Lower Low-density Lipoprotein Levels Research Articles

Perrault syndrome: a forgotten presentation for infertile women.

Perrault syndrome (PRLTS) is an uncommon hereditary condition distinguished by ovarian failure in females and sensorineural hearing loss. Infertility can be the presenting problem for a serious disease. History and physical examination is very essential among infertile couples. Perrault syndrome (PRLTS) is an uncommon hereditary condition distinguished by ovarian failure in females and sensorineural hearing loss. This case presentation describes a 22-year-old female from Saudi Arabia with PRLTS. The patient presented with progressive bilateral hearing loss since childhood, impacting her academic achievement. Additionally, she experienced amenorrhea since the age of 18 years, with previous investigations showing no hormonal imbalances. Other laboratory tests, including bone mineral density, kidney and liver function, electrolytes, and lipid profile, showed mostly normal results, except for a slightly abnormal lipid profile with low high-density lipoprotein and high low-density lipoprotein levels. This case highlights the challenges faced by individuals with PRLTS, specifically progressive hearing loss and gonadal dysfunction, leading to infertility. Further evaluation and management are warranted to address the patient's hearing impairment and fertility concerns, with a multidisciplinary approach involving audiology, endocrinology, and reproductive medicine.

Combined Diabetes Education/Skills Training and Social Needs Resolution Intervention for Older African Americans with Poorly Controlled Type 2 Diabetes (DM Social Needs): Study Protocol for a Randomized Controlled Trial.

Approximately 11.3% of the US population has diabetes. The burden of diabetes is higher in older adults and African Americans (AAs), such that 40% of adults aged 50 years and older have diabetes; African Americans are 60% more likely to be diagnosed with diabetes compared to non-Hispanic Whites (NHWs). Structural racism has resulted in fewer economic and educational opportunities for AAs, higher social risks, and unmet basic needs, which result in financial instability, housing instability, food insecurity, and a lack of transportation compared to NHWs. The presence of these unmet basic needs is a driver of poor adherence to diabetes self-management in older AAs. To test the preliminary efficacy of a nurse case-manager, telephone-delivered intervention that provides foundational diabetes self-management education and skills training, while also addressing and resolving the unmet social needs of older AAs with poorly controlled type 2 diabetes mellitus (T2DM). The primary hypothesis is that older AAs with T2DM randomized to the DM Social Needs intervention will have significantly lower hemoglobin A1C (HbA1C), blood pressure, and LDL levels compared to the usual care arm at 6 months post randomization. This is a three-year prospective, randomized clinical trial that will enroll 100 AAs aged 50 and older with type 2 diabetes (T2DM) and HbA1C ≥ 8% into one of the following two groups: (1) a nurse case-manager, telephone-delivered intervention that provides foundational diabetes self-management education and skills training, but also addresses and resolves unmet social needs; or (2) an enhanced usual care group that will receive mailed diabetes education materials. Participants will be followed for 6 months to determine the effect of the intervention on HbA1C, blood pressure, and low-density lipoprotein (LDL) cholesterol levels. Baseline characteristics will be presented by study group, and within- and between-group changes in primary outcomes from baseline to 6 months will be reported. The results from this study will provide insights into the efficacy of a combined diabetes education and skills training and social needs resolution intervention for older African Americans with poorly controlled type 2 diabetes and will inform strategies to improve diabetes outcomes for this vulnerable population.

A Family with Familial Hypobetalipoproteinemia Caused by a c.1468C>T in APOB.

We herein report the first family of Japanese individuals with familial hypobetalipoproteinemia caused by the c.1468C>T mutation in apolipoprotein B (APOB). A 13-year-old boy with extremely low levels of low-density lipoprotein (LDL) cholesterol (24 mg/dL) was referred to our hospital. The patient had no secondary causes of hypobetalipoproteinemia. His father and grandmother also exhibited low LDL cholesterol levels. A genetic analysis confirmed that they all had this variant in APOB (c.1468C>T). None of the patients exhibited atherosclerotic cardiovascular diseases or any other complications associated with low LDL cholesterol levels, including fatty liver, neurocognitive disorders, and cerebral hemorrhaging.

Dietary supplementation of distiller's grains yeast cultures improves performance and immunity by altering the intestinal flora of broilers.

Distiller's grains are a by-product of liquor production with a higher yield than liquor. Developing and utilizing distiller's grains well could alleviate the problem of scarce feed resources. Our present experiment was conducted with 6000 yellow-feathered broilers to study the effects of adding distiller's grains yeast cultures (DGYC) to the diet on growth performance and immunity of broilers. The broilers were divided into five groups, receiving different DGYC concentrations during two stages. Growth performance, intestinal microorganisms and immune organ development were measured. The results showed that groups B and D, supplemented with medium and high concentrations of DGYC, respectively, had significantly improved growth performance compared to the control group (P < 0.05). Group D also showed higher immune organ index (P < 0.01), increased serum total protein, high-density lipoprotein and immunoglobulin levels (P < 0.05) and lower levels of low-density lipoprotein, triglycerides, interleukin 1β and tumor necrosis factor α (P < 0.05). Hematoxylin and eosin staining confirmed improved immune organ development in group D (P < 0.05). Furthermore, in high-concentration group D, levels of short-chain fatty acids (SCFA; acetic, propionic and butyric acids) in cecal chyme were significantly increased (P < 0.05). The richness (Chao1) and diversity (Faith-pd) index of cecal microbiota were significantly higher in group D compared to the control group (P < 0.05). The microbial composition in group D differed from the control and medium-concentration group B. Seven bacteria (Clostridia-UCG-014, UCG-009, DTU089, UCG-010, Campylobacter, Harryflintia, Shuttleworthia) showed significant differences (P < 0.05). After DGYC feeding, DTU089 decreased, while other SCFA-producing bacteria increased (P < 0.05). Subsequently, KEGG function and corresponding signal pathway predictions were performed on bacteria with significant differences. Group D exhibited a higher enrichment of immune function pathways (P < 0.01) and showed significant changes in four immune signaling pathways according to the signal pathway heatmap. Our data suggest that high concentrations of DGYC can be applied as a feed additive for broilers that promotes growth, improves intestinal health and enhances certain immunity. © 2024 Society of Chemical Industry.

Association of Beverage Consumption with Cardio-metabolic Risk Factors and Alanine Transaminase Levels in Children and Adolescents: The CASPIAN-V Study.

This study aims to evaluate the association of beverage consumption with cardiometabolic risk factors and alanine transaminase (ALT) levels in children and adolescents. This nationwide study is a part of the fifth survey of a national surveillance program in Iran. Overall, 4200 students, aged 7-18 years, were selected from 30 provinces by multi-stage cluster sampling. In addition to filling in questionnaires, blood sampling and biochemical tests were done. The weekly use of six different beverage types including milk, juice, tea, coffee, soda, and non-alcoholic beer, was documented by interview. The participation rate was 91.5% (n = 3843), and data of 3733 students were complete for the current study. Beverages containing high levels of sugar such as soda and non-alcoholic beer were significantly associated with higher levels of ALT. Model coefficient of regression (SD) was 0.66 (0.31) (P value: 0.034). Healthy beverages such as milk and fresh juice and also beverages containing high levels of caffeine did not have significant association with ALT levels (P value = 0.32, P value = 0.60). Healthy beverages had a significant and inverse relationship with triglycerides (TG) (P value = 0.029), total cholesterol (TC) (P value = 0.008) and low-density lipoprotein (LDL) (P value = 0.008) levels. This study showed that consuming sugar-sweetened beverages is significantly associated with higher levels of ALT, whereas healthy beverages are associated with a better cardiometabolic profile meaning that consuming healthy beverages leads to lower TG, TC, and LDL levels. The effects of beverages on children's health should be emphasized in health recommendations.

Effects of Dried khat (Catha edulis) Leaves as a Natural Feed Additive on the White Leghorn Layers Performance

Khat contains many bioactive compounds that are beneficial for chickens’ health. Most of the chemical constituents found in Khat are biologically active and are used worldwide for the treatment of many diseases. However, there are few studies on the use of Khat in poultry as a nutrition, antioxidant, and antimicrobial activity. Therefore, the present study evaluated the effects of dried Khat leave (DKL) as a natural feed additive on the White Leghorn layer's performance, serum chemistry, and hematology. A total of 180 White Leghorn chickens, aged 168 days were randomly divided into four groups consisting of 45 chickens in three replications. Thirteen layers and two cocks were assigned to each replication and reared on a deep litter system. The diets of layers in T1, T2, T3, and T4 were supplemented by DKL at proportion of 0%, 0.2%, 0.4%, and 0.6%, respectively. The layers were evaluated for feed intake, body weight gain, egg production, feed conversion ratio, and some blood parameters, such as total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, albumin, globulin, red blood cells, hemoglobin, packed cells volume, white blood cells, and total protein. Feed intake in T1 (103.5 g) was significantly higher than T4 (98.5 g) and T3 (98.9 g). Layers in T1 significantly gained higher body weight than layers in other treatments. The use of DKL in layer chickens’ diet did not affect egg production, egg mass, and feed conversion ratio. An increase in the level of DKL in the layers diet significantly reduced the serum high-density lipoprotein, cholesterol, and albumin. The present study showed that chickens that received a higher proportion of dried khat leaf (0.6%) significantly recorded lower levels of low-density lipoprotein and total cholesterol in their blood.

Anti-diabetic Activity of Spirulina and Chlorella in In vivo Experimental Rats

The effects of supplying experimental rats with unicellular green algae Chlorella and tiny filamentous cyanobacteria Spirulina, on type 2 diabetes (T2DM) were examined in the present study. Eight sets of male Sprague-Dawley albino rats, each with six individuals, were used in the investigation. Throughout the trial, Group 1 was the negative control group and was given saline regularly. Group 2 was given alloxan to induce diabetes. Spirulina was given to groups 3, 4, and 5 at dosages of 100, 200, and 300 mg/kg body weight, respectively, after diabetes induction. Similarly, groups 6, 7, and 8 received dosages of 100, 200, and 300 mg/kg body weight of Chlorella, respectively. The findings indicated that the control group had significantly higher levels of triglycerides, low-density lipoprotein (LDL), blood sugar, and very low-density lipoprotein (VLDL) and considerably lower levels of insulin, high-density lipoprotein (HDL), and phospholipids. However, rats given Spirulina (groups 3, 4, and 5) showed notably higher insulin, HDL, and phospholipids levels and significantly lower blood glucose, cholesterol, VLDL, LDL, and triglycerides levels. Rats fed with Chlorella (groups 6, 7, and 8) also showed increased effectiveness of feed ratios, greater final weights, and body weight growth percentages compared to the control group. The present study shows that supplementing with Spirulina and Chlorella improves insulin lipid patterns, blood sugar, and type 2 diabetes in vivo laboratory rats. According to the research, Spirulina and Chlorella may be used as functional meals to help control and cure diabetes.

Serum Levels of Adiponectin Are Strongly Associated with Lipoprotein Subclasses in Healthy Volunteers but Not in Patients with Metabolic Syndrome.

Metabolic syndrome (MS) is a widespread disease in developed countries, accompanied, among others, by decreased adiponectin serum levels and perturbed lipoprotein metabolism. The associations between the serum levels of adiponectin and lipoproteins have been extensively studied in the past under healthy conditions, yet it remains unexplored whether the observed associations also exist in patients with MS. Therefore, in the present study, we analyzed the serum levels of lipoprotein subclasses using nuclear magnetic resonance spectroscopy and examined their associations with the serum levels of adiponectin in patients with MS in comparison with healthy volunteers (HVs). In the HVs, the serum levels of adiponectin were significantly negatively correlated with the serum levels of large buoyant-, very-low-density lipoprotein, and intermediate-density lipoprotein, as well as small dense low-density lipoprotein (LDL) and significantly positively correlated with large buoyant high-density lipoprotein (HDL). In patients with MS, however, adiponectin was only significantly correlated with the serum levels of phospholipids in total HDL and large buoyant LDL. As revealed through logistic regression and orthogonal partial least-squares discriminant analyses, high adiponectin serum levels were associated with low levels of small dense LDL and high levels of large buoyant HDL in the HVs as well as high levels of large buoyant LDL and total HDL in patients with MS. We conclude that the presence of MS weakens or abolishes the strong associations between adiponectin and the lipoprotein parameters observed in HVs and disturbs the complex interplay between adiponectin and lipoprotein metabolism.

Jatropha curcas L. Leaf Extract Effects on Blood Pressure and Lipid Levels in Hypertensive Rats with High-Fat Diet

Background: One of the main risk factors for cardiovascular diseases such as coronary atherosclerotic heart disease (CAHD) is dyslipidaemia or high levels of low-density lipoprotein (LDL) and triglycerides (TG) and low levels of high-density lipoprotein (HDL). Hypertension is also a cause of cardiovascular disease. One potential plant to lower LDL levels and blood pressure is Jatropha curcas, which is known to contain saponins, polyphenols, and flavonoids. Objective: The purpose of this study was to determine the effect of the ethanol extract of Jatropha curcas leaves (EEJCL) on blood pressure, LDL levels, and HDL levels in hypertensive rats given a high-fat diet. Methods: This study is an experimental study with a pretest-posttest control group design on male Wistar strain rats. Rats were divided into seven groups, namely the normal group, control group (induced with NaCl and given a high-fat diet), Captopril group, Simvastatin group, and EEJCL groups given doses of 1.8, 2.7, and 4.05 g/kg BW. The data obtained were analysed using the One-Sample Kolmogorov-Smirnov Test, Homogeneity of Variance, One-Way ANOVA, and Tukey Test. Results: The results showed that the administration of EEJCL could significantly lower LDL levels and blood pressure and increase HDL levels (p &lt; 0.05) at doses of 1.8, 2.7, and 4.05 g/kg BW, and the dose of 4.05 g/KgBW was the most optimal dose. Conclusion: EEJCL has a potential for development in the treatment of hypertension and dyslipidaemia.

Comparative Effects of Fermented and Unfermented Parkia biglobosa Bean Seeds in Diabetic Induced Experimental Rats

Aims: The present work investigates the hypoglycemic effect of fermented seeds of Parkia biglobosa (PB, African locust beans) in alloxan-induced diabetic rats. Its effect was compared with that of unfermented Parkia biglobosa.&#x0D; Methodology: In order to assess the hypoglycemic effects of the fermented seeds on experimental animals, fasting blood sugar (FBS), total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were determined. The microbiota analysis of the fecal sample was also determined.&#x0D; Result: Alloxan administered to the rats significantly increased the FBS of the test animals. However, dietary supplementation with fermented PB for three weeks ameliorated the FBS of the rats like that of the unfermented group. The animals fed with fermented Parkia biglobosa gained weight like those fed with unfermented Parkia biglobosa. High levels of HDL and low levels of LDL were observed in animals treated with fermented Parkia biglobosa compared with low levels of HDL and high levels of LDL observed in animals treated with unfermented Parkia biglobosa.&#x0D; Conclusion: The results of this present study demonstrate that both fermented and unfermented seeds of Parkia biglobosa exert a hypoglycemic effect. Hence, Parkia biglobosa has an anti-diabetic property with fermented form seemingly better.

Quantitative or qualitative biomolecular changes in blood serum composition induced by childhood obesity: A Fourier transform infrared examination

Childhood obesity (CO) negatively affects one in three children and stands as the fourth most common risk factor of health and well-being. Clarifying the molecular and structural modifications that transpire during the development of obesity is crucial for understanding its progression and devising effective therapies. The study was indeed conducted as part of an ongoing CO treatment trial, where data were collected from children diagnosed with CO before the initiation of non-drug treatment interventions. Our primary aim was to analyze the biochemical changes associated with childhood obesity, specifically focusing on concentrations of lipids, lipoproteins, insulin, and glucose. By comparing these parameters between the CO group (n = 60) and a control group of healthy children (n = 43), we sought to elucidate the metabolic differences present in individuals with CO. Our biochemical analyses unveiled lower LDL (low-density lipoproteins) levels and higher HDL (high-density lipoproteins), cholesterol, triglycerides, insulin, and glucose levels in CO individuals compared to controls. To scrutinize these changes in more detail, we employed Fourier transform infrared (FTIR) spectroscopy on the serum samples. Our results indicated elevated levels of lipids and proteins in the serum of CO, compared to controls. Additionally, we noted structural changes in the vibrations of glucose, β-sheet, and lipids in CO group. The FTIR technique, coupled with principal component analysis (PCA), demonstrated a marked differentiation between CO and controls, particularly in the FTIR region corresponding to amide and lipids. The Pearson test revealed a stronger correlation between biochemical data and FTIR spectra than between 2nd derivative FTIR spectra. Overall, our study provides valuable insights into the molecular and structural changes occurring in CO.

Effect of the AADE7 Self-Care Behaviors Framework on Diabetes Education Management in a Shared Care Model.

Diabetes self-management education (DSME) provides diabetic patients with knowledge of diabetes, requires attention and recording of dietary habits, and increases the frequency and accuracy of blood glucose monitoring. DSME also achieves better blood glucose control, thus benefiting diabetic patients and reducing the risk of diabetes complications. However, few studies have systematically examined whether DSME follows AADE 7 Self-Care Behaviors (AADE7™). Therefore, this study aimed to investigate the control effect of AADE7™-based management on laboratory test indicators of diabetic patients. The patients with diabetes who received shared care management in our hospital between June 2014 and April 2022 were analyzed retrospectively. According to the process of outpatient consultation, each patient received health education provided by diabetes education nurses and dietitians after consultation. Health education was a process from assessment to health guidance. The basic information of all patients was recorded, and AADE7™ behavior assessment and health education session were conducted through interviews. A total of 13,650 were given shared care management, requiring more than 6 follow-up visits per year, as well as health education. It was reassessed annually according to AADE standards. The impact of the patients' behavior change after the AADE7™-based management on the relevant test indicators was observed. After eight years of intervention, a total of 8319 samples were obtained after excluding the outliers. Stepwise regression analysis was performed, and the results showed that, with other conditions held constant, a greater number of days per week to follow a healthy diet, to take hypoglycemic medication as prescribed, to monitor blood glucose, and to exercise and higher education level were associated with lower levels of glycosylated hemoglobin. The change from drinking to nondrinking was associated with lower triglycerides. If low blood glucose was monitored, patients who reviewed and took immediate action showed lower levels of low-density lipoprotein, urine microalbumin, and urine microalbumin/creatinine ratio compared with those without review and immediate action. Significance tests for each term showed P value <0.05. The AADE7™ framework is a tool supporting patient-centered self-management and education. In the AADE7™ standards, successful self-management is considered as a key outcome in the care of patients with diabetes and related diseases. This tool can effectively improve patient compliance and increase the rate of blood glucose compliance rates in patients with diabetes and therefore is worthy of clinical promotion.

Association Between Smoking and Lipid Profile in Men Aged 35 to 70 Years: Dose-Response Analysis.

Dyslipidemia is linked to various health complications, including cardiovascular disease and inflammation. This study aimed to assess the association between smoking and lipid profile in the Tabari cohort population. Data from the Tabari Cohort Study involving 4,149 men were analyzed. A standardized questionnaire collected smoking history, while blood samples measured lipid levels and anthropometric measurements were recorded. Statistical analysis utilized chi-square tests and logistic regression, adjusting for potential confounders. The prevalence of smoking was 893 (21.52%; urban: 20.6%, mountainous: 23.8%, significant level: .024). The adjusted odds ratio (OR) of low high-density lipoprotein (HDL) among smokers 1.48 (95% confidence interval [CI]: 1.25-1.77, p < .001) was the same as non-smokers. The adjusted OR of high low-density lipoprotein (LDL) in men with 1 to 10, 11 to 20, and more than 20 cigarettes per day was 0.95 (95% CI: 0.73-1.25), 1.30 (95% CI: 0.99-1.71), and 2.64 (95% CI: 1.32-5.27) and low HDL was equal to 1.34 (95% CI: 1.06-1.68), 1.61 (95% CI: 1.26-2.05), and 2.24 (95% CI: 1.13-4.42) compared with non-smokers, respectively. The study findings indicate that smoking is associated with lower HDL levels, even after adjusting for potential confounders. The odds of low HDL and high LDL increases with higher smoking intensity. The low HDL and high LDL levels in individuals smoking over 20 cigarettes/day, respectively, show a 2.24-fold and a 2.64-fold increased odds compared to non-smokers. These findings highlight the importance of smoking cessation in relation to lipid profiles and related health risks.

Association between total cholesterol levels and all-cause mortality among newly diagnosed patients with cancer

We aimed to determine the association between cholesterol values and the risk of all-cause mortality in newly diagnosed patients with cancer in a large-scale longitudinal cohort. Newly diagnosed patients with cancer were reviewed retrospectively. Cox proportional hazards regression models determined the association between baseline levels of total cholesterol (TC), triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol and the risk of all-cause mortality. A restricted cubic spline curve was used to identify the association between total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol with the risk of death on a continuous scale and to present the lowest values of lipid measurements associated with death. The median follow-up duration of the study was 5.77 years. Of the 59,217 patients with cancer, 12,624 patients were expired. The multivariable adjusted hazard ratio (aHR) for all-cause mortality in patients with cancer with 1st–5th (≤ 97 mg/dL) and 96th–100th (> 233 mg/dL) in TC levels was 1.54 (95% CI 1.43–1.66) and 1.28 (95% CI 1.16–1.41), respectively, compared to 61st–80th (172–196 mg/dL). The TC level associated with the lowest mortality risk in the multivariable model was 181 mg/dL. In comparison with LDL-C levels in the 61st–80th (115–136 mg/dL), the multivariable aHR for all-cause mortality in cancer patients with LDL-C levels in the 1st-5th (≤ 57 mg/dL) and 96th–100th (> 167 mg/dL) was 1.38 (95% CI 1.14–1.68) and 0.94 (95% CI 0.69–1.28), respectively. The 142 mg/dL of LDL cholesterol showed the lowest mortality risk. We demonstrated a U-shaped relationship between TC levels at baseline and risk of mortality in newly diagnosed patients with cancer. Low LDL levels corresponded to an increased risk of all-cause death.

Comparison Between Healthy Plant-Based Diets and Unhealthy Plant-Based Diets and Their Health Impacts

A plant-based diet (PBD), also known as a vegetarian diet, has become a popular topic in recent years. Numerous research studies have investigated the advantageous aspects of adhering to a healthful PBD. Compared to the typical omnivorous diet, a healthful PBD, consisting of whole grains, fruits, and vegetables, can help protect individuals from Type II Diabetes (T2D), cardiovascular diseases (CVD), cancer, and high blood pressure. This is primarily because PBD are rich in dietary fiber, micronutrients, polyphenols, and low in harmful saturated fatty acids. One of the key features of metabolic syndrome is insulin resistance, which leads to an increase in blood glucose levels. Insulin resistance can potentially trigger the development of CVD and T2D. Transitioning to a healthful PBD can reduce the risk of insulin resistance. Additionally, the risk of CVD can be reduced by replacing animal fats (saturated fatty acids) with vegetable fats (monounsaturated fatty acids), as MUFAs help lower low-density lipoprotein levels in cells. Dietary fibers play a significant role in promoting healthier body indexes. They slow down food movement in the intestine and facilitate the excretion process. Fiber can also reduce the risk of obesity by maintaining a better body mass index. However, it's important to note that not all PBD are healthy, and an irrational PBD can worsen one's physical condition.

Is It Ever Wise to Edit Wild-Type Alleles? Engineered CRISPR Alleles Versus Millions of Years of Human Evolution.

The tremendous burden of lipid metabolism diseases, coupled with recent developments in human somatic gene editing, has motivated researchers to propose population-wide somatic gene editing of PCSK9 (proprotein convertase subtilisin/kexin type 9) within the livers of otherwise healthy humans. The best-characterized molecular function of PCSK9 is its ability to regulate plasma LDL (low-density lipoprotein) levels through promoting LDL receptor degradation. Individuals with loss-of-function PCSK9 variants have lower levels of plasma LDL and reduced cardiovascular disease. Gain-of-function variants of PCSK9 are strongly associated with familial hypercholesterolemia. A new therapeutic strategy delivers CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats; CRISPR-associated protein 9) specifically to liver cells to edit the wild-type alleles of PCSK9 with the goal of producing a loss-of-function allele. This direct somatic gene editing approach is being pursued despite the availability of US Food and Drug Administration-approved PCSK9 inhibitors that lower plasma LDL levels. Here, we discuss other characterized functions of PCSK9 including its role in infection and host immunity. We explore important factors that may have contributed to the evolutionary selection of PCSK9 in several vertebrates, including humans. Until such time that more fully understand the multiple biological roles of PCSK9, the ethics of permanently editing the gene locus in healthy, wild-type populations remains highly questionable.

Statin adherence in patients enrolled in the disease management program for coronary artery disease – comparison between patients’ and general practitioners’ self-reports and patient records

IntroductionPatients with coronary artery disease (CAD) should take a statin daily for secondary prevention. However, statin adherence in patients with CAD is low. This study investigated the proportion of adherent patients enrolled in the disease management program for CAD (DMP-CAD). Adherence was examined by comparing patients’ self-reports, general practitioners’ (GPs) self-reports, and prescription data.MethodsBetween October 2019 and March 2020, all patients enrolled in the DMP-CAD in three GP practices in Germany were invited to participate in the study. Participants completed a questionnaire on the tolerability of statins. Further, prescription data from patient records, low-density lipoprotein (LDL) levels, and GPs’ assessment of statin adherence were examined. The Medication Possession Ratio (MPR) served as a measurement tool for adherence.ResultsSeventy-four patients were included. MPR showed high statin adherence for most patients (83.8%). However, GPs did not reliably identify non-adherence in their patients. Generally, the mean LDL values were above the guideline recommendations (97.7 ± 27.9 mg/dl), with higher values in the non-adherent (123.6 ± 42 mg/dl) than in the adherent group (93.1 ± 22 mg/dl). Non-adherent patients were more likely to be employed (41.7% vs. 11.3%).DiscussionPatients in this study showed high statin adherence. However, the LDL target value was often not reached. Therefore, GPs should take advantage of the good adherence of their patients and try to lower LDL levels by adjusting the dosage and/or changing the statin prescribed. Future studies should investigate typical characteristics of non-adherent patients in DMP-CAD so that GPs can target these patient groups and improve their adherence.

Effect of Avocado Consumption on Risk Factors of Cardiovascular Diseases: A Systematic Review and Meta-Analysis.

High cholesterol levels are a significant risk factor for heart disease, the leading cause of death worldwide. Lowering cholesterol plays a crucial role in maintaining good health. One approach to reducing cholesterol is through dietary modifications, and avocados have been recognized as a potential food choice for this purpose. Avocados are rich in monounsaturated fatty acids (MUFAs), fiber, and plant sterols, which have cholesterol-lowering effects. Incorporating avocados into a low-fat diet can be beneficial. This study design followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and conducted databases in Cochrane, SCOPUS, PubMed, and Web of Science up until May 2023, combining keywords related to avocados and cardiovascular diseases (CVDs). The study focused on randomized clinical trials (RCTs) and excluded observational studies, meta-analyses, surveys, abstracts, and reviews. Seven RCTs were included in the study, all reporting total cholesterol (TC) levels. The findings of the study showed that individuals who followed an avocado diet experienced reduced TC levels compared to those who followed a habitual diet or a low-fat diet. The avocado group exhibited lower TC levels compared to the control group in both the habitual diet and low-fat diet subgroups. When considering high-density lipoprotein (HDL) levels, the control group had higher HDL levels than the avocado group in the habitual diet subgroup, while the avocado group had higher HDL levels than the control group in the low-fat diet subgroup. In both the habitual diet and low-fat diet subgroups, the avocado group had lower levels of low-density lipoprotein (LDL) compared to the control group. The study concluded that incorporating avocados into the diet can be a beneficial dietary strategy for individuals aiming to lower their cholesterol levels and promote heart health. The avocado diet was associated with decreased LDL levels, but it did not significantly impact triglyceride (TG) levels or fasting glucose levels. Systolic blood pressure values showed minimal changes with the avocado diet.

Effectiveness of Atorvastatin in Treatment of Obese Patients with Dyslipidaemia

Background: Numerous comorbidities, such as type 2 diabetes mellitus, hypertension, dyslipidemia, and cardiovascular (CV) disease are all made more likely by obesity. A higher mortality rate in the general population is strongly correlated with a high body mass index (BMI). In patients who are at high risk of experiencing an atherosclerotic CV event, the use of statins lowers mortality and recurrent adverse cardiac events across a broad range of cholesterol levels. Therefore, statin therapy is advised for secondary prevention in all high-risk patients, including those with obesity. Objectives: There is evidence to support the primary prevention of coronary artery disease, morbidity, and mortality using statins for lipid modifications. The purpose of this study is to ascertain the immediate impact of atorvastatin on the lipid profile in obese Jordanian patients. Methods: According to NCEP ATP III criteria, 200 overweight and obese patients with hypercholesterolemia were included. They received treatment for 2 months after being randomly divided into 3 groups based on the dosage of atorvastatin: 10, 20, and 40 mg/day. Results: With all atorvastatin doses, there was a significant desirable increase in high-density lipoprotein (HDL), and significant reduction in total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), and very low-density lipoprotein (VLDL). Conclusion: In dyslipidemic obese patients, short-term atorvastatin therapy resulted in lower levels of TC, TG, LDL, and VLDL as well as a desirable increase in HDL.

New Loss-of-Function Mutations in PCSK9 Reduce Plasma LDL Cholesterol.

Lower plasma levels of LDL (low-density lipoprotein) cholesterol (LDL-C) can reduce the risk of atherosclerotic cardiovascular disease. The loss-of-function mutations in PCSK9 (proprotein convertase subtilisin/kexin type 9) have been known to associate with low LDL-C in many human populations. PCSK9 genetic variants in Chinese Uyghurs who are at high risk of atherosclerotic cardiovascular disease due to their dietary habits have not been reported. The study involved the whole-exome and target sequencing of college students from Uyghur and other ethnic groups in Xinjiang, China, for the association of PCSK9 loss-of-function mutations with low plasma levels of LDL-C. The mechanisms by which the identified mutations affect the function of PCSK9 were investigated in cultured cells using biochemical and cell assays. The causal effects of the identified PCSK9 mutations on LDL-C levels were verified in mice injected with adeno-associated virus expressing different forms of PCSK9 and fed a high-cholesterol diet. We identified 2 PCSK9 mutations-E144K and C378W-in Chinese Uyghurs with low plasma levels of LDL-C. The E144K and C378W mutations impaired the maturation and secretion of the PCSK9 protein, respectively. Adeno-associated virus-mediated expression of E144K and C378W mutants in Pcsk9 KO (knockout) mice fed a high-cholesterol diet also hampered PCSK9 secretion into the serum, resulting in elevated levels of LDL receptor in the liver and reduced levels of LDL-C in the serum. Our study shows that E144K and C378W are PCSK9 loss-of-function mutations causing low LDL-C levels in mice and probably in humans as well.