Differences In Total Cholesterol Levels Research Articles

The role of dysfunctional HDL in atherosclerosis

This review focuses on HDL function in modulating LDL oxidation and LDL-induced inflammation. Dysfunctional HDL has been identified in animal models and humans with chronic inflammatory diseases including atherosclerosis. The loss of antiinflammatory function correlated with a loss of function in reverse cholesterol transport. In animal models and perhaps in humans, dysfunctional HDL can be improved by apoA-I mimetic peptides that bind oxidized lipids with high affinity.

Differences in risk factors for coronary heart disease in patients from continental and Mediterranean regions of Croatia

There are few data on differences in exposure to risk factors for coronary heart disease (CHD) in relation to geographic areas, especially areas with large differences in terms of continental and Mediterranean climates. To study these differences in Croatia, we analyzed data from the Treatment and Secondary Prevention of Ischemic Coronary Events in Croatia V (TASPIC-CRO V) study, which recruited Croatian CHD patients in two principal regions (Mediterranean and continental) of the country. A total of 31 Croatian research centers participated in the study. We collected information on personal details, demographic characteristics and risk factor exposure from the hospital medical records of 3054 CHD patients. Risk factors included history of cigarette smoking, hypertension, hyperlipidemia (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) and diabetes type 2. Both univariate and multivariate analyses showed that the prevalence of hypertension in examined CHD patients was significantly higher in the continental part of Croatia than in the Mediterranean part (univariate analysis: P < 0.001; multivariate analysis: P = 0.003). Multivariate analysis revealed a higher prevalence of decreased HDL-cholesterol in continental Croatia (P = 0.006) and a higher prevalence of smokers in coastal Mediterranean Croatia (P = 0.007). A significant difference in total cholesterol levels was noted between hospitalized CHD patients in two Mediterranean subregions (P < 0.001). No significant differences between continental and coastal Mediterranean parts of Croatia were found for other CHD risk factors. Higher prevalences of both hypertension and decreased HDL-cholesterol were recorded in hospitalized CHD patients in the continental part of Croatia, but in coastal Mediterranean Croatia there was higher prevalence of smokers. Differences in total cholesterol, LDL-cholesterol and triglycerides between hospitalized CHD patients in continental and coastal Mediterranean Croatia did not follow the expected continental-Mediterranean pattern.

Comparative results of a 4-year study on cardiovascular parameters, lipid metabolism, body composition and bone mass between untreated and treated adult growth hormone deficient patients

Objective To evaluate the long-term evolution of cardiovascular parameters, lipid metabolism, body composition and bone mass in untreated and treated adult growth hormone deficient patients (AGHD) comparing the differences between the two groups and within each group. Design Seventy-one AGHD-patients were enrolled; 48 received growth hormone (GH) therapy: treated group (TG) and 23 received no GH therapy: control group (CG). In the TG, 22 were childhood-onset (CO) GH-deficient patients, 18–44 years (12 males) and 26 were adult-onset (AO) GH-deficient patients, 27–66 years (10 males). In the CG, 10 patients were AGHD-CO, 20–43 years (8 males) and 13 were AGHD-AO, 25–70 years (8 males). For patients in the TG, GH was administered at a starting dose of 0.1 mg/day, adjusted to maintain IGF-I levels between 0 and 2 SDS for gender and age. At baseline and during the 4th year of replacement therapy or follow-up, the following parameters were evaluated: body mass index, waist circumference, blood glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, total cholesterol/HDL-cholesterol ratio, systolic and diastolic blood pressure, 2-D echocardiogram with mitral Doppler, bone mineral density (total body, lumbar spine, and femoral neck), bone mineral content (BMC) and body composition. Results In the TG, there was a decrease in diastolic blood pressure (−4.0 ± 1.8 mmHg, p < 0.035) and an increase in blood glucose levels (0.58 ± 0.19 mmol/L, p < 0.025), bone mineral content (0.2 ± 0.0 kg, p < 0.015) and bone mineral density of lumbar spine (0.3 ± 0.1 SDS, p < 0.015) and femoral neck (0.4 ± 0.1 SDS, p < 0.001). All other variables did not show significant changes in any of the two groups. At year 4, changes (delta) differed between patients in the TG and those in the CG with regard to cholesterol levels (TG: −0.27 ± 0.16 mmol/L, CG: 0.34 ± 0.23 mmol/L, p < 0.045), blood glucose (TG: 0.58 ± 0.19 mmol/L, CG: −0.12 ± 0.19 mmol/L, p < 0.025) and BMC (TG: 0.2 ± 0.0 g, CG: 0.0 ± 0.0 g, p < 0.015). An assessment of the changes in variables over time, with and without therapy, considering CO and AO separately, revealed a significant difference in total cholesterol levels during year 4 in CO patients CO (TG: −0.28 ± 0.25 mmol/L and CG: 0.84 ± 0.25 mmol/L, p < 0.015). No differences related to the time of onset of GHD were found in changes in the remaining variables studied. There were no differences related to gender, GHD etiology or the presence of other pituitary hormone deficiencies in the evolution of the parameters analyzed. Conclusions Our 4-year study in GH deficient adults showed significant beneficial effects on some cardiovascular risk parameters and BMC in treated patients. However, there are still unsettled issues regarding long-term benefits and these patients should be carefully monitored.

Successful rescue therapy with mycophenolate mofetil in kidney transplantation improves the long-term graft survival

The aim of this study was to compare the graft survival after kidney transplantation in patients treated with azathioprine (AZA) or mycophenolate mofetil (MMF) and analyze the significance of different risk factors for graft survival. A total of 137 patients, transplanted between January 1996 and June 2001, were retrospectively divided into two groups: patients who received AZA together with cyclosporine A and methylprednisolone (AZA group, n=72) and patients who received MMF either immediately or were switched from AZA to MMF during 3 months (MMF group, n=65). According to Kaplan-Meier analysis, a 1-year graft survival was 79% in the AZA group and 85% in the MMF group; a 6-year graft survival was 51% and 67%, respectively (P=0.046). Multivariate Cox survival model demonstrated that MMF therapy reduced the risk of graft loss by 34% (P=0.028), while delayed graft function increased the risk of graft loss (risk ratio 2.26, P=0.009). A statistically significant difference in total cholesterol level (6.7 vs. 5.7 mmol/L, respectively; P=0.002), mean systolic blood pressure (145 vs. 134 mmHg, P=0.009), and cyclosporine A daily dose (238 vs. 203 mg, P=0.015) between the AZA and MMF groups at 1 year was revealed. MMF rescue therapy improves the long-term graft survival compared to AZA despite high early rejection rate and avoids the negative impact of acute rejections on graft survival.

Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome

Purpose Women with polycystic ovary syndrome are hyperandrogenemic and insulin resistant, which are associated with alterations in circulating lipid and lipoprotein levels. We sought to determine the prevalence of, and risk factors for, lipid abnormalities in these women. Subjects and methods Non-Hispanic white women with polycystic ovary syndrome (n = 195) and ethnically matched control women (n = 62) had fasting blood obtained for hormone and lipid levels. Subjects were categorized by body mass index (nonobese <27 kg/m 2, obese ≥27 kg/m 2), and analyses were adjusted for age. Results Total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels increased significantly in obese women with polycystic ovary syndrome (n = 153) compared with obese control women (n = 35; mean difference in total cholesterol level = 29 mg/dL; 95% confidence interval [CI]: 14 to 45 mg/dL; P <0.001; mean difference in LDL-C level = 16 mg/dL; 95% CI: 4 to 30 mg/dL; P = 0.006). Similarly, total cholesterol and LDL-C levels increased significantly in nonobese women with polycystic ovary syndrome (n = 42) compared with nonobese control women (n = 27; mean difference in total cholesterol = 32 mg/dL; 95% CI: 13 to 52 mg/dL; P <0.001; mean difference in LDL-C level = 32 mg/dL; 95% CI: 15 to 52 mg/dL; P <0.001). In obese women, high-density lipoprotein cholesterol (HDL-C) and triglyceride levels increased significantly in women with polycystic ovary syndrome compared with control women (mean difference in HDL-C level = 6 mg/dL; 95% CI: 2 to 12 mg/dL; P = 0.002; mean difference in triglyceride level = 34 mg/dL; 95% CI: 1 to 77 mg/dL; P = 0.04). Differences in LDL-C and HDL-C levels, but not triglyceride levels, remained significant after adjusting for alcohol intake, smoking, and exercise. Although age, body mass index, and polycystic ovary syndrome status were significant predictors of lipid levels, these factors accounted for no more than 25% of the variance. Conclusions In this large study of non-Hispanic white women, elevations in LDL-C levels were the predominant lipid abnormality in women with polycystic ovary syndrome, independent of obesity. The characteristic dyslipidemia of insulin resistance was absent. Indeed, obese women with polycystic ovary syndrome had relatively elevated HDL-C levels, which may confer some protection against cardiovascular disease.

Is the apoE4 allele an independent predictor of coronary events?

Purpose: Although the apolipoprotein E genotype ϵ4 (apoE4) has been associated with high cholesterol levels, whether it is an independent predictor of coronary events is not certain. Subjects and Methods: We measured apoE genotypes in 730 participants in the Baltimore Longitudinal Study of Aging (421 men and 309 women, mean [± SD] age of 52 ± 17 years) who were free of preexisting coronary heart disease. A proportional hazards regression model was used to study the association between risk factors and the occurrence of coronary events, defined as angina pectoris, documented myocardial infarction by history or major Q waves on the electrocardiogram (Minnesota Code 1:1 or 1:2), or coronary death, adjusted for other risk factors, including total plasma cholesterol level. Results: The apoE4 allele was observed in 200 subjects (27%), including 183 heterozygotes and 17 homozygotes. Coronary risk factor profiles were similar in those with and without apoE4. Coronary events developed in 104 (14%) of the 730 subjects, including 77 (18%) of the 421 men during a mean follow-up of 20 years and 27 (9%) of the 309 women during a mean follow-up of 13 years. Coronary events occurred significantly more frequently in subjects with apoE4 (n = 40, 20%) than in those without this allele (64, 12%, P <0.05). In a multivariate model, apoE4 was an independent predictor of coronary events in men (risk ratio [RR]= 2.9, 95% confidence interval [CI]: 1.8 to 4.5, P <0.0001) but not in women (RR = 0.9, 95% CI: 0.4 to 1.9, P = 0.62). Conclusion: The apoE4 genotype is a strong independent risk factor for coronary events in men, but not women. The association does not appear to be mediated by differences in total cholesterol levels.

Prevalencia de obesidad , hipertensión arterial y dislipidemia en grupos aborígenes rurales de Chile

Chilean aboriginal ethnic groups (mapuche and aymaras) have a very low prevalence rate of type 2 diabetes. The investigation of a possible relationship between this low prevalence of diabetes and obesity, hypertension and serum lipid profiles in both groups is worthwhile. To study the prevalence of obesity, hypertension and lipid profile in two Chilean aboriginal communities. The prevalence of obesity, hypertension, fasting serum total cholesterol, HDL cholesterol, triglycerides, glucose, insulin, leptin and oral glucose tolerance test were measured in 345 mapuche (106 male) and 247 aymara (100 male) individuals. Sixty three percent of mapuche women, 37.9% of mapuche men, 39.7% of the aymara women and 27.0% of aymara men had a body mass index over 27 kg/m2. Twenty percent of mapuche men, 18.0% of mapuche women, 9.0% of aymara men and 4.8% of the aymara women had high blood pressure values. Serum HDL cholesterol was below 35 mg/dl in 16% of mapuche women, 14% of mapuche men, 25% of the aymara women and 27% of aymara men. No differences in total cholesterol levels were observed between mapuches and aymaras. Mapuche women have higher prevalence of obesity and high blood pressure than aymara women. Low serum HDL cholesterol has a higher prevalence among aymara individuals.

Levels of Serum HDL-cholesterol and Total Cholestetol in Kawasaki Disease and Their Significance

Background:The value of serum lipid in children after recovery of Kawasaki disease may be important because of the predilection of this disease for the coronary artery. Methods:To determine the alterations in serum total cholesterol(TC) and high density lipoprotein (HDL)-cholesterol levels in Kawasaki disease(KD), we measured serum HDL-cholesterol and TC in 35 patients(mean age 36.8±22.0 months, range 6 to 93 months) with Kawasaki disease(KD) during 10 days or less after the onset(group A) and 2 months later after recovery. TC and HDL-cholesterol were also measured in an acute febrile respiratory illness group(group B) and a nonfebrile respiratory illness group(group C) to compare with those of KD. Results:HDL-cholesterol levels in group A were depressed(29.6±11.0mg/dl) compared with groups B and C(47.3±13.3mg/dl and 45.1±12.4mg/dl, respectively, p<0.01). TC levels in group A (145.1±33.1mg/dl) were not significantly different from those of group B(146.8±33.4mg/dl) and C (157.1±29.6mg/dl). Also the level of serum HDL-cholesterol in the acute phase of KD was significantly lower when compared with that after recovery(30.2±13.2mg/dl vs 50.0±10.2mg/dl, p<0.05). In KD patients, TC levels were not significantly different between the acute & recovery phases(145.0±26.6mg/dl, 153.4±32.6mg/dl). Echo-cardiography confirmed coronary artery aneurysms in 11 patients(31.4%) and otherwise, normal findings(n=24) in the KD group. There were no significant difference in TC level(140.7±27.6mg/dl vs. 146.9±35.4mg/dl, p=NS) and HDL cholesterol level(30.1±12.5mg/dl vs. 29.2±10.7mg/dl, p=NS) between patients with and without coronary aneurysms. Conclusions:HDL-cholesterol levels were significantly depressed only in the acute phase of KD but TC levels did not change significantly. Both levels were not related to coronary artery aneurysm.

Excess body weight. An underrecognized contributor to high blood cholesterol levels in white American men.

The influence of body weight on serum lipids is often overlooked in clinical practice. The association between body weight adjusted for height as calculated by body-mass index (BMI) and serum lipid and lipoprotein levels in white men was examined using the second National Health and Nutrition Examination Survey (NHANES II). Lipid results were categorized into six different levels of BMI: (1) 21.0 kg/m2 or lower, (2) 21.1 to 23.0 kg/m2, (3) 23.1 to 25.0 kg/m2, (4) 25.1 to 27.0 kg/m2, (5) 27.1 to 30.0 kg/m2, and (6) greater than 30.0 kg/m2, and three age groups: (1) young men (20 through 44 years), (2) middle-aged men (45 through 59 years), and (3) older men (60 through 74 years). Using linear trend analysis, changes in BMI from categories 2 to 5 in young men were associated with a total cholesterol level 0.59 mmol/L (23 mg/dL) higher (P < .01), a non-high-density lipoprotein (non-HDL) cholesterol level 0.70 mmol/L (27 mg/dL) higher (P < .01), and a low-density lipoprotein (LDL) cholesterol level 0.59 mmol/L (23 mg/dL) higher (P = .03). For middle-aged men and older men, the same change in BMI was associated with smaller but still significant differences in total cholesterol levels (higher by 0.31 mmol/L [12 mg/dL] [P < .01] and 0.28 mmol/L [11 mg/dL] [P < .01], respectively) and non-HDL cholesterol levels (higher by 0.37 mmol/L [14 mg/dL] [P < .01] and 0.25 mmol/L [10 mg/dL] [P < .01], respectively), whereas the LDL cholesterol levels were unchanged. Although advancing age may blunt the BMI-associated differences in total and LDL cholesterol levels, the BMI-associated differences in triglyceride levels (higher by 0.70 to 1.33 mmol/L [62 to 118 mg/dL] [P < .001]) and HDL cholesterol levels (lower by 0.18 to 0.39 mmol/L [7 to 15 mg/dL] [P < .001]) were of similar magnitude in all age groups. Excess body weight is associated with deleterious changes in the lipoprotein profile. Higher BMI was associated at all ages with higher plasma triglyceride level, lower HDL cholesterol level, and higher total and non-HDL cholesterol levels. In young men, the higher total cholesterol level was reflected mainly in the LDL cholesterol level; in middle-aged and older men, in the non-HDL fraction. Programs to reduce coronary heart disease by improving lipid levels should include more emphasis on achieving and maintaining ideal body weight.

Association of angiographically detected coronary artery disease with low levels of high-density lipoprotein cholesterol and systemic hypertension

The prevalence of risk factors for atherosclerosis in 488 consecutive patients undergoing cardiac catheterization for the investigation of chest pain was compared with that in 868 subjects from a population sample. The presence and severity of angiographic coronary artery disease (CAD) (defined as mean diameter stenosis > 50%), total and high-density lipoprotein (HDL) cholesterol, triglycerides, history of systemic hypertension, smoking, diabetes mellitus, family history and drug therapy were assessed. Low HDL cholesterol (< 0.9 mmol/liter [35 mg/ dl]) was more prevalent in patients with CAD than in the population sample in both men (44% [95% confidence interval 38 to 48] vs 21% [12 to 28]; p < 0.01) and women (12% [9 to 15] vs 1% [0 to 3]; p < 0.01). There were no differences in total cholesterol levels between these 2 groups. Total:HDL cholesterol ratios were significantly greater in patients with CAD. History of systemic hypertension was more prevalent in both men and women with CAD than in the population sample (47% [37 to 57] vs 20% [16 to 25] for men, and 31% [26 to 36] vs 21% [17 to 26] for women; p < 0.01). The prevalence of other risk factors was not significantly different between the 2 groups. In patients with CAD, the severity of disease was inversely correlated with levels of HDL cholesterol in both men and women (p < 0.01), and positively correlated with total cholesterol in men aged < 55 years (p < 0.01). Low HDL cholesterol (< 0.9 mmol/liter [35 mg/dl]) was more frequent when total cholesterol was < 5.2 mmol/liter (200 mg/dl) than when it was > 5.2 mmol/liter (200 mg/dl) (63% [49 to 74] vs 39% [33 to 45] for men [p < 0.05], and 50% [20 to 80] vs 16% [10 to 25] for women [p < 0.05]). Men and women with angiographic CAD are more likely to have low HDL cholesterol levels and history of hypertension than is an agematched population sample.

Lp(a) Lipoprotein as a Risk Factor for Myocardial Infarction

The Lp(a) lipoprotein is structurally related to low-density lipoprotein but is found in lower plasma concentration. It has been associated with coronary disease in several white populations. To test the generalizability of this association, we measured serum Lp(a) by quantitative immunoelectrophoresis in 303 Hawaiian men of Japanese ancestry with a prior myocardial infarction (MI) and in 408 population-based controls. Mean values were 17.1 and 13.7 mg/dL (0.171 and 0.137 g/L), respectively. Increased risk for MI was shown mainly for men in the upper quartile of the Lp(a) lipoprotein distribution (greater than or equal to 20.1 mg/dL [greater than or equal to 0.201 g/L]). Odds ratios at younger than 60, 60 to 69, and 70 years of age or older were 2.5, 1.6, and 1.2 times those for men in the lower three quartiles, respectively. In a multiple logistic model the association with MI remained significant and was not explained by differences in total cholesterol levels, high-density lipoprotein or low-density lipoprotein cholesterol levels, subscapular skin fold, systolic blood pressure, history of smoking, alcohol consumption, or age. We conclude that Lp(a) is an important attribute that should often be considered when coronary heart disease risk is assessed.

Factors affecting serum total cholesterol level of lactating Holstein cows.

Several factors affecting serum total cholesterol level of lactating Holstein cows were statistically evaluated. One thousand and sixty-three lactating Holstein cows were examined in a period from July, 1982 to April, 1983. Data from each cow were classified according to farms, number of calvings, health condition, daily milk yield and lactation day. Serum total cholesterol was significantly influenced by all these factors, especially daily milk yield and lactation day. However, no significant difference in total cholesterol level was observed between the summer and winter periods when other factors such as the number of calvings, health condition and lactation day were excluded.

The effect of vigorous physical activity at work on serum lipids with a special reference to serum high‐density lipoprotein cholesterol

Serum lipid concentrations of lumberjacks whose occupational physical activity is most vigorous were compared with those of electricians. The lumberjacks had significantly higher serum HDL-cholesterol and significantly lower triglyceride and free fatty acid concentrations but there were no significant differences in total cholesterol levels. The favourable effect of vigorous physical activity at work on lipid metabolism is, however, epidemiologically not seen, obviously due to negative risk factors in lumberjacks' life.