High Frequency Of Dyslipidemia Research Articles

Dementia-associated Dyslipidemia Study

Introduction: As age advances, the risk of several noncommunicable diseases (NCDs) like diabetes, hypertension, heart disease,dyslipidemia, etc increases. Dementia is among the most common diseases of older adults and accounts for significant diseaseburden globally. Dyslipidemia is especially common in older adults with diabetes. In the current study, the aim was to assessif patients with dementia have dyslipidemia and if so, whether the frequency was different in age-matched control group.Material and methods: A total of 836 subjects over the age of 60 years were screened and of these, 536 (67.12 ± 4.5 years) subjectswho met the diagnostic criteria for diagnosis of dementia (Diagnostic and Statistical Manual-IV) were enrolled for the study. Atotal of 32 cognitively normal subjects above the age of 60 years, but without cardiovascular risk factors (65.12 ± 3.5 years) wereselected as controls. Selected patients underwent lipid profile assessment apart from detailed neuropsychological, neurological,and radiological examination. The frequency of dyslipidemia among cases and control was compared. Results: Totalserum cholesterol, very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL) in patients with dementia were234.56 ± 22.5 mg/dL, 136.58 ± 11.3 mg/dL, 35.5 ± 3.5 mg/dL, respectively, while high-density lipoprotein (HDL) was 28.7 ± 7.8mg/dL. Corresponding values in the healthy controls were: Total cholesterol (TC) = 156.36 ± 12.5 mg/dL, LDL = 86.15 ± 12.3mg/dL, VLDL = 25.5 ± 3.5 mg/dL, HDL = 37.7 ± 1.8 mg/dL. Comparison of means using paired t-test showed all biochemicalvalues (TC, LDL, VLDL, HDL) differed from controls (p < 0.0001). Out of 536 cases with dementia, 157 (29%) had deranged lipidprofile. Patients of Alzheimer's disease (AD) with comorbid diabetes and hypertension were more likely to have dyslipidemiacompared to AD patients without these two comorbidities (p < 0.05). Conclusion: The current study indicates that patientswith dementia have a high frequency of dyslipidemia, and the frequency is higher compared to healthy controls (p ≤ 0.05)

Frecuencia y factores asociados a la dislipidemia en pacientes atendidos en un centro médico de Chiclayo, julio a diciembre del 2020

Objective. To determine the frequency and factors associated with dyslipidemia in patients treatedin a Medical Center of Chiclayo, July to December 2020. Material and methods. An analytical crosssectionalstudy was conducted on secondary data (retrospective) in a population of 1,120 patientsadmitted to the “Inkamay” Medical Center in the city of Chiclayo, during March to June 2020. Thestudy was census. The data were collected by documenting the clinical records and record books ofthe clinical laboratory. Results. The population was characterized by a median age of 53 years (IQR= 41-64), weight of 65 kg (IQR = 58-74), BMI of 26.2 Kg/M2 (IQR = 24.0-29.4) and predominance of thefemale sex (68.5%). 59.9% had dyslipidemia with high levels of cholesterol or triglyceridemia; likewise,32.6% and 42.0% had high levels of HDLc and LDLc, respectively. The bivariate analysis showed anassociation of age older than 30 years (p<0.001), overweight and obesity (p <0.001), and glycemiagreater than 126 mg/dL (p=0.007) with the higher frequency of dyslipidemia. The association of sexwith dyslipidemia was not demonstrated. Conclusions. More than half of the patients in the studypopulation had dyslipidemia with abnormally high cholesterol or triglyceridemia levels, which wererelated to older age, higher BMI, and hyperglycemia.

Late-Onset Psoriatic Arthritis: Are There Any Distinct Characteristics? A Retrospective Cohort Data Analysis.

As life expectancy increases, psoriatic arthritis (PsA) in older individuals becomes more prevalent. We explored whether late-onset versus earlier-onset PsA patients display different clinical features at diagnosis and/or during the disease course, as well as different treatment approaches and comorbidity profiles. We retrospectively collected data from consecutive PsA patients attending two rheumatology centers (December 2017-December 2022). Late-onset PsA patients (diagnosis-age: ≥60 years) were compared to those diagnosed before 60 years old. Univariate analyses and logistic regression were performed to examine for factors associated with late-onset PsA. For sensitivity analyses, the cohort's mean diagnosis age was used as the cut-off value. Overall, 281 PsA patients were included (mean ± SD diagnosis-age: 46.0 ± 13.3 years). Of them, 14.2% (N = 40) had late-onset PsA. At diagnosis, after controlling for confounders, no demographic and clinical differences were identified. During the disease course, the late-onset group exhibited 65% fewer odds of manifesting enthesitis (adjusted Odds-ratio-adOR 0.35; 95% confidence interval 0.13-0.97), but higher frequency of dyslipidemia (adOR 3.01; 1.30-6.95) and of major adverse cardiovascular events (adOR 4.30; 1.42-12.98) compared to earlier-onset PsA group. No differences were found in the treatment approaches. In sensitivity analyses, PsA patients diagnosed after 46 (vs. ≤46) years old had an increased frequency of hypertension (adOR 3.18; 1.70-5.94) and dyslipidemia (adOR 2.17; 1.25-3.74). The present study underpins that late-onset PsA is not uncommon, while the age at PsA onset may affect the longitudinal clinical expression of the disease. Patients with late-onset PsA were less likely to manifest enthesitis but displayed increased cardiovascular risk.

Body mass index is superior to other body adiposity indexes in predicting incident hypertension in a highly admixed sample after 10-year follow-up: The Baependi Heart Study.

Hypertension is the leading cause of overall mortality in low‐ and middle‐income countries. In Brazil, there is paucity of data on the determinants of incident hypertension and related risk factors. We aimed to determine the incidence of hypertension in a sample from the Brazilian population and investigate possible relationships with body adiposity indexes. We assessed risk factors associated with cardiovascular disease, including adiposity body indexes and biochemical analysis, in a sample from the Baependi Heart Study before and after a 10‐year follow‐up. Hypertension was defined by the presence of systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or the use of antihypertensive drugs. From an initial sample of 1693 participants, 498 (56% women; mean age 38 ± 13 years) were eligible to be included. The overall hypertension incidence was 24.3% (22.3% in men and 25.6% in women). Persons who developed hypertension had higher prevalence of obesity, higher levels for blood pressure, higher frequency of dyslipidemia, and higher body adiposity indexes at baseline. The best prediction model for incident hypertension includes age, sex, HDL‐c, SBP, and Body Mass Index (BMI) [AUC = 0.823, OR = 1.58 (95% CI 1.23‐2.04)]. BMI was superior in its predictive capacity when compared to Body Adiposity Index (BAI), Body Roundness Index (BRI), and Visceral Adiposity Index (VAI). Incident hypertension in a sample from the Brazilian population was 24.3% after 10‐year follow‐up and BMI, albeit the simpler index to be calculated, is the best anthropometric index to predict incident hypertension.

The Association between Treatment Modality, Lipid Profile, Metabolic Control in Children with Type 1 Diabetes and Celiac Disease-Data from the International Sweet Registry.

Background and Aims: A higher frequency of dyslipidemia is reported in children with type 1 diabetes (T1D) and celiac disease (CD). Recently, continuous subcutaneous insulin infusion (CSII) has been associated with better lipid profiles in patients with T1D. The aim of this study was to investigate the association between treatment modality and lipid profile, metabolic control, and body mass index (BMI)-SDS in children with both T1D and CD. Methods: Cross-sectional study in children registered in the international SWEET database in November 2020. Inclusion criteria were children (2–18 years) with T1D and CD with available data on treatment modality (CSII and injections therapy, IT), triglyceride, total cholesterol, HDL, LDL, dyslipidemia, HbA1c, and BMI-SDS. Overweight/obesity was defined as > +1 BMI-SDS for age. Data were analyzed by linear and logistical regression models with adjustment for age, gender, and diabetes duration. Results: In total 1009 children with T1D and CD (female 54%, CSII 54%, age 13.9 years ±3.6, diabetes duration 7.2 years ±4.1, HbA1c 7.9% ±1.4) were included. Significant differences between children treated with CSII vs. IT were respectively found; HDL 60.0 mg/dL vs. 57.8 mg/dL, LDL 89.4 mg/dL vs. 94.2 mg/dL, HbA1c 7.7 vs. 8.1%, BMI-SDS 0.4 vs. 0.6, overweight and obesity 17% vs. 26% (all p < 0.05). Conclusions: CSII is associated with higher HDL and lower LDL, HbA1c, BMI-SDS, and percentage of overweight and obesity compared with IT in this study. Further prospective studies are required to determine whether CSII improves lipid profile, metabolic control and normalize body weight in children with both T1D and CD.

Association Between Dyslipidemia and Helicobacter Pylori Infection

Introduction: The association between Helicobacter pylori infection and elevated plasma levels of LDL cholesterol and decreased HDL cholesterol has been reported. Objective: To determine the frequency of altered plasma levels of LDL cholesterol, HDL cholesterol and triglycerides in pediatric patients with Helicobacter pylori infection. Materials and Methods: Prospective, observational and analytical study. Pediatric patients with Helicobacter pylori infection, July 2019 - June 2020 period. Exclusion criteria: Obesity, diabetes mellitus, hypothyroidism, hepatopathy, nephropathy, collagen disease, corticotherapy, use of proton pump inhibitors and H2 antihistamines. Antibodies against Helicobacter pylori and plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were studied. Two groups of patients: Those with Helicobacter pylori infection and the other of uninfected children. Results: Patients attended: 39; studied: 22; excluded: 17. Group of non-infected: 25.Triglyceride levels (mg/dL) were 117 + -21 in patients with Helicobacter pylori and 98 + -19 in those not infected (p = 0.01); HDL cholesterol levels (mg/dL), 39 + -14 in those infected and 47 + -13 in patients without Helicobacter pylori infection (p = 0.03). Conclusions:Patients with Helicobacter pylori infection had a higher frequency of dyslipidemia, compared to the group of uninfected children.

Clinical Characteristics of Resistant vs. Refractory Hypertension in a Population of Hypertensive Afrodescendants.

ResumoFundamentos Afrodescendentes têm sido associados a uma maior gravidade da hipertensão arterial e maior incidência de complicações cardiovasculares. Características na apresentação da hipertensão resistente (HR) ou hipertensão refratária (HRf), especificamente nessa etnia, não têm sido devidamente estudadas.Objetivos O estudo compara características clínicas e epidemiológicas e prevalência de eventos cardiovasculares em afrodescendentes com diagnóstico de HR ou de HRf. Métodos: Estudo transversal realizado em ambulatório de referência para pacientes com Hipertensão Grave. O nível de significância foi de 5%.Resultados Avaliados 146 pacientes consecutivos, dos quais 68,7% eram do sexo feminino. A média de idade foi de 61,8 anos, sendo 88,4% afrodescendentes (pardos ou negros). 51% apresentavam HRf. Houve alta prevalência de fatores de risco cardiovascular: 34,2% tinham diabetes, 69,4% dislipidemia, 36,1% obesidade e 38,3% história de tabagismo. Função renal reduzida foi observada em 34,2%. Eventos cardiovasculares prévios ocorreram em 21,8% para infarto do miocárdio e em 19,9% para acidente vascular cerebral. O escore de risco de Framingham foi moderado/alto em 61%. Os pacientes com HRf eram mais jovens (média de idade de 59,38±11,69 anos versus 64,10±12,23 anos, p=0,02), tinham mais dislipidemia (83,8 versus 66,7%, p=0,021) e acidente vascular cerebral (30,4 versus 12,3%, p=0,011) quando comparados aos com HR. O uso de combinação de ACEi/BRA+CCB+Diurético, clortalidona e espironolactona também foi mais frequente em indivíduos com HRf.Conclusão Afrodescendentes com HR apresentaram alto risco cardiovascular, alta prevalência de HRf, maior frequência de dislipidemia e de acidente vascular cerebral, compatível com alta incidência de lesão a órgãos-alvo. (Arq Bras Cardiol. 2020; 115(1):31-39)

ASSOCIATION OF DYSLIPIDEMIA WITH DIABETES IN PATIENTS WITH STROKE PATIENTS.

Background; Stroke is a global health problem. Stroke is responsible for major disabilities in adult population, and is 2 nd leading cause of deaths all over the world. Different studies have reported dyslipidemia as major cause of stroke in different populations. Objective; To determine the frequency of dyslipidemias in patients with ischemic stroke at Nishtar Hospital Multan. Material and methods; All the cases of stroke (n=240) Patients having finding on CT scan brain (plain) consistent with ischemic stroke of either sex aged less than 80 years were enrolled in this cross-sectional study from department of Medicine, Nishtar Hospital, Multan. Complete history about onset of illness, diabetes, hypertension and cardiac illness of the patients was taken. Baseline laboratory investigations including lipid profile and Hb A 1 c were done. Results; Of these 240 study cases, 155 (64.6 %) were male patients and 85 (35.4%) were female patients. Mean age of our study cases was 68.37 ± 14.55 years (with minimum age was 34 years while maximum age was 79 years). Out of these 240 study cases, 138 (57.5 %) were from poor families, 53(22.1 %) were diabetic and only 11 out of 53 (20.75%) had controlled glycemic levels. Hypertension was present in 182 (75.8%) of our study cases and 39 (16.3 %) were obese. Smoking was present in 101 (42.1%), previous history of stroke was present in 35 (14.6%) and 83 (34.6%) were Saraikis. Mean duration of illness was 2.24 ± 0.53 months and 135 (56.3%) had disease duration more than 1 month. Mean serum cholesterol level was 202.06 ± 45.36 mg/dl, mean serum LDL level was 91.13 ± 10.24 mg/dl, mean serum triglyceride level was 147.51 ± 20.21 mg/dl and mean serum HDL level was 42.92 ± 3.85 mg/dl and dyslipidemia was present in 85 (35.4 %). Diabetes was significantly associated with dyslipidemia (p = 0.002). Conclusion; Very high frequency of dyslipidemia was noted in diabetic patients having ischemic stroke. Dyslipidemia was significantly associated with diabetes, hypertension, obesity, smoking, previous history of stroke and ethnicity. Early diagnosis followed by timely management can help reduce disease morbidity and improve clinical outcomes in these patients. Keywords; ischemic stroke, dyslipidemia, frequency. DOI : 10.7176/JMPB/62-14 Publication date: December 31 st 2019

Predictive values of dyslipidemia and B-type natriuretic peptide levels in juvenile systemic lupus erythematosus: A two center-experience.

B-type natriuretic peptide (BNP) is a biomarker that helps in determining the diagnosis and prognosis of heart failure (HF). There is an increased risk for cardiovascular disease (CVD) in systemic lupus erythematosus (SLE) with high disease activity, demonstrated by the higher frequency of dyslipidemia and higher BNP concentrations than in healthy controls. The aim of the work was to evaluate the association between the levels of lipids and BNP in pediatric patients with SLE with HF. We classified our subjects into three groups as follows: Group 1 (active SLE group): included 38 patients who subgrouped into 16 with HF and 22 without HF; Group 2 (inactive SLE group): included 38 patients, and Group 3 (control group): included 38 apparently healthy children. All children were subjected to complete history taking, clinical examination, SLE disease activity index scoring and investigations included complete blood count, erythrocyte sedimentation rate, 24-h urinary protein, anti-double strand deoxy-ribonucleic acid and anti-nuclear antibody, lipid profile, serum albumin, protein, and BNP. There was a significantly elevated lipid level and decreased high-density lipoproteins in lupus patients than in healthy controls. The dyslipidemia was more prevalent in active SLE. There were significantly elevated BNP levels in lupus patients than in healthy controls. In this study, we found that BNP was a biomarker in determining the diagnosis and prognosis of HF. This study revealed that BNP levels were increased in SLE patients without cardiac symptoms as compared to healthy controls; furthermore, the BNP levels were higher in active SLE patients with HF. The data indicated that there is a high risk for CVD in SLE with high disease activity, as demonstrated by the higher frequency of dyslipidemia and higher BNP concentrations than in healthy controls.

DERANGED SERUM LIPID LEVELS IN WOMEN WITH PREECLAMPSIA.

Background; Preeclampsia (PE), as a risky pregnancy, is a systemic disease characterized by hypertension, proteinuria and edema, which are thought to be the result of diffuse endothelial activation and dysfunction. About 5% of all pregnant women have PE during the second half of gestation that can cause maternal death throughout the world and is accompanied by substantial perinatal morbidity and mortality. Objective; To determine the frequency of dyslipidemia in women with preeclampsia at a tertiary care hospital. Material and Methods; A total of 135 women with preeclampsia (Both primigravida and multigravida) aged 20 – 40 years were included in our study. Patients with twin pregnancy, taking lipid lowering therapy were excluded from our study. Detailed history and physical examination was conducted. Five ml venous blood sample was drawn and sent to central pathology laboratory of Nishtar Hospital, Multan for serum lipid profile estimation. Data was analyzed by using SPSS Version 20. Results; Mean gestational age of our study cases was 33.24 ± 2.77 weeks. Mean age of our study cases was 29.61 ± 3.54 years. Family history was positive in 41 (30.4%) of our study cases. Diabetes was present in 25 (18.5 %) of our study cases. Mean parity was 2.59 ± 1.72 and 77 (57.0%) had parity up to 3. Mean body mass index of our study cases was 25.85 ± 2.54 kg/m 2 and obesity was present in 31 (23.0 %) of our study cases. Of these 135 study cases, 104 (77.0 %) were illiterate while 31 (23.0%) were literate. Of these 135 study cases, dyslipidemia was present in 73 (54.1%). Mean Serum Cholesterol level was 223.45 ± 47.21 mg/dl and it was deranged in 71 (52.59 %), mean serum LDL level was 147.15 ± 31.25 mg/dl and it was deranged in 72 (53.33%), mean serum triglyceride level was 154.21 ± 15.29 mg/dl and it was deranged in 70 (51.85%) of our study cases and mean HDL level was 52.42±8.53 mg/dl while it was deranged in 14 (10.37%). Conclusion; Very high frequency of dyslipidemia was noted in our study in pre-eclamptic women. Dyslipidemia was significantly associated with gestational age, parity and diabetes. All the preeclamptic women should be screened for serum lipid levels and be managed accordingly to avoid future fetomaternal adverse outcomes. Keywords; Preeclampsia, dyslipidemia, Frequency. DOI : 10.7176/JMPB/52-08

ILLITERACY AND DYSLIPIDEMIA: RISK FACTORS FOR ALZHEIMER’S DISEASE, BUT MARKERS OF BETTER CLINICAL EVOLUTION?

Illiteracy is a risk factor for the occurrence of dementia and is associated with a lower cognitive reserve, but patients with a higher educational level tend to have a faster cognitive decline. One hundred and fort three patients with Alzheimer Disease an outpatient clinic of cognitive disorders in the northeastern region of Brazil were followed retrospectively. All patients were a follow-up at least 1 year. Patients who presented stability or increase in the MMSE score between the first and last visit were considered good responders. Student T test, Mann-Whitney test and Chi-square were used to compare good response and the group without good. A logistic regression analysis was performed to identify independent factors of good response. The mean age of onset of symptoms was 73.4(±7.2) years, with a predominance of females of 99 (69.2%). The illiteracy rate was 25.9% (37) and 63% (90) had less than 4 years of study. The mean initial MMSE was 15.3(±5.6) points. The mean follow-up of the patients was 29.96 (±16.2) months and the mean last MMSE was 12.79 (±6.5) points. During this follow-up period, 39 patients (27.3%) had a good response to treatment. There was no difference between good and no responders according to age and follow-up time, but there was a tendency to lower initial MMSE 14.4(±4.8) x 16.4(±5.8) (p = 0.07) and lower initial score in Pfeffer scale 16.5(±8.2) x 20, 68(±8) (p = 0.05). There was a higher frequency of dyslipidemia 62.16 x 36.14 (p = 0.01) and illiteracy 51.42% x 21.11 (p = 0.02) in good responders. The presence of neuropsychiatric symptoms in follow up was more frequent in non responders (69.9% x 50%) p = 0.046. In the logistic regression, only illiteracy (OR 5.23 CI 1.87–14.77) and dyslipidemia (OR 4.53 CI 1.75–11.73) had an association with good prognosis. Illiteracy and dyslipidemia were associated with good evolution in a group of patients with AD and low educational level.

HYPOTHYROIDISM;

Cardiovascular diseases (CVDs) are the number one cause of death globally:more people die annually from CVDs than from any other cause. An estimated 17.5 millionpeople died from CVDs in 2012, representing 31% of all global deaths. Although CVDs areuncommon entity in young patients, it constitutes significant health problem due to itsdyslipidemia cases and devastating effects on active life style of young patients, it is thereforeimportant to identify diseases in young that are associated with or a cause of dyslipidemia1.Hypothyroidism is an important cause of dyslipidemia in young that can significantly increasethe risk of CVDs2. Objectives: This study is designed “to determine frequency of dyslipidemiain young hypothyroid patients”. Place and duration of Study: Study conducted at MedicalOPD JPMC, Karachi (outpatient) in six months duration from 25th May 2009 to 24th November2009. Patients and Methods: Study is performed on 100 newly diagnosed cases of primaryhypothyroidism between ages 25 to 55 years, non-smokers, having no previous history ofIschemic Heart Disease (IHD) or family history of premature CVD, diabetes mellitus (DM), hepaticor renal disease, not on drugs which could alter serum lipids. Selected case undergone 14hours fasting lipid profile check. Results: Out of 100 hypothyroid cases, 91% had dyslipidemiawhich was directly proportional to severity of hypothyroidism. Out of 100 hypothyroid cases,95 (95%) were of young age group i-e from 25-49 years, and all of them were dyslipidemic,while 05 (5%) hypothyroid patients were of age group more than 50 years and none of themhad dyslipidemia. (0.00%) and this distribution of dyslipidemic in young hypothyroid patientsis statistically significant (p value 0.031) Conclusion: Hypothyroidism is associated with highfrequency of dyslipidemia in young patients which significantly predisposes them to risks ofCVDs.

High frequency of dyslipidemia in children and adolescents with Down Syndrome

To describe the frequency of dyslipidemia in a population of Chilean children and adolescents with DS. Retrospective study, including patients with DS, aged 2 to 18 years, who participated in a special health care program for people with DS in Health Net UC CHRISTUS, between 2007 and 2015. Patients who had a lipid profile between their routine laboratory tests were included. Clinical characteristics, relevant comorbidities, malformations, medications, nutritional status and pubertal development were obtained from medical records. Diagnosis of dyslipidemia was considered according to the criteria of the NHLBI 2011. The medical records of 218 children with DS were revised, 58,3% had some type of dyslipidemia. The most frequent single dyslipidemias were low HDL Chol (15,1%) and hypertriglyceridemia (12,8%). Atherogenic dyslipidemia (low HDL plus hypertriglyceridemia) was the most frequent combined dyslipidemia (13,3%). The occurrence of atherogenic dyslipidemia was not associated with overnutrition and obesity. A high frequency of dyslipidemia was found in Chilean children and adolescents with DS. Our results make us suggest that lipid profile should be performed early in all patients with DS, independent of the presence of risk factors for dyslipidemia.

Association Between Prior Aspirin Use and Morphological Features of Culprit Lesions at First Presentation of Acute Coronary Syndrome Assessed by Optical Coherence Tomography.

The effect of prior use of aspirin (ASA) on the onset of acute coronary syndrome (ACS) has not been clarified. This study used optical coherence tomography (OCT) to investigate the morphological features of culprit lesions of ACS in patients with prior ASA use.Methods and Results:In total, 442 patients with their first ACS episode undergoing OCT for the culprit lesions were investigated. Clinical characteristics, OCT findings, and adverse events at 30 days were compared between patients with prior ASA use and ASA-naïve patients (non-ASA). 67 patients (15.2%) had received ASA at presentation. The ASA group was older, had higher frequency of dyslipidemia and hypertension, and lower renal function than the non-ASA group. Non-ST-elevation ACS was more prevalent in the ASA than in the non-ASA group (79.1 vs. 53.6%, P<0.001). Propensity score matching yielded 49 patients in both groups. OCT revealed less frequent thrombi in the ASA than in the non-ASA group in both the entire (37.3 vs. 75.2%, P<0.001) and score-matched cohorts (38.8 vs. 75.5%, P<0.001), whereas no significant difference was observed in plaque characteristics. Rate of adverse events did not differ between the ASA and the non-ASA groups in the matched cohort. With a first ACS presentation, patients with prior ASA use were more likely to present with non-ST-elevation ACS with less frequent intraluminal thrombi, but no significant difference in underlying plaque characteristics or clinical course.

Ассоциация полиморфизмов I/D и T-786С генов ACE и NOS3 с особенностями течения ишемической болезни сердца на фоне сахарного диабета 2-го типа

to study relationship of ACE insertion-deletion (I/D) polymorphism and NOS3 T-786C polymorphism with characteristics of the course of ischemic heart disease (IHD) at the background of diabetes mellitus. Were examined 114 patients with IHD, 29.8% of patients had type 2 diabetes mellitus. ACE and NOS3 polymorphisms were determined by allele-specific polymerase chain reaction with primers by "Lytech". Patients with combined pathology belonged to older age group, had increased frequency of obesity and predominance of functional class II chronic heart failure. In this group we detected association of D allele of the ACE gene with higher frequency of dyslipidemia and obesity. Among patients with IHD without diabetes we observed associations of ACE I/D and NOS3 T-786C polymorphisms (close and moderate, respectively) with severity of effort angina. We also found that frequency of dyslipidemia among carriers of II and TT genotypes was lower than among carriers of other genotypes. Presence of type 2 diabetes as background pathology leads to a change of character of association of ACE I/D and NOS3 T-786C polymorphisms with clinical characteristics of patients with IHD.

Dyslipidemia in patients with systemic lupus erythematosus: Association with disease activity and B-type natriuretic peptide levels.

The aim of the present study was to evaluate the association between the levels of lipids and B-type natriuretic peptide (BNP) in systemic lupus erythematosus (SLE) patients with heart failure (HF). A total of 46 patients with active SLE and 40 healthy, age-matched control subjects were studied. BNP was measured by an immunofluorescence assay in fresh plasma. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, apolipoprotein (Apo) B, ApoA-I and lipoprotein(a) were assessed. Compared with the control subjects, HDL-C and ApoA-I levels were considerably decreased and TG level increased markedly from SLE patients. The average concentration of HDL-C and ApoA-I in the SLE group with HF was significantly reduced compared to those patients without HF. The results showed that the levels of HDL-C and ApoA-I in SLE patients were negatively correlated with BNP. Disease activity was associated with the TC and TG levels. The present data indicated the presence of a cardiovascular (CV) risk in active SLE with high disease activity, which was demonstrated by the high frequency of dyslipidemia and higher BNP concentrations. Therefore, dyslipoproteinemia may underlie some of the increased risk for CV disease and HF in patients with SLE.

BIOCHEMICAL SPECTRUM OF BLOOD SERUM AS INDICATOR OF YAKUTIA RESIDENTS ADAPTEDNESS TO NORTHERN CONDITIONS

The analysis of lipid metabolism in the population of Yakutia has revealed high percentage of disturbed lipid metabolism both among the indigenous and alien population of Yakutia. The high frequency of dyslipidemia and hypercholesterolemia at the young age in the alien residents of Yakutia is one of the indicators of lower body adaptive reactions. For detection of maladaptation and timely preventive actions, it is necessary to identify informative biochemical methods that characterize body functional states. The sample of 1 422 residents of Yakutia aged 18 to 72 y. o. has been examined. The number of indigenous residents of Yakutia was 758 persons (the mean age 45.02 ± 3.54 years), the alien population - 664 (the mean age 43.67 ± 2.61 years); the women - 878, the men - 544. Dyslipidemia was associated with activity of the enzymes characterizing the body energy needs depending on the degree of adaptedness to climatic and geographical conditions of Yakutia. There have been obtained significant differences of the enzymes activity indicative of different intensity of adaptive metabolic processes in high latitudes depending on ethnicity. During prophylactic medical examinations of the population for identification of disease onset risk groups and development of preventive measures to restore the body reserves, attention should be paid to the serum enzymes activity. De Ritis ratio can serve as one of the criteria of assessment of the body adaptive reactions to uncongenial climatic-geographic factors.

Familial hypercholesterolemia: Molecular characterization of possible cases from the Azores Islands (Portugal)

Familial hypercholesterolemia (FH) is an autosomal dominant disorder of the cholesterol metabolism, which constitutes a risk factor for coronary arterial disease (CAD). In the Azores Islands (Portugal), where mortality from CAD doubles its rate comparatively to the rest of the country and where a high frequency of dyslipidemia has been reported, the prevalence and distribution of FH remain unknown. The molecular characterization of a group of 33 possible cases of FH of Azorean background was undertaken in this study. A DNA array was initially used to search mutations in the LDLR, APOB and PCSK9 loci in 10 unrelated possible cases of FH. No mutations were detected in the array; after sequencing the full LDLR gene, 18 variants were identified, corresponding to two missense (c.806G>A; c.1171G>A) and sixteen synonymous alterations. Six of the synonymous variants which are consistently described in the literature as associated with altered cholesterol levels were used to build haplotypes. The most frequent haplotype corresponded to TTCGCC (45%), a “risk” haplotype, formed exclusively by alleles that were reported to increase cholesterol levels. Some of the variants detected in the full sequencing of the LDLR gene fell within the ligand-binding domain of this gene, defined by exons 2 to 6. To add information as to the role of such variants, these exons were sequenced in the remaining 23 possible FH cases. Two missense alterations (c.185C>T; c.806G>A) were found in this subset of possible FH cases. The missense alteration c.185C>T, identified in one individual, is novel for the Portuguese population. In silico analysis was not conclusive for this alteration, whose role will have to be further investigated. This study represents the first approach to the establishment of the mutational profile of FH in the Azores Islands.

DIFFERENCE IN LIPID LEVELS;

Objectives: To determine the frequency of dyslipidemias in patients with stroke and to compare the lipid levels in ischemic andhemorrhagic stroke patients. Study design: An observational study. Setting: Medical wards of Civil Hospital Karachi. Period: January 2010 toJune 2011. Methodology: A total of three hundred and fifty- five patients above the age of 18 years with clinical evidence of stroke. CT scanbrain and fasting lipid levels were done in all patients. The lipid levels were compared between the ischemic and hemorrhagic stroke patients.Data was analyzed with SPSS version 16.0. Results: Out of the 355 patients 161 (45.4%) had dyslipidemia. Among the dyslipidemic patients,there was not a statistically significant difference in serum cholesterol, triglycerides, and LDL and HDL levels between ischemic andhemorrhagic stroke. (p- value &gt; 0.05). Conclusions: There is a high frequency of dyslipidemia in stroke patients. While comparing ischemicand hemorrhagic strokes there was not a significant difference between the various lipid fractions.

Clinicoradiological Profile and Serum Lipid Levels of Intracerebral Hemorrhage in Prior Statin Users

We aimed to evaluate whether serum lipid levels can influence the clinicoradiological recovery of intracerebral hemorrhage (ICH) in prior statin users. Medical records were reviewed retrospectively in 381 ICH patients (253 men and 128 women). Cardiovascular disease (CVD) risk factors, blood pressure at admission and the first in-hospital day, admission and 30-day scores of National Institute Health Stroke Scale (NIHSS) and modified Rankin scale (mRS), hematoma volume (HV), serum lipid levels were compared between prior statin users and non-users. Statins were pretreated in 56 patients (31 men and 25 women). Statin users were older age, and had higher frequencies of dyslipidemia, diabetes mellitus, atrial fibrillation, prior stroke history and large HV compared to non-users. Serum levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were significantly decreased in the statin group compared to the non-statin group. There were no statistical differences in the other CVD risk factors, functional scores and other serum lipid levels between the two groups. HV was correlated inversely with serum levels of TC and LDL-C in both groups. Multiple logistic regression analysis showed that serum TC levels ≤150 mg/dL were associated with statin use [Odds ratio (OR)=5.5, 95% confidence interval (CI)=1.55-19.58], worsening of NIHSS score (OR=1.4, 95% CI=1.21-1.63) and HV (OR=1.1, 95% CI=1.07-1.13) in ICH patients. A significant association was found between worsening of NIHSS score (OR=2.0, 95% CI=1.32-3.12) and worsening of mRS score (OR=3.3, 95% CI=1.33-8.00), HV (OR=1.3, 95% CI=1.01-1.76), and serum TC levels ≤150 mg/dL in statin users. Prior statin users with serum TC levels ≤150 mg/dL had worsening of outcome and HV. Excessive lowering of serum TC levels due to statin pretreatment may cause unfavorable clinicoradiological recovery of ICH. Physicians should monitor serum lipid levels carefully in statin users.