Friedewald Formula Research Articles

Comparison between the Direct Method and Friedewald's Formula for the Determination of Low-Density Lipoprotein Cholesterol Serum Levels in Horses

Comparison between the Direct Method and Friedewald's Formula for the Determination of Low-Density Lipoprotein Cholesterol Serum Levels in Horses

Circulating Levels of PCSK9, ANGPTL3 and Lp(a) in Stage III Breast Cancers

<h3>Lead Author's Financial Disclosures</h3> Nothing to disclose. <h3>Study Funding</h3> None. <h3>Background/Synopsis</h3> Growing evidence demonstrate the role of cholesterol in sustaining tumor growth and metastasis in a large variety of cancers. Given that cholesterol-lowering drugs are being used in combination to lower cholesterol levels in cardiovascular diseases, it becomes intuitive to verify whether these drugs could be used to induce a sufficient depletion of cholesterol to impede tumor progression. A new generation of lipid-lowering drugs are available, yet the circulating levels of their targets have not been determined in cancers. Given that drugs directed against PCSK9 (drugs: evolocumab, alirocumab), ANGPTL3 (drug: evinacumab) and Lp(a) (drug: AKCEA-APO(a)-LRx) are available, it would be important to assess their circulating levels in cancers. Elevated levels of these proteins would pave the way to trials studying lipid-lowering drugs as adjuvant treatments in cancers. <h3>Objective/Purpose</h3> To compare circulating levels of PCSK9, ANGPTL3, and Lp(a) in women with stage III breast cancer versus women with a premalignant or benign breast lesion. <h3>Methods</h3> Twenty-three plasma samples from women diagnosed with a stage III breast cancer (ductal, lobular or mixed) were matched for age with twenty-three plasma samples from women bearing a premalignant (stage 0, N=9) or benign (N= 14) breast lesion. The lipid profile (total cholesterol, HDL cholesterol and triglycerides) was measured on a Siemens Vista platform. LDL were calculated with the Friedewald formula. Apo B and Lp(a) were measured on a Roche Modular platform. ANGPTL3 and PCSK9 plasma levels were quantitated by ELISA (kits purchased from Abcam and Biolegend, respectively). Statistical analysis was performed using SAS (version 9.4) software. <h3>Results</h3> PCSK9 levels were significantly higher in women with stage III breast cancer compared to age-matched counterparts presenting a benign lesion (95.92 +/- 15.67 ng/ml vs. 78.54 +/- 11.12 ng/ml, p< 0.05, n=14). Moreover, PCSK9 concentrations (ng/ml) positively correlated with the disease severity (benign, stage 0, stage III) (r=0.34, p<0.05, n=46). In contrast, ANGPTL3 and Lp(a) plasma levels did not display any association with breast disease status. <h3>Conclusions</h3> The data suggest that PCSK9 levels increase with the severity of breast carcinoma. We hypothesize a mechanism whereby tumoral uptake of cholesterol triggers hepatic secretion of PCSK9 to maintain cholesterolemia. PCSK9 inhibition in combination with statin therapy may be an interesting pharmacological approach to deprive tumors of cholesterol, enhance anti-tumor immune response and impede cancer progression.

Difference in the Standard and Novel Lipid Profile Parameters Between Patients With Alzheimer’s Disease and Vascular Dementia Stratified by the Degree of Cognitive Impairment

Background: Lipids and lipoproteins are significantly involved in maintaining structural and functional components of the human brain and neurons, but their role in the development of Alzheimer’s disease (AD) and vascular dementia (VD) remains unclear. Objective: The aim of the present study was to explore the differences in the standard and novel lipid profile parameters in patients with AD and VD, stratified by the degree of cognitive impairment (CI). Methods: Present study included 66 patients with AD, 50 patients with VD, and 60 control subjects. For an evaluation of the global cognitive function the Montreal Cognitive Assessment (MoCA) test was used. In order to distinguish patients with VD from those with AD the Hachinski ischemic score was used. Plasma total cholesterol (TC), high-density lipoprotein -cholesterol (HDL-C), and triglycerides (TG) levels were determined using standard enzymatic colorimetric techniques, whereas the Friedewald formula was used to calculate low-density lipoprotein-cholesterol (LDL-C) levels. The non-traditional lipid indices such as TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratio were separately calculated. The differences between the groups were analyzed with the Kruskal Wallis test followed by the Mann-Whitney test or with ANOVA followed by the Tuckey posthoc test. Results: Results of the conducted study have found that the patients in AD group with moderate CI and patients in AD group with severe CI exhibited significantly lower levels of serum TC, TG, LDL-C, VLDL-C, Non-HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C and LDL-C/HDL-C compared to cognitively normal control subjects. Moreover, patients in VD group with severe and moderate CI had significantly lower level of TG compared to control group of subjects. Our results have also shown that patients in AD group with moderate CI had significantly lower level of TC, TG, LDL-C, Non-HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C compared to VD patients with moderate CI. In addition, patients in AD group with severe CI had significantly lower level of TC, LDL-C, Non-HDL-C and TC/HDL-C compared to VD patients with severe CI. Conclusion: The results of this study have shown dysregulation of lipid metabolism in AD and VD patients with different degree of CI. In both moderate and in severe CI, patients with AD had lower levels of majority of standard and novel lipid parameters compared to patients with VD. Further larger prospective studies are required to elucidate the accuracy of standard and novel lipid parameters in the assessment of different degree of CI in AD and VD.

Взаємозв’язок між показниками адипокінового та ліпідного профілю у пацієнтів на гострий інфаркт міокарда та цукровий діабет 2 типу

Introduction. Nowadays, it becomes topical to search for methods of diagnosis and treatment for polymorbid patients. The importance of the study on pathophysiological mechanisms of acute myocardial infarction (AMI) in patients with type 2 diabetes mellitus (DM) has been shown. The aim of the study: to examine the relationship between adipokine and lipid profiles in AMI patients with the presence or absence of type 2 DM. Material and methods. The study was conducted over a period from September 1, 2018 to December 31, 2020. A total of 134 patients with ST-segment elevation AMI in the presence or absence of type 2 DM aged 58.97 ± 7.92 years hospitalized in the intensive care unit of Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” and Kharkiv Railway Clinical Hospital No. 1 of the branch “Center of Healthcare” were enrolled in the study. Group 1 included 74 patients with AMI and type 2 DM aged 59.42 ± 7.66 years. Group 2 (comparison group) comprised 60 patients with AMI without type 2 DM aged 58.42 ± 8.25 years. The control group consisted of 20 otherwise healthy individuals. Serum concentrations of fatty acid-binding protein 4 (FABP4) and C1q/ TNF-related protein 3 (CTRP3) of patients were measured by enzyme-linked immunosorbent assay. Serum total cholesterol (TC) and highdensity lipoprotein (HDL) cholesterol were analyzed by peroxidase enzymatic method. Triglyceride (TG) levels were measured by enzymatic colorimetric method. The atherogenic index was calculated by the A.M. Klimov formula. The levels of very low-density lipoprotein (VLDL) cholesterol and low-density lipoprotein (LDL) cholesterol were estimated by the Friedewald formula. Results and discussion. The patients in Group 1 were found to have higher levels of serum TG in comparison with Group 2 patients (р&lt;0.05). In groups 1 and 2, there was an upward tendency in the levels of TC and LDL (р ˃0.05), as well as a significant 4.04 and 2.92 times increase in VLDL, respectively, as compared to the control group (p&lt;0.05). The serum levels of FABP4 were significantly increased, while CTRP3 levels were decreased in AMI patients compared to those in otherwise healthy individuals (р&lt;0.05). In AMI patients with type 2 DM (group 1), an inverse correlation was found between FABP4 and VLDL (r = 0.502, p&lt;0.05), TG (r = 0.596, p&lt;0.001); between CTRP3 and TC (r = -0.507, p&lt;0.05), LDL (r = -0.512, p&lt;0.05). In patients with AMI (group 2), an inverse correlation was revealed between FABP4 and VLDL (r = 0.453, p = 0.006), TG (r = 0.439, p = 0.009); between CTRP3 and TC (r = -0.413, p = 0.001), LDL (r = -0.429, p = 0.01). Conclusions. The characteristics of changes in the FABP4 and CTRP3 serum levels are evidence of an adipokine metabolism imbalance in AMI with the presence or absence of type 2 DM, indicating a metabolic shift in this patient category. The relationship between lipid profile markers and FABP4 and CTRP3 may indicate the influence of the latter on lipid metabolism.

Traditional and Non-traditional Lipid Profiles in Bosnian Patients with Probable Alzheimer's Disease and Vascular Dementia.

Background:Conflicting data exist on traditional lipid profiles in patients with Alzheimer’s disease (AD) and vascular dementia (VD), whereas scarce number of studies evaluated non-traditional lipid profiles in patients with AD and VD. Studies have shown that ethnic background may affect lipid profile.Objective:The aim of the present study was to conduct comparative assessment of traditional and non-traditional lipid profiles in Bosnian patients with AD and VD.Methods:A controlled, cross-sectional study was performed with 66 patients with AD, 50 patients with VD, and 60 control subjects. The Montreal Cognitive Assessment (MoCA) test was used for an evaluation of the global cognitive function. The Hachinski ischemic score was used to distinguish patients with VD from those with AD. Plasma total cholesterol (TC), high-density lipoprotein -cholesterol (HDL-C), and triglycerides (TG) levels were determined using standard enzymatic colorimetric techniques, whereas the Friedewald formula was used to calculate low-density lipoprotein-cholesterol (LDL-C) levels. The non-traditional lipid indices such as TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratio were separately calculated. The differences between the groups were analyzed with ANOVA followed by the Tuckey posthoc test or with the Kruskal Wallis test followed by the Mann-Whitney test.Results:Results of the present study have shown that patients in AD group had significantly lower level of TC, TG, LDL-C, VLDL-C, Non-HDL-C and significantly lower atherogenic index compared to the control group (CG) and compared to the VD patients. Significant difference in values of TG and VLDL-C was observed between VD and the CG, whereas no significant difference in values of TC, LDL-C, atherogenic index and Non-HDL-C was observed between these two groups. Our results have also shown that TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratios were significantly lower in AD patients compared to the VD and CG. Moreover, TG/HDL-C ratio was significantly lower in VD compared to the CG. However, a significant difference in TC/HDL-C and LDL-C/HDL-C was not observed between VD and the CG.Conclusion:Based on the results of the present study it can be deduced that there is a difference in traditional and non-traditional lipid profiles between AD and VD patients of Bosnian descent. Obtained results suggest that lipids are decreased in AD and in VD to a certain extent. However, since there is an inconsistence in literature whether there is an association between cholesterol and cognition, large prospective studies are required to elucidate this controversy.

Concordance of apolipoprotein B concentration with the Friedewald, Martin-Hopkins, and Sampson formulas for calculating LDL cholesterol.

IntroductionTwo new formulas, the Martin-Hopkins and the Sampson formula, were recently developed to overcome shortcomings of the Friedewald formula for calculating LDL-cholesterol. We aimed to compare the concordance of the two formulas with apolipoprotein B (apoB), a surrogate marker of the number of LDL particles.Materials and methodsIn a study of serum lipid data of 1179 patients who consulted the AZ St-Jan Hospital Bruges for cardiovascular risk assessment, the correlation and concordance of the Friedewald, Martin-Hopkins and Sampson formulas with apoB concentration, measured by immunonephelometry, were determined and compared.ResultsThe Martin-Hopkins formula showed significantly higher correlation coefficient than the Friedewald formula with apoB in the entire dataset and in patients with low LDL-cholesterol < 1.8 mmol/L. Both Martin-Hopkins and Sampson formulas yielded > 70% concordance of LDL-cholesterol with regard to treatment group classification based on population-equivalent thresholds of apoB in hypertriglyceridemic patients (2-4.5 mmol/L), with the highest concordance (75.6%) obtained using Martin-Hopkins formula vs. 60.5% with Friedewald formula.ConclusionThe Martin-Hopkins (and, to a lesser extent, Sampson) formula is more closely associated with the number of LDL particles than Friedewald formula. This, in combination with literature evidence of lesser accuracy of the Friedewald formula, is an argument to switch from Friedewald to a modified, improved formula.

Abstract 9747: Safety, Pharmacokinetics and Pharmacodynamics of Multiple Ascending Doses of AZD8233, Targeting PCSK9, in Patients with Dyslipidemia

Introduction: Inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) reduces cardiovascular risk by lowering low-density lipoprotein-cholesterol (LDL-C) levels. AZD8233 is an antisense oligonucleotide in development for the treatment of dyslipidemia. In a single ascending dose study (NCT03593785), AZD8233 was well tolerated and effectively reduced PCSK9 and LDL-C levels in patients with elevated LDL-C. Here, we report results from a multiple ascending dose study of AZD8233. Methods: This was a phase 1, randomized, single-blind, placebo-controlled study (NCT04155645) in patients with dyslipidemia. Participants were receiving statins for ≥ 3 months, had an LDL-C in the range 70-190 mg/dL, and were 18-65 years old. Three cohorts of 11 participants received four subcutaneous injections over an 8-week period (days 1, 8, 29, and 57) of either AZD8233 (15 mg, 30 mg, or 90 mg; n = 8) or placebo (n = 3), and were followed up for 16 weeks post dose. The primary objective was to assess safety and tolerability; secondary objectives included assessment of pharmacokinetics and pharmacodynamics of AZD8233; circulating LDL-C was estimated using the Friedewald formula. Results: Overall, 34 patients were randomized and data are available from 33 patients; 15 were male, the mean age was 58 years, and baseline PCSK9 and LDL-C levels were comparable across treatment groups. Treatment with AZD8233 did not result in any clinically relevant safety or tolerability findings. Peak plasma concentrations of AZD8233 were reached within 0.5 to 5 hours post dosing, followed by a biphasic decline. A decrease from baseline in PCSK9 (69.7%, 79.9%, and 95.3%) and LDL-C levels (63.8%, 65.7%, and 83.3%) was observed at 12 weeks for the AZD8233 15 mg, 30 mg, and 90 mg groups, respectively vs placebo ( Figure ). Conclusions: Multiple doses of AZD8233 were generally safe, well tolerated, and reduced PCSK9 and LDL-C levels in a dose-dependent manner in statin-treated patients with dyslipidemia.

The Effect of Soya and Genistein Supplementation on Serum Lipid Profile of Male Dawley Sprague Rat

Background: Non-medical therapy is needed to reduce blood lipid levels and prevent atherosclerosis. Foods that contain Isoflavones can improve lipid profiles in the blood.Aim: To determine the effect of soya and genistein supplementation in various doses on total cholesterol, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Triglycerides in male Sprague-Dawley rats.Methods: 35 male Sprague-Dawley rats aged 6-8 weeks were divided into 7 groups, control group; low, medium, and high doses of soy milk; and low, moderate, and high doses of genistein. The treatment was given orally for 60 days. The control used was mice with standard feed. On the 61st day, blood and hepatic tissue samples were taken and checked for lipid profiles using the Friedewald formula. Statistical analysis was carried out by one-way ANOVA and Tukey's posthoc test and Dunnet test, then regression analysis.Results: There was a significant increase in total cholesterol levels (p &lt;0.05) and  LDL levels in low and moderate doses of soy milk group compared to all groups of genistein. There was no significant differences in HDL levels in soya and genistein groups. There was significant increase in Triglyceride levels in all groups of soy milk and low and moderate doses of Genistein compared to high doses of genistein.Conclusion:  Soya and genistein supplementation had increased effect on the Total Cholesterol, LDL and Triglycerides but no effect on HDL in all groups.

Estimation of Low-Density Lipoprotein Cholesterol Concentration Using Machine Learning.

Low-density lipoprotein cholesterol (LDL-C) can be estimated using the Friedewald and Martin-Hopkins formulas. We developed LDL-C prediction models using multiple machine learning methods and investigated the validity of the new models along with the former formulas. Laboratory data (n = 59,415) on measured LDL-C, high-density lipoprotein cholesterol, triglycerides (TG), and total cholesterol were partitioned into training and test data sets. Linear regression, gradient-boosted trees, and artificial neural network (ANN) models were formed based on the training data. Paired-group comparisons were performed using a t-test and the Wilcoxon signed-rank test. We considered P values <.001 with an effect size >.2 to be statistically significant. For TG ≥177 mg/dL, the Friedewald formula underestimated and the Martin-Hopkins formula overestimated the LDL-C (P <.001), which was more significant for LDL-C <70 mg/dL. The linear regression, gradient-boosted trees, and ANN models outperformed the aforementioned formulas for TG ≥177 mg/dL and LDL-C <70 mg/dL based on a comparison with a homogeneous assay (P >.001 vs. P <.001) and classification accuracy. Linear regression, gradient-boosted trees, and ANN models offer more accurate alternatives to the aforementioned formulas, especially for TG 177 to 399 mg/dL and LDL-C <70 mg/dL.

Applicability of Martin-Hopkins formula and comparison with Friedewald formula for estimated low-density lipoprotein cholesterol in e_COR study population.

Low-density lipoprotein cholesterol (LDL) is essential in managing cardiovascular disease risk. Since 1972, the Friedewald formula has been used to estimate LDL concentration, although with some limitations. In 2013, Martin et al. proposed a similar but more accurate formula for calculating LDL. To assess the applicability of the new formula, which we have named the Martin-Hopkins formula, in the Portuguese population and compare it with the Friedewald formula using direct LDL. Cross-sectional study, including 1689 participants from the e_COR study. We applied the Martin-Hopkins and Friedewald formulas for estimated LDL (LDL-M and LDL-F). The Friedewald formula was not applied in 12 cases due to triglycerides ≥400mg/dL. Direct LDL was measured and the accepted significance level was p<0.05. Of the total subjects, 50.2% were male and had a median age of 51 (34) years. LDL-D was 117.0 (44.0) mg/dL, LDL-M was 114.6 (43.7) mg/dL and LDL-F was 113.8 (43.2) mg/dL. The Spearman coefficient (ρ) between LDL-M/LDL-D was 0.987 and between LDL-F/LDL-D was 0.983, p=0.001. This strong correlation was maintained in the group with diabetes (LDL-M/LDL-D ρ=0.987; LDL-F/LDL-D ρ=0.978, p=0.001) and hypertriglyceridemia (LDL-M/LDL-D ρ=0.983; LDL-F/LDL-D ρ=0.982, p=0.001). In terms of agreement, the highest value of κ=0.90 was obtained for LDL-M when LDL-D <100mg/dL. The Martin-Hopkins formula performed well and had good applicability, showing superiority in relation to the Friedewald formula, especially for LDL-D values <100mg/dL, diabetes, and hypertriglyceridemia.

A Tale of Two Approaches.

To summarize and assess the literature on the performances of methods beyond the Friedewald formula (FF) used in routine practice to determine low-density lipoprotein cholesterol (LDL-C). A literature review was performed by searching the PubMed database. Many peer-reviewed articles were assessed. The examined methods included direct homogeneous LDL-C assays, the FF, mathematical equations derived from the FF, the Martin-Hopkins equation (MHE), and the Sampson equation. Direct homogeneous assays perform inconsistently across manufacturers and disease status, whereas most FF-derived methods exhibit variable levels of performance across populations. The MHE consistently outperforms the FF but cannot be applied in the setting of severe hypertriglyceridemia. The Sampson equation shows promise against both the FF and MHE, especially in severe hypertriglyceridemia, but data are still limited on its validation in various settings, including disease and therapeutic states. There is still no consensus on a universal best method to estimate LDL-C in routine practice. Further studies are needed to assess the performance of the Sampson equation.

Lipid measurements in the management of cardiovascular diseases: Practical recommendations a scientific statement from the national lipid association writing group

Lipoprotein measurements are pivotal in the management of patients at risk for atherosclerotic coronary heart disease (CHD) with myocardial infarction and coronary death as the main outcomes, and for atherosclerotic cardiovascular disease (ASCVD), which includes CHD and stroke. Recent developments and changes in guidelines affect optimization of using lipid measures as cardiovascular biomarkers. This scientific statement reviews the pre-analytical, analytical, post-analytical, and clinical aspects of lipoprotein measurements. Highlights include the following: i) It is acceptable to screen with nonfasting lipids. ii) non-high-density lipoprotein HDL-cholesterol (non-HDL-C) is measured reliably in either the fasting or the nonfasting state and can effectively guide ASCVD prevention. iii) low density lipoprotein cholesterol (LDL-C) can be estimated from total cholesterol, high density lipoprotein cholesterol (HDL-C), and triglyceride (TG) measurements. For patients with LDL-C>100 mg/dL and TG ≤150 mg/dL it is reasonable to use the Friedewald formula. However, for those with TG 150-400 mg/dL the Friedewald formula for LDL-C estimation is less accurate. The Martin/Hopkins method is recommended for LDL-C estimation throughout the range of LDL-C levels and up to TG levels of 399 mg/dL. For TG levels ≥400 mg/dL LDL-C estimating equations are currently not recommended and newer methods are being evaluated. iv) When LDL-C or TG screening results are abnormal the clinician should consider obtaining fasting lipids. v) Advanced lipoprotein tests using apolipoprotein B (apoB), LDL Particle Number (LDL-P) or remnant cholesterol may help to guide therapeutic decisions in select patients, but data are limited for patients already on lipid lowering therapy with low LDL-C levels. Better harmonization of advanced lipid measurement methods is needed. Lipid measurements are recommended 4-12 weeks after a change in lipid treatment. Lipid laboratory reports should denote desirable values and specifically identify extremely elevated LDL-C levels (≥190 mg/dL at any age or ≥160 mg/dL in children) as severe hypercholesterolemia. Potentially actionable abnormal lipid test results, including fasting triglycerides (TG) ≥500 mg/dL, should be reported as hypertriglyceridemia. Appropriate use and reporting of lipid tests should improve their utility in the management of persons at high risk for ASCVD events.

Comparison of Formula-Based Methods with Diverse TGL: VLDL-C Ratio for Calculating LDL-C in a Tertiary Care Hospital.

Background The most popular Friedewald formula (FF) was tailored with a fixed factor of 5 for triglyceride-very low-density lipoprotein cholesterol (TGL:VLDL-C) ratio. Some of the subsequent studies on diverse population demonstrated modified FF with only altered TGL:VLDL-C ratio, comprising either a fixed or an adjustable factor. Hata and Nakajima as well as Puavilai et al proposed fixed factors of 4 and 6, respectively. Recently, Martin et al recommended an adjustable factor derived as N-strata-specific median TGL:VLDL-C ratio based on TGL and non-high-density lipoprotein cholesterol (non-HDL-C). Aim This comparative retrospective study evaluates the efficacy of LDL-C formulae, varying only in TGL-VLDL-C ratio, using direct LDL-C assay as a reference method in a tertiary care hospital. Materials and Methods A total of 1,747 patient records with lipid profile data were procured. Concordance analysis, absolute difference, and post hoc test were employed as analytical tools. The impact of total cholesterol (TChol), TGL, and HDL-C on formulae was also evaluated. Results Overall, Martin equation had relatively the highest concordance, narrowest absolute difference, and minimal influence of TChol, TGL, and HDL-C. On the contrary, the Hata method revealed comparatively the lowest concordance, widest absolute difference, and high influence of TChol, TGL, and HDL-C. The remaining formula-based approaches, that is, FF and Puavilai calculation, executed mostly inconsistent intermittent features between Martin equation and Hata method. Conclusion Relatively dominant and competitive analytical attributes of the Martin equation with an adjustable TGL:VLDL-C factor outweigh the remaining three formulae-based methods with fixed TGL:VLDL-C factor in Indian adults.

Evaluation of Anti-hyperlipidemic Activity of Red Onion In Experimental Animals

Objective: To evaluate antihyperlipidemic effect of red onion on poloxamer 407 induced hyperlipidemia in wistar albino rats.&#x0D; Methods: Hyperlipidemia was induced by intraperitoneal injection of poloxamer-407 (P-407) at a dose of 1.0g/kg body weight in wistar albino rats. Drug treatments were done by oral gavage for 21 days. At the end of the study, animals were kept fasted over night and then blood samples were collected. The serum total cholesterol (TC), triglycerides (TG), and High density lipoprotein (HDL) were measured while low density lipoprotein (LDL) and very low density lipoprotein (VLDL) were calculated by Friedewald formula and atherogenic index was also calculated.&#x0D; Results: From the present investigation, it was observed that ethanolic extract of red onion have shown significant reduction in serum cholesterol, triglyceride and lipoprotein levels and increase in HDL level in P-407 induced hyperlipidemia.&#x0D; Conclusion: The findings in this study revealed the effectiveness of ethanolic extract of red onion against hyperlipidemic activity.&#x0D;

Aplicabilidade da fórmula Martin‐Hopkins e comparação com a fórmula Friedewald na estimativa do colesterol LDL na população do estudo e_COR

IntroductionLow‐density lipoprotein cholesterol (LDL) is essential in managing cardiovascular disease risk. Since 1972, the Friedewald formula has been used to estimate LDL concentration, although with some limitations. In 2013, Martin et al. proposed a similar but more accurate formula for calculating LDL. AimTo assess the applicability of the new formula, which we have named the Martin‐Hopkins formula, in the Portuguese population and compare it with the Friedewald formula using direct LDL. Material and methodsCross‐sectional study, including 1689 participants from the e_COR study. We applied the Martin‐Hopkins and Friedewald formulas for estimated LDL (LDL‐M and LDL‐F). The Friedewald formula was not applied in 12 cases due to triglycerides ≥400mg/dL. Direct LDL was measured and the accepted significance level was p<0.05. ResultsOf the total subjects, 50.2% were male and had a median age of 51 (34) years. LDL‐D was 117.0 (44.0) mg/dL, LDL‐M was 114.6 (43.7) mg/dL and LDL‐F was 113.8 (43.2) mg/dL. The Spearman coefficient (ρ) between LDL‐M/LDL‐D was 0.987 and between LDL‐F/LDL‐D was 0.983, p=0.001. This strong correlation was maintained in the group with diabetes (LDL‐M/LDL‐D ρ=0.987; LDL‐F/LDL‐D ρ=0.978, p=0.001) and hypertriglyceridemia (LDL‐M/LDL‐D ρ=0.983; LDL‐F/LDL‐D ρ=0.982, p=0.001). In terms of agreement, the highest value of κ=0.90 was obtained for LDL‐M when LDL‐D <100 mg/dL. ConclusionThe Martin‐Hopkins formula performed well and had good applicability, showing superiority in relation to the Friedewald formula, especially for LDL‐D values <100 mg/dL, diabetes, and hypertriglyceridemia.

The Effects of Calculated Remnant-Like Particle Cholesterol on Incident Cardiovascular Disease: Insights from a General Chinese Population.

Background: Growing evidence suggests that remnant cholesterol (RC) contributes to residual atherosclerotic cardiovascular disease (ASCVD) risk. However, the cutoff points to treat RC for reducing ASCVD are still unknown. This study aimed to investigate the relationships between RC and combined cardiovascular diseases (CVDs) in a general China cohort, with 11,956 subjects aged ≥ 35 years. Methods: Baseline RC was estimated with the Friedewald formula for 8782 subjects. The outcome was the incidence of combined CVD, including fatal and nonfatal stroke and coronary heart disease (CHD). The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals. The restricted cubic spline (RCS) model was used to evaluate the dose–response relationship between continuous RC and the natural log of HRs. Results: After a median follow-up of 4.66 years, 431 CVD events occurred. In the Cox proportional models, participants with a high level of categorial RC had a significantly higher risk for combined CVD (HR: 1.37; 95% CI: 1.07–1.74) and CHD (HR: 1.63; 95% CI: 1.06–2.53), compared to those with a medium level of RC. In the stratification analyses, a high level of RC significantly increased combined CVD risk for subgroups females, age < 65 years, noncurrent smokers, noncurrent drinkers, normal weight, renal dysfunction, and no hyperuricemia. The same trends were found for CHD among subgroups males, age < 65 years, overweight, renal dysfunction, and no hyperuricemia; stroke among subgroup females. In RCS models, a significant linear association between RC and combined CVD and a nonlinear association between RC and CHD resulted. The risk of outcomes was relatively flat until 0.84 mmol/L of RC and increased rapidly afterwards, with an HR of 1.308 (1.102 to 1.553) for combined CVD and 1.411 (1.061 to 1.876) for CHD. Stratified analyses showed a significant nonlinear association between RC and CVD outcomes in the subgroup aged < 65 years or the diabetes subgroup. Conclusions: In this large-scale and long-term follow-up cohort study, participants with higher RC levels had a significantly worse prognosis, especially for the subgroup aged 35–65 years or the diabetes mellitus subgroup.

Effect of virgin olive and Pistacia Lentiscus oils fortified with tomato lycopene on biochemical parameters in Wistar rats

Background: Pistacia lentiscus oil (PLO) and virgin olive oil (VOO) contain a large variety of phytochemicals providing beneficial effects. Lycopene is the main carotenoid with antioxidant properties. The consumption of lycopene containing foods may fight against cardiovascular diseases. Aims: The present study aims to evaluate the effects of fortified oils (VOO and PLO) with lycopene on some biochemical parameters in Wistar rats. Material and Methods: The experimentation included 50 male Wistar rats from the Algerian Pasteur Institute for the duration of 9 weeks of treatment. Rats were divided into five experimental groups (n=10) and fed a different experimental diet each for 9 weeks: control group (C), Pistacia lentiscus oil group (PLO), lycopene-enriched Pistacia lentiscus oil group (PLO-Lyc), virgin olive oil group (VOO) and lycopene-enriched virgin olive oil (VOO-Lyc). Total Cholesterol (TC) concentration was determined by the enzymatic method CHOD-PAP, High-density lipoprotein-cholesterol (HDL-C) with Biotrol diagnostic, the levels of low-density lipoprotein-cholesterol (LDL-C) were calculated using the Friedewald formula (LDL-C=TC−HDL-C−TGs/5). Triglycerides (TG) were determined by the enzymatic method PAP-1000 and Serum phospholipids (PL) were determined by an enzymatic colorimetric method. The plasma atherogenic index (PAI) was calculated as (TC/HDL-C). Results: Results showed that ingestion of PLO and VOO diminished TC, LDL-C, TG, and PL levels, whereas the HDL-C levels raised in all the groups assayed. Moreover, the lowest level of plasma atherogenic index (PAI) was shown in the VOO-Lyc group after 3, 6, and 9 weeks of treatment. Conclusions: The enrichment of PLO and VOO with lycopene improved the beneficial effects derived from the consumption of both oils on serum biochemical parameters. These findings suggest that lycopene enriched PLO and VOO may be used as a natural product to defend against some cardiovascular diseases (CVD) as hyperlipidemic and hypercholesterolemic acquired disorders. Keywords: lycopene, Pistacia lentiscus oil, virgin olive oil, LDL-C, HDL-C, triglycerides.

Comparing Calculated LDL with Direct Method: A Retrospective, Real-World Evidence Study on Diagnostic Lab Reports from A Single Center in India

Objective: To compare and validate the calculated LDL values from Friedewald and Anandaraja formulas with directly measured values in the Indian population. Material and Methods: The study was conducted on randomly selected 102 individuals of 16 to 88 years of age during December 2019. The direct LDL values were measured using selective solubilization assay, and Friedewald and Anandaraja formulas were used to calculate LDL for comparison. The correlations between direct and calculated methods were assessed using the linear regression method. Receiver operating characteristic analysis with nonparametric distribution was used to compare the sensitivity and specificity of the three methods. Results: The average LDL of direct method, 107.3 mg/dL, Friedewald formula, 89.7 mg/dL, and Anandaraja was 99.0 mg/dL. The relation between direct and calculated values assessed by linear regression showed 97% and 87% of correlation with Friedewald and Anandaraja, respectively. The ROC analysis inferred that direct (AUC 0.74; 95% CI 0.64-0.83) and Friedewald (AUC 0.71; 95% CI 0.61-0.81) methods had shown about 70% efficiency in predicting true positive and true negative dyslipidemia cases. In our dataset, the Anandaraja formula could not well differentiate positives from negative cases of dyslipidemia with merely 60% AUC. Conclusion: The underpredicted values from the Friedewald formula were associated with deranged cholesterol and HDL values, not triglycerides. Anandaraja formula overpredicted by 10 to 30 mg/dL when triglycerides were &lt;150 mg/dL and underpredicted by 10-43 mg/dL while non-HDL was &gt;140 mg/dL.

Apolipoprotein B/A1 ratio as a potential marker of cardiovascular risk in women

Background: There has been a significant steady rise in the prevalence of cardiovascular disease (CVD) among Nigerian women within the last decade. The balance between pro-atherogenic particles and antiatherogenic particles has been markedly reflected in the apolipoprotein B/A1 ratio (Apo B/A1), and this ratio has been shown to be the strongest single lipoprotein-related cardiovascular risk factor. The cutoff value for the apo B/A1 ratio that defines high cardiovascular risk has been proposed to be 0.8 for women. This study is to determine the apo B/A1 ratio in apparently healthy Nigerian women and to evaluate the relationship of this ratio with other lipid indices. Methods: A total of 161 apparently healthy female adults between the ages of 30 and 66 years were selected for this study over a period of 6 months. Plasma total cholesterols (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) were measured using the enzymatic methods, whereas low-density lipoprotein cholesterol (LDL-C) was calculated using the Friedewald formula. Apolipoprotein A1 and B were determined using immunoturbidimetry methods. Results: The mean of plasma apo B/A-I ratio in the studied participants was 0.68, with values ranging from 0.27 to 1.46. The percentage of participants with the apoB/apoA-I ratio exceeding 0.8 (the cutoff value for CVD risk) was 24.2%. The participants with apoB/apoA-I &gt;0.8 were characterized by higher mean TC (216 mg/dl vs. 171 mg/dl; P &lt; 0.001), TG (80 mg/dl vs. 66 mg/dl; P = 0.007), LDL-C (163 mg/dl vs. 120 mg/dl; P &lt; 0.001), and lower HDL-C (36 mg/dl vs. 43 mg/dl; P &lt; 0.001) compared with women with apoB/apoA-I &lt; 0.8. Conclusion: This study has demonstrated that the women with apo B/A1 &gt;0.8 have worse atherogenic lipid profile (high plasma TC, TG, low-density lipoprotein cholesterol, and low high-density cholesterol). It has also shown that only the apoB/A-I ratio correlates with other lipid markers; it should be considered as a potential useful tool in cardiovascular risk assessment in women. Its potential use in the national guideline for assessment and management of dyslipidemia will be invaluable.

Which LDL Value Should Clinicians Look at?

Objectives LDL cholesterol is routinely estimated by the Friedewald formula to guide the treatment of dyslipidemia. However, Friedewald equation has certain limitations, especially with high triglyceride levels. Direct methods are available for LDL estimation but have received relatively little scrutiny in the Indian setting. This study was aimed at comparing the calculative and direct methods of LDL estimation in Indian hyperlipidemic patients. Materials and Methods In this observational study, data from 380 consecutive lipid profiles of patients visiting a tertiary care hospital in Mumbai were analyzed retrospectively. CHOD PAP method was used to estimate total cholesterol. Enzymatic colorimetric method was used to estimate triglycerides. Enzyme selective protection method was used to estimate HDL. Direct LDL was estimated by homogenous enzymatic colorimetric assay and very low-density lipoprotein was calculated, whereas Friedewald’s formula was used to derive calculated LDL. Results Total cholesterol values correlated positively with the LDL values measured by both methods. However, a statistically significant difference was noted between the correlation coefficients of both the methods. Triglyceride values correlated weakly with the LDL levels measured by both the methods. A weak negative correlation was observed with LDL by the calculated method, whereas a weak positive correlation existed between TG and LDL by the direct method. The difference between the correlation coefficients was statistically significant. Conclusion Both direct and calculated methods of LDL estimation have their limitations. A robust study with a larger sample size is needed to further investigate whether the differences in the different LDL estimation methods can translate to “clinical relevance” in the Indian setting.