Ratio Of Low-density Lipoprotein Cholesterol Research Articles

A-223 Direct LDL or not Direct-LDL, that is the question

Abstract Background Management of Cardiovascular Disease (CVD) risk is dependent on Low Density Lipoprotein Cholesterol (LDL-C) levels; therefore LDL-C serves as the marker for the assessment of CVD risk and the focus of lipid lowering treatment. The gold standard reference method for measurement of LDL-C is beta-quantification. We compared calculated LDL-C with Friedewald (F-LDL-C), Martin-Hopkins (M-LDL-C) and Sampson (S-LDL-C) equations versus LDL-C directly measured (D-LDL-C). In CVD management also cholesterol ratios are evaluated. TC/HDL is associated with morbidity and mortality in the general population. Furthermore, several studies have stated that high triglycerides (TG) levels and low HDL-C (TG/HDL ratio) could function as an atherogenic index. Methods 11399 samples were analyzed on Siemens Atellica Solution® for the lipid profile determination measuring Total Cholesterol (TC), D-LDL-C, HDL-C and TG. In the absence of additional clinical parameters, based on desirable levels for LDL-C recommended by guidelines, CVD risk was evaluated by assigning to LDL-C a cut-off of 100 mg/dL. In presence of misclassifications, we used two other parameters to assess LDL-C results: TG/HDL-C ratio and CT/HDL-C. Results Patients cohort had a mean age of 57.7 (±16.8) years of which 53% (age=58.6, ±15.9) were males and 47% (age=56.5, ±17.8 years) were females. Of these, the 57.7% were outpatients and 42.3% inpatients (42.1% of infectious diseases - 24.4% of the cardiovascular department). Data about LDL-C misclassification and ratio data parameters are shown in table 1. Discordant patients for D-LDL-C vs F-LDL-C are 8.5%, that of D-LDL-C vs M-LDL-C are 7.7% and D-LDL-C vs S-LDL-C are 7.2%. Conclusions Is known that LDL plays a central role in the pathogenesis of atherosclerosis. Accurate estimation of LDL-C is a fundamental point for the stratification of CVD risk and the achievement of the therapeutic goal; however, we are still uncertain about the best and accurate way to measure it.

Inverse relationship between LDL-C/HDL-C ratio and atrial fibrillation in chronic kidney disease patients

Atrial fibrillation (AF) is more prevalent in individuals with chronic kidney disease (CKD) compared to the general population. While a potential inverse correlation between lipid levels and AF has been proposed, it remains unclear if this relationship applies to CKD patients. This study examined the connection between the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) and the likelihood of AF in CKD patients. Data was gathered from 21,091 consecutive CKD patients between 2006 and December 31, 2015. We examined the link between the LDL-C/HDL-C ratio and AF in CKD patients through binary logistic regression, as well as various sensitivity and subgroup analyses. The dataset that backs up these analyses is available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230189. Of the 21,091 CKD patients, 211 (1.00%) were diagnosed with AF. The cohort, predominantly male (79.93%), had a mean age of 60.89 ± 10.05 years. The mean LDL-C/HDL-C ratio was 1.39 ± 0.35. After adjusting for covariates, a significant inverse association was observed between the LDL-C/HDL-C ratio and the incidence of AF in CKD patients (OR = 0.422, 95% CI 0.273–0.652, P = 0.00010). The robustness of these findings was confirmed through sensitivity analysis. Subgroup analysis revealed a strong correlation between the LDL-C/HDL-C ratio and incident AF in patients without hypertension (HR = 0.26, 95% CI 0.15–0.45). Conversely, this association was absent in hypertensive patients (HR = 1.09, 95% CI 0.54–2.17). Our research shows an independent inverse correlation between the LDL-C/HDL-C ratio and the risk of AF in CKD patients. It is advised to refrain from excessively aggressive reduction of LDL levels in CKD patients, as this could elevate the risk of developing AF.

The relationship between NLR, LDL-C/HDL-C, NHR and coronary artery disease.

Chronic inflammation and dyslipidemia are key risk factors for atherosclerotic cardiovascular diseases. We retrospectively explored the association between the neutrophil to lymphocyte ratio (NLR), the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), and the neutrophil to HDL-C ratio (NHR), and the severity of coronary lesions in patients with acute coronary syndrome (ACS). In June 2023, we selected 1210 patients who were diagnosed with ACS based on chest pain from January 2017 to December 2022. Of these, 1100 patients with abnormal coronary angiography were categorized into the experimental group, and 110 patients with normal coronary angiography were classified as the control group. We collected routine blood tests, lipid profiles, and coronary angiography results at admission (before coronary angiography). Patients were then stratified into a control group (Gensini score = 0) and an experimental group (Gensini score = 0) based on the Gensini score. The experimental group was further divided into a low score group (Gensini score < 69) and a high score group (Gensini score ≥ 69). 1. Statistically significant differences were observed between the control and experimental groups in terms of gender, age, body mass index (BMI), hypertension, diabetes, smoking history, and counts of neutrophils (NEU), lymphocytes (LYM), monocytes (MON), eosinophils (EOS), red cell distribution width (RDW), total cholesterol (TC), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR (P&lt;0.05). Furthermore, differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, TC, triglyceride (TG), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR were significant between the low and high score groups (P&lt;0.05). 2. NEU, LYM, MON, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR showed significant correlations with the Gensini score (r>0.2, P<0.05), with NLR and LDL-C/HDL-C showing the strongest correlations (r = 0.822, P = 0.000). 3. The Receiver Operating Characteristic (ROC) curve indicated that the combination of NLR and LDL-C/HDL-C had superior sensitivity and specificity in predicting the severity of coronary lesions, with a significant difference (P&lt;0.05). The sensitivity was 87.1%, the specificity was 90.9%, and the cut-off point was 2.04. 4. A predictive model was developed based on the ratio of NLR and LDL-C/HDL-C to the Gensini score. The final model score was calculated as 6.803 + 7.029NLR + 13.079LDL-C/HDL-C (R2 = 0.708). Compared to NLR, LDL-C/HDL-C, and NHR, the combined NLR and LDL-C/HDL-C ratio is a more accurate marker for assessing the severity of coronary artery disease in ACS patients. Its convenience and effectiveness make it a promising tool for early assessment, timely risk stratification, and appropriate clinical intervention, ultimately improving clinical outcomes for ACS patients.

The role of small dense LDL-C/large buoyant LDL-C ratio as an independent risk factor in patients with type 2 diabetes mellitus and metabolic syndrome

Dyslipidemia plays a key role in metabolic syndrome (MS), intricately linked to type 2 diabetes mellitus (T2DM). This study aimed to investigate the differences in low-density lipoprotein cholesterol (LDL-C) subfraction levels between T2DM and T2DM with MS, and identify the risk factors associated with the disease. A total of 246 individuals diagnosed with T2DM, including 144 T2DM patients with MS, and 147 healthy subjects were recruited. All participants underwent a comprehensive clinical evaluation. Lipoprotein subfraction analysis was performed using the Lipoprint LDL system. Multivariate logistic regression analysis revealed that several lipid markers, including triglyceride (TG), LDL-C, large buoyant LDL-C (lbLDL-C), small dense LDL-C (sdLDL-C), LDLC2-5, and sdLDL-C/lbLDL-C ratio, were identified as independent risk factors for T2DM. Additionally, TG, sdLDL-C, LDLC-4, LDLC-5, and sdLDL-C/lbLDL-C ratio were found to be independent risk factors for T2DM with MS. Furthermore, the results of the receiver operating characteristic (ROC) curves demonstrated that sdLDL-C, LDLC-4, LDLC-3, and sdLDL-C/lbLDL-C ratio exhibited excellent predictive performance for the risk of T2DM (AUC >0.9). The sdLDL-C/lbLDL-C ratio emerges as a shared independent risk factor for T2DM and MS complications. Furthermore, sdLDL-C/lbLDL-C ratio, along with LDL-4 and LDL-3, exhibits noteworthy predictive capabilities for T2DM.

Association Between Insulin Resistance Markers and Poor Prognosis in Patients With Acute Ischemic Stroke After Intravenous Thrombolysis.

This study aims to investigate the significance of insulin resistance markers in predicting poor prognosis in acute ischemic stroke (AIS) patients after intravenous thrombolysis and to establish the corresponding nomogram. From January 2019 to March 2023, the data of 412 patients with AIS who received intravenous alteplase thrombolytic therapy in the Affiliated Taizhou People's Hospital of Nanjing Medical University were selected. Patients were randomly divided into training groups (70%, 288 cases) and validation groups (30%, 124 cases). In the training group, multivariate logistic regression analysis was used to establish the best nomogram prediction model. The predictive ability of the nomogram was further evaluated by the area under the receiver operating characteristic curve, calibration curve, decision curve analysis, and reclassification analysis. Furthermore, the model was further validated in the validation set. Multivariate logistic regression analysis showed that systolic blood pressure, diabetes, National Institutes of Health Stroke Scale score, triglyceride-glucose index, triglyceride-glucose-body mass index, ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol were associated with poor prognosis in AIS patients after intravenous thrombolysis ( P <0.05). Compared with conventional factors, the nomogram showed stronger prognostic ability, area under receiver operating characteristic curves were 0.948 (95% CI: 0.920-0.976, P <0.001) and 0.798 (95% CI: 0.747-0.849, P <0.001), respectively. Triglyceride-glucose index, triglyceride-glucose-body mass index, and low-density lipoprotein cholesterol to high-density lipoprotein cholesterol levels upon admission can serve as markers for poor prognosis in AIS patients after intravenous thrombolysis. The nomogram enables a more accurate prediction of poor prognosis in AIS patients after intravenous thrombolysis.

Optimized Sugar-Free Citrus Lemon Juice Fermentation Efficiency and the Lipid-Lowering Effects of the Fermented Juice.

Aging and obesity make humans more prone to cardiovascular and metabolic syndrome diseases, leading to several serious health conditions, including hyperlipidemia, high blood pressure, and sleep disturbance. This study aimed to explore the hypolipidemic effect of fermented citrus lemon juice using a hyperlipidemic hamster model. The sugar-free lemon juice's fermentation was optimized, and the characteristics of fresh and fermented lemon juice (FLJ) were evaluated and compared, which contained polyphenols and superoxide dismutase-like activity. Results showed that the absorption and utilization efficiency of FLJ was higher compared with the unfermented lemon juice. This study's prefermentation efficiency evaluation found that 21-30 days of bacterial DMS32004 and DMS32005 fermentation of fresh lemon juice provided the best fermentation benefits, and 21-day FLJ was applied as a remedy after the efficiency compassion. After six weeks of feeding, the total cholesterol (TC) and triglyceride (TG) values in the blood and liver of the FLJ treatment groups were decreased compared with the high-fat diet (HFD) group. In addition, the blood low-density lipoprotein cholesterol (LDL-C) levels were significantly reduced in the FLJ treatment groups compared with the HFD group. In contrast, the blood high-density lipoprotein (HDL-C) to LDL-C ratio increased considerably in the FLJ treatment groups, and the total to HDL ratio was significantly lower than in the HFD group. Compared with the HFD group, the TC content in the FLJ treatment groups' feces increased significantly. This study demonstrated that the sugar-free fermentation method and fermentation cycle management provided FLJ with the potential to regulate blood lipids. Further research and verification will be carried out to isolate specific substances from the FLJ and identify their mechanisms of action.

Differences in Absorption and Metabolism between Structured 1,3-Oleate-2-palmitate Glycerol and 1-Oleate-2-palmitate-3-linoleate Glycerol on C57BL/6J Mice.

This study investigated differences in absorption and metabolism between 1,3-oleate-2-palmitate glycerol (OPO) and 1-oleate-2-palmitate-3-linoleate glycerol (OPL) using C57BL/6J mice. OPL was associated with higher postprandial plasma total triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) concentrations, and the ratio of LDL-C to high-density lipoprotein cholesterol (HDL-C) compared to those of OPO (p > 0.05). OPO significantly increased postprandial oleic acid (OA) concentrations compared to OPL over the entire monitoring period (p < 0.05), while OPL significantly elevated linoleic acid (LA) levels compared to OPO (p < 0.05). After 1 month of feeding, the mice in both OPO and OPL groups showed lower final weight, weight gain, and liver TG, LDL-C, and LDL/HDL concentrations compared to the control (soybean oil) group. Lipidomics results showed that OPO increased the biosynthesis of very long-chain fatty acids and decreased the abundance of AcCa (16:1), AcCa (18:2), AcCa (18:1), AcCa (16:0), CarE (16:0), and CarE (16:1) relative to OPL. These lipid metabolites were positively correlated with liver TG, LDL-C, and LDL/HDL levels and negatively related to peroxisome proliferator-activated receptors α (PPARα) and acyl-CoA oxidase (ACOX1) expression. This study showed differences in physiologic functions between OPO and OPL and provided support for the future application of OPL in infant formula.

Association of the low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and major adverse cardiac and cerebrovascular events in patients with coronary heart disease undergoing percutaneous coronary intervention: a cohort study

Background Although dyslipidemia increases the risk of coronary heart disease (CHD) and its adverse prognosis, the association between the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) and major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in patients with CHD has not been adequately demonstrated. Therefore, the aim of this study was to assess the role of LDL-C/HDL-C in the risk of MACCE after PCI in patients with CHD. Methods In this large cohort observational study, we enrolled 2226 patients with CHD treated with PCI. LDL-C/HDL-C was considered as an exposure variable and MACCE was considered as an outcome variable. Univariate and multivariate Logistic regression models and subgroup analyses were used to assess the relationship between LDL-C/HDL-C and the risk of MACCE. Results A total of 2226 patients (mean age: 60.02 years; 68.00% male) were included in the analysis, and 373 patients suffered MACC. Patients who developed MACCE had higher levels of LDL-C/HDL-C compared to patients who did not develop MACCE [(2.79 ± 1.15) vs (2.64 ± 1.09), p = 0.023]. Univariate Logistic regression analysis showed a correlation between LDL-C/HDL-C and the risk of MACCE (OR: 1.121, 95% CI: 1.019–1.233, p = 0.019). Multivariate Logistic regression analysis showed that higher levels of LDL-C/HDL-C remained strongly associated with a higher risk of MACCE after stepwise adjustment for confounding variables [Model 4: T3 vs T1, OR: 1.455, 95% CI: 1.095-1.933, p = 0.010; per unit increase, OR: 1.158, 95% CI: 1.047–1.281, p = 0.004]. Further subgroup analysis showed that the association between LDL-C/HDL-C and MACCE risk remained in the subgroup ≤60 years, male, without diabetes, and with hypertension (p < 0.05). Conclusion Higher LDL-C/HDL-C was closely associated with a higher risk of MACCE after PCI in patients with CHD.

A 8-week, randomized, double-blind, placebo-controlled human trial to evaluate the efficacy and safety of Saccharum officinarum wax alcohols (Policosanol) on improvement of blood cholesterol

BackgroundThe prevalence of atherosclerotic cardiovascular disease appears to be reduced, according to a large body of research, by lowering blood levels of the ratio of low-density lipoprotein cholesterol (LDL-C)/ high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)/HDL-C, and LDL-C. ObjectiveThe objective of the investigation was to determine the safety and endurance of policosanol (20 mg/d), as well as its efficacy in healthy individuals. Two parallel groups in this randomized, double-blind, placebo-controlled human experiment received either a policosanol (20 mg/d) or a placebo for eight weeks. 80 people were randomly assigned, with a mean (SD) age (years) of 42.61 (13.51), a mean (SD) BMI (kg/m2) of 24.53 (3.57), a mean (SD) weight (kg) of 66.71 (14.30), and a mean (SD) height (cm) of 164.21. (7.99). ResultsAt 8 weeks, when compared to the baselinegroup, the policosanol (20 mg/d) batch displayed considerably greater LDL-C (-4.87 ± 11.30 mg/dL; p = 0.014), total cholesterol (-6.82 ± 14.32 mg/dL; p = 0.007), triglyceride (-9.37 ± 19.27 mg/dL; p = 0.008), non HDL-C reductions (-10.32 ± 13.75 mg/dL; p = 0.0001), and significantly greater augmentation of HDL-C (3.50 ± 4.55 mg/dL; p = 0.010). Policosanol (20 mg/d) treatment also significantly reducing the serum levels of TC/HDL-C (p = 0.0001) and LDL-C/HDL-C (p = 0.0002), triglyceride/HDL-C (p = 0.001), and T-cholesterol-HDL-C/HDL-C (p = 0.0001) ratios. ConclusionIn humans, policosanol delivery resulted in a lowering of LDL-C levels and an improvement in other lipid markers, demonstrating the product potential to regulate hypercholesterolemia.

Description of The Risk Level of Heart Disease to The Ratio of LDL/HDL Patients at Rsud Dr. Adjidarmo

The increased risk of stroke is associated with high low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, and a high ratio of LDL and HDL cholesterol, and will be amplified if other stroke risk factors are present. The purpose of this study was to determine the ratio of LDL and HDL cholesterol in patients at RSUD Dr. Adjidarmo. The research design is descriptive research. With a total population of 150 people, a sample of 20% of the population, namely 30 people, was taken. The data collection technique in this study was primary data, namely through the medical records of heart patients who had received outpatient care at the Cardiac and Vascular Polyclinic at RSUD Dr. Adjidarmo Rangkasbitung. The data analysis technique was performed by entering data into tables and calculating the ratio between LDL and HDL for the group of patients at risk of heart disease based on the ratio obtained. The results of the study of the 30 respondents who were examined gave an overview of the results of the examination, with low risk LDL/HDL ratio values (low risk) of 21 people (70%); the average risk LDL/HDL ratio was 5 people (16.67%); the moderate risk LDL/HDL ratio was 1 person (3.3%); and the high risk LDL/HDL ratio was 3 people (10%). Patients who have a risk of developing coronary heart disease are 16 men (53.3%) and 14 women (46.7%). The average age of patients with coronary heart disease is over 50 in men and over 39 in women.

The correlation between the serum LDL-C/Apo B ratio and lumbar bone mineral density in young adults

BackgroundNumerous studies have confirmed that atherosclerosis is related to osteoporosis (OP), and patients with atherosclerosis are more prone to OP. The ratio of low-density lipoprotein cholesterol (LDL-C) to apolipoprotein B (Apo B) is the valid indicator of atherosclerosis. Nevertheless, conclusions regarding relation between LDL-C/Apo B ratio and bone mineral density (BMD) are still lacking. As a result, this study concentrated on investigating the relationship between LDL-C/Apo B ratio and lumbar BMD in the young adult population according to the National Health and Nutrition Examination Survey (NHANES).MethodsInformation of 2027 young adults (age 20–40 years) from NHANES database was obtained for this cross-sectional study. The correlation between serum LDL-C/Apo B ratio and lumbar BMD was explored through weighted multiple stratified linear regression, while the smooth curve fitting model was utilized for analyzing nonlinear relation. In the nonlinear relation, the inflection point was calculated by saturation threshold analysis. The weighted two-piecewise linear regression model was constructed.ResultsAfter covariates were adjusted, the relation between serum LDL-C/Apo B ratio and lumbar BMD varied by sex (males: β = -0.0126, 95% CI -0.0892, 0.0640; females: β = 0.0322, 95% CI -0.0367, 0.1011). By performing age-stratified subgroup analysis, the association also varied by age and sex. Males aged 20–30 years presented a negative trend (β = -0.0570, 95% CI -0.1656, 0.0517), and males with the age of 31–40 years showed a positive trend (β = 0.0810, 95% CI -0.0312, 0.1931). Women showed a positive trend by age (females of 20–30 years: β = 0.0051, 95% CI -0.0935, 0.1036; females of 31–40 years: β = 0.0265, 95% CI -0.0767, 0.1296). In race-stratified subgroup analysis, the relations varied by sex and race. To be specific, non-Hispanic black males showed a negative trend (β = -0.0754, 95% CI -0.2695, 0.1188), and males of other races exhibited a positive trend. The trend was positive for women of all races.ConclusionDifferences were detected in the association between serum LDL-C/Apo B ratio and lumbar BMD among cases aged 20–40 years across sex, age, and race/ethnicity. In addition, the inflection points in U-shaped relationships were also calculated.

Low-density lipoprotein cholesterol to apolipoprotein B ratio predicts mortality and cardiovascular events in peritoneal dialysis patients.

The ratio of low-density lipoprotein cholesterol (LDL-C)/apolipoprotein B (apo B) is associated with all-cause mortality and cardiovascular events in chronic kidney disease patients. The aim of this study was to investigate the association between the LDL-C/apo B ratio (LAR) and all-cause mortality and cardiovascular events in peritoneal dialysis (PD) patients. A total of 1199 incident PD patients were enrolled from November 1, 2005 to August 31, 2019. The LAR was used to divide the patients into two groups by X-Tile software and restricted cubic splines using 1.04 as the cutoff. The incidence of all-cause mortality and cardiovascular events at follow-up was compared according to LAR. Of the 1199 patients, 58.0% were men, the mean age was 49.3 ± 14.5years, 225 patients had a history of diabetes, and 117 patients had prior cardiovascular disease. During the follow-up period, 326 patients died, and 178 patients experienced cardiovascular events. After full adjustment, a low LAR was significantly associated with HRs for all-cause mortality of 1.37 (95% CI 1.02-1.84, P = 0.034) and for cardiovascular events of 1.61 (95% CI 1.10-2.36, P = 0.014). This study suggests that a low LAR is an independent risk factor for all-cause mortality and cardiovascular events in PD patients, indicating that the LAR may provide significant information when assessing all-cause mortality and cardiovascular risks.

Association between Low-Density Lipoprotein Cholesterol Level and Cardiovascular Outcomes in Korean Adults: A Nationwide Cohort Study.

To validate the treatment target of low-density lipoprotein cholesterol (LDL-C) level according to the cardiovascular disease (CVD) risk which was recommended by Korean dyslipidemia guideline. We used the Korean National Health Insurance Service database which included 3,958,048 people aged 20 to 89 years who underwent regular health screening. The primary outcome was incident CVD, defined as a composite of myocardial infarction and stroke during the follow-up period from 2009 to 2018. The risk of CVD increased from LDL-C level of 70 mg/dL in very high-risk and high-risk groups and from 130 mg/dL in moderate-risk and low-risk groups. Adjusted hazard ratios (HRs) of LDL-C ranges 70-99, 100-129, 130-159, 160-189, and ≥190 mg/dL were 1.20 (95% confidence interval [CI], 1.08-1.33), 1.27 (1.15-1.42), 1.39 (1.23-1.56), 1.69 (1.45-1.96), and 1.84 (1.49- 2.27) in very high-risk group, and 1.07 (1.02-1.13), 1.16 (1.10-1.21), 1.29 (1.22-1.36), 1.45 (1.36-1.55), and 1.73 (1.58-1.90) in high-risk group. Adjusted HRs (95% CI) of LDL-C ranges 130-159, 160-189, and ≥190 mg/dL were 1.15 (1.11-1.20), 1.28 (1.22- 1.34), and 1.45 (1.36-1.54) in moderate-risk group and 1.07 (1.02-1.13), 1.20 (1.13-1.26), and 1.47 (1.37-1.57) in low-risk group. We confirmed the incidence of CVD was increased in higher LDL-C range. The risk of CVD increased from ≥70 mg/dL of LDL-C in very high-risk and high-risk groups, and from ≥130 mg/dL of LDL-C in moderate-risk and low-risk groups in Korean adults.

Phytosterol of lotus seed core powder alleviates hypercholesterolemia by regulating gut microbiota in high-cholesterol diet-induced C57BL/6J mice

The present study aimed to investigate the regulatory mechanisms of lotus seed core powder phytosterol extract (LSP-PE) on hypercholesterolemia and intestinal microbiota in high-cholesterol diet (HCD)-induced C57BL/6 J mice. Gavage with LSP-PE reduced levels of serum total cholesterol (TC), ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), hepatic TC, hepatic triglyceride (TG), hepatic LDL-C, hepatic very low-density lipoprotein (VLDL), fecal TC and fecal total bile acid (TBA), while augmented hepatic HDL-C content. In contrast with HCD group, high-dose LSP triggered significant diminutions of serum ALT, serum AST, hepatic ALT and hepatic AST levels in HCD-fed mice, which were 16.49, 28.94, 43.42, and 44.47%, respectively, thus remarkably ameliorating the pathological changes of liver and small intestine. In-depth genetic research found that LSP was effective in down-regulating the expression of cholesterol metabolism related genes including Niemannpick C1-like protein 1 (NPC1L1), acyl-coA cholesterol acyl-transferase 2 (ACAT2), microsomal triglyceride transporter (MTP) and ATP binding cassette subfamily G member 5 (ABCG5). Moreover, LSP-PE could restore the disorder of intestinal flora via augmenting the Actinobacteria abundance as well as decreasing the Firmicutes/Bacteroidetes ratio and abundances of Proteobacteria and Verrucomicrobia to regulate cholesterol metabolism-related genes. In summary, LSP-PE possessed excellent cholesterol-lowering activity by positively regulating the gut microbiota and the expression levels of genes related to cholesterol absorption and metabolism. Therefore, this work suggested LSP phytosterol as a potential supplement to alleviate the symptoms of hypercholesterolemia.

Serum LDL-C/HDL-C ratio and the risk of carotid plaques: a longitudinal study

BackgroundDyslipidemia contributes to an increased risk of carotid atherosclerosis. However, the association between the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) and carotid plaque formation has not been well documented. This study aims to assess the role of LDL-C/HDL-C in the risk of carotid plaque formation in a Chinese population.MethodsWe followed 2,191 participants who attended the annual routine health examination. Cox proportional hazards regression, restricted cubic spline (RCS), and subgroup analysis were applied to evaluate the association between the LDL-C/HDL-C ratio and carotid plaques. The hazard ratio (HR) and 95% confidence interval (CI) were used to estimate the strength of the association.ResultsAmong 2,191 participants, 388 had incident carotid plaques detected, with a median follow-up time of 1.05 years. Compared with subjects younger than 45 years, those aged 45 to 59 years (HR: 2.00, 95% CI: 1.55–2.58) and over 60 years (HR: 3.36, 95% CI: 2.47–4.58) had an increased risk of carotid plaque formation. Males (HR: 1.26, 95% CI: 1.01–1.56), diabetes (HR: 1.46, 95% CI: 1.06–2.01) and a high LDL-C/HDL-C ratio (HR: 1.22, 95% CI: 1.07–1.38) were significantly linked with the occurrence of carotid plaques. After adjusting for potential confounding factors, we observed that a high LDL-C/HDL-C ratio promoted carotid plaque events (HR: 1.30, 95% CI: 1.12–1.50). The RCS analysis revealed a significant nonlinear association. The association was stronger among females (P-interaction < 0.05).ConclusionA high LDL-C/HDL-C ratio could accelerate the occurrence of carotid plaques. Older men with diabetes and dyslipidemia are the critical target population. Women may be more likely to benefit from lipid-lowering interventions and thus avoid carotid plaque formation.

Negative-High Titer of Helicobacter pylori Antibody and Lipid Profiles.

Background Helicobacter pylori (HP) is a causative factor for several gastrointestinal diseases. A HP seropositive antibody titer (i.e., ≥10 U/mL), a threshold indicating an HP infection, is known to be associated with changes in lipid metabolism. There is evidence that HP infection can be found in some individuals with HP antibody titer of between 3 and 9.9 U/mL (termed as “negative-high titer”). However, it is unknown about the relationship between HP negative-high titer and lipid metabolism. The present study aimed to quantify the association between HP negative-high antibody titer and lipid profiles. Materials and Methods We surveyed 2,478 people who underwent a Ningen Dock examination and had serological HP antibody data, from May 2016 to December 2020 at National Center for Global Health and Medicine, Tokyo, Japan. Multiple regression models were used to quantify the association between HP antibody titer and serum lipid levels. Results The adjusted odds ratio (95% confidence interval [CI]) for dyslipidemia in HP negative-high and positive titer was 1.24 (0.96, 1.79) and 1.36 (1.10, 1.68), respectively, compared with HP negative-low titer; p trend =0.005. The adjusted mean (95% CI) of high-density lipoprotein cholesterol (HDL-C) in HP negative-low, negative-high, and positive titer was 58.78 (57.86–59.71), 55.30 (53.70–56.91), and 53.76 (52.90–54.63) mg/dL, respectively; p trend <0.001. Higher HP antibody titers were also associated with higher ratio of low-density lipoprotein cholesterol (LDL-C) to HDL-C, but not triglycerides, or total cholesterols. Conclusion The present cross-sectional study suggests that a HP negative-high antibody titer may be associated with dyslipidemia, HDL-C, and LDL-C to HDL-C ratio among Japanese Ningen Dock's participants.

How should low-density lipoprotein cholesterol be calculated in 2022?

The reference method for low-density lipoprotein-cholesterol (LDL-C) quantitation is β-quantification, a technically demanding method that is not convenient for routine use. Indirect calculation methods to estimate LDL-C, including the Friedewald equation, have been used since 1972. This calculation has several recognized limitations, especially inaccurate results for triglycerides (TG) >4.5 mmol/l (>400 mg/dl). In view of this, several other equations were developed across the world in different datasets.The purpose of this review was to analyze the best method to calculate LDL-C in clinical practice by reviewing studies that compared equations with measured LDL-C. We identified 45 studies that compared these formulae. The Martin/Hopkins equation uses an adjustable factor for TG:very low-density lipoprotein-cholesterol ratios, validated in a large dataset and demonstrated to provide more accurate LDL-C calculation, especially when LDL <1.81 mmol/l (<70 mg/dl) and with elevated TG. However, it is not in widespread international use because of the need for further validation and the use of the adjustable factor. The Sampson equation was developed for patients with TG up to 9 mmol/l (800 mg/dl) and was based on β-quantification and performs well on high TG, postprandial and low LDL-C samples similar to direct LDL-C. The choice of equation should take into the level of triglycerides. Further validation of different equations is required in different populations.

Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol

Worsened lipid profiles were observed in chronic hepatitis C (CHC) patients during direct-acting antivirals (DAAs) treatment, among which combination drugs confounded the effect of individual ingredient on lipid. Tenofovir alafenamide (TAF) also worsened lipid profiles in HIV patients. Structural similarity between sofosbuvir (SOF) and TAF prompted us to investigate rapid increase in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in CHC patients treated with SOF-based DAAs. A retrospective study was performed to analyze 487 CHC patients receiving DAAs with SVR12. Relative risks on elevating TC and LDL-C were analyzed by logistic regression to determine SOF-based over non-SOF-based regimens. TC or LDL-C levels at baseline, week-4 and SVR12 were compared by Wilcoxon matched-pairs signed rank test. Week 4 or SVR12 to baseline ratios of serum TC or LDL-C between regimens were compared by Mann–Whitney's test. 487 patients were treated with Harvoni (SOF-based, 206 patients), Epclusa (SOF-based, 124 patients), Maviret (non-SOF-based, 122 patients), or Zepatier (non-SOF-based, 35 patients). At week 4 during drug treatment, Harvoni, Epclusa, and Maviret induced statistically significant elevation of TC and LDL-C, but Zepatier did not. SOF-based regimens had 2.72-fold higher relative risk (RR) causing 10% elevation of TC (95% CI 1.84–4.02, p < 0.001) and 2.04-fold higher RR causing 10% elevation of LDL-C (95% CI 1.39–3.01, p < 0.001) than non-SOF-based DAAs. SOF-based DAAs were associated with significantly larger amplitude of increases in TC and LDL-C than non-SOF-based DAAs during the initial 4 weeks of treatment, but the increases were not sustained to SVR12.

Skeletal Muscle Mass is Associated with HDL Cholesterol Levels and the Ratio of LDL to HDL Cholesterol in Young Men: A Pilot Study

Background: It is unclear whether greater skeletal muscle mass is beneficial for improving cardiometabolic health in young individuals. Our purpose was to investigate the association between skeletal muscle mass and cardiometabolic risk factors in young males. Methods: Data were collected from thirty-seven young males (23.2 ± 0.3 years). Participants were categorized based on skeletal muscle mass (skeletal muscle index-percentile score, SMI-PS) assessed by bioelectrical impedance analysis. They were divided into two group: standard skeletal muscle mass group (SMG, n = 17, SMI-PS = 102.2 ± 1.0%), high skeletal muscle mass group (HMG, n = 20, SMI-PS = 120.5 ± 1.8%). Arterial stiffness assessed by brachial-ankle pulse wave velocity (baPWV) and blood parameters including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), fasting glucose (FG) and hemoglobin A1c (HbA1c) were assessed. Results: The level of HDL-C in HMG was significantly higher compared to SMG (p &lt; 0.001), whereas the ratio of LDL-C to HDL-C in HMG was significantly lower compared to SMG (p &lt; 0.001). However, no changes in baPWV, TC, LDL-C, TG, FG, and HbA1c were found between groups. Interestingly, there was a positive correlation between SMI-PS and HDL-C (r = 0.469, p = 0.003), whereas there was a negative correlation between SMI-PS and LDL-C/HDL-C (r = –0.38, p = 0.02). Conclusions: This study suggests that an increase in skeletal muscle mass may have an additive benefit on improving lipid components through the increased HDL-C level and decreased the ratio of LDL-C to HDL-C in young men.

Effects of dietary n-6:n-3 polyunsaturated fatty acid ratio on growth performance, blood indexes, tissue fatty acid composition and the expression of peroxisome proliferator-activated receptor gamma signaling related genes in finishing pigs.

ObjectiveThis study investigated the effects of dietary n-6:n-3 polyunsaturated fatty acid (PUFA) ratio on growth performance, blood indexes, tissue fatty acid composition and the gene expression in finishing pigs.MethodsSeventy-two crossbred ([Duroc×Landrace]×Yorkshire) barrows (68.5±1.8 kg) were fed one of four isoenergetic and isonitrogenous diets with n-6:n-3 PUFA ratios of 2:1, 3:1, 5:1, and 8:1.ResultsAverage daily gain, average daily feed intake and gain-to-feed ratio had quadratic responses but the measurements were increased and then decreased (quadratic, p<0.05). The concentrations of serum triglyceride, total cholesterol and interleukin 6 were linearly increased (p<0.05) with increasing of dietary n-6:n-3 PUFA ratio, while that of high-density lipoprotein cholesterol tended to decrease (p = 0.062), and high-density lipoprotein cholesterol:low-density lipoprotein cholesterol ratio and leptin concentration were linearly decreased (p<0.05). The concentration of serum adiponectin had a quadratic response but the measurement was decreased and then increased (quadratic, p<0.05). The proportion of C18:3n-3 was linearly decreased (p<0.05) in the longissimus thoracis (LT) and subcutaneous adipose tissue (SCAT) as dietary n-6:n-3 PUFA ratio increasing, while the proportion of C18:2n-6 and n-6:n-3 PUFA ratio were linearly increased (p<0.05). In addition, the expression levels of peroxisome proliferator-activated receptor gamma (PPARγ) and lipoprotein lipase in the LT and SCAT, and adipocyte fatty acid binding protein and hormone-sensitive lipase (HSL) in the SCAT had quadratic responses but the measurements were increased and then decreased (quadratic, p<0.05). The expression of HSL in the LT was linearly decreased (p<0.05) with increasing of dietary n-6:n-3 PUFA ratio.ConclusionDietary n-6:n-3 PUFA ratio could regulate lipid and fatty acid metabolism in blood and tissue. Reducing dietary n-6:n-3 PUFA ratio (3:1) could appropriately suppress expression of related genes in PPARγ signaling, and result in improved growth performance and n-3 PUFA deposition in muscle and adipose tissue in finishing pigs.