Mean Cholesterol Levels Research Articles

Vitamin B3 (Niacin) in Diet Act as Protective Negotiator for Development of Myocardial Infarction

Background: Vitamin B3 (Niacin) is known to decrease LDL‐cholesterol, and triglycerides, and increase HDL‐cholesterol levels. The evidence of benefits with niacin monotherapy or add‐on to statin‐based therapy is controversial. Aim: To determine the effects of vitamin B3 with statins on lipid profile of patients of angina pectoris with dyslpidemia. Study Design: Randomized control trial study. Place and Duration of Study: Department of Biochemistry, Shaikha Fatima Institute of Nursing & Health Sciences (SFINHS), Lahore with collaboration of Cardiology OPD of Shaikh Zayed Hospital Lahore from 1st November 2019 to 31st January 2020. Methodology: Seventy four diagnosed cases of angina pectoris with dyslipidemia were recruited with age range from 30 to 50 years. They were divided into two groups; Group I contained 36 patients as controlled group which was given treatment of angina with Tab. Rovista (statin) 10mg at dinner for treatment of dyslipidemia and Group II contained 38 patients as case study group which was given treatment of angina with Tab. Rovista (statin) 10 mg at dinner and tablet Vitamin B3 500 mg with single OD dose at day time for treatment of dyslipidemia for 8 weeks. Results: The mean serum cholesterol levels at zero level (before the start of treatment) of group I was 244 mg/dl and group II was 246 mg/dl, LDL of group I was 169 mg/dl while group II was 170 mg/dl and HDL of group I was 20 mg/dl while group II was 19 mg/dl . After the treatment group I which taken only statins for treatment of dyslipidemia the mean serum cholesterol levels was 210 mg/dl, LDL was 144 mg/dl and HDL was 26 mg/dl while the mean values of group II (taken statin as well as vitamin B3) serum cholesterol level was 192 mg/dl, LDL was 122 mg/dl and HDL was 44 mg/dl. The results shown there were significant effects of statin therapy along with vitamin B3 on serum LDL and serum HDL levels. Conclusion: There were significant effects of statin therapy along with vitamin B3 on serum LDL and Serum HDL levels. Key Words: Vitamin B3, Serum Cholesterol, Serum LDL &HDL

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.

Mental Stress and Multiple Risk Factors of Cardiovascular Diseases with Regional Variations in Women of Urban and Rural Areas of Sindh, Pakistan

Introduction: The high prevalence of risk factors in women in developing countries of South Asia appears to have been translated into early and severe CHD in contrast to their counterpart in the first world nations, which has been related to obesity and insulin resistance and genetically determined increased lipoprotein Lp(a) levels. Mental stress due to urbanization, sedentary life style and physical inactivity may be the most important factor initiating obesity and the clustering of all other risk factors hypertension, dyslipidaemia and (WHR). These risk factors vary in different regions of South Asia. Aims and Objectives: Our aim of the study was to describe and analyse differences between the frequency of risk factors such as psychological stress due to, socio-economical aspects, life style especially physical activity, and health behaviours which may contribute in the course of CAD in women of both rural and urban areas of Pakistan because no such significant data is available in women with CAD. Study Design: This descriptive cross-sectional comparative study was conducted in Cardiology Department of Dow University of Health and Sciences Karachi, Pakistan, from March 2014 to March 2016 by filling a questionnaire and laboratory data. The study group comprised female subjects around 577 (Urban 347 {60.1%} and Rural 230 {39.9%}) women ranged from 25-65 years of age who underwent coronary angiography and had definite coronary atherosclerotic diseases. Our study was conducted by examining the psychological stress in women of both areas and its strength of association with frequency of other risk factors in female patients of urban and rural areas with definite CHD taking account the difference in age and education level into account. Result: Analysis of this study conducted at department of Cardiology in Dow University Karachi from March 2014 to March 2017 revealed that the women of rural area were comparatively more physically active then women of urban area. Prevalence of mental stress, hypertension, diabetes, obesity, higher BMI, hyperlipidaemia (especially TC) waist and hip circumference of both areas were found to be different after adjustment made for age. A considerable association was found between psychological stress and other factors in ischemic heart disease patients showing the p-value (p=0.043). Psychological stress was found 82% in both groups and (13%) women had no stress rated as normal more in rural (26%) vs (04%) in urban population. Physical inactivity in women with CHD was found in 92% urban in contrast to 45% in rural population, (p=0.009). Hypertension prevalence was more in urban 253 in comparison to 151 women in rural area. Diabetes Mellitus was also found more in urban than rural population, especially in age below 50, 79 (23%) urban vs 60 (26%) in rural population. Women beyond 50 years of age, 85 (24%) urban vs 64 (27%) rural area had prevalence of obesity comparatively higher in urban residents 71 (20%) than 44(%) in rural dwellers and 32 (9%) urban vs 16 (7%) in rural women in age range below 50 years. Higher waist circumstance was observed more in urban residents (4.8 cm) whereas BMI was more (1.8 unit) in women of rural area than urban women. Prevalence of smoking and nicotine chewing was relatively higher in urban population in below 50 years of age with 30 (09%) urban vs 13 (05%) in rural women and in age beyond 50, 11 (03%) urban vs 10 (04%) in rural women was witnessed. Average total cholesterol, serum triglycerides and LDL were found to be higher in urban compared to rural area residents and HDL was comparatively lower in urban area group. Mean cholesterol level was seen at average of 353 mg% in urban vs 223 mg% in rural population. Serum cortisol level showed significant variation in urban group 19.1 vs 14.2 in rural group (sample, as well as serum fibrinogen was raised more raised in urban population). Conclusion: Our study shows increased prevalence of mental stress and physical inactivity in female residents of urban area leading to Higher blood pressure, DM, dyslipidaemia and central obesity specially in Waist circumference than rural area. The mental stress induced by excessive demands of work at home and at working place with too little control is not unique to women of urban areas.

Pengaruh Buah Sirsak Terhadap Faktor Risiko Kardiovaskular (Kolesterol Total, HDL, LDL, Trigliserida)

Soursop fruit contains phenolic, tannins, flavonoids. Phenolic inhibit xanthine oxidase inhibitors which inhibit the production of uric acid, this will affect in decreasing cardiovascular risk. Tannins reducing triglyceride levels. Flavonoids reduce HMG-CoA reductase and total cholesterol. Several studies conducted on animal experiments and the results of soursop fruit reduce lipid profile. What is the effect of soursop fruit consumption on cardiovascular risk in healthy humans? This epidemiological research was conducted in Mlati, Sleman, Indonesia. There were 143 subjects that conform to the inclusion and exclusion criteria subsequently randomized to two groups. Group I was given 2x100 g/day of soursop and group II was without soursop. A laboratory examination was conducted of total cholesterol, HDL, LDL, and triglyceride levels at weeks 0, 7, and 13 both in the soursop and non-soursop groups. Regular soursop consumption was evaluated every two weeks for three months. Data analysis was performed using an independent t test, a nonparametric Mann–Whitney test, and a chi-square test. There was no significant difference in total cholesterol (p=0.254 and p=0.932), HDL (p=0.400 and p=0.960), LDL (p=0.221 and p=0.710), triglycerides (p=0.423 and p=0.580) between the soursop and non-soursop groups. The consumption of soursop fruit at 2x100 g/day has no significant effect on improvement in cardiovascular risk (total cholesterol, HDL, LDL, triglycerides) in healthy subjects, but in subjects with hypercholesterolemia and hypertriglyceridemia, the mean cholesterol and triglyceride levels decreased at week 7 and 13 compared to no soursop consumption

CARDIOVASCULAR PROFILE OF CROATIAN MILITARY VETERANS WITH HISTORY OF PTSD

Abstract Objective: The purpose of this analysis was to evaluate cardiovascular profile of military veterans with confirmed diagnosis of PTSD Design and method: We evaluated cardiovascular risk of military veterans in relation to their history of combat exposure and targeted a specific group of veterans with confirmed diagnosis of PTSD. All subjects underwent physical examination which included measurement of vital signs. Blood pressure was measured using Omron M6 device, central BP and PWV were determined by MobiloGraph. CV risk was calculated using Heart Score chart for high-risk countries. Results: Mean age was 53,40 ± 6,95. 90,0% were active or former tobacco users, while 20,0% drank alcohol. Mean cholesterol level was 5,89 ± 1,36; mean levels of LDL and triglycerides were 3,65 ± 1,35 and 1,81 ± 0,75 respectively. Body mass index mean was 28,25 ± 4,02. 10,0% of all subjects had left ventricular hypertrophy. Mean value for Pulse Wave Velocity was 8,90 ± 1,03. Average value measured in estimated glomerular filtration rate (eGFR) was 98,20 ± 11,73. 30,0% had diabetes; 10,0% had coronary heart disease; 10,0% had previous myocardial infarction. Analysis showed 40,0% of PTSD veterans had hypertension, 20,0% had well controlled hypertension with pharmacotherapy while10% had uncontrolled but treated hypertension. 60,0% of PTSD military veterans had resting heart rate below 80/min, 10,0% had heart rate between 80 and 84/min and 30,0% had heart rate equal or higher than 85/min. Conclusions: There is limited data regarding cardiovascular risk in veterans with history of PTSD. A possible explanation for insufficient data is veterans’ avoidance of Croatian healthcare system due to social stigma associated with PTSD. Veterans prefer to obtain support and assistance through various veterans’ associations and religious organizations. Eliminating stigma around PTSD, its’ early detection and appropriate treatment could improve registration of veterans with Croatian healthcare system and allow better understanding of their cardiovascular profile while ensuring optimal management of their cardiovascular risks.

Effect of prolonged venostasis on lipid profile parameters among apparently healthy University students: A case-control study in Ghana

Background: The effect of prolonged tourniquet application on lipid profile parameters (total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c)) among healthy students in the University of Cape Coast was assessed in this study. Methods: A total of 30 participants were sampled and venous blood was taken from both arms at different duration of tourniquet application. Blood was allowed to clot, centrifuged and serum separated and stored until assay. Lipid profile parameters were measured using the enzymatic techniques with the aid of a spectrophotometer. Lipid parameters were expressed in mmol/L. The relationship between the concentrations was analyzed using GraphPad Prism version 6.0. Results: The mean serum levels of total cholesterol and HDL-c were significantly (p<0.05) elevated after long duration (13.44±2.40 s) of tourniquet application compared to short duration (11.20±0.38 s) of tourniquet application. Despite the fact that the serum levels of triglyceride and LDL-c increased after long duration of tourniquet application compared to short duration, the difference was not significant (p>0.05). There was significant % mean differences of 7.0% (p<0.0001) and 11.2% (p=0.0082) in the concentrations of total cholesterol and HDL-c respectively following prolonged tourniquet application of 120-180 s. A significant increase of up to 7% (5.01±0.04, 5.352±0.05, p<0.0001) and 11% (2.41±0.07, 2.674±0.07, p=0.0082) in the concentrations of total cholesterol and HDL-c respectively was also recorded. Conclusion: Prolonged venostasis has a direct effect on the concentration of serum total cholesterol and HDL-c but not triglyceride and LDL-c. Nonapplication of tourniquet in patients with prominent veins, the application of standardized external pressure as well the early release of tourniquet after needle insertion in the vein should be followed during sample taking for lipid profile. Annals of Medical Laboratory Science (2021) 1(1), 1 - 7

Predictive scores for identifying patients with type 2 diabetes mellitus at risk of acute myocardial infarction and sudden cardiac death.

IntroductionThe present study evaluated the application of incorporating non‐linear J/U‐shaped relationships between mean HbA1c and cholesterol levels into risk scores for predicting acute myocardial infarction (AMI) and non‐AMI‐related sudden cardiac death (SCD) respectively, amongst patients with type 2 diabetes mellitus.MethodsThis 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. Patients recruited were followed up until 31 December 2019 or their date of death. 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.ResultsThis study included 261 308 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 low high‐density lipoprotein‐cholesterol (HDL‐C) were significant predictors of AMI on multivariate Cox regression. Mean HbA1c was linearly associated with AMI, whilst HDL‐C was inversely 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.ConclusionA holistic combination of demographic, clinical and laboratory indices can be used for the risk stratification of patients with type 2 diabetes mellitus for AMI and SCD.

Efficacy and safety of co-formulated elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide in HIV-positive patients: real-world data.

Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) is a recommended and widely used regimen for HIV infection. In this study, we aimed to determine the efficacy and safety of E/C/F/TAF in people living with HIV (PLWH), who are either treatment-naïve or switched from any tenofovir disoproxil fumarate-containing regimen. For switched patients, we aimed to determine the impact of switching from tenofovir disoproxil fumarate (TDF) to TAF on lipid profile and kidney functions. ACTHIV-IST Study Group produced a database, and five dedicated HIV centres in Istanbul entered data of PLWH who switched from any TDF-containing regimen to E/C/F/TAF and treatment-naïve patients who were initiated with the E/C/F/TAF regimen between January 2017 and December 2019. Clinical findings, viral parameters, lipid studies, renal function tests, adverse events and adherence to the treatment were recorded in this prospective observational study. The study included a total of 614 switched and treatment-naïve patients. Of 430 treatment-experienced patients, 89% (382) were men, and the mean age was 42 ± 12years. Among them, 47% (181/382) self-identified as men who have sex with men (MSM). The median duration of HIV diagnosis was 54 ± 29months. The median duration of E/C/F/TAF use was 20 ± 36 months and that of previous treatment was 23 ± 18months. HIV-RNA was undetectable at baseline and month 12 in 84.1% (360/428) and 86.1% (328/381) of patients, respectively (p > 0.05). Mean CD4 counts were 708 ± 287cells/µL and 802 ± 305 cells/µL at baseline and month 12, respectively (p < 0.001). Serum creatinine levels remained stable during the treatment period. Mean total cholesterol levels at baseline and month 12 were 172 and 211mg/dL (p < 0.01), LDL-cholesterol 104 and 138mg/dL (p < 0.01), HDL-cholesterol 39 and 49mg/dL (p < 0.01) and triglycerides 134 and 174mg/dL (p < 0.01), respectively. The treatment was generally well tolerated. Eight patients discontinued the therapy (drug interaction: 3; lost to follow-up: 1; pregnancy: 1; pulmonary tuberculosis: 1; side effect: 1; patient's decision: 1). Of 184 treatment-naïve patients, 88% (162) were men, and the mean age was 36.5±12years. Among them, 50% (81/162) self-identified as MSM. The mean duration of HIV infection was 21.6 ± 17.1months. The mean duration of E/C/F/TAF use was 16 ± 4months. HIV-RNA was undetectable at baseline and month 12 in 1% and 89.1% of patients, respectively. Mean CD4 counts at baseline and month 12 were 469 ± 223 cells/µL and 740 ± 298 cells/µL, respectively. During the treatment period, creatinine levels remained stable. Total cholesterol, LDL-cholesterol, triglyceride and also HDL-cholesterol levels increased. Mean total cholesterol levels at baseline and month 12 were 167 and 211mg/dL (p < 0.01), LDL-cholesterol 108 and 143mg/dL (p < 0.01), HDL-cholesterol 41 and 47mg/dL (p < 0.01) and triglycerides 136 and 172mg/dL, respectively (p < 0.01). The treatment was generally well tolerated. Three patients discontinued the therapy (drug interaction: 1; non-responder: 1; patient's decision: 1). Starting with or switching to E/C/F/TAF in PLWH effectively suppresses HIV infection, is associated with an increase in CD4 cell count and is well tolerated in a real-life setting. Renal functions remained stable during the treatment. E/C/F/TAF use was associated with an increase in LDL-cholesterol and triglyceride levels along with an increase in HDL-cholesterol levels.

Different of Cholesterol Levels in Cigarette Smokers and Electronic Cigarette

Smoking causes an increase in cholesterol in the blood. It is well known that tobacco contains nicotine has a considerable influence on the increase of blood lipid levels. Normally, lipids play an important role in all aspects of biological life, but excessive cholesterol causes changes in lipid composition, induces ROS formation and lipid oxidation. This process can also cause damage to proteins and DNA, changing cellular function, which causes tissue damage. This research using analytic survey, with analytic cross sectional design with 30 subjects. The mean cholesterol level between tobacco smokers is 210.0 mg / dl and electric smokers is 123.73 mg / dl. The average difference in cholesterol levels among smokers was tested using One way ANOVA, p value = 0.000 (p &lt;0.05). The cholesterol level of the tobacco smoker group was significantly higher when compared to the electronic smoker group.

Evaluation of the impact of deranged lipid and glucose profile among stroke patients: An observational study

Aims: The aim of the study to evaluate the impact of dyslipidemia and hyperglycemia among stroke patients. Material and Methods: This was a cross-sectional study conducted in the Department of Medicine, Metro Hospital and Cancer Research Centre, Jabalpur, MP, India from October 2018 to January 2020. During the study period, a total of 140 stroke patients were admitted out of them, 120 patients were participated in this cross-sectional study. Age, gender, and social status, past medical history (hypertension, diabetes, atrial fibrillation, ischemic heart disease, transient ischemic attack, and previous history of stroke), other risk factors (smoking, alcohol use, and obesity/BMI) and family history were obtained from all the patients. Results: The mean age of 65.9 years with 76.67% of them aged above 50 years, and 66.67% of them were males. The co-morbidity, 94 (78.33%) patients had hypertension, 65(54.17%) patients had diabetes mellitus, and 12(10%) patients had transient ischemic attack. 59 patients (49.17%) were smokers, the majority of the smokers were males, and 13(10.83%) patients were obese with a BMI above 30 kg/m2 with a mean of 32.3 kg/m2. 96 (80%) patients had a family history of hypertension, 63 (52.5%) patients had a family history of stroke and 73(60.83%) patients had a family history of diabetes mellitus. Regarding the lipid profile and hyperglycemia, it was found that, 35 patients (29.17%) had LDL greater than 130 mg/ dl, 23 patients (19.17%) had cholesterol equal or greater than 200 mg/dl, 20(16.67%) patients had TAG equal or greater than 200 mg/dl, 73 (60.83%) patients had low HDL. 63 patients (52.5%) had HbA1C levels equal or greater than 6.5% and 66 patients (55%) had FBG equal or greater than 126 mg/dl. The mean level of cholesterol, LDL, HDL and TAG were 162.7, 115.4, 41.7, and 134.1mg/dl respectively. The mean of the HbA1c was 7.1%, while the mean of FBG was 156mg/dl. Conclusion: Most of the patients with stroke had low HDL levels, high levels of FBG and HbA1c. Hypertension, DM, smoking and family history of HTN and DM are significant risk factors for the incidence of stroke.

Hematological and Biochemical Profile of Sickle Cell Patients in Critical and Inter-Critical Periods in Brazzaville, Republic of Congo

Introduction: Sickle cell disease is a public health problem in the Republic of Congo where the prevalence of sickle cell trait is estimated at 1.25%. The objective of this study is to describe the variations of hematological and biochemical parameters of hemolysis in sickle cell patients in critical and inter-critical periods. Methods: This is a descriptive cross-sectional study including sickle cell patients followed regularly at the National Reference Center for Sickle Cell Disease (CNRDr) from November 2019 to March 2020. A sample of 167 patients (sickle cell subjects in crisis and in steady state as well as control subjects) was randomly selected during the study period. The blood count was performed using a Sysmex-XN 350 automated system and the biochemical parameters were determined using the Cobas e 311 automated system. Statistical analysis was performed with SPSS version 22 software. Results: The study showed that the mean cholesterol level in controls was 4.16 ± 0.77 ul compared with 9.64 ± 4.34 ul in sickle cell crisis subjects. Hb and HCT levels were significantly higher in controls compared with sickle cell subjects in crisis. During crisis, total bilirubin, direct bilirubin, triglycerides, LDH, AST, and CRP were significantly elevated. Hematological parameters such as Hb and HCT were elevated in controls, while the mean WBC value and RET were higher in sickle cell patients in steady state. The mean values of the biochemical parameters were higher in sickle cell patients in steady state. Conclusion: Evaluation of the influence of sickle cell trait on biochemical and hematological parameters showed significant differences between sickle cell and control subjects.

Correlation of Leptin With Acute Myocardial Infarction: A Case Control Study

Introduction: Leptin, a satiety hormone, has the ability to inhibit hunger and is thus, a regulator of body weight. Leptin is also elevated in cardiovascular events such as acute myocardial infarction (AMI) and hence is considered as modifiable risk factors for AMI. The purpose of this study is therefore to investigate the correlation of leptin with AMI.Methodology: In this retrospective study, data of patients were taken from the database between January 2017 to December 2019 from a cardiovascular unit of tertiary care hospital in Pakistan. Patients were divided into two groups, based on participants who had suffered from AMI and other groups who had not suffered an AMI. Leptin levels were compared for both groups. Age, body mass index (BMI), and smoking history were noted in a self-structured questionnaire. In addition, mean blood pressure and cholesterol levels were also noted for both groups.Results: Leptin was significantly higher in patients with first time AMI (29.21 ± 9.21 ng/mL vs. 11.23 ± 3.12 ng/mL: p-value, <0.0001). BMI (27.2 ± 3.2 kg/m2 vs. 24.9 ± 2.8 kg/m2: p-value, <0.0001) and percentage of smokers (40.9% vs. 22.9%: p-value, 0.032) were also significantly higher in patients with AMI.Conclusion: A positive correlation was found between AMI and serum leptin levels in smokers and obese patients. Hence, we suggest that cardiologists should stress upon controlling these modifiable risk factors to reduce the incidence of AMI in the future.

Investigating the Relationship between Low Serum Cholesterol and Suicide in Attempters with Depression

Background & Objective: It has been postulated that depressed individuals with low total cholesterol levels may be more likely to die prematurely from suicide. This study aimed to examine the association between low serum cholesterol and suicide in depressed attempters. Materials & Methods: In this cross-sectional study, 180 suicide attempters, who met the inclusion criteria and were willing to participate in the study, were recruited in 2017. The data was collected using a demographic questionnaire and the Beck Depression Inventory-Second Edition (BDI-II). The blood cholesterol level was measured via an auto-analyzer. Results: The mean age was 26.39±10.75 years. The average cholesterol level in the moderate, severe, and serious depression groups was 151.30±35.23, 145.89±36.32, and 145.15±33.33, respectively. The mean age was higher in the group with a higher depression level, though the difference was not significant (P=0.06). The percentage of suicide attempts in single individuals was significantly higher (P=0.02). The mean cholesterol level in the group with the highest level of depression was the lowest, but the difference was insignificant (r=-.01, P=0.85). Only in females, the level of blood cholesterol showed a nearly significant difference between groups with different severities of depression (P=0.05). Cholesterol had a significant correlation with suicide frequency (P=0.008, r=0.28). Conclusion: Our results revealed no significant association between low serum cholesterol and suicide in attempters with depression; but low total serum cholesterol may be associated with depression and suicide in depressed subjects. Yet, more studies are required for verification of this causality. © 2020, Journal of Advances in Medical and Biomedical Research. All rights reserved.

Assessment of lipid profile among patients with seborrheic dermatitis

Background: Although the complicated interplay of Malassezia, keratinocytes and the immune response against a modified lipid composition in the skin have a vital role in the pathogenesis of Seborrheic Dermatitis (SD), the pathophysiology itself is still inadequately understood. The association of SD with metabolic syndrome like dyslipidemia can be explained by inflammation in both conditions' pathogenesis. The present study was aimed at evaluating the relationship between the lipid profile abnormality and the SD. Methods: A prospective cross-sectional study was conducted in the Dermatology teaching center in Sulaimani, Iraq, from 1/9/2019 to 1/3/2020. This study used a structured data collection format comprised of items concentrating on socio-demographic characteristics, duration of the disease, level of SD, the severity of SD, and lipid profile. The data were analyzed by STATA 14 statistical software and summarized in tables and figures. The Chi-square test was done to detect the association between categorical variables. P-value &lt;0.05 was significant.Results: A total of 100 patients with seborrheic dermatitis with the average age of patients was 37.5 ±13.06 years, and 61 were females. The mean fasting total cholesterol (219.72 mg/dl vs.114.83 mg/dl), LDL-C (123.92 mg/dl vs. 85.08 mg/dl) and triglycerides (170.38 mg/dl vs.102.17 mg/dl) levels were higher for the high-level cases than the normal level cases. The HDL-C level (31.06 mg/dl vs. 38.94 mg/dl) of the high-level patients was lower than normal patients. Age, total cholesterol level, LDL-C, triglycerides, and HDL-C had a statistically significant association with the disease's level and severity. The duration of the disease had a statistically significant association with only the level of disease.Conclusion: Lipid profile has a statistically significant association with the level and severity of SD. Finally, we recommend a large observational study to depict the causal relationship between serum lipid abnormality and SD.

Reduction of epicardial adipose tissue thickness with PCSK9 inhibitors

Abstract Introduction Epicardial adipose tissue (EAT) is clinically related to atherosclerosis and increased cardiovascular risk. The proprotein convertase subtilisin/kexin type 9 inhibitors (IPCSK9) are a novel group of effective drugs for lowering LDL cholesterol and cardiovascular events, however their effect on EAT has not yet been determined. Objective To assess the effect of treatment with PCSK9 inhibitors on epicardial adipose tissue. Methods The study enrolled 41 patients under treatment with PCSK9 inhibitors. At the end of the study only 24 patients were included, who were measured thickness of epicardial adipose tissue (TEAT) by transthoracic echocargiogram (just an echocardiographer using Siemens Acuson SC 2000 Prime with two-dimensional 4V1c transducer in two projections: long parasternal axis in the pericardial space of the outer edge of the myocardium above the right ventricle and in a short parasternal axis at the height of papillary muscles on the right ventricle, in telesystole and averaging three measurements; It was measured in millimeters.) using in 2 times before and after 6 months of initiation of treatment. Results Of 24 patients, 16 patients recieved evolocumab and 8 alirocumab patients; the mean TEAT pre-treatment and post-treatment was 6.84 mm (1.97) and 5.41 mm (1.86), respectively (p=0.0001); The mean percentage of change of the TEAT after 6 months of treatment was −20.39 (17.20). The mean serum LDL cholesterol levels pre-treatment and post-treatment were 188.04 mg/dL (144.0) and 94.96 mg/dL (106.04), respectively (p=0.0001); The mean change in LDL cholesterol was −51.89 (22.81). Just one patient had myocardial infarction. There was no difference between the means of reducing the percentage of change in epicardial adipose thickness between evolocumab and alirocumab. There was no correlation between lipid decrease and TEAT. Conclusion There is a significant reduction after 6 months of treatment with PSCK9 inhibitors in thickness of epicardial adipose tissue. Effect of IPCSK9 in TEAT and Lipids Funding Acknowledgement Type of funding source: None

Impact of chemerin, lipid profile, and insulin resistance on disease parameters in patients with multiple sclerosis.

Plasma chemerin, which has chemotactic and adipogenic functions, is increased in several inflammatory diseases. However, its relationship with multiple sclerosis (MS) has not been explored yet. In this study, we aimed to determine chemerin levels and their possible role in MS. Chemerin serum concentrations were evaluated by using ELISA kit in 91 clinically definite MS patients and 52 healthy controls. The mean serum chemerin, insulin, and cholesterol levels were compared. Patients were divided into two groups according to the body mass index (BMI), and the relationships between clinical and metabolic parameters were evaluated. Serum chemerin levels were 10.46 ± 1.65ng/mL in MS patients and 10.26 ± 2.14ng/mL in the control group. No significant difference was found between patients and controls (p = 0.55). We found no difference regarding age, gender, and BMI between two groups (p = 0.053, p = 0.54, p = 0.41). However, female patients with MS had higher chemerin levels than male patients. There were no associations between serum chemerin levels and EDSS score, annualized relapse rate, BMI, insulin resistance, and serum cholesterol levels in MS patients. In this study, we aimed to determine serum chemerin levels in patients with MS. However, in our study, there was no significant difference between serum chemerin levels of MS patients and healthy controls'. Additionally, chemerin levels were not associated with other metabolic parameters, as well as cognitive dysfunction. Further studies are needed to evaluate the role of chemerin in MS patients.

No association between subclinical hypothyroidism and dyslipidemia in children and adolescents

BackgroundThere are controversies about the correlation between higher levels of thyroid stimulating hormone (TSH) and dyslipidemia in children. This study was designed to assess the relation between lipid profile components and TSH levels in children.MethodThis cross-sectional study was performed in a pediatric endocrinology growth assessment clinic in Shiraz, southern Iran. Children aged 2–18 years who referred to the clinic from January until April 2018 were included. TSH levels equal or above 5 mIU/L and lower than 10 mIU/L with normal free T4 (FT4) were considered as having subclinical hypothyroidism (SH).ResultsSix hundred sixty-six children were euthyroid while 181 had SH. No significant difference was found between the mean serum total cholesterol (P = 0.713), LDL-C (P = 0.369), HDL-C (P = 0.211), non-HDL-C (P = 0.929), and triglyceride (P = 0.215) levels between euthyroid children and subjects with SH. There was also no significant difference in the prevalence of dyslipidemias in any lipid profile components between the two groups. The adjusted correlation was not significant between TSH levels and any lipid profile component.ConclusionBased on the results of our study, we found no correlation between SH and dyslipidemia in children. The association between dyslipidemia and SH in children still seems to be inconsistent based on the results of this and previous studies. We recommend a meta-analysis or a significantly larger retrospective study on this subject.

Estimated glucose disposal rate demographics and clinical characteristics of young adults with type 1 diabetes mellitus: A cross-sectional pilot study.

Background:Estimated glucose disposal rate (eGDR) is a practical measure of Insulin Resistance (IR) which can be easily incorporated into clinical practice. We profiled eGDR in younger adults with type 1 diabetes mellitus (T1DM) by their demographic and clinical characteristics.Methods:In this single centre study, medical records of TIDM were assessed and eGDR tertiles correlated with demographic and clinical variables.Results:Of 175 T1DM individuals, 108 (61.7%) were males. Mean age (±SD) was 22.0 ± 1.6 years and median time from diagnosis 11.0 years (range 1–23). Individuals were predominantly Caucasian (81.7%), with 27.4% being overweight (BMI: 25–30 kg/m2) and 13.7% obese (BMI > 30 kg/m2). Mean total cholesterol (TC) levels were significantly lower in high and middle eGDR tertiles (4.4 ± 1 and 4.3 ± 0.8 mmol/l, respectively) compared with low eGDR tertile (4.8 ± 1, p < 0.05 for both). Triglyceride (TG) levels showed a similar trend at 1.1 ± 0.5 and 1.1 ± 0.5 mmol/l for high and middle eGDR tertile compared to low eGDR tertile (1.5 ± 1 mmol/l, p < 0.05 for both). Renal function was similar across eGDR tertiles and no difference in retinopathy was detected.Conclusion:TC and TG are altered in individuals with T1DM and low eGDR, suggesting that this subgroup requires optimal lipid management to ameliorate their vascular risk.

Quercetin Ameliorates Lipid and Apolipoprotein Profile in High-Dose Glucocorticoid Treated Rats.

ResumoFundamento Os glicocorticóides (GCs) são amplamente prescritos para o tratamento de numerosos distúrbios clínicos devido às suas propriedades anti-inflamatórias e imunomoduladoras, e um dos efeitos indesejáveis mais comuns desses medicamentos é a dislipidemia.Objetivo Avaliar o efeito da quercetina, um flavonoide derivado de plantas, no perfil lipídico de ratos tratados com glicocorticóides em altas doses.Métodos Um total de 32 ratos Sprague-Dawley foram distribuídos aleatoriamente entre quatro grupos (8 ratos por grupo) e tratados por 6 semanas com uma das seguintes opções : (i) solução salina normal; (ii) 40 mg/kg de succinato sódico de metilprednisolona (MP); (iii) MP + 50 mg/kg de quercetina; (iv) MP + 150 mg/kg de quercetina. O MP foi injetado por via subcutânea e a quercetina foi administrada por gavagem oral 3 dias por semana. No final do estudo, o perfil lipídico dos animais foi medido através de kits enzimáticos. Os dados foram analisados e a significância estatística foi estabelecida em p <0,05.Resultados Os níveis séricos médios de colesterol total (CT), triglicerídeos (TG) e LDL aumentaram drasticamente em animais tratados com GC em comparação com o grupo controle. Ambas as doses de quercetina (50 e 150 mg/kg) melhoraram o CT (43% e 45%), LDL (56% e 56%) e TG (46% e 55%, respectivamente). A razão Apo B/A1 diminuiu mais de 20% após a ingestão de Anti-Inflamatory Agents.Conclusões Esses dados sugerem que a ingestão de quercetina Quercetin; induzida por glicocorticóides. (Arq Bras Cardiol. 2020; 115(1):102-108)

Secular trends in cardiovascular risk factors among women aged 45\u201354\u2009years in Gothenburg, Sweden, from 1980 to 2014

BackgroundA declining trend in mean cholesterol levels and smoking has been observed in high-income western countries during the last few decades, whereas obesity rates have increased. Simultaneously, mortality from coronary heart disease has decreased. The aim of the present study was to determine whether the trends in cardiovascular risk factors have continued in successive cohorts of middle-aged women over a period of 34 years.MethodsSix population-based, cross-sectional samples of women (n = 2294) mean age: 49.8 years (range: 45–54), living in Gothenburg, Sweden, were investigated between 1980 and 2014.ResultsBody mass index (BMI) increased over time, with a mean BMI of 24.7 kg/m2 in 1980 to 25.7 kg/m2 in 2013–2014, corresponding to a weight gain of 4.5 kg, together with an increase in the proportion of obese individuals (BMI ≥ 30 kg/m2) from 10.4 to 16.6% (p = 0.0012). The proportion of smokers and women with hypertension decreased from 34.5 to 12.8% (p = 0.0006) and from 37.7 to 24.5% (p < 0.0001) respectively. Mean total serum cholesterol levels decreased from 6.23 (SD 1.09) mmol/L in 1980 to 5.43 (SD 0.98) mmol/L in 2013–2014 (p < 0.0001). Self-reported leisure time regular exercise increased from 7.8% in 1980 to 35.6% in 2013–2014 (p < 0.0001). For women born in 1963, the prevalence ratio of not having any of five major cardiovascular risk factors was 1.82 (95% confidence interval (CI) 1.38–2.41), compared with women born in 1925–1934.ConclusionThe trend towards increasing obesity, more leisure-time physical activity and less smoking remains, while the decrease in serum cholesterol appears to have abated.