High-density Lipoprotein Ratio Research Articles

Peripheral Blood Cell Profile and Monocyte–High-density Lipoprotein Ratio in Alzheimer’s Disease: A Hospital-based Case-control Study

IntroductionAlzheimer’s disease (AD) is a neurodegenerative disorder characterized by a progressive decline in memory and cognitive abilities. The monocyte/HDL-C ratio (MHR) has emerged as a new marker of inflammation in recent years. The purpose of this research was to examine MHR alterations in AD and to assess its feasibility as a straightforward and easily computable biomarker for evaluating the severity of the disease.Material and methodsA retrospective case-control study was conducted with 101 patients with AD and 81 age and sex-matched controls from the hospital records. AD was diagnosed according to the National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criteria. The hospital’s electronic patient record data between September 2021 and April 2022 were screened.ResultsIndividuals diagnosed as having AD were classified into three subgroups based on the progression of the disease, mild, moderate, and severe. MHR was higher in the moderate and severe dementia subgroups compared with the controls according to subgroup analysis (P=0.013). An increase in MHR was found in patients with AD. The multivariate logistic regression analysis model revealed that a one-unit increase in MHR resulted in a 1.081 times increase in the risk of AD (OR: 1.081, 95% CI: [1.005-1.162]; P= 0.035).ConclusionsHigh MHR values could not be used as a diagnostic test for AD. Instead, because it negatively correlates with MMSE, it could be a good index reflecting the increased AD risk and disease severity.

The association between different types of dietary fat intake and blood lipids in Type 2 diabetes patients: sex differences

Purpose Blood lipid and lipoprotein abnormalities are common among patients with diabetes. The study aimed to assess dietary fat intake and its association with blood lipids among patients with Type 2 diabetes mellitus (T2DM) considering sex differences.Design/methodology/approach A cross-sectional observational study was conducted with patients (207 males and 197 females) with T2DM. The daily food intake and its contents of fat and fat types were assessed through face-to-face interview. Anthropometric measurements, glycated hemoglobin (HbA1c), triglyceride, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol were initially recorded.Findings The results revealed that TC, LDL and HDL cholesterol levels were significantly higher in females than in males. However, the TC: HDL ratio was significantly higher in males than in females. The results also showed that the daily intake of saturated fatty acid (SFA) slightly exceeded the daily recommended allowance. However, the monounsaturated fatty acid + polyunsaturated fatty acid/SFA (MUFA + PUFA/SFA) ratio was within the recommended ratio. In addition, this study found that the main sources of SFA and cholesterol intake were milk and milk products. A significant association between high fat intake and HbA1c levels was observed (r = 0.234, p < 0.001).Research limitations/implications As it is a cross-sectional observational study, this study has the natural limitation where it can only demonstrate an association.Originality/value The types of dietary fat intake may contribute to blood lipid abnormalities and differences effects may exist among male and female. Studies on the effect of daily fat intake and its types on blood lipids in patients with diabetes, in particular Saudi patients with diabetes are limited. This study focused on the amount and type of the consumed fat among male and female Saudi patients with T2DM and studied the relationship between the type of consumed fat and blood lipid profiles.

Prognostic Value of Cardiac and Noncardiac Biomarkers in Infective Endocarditis: A Prospective Cross-sectional Study

Background and Aims: Infective endocarditis (IE) is associated with several morbidities and high rate of mortality. Predicting these morbidities can be helpful in managing patients and can prevent possible complications, result from IE. In this study, we aimed to evaluate the association between C-reactive protein (CRP), N-terminal pro brain natriuretic peptide (BNP), monocyte to high density lipoprotein (HDL) ratio Charlson comorbidity index, and European System for Cardiac Operative Risk Evaluation (Euro SCORE) in complicated cases of IE. Materials and Methods: This prospective study was conducted on a referral center from January 2017 to December 2020. Patients with definite or possible diagnosis of IE based on the modified Duke criteria were included in this study. Demographic information and serum levels of N-terminal pro BNP, D-Dimer, CRP were evaluated in patients. In addition, we used Charlson comorbidity index and The Euro SCORE for subjective assessment. Results: One hundred and four patients (64 males, median age: 58) included in the final analysis. Intracardiac involvement, central nervous system (CNS) complications and systemic complications were observed in nine patients (9.7%), 16 patients (15.4%), and eight patients (7.7%) respectively. The mortality rate was 14.4%. D-dimer (P = 0.008), pro-BNP (P = 0.008), and Charlson criteria (P = 0.012) were higher in patients with systematic complications. In addition, NT pro-BNP was significantly associated with CNS complications (P = 0.04) and D-Dimer level was significantly associated with in-hospital mortality (P = 0.008). Conclusion: Serum biomarkers such as pro-BNP and D-dimer, and comorbidity indices can be used for risk stratification of patients with IE. The level of pro-BNP is significantly associated with CNS complications and the level of D-dimer is significantly with mortality in patients with IE.

Assessment of cardiac biochemical markers cystatin C and lipoprotein(a) and their relationship with glycemic control in type 2 diabetes mellitus patients

Introduction: Type 2 diabetes mellitus, is one of the predominant health emergencies of this century. Cardiovascular diseases are associated with raised morbidity and mortality in diabetes, contributing to substantial share of community health expenditure. This study was taken up to determine level of cardiac biomarkers cystatin C (CysC) and lipoprotein(a) (Lp(a)) & their association with glycemic control & lipid profile parameters to assess cardiovascular risk profile in type 2 diabetes mellitus. Materials and methods: This study included 100 type 2 diabetes mellitus patients and 100 apparently healthy controls. Diabetic patients were categorised as good glycemic control (50) - HbA1c ≤ 7.5% and poor glycemic control (50) - HbA1c > 7.5% groups. Biochemical parameters CysC, Lp(a), HbA1c and lipid profile were analysed in all participants. Results: Lp(a) and CysC were significantly increased in diabetic patients than in controls. CysC, total cholesterol (TC), low density lipoprotein (LDL), TC/HDL, LDL/ high density lipoprotein (HDL) ratio were significantly increased and HDL was decreased in poor glycemic control group than good glycemic control. CysC correlated positively with HbA1c, Lp(a), TC and LDL while negatively with HDL which was statistically significant. Correlation observed between Lp(a) and HbA1c was not significant. Conclusion: Our study denotes increased cardiovascular disease risk in diabetic patients particularly in those with poor glycemic control. Evaluation of CysC and Lp(a) together, would ameliorate cardiovascular disease (CVD) risk prediction and facilitate appropriate interventions. This study aids in stratification of high-risk diabetic persons for cardiovascular diseases at early asymptomatic phases which will prevent or delay disease advancement and improve clinical outcomes in diabetic patients.

The significance of ratio between serum triglycerides and HDL cholesterol as a common man’s bio marker of insulin resistance in type 2 diabetes mellitus: A cross sectional comparative study

Introduction: Insulin resistance is the most common abnormality associated with obesity, as a major pathophysiological factor in the development and progression of cardiovascular diseases and diabetes mellitus. This study is undertaken to know the significance of ratio of triglycerides (TG) to high-density lipoprotein (HDL) cholesterol as a serum biomarker in assessing the insulin resistance compared to homeostatic model assessment of insulin resistance (HOMA-IR) in type 2 diabetes mellitus (DM) subjects. Materials and methods: This was a cross sectional comparative study done at Mysore Medical College and Research Institute, Mysuru on 180 subjects of type 2 DM from April 2022 to October 2022. The blood sample was subjected for laboratory tests, such as complete blood count (CBC), fasting blood sugar (FBS), post prandial blood sugar (PPBS), HbA1c, lipid profile, ECG, serum insulin level and HOMA-IR, renal function tests (RFT), liver function tests (LFT). The results were tabulated and compared between the HOMA-IR value and triglycerides/HDL cholesterol ratio of type 2 DM subjects. The cut off value of HOMA-IR to assess insulin resistance was 2.50 and triglycerides to HDL ratio was 3.0. Results: The majority of patients i.e. 112(62.22%) had TG/HDL ratio of >3.0 and 116(64.44%) patients had HOMA-IR of >2.5.The patients with uncontrolled type 2 DM had significantly higher TG/HDL ratio [p value 0.01] and HOMA-IR (p value- 0.01). Conclusion: This study concludes that, the ratio of serum triglycerides /HDL cholesterol is a cost effective blood biomarker and it’s correlating significantly with the HOMA-IR and serum fasting insulin levels, while assessing the insulin resistance in type 2 DM subjects.

The Effect of Chia Seeds on High-Density Lipoprotein (HDL) Cholesterol.

Chia seeds are touted as a healthy food capable of providing a beneficial effect on high-density lipoprotein (HDL) cholesterol. Similar claims have been made for oats in various forms, claiming that they improve cholesterol or are in some way "heart healthy." This study aims to demonstrate the effect of daily consumption of chia seeds, if any, on HDL cholesterol levels and compare this to the effects of oats on HDL levels. This pilot study is a randomized controlled trial performed at an academic primary care center. Participation was voluntary, and all participants provided written consent prior to enrollment. There were no exclusion criteria other than that participants must be adults and willing to come in to get their cholesterol profiles checked at the beginning and end of the study. The participants consumed their assigned breakfast in a standard serving size for a month with blood draws and weights recorded before and after the diet. The patients' cholesterol profiles were also compared with their weights. To standardize the delivery of chia seeds, the group consuming chia seeds mixed them with oatmeal. The three meal groups consisted of Cheerios (red group), oatmeal (white group), and oatmeal with chia seeds (blue group). Initially, there were a total of 11 subjects, three in the red group, four in the white group, and four in the blue group. Two subjects were lost to follow-up, one each from the red and white groups. Statistical analysis including one-way analysis was done with the means, Wilcoxon/Kruskal-Wallis, and one-way analysis tests. The results showed a similar weight gain pattern between the three groups, with an average of 2.8 lbs gained in the red group, 2.4 lbs gained in the white group, and 2.6 lbs gained in the blue group. The average HDL levels decreased by 1.00 mg/dL in the red group (standard deviation (SD) 2.82843), increased by 2.00 mg/dL in the white group (SD 8.88819), and increased by 5.75 mg/dL in the blue group (SD 8.01561). The HDL:total cholesterol ratios decreased by 0.00748 in the red group (SD 0.002660), an average of 0.04053 in the white group (SD 0.028138), and an average of 0.01614 in the blue group (SD 0.023808). The results suggest that both chia seeds and oatmeal may be good dietary sources to naturally increase HDL cholesterol, more substantially so with the diet including chia seeds, but may or may not improve total cholesterol:HDL ratios. The effect of weight gain is unclear, as all groups gained weight similarly. Hence, further study is warranted.

Cardiometabolic Risk Factors Associated With Right Ventricular Function and Compensation in Patients Referred for Echocardiography.

Background Pulmonary hypertension and right ventricular (RV) dysfunction are drivers of adverse outcomes; however, modifiable risk factors for RV dysfunction are not well described. We investigated the association between clinical markers of metabolic syndrome and echocardiographic RV function in a large referral population. Methods and Results Using electronic health record data, we performed a retrospective cohort study of patients aged ≥18 years referred for transthoracic echocardiography between 2010 and 2020 with RV systolic pressure (RVSP) or tricuspid annular plane systolic excursion (TAPSE) values. Pulmonary hypertension was defined by RVSP >33 mm Hg and RV dysfunction by TAPSE ≤1.8 cm. Our sample included 37 203 patients of whom 19 495 (52%) were women, 29 752 (83%) were White, with a median age of 63 years (interquartile range, 51-73). Median (interquartile range) RVSP was 30.0 mm Hg (24.0-38.7), and median TAPSE was 2.1 cm (1.7-2.4). Within our sample, 40% had recorded RVSP >33 mm Hg, and 32% with TAPSE <1.8 cm. Increase in RVSP from normal (<33 mm Hg) to mildly elevated (33-39 mm Hg) or elevated (>39 mm Hg) was associated with lower low-density lipoprotein and high-density lipoprotein, and higher hemoglobin A1c and body mass index (P<0.001). A decrease in TAPSE between groups of TAPSE >1.8 cm, TAPSE 1.5-1.8 cm, and TAPSE <1.5 cm was associated with increased triglyceride:high-density lipoprotein ratio and hemoglobin A1c, and decreased body mass index, low-density lipoprotein, high-density lipoprotein, and systolic blood pressure (P<0.001). Most associations between cardiometabolic predictors and RVSP and TAPSE were nonlinear with clear inflection points associated with higher pulmonary pressure and lower RV function. Conclusions Clinical measures of cardiometabolic function were highly associated with echocardiographic measures of right ventricular function and pressure.

Data-driven phenomapping for novel classification for cardiovascular outcomes compared with traditional obesity index: Tehran Lipid and Glucose Study

ObjectiveThis study aimed to propose a data-driven framework for classification of at-risk people for cardiovascular outcomes regarding obesity and metabolic syndrome.DesignA population-based prospective cohort study with a long-term follow-up.SettingData from...

Evaluation of neutrophil-lymphocyte ratio, lymphocyte-monocyte, and monocyte-high density lipoprotein ratios in patients with fibromyalgia and determination of their relationship with disease activity, pain, and depression levels.

This study aimed to evaluate neutrophil-lymphocyte ratio, lymphocyte-monocyte, and monocyte high-density lipoprotein ratios in patients with fibromyalgia and determine their relationship with disease activity, pain, and depression levels.This study was conducted with 40 healthy controls and 87 newly fibromyalgia (FM) diagnosed patients. Demographic characteristics, duration of pain, body mass index (BMI), and laboratory test results were recorded. The hematological indices and ratios were determined with a hemogram test. Disease activity was evaluated with a fibromyalgia impact questionnaire (FIQ). Depression status was evaluated with the beck depression inventory (BDI).A total of 127 participants, 40 in the control group and 87 in the patient group, were included in the study. BMI values of the patient group were statistically higher than the control group (p=0.025). The white blood cell count of the patient group was statistically higher than the control group (p=0.007). Monocyte values were statistically higher in the patient group (p<0.001). Monocyte to high-density lipoprotein-cholesterol ratio (MHR) values in the patient group were statistically higher than the control group (p<0.001). Lymphocyte-monocyte-ratio (LMR) values of the control group were statistically higher than the patient group (p<0.001).This study shows that in fibromyalgia patients, monocyte level and MHR were higher than in healthy subjects. Also, high-density lipoprotein-cholesterol (HDL-C) level was found lower, and the total cholesterol level was found higher in patients with FM. Increased LMR and HDL-C values were found as responsible for decreasing the risk of developing FM and increased glucose and total cholesterol values were responsible for increasing the risk of FM developing.

Serum Triglyceride to High-Density Lipoprotein Ratio as a Marker of Insulin Resistance Among 5-15-Year-Old Sri Lankan Children in an Urban Setting.

Objective: Prevalence of insulin resistance (IR) among South Asian populations is relatively high. It increases with the obesity epidemic. Since determining IR is costly, triglyceride to high-density lipoprotein (TG/HDL) ratio has shown to be a good proxy marker for IR in adults. However, it is not yet well established in children. This study aimed to assess TG/HDL ratio as a marker of IR in 5-15-year-old children in Colombo District of Sri Lanka. Methods: A cross-sectional descriptive study was conducted among 309 school children 5-15 years of age, selected using two-stage probability-proportionate-to-size cluster sampling technique. Sociodemographic data, and anthropometric and biochemical parameters were obtained. After a 12-hr overnight fast, blood was taken for biochemical investigations. Results: Three hundred nine children (173 girls) were recruited. Mean age of girls was 9.9 years and boys 10.3 years. Based on body mass index (BMI) z-score, 15.3% were overweight and 6.1% were obese. Metabolic syndrome was present in 2.3% of children and IR based on Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) ≥2.5 in 7.5%. Mean TG/HDL ratio, waist circumference (WC), hip circumference (HC), BMI, waist-to-height-ratio (WHtR), and body fat percentage were significantly higher (P < 0.01) among children with IR compared with non-IR children. TG/HDL ratio significantly correlated with BMI, % fat mass, WC, HC, WHtR, and HOMA-IR. TG/HDL ratio is an independent risk factor in determining IR. The cutoff value of TG/HDL ratio ≥3 had higher specificity (89.8%) but lower sensitivity (47.8%) for detection of IR. TG/HDL ratio >1.5 had a higher sensitivity (82.6%) but lower specificity (47.7%). Conclusions: TG/HDL ratio is a good proxy marker of IR among 5-15-year-old children. A cutoff value of ≥1.5 had satisfactory sensitivity and specificity.

Combinative predictive effect of left ventricular mass index, ratio of HDL and CRP for progression of chronic kidney disease in non-dialysis patient.

This current study scrutinized the association amongleft ventricular mass index (LVMI), ratio ofhigh-density lipoprotein (HDL) and C-reactive protein (CRP), and renal function. Furthermore, we examined the predictive effects of left ventricular mass index and HDL/CRP on progression of non-dialysis chronic kidney disease. We enrolled adult patients with chronic kidney disease (CKD) who were not receiving dialysis and obtained follow-up data on them. We extracted and compared data between different groups. To investigate the relationship between left ventricular mass index (LVMI), high-density lipoprotein (HDL)/C-reactive protein (CRP) levels, and CKD, we employed linear regression analysis, Kaplan-Meier analysis, and Cox proportional hazards regression analysis. Our study enrolled a total of 2351 patients. Compared with those in the non-progression group, subjects in the CKD progression group had lower ln(HDL/CRP) levels (-1.56 ± 1.78 vs. -1.14 ± 1.77, P < 0.001) but higher left ventricular mass index (LVMI) values (115.45 ± 29.8 vs. 102.8 ± 26.31g/m2, P < 0.001). Moreover, after adjusting for demographic factors, ln(HDL/CRP) was found to be positively associated with estimated glomerular filtration rate (eGFR) (B = 1.18, P < 0.001), while LVMI was negatively associated with eGFR (B = -0.15, P < 0.001). In the end, we found that both LVH (HR = 1.53, 95% CI 1.15 to 2.05, P = 0.004) and lower ln(HDL/CRP) (HR = 1.46, 95% CI 1.08 to 1.96, P = 0.013) independently predicted CKD progression. Notably, the combined predictive power of these variables was stronger than either variable alone (HR = 1.98, 95% CI 1.5 to 2.62, P < 0.001). Our study findings indicate that in pre-dialysis patients, both HDL/CRP and LVMI are associated with basic renal function and are independently correlated with CKD progression. These variables may serve as predictors for CKD progression, and their combined predictive power is stronger than that of either variable alone.

UHPLC-QTOF-MS Metabolic Profiling of Marchantia polymorpha and Evaluation of Its Hepatoprotective Activity Using Paracetamol-Induced Liver Injury in Mice.

Marchantia species were traditionally used to treat liver failure. Marchantia polymorpha chloroform extract showed a marked hepatoprotective activity in a dose-dependent manner in paracetamol-induced extensive liver damage in mice. At a dose of 500 mg/kg (MP-500), it resulted in a reduction in aspartate transaminase by 49.44%, alanine transaminase by 44.11%, and alkaline phosphatase by 24.4% with significant elevation in total proteins by 58.69% with respect to the diseased group. It showed significant reductions in total bilirubin, total cholesterol, triglycerides, low density lipoprotein (LDL), very LDL, total lipids, and to high density lipoprotein ratio (CH/HDL) by 53.42, 30.14, 35.02, 45.79, 34.74, 41.45, and 49.52%, respectively, together with a 37.69% increase in HDL with respect to the diseased group. It also showed an elevation of superoxide dismutase by 28.09% and in glutathione peroxidase by 81.83% in addition to the reduction of lipid peroxidation by 17.95% as compared to the paracetamol only treated group. This was further supported by histopathological examination that showed normal liver architecture and a normal sinusoidal gap. Metabolic profiling by ultrahigh performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometer (UHPLC-QTOF/MS) led to the tentative identification of 28 compounds belonging to phenols, quinolones, phenylpropanoid, acylaminosugars, terpenoids, lipids, and fatty acids to which the activity was attributed. Four compounds were detected in the negative ionization mode which are neoacrimarine J, marchantin A, chitobiose, and phellodensin F, while the rest were detected in the positive mode. Thus, it can be concluded that this plant could serve as a valuable choice for the treatment of hepatotoxicity that further consolidated its traditional use.

Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study.

Chronic inflammation is associated with obesity and is an underlying pathophysiology for cardiovascular disease (CVD) development in postmenopausal women. This study aims to determine feasibility and efficacy of an anti-inflammatory dietary intervention to lower levels of C-reactive protein in weight stable postmenopausal women with abdominal obesity. This mixed-methods pilot study used a single arm pre-post design. Thirteen women followed a 4-week anti-inflammatory, dietary intervention, optimizing consumption of healthy fats, low glycemic index wholegrains, and dietary antioxidants. Quantitative outcomes included change in inflammatory and metabolic markers. Focus groups were undertaken and thematically analyzed to explore participants lived experience of following the diet. There was no significant change in plasma high-sensitivity C-reactive, protein. Despite discouraging weight loss, median (Q1-Q3) body weight decreased by -0.7 (-1.3 to 0 kg, P = 0.02). This was accompanied by reductions in plasma insulin (0.90 [-0.05 to 2.20] mmol/L), Homeostatic Model Assessment of Insulin Resistance (0.29 [-0.03 to 0.59]), and low-density lipoprotein:high-density lipoprotein ratio (0.18 [-0.01 to 0.40]) ( P ≤ 0.023 for all). Thematic analysis revealed that postmenopausal women have a desire to improve meaningful markers of health status that do not focus on weight. Women were highly engaged with learning about emerging and innovative nutrition topics, favoring a detailed and comprehensive nutrition education style that challenged their proficient health literacy and cooking skills. Weight-neutral dietary interventions targeting inflammation can improve metabolic markers and may be a viable strategy for CVD risk reduction in postmenopausal women. To determine effects on inflammatory status, a fully powered and longer-term randomized controlled trial is required.

Associations between neutrophil-lymphocyte ratio and monocyte to high-density lipoprotein ratio with left atrial spontaneous echo contrast or thrombus in patients with non-valvular atrial fibrillation

BackgroundThe importance of inflammation in thrombosis is increasingly appreciated. Neutrophil-lymphocyte ratio (NLR) and monocyte to high-density lipoprotein ratio (MHR) are important indicators of systemic inflammation. This study aimed to investigate the associations between NLR and MHR with left atrial appendage thrombus (LAAT) and spontaneous echo contrast (SEC) in patients with non-valvular atrial fibrillation.MethodsThis retrospective, cross-sectional study enrolled 569 consecutive patients with non-valvular atrial fibrillation. Multivariable logistic regression analysis was used to investigate independent risk factors of LAAT/SEC. Receiver operating characteristic (ROC) curves were used to evaluate the specificity and sensitivity of NLR and MHR in predicting LAAT/SEC. Subgroup and Pearson correlation analyses were used to assess the correlations between NLR and MHR with the CHA2DS2-VASc score.ResultsMultivariate logistic regression analysis showed that NLR (OR: 1.49; 95%CI: 1.173–1.892) and MHR (OR: 2.951; 95%CI: 1.045–8.336) were independent risk factors for LAAT/SEC. The area under the ROC curve of NLR (0.639) and MHR (0.626) was similar to that of the CHADS2 score (0.660) and CHA2DS2-VASc score (0.637). Subgroup and Pearson correlation analyses showed significant but very weak associations between NLR (r = 0.139, P < 0.05) and MHR (r = 0.095, P < 0.05) with the CHA2DS2-VASc score.ConclusionGenerally, NLR and MHR are independent risk factors for predicting LAAT/SEC in patients with non-valvular atrial fibrillation.

Predictive value of triglycerides to high density lipoprotein ratio in patients with first attack of acute coronary syndrome.

To identify patients who are at risk for a first cardiovascular event, mitigate the risk, and institute early intervention. The triglyceride to high-density lipoprotein-C (TG/HDL-C) ratio has been found to be a very useful biomarker for directing treatment and prevention therapy. This retrospective cross-sectional study included adult patients (aged >18 years) experiencing first-time acute coronary syndrome (ACS). We examined all patient databases for a definite diagnosis of angina, non-ST segment elevation myocardial infarction (NSTEMI), or ST-segment elevation myocardial infarction (STEMI). Lipid profiles were obtained prior to or at the time of admission. A total of 265 patients were included in the study (mean age 57.83 ± 11.4 years) and 79.2% were men. Male gender, presence of diabetes, raised total cholesterol, raised low-density lipoprotein (LDL), and raised troponin level on admission were significantly positively correlated with STEMI (p=0.004, p=0.001, p<0.001, and p<0.001), whereas TG/HDL-C ratio was significantly negatively correlated with STEMI (p=0.048), while there was no significant results with NSTEMI (p=0.264) and angina (p=0.326). Total cholesterol and raised low-density lipoprotein (LDL) were significantly positively correlated with NSTEMI (p=0.013 and p=0.024). Patients with first-time ACS may not have an increased TG/HDL-C ratio. High LDL levels had the most significant association with an ACS event, along with total cholesterol and diabetes. Further research is needed on a larger scale to determine the association of TG/HDL-C ratio with ACS and differentiate the different types of ACS events according to their clinical and laboratory characteristics.

The monocyte-to-high-density lipoprotein ratio is associated with the occurrence of atrial fibrillation among NAFLD patients: A propensity-matched analysis.

Accumulating evidence suggests that patients with nonalcoholic fatty liver disease (NAFLD) have a significantly high risk of incident atrial fibrillation (AF). Systemic inflammation, metabolic disorders and oxidative stress could be the potential mechanisms by which NAFLD drives AF. Monocyte-to- high-density lipoprotein ratio (MHR) has emerged as a novel biomarker of inflammation and oxidative stress that has not been studied in AF with NAFLD patients. We aimed to investigate the relationship between MHR and the risk of AF among NAFLD patients. A retrospective analysis was performed for the clinical data of the patients with NAFLD in the Second Hospital of Shanxi Medical University from January 2019 to October 2022, among whom 204 patients with AF were enrolled as NAFLD+AF group and 613 patients without AF were enrolled as NAFLD control, and 152 patients were selected from each group based on propensity score matching (PSM) at a ratio of 1:1 to balance the covariates between groups. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Logistic regression analysis was performed to identify the independent predictor for occurrence of AF among NAFLD patients. Trend chi-square test to analyze the prevalence of AF among MHR tertiles, and then the correlation between MHR and the risk of AF confirmed by restricted cubic splines (RCS). The receiver operating characteristic (ROC) curve analysis was used to determine the optimum MHR cutoff value to predict AF. Univariate analysis showed that AF patients had higher MHR than non-AF patients (P < 0.001). Meanwhile, compared with pure NAFLD patients, multivariate logistic regression analysis showed that MHR remained to be an independent risk factor for AF after adjusting for confounding risk factors (OR = 10.67, 95% CI 2.17-52.37, P = 0.004). TC、HDL-C were also independent risk factors for AF. Among them, TC and HDL-C are protective factors for AF. The trend chi-square test showed that the risk of AF increased with an increase in MHR (P < 0.05). However, the RCS showed a nonlinear and J-shaped relationship between MHR and the risk of AF (P for non-linearity = 0.023). The occurrence of AF increased with increasing MHR only when MHR > 0.44. The ROC curve showed that MHR combined with traditional risk factors can improve the ability to predict AF. MHR is an independently associated with incident AF in patients with NAFLD and show a certain predictive value.

Long-Term Effect of Weight Regain Following Behavioral Weight Management Programs on Cardiometabolic Disease Incidence and Risk: Systematic Review and Meta-Analysis.

Behavioral weight management programs (BWMPs) enhance weight loss in the short term, but longer term cardiometabolic effects are uncertain as weight is commonly regained. We assessed the impact of weight regain after BWMPs on cardiovascular risk factors, diabetes, and cardiovascular disease. Trial registries, 11 databases, and forward-citation searching (latest search, December 19) were used to identify articles published in English, from any geographical region. Randomized trials of BWMPs in adults with overweight/obesity reporting cardiometabolic outcomes at ≥12 months at and after program end were included. Differences between more intensive interventions and comparator groups were synthesized using mixed-effects, meta-regression, and time-to-event models to assess the impact of weight regain on cardiovascular disease incidence and risk. One hundred twenty-four trials reporting on ≥1 cardiometabolic outcomes with a median follow-up of 28 (range, 11-360) months after program end were included. Median baseline participant body mass index was 33 kg/m2; median age was 51 years. Eight and 15 study arms (7889 and 4202 participants, respectively) examined the incidence of cardiovascular disease and type 2 diabetes, respectively, with imprecise evidence of a lower incidence for at least 5 years. Weight regain in BWMPs relative to comparators reduced these differences. One and 5 years after program end, total cholesterol/HDL (high-density lipoprotein) ratio was 1.5 points lower at both times (82 studies; 19 003 participants), systolic blood pressure was 1.5 mm mercury and 0.4 mm lower (84 studies; 30 836 participants), and HbA1c (%) 0.38 lower at both times (94 studies; 28 083 participants). Of the included studies, 22% were judged at high risk of bias; removing these did not meaningfully change results. Despite weight regain, BWMPs reduce cardiometabolic risk factors with effects lasting at least 5 years after program end and dwindling with weight regain. Evidence that they reduce the incidence of cardiovascular disease or diabetes is less certain. Few studies followed participants for ≥5 years. URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42018105744.

Monocyte to high-density lipoprotein ratio predicts clinical outcomes after acute ischemic stroke or transient ischemic attack.

The monocyte to high-density lipoprotein cholesterol ratio (MHR) has emerged as a novel inflammatory biomarker of atherosclerotic cardiovascular disease. However, it has not yet been identified whether MHR can predict the long-term prognosis of ischemic stroke. We aimed to investigate the associations of MHR levels with clinical outcomes in patients with ischemic stroke or transient ischemic attack (TIA) at 3months and 1year. We derived data from the Third China National Stroke Registry (CNSR-III). Enrolled patients were divided into four groups by quartiles of MHR. Multivariable Cox regression for all-cause death and stroke recurrence and logistic regression for the poor functional outcome (modified Rankin Scale score 3-6) were used. Among 13,865 enrolled patients, the median MHR was 0.39 (interquartile range, 0.27-0.53). After adjustment for conventional confounding factors, the MHR level in quartile 4 was associated with an increased risk of all-cause death (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.10-1.90), and poor functional outcome (odd ratio [OR], 1.47; 95% CI, 1.22-1.76), but not with stroke recurrence (HR, 1.02; 95% CI, 0.85-1.21) at 1year follow-up, compared with MHR level in quartile 1. Similar results were observed for outcomes at 3months. The addition of MHR to a basic model including conventional factors improved predictive ability for all-cause death and poor functional outcome validated by the C-statistic and net reclassification index (all p < 0.05). Elevated MHR can independently predict all-cause death and poor functional outcome in patients with ischemic stroke or TIA.

Assessment of the relationship between monocyte to high-density lipoprotein ratio and subclavian artery stenosis.

Assessment of the monocyte-to-high-density lipoprotein ratio (MHR) is a new tool for predicting inflammation, which plays a major role in atherosclerosis. Subclavian artery stenosis (SAS) is usually asymptomatic, and atherosclerosis is the most common cause of chronic obstruction of the subclavian artery in adults. The aim of this study was to determine the relationship between the MHR and SAS. Between January 2015 and January 2020, 43 patients with SAS and 43 patients without SAS were enrolled in the study. The patients' angiographic, demographic and clinic characteristics were reviewed from their medical records. Monocytes and HDL (high-density lipoprotein) cholesterols were measured through a complete blood count. The MHR was calculated as the ratio of the absolute monocyte count to the HDL cholesterol value. The resulting MHR values were divided into the following three groups: low (7.16 ± 1.59), moderate (11.08 ± 1.53) and high (21.70 ± 5.62). A p-value of less than 0.05 was considered significant. MHR was found to be significantly higher in the SAS group compared to the control group with normal subclavian arteries (p<0.001). The frequency of SAS was found to increase with an increase in the MHR tertiles. Sensitivity and specificity values were 69.8% and 95.3%, respectively. The cut-off of the MHR value, taken as 13.39, was found to provide a significantly accurate prediction of the subclavian diagnosis (ROC area under the curve: 0.868, 95% CI: 0.789-0.947, p<0.001). After adjusting for other hematological parameters in the multivariate analysis, MHR (p=0.061) was found to be a predictor of the presence of SAS. This study showed that MHR can be a convenient marker for predicting SAS because of the correlation between MHR and SAS.

Evaluation of triglyceride-glucose index, triglyceride to high-density lipoprotein cholesterol ratio, and other lipid ratios in hypertension

Background: Hypertension is one of the most common diseases with increasing morbidity and mortality. HTN is associated with cardiovascular risk factors such as insulin resistance (IR) and hyperlipidemia. Recently, triglyceride-glucose (TyG) index has been proposed as a marker for insulin resistance. Aims and Objectives: This study aimed to assess TyG index, triglyceride to high-density lipoprotein ratio, and other lipid ratios in HTN patients. Materials and Methods: The present study was conducted on 200 subjects and was categorized into two groups. 100 hypertensive patients were considered as cases and 100 healthy individuals as controls. Serum sample of the subjects was used for the estimation of total cholesterol, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Low-density lipoprotein (LDL) cholesterol was calculated. TyG index and TG/HDL ratio and other lipid ratios were calculated. Blood pressure (BP) was recorded. Results: In this, BP, total cholesterol, TG, LDL, Very low-density lipoprotein cholesterol, Non-HDLC, TC/HDL ratio, TG/HDL ratio, and TyG index were increased in cases and HDL and HDL/LDL ratio were decreased. Study parameters were positively correlated with TyG index and TG/HDL ratio, except HDL, and HDL/LDL ratio. Conclusion: The study concludes that significantly increased TyG index and TG/HDL ratio in hypertensive cases and their correlation with blood pressure.