Fasting Lipid Profile Research Articles

Status of lipid control in Bangladeshi subjects with type 2 diabetes mellitus on lipid-lowering drugs: a multicenter, facility-based, cross-sectional study

BackgroundAchievement of lipid targets is crucial in patients with type 2 diabetes mellitus (T2DM) to mitigate the risk of cardiovascular diseases (CVD). Data on lipid-control status among patients with T2DM in Bangladesh are scarce. This study was conducted to determine the lipid-control status among patients with T2DM who were on lipid-lowering drugs in the country.MethodsThis cross-sectional study was conducted in the diabetes outpatient departments of several tertiary hospitals in Bangladesh from January 2022 to December 2022. Adults of both sexes diagnosed with T2DM for at least one year and were on the lipid-lowering drug(s) for a minimum of 3 months were included in the study by consecutive sampling. Patients’ data were collected by face-to-face interviews, and blood samples were collected for fasting lipid profile. The lipid target was set at < 200 mg/dL for total cholesterol (TC), < 150 mg/dL for triglyceride (TG), < 100 mg/dL for low-density lipoprotein cholesterol (LDL-C), > 40 mg/dL for high-density lipoprotein cholesterol (HDL-C), and < 160 mg/dL for non-HDL cholesterol (non-HDL-C).ResultThree thousand sixty patients (age 44.7 ± 13.3 years, female 57%) with T2DM were evaluated. Overall, almost 81% of the study subjects achieved the LDL-C target. Besides, TC, TG, HDL-C, and non-HDL-C targets were achieved by 40.8, 21.6, 66.3, and 44.1% of patients, respectively. However, all the lipid parameters were under control in only 8.8% of patients. Almost 77.6% of the patients with ischemic heart disease, 81.5% of patients with stroke, and 65% of patients with CKD had LDL levels < 70 mg/dL. Only 10.03% achieved the HbA1c target of < 7%. 7.4% of patients achieved both HbA1c < 7% and LDL < 100 mg/dL and 5% achieved both HbA1c < 7% and LDL < 70 mg/dL. Advanced age (aOR 0.97, 95% CI 0.96, 0.98, p < 0.001), longstanding T2DM (aOR 0.53, 95% CI 0.39, 0.72, p < 0.001), and non-statin therapy (aOR 0.25, 95% CI 0.16, 0.37, p < 0.001) were negatively associated with lipid control (LDL < 100 mg/dL) while using oral hypoglycemic drugs or insulin (aOR 2.01, 95% CI 1.45, 2.77, p < 0.001) and having cardiovascular comorbidity (aOR 3.92, 95% CI 3.00, 5.12, p < 0.001) were positively associated with lipid control.ConclusionThough most patients with T2DM achieved their target LDL level, the prevalence of both glycemic and overall lipid control was low in our study despite lipid-lowering therapy.

Effect of Virgin Coconut Oil on Cognition of Mild‐to‐moderate Alzheimer’s Disease Patients with APOE ε4 Allele

AbstractBackgroundVirgin coconut oil (VCO) is an excellent source of medium chain fatty acids and thus, a potential natural ketogenic agent that can be used to substitute glucose in Alzheimer’s disease (AD) brain, in which the glucose metabolism is compromised. High content of polyphenols in VCO will also support to reduce inflammation and oxidative stress associated with AD. The aims of this double‐blind placebo‐controlled trial were to investigate the effect of VCO on cognition in mild‐to‐moderate AD patients and the association of apolipoprotein E (APOE) ε4 genotype on the outcome.MethodStudy participants were 120 mild‐to‐moderate AD patients [Mini‐Mental State Examination (MMSE) score = 15‐25, age ≥65 years], randomly allocated to either treatment or control groups and orally fed 30 mL/ day of VCO as the treatment and a same amount of canola oil as the placebo for 24 weeks. Cognition was assessed by MMSE, Montreal Cognitive Assessment (MOCA), and executive clock drawing task (CLOX) at the baseline and at the end of the intervention. APOE genotyping was conducted at the baseline. Fasting lipid profile and glycated hemoglobin (HbA1C) levels were analyzed at the baseline and at the end of the intervention.ResultThere was no significant difference in the post‐intervention changes of cognitive assessment scores, lipid profile and HbA1C levels between the treatment and control groups. The MMSE scores of the APOE ε4 carriers in the treatment group was improved compared to the non‐carriers (change of MMSE = 2.37, p = 0.021), whereas there was no difference in the control group. In both treatment and control groups, the lipid parameters were not compromised during the intervention.ConclusionOral supplementation of 30 mL/day of VCO for 24 weeks did not improve cognition of mild‐to‐moderate AD patients compared to canola oil. However, VCO improved the MMSE scores of APOE ε4 carriers compared to non‐carriers. Consumption of VCO was safe as it did not compromise lipid parameters.

IBC-Oxford University2023_BJSOral_2Gut Microbiota and Metabolic Status shift 1 year after Laparoscopic Roux-en-Y vs One Anastomosis Gastric Bypass. Results of a Multi-centre Randomised Controlled Trial

Abstract Introduction The comparison of effectiveness between R-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB/MGB) remains unclear, as well as the changes in gut microbiota (GM). Materials: prospective, cohort, multi-centre study enrolling 96 patients with severe obesity, applying inclusion criteria, randomised between OAGB/MGB or RYGB. Faecal and blood samples were collected, pre- (T0) and 12 months postoperatively (T1). GM was determined by V3-V4 16S rRNA regions sequencing and home-made bioinformatic pipeline based on Qiime2 plugin and R packages. A standardised meal test was performed at T0 and T1 with 250 ml of liquid meal Oxepa (Abbott, Japan). Aim To evaluate and compare OAGB/MGB vs RYGB microbiota profile shift postoperatively and its impact on metabolic and nutritional status. Results 54 patients completed the study, 27 for each procedure (females 61%). No significant differences were found at T0 for anthropometric and nutritional parameters, while a statistically significant anthropometrics’ reduction was registered at T1, with a significant improvement of glucose and lipid profile, and significant reduction in vitamins and iron. Postoperatively fasting glucose, lipid profile, vitamins and minerals were not significantly different between the 2 procedures. Fasting GLP-1 was higher at T1, but postprandial values showed a lower peak both 60' and 120' after ingestion of the mixed meal., with no significant difference between the 2 groups. Examining the GM’s alpha and beta diversity, Firmicutes/Bacteroides ratio increased postoperatively, mainly dependent on Bacteroidetes decreasing. Relative abundances evaluation highlighted those main differences between the identified clusters (group A 29 subjects, group B 14 subjects and group C 10 subjects) were dependent on variation in Bacteroidetes and Firmicutes. A different trend was detected at Phylum level between T0 and T1 of each cluster. Bacteroides and Streptococcus genera appeared mainly changed between the three groups (both showing p&amp;lt; 0.001). Conclusions The emergence of slightly different GM profile postoperatively may be related to clinical condition or may play a key role in the long-term outcome and may represent a biomarker to follow bariatric surgery’s outcomes. No difference between the two bypass techniques were found in GM profile or other examined metabolic parameters one year postoperatively.

Association of Fasting Serum Lipid Level with Diabetic Retinopathy

Background: Diabetic eye disease is now one of the major causes of blindness in the world. Elevated serum lipids have been speculated to cause or exacerbate diabetic retinopathy by several mechanisms. Objectives: To observe the relationship of serum lipids with diabetic retinopathy. Methods: This cross sectional observational study was carried out in the Department of Ophthalmology, Combined Military Hospital Dhaka, from July 2016 to December 2016. A total of 150 patients were selected for the study and divided into three groups. Group I comprises 50 patients with different stages of retinopathy. Group II comprises 50 diabetic patients without retinopathy, and group III comprises 50 non diabetic healthy control people. Results: The age range was 27 to 70 years; Male and female ratio was 1.54:1. The mean duration of diabetes in group I was 9.82 ± 4.04 years and 8.38 ± 3.39 years in group II. Measuring Fasting lipid profile in between group I and group II and between group I and III were statistically significant (p&lt; 0.001). Conclusion: Patients with diabetic retinopathy have been found to have a close association with elevated serum lipid levels. J.Natl.Inst.Ophthalmol.2023;6(1): 16-20

Effect of Buffalo Curd Milk-Edamame Pudding Snack Consumption on Fasting Blood Glucose Levels and Lipid Profile in Diabetes Mellitus Patients

Background: Buffalo milk curd, a native probiotic source from Indonesia, is dominated by live indigenous Lactic Acid Bacteria known for their ability to lower blood glucose levels. Edamame contains amino acid arginine, chromium, antioxidants, and fibre, aiding in blood glucose control and lipid profile reduction. Objectives: This study aimed to assess the effects of buffalo milk curd and edamame-based pudding snacks on fasting blood glucose levels and lipid profiles in Type 2 diabetes mellitus (T2DM) patients. Methods: This study used a True Experiment Design with Pretest-Posttest Control Group Design. The study involved 32 patients divided into treatment and control groups. During the study, the treatment group received 250 g of snacks in the morning and evening for one week. Blood glucose levels and lipid profiles were measured using the enzymatic colourimetry method. Results: The results showed decreased fasting blood glucose levels before and after treatment in both control (-17.06 ± 40.17) and treatment (-48.38 ± 40.27 mg/dl) groups (p=0.036). Total cholesterol levels also decreased in control (-15.87 ± 23) and treatment (-41.4 ± 19 mg/dl) groups (p=0.001). There were decreased LDL levels in control (-6.81 ± 29.09) and treatment (-27.3 ± 25.09 mg/dl) groups (p=0.04). However, HDL and TG levels showed no differences at the end of the study. Conclusions: Buffalo curd milk-edamame pudding snacks can reduce fasting blood glucose levels and lipid profiles, particularly total cholesterol and LDL levels, in Type 2 DM patients.

Dyslipidemia Protective Effect of Resistant Starch-Based Dough Meals on Diabetes-Induced Rats

Aim: The adoption of functional foods as healthy diet therapy for the management of metabolic disorders such as diabetes is in vogue in the present world where many are no longer consuming carbohydrate or starchy foods. This study investigated the effect of resistant starch-based dough meals on dyslipidemia in rats with streptozotocin (STZ)-induced diabetes.&#x0D; Place and Duration: Functional Foods Laboratory and Animal House of Department of Biochemistry, Federal University of Technology, Akure, from July 2022 to February 2023.&#x0D; Methodology: Flour samples were prepared by dispersing the flour into boiling water and turning and being allowed to cook for 15 min to obtain dough meals: PLD – (100% Plantain flour), used as a control sample; PLPRD – plantain flour: pigeon pea flour: rice bran flour (73.08:15.15:11.76); PSPRD – native plantain starch: pigeon pea flour: rice bran flour (73.08:15.15:11.76); AP1SPRD – acetylated plantain starch: pigeon pea flour: rice bran flour (73.08:15.15:11.76); AP2SPRD – acetylated plantain starch: pigeon pea flour: rice bran flour (70.67:18.15:11.18). The weight gained, food intake, haematological parameters, fasting blood glucose and lipid profile of the resistant starch-based dough meal were compared with the commercial flour product, CRD (100% Cerolina flour: wheat and soybean) and the DM (untreated high-fat diet–STZ-induced diabetic rats) and NC (Normal control rats).&#x0D; Results: The weight gained and food intake ranged from 50.98±0.53 g to 180.12±1.07 g in NC and 33.98±1.64 g to 140.87±1.80 g in DM. The feed conversion ratio to the feed efficiency ratio was 0.28:0.25 and 4.15:3.53 in NC and DM respectively, which attributed to the food product to weight loss. The values of the haematological parameters (PCV, RBC, HB, MCV, MCH and MCHC) confirmed that the experimental rats had no trace of infection due to the generation of antibodies by WBC and differential counts (neutrophils, eosinophils, basophils, monocytes and lymphocytes). Rats fed with DM+AP1SPRD showed a decrease in low-density lipoprotein cholesterol (LDL-C), total cholesterol and triglyceride, and an increase in high-density lipoprotein cholesterol (HLDL-C).&#x0D; Conclusion: A resistant starch-based dough meal was significant for the production of short-chain fatty acids with lots of benefits on health. The intervention of resistant starch-based dough meals, AP1SPRD and AP2SPRD used in this study, almost normalized metabolic profiles in the experimental rats, similar to the control group by reducing the total cholesterol, total triglycerides and LDL-C while increasing HDL-C.

Exploring the Health Benefits and Therapeutic Potential of Roselle (Hibiscus sabdariffa) in Human Studies: A Comprehensive Review.

Hibiscus sabdariffa (HS), commonly known as Roselle, has a rich history of traditional uses and is recognized for its diverse pharmacological properties, including antihypertensive, anti-inflammatory, antimicrobial, and more. This comprehensive review synthesizes the existing literature on the health benefits associated with the consumption of HS or its ingredients. Key areas of focus include metabolic health, blood sugar, and lipid regulation, wherein studies have reported varying effects on parameters such as fasting blood glucose, insulin sensitivity, and lipid profiles. Furthermore, Roselle exhibits anti-inflammatory properties, as evidenced by its impact on inflammatory markers such as MCP-1 and TNF-α. Additionally, HS extracts have shown notable antibacterial efficacy against various strains, with a potential role in urinary tract infection management. Studies also suggest potential benefits for renal function, with improvements in markers such as blood urea nitrogen and creatinine levels.In this article, we aim to review the existing literature on the health benefits of HS.

Are higher levels of lipid profile parameters associated with increased chances of uncontrolled asthma among adults?

Studies on the relationship between asthma and various parameters of fasting lipid profile have reported conflicting results. In this study, we intend to explore this association between asthma and its level of control with fasting serum lipid profile further. In our observational prospective cohort study, we studied 107 known asthmatic patients presenting in large tertiary care centre of North India. Fasting serum samples for lipid profile reports of all patients were collected. Patients were divided into controlled and uncontrolled asthma groups on the basis of clinical symptoms and spirometric findings. We evaluated the statistical difference and significance for various lipid profile parameters in between two groups using an independent t-test. On comparing the fasting lipid profile of 38 patients with uncontrolled asthma and 69 patients with controlled asthma, we found that serum levels of low-density lipoprotein (LDL) and ratio of total cholesterol to high-density lipoprotein (TC: HDL) were significantly higher among patients with uncontrolled asthma. On statistical analysis, their P values were 0.03 and 0.047, respectively. Serum levels of LDL and ratio of TC: HDL were higher in patients with uncontrolled asthma.

The effects of powdered drinks enriched with curcumin and probiotics on lipid profile and atherogenic indices in patients with metabolic syndrome: A randomized, double-blinded, placebo-controlled clinical trial.

Cardiovascular disease is prevalent globally and is the most common complication of metabolic syndrome (MetS). Previous studies have suggested that curcumin and probiotics may improve the lipid profile, so we aimed to investigate the effects of the edible powder enriched with these substances on lipid profile level and atherogenic indices such as Atherogenic Coefficient (AC), Castelli Risk Index-I (CRI-I), Castelli Risk Index-II (CRI-II), and Atherogenic Index of Plasma (AIP). In the present parallel randomized double-blinded placebo-controlled clinical trial, 124 people with MetS with overweight or obesity were randomly allocated to 4 groups and were followed up for 8 weeks. The participants received a low-calorie diet and a daily sachet of enriched powder drink. The sachets contained either 109 CFU of probiotics or 1 g of curcumin, or probiotic + curcumin (pro + cur), or placebo, respectively. The fasting lipid profile and atherogenic indices were measured at the beginning and end of the study. One hundred and fourteen participants completed the study. At the end of the study, the within- and between-group comparisons showed no significant differences in lipid profile and atherogenic indices (p > .05). Based on the results of the current study, taking an oral powder containing 1 g curcumin and 109 CFU probiotics for 8 weeks had no effect on the lipid profile level and atherogenic indices; however, more studies are recommended.

Association of vitamin D with triglyceride-glucose index and cardiometabolic risk factors in subclinical hypothyroidism

BackgroundThe present study aimed to explore the association of vitamin D with triglyceride-glucose (TyG) index and cardiometabolic risk factors in subclinical hypothyroidism (SCH). MethodsWe recruited 75 individuals diagnosed with SCH and 75 healthy controls of both genders aged 20 to 65 years. Triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) and 25-hydroxyvitamin D [25(OH)D] were measured using chemiluminescent immunoassay. Fasting plasma glucose and lipid profile were analyzed by standard methods. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)]/2. ResultsThere were significant decreases in 25(OH)D levels and changes in cardiometabolic risk factors among individuals with SCH compared to healthy controls. Additionally, there was a significant increase in the TyG index among the SCH group. Correlation and regression analysis revealed that 25(OH)D was significantly and negatively associated with TyG index, diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C). However, it was positively associated with high-density lipoprotein cholesterol (HDL-C). ConclusionPresent study shows that SCH patients have lower vitamin D levels and higher TyG index, increasing cardiovascular disease risk. Screening and managing vitamin D deficiency is crucial in these subjects. In addition, TyG index could be used as an indicator for identifying vitamin D deficiency.

Assessment of Lipid Profile Treatment Practices and Lipid Levels in Post-Myocardial Infarction Patients: Results from a Tertiary Care Hospital of Pakistan

Objectives: Acute myocardial infarction (AMI) stands as a global leading cause of mortality. Following AMI, meticulous management of patients' lipid profiles for secondary prevention becomes paramount. We conducted this study to assess lipid profile practices and levels in post-AMI patients, which are crucial for secondary prevention.&#x0D; Methodology: In this cross-sectional study, we analyzed patients who had experienced their first AMI event in the past three years. We assessed fasting and non-fasting lipid profiles, reviewed statin therapy prescriptions, and examined patient compliance. The recommended dose was defined as rosuvastatin ≥20 mg or atorvastatin ≥40 mg, with target total cholesterol levels set at &lt;160 mg/dL and target LDL (low-density lipoprotein) cholesterol at &lt;55 mg/dL.&#x0D; Results: Among 195 patients, 71.3% were male, and the mean age was 57.1±10.2 years. The median duration since AMI was 36 [IQR: 10-48] months and 60% were diagnosed with STEMI (ST-segment elevation myocardial infarction). Only 13.8% of patients were advised to undergo lipid profile testing after AMI, 88.7% of patients were on the recommended statin therapy, and 91.8% of patients were compliant with statin therapy. Only 11.5% had LDL-cholesterol within the target range and 71.7% had total cholesterol within the target range. Hospital admission in the past 12 months was reported by 14.4%, and the re-admission rate was significantly higher among non-compliant patients (37.5% vs. 5.6%). Subsequent AMI event rate was also significantly higher among non-compliant patients (43.8% vs. 11.7%).&#x0D; Conclusion: Our study highlights that while most post-AMI patients receive the recommended minimum statin therapy, the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.

Ameliorative effects of Scutellaria Pinnatifida subsp. pichleri (Stapf) Rech.f. Extract in streptozotocin-induced diabetic rats: chemical composition, biochemical and histopathological evaluation

BackgroundsScutellaria Pinnatifida subsp. pichleri (Stapf) Rech.f. (SP) is used in folk medicine for the treatment of diabetes. The aim of the study was to determine the phenolic profile of SP extract (SPE) by LC-MS/MS and to investigate the antidiabetic, hepatoprotective and nephroprotective effects of SPE in streptozotosin (STZ)-induced diabetic rat model.MethodsForty-two rats were randomly divided into six groups (n = 7): Control (nondiabetic), diabetes mellitus (DM), DM + SP-100 (diabetic rats treated with SPE, 100 mg/kg/day), DM + SP-200 (diabetic rats treated with SPE, 200 mg/kg/day), DM + SP-400 (diabetic rats treated with SPE, 400 mg/kg/day) and DM + Gly-3 (diabetic rats treated with glibenclamide, 3 mg/kg/day). Live body weight, fasting blood glucose (FBG) level, antidiabetic, serum biochemical and lipid profile parameters, antioxidant defense system, malondyaldehyde (MDA) and histopathological examinations in liver, kidney and pancreas were evaluated.ResultsApigenin, luteolin, quinic acid, cosmosiin and epigallocatechin were determined to be the major phenolic compounds in the SPE. Administration of the highest dose of SP extract (400 mg/kg) resulted in a significant reduction in FBG levels and glycosylated hemoglobin levels in STZ-induced diabetic rats, indicating an antihyperglycemic effect. SPE (200 and 400 mg/kg) and glibenclamide significantly improved MDA in liver and kidney tissues. In addition, SPE contributed to the struggle against STZ-induced oxidative stress by stimulating antioxidant defense systems. STZ induction negatively affected liver, kidney and pancreas tissues according to histopathological findings. Treatment with 400 mg/kg and glibenclamide attenuated these negative effects.ConclusionsIn conclusion, the extract of the aerial part of Scutellaria pinnatifida subsp. pichleri has hepatoprotective, nephroprotective and insulin secretion stimulating effects against STZ-induced diabetes and its complications due to its antidiabetic and antioxidant phytochemicals such as apigenin, luteolin, quinic acid, cosmosiin and epigallocatechin.

Prevalence, patterns and associated risk factors for dyslipidaemia among individuals attending the diabetes clinic at a tertiary hospital in Central Malawi

BackgroundDyslipidaemia among individuals with diabetes is a significant modifiable risk factor for atherosclerotic cardiovascular diseases (ASCVDs). ASCVDs are a major cause of mortality and morbidity globally, especially in people with diabetes. In Malawi, limited data exist on the prevalence and biochemical characteristics of diabetic dyslipidaemia. This study investigated the prevalence and biochemical characteristics of dyslipidaemia in individuals attending the diabetes clinic at Kamuzu Central Hospital, the largest tertiary referral hospital in Central Malawi.MethodsUsing a cross-sectional design, sociodemographic, medical and anthropometric data were collected from 391 adult participants who were enrolled in the study. Blood samples were analysed for glycosylated haemoglobin (HBA1c) and fasting lipid profiles. The prevalence of dyslipidaemia was calculated, and the biochemical characteristics of the dyslipidaemia were defined. The associations between dyslipidaemia and risk factors such as sociodemographic characteristics, obesity, and HBA1c levels were evaluated using logistic regression analysis.ResultsPrevalence of dyslipidaemia was observed in 71% of the participants, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality among the study participants. None of the participants were receiving any lipid-lowering therapy. On bivariate analysis, dyslipidemia was positively associated with female sex [OR 1.65 (95% CI 1.05- 2.58); p = 0.09], age ≥ 30 years [OR 3.60 (95% CI 1.17-7.68); p = 0.001] and overweight and obesity [OR 2.11 (95% CI 1.33-3.34); p = 0.002]. On multivariate analysis, being overweight or obese was an independent predictor of dyslipidaemia [AOR 1.8;(95% CI 1.15- 3.37); p = 0.04].ConclusionDyslipidaemia was highly prevalent among individuals with diabetes in this study, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality. Overweight and obesity were also highly prevalent and positively predicted dyslipidaemia. This study highlights the importance of appropriately addressing dyslipidaemia, overweight and obesity among individuals with diabetes in Malawi and other similar settings in Africa as one of the significant ways of reducing the risk of ASCVDs among this population.

Association of visceral adiposity index with cardiovascular risk factors among young adults

Introduction and Aim: The frequent cause of mortality today is cardiovascular disease. Though dyslipidemia predicts cardiovascular risk, the possibility of risk cannot be excluded in normal lipid profile. Therefore, the study was conducted to associate visceral adiposity index (VAI) with cardiovascular risk factors among young adults. Materials and Methods: It is a cross-sectional study in which 150 men and 150 women between the ages of 20 and 40 participated. A detailed clinical history, anthropometric measurements, fasting plasma glucose and fasting lipid profile were estimated. VAI was calculated. Results: Mean VAI was 2.13±0.5 in men and 2.65±0.8 in women. Based on visceral adiposity index, 53% men and 61% women have a high risk of cardiovascular disease. VAI correlated positively with waist circumference, BMI, waist hip ratio, blood pressure, fasting plasma glucose, serum triglyceride, lipid ratios. VAI showed significant negative correlation with HDL cholesterol. Conclusion: We explored the increase in cardiovascular risk among young adults. Though mean values of lipid profile and lipid ratios were within the desired range in our study, around 50% of the young adults had high risk for cardiovascular disease. Hence, VAI index can be used along with the existing lipid profile to identify those at increased cardiovascular risk.

A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension.

Objective: This study aims to compare the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in hypertensive patients. Study Design: Prospective Observational. Setting: Hayatabad Medical Complex Peshawar. Period: December 2022 to May 2023. Material &amp; Methods: Approach was employed to investigate the metabolic impact of these antihypertensive medications. Involving a cohort of 660 hypertensive individuals. Data collection spanned over 12-week duration, with fasting glucose and lipid profiles assessed at baseline and 4, 8, and 12 weeks. Participants were categorized into hydrochlorothiazide and captopril groups, receiving standardized dosages of 25 mg/day and 50 mg/day, respectively. Fasting blood samples were analyzed for glucose and lipid parameters. Statistical analyses included paired t-tests and subgroup comparisons. Results: Both groups exhibited reductions in fasting glucose and lipid levels; however, these changes were not statistically significant within the 12-week timeframe. Comparison with national and international studies underscores population-specific variations in antihypertensive effects on metabolism. Conclusion: This study provides insights into the metabolic effects of hydrochlorothiazide and captopril among hypertensive patients. While immediate changes were not significant, the study contributes to the body of knowledge and calls for further research with extended follow-up and broader participant cohorts.

Pattern of Thyroid Dysfunction in Type II Diabetes Mellitus Patients in a Tertiary Care Center: A Cross-Sectional Study

Background: Early identification and intervention of thyroid dysfunction which occurs in association with type-II diabetes mellitus may significantly reduce the risk of adverse cerebrovascular and cardiovascular events in such patients. Hence, this study analyzed the pattern of thyroid dysfunction in T2DM (Type 2 Diabetes mellitus) patients. Methods: The present cross-sectional study was done on 250 T2DM patients, who visited the department of General Medicine in a tertiary care teaching center. Medical history was recorded and venous blood samples were collected for investigations (HbA1C (Hemoglobin A1C), FBS (Fasting blood sugar), PPBS (Postprandial blood sugar), TSH (Thyroid stimulating hormone), T4 (Tetraiodothyronine), anti-TPO (Thyroid peroxidase), and fasting lipid profile). Thyroid dysfunction in patients with T2DM was considered as the primary outcome variable. P value &lt;0.05 was considered statistically significant. Data were analyzed using coGuide software, V.1.03. Results: Females (55.6%) outnumbered males (44.4%) in this study. The prevalence of thyroid dysfunction in our study was 23.6% (95%CI 0.184 to 0.293). Subclinical hypothyroidism was found in 67.79% (95%CI 0.543 to 0.793) participants, overt hypothyroidism in 27.11% (95%CI 0.163 to 0.402), and hyperthyroidism in 5.10% (95%CI 0.010 to 0.141). Females (84.6%) had significantly higher prevalence of anti-TPO positivity compared to males (15.4%)(p=0.013). Conclusions: Findings of this study showed that T2DM patients have higher prevalence of thyroid dysfunction with predominance of subclinical hypothyroidism. Hence, this study emphasizes the importance of annual investigation of TSH levels in all the patients with T2DM. Keywords: Autoimmune Diseases, Hyperthyroidism, Hypothyroidism, Thyroid­Stimulating Hormone, Type II Diabetes Mellitus

A Cross-sectional Study to Assess Insulin Resistance and Atherogenic Index of Plasma as Predictors of Risk of Cardiometabolic Disease among Undergraduate Medical Students at a Tertiary Care Teaching Hospital, Karnataka

Background: Medical profession is known for stress and challenges due to hectic academic schedules which makes students, high-risk candidates for diabetes mellitus, hypertension and cardiometabolic disease (CMD). Surrogate markers such as homeostatic model assessment insulin resistance (HOMA-IR) and atherogenic index of plasma (AIP) along with routine parameters enable early prediction of the disease. Hence, this study aimed at determining HOMA-IR and AIP along with assessment of their correlation with anthropometric and biochemical parameters associated with CMD risk among undergraduate medical students. Methodology : 460 medical students consented to participate in the study. The data related to socio-demographic profile, anthropometry, blood pressure and biochemical parameters such as fasting plasma glucose (FPG), fasting plasma insulin (FPI) and lipid profile was collected and analyzed. HOMA-IR and AIP were calculated. The strength of association between study variables was determined by relevant statistics. Results: The study showed the prevalence of overweight (17.8%), obesity (20.4%), pre-hypertension (37.82%) and hypertension (3.47%). 98.5% of the participants had normal FPG and FPI, whereas 1.5% had impaired levels. Lipid profile analysis showed hypercholesterolemia (3.7%), hypertriglyceridemia (8.1%), increased LDL-c (33.7%) and reduced HDL-c (55.2%). High HOMA-IR and AIP were contributed by 28.9% and 73.3% respectively. HOMA-IR and AIP showed statistically significant positive correlation with CMD risk factors. Conclusion: HOMA-IR and AIP considered as the better predictors of CMD risk among apparently healthy medical students. Thus, incorporation of these surrogate markers along with routine parameters for regular screening can help in early prediction of the risk of CMD among undergraduate medical students. Keywords: Homeostatic model assessment insulin resistance, Atherogenic index of plasma, Cardiometabolic disease, Medical students

Atherosclerotic cardiovascular disease risk profile of patients with chronic hepatitis B treated with tenofovir alafenamide or tenofovir disoproxil fumarate for 96 weeks.

Patients with chronic hepatitis B (CHB) who switch from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) show changes in lipid profiles. To evaluate how these changes affect cardiovascular risk. This pooled analysis, based on two large prospective studies, evaluated fasting lipid profiles of patients with CHB who were treated with TAF 25 mg/day or TDF 300 mg/day for 96 weeks. Patients who fulfilled the American College of Cardiology criteria (age 40-79 years, high-density lipoprotein [HDL] 20-100 mg/dL, total cholesterol [TC] 130-320 mg/dL and systolic blood pressure 90-200 mmHg) required to assess 10-year atherosclerotic cardiovascular disease (ASCVD) risk with baseline lipid data and at least one post-baseline measurement were included in the ASCVD-risk population. The 10-year ASCVD risk was calculated for patients in this population, and changes from baseline to Week 96 were assessed using intermediate- (≥7.5%) and high-risk (≥20%) cut-offs. Among 1632 patients, 620 (38%) met the criteria for the ASCVD-risk population. At Week 96, fasting levels of all lipids, except TC:HDL ratio, were lower with TDF than TAF. No significant increase was observed in overall ASCVD risk or in any ASCVD-risk categories during the 96-week treatment period compared with baseline. A similar proportion of patients in the TAF and TDF treatment groups (1.3% and 2.3%, respectively; p = 0.34) reported cardiovascular events. Despite on-treatment differences in lipid profiles with TAF and TDF, predicted cardiovascular risk and clinical events were similar for both groups after 96 weeks.

METABOLIC SYNDROME AMONG PATIENTS OF HEPATITIS C PRESENTING TO A TERTIARY CARE HOSPITAL

Background and objectives: Hepatitis C has evolved to become a global pandemic, equally affecting Pakistan as well. According to one WHO report the estimated prevalence of chronic hepatitis C is 1% worldwide (71 million people) while Pakistan alone contributes more than 12 million people to this figure, with Punjab reporting the highest prevalence of 6.7%. This infection does not only affect the Liver but also produces extrahepatic manifestations in various organs like skin, blood, and gastrointestinal tract as well as leads to many autoimmune conditions. There are many more linked to hepatitis but still remains unclear hence in this study we aim to assess the frequency of metabolic syndrome and the distribution of its features among patients of hepatitis C.Methods: Conducted from 01.08.2019 to 02.01.2020 at Sheikh Zayed Hospital Lahore this cross-sectional study enrolled a total of 110 patients with hepatitis C presenting to the Outpatient Medicine Department. After informed consent, the demographic profile was noted in the proforma. The blood pressure and BMI of the patients were assessed using a standard protocol. A sample of 3ml of blood was taken for fasting lipid profile. Information regarding the study variable was recorded in the proforma and confidentiality of the data was ensured. SPSS was used to analyze the data.Results: Of the total 110 hepatitis C patients enrolled, 54.5% were male, the mean age was 41.06 ± 14.78 years and the mean duration of having hepatitisC was 6.76 ± 3.27 months. Metabolic syndrome was present in 31.8%of the total study participants. Further analysis revealed that metabolic syndrome was not significantly associated with age (p-value = 0.955), gender (p-value = 0.970), or duration of hepatitis C (p-value = 0.125).Conclusion: Metabolic syndrome affects 1 in every 3 patients of Hepatitis C presenting to the tertiary care hospital. Hence screening for metabolic syndrome must be performed among all patients suffering from hepatitis C from an early disease period and all such patients must be educated regarding prevention and control of this syndrome.

Insulin resistance in non-diabetic hypothyroid patients: a critical examination of METS-IR as a diagnostic marker

Objectives Insulin resistance (IR) is a significant metabolic disturbance that plays a pivotal role in various health conditions, including hypothyroidism. Homeostatic Model Assessment For Insulin Resistance (HOMA-IR) is widely used for assessing IR. However, alternative indices, such as the Metabolic Score for Insulin Resistance (METS-IR), have been developed for diverse applications. This study aimed to meticulously investigate IR in patients with hypothyroidism and to compare the effectiveness of METS-IR with HOMA-IR. To enrich our analyses, additional metrics, including the Triglyceride Glucose (TyG) Index, the Triglyceride to High-Density Lipoprotein Cholesterol Ratio (TG/HDL-C), and the Quantitative Insulin Sensitivity Check Index (QUICKI) have been incorporated. Methods This cross-sectional study included 260 non-diabetic adults, 130 with hypothyroidism (case group), and 130 healthy volunteers (control group). Parameters, including Thyroid-Stimulating Hormone (TSH), free thyroxine (T4), fasting blood glucose, HbA1c, insulin levels, and lipid profiles, were measured. IR indices were calculated. Results The groups were matched for age and gender (p = .143; p = .099). The case group demonstrated a notably elevated mean METS-IR of 195.58, in contrast to the control group’s mean METS-IR of 131.10 (p = .044). The mean HOMA-IR was significantly higher in the case group than in the control group, with average of 2.00 and 1.81, respectively (p = .027). METS-IR was positively correlated with TyG (r = 0.505, p = .001) and TG/HDL-C (r = 0.844, p = .001). Meanwhile, the relationships between METS-IR, HOMA-IR, and QUICKI were significant at r = 0.194 (p = .027) and r = .210 (p = .016), respectively. METS-IR was significantly higher in patients with overt hypothyroidism (p = .016). Conclusion This study emphasizes the efficacy of METS-IR as a diagnostic tool for IR in patients with hypothyroidism, establishing it as a proficient alternative to HOMA-IR. These findings were substantiated by the correlations observed with the TyG, TG/HDL-C, and QUICKI measurements. Variations in METS-IR between individuals with subclinical and overt hypothyroidism accentuate its effectiveness in identifying metabolic abnormalities in hypothyroid conditions.