Low High-density Lipoprotein Cholesterol Levels Research Articles

High-density lipoprotein cholesterol as a prognostic marker for 90-day transplant-free mortality in hepatitis B virus-related acute-on-chronic liver failure

BackgroundHepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is linked to dyslipidemia and inflammatory responses. This study aimed to investigate the correlation between high-density lipoprotein cholesterol (HDL-C) levels and 90-day transplant-free (TF) mortality in patients with HBV-ACLF.MethodsA prospective cohort of 287 patients with HBV-ACLF from Beijing Ditan Hospital was enrolled between January 2016 and December 2019. The prognostic accuracy of lipid profile parameters was evaluated by the area under the receiver operating characteristic curve (AUC), and the association between HDL-C levels and mortality was assessed using a restricted cubic spline analysis. Correlations between lipid profile parameters and inflammatory factors were analyzed. Kaplan–Meier curves were used to assess 90-day TF mortality, and log-rank tests were used for comparison analysis. These results were internally validated between January 2020 and December 2023 (n=125).ResultsPatients with lower HDL-C levels exhibited higher mortality rates (adjusted hazard ratio for HDL-C < 0.13 mmol/L: 4.04, 95% confidence interval: 1.35–11.85) compared with those in the reference group (with HDL-C levels above 0.36 mmol/L). An “L-shaped” association was observed between HDL-C levels and TF mortality. The prognostic value of HDL-C (AUC at day 90: 0.732) was comparable to the model for end-stage liver disease score of 0.729. Additionally, HDL-C levels were inversely correlated with interleukin (IL)-4, IL-6, and tumor necrosis factor-α (all P<0.05). In the training cohort, the 90-day TF mortality rates were 8.3%, 15.2%, 24.0%, and 43.2% for the extremely low, low, medium, and high-risk subgroups, respectively, while in the validation cohort, they were 4.5%, 18.5%, 31.2%, and 44.7%, respectively.ConclusionsHDL-C levels < 0.13 mmol/L were associated with increased 90-day transplant-free mortality in patients with HBV-ACLF. An inverse correlation was found between HDL-C levels and inflammatory markers.

Screening for Subclinical Atherosclerosis in Patients with Familial Hypercholesterolemia: Insights and Implications.

Background/Objectives: Familial hypercholesterolemia (FH) is a monogenic dyslipidemia that leads to early cardiovascular events. Subclinical atherosclerosis refers to the formation of atheromatous plaques in arterial beds before any clinical events. In our study, we investigated the presence, extent, and independent predictors of subclinical atherosclerosis among patients diagnosed with FH. Methods: This was a single-center, prospective, and cross-sectional study. This original study included 215 patients diagnosed with FH from a cohort of 1145 individuals assessed according to the Dutch Lipid Clinical Network (DLCN) criteria. Carotid and femoral ultrasonography were performed, and the coronary artery calcium score was measured to screen for subclinical atherosclerosis. Apolipoprotein A-I, apolipoprotein B, and lipoprotein (a) were analyzed using the nephelometric method. Results: The study cohort comprised 136 females (63%) with a mean age of 54 (43-62) years. The stigmata rate was 18%. The rate of statin use during subclinical atherosclerosis screening was 32% and only eight patients (4%) attained LDL-C values < 70 mg/dL. Subclinical atherosclerosis was observed in 148 patients (69%), with rates of 48%, 47.5%, and 40.5% in the coronary arteries, carotid bifurcation, and femoral bifurcation, respectively. Advanced age, male sex, high pretreatment low-density lipoprotein-cholesterol (LDL-C) level, diabetes, and a low Apo A-I/Apo B ratio were identified as independent predictors of subclinical atherosclerosis. Lp(a) levels ≥ 30 mg/dL predicted coronary atherosclerosis, while diabetes and low Apo A-I/Apo B ratios predicted carotid atherosclerosis, and smoking predicted femoral atherosclerosis. Conclusions: Subclinical atherosclerosis is prevalent, and medication adherence remains suboptimal among FH patients. Screening for subclinical atherosclerosis may impact the treatment strategies, via an increase in physician commitment to treatment protocols and improving patient compliance.

Correlation of dyslipidemia characterized by abnormal cholesterol in first trimester with early pregnancy loss: a retrospective study.

Dyslipidemia has been linked to adverse pregnancy outcomes in observational studies. This study aimed to explore how variations in lipid levels during the first trimester might influence early pregnancy loss (EPL). Blood samples from pregnant women were analyzed to examine the relationship between EPL and lipid metabolism using logistic regression and restricted cubic splines (RCS). Sensitivity analysis was conducted to verify the robustness of the results. Elevated low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels at most times of 4-9weeks of gestation were associated with a higher risk of EPL, regardless of whether the control group was successful pregnancy or live birth. Specifically, taking the successful pregnancy group as a control example, increased EPL risks were observed in the highest quartile of plasma TC at 4weeks (OR = 2.18, 95%: 1.14-4.21) and 7weeks (OR = 4.30, 95%: 1.87-9.93) of pregnancy. Significant EPL risks were also noted in the third (Q3) and fourth (Q4) quartiles of LDL-C at 4weeks (Q3, OR = 2.98, 95%: 1.47-6.08; Q4, OR = 2.66, 95%: 1.27-5.55) and 7weeks (Q3, OR = 3.12, 95%: 1.44-6.73; Q4, OR = 5.17, 95%: 2.14-12.49). High TC levels (> 3.25-3.78mmol/L) and high LDL-C levels (> 1.92-2.04mmol/L) were linked to an increased risk of EPL compared to lower levels of TC (≤ 2.91-3.05mmol/L) and LDL-C (≤ 1.64-1.75mmol/L).RCS analysis further confirmed this finding that plasma TC and LDL-C levels at 4 and 7weeks of gestation may have a linear relationship with the risk of EPL. By the way, triglyceride levels at 6 and 8weeks of gestation were associated with a higher risk of EPL, whereas high-density lipoprotein cholesterol (HDL-C) levels at 5 and 9weeks of gestation have a completely opposite relationship with EPL risk. Elevated cholesterol levels during the first trimester are associated with an increased risk of early pregnancy loss, emphasizing the need for lipid monitoring during pregnancy and even before pregnancy.

Serum homocysteine and lipid levels in the third trimester and their relationship with perinatal outcomes in diet-controlled gestational diabetes mellitus.

This study investigates the relationship between serum homocysteine, blood lipids, and perinatal outcomes in patients with diet-controlled gestational diabetes mellitus (GDM) and those with normal glucose tolerance (NGT). A prospective cohort of 150 diet-controlled GDM patients and 150 pregnant women with NGT, all delivering at our hospital, were selected based on predefined criteria. Data on demographics, physical parameters, and perinatal outcomes were compiled. Blood samples for fasting plasma glucose (FPG), homocysteine (Hcy), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), and apolipoprotein A1 (apoA1) were collected before delivery. GDM patients exhibited higher levels of FPG, Hcy, and the apoB/apoA1 ratio, but lower HDL-C and apoA1 levels compared to the NGT group. Adverse outcomes such as macrosomia, premature rupture of membranes, and postpartum hemorrhage were more prevalent in the GDM group. In GDM patients, neonatal birth weight positively correlated with FPG and TG levels. Stratified Hcy analysis in GDM showed no significant differences in perinatal outcomes. However, the third quartile of the apoB/apoA1 ratio had a lower incidence of macrosomia compared to the first quartile, and the second quartile showed a higher incidence of birth asphyxia. GDM patients demonstrated increased levels of Hcy, FPG, and the apoB/apoA1 ratio, correlating with more adverse perinatal outcomes than healthy pregnant individuals. The relationships between Hcy, lipids, and these outcomes remain inconclusive, highlighting the need for further research.

Plasma Lipid Profile Among Perimenopausal Latvian Women in Relation to Dietary Habits.

Background/Objectives: Hormonal changes throughout a woman's life cycle significantly affect serum lipid levels. Alterations in the serum lipid profile can increase the risk of cardiovascular diseases (CVDs). Additionally, nutrition and dietary habits are crucial for managing dyslipidemia. The current study evaluated the association between dietary habits and plasma lipid profiles among perimenopausal women in Latvia. Methods: The randomized clinical trial involved perimenopausal women (n = 61) aged 49 ± 3 years with moderately high low-density lipoprotein cholesterol (LDL-C) levels of 3.61 ± 0.30 mmol L-1. A series of questionnaires were completed, including a questionnaire on the subject's demographic, anthropometric, lifestyle, health, physical activity, and dietary factors, a 24 h food diary, a 72 h food diary, and a food-frequency questionnaire (FFQ). Blood testing was conducted for all participants, which included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), alanine aminotransferase (ALAT), and glucose level analyses. Results: The consumption of refined sugar, honey, syrup, and jam demonstrated a strong positive association with higher levels of remnant cholesterol (β = 0.462, p ≤ 0.05) and non-high-density lipoprotein cholesterol (non-HDL-C) (β = 0.395, p ≤ 0.05). Similarly, the consumption of fruit juices is associated with increased LDL-C (β = 0.303, p ≤ 0.05) and non-HDL-C (β = 0.285, p ≤ 0.05). Conversely, higher meat and poultry consumption negatively correlates with TC levels (β = -0.290, p ≤ 0.05). Conclusions: This underscores the need for further examination to understand the impact of dietary habits on lipid profile.

Changes in blood glucose and lipid metabolism levels in children with central precocious puberty and its correlation with obesity.

This study analyzed the changes in blood glucose and lipid metabolism levels in children with central precocious puberty (CPP) and the correlation between CPP and obesity. In total, 88 children with CPP aged 6-10 years who were admitted to our hospital between January 2023 and June 2024 (the CPP group), and 88 children without CPP in the same age group who received health check-ups (the non-CPP group) were retrospectively enrolled in this study. General data [gender, age, bone age, and body mass index (BMI)] were collected. Levels of blood glucose metabolism indicators [fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), and hemoglobin A1c (HbA1c)] and blood lipid metabolism indicators [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] were compared. The incidence of obesity was calculated, and the Tanner stages of the obese group and the non-obese group were compared. The correlation between CPP degree (measured by Tanner staging) and obesity degree (measured by BMI) was analyzed using Spearman's correlation analysis. The differences in gender and age between the CPP and non-CPP groups were insignificant (P > 0.05). Bone age and BMI in the CPP group were higher than in the non-CPP group (P < 0.05). The CPP group had higher serum FPG, 2hPG, HbA1c, TG, TC, and LDL-C levels and lower serum HDL-C levels than the non-CPP group. The incidence of obesity was higher in the CPP group (21.59%, 19/88) than in the non-CPP group (6.82%, 6/88). The Tanner staging scores in the obese group for the boys (testes and pubic hair), girls (breasts and pubic hair), and as a whole (testes/breasts and pubic hair) were elevated compared to those in the non-obese group (P < 0.05). Spearman's correlation showed that the CPP degree (measured by Tanner staging) was positively correlated with the obesity degree (measured by BMI) in boys, girls, and the study sample as a whole (P < 0.001). Children with CPP had abnormal levels of blood glucose and lipid metabolism, and the CPP degree in these children was positively correlated with the degree of obesity.

Association of LDL-cholesterol with prognosis in patients admitted for acutely decompensated heart failure.

The association of low-density lipoprotein cholesterol (LDL-C) levels and prognosis in patients with heart failure (HF) remains uncertain. This study aimed to evaluate the prognostic significance of LDL-C in patients admitted for acutely decompensated HF and establish a safety cut-off value in this population. This retrospective, observational study included 167 consecutive patients admitted for acute HF. LDL-C levels were measured on hospital admission, and patients were categorized according to their estimated cardiovascular (CV) risk. The primary endpoint was all-cause mortality at 1-year, while secondary endpoints included HF hospitalizations, major thrombotic events, and net clinical benefit. During the follow-up period, 14.4% of patients died. Higher LDL-C levels were independently associated with improved survival, with a 4-fold increase in survival probability for each 1mg/dL increase in serum LDL-C. The minimum LDL-C value not associated with increased mortality risk was 88mg/dL. Patients with LDL-C below this cut-off had a significantly higher risk of mortality and a tendency for higher HF hospitalization risk. The net clinical benefit endpoint was also influenced by LDL-C levels, with LDL-C below 88mg/dL associated with an increased risk of events. In patients admitted for acutely decompensated HF, higher LDL-C levels were associated with reduced risk of mortality. An LDL-C value below 88m/dL was associated with increased mortality, suggesting the need for a more liberal LDL-C target in this specific patient population. These findings highlight the importance of considering LDL-C levels in the management and risk assessment of patients with HF.

Increased serum galectin-3 level is associated with endothelial dysfunction and cardiovascular events in patients with hypertension.

Endothelial dysfunction can lead to various harmful cardiovascular complications. The importance of galectin-3 (Gal-3) has been proposed in some cardiac diseases related to chronic inflammation. However, its role in hypertension-induced endothelial dysfunction remains unclear. We enrolled 120 patients with hypertension, assessed their baseline characteristics, and monitored their 7-year cardiovascular outcomes. We performed an enzyme-linked immunosorbent assay to measure serum Gal-3 levels. The vascular reactivity index (VRI) was examined by digital thermal monitoring. Patients with VRI <1.0, 1.0 to <2.0, and ≥2.0 were defined as having poor, intermediate, and good vascular reactivity, respectively. Among the recruited patients, 12 had poor vascular reactivity, 57 had intermediate vascular reactivity, and 51 had good vascular reactivity. Older age, higher total cholesterol levels, higher low-density lipoprotein cholesterol levels, lower estimated glomerular filtration rate, and higher Gal-3 levels were associated with poor endothelial dysfunction. Multivariate linear regression analysis showed that age and Gal-3 levels were correlated with VRI. During the 7-year follow-up period, patients with higher Gal-3 levels had more cardiovascular events. Higher Gal-3 levels are associated with endothelial dysfunction and unfavorable cardiovascular outcomes in patients with hypertension, suggesting its potential role in the hypertension-induced endothelial dysfunction.

The role of lysosomal acid lipase deficiency in dyslipidemia and liver disorders.

Cholesterol ester storage disease (CESD) is a rare autosomal recessive lysosomal storage disorder caused by mutations in the LIPA gene, leading to reduced lysosomal acid lipase activity, cholesterol ester accumulation, and systemic manifestations including liver dysfunction and dyslipidemia. We report the case of a 25-year-old male presenting with subacute jaundice, hyperbilirubinemia (total bilirubin 51 mg/dL, predominantly direct), and dyslipidemia characterized by elevated total cholesterol and low HDL cholesterol levels. Initial diagnostic workup for acute hepatitis and liver dysfunction, including serological and imaging studies, was unremarkable. Liver biopsy revealed canalicular cholestasis and T-lymphocyte infiltration without fibrosis, raising suspicion for a metabolic or genetic etiology. Genetic analysis confirmed a heterozygous pathogenic mutation (c.894 G>A) in the LIPA gene, establishing the diagnosis of CESD. The patient required advanced management with a molecular adsorbent recirculating system to address refractory hyperbilirubinemia. CESD often mimics other metabolic and hepatic conditions, such as familial hypercholesterolemia or non-alcoholic fatty liver disease, necessitating high clinical suspicion and genetic confirmation for diagnosis. This case underscores the importance of recognizing CESD in patients with atypical dyslipidemia and persistent hepatic abnormalities, as early identification enables targeted therapeutic interventions, including Sebelipase alfa enzyme replacement therapy.

Sex differences in the association between lipids and cognitive function in older adults

Background: It is well known that cognitive function is associated with gender differences. However, the effect of sex differences on the relationship between lipids fractions and cognitive function in older adults has been contentious. Methods: 2,170 participants from the U.S. National Health and Nutrition Examination Surveys (1999-2002 and 2011-2014) were included. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST). Multiple linear regression models and restricted cubic spline curve fitting were used. Results: Overall, low HDL-C levels were negatively associated with DSST scores in every group. The levels of TC, TG, and LDL-C were not significantly associated with DSST scores, not only in the total population but also in the males. In the females, after adjustment for potential confounding factors, high TC levels were negatively related to DSST scores (OR = −3.590, 95% CI: – 6.343 to – 0.837), and high TG levels were found positively associated with DSST scores (OR = 2.323, 95% CI: 0.159–4.488). Conclusion: Low plasma HDL is associated with cognitive dysfunction in older adults. In older women, high TC levels are positively associated with cognitive decline while high TG levels may protect cognitive function.

Association between the EHBP1 SNPs and dyslipidemia in the end-stage renal disease patients with dialysis in Chinese Han population

BackgroundLipid metabolism is influenced by mutations in the EH domain binding protein 1 gene (EHBP1). This study investigated the link between the EHBP1 single-nucleotide polymorphisms (SNPs) and dyslipidemia risks in maintenance dialysis patients with end-stage renal disease in Chinese Han population.MethodsA total of 539 patients were divided into dyslipidemia (379) and control (160) groups. The patients with dyslipidemia were divided into four subgroups: high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol (HDLC), high triglyceride (TG) and high total cholesterol groups. The genotype distributions of three EHBP1 SNPs (rs2710642, rs10496099 and rs1168816) were determined by high-throughput sequencing technology and were analyzed via generalized multifactor dimension reduction and binary logistic regression analysis.ResultsThe high-TG and control groups differed in terms of the genotype frequency of the rs2710642. One haplotype was detected in both the dyslipidemia and high-TG groups. The risk of dyslipidemia was 2.72-fold higher in participants with rs2710642GG compared with those of rs2710642AA and 2.62-fold higher compared with those with rs2710642AA + GA. Subjects who carried rs2710642GG had a 2.94 times greater risk of high TG levels than those who carried rs2710642AA and a 2.89 times greater risk than those who carried rs2710642AA + GA. Compared with those who carried rs2710642AA + GA, those who carried rs2710642GG were 2.53 times more likely to have low HDLC levels. The rs2710642–body mass index (BMI) (≥ 24 kg/m2) and rs11688816A–rs2710642G haplotype interactions increased the risk of dyslipidemia, and the rs2710642–BMI (≥ 24 kg/m2) interaction increased the risk of high TG levels. The rs10496099–rs2710642 and rs10496099–rs2710642–rs11688816 interactions increased the risk of low HDLC levels.ConclusionsThese results suggest that the EHBP1 rs2710642G and rs2710642GG and interactions with rs11688816A or BMI (≥ 24 kg/m2) were linked to higher dyslipidemia risks in end-stage renal disease patients in Chinese Han population.

The Influence of Long COVID on the Cardiovascular System and Predictors of Long COVID in Females: Data from the Polish Long COVID Cardiovascular (PoLoCOV-CVD) Study.

Background/Objectives: Female sex is one of the Long COVID (LC) risk factors; however, the LC predictors in females have not been established. This study was conducted to assess the influence of LC on the cardiovascular system and to assess the age-independent predictors of LC in females. Methods: Patient information and the course of the disease with symptoms were collected in women at least 12 weeks after COVID-19 recovery. The study participants were followed for 12 months. ECG monitoring, 24 h ECG monitoring, 24 h blood pressure monitoring, echocardiography, and biochemical tests were performed. Results: We studied 1946 consecutive female patients (age 53.0 [43.0-63.0] vs. 52.5 [41.0-63.0], p = 0.25). A more frequent occurrence of LC was observed in females with a severe SARS-CoV-2 infection (p = 0.0001). Women with LC compared to the control group had higher body mass index (p = 0.001), lower level of HDL cholesterol (p = 0.015), higher level of TG (p < 0.001) and higher TG/HDL ratio (p < 0.001), more often myocardial damage (p < 0.001), and lower LVEF (p = 0.01). LC women had more often QRS fragmentation, longer QTcB, and one of the ECG abnormalities. In a multivariate analysis in younger females with BMI > 24.8 kg/m2, TG/HDL ratio > 1.89 and severe course of COVID-19 and in older females, TG/HDL ratio > 1.89, lower LVEF, and also severe course of infection were independent LC predictors. Conclusions: Independent predictors of LC occurrence in women, regardless of age, are severe course of COVID-19 and TG/HDL ratio > 1.89. The presence of comorbidities and lifestyle before COVID-19 had no impact on the occurrence of LC in females regardless of age.

Prognostic Role of Neutrophil Percentage-to-Albumin Ratio in Patients with Non-ST-Elevation Myocardial Infarction.

Background and Objectives: This study aimed to investigate whether neutrophil percentage-to-albumin ratio (NPAR) levels on admission have prognostic significance regarding one-year major adverse cardiovascular and cerebrovascular events (MACCEs) in non-ST-elevation myocardial infarction (NSTEMI) patients. Materials and Methods: A total of 464 patients aged 59.2 ± 11.6 years constituted the cohort of this retrospectively designed study. Considering a 1-year follow-up period, the patients were divided into two groups: those with MACCEs and those without. The complete blood count, serum C-reactive protein and serum albumin levels were measured at admission. The NPAR, C-reactive protein/albumin ratio (CAR) and systemic immune-inflammation (SII) index were calculated for all patients, and the associations of these inflammatory-based biomarkers with 1-year MACCEs were evaluated. Results: During the 12-month follow-up period, MACCEs were observed in 75 (16.2%) patients, of which 35 (7.5%) patients died. The patients with MACCEs had higher CRP (p < 0.001), a higher percentage of neutrophils (p < 0.001), lower albumin levels (p < 0.001), a higher CAR (p < 0.001), a higher SII index (p = 0.008) and a higher NPAR (p < 0.001). A high anatomical SxSI score, a high low-density lipoprotein cholesterol level, hypoalbuminemia, high neutrophil counts, a high NPAR level and a high CAR level were independent predictors for one-year MACCEs (all p < 0.05). The NPAR (area under the curve [AUC] = 0.775, p < 0.001) and albumin level (AUC = 0.708, p < 0.001) had better and sufficient discriminatory power and predictive accuracy in determining one-year MACCEs, when compared to the neutrophil (AUC = 0.693, p < 0.001), CAR (AUC = 0.639, p < 0.001) and SII index (AUC = 0.660, p < 0.001), in terms of the receiver operating characteristic curve. The DeLong test revealed that the predictive performance of the NPAR was superior to that of the other inflammatory parameters. In particular, individuals with an NPAR value greater than 17.6 were at greater risk of developing MACCEs (p < 0.001). Conclusions: The NPAR can be used as a newly identified promising inflammatory biomarker to predict one-year MACCEs in NSTEMI patients undergoing revascularization therapy.

Effect of Statins on the Prognosis After Thoracic Endovascular Aortic Repair for Patients With Acute Type B Aortic Dissection.

To analyze the clinical efficacy of long-term statin therapy following thoracic endovascular aortic repair (TEVAR) in patients with acute type B aortic dissection (ATBAD). We retrospectively analyzed data from 645 patients treated between January 2005 and June 2022, dividing them into Statin Group (n=330) and Non-statin Group (n=315) based on whether they received long-term postoperative statin therapy. Patients were further categorized based on median admission low-density lipoprotein cholesterol (LDL-C) levels into High and Low LDL-C Groups to assess the effect of statins on the prognosis of ATBAD patients after TEVAR. The cohort had an average age of 53.44±11.42 years old, and 81.71% were male. Statin therapy significantly reduced occurrences of all-cause death (3.03% vs 8.57%, p=0.002) and aorta-related death (0.91% vs 3.81%, p=0.015), particularly in patients with high admission LDL-C levels. In addition, patients with statin therapy had a lower incidence of aorta-related adverse events (ARAE) (4.24% vs 11.11%, p=0.001). Kaplan-Meier analysis indicated statins reduced 5-year cumulative incidence rates of all-cause death and ARAE (all Log-rank p<0.05). These trends were sustained after adjustment. Multivariate Cox analysis confirmed that statin therapy was associated with reduced risks of all-cause and aorta-related deaths, as well as ARAE. Long-term statin therapy appears to decrease the risk of all-cause and aorta-related death in ATBAD patients after TEVAR, particularly patients with high admission LDL-C levels. Patients with lower LDL-C levels at admission have a reduction of aorta-related death in the follow-up period. Statin therapy also was associated with a lower incidence of ARAE in follow-up. These findings suggest that statins might be crucial in improving long-term outcomes in this patient population. Long-term statin therapy administered to patients with acute type B aortic dissection (ATBAD) following thoracic endovascular aortic repair (TEVAR) demonstrates a substantial reduction in both all-cause and aorta-related mortality. Notably, this therapeutic benefit is most evident in patients presenting with elevated low-density lipoprotein cholesterol (LDL-C) levels at admission. Furthermore, statin therapy is associated with a decreased incidence of aorta-related adverse events during follow-up. These findings underscore the pivotal role of statin therapy in enhancing long-term clinical outcomes for ATBAD patients undergoing TEVAR, thereby contributing to improved patient care and prognosis.

Incidence and risk factors regarding atherosclerotic cardiovascular disease in middle-aged and elderly people with HIV treated in Chongqing, China

BackgroundAtherosclerotic cardiovascular disease (ASCVD) has become an increasingly common cause of death among people living with HIV (PLHIV) receiving successful antiretroviral therapy (ART). In Chongqing, approximately half of the PLHIV were middle-aged or elderly, and their diets were mainly high in salt, spices and oil; however, there is still a lack of relevant research on the risk factors and whether the disease burden of ASCVD is greater in these areas. This study was to investigate the risk of ASCVD in middle-aged and elderly PLHIV receiving ART and analyze the factors influencing high risk.MethodsA cross-sectional study was conducted at Chongqing Public Health Medical Center. Questionnaire surveys, physical examinations and laboratory examinations were used to collect information from PLHIV aged ≥ 45 years. Pooled cohort equations (PCEs) were used to calculate the 10-year ASCVD risk and analyze the influencing factors. The 10-year ASCVD risk score was used to define patients in the low-risk subgroup (< 7.5%) and high-risk subgroup (≥ 7.5%), and the risk factors were compared between the two groups.ResultsIn total, 463 PLHIV (median age 55.0 years, male 68.5%) were included, and the median duration of ART was 45.0 (15.0, 70.3) months. Of the 463 PLHIV, 13 (2.8%) had a known history of ASCVD. In the present study, 153 PLHIV (33.0%) were classified into the high-risk group, and 310 PLHIV (67.0%) were classified into the low-risk group. Compared with the low-risk group, the high-risk group was more likely to be female, older age, live in urban areas, be unemployed, have poor sleep quality, have higher low-density lipoprotein cholesterol (LDL-c), have higher total cholesterol (TC), and have diabetes and hypertension; however, coffee consumption was associated with a low risk of ASCVD. In addition, there were no differences in HIV viral load, CD4 + T-cell count, or duration on ART, or ART regimes between the two groups. According to multiple logistic regression, older age [odds ratio (OR) = 62.469, 95% CI 27.456, 142.134], female sex [OR = 9.635, 95% CI 4.384, 21.179], higher LDL-c levels [OR = 1.018, 95% CI 1.000, 1.036], accompanied hypertension [OR = 8.642, 95% CI 3.373, 22.143] and diabetes [OR = 10.806, 95% CI 3.787, 30.834] were found to be independent risk factors for the 10-year risk of ASCVD.ConclusionsThe overall 10-year ASCVD risk is great for middle-aged and elderly PLHIV in Chongqing, China. The risk factors for the 10-year risk of ASCVD were older age, female sex, elevated LDL-c level, and coexisting hypertension and diabetes.

Association of plasma endocan levels with metabolic parameters and predictive value of endocan for the development of complications in patients with type 2 diabetes mellitus: An observational study

The aim of the current research was to investigate the association between plasma endocan levels and metabolic control parameters, as well as to evaluate its predictive value for clinical complications in patients with type 2 diabetes mellitus (DMT2). A total of 100 DMT2 patients participated in this prospective observational study. Plasma endocan levels were significantly elevated in DMT2 patients with HbA1c&gt;7% (1.38±0.33 vs. 0.68±0.23 ng/mL; p&lt;0.0001), compared to patients with HbA1c ≤7%. Patients with plasma endocan concentrations &gt;1.10 ng/mL (median value of 1.10 ng/mL) demonstrated significantly higher levels of metabolic parameters: body mass index (BMI), HbA1c%, fasting glucose level, LDL cholesterol, total cholesterol, triglycerides, along with significantly lower HDL cholesterol levels. Furthermore, patients with plasma endocan levels &gt;1.10 ng/mL were found to have an increased risk for the following complications: retinopathy (RR: 2.7500; 95% CI: 1.2150 to 6.2244; p= 0.0152, nephropathy (RR: 2.0952; 95% CI: 1.2294 to 3.5710; p=0.0065), neuropathy (RR: 1.9945; 95% CI: 1.2025 to 3.3081); p=0.0075 ), angina pectoris (RR: 2.4881; 95% CI 1.0865 to 5.6979; p=0.0311, hypertension (RR: 1.1372; 95% CI 1.0060 to 1.2856; p=0.0398), cardiomyopathy (RR: 2.6190; 95% CI 1.1507 to 5.9612; p=0.0218), myocardial infarction (RR: 9.4286; 95% CI 1.2742 to 69.7697; p=0.0280) and stroke (RR: 4.4638; 95% CI 1.3765 to 14.4758; p=0.0127). Correlation analysis revealed that plasma endocan levels were positively correlated with HbA1c% (r=0.856, p&lt;0.0001), fasting glucose level (r=0.631, p&lt;0.0001), LDL (r=0.347, p=0.0004), cholesterol (r=0.282, p=0.0045) and triglycerides (r=0.366, p=0.0002). Conversely, plasma endocan levels were negatively correlated with HDL cholesterol (r= - 0.429, p&lt;0.0001). In conclusion, higher plasma endocan levels were strongly associated with poor metabolic control in DMT2 patients and exhibited significant predictive value for both microvascular and macrovascular complications.

Effect of Diet on HDL in Obesity.

Alterations of plasma lipoprotein levels and oxidative stress are frequently observed in obese patients, including low high-density lipoprotein (HDL) cholesterol (HDL-C) levels and alterations of HDL composition. Dysfunctional HDL with lower antioxidant and anti-inflammatory properties have also been demonstrated in obesity. There is increasing evidence that white adipose tissue (WAT) participates in several metabolic activities and modulates HDL-C levels and function. In obese subjects, the changes in morphology and function of adipose tissue lead to impaired regulatory function and are associated with a state of low-grade chronic inflammation, with increased release of pro-inflammatory adipokines and cytokines. These alterations may affect HDL metabolism and functions; thus, adipose tissue is considered a potential target for the prevention and treatment of obesity. A cornerstone of obesity prevention and therapy is lifestyle modification through dietary changes, which is reflected in the modulation of plasma lipoprotein metabolism. Some dietary components and metabolites directly affect the composition and structure of HDL and modulate its anti-inflammatory and vasoprotective properties. The aims of the review are to summarize the crosstalk between adipocytes and HDL dysfunction in human obesity and to highlight recent discoveries on beneficial dietary patterns as well as nutritional components on inflammation and HDL function in human obesity.

Structure of apolipoprotein B100 bound to the low-density lipoprotein receptor.

Apolipoprotein B100 (apoB100) is a structural component of low-density lipoprotein (LDL) and a ligand for the LDL receptor (LDLR)1. Mutations in apoB100 or in LDLR cause familial hypercholesterolaemia, an autosomal dominant disease that is characterized by a marked increase in LDL cholesterol (LDL-C) and a higher risk of cardiovascular disease2. The structure of apoB100 on LDL and its interaction with LDLR are poorly understood. Here we present the cryo-electron microscopy structures of apoB100on LDL bound to the LDLRand a nanobody complex, which can form a C2-symmetric, higher-order complex. Using local refinement, we determined high-resolution structures of the interfaces between apoB100 and LDLR. One binding interface is formed between several small-ligand-binding modules of LDLR and a series of basic patches that are scattered along a β-belt formed by apoB100, encircling LDL. The other binding interface is formed between the β-propeller domain of LDLR and the N-terminal domain of apoB100. Our results reveal how both interfaces are involved in LDL dimer formation, and how LDLR cycles between LDL- and self-bound conformations. In addition, known mutations in either apoB100 or LDLR, associated with high levels of LDL-C,are located at the LDL-LDLR interface.

Association Between Melanoma Metastasis and Metabolic Syndrome: A Cross-Sectional Study in a Chinese Population.

Metabolic syndrome (MetS) remains a significant global public health concern. However, the relationship between MetS, its individual components and melanoma metastasis remains unexplored. We analysed the clinical data of 258 Chinese melanoma patients who had not undergo systemic therapy. Binary logistic regression, adjusted for sex and age, was employed to evaluate the connection between MetS and its components and melanoma metastasis. Of the 258 melanoma patients, 92 met the MetS criteria upon diagnosis. No direct association between MetS and melanoma metastasis was identified. However, specific components of MetS, namely low HDL-cholesterol levels (OR = 2.85, 95% CI:1.50-5.41, p < 0.05) and dysglycaemia (OR = 4.23, 95% CI:1.80-8.96, p < 0.05), were associated with melanoma metastasis. In subgroup analysis, hypertriglyceridemia correlated with melanoma metastasis in non-elderly patients (< 65 years) (OR = 2.69, 95% CI: 1.14-6.33, p < 0.05). Central obesity and hypertension showed no association. A dose-response analysis further indicated that melanoma metastasis risk escalated with increasing fasting blood glucose and blood triglyceride concentrations, and with decreasing blood HDL concentration. Our results suggest that monitoring and managing individual components of the MetS, particularly HDL-cholesterol levels, fasting glucose and triglyceride levels, may have potential prognostic benefits for melanoma in the Chinese population.

Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome.

To verify the prevalence and factors associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among women with Polycystic Ovary Syndrome (PCOS). A cross-sectional study was conducted with 53 patients with PCOS. The diagnosis of PCOS followed the Rotterdam criteria. The diagnosis of NAFLD was made through US showing hepatic steatosis, excluding significant alcohol consumption and chronic liver disease. The following variables were compared between the groups of women with and without NAFLD: age, race, anthropometric data, blood pressure levels, liver enzymes, glycemic and lipid profiles, total testosterone, presence of hirsutism, and metabolic syndrome (MS). Variables were compared between the groups using T-test, Mann-Whitney, and Chi-square tests. Among 53 patients with PCOS, 50.9% had NAFLD. The NAFLD group had higher weight (p=0.003), BMI (p=0.001), waist circumference (p≤0.001), fasting glucose (p=0.021), HbA1C% (p=0.028), triglycerides (p=0.023), AST (p=0.004), ALT (p=0.001), higher prevalence of MS (p=0.004), and lower levels of HDL cholesterol (p=0.043). The other variables did not differ between the groups. Both groups were predominantly of caucasian race, and there was no significant difference in age. The prevalence of NAFLD among patients with PCOS was 50.9%. Metabolic and hepatic enzyme abnormalities were more prevalent in this group compared to the group without the disease. Obesity tripled the prevalence of NAFLD.