HDL Cholesterol Research Articles

Clinical, biochemical profile and atherosclerotic cardiovascular risk score (ASCVD) in patients with high HDL cholesterol.

It was observed that many people in the western coastal belt were found to have a high HDL cholesterol, the cause of which was not known. This study was done to learn about the factors contributing to the high HDL cholesterol in these patients and its effect on ASCVD risk. In this prospective, case control study, 150 patients were recruited, of which 63 were cases (patients with high HDL cholesterol), and 87 were controls (patients with normal HDL cholesterol). Details regarding their diet, sea-food consumption, habits, comorbidities, daily activity (using GPAQ questionnaire), and blood reports were collected. ASCVD risk score was calculated using an online ASCVD risk estimator. Blood samples of 96 patients (cases 40, controls 56) was tested for cholesterol esterase transfer protein (CETP) levels using ELISA, and the results were compared. Patients with high HDL cholesterol were found to be physically more active and had median metabolic equivalent (METs) of 4680 (1200, 8580) compared with controls with median METs of 1680 (720, 5580), P-0.013. Cases had a lower mean BMI 23.09(SD-3.69), than in patients with normal HDL cholesterol with a mean of 24.41(SD-4.01), P-0.04. Cases also had a lower triglyceride level (91(69,118) in cases vs 121 (80,151) in controls, P-0.002. Alcohol and sea food consumption had no role on HDL levels in this study. The median CETP level was lower in patients with high HDL levels, 0.336(0.08, 0.336) versus 1.435(0.061, 2.893) in the control group although not statistically significant. Patients with high HDL cholesterol were found to have a significantly lower median 10-year ASCVD risk score 3.05 (0.6, 8.95), compared with patients with normal HDL 6.45 (2.7,14.2). Patients with high HDL cholesterol were found to be physically more active, had a lower BMI, a lower triglyceride level, and a lower ASCVD risk compared with controls. They also had a lower CETP level. Further research will be required to determine the normal CETP level in Indian population, their genetic makeup, and whether it has a role in cardiovascular protection.

Dietary and plasma atherogenic and thrombogenic indices and cardiometabolic risk factors among overweight and individuals with obesity

BackgroundObesity and hyperlipidemia are the two central metabolic disorders linked to non-communicable diseases (NCDs) that increase the risk of cardiovascular disease (CVD). Apart from dyslipidemia, the Atherogenic Index of Plasma (AIP), which is associated with dietary consumption, is another marker for predicting the risk of CVD. Healthy fat quality indicators may impact AIP. The purpose of this study is to ascertain whether there is any connection between Iranian obese people’s plasma and dietary indices and cardiometabolic risk factors.MethodsThis cross-sectional study, consisted of 645 overweight and obese participants. The study included assessments of body composition and anthropometric measurements. Dietary fatty acid consumption was evaluated using a validated Food Frequency Questionnaire (FFQ) containing 168 items. Additionally, biochemical parameters, including serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were measured using enzymatic methods. The lipid profile was quantified.ResultsFor participants in higher tertiles of the AIP, the percentage of men was significantly higher than women (men: 48.1%, women: 51.7%, p < 0.001). Additionally, individuals in higher tertiles of AIP had a higher waist-to-hip ratio (WHR) (mean WHR: 0.92 ± 0.05 vs. 0.86 ± 0.04 in lower tertile, p < 0.001). Participants in the highest tertile of AIP had higher systolic blood pressure (SBP: 132 ± 8 mmHg vs. 118 ± 6 mmHg in lower tertile, p < 0.001), total cholesterol (TC: 210 ± 15 mg/dL vs. 185 ± 12 mg/dL, p < 0.001), triglycerides (TG: 180 ± 20 mg/dL vs. 120 ± 15 mg/dL, p < 0.001), and glucose concentrations (fasting glucose: 105 ± 10 mg/dL vs. 90 ± 8 mg/dL, p < 0.001). Participants in the lower tertile of AIP had higher HDL cholesterol levels (HDL: 60 ± 5 mg/dL vs. 45 ± 4 mg/dL in higher tertile, p < 0.001). In the model for Thrombogenicity Index (TI), participants in the higher tertile had higher glucose concentrations (glucose: 110 ± 12 mg/dL vs. 95 ± 9 mg/dL in lower tertile, p = 0.04).ConclusionThis research introduces a novel field of investigation and emphasizes the possible importance of TI, AI, and AIP indices in regulating cardiometabolic risk factors.

How Does the Weekend Catch-Up Sleep Ratio Affect the Health and Lifestyle of Korean Adults? An Age- and Sex-Matched Study

ABSTRACT This study examined the impact of Catch-Up Sleep Ratio (CSR) on health outcomes in Korean adults. Adjusted for age and gender, 2,484 participants were categorized into three groups: Weekday (CSR <1.0), Average (1.0 ≤ CSR < 1.5), and Weekend (1.5 ≤ CSR). Weekday participants were less likely to meet WHO’s moderate physical activity guidelines (OR = 0.79, p < .05), walk 4–6 days per week (OR = 0.70, p < .05), or engage in prolonged sedentary behavior (OR = 0.60, p < .001). The Weekend group exhibited higher odds of obesity (OR = 1.96, p < .01), increased stress (OR = 1.78, p < .001), and perceived themselves as more obese (OR = 1.32, p < .01) while showing lower rates of low HDL cholesterol (OR = 0.66, p < .01). These findings suggest that CSR could significantly impact health behaviors and outcomes.

Abstract 12: High HDL Cholesterol Is Associated With Reduced Reperfusion Injury And Favorable Functional Outcome Following Thrombectomy For Ischemic Stroke

Introduction: Animal research suggests that HDL cholesterol (HDL-C) ameliorates reperfusion injury, a phenomenon that worsens clinical outcome following recanalization therapy for ischemic stroke. Hypothesis: We hypothesized that higher HDL-C levels have a guarding effect against cerebral reperfusion injury in human stroke survivors treated with thrombectomy. Methods: We included patients with anterior circulation large vessel occlusion (acLVO) stroke who underwent thrombectomy from 01/2017 to 01/2023 at a tertiary stroke center in Germany into a prospective registry study with retrospective analysis. We assessed the association of HDL-C serum levels and imaging indices of post interventional reperfusion injury (any intracerebral or subarachnoid bleeding involving the ischemic brain region on CT or MRT), functional outcome quantified via modified Rankin scale (mRS) at 90 days and neurological outcome via National Institutes of Health Stroke Scale (NIHSS) score at discharge using multivariable lasso logistic and linear regression adjusted for demographic, clinical and imaging characteristics. We performed sensitivity analysis applying propensity score matching and shift analysis using ordered logistic regression. Results: In our study population of 811 acLVO patients treated with thrombectomy (420 females, median age 77 years [66-84, interquartile range]) reperfusion injury was associated with detrimental functional outcome (adjusted OR 2.87; 95% CI [1.86;4.41]; p=0.000). Higher HDL-C was associated with lower odds of reperfusion injury (adjusted OR 0.57; 95% CI [0.35;0.95]; p=0.03) and emerged as predictor of favorable functional outcome defined as 90-day mRS 0-2 (adjusted OR 0.57; 95% CI [0.34;0.99]; p=0.04) and alleviated neurological deficits with lower NIHSS score at discharge (ß=-2.51; 95CI% [-4.88; -1.30]; p=0.04). On propensity score analysis an HDL-C level exceeding the median (1.15 mmol/L) was associated with a 13.8 % decrease in the probability of reperfusion injury (ß=-0.14; 95CI% [-0.23; -0.05]; p=0.003). A significant shift of 90-day mRS distribution favoring high HDL is shown in the figure. Conclusions: In patients undergoing thrombectomy for acLVO a higher level of HDL-C reduced the odds of reperfusion injury, which translated into improved functional and neurological outcome, hence constituting a possible target of adjunctive neuroprotective treatment.

Development and Validation of Healthy and Unhealthy Plant-Based Diet Propensity Scores in European Children, Adolescents and Adults From the I.Family Study.

Plant-based dietary patterns may reduce the risk of chronic diseases, but their benefits and risks in younger populations remain unclear due to variations in diet quality and nutrient adequacy. Robust tools to assess adherence to these patterns are essential. The aim of this study was to develop and validate three plant-based diet propensity (PBDP) scores - overall, healthy and unhealthy - to capture plant-based dietary patterns and assess their associations with nutrient intakes and health indicators in children, adolescents and adults. This cross-sectional study of children, adolescents and adults used data from the I.Family study (n = 15,780 participants) from eight European countries. Dietary intake was assessed using a food frequency questionnaire. The overall PBDP score was constructed by categorising all plant-based food groups as positive and animal-based food groups as negative. The healthy PBDP emphasised healthy plant-based food groups, whereas the unhealthy PBDP emphasised less healthy plant-based food groups. Validity was assessed through correlations with nutrient intakes and comparison across demographic groups. Associations with health indicators were also analysed. PBDP scores showed expected associations with nutrient intakes. Higher overall and healthy PBDP scores were observed in females, adults, individuals with higher parental educational levels and those from Belgium and Spain. The healthy PBDP score was associated with higher HDL cholesterol, improved bone stiffness and lower triglycerides. The unhealthy PBDP score was associated with lower HDL cholesterol in adults, but not in children or adolescents. PBDP scores describe plant-based dietary patterns across demographic groups and are valid and reliable in adults. The findings highlight challenges in assessing dietary patterns in children and adolescents. Future research should address these challenges to enhance the validity of PBDP scores in younger populations and further explore their potential in guiding dietary recommendations across all age groups.

Improvement of measured and perceived disability in overweight patients with Multiple Sclerosis trough different patterns of Mediterranean hypocaloric diet.

overweight and other cardiovascular risk factors are known contributors to disability accrual in Multiple Sclerosis (MS). We aimed to explore the impact of three hypocaloric dietetic patterns, based on the Mediterranean diet, on cardiovascular risk and clinical status in overweight persons with MS (pwMS). overweight pwMS (body mass index-BMI ≥25 kg/m2) were prospectively enrolled, randomly allocated to three hypocaloric dietetic plans differing in macronutrients composition (carbohydrates/proteins/lipids: diet A 65 %/15 %/20 %; diet B 35 %/25 %/40 %; diet C 50 %/20 %/30 %) and followed-up for 1 year (6 months of dietetic intervention + 6 months of observation). The Multiple Sclerosis Performance Test, a self-administered, iPad®-based system for quantifying cognition, upper and lower extremity motor function, and vision was performed at baseline, 6 and 12 months. Questionnaires for the evaluation of sleep quality, fatigue, anxiety, depression, stigma, social participation and satisfaction were administered. Information about cardiovascular risk parameters (BMI, waist circumference-WC, umbilical circumference-UC, hip circumference-HP, blood pressure, HDL and LDL cholesterol, triglycerides, glycemia) were collected. Adherence to the dietetic plan was quantified as days of complete to insufficient adherence across the treatment period. Between-group comparisons were performed with Chi-square and ANOVA; longitudinal analyses with one-way ANOVA for repeated measures and mixed-design ANOVA. fifty-three patients completed the study (diet A n = 19, diet B n = 18, diet C n = 16). The three groups were well matched for sex, age, disease duration and EDSS. Along the 6 months of dietetic intervention, no difference in adherence was detected across the three dietetic plans (p = 0.84). Overall, patients showed a significant weight loss over time (p < 0.001) with no difference across diets (p = 0.34). BMI, WC, UC, HC and cholesterol improved over time (p ranging from 0.06 to 0.001), with no differences across diets (p ranging from 0.16 to 0.58). Among all tested clinical variables, fatigue, anxiety, information processing speed and manual dexterity improved significantly (p = 0.005, p = 0.012, p = 0.013, p = 0.005), with no differences across diets (p = 0.84, p = 0.89, p = 0.53, p = 0.72). dietetic interventions in overweight pwMS, irrespective of their specific macronutrients composition, are able to improve the cardiovascular profile, the perception of subjective symptoms as well as objective disability scores.

Analysis of 26 Studies of the Impact of Coconut Oil on Lipid Parameters: Beyond Total and LDL Cholesterol

Coconut oil (CNO) is often characterized as an “artery-clogging fat” because it is a predominantly saturated fat that ostensibly raises total cholesterol (TChol) and LDL cholesterol (LDL-C). Whereas previous analyses assessed CNO based on the relative effects on lipid parameters against other fats and oils, this analysis focuses on the effects of CNO itself. Here, we review the literature on CNO and analyze 984 lipid profile data sets from 26 CNO studies conducted over the past 40 years. This analysis shows considerable heterogeneity among CNO studies regarding participant selection, the amount consumed, and the study duration. The analysis reveals that, overall, CNO consumption gives variable TChol and LDL-C values, but that the HDL-cholesterol (HDL-C) values increase and triglycerides (TG) decrease. This holistic lipid assessment, together with the consideration of lipid ratios, shows that CNO does not pose a health risk for heart disease. Because the predominantly medium-chain fatty acid profile of CNO is significantly different from that of lard and palm oil, studies using these as reference materials do not apply to CNO. This paper concludes that the recommendation to avoid consuming coconut oil due to the risk of heart disease is not justified.

Influence of waist circumference measurement site on the cardiometabolic risk factors in Korean adults.

Waist circumference (WC) has been recognized as a simple anthropometric measure of abdominal obesity and associated health risk. We compared WC values at five measurement sites, and examined whether measurement sites influence the relationships between WC and cardiometabolic risk in Korean adults. In this cross-sectional study, participants included 180 men and 176 women (age: 30-60 years, BMI: 18.5-30.0 kg/m2) who underwent a regular health examination between 2021 and 2022. WC was measured at the following sites; lowest rib, superior border of the iliac crest, midpoint between the lowest rib and the iliac crest, umbilicus, and narrowest waist. Fasting glucose and lipids, and resting blood pressure were measured after a 10-hour overnight fast. Cardiometabolic risk factors were defined using the modified National Cholesterol Education Program Adult Treatment Panel-III. All WC measures at five sites were highly correlated (P < 0.01) with each other in men (r = 0.933-0.995) and women (r = 0.893-0.990). Differences in absolute mean WC values existed in both men and women. The prevalence of abdominal obesity (men: 17.2 %-34.4 %, women: 5.7 %-40.9 %) and metabolic syndrome (men: 30.6 %-38.9 % women: 13.6 %-22.2 %) varied depending on the measurement site. All five WC sites were similarly associated (P < 0.05) with an increased odd ratio for elevated glucose, elevated triglycerides, low HDL cholesterol and cardiometabolic risk clustering in men, and elevated blood pressure and cardiometabolic risk clustering in women. Although the differences in absolute WC values existed, the associations between WC at each site and cardiometabolic risk were similar in Korean adults.

Characteristic of adult patients with cyanosis due to congenital heart disease: special focus on endothelial damage.

Abstract Background Patients with cyanosis secondary to congenital heart disease (CHD) are characterized by erythrocytosis and increased blood viscosity, which contributes to endothelial dysfunction that is associated with an increased risk of atherosclerosis. Flow-mediated dilatation (FMD) is a phenomenon associated with NO release that indirectly assesses endothelium function. The intima-media complex measured in the carotid artery indicates the severity of atherosclerosis. Aim The aim of this study is to evaluate the intima-media complex and flow mediated dilation and demonstrate their potential relationship with the clinical presentation in cyanotic population. Methods A cross-sectional study including 36 adult CHD cyanotic patients [(12 males)(39 median, 19-73 years)] with arterial blood oxygen saturation less than 92% and 30 healthy controls [(11 males)(38.5 median, 26-59 years)] was performed. All patients underwent clinical examination, blood testing, and echocardiography. Endothelial function was assessed using intima-media thickness and flow-mediated dilatation during ultrasonography. Lipid profile, erythrocytosis indicators, as well as inflammatory and vascular markers, including sphingosine-1-phosphate, were measured. Results We did not demonstrate any difference between CHD patients and the control group in the intima-media complex, flow-mediated dilatation, and the size of the brachial artery after ischemia. Among the laboratory indicators of erythrocytosis, atherosclerosis, and inflammation, the size of the brachial artery after ischemia correlated positively with the level of erythrocytes (p=0.008), hemoglobin (p=0.02), hematocrit (p=0.03), LDL cholesterol (p=0.01), and negatively with d-dimer (p=0.003). Flow-mediated dilation correlated positively only with HDL cholesterol (p=0.02) concentration. The intima-media complex correlates positively only with body mass index (p=0.04). Conclusions Endothelial function assessed by FMD and the severity of atherosclerosis assessed by IMT do not appear to be abnormal in patients with cyanosis secondary to CHD. Endothelial dysfunction Logistic regression for FMD&amp;lt;7%

Therapeutic Potential of Asparagus Racemosus Root in Managing Hyperglycemia, Dyslipidemia, and Platelet Aggregation in Neonatal Streptozotocin-induced Type 2 Diabetic Rats

Lipid abnormalities frequently accompany hyperglycemia and thus a primary goal in diabetes therapy is the management of dyslipidemia. Asparagus racemosus root has previously been shown to reduce postprandial blood glucose in diabetic rats by delaying carbohydrate absorption and enhancing insulin secretion. In the present study, the chronic effects of A racemosus root on serum glucose, fructosamine, lipids, and platelet aggregation were assessed in rats with type 2 diabetes induced by neonatal streptozotocin injection. The type 2 diabetes model was created by injecting 48-hour-old pups with a single intraperitoneal dose of streptozotocin (STZ). Platelet aggregation was measured by optical aggregometry. Daily oral administration of ethanol extract of A racemosus to diabetic rats (n = 10) lowered serum glucose by 21% (p&lt;0.01) and fructosamine by 11% (p&lt;0.05) after 28 days. Total cholesterol (p&lt;0.05), triglyceride (p&lt;0.05), and NEFA (p&lt;0.01) levels were also lowered by 9%, 16% and 38% respectively. No difference in HDL cholesterol or body weights was observed compared to control rats but platelet aggregation was significantly reduced by 18% (p&lt;0.05). Food and water intake, stool formation, water content of stools, and urine formation were unchanged in extract-treated rats in a 24-hour acute observational study in Nalgene Metabolic Cages. In conclusion, this study reveals that ethanol extract of A racemosus root lowers circulating glucose, and atherogenic blood lipids and decreases platelet aggregation. Thus, A racemosus is the source of glucose-lowering bioactive agents and a useful dietary adjunct in the management of diabetes, dyslipidemia, and related complications.

Association between early dietary patterns and cardiometabolic health at age 8: a confirmatory analysis of the European Childhood Obesity Project

Background & AimMetabolic and cardiovascular health outcomes are strongly influenced by diet. Dietary habits established in early childhood may persist into adulthood. This study aimed to examine the association between dietary patterns at both 2 and 8 years of age, explaining the maximum variability of high- and low-quality fats, sugars, and fibre, and cardiometabolic markers at age 8 years.MethodsThis was a secondary analysis of the European Childhood Obesity Project, formerly a randomized clinical trial across five European countries performed in healthy term newborns. Children in the study were categorized at ages 2 and 8 years into two groups based on cluster analysis of dietary patterns (DP) derived from Reduction Rank Regression (RRR). A cross-sectional and prospective analysis was conducted to evaluate the associations between these DPs and cardiometabolic outcomes, including body mass index (BMI), blood pressure (BP), and biochemical markers. Triglycerides, HDL cholesterol and insulin resistance index (HOMA-IR) were also categorized as altered versus normal values. Asociations between dietary patterns and health outcomes were assessed using linear and logistic regression models, adjusting for covariates based on a step-wise approach.ResultsA total of 336 children were classified based on quality of nutrient intakes into either a “Poor-Quality dietary pattern” (PQ-DP) (48% and 66% of infants at 2 and 8 years, respectively) or the “Health-Conscious dietary pattern” (HC-DP) (52% and 34% of infants at 2 and 8 years, respectively). Following a PQ-DP at both ages 2 and 8 was associated with higher triglycerides (β = 0.061, p = 0.049), systolic and diastolic BP (β = 13.019, p < 0.001 & β = 7.612, p = 0.014, respectively) and altered levels of HOMA-IR (OR = 3.1, p = 0.037, 95% CI = 1.1–9.1) at 8 years, compared to children with an HC-DP at both ages, after adjusting for confounders.ConclusionAdherence to a dietary pattern with a poorer nutritional profile in early childhood and school age is associated with worse cardiometabolic risk markers at 8 years old.

P-582. Long-term effectiveness and tolerability of Dolutegravir/Lamivudine in Korea: 3 year follow up

Abstract Background Many studies have revealed the real-world effectiveness and tolerability of Dolutegravir/Lamivudine (DTG/3TC). However, most studies were conducted in Western countries, and data from Asian countries are still lacking; in particular, the results from long-term use have not been reported in Asian countries. As DTG/3TC has been introduced and is becoming increasingly widespread in Asia, it is necessary to investigate the maintenance rate, reasons for discontinuation, long-term effectiveness, and metabolic parameter changes. Methods We performed a retrospective cohort study with adult people with HIV treated with DTG/3TC specific combination at a tertiary hospital in Korea. Among them, those who were followed up for more than 36 months were included. Both treatment-naïve and those who switched from other antiretroviral therapies to DTG/3TC were included. Baseline characteristics, DTG/3TC maintenance rates, effectiveness, and metabolic parameters changes over 36 months were investigated. Results From July 2020 to April 2024, 305 people with HIV started DTG/3TC. Among them, 134 people with HIV followed for more than 36 months were included (16 treatment-naïve and 118 switching). Most were male (N=126, 94%), and the median age was 45.5 years. There were no cases of switching from DTG/3TC to other ARTs during the 36-month follow-up after starting DTG/3TC. All of the treatment-naïve group maintained HIV RNA &amp;lt; 50 copies/mL from 6 to 36 months after starting DTG/3TC. The rate of HIV RNA &amp;lt; 50 copies/mL at the 36 months in the switching group was 99.2% (117/118). In the treatment-naïve group, CD4 cell count increased from a median of 494 cells/uL at baseline to 795 cells/uL at 36 months (p=0.005). During the 36-month follow-up, there were no significant changes in lipid profile and body weight in both treatment-naïve and switching groups except for an increase in HDL cholesterol in the switching group (from median 45 mg/dL at baseline to median 49 mg/dL at 36-month, p=0.001). Effectiveness of Dolutegravir/Lamivudine for the treatments-naive and switching groups Conclusion In our long-term follow-up study conducted in South Korea, DTG/3TC worked effectively in viral suppression and CD4 count maintenance, and no significant adverse effects were observed on lipid profiles and body weight gain in both treatment-naïve and switching groups. Tolerability of Dolutegravir/Lamivudine for the treatments-naive and switching groups Disclosures All Authors: No reported disclosures

Comparative Study of Subclinical Hypothyroidism in Patients with and Without Metabolic Syndrome

Background: A group of metabolic abnormalities known as metabolic syndrome (MetS) greatly raises the risk of type 2 diabetes mellitus and cardiovascular illnesses. People with MetS frequently have subclinical hypothyroidism (SCH), which is defined by high levels of thyroid-stimulating hormone (TSH) with normal free thyroxine (T4). The research examined the relationship between thyroid function and metabolic parameters, as well as to assess the incidence of subclinical hypothyroidism in individuals with and without MetS. Methods: There were 960 participants in all, 480 of whom had a diagnosis of MetS and 480 of whom were healthy controls. Blood pressure and waist circumference were measured clinically. After an overnight fast, blood samples were taken utilising fully automated clinical chemistry and hormone analyzers to assay lipid profile, fasting blood glucose (FBG), and thyroid function tests (T3, T4, and TSH). The Pearson correlation coefficient and Student's t-test were used to analyse the data. Results: Statistically, there was a significant variation in the prevalence of subclinical hypothyroidism between the MetS group (16.3%) and the control group (5%; p &lt; 0.001). In addition to having decreased HDL cholesterol, MetS patients also had higher FBG, blood pressure, triglycerides, and waist circumference. TSH levels and the elements of MetS, such as waist circumference (r = 0.41, p &lt; 0.001), systolic blood pressure (r = 0.38, p &lt; 0.001), FBG(r = 0.44, p &lt; 0.001), triglycerides (r = 0.39, p &lt; 0.001), and HDL cholesterol (r = -0.32, p &lt; 0.001), were found to be significantly correlated with each other. Conclusion: The results of the study indicate that people with metabolic syndrome have a higher incidence of subclinical hypothyroidism, which may indicate a relationship between thyroid function and metabolic health. Regular thyroid function testing could help improve clinical outcomes by enabling early detection and management of SCH in MetS patients. Recommendations: When treating patients with metabolic syndrome, healthcare professionals should think about doing routine thyroid function tests. To manage thyroid dysfunction in patients with metabolic syndrome (MetS), further research is required to investigate the underlying mechanisms and create tailored therapies. Keywords: Metabolic Syndrome, Subclinical Hypothyroidism, Thyroid Function, Cardiovascular Risk, Metabolic Health

The Association Between Metabolic Syndrome and the Risk of Endometrial Cancer in Pre- and Post-Menopausal Women: A UK Biobank Study

Background: Metabolic syndrome (MetS) is a syndrome that comprises central obesity, increased serum triglyceride (TG) levels, decreased serum HDL cholesterol (HDL) levels, raised blood pressure (BP), and impaired glucose regulation, including prediabetic and diabetic glycaemic levels. Recently, the association with endometrial cancer (EC) has been described but it is unclear if the risk associated with MetS is higher than the individual effect of obesity alone. This study investigates the association between MetS components and differing MetS definitions on EC risk and compares the risk of MetS with the risk posed by obesity alone. It also analyses how MetS affects the risk of EC development in the pre- and post-menopausal subgroups. Methods: A prospective cohort study was undertaken using data from the UK biobank. Multivariable Cox proportional risk models with the time to diagnosis (years) were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of MetS and its components on the risk of EC. A subgroup analysis was also undertaken for pre- and post-menopausal participants. Kaplan–Meier (KM) was undertaken to assess the difference in the risk of EC development in differing BMI classes, and in pre- and post-menopausal subgroups. Results: A total of 177,005 females from the UK biobank were included in this study. Of those participants who developed EC (n = 1454), waist circumference &gt; 80 cm, BMI &gt; 30 kg/m2, hypertension &gt; 130/80 mmHg, hyperlipidaemia and diabetes (HbA1C &gt; 48 mmol/L were significant predictors of EC development, with waist circumference being the strongest predictor (HR = 2.21; 95% CI: 1.98–2.47, p &lt; 0.001). Comparing the pre- and post-menopausal subgroup, hypertriglyceridaemia and diabetes were the strongest predictors of EC in the pre-menopausal subgroup (HR = 1.53; 95% CI: 1.18–1.99 and HR = 1.51; 95% CI: 1.08–2.12, p &lt; 0.05, respectively). Raised waist circumference was not a significant independent predictor in the pre-menopausal subgroup. A KM curve analysis showed a clear distinction between those with and without MetS in the pre-menopausal group, suggesting a benefit of testing for MetS components in pre-menopausal women with obesity. Conclusions: Components of MetS, both independently and in combination, significantly increase the risk of EC. Screening those with obesity for MetS in their pre-menopausal years may help to identify those at the highest risk.

Cardiovascular Risk Assessment in the Immediate Postoperative Period of Bariatric Surgery

Objectives: Since obesity and overweight are strongly associated with cardiovascular diseases, we investigated cardiovascular events risk in individuals who lost weight through bariatric surgery. Methods: Serum levels of glucose, insulin, triacylglycerol, HDL cholesterol, non-HDLDL cholesterol, and lipoprotein ratios were assessed in patients with obesity before and after bariatric surgery, including a 6-month follow-up period. Results: Bariatric surgery significantly improved BMI, triglyceride levels, glucose, and insulin sensitivity. However, HDL cholesterol levels dropped sharply in the first month (p &lt; 0.0001), coinciding with elevated atherogenic indices, indicating a transient increase in cardiovascular risk. By 6 months, indices improved significantly, HDL recovered, and LDL particle size increased, suggesting reduced atherogenic potential. Conclusions: Individuals undergoing bariatric surgery have a higher cardiovascular events risk in the immediate postoperative period. Health professionals should be aware of and monitor these patients closely.

Activating transcription factor-3 orchestrates the modulation of vascular anti-contractile activity and relaxation by governing the secretion of HDL-bound sphingosine-1-phosphate in perivascular adipose tissue.

Perivascular adipose tissues (PVATs) play a critical role in modulating vascular homeostasis and protecting against cardiovascular dysfunction-mediated blood pressure dysregulation. We demonstrated that the activating transcription factor-3 (Atf3) gene in the PVAT is crucial for improving vascular wall tension abnormalities; however, its protective mechanism remains unclear. Herein, we aim to determine whether ATF3 regulates PVAT-derived relaxing factor (PVDRF) biosynthesis and if its secretion contributes to vasorelaxation. This study employed an in vivo animal model using global Atf3-deficient mice, in vitro blood vessel myography, and biochemical analyses to evaluate ATF3-mediated PVDRF release and reactivity in the vasculature. Wild-type (WT) mouse thoracic aortic PVAT extracts significantly induced resting tone dilation and attenuated vasoconstrictor-induced contractile responses compared to Atf3-/- mice. Heat-stable PVAT extracts from WT mice caused sustained and reproducible vasodilation without tachyphylaxis in control aortic rings. Biochemical evaluation of PVDRF release revealed that Atf3-/- mice had lower sphingosine-1-phosphate (S1P) and HDL cholesterol (HDL-C) levels than WT mice. Furthermore, PVAT extracts from WT mice induced long-lasting vasorelaxation, which was significantly inhibited by the S1P3 receptor antagonist TY52156 and scavenger receptor class B type 1 receptor antagonist glyburide. ATF3 within the PVAT can modulate vascular function by strengthening sphingosine kinase 1 (sphk1)-S1P-S1P3 receptor lipid signalling and stimulating S1P binding to HDL to form the vasodilator HDL-S1P. ATF3 is an essential modulator for maintaining the physiological function of PVAT, providing a novel target for treatment of obesity-related cardiovascular diseases.

P0275 The Impact of Sarcopenia on Clinical Outcomes in Pediatric Crohn’s Disease

Abstract Background Sarcopenia, the age-related progressive loss of muscle mass and strength, affects up to 50% of adults with Crohn’s Disease (CD) and is related to major clinical outcomes. However, data on children is scarce. We investigated whether sarcopenia at the diagnosis impacts the outcomes of children with CD. Methods Retrospective, single-center, case-control study of newly diagnosed children with CD undergoing magnetic resonance (MR) within one month from the diagnosis, from 2011 to 2022. Sarcopenia was assessed by measuring total psoas muscle area (tPMA) at L3-L4 level on the MR and defined as z-score values ≤2 standard deviations. Sarcopenic and nonsarcopenic children were compared for the risk of disease flares, IBD-related hospitalization, complications, need for step-up treatment, and courses of steroids over a 2-year follow-up. Results Seventy-eight children were included (mean age 11.7 years, 41% females), 46 (59%) sarcopenic and 32 (41%) nonsarcopenic. Sarcopenic children presented at the diagnosis with higher serum levels of total cholesterol (140 ± 28 mg/dL vs. 105.6 ± 27 mg/dL, p=0.009) as well as LDL and HDL cholesterol (77 ± 26 vs. 57.7 ± 24. 4 mg/dL, p=0.03 and 42.8 ± 9.2 vs 36 ± 8 mg/dL, p=0.02, respectively). The risk of clinical relapse was higher in sarcopenic vs nonsarcopenic patients at 6 [21.7% vs. 0%, OR 8.6 (95% CI 1.2-96.2), p=0.004] and 12 months [34.7% vs. 6.6%, OR 7.4 (95% 1.6-34.4), p=0.005]. Additionally, the risk of steroid use was higher in sarcopenic vs. nonsarcopenic children at 12 months [34.7% vs. 13.3%, OR 3.4 (95% CI 1.1-10.3), p=0.06]. Kaplan Meier analysis showed lower survival free from relapses in sarcopenic vs nonsarcopenic patients [Log Rank p=0.004, HR 2.8 (95%CI 1.3-5.7)]. Multivariate logistic regression analysis identified sarcopenia as an independent predictor of relapse risk [OR (95%CI)142 (2.1-470), p=0.051]. Conclusion The presence of sarcopenia at the diagnosis seems to increase the risk of unfavorable outcomes, specifically clinical relapses in the first year of diagnosis. An altered lipid profile may indicate an increased risk of reduced muscle mass children, highlighting the need for targeted nutritional and therapeutic interventions

Evaluation of the Anti-Diabetic and Biochemical Effects of Ocimum sanctum Extract in Alloxan Induced Rat Model

Herbal medicine has been employed by individuals to treat medical ailments since the dawn of civilization. This study aims to evaluate the efficacy of Ocimum sanctum as an antidiabetic agent and its impact on lipid profiles. We employed the alloxan-induced diabetes model to assess the efficacy of the antidiabetic drug. Only the 900 mg/kg dosage exhibited statistically significant (p &lt; 0.05) antidiabetic effect as compared to the 300 and 600 mg/kg dosages. Although there was a little reduction in HDL, LDL, and total cholesterol, the results for all groups were not statistically significant. Statistically substantial reductions (p &lt; 0.05) were seen for SGPT in groups 5 and 6 at dosages of 600 and 900 mg/kg for triglycerides, SGPT, and SGOT. The renal function test revealed a statistically significant urea level of 92.08±6.52* in group 6 at a dose of 900 mg/kg. Concerning creatinine levels, groups 5 and 6 had statistically substantial outcomes at the 600 and 900 mg/kg dosages, with values of 2.23±0.70* and 1.83±0.58*, respectively. The ethanolic extract of this plant exhibits notable antidiabetic and antihyperlipidemic properties, and additional investigation may contribute to the development of alternative medicinal applications.

P0249 The Impact of Obesity on the Persistence of Advanced Therapies in Inflammatory Bowel Disease

Abstract Background Obesity has emerged as a factor influencing outcomes in inflammatory bowel disease (IBD), yet its effect on the persistence of advanced biologic therapies, especially in Asian populations, remains unclear. This study evaluates obesity’s impact on clinical outcomes and treatment persistence among Taiwanese IBD patients on advanced biologic therapies. Methods This retrospective cohort study was conducted at Chang Gung Memorial Hospital, Taiwan, involving IBD patients on advanced biologics between April 2017 and October 2024. Patients were categorized by BMI into obesity (≥27 kg/m²) and control (&amp;lt;27 kg/m²) groups. Outcomes included one-year therapy persistence, infections, IBD-related hospitalizations, surgeries, and flare-ups, with persistence compared across biologic agents. Results Among 555 IBD patients, 68 were obese. Obese patients had distinct characteristics: higher male prevalence (86.8% vs. 65.3%), smoking rates (20.6% vs. 7.8%), and comorbidities such as hypertension (30.6% vs. 13.6%) and cardiovascular disease (11.8% vs. 2.5%). Lab results indicated elevated white blood cells, hemoglobin, albumin, and triglycerides, and lower HDL cholesterol in the obesity group. While overall one-year persistence rates were similar, Ustekinumab showed a lower persistence in obese patients. Conclusion Obesity in Asian IBD patients is linked to specific clinical traits and comorbidities. Although obesity did not affect overall therapy persistence, Ustekinumab’s lower persistence among obese patients suggests the need for tailored treatments. Future studies should explore optimal therapies for obese IBD patients.

Lipid Profile of Under-5 Years Children from a Tertiary Care Centre

Introduction: There is a considerable lack of study estimating lipid profile levels in children below 5 years of age. We therefore carried out this cross-sectional study to evaluate the lipid profile level of healthy Indian children under five years of age from a tertiary level hospital in India. Methodology: This observational cross-sectional study was conducted in a tertiary care center. We randomly enrolled 119 healthy children aged 1 month to 5 years, in whom Total cholesterol, triglyceride, HDL, LDL, and VLDL were measured in a random venous blood sample via a BA400 automatic analyzer by BioSystems using Glycerol Phosphate Oxidase/Peroxidase method using the principle of spectrophotometry. Total cholesterol was calculated as the sum of all the lipids detected. Results: Median age was 16 months (9.5 months - 28 months), and 59.6% were male. The overall mean reference range for Total cholesterol was 132.6±38.3 mg/dL, Triglycerides was 98.5±46.2 mg/dL, LDL was 71.5±25.0 mg/dL, HDL was 42.6±15.8mg/dL and VLDL was 19.6±9.3mg/dL. There was no significant difference in lipid profiles between the sexes. HDL level was significantly higher in those above 24 months (p=0.02), while the other components were similar between various age groups. Conclusion: There was no significant difference between the lipid profile of children in our cohort, and previously published studies. Levels of HDL cholesterol increased with age after 24 months of age.