HDL Ratio Research Articles

Gender-specific association between a lipid composite index and asthma among US adults: insights from a population-based study

BackgroundAbnormalities in lipid metabolism are common among adult asthmatics. However, the precise directionality linking asthma to blood lipid levels remains controversial. Our study aimed to evaluate the association between the Non-HDL to HDL Ratio (NHHR), a lipid composite index, and asthma prevalence among the adult population in the United States.MethodsUtilizing adult participants’ data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2009 to 2018, the study employed a multivariable logistic regression model, adjusting for covariables, to establish the relationship between NHHR levels and the prevalence of asthma. Furthermore, smoothing curve fitting and subgroup analyses were conducted to investigate the robustness of this association.ResultsThis study included 26,023 adult individuals (mean age = 49.63 ± 17.66). In the fully adjusted model, a significant inverse association was observed between log-transformed NHHR values and asthma prevalence (OR = 0.85, 95% CI: 0.79–0.93). Subgroup analysis revealed that gender served as a modulator, altering the association between NHHR levels and asthma prevalence. A more pronounced negative association between lnNHHR and asthma prevalence was noted among male participants [(Male: OR = 0.78, 95% CI: 0.69–0.88) vs. (Female: OR = 0.92, 95% CI: 0.83–1.03), P for interaction = 0.0313].ConclusionsOur study revealed an inverse association between NHHR levels and the prevalence of asthma in the US adult population, which is influenced by gender. NHHR measurement may be a potential tool for early identification and prediction of adult asthmatics in specific populations.

Proteomics in low CVD risk black women living with HIV: H-ART to Heart Study

Abstract Background 39 million people worldwide are living with HIV (human immunodeficiency virus), acquired immune deficiency syndrome (AIDS)-related deaths have reduced by 51% since the peak in 2004. BWLWH represent 42% of those infected but only 9% are represented in clinical trials. HIV/AIDS has been shown to be associated with the development of heart failure, pulmonary hypertension and myocarditis. Previous studies in asymptomatic PLWH have revealed a high burden of underlying CVD and subclinical disease. The H-ART to Heart study is designed to examine potential signals and pathways of cardiovascular disease (CVD) in asymptomatic BWLWH with no traditional CV risk factors compared to HIV negative controls (-). Methods A cross-sectional study comparing asymptomatic BWLWH aged 35-55yrs (diagnosed >10 yrs, with undetectable viral loads) to HIV negative controls. Black African/Caribbean women without known CV risk factors (hypertension, hyperlipidaemia, diabetes, smoking, inflammatory arthritis, depression, severe mental illness) or hepatitis co-infection were included. Assessment included blood pressure (BP), 10yr CVD risk calculation % (Q-Risk 3), bloods including lipids. A targeted discovery proteomics approach was used to evaluate 92 unique proteins using the O-link Target 96 Cardiovascular II panel. Results 48 participants were recruited (23 BWLWH; 25 controls), mean duration of HIV was 17.6 years, mean duration of ART was 11.5 years, demographic details - Age 47.7± 44.7±; p=0.06, BP 125/77 v 123/79 ; p=0.89; BMI (kg/m²) 30.1±5.1 v 28.51±4.27 p=0.25; cLDL 3.49±1.22 v 2.42±0.74 p<0.02; Total Chol:HDL ratio 3.01±0.98 v 2.77±0.56 p=0.353; Q-Risk 3 1.92%±1.27 v 1.49%±1.12 p=0.219; There were no significant differences in baseline data apart from higher mean cLDL in BWLWH. Of the 92 proteins tested, 9 were significant in BWLWH (Figure 1). As demonstrated by the Heat map. Conclusion Data from our study of asymptomatic low risk BWLWH with no CVD risk factors indicates several pathways (Figure 2.) for further investigation in this previously under investigated vulnerable patient sub group. Whether this finding is of importance in CV risk assessment of BWLWH remains to be seen.

The added value of device measured physical activity to the prediction of incident cardiovascular disease.

Abstract Background Conventional risk prediction models for Major Adverse Cardio/Cerebrovascular Events (MACCE) primarily rely on non-modifiable factors such as age, sex, and physiological measurements, including LDL/HDL cholesterol and blood pressure readings, that are prone to variations across medical practices and are often unavailable in many parts of the world. In this study, we investigate the potential of inexpensive wearable measurements of physical activity to enhance MACCE prediction when physiological measurements are unavailable. Purpose To assess the added value of physical activity measurements, collected via wrist-worn accelerometers, to established cardiovascular risk prediction models. Additionally, we seek to investigate whether physical activity measurements can substitute for common physiological measurements in established cardiovascular risk models. Methods We obtained accelerometer-measured physical activity over 7 days between 2013 and 2015 from 69,898 UK Biobank (UKB) participants without a prior history of MACCE, defined as death or hospitalisation due to (1) myocardial infarction, (2) heart failure, or (3) Stroke/transient ischaemic attack. We assessed the added value of daily step counts, sleep duration, and a deep learning-derived activity health score (Fig 1), calculated from complete 7-day accelerometer recordings, to established clinical risk models (SCORE2, QRISK3 and AHA) before and after excluding measurements of cholesterol and systolic blood pressure (SBP). The primary outcome was the first recorded MACCE within 6 years. Risk scores were developed in men and women using Cox proportional hazards models. We assessed predictive performance using Harrel’s C-index, net reclassification index (NRI), and net benefit at the recommended treatment threshold for each model. Results Of the 69,898 UKB participants in the study, 3,386 (4.8%) experienced a MACCE over a 6-year follow-up period. In place of HDL ratio and SBP, the addition of deep-learned activity health scores modestly improved performance in the best clinical baseline, QRISK3 for Female participants ΔC-index women:0.003 (95% CI 0.002-0.004); Δnet benefit 0.02(0.01-0.03); NRI 0.04, (0.02-0.07), and outperformed manually extracted steps and sleep measurements. We report no significant improvements for men. We find a greater increase in model performance when both HDL ratio and SBP, plus activity health scores, are included in the model. ΔC-index women:0.008, (0.007-0.009); men: 0.003 (0.002-0.004) (Fig 2). Conclusion Our findings indicate that in the absence of cholesterol and systolic blood pressure, the addition of device-measured physical activity modestly improves the performance of clinical risk scores among individuals without prior cardiovascular disease (CVD). These findings could further refine intervention strategies for targeted prevention of CVD, particularly in settings where physiological measurements may be unavailable.

Inflammatory biomarkers and clinical adverse effects associated with Isotretinoin treatment: A prospective study

Background Isotretinoin is considered now one of the most important drugs in the treatment of different dermatological diseases. However, different body systems can be affected during the treatment due to isotretinoin induced apoptosis. Objectives To evaluate the clinical adverse effects and laboratory changes associated with isotretinoin used in the treatment of different dermatological diseases. Methods 73 patients on isotretinoin treatment fulfilled a questionnaire about side effects associated with isotretinoin. Complete blood count (CBC), fasting lipid profile, liver enzymes, and the inflammatory markers Monocytes/HDL ratio (MHR), Neutrophil/lymphocyte (NLR), and Platelets/lymphocyte ratios (PLR) were assessed before treatment and monthly during the treatment period. Results The commonest adverse effects were related to dryness of skin and mucus membrane. 32.9% complained of myalgia and 12.3% arthralgia. Headache was reported in 13.7%, mood alteration in 11%, and insomnia in 12.3%. 24.5% of studied females reported menstrual irregularities. There were no statistically significant changes in CBC. TG, cholesterol, AST, ALT, and MHR significantly increased while HDL, NLR and PLR ratios significantly decreased after isotretinoin treatment. Conclusion: isotretinoin affects different body systems by side effects that are reversible in most instances; however, some of them are serious and need regular monitoring especially in high- risk patients.

Effect of fibromyalgia on demographic, biochemical, metabolic and inflammatory profiles: a single-centre retrospective study.

The objective of this study is to ascertain the disparities in demographic features and biochemical profiles between individuals diagnosed with fibromyalgia (FM) and a control group of healthy individuals. This retrospective, cross-sectional study compared the demographic, biochemical, metabolic, and inflammatory indexes and rates of 174 FM patients diagnosed using the American College of Rheumatology 2016 diagnostic criteria between January 2023 and January 2024, and 186 healthy control groups. There was no difference between the FM and control groups in terms of alcohol consumption, marital status, or diabetes mellitus. The smoking rate is higher, and the educational level was found to be lower for FM versus the control. There was no significant difference between FM and controls regarding waist-height ratio, triglyceride-glucose index, plasma atherogenic index, vitamin B12, and folate levels. Monocyte HDL ratio, cardiometabolic index, magnesium, HbA1c, and ferritin levels were significantly higher in the control than in FM (p<0.001, p=0.039, p=0.007, p<0.001, p<0.001, respectively). C-reactive protein, erythrocyte sedimentation rate, systemic immune-inflammatory index, neutrophil-lymphocyte rate, platelet lymphocyte rate, and vitamin D levels were found to be higher in FM compared to control (p=0.001, p=0.032, p=0.003, p=0.030, p=0.003, p<0.001, respectively). A weak positive correlation was observed between the fibromyalgia impact questionnaire (FIQ) score and disease duration, as well as between pain degree and ESR, and pain degree and CRP. The study revealed a weak inverse relationship between Widespread Pain Index (WPI) and waist circumference. This study highlights fthe association f ibromyalgia with elevated inflammatory markers, altered metabolic parameters, and specific demographic characteristics.

Uric Acid/ HDL Ratio as a Marker of Disease in Coronary Artery Ectasia Versus Normal Coronaries

Uric Acid/ HDL Ratio as a Marker of Disease in Coronary Artery Ectasia Versus Normal Coronaries

A combined observational and Mendelian randomization investigation reveals NMR-measured analytes to be risk factors of major cardiovascular diseases

Dyslipidaemias is the leading risk factor of several major cardiovascular diseases (CVDs), but there is still a lack of sufficient evidence supporting a causal role of lipoprotein subspecies in CVDs. In this study, we comprehensively investigated several lipoproteins and their subspecies, as well as other metabolites, in relation to coronary heart disease (CHD), heart failure (HF) and ischemic stroke (IS) longitudinally and by Mendelian randomization (MR) leveraging NMR-measured metabolomic data from 118,012 UK Biobank participants. We found that 123, 110 and 36 analytes were longitudinally associated with myocardial infarction, HF and IS (FDR < 0.05), respectively, and 25 of those were associated with all three outcomes. MR analysis suggested that genetically predicted levels of 70, 58 and 7 analytes were associated with CHD, HF and IS (FDR < 0.05), respectively. Two analytes, ApoB/ApoA1 and M-HDL-C were associated with all three CVD outcomes in the MR analyses, and the results for M-HDL-C were concordant in both observational and MR analyses. Our results implied that the apoB/apoA1 ratio and cholesterol in medium size HDL were particularly of importance to understand the shared pathophysiology of CHD, HF and IS and thus should be further investigated for the prevention of all three CVDs.

The metabolic health of New Zealand vegans

The popularity of a vegan diet is growing worldwide. Data analysed from the 2018 NZ Attitudes and Values study showed that 1.1% of New Zealanders followed a vegan diet(1). Though there are potential nutrient deficiencies in a vegan diet, it is generally accepted that a vegan diet, with its emphasis on a variety of vegetables, fruit, grains, legumes, and pulses, has greater metabolic benefits than a Western-style diet high in red meat and processed foods and lower in plants(2). This observational cross-sectional study aimed to explore the dietary intake (4-day food diary) and metabolic health status (including anthropometry, blood pressure, lipids, body fat percentage, omega-3 index and glycaemic control) of adults who had been consuming a vegan diet for 2+ years. Participants (N = 212) were predominantly female (N = 155) with a mean (SD) age of 39.5 (12.4) years. Mean cardiometabolic markers of systolic and diastolic blood pressure, BMI, waist circumference, HbA1c, total cholesterol, LDL-cholesterol, HDL-cholesterol, Chol:HDL ratio and triglycerides were all below the thresholds for disease risk. Omega-3 index results &lt;4% placed most participants (86.3%) in the high-risk category for heart disease. Many female participants (71%) had &gt;30% body fat, compared to 5.3% of males. With reference to the AMDR (total fat 20-35%, carbohydrate 45-65% and protein 15-25%), the intake of total fat was at the upper end (males 34.4%, females 35.9%), carbohydrate was at the lower end (males 46.2%, females 44.7%), and protein was below the lower end (males 14.9%, females 14.2%). Saturated fat intakes ranged from 4.0-65.9 g/d, with a mean (SD) of 24.9 (10.5) g/d for males and 20.2 (9.9) g/d for females. The mean (SD) dietary fibre intake was much higher than the AI set by the Ministry of Health of 25g/d for females and 30g/d for males, at 55.0 (17.8) g/d for males and 43.4 (12.8) g/d for females, ranging from 10.9-133.9g/d. This is the first New Zealand study to examine the metabolic health and dietary intake of adult vegans. The results of cardiometabolic health markers indicate that the vegan diet confers cardioprotective benefits. However, the low Omega-3 index of most participants is concerning, which warrants longitudinal research to assess the level of risk conferred by a low Omega-3 index result in a population with no other cardiometabolic risk factors. The findings of the present study may help guide the growing New Zealand vegan community towards a nutritionally optimal vegan diet.

Patients with Coronary Heart Disease with Lipid Profile

Background: The lipid profile and their ratio are important in management and follow up of patients with coronary heart disease. We studied the lipid profile and their ratios with proven coronary artery disease. Methods: It was retrospective study to determine the lipid profile and their ratios in patients with proven coronary artery disease at Shakuntala Pathology Lab., Nagpur. 200 patients were studied. Results: Out of 200 patients studied, 126 (63%) were males while 74 (37%) were females. out of 126 males,12 (9.52%) had raised cholesterol values of &gt;200 mg/dL. 20 (15.87%) had raised triglyceride values of &gt;200 mg/dL. 30 (23.80%) had lower HDL values of 150 mg/dL. 90 (71.42%) had raised values of &gt;3.5 for cholesterol to HDL ratio. Out of 74 female patients, 20 (27.02%) patients had raised cholesterol values. 12 (16.21%) patients had raised triglycerides values. 13 (17.56%) patients had lower HDL values. 6 (8.10%) patients had raised LDL values. 50 (67.56%) patients had raised values for cholesterol to HDL ratio. Conclusions: Our study shows more prevalence of coronary heart disease in males than females. Hypercholesteremia and hypertriglyceridemia was more prevalent in females. HDL values were lowered in more number of males than females. LDL values were raised in more number of females than males. Total cholesterol to HDL ratio was raised in more number of males than females.

Increased skeletal muscle mass index was involved in glycemic efficacy following diabetes treatment, and changes in fat mass index correlated with the changes in the lipid ratio in type 2 diabetes

AimThis study aimed to investigate the association between changes in body composition, glycated hemoglobin, and lipid ratio during the treatment of patients with type 2 diabetes mellitus (T2DM). MethodsThis retrospective analysis used data from outpatients with T2DM who had confirmed body composition and measured laboratories at administration and after treatment. The baseline characteristics and prescribed treatment were collected. The total cholesterol/high-density lipoprotein cholesterol (HDL) ratio, low-density lipoprotein cholesterol (LDL)/HDL ratio, and triglyceride–glucose (TyG) index were also calculated. ResultsA total of 207 patients (mean patient age, 62.0 ± 13.7 years; 68.1 % males) were enrolled. Fat mass index (FMI) changes correlated with the changes in the lipid ratio, whereas skeletal muscle mass index (SMI) changes inversely correlated with glycated hemoglobin (HbA1c) changes. Multiple regression analysis showed that changes in LDL/HDL and TyG correlated with FMI changes (t = 2.388, p = 0.017, t = 2.022, p = 0.044). Conversely, HbA1c changes correlated with SMI changes (t = −2.552, p = 0.011). ConclusionIn patients with T2DM, increased SMI was involved in glycemic efficacy, and FMI changes were associated with LDL/HDL and TyG.

The correlation between stress score. Quality and duration of sleep with lipid profile and glycemic status.

Diabetes (DM) is a disease of global concern. Studies have suggested that sleep disturbance is affiliated with insulin resistance and poor lipid. Impaired glucose tolerance precedes the diabetic state and we are aware that the blood glucose levels are deranged in these patients, but not much research is done to comment on the pattern of lipid abnormalities, sleep quality and stress in these patients. Hence our study is aimed to identify abnormal patterns or similarities in the above parameters in pre diabetic and diabetic groups. This is a cross - sectional study carried out at the tertiary care hospitals.The data of 45 pre diabetic and diabetic (30 to 70 years) were collected from the files history from Medical Records Department (MRD) after taking permission. The following parameters like glucose and lipid parameters were taken for the study and standard questionnaire was given to correlate the sleep and stress levels. Data analysis were done using SPSS (Statistical Package for Social Sciences) version write the verson number). In the pre diabetic participants, sleep duration varied with stress levels (p=0.03) and their HDL was positively correlated to HbA1c (p=0.02) In the diabetic participants, TC (total cholesterol) varied with both stress (p=0.02) and sleep quality (p=0.001), LDL,& TC: HDL ratio varied only with sleep quality (p=0.04 ratio quality (p=0.01). Triglyceride levels were significantly higher in the diabetic group (p=0.04), as it is a major component of the triad of diabetic dyslipidemia. No other correlations or variations were significant. Poor sleep, abnormal lipid profiles, and stress may serve as risk factors predicting the onset of prediabetes and poor glycemic control. Confirming a direct relationship between these parameters through cohort or experimental studies could facilitate early detection of diabetes and encourage the adoption of appropriate healthy lifestyle measures.

Changes in the chronic and postprandial blood lipid profiles of trained competitive cyclists and triathletes following a ketogenic diet: a randomized crossover trial

BackgroundThe ketogenic diet (KD) is the most popular carbohydrate restriction strategy for endurance athletes. However, because the primary goal of employing the KD is to gain a competitive advantage in competition, endurance athletes may be less concerned with the influence of the KD on their cardiometabolic health; particularly their blood lipid profiles. Thus, the purpose of this study was to examine the chronic and postprandial blood lipid alterations following a two-week ad libitum KD compared to an ad libitum high-carbohydrate diet (HCD) and the athletes’ habitual diet (HD) in a group of trained competitive cyclists and triathletes.MethodsSix trained competitive cyclists and triathletes (female: 4, male: 2; age: 37.2 ± 12.2) completed this randomized crossover trial, which required them to follow a two-week ad libitum KD and HCD in a randomized order after their HD. Fasting blood lipids were collected following their HD and after two-weeks of the KD and HCD conditions. Postprandial blood lipid responses to a test meal reflective of the assigned diet were collected at the end of each diet condition.ResultsFasting total cholesterol (TC) was significantly higher following the KD compared to the HD (p < 0.001) and HCD (p = 0.006). Postprandial incremental area under the curve for triglycerides (TRG), TRG:HDL ratio, and VLDL-C were significantly higher following the KD test meal compared to the HD (all p < 0.001) and HCD (all p = 0.001) test meals but LDL-C and LDL:HDL ratio were significantly lower following the KD compared to the HD and HCD test meals (all p < 0.001).ConclusionsTrained competitive cyclists and triathletes demonstrate increased TC in response to a two-week KD compared to a HCD or HD. Endurance athletes contemplating a KD should consider the potential for these blood lipid alterations, and future research should focus on postprandial blood lipid responses to determine if these changes manifest in chronic blood lipid shifts.Trial registrationClinicalTrials.gov Identifier: NCT04097171 (11 October 2019).

Association between cheese and fish consumption and the occurrence of depression based on European population: mediating role of metabolites.

The consumption of cheese and fish has been linked to the onset of depression. However, the connection between consuming cheese, consuming fish, experiencing depression, and the pathways that mediate this relationship remains unclear. The purpose of this research was to investigate the potential association between the consumption of cheese and fish and the occurrence of depression. Moreover, it is important to identify any metabolites that might be involved and understand their respective roles and functions. A two-step, two-sample Mendelian randomization (MR) study was conducted using genome-wide association study (GWAS) data on cheese, non-oily fish, and oily fish consumption and depression, along with 12 alternate mediators. The study included a total of 451,486 participants in the cheese consumption group, 460,880 in the non-oily fish consumption group, 460,443 in the oily fish consumption group, and 322,580 with a diagnosis of depression. The single nucleotide polymorphism (SNP) estimates were pooled using inverse-variance weighted, weighted median, MR-Egger, simple mode, and weighted mode. The data we collected suggested that consuming more cheese correlated with a lower likelihood of experiencing depression (OR: 0.95; 95% CI: 0.92 to 0.98). Neither non-oily fish nor oily fish consumption was directly linked to depression onset (p = 0.08, p = 0.78, respectively). Although there was a direct causal relationship with depression, the mediating relationship of triglycerides (TG), total cholesterol in large HDL, cholesterol to total lipids ratio in large HDL, free cholesterol to total lipids ratio in large HDL, glycine, and phospholipids to total lipids ratio in very large HDL of cheese intake on depression risk were - 0.002 (95% CI: -0.023 - 0.020), -0.002 (95% CI: -0.049 - 0.045), -0.001 (95% CI: -0.033 - 0.031), -0.001 (95% CI: -0.018 - 0.015), 0.001 (95% CI: -0.035 - 0.037), and - 0.001 (95% CI: -0.024 - 0.021), respectively. The mediating relationship of uridine, free cholesterol to total lipids ratio in large HDL, total cholesterol in large HDL, acetoacetate, and 3-hydroxybutyrate (3-HB) between non-oily fish consumption and depression risk were 0.016 (95% CI: -0.008 - 0.040), 0.011 (95% CI: -1.269 - 1.290), 0.010 (95% CI: -1.316 - 1.335), 0.011 (95% CI: -0.089 - 0.110), and 0.008 (95% CI: -0.051 - 0.068), respectively. The mediation effect of uridine and free cholesterol to total lipids ratio in large HDL between intake of oily fish and the risk of depression was found to be 0.006 (95% CI: -0.015 - 0.028) and - 0.002 (95% CI: -0.020 - 0.017), respectively. The correlation between eating cheese and experiencing depression persisted even when adjusting for other variables like Indian snacks, mango consumption, sushi consumption, and unsalted peanuts using multivariable MR. The consumption of cheese and fish influenced the likelihood of experiencing depression, and this may be mediated by certain metabolites in the body. Our study provided a new perspective on the clinical treatment of depression.

Low serum HDL-cholesterol is associated with increased risk of the subcortical small vessel type of dementia

BackgroundThere are conflicting results whether serum lipid pattern is related to the amount of white matter hyperintensities (WMHs) on magnetic resonance imaging. Little is known of the associations between lipid concentrations and the subsequent risk of the subcortical small vessel type of dementia (SSVD), in which WMHs are a prominent manifestation. Here, we determined whether lipid levels are associated with the risk of SSVD, Alzheimer's disease (AD), or mixed dementia (combined AD and SSVD). MethodsThis was a longitudinal, prospective study of 329 patients with subjective or objective mild cognitive impairment at baseline. The statistical analyses included Cox proportional hazards regression with adjustments for age, gender, education, body mass index, current smoking, hypertension, diabetes mellitus, and APOE ε4 genotype. ResultsDuring the follow-up (mean 4.1 years), 80 patients converted to dementia [SSVD, n = 15 (5 %); AD, n = 39 (12 %); and mixed dementia, n = 26 (8 %)]. Serum high-density lipoprotein cholesterol (HDL, per SD increase) was inversely associated with the risk of SSVD, whereas triglycerides (TG), low-density lipoprotein cholesterol (LDL)/HDL ratio, and TG/HDL ratio were positively associated with SSVD risk. Furthermore, the lowest HDL tertile was associated with a sevenfold, and the highest tertile of TG/HDL ratio with a threefold, increase in SSVD risk. There were no associations with the risk of AD or mixed dementia after adjustment for covariates. ConclusionIn a memory clinic population, low HDL and high TG/HDL ratio were independent risk factors of SSVD, but not of AD or mixed dementia.

The role of metabolic factors in the association between obesity and cholelithiasis: A two-step, two-sample multivariable mendelian randomization study

Background and purposeThe extent to which the effects of BMI on cholelithiasis are mediated by metabolic factors (including blood pressure, blood lipids, body mass, and fasting blood glucose) is unclear. Therefore, in this study, the authors used genetic evidence to test the effects of these characteristics. MethodsSummary-level data for exposures and main outcomes were extracted from GWAS consortia. The authors used a two-step, two-sample Multivariable Mendelian Randomization (MVMR) analysis to illustrate the effect of BMI on cholelithiasis and a stepwise test method to quantify the possible mediating effects of cardiometabolic factors on cholelithiasis. ResultsFor each one-unit logarithmic increase in body mass index, the risk of cholelithiasis increased by 98 % (Odds Ratio [OR = 1.98], 95 % CI: 1.73 %‒2.28 %). After mediation analysis, the authors found that high-density lipoprotein and triglycerides were the main mediating factors, while the mediating effects of other metabolic factors were not significant. The total effect ratios of HDL and TG on cholelithiasis were 7.3 % (95 % CI: 8.51 %‒12.85 %) and 3.5 % (95 % CI: 3.59 %‒6.50 %), respectively. HDL and TG played a significant role in regulating cholelithiasis, but there was no evidence to show the regulatory effect of LDL on cholelithiasis. The total effects of BMI and triglycerides on cholelithiasis were 10.7 % and 5.0 %, respectively. ConclusionThe authors found that among the metabolic factors evaluated, the decrease of HDL and the increase of TG mediated a high proportion of the effect of BMI on cholelithiasis. Therefore, intervention with these factors may reduce the increased risk of cholelithiasis in patients with high BMI.

Correlation of Glycated Hemoglobin with Serum Triglyceride to High Density Lipoprotein Ratio in Type 2 Diabetes Mellitus Patients

Introduction: Diabetes mellitus is an endocrine disorder characterized by hyperglycemia. It may be due to a defect in insulin secretion or action or both. Importantly, lipid metabolism is also abnormal in diabetes such as an increment of TG level and reduction in plasma HDL level which is the major cardiovascular risk. Glycated hemoglobin is measured to monitor the long-term glycemic status of the patients.Materials and Methods: The current study is designed retrospectively to find out the correlation between HbA1C and TG to HDL ratio. The data onthe lipid profile of newly diagnosed diabetes mellitus were retrieved from the laboratory software of National Medical College, a tertiary care hospital in Madhesh province, Nepal. The categorical data were expressed in frequency and percentage and continuous data were expressed in mean and standard deviation depending on their distribution. Pearson correlation analysis was used to correlate the glycated hemoglobin and TG to HDL ratio. Results: The current study investigated the diabetic and lipid profile in 604 retrospectively enrolled patients. Out of which 358 (59.3%) were diabetic and 246 (40.7%) were healthy subjects.The comparison of serum lipid levels between diabetes and healthy subjects revealed a significant difference concerningTriglycerides, total cholesterol, HDL, LDL, and VLDL (P value less than 0.05). The correlation analysis revealed a significant positive correlation betweenTG/HDL ratio and glycated hemoglobin (0.09, 0.02).Conclusion: Our results revealed the correlation between HbA1C and TG/ HDL ratio in the Nepalese diabetic population. Hypertriglyceridemia was common in diabetic patients. Elevation of the TG/HDL ratio aggravates the cardiovascular risks in the diabetic patients.

Chemerin: A Novel Biomarker of Coronary Artery Disease

Introduction: Dysregulated secretion of adipokines causing adipose tissue dysfunction can contribute to the pathogenesis of obesity-linked complications like atherosclerosis. Chemerin, a newly discovered adipokine, secreted by visceral adipose tissue and liver, is involved in the regulation of glucose and lipid homeostasis. Elevated levels of chemerin in the blood have been associated with atherosclerosis and coronary artery disease. Aim: To examine the chemerin levels in coronary artery disease (CAD) patients, to determine its association with CAD, and to find the correlation of chemerin with HsCRP and other lipid parameters. Materials and Method: This is a cross-sectional study that included 100 participants divided into two groups namely, group I comprising CAD patients, and group II healthy individuals. Serum levels of chemerin were measured by ELISA. HsCRP were measured by immunoturbidimetry method. Atherogenic index of plasma (AIP), LDL and TC/ HDL ratios were calculated parameters. Results: Chemerin levels were significantly increased in CAD patients (48.66 ± 12.7) (ng/ml) compared to healthy controls (32.92 ± 17) (ng/ml) (p = 0.04). AIP was significantly increased in CAD patients (6.92 ± 3.10) compared to healthy controls (3.27 ± 1.42) (p = 0.000). Chemerin had a good correlation with AIP (p = 0.001). Logistic regression analysis showed a significant association of chemerin with the occurrence of CAD (OR = 1.09, 95% CI, p = 0.004). ROC curve obtained with the area under the curve being 0.79. Conclusion: Chemerin, a pro-inflammatory adipokine, could play an important role in atherosclerosis and can be used as a marker for the diagnosis of CAD patients

Uric acid to HDL ratio: A marker for predicting incidence of metabolic syndrome in patients with type II diabetes

Background and aimMetabolic syndrome (MetS) refers to existence of a set of risk factors for developing cardiovascular disease and diabetes. Recently, uric acid to HDL ratio has attracted attention in predicting development of diabetes and incidence of metabolic syndrome in diabetic individuals. This study was performed to investigate UHR in patients with type II diabetes as a predicting factor for metabolic syndrome. Methods and resultsThis descriptive-analytical study examined 300 patients with type II diabetes referring to diabetes clinic of Ali-Ibn Abi-Talib hospital, Rafsanjan city in 2021, selected through convenient sampling. Data were collected by a research-made checklist (including demographic, clinical and laboratory parameters) and analyzed by SPSS 24 and chi-square, Fisher exact test, independent paired t-test, one-way analysis of variance (ANOVA), Mann-Whitney U, and receiver operating characteristic (ROC). The findings revealed that 74.33 % (95 % CI: 69 to 79.18 %) of the patients had metabolic syndrome. Further, patients with metabolic syndrome demonstrated a significantly higher mean UHR ratio and triglyceride levels compared to their counterparts without the syndrome (p = 0.002 and p < 0.001, respectively). The ROC analysis identified a UHR threshold of 8.118 % with a sensitivity of 70.32 % and specificity of 55.08 % for diagnosing metabolic syndrome development in type II diabetes (AUC: 0.621, P = 0.001, 95%CI: 0.549–0.694). ConclusionThe results of the present study revealed that the prevalence of metabolic syndrome was high in diabetic patients. UHR showed good sensitivity in the diagnosis of metabolic syndrome in type II diabetes. Thus, regular monitoring of laboratory tests is recommended in patients with diabetes.

Association between normal-weight obesity and cardiometabolic risk factors among adults in Addis Ababa, Ethiopia

The relationship between normal-weight obesity (NWO)—high percent body fat (%BF) in individuals with normal body mass index (BMI)—and cardiometabolic abnormalities has not been explored in Africa. We determined the prevalence of the NWO and evaluated its association with hypertension, elevated blood sugar and dyslipidaemia among adults in Addis Ababa, Ethiopia. A cross-sectional study was conducted among adults 18–64 years (n = 600). Blood pressure, blood glucose, lipid profile, and anthropometric measurements were completed. As a function of skinfold thickness, body density and %BF were estimated using Durnin & Womersley and Siri Equations, respectively. The relationship between the NWO and the outcomes of interest, assessed using adjusted linear and logit models. The age- and sex-standardised prevalence of NWO was 18.9% (95% confidence interval (CI) 15.8, 22.2%). Comparison between normal-weight lean (normal %BF and BMI) and normal-weight obese individuals suggested no difference in systolic blood pressure (β = 2.55; 95% CI − 0.82, 5.92); however, diastolic blood pressure (β = 3.77: 95% CI 1.37, 6.18) and odds of hypertension (adjusted odds ratio (AOR) = 2.46: 95% CI 1.18, 5.13) were significantly raised in the latter. Similarly, adults with NWO had elevated blood glucose (β = 2.30; 95% CI 1.23, 15.66) and increased odds of high blood sugar level (AOR = 1.68; 95% CI 1.05, 2.67). LDL (β = 8.73: 1.56, 15.90), triglyceride (β = 20.99: 0.78, 41.22), total cholesterol (β = 10.47: 1.44, 19.50), and Cholesterol to HDL ratio (β = 0.65: 0.27, 1.04) were also raised among adults with NWO. NWO is common among adults in Addis Ababa and is associated with cardiometabolic derangements.

Optimized Sugar-Free Citrus Lemon Juice Fermentation Efficiency and the Lipid-Lowering Effects of the Fermented Juice.

Aging and obesity make humans more prone to cardiovascular and metabolic syndrome diseases, leading to several serious health conditions, including hyperlipidemia, high blood pressure, and sleep disturbance. This study aimed to explore the hypolipidemic effect of fermented citrus lemon juice using a hyperlipidemic hamster model. The sugar-free lemon juice's fermentation was optimized, and the characteristics of fresh and fermented lemon juice (FLJ) were evaluated and compared, which contained polyphenols and superoxide dismutase-like activity. Results showed that the absorption and utilization efficiency of FLJ was higher compared with the unfermented lemon juice. This study's prefermentation efficiency evaluation found that 21-30 days of bacterial DMS32004 and DMS32005 fermentation of fresh lemon juice provided the best fermentation benefits, and 21-day FLJ was applied as a remedy after the efficiency compassion. After six weeks of feeding, the total cholesterol (TC) and triglyceride (TG) values in the blood and liver of the FLJ treatment groups were decreased compared with the high-fat diet (HFD) group. In addition, the blood low-density lipoprotein cholesterol (LDL-C) levels were significantly reduced in the FLJ treatment groups compared with the HFD group. In contrast, the blood high-density lipoprotein (HDL-C) to LDL-C ratio increased considerably in the FLJ treatment groups, and the total to HDL ratio was significantly lower than in the HFD group. Compared with the HFD group, the TC content in the FLJ treatment groups' feces increased significantly. This study demonstrated that the sugar-free fermentation method and fermentation cycle management provided FLJ with the potential to regulate blood lipids. Further research and verification will be carried out to isolate specific substances from the FLJ and identify their mechanisms of action.