Low HDL Levels Research Articles

Kegiatan Pengabdian Masyarakat dalam Edukasi Penyakit Dislipidemia serta Komplikasinya terhadap Penyakit Kardiovaskular

Coronary heart disease occurs when the blood vessels that supply blood to the heart are blocked by plaque build up in the walls of the blood vessels. Uncontrolled dyslipidemia can lead to faster plaque build up and a higher risk of having a heart attack. Community service activities are important to increase public awareness of dyslipidemia and coronary heart disease for early detection before complications occur. Community service activities were carried out at the Kalam Kudus II Jakarta Foundation involving 52 respondents. Activities carried out in the form of community education, physical and supporting examinations, and counseling. The results showed that 6 (11.5%) respondents had high total cholesterol and high LDL levels, 37 (71.2%) respondents had low HDL levels, 8 (15.4%) respondents had high triglyceride levels, and 8 (15.4%) of respondents diagnosed with suspected coronary heart disease based on examination of the electrocardiogram. Early detection is an effort to detect the presence of cardiovascular disease and dyslipidemia at an early stage so that action can be taken immediately to prevent more serious conditions. Education and early detection of cardiovascular disease and dyslipidemia are very important to prevent more serious diseases from occurring in the future. Through appropriate counseling and early detection, it is hoped that the public will be more aware of the importance of maintaining health and preventing cardiovascular disease and dyslipidemia.

Dyslipidaemias in patients with diabetes mellitus type 2 - a cumulative impact on coronary artery disease occurence

<p><strong>Introduction.</strong> Cardiovascular complications are one of the leading causes of mortality releted to diabetes mellitus typ 2 (T2DM). Dyslipidemia is one of the associated risk factors for coronary artery disease (CAD) in patients with T2DM. The aims of our study were: to determine the characteristics of lipid disorders in persons with T2DM; to determine the cumulative impact of investigated risk factors (gender, age, genetic predisposition, smoking habits, diabetes mellitus, hypertension, obesity) for the occurence of the coronary artery disease; to determine the influence of lipid profile on coronary artery disease development. <strong>Methods.</strong> A cross-sectional study was conducted in the Educative Center of the Primary Health Center Banja Luka in the period 01.11.2021–30.04.2022. Adult patients (≥18 years) with T2DM were recruited into the study. The data about socio-demographic characteristics, lifestyle and clinical factors were collected using structural questionnaire as a tool. For all subjects, anthropometric measurements, blood pressure readings, and laboratory findings (fasting blood glucose, HbA1c, lipid profile) were taken.<strong> Results.</strong> A total of 221 patients with T2DM participated in the study, 52.03% were males. Hypertriglycerdidemia was found in 63.81% subjects, hypercholesterolemia in 56.60%, low HDL-cholesterol in 49.77% subjects and increased level of LDL-cholesterol in 39.37% subjects. Metabolic dyslipidemia (increased triglyceride levels and low HDL levels), representing the major predictor of CAD, was found in 35.29% subjects. Older age, physical inactivity, obesity, hypertension and high levels of fasting glucose in blood were significantly related to dyslipidaemia in patients with T2DM. <strong>Conclusion.</strong> The representation of dyslipidemia in our subjects with T2DM is high, what increases the risk for coronary artery disease. Therefore, it is necessary not only to implement the therapy for glucoregulation, but also the secondary preventive measures for dyslipidemia, and that is the cardiovascular prevention.</p>

Usefulness of impedanciometry for the assessment of obesity in a high risk dyslipidemia screening unit

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Residual risk is related to future events in already treated patients. In addition, obesity increases cardiovascular risk. Body mass index (BMI) is the OMS-defined measure for the diagnosis of obesity, but not the only one, as body fat percentage (%BF) allows a more accurate estimation of visceral fat. Objective To identify the clinical utility of adding body fat percentage (%BF) measured by impedanciometry to the assessment of obesity, and to compare the residual lipid profile of obese versus non-obese patients according to the measurement methods. Methods Prospective observational study, which analysed 213 patients included in a High Risk Dyslipidemia Screening Unit. Three groups were classified: group A (BMI <30 and %BF <25%-35% according to gender; group B (BMI <30 but %BF ≥25% -35%) and group C (BMI ≥30 and %BF ≥25-35%). Clinical characteristics, screening unit inclusion variables and residual lipid profile were analysed, as well as the association with early coronary heart disease and with the development of cardiovascular disease among the three groups. Results Of the 213 patients included, 91 belonged to Group A (non-obese patients), 80 belonged to Group C (obese according to BMI and %BF) and 42 patients belonged to Group B (classified as obese according to %BF but with BMI <30). When comparing the three groups, it was observed that the patients in group B had a residual lipid profile more similar to that of group C patients. They had higher levels of TG, remnant cholesterol and VLDL; with lower levels of HDL (p<0.05), with no statistically significant differences in the levels of Lp(a), ApoB, LDL and non-HDL in relation to those in group A. Fifty percent of group B patients developed coronary heart disease, compared to 56% of group C and 36% of group A patients (p= 0.029). There were no differences in the development of early coronary heart disease. There were 31.6% of patients with BMI<30 who were reclassified as obese according to %BF. If we classified the obese according to BMI, 45.5% developed cardiovascular disease and 45.2% developed early coronary heart disease. If we reclassify the obese according to %BF, the percentage rises to 65.7% and 65.6% respectively. All data are shown in table 1. Conclusion Adding the % of BF by impedanciometry for the diagnosis of obesity in a high risk dyslipidemia screening unit allows the identification of an important percentage of patients with a higher cardiovascular risk and a worse residual lipid profile. BMI is insufficient as a single parameter for the assessment of obesity and for stratifying cardiovascular risk.

Corelation of hypothyroidism and dyslipidemias with plantar fasciitis in Indian population

Background: Plantar fasciitis (PF) affects millions of people but still there is lack of knowledge of all the factors involved in causing this condition. The main objective of this study is to investigate the relationship between thyroid hormones, dyslipidemias, hyperuricemia, liver and renal function tests. Methods: 200 patients were enrolled,100 with a clinical diagnosis of PF in the case group and 100 without PF in the control group. Patients thyroid profile (T3, T4, TSH), liver profile (Bilirubin, SGOT, SGPT), renal profile (Serum creatine, urea), lipid profile (serum total cholesterol, LDL, HDL, VLDL, triglyceride) and uric acid levels were checked and compared between the two groups. Results: Patients with PF had a higher TSH level with a mean of 4.33 mg/dl (range 0.64-20.56) than the control group with TSH mean of 2.51 mg/dl (range 0.51-8.78) (p<0.001). Serum cholesterol level was significantly higher in patients with PF than in the control group (p=0.002). Triglycerides (p=0.01), LDL (p<0.01), VLDL (p=0.021) were significantly higher in patients than in controls. HDL levels were found to be significantly lower in patients than in controls (p=0.003). Conclusions: Significantly higher TSH levels, serum cholesterol, serum triglyceride, serum LDL, serum VLDL and low HDL levels were seen in the Indian population suffering from PF. Thus, hypothyroidism and dyslipidemias should be evaluated while treating PF.

Effect of Smoking on Serum Lipid Profile among University’s Students in Dhamar City, Yemen

A cross sectional study was performed to evaluate the changes on serum lipid profile and associated risk factors in apparently healthy smoker and non-smoker students at the University of AlHikma Dhamar city, Yemen during the period between November 2021 to March, 2022. Two hundred five students were randomly selected, 104 students were smokers and 101 nonsmokers. Sociodemographic data were collected using a self-administered questionnaire. Anthropometric measurements and laboratory analysis for lipid profile were assessed using standard techniques. The results revealed that smokers had significantly (P<0.05) higher levels of TC (164.93 mg/dl), TG (149.63 mg/dl), LDL (71.60 mg/dl) and VLDL (29.58 mg/dl) and lower level of HDL (64.70 mg/dl) compared to the non-smokers group. Duration and numbers of cigarette smoked were positively correlated with lipid profile values of participants (r=.300; P=.000 and r= .317; P.=000) and (r=.210; P=.003 and r=.213; P=.002) for TG and VLDL respectively; while none with other values. Significant association was observed between weight (r=.235; P=.001 and r=.145; P=.000); heartbeat (r=.205; P=.003 and r=.256; P=.000); diastolic (r=.151; P=.030) and BMI (r=.155; P=.027) indices and lipid profile (TG and VLDL); (TC and LDL); (HDL and TC) of the participants respectively; whereas, none with height and systolic indices. In conclusion, smoking is clearly associated with increase serum lipid and lipoprotein values with exception HDL which significantly decreased in smoker compared to non-smokers students. This association is dependent on number of sociodemographic and anthropometric factors. Adopting anti-smoking programs among University`s students to prevent the harmful effects of smoking are urgently required.

Abstract #1413302: A Case of a 25-Year-Old Woman with Congenital Pseudohypoparathyroidism and Hypothyroidism with Prediabetes

Pseudohypoparathyroidism (PHP) is a group of rare disorders, with fewer than 60 clinically-confirmed cases worldwide by 2016. PHP and related disorders mostly result from the genetic and/or epigenetic changes that cause end-organ parathyroid hormone resistance with a cyclic adenosine monophosphate (cAMP) generator down-regulation. These changes are often associated with the GNAS gene. PHP type IA tends to present with hypocalcemia, hyperphosphatemia, elevated PTH levels and Albright hereditary osteodystrophy (AHO). Clinical features of AHO are obesity, round face, short stature, brachydactyly (BD), subcutaneous ossifications and mental retardation. PHP is associated with increased risk for metabolic syndrome and diabetes with related complications. We present a case of a 25-year-old woman, who was referred to the adult Endocrinology clinic for management of PHP type IA and hypothyroidism by her primary care provider who was managing her condition for the last 7 years. She was last evaluated by her pediatric endocrinologist at age 18. She was initially diagnosed with PHP and hypothyroidism at age 7 after a syncopal episode requiring hospitalization. She had severely low serum calcium and elevated thyroid stimulating hormone levels upon diagnosis. She has a past medical history of seizures as a child. There is no family history of PHP. On physical examination, she had a round face with short stature, shortened chubby extremities and absent knuckles in all except index fingers of both hands. She weighed 173 pounds with a height of 62 inches and a BMI of 31.64. She is currently taking 150 mcg oral once daily levothyroxine, 0.25 mcg oral once daily calcitriol and calcium carbonate 625 mg oral four times per day. Laboratory investigations: Her TSH is 3.4, serum calcium is 8.7mg/dl, intact parathyroid hormone level is 169.4 picograms/milliliter. Her 25-OH-vitamin D level is low at 14.8nanogram/milliliter. Her serum Phosphorus is high at 5.3 mg/dl and her HbA1c is high at 5.8 mg/dl. Her lipid profile is normal except for a low level of HDL at 35 mg/dl. Patients with PHP are at higher risk for weight gain, type 2 diabetes, dyslipidemia and hypertension. Our patient with PHP and prediabetes was referred to the dietitian for nutrition education. Increasing physical activity was recommended. Vitamin D deficiency was treated with a high dose vitamin D course. Calcium and calcitriol treatments were continued. We conclude that patients with PHP should transition from pediatric endocrinology to adult endocrinology in a timely fashion for regular follow-ups to avoid morbidity and mortality. Educational programmes, as well as psychological support, should be provided to patients and families even in the presence of a normal BMI as a preventive strategy.

Evaluation of the relationship of obesity with some vital factors as a predictive indicator of cholecystitis in Thi-Qar Governorate

Cholecystitis represents inflammation of the gallbladder. It can lead to many complications,cholecystitis can be either acute or chronic. The inflammation is caused by a blockage in the gallbladder, which stops the flow of bile that flows directly into the small intestine to digest fats. Often this blockage is caused by gallstones, which leads to condensation and stagnation of bile. Adults who haveobese, are at increased risk of many chronic diseases such as diabetes, gallstones, high blood pressure and heart disease. Obesity is associated with increased bile cholesterol excretion. The study has included (175) samples of cholecystitis patients who attended the hospital for the period from January to September 2022, the samples were divided according to gender and obesity status. It was found that the highest incidence of cholecystitis in males was in the age group (55-64) and it was (14%), then the age groups (35-44) and (>65) was (12%).The highest incidence of cholecystitis among women in the age group (35-44) was (27%), then the age group (45-54) was (23%) and then the age group (55-64) was (15%). This study has found that, both obesity status and (BMI >25) were higher in women (79%) while it was in males (52%), and it hasfound that, blood pressure, diabetes and metabolic syndrome arethe most common comorbid conditions associated with cholecystitis.

Impact of dietary choline on lipid metabolism and atherosclerosis development in apoEKO mice deficient or overexpressing apolipoprotein A-I: Selected Abstract - XVI SITeCS Congress

TMAO, a metabolite of dietary choline, is considered a pro-atherogenic molecule for its ability to interfere with the reverse cholesterol transport, in which apolipoprotein A-I and HDL play a key role. In the present work it was evaluated how TMAO impacts on the development of atherosclerosis in mice with different levels of apoA-I/HDL. Mice deficient in both murine apoA-I and apoE (DKO) and DKO mice overexpressing human apoA-I (DKO/hA-I), characterized by extremely low or high plasma HDL levels respectively, were fed for 16 weeks two standard rodent diets, differing only in their choline content (0.09% or 1.2%). At the end of the dietary treatment, atherosclerosis development was quantified at the aortic sinus, targeted plasma metabolomics was performed, and gene expression was evaluated in liver, duodenum, jejunum and ileum. With both diets, DKO mice developed much larger plaques than DKO/hA-I mice. High-choline diet increased plasma TMAO levels in both genotypes. Interestingly, a worsening of plaque development by high choline diet occurred in DKO/hA-I mice only (0.057±0.048 mm2 vs 0.0988±0.064 mm2, p<0.01). Plasma metabolomics indicated that choline supplementation, only in the presence of HDL, significantly increased the concentration of some ceramide species in addition to several markers of impaired kidney function. High-choline diet increased the hepatic gene expression of Fmo1 and Fmo2 in DKO/hA-I, whereas the expression of Scarb1 was lower in DKO/hA-I compared to DKO mice, regardless of the dietary treatment. Intestinal expression of genes involved in inflammatory response and in lipid metabolism was comparable between genotypes and was not modified by choline supplementation. In conclusion, high choline diet increased plasma TMAO concentration in both genotypes, but affected atherosclerosis development, plasma metabolome and hepatic gene expression only in high HDL mice. Intestinal gene expression was not affected neither by genotype nor by dietary choline content.

Therapeutic effect of human ApoA-I-Milano variant in aged transgenic mouse model of Alzheimer's disease.

Therapies based on apolipoprotein A-I (ApoA-I), classically tested for cardiovascular diseases, were recently proposed for Alzheimer's disease (AD). Based on a drug reprofiling approach, our objective was to explore the use of a natural variant of ApoA-I form, ApoA-I-Milano (M), as a treatment for AD. ApoA-I-M contains the R173C mutation, and confers protection against atherosclerosis development, although ApoA-I-M carriers exhibit low HDL levels. Middle-aged (12-month-old) and aged (21-month-old) APP23 mice were intraperitoneally treated for 10 weeks with human recombinant ApoA-I-M (hrApoA-I-M) protein or saline. Pathology progression through behavioural parameters and biochemical determinations was evaluated. In middle-aged group, hrApoA-I-M treatment reduced the anxiety behaviour associated with this AD model. In aged mice, hrApoA-I-M reversed T-Maze performance alterations, a cognitive improvement accompanied by neuronal loss recovery in the dentate gyrus. Aged mice treated with hrApoA-I-M showed lower brain Aβ40 soluble levels and elevated Aβ40 levels in cerebrospinal fluid, without modifying insoluble brain Aβ burden. Interestingly, hrApoA-I-M sub-chronic treatment induced a molecular effect on the cerebrovasculature, increasing occludin expression and ICAM-1 presence, as well as promoting an elevation of plasma soluble RAGE in all hrApoA-I-M-treated mice, drastically decreasing the AGEs/sRAGE ratio, a marker of endothelial damage. Peripheral hrApoA-I-M treatment shows a beneficial impact on working memory, involving mechanisms related with brain Aβ mobilization and modulation of the levels of cerebrovascular markers. Our study shows the potential therapeutic applicability of a safe and non-invasive treatment based on peripheral administration of hrApoA-I-M in AD.

Relationship of Blood Pressure with Body Mass Index (BMI): A Study in a Tertiary Care Hospital, Rangpur, Bangladesh

Introduction: Overweight and obesity is a complaint of abnormally increased body fat mostly resulting from increased energy intake relative to vitality expenditure and is a main sustenance-related syndrome worldwide. The extensive increase in its prevalence in current years and its association with reduced life expectancy has made obesity one of the most vital public health problems. Low levels of HDL and high levels of triglycerides can also increase fat build-up in the arteries, as a result, increase peripheral resistance & rise blood pressure. The purpose of the study was to understand the relationship of blood pressure with body mass index (BMI). Methods: A cross-sectional study was carried out in the Department of Physiology and Biochemistry, Rangpur Medical College, Rangpur from January 2013 to December 2013. A purposive sampling technique was followed. A total number of 90 people from 18 to 45 years old were included in the study, categorized into three groups, such as Group-A:(Control 30): Healthy subject of normal weight, Group-B:(Experimental 30): Healthy subject of overweight & Group-C(Experimental-30): Healthy subjects of obese. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using the “t” test, “r” test & Statistical Package for the Social Sciences (SPSS) Version 25.0 where (p<0.05) considered as the level of significant with 95%CI. Result: In group A, the mean BMI of people was 18.5-22.9, in group B mean BMI of patients was 23.0-24.9, and in group C, the mean BMI of patients was 25.0 or greater. The mean ± SD systolic blood pressure levels were 106 ± 7.701 mmHg in group A and 110 ± 10.667 mmHg in group B. There was no significant difference (p>0.05) between the two groups. The mean ± SD diastolic blood pressure levels were 68 ± 6.644 mmHg in group A and 68.33 ± 7.232 mmHg in group B. There was no significant difference ...

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.