Mean Total Cholesterol Levels Research Articles

E056 Particularities of the lipid profile in rheumatoid arthritis

Abstract Background/Aims Rheumatoid arthritis (RA), like all autoimmune diseases, is associated with a high cardiovascular risk. This risk is essentially linked to the chronic inflammation and dyslipidaemia engendered by this chronic inflammatory rheumatism. The objective of this work was to study the particularities of the lipid profile in RA. Methods We conducted a retrospective study including patients with RA according to ACR- EULAR 2010 criteria, followed in an internal medicine department between 2015 and 2022. Lipid profile data (total cholesterol (TC), high-density lipoproteins (HDLc), low-density lipoproteins (LDLc), and triglycerides (TG)) were collected. Results Eighty patients with RA were studied. The mean age was 60.79 years [range 30-91]. The sex ratio (F/H) was 4.33, with a clear female predominance. The mean age of disease onset was 46.34 years [extremes: 22-82]. A personal history of dyslipidaemia was noted in 19 patients: hypercholesterolemia, hypertriglyceridemia, and mixed dyslipidaemia were found in 8, 4 and 7 cases. Other comorbidities were arterial hypertension in 35% of cases (n = 28), diabetes in 30% of cases (n = 24), renal insufficiency in 6.25% of cases (n = 5) and a cardiovascular accident in 5% of cases (n = 4). Obesity was present in 15% of patients and smoking in 5%. 69 patients had a lipid panel. Dyslipidaemia was present in 66.7% of cases (n = 46). The mean TC level was 4.47 ± 1.0 mmol/L [range: 2.32 - 6.96 mmol/L], the mean TG level was 2.64 ± 0.81 [range: 0.90 - 4 mmol/L], the mean HDLc level was 1.106 ± 0.394 mmol/L [0.50 - 2] and the mean LDLc level was 1.38 ± 0.565 mmol/L [0.56 - 3.59 mmol/L]. Hypercholesterolemia (21.3%) and hypocholesterolaemia (21.3%) were the most common lipid abnormalities. Hypertriglyceridemia was observed in 10% of cases (n = 8). A low HDLc was observed in 20% of cases (n = 16). Only one patient had a high HDLc, with HDLc= 2 mmol/l. A low LDL was present in 10% of cases (n = 8). Conclusion In our study, hypolipidemia was the most common dyslipidaemia. This confirms the lipid paradox found in RA. Indeed, systemic inflammation is responsible for quantitative and qualitative alterations in lipoproteins. Stabilization of the disease leads to normalization of the lipid balance and improved control of cardiovascular risk. Disclosure I. Fenniche: None. M. Somai: None. I. Rachdi: None. I. Arbaoui: None. F. Daoud: None. S. Kochbati: None. B. Daoud: None. Z. Aydi: None. F. Boussema: None.

Distal Upper Extremity Arterial Calcification as a Predictor for Subclinical Coronary Artery Disease by Coronary Artery Calcium Scoring.

Several studies have linked calcification of the thoracic and lower extremity arterial trunks to an increased risk of developing coronary artery disease (CAD). Calcifications of the radial and/or ulnar artery are regularly identified in hand/wrist x-rays; however, the clinical relevance of these findings as related to identifying subclinical CAD is not well understood. Associations between CAD and upper extremity calcifications have been reported, but the timeline is unclear. The purpose of this study was to evaluate the association between upper extremity arterial calcifications on hand radiographs with CAD by coronary artery calcification (CAC) scoring in patients with no known history of CAD. This is a pilot single-center, prospective, matched cohort study. We included patients with no known history of CAD, related symptoms, or major risk factors. We recruited five patients with calcifications (cal+) and five patients matched by age, race, sex, and medical history but without calcifications (cal-). CAC scores were determined from computed tomography scanning, and lipid profile was evaluated. In the cal+ group, the mean CAC total score was 244.1; in the control (cal-) group, it was 85.2. The mean total cholesterol levels were 220.8 mg per dL and 167 mg per dL in the cal+ and cal- groups, respectively. Two cal+ patients with CAC scores of 937 and 669 died shortly after being enrolled in our study. Preliminary findings suggest that calcifications in the radial or ulnar artery in otherwise asymptomatic patients with no history of CAD may be an independent sign of CAD.

Abstract P505: Investigating Sudden Death in a Large North Carolina County: Methods and Findings of a Population-Based Registry

Introduction: Evidence on drivers of sudden death (SD) is needed to understand its persistently high incidence and inform prevention interventions. SD studies have been hampered by data limitations and restrictive SD criteria. We conducted a population-based study of all-cause, out-of-hospital SD using Emergency Medical Services (EMS) data from Wake County, a large North Carolina county with >1 million residents. Methods: We screened EMS records of out-of-hospital deaths between 2013-2015 among persons aged 18-64 years, collected medical and death records, and adjudicated 399 SD cases according to a standardized protocol. Deaths occurring in hospices or nursing homes were excluded, as were those due to unnatural death or cancer. Deaths were not excluded by time last seen or coronary artery disease (CAD) criteria. Frequency matched living controls were identified from the same county and time. We compiled and summarized findings based on peer-reviewed papers and published abstracts in Table 1. Results: Cardiovascular disease risk factors were common among decedents, including hypertension (60.4%, 244 of 371), though only 14.8% (55 of 371) had documented CAD. SD cases had lower adjusted mean total cholesterol, low-density lipoprotein and high-density lipoprotein levels compared to controls. Furthermore, left ventricular hypertrophy and inflammation suggested nodes on a common causal pathway. Poor health care management was frequent as well as mental health and substance use problems. Environmental factors such as poverty, air pollution and absence of nearby greenways were associated with SD. Conclusions: Conducting a population-based registry of adjudicated SD cases was feasible and provided high quality data for study. Our findings suggest that SD is not only tied to CAD but a syndrome with potentially different environmental and inflammatory etiologies. Future studies should investigate modifiable risk factors for interventions to prevent SD.

Association between organophosphate flame retardant exposure and lipid metabolism: data from the 2013-2014 National Health and Nutrition Examination Survey.

Organophosphate flame retardants (OPFRs) are emerging environmental pollutants that can be detected in water, dust, and biological organisms. Certain OPFRs can disrupt lipid metabolism in animal models and cell lines. However, the effects of OPFRs on human lipid metabolism remain unclear. We included 1,580 participants (≥20 years) from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) to explore the relationship between OPFR exposure and lipid metabolism biomarkers. After adjusting for confounding factors, results showed that one-unit increases in the log levels of diphenyl phosphate (DPhP) (regression coefficient = -5.755; S.E. = 2.289; p = 0.023) and log bis-(1-chloro-2-propyl) phosphate (BCPP) (regression coefficient = -4.637; S.E. = 2.019; p = 0.036) were negatively associated with the levels of total cholesterol (TC) in all participants. One-unit increases in the levels of DPhP (regression coefficient = -2.292; S.E. = 0.802; p = 0.012), log bis (1,3-dichloro-2-propyl) phosphate (BDCPP) (regression coefficient = -2.046; S.E. = 0.825; p = 0.026), and log bis-2-chloroethyl phosphate (BCEP) (regression coefficient = -2.604; S.E. = 0.704; p = 0.002) were negatively associated with the levels of high-density lipoprotein cholesterol (HDL-C). With increasing quartiles of urine BDCPP levels, the mean TC levels significantly decreased in all participants (p value for trend = 0.028), and quartile increases in the levels of DPhP (p value for trend = 0.01), BDCPP (p value for trend = 0.001), and BCEP (p value for trend<0.001) were negatively corelated with HDL-C, with approximately 5.9, 9.9, and 12.5% differences between the upper and lower quartiles. In conclusion, DPhP, BDCPP, and BCEP were negatively related to HDL-C concentration, whereas DPhP and BCPP levels were negatively associated with TC level. Thus, exposure to OPFRs may interfere with lipid metabolism.

Atherogenic Index, Cardiovascular Risk Ratio, and Atherogenic Coefficient as Risk Factors for Cardiovascular Disease in Pre-eclampsia in Southeast Nigeria: A Cross-Sectional Study.

Pre-eclampsia is a key trigger for maternal and perinatal morbidity and mortality. Current evidence suggests an association between dyslipidemia and atherosclerosis. Thus, the importance of evaluating some indices of atherosclerosis during pregnancy cannot be over-emphasized. To evaluate the effect of some lipid profile indices as risk factors for developing cardiovascular disease (CVD) among women with pre-eclampsia in Enugu, Southeast Nigeria. A cross-sectional study of two groups of eligible pregnant women between 20 and 40 weeks of gestation selected at three healthcare facilities in Enugu, Nigeria was carried out. The case group consisted of 160 women with pre-eclampsia, while the control group consisted of 160 normotensive pregnant women. Participants' fasting blood samples were analyzed for different fractions of lipids and their atherogenic indices were calculated. There were significantly higher mean levels of total cholesterol (TC), low-density lipoprotein (LDL), and triglyceride (TG) [P < 0.001] in pre-eclampsia than in normal pregnancy. The atherogenic index of plasma (AIP), cardiovascular risk ratio (CRR), and atherogenic coefficient (AC) were significantly higher in pre-eclampsia than in normal pregnancy (P < 0.001) and there was a significant positive correlation between mean arterial pressure (MAP) and AIP (r = 0.421), CRR (r = 0.416) and AC (r = 0.634) for women with pre-eclampsia. Pre-eclampsia is associated with an increased risk of CVDs. Determining the atherogenic indices and assessing the AIP level in pre-eclamptic women may predict disease risk and help in early management and measures for its prevention.

Exploring Serum Lipid Profile Changes in Patients During Laparoscopic Choecystectomy

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

Abstract C087: Association of serum lipid profile with prostate cancer risk and aggressiveness in Nigerian men

Abstract OBJECTIVE Though prostate cancer (PCa) is the most common cancer and cause of cancer death among Nigerian men, its relationship with serum lipid profiles, a biochemical measurement of dietary fat, has not been explored among Nigerian men. The study aimed to determine the association of serum lipid profile with prostate cancer risk and aggressiveness. METHODS The study was a case-control conducted at University College Hospital, Ibadan, Nigeria. The cases were newly diagnosed prostate cancer patients ages 50-75 years, while the controls were age-matched healthy men with confirmed normal PSA. Participants with uncontrolled comorbidities, poor performance status (ECOG ≥3), and weight loss in the past month were not eligible. The patient characteristics (age, marital status, employment status, highest level of education, high-fat diet, lack of exercise, tobacco smoking, alcohol intake, family history of prostate cancer, comorbidities, and tumor characteristics [PSA at presentation, histology, Gleason score, and stage at presentation] in the cases alone) were collected using an interviewer-administered questionnaire. A serum lipid profile test (including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) was done in all participants. Analysis of the variables was on SPSS version 23.0, with a t-test to compare the serum lipid profile between the case and control groups, a chi-square to compare the sociodemographic and patient characteristics between both groups and an ANOVA test to determine the association between serum lipid profile and Gleason's score (disease grade) or stage of prostate cancer. RESULTS Enrolled in each group were seventy-four participants. The mean age ± standard deviation was 65.0 ± 5.9 years for cases and 63.0 ± 6.5 years for controls. Participants with a high-fat diet (p = 0.006), physical inactivity (p = 0.046), alcohol consumption (p = 0.005), and family history (p = 0.002) were significantly higher in the case group than the controls. A high proportion of the cases had high-grade disease (GS ≥ 8) [39.2%] and stage 4 disease (35.2%). The mean levels of TC (p&amp;lt;0.001) and HDL-C (p&amp;lt;0.001) were significantly higher in the cases. The mean TG increased while HDL-C decreased as the disease stage advanced but with no statistical significance. While the mean TC (p = 0.001) increased significantly with worsening prostate cancer grade, the mean HDL-C was highest in low-grade disease (p &amp;lt;0.001). CONCLUSION Elevated total cholesterol and high-density lipoprotein cholesterol were associated with increased prostate cancer risk. While elevated total cholesterol was associated with high-grade prostate cancer, a high level of high-density lipoprotein cholesterol was associated with the low-grade disease. Hence, regular serum lipid profile tests may be encouraged among Nigerian men for early detection and treatment of any cholesterol derangement to avoid its predisposition to prostate cancer. Citation Format: Kehinde Oluwatosin Adeyinka, Adeniyi Adenipekun, Atara Ntekim, Augustine Oghenewveyin Takure, Rotimi Solomon. Association of serum lipid profile with prostate cancer risk and aggressiveness in Nigerian men [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C087.

Cardiovascular risk factors among Polish employees of uniformed services.

Employees of uniformed services (EoUS) were screened for cardiovascular risk factors. A total of 1138 EoUS (age M±SD 49.9±6.0 years) and 263 controls (age M±SD 54.4±9.7 years) under the care of the cardiology clinic in Gdańsk, Poland, were included in the study. Medical history and blood samples were collected, and a physical examination was performed. Ten-year cardiovascular risk of death was calculated using the systematic coronary risk evaluation (SCORE) risk algorithm for high-risk countries. Significantly higher values of mean systolic and mean diastolic blood pressure, mean total cholesterol level and mean BMI were recorded among the EoUS compared to controls (M±SD 141.7±11.6 mm Hg vs. 135.5±11.0 mm Hg, p < 0.001; 90.1±5.9 mm Hg vs. 84.5±6.8 mm Hg, p < 0.001; 6.01±0.76 mmol vs. 5.44±0.87 mmol, p < 0.001; 29.3±4.7 vs. 29.0±4.1, p < 0.001, respectively). Smoking cigarettes was most frequently reported by the youngest group (20-39 years old) - 47.7% and it was significantly higher in the entire EoUS group compared to control group (35.5% vs. 16.7%, p = 0.001). The occurrence of observed risk factors (blood pressure ≥140/90 mm Hg, total cholesterol concentration >5 mmol, smoking,) was significantly higher among EoUS compared to controls (92.1% vs. 57.8%, p < 0.001; 89.0% vs. 66.9%, p < 0.001; 35.5% vs. 16.7%, p < 0.001, respectively). In the male group, the mean calculated ten-year risk of fatal cardiovascular events, the percentage of high calculated risk, and very high risk were higher in the EoUS group compared to controls (M±SD 4.44±3.49 vs. 4.23±3.86, p = 0.001; 23.7% vs. 20.2%, p = 0.007; 7.4% vs. 6.5%, p = 0.03, respectively). The prevalence of all identified risk factors was found to be higher among employees of uniformed services when compared to the control group. The presence of these risk factors within the population of uniformed service employees results in a greater risk of mortality from cardiovascular diseases. Int J Occup Med Environ Health. 2023;36(5):656-71.

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

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

Sex differences in cholesterol and triglyceride levels among hospitalized adolescents and young adults with eating disorders.

To determine sex differences in cholesterol and triglyceride levels among adolescents and young adults hospitalized for medical complications of eating disorders. A retrospective electronic medical record review of patients aged 9-25 years admitted to the University of California, San Francisco Eating Disorders Program for medical stabilization, between 2012 and 2020, was conducted. Non-fasting total cholesterol and triglycerides were collected; however, LDL and HDL levels were not available. Among 83 males and 441 females, mean ± SD age was 15.5 ± 2.8 years, 64.1% had anorexia nervosa, and admission percent median body mass index was 87.3 ± 13.9. The proportion of males and females with high total cholesterol (13.3% vs. 18.1%, Cramer's V = 0.05, p = .28) and high triglyceride levels (9.6% vs. 8.1%, Cramer's V = 0.02, p = .63) did not differ. Mean total cholesterol levels were higher in females compared to males (F 169.6 ± 41.1 mg/dL vs. M 154.5 ± 45.1 mg/dL, Cohen's d = 0.36, p = .003), although a majority were within the normal range. In adjusted linear regression models, male (compared to female) sex (B = -14.40, 95% CI -24.54, -4.27) and higher percent median body mass index (B = -0.33, 95% CI -0.60, -0.06) were associated with lower total cholesterol levels in adjusted models (R2 = 0.04). Building on prior work showing equally severe complications of eating disorders in males compared to females, we did not find sex differences in those presenting with high total cholesterol or triglycerides. Future research is needed to understand the pathophysiology and role of dyslipidemia in acute malnutrition, and the impact of nutritional rehabilitation and weight restoration. We found that the proportion of male and female adolescents and young adults hospitalized for medical complications of an eating disorder with high total cholesterol did not significantly differ. Although average total cholesterol levels were higher in female compared to male patients with eating disorders, a majority of these levels remained within the normal range. Patients with more severe malnutrition had a higher risk of elevated total cholesterol levels. Clinicians should consider monitoring cholesterol levels in young people hospitalized for restrictive eating disorders.

Thyroid Profile and Serum Lipid Level in Women with Normal Pregnancy

Objective: To evaluate the changes in thyroid profile and serum lipid level in normal pregnancy.Methods: This observational study was conducted at the Department of Biochemistry of Santosh Medical College, Ghaziabad, UP, India, from June 2021 to February 2022. In this study, 200 average pregnant women were enrolled. The thyroid profile was estimated using the ELISA method, and the lipid profile was measured using the enzymatic kit method. All data were expressed as means and standard deviations, and SPSS version 17 was used for statistical analysis.Results: This observational study observed that the mean T3, T4, and TSH levels increased significantly in the second trimester compared to the first trimester. In contrast, the mean value of T3, T4, and TSH decreased in the third trimester as compared to the second trimester. The mean levels of total cholesterol, triglyceride, and LDL-cholesterol increased significantly, while the mean value of HDL-cholesterol decreased significantly in the second and third trimesters when compared to the first trimester.Conclusion: This study demonstrated abnormal lipid and thyroid metabolism. Changes in thyroid profile may be associated with adverse obstetric outcomes. The altered lipid parameters, mainly High TG and low HDL-C concentrations, may promote vascular dysfunction and oxidative stress.

Thyroid Profile and Serum Lipid Level in Women with Normal Pregnancy

Objective: To evaluate the changes in thyroid profile and serum lipid level in normal pregnancy. Methods: This observational study was conducted at the Department of Biochemistry of Santosh Medical College, Ghaziabad, UP, India, from June 2021 to February 2022. In this study, 200 average pregnant women were enrolled. The thyroid profile was estimated using the ELISA method, and the lipid profile was measured using the enzymatic kit method. All data were expressed as means and standard deviations, and SPSS version 17 was used for statistical analysis. Results: This observational study observed that the mean T3, T4, and TSH levels increased significantly in the second trimester compared to the first trimester. In contrast, the mean value of T3, T4, and TSH decreased in the third trimester as compared to the second trimester. The mean levels of total cholesterol, triglyceride, and LDL-cholesterol increased significantly, while the mean value of HDL-cholesterol decreased significantly in the second and third trimesters when compared to the first trimester. Conclusion: This study demonstrated abnormal lipid and thyroid metabolism. Changes in thyroid profile may be associated with adverse obstetric outcomes. The altered lipid parameters, mainly High TG and low HDL-C concentrations, may promote vascular dysfunction and oxidative stress.

Comparison of umbilical cord blood lipid profiles between appropriate and small for gestational age newborns with their mothers’ lipid profiles: a case-control study from tertiary care centre of Karnataka

Background: Fetal malnutrition and fetal growth restriction results in dysfunctions of neuroendocrine system, pancreas and adipose-tissue; finally increasing the food intake and decreasing energy use. This results in an increase in adipose deposition and insulin-resistance and ultimately increasing chances of adult metabolic-diseases. This study makes an effort to compare and contrast the lipid-profiles of Small for Gestational Age (SGA) and Appropriate for Gestational Age (AGA)newborns correlating and with their mother’s lipid-profiles. Methods: This was a case-control study, conducted in the Departments of Pediatrics and OBG of Karwar Institute of Medical Sciences,Karwar, Karnataka,India over a period of twelve months(January-2021 to January-2022). With 500neonates, 357appropriate for gestational age (AGA) and 143 small for gestational age(SGA) babies were included for the study as controls and cases for their lipid profiles using their cord-blood. Results: here, we found that SGA-babies had lower gestational age (37.40±1.01 weeks) at birth compared to AGA-babies (39.22±1.05 weeks) which was statistically significant. The mean Total Cholesterol (TC) level (84.47±27.39 mg/dl) was higher in SGA-babies compared to AGA-babies (56.87±32.28 mg/dl) and this difference was statistically highly significant (p value&lt;0.0001). The mean very low density lipoprotein (VLDL) level (14.10±10.67 mg/dl) was higher in SGA-babies than AGA-babies (7.17±3.69 mg/dl) with p value&lt;0.0001 (highly significant). The mean low density lipoprotein (LDL) level (38.74±19.85 mg/dl) was higher in SGA-babies compared to AGA-babies (25.63±14.15 mg/dl) and this difference was statistically significant (p value&lt;0.0001). The mean high density lipoprotein (HDL) levels of AGA and SGA-babies were comparable with low statistical significance (26.70±14.90 mg/dl of SGA; 24.45±9.567 mg/dl of AGA, p value 0.095). Conclusions: Levels of all lipids were observed to be higher in SGA babies than in AGA babies. Mothers who gave birth to SGA babies were found to have statistically significant high VLDL levels.

The Role of the Low-Density Lipoprotein/High-Density Lipoprotein Cholesterol Ratio as an Atherogenic Risk Factor in Young Adults with Ischemic Stroke: A Case-Control Study.

Dyslipidemia is a major atherogenic risk factor for ischemic stroke. Stroke patients tend to have high levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). Therefore, it is noteworthy that there has been an increase in ischemic stroke cases in young and elderly individuals in recent years. This study investigated the TC/HDL-C ratio and the LDL-C/HDL-C ratio, which may be more specific and common lipid parameters in young patients with ischemic stroke. This study aimed to demonstrate the sensitivity and specificity of TC/HDL-C and LDL-C/HDL-C ratios as atherogenic markers for young adult ischemic strokes. This trial was conducted as a retrospective case-control study. A total of 123 patients (patient group) and 86 healthy individuals (control group) aged 18-50 years were randomly selected from four different hospitals. Lipid parameters and TC/HDL-C and LDL-C/HDL-C ratios were compared between these two groups. The mean age was 38.8 ± 7.3 years in patients and 37.7 ± 9 years in controls (p > 005). The HDL-C levels were 39.1 ± 10.8 mg/dL in patients and 48.4 ± 13.8 mg/dL in controls (p < 0.001). LDL-C/HDL-C ratios were 3.23 ± 1.74 and 2.38 ± 0.87, and TC/HDL-C ratios were 5.24 ± 2.31 and 4.10 ± 1.25 in the patient and control groups, respectively (p < 0.001). The LDL-C/HDL-C and TC/HDL-C cutoff values in ROC analyses were 2.61 and 4.40 respectively; the AUCs (95% CI) were determined to be 0.680 (0.608-0.753) and 0.683 (0.610-0.755) (p < 0.001), respectively. An increased risk of stroke was observed in those with a high LDL-C/HDL-C ratio (OR = 1.827; 95% CI = 1.341-2.488; p < 0.001). Our study obtained similar results when we compared the mean TC and LDL-C levels between the two groups. However, considering the TC/HDL-C and LDL-C/HDL-C ratios, it is noteworthy that there was a significant difference between the patient and control groups.

Cord blood triglyceride and total cholesterol in preterm and term neonates: reference values and associated factors from the Japan Environment and Children's Study.

This study aimed to investigate the associations between cord serum total cholesterol (TC) and triglyceride (TG)levels and perinatal factors and determine the reference levels of cord blood TC and TG in Japanese neonates. This was a prospective birth cohort study using data from the Japan Environment and Children's Study, which included data on births from 2011 to 2014 in Japan. TC and TG levels were determined in cord blood samples. A total of 70,535 pairs of neonates (male: 36,001, female: 34,524) and mothers were included. The mean cord blood TC and TG levels were 72.2mg/dL and 24.4mg/dL, respectively. Multiple regression analyses revealed that gestational age and birth weight were significantly associated with cord blood TC (coefficient -2.35, 95% confidence interval [CI] -2.40 - -2.22 and coefficient 0.002, 95% CI 0.002-0.003, respectively) and TG (coefficient 3.09, 95% CI 3.01-3.17 and coefficient - 0.009, 95% CI - 0.009-0.008, respectively) levels. Mean cord blood TG and TC levels decreased over the preterm period; however, these parameters increased during the term. Furthermore, the mean cord blood TC and TG levels decreased over the entire range of birth weight categories. Conclusion: Mean cord blood TG and TC levels decreased over the preterm period; however, these parameters increased during the term. Furthermore, the mean cord blood TC and TG levels decreased over the entire range of birth weight categories in Japanese newborns. Maternal complications such as maternal parity, HDP, PROM, maternal obesity and income level were associated with cord TC and TG levels. What is Known: • No studies have ascertained the reference levels of cord blood lipid levels in Japan. What is New: • Mean cord blood TG and TC levels decreased over the preterm period; however, these parameters increased during the term.

A study of factors influencing long-term glycemic variability in patients with type 2 diabetes: a structural equation modeling approach.

The present study aims to utilize structural equation modeling (SEM) to investigate the factors impacting long-term glycemic variability among patients afflicted with type 2 diabetes. The present investigation is a retrospective cohort study that involved the collection of data on patients with type 2 diabetes mellitus who received care at a hospital located in Chengdu, Sichuan Province, over a period spanning from January 1, 2013, to October 30, 2022. Inclusion criteria required patients to have had at least three laboratory test results available. Pertinent patient-related information encompassing general demographic characteristics and biochemical indicators was gathered. Variability in the dataset was defined by standard deviation (SD) and coefficient of variation (CV), with glycosylated hemoglobin variation also considering variability score (HVS). Linear regression analysis was employed to establish the structural equation models for statistically significant influences on long-term glycemic variability. Structural equation modeling was employed to analyze effects and pathways. Diabetes outpatient special disease management, uric acid variability, mean triglyceride levels, mean total cholesterol levels, total cholesterol variability, LDL variability, baseline glycated hemoglobin, and recent glycated hemoglobin were identified as significant factors influencing long-term glycemic variability. The overall fit of the structural equation model was found to be satisfactory and it was able to capture the relationship between outpatient special disease management, biochemical indicators, and glycated hemoglobin variability. According to the total effect statistics, baseline glycated hemoglobin and total cholesterol levels exhibited the strongest impact on glycated hemoglobin variability. The factors that have a significant impact on the variation of glycosylated hemoglobin include glycosylated hemoglobin itself, lipids, uric acid, and outpatient special disease management for diabetes. The identification and management of these associated factors can potentially mitigate long-term glycemic variability, thereby delaying the onset of complications and enhancing patients' quality of life.

Lipid distributions in the Global Diagnostics Network across five continents.

Lipids are central in the development of cardiovascular disease, and the present study aimed to characterize variation in lipid profiles across different countries to improve understanding of cardiovascular risk and opportunities for risk-reducing interventions. This first collaborative report of the Global Diagnostics Network (GDN) evaluated lipid distributions from nine laboratory organizations providing clinical laboratory testing in 17 countries on five continents. This cross-sectional study assessed aggregated lipid results from patients aged 20-89 years, tested at GDN laboratories, from 2018 through 2020. In addition to mean levels, the World Health Organization total cholesterol risk target (<5.00 mmol/L, <193 mg/dL) and proportions in guideline-based low-density lipoprotein cholesterol (LDL-C) categories were assessed. This study of 461 888 753 lipid results found wide variation by country/region, sex, and age. In most countries, total cholesterol and LDL-C peaked at 50-59 years in females and 40-49 years in males. Sex- and age-group adjusted mean total cholesterol levels ranged from 4.58 mmol/L (177.1 mg/dL) in the Republic of Korea to 5.40 mmol/L (208.8 mg/dL) in Austria. Mean total cholesterol levels exceeded the World Health Organization target in Japan, Australia, North Macedonia, Switzerland, Germany, Slovakia, and Austria. Considering LDL-C categories, North Macedonia had the highest proportions of LDL-C results >4.91 mmol/L (>190 mg/dL) for both females (9.9%) and males (8.7%). LDL-C levels <1.55 mmol/L (<60 mg/dL) were most common among females in Canada (10.7%) and males in the UK (17.3%). With nearly a half billion lipid results, this study sheds light on the worldwide variability in lipid levels, which may reflect inter-country differences in genetics, lipid testing, lifestyle habits, and pharmacologic treatment. Despite variability, elevated atherogenic lipid levels are a common global problem, and these results can help inform national policies and health system approaches to mitigate lipid-mediated risk of cardiovascular disease.

Calculated Nutritional Indices in Symptomatic Hospitalized Nigerian Covid-19 Patients.

Multifaceted approaches are needed to control the ongoing COVID-19 pandemic, therefore assessing the patients' nutritional status is desirable to justify the suggestion of biochemical nutritional markers or nutritional indices in the prognosis of COVID-19. This longitudinal study determined biochemical nutritional markers (albumin, prealbumin and total cholesterol) and nutritional indices [Controlling Nutritional Status (CONUT) score and Prognostic Nutritional Index (PNI)] in symptomatic hospitalized COVID-19 patients compared with control. These parameters were related to age, sex and days of admission of the patients. Plasma obtained were analyzed for biochemical nutritional markers and indices calculated. Data were analyzed using the Statistical Package for Social Sciences (SPSS Inc., USA) version 20.0. The mean prealbumin (PAB) and total cholesterol (TC) levels were significantly lower in COVID-19 patients compared to control (P<0.05). PNI classified 90% of COVID-19 patients as well-nourished while CONUT score classified 75.6% of COVID-19 patients as mildly malnourished. In COVID-19 patients at discharge, the mean level of TC was significantly increased compared with COVID-19 patients at admission. The mean albumin level in patients with ≤10days of admission was significantly lower when compared to those with those having >10days of admission. There were no significant differences in the PNI and CONUT scores of the participants in relation to age, gender and days of admission. This study concluded that Severe Acute Respiratory Syndrome Coronavirus 2 (SAR-COV 2) infection affects certain biochemical nutritional biomarkers and that PNI and CONUT could be use as cheap, reliable and affordable nutritional prognostic tools in the management of COVID-19 patients.

Comparing the effects of mHealth app use and face-to-face training on the clinical and laboratory parameters of dietary and fluid intake adherence in hemodialysis patients: a randomized clinical trial

BackgroundNumerous factors are likely to result in poor treatment adherence, which is one of the important factors contributing to increased complications and the low efficacy of hemodialysis (HD), particularly inadequate knowledge of patients. This study aimed to compare the effects of a mobile health (mHealth) app (the Di Care app) use and face-to-face training on the clinical and laboratory parameters of dietary and fluid intake adherence in patients undergoing HD.MethodsThis single-blinded, two-stage/two-group randomized clinical trial was fulfilled in 2021-22 in Iran. Seventy HD patients were recruited, using the convenience sampling method, and were then randomized into two groups: mHealth (n = 35) and face-to-face training (n = 35). ​ The patients in both groups received the same educational materials via the Di Care app and face-to-face training for one month. Before and 12 weeks after the intervention, the mean interdialytic weight gain (IDWG), potassium (K), phosphorus (P), total cholesterol (TC), triglyceride (TG), albumin (AL), and ferritin (FER) levels were measured and compared. The data were analyzed using the SPSS via descriptive statistics (mean, SD, frequency, and percentage) and analytical tests (independent-samples t-test, paired-samples t-test, Wilcoxon signed-rank test, Mann-Whitney U test, Chi-square test, and Fisher’s exact test).Results​Prior to the intervention, the mean IDWG and the K, P, TC, TG, AL, and FER levels, were not significantly different in both groups (p > 0.05). The mean IDWG (p < 0.0001), and the K (p = 0.001), P (p = 0.003), TC/TG (p < 0.0001), and FER (p = 0.038) levels in the HD patients in the mHealth group decreased. ​As well, the mean IDWG (p < 0.0001), and the K (p < 0.0001) and AL (p < 0.0001) levels showed a descending trend in the face-to-face group. The fall in the mean IDWG (p = 0.001) and the TG level (p = 0.034) in the patients in the mHealth group was significantly greater than that in the face-to-face group.ConclusionsThe Di Care app use and the face-to-face training could improve dietary and fluid intake adherence in patients. However, mHealth could have more effect on the laboratory parameters than face-to-face training, largely reducing the IDWG.Trial registrationThis study was registered in the Iranian Registry of Clinical Trials (No. ID IRCT20171216037895N5).

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

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