Dyslipidemia Status Research Articles

The association between pulse wave analysis, carotid-femoral pulse wave velocity and peripheral arterial disease in patients with ischemic heart disease

IntroductionFunctional changes in peripheral arterial disease (PAD) could play a role in higher cardiovascular risk in these patients.Methods123 patients who underwent elective coronary angiography were included. Ankle-brachial index (ABI) was measured and arterial stiffness parameters were derived with applanation tonometry.Results6 patients (4.9%) had a previously known PAD (Rutherford grade I). Mean ABI was 1.04 ± 0.12, mean subendocardial viability ratio (SEVR) 166.6 ± 32.7% and mean carotid-femoral pulse wave velocity (cfPWV) 10.3 ± 2.4 m/s. Most of the patients (n = 81, 65.9%) had coronary artery disease (CAD). There was no difference in ABI among different degrees of CAD. Patients with zero- and three-vessel CAD had significantly lower values of SEVR, compared to patients with one- and two-vessel CAD (159.5 ± 32.9%/158.1 ± 31.5% vs 181.0 ± 35.2%/166.8 ± 27.8%; p = 0.048). No significant difference was observed in cfPWV values. Spearman's correlation test showed an important correlation between ABI and SEVR (r = 0.196; p = 0.037) and between ABI and cfPWV (r = − 0.320; p ≤ 0.001). Multiple regression analysis confirmed an association between cfPWV and ABI (β = − 0.210; p = 0.003), cfPWV and mean arterial pressure (β = 0.064; p < 0.001), cfPWV and age (β = 0.113; p < 0.001) and between cfPWV and body mass index (BMI (β = − 0.195; p = 0.028), but not with arterial hypertension, dyslipidemia, diabetes mellitus or smoking status. SEVR was not statistically significantly associated with ABI using the same multiple regression model.ConclusionReduced ABI was associated with increased cfPWV, but not with advanced CAD or decreased SEVR.

Dyslipidemia Fact Sheets in Korea 2020: an Analysis of Nationwide Population-based Data.

ObjectiveThe Korean Society of Lipid and Atherosclerosis (KSoLA) has published the Dyslipidemia Fact Sheets in Korea 2020 to provide an overview of magnitude and management status of dyslipidemia and their recent trends therein.MethodsThe Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 2007–2018 Korea National Health and Nutrition Examination Survey (KNHANES) and the 2002–2018 National Health Insurance Big Data (NHI-BD).ResultsBetween 2007 and 2018, the crude prevalence of hypercholesterolemia increased from 9.0% to 20.7%. During the same period, its management rate also improved yet remained unsatisfactory. In 2018, the prevalence of dyslipidemia was 45.6% in men and 31.3% in women, which increased with older age and presence of metabolic abnormalities. Indeed, the number of people diagnosed with dyslipidemia has increased nearly 8-fold from 1.5 million in 2002 to 11.6 million in 2018; alongside, the number of people receiving pharmacological treatment for dyslipidemia has also risen. Of the 7.7 million people treated for dyslipidemia in 2018, statin accounted for the majority (91.8%) of lipid-lowering drug prescriptions, followed by ezetimibe (14.6%), fibrate (8.5%), and omega-3 acid (5.9%). The most frequently used combination therapy was statin plus ezetimibe, accounting for 72% of dual therapy prescriptions.ConclusionDyslipidemia continues to impose a substantial disease burden in Korea. Both healthcare practitioners and patients need to actively adopt guideline-recommended lifestyle modification and pharmacological treatment for comprehensive, timely, and sustained management.

Role of dyslipidemia in the development of early-onset preeclampsia.

Preeclampsia (PE) is a gestational-related disease presented with hypertension, peripheral edema, and proteinuria after 20 weeks of gestation. In PE, there are various metabolic changes like dyslipidemia. In addition, both PE and dyslipidemia are associated with changes of platelet indices. Thus, objective of the current study was to illustrate the potential role of dyslipidemia and platelet changes in pregnant women with PE. This case–control study involved 37 preeclamptic pregnant women as compared to 24 healthy pregnant women as controls. Blood pressure profile, lipid profile, proteinuria, and platelet indices were measured. Blood pressure profile was higher in preeclamptic pregnant women as compared to the controls (P < 0.01). There was a significant dyslipidemic status in preeclamptic pregnant women compared with the controls (P < 0.01). Platetetcrit (PCT) and platelet count (PC) were lower in preeclamptic pregnant women compared with the controls (P = 0.001). On the other hand, platelet distribution width (PDW), mean platelet volume (MPV), and platelet-large cell ratio (P-LCR) were higher in the pregnant women with PE as compared with the controls (P = 0.001). PCT and PC were insignificantly linked, while P-LCR, MPV and PDW were significantly correlated with total cholesterol, triglyceride, low-density lipoprotein (LDL)/high-density lipoprotein (HDL) ratio, systolic blood pressure, DBP, and MAP in preeclamptic patients compared with women of normal pregnancy. Both dyslipidemia and alterations in the platelet indices are correlated with blood pressure profile in PE. High MPV and PDW in association with high LDL/HDL ratio in pregnant women herald risk of PE.

Ersonified diagnostic and correction dyslipidemia approach by profiling of apolipoproteins

Many questions remain in the diagnosis, treatment, and prevention of dyslipidemia, despite the available clinical recommendations. Among these issues is the cause of cardiovascular diseases, when achieving and maintaining the target values of lipid metabolism. We need to change the existing paradigm. Apolipoproteins as protein components of lipoproteins can significantly more accurately characterize the dyslipidemic status of a patient, since their structure and composition are unique. A personalized strategy for the prevention and treatment of dyslipidemia is possible based on the apolipoprotein profile. At present, new data on the functions of apolipoproteins, their genetic polymorphisms, and molecular preparations for correcting their content and lipid metabolism have been proposed.

Comperative Study on the Intervention of ‘Spice ‘ Mixture (SM) Prepared by Natural Food Additives (NFA) Alone or Intervention of SM with Mind Calming Exercise in the Management on Female Obesity

Obesity has become huge health problem in the entire world. In Sri Lanka, the prevalence of obesity is estimated to be 20.3% in men and 36.5% in women in four provinces. Further, the highest prevalence rate in Western Province, especially in Colombo was estimated to be 32.2%, among adults. Obesity is associated with osteoarthritis, obstructive sleep apnea, gall stones, and hiatus hernia. In addition to this obesity is related to numerous other problems, such as menstrual and mental disorders and varicose vein etc. According to the concept of Unani four treatment modalities are there; they are known as Dieto therapy (Ilaj Bil Ghiza), Pharmaco therapy (Ilaj Bil Dawa), Regimental therapy (Ilaj Bit Tadbeer) and Surgery (Ilaj Bil Yad). Biomarkers such as Lipid profile (VLDL, LDL, HDL And Serum triglycerides), Haemoglobin percentage, SGPT and SC (Serum Creatinine) were considered. Blood sample analysis was performed at NATH (National Ayurvedic Teaching Hospital), Borella, National Diabetic Centre, Rajagiriya and Asiri Hospitals Ltd. According to Unani or Greco-Arabic medical concept, improper digestion may play a main role to cause obesity. Improper digestion was corrected by using a ‘spice’ mixture made by Natural Food Additives (NFA), which possesses the actions of carminative, digestive and strengthens the gastro-intestinal tract. The preparation of ‘spice’ mixture included Natural Food Additives (NFA). They are Cumin (Cuminum cyminum), Garlic (Allium sativum), Curry Leaves (Murraya koenigii), Ceylon Cinnamon (Cinnamomum zeylanicum) and Black Pepper (Piper nigram). Studies revealed that waist circumferences (WC) is closely linked to CV disease risk factors. Also, WHO Expert Committee on Obesity in Asian and Pacific populations suggested that revised cutoff points for WC: 90 cm for men and 80 cm for women to identify patients with abdominal obesity. South Asians are more prone to insulin resistance and dyslipidaemic state of abdominal obesity. Study concluded that the intervention of ‘spice’ mixture reduces obesity and the effective mind calm exercises would give more beneficial effect in weight reduction.

Unveiling coronary inflammation by perivascular fat angio-CT: a propensity-matched score analysis

Abstract Background Inflammation plays a pivotal role in the atherogenic process and recently has been the target of successful clinical trials. A new CT angiography method allows the identification of inflammatory pericoronary fat, which is associated with cardiovascular events. We aimed to determine whether patients with obstructive coronary artery disease (CAD) have a higher pericoronary inflammatory milieu when compared to those without CAD. Methods From a prospective CT angiography registry of patients with suspected obstructive CAD, those with a luminal stenosis &amp;gt;70% confirmed by invasive coronary angiography were screened (previous coronary artery bypass grafting was an exclusion criteria). Subsequently, we applied a 1:1 propensity score (PS) without replacement protocol to match obstructive CAD patients with those without CAD (non-CAD), using age, gender, BMI, hypertension, dyslipidemia, diabetes and smoking status as covariates. Similar to previous reports, pericoronary fat characterization by CT angiography was performed by analyzing the fat attenuation index (FAI) at the −30 to −190 HU range. Inflammatory fat was defined by a FAI &amp;gt;−70 HU. The proximal 50mm of the right coronary artery (RCA) was used to perform fat quantification and characterization. The perivascular fat was defined as the adipose tissue within a radial distance from the outer vessel wall equal to the diameter of the vessel. Results A matched cohort of 48 patients was identified (mean age 63 years; 77% males) – 24 obstructive CAD and 24 non-CAD patients. Mean FAI was numerically higher in obstructive CAD compared to the non-CAD cohort (−74±7 vs −78±7; p=0.083). Although not statistically significant, those with obstructive CAD had an increased proportion of inflammatory fat (51±10 vs 46±10%; p=0.107). After adjustment for body surface area (BSA), differences in the inflammatory fat proportion became apparent between obstructive CAD and non-CAD patients (28±6 vs 24±5%/m2; p=0.024). Furthermore, we observed a significant correlation between the inflammatory fat proportion (both absolute value and BSA adjusted) and the total number of RCA plaques (r=0.458; p=0.003; and r=0.451; p=0.003, respectively). Finally, there was 1 additional plaque observed in the RCA for each increase in 10% of proportion of inflammatory fat (p=0.018). Conclusions Perivascular coronary inflammation, as measured by FAI, seems significantly heightened in patients with obstructive CAD compared to a matched cohort of non-CAD patients. Further studies are needed to ascertain the mechanisms and possible implications of this association. Funding Acknowledgement Type of funding source: None

Ceramides are related to subclinical atherogenesis in the general population

Abstract Introduction Biomarkers for risk stratification of patients with cardiovascular disease are essential for disease prevention. Ceramides play an important role during atherogenesis. For the C24:0/C16:0 ratio an inverse association with incident coronary artery disease and heart failure has been shown. Hence, ceramides may be a new predictive biomarker for cardiovascular disease. Purpose We explored the relation of three specific ceramides (i.e. C16:0, C22:0 and C24:0) and their ratios with subclinical atherosclerosis, assessed by carotid intima media thickness (cIMT), carotid lumen diameter (LD), brachial artery flow mediated dilation (FMD), nitroglyceride mediated brachial artery dilation (NMD) as well as with the presence of atherosclerotic plaques in the common carotid artery, the carotid bifurcation, and the internal as well as external carotid artery. Methods We used data from the population-based Study of Health in Pomerania (SHIP-1) from North-East Germany (n=2,506, 47% male, 53 median age, 25th and 75th inter-quartile range 41–64 years). Ceramides were quantified by liquid chromatography/tandem mass spectrometry assay. Extracranial carotid arteries were measured with B-mode ultrasound and used to assess plaque presence, LD, NMD, FMD and cIMT with standard procedures. Subjects with missing data were excluded. The relationship between ceramides and log LD, log cIMT, NMD, FMD as well as plaque score were modelled using multivariable regression models adjusted for sex, age, body mass index, diabetes mellitus, dyslipidaemia, hypertension and smoking status. Results A 1 μg/ml higher C22:0 and C24:0 were associated with a 3% (95% confidence interval [CI] 1% - 5%, p&amp;lt;0.01) and 1% (95% CI 0% - 1%, p=0.01) smaller LD, respectively. Furthermore, an increased C22:0/C16:0 and C24:0/C16:0 ratio were related to a 1.2% (95% CI 0.6% - 1.8%) and 0.2% (95% CI 0.009% - 0.37%, p&amp;lt;0.01) narrower LD, respectively. A one point higher C22:0/C16:0 ratio was associated with a 0.04 mm (95% CI 0 – 0.08 mm, p=0.04) greater absolute FMD. Moreover, a 1 μg/ml higher C16:0 or C22:0 concentration increased the odds for the presence of plaque by 13.6% (95% CI 2.33–79.0, p&amp;lt;0.01) and 1.68% (95% CI 1.08–2.61, p=0.02). Neither C24:0 nor the C22:0/C16:0 or C24:0/C16:0 ratios were related to the presence of atherosclerotic plaques and did not find any significant associations between ceramides and cIMT or NDM. Conclusions We found significant associations of ceramides with various markers of subclinical atherosclerosis. Hence, our findings further support the investigation of ceramides as biomarkers of vascular disease. However, our results indicate that not all ceramides are equal with regards to atherosclerosis. For example, C22:0 is related with vasoprotective effects (high HDL-C, low triglycerides) and intriguingly, more atherosclerotic plaques. Future studies should explore the role of ceramides during the different stages of atherosclerosis. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): BMBF

Association between serum matrix metalloproteinase-9 and poor prognosis in acute ischemic stroke patients: The role of dyslipidemia

Background and aimsWhether the prognostic value of matrix metalloproteinase-9 (MMP-9) is modified by patients' dyslipidemia status is unknown. The aim of present study was to evaluate the prognostic effect of MMP-9 among ischemic stroke patients stratified by dyslipidemia status. Methods and resultsMMP-9 levels were measured for 2977 acute ischemic stroke patients from 26 participating hospitals across China, and data of clinical outcomes within one year after ischemic stroke was collected. The primary outcome was a composite outcome of major disability and death at one year after stroke onset, and secondary outcomes were major disability, death, vascular events and recurrent stroke. The association between MMP-9 and primary outcome was appreciably modified by dyslipidemia status (Pinteraction = 0.048). After multivariate adjustment, increased MMP-9 level was associated with increased risk of primary outcome at one year after ischemic stroke in the patients with dyslipidemia (odds ratio, 1.34; 95% confidence interval, 1.06–1.79), but not in those without dyslipidemia (odds ratio, 1.23; 95% confidence interval, 0.90–1.68). Increased MMP-9 was also significantly associated with major disability, death and vascular events in the patients with dyslipidemia but not in those without dyslipidemia (P for interaction < 0.05 for all). ConclusionIncreased MMP-9 was associated with poor prognosis within one-year after stroke only in patients with dyslipidemia, suggesting that the prognostic value of MMP-9 be modified by dyslipidemia status of ischemic stroke patients. Further prospective study from other populations and randomized clinical trials are needed to verify our findings and clarify the potential mechanisms.

Assessment of Serum Lipid Profiles and High-sensitivity C-reactive Protein Among Patients Suffering from Rheumatoid Arthritis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study.

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by severe joint pain, swelling, damage, and disability which leads to joint destruction and loss of function. The complication of RA is associated with cardiovascular diseases, particularly due to systemic inflammation and dyslipidemia. The purpose of this study was to assess the development of atherosclerosis, which acts as a major risk factor for cardiovascular complications in RA patients.MethodsA hospital-based cross-sectional study was conducted at the Rheumatology Clinic of Tikur Anbessa Specialized Hospital. The study made a comparison of risk factors (dyslipidemia and inflammatory status) between individuals having RA as a case group and apparently healthy individuals as a control group. Simple descriptive statistics, one-way ANOVA, independent sample t-test and multivariate analysis were utilized for statistical analysis. p-value of <0.05 at the 95% confidence level was considered as statistically significant.ResultsThe result of this study demonstrated that there was a significant elevation of mean ±SD of TC, TC/HDL, LDL/HDL, and lowered value of HDL-C was seen among RA patients than controls (P-value <0.05). The mean ±SD of inflammatory marker, high-sensitivity C-reactive protein (hsCRP), was significantly higher among RA patients compared to controls (P<0.05). HDL-C had a significant negative correlation with a hsCRP whereas TC/HDL-C and LDL/HDL-C had a significant positive correlation with hsCRP (P<0.05).ConclusionIn this study, RA patients had lipid abnormalities and elevated systemic inflammation than controls. An increase in hsCRP and dyslipidemia status among RA patients indicates the possible development of an atherosclerotic event. Therefore, assessment of lipid profiles and hsCRP in early RA patients may be helpful to assess the possible development of cardiovascular complications.

From Cells‐to‐Organism: Impact of Dyslipidemia on Inwardly Rectifying K+ Channels and Cerebral Vascular Function

Recent studies have noted that dyslipidemia can diminish dilatory function of resistance arteries by altering the activity of ion channels that set membrane potential. Focusing on the cerebral circulation, this study determined whether inwardly rectifying K+ (KIR) channels are targeted early in dyslipidemia and if alterations impact blood flow control. Experiments began at the cellular level (patch‐clamp electrophysiology) and then were extended to isolated arteries (pressure myography) and whole animals (arterial spin‐labelling magnetic resonance imaging). Initial lipid analysis confirmed the dyslipidemic state of LDLR−/− (normal chow) and C57BL/6 mice fed a high‐cholesterol high‐fat (HFHC) diet for 8 weeks; note aortic plaque formation was absent in these animal models. Patch‐clamp electrophysiology revealed a marked reduction in endothelial but not smooth muscle KIR activity in both dyslipidemic models. Flow activation of KIR was also reduced in endothelial cells from LDLR−/− and HFHC mice. However, endothelial KIR activity was recovered in dyslipidemic mice by depleting the plasma membrane of cholesterol. Consistent with these cellular changes, we observed diminished shear‐induced vasodilation in cerebral arteries isolated from dyslipidemic animals. To our surprise, these cellular/tissue level changes didn’t alter cerebral blood flow at baseline or in response to a blood pressure challenge (phenylephrine injection through a peritoneal catheter, 0.816 mg/kg). The maintenance of blood flow control was observed across a full range of structures including the cortex, cerebral nuclei, hippocampus, thalamus, hypothalamus and midbrain. In closing, our findings highlight that while KIR channel function is targeted early on in dyslipidemia, compensatory mechanisms can maintain brain blood flow to preserve neurological function.Support or Funding InformationCanadian Institutes of Health Research

Impaired fasting glucose and major adverse cardiovascular events by hypertension and dyslipidemia status: the Golestan cohort study

BackgroundWhether pre-diabetes in the absence of hypertension (HTN) or dyslipidemia (DLP) is a risk factor for occurrence of major adverse cardiovascular events (MACE) is not fully established. We investigated the effect of impaired fasting glucose (IFG) alone and in combination with HTN, DLP or both on subsequent occurrence of MACE as well as individual MACE components.MethodsThis longitudinal population-based study included 11,374 inhabitants of Northeastern Iran. The participants were free of any cardiovascular disease at baseline and were followed yearly from 2010 to 2017. Cox proportional hazard models were fitted to measure the hazard of IFG alone or in combination with HTN and DLP on occurrence of MACE as the primary endpoint.ResultsFour hundred thirty-seven MACE were recorded during 6.2 ± 0.1 years follow up. IFG alone compared to normal fasting glucose (NFG) was not associated with an increase in occurrence of MACE (HR, 0.87; 95% CI, 0.19–4.02; p, 0.854). However, combination of IFG and HTN (HR, 2.88; 95% CI, 2.04–4.07; p, 0.000) or HTN + DLP (HR, 2.98; 95% CI, 1.89–4.71; p, 0.000) significantly increased the risk for MACE. Moreover, IFG + DM with or without HTN, DLP, or both was also associated with an increase in the incidence of MACE.ConclusionIFG, per se, does not appear to increase hazard of MACE. However, IFG with HTN or HTN + DLP conferred a significant hazard for MACE in an incremental manner. Moreover, IFG without HTN, adjusted for DLP, can be associated with an increase in the risk for CVD- death.

Central obesity among an African type 2 diabetic population: Prevalence and correlates

BackgroundThe rising prevalence of non-communicable diseases especially obesity and type 2 diabetes among African populace is becoming a public health epidemic with socio-cultural and economic implications. We assayed for the prevalence and correlates of central obesity among an African type 2 diabetic population. MethodA multi-centered, cross-sectional and descriptive study among 399 type 2 diabetic participants aged 18–70 years from three study sites (urban, semi-urban and rural) was conducted. Prevalence was compared among age-groups, sex, location, BMI category, blood pressure category, glycemic control status and dyslipidemic status. ResultsAn overall prevalence of 55.4% was obtained while age-based prevalence rose with age before declining among the 61–70 years group of persons. The females had the higher sex-based prevalence of 70.7%–23.3% for males and semi-urban participants gave the highest location-based prevalence of 67.7% in contrast to 55.8% and 40.9% for urban and rural residents respectively. General obesity, hypertension, good glycemic control, and non-dyslipidemia gave the highest prevalence in their various categories. After adjusting for co-founders, age 51–60, age 61–70, female sex, semi-rural residence, rural residence, been over-weight, general obesity, and hypertension were independently associated with CO. ConclusionFindings from our study revealed that CO is highly prevalent among Africans with type 2 diabetes. Elderly persons, female sex, BMI above 25 kg/m2, hypertension and residence in semi-urban and rural settings were highlighted as independent predisposing factors. Regular exercise and consumption of low-calorie diets (weight loss strategies) are recommended for type 2 diabetics within the middle age class and those in the elderly category in addition to their glycemic and lipidemic control goals. Government at all levels should ensure the provision of basic social amenities to meet the needs of rural and semi-urban areas experiencing rapid urbanization.

Polysaccharide Peptide (PsP) of Ganoderma lucidum as vasa vasorum anti-Angiogenesis agent in Dyslipidemic state by Measuring Lp-PLA2 and H2O2 Levels: In Vivo Study using wistar strain Rattus novergicus model of Atherosclerosis with Dyslipidemia

Polysaccharide Peptide (PsP) of <i>Ganoderma lucidum</i> as vasa vasorum anti-Angiogenesis agent in Dyslipidemic state by Measuring Lp-PLA2 and H₂O₂ Levels<i>: In Vivo</i> Study using wistar strain <i>Rattus novergicus</i> model of Atherosclerosis with Dyslipidemia

Link between ACE I/D Gene Polymorphism and Dyslipidemia in Diabetic Nephropathy: A Case-control Study from Hyderabad, India.

Introduction:Diabetic nephropathy (DN) is the commonest single cause of end-stage renal failure, and dyslipidemia is a critical risk factor in the occurrence of DN. In the light of recent reports emphasizing the importance of angiotensin I-converting enzyme (ACE) in the modulation of plasma lipids, we sought to evaluate the influence of ACE I/D gene polymorphism with dyslipidemia status among type 2 diabetic (T2D) patients with and without nephropathy in the genetic predisposition and the progression to DN.Method:This study comprised of 600 subjects, which include patients with DN, T2D, and healthy controls (HC). Polymerase chain reaction based genotyping of ACE I/D polymorphism was performed and appropriate statistical analysis was done.Results:Out of the 600 subjects, 20 (10%) of the HC, 73 (36.5%) of the T2D group, and 125 (62.5%) of the DN subjects had dyslipidemia. The D allele (0.62) and DD (42.5) genotype frequencies were higher in the DN group in comparison with T2D and HC (P < 0.05). The genotypes also varied among patients with dyslipidemia (χ2 5.04; P < 0.05) but not in the non-dyslipidemia group. Under the co-dominant model, DD genotype conferred a risk of 1.26 (P < 0.001) toward DN, whereas the ID genotype offered protection from DN among the dyslipidemic subjects (OR = 0.05; P < 0.01). In addition, genotype-dependent difference was seen in the plasma lipid levels among study groups. A multiple logistic regression analysis revealed male gender, BMI, HbA1c, TG, HDL, and ACE DD genotype as independent risk factors for the development of DN.Conclusion:The study showed a significant predisposing association of ACE DD genotype with DN and protective effect of ID genotype on DN in the dyslipidemia subgroup.

Actual causes of death in thyroid cancer patients in Korea: A Nationwide Case Control Cohort Study.

Thyroid cancer (TC) incidence has increased robustly in Korea. However, the actual cause of death, overall mortality risk, and cause-specific mortality risk in TC patients have not been clearly elucidated. Retrospective cohort study. We analyzed 4082 TC patients from the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS, 2002-2013) with a median of 48-month follow-up. We compared these patients with 12 246 controls matched for age, sex, and histories of major cardiovascular disease (CVD) to investigate the cause of death and risks of overall and cause-specific mortality. Overall, 61 deaths (1.5%) occurred in the TC group. The most common cause of death was TC-specific mortality (32.8%), followed by other malignancy-related mortality (31.1%) and CVD mortality (13.1%). The overall mortality risk was comparable between the TC and control groups (unadjusted hazard ratio (HR): 1.17; 95% confidence interval (CI): 0.87-1.58); the adjusted HR remained at 1.25 (95% CI: 0.90-1.74) after multivariate adjustment for body mass index (BMI), socioeconomic status (SES), smoking, alcohol consumption, and histories of hypertension, diabetes mellitus, and dyslipidemia. In addition, there was not enough evidence against the surmise that the CVD mortality risk was similar between the TC and control groups, with an HR of 0.50 (95% CI: 0.22-1.16) after adjustment for CVD risk factors. Excellent overall survival was observed in TC patients. The most common cause of death was TC-specific mortality, suggesting the importance of thyroid cancer treatment. The overall and cause-specific mortality risks, particularly CVD mortality risk, did not differ between TC patients and the general population.

Apolipoproteins A and B and PCSK9: Nontraditional Cardiovascular Risk Factors in Chronic Kidney Disease and in End-Stage Renal Disease.

Purpose Nontraditional cardiovascular risk factors as apolipoprotein A (ApoA), apolipoprotein B (ApoB), and the proprotein convertase subtilisin/kexin type 9 (PCSK9) increase the prevalence of cardiovascular mortality in chronic kidney disease (CKD) or in end-stage renal disease (ESRD) through quantitative alterations. This review is aimed at establishing the biomarker (ApoA, ApoB, and PCSK9) level variations in uremic patients, to identify the studies showing the association between these biomarkers and the development of cardiovascular events and to depict the therapeutic options to reduce cardiovascular risk in CKD and ESRD patients. Methods We searched the electronic database of PubMed, Scopus, EBSCO, and Cochrane CENTRAL for studies evaluating apolipoproteins and PCSK9 in CKD and ESRD. Randomized controlled trials, observational studies (including case-control, prospective or retrospective cohort), and reviews/meta-analysis were included if reference was made to those keys and cardiovascular outcomes in CKD/ESRD. Results 18 studies met inclusion criteria. Serum ApoA-I has been significantly associated with the development of new cardiovascular event and with cardiovascular mortality in ESRD patients. ApoA-IV level was independently associated with maximum carotid intima-media thickness (cIMT) and was a predictor for sudden cardiac death. The ApoB/ApoA-I ratio represents a strong predictor for coronary artery calcifications, cardiovascular mortality, and myocardial infarction in CKD/ESRD. Plasma levels of PCSK9 were not associated with cardiovascular events in CKD patients. Conclusions Although the “dyslipidemic status” in CKD/ESRD is not clearly depicted, due to different research findings, ApoA-I, ApoA-IV, and ApoB/ApoA-I ratio could be predictors of cardiovascular risk. Serum PCSK9 levels were not associated with the cardiovascular events in patients with CKD/ESRD. Probably in the future, the treatment of dyslipidemia in CKD/ESRD will be aimed at discovering new effective therapies on the action of these biomarkers.

Differences in Consumption of Flavonoid Phytochemicals toward Total Cholesterol and LDL-Cholesterol Levels in Dyslipidemia and Non-Dyslipidemia Groups of Minangkabau Ethnic Women

Introduction: Dyslipidemia is the primary risk factor for cardiovascular disease. Prevalance of dyslipidemia in Indonesia is still high, which is related to lifestyles such as unhealthy diet. Flovonoids are one type of phytochemical that is abundant in fruits, vegetables, nuts, and flavors that have a preventive effect on degenerative diseases. Purpose: To determine differences in flavonoid phytochemical consumption of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in dyslipidemia and non-dyslipidemia groups of Minangkabau ethnic women. Method: The study design was comparative cross-sectional, examination of lipid levels of TC and LDL-C was carried out to determine dyslipidemia status. Subjects consisted of 72 women with dyslipidemia and 74 women with non-dyslipidemia. Interviews on food consumption used a food consumption frequency questionnaire (semi-quantitative food frequency questionnaire). Results: The mean TC and LDL-C were higher in the dyslipidemia group, there was an inverse correlation between flavan 3-ols, flavones, flavonols, antocyanidins and isoflavones with TC and LDL-C. There were significant differences in flavonols and antocyanidin consumptions among the dyslipidemia and nondyslipidemia groups (p &lt; 0.05). Conclusion: The flavonoid consumption can improve dyslipidemia status (TC and LDL-C).

Prevalence and pattern of dyslipidemia in patients with type 2 diabetes mellitus in Zaria, Northwestern Nigeria.

IntroductionDyslipidemia confers excess atherosclerotic cardiovascular risk in type 2 diabetes mellitus (DM) patients, and this requires prompt identification and management to reduce morbidity and mortality. This study assessed the prevalence and pattern of dyslipidemia in type 2 DM patients in Zaria, Northwestern Nigeria.MethodsThis was a cross-sectional study of newly diagnosed type 2 DM patients at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Demographic, clinical and laboratory data were extracted from the case notes of eligible patients and analyzed using STATA version 14. Continuous variables were presented as mean ± standard deviation (SD), or median and interquartile range (IQR) while categorical variables were as frequencies and percentages. Student t and chi-square tests were used to test for association at p < 0.05.ResultsA total of 322 subjects (161 male, 161 female) with a mean age of 53.5 ± 10.8 years partook in the study. The prevalence of dyslipidemia was 69.3%. Mixed dyslipidemia of high triglyceride (TG) and high low-density lipoprotein cholesterol (LDL-C) was present in 41.0%; high TG and low high-density lipoprotein cholesterol (HDL-C) in 2.8%; and high LDL and low HDL in 2.5%. Atherogenic dyslipidemia, isolated hypercholesterolemia and isolated low HDL-cholesterol were present in 3.4%, 2.5% and 23.6% respectively. Dyslipidemia status was not associated with age, sex, duration of DM or hypertension, obesity, and mean fasting blood sugar (FBS) and 2-hour postprandial glucose.ConclusionThe prevalence of dyslipidemia is high in the newly diagnosed type 2 DM patients and therefore, initial management should incorporate measures to control dyslipidemia.

Effectiveness Treatment for Diabetes Prevention: 6-Months Results from the Prediabetes

ADA has the same cut-off value for IGT (140-200 mg/dL) but has a lower cut-off value for IFG (100-125 mg/dL) and has additional hemoglobin A1c (HbA1c) based criteria of a level of 5.7% to 6.4% for the definition of prediabetes. Due to progressive nature of prediabetes to diabetes, dual drug therapy produces additive effects, allows the use of submaximal doses, and less side effects of individual agents. Therefore, the present study was designed to study the effect of FDC of Metformin with Pioglitazone Versus FDC of Metformin with Voglibose on Lipid levels as an add-on drug in obese with prediabetes patients whose dyslipidemia status was uncontrolled with metformin alone. Material and Methods: The present study was open, randomized parallel group comparison of two active treatment groups over a period of six months. Sixty-seven patients of either sex in the age group of 30-60 years, suffering from obese with prediabetes, with FBG: 100-125 mg/dl and PPBG: 140-200 mg/dl as per ADA were selected at randomly. The effect of FDC of Metformin with Pioglitazone and FDC of Metformin with Voglibose were observed on various parameters of FBG, PPBG, Serum Adiponectin and Serum ghrelin levels. Results: At the end of 3rd and 6th months it was observed that though both FDC of Metformin with Pioglitazone and FDC of Metformin with Voglibose reduced Blood Glucose significantly but FDC of Metformin with Pioglitazone caused a statistically significantly greater amount change in FBG, Serum Adiponectin and Serum ghrelin levels as compared with FDC of Metformin with Voglibose. Conclusions: Though FDC of Metformin with Pioglitazone and Metformin with Voglibose were equally effective in lowering FBG, Serum Adiponectin and Serum ghrelin levels yet Metformin with Pioglitazone showed better results in improving Glycemia, as compared with FDC of Metformin with Voglibose.

Association between Prescription and Control Status of Dyslipidemia and Hypertension among Japanese Patients with Diabetes.

Aims: The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the “Specific Health Check and Guidance in Japan,” which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.Methods: Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.Results: The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%–75% for LDL-C, and around 30%–40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.Conclusions: The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD.