Dyslipidemia In Patients Research Articles

A COMPARITIVE CLINICAL STUDY OF CHATURUSHAN ON MODIFIABLE FACTORS OF FRAMINGHAM HEART SCORE IN CARDIO-VASCULAR RISK

Twenty first century is the century of globalization, industrialization, and modernization. This advancement has led to a drastic increase in the incidence of lifestyle related diseases like Obesity, DM, HTN, Hyperlipidemia etc. eventually leading to the risk of number of chronic disorders such as cardio-vascular disease(CVD). Aim & objective: In this clinical study, we are aiming to Study the Effect of Chaturushan as dietary supplement in CVD Risk assessment as per Framingham Heart Score. Objectives:. To assess the effect of Chaturushan on Total cholesterol, Sr.HDL and Blood Pressure in the experimental group and to compare the same for Gomutra Haritaki(GH) which is an already proven drug and taken here as a control. Materials & Methods: In this study 60 patients of Dyslipidemia bearing a risk of cardio-vascular disease were selected by using selection criteria irrespective of age, sex, and socio-economical status. In Group A (n = 30), patients were administered Chaturushan churna 2gm daily in 2 divided doses. for 3 months and in Group B (n = 30), Gomutra Haritaki churna was given in similar dose and duration. Effect of therapy was assessed objectively by Framingham Heart Score including Total cholesterol, Sr.HDL, Systolic and Daistolic BP. Also, Physical parameters like body weight, waist circumference and Body Mass Index (BMI) were assessed and subjectively by the cardinal symptoms.After completion of therapy all values were recorded and statistically analyzed and results were obtained. Conclusion:Chaturushan a dietary supplement was found quite effective in lowering the Total cholesterol levels as per FHS But, on comparing the effects of the two groups subjectively, it can be concluded that both the supplements are equally effective in reducing the subjective scores of the disease.

The effects of pemafibrate and omega-3 fatty acid ethyl on apoB-48 in dyslipidemic patients treated with statin: A prospective, multicenter, open-label, randomized, parallel group trial in Japan (PROUD48 study).

We compared the lowering effects of pemafibrate and omega-3 fatty acid ethyl on fasting apolipoprotein (apo) B-48 (apoB-48), a marker that reflects postprandial hypertriglyceridemia, which is one of the residual risks for atherosclerotic cardiovascular disease (ASCVD) with statin treatment. This prospective, multicenter, open-label, randomized, parallel group trial was conducted at 4 medical institutions between April 2020 and May 2022. A total of 126 ambulatory patients with dyslipidemia receiving statin treatment for more than 4 weeks, aged 20-79 years with fasting triglyceride (TG) levels of ≥177 mg/dl were randomly assigned to 16-week pemafibrate 0.4 mg per day treatment group (PEMA, n = 63) or omega-3 fatty acid ethyl 4 g per day treatment group (OMEGA-3, n = 63). The primary endpoint was the percentage change in fasting apoB-48 from baseline to week 16. The percentage changes in fasting apoB-48 in PEMA and OMEGA-3 were -50.8% (interquartile range -62.9 to -30.3%) and -17.5% (-38.3 to 15.3%) (P < 0.001), respectively. As the secondary endpoints, the changes in fasting apoB-48 in PEMA and OMEGA-3 were -3.10 μg/ml (-5.63 to -1.87) and -0.90 μg/ml (-2.95 to 0.65) (P < 0.001), respectively. Greater decreases with significant differences in the percentage changes in TG, remnant lipoprotein cholesterol, apoC-III, fasting plasma glucose, alanine aminotransferase, gamma-glutamyl transpeptidase, and alkaline phosphatase were observed in PEMA, compared with OMEGA-3. Greater increases with significant differences in those in high-density lipoprotein (HDL) cholesterol, apoA-I, and apoA-II were observed in PEMA, compared with OMEGA-3. PEMA showed anti-atherosclerotic lipoprotein profiles in gel-permeation high-performance liquid chromatography analyses, compared with OMEGA-3. Although adverse events occurred in 9 of 63 (14.3%) patients in PEMA and 3 of 63 (4.8%) patients in OMEGA-3, no serious adverse events associated with drug were observed in either group. This is the first randomized trial to compare the lowering effects of pemafibrate and omega-3 fatty acid ethyl on fasting apoB-48. We concluded that pemafibrate was superior to omega-3 fatty acid ethyl in lowering effect of fasting apoB-48. Pemafibrate is expected to reduce the residual risk for ASCVD with statin treatment. https://rctportal.niph.go.jp/en, identifier jRCTs071200011.

Virgin Coconut Oil: A Dietary Intervention for Dyslipidaemia in Patients with Diabetes Mellitus.

Hyperlipidaemia is causally related to coronary artery diseases (CAD) and peripheral artery diseases (PAD) in people with Diabetes Mellitus (DM). An in vivo study confirmed that virgin coconut oil (VCO) could maintain levels of lipids in the blood as effectively as conventional therapy. Therefore, this study aimed to determine the effect of VCO on the lipid profiles and ankle-brachial index (ABI) of patients with DM. In this experimental study with pre- and post-test design and a control group, the participants were selected purposively. The ABI was evaluated on the first visit. Baseline lipid profile readings were taken. Each participant took 1.2 mL/kgBW of VCO daily and divided it into three doses. After 30 days of taking VCO, laboratory examinations and ABI were repeated, and adverse events were evaluated. The dependent t-test and Wilcoxon sign rank test with a significance level of α ≤ 0.05 showed a significant decrease in low-density lipoprotein (LDL) (p = 0.002), a significant increase in high-density lipoprotein (HDL) levels (p = 0.031), a significant decrease in energy intake (p = 0.046) and cholesterol intake (p = 0.023) at the endpoint in the VCO group. In conclusion, this therapy is beneficial for maintaining lipid profile when combined with dietary therapy. Future studies should investigate the duration and dosage of VCO on patients to maintain lipid-linked protein.

Evaluation of an Association of Thyroid Disorder and Dyslipidemia in Patients with Cardiovascular Disease: A Cross-sectional Study

Background: Subclinical Hypothyroidism (SCH) is defined as normal serum free thyroid hormone levels coexisting with elevated serum Thyroid-Stimulating Hormone (TSH) levels. SCH is a common condition observed in clinical practice with several unique features. The present study was conducted to find prevalence of subclinical hypothyroidism in patients with myocardial infarction and demographic differences between patients with and without SCH. Materials and Methods: A total of 100 patients with Myocardial Infarction of Adult (age &gt; 18 years) males and females were selected from the patients attending Medicine OPD, IPD or Intensive Care Unit (ICU) in GMC, Azamgarh. Clinical examination, laboratory investigations for myocardial infarction, thyroid status and lipid profile was done in all patients in our study. All Patients with TSH values &gt; 10mU/L or &lt; 0.04mU/L or Known cases of Thyroid abnormalities were excluded from the study. Statistical analysis was done using excel and SPSS software. Results: Out of 100 patients 44 patients of MI had subclinical hypothyroid were as rest 56 patients were euthyroid. In both the groups no statistical difference was seen in the type of Myocardial infarction. There was significant difference in lipid profile (p&lt;0.05) in SCH group as compared to euthyroid group. Conclusion: Patients with Subclinical hypothyroid and MI had more lipid abnormalities as compared to Euthyroid group although the type of myocardial infarction was similar in both the groups. Males had more myocardial infarction as compared to females in both the subclinical hypothyroid and euthyroid groups.

Associations of eicosapentaenoic acid and docosahexaenoic acid intakes with cardiovascular and all-cause mortality in patients with diabetes: Result from National Health and Nutrition Examination Survey 1999-2008.

The evidence on eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake status and long-term mortality among people with diabetes is scarce. This study aimed to investigate the relationship between EPA and DHA intakes with all-cause and cause-specific mortality in adults with diabetes. This study included 2,991 adults with diabetes from the National Health and Nutrition Examination Survey (NHANES) 1999-2008. Death outcomes were ascertained by linkage to the database records through 31 December 2015. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality from all causes, cardiovascular disease (CVD), and coronary heart disease (CHD) in patients with diabetes. Among 2,991 patients with diabetes, the mean age was 61.9 years (55.2% males). During the mean follow-up duration of 9.4 years, a total of 1,091 deaths were documented, of which 273 were due to CVD, including 227 CHD deaths. EPA and DHA intakes were associated with lower mortality risks, especially that of CVD. After adjusting for demographic, major lifestyle factors, overall dietary intake patterns, and history of hypertension and dyslipidemia, the multivariable HRs (95% CIs) of mortality risk comparing Q4 to Q1 of EPA intake were 0.55 (0.33-0.92; P-trend = 0.019) for CHD, 0.55 (0.36-0.83; P-trend = 0.005) for CVD, and 0.91 (0.70-1.18; P-trend = 0.264) for all-cause. The respective HRs (95% CIs) comparing Q4 to Q1 of DHA were 0.60 (0.37-0.98; P-trend = 0.051) for CHD, 0.58 (0.38-0.89; P-trend = 0.014) for CVD, and 0.92 (0.72-1.18; P-trend = 0.481) for all-cause. In subgroup analysis, we found that the association trends of EPA and DHA intakes with death risk remained robust among patients with diabetes, especially among those who are old, female, those with higher BMI, and dyslipidemia patients with CVD and CHD. In the USA, higher EPA and DHA intakes were associated with a lower risk of CHD and CVD mortality in patients with diabetes. Our study supports the benefits of adequate EPA and DHA intakes in promoting the health of patients with diabetes.

Downregulation of Circulating Hsa-miR-200c-3p Correlates with Dyslipidemia in Patients with Stable Coronary Artery Disease.

Coronary heart disease (CHD), one of the leading causes of disability and death worldwide, is a multifactorial disease whose early diagnosis is demanding. Thus, biomarkers predicting the occurrence of this pathology are of great importance from a clinical and therapeutic standpoint. By means of a pilot study on peripheral blood cells (PBMCs) of subjects with no coronary lesions (CTR; n = 2) and patients with stable CAD (CAD; n = 2), we revealed 61 differentially methylated regions (DMRs) (18 promoter regions, 24 genes and 19 CpG islands) and 14.997 differentially methylated single CpG sites (DMCs) in CAD patients. MiRNA-seq results displayed a peculiar miRNAs profile in CAD patients with 18 upregulated and 32 downregulated miRNAs (FC ≥ ±1.5, p ≤ 0.05). An integrated analysis of genome-wide DNA methylation and miRNA-seq results indicated a significant downregulation of hsa-miR-200c-3p (FCCAD = -2.97, p ≤ 0.05) associated to the hypermethylation of two sites (genomic coordinates: chr12:7073122-7073122 and chr12:7072599-7072599) located intragenic to the miR-200c/141 genomic locus (encoding hsa-miR-200c-3p) (p-value = 0.009) in CAD patients. We extended the hsa-miR-200c-3p expression study in a larger cohort (CAD = 72, CTR = 24), confirming its reduced expression level in CAD patients (FCCAD = -2; p = 0.02). However, when we analyzed the methylation status of the two CpG sites in the same cohort, we failed to identify significant differences. A ROC curve analysis showed good performance of hsa-miR-200c-3p expression level (AUC = 0.65; p = 0.02) in distinguishing CAD from CTR. Moreover, we found a significant positive correlation between hsa-miR-200c-3p expression and creatinine clearance (R2 = 0.212, p &lt; 0.005, Pearson r = 0.461) in CAD patients. Finally, a phenotypic correlation performed in the CAD group revealed lower hsa-miR-200c-3p expression levels in CAD patients affected by dyslipidemia (+DLP, n = 58) (p &lt; 0.01). These results indicate hsa-miR-200c-3p as potential epi-biomarker for the diagnosis and clinical progression of CAD and highlight the importance of deeper studies on the expression of this miRNA to understand its functional role in coronary artery disease development.

Prevalence of suicide attempts and correlates among first-episode and untreated major depressive disorder patients with comorbid dyslipidemia of different ages of onset in a Chinese Han population: a large cross-sectional study

BackgroundPatients with dyslipidemia are at increased risk for suicide, especially those with major depressive disorder (MDD). Few studies have investigated the independent effects of suicide attempts on comorbid dyslipidemia in patients with MDD. Moreover, there are no comparisons of differences in factors associated with suicide attempts among patients with MDD with dyslipidemia at different ages of onset. The aim of this study was to investigate the prevalence of suicide attempts and associated variables in first episode and untreated patients with MDD with comorbid dyslipidemia at different ages of onset.MethodsWe recruited 1718 patients with first-episode untreated MDD in this study. Demographical and clinical data were collected, and lipid profiles, thyroid function, and blood glucose levels were measured. The Hamilton Depression Scale 17 (HAMD-17), Hamilton Anxiety Scale (HAMA), Clinical Global Impression Severity Scale (CGI), and Positive and Negative Syndrome Scale (PANSS) positive subscale were assessed for depression, anxiety and illness severity, as well as psychotic symptoms, respectively.ResultsThe percentage of patients with MDD with comorbid dyslipidemia was 61% (1048/1718). Among patients with MDD with comorbid dyslipidemia, the incidence of suicide attempts was 22.2% (170/765) for early adulthood onset and 26.5% (75/283) for mid-adulthood onset. Independent factors associated with suicide attempts in early adulthood onset patients with MDD with dyslipidemia were as follows: HAMA score (B = 0.328, P < 0.0001, OR = 1.388), Suspicion /persecution (B = -0.554, P = 0.006, OR = 0.575), CGI (B = 0.878, P < 0.0001, OR = 2.406), systolic blood pressure (B = 0.048, P = 0.004, OR = 1.049), hallucinatory behavior (B = 0.334, P = 0.025, OR = 1.397), and TPOAb (B = 0.003, p < 0.0001, OR = 1.003). Independent factors associated with suicide attempts in mid-adulthood onset patients with MDD with comorbid dyslipidemia were as follows: HAMA score (B = 0.182, P < 0.0001, OR = 1.200), CGI (B = 1.022, P < 0.0001, OR = 2.778), and TPOAb (B = 0.002, P = 0.009, OR = 1.002).ConclusionOur findings suggest an elevated risk of suicide attempts in patients with MDD with comorbid dyslipidemia. The incidence of suicide attempts was similar in the early- and mid-adulthood onset subgroups among patients with MDD with dyslipidemia, but the factors associated with suicide attempts were different in these two subgroups.

Correlation of Blood Pressure with Microalbuminuria and Dyslipidaemia in Patients with Essential Hypertension: A Case-control Study

Introduction: Hypertension (HTN) is one of the most common disease affecting the people around the world. Microalbuminuria and dyslipidaemia has been considered as an early indicator of vascular damage, endothelial dysfunction and renal disease. Studies, conducted to evaluate microalbuminuria, dyslipidaemia in essential hypertensive patients are scarce. Aim: To assess the microalbuminuria, dyslipidaemia in essential hypertensive patients and also, to correlate these parameters with Blood Pressure (BP). Materials and Methods: This case-control study was conducted in the Department of Biochemistry at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Sambalpur, Odisha, India, from January 2020 to February 2021. The study included 70 healthy individuals as controls and 70 essential hypertensive patients as cases in the age group of 25 to 55 years. According to Joint National Committee (JNC) 7 guidelines, out of 70, 20 cases were categorised as stage I (BP≥140-159/90-99 mmHg) and 50 as stage II (BP≥160/100 mmHg). Renal profile, lipid profile, total protein and albumin, microalbumin and Albumin-creatinine Ratio (ACR) were evaluated. Pearson correlation coefficient was applied to statistically analyse the data. Results: In the present study, 38 (54.3%) were males and 32 (45.7%) were females. Whereas, in controls, 44 (62.8%) were males and 26 (37.2%) were females. The mean age in cases 44.4±8.58 years, Systolic Blood Pressure (SBP) 156.0±35.1 mmHg, Diastolic Blood Pressure (DBP) 101±12.9 mmHg, serum creatinine 1.08±0.29 mg/dL, serum uric acid 7.37±1.8 mg/dL, serum total cholesterol 171±44.7 mg/dL, serum triglycerides 173±48.4 mg/dL, Low-density Lipoprotein Cholesterol (LDL-C) 107±38.8 mg/dL, Very Low-density Lipoprotein Cholesterol (VLDL-C) 35.1±10.2 mg/dL, microalbuminuria 75±31.9 mg/L, and urinary ACR 78±44.1 were significantly increased and serum High-density Lipoprotein Cholesterol (HDL-C) 31.7±7.07 mg/dL levels were decreased in cases than controls. Urinary ACR was significantly increased in stage II. ACR was positively correlated with SBP, DBP, creatinine, uric acid, total cholesterol, triglycerides, VLDL-C and negatively correlated with HDL-C. Conclusion: Blood pressure was positively correlated with lipid profile parameters, except HDL-C. Increased urinary albumin excretion rate may be useful and inexpensive marker for the identification of patients with higher cardiovascular risk and organ damage.

Association between Physical Activity Level with Depression, Anxiety, and Stress in Dyslipidaemia Patients

Background: Dyslipidemia is a significant risk factor for cardiovascular and cerebrovascular events globally. Current findings have linked dyslipidemia with mental health. Since physical activity level (PAL) is a modifiable risk factor associated with CVD and depression risk, it is worth knowing if the level of PA among dyslipidaemia patients does affect their mental health. Objective: Hence, the main objective of this study was to determine the association between depression, anxiety, and stress and physical activity among lipid-lowering drug (LLD)-treated dyslipidaemia patients. Methods: This was a cross-sectional study that was conducted among dyslipidaemia patients receiving LLD treatment from the Lipid Clinic in Hospital Al-Sultan Abdullah UiTM (HASA) and the Clinical Training Centre (CTC) in Sungai Buloh. Mental health was assessed using the Depression Anxiety Stress Scale (DASS-21), physical activity was assessed using the International Physical Activity Questionnaire (IPAQ-SF), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: Most participants fell into the low physical activity level (60.5%), 34.8% fell into the moderate category, and only 4.8% fell into the high physical activity group. A multiple regression model to identify the association between sociodemographic factors, PAL, and sleep quality with depression, anxiety, and stress revealed that low PAL is negatively associated with stress (B = -0.794; OR (95% CI) = 0.45 (0.21 - 0.99); (p = 0.046) but was not significantly associated with depression and anxiety. Conclusions: Although PAL was only associated with stress in this study, interventions should target increasing physical activity, which is an important modifiable risk factor that can reduce the risk of developing depression, anxiety, and stress.

Dyslipidemia as a risk factor for acute myocardial infarction in postmenopausal women: An observational study

Abstract Objective: This study has evaluated risk factors, especially dyslipidemia, for an acute myocardial infarction (AMI) in postmenopausal women. Materials and Methods: This was a hospital-based, observational, single-center study among 100 postmenopausal women admitted to the medicine ward with AMI. They were categorized based on lipid profile groups, viz., dyslipidemic group and non-dyslipidemic group. All clinical parameters were studied between the groups. Results: Among anthropometric profiles, in the comparison of mean height (cm), weight (kg), body mass index (BMI) (kg/m2), and waist circumference (WC) (cm) for the dyslipidemic group and non-dyslipidemic group, only WC was statistically significant (P &lt; 0.001). Most patients were hospitalized between 6 and 12 h after the onset of symptoms. At the time of hospitalization, most patients from both groups were observed to have diabetes and hypertension with poor control of postprandial blood sugar, glycated hemoglobin, and diastolic blood pressure (DBP) (P &lt; 0.05). The dyslipidemic group’s mean C-reactive protein was higher (P &lt; 0.05). The comparison of mean total cholesterol, triglyceride (TG), low density lipoprotein-cholesterol in mg/dL, and TG: high density lipoprotein was significantly increased (P &lt; 0.001), while high density lipoprotein-cholesterol (mg/dL) was significantly decreased (P &lt; 0.001) in the dyslipidemic group. ST-segment elevation myocardial infarction is standard in both groups. The maximum patient has regional wall motion abnormality in echocardiography after day 3 of admission. Among the dyslipidemic group, ejection fraction was on the lower side, and the predominant complication was in the left ventricular failure (LVF) (P &lt; 0.05). Conclusion: WC has a positive association with patients with AMI who have dyslipidemia and can be used as an indicator of the risk of AMI when BMI is normal. WC is a surrogate marker of abdominal fat mass (subcutaneous and intra-abdominal); increased WC is a significant component marker of metabolic syndrome and insulin resistance related to cardiovascular mortality. There was poor glycemic control and blood pressure (mainly DBP) among the dyslipidemic patients. Hypertriglyceridemia is the most common lipid abnormality, followed by hypercholesterolemia among the dyslipidemic group. LVF is the most common complication in dyslipidemic patients.

Role of Ezetimibe and Statins in Dyslipidemia Patients

Cardiovascular diseases are the leading cause of premature mortality globally. It is associated with significant morbidity and socioeconomic burden henceforth numerous initiatives have been taken to lower the risk in patients through preventive measures. The pathogenesis and progression of nearly all cardiovascular diseases are primarily caused by atherosclerosis and the association of cardiovascular disease risk to dyslipidemia is well-established since it increases the risk of cardiovascular events. Therefore, managing cholesterol, especially low-density lipoprotein, to reduce the burden of atherosclerotic plaque and, potentially, future cardiac complications, has been a key component of preventive measures. Due to its simplicity in dosage, lack of significant medication interactions, and favourable safety profile, statins have been the gold standard therapy for the treatment of dyslipidemia. However, the need for combined therapy arises when statin medication alone is insufficient to effectively reduce increased cholesterol levels. Ezetimibe is frequently added to regimens to support cholesterol reduction by preventing cholesterol absorption. Combinations of statin and ezetimibe may be a beneficial treatment choice for high-risk individuals who necessitate further lowering of cholesterol. Studies in the literature demonstrate that statin plus ezetimibe combined therapy is more beneficial and safer than high-intensity statin monotherapy, which implies that adding ezetimibe to statin should be favoured over increasing statin dose and that high-intensity statin is needed to be administered more carefully, especially in patients with related risks. The purpose of this research is to review the role of ezetimibe and statins in dyslipidemia patients.

Management of dyslipidaemia in individuals with severe mental illness: a population-based study in the Greater Copenhagen Area.

Severe mental illness (SMI) is associated with increased cardiovascular risk. Dyslipidaemia is a potentially modifiable risk factor, which may be inadequately managed in patients with SMI. To assess management of dyslipidaemia in patients with SMI versus healthy controls (HCs) in 2005 and 2015. Using Danish registers, we identified adult patients with SMI in the Greater Copenhagen Area (schizophrenia spectrum disorders or bipolar disorder) with ⩾1 general practitioner contact in the year before 2005 and 2015, respectively, and HCs without SMI matched on age and gender (1:5). Outcomes were lipid-profile measurements, presence of dyslipidaemia and redemption of lipid-lowering pharmacotherapy. Differences in outcomes between patients with SMI and controls were measured with multivariable logistic regression. We identified 7217 patients with SMI in 2005 and 9939 in 2015. After 10 years, patients went from having lower odds of lipid measurements to having higher odds of lipid measurements compared with HCs [odds ratio (OR)2005 0.70 (99% confidence interval (CI) 0.63-0.78) versus OR2015 1.34 (99% CI 1.24-1.44); p2005versus2015 < 0.01]. Patients had higher odds of dyslipidaemia during both years [OR2005 1.43 (99% CI 1.10-1.85) and OR2015 1.23 (99% CI 1.08-1.41)]. Patients went from having lower odds of receiving lipid-lowering pharmacotherapy to having higher odds of receiving lipid-lowering pharmacotherapy [OR2005 0.77 (99% CI 0.66-0.89) versus OR2015 1.37 (99% CI 1.24-1.51); p2005versus2015 < 0.01]. However, among persons at high cardiovascular risk, patients had lower odds of receiving lipid-lowering pharmacotherapy during both years, including subsets with previous acute coronary syndrome [OR2005 0.30 (99% CI 0.15-0.59) and OR2015 0.44 (99% CI 0.24-0.83)] and ischaemic stroke or transient ischaemic attack (TIA) [OR2005 0.43 (99% CI 0.26-0.69) and OR 2015 0.61 (99% CI 0.41-0.89)]. These results imply an increased general awareness of managing dyslipidaemia among patients with SMI in the primary prophylaxis of cardiovascular disease. However, secondary prevention with lipid-lowering drugs in patients with SMI at high cardiovascular risk may be lacking.

Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement.

Dyslipidemia in patients with diabetes is an important treatment target as a modifiable risk factor for cardiovascular disease (CVD). Although the primary treatment goal for dyslipidemia is to control low-density lipoprotein cholesterol (LDL-C), achieving this goal remains suboptimal according to recent studies. It is important to set the target goal for LDL-C control based on an accurate risk assessment for CVD. Here, we summarize the latest evidence on lipid management in patients with diabetes and present a consensus of the Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis on the treatment goals of LDL-C according to the duration of diabetes, presence of CVD, target organ damage, or major cardiovascular risk factors. In patients with type 2 diabetes mellitus (T2DM) and CVD, an LDL-C goal of <55 mg/dL and a reduction in LDL-C level by 50% or more from the baseline is recommended. For the primary prevention of CVD in patients with T2DM with a duration of diabetes ≥10 years, major cardiovascular risk factors, or target organ damage, an LDL-C goal of <70 mg/dL is recommended. In patients with T2DM with a duration of diabetes <10 years and no major cardiovascular risk factors, an LDL-C goal of <100 mg/dL is recommended.

A Case Series of Dyslipidemia Managed with Kutaki (Picrorhiza Kurroa Royle Ex Benth)

Background-Raised total cholesterol, high LDL-C, low HDL-C, and elevated triglycerides are all symptoms of dyslipidemia. It is included in metabolic disorders. It is a major component in causation of atherosclerosis, coronary artery disease and cerebrovascular disease. There is a 1-2 percent rise in the incidence of Coronary Heart Disease for every 1% increase in cholesterol level. As per Ayurveda, it can be considered as a Medadhatu Dushti that is “Medoroga”. Acharya Charaka described drugs having deepana, pachana, medohar, lekhana and strotoshodhaka properties for management of Medoroga. Kutaki (Picrorhiza kurroa Royle ex. Benth) can be used in such conditions due to its lekhana and medohar properties.Various animal research studies conducted on Kutaki proved its antihyperlipidemic and hepatoprotective property. Hence in this case series three patients of dyslipidemia were treated with single dravya Kutaki in tablet form. Case Report-All the three female patients, aged between 40 to 50 years, were treated with Kutaki tablet (500mg) two times a day in the morning and evening (8am-8pm) empty stomach with water for 60 days. After completion of treatment, assessment was done by comparing Serum lipid profile value as with baseline after completion of treatment. Observations and Result -All the three patients showed improvement in lipid values. There was no change in weight or BMI was noted. Conclusion-Hence, it can be concluded that Kutaki is safe and effective in dyslipidemia for normalization of lipid in the blood due to its lekhana, Kapha Medohara (alleviation of vitiated Kapha and Meda) properties.

Effects of lipids on inflammation and DNA damage in diabetes mellitus patients

We aimed to see the effect of lipids on 8-hydroxy-2'-deoxyguanosine (8-OHdG), a marker of DNA damage, and Interleukin-6 (IL-6), an inflammatory cytokine, in Diabetes Mellitus (DM) patients. Serum IL-6, and 8-OHdG levels were determined using kits based on the ELISA principle. The groups were different in terms of total cholesterol, LDL cholesterol and triglyceride. Group 2 (dyslipidemia positive DM positive) was significantly higher than the other groups. There was no statistical difference between group 1 (dyslipidemia negative DM positive) and the control group (p&lt;0.001). 8-OHdG levels differ between groups. The level of 8-OHdG was significantly higher in group 2 compared to the other groups (p&lt;0.001). IL-6 was different between groups. Group 2, IL-6 level was found to be significantly higher than the other groups (p&lt;0.001). A positive correlation was found between serum 8-OHdG level and total cholesterol (r=0.417 p&lt;0.001), LDL cholesterol (r=0.491 p&lt;0.001) and triglyceride (r=0.441 p&lt;0.001). A positive correlation was found between IL-6 and total cholesterol (r=0.522 p&lt;0.001), LDL cholesterol (r=0.646 p&lt;0.001) and triglyceride (r=0.495 p&lt;0.001). IL-6 and 8-OHdG levels are high in dyslipidemic DM patients with a high lipid profile. IL-6 and 8-OHdG levels are elevated in dyslipidemic DM patients with a high lipid profile. IL-6 and 8-OHdG can be used as biomarkers to evaluate dyslipidemic complications seen in DM patients in the early diagnosis.

PS-P16-5: ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) RISK STRATIFICATION OF HYPERTENSIVE ADULTS AT A TERTIARY HOSPITAL

Background: Most hypertensive patients have cardiometabolic risk factors, which raises the likelihood of developing atherosclerotic cardiovascular events. As a result, international professional societies have recommended the use of ASCVD risk assessment in the diagnosis and treatment of hypertension. However implementation of this recommendation remains a challenge in local practice. Objective: To determine the atherosclerotic cardiovascular risk stratification of adult patients with hypertension using a Cardiovascular Specialty Organization's Risk Factor Counting method at a tertiary hospital Outpatient Department Methodology: The research study employed a descriptive, cross-sectional study design of 122 hypertensive adults between November 2020 to October 2021. Data gathered were a clinicodemographic profile, family history, smoking status, body mass index, and diagnostic tests including 12 lead electrocardiogram, urinalysis, lipid profile, and fasting blood sugar or Hba1c. Statistical analysis was done using the SPSS version 26. Results: The majority of the 122 enrolled patients were aged 51 to 60 (37.7%) and 61 to 70 years old (23.0%) Results revealed that the majority of hypertensive adults in a tertiary hospital were high risk at 79.51% and 20.49% were low to intermediate risk. There was a significant difference in the risk classification distribution of patients based on their age, diabetes, dyslipidemia, BMI, and microalbuminuria or proteinuria. Diabetic and dyslipidemic patients were 35.6 and 5.52 times more likely, to be ASCVD high risk respectively. Obese I and Obese II were 6.96 and 5.24 times more likely to be at a high risk of ASCVD as well. Conclusions: In conclusion, the majority of hypertensive adults were at high risk for cardiovascular complications. Among the risk factors studied, diabetes, dyslipidemia, and body mass index, when compared to other risk variables, were significantly associated with high ASCVD risk.

Effect of the common AYUSH Yoga protocol in the management of Dyslipidemia: A clinical study

The present study was undertaken with a view to evaluating the effect of common Ayush Yoga protocol in the management of Dyslipidemia patients. A study was conducted on a clinical experimental basis. The interventional module used the common Ayush Yoga protocol which has a different form of Yogic practice, such as Yogasanas, Pranayama, Dhyana, etc. Interestingly, it is assumed that different Yogic practices have a different impact on physiological and psychological variables. This research aimed to find out the effect of common Ayush Yoga protocol practices on Dyslipidemia patients. Sixty (60) sample were selected for the Haryana region dist. Bhiwani only. The primary data for investigation were derived from clinical reports and personal observations. They were divided into two groups of 30 – 30 sample people. Group I served as the Yoga intervention group, and Group II as the control group. Common Ayush Yoga protocol practices were given to an experimental or interventional group only and the control group was not given any exposure and was kept under control. Initial and final data records were collected and statistically analyzed using the pre-post ‘t-test’. Results showed that common Ayush Yoga protocol treatment has prevention in the condition of Dyslipidemia patients

Clinicopathological Characteristics and Outcomes of Immunoglobulin A Nephropathy with Different Types of Dyslipidemia: A Retrospective Single-Center Study

Introduction: Immunoglobulin A nephropathy (IgAN) is one of the most common glomerulonephritic diseases in the world. Several lines of evidence have suggested that dyslipidemia is related to the disease progression and prognosis of IgAN. However, the study is scarce on the clinicopathological characteristics and outcomes of IgAN with dyslipidemia. Methods: This study retrospectively analyzed 234 patients with biopsy-proven idiopathic IgAN at the Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, between January 2015 and June 2021. The participants were divided into dyslipidemia (n = 119) and non-dyslipidemia (n = 115), and the dyslipidemia group was also divided into the following 4 groups: hypertriglyceridemia group, hypercholesterolemia group, mixed hyperlipidemia group, and low high-density lipoprotein cholesterol group. The estimated glomerular filtration rate (eGFR) was estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Results: The prevalence of dyslipidemia in IgAN patients in our center was 50.9% (119/234). The patients with dyslipidemia presented with higher systolic blood pressure (BP), diastolic BP, serum creatinine, uric acid, hemoglobin, proteinuria, and eGFR (p < 0.05). Proportions of males, hypertension, and chronic kidney disease stage 2∼5 were also higher in the dyslipidemia group (p < 0.05). Similarly, the pathological characteristics performed were worse in the dyslipidemia group. Most dyslipidemia patients had a higher percentage of mesangial hypercellularity (M1) and tubular atrophy/interstitial fibrosis (T1∼2) in the Oxford Classification’s scoring system (p < 0.05). Multivariate logistic regression analysis revealed that male gender (odds ratio [OR] = 2.397, 95% confidence interval [CI]: 1.051–5.469, p = 0.038) and proteinuria (OR = 1.000, 95% CI: 1.000–1.001, p = 0.035) were possible risk factors for dyslipidemia. A total of 13 patients (13.8%) in the dyslipidemia group had an endpoint event, of which 6 patients (6.4%) had a ≥50% decrease in eGFR from baseline and 7 patients (7.4%) reached the end-stage renal disease stage. Kaplan-Meier survival curve analysis showed that patients in the dyslipidemia group had a worse outcome than those in the non-dyslipidemia group (log-rank test, p = 0.048). Conclusions: IgAN patients with dyslipidemia presented more severe clinicopathological characteristics. Male gender and proteinuria are significantly associated with the occurrence of dyslipidemia in IgAN patients. Patients in the dyslipidemia group had a worse prognosis than those in the non-dyslipidemia group, which may be essential for the disease management of IgAN and help identify the high-risk patients.

Association of Non-Hdl-C-To-Hdl-C Ratio with Coronary Lesions and Its Prognostic Performance in First-Onset Nstemi

Aim: The study sought to investigate the association of non-high-density-lipoprotein cholesterol-to-high-density-lipoprotein cholesterol ratio (NON-HDL-C:HDL-C) with coronary lesions and major adverse cardiovascular events (MACE) in first-onset non-ST-segment elevation acute myocardial infarction. Methods: A cohort of 426 patients undergoing early invasive therapy was enrolled in the final analysis. MACE included cardiac death, nonfatal myocardial infarction, target vessel revascularization, congestive heart failureand nonfatal stroke. Results: NON-HDL-C:HDL-C revealed a powerful diagnostic performance for multiple cardiovascular risk factors (p<0.05). NON-HDL-C:HDL-C was an independent predictor for severe coronary lesions and MACE (p<0.05). Subgroup analysis further examined the robustness, especially in elderly, male, dyslipidemic or nondiabetic patients. Conclusion: NON-HDL-C:HDL-C is associated with coronary lesions and prognosis in non-ST-segment elevation acute myocardial infarction.

TYPE 2 DIABETES MELLITUS PATIENTS WITH AND WITHOUT HYPERTENSION: XANTHINE OXIDASE ACTIVITY AND URIC ACID CONCENTRATION

A metabolic condition known as type 2 diabetes mellitus (T2DM) has spread all over the world. Pancreatic insulin resistance and β-cell dysfunction are its defining features. In 2021, almost 537 million people worldwide had diabetes. The prevalence of hypertension (HTN) in T2DM more than 50% result from uncontrolled blood glucose. The prevalence of microvascular and macrovascular complications in T2DM with HTN, more common than in those without HTN. Hyperglycemia is related to overproduction of reactive oxygen species (ROS) and oxidative stress (OS). The etiology of metabolic disorders is associated with OS. On the other hand, OS increases the risk of cardiovascular disease (CVD) by causing endothelial dysfunction. An important source of ROS is xanthine oxidase (XOD), while uric acid (UA) has two properties: pro- oxidant and antioxidant. Sixty T2DM patients with and without hypertension participated in this research. These patients were compared to a control group of thirty people. Lipid profile, XOD and UA were determined in this research. The results of the study showed a significant increase in XOD and UA values in T2DM patients compared to controls. The elevated OS agents and lipids biomarkers mainly in T2DM group could contribute to increasing cardiometabolic risks and weakening the overall health status of the participants. Triglyceride (TG), total cholesterol (TC), LDL-c and HDL-c abnormalities are risk factors of CVD. Dyslipidemia and elevated HbA1c in diabetic patients can be considered as a very high-risk group for CVD.