Low HDL Levels Research Articles

The association of snoring, growth, and metabolic risk factors at the age of two years

Background and aimsThis observational study examined the association of snoring and growth during early childhood and the cardiovascular and metabolic risk factors based on blood samples at the age of two years.Methods and resultsThe sample comprised 78 children from the CHILD-SLEEP birth cohort with full-night polysomnography (PSG) and a questionnaire consisting of parts concerning the child's sleep and environmental factors at 24 months. The growth charts were collected from well-baby clinics. Metabolic blood samples were drawn from 31 children.There were no statistically significant differences in the growth parameters of snoring children compared to controls during the first two years of life. However, in linear regression models, snoring time in PSG significantly predicted lower levels of HDL (β = -0.484, p = 0.007) and ApoA1 (β = -0.451, p = 0.049) and higher levels of hs-CRP (β = 0.410, p = 0.019).ConclusionIn conclusion, in Finnish children the levels of HDL and ApoA1 were inversely related to the snoring time in PSG. In addition, the snoring time in PSG significantly predicted higher levels of hs-CRP. These results suggest that snoring in early childhood could negatively alter the serum metabolic profile, adding to the risk of cardiovascular diseases in adulthood.

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.

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.

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.

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.

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 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.

Pro-inflammatory cytokines increase temporarily after adjuvant treatment for breast cancer in postmenopausal women: a longitudinal study

BackgroundBreast cancer patients have an increased risk of cardiometabolic disease and for many patients, adjuvant therapy causes an altered lipid profile, insulin resistance and inflammation. Previous follow-up studies are inconclusive regarding the duration of therapy-induced inflammation. We examined the acute and persistent changes of adjuvant chemotherapy on inflammatory and metabolic health markers in breast cancer patients.MethodsPlasma levels of IL-6, IL-8, IL-10, IFN-γ, TNF-α, high-sensitivity C-reactive protein (hsCRP) and metabolic health parameters were analyzed before, shortly after and every six months up to two years after adjuvant chemotherapy treatment in 51 postmenopausal early breast cancer (EBC) patients, as well as in 41 healthy age- and BMI-matched controls. A target-specific multiplex assay was applied for cytokine measurements.ResultsBefore initiation of adjuvant therapy, plasma IL-8 levels were higher in EBC patients (31%, p = 0.0001). Also, a larger proportion of the patients had a hsCRP level above 2 mg/L (41%) compared to the controls (17%, Χ2 = 5.15, p = 0.023). Plasma levels of all five cytokines, but not hsCRP, were significantly increased after compared to before adjuvant chemotherapy (15–48% increase; all p ≤ 0.05). Already six months after ending chemotherapy treatment, all plasma cytokine levels were significantly reduced and close to pre-chemotherapy levels. Adjuvant chemotherapy caused a worsened lipid profile (increased triglycerides, lower HDL levels), insulin resistance and increased plasma insulin levels that remained high during the first year after chemotherapy.ConclusionPostmenopausal women with EBC have temporarily increased plasma levels of pro-inflammatory cytokines after adjuvant chemotherapy. Although transient, the therapy-induced increase in plasma cytokine levels, together with dyslipidemia and insulin resistance, may contribute to cardiometabolic risk in breast cancer patients treated with adjuvant chemotherapy.Trial registration The clinical trial (registration number NCT03784651) was registered on www.clinicaltrials.gov on 24 December 2018.

8481 A 32 Year Old Male With Recurrent Acute Pancreatits and Severe Hypertriglyceridemia: Importance of Considering Genetic Variants

Abstract Disclosure: M.F. Salazar Zelaya: None. J.D. Sibaja Jiménez: None. Background : Hypertriglyceridemia is a common medical scenario in daily practice, causing a variety of symptoms including recurrent episodes of acute pancreatits, which can be severe. Multiple genetic variants can lead to different spectrums of the disease. CLINICAL CASE: A 32 year old male police officer presented to our Endocrinology Outpatient Clinic with a history of long standing hypertriglyceridemia and six previous episodes of acute pancreatits, two in the last twelve months. Familiy history was negative for lipid disorders. The patient had adecuate adherence to diet and exercise as well to prescribed medications, which included Fenofibrate 250 mgs/day and Rosuvastatin 40 mgs/day. The patient denied consumption of alcoholic beverages. Recent abdominal ultrasound was reported without abnormalities. His lipid panel reported elevated triglycerides at 5831 mg/dl (n&amp;lt;150 mg/dl), Total Cholesterol normal at 147 (n&amp;lt;200 mg/dl), low HDL levels at 12 mg/dl (range 12-92 mg/dl) and direct LDL Cholesterol at 120 mg/dl. His TSH value was normal at 1.02 uUI/mL (range 0.55-4.78 uUI/mL). Creatinine level was normal at 0.81 mg/dl (range 0.7-1.3 mg/dl). Liver function tests were normal with AST level at 25 IU/L (range 13-39 IU/L) ALT levels at 22 IU/L (range 7-52 IU/L) and alcaline phosphatase at 62 IU/L (range 34-104 IU/L).His fasting glucose level were normal at 82 mg/dl (n&amp;lt;100 mg/dl). Due to a high Familial Chylomicronemia Syndrome clinical score (13 points) we proceeded with genetic analysis of this patient. Next Generation Sequencing for genes related with chylomicronemia (APOA5, APOC2, GPIHBP1,LMFI, LPL) was performed to determine gene sequence plus copy number variation.Two heterocigote variants were reported, both in the LPL gene. The first one: LPL (NM 000237.3) c.644&amp;gt;A;p.Gly215Glu heterozygous is a missense variant already reported in the literature, registered in ClinVar (ID 1522) and the Leiden Open Variation Database. This variant is classified as pathogenic according to criteria PS3, PM1, PP3, PP5 of the American College of Medical Genetics and Genomics. The second one: LPL (nm 000237.3): c.383C&amp;gt;A;p.Thr128Asn;heterozygous is also a missense variant which to the extent of our knowledge has previously been reported only once in the literature: ClinVar (ID 1520537). This variant is classified currently as of unknown clinical significance according to PM2 criteria. There is however and entry reported (PMID: 8778602) of another variant affecting the same codon (p.Thr128AIa) that is associated to chylomicronemia syndrome. Conclusion: In cases of severe hypertriglyceridemia, suspicion and determination of gene variants are of great importance nowadays as they could eventually guide treatment, given the availability in some countries (and currently pending FDA approval) of new pharmacological therapies such as apo C-III inhibitors. Presentation: 6/2/2024

Effect of Mediterranean Diet Composition on Metabolic Syndrome Marker Parameters Based on NCEP-ATP III Criteria

Metabolic syndrome refers to a cluster of metabolic abnormalities in the body, including central obesity, elevated blood pressure, high glucose, and triglyceride levels, as well as low HDL levels. The Mediterranean diet, known for its specific composition, is believed to mitigate metabolic syndrome. This study aims to assess the impact of adhering to the Mediterranean diet on individuals with metabolic syndrome. It employs an observational analytic approach, utilizing a prospective cohort of 30 participants who followed the Mediterranean diet regimen as part of their treatment at a clinic in Bandung City. Systematic Random Sampling was used to select participants, and blood pressure was measured at the beginning (T1) and end (T2) of the study. Data on dietary intake were collected using the Relative Mediterranean Diet (rMED) scale via a Food Frequency Questionnaire (FFQ). Statistical analyses, including ANOVA and Tukey’s post-hoc test, were conducted to compare dietary compositions across adherence groups and to assess the impact of the Mediterranean diet on metabolic syndrome components. The findings revealed that participants, with an average age of 57.94 years and 69.44% female, experienced significant improvements in certain metabolic syndrome components, such as waist circumference (fruit and nut intake), triglycerides (vegetable intake), HDL (meat intake), and blood glucose (dairy product intake). However, no significant effects were observed for legumes, seeds, fish, and olive oil components on MetS. Keywords: components, Mediterranean diet, MetS, NCEP-ATP III

Association between pseudoexfoliation syndrome and dyslipidemia: A case control study

: Pseudoexfoliation syndrome, also known as PEX 1, is a systemic micro fibrillopathy associated with ageing that is brought on by the gradual buildup of extracellular white and grey matter on various ocular and extra ocular structures. It is deposited in extra-ocular tissues such the heart, blood vessels, meninges, liver, and lungs. Numerous investigations have shown a connection between PEX and glaucoma. A person with PEX is typically thought to be at risk for acquiring glaucoma, and vice versa.Atherosclerosis is facilitated by dyslipidemia, which is an increase in plasma cholesterol, triglycerides (TGs), or both, or a low HDL level. A potential risk factor for the progression of cardiovascular disease is dyslipidemia. Numerous investigations have discovered abnormal lipid profiles in pseudoexfoliation syndrome patients, including elevated levels of triglycerides, cholesterol, and LDL. Due to the straight association between lipid levels, atherosclerosis, and cardiovascular risk, patients with PEX are shown to be at an elevated risk of cardiovascular and cerebrovascular events.To study the correlation between dyslipidemia and pseudoexfoliation syndrome in patients above 50 years of age and compare it with age matched controls.This case control study was conducted from November 2020 to November 2022 at SKIMS Medical College and Hospital, Srinagar and included 150 patients with PEX above 50 years of age and compared with age matched controls. In this study mean total cholesterol among cases was 176.88±34.76 mg/dl versus 172.94±51.51 mg/dl in controls. P-value for total cholesterol was statistically insignificant (0.438). Mean triglyceride level among cases was 180.11±54.70 mg/dl while as mean triglyceride level among controls was 163.14±46.21 mg/dl and P-value was found to be statistically significant. Mean LDL level among cases was 104.57±32.80 mg/dl while as in controls mean was 82.70±27.60 mg/dl. P-value for LDL levels was found to be statistically significant. Mean HDL levels among cases was found to be 41.93±8.94 mg/dl while as in controls mean was 39.67±13.73 mg/dl. P-value for HDL levels was statistically insignificant (0.09). Mean VLDL levels among cases was found to be 25.34±19.52 mg/dl while as in controls mean was 27.66±14.36mg/dl. P-value for VLDL levels was statistically insignificant (0.242).There is significant correlation between dyslipidemia and pseudoexfoliation syndrome in patients above 50 years of age.

Association Between Low Serum HDL Levels and Severity of Coronary Artery Disease Among Patients with Non-ST Elevated Myocardial Infarction

Introduction: Coronary artery disease is one of the leading causes of non-communicable diseases related deaths worldwide. Decreased serum high-density lipoprotein level are associated with an increased severity of coronary artery disease. Present study aims to evaluate the association between this low HDL level and the severity of coronary artery disease assessed by SYNTAX Score in patients with non-ST elevation Myocardial infarction. Materials &amp; Methods: This was a cross sectional study conducted in the Department of Cardiology at National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, from May 2020 to April 2021, on 170 admitted adult patients of non-ST elevated myocardial infarction undergoing coronary angiogram. Study population was divided in two groups; Group-I: Respondents with HDL level ≥ 40 mg/dl, Group-II: Respondents with HDL level &lt; 40 mg/dl. Transthoracic echocardiography was done before coronary angiography. All coronary lesions with diameter stenosis &gt; 50% in vessels &gt; 1.5 mm was scored, using the SYNTAX algorithm. A low score was defined as ≤ 22, an intermediate score as 23 to 32, and a high score as ≥ 33. To determine statistical significance, Chi-square test and independent sample t-test were considered according to applicability. P value of &lt; 0.05 was considered statistically significant. Results: Highest proportion of respondents were from age group 51 – 60 years, 48.2% and 43.5% for group-I and group-II respectively. Study population was male predominant, 88.2% among patients from group-I and 83.5% among patients from group-II. Smoking was the most prevalent risk factor for group-I patients at 58.8%. Hypertension was the most prevalent risk factor for group-II patients at 45.9%. Mean total cholesterol, low-density lipoprotein and high-density lipoprotein were higher among patients from group-I than group-II and these differences were statistically significant (p &lt; 0.05). Mean triglycerides was higher among patients from group-II than group-I and this difference was statistically significant (p &lt; 0.05). Triple vessel was more prevalent (36.5% vs 22.4%) among patients from group-II than group-I and this difference was statistically significant (p &lt; 0.05). Mean SYNTAX score (SS) was higher among patients from group-II than group-I, 17.4 ± 8.6 and 11.5 ± 8.4 respectively, and this difference was statistically significant (p &lt; 0.05). There was strong negative correlation between HDL level and Syntax score (r = - 0.299, p &lt; 0.05). Conclusion: Present study demonstrated significant negative correlation between low serum HDL levels with severity of coronary artery disease among patients with non-ST elevated myocardial infarction. Serum HDL levels can be used as a predictor for the severity of coronary artery disease among such patients. Bangladesh Heart Journal 2024; 39(2): 138-143

Preoperative Serum Lipids as Novel Predictors of Survival in 3575 Papillary Thyroid Cancer Patients.

The objective of this study is to investigate the association between preoperative serum lipids levels and papillary thyroid cancer (PTC) patients' outcomes. A retrospective cohort study including 3575 PTC patients from year 2012-2016 with follow-ups in our institute were enrolled. Preoperative serum lipids were divided into categorical variables by Receiver-operating curves. Univariable and multivariable cox regression models were developed and independent risk factors were used to construct a nomogram to predict disease-free survival (DFS) rate. Among the 3575 patients, the mean follow-up time was 56.7 months. Comparing with the patients with high level of triglycerides (TAG≥0.605 mmol/L) and high-density lipoprotein (HDL≥0.935 mmol/L), those with low level of TAG (hazard ratio [HR] 2.28 [95% CI, 1.35-3.83]) and HDL (HR 1.64, [1.02-2.62]) had a significantly higher risk of recurrence in PTCs. The 5-year DFS rate of patients with low level of TAG was 94.4%, which was much lower than that in the high level group (97.2%, P＜0.001). While TC (P = 0.13), LDL (P = 0.07) and VLDL (P = 0.15) were not statistically correlated with PTCs' recurrence. The nomogram model showed clinical predictive value with the c-index of 0.80 (95% CI 0.73-0.87) and 0.82 (95% CI 0.73-0.90) for 3- and 4-year DFS in the training cohorts. In the present study, we provide initial evidence that low levels of TAG and HDL were independently associated with the recurrence of PTC, indicating that preoperative serum concentrations of lipids are helpful in predicting PTC patients' prognosis in clinical practice.

Lipid Profiles and Liver Enzymes in Autistic Patients in Iraq, a Case-Control Study

his study investigated possible differences in lipid profile and liver enzymes between autistic children and healthy controls. The study included 32 autistic patients (26 males, 6 females, 5-10 years) and 32 age- and gender-matched healthy subjects. Blood samples were taken from all participants, and cholesterol, triglycerides, HDL, LDL, VLDL, ALP, ALT, and AST levels were measured. The results showed that the levels of cholesterol, triglycerides, VLDL, ALT, and AST were significantly reduced in the autistic group compared to the control group No significant differences were observed in the levels of HDL, LDL and ALP. ROC analysis revealed strong discriminatory power for ALT and AST to discriminate between autistic and healthy children. The Pearson correlation matrix showed strong positive correlations between most of the measured parameters. These findings are consistent with previous studies suggesting altered lipid metabolism in autism. The observed reduction in lipid levels may be related to its important role in brain development and synaptogenesis. Low HDL levels may be associated with impaired lipid metabolism in autistic individuals. Significant differences in liver enzymes (ALT and AST) suggest the possibility of mitochondrial dysfunction in autistic children. This study highlights the potential role of lipid profile and liver enzyme testing in the understanding and diagnosis of autism. Further research is needed to investigate the underlying mechanisms by which these factors are associated with autism spectrum disorders.

Factors Associated with High-Risk Plaque Characteristics Among Patients with Medium to Severe Carotid Artery Stenosis

ObjectiveThere has been a large discussion in literature regarding the proper management of asymptomatic patients with significant carotid artery stenosis (CAS). This study aims to identify potential risk factors associated with high-risk carotid plaques. MethodsThis is a retrospective study based on a prospective database. Eligible patients had medium to severe symptomatic or asymptomatic carotid stenosis (≥50%, NASCET criteria). This study will analyze patients recruited by our institution as part of the multicenter TAXINOMISIS project (NCT03495830). According to protocol, all patients underwent a colored Duplex ultrasound examination and a magnetic resonance angiography (MRA) at baseline. Carotid plaques were classified according to Gray-Weale ultrasonographic criteria (Types I-V). Main outcomes included the occurrence of symptoms, the high/low echogenicity of the plaque, the existence of intraplaque hemorrhage (IPH) and the existence of lipidic/necrotic core. Secondary, risk factors associated with the aforementioned outcomes were evaluated. ResultsA total of 62 patients (mean age: 68.7+/-9.3 years, 66.1% males, 24.2% symptomatic) were recruited by our department. Mean carotid stenosis was 70.81%±13.53%. In multivariate regression analysis, CRP > 2mg/l was strongly associated with symptomatic stenosis (OR=9.92 [1.12-88.178]; P=0.039), and low HDL levels (<1200mmol/l) were associated with lipidic/necrotic plaque core (OR=16.88 [1.10-259.30]; P=0.043). Low HDL levels (OR=7.22 [1.00-51.95], P=0.049) and HbA1c >7% (OR=0.08 [0.01-0.93], P=0.044) were associated with type III/IV plaques whereas HgAbc1 >7% (OR=14.26 [1.21-168.34], P=0.035) was associated with Type V plaques. ConclusionsThis preliminary study has revealed some potential risk factors associated with unstable carotid plaques. This data could help the future development of prognostic models in order to early detect patients that could benefit from further intervention.

Efficacy and Safety of Filgotinib in Rheumatoid Arthritis Patients Aged over and under 65 Years (ENANTIA-65).

According to recent data, the age of patients could represent an important risk factor for MACE (major cardiovascular events), cancer, and VTE (venous thromboembolism) during treatment with JAK inhibitors in rheumatoid arthritis. We decided to analyze the population involved in the ReLiFiRa study by identifying two groups of patients: 65 years or more and less than 65 years of age, evaluating the efficacy and tolerability of 200 mg of Filgotinib daily. Of the 120 ReLiFiRa patients, 54 were younger than 65 years old and 66 patients were 65 years old or older. The data of efficacy and tolerability of treatment with FIL 200 mg daily for 6 months were evaluated. After six months of treatment, FIL was effective in both age groups. In both groups, the median values of steroid DAS28, CDAI, ERS, PCR, tender joints, swollen joints, VAS, HAQ, PGA patients, and PGA physicians were reduced with a statistically significant difference comparing these values with the baseline values. The difference in age did not impact the effectiveness of the drug. The lipid profile data also did not demonstrate significant differences between the two age groups; however, the comparison between younger vs. older patients' populations regarding the total cholesterol/HDL ratio and LDL/HDL ratio shows a statistically significant difference: total cholesterol/HDL 3.4 (2.12-3.66) vs. 3.64 (3.36-4.13) p = 0.0004, LDL/HDL 1.9 (0.98-2.25) vs. 2.41 (2.04-2.73) p = 0.0002. There are no differences regarding the atherogenic index (LDL-C/HDL-C) and coronary risk index (TC/HDL-C) compared to baseline. After six months of treatment with FIL, the older population group showed a higher level of LDL and a lower level of HDL compared to younger patients. The atherogenic index and coronary risk index are higher in patients aged ≥ 65 years, but interestingly, there were no differences when comparing the 6-month data to baseline values. This condition highlights the impact of typical risk factors that act independently of treatment with Filgotinib.

Evaluation of Secondary Dyslipidemia in Obese Children

Objective: This study was conducted to determine the frequency of dyslipidemia secondary to childhood obesity, a recently emerging clinical entity, and to compare serum lipid profiles in obese and non-obese children. Material and Methods: After screening children with an obese appearance, a group of 119 obese children aged between 2 to 16 years with a body mass index above the 95th percentile and a control group of 124 children in a similar age range were compared in terms of serum lipid profile. Results: An abnormal lipid profile was determined in 62.6% of obese children, and serum levels of total cholesterol and triglycerides were higher in this group. It was found that Childhood obesity was associated with higher levels of total cholesterol (44.5%), triglycerides (48.7%), LDL (38.7%), and lower levels of HDL (23.5%). Conclusion: Obese children have a higher risk of secondary dyslipidemia and associated comorbidities. In order to prevent childhood obesity and its dangerous consequences, effective measures must be implemented in terms of screening, early diagnosis and appropriate treatment.