HDL-C Levels Research Articles

The outcomes of electronic personal health records in patients with heart failure or coronary artery disease.

There are limited data on the efficacy of smartphone-based personal health records (PHRs) in patients with cardiovascular disease. This study aimed to examine the processes, outcomes and challenges associated with the implementation of integrated PHRs in patients with heart failure (HF) or coronary artery disease (CAD). This prospective single-group study evaluated the effects of a PHR system with the capability to capture electronic health records and vital signs in patients with HF or CAD. The outcomes measured were the 6-month changes in blood pressure (BP), body weight (BW), brain natriuretic peptide (BNP) levels, lipid profiles and haemoglobin (Hb) A1c levels. Between June 2021 and March 2022, we enrolled 111 patients (median age: 61years and 47% women) with CAD and/or HF. Over 6months, the PHR review count distribution was skewed: median 749 times (lowest 2, highest 5724)/180days, suggesting both low and excessive PHR users. After 3days, 23% of the patients discontinued inputting their vital signs and medication status. At 6months, compared with patients who discontinued, those who continued to input their vital signs (N=86) showed a significant decrease in their systolic BP and LDL-C levels but not in the diastolic BP, BW, BNP, HDL-C, triglyceride or HbA1c levels. The implementation of smartphone-based PHRs in daily practice is challenging for patients with HF or CAD. However, we observed positive indications of the benefits of PHR in these patients. UMIN000044369.

Lipid variability in drug-naïve individuals affected with Major Depressive Disorder: a systematic review and meta-analysis

Background This study aimed to provide a comprehensive synthesis of the evidence examining lipid profiles in drug-naïve MDD patients. Materials and methods We searched PubMed, Scopus, and ISI Web of Science up to August 2023 for total cholesterol, HDL-C, LDL-C, and triglyceride levels in drug-naïve MDD patients. Results A total of 17 articles comprising 2174 individuals including drug-naïve MDD subjects and controls were included. Our results showed that concentrations of total cholesterol were lower in drug-naïve MDD patients compared with healthy controls (SMD −0.49, 95% CI −0.881 to −0.105; p = 0.015; I2 = 90.6%). However, comparison of other lipid levels between MDD patients and healthy controls demonstrated no significant difference. The results revealed that the association of total cholesterol levels with MDD is more prominent in male-dominant studies (SMD −1.20, 95% CI −2.23 to −0.18, I2 = 87.9%) than in female-dominant studies (SMD −0.25, 95% CI −0.63–0.13, I2 = 89.0%). In meta-regression, none of the factors including year of publication, Newcastle-Ottawa Scale score, sample size, BMI, and mean age of participants had a significant influence on the association between cholesterol levels and MDD. Conclusions Lower levels of total cholesterol, especially in males, are associated with MDD, so early lipid monitoring and targeted interventions are necessary.

Chronobiological disruptions: unravelling the interplay of shift work, circadian rhythms, and vascular health in the context of stroke risk.

Shift work, particularly night shifts, disrupts circadian rhythms and increases stroke risk. This manuscript explores the mechanisms connecting shift work with stroke, focusing on circadian rhythms, hypertension, and diabetes. The circadian system, controlled by different mechanisms including central and peripheral clock genes, suprachiasmatic nuclei (SCN), and pineal gland (through melatonin production), regulates body functions and responds to environmental signals. Disruptions in this system affect endothelial cells, leading to blood pressure issues. Type 2 diabetes mellitus (T2DM) is significantly associated with night shifts, with circadian disturbances affecting glucose metabolism, insulin sensitivity, and hormone regulation. The manuscript examines the relationship between melatonin, insulin, and glucose balance, highlighting pathways that link T2DM to stroke risk. Additionally, dyslipidemia, particularly reduced HDL-c levels, results from shift work and contributes to stroke development. High lipid levels cause oxidative stress, inflammation, and endothelial dysfunction, increasing cerebrovascular risks. The manuscript details the effects of dyslipidemia on brain functions, including disruptions in blood flow, blood-brain barrier integrity, and neural cell death. This comprehensive analysis emphasizes the complex interplay of circadian disruption, hypertension, diabetes, and dyslipidemia in increasing stroke risk among shift workers. Understanding these mechanisms is essential for developing targeted interventions to reduce stroke susceptibility and improve cerebrovascular health in this vulnerable population.

2-Acetamidophenol (2-AAP) Suppresses the Progression of Atherosclerosis by Alleviating Hyperlipidemia and Attenuating the Ferroptosis Pathway

Hyperlipidemia and consequent endothelial inflammation, along with foam cell generation, promote the progression of atherosclerosis (AS). Here, we aimed to investigate the effects of 2-acetamidophenol (2-AAP), which was selected by zebrafish phenotypic screening, in alleviating AS by relieving hyperlipidemia and inhibiting foam cell formation, as well as the underlying mechanisms. In a zebrafish hyperlipidemia model, 2-AAP increased lipid-lowering efficacy; alleviated TC, TG, LDL-C, and MDA levels; elevated HDL-C and T-SOD levels; significantly improved intravascular macrophage aggregation; and improved blood flow. In an ox-LDL-induced RAW264.7 model, 2-AAP inhibited lipid phagocytosis in RAW264.7 cells; reduced the intracellular TC, TG, FC, and CE contents; and decreased the CE/TC ratio, thus slowing foam cell generation. In addition, 2-AAP alleviated intracellular ROS and ferrous ion accumulation in RAW264.7 cells, reduced the MDA content, and increased GPX4 viability. Furthermore, transcriptome analyses and gene expression validation showed 2-AAP treatment upregulates genes related to GSH synthesis and transport, such as gclc, gclm, gss, and gpx4a, and enhanced the expression levels of genes involved in the storage and transportation of iron ions, such as fpn1, fth, and g6pd, indicating that 2-AAP dramatically regulated the ferroptosis and glutathione metabolic pathways. Overall, our study demonstrated that 2-AAP demonstrated potential in AS by alleviating hyperlipidemia and attenuating the ferroptosis pathway and provided evidence supporting the future application of 2-AAP in AS treatment.

Abstract 4138633: Infusion of human apolipoprotein A-I (CSL112) promotes several aspects of reverse cholesterol transport

Background: High-density lipoprotein (HDL)-cholesterol is inversely correlated with cardiovascular risk, but increasing its circulating concentration is insufficient to prevent adverse cardiovascular outcomes. Instead, the emerging paradigm is on increasing the function of HDL and its major protein constituent apolipoprotein A-I (apoA-I), to increase reverse cholesterol transport. Objective: To investigate the effect of apoA-I [human] (CSL112) infusion on HDL protein composition, and provide further insights into the mechanism of action of CSL112 administered post-acute myocardial infarction (AMI). Methods: A mass spectrometry (MS)-based proteomic approach was used to evaluate changes in HDL protein composition in patients (n=50) from the AEGIS-I (ApoA-I Event Reducing in Ischemic Syndromes I) study who received either placebo or CSL112 post AMI. HDL was immuno-isolated from patient plasma using anti-apoA-I antibodies. Cholesterol esterification rate (CER) was measured to determine lecithin-cholesterol acyl transferase (LCAT) activity. Cholesterol efflux capacity (CEC) and hepatocyte uptake were assessed using patient serum in ex vivo cell-based assays. Results: CSL112 induced extensive rearrangement of HDL proteins at 4 hours post-infusion. Levels of apolipoproteins A2, B, C, and E as well as the acute phase proteins serum amyloid A1 and A4 were significantly reduced. By contrast, apoA-I, apoM, and LCAT significantly increased. Elevated apoA-I and LCAT levels on HDL were associated with an increase in CEC, plasma HDL-C levels, and CER in CSL112-treated patients. Furthermore, enhanced CEC strongly correlated with cholesterol uptake by hepatic cells (r=0.95 p<0.001). Conclusion: CSL112 altered HDL composition and increased HDL functionality by promoting multiple steps of the reverse cholesterol transport pathway.

Dapagliflozin alleviates high-fat-induced obesity cardiomyopathy by inhibiting ferroptosis.

Dapagliflozin (Dapa) is a novel hypoglycaemic agent with multiple cardiovascular protective effects, and it is widely used in treatment of heart failure patients, but whether it can improve obese phenotype of heart failure and its mechanism is still unclear. Ferroptosis is an iron dependent form of cell death and has been proved to be an important role in heart failure. The aim of this study is to determine whether Dapa improves obesity-related heart failure by regulating ferroptosis in high-fat diet rats. Male SD rats were fed a high-fat diet for 12 weeks and confirmed of obese heart failure by metabolic parameters and cardiac ultrasound. Being overweight by 20% compared with the normal group, with elevated systolic blood pressure and abnormal levels of insulin and blood lipid (TG and LDL-c), is recognized as obesity. The obese rats with reduced EF, FS, and E/A shown on ultrasound are defined as the obese heart failure (OHF) group. Histological tests confirmed the more pronounced cardiac fibrosis, mitochondrial volume and collagen deposition in OHF group. Dapa treatment effectively reduced body weight, INS, ISI/IRI index, TG and HDL-C levels (P < 0.05). Also, Dapa administration can slightly decrease the SBP and DBP levels; however, there was no statistical difference among those four groups. Furthermore, Dapa treatment can significantly improve high-fat induced systolic and diastolic dysfunction via regulating cardiac histological abnormalities, including less obvious mitochondrial swelling, muscle fibre dissolution and collagen deposition. Additionally, genes from the OHF group were used by GO enrichment analysis, and it shows that ferroptosis metabolic pathway participated in the development of obese phenotype of heart failure. More importantly, Dapa significantly inhibited Fe2+ and MDA levels (P < 0.05), but augmented GSH content (P < 0.05). In addition, the mRNAs and protein expression of some important regulators of ferroptosis, like GPX4, SLC7A11, FTH1 and FPN1, were all decreased after Dapa intervention. Dapa improved high-fat induced obese cardiac dysfunction via regulating ferroptosis pathway.

High-density lipoprotein cholesterol to c-reactive protein ratio predicts atrial fibrillation recurrence after electrical cardioversion.

Atrial fibrillation (AF) recurrence after cardioversion is common, and inflammation plays a critical role in its pathophysiology. We aimed to elucidate the predictive role of the ratio of high-density lipoprotein cholesterol to c-reactive protein (HDL-C/CRP) as an inflammatory marker in AF recurrence after electrical cardioversion (ECV). We analyzed patients who underwent elective ECV for atrial fibrillation between June 2020 and December 2023. Baseline levels of HDL-C and CRP were obtained. Ninety-six patients were included. The median age was 59 years, and 48% were female. Atrial fibrillation recurred after ECV in 56 patients (58%). In the AF recurrence group, CHA2DS2-VASc score was higher (2 [1-3] vs. 1[0-2]; p = 0.013), left atrial diameter was larger (43 ± 5 vs. 40 ± 6 mm; p = 0.015), and HDL-C/CRP ratio was lower (5.6 [2.7-13.0] vs. 14.0 [4.8-38.0]; p = 0.003) compared with the sinus rhythm group. Cox regression analysis showed that HDL-C/CRP was a predictor of AF recurrence at follow-up (unadjusted HR = 0.97; CI 95%: 0.95-0.99; p = 0.004; adjusted HR = 0.98; CI 95%: 0.96-0.99; p = 0.030). ROC curve showed that HDL-C/CRP ratio was able to predict AF recurrence after ECV (AUC = 0.68; p = 0.003). Kaplan-Meier analysis showed that patients with baseline HDL-C/CRP <7.4 had higher AF recurrence (log-rank test p = 0.013). Our research demonstrated that the lower HDL-C/CRP ratio predicted AF recurrence after ECV during follow-up.

Antidiabetic activity of Inonotus obliquus water extract in alloxan-induced diabetic mice.

The Inonotus obliquus is a medicinal mushroom that grows on mature birch trees and is commonly used in traditional medicine for various ailments. The current study aimed to explore the hypoglycemic, hypolipidemic, and pancreatic protective effects of the water extract of Mongolian natural Inonotus obliquus on alloxan-induced diabetic mice. Alloxan monohydrate (200 mg/kg) was intraperitoneally single injected into C57BL/6 mice to induce diabetes. Alloxan-induced diabetic mice were orally given the water extract of inonotus obliquus (WEIO) at doses of 500 mg/kg and subcutaneously administered with insulatard 0.6 IU for 4weeks. Subsequently, the levels of factors related to blood glucose, insulin and lipids were assessed. WEIO significantly restored body weight, reduced fasting blood glucose levels, improved glucose tolerance ability, and increased insulin levels compared to the control diabetic mice. WEIO also enhanced cholesterol transportation in the liver, correlated with increased HDL-C levels and decreased TC, TG and LDL-C levels. Histologic examinations revealed that WEIO alleviated alloxan-induced pancreatic tissue damage. Natural Mongolian I. Obliquus water extracts have an antihyperglycemic effect and enhance islet cell function in alloxan-induced diabetic mice. It is a good candidate for a hypoglycemic functional food or medicine.

OTUD7B inhibited hepatic injury from NAFLD by inhibiting K48-linked ubiquitination and degradation of β-catenin

Non-alcoholic fatty liver disease (NAFLD) is the prevalent liver disease. Ovarian tumor domain-containing 7B (OTUD7B) is a deubiquitinating enzyme and its role in NAFLD remains unclear. In high-fat diet (HFD)-induced NAFLD mouse model and palmitic acid (PA)-treated HepG2 cells, OTUD7B expression was decreased. Adenoviral overexpression of OTUD7B in mice resulted in reduced body weight and liver injury, with decreased serum aminotransferase (ALT) and aspartate aminotransferase (AST) levels. OTUD7B overexpression attenuated hepatic lipid deposition (serum TG, TC, LDL-C, HDLC, and FFA levels), which might be through the suppression of lipogenesis and β-oxidation-related genes. The contents of hepatic inflammatory factors (TNF-α, IL-6, and IL-1β) were decreased following OTUD7B overexpression in NAFLD mice. A mechanism study indicated that the protective effect of OTUD7B overexpression might be associated with β-catenin signal activation. OTUD7B overexpression promoted PA-induced β-catenin activity in TopFlash assay, and increased total β-catenin and c-myc levels in cells. The increase in β-catenin levels was contributed to the stabilization via inhibiting K48-linked ubiquitination and proteasomal degradation by OTUD7B. NR4A2 role in NASH has been proved. NR4A2 ChIP-seq and RNA-seq data excluded transcriptional regulation of NR4A2 to OTUD7B, and it was experimentally evidenced that NR4A2 bound to OTUD7B promoter region and positively transcriptionally regulate OTUD7B expression. In summary, OTUD7B overexpression ameliorated hepatic inflammation and steatosis in NAFLD. The possible mechanism of OTUD7B might be through the inhibition of β-catenin degradation by removing K48-linked ubiquitination, which might be regulated by NR4A2.

Microencapsulated Pomegranate Juice Reduces Metabolic Syndrome (MetS) Criteria in Wistar Rats with MetS Induced with 30% Sucrose

Pomegranate juice possesses therapeutic properties against metabolic syndrome. Microencapsulation of pomegranate juice (MPJ) may extend its shelf life; however, further research is necessary to ascertain its comparative efficacy with fresh juice. This work evaluated the effect of MPJ in an animal model with induced metabolic syndrome (MetS). MetS was induced in Male Wistar rats by administering 30% sucrose orally for 22 weeks. Once MetS was verified in the animals, seven groups were formed as follows: control (Ctrl); MetS; MetS + Placebo; Ctrl + MPJ; MetS + MPJ1 600; MetS + MPJ2 1800; and MetS + MPJ3 2900 mg/kg. Systolic and diastolic blood pressure, glucose, triglycerides, and total HDL-c levels in the MetS + MPJ groups improved significantly (p &lt; 0.05) vs. the MetS group at the end of the study. Microencapsulation maintained the anti-metabolic-syndrome properties of pomegranate juice and could be used to control metabolic syndrome.

Reduced rank regression dietary patterns and dyslipidemia in Brazilian adolescents: results from the Study of Cardiovascular Risk in Adolescents (ERICA).

Evidence on the harmful effects of diet on serum lipids in adolescence has not been consistent. The present study sought to establish which dietary patterns are associated with biomarkers of dyslipidemia. Data from 36,217 Brazilian adolescents participating in the Study of Cardiovascular Risk in Adolescents were evaluated. Dietary patterns were identified using the reduced rank regression analysis. Linear regression models were applied to verify the association between dietary pattern scores and the biomarkers of dyslipidemia. The two first dietary patterns identified by reduced rank regression (RRR-DP1 and RRR-DP2) were kept for further analysis. The RRR-DP1 was highly and positively loaded for sweets and red meat and negatively loaded for beans, fruits, vegetables, and rice. The RRR-DP2 was positively loaded for beans and rice and negatively loaded for sugar-sweetened beverages, fruit juices, and sweets. Linear regression models estimated that one standard deviation (SD) increase in the RRR-DP1 score was only associated with a mean increase of 0.29 mg/dL in HDL-cholesterol (95% CI 0.06;0.53), while one SD increase in the RRR-DP2 score was associated with the lower mean of triglycerides (β = -2.24, 95% CI -3.57;-0.91), LDL-c (β = -0.82 95% CI -1.53;-0.12), and total cholesterol (β = -1.30 95% CI -1.94;-0.65). Higher adherence to the dietary patterns positively loaded for red meat and sweets was associated with increased HDL-c levels, while adherence to a more Brazilian traditional dietary pattern (RRR-DP2) was associated with a better lipids profile.

Impact of oral isotretinoin on the inflammatory markers: can lymphocyte/HDL-C and platelet/HDL-C ratios be new indicators of inflammation in acne vulgaris patients?

Introduction The effect of isotretinoin on inflammatory markers has been reported with conflicting results. No studies have been reported on the relationship between isotretinoin and lymphocyte/high-density lipoprotein cholesterol [HDL-C] ratio (LHR), neutrophil/HDL-C ratio (NHR), or platelet/HDL-C ratio (PHR) in acne patients. Objectives We aimed to investigate how isotretinoin affects the inflammatory markers, including LHR, NHR, and PHR, in acne vulgaris patients. Methods A total of 361 patients with moderate-to-severe acne vulgaris who received systemic isotretinoin for at least six months were included. Complete blood count and biochemical analyses, including monocyte/HDL-C ratio (MHR), NHR, LHR, PHR, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), the aggregate index of systemic inflammation (AISI), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), obtained at the treatment onset and the end of the first, third, and sixth months of treatment were investigated. Results There was no significant difference in MHR and NHR levels between repeated measures. A significant increasing trend was seen in LHR and PHR (P = 0.001 and P = 0.011, respectively). HDL-C levels gradually and significantly declined during the six months (P < 0.001). Serum NLR, derived NLR, SII, SIRI, MLR, and AISI showed a significant decrease in line with clinical improvement in acne during the six months of therapy (P < 0.05). Conclusions Declining levels of NLR, MLR, SII, SIRI, and AISI may indicate the anti-inflammatory effects of isotretinoin on the pilosebaceous unit, whereas increasing levels of LHR and PHR may show systemic inflammatory activity of isotretinoin.

Exercise improves muscle mitochondrial dysfunction-associated lipid profile under circadian rhythm disturbance.

We investigated whether endurance exercise training (EXT) ameliorates circadian rhythm (CR)-induced risk factors by improving skeletal muscle (SKM) mitochondrial biogenesis, reducing oxidative stress, and modulating apoptotic protein expression. We distinguished between regular and shift workers using the National Health and Nutrition Examination Survey (NHANES) and investigated the health problems caused by shift work (CR disturbance) and the potential therapeutic effects of exercise. In our animal study, 36 rats underwent 12 weeks of CR disturbance, divided into regular and irregular CR groups. These groups were further split into EXT (n = 12) and sedentary (n = 12) for an additional 8 weeks. We analyzed SKM tissue to understand the molecular changes induced by CR and EXT. NHANES data were analyzed using SAS 9.4 and Prism 8 software, while experimental animal data were analyzed using Prism 8 software. The statistical procedures used in each experiment are indicated in the figure legends. Our studies showed that CR disturbance increases dyslipidemia, alters circadian clock proteins (BMAL1, PER2), raises apoptotic protein levels, and reduces mitochondrial biogenesis in SKM. EXT improved LDL-C and HDLC levels without affecting muscle BMAL1 expression. It also enhanced mitochondrial biogenesis (AMPK, PGC-1α, Tfam, NADH-UO, COX-I), antioxidant levels (Catalase, SOD1, SOD2), and apoptotic protein (p53, Bax/Bcl2) expression or activity in SKM. We demonstrated that shift work-induced CR disturbance leads to dyslipidemia, diminished mitochondrial biogenesis, and reduced antioxidant capacity in SKM. However, EXT can counteract dyslipidemia under CR disturbance, potentially lowering the risk of cardiovascular disorders.

Studies of Lipid Profiles Among Infants with Respiratory Distress Syndrome

Background: Respiratory distress syndrome (RDS) is known as hyaline membrane disease (HMD). It is the major cause of neonatal respiratory distress, especially in preterm infants Infants with RDS present with tachapnea, cyanosis, grunting, subcostal and intercostal retractions and nasal flaring. Oliguria with mild generalized edema may be present. Oxygen requirement may increase rapidly and is typically higher than that seen in infant with transient tachapnea of the newborn (TTN). Objective: to evaluate the relationship between the maternal and cord blood lipid profiles in preterm babies with respiratory distress syndrome. Methods: This is a case control study which was conducted on 50 preterm neonates admitted to the neonatal intensive care unit of Shebin El-Kom teaching hospital between January 2020 and October 2021. Results: the mean of total cholesterol was significantly higher in infants whose mothers had received antenatal steroid for lung maturity than those whose mothers had not (P&lt;0.05). But there was no significant difference in the mean of levels of TG, HDL-cholesterol, LDL-cholesterol and VLDL cholesterol between both groups. Also, There is a positive correlation between weight gain during pregnancy and neonatal cord blood levels of (Total cholesterol, TG, HDL-C, LDL-C and VLDL-C), There is a positive correlation between maternal blood levels of (total cholesterol, TG, LDL-C and VLDL-C) and their neonatal cord blood levels of (total cholesterol, TG, HDL-C, LDL-C and VLDL-C), There is a positive correlation between the maternal blood level of HDL-C and their neonatal cord blood levels of (total cholesterol and HDL-C).also, the cutoff values of cord blood (total Cholesterol, HDL-C, and LDL-C) below which RDS can be predicted are 80, 45.5 and 23.2 mg/dl respectively with a sensitivity of 83.3%, 86.7% and86.7% and with specificity of 95%, 80% and 70% respectively. Conclusion: RDS is accompanied with lipid alteration in the infants and their mothers. The results of this study point to the importance of measuring maternal serum and cord blood lipid profile as a predictor for the occurrence of RDS.

The causal effects of lifestyle, circulating, pigment, and metabolic factors on early age-related macular degeneration: a comprehensive Mendelian randomization study

PurposeEarly detection of lifestyle factors, skin and hair color, circulating parameters, and metabolic comorbidities is crucial for personalized prevention and treatment of early age-related macular degeneration (AMD). This study aimed to assess the relationships between genetically predicted comprehensive risk factors and early AMD.Methods and resultsPublicly available genome-wide association study (GWAS) data were utilized to identify genetic variants significantly associated with each trait. We applied a Bonferroni-corrected significance level of P < 0.0017. P values between 0.0017 and 0.05 were considered suggestive associations. Univariable Mendelian randomization (MR) analyses revealed that elevated serum HDL-C, lower serum TG, and decreased three circulating fatty acids levels were robust indicators of an increased risk of early AMD (all P < 0.0017), with odds ratios (ORs) and 95% confidence intervals (CIs) of 1.218 (1.140–1.303), 0.784 (0.734–0.837), 0.772 (0.698–0.855), 0.776 (0.706–0.852), and 0.877 (0.798–0.963), respectively. Additionally, the “never eat wheat products”, “age started wearing glasses”, and “skin color” were significantly associated with the risk of early AMD (both P < 0.0017), with ORs (95% CIs) of 23.853 (2.731–208.323), 1.605 (1.269–2.030) and 1.190 (1.076–1.317), respectively. Multivariable MR analysis confirmed that elevated serum HDL-C (OR = 1.187, 1.064–1.324) increased the risk of early AMD, while higher serum TG (OR = 0.838, 0.738–0.950) was associated with a significantly lower risk. Furthermore, validation results indicated that serum HDL-C 1.201 (1.101–1.310) and TG 0.795 (0.732–0.864) were significantly associated with the risk of early AMD. There were suggestive associations of smoothies, chronotype, and hair color (0.0017 < P < 0.05), but sun/UV protection, smoking, BMI, diabetes, high blood pressure, cardiovascular diseases, fresh fruit intake, fish oil/cod liver oil supplement, sleeplessness, serum C-reactive protein level, and iron level were not associated with the risk of early AMD.ConclusionsOur comprehensive MR analysis demonstrated that elevated circulating HDL-C levels increase the risk of early AMD, while TG and fatty acid levels are associated with a decreased risk. These findings provide robust evidence for improved diagnosis and personalized prevention and treatment of early AMD.

Vector of glycated hemoglobin in the formation of dysglycemia in postmenopause: Emphasis on early diagnosis and therapy

Introduction. The close relationship of postmenopause with insulin resistance (IR) and metabolic syndrome (MetS) marks a high cardiometabolic risk of dysglycemia, determining the need for its early diagnosis and therapy. Pathogenetically substantiated criteria for the diagnosis of prediabetes and the nature of early drug therapy for type 2 diabetes mellitus (T2DM) are debated. Information on the relationship between glucose homeostasis parameters and menopausal MetS is fragmentary.Aim. To evaluate the associations of glycated hemoglobin (HbA1c) levels with indices of IR, β-cell function and MetS character- istics in a cohort of postmenopausal women with different carbohydrate metabolic states.Materials and methods. In 94 Caucasian postmenopausal women 58.0 (53.0; 63.0) years old the following were determined: HbA1c, fasting glycemia (FG), TyG and HOMA2 indices, C-peptid, BMI, waist circumference (WC), blood pressure (BP), triglycerides (TG), HDL-C levels. When classifying women by HbA1c (ADA criteria), 15 had normoglycemia, 24 prediabetes, 55 T2DM. ME (25–75%) was assessed using SPSS (version 17); intergroup differences according to the Mann – Whitney test; Spearman and partial correlation analysis were performed.Results. HbA1c age independently correlated with IR parameters: TyG (R = 0.590; p &lt; 0.001), HOMA2-IR (R = 0.318; p &lt; 0.05) and beta cell function: HOMA2-B (R = -0.355; p &lt; 0.001); with lipid markers of MetS (TG, HDL-C, respectively R = 0.382; -0.448; p &lt; 0.001), anthropometric and blood pressure levels.Conclusion. Associations of HbA1c in postmenopausal women with a spectrum of glucose homeostasis parameters and MetS mark it as a vector of formation and progression of dysglycemia due to a close connection with the functional state of β-cells and the importance of lipoglucotoxicity in the dynamics of postmenopausal IR. The obtained data pathogenetically determine the use of HbA1c in the verification of dysglycemia and the early administration of combined antihyperglycemic therapy aimed at preserving β-cell function. The potential of dipeptidyl peptidase-4 inhibitors in slowing the progression of type 2 diabetes mellitus is considered

The Cardiometabolic Multimorbidity Risk Profile of Females Living in Glendale, ILembe District of Kwa-Zulu Natal

Background: Empirical studies have indicated that cardiometabolic multimorbidity risk profiles are upsurging among the South African population. However, there is a limited number of studies that have been conducted to validate these findings in rural communities. Aim: To study the prevalence of cardiometabolic risk factors of females residing in rural Glendale in the ILembe District, South Africa. Methods: One hundred females (aged 18–40 years) voluntarily participated in a cross-sectional observational study. All participants completed an ISAK somatotype profiling, and measured their fasting cholesterol, glucose, blood pressure and resting heart rate. Results: Participants’ average age, body mass index, stature, and body mass, were 28.34 ± 7.07 years, 29.5 ± 8.06 kg/m2, 157.26 ± 6.09 cm, and 72.9 ± 21.12 kg, respectively. The cohort had a mean waist circumference of 94.2 ± 22.1 cm, hip circumference of 108.4 ± 20.9 cm, and waist-to-hip ratio of 0.86. Participants’ mean heart rate, systolic blood pressure, and diastolic blood pressure were 86.31 ± 8.68 bpm, 116.79 ± 16.34 mmHg, and 82.14 ± 10.87 mmHg, respectively. Eleven participants recorded a resting heart rate greater than 100 bpm. Average blood glucose, total cholesterol, low-density lipoprotein, and high-density lipoprotein recorded were 4.87 ± 1.26 mmol/L, 3.78 ± 0.94 mmol/L, 1.76 ± 1.86 mmol/L, and 1.31 ± 0.4 mmol/L. Eighty-three participants HDL-C were below the recommended normative value of 1.55 mmol/L. Conclusion: The average participant presented as overweight, with elevated diastolic blood pressure, and a resting heart rate that has been proven to increase one’s cardiometabolic multimorbidity risk profile. Additionally, a small portion of the cohort were identified to be prediabetic and diabetic. Large proportion of participants had low HDL-C levels suggestive of poor cardiovascular disease protection.

Is there a gender difference in the effects of cardiovascular risk factors on the anatomical localization and severity of obstruction on coronary arteries?

Abstract Background Whether there is a gender difference in the effects of traditional cardiovascular risk factors(CVRF) on the anatomical localization(AL) and severity(AS) of obstruction on coronary arteries(CA) remains unclear. Purpose In our study, we investigated whether there is a gender difference in the relationship between CVRF and obstruction on CA . Methods We included 978 patients(49.9% women, mean age: 61+10.3) with stable chest pain undergoing invasive coronary angiography between 2019-2021 who were recruited from the database of our clinic. We examined the gender difference in hypertension(HT), diabetes mellitus(DM), smoking, hyperlipidemia, previous history of CAD(H.CAD) and family history of premature CAD(F.CAD) and their correlation with the AL and AS of obstruction on CA in both gender. Results Women were older(p&amp;lt;0.001) with higher rates of HT (p=0.001) and DM(p=0.026) and higher TC, LDLC and HDLC levels respectively (rs) as (p=0.001, p=0.001, p=0.001). Whereas H.CAD and smoking rates were higher in men rs as (p=0.001, p=0.009). The incidence of critical stenosis (≥70 obstruction) &amp; intermediate lesions (50-69%) on all CA and Syntax scores were higher in men(p&amp;lt;0,01). In patients with HT, severe CAD was more prominent on circumflex (Cx)(p=0.029) and right coronary artery(RCA)(p=0.002) in women and on the proximal ( p=0.024) and mid portion of left anterior descending artery(LAD) (p=0.045) in men. In patients with DM a statistically significant(ss) correlation was found between the presence of DM and AS in all vessels except for left main coronary artery (LMCA) in women (LAD prox:p=0.001; LAD mid:p=0.001; diagonal artery(Dg):p=0.003; Cx:p=0.001; RCA:p=0.001 ;LMCA:p&amp;gt;0.05). However no such correlation was observed in men(p&amp;gt;0.05). In patients with H.CAD moderate/severe lesions were more common on proximal(p=0.013) and mid portions of LAD(p=0.021), on CX( p=0.006) and on RCA(p=0.016) in men and more common on the proximal portion of LAD(p=0.047), CX(p=0.014) and RCA(p=0.009) in women. For either smoking and F.CAD there was no such correlation in either gender (p&amp;gt;0,05). As for blood lipid levels no correlation was observed between LDLC, HDLC and triglyceride levels and AL&amp;AS in men(p&amp;gt;0,05). However there was a negative, weak correlation between the HDLC levels and obstruction on LAD mid portion(r=-0.140; p=0.003); on Dg(r=-0.100; p=0.034) on CX (r=-0.154; p=0.001) and on RCA (r=-0.151; p=0.001) in women. Conclusion Major traditional CVRFs have a sex specific impact on AL and AS of obstruction on CA. In the era of precisıon medicine we need gender specific risk scoring systems taking these gender differences into account.

Measures of insulin resistance and aortic valve calcification in the general population

Abstract Background Insulin resistance (IR) is a key component in several cardiovascular risk factors. The triglyceride-glucose index (TyG index), triglyceride to high density lipoprotein-cholesterol ratio (TG/HDL-C) and visceral adiposity index (VAI) are easily accessible surrogate measures of IR and have been associated with coronary artery calcification and other cardiovascular diseases. Less is known about IR and aortic valve calcification (AVC). Purpose To investigate the association between different measures of IR (TyG index, TG/HDL-C, VAI) and AVC. Method The Swedish Cardiopulmonary Bioimage Study (SCAPIS) recruited 30 154 randomly selected individuals aged 50 to 64 years from the general population in Sweden between 2013 to 2018. AVC was assessed visually on cardiac computed tomography and categorized as present or absent. TyG index was calculated based on triglyceride and glucose levels, TG/HDL-C ratio using triglyceride and HDL-C levels and VAI using waist circumference, triglyceride and HDL-C levels. The association between IR indexes (as continuous variables by 1 unit increment and categorical variables by quartiles) and AVC was assessed using multivariable logistic regression models. Results In total, measures of IR were available in 29 268 participants of whom 2118 (7%) had AVC. Mean IR index levels were higher in participants with compared to without AVC (TyG index: 8.65 vs. 8.49; p&amp;lt;0.01; TG/HDL-C: 1.11 vs. 0.91; p&amp;lt;0.01 and VAI: 1.73 vs. 1.48; p&amp;lt;0.01). All three indices of IR were associated with AVC in continuous analyses. Subsequently, in multivariable logistic regressions adjusted for age, sex, study site and smoking, there was a stepwise increase in the risk of AVC with increasing quartiles of TyG index, TG/HDL-C and VAI (Figure 1). Conclusion Three different surrogate measures of IR (TyG index, TG/HDL-C and VAI) were all associated with AVC in a middle-aged general population suggesting that they could all be used as risk markers in clinical practice.

Correlation between LDL/HDL-cholesterol ratio and long term prognosis after acute coronary syndrome and severity of coronary artery disease

Abstract Introduction Dyslipidaemia is an important correctable risk factor for coronary artery disease (CAD). Many studies have confirmed that the lower the low-density lipoprotein cholesterol (LDL-C) levels are, the lower is the CAD morbidity and mortality rates (1). However, many patients who achieved low levels of LDL-C still experience a major adverse cardiovascular event (MACE) because of the other residual risk factors. Therefore, there is a constant need for better stratification of patients who are at higher risk for novel MACE following their first acute coronary syndrome (ACS). Evidence increasingly suggests that the ratio of LDL-C/HDL-C might be a new and better marker of cardiovascular disease, as it simultaneously evaluates the levels of both LDL-C and HDL-C (2). Purpose The aim of this study was to investigate the prediction value of LDL-C/HDL-C ratio for long term prognosis after ACS as well as its correlation with CAD severity. Methods We included patients hospitalized at out centre with ACS from January 2017 to January 2024. Demographic data, data on LDL-C and HDL-C levels on admission and calculated Syntax score were used. Syntax score is a comprehensive angiographic scoring system which determines complexity by using coronary anatomy and lesion characteristics (3). Follow-up data were collected either by clinical follow-up visits or by telephone interviews. The MACE was defined as the composite of cardiovascular death, acute coronary syndrome and need for elective or urgent percutaneous or surgical revascularization. Results This registry-based study included 2471 patients with ACS, median age of 64 (interquartile range 56-73) years, 31% female. Total of 1099 patients (44%) had non-ST elevation ACS and 1372 (54%) had ST elevation myocardial infarction (STEMI). Median Syntax score was 13 (IQR 7-20.5), with 1494 (61%) patients having low Syntax score (≤16), 508 (21%) patients medium (16-22), and 448 (18%) high score (&amp;gt;22), respectively. Median follow up was 17 (3-27) months. LDL-C/HDL-C ratio correlated significantly with cardiovascular death, with weak coefficient (2.94 vs. 2.54 p&amp;lt;0.001; rho=0.102, p&amp;lt;.0001), however did not correlate with MACE (2.88 vs. 2.92, p=0.188, rho=0.06, p=0.77). This remained identical when tested for patients with STEMI and non-STE ACS. In addition, LDL-C/HDL-C ratio did not correlate with CAD severity as assessed with Syntax score (low 2.92 vs. medium 2.83 vs. high 2.86, p=0.597; rho=0.4, p=0.09). Conclusion Our data suggest that LDL-C/HDL-C ratio cannot be used as a relevant predictor of post-ACS long-term MACE or cardiovascular death, nor it can be correlated with CAD severity. Further studies are needed to establish the real value of LDL-C/HDL-C ratio as a post-ACS predictor.