Low Serum High-density Lipoprotein Cholesterol Research Articles

Association of the ESR1 (rs9340799), OLR1 (rs3736234), LIPC (rs2070895), VDR (rs2228570), and CETP (rs708272) Polymorphisms With Risk of Coronary Artery Disease in Iranian Patients.

Coronary artery disease (CAD) is a devastating illness and a leading cause of death worldwide, primarily caused by atherosclerosis resulting from a genetic-environmental interaction. This study aimed to investigate the relationship between the ESR1 (rs9340799), OLR1 (rs3736234), LIPC (rs2070895), VDR (rs2228570), and CETP (rs708272) polymorphisms, lipid profile parameters, and CAD risk in a southeast Iranian population. A total of 400 subjects (200 CAD patients with hyperlipidemia and 200 healthy controls) were enrolled in this case-control study. Five selected polymorphisms were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. For all single nucleotide polymorphisms (SNPs), the population under study was in the Hardy-Weinberg equilibrium. The T-risk allele frequency of rs2228570 was associated with an increased risk of CAD. The TT and CT genotypes of rs2228570 had also been associated with the risk of CAD. Additionally, the TT genotype was associated with higher serum low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) levels. The GG genotype of the rs3736234 was associated with higher body mass index (BMI) and triglyceride (TG) levels, and the AA genotype of the rs708272 was associated with higher HDL-c levels. Based on these findings, we propose that the VDR (rs2228570) polymorphism was associated with serum HDL-c and LDL-c levels and may serve as potential risk factors for CAD within the Iranian population. Moreover, rs3736234 and rs708272 influence the concentrations of TG and HDL-c, respectively. These findings provided insights into the complex interplay between genetic variations, cardiovascular risk, and lipid metabolism.

Factors associated with gastric and duodenal neuroendocrine tumors: A multicenter case-control study

Background and AimsThe incidence of gastric and duodenal neuroendocrine tumors (GNET and DNET, respectively) is increasing, however associated factors of these diseases are not well known. Here, we investigated the factors associated with GNET and DNET. MethodsPatients with GNET and DNET presenting at eight tertiary referral centers between 2001 and 2020 were included and compared with healthy controls who underwent upper endoscopic screening. Clinical factors and laboratory data were analyzed to determine associated factors of GNET and DNET. ResultsOverall, 396 patients with GNET and 193 patients with DNET were included and compared with 1725 healthy controls. Multivariate analysis showed that age (odds ratio [OR] 0.98), diabetes (OR 1.72), hypertension (OR 1.97), low serum high-density lipoprotein cholesterol (HDL-C) levels (OR 2.54), and past/present H. pylori infection (OR 1.46) were significantly associated with GNET. In contrast, DNET was significantly associated with diabetes (OR 1.80), hypertension (OR 1.68), low serum HDL-C levels (OR 2.29), and past/present H. pylori infection (OR 5.42). In the sex-based subgroup analysis in GNET, current smoking was strongly associated in women (OR 9.85), but not in men. ConclusionsThis study identified several common metabolic factors associated with GNET and DNET. Additionally, some factors had sex-specific associations.

Breakfast Skipping and Traits of Cardiometabolic Health: A Mendelian Randomization Study

BackgroundBreakfast skipping has been linked to poor cardiometabolic health in observational studies, but the causality remains unknown. Herein, we used Mendelian randomization (MR) approach to elucidate the potential causal effects of breakfast skipping on cardiometabolic traits. MethodsGenetic association estimates for breakfast skipping, cardiometabolic diseases, and cardiometabolic risk factors were extracted from the UK Biobank and several large genome-wide association studies. Two-sample MR analyses were performed primarily using the inverse variance weighted method, followed by sensitivity analysis to test the reliability of results. ResultsMR results indicated no causal relationship between breakfast shipping with coronary heart disease (odds ratio [OR]: 1.079, 95% confidence interval [CI]: 0.817–1.426; p = 0.591), stroke (OR: 0.877, 95% CI: 0.680–1.131; p = 0.311), and type 2 diabetes mellitus (OR: 1.114, 95% CI: 0.631–1.970; p = 0.709). However, genetically predicted breakfast skipping was significantly associated with increased body mass index (β: 0.250, standard error [SE]: 0.079; p = 0.001), waist-to-hip ratio (β: 0.177, SE: 0.076; p = 0.019), and low-density lipoprotein cholesterol (β: 0.260, SE: 0.115; p = 0.024). We found no evidence of association of genetic liability to breakfast skipping with blood pressure, glycemic traits, and other blood lipids. Sensitivity analysis supported the above results. ConclusionOur study suggested that breakfast skipping is causally linked to weight gain and higher serum low-density lipoprotein cholesterol, which may mediate the increased risk of cardiometabolic diseases reported in epidemiological studies.

Two Cases of Acquired High-Density Lipoprotein Deficiency with Immunoglobulin G4-Related Lecithin-Cholesterol Acyltransferase Autoantibody.

Lecithin-cholesterol acyltransferase (LCAT) plays a significant role in the progression from premature to mature high-density lipoprotein (HDL) in circulation. Consequently, primary or secondary LCAT deletion or reduction naturally results in low serum HDL cholesterol levels. Recently, rare cases of acquired HDL deficiency with LCAT autoantibodies have been reported, mainly from Japan, where LCAT autoantibodies of immunoglobulin G (IgG) caused the HDL deficiency. Here to our knowledge, we report for the first time two cases of acquired HDL deficiency caused by IgG4 linked LCAT autoantibodies with or without a high serum IgG4 level. Furthermore, these cases can extend to a new concept of "IgG4 autoimmune disease" from the viewpoint of verifying the serum autoantibody and/or renal histopathology.

Impact of orthotopic liver transplantation on serum lipid level and growing development in patients with homozygous or compound heterozygous familial hypercholesterolemia

Objective: To investigate the impact of orthotopic liver transplantation on serum lipid and growing development in patients with homozygous (HoFH) or compound heterozygotes (cHeFH) familial hypercholesterolemia. Methods: Patients who were treated in Peking Union Medical College Hospital from August 2019 to August 2021, entered the rare disease database and underwent liver transplantation, were included in this single center retrospective cohort study. The height for age Z score (HAZ) and length for age Z score (WAZ) at birth, at the time of transplantation and one year after transplantation were calculated respectively by collecting demographic characteristics, clinical manifestations, echocardiography, lipid-lowering treatment, blood lipid level data and donor characteristics data of liver transplantation. The serum cholesterol level and growing development changes before and after liver transplantation were evaluated. Results: A total of five patients with HoFH or cHeFH, including two females, were included in this study. The median age was 10 years (6-22 years). The median follow up duration was 28 months (24-33 months). All HoFH or cHeFH patients in this study received the maximum daily dosage of the lipid-lowering drug combined with low salt and low-fat diet control treatment for at least 3 months before orthotopic liver transplantation. The average level of total cholesterol (TC) decreased by 27% compared with that before treatment, the level of low-density lipoprotein cholesterol (LDL-C) decreased by 21% after 3 months treatment. There was no intervention of lipid-lowering therapy after operation. One month after liver transplantation, the average levels of TC and LDL-C further decreased rapidly by 68% and 76% respectively. One year after liver transplantation, the level of LDL-C decreased from (17.1±1.6)mmol/L without any intervention before transplantation to (3.0±0.7)mmol/L, and remained stable thereafter. In addition, compared with no intervention before liver transplantation, the serum triglyceride (TG) level decreased after the maximum daily dosage of the lipid-lowering drug and low salt and low-fat diet control for 3 months ((1.88±0.27) mmol/L vs. (1.12±0.55)mmol/L, P=0.031), and the HDL-C level also decreased significantly ((1.95±0.49)mmol/L vs. (0.95±0.30)mmol/L, P=0.006) at the same time period. TG and HDL-C remained stable after liver transplantation during the 24-month follow-up period (P>0.05). One and two years after liver transplantation, there was no significant difference in height and weight, malnutrition and growth retardation between the patients in this cohort and Chinese children of the same age. Conclusion: Early liver transplantation is a feasible and effective treatment option for HoFH or cHeFH patients with extremely high serum low-density lipoprotein cholesterol levels.

Association between Maternal Serum Lipids and Intrapartum Oxytocin Requirements during Labor Induction and Augmentation.

This study aimed to investigate the relationship between maternal serum lipid parameters and oxytocin requirements among women with term vaginal deliveries. In this secondary analysis of a prospective cohort study, women who presented for delivery at ≥37 weeks' gestation and received oxytocin during their labor were included. Maternal serum was collected intrapartum. The cohort was stratified into two groups based on maximum oxytocin infusion dose during labor. Primary outcomes were maternal total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels. Generalized linear regression models were used to assess the association between lipid parameters and maximum oxytocin dose requirements while controlling for potential confounders. For secondary analyses, the cohort was stratified by HDL-C into two groups. Multivariable logistic regression was used to evaluate the relationship between low maternal HDL-C and additional intrapartum oxytocin parameters. There were no differences in maternal total cholesterol, LDL-C, or triglyceride values between high and low maximum oxytocin groups. Median serum HDL-C was significantly lower among women in the high oxytocin group compared with those in the low oxytocin group (56 vs. 62 mg/dL, p < 0.01). For every 0.26 mg/dL lower HDL-C, women had 1 mU/min higher maximum oxytocin infusion dose during labor. Women with low serum HDL-C were also more likely to require maximum oxytocin doses above the 75th percentile (adjusted odds ratio [aOR]: 1.99, 95% confidence interval [CI]: 1.06-3.75) and above the 90th percentile (aOR: 2.47, 95% CI: 1.10-5.54). Among women undergoing induction of labor, low serum HDL-C was also associated with longer duration of oxytocin infusion (aOR: 2.07, 95% CI: 1.02-4.20). Low maternal HDL-C levels at term are associated with higher maximum oxytocin infusion doses among women undergoing labor induction or augmentation. Given the growing prevalence of metabolic syndrome in the United States and persistently high rates of cesarean delivery, HDL-C or its components may present a new target for predicting and improving labor outcomes. · Serum HDL-C at term is inversely correlated with oxytocin infusion doses at term.. · Low maternal serum HDL-C is associated with higher oxytocin requirements during labor induction or augmentation.. · No association between maternal serum total cholesterol, LDL-C, or triglyceride levels and oxytocin requirements in labor..

Relationship between Chewing Status and Fatty Liver Diagnosed by Liver/Spleen Attenuation Ratio: A Cross-Sectional Study.

This cross-sectional study investigated the relationship between chewing status and fatty liver among Japanese adults. Between April 2018 and March 2021, 450 individuals (352 males, 98 females; mean age 54.7 years) were recruited at the Asahi University Hospital Human Health Center. Chewing status was evaluated using a self-reported questionnaire. Liver/spleen (L/S) attenuation ratio < 0.9 on computed tomography was considered to indicate fatty liver, which was present in 69 participants (15%). Compared with participants without fatty liver, those with fatty liver had higher proportion of 25.0 (kg/m2) ≤ body mass index (BMI) (p < 0.001), higher serum hemoglobin A1c (HbA1c) (p < 0.001), higher systolic blood pressure (p < 0.001), higher diastolic blood pressure (p < 0.001), and lower serum high-density lipoprotein cholesterol (HDL cholesterol) (p = 0.011). Significant differences were also found in chewing status (p < 0.001) and eating speed (p = 0.011). Presence of fatty liver was positively associated with BMI (25.0 ≤; odds ratio [OR], 5.048; 95% confidence interval [CI], 2.550−9.992), serum HbA1c (OR, 1.937; 95% CI, 1.280−2.930), and chewing status (poor; OR, 8.912; 95% CI, 4.421−17.966) after adjusting for sex, age, BMI, serum HbA1c, systolic blood pressure, diastolic blood pressure, serum HDL cholesterol, chewing status, and eating speed. Poor chewing status was positively associated with L/S attenuation ratio. These results indicate a positive relationship between poor chewing status and fatty liver diagnosed by L/S attenuation ratio in Japanese adults.

Management of Familial Hypercholesterolemia with Special Emphasis on Evinacumab.

Familial hypercholesterolemia (FH) is an underdiagnosed disease that contributes to a significant number of cardiovascular incidents through high serum Low-Density Lipoprotein Cholesterol (LDL-C) values. Its treatment primarily requires healthy lifestyle and therapy based on statins, ezetimibe and Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9); however, there are also new treatment options that can be used in patients who do not respond to therapy, among which we highlight evinacumab. Elevated LDL-C values, together with clinical manifestations associated with cholesterol deposition (e.g., tendon xanthomas, xanthelasma and arcus cornealis) and family history are the main elements in the diagnosis of FH. Pathognomonic signs of FH include extensor tendon xanthomas; however, their absence does not exclude the diagnosis. Elevated LDL-C levels lead to premature Atherosclerotic Cardiovascular Disease (ASCVD), which is why early diagnosis and treatment of FH is essential. Evinacumab, a novelty in pharmacological practice, having a complex mechanism of action, causes desirable changes in lipid parameters in patients with homozygous form of familial hypercholesterolemia (HoFH). This review collects and summarizes the most important aspects of the new drug, especially being a discovery in the treatment of HoFH, giving these patients hope for a longer and more comfortable life.

Distribution of lipid levels and prevalence of hyperlipidemia: data from the NHANES 2007–2018

BackgroundLipid-lowering therapy is important, and the distribution of lipid levels and the incidence of hyperlipidemia may vary in different subgroups of the population. We aimed to explore the distribution of lipid levels and the prevalence of hyperlipidemia in subpopulations with subgroup factors, including age, sex, race, and smoking status.MethodsOur study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, ultimately enrolling and analyzing 15,499 participants. A cross-sectional analysis was performed to assess the distribution of lipids and prevalence of hyperlipidemia in subpopulations, and multifactorial logistic regression analyses were performed for the prevalence of hyperlipidemia, adjusted for age, sex, race and smoking status.ResultsBlacks had significantly lower mean serum total cholesterol and triglycerides and higher serum high-density lipoprotein cholesterol (HDL-C) than whites (P < 0.001). In contrast, Mexican Americans had markedly higher mean serum triglycerides and lower serum HDL-C than whites (P < 0.001). Furthermore, the prevalence of hypercholesterolemia and hypertriglyceridemia was lower in blacks than in whites (P = 0.003 and P < 0.001, respectively), while the prevalence of hypertriglyceridemia was significantly higher in Mexican Americans than in whites (P = 0.002). In addition, total cholesterol and triglyceride levels were significantly higher in women aged 65 years or older and markedly higher than in men in the same age group (P < 0.001). In addition, overall mean total cholesterol, triglyceride, and low-density lipoprotein cholesterol (LDL-C) levels were higher in smokers than in nonsmokers (P = 0.01, P < 0.001, and P = 0.005, respectively).ConclusionBased on NHANES data, the mean lipid levels and prevalence of hyperlipidemia differed by sex, age, race, and smoking status.

High low-density lipoprotein cholesterol level is associated with an increased risk of incident early-onset vasomotor symptoms

We investigated the associations between serum lipid profiles and risk of early-onset vasomotor symptoms (VMSs) in premenopausal women. This cohort study comprised 2,540 premenopausal women aged 42–52 years without VMSs at baseline (median follow-up: 4.4 years). VMSs, including hot flashes and night sweats, were assessed using the Menopause-Specific Quality of Life questionnaire (Korean version). Early-onset VMSs were defined as VMSs that occurred premenopause; moderate/severe VMSs were defined as a score of ≥ 3 points (range: 0 to 6, 6 being most bothersome). Cox proportional hazard regression models were used to estimate hazard ratios with 95% confidence intervals (CI) for the development of VMSs across the lipid levels. Higher low-density lipoprotein (LDL) cholesterol levels were positively associated with increased risk of early-onset VMSs. Compared to the < 100 mg/dL LDL group, the multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for incident VMSs were 1.19 (1.03–1.37) and 1.20 (1.03–1.40) in participants with LDL cholesterol levels of 100–129 mg/dL and ≥ 130 mg/dL, respectively (P for trend = 0.027). The multivariable-adjusted HR for incident moderate/severe VMSs was 1.37 (95% CI: 1.08–1.73) in participants with LDL ≥ 130 mg/dL, compared to those with LDL < 100 mg/dL. Meanwhile, triglycerides and total and high-density lipoprotein cholesterol levels were not significantly associated with early-onset VMSs risk in premenopausal women. Premenopausal women with high serum LDL cholesterol concentrations had a higher risk of incident early-onset VMSs. Further studies should confirm our findings and examine whether LDL-lowering interventions reduce the risk of early-onset VMSs among women during menopause transition.

Association of hemoglobin glycation index with cardiovascular risk factors in non-diabetic adults: A cross-sectional study

Background and aimsThe study aimed to explore the association of hemoglobin glycation index (HGI) with cardiovascular risk factors in non-diabetic adults. MethodsThis cross-sectional study included 200 adults of 20–60 years of age. Predicted glycated hemoglobin (HbA1c) was calculated from linear regression equation. HGI was calculated using the formula HGI = measured HbA1c– predicted HbA1c. The study subjects were classified into three groups based on their HGI tertiles. Cardiovascular risk factors were compared between the groups and Pearson correlation test was done to correlate HGI with cardiovascular risk factors. ResultsSerum total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) showed significant increase with increase in HGI in non diabetic individuals. High HGI group had significantly high serum total cholesterol, triglyceride, LDL-C and VLDL-C compared to low HGI group. Serum total cholesterol, triglyceride, LDL-C and VLDL-C showed a statistically significant positive correlation with HGI. ConclusionWe have found a statistically significant correlation of HGI with serum lipid profile, a significant cardiovascular risk factor in non-diabetic individuals. HGI, a simple derivative of HbA1c and fasting plasma glucose may be used to identify cardiovascular risk in non-diabetic individuals. Further prospective studies are required in larger sample size to confirm the clinical implications of HGI.

Serum high-density lipoprotein cholesterol level has a significant prognostic impact on outcomes of follicular lymphoma patients.

We investigated the potential of nutritional and inflammatory parameters as prognostic factors for follicular lymphoma (FL), and also examined the predictive value of the early progression of disease within 24 months of first-line chemo-immunotherapy (POD24).We retrospectively analyzed 46 patients with FL admitted to Teikyo University Hospital and treated with chemo-immunotherapy between May 2009 and July 2019. Physical characteristics, blood parameters, and markers or scores for consumptive/inflammatory and nutritional conditions were used as variables.Nine parameters correlated with poor overall survival (OS) in univariate analysis: An Eastern Cooperative Oncology Group (ECOG) scale performance status (PS) ≥2, five or more involved nodal sites, positive bone marrow (BM) involvement, a serum albumin level <3.5 g/dL, CRP >0.5 mg/dL, lactate dehydrogenase (LD) higher than the upper normal limit (UNL), high-density lipoprotein cholesterol (HDL-C) <40 mg/dL, modified Glasgow prognostic score of 1–2, and the geriatric nutritional risk index <82. In multivariate analysis, ECOG PS ≥2, positive BM involvement, and a serum HDL-C level <40 mg/dL remained significant for poor progression-free survival. One-year OS rate after receiving salvage chemotherapy was lower in the POD24 group (50%) and POD24 correlated with ECOG PS ≥2, positive BM involvement, a serum lactate dehydrogenase >UNL, and HDL-C <40 mg/dL by Fisher’s exact test.These results indicate that low serum HDL-C levels appear to be important for predicting the risk of POD24 and the worse prognosis of FL.

Prevalence and Characteristics of Prediabetes and Metabolic Syndrome in Seemingly Healthy Persons at a Health Check-Up Clinic

PurposeThis study investigated the prevalence and characteristics of prediabetes (PreDM) and metabolic syndrome (MetS) in seemingly healthy persons attending a health check-up clinic at a tertiary care hospital.Patients and MethodsThis was a cross-sectional study that enrolled 1213 subjects (339 male, 874 female) who underwent an annual health check-up at Siriraj Hospital, Bangkok, Thailand from 2009 to 2019. Factors that independently related to PreDM were analyzed using unconditional logistic regression analysis with adjustments for age, BMI, and gender.ResultsThe prevalence of PreDM and MetS was 54.3% and 19.7% respectively. Participants with impaired fasting glucose (IFG) and glycated hemoglobin (HbA1c) 38.8–46.4 mmol/mol had significantly higher waist circumference (WC) and blood pressure (BP) compared to those with IFG or HbA1c 38.8–46.4 mmol/mol alone (P < 0.05). Among three PreDM subgroups, the average age was lowest in the HbA1c 38.8–46.4 mmol/mol subgroup (P < 0.001). PreDM participants with MetS were older (p = 0.03), had higher WC, BP, fasting plasma glucose and serum triglyceride level (all P < 0.001) but had lower serum high-density lipoprotein (HDL) cholesterol level (P < 0.001). Multivariate analysis revealed high MetS score, obesity, and low serum HDL cholesterol level to be independently associated with PreDM with odds ratios of 9.02 (95% confidence interval [CI]: 4.03–20.18), 1.8 (95% CI: 1.07–3.04), and 1.42 (95% CI: 1.02–1.96), respectively.ConclusionThe prevalence of PreDM and MetS was relatively high in seemingly healthy persons. Distinct PreDM subgroups with or without MetS exhibited diverse clinical and biochemical features suggesting dissimilar pathogenesis.

Subretinal Drusenoid Deposits and Lower Serum High-Density Lipoprotein Cholesterol Levels Possess Latent Relation to Cardiovascular Disease and Can Be a Feasible Predictor.

Objective To ascertain whether lipid-related subretinal drusenoid deposits (SDD) are correlated with coexisting cardiovascular disease (CVD), as well as to reveal latent serum markers of CVD. Methods Patients older than 50 years and plagued by age-related macular degeneration (AMD) were included. Subjects with other retinal degenerations and vascular diseases, any recent treatment at other medical care institutions, and any previous oculopathy or ophthalmic surgery were excluded. All subjects were examined to ascertain whether they possess SDD, to analyze serum cholesterols, including low-density lipoprotein cholesterol (LDL), triglycerides (TG), high-density lipoprotein cholesterol (HDL), and total cholesterol (TC). Subjects were divided into SDD and non-SDD groups and further divided into subgroups by assessment of pump defect, valve defect, and carotid defect. Finally, logistic model trees and random forest algorithm analysis were performed. Results A total of 85 AMD patients including 43 with and 42 without SDD were involved. The 42 AMD (97.67%, 42/43) patients with SDD showed CVD, including 3 subjects presenting valve defect, 3 subjects presenting carotid defect, 8 subjects presenting pump defect, 14 subjects presenting both pump and valve defects, and 14 subjects presenting pump, valve, and carotid defects. By contrast, 5 AMD (11.90%, 5/42) patients without SDD showed CVD. Cholesterol level of SDD subjects presented significant higher TC (5.66 ± 1.01 vs. 5.58 ± 0.72, p = 0.032, Wilcoxon test) and lower HDL cholesterol (61 ± 17 vs. 70 ± 21, p = 0.031, Wilcoxon test) than that of non-SDD. The cases with HDL < 62 mg/dL were significantly related to CVD (p = 0.013, Wilcoxon test), and the cases with HDL < 40 mg/dL were not (p = 0.659, Wilcoxon test). Through machine learning based on the image from color fundus photography, the accuracy of predicting CVD was 95%. Conclusions The presence of SDD of AMD and lower serum HDL cholesterol level can predict certain CVD for AMD patients. The machine learning based on the SDD image and serum HDL cholesterol may open new avenue for the detection of CVD as a noninvasive approach.

Factors related to overweight and obese populations maintaining metabolic health.

BackgroundFor people who are overweight or obese, maintaining a metabolically healthy status can decrease the risks of developing cardiovascular diseases and Type 2 diabetes. Despite this, only a limited amount of research has discussed the metabolically healthy overweight and obesity (MHOO) population in Asia and the factors associated with them maintaining their metabolic health.MethodsThis study enrolled 195 MHOO participants from communities in northern Taiwan during 2009–2010 (baseline). Of the 195 participants, 89 completed the follow-up assessment after a median follow-up time of nine years. Body type was determined by body mass index (BMI, kg/m2). We defined overweight as a BMI ≥ 24 kg/m2 and <27 kg/m2 and defined obese as a BMI ≥ 27 kg/m2. Metabolic health was defined as the absence of cardiometabolic diseases and the presence of ≤1 of the cardiometabolic risk factors, namely hypertension, hyperglycemia, hypertriglyceridemia, and low serum high-density lipoprotein cholesterol. Metabolic health, BMI, and other covariates were evaluated at both baseline and follow-up. Generalized estimating equations (GEE) models were used to analyze the factors associated with maintenance of metabolic health during the follow-up period.ResultsAt baseline, the mean age of the study participants was 47.4 (SD 5.3) years and 46 (51.7%) of the participants were women. There were 51 (57.3%) individuals who maintained their metabolic health status at the time of the nine-year follow-up. The detrimental factors pertaining to metabolic health included older age, longer duration until follow-up, BMI ≥ 27 kg/m2, and increase in waist circumference. No significant relationships were observed between sociodemographic factors and lifestyle factors, such as sex, level of education, cigarette smoking, alcohol consumption, and physical activity, and sustained metabolic health among MHOO individuals.ConclusionsTo maintain metabolic health and prevent negative changes in health status, control of bodyweight and waist circumference should remain a priority for MHOO individuals even when there are no metabolic disorders present.

Aggravation of retinal hard exudates after intravitreal anti-vascular endothelial growth factor therapy for cystoid macular edema and the risk factors: a retrospective study

Background/aimsTo evaluate retinal hard exudates (HEs) progression in patients with cystoid macular edema (CME) secondary to diabetic retinopathy (DR) or branch retinal vascular occlusion (BRVO) after intravitreal injections of ranibizumab (IVR) treatment and identify the risk factors for the deterioration of HEs.MethodsThis retrospective study enrolled 288 eyes with center-involving CME secondary to DR or BRVO from 288 patients (one eye per patient). All patients were treated with three loading doses of ranibizumab intravitreally at a monthly interval. The morphologic features of HEs were observed, and the HEs areas were quantified using a semi-automatic method at baseline, 1 month after the first dose of IVR and 1 month after the third dose of IVR therapy. HEs progression was defined as having a > =2-grade increase in the HEs severity scale. The best-corrected vision acuity (BCVA) and alterations in HEs areas were compared between DR and BRVO groups. And logistic regression analyses were used to identify the risk factors for HEs exacerbation.ResultsMorphological changes of retinal HEs occurred in all eyes after IVR therapy, although HEs area was not significantly changed in some eyes. DR group has a higher percentage of eyes with progressed HEs area than the BRVO groups (34.9% vs. 21.8%, P = 0.019) 1 month after the first dose of IVR. Both DR and BRVO groups had a decreased percentage of enlarged HEs 1 month after the third injection, but the DR group is still higher than the BRVO group (17.1% vs. 8.4%, P = 0.027). At baseline, there was no correlation between VA and HEs areas. After the first and third doses of IVR, there still was no consistent correlation between HEs severity and change in VA over time. Furthermore, CME with subretinal fluid (SRF) is associated with a higher risk of HEs progression (P = 0.001). Long CME duration and high serum low-density lipoprotein cholesterol (LDL-C) level were identified as risk factors for HEs progression following IVR treatment in both univariable and multivariable regression analyses (Odds ratio (OR) = 1.88, P = 0.012 and OR = 1.14, P = 0.021, respectively).ConclusionsAlterations in the area of retinal HEs are widely observed after IVR treatment for CME. The eyes with CME secondary to DR have a higher percentage of progressed HEs than the BRVO eyes. DME with SRF, extended duration of CME, and high LDL-C level are potential risk factors of deteriorated HEs after IVR treatment.

Effect of Xuezhikang Therapy on Expression of Pulmonary Hypertension Related miR-638 in Patients With Low HDL-C Levels.

Objective: Low plasma level of high-density lipoprotein cholesterol (HDL-C) associated with poor outcomes in several cardiovascular diseases, including pulmonary arterial hypertension (PAH). Regulation of miR-638 have been proved to be associated with PAH. The aim of this study was to evaluate the expression of miR-638 after Xuezhikang (XZK) therapy in patients with low HDL-C. Methods: Plasma levels of miR-638 were quantified by real-time polymerase chain reactions in 20 patients with PAH and 30 healthy controls. A total of 40 subjects with low HDL-C were assigned to receive an XZK therapy for 6 months. The miR-638 expression profiles were detected in PAH patients, XZK-treated subjects and lovastatin treated pulmonary arterial smooth muscle cells (PA-SMCs). Results: The relative expression level of miR-638 in the plasma was lower in the PAH patients than that in the controls (p < 0.001). An increase of 11.2% from baseline in the HDL-C level was found after XZK therapy (p < 0.001). The relative expression of miR-638 was increased after XZK treatment (p < 0.01). The changes of miR-638 were inversely associated with baseline HDL-C levels. A significantly reduction in miR-638 expression were found in PDGF-BB-treated hPA-SMCs compared to the control cells, and the pre-treatment of the cells with lovastatin significantly re-gain the expression levels in miR-638. Conclusion: In patients with low HDL-C levels, XZK therapy raised the expression of miR-638, suggesting that the potential therapeutic effect of XZK in PAH patients with low serum HDL-C levels deserves further exploration.

Associations between empirically derived dietary patterns and cardiovascular risk factors among older adult men.

Cardiovascular disease (CVD) remains the leading cause of death globally, and epidemiological studies have suggested a link between diet and cardiometabolic risk. Currently, the prevalence of CVD is rapidly increasing with an aging population and continues to contribute to the growing economic and public health burden. However, there is limited evidence available regarding dietary patterns and cardiometabolic risk factors in older adults. We conducted a cross-sectional study to assess dietary patterns and cardiometabolic risk factors in males ≥60 years. Factor analysis identified a "healthy" diet and an "unhealthy" diet as the two primary dietary patterns. Multivariable logistic regression was used for estimating the associations of identified dietary patterns and cardiometabolic risk factors including anthropometric measures, blood pressure, glycemic biomarkers, lipid profile, and inflammatory biomarkers. A healthy dietary pattern was significantly associated with decreased odds of high serum fasting blood sugar (FBS) (OR: 0.32; 95% CI: 0.15-0.67; Ptrend=0.002), but increased odds of high serum low-density lipoprotein cholesterol (LDL-C) (OR: 1.82; 95% CI: 1.02-3.24; Ptrend=0.04). In comparison, an unhealthy diet was associated with increased odds of obesity (OR: 2.33; 95% CI: 1.31-4.15; Ptrend=0.004) and high LDL-C (OR: 2.00; 95% CI: 1.10-2.61; Ptrend=0.02). Thus, in older adults, adherence to an unhealthy dietary pattern has a significant impact on clinically relevant risk factors for cardiometabolic risk.

The Association Between rs1748195 and rs11207997 Variants of the ANGPTL3 Gene and Susceptibility to Cardiovascular Disease in the MASHAD Cohort Study.

There is a strong genetic predisposition to cardiovascular disease (CVD). Loss-of-function variants of the angiopoietin-like 3 (ANGPTL3) gene have been reported to be associated with several lipid-related CVD risk factors that include serum high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) level, and total cholesterol (TC). We aimed to determine the association of two genetic variants, rs1748195 and rs11207997, of the ANGPTL3 locus and CVD risk in the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. The participants were 1002 individuals in the MASHAD cohort, with or without CVD, during the 6 years of follow-up. The subjects were categorized into two groups according to serum HDL concentration. DNA was extracted by the routine salting-out method, and genotyping of rs1748195 and rs11207997 variants of the ANGPTL3 gene was performed using the ARMS PCR method. Univariate and multivariate statistical analysis was used to assess the two gene variants' association with incident CVD and baseline lipid profile. There was a significant relationship between rs1748195 GG genotype and CVD risk in the individuals with a normal serum HDL-C. There was a significant association between the CT genotype of the rs11207997 polymorphism and CVD risk in individuals with a low serum HDL-C. Furthermore, carriers of the GG genotype of the rs1748195 and CT genotype of rs11207997 variant of ANGPTL3 had a higher risk of developing CVD disease. We have shown that the 1748195(GG) and 11207997(CT) gene variants of the ANGPTL3 locus are associated with an increased risk of CVD in an Iranian population sample.

Dietary oxidized fish oil negatively affected the feed utilization, health status and fillet quality of juvenile Amur sturgeon, A. schrenckii

This study was carried out to explore the effects of dietary oxidized fish oil on growth, feed utilization, health status and fillet quality of juvenile Amur sturgeon (A. schrenckii) (initial mean body weight = 70.0 ± 0.02 g). An 8-week experiment with diets containing 6% fresh fish oil (FFO) or 6% oxidized fish oil (OFO) was conducted. The peroxide values (POV) of fresh and oxidized fish oil were 9.14 and 384.73 meq/kg, respectively. The results indicated that compared to the FFO group, dietary OFO had no significant influence on growth (P > 0.05), but increased feeding rate (FR) and decreased productive protein value (PPV) significantly (P < 0.05). The fish in the OFO group had lower serum high-density lipoprotein cholesterol (HDL-C), albumin (ALB), and the ratio of ALB to globulin (GLOB), and higher serum malonaldehyde (MDA) and superoxide anion free radical (O2−) than those in the FFO group (P < 0.05). OFO induced inflammatory cell infiltration in the liver, and the expressions of hepatic inflammatory cytokines were significantly up regulated in the fish fed with OFO (P < 0.05). The fish in the OFO group showed abnormal yellow skin, and the yellowness value of the dorsal muscle was significantly elevated in comparison with the FFO group (P < 0.05). The contents of muscle protein, lipid, and glycogen were significantly declined by dietary OFO (P < 0.05). Dietary OFO affected the muscle essential amino acid (EAA) composition remarkably, among which the proportions of Ile and Met were reduced while Leu was promoted significantly (P < 0.05). The fish fed with OFO had significantly higher n-6 polyunsaturated fatty acids (PUFA) proportion and n-6 PUFA/n-3 PUFA ratio (P < 0.05) than the fish fed with FFO, but there were no changes in the proportion of saturated (SFA), monounsaturated fatty acid (MUFA) and n-3 PUFA (P > 0.05). The total free amino acid (FAA) was enhanced significantly by dietary OFO, but the delicious amino acid (DAA) proportion was decreased in the muscle of the fish fed with OFO (P < 0.05). In summary, dietary OFO had no significant influence on growth, but decreased feed utilization of Amur sturgeon. Dietary OFO impaired the health status of Amur sturgeon by inducing oxidative stress, lowering serum HDL-C, ALB and causing liver damage. Dietary OFO adversely affected the fillet quality of Amur sturgeon by altering body color, muscle proximate composition, glycogen content, EAA, fatty acid and FAA profiles.