High-density Lipoprotein Triglycerides Research Articles

#707 Effectiveness of a personalized approach to the treatment of patients with chronic coronary syndrome with type 2 diabetes and renal dysfunction

Abstract Background and Aims To evaluate the effectiveness of complex personalized treatment of patients with chronic coronary syndrome (CCS) with type 2 diabetes mellitus (T2DM). Method We observed patients with chronic stable angina pectoris III (FC) (Group I, 16) and CV IV FC (Group II, 18) with T2DM who underwent planned stenting of the coronary arteries (SCA). At baseline and after 3 and 6 months, we studied cholesterol, LDL cholesterol and HDL cholesterol, triglycerides (TG), ALT and AST, total bilirubin (TB), polymorphism of the CYP2C19 and 9p21 genes (rs 2383206 and rs 10757272), assessed myocardial viability (ECHOCG, MSCT), an ultrasound of the liver was performed. Against the background of basic therapy (antiplatelet agents, statins, beta blockers, ACE inhibitors), patients received a herbal hepatoprotector. Results Initial lipid parameters in patients with CCS and T2DM: cholesterol—6.9 mmol/l; LDL cholesterol –3.6; HDL cholesterol –1.1; TG –2.5 mmol/l. Parameters of global and regional systolic function were reduced. At the end of observation, lipid content: cholesterol—5.0; LDL cholesterol—2.3; HDL cholesterol –1.18; TG—1.61 mmol/l. Statins and antiplatelet agents were well tolerated, and there were no cases of withdrawal. Enzyme activity (ALT, AST), OB content were within normal values. The genetic studies carried out helped to select the most effective and safe doses of antiplatelet drugs and statins and significantly reduced the risk of complications and drug resistance. The hepatoprotector had a beneficial effect on the condition and function of the liver and improved the tolerability of medications. A personalized approach to the treatment of CCS was carried out taking into account the results of genetic testing with the selection of optimal doses of drugs. When the genotypes of CYP2C19*17 (rs 12248560) CC, ST and TT were distributed, the dose of antiplatelet agents was increased, and when the genotypes of the CYP2C19 gene (rs 4244285) GG, AG and AA were distributed, they were reduced. Assessment of myocardial viability, selection of doses of statins and antiplatelet agents according to individual characteristics, as well as a hepatoprotector increased the effectiveness and safety of treatment. SCA and basic treatment had an impact on the pathogenetic links of CCS, which is especially important in the treatment of patients with concomitant T2DM. Conclusion A personalized approach to the treatment of patients with CCS with T2DM who require SCA, taking into account the functional state and viability of the myocardium, the pharmacogenetic characteristics of the drugs, increases the effectiveness of revascularization, prevents the development of resistance, side effects and complications.

High-density lipoprotein metrics during midlife and future subclinical atherosclerosis in women: the SWAN HDL study.

The clinical utility of high-density lipoprotein cholesterol (HDL-C) in risk classification is limited, especially in midlife women. Novel metrics of HDL may better reflect this risk. We clustered a comprehensive profile of HDL metrics into favorable and unfavorable clusters and assessed how these two clusters are related to future subclinical atherosclerosis (carotid intima media thickness [cIMT], interadventitial diameter [IAD], and carotid plaque presence) in midlife women. Four hundred sixty-one women (baseline age: 50.4 [2.7] years; 272 White, 137 Black, 52 Chinese) from the Study of Women's Health Across the Nation HDL ancillary study who had baseline measures of HDL cholesterol efflux capacity (HDL-CEC), lipid contents (HDL-phospholipids [HDL-PL] and HDL triglycerides [HDL-Tg]), and HDL particle (HDL-P) distribution and size, followed by carotid ultrasound (average 12.9 [SD: 2.6] years later), were included. Using latent cluster analysis, women were clustered into a favorable (high HDL-CEC, HDL-PL, large and medium HDL-P, less HDL-Tg and small HDL-P, larger size) or an unfavorable HDL cluster (low HDL-CEC, HDL-PL, large and medium HDL-P, more HDL-Tg, and small HDL-P, smaller size) and then linked to future subclinical atherosclerosis using linear or logistic regression. The favorable HDL cluster was associated with lower cIMT, IAD, and odds of carotid plaque presence. These associations were attenuated by body mass index, except in Chinese women where the association with cIMT persisted (0.72 [0.63, 0.83]). The association between favorable HDL clusters and a better postmenopausal subclinical atherosclerosis profile is largely explained by body mass index; however, racial/ethnic differences may exist.

Association between lipid profiles and cigarette smoke among adults in the Persian cohort (Shahedieh) study

ObjectivesExposure to cigarette smoke introduces a large amount of nicotine into the bloodstream through the lungs. So, smoking can be a risk factor for many diseases. The present study was conducted to investigate the effect of active and passive cigarette smoke on the blood lipid profile and dyslipidemia.MethodsThis cross-sectional study was performed on 5052 individuals who participated in the recruitment phase of the Shahedieh cohort study. A logistic regression model was used to investigate the relationship between smoking exposure status and lipid profiles.ResultsThe prevalence of abnormal low-density lipoprotein-cholesterol (LDL-C), abnormal HDL-C, abnormal total cholesterol (TC), abnormal triglyceride (TG), and dyslipidemia were 254 (5.00%), 562 (11.10%), 470 (9.30%), 1008 (20.00%), and 1527 (30.20%), respectively. Adjusting for confounders, it was observed that current smokers had higher odds of having abnormal HDL-C [OR (95% CI), 2.90 (2.28–3.69)], abnormal TG [OR (95% CI), 1.71 (1.38–2.13)] and dyslipidemia [OR (95% CI), 1.86 (1.53–2.25)]. Ex-smokers also had greater odds of abnormal HDL-C [OR (95% CI), 1.51 (1.06–2.16)] compared to non-smokers who were not exposed to cigarette smoke.ConclusionsThe findings indicated that current smokers had higher TG and lower HDL. So, necessary measures should be taken to reduce smoking. The findings also showed that the prevalence of abnormal TG and HDL in ex-smokers was lower than in current smokers. Therefore, the existence of incentive policies to quit smoking seems necessary.

Exploring the bi-directional relationship between periodontitis and dyslipidemia: a comprehensive systematic review and meta-analysis.

As periodontitis and dyslipidemia are diseases that occur with high incidence, the relationship between them has attracted much attention. Previous studies on these diseases have tended to focus on lipid parameters and periodontitis, we aimed to investigate the relationship between dyslipidemia and periodontitis. A comprehensive search to identify the studies investigating the relationship between dyslipidemia and periodontitis was performed on PubMed, Web of Science and Cochrane Library before the date of August, 2023. Studies were considered eligible if they contained data on abnormal blood lipid parameters and periodontitis. Studies that reported mean differences and 95% confidence intervals or odds ratios were used. A total of 73 publications were included in the meta-analysis. Hyper total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and lower high-density lipoprotein (HDL) levels are risk factors for periodontitis. Periodontal disease is a risk factor for high TG and low HDL levels. Three months after periodontal treatment, the levels of TC, TG and HDL were significantly improved, and statin treatment only improved gingival index (GI) levels compared to that of the dietary control. The findings reported here suggest that the mutual promotion of periodontitis and dyslipidemia can be confirmed. Non-surgical periodontal therapy may improve lipid abnormalities. It can't be demonstrated whether systematic application of statins have a better effect on the improvement in periodontal status in patients with dyslipidemia compared to that of the control.

Association of Apelin, Chemerin and Omentin Levels with Oxidative Stress Markers in Non-Diabetic and Induced Diabetic Rats

Abstract 
 Oxidative stress has a significant impact on the etiology of type 1 diabetes mellitus (T1DM). However, associations of adipokines with oxidative stress biomarkers have yet to be investigated. Therefore, the present study aimed to investigate the estimation of serum apelin, chemerin, and omentin levels in induced TIDM and their correlations with oxidative stress markers. The study included sixty male albino rats divided into two groups. The first group (n = 30) was diabetic (TIDM induced with an intraperitoneal injection of 40mg/kg STZ). The non-diabetic control group was the second (n: 30). The enzyme-linked immunosorbent (ELISA) test was used to quantify the serum levels of apelin, chemerin, omentin and asymmetric dimethylarginine (ADMA). Furthermore, blood glucose, lipid profile triglyceride (TG), cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), liver enzymes (alanine aminotransferase (ALT) and aspartate transaminase (AST)), malondialdehyde (MDA) and nitric oxide (NO) parameters were evaluated. Rats with induced TIDM had significantly higher serum levels of apelin, chemerin, omentin, malondialdehyde MDA, ADMA, and NO compared to non-diabetics. According to the coefficient of correlation analysis, the results revealed a positive association between apelin and LDL, ALT, and MDA and a negative correlation between apelin and AST: ALT. In addition, no correlation was found between apelin and serum levels of glucose, cholesterol, HDL, LDL: HDL TG, TG: HDL, VLDL, AST, creatinine, uric acid, albumin, NO, and ADMA. LDL, ALT, and MDA. Serum chemerin level correlated positively with LD: HDL and ADMA. Also, the plasma level of omentin showed a significant and positive correlation with both TG: HDL and MDA values. In conclusion, the results of this study introduced apelin and chemerin as potential biomarkers for the early detection of diabetes. Elevated serum apelin levels in induced T1DM could provide compensatory action for low insulin levels. While, apelin, chemerin and omentin’s positive correlations with MDA level suggest the potential roles of these adipokines in diabetes-induced complications caused by oxidative stress.

Correlation between TCF7L2 gene expression and certain biochemical parameters in type 2 diabetes mellitus

ObjectivesThe transcription factor 7-like 2 gene (TCF7L2) is associated with a predisposition to type 2 diabetes mellitus (T2DM) in different ethnic populations. This article investigated the relationship between TCF7L2 gene expression and several biochemical indexes among different age categories of T2DM in a sample of the Iraqi population. MethodsOne hundred and fifty blood samples were collected from three groups: young T2DM (10–35 years), old T2DM (40–80 years), and healthy control (10–65 years) groups. Both sexes were enrolled. qPCR was performed to explore the expression of the TCF7L2 gene. Biochemical tests were performed to assess hemoglobin A1C (HbA1c), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels. The body mass index (BMI) was calculated. The results were statistically analyzed. ResultsPatients with T2DM had higher BMI, TG, and LDL, and lower HDL than the control group. There was a strong positive correlation between hemoglobin A1C (HbA1c) and BMI, TG, and LDL and a negative correlation between HbA1c and HDL. Expression of the TCF7L2 gene showed a significant difference between old and young patients by 1.68- and 0.207-fold, respectively. These results showed that old patients had higher gene expression than young patients. ConclusionTCF7L2 gene expression was affected by age, with higher expression in old T2DM patients. This may influence beta cell functions and insulin secretion.

Lipid Profiles Impact on the Oncologic Outcome of Upper Tract Urothelial Carcinoma.

The prognosis of upper tract urothelial carcinoma (UTUC) varies, with T3/T4 UTUC having less than 50% 5-year survival post-radical nephroureterectomy (RNU). Lipid profiles including cholesterol (CHOL), low-density lipoprotein (LDL), and triglycerides (TGs), and high-density lipoprotein (HDL) have shown correlations with oncologic outcomes in various cancers. We aimed to investigate the prognostic significance of the lipid profiles in UTUC patients who had received RNU. In this retrospective study, a total of 217 UTUC patients who underwent RNU were analyzed. Prognostic factors for overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) were assessed using Cox proportional hazards regression model and competing risk analysis. The median follow-up duration was 2.36 years. Fifty-one (23.50%) of the patients experienced tumor progression, 16 (7.37%) died from UTUC, and 41 (18.89%) died from all causes during the follow-up period. Multivariate analysis revealed that elevated CHOL, low HDL, and elevated TG were linked to worse OS (P = 0.0188, 0.0002, and 0.0001, respectively). Higher CHOL, LDL, and TG, as well as lower HDL significantly affected PFS (P < 0.001 for all), and elevated CHOL and TG were associated with poorer CSS (P = 0.0033 and 0.0179). A competing risk model indicated that elevated LDL increased the risk of cancer progression (P = 0.407), with CHOL increasing the risk of UTUC-specific mortality (P = 0.0162). Limitations include retrospective design, limited, single-time sampling and relatively small sample size. Lipid profiles were identified as prognostic indicators for UTUC patients post-RNU. It highlights the potential importance of lipid management in improving tumor-related outcomes.

The metabolic health of New Zealand vegans

The popularity of a vegan diet is growing worldwide. Data analysed from the 2018 NZ Attitudes and Values study showed that 1.1% of New Zealanders followed a vegan diet(1). Though there are potential nutrient deficiencies in a vegan diet, it is generally accepted that a vegan diet, with its emphasis on a variety of vegetables, fruit, grains, legumes, and pulses, has greater metabolic benefits than a Western-style diet high in red meat and processed foods and lower in plants(2). This observational cross-sectional study aimed to explore the dietary intake (4-day food diary) and metabolic health status (including anthropometry, blood pressure, lipids, body fat percentage, omega-3 index and glycaemic control) of adults who had been consuming a vegan diet for 2+ years. Participants (N = 212) were predominantly female (N = 155) with a mean (SD) age of 39.5 (12.4) years. Mean cardiometabolic markers of systolic and diastolic blood pressure, BMI, waist circumference, HbA1c, total cholesterol, LDL-cholesterol, HDL-cholesterol, Chol:HDL ratio and triglycerides were all below the thresholds for disease risk. Omega-3 index results &lt;4% placed most participants (86.3%) in the high-risk category for heart disease. Many female participants (71%) had &gt;30% body fat, compared to 5.3% of males. With reference to the AMDR (total fat 20-35%, carbohydrate 45-65% and protein 15-25%), the intake of total fat was at the upper end (males 34.4%, females 35.9%), carbohydrate was at the lower end (males 46.2%, females 44.7%), and protein was below the lower end (males 14.9%, females 14.2%). Saturated fat intakes ranged from 4.0-65.9 g/d, with a mean (SD) of 24.9 (10.5) g/d for males and 20.2 (9.9) g/d for females. The mean (SD) dietary fibre intake was much higher than the AI set by the Ministry of Health of 25g/d for females and 30g/d for males, at 55.0 (17.8) g/d for males and 43.4 (12.8) g/d for females, ranging from 10.9-133.9g/d. This is the first New Zealand study to examine the metabolic health and dietary intake of adult vegans. The results of cardiometabolic health markers indicate that the vegan diet confers cardioprotective benefits. However, the low Omega-3 index of most participants is concerning, which warrants longitudinal research to assess the level of risk conferred by a low Omega-3 index result in a population with no other cardiometabolic risk factors. The findings of the present study may help guide the growing New Zealand vegan community towards a nutritionally optimal vegan diet.

Apo Lipoproteins A1 and B in Multidrug-Resistant Tuberculosis (MDR-TB)

Aims: The medical management of multidrug-resistant tuberculosis (MDR-TB) has become a major public health issue. Apolipoproteins play a key role in lipoprotein metabolism such as the recognition of receptors involved in lipoprotein metabolism. Thus, the study of the inter- relationships between apolipoproteins (A1 and B) and MDR-TB could represent an important approach to the biological management of MDR-TB patients. Methodology: This is an experimental study carried out on eighty-two (82) patients including thirty-eight (38) MDR-TB patients which age ranged from 18 to 60 years old recruited from three tuberculosis centers (CAT) in the city of Abidjan and forty-four (44) non-tuberculosis patients used as control aged 18 to 60 years old recruited at the National Blood Transfusion Center (CNTS) in Treichville (Abidjan, Côte d’Ivoire). Total cholesterol, HDL-cholesterol and triglycerides were measured by the colorimetric-enzymatic method. Apolipoproteins A1 and B were measured using the immunoturbidimetric method. Results and Conclusion: Showed a dyslipidemia concerning cholesterol and its HDL fraction, triglycerides and apolipoproteins A1 and B suggest an atherogenic profile in multidrug-resistant TB patients.

Associations between lipid abnormalities and diabetic retinopathy across a large United States national database.

While dyslipidaemia has been suggested as a potential risk factor for diabetic retinopathy (DR), previous studies have reported conflicting findings. This study aimed to better characterize the relationship between abnormal serum levels of various lipid markers and the risk of the development and progression of DR. This retrospective cohort study utilized a United States national database of electronic medical records. Adults with a history of type 2 diabetes mellitus without type 1 diabetes mellitus were divided into cohorts based on the presence of abnormal serum levels of various lipid markers. Propensity score matching was performed to match cohorts with abnormal lipid levels to those with normal lipid levels on covariates. The cohorts were then compared to evaluate the hazard ratios (HR) of receiving a new DR diagnosis, pars plana vitrectomy, panretinal photocoagulation, vitreous haemorrhage, proliferative diabetic retinopathy, diabetic macular oedema (DMO), and traction retinal detachment. The database contained 1,126,231 eligible patients (mean age: 60.8 [14.2] years; 46.0% female). Among patients without prior DR, low HDL (HR = 0.94, CI = 0.90-0.98), total cholesterol (HR = 0.88, CI = 0.85-0.91), and high triglyceride (HR = 0.91, CI = 0.86-0.97) levels were associated with a decreased risk of receiving a DR diagnosis. Among patients with preexisting DR, high LDL levels was associated with an increased risk of DMO (HR = 1.42, CI = 1.15-1.75), whereas low HDL levels was associated with a marginally decreased risk (HR = 0.92, CI = 0.85-0.99). Elevated levels of markers of dyslipidaemia are inversely associated with the risk of receiving a DR diagnosis, but this relationship is blunted after the onset of DR.

Abstract P182: Ratio of Cholesterol to Triglycerides Within High-Density Lipoprotein (HDL) as a Novel Marker of Risk for Myocardial Infarction (MI)

Background: HDL cholesterol, together with LDL-c and triglycerides, are biomarkers widely used to assess risk of myocardial infarction (MI). Thereafter, apoA1 and HDL particle number (HDL-P) were identified as biomarkers inversely associated with risk of MI. State-of-the-art nuclear magnetic resonance spectroscopy allows for profiling of lipidomic markers within HDL, providing an unprecedented opportunity to identify novel biomarkers of MI. Methods: We examined associations between HDL lipid components and risk of MI in the UK Biobank. We leveraged the most up to date lipidomic data measured by NMR. A total of 8229 MI incidents were documented among 249,140 participants over a median 17.7 years of follow-up. Results: Independent of existing risk factors including LDL-c, triglycerides, apo-A1, HDL-P, the percentage of cholesterol over total lipids in HDL was inversely associated with the risk of MI with Hazard Ratio (HR) of 0.85 (0.76, 0.95), when comparing the highest quintile to the lowest. The percentage of triglycerides in HDL was positively associated with 1.13 (1.01, 1.26). We created the ratio of cholesterol to triglyceride within HDL and found it to be inversely associated with risk of MI (HR=0.89 [0.79, 0.99]). This finding is robust and consistently supported across subclasses of HDL. Conclusions: The ratio of cholesterol to triglycerides within HDL particles may be a new marker of risk for MI, independent of existing biomarkers. Table 1 . Hazard Ratios for Myocardial Infarction (MI) across Percentages of Lipids in HDL. Model 1: Cox model adjusted for conventional covariates: Age, Sex, Race, Body Mass Index, Hypertension status, Statin Use, Type 2 Diabetes status, Smoking, Education, Alcohol intake, and Townsend Deprivation Index, LDL-C, and TriglyceridesModel 2: Cox model adjusted for Model 1 covariates plus Apolipoprotein A1 and HDL particle number.

Circulating metabolomic markers linking diabetic kidney disease and incident cardiovascular disease in type 2 diabetes: analyses from the Hong Kong Diabetes Biobank

Aims/hypothesisThe aim of this study was to describe the metabolome in diabetic kidney disease (DKD) and its association with incident CVD in type 2 diabetes, and identify prognostic biomarkers.MethodsFrom a prospective cohort of individuals with type 2 diabetes, baseline sera (N=1991) were quantified for 170 metabolites using NMR spectroscopy with median 5.2 years of follow-up. Associations of chronic kidney disease (CKD, eGFR<60 ml/min per 1.73 m2) or severely increased albuminuria with each metabolite were examined using linear regression, adjusted for confounders and multiplicity. Associations between DKD (CKD or severely increased albuminuria)-related metabolites and incident CVD were examined using Cox regressions. Metabolomic biomarkers were identified and assessed for CVD prediction and replicated in two independent cohorts.ResultsAt false discovery rate (FDR)<0.05, 156 metabolites were associated with DKD (151 for CKD and 128 for severely increased albuminuria), including apolipoprotein B-containing lipoproteins, HDL, fatty acids, phenylalanine, tyrosine, albumin and glycoprotein acetyls. Over 5.2 years of follow-up, 75 metabolites were associated with incident CVD at FDR<0.05. A model comprising age, sex and three metabolites (albumin, triglycerides in large HDL and phospholipids in small LDL) performed comparably to conventional risk factors (C statistic 0.765 vs 0.762, p=0.893) and adding the three metabolites further improved CVD prediction (C statistic from 0.762 to 0.797, p=0.014) and improved discrimination and reclassification. The 3-metabolite score was validated in independent Chinese and Dutch cohorts.Conclusions/interpretationAltered metabolomic signatures in DKD are associated with incident CVD and improve CVD risk stratification.Graphical

The causal relationship between 25-hydroxyvitamin D and serum lipids levels: A bidirectional two-sample mendelian randomization study.

Serum vitamin D levels were linked to lipid metabolism in observational studies, but the exact mechanism was unclear. Several studies have attempted to decipher the relationship between 25(OH)D and lipid levels. Conventional observational studies are vulnerable to confounding. Mendelian randomization (MR) analysis can better control for confounding factors and reverse causality, allowing for the inference of causal association. We, therefore, sought to use MR to investigate the possible causal relationship between 25(OH)D and blood lipid levels (HDL cholesterol, LDL cholesterol, triglycerides, and total cholesterol). A bidirectional two-sample Mendelian randomization (MR) was performed on data primarily from European ancestors. In addition, the potential causal effect of lipids on 25(OH)D was assessed by regressor-based multivariate magnetic resonance (MVMR). The single-nucleotide polymorphisms (SNPs) related to 25(OH)D were selected from a large-scale genome-wide association study (GWAS) database named IEU GWAS, and the SNPs associated with the four blood lipids were chosen from UK Biobank (UKB) lipid GWAS. When blood lipids were the outcome, the results of bidirectional two-sample MR demonstrated that 25(OH)D exhibited a negative causal association with TG, TC, and LDL-C: β = - 0.23, 95% CI = -0.28 to -0.19, P<0.001; β = - 0.16, 95% CI: - 0.30 to-0.03, P < 0.05; β = - 0.11, 95% CI: - 0.23 to 0, P < 0.05. There was no causal relationship between 25(OH)D and HDL-C (β = 0.05, 95% CI: - 0.11 to 0.20, P = 0.56). When setting blood lipids as exposure, TG and 25(OH)D, β = -0.13, 95% CI: - 0.15 to -0.10, P < 0.05; TC and 25(OH)D, β = -0.11, 95% CI: - 0.15 to -0.07, P < 0.05; HDL-C and 25(OH)D, β = 0.02, 95% CI: 0 to 0.03, P = 0.07; LDL-C and 25(OH)D, β = -0.08, 95% CI: - 0.11 to -0.05, P < 0.05). Our MVMR study also showed a significant relationship between genetically determined lipid traits and 25(OH)D levels (TG and 25(OH)D, P < 0.05; TC and 25(OH)D, P < 0.05). In all MR analyses, there was no horizontal pleiotropy (all P > 0.05), or statistical heterogeneity. The "Leave-one-out" sensitivity analysis confirmed the stability of our results. MR Studies have shown a bidirectional causal relationship between genetically-determined 25(OH)D levels and serum TG and TC levels. The findings have potential implications for etiological understanding and disease prevention.

Small dense low density lipoprotein predominance in patients with type 2 diabetes mellitus using Mendelian randomization.

Patients with T2DM often suffer from CVD-related complications, significantly impacting morbidity and mortality rates. The upsurge in CVD prevalence among them is partly linked to sd LDL particles. Understanding the mechanisms behind elevated sd LDL levels is critical for preventing and managing cardiovascular complications in diabetes. MR was employed to identify instrumental variables and establish causality, exploring underlying mechanisms. Notably, T2DM itself, insulin resistance, and fasting glucose seemingly do not directly impact sd LDL levels. Instead, the presence of T2DM or insulin resistance, leading to reduced HDL cholesterol or elevated TG levels, directly contributes to subsequent sd LDL increases, indicating a comprehensive mediating effect. While LDL cholesterol levels correlate positively with sd LDL, they appear unaffected by T2DM or insulin resistance. Importantly, hypertension induced by T2DM or insulin resistance exhibits a positive effect on sd LDL reversal. Unlike T2DM or insulin resistance, blood glucose levels show no significant impact on all processes. It is hoped that these insights might influence the treatment of patients with diabetes and the management of blood parameters in clinical practice. Examining the effect of T2DM or insulin resistance on sd LDL within HDL cholesterol and triglycerides pathways might provide valuable insights for targeted cardiovascular treatments. Additionally, the study's exploration of the potential positive effects of elevated blood pressure on sd LDL reversal may introduce novel considerations for blood pressure management in patients with diabetes.

Quantification of lipoproteins by proton nuclear magnetic resonance spectroscopy (1H-NMRS) improves the prediction of cardiac autonomic dysfunction in patients with type 1 diabetes.

To assess if advanced characterization of serum glycoprotein and lipoprotein profile, measured by proton nuclear magnetic resonance spectroscopy (1H-NMRS) improves a predictive clinical model of cardioautonomic neuropathy (CAN) in subjects with type 1 diabetes (T1D). Cross-sectional study (ClinicalTrials.gov Identifier: NCT04950634). CAN was diagnosed using Ewing's score. Advanced characterization of macromolecular complexes including glycoprotein and lipoprotein profiles in serum samples were measured by 1H-NMRS. We addressed the relationships between these biomarkers and CAN using correlation and regression analyses. Diagnostic performance was assessed by analyzing their areas under the receiver operating characteristic curves (AUCROC). Three hundred and twenty-three patients were included (46% female, mean age and duration of diabetes of 41 ± 13years and 19 ± 11years, respectively). The overall prevalence of CAN was 28% [95% confidence interval (95%CI): 23; 33]. Glycoproteins such as N-acetylglucosamine/galactosamine and sialic acid showed strong correlations with inflammatory markers such as high-sensitive C-reactive protein, fibrinogen, IL-10, IL-6, and TNF-α. On the contrary, we did not find any association between the former and CAN. A stepwise binary logistic regression model (R2 = 0.078; P = 0.003) retained intermediate-density lipoprotein-triglycerides (IDL-TG) [β:0.082 (95%CI: 0.005; 0.160); P = 0.039], high-density lipoprotein-triglycerides (HDL-TGL)/HDL-Cholesterol [β:3.633 (95%CI: 0.873; 6.394); P = 0.010], and large-HDL particle number [β: 3.710 (95%CI: 0.677; 6.744); P = 0.001] as statistically significant determinants of CAN. Adding these lipoprotein particles to a clinical prediction model of CAN that included age, duration of diabetes, and A1c enhanced its diagnostic performance, improving AUCROC from 0.546 (95%CI: 0.404; 0.688) to 0.728 (95%CI: 0.616; 0.840). When added to clinical variables, 1H-NMRS-lipoprotein particle profiles may be helpful to identify those patients with T1D at risk of CAN.

Effects of waste-based concentrates from broiler farm on physico-chemical qualities and blood profile of landrace pigs.

The study aimed to determine the effect of giving concentrate protein from closed-house (CP-CH) broiler farm waste in rations on the meat quality (physical-chemical) and blood profile of landrace crossbreed pigs. The study used a completely randomized design (CRD) with 3 treatments and 4 replications with 12 finisher-phase landrace pigs with an average body weight of 63.42 ± 2.39 kg. The treatments were: A (control): use of 0% CP-CH + 24% CP-152 concentrate; B: 12% CP-CH + 12% CP-152 concentrate; and C: 24% CP-CH + 0% CP-152 concentrate. The research parameters were meat quality (physical-chemical meat) and blood lipid profile [total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TGs)]. The results showed that treatment group B obtained physical meat quality (pH, drip loss, cooking loss, and water holding capacity) and meat chemical quality (moisture, protein, fat, and ash content) that were almost the same as the control (p > 0.05). By administering 24% CP-CH + 0% CP-152 (C) concentrate, there was a significant decrease in the physical and chemical quality of crossbreed landrace pigs (p < 0.05). Administration of CP-CH at 12%-24% did not affect total cholesterol, HDL, LDL, or blood TGs in landrace-crossbreed pigs. Giving 12% CP-CH (B) obtained meat quality (physical and chemical) almost the same as the control group. Treatment group C significantly reduced the physical and chemical quality of the meat. Administration of CP-CH at 12%-24% did not affect the blood profile of landrace crosses.

Effect of Cupping Therapy on Biochemical and Hematological Parameters

Background: The word Hijama is derived from Arabic means to suckle and restore to normal state of internal equilibrium. Cupping therapy is one of the alternative and conventional therapies, which have significant association and beneficial in some clinical conditions such as Lower back pain, neck and shoulder pain, headache and migraine, knee pain and hypertension. The aim was to determine biochemical and hematological parameters in before and after cupping therapy. Method: A comparative cross-sectional study was carried out at MLT lab of the CUSIT Peshawar from January 2023 to September 2023. A total 210 Convenient Samples collected from different Hijama center in district Peshawar. SPSS Paired T Test were used for statistical analysis. Results: Statistically positive changes in biochemical parameters such as ALT, ALP, SBR, Uric acid, Cholesterol, Triglyceride HDL, LDL and VLDL. Biochemical parameters including Total protein, Urea and Creatinine not statistically significant in cupping therapy. Where, hematological parameters such as White blood cell count, Red Blood cells count, Hemoglobin Level, Platelets count and coagulation cascade were found significantly in cupping therapy. Conclusion: This study concluded that the cupping therapy have positive impact on biochemical and hematological parameters. This study recommend that cupping therapy is good in certain health condition such as pain reduction, Muscle relaxation, improve blood circulation and activation of the immune system.

Dyslipidaemia is associated with Cutibacterium acnes hip and knee prosthetic joint infection.

Optimization of medical factors including diabetes and obesity is a cornerstone in the prevention of prosthetic joint infection (PJI). Dyslipidaemia is another component of metabolic syndrome which has not been thoroughly investigated as an individual, modifiable risk factor. This study examined the association of dyslipidaemia with PJI caused by the lipophilic microbe Cutibacterium acnes (C. acnes). A retrospective chart review examined patients with positive C. acnes culture at hip or knee arthroplasty explantation. A control group with methicillin-sensitive Staphylococcus aureus (MSSA) positive cultures at explantation was matched for age, sex, and surgical site, as well as a second control group with no infection. A total of 80 patients were included, 16 with C. acnes, 32 with MSSA, and 32 with no infection. All patients had a lipid panel performed within oneyear of surgery. Lipid values and categories were compared using multinomial logistic regressions. High or borderline triglycerides (TG) (relative risk ratio (RRR) = 0.13; P = 0.013) and low high-density lipoprotein (HDL) (RRR = 0.13; P = 0.025) were significantly associated with C. acnes PJI compared to MSSA-PJI. High or borderline TG (RRR = 0.21; P = 0.041) and low HDL (RRR = 0.17; P = 0.043) were also associated with a greater probability of C. acnes infection compared to no infection. The presence of elevated TG and low HDL were both associated at a statistically significant level with C. acnes hip or knee PJI compared to controls with either MSSA PJI or no infection. This may represent a specific risk factor for C. acnes PJI that is modifiable.

Associations of normal fasting glucose levels and of insulin resistance with degenerative rotator cuff tear

BackgroundThe upper normoglycemic range has been proposed as a risk factor for degenerative rotator cuff tendon tear (RCT), and insulin resistance has been suggested as a risk factor for tendinopathy. However, no research has established their association with degenerative RCT in the general population. This study aimed to determine whether fasting glucose levels and insulin resistance are risk factors for degenerative RCT in the normoglycemic population and identify the risk range for fasting glucose.MethodsThis study included 418 normoglycemic participants from a rural cohort. Participants completed questionnaires, physical exams, blood tests, and MRI evaluations of both shoulders. Insulin resistance was assessed using a triglyceride/high-density-lipoprotein (TG/HDL) ≥ 3.5. Logistic regression analysis was used to determine the association between fasting glucose level, TG/HDL ≥ 3.5, and other factors and degenerative RCT. The study calculated the areas under the receiver operating characteristic curve (AUC) to determine the more appropriate predicting value between the scale and categorical values of fasting glucose levels, and compared the AUCs using the DeLong method.ResultsIn the multivariable analyses, both scale and categorical values of fasting glucose levels, and TG/HDL ≥ 3.5 were significantly associated with degenerative RCT. Fasting glucose levels ≥ 90.5 mg/dL (OR: 3.87, 95% CI: 2.10–7.06) in scale value and 90–99 mg/dL (OR: 4.13, 95% CI: 2.87–8.12) in categorical value were significantly associated with degenerative RCT (P < .001). The AUC of the scale value of fasting glucose levels ≥ 90.5 mg/dL was 0.68. The AUC of the categorical value of fasting glucose levels of 90–99 mg/dL was 0.70. Because of the significantly larger AUC of the categorical value of fasting glucose levels of 90–99 mg/dL, those fasting glucose levels were determined to be independently associated with degenerative RCT (P < .001).ConclusionsHigh fasting glucose levels within the normal range may link to increase insulin resistance and risk of degenerative RCT. Normoglycemic levels of 90–99 mg/dL and insulin resistance may be risk factors for degenerative RCT.Level of evidenceLevel III, prognostic study.

Serum lipoprotein subfractions are associated with the periodontal status: Results from the population-based cohort SHIP-TREND.

To investigate the medium-term associations of serum protein subfractions derived from proton nuclear magnetic resonance (1 H-NMR) spectroscopy with periodontitis and tooth loss. A total of 3031 participants of the cohort Study of Health in Pomerania (SHIP-TREND) were included. In addition to conventional serum testing, serum lipoprotein contents and subfractions were analysed by 1 H-NMR spectroscopy. Confounder-adjusted associations of lipoprotein variables with periodontitis and the number of missing teeth variables were analysed using mixed-effects models with random intercepts for time across individuals, accounting for multiple testing. While only spurious associations between lipoprotein levels from conventional blood tests were found-that is, triglycerides were associated with mean clinical attachment level (CAL) and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with the number of missing teeth - several associations emerged from serum lipoprotein subfractions derived from 1 H-NMR analysis. Specifically, elevated LDL triglycerides were associated with higher levels of mean probing depth (PD), mean CALs, and increased odds of having <20 teeth. HDL-4 cholesterol levels were inversely associated with mean PD. Systemic inflammation (C-reactive protein) might mediate the effects of LDL and HDL triglyceride contents on periodontitis severity. Several associations between serum lipoprotein subfractions and periodontitis were observed. As the underlying biochemical mechanisms remain unclear, further research is needed.