Lower HDL Cholesterol Values Research Articles

Changes in Metabolic Health and Sedentary Behavior in Obese Children and Adolescents.

Obesity is becoming more common among children and adolescents. As in adults, obesity in the pediatric population is associated with an increased risk of metabolic disorders and diseases. In the related literature, little attention has been devoted to evaluating how metabolic health and sedentary behavior change in the obese pediatric population. Therefore, this study aimed to assess changes in metabolic health and sedentary behavior in obese children aged 7-12 and adolescents aged 13-17. For this single-center hospital-based prospective observational study, we included 202 Polish children and adolescents aged 7-17 years. We performed blood pressure measurements and collected blood samples to assess metabolic health markers. Based on the performed measurements, we also calculated additional indexes and ratios: BMI, WHtR, ABSI, VAI, and HOMA-IR. The analysis of the results showed clear and significant differences between the study groups. The older boys and girls were identified with higher values of anthropometric ratios, blood pressure, time spent sitting, and lower HDL cholesterol values (p < 0.05). The analysis also revealed a strong-to-moderate correlation between age and anthropometric ratios, blood pressure, HDL cholesterol, and sitting time (p < 0.05). Obese children and adolescents included in this study represent poor metabolic health and are at great risk of developing other metabolic diseases such as type 2 diabetes, hypertension, or metabolic syndrome. This risk increases with age; therefore, a number of preventive and therapeutic actions should be taken in overweight and obese children and adolescents to avoid further metabolic complications.

Aggression in Women with Schizophrenia Is Associated with Lower HDL Cholesterol Levels.

This study assessed the association between serum lipid levels and aggression in female patients with schizophrenia. The study included female patients with schizophrenia (N = 120). The participants were subdivided into two groups (aggressive and nonaggressive), with 60 participants in each group. Serum lipids—cholesterol, triglycerides, high-density lipoproteins (HDL cholesterol), and low-density lipoproteins (LDL cholesterol)—were determined. The clinical part of the study included an evaluation using psychiatric scales: the positive and negative syndrome scale (PANSS), the aggression subscale of the PANSS scale (PANSS-AG), and the overt aggression scale (OAS). Significant differences were only observed in HDL cholesterol levels, where aggressive subjects had significantly lower values of HDL cholesterol (t = 2.540; p = 0.012), and the representation of subjects with low cholesterol values was almost three-times higher in the group of subjects with aggression (χ2 = 7.007; p = 0.008) compared to the nonaggressive group. The nominally significant predictor for HDL cholesterol in nonaggressive and aggressive participants was the total value of the PANSS scores. In subjects with aggression, suicidality was not significantly associated with HDL cholesterol levels. Our findings suggest that lower HDL cholesterol is significantly associated with aggression in women with schizophrenia.

Cardiometabolic profile of young women with hypoprolactinemia

PurposeUnlike hyperprolactinemia, clinical significance of prolactin deficiency remains poorly understood. The aim of this study was to assess the cardiometabolic profile of patients with low prolactin levels.MethodsThe study population consisted of three groups of young women. Two groups were chronically treated with cabergoline but differed in prolactin levels, which were either abnormally low (group A; n = 16) or within the reference range (group B, n = 23). Group C, serving as a control group, included 28 drug-naïve women with normal prolactin levels. The dose of cabergoline in group A was then tapered down. Glucose homeostasis markers, plasma lipids and circulating levels of hormones, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, as well as the carotid intima-media thickness were assessed at baseline and 6 months later.ResultsCompared with subjects with normal prolactin levels, women with hypoprolactinemia had higher levels of 2-h postchallenge glucose, glycated hemoglobin, triglycerides, uric acid, hsCRP and fibrinogen, lower values of HDL-cholesterol, total testosterone and free androgen index, as well as reduced insulin sensitivity. No differences in these variables were observed between groups B and C. Apart from prolactin normalization, cabergoline dose reduction reversed all laboratory disturbances reported in group A.ConclusionThe obtained results suggest that hypoprolactinemia in women of reproductive age may increase cardiometabolic risk.

Rare primary dyslipidaemias associated with low LDL and HDL cholesterol values in Portugal.

Background: Dyslipidaemia represents a group of disorders of lipid metabolism, characterized by either an increase or decrease in lipid particles, usually associated with triglycerides, LDL cholesterol (LDL-C) and/or HDL cholesterol (HDL-C). Most hyperlipidaemias and HDL deficiencies confer an increased cardiovascular risk, while hypolipidaemia, such as abeta or hypobetalipoproteinemia, may present different manifestations ranging from poor weight progression to neurological manifestations. The aim of this study is to present 7 cases with rare dyslipidaemias associated with low LDL or low HDL cholesterol values, referred to our laboratory for the genetic identification of the cause of the dyslipidaemia. Methods: Lipid profile was determined for each individual in an automated equipment Integra Cobas (Roche). Molecular analysis was performed by NGS with a target panel of 57 genes involved in lipid metabolism (Sure select QXT, Agilent) and samples were run in a NextSEQ Sequencer (Illumina). Only genes associated to rare forms of low HDL-c or LDL-c were analysed for this work, namely: ABCA1, APOA1, LCAT, SCARB1, APOB, PCSK9, MTTP, SAR1B, and ANGPTL3. All rare variants (MAF<5%) found in these genes were confirmed by Sanger sequencing. Results and discussion: This study includes 7 index cases (IC), with the following clinical diagnoses: Fish Eye Disease (1), Hypoalphalipoproteinemia (1) and Abetalipoproteinemia (ABL) / Familial Hypobetalipoproteinemia (FHBL) (5). We have identified one IC with a compound heterozygosity in LCAT causing Fish Eye Disease and one IC with a variant in ABCA1 in homozygosity causing Tangier disease. We found variants causing homozygous FHBL in 2 IC, one of whom has an undescribed pathogenic variant in homozygosity in APOB (c.12087+1G>A) and the other is a possible compound heterozygous for APOB variants c.2604+1G>A and c.4651C>T/p.(Gln1551*). In two patients only a variant in heterozygosity (c.3365delG/p.(Gly1122Vfs*62) and c.11095A>T/p.(Arg3699*)). In the remaining patient, no variants were identified. NGS proved to be a fundamental key for genetic testing of rare lipid disorders, allowing us to find the genetic cause of disease in 6/7 patients with low HDL-c and LDL-c. Patients with these rare conditions should be identified as early as possible in order to minimize or prevent clinical manifestations. The unsolved case is still under investigation.

Association of PPARG rs3856806 C>T polymorphism with body mass index, glycaemia and lipid parameters in Serbian adolescents

Background/Aim: Peroxisome proliferator-activated receptor gamma (PPARg) belongs to a family of nuclear hormone receptors and ligand-activated transcription factors. PPARG gene is expressed in many tissues including adipose tissue where it plays a crucial role in differentiation of adipocyte, insulin resistance, blood glucose levels and lipid metabolism. The aim of the study was to examine the association of rs3856806 polymorphism with the body mass index (BMI), fasting glucose levels and lipid parameters in Serbian adolescents. Methods: This research included 287 adolescents of both genders (143 boys and 144 girls), 14-15 years of age. Genotype detection was done by polymerase chain reaction-restriction fragment length polymorphism (RFLP) assay. Results: Results showed statistically significant difference in terms of fasting glucose levels among girls (p = 0.013) depending on their genotype. Female carriers of CC genotype had significantly higher level of fasting glucose levels. Also, results showed that in the group of overweight and obese girls, carriers of CT or TT genotype had statistically significant lower values of HDL cholesterol compared to girls - carriers of CC genotype (p = 0.000). However, this result was not confirmed by multiple regression analysis. Statistically significant association of rs3856806 polymorphism was not observed with BMI nor with other lipid parameters. Conclusion: This polymorphism is associated with fasting glucose level and HDL cholesterol among girls. To draw definite conclusions, further research should be conducted including non-genetic factors and other polymorphisms among this gene.

Prediction Models of Albumin Renal Excretion in Type 2 Diabetes Mellitus Patients

Microalbuminuria is a cardiovascular risk factor in type 2 diabetes mellitus patients. It is very important to know which the predictor factors for albuminuria are, because these elements may be influenced by pharmacological measures. In our study we propose three models for the prediction of albumin glomerular excretion in a group of 446 type 2 diabetes mellitus patients: the clinical-biochemical model, the pharmacological model, and the integrative model that reunites the two models. In the clinical-biochemical model, albumin excretion was statistically significant influenced by HbA1c (positive correlation) and blood pressure (positive correlation). In the pharmacological model, albumin excretion was influenced by angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation). In the integrative model, the factors were HbA1c (positive correlation), diastolic blood pressure (positive correlation), angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation) and statins treatment (negative correlation). The prevalence of microalbuminuria was 16.14 %. Patients with microalbuminuria had statistically significant higher values of HbA1c, systolic blood pressure, diastolic blood pressure, triglycerides and lower values of HDL-cholesterol. A low glucose control was the most important risk factor for an increased albumin glomerular elimination. The importance of our study consists in the fact that all the elements that predict albuminuria can be influenced: HbA1c, blood pressure, therapy with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and statins.

Prediction Models of Albumin Renal Excretion in Type 2 Diabetes Mellitus Patients

Microalbuminuria is a cardiovascular risk factor in type 2 diabetes mellitus patients. It is very important to know which the predictor factors for albuminuria are, because these elements may be influenced by pharmacological measures. In our study we propose three models for the prediction of albumin glomerular excretion in a group of 446 type 2 diabetes mellitus patients: the clinical-biochemical model, the pharmacological model, and the integrative model that reunites the two models. In the clinical-biochemical model, albumin excretion was statistically significant influenced by HbA1c (positive correlation) and blood pressure (positive correlation). In the pharmacological model, albumin excretion was influenced by angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation). In the integrative model, the factors were HbA1c (positive correlation), diastolic blood pressure (positive correlation), angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation) and statins treatment (negative correlation). The prevalence of microalbuminuria was 16.14 %. Patients with microalbuminuria had statistically significant higher values of HbA1c, systolic blood pressure, diastolic blood pressure, triglycerides and lower values of HDL-cholesterol. A low glucose control was the most important risk factor for an increased albumin glomerular elimination. The importance of our study consists in the fact that all the elements that predict albuminuria can be influenced: HbA1c, blood pressure, therapy with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and statins.

Metabolic Syndrome and Pharmacological Treatment Measures

Metabolic syndrome is a set of several different pathological conditions and risk factors that are often the cause of many unwanted cardiac and cerebrovascular occurrences. It is highly represented around the world, especially in countries with excessive and inadequate nutrition, insufficient physical activity of the population and obesity, with a constant growth trend. The work included 1052 patients with HTA of which DM was 309 (29.4%). Out of the total number of 1052 patients with metabolic syndrome there were 675 (64.2%) patients. Observing certain determinants of the metabolic syndrome HTA was present in all observed patients. Low HDL cholesterol values were found in 503 (74.5%) patients and the lowest incidence was hyperglycaemia (252 mg / 37.3%). Implemented pharmacological treatment measures have led, in most patients, the blood pressure to optimal or normal. The effect of pharmacological therapy on glycaemic value in patients with metabolic syndrome led to the normalization of glycaemia in majority of patients. The results achieved have improved the quality of life of patients and motivated them for further treatment.

A study on high prevalence of metabolic syndrome among competitive exam appearing students from Andhra Pradesh

Background: Metabolic syndrome is a pool of risk factors which are indicators of future development of cardiovascular disease and type 2 diabetes mellitus in adults. Stress is strongly associated with metabolic syndrome. Adolescents are more prone to academic stress and leads to development of metabolic syndrome also.Aim & Objectives: A comparative study to determine prevalence of metabolic syndrome among the adolescent students appearing for competitive exams. Methods: A comparative descriptive study was conducted among the intermediate students of 16-19 years age group. Students were selected randomly from students residing at hostel in private junior colleges, Guntur. A sample of hundred students were selected, fifty from exam appearing students and another fifty from non-exam appearing students in the present academic year. Comparison done between both the students groups. Prevalence of metabolic syndrome was measured in both groups based on International Diabetes Federation Criteria. Relevant statistical tests were used to test the statistical significance. Results: In the current study the results reveal that exam appearing students had higher values of waist circumference, blood pressure, fasting plasma glucose and triglycerides and lower values of HDL-Cholesterol. The prevalence of metabolic Syndrome was high among exam appearing students (34%) when compared to non-appearing students (6%). (X2=12.25, P=0.0005) The risk of metabolic syndrome in competitive exam appearing students was eight times higher than in non-exam appearing students (OR=8.07). Conclusion: Finally we conclude that, the prevalence of metabolic syndrome was significantly higher among the students appearing for competitive exams when compared to the students not appearing for competitive exams.

Study of prevalence and pattern of dyslipidaemia in type 2 diabetes mellitus patients attending rural health training centre of medical college in Bhopal, Madhya Pradesh, India

Background: Diabetes is endemic globally with increasing prevalence in both developing and developed countries. Persistent hyperglycaemia of diabetes is associated with micro as well as macro vascular complications like coronary heart disease, stroke, diabetic renal disease, diabetic retinopathy and neuropathy etc. Dyslipidemia contribute to considerable increased risk of atherosclerosis and consequent mortality in diabetic patients. It often precedes onset of diabetes particularly type 2 DM and may persist inspite of adequate control of blood sugar. The objective of the study was to study prevalence and pattern of dyslipidemia in type 2 diabetes mellitus patients attending Rural Health and Training Centre of medical college in Bhopal, Madhya Pradesh. Methods: This was a cross sectional study carried out among 50 Type 2 diabetic mellitus patients attending OPD of Rural Health Training Centre (RHTC) of medical college in Bhopal Madhya Pradesh. Study population included known as well as newly diagnosed type 2 diabetic patients more than 30 years of age attending OPD at RHTC. Results: According to ATP III guidelines dyslipidemia was observed in 43 (86%) study subjects. Hypercholesterolemia was seen in 18 (36%) study subjects. Increased LDL and triglycerides was observed in 33 (66%) and 32 (64%) study subjects respectively. Lower HDL cholesterol values were observed in 26 (52%) study subjects. Out of 43 study subjects having dyslipidemia, 14 (32.6%) study subjects were having isolated single parameter dyslipidemia, while 10 (23.2%) had combined two parameter dyslipidemia and 19 (44.2%) study subjects showed mixed dyslipidemia. Conclusion: Results suggest high (86%) prevalence of dyslipidemia among type 2 diabetes mellitus study subjects. Most common pattern observed was mixed type dyslipidemia. These lipid abnormalities might be the important in view of development of cardiovascular or cerebrovascular diseases. Hence type 2 diabetic patient should undergo the routine monitoring of blood sugar and lipid profile so that any abnormalities can be identified and preventive measures along with interventions can be initiated at the earliest.

Aerobic Capacity, Physical Activity and Metabolic Risk Factors in Firefighters Compared with Police Officers and Sedentary Clerks.

BackgroundThis study examined the association between the physical work environment and physiological performance measures, physical activity levels and metabolic parameters among German civil servants. A main focus in this study was to examine the group differences rather than measuring the absolute values in an occupational group.MethodsWe prospectively examined 198 male German civil servants (97 firefighters [FFs], 55 police officers [POs] and 46 sedentary clerks [SCs]). For each parameter, the groups were compared using a linear regression adjusted for age.ResultsThe 97 FFs showed a similar maximal aerobic power (VO2max l/min) of 3.17±0.44 l/min compared with the POs, who had a maximal aerobic power of 3.13±0.62 l/min (estimated difference, POs vs. FFs: 0.05, CI: -0.12-0.23, p=0.553). The maximal aerobic power of the FFs was slightly higher than that of the SCs, who had a maximal aerobic power of 2.85±0.52 l/min (-0.21, CI: -0.39-0.04, p=0.018 vs. FFs). The average physical activity (in metabolic equivalents [METS]/week) of the FFs was 3818.8±2843.5, whereas those of the POs and SCs were 2838.2±2871.9 (-808.2, CI: 1757.6-141.2, p=0.095) and 2212.2±2292.8 (vs. FFs: -1417.1, CI: -2302-531.88, p=0.002; vs. POs: -2974.4, CI: -1611.2-393.5, p=0.232), respectively. For the FFs, the average body fat percentage was 17.7%±6.2, whereas it was 21.4%±5.6 for the POs (vs. FFs: 2.75, CI: 0.92-4.59, p=0.004) and 20.8%±6.5 for the SCs (vs. FFs: 1.98, CI: -0.28-4.25, p=0.086; vs. POs: -0.77, CI: 3.15-1.61, p=0.523). The average waist circumference was 89.8 cm±10.0 for the FFs, 97.8 cm±12.4 (5.63, CI: 2.10-9.15, p=0.002) for the POs, and 97.3±11.7 (vs. FFs: -4.89, CI: 1.24-8.55, p=0.009; vs. POs: -0.73, CI: -5.21-3.74, p=0.747) for the SCs.ConclusionsThe FFs showed significantly higher physical activity levels compared with the SCs. The PO group had the highest cardiovascular risk of all of the groups because it included more participants with metabolic syndrome; furthermore, the POs had an average of 2.75% higher body fat, lower HDL cholesterol values and higher waist circumferences compared with the FFs and higher LDL cholesterol values compared with the SCs. Our data indicate that sedentary occupations appear to be linked to obesity and metabolic syndrome in middle-aged men.

HDL cholesterol and high-sensitive troponin T as predictive biomarkers of atrial fibrillation after heart surgery

Atrial fibrillation (AF) has an incidence rate of approximately 30% and is the most frequent arrhythmia following heart surgery. Factors such as inflammation, the presence of heart fibrosis, stress and cardiomyocyte apoptosis, have all been associated with AF. We believe that atrial remodelling is a pre-existent process in patients with post-surgical AF. We have analyzed the factors related to the incidence of atrial fibrillation in the period after heart surgery. We included consecutive, hemodynamically stable patients with a sinusal rhythm who were subjected to programmed heart surgery with extracorporeal circulation. An assessment was made of the fall in atrial fibrillation after surgery using prolonged electrocardiographic monitoring. A total of 100 patients were included in the study and were subjected to either coronary revascularisation surgery (59) or aortic valve substitution due to severe aortic stenosis (41). Postoperative AF occurred in 29 patients who received predominantly more valve surgery than coronary surgery. The following factors were predictive of postoperative AF in the multivariate analysis: Male sex; beta-blocker therapy for chronic disease; the use of intraoperative; fibrinogen perfusion; low HDL cholesterol values; and high sensitive troponin T values, in the preoperative period. HDL cholesterol and high sensitive troponin T can be useful biomarkers to predict the occurrence of AF after surgery. The early identification of these patients who develop of FA allows us to take preventive measures to minimize the negative effects.

Cardiopatía isquémica en población inmigrante

ObjectiveTo compare the characteristics on debut in coronary artery disease (CAD) between native and immigrant patients. Materials and methodsA cross-sectional retrospective study was performed through the review of computerized medical records. We included 129 patients diagnosed of CAD, from 30 to 74 years, natives and immigrants, with cardiovascular risk factors (CVRF) reported in their medical records. The main variables were age at time of diagnosis of CAD, sex, type of CAD, CVRF present at diagnosis. We also calculated coronary risk using the REGICOR scale and recorded the number of coronary arteries significantly injured on angiography and treatment received. ResultsA total of 40.3% of the patients were immigrants, 73.1% of them from South Asia. Mean age at the debut of CAD was 60.1 years in natives (95% CI; 58.2 to 61.9) and 48.9 years in immigrants (95% CI; 46.5 to 51.3, P<.001). The immigrants had lower values of HDL-cholesterol (P=.001), higher levels of triglycerides (P=.031) and lower coronary risk estimated on the REGICOR scale (P<.001). Three-vessel or left main coronary artery disease (P=.012) was more frequent among immigrants. ConclusionsDebut of CAD in immigrants appeared 10 years early than in natives with more severe coronary lesions. The risk calculated by REGICOR function could be underestimated in the immigrant group. It is important to know these differences to bring better primary prevention strategies in the immigrant population.

AB0252 Impact of age, disease-related factors, obesity and depression on lipid status and glycoregulation in patients with rheumatoid arthritis

BackgroundThe risk for cardiovascular disease is increased in rheumatoid arthritis (RA). Assessments based only on traditional risk factors are insufficient to capture the extent of cardiovascular risk in RA.ObjectivesThis study...

Metabolic Risk Profile among Overweight and Obese Lactating Women in Sweden

BackgroundObesity and cardiovascular diseases are increasing globally and any association between reproduction and these conditions is of concern. Unfortunately, little is known about normal levels of metabolic risk factors in women of different body mass index throughout the reproductive cycle. This study is one of the first to describe the metabolic risk profile of lactating overweight or obese women at 8–12 weeks postpartum.MethodsDuring 2007–2009, 66 overweight or obese Swedish lactating women without known diseases underwent detailed measurements of their metabolic profiles, dietary intake and general health before entering a lifestyle intervention trial. Baseline measurements took place between 8–12 wk postpartum. Almost all women were exclusively breastfeeding their term infants.ResultsThe women were regarded as healthy, as reflected in the absence of diagnosed diseases, their own perceptions and in normal hemoglobin, albumin and fasting plasma glucose values. Four women were diagnosed with metabolic syndrome. In these cases, underlying conditions included large waist circumference, low HDL cholesterol values, high triglyceride values and relatively high blood pressure. The metabolic profile differed between overweight and obese women; obese women had significantly higher levels of fasting insulin (p = 0.017), borderline higher HOMA values (p = 0.057) and significantly higher triglyceride values (p = 0.029), as well as larger waist and hip circumferences (p<0.001 and p<0.001). However, no significant differences between overweight and obese women were detected for LDL or total cholesterol levels. Overweight and obese women reported similar total energy and macronutrient intakes, but obese women tended to be less physically active (p = 0.081).ConclusionsAmong generally healthy lactating women, obesity as compared to overweight is associated with increased metabolic risk. This cut-off is thus important also in the early postpartum period, and obesity among these women should warrant proper health investigation. Macronutrient intake did not differ between the groups and, hence, cannot explain these differences.Trial registrationClinicalTrials.gov Identifier: NCT01343238

2152 – The total serum cholesterol in alcoholics with secundary depression

Introduction High rate of depression and suicide found in alcoholics. Low total serum cholesterol is related with suicidal behavior, impulsivity and depression. Alcoholics have elevated serum triglycerides and LDL cholesterol, but lower values of HDL-cholesterol. Objectives To investigate the serum cholesterol levels and differences between secondary depressed and non-depressed alcoholics biochemical blood tests were performed. Methods A total group of eighty six non-cirrhotic male primary alcoholics, without malnutrition was recruited during inpatient treatment. After 4 weeks alcoholics were divided in the depressive (DA) group and non-depressive NDA group according the Hamilton Depression Rating scale- HAMD cut-off score under 8. Biochemical blood tests were performed for all participants on admission and retrospectively were analyzed. Differences between groups were tested by Student t-test. Results There were not significant difference among groups for demographic and biochemical serum parameters. The DA group showed lower level of total serum cholesterol (5,9 ± 1.24) than NDA group (6.4 ± 1.20) on admission, with values between normal rang (3.63-6.7 mmol/l) p = 0.072. Conclusion The group of depressive alcoholics showed trend of lower level of total serum cholesterol on admission. It would be useful to investigate low serum cholesterol as possible predictive factor of secondary depression among alcoholics.

Analysis of Clinical Arterial and Metabolic Parameters in Chronic Phase CML Patients On Nilotinib in a Single Center Cohort

AbstractAbstract ▪3756▪This icon denotes a clinically relevant abstractThe introduction of second generation tyrosine kinase inhibitors (TKI2) in the treatment of chronic phase chronic myelogenous leukemia (CML) has improved the response rates in the second, and now, in the first line setting. Nilotinib, a TKI2 with a restricted kinase inhibition profile, demonstrated higher rates of response over imatinib (IM) as front line therapy with a very good short-term tolerability profile. Even if the proportion of patients (pts) in undetectable disease increases with time, the majority will have to continue this treatment for several yrs to avoid progression. In this perspective, mid- and long-term safety issues are of concern, and recent reports point out the onset of arteriopathies in such pts with a suspected abnormal frequency.We have prospectively analysed our on-nilotinib cohort of CP CML between September 2011 and July 2012 with standard clinical assessments [height, weight, body mass index (BMI), ankle-brachial index (ABI)], and basic routine metabolic laboratory assessments (fasting glucose, total, HDL and LDL cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, glycosylated hemoglobin) and BCR-ABL (IS), to explore and detect at early stages abnormalities that may have some later cardio-vascular consequences for pts on this drug.We analysed a series of 54 CML pts all in CP. The median age at diagnosis was 50 (18–73) and 55 (20–78) yrs at nilotinib initiation. The Sokal score was low for 27%, intermediate for 55%, high for 8%, unknown for 10 pts. At CML diagnosis, 13 pts had hypertension, 4 diabetes mellitus, 2 previous peripheral arterial disease (PAD), 4 coronary artery disease (CAD), and 9 pts had tobacco addiction. Thirty-seven pts had IM first line for a median of 4.2 (0.2–11) yrs, then nilotinib for IM-intolerance (14 pts) or IM-resistance (16 pts), or entering a clinical trial (5 pts) and 2 for unknown reasons for a median of 2.8 (0.5–5.6) yrs. Seventeen pts had nilotinib first line for a median of 1 (0.3–4.7) year. The disease duration ranged from 0.4 to 19.3 yrs (median 5.6). Overall, the median duration of nilotinib was 2.2 (0.3–6.8) yrs. Two pts were in CHR, 11 pts in CCyR, 28 in MMR, 13 in undetectable disease (MR4.5) at assessment. In pts on nilotinib without statins at time of assessment, 62% (n=40) showed high total cholesterol values (>2 g/l), 46% (n=37) had high LDL cholesterol (>1.5 g/l) and 57% (n=37) low HDL cholesterol values (<0.6 g/l). Triglycerides were high (>1.48 g/l) in 18% of pts (n=49). Glycosylated hemoglobin was high (>6%) in 18% of the pts treated (n=38), and glucose (> 5.8 mmol/l) in 20% (n=11). Seven pts (13%) were overweight (BMI>30) and the median BMI was 24.6 (16.7–47). On 54 pts, 25% of pts (n=13) had an abnormal ABI (<1) and true arterial problems were authentified by Doppler ultrasound in 13% (n=7) of pts after a median of 2.6 (0.6–4.4) yrs of nilotinib: carotid atherosclerosis, inflammatory carotiditis, one CAD, 4 PADs, with 5 newly diagnosed on nilotinib. In order to correlate the different parameters together we use the correlation circle strategy (see figure 1 below) resulting from the principle components analysis (PCA), in this circle each arrow represents a studied parameter, and the closest one parameter is to another one, the closest the arrows are. Perpendicular arrows denote no correlation at all. The length of each arrow depends on the weight of each parameter compared to the others within the PCA. [Display omitted] As seen; there is a strong correlation between the duration of nilotinib and the total cholesterol, high LDL cholesterol, arterial problems and age at nilotinib initiation. ABI failed in detecting authentified arterial problems detected by other means. The Pearson correlation test nearly reached statistical significance between nilotinib duration and arterial problems (p=0.07).In conclusion, nilotinib induces clear metabolic disturbances along treatment, particularly for lipids and glucose parameters, which can be responsible for significant arteriopathies, that ABI failed to detect. These results should promote the lipids and glucose parameters follow-up during CML treatment by nilotinib in order to detect disturbances at early times, correct them using strict dietary rules and/or concomitant medications to avoid arterial problems at later time points. Disclosures:Nicolini:Novartis, Bristol Myers-Squibb, Pfizer, ARIAD, and Teva: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.

A STUDY OF ATHEROSCLEROTIC RISK FACTORS IN POSTMENOPAUSAL WOMEN

Background and Objectives: Menopause is a normal ageing phenomenon in women. The risk of cardiovascular diseases gradually increases in postmenopausal women, which may be due to lower level of estrogen. Changes in lipoproteins have been associated with a 30% decline in atherosclerotic cardiovascular disease (ASCVD) risk. This study was designed to compare lipid profile between postmenopausal women and premenopausal women.Methods: 72 apparently healthy women in the age group of 40-60 years who were attending the OPD of Shri B.M. Patil Medical College Bijapur were randomly selected for the study. They were divided into premenopausal (control) (n=36) and postmenopausal (study)(n=36) group depending upon attainment of menopause. Baseline characteristics such as age and weight were recorded. Total Cholesterol, Serum Triglycerides, Serum High Density Lipoprotein, and Serum Low Density Lipoprotein were estimated using enzymatic methods. Statistical analysis done by using SPSS version 9.0Results: We found no significant statistical difference in baseline characteristics. Statistically significant higher values of TC, LDL-C, TG levels and statistically significant lower values of HDL cholesterol were found in postmenopausal women compared to premenopausal women.Conclusion: Serum lipid profile changes to unfavorable lipid profile which is possibly mediated by changing hormonal status after menopause especially estrogen which has role in lipid metabolism, Thus dyslipidemia contributing to increase in cardiovascular disease after menopause.

C-peptide and the risk for incident complications and mortality in type 2 diabetic patients: a retrospective cohort study after a 14-year follow-up

C-peptide, a cleavage product of insulin, exerts biological effects in patients with type 1 diabetes mellitus, but its role in type 2 diabetes mellitus is controversial. Our aim was to examine the associations between fasting C-peptide levels and all-cause mortality, specific-cause mortality and the incidence of chronic complications in patients with type 2 diabetes. Retrospective cohort study with a median follow-up of 14 years. A representative cohort of 2113 patients with type 2 diabetes mellitus and a subgroup of 931 individuals from this cohort without chronic complications at baseline from a diabetic clinic were studied. Patients with higher C-peptide levels had higher baseline BMI and triglyceride and lower HDL-cholesterol values. During the follow-up, 46.1% of the patients died. In a Cox proportional hazard model, after multiple adjustments, no significant association was found between the C-peptide tertiles and all-cause mortality or mortality due to cancer, diabetes or cardiovascular diseases. In the subgroup of 931 patients without chronic complications at baseline, the incidence of microvascular complications decreased from the first to the third C-peptide level tertile, while the incidence of cardiovascular disease did not differ. The risks for incident retinopathy (hazard ratio (HR)=0.33; 95% confidence interval (CI) 0.23-0.47), nephropathy (HR=0.27; 95% CI 0.18-0.38) and neuropathy (HR=0.39; 95% CI 0.25-0.61) were negatively associated with the highest C-peptide tertile, after adjusting for multiple confounders. Higher baseline C-peptide levels were associated with a reduced risk of incident microvascular complications but imparted no survival benefit to patients with type 2 diabetes mellitus.

Evolution of Lipid Profiles after Bariatric Surgery

The most commonly encountered dyslipidemia in obese individuals is characterized by a cluster of interrelated plasma lipid and lipoprotein abnormalities including hypertriglyceridemia, low HDL cholesterol values, and increased small, dense LDL cholesterol particles. The aim of this study was to assess the changes in lipid profiles at baseline (pre-operatively) and at follow-up (6, 12, and 18months) after a laparoscopic Roux-en-Y gastric bypass (LRYGBP). A retrospective observational study was performed involving all patients who consecutively underwent a LRYGBP between January 1, 2007 and December 31, 2009. Fasting lipids sub-fractions (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) were measured and HOMA-IR calculated pre-operatively and at follow-up post-LRYGBP. Pearson's correlation coefficients were used to assess the relationship between excess weight loss (EWL) and lipid sub-fractions. ANOVA was used to assess the differences between each lipid sub-fraction at various time-points. One hundred twenty eight (N = 128) medical charts were reviewed, and those containing data on lipid fractions at the three follow-up time-points were analyzed. One hundred fourteen patients (N = 114), 84 of whom were women (73.7%), were finally included in the study. Total cholesterol, LDL cholesterol, triglycerides, and HOMA-IR were significantly reduced after LRYGBP (P < 0.0005 for all). Inversely, HDL cholesterol disclosed a significant rise (P < 0.0005). Noteworthy significant associations between lipid subfractions and EWL were detected overall (P < 0.0005 for all). A gender effect was found since female patients displayed a milder association than male patients (P < 0.0005). LRYGBP-induced weight loss improves the lipid profile while reducing insulin resistance, with male patients showing a better profile than female patients.