Hypertriglyceridemia Group Research Articles

Cumulative effects of hypertriglyceridemia in HIV-infected patients switching from NNRTIs to PI-based antiretroviral therapy.

The objective of this study was to investigate changes in serum lipids among HIV-infected patients switching from non-nucleoside-reverse transcriptase inhibitors (NNRTI) to protease inhibitor (PI)-based highly active antiretroviral therapy (HAART), and to determine if changes of lipid profiles impacted the monocyte subsets recovery. Fifty-seven subjects who switched from NNRTIs to PI-based HAART (NNRTIs to PI group) and fifty-five subjects who initially started with PI-based HAART (initial PI group) were recruited. According to their baseline triglyceride (TG) levels, the NNRTIs to PI and initial PI groups were further divided into non-hypertriglyceridemia and hypertriglyceridemia subgroups, respectively. The effects of PI-based HAART on lipid profiles and monocyte subsets were analyzed. At 48 weeks, the TG changes in the NNRTIs to PI group was higher than that of the initial PI group. The increases of serum TG levels in the initial PI non-hypertriglyceridemia group was greater than that of the NNRTIs to PI non-hypertriglyceridemia group. For the hypertriglyceridemia group at baseline, significant increment in TG levels were observed in the NNRTIs to PI hypertriglyceridemia group. The percentages of circulating CD14highCD16+ and CD14lowCD16+ subsets were elevated in the two groups. At 48 weeks, the proportion of CD14highCD16+ monocytes declined gradually, and the proportion of CD14lowCD16+ monocytes decreased independently of the TG level. For non-hypertriglyceridemia individuals at baseline, PI-based regimens increased the TG level in the initial PI group. For the NNRTIs to PI hypertriglyceridemia group, PI-based regimens reinforced HAART-related hypertriglyceridemia.

POS-118 Hypertriglyceridemia is related to glomerulosclerosis in IgA Nephropathy

Hypertriglyceridemia (HTG) is one factor contributing to atherosclerosis and is a common complication of renal failure. HTG is a significant risk factor for decreased renal function in patients with IgAN. Dyslipidemia causes glomerulosclerosis, and promotes endothelial and mesangial proliferation. Previous study showed that HTG was significant risk factor of decreased renal function in patient with IgA nephropathy. In this study, we aim to evaluate histopathologic features in IgAN between HTG group compared to normal TG group.

S106 Acute Pancreatitis from Hypertriglyceridemia Is More Severe and Associated with Longer Length of Stay

Introduction: Hypertriglyceridemia (HTG) is a relatively uncommon cause of Acute Pancreatitis (AP) representing <10% of cases. Studies comparing outcomes of HTG-AP with other causes of AP have yielded inconsistent results, likely due in part to non-standardized AP management, which lead to varied outcomes and prognosis in HTG-AP patients. This study aimed to investigate the clinical characteristics and outcomes of patients admitted with HTG-AP versus AP from other etiologies. Methods: This single-center study compared the clinical course and outcomes of AP patients from January 2015 to August 2020. All of the patients presenting with AP were diagnosed and managed according to a standardized protocol (Methodist Acute Pancreatitis Protocol) which is comprised of computer physician orders (e.g. fluid resuscitation, enteral feeding), physician and nursing education, and a patient navigator to optimize adherence to AP published guidelines (APPG). Measured outcomes included length of stay (LOS), in-patient mortality, 30-day readmission, and final pancreatitis severity characterized as mild, moderately severe, or severe as defined by the APPG. Fisher's exact test and Wilcoxon rank-sum (Mann-Whitney) tests were used for statistical analyses. Results: Data from 42 patients admitted with HTG-AP and 243 patients with non-HTG-AP were analyzed (Table 1). The mean age (SD) was 39.95 (± 10.95) years for the HTG-AP group and 50.55 (± 17.78) years for the non-HTG-AP group (P=0.0003). The mean LOS was 7.74 (± 11.54) days for the HTG-AP group and 4.20 (± 4.16) days for the non-HTG-AP group (P=0.0014). Also, 9.52% of the HTG-AP group and 2.88% of the non-HTG-AP group had severe pancreatitis. The odds of having moderately severe and severe pancreatitis were higher than mild AP in the HTG group compared to that in the non-HTG group. The difference in mortality between the HTG-AP group (0%) and non-HTG-AP group (1.65%) was not statistically significant (P=1.000). Thirty-day readmission rates were 7.14% for the HTG-AP group and 2.93% for the non-HTG-AP group (P=0.175). Conclusion: The HTG-AP group had a longer LOS and higher pancreatitis severity compared to the non-HTG-AP group, despite the fact that all patients were managed with a standardized early medical management protocol. These findings suggest a need to improve risk stratification based on AP etiology and identify opportunities to improve management of HTG-AP.Table 1.: Differences in demographics and outcomes between patients with hypertriglyceridemia acute pancreatitis and acute pancreatitis from other etiologies.

Determination of the Optimal Cutoff Value of Triglyceride That Corresponds to Fasting Levels in Chinese Subjects With Marked Hypertriglyceridemia

The level of triglyceride (TG) ≥ 2. 3 mmol/L is suggestive of marked hypertriglyceridemia (HTG) and requires treatment with a triglyceride-lowering agent in high-risk and very high-risk patients as recommended by the 2019 ESC/EAS guidelines for the management of dyslipidemia. However, the optimal cutoff value required to diagnose non-fasting HTG that corresponds to the fasting goal level of 2.3 mmol/L in Chinese subjects is unknown. This study enrolled 602 cardiology inpatients. Blood lipid levels, including calculated non-high-density lipoprotein cholesterol (non-HDL-C) and remnant cholesterol (RC), were measured at 0, 2, and 4 h after a daily Chinese breakfast. Of these, 482 inpatients had TG levels of <2.3 mmol/L (CON group) and 120 inpatients had TG levels of ≥2.3 mmol/L (HTG group). Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values for postprandial HTG that corresponded to a target fasting level of 2.3 mmol/L. Marked hypertriglyceridemia (≥2.3 mmol/L) was found in 120 (19.9%) patients in this study population. The levels of non-fasting TG and RC increased significantly in both groups and reached the peak at 4 h after a daily meal, especially in the HTG group (p < 0.05). The optimal cutoff value of TG at 4 h, which corresponds to fasting TG of ≥2.3 mmol/L, that can be used to predict HTG, was 2.66 mmol/L. According to the new non-fasting cutoff value, the incidence of non-fasting HTG is close to its fasting level. In summary, this is the first study to determine the non-fasting cutoff value that corresponds to a fasting TG of ≥2.3 mmol/L in Chinese patients. Additionally, 2.66 mmol/l at 4 h after a daily meal could be an appropriate cutoff value that can be used to detect non-fasting marked HTG in Chinese subjects.

Hypertriglyceridemia Is Associated with More Severe Histological Glomerulosclerosis in IgA Nephropathy

IgA nephropathy (IgAN) is a globally well-known primary glomerular nephropathy. Hypertriglyceridemia (HTG) is one factor contributing to atherosclerosis and is a common complication of renal failure. HTG is a significant risk factor for decreased renal function in patients with IgAN. We evaluated the association of HTG with the histopathological features of IgAN patients. A total of 480 patients diagnosed with IgAN via kidney biopsy from eight university hospitals affiliated with the College of Medicine of the Catholic University of Korea were included in the final cohort. Pathological features were evaluated by eight expert pathologists with hospital consensus. HTG was defined as a serum triglyceride (TG) level of ≥150 mg/dL. In the study population analysis, the HTG group was older, with more males; higher body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) and spot urine protein ratio; and lower estimated glomerular filtration rate (eGFR). In the lipid profile analysis, eGFR was negatively correlated with TGs/ high-density lipoprotein cholesterol (HDL) and triglyceride-glucose index (TyG). Proteinuria positively correlated with TGs/HDL, non-HDL/HDL, LDL/HDL, TyG, TGs and LDL. The percentages of global sclerosis (GS), segmental sclerosis (SS) and capsular adhesion (CA), and the scores for mesangial matrix expansion (MME) and mesangial cell proliferation (MCP), were more elevated in the HTG group compared to the normal TG group. Multivariable linear regression analysis showed that the percentages of global sclerosis, segmental sclerosis and capsular adhesion, as well as the scores for mesangial matrix expansion and mesangial cell proliferation, were positively associated with TG level. In binary logistic regression, the HTG group showed a higher risk for global sclerosis and segmental sclerosis. In conclusion, HTG is a significant risk factor for glomerulosclerosis in IgAN.

ANGPTL3 and ANGPTL8 in Thai subjects with hyperalphalipoproteinemia and severe hypertriglyceridemia

BackgroundThe role of ANGPTL3 and ANGPTL8 in lipid regulation in patients with very high levels of HDL-cholesterol and triglyceride is unknown. ObjectiveWe examined plasma levels of ANGPTL3 and ANGPTL8 in subjects with hyperalphalipoproteinemia (HALP) and in those with severe hypertriglyceridemia (HTG). MethodsPlasma ANGPTL3 and ANGPTL8 levels were measured by ELISA in 320 subjects, consisting of HALP subjects with HDL-cholesterol ≥100 mg/dl (n=90) and healthy controls (n=90) and subjects with triglyceride ≥886 mg/dl (n=89) and control subjects (n=51). ResultsThe mean plasma ANGPTL3 level was significantly higher in the HALP group compared to that of the controls (297 ± 112 ng/mL vs. 230 ± 100 ng/mL, p<0.001). Similarly, the mean plasma ANGPTL8 level was also higher in the HALP group (30 ± 11 ng/mL vs. 20 ± 8 ng/mL, p<0.001). Both ANGPTL3 and ANGPTL8 levels positively correlated with HDL-cholesterol levels. In the severe HTG group, plasma ANGPTL3 level was significantly higher than those in the control group (223 ± 105 ng/mL vs. 151 ± 60 ng/mL, p<0.001), but not ANGPTL8 (23 ± 20 ng/mL vs. 31 ± 23 ng/mL in controls, p=0.028). Only ANGPTL3, but not ANGPTL8, levels positively correlated with triglyceride levels. ConclusionPlasma level of ANGPTL3 was increased in both HALP and severe HTG whereas an increase in plasma level of ANGPTL8 was found only in HALP, and not in severe HTG, suggesting that both ANGPTL3 and ANGPTL8 might play distinct roles in lipid regulation on these two extremes of dyslipidemia.

Development of Metabolic Syndrome Decreases Bone Mineral Density T-Score of Calcaneus in Foot in a Large Taiwanese Population Follow-Up Study.

Studies have suggested that there may be common pathogenic pathways linking osteoporosis and metabolic syndrome (MetS) due to the multiple risk factors for atherosclerotic cardiovascular disease caused by MetS. However, results on the association between MetS and bone health are inconsistent and sometimes contradictory. In this study, we aimed to investigate the associations between the effects of MetS risk factors and bone mineral density (BMD) T-score in a longitudinal study of 27,033 participants from the Taiwan Biobank with a follow-up period of 4 years. BMD of the calcaneus was measured in the non-dominant foot using ultrasound in the Taiwanese population. The overall prevalence rates of MetS were 16.7% (baseline) and 21.2% (follow-up). The participants were stratified into four groups according to the status of MetS (no/yes at baseline and follow-up). We investigated associations between MetS and its five components (baseline, follow-up) with BMD ΔT-score and found that the (no, yes) MetS group, (no, yes) abdominal obesity group, (no, yes) hypertriglyceridemia group, and (no, yes) low high-density lipoprotein (HDL) cholesterol group had the lowest ΔT-score. Furthermore, in the (no, yes) MetS group, high Δwaist circumference (p = 0.009), high Δtriglycerides (p = 0.004), low ΔHDL cholesterol (p = 0.034), and low Δsystolic blood pressure (p = 0.020) were significantly associated with low ΔT-score, but Δfasting glucose was not. In conclusion, in this large population-based cohort study, our data provide evidence that the development of MetS is strongly associated with increased rates of BMD loss in the Taiwanese population. This suggests that the prevention of MetS should be taken into consideration in the prevention of osteoporosis in the Taiwanese population.

Hyperuricemia and hypertriglyceridemia indicate tubular atrophy/interstitial fibrosis in patients with IgA nephropathy and membranous nephropathy.

Hyperuricemia (HUA) and hypertriglyceridemia (HTG) were very common in chronic kidney disease (CKD) and associated with accelerated progression of CKD. This was a retrospective, cross-sectional study which aimed to explore the relationship between serum uric acid levels or triglyceride levels and tubular atrophy/interstitial fibrosis (proven by renal biopsy). The present study enrolled 229 CKD individuals who included 127 biopsy-proven primary IgA nephrology (IgAN) patients and 102 biopsy-proven primary membranous nephropathy (MN) patients. The baseline characteristics at the time of the kidney biopsy were collected. According to the serum uric acid (UA) or triglyceride (TG) whether it exceeds the normal reference range, patients were divided into non-HUA (n = 127), HUA (n = 102), non-HTG (n = 119), and HTG group (n = 110). Based on the extent of tubular atrophy/interstitial fibrosis, patients were divided into no/mild injury (T0, n = 127), moderate injury (T1, n = 102). Multivariable logistic regression for factors predicting moderatetubular atrophy/interstitial fibrosis was performed. There were 127 IgAN and 102 MN cases among 229 patients in the present study. The prevalence of HUA was 44.5% (n = 102), 40.9% (n = 52), and 49.0% (n = 50) in all patients, IgAN patients and MN patients, respectively (P = 1.49). The prevalence of HTG was 48.0% (n = 110), 29.9% (n = 38), and 70.6% (n = 72) (P < 0.001), respectively, as well. Multivariate logistic regression analysis showed that HUA and HTG were independent risk factors for moderatetubular atrophy/interstitial fibrosis (HUA OR = 2.335, 95% CI = 1.147-4.755, P = 0.019; HTG OR = 2.646, 95% CI = 1.289-5.432, P = 0.008). The area under curve (AUC) of model 1 (HUA + eGFR + HTG + age + serum globulin + 24h urinary protein, AUC = 0.876) was larger than the other two models; however, there was no significant difference among these models (all P > 0.05). Hyperuricemia and hypertriglyceridemia, which were prevalent in CKD patients, were the independent risk factors for moderatetubular atrophy/interstitial fibrosis. HUA together with HTG could improve the value of diagnosis for moderatetubular atrophy/interstitial fibrosis to some extent.

Plasma glycerol levels in men with hypertriglyceridemia

When plasma triglyceride is assessed in standard laboratories, it is a measurement of plasma glycerol after hydrolysis of triglycerides into fatty acids and glycerol. In most patients, the plasma level of free glycerol will only marginally influence the measurement of plasma triglyceride. However, in rare cases elevated free glycerol concentrations causes pseudohypertriglyceridemia and blanking for free glycerol becomes important. In this study, we investigated the plasma free glycerol level in 100 adult men with mild to moderate hypertriglyceridemia to assess the need for providing a free glycerol measurement in our clinical biochemistry department. The plasma samples were obtained in our blood sampling facility that receives both in- and outpatients. The highest plasma level of free glycerol observed was 300 µmol/L and in 99% of the investigated men the inclusion of plasma free glycerol in the measurement of plasma triglyceride cause a less than 10% false increase in plasma triglyceride. A weak positive correlation between the plasma levels of free glycerol and triglyceride was observed. When subdividing the cohort into mild and moderate hypertriglyceridemia, the positive correlation was only maintained in the moderate hypertriglyceridemia group that also demonstrated a 23% higher plasma glycerol level than men with mild hypertriglyceridemia. We conclude that even though glycerol blanking is relevant in rare occasions, then this study does not support providing such a measurement in our department. The positive correlation between free glycerol and triglyceride in this cohort likely reflects a shared association with metabolic dysregulation.

High Body Mass Index and Triglycerides Help Protect against Osteoporosis in Patients with Type 2 Diabetes Mellitus.

Purpose This study was conducted to investigate whether high body mass index (BMI) and triglycerides (TGs) were protective factors for reducing osteoporosis (OP) in patients with type 2 diabetes mellitus (T2DM). Participants and Methods. Seventy-nine patients (aged 20 to 81) with T2DM were included in the study. Basic information and blood indicators were collected. Bone mineral density was used to diagnose OP. Participants were grouped according to BMI (normal weight vs. overweight/obese participants), TG (normal TG vs. hypertriglyceridemia), and OP (non-OP vs. OP), and differences were compared between groups. Regression analysis was used to explore whether BMI or TG were independent factors affecting OP. Results The proportions of OP in the overweight/obese and hypertriglyceridemic groups were significantly lower than those in the normal weight (30.0% vs. 69.0%; P = 0.001) and normal TG (27.3% vs. 56.5%; P = 0.010) groups. In the OP group, the BMI (24.8 ± 3.4 vs. 26.6 ± 2.5 kg/m2; P = 0.009) was significantly lower than that in the non-OP group, and TG showed the same trend (1.30 (0.81) vs. 1.71 (1.1) mmol/L; P = 0.020). Logistic regression in the crude model showed that the odds ratios (ORs) of OP in the overweight/obese and hypertriglyceridemic groups were 0.193 (95% CI: 0.071, 0.520) and 0.315 (95% CI: 0.119, 0.830) compared with those of the normal weight and normal TG groups. After adjusting for sex and smoking, the ORs were 0.204 (95% CI: 0.074, 0.567) and 0.242 (95% CI: 0.082, 0.709) for the overweight/obese and hypertriglyceridemic groups, respectively. After adjusting for all confounding factors, the ORs for these groups were 0.248 (95% CI: 0.083, 0.746) and 0.299 (95% CI: 0.091, 0.989), respectively. Conclusion BMI and TG are independent protective factors against OP in patients with T2DM.

The Effect of Sex Differences on Endothelial Function and Circulating Endothelial Progenitor Cells in Hypertriglyceridemia.

Background Men have a higher risk and earlier onset of cardiovascular diseases compared with premenopausal women. Hypertriglyceridemia is an independent risk factor for the occurrence of ischemic heart disease. Endothelial dysfunction is related to the development of ischemic heart disease. Whether sex differences will affect the circulating endothelial progenitor cells (EPCs) and endothelial function in hypertriglyceridemia patients or not is not clear. Methods Forty premenopausal women and forty age- and body mass index (BMI)-matched men without cardiovascular and metabolic disease were recruited and then divided into four groups: normotriglyceridemic women (women with serum triglycerides level <150 mg/dl), hypertriglyceridemic women (women with serum triglycerides level ≥150 mg/dl), normotriglyceridemic men (men with serum triglycerides level <150 mg/dl), and hypertriglyceridemic men (men with serum triglycerides level ≥150 mg/dl). Peripheral blood was obtained and evaluated. Flow-mediated dilatation (FMD), the number and activity of circulating EPCs, and the levels of nitric oxide (NO), vascular endothelial growth factor (VEGF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) in plasma and culture medium were measured. Results The number and activity of circulating EPCs, as well as the level of NO in plasma or culture medium, were remarkably increased in premenopausal females compared with those in males both in the hypertriglyceridemic group and the normotriglyceridemic group. The EPC counts and activity, as well as the production of NO, were restored in hypertriglyceridemic premenopausal women compared with those in normal women. However, in hypertriglyceridemic men, the EPC counts and activity, as well as levels of NO, were significantly reduced. The values of VEGF and GM-CSF were without statistical change. Conclusions The present study firstly demonstrated that there were sex differences in the number and activity of circulating EPCs in hyperglyceridemia patients. Hypertriglyceridemic premenopausal women displayed restored endothelial functions, with elevated NO production, probably mediated by estradiol. We provided a new insight to explore the clinical biomarkers and therapeutic strategies for hypertriglyceridemia-related vascular damage.

Hypertriglyceridemia-induced brain-derived neurotrophic factor in rat submandibular glands

ObjectivesSalivary glands produce brain-derived neurotrophic factor (BDNF), which increases plasma BDNF content. Salivary BDNF influences the hippocampus and enhances anxiety-like behaviors. Dyslipidemia affects the brain, promoting depression and anxiety-like behaviors. This study was performed to investigate whether hypertriglyceridemia influences salivary BDNF expression. MethodsHypertriglyceridemia was induced in rats by high-fat diet intake for 10 weeks. BDNF protein levels in the saliva and submandibular glands were measured using enzyme-linked immunosorbent assay (ELISA). Bdnf mRNA levels in the submandibular gland were determined using real-time polymerase chain reaction. ResultsA hypertriglyceridemia rat model was established. Body weight did not differ between the control and hypertriglyceridemia groups. Bdnf mRNA and protein expression was increased in the submandibular gland in the hypertriglyceridemia group compared to the control group. BDNF expression was also significantly increased in the saliva of the hypertriglyceridemia group. ConclusionsThis is first study to show that hypertriglyceridemia induces BDNF expression in the rat submandibular gland and suggests that salivary BDNF is associated with lipid metabolism.

The triglyceride-lowering effects of PCSK9 inhibitor differ in patients with different baseline triglyceride levels

To investigate the triglyceride (TG)-lowering effects of PCSK9 inhibitor in patients with in different baseline triglyceride levels. Between February, 2019 and March, 2020, a total of 59 patients were treated with PCSK9 inhibitor (Evolocumab) in 5 hospitals, including Nanfang Hospital, Guangdong Provincial People's Hospital, First Affiliated Hospital of Sun Yat-sen University, Foshan Nanhai District People's Hospital and Yulin First People's Hospital. According to baseline triglyceride levels, the patients were divided into normal TG group (&lt; 1.70 mmol/L, n=24), mild hypertriglyceridemia group (1.70-2.29 mmol/L, n=11), moderate hypertriglyceridemia group (2.30-5.63 mmol/L, n=13), and severe hypertriglyceridemia group (≥5.64 mmol/L, n=11), and the changes in TG level after the treatment were compared among the 4 groups. In the groups with normal and mildly elevated baseline TG level, the patients did not show significant changes in TG levels after the treatment. In patients with moderately and severely elevated baseline TG levels, treatment with PCSK9 inhibitor significantly reduced their TG levels (P &lt; 0.005). PCSK9 inhibitor has a significant TG-lowering effect in patients with moderate to severe hypertriglyceridemia but not in patients with only mildly elevated baseline TG level.

Major Lipids, Apolipoproteins, and Alterations of Gut Microbiota.

The gut microbiota has been linked to blood lipids. However, the relationship between the gut microbiome and other lipid markers like apolipoproteins A1 (apoA1) and B (apoB) as well as classical lipid markers in Asians remain unclear. Here, we examined the associations between gut microbial diversity and taxonomic compositions with both apolipoproteins and lipid markers in a large number of Korean patients. The fecal 16S rRNA gene sequencing data from 1141 subjects were analyzed and subjects were categorized into control group (G0) or abnormal group (G1) according to blood lipid measurements. The microbial diversity and several taxa of the gut microbiota were significantly associated with triglyceride, apoA1, and apoB levels, but not with total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels. The alpha diversity of the gut microbiota was inversely associated with high triglyceride level. Interestingly, G1 of apoA1 showed increased microbial richness and distinct microbial community compared with G0 of apoA1. A high abundance of Fusobacteria and low abundance of Oscillospira were found in the hypertriglyceridemia group. In this large-scale study, we identified associations of gut microbiota with apolipoproteins and classical lipid markers, indicating that the gut microbiota may be an important target for regulating blood lipids.

The role of hypertriglyceridemia and treatment patterns in the progression of IgA nephropathy with a high proportion of global glomerulosclerosis.

Many studies have focused on finding predictors for mild IgAN progression. However, the cases of severe IgAN with a high proportion of global glomerulosclerosis have received inadequate attention. A group of 172 primary IgAN patients with 50-75% global glomerulosclerosis was studied retrospectively between April 2007 and October 2017. Patients were divided into three groups according to the serum triglyceride tertiles: < 1.42µmol/L (Group 1), 1.42-2.29µmol/L (Group 2), and > 2.29µmol/L (Group 3). Groups 1 and 2 comprised non-hypertriglyceridemia subjects, while Group 3 was defined as the hypertriglyceridemia (HTG) group. The patients were followed for 4-96months (median 39.43months). The study end point was defined as a 50% decline in estimated glomerular filtration rate (eGFR) or ESRD. A high proportion of global glomerulosclerosis is not absolutely correlated with severe clinical features and poor renal outcome. In our retrospective observation, eGFR decreased by less than 10% of the baseline during follow-up in 43.6% of the patients. However, in our patients with HTG, the cumulative renal survival rate was significantly lower compared to those without HTG. Multivariate Cox regression analysis also showed that triglyceride is an independent predictor of poor renal outcomes. Furthermore, in the HTG group, the cumulative renal survival rates were higher in patients treated with Tripterygium wilfordii Hook F (TwHF) compared to those without TwHF. A high proportion of global glomerulosclerosis combined with HTG at biopsy have better predictive validity for the disease progression of IgAN than global glomerulosclerosis alone. TwHF may partially affect the renal outcome of severe IgAN with HTG, and this may relate to its regulation of lipid metabolism and immunoinflammatory response.

The Gene Score for Predicting Hypertriglyceridemia: New Insights from a Czech Case-Control Study.

Plasma triglyceride (TG) values are significant predictors of cardiovascular and total mortality. The plasma levels of TGs have an important genetic background. We analyzed whether 32 single nucleotide polymorphisms (SNPs) identified in genome-wide association studies are discriminators of hypertriglyceridemia (HTG) in the Czech population. The objective of this study was to replicate and test the original findings in an independent study and to re-analyze the gene score leading to HTG. In total, we analyzed 32 SNPs in 209 patients with plasma TG levels over 10mmol/L (HTG group) and compared them in a case-control design with 524 treatment-naïve controls (normotriglyceridemic [NTG] group) with plasma TG values below 1.8mmol/L. Sixteen SNPs were significantly associated with an increased risk of HTG development, with odds ratios (ORs) (95% confidence interval [CI]) varying from 1.40 (1.01-1.95) to 4.69 (3.29-6.68) (rs964184 within the APOA5 gene). Both unweighted (sum of the risk alleles) and weighted gene scores (WGS) (log of the achieved ORs per individual genotype) were calculated, and both gene scores were significantly different between groups. The mean score of the risk alleles was significantly increased in the HTG group compared to the NTG group (18.5 ± 2.5 vs. 15.7 ± 2.3, respectively; P < 0.00001). Subjects with a WGS over 9 were significantly more common in the HTG group (44.5%) than in the NTG group, in which such a high score was observed in only 4.7% of subjects (OR 16.3, 95% CI 10.0-36.7; P < 0.0000001). An increased number of risk genetic variants, calculated both in a weighted or unweighted manner, significantly discriminates between the subjects with HTG and controls. Population-specific sets of SNPs included into the gene score seem to yield better discrimination power.

Association of elevated serum triglyceride levels with a more severe course of acute pancreatitis: Cohort analysis of 1457 patients

BackgroundPrevious publications have reported an association between hypertriglyceridemia (HTG) and severity of acute pancreatitis, but this relationship remains somewhat controversial. ObjectiveTo evaluate the outcome of acute pancreatitis according to serum triglyceride levels on admission. MethodsRetrospective analysis of prospectively collected data, which included all consecutive cases of acute pancreatitis admitted to a tertiary hospital (January 2002–December 2014). Acute pancreatitis patients were classified into 3 groups based on serum triglyceride levels (mg/dl) measured within 48 h from admission: normal triglycerides-mild HTG (<200); moderate HTG (200–749); severe HTG (≥750). Primary outcomes were the difference in organ failure, pancreatic necrosis, acute peripancreatic collections and mortality among the three groups. ResultsA total of 1,457 cases were included: 1,335 with normal-mild HTG, 77 with moderate HTG and 45 with severe HTG. The rates of organ failure (11.2% in normal-mild HTG group, 15.6% in moderate HTG and 20.0% in severe HTG), persistent multiple organ failure (2.5% vs. 5.2% vs. 6.7%), pancreatic necrosis (9.2% vs. 14.3% vs. 26.7%) and acute collections (21.6% vs. 40.3% vs. 55.6%) increased significantly with hypertriglyceridemia severity grades. On multivariate analysis, triglycerides as a quantitative variable, evaluated in increments of 100 mg/dl, was independently associated with organ failure, pancreatic necrosis, acute collections and mortality (p < 0.05). ConclusionsElevated serum triglyceride levels are independently associated with a more severe course of pancreatitis. It must be highlighted the elevated frequency of local complications in patients with HTG that increases proportionally and significantly with HTG severity grades.

High Fiber Diet Suppression of TLR4 and NFκβ Gene Expression Correlated with TNF-α and IL-6 Levels in Hypertriglyceridemia Rats

Hypertriglyceridemia causes hypoxia and increases the release of free fatty acids in adipose tissue through lipolysis which stimulates an increase in TLR4 and NFκβ levels as well as TNF-α and IL-6 secretion. The high fiber diet had a suppressing effect against TLR4 and NFκβ gene expression and decreased TNF-α and IL-6 levels. This study evaluated the effect of high fiber diet (P1= 1.04 g content of fiber/rat/day, P2= 2.07 g content of fiber /rat/day and P3= 3.11 g content of fiber/rat/day) on TNF-α and IL-6 levels as well as expression of TLR4 and NFκβ in rats induced by high fat and fructose diet for 6 weeks. The findings indicate that the administration of high fiber diet to the hypertriglyceridemia rats could control body weight gain and significantly reduce TNF-α and IL-6 levels (pp<0.05) when compared with the normal and hypertriglyceridemia groups. The suppression of TLR4 and NFκβ were correlated with TNF-α and IL-6 levels. In conclusion, the administration of the high fiber diet to the hypertriglyceridemia rats was able to decrease TNF-α and IL-6 levels possibly by suppression of TLR4 and NFκB gene expression.

Postprandial Hypertriglyceridemia Is Associated with the Variant 54 Threonine FABP2 Gene.

Purpose: Fasting or postprandial hypertriglyceridemia is considered an independent cardiovascular disease (CVD) risk factor. The intestinal fatty acid binding protein (FABP2) is involved in the intracellular transport and metabolism of fatty acids. The presence of the Ala54Thr polymorphism of the FABP2 gene appears to be involved in postprandial hypertriglyceridemia. We explored the possible association of the Ala54Thr polymorphism with fat intolerance in apparently healthy, fasting, normolipidemic subjects with normal body-mass index and without diabetes. Methodology: A total of 158 apparently healthy individuals were classified as fat tolerant (n = 123) or intolerant (n = 35) according to their response (plasma triglycerides) to an oral abbreviated tolerance test with blood samples taken at 0, 2 and 4 h. At 0 h, all subjects ingested 26.3 g of fats. Presence of the Ala54Thr polymorphism of the FABP2 gene was evaluated by polymerase chain reaction–restriction fragment length (PCR–RFLP). Results: The group with fat intolerance (postprandial hypertriglyceridemia group) showed an increased frequency of the Thr54Thr genotype when compared with the group with normal fat tolerance (control group) (23% vs. 4%, respectively, OR: 16.53, 95% CI: 4.09–66.82, p: 0.0001, pc: 0.0003). Carriers of at least one Thr54 allele were up to six times more prevalent in the fat intolerant group than in the non-carriers. (OR: 6.35; 95% CI: 1.86–21.59, p: 0.0003, pc: 0.0009). The levels of plasma triglycerides (Tg) at 4 h after the test meal were higher in carriers of at least one 54Thr allele than in carriers of the Ala54 allele (p < 0.05). Conclusions: There is a significant association between postprandial hypertriglyceridemia and the presence of at least one 54Thr allele of the FABP2 gene. In addition, subjects with this genotype showed an increased ratio of Tg/HDL-cholesterol. This parameter is a marker of increased CVD risk and insulin resistance.

Investigated the prevalence of hypouricemia in Peking Union Medical College Hospital

Objective To investigate the prevalence and possible factors of hypouricemia in Peking Union Medical College Hospital. Methods A retrospective investigation. Serum uric acid, lipids, glucose and other chemistry tests were analyzed among 83176 outpatients (Male: 30795, Female: 52381), 15849 inpatients (Male: 7402, Female: 8447) and 24081 healthy subjects (Male: 11859, Female: 12222) in Peking Union Medical College Hospital from December 2015 to April 2016. Grouped by gender and age, the prevalence of hypouricemiawas analyzed in all subjects and the etiology and possible risk factors of hypouricemia were explored among all patients. Results The serum uric acid of outpatients, inpatients and healthy subjects were 286 (235-348)μmol/L, 282 (226-348)μmol/L and 298 (244-358)μmol/L, respectively. And the prevalence were 0.6%(499/83176), 2.5%(390/15849) and 0.2%(39/24081), respectively. The prevalence of hypouricemia ofwomen was significantly higher than that ofmen(outpatients: 0.7% vs 0.4%, P<0.001; inpatients: 2.8% vs 2.1%, P=0.004; healthy subjects: 0.30% vs 0.04%, P<0.001). After analyzing 507 hypouricemia patients, the top three clinical diagnoses that related with hypouricemia were kidney diseases, tumor and rheumatic diseases. Compared with the control group, the prevalence of hypouricemia in hypertriglyceridemia group and group with eGFR higher than 90 ml/(min·1.73 m2) were lower (OR: 0.33, 95% CI: 0.21-0.50; OR: 0.16, 95% CI: 0.09-0.29), and the prevalence of hypouricemia in hyperglycemia group was higher (OR: 1.62, 95% CI: 1.12-2.35). Conclusion The prevalence of hypouricemia of Chinese women was higher than that of men and may be related with TG, Glu and eGFR.(Chin J Lab Med, 2018, 41: 237-241) Key words: Kidney diseases; Uric acid; Prevalence; Risk factors