Low High-density Lipoprotein Levels Research Articles

Assessment of risk factors, clinical presentation and angiographic profile of coronary slow flow phenomenon

Background: Primary coronary slow flow phenomenon (PCSFP) is a clinical entity that causes attacks of mild to severe chest pain. It is characterized by delayed coronary vessel opacification in the absence of epicardial stenosis. This work aimed for the assessment of predictors, clinical presentation, and angiographic profile of PCSFP. Subjects and Methods: This cross-sectional case–control study was done between February 2019 and January 2020, including 150 patients who presented by ST-segment myocardial infarction, non-ST segment myocardial infarction, unstable angina, chronic coronary syndrome, or atypical chest pain. The patients were divided into two groups: group 1: consisted of 100 patients who had PCSFP and Group 2: consisted of 50 patients who had normal coronary flow (NCF). Results: PCSFP was significantly more prevalent in young male patients. Among the traditional risk factors, there was significantly more prevalence of hypertension (63.0% vs. 28.0%, P = 0.001), obesity (body mass index ≥30 kg/m2 (47.0% vs. 4.0%, P = 0.001), and history of smoking (66.0% vs. 40.0%, P < 0.002) in PCSFP patients as compared to NCF patients. Triglyceride (TG), cholesterol, low-density lipoprotein, high-sensitivity C-reactive protein (hs-CRP), and hemoglobin all were higher in patients with PCSFP. Low high-density lipoprotein levels were associated with PCSFP. In multivariable analysis, PCSFP was significantly independently associated with male sex, high TG, cholesterol, and hs-CRP. TG (odds ratio [OR]: 14.427, 95% confidence interval [CI]: 3.514–59.226) and cholesterol (OR: 11.739, 95% CI, 2.439–56.513) are the strongest independent predictors for PCSFP. Conclusion: PCSFP is more common in young smoker males, is associated with hypertension, obesity, high hs-CRP, TG, and cholesterol levels. High cholesterol and TG and male sex are the strongest risk factors for PCSFP. Furthermore, inflammation plays an important factor in the pathogenesis of PCSFP due to the association of high hs-CRP level in those patients.

Effectiveness of Daily Living Activities Program on Total Cholesterol, Low-Density Lipoprotein, and High-Density Lipoprotein of Patients with coronary artery disease

Background: High levels of total cholesterol, low-density lipoprotein (LDL), and low levels of high-density lipoprotein (HDL) are risk factors for patients with coronary artery disease (CAD). Daily activities are very important for CAD patients due to their effect on improving heart functions, lipid profile, reduced risk factors, decreased incidence and the recurrence rate of CAD. &#x0D; Aims of the study: To find out the effectiveness of daily living activities program on Total Cholesterol, LDL, and HDL of Patients with coronary artery disease. &#x0D; Methodology: A pre-experimental study design was implemented of the period 20th of December 2020 to the 4th of April 2021.The study was carried out in AL-Nasiriya Heart Center in AL-Nasiriya city on 40 coronary artery disease patients selected by using A non-probability (purposive) sampling method was used for selecting the study sample. The study instrument is composed of 4 parts. The first is demographic characteristics, the second part is the clinical history of patient and unhealthy behaviors, the third part is about investigation of total cholesterol, low-density lipoprotein, and levels of high-density lipoprotein, and the fourth part consists of two items related to patients’ responses regarding risk factors, importance of activity, healthy diet, and stress management. &#x0D; Results: The study reveals that (50.0%) of the participants in the study sample at age group (56–66) years old, and (57.5%) of the participants in the study sample are females, (82.5%) of study sample is married and (85.0%) was urban resident, (35.0%) of the study sample was Graduated of middle school education, (52.5%) of study sample was housewives, and (52.0%) of them are in sufficient income, also (55.0%) of them have (7-9) persons in their family. The results indicate that there is significant statistically differences between pre and post-test for total cholesterol p value (0.044), high density lipoprotein p value (0.00), and low density lipoprotein p value (0.006). Also showed that the cholesterol normal category was (2.5%) changed to (12.5%); Borderline high category was (97.5%) decreased to (87.5%) at post-test, high density lipoprotein normal category was (00.0%) changed to (17.5%); borderline high category was (12.5%) changed to (37.5%); high category was (87.5%) changed to (45%) at post-test, low density lipoprotein normal category was (00.0%) increased to (17.5%); borderline high category was (100%) changed to (82.5). &#x0D; Conclusion: The study concluded that the instructional program of daily living activities was effective in improving the levels of total cholesterol, low-density lipoprotein (LDL), and levels of high-density lipoprotein (HDL) of the study sample after the program implementation. &#x0D; Recommendations: Educating coronary patients on the effects of hyperlipidemia on the health of their coronary arteries, as well as encouraging them to participate in daily activities. Increase patient awareness by using Mass Media about the importance of exercise and a healthy lifestyle and its impact on the lipid profile to reduce the incidence and the recurrence rate of CHD.&#x0D;

A Role for ER-Beta in the Effects of Low-Density Lipoprotein Cholesterol and 27-Hydroxycholesterol on Breast Cancer Progression: Involvement of the IGF Signalling Pathway?

Cholesterol—in particular, high levels of low-density lipoprotein (LDL) and its metabolite, 27-hydroxycholesterol (27-OHC)—is correlated with increases in the risks of breast cancer and obesity. Although the high expression of LDL/27-OHC has been reported in breast cancer, its effects and mechanism of action remain to be fully elucidated. In this study, we found that the effects of LDL on cell proliferation were mediated by the activation of the cytochrome P450 enzyme, sterol 27 hydroxylase, and cholesterol 27-hydroxylase (CYP27A1) in both ER-α-positive and ER-α-negative breast cancer cells. We found that treatment with 27-OHC only increased cell growth in oestrogen receptor-α (ER-α)-positive breast cancer cells in an ER-α-dependent manner, but, interestingly, the effects of 27-OHC on cell migration and invasion were independent of ER-α. Using ER-α-negative MDA-MB-231 cells, we found that 27-OHC similarly promoted cell invasion and migration, and this was mediated by oestrogen receptor β (ER-β). These results suggest that 27-OHC promotes breast cancer cell proliferation in ER-α-positive breast cancer cells via ER-α, but migration and invasion are mediated via ER-β in ER-α positive and negative cell lines. The addition of LDL/27OHC increased the production of IGF-I and the abundance of IGF-IR in TNBC. We further found that modulating ER-β using an agonist or antagonist increased or decreased, respectively, levels of the IGF-I and EGF receptors in TNBC. The inhibition of the insulin-like growth factor receptor blocked the effects of cholesterol on cell growth and the migration of TNBC. Using TCGA and METABRIC microarray expression data from invasive breast cancer carcinomas, we also observed that higher levels of ER-beta were associated with higher levels of IGF-IR. Thus, this study shows novel evidence that ER-β is central to the effects of LDL/27OHC on invasion, migration, and the IGF and EGF axes. Our data suggest that targeting ER-β in TNBC could be an alternative approach for downregulating IGF/EGF signalling and controlling the impact of LDL in breast cancer patients.

Association between Carotid Intima-Media Thickness and the Use of Biological or Small Molecule Therapies in Patients with Rheumatoid Arthritis.

Objective: The objective of this study was to assess the association of carotid intima-media thickness (CIMT), and also the presence of atheromatous plaque, with biological and targeted synthetic disease-modifying antirheumatic drugs, in an established cohort of patients with rheumatoid arthritis (RA). Patients and Methods: We conducted a cross-sectional observational study based on a cohort of patients with RA and a registry of healthy controls, in whom the CIMT and presence of atheromatous plaque were assessed by ultrasound. Data were collected on disease activity, lab results and treatments. Descriptive and bivariate analyses were performed and two multivariate linear regression models (with CIMT as the dependent variable) were constructed to identify variables independently associated with CIMT in our sample of patients with RA. Results: A total of 176 individuals (146 patients with RA and 30 controls) were included. A higher percentage of patients than controls had atheromatous plaque (33.8% vs. 12.5%, p = 0.036), but no differences were found in terms of CIMT (0.64 vs. 0.61, p = 0.444). Compared to values in patients on other therapies, the CIMT was smaller among patients on tumour necrosis factor alpha (TNFα) inhibitors (mean [SD]: 0.58 [0.10] vs. 0.65 [0.19]; p = 0.013) and among those on Janus kinase inhibitors (mean [SD]: 0.52 [0.02] vs. 0.64 [0.18]; p < 0.001), while no differences were found as a function of the use of the other therapies considered. The multivariate linear regression analysis to identify factors associated with CIMT in our patients, adjusting for traditional cardiovascular risk factors such as hypertension, high levels of low-density lipoproteins, diabetes mellitus and smoking, showed that male sex, older age and having a greater cumulative erythrocyte sedimentation rate were independently associated with a larger CIMT, while patients on TNFα inhibitors had a CIMT 0.075 mm smaller than those on other treatments. Conclusions: The use of TNFα inhibitors may protect against subclinical atherosclerosis in patients with RA, patients on this biologic having smaller CIMTs than patients on other disease-modifying antirheumatic drugs. Nonetheless, these results should be confirmed in prospective studies with larger sample sizes.

English

BACKGROUND The world is still experiencing corona virus disease-19 (COVID-19) pandemic. So far, we experienced a total of more than 23 crore cases and 47 lakh deaths from COVID 19 disease. Severe acute respiratory syndrome – corona virus – 2 (SARSCoV-2) was believed to affect lipid metabolism, with many authors reporting an increase in triglycerides and a decrease in high density lipoprotein (HDL) levels. This study gave the clinical features of COVID-19 patients with various HDL-C levels and an interrelation between HDL-C levels and the risk for adverse outcome in the form of deaths. METHODS We conducted a cross sectional study on 100 COVID-19 adult patients diagnosed by reverse transcription – polymerase chain reaction (RT-PCR) test admitted to the medicine department, from January 2020 to December 2020, who were also tested for lipid parameters. The detailed history and lab parameters of the patients were collected and the severe outcome of the same was measured in terms of deaths. RESULTS The mean age of study participants was 57.92 ± 12.41 years. Majority of the participants were from the age group of 41 to 60 years with 50 patients (50 %). There were 73 males (73 %) and 27 females (27 %) in our study. We observed that a total of 36 patients had co-morbidities (36 %), such as diabetes seen in 22 cases (22 %), hypertension in 18 cases (18 %), ischaemic heart disease (IHD) in 8 cases (8 %). A significant association was seen between the presence of co-morbidities and deaths in our study (P = 0.043). A significant association was seen between the patients who required intensive care and deaths (P &lt; 0.001). We found a significant difference between the triglycerides and HDL parameters of lipid profiles in patients who died as compared to those who survived. (P &lt; 0.05) The mean triglyceride level in patients who died was 223.14 ± 56.59, significantly higher than those who survived 134.43 ± 96.16. (P = 0.003) CONCLUSIONS The lipid profile evaluation in our study was found to be effective in detecting the correlation of severity and outcome in COVID-19 patients. We conclude that the severity of COVID-19 cases is associated with low HDL and high triglyceride levels. KEY WORDS COVID-19, Lipid Profile, HDL, Triglycerides, Patient Outcome.

Lipid Profile of the Patient with Acute Coronary Syndromes Undergoing Coronary Angiography (CAG) in Rural Costal Region of Maharashtra

Background: Coronary Heart Disease (CHD) is widely prevalent across the globe and significantly high level of Cholesterol in circulation is a single major risk factor associated with coronary heart disease. It is well established that cardiovascular disease is associated with hypertension and elevated blood levels of low-density lipoprotein (LDL), total cholesterol, and triglycerides. In disparity, a low level of high-density lipoprotein (HDL) is a risk factor for mortality from cardiovascular disease. Aim: The present study was conducted with the aim to assess the lipid profile in patients of Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) in rural coastal population. Patients and Methods: The present study was done on 62 patients with Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) Serum levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were examined in biochemical laboratory of the hospital. Coronary angiography was performed for the presence of lesions. Results: 43.5% of the patients (n=27) were elderly (age&gt;60 years). Approximately 82% of the patients (n=51) aged more than 50 years. Males outnumbered females with a ratio of 2.4:1. 71% of the patients were males. Mean cholesterol levels were 177.86 mg/dl. Approx 3/4th of the patients (n=41) had cholesterol level &lt;200 mg/Dl. Mean triglycerides levels in the patients were 158.29 mg/dl. Only 11 patients out of 62 CAD patients had abnormal triglycerides. Mean LDL level was 119.5 mg and Mean HDL level was 34.5 mg %. The high plasma concentration of low-density lipoprotein (LDL-C) in 30% and the low plasma concentration of high-density lipoprotein (HDL-C) n 33% of patients were important abnormal findings in our patients. Conclusion: Dyslipidemia as in form of very low levels of HDL cholesterol with comparatively high levels of LDL-c with near normal total Cholesterol and triglyceride levels associated with ACS in our rural costal region of Maharashtra.

Prevalence of Metabolic Syndrome and Related Factors in Patients with Non-alcoholic Fatty Liver

Objectives: This study was designed to investigate the prevalence of metabolic syndrome in patients diagnosed with non-alcoholic fatty liver disease (NAFLD) referring to the gastrointestinal and endocrinology clinics of Golestan and Imam Khomeini Hospitals, Ahvaz. Methods: The current cross-sectional study was performed on patients with NAFLD referring to the gastroenterology and endocrinology clinics of Golestan and Emam Khomeini hospitals, Ahvaz in the second half of 2020. Demographic information included age, gender, lumbar posture (while standing and the waist be in the upper edge of the iliac crest at the end of a normal exhalation using a non-elastic meter), grading fatty liver evidenced by ultrasound, and blood pressure and laboratory parameters, including triglyceride (TG), fasting blood sugar (FBS), and high-density lipoprotein (HDL) was recorded in the checklist. Data analysis was performed using SPSS 26.0 software. Results: This study was performed on 130 patients with an average age of 46.22 ± 14.27 years. Patients comprised 42 men (32.8%) and 88 women (67.2/%). Also, 63.84% of the patients with NAFLD had metabolic syndrome, and 56.2, 69.6, and 81.8% with grades 1, 2, and 3 of fatty liver, respectively had metabolic syndrome. There was a significant difference in terms of mean height and weight in both gender. There was a significant relationship between age and FBS, so that the levels of FBS increased statistically significantly with age (P &lt; 0.05). Gender had a statistically significant relationship with HDL and waist circumference (P = 0.038). There was no statistically significant relationship between blood pressure, TG, HDL, FBS, and waist circumference, and different grades of fatty liver (P &gt; 0.05). Conclusions: The current study showed a significant number of patients with NAFLD had metabolic syndrome, so that the most common symptom of metabolic syndrome was low HDL levels, followed by high FBS levels, blood pressure, and TG levels and waist circumference size. Nevertheless, it was not probable to assess whether NAFLD precedes the progress of metabolic syndrome.

Differences of gut microbiota and lipid metabolism in Chinese perch ( Siniperca chuatsi ) with different growth rates

This study is aimed to explore the differences of gut microbiota and lipid metabolism in Chinese perch (Siniperca chuatsi) with different growth rates. After 180 days post-fertilization, among the population of Chinese perch (1,275 fish in total), 36 fish with different growth rates were selected from the low growth rate group (L group, initial weight 87 ± 2 g), the medium growth rate group (M group, initial weight 223 ± 4 g) and the high growth rate group (H group, initial weight 468 ± 13 g), respectively, with a total of 108 fish. The microbial species abundance and evenness in both M and H groups were obviously higher than those in the L group. The activities of lipase and trypsin in the gut showed a similar changing trend to the intestinal microbial diversity in L, M and H groups. The M and H groups showed a similar microbial composition, but they had different main functional bacteria. There were more microbial species in the H group than in the M group. Butyricicoccus might be used as an indicator to distinguish the growth rate of the M and H group. The intraperitoneal fat ratio and levels of triglyceride and total cholesterol in the plasma increased gradually with the increase in the growth rate. A large amount of fat accumulation was observed in the liver and gut of the H group, and the H group showed significantly higher levels of low-density lipoprotein and high-density lipoprotein in the plasma compared with the L and M groups. It was also found that the fat of the L and M groups mainly accumulated in the liver and gut, respectively, and the level of low-density lipoprotein in the plasma of the M group than that in the L group. The mRNA level of fas and srebp1 decreased gradually with the increase in the growth rate. The M and H group had high mRNA levels of pparα and cpt1 than the L group. The mRNA levels of lpl and hl were higher in the H group than those in the L and M groups.

Development and evaluation of indigenous snack Promega Khakra enriched with omega-3 rich canola oil and flax seed

There has been an increase in the incidence of life style diseases like, obesity, diabetes mellitus, high blood pressure etc., in our society. Awareness regarding the role of food in causing these lifestyle diseases has also increased among the population. Print media and social media have also started highlighting the ill effects of poor food choices. In general people have become health conscious and acknowledge the importance of healthy food when compared to the easily available junk and fast food. The Corona pandemic has also increased the demand for healthy nutrition. Therefore, there is a need to develop products which will meet the demands of this ever-growing health conscious population. These newer products should be preservative free, natural and should also have health benefits. High levels of Low-density lipoprotein (LDL) cholesterol in an individual has been associated with a wide range of cardiovascular diseases. Omega-3 fatty acids play a significant role in lowering high LDL cholesterol levels. Omega-3 fatty acids also improve cognitive functions among all age groups. There are very few vegetarian foods which provide omega-3 fatty acids. Khakra is a popular traditional Gujarati snack prepared mainly from wheat flour. An attempt has been made to develop a healthy khakra enriched with protein and omega-3 fatty acids (Promega khakra). Various flours like, wheat flour, gram flour, jowar flour and seeds like flax seeds and chia seeds were used in the development of this healthy enriched khakra. Canola oil was used in the preparation of the enriched khakra. Different compositions and combinations were tried to arrive at an acceptable product. These variations were evaluated for their acceptability using a 9 point hedonic scale by 25 semi trained panelists. Sensory evaluation and statistical analysis revealed that khakras (V-1) made with the following ingredients wheat flour (32%), ground flax seeds (19%), jowar flour (6%), gram flour (6%), canola oil (23%), kasuri methi (5%), cumin seeds (3%), turmeric powder (2%), red chilli powder (2%) and salt (2%) was well accepted (7.64 ± 0.71) . Nutritional composition of the standardised khakra showed the following per 100gms: Energy 410.88 kcals, carbohydrates 49.66 g, protein 12.24 g, fat 22.85g, total fiber 9.38g, moisture 1.56 per cent, ash 4.31 percent. The omega-3 content was 2.6 per 100gm (2 promega khakras) which meets approximately 3/4th of the daily requirement of an adult. The healthy Promega khakras thus developed can be consumed by all age groups.

Low blood levels of high-density lipoprotein (HDL) cholesterol are positively associated with cancer

PurposeThere is a growing body of evidence suggesting a decisive involvement of the human lipid metabolism in cancer development. However, clinical data on the association between blood triglyceride or cholesterol levels including the cholesterol transporters high-density and low-density lipoproteins (LDL, HDL) and cancer incidence have remained inconclusive. Here, we investigated the association between blood triglyceride as well as total, LDL and HDL cholesterol levels and cancer among outpatients from Germany.Methods61,936 patients with available blood lipid values were identified from the IQVIA Disease Analyzer database and followed up between 2005 and 2019. Multivariable logistic regression models were used to study the association between lipid values and cancer.ResultsThe probability of cancer was significantly lower among patients with elevated total cholesterol concentrations and higher in patients with decreased HDL serum levels. In contrast, serum concentrations of LDL and triglycerides had no impact on cancer risk. In cancer site-stratified analyses, we observed a trend towards higher rates of cancers from digestive organs, breast, skin cancer, urinary tract and cancers from lymphoid and hematopoietic tissue in patients with HDL values < 35 mg/dl, while a negative association between total cholesterol > 250 mg/dl and respiratory organ as well as urinary tract cancers was observed.ConclusionOur data strongly support the hypothesis that serum-specific lipid profiles are positively associated with cancer.

Low Density Lipoprotein Receptor (LDLR) and 3-Hydroxy-3-Methylglutaryl Coenzyme a Reductase (HMGCR) Expression are Associated with Platinum-Resistance and Prognosis in Ovarian Carcinoma Patients.

PurposeThe efficacy of post-surgery platinum-based chemotherapy, the primary choice for the treatment of ovarian cancer (OC), is greatly reduced by the development of drug-resistance. In this study, we investigated the association of expression low-density lipoprotein receptor (LDLR) and 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), two cholesterol metabolism-related proteins, in OC tissues and chemoresistance and patient prognosis.MethodsSurvival analysis using LDLR and HMGCR expression in the ovarian cancer patients using the dataset of Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) was carried out online. A retrospective study was performed on 65 patients who had undergone surgery for ovarian cancer. In addition, patients were divided into 2 groups: platinum resistance group and platinum sensitivity group. Serum lipid metabolism data were collected and analyzed. Protein expressions of LDLR and HMGCR in ovarian cancer tissue were detected by immunohistochemistry.ResultsOnline survival analysis showed that patients with higher LDLR expression had poorer prognosis than those with lower LDLR expression in ovarian cancer cells, while a higher HMGCR expression was associated with better OC prognosis. Overall survival (OS) and disease-free survival (DFS) were lower in patients with higher LDLR levels (OS: P=0.046, DFS: P=0.009). Platinum-resistant patients had higher levels of low-density lipoprotein (LDL) and cholesterol in serum as compared with platinum-sensitive patients (P<0.001). Immunohistochemistry showed that LDLR expression was high and HMGCR was low in platinum-resistant patients.ConclusionThe expression of LDLR and HMGCR proteins, involved in the regulation of cholesterol metabolism and the plasma LDL and cholesterol levels were significantly different in platinum-resistant and platinum-sensitive ovarian cancer patients. We postulate that cholesterol metabolic reprogramming might play a role in platinum resistance in ovarian cancer.

The associations between alcohol intake and cardiometabolic risk in African-origin adults spanning the epidemiologic transition

BackgroundCardiometabolic (CM) risk affects approximately 25% of adults globally, and is diagnosed by meeting 3 out of 5 of the following CM risk factors: elevated blood pressure, high triglycerides, elevated blood sugar, low high-density lipoprotein (HDL) level, and abdominal obesity. Adults with CM risk are approximately 22% more likely to have higher mortality rates, and alcohol consumption may be associated with higher CM risk. While previous studies have investigated this potential connection, the majority of them did not include African-origin adults. Therefore, the study aimed to explore the association between alcohol intake and CM risk in 5 African-origin cohorts, spanning the epidemiologic transition in Ghana, South Africa, Jamaica, Seychelles and the United States of America.MethodsMeasurements included clinical measures for CM risk and self-reported alcohol consumption. Each participant was categorized into one of three drinking categories: non-drinker, light drinker (1–3 drinks daily for men and 1–2 drinks daily for women) and heavy drinker (4 or more drinks every day for men and 3 or more drinks per day for women). Using non-drinker status as the reference, the association between alcohol consumption status and prevalence of each of the five CM risk factors and overall elevated CM risk (having 3 out of 5 risk factors) was explored, adjusting for site, age and sex. Associations were explored using logistic regression and significance was determined using odds ratios (OR) and 95% confidence intervals.ResultsNeither light nor heavy drinking was associated with increased odds for having higher CM risk compared to nondrinkers (OR = 1.05, p = 0.792 and OR = 1.11, p = 0.489, respectively). However, light drinking was associated with lower odds for having low high density lipoproteins (HDL) cholesterol (OR = 0.69, p = 0.002) and increased risk for high triglycerides (OR = 1.48, p = 0.030). Heavy drinking was associated with elevated blood pressure (OR = 1.59, p = 0.002), high triglycerides (OR = 1.73, p = 0.006) and decreased risk of low HDL-cholesterol (OR = 0.621, p < 0.0005). Finally, country-specific analyses indicated that the relationship between heavy drinking and elevated CM risk varied widely across sites.ConclusionWhile several CM risk factors were associated with alcohol consumption, the associations were inconsistent and varied widely across five international cohorts of African-origin. Future studies should focus on understanding the individual site-related effects.

Cholesterol metabolism in Alzheimer’s disease

Alzheimer's disease (AD) is the most common form of dementia and affects around 24 million individuals worldwide. Several studies showed an association between high plasma low-density lipoprotein (LDL) levels and an increased risk of developing AD. To that effect, multiple drugs treating hypercholesterolaemia, such as statins, have been tested to prevent AD. In this study, we propose a new pharmacological target called Cholesteryl Ester Transfer Protein (CETP). In recent years, studies have shown an association between different genetic variants of CETP and the risk of developing AD. CETP is a plasma shuttle protein which promotes the transfer of cholesteryl esters from anti-atherogenic (high-density lipoprotein or HDL) particles to pro-atherogenic (LDL and very-low-density lipoproteins or VLDL) particles. The net effect of this interaction leads to more pro-atherogenic lipoproteins in plasma. Interestingly, CETP is expressed by astrocytes in the brain. Therefore, we propose that CETP inhibition may have general beneficial effects and prevent the development of AD. We assessed the effect of CETP expression and inhibition in cell culture and mouse models. Mice from four different genotypes were used: wildtype (WT), human CETP transgenic mice (hCETP), human APP transgenic mice (McGill-Thy1-hAPP), and hAPP/hCETP double transgenic mice. CETP inhibitor evacetrapib or vehicle were administered i.p. at 2 months of age every day for 10 weeks, followed by cognitive tests and biochemical analyses. CETP expression in cell cultures increased the production of A-beta peptides, whereas CETP inhibition normalized A-beta levels. In mice, we showed that at 5 months of age, female hAPP mice were cognitively impaired both in the evacetrapib and vehicle condition. Double transgenic hAPP/CETP female mice performed worse as compared to hAPP females indicating that CETP aggravated AD. Administration of evacetrapib apparently rescued the cognitive deficits elicited through CETP. Preliminary biochemical results indicate that A-beta levels are increased in double transgenic hAPP/CETP mice as compared to hAPP. CETP may play an aggravating role in AD, which has not yet been investigated since mice naturally lack CETP. We propose that CETP inhibitors such as evacetrapib may be promising pharmacological treatments contributing to the prevention of cognitive decline in AD.

Accumulation of LDL/ox-LDL in the necrotic region participates in osteonecrosis of the femoral head: a pathological and in vitro study

BackgroundOsteonecrosis of the femoral head (ONFH) is a common but intractable disease that appears to involve lipid metabolic disorders. Although numerous studies have demonstrated that high blood levels of low-density lipoprotein (LDL) are closely associated with ONFH, there is limited evidence to explain the pathological role of LDL. Pathological and in vitro studies were performed to investigate the role of disordered metabolism of LDL and oxidized LDL (ox-LDL) in the femoral head in the pathology of ONFH.MethodsNineteen femoral head specimens from patients with ONFH were obtained for immunohistochemistry analysis. Murine long-bone osteocyte Y4 cells were used to study the effects of LDL/ox-LDL on cell viability, apoptosis, and metabolism process of LDL/ox-LDL in osteocytes in normoxic and hypoxic environments.ResultsIn the pathological specimens, marked accumulation of LDL/ox-LDL was observed in osteocytes/lacunae of necrotic regions compared with healthy regions. In vitro studies showed that ox-LDL, rather than LDL, reduced the viability and enhanced apoptosis of osteocytes. Pathological sections indicated that the accumulation of ox-LDL was significantly associated with impaired blood supply. Exposure to a hypoxic environment appeared to be a key factor leading to LDL/ox-LDL accumulation by enhancing internalisation and oxidation of LDL in osteocytes.ConclusionsThe accumulation of LDL/ox-LDL in the necrotic region may contribute to the pathology of ONFH. These findings could provide new insights into the prevention and treatment of ONFH.

Caregiving for a Spouse with Cognitive Impairment: Effects on Nutrition and Other Lifestyle Factors.

Being a spousal caregiver (SCG) for a patient with cognitive impairment is well known to be associated with increased risk for dementia and cognitive decline. This study examined the impact of the care-recipient's cognitive status on lifestyle factors influencing cognitive decline in SCGs, focusing on nutritional status and blood biomarkers. Fifty-one SCGs participated (mean age 73.5±7.0 years) in this study. All participants underwent clinical assessment including the Mini Nutritional Assessment (MNA), Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and International Physical Activity Questionnaire to evaluate lifestyle factors, and the Mini-Mental State Examination to assess global cognition. Also, nutritional blood biomarkers were measured. SCGs caring for a demented spouse showed significantly higher depression scores (t = -3.608, p = 0.001) and malnutrition risk (t = 2.894, p = 0.006) compared to those caring for a non-demented spouse. Decreased care recipients' cognition was significantly correlated with higher GDS (β= -0.593, t = -4.471, p < 0.001) and higher MNA scores (β= 0.315, t = 2.225, p = 0.031) and lower level of high-density lipoprotein (HDL) cholesterol (β= 0.383, t = 2.613, p = 0.012) in their SCGs. Gender had moderating effects on association of care-recipients' cognition with sleep quality (B[SE] = 0.400[0.189], p = 0.041) and HDL cholesterol (B[SE] = -1.137[0.500], p = 0.028) among SCGs. Poorer care-recipient's cognition was associated with worse sleep quality and low HDL cholesterol among wives but not husband caregivers. This study provides substantial evidence that SCGs are at risk for depression and malnutrition, which can further affect cognitive decline. As such, these factors should be well assessed and monitored among SCGs for patient with cognitive impairment.

The association between FTO rs9939609 polymorphism and serum lipid profile in adult women

BackgroundFTO gene is considered to play an important role in many metabolic diseases. Evidence from studies indicated the possible association between the FTO rs9939609 polymorphisms with serum lipid profile. Therefore, this study aimed to investigate the association of FTO rs9939609 polymorphism with lipid profile in Iranian women.MethodsThis cross-sectional study was carried out on 380 adult women. Information about age, height, weight, BMI, physical activity, and dietary intake were collected. The serum levels of Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Triglyceride (TG), and total cholesterol were measured. The FTO gene was genotyped for rs9939609 polymorphism. The participants were divided into two groups of TT and AT/AA considering dominant model of FTO rs9939609 polymorphism.ResultsGeneral characteristics of the participants with different FTO genotypes were not significantly different. The lower levels of HDL were observed in AT/AA genotypes compared to the TT wild type genotype of FTO rs9939609 polymorphism (P = 0.004). Adjustments of age, BMI, and physical activity did not change the results.ConclusionsHowever, the significant association between FTO genotype and the HDL level was disappeared after further adjustments for dietary intake. Further studies are warranted to identify the underlying mechanisms of the possible association between FTO gene and serum lipid profile.

Abstract 10888: Lipid Profile Predicts Number and Length of Coronary Artery Stents

Introduction: Higher levels of low-density lipoprotein (LDL) are associated with an increased incidence of cardiovascular events. Little is known about the impact of lipid profile on the severity and extent of disease. This study aims to characterize the lipid profile’s ability to predict the number of and total length of coronary artery stents. Hypothesis: In patients undergoing percutaneous coronary intervention, the lipid panel is predictive of the total length and number of coronary stents deployed. Methods: We retrospectively identified unique, consecutive patients undergoing percutaneous coronary intervention at a single center from April 2018 to March 2021. Inclusion criteria included the availability of a lipid panel in the electronic medical record. Associations between lipid levels with stent number or stent length were tested by univariable linear regression. Results: For a single coronary angiogram procedure, 1547 unique patients had a lipid panel in the EMR within 2 weeks of the procedure with a median of 2 stents deployed with median total stent length of 38 mm. High-density lipoprotein (HDL), LDL, but not total cholesterol, triglycerides (TG), were predictive of stent length (HDL inversely, p =0.004; LDL p =0.01) and number of stents (HDL inversely, p =0.008; LDL p =0.04). Conclusions: These results indicate that the lipid panel has implications for the severity and extent of coronary artery disease found during coronary angiography, reflected in the number of and total length of coronary artery stents.

Obesity in young South African women living with HIV: A cross-sectional analysis of risk factors for cardiovascular disease.

Young South African women are faced with a dual epidemic of HIV and obesity, placing them at a high risk of developing atherosclerotic cardiovascular disease (CVD). We sought to determine the prevalence of CVD risk factors in a cohort of reproductive-aged South African women living with HIV (WLHIV). While the main purpose of an ongoing intervention study is the reduction of cardiovascular disease through the integration of CVD screening and prevention in the HIV management plan for women of reproductive age (ISCHeMiA trial), we present the prevalence of risk factors for CVD in this cohort of young women at baseline. Sociodemographic, conventional CVD risk factors, HIV-related factors and self body image perception were assessed through study questionnaires and standardized clinical and laboratory procedures. Of the 372 WLHIV enrolled from November 2018 to May 2019, 97% had received efavirenz-based antiretroviral treatment (ART) for at least 1 year and 67.5% (248/367) of women were overweight or obese at the time of enrolment. The prevalence of metabolic syndrome was 17.6% (95%CI 11.6-22.8) at a median age of 35 years (IQR 30.5-40.5). A significant proportion of women had abnormally low levels of high-density lipoprotein (43.2%, 80/185) and elevated levels of high sensitivity C-reactive protein (59.5%, 110/185). Seventy five percent of overweight women with an increased waist circumference reported to be satisfied with their body image. The high prevalence of metabolic syndrome, obesity and elevated markers of inflammation in young South African WLHIV, underscores the need for a proactive integrated management approach to prevent atherosclerotic cardiovascular disease in low and middle income settings.

Effect of numbers of metabolic syndrome components on mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis with metabolic syndrome.

This study investigated the effect of the number of metabolic syndrome (MetS) components on all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with MetS. The medical records of 93 AAV patients with MetS were retrospectively reviewed. MetS was diagnosed when three or more the following MetS components for Asians were met: (i) increased waist circumference; ii) high blood pressure; (iii) hypertriglyceridaemia; (iv) low level of high-density lipoprotein (HDL)-cholesterol; and (v) impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM). All-cause mortality was defined as death owing to any aetiology. The median age was 61.4 years and 33 patients were men. Among 93 AAV patients with MetS, as the number of MetS components increased, the cumulative patient survival rate significantly decreased (p = 0.024). Compared to surviving AAV patients with MetS, deceased AAV patients with MetS were older, had higher Birmingham vasculitis activity score (BVAS) and Five-factor score (FFS), a lower frequency of IFG or T2DM, and a higher number of MetS components. In the multivariable Cox analysis, AAV patients with MetS who had all five MetS components were approximately 62 times more susceptible to all-cause mortality than those who had only three components. In terms of IFG or T2DM, patients with only IFG exhibited a significantly lower cumulative patients' survival rate than those without. The presence of many MetS components at the initial diagnosis of AAV was an independent and significant predictor of all-cause mortality in AAV patients with MetS.

High-density lipoproteins and clinical outcomes of COVID-19 in hemodialysis patients: A multicenter, propensity-score matched case-control study

Abstract. A decline in high-density lipoprotein (HDL) has been observed in the general population of COVID-19 infected patients. However, little research has been devoted to this topic in hemodialysis (HD) patients and there is a general lack of data on the association between the baseline HDL level and COVID-19 outcomes in HD patients. The present study aimed to assess the association between baseline HDL levels and the risk of developing severe outcomes of COVID-19 infection in HD patients.&#x0D; Methods. A total of 428 HD patients aged 55 (44-64) years and a dialysis vintage of 44 (21-76.6) months were enrolled in this multicenter propensity-score matched case-control study. After propensity-score matching (1 :1), 142 COVID-19 infected HD patients were compared with 142 HD patients who had never been infected with COVID-19. Propensity scores were estimated with MedCalc software based on potential confounding variables (age, diabetes, dialysis vintage and cardiovascular events). Baseline HDL levels were obtained from electronic health records of the patients (the last measurements were carried out before the COVID-19 onset). The endpoints of the study were COVID-19-related hospitalization, oxygen maintenance, and death.&#x0D; The data were presented as the median and the interquartile ranges [Me (Q25-Q75)] and compared using the Mann-Whitney or Kruskal-Wallis tests, as appropriate. The Spearmen correlation test was used to assess the association between HDL and other markers. The multivariate logistic regression and the receiver operating characteristic (ROC) analyses were performed to evaluate the ability of HDL for predicting the severity of COVID-19 infection. The Cox regression analysis was used to determine the association between HDL and COVID-19-associated mortality.&#x0D; Results. Among 142 patients infected with COVID-19, 40 patients (28%) patients were hospitalized, 34 patients (24%) needed oxygen supplements and 16 patients (11.3%) died. The baseline HDL level was significantly lower in the COVID-19 patients compared with the non-infected patients (1.22 (0.97-1.59) vs 1.52 (1.08-1.85) mmol/L, p = 0.011). Moreover, the baseline HDL level was significantly negatively associated with CT findings of pulmonary involvement (r = -0.76, p &lt; 0.0001) and had a strong inverse correlation with serum C-reactive protein (r = -0.42, p = 0,0002) and D-dimer (r = -0.65, p &lt; 0.0001). The multivariate logistic regression analysis demonstrated that HD patients with HDL concentration &lt;1.22 mmol/l have 3 times higher risk of COVID-19 infection (OR 2.8; 95% CI 1.2; 6.5, p = 0.003). In the Cox regression analysis adjusted for the patients’ age, diabetic status, dialysis vintage and cardiovascular events, low HDL level (&lt;1.22 mmol/L) was found to be associated with COVID-19-related mortality in the HD patients (χ2 = 9.2, p = 0.002).&#x0D; Conclusions. Baseline low HDL-C level was independently associated with COVID-19 morbidity, severity and mortality in HD patients.