Decreased HDL-cholesterol Levels Research Articles

Occupational noise and genetic variants in stress hormone biosynthesis-based genes and rates of blood lipid changes in China: A five-year longitudinal study

Lipid profiles are influenced by both noise and genetic variants. However, little is known about the associations of occupational noise and genetic variants with age-related changes in blood lipids, a crucial event in the initiation and evolution of atherosclerotic cardiovascular diseases. We aimed to evaluate the associations of blood lipid change rates with occupational noise and genetic variants in stress hormone biosynthesis-based genes. This cohort was established in 2012 and 2013 and was followed up until 2017. A total of 952 participants were included in the final analysis and all of them were categorized to two groups, the exposed group and control group, according to the exposed noise levels in their working area. Single nucleotide polymorphisms (SNPs) in stress hormone biosynthesis-based genes were genotyped. Five physical examinations were conducted from 2012 to 2017 and lipid measurements were repeated five times. The estimated annual changes (EACs) of blood lipid were calculated as the difference in blood lipid levels between any 2 adjacent examinations divided by their time interval (year). The generalized estimating equations for repeated measures analyses with exchangeable correlation structures were used to evaluate the influence of exposing to noise (versus being a control) and the SNPs mentioned above on the EACs of blood lipids. We found that the participants experienced accelerated age-related decline in high-density lipoprotein cholesterol (HDL-C) levels as they were exposed to noise (β = −0.38, 95% confidence interval (CI), −0.66 to −0.10, P = 0.007), after adjusting for work duration, gender, smoking, alcohol consumption, and pack-years. This trend was only found in participants with COMT-rs165815 TT genotype (β = −1.19, 95% CI, −1.80 to −0.58, P < 0.001), but not in those with the CC or CT genotypes. The interaction of noise exposure and rs165815 was marginally significant (Pinteraction = 0.010) after multiple adjustments. Compared with DDC-rs11978267 AA genotype carriers, participants carrying rs11978267 GG genotype had decreased EAC of triglycerides (TG) (β = −5.06, 95% CI, −9.07 to −1.05, P = 0.013). Participants carrying DBH-rs4740203 CC genotype had increased EAC of total cholesterol (TC) (β = 1.19, 95% CI, 0.06 to 2.33, P = 0.039). However, these findings were not statistically significant after multiple adjustments. These results indicated that Occupational noise exposure was associated with accelerated age-related decreases in HDL-C levels, and the COMT-rs165815 genotype appeared to modify the effect of noise exposure on HDL-C changes among the occupational population.

Anti-atherogenic role of green tea (Camellia sinensis) in South Indian smokers

Ethnopharmacological relevanceGreen tea (Camellia sinensis) is a popular beverage consumed all over the world due to its health benefits. Many of these beneficial effects of green tea are attributed to polyphenols, particularly catechins. Aim of the studyThe present study focuses on underlying anti-platelet aggregation, anti-thrombotic, and anti-lipidemic molecular mechanisms of green tea in South Indian smokers. Materials and methods: We selected 120 South Indian male volunteers for this study to collect the blood and categorised them into four groups; control group individuals (Controls), smokers, healthy control individuals consuming green tea, and smokers consuming green tea. Smokers group subjects have been smoking an average 16–18 cigarettes per day for the last 7 years or more. The subjects (green tea consumed groups) consumed 100 mL of green tea each time, thrice a day for a one-year period. ResultsLC-MS analysis revealed the presence of multiple phytocompounds along with catechins in green tea extract. Increased plasma lipid peroxidation (LPO), protein carbonyls, cholesterol, triglycerides, and LDL-cholesterol with decreased HDL-cholesterol levels were observed in smokers compared to the control group and the consumption of green tea showed beneficial effect. Furthermore, docking studies revealed that natural compounds of green tea had high binding capacity with 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA) when compared to their positive controls, whereas (−) epigallocatechin-3-gallate (EGCG) and (−) epicatechin-gallate (ECG) had high binding capacity with sterol regulatory element-binding transcription factor 1 (SREBP1c). Further, our ex vivo studies showed that green tea extract (GTE) significantly inhibited platelet aggregation and increased thrombolytic activity in a dose dependent manner. ConclusionIn conclusion, in smokers, catechins synergistically lowered oxidative stress, platelet aggregation and modified the aberrant lipid profile. Furthermore, molecular docking studies supported green tea catechins' antihyperlipidemic efficacy through strong inhibitory activity on HMG-CoA reductase and SREBP1c. The mitigating effects of green tea on cardiovascular disease risk factors in smokers that have been reported can be attributed majorly to catechins or to their synergistic effects.

AN AYURVEDIC METHODOLOGY FOR MANAGING DIABETIC DYSLIPIDEMIA - A CASE REPORT

Diabetic dyslipidemia is characterized by elevated plasma triglyceride levels, decreased HDL cholesterol levels, and an increase in small dense LDL-cholesterol particles. These lipid alterations in diabetes are linked to heightened free fatty acid flux due to insulin resistance. With the availability of various lipid-lowering medications and supplements, patients now have more options to reach target lipid levels. Lipid-lowering therapies in modern medicine, such as statins and fibrates, are generally well-tolerated with minimal side effects. However, these treatments often necessitate lifelong usage, which can impose significant financial strain, particularly in developing countries like India.In Ayurveda, dyslipidemia is understood as the manifestation of an imbalance in the Medovahasrotas.Dyslipidemia manifests as the consequent output of Medovahasrotodushti. A 31-year-old male patient presented with complaints of pain in calf muscles and weight gain. Upon investigation, his total cholesterol level was found to be elevated at 211 mg/dl, and triglycerides were elevated to 683.80 mg/dl. Giloykwath along with arjunkwath, Madhunashinivati extra power, Tablet lipidom, and Tablet Madhugrit were administered for the shaman therapy. Upon completion of the treatment, significant improvements were observed in the patients complaints. Additionally, a significant improvement was noted in the Lipid Profile.

High Growth Differentiation Factor-15 (GDF-15) in Rheumatoid Arthritis Patients Potential Risk for Cardiovascular Disease

Rheumatoid arthritis (RA) is a chronic autoimmune disorder primarily affecting joints, leading to pain, stiffness, and functional disability. The inflammatory mechanisms underlying RA also impact various organ systems, with significant implications for morbidity and mortality. In this study, we analyzed the growth differentiation factor-15 (GDF-15), a cytokine implicated in inflammation and associated with RA and cardiovascular diseases. We conducted a case-control study involving 150 RA patients and 150 healthy individuals, assessing various biomarkers (ACPA, CRP, ESR, and RF) including GDF-15, lipid profile, and inflammatory markers. Our results demonstrated significantly elevated levels of GDF-15 in RA patients (309.44 pg/ml) compared to controls (64.40 pg/ml), indicating its potential role as a biomarker for RA and cardiovascular risk (p&lt;0.001). Furthermore, RA patients exhibited dyslipidemia characterized by elevated total cholesterol, triglycerides, LDL cholesterol, and atherogenic indices, along with decreased HDL cholesterol levels, predisposing them to a higher risk of atherosclerosis and cardiovascular complications (p&lt;0.001). Correlation analyses revealed associations between GDF-15 levels, lipid profile parameters, and disease severity markers, highlighting the intricate interplay between inflammation, lipid metabolism, and RA progression. These findings demonstrated the importance of early detection and management of dyslipidemia in RA patients to mitigate cardiovascular risk. Overall, our study contributes to understanding the pathophysiology of RA and identifies potential biomarkers for disease monitoring and risk stratification.

Correlates of normal and decreased HDL cholesterol levels in type 2 diabetes: a cohort-based cross-sectional study

BackgroundThe literature describes an inverse association between the values of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C). This survey was designed to exhibit the features of people with type 2 diabetes (T2D) who display this inverse association and identify potential contributing factors to having normal HDL-C values.MethodsA total of 6127 persons with T2D were assigned to the present survey. Demographic features and clinical status data were compared between subjects with a substantial inverse association of TG and HDL-C and those without. Logistic regressions were performed to ascertain the role of different factors related to normal HDL-C. Moreover, the restricted cubic spline (RCS) functions were conducted to scrutinize the underlying relationships between the studied variables and low HDL-C levels.ResultsPatients with high TG (150 ≤ TG < 400) compared to patients with normal TG (TG < 150) were less likely to have normal HDL-C. Younger age, narrow hip, lower levels of blood pressure, two-hour postprandial glucose (2hPP), fasting blood sugar (FBS), hemoglobinA1C (HbA1C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and non-HDL-C, higher atherogenic index of plasma (AIP), and TG/HDL-C ratio correlate with an inverse connection between the values of HDL-C and TG (all P < 0.05). Age greater than 65 years (odds ratio (OR) 1.260, 95% confidence intervals (CI) 1.124-1.413) had a positive association, whereas female sex (OR 0.467, CI 0.416-0.523) , 25 kg/m2 < body mass index (BMI) (OR 0.786, CI 0.691-0.894), and higher serum creatinine levels (OR 0.481, CI 0.372-0.621) had an inverse association with having normal HDL-C.ConclusionsPatients with an inverse connection between TG and HDL-C values had considerably different anthropometric features, lipid profiles, and glucose indices compared to those without this relationship. Furthermore, patients who aged less than 65 years, had female gender, BMI more than 25 kg/m2, and higher serum creatinine levels were less likely to exhibit normal HDL-C levels.

Dyslipidemias and Obesity

The studies that initially suggested the association between obesity, dyslipidemia and coronary heart disease were population-based studies, in which the predictive factors for coronary heart disease were investigated. In a later study of this same Framingham group, it was suggested that obesity was an independent risk marker for coronary artery disease. Other reports showed that also in obese individuals the elevation of the fraction of low-density lipoprotein-LDL and the reduction of the fraction of high-density lipoproteinHDL had a positive correlation with the risk of coronary heart disease. It was also observed that triglyceridemia would have a positive correlation with the risk of coronary heart disease. Hypertriglyceridemia in the obese results from greater synthesis and less removal of triglyceride-rich lipoproteins. In the obese individual, the greater supply of free fatty acids supplied to the liver promotes the greater production of very low-density lipoprotein particles-VLDL cholesterol rich in triglycerides. The hyperinsulinemia observed in metabolic syndrome contributes to the increased formation of these particles in the hepatocyte. For the treatment of dyslipidemia associated with obesity, the patient should receive guidance to lose weight, through an adequate diet and physical exercises. Regarding the diet, there is a controversy about which carbohydrate content it should contain, since, once the fat content is decreased, an increase in the carbohydrate content may occur, favoring hyperinsulinism and postprandial hyperglycemia. In individuals undergoing a strict weight losing diet, a transient phase of increased triglyceride and total cholesterol levels and decreased HDL-cholesterol levels may occur. In some cases, it is necessary to use lipid-lowering medications, the choice of which will depend on the type of lipid alteration found and the patient's response to treatment

Association of Vitamins D, B6, and B12 Deficiencies with Hyperlipidemia Among Jordanian Adults.

Obesity is an abnormal fat accumulation that adversely affects human health. Studies reported several vitamin deficiencies in obese patients. The current study investigates the deficiencies of vitamins D, B6, and B12 among Jordanian adults with hyperlipidemia and demonstrates the association between serum vitamin levels and metabolic and lipid profile parameters. Sixty male subjects were divided into 40 hyperlipidemic patients (age: 45.9 yr. ±10.2) and 20 controls (age: 41.2 yr. ±10.7). The blood levels of triglycerides, total cholesterol, high density lipoprotein (HDL)-cholesterol, hemoglobin A1c, and vitamins D, B6, and B12 were measured. The hyperlipidemic patients showed significantly increased triglycerides, total cholesterol, non-HDL, cholesterol/HDL ratio, low-density lipoprotein (LDL)- cholesterol levels, and decreased HDL-cholesterol levels compared to the controls. No significant differences were found in the blood levels of vitamin D, vitamin B6, or vitamin B12 between groups. However, 50% of the hyperlipidemic patients and 54.5% of the controls exhibited vitamin D deficiency. Only the hyperlipidemic patients exhibited deficiencies of vitamins B6 and B12 in 5.4% and 3.3% of cases, respectively. In the controls, vitamin B12 level was inversely associated with total cholesterol, whereas in the hyperlipidemic patients, vitamin B6 level was inversely correlated with total cholesterol and non-HDL levels. The hyperlipidemic patients exhibited vitamins D, B6, and B12 deficiencies. Additionally, vitamins B6 and B12 levels were inversely correlated with total cholesterol and non-HDL levels. Our findings highlight the importance of routine evaluation of vitamin levels in patients with hyperlipidemia.

LES XANTHOMATOSES HYPERLIPIDEMIQUES: AU-DELA DE LA RARETE, QUELLE PRISE EN CHARGE ?

Xanthomas are benign pseudo tumors, often linked to a disorder of lipoprotein metabolism and which require screening.We report the case of a 33-year-old young adult, with no significant medical history, who consulted for painless yellowish nodules progressively appearing over the past year on the limbs. Cutaneous and mucosal examination reveals small smooth-surfaced nodules, orange-yellow in color, painless, non-pruritic, of varying sizes, located on the forearms, elbows, hands, knees, ears and posterior surface of the neck. The histopathological study of a skin nodule biopsy suggests lipid overload, confirming the diagnosis of xanthomas. The lipid profile, conducted after a 12-hour fast, shows hypertriglyceridemia at 10.28 g/L, hypercholesterolemia at 7.79 g/L, elevated LDL cholesterol levels at 3.64 g/L and decreased HDL cholesterol levels at 0.31 g/L. Thyroid function tests and cardiovascular investigations are unremarkable. The diagnosis of familial combined hyperlipidemia type III, according to the Fredrickson classification is established.The patient is prescribed lifestyle modifications along with treatment consisting of daily pravastatin 40mg and fenofibrate 160mg. The patients condition shows improvement with regression of these lesions.Xanthomatoses linked to familial hypercholesterolemia are very rare. This condition can significantly impact patients lives due to its complications, particularly coronary complications, despite well-managed medical treatment.

Genetic association of lipids and lipid-lowering drugs with sepsis: a Mendelian randomization and mediation analysis.

The impact of lipid-lowering medications on sepsis is still not well defined. A Mendelian randomization (MR) study was carried out to probe the causal connections between genetically determined lipids, lipid-reducing drugs, and the risk of sepsis. Data on total serum cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB), and triglycerides (TG) were retrieved from the MR-Base platform and the Global Lipids Genetics Consortium in 2021 (GLGC2021). Our study categorized sepsis into two groups: total sepsis and 28-day mortality of sepsis patients (sepsis28). The inverse-variance weighted (IVW) method was the primary method used in MR analysis. Cochran's Q test and the MR-Egger intercept method were used to assess the heterogeneity and pleiotropy. In the MR analysis, we found that ApoA-I played a suggestively positive role in protecting against both total sepsis (OR, 0.863 per SD increase in ApoA-I; 95% CI, 0.780-0.955; P = 0.004) and sepsis28 (OR, 0.759; 95% CI, 0.598-0.963; P = 0.023). HDL-C levels were also found to suggestively reduce the incidence of total sepsis (OR, 0.891 per SD increase in HDL-C; 95% CI, 0.802-0.990; P = 0.031). Reverse-MR showed that sepsis28 led to a decrease in HDL-C level and an increase in TG level. In drug-target MR, we found that HMGCR inhibitors positively protected against total sepsis (, 0.719 per SD reduction in LDL-C; 95% CI, 0.540-0.958; P = 0.024). LDL-C and HDL-C proxied CETP inhibitors were found to have a protective effect on total sepsis, with only LDL-C proxied CETP inhibitors showing a suggestively protective effect on sepsis28. In Mediated-MR, BMI exhibited a negative indirect effect in HMGCR inhibitors curing sepsis. The indirect impact of ApoA-I explained over 50% of the curative effects of CETP inhibitors in sepsis. Our MR study suggested that ApoA-I and HDL-C protected against sepsis, while HMGCR and CETP inhibitors showed therapeutic potential beyond lipid-lowering effects. ApoA-I explained the effects of CETP inhibitors. Our study illuminates how lipids affect sepsis patients and the effectiveness of new drugs, opening new avenues for sepsis treatment.

Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department.

High-density lipoprotein cholesterol (HDL-C) is reported as a biomarker of systemic inflammation and multi-organ failure (MOF), which has been rarely investigated in acute pancreatitis (AP), a frequent condition in the emergency department (ED). The objective was to study the predictive capacity of the decrease in HDL-C to the progression of MOF in AP in the ED; analyzing 114 patients with AP for one year in a longitudinal and prospective study, AP severity was obtained by the Atlanta classification, in relation to modified Marshall and Bedside Index for Severity in Acute Pancreatitis (BISAP) scores, and clinical and laboratory parameters in a 48 h hospital stay. The area under the receiver operating characteristic (ROC) curve was used to estimate the validity of the predictor and define optimal cut-off points. It was found that AP was classified as severe in 24.5%, mainly for biliary etiology (78.9%) and female sex (73.6%). As a biomarker, HDL-C decreased from 31.6 to 29.5 mg/dL in a 48 h stay (p < 0.001), correlating negatively with the increase in severity index > 2 and the modified Marshall (p < 0.032) and BISAP (p < 0.009) scores, finding an area under the ROC curve with a predictive capacity of 0.756 (95% CI, 0.614-0.898; p < 0.004) and a cut-off point of 28.5 mg/dL (sensitivity: 79%, specificity: 78%), demonstrating that the decrease in HDL-C levels serves as a useful indicator with a predictive capacity for MOF in mild to severe AP, during a 48 h hospital stay in the ED.

ASSOCIATION BETWEEN CHRONIC KHAT (CATHA EDULIS) CHEWING AND PLASMA LIPID PROFILE AMONG ADULT MALES FROM AL SHUAIB DISTRICT DHALA GOVERNURATE.YEMEN

This study aims to investigate the association between chronic khat chewing (5 to 30 years duration) and dyslipidemia among healthy males in Al Shuaib District. One hundred participants from different villages agreed to complete the study with us. In this cross sectional study sample objects 230 males were selected randomly and divided according to ages and chewing khat duration, into four groups each (n= 20) and a control group of (n=20) non khat chewers. Data were obtained using a questionnaires and fasting blood sample collected and examined for lipid profile measurements including levels of total cholesterol TC, triglyceride TG, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C).The mean levels of TC in groups D (179.5mg/dl) and E (180mg/dl) was higher significantly than control group subjects (156mg/dl). levels of HDL decreased in khat chewers; D and E groups (44.5mg/dl and 41mg/dl) respectively compared to the control group (46.4mg/dl). On the other hand, the average LDL increased in the D and E subject groups (103.4mg/dl) and (112.4mg/dl) respectively compared with control 93.8mg/dl. The level of TG was increased in all study groups A, B, D and E having statistical significance p &lt; 0.05 compared with control C. There was a higher dyslipidemia among subjects of khat chewing groups than non khat chewers in relation to increase of mean years of khat chewing. There is a significant association between chronic khat chewing and dyslipidemia especially the decrease in HDL-C level was the main lipid variable followed by TG level. The imbalanced lipid profile might be due to genetic factor or social dietary habits, besides wide spread use of pesticides during cultivation of khat plant which have toxicity in area of study.

The Triglyceride/High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio as a Risk Marker for Metabolic Syndrome and Cardiovascular Disease.

Atherosclerosis is an immunoinflammatory pathological procedure in which lipid plaques are formed in the vessel walls, partially or completely occluding the lumen, and is accountable for atherosclerotic cardiovascular disease (ASCVD). ACSVD consists of three components: coronary artery disease (CAD), peripheral vascular disease (PAD) and cerebrovascular disease (CCVD). A disturbed lipid metabolism and the subsequent dyslipidemia significantly contribute to the formation of plaques, with low-density lipoprotein cholesterol (LDL-C) being the main responsible factor. Nonetheless, even when LDL-C is well regulated, mainly with statin therapy, a residual risk for CVD still occurs, and it is attributable to the disturbances of other lipid components, namely triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). Increased plasma TG and decreased HDL-C levels have been associated with metabolic syndrome (MetS) and CVD, and their ratio, TG/HDL-C, has been proposed as a novel biomarker for predicting the risk of both clinical entities. Under these terms, this review will present and discuss the current scientific and clinical data linking the TG/HDL-C ratio with the presence of MetS and CVD, including CAD, PAD and CCVD, in an effort to prove the value of the TG/HDL-C ratio as a valuable predictor for each aspect of CVD.

Dyslipidemia And Nephropathy In Diabetes Mellitus: A Review

The prolonged increase of blood glucose give rise to complications of diabetes- premature atherosclerosis (including cardiovascular diseases and stroke), retinopathy, nephropathy and neuropathy. The lipid abnormality (dyslipidemia) associated with type 2 diabetes predominantly consists of elevated triglycerides and decreased HDL cholesterol levels. The incident of dyslipidemia in male is higher in comparison to female type 2 diabetic patients. It was also observed that type 2 diabetic patients with higher BMI has higher chance of developing dyslipidemia Diabetic nephropathy is one of the main microvascular complication of diabetes. In diabetic subjects, a major cause of morbidity and mortality is diabetic nephropathy (DN). Diabetic patients are in risk for the development of dyslipidemia and Diabetic nephropathy. Hyperglycemia causes lipid derangement and nephropathy. Elevated levels of serum cholesterol, triglycerides and lipoproteins are the main lipid derangements in diabetes which are common risk factor for coronary artery disease. It is found that elevated blood glucose levels and duration of diabetes are responsible for nephropathy and microalbuminuria. However Apo B and Lp(a) increases in the microalbuminuria and macroalbuminuria respectively.

Status and influencing factors of lower limb amputation in patients with diabetic foot ulcer.

To investigate the influencing factors of lower limb amputation in patients with diabetic foot ulcers. Patients with diabetic foot ulcers who were hospitalised in a tertiary general hospital in Guizhou Province from January 2019 to March 2022 were retrospectively collected. Sociological information of the general population, comorbidities, laboratory-related indicators, and information on the specialty situation, using univariate analysis and multifactor analysis, compared the influencing factors of amputation and non-amputee patients. A total of 205 patients with diabetic foot and 69 ampute patients (33.7%) were enrolled. The univariate analysis found that the decrease in HDL cholesterol levels was associated with the occurrence of lower extremity amputation, and logistic stepwise regression analysis showed that HDL-C was inversely correlated with the amputation rate of patients with diabetic foot ulcers, and the risk of amputation at low levels of HDL-C was 2.452 times higher than that of high-level HDL-C (95% CI: 1.105-5.846). Decreased HDL cholesterol levels are an independent predictor of amputation in patients with diabetic foot ulcers.

A study on lipid profile in thyroid dysfunction

Background: Thyroid diseases are among the most common endocrine disorders worldwide. Thyroid hormones play a key role in regulating the synthesis, metabolism, and mobilization of lipids. Levels of circulating lipids may alter in thyroid dysfunction. Aim and Objectives: The aim of the study was to find out the alterations of lipid levels in thyroid dysfunction. Materials and Methods: The study was designed as cross-sectional observational study and analysis of values was done by significant tests difference in means. 20 patients with hypothyroidism, 20 patients with hyperthyroidism, and 20 normal were participated in the study. Levels of total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), LDL-C, and LDL/HDL ratio were estimated and compared. Results: In patients with hypothyroidism, there was an increase in total cholesterol, LDL-C, and triglyceride levels and decrease in HDL-C levels. In hyperthyroidism, total cholesterol, triglycerides, LDL-C, VLDL-C, and LDL/HDL ratio were found to be significantly decreased. Conclusion: Altered thyroid function can lead to significant changes in the lipid profile. Hypothyroidism is an important risk factor for heart diseases. Hence, routine screening of thyroid hormones may be of considerable help for early intervention and treatment of thyroid dysfunction-related cardiac disease.

Carbohydrate metabolism and lipid profile in patients with Parkinson's disease with subthalamic deep brain stimulation.

Assessment of potential effect of subthalamic nucleus deep brain stimulation (STN-DBS) on glucose metabolism in patients with Parkinson's disease (PD). Although a valuable alternative to pharmacotherapy in advanced PD, STN-DBS is thought to negatively affect the cardiometabolic profile of patients (including body mass, lipid profile). Exacerbation of glucose metabolism dysregulation after DBS could therefore be assumed. Two groups of patients with Parkinson's disease were included: 20 treated pharmacologically (PHT) and 20 newly qualified for STN-DBS (DBS) - with the first assessment prior to surgery, and the second 11 months after surgery on average. Body mass index (BMI), plasma concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and glucose levels during a three-point oral glucose tolerance test were measured three times (median intervals between visits 12 and 14 months respectively). Significant differences between the two groups were noted with respect to changes in BMI, and serum concentration of TG and HDL-C over the course of the study. In the DBS group, a significant increase in BMI (26.42 vs. 27.24 kg/m2, p = 0.03) and TG level (103.8 vs. 142.8 mg/dL, p < 0.001) with a simultaneous decrease in HDL-C level (54.4 vs. 46 mg/dL, p < 0.01) was observed. Mean glucose level after oral glucose administration was lower in the DBS than in the PHT group (147.4 vs. 120.2 mg/dL, p = 0.03 after one hour and 109.9 vs. 82.3 mg/dL, p < 0.01 after two hours) during the second visit. Also inter-visit changes in fasting glucose levels (8.4 mg/dL in the PHT group and -5.8 mg/dL in the DBS group, p = 0.02) differed over the study duration. Our observations are similar to previous ones indicating less favourable changes in BMI and some lipid fractions in patients treated surgically. Interestingly, such a trend was not observed for glucose metabolism parameters, suggesting that mechanisms other than simple body mass changes are involved in early biochemical changes after STN-DBS in PD patients. The metabolic consequences of DBS require further investigation as an additional factor potentially affecting the outcome of therapy, and routine patient follow-up should not be limited to neurological and psychological assessments.

Role of psyllium (Plantago ovata) in the treatment of diabetic dyslipidemia

Diabetic dyslipidemia is a metabolic syndrome growing exponentially in number during these last decade. Unhealthy diet such as fast food and sedentary lifestyle contributes to this increasing prevalence of metabolic syndrome. Diabetic dyslipidemia is characterized with increased blood level of triglycerides, LDL cholesterol, and decreased HDL cholesterol level. In most cases, patient with diabetic dyslipidemia is asymptomatic, yet has increased chances of complications of cardiovascular disease, including stroke and myocardial infarction. Although drugs such as statin are preferred to be used as main drug of diabetic dyslipidemia, lifestyle and diet modification still plays an important role in the therapy. Psyllium (Plantago ovata), commonly added in diet, is known to have hypocholesterolemic and hypoglycemic effect. The aim of this article is to review the role and effect of psyllium in patient with diabetic dyslipidemia.

Cross-sectional study to estimate the prevalence and risk factors of nonalcoholic fatty liver disease in children and adolescents with psoriasis.

Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent comorbidity in adult patients with psoriasis, but there is a paucity of data on NAFLD in paediatric patients with psoriasis. To estimate the prevalence of NAFLD in children and adolescents with psoriasis compared with age- and sex-matched healthy controls (HCs) and to evaluate risk factors for NAFLD in paediatric psoriasis. This was a cross-sectional study performed from July 2019 to December 2020 in a single tertiary care centre, which enrolled 52 children/adolescents aged 2-18 years diagnosed with psoriasis at least 6 months previously, and 52 HCs matched for age and sex. Anthropometric, metabolic and radiological assessment was performed for all participants. NAFLD prevalence was determined by liver enzyme (serum glutamic pyruvic transferase) levels, ultrasonography, shear wave elastography and aspartate aminotransferase/platelet index. Multivariate analysis was performed to determine the independent risk factors for NAFLD. The frequency of NAFLD was found to be 28·8% in patients with paediatric psoriasis compared with 3·8% in HCs. Logistic regression showed that greater disease severity (Psoriasis Area and Severity Index ≥ 10), obesity and decreased high-density lipoprotein cholesterol (HDL-C) level were independently associated with NAFLD, and thus can be considered risk factors for NAFLD. Patients with paediatric psoriasis have a higher prevalence of NAFLD compared with HCs. Children who are obese or have moderate to severe psoriasis or decreased HDL-C levels are at a higher risk of developing NAFLD.

The clinical significance of preoperative serum triglyceride, high-density lipoprotein, and low-density lipoprotein levels in lung squamous cell carcinoma

To evaluate the prognostic role of the preoperative plasma lipid profile, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in patients with lung squamous cell carcinoma (LUSC) who underwent complete resection. Clinical data, including preoperative plasma profile levels, were retrospectively collected and reviewed in 300 patients with LUSC who underwent radical lung resection between 2016 and 2017. The overall survival (OS) and disease-free survival (DFS) were assessed by the Kaplan–Meier method and the Cox proportional hazards regression model. TG ≤ 1.35, HDL-C ≤ 1.17, and LDL-C ≤ 2.32 were deemed as independent preoperative risk factors for OS, and HDL-C ≤ 1.17 was an independent preoperative risk factor for DFS. In the multivariate analyses involving OS and DFS, a decreased HDL-C level was significantly associated with worse OS (HR, 0.546; 95% CI, 0.380–0.784, P = 0.001) and DFS (HR, 0.644; 95% CI, 0.422–0.981, P = 0.041). Additionally, an increased TG (HR, 0.546; 95% CI, 0.366–0.814, P = 0.003) or LDL-C (HR, 0.652; 95% CI, 0.456–0.933, P = 0.019) level was significantly associated with better OS. In patients with LUSC, decreased levels of HDL-C may predict worse outcomes for both DFS and OS, while increased TG or LDL-C levels may predict better OS.

Association of remnant cholesterol and lipid parameters with new-onset carotid plaque in Chinese population.

BackgroundRemnant lipoprotein cholesterol (RC) is an independent risk factor for cardiovascular disease (CVD). However, the relationships of remnant cholesterol and other conventional lipid parameters with new-onset carotid plaque are not fully understood in the Chinese community-based population.Materials and methodsA total of 872 plaque-free participants (51.39 ± 4.96 years old) with no history of CVD were included in this study. The plasma concentrations of RC were calculated by subtracting low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) from total cholesterol (TC). Multivariate regression models were used to evaluate and compare the associations between RC and other lipid parameters and new-onset carotid plaque.ResultsAfter a mean 6.77-year follow-up, the incidence of new-onset carotid plaque was 188 (21.56%). RC was significantly associated with new-onset carotid plaque [Odd ratio (OR) = 1.57 per 1 mmol/L increase, 95% confidence interval (CI): 1.03–2.41, p = 0.038]. The highest tertile of RC (T3 group) had the highest risk of new-onset carotid plaque (OR = 2.53, 95% CI: 1.63–3.95). Similar results were seen for increased other lipid parameters, but decreased HDL-C levels. When adding another lipid parameter into the adjusted model with RC simultaneously, only RC remained significantly associated with new-onset carotid plaque after adjusting for other lipid parameters (all p value < 0.005). Furthermore, RC was strongly associated with new-onset carotid plaque in participants with lower baseline LDL-C levels.ConclusionIncreased RC levels were superior to other conventional lipid parameters to be associated with new-onset carotid plaque in the Chinese community-based population. Furthermore, RC should be considered in participants with lower LDL-C levels for the purpose of early atherosclerosis prevention.