Mean Low-density Lipoprotein Research Articles

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.
 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.
 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).
 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.

A Study on the Lipid Profile of Hypertensive Patients

Background: Dyslipidaemia and hypertension are the commonest risk factors for coronary artery disease (CAD). To study the lipid profile in hypertensive patients.
 Methods: The present study was carried out on a total of 100 hypertensive patients attending our Hospital and 100 age and sex matched healthy controls. Twelve hour fasting lipid analysis was done for Serum triglycerides (TG), total cholesterol(TC), High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL).
 Results: The Mean serum total cholesterol values were highly significant in hypertensive subjects (235.36±32.36mg/dL) as compared to the healthy control subjects (152.36±12.01mg/dL). The mean serum TG level was 110.36±16.12 mg/dl in healthy control subjects, and 215.23±35.36 mg/dl in hypertensive patients. This difference was highly significant. The mean values for HDL was 27.23±6.02 mg/dL for hypertensive subjects whereas 43.21±5.36 mg/dl for healthy control subjects, respectively. The Mean serum LDL values were highly significant in hypertensive subjects (154.36±31.26 mg/dL) as compared to the healthy control subjects (95.36±16.02mg/dL).
 Conclusion: All the lipid profile like cholesterol, LDL, TG and HDL were derange in the hypertensive than those in the healthy controls.
 Keywords: Hypertension ,Lipid profile, HDL ,TG , LDL.

Therapeutic Effect of Roxadustat on Patients With Posttransplant Anemia

Roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, has been reported to be effective in treating conservative renal failure and renal anemia in patients undergoing dialysis. Nonetheless, its effect on posttransplant anemia (PTA) has not yet been analyzed. This study was conducted in accordance with the 1975 Declaration of Helsinki, as revised in 2013. Roxadustat was administered in 31 patients with a hemoglobin level ≤11 g/dL after renal transplant. The mean hemoglobin, serum iron, ferritin, and low-density lipoprotein (LDL) cholesterol levels and the estimated glomerular filtration rate at 4, 8, 12, 16, and 20 weeks after administration were compared with those before administration. The average (standard deviation) hemoglobin level in 25 patients (6 patients dropped out) increased from 9.8 (0.78) g/dL before administration to 12.1 (1.44) g/dL (P < .001) after 12 weeks of roxadustat administration. The mean ferritin level in patients decreased from 107.6 (84.95) ng/mL before administration to 51.7 (44.04) ng/mL (P=.022) after 8 weeks of roxadustat administration. The mean LDL cholesterol level decreased from 114.1 (31.67) mg/dL before administration to 78.7 (18.26) mg/dL (P=.0012) after 8 weeks of roxadustat administration. Complications observed in patients after roxadustat administration included reduced hemoglobin levels in 3 patients, gastrointestinal symptoms in 2 patients, and myocardial infarction in 1 patient. Hemoglobin levels significantly increased, whereas ferritin and LDL cholesterol levels significantly decreased in patients with PTA after roxadustat administration. Roxadustat seems to be an effective treatment for patients with PTA; however, the blood clotting tendency due to iron deficiency should be monitored in patients.

Eighteen-year trends in the management of patients with diabetes in the Shiga Diabetes Clinical Survey: overall trends and differences by age group.

To examine the trends in the management of patients with diabetes over an 18-year period in Japan. We recorded the height, body mass, laboratory data, diabetes treatment, and screening status of diabetic complications from the data collected during the Shiga Diabetes Clinical Survey, which has been performed every 6years since 2000. We then evaluated the management of patients with diabetes in Shiga Prefecture. The study included 17,870, 18,398, 24,243, and 26,624 participants in each of the 4years of measurements. The mean age and body mass index (BMI) of the participants gradually increased. The percentage of patients with BMI of ≥ 25kg/m2 was higher in younger patients. Glycemic control significantly improved over 18years (hemoglobin A1c: 7.3% ± 1.4% in 2000 to 7.1% ± 1.1% in 2018, P for trend < 0.001). The mean hemoglobin A1c levels were higher in younger patients than in elderly patients and increased from 2012 to 2018 in patients aged ≥ 65years. The proportion of participants who underwent screening for albuminuria and diabetic retinopathy increased. The mean blood pressure and low-density lipoprotein cholesterol concentration decreased. Glycemic control has been maintained at an acceptable level since the previous survey. Although glycemic control has become less strict in elderly patients with diabetes, glycemic control is poorer in younger patients than in elderly patients. Obesity is an increasingly important problem, particularly in younger patients. The frequency of screening for diabetic complications and the control of blood pressure should be improved. The online version contains supplementary material available at 10.1007/s13340-022-00573-2.

Impact of coronavirus disease 2019 epidemics on prevention and care for HIV and other sexually transmitted infections.

To assess the impact of coronavirus disease 2019 (COVID-19) epidemics on the prevention and care for HIV and other sexually transmitted infections at a major reference centre providing preventive and clinical services in Catalonia, Spain. We retrospectively compared anonymized clinical and laboratory data from March to December 2020 vs. 2019. Monthly clinical data on HIV preexposure and postexposure prophylaxis users and on adults with HIV infection were retrieved from the administrative hospital database. Monthly tests for HIV, hepatitis B and C, Treponema pallidum, Neisseria gonorrhoeae,and Chlamydia trachomatis, and plasma lipids and glucose were recovered from the laboratory database. There were less (↓28%, P = 0.003) but more advanced (mean CD4+ cells/μl 305 vs. 370, P < 0.001) HIV infections and more gonorrhoea (↑39%, P < 0.001) and chlamydia (↑37%, P < 0.001) infections in 2020 vs. 2019. In people with HIV, rates of HIV RNA less than 50 copies/ml remained stable (11 vs. 11%, P = 0.147) despite less scheduled visits (↓25%, P < 0.001). However, they had less antiretroviral prescription changes (↓10%, P = 0.018), worse plasma lipids [mean total cholesterol 190 vs. 185 mg/dl, P < 0.001;mean low-density lipoprotein (LDL) cholesterol 114 vs. 110 mg/dl, P < 0.001; mean triglycerides 136 vs. 125 mg/dl, P < 0.001; mean high-density lipoprotein (HDL) cholesterol 47 vs. 48 mg/dl, P = 006], and an excess of mortality (↑264%, P = 0.006) due in great part not only to COVID-19 but also to other causes. In our setting, COVID-19 epidemics was associated with an increase in some prevalent sexually transmitted infections, with less but more advanced HIV infections, and with worse nonvirologic healthcare outcomes and higher mortality in people living with HIV.

Comprassion the Lipid Profile among Children Suffreing from Nephrotic Syndrome before and after Remission

Aims: The study aimed to investigate serum cholesterol, triglycerides, LDL (low density lipoprotein), VLDL (very low-density lipoprotein), and HDL (high density lipoprotein) levels in nephrotic syndrome at the onset and during remission in first episode and relapse cases, as well as the relationship between dyslipidemia persistence and severity and disease duration and relapse frequency.&#x0D; Materials and Methods: A hospital-based prospective study including 30 children aged 0 to 12 years with nephrotic syndrome. They were steroid responsive in 22 cases and steroid dependent in 8 cases. They were assessed clinically and a lipid profile was taken at the start, during remission, and after treatment. A total of 30 children without liver or kidney disease were included as controls.&#x0D; Results: The mean blood cholesterol, triglycerides, LDL, and VLDL all increased significantly (p0.005). When compared to controls, HDL levels increased dramatically (P value 0.001) after nephrotic syndrome treatment. Lipid levels (serum cholesterol, triglycerides, LDL, VLDL) were significantly lower during remission in first-episode nephrotic syndrome cases, whereas lipid levels were significantly greater even during remission in recurrent cases. After treatment, total cholesterol and TGL levels were found to be higher, with P values of 0.004 and 0.004 respectively, as the duration of disease increased.&#x0D; Conclusion: The current investigation demonstrates that widespread hyperlipidemia is present in nephrotic syndrome. When compared to recently diagnosed with NS, this was much higher in relapse cases. Lipid profiles return to normal during remission recently diagnosed with NS, but they are considerably higher in recurrence instances, even during remission. As a result, there is a justification for treatment.

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.

Association of lipoprotein(a) with lipid profile and response to statin treatment in hyperlipidaemic patients.

To determine serum levels of lipoprotein(a) in the local population, its relationship with other parameters of lipid profile and statins' response to lipoprotein(a). The cross-sectional analytical study was conducted at the Pak-Emirates Military Hospital and Army Medical College, Rawalpindi, Pakistan, from March 2018 to March 2019, and comprised of healthy controls in group I, persons with hyperlipidaemia without medications in group II, and diagnosed cases of hyperlipidaemic on statin therapy in group III. The samples were studied using enzyme-linked immunosorbent assasy for lipoprotein(a) estimation, and an automated chemistry analyser for lipid profile estimation. Data was analysed using SPSS 21. Of the 90 subjects with a mean age of 43±5 years, 30(33.3%) were in each of the three groups. Mean body mass index, total cholesterol, triglycerides and low-density lipoprotein were significantly different among the groups. Lipoprotein(a) level was not correlated with statins (p>0.05), but had a positive correlation with low-density lipoprotein. Lipoprotein(a) was found to be raised even in the absence of dyslipidaemia, and it was controversially raised with statin therapy. Lipoprotein(a) can very well be regarded as an independent risk factor for all the known complications of hyperlipidaemia.

A Within-Subject Before-After Study of the Impact of Antidepressants on Hemoglobin A1c and Low-Density Lipoprotein Levels in Type 2 Diabetes

Data on the effect of treatment with antidepressant drugs on metabolic control in diabetes are sparse. In this controlled within-subject before-after study, the impact of initiation and discontinuation of antidepressant treatment on hemoglobin A1c (HbA1c) and low-density lipoprotein (LDL) levels in type 2 diabetes was estimated. All individuals with newly developed type 2 diabetes (first HbA1c ≥ 6.5%) between 2000 and 2016 in Northern and Central Denmark were identified using register-based health care data. Among these, we identified individuals initiating and discontinuing antidepressant treatment. Using a within-subject before-after design, we examined HbA1c and LDL in the 16 months leading up to and the 16 months after antidepressant treatment initiation or discontinuation, respectively. For comparison, we ran similar time trend analyses in a reference population of age- and sex-matched type 2 diabetes individuals not receiving antidepressant treatment. Mean HbA1c decreased after initiation of antidepressant treatment (-0.16%; 95% confidence interval [CI], -0.18 to -0.13%). In the reference population, no material change in HbA1c over time (-0.03%; 95% CI, -0.04 to -0.01%) was seen. Mean LDL decreased not only in antidepressant initiators (-0.17 mmol/L; 95% CI, -0.19 to -0.15 mmol/L) but also in the reference population (-0.15 mmol/L; 95% CI, -0.16 to -0.13 mmol/L). Among antidepressant discontinuers, there was also a decrease in HbA1c (-0.32%; 95% CI, -0.37 to -0.28%), with no change in the reference population (-0.02%; 95% CI, -0.04 to 0.00%). Decreases in LDL were found both in antidepressant discontinuers (-0.09 mmol/L; 95% CI, -0.14 to -0.04 mmol/L) and in the reference population (-0.16 mmol/L0; 95% CI, -0.18 to -0.13 mmol/L). Antidepressant treatment in type 2 diabetes may have a beneficial effect on glycemic control, as the decrease in HbA1c after discontinuation of antidepressants likely reflects remission of depression. Conversely, antidepressant treatment does not seem to affect LDL levels.

Low Detection Rates of Genetic FH in Cohort of Patients With Severe Hypercholesterolemia in the United Arabic Emirates.

Background: Programs to screen for Familial hypercholesterolemia (FH) are conducted worldwide. In Western societies, these programs have been shown to be cost-effective with hit/detection rates of 1 in 217–250. Thus far, there is no published data on genetic FH in the Gulf region. Using United Arab Emirates as a proxy for the Gulf region, we assessed the prevalence of genetically confirmed FH in the Emirati population sample. Materials and Methods: We recruited 229 patients with LDL-C >95th percentile and employed a customized next generation sequencing pipeline to screen canonical FH genes (LDLR, APOB, PCSK9, LDLRAP1). Results: Participants were characterized by mean total cholesterol and low-density lipoprotein cholesterol (LDL-c) of 6.3 ± 1.1 and 4.7 ± 1.1 mmol/L respectively. Ninety-six percent of the participants were using lipid-lowering medication with mean corrected LDL-c values of 10.0 ± 3.0 mmol/L 15 out of 229 participants were found to suffer from genetically confirmed FH. Carriers of causal genetic variants for FH had higher on-treatment LDL-c compared to those without causal variants (5.7 ± 1.5 vs 4.7 ± 1.0; p = 3.7E-04). The groups did not differ regarding high-density lipoprotein cholesterol, triglycerides, body mass index, blood pressure, glucose, and glycated haemoglobin. Conclusion: This study reveals a low 7% prevalence of genetic FH in Emiratis with marked hypercholesterolemia as determined by correcting LDL-c for the use of lipid-lowering treatment. The portfolio of mutations identified is, to a large extent, unique and includes gene duplications. Our findings warrant further studies into origins of hypercholesterolemia in these patients. This is further supported by the fact that these patients are also characterized by high prevalence of type 2 diabetes (42% in the current study cohort) which already puts them at an increased risk of atherosclerotic cardiovascular disease. These results may also be useful in public health initiatives for FH cascade screening programs in the UAE and maybe the Gulf region.

The risk factor profile in Egyptian patients with acute coronary syndrome: an observational study

ObjectiveTo evaluate the pattern of risk factor profile among Egyptian patients with acute coronary syndrome (ACS).BackgroundLittle is known about risk factors and treatment modalities in Egyptian patients with ACS.Patients and methodsThis cross-sectional study was conducted on 200 adult participants presented to the National Heart Institute, Cairo, Egypt, during May 2017 throughout April 2018. Patients with ACS including ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, or unstable angina were included. All patients were subjected to history taking, clinical examination, 12-lead ECG, and plasma troponin I to confirm myocardial necrosis and to identify ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina.ResultsThe percent of current smokers was significantly higher than nonsmokers (63.5 vs. 36.5%, P = 0.001). History of hypertension was significantly more frequent among the studied patients (57.5 vs. 42.5%, P = 0.034), and the same was observed for diabetes mellitus (60.5 vs. 39.5%, P = 0.003). Dyslipidemia (57%) was also significantly higher. Regarding the BMI, a high percentage of the studied patients were overweight and obese (40.5%). The mean low-density lipoprotein and BMI were significantly higher in females than males (P = 0.043 and 0.018, respectively).ConclusionThe findings of the present study revealed a number of modifiable risk factors for ACS among Egyptian patients. These comprised smoking, obesity, hypertension, diabetes mellitus, and dyslipidemia. Considering lifestyle interventions and awareness of the public especially among women would contribute toward minimizing ACS.

Cross-sectional Study Shows an Association between Paediatric Lichen Planus and Dyslipidemia.

Few studies have shown an association between adult lichen planus and dyslipidemia, but none has shown an association with the pediatric population. We planned to study the association between pediatric lichen planus and metabolic syndrome (MS). This is a single-centre, cross-sectional, case-control study from July 2018 to December 2019 at a tertiary care institute. Twenty children in the age group of 6-16 years, diagnosed as cases of childhood/adolescent lichen planus, and 40 age- and sex-matched controls were included in this study and evaluated for metabolic syndrome.Patients' anthropometry including weight, height, waist circumference, and body mass index (BMI) was recorded. Blood samples were sent for the measurement of fasting plasma glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, and triglyceride levels. The mean HDL was found to be significantly lower in children with lichen planus compared to children without lichen planus (p = 0.012), although there was no statistically significant difference in the frequency of patients having deranged HDL levels between the groups (p = 0.326). Children with lichen planus had a higher prevalence of central obesity, but the difference was not statistically significant (p = 0.101). There was no significant difference between mean BMI, hypertension, triglyceride, LDL, and fasting blood sugar values between the groups. Using the logistic regression analysis model, it was found that the strongest independent variable that impacts the occurrence of lichen planus was an HDL value less than 40 mg/dl (p = 0.017; OR 1.02 to 1.29). This study shows an association between paediatric lichen planus and dyslipidemia.

Seroprevalence, risk factors and impact of dengue fever/hepatitis B coinfection on liver function parameters in Cameroonian patients.

IntroductionDengue and hepatitis B are viral infections endemic to tropical areas with liver consequences. However, coinfection cases have been poorly documented worldwide and especially on the African continent. This study aimed at analysing the seroepidemiology of dengue-hepatitis B co-infection in patients recruited at the Regional Hospital of Ngaoundere (Cameroon).Material and methodsA cross-sectional study was conducted among 225 patients, aged 15-55 years, enrolled at the Laboratory service of Ngaoundere Regional Hospital from 25 September to 10 December 2021. HBsAg and dengue infection were diagnosed using the serological rapid tests. Part of the blood samples was used to quantify lipid profile and liver function parameters.ResultsOf the 225 patients recruited, 22.22% (50) tested positive for hepatitis B and 18.18% (38/202) were positive for dengue fever, with a dengue-hepatitis B coinfection rate of 4.95% (10/202). Coinfected patients were not significantly associated with liver injury compared to monoinfected patients. However, they displayed a higher risk of presenting abnormal γ-glutamyltransferase (γ-GT) (RR = 1.74, 90% vs. 51.51%) and alanine aminotransferase (ALT) values (RR = 1.52, 60% vs. 39.39%) compared to the monoinfected group. Also, there was no difference in total and direct bilirubin between patient groups. The mean triglyceride and low-density lipoprotein (LDL) cholesterol levels and coronary heart index values were higher in the coinfected group than in the monoinfected group, but without significance.ConclusionsTaken altogether, these findings suggest that the presence of hepatitis B in dengue patients may slightly affect the liver’s metabolic functions. Clinical surveillance of this coinfection is therefore required to avoid further liver complications.

Control of Cardiovascular Risk Factors in Revascularized Patients with Diabetes: Algerian experience

Patients with type 2 diabetes and revascularized coronary disease are a group with very high cardiovascular risk that has been rarely studied. This Algerian study analyzes the clinical characteristics and risk factor control of these patients. The analysis selected patients with type 2 diabetes who had participated in an a multicenter, observational study (military hospitals of Algeria) conducted in 978 patients > 18 years of age who had undergone coronary surgery or percutaneous coronary intervention. Demographic and therapeutic variables, as well as clinical and analytical parameters, were collected and comparatively analyzed. The mean age (standard deviation) of the 371 diabetic patients included in the analysis was 67.7 (9.6) years (71.3% men; mean time since revascularization, 3.5 years). Most (57.6%) were receiving treatment with oral hypoglycemics alone, where as 30.4% were receiving insulin alone or in combination. The mean glycohemoglobin figure was 7.3% (in 72%, < 7.5%); 73.9% had been diagnosed with dyslipidemia. Mean low-density lipoprotein cholesterol was 93.5 mg/dL (in 73%, > 70 mg/dL). Among these patients, 93.5% were receiving statins. A total of 76.4% had been diagnosed with hypertension; systolic/diastolic blood pressure was < 130/80 mmHg in 56% and < 140/90 mmHg in 93%. Cardiovascular risk and prevention may be improved in revascularized diabetic patients in Spain through further control of risk factors, particularly dyslipidemia. Patients with glycohemoglobin > 7.5% should be individually assessed in terms of glycemic targets.

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.

Effects of Ephedrine-Containing Products on Weight Loss and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Ephedrine, the main active ingredient of mahuang, may lead to weight loss; however, it can also induce cardiovascular side effects. As ephedrine use remains controversial, this study aimed to systematically review previous studies on ephedrine-containing products and perform meta-analysis of the existing evidence on weight, blood pressure (BP), heart rate, and lipid change effects of ephedrine-containing products. We searched for placebo-controlled randomized studies in PubMed, Web of Science, and EMBASE until July 2021 using the following search terms: (ephedr* OR mahuang) AND (“weight loss” OR obes* OR overweight). Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of ephedrine-containing products on weight, BP, heart rate, and lipid profiles. A total of 10 articles were included. Compared with the placebo group, the ephedrine-containing product group was associated with greater weight loss, with an MD of −1.97 kg (95% CI: −2.38, −1.57). In the ephedrine-containing product group, the mean heart rate was 5.76 beats/min higher than in the placebo group (95% CI: 3.42, 8.10), whereas intergroup differences in systolic and diastolic BP were not statistically significant. The ephedrine-containing product group had a significantly higher mean high-density lipoprotein cholesterol level (MD: 2.74 mg/dL; 95% CI: 0.94, 4.55), lower mean low-density lipoprotein cholesterol level (MD: −5.98 mg/dL; 95% CI: −10.97, −0.99), and lower mean triglyceride level (MD: −11.25 mg/dL; 95% CI: −21.83, −0.68) than the placebo group. Compared with placebo, the ephedrine-containing products showed better effects on weight loss and lipid profiles, whereas they caused increased heart rate. The ephedrine-containing products may be beneficial to obese or overweight patients; however, close monitoring is needed, especially heart rate monitoring.

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.

Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care).

Purpose: Refugee and immigrant patients face significant barriers to health care and are more likely to have poorly controlled chronic disease than the general U.S. population. I-Care aims to improve health equity for refugees and immigrants who face a disproportionate burden of chronic disease.Methods: Refugees and immigrants with uncontrolled diabetes and associated cardiovascular risk factors were enrolled in a care management program within an academic adult medicine clinic. The program utilized a care manager to coordinate care and services between designated primary care providers, affiliated clinical teams, and community partners. Health literacy, chronic disease parameters, and care utilization were assessed at enrollment and 8–12 months later.Results: A total of 50 refugees and immigrants were followed for 8 to 12 months. Clinical parameters found a reduced mean HbA1c from 9.32 to 8.60 (p=0.05) and reduced low-density lipoprotein mean from 96.22 to 86.60 (p=0.01). The frequency of normal blood pressures was 9 (18%) at enrollment and 16 (32%) at 1 year. The cumulative frequency of emergency room visits decreased from 66% to 36% and hospitalizations from 22% to 8%. Rates of comprehensive care monitoring, including monofilament testing and one-time ophthalmology visits, increased from 60% to 82% and from 32% to 42%, respectively. Cumulative frequency of interdisciplinary support engagement with pharmacy and nutrition visits increased from 58% to 78% and from 26% to 38%, respectively.Conclusion: This program highlights the importance of a multidisciplinary community-engaged care model that has demonstrated improvement in quality metrics and health care costs for refugees and immigrants.

Trends in low-density lipoprotein cholesterol level among Chinese young adults hospitalized with first acute myocardial infarction.

BackgroundRepresentative data has shown a linear increase in mean low-density lipoprotein cholesterol (LDL-C) levels among Chinese adults, contributing to the burden of atherosclerotic cardiovascular disease (ASCVD). This study aimed to assess the trends in LDL-C levels and their association with coronary artery stenosis during the first acute myocardial infarction (AMI) in young Chinese adults.MethodsA retrospective study including 2,781 adults, aged 18–44 years, hospitalized for their first AMI in Beijing Anzhen hospital between 2007 and 2017 was performed.ResultsMean LDL-C level was 2.82±0.97 mmol/L with the prevalence of elevated LDL-C being 21.6% (601/2,781). Of the study, only 4.2% were aware of their elevated LDL-C status. Neither mean LDL-C concentration nor prevalence of elevated LDL-C showed a downward trend between 2007 and 2017 (P>0.05). Patients aged <35 years had the highest LDL-C level and frequency of elevated LDL-C among the three age groups (aged <35, 35–39, and 40–44 years; P<0.01). Patients with LDL-C ≥3.4 mmol/L evinced a more than 50% increased risk of coronary artery stenosis compared with those with LDL-C <1.4 mmol/L [adjusted odds ratio (OR) 3.19; 95% confidence interval (CI): 1.62 to 6.29]. Of the study, 62.0% had at least two conventional risk factors (RFs), and smoking, accompanied by hypertension, obesity, or elevated LDL-C were the most common combinations.ConclusionsThe current study provides an overview of trends in LDL-C level and elevated LDL-C among young adults at the time of first AMI. Patients had a high prevalence of elevated LDL-C but low awareness of this status. Coronary artery stenosis was positively correlated with LDL-C level. Preventive strategies, including public education regarding cholesterol levels and benefits of maintaining LDL-C below 3.4 mmol/L should be considered for young adults as a primary preventive strategy.

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.