Higher Triglyceride Levels Research Articles

A-224 Non HDL Cholesterol: could be e new cardiovascular disease risk stratification factor?

Abstract Background A worldwide study demonstrated that among all modifiable risk factors of Cardiovascular Disease (CVD) to the abnormal cholesterol levels is attributable the highest risk of events. LDL-C is considered the most important lipoprotein risk factor. Some recent epidemiologic studies have suggested that non-HDL cholesterol (N-HDL-C) may be superior to LDL-C for identifying CVD risk. N-HDL-C is easily calculated from a lipid profile and represents all apolipoprotein B containing lipoproteins. Recent guidelines recommend LDL-C as a primary indicator and non-HDL-C as secondary. Moreover, cholesterol ratios are useful to stratification; the TC/HDL-C is associated with morbidity and mortality in the general population; in addition, several studies have stated that high triglycerides (TG) levels and low HDL-C are associated with increased risk and could function as atherogenic index. Methods 11399 samples were analyzed on Atellica Solution for the determination of Total Cholesterol (TC), D-LDL-C, HDL-C and TG. In the absence of clinical parameters, based on the desirable levels recommended by the guidelines, CVD risk was evaluated by assigning a cut-off of 100 and 130 mg/dL for D-LDL-C and N-HDL-C respectively Results Patients cohort mean (±SD) for CT, D-LDL, HDL, TG and N-HDL-C are 180 mg/dL (±43.2), 113 mg/dL (± 38.5), 51.7 mg/dL (±15.6), 116 mg/dL (±73.8), 128 mg/dL (±39.5) respectively. Of the examined patients, the 57.7% were outpatients, 21.8% of infectious diseases and 12.6% of the cardiovascular department. Data about D-LDL-C and N-HDL-C comparison, evaluated on discordant patients, are shown in table 1. Conclusions The data obtained from evaluation would seem to confirm hypothesis according to which non-HDL cholesterol would have a greater power in the identification of CVD risk because of cholesterol ratios are suggestive of increased risk for patients with an LDL-C<100 and N-LDL-C>130 mg/dL. Further studies assessing CVD risk, not only through laboratory data, are necessary to confirm this supposition.

A-223 Direct LDL or not Direct-LDL, that is the question

Abstract Background Management of Cardiovascular Disease (CVD) risk is dependent on Low Density Lipoprotein Cholesterol (LDL-C) levels; therefore LDL-C serves as the marker for the assessment of CVD risk and the focus of lipid lowering treatment. The gold standard reference method for measurement of LDL-C is beta-quantification. We compared calculated LDL-C with Friedewald (F-LDL-C), Martin-Hopkins (M-LDL-C) and Sampson (S-LDL-C) equations versus LDL-C directly measured (D-LDL-C). In CVD management also cholesterol ratios are evaluated. TC/HDL is associated with morbidity and mortality in the general population. Furthermore, several studies have stated that high triglycerides (TG) levels and low HDL-C (TG/HDL ratio) could function as an atherogenic index. Methods 11399 samples were analyzed on Siemens Atellica Solution® for the lipid profile determination measuring Total Cholesterol (TC), D-LDL-C, HDL-C and TG. In the absence of additional clinical parameters, based on desirable levels for LDL-C recommended by guidelines, CVD risk was evaluated by assigning to LDL-C a cut-off of 100 mg/dL. In presence of misclassifications, we used two other parameters to assess LDL-C results: TG/HDL-C ratio and CT/HDL-C. Results Patients cohort had a mean age of 57.7 (±16.8) years of which 53% (age=58.6, ±15.9) were males and 47% (age=56.5, ±17.8 years) were females. Of these, the 57.7% were outpatients and 42.3% inpatients (42.1% of infectious diseases - 24.4% of the cardiovascular department). Data about LDL-C misclassification and ratio data parameters are shown in table 1. Discordant patients for D-LDL-C vs F-LDL-C are 8.5%, that of D-LDL-C vs M-LDL-C are 7.7% and D-LDL-C vs S-LDL-C are 7.2%. Conclusions Is known that LDL plays a central role in the pathogenesis of atherosclerosis. Accurate estimation of LDL-C is a fundamental point for the stratification of CVD risk and the achievement of the therapeutic goal; however, we are still uncertain about the best and accurate way to measure it.

Application of a Machine Learning Predictive Model for Recurrent Acute Pancreatitis.

Acute pancreatitis is the main cause of hospitalization for pancreatic disease. Some patients tend to have recurrent episodes after experiencing an episode of acute pancreatitis. This study aimed to construct predictive models for recurrent acute pancreatitis (RAP). A total of 531 patients who were hospitalized for the first episode of acute pancreatitis at the Affiliated Hospital of Southwest Medical University from January 2018 to December 2019 were enrolled in the study. We confirmed whether the patients had a second episode until December 31, 2021, through an electronic medical record system and telephone or WeChat follow-up. Clinical and follow-up data of patients were collected and randomly allocated to the training and test sets at a ratio of 7:3. The training set was used to select the best model, and the selected model was tested with the test set. The area under the receiver operating characteristic curves, sensitivity, specificity, positive predictive value, negative predictive value, accuracy, decision curve, and calibration plots were used to assess the efficacy of the models. Shapley additive explanation values were used to explain the model. Considering multiple indices, XGBoost was the best model. The area under the receiver operating characteristic curves, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the XGBoost model in the test set were 0.779, 0.763, 0.883, 0.647, 0.341, and 0.922, respectively. According to the Shapley additive explanation values, drinking, smoking, higher levels of triglyceride, and the occurrence of ANC are associated with RAP. The XGBoost model shows good performance in predicting RAP, which may help identify high-risk patients.

In vitro fertilization-induced extreme hypertriglyceridemia with secondary acute pancreatitis in emergency department: A case report and literature review

Abstract Acute pancreatitis is one of the severe complications of hypertriglyceridemia, which needs to be recognized early to provide appropriate treatment. Hypertriglyceridemia-induced pancreatitis has several causes, in which in vitro fertilization (IVF) is a rare etiology that is becoming increasingly popular. We report a 33-year-old female patient with a history of hypertension who has failed an IVF cycle and started a new IVF procedure 1 month before admission. She was diagnosed with severe triglyceridemia-induced acute pancreatitis with extremely high serum triglycerides (TGs) levels (18,547 mg/dL). We combined plasmapheresis and intravenous (IV) insulin and significantly reduced blood TG over a short time. She was discharged with a TG level of 366.7 mg/dL on the 10th day. It is essential to monitor serum TG levels in plasma before, during, and after this therapy, especially in the 1st month after initiating IVF. Although plasmapheresis combined with IV insulin is not officially recommended for acute triglyceridemia-induced pancreatitis, the therapy can be considered in cases with extremely high serum TG levels.

Serum levels of per- and poly-fluoroalkyl substances among middle-aged and elderly populations in Beijing and their association with dyslipidemia

Per- and poly-fluoroalkyl substances (PFAS), ubiquitous environmental pollutants, have been reported as possible contributors to human dyslipidemia. However, evidence for emerging PFAS remains scarce. Using a nested case-control study (n = 357) in a middle-aged and elderly population from Beijing, we investigated the serum concentrations of eight traditional and fourteen emerging PFAS and their potential links with dyslipidemia. Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) were found to be the dominant PFAS. Serum levels of perfluorohexanesulfonic acid (PFHxS) and 6:2 chlorinated polyfluoroalkyl ether sulfonate (6:2 Cl-PFESA/F53B) were associated with higher risk of elevated low-density lipoprotein cholesterol (LDL-C) with odds ratios (OR) of 3.88 (95% CI: 1.44–10.51) and 2.71 (95% CI: 1.11–6.57), respectively. These compounds also positively correlated with high total cholesterol (TC). PFOA, perfluorodecanoic acid (PFDA), and 6:2 Fluorotelomer phosphate monoester (6:2 PAP) were linked to increased risk of high triglycerides (TG) with OR of 2.79 (95% CI: 1.30–6.01), 2.41 (95% CI: 1.27–4.60), and 1.53 (95% CI: 1.05–2.22), respectively. Conversely, perfluorooctane sulfonamidoacetic acid (FOSAA) was negatively associated with high TG levels. These findings indicate that both traditional and emerging PFAS may induce dyslipidemia, emphasizing the potentially serious impact of emerging PFAS on human health.

Falsely Elevated Triglyceride and Lipase Levels Due to Hyperglycerolemia in a Burn Patient Treated with Topical Silver Sulfadiazine

Pseudohypertriglyceridemia is an overestimation of serum triglyceride levels, potentially leading to an inaccurate diagnosis of hypertriglyceridemia. This can result from hyperglycerolemia, which interferes with enzymatic measurement methods. Hyperglycerolemia may arise from drugs or genetic glycerol kinase defects. We present a case of a severely burned patient with very high triglyceride levels (up to 5,696 mg/dL) that was resistant to lipid-lowering treatment, identified during the work up for pancreatitis associated with elevated lipase levels. Despite the very high triglyceride levels reported in the laboratory results, the standing plasma showed clear plasma, with no significant peak of pre-beta lipoprotein observed on serum lipoprotein electrophoresis. Serum apolipoprotein B levels were low, and urine triglyceride levels were high. This case confirms that very high serum glycerol levels caused the falsely elevations of triglyceride and lipase levels, resulting from hyperglycerolemia induced by the massive topical application of silver sulfadiazine cream (containing glycerine and glyceryl stearate) to the severely burned wound, which interfered with the laboratory assays. Triglyceride and lipase levels dramatically decreased after reducing the dose of silver sulfadiazine cream. No genetic defects related to glycerol kinase deficiency were identified.

Does Adopting Western Low-density Lipoprotein Cholesterol Targets Expose Indians to a Higher Risk of Cardiovascular Events? Expert Opinion From the Lipid Association of India.

Adverse cardiovascular (CV) events have declined in Western countries due at least in part to aggressive risk factor control, including dyslipidemia management. The American and European (Western) dyslipidemia treatment guidelines have contributed significantly to the reduction in atherosclerotic cardiovascular disease (ASCVD) incidence in the respective populations. However, their direct extrapolation to Indian patients does not seem appropriate for the reasons described below. In the US, mean low-density lipoprotein cholesterol (LDL-C) levels have markedly declined over the last 2 decades, correlating with a proportional reduction in CV events. Conversely, poor risk factor control and dyslipidemia management have led to increased CV and coronary artery disease (CAD) mortality rates in India. The population-attributable risk of dyslipidemia is about 50% for myocardial infarction, signifying its major role in CV events. In addition, the pattern of dyslipidemia in Indians differs considerably from that in Western populations, requiring unique strategies for lipid management in Indians and modified treatment targets. The Lipid Association of India (LAI) recognized the need for tailored LDL-C targets for Indians and recommended lower targets compared to Western guidelines. For individuals with established ASCVD or diabetes with additional risk factors, an LDL-C target of <50 mg/dL was recommended, with an optional target of ≤30 mg/dL for individuals at extremely high risk. There are several reasons that necessitate these lower targets. In Indian subjects, CAD develops 10 years earlier than in Western populations and is more malignant. Additionally, Indians experience higher CAD mortality despite having lower basal LDL-C levels, requiring greater LDL-C reduction to achieve a comparable CV event reduction. The Indian Council for Medical Research-India Diabetes study described a high prevalence of dyslipidemia among Indians, characterized by relatively lower LDL-C levels, higher triglyceride levels, and lower high-density lipoprotein cholesterol (HDL-C) levels compared to Western populations. About 30% of Indians have hypertriglyceridemia, aggravating ASCVD risk and complicating dyslipidemia management. The levels of atherogenic triglyceride-rich lipoproteins, including remnant lipoproteins, are increased in hypertriglyceridemia and are predictive of CV events. Hypertriglyceridemia is also associated with higher levels of small, dense LDL particles, which are more atherogenic, and higher levels of apolipoprotein B (Apo B), reflecting a higher burden of circulating atherogenic lipoprotein particles. A high prevalence of low HDL-C, which is often dysfunctional, and elevated lipoprotein(a) [Lp(a)] levels further contribute to the heightened atherogenicity and premature CAD in Indians. Considering the unique characteristics of atherogenic dyslipidemia in Indians, lower LDL-C, non-HDL-C, and Apo B goals compared to Western guidelines are required for effective control of ASCVD risk in Indians. South Asian ancestry is identified as a risk enhancer in the American lipid management guidelines, highlighting the elevated ASCVD risk of Indian and other South Asian individuals, suggesting a need for more aggressive LDL-C lowering in such individuals. Hence, the LDL-C goals recommended by the Western guidelines may be excessively high for Indians and could result in significant residual ASCVD risk attributable to inadequate LDL-C lowering. Further, the results of Mendelian randomization studies have shown that lowering LDL-C by 5-10 mg/dL reduces CV risk by 8-18%. The lower LDL-C targets proposed by LAI can yield these incremental benefits. In conclusion, Western LDL-C targets may not be suitable for Indian subjects, given the earlier presentation of ASCVD at lower LDL-C levels. They may result in greater CV events that could otherwise be prevented with lower LDL-C targets. The atherogenic dyslipidemia in Indian individuals necessitates more aggressive LDL-C and non-HDL-C lowering, as recommended by the LAI, in order to stem the epidemic of ASCVD in India.

Relationship between Lipid and Blood Glucose Levels with Stroke Risk in Dupak Surabaya

Background: Stroke is a syndrome characterized by rapidly developing symptoms and/or clinical signs in the form of focal or global brain functional disorders lasting more than 24 hours which are not caused by causes other than vascular. Stroke is the number one cause of disability and the main cause of death in Indonesia (19.42% of total deaths). Dyslipidemia and diabetes mellitus are two-fold risk factors for stroke.This research is to determine the relationship between lipids and blood glucose and a high risk of stroke. Methods: This research uses descriptive analytical methods with a cross sectional approach. The population is residents in Dupak Surabaya. The sampling method is random sampling technique. The total research sample was 53 participants. The statistical test used is Chi Square. Result: Statistical results show that there is no relationship between high cholesterol levels and the risk of stroke and there is a relationship between high triglyceride and blood sugar levels and the risk of stroke.Conclusion:This research concluded that there was a significant relationship between high levels of triglycerides and blood glucose and the risk of stroke and there was no significant relationship between high cholesterol levels and the risk of stroke. This lack of significant association could be due to the heterogeneous population and the presence of previous anti-cholesterol medication.

Prevalence of metabolic syndrome among adults treated at a district hospital outpatient department.

Metabolic syndrome (MetS) is a collection of risk factors, including hypertension, high fasting blood glucose, high fasting triglyceride and low high-density lipoprotein (HDL) cholesterol levels that may increase the risk for cardiovascular disease and type 2 diabetes. The study aimed to determine the prevalence of MetS among adults attending a Free State district hospital's outpatient department. A cross-sectional study included a consecutive sample of consenting patients 18 years and older from 18 October 2021 to 19 November 2021. Patients' waist circumference was measured, and data were extracted from patients' files. The 409 participants were predominantly females (64.2%). The median age was 60 years. Triglyceride and HDL cholesterol levels were available for 27.4% and 26.9% of patients, respectively. Of the 278 (68.0%) patients with sufficient information to determine their MetS status, 187 (67.3%) had MetS. Of the males with sufficient information, 49.1% (n= 56/114) had MetS compared to 79.9% (n= 131/164) of the females with sufficient information (p 0.001). The age group 60-79 years had the highest prevalence (76.7%,p 0.001). In all race groups, at least two-thirds of patients had MetS (p= 0.831). Incomplete patient notes and failure to do investigations led to a third of patients not having sufficient information to determine their MetS status. In patients with sufficient information, a high prevalence of MetS was found.Contribution:This study highlights the challenges of determining MetS retrospectively in an outpatient population and the need for completeness of medical note keeping and routine investigations in high-risk patients. It also notes the high prevalence of MetS.

Dietary patterns and metabolic syndrome amongst adult residents: A cross-sectional study in a rapidly urbanized Southern Chinese city.

We aimed to investigate and summarize dietary patterns and explore the association between dietary patterns and metabolic syndrome (MS) and its components among adult residents in a rapidly urbanized city. We employed a multi-stage random sampling method to select 1000 adult residents who underwent a comprehensive survey, including questionnaires, physical examinations, and laboratory tests. The diagnosis of metabolic syndrome was made when the participant met 3 or more of the 5 criteria outlined in the "2017 Chinese Guidelines for the Prevention and Treatment of Type 2 diabetes." Factor analysis and a nonconditioned logistic regression model were used. Nine hundred seventy-five participants with a mean (SD) age of 41.08 (11.06) were included. The prevalence of metabolic syndrome was 19.4% (n = 189). Significant differences were observed between the MS and non-MS groups in terms of patient characteristics in terms of sex (P < .001), age (P < .001), education (P < .001), marital status (P = .025), smoking (P < .001), and alcohol consumption (P = .044). Three dietary patterns were summarized: traditional, coastal, and meat. The coastal pattern was associated with a significantly lower prevalence of MS (P < .001), elevated blood pressure (P < .001), and high triglyceride levels (P = .03). However, in the multivariate analysis, we found no significant associations between dietary patterns and MS or its components after adjusting the demographic characteristics and behaviors, even when the P-value was close to .05. In this study, we did not find an association between dietary patterns and MS and its components after adjusting covariates as much as possible in Pingshan, Shenzhen, a rapidly urbanized city, but underscore the potential health benefits of the coastal dietary pattern, which highlights the importance of conducting further research for a comprehensive understanding.

A Risk Prediction Model for New-Onset Chronic Kidney Disease in the Elderly

Plain Language SummaryDifferent regions have different risk factors for chronic kidney disease (CKD), and using a single model for prediction can often lead to errors. This study aimed to create an easy-to-use tool to predict the risk of CKD in older adults. We analyzed data from 5,416 people aged over 65 who had regular health check-ups between January 2017 and July 2021. We found that about 20% developed CKD during a follow-up period of 2.3 years. Factors like age, being female, diabetes, high triglyceride levels, and initial kidney function were used to build the prediction model. This model was good at forecasting CKD risk and was validated to ensure its accuracy. It can help doctors quickly identify older adults who might be at risk of kidney problems and start early treatment.

Diabetes-Related Changes in Carotid Wall Properties: Role of Triglycerides.

Background/Objectives: This study compares the power of the radiofrequency (RF) signal reflected from the media layer (media power) of the common carotid artery (CCA) and the CCA stiffness between individuals with and without type 2 diabetes mellitus (T2DM). It also evaluates the associations of CCA media power with plasma glucose and lipid levels, as well as carotid stiffness. Methods: A total of 540 individuals, 115 with and 425 without T2DM (273 males, mean age = 64 ± 8 years) were studied using RF-based tracking of the right CCA. The following parameters were measured: CCA media thickness, luminal diameter, wall tensile stress (WTS), local pulse wave velocity (PWV), and media power. Results: Compared to the non-diabetic individuals, the T2DM patients had significantly higher CCA media thickness (652 ± 122 vs. 721 ± 138 microns, p < 0.005), luminal diameter (6.12 ± 0.78 vs. 6.86 ± 0.96 mm, p < 0.0005), media power (36.1 ± 4.8 vs. 39.3 ± 4.6, p < 0.0001), and PWV (7.65 ± 1.32 vs. 8.40 ± 1.89 m/s; p < 0.01), but comparable WTS (32.7 ± 10.4 vs. 33.1 ± 10.7 kPa; p = 0.25). In the entire population, CCA media power was independently associated with male sex, pulse pressure, current smoking, and T2DM; when T2DM was not included in the model, triglycerides emerged as an independent determinant of media power. The CCA PWV was independently associated with age, pulse pressure, media power, and T2DM. Conclusions: Our findings suggest the presence of structural changes in the arterial media of T2DM patients, leading to carotid stiffening and remodeling, aiming to preserve WTS. T2DM-related changes in arterial wall composition may be driven by high plasma triglyceride levels, which have previously been associated with both arterial stiffening and the incidence of CV events.

Endothelial Dysfunction in Children with Frequently Relapsing and Steroid-Dependent Nephrotic Syndrome

Background Children with frequently relapsing (FR) or steroid-dependent (SD) nephrotic syndrome (NS) show endothelial dysfunction and risk of endothelial injury during relapses, increasing the risk of accelerated atherosclerosis and adverse cardiovascular events. This study examines the plasma levels of markers of endothelial dysfunction [sE-selectin and vascular cell adhesion molecule-1 (VCAM-1)] in children aged 1–16 years with FRNS and SDNS in relapse. Materials and Methods Fifty-six children with FRNS and SDNS between 1 and 16 years were enrolled at the time of relapse and followed till six weeks of steroid-induced remission. Markers of endothelial dysfunction (sE-selectin and VCAM-1) in plasma were measured in these children and in an equal number of controls. Results Plasma sE-selectin and VCAM-1 levels were significantly raised during relapse, declined after six weeks of steroid-induced remission, and became comparable to controls (p &lt; 0.0001). We found high serum total cholesterol and triglycerides levels during relapse that remained elevated even after steroid-induced remission as compared to controls (p &lt; 0.0001). Raised levels of these markers confirm endothelial dysfunction in FRNS and SDNS patients. Conclusion Children with FRNS and SDNS had endothelial dysfunction during relapse, which was largely dependent upon disease activity.

Metformin and Caffeine’s Influence on Lipid Profile Indices of Streptozotocin-Induced Dyslipidemia in an Animal Model

Dyslipidemia has been linked to insulin resistance and hyperglycemia. Hyperglycemia, which is the outcome of either insufficient insulin production or insensitivity to insulin, is the hallmark of diabetes mellitus (DM). In this study, thirty-six (36) male Wistar rats with diabetes induced by streptozotocin were used to determine the effect of metformin and caffeine on blood glucose levels and lipid profile indices. The rats weighed between 150 and 200 grams and were split into six groups of six animals each at random. Group A was given unlimited access to chow (Grower feed) and water adlibitum. Group B was administered 60 mg/kg of streptozocin (STZ) without any medication, while Group C was given 60 mg/kg of STZ together with 50 mg/kg of metformin. Groups D and E were administered 60 mg/kg of streptozocin and 25 mg/kg and 50 mg/kg of caffeine, for a duration of 21 days respectively. Group F was given 50 mg/kg of caffeine together with 50 mg/kg of metformin for a duration of 21 days. After performing a post-hoc LSD comparison and using ANOVA to analyze the results, the lipid profile and blood glucose level were deemed significant at p&lt;0.05. A paired t-test was used to analyze body weight. Rats with diabetes had reduced body weight, whereas those receiving metformin and caffeine treatments had noticeably increased body weight. The findings demonstrated that whereas metformin and caffeine therapy greatly reduced blood glucose levels, STZ caused hyperglycemia in group B. However, diabetic rats had considerably higher levels of triglycerides (TG) and total cholesterol (TC), which were reduced by metformin and caffeine administration. HDL activity was considerably increased after treatment with metformin and caffeine, despite the rats' reduced HDL levels in group B. Rats with diabetes had considerably elevated levels of LDL and VLDL, and therapy with metformin and caffeine markedly restored their activity. The study shows that caffeine plus metformin may be utilized to control the lipid profile and blood glucose levels in diabetic rats.

Lipid levels and multiple myeloma risk: insights from Meta-analysis and mendelian randomization

BackgroundLipid levels have been suggset to be correlated with multiple myeloma (MM) risk, though causality remains unconfirmed. To explore this further, a detailed study combining meta-analysis and Mendelian randomization (MR) was conducted.MethodsLiterature searches were performed on PubMed and Embase; summary data for plasma lipid traits were extracted from the IEU and MM data from the FinnGen database. Meta-analysis and MR were utilized to analyze the link of lipids with MM risk, including mediator MR to identify potential mediators. The study was conducted in accordance with PRISMA and STROBE-MR guidelines.ResultsObservational studies analyzed through meta-analysis showed that elevated levels of LDL, HDL, total cholesterol (TC), and triglycerides correlate with a lower risk of MM, with HRs of 0.73, 0.59, 0.60, and 0.84, respectively. MR analysis confirmed a potential causal link of triglyceride with a reduced MM risk (OR: 0.67, 95% CI: 0.46–0.98), independent of BMI. Mediation analysis pointed to X-11,423-O-sulfo-L-tyrosine and neuropilin-2 as potential mediators.ConclusionsThe findings suggest that higher lipid levels (LDL, HDL, TC, and triglycerides) are linked with a reduced MM risk, and higher triglyceride levels are causally associated with a reduced MM risk. This suggests new avenues for therapeutic interventions targeting MM.

The association between macrosomia and glucose, lipids and hormones levels in maternal and cord serum: a case-control study

BackgroundThe formation of macrosomia is associated with excessive nutrition and/or unable to regulate effectively. This case-control study aims to explore the relationship between macrosomia and glucose, lipids and hormones levels in maternal and cord serum.MethodsIn the case-control study, 78 pairs of mothers and newborns were recruited who received care at one hospital of Hebei, China between 2016 and 2019. According to the birth weight (BW) of newborns, participants were divided into macrosomia group (BW ≥ 4000 g, n = 39) and control group (BW between 2500 g and 3999 g, n = 39). Maternal vein blood and cord vein blood were collected and assayed. All data were compared between the two groups. Unconditional logistics regression analysis was used to test the relationship between macrosomia and glucose, lipids and hormones in maternal and cord serum.ResultsIn maternal and cord serum, the levels of leptin, leptin/adiponectin ratio (LAR), glucose and triglyceride (TG) in macrosomia group were higher than those in control group, and the levels of high-density lipoprotein cholesterol (HDL-C) were lower. The percentage of maternal glucose and lipids transfer to cord blood did not differ between the two groups. High levels of TG in maternal serum were positively correlated with macrosomia, and high levels of LAR, TG and glucose in cord serum were positively correlated with macrosomia.ConclusionIn conclusion, the results of the current study, suggest that the nutrients and metabolism-related hormones in maternal and umbilical cord are closely related to macrosomia. During pregnancy, the nutritional status of pregnant women should be paid attention to and to obtain a good birth outcome.

The causal relationship between triglycerides and myocardial infarction: A two-sample Mendelian randomization.

The causal relationship between triglycerides and myocardial infarction (MI) was investigated using Mendelian randomization (MR) studies. Triglycerides were the exposure factor, and MI served as the outcome variable. Inverse variance weighting was used as the main analysis method, MR-Egger, and weight median as other analysis methods for MR analysis. In addition, heterogeneity test, level multivariate analysis, and sensitivity analysis were carried out. Inverse variance weighting results showed that the increase in triglyceride level affected the incidence of MI (OR = 1.287; 95% CI = 1.185-1.398; P = 1.988 × 10-9). Consistently, the results from all 3 methods indicated a statistically significant increase in the risk of MI with higher triglyceride levels (P < .05). The results showed that patients with high triglyceride levels had a higher incidence of MI, suggesting that MI should be prevented in the high triglyceride population.

EP110 - Chyloperitoneum in Follicular lymphoma – presenting as an inguinal hernia

Abstract Introduction Follicular lymphoma is one of the subtypes of slow growing Non-Hodgkin Lymphoma. Rarely, follicular lymphoma can present with chyloperitoneum or chylous ascites which is characterized by a milky-white coloured fluid with raised triglyceride levels. Case Report We present a case of a 60-year-old diabetic male, complaining of a right sided inguinal swelling for 1 year. Examination revealed a reducible right inguinal swelling with a positive cough impulse. The laboratory workup was unremarkable. Ultrasound scan of anterior abdominal wall showed a defect of 2.1 cm in right inguinal region with protrusion of abdominal contents and a positive cough impulse. A diagnosis of right sided reducible direct inguinal hernia was made. Patient was scheduled for Lichtenstein repair. Per-operatively, the hernial sac contained healthy omentum with milky-white ascitic fluid. Omentum was reduced and suture repair was performed. A drain was placed intra-peritoneally. The postoperative course of the patient was uneventful. Ascitic fluid analysis showed high triglyceride levels and no evidence of malignant cells, suggesting chylous ascites. Contrast enhanced CT scan of abdomen and pelvis revealed a large homogenous minimally enhancing soft tissue density retroperitoneal mass in peri aortic and paravertebral location with abdominal lymphadenopathy suggesting retroperitoneal lymphoma. Excisional biopsy of an enlarged inguinal lymph node confirmed follicular lymphoma with positive BCL2 and CD10 markers. Conclusion Follicular lymphoma presents in a variety of ways including chylous ascites in an inguinal hernia and a high index of suspicion is required to diagnose it.

Hypoglycemic, hypolipidemic and antioxidant potential of Myrcia pubipetala in an animal model of type 1 diabetes

Myrcia genus plants, like Myrcia pubipetala, traditionally used as hypoglycemic agents, hold promise for Type 1 Diabetes Mellitus (DM1) research but need more comprehensive chemical and pharmacological investigation. This is an experimental study involving controlled administration of treatments to a group of rats to assess their effects compared with a control group, investigating the effects of M. pubipetala on alloxan-induced Type 1 Diabetes Mellitus in rats. After the induction of diabetes, the rats received the hydroalcoholic extract (HAE) or aqueous fraction (AF) (25, 50, 100, or 150 mg kg-1) of M. pubipetala, or water. The results showed that diabetic rats presented cell damage in kidneys, oxidative stress, and high levels of glucose and triglycerides in their plasma and erythrocytes. The HAE (150 mg kg-1), per se, reduced lipid and protein oxidation, and the AF (150 mg kg-1) decreased lipoperoxidation. AF (150 mg kg-1), per se, decreased triglyceride levels. Conclusion: treatment with HAE and AF reduced oxidative damage, positively modulated antioxidant defenses, and exerted hypoglycemic and hypolipidemic effects, representing a potential adjuvant treatment for diabetes.

Triglyceride to high-density lipoprotein cholesterol ratio as a marker of non-alcoholic fatty liver disease in type 2 diabetes

Type 2 diabetes mellitus (T2DM) and non-alcoholic liver disease (NAFLD) shared a common feature, insulin resistance (IR), which is marked by a change in the lipoprotein fraction, namely increased triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) levels. Blood lipids are routinely examined in T2DM patients; thus, our study aimed to investigate the performance of TG/HDL-C ratio values to identify hepatic steatosis, the earliest manifestation of nonalcoholic fatty liver disease (NAFLD), in T2DM patients. One hundred adult T2DM patients over 30 years old were recruited from the diabetes outpatient clinic at the Dr. Soetomo General Academic Hospital from August to October 2023. Data regarding sociodemographics, medication, glycosylated hemoglobin (HbA1c), lipid profiles, and FibroScan with controlled attenuation parameter (CAP) were collected from all participants. The group with hepatic steatosis (CAP≥237 dB/m) had a higher body mass index (BMI), higher TG levels, and TG/HDL-C ratio values. The TG/HDL-C ratio was significantly correlated with CAP values. Hepatic steatosis can be identified using the TG/HDL-C ratio with a cut-off value of 2.83 (sensitivity:72.4%; specificity:71.4%). An elevated TG/HDL-C ratio is associated with a higher risk (OR:6.562; p&amp;lt;0.05) of having hepatic steatosis. The TG/HDL-C ratio is a potential marker to predict NAFLD in T2DM patients.