Differences In Low-density Lipoprotein Research Articles

High-Throughput Sequencing Technology Assisted Investigation of the Correlation Between Intestinal Flora, Serum Biochemistry, Blood Lipids, and Tumour Markers in Patients with Gastric Cancer and Healthy Plateau Residents.

The goal is to use high-throughput sequencing technology to compare and study the structure and variety of intestinal flora in people with gastric cancer and healthy people in the Qinghai-Tibet Plateau. Recent research has connected gut flora structure to numerous disorders. Metabolites, endotoxins, and immunomodulatory modulation might cause gastrointestinal or other systemic diseases and affect gastric cancer treatment and prognosis. We used the correlation study to uncover biomarkers associated with good intestinal flora and gastric cancer groups on the plateau to investigate their involvement in gastric cancer development. To investigate the possible links between intestinal flora and gastric cancer in the Qinghai Plateau region using a variety of clinical phenotypic data and to investigate the flora that may be linked to gastric cancer. The 22 Qinghai Province tertiary hospital gastric cancer patients and 30 healthy people had their fresh faeces collected. To examine intestinal flora diversity and composition, 52 patients underwent 16S rDNA high-throughput gene sequencing of intestinal bacteria. The correlation between clinical phenotypes and the top 15 dominant intestinal flora at the phylum level was analyzed. The difference in total protein TP between the healthy group and the gastric cancer group was statistically significant (P<0.001). Globulin was significantly different (P<0.05), TC of total cholesterol was significantly different (P<0.05). High-density lipoprotein showed statistical significance (P<0.05).The difference in low-density lipoprotein was statistically significant (P<0.001). Alphafetoprotein was significantly different (P<0.05). CA72-4 carbohydrate antigen (P<0.05). There were significant differences in total protein, globulin, total cholesterol, high density lipoprotein, low-density lipoprotein, alpha-fetoprotein and carbohydrate antigen CA72-4 in patients with gastric cancer in the plateau area compared with the healthy group, and the different clinical variables were correlated with intestinal flora at some phylum and genus levels.

The correlation of lipid profile with subclinical and overt hypothyroidism: A cross-sectional study from Syria.

We proceeded with this study to investigate the relationship between hypothyroidism and lipid profile disturbance. A cross-sectional study at Al- Mowasat University Hospital in Damascus was conducted from March 2021 to March 2022, and included 324 adults. For each participant with abnormal thyroid stimulating hormone (TSH), free thyroxine (FT4) was requested. The participants were categorized into 3 groups: euthyroid (226 participants), subclinical hypothyroidism (SCH) (75 participants), and overt hypothyroidism (23 participants). Fasting lipid profile was tested as: cholesterol (Chol), triglycerides (TG), low density lipoprotein (LDL), and high density lipoprotein (HDL). A significant relationship between hypothyroidism and dyslipidemia was noticed. LDL, TG, and Chol but not HDL showed a significant difference between study groups (euthyroidism, subclinical, and overt hypothyroidism). The lowest levels of these parameters were in euthyroidism and increased in subclinical and overt hypothyroidism subsequently. Overt hypothyroidism showed a significant difference in LDL, TG, and Chol compared to euthyroidism, however, we did not find a difference in lipid parameters in SCH compared to euthyroidism. LDL and Chol showed significant differences between subclinical and overt hypothyroidism. TSH had a positive weak correlation with LDL, TG, and Chol, however, there was no correlation with HDL. Also, FT4 had a negative weak correlation with LDL, TG, and Chol, however, there was a positive correlation with HDL. Our findings suggest a higher level of lipids (LDL, TG, and Chol) among SCH and overt hypothyroidism compared to general population. A weak correlations of lipid parameters with TSH and FT4 were detected. It is not well evident whether a restoration of euthyroidism might influence the morbidity and mortality, especially cardiovascular comorbidities, in this population, which mandates future studies.

Association of statin use and increase in lipoprotein(a): a real-world database research

BackgroundThere is an increased concern that statins may have an unintended effect of elevated lipoprotein(a) [Lp(a)]. We conducted a large sample real-world study to test the association.MethodsThis retrospective cohort study was conducted using data from an integrated SuValue database, which includes 221 hospitals across China covering more than 200,000 of population with longitudinal follow-up to 10 years. Propensity score matching was applied to identify two comparable cohorts with statin users and non-statin users. Detailed follow-up information such as Lp(a) levels were extracted. The hazard ratio was calculated on Lp(a) changes based on the statin usage cohorts. Detailed subgroup and different characteristic cohorts’ analyses were also conducted.ResultsAfter baseline propensity score matching, a total of 42,166 patients were included in a 1:1 matched ratio between statin users and non-statin users. In the case of no difference in low density lipoprotein (LDL-C), Lp(a) was increased significantly with the use of statins (adjusted HR 1.47; 95% confidence interval [CI] 1.43–1.50). Lp(a) increase was observed in various subgroup analyses and different cohorts. The dose intensity of statin was positively associated with the evaluated Lp(a) level.ConclusionThe use of statins was associated with an increased risk of Lp(a) elevation compared with non-statin use counterparts. The clinical relevance of these increases needs to be addressed in surrogate marker trials and/or large, cardiovascular outcomes trials.

Nurse-led interventions for prevention and control of noncommunicable diseases in low- and middle-income countries

Background: Low- and middle-income countries (LMICs) face numerous challenges in the implementation of noncommunicable diseases (NCDs) prevention programs due to a shortage of health workforce. Task shifting to nurses is a viable and effective solution to address the healthcare human resource crisis. We, therefore, intend to assess the existing evidence on the effectiveness of interventions by nurses for the management of chronic NCDs in LMICs. Methods: We did a systematic review and meta-analysis of the trials that utilized nurses for the management of NCDs in LMICs. We searched PubMed, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and clinical registries of different LMICs to search for relevant literature. Meta-analysis using an inverse-variance weighted random effect model was used to summarize the findings. The study protocol was registered in the PROSPERO database (CRD42019118430). Results: We found 2097 studies from the literature search, out of which 39 studies with 15,672 participants were eligible for narrative synthesis. Result of the meta-analysis showed that nurse-led interventions were effective in the reduction of systolic blood pressure (SBP) (average pooled mean difference was −4.32 [95% (confidence interval) CI − 7.07–−1.57]), diastolic blood pressure (DBP) (−3.11 mmHg; 95% CI −4.96–−1.26), glycated hemoglobin (HbA1c) (−0.73; 95% CI − 1.08–−0.38), fasting blood sugar (FBS) (−0.8; 95% CI −13.42–−2.58), total cholesterol (TC) (−1.18; 95% CI −20.06–−3.57), and triglycerides (TG) (−12.20; 95% CI − 23.52–−0.87). However, there was no major significant difference in low-density lipoprotein (LDL) and high-density lipoprotein (HDL). The overall quality of evidence based on the Grading of Recommendations Assessment, Development, and Evaluations was moderate for FBS, low for SBP, DBP, HbA1c, HDL, TC, and TG, and very low for LDL. Interpretation: Nurse-led interventions as compared to usual care are effective for the management of diabetes and hypertension and can be effectively used for national NCD programs in LMICs.

Small Dense LDL: Scientific Background, Clinical Relevance, and Recent Evidence Still a Risk Even with 'Normal' LDL-C Levels.

Residual cardiovascular disease event risk, following statin use and low-density lipoprotein cholesterol (LDL-C) reduction, remains an important and common medical conundrum. Identifying patients with significant residual risk, despite statin drug use, is an unmet clinical need. One pathophysiologic disorder that contributes to residual risk is abnormal distribution in lipoprotein size and density, which is referred to as lipoprotein heterogeneity. Differences in low density lipoprotein (LDL) composition and size have been linked to coronary heart disease (CHD) risk and arteriographic disease progression. The clinical relevance has been investigated in numerous trials since the 1950s. Despite this long history, controversy remains regarding the clinical utility of LDL heterogeneity measurement. Recent clinical trial evidence reinforces the relevance of LDL heterogeneity measurement and the impact on CHD risk prediction and outcomes. The determination of LDL subclass distribution improves CHD risk prediction and guides appropriate treatment.

Elevated plasma levels of osteoglycin in cardiovascular patients: a systematic review and meta-analysis.

To evaluate the levels of osteoglycin (OGN) in patients with cardiovascular disease. A meta-analysis was conducted on retrospective studies that compared patients with and without cardiovascular disease. Data including the levels of OGN, low density lipoprotein (LDL), and high density lipoprotein (HDL) were analyzed and expressed as mean differences (MD) with a 95% confidence interval (CI). This meta-analysis included 6 studies with a total of 1,443 patients. The results showed that the concentration of OGN in the blood of patients with cardiovascular disease was significantly elevated compared to that observed in control patients. There were no significant differences in LDL and HDL expression between cardiovascular patients and control patients. Sensitivity analysis and funnel plots showed that this investigation was robust and had low publication bias. This report demonstrated that the blood concentration of OGN in patients with cardiovascular disease is significantly elevated compared to that in control patients. Furthermore, the elevated levels of OGN suggests that OGN may be a biomarker/or therapeutic target for patients with cardiovascular disease. Although the structure of OGN is simple, it is indispensable in many important life processes. It plays a protective role in the occurrence of cardiovascular and cerebrovascular diseases through antioxidant, anti-inflammatory, anti-apoptosis and increasing tolerance to hypoxia.

Epidemiological Profile of Diabetes Mellitus Patients in Diabetes Center in King Salman Specialist Hospital Hail Region Saudi Arabia

Objective: To investigate the degree of association between the specific epidemiologic factors of diabetes in the Hail Region of Saudi Arabia.&#x0D; Methodology: The research is considered a case study using information from the King Salman Specialist Hospital in Hail Saudi Arabia. 5000 Medical reports and records were used in the retrospective cross-sectional study. Data analysis was done using SPSS statistical software.&#x0D; Results: The Chi-square results indicated an insignificant association between gender and follow-up status (P &gt; 0.05). Both males and females sought treatment equally, whether follow-up or new treatments (P &gt; 0.05). There was a significant association between gender and diabetes type.&#x0D; The t-test results had varied results for the differences in age, BMI, and diabetes treatment. Age differences had no significant impact on the prevalence of diabetes among males and females (t (4998) = -0.63, P &gt; 0.05. Men had lower glycohemoglobin levels (8.11) differed significantly from that of women (8.58) t (4786) = -10.62, p &lt; 0.05. also, the creatine levels were higher in females than males. There were significant differences in low-density lipoprotein, hemoglobin, and BMI between men and women.&#x0D; Conclusions: The findings indicated differences in treatment such as unawareness of insulin injection, ignorance of health practices and unhealthy dietary habits, gender-related disparities, the inheritance of genes through which the disorder manifests, and exposure to environmental factors triggering and exacerbating the condition. Future studies should consider the genetic dimension Diabetes.

Comparative study of lipid profile of pigs, goats and cattle slaughtered at Nsukka Municipal Abattoir, Enugu State, Nigeria Fat contents of meat largely determine

Fat contents of meat largely determine consumer's choice and the general acceptability by people. Thus, this research was carried out to compare the lipid profile of pigs with that of goats and cattle in the study area. One hundred and ninety two animals; 64 from each species, aged two to three years slaughtered at Nsukka Municipal abattoir were used. Samples of Rectus abdominus muscle, liver, kidney, brain, skin and large intestine were collected. Two g of each of the sample was grinded, centrifuged, decanted and the supernatants used to determine their cholesterol, low density lipoprotein (LDL), high densitylipoprotein (HDL) and triglyceride profile by enzymatic colorimetric method using reagents test kits. Result showed that although cholesterol profile in liver, kidney and intestine of the goats was significantly (p &lt; 0.05) higher than in pigs and cattle, its concentration was significantly (p &lt; 0.05) higher inmuscle and skin of the pigs than goats and cattle. Highest concentration of cholesterol which ranged from 1205.34 to 1328.34mg/dL was from brain tissues of the animals. The HDL in muscles of the pigs and goatsshowed no significant (p &gt;0.05) difference but were significantly (p &lt; 0.05) higher than that of cattle. There was insignificant (p &gt; 0.05) difference in LDL and triglyceride profiles in tissues/organs of the three animal species. It was concluded that Nigerian pig todays share similar lipid profile with goats and cattle.

Physiological effect of cholecystectomy on lipid profile of patients with cholelithiasis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The association of cholecystectomy with alterations in lipid profile is well documented. Objectives of this study were to determine the effect of cholecystectomy on lipid profile of cholelithiasis patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This cross-sectional observational study was done on 170 patients admitted in general surgery department of Naz Memorial Hospital, Karachi from July 2018 to June 2019. Symptomatic cholelithaisis patients between 18 to 60 years, elective cholecystectomy was included while patients previously on lipid lowering agents, diagnosed renal failure, nephrotic syndrome, cardiac failure, pregnant mothers, hypothyroidism, pancreatitis and obstructive jaundice were excluded. For data analysis, SPSS was used. Wilcoxon signed ranked test was used to compare mean values of pre and post-operative lipid profiles after cholecystectomy keeping p value of &amp;lt;0.05 as significant. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 60% of patients were females with majority, 31% patients between 31-40 years while least, i.e. 11% were between 61-70 years. The mean pre-operative and post-operative difference of 52±7.32 mg/dl was seen in total cholesterol levels (p&amp;lt;0.001). The mean difference in high density lipoprotein (HDL) between pre and post-operative was of 13±0.36 mg/dl (p&amp;lt;0.001). The mean difference in low density lipoprotein (LDL) between pre- and post-operative was 61±10.45 mg/dl (p&amp;lt;0.001). The mean difference in triglycerides levels between pre- and post-operative was 46±25.49 mg/dl (p&amp;lt;0.001).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Cholecystectomy in gall stone disease patients elicited favorable response in significantly lowering levels of total serum cholesterol, LDL and triglycerides while substantially increasing levels of HDL cholesterol.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Gender differences in LDL and HDL subfractions in atherogenic and nonatherogenic phenotypes

ObjectivesThe aim of our study was to examine the role of low density lipoprotein (LDL)-subfractions in individuals with the atherogenic and non-atherogenic phenotype and the gender differences in lipoprotein subfractions including small dense LDL (sdLDL) and small high density lipoprotein (sHDL) subfractions representing the most atherogenic lipoprotein subfractions. Design & methods35 persons in the atherogenic group (AG) (with sdLDL3–7 subfractions ≥6 mg/dl) and 104 individuals in the non-atherogenic group (NAG) (sdLDL3–7 subfractions <6 mg/dl) were included in our study. To analyze plasma lipoprotein subfractions, a polyacrylamide gel electrophoresis–the Lipoprint system was used. ResultsMales compared to females in the AG had significantly higher levels of atherogenic lipoprotein subfractions such as HDL8, HDL9 and HDL10. All participants in AG had significantly lower levels of intermediate density lipoprotein IDL-A than those in NAG but significantly higher levels of IDL-B and IDL-C. Males in the AG compared to NAG had significantly lower levels of LDL1 and higher levels of LDL2 and LDL3–7 subfractions. In the NAG LDL2 positively correlated with sHDL subfractions while in the AG with the large HDL subfraction. ConclusionResults of our study demonstrate more atherogenic profile in males compared to females and a double role of LDL2 subfraction in the atherogenic process depending on the phenotype (atherogenic/non-atherogenic) of individuals.

Effect of lifestyle focused text messaging on risk factor modification in patients with diabetes and coronary heart disease: A sub-analysis of the TEXT ME study

AimsThere is potential to provide public health interventions through text messaging for patients with Type 2 diabetes mellitus (T2DM). Our objective was to ascertain if lifestyle focused text messaging addressing cardiovascular risk factors in patients with coronary heart disease (CHD) and T2DM, was more effective than usual care. MethodsThis is a secondary analysis of the TEXT ME study, a randomised clinical trial of a 6-month text messaging intervention in patients with coronary heart disease. The measured outcomes include cholesterol, blood pressure (BP), body mass index (BMI), HbA1c, waist/hip circumference and smoking status. Our objective was to ascertain if lifestyle focused text messaging in patients with T2DM was more effective than usual care, and to determine if the intervention was more effective in patients with T2DM compared to those without. Results229 participants in the TEXT ME study had T2DM (32%), 111 participants in the intervention group and 118 in the control group. At 6 months, the mean difference in systolic BP was −7.6 mmHg (95%CI −11.8, −3.37, p = 0.0003) and diastolic BP −3.7 mmHg (95%CI −6.12, −1.24, p = 0.0032). The mean difference in low density lipoprotein in the intervention arm, compared to the control arm, was −0.05 mmol/L (95%CI −0.27, 0.18, p = 0.813), and in triglycerides was −0.29 mmol/L (95%CI −0.59, 0.01, p = 0.035) respectively. The mean difference in BMI was −0.89 kg/m2 (95%CI −2.74, 0.95, p < 0.0001) in the intervention group, waist circumference −3.98 cm (95%CI −8.57, 0.61, p < 0.0001) and hip circumference −3.26 cm (95%CI −7.67, 1.16, p = 0.0006). Intervention subjects with diabetes were less likely to be smokers at 6 months. The mean difference in HbA1c between the control and intervention group was not significant (p = 0.126). The intervention was as effective in patients with diabetes, compared to those without. ConclusionAmong patients with coronary heart disease with T2DM, lifestyle-focused text messaging resulted in significant risk factor reduction.

Big data and analysis of risk factors for gallbladder disease in the young generation of Korea.

Background/PurposeFew studies have examined the risk factors for gallbladder (GB) disease in young adults. This study aimed to evaluate risk factors for GB disease in young adults based on big data in Korea.MethodsAll participants underwent routine checkup at the Korea Medical Institute from June 2014 to May 2015. After excluding 677 individuals with missing information in records, 724,114 individuals (435,635 men, 288,479 women) were finally included. The definition of abnormal GB finding included stones, sludge, polyps, and adenomyomatosis detected using ultrasonography. All statistical analyses were performed using SAS software version 9.2.ResultsOverall, 27,130 (17.5%) individuals were diagnosed as having abnormal GB finding in the young age group (N = 154,463, aged 20–39 years). In men, significant differences in low-density lipoprotein (LDL) and cholesterol levels were observed between the abnormal GB finding group and normal GB group (p < 0.05). In women, a significant difference in smoking history was noted between the abnormal GB finding group and normal GB group (p < 0.05). The prevalence rate of GB stones was 1.9% (27,979/154,463) in the young age group. High body mass index (BMI), large thigh circumference, and low high-density lipoprotein (HDL) level in women and low HDL level in men were independent risk factors for the presence of GB stones (p < 0.05).ConclusionIn this study, obesity-related factors (BMI, waist size, thigh circumference, and cholesterol, LDL, and HDL levels) correlated with GB disease in the young generation of Korea.

Comparison of efficacy and safety of combination therapy with statins and omega-3 fatty acids versus statin monotherapy in patients with dyslipidemia: A systematic review and meta-analysis.

Objective:Dyslipidemia is a major risk factor for the development of cardiovascular disease. Both statins and omega-3 fatty acids demonstrate beneficial effects on lipid concentrations. The goal was to evaluate the safety and efficacy of combination therapy with statins and omega-3 fatty acids.Methods:We performed a systematic review and meta-analysis of published data to compare the safety and efficacy of combination therapy with statins and omega-3 fatty acids versus statin monotherapy in patients with dyslipidemia. Six articles were assessed in the present meta-analysis (quantitative assessment) and qualitative assessment.Results:In terms of efficacy, the combination treatment afforded a significantly greater reduction in total cholesterol/high-density lipoprotein cholesterol than statin alone did [standard difference in means = −0.215; 95% confidence interval (CI) −0.359–−0.071]. However, there was no significant difference in low-density lipoprotein (LDL) cholesterol between the 2 groups. Qualitative assessment of other lipid parameters was performed. Combination therapy with statins and omega-3 fatty acids was generally more effective on lipid concentration than statin monotherapy. In terms of safety, there were no significant differences in total adverse events between the 2 groups. Gastrointestinal adverse events were found to be significantly increased in patients receiving combination therapy using the fixed-effects model (relative risk = 0.547; 95% CI 0.368–0.812).Conclusions:We suggest that combination therapy with statins and omega-3 fatty acids enhances lipid profile, except LDL cholesterol, compared with statin monotherapy. Nevertheless, statin and omega-3 fatty acid combination should be cautiously recommended, taking into account the clinical importance of LDL cholesterol and safety issues associated with their concomitant use.

Values of serum LDL and PCT levels in evaluating the condition and prognosis of acute cerebral infarction.

Values of low density lipoprotein (LDL) and procalcitonin (PCT) levels in evaluating the condition and prognosis of patients with acute cerebral infarction (ACI) were investigated. According to the volume of cerebral infarction, 150 patients with ACI (observation group) were divided into the mild infarction group (n=50), moderate infarction group (n=50), and severe infarction group (n=50). Besides, another 50 healthy subjects were enrolled during the same period as the control group. The levels of serum LDL and PCT on admission and at the 1st, 3rd, 7th and 10th day after treatment were detected, which were compared with those in the control group. Ten days after treatment, patients were divided into two groups, the effective group and non-effective group, based on the clinical efficacy. The differences in LDL and PCT levels were compared between the two groups. After 1 month, the clinical efficacy was evaluated again, and the correlations of LDL and PCT levels with prognosis were analyzed. The levels of serum LDL and PCT in the observation group 1 day after admission were higher than those in the control group (P<0.05), which reached the peak at the 3rd day and continuously declined after the 7th day. The LDL and PCT levels had statistically significant differences between the effective group and non-effective group (P<0.05). Pearson's correlation analysis showed that the serum LDL and PCT levels in acute phase were negatively correlated with the National Institutes of Health Stroke Scale (NIHSS) score after 1 month of treatment (P<0.05). The dynamic monitoring of serum LDL and PCT levels in ACI patients can help evaluate the condition and prognosis of patients.

Rapid Changes in Serum Lipid Profiles during Combination Therapy with Daclatasvir and Asunaprevir in Patients Infected with Hepatitis C Virus Genotype 1b.

Background/AimsChanges in lipid profiles in patients infected with hepatitis C virus (HCV) during direct-acting antiviral therapy have been reported in recent years. However, the clinical aspects of disturbed lipid metabolism in chronic HCV infection have not been fully elucidated.MethodsDynamic changes in serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol and apolipoprotein levels in patients infected with HCV genotype 1b were examined during combination therapy with daclatasvir (DCV) and asunaprevir (ASV).ResultsTotal, LDL−, and HDL-cholesterol levels increased rapidly and persistently after week 4. Apolipoprotein (apo) A-I, apo B, apo C-II, and apo C-III levels were significantly higher at week 4 than at week 0. In contrast, apo A-II and apo E levels were significantly lower. The differences in LDL− and HDL-cholesterol levels were positively correlated with those of apo B and apo A-I, respectively. Interestingly, in patients with non-sustained virological response, these cholesterol levels decreased rapidly after viral breakthrough or viral relapse. Furthermore, similar changes were observed for apo A-I, apo B and apo C-III levels.ConclusionsClearance of HCV using combination therapy with DCV and ASV results in rapid changes in serum lipid profiles, suggesting an influence of HCV infection on disturbed lipid metabolism.

Efficacy of probiotics in non-alcoholic fatty liver disease in adult and children: A meta-analysis of randomized controlled trials.

To evaluate the efficacy of probiotics in the treatment of adult and childhood non-alcoholic fatty liver disease (NAFLD). Randomized controlled trials on the efficacy of probiotics in the treatment of adult and childhood NAFLD published before July 2015 were searched in multiple databases, including Cochrane Library, PubMed/MEDLINE, EBSCO, OVID, SCI, CNKI, and VIP. Article identification and data extraction were carried out by two reviewers based on the inclusion and exclusion criteria. RevMan 5.3 software was used for the meta-analysis. Nine randomized controlled trials with a total of 535 cases of NAFLD were included. Statistical differences in homeostasis model assessment, total cholesterol, high density lipoprotein, triglyceride, and tumor necrosis factor-α were detected between the probiotics and control groups with variations in different patient populations. No significant differences in body mass index (BMI), glucose, or insulin were detected between the two groups. Statistical differences in low density lipoprotein, alanine aminotransferase, aspartate transaminase, and BMI were detected between the two childhood groups (P ≤ 0.05). Probiotics provided improvements in the outcomes of homeostasis model assessment, total cholesterol, high density lipoprotein, and tumor necrosis factor-α in any NAFLD patients and triglyceride in Italian and Spanish patients, but no improvement in the outcomes of BMI, glucose, or insulin in adult NAFLD patients. The currently available data are not sufficient to compare the effects of probiotics between adult and childhood NAFLD patients.

The effects of herring-roe lyophilized powder on lipid metabolism

Herring-roe, which contains large amounts of docosahexaenoic acid and eicosapentaenoic acid, has anti-dyslipidemia effects. Here, we evaluated the effects of herring-roe on lipid metabolism in 33 adult subjects in a randomized, double-blind, placebo-controlled study. We divided the subjects into a test group that ingested herring-roe lyophilized powder (herring-roe powder) and a placebo group that ingested non-herring-roe powder, with each member of each group ingesting 15 g daily for 8 weeks. Hematological tests and body composition measurements were performed before and after 4, 6, and 8 weeks of the study period. Although no significant differences in low density lipoprotein were observed, high density lipoprotein was found to be increased in subjects who ingested herring-roe powder. In addition, the level of free fatty acid was significantly improved in the herring-roe powder group. These results suggest that ingestion of herring-roe could influence lipid metabolism.

Nutritional status and laboratory parameters among internal medicine inpatients.

Malnutrition is a clinical state resulting in prolonged hospital stay, increase in severity of infections and poor wound healing. Our aim was to investigate the prevalence and etiologic factors of malnutrition in medical inpatients. A total of 290 consecutively admitted internal medicine patients from February to May 2012 were included. On admission, demographic data, anthropometric measurements, laboratory parameters and nutritional screening test results were recorded. Nutritional risk score-2002 for patients under 65 years old, mini nutritional assessment for older patients and subjective global assessment (SGA) tests performed. Relation of demographic characteristics, laboratory parameters, weight and body mass index (BMI) with nutritional status were evaluated. Mean age was 61±17 years; 145 patients were male. Among 160 patients<65 years old, 34 were in malnutrition (21%), 41 (26%) were under risk of malnutrition and 85 (53%) were normal. When they were divided into three groups according to SGA, we found significant difference in hemoglobin, low density lipoprotein (LDL), high density lipoprotein, cholesterol, triglyceride, albumin and protein, weight and BMI. Among 130 patients over 65 years old, 47 patients (37%) were in malnutrition, 41 (31%) were under risk of malnutrition and 42 (32%) were normal. There was significant difference in LDL, cholesterol, albumin, protein, weight and BMI between three groups; each 1 g/dl decrease in serum albumin and age older than 65 years old increased malnutrition risk 5.21 and 1.97 times, respectively. Malnutrition risk is high among internal medicine inpatients and risk seems to be higher among older patients. Nutritional screening of geriatric patients, close follow-up and providing earlier health care would contribute rehabilitation of chronic diseases and decrease re-admissions.

Difference of dilation resistance to coronary stenting between fibrous plaques and lipid-rich plaques

Background Dilation resistance to stenting in non-calcified coronary plaques was compared in patients with percutaneous coronary intervention (PCI) in order to confirm the clinical usefulness of multislice computed tomography in examining coronary plaque type and to provide information pertaining to the effects of plaque type on dilatation resistance. Methods A retrospective analysis of 64-slice computed tomography coronary imaging data collected in the month prior to coronary stenting in 93 patients (65 male and 28 female, mean age of (57.22±7.22) years) was conducted. Non-calcified coronary plaques were divided into lipid-rich (lipid content &gt;25% of plaque volume) and fibrous plaques according to the Hammer-Hansen S method: where lipids, fiber, and intraluminal components were indicated by contrast using Hu values of -100-49, 50-129, and &gt;130, respectively. Clinical features, pre-dilatation balloon specifications and filling pressure, and stent size and release pressure were compared. Results High-sensitivity C-reactive protein levels were higher in the lipid-rich plaque group. In patients with typical symptoms, unstable angina was more commonly observed in the lipid-rich plaque group. No significant differences in low density lipoprotein, pre-dilatation balloon specifications, pre-dilatation pressure, or stent specifications were observed. Stent release pressure in the lipid-rich plaque group ((1130.16±202.04) kPa), was significantly lower than that observed in the fibrous plaque group ((1240.61±193.29) kPa, P=0.009). Conclusion Softer, lipid-rich plaques exhibit lower dilation resistance during stenting in PCI patients.

Capsule Commentary on Persell et.al., Electronic Health Record-Based Patient Identification and Individualized Mailed Outreach for Primary Cardiovascular Disease Prevention: a Cluster Randomized Trial

This trial by Persell et al.1 tested an intervention that leveraged electronic health records to identify patients with risk factors for cardiovascular disease but not receiving statin treatment. The investigators provided a list of patients meeting these criteria to clinicians and mailed personalized letters to the patients on the list, offering advice regarding the benefit of statin treatment, controlling hypertension or quitting smoking. The result was not more contacts with primary care clinicians, but more productive contacts with respect to cardiovascular risk reduction. In particular, a greater proportion of intervention patients received statin prescriptions, with a nonsignificant trend towards greater hypertensive treatment. While there was no difference in low-density lipoprotein (LDL) levels at 9 months, a post-hoc analysis at 18 months showed benefit. In addition to being post-hoc, interpretation of the findings at 18 months is hampered by the fact that the control group received feedback reports at 9 months. Thus, it is unclear if findings at 18 months are attributable to the patient letters alone or a function of the time necessary for the combined intervention to have an impact on measured cholesterol values. Previous studies have compared audit and feedback versus audit and feedback plus mailed patient educational reminders with mixed results.2 To move the field forward, researchers should determine how to best develop and implement interventions by conducting multi-arm trials comparing different versions of quality improvement strategies and by embedding qualitative methods within quality improvement trials.3 For clinicians and administrators, this study provides an example of how data can be used to automate routine tasks while supporting patients and clinicians to achieve evidence-informed decision-making. Unfortunately, electronic health records are not a panacea4 and many providers are unable to fully leverage data for quality improvement.5 Furthermore, this study aimed to improve primary prevention of cardiovascular disease; practices with limited quality improvement resources should focus on higher-risk populations.