Low HDL Research Articles

Association of plasma endocan levels with metabolic parameters and predictive value of endocan for the development of complications in patients with type 2 diabetes mellitus: An observational study

The aim of the current research was to investigate the association between plasma endocan levels and metabolic control parameters, as well as to evaluate its predictive value for clinical complications in patients with type 2 diabetes mellitus (DMT2). A total of 100 DMT2 patients participated in this prospective observational study. Plasma endocan levels were significantly elevated in DMT2 patients with HbA1c>7% (1.38±0.33 vs. 0.68±0.23 ng/mL; p<0.0001), compared to patients with HbA1c ≤7%. Patients with plasma endocan concentrations >1.10 ng/mL (median value of 1.10 ng/mL) demonstrated significantly higher levels of metabolic parameters: body mass index (BMI), HbA1c%, fasting glucose level, LDL cholesterol, total cholesterol, triglycerides, along with significantly lower HDL cholesterol levels. Furthermore, patients with plasma endocan levels >1.10 ng/mL were found to have an increased risk for the following complications: retinopathy (RR: 2.7500; 95% CI: 1.2150 to 6.2244; p= 0.0152, nephropathy (RR: 2.0952; 95% CI: 1.2294 to 3.5710; p=0.0065), neuropathy (RR: 1.9945; 95% CI: 1.2025 to 3.3081); p=0.0075 ), angina pectoris (RR: 2.4881; 95% CI 1.0865 to 5.6979; p=0.0311, hypertension (RR: 1.1372; 95% CI 1.0060 to 1.2856; p=0.0398), cardiomyopathy (RR: 2.6190; 95% CI 1.1507 to 5.9612; p=0.0218), myocardial infarction (RR: 9.4286; 95% CI 1.2742 to 69.7697; p=0.0280) and stroke (RR: 4.4638; 95% CI 1.3765 to 14.4758; p=0.0127). Correlation analysis revealed that plasma endocan levels were positively correlated with HbA1c% (r=0.856, p<0.0001), fasting glucose level (r=0.631, p<0.0001), LDL (r=0.347, p=0.0004), cholesterol (r=0.282, p=0.0045) and triglycerides (r=0.366, p=0.0002). Conversely, plasma endocan levels were negatively correlated with HDL cholesterol (r= - 0.429, p<0.0001). In conclusion, higher plasma endocan levels were strongly associated with poor metabolic control in DMT2 patients and exhibited significant predictive value for both microvascular and macrovascular complications.

Wrist Circumference as a Novel Predictor of Coronary Artery Disease and Metabolic Syndrome

Introduction: Wrist circumference is a good predictor of obesity and insulin resistance. Wrist circumference may be considered as an indirect determinant of hyperinsulinemia and insulin resistance. The present study aimed to assess wrist circumference as an alternative tool for differentiating patients with coronary artery disease and metabolic syndrome from those without coronary artery disease and metabolic syndrome. Materials and Methods: The study was conducted on patients ≥ 30 years old undergoing coronary angiography following acute coronary syndrome or for evaluation of coronary artery disease. Results: Diabetic, hypertensive, and obese patients had more wrist circumference. High TG, low HDL levels were associated with higher wrist circumference (p=0.005). Wrist circumference was positively correlated with waist-hip ratio (p<0.001). Patients with Metabolic Syndrome have a mean Wrist circumference of 16.54 whereas patients without Metabolic Syndrome have a mean wrist circumference of 15.89(p<0.001). Coronary artery disease patients had higher mean wrist circumference than non-coronary artery disease patients (16.59 vs 15.9) (p<0.001). Triple-vessel disease patients have higher wrist circumference than double-vessel-disease patients; Doublevessel- disease patients have higher wrist circumference than single-vessel disease (p<0.001). Multivariate logistic model shows the main predictors for coronary artery disease are male sex, smoking, high BMI, low HDL, and wrist circumference. Conclusion: Measurement of Wrist circumference can serve as an easy anthropometric marker to identify individuals at risk of cardio-metabolic disorder, and predict the severity of Coronary Artery Disease can be used in large epidemiological studies.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and sarcopenia based on NHANES

The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, or NHHR, has garnered increased attention because of its connection to metabolic diseases. It is yet unknown, nevertheless, how NHHR and sarcopenia relate to one another in the US population. Examining the relationship between NHHR and the prevalence of sarcopenia in the US population is the main goal of this study. Utilizing information gathered from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, a study was conducted to look at the connection between NHHR and sarcopenia in the US population. The individuals’ baseline features were categorized based on whether or not sarcopenia was present. We used subgroup analysis, restricted cubic spline (RCS), and weighted logistic regression to examine the connection between NHHR and sarcopenia prevalence. Sensitivity analysis was used to confirm that the study’s findings were reliable and consistent. R (version 4.2.3) was used for all analyses, and P < 0.05 was used to indicate statistical significance. There were 10,087 individuals in all, 9,187 of whom were not sarcopenic and 900 of whom were. Sarcopenic patients were generally older, predominantly of Mexican American descent, and had lower educational levels. These patients were generally less active and exhibited higher levels of total cholesterol and BMI, along with lower HDL levels. Following complete adjustment, the weighted logistic regression model indicated that a 7% increased risk of sarcopenia was linked to every unit rise in NHHR (OR = 1.07, 95% CI = 1.02–1.13). An inflection point was identified at 2.90 by RCS analysis, which revealed a nonlinear association between NHHR and the prevalence of sarcopenia. Subgroup analysis showed that, regardless of the demographic group, there was a continuous positive correlation between NHHR and the prevalence of sarcopenia. The results of the interaction test provided evidence in favor of NHHR functioning as a stand-alone risk factor for sarcopenia. Our research suggests that a higher prevalence of sarcopenia may be linked to an increase in NHHR. Consequently, NHHR may function as a separate risk factor for sarcopenia.

Validation and epidemiologic definition of the novel steatotic liver disease nomenclature in a national United States cohort with cirrhosis.

Novel steatotic liver disease (SLD) definitions were introduced in 2023. Accurate and meaningful classifications using clinical data are needed to study interventions and outcomes. In a national cohort of Veterans with cirrhosis and imaging-confirmed steatosis, seven algorithms differentially emphasizing cardiometabolic risk factors (CMRFs) and alcohol exposure were developed to define alcohol-associated liver disease (ALD), metabolic dysfunction associated SLD (MASLD), and MASLD with increased alcohol intake (MetALD). The primary outcome was classification of SLD, which was validated using hospitalizations for major acute cardiac events (MACE) and alcohol use disorder (AUD). Secondary outcomes included longitudinal CTP class, incident hepatocellular carcinoma, and all-cause mortality. In all, 31,514 patients with cirrhosis (median age 64 years) were included. CMRFs (98.8% ≥1) and hazardous alcohol use (65.3%) were highly prevalent. The distributions of MASLD, MetALD, and ALD varied substantially across classification methods with varying CMRF and alcohol criteria. For example, MetALD ranged from 4.7% to 47.2%. Using method 4, incidence rates of MACE hospitalizations in MASLD, MetALD, and ALD were 16.7, 14.5, and 8.4 per 100 person-years, respectively and incidence rates of AUD hospitalizations were 2.0, 26.1, and 47.6 per 100 person-years, respectively. Hypertriglyceridemia and low HDL were common across SLD subtypes, including ALD (67.3% hypertriglyceridemia, 48.2% low HDL). Patients with ALD (HR 1.41, 95% CI 1.34-1.48) had significantly higher hazards of mortality relative to MASLD. Classification of SLD is highly sensitive to relative weighting of CMRFs and alcohol use. Clinically relevant definitions should consider data availability on alcohol and the limitations of lipid measurements in distinguishing SLD subtypes.

Obicetrapib Treatment Increases Pre-Beta1 HDL and Lipophilic Antioxidants in the Ocean and Rose2 Studies

Background and Aims: Non-lipidated ApoA1 (pre-beta1 HDL) captures cholesterol and lipophilic antioxidants via ABCA1. HDL particles transport antioxidants to tissues such as retina and brain. The effect of HDL raising interventions on pre-beta1 HDL levels and the distribution of lipophilic antioxidants amongst lipoproteins is unknown. CETP-inhibition was hypothesized to reduce the antioxidant capacity of HDL, although direct evidence was never presented. This is now addressed in phase II studies of the novel CETP-inhibitor obicetrapibMethods: Plasma samples from two phase II studies with obicetrapib were used to measure changes in pre-beta1 HDL by ELISA with a selective antibody to ApoA1 aa 137-144 (LQEKLSPL).. Lipophilic antioxidants were quantified in plasma, non-HDL, and HDL-fractions by ULPC ms-ms.Results: In both studies, no significant changes occurred in placebo groups but, in the obicetrapib treated groups, plasma pre-beta1 HDL increased by 12% (p<0.04) and 24% (p<0.03). In OCEAN, plasma ApoA1 and HDL-C levels correlated with increasing levels of antioxidants in the HDL fraction.In ROSE2, α-tocopherol was raised in plasma by 16% (p<0.003) and in HDL by 58% (p<0.00003). In both studies pre-beta1 HDL in obicetrapib treated patients was correlated with α-tocopherol in plasma.Conclusions: CETP inhibition with obicetrapib increases pre-beta1 HDL, impacts excess cholesterol efflux, and also raises important HDL antioxidants. Thus, these results support the potential therapeutic use of obicetrapib in diseases with high unmet medical need that are associated with low HDL and low levels of lipophilic antioxidants in plasma and tissues, such as AMD, neurodegenerative disorders, and sickle cell anemia.

Unearthing Insights into Metabolic Syndrome by Linking Drugs, Targets, and Gene Expressions Using Similarity Measures and Graph Theory.

Metabolic syndrome (MetS) is a group of metabolic disorders that includes obesity in combination with at least any two of the following conditions, i.e., insulin resistance, high blood pressure, low HDL cholesterol, and high triglycerides level. Treatment of this syndrome is challenging because of the multiple interlinked factors that lead to increased risks of type-2 diabetes and cardiovascular diseases. This study aims to conduct extensive in silico analysis to (i) find central genes that play a pivotal role in MetS and (ii) propose suitable drugs for therapy. Our objective is to first create a drug-disease network and then identify novel genes in the drug-disease network with strong associations to drug targets, which can help in increasing the therapeutical effects of different drugs. In the future, these novel genes can be used to calculate drug synergy and propose new drugs for the effective treatment of MetS. For this purpose, we (i) investigated associated drugs and pathways for MetS, (ii) employed eight different similarity measures to construct eight gene regulatory networks, (iii) chose an optimal network, where a maximum number of drug targets were central, (iv) determined central genes exhibiting strong associations with these drug targets and associated disease-causing pathways, and lastly (v) employed these candidate genes to propose suitable drugs. Our results indicated (i) a novel drug-disease network complex, with (ii) novel genes associated with MetS. Our developed drug-disease network complex closely represents MetS with associated novel findings and markers for an improved understanding of the disease and suggested therapy.

Efek Ekstrak Arbei (Rubus idaeus) terhadap Kadar Kolesterol Total Tikus Wistar Model Sindrom Metabolik

Metabolic syndrome is characterized by low HDL levels, high triglycerides, hypertension, increased blood glucose, and obesity, often associated with obesity and type 2 diabetes. This study aimed to investigate the effect of Wild Red Raspberry (Rubus idaeus) on total cholesterol levels in Wistar rats (Rattus norvegicus) with a metabolic syndrome model. Method This research employed a quantitative experimental laboratory study with a pretest-posttest control group design. A total of 30 male Wistar rats were divided into five groups: K1 (negative control), K2 (positive control), and K3, K4, K5 (metabolic syndrome) treated with Rubus idaeus extract at doses of 30 mg/200gBW/day, 60 mg/200gBW/day, and 90 mg/200gBW/day. Total cholesterol levels were measured on days 8, 36, and 64. Data analysis was performed using Shapiro-Wilk normality test, and the results were not normal in distribution and hemogenity although after transformatted, so non-parametric tests Kruskal-Wallis, were used, followed by Mann-Whitney tests. Result ,the administration of Rubus idaeus extract resulted in the highest total cholesterol levels in group K3 and the lowest in group K5. Statistical analysis showed significant differences (p &lt; 0.05) before and after treatment in each group, with Pearson correlation tests demonstrating a very strong relationship between the dosage of Rubus idaeus and total cholesterol levels. Conclusion, the administration of Rubus idaeus extract significantly reduces total cholesterol levels, with the dose of 90 mg/200gBW being the most effective in lowering total cholesterol levels.

Correlation of the FIB-4 Liver Biomarker Score with the Severity of Heart Failure

Background and Objectives: Heart failure is associated with high morbidity and mortality and linked with several pre-existing health conditions and risk factors. Early detection and prompt management in heart failure improves patient outcomes. Liver involvement is associated with heart failure disease progression, and hence liver biomarkers and liver fibrosis may have a prognostic impact. Several blood test based markers and scoring systems estimate liver fibrosis and hence can be useful prognostic tools. Materials and Methods: We retrospectively analyzed a series of 303 patients with decompensated heart failure in a city in western Romania over a period of 6 months. Several biochemical parameters were measured, the FIB-4 score was estimated and echocardiography was performed. Results for targeted variables are presented using descriptive statistics. Patients were analyzed based on their LVEF categories. Statistical analysis was based on ANOVA one-way tests for continuous variables and Chi-square tests for categorical variables. Pairwise comparisons were performed based on Bonferroni adjusted significance tests. The correlations between FIB-4 score, LVEF and NT-pro BNP in patients with and without diabetes and hypertension were explored using Spearman’s correlation coefficient. Result: Age, gender, NYHA class, death, history of (h/o) type 2 diabetes mellitus (T2DM), h/o coronary artery disease (CAD), h/o arrhythmias, sodium, potassium, creatinine, eGFR, uric acid, NT-pro BNP, left atrial volume, LDL, HDL, and TG were analyzed by LVEF categories using ANOVA one-way tests, Chi-square tests, and Bonferroni correction comparisons. We found a strong statistically significant correlation between each of NT-pro BNP, left atrial volume, LDL, and HDL with the LVEF categories. Discussion: Early detection of cardiac dysfunction leads to better management in patients with cardiovascular risk factors including diabetes and hypertension. High LDL and low HDL levels contribute to a reduction in left ventricular (LV) function. Available literature suggests the FIB-4 score as superior to other non-invasive markers of fibrosis. It utilizes the patient’s age, platelet count, AST, and ALT, which can be available retrospectively, making it an easy and inexpensive tool. FIB-4 score has a few limitations. Conclusions: Our study has shown a statistically significant positive correlation between severity categories of LVEF and FIB-4 score for heart failure patients with and without diabetes, and for heart failure patients with or without hypertension. We propose the implementation of FIB-4 score as a prognostic tool for heart failure.

The role of nutraceuticals in managing metabolic syndrome: a review of clinical studies

BackgroundMetabolic syndrome (MetS) encompasses a cluster of metabolic disorders including central obesity, elevated triglycerides, low HDL cholesterol, high blood pressure, and elevated fasting glucose. These disorders collectively heighten the risk of cardiovascular disease (CVD), insulin resistance, and type 2 diabetes mellitus (T2DM). With its increasing global prevalence, MetS presents significant public health challenges that necessitate comprehensive management strategies. Traditional treatments primarily involve pharmacological interventions, which are often associated with adverse effects and can lead to patient non-compliance.Main bodyNutraceuticals represent a promising alternative to conventional treatments for MetS. These compounds, derived from whole foods and dietary supplements, are being investigated for their potential benefits in improving insulin sensitivity, and lipid profiles, reducing inflammation, and addressing various components of MetS. This review critically evaluates clinical studies focused on nutraceuticals and their efficacy in enhancing metabolic health. By examining a range of interventions, the review provides evidence supporting the role of nutraceuticals in managing MetS.ConclusionThe findings of this review are pertinent to patients, researchers, and medical practitioners. For patients, nutraceuticals offer a potentially safer and more tolerable management option that could improve treatment adherence and quality of life. Researchers will benefit from understanding the mechanisms of action of these comp ounds, which can guide future studies aimed at optimizing their clinical use. Medical practitioners can utilize the insights provided to integrate nutraceuticals into their therapeutic strategies, promoting a more holistic approach to managing MetS and mitigating the burden of related chronic diseases. This comprehensive analysis serves as a foundation for advancing patient care and public health in the context of MetS.

Using Risk Assessment to Improve Screening for Albuminuria among US Adults without Diabetes.

Guidelines currently recommend annual screening for albuminuria only among persons with diabetes mellitus (DM). There is no guidance about albuminuria screening in those with other important risk factors for chronic kidney disease (CKD), such as hypertension and/or family history of kidney disease. We sought to create a risk score that predicts the likelihood of albuminuria in adults without diabetes to prompt earlier detection and management of CKD. Data from 44,322 participants without diabetes, aged 18 + years from the National Health and Nutrition Examination Surveys 1999-2020 were analyzed. Survey-weighted logistic regression was used to assess associations between individual characteristics and presence of albuminuria (urinary albumin to creatinine ratio [UACR] ≥ 30mg/g), including interaction terms, in three separate models. The sample was divided equally into development and validation data sets. C-statistics were used to assess model fit. The prevalence of albuminuria was 9.7% in the US adult population. Higher odds of albuminuria among the non-diabetic population were observed in females, non-Hispanic Black, and smokers, as well as those with low eGFR, hypertension, cardiovascular disease, prediabetes, low HDL cholesterol, and high uric acid levels. Age showed a J-shaped relationship with albuminuria, with lowest odds for ages 25-64years. The C-statistic was 0.756 for the developmental and 0.752 for the validation set of the final model. Using this model, screening individuals with a predicted probability of ≥ 5% would capture 85% of individuals with albuminuria. These results suggest that it may be helpful to use a risk score framework for albuminuria screening in people without DM to encourage earlier detection and management of CKD. Longitudinal studies are warranted to confirm this approach along with evaluation of its cost effectiveness.

Discussion on the calculation formula of haemoglobin glycation index for Chinese population

To explore the formula for calculating the haemoglobin glycation index (HGI) in an appropriate Chinese population. Evaluating the applicability of the HGI calculation formula proposed by Hempe et al. in the Chinese population; according to the data from CHARLS 2011, 10,587 self-reported nondiabetics aged 20 years and older were selected as the study subjects, regression equations were constructed to fit the linear relationship between HbA1c and FPG in the population, and the profile characteristics of the resultant population were analysed. The standardized HGI formula put forth by Hempe and colleagues has been found unsuitable for application to the Chinese population. Leveraging CHARLS dataset, we derive a novel HGI calculation formula tailored to the Chinese demographic: HGI = Measured HbA1c-Predicted HbA1c, where Predicted HbA1c = 0.011×FPG + 4.032. We found statistically significant differences in HGI among obese individuals; those with higher waist circumference, total cholesterol levels, LDL levels, diastolic blood pressure and those with lower HDL levels. The HGI calculation formula proposed using CHARLS data is more applicable to the Chinese population and can be used as a standardised HGI to Chinese.

Association Between Metabolic Disorders and Cognitive Domains in Community-Dwelling Older Adults

ABSTRACT Objectives evaluate the association between Metabolic Syndrome (MetS) and cognitive performance (global and in each domain) in community-dwelling older adults. Methods cross-sectional study with 544 participants (≥60 years). Cognition was assessed using the Cognitive Abilities Screening Instrument – Short (CASI-S), evaluating four domains: memory, orientation, executive function, recall. MetS was identified considering five components: abdominal obesity, diabetes, hypertriglyceridemia, low HDL, and hypertension. Mann–Whitney test and Poisson regression models adjusted for age and education were used to assess the differences in cognition scores. Results Hypertensive participants had lower global cognition, and those with hypertriglyceridemia had lower memory scores; obese individuals reached lower executive function and higher recall scores. Diabetes was associated with worse recall in men, and low HDL to lower memory scores; hypertensive women had worse recall. In adjusted models, association between abdominal obesity, executive function and recall (total sample) remained significant (p = .003 and p = .048, respectively). Conclusions Global cognition was not associated to metabolic disorders, but obesity was associated to lower executive function and higher recall. Clinical Implications Assessing each cognitive domain may be more sensitive in subjects with MetS components, and interaction between components, sex and education also must be considered to establish adequate care strategies for the older adults.

Relationship of Body Fat Distribution and Anthropometric Status with Lipid Profiles in Ethnic Minang Adult Women

Background The prevalence of metabolic syndrome is increasing, and it is a risk factor for cardiovascular disease. One of the indicators of metabolic syndrome is dyslipidemia. Objective This study analyzes adult women's body fat distribution, anthropometric status, and lipid profiles. Methods This study used a cross-sectional design with simple random sampling. A total of 159 adult women aged 25-44 living in the Pesisir Selatan district participated in the study. Ethical approval was obtained, and the respondents were not taking cholesterol-lowering drugs. Body fat distribution, anthropometric status, and lipid profile data were assessed using standard procedures and compared with the categories recommended for Indonesian women. Results The average age of respondents was 36.6 years. 45.3% of the respondents suffered from dyslipidemia. Most of them were obese based on BMI and had central obesity based on WC. Additionally, 76% had an above-normal fat mass. Lipid profile data showed that some (45.3%) had high total cholesterol, 44% had high LDL, 8% had high TG, and a small proportion (15%) had low HDL levels. There was a significant relationship (p &lt; 0.01) between body fat distribution and anthropometric status with lipid profiles, except for total cholesterol (p &lt; 0.05). A negative correlation was found between body fat percentage, BMI, and WC with HDL, while a positive correlation existed between body fat percentage, BMI, and WC with TG and LDL levels. Conclusions Obesity is found to be higher, and dyslipidemia begins to occur in women at a younger age, increasing the risk of metabolic syndrome. Education and routine screening are necessary to prevent non-communicable diseases.

Abstract 4138472: Bioactive Oxylipins Predict Coronary Artery Calcification Severity in Heart Failure with Preserved Ejection Fraction

Background: Inflammation is a common underlying cause in atherosclerosis and heart failure with preserved ejection fraction (HFpEF). Recent data have highlighted the critical role of circulating bioactive polyunsaturated fatty acid oxidized lipids, or oxylipins, in initiating and resolving inflammation. We sought to study the role of oxylipins in predicting coronary artery calcification (CAC) in HFpEF. Hypothesis: We hypothesize that oxylipins can predict and distinguish CAC severity in HFpEF patients. Methods: We collected venous blood samples during right heart catheterization from 71 HFpEF patients. We categorized patients by CT-based CAC severity: none (control; n=16), mild (&lt;25% CAC, n=7), moderate (26-50% CAC, n=22), and severe (&gt;50% CAC, n=26). We measured 143 oxylipins in all study participants using mass spectrometry. Along with unpaired T-tests, machine learning analysis was used to determine lipid permutation importance and evaluate predictive accuracy for CAC severity. Results: Demographic variables showed no significant differences between groups. Increased total cholesterol (p=0.031) and low HDL (p=0.011) were associated with CAC severity. Pro-inflammatory 12(S)-HHTrE (a degradation product of TxA2) levels were elevated in severe CAC vs control (p=0.031). The inactivated anti-inflammatory 5,6 DiHETrE levels were higher in moderate CAC vs control (p=0.032) and severe CAC vs control (p=0.021). Out of 143 oxylipins, the panel of LTB5, 11(R)-HEDE, 20-HETE, 5-HEPE, 11(12)-EpETrE, 14(15)-EpETE, 19,20-DiHDoPE, PD1, and 5-oxoETE were the most significant predictors of severe vs non-severe (none, mild, moderate) CAC, with 88.88% predictive accuracy. Conclusion: In HFpEF patients, CAC severity can be predicted by a novel panel of circulating, bioactive venous oxylipins.

Abstract 4137058: Clinical Characteristics and Outcomes of South Asians Presenting with Acute Coronary Syndrome

Background: Patients of South Asian descent have a higher incidence of atherosclerotic cardiovascular disease and are affected by clinically significant coronary artery disease at an earlier age when compared to the general population. As a result, they have been shown to have a higher rate of cardiovascular events. This at-risk population has not been well studied as it pertains to acute coronary syndrome. Methods: Out of 1610 patients who presented to one of two tertiary care centers between 2021-2022 with a diagnosis of acute coronary syndrome and underwent coronary angiography, 240 patients were identified as being South Asian and were included in the study. 480 non-South Asian patients were randomly selected as controls. A retrospective analysis was conducted to study the demographics, risk factors, clinical presentation, diagnostic features, and outcomes of the two groups. Results: South Asian patients who were diagnosed with acute coronary syndrome and underwent coronary angiography were significantly younger than non-South Asian patients (61 vs 65 years, p &lt; 0.001). Though they were less likely to be smokers, they were significantly more likely to have other known risk factors including hypertension, dyslipidemia, and a history of prior myocardial infarction (p &lt; 0.001). South Asians had mean lower HDL (p = 0.02), higher triglycerides (0.006), and higher Hgb A1C (p &lt; 0.001). Surprisingly, rates of multivessel disease (defined as stenosis of 50% or greater in two or three vessels) were similar between the two groups. South Asians were more likely to be referred for CABG after initial coronary angiography most likely due to diffuse disease (p = 0.014). Clinical outcomes including pre-discharge LVEF, and 2-year mortality were similar between the groups. Conclusions: South Asians are a notoriously high-risk group when it comes to early-onset and more severe coronary artery disease. The pathophysiology behind this disproportionate manifestation of cardiovascular disease is not entirely understood, but several efforts to delineate this are ongoing. Our data demonstrate that this is at least in part, due to a higher prevalence of conventional modifiable and nonmodifiable risk factors in South Asian patients.

Abstract 4123804: Joint associations of sleep and daily step count with cardiometabolic health markers: a pooled analysis of the ProPASS consortium

Background: Poor sleep and physical inactivity are lifestyle-related behaviors that impact cardiometabolic health, but there is limited insight into their combined association with cardiometabolic markers. Aims: This study investigated the joint association of device-measured sleep patterns (regularity and duration) and daily step counts with cardiometabolic biomarkers. Methods: Harmonized individual participant data of 12,223 adults (mean±SD age:54.6±9.5 years; 54.8% female) from the pooled Prospective Physical Activity, Sitting and Sleep consortium (ProPASS), comprising six cohorts with thigh-worn accelerometry data were analysed. Sleep regularity was assessed using the validated Sleep Regularity Index (SRI, range 0-100), quantifying day-to-day sleep consistency. We used generalized linear models to examine cross-sectional joint associations between sleep patterns, regularity (SRI tertiles ≤75.8, low; 75.8-84.5, medium; &gt;84.5, high) and duration (&lt;7h, short; 7-8h, adequate; &gt;8h, long), and daily step counts (step tertiles &lt;8488, low; 8488-11601, medium; &gt;11601, high steps/day) with a composite cardiometabolic health score and individual biomarkers, including BMI, waist circumference, total cholesterol, HDL cholesterol, triglycerides, and HbA1c. Results: Lower sleep regularity, deviation from adequate sleep, along with lower step counts were adversely associated with the composite cardiometabolic health risk score. Compared to optimal sleep patterns (SRI&gt;84.5 or 7-8h/day) and high step groups, low sleep regularity and short sleep duration were separately associated with the least favourable composite cardiometabolic health (z-score [95%CI] 0.32 [0.28,0.37] and 0.25 [0.21,0.29], respectively) among participants with low volume of steps. Low sleep regularity and low daily steps were jointly associated with higher BMI (2.98 [2.67,3.29] kg/m 2 ), waist circumference (8.61 [7.81,9.4] cm), total cholesterol (0.15 [0.08,0.23] mmol/L), and lower HDL levels (0.17 [0.14,0.2] mmol/L), regardless of sleep duration. For short/long sleep duration and low daily step count, such associations were only evident in BMI and waist circumference. Conclusions: Our findings suggest that the potential deleterious associations of irregular or inadequate sleep duration with cardiometabolic health outcomes may be exaggerated by lower daily step counts. Future studies should examine the prospective joint association of sleep patterns and physical activity on cardiometabolic health.

Abstract 4142798: Differences in Clinical presentation in Spontaneous Coronary Artery Dissection vs. Type 1 Myocardial Infarction

Background: Spontaneous coronary artery dissection (SCAD) refers to the nontraumatic, non-iatrogenic, and nonatherosclerotic separation of the coronary artery wall leading to acute coronary syndrome. This condition predominantly affects women with minimal or no traditional cardiac risk factors. We aimed to determine the differences in clinical presentation between SCAD and Type 1 myocardial infarction (MI) in the Aurora Health Care community. Methods: A retrospective, matched cohort, multicenter community study was carried out on adult patients aged &gt;18 years admitted to all Aurora Hospitals from January 2012 to December 2022. A total of 57 patients were diagnosed with SCAD during that period. SCAD group and Type 1 MI group were matched by age and gender at a 1:5 ratio using a propensity score-based matching. Outcomes between the SCAD and the Type 1 MI groups were compared using chi-squared tests or Fisher’s exact tests, and t-tests or nonparametric equivalents (Wilcoxon). Results: A higher percentage of Type 1 MI patients presented as NSTEMI compared to SCAD patients (70% vs. 59.6%, p=0.028). Although not statistically significant, SCAD patients had a higher occurrence of STEMI than Type 1 MI patients (42.1% vs. 32.6%, p=0.169). On admission, SCAD patients had a higher maximum troponin (12,000 vs. 3,550, p=0.012). Type 1 MI patients had higher HgbA1C (6 vs. 5.4, p=0.0008). Both patients had similar LDL levels, but Type 1 MI had lower HDL levels (44 vs. 48, p=0.024). ESR, CRP, and D-dimer levels showed no significant difference. LV ejection fraction was 53% in both groups, and the LV global longitudinal strain was similar. The Type 1 MI group exhibited higher grades of diastolic dysfunction (Grade 2 and Grade 3) and mitral valve disease. E/e was higher in Type 1 MI compared to SCAD (11.5 vs 8.8, p &lt;0.0001). Type 2 SCAD was most prevalent at presentation, with the most frequently affected artery being LAD (47.4%) and the most frequently affected branch vessel being obtuse marginal (36.4%). The most common location was distal (59.6%), followed by mid (22.8%), with the diameter of the vessel involved mostly between 2-3.5 mm. Conclusion: This study observed that although more SCAD patients presented as STEMI with higher troponins, Type 1 MI patients were sicker overall. These differences in clinical findings can aid in diagnosis as the management of these two populations differ.

Prevalence of metabolic syndrome and its components according to altitude levels: a systematic review and meta-analysis

Metabolic syndrome has a multifactorial origin; however, epidemiological data correspond to populations located at sea level. It has been reported that the altitude can affected the prevalence due to physiological changes. The aim of this study is to show the global prevalence of metabolic syndrome at altitude and its components. We use four databases, all studies published up to November 2023. The prevalences from studies were meta-analyzed using a random-effects model. To assess sources of heterogeneity, subgroup analyses were performed. We included 28 studies. The number of participants was 29 195. The prevalence of metabolic syndrome was 30.3% (95% CI 22.8–38.4%). According to the altitude level, at 1500–2500 was 36.5%, 2500–3500 (21.8%), and > 3500 (30.9%), also it was higher in women (35.5%) that men (26.8%). It was observed that there is an inverse relationship between higher altitude and the prevalence of metabolic syndrome. Among its components, abdominal obesity and low HDL were present in more than 40.0%, while high blood pressure, high triglycerides and impaired glucose were present in less than 30.0%. We recommend that our results be considered for future research in populations living at altitude since they have different characteristics from populations at sea level.

Analysis of the Prevalence of Cardiovascular Risk Factors in Patients with Chronic Hepatitis C

Cardiovascular diseases are the most common and important cause of morbidity, hospitalisation, and mortality in Poland and worldwide. Hence, in recent years there has been a strong emphasis on preventive cardiology, aimed at early identification and prevention of cardiovascular risk factors and lifestyle changes. The main classical risk factors include lipid disorders, hypertension, diabetes, obesity, and smoking. A new non-classical risk factor is HCV infection. The study group consisted of 320 patients with a mean age of 43 years, diagnosed with chronic hepatitis C. In the study group, ischaemic heart disease was diagnosed in 4 patients, representing 1.25%. Six people had a history of ischaemic stroke, representing 1.87% of the study group. Among the subjects, the most common cardiovascular risk factor was hyperlipidaemia (28%); there was no correlation with the severity of liver fibrosis for total cholesterol, LDL fraction, or TG, but more advanced liver fibrosis was observed in patients with low HDL fraction cholesterol values. Hypertension was present in 25% of patients and occurred in patients with more advanced liver fibrosis and steatosis. Diabetes was found in 11,56% of patients, also the mean fasting glucose level was elevated and was associated with more advanced liver fibrosis. The majority of patients were overweight and 32% were diagnosed as obese. The mean CRP value was 1.73 which may indicate moderate -cardiovascular risk. The results obtained may contribute to the awareness of physicians and the attempt to create recommendations for comprehensive - interdisciplinary care of patients chronically infected with HCV, concerning the need for systematic periodic examinations to assess individual cardiovascular risk factors, with the aim of prevention and early prevention of cardiovascular events.

Nutritional, Metabolic, and Inflammatory Alterations in Children with Chylous Effusion in the Postoperative Period of Cardiac Surgery: A Descriptive Cohort.

The occurrence of chylous effusion in children undergoing cardiac surgery is progressively increasing due to technical advances that have led to a rise in the number of surgeries. In this context, the objective was to describe the clinical profile of a cohort of patients at the time of chylous effusion diagnosis. A retrospective cohort analysis was conducted between January 2011 and July 2023, involving 23 patients, aged 0 to 18 years, treated at a quaternary university hospital in southeastern Brazil. Data were obtained from the follow-up records of the Multidisciplinary Nutritional Therapy Team (MNTT) for patients who received nutritional support after developing chylous effusion in the postoperative period of cardiac surgery. The younger population predominated (median age of 6 months), with a high prevalence of malnutrition (60.9%). At the time of chylous effusion diagnosis, 83% had lymphopenia, and 74% had hypoalbuminemia. The longer the time elapsed after surgery for the onset of chylous effusion, the lower the HDL cholesterol, the lower the albumin levels, the greater the surgical complexity, the younger the patient, and the lower their weight. Hypocalcemia occurred in nearly half of the sample and hypophosphatemia in 26% of the analyzed cases. There was a notable presence of lymphopenia, hypoalbuminemia, and low HDL cholesterol, as well as a high incidence of mineral imbalances, particularly hypocalcemia and hypophosphatemia, which, if untreated, may lead to unfavorable outcomes. Therefore, clinical and laboratory monitoring of children in the postoperative period of cardiac surgery is important and can aid in the early diagnosis of chylous effusion and, consequently, in the timely initiation of treatment.