Lower Total Cholesterol Levels Research Articles

Mean Differences of Total Cholesterol Levels among Vegetarians and Non-Vegetarians at Maha Vihara Maitreya Duta Palembang, Indonesia

Total cholesterol level is one of the risk factor of cardiovascular disease. The proportion rate of hypercholesterolemia in Indonesia remains high, numbering around one third of (35,9%) Indonesians. Hypercholesterolemia is a modifiable risk factor, one of early measures that can be taken to prevent hypercholesterolemia is nutritional intervention. A dietary pattern high in plant sources and lower fat consumption has been recommended by several health organisation for prevention of hypercholesterolemia. This study was intended to determine mean difference of cholesterol level between vegetarian and nonvegetarian in Maha Vihara Maitreya Duta Palembang. This was an observational analytical study with cross-sectional design. A total of 173 subjects at Maha Vihara Maitreya Duta Palembang was included which consist of 80 Vegetarian and 93 Nonvegetarian. Measurement of total cholesterol level was done using rapid diagnostic test (RDT) Autocheck® Multi Monitoring System and parametric Independent T Test was chosen as method of statistical analysis. p <0.001 indicates significant differences of total cholesterol level between vegetarian (172,51± 39,05 mg/dL ) and nonvegetarian (228,67±68,07 mg/dL) groups. The mean differences of total cholesterol of vegetarian group is 56,16 mg/dl lower than non vegetarian groups. A significant differences exist in total cholesterol level between vegetarian and non vegetarian group at Maha Vihara Maitreya Duta Palembang. Vegetarian groups has lower total cholesterol level compared to nonvegetarian.

Total cholesterol concentration predicts the effect of plasmapheresis on hypertriglyceridemic acute pancreatitis: a retrospective case\u2013control study

BackgroundWhat kind of patients with hypertriglyceridemic acute pancreatitis (HLAP) might benefit from plasmapheresis (PP) remains unknown. The objective of this study is to determine the predict function of total cholesterol (TC) on the Triglyceride (TG)-lowing effect in patients on either non-PP or PP therapy.MethodsPatients were categorized into high total cholesterol (HTC)/low total cholesterol (LTC) groups based on TC level of 12.4 mmol/L. The primary outcome was TG reduction to below 500 mg/dL within 48 h. Linear mixed-effect model and logistic regression analyses were used to assess the association of TC level and TG-lowing efficacy in different therapy groups.ResultsCompared with LTC group, patients with HTC showed more severe imaging manifestations (p < 0.001) and higher APACH II scores (p = 0.036). Deaths occurred only in HTC groups. Significant interaction of time sequence with the 2 TGs-lowing therapy groups on TG level was only found in HTC group (p < 0.001). In patients with elevated TC level, primary outcome occurred in 66.67% of patients in the PP group, and 27.91% in the non-PP group. After adjustment for age, gender, CT grade and APACH II score, the odd ratio remain significant (OR 5.47, 95% confidence interval [CI] 1.84–16.25, p = 0.002). Furthermore, in patients with lower TC level, no significant difference was found in primary outcome between PP group and non-PP group (81.25% versus 62.30%, adjusted OR 2.05; 95% CI 0.45–9.40; p = 0.353).ConclusionsTC could be a potential biomarker to predict the effects of TG-lowing therapy in patients with HLAP.

Evolution of patients infected with SARS-CoV-2 according to previous metabolic status

Introduction: coronavirus disease 2019 (COVID-19) encompasses a wide spectrum of symptoms, including respiratory, gastrointestinal, hematological, and dermatological manifestations. The virus interaction with cells located in the respiratory tract causes the release of inflammatory mediators, whose involvement could be exacerbated by co-existing obesity, diabetes, and cardiovascular events. Objectives: the objective of this research was to analyze the clinically metabolic status in patients who have suffered COVID-19 disease in order to predict the outcome. Methods: this research is a retrospective study based on a cohort of 165 consecutively admitted patients with criteria for COVID-19 pneumonia according to WHO guidelines at the Hospital Universitario Puerta de Hierro between March and April 2020. Recorded variables included demographic and epidemiological data plus diagnoses as well as morbid complications during hospitalization. The Biochemistry Unit Laboratory carried out laboratory analyses according to validated operational procedures. The statistical tests included univariate and multivariate models adjusted for baseline characteristics and clinically relevant features. Results: the most frequent comorbidity in our cohort was arterial hypertension (44.0 %), followed by dyslipidemia (32.1 %), obesity (30.9 %), and diabetes mellitus (20.0 %). The association between admission to the intensive care unit (ICU) with body mass index (BMI) in a multivariate model was statistically significant, evidencing that obese subjects (BMI ≥ 30 kg/m2) have a 19 % higher risk of requiring ICU care. The univariate model revealed a statistically significant association between obesity and ICU admission and length of hospital stay (p < 0.05). The relationship between baseline blood glucose and in-hospital mortality was also statistically significant (p = 0.03), as well as with total cholesterol and ICU admission (p = 0.007). Conclusions: obesity is related to a longer time of hospitalization and a higher rate of admissions to the ICU. Low total cholesterol levels and abnormal baseline blood glucose were risk factors for ICU requirement and in-hospital mortality. Patient categorization based on obesity could be valuable in the development of a precision medicine model within the COVID-19 pandemic.

Investigating the Relationship between Low Serum Cholesterol and Suicide in Attempters with Depression

Background & Objective: It has been postulated that depressed individuals with low total cholesterol levels may be more likely to die prematurely from suicide. This study aimed to examine the association between low serum cholesterol and suicide in depressed attempters. Materials & Methods: In this cross-sectional study, 180 suicide attempters, who met the inclusion criteria and were willing to participate in the study, were recruited in 2017. The data was collected using a demographic questionnaire and the Beck Depression Inventory-Second Edition (BDI-II). The blood cholesterol level was measured via an auto-analyzer. Results: The mean age was 26.39±10.75 years. The average cholesterol level in the moderate, severe, and serious depression groups was 151.30±35.23, 145.89±36.32, and 145.15±33.33, respectively. The mean age was higher in the group with a higher depression level, though the difference was not significant (P=0.06). The percentage of suicide attempts in single individuals was significantly higher (P=0.02). The mean cholesterol level in the group with the highest level of depression was the lowest, but the difference was insignificant (r=-.01, P=0.85). Only in females, the level of blood cholesterol showed a nearly significant difference between groups with different severities of depression (P=0.05). Cholesterol had a significant correlation with suicide frequency (P=0.008, r=0.28). Conclusion: Our results revealed no significant association between low serum cholesterol and suicide in attempters with depression; but low total serum cholesterol may be associated with depression and suicide in depressed subjects. Yet, more studies are required for verification of this causality. © 2020, Journal of Advances in Medical and Biomedical Research. All rights reserved.

PSV-15 Influence of the temperament of water buffaloes on the serum lipid levels

Abstract This study evaluated the effect of the temperament of 75 water buffaloes of three genetic groups (GG: Jafarabadi, Mediterranean, and Murrah; n = 25 for each GG) on serum lipid levels. The animals were classified for temperament through the temperament score (TSc) obtained by the mean of the sum of the scores of the entry time into the squeeze chute (1 to 5: 1=greater time spent for entry, and 5=less time spent for entry) and the exit velocity score (1 to 5: 1=lower speed, and 5=higher speed) calculated after the period of adaptation to the feedlot (d0). The animals were categorized into adequate (ADQ; TSc≤3) or excitable (EXC; TSc &amp;gt;3) temperaments. Blood samples were collected from the jugular vein on days -28, 0, and 84, and evaluated for serum levels of total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) using colorimetric enzymatic analyses performed by commercial kits. Data were analyzed using MIXED procedure in SAS, considering the GG, temperament, day, and the resulting interactions as fixed effects. The term day was used for repeated measures in time. Correlations were estimated using the CORR procedure in SAS. There were no interactions for the variables evaluated (P ≥ 0.11). ADQ animals showed lower levels of total cholesterol (65.95 vs 70.96mg/dL for ADQ and EXC, respectively; SEM=2.33; P = 0.04) and LDL (26.74 vs 30.40mg/dL for ADQ and EXC, respectively; SEM=1.57; P = 0.02) than EXC animals. There was no effect of temperament for the triglycerides (P = 0.41), HDL (P = 0.47), and VLDL (P = 0.46). Positive correlations were verified between both the TSc and triglycerides (r=0.32; P &amp;lt; 0.01), and TSc and VLDL (r=0.33; P &amp;lt; 0.01). Tendency for a positive correlation was detected between TSc and LDL (r=0.20; P = 0.09). In conclusion, there are differences in serum lipid levels between water buffalo temperaments which deserves further investigation. Supported by FAPESP (#2018/25939-1; #2014/05473-7).

Effect of herbal formulation intake on health indices in albino Wistar rat model.

Dyslipidemia management activity of ginger‐, garlic‐, and lemon‐based herbal mixture was tested as paste and herbal extract in hypercholesterolemic adult male albino rats. Atherogenic diet‐induced hypercholesterolemia in rats was treated by supplementing the diet with 2.5% herbal paste (4.2 g/kg b.w.) or 2.5 ml oral gavage (20 ml/kg b.w.) of liquid herbal extract daily for 42 days. Hematological and serological outcomes of herbal formulation feeding were compared with the cholesterol‐fed positive control and normal control. The results suggest the significant (p < .05) inhibitory properties of herbal paste and liquid extracts against dyslipidemia showing 31%–37%, 62%–68%, and 40%–56% lower levels of total cholesterol, triglycerides (TGs), and low‐density lipoprotein cholesterol (LDL‐C), respectively. Treating cholesterol‐fed animals with herbal paste and extract significantly (p < .05) increased total protein (5–5.5 g/dl) and serum albumin (3.7–4.2 g/dl) concentration as compared to the normal control. Contrary to significant hypocholesterolemic activity, higher serum total bilirubin levels, that is, 0.70 mg/dl, were observed in rats subchronically exposed to herbal paste and liquid extracts. Nonsignificant (p > .05) impact of herbal formula feeding was observed on hematological indices except lymphocyte counts, that is, 93% in rats fed on herbal paste. The results validate conventional hypocholesterolemic claims associated with ginger‐, garlic‐, and lemon‐based herbal formulations; however, deeper insight into their dose‐dependent response in hypercholesterolemia is necessitated to rule out the toxicological impact on the consumer.

Prognostic value of DCTA scoring system in heart failure.

The aim of this study was to evaluate the prognostic value of anovel scoring system, based on D‑dimer, total cholesterol, high-sensitivity cardiac troponinT (hs-cTnT), and serum albumin levels, in patients with heart failure. Atotal of 221patients diagnosed with heart failure between May 2016 to January 2020 were enrolled in this retrospective study. The prognostic significance of the biomarkers D‑dimer, total cholesterol, hs-cTnT, and serum albumin was determined with univariate and multivariate Cox proportional hazard models. Anovel prognostic score based on these predictors was established. The Kaplan-Meier method and log-rank test were used to compare the adverse outcomes of patients in different risk groups. Results from univariate and multivariate analyses showed that high D‑dimer, low serum albumin, high hs-cTnT, and low total cholesterol levels were independent prognostic factors for adverse outcomes (D-dimer >0.63 mg/l, HR = 1.84, 95% CI = 1.16-2.94, p = 0.010; serum albumin >34 g/l, HR = 0.67, 95% CI = 0.45-0.99, p = 0.046; hs-cTnT >24.06 pg/ml, HR = 1.65, 95% CI = 1.08-2.53, p = 0.020; total cholesterol >3.68 mmol/l, HR = 0.63, 95% CI = 0.43-0.92, p = 0.017). Moreover, all the patients were stratified into low-risk or high-risk group according to ascoring system based on these four markers. Kaplan-Meier analyses demonstrated that patients in the high-risk group were more prone to having adverse outcomes compared with patients in the low-risk group. D‑dimer, total cholesterol, hs-cTnT, and serum albumin levels were independent prognostic factors in the setting of heart failure. Anovel and comprehensive scoring system based on thesebiomarkers is an easily available and effective tool for predicting the adverse outcomes of patients with heart failure.

Sex-Specific Protective Effects of APOE ε2 on Cognitive Performance.

Apolipoprotein E (APOE) has an important role in the multiple trajectories of cognitive aging. However, environmental variables and other genes mediate the impact of APOE on cognition. Our main objective was to analyze the effect of APOE genotype on cognition and its interactions and relationships with sex, age, lipid profile, C-reactive protein, and Brain-derived neurotrophic factor (BDNF) genotype in a sample of 648 healthy participants over 50 years of age with a comprehensive neuropsychological assessment. Our results showed that APOE ε2 carriers performed better in the Verbal Memory (p = .002) and Fluency Domains (p = .001). When we studied the effect of sex, we observed that the beneficial effect of APOE ε2 on the normalized values of these cognitive domains occurred only in females (β = 0.735; 95% confidence interval, 0.396-1.074; p = 3.167·10-5 and β = 0.568; 95% confidence interval, 0.276-0.861; p = 1.853·10-4, respectively). Similarly, the sex-specific effects of APOE ε2 were further observed on lipidic and inflammation biomarkers. In the whole sample, APOE ε2 carriers showed significantly lower levels of total cholesterol, low-density lipoprotein cholesterol, and C-reactive protein. These differences were found only among females. Furthermore, total cholesterol and low-density lipoprotein cholesterol mediated the protective effect of APOE ε2 on cognition in the whole sample and total cholesterol in females, providing candidate physiological mechanisms for the observed genetic effects. Our results show that the neuroprotective role of APOE ε2 in cognition varies with sex and that the lipidic profile partially mediates this protection. Age-related cognitive and functional decline is a continuous biological process with different cognitive trajectories (1). Complex interactions between heritability, environmental influence, and cognitive functions in aging have been highlighted (2). In particular, genetic differences explain around 15%-25% of the variance in life expectancy (3). Therefore, the identification of susceptibility genes and their biological effects on cognitive aging is required to establish interindividual differences in this process and promote early personalized interventions to delay cognitive decline and minimize the financial burden of aging in the health care system.

Prevalence and Factors Associated with Hepatic Iron Overload in Obese Individuals Undergoing Bariatric Surgery: a Cross-Sectional Study.

Slight to moderate hepatic iron overload (HIO) can be found in cases of liver disease, including non-alcoholic fatty liver disease (NAFLD), but the mechanism is not completely understood, as well as its relationship with obesity. To determine the prevalence of HIO assessed through histopathological examination in obese individuals undergoing bariatric surgery and to identify correlations between this condition and demographic, anthropometric, clinical, laboratory, and NAFLD-related aspects. This is a cross-sectional study which enrolled individuals undergoing bariatric surgery from January 2018 to February 2019 at a tertiary university hospital. NAFLD and HIO were assessed through histological examination. Of 125 individuals, 87.2% were female and the average age was 38.8 ± 9.2years. The average BMI was 37.2 ± 3.1kg/m2. NAFLD was present in 66.4% and HIO in 17.6%, with 63.6% of patients with overload classified as mild (grade I) and 22.7% moderate (grade II). HIO was significantly more frequent in males (p = 0.003) and was significantly associated with higher levels of glucose (92.1 ± 28.4 vs. 80.7 ± 39.6; p = 0.02), ferritin (385.5 ± 290.9 vs. 131.6 ± 99.7; p < 0.0001), serum iron (82.4 ± 35.7 vs. 66.6 ± 25.1; p = 0.03), glutamic-oxaloacetic transaminase (27.3 ± 19.5 vs. 20.6 ± 8.8; p = 0.02), and glutamic-pyruvic transaminase (37.6 ± 36.4 vs. 24.6 ± 16.3; p = 0.01). Multivariate analysis showed that HIO intensity was significant and independently associated with ferritin levels (R = 0.19; p = 0.01), serum iron (R = 0.25; p < 0.0001), blood glucose (R = 0.16; p = 0.001), and total cholesterol (R = - 0.17; p < 0.0001). In obese individuals, HIO presented a high prevalence and was associated with higher levels of ferritin, serum iron, glucose, and transaminases; lower levels of total cholesterol; and male gender.

Mean Differences of Total Cholesterol Levels among Vegetarians and Non-Vegetarians at Maha Vihara Maitreya Duta Palembang, Indonesia

Total cholesterol level is one of the risk factor of cardiovascular disease. The proportion rate of hypercholesterolemia in Indonesia remains high, numbering around one third of (35.9%) Indonesians. Hypercholesterolemia is a modifiable risk factor, one of early measures that can be taken to prevent hypercholesterolemia is nutritional intervention. A dietary pattern high in plant sources and lower fat consumption has been recommended by several health organisation for prevention of hypercholesterolemia. This study was intended to determine mean difference of cholesterol level between vegetarian and nonvegetarian in Maha Vihara Maitreya Duta Palembang. This was an observational analytical study with cross-sectional design. A total of 173 subjects at Maha Vihara Maitreya Duta Palembang was included which consist of 80 Vegetarian and 93 Nonvegetarian. Measurement of total cholesterol level was done using rapid diagnostic test (RDT) Autocheck® Multi Monitoring System and parametric Independent T Test was chosen as method of statistical analysis. p&lt;0.001 indicates significant differences of total cholesterol level between vegetarian (172.51± 39.05 mg/dL) and nonvegetarian (228.67±68.07 mg/dL) groups. The mean differences of total cholesterol of vegetarian group is 56,16 mg/dl lower than non vegetarian groups. A significant differences exist in total cholesterol level between vegetarian and non vegetarian group at Maha Vihara Maitreya Duta Palembang. Vegetarian groups has lower total cholesterol level compared to nonvegetarian.

Effectiveness of niacin supplementation for patients with type 2 diabetes: A meta-analysis of randomized controlled trials.

Lipid profiles and glycemic control play a critical role in subsequent atherosclerotic cardiovascular disease for patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the effectiveness of niacin supplementation on lipid profiles and glycemic control for patients with T2DM. The PubMed, Embase, and the Cochrane Library databases were searched to identify randomized controlled trials (RCTs) that investigated the effects of niacin supplementation for patients with T2DM throughout December 2019. The weighted mean differences (WMDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect estimates using a random-effects model. Eight RCTs comprised a total of 2110 patients with T2DM who were selected for final quantitative analysis. The patients' niacin supplementation was associated with lower levels of total cholesterol (WMD, -0.28; 95% CI, -0.44 to -0.12; P = .001), triglyceride (WMD, -0.37; 95% CI, -0.52 to -0.21; P < .001), and low-density lipoprotein (WMD, -0.42; 95% CI, -0.50 to -0.34; P < .001). Moreover, the level of high-density lipoprotein was significantly increased when niacin supplementation (WMD, 0.33; 95% CI, 0.21 to 0.44; P < .001) was provided. However, niacin supplementation produced no significant effects on plasma glucose (WMD, 0.18; 95% CI, -0.14 to 0.50; P = .275) and hemoglobin A1c (HbA1c) levels (WMD, 0.39; 95% CI, -0.15 to 0.94; P = .158). This study found that niacin supplementation could improve lipid profiles without affecting the glycemic levels for patients with T2DM. Additional large-scale RCTs should be conducted to evaluate the long-term effectiveness of niacin supplementation.

Clinical Outcomes and Predictors of ST-Elevation Versus Non-ST-Elevation Myocardial Infarction with Non-Obstructive Coronary Arteries

BackgroundMyocardial infarction with nonobstructive coronary arteries (MINOCA) can be clinically categorized as ST-segment elevation (STE) and non-ST-segment elevation (NSTE), whose clinical prognosis are poorly understood. The aim of this study was to compare the clinical outcome and their predictors of patients with STE and NSTE in MINOCA population. MethodsA total of 265 patients with MINOCA (102 with STE, and 163 with NSTE) were consecutively collected. Clinical profile, prognosis, and predictors of all patients were assessed. ResultsThe proportion of patients with NSTE was greater than patients with STE in MINOCA population. Patients with NSTE were older and more likely to be female and had a higher incidence of atrial fibrillation. Both high density lipoprotein (HDL) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were higher in the NSTE group. Patients with STE were more likely to have a history of smoking and a higher diastolic blood pressure. During the 1-year follow up, there were no differences in the outcomes between the STE and NSTE groups, with no significant differences in mortality and a similar rate of major adverse cardiovascular events (MACE) (20.9% vs 19.3%, P = 0.767). The multivariable predictors of MACE in the NSTE groups were age, lower level of total cholesterol, hypertension, and smoking history, whereas reduced left ventricular ejection fraction, and diabetes mellitus were the multivariable predictors of major adverse cardiac events in the STE group. ConclusionsThere were differences in the clinical profile between STE and NSTE in the MINOCA population, whereas the outcomes during the 1-year follow up were similar. The STE and NSTE groups had different predictive factors for major adverse cardiac events.

Low cholesterol levels are associated with a high mortality risk in older adults without statins therapy: An externally validated cohort study

BackgroundThe relationship of total cholesterol (TC) levels with mortality among older adults without statin therapy has not been fully studied. AimsTo examine the relationship between TC and all-cause mortality in adults aged 65 years and older in Russia without statin therapy. MethodsThis was a population-based prospective cohort study of community-dwelling people aged 65 years and older in Russia. Data from 379 individuals on cardiovascular risk factors; comorbidities; cognitive, physical and autonomous function; lipid panel; B-type natriuretic peptide; C-reactive protein; and others were collected through interviews, clinical examinations, and laboratory tests. The total follow-up time was 3 years. Cox proportional hazards models for all-cause mortality, C-statistics, internal validation and external validation using the Belgian population from the BELFRAIL study were performed. ResultsA U-shaped association between the TC level and all-cause mortality was identified. Older adults without statin therapy and with low/high TC levels were at higher risk for mortality even after adjustment for covariates, with a hazard ratio (HR) of 5.78 (1.96–17.03) for TC < 5.4 mmol/L and an HR of 6.24 (1.69–22.94) for TC levels > 7.2 mmol/L. The association between low TC and all-cause mortality was confirmed in an external population of adults 80 years and older. ConclusionThe TC level range associated with the lowest mortality was 5.4–7.2 mmol/L, irrespective of concomitant diseases or health status. The association between low TC levels and a high risk of all-cause mortality was confirmed in a Belgian cohort of adults 80 years and older.

Total cholesterol and the risk of primary liver cancer in Chinese males: a prospective cohort study

Objective: To investigate the association between total cholesterol (TC) and primary liver cancer in Chinese males. Methods: Since May 2006, all the male workers, including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study. Information about demographics, medical history and TC levels was collected at the baseline interview, as well as information on newly-diagnosed primary liver cancer cases during the follow-up period. A total of 110 612 males were recruited in the cohort by 31 December 2015. TC levels were divided into four categories by quartile (<4.27, 4.27-4.90, 4.90-5.56 and ≥5.56 mmol/L), with the first quartile group serving as the referent category. Cox proportional hazards regression model was used to evaluate the association between TC levels and primary liver cancer risk. Results: By December 31, 2015, a follow-up of 861 711.45 person-years was made with a median follow-up period of 8.83 years. During the follow-up, 355 primary liver cancer cases were identified. Compared with the first quartile, the HR of incident primary liver cancer among participants with the second, third and highest quartile TC levels were 0.76 (95%CI: 0.58-1.01), 0.59 (95%CI: 0.43-0.79), and 0.36 (95%CI: 0.25-0.52), respectively after adjusting for age, educational level, income level, smoking status, drinking status, body mass index, and HBsAg status (Pfor trend<0.001). Subgroup analyses found that the association between TC levels and primary liver cancer was robust (all Pfor trend<0.05). The results didn't change significantly after exclusion of newly-diagnosed cases within the first 2 years, males with history of cirrhosis or subjects who took antihyperlipidemic drugs, participants with higher TC levels had a lower risk of primary liver cancer (all Pfor trend<0.05) and HR(95%CI) of incident primary liver cancer among participants with the highest quartile TC levels were 0.41 (0.28-0.61), 0.36 (0.25-0.53) and 0.38 (0.26-0.54), respectively. Conslusion: In this large prospective study, we found that baseline TC levels were inversely associated with primary liver cancer risk, and low TC level might increase the risk of primary liver cancer.

LOW TOTAL CHOLESTEROL SERUM LEVELS AS A POOR OUTCOME PREDICTOR FOR INTRA-CEREBRAL HEMORRHAGE STROKE

Background: Stroke is affected by several factors, age, infection during treatment, obesity, and total cholesterol (TC) levels.  Objective: The study aimed to prove low TC serum levels as an unfortunate outcome predictor for intracerebral hemorrhage stroke. Methods: This study is a prospective cohort design. The research did in the Stroke Unit of Sanglah Hospital, Denpasar, from July 1st, 2018 to January 31th, 2019. The study involved patients with hemorrhage strokes with low TC serum levels and aged 40-95 years. Depending on variable divided into two groups with low TC serum levels (&lt;180 mg/dL) and normal TC serum levels (&gt;180mg/dL). Independent variable is The National Institutes of Health Stroke Scale (NIHSS) as an outcome. The processing of data analysis using Mac for SPSS version 23. Result: This study used 70 subjects. The age characteristics of the study subjects with a median value of 62 years in for low TC levels, and 57 years for normal TC levels, dominant in male (60% ), working (71.5%), not obese (58.6%), stroke-related infections (51.4%), and mean arterial blood pressure (MABP) £130mmHg (90%). Subjects with low TC had a risk of 64 times experiencing adverse outcomes (RR = 64: CI 95% = 14.06-291.32: p &lt;0.001). Multivariate analysis showed a low TC serum level as an independent variable.Conclusion: Low TC serum levels as an independent predictor having a poor outcome in intracerebral hemorrhage stroke

Replacing fish meal by Chlorella sp. meal: Effects on zebrafish growth, reproductive performance, biochemical parameters and digestive enzymes

Protein-rich microalgae are a potential alternative to fishmeal in aquaculture. In this context, this study evaluated the effects of fish meal (FM) replacement by Chlorella sp. meal (CM) on the growth performance, biochemical parameters, enzymatic activity and reproductive performance of zebrafish (Danio rerio). Six experimental diets were formulated to progressively replace FM. Up to 100% of FM was replaced with CM content at 0, 10, 20, 30, 40 and 50 g/kg diet. A total of 450 zebrafish were randomly divided into six groups, each group containing five replicates with 15 animals per replicate. After 60 days of feeding trials, animals fed 40 g/kg CM showed significantly better growth compared to animals fed diets with no CM. Likewise, animals fed 50 g/kg of CM presented the lowest levels of total cholesterol, LDL and triglycerides. The inclusion of CM had no significant effects on enzymatic amylase and lipase activity, while significantly increasing alkaline phosphatase activity. The highest levels of Chlorella sp. meal in the diets (40 and 50 g/kg of CM) provided the highest egg production (P = .004), hatching rate (P = .004) and larval survival (P = .009) at 6 days post-fertilization. The replacement of FM by CM generated an increase in the final weight, accompanied by an improvement in total cholesterol, LDL, triglyceride levels, in addition to improving the reproductive performance of zebrafish, proving to be an interesting alternative to FM in zebrafish juvenile diets.

Low levels of cholesterol and the cholesterol type are not associated with depression: Results of a cross-sectional NHANES study

Reports suggest low levels of cholesterol are associated with depression. However, results have not been replicated, the direction of the associations among types of cholesterol levels is not consistent, there is large study heterogeneity, and many studies have small samples. The objective of the study was to assess the association of cholesterol with depression. This is a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES). The NHANES is a research program that collects health information from a representative U.S. We included subjects aged ≥18 years who responded to NHANES surveys from 2009 to 2015. Subjects were classified as having major depression if the Patient Health Questionnaire scores were ≥10. Exposures were total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. We considered the age, body mass index, gender, smoking, alcohol use, health status, and exposure to statins and antipsychotics as potential confounders. To assess the association of the exposures with depression, we used decision tree and logistic regression models. A total of 19,527 subjects were analyzed, and 8% had depression. Subjects with depression were more likely to be women and smokers, and to have higher body mass index, poor health, higher levels of total cholesterol and triglycerides and lower levels of high-density lipoprotein cholesterol than subjects with no depression. After adjustment, low levels of total cholesterol (<129mg/dL) were associated with decreased risk of depression compared with higher levels, OR=0.64 and 95% CI (0.42-0.98). This large population-based study found no association of low cholesterol or any other lower type of cholesterol levels with increased risk of depression. These findings are generalizable to the U.S.

2261-PUB: Type 2 Diabetes Mellitus Debut in Peru: The DDPeru Study

Objective: To describe the clinical and metabolic characteristics of debut type 2 diabetes mellitus (T2D) Peruvian patients and to evaluate if there are any differences between the different geographical regions. To describe the initial pharmacological treatment of these patients. Methods: Case series study that took place in different regions of Peru, from July 2016 to November 2017. The inclusion criteria were: patient older than 20 years old, ambulatory setting, first time diagnosis of T2D through: fasting glycemia ≥ 126 mg/dl or random glycemia ≥ 200 mg/dl with symptoms, or oral glucose tolerance test (OGTT) ≥ 200 mg/dl on the 2 hour sample. Also, a description of their initial treatment was registered. Results: Five hundred eighty-one patients were identified, from which two hundred eighty-four (48.9%) were women. The average age of diagnosis was 53.2 ± 12.8 years old. Average weight was 77.3 +/- 16.6 kg, from which 228 patients (39.2%) were over weighted and 178 (30.6%) had type I obesity. Average glycemia was 249.4 mg/dl and average HbA1c was 8.9 %. In those who had abdominal ultrasonography (US), 56.7% had fatty liver. Most of the patients that were from Lima or the northern region of the country, had higher levels of glycemia and HbA1c. The T2D patients that were from high altitude presented more often fatty liver in the US, and lower levels of total cholesterol and LDL-c than those patients from the coast. The younger the patient, more cardiometabolic risk factors were present. Sixty percent of the patients received monotherapy, being metformin the preferred drug. Conclusions: Patients with T2D debut from Lima and the northern region of Peru, and also the younger patients, have more cardiometabolic risk factors than their counterparts from the rest of the country and the older ones. We didn’t find any clinical difference between patients from the coast or from high altitude. Metformin was the most prescribed drug to treat these patients. Disclosure J. Rocca: Consultant; Self; Merck KGaA. Other Relationship; Self; Novo Nordisk A/S. M. Calderon: None. A. Whittembury: None. V. Ulloa: Employee; Self; Novo Nordisk A/S. Funding Novo Nordisk Peru S.A.C.

Hypolipidemic and Hypoglycaemic Effect of Wholemeal Bread with Amaranth (Amaranthus dubius Mart. ex Thell.) on Sprague Dawley Rats.

The effect of consuming breads made with wheat flour and Amaranth (Amaranthus dubius Mart. ex Thell.) wholemeal flour on Sprague Dawley rats with hyperlipidaemia and hyperglycaemia induced through feeding was studied. Four diets were provided: control (CD: Ratarina®), commercial bread (CBD), bread with 100 g·kg−1 (ABD10) and 200 g·kg−1 (ABD20) amaranth flour. Zoometric and blood chemistry parameters were measured before and after consuming the diets. A completely random factorial design of 2 × 4 × 2 was used. The factors were blood lipids and glucose level (normal, N and elevated, E), diet (CD, CBD, ABD10 and ABD20) and sex (female, F and male, M). The rats consuming ABD10 and ABD20 diets presented the lowest glucose values, although with no differences (p > 0.05) between the groups of elevated blood lipids and glucose rats (E). Triglyceride concentrations decreased in ABD10 and ABD20 treatments in comparison with CD, elevated blood lipids and glucose (E) rats, while ABD10 rats showed lower total cholesterol level than normal (N) rats. The high-density lipoprotein cholesterol values increased in the ABD10 and ABD20 groups (p < 0.05), while it did lower for very low-density lipoprotein cholesterol and cardiac risk index (p < 0.05). In ABD10 and ABD20 treatments, the abdominal circumference decreased in both sexes (p < 0.05) between weeks 23 and 31. In conclusion, consumption of bread with amaranth improved lipid profiles of rats and could help to prevent metabolic and cardiovascular diseases.

Usefulness of routine blood test-driven clusters for predicting acute exacerbation in patients with asthma

AimAcute exacerbation (AE) is a significant burden in the management of asthma. In this study we aimed to investigate whether routine blood test results predicted AE in asthmatics. MethodsWe applied k-means cluster to routine blood test results which included eosinophil counts, total calcium, phosphorus, uric acid (UA), total cholesterol, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate transaminase (AST), alanine transferase (ALT), gamma-glutamyltransferase, blood urea nitrogen, creatinine, and high-sensitive C-reactive protein (hsCRP) obtained from 590 asthmatics. AEs collected over the prospective follow-up of one-year were used to evaluate clinical trajectories of these clusters. ResultsThree blood clusters were identified. The essential features of each cluster can be characterized as follows: (i) high eosinophil count, UA, total cholesterol, AST, ALT, and hsCRP levels (Cluster 1); (ii) intermediate features (Cluster 2); (iii) low UA, total cholesterol and total bilirubin levels (Cluster 3). Kaplan-Meier analysis confirmed that clusters were strongly predictive of time to the first AE (log-rank P = 0.001). Hazard ratio for each group was as follows: Cluster 2 = 1, Cluster 1 = 2.67 (1 vs. 2, P = 4.68 × 10−4), and Cluster 3 = 1.69 (2 vs. 3, P = 0.021). ConclusionsWe defined three blood clusters in asthmatics. These blood clusters are easily identifiable from routine test results and may help clinicians to predict the future risk of AE in asthmatics.