Fasting Triglyceride Levels Research Articles

SAT034 Exploring The Role Of Zfp664 In Hepatic Glucose Regulation

Abstract Disclosure: A. Tsay: None. J. Wang: None. Genome wide association studies (GWAS) identify the association between variants at genomic loci and common diseases. These variants consist of single nucleotide polymorphisms (SNPs), which can be localized within coding or non-coding regions. The former could affect the functions of proteins encoded by these genes. The latter could modulate the expression of genes contained or localized nearby these SNPs. Several SNPs associated with metabolic disease such as diabetes, obesity, and dyslipidemia are found in and nearby the human ZNF664 gene, which encodes a zinc finger protein that is predicted to be a transcriptional regulator. The mouse homolog of ZNF664 is Zfp664, whose amino acid sequence is identical to ZNF664. To learn whether Zfp664 contains a transcriptional activation or repression function, the expression plasmid harboring the cDNA of full length or deletion mutants of mouse Zfp664 fused to yeast GAL4 DNA binding domain (DBD) was transfected into HEK293T cells along with a luciferase reporter plasmid containing 5 copies of the GAL4 binding sites. We saw decreased luciferase activity in cells overexpressing the GAL4 DBD and full length Zfp664 fusion protein. Thus, Zfp664 acts as a transcriptional repressor. The deletion analysis identified that amino acid 7 to 95 of Zfp664 was required for its transcriptional repressive activity. To test the metabolic function of hepatic Zfp664, 8 weeks old male C57Bl/6J mice were infected with adeno-associated virus (AAV) expressing either scramble small hairpin RNA (shRNA, as a control) or shRNA targeting Zfp664 and then fed a normal chow diet or western diet (42% kcal from fat, 0.2% total cholesterol) for 12 weeks. We found that mice infected with AAV expressing Zfp664 shRNA had a lower expression of Zfp664 in the liver but not in epididymal white adipose tissue and gastrocnemius muscle. Under chow diet feeding, not only did hepatic Zfp664 knockdown not affect glucose tolerance and insulin sensitivity, but it also did not affect fasting glucose, insulin, triglyceride, and total cholesterol levels. In contrast, in mice fed a western diet, hepatic Zfp664 knockdown worsened glucose tolerance and elevated fasting insulin levels. Moreover, the expression of hepatic gluconeogenic genes, such as phosphoenolpyruvate carboxykinase (Pck1) and the catalytic subunit of glucose-6-phosphatase (G6pc), was increased. The fasting plasma triglyceride and total cholesterol levels were not affected by hepatic Zfp664 knockdown in western diet fed mice. Overall, these results discover the novel role of Zfp664 in the regulation of hepatic glucose homeostasis. Presentation: Saturday, June 17, 2023

Triglyceride glucose index and renal function decline in Han Chinese hypertensive patients.

Elevated triglyceride glucose (TyG) index is associated with an increased risk of cardiovascular disease. The current study aimed to investigate whether the TyG index was correlated with renal function decline in patients with hypertension. Han Chinese participants with essential hypertension were included. The TyG index was calculated as ln[fasting triglycerides (mg/dL)*fasting glucose (mg/dL)/2]. Renal function decline was defined as >25% decline in estimated glomerular filtration rate (eGFR). The Cox proportional hazard regression model was used to examine the independent effect of the TyG index on renal events. In total, 548 Han Chinese hypertensive participants with a mean age of 62.1±14.3years were eligible for enrollment. During a mean follow-up period of 4.7±3.1years, 97 patients suffered from >25% decline in eGFR. When compared to those without eGFR decline, patients with eGFR decline had higher fasting triglyceride levels (P=.056), fasting glucose levels (P=.014), and TyG indexes (P=.014). The Cox proportional hazard regression model revealed that the TyG index (hazard ratio [HR]=1.490; 95% confidence interval [CI]=1.016-2.185, P=.041), office systolic blood pressure (HR=1.013; 95% CI=1.000-1.026, P=.047), diabetes mellitus (HR=1.797, 95% CI=1.026-3.147, P=.040), and baseline eGFR (HR=1.015; 95% CI=1.002-1.028, P=.025) were associated with renal events. In conclusions, an elevated TyG index is independently associated with an increased risk of eGFR decline in hypertensive patients.

Association of Thyroid Function With Lipid Profile in Patients With Metabolic Syndrome: A Prospective Cross-Sectional Study in the Indian Population.

Introduction Metabolic syndrome is a group of aberrant metabolic indicators including hypertension, dyslipidemia, impaired fasting blood glucose, and obesity. It has been reported that thyroid hormones have a strong influence on the cardiovascular system, and hypothyroidism has been linked to metabolic syndrome components. The objective of the study was to find out the association of thyroid function with lipid profile in patients with metabolic syndrome. Methods A prospective cross-sectional study was conducted in an apparently healthy adult population visiting the outpatient Department of Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India. Metabolic syndrome was diagnosed according to the International Diabetes Federation (IDF) criteria. Fasting blood glucose, triglyceride, and HDL levels were tested using the enzymatic photometric method. Thyroid-stimulating hormone (TSH), free T4, free T3, and insulin assays were performed using chemiluminescence immunoassay (CLIA). Results Out of 197 subjects recruited, 86 (51 males and 35 females) were diagnosed with metabolic syndrome according to the IDF criteria, and the rest 111 without metabolic syndrome were considered to be the controls. The mean age of subjects with and without metabolic syndrome was 45.8±8.5 and 46.4±9.6 years, respectively. The prevalence of thyroid dysfunction in the present study was 22%. In subjects with metabolic syndrome, most of the clinical and hormonal parameters (waist circumference, waist-height ratio, fasting blood sugar, fasting insulin, triglycerides, T3, and TSH) were significantly higher (p<0.001) as compared to those without metabolic syndrome. In case of lipid profile, the triglycerides in those with metabolic syndrome (262.8±112.3 mg/dL) were significantly higher (p<0.001) than those without metabolic syndrome (137.9±19.01 mg/dL), while the serum levels of HDL were significantly higher (p<0.001) in group without metabolic syndrome (50.5±3.9 mg/dL) as compared to those with metabolic syndrome (43.4±5.2 mg/dL). Also, the TSH levels were significantly higher (p<0.001) in subjects with metabolic syndrome (5.3±3.4 μl/mL) as compared to those without metabolic syndrome (2.6±1.4 μl/mL). Among all the components of metabolic syndrome, waist circumference and HDL showed a significant strong positive correlation (r=0.51) with TSH, and systolic blood pressure (r=0.39), diastolic blood pressure (r=0.39), and fasting blood sugar levels (r=0.44) showed significantly moderate positive correlation with TSH levels. T4 (OR=8.82; 95% CI: 1.56-49.8) and TSH (OR=1.61; 95% CI: 1.19-2.18) levels were observed to have significantly higher odds as risk factors for metabolic syndrome. Conclusion There is a significant association of thyroid function with lipid profile in metabolic syndrome. It was observed that along with metabolic alterations, cardiovascular symptoms of hypothyroidism and subclinical hypothyroidism are possible. Therefore, while evaluating people with metabolic syndrome, it may be appropriate to look into how well their thyroid glands are functioning.

Scutellarin alleviates liver injury in type 2 diabetic mellitus by suppressing hepatocyte apoptosis in vitro and in vivo

ObjectiveScutellarin is a primary active composition come from Erigeronbreviscapus. It is well known that scutellarin has anti-inflammatory and antioxidant physiological functions. In this study, we detected the effects of scutellarin on hepatocyte cell apoptosis in type 2 diabetes mellitus (T2DM) rats. MethodsSprague Dawley (SD) (6–8 weeks, 160–180 g) rats were randomly divided into six groups: control, model, scutellarin low-dose, medium-dose, high-dose treatment, and rosiglitazone positive groups; with 10 SD rats in each group (n = 10). The changes of biochemical factors in serum were detected by automatic biochemical instrument, the pathological changes of liver tissue were detected by hematoxylin and eosin (HE) staining, the apoptosis of liver tissue and cells was detected by tissue staining and flow analyzer, and the expression of apoptosis-related factors were determined by qPCR, Western blot and immunohistochemistry in liver tissues or cells. ResultsThe results showed that scutellarin decreased the levels of fasting blood glucose, total cholesterol, triglyceride, and low-density lipoprotein and increased the levels of high-density lipoprotein. Meanwhile, scutellarin decreased the levels of alanine transaminase (ALT) and aspartate transaminase (AST) and improved liver function. In addition, scutellarin suppressed the secretion of interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and reduced hepatocyte apoptosis. Furthermore, scutellarin inhibited the expression of cleaved Caspase-3, Bax, and cytochrome C (Cyt-C) and promoted the expression of Bcl-2. ConclusionScutellarin can inhibit the apoptotic pathway, thereby relieving T2DM.

Epidemiology of lean/non-obese nonalcoholic fatty liver disease in China: A systematic review and meta-analysis.

To assess the prevalence and metabolic characteristics of lean/non-obese (L/NO) nonalcoholic fatty liver disease (NAFLD) in China. The databses, inlcuding PubMed, Web of Science, EMBASE, as well as Cochrane databases, were retrieved for eligible studies. The prevalence together with clinical features of L/NO-NAFLD in China were analyzed using a random/fixed effects model. Lean or nonobese participants were characterized by the cut-offs of body mass index used in original studies. Heterogeneity was identified using meta-regression and subgroup analyses. We included 25 studies for the final analysis comprising 229091L/NO Chinese adults and 22641 diagnosed with NAFLD, with the NAFLD prevalence of 8.98% (95% confidence interval [CI]: [5.55-13.13] for L-NAFLD Chinese participants and 13.77% (95% CI: [11.13-16.63]) for NO-NAFLD Chinese participants. This prevalence gradually increased during the past few years. The community and health checkup populations presented similar prevalence (14.19% vs. 13.55%). Meanwhile, L/NO patients with NAFLD showed lower blood pressure (128.86/80.48 vs. 136.09/84.98mmHg), waist circumference (80.63 vs. 92.73cm), fasting blood glucose (5.53 vs. 5.69 mmol/L), uric acid (339.14 vs. 365.46 μmol/L), triglyceride levels (1.63 vs. 1.94 mmol/L), alanine transaminase (30.28 vs. 33.12 IU/L), and γ-glutamyl transferase (29.9 vs. 43.68 IU/L), but higher levels of high-density lipoprotein cholesterol (1.33 vs. 1.26 mmol/L) compared to overweight/obese (OW/O) patients with NAFLD. Prevalence of NAFLD was slightly lower among the L/NO-NAFLD Chinese population than the global level but has obviously increased recently. In addition, the metabolic profile of L/NO-NAFLD patients was generally better compared to OW/O-NAFLD patients.PROSPERO Reg. No.: CRD42022327240.

TYG-BMI AS A SURROGATE MARKER IN HYPERTENSIVE PATIENTS - AN OBSERVATIONAL STUDY IN TERTIARY CARE HOSPITAL

Background: Previous epidemiological studies have shown that the triglyceride-glucose index (Ty-G) was well- known predictor for the development of diabetes mellitus. A study proposed that traditional lipid ratios, particularly the TGHDL- C ratio based on the proportion between pro atherogenic and anti-atherogenic fractions are more effective than single lipids measure in identifying IR. Ty-G index predicted the subsequent occurrence of HTN in a positive and dose-dependent manner. Therefore, early detection of the Ty-G index may be beneficial for early interventions to prevent HTN among the Chinese population Methodology: The present study was an observational study and the results of total 128 hypertensive patients and healthy volunteers aged between 35 to 60 years was collected from a Tertiary care hospital. Body mass index (BMI), Waist Circumference (WC), blood pressure, fasting blood glucose and Triglyceride levels were measured. Receiver Operating Characteristic (ROC) Curve was used to check association between the study groups. Results: ROC curve based on sensitivity and specificity with reference to TyG-BMI as dependent variable among the groups. Area under curve for Waist/Hip ratio(W/H) was 0.543, HbA1c was 0.766, albumin/creatinine was 0.512, aspartate aminotransferase/alanine aminotransferase was 0.528, triacylglycerol/high density lipoprotein was 0.681 with cut-off value of W/H is 0.81, HbA1c is 5.05, albumin/creatinine is 2.56, AST/ALT is 0.41, TAG/HDL is 0.71 respectively. TyG-WC as dependent variable in normotensive and hypertensive subjects, area under curve for W/H was 0.626, HbA1c was 0.671, albumin/creatinine was 0.527, AST/ALT was 0.528, TAG/HDL was 0.681 with cut-off value of W/H ratio is 0.80, HbA1c is 5.05, albumin/creatinine is 2.56, AST/ALT is 0.55, TAG/HDL is 1.64 respectively. Conclusion: Our observational study suggests that higher Ty-G index was associated with higher probabilities of hypertension in general adult population. Large-scale prospective cohort studies are looked-for to elucidate the latent pathophysiological mechanisms underlying the association among Ty-G index and hypertensive subjects.

Association of angiotensin-converting enzyme I/D polymorphism and apolipoprotein B with cardiometabolic abnormalities among young adults: a pilot study from Delhi

BackgroundAngiotensin-converting enzyme (ACE) gene polymorphism and elevated apolipoprotein B (apoB) are important risk factors for several cardiometabolic abnormalities. However, much less attention has been given to the relationship between these risk factors and cardiometabolic abnormalities among young adults. Considering this gap, the present study explored the association of ACE I/D polymorphism and apoB with cardiometabolic abnormalities among young adults of Delhi, India.MethodsThis cross-sectional study was conducted among young adults (aged 18–30) of either sex residing in Delhi, India. A total of 330 individuals were invited to participate in the study, and data on the socio-demographic variables were collected using a pre-tested interview schedule. Somatometric and physiological measurements were obtained using standard protocols. However, blood sample collection and biochemical and genetic analyses could successfully be performed for 178 individuals. Fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels were estimated using Erba XL-640 biochemical analyzer. LDL and TG values were used to calculate apoB levels. Genotyping for ACE I/D polymorphism was performed by allele-specific PCR amplification followed by electrophoresis. Statistical analysis was done using SPSS v.20.ResultsACE I/D polymorphism was not found to be associated with hypertension, obesity, and abnormal FBG, TG, and HDL levels. However, DD and ID genotypes and D allele, with II as the reference genotype, significantly reduced the risk for high TC (OR, p value = 0.14, 0.01*; 0.29, 0.04*; 0.22, < 0.01*, respectively) and high LDL (OR, p value = 0.17, 0.03*; 0.20, 0.03*; 0.19, < 0.01*, respectively). Except for abnormal FBG, the prevalence of all the studied cardiometabolic abnormalities was significantly higher in the 4th quartile of apoB when compared to other quartiles. Linear regression model revealed a significant positive association of apoB levels with diastolic blood pressure, studied obesity parameters, TC, TG, and LDL levels.ConclusionThe D allele of ACE I/D polymorphism was not associated with most of the studied cardiometabolic abnormalities in the present study. Further, the association of high apoB with cardiometabolic abnormalities hints toward the importance of apoB in the early diagnosis of CVDs.

The triglyceride-glucose index is associated with atherosclerosis in patients with symptomatic coronary artery disease, regardless of diabetes mellitus and hyperlipidaemia

BackgroundDiabetes and hyperlipidaemia are both risk factors for coronary artery disease, and both are associated with a high triglyceride-glucose index (TyG index). The TyG index has been presented as a marker of insulin resistance (IR). Its utility in predicting and detecting cardiovascular disease has been reported. However, few studies have found it to be a helpful marker of atherosclerosis in patients with symptomatic coronary artery disease (CAD). The purpose of this study was to demonstrate that the TyG index can serve as a valuable marker for predicting coronary and carotid atherosclerosis in symptomatic CAD patients, regardless of diabetes mellitus and hyperlipidaemia.MethodsThis study included 1516 patients with symptomatic CAD who underwent both coronary artery angiography and carotid Doppler ultrasound in the Department of Cardiology at Tianjin Union Medical Center from January 2016 to December 2022. The TyG index was determined using the Ln formula. The population was further grouped and analysed according to the presence or absence of diabetes and hyperlipidaemia. The Gensini score and carotid intima-media thickness were calculated or measured, and the patients were divided into four groups according to TyG index quartile to examine the relationship between the TyG index and coronary or carotid artery lesions in symptomatic CAD patients.ResultsIn symptomatic CAD patients, the TyG index showed a significant positive correlation with both coronary lesions and carotid plaques. After adjusting for sex, age, smoking, BMI, hypertension, diabetes, and the use of antilipemic and antidiabetic agents, the risk of developing coronary lesions and carotid plaques increased across the baseline TyG index. Compared with the lowest quartile of the TyG index, the highest quartile (quartile 4) was associated with a greater incidence of coronary heart disease [OR = 2.55 (95% CI 1.61, 4.03)] and carotid atherosclerotic plaque [OR = 2.31 (95% CI 1.27, 4.20)] (P < 0.05). Furthermore, when compared to the fasting blood glucose (FBG) or triglyceride (TG) level, the TyG index had a greater area under the ROC curve for predicting coronary lesions and carotid plaques. The subgroup analysis demonstrated the TyG index to be an equally effective predictor of coronary and carotid artery disease, regardless of diabetes and hyperlipidaemia.ConclusionThe TyG index is a useful marker for predicting coronary and carotid atherosclerosis in patients with symptomatic CAD, regardless of diabetes mellitus and hyperlipidaemia. The TyG index is of higher value for the identification of both coronary and carotid atherosclerotic plaques than the FBG or TG level alone.

Aerobic exercise combined with memory strategy training improve the cognitive function.

Type 2 diabetes mellitus (T2DM) is closely associated with the occurrence of cognitive impairment, imposing a heavy burden on the patient's family and society. Aerobic exercise and targeted memory strategies have been widely reported to improve cognitive function. A total of 122 T2DM patients with Montreal Cognitive Assessment Scale (MoCA) test scores of less than 26 received the aerobic exercise combined with memory strategy training. After 6 months of intervention, a final group of 113 patients entered the final evaluation and analysis. Diabetes-specific quality of life scale (DSQL) and activities of daily living (ADL) assessments were performed to evaluate the life quality of the patients. The scores of MoCA and ADL were significantly upregulated, and the scores of DSQL were significantly reduced after the 6-month intervention of T2DM patients. The levels of fasting plasma glucose (FPG), hemoglobin A1c, total cholesterol (TC), and triglyceride (TG) levels of T2DM patients with cognitive impairment significantly decreased post intervention. A significant decrease in low density lipoprotein cholesterol (LDL-C) and an increase in high density lipoprotein cholesterol (HDL-C) were observed. The FPG, HbA1, TC, TG, and LDL-C levels were significantly lower, and the HDL-C levels were significantly higher in patients with normal cognitive function than in patients with abnormal cognitive function. Aerobic exercise combined with memory strategy training effectively improved the memory and cognitive function in patients with T2DM.

Liver enzymes mediate the association between aldehydes co-exposure and hypertriglyceridemia

Aldehydes are recognized environmental toxicants that may affect lipid metabolism. For instance, acrolein has been found to increase serum triglyceride (TG) levels exclusively. However, it remains unclear whether other aldehydes are also associated with hypertriglyceridemia (HTG), and what mechanisms may be involved. This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES, 2013–2014) to identify associations between serum aldehydes, liver enzymes, and HTG. Serum aldehydes included crotonaldehyde (CRAL), propanaldehyde (3AL), butyraldehyde (4AL), pentanaldehyde (5AL), isopentanaldehyde (I5AL), and heptanaldehyde (7AL). Liver enzymes included alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and gamma-glutamyltransferase (GGT). HTG was defined as fasting TG levels ≥ 1.7 mmol/L. Aldehyde co-exposure was quantified using weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR), while mediation analysis was performed to investigate the role of liver enzymes. Among 1474 participants (mean age 38.6 years, male 50.0%), 426 were diagnosed with HTG. 4AL, 5AL, I5AL, and 7AL were shown to be positively associated with HTG (all P values <0.05). Aldehydes co-exposure was also positively associated with HTG (OR 1.706, 95%CI 1.299–2.240), with 5AL contributing the highest weight (35.3%). Furthermore, aldehydes co-exposure showed positive associations with ALT, AST, and GGT (all P values <0.05), and all four liver enzymes were positively associated with HTG (all P values <0.05). Mediation analysis revealed that liver enzymes (ALT, AST, and GGT) may mediate the associations of 5AL and 7AL with HTG (all P values <0.05). This study identified a positive association between aldehyde co-exposure and HTG, which may be partially mediated by liver enzymes.

Variability of longitudinal triglyceride phenotype in patients heterozygous for pathogenic APOA5 variants

Biallelic pathogenic variants in APOA5 are an infrequent cause of familial chylomicronemia syndrome characterized by severe, refractory hypertriglyceridemia (HTG), and fasting plasma triglyceride (TG) >10mmol/L (>875mg/dL). The TG phenotype of heterozygous individuals with one copy of a pathogenic APOA5 variant is less familiar. We evaluated the longitudinal TG phenotype of individuals with a single pathogenic APOA5 variant allele. Medically stable outpatients from Ontario, Canada were selected for study based on having: 1) a rare pathogenic APOA5 variant in a single allele; and 2) at least three serial fasting TG measurements obtained over >1.5 years of follow-up. Seven patients were followed for a mean of 5.3±3.7 years. Fasting TG levels varied widely both within and between patients. Three patients displayed at least one normal TG measurement (<2.0mmol/L or <175mg/dL). All patients displayed mild-to-moderate HTG (2 to 9.9mmol/L or 175 to 875mg/dL) at multiple time points. Five patients displayed at least one severe HTG measurement. 10%, 54%, and 36% of all TG measurements were in normal, mild-to-moderate, and severe HTG ranges, respectively. Heterozygosity for pathogenic variants in APOA5 is associated with highly variable TG phenotypes both within and between patients. Heterozygosity confers susceptibility to elevated TG levels, with secondary factors likely modulating the phenotypic severity.

Association between serum asprosin and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus in the community.

This study aimed to investigate the relationship between serum asprosin level and diabetic peripheral neuropathy (DPN) in community patients with type 2 diabetes mellitus (T2DM). A total of 498 patients with T2DM were recruited from Zhuoma Community Health Service Station and Chengbei West Street Community Health Service Center in Changzhi City of Shanxi Province between November 2019 and July 2021. Their height, weight, and body mass index (BMI), as well as fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), and serum asprosin levels, were analyzed. Patients were divided into the DPN group (n = 329) and the non-DPN group (n = 169) according to the presence or absence of DPN. The t-test, Mann-Whitney U test, and χ² test were used to compare the indicators between the two groups. Pearson or Spearman correlation analysis was used to evaluate the correlation between serum asprosin and other clinical data. Multivariate logistic regression analysis was used to analyze the influencing factors of DPN. Compared with the non-DPN group, the DPN group had higher serum asprosin (p < 0.05). The prevalence of DPN gradually increased according to the tertiles of asprosin (56%, 67%, and 75%; p < 0.05). Multivariate logistic regression analysis showed that after adjustment for covariates, patients with asprosin concentrations between 295.4-367.0 pg/ml and concentrations > 367.0 pg/ml had a higher risk of diabetic neuropathy compared than those with asprosin levels < 295.4 pg/ml (p < 0.05). Serum asprosin was found to be positively correlated with DPN, and it resulted as an influencing factor for DPN in patients with T2DM in the community. With the increase of asprosin, the risk of DPN also increased.

Assessment of Triglyceride Glucose Index in Type 2 Diabetes Mellitus Patients With and Without Cardiac Autonomic Neuropathy.

Background Cardiac autonomic neuropathy (CAN) is a major complication of type 2 diabetes mellitus (T2DM). Hyperglycaemia and hypertriglyceridemia are known risk factors in the development of CAN with T2DM. The triglyceride glucose (TyG) index is calculated using both the fasting blood glucose (FBG) and fasting triglyceride levels (FTG). There is a paucity of literature revealing a direct relationship between the TyG index and CAN in T2DM patients of the south Indian population. Objective To assess the TyG index levels in T2DM with and without CAN. Methods A cross-sectional study was performed, involving 100 T2DM patients (58 males and 42 females) aged between 30 and 60 years, who attended medicine OPD, Sri Venkateswaraa Medical College, Hospital and Research Centre (SVMCH & RC) during the study period. Age, duration of illness, height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Glycated hemoglobin (HbA1C) and lipid profile values were taken from patients' recent medical records. Ewing autonomic function tests were used to diagnose CAN, which included heart rate response to standing, heart rate response to deep breathing, heart rate response to Valsalva maneuver, blood pressure response to standing and blood pressure response to isometric handgrip. FBGand FTGwere measured and the TyG index was calculated from these parameters. Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Version 20.0, Armonk, NY) was used forthe statistical analysis and a 'P' value < 0.05 was considered statistically significant. Results In our study, out of 100 T2DM patients, 42 patients were diagnosed with CAN. The mean levels of TyG Index,HbA1C, FBG, FTG, BMI and WC were significantly (p<0.05) higher in T2DM patients with CAN when compared to T2DM without CAN. We couldn't find any significant difference (p<0.05) in age, duration of illness, blood pressure and lipid profile parameters between the groups. Conclusion We found that abdominal obesity, hyperglycemia, and hypertriglyceridemiaare the risk factors for developing CAN in T2DM patients. Our study results also showed that the TyG index can be used to predict CAN in T2DM patients.

Syndecan-4 as a genetic determinant of the metabolic syndrome

BackgroundSyndecan-4 (SDC4) is a member of the heparan sulfate proteoglycan family of cell-surface receptors. We and others previously reported that variation in the SDC4 gene was associated with several components of the metabolic syndrome, including intra-abdominal fat, fasting glucose and triglyceride levels, and hypertension, in human cohorts. Additionally, we demonstrated that high fat diet (HFD)-induced obese female mice with a Sdc4 genetic deletion had higher visceral adiposity and a worse metabolic profile than control mice. Here, we aimed to first investigate whether the mouse Sdc4 null mutation impacts metabolic phenotypes in a sex- and diet-dependent manner. We then tested whether SDC4 polymorphisms are related to the metabolic syndrome (MetS) in humans.MethodsFor the mouse experiment, Sdc4-deficient (Sdc4−/−) and wild-type (WT) mice were treated with 14-weeks of low-fat diet (LFD). Body composition, energy balance, and selected metabolic phenotypes were assessed. For the human genetic study, we used logistic regression models to test 11 SDC4 SNPs for association with the MetS and its components in a cohort of 274 (113 with MetS) elderly subjects from southern Italy.ResultsFollowing the dietary intervention in mice, we observed that the effects of the Sdc4 null mutation on several phenotypes were different from those previously reported in the mice kept on an HFD. Nonetheless, LFD-fed female Sdc4−/− mice, but not males, displayed higher levels of triglycerides and lower insulin sensitivity at fasting than WT mice, as seen earlier in the HFD conditions. In the parallel human study, we found that carriers of SDC4 rs2228384 allele C and rs2072785 allele T had reduced risk of MetS. The opposite was true for carriers of the SDC4 rs1981429 allele G. Additionally, the SNPs were found related to fasting triglyceride levels and triglyceride glucose (TyG) index, a reliable indicator of insulin resistance, with sex-stratified analysis detecting the association of rs1981429 with these phenotypes only in females.ConclusionsAltogether, our results suggest that SDC4 is an evolutionary conserved genetic determinant of MetS and that its genetic variation is associated with fasting triglyceride levels in a female-specific manner.

Concordance/discordance between serum apolipoprotein B, low density lipoprotein cholesterol and non-high density lipoprotein cholesterol in NATPOL 2011 participants – An epidemiological perspective

BackgroundThe study compared the distribution of serum LDL-C, non-HDL-C, and apolipoprotein B (apoB) among participants of the NATPOL 2011 survey and analysed concordance/discordance of results in the context of the risk for atherosclerotic cardiovascular disease (ASCVD). MethodsSerum levels of apoB, LDL-C, non-HDL-C and small dense LDL-C were measured/calculated in 2067–2098 survey participants. The results were compared between women and men, age groups and in relation to body mass index (BMI), fasting glucose and TG levels, and the presence of CVD. Percentile distribution of lipid levels and concordance/discordance analysis were based on medians and ESC/EAS 2019 target thresholds for ASCVD risk and on comparison of measured apoB levels and levels calculated from linear regression equations with serum LDL- C and non-HDL-C as independent variables. ResultsSerum apoB, LDL-C and non-HDL-C were similarly related to sex, age, BMI, visceral obesity, cardiovascular disease, and fasting glucose and triglyceride levels. Serum apoB, LDL-C and non-HDL-C very high- and moderate- target thresholds were exceeded in 83%, 99% and 96.9% and in 41%, 75% and 63.7% of subjects, respectively. The incidence of the discordances between the results depended on the dividing values used and ranged from 0.2% to 45.2% of the respondents. Subjects with high apoB / low LDL-C/non-HDL-C discordance had features of metabolic syndrome. ConclusionsDiagnostic discordances between apoB and LDL-C/non-HDL-C indicate limitations of serum LDL-C/non-HDL-C in ASCVD risk management. Due to the high apoB/low LDL-C/non-HDL-C discordance, obese/metabolic syndrome patients may benefit from replacing LDL-C/non-HDL-C by apoB in ASCVD risk assessment and lipid-lowering therapy.

Estimating Triglyceride Levels Using Total Cholesterol, Low-Density Lipoprotein Cholesterol, and High-Density Lipoprotein Cholesterol Levels: A Cross-Sectional Study.

Objective: Triglyceride (TG) levels are affected by food intake, and the cutoff values for nonfasting TG levels vary. This study aimed to calculate fasting TG levels based on total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. Methods: Multiple regression analysis was performed to determine estimated triglyceride (eTG) levels using data from 39,971 participants divided into six groups based on non-high-density lipoprotein cholesterol (nHDL-C) levels (<100, <130, <160, <190, <220, and ≥220 mg/dL). Results: Provided that fasting TG and eTG levels ≥150 mg/dL were positive and those <150 mg/dL were negative, the three groups (nHDL-C levels <100, <130, and <160 mg/dL) consisting of 28,616 participants had a false-positive rate of <5%. The coefficient and constant terms in the formula for the eTG in groups with nHDL-C levels <100, <130, and <160 mg/dL were as follows: constant terms, 12.193, 0.741, and -7.157; coefficients of LDL-C, -3.999, -4.409, and -5.145; coefficients of HDL-C, -3.869, -4.555, and -5.215; and coefficients of TC, 3.984, 4.547, and 5.231, respectively. The adjusted coefficients of determination were 0.547, 0.593, and 0.678, respectively (P < 0.001, P < 0.001, and P < 0.001, respectively). Conclusion: Fasting TG levels can be calculated from TC, LDL-C, and HDL-C levels when nHDL-C levels are <160 mg/dL. Using nonfasting TG and eTG levels as indicators of hypertriglyceridemia might eliminate the need for venous sampling after overnight fasting.

Kruppel benzeri faktör 2 polimorfizmlerinin koroner arter hastalığı riski ile ilişkisi

Purpose: Coronary artery disease is defined as complications that develop in proportion to the prevalence of ischemia due to occlusion of the coronary arteries and the resulting cell death. The development of atherosclerosis is significantly influenced by endothelial cell dysfunction. Kruppel-like factor 2, a transcription factor, has been shown to regulate critical biological events in endothelial biology, such as vascular tone, migration, proliferation, vasoreactivity, and angiogenesis. In our study, it was aimed to clarify the relationship between coronary artery disease and Kruppel-like factor 2 protein levels and C1239A polymorphisms.&#x0D; Materials and Methods: 191 individuals who underwent coronary angiography at Mersin University Faculty of Medicine, Department of Cardiology, Health, Research and Application Center were included in the study. Measurements of serum fasting blood glucose, HDL cholesterol, total cholesterol, and triglyceride levels were performed on the AU5800 (Beckman Coulter, United States) autoanalyzer. Serum LDL levels were calculated using the Friedwald equation. Serum Kruppel-like factor 2 protein levels were measured by sandwich enzyme-linked immunoassay method on the Multiskan GO (Thermo Scientific, Finland) device. Kruppel-like factor 2 C1239A variations were detected on the Applied Biosystem VIIA™ 7 Real-Time PCR (Life Technologies Co., United States) device by TaqMan® single nucleotide polymorphism (SNP) genotyping method.&#x0D; Results: Men had a 3.8-fold higher risk of CAD than women. (Odd’s ratio 3.83, 95% Confidence interval 1.98-7.39; p

Assessment of Corrected QT Interval and QT Dispersion in Patients with Uncomplicated Metabolic Syndrome.

Metabolic syndrome (MS) itself has become a new entity being a constellation of physiological, biochemical, metabolic, and clinical factors that have been related to an increased risk of cardiovascular diseases, type 2 diabetes mellitus (T2DM), and morbidity and mortality. The burden of MS is increasing all over the world with the current prevalence being 30%. The QT interval and QT dispersion (QTd) have been long associated with ventricular arrhythmia and sudden cardiac deaths. The association between QT and diabetes and healthy subjects has been clearly studied, but the association between QT and uncomplicated MS has not been very well defined. A total of 400 patients visiting the medicine clinics were assessed for blood pressure, anthropometric measurements, fasting serum lipid profile, FBS, and electrocardiogram (ECG). The patients diagnosed with uncomplicated MS as per the International Diabetic Federation (IDF) criteria were included in the study. QT interval in the ECG was recorded, and the relationship between various parameters of an uncomplicated MetS and the QT interval was recorded. Our study revealed more females with uncomplicated MS as compared to males and increasing burden as age progressed. Body mass index (BMI), waist circumference (WC), hip circumference (HC), WHP, systolic blood pressure (SBP), Diastolic blood pressure (DBP), Fasting blood sugar (FBS), serum cholesterol, triglyceride (TG), and low-density lipoprotein (LDL) levels were positively correlated with QT values. QT interval, a strong predictor of malignant ventricular arrhythmias and sudden cardiac deaths, is associated with uncomplicated MS.

Correlation of lipocalin 2 and glycolipid metabolism and body composition in a large cohort of children with osteogenesis imperfecta

PurposeLipocalin 2 (LCN2) is a newly recognized bone-derived factor that is important in regulation of energy metabolism. We investigated the correlation of serum LCN2 levels and glycolipid metabolism, and body composition in a large cohort of patients with osteogenesis imperfecta (OI).MethodsA total of 204 children with OI and 66 age- and gender-matched healthy children were included. Circulating levels of LCN2 and osteocalcin were measured by enzyme-linked immunosorbent assay. Serum levels of fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), and low- and high-density lipoprotein cholesterol (LDL-C, HDL-C) were measured by automated chemical analyzers. The body composition was measured by dual-energy X-ray absorptiometry. Grip strength and timed-up-and-go (TUG) were tested to evaluate the muscle function.ResultsSerum LCN2 levels were 37.65 ± 23.48 ng/ml in OI children, which was significantly lower than those in healthy control (69.18 ± 35.43 ng/ml, P < 0.001). Body mass index (BMI) and serum FBG level were significantly higher and HDL-C levels were lower in OI children than healthy control (all P < 0.01). Grip strength was significantly lower (P < 0.05), and the TUG was significantly longer in OI patients than healthy control (P < 0.05). Serum LCN2 level was negatively correlated to BMI, FBG, HOMA-IR, HOMA-β, total body, and trunk fat mass percentage, and positively correlated to total body and appendicular lean mass percentage (all P < 0.05).ConclusionsInsulin resistance, hyperglycemia, obesity, and muscle dysfunction are common in OI patients. As a novel osteogenic cytokine, LCN2 deficiency may be relevant to disorders of glucose and lipid metabolism, and dysfunction of muscle in OI patients.

Triglyceride–glucose index as a marker of adverse cardiovascular prognosis in patients with coronary heart disease and hypertension

BackgroundThe triglyceride–glucose (TyG) index has been proposed as a potential predictor of adverse prognosis of cardiovascular diseases (CVDs). However, its prognostic value in patients with coronary heart disease (CHD) and hypertension remains unclear.MethodsA total of 1467 hospitalized patients with CHD and hypertension from January 2021 to December 2021 were included in this prospective and observational clinical study. The TyG index was calculated as Ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. Patients were divided into tertiles according to TyG index values. The primary endpoint was a compound endpoint, defined as the first occurrence of all-cause mortality or total nonfatal CVDs events within one-year follow up. The secondary endpoint was atherosclerotic CVD (ASCVD) events, including non-fatal stroke/transient ischemic attack (TIA) and recurrent CHD events. We used restricted cubic spline analysis and multivariate adjusted Cox proportional hazard models to investigate the associations of the TyG index with primary endpoint events.ResultsDuring the one-year follow-up period, 154 (10.5%) primary endpoint events were recorded, including 129 (8.8%) ASCVD events. After adjusting for confounding variables, for per standard deviation (SD) increase in the TyG index, the risk of incident primary endpoint events increased by 28% [hazard ratio (HR) = 1.28, 95% confidence interval (CI) 1.04–1.59]. Compared with subjects in the lowest tertile (T1), the fully adjusted HR for primary endpoint events was 1.43 (95% CI 0.90–2.26) in the middle (T2) and 1.73 (95% CI 1.06–2.82) in highest tertile (T3) (P for trend = 0.018). Similar results were observed in ASCVD events. Restricted cubic spline analysis also showed that the cumulative risk of primary endpoint events increased as TyG index increased.ConclusionsThe elevated TyG index was a potential marker of adverse prognosis in patients with CHD and hypertension.