT. "P" ETHANOL EXTRACT ON ENHANCEMENT SERUM CREATININE LEVELS OF MALE WISTAR RATS DYSLIPIDEMIA MODEL

The elevation of serum creatinine levels can be used as a biomarker of decreased kidney function. Dyslipidaemia is one of the causes of decreased kidney function. Long-term consuming statins has been shown to lower cholesterol levels but can increase serum creatinine levels. Moringa leaves (Moringa oleifera L.) and red ginger rhizomes (Zingiber officinale Rosc.) have antioxidant effects. The aim of this study was to determine the inhibitory effect on increasing serum creatinine levels of the concoction Moringa Leaves and Red Ginger Rhizome extract (CML-RGRE). This True Laboratory Experimental Study with Completely Randomized Design was conducted on 30 male Wistar rat dyslipidemia models, induced by high-fat feeding (HFF) and Propylthiouracil (PTU) 0.01% for 21 days. The subjects were divided into 6 groups (n=5), during treatment all subjects were still given HFD and PTU. Groups I, II, III were treated with CML-RGRE dose 135, 202.5, 270 mg/kg BW, IV as dyslipidemia control no added any treatment, comparison control groups V treated with 1.8 mg/kg BW and VI with fenofibrate 5.4 mg/kg BW. Serum creatinine levels (mg/dL) of all subjects were measured after 7 days acclimatization, after creating dyslipidemia models, and after 21 days treatment by using a spectrophotometer with colorimetric kinetic methods. Data of decreased serum creatinine levels were analyzed using ANOVA test, followed by Fischer's LSD, ? = 0.05. All doses of CML-RGRE were very effectively inhibited the increase of serum creatinine levels (p &lt; 0.01). The concoction Moringa leaves, and Red Ginger Rhizome ethanol extract has effectively inhibited the increase of serum creatinine levels of animal dyslipidemia models.

Profile of dyslipidemia among attendees of preventive OPD in a tertiary care hospital in district Ghaziabad - A Cross sectional study

BACKGROUND: Cardiovascular diseases (CVD) are the major cause of morbidity and mortality in our society with Dyslipidemia contributing significantly to atherosclerosis. OBJECTIVE: To find proportion and distribution of Dyslipidemia among the apparently healthy young adult visiting the preventive OPD of a tertiary care Hospital. MATERIAL AND METHODS: The study was conducted for a period of 2 months --from 1st May 2022 to 30th June 2022. Based on inclusion and exclusion criteria 400 subjects (250 males and 150 females) with &gt; or =40 age group were selected from a total no. of patients who had attended preventive OPD run by department of community medicine at Santosh medical college and hospital Ghaziabad. RESULTS: The total proportion of Dyslipidemia was found to be 23.75% among total study participants. The proportion of Dyslipidemia was observed to be higher in males than in females. Among participants who had a total Cholesterol (TC) concentration &gt; or = 200 mg/dl, 44.8% were males and 24.8% were females. High density lipoprotein cholesterol (HDL-C) was abnormally low in 65.2% males and 34.7% in females. Isolated Low-density lipoprotein-C was abnormally high (&gt;100 mg/dl) in 28% of males and 24.7% of females. Deranged levels of Total Cholesterol, Triglycerides and LDL levels found 24.8% in males and 22.6% in females. CONCLUSION: There is significant proportion of Dyslipidemia in healthy adults which indicates that there is a need for awareness programs for the prevention and control of Dyslipidemia.

Utilization of Hypolipidemic Drugs, Patterns, and Factors Affecting Dyslipidemia Among Type 2 Diabetes Mellitus at a Tertiary Care Teaching Hospital in South India.

Background The prevalence of dyslipidemia is higher in type 2 diabetes mellitus (T2DM) and hypolipidemic drugs like statins are effective for the primary and secondary prevention of cardiovascular events. Most of the patients with type 2 diabetes have a mixed type of dyslipidemia. This study aimed to evaluate the utilization of hypolipidemic drugs, patterns, and factors affecting dyslipidemia in T2DM participants. Methods This cross-sectional observational study was approved by the institutional ethics committee (IEC) of the Vydehi Institute of Medical Sciences and Research Center. It was conducted for a period of one year from July 2021 to June 2022. Participants with T2DM visiting the Department of General Medicine and Endocrinology were enrolled after obtaining informed consent. Demographic details, medication history, and laboratory data were recorded in case report form and statistical measures were applied. Results Out of 237 participants enrolled in the study,the predominance (n=133, 56%) was males. The mean age of the study population was 47.92±9.17 years, and the mean duration of diabetes was 6.8±5.3 years. Out of the total participants, 164 (69%) had deranged lipid profiles. Out of them, 129 (78.65%) were on hypolipidemic drugs. Regarding drug utilization, 122 (94.6%) received statins either rosuvastatin (54%) or atorvastatin (40%). In the deranged lipid profilespattern, 24% (58) participants had oneabnormal lipid parameter and the majority 70% (166) had combined lipid profile abnormality. Factors like increased BMI were significantly associated with dyslipidemia(p=0.004). Utilization of hypolipidemic drugs was also significantly associated with the control of dyslipidemia (p<0.001). It was observed that participants who were not on lipid-lowering drugs had 5.38 times more chance ofdyslipidemia (OR=5.38; CI=2.82-10.28; p<0.001). Conclusion A high prevalence of dyslipidemia was observed among diabetic patients. Statins were the most prescribed drug in the study.BMI and lack of pharmacotherapy were found to have a statistically significant association with dyslipidemia in diabetic patients.

Association of clinical and genetic risk factors with management of dyslipidaemia: analysis of repeated cross-sectional studies in the general population of Lausanne, Switzerland

ObjectivesTo assess the importance of clinical and genetic factors in management of dyslipidaemia in the general population.DesignRepeated cross-sectional studies (2003–2006; 2009–2012 and 2014–2017) from a population-based cohort.SettingSingle centre in Lausanne,...

Atherogenic Dyslipidemias: Unmet Needs and the Therapeutic Potential of Emerging and Novel Approaches and Drugs.

Innovative lipid-modifying agents are valuable resources to improve the control of atherogenic dyslipidemias and reduce the lipid-related residual cardiovascular risk of patients with intolerance or who are not fully responsive to a consolidated standard of care (statins plus ezetimibe). Moreover, some of the upcoming compounds potently affect lipid targets that are thus far considered "unmodifiable". The present paper is a viewpoint aimed at presenting the incremental metabolic and cardiovascular benefits of the emerging lipid-modulating agents and real-life barriers, hindering their prescription by physicians and their assumption by patients, which need to be worked out for a more diffuse and appropriate drug utilization.

Diabetic retinopathy relates to the incidence of foot ulcers and amputations in type 2 diabetes.

We investigated whether Diabetic Retinopathy (DR) is related to Diabetic Foot Ulcer (DFU) development, adjusted for the stratification of the International Work Group on Diabetic Foot (IWGDF) guidance. DR and IWGDF stratification was registered retrospectively in patients hospitalised from 2009 to 2017 for uncontrolled and/or complicated type 2 diabetes. New DFUs were registered until 2020. Survival analyses categorised the subjects for DR, and multivariate Cox regression adjusted for confounders. The 522 patients (57.9% male) were 62±9years old with a diabetes duration of 14±10years, HbA1c of 8.7±1.8%, 33.9% macroangiopathies and 44.8% diabetic kidney diseases. Their grades of DFU risk were 0 for 43.3%, 1 for 23.9%, 2 for 7.1%, and 3 for 25.6%. During the 52months follow-up (Inter Quartile Range: 32-71), 58 new DFUs and 18 lower-limb amputations occurred, mostly in patients with DR present in 140 (26.8%) patients. Adjusted for age, sex and conventional risk factors (duration and control of diabetes, arterial hypertension, and dyslipidemia), and other complications (macroangiopathy and diabetic kidney disease), DR was associated with a greater incidence of DFUs. Adjusted for the IWGDF classification, DR was related to new DFUs (HR: 2.51, 95%Confidence Interval [CI]: 1.48-4.26) and amputations (HR: 3.56, 95%CI: 1.26-10.07). This relationship persisted in ascending IWGDF grades with incidences of DFUs from 2/1000 (grade 0, no DR) to 121/1000 patient-years (grade 3 and DR) and amputations from 0 (grade 0, no DR) to 38/1000 patient-years (grade 3 and DR). Diabetic retinopathy independently relates to the incidence of foot ulcers and amputations in patients hospitalised for type 2 diabetes.