Lower Total Cholesterol Levels Research Articles

Predictors of relapse in high lethality suicide attempters: a six-month prospective study

BackgroundThis study is aimed to investigate the association between clinical, metabolic, inflammatory and environmental (photoperiod defined as daily sunlight exposure) parameters and suicide re-attempts after the index suicide attempt. Possible predictors of suicide re-attempts were also explored. MethodsOverall, 432 subjects with suicide attempts, of which 79 relapsed within the following six months were included in this prospective study. We adopted the Joiner's definition of suicide lethality, as “the acquired ability to enact lethal self-injury”. The Cox regression was used to test the association between the mentioned variables and Kaplan-Meier plots showed the trend of suicide re-attempts. ResultsAmong participants, 30.8% committed a high-lethality suicide attempt. Cox regression confirmed the association between lifetime suicide attempts and number of suicide attempts in the study time-frame and suicide-reattempts. The longer photoperiod (Spring/Summer) was associated with suicide re-attempts, particularly patients with admission in June/July for the index event. Total cholesterol (TC), low-density lipo-protein cholesterol and c-reactive protein serum levels were significantly associated with suicide re-attempts but Cox regression confirmed only the association between lower TC serum levels and suicide re-attempt. LimitationsPatients’ seasonal environment, psychological factors, presence of acute life-events fostering the suicidal crisis and detailed medical history have been not investigated. Findings were derived from a single psychiatric unit. ConclusionsLifetime suicide attempts, higher number of previous suicide attempts, lower total cholesterol levels, and suicide attempt during longer photoperiod were significant predictors of suicide re-attempts. Further studies are needed in order to better characterize single- vs. multiple suicide attempter's profiles.

Low Cholesterol Level Linked to Reduced Semantic Fluency Performance and Reduced Gray Matter Volume in the Medial Temporal Lobe.

Hyperlipidemia has been proposed as a risk factor of dementia and cognitive decline. However, the findings of the relationship between cholesterol level and cognitive/brain function have been inconsistent. Here, using a well-controlled sample from the Parkinson’s Progression Markers Initiative (PPMI), we investigated the probable non-linear relationship between plasma total cholesterol (TC) level, gray matter volume (GMv), and cognitive performance in 117 non-demented subjects (mean age, 61.5 ± 8.9 years), including 67 Parkinson’s disease (PD) patients and 50 demographically matched controls. A quadratic relationship between semantic fluency (SF) performance and TC levels was identified. Within the subjects with a desirable TC level (TC < 200 mg/dl), low TC (lTC) levels were associated with reduced SF performance, as well as reduced GMv in three medial temporal regions [including bilateral anterior hippocampus (HIP)]. In contrast, no significant relationship between TC and cognition performance/GMv was found in individuals with a high cholesterol level (i.e., TC ≥ 200 mg/dl). Further region of interest (ROI)-based analysis showed that individuals with TC levels ranging from 100 to 160 mg/dl had the lowest GMv in the medial temporal regions. These findings suggest that low-normal TC level may be associated with reduced cognitive function and brain atrophy in regions implicated in neurodegenerative diseases, adding to a growing body of literature supporting a probable non-linear relationship between cholesterol level and brain health. However, this finding needs to be verified with other large public cohort data that do not include PD patients.

Echocardiographic and biochemical profile in children with celiac disease

Background: A number of heart diseases such as autoimmune myocarditis, cardiomyopathy, and ischemic heart disease are recently being reported among celiac patients. Studies have also demonstrated subclinical cardiac dysfunction and clustering of many traditional cardiovascular risk factors in children with celiac disease. Objective: The present study was conducted for echocardiographic and biochemical assessment of children with celiac disease. Materials and Methods: A cross-sectional observational study was conducted among 36 children (aged 1–16 years) who were newly diagnosed with celiac disease and age- and sex-matched controls. Venous blood samples were assessed for serum C-reactive protein (CRP), folic acid, Vitamin B12, and homocysteine levels, and fasting lipid profile including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) levels using appropriate methods. Echocardiographic parameters were measured by M-mode ultrasonography measuring left atrial dimension (LAD), left ventricular end-diastolic dimension (LVEDD), right ventricular diastolic diameter (RVDD), interventricular septal thickness at end-diastole (IVSd), left ventricular posterior wall thickness at end-diastole (LVPWd), aortic root dimension (ARD), and ejection fraction (EF). Results: Among the echocardiographic parameters, EF was significantly lower while other parameters such as LAD, LVEDD, RVDD, IVSd, LVPWd, and ARD showed no significant increase among the cases. Significantly lower levels of TC, HDL-C, and LDL-C with normal TG, CRP, Vitamin B12, and folic acid levels with significantly increased serum homocysteine levels were noted among cases. Conclusion: A significant difference in EF and the presence of biochemical risk factors for cardiovascular diseases warrants further detailed evaluation and follow-up with regular monitoring of cardiac functions.

Haemorrhagic transformation following ischaemic stroke: A retrospective study

The aim of this study was to identify the prevalence of haemorrhagic transformation (HT) in patients with ischaemic stroke, and evaluate its association with medical comorbidities, stroke subtypes, premorbid medication, and long-term survival. To achieve this, we performed a retrospective analysis of 527 consecutive stroke rehabilitation patients. Of these, 102 (19.4%) developed HT. Older patients, and those with large artery strokes, had a higher risk of HT. Forty-one patients received alteplase (rtPA), of which 15 (36.6%) developed HT. A total of 129 (24.5%) patients were taking aspirin prior to their stroke and, of these, 39 (30.2%) developed HT. Twenty-three (4.36%) patients were taking vitamin k antagonists, prior to stroke, of which 14 (60.9%) developed HT. There were 102 patients (19.35%) with underlying atrial fibrillation, of whom 55 (53.9%) developed HT. Patients with known ischaemic heart disease had an increased risk of HT, and patients with HT had significantly lower total cholesterol levels (4.96 vs. 5.34) and lower LDL cholesterol levels (3.20 vs. 3.5). In conclusion, older age, atrial fibrillation, treatment with oral anticoagulants and antiplatelet medications prior to stroke, low total and LDL cholesterol, and rtPA use, are all associated with HT. Survival was not affected by the presence of HT.

Abstract P193: Lipidomics of APOE Genotype Among Older Black Men Revealed ε2 Carriers Were More Different and ε4 Carriers Were Less Different When Compared to ε3 Homozygous

Introduction: The ability of apolipoprotein E (APOE) to regulate lipid metabolism in the brain and periphery is impacted by APOE genotype. The ε4 and ε2 variants are associated with higher and lower risks of Alzheimer’s disease, respectively, than ε3 homozygous. The ε4 variant is also associated with a higher cardiovascular disease risk. Differences in lipoprotein affinity by APOE genotype can cause altered profiles of plasma lipids and lipoproteins. APOE ε4 carriers have higher levels of triglycerides and total cholesterol, whereas ε2 carriers have higher levels of triglycerides, but lower levels of total cholesterol. A detailed description of specific lipid molecular species that differ by APOE genotype may indicate therapeutic targets to mitigate the associated higher disease risk. We used lipidomics to identify metabolites and metabolic pathways that differ by APOE genotype among 278 black men ages 70-81 from the Health, Aging, and Body Composition study. Hypothesis: Multiple cholesterols and triglycerides will differ by APOE genotype. Methods: Using liquid chromatography-mass spectrometry, 222 lipids/lipid-like metabolites were detected in overnight-fasting plasma. APOE genotype was categorized as ε4 carriers (ε3ε4 and ε4ε4), ε2 carriers (ε2ε3 and ε2ε2), or ε3 homozygous. We excluded ε2ε4 carriers (n=14). We identified metabolites associated with APOE genotype using linear regression, adjusting for age and study site. To account for multiple comparisons, we used a Benjamini-Hochberg correction with 30% false discovery rate. We applied a Lipid Pathway Enrichment Analysis. Results: LDL cholesterol was lower among ε2 carriers vs. remaining participants. There was no difference in HDL cholesterol or triglycerides by APOE genotype. Twenty-three lipids/lipid-like molecules differed by APOE genotype (p&lt;0.05); 12 were significantly lower and eight were significantly higher among ε2 carriers vs. ε3 homozygous and ε4 carriers, two metabolites were higher among ε2 vs. ε4 carriers, and one metabolite was lower among ε4 carriers vs. ε3 homozygous. Top pathways identified were fat digestion/absorption (p=0.005) and cholesterol metabolism (p=0.005). Five lipids/lipid-like molecules remained significant after accounting for multiple comparisons: C16:1 monoacylglycerols, C18:2 cholesteryl esters (CE), C20:3 CE, C16:0 CE, and C54:10 triacylglycerol. BMI or waist circumference did not alter associations. Conclusion: The ε2 carriers had lower levels of all seven cholesteryl esters and higher levels of all, but one of the seven triacylglycerols associated with APOE genotype. Almost all metabolites that differed significantly by APOE genotype were due to differences in ε2 carriers, whereas ε3 homozygous and ε4 carriers were more similar. The observed differences in lipid species provides a better metabolic characterization of APOE genotype in this cohort of older black men.

Preoperative serum total cholesterol is a predictor of prognosis in patients with renal cell carcinoma: a meta- analysis of observational studies.

ABSTRACTPurpose Several studies have demonstrated the strong correlation between the levels of preoperative serum total cholesterol (TC) and the survival of patients with surgically treated renal cell carcinoma (RCC). However, this association remains controversial. We performed a meta-analysis of published reports to evaluate the prognostic significance of the preoperative serum TC levels for patients with surgically treated RCC.Material and Methods The databases from MEDLINE (via PubMed), Embase, Web of Science and Cochrane Library were systematically searched to identify the eligible studies published before August 2019. Multivariate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated through inverse variance by using random-effects models.Results Nine cohort studies comprising 15.609 patients were identified. Low preoperative serum TC levels were associated with poor cancer-specific survival (CSS; HR=0.98, 95% CI: 0.97-0.99; P=0.005; I2=74.2%) and progression-free survival (PFS; HR=0.69, 95% CI: 0.49-0.98; P=0.036; I2=80%) in patients with surgically treated RCC. However, no significant association was observed between low preoperative serum TC levels and shorter overall survival (HR=0.93, 95% CI: 0.87-1.00; P=0.057; I2=86.2%). Sensitivity analyses validated the reliability and rationality of the results.Conclusions Preoperative serum TC level is an independent poor prognostic factor for patients with surgically treated RCC, with lower levels associated with worse CSS and PFS. Hence, this parameter may provide additional guidance in the selection of therapeutic strategies to improve prognosis, considering that cholesterol is a broadly applied routine marker in clinical practice.

Cardiovascular Risk Assessment and Therapeutic Implications in Rheumatoid Arthritis.

Patients with rheumatoid arthritis (RA) suffer from a magnitude of excess cardiovascular risk. A paradoxical lipid pattern has been observed in rheumatoid arthritis patients where low levels of total cholesterol and low-density lipoprotein are associated with a higher risk of cardiovascular disease. This paper aims to break down the evidence explaining why patients with low to normal LDL, and total cholesterol have such excess cardiovascular risk. A component of the enhanced cardiovascular risk is systemic inflammation and the subsequent pro-atherogenic dyslipidemia patterns. Due to this "lipid paradox," current risk algorithms and guidelines designed for the general population may underestimate cardiovascular risk in patients with rheumatoid arthritis. The purpose of this paper is to critically evaluate some of the discrepancies and layers of cardiovascular risk in RA patients, the role RA medication may have in mitigating or increasing cardiovascular risk, and the possible role of statin therapy.

Role of the DNA repair genes H2AX and HMGB1 in human fat distribution and lipid profiles

IntroductionRegional fat distribution strongly relates to metabolic comorbidities. We identified the DNA repair genes H2AX and HMGB1 to be differentially expressed between human subcutaneous (SAT) and omental visceral adipose tissue...

Deficiency of T-type voltage-gated calcium channels results in attenuated weight gain and improved endothelium-dependent dilatation of resistance vessels induced by a high-fat diet in mice.

The deletion of T-type Cav3.1 channels may reduce high-fat diet (HFD)-induced weight gain, which correlates positively with obesity and endothelial dysfunction. Therefore, experiments were designed to study the involvement of T-type Cav3.1 channels in HFD-induced endothelial dysfunction in mice. Wildtype (WT) and Cav3.1-/- mice were fed either a normal diet (ND) or an HFD for 8weeks. Body composition was assessed, and thoracic aortae and mesenteric arteries were harvested for myography to assess endothelium-dependent responses. Changes in intracellular calcium were measured by fluorescence imaging, and behavior was assessed with the open-field test. Cav3.1-/- mice had attenuated HFD-induced weight gain and lower total fat mass compared with WT mice. Cav3.1-/- mice on an HFD had reduced plasma cholesterol levels compared with WT mice on the same diet. Increased feeding efficiency, independent of food intake, was observed in WT mice on an HFD compared with an ND, but no difference in feeding efficiency between diets was observed for Cav3.1-/- mice. Nitric oxide-dependent dilatation was increased in mesenteric arteries of Cav3.1-/- mice compared with WT mice on an HFD, with no difference observed in aortae. No differences in mouse locomotor activity were observed between the experimental groups. Mice on an HFD lacking T-type channels have reduced weight gain, lower total cholesterol levels, and increased dilatation of resistance vessels compared with WT mice on an HFD, suggesting that Cav3.1 deletion protects against endothelial dysfunction in resistance vessels but not in large conduit vessels.

26-Year-Old Woman With Shortness of Breath and Chest Pain

26-Year-Old Woman With Shortness of Breath and Chest Pain

A small molecule inhibitor of PCSK9 that antagonizes LDL receptor binding via interaction with a cryptic PCSK9 binding groove

Proprotein convertase (PC) subtilisin kexin type 9 (PCSK9) inhibits the clearance of low density lipoprotein (LDL) cholesterol from plasma by directly interacting with the LDL receptor (LDLR). As the interaction promotes elevated plasma LDL cholesterol levels and a predisposition to cardiovascular disease (CVD), it has attracted much interest as a therapeutic target. While anti-PCSK9 monoclonal antibodies have been successful in the treatment of hypercholesteremia by decreasing CVD risk, their high cost and a requirement for injection have prohibited widespread use. The advent of an orally bioavailable small molecule inhibitor of the PCSK9-LDLR interaction is an attractive alternative, however efforts have been tempered as the binding interface is unfavourable for binding by small organic molecules. Despite its challenging nature, we report herein the discovery of compound 3f as a small molecule inhibitor of PCSK9. The kinase inhibitor nilotinib emerged from a computational screen that was applied to identify compounds that may bind to a cryptic groove within PCSK9 and proximal to the LDLR-binding interface. A subsequent in vitro PCSK9-LDLR binding assay established that nilotinib was a bona fide but modest inhibitor of the interaction (IC50 = 9.8 µM). Through multiple rounds of medicinal chemistry, 3f emerged as a lead-like molecule by demonstrating disruption of the PCSK9-LDLR interaction at nanomolar levels in vitro (IC50 = 537 nM) with no inhibitory activity (IC50 > 10 µM) against a small panel of kinases. Compound 3f restored LDL uptake by liver cells at sub-micromolar levels and demonstrated excellent bioavailability when delivered subcutaneously in mice. Most significantly, compound 3f lowered total cholesterol levels in the plasma of wild-type mice, thereby providing proof-of-concept that the notion of a small molecule inhibitor against PCSK9 is therapeutically viable.

Prolyl Hydroxylase Domain Inhibitor Protects against Metabolic Disorders and Associated Kidney Disease in Obese Type 2 Diabetic Mice.

Prolyl hydroxylase domain (PHD) inhibitors, which stimulate erythropoietin production through the activation of hypoxia-inducible factor (HIF), are novel therapeutic agents used for treating renal anemia. Several PHD inhibitors, including enarodustat, are currently undergoing phase 2 or phase 3 clinical trials. Because HIF regulates a broad spectrum of genes, PHD inhibitors are expected to have other effects in addition to erythropoiesis, such as protection against metabolic disorders. However, whether such beneficial effects would extend to metabolic disorder-related kidney disease is largely unknown. We administered enarodustat or vehicle without enarodustat in feed to diabetic black and tan brachyury (BTBR) ob/ob mice from 4 to 22 weeks of age. To elucidate molecular changes induced by enarodustat, we performed transcriptome analysis of isolated glomeruli and in vitro experiments using murine mesangial cells. Compared with BTBR ob/ob mice that received only vehicle, BTBR ob/ob mice treated with enarodustat displayed lower body weight, reduced blood glucose levels with improved insulin sensitivity, lower total cholesterol levels, higher adiponectin levels, and less adipose tissue, as well as a tendency for lower macrophage infiltration. Enarodustat-treated mice also exhibited reduced albuminuria and amelioration of glomerular epithelial and endothelial damage. Transcriptome analysis of isolated glomeruli revealed reduced expression of C-C motif chemokine ligand 2/monocyte chemoattractant protein-1 (CCL2/MCP-1) in enarodustat-treated mice compared with the vehicle-only group, accompanied by reduced glomerular macrophage infiltration. In vitro experiments demonstrated that both local HIF-1 activation and restoration of adiponectin by enarodustat contributed to CCL2/MCP-1 reduction in mesangial cells. These results indicate that the PHD inhibitor enarodustat has potential renoprotective effects in addition to its potential to protect against metabolic disorders.

Association of Lipid biomarkers with drinking patterns and severity in alcoholic liver disease - A hospital- based cross- sectional stud

Alcoholic liver disease (ALD) is one of the leading causes of death due to cirrhosis. Dyslipidemia is a common finding in ALD and lipid parameters are shown to be associated with disease severity. However the effect of alcohol drinking pattern on lipid abnormalities is still unclear. Hence this cross sectional study was planned to estimate the serum lipid profile in ALD patients and to determine the association of lipid parameters with alcohol drinking pattern and the severity of liver disease.50 male patients with ALD and 50 age matched controls were enrolled. AUDIT score was used to assess their drinking pattern. Serum lipid profile and liver parameters were estimated and compared between the cases and controls. The patients were grouped based on severity into Child Pugh's group A, B and C and the study parameters were compared between the groups. All statistical analyses were done using SPSS v20.0. The mean total cholesterol level (126.98±45.06 vs 163.2±24.38 mg/dL), LDL and HDL cholesterol was significantly less in ALD compared to controls. Total cholesterol and LDL cholesterol levels were low in Child Pugh's Score C group. Mean AUDIT score was18 ± 4. Low Total cholesterol and LDL cholesterol levels correlate with disease severity and are markers of poor prognosis. Lipid parameters do not correlate with alcohol drinking patterns in ALD.

Skeletal muscle area and density are associated with lipid and lipoprotein cholesterol levels: The Multi-Ethnic Study of Atherosclerosis

Loss of muscle mass with age may be a key player in metabolic dysregulation. We examined the associations between abdominal muscle areaanddensitywith lipids and lipoproteins. One thousand eight hundred and sixty eight adults completed health history and physical activity questionnaires, provided venous blood samples for lipids and inflammatory biomarkers, and underwent computed tomography to quantify body composition. Associations between muscle area and density with multiple lipid measures were assessed with multivariable linear and logistic regression. The mean age and body mass index of participants was 65years and 28kg/m2, respectively, and 50% were female. After adjustment for demographics, cardiovascular disease risk factors, lipid-lowering medications, physical activity, sedentary behavior, inflammatory biomarkers, and central obesity, a 1-standard deviation increase in total abdominal, stability, and locomotor muscle areas was associated with a 13%, 11%, and 8% lower high-density lipoprotein cholesterol level, respectively (P<.05). With similar adjustment, a 1-standard deviation increase in total abdominal and stability muscle area was associated with a 13% and 12% lower total cholesterol level, respectively (P<.01). Compared to the lowest quartiles of total, stability, and locomotor muscle area, those in the higher quartiles of muscle area had over a 40% reduction in the odds of triglyceride levels greater than 150mg/dL (P<.05). Total abdominal muscle density was positively associated with total cholesterol (P<.05) but was not associated with the other lipid outcomes. Maintaining adequate skeletal muscle mass with age may decrease specific lipid levels related to hyperlipidemia and development of cardiometabolic disease.

Effect of isolation practice on the transmission of middle east respiratory syndrome coronavirus among hemodialysis patients: A 2-year prospective cohort study.

Hemodialysis (HD) patients had a high rate of infection transmission and mortality during the middle east respiratory syndrome coronavirus (MERS-CoV) outbreak in Saudi Arabia. A standardized guideline on isolation technique for exposed HD patients is not available. Thus, this study aimed to evaluate the effect of different isolation strategies on the prevention of secondary viral transmission and clinical outcomes among exposed HD patients.During the 2015 MERS-CoV outbreak in Korea, 116 patients in 3 HD units were incidentally exposed to individuals with confirmed MERS-CoV infection and underwent different types of isolation, which were as follows: single-room isolation (n = 54, 47%), cohort isolation (n = 46, 40%), and self-imposed quarantine (n = 16, 13%). The primary outcome was rate of secondary viral transmission. The secondary outcome measures were changes in clinical and biochemical markers during the isolation period, difference in clinical and biochemical markers according to the types of isolation practice, and effect of isolation practice on patient survival.During a mean isolation period of 15 days, no further cases of secondary transmission were detected among HD patients. Plasma hemoglobin, serum calcium, and serum albumin levels and single-pool Kt/V decreased during the isolation period but normalized thereafter. Patients who were subjected to self-imposed quarantine had higher systolic and diastolic blood pressure, lower total cholesterol level, and lower Kt/V than those who underwent single-room or cohort isolation. During the 24-month follow-up period, 12 patients died. However, none of the deaths occurred during the isolation period, and no differences were observed in patient survival rate according to different isolation strategies.Although 116 participants in 3 HD units were incidentally exposed to MERS-CoV during the 2015 outbreak in Korea, strict patient surveillance and proper isolation practice prevented secondary transmission of the virus. Thus, a renal disaster protocol, which includes proper contact surveillance and isolation practice, must be established in the future to accommodate the needs of HD patients during disasters or outbreaks.

The association of lipid metabolism and non-alcoholic fatty liver disease in children with obesity.

Aim:Obesity, insulin resistance, and hyperlipidemia have been shown as risk factors for non-alcoholic fatty liver disease. In this study, the association between lipid and lipoprotein metabolism abnormalities and the presence of non-alcoholic fatty liver disease was investigated in patients with obesity.Material and Methods:In this study, the clinical, laboratory and imaging findings of 357 children and adolescent patients (199 girls and 158 boys) aged 2–18 years who were diagnosed as having obesity between 2013 and 2018 were retrospectively analyzed. The clinical and laboratory features of the patients who were diagnosed as having non-alcoholic fatty liver disease using ultrasonography were compared with patients who did not have non-alcoholic fatty liver disease. All lipid and lipoprotein levels were defined as hypo-, normo- and hyperlipidemic in comparison with the reference values according to age and sex.Results:The frequency of non-alcoholic fatty liver disease was 44.5% in the entire study group and was higher in males (p<0.05). The body weight, body mass index, alanine aminotransferase, glucose, insulin, non-high-density lipoprotein-cholesterol, and HOMA-IR scores were found to be higher in the patients with non-alcoholic fatty liver disease, whereas the high-density lipoprotein-cholesterol level was lower (p<0.05). There was no difference in the frequency of non-alcoholic fatty liver disease among the patients with low, normal, and high total cholesterol, triglyceride and low-density lipoprotein-cholesterol levels (p>0.05). The frequency of lipid metabolism disorder (hypolipidemia and/or hyperlipidemia) was found as 77.5% in all patients.Conclusion:Non-alcoholic liver disease and lipid metabolism disorders are common in children and adolescents with obesity. The frequency of non-alcoholic fatty liver disease in hypolipidemic, normolipidemic, and hyperlipidemic patients was not different. This finding indicated that the increase in the amount of body fatty tissue and insulin resistance were more important risk factors in the development of non-alcoholic fatty liver disease.

Plasma high-density lipoprotein cholesterol responses to endurance exercise training: A meta-analysis of randomized controlled trials

Background: Endurance exercise improves lipid and lipoproteins levels, while low high-density lipoprotein cholesterol (HDL-C) levels are risk factors for cardiovascular disease. There is a lack of evidence for the exercise characteristics in increasing lipids level, irrespective of the fact that endurance exercise increases lipids and lipoproteins level. The aim of this study was to clarify the effect and characteristics of endurance exercise in increasing HDL-C in randomized controlled trials. Methods: A search was performed for published studies between 1999 and 2014. Studies that assessed endurance exercise for ≥8 weeks and also reported the HDL-C levels pre- and post-training were included. The random effects model was used to measure the association between exercise and net change of HDL-C. Univariate regression analyses investigated the correlation of exercise characteristics. Subgroup and sensitivity analyses were performed to explore the sources of heterogeneity and the effect of potential confounders. The influence of pre-exercise lipid profile was assessed by meta-regression. Data were analyzed using Stata SE (12.0). Results: Fourteen studies with a total of 777 subjects were included. The mean HDL-C was reported to be increased and was statistically significant (weighted mean difference: 4.41 mg/dL; 95% confidence interval [CI]: 2.16–6.66 mg/dL, P < 0.001; I2 = 87.4%, P < 0.001). Univariate analysis indicated that exercise length was significantly associated with a net change of HDL-C (r = 0.56, P = 0.01). Nevertheless, there was no significant association between exercise frequency, duration, and total minutes. By subgroup analysis, exercise increased HDL-C level in Asia, Europe, and Africa and among all body mass index groups (P < 0.05). None of the studies omitted, in turn, seemed to substantially influence the effect of exercise on HDL-C by sensitivity analysis. Meta-regression showed that pre-exercise total cholesterol (TC) negatively correlated with net change of HDL-C (95% CI: 0.127, −0.018, r = −0073, P = 0.012). However, pre-exercise triglycerides, low-density lipoprotein cholesterol, and HDL-C did not correlate with a net change of HDL-C. Conclusions: Regular endurance exercise increases HDL-C level in any weight population. Exercise length of more than 8 weeks was the most important element of an exercise prescription. Among all lipid profiles, only the initial lower TC level responded better to exercise training and was more effective in increasing HDL-C level.

Correlations between blood lipid, serum cystatin C, and homocysteine levels in patients with Parkinson's disease.

The aim was too study the correlations between blood lipid, serum cystatin C (Cys C) and homocysteine (Hcy) levels in patients with Parkinson's disease (PD). A total of 322 PD patients and 214 healthy subjects were selected as case and control groups, respectively. The risk factors were explored by logistic regression analysis. The case group was subtyped according to main motor symptoms and age of onset. The correlations of significantly different indices with age, duration of disease, and equivalent dose of levodopa were studied by Spearman's correlation analysis. Receiver operating characteristic curves were plotted to analyze diagnostic values. Compared to the control group, the PD group had lower serum total cholesterol, triglyceride, and apolipoprotein B (Apo B) levels and higher high-density lipoprotein cholesterol (HDL-C), Hcy, and Cys C levels (P < 0.05). Decreased Apo B level and increased HDL-C and Hcy levels were independent risk factors (P < 0.05). The Cys C level of early-onset patients was lower than of late-onset patients (P < 0.05). Hcy (r = 0.198, P < 0.05) and Cys C (r = 0.281, P < 0.05) levels were positively correlated with age. Triglyceride level was negatively correlated with age (r = -0.202, P < 0.05) and disease duration (r = -0.198, P < 0.05). Unified Parkinson's Disease Rating Scale III score was positively correlated with disease duration (r = 0.435, P < 0.05) and equivalent dose of levodopa (r = 0.423, P < 0.05). The areas under the curve for Apo B, HDL-C, and Hcy levels were 0.341, 0.588, and 0.643, respectively (P < 0.05). The combination of Apo B, HDL-C, and Hcy levels showed high diagnostic value, with a sensitivity of 76.4% and specificity of 69.5%. Low serum levels of total cholesterol, triglyceride, and Apo B, and high levels of HDL-C, Hcy, and Cys C may be correlated with PD onset and progression. Decreased Apo B level and elevated HDL-C and Hcy levels are independent risk factors. Early-onset and late-onset PD may have different progression mechanisms.

Higher Cholesterol Level Predicts Cardiovascular Event and Inversely Associates With Mortality in Hemodialysis Patients: 10‐Year Outcomes of the Q‐Cohort Study

The prevalence of atherosclerotic diseases is higher in hemodialysis patients. The aim of the current study was to investigate associations between cholesterol level and the incidences of cardiovascular disease (CVD) and mortality in hemodialysis patients. A total of 3517 participants undergoing maintenance hemodialysis were followed up for 10 years. Total cholesterol (TC) level was divided into quartile in baseline data. The multivariate analyses were calculated by a Cox proportional hazards model. The incidences of ischemic heart disease (IHD), peripheral artery disease (PAD), and CVD were significantly positively associated with higher cholesterol levels after adjustment for confounding factors (P < 0.01, P = 0.04, and P < 0.01, respectively). Furthermore, the incidences of cancer-associated mortality and all-cause mortality were significantly positively associated with lower cholesterol levels after adjustment for confounding factors (both P < 0.01). The lowest TC level at all-cause mortality risk was 179 mg/dL. From these results, higher TC predicts IHD, PAD, and CVD events, and lower TC predicts cancer-associated mortality and all-cause mortality in patients undergoing maintenance hemodialysis.

Low cholesterol levels in children predict impulsivity in young adulthood.

Severe behavioural issues such as impulsive action and suicide have since long been associated with low levels of cholesterol. While it is known that cholesterol plays a role in neural development and hence low levels of serum lipids could have long-term effects on behaviour, no longitudinal studies showed the association of serum lipids levels with impulsivity. We aimed to examine the prognostic properties of serum lipid levels during childhood and adolescence on measures of impulsivity during early adulthood in a representative birth cohort sample. We have investigated whether serum lipid levels measured at 9, 15, 18 and 25 years of age have an association with impulsivity in 25 years old young adults. This analysis was based on data of the birth cohort representative samples of the Estonian Children Personality Behaviour and Health Study (original n = 1238). Impulsivity was self-reported with the Adaptive and Maladaptive Impulsivity Scale. Total and low-density lipoprotein (LDL) cholesterol measured in boys aged 9, 15 and 18 years predicted disinhibition and thoughtlessness in 25-year-old young adults. High scores of disinhibition were associated with low total and LDL cholesterol levels in males but, while less consistently, with high total and LDL cholesterol levels in females. Cross-sectional analysis did not result in systematic outcomes. Serum lipid levels could have an impact on the development of Maladaptive Impulsivity starting from an early age. This effect of cholesterol continues throughout adolescence into young adulthood.