Elevated Cholesterol Concentrations Research Articles

Synergistic benefits of dietary silymarin and selenium on growth, immune functions, antioxidants, and gut/liver health of Thinlip mullet (Liza ramada) juveniles

Abstract This study investigates the synergistic impact of silymarin (SI) levels combined with inorganic selenium (sodium selenite: Se) on growth, feed utilization, biochemical parameters, antioxidants, innate immunity, intestinal and liver histology, and gene expression of Thinlip mullet (Liza ramada) juveniles. The experimental design involved thinlip mullets initially weighing 3.5±0.13 g, distributed in a completely randomized design with 30 fish per hapa (0.5 × 0.5 × 1 m), and conducted in triplicate over 60 days. Seven experimental diets were employed, including a control (without SI and Se supplementation), a negative control (with only Se supplementation), and four treatments with varying levels of silymarin (250, 450, 650, 850 mg/kg) alongside selenium (0.5 mg/kg diet). The growth performance results highlighted significant enhancements in final body weight, weight gain, and specific growth rate, particularly in the SI 850 mg/kg + Se treatment. Survival rates, feed intake, and feed conversion ratios showed positive trends across the SI-Se supplemented groups. Biochemical profiles of serum exhibited that the control diet-induced elevated concentrations of glucose, cholesterol, Alanine aminotransferase, Aspartate aminotransferase, and urea, while Se or SI supplementation significantly mitigated these levels, with the lowest concentrations observed in the SI-Se supplemented groups. Moreover, SI supplementation increased serum protein content. Antioxidant enzyme activities, represented by superoxide dismutase (SOD), catalase (CAT), and catalase (GPx), demonstrated notable improvements in the SI-Se fortified groups, with significantly elevated GPx activity compared to the Se-supplemented and control groups. Immune system responses, including lysozyme, bactericidal, Nitro-blue Tetrazolium (NBT%), and serum alternative complement pathway (ACH50) activities, were highest in the SI-Se augmented groups. SI and Se in L. ramada reduce liver pro-inflammatory gene expression (il-1β, hepcidin) vs. control group. Histological examinations of the intestine and liver depicted structural enhancements, especially at moderate and high levels of SI with Se supplementation. The results indicate improved intestinal villi morphology and hepatic architecture, supporting the positive influence of dietary treatments on the health of thinlip mullet juveniles. In conclusion, the combined supplementation of SI at 850 mg/kg diet and Se at 0.5 mg/kg diet positively influenced the growth, biochemical profiles, antioxidant status, immune responses, gene expression, and histological integrity of Thinlip mullet juveniles, providing valuable insights for optimizing aquafeed formulations.

Ginkgo biloba supplement modulates mTOR/ERK1/2 activities to mediate cardio-protection in cyclosporin-A-induced cardiotoxicity in Wistar rats

BackgroundCyclosporine-A (Cs-A), an immunosuppressant drug indicated for organ transplant patients has been associated with toxicities arising from activation of pathological signalling. Meanwhile Ginkgo biloba supplement (GBS) is an antioxidant-enhancing herbal product widely used for treating neurological and vascular dysfunctions. ObjectivesThis study investigated the ameliorative effect of GBS on cyclosporine-A induced cardiotoxicity in Wistar rats. MethodsThe study included 20 Wistar rats (n = 5) and they were treated as follows: group 1 received distilled water (10 mL/kg), group 2 received Cs-A (25 mg/kg), group 3 received GBS (50 mg/kg) and group 4 received Cs-A (25 mg/kg) and GBS (50 mg/kg). All treatment were done intraperitoneal for 14 days and thereafter, animals were euthanised and heart tissues were harvested for biochemical assays as well as immunohistochemical studies. Blood was also collected for serum biochemical studies. ResultsOur results revealed that GBS reduces Cs-A induced increase of AST, ALT, ALP, LDH, and GGT levels in serum relative to Cs-A group. Also, increased oxido-nitrergic markers like MDA, NO, together with elevated concentrations of cholesterol, triglycerides, LDL, creatine kinase-MB, troponin-I, as well as pro-inflammatory cytokines (IL-6, and TNF-α) and heart weight index were reduced by GBS. The Cs-A induced suppression of low-density lipoprotein, antioxidant (GSH, SOD, CAT), Na-K ATPase activities and antiapoptotic element, Bcl-2 were increased by GBS. Additionally, signalling pathways including ERK1/2, and mTOR as well as ventricular thickness were significantly alleviated by GBS treatment. ConclusionThe findings suggest that GBS ameliorated Cs-A-induced cardiotoxicity by activating mTOR/ERK1/2 signalling pathways.

Contrasting Evidences Between High Cholesterol Levels and The Risk of Cardiovascular Disease: A Review

Introduction: The cholesterol hypothesis had been kept alive for decades by reviewers who used statistics that excluded the results from unsuccessful trials and ignored numerous contradictory observations. High dietary cholesterol intake had been associated with development of cardiovascular diseases (CVD) and mortality, for over several decades, without a direct link between the CVD and high serum cholesterol level. Hence, people avoided healthy cholesterol-rich diets due to the fear of developing CVD. The relationship between elevated plasma cholesterol and CVD and criteria for appropriate methods for screening patients with elevated cholesterol had remained a source of medical debates. Lack of decrease in overall mortality rates in patients without clinical coronary disease in whom aggressive lowering of cholesterol was achieved might have contributed to the lack of consensus on this most important issue.
 Methodology: With information derived from search engines, such as Elsevier, Springer, PubMed, Science Direct, Medline, Google Scholar and a library search for articles published in peer-reviewed journals.
 Results: Several research results showed that association between total serum cholesterol, its components and CVD is weak, absent or inverse implying that consuming healthy high cholesterol diets may not be harmful to health.
 Conclusion: This review provides evidence contrasting the links between elevated plasma cholesterol and CVD, and demonstrated that elevated cholesterol concentrations, rather, improve quality of life and life expectancy. In addition, most prevalent methods for cholesterol quantification in biological samples and foods, utilizing new technologies, such as Ambient Ionization Mass Spectrometry are summarized, along with other components of cholesterol.
 Keywords: Cholesterol, CVD, Quantification

Elevated remnant cholesterol and non-HDL cholesterol concentrations from real-world laboratory results: a cross-sectional study in Southeast Asians.

Triglyceride-rich remnant lipoproteins (TRLs) are considered atherogenic due to the presence of remnant cholesterol, which is transported by apolipoprotein B. In clinical practice, the concentration of TRLs can be estimated by calculating remnant cholesterol or non-HDL cholesterol levels. This study aims to investigate the proportion of patients who have low LDL cholesterol (LDL-C) concentration but elevated remnant cholesterol concentration, stratified by the presence of hypertriglyceridaemia and ethnicity, using real-world hospital data. Our secondary aim is to investigate the proportion of patients with elevated non-HDL cholesterol levels using guideline-recommended goals. A 2-year retrospective study was conducted at a single centre, analyzing lipid blood tests of all patients, including directly measured LDL-C. Fasting for blood tests was not mandatory. The study included a total of 21,605 consecutive patients with plasma lipid profiles analyzed in our hospital laboratory. The median age was 61 years. In patients with ASCVD (n = 14,704), 23.7% had an LDL-C level of <1.8 mmol/L, 11.3% had elevated remnant cholesterol concentrations at ≥0.65 mmol/L, and 48.8% were at the non-high-density lipoprotein cholesterol (non-HDL-C) goal (<2.6 mmol/L). Among patients diagnosed with atherosclerotic cardiovascular disease (ASCVD) with LDL-C levels of <1.8 mmol/L (n = 3,484), only 11.9% had high levels of remnant cholesterol, but 96% of the ASCVD patients also achieved the recommended non-HDL-C target of <2.6 mmol/L. When the LDL-C level was <1.8 mmol/L, the mean concentration of remnant cholesterol was 0.214 mmol/L when the triglyceride level was <1.7 mmol/L (n = 3,380), vs. 0.70 mmol/L when the triglyceride level was elevated (n = 724), p < 0.001. Among patients with a triglyceride level of ≥1.7 mmol/L and an LDL-C level of <.8 mmol/L, there were 254 patients with elevated remnant cholesterol concentration and 71 patients with suboptimal non-HDL levels. Malays had a higher mean remnant cholesterol concentration compared with both Chinese and Indians across all LDL-C levels, particularly in the presence of hypertriglyceridaemia. An elevated remnant cholesterol concentration of >0.65 mmol/L was present in 11% of all patients. The current guideline-recommended non-HDL-C goal, which uses a 0.8 mmol/L estimate of remnant cholesterol concentration, was achieved in >92% of patients, suggesting that it is unlikely to be clinically useful for the majority of our patient population except where there is concomitant hypertriglyceridaemia. Further studies are needed to establish the appropriate non-HDL-C goal or calculated remnant cholesterol concentration, paired with the LDL-C goal or otherwise, in a Southeast Asian population.

Silica-Calcite Sedimentary Rock (Opoka) Enhances the Immunological Status and Improves the Growth Rate in Broilers Exposed to Ochratoxin A in Feed.

Mycotoxins, such as Ochratoxin A (OTA), originating from fungi like Aspergillus and Penicillium, represent serious health hazards to poultry. The use of mycotoxin-adsorbing feed additives can reduce these risks. Opoka, a porous transitional rock, shows promise as one of these additives. This study is the first to examine the effect of Opoka administered with OTA on zootechnical parameters and the immune response of chickens. A 42-day investigation examined the impact of 1% of Opoka supplementation in feed on OTA-challenged broiler chickens. Seventy-two chickens were allocated into three groups of twenty-four individuals each: a control group, an OTA-exposed (2 mg/kg feed) group, and an OTA (2 mg/kg feed) plus 1% of Opoka group. Growth and blood parameters were monitored at predetermined intervals, and comprehensive biochemical, hematological, and cytometric analyses were conducted. The study showed that OTA exposure had a negative impact on chicken weight gain. However, adding Opoka to the diet improved weight gain, indicating its potential as a protective agent. Chickens fed with Opoka also had an increased white blood cell count, which suggests an improved immune response and elevated glucose and cholesterol concentrations. These findings indicate that Opoka may be useful in mitigating health complications caused by OTA exposure in broilers.

Comparison of the burden of familial hypercholesterolemia between two cohorts of French Canadians hospitalized 25 years apart for coronary heart disease

Familial hypercholesterolemia (FH) is associated with lifelong elevated plasma concentrations of low-density lipoprotein cholesterol (LDL-C) and high risk of premature coronary heart disease (CHD). Clinical recommendations and treatments have emerged to facilitate the management of FH patients. Their impact on the burden of FH is however not well documented. To compare the burden of FH between patients hospitalized for a CHD event 25 years apart in the French-Canadian founder population. Lipid profiles, cardiovascular risk factors, treatments and FH status of 2,029 patients consecutively hospitalized for an acute CHD event between 2017 and 2022 (2022 Cohort) were compared to those of 2,506 patients with angiographically-confirmed CHD who were admitted between 1995 and 1998 (1998 Cohort). At the time of admission, 24.6 % of CHD patients had LDL-C levels >5.0 mmol/L in 1998 compared to 1.4 % in 2022, and FH was diagnosed in 9.6 % of patients in the 1998 cohort compared to 5.5 % in 2022 (p<0.001). FH patients hospitalized for a CHD event were older in 2022 than in 1998 (p <0.001). The prevalence of premature CHD requiring a hospitalization significantly decreased from 1998 to 2022 (64.3% vs. 44.1 %, p<0.001). At the moment of admission, 18.2 % of FH patients had LDL-C concentration <2.0 mmol/L in 2022 vs 0 % in 1998 (p <0.001). Over 25 years, FH patients tend to be older and contribute to a lower proportion of hospitalizations for CHD in the French-Canadian founder population. Despite significant improvement in diagnosis and treatment, FH management remains however sub-optimal.

PCSK9 Targeting in the Management of Hypercholesterolaemia

It has long been established that elevated plasma concentrations of low-density lipoprotein cholesterol (LDL-C) are among the prominent contributors leading to the development of atherosclerotic plaques and, ultimately, cardiovascular disease. In the current era of optimal risk factor modification, proprotein convertase subtilisin/kexin type 9 (PCSK9) targeting has emerged as a potent therapeutic approach in the management of hypercholesterolaemia, addressing several substantial, unmet clinical needs. PCSK9 monoclonal antibodies, evolocumab and alirocumab, as well as inclisiran, which is a small interfering RNA that halts the transcription of PCSK9 mRNA, are being increasingly used in current clinical practice, as they induce intensive LDL-C reductions without any significant safety and tolerability concerns. Based on the success of these agents, the concept of PCSK9 targeting with novel agents with enhanced biological properties, or via different administration routes, has received considerable attention. In this regard, numerous antisense oligonucleotides, peptides, and proteins are currently under evaluation in randomised controlled trials, yielding propitious results up to date; they may enter clinical use in the coming years. Meanwhile, a PCSK9 vaccine, as well as genome editing via clustered regularly interspaced palindromic repeats/Cas9, hold great promise to eradicate LDL-C altogether as a cardiovascular risk factor. This review aims to present and discuss the current clinical and scientific evidence pertaining to the field of medications that exert their biological effect by targeting PCSK9, which are either in use in clinical practice, or are currently being evaluated in pre-clinical or clinical studies, and may prove beneficial in the near future.

A-116 Evaluation of Lp(a) Ultra assay for the Immunoturbidimetric Quantitative Determination of Lipoprotein (a) in Human Serum and Plasma With Siemens Healthineers Atellica CH 930 Analyzer

Abstract Objective The aim of this study is to evaluate the analytical performances of the Lp(a) Ultra assay for the immunoturbidimetric quantitative determination of lipoprotein (a) in human serum and plasma on Siemens Healthineers Atellica CH 930 Analyzer. Background Lipoprotein (a) has been found in artery walls and can have atherogenic effects. Because of its structural similarity to plasminogen, it can also inhibit fibrinolysis and hence acts thrombogenically. High Lp(a) concentrations in serum correlate with premature manifestation of atherosclerosis and strokes. In combination with elevated LDL Cholesterol concentrations, the coronary risk increases approximately six-fold. Methods Lp(a) Ultra is a latex immunoassay manufactured by Sentinel Diagnostics and developed to measure Lp(a) levels. If the antigen-antibody reaction takes place between Lp(a) in the sample and the anti-Lp(a) antibodies, which have been adsorbed to latex particles, agglutination occurs. This agglutination is detected as an absorbance change, with the magnitude of the change being proportional to the quantity of Lp(a) contained in the sample. Results The Limit of Blank LOB (4 samples × 5 replicates × 3 runs) was ≤2.0 mg/dL. The Limit of Detection LOD (4 samples × 5 replicates × 3 runs) was ≤ 3.0 mg/dL. The Limit of Quantitation LOQ (8 dilution levels × 10 replicates × 3 runs) was ≤5.0 mg/dL at %CV lower than 20%. The Intra Assay (5 samples × 20 replicates × 3 runs) gave the following %CVs: 2.4% at 12.1 mg/dL, 0.8% at 30.3 mg/dL, 0.6% at 47.8 mg/dL, 0.5% at 58.8 mg/dL, 1.7% at 87.1 mg/dL. Total precision study (5 samples × 2 runs × 2 replicates × 20 runs) gave the following %CVs: 4.0% at 11.5 mg/dL, 3.6% at 21.7 mg/dL, 3.0% at 32.0 mg/dL, 2.8% at 42.2 mg/dL, 2.3% at 50.7 mg/dL. The test was linear up to 130 mg/dL. Calibration stability was up to 30 days. Reagent on board stability was up to 30 days. This application (y) was compared with the same test applied on Beckman Coulter AU680 Analyzer (x) and gave the following results: using Passing Bablok analysis: y = 0.8 + 1.0x; correlation coefficient (r) = 0.997; using Deming analysis: y = 1.0 + 1.0x; correlation coefficient (r) = 0.997; number of samples = 120. There is not Hook effect/antigen excess up to 600 mg/dL. Conclusions Analytical performances of Lp(a) Ultra assay on Siemens Healthineers Atellica CH 930 Analyzer meet the requirements for its use as immunoturbidimetric quantitative determination of lipoprotein (a) in human serum and plasma and make this assay very suitable for the routine measurement of this analyte.

Alanyl-Glutamine Dipeptide Attenuates Non-Alcoholic Fatty Liver Disease Induced by a High-Fat Diet in Mice by Improving Gut Microbiota Dysbiosis.

Non-alcoholic fatty liver disease (NAFLD) manifests as a persistent liver ailment marked by the excessive buildup of lipids within the hepatic organ accompanied by inflammatory responses and oxidative stress. Alanyl-glutamine (AG), a dipeptide comprising alanine and glutamine, is commonly employed as a nutritional supplement in clinical settings. This research aims to evaluate the impact of AG on NAFLD triggered by a high-fat diet (HFD), while concurrently delving into the potential mechanisms underlying its effects. The results presented herein demonstrate a notable reduction in the elevated body weight, liver mass, and liver index induced by a HFD upon AG administration. These alterations coincide with the amelioration of liver injury and the attenuation of hepatic histological advancement. Furthermore, AG treatment manifests a discernible diminution in oil-red-O-stained regions and triglyceride (TG) levels within the liver. Noteworthy alterations encompass lowered plasma total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) concentrations, coupled with elevated high-density lipoprotein cholesterol (HDLC) concentrations. The mitigation of hepatic lipid accumulation resultant from AG administration is aligned with the downregulation of ACC1, SCD1, PPAR-γ, and CD36 expression, in conjunction with the upregulation of FXR and SHP expression. Concomitantly, AG administration leads to a reduction in the accumulation of F4/80-positive macrophages within the liver, likely attributable to the downregulated expression of MCP-1. Furthermore, AG treatment yields a decline in hepatic MDA levels and a concurrent increase in the activities of SOD and GPX. A pivotal observation underscores the effect of AG in rectifying the imbalance of gut microbiota in HFD-fed mice. Consequently, this study sheds light on the protective attributes of AG against HFD-induced NAFLD through the modulation of gut microbiota composition.

Association between Polyphenol Intake and Lipid Profile of Adults and Elders in a Northeastern Brazilian Capital

This research was aimed at evaluating the relationship between the estimated polyphenol intake and the atherogenic lipid profile in adult and elder residents in the city of Teresina, located in the Northeastern Region of Brazil. This study was a cross-sectional population-based survey with 501 adults and elders, conducted in Teresina, Brazil. Food intake was obtained by 24-h food recall. The estimated polyphenol intake was calculated by multiplying the food consumption data from the recall by the polyphenol content in the foods described in the Phenol-Explorer database. The mean intake of total polyphenols was 1006.53 mg/day. The phenolic acids was the class with the highest intake, followed by the flavonols. Coffee, beans and apples were the main foods contributing to the total polyphenol intake. In the individuals with elevated serum concentrations of total cholesterol and triglycerides, the intake of total polyphenols was significantly higher. The intake of total polyphenols, phenolic acids and lignans was higher in the subjects with dyslipidemia. This article provides, for the first time, data on the intake of the total polyphenol classes and subclasses in the evaluated population and the relationship with the lipid profile. The individuals with a higher intake of total polyphenols had a worse lipid profile, which may be a consequence of an improved diet in those individuals who present with dyslipidemia.

Urban particulate air pollution linked to dyslipidemia by modification innate immune cells

Air particulate matter (PM) is an essential risk factor for lipid metabolism disorders. However, the underlying mechanism remains unclear. In this cross-sectional study, 216 healthcare workers were recruited to estimate the associations among the daily exposure dose (DED) of air PM, innate immune cells, and plasma lipid levels. All participants were divided into two groups according to the air particulate combined DED (DED-PMC). The peripheral white blood cell counts, lymphocyte counts, and monocyte counts and percentages were higher in the higher-exposure group (HEG) than in the lower-exposure group (LEG), whereas the percentage of natural-killer cells was lower in the HEG than in the LEG. The plasma concentrations of the total cholesterol, triglycerides, LDL-C, and apolipoprotein B were higher in the HEG than in the LEG, whereas the HDL-C and apolipoprotein A1 were lower in the HEG than in the LEG. A dose-effect analysis indicated that when the DED of the air PM increased, there were increased peripheral monocyte counts and percentages, a decreased NK cell percentage, elevated plasma concentrations of total cholesterol, triglycerides, LDL-C, and apolipoprotein B, and reduced plasma levels of HDL-C and apolipoprotein A1. In addition, the modification of the innate immune cells was accompanied by alterations in the plasma lipid levels in a dose-dependent manner. Mediation effect analysis suggested innate immune cells were the potential mediators for the associations among air PM exposure on abnormal lipid metabolism. These results indicated that chronic exposure to air PM may disturb lipid metabolism by altering the distribution of innate immune cells in the peripheral blood, ultimately advancing cardiovascular disease risk.

Long-Term Efficacy and Safety of Evinacumab in Patients with Homozygous Familial Hypercholesterolemia: Real-World Clinical Experience.

Homozygous familial hypercholesterolemia (HoFH) is a rare, genetic condition characterized by markedly elevated plasma low-density lipoprotein cholesterol (LDL-C) concentrations from birth and increased risk of premature atherosclerotic cardiovascular disease. Evinacumab is an inhibitor of angiopoietin-like 3 protein that offers a new approach for correcting high LDL-C in HoFH. Evinacumab was administered intravenously (15 mg/kg Q4W) for 24 months in 7 patients with genetically confirmed HoFH, receiving background lipoprotein apheresis (LA) and/or lipid-lowering treatment (LLT). Assessment of efficacy and safety were carried out before and after 24 months of evinacumab treatment. The LDL-C lowering effect of evinacumab without LA were also investigated in the 7 HoFH patients after a subsequent compassionate extension period. Twenty-four months of treatment with evinacumab against background LA and LLT resulted in a significant reduction in LDL-C (-46.8%; p &lt; 0.001). LDL-C reduction with evinacumab was maintained during the compassionate extensions period in the absence of treatment with LA (-43.4%; mean follow-up of 208 ± 90 days). Evinacumab was well-tolerated, with no major adverse event reported or significant changes in liver and muscle enzyme concentrations. Our findings suggest that evinacumab is a safe and effective treatment for patients with HoFH receiving best standard of care in a routine setting.

The effect of experimentally induced hyperglycemia by alloxan on some hematological parameters in rabbits

The study was designed to investigate the effects of hyperglycemia on some hematological and serum lipid parameters in rabbits during a period of seventy days. This study was achieved in the university of Al-Qadisyiah / college of veterinary medicine college department of pathology from 31/10/2008 till 10/02/2009. The parameters evaluated include serum lipids, red and white blood cell indices. The results show that the hyperglycemia significantly reduced (P&lt;0.05) packed cell volume and red blood cell count when compared with control groups. Also, the hyperglycemia significantly reduced (P&lt;0.05) white blood cell count when compared with control. Moreover, the hyperglycemia significantly elevated (P&lt;0.05) total cholesterol concentration in the serum while it had less significant effect (P&lt;0.05) on serum HDL-cholesterol concentration when compared with controls. Whereas, hyperglycemia significantly increased (P&lt;0.05) serum triglycerol concentration. The results of this study suggest that hyperglycemia may have extrusive effect on serum cholesterol concentration, although it possibly possesses the potential of adversely affecting some hematological indices.

Low-Density Lipoprotein Cholesterol Treatment Target Achievement in Patients with Myocardial Infarction, Percutaneous Coronary Intervention, or Stroke in Hong Kong

Background: Elevated concentrations of low-density lipoprotein cholesterol (LDL-C) are an important cause of recurrent cardiovascular events. This study aimed to describe the distribution and achieved concentrations of LDL-C among patients with myocardial infarction (MI), percutaneous coronary intervention (PCI), stroke, or transient ischaemic attack (TIA) in Hong Kong. Methods: Patients with a lipid test from a public hospital were identified from the Clinical Database and Analysis Reporting System of the Hong Kong Hospital Authority. Among patients with an inpatient hospitalization for MI, PCI, stroke or TIA, between 2003 to 2016, the distribution of LDL-C levels and the number (%) of patients achieving an absolute concentration of LDL-C &lt;1.8 mmol/L at baseline (in-hospital) and during 12 months after hospital discharge were described. Results: A total of 18417 patients were included (mean [SD] age, 70.0 [12.9] years; male, 60.3%), of which 3637 had MI, 4096 had PCI, and 10684 had stroke or TIA. At hospital discharge 12082 (65.6%) patients were prescribed statins, 690 (3.7%) were prescribed nonstatins, and 1849 (10.0%) achieved an LDL-C &lt;1.8 mmol/L. Overall, 5654 (30.7%) patients did not have LDL-C result available within 12 months of discharge (MI, 605 [16.6%]; PCI, 432 [10.5%]; stroke or TIA, 4617 [43.2%]). Among the overall cohort, 4591 (24.9%) patients achieved an LDL-C &lt;1.8 mmol/L during 12 months of follow-up (MI, 1288 [35.4%]; PCI, 1542 [37.6%]; stroke or TIA, 1761 [16.5%]). Improvements in achieved LDL-C were observed over time with a mean LDL-C 2.64 (0.92) mmol/L and 20.0% of patients achieving an LDL-C &lt;1.8 mmol/L in 2003 as compared with a mean LDL-C 1.86 (0.70) mmol/L and 53.9% of patients achieving an LDL-C &lt;1.8 mmol/L in 2016. Conclusions: In this single centre cohort study from Hong Kong, nearly half of patients with MI, PCI, or stroke in 2016 appear to qualify for intensification of lipid-modifying drug treatment in order to achieve a treatment goal of LDL-C &lt;1.8 mmol/L. Further research is required in Hong Kong to assess contemporary management of LDL-C in a larger group of patients with established atherosclerotic cardiovascular disease.

The Level of Remnant Cholesterol and Implications for Lipid-Lowering Strategy in Hospitalized Patients with Acute Coronary Syndrome in China: Findings from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project.

Elevated remnant cholesterol is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). We aimed to evaluate the concentrations and general distribution of remnant cholesterol at admission in patients hospitalized for acute coronary syndrome (ACS), and those in patients who reached the low-density lipoprotein cholesterol (LDL-C) target or non-high-density lipoprotein cholesterol (non-HDL-C) target. Patients with ACS who were enrolled in the Improving Care for Cardiovascular Disease in China—ACS project from 2014 to 2019 were included. Elevated remnant cholesterol concentrations were defined as ≥1.0 mmol/L. Among 94,869 patients, the median (interquartile range) remnant cholesterol concentration at admission was 0.6 mmol/L (0.4–0.9 mmol/L) and 19.2% had elevated remnant cholesterol concentrations. Among patients with LDL-C concentrations < 1.4 mmol/L, 24.4% had elevated remnant cholesterol concentrations, while the proportion was 13.3% among patients with LDL-C concentrations between 1.4 and 1.7 mmol/L. Among patients with non-HDL-C concentrations < 2.6 mmol/L, 2.9% had elevated remnant cholesterol concentrations but 79.6% had LDL-C concentrations ≥ 1.4 mmol/L. Even among patients with LDL-C < 1.4 mmol/L and non-HDL-C < 2.6 mmol/L, 10.9% had elevated remnant cholesterol. In conclusion, one fifth of patients with ACS have elevated remnant cholesterol concentrations at admission. Elevated remnant cholesterol concentrations are present in patients with LDL-C or/and non-HDL-C concentrations within the target, which represents an unmet need to add remnant cholesterol as a target for the secondary prevention of ASCVD.

PCSK9 inhibition in children with familial hypercholesterolaemia

Heterozygous familial hypercholesterolaemia is the most prevalent monogenic dyslipidaemia, affecting approximately 1 in 300 people worldwide.1 If left untreated, elevated LDL cholesterol concentrations in heterozygous familial hypercholesterolaemia are associated with a more than ten-fold increased risk of premature atherosclerotic cardiovascular disease.1 For children and adolescents with heterozygous familial hypercholesterolaemia, clinical guidelines recommend early intervention with lifestyle modification and statin drugs, with increasingly assertive targets for LDL cholesterol.

Serum progranulin level in patients with newly diagnosed untreated familial hypercholesterolemia

Background and Aims : Familial hypercholesterolemia (FH) is a monogenic form of severe hypercholesterolemia, characterized by elevated total cholesterol and low-density lipoprotein-cholesterol concentrations that, if left untreated, is associated with early onset of atherosclerosis. Progranulin (PGRN) is a recently discovered growth factor with many biological functions. PGRN has anti-inflammatory properties because it inhibits neutrophil degranulation and blocks tumor necrosis factor α transmission, therefore, might be anti-atherogenic.

COVID-19 and Lipid Disorders.

An elevated cholesterol concentration has been suspected to increase the susceptibility for SARS-COV-2 infection. Cholesterol plays a central role in the mechanisms of the SARS-COV-2 infection. In contrast, higher HDL-cholesterol levels seem to be protective. During COVID-19 disease, LDL-cholesterol and HDL-cholesterol appear to be decreased. On the other hand, triglycerides (also in different lipoprotein fractions) were elevated. Lipoprotein(a) may increase during this disease and is most probably responsible for thromboembolic events. This lipoprotein can induce a progression of atherosclerotic lesion formation. The same is suspected for the SARS-COV-2 infection itself. COVID-19 patients are at increased risk of incident cardiovascular diseases, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure, and thromboembolic disorders. An ongoing lipid-lowering therapy, including lipoprotein apheresis, is recommended to be continued during the COVID-19 disease, though the impact of lipid-lowering drugs or the extracorporeal therapy on prognosis should be studied in further investigations.

A STUDY TO EVALUATE THE IMPORTANCE OF FASTING LIPID PROFILE ESTIMATION AS THE PART OF INITIAL EVALUATION OF HIV POSITIVE PATIENTS BEFORE STARTING HAART

BACKGROUND:-There is evidence that ART is associated with lipodystrophy syndrome, a disturbance of lipid metabolism characterised by insulin resistance, dyslipidaemia, and fat maldistribution, metabolic bone disease (osteopenia and/or osteoporosis), and lactic acidosis. ART- associated dyslipidaemia is characterized by elevated serum concentrations of total cholesterol, triglycerides, low density lipoprotein 2(LDL-c), very low-density lipoprotein (VLDL), and Apo lipoprotein B (apoB) and low levels of high density lipoprotein (HDL-c) constituting an atherogenic lipid 1 prole . In this study 143 young patients who were attending the Antiretroviral Therapy PlusMATERIAL AND METHODS:- Centre &amp; Medicine Wards, ACSR GMC NELLORE were included randomly. 5mlSample preparation and Biochemical assay :- of venous blood sample was collected by venipuncture from 12 hours overnight fast and centrifuged at 3000 cycles per minute and serum was separated for lipid prole measurement within one hour of blood collection. The serum levels of TC, HDL-C, LDL-C, VLDL and TG were measured using AU480 BECKMANS random access fully automated auto analyzer at Biochemistry laboratory, ACSR GMC, NELLORE. TC, LDL and TC/HDL lipid proles are signicant. F-Signicant values areRESULTS;- &lt;0.05, reject null hypothesis. It means that the difference among the lipid proles of TC, LDL and TC/HDL in the study group is statistically signicant with respect to regimen groups. HDL, TG and VLDL lipid proles are not signicant. F-Signicant values are &gt;0.05, no evidence to reject null hypothesis. It means that the no signicant difference among the lipid proles of HDL, TG, and VLDL in the study group is not statistically signicant with respect to regimen groups. SignicantCONCLUSIONS:- metabolic and morphological alterations occur in HIV infected patients especially in patients on HAART. The patients on HAART had an elevated Castelli Index I, indicating an increased risk for atherosclerotic cardiovascular disease in this population. There is need to assess lipid proles at baseline before initiation of HAART treatment and lipid prole monitoring during therapy to monitor any rising trends. New medications with more lipid friendly proles within existing drugs such as darunavir (PI), etravirine (NNRTI), new classes of drugs such as integrase inhibitors (raltegravir) and CCR5 inhibitors (maraviroc) can be used to avoid dyslipidaemia.

A STUDY TO ASSESS ANTHROPOMETRIC PARAMETERS AND SERUM LIPID VARIATIONS IN HIV PATIENTS RECEIVING HAART

Background:- There is evidence that ART is associated with lipodystrophy syndrome, a disturbance of lipid metabolism characterised by insulin resistance, dyslipidaemia and fat maldistribution, usually presenting as visceral abdominal obesity and cervical fat pad accumulation (buffalo hump)1,metabolic bone disease (osteopenia and/or osteoporosis) and lactic acidosis. ART- associated dyslipidaemia is characterized by elevated serum concentrations of total cholesterol, triglycerides, low density lipoprotein 2(LDL-c), very low-density lipoprotein (VLDL), Apo lipoprotein B (apoB) and low levels of high density lipoprotein (HDL-c) constituting an atherogenic lipid profile2. Materials And Methods:- In this study 100 young patients who were attending the Antiretroviral Therapy Plus Centre &amp; Medicine Wards, ACSR GMC, NELLORE were included randomly. Anthropometric Measurement :- Body weights were measured (to the nearest 0.5 kilogram) with the subject standing on a weighing scale after it was adjusted to zero kg. Heights were measured (to the nearest 1.0 centimeter) with the subject standing in an erect position against a vertical scale of portable standiometer and a L-square placed on the head and the head positioned to a level with the inferior margin of the bony orbit. The waist measurements were taken from the middle point between the iliac crest and the last rib as recommended by the WHO. Hip circumference was measured as the maximal circumference over the buttocks. BMIs were then calculated as weight in kilograms divided by the height in meter squared. Results:- The results of the study showed that the Anthropometric parameters on analysis showed a normal range BMI in 59% of patients. Waist-to-hip ratio which have been shown to be better reflector of body fat distribution and is significantly elevated in the HIV-infected patients on HAART. Waist-Hip ratio value analysis showed normal in 18.19% and abnormal in 81.81% of cases. The mean value in males is 0.9578 and in females is 0.9204. This showed a significant correlation to Waist/ hip ratio and the gender. Conclusions:- Significant metabolic and morphological alterations occur in HIV infected patients especially in patients on HAART. The patients on HAART had an elevated Castelli Index I, indicating an increased risk for atherosclerotic cardiovascular disease in this population. Waist-to-hip ratio which are the key indices for assessing body fat distribution were significantly raised in HAART-experienced patients in this study implying that HAART could result to lipodystrophy.