Low HDL Levels Research Articles

Frequency of Dyslipidemia in Ischemic Strokes Involving Different Regions of Brain

Background: Most strokes are ischemic; the type of artery involved can affect the prognosis and clinical symptoms. The risk factors for stroke include high blood pressure, diabetes, smoking, and elevated cholesterol. It has been demonstrated that lipid profile levels and the prognosis of stroke are related. Aim: To determine the frequency of dyslipidemia in ischemic stroke patients based on the location of the infarct. Study design: Cross-sectional study Place and duration of study: Department of Medicine, Fauji Foundation Hospital Rawalpindi from 10 August to 10 January 2022. Methods: Four hundred patients with MRI-proven ischemic stroke were enrolled. The blood samples were obtained, and a lipid profile was used to determine the lipid abnormalities (dyslipidemia). Results: Middle cerebral artery involvement was the most frequently observed among the enrolled ischemic stroke patients, i.e., 54.8%. The overall frequency of dyslipidemia was 92.3%; hypercholesterolemia, hypertriglyceridemia, high LDL, and low HDL was present in 47.8%, 50.8%, 33.8%, and 93.8%, respectively. All patients with middle cerebral artery involvement had low HDL levels, 34.25% had high LDL levels, 41.10% had high triglyceride levels, and 54.79% had high cholesterol levels. A significant effect of age, gender, recurrent stroke, and location of infarct was observed on the frequency of dyslipidemia. Conclusion: The frequency of dyslipidemia in ischemic stroke patients in Pakistan is relatively high. This emphasized how important it is to reduce these population-wide modifiable risk factors. Keywords: Stroke, Dyslipidemia, Ischemic stroke, Lipid profile

Increased Carotid Intima-media Thickness and Its Association with Carbohydrate Metabolism and Adipocytokines in Children Treated with Recombinant Growth Hormone.

Reports on the association between growth hormone therapy and cardiovascular risk factors in children are limited. This study aimed to evaluate carotid intima-media thickness (cIMT) in children treated with recombinant human growth hormone (rhGH) and assess the effects of rhGH therapy and changes in serum carbohydrate metabolism, lipid profile and adipocytokines on cIMT. Seventy-one isolated idiopathic GH deficiency (GHD) children and 44 age- and sex-matched, healthy controls were enrolled in this study. The study group was divided into two subgroups according to insulin resistance (IR) on oral glucose tolerance tests. Insulin secretion (HOMA B, total insulin) and sensitivity (HOMA-IR, QUICKI, Matsuda) indices were calculated. cIMT was measured and the standard deviation scores (SDS) were calculated. Associations between cIMT-SDS and insulin secretion and sensitivity indices, serum lipid levels, adipocytokines (leptin, resistin, ghrelin), and the other rhGH treatment-related factors were evaluated. The cIMT-SDS was increased in GHD children treated with rhGH compared to controls (0.02 (2.27) vs -1.01 (1.63), p=0.003). cIMT-SDS did not differ between children on rhGH treatment with or without IR. High cIMT-SDS was significantly associated with higher serum ghrelin level and lower serum high density lipoprotein level (ß=0.491, p=0.001 and ß= -0.027, p=0.017), but not with BMI-SDS, blood pressure, insulin secretion and sensitivity indices, or dose and duration of rhGH therapy. Our findings showed that GHD children treated with rhGH have increased cIMT. Alterations in carbohydrate metabolism were not associated with cIMT in children treated with rhGH. GH therapy per se appears to be associated with this increased cIMT but causality should be elucidated in further studies. cIMT also appears to be associated with higher ghrelin and lower HDL levels.

The prevalence and risk factors of chronic kidney disease among type 2 diabetes mellitus follow-up patients at Debre Berhan Referral Hospital, Central Ethiopia

Background: Chronic kidney disease is a progressive loss in renal function that is more accepted as global public health importance and its magnitude is overgrowing in the least developed countries like Ethiopia. No data was found in Debre Birhan Central Ethiopia on the magnitude of chronic kidney disease among type 2 diabetes patients. Methods: Institution-based cross-sectional study was conducted among 327 at Debre Berhan Referral Hospital from March to June 2019 in Adult (≥ 18 years) type 2 diabetes follow-up patients who volunteered to give informed written consent were included in the study. Systematic random sampling was used. Data were collected by interviews using structured and pre-tested questionnaires. Descriptive statistics of the continuous and categorical variables were done. The bi-variable and multivariable logistic regression was done to show the net effect of explanatory variables on chronic renal disease. Results: A total of 327 study participants were involved in the final analysis. The Prevalence of CKD among type 2 diabetic patients was 15.9%. A significant association was found with age > 60 years [AOR 3.5 (95% CI 1.8-6.8)], alcoholic patients [AOR 2.4 (95% CI 1.2-5.1)], glycated hemoglobin levels above 7% [AOR 2.5 (95 CI 1.5-4.1)], higher level of LDL greater than 100 g/dl [AOR 2.7 (95% CI 1.9-4)] and lower level of HDL [AOR 2.9 (95% CI 1.4-6)]. Conclusion: The magnitude of chronic kidney disease among type 2 diabetic follow-up patients was 15.9%. Estimated GFR should be determined for diabetic patients at regular intervals of time for earlier diagnosis of chronic kidney disease.

Very low HDL levels: clinical assessment and management.

In individuals with very low high-density lipoprotein (HDL-C) cholesterol, such as Tangier disease, LCAT deficiency, and familial hypoalphalipoproteinemia, there is an increased risk of premature atherosclerosis. However, analyzes based on comparisons of populations with small variations in HDL-C mediated by polygenic alterations do not confirm these findings, suggesting that there is an indirect association or heterogeneity in the pathophysiological mechanisms related to the reduction of HDL-C. Trials that evaluated some of the HDL functions demonstrate a more robust degree of association between the HDL system and atherosclerotic risk, but as they were not designed to modify lipoprotein functionality, there is insufficient data to establish a causal relationship. We currently have randomized clinical trials of therapies that increase HDL-C concentration by various mechanisms, and this HDL-C elevation has not independently demonstrated a reduction in the risk of cardiovascular events. Therefore, this evidence shows that (a) measuring HDL-C as a way of estimating HDL-related atheroprotective system function is insufficient and (b) we still do not know how to increase cardiovascular protection with therapies aimed at modifying HDL metabolism. This leads us to a greater effort to understand the mechanisms of molecular action and cellular interaction of HDL, completely abandoning the traditional view focused on the plasma concentration of HDL-C. In this review, we will detail this new understanding and the new horizon for using the HDL system to mitigate residual atherosclerotic risk.

ANALYSIS THE METABOLIC STATUS OF PATIENTS WITH CORONARY ARTERY DISEASE AND NONALCOHOLIC FATTY LIVER DISEASE DEPENDING ON BODY MASS INDEX.

The aim: To analyze the metabolic status of patients with coronary artery disease and nonalcoholic fatty liver disease depending on body mass index. Materials and methods: The cohort of patients included 107 people with coronary artery disease (CAD), nonalcoholic fatty liver disease (NAFLD) and over¬weight (n=56) or obesity (n=51). In all patients glucose, insulin, HbA1c, HOMA-IR, hsCRP, transaminases, creatinine, urea, uric acid, lipid profile, anthropometric parameters and ultrasound elastography were measured. Results: During the analysis of serum lipid spectrum in patients with obesity: lower levels of HDL and higher TG concentration compared with patients who had overweight. The insulin level was almost twice as high as in patients with overweight and the HOMA-IR index was 3.49 (2.13;5.78), where as in patients with overweight it was 1.85 (1.28;3,01), p<0.01. In patients with coronary artery disease and overweight, the of hsCRP was 1.92 (1.18;2.98) mg/l and was significantly different from the hsCRP level in obese patients, which was 3.15 (2.64;3.66) mg/l, p=0,004. Conclusions: In patients with coronary artery disease, non-alcoholic fatty liver disease and obesity, the metabolic profile was characterized by a more unfa¬vorable lipid spectrum: lower levels of HDL and higher triglicerid concentration. Carbohydrate metabolism in obese patients included disorders such us impared glucose tolerance, hyperinsulinemia and insulin resistance. There was also a correlation between body mass index with insulin and glycated hemoglobin. Higher concentration hsCRP in obese compared with patients with overweight was observed. This confirms the role of obesity in the patogenesis of coronary artery disease, non-alcoholic fatty liver disease and systemic inflammation.

A PROSPECTIVE STUDY ON CORRELATION OF SERUM LIPID PROFILE AND SEPSIS SEVERITY IN ADULT PATIENTS DIAGNOSED WITH SEPSIS IN A TERTIARY CARE HOSPITAL.

Introduction: Sepsis causes, extensive physiological and biochemical abnormalities. Literature shows that infections cause reasonable alterations in lipid metabolism and in the composition of lipoproteins. In these situations, there is an increase in the levels of triglycerides and VLDL cholesterol and decrease in levels of HDL and LDL cholesterol. Patients with sepsis, having hypocholesterolaemia indicates disease severity when other causes of this condition are to be ruled out. Hence this study was done to understand the role of serum lipids in patients with sepsis. Material and methods: A prospective study was done in 60 adults patients admitted with sepsis (According to the Third International consensus Denitions for Sepsis and Septic Shock 2016 (Sepsis – 3), in medical wards and medical ICU of a tertiary care teaching hospital during December 2021 to April 2022 after obtaining institutional ethical committee clearance and consent from patients. All patients who gave informed consent were enrolled consecutively till the sample size was reached. Patients were subjected to detailed history taking, clinical examination and biochemical investigations were done and data was recorded in a semi-structured questionnaire. Data was entered in MS excel and analysis was done using SPSS -20, Data represented in frequency tables. Correlation between parameters assessed and APACHE II and SOFA score was done using pearsons correlation coefcient with P&lt;0.05 considered as statistically signicant. Mean age of the study population was 40.22±11.831. Results: Majority of the study patients were males (71.7%). Respiratory tract infection (33/55%) was the major source of infection. Diabetes mellitus was the most common type of comorbidity (27/ 45%). HDL cholesterol was negatively correlated with both sepsis prognostic severity scores (APACHE II and SOFA score) which were highly signicant statistically. Pearsons correlation coefcient shows that total cholesterol, LDL cholesterol is poorly correlated with sepsis severity and triglycerides though negatively correlated the association is weak. Sepsis Conclusions: patients, shows alterations in lipid metabolism. Higher values of SOFA and APACHE II scores were associated with low HDL levels. Lipoproteins may function as potential biomarkers (especially high-density lipoprotein) in systemic inammatory response syndrome and sepsis

Secular Trends in Obesity and Serum Lipid Values among Children in Oita City, Japan, during a 27-Year Period.

We assessed 27-year trends in obesity and blood lipid levels of 10-year-old children to estimate the risk of metabolic syndrome in adulthood. Based on a screening program for lifestyle-related diseases in school children in Oita City, Japan, we evaluated secular trends in height, weight, percentage of overweight (POW), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C), and non-HDL cholesterol (non-HDL-C) of fifth graders (median age: 10.8 years) in Oita City from 1991 to 2017. We focused on the secular trend in the percentage of children with inappropriate serum levels of each lipid. We also evaluated the long-term trends in the 95th, 50th, and 5th percentiles for each parameter, as dependent variables, with the calendar year as an independent variable. Percentages of children with mild obesity (POW-20), moderate obesity (POW-30), and severe obesity (POW-50) were set as dependent variables. A total of 58,699 boys and 56,864 girls were evaluated during the study period. The percentage of children with severe obesity (POW-50) consistently increased during these years, and the 95th percentile of degree of obesity significantly increased in both boys and girls. The plot of percentages of children with inappropriate levels of TC, TG, and non-HDL-C showed a mild inverted U shape during the study period. The HDL-C level typically decreased in the study period, and the TC, TG, and non-HDL-C levels were markedly higher while the HDL level was lower in obese children than in non-obese children. The number of children with severe obesity increased, and obese children had higher percentages of inappropriate lipid levels than non-obese children. The rate of dyslipidemia with low HDL levels gradually increased in all children in Oita City, Japan, over the past 27 years.

Lipid parameters in the blood of coronary artery diseases patients depending on age and dietary components: a case study

Coronary artery disease (CAD) is the major cause of mortality worldwide and is defined as an elevated level of atherogenic cholesterol and low levels of HDL cholesterol. However, very few studies have been conducted in India on the association of blood lipid profile with age and diet. The study aims to estimate lipid parameters in the blood of CAD patients aged 40-70 years on different diets. Lipid parameters were analyzed by enzymatic method on EM-200 fully automated Biochemistry analyzer. The data obtained showed that the majority of patients who suffered from CAD were between the age group of 51-60 years. Patients with CAD had altered lipid profiles, with higher levels of serum TGs, total cholesterol and low levels of HDL. Vegetarians have been found to have reduced lipid risk factors for coronary heart disease compared to patients on a mixed diet. Keywords: age, cholesterol, coronary artery disease, dietary components, HDL, triglycerides

Serum Lipid Profiles of Primary Open Angle Glaucoma Patients Treated with Topical Timolol

Background: Primary open-angle glaucoma (POAG) and atherosclerosis both are fairly common diseases among elderly persons, any adverse changes in serum lipids as a result of glaucoma therapy can increase the risk of coronary heart disease many folds. As topical beta blockers are also widely used and often the first line therapy in many patients requiring treatment for glaucoma for a long time, there is also a possible risk that _-blockers such as timolol adversely affect serum lipid profiles.&#x0D; Objective: The study aimed to evaluate the effect of topical timolol on serum lipid profiles.&#x0D; Methods: This cross-sectional observational study was performed in the department of ophthalmology, Bangabandhu Sheikh Mujib Medical University With convenience type of sampling technique 40 patients with newly diagnosed cases of primary open-angle glaucoma were selected. Baseline fasting lipid profiles were estimated and then timolol maleate 0.5%, 1 drop 12 hourly in both eyes were prescribed. At follow-up after 4 and 12 weeks, again fasting lipid profiles were estimated of the same patients.&#x0D; Results: In this study the baseline mean TC, HDL, LDL &amp; TG were 175.4±19.28 , 46.63±5.33, 104.98±18.49,120.48±28.30 (mg/dl±SD) respectively. Baseline TC/HDL was 3.81±0.06. At follow up after 4 weeks there were increased level of TC, LDL,TG, TC/HDL by 0.45% (P=0.822), 0.8% (P=0.807) 1.82%(P=0.375), and 3.14%(P=0.307) respectively and HDL level decreased by 2.68%(P=0.232). At follow-up, after 12 weeks in comparison to baseline lipid levels, there was an increased level of TC, LDL, TG, and TC/HDL by 0.98% (P=0.959), 3% (P=0.996), 2.8% (P=0.104), and 17.0%(P=0.001) respectively and HDL level decreased by 13.61%(P=0.001).&#x0D; Conclusion: Topical timolol significantly lowers the plasma HDL level. Since the low level of HDL is strongly associated with an increased risk of myocardial infarction, our study cautions against the use of timolol in patients with a previous history of coronary heart disease.&#x0D; J Rang Med Col. September 2022; Vol. 7, No. 2:40-46

PSUN148 Disparities in COVID-19 Mortality in Hispanic and Non-Hispanic Patients with Metabolic Syndrome in a Community-Based Hospital

Abstract In Hispanic populations, rates of metabolic comorbidities such as obesity are higher than that of non-Hispanic White in the United States. Despite having higher comorbidity rates, Hispanic populations have a lower total risk of mortality compared to non-Hispanic counterparts. In this study, we explore whether this paradox exists for COVID-19 related deaths in Hispanic patients with Metabolic Syndrome (MetS). MetS is defined by the WHO as having at least 3 of the following 5 criteria: obesity, hypertension, diabetes, hypertriglyceridemia, and low levels of HDL. A retrospective study was conducted of patients hospitalized for COVID-19 between January 1, 2020 and May 1, 2021 at a regional county hospital in Southern California. In this cohort of 269 patients, 55.4% were male, mean age was 58.4 (IQR, 48-68) years, 63.9% had obesity, 42.4% had hypertension, 40.1% had diabetes, 18.2% had hypertriglyceridemia, and 32.3% had low HDL levels, and 30.9% fit the criteria for MetS. The racial demographic of this cohort was 78.8% Hispanic, 6.32% African American, 4.46% White and 3.72% Asian. Odds ratios and confidence intervals for the relationship between MetS and mortality were calculated separately among patients who were either Hispanic or non-Hispanic. Multivariable logistic regressions accounting for interactions between MetS and Hispanic patients were assessed. In our cohort, 49 (18.2%) patients died of COVID-19. Hispanic patients had a lower probability of mortality (16.0%; 95% CI 11.1-21.0) than non-Hispanic patients (26.3%; 95% Cl 14.9-37.7). Hispanic patients with MetS had a higher risk of mortality from COVID-19 ([OR] 1.57; 95% Cl 0.74-3.33) compared to Hispanic patients without MetS. Non-Hispanic patients with MetS also had a higher risk of mortality from COVID-19 ([OR] 4.38; 95% Cl 1.19-16.03) compared to non-Hispanic patients without MetS. The MetS effect on mortality in Hispanic was 64% lower than that in non-Hispanic patients, although this result did not reach statistical significance (p value=0.18.) Our data suggests that MetS is a risk factor for COVID-19 mortality and MetS may have a lower impact on COVID-19 related death in the Hispanic population than non-Hispanic counterparts. Studies with larger sample sizes will be required to confirm these relationships. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

ODP149 Hypertriglyceridemia-Induced Acute Pancreatitis in Second Trimester of Pregnancy

Abstract Background Acute pancreatitis (AP) during pregnancy is a rare, potentially life-threatening disease, with an incidence of 1 case per 1,000-10,000. Hypertriglyceridemia (HTG)-induced pancreatitis accounts for only 5% of cases. Here we describe a rare case of HTG-induced AP during the second trimester of pregnancy, which was treated with concurrent insulin and plasmapheresis. Clinical Case A 35-year-old multigravida female was admitted for preterm premature rupture of membranes at 26 weeks gestation. Symptoms began on day 8 of admission and included severe epigastric pain radiating to the back. On exam, there was significant epigastric tenderness on palpation. There were no xanthelasmas or tendon xanthomas seen. She was afebrile but tachycardic. Laboratory evaluation noted a triglyceride (TG) level of &amp;gt;5,680 mg/dL (n&amp;lt;150), amylase 201 U/L (n&amp;lt;100) and lipase 277 U/L (n&amp;lt;60), consistent with AP. She was euglycemic. CT of the abdomen showed interstitial edematous pancreatitis with a peripancreatic collection. She was placed on NPO and started on intravenous (IV) fluid therapy, in combination with IV insulin and 10% dextrose. The patient also underwent one session of plasmapheresis. TG levels downtrended rapidly to 3,585 mg/dL within 24 hours. Once TG levels decreased below 1,000 mg/dL, insulin and dextrose infusions were stopped, and combination therapy of fenofibrate, omega-3 fatty acids, and low-fat low-carbohydrate diet was started. At 28 weeks and 5 days gestation, a cesarean section was performed due to suspected fetal distress. The patient was discharged on fenofibrate and Omega-3 fatty acids with a TG level of 456 mg/dL. Genetic testing revealed a heterozygous variant in the LPL gene mutation (c.644G&amp;gt;A; p. Gly215Glu) and a heterozygous variant of uncertain significance (VUS) in the ABCA1 gene (c.1765G&amp;gt;A; p. Val589Ile). She had no known family history of hyperlipidemia or cardiovascular disease. Conclusion Lipoprotein lipase (LPL) deficiency is an autosomal recessive disorder caused by biallelic pathogenic mutations in the LPL gene. The heterozygous c.644G&amp;gt;A variant has been previously described in several patients with LPL deficiency, however its impact on the function of the LPL protein has not yet been clearly defined. The ABCA1 gene is associated with Tangier disease, characterized by very low HDL levels and HTG. The ABCA1 gene variant detected in this case is classified as VUS as its effect on the gene function is not yet known. Further investigation is warranted to understand the role of these variants in familial dyslipidemia. Aside from the described patient, only one other case report of HCT-induced AP treated with concomitant plasmapheresis and IV insulin therapy has been reported in the literature. There are no published guidelines regarding the optimal treatment for HTG-induced AP in pregnancy. Combined treatment modality with plasmapheresis and IV insulin seems to be effective, however, its risks and benefits should be carefully assessed. Presentation: No date and time listed

RF16 | PSUN159 Poor Diet Habits, Depression and Low Physical Activity Correlate with Cardiometabolic Risk Markers in Persons with Severe Mental Illness on Second-Generation Antipsychotic Medications.

Abstract Cardiovascular morbidity and mortality are high in persons with severe mental illness. Psychotropic medications, particularly second-generation antipsychotics (SGA), and also adverse health behaviors are mediators of adverse cardiometabolic health outcomes in persons with severe mental illness. Identifying and addressing specific risk factors early and aggressively is key to improving health outcomes in these patients; yet studies addressing the above problems are limited. We therefore evaluated 39 patients with schizophrenia, schizoaffective, or bipolar disorder on SGA in a comprehensive cardiometabolic, lifestyle, and mental health screening program. Data were analyzed using SPSS version 24. As previously reported, the majority of screened patients had prediabetes (PD) or diabetes mellitus (DM), 74% per oral Glucose Tolerance Testing (oGTT), 56% per HbA1c criteria. Pulse rates, insulin resistance indices (Homeostatic Model Assessment of Insulin Resistance, HOMA IR, and Matsuda) were significantly different between patients classified as normal or with PD/DM, using either oGTT or HbA1c criteria. However, patients with PD/DM per HbA1c, but not oGTT criterium, also had higher waist/hip ratios (p=0.01), triglyceride (p=0.01) and hsCRP levels (p=0.04) as well as lower HDL levels (p=0.04). We then determined whether dietary habits (by UK Diabetes and Diet Questionnaire, UKDDQ), mood (by Patient Health Questionnaire, PHQ-9) and/or physical activity (average daily step count) were associated with unfavorable, and potentially modifiable cardiometabolic biomarkers (fasting, 2h-oGTT plasma glucose, serum insulin, triglycerides, HDL, LDL, HbA1c, hsCRP and adiponectin). We find that fasting plasma glucose and triglyceride levels significantly correlated with UKDDQ scores (fasting plasma glucose: r=0.34, p=0.03, fasting triglyceride levels: r=0.37, p=0.02); a trend was observed for higher insulin resistance indices (HOMA IR) being associated with higher UKDDQ scores (r=0.31, p=0.06). We also confirm a strong negative correlation of the average daily step count with hsCRP levels (r=-0.62, p&amp;lt;0.0001). PHQ-9 scores negatively correlated with adiponectin levels (r=-0.475, p&amp;lt;0.005). Altogether, in our patient population with severe mental illness on SGA, unhealthy diet habits, low physical activity, and symptoms of depression were associated with higher fasting glucose and triglycerides, higher hsCRP and lower adiponectin levels, all of which may potentially contribute to adverse cardiometabolic outcomes. Future studies should assess the impact of specifically tailored individual lifestyle counseling and medical management interventions in this high-risk patient population. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 1:06 p.m. - 1:11 p.m.

Sex-disaggregated population analysis in patients with hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a common chronic inflammatory skin disease, which affects both sexes. Identification of sex-specific risk factors, comorbidity, clinical manifestations, and treatments in HS patients. A non-interventional, cross-sectional, mono-centric study with 500 HS patients. All patients were examined by dermatologists. Prospectively collected demographic, anamnestic, clinical data, and blood parameters were evaluated. There were no significant differences in age at HS onset and in disease duration between female and male patients. Furthermore, no differences regarding the family history for HS were found between sexes. Regarding further risk factors for HS, central obesity was more frequent in women while extensive cigarette smoking and acne vulgaris were more commonly found among male patients. Regarding comorbidity, lower HDL-levels were significantly more frequent in men. Female patients were found to suffer significantly more often from back pain, especially in the neck/shoulder region and lower back. Analyzing the clinical manifestation of HS, the groin was more frequently involved in women and the axillae in men. Women showed a higher number of skin sites with inflammatory nodules, whereas fistulas were observed more frequently in men. Nevertheless, there was no difference in HS treatment applied to female vs. male patients. Data were obtained from a mono-centric study. Significant differences in HS risk factors, comorbidity, and clinical manifestation exist between female and male patients. Thus, sex-specific differences should be taken into account in the prevention as well as medical and surgical treatment of HS patients.

ATP-Binding Cassette Transporter Family C Protein 10 Participates in the Synthesis and Efflux of Hexosylceramides in Liver Cells.

In addition to sphingomyelin and ceramide, sugar derivatives of ceramides, hexosylceramides (HexCer) are the major circulating sphingolipids. We have shown that silencing of ABCA1 transmembrane protein function for instance in cases of loss of function of ABCA1 gene results in low levels of HDL as well as a concomitant reduction in plasma HexCer levels. However, proteins involved in hepatic synthesis and egress of HexCer from cells is not well known although ABCA1 seems to be indirectly controlling the HexCer plasma levels by supporting HDL synthesis. In this study, we hypothesized that protein(s) other than ABCA1 are involved in the transport of HexCer to HDL. Using an unbiased knockdown approach, we found that ATP-binding cassette transporter protein C10 (ABCC10) participates in the synthesis of HexCer and thereby affects egress to HDL in human hepatoma Huh-7 cells. Furthermore, livers from ABCC10 deficient mice had significantly lower levels of HexCer compared to wild type livers. These studies suggest that ABCC10 partakes in modulating the synthesis and subsequent efflux of HexCer to HDL in liver cells.

Elevated Neutrophil Counts, Triglycerides, Monocyte/High-Density Lipoprotein Ratios, and Lower High-Density Lipoprotein in Patients with Retinal Vein Occlusion

Introduction: The aim of the study was to evaluate associations of peripheral blood immune cells and blood lipid profile levels with retinal vein occlusion (RVO). Methods: This retrospective study included 127 patients with RVO and 108 controls. Patients with RVO were divided into branch RVO (BRVO), central RVO (CRVO), ischemic RVO, or nonischemic RVO groups. Medical records were collected and analyzed. Results: The RVO group had higher mean neutrophil, triglyceride (TG), and monocyte/high-density lipoprotein (HDL) ratio (MHR) levels and lower HDL levels (p = 0.037, p < 0.001, p = 0.004, and p = 0.002, respectively). TG and MHR levels were significantly higher in the BRVO and CRVO groups compared with the control group (p < 0.001 and p = 0.016, respectively), but there was no difference in BRVO and CRVO group (p = 0.972 and p = 0.916, respectively). Mean HDL levels were significantly lower in the BRVO and CRVO groups than in the control group (p = 0.005), but the difference between the BRVO group and CRVO group was not significant (p = 0.290). Neutrophils, TG, and MHR were independent risk factors for RVO. HDL was an independent protective factor for RVO. Age was an independent risk factor for ischemic RVO. Conclusions: Lower HDL, and higher neutrophil, TG, and MHR levels are associated with RVO. Age is an independent risk factor for ischemic RVO.

Suicide attempt rate and the risk factors in young, first-episode and drug-naïve Chinese Han patients with major depressive disorder

BackgroundIn recent years, the rates of suicide among young people have been increasing, and major depressive disorder (MDD) is regarded to be its main cause. Many factors such as thyroid dysfunction and metabolic abnormalities are thought to mediate this process, but the conclusions are inconsistent. This study investigated the rate of suicide attempts and associated risk factors among young, first-episode and drug-naïve Chinese Han patients with MDD.MethodsA total of 917 patients with MDD (aged 18 ~ 35 years) were recruited. Demographic and clinical data were collected and thyroid function, fasting blood glucose and lipid profiles were measured. The Hamilton Depression Rating Scale-17 items (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), positive symptom subscale of Positive and Negative Syndrome Scale (PANSS) and clinical global impression of severity scale (CGI-S) were adopted to assess depression, anxiety, psychotic symptoms and disease severity respectively.ResultsThe rate of suicide attempts was 19.5% in young MDD patients. There were significant differences in age (p = 0.003), education level (p = 0.001), age of onset (p = 0.004) and disease duration (p = 0.001) between patients with and without suicide attempts. Compared with patients without suicide attempts, patients with suicide attempts had significantly higher scores on the HAMD-17, HAMA, PANSS positive symptom subscale and CGI-S (all p < 0.001). Patients with suicide attempts had significantly higher levels of TSH (p < 0.001), TgAb (p = 0.004), TPOAb (p < 0.001), TG (p = 0.016), TC (p < 0.001), LDL (p < 0.001), and fasting glucose (p < 0.001), but significantly lower levels of HDL (p < 0.001). Logistic regression analysis showed that marital status (OR = 0.515, 95%CI: 0.280–0.950, p = 0.515), disease duration (OR = 1.100, 95%CI: 1.013–1.194, p = 0.024), HAMA score (OR = 1.313, 95%CI: 1.205–1.430, p < 0.001), CGI-S score (OR = 1.875, 95%CI: 1.339–2.624, p < 0.001), levels of FT3(OR = 0.717, 95%CI: 0.536–0.959, p = 0.025), TPOAb (OR = 1.004, 95%CI: 1.002–1.006, p < 0.001), TC (OR = 1.330, 95%CI: 1.011–1.750, p = 0.042) and LDL (OR = 0.736, 95%CI: 0.558–0.971, p = 0.030) were all independently associated with suicide attempts in young MDD patients.ConclusionsIn China, the rate of suicide attempts in young patients with MDD is quite high and thyroid dysfunction and metabolic abnormalities may be implicated in its pathogenesis.

Effects of gender-affirming hormone therapy on cardiovascular risk factors focusing on glucose metabolism in an Austrian transgender cohort

Objective We aimed to investigate the effect of gender-affirming hormone therapy (GAHT) on cardiovascular disease risk factors focusing on glucose tolerance. Patients and Methods This primarily translational study enrolled 16 transgender persons assigned female at birth (AFAB), 22 assigned male at birth (AMAB), and 33 age- and BMI-matched cisgender controls at the Medical University of Vienna from 2013 to 2020. A 3-Tesla MRI scan to measure intramyocardial, pancreatic, hepatic fat content and subcutaneous-to-visceral adipose tissue ratio (SAT/VAT-ratio), an oral glucose tolerance test (oGTT), bloodwork including brain natriuretic peptide (pro-BNP), sex hormones and two glucose-metabolism related biomarkers (adiponectin, betatrophin) were performed. Results Estrogen intake was associated with higher fasting insulin (p = 0.034) and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (p = 0.037), however, lower HbA1c levels (p = 0.031) in AMAB than cisgender males. Adiponectin (p = 0.001) and betatrophin (p = 0.034) levels were higher in AMAB than cisgender males, but similar to cisgender females. Compared to cisgender females, AFAB displayed no differences in glucose metabolism or SAT/VAT-ratio. AFAB had lower pro-BNP levels (p = 0.014), higher liver enzymes (AST: p = 0.011; ALT: p = 0.012) and lower HDL levels (p = 0.017) than cisgender females, but comparable levels to cisgender males. AMAB showed an increased heart rate (p < 0.001) and pro-BNP (p = 0.002) levels, but a more favorable SAT/VAT-ratio (p = 0.013) and lower creatine kinase (CK) (p = 0.001) than cisgender males. There were no relevant differences in organ fat content between transgender persons and their respective cisgender controls. Conclusion In AMAB, most investigated parameters adapted to levels seen in cisgender females except for parameters related to fasted insulin resistance. AMAB should be monitored with respect to the development of insulin resistance.

The incidence and aggravating factors of male hypogonadism in type 2 diabetes

BACKGROUND: Male hypogonadism is associated with type 2 diabetes mellitus (T2DM), therefore, it is of interest to study its frequency. The clinical symptoms of hypogonadism are not specific, and laboratory diagnostics is the basis for its detection. The optimal method for this diagnostics is isotope dilution liquid chromatography/tandem mass spectrometry, which was used in our study. AIMS: Assessment of the incidence and aggravating factors of male hypogonadism in type 2 diabetesMATERIALS AND METHODS: A full-design, cross-sectional, screening, single-center, non-interventional study included men with T2DM, who were he was treated in Endocrinology Research Centre, Moscow. The study was conducted from October 2021 to January 2022. Medical history assessment, physical examination with determination of body mass index (BMI), measurement estimation of total testosterone by isotope dilution liquid chromatography/tandem mass spectrometry, glycated hemoglobin (HbA1c) and lipid profiles were performed. The groups were compared using the Mann-Whitney U-test for quantitative indicators and χ² with Yates’ correction for qualitative ones. Differences were considered statistically significant with p0,05.RESULTS: Hypogonadism was detected in 355 (70.3%) men with T2DM. Patients with hypogonadism had statistically significantly higher BMI, worse glycemic control, lower HDL levels, and higher triglycerides than eugonadal men. An additional comparative analysis among non-obese individuals showed the presence of statistically significant differences in the level of HbA1c (higher in hypogonadal men) and HDL (lower in hypogonadal men). An analysis of hypogonadal patients depending on the presence of obesity showed statistically significant differences between groups in the level of total testosterone (lower in obese men) and triglycerides (higher in obese men).CONCLUSIONS: The prevalence of male hypogonadism in type 2 diabetes was 70,3%. Its development was associated with obesity and poor glycemic control.

The potential role of insulin resistance in predicting outcome from intravenous thrombolytic therapy

BackgroundThe potential impact of insulin resistance on stroke prognosis after IV thrombolysis is poorly understood. This study aimed to assess the effect of insulin resistance and metabolic syndrome on the outcome of IV thrombolysis in non-diabetic patients with acute ischaemic stroke.MethodsThis prospective observational study was conducted on 70 non-diabetic acute ischaemic stroke patients who received rt-PA within 3 h of stroke onset. Patients were subjected to baseline and follow-up NIHSS measurements at 24 h and 3 months post-treatment. Stroke outcome was assessed after 3 months using the Modified Rankin Scale (mRS). The homeostasis model assessment–insulin resistance (HOMA-IR) was calculated for the included patients at stroke onset.ResultsThe mean age of included patients was 57.04 ± 14.39 years. Patients with unfavourable outcome had a significantly higher frequency of insulin resistance and metabolic syndrome, higher values of baseline NIHSS, insulin, HOMA-IR, uric acid and lower levels of HDL than those with favourable outcome (P value = 0.035, 0.007, ≤ 0.001, 0.001, ≤ 0.001, 0.002, 0.033, respectively). Each point increase in NIHSS before rt-PA increased the odds of an unfavourable outcome by 2.06 times (95% CI 1.22 − 3.478). Also, insulin resistance increased the odds of the unfavourable outcome by 11.046 times (95% CI 1.394–87.518). There was a statistically significant improvement in NIHSS 3 months after receiving rt-PA in all patients, significantly higher in patients who did not have insulin resistance or metabolic syndrome.ConclusionInsulin resistance and metabolic syndrome were associated with worse functional outcomes in non-diabetic stroke patients after receiving rt-PA.

Elevation of serum interleukine-6 in hypoalphalipoproteinemia patients A proinflammatory condition

HDL molecules have an established role in the regression processes of atherosclerosis as well as a putative role as anti-inflammatory agents. Our study investigated whether hypoalpha-lipoproteinemia, characterized by very low HDL levels, might be associated with increased inflammation markers such as Interleukine-6. In this study, (60) patients with HA were taken, were compared with 40 healthy controls, where the patients group were divided into two groups, the first group: HA without CHD group: included thirty (30) patients with hypoalphalipoproteinemia and without coronary heart disease aged (31-60 years). The second group: HA with CHD: included thirty (30) patients with hypoalpha-lipoproteinemia and coronary heart disease, documented by angiography aged (31-60 years). Control group: included forty (40) supposed healthy subjects aged (31-60 years). The results showed a significant increase in the levels of (IL-6) in all groups of patients compared to control groups (P&lt;0.05). In the patient group, IL-6 values were significantly higher in subjects with angiographically documented coronary atherosclerotic disease than in those without. Moreover, IL-6 concentrations were inversely correlated with HDL cholesterol. Also our study shows that negative correlation between HDL and (Total cholesterol, TG, LDL, VLDL, Atherogenic index and HS-CRP).