Mean HDL Levels Research Articles

Pre- and post-pandemic comparisons in cardiovascular markers: a population-based study

IntroductionThe COVID-19 pandemic, starting in 2020, raised concerns about potential long-term health impacts, including its effects on cardiovascular health and related biomarkers. This study part of the Bus Santé in Geneva, Switzerland, compared cardiovascular and metabolic profiles pre- (2016–2019) and post-pandemic (2023–2024) among individuals aged 30–75.MethodsParticipants completed questionnaires and underwent a clinical visit, including a physical examination and fasting blood test to assess lipid and glycemic profiles. Linear regression was used to estimate results including mean systolic and diastolic blood pressure, cholesterol, and glycemic profiles, after adjusting for age, sex, smoking, and socioeconomic status. Quantile regression models were used to estimate median values.ResultsA total of 4,558 participants were included. The study observed modest declines in mean glucose, cholesterol, HDL, and LDL levels post-pandemic, with stable blood pressure. The prevalence and treatment rates of diabetes, hypertension, and dyslipidemia remained consistent. Unawareness of these conditions was stable.ConclusionDespite initial fears of a pandemic-induced health debt, results indicate healthy cardiovascular profiles post-pandemic, likely driven by improved lifestyle behaviors. This study highlights the importance of monitoring of cardiovascular health and suggests that lifestyle improvements may offset potential adverse pandemic effects in developed nations like Switzerland.

Abstract 4138035: Inclisiran in Routine Clinical Practice: Results from a Nationwide Study of >5,000 Patients

Introduction: Inclisiran is a small interfering RNA drug which inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9). Inclisiran was recently approved for the treatment of hypercholesterolemia and durably lowers LDL levels by around 50% with injections once every six months based on the results of large, randomized controlled trials. However, no nationwide studies have evaluated the use or effectiveness of Inclisiran in routine clinical practice. Goals/Aims: To characterize the use and effectiveness of Inclisiran in routine clinical practice in a large nationwide cohort. Methods/Approach: We used the Truveta healthcare database, a large nationwide database of electronic health records, to study patients who were administered Inclisiran up to September 2023. Patient demographic characteristics and lipid levels before and after treatment were summarized. Means and 95% confidence intervals were estimated using t-tests. Results/Data: A total of 5,256 patients (median age 71, first quartile 65, third quartile 76) were prescribed Inclisiran, of whom 2,919 (55.5%) were Female. In terms of race, most of the patients identified as White (81.0%), and a smaller proportion as African American (7.3%), Asian (2.1%), or American Indian/Alaska Native (0.5%); 7.3% of patients identified as more than one race or did not provide race data. Mean LDL and HDL levels (mg/dL) before Inclisiran were 125 (95% CI 123-127) and 51 (95% CI 51-52) respectively and after Inclisiran were 88 (95% CI 85-90) and 50 (95% CI 49-51) respectively. The mean difference in LDL after treatment was -39 (95% CI -42 to -37) mg/Dl for a mean percent change of -22% (95% CI -25% to -19%). Effects of Inclisiran on LDL levels are shown in Figure 1. At the conference, we will compare effects of Inclisiran to those of Alirocumab and Evolocumab (two older monoclonal antibodies against PCSK9) using a propensity score overlap weighting design. Conclusions: In a large cohort of patients administered Inclisiran in routine clinical practice, Inclisiran use was associated with substantial decreases in LDL levels, but those decreases were nonetheless smaller than the effects seen in randomized controlled trials of the drug.

Association between pseudoexfoliation syndrome and dyslipidemia: A case control study

: Pseudoexfoliation syndrome, also known as PEX 1, is a systemic micro fibrillopathy associated with ageing that is brought on by the gradual buildup of extracellular white and grey matter on various ocular and extra ocular structures. It is deposited in extra-ocular tissues such the heart, blood vessels, meninges, liver, and lungs. Numerous investigations have shown a connection between PEX and glaucoma. A person with PEX is typically thought to be at risk for acquiring glaucoma, and vice versa.Atherosclerosis is facilitated by dyslipidemia, which is an increase in plasma cholesterol, triglycerides (TGs), or both, or a low HDL level. A potential risk factor for the progression of cardiovascular disease is dyslipidemia. Numerous investigations have discovered abnormal lipid profiles in pseudoexfoliation syndrome patients, including elevated levels of triglycerides, cholesterol, and LDL. Due to the straight association between lipid levels, atherosclerosis, and cardiovascular risk, patients with PEX are shown to be at an elevated risk of cardiovascular and cerebrovascular events.To study the correlation between dyslipidemia and pseudoexfoliation syndrome in patients above 50 years of age and compare it with age matched controls.This case control study was conducted from November 2020 to November 2022 at SKIMS Medical College and Hospital, Srinagar and included 150 patients with PEX above 50 years of age and compared with age matched controls. In this study mean total cholesterol among cases was 176.88±34.76 mg/dl versus 172.94±51.51 mg/dl in controls. P-value for total cholesterol was statistically insignificant (0.438). Mean triglyceride level among cases was 180.11±54.70 mg/dl while as mean triglyceride level among controls was 163.14±46.21 mg/dl and P-value was found to be statistically significant. Mean LDL level among cases was 104.57±32.80 mg/dl while as in controls mean was 82.70±27.60 mg/dl. P-value for LDL levels was found to be statistically significant. Mean HDL levels among cases was found to be 41.93±8.94 mg/dl while as in controls mean was 39.67±13.73 mg/dl. P-value for HDL levels was statistically insignificant (0.09). Mean VLDL levels among cases was found to be 25.34±19.52 mg/dl while as in controls mean was 27.66±14.36mg/dl. P-value for VLDL levels was statistically insignificant (0.242).There is significant correlation between dyslipidemia and pseudoexfoliation syndrome in patients above 50 years of age.

Oxidative Stress in Depression: A Case-control Study of Serum MDA Levels and Lipid Levels in Patients With Depression in a Tertiary Care Hospital in South India

Introduction: Numerous theories have been proposed to substantiate the etiopathogenesis of depression. Recently, the hypothesis involving the oxidative stress (OS) pathway has been explored. Hence, potential markers are also being investigated for their role in depression. We aimed to assess the serum malondialdehyde (MDA) and serum lipid levels in individuals with depression and controls and explore associated factors. Methodology: A semi-structured questionnaire, complete with a mandatory consent form and a reliable, validated scale, namely the Hamilton Depression scale (HAM-D), was used. The method of sampling was purposive, with 100 depression cases in the psychiatry outpatient being included and 50 age-matched, gender-matched controls. Blood was collected from both groups to evaluate serum MDA and serum Lipid levels. Appropriate statistics using SPSS 20 were administered. Results: Our study had a female preponderance in cases, with 38% having major depressive disorder (MDD), 50% of whom showed suicidal ideas, and 10% had a prior history of deliberate self-harm. Mean HAM-D scores were higher in cases than controls, 18.57 ± 6.02, and mean MDA levels were higher in cases, 2.5 ± 1.02 mmol/L. HDL levels were lower in depression cases compared to controls, 38.34 ± 7.442. An inverse correlation was seen between mean serum MDA levels and HDL levels in depression cases. A significant relationship was observed between the parameters of depression and serum MDA levels. Conclusion: Significantly elevated mean serum MDA levels were observed in depression cases, along with significantly lowered mean HDL values compared to controls. We found a positive correlation between serum MDA levels and the severity, recurrence, and suicidality of depression. An inverse relation was observed between serum MDA values and mean HDL levels in depression. This emphasizes the need for clinical vigilance in employing these biomarkers not merely for assessment but also for HDL as a preventive measure in depression.

Biochemical Side Effect of Antiepileptic Drugs on Liver Enzymes, Lipid Profile and Haematological Profile in Epileptic Pediatric Patients

Antiepileptic drugs are large group of medications with variable mechanisms of action. There are various effects have been reported with long-term antiepileptic therapy. To assess the effects of the antiepileptic drugs on blood indices, liver function and lipid enzymes in epileptic pediatric age group. A comparative case-control study was performed in which 50 epilepsy cases were matched with 50 controls for age and sex. The mean age of the cases was 9.1(± 3.7) years, 86% from Benghazi. The 68% were primarily generalized seizure, 64% tonic clonic convulsion. The age at diagnosis between 2 months - 13 years. The 74% used Na-valproate as a single or a combined therapy and Carbamazepine was prescribed as a single medication in 18%. No statistical significant differences in the means of CBC indices and liver function profiles (AST and ALT) in the treatment groups compared to the control. Alkaline phosphatise was highly significant difference in the mean between the two groups (P=0.007). Mean of serum Cholesterol level showed higher in the cases than controls with highly statistical significant difference (P<0.001). HDL mean level is higher for cases on carbamazepine and Na-valproate group compared to controls with statistical significant difference (P=0.011). Cases on carbamazepine and Na-valproate group as well showed higher mean LDL level compared to the controls with statistically significant (P=0.006). No any statistical significant difference in means of CBC indices between epileptic patient treated with AED and control. Carbamazepine group expressed higher mean HDL level as compared to Na-valproate group, this difference is highly significant. Key words: Antiepileptic drugs, liver enzymes, lipid profiles.

Exploring the Association Between Systemic Lupus Erythematosus and High-Density Lipoproteins: A Systematic Review and Meta-Analysis.

Systemic lupus erythematosus (SLE) is an autoimmune disease with inflammation as a critical feature. Recently, high-density lipoprotein cholesterol (HDLc) have been evidenced to have anti-inflammatory effects, suggesting a potential link between HDL and SLE that needs to be thoroughly studied. The aim was to explore the association between SLE and HDLc through a systematic review with meta-analysis. A systematic review with meta-analysis was conducted to assess mean differences in HDL levels between patients with SLE and healthy controls. Both qualitative and quantitative syntheses were performed, including an assessment of heterogeneity using I2, a publication bias evaluation, a methodologic quality assessment, and a forest plot under a random effects model. Subgroup analyses were conducted based on disease activity and the report of corticosteroid dosage. A total of 53 studies were included in the qualitative synthesis, and 35 studies were included in the quantitative synthesis, comprising 3,002 patients with SLE and 2,123 healthy controls. Mean HDL levels were found to be lower in patients with SLE as follows: in the meta-analysis including all articles -6.55 (95% confidence interval [CI] -8.77 to -4.33); in patients with mild disease activity -5.46 (95% CI -8.26 to -2.65); in patients with moderate or severe disease activity -9.42 (95% CI -15.49 to -3.34); in patients using corticosteroids -5.32 (95% CI -10.35 to -0.29); and in studies with excellent methodologic quality -8.71 (95% CI -12.38 to -5.03). HDL levels appear to be quantitatively altered in patients with SLE, suggesting a potential contribution to immune dysregulation, highlighting the importance of HDL in autoimmune diseases.

Profile of Stroke Patients Admitted to the Medicine Unit of Dhaka Medical College Hospital

Background & objective: Stroke is a leading cause of death and a serious disability for adults. However, it is preventable and manageable, provided a complete updated profile (incidence, prevalence, and long-term outcome) of the disease is in our hands. The present study was therefore undertaken to assess the demographic, clinical characteristics, and outcome of the stroke patients admitted to the Dhaka Medical College Hospital. Methods: This descriptive cross-sectional study was conducted in the Department of Medicine, over a period of 12 months between January 2004 and December 2004 at the Dhaka Medical College Hospital (DMCH), Dhaka. The study sample consisted of 101 stroke patients who were admitted to the Green Medicine Unit of DMCH. However, stroke patients who were too severely debilitated or in a state of stupor were not allowed to participate in the study. Through pertinent clinical laboratory and imaging tests, stroke risk variables were evaluated. The outcome was evaluated in terms of the number of patients cured, died, or remained static. Result: There was no significant difference between ischemic and haemorrhagic stroke patients in terms of age (p = 0.658), sex (p = 0.276) and diurnal variation of its occurrence (p = 0.490). While diabetes mellitus and ischaemnic heart diseases were generally associated with haemorrhagic stroke (p = 0.039 and p = 0.056 respectively), hypertension was more or less common in ischemic stroke (p = 0.176). In both groups, hemiplegia was the most frequent cause of admission, after coma. While seizures were more common in the ischemia group, vomiting was a more common manifestation in the hemorrhagic group. The majority of patients in both groups maintained a steady pulse and normal blood pressure. The total cholesterol level was relatively greater in the ischemic group than in the hemorrhagic group. The mean HDL level in the hemorrhagic group was significantly higher than in the ischemic cohort. However, there was no appreciable difference in serum LDL and Tg levels across the groups. A substantial proportion of patients in both groups had to stay in the hospital for a brief period (10 or < 10 days). After receiving treatment, nearly 85% of the patients in the hemorrhagic group and 76.3% of the patients in the ischemic group were cured; some 5.5% in the ischemic group and 4.3% in the haemorrhagic group died of the disease. Conclusion: The study concluded that smoking, uncontrolled hypertension, and diabetes mellitus are the three main risk factors for stroke. After a median treatment of 7 days, most patients in both the hemorrhagic and ischemic groups recovered, leaving a few to die of the disease. The risk of stroke can significantly be reduced by lowering blood pressure, treating diabetes, and giving up smoking. Ibrahim Card Med J 2023; 13 (1&2): 47-52

Evaluation of Hyperlipidemia in Patients with Gallstones

Introduction: Gallstone disease is one of the biggest global public health problems. The most common complications associated with gallstone disease include cholecystitis, pancreatitis, and cholangitis. The current study aimed to show that serum lipids have a significant role in the etiology of cholelithiasis. Methods: Before surgery, all patients had blood samples taken. Lipid profile tests including very low-density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and total cholesterol (TC) were performed on the serum, which was collected using standard procedures. Results: The results showed that mean serum lipid levels were significantly different (P<0.001) between the patients and the control group. In addition, the study revealed statistically significant differences between the genders (P<0.001); in other words, significant differences were found between males and females in patients and controls in mean serum TC, HDL, and TG levels. On the other hand, the findings of the study indicated a notable rise (P<0.001) in serum TC, triglyceride, and HDL levels in the age category 40-59 years, followed by the age category≥60 years and the age category 29-39 years. Conclusion: Overall, changes in serum lipid profile are a possible consequence of the presence of gallstones; in other words, serum TC, HDL, and TG levels were significantly higher in patients with gallstone disease compared to the control group.

Role of Circulating Endocan as a Biomarker in Non-Alcoholic Fatty Liver Disease

Abstract Background Nonalcoholic fatty liver disease (NAFLD) has a prevalence of 25% worldwide and is described as the leading cause of chronic liver disease. Liver disease was found to be the third leading cause of death among persons with NAFLD. Its prevalence is increasing in conjunction with metabolic syndrome due to engaged risk factors, which include high body mass index and abdominal obesity, type 2 diabetes, dyslipidemia (high triglycerides and/or low high-densitylipoproteins), age, male sex, and alcohol consumption. Aim of the Work The aim of this study is to study serum level of Endocan in patients with nonalcoholic Fatty Liver disease (NAFLD) to detect its relation to the incidence and severity of nonalcoholic Fatty Liver Disease (NAFLD). Patients and Methods This study was conducted at Ain Shams University hospitals to evaluate the role of serum endocan as a diagnostic biomarker for NAFLD. We included a total of 100 subjects who were divided into two equal groups; Group 1 included 50 patients with NAFLD, and Group 2 included 50 healthy controls. Results Both BMI and waist circumference showed a significant increase in cases compared to controls. The prevalence of DM in the NAFLD group was 36% which was statistically significantly higher as compared with the control group. The mean SBP was statistically significantly higher in the NAFLD group, while DBP showed comparable findings. The mean liver size as detected by US was statistically significantly higher in the NAFLD group as compared with the control group, while spleen size didn’t reveal a statistically significant difference between the two groups. The mean fasting blood glucose, mean HbA1C, mean post-prandial glucose, mean cholesterol level, mean TGs, mean LDL, mean ALT and mean AST, mean ALP, mean GGT and mean ferritin level were statistically significantly higher in the NAFLD group as compared with the control group. The mean HDL level was statistically significantly lower in the NAFLD group as compared with the control group. Other laboratory variables were comparable between the two groups. The mean serum endocan level was statistically significantly higher in the NAFLD group as compared with the control group (54.58 ± 18.61 and 30.69 ± 6.49 respectively). Each of APRI, FIB-4 and NAFLD scores showed significant difference between the two groups. Conclusion Based on the previous findings, one can conclude that: Serum endocan may act as a surrogate marker for the diagnosis of NAFLD as it was significantly elevated in cases compared to controls. As well as detection of disease severity as it has a positive correlation with APRI, FIB-4 score yet still further studies on larger scales are required. This confirms the state of endothelial dysfunction associated with this disease NAFLD is associated with impaired lipid profile, impaired liver functions, and higher incidence of diabetes compared to controls.

Can the monocyte-to-HDL ratio be used as an inflammation marker in patients with fibromyalgia syndrome?

The monocyte-to-high-density lipoprotein (HDL) ratio (MHR) may be used as a marker of inflammation and oxidative stress. This study aimed to evaluate the use of MHR and platelet markers in patients with fibromyalgia syndrome (FMS) and demonstrate MHR's relationship with inflammation, the Fibromyalgia Impact Questionnaire (FIQ), and quality of life. Ninety FMS patients and 90 healthy controls, whose clinical and laboratory evaluations were performed simultaneously, were included in the study. The monocyte, platelet, HDL, MHR, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), mean platelet volume (MPV), and platelet distribution width (PDW) values of all patients were evaluated. The quality of life of the participants was assessed using the FIQ and their general health using the health assessment questionnaire (HAQ). Age, body mass index (BMI), and marital status distribution were similar in both groups. The FMS patients had a mean disease duration of 11.29 ± 2.62 months. The median monocyte, platelet, MPV, visual analog scale (VAS), FIQ, and HAQ values and the mean MHR of the FMS patients were significantly higher than the control group, while the mean HDL level was significantly lower (P < 0.05). There was a weak negative correlation between the MPV and HAQ score and the PDW and HAQ score (rs = -0.225, P = 0.042 and rs = -0.249, P = 0.024, respectively), whereas no correlation was detected between the MHR and the FIQ and HAQ scores in FMS patients. According to the receiver operating characteristic curve analysis, MHR had prediction of FMS (P = 0.002; sensitivity = 0.63, specificity = 0.50, cut-off point ≥8.4). Our results suggest that the monocyte, platelet, HDL, MHR, and MPV parameters can be used in the evaluation of inflammation in FMS patients.

A cross-sectional study of lipid profile among school-going children with subclinical hypothyroidism in rural Telangana

Abstract Background: Subclinical hypothyroidism (SCH) is defined as serum thyroid-stimulating hormone (TSH) concentration above the statistically defined upper limit of the reference range and serum-free thyroxine (fT4) concentration within its reference range. The correlation of higher levels of TSH and dyslipidaemia in children is controversial. This study was done among school children to document the prevalence of SCH and to investigate the association between the lipid profile and TSH in children with SCH. Methods: A cross-sectional study among 982 school-going children (6-12 years) was conducted and 91 children with SCH were included. Their weight, height, body mass index (BMI), fasting lipid profile (serum total cholesterol [TC], triglycerides [TG] and high-density lipoprotein [HDL]) were converted to z scores and compared with the reference population data. Results: The prevalence of SCH was 11%. Mean TC, TG and HDL levels (mg/dL) were 169 ± 8.8, 66.4 ± 7.7 and 40.5 ± 4.1, respectively. The mean HDL value in the study population was significantly lower, whereas the mean TC levels were significantly higher than the population mean. There was no correlation between TC z scores and TSH (ρ = 0.071) and HDL z scores and TSH (ρ = −0.01371). Multiple linear regression showed a statistically significant association between TSH and HDL z scores (P = 0.006) and TSH and TC z scores (P = 0.008) after adjusting for age and BMI z scores. Conclusions: Children with SCH have an abnormal lipid profile. There is association between TSH and dyslipidaemia (decreased HDL and increased TC) in SCH.

Efficacy of lipid, NT-proBNP and D-dimer biomarkers in the differential diagnosis of patients presenting to the emergency department with syncope

Aims: Syncope is defined as a temporary loss of consciousness in any disorder characterized by a self-limited loss of consciousness, whatever the mechanism. It constitutes 3% of emergency service applications. NT-proBNP, D-dimer and lipids are important parameters in the diagnosis and differential diagnosis of patients with syncope. This study aims to determine the levels of these biomarkers during and after treatment in patients admitted to the emergency department(ED) due to syncope. Methods: Forty-nine patients admitted to the emergency department due to syncope were included in this study. Forty-nine age- and sex-matched individuals without a history of syncope were taken as the control group. Blood samples were taken from the patient group three times, at the time of admission to the emergency department, 24 hours after admission, and on the day they were discharged from the hospital, and only once from the control group. The patient and control groups were compared in terms of NT-proBNP, D-dimer and lipids. Results: The mean HDL level at discharge was 33.63±9.62 mg/dl, which was significantly lower than the mean HDL level in the control group (38.77±10.33 mg/dl) (t=2.14, p=0.012). Although the mean LDL levels at discharge (108.02±48.03 mg/dl) were higher than the control group (92.53±37.39 mg/dl), this increase was not statistically significant (t=1.78, p=0.078). However, the mean LDL levels during hospitalization and after 24 hours (126.08±51.88 mg/dl, 116.26±48.21 mg/dl, respectively) compared to the control group (92.53±7.39 mg/dl) were statistically significantly higher (t=3.67, p=0.001, t=2.73, p=0.008). NT proBNP and D-dimer median values at the time of admission to the emergency department (844.00 pg/ml, 616.50 mcg/L, respectively), after 24 hours (1985.00 pg/ml, 662.00 mcg/L, respectively) and at discharge (748.00 pg/ml, 702.50 mcg/L respectively) compared to the control group (85.00 pg/ml, 176.00 mcg/L, respectively), a statistically significant increase was detected (p=0.001). Conclusion: In the patients admitted to the ED with a diagnosis of syncope, early treatment can be achieved getting the differential diagnosis of syncope in a short time with NT-proBNP, D-dimer and lipid blood levels that can be worked easily. In addition, the need for serious interventional procedures and further investigations in the diagnostic process will be reduced.

98-OR: Oral Insulin Alleviates Liver Fibrosis and Reduces Fat in Patients with NASH and Type 2 Diabetes—Results of Phase II Clinical Trial

NAFLD is the most common liver disorder in the USA. NASH is an advanced form of NAFLD and a leading cause of end-stage liver disease and indication for liver transplantation. Insulin resistance and inflammation underlie the pathogenesis of the disease. This double-blind, randomized, placebo-controlled, multicenter study aimed to determine the effect of oral insulin in patients with NASH and T2DM. Patients were treated twice daily for 12 weeks with an 8 mg insulin (n=21) or placebo (n=11) capsule. Safety was monitored throughout the study. At screening and after 12 weeks of treatment, liver fat content was measured by MRI-PDFF and liver fibrosis and steatosis levels by FibroScan®. No severe drug-related adverse events were reported during the study. After 12 weeks of treatment, mean percent reductions in whole-liver (-11.2±22.8% vs. -6.5±15.3%, respectively) and liver segment 3 (-11.7±21.1% vs. +0.1±17.3%, respectively) fat content were higher in the insulin as compared to the placebo arm. Patients receiving insulin showed a median -1.1 kPa and -21.0 dB/m reduction from baseline fibrosis and steatosis levels, respectively. In comparison, placebo-treated patients showed median increases of 0.3 kPa and 13.0 dB/m, respectively. At Week 12, HbA1c levels decreased by a mean -0.27±1.3% in the oral insulin cohort and increased by a mean 0.23±0.73% in the placebo cohort. Mean percent changes from baseline ALT and AST levels were -0.1±30.4% and -0.8±28.6%, respectively, in the oral insulin arm and 3.0±26.7% and 13.4±46.6%, respectively, in the placebo arm. Over the treatment period, mean total cholesterol, HDL, LDL, and triglycerides levels were consistently lower than baseline in the active arm and higher than baseline in the placebo arm. The results of this feasibility study support the safety and potential therapeutic effect of orally delivered insulin on liver fibrosis, fat accumulation, and inflammatory processes. Disclosure Y.Ishay: None. J.M.Neutel: None. Y.Kolben: None. R.Gelman: None. O.Sneh arbib: None. O.Lopez: None. R.Sotolongo: None. Y.Ilan: None. M.Kidron: Employee; Oramed Pharmaceuticals.

Dyslipidemia and atherogenic indexes in children with transfusion-dependent thalassemia

ObjectiveThis study endeavored to assess the lipid profile and atherogenic lipid indexes in children with transfusion-dependent thalassemia (TDT) and to compare them with matched healthy children. MethodThe study group consisted of a total of 72 TDT patients aged 3 to14 years, while the control group had 83 age- and sex-matched healthy children. The fasting lipid profile and lipid indexes were estimated and the atherogenic index of plasma (AIP), Castelli's risk indexes I and II, atherogenic coefficient were calculated and compared between the two groups. ResultCompared to the control group, the mean LDL, HDL and cholesterol levels were significantly lower among the case group (p-value < 0.001). The mean VLDL and triglycerides were significantly higher in the case group (p-value < 0.001). Lipid indexes, including the atherogenic index of plasma (AIP), Castelli's risk indexes I and II and atherogenic coefficients were significantly higher in TDT children. ConclusionDyslipidemia and increased risk of atherosclerosis were found in TDT children, as they had elevated atherogenic lipid indexes. Our study underlines the importance of the routine use of these indexes in TDT children. Future studies should focus on lipid indexes in this high-lipid group of children so that preventive strategies can be planned accordingly.

Nutritional Assessment in Chronic Kidney Disease Patients in the Bundelkhand Region (Uttar Pradesh), India

Introduction This research aimed to assess the nutritional intake and anthropometry of patients presenting with CKD in a hospital clinic. Methods The study was carried out on 100 CKD patients who were on maintenance hemodialysis at Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India. The patient’s file was inspected to get the relevant anthropometric and biochemical data. The information was gathered using a pre-designed proforma. Results The study included 100 CKD patients with a mean age of 45.74 ± 14.93 years. Males outnumber females, with a male-to-female ratio of 6.69:1. The mean calorie and protein given to the CKD patients (according to body weight) are 1657.60 ± 240.179 and 71.75 ± 77.165, respectively. The mean weight, BMI, and MUAC of the CKD patient were 57.371±6.22, 21.56 ± 1.705, and 23.86 ± 1.709, respectively. After 3 months of nutritional assessment, the patient’s mean weight, BMI, and MUAC were increased. The mean cholesterol, Triglyceride, HDL, VLDL, and RBS levels of the CKD patient were 163.90 ± 29.75, 139.76 ± 35.72, 49.46 ± 6.29, 28.488 ± 7.114, and 117.65 ± 21.46, respectively. After three months of the nutritional assessment, the patient’s mean cholesterol, Triglyceride, HDL, and VLDL levels increased while RBS level decreased. The CKD patient’s mean S. creatinine and S. albumin levels were 9.97 ± 3.453 and 3.285 ± 0.531, respectively. After 3 months of nutritional assessment, the patient’s mean S. creatinine and S. albumin levels increased to 10.4231 ± 3.420 and 4.056 ± 5.6389, respectively. Conclusion The nutritional diet influences body weight, BMI, and biochemical indicators. Low energy and protein intake was reported; hence, educating patients, co-patients, and families about the essential foods that fulfill the recommended intake for CKD patients is required. Follow-up patients showed better nutritional knowledge as compared with baseline patients.

The characteristics of serum lipid spectrum in PanNENs and its correlation with clinicopathological features and prognosis.

The role of dyslipidemia in pancreatic neuroendocrine tumors (PanNENs) is unclear. The aim of this study is to analyze the characteristics of serum lipid spectrum in PanNENs, and the effect of the variation in lipid profile on the development of PanNENs clinicopathological features and prognosis. All PanNENs patients between November 2012 and September 2020 in the authors' research center were identified from patient medical records and databases. A total of 185 with PanNENs patients were ultimately included in this study, including 100 nonfunctional PanNENs and 85 insulinomas. Clinicopathologic features, serum lipid level and overall survival results were retrospectively analyzed using statistical methods. In 185 PanNENs, 95 (51.4%) patients appear to have dyslipidemia. Patients with insulinoma had a lower proportion of abnormal HDL than those with nonfunctional PanNENs (10.6% vs 23%, P=0.026). The mean serum HDL levels of insulinomas were 0.131 mmol/L higher than the NF-PanNENs (1.306 ± 0.324 vs 1.175 ± 0.315, P=0.006). In multivariate logistic analysis, high levels of HDL are negatively correlated to tumor size (OR 0.233, 95% CI: 0.069-0.790, P=0.019), but HDL was not associated with pathological grade or metastasis. And a correlation has been found between hypercholesterolemia and the original location of the tumor (OR:0.224, 95%CI: 0.066-0.753, P =0.016). In addition, the outcome of the survival analysis revealed that dyslipidemia did not influence the prognosis of PanNENs patients (P>0.05). HDL was negatively correlated with the tumor size of PanNENs. The serum HDL level of insulinoma patients is higher than nonfunctional PanNENs.

Heart failure (MYHF) registry: shedding light on lipid profiles and in-hospital outcome of heart failure patients

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Novartis Corporation Sdn Bhd Background Heart failure is a debilitating disease associated with multiple comorbidities and poor prognosis. Dyslipidemia, is the top 5 most common comorbidities, including HF patients. Nonetheless, the lipid profiles in HF population is scarcely available and poorly understood. Purpose This report aimed to describe the lipid profiles and in-hospital outcome of hospitalized HF patients. Methods MYHF registry is a prospective, observational study of symptomatic HF patients (NYHA II-IV) hospitalized in 18 tertiary care centers in Malaysia over a period of 3 years starting in 2019. Lipid profiles will be described, and in-hospital outcome will be analyzed using univariate and multivariate models. Results In MYHF registry, 1 out of 2 hospitalized HF patients (55.7%) had ischemic heart disease, significantly higher in patients with HFrEF and HFmrEF, as compared to HFpEF (p&amp;lt;0.001). Similarly, 1 in 2 (46.6%) patients had dyslipidemia as comorbidity but was comparable across EF subgroups (p=0.365). Statin utilization at discharge increased by 20% from admission (from 62.2% to 74.6%), indicating that hospitalization provides good opportunity for statin initiation in indicated HF patients. At admission, the mean total cholesterol, LDL-C, HDL, and TG levels were 4.30 mmol/L (SD 1.66), 2.62 mmol/L (SD 1.34), 1.05 (SD 0.46), and 1.37 (SD 1.08), respectively. Of those with measured LDL-C level, only 31.4% achieved LDL-C goal of &amp;lt;1.8 mmol/L and 39.8% of patients had LDL-C ≥2.6 mmol/L. With univariate analysis, patients with LDL-C goal of ≥ 1.8 mmol/L had lesser risk of in-hospital mortality [OR 0.42 (0.21,0.86), p-value = 0.018], indicating LDL-C paradox. Further analysis with multivariate model revealed that patients with LDL-C goal of ≥ or &amp;lt; 1.8 mmol/L did not differ in in-hospital mortality outcome (p-value = NS). Conclusion Dyslipidemia is highly common in general population and in HF patients. With statin therapy, only 31.4% achieved LDL-C &amp;lt; 1.8 mmol/L at admission. The finding highlights the unmet need for combination lipid lowering therapies to get patient to LDL-C target goal. Hospitalization also provided good opportunity of statin therapy initiation. The knowledge gained will be crucial for guiding management of HF patients with common comorbidity like dyslipidemia.

Retrospective Hospital Based Study Of Carotid Doppler Findings in Acute Ischemic Stroke Patients With Diabetes Mellitus in A Tertiary Care Hospital in Bangladesh

Background: To evaluate Doppler study findings of Neck Vessels findings in ischemic stroke patients with Diabetes Mellitus admitted in a tertiary hospital. Methods: This cross-sectional descriptive study was carried on 96 diabetic subjects with ischemic stroke aged 40-87 years admitted in the Department of Neurology, BIRDEM general Hospital, over a period of six months. Results: The mean age was 63.45 years with standard deviation of mean (SD) ±19.65 years and their age ranged from 40 to 87 years. Out of 96 subjects 64 (66.67%) were male and rest 32 (33.33%) were female. Study subjects had hypertension (75%), Dyslipidemia (57.29%), history of smoking (53.12%) and alcoholism (1.04%) as common risk factors of ischemic stroke. It was revealed that mean fasting blood glucose (FBG), after meal blood glucose (AG) and HbA1C% level was 11.61 mmol/l, 16.53 mmol/l and 9.3% respectively. Mean ± SD total cholesterol level was 245±102.4 mg/ dl. Mean (± SD) triglyceride, HDL and LDL levels were 362 (±265) mg/dl, 35.83 (±13.72) mg/dl and 135 (±49.43) mg/dl respectively. It was observed that majority 85 (88.54%) of the subjects presented with hemiplegia after acute stroke. Other common clinical presentations were aphasia 64 (66.67%), headache 33 (34.37%), convulsion 20 (20.83%), vomiting 12(12.50%) and cranial nerve palsy 15 (15.62%). Atherosclerotic change (60.41%) in the arterial wall was most common finding in doppler study among the study subjects. Plaques were also found and most (29.17%) of the plaques was homogenous. Calcified plaque was seen in 4.17% cases. Complete occlusion of internal carotid arterial flow was found on both right (2.08%) and left (3.12%) sides. 3.12% subjects were hemodynamically normal on Doppler study. Conclusion: The majority of the Diabetic subjects with ischemic stroke had atherosclerotic change in carotid arterial systems with presence of plaque in this study. Bangladesh J Medicine 2022; 33: 31-35

Elevated Neutrophil Counts, Triglycerides, Monocyte/High-Density Lipoprotein Ratios, and Lower High-Density Lipoprotein in Patients with Retinal Vein Occlusion

Introduction: The aim of the study was to evaluate associations of peripheral blood immune cells and blood lipid profile levels with retinal vein occlusion (RVO). Methods: This retrospective study included 127 patients with RVO and 108 controls. Patients with RVO were divided into branch RVO (BRVO), central RVO (CRVO), ischemic RVO, or nonischemic RVO groups. Medical records were collected and analyzed. Results: The RVO group had higher mean neutrophil, triglyceride (TG), and monocyte/high-density lipoprotein (HDL) ratio (MHR) levels and lower HDL levels (p = 0.037, p < 0.001, p = 0.004, and p = 0.002, respectively). TG and MHR levels were significantly higher in the BRVO and CRVO groups compared with the control group (p < 0.001 and p = 0.016, respectively), but there was no difference in BRVO and CRVO group (p = 0.972 and p = 0.916, respectively). Mean HDL levels were significantly lower in the BRVO and CRVO groups than in the control group (p = 0.005), but the difference between the BRVO group and CRVO group was not significant (p = 0.290). Neutrophils, TG, and MHR were independent risk factors for RVO. HDL was an independent protective factor for RVO. Age was an independent risk factor for ischemic RVO. Conclusions: Lower HDL, and higher neutrophil, TG, and MHR levels are associated with RVO. Age is an independent risk factor for ischemic RVO.

Lipid Disorders among Diabetic Patients: An Observational Study

Background: Lipid disorder is one of the common disorders which is seen in most of the diabetic patients that causes cardiovascular disorders. The incidence of coronary artery diseases is 3 to 5 times higher in diabetic patients compared to general population. Although this has been demonstrated for the Caucasian population few data are available for Asian Indians and Bangladeshi population. Individuals with diabetes may have several forms of dyslipidemia leading to additive cardiovascular risk of hyperglycemia. The aim of this study was to evaluate the levels of lipid disorder among diabetic patients in Bangladesh. Methods: An observational study was conducted at the Department of Medicine in Sheikh Hasina Medical College Hospital, Jamalpur, Bangladesh during the period from August 2020 to April 2021. One hundred and four (104) diabetic patients were enrolled as study participants in the study. Proper written consents were taken from all the participants before starting data collection. A pre-designed questionnaire was used in patients` data collection. The serum total cholesterol (TC), HDL-cholesterol and triglycerides (TG) were assayed in patients and controls, using standardized assay methods. All data were processed, analyzed and disseminated by MS Office and SPSS version 21 as per need. Result: In this study, we observed that the mean (±SD) TC (mg/dl) of case and control group participants were 208.9±54.6 and 257.4±103.4 respectively where we found significant correlation between the groups (P=0.006). We did not find any correlation between the groups in analyzing TG (mg/dl), HDL (mg/dl) and LDL (mg/dl). In case group the mean (±SD) TG (mg/dl), HDL (mg/dl) and LDL (mg/dl) level were found 216.4±306.0, 39.2±11.0 and 114.8±47.4 respectively. On the other hand, in the control group the mean (±SD) TG (mg/dl), HDL (mg/dl) and LDL (mg/dl) level were found 222.9±124.0, 39.8±6.2 and 122.4±46.3 respectively. Conclusion: In this current study, in analyzing the comparative statuses of lipid profile we found significant correlation between the groups of diabetic and non-diabetic patients in serum total cholesterol component. Although in analyzing other components of lipid we did not get any significant correlation between the groups, we think lipid profiling may be a potential predictor of diabetic patient screening.