Higher High-density Lipoprotein Research Articles

Genetic European Ancestry and Incident Diabetes in Black Individuals: Insights From the SPRINT Trial.

Black individuals have high incident diabetes risk, despite having paradoxically lower triglyceride and higher HDL (high-density lipoprotein) cholesterol levels. The basis of this is poorly understood. We evaluated the participants of SPRINT (Systolic Blood Pressure Intervention Trial) to assess the association of estimated European genetic ancestry with the risk of incident diabetes in self-identified Black individuals. Self-identified non-Hispanic Black SPRINT participants free of diabetes at baseline were included. Black participants were stratified into tertiles (T1-T3) of European ancestry proportions estimated using 106 biallelic ancestry informative genetic markers. The multivariable-adjusted association of European ancestry proportion with indices of baseline metabolic syndrome (ie, fasting plasma glucose, triglycerides, HDL cholesterol, body mass index, and blood pressure) was assessed. Multivariable-adjusted Cox regression determined the risk of incident diabetes (fasting plasma glucose ≥126 mg/dL or self-reported diabetes treatment) across tertiles of European ancestry proportion. Among 2466 Black SPRINT participants, a higher European ancestry proportion was independently associated with higher baseline triglyceride and lower HDL cholesterol levels (P<0.001 for both). European ancestry proportion was not associated with baseline fasting plasma glucose, body mass index, and blood pressure (P>0.05). Compared with the first tertile, those in the second (hazard ratio, 0.64 [95% CI, 0.45-0.90]) and third tertiles (hazard ratio, 0.61 [95% CI, 0.44-0.89]) of the European ancestry proportion had a lower risk of incident diabetes. A 5% point higher European ancestry was associated with a 29% lower risk of incident diabetes (hazard ratio, 0.71 [95% CI, 0.55-0.93]). There was no evidence of a differential association between the European ancestry proportion tertiles and incident diabetes between those randomized to intensive versus standard blood pressure treatment. The higher risk of incident diabetes in Black individuals may have genetic determinants in addition to adverse social factors. Further research may help understand the interplay between biological and social determinants of cardiometabolic health in Black individuals. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062.

Evaluation of Prevalence of Dyslipidemia and its Pattern in Type II Diabetic Patients in Mirpurkhas

Aim: To probe the existence of dyslipidemia in Type II diabetic patients at Mirpurkhas and to assess different pattern of dyslipidemia in Type II diabetic patients. Study design: Cross sectional prospective study. Place and duration of study: Two GP Clinics @ Mirpurkhas, 06 Months from 1st September 2020 to 28th February 2021. Methodology: Four hundred type II diabetic patients were registered. Complete history and physical examination done for all registered patients. The age, sex, occupation, address, family history of diabetes, addiction was recorded. Results: There were 241 (60.25%) females and 159 (39.75%) males. The prevalence of dyslipidemia in diabetic males was 58.49% and for females were 58.09%. High triglycerides and low high-density lipoprotein (HDL) were most prevalent pattern of dyslipidemia found in females and high low-density lipoprotein (LDL) followed by low high-density lipoprotein (HDL) was found in males. Overall, low HDL and high TG was most prevalent pattern found. Conclusion: Dyslipidemia is very prevalent in diabetic patients, and common patterns are hypertriglyceridemia and reduced levels of high-density lipoprotein cholesterol whereas, dyslipidemia may lead to cardiovascular abnormalities in diabetic patients. Optimal control of sugars and cholesterol can play major role in prevention of such sinister complications. Keywords: Dyslipidemia, Diabetes, Cardiovascular disorders. Prevalence

Very High High-Density Lipoprotein Cholesterol Levels and Cardiovascular Mortality

Previous studies have shown reduced cardiovascular risk with increasing high-density lipoprotein cholesterol (HDL-C) levels. However, recent data in the general population have shown increased risk of adverse outcomes at very high concentrations of HDL-C. Thus, we aimed to study the gender-specific relation between very high HDL-C levels (>80, >100mg/100ml) and adverse cardiovascular outcomes and the genetic basis in the general population enrolled in the United Kingdom Biobank. A total of 415,416 participants enrolled in the United Kingdom Biobank without coronary artery disease were included in this prospective cohort study, with a median follow-up of 9years. A high HDL-C level >80mg/100ml was associated with increased risk of all-cause death (Hazard ratio [HR] 1.11, confidence interval [CI] 1.03 to 1.20, p=0.005) and cardiovascular death (HR 1.24, CI 1.05 to 1.46, p=0.01) after adjustment for age, gender, race, body mass index, hypertension, smoking, triglycerides, LDL-C, stroke history, heart attack history, diabetes, eGFR, and frequent alcohol use (defined as ≥3 times/week) using Cox proportional hazard and Fine and Gray's subdistribution hazard models, respectively. In gender-stratified analyses, such associations were only observed in men (all-cause death HR 1.79, CI 1.59 to 2.02, p <0.0001; cardiovascular death HR 1.92, CI 1.52 to 2.42, p <0.0001), but not in women (all-cause death HR 0.97, CI 0.88 to 1.06, p=0.50; cardiovascular death HR 1.04, CI 0.83 to 1.31, p=0.70). The findings persisted after adjusting for the genetic risk score comprised of known HDL-C-associated single nucleotide polymorphisms. Very high HDL-C levels are associated with an increased risk of all-cause death and cardiovascular death among men but not in women in the general population free of coronary artery disease.

Association of Serum Low-Density Lipoprotein, High-Density Lipoprotein, and Total Cholesterol With Development of Knee Osteoarthritis.

Studies suggest an association between elevated total serum cholesterol, particularly low-density lipoprotein (LDL), and osteoarthritis (OA). The present study was undertaken to evaluate the association between total cholesterol, LDL, and high-density lipoprotein (HDL) and risk of knee OA. We studied participants from the Multicenter Osteoarthritis study (MOST) cohort at risk of developing knee OA. From baseline through 7 years, repeated knee radiographs and magnetic resonance images (MRIs) were obtained, and knee symptoms were queried. From baseline fasting blood samples, lipids and lipoproteins were analyzed using standard assays. After excluding participants with baseline OA, we defined 2 sets of patients: those developing radiographic OA, and those developing symptomatic OA (knee pain and radiographic OA). Controls did not develop these outcomes. Additionally, we examined worsening of cartilage loss and synovitis on MRI and of knee pain using the Western Ontario and McMaster Universities Osteoarthritis Index scale. We carried out logistic regression adjusting for age, sex, body mass index, education, baseline pain, and depressive symptoms, testing total cholesterol and lipoproteins as continuous measures, and we performed sensitivity analyses examining whether commonly used thresholds for high cholesterol, LDL, or low HDL increased risk. We studied 337 patients with incident symptomatic OA and 283 patients with incident radiographic OA. The mean age at baseline was 62 years (55% women). Neither total cholesterol, LDL, nor HDL showed a significant association with radiographic or symptomatic OA. Additionally, we found no association of these lipid measures with cartilage loss, worsening synovitis, or worsening knee pain. Our data do not support an association between total cholesterol, LDL, or HDL with OA outcomes.

Hypertriglyceridemia promotes dysfunctions in high-density lipoprotein increasing the cardiovascular risk

Hypertriglyceridemia is associated with several metabolic diseases. The triglycerides (TG) disrupt the cholesterol reverse transport and contribute to increased levels of low-density lipoprotein (LDL). High-density lipoprotein (HDL) acts in cholesterol reverse transport as an anti-inflammatory and antioxidant. This study aims to investigate the role of hypertriglyceridemia in the functionality of HDL. Individuals were divided into 4 groups based on high or low HDL-c and triglycerides levels. Biochemical and anthropometric analysis were performed. This study demonstrated that triglycerides promote dysfunctions on HDL, increasing the cardiovascular risk. Blood pressure was higher in subjects with low HDL. Women presented higher levels of HDL-c and low percentage of fat mass. The highest levels of triglycerides were observed in older age. In addition, high levels of triglycerides were associated with higher total cholesterol and LDL-c levels, non-HDL-c, non-esterified fatty acids, and blood glucose, increasing in the ratio of non-HDL-c/HDL-c and ApoB/ApoA-I. The increase of triglycerides levels progressively impairs the antioxidant capacity of HDL, probably due to a higher occurrence of fatty acid peroxidation in individuals with hypertriglyceridemia. Patients with high HDL and low TG levels increased the Lag Time. Furthermore, a positive correlation was found between TG versus HDL particle size, variables that depend on age and anthropometric parameters.

A comparative study of novel inflammatory markers (High sensitivity C-reactive protein and Lipoprotein A) and LDL/HDL cholesterol ratio in acute coronary syndrome at tertiary care center in Central India

In India, cardiovascular disease (CVD) is one of the leading causes of death. All subjects are not accurately predicted for risk of CVD by traditional risk factors. To improve the present risk prediction model, a search of novel biomarkers is required to recognize the risk of cardiovascular events. Novel biomarkers involved in inflammation cascade and developing atherosclerosis and coronary heart disease are of utmost importance. The objectives were to study high sensitivity C-reactive protein (hs-CRP), lipoprotein A and LDL/HDL cholesterol ratio in acute coronary syndrome (ACS) and its association with ACS severity. Eighty patients (aged 18-70 years of either sex) with ACS (diagnosed based on clinical history, clinical examination, electrocardiogram changes, and creatine phosphokinase-MB) were studied at a tertiary care hospital from 2017 to 2020. High sensitivity C-reactive protein (hs-CRP), lipoprotein A, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were estimated and the association was obtained. Incidence of ACS was seen highest in 56-65 years (28.75%) with males contributing 85% patients. The most common diagnosis was ST-elevation myocardial infarction (78.75%). The hs-CRP levels and lipoprotein A were increased in 49 and 44 patients out of 80, respectively. Patients with high hs-CRP (n=43 of 48; p&lt;0.0001) and lipoprotein A (n=32 out of 48; p=0.026) at admission were prone for going into complications. High sensitivity-CRP and lipoprotein A levels obtained at admission in ACS patients can be used to identify patients who are likely to develop significant complications in the immediate in-hospital course and predict the prognosis.

Association Between High Density Lipoprotein Level With Degree Of Stenosis In Coronary Artery Disease

Coronary Artery Disease (CAD) can be prevented by early detection and control of risk factors. This study aimed to determine the relationship of High Density Lipoprotein (HDL) levels with stenosis levels based on Significant Non-Significant angiography in CAD patients. Observational research method with cross-sectional design from secondary data at RSI Sultan Agung Semarang in January 2016 - October 2018, 363 respondents met the inclusion and exclusion criteria. Data were analyzed by Spearman test and logistic regression. In low HDL, significant stenosis was found to be 80.5% and non-significant 19.5%, significant HDL was found with significant stenosis 67.0% and non-significant 33.0%, whereas in high HDL, all (100%) with significant stenosis. The results with the Spearman test obtained p = 0.022. In the multivariate analysis of sex as the predominant variable (p=0,000; PR=4.743; 95%CI=1.496-4.109). age (p = 0.013; PR = 3.48; 95% CI = 1.24- 6.13), hypertension (p = 0.044; PR = 1.79; 95% CI = 1.10-3.17). There was a significant relationship between HDL levels and significant stenosis levels based on significant non-angiography in CAD patients and after being analyzed together with the disrupting variables as sex the most influential factors.

Growth Performance, Nutrient Digestibility, Biochemical Properties, Hematological Traits, and Intestinal Histopathology of Broiler Chicks Fed Mannan Oligosaccharides

, , , , and Antibiotics as growth promoters in poultry diets are currently restricted, so other feed additives, such as prebiotics and probiotics, have been suggested as an antibiotics alternative to improve the performance and gut health of poultry. The current experiment was conducted to study the effects of adding Mannan oligosaccharides (MOS) as a potential replacement for an antibiotic on productive performance, nutrient digestibility, some blood parameters, and caecal microbiota of broiler chickens. For conducting the current research experiment, a total of 180 one–day old Ross broiler chicks were randomly divided into one control group fed a basal diet and four dietary treatments with six replicates for each treatment. The treatment groups were fed a basal diet supplemented with different levels of MOS 0.5, 1, and 2 g/Kg diet and Lincomycin 4.4 mg/Kg diet during 35 days of the feeding trial. With exception of the growing period, the group fed a basal diet supplemented with 2 g MOS/Kg feed had considerably higher body weight and weight gain, while having the lowest feed consumption and best feed conversion ratio compared to the other treatment groups, during all experimental periods. Moreover, dietary supplementation of MOS resulted in a significant decrease in the counts of caecal E. coli and Enterococcus, while Lactobacillus and Yeast bacteria counts were significantly higher, compared to non-supplemented groups. Broiler chicks having a 2 g MOS/kg diet recorded lower values of cholesterol, low-density lipoprotein (LDL), urea, and liver enzymes, including Aspartate transaminase (AST) and Alanine aminotransferase (ALT), while they recorded significantly higher high-density lipoprotein (HDL), compared to the other experimental groups. Group treated with MOS 2 g/Kg feed improved digestibility of crude protein, ether extract, crude fiber, nitrogen-free extract, and organic matter, compared to the control group, Additionally, MOS supplementation also increased the intestinal villi length, width, and crypt depth and decreased intestinal inflammation, compared to the control group. In conclusion, supplementation of MOS at 2 g/kg diet improved growth performance, digestibility, and blood parameters without having adverse effects on the intestine of broiler chickens, comparable to the Lincomycin.

Prevalence and Influencing Factors of Metabolic Syndrome among Adults in China from 2015 to 2017.

The prevalence and influencing factors of metabolic syndrome (MetS) in Chinese residents aged 20 or older were investigated. The data were collected from China Nutrition and Health Surveillance (2015–2017), which used a stratified, multistage, random sampling method. A total of 130,018 residents aged 20 years or older from 31 provinces were included in this study. The National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria were used to define MetS. The standardised prevalence of high waist circumference, high blood pressure and low high-density lipoprotein cholesterol were 40.8%, 49.4% and 41.1%, respectively. The following factors were associated with a higher prevalence of MetS: female [odds ratio (OR) = 1.773, 95% CI = 1.709–1.840]; older age (OR = 1.037, 95% CI = 1.036–1.039); living in north China (OR = 1.087, 95% CI = 1.058–1.117); high body mass index (OR = 1.402, 95% CI = 1.395–1.408); higher income [OR (95% CI): 1.044 (1.007–1.083), 1.083 (1.044–1.124) and 1.123 (1.078–1.170) for moderate, high, and very high income, respectively]; family history of hypertension (OR = 1.237, 95% CI = 1.203–1.273); family history of diabetes (OR = 1.491, 95% CI = 1.426–1.558) and current smoking status (OR = 1.143, 95% CI = 1.098–1.191). Living in the countryside (OR = 0.960, 95% CI = 0.932–0.988), moderate alcohol consumption (OR = 0.917, 95% CI = 0.889–0.946) and being physically active (OR = 0.887, 95% CI = 0.862–0.913) were associated with a lower prevalence of MetS. The prevalence of MetS among residents aged 20 years or older in China is increasing, especially among women, people aged 45 years or older and urban residents. Preventive efforts, such as quitting smoking and engaging in physical activity, are recommended to reduce the risk of MetS.

Inverse correlation between serum irisin and cardiovascular risk factors among Chinese overweight/obese population

BackgroundIrisin is a novel myokine associated with obesity, which is a traditional cardiovascular risk factor (CVRF). The present study aimed to investigate the association between serum irisin and a single CVRF as well as the clustering of CVRFs among Chinese overweight/obese population.MethodsA total of 98 overweight and 93 obese subjects without clinical treatments were enrolled in this study. Subjects were then divided into two groups, based on the serum irisin level: a low irisin group (1.10–13.44 ng/ml) and a high irisin group (13.49–29.9 ng/ml). The clustering of CVRFs, smoking, diabetes mellitus, dyslipidemia and hypertension, was classified as 0, 1, 2 and ≥ 3 CVRFs. The demographic and baseline clinical characteristics of all participants were collected and serum irisin was measured.ResultsThe high serum irisin group had significantly higher high-density lipoprotein cholesterol but lower fasting plasma glucose than the low serum irisin group. Additionally, the high serum irisin group had a significantly lower prevalence of smoking, diabetes mellitus and dyslipidemia than the low serum irisin group. Increased serum irisin was significantly associated with a reduced risk of smoking and dyslipidemia in both the unadjusted and adjusted models. Furthermore, high serum irisin significantly reduced the risk of the prevalence of 1, 2 and ≥ 3 CVRFs.Conclusionsamong the Chinese overweight/obese populations, high serum irisin is negatively associated with smoking, dyslipidemia and the clustering of CVRFs. Thus, high serum irisin is potentially associated with a low risk of cardiovascular diseases in the Chinese overweight/obese population.

Metformin versus insulin therapy for gestational diabetes: Effects on offspring anthropometrics and metabolism at the age of 9 years: A follow-up study of two open-label, randomized controlled trials.

AimsTo compare anthropometrics, and lipid and glucose metabolism in the 9‐year‐old offspring of mothers treated with metformin or insulin for gestational diabetes mellitus (GDM).Materials and MethodsThis was a Finnish two‐centre, 9‐year follow‐up study of two open‐label, randomized controlled trials comparing the effects observed in the offspring of mothers who received metformin and insulin treatment for GDM. Measurements included anthropometrics, blood pressure, lipoproteins, and oral glucose tolerance tests. This study was registered with ClinicalTrials.gov, number NCT02417090.ResultsAt the age of 9 years 172 children (55% of the original study cohort, 82 from the metformin and 90 from the insulin group) participated in the study. No differences were found between the 9‐year‐old offspring groups in anthropometric variables, including body mass index and waist‐to‐height ratio. The offspring in the metformin group had higher high‐density lipoprotein (HDL) cholesterol concentrations (1.72 vs. 1.54 mmol/L; P = 0.039) but lower low‐density lipoprotein cholesterol (2.39 vs. 2.58 mmol/L; P = 0.046) and apolipoprotein B concentrations (0.63 vs. 0.67 g/L; P = 0.043) than the offspring in the insulin group. The difference in HDL cholesterol concentration was found to be significant only in boys (P = 0.003). The 2‐hour glucose value in the oral glucose tolerance test was 0.6‐mmol/L lower in boys from the metformin group than in those from the insulin group (P = 0.015).ConclusionsMetformin treatment for GDM is associated with similar offspring growth and glucose metabolism but a more favourable lipid profile at the age of 9 years as compared to insulin treatment.

Negative Association between Acrylamide Exposure and Metabolic Syndrome Markers in Adult Population.

Metabolic syndrome encompasses multiple conditions that increase the risk of cardiovascular disease, and exposure to environmental chemicals can cause metabolic syndrome. This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (2003–2006) on 4318 adult participants to assess the association between acrylamide (AA) exposure and metabolic syndrome. Concentrations of hemoglobin-adducted AA (HbAA) and hemoglobin-adducted glycidamide (HbGA) were evaluated. Metabolic syndrome markers related to HbAA and HbGA and the effect of exposure to AA and GA on the prevalence of metabolic syndrome were studied by ANOVA and multivariate logistic regression analyses, respectively. HbAA concentration inversely correlated with the number of metabolic syndrome markers (p < 0.05). An increased HbAA concentration was noted with reduced high triglyceride and low high-density lipoprotein cholesterol levels in the adjusted model (p < 0.05). High fasting plasma glucose level significantly correlated with HbGA concentration in the adjusted model. In conclusion, AA exposure alters metabolic syndrome markers in adults. Additional clinical and animal studies will clarify the role of AA exposure at different stages in the progression of metabolic syndrome-related diseases.

Endocrine disorders in patients with Fabry disease: insights from a reference centre prospective study

ContextFabry Disease (FD) is a rare X-linked storage disease characterised by a-galactosidase A deficiency and diffuse organ accumulation of glycosphingolipids. Enzyme replacement and chaperone therapies are only partially effective. It remains unclear if FD-related endocrine disorders contribute to the observed morbidity.ObjectiveTo investigate the function of the endocrine system in patients with FD.DesignWe conducted an observational prospective study from 2017 to 2020.Setting and patientsWe included 77 patients with genetically confirmed FD (27 men, 20/27 Classic, 7/26 Late Onset phenotype, 50 women, 41/50 and 9/50 respectively), who are systematically followed by our reference centre.Results36/77 (46.8%) patients had VitD deficiency (25(0H)VitD <20 μg/L) despite the fact that 19/36 (52.8%) were substituted with cholecalciferol. Only 21/77 (27.3%) patients had normal VitD levels without VitD substitution. 11/77 (14.3%) had significant hypophosphatemia (p < 0.80 mmol/L). Three new cases (3.9%) of subclinical, two (2.6%) of overt and six (7.8%) of known hypothyroidism were identified. Of note, men had significantly higher renin levels than women [61.4 (26.1–219.6) vs.25.4 (10.9–48.0) mU/L, p = 0.003]. There were no major abnormalities in adrenal, growth and sex-hormone axes. Patients of Classic phenotype had significantly higher High-Density Lipoprotein Cholesterol (HDL-C) levels (p = 0.002) and in men those levels were positively correlated with globotriaosylsphingosin (Lyso-Gb3) values. 10/77 (13%) of the patients were underweight.ConclusionsVitD supplementation should be considered for all patients with FD. Thyroid screening should be routinely performed. Malnutrition should be prevented or treated, particularly in Classic phenotype patients. Overall, our data suggest that FD specialists should actively seek and diagnose endocrine disorders in their patients.

Triglycerides and low HDL cholesterol predict coronary heart disease risk in patients with stable angina

We assessed whether high triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, expressed by an increased TG/HDL-C ratio, predict coronary atherosclerotic disease (CAD) outcomes in patients with stable angina. We studied 355 patients (60 ± 9 years, 211 males) with stable angina who underwent coronary computed tomography angiography (CTA), were managed clinically and followed for 4.5 ± 0.9 years. The primary composite outcome was all-cause mortality and non-fatal myocardial infarction. At baseline, the proportion of males, patients with metabolic syndrome, diabetes and obstructive CAD increased across TG/HDL-C ratio quartiles, together with markers of insulin resistance, hepatic and adipose tissue dysfunction and myocardial damage, with no difference in total cholesterol or LDL-C. At follow-up, the global CTA risk score (HR 1.06, 95% confidence interval (CI) 1.03–1.09, P = 0.001) and the IV quartile of the TG/HDL-C ratio (HR 2.85, 95% CI 1.30–6.26, P < 0.01) were the only independent predictors of the primary outcome. The TG/HDL-C ratio and the CTA risk score progressed over time despite increased use of lipid-lowering drugs and reduction in LDL-C. In patients with stable angina, high TG and low HDL-C levels are associated with CAD related outcomes independently of LDL-C and treatments.Trial registration. EVINCI study: ClinicalTrials.gov NCT00979199, registered September 17, 2009; SMARTool study: ClinicalTrials.gov NCT04448691, registered June 26, 2020.

Deterioration of Nutritional Status and Its Negative Association with Depression Among Older HIV-Infected Asian Population: A Four-Year Longitudinal Study.

There is limited evidence about the long-term changes in nutritional status among the elderly people living with human immunodeficiency virus (PLWH). We aimed to investigate the changes in nutritional status and related factors over 4 years in the elderly PLWH. The longitudinal study was conducted prospectively among 250 PLWH, 50 years of age and older, receiving antiretroviral therapy (ART). The Mini Nutritional Assessment (MNA) and Thai Depression Scale (TDS) to assess nutritional status and depression, respectively, were performed at the outpatient clinic both at baseline and 4-year follow-up. Majority were male (60.8%) with median age of 58 years. The median CD4 was 612.5 cells/mm3 and 98% had HIV RNA <50 copies/mL. Median duration of ART was 20 years. Median body mass index was 23.1 kg/m2. The most common ART were rilpivirine (45.2%) and dolutegravir (18.8%). Fifty-one patients (20.4%) deteriorated in nutritional status and mean MNA scores declined (25.8 vs. 24.8, p < .001) at follow-up period. In multivariate analysis, high TDS scores (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.17-1.52), polypharmacy (OR, 1.35; 95% CI, 1.10-1.65), and high-density lipoprotein cholesterol (HDL-C) levels (OR, 1.04; 95% CI, 1.01-1.07) were associated factors of deterioration in nutritional status. In this 4-year longitudinal follow-up, 20% of the aging PLWH have deterioration of nutritional status. High TDS scores (depression), polypharmacy, and high HDL-C were significantly associated with declining nutritional status. Our findings highlight the importance of screening and monitoring nutritional and depression status in routine HIV treatment and care for geriatric HIV-infected population.

Metabolic syndrome and its component traits present gender-specific association with liver cancer risk: a prospective cohort study

Background & AimsLittle is known on the gender-specific effect and potential role of non-linear associations between metabolic syndrome (MetS) components and liver cancer risk. We evaluated these associations based on the UK Biobank cohort.MethodsWe included 474,929 individuals without previous cancer based on the UK Biobank cohort. Gender-specific hazard ratios (HRs) and 95% confidence interval (CIs) were calculated by Cox proportional hazards regression, adjusting for potential confounders. Non-linear associations for individual MetS components were assessed by the restricted cubic spline method.ResultsOver a median follow-up of 6.6 years, we observed 276 cases of liver cancer (175 men, 101 women). MetS [HR 1.48, 95% CI 1.27–1.72] and central obesity [HR 1.65, 95% CI 1.18–2.31] were associated with higher risk of liver cancer in men but not in women. Participants with hyperglycaemia has higher risk of liver cancer. High waist circumference and blood glucose were dose-dependently associated with increased liver cancer risk in both genders. For high density lipoprotein (HDL) cholesterol (both genders) and blood pressure (women), U-shaped associations were observed. Low HDL cholesterol (< 1.35 mmol/L) in men and high HDL cholesterol in women (> 1.52 mmol/L) were associated with increased liver cancer risk.ConclusionsMetS components showed gender-specific linear or U- shaped associations with the risk of liver cancer. Our study might provide evidence for individualized management of MetS for preventing liver cancer.

High-density Lipoprotein Cholesterol and the Risk of Future Retinal Artery Occlusion Development: A Nationwide Cohort Study

To evaluate the association between high-density lipoprotein (HDL) cholesterol levels and the future risk of retinal artery occlusion (RAO). Population-based cohort study. This study used data provided by the Korean National Health Insurance Service. A total of 9,316,212 individuals aged > 40 years who participated in the Korean National Health Screening Program in 2013 or 2014 were included. Data on risk factors - including age, sex, income level, systemic comorbidities, behavioral factors, and baseline lipid profiles - were collected from health screening results and claims data. Patients were followed up until December 2018 and incident cases of RAO were identified using registered diagnostic codes from claims data. A prospective association between HDL cholesterol level and incident RAO was investigated using the multivariable-adjusted Cox proportional hazard model. During an average follow-up period of 4.93 years, 9878 patients were newly diagnosed with RAO. Compared with those with low HDL cholesterol levels (< 40 mg/dL), patients with high HDL cholesterol levels (≥ 60 mg/dL) had a lower risk of future RAO development, with a hazard ratio (95% CI) of 0.78 (0.73-0.83) in the age-adjusted and sex-adjusted model and 0.88 (0.83-0.95) in the full-adjusted model. The younger subgroup (< 60 years) had an HR of 0.81 in the high HDL cholesterol group compared with the low HDL cholesterol group, while the older subgroup (≥ 60 years) had an HR of 0.93 (P for interaction=.012). A low HDL cholesterol level is an independent risk factor for the development of RAO.

Dyslipidemia in Chronic Kidney Disease

Objective: To determine the frequency for pattern of dyslipidemia in patients with chronic kidney disease. Study Design: Descriptive, cross-sectional Place and Duration of Study: Department of Nephrology, Jinnah Postgraduate Medical Centre (JPMC) from 26th December 2018to 28thJune 2019. Methodology: One hundred and thirty-two patients were enrolled. Blood sample of 5 ml of each patient was taken and sent to the institutional pathology laboratory for measurement of lipid profile and pattern of dyslipidemia i.e. high cholesterol, low HDL, high LDL, hypertriglyceridemia was noted. Results: The mean age was 44.68±9.39 years and mean of duration of chronic kidney disease was 5.13±2.19 months. Seventy eight (59%) were males and 54 (41%) were females. Pattern of dyslipidemia i.e. high cholesterol, low HDL, high LDL and hypertriglyceridemia were documented in 89 (67.4%), 61 (46.2%), 65 (49.2%) and 37 (28.0%) patients respectively. Conclusion: Dyslipidemia is common among patients with chronic kidney disease is considerable. Regular evaluation of all chronic kidney disease patients for dyslipidemia and treatment need to be instituted. Key words: Dyslipidemia, Chronic kidney disease (CKD), Cholesterol, Low density lipoprotein (LDL), High density lipoprotein (HDL), Hypertriglyceridemia

The relationship between uric acid to high-density lipoprotein cholesterol ratio and collateral index in patients with chronic total occlusion.

Background High serum uric acid (UA) levels and low high-density lipoprotein cholesterol (HDL-C) levels are accepted as risk factors for cardiovascular mortality. Hyperuricemia and low HDL-C levels were associated with an increased risk of cardiovascular mortality and the development of diabetes and hypertension. However, the association of UA with cardiovascular (CV) mortality,collateral index are undetermined in patients with chronic total occlusion (CTO).Material and methods 124 patients who underwent coronary angiography with the diagnosis of stable or unstable angina pectoris and had chronic total occlusion were included in our study. Blood samples were collected from all patients before the angiography procedure. Coronary collateral circulation (CCC) was graded according to the Rentrop grading system of 0-3. Rentrop grades of 0 and 1 indicated low-grade CCC group, whereas grades 2 and 3 indicated high-grade CCC group. We divided our patients into two groups as low-grade CCC and high-grade CCC and examined these two groups in terms of uric acid / HDL ratios. Group 1: Rentrop classification grade 0-1 (mean age, 63,9±9,9), Group 2: Rentrop classification grade 2-3 (mean age, 62,1±9,4).Results The baseline characteristics were similar in both groups. Uric acid / High density lipoprotein-cholesterol ratios and uric acid levels were higher in group 1 with poor collateral circulation [group 1; 0,21 (0,07-0,39) vs. group 2; 0,16 (0,08-0,31), group 1; 8,2 (3,4-10,4) vs. group 2; 5,85 (3,5-7,7), p&lt;0,001, p&lt;0,001 respectively].Conclusions We found that high Uric acid / High-density lipoprotein-cholesterol ratios and high uric acid levels are associated with poor collateral circulation.

Atherosclerosis in Fabry Disease-A Contemporary Review.

Fabry disease (FD) is a lysosomal storage disorder characterised by a deficiency in the enzyme α-galactosidase A resulting in sphingolipid deposition which causes progressive cardiac, renal, and cerebral manifestations. The case illustrates a patient with FD who died suddenly, and medical examination demonstrated myocardial scarring and prior infarction. Angina is a frequent symptom in FD. Our own data are consistent with registry data indicating a high prevalence of risk factors for coronary artery disease (CAD) in FD that may accelerate conventional atherosclerosis. Patients with FD also have a higher high-density lipoprotein (HDL)/total cholesterol (T-Chol) ratio which may further accelerate atherosclerosis through expression of early atherosclerotic markers. Patients with FD may develop CAD both via classical atherosclerosis and through formation of thickened fibrocellular intima containing fibroblasts with storage of sphingolipids. Both mechanisms occurring together may accelerate coronary stenosis, as well as alter myocardial blood flow. Our data supports limited data that, although coronary flow may be reduced, the prevalence of epicardial coronary stenosis is low in FD. Microvascular dysfunction and arterial wall stress from sphingolipid deposition may form reactive oxygen species (ROS) and myeloperoxidase (MPO), key atherosclerotic mediators. Reduced myocardial blood flow in FD has also been demonstrated using numerous imaging modalities suggesting perfusion mismatch. This review describes the above mechanisms in detail, highlighting the importance of modifying cardiovascular risk factors in FD patients who likely develop accelerated atherosclerosis compared to the general population.