Higher Total Cholesterol Levels Research Articles

Serum lipid profiles and uptake of lipid-lowering therapy in patients with premature atherosclerotic cardiovascular disease (ASCVD) in comparison to older patients with ASCVD

Abstract Background Serum lipid levels are well-established risk factors for developing atherosclerotic cardiovascular disease (ASCVD). There are multiple guideline-supported treatments for managing dyslipidaemia for secondary prevention of ASCVD events. Lipid profiles and uptake of guideline-directed lipid-lowering therapy (GDLLT) is poorly characterised in patients with premature ASCVD compared to their older counterparts. Purpose To investigate serum lipid profiles and GDLLT uptake in patients with premature ASCVD in comparison to older patients with ASCVD. Methods Consecutive patients who underwent inpatient invasive coronary angiography at our institution between January 2019-December 2021 were examined. Patients with confirmed ASCVD on coronary angiography were stratified into two groups based on the 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias definition of premature ASCVD: Group 1 comprised of younger patients (<55 years for men, <60 years for women) and Group 2 comprised of older patients (≥55 years for men, ≥60 years for women). Demographics, clinical and biochemical parameters (including lipid profiles) and medications were obtained from the electronic medical record and compared between groups to identify differences in risk factor profiles. Results A total of 1437 patients (980 [68.2%] male, mean age 62.4±13.9 years) underwent coronary angiography. 916 patients (63.7%) had confirmed ASCVD, of which 225 were classified as premature ASCVD (24.6%, mean age 47.8±10.1 years) vs 691 older patients with ASCVD (75.4%, mean age 69.5±8.7 years). Group 1 patients had significantly higher mean BMI (31.7±8.1 vs 69.5±8.7; p=0.001) and lower prevalence of hypertension (54.2% vs 69.5%; p<0.001) or chronic kidney disease (5.3% vs 12.6%; p=0.002) compared to Group 2. There were no significant differences in sex, diabetes mellitus, or smoking history. Lipid profiles were significantly different between the two groups: Group 1 had higher levels of total cholesterol (TC), LDL-C, triglycerides, and TC/HDL-C ratio, but lower HDL-C levels (all p<0.001). A lower proportion of Group 1 patients were on GDLLT (42.7% vs. 60.3%; p<0.001). Amongst patients on GDLLT, there were similar rates in the use of high-intensity statins between groups, but Group 1 patients were significantly more likely to have an LDL-C level ≥1.8mmol/L (p=0.003). Multivariable models for individual lipid subfractions, accounting for gender, cardiovascular risk factors, and LLT use, showed that all lipid parameters remained significantly different between groups (all p<0.001). Conclusion Patients with premature ASCVD have significantly different lipid profiles compared to older ASCVD patients. They also have lower uptake of guideline-directed LLT and are less likely to meet recommended LDL-C targets for high-risk ASCVD despite therapy. These findings highlight the need for tailored risk factor evaluation and management in this population.

Prevalence and associated factors of dyslipidemia in elderly people: Results from the Ardakan Cohort Study on Ageing, Iran.

Dyslipidemia is a major modifiable factor in elderly people. The study objective was to assess the prevalence and associated risk factors of dyslipidemia among the Iranian population aged over 50. This population-based cross-sectional study is part of the Iranian Longitudinal Study on Ageing conducted in Ardakan, Iran. In total, 5,197 participants aged over 50 years old were included through a stratified random sampling method. Dyslipidemia was defined in compliance with the Adult Treatment Panel III criteria. The Chi-square and independent sample t-test were used to compare categorical and quantitative variables, respectively. A logistic regression analysis was applied to determine associated factors of dyslipidemia. The mean age of the participants was 62.24±7.52. The prevalence of dyslipidemia was 68.85%. High levels of total cholesterol, triglyceride, low-density lipoprotein, and low level of high-density lipoprotein were seen among 9.74%, 24.66%, 5.54%, 19.20% of the participants, respectively. In addition, 66.05% of the study participants were under the treatment of lipid-lowering medications. Among the possible investigated risk factors of dyslipidemia, male gender (odds ratio (OR) = 0.56, 95% confidence interval (CI): 0.47, 0.68), waist circumference (OR = 1.03, 95%CI: 1.02, 1.04), diabetes mellitus (OR = 2.28, 95%CI: 1.96, 2.66), and hypertension (OR = 1.59, 95%CI: 1.38, 1.83) showed a statistically significant association (p<0.05). Dyslipidemia is highly prevalent in Ardakan's older population. So, lipid management interventions are necessary for this population.

Fatty Acid β-Oxidation May Be Associated with the Erythropoietin Resistance Index in Stable Patients Undergoing Haemodialysis.

Lipid metabolism and adiponectin modulate erythropoiesis in vitro and in general population studies and may also affect responsiveness to erythropoietin in patients undergoing haemodialysis (HD). However, little is known about the impact of lipid-associated biomarkers on reticulocyte production and erythropoietin resistance index (ERI) in patients undergoing HD. Therefore, we aimed to investigate their impacts in 167 stable patients undergoing HD. Pre-dialysis blood samples were collected and analysed for reticulocyte counts and serum lipid profiles by routine analyses and serum carnitine profiles (C0-C18) by LC-MS/MS. ERI was calculated as erythropoietin dose/kg/week normalized for haemoglobin levels. The independent positive determinants of reticulocyte count were log [Triglyceride (TG)] and logC18:1. A large proportion of longer-chain acylcarnitines was positively correlated with reticulocyte counts, possibly resulting from the accumulation of acylcarnitines in mitochondria undergoing fateful exocytosis from reticulocytes. These results indicate a possible association between reticulocyte formation and reduced β-oxidation, which occurs during the peripheral phase of erythroblast enucleation. Total cholesterol (TC) and log [C2/(C16 + C18:1)] as a putative marker of β-oxidation efficiency were negative independent determinants of ERI. Moreover, acyl chain length had a significantly positive impact on the correlation coefficients of individual acylcarnitines with ERI, suggesting that enhanced β-oxidation may be associated with reduced ERI. Finally, adiponectin had no independent association with reticulocyte counts or ERI despite its negative association with HDL-C levels. Enhanced fatty acid β-oxidation and higher TC levels may be associated with lower ERI, whereas higher TG levels and longer acylcarnitines may be related to the latest production of reticulocytes in stable patients undergoing HD.

Predictors in Youth of Adult Cardiovascular Events.

Childhood risk factors are associated with cardiovascular events in adulthood. We compared the utility of a risk model based solely on nonlaboratory risk factors in adolescence versus a model that additionally included lipids to predict cardiovascular events in adulthood. The study comprised 11 550 participants from 7 longitudinal cohort studies in the United States, Australia, and Finland with risk factor measurements in adolescence and followed into adulthood. The adolescent risk factors were defined by using clinical standards including overweight or obesity, elevated blood pressure, smoking, and borderline high or high levels of total cholesterol and triglycerides. The main outcomes were medically adjudicated fatal or nonfatal cardiovascular disease events occurring after age 25. Of 11 550 participants (55.1% female, mean age 50.0 ± 7.7 years), 513 (4.4%) had confirmed cardiovascular events. In a multivariable model (hazard ratio [95% confidence interval]), elevated blood pressure (1.25 [1.03-1.52]), overweight (1.76 [1.42-2.18]), obesity (2.19 [1.62-2.98]), smoking (1.63 [1.37-1.95]), and high total cholesterol (1.79 [1.39-2.31]) were predictors of cardiovascular events (P < .05). The addition of lipids (total cholesterol and triglycerides) into the nonlaboratory model (age, sex, blood pressure, BMI, and smoking) did not improve discrimination in predicting cardiovascular events (C-statistics for the lipid model 0.75 [SD 0.07] and nonlaboratory model 0.75 [0.07], P = .82). Nonlaboratory-based risk factors and lipids measured in adolescence independently predicted adult cardiovascular events. The addition of lipid measurements to nonlaboratory risk factors did not improve the prediction of cardiovascular events.

Associations of Blood Lipids with the Risk and Prognosis of Sudden Sensorineural Hearing Loss: A Meta-analysis.

Patients with sudden sensorineural hearing loss (SSNHL) may lose their hearing. The relationship between SSNHL and total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels is still unclear. The association of TC, TG, HDL-C, and LDL-C levels with the risk and prognosis of SSNHL was explored in this study. After searching for literature in different databases, 13 researches were used to summarize the risk and prognosis of SSNHL associations with TC, TG, HDL-C, and LDL-C using meta-analysis. Total cholesterol had a significant association with the risk of SSNHL (95% CI, 1.34-2.91). Adjustment for confounding factors and grouping criteria of TG were all significant sources of heterogeneity. One of the significant sources of heterogeneity in the LDL-C subgroup analyses was an adjustment for confounders. Sensitivity analysis revealed a robust association between TC and the risk of SSNHL. There was a significant publication bias in the association between TC and SSNHL prognosis High TC level is a risk factor for SSNHL.

Cardiometabolic factors and vitamin D deficiency in pediatric patients with chronic kidney disease.

Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular disease. Up to 80% of patients with CKD may exhibit inadequate vitamin D (VD) levels, which have been linked to the presence of cardiometabolic factors (CFs) in the adult population. However, research on this association in the pediatric population is limited. To analyze the effects of 25-hydroxyvitamin D3 (25-[OH]D) levels and status on the presence of CFs in children receiving kidney replacement therapy (KRT). This cross-sectional study included pediatric patients receiving KRT, aged 8-17 years, who were receiving hemodialysis or peritoneal dialysis from January 2021 to March 2024. We conducted anthropometric measurements, blood pressure assessments, and glucose, 25-(OH)D, and lipid profiling for all participants. The daily dose of cholecalciferol supplementation, as well as other medications affecting bone and lipid metabolism and antihypertensive drugs, were documented. Statistical analyses were performed using Student's t-tests and chi-square tests to compare the CFs between groups with and without VD deficiency. The study involved 156 patients with an average age of 12.9 years and a mean serum VD level of 22.5 ng/dL. Patients with VD deficiency presented higher levels of total cholesterol and diastolic blood pressure (p < 0.05). No statistically significant differences were found in other biochemical profile variables or in the frequency of cardiometabolic factors. Vitamin D deficiency seems to increase the risk of dyslipidemia and uncontrolled hypertension in children and adolescents with end-stage CKD.

Sex differences in the correlation between lipids related to cardiovascular risk factors and small dense LDL particles in patients with type 2 diabetes.

Sex differences in lipid metabolism associated with prevalent small dense (S-) low-density lipoprotein (LDL) cholesterol particles are not elucidated. An LDL to apolipoprotein B (ApoB) ratio < 1.2 can estimate how prevalent S-LDL particles are and, thus, reflect cardiovascular risk. The aim of this study was to evaluate the sex distribution of LDL/ApoB ratio among patients with type 2 diabetes (DM) and to assess, in both sexes, the correlations between key lipid parameters and LDL/ApoB < 1.2. The study included 190 Caucasian participants (mean age 51.8 ± 6.4 years) with DM (DM group) or without DM (control group) divided into subgroups according to sex. The participants were examined for levels of several lipid parameters, selected lipid-related oxidative stress markers, and estimated S-LDL prevalence. An LDL/ApoB < 1.2 (p < 0.05) was observed in 67% of male and female patients with DM. Although triglyceride levels did not differ between men and women, women had higher levels of total cholesterol (p < 0.05) and LDL cholesterol (p < 0.01) than men. Among women with LDL/ApoB < 1.2, strong correlations were observed between values of lipid hydroperoxides (LOOH) and atherogenic index of plasma (p < 0.005) and between levels of triglycerides and LOOH (p < 0.005) and ApoB (p < 0.0001). The findings indicate that women with LDL/ApoB < 1.2 tend to have a higher cardiovascular risk than men. Additionally, LDL/ApoB < 1.2 can be a surrogate marker for estimating the S-LDL prevalence in individuals with potentially increased cardiovascular risk.

High levels of blood lipid and glucose predict adverse prognosis in patients with aneurysmal subarachnoid hemorrhage

ObjectiveWe conducted a retrospective study on the prognostic factors of aneurysmal subarachnoid hemorrhage (aSAH) patients in the author's Hospital from January 2019 to May 2023. To discuss the association of the blood lipid and glucose levels of patients with the prognosis of aSAH, and verify that high blood lipid and glucose levels are important factors affecting adverse prognosis. MethodsAll patients with aSAH were collected as the case group, which was divided into two groups according to the modified Rankin Scores (mRS), the good prognosis group (Group A, mRS ＜ 3) and the adverse prognosis group (Group B,mRS ≥3). The clinical data of age, gender, accompanied chronic diseases (hypertension, diabetes), smoking, drinking, Glasgow Coma Scale (GCS), Hunt-Hess (H-H) grade, Modified Fisher grade, total cholesterol (TC) , triglyceride (TG) , high-density cholesterol lipoprotein (HDL-C) , low-density cholesterol lipoprotein (LDL-C) , blood glucose (BG) , responsible aneurysm diameter and location were recorded too. Correlations between blood lipid and glucose levels and Modified Fisher grade were assessed by the Spearman correlation analysis. The receiver operating characteristic (ROC) curve was utilized to evaluate the diagnostic efficacy. The effect of blood lipid and glucose levels on adverse prognosis was analyzed by Logistic regression models. ResultA total of 259 patients with aSAH were enrolled. The average age of all patients is (56.54 ± 10.52) years, including 96 males and 163 females. They were divided into Group A (n = 146) and Group B (n = 113). Univariate analysis results show that age, the levels of TC, TG, LDL-C, and BG were higher in Group B (P < 0.05). Besides, Group B had more severe GCS, H-H grade, and Modified Fisher grade than Group A, and a higher proportion of intracranial aneurysms with larger diameter (P < 0.05). Correlation analysis showed that TC, TG, LDL-C, and BG levels were positively correlated with Modified Fisher grade (P < 0.05) and H-H grade (P < 0.05). Multivariate logistic regression model analysis showed that high level of Modified Fisher grade (OR = 0.079, 95%CI: 0.027–0.230) , high level of H-H grade (OR = 0.204, 95%CI: 0.067–0.622) , TC (OR = 10.711, 95%CI: 2.457–46.700) , LDL-C (OR = 0.178, 95%CI: 0.039–0.823) and BG (OR = 1.273, 95%CI: 1.012–1.602) increased the risk of adverse prognosis. The AUC of “H-H grade”, “Modified Fisher grade”, “TC level”, “LDL-C level” and “BG level” was 0.822, 0.885, 0.860, 0.772, and 0.721, respectively, in the ROC curve. ConclusionModified Fisher grade, H-H grade, TC, LDL-C, and BG levels at admission were independent predictors of adverse prognosis of aSAH. Besides, TC, LDL-C, and BG levels were positively correlated with Modified Fisher grade and Hunt-Hess grade. What's more, high levels of TC, LDL-C, and BG combined with Modified Fisher grade and H-H grade can identify high-risk groups with adverse prognoses in aSAH patients.

Relationships between Serum Lipid, Uric Acid Levels and Mild Cognitive Impairment in Parkinson's Disease and Multiple System Atrophy.

Mild cognitive impairment is one of the non-motor symptoms in Parkinson's disease (PD) and multiple system atrophy (MSA). Few studies have previously been conducted on the correlation between serum uric acid (SUA) and lipid levels and mild cognitive impairment in PD and MSA. Participants included 149 patients with PD and 99 patients with MSA. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate cognitive function. Evaluations were conducted on SUA and lipid levels, which included triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC). Patients with PD and MSA diagnosed with mild cognitive impairment demonstrated multiple cognitive domain impairment when compared with patients with normal cognition. Attentional impairment was more pronounced in patients with MSA when compared with PD (p = 0.001). In PD, the risk of mild cognitive impairment was lower in the highest quartiles and secondary quartile of SUA than in the lowest quartiles (odds ratio [OR] = 0.281, 95% confidence intervals [CI]: 0.097-0.810, p = 0.019; and OR = 0.317, 95% CI: 0.110-0.911, p = 0.033). In MSA, the risk of mild cognitive impairment was lower in the third and highest quartile of SUA than in the lowest quartile (OR = 0.233, 95% CI: 0.063-0.868, p = 0.030; and OR = 0.218, 95% CI: 0.058-0.816, p = 0.024). In patients with PD, the MoCA scores were negatively correlated with TC levels (r = -0.226, p = 0.006) and positively correlated with SUA levels (r = 0.206, p = 0.012). In MSA, the MoCA scores were positively correlated with SUA levels (r = 0.353, p = 0.001). Lower SUA levels and higher TC levels are a possible risk factor for the risk and severity of mild cognitive impairment in PD. Lower SUA levels are a possible risk factor for the risk and severity of mild cognitive impairment in MSA.

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

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

Effect of intravenous methylprednisolone on serum antibody levels in thyroid eye disease

Background/aimsWe evaluated longitudinal autoantibody changes after intravenous methylprednisolone (IVMP), compared them with those in untreated patients and identified prognostic factors for treatment response.MethodsIn this single-centre, retrospective, observational study, a total...

Burden of noncommunicable diseases and COVID-19 pandemic prevention and control strategies

Noncommunicable diseases (NCDs) are the leading cause of death in 21st century. The risk factors for development and progression of NCDs include sedentary lifestyle, inadequate fruits and vegetables intake, tobacco use, high blood pressure, high total cholesterol levels, obesity, high salt intake, low physical activity, and air pollution. People with NCDs and comorbidities like hypertension, cardiovascular diseases, diabetes, chronic respiratory infection and cancer are more vulnerable to severe COVID-19 infection that ultimately results into mortality. To reduce the impact of NCDs on COVID-19 cases, prevention is the best measure. Primary and secondary level prevention of NCDs plays a main role to control bad outcome in COVID-19 cases. The strategies that are required to address this comorbidity includes integration and convergence of the existing communicable and NCD programs, strengthening health care systems by giving major focus on primary health care services, health and wellness centers, universal health coverage, updating guidelines, enhancing community participation, capacity building, appropriate policy making, multi-sectoral participation and coordination.

Associations of BMI growth rates and body composition with cardiometabolic risks in Chinese preschool children.

To examine the relationship between body mass index (BMI) growth rates, body composition, and cardiometabolic markers in preschool children. Three-year-old children were recruited for this cohort study. BMI and body composition measurements were obtained at enrollment, with multiple BMI measurements spanning ages 1 month to 3 years extracted from medical records. Levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-cholesterol (non-HDL-C), remnant cholesterol (RC), uric acid (UA), and fasting plasma glucose (FPG) were measured at 3 years. Data analyses employed piecewise linear mixed models and logistic regression models. Out of 3822 children recruited, 3015 were included in the analysis. The accelerated zBMI growth rate between 6 and 24 months was positively correlated with high TG and LDL-C levels, with sex, birthweight, and size-for-gestational age disparities. Obesity increased the risks of high TG level and the highest RC quartile in boys. Fat mass index (FMI) and percentage of fat mass (FM%) were linked with high UA level and dyslipidemia, particularly high TG and non-HDL-C levels, in boys. Fat-free mass index (FFMI) showed negative associations with high levels of TC and non-HDL-C in boys and high LDL-C level in girls (P<0.05). This study underscores the significant impact of BMI growth rates and body composition on cardiometabolic markers in 3-year-old children. The effects of BMI growth rates in specific periods varied by sex, birthweight, and size-for-gestational age, and boys exhibiting a higher susceptibility to adverse outcomes.

Gender difference in coronary artery disease

Background: Coronary artery disease (CAD) continues to exert a substantial impact on global health, being the main factor causing morbidity and mortality in North America and Europe. Men and women have different incidences of CAD and risk factors, which has been widely reported across populations. In light of a notable scarcity of studies examining the variation in CAD risk among different subgroups. We investigated how cholesterol, glucose, blood pressure, and age affect CAD risk in different sex and smoking groups. Method: Framingham Heart Study, a longest-running cardiovascular epidemiological investigation used furnishing valuable insights into CAD risk. Investigating the relationship between these characteristics and the occurrence of CHD involved using logistic regression. Result: For blood pressure variable among smoking group, there were significant increase in male group (=0.0255, P&lt;0.001) compared with non-smoking group (=0.0164 in male, =0.0162 among female group, P&lt;0.001) and reduction among female group (=0.0089, P&lt;0.001). Within the female group, the age variable exhibited a notable reduction in smoking group (=0.0460, P=0.0020) compared with the non-smoking group (=0.0829, P&lt;0.001). After adding the interactions between smoking and blood pressure, smoking and age. In the male group, both smoking and the interaction become insignificant, whereas in the female group the interaction is significant. Conclusion: Our study suggested that high level of glucose, total cholesterol and blood pressure increased the risk of CAD. By dividing into subgroup, we discovered that the combined presence of smoking and increased blood pressure, and of smoking and age could potentially exert a more adverse effect on pressure wave reflection in women compared to men.

Analysis of Waist-to-Hip Ratio with Total Cholesterol Levels in Obese and Non-Obese Employees at El Tari Airport Kupang

Increased cholesterol levels are one of the causes of obesity. One type of obesity is central obesity, characterized by the amount of accumulation of fat in the abdominal area. Waist-to-Hip Ratio (WHR) measurement is more potent than Body Mass Index (BMI) in predicting cardiovascular disease risk. WHR is also used to identity the occurrence of central obesity, which is a risk factor for elevated cholesterol levels. This study aimed to analyze the difference in total cholesterol levels in the group of normal and above normal WHR employees at El Tari Airport, Kupang. This study was an observational analytic type with the cross-sectional method and used venous blood samples to measure total cholesterol levels and WHR. Data analysis using independent sample t-test. The results of the independent sample t-test showed a significant difference in total cholesterol levels between obese employees (above normal WHR) and non-obese employees (normal WHR). The significance result is 0.027 (p &lt; 0.05) in the independent sample t-test. This indicates that WHR can be used to identify central obesity in a person and also person with above normal WHR tend to have high total cholesterol levels.

Enhanced atherosclerosis in apolipoprotein E knockout rabbits: role of apoB48-rich remnant lipoproteins.

Apolipoprotein E (apoE) acts as a binding molecule for both the low-density lipoprotein receptor and the lipoprotein receptor-related protein and this function is essential for facilitating the hepatocyte uptake of lipoproteins containing apoB. The absence of apoE leads to increased atherogenicity in both humans and mice, although the precise molecular mechanisms remain incompletely understood. This study aimed to investigate the susceptibility of apoE knockout (KO) rabbits, in comparison with wild-type (WT) rabbits, to diet-induced hyperlipidemia and atherosclerosis. ApoE KO rabbits and WT rabbits were fed a diet containing 0.3% cholesterol for 16 weeks. Plasma lipid levels, lipoproteins, and apolipoproteins were analyzed. Atherosclerosis was evaluated at the endpoint of experiments. In addition, we evaluated the oxidizability of those lipoproteins containing apoB to investigate the possible mechanisms of atherosclerosis. Male apoE KO rabbits showed significantly elevated levels of total cholesterol and triglycerides compared to WT rabbits, while female apoE KO rabbits displayed similar high total cholesterol levels, albeit with significantly higher triglycerides levels than WT controls. Notably, both male (2.1-fold increase) and female (1.6-fold increase) apoE KO rabbits exhibited a significantly augmented aortic lesion area compared to WT controls. Pathological examination showed that the increased intimal lesions in apoE KO rabbits were featured by heightened infiltration of macrophages (2.7-fold increase) and smooth muscle cells (2.5-fold increase). Furthermore, coronary atherosclerotic lesions were also increased by 1.3-fold in apoE KO rabbits. Lipoprotein analysis revealed that apoB48-rich beta-very-low-density lipoproteins were notably abundant in apoE KO rabbits, suggesting that these remnant lipoproteins of intestinal origin serve as the primary atherogenic lipoproteins. Moreover, apoB48-rich remnant lipoproteins isolated from apoE KO rabbits exhibited heightened susceptibility to copper-induced oxidation. The findings indicate that apoB48-rich remnant lipoproteins, resulting from apoE deficiency, possess greater atherogenic potential than apoB100-rich remnant lipoproteins, regardless of plasma TC levels.

Assessment of Factors Affecting Therapeutic Response of the DPP-4 Inhibitor Sitagliptin in A Sample of Iraqi Type 2 Diabetic Patients

Background: Type 2 diabetes is a complex and diverse disease, and the response to dipeptidyl peptidase-4 inhibitors may exhibit substantial variability between individuals. Several variables may play a role in variances in individual responses to treatment. Objective: The purpose of the research was to assess the degree to which Iraqi patients with type 2 diabetes responded to sitagliptin and to investigate the factors that contribute to sitagliptin's overall efficacy. Patients and methods: Eighty patients with type 2 diabetes who were using sitagliptin (100 mg per day) were included in this observational, cross-sectional study. Sociodemographic and patient clinical data were collected. Glycated hemoglobin (HbA1c), lipid profile parameters, and C-reactive protein were measured. Results: The response rate to sitagliptin was 43.8%. Smokers and hypertensive patients, in addition to those not on diet, had higher HbA1c levels with nearly significant p values than non-smokers, normotensive patients, and those on diet, respectively. Poor response patients had higher levels of total cholesterol and triglycerides. Conclusions: Possible variables that may have influenced the response to sitagliptin include smoking, hypertension, and an unhealthy diet. Furthermore, elevated levels of triglycerides may serve as an indicator of poor response.

Assessment of Cardiometabolic Risk Factors and Insulin Sensitivity by Hyperinsulinemic-Euglycemic Clamp in Resistance to Thyroid Hormone β Syndrome.

Background: Resistance to thyroid hormone beta (RTHβ) is a rare disease resulting from mutations in the THRB gene, characterized by reduced T3 action in tissues with high thyroid hormone receptor β expression. Thyroid hormones regulate body composition and metabolism in general, and increased or decreased hormone levels are associated with insulin resistance. This study evaluated the presence of cardiometabolic risk factors and insulin sensitivity in patients with RTHβ. Methods: In all, 16 patients, 8 adults (52.3 ± 16.3 years of age) and 8 children (10.9 ± 3.9 years of age), were compared to 28 control individuals matched for age, sex, and body mass index (BMI). Anthropometry evaluation and blood samples were collected for glycemia, lipids, insulin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), leptin, adiponectin, ultrasensitive C-reactive protein (CRPus), free thyroxine, total triiodothyronine, thyrotropin, and anti-thyroid peroxidase measurements. Body composition was assessed using dual-emission X-ray absorptiometry and bioimpedance. Insulin sensitivity was evaluated in adult patients and controls using the hyperinsulinemic-euglycemic clamp (HEC), whereas homeostasis model assessment of insulin resistance (HOMA-IR) was calculated in all individuals studied. Results: Patients and controls presented similar weight, BMI, abdominal perimeter, and total fat body mass. Patients with RTHβ demonstrated higher total cholesterol (TC), p = 0.04, and low-density lipoprotein cholesterol (LDL-C), p = 0.03, but no alteration was observed in other parameters associated with metabolic risk, such as leptin, TNF-α, and CRPus. Two adult patients met the criteria for metabolic syndrome. There was no evidence of insulin resistance assessed by HEC or HOMA-IR. Elevated IL-6 levels were observed in patients with RTHβ. Conclusion: Using HEC as the gold standard method, no evidence of reduced insulin sensitivity in skeletal muscle was documented in RTHβ adult patients; however, higher levels of TC and LDL-C were observed in these patients, which suggest the need for active monitoring of this abnormality to minimize cardiometabolic risk. In addition, we demonstrated, for the first time, that the increase in IL-6 levels in patients with RTHβ is probably secondary to metabolic causes as they have normal levels of TNF-α and CRPus, which may contribute to an increase in cardiovascular risk. A larger number of patients must be studied to confirm these results.

Correlation between estradiol-to-testosterone ratio and thyroid peroxidase antibody positivity in men with treatment-naïve primary hypothyroidism or euthyroidism.

Thyroid diseases pose a substantial socioeconomic burden globally. The aim of this study was to evaluate the correlation between estradiol-to-testosterone (E2/T) ratio and thyroid peroxidase antibody (TPOAb) positivity in male patients with hypothyroidism or euthyroidism. Cross-sectional observational study including 115 male patients with hypothyroidism or euthyroidism. The patients were divided into two groups based on positive or negative TPOAb results, with TPOAb positivity defined by a serum TPOAb value ≥ 35 IU/mL. Patients with positive TPOAbs, compared with those with negative TPOAbs, had a higher prevalence of goiter and obesity and higher levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol. The median estradiol level was higher, and the median total testosterone and sex-hormone binding globulin (SHBG) levels were lower in the TPOAb-positive versus the TPOAb-negative group (p < 0.001). In subgroup analysis including only patients with hypothyroidism (n = 80), the median E2/T ratio was higher in the TPOAb-positive group (p = 0.016). The prevalence of TPOAb positivity increased with the increase in E2/T ratio quartiles, from 37.9% in the lowest quartile to 96.2% in the highest quartile (p value for trend across all quartiles < 0.001). On adjusted multivariate analysis, the E2/T ratio emerged as an independent predictor of TPOAb positivity. An E2/T ratio cutoff value of 6.565 x10-3 demonstrated the best diagnostic accuracy, with a sensitivity of 78.2% and specificity of 67.6%. The present study provides insights into the role of the E2/T ratio as a predictor of thyroid disorders.

Effect of vitamin D deficiency on uric acid/HDL cholesterol ratio

Aims: It has been suggested that vitamin D deficiency is involved in the etiology of cardiovascular diseases. High uric acid and low HDL cholesterol levels are critical risk factors for cardiovascular diseases. High uric acid levels, high total cholesterol and triglyceride levels, and low HDL-C levels are often encountered in cases with vitamin D deficiency. Our study aimed to investigate the relationship between vitamin D levels and uric acid /HDL-C (UHR) and plasma atherogenic index (PAI, triglyceride /HDL-C) in patients with vitamin D deficiency. Methods: This retrospective study included patients whose vitamin D levels were checked in our clinic. The subjects were divided into two groups according to their vitamin D levels and the relationship between laboratory variables, such as uric acid, HDL cholesterol, UHR, and plasma atherogenic index, was examined. Results: A total of 675 patients, 167 (24.7%) males and 508 (75.3%) females, were included in the study. The mean age of the patients was 53.6±15.2 years. It was found that patients with vitamin D deficiency had high UHR and PAI levels and low HDL-C levels (p=0.001, p=0.025; p=0.032, p=0.016). Conclusion Our results suggest that vitamin D deficiency has a positive correlation with HDL cholesterol levels and an impact on the risk of cardiovascular diseases by increasing the uric acid/HDL ratio and plasma atherogenic index.