Differences In High-density Lipoprotein Cholesterol Levels Research Articles

Effects of insulin resistance on cardiovascular risk factors in obese and non-obese patients

Objectives: It is known that insulin resistance increases cardiovardiovascular risk. But it could not obviously be understood whether insulin resistance itself or the metabolic syndrome parameters, like obesity, that already exist in most of them, are responsible for this increased risk. Our aim is to determine cardiovascular risks in obese and non-obese insulin-resistant patients. Methods: One hundred thirty-nine patients were included in the study. They were divided into 4 groups: Group 1 (having obesity and insulin resistance), Group 2 (having only insulin resistance but not obesity), Group 3 (having obesity but not insulin resistance), and Group 4 (having neither obesity nor insulin resistance). Patients having any systemic disease were excluded. Insulin resistance is calculated via Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) formula. Electrocardiographic, echocardiographic and lipid parameters of these patients were compared. Results: High-density lipoprotein (HDL) levels of Group-4 were higher than Group 1 and Group 2. There was no statistical difference in HDL cholesterol levels between Group 3 and the others. Triglyceride and very low-density lipoprotein levels were higher in Group 1. There was no difference in P wave dispersion between the groups. In echocardigraphy, epicardial fat tissue thickness of Group 1 was significantly higher. Prevalance of diastolic dysfunction was higher in Group 1 compared to Group 4. Conclusions: Insulin resistance itself is a risk factor for low HDL levels independent of obesity. When obesity is added to insulin resistance, other cardiovascular risk factors appear, like high triglyceride levels, increase in epicardial fat tissue thickness and presence of diastolic dysfunction. Early detection of insulin resistance may alert us to the risks of cardiovascular diseases.

Evaluation of Lipid Profile Changes In Patients With Inflammatory Bowel Disease: A Single Center Experience

Introduction: Inflammatory Bowel Disease (IBD) encompasses chronic inflammatory disorders of the gastrointestinal tract, including Crohn's disease and ulcerative colitis. While initially considered a localized disorder, IBD has emerged as a systemic disease with a growing recognition of its potential impact on lipid metabolism and cardiovascular health. This study aims to comprehensively investigate lipid profiles and dyslipidemia prevalence among IBD patients, shedding light on potential associations with disease characteristics. Materials and Methods: A single-center cross-sectional observational study was conducted on 707 IBD patients between December 2007 and February 2021. Inclusion criteria comprised confirmed IBD diagnosis, age 18-65, and informed consent. Demographic data, medical history, anthropometric measurements, and fasting blood samples for lipid profile analysis were collected. Lipid profiles included total cholesterol, high-density lipoprotein cholesterol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C), and triglycerides. Statistical analyses, including t-tests, chi-square tests, and multivariate regression, explored associations. Results: This study reveals a high prevalence of dyslipidemia in IBD patients (58%), surpassing the general population. Notably, male IBD patients displayed significantly higher levels of total cholesterol, LDL-C, and triglycerides than their counterparts in the general male population. Differences in HDL-C levels were also observed. There were no significant variations in lipid profiles between Crohn's disease and ulcerative colitis patients within the IBD subgroup. Conclusion: The findings underscore the importance of regular lipid profile assessments in clinical management, particularly for male IBD patients. The significantly elevated prevalence of dyslipidemia in this population implies a potential influence of IBD on lipid metabolism and cardiovascular risk. Further research is needed to elucidate mechanisms and potential therapeutic interventions. Addressing dyslipidemia among IBD patients holds promise for reducing cardiovascular risk and enhancing overall health outcomes in this complex patient group.

Protective cardiovascular benefits of exercise training as measured by circulating endothelial cells and high-density lipoprotein in adults

ObjectiveThis study aims to determine the protective cardiovascular effect of aerobic exercise training by measuring cluster of differentiation 146 (CD146), circulating endothelial cell (CEC), and high-density lipoprotein-cholesterol (HDL-C) levels in adults. MethodsThis study was an experimental pre-post-test without a control group. Forty-five participants were divided into three groups based on aerobic exercise training intensity: low, moderate, and high. Whole blood samples were measured for HDL-C levels. In addition, CEC was isolated from Peripheral Blood Mononuclear Cells (PBMC) samples, then identified by CD146 marker using flow cytometry. ResultsCEC percentage and HDL-C increase after aerobic exercise training. There was a significant difference in CEC percentage between the intensity groups. However, there was no difference in HDL-C levels. ConclusionAerobic exercise training can protect cardiovascular health by stimulating CEC mobilization, identified by CD146. In addition, an HDL-C level increase also contributes to cardiovascular protection by decreasing inflammation levels, inhibiting low-density lipoprotein-cholesterol oxidation, improving endothelial regeneration capabilities, and lowering blood glucose.

Sex and Racial Differences in High-Density Lipoprotein Levels in Acute Coronary Syndromes

BackgroundThis study aimed to assess sex and racial differences related to high-density lipoprotein cholesterol (HDL-C) levels in those presenting with acute coronary syndromes (ACS). MethodsRecords from patients with ACS presenting to the Emergency Department of University of Florida Hospital Jacksonville from 2009 to 2012, were reviewed. Detailed medical history was obtained. HDL-C levels were measured within 72 h of presentation. Pearson chi-square and Wilcoxon rank sum tests were used to compare groups in univariate analysis. Analysis of variance was performed to determine independent predictors of higher HDL-C levels using variable selection. ResultsOf 2400 patients screened, 614 (382 men and 232 women) met inclusion criteria. Hypertension, chronic kidney disease or prior CAD history was similar between sexes and races. Women were more likely to be older (62.4 vs 58.4 years), diabetic (56.5 vs 36.5%) and have higher body mass index (31.2 vs 30.1 kg/m2). Blacks were more likely to be diabetic (50.3 vs 41.3%). After adjusting for all clinical markers, women and blacks along with absence of CAD or diabetes, were significantly associated with higher HDL-C levels. ConclusionsHigh HDL-C levels (> 40 mg/dL), considered cardio-protective, were seen in women and blacks with ACS more often than in men and whites. Significant differences in HDL-C levels between sexes were seen in whites but not in blacks. Relevance and quality of HDL-C levels in racial groups need further study as this may have important implications in the interpretation of current guidelines.

Association of the HDL-c Level with HsCRP, IL-6, U-NAG, RBP and Cys-C in Type 2 Diabetes Mellitus, Hypertension, and Chronic Kidney Disease: An Epidemiological Survey.

PurposeTo explore the association between the anti-inflammatory and renal protective roles of high-density lipoprotein cholesterol (HDL-c) and its different levels in type 2 diabetes mellitus (T2D), hypertension (HTN), and chronic kidney disease (CKD) and to lay a theoretical basis for precise, maximum-benefit HDL-c-raising therapy for patients with these diseases.Patients and MethodsA total of 2127 participants (195 with T2D, 618 with HTN, 162 with CKD, and 1152 controls) were selected and divided into four groups according to their baseline HDL-c level, namely, low HDL-c (L-HDL-c, ≤1.03 mmol/L), medium HDL-c (M-HDL-c, 1.04–1.55 mmol/L), high HDL-c (H-HDL-c, 1.56–2.05 mmol/L) and extremely high HDL-c (E-HDL-c, ≥ 2.06 mmol/L). Serum and morning urine samples were collected to analyze the correlation between high-sensitivity C-reactive protein (HsCRP), interleukin-6 (IL-6), urine n-acetyl-β-d-glucosidase (U-NAG), retinol binding protein (RBP), and cystatin c (Cys-C) levels with the HDL-c levels.ResultsThe HDL-c levels of patients with T2D, HTN and CKD were universally lower than those in the control group in both sexes (p<0.05), while male patients also manifested a lower level of HDL-c than female patients. However, although they had lower values of the renal impairment index, female patients were found to have anomalously higher amounts of proinflammatory cytokines. In addition, the correlations between HsCRP and RBP levels and HDL-c levels were most significant in patients with HTN (p<0.05), whereas in patients with T2D and CKD, such relevance was less significant.ConclusionExistence of substantial differences in HDL-c levels between different types of disease and sex highlighted that a higher HDL level does not always predict a better clinical outcome of patients. Moreover, we found that both HsCRP and RBP correlated negatively with HDL-c in HTN patients, indicating that monitoring HsCRP and RBP may serve as indicators for therapeutic efficacy of HDL-c-raising medications in HTN patients.

Anti-hyperglycaemic, Anti-dyslipidaemic and Hepatoprotective Effects of the Polyherbal Mixture Diarth in Alloxan-induced Diabetic Rats

Aim: This study evaluates the anti-hyperglycaemic, anti-dyslipidaemic and hepatoprotective effects of the polyherbal mixture diarth, in alloxan-induced diabetic rats.&#x0D; Methodology: A total of 35 male Wistar albino rats weighing between 120-140 g were used for this study. Diabetes was induced by a single intraperitoneal injection of freshly prepared alloxan-monohydrate (140 mg/kg body weight). Fasting plasma glucose (FPG) was determined using the glucose oxidase method. Total Cholesterol (TC), Triglyceride (TG) and High density lipoprotein cholesterol (HDL-C) were determined using enzymatic methods. Low density lipoprotein cholesterol (LDL-C) was calculated using the Friedewald’s equation. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined using Reitman-Frankel method, while alkaline phosphatase (ALP) was determined using the colorimetric phenolphthalein method. Phytochemical analysis was done on the herbal mixture, using classical methods.&#x0D; Results: The results revealed the presence of the phytochemicals saponins, alkaloids, cardiac glycosides, flavonoids and tannins in the polyherbal mixture diarth. The results revealed significantly lower FPG levels in the negative control and treatment groups compared to the diabetic control. FPG level was significantly higher in the glibenclamide treated group, but showed no significant differences in the diarth group and the combination group (glibenclamide + diarth), compared to negative control. TC levels in the diabetic control was significantly higher compared to the negative control and treatment groups. There were no significant differences in TC levels in the negative control and the treatment groups. The diabetic control had significantly higher TG level compared to the negative control. TG level in the glibenclamide treated group was not significantly different from that of the diabetic control. TG level in the diarth treated group was significantly lower than the diabetic control, but also significantly higher than that of the negative control. TG levels in the combination group (diarth + glibenclamide) was significantly lower than the diabetic control, and showed no significant difference compared to the negative control. The negative control and treatment groups had significantly higher HDL-C levels compared to the diabetic control. The treatment groups showed no significant difference in HDL-C levels, compared to the negative control. The negative control and treatment groups had significantly lower LDL-C levels compared to the diabetic control. The treatment groups showed no significant difference in LDL-C levels, compared to the negative control. The results show significantly elevated ALT, AST and ALP in the diabetic rats compared to the negative control and treatment groups. The treatment groups showed no significant differences in ALT and AST levels compared to the negative control.&#x0D; Conclusion: 140 mg/kg body weight of alloxan produced significant diabetes in the Wistar rats with dyslipidaemia and elevated liver enzyme levels. Treatment with the polyherbal mixture diarth showed anti-hyperglycaemic, anti-dyslipidaemic and hepatoprotective effects. The effects were equipotent compared to treatment with glibenclamide, thus could be incorporated in the management of diabetes.

Lipidaemic and Hepatic Status of Type 2 Diabetic Rats Treated with the Polyherbal Capsule Glucoblock

The scourge of diabetes has led to an increase in the use of complementary and alternative medicine. The lack of regulation and control leads to the indiscriminate use of these herbals, with potential risk to patients.&#x0D; Aim: This study evaluates the lipidaemic and hepatic status of type 2 diabetic rats treated with the polyherbal capsule glucoblock.&#x0D; Methodology: A total of 35 male Wistar albino rats weighing between 120-220 g were used for this study. The rats were placed on high fat diet and diabetes was induced by a single intraperitoneal injection of freshly prepared streptozotocin (STZ) (45 mg/kg body wt). Fasting plasma glucose (FPG) was determined using the glucose oxidase method. Total Cholesterol (TC), Triglyceride (TG) and High Density Lipoprotein Cholesterol (HDL-C) were determined using enzymatic methods. Low Density Lipoprotein Cholesterol (LDL-C) was calculated using the Friedewald’s equation. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) were determined using Reitman-Frankel method, while alkaline phosphatase (ALP) was determined using the colorimetric phenolphthalein method. Liver sections were stained using haematoxylin and eosin (H&amp;E) staining technique, and phytochemical analysis was also done on the herbal capsule.&#x0D; Results: The results show no significant differences in TC levels in all groups compared to the negative control. TG level was significantly higher in the diabetic control group when compared to the negative control. TG level in the singular treatment groups were significantly lower, but the combination group (glibenclamide + glucoblock) showed no significant difference compared to the diabetic control. The negative control had significantly higher HDL-C compared to the diabetic control and treatment groups. There were no significant differences in HDL-C levels in all the treatment groups, when compared to the diabetic control. The negative control had significantly lower LDL-C compared to the diabetic control and treatment groups. There were no significant differences in LDL-C levels in all the treatment groups, when compared to the diabetic control. ALT, AST and ALP levels were significantly higher in the diabetic control, but was significantly reduced to normal levels by the treatments. Liver sections of the negative control showed normal histoarchitecture. The diabetic control showed inflammation and fatty deposition. The treatment groups showed a nearly normal histoarchitecture, with fatty deposits.&#x0D; Conclusion: High fat diet in combination with a sub-diabetic dose of streptozotocin produced significant diabetes in the Wistar rats with dyslipidaemia and elevated liver enzyme levels. The anti-diabetic treatments, glibenclamide and glucoblock did not correct the dyslipidaema caused by diabetes. However, the treatments had equipotent hepatoprotective effect and restored liver enzyme levels to normal as well as improving liver histology.

Therapeutic Effects of the Anti-diabetic Polyherbal Drug Diawell in Combination with Metformin on Liver and Lipid Parameters in Type 2 Diabetic Rats

Type 2 diabetes is one of the most important diseases worldwide. It affects several organ systems including the liver and lipid metabolism. Many herbal formulations have shown anti-diabetic potential, however, their safety and efficacy remain a debate in the medical community.&#x0D; Aim: This study evaluates the therapeutic effects of the anti-diabetic polyherbal drug diawell in combination with metformin on liver enzyme and lipid profile in type 2 diabetic rats.&#x0D; Methodology: A total of 35 male Wistar albino rats weighing between 120-220 g were used for this study. The rats were placed on high fat diet, and diabetes was induced by a single intraperitoneal injection of freshly prepared streptozotocin (STZ) (45 mg/kg body wt). Fasting plasma glucose (FPG) was determined using the glucose oxidase method. Total Cholesterol (TC), Triglyceride (TG) and High density lipoprotein cholesterol (HDL-C) were determined using enzymatic methods. Low density lipoprotein cholesterol (LDL-C) was calculated using the Friedewald equation. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined using Reitman-Frankel method, while alkaline phosphatase (ALP) was determined using the colorimetric phenolphthalein method. Liver sections were stained using haematoxylin and eosin (H&amp;E) staining technique, and phytochemical analysis was also done on the herbal tablet.&#x0D; Results: The results show no significant differences in mean TC levels in all groups. TG level was significantly higher in the diabetic control when compared to the negative control. There were no significant differences in TG levels in the metformin group, and diawell group when compared to the diabetic control. TG levels in the combination group (metformin + diawell) was significantly lower versus the diabetic control, and showed no significant difference compared to the negative control. HDL-C was significantly higher in the negative control when compared to the diabetic control and the treatment groups. There were no significant differences in HDL-C levels in all the treatment groups, when compared to the diabetic control. LDL-C levels were significantly lower in the negative control compared to the diabetic control and treatment groups. There were no significant differences in LDL-C levels in all the treatment groups, when compared to the diabetic control. The diabetic control had significantly higher ALT, AST and ALP levels compared to the negative control and treatment groups. All the treatment groups showed no significant differences in ALT and AST levels compared to the negative control. Liver sections of the negative control showed normal histoarchitecture. The diabetic control showed inflammation and fatty deposition. The treatment groups showed a nearly normal histoarchitecture, with fatty deposits.&#x0D; Conclusion: High fat diet in combination with 45 mg/kg of STZ produced significant diabetes in the Wistar rats with dyslipidaemia and elevated liver enzyme levels. Metformin and the polyherbal tablet diawell had no impact on the lipid levels as it did not correct the dyslipidaema, however, the treatments showed hepatoprotective potentials and restored liver enzyme levels to normal. Lipid lowering drugs should be included in the management of type 2 diabetes, and there should be proper evaluation of anti-diabetic herbal products.

Serum lipid profiles and post-stroke depression in acute ischemic stroke patients.

Purpose: Post-stroke depression (PSD) is a psychiatric complication after stroke that leads to poorer stroke outcomes. Recent observational studies have indicated that lipid profiles were associated with a higher risk of stroke and depression. This study aims to further explore the possible relationship between serum lipid profiles and the development of PSD.Methods: A total of 373 acute ischemic stroke patients were examined. Serum lipid profiles including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) were measured within 24 hrs of admission. Depression symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17) at the one-month follow-up, and HAMD scores ≥7 indicated a diagnosis of PSD.Results: A total of 114 patients were diagnosed with PSD at the one-month follow-up, for a percentage of 30.6%. There were significant differences in HDL-C levels (P<0.001), LDL-C levels (P=0.002) and the LDL/HDL ratio (P<0.001) between the PSD and non-PSD groups, but no differences were observed in TGs, TC, Apo A1 or Apo B. Low serum HDL-C levels (r = −0.157, P<0.001) and elevated LDL-C levels (r =0.139, P=0.002) and the LDL/HDL ratio (r =0.227, P<0.001) were associated with HAMD scores. After adjusting for the NIHSS score, BI score, mRS score and alcohol consumption in the logistic analysis, low HDL-C levels and the highest quartile (≥3.07) of the LDL/HDL ratio were independently associated with the development of PSD (OR =0.250, 95% CI, 0.077–0.813, P=0.021 and OR =1.874, 95% CI, 1.050–3.347, P=0.034, respectively).Conclusion: Decreased levels of HDL-C and elevated levels of LDL/HDL ratio are associated with PSD. HDL-C and the LDL/HDL ratio are independent predictors of PSD.

High-density lipoprotein-cholesterol and antipsychotic medication in overweight inpatients with schizophrenia: post-hoc analysis of a Japanese nationwide survey

BackgroundPatients with schizophrenia have an increased prevalence of metabolic disturbances compared with the general population. However, the mechanisms underlying the metabolic side effects of antipsychotics are unknown. The aim of the present study was to compare the levels of high-density lipoprotein (HDL)-cholesterol in Japanese schizophrenia patients medicated with olanzapine, risperidone, or aripiprazole monotherapy.MethodsThis study was a post-hoc analysis of a nationwide survey, which included 433 Japanese outpatients with schizophrenia and 674 inpatients. A brief questionnaire was compiled that covered demographic data, systolic blood pressure, diastolic blood pressure, and HDL-cholesterol after reviewing the relevant literature and guidelines. To compare demographic and clinical characteristics, analysis of variance was performed for continuous variables and the chi-square test was performed for categorical variables. For comparisons of HDL-cholesterol levels among the three antipsychotic groups, analysis of covariance was carried out with age, diastolic blood pressure, chlorpromazine-equivalent dosage, and waist circumference as confounding variables after stratification by body mass index (BMI) for each outpatient group and inpatient group.ResultsThe mean age was 57.9 ± 14.0 years and the mean BMI was 23.4 ± 4.5 kg/m2. HDL-cholesterol levels when stratified by BMI differed significantly (p = 0.019) between the three antipsychotic groups after age, diastolic blood pressure, chlorpromazine-equivalent dosage, and waist circumference in inpatients. A significant difference in HDL-cholesterol levels was only found in the overweight inpatient group, and no significant differences in HDL-cholesterol levels were found among the three antipsychotics for outpatients of all BMI stratifications or inpatients that were underweight or of normal weight. For post-hoc analysis of HDL-cholesterol levels in overweight inpatients, HDL-cholesterol was significantly lower in the olanzapine group than in the aripiprazole group (p = 0.023).ConclusionsThis study reveals a difference in HDL-cholesterol levels in overweight Japanese inpatients with schizophrenia resulting from the use of different antipsychotics. In the post-hoc analysis of HDL-cholesterol levels in overweight inpatients, HDL-cholesterol was significantly lower in the olanzapine group than in the aripiprazole group. Further studies incorporating more detailed evaluations, including diet and physical activity, are needed to clarify the differences in HDL-cholesterol according to antipsychotic use.

Generic atorvastatin is as effective as the brand-name drug (LIPITOR\xae) in lowering cholesterol levels: a cross-sectional retrospective cohort study

BackgroundIn a world of ever increasing health care costs, generic drugs represent a major opportunity to ensure access to essential medicines for people who otherwise would be unable to afford them. However, some clinicians and patients are still questioning the safety and effectiveness of generic formulations compared to the proprietary drugs necessitating further systematic research analyzing the generic drugs’ efficacy. Our objective was to compare the lipid lowering effects of generic and branded atorvastatin.MethodsThis cross-sectional, retrospective cohort study was conducted at the University of Malaya Medical Centre from 1 May 2013 until 30 May 2013. We analyzed the lipid profiles (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides) of 629 patients before and at least 3 months after switching them from proprietary atorvastatin (Lipitor®) to generic atorvastatin (atorvastatin calcium from Ranbaxy Laboratories, Inc.). We also investigated if there was any difference in the effectiveness of both atorvastatin formulations in various ethnic groups.Results266 patients were included in this study. When comparing the median values we found no statistically significant differences (Wilcoxon signed-rank test; p < 0.05) between proprietary and generic atorvastatin in lowering total cholesterol (4.60 mmol/l pre-transition vs. 4.50 mmol/l post-transition; p = 0.583), LDL-cholesterol (2.42 mmol/l vs. 2.41 mmol/l; p = 0.923) and triglycerides (1.50 mmol/l vs. 1.50 mmol/l; p = 0.513). While there was a statistically significant (p = 0.009) difference in HDL-cholesterol levels favouring proprietary atorvastatin, the extent of this change (1.26 mmol/l vs. 1.25 mmol/l) was deemed not to be clinically relevant. There was no statistically significant difference when analyzing the effects on various ethnic groups.ConclusionsSubstituting proprietary atorvastatin for its generic formulation atorvastatin calcium does not result in a less effective management of hyperlipidemia. Our findings lend support to the approach of lowering health care costs by switching patients from branded drugs to their less expensive generic analogues.

Loss of sex difference in high-density lipoprotein cholesterol in diabetic women during acute stress.

The gender gap in high-density lipoprotein cholesterol (HDL-C) is well documented in health and also maintained in diverse chronic conditions, including menopause and diabetes. The mechanism for this difference in HDL-C and its regulation is not well understood. We evaluated whether this gender gap is maintained during acute stress. Diabetic patients with metabolic decompensation (n=179) were studied in the fasting state within 24 hours of admission to hospital, and again at outpatient follow-up. Fasting lipids and measures of glycemic control were evaluated on both occasions. The population was predominately minority, 78% Hispanic or African American. During admission, fasting lipid concentrations were not different in women (W) (n = 88) and men (M) (n = 91); serum total cholesterol (total-C), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and HDL-C were similar. Glycemic control was also similar; hemoglobin A1c (A1C) and serum glucose at presentation to hospital were not different in men and women. Compared with a subset of patients with pre-admission data (W, 35; M, 24), a decline of HDL-C was observed, greater in women (P = .005). At outpatient follow-up after admission, median duration approximately 4 months in each group (P = .39), changes in TG, LDL-C, and total-C from baseline admission were not different in men and women. In contrast, whereas HDL-C increased in both groups, the increase (median [interquartile range]) was significantly greater in women, 11 (4, 23) vs 6 (-1, 15) mg/dL (P < .003). This larger increase restored the gender gap in fasting HDL-C, 48 (39, 61) and 41 (36, 49) mg/dL in women and men at follow-up (P < .002). A1C improved similarly in each group. The sex difference in HDL-C levels is lost at time of admission to hospital in patients with diabetes, and returns when acute stress has resolved. These results raise the possibility that recurrent episodes of acute stress may lead to cumulative loss of the HDL-C advantage in women.

Comparison of Vegetarian Diets and Omnivorous Diets on Plasma Level of HDL-c: A Meta-Analysis

Low plasma level of high density lipoprotein cholesterol (HDL-c) was an independent risk factor for cardio vascular disorder, and associated with poor outcomes in pulmonary arterial hypertension. To compare the effects of vegetarian diets and omnivorous diets on HDL-c in plasma, we identified cross-sectional and cohort studies related to HDL-c listed on PubMed and ISI Web of Knowledge as well as the corresponding references (until Nov, 2013). Twelve studies with a total of 4177 individuals were selected for meta-analysis. This meta-analysis indicates that vegetarian diets did not alter plasma HDL-c concentrations, as it wasn’t initially expected by the authors [Standardized Mean Difference (SMD) = 0.02 mmol/l; 95% confidence interval (CI): −0.19 to 0.22 mmol/l]. In Asia and Latin America countries, no significant differences in HDL-c levels between vegetarians and omnivores were found (SMD = −0.09 mmol/l; 95% CI: −0.43 to 0.25 mmol/l). In Europe and North America countries, the plasma level of HDL-c was also not different between the two diets (SMD = 0.09 mmol/l; 95% CI: −0.19 to 0.36 mmol/l). In light of this meta-analysis, we conclude that there is no evidence that plasma HDL-c levels differs in vegetarians and omnivores, even after adjusting for cultural circumstances.

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

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

Letter: Prevalence of Dyslipidemia among Korean Adults: Korea National Health and Nutrition Survey 1998-2005 (Diabetes Metab J 2012;36:43-55)

The prevalence of metabolic syndrome is increasing worldwide [1,2] and is becoming a social and economic problem. Recently, the increasing prevalence of metabolic syndrome in Korea has also been reported based on the Korean National Health and Nutritional Survey (KNHANES) [3]. The age-adjusted prevalence of metabolic syndrome in adults aged ≥20 years in Korea increased significantly from 24.9% in 1998 to 31.3% in 2007, and, of five individual metabolic syndrome components, the incidence of low high density lipoprotein cholesterol (HDL-C) criteria increased the most over 10 years (13.8% of increasing) [3]. Hypertriglyceridemia also showed a significant 4.9% increase during that period [3]. Metabolic syndrome is an important risk factor for atherosclerosis [4]. It is a disease characterized by insulin resistance [5], and dyslipidemia is one of its important components [6]. However low density lipoprotein cholesterol (LDL-C) level is not included in the criteria of metabolic syndrome. Elevated LDL-C level is a major cause of coronary heart disease and other atherosclerotic disease and can provide additional information for the future risk of atherosclerosis aside from metabolic syndrome [7]. Lee et al. [8] defined dyslipidemia according to LDL-C level as well as triglyceride and HDL-C level and investigated the change of prevalence of dyslipidemia among Korean adults during 1998-2005 with KNHANES data. Considering the importance of LDL-C for the risk of atherosclerosis, this study is very important in the view of public health in Korea. Dyslipidemia in this study is defined as total cholesterol ≥240 mg/dL, LDL-C ≥160 mg/dL, HDL-C <40 mg/dL, and triglyceride ≥200 mg/dL. However, it is known that women have higher levels of HDL-C than men [9-11], and the definition of low HDL cholesterolemia in the criteria of metabolic syndrome is different in men and women according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) [6], with an HDL-C level <50 mg/dL required for women. A relatively lower prevalence of dyslipidemia in the women in this study [8] compared to that of a previous report [3] despite adding a criterion for LDL-C to the requirements of dyslipidemia might be due to a lower cutoff level of low HDL cholesterolemia in women. Based on the appropriate cutoff level of low HDL cholesterolemia for the prediction of a clinically important end-point such as coronary heart disease in the Korean population, the sex difference in HDL-C level should be considered. Cardiovascular and cerebrovascular disease is the second most prevalent cause of death in Korea following malignancy [12], and the incidence of mortality from cardiovascular disease has persistently increased during recent years [12]. Considering that dyslipidemia is a major cause of such diseases, the study of Lee et al. [8] is important to understand the increasing tendency of dyslipidemia and the very low control rate of dyslipidemia in the Korean population and to support the need for an urgent health and medical policy plan to control dyslipidemia.

Influence of Lipid Profiles on the Risk of Hemorrhagic Transformation after Ischemic Stroke: Systematic Review

Background: It has been suggested that low cholesterol levels might be associated with an increased risk of hemorrhagic transformation (HT) in patients with acute cerebral ischemia. We systematically reviewed the literature to determine the influence of lipid profiles on the HT risk. Methods: We searched PubMed from 1966 and EMBASE from 1980 for studies that investigated the association between lipid profiles and HT. We performed a meta-analysis (weighted mean difference method) for the comparison between presence and absence of HT (all or symptomatic) for total, low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) cholesterol, and triglycerides. Results: Eight studies investigating 1,763 patients were eligible, but none was designed specifically to address this question. All studies recruited acute stroke patients selected on the presumed cause of cerebral ischemia or treatment received. The meta-analysis showed that: (i) patients with all HT had lower LDL cholesterol levels (p = 0.008) but no difference in HDL cholesterol levels (p = 0.066), total cholesterol (p = 0.129) and triglycerides (p = 0.900); (ii) patients with symptomatic HT had lower total cholesterol levels (p = 0.035) but did not differ in LDL (p = 0.056) and HDL cholesterol (p = 0.138) and triglyceride (p = 0.851) levels. Conclusion: HT is associated with baseline total and LDL cholesterol levels, but the mechanism of this association needs to be explored to identify preventive strategies.

The non-synonymous Arg230Cys variant (R230C) of the ATP-binding cassette transporter A1 is associated with low HDL cholesterol concentrations in Mexican adults: A population based nation wide study

ObjectiveTo search for an association between the non-synonymous Arg230Cys variant (R230C) of the ATP-binding cassette transporter A1 and low HDL cholesterol levels in a Mexican, population-based nation wide survey. MethodsThe 2000 National Health Survey is a cross sectional study that included individuals from 400 cities. All individuals who had a 9–12-h fasted blood sample and a DNA sample were selected (n=1729). These cases were randomly distributed; no bias was detected for sex, education, region or socioeconomic status. The R230C variant was genotyped using TaqMan assays. ResultsIn individuals with the R230C/C230C genotypes (39.03mg/dl (36.63–41.43)) lower HDL-C levels (p<0.001) were observed compared to those with the R230R genotype (44.7mg/dl (43.31–46.24)). The difference remained significant after adjusting for gender, body mass index and waist circumference; the mean difference in HDL cholesterol levels between alleles was 5.73±1.4mg/dl. The magnitude of the effect was significantly greater in males. The C230 allele of ABCA1 was associated with an increased risk for hypoalphalipoproteinemia (OR 1.66 (95%CI 1.08–2.54), p<0.05). The population attributable risk (PAR) for having hypoalphalipoproteinemia of the C230 allele of the ABCA1, after considering the confounding effect of waist circumference and gender, was 12.2% (95%CI 1.4–24.2%). ConclusionThe non-synonymous Arg230Cys variant of ABCA1 is associated with low levels of HDL cholesterol levels in Mexican adults. The HDL cholesterol lowering effect of the variant is greater in males. The size of the effect is greater compared to that reported for other ABCA1 variants.

Gender Difference in the Level of HDL Cholesterol in Korean Adults

BackgroundHigh density lipoprotein (HDL) cholesterol level varies with ethnicity and gender. In Korea there has not been an agreement on standards for HDL cholesterol level. Therefore, in order to establish a foundation for research on HDL cholesterol, we investigated the gender difference in HDL cholesterol level after adjusting associated factors.MethodsThe study population included 4,465 individuals (1,833 men, 2,632 women) representing 33,502,918 Koreans 20 years of age or older, who participated in the 2005 Korean National Health and Nutrition Survey. After stratifying by gender, we analyzed the HDL cholesterol level according to the general characteristics of the study population. Then we identified independent factors associated with HDL cholesterol level. After adjusting for covariates, we estimated the gender difference in HDL cholesterol level.ResultsWe demonstrated that age, current smoking, body mass index, alcohol intake, triglyceride and low density lipoprotein cholesterol level have significant impact on HDL cholesterol level. In addition, educational status was also an important factor for men, while fat intake was a significant factor for women. After adjusting associated factors, the means (standard errors) of HDL cholesterol level were 43.8 (0.2) mg/dL in men and 46.3 (0.2) mg/dL in women, respectively.ConclusionThe mean gender difference in HDL level (2.5 mg/dL) in Korean adults was, therefore, less than those observed in previous western studies.

Ethnic differences in total and HDL cholesterol among Turkish, Moroccan and Dutch ethnic groups living in Amsterdam, the Netherlands

BackgroundHigh total cholesterol and low HDL (high-density lipoprotein) cholesterol are important determinants of cardiovascular disease. Little is known about dyslipidemia among Turkish and Moroccan migrants, two of the largest ethnic minority groups in several European countries. This study examines ethnic differences in total and HDL cholesterol levels between Dutch, Turkish and Moroccan ethnic groups.MethodsData were collected in the setting of a general health survey, in Amsterdam, the Netherlands, in 2004. Total response rate was 45% (Dutch: 46%, Turks: 50%, Moroccans: 39%). From 1,220 adults information on history of hypercholesterolemia, lifestyle and demographic background was obtained via health interviews. In a physical examination measurements of anthropometry and blood pressure were performed and blood was collected. Total and HDL cholesterol were determined in serum.ResultsTotal cholesterol levels were lower and hypercholesterolemia was less prevalent among the Moroccan and Turkish than the Dutch ethnic population. HDL cholesterol was also relatively low among these migrant groups. The resulting total/HDL cholesterol ratio was particularly unfavourable among the Turkish ethnic group. Controlling for Body Mass Index and alcohol abstinence substantially attenuated ethnic differences in HDL cholesterol levels and total/HDL cholesterol ratio.ConclusionsTotal cholesterol levels are relatively low in Turkish and Moroccan migrants. However part of this advantage is off-set by their relatively low levels of HDL cholesterol, resulting in an unfavourable total/HDL cholesterol ratio, particularly in the Turkish population. Important factors in explaining ethnic differences are the relatively high Body Mass Index and level of alcohol abstinence in these migrant groups.

Decreased Serum Lipids in Patients with Probable Alzheimer´s Disease

Alzheimer;s disease (AD) is a multifactorial disease but its aetiology and pathophisiology are still not fully understood. Epidemiologic studies examining the association between lipids and dementia have reported conflicting results. High total cholesterol has been associated with both an increased, and decreased, risk of AD and/or vascular dementia (VAD), whereas other studies found no association. The aim of this study was to investigate the serum lipids concentration in patients with probable AD, as well as possible correlation between serum lipids concentrations and cognitive impairment. Our cross-sectional study included 30 patients with probable AD and 30 age and sex matched control subjects. The probable AD was clinically diagnosed by NINCDS-ADRDA criteria. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were determined at the initial assessment using standard enzymatic colorimetric techniques. Low-density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) levels were calculated. Subjects with probable AD had significantly lower serum TG (p<0,01), TC (p<0,05), LDL-C (p<0,05) and VLDL-C (p<0,01) compared to the control group. We did not observe significant difference in HDL-C level between patients with probable AD and control subjects. Negative, although not significant correlation between TG, TC and VLDL-C and MMSE in patients with AD was observed. In the control group of subjects there was a negative correlation between TC and MMSE but it was not statistically significant (r = -0,28). Further studies are required to explore the possibility for serum lipids to serve as diagnostic and therapeutic markers of AD.