Elevated Triglyceride Levels Research Articles

A review on the treatment of hyperlipidemia with Erchen Decoction

Hyperlipidemia, commonly referred to as dyslipidemia, is characterized by elevated serum cholesterol and/or triglyceride levels. This condition contributes significantly to the high mortality rates associated with cardiovascular diseases, posing a serious threat to global health. Although statins remain the predominant pharmacological treatment for hyperlipidemia, their associated side effects have led to a growing interest in alternative therapeutic approaches. Traditional Chinese Medicine (TCM) is exploring these alternatives, with the Erchen Decoction (ECD) emerging as a promising candidate. This review aims to summarize current clinical research, elucidate the mechanisms of action, and assess the compatibility of ECD in the management of hyperlipidemia. By doing so, we hope to provide valuable insights and references for clinical practice and future research.

Abstract 4122301: The Role of Hepatic CDS2 in Phosphatidylinositol Homeostasis and Lipid Metabolism

Background: Recent studies in both human genetics and mouse models have highlighted the significance of phosphatidylinositol (PI) in the progression of fatty liver disease (FLD). Despite this, the precise mechanisms underlying PI's role remain elusive. Aims: This study aimed to elucidate the involvement of PI in FLD by disrupting hepatic PI biosynthesis through modulation of CDP-diacylglycerol synthase 2 (CDS2) expression, the primary enzyme in PI biosynthesis (A). Methods: We generated liver-specific knockouts of CDS2 and SCAP (SREBP cleavage-activating protein) using adeno-associated virus (AAV) expressing sgRNA against each gene. Phospholipid species were analyzed and quantified by LC/MS. Results: CDS2 liver-specific knockout mice (B, C) exhibited a pronounced development of fatty liver, characterized by elevated triglyceride and cholesterol levels (C). Notably, liver PI levels were significantly reduced in CDS2 knockout mice (E), accompanied by dysregulated activation of sterol regulatory element-binding protein (SREBP) even during fasting conditions (F), leading to increased de novo lipogenesis. Intraperitoneal administration of exogenous PI effectively normalized SREBP cleavage (G), highlighting PI's critical role in SREBP regulation. Furthermore, simultaneous knockout of SCAP with CDS2 restored the normal liver phenotype, implicating SREBP activation as a central mechanism underlying fatty liver development in CDS2 knockout mice (H, I). Conclusion: Deletion of CDS2 in the liver reduced PI levels, subsequently inducing significant fatty liver due to dysregulated SREBP activation. This study underscores the importance of CDS2 in maintaining PI homeostasis, which in turn regulates SREBP activity and lipid metabolism. Our findings provide valuable insights into the pathogenesis of metabolic disorders and offer potential therapeutic strategies for targeting FLD.

Anatomical and carcass traits, partition of fat deposits, and meat quality in culled adult goats finished with high-fat diet

The objective of this study was to examine the impact of a high-fat finishing diet on the in vivo performance, anatomical and carcass characteristics, and meat quality of adult culled goats. Over a period of 28 days leading up to slaughter, eighteen adult culled goats were subjected to a finishing diet provided in quantities sufficient to meet 3.0 times the nutritional requirements of adult non-dairy maintenance goats. The female goats were divided into two groups: one fed with the baseline diet without fat supplementation (n = 9) and the other fed a diet concentrated supplemented with whole full-fat linseed (n = 9). The diets varied in fat content (2.8% vs. 8.4% DM). The high-fat group exhibited a higher dry matter intake compared to the control group (+37%), along with elevated plasma cholesterol and triglyceride levels. The control group experienced a significant decrease in daily weight gain between the second and final week of the finishing period (-70%), in contrast to the increase observed in the high-fat group (+59%). At slaughter, no differences were noted between the groups in anatomical and carcass characteristics. Additionally, no differences were found between the diets regarding proximate composition, pH, yellow color component, and lightness of loin. The high-fat group exhibited a higher redness of loin. The inclusion of high-fat levels in finishing diets for culled adult goats allows for increased feed intake and performance but does not appear to affect carcass or meat quality.

Abstract 4138294: Medicare Utilization and Associated Spending on Icosapent Ethyl

Introduction: In 2019, Icosapent Ethyl became the first US Food and Drug Administration (FDA) approved medication for reducing cardiovascular risk beyond cholesterol-lowering therapy in high-risk patients. It was approved specifically as an adjunct to maximal tolerated statin therapy to reduce cardiovascular risk in adult patients with elevated triglyceride (TG) levels. The National Lipid Association now has a Class I recommendation for the use of icosapent ethyl (4 g/d) to reduce cardiovascular risk in patients with TG > 150 mg/dl. Methods: We analyzed available data from Medicare Part D prescription drug events published from the year 2018 to 2022. All data were de-identified and made publicly available. All costs were adjusted for inflation and represented in 2022 US dollars. Results: The number of Medicare Part D beneficiaries prescribed Icosapent Ethyl increased from 141,336 to 303,971 (215%) between 2018 and 2022 (Fig. A) and the number of claims increased from 704,334 to 1,527,133 (216%) (Fig. B). The total spending increased from $278 million to $787 million (282%) within the same timeframe (Fig. C). The average spending per claim has increased from $396 to $515 (130%) (Fig. D) and the average spending per beneficiary has also increased from $1976 to $2591 (131%) (Fig. E) between 2018 and 2022. Discussion: We observed a marked increase in the use of icosapent ethyl from 2018 to 2022. We can see a sharp rise of 187% in beneficiaries from 2018 to 2019 following FDA approval. The total number of claims and total spending also increased by 181% and 200%, respectively, from 2018 to 2019. The average spending per claim and average spending per beneficiary has increased from 2018 to 2022. It also demonstrates the cost burden to Medicare with the use of such lipid-lowering agents. Many Medicare plans include icosapent ethyl as a Tier 4 drug, which is the second most expensive drug tier. Limitations: The pattern of data used may not be generalizable to other payer demographics. Policy changes can affect the comparability of data over different periods. Conclusion: Our data highlights the increasing use of icosapent ethyl as a cardiovascular risk-reduction medication in the Medicare population. There has been a steady increase in the number of claims and beneficiaries since the approval of icosapent ethyl with an increase in average spending from 2018 to 2022.

Metabolism and Clinical Significance of Triglycerides

Triglycerides, the principal form of fat storage in animals and humans, are essential in view of their roles in energy metabolism and regulation. Indeed, they have been ascribed very vital functional significance in a plethora of physiological processes, which extends to energy storage, metabolic signaling, and disease pathology. Biochemistry and metabolism of triglycerides is a multivaried area of science that includes different mechanisms that control synthesis, storage, and utilization in organisms. For many years, the issue of triglycerides and their relationship to cardiovascular disease (CVD) has been one of the central themes of research. Elevated triglyceride levels frequently associate with an elevated cardiovascular risk, but the situation is complex and multifaceted at all. It has now been reported that triglycerides could act not only as a biomarker regarding cardiovascular risk but also play an actual part in the fostering of cardiovascular disorders. The present literature review juxtaposes key findings on triglyceride metabolism, thereby underlining implications for health and disease, with the end to identify works currently associating triglyceride implications in cardiovascular health, and further to explore determinants of triglyceride levels gap that warrant further investigation.

Comparative Transcriptome Analysis Reveals the Impact of a High-Fat Diet on Hepatic Metabolic Function in Tilapia (Oreochromis niloticus)

Hepatic steatosis is prevalent among cultured fish, yet the molecular mechanisms remain incompletely understood. This study aimed to assess changes in hepatic metabolic function in tilapia and to explore the underlying molecular mechanisms through transcriptomic analyses. Tilapia were allocated into two groups: a normal control (Ctr)-fed group and a high-fat diet (HFD)-fed group. Serum biochemical analyses revealed that HFD feeding led to liver damage and lipid accumulation, characterized by elevated levels of glutamic-pyruvic transaminase (GPT), glutamic-oxaloacetic transaminase (GOT), triglycerides (TGs), and total cholesterol (TC). Transcriptome analysis showed that 538 genes were significantly downregulated, and 460 genes were significantly upregulated in the HFD-fed fish. Gene Ontology (GO) enrichment analysis showed that these differentially expressed genes (DEGs) were apparently involved in the lipid metabolic process and monocarboxylic acid metabolic process. Meanwhile, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated significant alterations in pathways of steroid biosynthesis, porphyrin metabolism, terpenoid backbone biosynthesis, and retinol metabolism after HFD feeding. Additionally, results from Gene Set Enrichment Analysis (GSEA) revealed that gene expression patterns in pathways including oxidative phosphorylation, protein export, protein processing in the endoplasmic reticulum, and ribosome biogenesis were positively enriched in the HFD-fed tilapia. These findings provide novel insights into the mechanisms underlying HFD-induced hepatic dysfunction in fish, contributing to the optimization of feeding strategies in aquaculture.

Isolation and assessment of probiotic potential of Acidipropionibacterium acidipropionici C03B-STR from goat milk with cholesterol-lowering capability.

Elevated levels of cholesterol or triglycerides in the blood are one of the major risk factors for coronary heart disease, which is the foremost leading cause of death across the world. The aims of this study were to isolate and verify the potential probiotic strain and cholesterol-lowering capability from goat milk. The C03B-STR isolate had a broad-spectrum antibacterial property and exhibited remarkable bacteriostatic activity against Klebsiella pneumoniae ATCC 13883 (27.00 ± 1.73mm), Pseudomonas aeruginosa ATCC 27853 (19.33 ± 0.57mm) and Staphylococcus aureus ATCC 10832 (19.00 ± 1.00mm) by agar well diffusion assay. This isolate is closely related to the 16S rDNA sequence of Acidipropionibacterium acidipropionici. Acidipropionibacterium acidipropionici C03B-STR can survive under acidic conditions (60.51 ± 0.02% of survival rate at pH 3.0 for 3h) and was as bile-tolerant strain (> 80% of survival rate at 0.30% bile salts after 3h of incubation). Furthermore, it showed significantly high cell surface hydrophobicity (74.36 ± 0.23%) and aggregation capability (> 83%) (p ≤ 0.05) but displayed low to moderate co-aggregation ability (44-61%). This strain can also be regarded as strongly adhesive (73.69 ± 0.74%) and inhibit pathogen attachment to the Caco-2 cell lines (39.20 ± 0.59-69.01 ± 0.29%). A. acidipropionici C03B-STR appeared to be safe (non-haemolytic) and controllable (sensitive to various antibiotics). Notably, it had the potential to suppress cholesterol uptake in Caco-2 cells (approximately 45%) and also reduced cholesterol level above 84% during the exponential phase under acidic conditions. Thus, A. acidipropionici C03B-STR from goat milk may be a promising novel potential cholesterol-lowering probiotic strain for application in functional foods and biotherapeutics.

Influence of Inflammatory State on the Need to Customize Parenteral Nutrition in Adolescents.

Parenteral nutrition (PN) can be standardized or customized according to a patient's individual needs, including clinical, metabolic, nutritional, and inflammatory conditions. The influence of inflammation on the indication of standard or customized PN for adolescents hospitalized in a quaternary hospital in the southeastern of Brazil was evaluated. A historical cohort study of 61 adolescents admitted to the hospital was conducted. Nutritional, clinical, and biochemical data from the first 7 days of PN use were analyzed. Elevated serum mineral and triglyceride levels, as well as renal or liver failure (grade III or IV), were considered unequivocal reasons for PN customization, while restoring energy-protein adequacy and low serum mineral levels were considered questionable reasons. Inflammatory status was analyzed during the study period. A total of 128 PN solutions were prescribed, comprising 55 standardized and 73 customized. Overall, 40/61 patients required customized PN. The main reason for customization was to restore energy-protein adequacy (n = 48), while 24.7% (n = 18) of individualizations were for unequivocal reasons. Restoring energy-protein adequacy in the first 48 h was shown to have contributed to high transthyretin, which reduced the need for additional customized PN (r = -0.544; p = 0.044). A positive correlation was found between the total number of PN readjustments and C-Reactive Protein levels (r = 0.509; p = 0.044). Conditions such as malnutrition or an inflammatory state in adolescents presenting metabolic changes are indications for the use of customized PN.

Lipid metabolism disorders and albuminuria risk: insights from National Health and Nutrition Examination Survey 2001–2018 and Mendelian randomization analyses

Background Previous studies have revealed an underlying connection between abnormal lipid metabolism and albuminuria. We aim to investigate the causal relationship between lipid metabolism disorders and the risk of albuminuria from both a population and genetic perspective. Methods A cross-sectional study was conducted by using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2018. Multivariable-adjusted logistic regression, subgroup analysis, interaction tests and restricted cubic spline (RCS) were employed statistically. Mendelian randomization (MR) analysis was performed to validate the causal relationship between exposure and outcome to mitigate confounding factors and reverse causation interference. Results After adjusting for confounders, HDL levels (1.03-2.07 nmol/L) were associated with a reduced risk of albuminuria. In contrast, elevated cholesterol levels (>6.2 nmol/L) and triglyceride levels (>2.3 nmol/L) were associated with an increased risk of albuminuria. Serum triglyceride concentration emerged as a potential risk factor for albuminuria. In MR analysis, a reduced risk of albuminuria was associated with serum total HDL level (IVW: OR = 0.91, 95% CI = 0.86-0.97, p = 0.002). In contrast, cholesterol esters in medium VLDL (IVW: OR = 1.05, 95% CI = 1.00-1.10, p = 0.032), chylomicrons and extremely large VLDL (IVW: OR = 1.08, 95% CI = 1.03-1.14, p = 0.003), and triglycerides (IVW: OR = 1.14, 95% CI = 1.09-1.19, p < 0.001) were associated with an increased risk of albuminuria. Conclusion A causal relationship exists between serum lipid metabolism disorder and albuminuria risk. Further validation of additional blood lipid metabolism biomarkers is imperative for future studies.

ANGPTL3 as a target for treating lipid disorders in type 2 diabetes patients

Type 2 diabetes mellitus (T2DM) is a globally prevalent metabolic disorder, and cardiovascular disease (CVD) is a significant cause of mortality and morbidity in diabetic individuals. In addition to hyperglycemia, lipid abnormalities associated with T2DM play a crucial role in the development of CVD complications. Diabetic dyslipidemia is characterized by elevated levels of triglyceride (TG)-rich lipoproteins and small dense low-density lipoprotein (LDL) particles, reduced high-density lipoprotein (HDL) cholesterol, and impaired HDL function. Angiopoietin protein-like 3 (ANGPTL3) is a liver-derived protein that plays a crucial role in regulating plasma lipoprotein metabolism by inhibiting lipoprotein lipase and influencing lipid levels. Inhibiting ANGPTL3 has shown promising effects in promoting HDL-mediated cholesterol reverse transport and reducing the levels of TG-rich lipoproteins and LDL cholesterol. Here, we explore the potential of ANGPTL3 as a therapeutic target for lipid management in T2DM patients.

Hubungan Antara Kadar HbA1c dengan Kadar Trigliserida terhadap Pasien Prolanis Diabetes Melitus Tipe 2 di Laboratorium Klinik Kimia Farma Depok

Diabetes Mellitus (DM) is a group of metabolic disorders characterized by elevated blood glucose levels resulting from abnormalities in insulin secretion, insulin action, or both. Patients with Type 2 DM are at a higher risk of developing cardiovascular diseases, often indicated by dyslipidemia, which is characterized by elevated triglyceride levels, increased Low-Density Lipoprotein (LDL) levels, and decreased High-Density Lipoprotein (HDL) levels. This study employs an analytical observational design. The data obtained shows that controlled and uncontrolled HbA1c levels with normal triglyceride levels were found in 24.7% of the patients, while 75.3% had high triglyceride levels. The data were further analyzed using the Statistical Package for the Social Sciences 25 (SPSS 25) with a non-parametric test, specifically the Chi-Square continuity correction test, with a significance level of p 0.05. The Chi-Square test results indicated that H0 was rejected and Ha was accepted, with a p-value of 0.036 for the relationship between HbA1c and triglycerides. These results suggest a correlation between HbA1c levels and triglyceride levels in Prolanis Type 2 DM patients at Kimia Farma Clinical Laboratory in Depok. These findings can serve as an evaluation material for Prolanis DM Type 2 patients to control their glycemic levels by routinely monitoring their HbA1c and triglyceride levels.

Association between sarcopenic obesity and osteoarthritis: The potential mediating role of insulin resistance

BackgroundSarcopenic obesity (SO) and osteoarthritis (OA) are highly prevalent musculoskeletal conditions that significantly impair health-related quality of life. AimThis study investigated the association between SO and OA, and explored the potential mediating role of insulin resistance in this relationship. We utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. MethodsThis cross-sectional analysis employs NHANES data collected from 1999 to 2018, including participants aged 18 years and older. SO was assessed using dual-energy X-ray absorptiometry (DXA) measurements. Insulin resistance was estimated using the triglyceride-glucose (TyG) index. OA status was based on self-reported physician diagnosis. Statistical analyses included weighted logistic regression, restricted cubic spline (RCS) interaction analysis, mediation analysis using structural equation modeling (SEM), and receiver operating characteristic (ROC) curve analysis. Subgroup analyses were conducted based on age, sex, and diabetes status. ResultsThe sarcopenic obese group demonstrated the highest prevalence of OA (23.4 %), hypertension (47.8 %), and diabetes (12.0 %). Additionally, they exhibited elevated levels of triglycerides, cholesterol, glucose, blood urea nitrogen (BUN), creatinine, and uric acid. Logistic regression revealed significant positive associations between sarcopenic obesity, the TyG index, and OA risk. RCS analysis identified significant non-linear relationships and interactions of the TyG index with age, sex, and diabetes status on OA risk. Mediation analysis indicated that the TyG index mediated approximately 4.9 % of the effect of sarcopenic obesity on OA risk. ROC curve analysis demonstrated moderate diagnostic accuracy for the TyG index (AUC = 0.65), which improved when incorporated into the multivariate model (AUC = 0.78). Subgroup analyses confirmed significant associations between the TyG index and sarcopenic obesity with OA risk across different age, sex, and diabetes status categories. ConclusionOur findings suggest a significant correlation between insulin resistance, as measured by the TyG index, and elevated OA risk in individuals with sarcopenic obesity. Targeting insulin resistance through future research may be a promising avenue to lower OA risk in this population.

Correlation of obesity indices with metabolic syndrome among Igbos in Enugu and their optimal cut-off points

Background: Metabolic syndrome also known as insulin resistance syndrome or Syndrome X, represents an association of risk factors for cardiovascular disease and type 2 diabetes mellitus. Its central diagnostic criteria include obesity, impaired fasting glucose, low HDL-cholesterol; elevated triglycerides levels and high blood pressure. Insulin resistance is believed to be the main cause of Metabolic Syndrome and is connected to the level of visceral or intra-abdominal adipose tissue, which could be assessed either by calculating body mass index or by measuring waist circumference. Objectives: This study aimed at determining the correlation of indices of obesity with metabolic syndrome among Igbos in Enugu and their optimal cut-off points. Method: This was a cross-sectional community-based descriptive survey carried out in Enugu Metropolis involving 469 apparently healthy adult volunteers age range 18-75 screened for metabolic syndrome using the Joint Interim Statement definition. Stratified random sampling technique was used in the selection of participants. The data obtained were coded and analyzed into percentages, mean and standard deviation using the Statistical Package for Social Sciences (SPSS), version 23. t-test was used to compare continuous variables for associations, while Youden index and Receiver Operating Characteristic analysis were used to determine optimal cut-off point of the obesity indices that best balances sensitivity and specificity of the obesity indices. Pearson correlation coefficient was used to examine correlation between obesity indices and cardiovascular risks. Statistical significance is set at p&lt; 0.05 and 95% confidence interval. Result: The study revealed that all indices of obesity showed positive correlation with metabolic syndrome. BMI showed the least strength of correlation while WC is the best discriminator for predicting Metabolic Syndrome however, the optimal cut-off point of the obesity indices differ from the standard cut-off points. Conclusion: All the obesity indices used in the study showed positive correlation with metabolic syndrome however, WC is to be preferred in screening for metabolic syndrome. The optimal cut-off point obtained can be applied specifically for Igbos in Enugu

Study on Surface Esterification of Cellulose Nanocrystals Their and Lipid-Lowering Effect

ABSTRACT With the rapid development of the economy and changes in dietary structure, there is an excessive intake of high sugar and high-fat foods. To address this issue, in this study, we grafted palmitic acid onto CNC in the form of ester groups and evaluated its adsorption performance. Research had found that among these three methods, the CDI catalytic method can successfully obtain esterification modified CNC while also taking into account its environmentally friendly and pollution-free characteristics. Compared with CNC, its adsorption capacity for oil had increased, with the maximum adsorption capacity increasing from 35.80 g/g to 46.91 g/g. Meanwhile, the degree of esterification substitution of esterification modified CNC was measured, and the result was 0.03. Especially, after adding CNC-PA, the hydrolysis of fat was significantly reduced during the simulated digestion in vitro, whilst the absorption of fat in the intestine was significantly inhibited. In vivo testing also confirmed that consuming a diet containing CNC-PA significantly reduced elevated levels of triglycerides (TG) compared to the high-fat control group while long-term feeding of a diet containing CNC-PA reduced weight and fat accumulation.

Propofol, Triglycerides, and Acute Pancreatitis: A Multi-Center Epidemiologic Analysis.

Propofol is one of the first-line sedative-hypnotic agents for critically ill adults requiring mechanical ventilation. While propofol can elevate triglyceride levels, and the latter is a risk factor for pancreatitis, the association between propofol and acute pancreatitis is unclear. To determine the clinical impact and potential associations between propofol infusion, hypertriglyceridemia and acute pancreatitis. This is an observational multicenter study of adults (≥18 years old) admitted to an intensive care unit. requiring mechanical ventilation and receiving continuous propofol infusion for at least 24 hours. The primary outcomes were the frequency of hypertriglyceridemia and acute pancreatitis. Further analyses were done to determine the clinical impact of elevated triglyceride levels (i.e. sedation changes) and risk factors for pancreatitis development. Of 11,828 patients included, 33.2% (N=3922) had triglyceride levels measured, of whom 21.7% (N=851) had hypertriglyceridemia at 4.5 (SD 6.8) days after propofol initiation. Of those still requiring sedation, 70.4% (N=576/818) received alternative sedatives following hypertriglyceridemia. Pancreatitis occurred in 1.2% (N=47/3922) and was more frequent in those with hypertriglyceridemia (3.2%, 27/851 versus 0.7%, 20/3071; P<0.001). Following adjustment for potential confounding variables, each 100 mg/dL increase in triglyceride levels was associated with an 11% increase in risk of pancreatitis. Propofol dose was not associated with pancreatitis development. Acute pancreatitis is uncommon in patients receiving propofol infusion, and occurs over a wide range of triglyceride levels, indicating a multifactorial pathophysiology. Hypertriglyceridemia frequently prompts the use of alternative sedatives. Further study is needed to determine how to best monitor and treat hypertriglyceridemia in critically ill patients receiving propofol infusion.

Serum vitamin D levels in older adults with and without dyslipidemia: A comparison using baseline data from the Birjand Longitudinal Aging Study (BLAS)

Background & AimsNowadays, research on extraskeletal effects of Vitamin D on human health is growing This study aimed to Serum vitamin D levels measurement in older adults with and without dyslipidemia: a comparison using baseline data from the Birjand Longitudinal Aging Study (BLAS). MethodsThis cross-sectional study included 420 elderly people over 60 years old divided into in two equal groups with and without dyslipidemia. Data were drawn from the first phase of Birjand Longitudinal Aging Study (BLAS). A questionnaire containing demographic information and Mini nutritional assessment (MNA) was completed through interviews. Body mass index (BMI) was calculated, and after 12 hours of fasting, 5 mL of venous blood was taken to measure the serum levels of 25(OH) D and lipid profile. ResultsAmong the elderly, 37.3%, 33.3% and 29.3% had sufficient, insufficient and deficient Vitamin D levels, respectively. A significant difference in triglyceride levels was observed between the two groups of elderly individuals with insufficient and deficient Vitamin D levels (p=0.011). Multiple logistic regression showed that an increase in the atherogenic index of plasma (AIP) (P = 0.005, OR = 18.46) and BMI (P = 0.001, OR = 18.46) significantly increased the odds of dyslipidemia. ConclusionsVitamin D deficiency or insufficient was common among the elderly and was associated with elevated serum triglyceride levels.

Elevated triglycerides and treatment eligibility in patients with severe, asymptomatic carotid stenosis: CREST 2 Trials

BackgroundData from the Centers for Disease Control show that approximately one-quarter of adults have elevated triglyceride (TG) levels. Some clinical trials, but not all, have demonstrated that pharmacologic treatment of high TG levels in patients already on statin therapy reduces the rate of major vascular events such as myocardial infarction and stroke. We assessed the prevalence of elevated TG levels in patients with asymptomatic carotid stenosis (CS), and medical conditions associated with high TG. MethodsBaseline lipid profiles from patients enrolled in the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST 2) were analyzed. to determine treatment eligibility for high TG levels using the criteria established by the REDUCE-IT trial (triglyceride levels ≥150 mg/dL with LDL managed by a statin to <100 mg/dL). Equally assessed was the percentage of patients who were using pharmacologic treatment for high TG levels at study entry. Demographic factors and baseline medical conditions associated with high (>150 mg/dl) TG values were also analyzed. Chi-square and t=tests were used to assess baseline factors and abnormal TG values. ResultsAs of October 2023, of 2377 randomized CREST-2 patients, 2328 (98 %) (mean age 70.0 years, 63 % men) had baseline lipid profiles suitable for analysis. Among 1961 (84 %) patients who met REDUCE-IT criteria, analysis of lipid profiles revealed that 20.5 % of the patients were eligible for treatment of high triglycerides. Of the 1464 patients with fasting lipid profiles, 17.8 % were eligible for treatment. The median TG value was 205 (IQR 91) mg/dl in the total population. TG levels of 150 mg/dl or higher were strongly associated with hypertension, diabetes, obesity, high hemoglobin A1c, and reduced physical activity (all p<0.0001). ConclusionsElevated TG levels are strongly associated with diabetes, hypertension, obesity, and reduced physical activity. Further research is needed on whether treatment of elevated TG levels in patients with asymptomatic carotid stenosis confers benefit.

Parenteral nutrition customization in pediatrics: A descriptive cohort study.

The main objective of this study was to analyze the reasons for customizing parenteral nutrition (PN) in pediatric patients admitted to a quaternary hospital. We performed a descriptive cohort study on 264 hospitalized children receiving PN. Anthropometric, biochemical, and hospitalization data were collected from patient records. Unequivocal reasons for customizing PN were defined as situations precluding prescription of a standard adult/teenager PN and included renal and/or liver failure, energy-protein adequacy, and elevated mineral and triglyceride levels. A total of 264 patients, with a median age of 2.2 years (IQR: 0.3-9.0 years), comprising intensive care (n = 216; 81.8%) and malnourished (n = 91; 36.1%) patients, were evaluated. In the first 48 h, 87.9% (n = 232) of the sample required customized PN for energy-protein adequacy (210 of 232), maintained over subsequent days in most cases. Among patients requiring second individualization, mineral disturbance was the main reason observed, especially within the first 4 days of PN use (n = 21; 60%). Unequivocal reasons for customizing PN occurred in 97.4% (n = 226) of cases in the first 48 h; 96.2% (n = 177) of cases on the fourth day; and 90.1% (n = 92) of cases on the seventh day of PN use. An inverse correlation was found between weight/age z score and number of second individualizations (r = -0.222; P = 0.002). Customized PN proved essential, especially for younger, malnourished, and intensive care patients. Investment in training a Nutritional Multidisciplinary Therapy Team and acquiring a specific electronic system for prescribing PN is suggested.

Evaluation of Comparative Efficacy of Kutaki (Picrorhiza kurroa Royle ex. Benth) versus Atorvastatin in the Management of Dyslipidemia - A Randomised Controlled Trial

Introduction: Dyslipidemia is a lipoprotein metabolism condition marked by elevated blood levels of triglycerides, total cholesterol, and low-density lipoprotein (LDL) cholesterol as well as decreased levels of high-density lipoprotein (HDL) cholesterol. It can be correlated with (Medoroga) Medodushti Aim and objectives: To evaluate comparative effectiveness of Kutaki (Picrorhiza kurroa Royle ex. Benth) and Atorvastatin in the management of Dyslipidemia. Methodology: Total 160 patients were randomly divided into two equal groups. Patients in Study Group A were treated with Kutaki Vati and patients in Control Group B were treated with Atorvastatin for 60 days. Data was collected by assessment of Objective parameters like body weight, BMI, lipid levels (TCH-Total serum cholesterol , HDL-High-density lipoproteins, LDL-Low-density lipoproteins, TG- Serum Triglycerides, VLDL-Serum Very Low-density lipoproteins, AST, ALT, S.Urea, S.Creatinine, Fasting blood sugar on the day 0, 30 and 60. The analysis was done with the help of inferential and descriptive statistics. Observation and Result-Kutaki and Atorvastatin both showed significant improvement in lipid levels but Kutaki showed reduction in body weight and BMI with correction in deranged Agni and bowel habit( constipation) which was not seen in Atorvastatin group. Kutaki showed no rise in AST, ALT, S Creatinin and S.urea indicating its hepatoprotective and nephroprotective properties. Conclusion-Both groups are equally effective in the management of Dyslipidemia (Medoroga).But Kutaki is effective in reducing bodyweight and BMI and safe as it showed no rise in AST, ALT, S Creatinin and S.urea.

Effect of Mediterranean Diet Composition on Metabolic Syndrome Marker Parameters Based on NCEP-ATP III Criteria

Metabolic syndrome refers to a cluster of metabolic abnormalities in the body, including central obesity, elevated blood pressure, high glucose, and triglyceride levels, as well as low HDL levels. The Mediterranean diet, known for its specific composition, is believed to mitigate metabolic syndrome. This study aims to assess the impact of adhering to the Mediterranean diet on individuals with metabolic syndrome. It employs an observational analytic approach, utilizing a prospective cohort of 30 participants who followed the Mediterranean diet regimen as part of their treatment at a clinic in Bandung City. Systematic Random Sampling was used to select participants, and blood pressure was measured at the beginning (T1) and end (T2) of the study. Data on dietary intake were collected using the Relative Mediterranean Diet (rMED) scale via a Food Frequency Questionnaire (FFQ). Statistical analyses, including ANOVA and Tukey’s post-hoc test, were conducted to compare dietary compositions across adherence groups and to assess the impact of the Mediterranean diet on metabolic syndrome components. The findings revealed that participants, with an average age of 57.94 years and 69.44% female, experienced significant improvements in certain metabolic syndrome components, such as waist circumference (fruit and nut intake), triglycerides (vegetable intake), HDL (meat intake), and blood glucose (dairy product intake). However, no significant effects were observed for legumes, seeds, fish, and olive oil components on MetS. Keywords: components, Mediterranean diet, MetS, NCEP-ATP III