High-density Lipoprotein Cholesterol Values Research Articles

Turkish assessment of SURF (SUrvey of Risk Factor Management) study: Control rates of cardiovascular risk factors derived from databases of 15 different levels of health centers in Turkey.

The aim of this study was to evaluate the adherence to recommendations for secondary prevention and the achievement of treatment targets for the control of risk factors in patients with established coronary heart disease (CHD) who were followed-up at various healthcare facilities in Turkey. According to the protocol of the international Survey of Risk Factor Management study, questionnaire forms were completed and demographic, anthropometric, and laboratory data of CHD patients who were followed-up at a total of 15 selected primary, secondary, and tertiary healthcare centers were recorded. Among a total of 724 CHD patients (69.8% male; mean age: 63.3±10.7 years) included in the study, 18.4% were current smokers, only 19.1% had normal body mass index, and 22.1% had waist circumference below the limit of abdominal obesity. Physical activity was insufficient in 53% of the patients, 47.3% had low high-density lipoprotein cholesterol value, 46% had triglyceride level above 150 mg/dL, and 67% had glycated hemoglobin value of 6.5% or above. Of all the patients, 88.1% were using antiplatelet drugs, 71.4% were using beta-blockers, 55.7% were using statins, and 41.9% were using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Blood pressure was under control in 56.7% of the hypertensive patients using antihypertensive drugs, and the proportion of diabetic patients who reached glycemic control targets using antidiabetic drugs was 35.9%. Low-density lipoprotein cholesterol was below 70 mg/dL in 12.2% of the patients using statins. According to the data obtained, among Turkish CHD patients, the control rate of cardiovascular risk factors is low, and implementation of the recommendations regarding lifestyle modification and medication use for secondary prevention in the current guidelines are insufficient.

Homogeneous Assays for LDL-C and HDL-C are Reliable in Both the Postprandial and Fasting State.

Aim: Most epidemiological and clinical studies calculated low-density lipoprotein-cholesterol (LDL-C) by Friedewald's formula which cannot be used in the postprandial samples. Although the homogeneous assays with poor analytical performance were withdrawn from the market, it remained unclear whether the currently available reagents for LDL-C and high-density lipoprotein-cholesterol (HDL-C) are as accurate for postprandial samples as for fasting samples.Methods: Fresh blood samples were collected from 59 non-diseased and 109 diseased subjects. Postprandial samples constituted 72.9% and 39.4% of these samples. LDL-C and HDL-C concentrations were measured using the homogeneous assays of four manufacturers (Denka Seiken, Wako, Kyowa Medex, and Sekisui Medical). Simultaneously, LDL-C and HDL-C concentrations were determined using the reference measurement procedures (RMPs) of the Centers for Disease Control and Prevention (CDC). Total errors were calculated using a routine method (TEcom) and via error component analysis (TEeca).Results: All homogeneous assays for LDL-C and HDL-C met the National Cholesterol Education Program (NCEP) requirements in terms of coefficient of variation, and TEcom in both non-diseased and diseased subjects. LDL-C and HDL-C values measured by the homogeneous assays were in good agreement with those measured by the RMPs in both fasting and postprandial samples. The TEcom and TEeca values of the postprandial samples were similar to those of fasting samples, although the TEeca values were up to 4.4-fold greater than the TEcom values.Conclusions: In both non-diseased and diseased subjects, the homogeneous assays for LDL-C and HDL-C of four manufacturers are as accurate for postprandial samples as for fasting samples.

Factors Affecting Children’s Cholesterol Levels with a View to Prevent Cardiovascular Disease—The Unique Benefits of Health Screening at the Elementary School

Background: The prevention of cardiovascular disease (CVD) can substantially contribute to reducing the mortality rate across countries. The level of interest in cholesterol among experts increases when the subjects are elderly and obese individuals. However, specialists do not recommend that children should receive the cholesterol test. The objective of this study was to investigate the distribution of cholesterol levels among the children of public school and their parents’ lifestyles that are associated with cholesterol levels, and to assess the need for and utility of cholesterol testing in school settings. Methods: The study investigated a group of 226 fourth-grade public school children aged between 9 and 10 years and guardians in Akitakatacity of Hiroshima Prefecture, Japan. Multiple regression analyses were performed with the logarithmic value of cholesterol levels as a response variable, awareness about lifestyles and health of children as an explanatory variable, and child’s sex and body mass index (BMI) as moderating variables. Using questionnaires about lifestyles, the step-down procedure was applied in multiple regression analyses to narrow down relevant lifestyle variables. Results: The percentage of children with the high total cholesterol (TC) value was about 15 and with low-density lipoprotein (LDL) cholesterol value was about 10. Children with low high-density lipoprotein (HDL) cholesterol value were 5%. Treatment was not required according to the comprehensive assessment. Cholesterol levels were associated with the situation of the children and their guardians as follows, guardian need to consider the food, and child has the correct knowledge about food like how to eat snacks. Conclusions: Children had poor cholesterol levels. From childhood, along with the parents, there is a need to learn about appropriate level of cholesterol for CVD prevention.

Strenuous physical exercise and hematological indices of cardiovascular risk: the exception case of a 93-year-old man running a 100-km distance

We describe here the variation of hematological and biochemical parameters in a 93-year-old man, who successfully completed a 100-km distance run. The athlete completed the trial at an average speed of 5.6 km/h. The red blood cell distribution width (RDW) increased immediately after crossing the finishing line and peaked 1 day afterward, displaying a 14% increase from baseline. The RDW then declined to a value still higher than the baseline after 1 week. The value of mean platelet volume (MPV) increased immediately after crossing the finishing line, decreased in the following 2 days and returned to baseline after 1 week. The serum concentration of cardiac troponin T (cTnT) peaked immediately at the end of the run (with a nearly 2.8-fold increase), and then declined on the following day, returning to baseline after 1 week. The value of high-density lipoprotein cholesterol (HDL-C) increased at the end of the run, peaked the day after and then slowly declined during the following days, to approximate the baseline concentration after 1 week. The values of total cholesterol and low-density lipoprotein cholesterol (LDL-C) declined after crossing the finishing line, reached the nadir 2 days after, but 1 week after the trial were still approximately 10% lower than the baseline concentration. These variations, firstly described in an elderly man running such a long distance, suggest that strenuous physical exercise generates considerable biochemical changes, triggering an acute prothrombotic state, which is then followed by a longer period of reduced cardiovascular risk.

Calibration of High-Density Lipoprotein Cholesterol Values From the Korea National Health and Nutrition Examination Survey Data, 2008 to 2015.

BackgroundFor correct interpretation of the high-density lipoprotein cholesterol (HDL-C) data from the Korea National Health and Nutrition Examination Survey (KNHANES), the values should be comparable to reference values. We aimed to suggest a way to calibrate KNHANES HDL-C data from 2008 to 2015 to the Centers for Disease Control and Prevention (CDC) reference method values.MethodsWe derived three calibration equations based on comparisons between the HDL-C values of the KNHANES laboratory and the CDC reference method values in 2009, 2012, and 2015 using commutable frozen serum samples. The selection of calibration equation for correcting KNHANES HDL-C in each year was determined by the accuracy-based external quality assurance results of the KNHANES laboratory.ResultsSignificant positive biases of HDL-C values were observed in all years (2.85-9.40%). We created the following calibration equations: standard HDL-C=0.872×[original KNHANES HDL-C]+2.460 for 2008, 2009, and 2010; standard HDL-C=0.952×[original KNHANES HDL-C]+1.096 for 2012, 2013, and 2014; and standard HDL-C=1.01×[original KNHANES HDL-C]-3.172 for 2011 and 2015. We calibrated the biases of KNHANES HDL-C data using the calibration equations.ConclusionsSince the KNHANES HDL-C values (2008-2015) showed substantial positive biases compared with the CDC reference method values, we suggested using calibration equations to correct KNHANES data from these years. Since the necessity for correcting the biases depends on the characteristics of research topics, each researcher should determine whether to calibrate KNHANES HDL-C data or not for each study.

High-density lipoprotein-cholesterol levels and risk of cancer in HIV-infected subjects: Data from the ICONA Foundation Cohort.

Investigation of the relationship between high-density lipoprotein-cholesterol (HDL-c) and the risk of developing cancer in a prospective cohort of human immunodeficiency virus (HIV)-infected patients.The Italian Cohort of Antiretroviral-naïve Patients Foundation Cohort is an Italian multicenter observational study recruiting HIV-positive patients while still antiretroviral treatment-naïve, regardless of the reason since 1997.Patients with at least 1 HDL-c value per year since enrollment and one such value before antiretroviral treatment initiation were included. HDL-c values were categorized as either low (<39 mg/dL in males or <49 mg/dL in females) or normal. Cancer diagnoses were classified as AIDS-defining malignancies (ADMs) or non-AIDS-defining malignancies (NADMs). Kaplan–Meier curves and Cox proportional-hazards regression models were used.Among 4897 patients (13,440 person-years of follow-up [PYFU]), 104 diagnoses of cancer were observed (56 ADMs, 48 NADMs) for an overall incidence rate of 7.7 (95% confidence interval [CI] 6.3–9.2) per 1000 PYFU.Low HDL-c values at enrollment were associated with higher risk both of cancer (crude hazard ratio [HR] 1.72, 95% CI 1.16–2.56, P = 0.007) and of NADM (crude HR 2.50, 95% CI 1.35–4.76, P = 0.003). Multivariate analysis showed that the risk of cancer diagnosis was higher in patients with low HDL-c values (adjusted HR [AHR] 1.87, 95% CI 1.18–2.95, P = 0.007) in older patients, those patients more recently enrolled, and in those with low current cluster of differentiation 4+ levels, and/or high current HIV-ribonucleic acid.The multivariate model confirmed an association between HDL-c (AHR 2.61, 95% CI 1.40–4.89, P = 0.003) and risk of NADM.Low HDL-c is an independent predictor of cancer in HIV-1-infected subjects.

Evaluation of the point of care Afinion AS100 analyser in a community setting.

Background A 'one stop shop' model for multifactorial risk factor management in a culturally sensitive environment may improve cardiovascular disease and diabetes prevention. A full biochemical profile for cardiovascular disease risk assessment includes a lipid profile, glucose, glycated haemoglobin and urine albumin creatinine ratio measurements. This may require the use of more than one point of care testing instrument. Methods Individuals who attended a community cardiovascular disease risk screening or an audit programme of the diabetic care pathway in the community were sampled. Bland-Altman and Deming regression plots were used to assess agreement between methods for total cholesterol, high-density lipoprotein cholesterol, triglycerides, glycated haemoglobin and urine albumin creatinine ratio. Results There was good agreement between the Afinion AS100 analyser, Cholestech LDX and the laboratory methods for total cholesterol, high-density lipoprotein cholesterol and triglycerides ( n = 232). The Afinion AS100 agreed well with the laboratory method for glycated haemoglobin ( n = 255) and urine albumin creatinine ratio ( n = 176). There was statistically significant bias ( p = 0.03 to <0.0001) for several measurements. However, these were judged not to be clinically relevant. Specifically for the total cholesterol and high-density lipoprotein cholesterol values, we obtained good agreement (weighted kappa: 0.91 and 0.94 for the Afinion AS100 vs. Cholestech LDX and Afinion AS100 vs. laboratory method, respectively) for cardiovascular disease risk calculation using QRISK2. Conclusions Point of care testing can support a 'one stop shop' approach by providing rapid, reliable results. The Afinion AS100 analyser provides a multi-analyte platform and compares well with laboratory-based methods and another well-established point of care testing analyser.

Prediction of Preadolescent Overweight and Poor Cardiometabolic Outcome in Children up to 6 Years of Age: Research Protocol.

BackgroundDynamic risk estimations may enable targeting primary prevention of overweight and overweight-related adverse cardiometabolic outcome in later life, potentially serving as a valuable addition to universal primary prevention. This approach seems particularly promising in young children, as body mass index (BMI) changes at a young age are highly predictive of these outcomes, and parental lifestyle interventions at a young age are associated with improved long-term outcome.ObjectiveThis paper describes the design of our study, which aims to develop digitized tools that can be implemented in the Dutch Child Health Care (CHC) system or by pediatricians for children up to 6 years of age. These tools will enable (1) dynamically predicting the development of overweight, hypertension or prehypertension, low high-density lipoprotein cholesterol (HDL-C) values, and high total cholesterol to HDL-C ratio by early adolescence and (2) identifying children who are likely to have poor cardiometabolic outcome by the age of 5-6 years and by the age of 10 years.MethodsData will be obtained from the Generation R (n=7893) and Prevention and Incidence of Asthma and Mite Allergy (PIAMA; n=3963) cohorts, two Dutch prenatally recruited cohorts. We will select candidate predictors that can be assessed during the first visit and/or during subsequent visits to the CHC center or pediatrician, including sex; parental age, education level, and BMI; smoking exposure; ethnicity; birth weight; gestational age; breastfeeding versus formula feeding; and growth data through the age of 6 years. We will design dynamic prediction models that can be updated with new information obtained during subsequent CHC visits, allowing each measurement to be added to the model. Performance of the model will be assessed in terms of discrimination and calibration. Finally, the model will be validated both internally and externally using the combined cohort data and then converted into a computer-assisted tool called ProCOR (Prediction Of Child CardiOmetabolic Risk).ResultsThis is an ongoing research project financed by the Dutch government. The first results are expected in 2016.ConclusionsThis study may contribute to the national implementation of digitized tools for assessing the risk of overweight and related cardiometabolic outcome in young children, enabling targeted primary prevention, ultimately yielding relevant health gains and improved resource allocation.

Predictive value of chemotherapy-related high-density lipoprotein cholesterol (HDL) elevation in patients with colorectal cancer receiving adjuvant chemotherapy: an exploratory analysis of 851 cases

BackgroundThe phenomenon of chemotherapy-related lipid alterations has been reported based on a small number of patients and varies among different cancers. However, little is known about these alterations in colorectal cancer (CRC) patients.ResultsPatients in cohort 1, but not in cohort 2, exhibited significantly increased cholesterol, triglyceride, HDL-C, and ApoA-I levels, and decreased LDL-C and ApoB levels after adjuvant chemotherapy. Patients with chemotherapy-related HDL-C elevation exhibited better 3-year DFS (84.5% vs. 73%, P = 0.001) and 7-year OS (82% vs. 70%, P = 0.002) than those without. Similarly, the 3-year DFS (83.3% vs. 77.6%, P = 0.008) and 7-year OS (81% vs. 74.6%, P = 0.040) were superior in chemotherapy-related ApoA-I elevation patients. However, only HDL-C elevation remained an independent prognostic value in the multivariate Cox model.MethodsEight hundred fifty-one CRC patients with curative-intent resection were retrospectively analyzed. Six hundred sixty-seven receiving fluoropyrimidine-based adjuvant chemotherapy for more than 3 months were enrolled in cohort 1. The lipid alterations before and after chemotherapy were studied. Simultaneously, 184 patients not treated with chemotherapy (cohort 2) were included as a control for the comparisons of lipids alterations within 1 month after resection and at half-year follow-up. Furthermore, these significant alterations were investigated with respect to the prognostic value of disease-free survival (DFS) and overall survival (OS). An internal validation was performed.ConclusionWe observed significant changes in the levels of various lipids in CRC patients receiving adjuvant chemotherapy. Furthermore, chemotherapy-related HDL-C elevation was determined to be an independent prognostic indicator for superior DFS and OS.

High-density lipoprotein cholesterol and in-hospital mortality in patients with acute aortic dissection.

The association between high-density lipoprotein cholesterol (HDL-C) and mortality in patients with acute aortic dissection (AAD) is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group (n=585), low HDL-C group (n=343) had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group (21.6% vs. 12.6%, log-rank=10.869, P=0.001). After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference (adjusted hazard ratio, 1.23; 95% confidence interval, 0.86-1.77; P=0.259). Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.

Metabolic Syndrome in Children and Adolescents Living with HIV.

Metabolic syndrome (MetS) is considered an independent risk factor for developing cardiovascular disease. It is well known that the prevalence of metabolic disorders have increased in pediatric HIV-infected children. The objective of this study is to assess the prevalence and characteristics of MetS in HIV-infected children and adolescents in Spain. A cross-sectional multicenter study in 152 patients from the pediatric cohort of the Spanish AIDS Research Network (CoRISpe) was performed. MetS was defined according to the new International Diabetes Federation (IDF) diagnostic criteria and the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Measurements included anthropometry, waist circumference, blood pressure, fasting lipids, glucose and insulin and lipodystrophy assessment. Demographic, clinical, immunological, virological and antiretroviral therapy data were obtained from the Network database. An abnormally low high-density lipoprotein-cholesterol level was the most prevalent disturbance (21.05%) found. Three patients met IDF criteria for MetS (1.97%), and MetS was significantly associated with lipohypertrophy (P=0.029) in the analysis. When the modified NCEP-ATP III criteria were used, the prevalence of MetS was 5.92% (9 patients), and MetS was significantly associated with Tanner stage ≥2 (P=0.041), lipohypertrophy (P=0.001) and higher Z scores for weight and body mass index (P=0.002 and P<0.001). Insulin resistance was observed in 17 patients (11.18%) and was associated with MetS (as per the modified NCEP-ATP III criteria) (P=0.03) and lower high-density lipoprotein-cholesterol values (P=0.036). The prevalence of MetS in our cohort was 1.97% or 5.92%, depending on the diagnostic criteria used. MetS should be actively assessed, particularly in children who show lipohypertrophy.

High-density lipoprotein cholesterol values independently and inversely predict cardiac troponin T and I concentration.

This retrospective study was planned to establish potential associations between circulating values of cardiac troponins and those of conventional blood lipids. The study population consisted of patients attending an inpatient clinic of the University Hospital of Verona during the year 2015 as part of routine cardiovascular risk assessment. No exclusion criteria were applied. Serum lipids including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were measured using reference enzymatic techniques, whereas troponin T (TnT) was measured using a high-sensitivity (HS) immunoassay. A second analysis was also performed in the General Hospital of Verona, extracting data from the local laboratory database of all patients in whom troponin I (TnI) and blood lipids were simultaneously measured during the same year. In univariate analysis, HS-TnT was found to be associated with age, sex, TC, LDL-C, HDL-C, but not with TG. In multivariate linear regression analysis, age (positive correlation; P<0.001) and HDL-C (negative correlation; P=0.032) remained significantly associated with HS-TnT. The frequency of HS-TnT values >50 ng/L was higher in subjects with HDL-C <1 mmol/L than in those with HDL-C ≥1 mmol/L [odds ratio (OR), 1.84; 95% confidence interval (CI), 1.03-3.32]. The frequency of HS-TnT values >50 ng/L was also higher in elderly subjects than in younger ones (OR, 2.10; 95% CI, 1.15-3.84). The combination of age and HDL-C explained 35% of overall variability of TnT concentration. In the second analysis, HDL-C was also found to be an independent and negative predictor of TnI in multivariate linear regression analysis (P=0.010). The combination of age and HDL-C explained approximately 28% of the overall variability of TnI concentration. Our study suggests that HDL-C values inversely predict cardiac troponins concentration irrespective of age, sex and other blood lipids.

Relationship between Serum Ferritin Levels and Dyslipidemia in Korean Adolescents.

BackgroundFerritin is associated with various cardiometabolic risk factors such as dyslipidemia, hypertension, obesity, and insulin resistance in adults. We aimed to study the association between serum ferritin levels and dyslipidemia in adolescents, because dyslipidemia is considered an important modifiable cardiovascular risk factor in the young.MethodsWe analyzed 1,879 subjects (1,026 boys and 853 girls) from the 2009–2010 Korean National Health and Nutrition Examination Survey IV. Subjects were categorized into quartiles according to their lipid parameters, which were classified according to age and gender. Those in the highest quartile groups for total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride concentrations were diagnosed as having dyslipidemia. Those in the lowest quartile for high-density lipoprotein cholesterol (HDL-C) values were diagnosed with abnormal levels.ResultsIn boys, total cholesterol, LDL-C, and triglyceride concentrations were significantly correlated with serum ferritin levels. In both boys and girls, serum ferritin levels were negatively associated with HDL-C values, even after adjusting for all covariates. Furthermore, there was no significant correlation between serum ferritin levels and total cholesterol, LDL, and triglyceride concentrations in girls.ConclusionSerum ferritin levels were significantly associated with major dyslipidemia parameters, more prominently in boys than in girls, and this association represents a cardiometabolic risk factor.

Extremely elevated HDL-cholesterol levels are not associated with increased carotid intima-media thickness: data from ELSA Brasil

There is evidence that extremely elevated high-density lipoprotein cholesterol (HDL-c), that is, hyperalphalipoproteinemia (HALP) may indicate dysfunctional HDL, conferring increased cardiovascular risk. We studied carotid intima-media thickness (cIMT) a marker of subclinical vascular disease according to HDL-c distribution. cIMT was studied in subjects with "normal" HDL-c levels (HDL-c 40-50mg/dL for men; 50-60mg/dL for women, mean 49.6±5.7mg/dL, n=3226); in those with HALP (HDL-c ≥90mg/dL for both sexes, mean 101.2±10mg/dL, n=264) and according to HDL-c quintile distribution (n=9779). Multiple linear regression was used to test the association of HDL-c and cIMT. Subjects with HALP were older (54.5±9.6 vs 51.1±8.8years, P<.001); more frequently females (86.4% vs 49%, P<.001); and presented a lower burden of risk factors: hypertension (24.6% vs 32.7%, P=.009), diabetes (10.2% vs 20.4%, P<.001), and obesity (18.6% vs 37.6%, P<.001). A similar profile was seen with higher HDL-c quintiles in the whole study population. When compared to normal HDL-c values, HALP was associated with lower maximal cIMT (0.779±0.189mm vs 0.818±0.200mm, P=.002), and there was a lower prevalence of individuals with cIMT ≥ 75(th) percentile for age and gender or high cIMT (17.5% vs 26.2%, P=.003). After multivariate analysis, no association was seen between HALP and increasing cIMT values, indeed the 5(th) HDL-c quintile was associated with lower risk of high cIMT (OR= 0.80; 95% CI= 0.68-0.95). HALP is associated with lower cIMT and does not indicate a pro-atherogenic phenotype.

Hypolipidemic effects of hickory nut oil using cold pressure extraction.

Optimal conditions of hickory nut oil cold press technology were studied. L9(34) orthogonal experiment results showed that optimal conditions were a pressing pressure of 15 MPa, pressing temperature of 50°C, pressing cycle of 4 s, and stop cycle of 9 s. Fatty acid compositions were determined using GC-MS and hypolipidemic effects in mice were investigated. Compared to a high fat diet group, hickory nut oil administration decreased serum and visceral total cholesterol, triacylglycerol, and serum low density lipoprotein cholesterol levels. Serum high density lipoprotein cholesterol values were increased. Hickory nut oil can be used as a valuable bioactive source of natural hypolipidemic compounds.

Nutrient digestion, microbial protein synthesis, and blood metabolites of Jersey heifers fed chitosan and whole raw soybeans

This study was undertaken to determine the effects of chitosan and whole raw soybean on nutrient intake and total tract digestion, nitrogen utilization, microbial protein synthesis, blood metabolites, and energy balance of dairy heifers. Twelve Jersey heifers (6±0.5 months of age and 139.50±25.56 kg of live weight; mean ± standard deviation) were randomly assigned to a replicated Latin square design with a 2 × 2 factorial arrangement. The experimental period consisted of 14 days of adaptation to diets, six days of sampling, and five days of washout. The experimental diets were: control (CO); chitosan (CHI, inclusion of 2.0 g kg−1 DM of chitosan); whole raw soybean (WS, 163.0 g kg−1 of WS on diet DM basis); and chitosan + whole raw soybean (CHI+WS). Chitosan decreased dry matter and neutral detergent fiber intakes; however, CHI increased DM total tract digestion. An interaction effect was observed on retained nitrogen, which increased when animals were fed CHI+WS compared with CO or CHI, but did not differ from that of animals fed WS. Chitosan decreased microbial nitrogen and crude protein flow of heifers. Energy balance was improved when heifers received diets containing WS. Efficiency of energy utilization was not affected by experimental diets. An interaction effect was observed for blood high-density lipoprotein (HDL) concentration, which increased with both dietary inclusion of CHI and WS compared with the other diets, and CHI provided the lowest value of HDL cholesterol. Chitosan and whole raw soybean do not alter nutrient intake and total tract digestion; however, they decrease nitrogen urinary excretion and increase blood HDL cholesterol of heifers.

Accuracy of Capillary Cholesterol Test When Fasting in Dyslipidemic Patients or General Population: Comparison with Venous Cholesterol Test

Results: The correlation between capillary and venous samples for total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), and low density lipoprotein cholesterol (LDLC) were 0.615, 0.605, 0.517, and 0.533, respectively, showing statistical significance (all P<0.05). All except TG had lower capillary mean values than venous mean values (all P<0.05). The percent bias values for TC (-13.25%), TG (21.54%), HDLC (-29.61%), and LDLC (-22.93%) were all outside of the acceptable ranges, and the misclassification rates were generally higher for higher CVD risk categories within all lipid parameters except HDLC. Conclusion: Our findings suggest that LipidPro has weak correlation and low accuracy compared with venous cholesterol values. The results further suggest that LipidPro has several limitations that must be addressed in order to make the most appropriate clinical decisions for screening, diagnosis and management of dyslipidemia patients.

The Association between Venous Thromboembolism and Lipid Profile in a Tunisian Population

Background and objectives: Lipids and lipoproteins modulate the expression and/or the function of thrombotic, fibrinolytic and rheological factors among patients with cardiovascular disease. Many studies have suggested a link between risk factors of venous thromboembolism (VTE) and dyslipidemia but results are heterogeneous. We sought to identify if dyslipidemia is a risk factor of VTE disease. Patients and methods: We have developed an hospital-based case-control study which was conducted in 32 patients with VTE and 33 age- and gender-matched healthy controls. We were proceeding to compare the lipid profile of the two groups after analysing the total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), Lipoprotein Lp(a), Apo-A1, Apo-B and Apo-E. Patients who have cancer and whose taken statins or fibrates are excluded. Results: The two groups have the same demographic characteristics but there were more diabetics, arterial hypertension and obese in the VTE group than the control group respectively (Diabetic: 37% vs. 18%, hypertension: 68.6% vs. 15.2% and (body mass index) BMI ≥30 Kg/m2: 43.8% vs. 18.2%). The mean value of the total cholesterol (TC), the LDL-C, Lipoprotein Lp (a), and Apo-B were statistically higher in the VTE group compared to control group respectively ; TC (4.942 ± 1.409 vs. 4.362 ± 0.872 mmol/L,P=0.049), LDL-C (3.114 ± 1.100 vs. 2.602 ± 0.695 mmol/L, P=0.001), Lp (a) (0.205 ± 0.115 vs. 0.0819 ± 0.0479 g/l, P <10-3), Apo-B (1.333 ± 0.253 vs. 0.8006 ± 0.238 g/l, P<10-3), but there was no statistical significant difference was observed between the two groups in the value of Triglycerides and Apo E respectively (1.710 ± 0.816 vs. 1.366 ± 0.636 mmol/L, P=0.62), (0.102 ± 0.070 vs. 0.0810 ± 0.153 g/l, P=0.48). However, the mean value of HDL-C and Apo-A1 were statically lower in the VTE group; HDL-C (1.048 ± 0.237 vs. 1.473 ± 0.334 mmol/L, P<0.001) and Apo-A1 (1.010 ± 0.2437 vs. 1.414 ± 0.2911 g/l, P<10-3). Furthermore, enhanced HDL-C ≤0.906 mmol/L was diagnosed in 21 patients (65.6%) in the VTE group versus 4 patients (12.1%) in the control group (P<0.001), so it was also independently associated with a risk of VTE. Conclusion: The present study shows a significant association between the occurrence of venous thromboembolism and lower levels of HDL-C and ApoA1 and higher levels of LDL-C, Apo-B and Lp(a), but, there were no effect of Triglycerides and ApoE. Nevertheless, these results must be confirmed with a large population study to prove an eventual independent factor for VTE and dyslipidemia

Monitoring of high-density lipoprotein cholesterol level is predictive of EGFR mutation and efficacy of EGFR-TKI in patients with advanced lung adenocarcinoma.

High-density lipoprotein cholesterol (HDL-C) has an inverse association with the incidence of lung cancer. However, whether it can be used as a predictive factor in advanced lung adenocarcinoma patients treated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) still remains undefined. This research aimed at studying the relationship of serum HDL-C baseline level and HDL-C kinetics to EGFR mutation, the efficacy of EGFR-TKI, and the predictive value of PFS. The presence of mutation rate in the 192 patients with lung adenocarcinoma was compared within stratified groups. Levels of baseline HDL-C and kinetics of HDL-C were analyzed retrospectively in patients treated with EGFR-TKI harboring EGFR mutation. Univariate and multivariate analyses were performed to investigate the prognostic value of HDL-C. EGFR mutation rate of HDL-C high-level group was significantly higher than that of low-level group (59.0% vs 35.6%, P=0.001). Multivariate logistic analysis showed that high-level HDL-C was an independent predictive factor for EGFR gene mutation (P=0.005; odds ratio =0.417; 95% confidence interval [CI], 0.227–0.768). Patients with a low level of HDL-C before therapy showed a progression of disease in most cases (P<0.001). According to HDL-C kinetics, patients who received EGFR-TKI treatment harboring EGFR mutation were divided into four groups. Univariate analysis showed that patients in nondecreased group had longer progression-free survival (P<0.001; hazard ratio =0.003; 95% CI, 0.001–0.018). Multivariate Cox proportional hazards model analyses showed the same result (P<0.001; hazard ratio =0.003; 95% CI, 0.001–0.018). Current results suggest that HDL-C seems to be a good independent predictive biomarker for advanced lung adenocarcinoma patients treated with the first-line EGFR-TKI. Roles of this biomarker include indicating EGFR mutation, assessing the efficacy of EGFR-TKI, and predicting the progression-free survival.

Waist Circumference Percentiles in Indigenous Argentinean School Children Living at High Altitudes.

Central obesity is associated with increased risk of type 2 diabetes. The study objectives were to develop waist circumference (WC) percentiles, to determine if WC is associated with metabolic risk, and to compare our WC percentiles with those reported in the 2007-2010 National Health and Nutrition Examination Survey (NHANES). A cross-sectional study of 1232 children (606 boys ) 5-14 years was performed from 2011 to 2014 in indigenous Koya children from northwestern Argentina. Anthropometric characteristics, glucose, lipids, and insulin levels were measured. Sex-specific reference percentiles were computed using the Lambda-Mu-Sigma (LMS) method. We obtained 2007-2010 NHANES data for comparison with our results. Compared with the NHANES 90th percentile, WC values for children in this study were lower by an average of 11.05 cm for girls and 12.66 cm for boys. The prevalence of low high-density lipoprotein cholesterol (HDL-C) was 11.8% in children with WC ≤50th percentile, 10.3% in children with WC >50th-70th percentile, 17.5% in children with WC >70th-90th percentile, and 21.3% in children with WC >90th percentile. The prevalence of high triglycerides (TG) was 19.5% in children with WC ≤50th percentile, 19.9% in children with WC >50th-70th percentile, 28.8% in children with WC >70th-90th percentile, and 39.7% in children with WC >90th percentile. Multiple logistic regression analyses showed that high TG values (>150 mg/dL) were significantly associated with WC [odds ratio (OR)] 1.05; 95% confidence interval (CI) 1.03-1.08; and low HDL-C values (<35 mg/dL) were significantly associated with WC (OR 1.04; 95% CI 1.01-1.06), adjusted for age and gender. We present for the first time WC reference data for indigenous Koya children ages 5-14 years. There was a significant association between WC and dyslipidemia in this community. Compared with the NHANES WC percentiles, our WC values were lower. These differences possibly reflect ethnicity or the lower prevalence of obesity.