Mean High-density Lipoprotein Cholesterol Levels Research Articles

CONNECTING THE DOTS: INVESTIGATING THE RELATIONSHIP BETWEEN HBA1C AND LIPID PROFILE

Objectives: To determine the association between lipd profile and HbA1c. Hemoglobin A1c (HbA1c) is used to monitor blood sugar levels. HbA1c is one among the panel of tests that is done for patients who come for routine master health check-ups. This helps us to identify pre-diabetic and diabetic individuals. Diabetic individuals are at increased risk for dyslipidemia. The aim of this study is to look into the association between lipid profile and HbA1c. Methodology: This study was done in a multispecialty hospital in the Western part of Tamil Nadu among the patients who came for master health check-ups between 2017 and 2024. Ethical Committee approval was obtained (EC/AP/1100/12/2023). From the laboratory database of 67,000 patients, patients who reported for the 1st time and had their HbA1c and lipid profile levels evaluated were selected. They were categorized into normal, pre-diabetic, and diabetic based on HbA1c values. Data were analyzed using the Statistical Package for Social Sciences 27. Categorical variables were expressed as frequency and percentages whereas continuous variables were expressed as mean and standard deviation. Analysis of variance (ANOVA) was used to find if there was a significant difference in lipid profile among the three groups. Results: Our study had 23,238 participants. Out of them 7168 (30.84%) had normal HbA1c levels, 8347 (35.91%) were pre-diabetics, and 7955 (34.23%) were diabetic patients. The mean total cholesterol (TC) level (186.8±40.14) and low-density lipoprotein (LDL) cholesterol level (129.74±37.20). It was high for pre-diabetic patients. The median very LDL (VLDL) cholesterol (29.00(21–39) levels were higher for diabetic patients. The mean high-density lipoprotein (HDL) cholesterol levels (39.54±9.40) were less for diabetic patients. One-way ANOVA revealed a significant difference in TC, HDL cholesterol, LDL cholesterol, and VLDL cholesterol levels between the three groups. Pearson correlation coefficient showed a positive correlation between VLDL, LDL, TC, and HbA1c. HbA1c and HDL cholesterol were negatively correlated. Conclusion: Our study revealed a significant correlation between HbA1c and these changes signify a higher risk of cardiovascular complications in individuals with diabetes mellitus. Understanding these associations underscores the need for vigilant monitoring and proactive management of lipid profiles among pre-diabetics and diabetics to reduce the risk of cardiovascular diseases and enhance their overall health.

Assessing alcohol consumption across phosphatidylethanol levels using HDL-cholesterol as a predictor.

Prior research has established a correlation between increases of High-Density Lipoprotein Cholesterol (HDL-C) levels and alcohol consumption. This study aimed to explore the association between phosphatidylethanol (PEth) levels and the amount of consumed ethanol, utilizing HDL-C as a surrogate marker on a population level. This endeavor offers an adjunct to other studies. PEth and HDL-C levels in 50 751 samples from 29 899 patients in Norway were measured simultaneously in whole blood and serum, respectively. Linear mixed model analyses were employed to assess HDL-C levels within different PEth intervals. Drawing on previous research indicating an increase of .0035mmol/L in HDL-C per gram of pure ethanol consumed per day, and assuming no alcohol intake in the zero PEth group, we estimated mean daily ethanol intake at the group level for males in each PEth interval. Results revealed a significant correlation between PEth and HDL-C levels (Spearman's rho = .385 for women, .420 for men, P <.001). Estimated mean HDL-C levels indicated higher alcohol consumption with increasing PEth. Specifically, men with PEth values in the .031-0.100μmol/L (22-70ng/ml) interval were estimated to consume approximately mean 20 grams of ethanol daily, while those in the .301-0.500μmol/L (212-351ng/ml) PEth interval had an estimated mean daily ethanol intake of 51 grams. The results from this study suggest an approximate estimation of mean daily amounts of consumed ethanol at group levels in different PEth intervals, based on previously shown correlation of ethanol consumption and HDL-C increase.

7055 Metabolic Disorders In Thalidomide Embryopathy

Abstract Disclosure: A. Tanabe: None. Thalidomide embryopathy (TE) is a congenital limb defect that occurs in neonates born to pregnant women who have taken thalidomide. Typical abnormalities of the TE are upper limb hypoplasia and and/or auditory dysfunction. In Japan, thalidomide was marketed as an agent for sleep-induce and digestive ulcers from 1958 to 1962. Up to now, approximately 290 cases have been certified and are supported by the government as drug-induced disease. Currently, many of the victims are in their late 50s, and in addition to congenital disabilities, various health issues such as lifestyle-related diseases can be developed. We investigated their metabolic condition using data of medical health checkup between 2017 and 2018. Fifty-one Japanese cases of TE (28 men and 23 women) were included in this study. The mean age was 56.4±1.6 years in men and 55.9±1.2 years in women. The prevalence of upper limb deformities was 64% in men and 74% in women; the remaining patients had only hearing impairment. The mean body mass index (BMI) was 22.7±2.1 in men and 22.5±4.0 in women. Eleven percent of men and 17% of women had a BMI between 25-30, while 9% of women and no men had a BMI of 30 or greater. Liver dysfunction was seen in 32% of men and 9% of women. The mean high-density lipoprotein cholesterol level was 60±17 mg/dL in men and 68±18 mg/dL in women. The mean low-density lipoprotein (LDL) cholesterol level was 120±28 mg/dL in men and 136±35 mg/dL in women, with 25% of men and 48% of women had LDL level of 140 mg/dL or greater. The mean triglyceride (TG) level was 144±85 mg/dL in men and 116±61 mg/dL in women, with 43% of men and 17% of women had a level of 150 mg/dL or greater. The mean HbA1c level was 6.0±1.0% in men and 5.9±0.4% in women. The prevalence of impaired glucose tolerance was 25% in men and 13% in women. Fatty liver (FL) evaluated by ultrasonography or CT scan was 61% in men and 39% in women. The patients with FL showed significantly high body fat percentage and TG level in men, high alanine aminotransferase, γ-glutamyl transpeptidase and TG levels in women, respectively, compared to the patients without FL. The prevalence of hypertriglyceridemia was significantly higher in men with FL compared with men without FL. There was no significant difference in with or without the upper limb abnormalities in both groups. Although without obvious overweight, more than 40 % of the patients had dyslipidemia and 50% of the patients had FL. The limb abnormalities can result in movement limitations however other factors may be involved in the development of metabolic disorders in TE. The results of this study provide valuable information for future health management in thalidomide embryopathy. (This study was conducted by a research grant from the National Center for Global Health and Medicine, Japan: 21A1015 and a Grant-in-Aid from the Ministry of Health, Labour, and Welfare, Japan: 20KC2005, 23KC2017). Presentation: 6/2/2024

Correlation of Serum Vitamin D and High-Density Lipoprotein (HDL) Cholesterol Levels With Disease Activity in Rheumatoid Arthritis: A Single-Center Experience From Eastern India.

Background Rheumatoid arthritis (RA) is a progressive, symmetric, and erosive polyarthritis with a variety of extraarticular manifestations such as mononeuritis multiplex, central nervous system vasculitis, Felty's syndrome, dyslipidemia, carditis, and interstitial lung disease. Vitamin D plays a role in both adaptive and innate immunity, and its deficiency leads to the development of many autoimmune disorders. Additionally, RA patients have a lipid paradox consisting particularly of dysfunctional and low levels of high-density lipoprotein (HDL) with reduced low-density lipoprotein lowering effect, which increases cardiovascular morbidity and potentiates widespread systemic inflammation. Both are modifiable risk factors. Although there are numerous studies on vitamin D and HDL cholesterol in disease progression in RA, there is sparse literature from India studying both these factors in combination. In this study, we tried to establish the correlation of serum vitamin D and HDL cholesterol levels, if any, with disease activity using the Disease Activity Score 28 Erythrocyte Sedimentation Rate (DAS28 ESR) score. Methods A descriptive cross-sectional study comprising 80 patients was conducted at a tertiary care center in Eastern India over 12 months. Newly diagnosed RA patients aged >17 years satisfying the diagnostic criteria were included. Serum vitamin D level and HDL cholesterol were measured. Then, the DAS28 ESR score was calculated, and a correlation was looked for between serum vitamin D and HDL cholesterol. Results Patients aged 35-43 years accounted for 32 (42.5%) of participants, of whom 58 (72.5%) were females. Almost half, 38 (47.5%), had vitamin D deficiency. The mean vitamin D level was 22.988 ± 10.01 ng/ml. The mean HDL cholesterol level was 42.3 ± 7.23 mg/dl. The mean DAS28-ESR score was 3.81 ± 1.19. A statistically significant inverse correlation was found between vitamin D levels and DAS28 ESR score (p -0.0003) and HDL (p -0.000349). Conclusions Vitamin D deficiency and low HDL cholesterol levels are more common in RA patients. These factors may contribute to increased disease activity. Both are treatable factors in addition to conventional therapies.

Plasma monomeric ApoA1 and high-density lipoprotein bound ApoA1 are markedly decreased and associated with low levels of lipophilic antioxidants in sickle cell disease: A potential new pathway for therapy.

Patients with sickle cell disease (SCD) exhibit high levels of reactive oxygen species and low plasma levels of lipophilic antioxidants, which may contribute to end-organ damage and disease sequelae. Apolipoprotein A1, the major apolipoprotein of high-density lipoprotein (HDL), is mainly secreted by the intestine and liver in the form of monomeric ApoA1 (mApoA1) present in plasma. Cholesterol and α-tocopherol are delivered to ApoA1 via the ATP-binding cassette transporter, subfamily A, member 1 (ABCA1). We measured cholesterol, mApoA1, ApoA1, and lipophilic antioxidants in the plasma of 17 patients with SCD and 40 healthy volunteers. Mean HDL cholesterol (-C) levels in SCD patients and healthy subjects were 59.3 and 48.1 mg/dL, respectively, and plasma lutein, zeaxanthin, and α-tocopherol were 64.0%, 68.7%, and 9.1% lower, respectively. To compare SCD to healthy subjects with similar HDL-C, we also performed subgroup analyses of healthy subjects with HDL-C above or below the mean. In SCD, the mApoA1 level was 30.4 μg/mL; 80% lower than 141 μg/mL measured in healthy volunteers with similar HDL-C (56.7 mg/dL). The mApoA1 level was also 38.4% greater in the higher versus lower HDL-C subgroups (p = .002). In the higher HDL-C subgroup, lutein and zeaxanthin transported by HDL were 48.9% (p = .01) and 41.9% (p = .02) higher, respectively, whereas α-tocopherol was 31.7% higher (p = .003), compared to the lower HDL-C subgroup. Plasma mApoA1 may be a marker of the capacity of HDL to capture and deliver liposoluble antioxidants, and treatments which raise HDL may benefit patients with high oxidative stress as exemplified by SCD.

Exploring Serum Lipid Profile Changes in Patients During Laparoscopic Choecystectomy

Background: For quite some time, cholecystectomy has been perceived as a safe surgical procedure, often with limited attention given to potential secondary effects. It's worth noting that the gallbladder plays a significant role as a regulatory component in coordination with vital metabolic pathways responsible for maintaining equilibrium in the body. When the gallbladder is removed, bile from the liver flows directly into the upper portion of the intestine. Therefore, this study aims to evaluate the impact of laparoscopic cholecystectomy on the serum lipid profile of patients. Material and methods: A total of 60 patients diagnosed with gallstones were enrolled in this study. Preoperative blood samples were collected from all patients under sterile conditions, two hours prior to their scheduled surgery, to evaluate their lipid profile. Results: The preoperative mean Total Cholesterol (TC) levels were measured at 160.5 mg%, while postoperatively, they showed a slight decrease to 150.8 mg%. Similarly, the mean High-Density Lipoprotein Cholesterol (HDL-C) levels before surgery were 42.1 mg%, and they decreased to 40.8 mg% after the procedure. In contrast, the mean Triglyceride (TG) levels saw an increase from 180.8 mg% preoperatively to 200.8 mg% postoperatively. Notably, the comparison of mean TC and TG levels before and after the surgery yielded significant results, indicating changes in these lipid parameters following laparoscopic cholecystectomy. Conclusion: Patients undergoing laparoscopic cholecystectomy experience noteworthy changes in their serum lipid profile.

High diet quality indices associated with lower risk of lipid profile abnormalities in Taiwanese kidney transplant recipients

Cardiovascular disease (CVD) and its risk factors seem to be linked with deteriorated graft function and persists as the major cause of mortality in kidney transplant recipients (KTRs). Diet quality is associated with CVD prevention in the healthy population, however, less study focuses on KTRs. The study aimed to determine the association between diet quality indices and lipid profile abnormalities as risk factors for CVD in KTRs. This prospective study enrolled 106 KTRs who had functioning allografts from September 2016. Lipid profiles included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) and were based on the National Cholesterol Education Program Adult Treatment Panel III recommendations. Three-day dietary data were collected by a well-trained registered dietitian. The Alternative Healthy Eating Index-Taiwan (AHEI-Taiwan), Alternative Healthy Eating Index-2010 (AHEI-2010), and Healthy Eating Index-2015 (HEI-2015) scores were calculated and divided into quartiles and compared accordingly. KTRs’ mean LDL-C, HDL-C, TC, and TG levels were 119.8 ± 36.6 mg/dL, 52.0 ± 17.9 mg/dL, 205.8 ± 43.9 mg/dL, and 160.2 ± 121.6 mg/dL, respectively. Compared with the lowest quartile, only the highest quartile of AHEI-Taiwan had lower TC and LDL-C levels. After adjustment for age, gender, energy, Charlson comorbidity index, transplant duration, and dialysis duration, logistic regression analysis revealed that the highest quartile of AHEI-Taiwan had 82% (odds ratio [OR], 0.18; 95% confidence interval [CI] 0.04–0.72, p < 0.05) lower odds of high TC and 88% (OR 0.12; 95% CI 0.03–0.58, p < 0.05) lower odds of high LDL-C, and the highest quartile of HEI-2015 had 77% (OR 0.23; 95% CI 0.05–0.95, p < 0.05) lower odds of high LDL-C. Higher adherence to a healthy diet as per AHEI-Taiwan and HEI-2015 guidelines associated with lower risk of lipid profile abnormalities in KTRs.

SAT678 Metabolic Disorders In Thalidomide Embryopathy

Abstract Disclosure: A. Tanabe: None. Thalidomide embryopathy (TE) is a disease that develops in neonates born from women who have taken thalidomide during early pregnancy. Most cases of TE are characterized by developmental abnormalities of the limbs and/or auditory organs. In Japan, thalidomide was marketed as an agent for sleep-induce and digestive ulcers from 1958 to 1962. Up to now, 309 patients have been certified and are supported by the government as drug-induced disease. Currently, many of the victims are in their late 50s, and in addition to congenital disabilities, various health issues such as lifestyle-related diseases can be developed. We investigated their metabolic condition using data of medical health checkup between 2017 and 2019. Sixty-five Japanese cases of TE (33 men and 32 women) were included in this study. The mean age was 56.3±1.5 years in men and 56.1±1.2 years in women. The prevalence of upper limb deformities was 70% in men and 72% in women. The mean body mass index (BMI) was 22.7±2.1 in men and 22.5±4.0 in women. Twelve percent of men and 9% of women had a BMI between 25-30, while 9% of women and no men had a BMI of 30 or greater. Liver dysfunction was seen in 67% of men and 19% of women. The mean low-density lipoprotein cholesterol level was 61±19 mg/dL in men and 69±22 mg/dL in women. The mean high-density lipoprotein (LDL) cholesterol level was 116±29 mg/dL in men and 142±35 mg/dL in women, with 21% of men and 56% of women had LDL level of 140 mg/dL or greater. The mean triglyceride (TG) level was 137±82 mg/dL in men and 121±70 mg/dL in women, with 39% of men and 22% of women had a level of 150 mg/dL or greater. The mean fasting blood glucose level was 114±31 mg/dL in men and 102±17 mg/dL in women. The mean HbA1c level was 5.9±0.9% in men and 5.9±0.4% in women. The prevalence of impaired glucose tolerance was 19% in men and 9% in women. Fatty liver evaluated by ultrasonography or CT scan was 56% in men and 41% in women. The patients with fatty liver showed significantly high BMI, body fat percentage and TGs in men, high alanine aminotransferase and TGs in women, respectively, compared to the patients without fatty liver. There was no significant difference in with or without the upper limb abnormalities in both groups. This is the second report of metabolic disorders in TE, following one from our research group in 2015. Although without obvious overweight, thirty percent of the patients had dyslipidemia and 50% of the patients had the fatty liver. Because there was no association between limb abnormalities and metabolic disorders, other factors could be involved in the development of metabolic disorders. The results of this study provide valuable information for future health management in thalidomide embryopathy. (This study was conducted by a research grant from the National Center for Global Health and Medicine, Japan: 21A1015 and a Grant-in-Aid from the Ministry of Health, Labour, and Welfare, Japan: 20KC2005, 23KC2017). Presentation: Saturday, June 17, 2023

#2768 DIFFERENT EFFECTS OF HYPOXIA-INDUCIBLE FACTOR PROLYL HYDROXYLASE INHIBITORS ON SERUM LIPIDS LEVELS IN HEMODIALYSIS PATIENTS

Abstract Background The activity of hypoxia-inducible factor (HIF), an oxygen-sensitive transcription factor involved in erythropoiesis, is regulated by HIF-prolyl hydroxylases. With reduced oxygen tension, the activity of these enzymes is suppressed, resulting in increased erythropoiesis. Chen et al. reported that the decrease in that total cholesterol (TC) was greater with roxadustat than with epoetin alfa, as was the decrease in low density lipoprotein-cholesterol (LDL-C) in patients undergoing dialysis [1]. Csiky et al. reported roxadustat was superior to erythropoiesis-stimulating agent (ESA) in decreasing LDL-C levels from baseline in patients on dialysis [2]. Roxadustat is an oral HIF-prolyl hydroxylase inhibitor (HIF-PHI) developed for dialysis-dependent chronic kidney disease (CKD) anemia. While the impact of HIF-PHI on mean hemoglobin (Hb) change in patients on hemodialysis (HD) has been investigated [1], its effects on serum lipid levels have yet to be explored. Clarifying such effects is particularly important because HD patients usually have lower plasma high-density lipoprotein-cholesterol (HDL-C) levels than healthy individuals. Low HDL-C levels are associated with an increased risk of death in HD patients. The effects of HIF-PHIs on dyslipidemia in patients on HD are unclear. This study aimed to investigate the effects of HIF-PHIs on serum lipid levels in HD patients. Methods We investigated the effect of HIF-PHIs in three groups by measuring the levels Hb, serum TC, LDL-C, HDL-C, triglycerides (TG), iron, total iron-binding capacity (TIBC), transferrin saturation (TSAT), ferritin. Study 1: We evaluated the efficacy of roxadustat in 13 patients (1 female and 12 males) with HD-dependent CKD anemia and dyslipidemia over 24 weeks. Study 2: We evaluated the efficacy of daprodustat in 9 patients (2 females and 7 males) with HD-dependent CKD anemia and dyslipidemia over 24 weeks. Study 3: We evaluated the efficacy of enarodustat in 15 patients (3 females and 12 males) with HD-dependent CKD anemia and dyslipidemia over 12 weeks. Results Study 1: The mean age and mean HD vintage were 77.7 and 6.6 years, respectively. After roxadustat treatment, the mean Hb values (from 10.4 to 10.7 g/dL) did not significantly change. There were no significant changes in mean serum iron, TG, ferritin. However, the following parameters showed a significant decrease: mean TC (from 138.4 to 106.6 mg/dL, p = 0.0002), LDL-C (77.7 to 53.8 mg/dL, p = 0.0002), HDL-C (from 43.3 to 35.9 mg/dL, p = 0.0005), and TSAT (from 32.6 to 31.2%, p = 0.0479). There was a significant increases in the mean TIBC (from 220.5 to 265.1 μg/dL, p = 0.0002). Study 2: The mean age and mean HD vintage were 74.6 and 3.2 years, respectively. After daprodustat treatment, the mean Hb values did not significantly change. There were no significant changes in the mean TC, LDL-C, TG, TSAT, ferritin. However, the mean HDL-C levels showed a statistically significant decrease (from 50.4 to 45.3 mg/dL, p = 0.0117). Furthermore, there were significant increases in the serum iron level (from 72.5 to 89.1 μg/dL, p = 0.0078) and the mean TIBC level (from 229.7 to 272.8 μg/dL, p = 0.0039). Study 3: The mean age and mean HD vintage were 69.3 and 8.9 years, respectively. After enarodustat treatment, the mean Hb values did not significantly change. There were no significant changes in the mean TC, LDL-C, HDL-C, TG, TSAT, ferritin, iron. There was a significant increase in the mean TIBC (from 230.0 to 259.4 μg/dL, p = 0.0151). Conclusions We found that HIF-PHIs had different effects on serum lipids levels in HD patients. Roxadustat treatment improved iron metabolism stabilized Hb levels, and significantly decreased LDL-C levels. Daprodustat and enarodustat treatment improved iron metabolism, maintained stable Hb levels.

Higher concentration of 25-hydroxycholesterol in treatment-naïve patients with type 2 diabetes compared to healthy individuals

Oxysterols are cholesterol oxidation derivatives with diverse biological activities. However, little is known about the oxysterol levels in treatment-naïve patients with type 2 diabetes. We utilized gas chromatography-mass spectrometry to investigate the potential association between oxysterol concentrations and type 2 diabetes and atherosclerosis in treatment-naïve patients diagnosed with type 2 diabetes. This case-control study enrolled 53 eligible patients with type 2 diabetes and 50 healthy volunteers. We compared serum oxysterol concentrations between the two groups; we examined the correlation between the oxysterol concentrations and the carotid plaque score in the type 2 diabetes group. Univariate analysis revealed significant differences in the concentrations of oxysterols (i.e., cholesterol-5α, 6α-epoxide; cholesterol-5β, 6β-epoxide; 7β-hydroxycholesterol; and 25-hydroxycholesterol [25-HC]) and other cardiovascular risk factors between the two groups. The 25-HC concentration was almost twofold greater in the type 2 diabetes group than in the healthy volunteers (median [interquartile range]: 8.52 [6.37-11.26] vs. 4.58 [3.45-5.44] ng/mL). After adjusting for multiple covariates, such as age, body mass index, mean arterial pressure, and triglyceride, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol levels, only the concentration of 25-HC showed a significant association with type 2 diabetes. However, the univariate analysis failed to demonstrate any significant correlation between oxysterol concentrations and the carotid plaque score among individuals with type 2 diabetes. The levels of various oxysterols differ between treatment-naïve patients with type 2 diabetes and healthy individuals; the 25-HC level differs the most prominently.

Cardiovascular Risk Factors are Linked to Venous Thromboebolism: A systematic review and meta-analysis of case-control studies

Background Cardiovascular risk factors are associated with venous thromboembolism (VTE) has received increased attention in the past few years. At present, it is not clear whether the each cardiovascular risk factor is risk factor for venous thromboembolism. Features of cardiovascular risk factor have shown to be been individually associated with VTE. However, whether each of the factors additively increases the risk of VTE is uncertain. We performed a meta-analysis to assess the association between some major cardiovascular risk components and VTE. Methods Online Pub Med and Embase database were searched for case-control studies evaluating cardiovascular risk factors and incident Venous Thromboembolism in adults. Independent observers extracted data regarding annualized VTE incidence from studies meeting predetermined criteria, (Blood pressure: ≥ 140/90 mmHg. Dyslipidemia: triglycerides (TG): ≥ 1.695 mmol/L and high-density lipoprotein cholesterol (HDL-C) ≤ 0.9 mmol/L in male, ≤ 1.0 mmol/L in female, waist circumference ≥90cm for men, ≥80cm for women or body mass index &gt; 30 kg/m2. Data were analyzed weighted, random-effects meta-analysis. Results Thirty two case-control studies with a total of 30929 patients met the inclusion criteria. Odds ratios or weighted means and 95% confidence intervals (CIs) were then calculated and pooled using a random-effects model. Statistical heterogeneity was evaluated through the use of X2 and I2 statistics. Compared with controls, the OR for VTE was 2.24 for obesity (95% CI, 1.83 to 2.75), 1.56 for hypertension (95% CI, 1.26 to 1.92) and 1.55 for diabetes mellitus (95% CI, 1.25 to 1.92). Weighted mean high-density lipoprotein cholesterol (HDL) levels were significantly lower in VTE patients with cardiovascular risk factor compared to controls with inverse correlation with risk of VTE, whereas no difference was observed for total cholesterol levels. Conclusion Cardiovascular risk factors are significantly associated with higher risk of VTE, which may imply that it may contribute to the multi factorial pathogenesis of VTE. Nevertheless, this report could not determine whether the combination of all three components is associated with a higher risk than each of the components in isolation.

Changes in Health-related Parameters Associated with Sports Performance Enhancement Drugs.

The purpose of this study was to evaluate changes in health-related parameters caused by the administration of anabolic-androgenic steroids and "fat-burning drugs" during a 6-month competition preparation period. The physiological, biochemical, and anthropometric parameters studied included serum cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, aspartate aminotransferase, alanine transaminase, bilirubin, body mass, and percentage of total body fat. Changes in the parameters studied were analyzed at monthly intervals during six months of preparation for competition. The study revealed a continuous increase in body mass, accompanied by a decrease in body fat percentage to the physiologically essential level. Total cholesterol levels remined in the desirable concentration range. The mean levels of triglycerides fluctuated between borderline high and high. Mean high-density lipoprotein cholesterol levels remained within the low range, while low-density lipoprotein cholesterol fluctuated between near-optimal / above-optimal, borderline high, and high levels. Serum levels of aspartate aminotransferase and alanine transaminase remained within the high concentration. The bilirubin concentration remained in the desirable range. The blood nitrogen urea concentration fluctuated between normal and elevated levels. Sports-enhancing drugs analyzed in this study do not have an immediate detrimental impact on the selected biochemical, physiological, and anthropometric parameters that define health.

Risk for Behçet’s disease gauged via high-density lipoprotein cholesterol: a nationwide population-based study in Korea

Behçet’s disease (BD) is a chronic inflammatory disease. Low levels of plasma high-density lipoprotein cholesterol (HDL-C) are associated with Crohn’s disease, another chronic inflammatory disease. However, the effects of low HDL-C levels on BD are unclear. We investigated the effects of HDL-C levels, and variability therein, on the risk for BD. We used the Korean National Health Insurance System database to identify 5,587,754 adults without a history of BD who underwent ≥ 3 medical examinations between 2010 and 2013. Mean HDL-C levels at each visit were used to calculate variability independent of the mean (VIM) and the coefficient of variation (CV). There were 676 new cases of BD (0.012%). The risk for BD was increased in participants with highly variable and low mean HDL-C levels. In a multivariate-adjusted model, the hazard ratios (95% confidence intervals) for BD incidence were 1.335 (1.058–1.684) in a high mean/high VIM group, 1.527 (1.211–1.925) in a low mean/low VIM group, and 2.096 (1.67–2.63) in a low mean/high VIM group compared to a high mean/low VIM group. Low mean HDL-C levels, and high variability therein, are independent risk factors for BD.

The Frequency of Subclinical Hypothyroidism in Obese Children and Adolescents and Its Relationship with Metabolic Parameters and Atherogenic Index.

ObjectiveThe effect of subclinical hypothyroidism on glucose and lipid metabolism in obese children is controversial. This study aims to compare cardiovascular risk factors in obese patients with or without subclinical hypothyroidism and determine the frequency of subclinical hypothyroidism in obese children and adolescents.Materials and MethodsA total of 1130 obese children and adolescents aged 6–18 years were included in this single-center cross-sectional study. Metabolic parameters such as thyrotropin, free thyroxine, free triiodothyronine, homeostasis model assessment for insulin resistance, atherogenic index, and lipids were evaluated. The patients were divided into two groups—subclinical hypothyroidism group (free thyroxine normal, thyroid-stimulating hormone 5.5–10 mIU/L) (n = 59) and the control group (free thyroxine normal, thyroid-stimulating hormone < 5 mIU/L) (n = 1071).ResultsSubclinical hypothyroidism was detected in 59 (5.2%) of 1130 patients. The mean body mass index was similar in both groups. The mean serum insulin, homeostasis model assessment for insulin resistance, triglyceride, atherogenic index of plasma, aspartate aminotransferase, and alanine aminotransferase levels were higher in the subclinical hypothyroidism group, and the mean high-density lipoprotein cholesterol level was lower than the control group (P = .005, P < .001, P = .028, P < .001, P = .001, P < .001, and P = .018, respectively). While a positive correlation was observed between the thyroid-stimulating hormone levels and insulin, homeostasis model assessment for insulin resistance, alanine aminotransferase, triglyceride, and basal cortisol levels, a negative correlation was found between thyroid-stimulating hormone and high-density lipoprotein cholesterol.ConclusionSubclinical hypothyroidism can negatively affect the lipid and glucose profile.

Whole-exome sequencing reveals damaging gene variants associated with hypoalphalipoproteinemia

Low levels of high density lipoprotein-cholesterol (HDL-C) are associated with an elevated risk of arteriosclerotic coronary heart disease. Heritability of HDL-C levels is high. In this research discovery study, we used whole-exome sequencing to identify damaging gene variants that may play significant roles in determining HDL-C levels. We studied 204 individuals with a mean HDL-C level of 27.8 ± 6.4 mg/dl (range: 4–36 mg/dl). Data were analyzed by statistical gene burden testing and by filtering against candidate gene lists. We found 120 occurrences of probably damaging variants (116 heterozygous; four homozygous) among 45 of 104 recognized HDL candidate genes. Those with the highest prevalence of damaging variants were ABCA1 (n = 20), STAB1 (n = 9), OSBPL1A (n = 8), CPS1 (n = 8), CD36 (n = 7), LRP1 (n = 6), ABCA8 (n = 6), GOT2 (n = 5), AMPD3 (n = 5), WWOX (n = 4), and IRS1 (n = 4). Binomial analysis for damaging missense or loss-of-function variants identified the ABCA1 and LDLR genes at genome-wide significance. In conclusion, whole-exome sequencing of individuals with low HDL-C showed the burden of damaging rare variants in the ABCA1 and LDLR genes is particularly high and revealed numerous occurrences in HDL candidate genes, including many genes identified in genome-wide association study reports. Many of these genes are involved in cancer biology, which accords with epidemiologic findings of the association of HDL deficiency with increased risk of cancer, thus presenting a new area of interest in HDL genomics.

Relationship Between High-Density Lipoprotein-Cholesterol and Red Cell Distribution Width in Patients With Coronary Artery Disease.

BackgroundA high red cell distribution width (RDW), which indicates ongoing inflammation, and low levels of high-density lipoprotein-cholesterol (HDL-C) are associated with increased mortality and morbidity in patients with coronary artery disease (CAD). Recent studies have suggested that HDL-C possesses anti-inflammatory and antioxidant effects, which may explain its anti-atherogenic properties. This study aims to determine the relationship between HDL-C levels and RDW in patients with CAD.Materials and methodsThis cross-sectional study was performed on 120 patients with CAD from July 2020 to June 2021 in the Hematology Department of Chughtai Lab Lahore. Patients were graded according to the degree of coronary artery stenosis as follows: Grade 1,30%-50%; Grade 2, 51%-70%; and Grade 3,>70%. The HDL-C level was measured from venous blood samples by a fully automated Abbot Alinity analyzer. The RDW was measured by Sysmex XN-5000. The sample size was calculated using the Select Statistics calculator. The mean RDW and HDL-C of the patients were calculated, and correlation analyses were performed using the Pearson correlation coefficient.ResultsThe HDL-C level was inversely related to the RDW. Of the 120 patients, 38, 44, and 38 had Grade 1, Grade 2, and Grade 3 stenosis, respectively. The mean HDL-C level and RDW were 30.58 ±3.77 mg/dL and 16.04% ±1.66%, respectively. The value of r was −0.8622 (strongly negative). Data were stratified based on the degree of stenosis. The values of r in Grades 1, 2, and 3 were −0.43 (moderately negative), −0.604 (moderately negative), and −0.27 (weakly negative), respectively.ConclusionThe RDW can be used as an additional marker to determine the disease status in CAD patients.

Evaluating the safety and efficacy of a polyherbal Unani formulation in dyslipidaemia-a prospective randomized controlled trial

Ethnopharmacological relevanceUnani System of Medicine offers treatment for obesity and dyslipidaemia. Jawarish Falafili (JF) is a Unani polyherbal pharmacopoeial preparation. It has been used in the treatment of obesity for a long time. Dyslipidaemia is a recognised modifiable risk factor for hypertension, ischemic heart disease and stroke. Limitations of the current conventional therapy have provided scope for research of a potential drug in this medical condition. It was hypothesised that JF may ameliorate dyslipidaemia in human participants.Aim of the study: The main objective of this study was to evaluate the safety and efficacy of the JF. Materials and methodsThis was a prospective randomized, active-controlled, open-label and parallel-group study. We randomized 74 participants of dyslipidaemia into treatment (n = 38) and control (n = 36) groups. Of them, 30 participants in each group completed the trial. The participants of any sex aged between 30 and 60 years, with serum total cholesterol (TC) ≥200 mg/dl and/or serum triglycerides (TG) ≥150 mg/dl and/or low-density lipoprotein cholesterol (LDL-C) level ≥130 mg/dl and/or high-density lipoprotein cholesterol (HDL-C) level <40 mg/dl were enrolled in this study. The participants of the treatment group were treated with JF (10 gm/day) once and atorvastatin (20 mg/day) was given to the control group for 90 days once at night daily. ResultsWe observed a significant reduction (treatment group versus control group) in mean serum TC by 22.89% versus 19.36%, TG by 29.90% versus 23.26% and LDL-C by 29.16% versus 27.92% from baseline (p < 0.05). But the change in mean serum HDL-C levels post-treatment was insignificant in both groups (p > 0.05). On intergroup comparison, the magnitude of the difference of mean TC, TG, LDL-C and HDL-C levels between the groups was not statistically significant (p > 0.00.05). ConclusionsThis study concluded that JF and atorvastatin were equally effective in controlling dyslipidaemia. They were tolerated well by all participants and found safe during the course of treatment.

Serum Lipids in COVID-19

Background: The coronavirus disease 2019 (COVID-19) pandemic still remains as an evolving condition. The available literature suggested that the level of various biochemical parameters was found to be associated with severity of the infection and can be used as markers of severity in patients with COVID-19. However, speculation for association of hypolipidemia with COVID-19 severity was also postulated. Hence, present study is conducted to find association of lipid profile with the severity of the disease. Materials and methods: A case–control study was carried out in the months of August to October 2020 in Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Cases included 103 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR)-positive admitted patients (52 with moderate disease and 51 with severe disease), whereas control included 100 SARS-CoV-2 RT-PCR-negative patients visiting outpatient clinic of Department of Respiratory Medicine of the hospital. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) values of participants were evaluated and compared among severe COVID-19 cases and controls as well as in moderate and severe COVID-19 diseased. Results: Among 103 patients, 52 patients had moderate disease and 51 had severe COVID-19 on admission. The mean serum total cholesterol level in cases was 145 ± 64.21 and 161.43 ± 43.48 mg/dL in controls (P = 0.035). Mean serum triglyceride level was 167.22 ± 99.04 mg/dL in COVID-19 cases and 141.73 ± 71.76 mg/dL in control (P = 0.037). Mean serum LDL-C level was 93.77 ± 38.68 mg/dL in cases and 110.74 ± 43.11 mg/dL in control (P = 0.004). Mean serum HDL-C level was 29.61 ± 11.71 mg/dL in cases and 42.35 ± 13.87 mg/dL in control population (P &lt; 0.001). Conclusion: Hypolipidemia was found to be significantly associated with COVID-19 infection in the current study. There was no statistically significant difference found in patients with moderate and severe COVID-19 in this small group study.

Role of High-Density Lipoprotein Cholesterol (HDL-C) as a Clinical Predictor of Decompensation in Patients with Chronic Liver Disease (CLD).

Introduction Systemic inflammation triggered by bacterial products like lipopolysaccharides (LPS) in the circulation is an important factor leading to decompensation in patients with chronic liver disease (CLD). High-density lipoprotein cholesterol (HDL-C) has a significant role in innate immune response to LPS in the circulation and could therefore increase the risk for decompensation in patients with CLD. In this study, we have explored the role of HDL-C as a prognostic marker for decompensation. Methods This was a prospective, observational, cohort study where consecutive patients with CLD were included. Patients with cholestatic liver disease and hepatocellular carcinoma were excluded. Fasting lipids were measured in all patients at the time of recruitment. Each patient was carefully followed up for development of decompensation events such as new-onset/worsening ascites, hepatic encephalopathy, or variceal bleed during follow-up. Results A total of 170 patients were included (mean age 60 ± 11.5 years, M : F = 6 : 1). At the end of follow-up, 97/170 patients (57%) had decompensation events. Mean HDL-C levels were significantly lower among patients with decompensation (27.5 ± 15 mg/dL vs. 43.5 ± 13.9 mg/dL; p value 0.004). Using ROC analysis, cut-off for HDL-C of 36.4 mg/dL was identified. On multivariate analysis, HDL-C (OR = 6.072; 95% CI 2.39-15.39) was found to have an independent association with risk of decompensation. Conclusions HDL-C level (<36.4 mg/dL) is a reliable marker for risk of decompensation and can be a useful addition to existing prognostic scoring systems in CLD. It can be a valuable tool to streamline treatment protocols and prioritise liver transplantation.

Effects of Ephedrine-Containing Products on Weight Loss and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Ephedrine, the main active ingredient of mahuang, may lead to weight loss; however, it can also induce cardiovascular side effects. As ephedrine use remains controversial, this study aimed to systematically review previous studies on ephedrine-containing products and perform meta-analysis of the existing evidence on weight, blood pressure (BP), heart rate, and lipid change effects of ephedrine-containing products. We searched for placebo-controlled randomized studies in PubMed, Web of Science, and EMBASE until July 2021 using the following search terms: (ephedr* OR mahuang) AND (“weight loss” OR obes* OR overweight). Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of ephedrine-containing products on weight, BP, heart rate, and lipid profiles. A total of 10 articles were included. Compared with the placebo group, the ephedrine-containing product group was associated with greater weight loss, with an MD of −1.97 kg (95% CI: −2.38, −1.57). In the ephedrine-containing product group, the mean heart rate was 5.76 beats/min higher than in the placebo group (95% CI: 3.42, 8.10), whereas intergroup differences in systolic and diastolic BP were not statistically significant. The ephedrine-containing product group had a significantly higher mean high-density lipoprotein cholesterol level (MD: 2.74 mg/dL; 95% CI: 0.94, 4.55), lower mean low-density lipoprotein cholesterol level (MD: −5.98 mg/dL; 95% CI: −10.97, −0.99), and lower mean triglyceride level (MD: −11.25 mg/dL; 95% CI: −21.83, −0.68) than the placebo group. Compared with placebo, the ephedrine-containing products showed better effects on weight loss and lipid profiles, whereas they caused increased heart rate. The ephedrine-containing products may be beneficial to obese or overweight patients; however, close monitoring is needed, especially heart rate monitoring.