Mean High-density Lipoprotein Cholesterol Research Articles

Is Adiponectin Elevation Associated with Left Atrial Remodeling and Impaired Mechanical Functions? (a Speckle Tracking Study).

Objectives Recent studies demonstrated that elevated adiponectin levels predicted an increased risk of atrial fibrillation (AF) and stroke; however, a causal relationship is yet to be unknown. Reduced left atrium (LA) functions detected by two-dimensional echocardiographic speckle tracking (2D-STE) can predict AF development. We aimed to investigate the relationship between adiponectin level and LA functions in hypertensive and diabetic patients at high risk for incident AF.Material and methods The study consisted of 80 hypertensive diabetic patients. All patients underwent echocardiography, and venous blood samples were taken. The relationship between adiponectin levels and LA functions was analyzed.Results We divided patients into two groups according to the mean adiponectin level (13.63 ng / ml). In the high adiponectin group, the mean age (p=0.001) and high-density lipoprotein (HDL) cholesterol (p=0.015) were higher, whereas estimated glomerular filtration rate (eGFR) (p=0.036) and hemoglobin (p=0.014) levels were lower. Although LA maximum volume, LA minimum volume, and LA pre-A volume were higher in the group with high adiponectin levels, they did not reach a statistical significance. Peak early diastolic LA strain (S-LAe) (p=0.048) and strain rate (SR-LAe) (p=0.017) were lower in this group. Multivariate logistic regression analysis demonstrated that age (p=0.003) and hemoglobin (p=0.006) were predictors of elevated adiponectin levels. On the contrary, S-LAe, HDL cholesterol, and eGFR lost their statistical significance.Conclusion In patients with HT and DM, elevated adiponectin level is associated with impaired LA mechanical functions. Increased age and hemoglobin level are independent predictors of elevated adiponectin levels.

Abstract 024: Effects Of Diet On 10-year Atherosclerotic Cardiovascular Disease Risk Using The Pooled Cohort Equations Risk Calculator: Results From The Dash Trial

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce cardiovascular disease (CVD) risk factors, but its effects on 10-year CVD risk based on the pooled cohort estimating equation has not been reported. Objective: To determine the effects of adopting the DASH diet on 10-year atherosclerotic cardiovascular disease (ASCVD) risk compared to a typical American (control) diet or a diet rich fruit and vegetables (F/V), but otherwise similar to control. Methods: The DASH trial was a 3-arm, parallel-group, randomized controlled feeding trial of 459 adults aged 22 to 75 years without CVD and not taking anti-hypertensive or diabetes medications. These participants were randomized to a control diet, a F/V diet, or the DASH diet for 8 weeks. Weight was kept constant. Blood pressure (BP) and lipids were measured at baseline and at 8-weeks to compare 10-year ASCVD risk scores across dietary assignments. Comparisons were performed via linear regression adjusted for baseline ASCVD risk score. Results: The mean age of participants was 45 years; 49% were women, 60% were black, and 10% were current smokers. Mean systolic BP was 131.3±10.8 mm Hg, mean LDL cholesterol was 121±32 mg/dL, and mean HDL cholesterol was 48±14 mg/dL. Both DASH and F/V diets shifted the distribution of ASCVD risk scores downward compared to the control diet ( Figure, Panel A ). Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk by 10.0% (95% CI: -17.7, -1.5; P = 0.02) and 11.7% (95% CI: -19.3, -3.3; P = 0.007) respectively ( Figure, Panel B ). There was no difference between the DASH and F/V diets (-1.9%; 95% CI: -10.3, 7.4; P = 0.68). Conclusions: Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk, while the DASH and F/V had similar effects.

Evolution of Cardiovascular Risk Factors in a Worker Cohort: A Cluster Analysis.

The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the development of personalized preventive approaches. Using data from annual medical examinations in a cohort of workers, the aim of the study was to characterize the evolution of CVRFs and the CVD risk score (SCORE) over three time points between 2009 and 2017. For descriptive analyses, mean, standard deviation, and quartile values were used for quantitative variables, and percentages for categorical ones. Cluster analysis was performed using the Kml3D package in R software. This algorithm, which creates distinct groups based on similarities in the evolution of variables of interest measured at different time points, divided the cohort into 2 clusters. Cluster 1 comprised younger workers with lower mean body mass index, waist circumference, blood glucose values, and SCORE, and higher mean HDL cholesterol values. Cluster 2 had the opposite characteristics. In conclusion, it was found that, over time, subjects in cluster 1 showed a higher improvement in CVRF control and a lower increase in their SCORE, compared with cluster 2. The identification of subjects included in these profiles could facilitate the development of better personalized medical approaches to CVD preventive measures.

Sudanese diabetics with hypertension are at high risk for cardiovascular disease

Objectives: To measure blood glucose, lipid profile levels, and blood pressure in diabetic hypertensive patients in order to identify the association between the parameters measured and an increased risk of cardiovascular risk in the Sudanese diabetic hypertensive patients. Material and methods: During the months of April 2012 and March 2013, a case-control study was employed in Gezira State, Sudan. The study enrolled 200 patient who met the participation criteria, with respondents divided into diabetic hypertensive and non-diabetic categories to estimate fasting blood glucose levels (FBG), Glycosylated hemoglobin (HbA1C) and lipid profile which include; total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG). The random access auto-analyzer bio system, A15 was used to test samples for various biochemical parameters. Individual information, as well as anthropometric and biochemical measurements were collected on a questionnaire. After each participant gave verbal consent, venous blood samples were drawn after an overnight fast. The statistical evaluation was achieved with the aid of a statistical package for social sciences (SPSS version 16, Chicago, IL, USA). Result: The WC and BMI both increased significantly by (p=<0.0001), according to the analysis of variance (ANOVA). FBG and HbA1C levels were significantly elevated by (p=<0.0001). The increase in systolic blood pressure (SBP) was significant by (p=<0.0001). The mean HDL-C level was at high risk (49.73) with a significant increase by (p=0.009). The mean LDL-C concentration was above the optimum level (109.03) with a non-significant increase (p=0.697). Conclusion: WC, BMI, DBP, FBG, and HDL-C all increased significantly. Diabetic- hypertensive participants were at a high risk of develops dyslipidemia and cardiovascular disease.

Risk stratification score for acute myocardial infarction and sudden cardiac death in type 2 diabetes mellitus

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Acute myocardial infarction (AMI) and sudden cardiac death (SCD) are major cardiovascular adverse outcomes in patients with type 2 diabetic mellitus. Although there are many risk scores on composite outcomes of major cardiovascular adverse outcomes or cardiovascular mortality for diabetic patients, these existing scores did not account for the difference in pathogenesis and prognosis between acute coronary syndrome and lethal ventricular arrhythmias. Furthermore, recent studies reported that HbA1c and lipid levels, which were often accounted for in these risk scores, have J/U-shaped relationships with adverse outcomes. Purpose The present study aims to evaluate the application of incorporating non-linear J/U-shaped relationships between mean HbA1c and cholesterol levels into risk scores for predicting for AMI and non-AMI related SCD respectively, amongst type 2 diabetes mellitus patients. Methods This was a territory-wide cohort study of patients with type 2 diabetes mellitus above the age 40 and free from prior AMI and SCD, with or without prescriptions of anti-diabetic agents between January 1st, 2009 to December 31st, 2009 at government-funded hospitals and clinics in Hong Kong. Risk scores were developed for predicting incident AMI and non-AMI related SCD. The performance of conditional inference survival forest (CISF) model compared to that of random survival forests (RSF) model and multivariate Cox model. Results This study included 261308 patients (age = 66.0 ± 11.8 years old, male = 47.6%, follow-up duration = 3552 ± 1201 days, diabetes duration = 4.77 ± 2.29 years). Mean HbA1c and high-density lipoprotein-cholesterol (HDL-C) were significant predictors of AMI under multivariate Cox regression and were linearly associated with AMI. Mean HbA1c and total cholesterol were significant multivariate predictors with a J-shaped relationship with non-AMI related SCD. The AMI and SCD risk scores had an area-under-the-curve (AUC) of 0.666 (95% confidence interval (CI)= [0.662, 0.669]) and 0.677 (95% CI= [0.673, 0.682]), respectively. CISF significantly improves prediction performance of both outcomes compared to RSF and multivariate Cox models. Conclusions A holistic combination of demographic, clinical, and laboratory indices can be used for the risk stratification of type 2 diabetic patients against AMI and SCD.

Identification of familial hypercholesterolemia in acute coronary syndrome patients: are we missing the mark?

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients (P) with familial hypercholesterolemia (FH) have considerable elevation in levels of low-density lipoprotein (LDL) cholesterol and a higher risk of premature coronary artery disease (CAD) and acute coronary syndromes (ACS). However, even in a hospital setting with a high volume of ACS P, the diagnosis of FH frequently goes undetected. The aim of this study was to evaluate the application of the Dutch Lipid Clinic Network (DLCN) Criteria in P admitted for ACS and analyse ACS recurrence, hospitalization and mortality in a 30-day follow-up. Methods Retrospective evaluation of P with ACS admitted to a tertiary center from 2005 to 2019. Data from the digital files including family history and laboratory tests was analysed and P were followed up for 30 days for hospitalization, recurrent ACS, all cause mortality and cardiovascular (CV) death. Evaluation of tendinous xanthomata, arcus cornealis and genetic analysis was not undertaken. Results 3811 P were evaluated, mean age 63 ± 13 years, 28% female gender, 1497 P (39%) with active or previous smoking habits, 847 P (22%) with diabetes mellitus, 419 P (11%) with family history of coronary disease, 1340 P (35%) with premature CAD, 53 P (1.4%) with premature cerebral or peripheral vascular disease and 522 (14%) with previous ACS. The mean LDL cholesterol level was 125 ± 43 mg/dL, the mean high-density lipoprotein (HDL) cholesterol level was 40 ± 16 mg/dL and the mean triglyceride level was 132 ± 89 mg/dL. The diagnosis at hospital admission was unstable angina (UA) in 189 P (5%), non-ST-segment elevation myocardial infarction (NSTEMI) in 1024 P (27%) and ST-segment elevation MI (STEMI) in 2598 P (68%). The hospital mortality rate was 4.3% (163P). Applying the DLCN criteria, 3089 P (81%) had a score of <3 ("unlikely FH"), 675 P (17.7%) a score of 3 to 5 ("possible FH"), 41 P (1.1%) a score of 6 to 8 ("probable FH") and 1 P (0.03%) a score of >8 ("definite FH"). Stratifying according to ACS type: among UA, 31 P (16%) had "possible FH" and 4 P (2.1%) had "probable FH". Among NSTEMI, 145 P (14.2%) had "possible FH", 9 P (0.9%) "probable FH" and 1 P (0.03%) had "definite FH". Finally, among STEMI P, 497 P (19.1%) had "possible FH" and 28 P (1.1%) had "probable FH". In a 30-day follow-up, there was an all cause mortality of 2% (78 P) and a CV death of 1.3% (49P), while the all cause hospitalization rate was 3.5% (134P) and the admission rate for recurrent ACS was 1.7% (65P). The DLCN criteria score was significantly correlated with CV death (OR 1.25, CI 95% 1.04-1.50, p = 0.020) and admission for recurrent ACS (OR 1.19, CI 95% 1.04-1.36, p = 0.04). Conclusion Application of the DLCN criteria in P admitted for ACS revealed 675 P (17.7%) with "possible FH" and 41 P (1.1%) with "probable FH" as well as show significant correlation with CV death and recurrent ACS. Routine assessment of these criteria can be an accessible tool to stratify likelihood of FH and proceed accordingly to genetic testing.

Comparison of the Japan Society of Clinical Chemistry reference method and CDC method for HDL and LDL cholesterol measurements using fresh sera

ObjectivesIn 2009, the Japan Society of Clinical Chemistry (JSCC) recommended a reference method for the measurement of serum high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels. This automated method uses cholesterol esterase-cholesterol dehydrogenase to measure cholesterol levels in fractions obtained after ultracentrifugation and dextran sulfate/magnesium chloride precipitation. In the present study, using fresh samples, we compared the LDL-C and HDL-C levels measured using this method with those measured using the traditional Centers for Disease Control and Prevention (CDC)-beta-quantification (BQ) method. Designand methods: Using both the JSCC and CDC-BQ methods, LDL-C/HDL-C levels were measured in 47 non-diseased and 126 diseased subjects, whose triglyceride levels were lower than 11.29 ​mmol/L (1000 ​mg/dL). ResultsFor LDL-C, the equation of the line representing the correlation between the two methods was y ​= ​0.991x + 0.009 ​mmol/L; r ​= ​0.999; and Sy/x ​= ​0.025 ​mmol/L, where x is the mean LDL-C level measured using the CDC-BQ method. Similarly, for HDL-C, the equation of the line representing the correlation between the two methods was y ​= ​0.988x + 0.041 ​mmol/L, r ​= ​0.999, and Sy/x ​= ​0.019 ​mmol/L, where x is the mean HDL-C level measured using the CDC-BQ method. ConclusionsThe JSCC method agreed with the CDC-BQ method in cases of both non-diseased and diseased subjects, including those with dyslipidemia.

Phospholipid transfer to high-density lipoprotein (HDL) upon triglyceride lipolysis is directly correlated with HDL-cholesterol levels and is not associated with cardiovascular risk

Background and aimsWhile low concentrations of high-density lipoprotein-cholesterol (HDL-C) represent a well-established cardiovascular risk factor, extremely high HDL-C is paradoxically associated with elevated cardiovascular risk, resulting in the U-shape relationship with cardiovascular disease. Free cholesterol transfer to HDL upon lipolysis of triglyceride-rich lipoproteins (TGRL) was recently reported to underlie this relationship, linking HDL-C to triglyceride metabolism and atherosclerosis. In addition to free cholesterol, other surface components of TGRL, primarily phospholipids, are transferred to HDL during lipolysis. It remains indeterminate as to whether such transfer is linked to HDL-C and cardiovascular disease. Methods and resultsWhen TGRL was labelled with fluorescent phospholipid 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate (DiI), time- and dose-dependent transfer of DiI to HDL was observed upon incubations with lipoprotein lipase (LPL). The capacity of HDL to acquire DiI was decreased by −36% (p<0.001) in low HDL-C patients with acute myocardial infarction (n = 22) and by -95% (p<0.001) in low HDL-C subjects with Tangier disease (n = 7), unchanged in low HDL-C patients with Type 2 diabetes (n = 17) and in subjects with high HDL-C (n = 20), and elevated in subjects with extremely high HDL-C (+11%, p<0.05) relative to healthy normolipidemic controls. Across all the populations combined, HDL capacity to acquire DiI was directly correlated with HDL-C (r = 0.58, p<0.001). No relationship of HDL capacity to acquire DiI with both overall and cardiovascular mortality obtained from epidemiological studies for the mean HDL-C levels observed in the studied populations was obtained. ConclusionsThese data indicate that the capacity of HDL to acquire phospholipid from TGRL upon LPL-mediated lipolysis is proportional to HDL-C and does not reflect cardiovascular risk in subjects widely differing in HDL-C levels.

Distribution of Lipids and Prevalence of Dyslipidemia among Indian Expatriates in Qatar

Background Dyslipidemia is a significant risk factor for cardiovascular diseases (CVD). If detected and managed in the early stages of life, can reduce morbidity and mortality associated with CVD in a vulnerable population. Out of the 94 expatriate nationalities in Qatar, Indians constitute the most prominent single nationality, accounting for 21.8% of the total population (2,773,885 in 2019). This study aims to determine the status of the lipid profile among Indians in Qatar. Study Design. We conducted an observational retrospective study on lipid profile test data of Indian expatriates visiting a private healthcare facility in Qatar from Oct 17 to Oct 2018 to evaluate the gender and age-specific distribution of lipids and the prevalence of dyslipidemia. Results Among the total 4483 Indian expatriates (3891 men and 592 women), the mean (SD) mg/dL levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) were higher in men TC 196.9 (40.6), TG 168.9 (114.6), and LDL-C 122.9 (37.2) mg/dL compared to women TC 185 (38.1), TG 117.7 (78.2), and LDL-C 114.1 (31.1) mg/dL, p value < 0.0001. Utilizing predefined National Cholesterol Education Program-Adult Treatment Panel III (NCEP ATP III) limits to categorize dyslipidemias; the greater prevalence of elevated TC, TG, and LDL-C was noted in men 44.7%, 45.8%, and 40.9% than women 31.6%, 22%, and 28.7%, respectively. However, women had higher levels of mean high-density lipoprotein cholesterol (HDL-C) as 47.1 (9.8) mg/dL vs. 40.6 (8.3) mg/dL in men, p value < 0.05, the prevalence of dyslipidemia, low HDL-C was also more 65.7% vs. 48.9% in women than men. With age, men showed a declining trend while women showed a rising trend for mean lipid levels as well as for the prevalence of dyslipidemia, high TC, TG, and LDL-C (p value < 0.0001). The mean HDL-C cholesterol increased, and the prevalence of dyslipidemia, low HDL-C decreased with age in both the genders. Conclusion Our results demonstrate the higher mean lipid levels and prevalence of atherogenic dyslipidemia among Indian expatriate men than women counterparts at the younger age group. The screening programs and awareness campaigns must be initiated to prevent the early onset of dyslipidemia induced atherosclerosis leading to CVD. Future controlled studies are needed to estimate the prevalence of dyslipidemias among Indian migrants in Qatar.

Association of High-Density Lipoprotein Cholesterol Variability and the Risk of Developing Parkinson Disease.

To investigate the longitudinal association among high-density lipoprotein cholesterol (HDL-C) level, HDL-C variability, and the risk of developing Parkinson disease (PD). We conducted a nationwide, population-based cohort study. We included 382,391 patients aged ≥65 years who underwent at least 3 health examinations provided by the Korean National Health Insurance System from 2008 to 2013 and followed up until 2017. Individuals with a history of PD and missing values were excluded (n = 1,987). We assessed HDL-C variability using 3 indices, including variability independent of the mean (VIM). A multivariate-adjusted Cox proportional hazards regression analysis was performed. Among the 380,404 participants, 2,733 individuals were newly diagnosed with PD during a median follow-up period of 5 years. The lowest quartile (Q1) group of baseline HDL-C and mean HDL-C was associated with increased PD incidence as compared with the highest quartile (Q4) group (adjusted hazard ratio [aHR], 1.20; 95% confidence interval [CI], 1.08-1.34; and aHR, 1.16; 95% CI, 1.04-1.30, respectively). The Q4 group of HDL-C variability (VIM) was associated with increased PD incidence compared to the Q1 group (aHR, 1.19; 95% CI, 1.06-1.33). The group with the Q1 of baseline HDL-C and with the Q4 of HDL-C variability had the highest risk of PD incidence (aHR, 1.6; 95% CI, 1.31-1.96). Lower HDL-C level and greater HDL-C variability were associated with a higher incidence of PD.

Correlation of Serum Zinc with Blood Pressure in Hypertensive Individuals

Background: Hypertension is one of the leading causes of mortality and morbidity worldwide. Trace elements deficiencies are believed to be related with development of hypertension and associated complications. Objective: To explore the correlation of serum zinc with blood pressure in hypertensive individuals. Methods: This study was conducted at the Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2020 to February 2021. A total of 100 adult subjects were selected purposively, among them 50 were diagnosed cases of hypertension and 50 were normotensive healthy adults as control group. Their blood pressure (BP) was measured and body mass index (BMI) was calculated accordingly. Serum zinc and serum lipid profile [Total Cholesterol (TC), High Density Lipoprotein- Cholesterol (HDL-C), Low Density Lipoprotein- Cholesterol (LDL-C) and Triglyceride (TG)] of the study subjects were measured. Data were analyzed and compared by statistical tests. Results: The mean(±SD) age was 46.9±12.7 years in hypertensive patients and 43.1±8.5 years in control group. Male subjects were predominant in both groups. Majority of the hypertensive patients were found over-weight. Mean(±SD) levels of serum TC, LDL-C, TG were significantly high (p<0.05) and mean serum HDL-C level was significantly low (p=0.018) in hypertensive group. Mean(±SD) serum zinc level was significantly low (p=0.020) in hypertensive group. In hypertensive group, serum zinc had significant negative correlation with systolic blood pressure [SBP (r= - 0.620, p<0.001)] and diastolic blood pressure [DBP (r= - 0.446, p=0.001)]. Conclusion: The serum zinc level is significantly low in hypertensive individuals. Serum zinc has a negative correlation with systolic and diastolic blood pressures in hypertensive individuals.

Mellituslu Erkek Hastalarda Akut-Kronik Glisemik Oran ile Erektil Disfonksiyon Arasındaki İlişkinin Değerlendirilmesi: Retrospektif, Olgu-Kontrol Çalışması

Objective: The aim of this study was to investigate the possible association between the acute to chronic (A/C) glycemic ratio and the presence of erectile dysfunction (ED) in diabetic men. Material and Methods: A total of 104 diabetic men, 45 of whom had ED while 59 did not, were retrospectively enrolled in this study. Clinical examination and laboratory analyses including A/C glycemic ratio, serum fasting glucose, hemoglobin A1c, lipid profile, and total testosterone were analyzed. Results: The total testosterone levels were lower in the diabetic ED patients compared to the non-ED diabetic participants (4.49 ng/dL vs 4.80 ng/dL, respectively). However, the difference was not statistically significant (p=0.093). Mean high-density lipoprotein cholesterol levels were significantly lower in the diabetic ED patients than in the controls (40±9 mg/dL vs 44±10 mg/dL; respectively; p=0.030). Although the median A/C glycemic ratios were higher in the diabetic ED patients (1.28±0.23 vs. 1.18±0.32), no statistical significant differences were noted between the two groups (p=0.054) Conclusion: The strong relationship between diabetes mellitus (DM) and ED demands caution since DM is a common disease in the population. We believe that developing biomarkers for the early diagnosis of ED will help provide treatment and improve the life quality of patients. Although we could not find a statistical relationship between the A/C glycemic ratio and ED in our study results, we think that further welldesigned prospective studies are needed in this area.

Antioxidative activity of statins and HDL-PON1 association in lacunar ischemic stroke with and without white matter hyperintensity

Purpose: Statins (HMG-coA reductase inhibitors) protect vessels from atherosclerosis through various mechanisms, but the clinical significance of statin-induced high-density lipoprotein cholesterol (HDL) changes has not been established. We evaluated the effects of statin treatment on the antioxidative activities of HDLs in ischemic stroke patients with and without white matter hyperintensity (WMH). Methods: From January to December in 2013, eighty-two ischemic stroke patients (57 men, 25 women; mean age 67.0 ± 11.8 years) at the Wonkwang Medical Center were recruited retrospectively and antioxidant activity was assessed via paraoxonase 1 (PON1) activity. We studied changes in the patients’ lipid profiles and assessed PON1 activity in patients with and without WMH, at baseline and 8 weeks after treatment with rosuvastatin 10 mg/d. Results: All patients evaluated antioxidant activity using PON1 activity at admission. After 8 weeks of rosuvastatin treatment, the mean HDL concentration increased to 0.83± 10.1 mg/dL. The HDL levels increased in 54 patients (64.3%) and decreased in 30 patients (35.7%). PON1 activity increased to 15.0% in all patients, regardLess of WMH after rosuvastatin treatment (+ 25.4% in subjects without WMH; P &lt; 0.001). Baseline PON1 activity modestly correlated with HDL levels (r = 0.365, P = 0.019); however, PON1 activity after treatment did not correlate with HDL levels (r = 0.149, P = 0.347). Conclusion: Our findings suggest that statins increase antioxidant activity, especially assessed via PON1 activity, in ischemic stroke patients who did not have WMH.

Study of platelet indices in hyperlipidemia

Introduction: Atherosclerosis is a chronic inflammatory condition n resulting from hyperlipidemia and involves platelet mediated recruitment of white blood cells to arteries. The platelet activation is measured indirectly through several platelet indices routinely available without any additional cost in newer fully automated haematology analysers. These indices include platelet count, mean platelet volume(MPV), platelet distribution width(PDW), plateletcrit(PCT), mean platelet(component) concentration (MPC), mean platelet dry mass (MPM), platelet large cell count and platelet large cell ratio (PLCR).. The present study was undertaken in the pathology department of our diagnostic centre to find an association between platelet indices reported by Advia 2120(Siemens) fully automated haematology analyser and hyperlipidemia. Materials and Methods: This was a prospective study carried out in our diagnostic centre from April to July 2018. 100 patients with hyperlipidemia without any associated diseases and 100 controls with normal lipid profile were included in the study. Statistical analysis was done using Pearson’s correlation test and data was expressed as mean ±SD for each parameter. A p value of < 0> Results: Maximum number of patients were in 41-60 years of age (65%). The male to female ratio was 1.7: 1 with 63% males and 37% females. The mean cholesterol ,mean triglyceride and mean HDL cholesterol level in study group was 218.6±36.3, 244.3±154,38.7±9.6 respectively and 158±26.8 ,94.1±34.8,and 42.1±9.3 in control group respectively. Mean LDL cholesterol was 131.1±39.4 in study group and 97.1±25.2 in control group. There was a significant difference in platelet counts in both groups with a p value of 0.01. PCT and MPC also showed a p value of 0.004. The mean platelet mass (MPM) was 2.17±0.2 in study group as compared to 2.13±021 in control group. Large platelet count was 7.09±4.9 in study group while it was 5.95±3.81 in control group which was also sig

Prognostic effect of high-density lipoprotein cholesterol level in patients with atherosclerotic cardiovascular disease under statin treatment

In patients with atherosclerotic cardiovascular disease (ASCVD) under statin treatment, the influence of on-treatment level of high-density lipoprotein cholesterol (HDL-C) on cardiovascular (CV) events is controversial. Statin-treated patients were selected from the Taiwanese Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) Registry, a multicenter, observational study of adult patients with ASCVD in Taiwan. Low HDL-C was defined as < 40 mg/dL for men and < 50 mg/dL for women. The primary outcome was a composite CV events including CV death, myocardial infarction (MI), stroke or cardiac arrest with resuscitation. A total of 3731 patients (mean age 65.6 years, 75.6% men) were included. Patients with on-treatment low HDL-C (44%, mean HDL-C 34.9 ± 6.8 mg/dL) were younger and with more diabetes and higher body weight. The mean follow-up time was 2.7 years. We used restricted cubic spline curves to examine the potential non-linear association between HDL-C and adverse outcomes. Decreased HDL-C levels were associated with a significantly increased risk of CV events in women (< 49 mg/dL in women) but not in men (< 42 mg/dL in men). However, the protective effect of elevated HDL-C levels was more prominent in men than in women. In ASCVD patients with statin therapy, low on-treatment HDL-C was common in Taiwan and associated with an increased risk of CV events in women. Higher HDL-C levels provided more protective effect in men than in women.

Association of Genetic West African Ancestry, Blood Pressure Response to Therapy, and Cardiovascular Risk Among Self-reported Black Individuals in the Systolic Blood Pressure Reduction Intervention Trial (SPRINT)

Self-identified Black race is associated with higher hypertension prevalence and worse blood pressure (BP) control compared with other race/ethnic groups. The contribution of genetic West African ancestry to these racial disparities appears not to have been completely determined. To determine the association between the proportion of West African ancestry with the response to antihypertensive medication, BP control, kidney function, and risk of adverse cardiovascular (CV) events among self-identified Black individuals in the Systolic Blood Pressure Intervention Trial (SPRINT). This post hoc analysis of the SPRINT trial incorporated data from a multicenter study of self-identified Black participants with available West African ancestry proportion, estimated using 106 biallelic autosomal ancestry informative genetic markers. Recruitment started on October 20, 2010, and ended on August 20, 2015. Data were analyzed from May 2020 to September 2020. Trajectories of BP and kidney function parameters on follow-up of the trial were assessed across tertiles of the proportion of West African ancestry using linear mixed-effect modeling after adjustment for potential confounders. Multivariable adjusted Cox models evaluated the association of West African ancestry with the risk of composite CV events (nonfatal myocardial infarction, CV death, and heart failure event). Among 2466 participants in the current analysis (1122 women [45.5%]; median West African ancestry, 81% [interquartile range, 73%-87%]), there were 120 composite CV events (4.9%) over a mean (SD) of 3.2 (0.9) years of follow-up. At baseline, mean (SD) high-density lipoprotein cholesterol levels were higher (tertile 3: 56.5 [15.0] mg/dL vs tertile 1: 54.2 [14.9] mg/dL; P = .006), smoking prevalence (never smoking: tertile 3: 367 [47.9%] vs tertile 1: 372 [42.2%]; P = .009) and mean (SD) Framingham Risk scores (tertile 3: 16.7 [9.7] vs tertile 1: 18.1 [10.2]; P = .01) were lower, and baseline BP was not different across increasing tertiles of West African ancestry. On follow-up, there was no evidence of differences in longitudinal trajectories of BP, kidney function parameters, or left ventricular mass (Cornell voltage by electrocardiogram) across tertiles of West African ancestry in either intensive or standard treatment arms. In adjusted Cox models, higher West African ancestry was associated with a lower risk of a composite CV event after adjustment for potential confounders (adjusted hazard ratio per 5% higher West African ancestry, 0.92 [95% CI, 0.85-0.99]). Among self-reported Black individuals enrolled in SPRINT, the trajectories of BP, kidney function, and left ventricular mass over time were not different across tertiles of the proportion of West African ancestry. A higher proportion of West African ancestry was associated with a modestly lower risk for CV events. These findings suggest that extrinsic and structural societal factors, more than genetic ancestry, may be the major drivers of the well-established racial disparity in cardiovascular health associated with hypertension.

Usage of a new pharmacological agent of ultra-small phospholipid nanoparticles (micelles) in the treatment of combined hyperlipidemia

Abstract Background and aims Based on the developed technology of prerparation of ultra small size phospholipid nanoparticles without the use of detergents/surfactants and stabilizers drug preparation, exhibiting hypolipidemic properties has been obtained. Preclinical studies have shown that phospholipid nanoparticles of 20–30 nm (PLN) activate reverse cholesterol transport. PLN is now at the stage of clinical trials (Phase II study completed). The aim of the study was to compare the efficacy, safety and tolerability of PLN relative to placebo in the treatment of combined hyperlipidemia. Methods This Phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group study was conducted at 4 centers. The patients (pts) received PLN or placebo (1:1), powder for oral solution preparation (in an aqueous environment is a nanoemulsion with a particle size of 20–30 nm), 500 mg (sachet) orally 2 times a day for 12 weeks. Lipid parameters, safety and tolerability were measured. The data is presented in M (s), Me (lq; hq). Mann-Whitney U Test was to compare the significant difference of groups. P value &amp;lt;0.05 was considered statistically significant. Results A total of 100 pts with combined hyperlipidemia were randomized (age 35–70 years, males 58%).The mean age of patients was 56.4 (10.2) years. Mean total cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), TG, and apolipoprotein B 100 (apoB) levels at baseline were 5.59 (0.8) mmol/l, 4.51 (0.75) mmol/l, 2.38 (0.6) mmol/l and 114.26 (24.96) mg/dl, respectively (n=100). Mean high-density lipoprotein cholesterol (HDL-C) and Lp(a) levels at baseline were 1.0 (0.25) mmol/l and 21.1 (3.9; 20.3)mg/dl, respectively (n=100). At Week 12, PLT significantly reduced total cholesterol, non-HDL-C levels, TG and apo B compared to placebo (p=0.02, p=0.03, p=0.001 and p=0.02, respectively). At the same time, the mean HDL-C level was significantly increased (p=0.03). The drug was well tolerated and no clinically significant laboratory abnormalities were detected. Conclusions This study demonstrates that therapy with PLT is well tolerated in additional beneficial effects on key lipid parameters in patients with moderate combined hyperlipidemia. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Ministry of industry and trade

Exploring the relation between methylxanthines and plasma lipids in two population-based studies

Abstract Background Chronic intake of caffeinated beverages might be associated with plasma lipids via disturbed lipid metabolism. Previous investigations have been limited by the use of self-reported caffeine intake instead of measured caffeine, whereas the associations between plasma lipids and other methylxanthines (paraxanthine, theobromine, theophylline) are unknown. Here, we investigated the associations of plasma lipids with caffeine and its metabolites in plasma and urine in two European populations. Methods Individuals were selected from the general population of North Belgium (FLEMENGHO) and Switzerland (SKIPOGH). Total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were measured in plasma using standard enzymatic methods. Plasma and 24h urinary caffeine, paraxanthine, theophylline, and theobromine excretions were measured using ultra-high performance liquid chromatography tandem mass spectrometry. We used mixed models to explore the associations of methylxanthines with plasma lipids while adjusting for major confounders. Results Overall, 1946 FLEMENGHO participants (911 men, age 45.9±15.2 years) and 990 SKIPOGH participants (467 men, age 47.1±17.3 years) were included. Mean plasma total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides in FLEMENGHO/SKIPOGH were 5.37/5.06, 3.12/3.12, 1.43/1.50, and 2.4/1.02 mmol/L. In both cohorts, adjusted mean total cholesterol, LDL cholesterol, and HDL cholesterol, increased with quartile of plasma caffeine, with stronger associations in men. Similar positive associations were observed for paraxanthine and theophylline. Similar associations were observed using 24h urine excretions in SKIPOGH. Conclusions Plasma and urinary caffeine, paraxanthine, and theophylline were positively associated with plasma lipids in men, whereas there were fewer meaningful associations in women. The increase in plasma lipids might mitigate the overall beneficial impact of caffeinated beverages on health. Key messages Caffeine constitutes one of the most widely consumed biological active substances. Plasma concentration and urinary excretion of caffeine and its derived metabolites is positively associated with plasma lipids.

Changes in Lipid Profile, Body Weight Variables and Cardiovascular Risk in Obese Patients Undergoing One-Anastomosis Gastric Bypass

Morbid obesity has a direct impact on the development of cardiovascular disease. One-anastomosis gastric bypass (OAGB) is an effective surgical technique for the control of body weight and the reduction of cardiovascular risk. This work examines the change in weight loss, lipid profile and cardiovascular risk in 100 patients (71 women, 29 men), mean age 42.61 ± 11.33 years at 3, 6, 9, 12, 18 and 24 months after OAGB. At 24 months post-surgery, mean body weight was significantly reduced compared to pre-operative values (116.75 ± 22.19 kg vs. 69.66 ± 13.07 kg), as were mean total cholesterol (201.86 ± 44.60 mg/dL vs. 172.99 ± 32.26 mg/dL), LDL (Low-Density Lipoprotein) cholesterol (126.90 ± 39.81 mg/dL vs. 96.28 ± 26.99 mg/dL), triglycerides (138.05 ± 78.45 mg/dL vs. 76.04 ± 30.34 mg/dL) and cardiovascular risk (total cholesterol/HDL (High-Density Lipoprotein) cholesterol: 4.32 ± 1.24 vs. 2.93 ± 0.71), while the mean HDL cholesterol concentration was significantly higher (49.09 ± 14.16 mg/dL vs. 61.98 ± 14.86 mg/dL) (all p < 0.001). In conclusion, OAGB surgery led to significant reductions in body weight, a significant improvement in the lipid profile, and a reduction in cardiovascular risk.

Aqueous extract of Azadirachta indica leaves favorably alters the course of streptozotocin-induced diabetes in rats: A comparative prospective cohort study

Introduction: Azadirachta indica (neem) is one of the plants commonly used in African traditional medicine for the treatment and management of diabetes mellitus. The present study was undertaken to evaluate the effect of aqueous extract of A. indica leaves on hematology, lipid profile and organ-system function of streptozotocin-induced diabetic male rats.&#x0D; Methods: Thirty albino rats of Wistar strain, weighing between 120 and 150 g, were randomly divided into 6 groups (A-F) and used for the study. Group A was used as a healthy normal control. Groups B-F were induced with diabetes using 50 mg/kg bodyweight (bw.) of streptozotocin. Group B was diabetic untreated; Group C was treated with 100 mg/kg bw. metformin; Groups D to F were treated with 100, 200 and 400 mg/kg bw. of the aqueous extract, respectively. The treatment was carried out daily for a period of 28 days. At the end of the experimental period, the hematological parameters were analyzed using auto haematology analyser. Lipid profiles and histopathological investigations were performed using standard methods.&#x0D; Results: The results obtained showed that aqueous extract of A. indica significantly (p &lt; 0.05) increased the hemoglobin concentration, packed cell volume, red blood cell count, and platelet count of the streptozotocin-induced diabetic rats compared with those of the diabetic-untreated rats. The mean hemoglobin concentrations for groups A, B, C, D, E and F were 11.78, 8.200, 15.18, 13.88, 14.03 and 14.93, respectively. Treatment with the graded doses of the aqueous extract of A. indica significantly (p &lt; 0.05) reduced the total cholesterol, low-density lipoprotein cholesterol, triglycerides and very-low-density lipoprotein, compared with those of the diabetic-untreated control. Treatment also significantly (p &lt; 0.05) increased the high-density lipoprotein cholesterol (HDL-c), compared with that of the control. The mean HDL-c concentration for groups A, B, C, D, E and F were 49.58, 29.79, 40.89, 38.53, 40.40 and 46.54, respectively. The histopathological studies showed regeneration of the pancreas, liver, kidney, heart, brain and lungs for the groups treated with the extract, compared with the diabetic-untreated animals that revealed severe damage to the organ-system functions.&#x0D; Conclusion: These results suggest that the aqueous extract of A. indica can be considered as an excellent remedy for diabetes and a substitute for drugs to reduce complications associated with diabetic conditions.