Increase In Total Cholesterol Research Articles

Early-life associations between per- and polyfluoroalkyl substances and serum lipids in a longitudinal birth cohort

BackgroundExposures to per- and polyfluoroalkyl substances (PFASs) may affect metabolic outcomes, including lipid concentrations in the blood. However, few studies have evaluated potential associations between PFASs and lipids longitudinally. ObjectivesWe estimated associations between PFAS and lipid concentrations at birth and at several points in childhood. MethodsWe measured concentrations of five major PFASs in cord serum and in serum collected at 18 months, five years and nine years in 490 children from a prospective cohort in the Faroe Islands. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations were measured at birth, 18 months and nine years. We estimated associations between PFAS and lipid concentrations and evaluated possible effect modification by sex. We also tested whether PFAS associations with age-nine lipids varied by exposure period. ResultsSerum PFAS concentrations at ages five and nine were positively associated with lipid concentrations at age nine. Cross-sectional associations between PFASs and lipids at age nine were the strongest, with increases in serum concentrations of perfluorodecanoic acid (PFDA), perfluorononanoic acid (PFNA) and perfluorooctanesulfonic acid (PFOS) associated with increases in TC, HDL-C and LDL-C. We found statistically significant differences in estimated PFAS effects by sex, where girls had stronger positive associations between PFASs and TC and LDL-C and boys had stronger positive associations with HDL-C. In repeated measure models, exposure period was a significant modifier of PFAS effects. ConclusionsOur findings suggest that childhood PFAS exposures may be associated with elevated serum lipid concentrations. This is a public health concern, as a detrimental lipid profile in childhood is a risk factor for later development of hyperlipidemia and cardiovascular disease.

P292 Effect of drug therapy on the lipid profiles of patient with Inflammatory Bowel Disease: a systematic review and meta-analysis

Abstract Background Increases of lipid levels associated with inflammatory bowel disease (IBD) medication have been previously reported. However, it is unknown whether this effect is similar for all IBD drug classes. Methods We performed a systematic literature search of randomized controlled trials and observational cohort studies of IBD treatment with corticosteroids, anti TNFα agents and tofacitinib that assessed total cholesterol (TC) before and after short-term (≤8 week) and long-term (≥12 week) treatment. Data of 11 studies (1,663 IBD patients) were pooled using a random effect model with as primary outcome TC levels. Lipid changes were reported as mean difference on the log2-scale (MDlog2) with 95% CI. The effect of patient and disease characteristics on TC changes were analyzed in 6 studies with individual patient data of 1,211 patients. Results A significant increase in TC was observed after treatment with corticosteroids, anti TNFα agents and tofacitinib (short-term +0.370, +0.197 and +0.190; long-term: +0.452, +0.068 and +0.162, respectively). (Figure 1) After correcting for age, sex, BMI and CRP, increases of TC levels after start of corticosteroids and tofacitinib treatment were higher (short-term: +0.293 and +0.161; long-term: +0.090 and +0.127, respectively) as compared to anti TNFα agents (short-term: -0.059, long-term: +0.041). (Figure 2) Conclusion Changes in lipid levels differ between IBD drug classes. TC levels increase was strongest for corticosteroids followed by tofacitinib but not observed for anti TNFα agents. Whether TC change associated with IBD treatment has effect on CVD risk requires further study.

P586 Drug-induced lipid changes in patients with Inflammatory Bowel Disease: a single center, prospective study

Abstract Background Drug use in the treatment of inflammatory bowel disease (IBD) might negatively impact lipid levels. In this study, we assessed drug-induced changes in the lipid profile after IBD induction therapy. Methods In this single center, prospective study IBD patients aged ≥17 years who started systemic drug therapy (corticosteroids, thiopurines, methotrexate, infliximab, adalimumab, vedolizumab, ustekinumab and tofacitinib) for IBD were included. Exclusion criteria were pregnancy, history of liver transplantation and use of lipid lowering drugs. Data on cardiovascular risk profile, disease activity (HBI, SCCAI, CRP, FCP) and concomitant medication use were collected. To calculate mean lipid changes after induction therapy, nonfasting lipid levels (total cholesterol (TC), HDL-c, LDL-c, triglycerides (TG)) were measured before and 8–10 weeks after start of therapy. Pearson correlation test was performed to assess the association between lipid changes and CRP. Results A total of 183 patients (87 males (48%), median age 36 years (IQR 28–48), 128 Crohn’s disease (70%), 46 CU (3%), 9 IBD-U (7%)) were included. (Table 1) Fourty-nine patients were on concomitant steroids at baseline (31%). Relative increases in TC, HDL-c and LDL-c were significant after treatment with corticosteroids and tofacitinib (+9%, +17%, +8% and +19%, +29%, +24%, respectively) and decrease in TG after treatment with corticosteroids, thiopurines, infliximab, adalimumab, ustekinumab and tofacitinib (-9%, -14%, -10%, -8%, -11%, -8%, respectively). (Table 2, Figure 1) A significant inverse relationship was found between CRP and TC (R -.171), HDL-c (R -.202), LDL-c (R -.153) but not with TG. Conclusion Serum lipid levels increased most after start of corticosteroids and tofacitinib as compared to other drug therapies. Whether these changes are explained by the control of inflammation or by the mechanism of action of these agents remains undetermined.

Experimentally Induced Hyperlipidemia and Associated Atherosclerosis in the Aorta and Vascular Expression of CD 31, CD44, Beta-catenin and E Cadherin in Wistar Male Rats

Background: Hyperlipidemia is the disorder of lipid metabolism, characterized by elevated serum total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoproteins cholesterol (VLDL-C) and decreased high-density lipoprotein cholesterol (HDL-C). Atherosclerosis is a cardiovascular and fibroproliferative inflammatory disease commonly associated with dyslipidemia.Methods: The study was conducted using 24 Wistar male rats, divided into two groups of 12 rats each. Hyperlipidemia and atherosclerosis were induced by the addition of 1% cholesterol and 15% saturated oil to the 1000g of standard rat diet and given to group II rats. Group I kept as control and maintained for 90 days. Result: The present experiment established hyperlipidemia with a significant increase of TC, TG, LDL-C and decreased HDL-C cholesterol with initiated atherosclerotic lesions in the aorta and showed varying degrees of positivity with CD31, CD44, Cadherin and Beta-catenin proteins.

Effects of lipid-lowering agents on plasma lipid profile and apolipoprotein B in patients with type 2 diabetes mellitus

Objectives: Type 2 Diabetes Mellitus (T2DM) accounts for about 90% of all cases of Diabetes Mellitus. Dyslipidaemia has been demonstrated to form a synergy with T2DM as risk factors for cardiovascular events. This study aimed to determine the plasma levels of Lipids and Apolipoprotein B-100 among Type 2 Diabetic patients, assess the effects of Lipid Lowering agents, and to study the relationship, if any, between these lipid parameters and glycemic control.Methods: One hundred and fifty participants consisting of fifty T2DM patients on a lipid-lowering agent, fifty newly diagnosed T2DM patients who are drug naïve (not on any anti-diabetic agent) and fifty apparently healthy non-diabetic controls were recruited for this study. Fasting blood samples were collected from all study participants for determination of Total Cholesterol (TC), LDL-C, Triglycerides(TG), High-Density Lipoprotein (HDL-C) and Apo B-100.
 Results: The results showed significant increases in plasma TC, LDL-C, TG and Apo B-100 with a remarkable reduction in plasma HDL-C level in the Type 2 Diabetic drug naïve group compared with the treatment and control groups. There was a significant positive correlation observed between serum Apo B-100 and level of glycaemia in the T2DM drug naïve group.Conclusion: This study further confirms the therapeutic benefits of lipid-lowering agents in reducing Apo B-100 among T2DM patients. Furthermore, maintaining good glycaemic control reduces the risk for the development of dyslipidaemia.
 Keywords: T2DM, Dyslipidaemia, Cardiovascular Diseases, Apolipoprotein B-100, Nigeria.

The efficacy of novel metabolic targeted agents and natural plant drugs for nonalcoholic fatty liver disease treatment: A PRISMA-compliant network meta-analysis of randomized controlled trials.

Background:Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent chronic liver disease characterized by excess accumulation of fat in hepatocytes. Because no drug has been approved for NAFLD treatment, this work analyzed the effects of agents resulting from 2 research hotspots, metabolic target agents, and natural plant drugs, on NAFLD with network meta-analysis.Methods:Public databases were searched through August 14, 2020. Randomized controlled trials that compared obeticholic acid, elafibranor, cenicriviroc, selonsertib, curcumin, silymarin, and resveratrol to placebo were included. Liver pathology improvement, hepatic biochemical indicators, and lipid metabolism indicators were analyzed.Results:Thirty-five studies were included in the meta-analysis. Obeticholic acid was found to significantly increase the frequency of liver biopsy improvement compared to placebo (OR: 2.10; 95% CI: 1.60, 2.77). The ranking results among the hepatic biochemical indicators showed that obeticholic acid (94.9%) and elafibranor (86.3%) have a relative advantage in reducing alanine aminotransferase (ALT) levels, and obeticholic acid also had an advantage (95.4%) in reducing aspartate aminotransferase (AST) levels. Considering lipid metabolic indicators, elafibranor (expSMD: 0.01; 95% CI: 0.00, 0.05; SUCRA: 100%), and obeticholic acid (expSMD: 0.48; 95% CI: 0.28,0.84; SUCRA: 75.6%) significantly reduced triglyceride (TG) levels compared with placebo; moreover, obeticholic acid, but not elafibranor, caused a serious increase in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels and a decrease in high-density lipoprotein cholesterol (HDL-C) levels.Conclusions:Novel metabolic targeted agents generally have better effects than natural plant drugs, especially obeticholic acid, and elafibranor. However, obeticholic acid showed serious adverse effects such as increasing LDL-C levels and decreasing HDL-C levels. Curcumin showed potential advantages for NAFLD but lacked statistical significance.

41502 Does dietary fat composition predict short-term elevations in lipid levels in adults on a modified Atkins diet?

ABSTRACT IMPACT: Our work provides guidance on whether dietary fat intake influences serum cholesterol levels in response to ketogenic diet therapy in adults with epilepsy. OBJECTIVES/GOALS: The modified Atkins diet (MAD) is used in the management of drug-resistant epilepsy in adults. Some patients on MAD show an increase in serum levels of total cholesterol and low-density lipoprotein (LDL) cholesterol. We explored whether dietary fat composition predicts short-term elevations in serum lipid levels in diet-naive adults who begin MAD. METHODS/STUDY POPULATION: Participants self-reported their diet intake with 3-day food records at baseline, 1 month and 2 months. Food records were analyzed using Nutrition Data System for Research software. Fasting serum levels of total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and triglycerides were also collected and LDL level calculated at baseline, 1 month, and 2 months. RESULTS/ANTICIPATED RESULTS: 38 patients submitted complete food records at each study visit (baseline, 1 month, and 2 month). Compared to baseline diet intake, there was a significant reduction in daily carbohydrate intake at 1 and 2 months (p<0.001) and a significant increase in daily fat intake at 1 and 2 months (p<0.001). There was also a significant increase in daily saturated fatty acid (SFA) intake at 1 and 2 months (p<0.001), daily mono-unsaturated fatty acid (MUFA) intake at 1 and 2 months (p<0.001), and daily cholesterol intake at 1 month (p<0.05) and 2 months (p<0.001), but no change in daily poly-unsaturated fatty acid (PUFA) intake over time. Compared to baseline, there was a significant increase in serum LDL at 1 month (p<0.001) and 2 months (p<0.01) and an increase in serum TC at 1 month (p<0.01) but not 2 months. DISCUSSION/SIGNIFICANCE OF FINDINGS: Despite a significant increase in total fat, saturated fat and mono-unsaturated fat intake as well as an increase in total cholesterol and LDL levels following MAD initiation, dietary fat composition appears to minimally predict serum lipid values in the short term.

Total cholesterol, arterial stiffness, and systolic blood pressure: a mediation analysis

On the basis of 45,092 participants (mean age of 54.04 ± 13.09 years) from the Kailuan study, this study was performed to explore the relationships among total cholesterol (TC), brachial-ankle pulse wave velocity (BaPWV), and systolic blood pressure (SBP) and quantify their separate effects. The correlations among TC, SBP, and BaPWV were analyzed using multivariate linear regression models. Mediation analysis was performed to determine whether the effect of TC on SBP can be explained by arterial stiffness. Multivariate linear regression analysis showed that for every one standard deviation increase in TC and BaPWV, SBP increased by 0.33 mmHg and 0.044 mmHg, respectively; for every one standard deviation increase in TC, BaPWV increased by 5.34 cm/s. Mediation analysis showed that the TC-induced SBP elevation was mediated by arterial stiffness in more than half of the whole cohort (indirect effect, 0.73; percent mediated, 54.5%). Furthermore, the TC-induced SBP elevation was mediated by arterial stiffness in less than half of the males (indirect effect, 0.70; percent mediated, 47.9%); however, the results were not statistically significant in females. In conclusion, TC and BaPWV are positively correlated with SBP, whereas TC is positively correlated with BaPWV. Almost half of the increase in SBP contributed to TC is mediated by arterial stiffness.

Assessment of C-reactive Protein, Lipid Profile and Body Mass Index in Type2 Diabetes Mellitus in Sudanese Patients

Background and aim: Diabetes mellitus (DM) is a disease characterized by chronic hyperglycemia caused by a lack of insulin or resistance, resulting in metabolism dysregulation, which accounts for the symptoms and complications of diabetes. The present study aimed to assess some biochemical markers such as C-reactive protein (CRP), lipid profile, and body mass index (BMI) in type 2 diabetes mellitus (T2DM) in Sudanese patients. Patients and methods: The study included 104 patients with type two diabetes mellitus (56 men and 48 women, 40 to 70 years old) and 104 non-diabetic healthy volunteers (56 men, 48 women, 40 to 70 years old). Anthropometric measurements were assessed, and blood samples were collected for analysis of lipid profile and C-reactive protein (CRP). Result: The result showed a significant increase in CRP, BMI, total cholesterol (TC), triglycerides (TGs), non-HDL-C, and LDL-C in the diabetic patients when compared with the healthy control group (P-value 0.000). The study also showed a significant increase in BMI, CRP, TC, non-HDL-C, TGs, and LDL-C in female patients in comparison with male patients with (P-value 0.014, 0.037, 0.003, 0.026, 0.046, and 0.014 respectively). Moreover, the study showed that CRP had a positive correlation with TC, non-HDL-C, TGs, LDL-C, and BMI, with (P-value 0.001, 0.000, 0.000, 0.008, and 0.000 respectively). Conclusion: The study finally concludes the coexistence of dyslipidemia, overweight, obesity, and inflammation in diabetes, in general, and with more frequent in female diabetes when compared with their male counterparts.

1067. Interferon-free Hepatitis C Treatment Increases Surrogates of Cardiovascular Disease Risk in Black Veterans

BackgroundSustained virologic response (SVR) after hepatitis C virus (HCV) treatment with either Interferon (IFN)-based or IFN-free regimens with direct-acting antivirals (DAAs) has been shown to reduce cardiovascular disease (CVD) events in majority white populations stratified by ASCVD score. However, the effect of IFN-free therapy on lipid profiles after SVR, as an indirect measure of CVD risk, is unknown in Black patients.MethodsWe evaluated HCV-infected Veterans from the Baltimore VA who were treated with DAAs between 2015-2019. We performed a retrospective analysis comparing lipid profile changes following SVR among those with early stage (F0-F2) fibrosis and advanced liver disease (ALD, F3-F4 fibrosis) using two-tailed paired t-tests. Independent t-tests were used to assess differences in lipid profiles based on fibrosis stage in patients with HIV and Type II Diabetes Mellitus (DM2).ResultsOf those treated for HCV (n=1,528), 96% (n=1,474) achieved SVR. Demographics are shown in Table 1. Most patients were Black males (75%) and a minority (2.7%) received statin therapy during treatment (Table 1). Of 1,094 patients for whom data was available, an increase in total cholesterol (TC) and LDL (p< 0.01 for both) was seen an average of 17 months after SVR, regardless of fibrosis stage (Figure 1). A significant decrease in triglyceride levels (p=0.04) was also seen in the ALD group after SVR (Figure 1). Mean pre-treatment HCV RNA level was comparable between fibrosis groups (F0-F2: 6.35 logs, F3-F4: 6.37 logs, p=0.46). There were 101 and 436 patients with HIV and DM2, respectively, for whom pre-treatment liver fibrosis data was available. In both groups, there were significant increases in LDL (p=0.008 (HIV), p=0.003 (DM2)) among patients with ALD following SVR.Table 1. Baseline characteristics of treated HCV-infected persons who achieved SVR. Figure 1. Mean lipid profile parameters before and after HCV treatment for patients who achieved SVR. TC was measured a mean of 8.1 months (228 days, SD 333 days) before treatment and 17.4 months (488 days, SD 196 days) after SVR. LDL was measured a mean of 8 months (224 days, SD 284 days) before treatment and 17.5 months (492 days, SD 201 days) after SVR. *=differences in means using paired t-test were statistically significant with p<0.05. HCV= Hepatitis C Virus, SVR= Sustained Virologic Response TC=Total Cholesterol, HDL= High Density Lipoprotein, LDL= Lipoprotein, TG= Triglycerides. ConclusionIn a cohort of mostly Black HCV-infected Veterans, significant increases in TC, driven by increases in LDL, were seen after SVR regardless of fibrosis stage. In addition, patients with ALD and HIV or DM2, who have an inherently higher risk of CVD, had increased LDL levels, suggesting that these patients should be screened and treated for HCV prior to development of ALD. Correlates such as the ASCVD score should be considered in the timing of HCV treatment, in order to reduce the long-term risk of CVD.Disclosures Shyam Kottilil, MD PhD, Arbutus Pharmaceuticals (Grant/Research Support)Gilead Sciences (Grant/Research Support)Merck Inc (Grant/Research Support, Advisor or Review Panel member)

Therapeutic effects of different drug regimens and metabolic markers in children with bipolar affective disorder: a comparative analysis

OBJECTIVE To study the changes in metabolic markers and clinical outcome after treatment with different drug regimens in children with bipolar affective disorder. METHODS A retrospective analysis was performed on the medical data of 220 children with bipolar affective disorder who attended the hospital from January 2017 to January 2020. According to the treatment method, 112 children treated with atypical antipsychotic drugs alone were enrolled as the control group, and 108 children treated with atypical antipsychotic drugs combined with mood stabilizer were enrolled as the study group. The two groups were compared in terms of baseline data, changes in related metabolic markers[fasting insulin (FIN), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after treatment, incidence rate of metabolic syndrome, and clinical outcome. RESULTS There were no significant differences in the baseline data including age, sex, and course of disease between the two groups (P > 0.05). The study group had a significantly higher overall response than the control group (92.6% vs 82.1%, P 0.05). After treatment, the control group had a significant increase in the level of FIN and a significantly higher level of FIN than the study group (P 0.05). There was no significant difference in the level of HbAlc between the two groups before and after treatment (P > 0.05). Before treatment, there were no significant differences in the levels of TC, TG, HDL-C, and LDL-C between the two groups (P > 0.05), and after treatment, the control group had significant increases in TC and TG and significantly higher levels of TC and TG than the study group (P 0.05). There were no significant differences in the levels of HDL-C and LDL-C between the two groups before and after treatment (P > 0.05). The study group had a significantly lower incidence rate of metabolic syndrome than the control group (2.8% vs 9.8%, P < 0.05). CONCLUSIONS Atypical antipsychotic drugs combined with mood stabilizer in the treatment of bipolar disorder in children have little effect on the level of metabolic markers, and the curative effect is significant.

Abstract 16851: Lipid Profile Differences Among Premenopausal and Postmenopausal African American Women and Implications for Treatment Per Guideline

Introduction: Postmenopausal women have an increased cardiovascular disease (CVD) risk compared to premenopausal women. Though literature demonstrates a relationship between abnormal CVD risk factor patterns, namely lipids, and menopause, less is known about this association in minority racial and ethnic groups. Examining this association in African Americans (AA) is important because they experience disproportionate CVD outcomes. Moreover, recent studies have shown that AA eligible for statin therapy were less likely to receive treatment. Hypothesis: Postmenopausal women are more likely to have a more abnormal lipid profile compared to premenopausal women. Methods: A cohort of 962 women (mean age 50 ± 14 years) from the 10,000 Women Project were categorized into self-declared premenopausal (n = 475, mean age 40 ± 9.8 years) and postmenopausal (n= 487, mean age 61 ± 9.1 years) groups. Data was obtained at community health screening events through self-declared health history surveys. Lipid profiles were obtained through a non-fasting point-of-care cholesterol test. Several CVD risk factors were compared among these groups that include serum total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), triglycerides (TG), pooled cohort Atherosclerotic Cardiovascular Disease (ASCVD) 10-year risk of heart disease or stroke score, BMI, waist circumference, and blood pressure. Student’s T test was utilized for statistical analysis. Results: Cholesterol testing revealed a significant increase in serum TC (p &lt; 0.0001), LDL (p = 0.0001), and TG (p = 0.001) in the postmenopausal group compared to the premenopausal group. Interestingly, there was also a significant increase in serum HDL in the postmenopausal group (p = 0.0081). Additionally, the ASCVD risk score, which is heavily weighted on age, was significantly higher in the postmenopausal group compared to the premenopausal group (p &lt; 0.0001). Conclusion: Menopause is associated with a more abnormal lipid profile and an elevated ASCVD risk score in AA women which places this group at a higher risk of CVD. Prioritizing lipid management, by adhering to cholesterol treatment guidelines, may assist with CVD risk reduction in this high-risk group.

Abstract 14904: Alteration of Lipid Profile and Prognostic Value of Lipids on the Length of Hospital Stay in Covid-19 Pneumonia Patients

Background: The outbreak of the novel coronavirus SARSCoV-2 (coronavirus disease 2019; COVID-19) has spread to most of countries in the world. The tight relationship of plasma lipids and COVID-19 pneumonia (NCIP-19) has not been well invested. To observe lipid profiles and their alterations in hospitalized patients with COVID-19 and evaluated the prognostic value of lipids for the length of hospital stay (LOS). Methods: 248 NCIP-19 cases aged 18 years or older were enrolled in this study. Serum lipids, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were detected at admission. In 68 severe cases, levels of serum lipids were subsequently detected every 5 ~ 10 days. Results: At admission, median levels of TG, TC, HDL-C, and LDL-C in all patients, were 1.11 mmol/L, 4.00 mmol/L, 0.89 mmol/L and 2.11 mmol/L, respectively. Compared with common cases (n=174), higher TG and HDL-C, lower LDL-C were observed in severe cases (n=74). Levels of TC and LDL-C at admission were negatively correlated with LOS. In severe cases, the average levels of serum lipids were lowest at admission and gradually increased during hospitalization. Compared with the LOS≤29d group, serum levels of TC, HDL-C, and LDL-C were significantly lower in the LOS&gt;29d group at admission; this lower trend always existed during the following tests for TC and LDL-C, but not for HDL-C and TG. Patients with LDL-C≥1.70 mmol/L at admission showed a lower risk of LOS prolongation (adjusted HR=0.557, 95% CI: 0.409-0.759, p &lt;0.001). Conclusions: In NCIP-19, serum lipid levels were low at admission. Levels of TC and LDL-C at admission were negatively correlated with LOS. LDL-C &lt;1.7 mmol/L at admission may act as the independent predictor of LOS prolongation. In severe cases, the gradual increase of TC, LDL-C, and HDL-C during the hospitalization might indicate the gradual recovery of the disease.

Dietary inflammatory index significantly affects lipids profile among adults: An updated systematic review and meta-analysis.

Background: The available data on the relationship between dietary inflammatory index (DII®) and serum lipids are controversial. This systematic review and meta-analysis aimed to investigate the relationship between DII® and serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) in general populations. Methods: PubMed, Web of Science, SCOPUS, and Cochrane electronic databases were systematically searched from inception to December 2019. Case-control, cohort or cross-sectional studies that evaluated the relationship between DII® and serum lipids were included. The random-effects model was applied to evaluate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). Results: In total, twenty-four cross-sectional and one case-control studies with a total sample size of 129,759 were included in the meta-analysis. The pooled results showed that the highest category of DII® was associated with 5.16mg/dl increase in TC (Pooled WMD: 5.16; 95% CI: 0.58-9.73, p=0.02) and 3.99mg/dl increase in LDL-C (Pooled WMD: 3.99; 95% CI: 1.16-6.81, p=0.006). However, no significant association between DII® scores, HDL-C and TG was found. In subgroup analysis, the geographical region, gender, and dietary assessment methods were potent sources of heterogeneity. Conclusion: This study showed that a higher level of DII® was associated with higher levels of TC and LDL-C in apparently healthy populations. Since the included studies had observational designs, therefore, no conclusion of causality was possible. More studies with interventional designs are required to elucidate the causality of the observed association between DII® and the risk of abnormal lipid profile.

Alteration of lipid profile and value of lipids in the prediction of the length of hospital stay in COVID-19 pneumonia patients.

To observe lipid profiles and their alterations in hospitalized patients with COVID‐19 pneumonia (NCP) and evaluate the value of lipids for the prediction of the length of hospital stay (LOS), a total of 248 patients aged 18 years or older were enrolled in this retrospective study. At admission, the median levels of triglyceride (TG), total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), and low‐density lipoprotein cholesterol (LDL‐C) in all patients were 1.11, 4.00, 0.89, and 2.11 mmol/L, respectively. Compared with common cases (n = 174), severe cases (n = 74) exhibited higher TG and HDL‐C, and lower LDL‐C. Levels of TC and LDL‐C were negatively correlated with LOS. In 68 severe cases, serum lipids were followed up during hospitalization, and the median LOS was 29 days. The average levels of serum lipids were lowest at admission and gradually increased during hospitalization. Compared with the LOS ≤ 29 days group, serum levels of TC, HDL‐C, and LDL‐C were significantly lower in the LOS > 29 days group at admission; this lower trend was found in the subsequent tests for TC and LDL‐C but not for HDL‐C or TG. Multiple‐variant COX regression showed that levels of TC or LDL‐C at admission were independent risk of LOS prolongation. Together, these findings suggest that in patients with NCP, levels of TC and LDL‐C at admission were negatively correlated with LOS. In severe cases, the gradual increase in TC, LDL‐C, and HDL‐C during hospitalization might indicate gradual recovery. TC < 3.75 mmol/L or LDL‐C < 1.7 mmol/L at admission may act as an independent predictor of prolonged LOS.

Protective effect of celastrol on type 2 diabetes mellitus with nonalcoholic fatty liver disease in mice.

To investigate the protective effects of celastrol on mice with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD), and to explore its underlying mechanism. The levels of low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), total cholesterol (TC), and triglyceride (TG) in serum were tested. Malondialdehyde (MDA) and superoxide dismutase (SOD), GOT, and GPT in serum were also detected. The histopathological changes of liver tissues were observed by HE staining. The apoptosis cell number of liver tissues was measured by TUNEL staining. Nrf‐2 and HO‐1 protein and mRNA expression were evaluated by IHC, WB, and RT‐PCR assay. Celastrol had effects to depress TG, TC, LDL‐C, GPT, GOT, and MDA concentration and increase HDL‐C and SOD concentration (p < .05, respectively) with dose‐dependent. Compared with model group, apoptosis cell number was significantly depressed in Cel‐treated groups with dose‐dependent (p < .05, respectively). Nrf‐2 and HO‐1 mRNA and protein expressions were significantly improved in Cel‐treated groups with dose‐dependent (p < .05, respectively). Celastrol can inhibit the oxidative stress reaction and liver cell apoptosis via regulation Nrf2/HO‐1 pathway in T2DM mice with NAFLD.

The Relationship between Leisure-Time Sedentary Behaviors and Metabolic Risks in Middle-Aged Chinese Women.

The prevalence of metabolic diseases has increased over the past few decades, and epidemiological studies suggest that metabolic diseases may be associated with lifestyle. The purpose of the present study was to investigate the relationship between leisure-time sedentary behaviors (LTSBs) and metabolic risks in middle-aged women in China. Data came from the China National Nutrition and Health Surveillance (CNNHS) in 2010–2012. A total of 2643 women aged 46 to 53 years were involved. Multiple linear regression was used to examine the association of leisure-time sedentary duration (LTSD) with total cholesterol (TC), triglyceride (TG), waist circumference (WC), and body mass index (BMI). Restrictive cubic splines (RCS) were used to plot the curves between LTSD and the risk of metabolic diseases. Region, education, income, alcohol consumption, exercise, daily energy intake, and fat energy ratio were adjusted for all models. After adjusting for potential influencing factors, the results of multiple linear regression showed that for each additional hour increase in LTSD, TC and TG increased by 0.03 mmol/L and 0.04 mmol/L, respectively. The results of RCS curves showed that the risks of MetS (p for trend = 0.0276), obesity (p for trend = 0.0369), hypertension (p for trend = 0.0062), and hypercholesteremia (p for trend = 0.0033) increased with the increase in LTSD. LTSB was associated with the risks of MetS, obesity, hypertension, and hypercholesteremia in middle-aged women. Reducing LTSD may be an effective way of preventing metabolic diseases in middle-aged women.

Diabetic Cardiovascular Autonomic Neuropathy: Insulin Resistance, Lipids and Simvastatin

Background: Treatment of diabetic cardiac autonomic neuropathy (CAN) is a complex process, that includes: lifestyle modification; reducing of insulin resistance (IR); optimal glycemic control; management of diabetic dyslipidemia; antioxidants; vitamins; treatment of myocardial metabolic abnormalities; thrombosis and others. The aim of study was to investigate the effects of simvastatin on insulin resistance and blood lipid profile parameters in patients with type 2 diabetes mellitus (DM) and the definite stage of cardiac autonomic neuropathy. Methods: The study involved 107 patients with type 2 DM among them 16 patients without CAN, 19 with subclinical stage of CAN and 72 with definite CAN. Median age of patients was 53.6±0.41 years, disease duration - 4.12±0.24 years and median glycated hemoglobin (HbA1c) - 7.01%±0.09%. The control group included 14 almost healthy people without DM. Patients with definite CAN were allocated into two treatment groups: 1st group - 22 patients received standard hypoglycemic therapy and simvastatin 20 mg/day; 2nd group - control (n = 15). The duration of the study was 3 mos. The concentrations of glucose, HbA1c, immunoreactive insulin (IRI) in the blood were determined. Lipid metabolism was assessed by the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) measurements. The IR index (HOMA-IR), atherogenic coefficient (AC), TG/HDL-C parameters, and TG-glucose (TyG) index were calculated. Result: It was established that in patients with type 2 DM with subclinical stage of CAN there was statistically significant increase in the parameters of HbA1c, IRI, TC, TG and HOMA-IR, AC, TyG indices and decrease of TG/HDL-C and HDL-C compared to control; increase of IRI, TG, TG/HDL-C and TyG indices compared to patients with type 2 DM without CAN. The definite stage of CAN is characterized by an increase of HbA1c, IRI, TC, LDL-C levels and HOMA-IR, AC indices and a significant decrease in the concentration of HDL-C (compared to patients with subclinical CAN). As a result of our study, we found out that prescription of simvastatin to patients with definite stage of CAN was accompanied by a statistically significant decrease in the concentration of TC, LDL-C, TG and an increase in the content of HDL-C (compared to 2nd, control group). Conclusion: Obtained results justify the appropriateness of statins prescription to patients with type 2 DM and the definite stage of CAN.

Effects of Lactobacillus fermentum CQPC04 on Lipid Reduction in C57BL/6J Mice.

Probiotics are functional foods that can effectively regulate lipid reduction and maintain body health. In this study, a strain of Lactobacillus fermentum CQPC04 (LF-CQPC04) isolated from traditional naturally fermented vegetables (Sichuan pickles) was studied, and its effects on lipid reduction in mice, as well as its mechanism of action, were observed. The results of this experiment show that LF-CQPC04 can reduce the abnormal weight gain and abnormal visceral index of mice caused by a high-fat diet. LF-CQPC04 can decrease TG (triglycerides), TC (total cholesterol), LDL-c (low-density lipoprotein cholesterol), AST (aspartate transaminase), ALT (alanine aminotransferase), and AKP (alkaline phosphatase) levels and increase HDL-c (high-density lipoprotein cholesterol) levels in the serum of high-fat mice. LF-CQPC04 can also decrease the levels of inflammatory cytokines, such as IL-6 (interleukin-6), IL-1β (interleukin-1 beta), TNF-α (tumor necrosis factor alpha), and IFN-γ (interferon gamma), and increase IL-4 and IL-10 levels in the serum of high-fat mice. The results of RT-qPCR (real-time quantitative polymerase chain reaction) and western blot experiments show that LF-CQPC04 can also down-regulate the expression of PPAR-γ (peroxisome proliferator-activated receptor gamma), C/EBP-α (CCAAT/enhances binding protein alpha) mRNA, and protein in the liver tissue of high-fat mice, while up-regulating the expression of Cu/Zn-SOD (copper/zinc superoxide dismutase), Mn-SOD (manganese superoxide dismutase), CAT (catalase), CYP7A1 (cholesterol 7 alpha hydroxylase), PPAR-α (peroxisome proliferator-activated receptor alpha), CPT1 (carnitine palmitoyl transferase 1), LPL (lipoprotein lipase), and ABCA1 (ATP-binding cassette transporter A1). Moreover, LF-CQPC04 shows stronger effects in regulating lipid reduction in mice than L-carnitine and commercial LB (Lactobacillus delbrueckii subsp. Bulgaricus) bacteria. LF-CQPC04 is beneficial for lipid reduction in animals and has good probiotic potential.

Is depression a cause of metabolic abnormality? A European Small State experience

Abstract Background A relationship between depression and metabolic syndrome has been reported. Considering the diabesity rates effecting the small state of Malta it was considered appropriate to explore for links between these diseases, their metabolic determinants with depression. Methods A national health examination survey was conducted. A validated questionnaire note down (1) self-reported depression (2) anti-depressive medication (3) PHQ-9 depression symptoms score (&amp;gt;5 positive for depression). Participants with the presence of one or more of these variables were labelled as having depression. Body mass index (BMI), waist circumference (WC) and blood pressure (BP) were measured. Blood testing for fasting blood glucose (FBG) and lipid profile were performed. The biochemical (FBG, Lipid profiles) and anthropometric profiles (BMI, WC, BP) of the depression population were compared to those without this disease. Univariant and multivariant binary logistic regression models were performed. Results The depression population (17.2% of the total population) had significantly higher median LDL, triglyceride (TG) and total cholesterol (TC) levels when compared to those without the disease (p = &amp;lt;0.01). On univariant modelling each variable (LDL OR:1.15 p = 0.01; TG OR:1.16 p = 0.01; TC OR:1.64 p = &amp;lt;0.01) showed a positive association with having depression even after adjusting for confounding factors (sex, age, education, smoking, alcohol habits). On multivariant modelling only an increase in TC was associated with increased risk of having depression (OR: 1.36 CI95%: 1.05-1.76 p = 0.02) after adjusting for confounders. Conclusions The various components of the metabolic syndrome appeared not to be associated with a diagnosis of depression. Only high cholesterol level exhibited a metabolic link with depression. Although further research is merited, it is suggested that physicians incorporate a depression screening tool as part of their consultation when examining high-risk patients. Key messages A metabolic syndrome profile is not linked with depression. A high cholesterol level is linked with depression, making these individuals susceptible to potential cardiovascular disease.