Mean High-density Lipoprotein Cholesterol Levels Research Articles

Cholesterol ester transfer protein gene is associated with high-density lipoprotein cholesterol levels in Korean population

High-density lipoprotein (HDL) cholesterol levels are associated with decreased risk of coronary artery disease. Several genome-wide association studies (GWAS) for HDL cholesterol levels have implicated cholesterol ester transfer protein (CETP) as possibly causal. We tested for the association between single nucleotide polymorphisms (SNPs) in CETP gene and HDL cholesterol levels in Korean population. A total of 979 subjects in Seoul City were genotyped using a genome-wide marker panel for a discovery study. Another 2,277 subjects in Bundang-Gu in Korea were used for a replication study with selected markers. In the discovery phase, the top SNP associated with mean HDL cholesterol levels was rs6499861 in the CETP gene on chromosome 16 (p=1.18×10−6 in the Seoul City sample, p=8.91×10−3 in the Bundang-Gu sample). Another SNP (rs6499863) in the CETP gene was also among the top five SNPs associated with HDL cholesterol levels (p=3.83×10−5 in the Seoul City sample, p=3.29×10−3 in the Bundang-Gu sample). SNP rs1800775 was also associated with HDL cholesterol levels (p=4.86×10−4 in meta-analysis results of 3256 samples). This study clearly demonstrates that genetic variants in CETP influence HDL cholesterol levels in Korean adults.

Metabolic Health of People Admitted to a Psychiatric Intensive Care Unit in Adelaide, South Australia

Metabolic Health of People Admitted to a Psychiatric Intensive Care Unit in Adelaide, South Australia

Serum high-density lipoprotein cholesterol levels correlate well with functional but not with cognitive status in 85-year-old subjects.

We evaluate the association between high-density lipoprotein cholesterol (HDL-C) levels and physical and cognitive performance indicators in 85-year-old subjects. Prospective cohort study. A community-based study. 321 subjects enrolled in the Octabaix Study. Functional status was determined using the Lawton-Brody Index (LI) and the Barthel Index (BI). Cognition was assessed using the modified Spanish version of the Mini-Mental State Examination (MEC). We also measured risks related to nutrition and falls, as well as comorbidity and chronic drug prescription. HDL-C serum concentrations <40 mg/dl for men and <46 mg/dl for women were used as cut-off values to discriminate between normal and low HDL-C concentrations. The sample consisted of 197 women (61%) and 124 men. Mean HDL-C levels were 56.5 ± 15 mg/dl, with gender differences being found (59.3 ± 15 mg/dl in women vs. 52.1 ± 13 mg/dl in men; p<0.0001). Sixty-one subjects (19%) had low HDL-C values. HDL-C levels correlated with BI (r=0.11, p=0.04) and LI (r=0.17, p=0.002) scores, but not with MEC scores (r=0.08, p=0.13). Poor BI and LI scores, lower MEC scores, a risk of falls and malnutrition, and polypharmacy were all associated with lower HDL-C values in the bivariate analysis. Multiple logistic regression analysis showed only a significant association between normal HDL-C serum values and better BI scores (p<0.001, OR 1.02, 95% CI 1.01-1.04). Individuals with higher levels of HDL-C had better functional and cognitive status, but after multivariate analysis this relationship only remained significant for functional status.

Effects of oral and transdermal estrogen on IGF1, IGFBP3, IGFBP1, serum lipids, and glucose in patients with hypopituitarism during GH treatment: a randomized study

To evaluate the effects of oral estradiol and transdermal 17β-estradiol on serum concentrations of IGF1 and its binding proteins in women with hypopituitarism. Prospective, comparative study. Eleven patients with hypopituitarism were randomly allocated to receive 2 mg oral estradiol (n=6) or 50 μg/day of transdermal 17β-estradiol (n=5) for 3 months. The oral estrogen group showed a significant reduction in IGF1 levels (mean: 42.7%±41.4, P=0.046); no difference was observed in the transdermal estrogen group. There was a significant increase in IGFBP1 levels (mean: 170.2%±230.9, P=0.028) in the oral group, but not in the transdermal group. There was no significant difference within either group in terms of median IGFBP3 levels. In relation to lipid profiles, there was a significant increase in mean high-density lipoprotein cholesterol levels in the oral group after 3 months of treatment, (27.8±9.3, P=0.003). We found no differences in the anthropometric measurements, blood pressure, heart rate, glucose, insulin, C-peptide, or the homeostasis model assessment index after treatment. Our preliminary data indicate that different estrogen administration routes can influence IGF1 and IGFBP1 levels. These findings in patients with hypopituitarism have an impact on their response to treatment with GH, since patients receiving oral estrogen require increased GH dosage. These results suggest that oral estrogens may reduce the beneficial effects of GH replacement on fat and protein metabolism, body composition, and quality of life.

HDL‐C Levels and Revascularization Procedures in Coronary Heart Disease Patients Treated With Statins to Target LDL‐C Levels

A low level of high-density lipoprotein cholesterol (HDL-C) is a strong predictor for cardiovascular disease morbidity and mortality at all low-density lipoprotein cholesterol (LDL-C) concentrations. We evaluated this association in routine clinical practice among statin-treated coronary heart disease patients who achieved LDL-C target levels. This association also exists in routine clinical practice. A retrospective dynamic cohort included all male coronary heart disease patients of the Sharon-Shomron district, Clalit Health Services, Israel, with LDL-C levels < 100 mg/dL and who were receiving statins (≥ 6 purchases/y) from January 1998 to June 2008. Data were collected on demographic variables; coexistence of hypertension, diabetes mellitus, and peripheral vascular diseases; details of revascularization procedures; and lipid levels. The outcome variable was revascularization procedure, by either percutaneous intervention or coronary artery bypass graft. The study group of 909 male patients was stratified into quintiles, based on mean HDL-C levels: Q1 (n = 179): ≤ 26.4 mg/dL; Q2 (n = 190): 26.4-≤ 30.0 mg/dL; Q3 (n = 191): > 30.0-≤ 34.0 mg/dL; Q4 (n = 186): > 34.0-≤ 41.0 mg/dL; Q5 (n = 163): > 41.0 mg/dL. During the study period, 307 (33.8%) of the cohort required ≥ 1 revascularization procedure. Those in the highest quintile underwent significantly fewer procedures (40.8% for Q1 vs 16.6% for Q5, P<0.001). This significant effect of the highest HDL-C quintile was not influenced by any variable. The protective effect of high HDL-C levels, regardless of other risk factors, in preventing revascularization procedures was confirmed in the routine clinical practice among statin-treated CHD patients who reached LDL-C level < 100 mg/dL. Possible additional benefits of using agents to raise HDL-C levels should be investigated.

Lipid Profiles and Hepatitis C Viral Markers in HCV-Infected Thalassemic Patients

Background/AimsThe distribution of blood lipids, glucose and their determinants in thalassemic patients with chronic hepatitis C virus (HCV) infection has rarely been investigated. Thus, we aimed to investigate the relationship between both liver histologic findings and viral markers and serum lipids in thalassemic patients chronically infected with HCV.MethodsWe enrolled 280 polytransfused thalassemic patients with chronic hepatitis C. HCV viral load was determined using the Amplicor test. Genotyping was performed using genotype specific primers. Fasting serum lipid, glucose, ferritin and liver function enzyme concentrations were measured. A modified Knodell scoring system was used to stage liver fibrosis and to grade necroinflammatory activity. Perls' staining was used to assess hepatic siderosis.ResultsJust one subject had total cholesterol >200 mg/dL, and 7% had triglycerides >150 mg/dL. The mean high-density lipoprotein cholesterol (HDL-C) and glucose levels were 37 and 104 (97-111) mg/dL, respectively. Viral markers, liver histological findings and aminotransferase activity were not associated with serum lipid levels. Serum triglycerides, total cholesterol and ferritin were independent risk factors for impaired glucose tolerance or diabetes in these patients.ConclusionsThe majority of the patients had blood lipid levels (with the exception of HDL) within the defined normal range; viral and liver histological factors do not appear to play a significant role in changing the levels of serum lipids or glucose in these patients.

Increased Prevalence of low High-density Lipoprotein Cholesterol (HDL-C) Levels in Korean Adults: Analysis of the Three Korean National Health and Nutrition Examination Surveys (KNHANES 1998–2005)

ObjectivesHigh-density lipoprotein cholesterol (HDL-C) is an independent risk factor for cardiovascular diseases that has shown a remarkable increase, but little is known about the prevalence of low HDL-C in Korea. This study aimed to evaluate changing trends of low HDL-C prevalence, and indicate other risk factors associated with low HDL-C. MethodsWe selected subjects aged ≥20 years from the Korean National Health and Nutrition Examination Survey (KNHANES) 1998, 2001, and 2005 (n = 7962, 6436, and 6412). The mean level of HDL-C and the prevalence of low HDL-C was calculated, and cardiovascular risk factors associated with low HDL-C, as well as demographic, anthropometric, lifestyle, and nutrition factors, were assessed using the KNHANES 2005 data. ResultsMean HDL-C levels in men and women between KNHANES 1998 and 2005 decreased significantly, from 48.1 to 42.3 and from 51.6 to 47.1 mg/dL, respectively (both p < 0.001). The decrease was slightly less for women compared with men for the same period, and women had higher HDL-C levels at all periods. Covariate-adjusted OR revealed that body mass index, waist circumference, and non-alcohol drinker in both men and women were associated with low HDL-C levels by KNHANES 2005, as were employed and light physical activity in men and low fat intake in women. ConclusionThe prevalence of low HDL-C increased significantly from KNHANES 1998 to 2001 and 2005 (p < 0.001) in both men and women. body mass index, waist circumference, and non-alcohol drinker were identified as associated with low HDL-C in Korean adults.

A survey on blood lipid levels among newborns and healthy inhabitants in urban Shanghai (2008–2009)

Dyslipidemia is considered one of the most important risk factors for coronary heart disease. This study was designed to analyze the blood lipid levels of different age inhabitants in urban Shanghai in the 2000s and compare the results with those in the 1970s (1385 subjects), 1980s (3302 and 2399 subjects), and 1990s (3647 subjects). Blood samples were collected from 2197 persons, as well as 200 newborns. The levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured. The TG level in adults >20 years of age was remarkably greater than those in the 1990s, but the TC level changed little and the LDL-C level apparently decreased. The mean HDL-C levels in adult women were similar to those in the 1970s and significantly greater by approximately 10 mg/dL than those in the 1990s (P < .001), whereas those in adult men >30 years of age were still low and were lower by about 10 mg/dL than the corresponding age groups in women. In adults aged 30-39, 40-49, and 50-59 years, the proportion of hypertriglyceridemia (TG levels ≥200 mg/dL) was 18.24%, 17.96%, and 21.88% in men and 2.70%, 7.08%, and 8.55% in women, respectively. Currently, hypertriglyceridemia and low HDL-C in middle-aged men older than 30years of age have become a growing problem.

Advanced chronic obstructive pulmonary disease is associated with high levels of high-density lipoprotein cholesterol

Chronic obstructive pulmonary disease (COPD) is an inflammatory systemic disease associated with numerous extrapulmonary manifestations. Amongst these is an increased risk for cardiovascular disease. The mechanisms for this association remain unclear. We sought to examine lipid trends in a well-characterized cohort of patients with severe COPD. We conducted a retrospective prospective analysis of 126 consecutive individuals evaluated for lung transplantation with a diagnosis of COPD in whom lipid values were available. Observed lipid values were compared with a reference population without severe COPD. Compared with the reference population, mean low-density lipoprotein cholesterol (LDL-C) levels were slightly reduced at 108 ± 44 vs 117 ± 29.5 mg/dl (p = 0.02) in men but were no different in women. Mean high-density lipoprotein cholesterol (HDL-C) levels were significantly elevated at 62 ± 24 vs 45 ± 12 mg/dl (p < 0.0001) in men and at 83 ± 27 vs 59 ± 16 mg/dl in women (p < 0.0001). Prednisone use correlated with higher HDL-C levels but did not fully explain the extent of elevation. Angiographically proven coronary artery disease was found in 61% of individuals and was unrelated to HDL-C levels. Severe COPD is associated with increased levels of HDL-C, which is partially attributable to oral steroid use. HDL-C in this population is not associated with reduced risk of angiographically proven coronary artery disease.

Serum high‐density lipoprotein cholesterol levels, their relationship with baseline functional and cognitive status, and their utility in predicting mortality in nonagenarians

Little is known about the role of high-density lipoprotein cholesterol (HDL-C) in oldest-old subjects. The aim of this study is to evaluate the association between HDL-C levels and physical and cognitive performance indicators in nonagenarians, and also to determine the influence of HDL-C levels on the 3-year mortality risk. The data analyzed were taken from the NonaSantfeliu Study. Functional status was determined by the Lawton-Brody Index (LI) for instrumental activities of daily living (IADL) and the Barthel Index (BI) for basic activities (BADL). Cognition was assessed using the Spanish version of the Mini-Mental State Examination (MEC). The sample consisted of 49 women (79%) and 13 men, aged 94.3 ± 2.6 years. Mean HDL-C levels were 60 ± 16 mg/dL, and 16 subjects (25.8%) had low HDL-C values. HDL-C levels did correlate with BI (r = 0.28, P = 0.02) and LI (r = 0.32, P = 0.01), but not with MEC (r = 0.18, P = 0.15). Normal HDL-C levels at baseline were significantly associated with higher BI scores (P < 0.006, odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01-1.05) and a lower number of prescription drugs used (P < 0.04, OR = 0.71, 95% CI = 0.49-0.99). Baseline HDL-C levels were significantly lower among the group of nonagenarians who died within the 3 years of follow up (P = 0.02). However, after adjusting for potential confounders, the association between HDL-C and mortality lost significance. Higher levels of HDL-C correlate with better functional status and less use of prescribed drugs in nonagenarians. However, the relationship between low HDL-C levels and long-term mortality in this population remains unclear.

Consumption of added sugars and indicators of cardiovascular disease risk among US adolescents.

Whereas increased carbohydrate and sugar consumption has been associated with higher cardiovascular disease risk among adults, little is known about the impact of high consumption of added sugars (caloric sweeteners) among US adolescents. In a cross-sectional study of 2157 US adolescents in the National Health and Nutrition Examination Survey (NHANES) 1999 to 2004, dietary data from one 24-hour recall were merged with added sugar content data from the US Department of Agriculture MyPyramid Equivalents databases. Measures of cardiovascular disease risk were estimated by added sugar consumption level (< 10%, 10 to < 15%, 15 to < 20%, 20 to < 25%, 25 to < 30%, and ≥ 30% of total energy). Multivariable means were weighted to be representative of US adolescents and variances adjusted for the complex sampling methods. Daily consumption of added sugars averaged 21.4% of total energy. Added sugars intake was inversely correlated with mean high-density lipoprotein cholesterol levels (mmol/L) which were 1.40 (95% confidence interval [CI] 1.36 to 1.44) among the lowest consumers and 1.28 (95% CI 1.23 to 1.33) among the highest (P trend = 0.001). Added sugars were positively correlated with low-density lipoproteins (P trend =0.01) and geometric mean triglycerides (P trend = 0.05). Among the lowest and highest consumers, respectively, low-density lipoproteins (mmol/L) were 2.24 (95% CI 2.12 to 2.37) and 2.44 (95% CI 2.34 to 2.53), and triglycerides (mmol/L) were 0.81 (95% CI 0.74, 0.88) and 0.89 (95% CI 0.83 to 0.96). Among those overweight/obese (≥ 85th percentile body-mass-index), added sugars were positively correlated with the homeostasis model assessment (P linear trend = 0.004). Consumption of added sugars among US adolescents is positively associated with multiple measures known to increase cardiovascular disease risk.

Disease-Modifying Antirheumatic Drugs Increase Serum Adiponectin Levels in Patients With Rheumatoid Arthritis

Adiponectin is an adipocyte-derived adipokine with immunosuppressive and anti-inflammatory properties. It also decreases expression of adhesion molecules. In terms of its relationship with acute-phase reactants, there are conflicting results in patients with rheumatoid arthritis (RA). The objectives of this study were to evaluate the levels of adiponectin in RA patients before and after the treatment with disease-modifying antirheumatic drugs (DMARDs) and to evaluate whether there is a correlation between adiponectin levels and disease activity and acute-phase-response reactants (APRRs). Serum adiponectin levels, APRRs, total and high-density lipoprotein cholesterol (HDL-C), body mass index, and body fat mass were measured in 27 patients with RA before and after the treatment with DMARDs plus prednisolone. An inclusion criterion for RA patients was to be DMARD naive for at least 6 months or to have been newly diagnosed with RA. Twenty patients with osteoarthritis were included in this study as a disease control. No significant difference was found between RA and osteoarthritis group in terms of baseline adiponectin level. Mean adiponectin level and mean HDL-C level increased significantly compared with mean baseline level after the treatment with DMARDs plus prednisolone (10 [SD, 4.9] vs. 13.9 [SD, 8.7] μg/mL; P < 0.001; 56.8 [SD, 19] vs. 65 [SD, 18] mg/dL, P < 0.004, respectively). APRRs and the 28-joint-count disease activity score decreased significantly at the end of the 3 months of therapy. The adiponectin levels tended to be negatively correlated with acute-phase reactants and disease activity, although no changes were significant. There was a positive correlation between HDL-C and adiponectin levels at 3 month (r = 0.53, P < 0.001). No correlation was found between erythrocyte sedimentation rate and adiponectin levels both at baseline and at 3 months. Adiponectin levels can be modified by effective treatment of rheumatoid arthritis. This suggests that active inflammation may decrease serum adiponectin levels. In consideration of the antiatherogenic and anti-inflammatory features of adiponectin, increased adiponectin levels in patients with RA may result in a more favorable cardiovascular profile.

Low High Density Lipoprotein Cholesterol: Prevalence and Associated Risk-Factors in a Large French Population

High density lipoprotein-cholesterol (HDL-C) is a strong predictor of cardiovascular risk. We investigated the distribution of HDL-C in a French general population according to age, sex, and the risk factors associated with low HDL-C values. A group of 18,483 men and 22,047 women 16-79 years of age were investigated during a medical check-up. Relevant parameters were studied in three groups according to age and gender-specific percentile classes (≤5th [HDL₅] median and >95th). Gender-specific logistic regression models selected variables associated with HDL₅. Using the National Cholesterol Education Program Adult Treatment Panel III criteria (threshold: 40 mg/dL in men, 50 mg/dL in women) the prevalence of low HDL-C was 11.1% and 26.4% in men and women and it decreased with age. Mean HDL-C levels increased with age. HDL₅ was positively associated with a sedentary lifestyle and deprivation (p < 0.00001) even after adjustment on alcohol consumption and smoking. Abdominal obesity, smoking, hypertriglyceridemia, hyperleucocytosis, and low alcohol consumption were associated with HDL₅ for both genders. The prevalence of low HDL-C was similar to that observed in other Europeans but lower than in the United States. HDL₅ was associated with cardiovascular risk factors, metabolic syndrome, and social deprivation. A prevention policy to increase HDL-C levels should focus on reducing smoking and abdominal obesity, particularly in deprived subjects.

1103 Pregnancy Induced Hypertension and Signs of Decreased Insulin Sensitivity in the Neonates

Aim: To determine the impact of maternal pregnancy induced hypertension (PIH) on insulin sensitivity in term neonates. Methods: The study group consisted of 130 term neonates without major malformations, whose mothers did not have chronic hypertension or intrauterine infections. Neonates were divided into two groups according to the maternal presence or absence of PIH. Anthropometric measurements were performed at birth. Fasting glucose and insulin levels were measured on the 3rd day after birth. Lipids were determined from blood samples obtained by venipuncture from 72 neonates. Results: The 24 neonates born to mothers with PIH had significantly lower birth weight, body length and chest circumference (p< 0.05) than 106 neonates born to mothers without PIH. Insulin levels and insulin:glucose ratio in neonates born to mothers with PIH were significantly higher than that in controls (mean±SE 15.98± 2.18 vs 10.33± 1.04 µIU/ml, p< 0.05; 4.15± 0.57 vs 2.52±0.27, p< 0.05, respectively), despite similar glucose levels (mean±SE 4.07± 0.26 vs 4.45± 0.14 mmol/l, p=0.265). This association was still observed after adjusting for birth weight. Furthermore, 12 neonates of mothers with PIH had significantly higher mean triglyceride levels, and lower mean high-density lipoprotein cholesterol levels than 60 neonates from mothers without PIH (mean±SE 1.98 ± 0.24 vs 1.36 ± 0.11 mmol/l, p< 0.05; 0.51 ± 0.11 vs 0.81± 0.05 mmol/l p< 0.05 respectively). Conclusion: Intrauterine environment may be a major determinant in neonatal metabolism; maternal PIH may influence birth weight and insulin sensitivity of term neonates.

Mutations in APOA-I and ABCA1 in Norwegians with low levels of HDL cholesterol

Background Epidemiological studies have shown that low levels of plasma high density lipoprotein (HDL) cholesterol are associated with increased risk of ischemic heart disease (IHD), but it appears that genetic forms of low HDL cholesterol levels, as opposed to lifestyle-induced low levels of HDL cholesterol, do not result in increased risk of IHD. Therefore, the etiology of reduced levels of plasma HDL cholesterol may represent a factor that should be considered in risk stratification with respect to primary prevention. Genes encoding proteins involved in HDL metabolism, such as the ATP-binding cassette transporter A1 (ABCA1) and apolipoprotein (apo) A-I genes, are candidate genes for harboring mutations that lead to low HDL cholesterol levels. Methods The ABCA1 and apoA-I genes in 56 Norwegian patients, with a mean HDL cholesterol level of 0.53 (± 0.15) mmol/l, were subjected to DNA sequencing. Results Several mutations were identified in the ABCA1 gene, and two mutations were identified in the apoA-I gene. A total of 18 patients (32%) were carriers of mutations considered to be pathogenic. Their mean HDL cholesterol level was 0.45 (± 0.15) mmol/l compared to 0.57 (± 0.14) mmol/l in noncarriers (p < 0.005). Conclusion Mutations in the genes encoding ABCA1 and apoA-I are common in Norwegians, with a markedly decreased HDL cholesterol level.

Caloric Sweetener Consumption and Dyslipidemia Among US Adults

Dietary carbohydrates have been associated with dyslipidemia, a lipid profile known to increase cardiovascular disease risk. Added sugars (caloric sweeteners used as ingredients in processed or prepared foods) are an increasing and potentially modifiable component in the US diet. No known studies have examined the association between the consumption of added sugars and lipid measures. To assess the association between consumption of added sugars and blood lipid levels in US adults. Cross-sectional study among US adults (n = 6113) from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Respondents were grouped by intake of added sugars using limits specified in dietary recommendations (< 5% [reference group], 5%-<10%, 10%-<17.5%, 17.5%-<25%, and > or = 25% of total calories). Linear regression was used to estimate adjusted mean lipid levels. Logistic regression was used to determine adjusted odds ratios of dyslipidemia. Interactions between added sugars and sex were evaluated. Adjusted mean high-density lipoprotein cholesterol (HDL-C), geometric mean triglycerides, and mean low-density lipoprotein cholesterol (LDL-C) levels and adjusted odds ratios of dyslipidemia, including low HDL-C levels (< 40 mg/dL for men; < 50 mg/dL for women), high triglyceride levels (> or = 150 mg/dL), high LDL-C levels (> or = 130 mg/dL), or high ratio of triglycerides to HDL-C (> 3.8). Results were weighted to be representative of the US population. A mean of 15.8% of consumed calories was from added sugars. Among participants consuming less than 5%, 5% to less than 17.5%, 17.5% to less than 25%, and 25% or greater of total energy as added sugars, adjusted mean HDL-C levels were, respectively, 58.7, 57.5, 53.7, 51.0, and 47.7 mg/dL (P < .001 for linear trend), geometric mean triglyceride levels were 105, 102, 111, 113, and 114 mg/dL (P < .001 for linear trend), and LDL-C levels modified by sex were 116, 115, 118, 121, and 123 mg/dL among women (P = .047 for linear trend). There were no significant trends in LDL-C levels among men. Among higher consumers (> or = 10% added sugars) the odds of low HDL-C levels were 50% to more than 300% greater compared with the reference group (< 5% added sugars). In this study, there was a statistically significant correlation between dietary added sugars and blood lipid levels among US adults.

Alterations in lipid profile of autistic boys: a case control study

We hypothesize that autism is associated with alterations in the plasma lipid profile and that some lipid fractions in autistic boys may be significantly different than those of healthy boys. A matched case control study was conducted with 29 autistic boys (mean age, 10.1 +/- 1.3 years) recruited from a school for disabled children and 29 comparable healthy boys from a neighboring elementary school in South Korea. Fasting plasma total cholesterol (T-Chol), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), the LDL/HDL ratio, and 1-day food intakes were measured. Multiple regression analyses were performed to assess the association between autism and various lipid fractions. The mean TG level (102.4 +/- 52.4 vs 70.6 +/- 36.3; P = .01) was significantly higher, whereas the mean HDL-C level (48.8 +/- 11.9 vs 60.5 +/- 10.9 mg/dL; P = .003) was significantly lower in cases as compared to controls. There was no significant difference in T-Chol and LDL-C levels between cases and controls. The LDL/HDL ratio was significantly higher in cases as compared to controls. Multiple regression analyses indicated that autism was significantly associated with plasma TG (beta = 31.7 +/- 11.9; P = .01), HDL (beta = -11.6 +/- 2.1; P = .0003), and the LDL/HDL ratio (beta = 0.40 +/- 0.18; P = .04). There was a significant interaction between autism and TG level in relation to plasma HDL level (P = .02). Fifty-three percent of variation in the plasma HDL was explained by autism, plasma TG, LDL/HDL ratio, and the interaction between autism and plasma TG level. These results indicate the presence of dyslipidemia in boys with autism and suggest a possibility that dyslipidemia might be a marker of association between lipid metabolism and autism.

Decreased high‐density lipoprotein cholesterol is associated with inflammation and insulin resistance in non‐diabetic haemodialysis patients

Lower serum high-density lipoprotein cholesterol (HDL-C) is associated with inflammation, insulin resistance and poor cardiovascular outcomes in the general population. However, in a large-scale study, the association between HDL and survival in haemodialysis patients was not present. The exact cause of lack of HDL-C protection in the dialysis population is still obscure. A total of 89 stable non-diabetic haemodialysis patients were recruited. Fasting serum biochemical parameters, complete blood counts and inflammatory markers were obtained before the mid-week dialysis. Insulin resistance was assessed by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). The mean age was 58.2±13.1 years, 37 (41.6%) patients were male. The mean HDL-C level was 56.3±17.1 mg/dL. By bivariate correlation analysis, a lower serum HDL-C level was related to higher body mass index (r=-0.425; P<0.001), higher triglyceride (r=-0.479; P<0.001) and higher HOMA-IR (r=-0.211; P<0.05) levels. The serum HDL-C level was also inversely related to high-sensitivity C-reactive protein (hsCRP) (r=-0.297; P=0.005) and tumour necrosis factor-α (TNF-α) (r=-0.295; P=0.005) and directly correlated with adiponectin (r=0.560; P<0.001). In multivariate linear regression analysis, HDL-C was found to be directly correlated with adiponectin (β-coefficient=0.569; P<0.001) and inversely correlated with TNF-α (β-coefficient=-0.292; P=0.001). A strong association between HDL-C, inflammatory surrogates, and insulin resistance in this non-diabetic, non-obese haemodialysis patient group is demonstrated. The HDL-C level is still a good parameter to screen high-risk patients.

Obesity-Related Dyslipidemia Associated with FAAH , Independent of Insulin Response, in Multigenerational Families of Northern European Descent

A more thorough understanding of the genetic architecture underlying obesity-related lipid disorders could someday facilitate cardiometabolic risk reduction through early clinical intervention based upon improved characterization of individual risk. In recent years, there has been tremendous interest in understanding the endocannabinoid system as a novel therapeutic target for the treatment of obesity-related dyslipidemia. N-arachidonylethanolamine activates G-protein-coupled receptors within the endocannabinoid system. Fatty acid amide hydrolase (FAAH) is a primary catabolic regulator of N-acylethanolamines, including arachidonylethanolamine. Genetic variants in FAAH have inconsistently been associated with obesity. It is conceivable that genetic variability in FAAH directly influences lipid homeostasis. The current study characterizes the relationship between FAAH and obesity-related dyslipidemia, in one of the most rigorously-phenotyped obesity study cohorts in the USA. Members of 261 extended families (pedigrees ranging from 4 to 14 individuals) were genotyped using haplotype tagging SNPs obtained for the FAAH locus, including 5 kb upstream and 5 kb downstream. Each SNP was tested for basic obesity-related phenotypes (BMI, waist and hip circumference, waist:hip ratio, fasting glucose, fasting insulin and fasting lipid levels) in 1644 individuals within these 261 families. Each SNP was also tested for association with insulin responsiveness using data obtained from a frequently sampled intravenous glucose tolerance test in 399 individuals (32 extended families). A well characterized coding SNP in FAAH (rs324420) was associated with increased BMI, increased triglycerides, and reduced levels of high-density lipoprotein cholesterol. Mean (standard deviation) high-density lipoprotein cholesterol level was 40.5 (14.7) mg/dl for major allele homozygotes, 39.1 (10.4) mg/dl for heterozygotes, and 34.8 (8.1) mg/dl for minor allele homozygotes (p < 0.01, Family-Based Association Test). This SNP was not associated with insulin sensitivity, acute insulin response to intravenous glucose, glucose effectiveness or glucose disposition index. Genetic variability in FAAH is associated with dyslipidemia, independent of insulin response.

Extended-Release Niacin or Ezetimibe and Carotid Intima–Media Thickness

Treatment added to statin monotherapy to further modify the lipid profile may include combination therapy to either raise the high-density lipoprotein (HDL) cholesterol level or further lower the low-density lipoprotein (LDL) cholesterol level. We enrolled patients who had coronary heart disease or a coronary heart disease risk equivalent, who were receiving long-term statin therapy, and in whom an LDL cholesterol level under 100 mg per deciliter (2.6 mmol per liter) and an HDL cholesterol level under 50 mg per deciliter for men or 55 mg per deciliter for women (1.3 or 1.4 mmol per liter, respectively) had been achieved. The patients were randomly assigned to receive extended-release niacin (target dose, 2000 mg per day) or ezetimibe (10 mg per day). The primary end point was the between-group difference in the change from baseline in the mean common carotid intima-media thickness after 14 months. The trial was terminated early, on the basis of efficacy, according to a prespecified analysis conducted after 208 patients had completed the trial. The mean HDL cholesterol level in the niacin group increased by 18.4% over the 14-month study period, to 50 mg per deciliter (P < 0.001), and the mean LDL cholesterol level in the ezetimibe group decreased by 19.2%, to 66 mg per deciliter (1.7 mmol per liter) (P < 0.001). Niacin therapy significantly reduced LDL cholesterol and triglyceride levels; ezetimibe reduced the HDL cholesterol and triglyceride levels. As compared with ezetimibe, niacin had greater efficacy regarding the change in mean carotid intima-media thickness over 14 months (P = 0.003), leading to significant reduction of both mean (P = 0.001) and maximal carotid intima-media thickness (P < or = 0.001 for all comparisons). Paradoxically, greater reductions in the LDL cholesterol level in association with ezetimibe were significantly associated with an increase in the carotid intima-media thickness (R = -0.31, P < 0.001). The incidence of major cardiovascular events was lower in the niacin group than in the ezetimibe group (1% vs. 5%, P = 0.04 by the chi-square test). This comparative-effectiveness trial shows that the use of extended-release niacin causes a significant regression of carotid intima-media thickness when combined with a statin and that niacin is superior to ezetimibe. (ClinicalTrials.gov number, NCT00397657.)