Mean Low-density Lipoprotein Levels Research Articles

Blood Sugar Concentration, HbA1C, and Lipid Profile in Heart Patients

The study included 45 samples (30 patients with heart disease and have diabetes and 15 patients with Type 2 DM), their age between (40-60) years for both gender. Samples were collected from Kirkuk general hospital from April 2023 to September 2023. The individuals of this study were divided into two groups: The first group was for patients with heart disease n (30), and the second group for individual have diabetes only n (15). Result: Heart disease patients had higher mean serum cholesterol, triglyceride, LDL, and VLDL levels (225.1±25.2, 209.5±8.3, 140.7±17.9, 41.9±4.61) compared to diabetes patients (196.3±27.2, 165±6.1, 119.67±15.2, 33.00±3.22) at a P-value < 0.05. HDL levels were similar across groups at P > 0.05. The research demonstrates the mean FBS and HbA1C of 30 heart disease and 15 diabetic patients. The study found that heart disease patients had higher mean serum FBS and HbA1C levels (282.8±36.41 mg/dl, 10.35±3.18%) compared to diabetes patients (175.2±32.79 mg/dl, 8.22±2.51%). A P-value < 0.05. Conclusion: The study concluded appositive association between dyslipidemia and heart disease in which increased cholesterol, triglyceride, low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), fasting blood glucose and HbA1C and no differences between heart disease and diabetes patients.

Differences and correlations of biochemical index levels in patients with bipolar disorder and major depressive disorder during a stable period.

The differences and correlation of biochemical indexes between bipolar disorder (BPD) and major depressive disorder (MDD) in stable stage were analyzed and discussed. Patients diagnosed with BPD and MDD in the Third People's Hospital of Foshan from January 2019 to December 2021 were selected as the research subjects, with 200 cases in each. Fasting serum was collected from patients and then detected regarding TC, TG, high-density lipoprotein, low-density lipoprotein (LDL), aspartate aminotransferase, lactic dehydrogenase, creatine kinase, creatine kinase-MB, urea, creatinine, uric acid, alanine aminotransferase, glucose (GLU), hemoglobin A1c, prolactin, high-sensitivity C-reactive protein, homocysteine. The results showed that the mean age and serum LDL, GLU, and HbAc1 levels of the MDD group were significantly higher than those of the BPD group (P < .05), while there was no significant difference in other indexes (P > .05). The prevalence of BPD was significantly negatively correlated with patient age (r = -0.164, P = .020), LDL (r = -0.150, P = .034), GLU (r = -0.140, P = .048), and HbAc1 (r = -0.215, P = .002) (P < .05). There were no significant differences in serum Hcy and high-sensitivity C-reactive protein levels between the BPD and MDD groups. The age, fasting blood glucose, glycosylated hemoglobin, and LDL of BPD patients were negatively correlated with their incidence.

Coronary calcium score (CAC) appears to be independent of lipid profile in treated patients with Heterozygous Familial Hypercholesterolaemia

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary artery calcium (CAC) score has been shown to improve the risk stratification and prediction of Atherosclerotic Cardiovascular Disease (ASCVD) in cohorts of patients with Heterozygous Familial Hypercholesterolaemia (FH) [i]. Objectives We sought to examine the CAC score in patients with FH who are on treatment and correlate to the therapy, Total Cholesterol (TC), Low Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL) levels. Method Retrospective Analysis of patients with established diagnosis of FH from a specialist lipid clinic who underwent CAC for risk stratification. Results The study included 64 patients, of which 33 patients (52%) were males with an average age of 57.4 years. At diagnosis, the mean elevated TC level was 7.40 ±1.60 mmol/l. 37 patients (58%) were on statin, (7 patients were on Rosuvastatin 20 mg, 20 patients were on Atorvastatin 40 mg, 8 patients were on Atorvastatin 20 mg, 2 patients were on Atorvastatin 80 mg), 8 patients (12%) were on a combination of PCSK9 and statins, 3 patients (5%) were on fibrates (fenofibrates) 160 mg, 3 patients (5%) were on Ezetimibe 10 mg, 4 patients (6%) were on Bempedoic Acid 180 mg, 9 patients (15%) were on lifestyle modifications and did not prefer to start on any lipid lowering agents. 71% of patients with TC level of 7.29 ±1.87 mmol/l had a calcium score of less than 100. CAC of &amp;gt;100 was observed in 29% of patients with a TC level of 7.44 ±1.50 mmol/l. (p value of 0.741) CAC score &amp;gt;100 appeared independent of (A) LDL level (27% with a mean LDL level of 4.81±1.81 mmol/l versus 73% with a CAC &amp;lt;100 and a mean LDL level of 4.40 ±1.38mmol/l) (p value of 0.424) and of HDL level (29% of patients with a mean HDL level of 1.45 ±0.64mmol/l versus 71% with a CAC score&amp;lt; 100 with a mean HDL level of 1.44 ±0.61mmol/l) (p value of 0.768). Despite therapy, 45 patients (27 %) had high LDL level with a mean LDL level of 4.5 ±1.50mmol/l though we found no difference in CAC score between the two groups (p value of 0.424). Conclusion In a single centre retrospective analysis of patients with Heterozygous Familial Hypercholesterolaemia on therapy, there appears to be no correlation between the CAC score of more than 100 and baseline therapy, Total Cholesterol, LDL or HDL levels achieved. We postulate that more stringent LDL reduction to ~1.4mmol/l should be adopted with further analysis of Coronary calcium score in the long term.

Study of Lipid Profile in Type 2 Diabetes Mellitus Patients in South Chennai Population.

Diabetes Mellitus is caused by the decreased utilization of glucose by tissues and is attributed either to hypoinsulinemia or hyperinsulinemia induced by the overstimulation of insulin-secreting beta cells. Patients with diabetes mellitus, obesity and dyslipidemia are prone to Metabolic syndrome. The study aims to estimate and compare the lipid profile in type 2 diabetes mellitus patients and healthy individuals. This case-control study was undertaken in type II Diabetic patients, where 48 were male, and 45 were female. The diabetic subjects were compared with 33 male and 55 Healthy female subjects who volunteered as controls. Venous blood samples from healthy and diabetic subjects were collected and used to measure routine parameters such as fasting blood sugar (FBS), post-prandial blood sugar(PPBS), Total cholesterol, HDL, and TGL. The Fasting Plasma Glucose and post-prandial glucose were significantly increased among diabetic subjects than the healthy controls. The triglyceride levels in cases had elevated levels in comparison to controls. HDL showed a marginal decrease in the diabetic group than the control group. Mean LDL levels in people with diabetes increase compared to the healthy controls. Besides, the VLDL levels also significantly increased among people with diabetes. There was a substantial increase in FBS and PPBS levels among the diabetic subjects compared to the healthy controls. The lipid profile constituting Total cholesterol, Triglycerides, HDL, LDL and VLDL levels showed the following changes: There was a significant increase in Total cholesterol, TGL, VLDL, and LDL levels, whereas the HDL levels were decreased among the diabetic subjects. Patients with type 2 diabetes mellitus must keep their blood sugar levels under control through follow-ups because uncontrolled diabetes mellitus leads to lipid dysfunction, which ultimately increases the risk of coronary artery disease. Keywords: , , Triglyceride (TGL), Low-Density Lipoprotein (LDL).

PCSK9 Inhibitor Use and Outcomes Using Concomitant Lipid-Lowering Therapies in the Veterans Health Administration

BackgroundReal-world data on use of PCSK9 inhibitors (PCSK9-Is), with or without statins and/or ezetimibe, and associated outcomes, can inform more effective prescribing. The objective was to evaluate clinical effectiveness and safety of PCSK9-Is within the Veterans Health Administration (VHA). MethodsIn this retrospective cohort study, we included Veterans who had at least one outpatient prescription for alirocumab and/or evolocumab filled within VHA between August 21, 2015, and September 30, 2020. Analyses included 4 mutually exclusive subgroups: PCSK9-I alone, PCSK9-I+statin, PCSK9-I+ezetimibe, and PCSK9-I+statin+ezetimibe subgroups. Primary outcomes included medication possession ratio, persistence, and low-density lipoprotein (LDL). ResultsAmong Veterans in the analytical cohort (n = 2428), 36.2% were on PCSK9-I monotherapy; 24.0% received a PCSK9-I+statin; 27.4% were on a PCSK9-I+ezetimibe; and 12.4% received triple therapy, that is, PCSK9-I+statin+ezetimibe. The mean medication possession ratio (standard deviation [SD]) for PCSK9-I monotherapy was 83.8% (13.3) compared to 84.3% (11.2) with PCSK9-I+statin therapy, 87.1% (10.1) with PCSK9-I+ezetimibe therapy, and 85.8% (11.7) with triple therapy. The percentage of patients who discontinued PCSK9-I in the monotherapy subgroup was 12.3% vs 9.5%, 6.6%, and 7.4% in the concomitant statin, ezetimibe, and triple-therapy subgroups, respectively (p = .002 among the groups). Mean LDL level was greater in the PCSK9-I monotherapy subgroup (85.6 mg/dL) compared with the concomitant statin (66.5 mg/dL), ezetimibe (65.7 mg/dL), and triple-therapy subgroups (68.1 mg/dL). ConclusionsVeterans showed good adherence and/or persistence with PCSK9-I regimens. On average, those receiving concomitant therapy with a statin and/or ezetimibe achieved significantly lower LDL levels.

COMPARSION OF LIPID PROFILE IN DIABETIC HYPERTENSIVES VS DIABETIC NORMOTENSIVES

Background: Lipid abnormalities are linked to a higher risk of cardiovascular disease and other morbidity in people with diabetes. Dyslipidemia may signal the onset of Type 2 diabetes in the future. A trio of diminished high density lipoprotein (HDL), increased triglycerides (TG), and increased low density lipoprotein (LDL) is known as diabetic dyslipidemia. As a result, diabetic dyslipidemia serves as a separate risk factor and predictor for coronary artery disease (CAD). Aim: To compare Serum lipid profile levels in type-2 diabetics with hypertension (Group 1) and type-2 diabetics without hypertension (Group 2). Methods: Prospective observational study was undertaken on 200 subjects aged 40-60 years from November 2019 to October 2020 with patients of Type-2 diabetes mellitus (both old and new cases) with hypertension (Group 1) and Type-2 diabetes mellitus without hypertension (Group 2) having any of the complications associated with diabetes and on age and sex matched diabetics without hypertension. Results: Mean value of total cholesterol ± standard deviation of Group 1 was 188.92 ± 34.66 mg/dl and that of Group 2 was 190 ± 46.54, the difference between the two groups being statistically not significant (p=0.853). Mean value of triglycerides ± standard deviation of Group 1 was 214.81 ± 78.35 mg/dl and that of Group 2 was 184.04 ± 62.69 mg/dl, the difference between the two groups being statistically highly significant (p=0.003). Mean value of LDL ± standard deviation of Group 1 was 104.42 ± 31.26 mg/dl and that of Group 2 was 109.57 ± 39.78 mg/dl, the difference between the two groups being statistically not significant (p=0.309). Mean value of HDL ± standard deviation of Group 1 was 42.98 ± 6.20 mg/dl and that of Group 2 was 43.80 ± 6.47 mg/dl, the difference between the two groups being statistically not significant (p=0.361). Mean systolic and diastolic blood pressure in Group 1 was 127.64 ± 13.41 and 86.20 ± 7.06 mmHg and that of Group 2 was 118 ± 10.80 and 77.52 ± 7.87 mmHg, the difference between the two groups being statistically highly significant (p&lt;0.0001). Mean Fasting Blood sugar of Group 1 was 197.80 ± 74.75 mg/dl and that of Group 2 was 177.91 ± 62.52mg/dl the difference being highly statistically significant (p= 0.043). Conclusion: The findings of this study concluded that there is a positive relationship between type-2 diabetes mellitus and lipid profile. Mean values of total cholesterol, LDL, triglycerides were significantly raised in type-2 diabetics, supporting the hypothesis that dyslipidemia is a significant complication of type-2 diabetes mellitus, which further contributes to the increased risk of multiple organ morbidities in diabetes. A significant difference in mean triglyceride level was found in both groups. There were no significant differences in mean HDL, LDL and cholesterol levels among the two groups as the levels of these parameters were raised to an almost equal extent in both the groups.

Prevalence and Determinants of Occurrence of Dyslipidemia in Subjects with Type 1 Diabetes Mellitus.

To describe the prevalence and determinants of occurrence of dyslipidemia in children and adolescents with type 1 diabetes mellitus (T1DM). A cross-sectional study was conducted in the diabetic clinic of a tertiary care referral hospital over two years. Subjects with T1DM aged 2-18 y had assessment of Lipid profile after 12h of fasting. Glycemic control was assessed by glycosylated hemoglobin (HbA1C). Modifiable and nonmodifiable determining factors were assessed during clinic visit as per standard criteria. Body mass index (BMI)more than 23rd adult equivalent and 27th adult equivalent were considered as overweight and obesity, respectively. Lipid parameters were considered as abnormal if: Low density lipoprotein (LDL) > 100mg/dL, high density lipoprotein (HDL) < 40mg/dL, triglycerides > 100mg/dL (< 10 y) and > 130mg/dL (> 10 y). A total of 171 subjects (mean age: 11.8 ± 3.5 y, M:F = 75:96) were recruited during the study period. The mean fasting LDL level, HDL level, and triglyceride level observed in the study sample were 106.6 ± 26.9mg/dL(62% abnormal), 52.6 ± 14.3mg/dL (9.4% abnormal), and 85.3 ± 39.4mg/dL (10.5% abnormal), respectively; 115 (67.3%) of the subjects had at least one abnormality in the serum lipid profile. On multivariate analysis, HbA1C was the most significant factor in determining the occurrence of dyslipidemia (p < 0.05). HbA1C was 9.9 ± 1.6 in subjects with abnormal LDL versus 9.1 ± 1.5 in those with normal LDL (p < 0.05). Prevalence of dyslipidemia in the study children and adolescents with T1DM was 67.3%. HbA1C remains the most important modifiable determinant of the occurrence of dyslipidemia.

The role of serum lipoprotein levels in predicting independent short-term mortality In COVID-19 patients

Background: Plasma lipoprotein levels typically change as a result of systemic inflammation in coronavirus disease (COVID-19). These changes have been reported to be related to the severity and prognosis of the disease. The aim of this study was to evaluate the relationship between serum high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, and cholesterol levels andindependent short-term (28-day) mortality in COVID-19 patients with critical disease.&#x0D; Material and Method: The retrospective study included patients that had a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on real-time reverse transcriptase polymerase chain reaction (RT-PCR) and were followed up in ICU due to pneumonia and acute hypoxemic respiratory failure between March 2020 and January 2021.&#x0D; Results: The 123 patients comprised 69 (56.1%) women and 54 (43.9%) men with a mean age of 65.41±13.93 years. Mean hospital and ICU stays were 16.07±9.84 and 8.54±8.24 days, respectively. Short-term (28-day) mortality occurred in 33 (26.8%) patients. Mean serum LDL, HDL, triglyceride, and cholesterol levels were 100.61±36.32, 41.57±10.74, 136.67±85.33, and 164.4±40.73 mg/dL, respectively. Short-term (28-day) mortality established a significant relationship with LDL and HDL levels, whereas no significant relationship was established with cholesterol and triglyceride levels (p=0.001, p=0.001, p=0.332, and p=0.222, respectively). The durations of hospital and ICU stay established a significant relationship with LDL levels (p=0.033 and p=0.002, respectively).&#x0D; Conclusion: Based on our results, we suggest that monitoring HDL and LDL levels with serial measurements in patients with critical and severe COVID-19 pneumonia may be useful for predicting the prognosis.

Abstract WMP17: Associations Between Post-Stroke Vascular Risk Factor Levels With Post-Stroke Cognitive Decline

Introduction: Associations between post-stroke vascular risk factors levels with post-stroke cognitive decline are uncertain. We determined associations between systolic blood pressure (BP), glucose, and low-density lipoprotein (LDL) cholesterol levels with post-stroke cognitive decline. Hypothesis: Higher post-stroke systolic BP, glucose, and LDL cholesterol levels are associated with faster post-stroke cognitive decline. Methods: This cohort study pooled data from 832 participants 18 and older with incident stroke and free of dementia before stroke (50% women and 32% Black) from 4 cohort studies from 1971-2019: Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, Framingham Offspring Study, and REasons for Geographic and Racial Differences in Stroke Study. Linear mixed-effects models were used to estimate longitudinal changes in cognition after incident stroke. The primary outcome was change in global cognition. Global cognition was harmonized across studies and standardized as T-scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1-SD difference in cognition. Median (IQR) follow-up was 5.5 (3.3-8.3) years. Results: In separate models, higher post-stroke glucose and LDL levels, but not systolic BP, were associated with faster declines in global cognition (Models M1a, M1b, and M1c, Table 1). In a model with all three vascular risk factors, higher post-stroke mean glucose and LDL levels were associated with faster global cognition decline, though not to traditional levels of statistical significance; however, post-stroke mean systolic BP was not associated with global cognition decline (Model M2, Table 1). Older age was associated with faster cognitive decline in all models. Conclusions: Our results suggest that higher post-stroke glucose and LDL levels are associated with faster post-stroke cognitive decline. We found no evidence that post-stroke BP levels are associated with post-stroke cognitive decline.

Lipid Profile of the Patient with Acute Coronary Syndromes Undergoing Coronary Angiography (CAG) in Rural Costal Region of Maharashtra

Background: Coronary Heart Disease (CHD) is widely prevalent across the globe and significantly high level of Cholesterol in circulation is a single major risk factor associated with coronary heart disease. It is well established that cardiovascular disease is associated with hypertension and elevated blood levels of low-density lipoprotein (LDL), total cholesterol, and triglycerides. In disparity, a low level of high-density lipoprotein (HDL) is a risk factor for mortality from cardiovascular disease. Aim: The present study was conducted with the aim to assess the lipid profile in patients of Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) in rural coastal population. Patients and Methods: The present study was done on 62 patients with Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) Serum levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were examined in biochemical laboratory of the hospital. Coronary angiography was performed for the presence of lesions. Results: 43.5% of the patients (n=27) were elderly (age&gt;60 years). Approximately 82% of the patients (n=51) aged more than 50 years. Males outnumbered females with a ratio of 2.4:1. 71% of the patients were males. Mean cholesterol levels were 177.86 mg/dl. Approx 3/4th of the patients (n=41) had cholesterol level &lt;200 mg/Dl. Mean triglycerides levels in the patients were 158.29 mg/dl. Only 11 patients out of 62 CAD patients had abnormal triglycerides. Mean LDL level was 119.5 mg and Mean HDL level was 34.5 mg %. The high plasma concentration of low-density lipoprotein (LDL-C) in 30% and the low plasma concentration of high-density lipoprotein (HDL-C) n 33% of patients were important abnormal findings in our patients. Conclusion: Dyslipidemia as in form of very low levels of HDL cholesterol with comparatively high levels of LDL-c with near normal total Cholesterol and triglyceride levels associated with ACS in our rural costal region of Maharashtra.

Effect of Methadone on Lipid Profile, Serum Leptin and Liver Enzymes Levels in Male and Female Rats

Methadone Maintenance Therapy (MMT) has been accepted as a gold-standard treatment for opioid therapy. It may associate with adverse effects. This study aimed to affect methadone on serum lipid profile, leptin levels, and liver enzymes in male and female rats. 41 Wistar rats weighing 200-300gr were randomly assigned into four groups, including two methadone treatments and two control groups, both male and female, that received 5mg/kg methadone or 1cc normal saline daily for 8 weeks respectively by gavage method. All animals were weighed weekly. Fasting blood sugar (FBS) was measured by a glucometer, and blood samples were taken by cardiac puncture for triglyceride, low-density lipoprotein (LDL),high-density lipoprotein (HDL), total cholesterol, Aspartate transaminase (AST), Alanine transaminase (ALT), alkaline phosphatase (ALP) and leptin levels measurement after 12h fasting. One-way ANOVA showed no significant difference in mean FBS, total cholesterol, triglyceride, and LDL levels among the four groups. Moreover, there was a statistically significant difference in the mean of HDL, ALT, AST, and ALP levels. Furthermore, repeated measures ANOVA indicated a significant increase in body weight of rats during 8 weeks. Our findings indicated changes in some metabolic effects associated with methadone treatment in a gender-dependent manner.

Impact of Toxoplasma gondii human infections on blood lipid levels

To evaluate the impact of Toxoplasma gondii human infections on blood lipid levels. A total of 1 000 healthy volunteers that were randomly sampled from a tertiary hospital during the period from December 2017 through December 2019 were enrolled, and assigned into the infection group and the control group according to the detection of serum anti-T. gondii antibody using enzyme-linked immunosorbent assay (ELISA). The serum levels of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglyceride (TG) were detected and compared between the two groups. The seroprevalence of anti-T. gondii antibody was 8.40% in the study subjects, and there were no significant differences between the infection and control groups in terms of gender (χ2 = 1.29, P > 0.05) or age (χ2 = 1.41, P > 0.05). The mean serum LDL (t = 3.89, P < 0.05) and TC levels (t = 3.81, P < 0.05) were significantly higher in the infection group than in the control group, while no significant differences were seen between the two groups in terms of mean serum TG (t = 0.97, P > 0.05) or HDL levels (t = 0.75, P > 0.05). In addition, the proportions of abnormal LDL (χ2 = 9.69, P < 0.01) and TC levels (χ2 = 10.39, P < 0.01) were significantly greater in the infection group than in the control group, while no significant differences were found in the proportion of abnormal TG (χ2 = 0.02, P > 0.05) or HDL level (χ2 = 0.11, P > 0.05) between the two groups. T. gondii human infections affect blood lipid levels, and the individuals sero-positive for anti-T. gondii antibody have higher mean serum LDL and TC, as well as higher proportions of abnormal TC and LDL than sero-negative individuals.

The determinants of lipid profiles in early adolescence in a Ugandan birth cohort

Dyslipidaemia in adolescence tracks into adulthood and is an important risk factor for cardiovascular disease. Little is known about the effects of environmental exposures and early-life exposure to infectious diseases common to tropical regions on lipids. In 1119 early adolescent participants in the Entebbe Mother and Baby Study, we used linear regression to examine whether prenatal, childhood or adolescent factors are associated with lipid levels. Reduced high-density lipoprotein (HDL) and elevated triglyceride levels were common (prevalence 31% and 14%, respectively), but elevated low-density lipoprotein (LDL) or total cholesterol (TC) were rare. Current malaria infection was associated with lower mean LDL (adjusted ß − 0.51; 95% CI − 0.81, − 0.21), HDL (adjusted ß − 0.40; 95% CI − 0.56, − 0.23), and TC levels (adjusted ß − 0.62; 95% CI − 0.97, − 0.27), but higher mean triglyceride levels (geometric mean ratio (GMR) 1.47; 95% CI 1.18–1.84). Early-life asymptomatic malaria was associated with modest reductions in HDL and TC. Body mass index (BMI) was positively associated with LDL, TC, and triglycerides. No associations with helminth infection were found. Our findings suggest that early-life factors have only marginal effects on the lipid profile. Current malaria infection and BMI are strongly associated with lipids and important to consider when trying to improve the lipid profile.

Apolipoprotein-E Gene Polymorphism and Lipid Composition among IUGR and AGA Neonates.

Objective The objective of this study is to study the profile of apolipoprotein E ( APOE ) gene polymorphism and lipid profile among intrauterine growth restriction (IUGR) and appropriate for gestational age (AGA) neonates. This is an observational study. This study was done at the neonatal unit of a teaching hospital in South India. All consecutively born IUGR neonates (cases) of more than 32 weeks' gestational age and AGA neonates (controls) were enrolled for the study. Genomic DNA extraction was done from a total of 102 peripheral venous blood samples. Genotyping of the APOE rs429358 and rs7412 defining the ε2, ε3, and ε4 alleles was done by polymerase chain reaction-restriction fragment length polymorphism method. Prefeed venous blood was collected and analyzed for lipid profile estimation. The allelic frequencies of cases versus control were ε2-9 (8.7%) versus 3 (2.9%); ε3-88 (84.6%) versus 81 (79.4%); and ε4-7 (6.7%) versus 18 (17.6%). The frequency of ε4 isoform allele, associated with adult onset of metabolic diseases was less among the IUGR group. The mean total cholesterol (TC), Low-Density Lipoprotein (LDL), High-Density Lipoprotein, and triglyceride (TG) were 107.59 ± 35.99, 51.69 ± 24.68, 21.75 ± 9.58, and 151.22 ± 61.84 mg/dL, respectively, in the IUGR group. The mean TC and LDL levels in IUGR group were marginally higher than AGA neonates (107 ± 35.99 vs. 100.37 ± 22.69 mg/dL and 51.69 ± 24.68 versus 46.9 ± 19.51 mg/dL, p > 0.05). In both groups, the mean TC and TGL levels were elevated in the ε4 isoform subgroup ( p > 0.05). In our study, the ε2 allele was the second most predominant APOE isoform and the ε4 allele of the APOE gene associated with adult-onset diseases was not increased among IUGR neonates. Neonates with ε4 allele showed an abnormal lipid profile in both study groups suggesting a possible association.

Cholesterol and glaucoma: a systematic review and meta-analysis.

PurposeIntraocular pressure is the main risk factor for glaucoma; however, additional risk factors may also matter. This systematic review and meta‐analysis were conducted to summarize the evidence regarding the association of cholesterol parameters (total cholesterol, low‐density lipoprotein (LDL) and high‐density lipoprotein (HDL) levels) and glaucoma.MethodsFour electronic databases were searched for all publications containing ‘glaucoma’ and one of various forms of ‘cholesterol’ or ‘lipoprotein’. Two independent reviewers screened abstracts and potentially full texts of identified articles for eligibility. Risk of bias was assessed with the Newcastle–Ottawa Scale. A random‐effects meta‐analysis was used to investigate the differences in total cholesterol, LDL and HDL levels between patients with and without glaucoma.ResultsOverall, 29 observational studies were included in the systematic review and 26 reported quantitative information to investigate differences in cholesterol parameters between patients with glaucoma (N = 7196) and patients without glaucoma (N = 350 441). Patients with glaucoma had significantly higher total cholesterol levels than patients without glaucoma (Mean Difference (MD) 7.9 mg/dl, 95% CI 3.3 to 12.5, p = 0.001) and lower mean HDL levels (MD −2.0 mg/dl, 95% CI: −3.1 to −0.9, p = 0.001). Patients with glaucoma had higher mean LDL levels than patients without glaucoma, albeit not statistically significant (MD 6.1 mg/dl, 95% CI: −4.3 to 16.4, p = 0.251).ConclusionThis systematic review and meta‐analysis of observational studies found an association of glaucoma and high total cholesterol and low HDL levels, respectively. Although this supports the hypothesis that lipid levels pose an additional risk for glaucoma development, heterogeneity was substantial and causality cannot be presumed from identified observational studies.

Impact of lipid levels and high-intensity statins on vein graft patency after CABG: Midterm results of the ACTIVE trial.

High-dose atorvastatin did not improve 1-year vein graft patency in the recent Aggressive Cholesterol Therapy to Inhibit Vein Graft Events trial. However, it remains unknown whether high-intensity statins may impact graft disease in the years that follow. In the trial, patients (N = 173) were randomized to receive atorvastatin 10 or 80 mg for 1 year after coronary bypass surgery (CABG). Beyond 1 year, the choice of statin was left to the patient's physician. In this study of participants who agreed to follow-up (N = 76), low-density lipoprotein (LDL) levels were measured and graft patency was assessed 3 years after surgery. The rate of vein graft disease 3 years after surgery was not significantly reduced with atorvastatin 80 mg during the first postoperative year or the use of open-label high-intensity statin thereafter (p = NS). However, a trend was observed between higher LDL levels during the first postoperative year and a greater incidence of vein graft disease at 3 years (p = .12). Among patients who had LDL levels more than 90 mg/dl in the first year after CABG, 38.5% had vein graft disease at 3 years, compared to 19.0% for those with LDL levels less than 90 mg/dl (p = .15). Higher mean LDL levels during the first postoperative year were associated with a higher rate of vein disease 3 years after surgery both at the graft level (p = .03) and at the patient level (p = .03) in multivariate analysis. Higher LDL levels during the first postoperative year were associated with significantly greater vein graft disease 3 years after CABG.

A Comparison of Effectiveness of Crystalline and Amorphous Atorvastatin

Background: Atorvastatin is a widely used statin, of which there are two available polymorphs: crystalline (original) and amorphous (generic). Pharmacological studies showed the similarity between both forms. However, the lipid-lowering effectiveness of the amorphous form was still uncertain. Objective: To compare the effectiveness of crystalline and amorphous form of atorvastatin. Materials and Methods: The authors conducted an observational cross-sectional analytic study by retrospectively collecting data from January 1, 2016 to December 31, 2017 of the patients at Queen Sirikit Heart Center of the Northeast where the original regimen of crystalline atorvastatin had been replaced by the amorphous atorvastatin at the same dose. Patients must have been prescribed each form of atorvastatin for at least six weeks. The lipid profiles taken at the closest to the switching point (before and after) were used. The primary outcome was changes in low-density lipoprotein (LDL) levels. The secondary outcomes were changes in total cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL) levels, as well as a comparison of LDL levels in patients whose tablets were split. Results: Eight hundred twenty-five patients were included in the present study. The mean age was 63.7±9.9 years. Five hundred sixty-eight patients (68.8%) were male, and 736 (89.2%) were treated as secondary prevention. The mean LDL levels during crystalline and amorphous atorvastatin use were 92.4±39.0 and 91.8±41.0 mg/dL, respectively (mean difference –0.6; 95% confidence interval [CI], –2.2 to 1.0; p=0.460). The mean TC, TG, and HDL levels during crystalline and amorphous form use were 153.1±43.3 and 152.0±48.6 mg/dL (p=0.400), 153.4±129.0 and 155.0±148.3 (p=0.740), 43.6±11.9, and 44.4±12.0 (p=0.004), respectively. Among the patients who had tablet splitting, the mean LDL levels during crystalline and amorphous atorvastatin use were 89.2±28.3 and 91.0±30.8 mg/dL, respectively (p=0.279). Side effects were recorded in nine patients, one of which was rhabdomyolysis. Conclusion: The effectiveness of amorphous atorvastatin at lowering lipids was comparable to that of atorvastatin in its crystalline form, and patients were generally able to tolerate amorphous atorvastatin. Keywords: Atorvastatin, Crystalline, Amorphous, Lipid-lowering, Low-density lipoprotein

ISCHEMIC STROKE;

Objectives: To establish the association of raised LDL levels withvarious risk factors causing cerebral ischemia in stroke patients. Background: Cerebrovascular accident (CVA) is a health concern worldwide. Itcauses enormous disabilities in adult age group, and is 2ndcommonest cause of deaths throughout the world. It has been established thatapproximately 15 million people succumb to stroke each year worldwide, out of this 5 million don’t survive and another 5 million become permanently handicapped and thus put significant burden on catering families. This study was conducted to identify contribution of different risk factorsin causing ischemic stroke in our population. Study Design: Descriptive, purposive case series study. Setting: Medical Unit-IV, Nishtar Medical College/Hospital, Multan. Period: One Year tenure spread between January 2017 to December 2017. Material and Methods: 205 cases between 40-70 years of age includingboth male and female patients with ischemic stroke, irrespective of disease duration were included in study. History of raised BP, previous stroke, history of stroke in family, diabetes and smoking was recorded on pre-designed questionnaire. Body mass index was calculated after noting weight and height of the patient.Venous blood (5 ml) sample was drawn and sent to the pathology laboratory of Nishtar Hospital Multan for estimation of serum LDL level and blood glucose level. Results: Of these 205 study cases, 92 (44.9%) patients were male while 113 (55.1%) patients were female. Mean age of patients in our setting was noted to 51.58 ± 8.05 years. In our study, 50 (24.4%) patients were smokers and 40 (19.5%) had history of hypertension. In our setting, family history of stroke was present in 39 (19%) and previous history of stroke was found in 31 (15.1%). Mean body mass index of our patients was calculated to be 23.17± 2.85 kg/m2and 30(14.6%) cases were obese in our study. Mean fasting blood glucose level was 118.32 ± 23.21 mg/dl(48 (23.4%) had diabetes). Mean low density lipoprotein level (LDL) noted in our study was 109.59 ± 49.15 mg/dl and raised level of LDL was seen in 88 (42.9%) of our study cases. Conclusion: By identifying the share of various risk factors contributing in ischemic stroke, we can target population at risk of ischemic stroke and strict control and regulation of modifiable risk factors we can prevent this ominous condition to occur. Our study results point towards early diagnosis which will ultimately lead to proper management to improve clinical outcome in such patients. Raised levels of LDL were significantly associated with gender, diabetes, hypertension, obesity, family history and previous history of stroke.

Evaluation of hypolipidemic effect of stem part of Berberis aristata in Type 2 diabetes mellitus patients as add on therapy

Background: Diabetes mellitus (DM) is one of the oldest common metabolic disorders characterized by hyperglycemia, hyperlipidemia, negative nitrogen balance, and ketonemia. It is a one of the most important pathological conditions associated with dyslipidemia that affects the whole body system. Several types of DM exist and result by a complex interaction of genes and drugs, gestational diabetes, environmental factors such as stress and sedentary lifestyle choices. DM is the leading cause of end-stage renal disease, coronary artery disease, cerebrovascular disease, nontraumatic lower extremity amputations, and adult blindness. Aims and Objectives: This study was conducted to evaluate the hypolipidemic effect of stem part of Berberis aristata in patients of Type 2 DM with dyslipidemia as add on therapy. Materials and Methods: A prospective randomized open parallel group study was conducted in total 90 patients having high fasting blood sugar (FBS) and dyslipidemia of either sex in the age group of 30-60 years attending of outpatient/indoor Department of Medicine of Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India. A total of 103 each Group 1 (N = 30) was taken as control while Group 2 (N = 30) and Group 3 (N = 30) was taken as study group who had received 1.5 and 3 g of B. aristata, respectively, as add on therapy along with their conventional antidiabetic and antihyperlipidemic (in certain number of patients) treatment. During the study, 13 patients (8 male and 5 female) did not complete the study and reason of premature withdrawal included protocol violation. Results: In our study, there were a statistically a highly significant improvement and stabilization of glycemic control in test Groups 2 and 3 when compared with control group (P 0.05) and highly significant in Group 3 (P < 0.001) as compared to control. The mean triglyceride level decreased highly significantly in the Group 2 and Group 3 (P < 0.001) as compared to control. The mean low density lipoprotein level decreased highly significant in the Group 2 and Group 3 (P < 0.001) as compared to control. Conclusion: It can be concluded that B. aristata as an add on therapy in Type 2 DM patients has a beneficial role with regard to the hyperglycemia and dyslipidemia very safe as no major side effects were observed affecting morbidity and mortality. Hence, B. aristata as an add on therapy could represent a good treatment option before initiating insulin and hypolipidemic therapy in diabetic patient with suboptional glycemic and lipideimic control to avoid unwanted adverse effects and can cut down cost of treatment.

A Randomized Open-Label Trial to Assess the Effect of Plant Sterols Associated with Ezetimibe in Low-Density Lipoprotein Levels in Patients with Coronary Artery Disease on Statin Therapy.

Consumption of food products enriched with plant sterols and the use of ezetimibe reduce cholesterol absorption in the intestine and effectively reduce low-density lipoprotein (LDL) plasma levels. We evaluated the therapeutic effect of the ezetimibe+plant sterol association in patients with coronary artery disease still not reaching recommended lipid levels despite the use of statins. We performed a prospective open-label study with 41 patients with stable coronary disease and LDL >70 mg/dL. Patients were randomized into four groups for a 6-week treatment: the control (CT) group remained on the same statin therapy, the ezetimibe (EZ) group received 10 mg/day of ezetimibe, the plant sterol (PS) group received spread enriched with 2 g of plant sterols, and the ezetimibe+PS (EZ+PS) group received 10 mg/day EZ +2 g PS. Initial mean LDL level was 97.4 ± 31.1 mg/dL in control group, 105.1 ± 23.1 mg/dL in EZ group, 95.4 ± 27.7 mg/dL in PS group, and 97.0 ± 8.3 mg/dL in EZ+PS group (P > .05). After 6 weeks of treatment, LDL of patients slightly increased in the control group (+8.9%; P > .05) and dropped in EZ group (-19.1%; P = .06), PS group (-16.6%; P = .01), and EZ+PS group (-27.3%; P < .01). Mean LDL levels after treatment were 70.5 ± 17.9 mg/dL in EZ+PS group, lower than the other groups (control was 106.1 ± 34.9 mg/dL, EZ group was 85.0 ± 35.6 mg/dL, and PS was 79.6 ± 29.7 mg/dL) (P = .05 variance analysis factor [ANOVA]). Body weight, body-mass index, and glucose plasma levels did not change significantly after intervention. The combination of PS+ezetimibe was associated with lower LDL levels and suggests beneficial therapeutic effect against major cardiovascular events.