High-density Lipoprotein Cholesterol Research Articles

Systematic review and meta-analysis assessing the status of carotid intima–media thickness and lipid profiles in type 2 diabetes mellitus

ObjectivesCarotid intima–media thickness (CIMT) is a measurement for subclinical atherosclerosis and has been associated with overall cardiovascular diseases, especially in type 2 diabetes mellitus (T2DM). We aimed to assess the...

Effects of repetitive transcranial magnetic stimulation therapy on weight and lipid metabolism in patients with treatment‐resistant depression: A preliminary single‐center retrospective cohort study

AbstractAimThis study aimed to elucidate the effects of repetitive transcranial magnetic stimulation (rTMS) on weight, body mass index (BMI), and lipid metabolism in patients with treatment‐resistant depression (TRD).MethodsThis retrospective observational study included patients with TRD who received rTMS treatment at the Jikei University Hospital from September 2018 to August 2021. The patients were diagnosed based on the DSM‐5 and ICD‐10 criteria and treated using the NeuroStar TMS System. For 3–6 weeks, 10‐Hz rTMS was administered to the left dorsolateral prefrontal cortex at 120% motor threshold. The primary outcomes were changes in weight and BMI, whereas the secondary outcomes included changes in total, high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL) cholesterol levels, thyroid function indicators, as well as HAMD‐17, HAMD‐24, and Montgomery–Åsberg Depression Rating Scale (MADRS) scores. Statistical analysis was conducted using paired t‐tests and repeated measures ANOVA.ResultsAmong the 34 patients (20 men and 14 women) included, no significant changes were observed in weight or BMI after rTMS treatment (average weight reduction: −0.50 kg, 95% CI: −0.14 to 0.56, p = 0.24; average BMI reduction: −0.21, 95% CI: −0.10 to 0.61, p = 0.15). However, significant reductions in total, HDL, and LDL cholesterol levels and FT4 were observed. Furthermore, the HAMD‐17, HAMD‐24, and MADRS scores significantly increased post‐treatment.ConclusionrTMS treatment did not affect weight or BMI in patients with TRD but is believed to improve lipid metabolism.

Correlation of Lipid Profile and BMI with Fasting Blood Glucose

The prevalence in Libya of overweight people has more than tripled from 19.5% in 1984 to 63.5% in 2009, while the rate of obesity has more than doubled over the past three decades leading to a much higher incidence of Type 2 diabetes T2DM. This makes investigation of links between BMI and lipid profiles in Libyan T2DM patients of vital importance. This study was conducted to determine the cor-relation between body mass index (BMI) and lipid profiles in patients with T2DM attending outpatient clinics in the Diabetes and Endocrinology Centre (Ibn Al-Nafees Hospital) Tripoli, Libya. The second objective was to compare BMI, FBS and lipid profiles between T2DM patients and a control group. The study was carried out during the period of June and July 2024 included 122 T2DM patients and 55 healthy subjects. The subject’s serum was analysed for total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). The possible correlation of BMI with lipid values were analysed. The Pearson’s co-efficient between the BMI and the lipid parameters did not show any significant correlation in T2DM patients. Comparisons of various parameters between T2DM patients and the control group showed that the mean values of fasting glucose levels, weight, BMI, TG, HDL-C and LDL-C were significantly higher in the T2DM group than the control group. There was no correlation found between BMI and lipid profiles in T2DM patients. Type 2 diabetic patients have significantly higher mean weight, BMI, FBS, TG, HDL-C and LDL-C compared with healthy controls

Relationship between thyroid-stimulating hormone and blood lipids in patients with first-episode depression

BackgroundPrevious studies demonstrated thyroid stimulating hormone (TSH) plays an important role in regulating lipid metabolism, but the relationship between the two is controversial. Meanwhile, it has not been reported in a population with major depressive disorder (MDD).MethodsWe divided 1718 first-episode and drug naïve patients with MDD into a TSH abnormal group (TSH-AB) and a TSH normal group (TSH-NOR). The participants in the two groups were assessed by the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and the positive subscale of Positive and Negative Syndrome Scale. The patients’ blood was tested for TSH, free T3, free T4, fasting blood glucose, lipid indexes and body mass index was recorded.ResultsThe participants in the TSH-AB group had significantly higher HAMD scores, HAMA scores and total scores of positive symptoms, as well as higher incidence of suicide attempts than those in the TSH-NOR group, accompanied by significantly higher thyroglobulin antibodies, thyroid peroxidase antibodies, fasting blood glucose values, total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) levels compared with those of TSH-NOR patients. However, the high-density lipoprotein cholesterol (HDL-C) of TSH-AB patients was lower than those of TSH-NOR patients. TSH values were positively correlated with TC, TG, and LDL-C values, and negatively correlated with HDL-C value.ConclusionTSH was highly correlated with abnormal lipid metabolism in patients with MDD. The specific molecular mechanism of the relationship between TSH, lipid metabolism and the development of depression needs to be further in-depth investigation.

Association of METS-IR index with Type 2 Diabetes: A cross-sectional analysis of national health and nutrition examination survey data from 2009 to 2018

Background With rising global diabetes prevalence, precise early identification and management of diabetes risk are critical research areas. The metabolic score for insulin resistance (METS-IR), a novel non-insulin-based tool, is gaining attention for quantifying insulin resistance using multiple metabolic parameters. Despite its potential in predicting diabetes and its precursors, evidence on its specific relationship with diabetes is limited, especially in large-scale population validation and mechanistic exploration. Objective This study aims to analyze the association between METS-IR and type 2 diabetes (T2DM) in American adults. Methods We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data from 2009 to 2018. Participants aged 20 years and above were included, excluding individuals with missing data on BMI, fasting blood glucose, high-density lipoprotein cholesterol glycated hemoglobin and diabetes status. Logistic regression analysis, subgroup analysis, and restricted cubic spline analysis were used to assess the association between METS-IR and T2DM, controlling for potential confounding factors. Results After adjusting for age, gender, race, education level, smoking status, drinking habits, depression, physical activity, hypertension, and hyperlipidemia, we found a positive association between METS-IR and the risk of T2DM. Specifically, each unit increase in METS-IR was associated with a 7% increase in the risk of T2DM (OR = 1.07, 95% CI: 1.06, 1.08). Subgroup analysis showed that the association between METS-IR and T2DM incidence was significantly positive in the highest quartile group, particularly among Mexican Americans over 40 years old and those diagnosed with depression, hypertension, or hyperlipidemia. Conclusion Our study revealed a significant positive association between METS-IR and the prevalence of T2DM, indicating that this relationship persists even after controlling for various confounding factors. Therefore, monitoring METS-IR may provide a valuable tool for the early identification of individuals at risk of glucose metabolism disorders. Further research should focus on the applicability of METS-IR in different populations and its potential impact on clinical practice.

The correlation between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with non-alcoholic fatty liver disease: an analysis of the population-based NHANES (2017–2018)

Background/objectiveNon-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver disorders, from benign steatosis to more severe conditions like non-alcoholic steatohepatitis, with risks of progressing to fibrosis, cirrhosis, and hepatocellular carcinoma. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) indicates lipid metabolic dysregulation and is associated with increased risks of various diseases. This study examines the relationship between NHHR and NAFLD to evaluate NHHR as a potential predictive biomarker for NAFLD.MethodsData from the 2017–2018 National Health and Nutrition Examination Survey (NHANES) were used for cross-sectional analysis. After excluding individuals with incomplete data, hepatitis infections, heavy alcohol use, and those under 18, the study included 2,757 adults. The relationship between NHHR and NAFLD was analyzed using multivariable logistic regression, including subgroup analysis and interaction testing.ResultsAmong the 2,757 participants (mean age 49.91 years), 44.9% had NAFLD. NHHR showed a significant positive association with NAFLD, with an unadjusted odds ratio (OR) of 1.71 and a fully adjusted OR of 1.45. Quartile analysis revealed a 228% higher prevalence of NAFLD in the highest NHHR quartile, with an OR of 3.28. This positive association was consistent across various subgroups.ConclusionOur findings suggest that elevated NHHR is positively correlated with the prevalence of NAFLD and possesses predictive value. We recommend that future research validate the clinical utility of NHHR, particularly for early detection of high-risk individuals and guiding personalized interventions.

Association between relative fat mass and kidney stones in American adults

Our study aimed to investigate the association between RFM and kidney stones, focusing specifically on the mediating role of high-density lipoprotein cholesterol (HDL-C). We performed a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007 to 2018. Our analytical approach included multivariate logistic regression modeling, subgroup analysis, generalized additive modeling (GAM), smoothed curve fitting, and receiver operating characteristic (ROC) curve, as well as mediation analysis to assess the association between RFM and kidney stones. Finally, we categorized RFM into normal and elevated groups to conduct a sensitivity analysis. This study involved 29,712 participants, with a kidney stone prevalence of 9.88%. We discovered a positive association between RFM and kidney stones (OR = 1.41 per SD increment, 95% CI: 1.24, 1.60). Subgroup analysis revealed a consistent positive association across all subgroups, with a notably higher likelihood of developing kidney stones in young adulthood (P for interaction < 0.05). The smooth curve fitting shows that RFM is nonlinearly and positively correlated with the prevalence of kidney stones. Additionally, HDL-C was found to be negatively associated with kidney stones. Importantly, HDL-C demonstrated a significant mediating effect, with a mediation ratio of 13.52%. ROC analysis indicated that RFM (AUC = 0.616) provided better diagnostic accuracy than traditional measures such as BMI (AUC = 0.565) and WC (AUC = 0.599). Furthermore, the sensitivity analysis further supports the robustness of our findings. RFM is nonlinearly and positively correlated with the prevalence of kidney stones, with HDL cholesterol playing a significant mediating role in this relationship. However, further studies are needed to confirm these associations and explore potential mechanisms.

Exploring the associations and potential mediators between lipid biomarkers and the risk of developing gout: NHANES 2007–2018

BackgroundGout stands as a prevailing manifestation of inflammatory arthritis. While it is linked to several well-established risk factors, the associations between lipid profiles and the risk of gout remain unclear.MethodsThis research involved National Health and Nutrition Examination Survey data (2007–2018). The cardiometabolic index, which incorporates the Triglycerides (TG)/High-density lipoprotein cholesterol (HDL) ratio and waist to height ratio (WHtR), was used to assess lipid profiles and metabolic health. Multivariate logistic regression analysis, propensity score matching, and mediation analyses were utilized to evaluate the associations of lipid profiles and the cardiometabolic index with the risk of developing gout.ResultsAmong 11,032 participants, each 1-unit increase in TG levels was associated with a 65% increase in the odds of developing gout before matching [1.65 (1.15–2.38), P = 0.007] and a 155% increase in the odds of developing gout after matching [2.55 (1.59–4.09), P = 0.007]. Each 1-unit increase in the cardiometabolic index was linked to an 81% increase in the odds of developing gout before matching [1.81 (1.22–2.70), P = 0.004] and a 215% increase in the odds of developing gout after matching [3.15 (1.84–5.40), P < 0.001]. The participants with HDL levels in the third quartile presented a 35% reduction in gout risk relative to those with HDL levels in the first quartile before matching [0.65 (0.46–0.92), P = 0.014] and a 51% reduction in gout risk after matching [0.49 (0.32–0.75), P < 0.001]. Mediation analyses revealed that BMI, WHtR, and homeostatic model assessment for insulin resistance (HOMA-IR) mediated the relationships between TG levels and the risk of developing gout at 18.75%, 24.28%, and 5.35%, respectively. For the association between HDL levels and the risk of developing gout, the mediating effects of BMI, WHtR, leukocytes, γ-glutamyltransferase (in those with HDL < 56 mmol/L), and HOMA-IR were 57.98%, 69.03%, 8.77%, 5.18%, and 11.14%, respectively.ConclusionThis study reveals the relationship between lipid profiles and the risk of developing gout. Regularly checking TG and HDL levels and actively managing obesity, insulin resistance, oxidative stress and inflammation are important for lowering the risk of developing gout.

Relationship of serum iron and thyroid hormone in obesity and after laparoscopic sleeve gastrectomy

BackgroundIron is an essential element for thyroid function. However, no study focuses on the association between iron and thyroid in individuals with obesity. Our research aimed to investigate the iron status in relation to baseline thyroid hormone levels and after laparoscopic sleeve gastrectomy (LSG).MethodsA total of 216 subjects with obesity were enrolled and divided into low and high iron groups depending on the median value. The association between iron and thyroid hormone was analyzed and compared before and after LSG at the 6-month follow-up in patients who underwent LSG.Results1) In all, Total Triiodothyronine (TT3) was significantly higher in high iron than low iron group (P = 0.008). TT3 and thyroid stimulating hormone (TSH) were significantly higher in high iron than low iron group (1.92 ± 0.61 vs. 1.69 ± 0.28 nmol/l, P = 0.029; 2.93 ± 1.66 vs. 1.88 ± 1.03 mU/l, P = 0.002) in females while not in males (all P > 0.05). 2) Iron was significantly positively associated with free triiodothyronine (FT3), free thyroxine (FT4), TT3 and TSH (all P < 0.05). Adjusted for body mass index (BMI), total cholesterol (TCH), high-density lipoprotein cholesterol (HDL-C), fasting insulin (FINS) and homeostatic model assessment of insulin resistance (HOMA-IR), FT3, FT4 and TSH were still significantly associated with iron (all P < 0.05). 3). Regression analysis showed that iron was significantly associated with FT4 (β = 0.338, P = 0.038). 3) LSG led to decreased FT3, FT3, TT3, total thyroxine (TT4) and TSH at 6 months follow-up (all P < 0.05). Changed FT4 was significantly associated with changed iron (r = 0.520, P = 0.009). Subjects with iron decreased had more significant decreased TT4 than subjects without iron decreased (P = 0.021).ConclusionSerum iron overload is significantly associated with impaired thyroid function in subjects with obesity. LSG led to improved thyroid function which is associated with a change in iron.Trial RegistrationNCT04548232 registration date is on October 9, 2022, registered in https://register.clinicaltrials.gov/.

Use of biomarkers of metals to improve prediction performance of cardiovascular disease mortality

BackgroundWhether including additional environmental risk factors improves cardiovascular disease (CVD) prediction is unclear. We attempted to improve CVD mortality prediction performance beyond traditional CVD risk factors by additionally using metals measured in the urine and blood and with statistical machine learning methods.MethodsOur sample included 7,085 U.S. adults aged 40 years or older from the National Health and Nutrition Examination Survey 2003–2004 through 2015–2016, linked with the National Death Index through December 31, 2019. Data were randomly split into a 50/50 training dataset used to construct CVD mortality prediction models (n = 3542) and testing dataset used as validation to assess prediction performance (n = 3543). Relative to the traditional risk factors (age, sex, race/ethnicity, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, hypertension, and diabetes), we compared models with an additional 17 blood and urinary metal concentrations. To build the prediction models, we used Cox proportional hazards, elastic-net (ENET) penalized Cox, and random survival forest methods.Results420 participants died from CVD with 8.8 mean years of follow-up. Blood lead, cadmium, and mercury were associated (p < 0.005) with CVD mortality. Including these blood metals in a Cox model, initially containing only traditional risk factors, raised the C-index from 0.845 to 0.847. Additionally, the Net Reclassification Index showed that 23% of participants received a more accurate risk prediction. Further inclusion of urinary metals improved risk reclassification but not risk discrimination.ConclusionsIncorporating blood metals slightly improved CVD mortality risk discrimination, while blood and urinary metals enhanced risk reclassification, highlighting their potential utility in improving cardiovascular risk assessments.

Gastroesophageal reflux disease influences blood pressure components, lipid profile and cardiovascular diseases: Evidence from a Mendelian randomization study

Abstract Background Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder associated with a range of cardiovascular and metabolic complications. However, the relationship between GERD and blood pressure components, lipid profile, and cardiovascular diseases remains unclear. Methods Leveraging genetic variants associated with GERD as instrumental variables, we performed this Mendelian randomization (MR) analyses. Blood pressure components, lipid profile parameters, as well as cardiovascular diseases were considered as outcomes. Furthermore, we conducted reverse MR analysis to explore the association of these factors with the risk of GERD. Results Our MR analysis discovered a potential causal influence of GERD on blood pressure components, with genetically predicted GERD positively associated with systolic blood pressure (β = 0.053, P = 0.036), diastolic blood pressure (β = 0.100, P &lt; 0.001), and mean arterial pressure (β = 0.106, P &lt; 0.001). Additionally, genetically predicted GERD showed a significant impact on lipid profile, leading to increased genetically predicted levels of low-density lipoprotein (LDL) cholesterol (β = 0.093, P &lt; 0.001), and triglycerides (β = 0.153, P &lt; 0.001), while having a negative effect on high-density lipoprotein (HDL) cholesterol (β = -0.115, P = 0.002). Furthermore, our study indicated a noteworthy causal association between genetically predicted GERD and increased risk of myocardial infarction [odds ratio (OR) = 1.272, P = 0.019)] and hypertension (OR = 1.357, P &lt; 0.001). No significant association was found between GERD and pulse pressure, total cholesterol, heart failure, and atrial fibrillation (P &gt; 0.05). Reverse MR analysis indicates that blood pressure components, lipid profile, and cardiovascular diseases do not lead to an increased risk of GERD (all P &gt; 0.05). Furthermore, mediation MR analysis reveals that LDL cholesterol (proportion mediated: 19.99%, 95% CI: 4.49% to 35.50%), HDL cholesterol (proportion mediated: 11.71%, 95% CI: 5.23% to 18.19%), and hypertension (proportion mediated: 35.09%, 95% CI: 24.66% to 45.53%) mediated the effect of GERD on myocardial infarction, while other factors did not participate in this pathway. Conclusions This MR study provides evidence supporting a causal relationship between GERD and alterations in blood pressure components, lipid profile, and increased risk of cardiovascular diseases.

Serum Selenium Levels and Their Relationship with Insulin Resistance in Individuals with Polycystic Ovary Syndrome.

Growing evidence indicates a potential link between polycystic ovary syndrome (PCOS) and selenium (Se) levels. This study aims to assess Se concentrations in Saudi women with and without PCOS and to explore the relationships between Se levels, insulin resistance (IR), adiponectin, and lipid markers. We randomly recruited 197 women aged 18 to 40, both with and without PCOS, for this age-matched case-control study. The PCOS participants were categorized into three groups based on their Se levels. All participants underwent interviews, and their anthropometric measurements and blood samples were collected for further analysis of biochemical variables. There was a notable difference between the two groups studied across all biochemical variables. Specifically, fasting blood glucose, insulin, the homeostasis model assessment (HOMA-IR) index, total cholesterol, low-density lipoprotein cholesterol, and triglycerides were significantly higher in the PCOS group compared to the control group (p < 0.01). Conversely, Se, high-density lipoprotein cholesterol, and adiponectin levels were significantly lower in women with PCOS than in their age-matched controls (p < 0.01). HOMA-IR was identified as the sole independent predictor of serum Se levels, explaining 17.2% of the variability in its circulating levels (β = - 0.57; 95% CI: - 0.96 to - 0.18, p = 0.004). The findings reveal that women with PCOS have lower serum Se levels compared to the controls. Furthermore, the results confirm a correlation between Se levels and insulin resistance.

The Influence of Hyperlipidemia on the Results of Mammography in Postmenopausal Women

Aim: To determine whether hyperlipidemia causes specific or nonspecific changes that can be detected by mammography in postmenopausal women. Materials and Method: This study was conducted retrospectively and designed as a case-control study in the gynecology clinics of Etlik Zubeyde Hanim Women’s Health Education and Training Hospital between January 2017 and January 2020. Healthy postmenopausal women with a total cholesterol (TC) level of 200 mg/dL and above 200 mg/dL, who were examined in our outpatient clinics and whose mammographic controls were performed in our hospital, were included in the study group (Group I). Healthy postmenopausal women with a TC level below 200 mg/dL who were followed up at the same clinic and whose mammographic controls were performed at our clinic were included in the control group (Group II). We analyzed TC, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides with mammography findings. Results: There were no significant differences between the groups in terms of age and body mass index. There were no significant differences between smoking status and family history of breast cancer. The BAC and BI-RADS scoring category scores differed significantly (p=0.006 and p=0.042, respectively). Conclusion: Postmenopausal women with hyperlipidemia have mammographic findings that can lead to breast cancer. Considering that hyperlipidemia may also have other causes of morbidity and mortality, such as hypertension, diabetes mellitus and cardiovascular disease, it is necessary to treat it with lifestyle changes and / or medications. As this was a retrospective study with a limited number of patients, it is clear that future randomized controlled trials could provide more reliable data on this topic.

Distinct characteristics of MetALD (metabolic dysfunction-associated steatotic liver disease with greater alcohol consumption) in the general population.

The term MetALD has been introduced to describe individuals who have metabolic dysfunction-associated steatotic liver disease (MASLD) with greater alcohol consumption, according to the new nomenclature for steatotic liver disease (SLD). This study aims to evaluate the prevalence and clinical characteristics of MetALD in the general population. This study is a retrospective, cross-sectional analysis that utilizes the population-based data from the Korea National Health and Nutrition Examination Survey (KNHANES) undertaken between 2019 and 2021. A total of 16521 participants aged over 18years were included in the analysis. The presence of hepatic steatosis was determined based on a hepatic steatosis index of 36 or higher. The prevalence of MetALD was 2.8% (95% confidence interval, 2.5-3.2). Individuals with MetALD were predominantly men (85.4%) and tended to be younger compared to those with MASLD. They showed a higher prevalence of hypertension and had significantly higher levels of fasting glucose, triglycerides, high-density lipoprotein cholesterol, and creatinine compared to individuals with MASLD. The average daily total energy intake was higher in the MetALD group. In addition, the MetALD group had a lower proportion of unemployment with higher income compared to the MASLD group. Patients with MetALD showed distinct clinical characteristics from those with MASLD. The characteristics of MetALD were similar to those with alcohol-related liver disease. Further analysis of MetALD across various regions and ethnic groups would be needed.

Association between the oxidative balance score with metabolic syndrome traits in US adults

ObjectiveTo explore the association between the Oxidative Balance Score (OBS), which represents the balance of multiple oxidative stress-related dietary and lifestyle exposures, and the risk of metabolic syndrome (MetS).MethodsA population-based cross-sectional study design was adopted and 16,850 participants in NHANES database were included in the statistics analysis stage. The OBS was constructed by combining information from 20 a priori selected pro- and antioxidant factors. Weighted logistic regression and restricted cubic splines (RCS) were used to estimate the association between OBS and MetS.ResultsParticipants in the highest OBS quartile, indicating low oxidative stress (OS) levels, exhibited a significantly lower risk of MetS (odds Ratio [OR] = 0.55, 95% confidence Interval [CI]: 0.47–0.64) compared to the lowest quartile. Specifically, higher OBS was inversely associated with abdominal obesity (OR = 0.61, 95% CI: 0.54–0.69), hypertension (OR = 0.69, 95% CI: 0.58–0.83), elevated triglycerides (OR = 0.68, 95% CI: 0.57–0.82), low high-density lipoprotein cholesterol (HDL-C) levels (OR = 0.60, 95% CI: 0.50–0.70) and fasting blood glucose (FBG) levels (OR = 0.74, 95% CI: 0.62–0.88). The observed inverse association between OBS and hypertension or FBG levels appeared to primarily influenced by BMI. The association between dietary OBS intervals and elevated FBG levels was not statistically significant in men, whereas the risk was lower by 25% in women.ConclusionsA higher OBS, representing a balance of multiple oxidative stress-related dietary and lifestyle exposures, is associated with a lower risk of MetS. Therefore, adhering to an antioxidant diet and lifestyle may help prevent the occurrence of metabolic disorders.

Serum triglyceride to high density lipoprotein cholesterol ratio in late pregnancy as a potential predictor of adverse birth outcomes: an analysis of real-world data

BackgroundThe association between serum triglyceride to high density lipoprotein cholesterol ratio (THR) in late pregnancy and adverse birth outcomes (ABO) remains controversial because of inconsistent results. The present study assessed the association between maternal serum THR and incidence of ABO [preterm birth (PTB), small and large for gestational age (SGA/LGA), low birth weight (LBW) and macrosomia] in a Chinese population.MethodsA total of 11,553 consecutive participants from a real-world database with data on lipid profiles and birth outcomes were included. Logistic regression models were applied to assess the association between THR and incident ABO. Mediation analysis was performed to investigate the contribution of pregnancy complications [gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP) and pre-eclampsia (PE)] to this association.ResultsApproximately 6.6% (762/11,553), 8.9% (1023/11,553), 15.5% (1792/11,553), 4.3% (494/11,553), and 7.4% (851/11,553) of individuals developed PTB, SGA, LGA, LBW and macrosomia, respectively. Significant trends across the quintiles of THR toward decreasing incidence of SGA and LBW and increasing incidence of LGA and macrosomia were observed. The multivariate-adjusted odds ratios (OR) in the top quintile of serum THR (> 3.16) versus the bottom quintile (< 1.44) were 0.52 for PTB, 0.48 for SGA, 0.64 for LBW, 2.80 for LGA and 3.80 for macrosomia, respectively. A 1-standard deviation (SD) increase in serum THR was associated with decreased risk of PTB [OR = 0.84, 95% confidence interval (CI): 0.76–0.93), SGA (OR = 0.71, 95% CI:0.65–0.78) and LBW (OR = 0.76, 95% CI:0.65–0.90) and increased risk of LGA (OR = 1.40, 95% CI:1.32–1.49) and macrosomia (OR = 1.49, 95% CI:1.38–1.62). In mediation analyses, PE mediated − 19.8%, -10.6% and − 24.6% of THR-associated PTB, SGA and LBW, respectively, GDM accounted for − 3.7%, 6.8% and 4.3% of THR-associated PTB, LGA and macrosomia, respectively, and ICP explained − 1.9% and − 2.1% of THR-associated PTB and LBW, respectively. In addition, incorporating THR to ABO predictive models significantly improved the area under the curve for SGA (0.743 vs. 0.753, P < 0.001), LGA (0.734 vs. 0.745, P < 0.001) and macrosomia (0.786 vs. 0.800, P < 0.001).ConclusionReal-world data showed an association between serum THR in late pregnancy and ABO risk, and this association may be partially mediated by prevalent pregnancy complications (PE/GDM/ICP), suggesting a potential role of THR in predicting ABO (SGA/LGA/macrosomia).

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with depressive symptoms: recent findings from NHANES 2005–2018

BackgroundThe ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) index is a relatively new composite lipid index, the relationship between NHHR and depression is unclear from the current study. The primary aim of our study was to examine the association between the prevalence of depression and NHHR in a US population.MethodsThe National Health and Nutrition Examination Survey (NHANES) provided the data for our investigation from 2005 to 2018. and primarily included participants who contained complete data on NHHR and depression in U.S. adults (age ≥20 years). Associations between NHHR and depression were assessed using multifactorial logistic regression analysis, subgroup analysis, and smoothed curve fitting.ResultsIn our study, 29,561 subjects in total showed a mean NHHR index of 3.12± 1.58,A noteworthy positive correlation was observed between NHHR and depression in multifactorial logistic regression analysis. Subgroup analyses and tests of interaction showed that gender, age, ethnicity, PIR, smoking, alcohol consumption, coronary heart disease, diabetes mellitus, hypertension, and stroke did not influence the NHHR and the association between depression (P for interaction &amp;gt; 0.05), whereas two stratification factors, BMI and sleep disturbance, may be potential factors in the association between NHHR and depression (P for interaction &amp;lt; 0.05).ConclusionAccording to our present study, if the level of NHHR rises in American adults, their likelihood of developing depression also increases.

Dynamic trajectories of left ventricular ejection fraction in heart failure with improved ejection fraction.

Heart failure with improved ejection fraction (HFimpEF) has been regarded as a new heart failure (HF) type in 2022. However, studies on the impact of left ventricular ejection fraction (LVEF) trajectories on the prognosis of patients with HFimpEF are scarce. In this study, we investigated dynamic trajectories of LVEF and different clinical outcomes in HFimpEF. This was a multi-center study included patients diagnosed with HF with reduced ejection fraction (HFrEF) between January 1, 2015, and October 31, 2022. Enrolled patients were divided into HFimpEF and persistent HFrEF groups. To further investigate different LVEF trajectories in HFimpEF patients, they were classified into persistent HFimpEF and transient HFimpEF subgroups. Adverse clinical outcomes encompassed all-cause death, cardiovascular death, and HF-related rehospitalization. A total of 734 patients were included (HFimpEF: n = 162; persistent HFrEF: n = 572). Cox regression analysis revealed that compared with persistent HFrEF, patients with HFimpEF experienced a lower risk of all-cause and cardiovascular death. Subgroup analysis determined that only 113 (69.75%) patients maintained an LVEF exceeding 40%. Cox regression analysis revealed that persistent HFimpEF patients had a lower risk of all-cause and cardiovascular death compared to those with transient HFimpEF. Finally, multivariate logistic analysis showed that gender and high-density lipoprotein cholesterol levels were independent predictors of persistent HFimpEF. HFimpEF does not accurately represent HF recovery, given that there are different trajectories of LVEF in HFimpEF. Patients with persistent HFimpEF experience better clinical outcomes, highlighting clinicians should identify clinical modifiable factors to maintain a stable HF stage for better prognosis. ChiCTR2400086622, 08/07/2024.

Blood lipid profiles associated with metastatic sites in advanced gastric cancer

BackgroundThis study explored the correlation between peripheral blood lipid levels and clinicopathological parameters in patients with advanced gastric cancer (GC), focusing on changes in lipid levels during disease progression.MethodsPathological features and serum lipid profiles of 179 patients with stage III-IV gastric adenocarcinoma were analyzed. Lipid parameters examined included total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), apolipoprotein AI (Apo AI), apolipoprotein B (Apo B), lipoprotein(a) (Lp(a)), among others. The total cholesterol-lymphocyte score (TL score) and BMI were also calculated. The association between lipid parameters and clinicopathological characteristics such as age, gender, family history, and metastasis sites was assessed.ResultsIn GC patients, females had higher TG levels than males. Patients with peritoneal metastasis had significantly lower levels of TC, LDL-C, Apo B, and B/A ratio. Those with lung metastasis exhibited higher LDL-C levels and lower levels of VLDL-C. No significant associations were found between lipid levels and metastasis to distant lymph nodes, liver, or bone. Female patients with ovarian metastasis had significantly lower VLDL-C levels. Multivariate analysis revealed low TC as an independent risk factor for peritoneal metastasis, high LDL-C and low VLDL-C levels for lung metastasis, and younger age and low VLDL-C for ovarian metastasis.ConclusionSpecific blood lipid levels are significantly associated with metastatic sites in advanced gastric cancer. Lipid profiles could serve as potential biomarkers for predicting metastatic sites in GC patients.

Models incorporating physical, laboratory and gut metabolite markers can be used to predict severe hepatic steatosis in MAFLD patients.

Metabolic-associated fatty liver disease (MAFLD) induced-severe hepatic steatosis poses significant health risks. Early prediction of this condition is crucial for prompt intervention. Short-chain fatty acids (SCFAs) and tryptophan are gut metabolites correlated with MAFLD pathogenesis in the gut-liver axis. This study aims to construct prediction models for severe hepatic steatosis by including SCFAs and tryptophan metabolites. This study enrolled 83 participants from the outpatient department in 2023. Physical measurements, serum metabolic and inflammatory markers, metabolites of serum SCFAs and tryptophan were collected. Severe hepatic steatosis was diagnosed using vibration-controlled transient elastography and abdominal sonography. All 40 (48.2%) participants diagnosed with severe hepatic steatosis had MAFLD, while approximately three-quarters of those without severe hepatic steatosis had MAFLD. In comparison to the non-severe hepatic steatosis group, individuals with severe hepatic steatosis exhibited higher levels of waist and arm circumference, serum triglyceride (TG), and lower levels of serum high-density lipoprotein cholesterol (HDL-C) and AST/ALT ratio. They also had higher serum levels of lipopolysaccharide-binding protein, isovaleric acid, and propionic acid, and lower levels of 3-methylvaleric acid, indole-3-propionic acid, and indoxyl sulfate. Models incorporating these markers predicted severe hepatic steatosis. One model additionally included waist circumference and triglyceride-glucose index, while the other incorporated arm circumference and TG/HDL-C ratio. The area under the curve reached 0.958 and 0.938, respectively (p < 0.001). SCFAs and tryptophan metabolites are valuable in predicting severe hepatic steatosis. Further research is needed to investigate the roles of these metabolites in MAFLD.