Mean HDL Cholesterol Levels Research Articles

Clinical Deep Data Accumulation System (CLIDAS) reveals a "Lipid paradox" of hypertriglyceridemia in Japanese patients

Abstract Background The association between triglycerides (TG), HDL cholesterol (HDL-C) and the prognosis of cardiovascular disease has not been established. Purpose The aim of this study was to elucidate the relationships between the combination of TG and HDL-C levels and the risk of a major adverse cardiac and cerebral events (MACCE) and to verify the usefulness of TG and HDL-C as a risk stratification factor using the Clinical Deep Data Accumulation System (CLIDAS) database. Methods CLIDAS is a database that accumlates electronic medical records in seven tertiary hospitals in Japan including patient characteristics, medications, laboratory test, physiological test, cardiac catheterization, and PCI treatment. We analyzed 9,690 patients who underwent PCI between April 2014 and March 2020. These patients were stratified into the acute coronary syndrome (ACS) group (N=4,135; 43%) and the chronic coronary syndrome (CCS) group (N=5,555; 57%). Furthermore, patients were divided into four groups based on mean serum TG levels (175 mg/dL) and HDL-C levels (40 mg/dL) as cutoff values: high TG/low HDL-C, low TG/low HDL-C, high TG/high HDL-C, and low TG/high HDL-C, and compared for major adverse cardiac and cerebrovascular events (MACCE). The median follow-up duration was 2.5 years. Results The patients with high TG/low HDL-C showed the highest event rates in myocardial infarction among the ACS group. The hazard ratio for high TG/low HDL-C versus low TG/high HDL-C was 1.76 (95% CI, 1.08 to 2.87, P < 0.05) after adjustment for age, sex, eGFR, and mean LDL-C levels, while we observed no risk stratification by the combination of TG and HDL-C levels in the CCS group (Figure 1). In contrast, the patients with low TG levels showed the paradoxically higher event rates of MACCE in both the ACS and CCS groups, as well as cardiovascular death in the CCS group, compared to those with high TG levels (Figure 2). The hazard ratio for low TG/low HDL-C versus high TG/low HDL-C was 3.21 (95% CI, 1.44 to 7.13, P <0.005), and the hazard ratio for low TG/high HDL-C versus high TG/high HDL-C was 2.23 (95% CI, 1.03 to 4.84, P < 0.05) in the CCS group after adjustment for age, sex, eGFR, and mean LDL-C levels. Conclusion In the CLIDAS database, while high TG and low HDL-C levels stratified the risk of ACS, low TG levels showed worsening prognosis for CV death, suggesting a "Lipid paradox" in the real world.Figure 1Figure 2

STUDY OF MATERNAL LIPID PROFILE IN PREECLAMPSIA

Introduction: This study evaluates relationship between serum lipid profile and preeclampsia1 . Objective:The study is to compare the mean lipid levels in pre-eclamptic and normal pregnancy. Design:This is a descriptive study. Participants: Among patients attending Out Patient Department in Chalmeda Anand Rao institute of medical sciences, 25 singleton pregnancies diagnosed as having preeclampsia and 25 pregnancies without such diagnosis were included in study. Outcome measures: Risk of preeclampsia, pregnancy induced hypertension, preterm birth, small/large for gestational age and child loss. Results:In pre-eclamptic mean triglycerides levels were (254 mg/dl ± 0.45 versus 116.59 ± 4.9) significantly higher than normal controls (p<0.05). Mean HDL-Cholesterol levels were (36.92 mg/dl ± 7.70 versus 51 ± 5.46) statistically significantly higher than normal controls (p<0.05). Mean LDL-Cholesterollevels were(132.95mg/dl ± 32.26 versus 99.36 ± 17.75) statistically significantly higher in pre-eclamptic as compared to normal controls (p<0.05). Conclusion: Pre-eclamptic women had deranged lipid profile as compared to normal pregnant women.

A study of effect of alcohol consumption on cardiovascular biomarkers in a tertiary care centre in the Kumaon Region

An important mechanism responsible for increased cardiovascular risks in chronic excessive alcohol use is the pro-oxidant effects of alcohol. There are some emerging risk factors like :- (i) lipoprotein(a) {Lp[a]}, (ii) High‑sensitivity C‑reactive protein (hs‑CRP), (iii) Lipid profile, (iv) Prothrombotic and proinflammatory factors that play an important role in the pathogenesis of atherosclerosis. So we investigated the relation between the levels of cardiovascular biomarkers & the degree of alcohol intake in alcoholic subjects. The present study was carried out in the Department of Biochemistry, in association with the Department of Medicine, Government Medical College, Haldwani. Estimation of Serum Level of hs-CRP & Lp (a) byturbidimetric immunoassay. Serum Cholesterol by CHOD-POD & Triglycerides by enzymatic colorimetric method. LDL cholesterol was calculated by Friedwald equation.The mean total cholesterol, TG, LDLc, hs-CRP, Lp(a) & including HDLc levels were significantly raised (p < 0.05) in cases as compared to controls. The mean serum total cholesterol & Lp (a) levels showed no significant association across different alcohol drinking groups (p>0.05). The mean TG & LDLc levels were significantly (p<0.05) higher in occasional drinkers and heavy drinkers than that of low-moderate & moderate drinkers. The mean serum HDL cholesterol levels in the occasional drinkers were significantly elevated in comparison to the low-moderate drinkers, moderate drinkers and heavy drinkers. The mean serum hs-CRP level in the mediocre and heavy drinkers was significantly low (p<0.05) as compared occasional drinkers and low-moderate drinkers. Our study suggests heavy drinking (>30drinks/week) must be strongly discouraged as it may lead to changes in cardiovascular markers and dyslipidemia. Our study also showed a beneficial effect of occasional drinking on HDLc and moderate drinking on hs-CRP.

IMPACT OF PLASMA HDL CHOLESTEROL LEVELS, MEASURED ONE YEAR BEFORE ACUTE MYOCARDIAL INFARCTION, ON MORTALITY AFTER THE ACUTE EVENT

Introduction: Although epidemiological studies demonstrated that HDL cholesterol (HDL-C) levels are associated with higher cardiovascular risk, pharmacological interventions for elevated HDL-C levels have failed to show a risk reduction. Objective: To evaluate patients admitted for acute myocardial infarction (AMI) to determine whether HDL-C levels measured up to 1 year before the event have an impact on post-event mortality. Methods: A retrospective cohort study was conducted using data from the database of the Curitiba (Brazil) city hall. This study included 1,363 patients hospitalized from 2008 to 2015, with a diagnosis of infarction and available HDL-C values measured up to 1 year before the coronary event. The mean HDL-C levels obtained in this period and at 6 and 12 months after discharge were correlated with hospital mortality. Results: HDL-C levels of ≤35 mg/dL resulted in lower mortality than values of ≥50 mg/dL. This indicates that the mortality risk of patients with HDL-C levels of ≥50 mg/dL was 30% higher than ≤35 mg/dL, regardless the age and the total follow up. The survival rate at 6 and 12 months of follow-up for patients with HDL-C levels of ≥50 mg/dL was reduced in relation to other quartiles, with higher evidence of mortality at 12 months. Conclusions: The patients with higher HDL-C levels in the year preceding an AMI presented worse prognosis than those with lower HDL-C levels after the acute event. This reinforces the paradoxical effect of HDL-C on cardiovascular risk and the results of recent intervention studies.

The Lipid Energy Model: Reimagining Lipoprotein Function in the Context of Carbohydrate-Restricted Diets

When lean people adopt carbohydrate-restricted diets (CRDs), they may develop a lipid profile consisting of elevated LDL-cholesterol (LDL-C) and HDL-cholesterol (HDL-C) with low triglycerides (TGs). The magnitude of this lipid profile correlates with BMI such that those with lower BMI exhibit larger increases in both LDL-C and HDL-C. The inverse association between BMI and LDL-C and HDL-C change on CRD contributed to the discovery of a subset of individuals—termed Lean Mass Hyper-Responders (LMHR)—who, despite normal pre-diet LDL-C, as compared to non-LMHR (mean levels of 148 and 145 mg/dL, respectively), exhibited a pronounced hyperlipidemic response to a CRD, with mean LDL-C and HDL-C levels increasing to 320 and 99 mg/dL, respectively, in the context of mean TG of 47 mg/dL. In some LMHR, LDL-C levels may be in excess of 500 mg/dL, again, with relatively normal pre-diet LDL-C and absent of genetic findings indicative of familial hypercholesterolemia in those who have been tested. The Lipid Energy Model (LEM) attempts to explain this metabolic phenomenon by positing that, with carbohydrate restriction in lean persons, the increased dependence on fat as a metabolic substrate drives increased hepatic secretion and peripheral uptake of TG contained within very low-density lipoproteins (VLDL) by lipoprotein lipase, resulting in marked elevations of LDL-C and HDL-C, and low TG. Herein, we review the core features of the LEM. We review several existing lines of evidence supporting the model and suggest ways to test the model’s predictions.

Age- and Gender-Related Serum Level of Interleukin 18 in Iranian Fars Ethnic Group with Metabolic Syndrome.

Background: The purpose of the present study was to investigate the age- and gender-related serum level of interleukin 18 (IL18) in male and female Iranian Fars ethnic group with metabolic syndrome components. Methods: The study included 226 native Iranian Fars ethnic groups. One hundred sixteen females and 110 men were selected. There were 60 females and 50 males with metabolic syndrome and 56 females and 60 males without metabolic syndrome. The serum fasting blood glucose (FBS), lipid profiles, and IL18 were measured. The National Cholesterol Education Program Adult treatment Panel III criteria were used to determine metabolic syndrome components. Results: There were significant differences between the males and females [except high-density lipoprotein (HDL)] with and without metabolic syndrome for the mean body mass index, FBS, HDL-cholesterol, waist circumference (WC), triglyceride (TG), and IL18 levels in all age groups. Serum IL18 was the highest in males and females in age groups 61-70 and 41-50 years with metabolic syndrome, respectively. Serum IL18 levels significantly correlated with TG and waist WC in males (and also correlated with HDL) and females with the metabolic syndrome. There were significant correlations between IL18 and TG and WC in males (and also correlated with HDL) in ages 61-70 years and females in ages 41-50 years with the metabolic syndrome. Conclusions: The increased IL18 level in both gender and different ages may have an important role in the alteration of some metabolic syndrome components. These alterations may be made to happen in different related metabolic diseases. IL18 seems to be a useful biomarker for the management of metabolic syndrome components and the risk factors of cardiovascular disease.

Gender-Related Differences and Short-Term Outcome of Stroke: Results from a Hospital-Based Registry in Sub-Saharan Africa

Background: Studies suggest that sex differences have an impact on patients with stroke, but existing data in Africa remain inconclusive about this inference. Objectives: To study sex differences in terms of the clinical profile and short-term outcome of stroke in the Douala General Hospital, Cameroon. Methods: A hospital-based prospective cohort study was carried out in a tertiary care hospital over an 8-year period, which included all patients admitted for confirmed acute stroke. Information about the history of stroke with emphasis on clinical profile and outcome was collected. Descriptive statistics, t test, and chi square test were used for comparisons, while the Kaplan-Meier curve was used for survival rate analysis. Results: Of the 818 patients included, 455 (55.6%) were male patients. When compared to males, female patients are more likely to experience a stroke at an older age (mean age 62.3 ± 14.1 vs. 58.4 ± 12.9 years, p < 0.001), to be unmarried, to remain unemployed, and to have higher rates of cardio-embolic stroke (p = 0.049), body mass index (p = 0.031), altered levels of consciousness at presentation (p = 0.005), higher mean HDL cholesterol levels (p = 0.001), and in-hospital complications (p = 0.011), especially urinary tract infections (p = 0.018). Males were more likely to have health insurance, to smoke, to consume alcohol (p < 0.001), and to have higher rates of dysarthria (p = 0.004), higher mean uric acid (p = 0.013), and creatinine (p < 0.001) concentrations. Ischemic and hemorrhagic strokes were more prevalent in men (p = 0.003). There are no sex differences in terms of stroke severity, length-of-hospital stay, case fatality, and functional outcome on admission. Conclusions: Sex differences exist in the clinical profile of stroke but not in the outcome. Knowledge of these differences could help influence stroke prevention, thereby improving stroke burden in Africa.

The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study

BackgroundThe existence of a bi-directional relationship between tuberculosis (TB) and insulin resistance (IR)/diabetes has been alluded to in literature. Although diabetes has been linked to increased tuberculosis risk, the relationship between tuberculosis as a causative factor for IR remains unclear. The study aimed to determine if an association existed between tuberculosis and IR development in adults with newly diagnosed pulmonary tuberculosis at baseline. It was additionally aimed to document changes in IR status during TB follow-up periods.MethodsThis cross-sectional study evaluated ambulatory participants at baseline for IR prevalence via anthropometry, biochemistry and diagnostic IR tests [homeostasis model assessment-IR (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI)]. A prospective cohort sub-section study was additionally performed on approximately half of the baseline study population, who were followed-up at two and five months whilst on tuberculosis treatment. Summary statistics, correlation co-efficients and appropriate analysis of variance were used to describe and analyse data. Participants were excluded if they presented with other forms of tuberculosis, were HIV-positive, obese or had any pre-disposing IR conditions such as diabetes or metabolic syndrome.ResultsFifty-nine participants were included from August 2013 until December 2014 (33.95 ± 12.02 years old; 81.4% male). IR prevalence was 25.4% at baseline, determined by a calculated HOMA-IR cut-off point of 2.477. Patients with IR were younger (p = 0.04). Although the difference between IR levels in participants between baseline and follow-up was not significant, a decrease was observed over time. The majority of participants (61.0%) presented with a normal BMI at baseline. Mean baseline values of fasting glucose were within normal ranges (4.82 ± 0.80 mmol/L), whereas increased mean CRP levels (60.18 ± 50.92 mg/L) and decreased mean HDL-cholesterol levels (males: 0.94 ± 0.88 mmol/L; females: 1.14 ± 0.88 mmol/L) were found.ConclusionsThe study found an association between tuberculosis and IR development in newly diagnosed pulmonary tuberculosis patients. Although not significant, IR levels decreased over time, which could be indicative of a clinical improvement. A high prevalence of IR amongst young tuberculosis patients therefore highlights the need for early identification in order to facilitate a reversal of IR and prevent possible IR-related complications.

Serum homocysteine and cysteine levels and changes in the lipid profile of children and adolescents over a 12-month follow-up period

There is evidence of associations between high serum homocysteine (Hcy) and cysteine (Cys) levels and changes in the lipid profile of adults; however, little information is available with respect to these associations in the pediatric age group. To identify the effect of high baseline serum Hcy and Cys levels, alone or in conjunction, on the lipid profile of children and adolescents over a 12-month follow-up period. A cohort study involving 540 boys and girls of 7-15 years of age was conducted over 12 months. The outcome variables were the lipid indicators and the principal exposure variable was serum Hcy and Cys levels. A generalized estimating equation (GEE) approach was used to identify the associations of interest. Irrespective of age, sex, socioeconomic status, diet or anthropometric status, when serum Hcy levels were above the 5th quintile of distribution at baseline, HDL-cholesterol decreased by a mean of 2.91mg/dl (p<0.01), while triglyceride levels increased by a mean of 1.58mg/dl (p<0.01) over the 12-month follow-up period. In individuals with high baseline Cys levels, there was a reduction of 1.95mg/dl (p<0.01) and an increase of 1.76mg/dl (p<0.01) in mean serum HDL-cholesterol and triglyceride levels, respectively, over the 12-month period. When serum Hcy and Cys levels were both above the 5th quintile of distribution at baseline, there was a reduction of 3.65mg/dl (p<0.01) in mean HDL-cholesterol and an increase of 3.53mg/dl (p<0.01) in mean triglyceride levels in the 12 months of follow-up. High baseline serum Hcy and Cys levels resulted in a reduction in mean HDL-cholesterol levels and an increase in mean triglycerides levels over the 12 months of follow-up in children and adolescents, with these alterations being greater when these two biochemical parameters were simultaneously high at baseline.

Tobacco Smoke Exposure Reduces Paraoxonase Activity in a Murine Model

AIM: To demonstrate a direct inhibitory effect of cigarette smoke exposure on paraoxonase 1 activity in a murine in vivo model. METHODS: At 8 weeks old, we randomized 10 C57/bl6 mice to an environment consisting of either filtered air or cigarette smoke for 6 months. Smoke exposure (7 hours per day, 5 days per week) was standardized using a model TE-10 smoking machine and adjusted to maintain constant sidestream and mainstream smoke. After 6 months of exposure, we assessed differences in lung air space, cholesterol, lipid, and lipoprotein profiles, as well as paraoxonase activity in mice exposed to cigarette smoke extract compared to unexposed control mice. RESULTS: Cigarette smoke exposure by the protocol used was sufficient to result in pathologic changes in lung architecture consistent with emphysema. Specifically, we observed that mice exposed to cigarette smoke had a significantly higher mean linear chord length compared to animals that were exposed to filtered air (p&lt;0.02). Despite this exposure, no differences in total HDL-cholesterol levels or HDL-cholesterol sub-fractions (i.e. HDL2 and HDL3 fractions) were noted between smoke-exposed and unexposed animals (p=1.00, 0.6, and 0.4, respectively). Notably, mean HDL-cholesterol levels were identical between groups (92.8 vs 92.8 mg/dL, p=1.0). Paraoxonase activity, however, was markedly reduced in mice exposed to cigarette smoke compared to those who were not exposed (102, SD=9.6 vs 144, SD=4.1 units of activity, respectively, p=0.002). CONCLUSION: In this murine model, tobacco smoke exposure directly inhibits paraoxonase activity independently of HDL-cholesterol levels rather than indirectly via reduction in HDL-cholesterol levels.

Mutational Analysis of GATA4 and NKX2.5 Genes in Dilated Cardiomyopathy Patients

Purpose: To evaluate the lipid profile abnormalities and association of the GATA4 (1232 C→T) and NKX 2.5 (73C→T) gene polymorphisms with Dilated cardiomyopathy (DCM) among Chinese population. Methods: The blood samples were collected from the Outpatient Department (OPD) of Cardiology Unit, Zhengzhou Central Hospital, China for a period of three years from 2010 – 2013. Dilated cardiomyopathy cases (n = 270) and healthy controls (n = 290) were genotyped using polymerase chain reaction (PCR), restriction fragment length polymorphism, (RFLP) denaturing high-performance liquid chromatography (DHPLC) and sequencing. Results: Evaluation of the age and sex of the patients indicated that DCM was more prevalent among males (71.1 %) than in females (28.9 %). Mean (± SD) values of the serum total cholesterol and serum LDL-cholesterol were higher in DCM patients (4.37 ± 0.16 and 3.19 ± 0.14 mmol/L, respectively) compared to the control group (4.29 ± 0.18 and 3.06 ± 0.19 mmol/L, respectively), while as there was significantly lower serum mean (± SEM) HDL-cholesterol levels in patients with DCM than in controls (p < 0.001). Exon 1 region of NKX 2.5 gene was screened for variations at 73C→T keeping in view both parameters (age and sex) among healthy controls and DCM patients. The results indicate that the homozygous mutant (TT) and heterozygous mutant (CT) nucleotides were significantly higher in DCM patients than in controls. Further analysis of GATA4 gene revealed that five DCM patients had 1232C/T variant, whereas, it was absent in the control group. Conclusion: GATA4 1232C/T and NKX 2.5 73C→T polymorphisms and high levels of serum triglycerides (TG) may be associated with the pathogenesis of DCM in the studied population Keywords: Dilated cardiomyopathy, Congestive heart failure, Polymerase chain reaction, Restriction fragment length polymorphism, Denaturing high-performance liquid chromatography

Lipid profile in patients with alcohol dependence syndrome

BACKGROUND: Alcohol dependence syndrome (ADS) has become a global public health challenge because of its high prevalence and the concomitant increase in risk of liver disease, cardiovascular disease and premature death. Influence of alcohol use on lipid metabolism is well recognized. Investigations had been carried out in the earlier period on abnormal lipid profile as a risk factor for Coronary Heart disease (CHD). Patients of alcohol dependence usually have a consumption pattern of more heavy use. Therefore it is useful to study the lipid profile in patients of alcohol dependence, to understand the effects of increasing levels of consumption. METHODS: This cross-sectional study was conducted in TU Teaching Hospital. ADS patients were screened by the consultant psychiatrist using the Alcohol Use Disorder Identification Test (AUDIT) questionnaire. A total of 89 patients scored positive on the AUDIT as having alcohol-related problems and were included in the study. 89 ADS patients and 89 healthy controls both male and female were enrolled as participants. Blood Pressure and other anthropometric parameters were measured while fasting blood samples were analyzed for serum lipid profile. SPSS program was used to analyze data, t-test &amp; Spearman's correlation coefficient was used to find correlation. RESULTS: Among the ADS cases 95% were current smokers. Mean age of cases and controls was 35.42±5.6 &amp; 34.53±3.5 years respectively. The mean total cholesterol levels were found to be higher in cases (5.41±0.70) than controls (3.79±0.74) with a strong statistical significance (p&lt;0.001). Also, Mean triglyceride (TG) levels (2.09±0.72), along with the mean HDL-cholesterol (1.66±0.40) and LDL-cholesterol levels (2.79±0.81) were also elevated in cases when compared to the control samples (p&lt;0.001). CONCLUSION: This study has demonstrated definitive lipid profile changes in patients of alcohol dependence, with some correlation to the liver dysfunction. Alcohol causes alteration in various parameters of lipid metabolism including those which predispose to CHD. Low to moderate alcohol use over prolonged periods has been linked to have protective influence for development of coronary heart disease (CHD), through increase in high density lipoprotein cholesterol (HDL-C) levels. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12312 Ann. Clin. Chem. &amp; Lab. Med. 1(1) 2015: 29-32

The rs13064411 polymorphism in the WDR52 gene, associated with PCSK9 levels, modifies statin-induced changes in serum total and LDL cholesterol levels.

Recently, the minor allele of the rs13064411A>G polymorphism in the WD repeat domain 52 (WDR52) gene was associated with increased statin-induced proprotein convertase subtilisin/kexin type 9 (PCSK9) levels and with LDL cholesterol response to statins. PCSK9 promotes LDL receptor degradation, leading to increased serum LDL cholesterol. We investigated whether the polymorphism was associated with cholesterol response to statins. We identified 1105 current, 322 past, and 4831 never statin users during follow-up in the prospective population-based Rotterdam Study. The mean delta total, LDL, and HDL cholesterol levels between current and no current statin users with the same number of minor alleles were analyzed using random-effect repeated measurements. We adjusted for age, sex, number of cholesterol measurements, and follow-up time. Compared with no users with the same genotype, current statin users carrying a minor allele showed a statistically significantly lower delta total and LDL cholesterol compared with reference homozygous major allele carriers [total: Δ=0.551 mmol/l (AG+GG) vs. Δ=0.732 mmol/l (AA), Pinteraction: 5.2×10(-7); LDL: Δ=0.566 mmol/l (AG+GG) vs. Δ=0.720 mmol/l (AA), Pinteraction: 1.8×10(-5)]. The effect was stronger in women (Pinteraction: 2.0×10(-5) for LDL cholesterol, 8.0×10(-6) for total cholesterol) and in high-dose users (defined daily doses>1.00) (Pinteraction: 7.0×10(-5) for LDL cholesterol, Pinteraction: 0.081 for total cholesterol). The polymorphism was not associated with HDL cholesterol in current statin users, or with total, LDL and HDL cholesterol in never statin users. The minor G allele of the rs13064411 polymorphism, associated with statin-induced PCSK9-levels, was associated with a decreased LDL-lowering and total cholesterol-lowering response to statins.

Serum Lipid Profiles in Pediatric Systemic Lupus Erythematosus Patients: A Study from Bangladesh

Aim: To assess the lipid profile in pediatric SLE (pSLE) patients in active disease state and compare it with inactive state. Methodology: It was an observational study carried out in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka-1000, Bangladesh from January 2013 to June 2014. A total 30 patients fulfilling the ACR 1997 criteria were enrolled in this study. Age and sex matched 15 controls were also included. Lipid profiles were measured at diagnosis, at 3 months follow up and at 9 months follow up. Results: At the time of diagnosis, pSLE patients’ mean triglyceride level and HDL cholesterol levels were significantly abnormal. At 3 three months follow up, when disease activity was high and patients were on high dose steroid therapy, there was increased total, LDL and HDL cholesterol level. At 9 months follow up when most of the patients had inactive disease and were on low dose steroid, all the lipids were within normal range. Comparison of active disease group with inactive disease group at 9 months found significant improvement of total cholesterol, triglycerides and HDL cholesterol levels. Conclusion: Control of SLE seems to be the most important factor in normalizing the lipids.

The effect of Metformin on endometrial tumor-regulatory genes and systemic metabolic parameters in polycystic ovarian syndrome – a proof-of-concept study

The aim of this proof-of-concept study was to determine the effects of three-month Metformin therapy on the expression of tumor-regulatory genes (p53, cyclin D2 and BCL-2) in the endometrium of women with polycystic ovary syndrome (PCOS). A total of 40 women, aged between 21 and 45 years with PCOS (Rotterdam criteria) were recruited. The participants were assessed at pre- and 3-month-post-Metformin therapy for the menstrual regularities, weight reduction, Ferriman Galway scores, fasting blood glucose (FBG), total cholesterol, LDL, HDL and p53, BCL-2 and cyclin D2 gene expression. Five participants conceived spontaneously after the initial recruitment. Majority (68%) resumed regular menstrual cycles after Metformin. There were significant reduction in BMI (p = 0.001), weight (p = 0.001) and Ferriman Galway scores (p = 0.001). A significant improvement was seen in mean FBG (p = 0.002), total cholesterol (p = 0.001), LDL (p = 0.003) and HDL cholesterol levels (p = 0.015). Tumor suppressor gene (p53) was significantly up-regulated after Metformin (10 out of 14 women), with p value 0.016. BCL-2 and cyclin D2 (oncogenes) were slightly up-regulated without significant difference (p = 0.119 and 0.155, respectively). In conclusion, Metformin therapy improved clinical and metabolic parameters in women with PCOS and up-regulated p53 tumor suppressor gene significantly. Further studies are however required to independently validate our findings.

Predictive value of HDL cholesterol for cancer‐associated venous thromboembolism during chemotherapy

Dyslipidemia is a well-known risk factor for the development of atherothrombosis; however, its involvement in venous thromboembolism (VTE) is still debated. Low levels of HDL cholesterol (HDL-C) have been found to be associated with VTE, which is a common complication of cancer and its treatment. VTE incidence is increased in cancer patients, especially those undergoing chemotherapy. We sought to investigate the value of pretreatment HDL-C in the risk prediction of future VTE in a population of ambulatory cancer patients undergoing chemotherapy. Blood lipid composition was retrospectively evaluated in 592 consecutive patients with primary (n = 373) or relapsing/recurrent (n = 219) solid cancers at the start of a new chemotherapy regimen (12% neoadjuvant, 31% adjuvant, 57% metastatic). VTE occurred during chemotherapy in 38 patients (median time-to-event: 3 months). Mean HDL-C levels were lower in patients who developed VTE during chemotherapy (41 mg dL(-1) ; standard deviation [SD] 13 mg dL(-1) ) than in those who did not (48 mg dL(-1) ; SD 14 mg dL(-1) ). Cox proportional hazard survival analysis showed that HDL-C levels ≤ 43 mg dL(-1) were able to significantly predict a first VTE episode, with a hazard ratio of 2.87 (95% confidence interval 1.45-5.68). Moreover, patients with HDL-C levels ≤ 43 mg dL(-1) had worse 1-year VTE-free survival (86%) than those with HDL-C levels > 43 mg dL(-1) (96%; log rank test, 3.14). Patients with low HDL-C levels have a three-fold higher risk of developing a first VTE episode during chemotherapy. Baseline analysis of HDL-C levels might be of clinical value in predicting VTE in cancer outpatients treated with anticancer drugs.

Dietary advice for reducing cardiovascular risk.

Changes in population diet are likely to reduce cardiovascular disease and cancer, but the effect of dietary advice is uncertain. This review is an update of a previous review published in 2007. To assess the effects of providing dietary advice to achieve sustained dietary changes or improved cardiovascular risk profile among healthy adults. We searched the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects (DARE) and the HTA database on The Cochrane Library (Issue 4, 2010). We searched MEDLINE (Ovid) (1950 to week 2 October 2010) and EMBASE (Ovid) (1980 to Week 42 2010). Additional searches were done on CAB Health (1972 to December 1999), CVRCT registry (2000), CCT (2000) and SIGLE (1980 to 2000). Dissertation abstracts and reference lists of articles were checked and researchers were contacted. Randomised studies with no more than 20% loss to follow-up, lasting at least three months and involving healthy adults comparing dietary advice with no advice or minimal advice. Trials involving children, trials to reduce weight or those involving supplementation were excluded. Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. Forty-four trials with 52 intervention arms (comparisons) comparing dietary advice with no advice were included in the review; 18,175 participants or clusters were randomised. Twenty-nine of the 44 included trials were conducted in the USA. Dietary advice reduced total serum cholesterol by 0.15 mmol/L (95% CI 0.06 to 0.23) and LDL cholesterol by 0.16 mmol/L (95% CI 0.08 to 0.24) after 3 to 24 months. Mean HDL cholesterol levels and triglyceride levels were unchanged. Dietary advice reduced blood pressure by 2.61 mm Hg systolic (95% CI 1.31 to 3.91) and 1.45 mm Hg diastolic (95% CI 0.68 to 2.22) and 24-hour urinary sodium excretion by 40.9 mmol (95% CI 25.3 to 56.5) after 3 to 36 months but there was heterogeneity between trials for the latter outcome. Three trials reported plasma antioxidants, where small increases were seen in lutein and β-cryptoxanthin, but there was heterogeneity in the trial effects. Self-reported dietary intake may be subject to reporting bias, and there was significant heterogeneity in all the following analyses. Compared to no advice, dietary advice increased fruit and vegetable intake by 1.18 servings/day (95% CI 0.65 to 1.71). Dietary fibre intake increased with advice by 6.5 g/day (95% CI 2.2 to 10.82), while total dietary fat as a percentage of total energy intake fell by 4.48% (95% CI 2.47 to 6.48) with dietary advice, and saturated fat intake fell by 2.39% (95% CI 1.4 to 3.37).Two trials analysed incident cardiovascular disease (CVD) events (TOHP I/II). Follow-up was 77% complete at 10 to 15 years after the end of the intervention period and estimates of event rates lacked precision but suggested that sodium restriction advice probably led to a reduction in cardiovascular events (combined fatal plus non-fatal events) plus revascularisation (TOHP I hazards ratio (HR) 0.59, 95% CI 0.33 to 1.08; TOHP II HR 0.81, 95% CI 0.59 to 1.12). Dietary advice appears to be effective in bringing about modest beneficial changes in diet and cardiovascular risk factors over approximately 12 months, but longer-term effects are not known.

Increased acylation stimulating protein levels in young obese males is correlated with systemic markers of oxidative stress

As little is known about relationship between acylation stimulating protein (ASP) and oxidative stress, whether there is any link between ASP and oxidative stress in young obese males were investigated. Forty-five obese (median body mass index (BMI) = 36.99 (IQR = 3.65) kg m(-2)) male subjects (median age = 22 (IQR = 6) years) and 24 age-matched (median age = 22.5 (IQR = 4.8) years) healthy male volunteers (median body mass index (BMI) = 23.67 (IQR = 2.45) kg m(-2)) were recruited into the study. All obese subjects have BMI > 30 kg m(-2), while all controls have BMI < 25 kg m(-2). Fasting plasma ASP, lipid hydroperoxide, high sensitivity C-reactive protein (hs-CRP), fasting insulin, triglyceride, LDL-cholesterol levels and HOMA-IR were higher, whereas the mean HDL-cholesterol levels and glutathione peroxidase (GPx) enzyme activity were significantly lower in obese subjects than controls. The linear regression analysis showed that lipid hydroperoxide was independently associated with only BMI, while ASP was independently associated with BMI and triglyceride. The present data support the concept that obesity occurs under condition of compex interactions by adipokines, insulin, inflammation, and oxidative stress.

Dietary advice for reducing cardiovascular risk.

Changes in population diet are likely to reduce cardiovascular disease and cancer, but the effect of dietary advice is uncertain. This review is an update of a previous review published in 2007. To assess the effects of providing dietary advice to achieve sustained dietary changes or improved cardiovascular risk profile among healthy adults. We searched the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects (DARE) and the HTA database on The Cochrane Library (Issue 4, 2010). We searched MEDLINE (Ovid) (1950 to week 2 October 2010) and EMBASE (Ovid) (1980 to Week 42 2010). Additional searches were done on CAB Health (1972 to December 1999), CVRCT registry (2000), CCT (2000) and SIGLE (1980 to 2000). Dissertation abstracts and reference lists of articles were checked and researchers were contacted. Randomised studies with no more than 20% loss to follow-up, lasting at least three months and involving healthy adults comparing dietary advice with no advice or minimal advice. Trials involving children, trials to reduce weight or those involving supplementation were excluded. Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. Forty-four trials with 52 intervention arms (comparisons) comparing dietary advice with no advice were included in the review; 18,175 participants or clusters were randomised. Twenty-nine of the 44 included trials were conducted in the USA. Dietary advice reduced total serum cholesterol by 0.15 mmol/L (95% CI 0.06 to 0.23) and LDL cholesterol by 0.16 mmol/L (95% CI 0.08 to 0.24) after 3 to 24 months. Mean HDL cholesterol levels and triglyceride levels were unchanged. Dietary advice reduced blood pressure by 2.61 mm Hg systolic (95% CI 1.31 to 3.91) and 1.45 mm Hg diastolic (95% CI 0.68 to 2.22) and 24-hour urinary sodium excretion by 40.9 mmol (95% CI 25.3 to 56.5) after 3 to 36 months but there was heterogeneity between trials for the latter outcome. Three trials reported plasma antioxidants, where small increases were seen in lutein and β-cryptoxanthin, but there was heterogeneity in the trial effects. Self-reported dietary intake may be subject to reporting bias, and there was significant heterogeneity in all the following analyses. Compared to no advice, dietary advice increased fruit and vegetable intake by 1.18 servings/day (95% CI 0.65 to 1.71). Dietary fibre intake increased with advice by 6.5 g/day (95% CI 2.2 to 10.82), while total dietary fat as a percentage of total energy intake fell by 4.48% (95% CI 2.47 to 6.48) with dietary advice, and saturated fat intake fell by 2.39% (95% CI 1.4 to 3.37).Two trials analysed incident cardiovascular disease (CVD) events (TOHP I/II). Follow-up was 77% complete at 10 to 15 years after the end of the intervention period and estimates of event rates lacked precision but suggested that sodium restriction advice probably led to a reduction in cardiovascular events (combined fatal plus non-fatal events) plus revascularisation (TOHP I hazards ratio (HR) 0.59, 95% CI 0.33 to 1.08; TOHP II HR 0.81, 95% CI 0.59 to 1.12). Dietary advice appears to be effective in bringing about modest beneficial changes in diet and cardiovascular risk factors over approximately 12 months, but longer-term effects are not known.

Plasma hormones, metabolites, milk production, and cholesterol levels in Murrah buffaloes fed with Asparagus racemosus in transition and postpartum period

Ten dry and pregnant Murrah buffaloes were selected to investigate the effect of Asparagus racemosus feeding on hormones, metabolites, milk yield, and plasma cholesterol levels. The treatment groups of buffaloes were fed with A. racemosus (shatavari) @ 150 g/day/animal during prepartum and @ 300 g/day/animal during the postpartum period. Blood samples collected on -6, -4, -2-week, day of parturition (0), and +2, +4, and +6-week postpartum were analyzed for plasma total cholesterol, triglycerides, HDL, low-density lipoproteins (LDL), prolactin, cortisol, and blood metabolites. Milk samples collected at weekly intervals (+1, +3, +5, and 7 weeks) were analyzed for total milk fat cholesterol. Prepartum plasma cholesterol concentrations were significantly higher in treatment group over the control (P < 0.05). Mean plasma triglycerides, LDL cholesterol, HDL cholesterol, glucose, and nonesterified fatty acid (NEFA) levels varied nonsignificantly between groups. Plasma prolactin and cortisol concentrations were significantly (P < 0.01) more in treatment group than in control group. On day of parturition, plasma prolactin, cortisol, LDL, and plasma total cholesterol were higher (P < 0.01) in treatment group buffaloes in comparison to control group. A. racemosus feeding significantly (P < 0.01) increased plasma prolactin, cortisol (P < 0.01), and milk fat cholesterol (P < 0.05) without affecting total cholesterol, HDL, LDL, glucose, and NEFA concentrations. The buffaloes of treatment group produced more milk (@ 0.526 kg/animal/day) suggesting thereby that A. racemosus is galactopoietic. It was concluded that feeding of A. racemosus increases plasma prolactin and cortisol and decreased plasma total cholesterol and LDL concentration.