High-density Lipoprotein Ratio Research Articles

Prognostic Value of Systemic Inflammatory Markers in Elderly Patients with Tumor-associated Venous Thromboembolism.

Elderly tumor patients are more prone to venous thrombotic events than nontumor patients. To investigate the relationship between systemic inflammatory markers and overall survival (OS) in elderly patients with tumorassociated venous thromboembolism (TAVTE). And to evaluate the prognostic value of combined lymphocyte platelettolymphocyte ratio (PLR) with neoplasm metastasis in elderly patients. A prospective study was conducted. A total of 172 elderly patients with TAVTE admitted to the hospital from January 2017 to December 2019 were included in the study, which were followed up for 2 years. Clinical and laboratory data were collected. All-cause mortality within after discharge were followed up. The optimal cutoff values of neutrophiltolymphocyte ratio (NLR), PLR, systemic immuneinflammation index (SII), and monocyte to highdensity lipoprotein ratio (MHR) for predicting efficacy and prognosis were determined according to receiver operating characteristic (ROC) curve and the areas under the ROC curve (AUC). Kaplan-meier curves were used to analyze the survival time. Univariate and multivariate COX logistic regression analyses were used to analyze the independent predictors of OS in elderly patients with TAVTE. The cut-off values for NLR, PLR, SII, and MHR were 3.375, 274.63, 399.73 and 0.58, respectively. And the area under the curve (AUC) was 0.639(95%CI: 0.556-0.721), 0.628(95%CI:0.544-0.712), 0.595(95%CI:0.510-0.680) and 0.596(95%CI: 0.510-0.683). Survival analysis showed that OS was longer in the NLR≤3.375 group (181.07 weeks, 95% CI: 150.11 ~ 212.03) than in the NLR >3.375 group (108.95 weeks, 95%CI: 90.38 ~ 127.51) (P = 0.005). The OS of PLR≤274.63 group (160.40 weeks, 95%CI: 138.41 ~ 182.38) was longer than that of PLR >274.63 group (43.85 weeks, 95%CI: 34.08 ~ 53.63) (P < 0.001). The OS of SII≤399.73 group (176.62 weeks, 95%CI:147.26 ~ 205.97) was longer than that of SII>399.73 group (126.55 weeks,95%CI: 105.04 ~ 148.05) (P = 0.012). The OS was longer in the MHR≤0.58 group (156.24 weeks, 95% CI: 127.05-185.43) than in the MHR>0.58 group (108.11 weeks, 95%CI:86.85-129.38) (P = 0.011). Univariate and multivariate Cox analysis showed that tumor metastasis and PLR>274.63 were independent predictors of the lower OS in elderly patients with TAVTE (P < 0.001). According to the tumor metastasis and the cut-off value of PLR, a combined scoring system MPS (Metastasis and PLR System) was designed. The OS of the 0, 1 and 2 score groups was 184.08 weeks (95%CI:158.11-210.05), 82.60 weeks (95%CI:61.57-103.64), and 23.83 weeks (95%CI: 9.575-38.09) (P < 0.001), respectively. Our findings suggest that the systemic inflammatory markers (NLR, PLR, SII, MHR) may have predictive value for all-cause mortality in elderly patients with TAVTE. PLR combined with tumor metastasis may be an effective index to predict the prognosis of elderly patients with TAVTE.

Inflammation as a link between depression and metabolic syndrome

Depression makes a major contribution to the overall global burden of disease, including the increased risk of a wide range of concomitant somatic pathology. А high percentage of mortality in psychiatric patients is attributed to physical diseases, mainly cardiovascular (CVD). Metabolic syndrome (MetS) is one of the risk factors for both the CVD and a frequent comorbid depression. The purpose of this review is to systematize data on the relationship between MetS and depression, in particular, on the shared pathogenetic mechanisms as systemic inflammation. The manuscript evaluates the issue of the use of hematological indices of systemic inflammation (HISIs) in the diagnosis of both MetS and affective pathology, and also provides data on new combined indicators, including the cellular link and lipidogram parameters. The latter include the ratios of lymphocytes and high-density lipoproteins (HDL) (Lymphocyte To High-Density Lipoprotein Ratio, LHR), neutrophils/HDL (Neutrophil To High-Density Lipoprotein Ratio, NHR), platelets/HDL (Platelet To High-Density Lipoprotein Ratio, PHR) and monocytes/HDL (Monocyte To High Density Lipoprotein Ratio, MHR). Understanding the relationship between hematological indices and metabolic syndrome in patients with depression can help identify individuals at high risk and identify timely preventive measures. Various clinical trials and studies indicate a link between hematological parameters and metabolic syndrome, but the question of choosing the most effective coefficients remains open. Further study of the problem can help identify potential risks of comorbid disorders and perform adequate preventive strategies.

Monocyte to high-density lipoprotein ratio as biomarker for cardiovascular health and cognitive function in the elderly diabetic and nondiabetic population: a case–control study

BackgroundAtherosclerosis plays a crucial role in the progression of cardiovascular disease, which is still a major global health concern. Its onset and advancement are significantly influenced by inflammation, especially when it comes to the immune system’s relationship with hypercholesterolemia. Effective serum biomarkers for atherosclerosis are still elusive, despite continuous research into anti-inflammatory therapies. Both monocytes and high-density lipoprotein play important roles in inflammatory and antioxidant processes, while high-density lipoprotein cholesterol (HDL-C) provides protective benefits, and monocytes are involved in the development of atherosclerotic plaque. The monocyte to high-density lipoprotein ratio (MHR) has emerged as a promising predictor of cardiovascular events, potentially more sensitive than each one’s individual levels. Studies have investigated the relationship between MHR and cardiovascular events in a number of diseases, such as acute coronary syndrome and chronic kidney disease. This study investigates the associations between MHR, atherosclerosis, arteriosclerosis, and cognitive impairment in elderly Egyptian populations, exploring its potential as a diagnostic marker and its role in predicting cognitive decline in diabetic individuals.Comprehending this intricate correlation is essential for developing preventive measures and targeted interventions for preventing cardiovascular disease and cognitive deterioration in the geriatrics.ResultsThe study included 100 participants, 50 with type 2 diabetes and 50 nondiabetic, with a mean age of 67 years. Significant negative correlations were found between MHR and the 3MS test (r: − 0.353, p = 0.012) and (r: − 0.170, p = 0.238) and between carotid femoral PWV and the 3MS test in diabetics and in nondiabetics (r: − 0.453, p = 0.001) in both groups, suggesting a potential link between MHR and cognitive impairment.ConclusionThis study highlights the complex relationship between monocyte to HDL-C ratio (MHR), atherosclerosis, and cognitive function in the elderly. Positive correlations were found between MHR and carotid intima-media thickness and carotid femoral PWV, suggesting a role for MHR in atherosclerosis. Notably, a negative correlation between MHR and cognitive function in diabetic individuals suggests a potential link between MHR and cognitive decline.

Alarmins in Chronic Spontaneous Urticaria: Immunological Insights and Therapeutic Perspectives

Background: In the world, approximately 1% of the population suffers from chronic spontaneous urticaria (CSU), burdening patients’ quality of life and challenging clinicians in terms of treatment. Recent scientific evidence has unveiled the potential role of a family of molecules known as “alarmins” in the pathogenesis of CSU. Methods: Papers focusing on the potential pathogenetic role of alarmins in CSU with diagnostic (as biomarkers) and therapeutic implications, in English and published in PubMed, Scopus, Web of Science, as well as clinical studies registered in ClinicalTrials.gov and the EudraCT Public website, were reviewed. Results: The epithelial-derived alarmins thymic stromal lymphopoietin and IL-33 could be suitable diagnostic and prognostic biomarkers and possible therapeutic targets in CSU. The evidence on the role of non-epithelial-derived alarmins (heat shock proteins, S-100 proteins, eosinophil-derived neurotoxin, β-defensins, and acid uric to high-density lipoproteins ratio) is more heterogeneous and complex. Conclusions: More homogeneous studies on large cohorts, preferably supported by data from international registries, will be able to elucidate the intriguing and complex pathogenetic world of CSU.

Dietary inflammatory index scores and cognitive aging: results from the Framingham heart Study offspring cohort.

Nutritional factors can abet or protect against systemic chronic inflammation, which plays an important role in the development and progression of dementia. We evaluated whether higher (i.e. pro-inflammatory) Dietary Inflammatory Index (DII) scores were associated with cognitive decline in the community-based Offspring Framingham Heart Study (FHS). 1,614 older adults (mean age 61 years [standard deviation (SD)], 9;55% women]) completed validated 126-item Food Frequency Questionnaires (FFQ), administered at FHS examination cycle 7 (1998-2001) and examination cycle 5 (1991-1995) and/or 6 (1995-1998). We created a DII score (based on the published method by Shivappa et al. 2014) for each available exam; a cumulative DII score was calculated by averaging exam-specific scores across the two or three exams. Cognitive testing was completed at call back sessions following examination cycles 7 and 8 (2005-2008). Exam 7 was considered as study baseline and participants were followed over a mean time of seven years (SD 1). We excluded participants with prevalent dementia at baseline and those with no cognitive testing data at either/or exams 7 and 8. We examined associations between the cumulative DII score and cognitive test scores over time using annualized change adjusting for age, sex, education (model 1) and additionally for exam 7 measures of body mass index, total energy intake, total cholesterol: high-density lipoprotein ratio, smoking and anti-cholesterol medication (model 2). Higher DII scores were significantly associated with (less) decline in performance on Similarities (verbal comprehension/reasoning) and Global cognition, following adjustments for model 1 covariates (Model 1:β and SE, 0.017, 0.008,p=0.03; 0.004,0.002,p=0.02, respectively). The effect sizes remained similar after additional adjustment for Model 2 covariates (0.018, 0.009,p=0.06; 0.004, 0.002,p=0.03, respectively). Additionally, we found that higher DII scores associated with accelerated decline in performance on Trail Making B-A (processing speed and executive function) (Model 2: -0.010, 0.004,p=0.03). We observed no relationships between higher DII scores and other neuropsychological tests. Further, stratified analyses revealed a linear relationship between higher DII scores and (less) decline in performance on Hooper visual organization among men, but not women (Model 2: 0.022, 0.010,p=0.02; -0.011, 0.009,p=0.23, respectively). Higher DII scores were associated with (less) cognitive decline. We take our unexpected findings with caution as we previous have seen a relationship between higher DII scores and increased risk for dementia. To date, such studies have been very limited, most studies that found a relationship were cross-sectional and have used less sensitive testing. Future longitudinal studies with sensitive neuropsychological test measures are encouraged to elucidate whether a longitudinal relationship between higher DII scores and age-related cognitive decline exists.

Prevalence and clinical correlates of impaired fasting blood glucose in children and adolescents with depressive disorder and relationship with triglyceride and high-density lipoprotein ratio

Depressive disorder is a significant public health problem worldwide, which adversely affects children and adolescents’ health. Impaired fasting blood glucose (IFG) is more common in depressive disorder, which becomes a clinical problem that needs to be focused on. The study purposed to determine the prevalence and related factors of IFG in Chinese children and adolescents with depressive disorder and the relationship between triglyceride and high-density lipoprotein cholesterol (TG/HDL-C) ratio and IFG. This research encompassed 756 individuals aged 8 to 18 with major depressive disorders, all diagnosed under DSM-5 criteria at the Third People’s Hospital of Fuyang from January 2020 to December 2021. We detected fasting blood glucose (FBG) and lipid levels and assessed the suicidal behaviors and depressive symptoms severity of each participant. The sociodemographic and included study variables were collected and analyzed. Our study employed multiple logistic regression to discern independent factors affecting IFG in conjunction with depressive disorders among children and adolescents. The prevalence of IFG was 6.5% (49/756). IFG was positively correlated with FBG, BMI, TG, TG/HDL-C, and was negatively correlated with gender and the type of antidepressant drug taken. Binary logistic analysis showed that male (OR = 2.57, 95% CI: 1.43–4.63, P = 0.002) and higher levels of TG (OR = 1.63, 95% CI: 1.11–2.38, P = 0.013) were independently associated with IFG in children and adolescents with depressive disorder. The incidence of IFG in children and adolescents with depressive disorder was high and was positively related to the TG/HDL-C ratio. The evaluation and management of IFG in pediatric depression should extend beyond pharmacological interventions. Comprehensive strategies in both assessment and management of IFG are essential to address this condition effectively in young patients facing depressive disorders.

Colchicine effect on biomarkers of cardiac remodelling and atherosclerosis in ST-elevation myocardial infarction: A randomized controlled trial.

Owing to its underlying inflammatory nature, atherosclerotic cardiovascular disease remains the leading global cause of mortality, particularly post-ST-elevation myocardial infarction (STEMI), a condition with significant risk for further cardiovascular events and mortality. This study aimed to investigate colchicine's effect on inflammation, cardiac remodelling and atherosclerotic risk in STEMI patients. We conducted a randomized controlled study on 88 STEMI patients undergoing percutaneous coronary intervention. Eligible patients were randomly assigned to 1 of 2 groups. The control group received the guideline-directed medical therapy for STEMI, and the test group received guideline-directed medical therapy and 0.5mg colchicine twice daily for 3months. The soluble suppressor of tumorigenicity (sST2), interleukin-1β, lipid profile parameters, triglyceride (TG)/high-density lipoprotein (HDL-C) ratio levels and left ventricular ejection fraction were evaluated for patients at baseline and the end of the 3months. No significant effects were reported for colchicine on sST2, interleukin-1β levels or left ventricular ejection fraction. Colchicine significantly lowered TG levels vs. controls, 134 (46-353) vs. 176 (72-825) respectively, P= .02, as well as TG/HDL-C ratio levels, 4.16 (2.75-5.24) vs. 5.11 (3.51-8.33),` respectively, P= .024. sST2 levels of the studied cohort were positively correlated with their TG/HDL-C ratio levels (R= .459, P< .001) at the end of follow-up. Our study highlights a promising impact of colchicine on atherosclerosis and cardiac remodelling factors in STEMI patients. Colchicine significantly reduced TG levels and TG/HDL-C ratio and was safe and well tolerated. Larger long-term studies powered to assess clinical outcomes of remodelling are necessary to confirm its beneficial effects in STEMI. NCT06054100.

The role of the triglyceride to high-density lipoprotein ratio in the diagnosis of malnutrition

The role of the triglyceride to high-density lipoprotein ratio in the diagnosis of malnutrition

Lymphocyte to high density lipoprotein ratio can predict the short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure patients

BackgroundAcute-on-chronic liver failure (ACLF) is a syndrome characterized by systemic inflammation, leading to high short-term mortality. The lymphocyte to high-density lipoprotein ratio (LHR) has been introduced as a novel marker of inflammation. However, its role as a prognostic inflammatory biomarker in the context of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) has received limited attention. MethodsWe retrospectively included 272 patients with HBV-ACLF who met the definition of APALC. Data on clinical features and laboratory tests were collected from medical records within 24 h. Logistic regression was used to identify risk factors for poor short-term prognosis, and LHR-based prediction (LHRB) models were constructed based on risk factors. Furthermore, the accuracy of the LHRB model was validated through rigorous testing. ResultsIn the survival and death groups, there were statistical differences in their CTP, MELD, MELD-Na, COSSH-ACLF II scores, and LHR. Multivariate logistic regression identified seven predictors significantly associated with 28-day mortality. Furthermore, statistically significant differences in short-term mortality and certain clinical laboratory tests for poor prognosis were observed between the high and low LHR groups. To assess the predictive performance of various models in terms of short-term mortality, the area under the receiver operating characteristic curve (AUROC) was calculated. The AUROC values for the CTP, MELD, MELD-Na, COSSH-ACLF II, and LHRB models were found to be 0.725, 0.788, 0.772, 0.871, and 0.877, respectively. The results in the validation group were similar to those in the training group, and the validation results suggested excellent performance of the LHRB model. ConclusionLHR levels have the potential to serve as indicators for the prognosis of HBV-ACLF. Additionally, the recently developed LHRB model offers an accessible risk assessment tool.

Asymmetric dimethylarginine serum concentration in normal weight and obese CKD patients treated with hemodialysis

IntroductionAsymmetric dimethylarginine (ADMA), a cardiovascular risk factor, increases in renal failure. The aim of this study was to investigate ADMA levels in normal weight and obese patients on hemodialysis.MethodsIn this cross-sectional study, 43 normal weight and 43 obese patients on regular hemodialysis were examined. Malnutrition-inflammation score (MIS), anthropometry, circulating ADMA, lipid profiles including triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and lipid ratios, glucose homeostasis parameters, blood pressure, and high-sensitivity C-reactive protein (hs-CRP) were assessed.ResultsSerum levels of ADMA were significantly lower in the obese compared to the normal weight patients (10268.2 ± 10092.4 vs. 13765.2 ± 9951.3 ng/l, P = 0.03). At the same time MIS score (6.1 ± 2.4 vs. 10.7 ± 3.2, P < 0.001), systolic blood pressure (119 ± 26.8 vs. 134.2 ± 24.7 mmHg, P = 0.018) and mean arterial pressure (91.3 ± 18.6 vs. 100.9 ± 15.9 mmHg, P = 0.028) were significantly lower in the obese than the normal weight group. Fasting blood glucose (P = 0.045), TG/HDL (P = 0.03), TC/HDL (P = 0.019), and LDL/HDL (P = 0.005) ratios, and hs-CRP (P = 0.015) levels were significantly higher in the obese than in the normal weight group.ConclusionCirculating ADMA was significantly lower in obese than in normal weight patients on hemodialysis, which was concomitant with lower MIS, indicating a better nutritional inflammatory status, and lower blood pressure.

Association of non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) with prognosis in cancer survivors: a population-based study in the United States.

Patients with cancer frequently exhibit alterations in serum lipid profiles associated with chemotherapy. It has been reported that lipid distribution in cancer correlates with tumor progression. However, the prognostic value of serum lipid biomarkers in cancer survivors remains a subject of debate. We aim to explore the relationship between non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and the prognosis of cancer survivors. In this study, we analyzed cancer survivor data from the National Health and Nutrition Examination Survey (NHANES) from 1999-2000 to 2017-2018. The study included prospective cohorts that included total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels as well as mortality data. Weighted multivariate cox regression models, competing risk models and restricted cubic spline (RCS) models were applied to investigate the association between NHHR and cancer survival. Subgroup and sensitivity analyses were performed to test the robustness of the results. This study involved 4,177 participants, representing about 19.6 million U.S. adults. After adjustment for various factors, the lower NHHR group (≤1.64) had a 31% (HR 1.31; 95% CI [1.11,1.54], p = 0.001) higher risk of death from any cause compared to the higher NHHR group. The link between NHHR and mortality remained stable across most subgroups, with notable interactions for smoking (p = 0.006) and diabetes status (p = 0.046). A J-shaped pattern was observed between NHHR and all-cause mortality, significantly among obesity-related cancer survivors (overall association test p-value = 0.0068, non-linear association test p-value = 0.0016). However, a non-significant negative correlation was observed for cancer-specific mortality (overall association test p-value = 0.48, non-linear association test p-value = 0.66). Considering the competitive risk of heart disease and cancer-specific mortality, there is no difference between the high and low NHHR groups, while the low NHHR group showed an increased risk of non-specific causes of death (p < 0.001). The results of this study suggest that NHHR is an important indicator that is strongly associated with all-cause mortality in cancer survivors, and that this relationship may be influenced by the interaction of diabetes and smoking status. This finding may provide important information for future research and patient management.

Predictive Value of Monocyte to High-Density Lipoprotein Ratio for Stroke Risk in Patients with Transient Ischemic Attack

Predictive Value of Monocyte to High-Density Lipoprotein Ratio for Stroke Risk in Patients with Transient Ischemic Attack

Low platelet to high-density lipoprotein ratio predicts poor short-term prognosis in hepatitis B-related acute-on-chronic liver failure

BackgroundAcute-on-chronic liver failure (ACLF) is characterized by a systemic inflammatory response, predominantly associated with hepatitis B virus in the Asia-Pacific region, with a high short-term mortality rate. The platelet to high-density lipoprotein ratio (PHR) has been used to predict the prognosis of patients with various inflammatory diseases. We aim to is to use the PHR to predict the short-term prognosis of patients with HBV-ACLF.MethodIn this study, we retrospectively analyzed clinical data from 270 HBV-ACLF patients. Using logistic regression, we identified independent risk factors for short-term mortality and developed a prognostic model. This model was then validated, compared, and its clinical utility assessed via decision curve analysis (DCA).ResultsAmong the 270 HBV-ACLF patients, 98 patients died within 28 days. The deceased group exhibited a higher proportion of severe hepatic encephalopathy and ascites. Additionally, there was a statistically significant difference (P = 0.046) in the novel inflammation scoring system, PHR, between the two groups. Following stringent variable selection, PHR was identified as a predictive factor for short-term mortality in HBV-ACLF patients using logistic regression analysis (OR: 0.835 (0.756–0.999), P = 0.009), and it exhibited a synergistic effect with certain traditional scores. The prognostic model constructed based on PHR demonstrated a superior ability to predict short-term mortality compared to traditional scores such as Child-Turcotte-Pugh (AUC: 0.889). Evaluation using calibration curves and decision curve analysis (DCA) suggested its practical utility.ConclusionPHR can predict short-term mortality in patients, with a low PHR upon admission being associated with an increased risk of death.

Monocyte to high-density lipoprotein ratio based prognostic nomogram for patients following allogeneic vascular replacement pancreaticoduodenectomy.

Preoperative immune-inflammatory condition influencing the metabolism of malignancies. We sought to investigate the prognostic value of a novel immune-inflammatory metabolic marker, the monocyte-to-high-density lipoprotein ratio (MHR), in patients with locally advanced pancreatic cancer. A retrospective analysis was conducted on the clinical data of 118 patients with locally advanced pancreatic cancer and obstructive jaundice who underwent allogeneic vascular replacement pancreaticoduodenectomy in our hospital from Apr. 2011 to Dec. 2023. To assess the predictive capacity of immune-inflammatory metabolic marker, we utilized the area under the receiver operating characteristic curve (AUC-ROC) and assessed the predictive potential of MHR in forecasting outcomes through both univariate and multivariate Cox proportional hazard analyses. The area under AUC for MHR in predicting 1-year postoperative survival was 0.714, with an optimal cutoff value of 1.184, yielding a sensitivity of 78.9% and specificity of 66.2%. Based on this cutoff value, patients were divided into a low MHR group (MHR ≤1.184, n = 61) and a high MHR group (MHR >1.184, n = 57). The median survival times for the low and high MHR groups were 27.0 months and 12.0 months, respectively (χ2 = 30.575, p < 0.001), and the median DFS were 18.0 months and 8.0 months, respectively (χ2 = 26.330, p < 0.001). Univariate and multivariate analyses indicated that preoperative MHR, preoperative creatinine, operation duration, and TNM stage were independent predictors of postoperative mortality, while preoperative MHR, preoperative creatinine, and TNM stage were independent predictors of postoperative recurrence risk. MHR, as an independent immune-inflammatory metabolic predictor of OS and DFS in patients with advanced PC after pancreaticoduodenectomy. Early monitoring and reduction of MHR may be of great significance in improving prognosis.

Association between Triglyceride - High Density Lipoprotein Ratio with Angiographic Severity of Coronary Artery Disease in Patients with Non-ST Segment Elevated Myocardial Infarction

Background: Non-ST Segment Elevated Myocardial infarction (NSTEMI) is a potentially life-threatening condition. Dyslipidaemia is a major contributor of coronary artery disease (CAD) and TG/HDL-C ratio can be an important marker for the prediction of the extent of CAD. This study was aimed to find out the relation between TG/HDL-C ratio with severity of coronary artery lesion in NSTEMI patients. Methods: A total of 200 NSTEMI patients were included and classified into two groups on the basis of TG/HDL-C ratio: Group-A (TG/HDL-C ratio ≤4, n=100) and Group-B (TG/HDL-C ratio &gt;4, n=100). Angiographic severity was measured by Gensini score in all the patients during the same hospital stay period. Relation between TG/HDL-C ratio and angiographic severity was evaluated. Results: Mean age of the study populations was 55.13±8.49 (years) with male predominance (75%). Hypertension, diabetes mellitus, dyslipidaemia and obesity were significantly higher in Group-B (p&lt;0.05). Gensini score in Group-B were significantly higher than Group-A (71±23 vs 30±12, p&lt;0.001). A strong positive linear relationship was found between TG/HDL-C ratio and Gensini score (r=+0.803). Multivariate logistic regression found TG/HDL-C ratio &gt;4 as the powerful independent predictor of Gensini score &gt;36 (AOR=7.98, 95% CI=4.0-15.91, p&lt;0.001). Conclusion: There is a significant positive correlation between TG/HDL-C ratio with Gensini score indicating increased severity of coronary disease in patients with NSTEMI. So early risk stratification and intensive management of NSTEMI can be done by using this cheap and easily available marker on admission. Cardiovasc j 2024; 16(2): 63-69

Non-insulin-based insulin resistance indices predict early neurological deterioration in elderly and middle-aged acute ischemic stroke patients in Northeast China

Insulin resistance (IR) has a strong association with acute ischemic stroke (AIS) occurrence and poor prognosis of afflicted patients. However, the relation between early neurological deterioration (END) risk and IR in elderly and middle-aged patients remains to be thoroughly studied. Here, we investigated the relationship between four indicators of IR and the risk of END in middle-aged patients patients with AIS. The study retrospectively analyzed 1696 elderly and middle-aged patients having AIS between January 2019 and June 2023. Within 7 days of admission, the patients were then stratified relying upon alternations in the National Institutes of Health Stroke Scale. Subsequently, we employed logistic regression analyses for assessing each index correlation with END on the basis of the tertiles of TyG index (TyGI), triglyceride to high-density lipoprotein ratio (TG/HDL), TyG-BMI, alongside IR metabolic score (METS-IR). These four indicators were significantly heightened in the END group (n = 680) in comparison to the non-END group (n = 1016). When grouping using tertiles, the four aforementioned indicators emerged as independent risk factors for END occurrence, whether or not adjusted for confounding factors. The results revealed a progressive elevation in END occurrence risk with the rise in the tertile of each indicator. Finally, we utilized receiver operating characteristic (ROC) curves for assessing the indicators' predictive power. TyG-BMI, TyGI, TG/HDL, and METS-IRs’ area under the curve (AUC) were, respectively, 0.736 (95% CI: 0.712–0.761; P < 0.001), 0. 694 (95% CI: 0.668–0.721; P < 0.001), 0.684 (95% CI: 0.658–0.711; P < 0.001), and 0.722 (95% CI: 0.697–0.747; P < 0.001). IR is associated with END risk in middle-aged AIS patients. TyG-BMI, TyGI, TG/HDL, and METS-IR are independent risk factors of END in elderly and middle-aged AIS patients. Simultaneously, these four IR indicators have significant predictive power for END.

TG/HDL-C Ratio for Predicting Insulin Resistance in Obese Children from Beijing, China.

International studies have found that the blood triglycerides to highdensity lipoproteins (TG/HDL-C) ratio predicted insulin resistance in children with overweight and obesity. However, there is a lack of such reports on children from China. The objective of this study is to explore the ability of the TG/HDL-C ratio as a blood biomarker for insulin resistance (IR) in obese children in Beijing. We evaluated 262 children with obesity from our paediatric outpatient clinic in a cross-sectional study. Detailed medical histories of all children were ascertained, as were clinical examination and laboratory test results, including blood lipids, fasting glucose, insulin, and glycated haemoglobin. We divided them into age groups of 6-9 and 10-13.5 years and then into IR and non-IR groups based on the homeostatic model assessment for IR (HOMA-IR). Analysis was accomplished with SPSS software (version 22.0). The TG/HDL-C ratio was higher in children with IR in the 6-9 and 10-13.5-year age groups (p < 0.001). Univariate and multivariate analyses displayed that the TG/HDL-C ratio and HOMA-IR were correlated in the 6-9 and 10-13.5-year-old groups (p < 0.05). In the 6-9-yearold group, IR identified by a TG/HDL-C ratio ≥ 0.645 had a sensitivity, specificity, and an area under the curve (AUC) of 79.1%, 60.9%, and 0.734, respectively. In the 10-13.5-year-old group, IR identified by a TG/HDL-C ratio ≥ 0.725 had a sensitivity, specificity, and an AUC of 79.4%, 62.9%, and 0.724, respectively. We showed the application of the TG/HDL-C ratio to predict insulin resistance in obese children in Beijing with different diagnostic thresholds based on age (6-9-year-old group with TG/HDL-C ≥ 0.645; 10-13.5-year-old group with TG/HDL-C ≥ 0.725), which were lower compared with the diagnostic threshold for insulin resistance in children reported in other countries.

Association between inflammatory biomarkers and hypertension among sedentary adults in US: NHANES 2009-2018.

Our study focuses on the relationship between inflammatory biomarkers and hypertension among sedentary adults in the United States, using data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. We categorized 24,614 participants into two groups based on their daily sedentary time: 9607 individuals in the sedentary group (≥7h) and 15,007 in the non-sedentary group(<7h). We found that the sedentary group had a significantly higher prevalence of hypertension than the non-sedentary group. Using weighted multiple logistic regression and smoothing curves, we assessed the correlation between inflammatory biomarkers and hypertension among the sedentary adults. The odds ratios for hypertension were 1.92 for the monocyte to high-density lipoprotein ratio (MHR), 1.15 for the systemic inflammation response index (SIRI), and 1.19 for the natural logarithm of the systemic immune-inflammation index (lnSII), all showing nonlinear associations. Furthermore, a significant positive correlation was found between sedentary time and inflammatory biomarkers (MHR, SIRI, and lnSII). Our findings suggest that prolonged sedentary behavior in the US significantly increases hypertension risk, likely due to marked increases in inflammation markers.

Cardiometabolic Characteristics of Obesity Phenotypes in Persons With HIV.

In the general population, it is established that adipose tissue depots pose various risks for cardiometabolic diseases. The interaction among obesity, HIV, and antiretroviral treatment promotes even greater risk for persons with HIV (PWH). As obesity is a heterogeneous condition, determining the specific obesity phenotypes present and their characteristics is critical to personalize care in PWH. Visceral, sarcopenic, myosteatotic, hepatosteatotic, and metabolically healthy obesity phenotypes were determined by pre-established cut points after segmentation of computed tomography scans at the L3 vertebra. Multivariable linear regression modeling included anthropometrics, clinical biomarkers, and inflammatory factors while controlling for age, sex, race, and body mass index (BMI). Of 187 PWH, 86% were male, and the mean ± SD age and BMI were 51.2 ± 12.3 years and 32.6 ± 6.3 kg/m2. Overall, 59% had visceral obesity, 11% sarcopenic obesity, 25% myosteatotic obesity, 9% hepatosteatotic obesity, and 32% metabolically healthy obesity. The strongest predictor of visceral obesity was an elevated triglyceride:high-density lipoprotein (HDL) ratio. Increased subcutaneous fat, waist circumference, and HDL cholesterol were predictors of sarcopenic obesity. Diabetes status and elevated interleukin 6, waist circumference, and HDL cholesterol predicted myosteatotic obesity. An increased CD4+ count and a decreased visceral:subcutaneous adipose tissue ratio predicted hepatosteatotic obesity, though accounting for only 28% of its variability. Participants with metabolically healthy obesity were on average 10 years younger, had higher HDL, lower triglyceride:HDL ratio, and reduced CD4+ counts. These findings show that discrete obesity phenotypes are highly prevalent in PWH and convey specific risk factors that measuring BMI alone does not capture. These clinically relevant findings can be used in risk stratification and optimization of personalized treatment regimens. This study is registered at ClinicalTrials.gov (NCT04451980).

Cigarette Smoking and its Association with Dyslipidemia among Middle-aged Population in Rajshahi District

Background &amp; objective: Dyslipidemia is one of the major risk factors for ischemic heart disease. Many factors contribute to the development of dyslipidemia. Smoking is one of them. Smoking and dyslipidemia are claimed to interact with each other and synergistically increase the risk of heart disease. The present study is, therefore, intended to find the association between smoking and dyslipidemia in the context of the Bangladeshi population. Methods:The present cross-sectional study was conducted in the Department of Biochemistry, Rajshahi Medical College (RMC), Rajshahi in collaboration with the Institute of Biological Science, Rajshahi University, Rajshahi over a period of five years between 2017 and 2022. A total of 230 adult (ranging from 30 to 60 years) male subjects who attended at Biochemistry Lab of RMC to have their blood tested for lipid profile were consecutively included in the study. However, individuals with the habit of chewing tobacco, ex-smokers, or those having any diseases influencing lipid profile, taking drugs (like β-blockers, thiazide, statins, fibric acid derivatives, and nicotinic acid) that may influence lipid profile, or obese persons under dietary restrictions were excluded from the study. The subjects who exhibited either serum TC: HDL ratio &gt; 4.5 or serum Tg: HDL ratio &gt; 3.5 or both conditions were considered as cases and the subjects who did not have either of the conditions were considered as controls in the present study. Result: In the present study, over one-third (34.8%) of subjects had a smoking habit with the mean duration of smoking being 13.6 ± 5.0 years. Dyslipidaemia (as defined by serum TC: HDL &gt; 4.5) was found in 33% of subjects, while the same condition, defined by serum Tg: HDL &gt; 3.5, was found in 42.6% of the subjects. While either of the two conditions was present in 13% of subjects, both conditions were concurrently observed in 31.3% of subjects. Of the total 230 subjects, 102(44.3%) were dyslipidaemic. Smoking habit was observed to be significantly higher in the case group (54.9%) than that in the control group (18.8%). The risk of having dyslipidaemia in smokers was &gt; 5-fold (95% CI = 2.9 – 9.5) higher than that in non-smokers (p &lt; 0.001). However, as the duration of smoking was correlated with different lipid profiles, it was not found to be significantly correlated with any of the lipid profiles. Conclusion: The study concluded that smokers are more likely to have dyslipidaemia than non-smokers. The risk of having dyslipidaemia in smokers is much higher than that in non-smokers. While serum total cholesterol, low-density lipoprotein (LDL) and serum triglycerides are increased, serum high-density lipoprotein (HDL) is reduced. Ibrahim Card Med J 2023; 13 (1&amp;2): 26-31