Mean Values Of Low-density Lipoprotein Research Articles

Appraisal of Olezarsen for Treatment of Hypertriglyceridemia

Olezarsen is antisense antinucleotide under investigation that inhibits synthesis of apolipoprotein C3 (ApoC3) resulting in reduction of plasma triglycerides levels. In a phase 3 clinical trial of patients having familial chylomicronemia syndrome (FCS) with extreme hypertriglyceridemia at baseline (mean plasma triglycerides 2,630 mg/dl), olezarsen 80 mg administered subcutaneously every 4 weeks decreased triglycerides by 43.5 percentage points (95% CI, 69.1 to 17.9; P<0.001) after 6 months compared with placebo. By 53 weeks, 1 episode of acute pancreatitis occurred in olezarsen group versus 11 episodes in the placebo group, rate ratio (RR) 0.12 (95% CI, 0.02 TO 0.66). Two phase 2 trials evaluated olezarsen in patients with moderately elevated triglycerides (<500 mg/dl) and high cardiovascular (CV) risk recorded similar magnitude of reduction of triglycerides. Olezarsen reduced levels of atherogenic lipoproteins such as ApoC3 by 73%, non-high-density lipoprotein cholesterol (non-HDL-C) by 17-23% and increased high-density lipoprotein cholesterol (HDL-C) levels by 30-40%. Meanwhile, olezarsen increased mean values of low-density lipoprotein (LDL-C) from 22.8 to 37.6 mg/dl in patients with FCS but had no significant effects in patients with high CV risk having higher baseline LDL-C levels. Discontinuation rates due to adverse effects of olezarsen were 9-12% versus 0% with placebo. The most common adverse effects of olezarsen were elevation of liver enzymes, mostly below 3 times the upper limit of normal, and injection-site reactions. Platelet count < 140,000/µl occurred in 18% in patients receiving olezarsen versus 3% with placebo (risk ratio 6.8; 95% CI, 0.91 to 51.3; P=0.03). No patient had severe thrombocytopenia with platelet number < 75,000/µl. Overall, olezarsen is a promising new therapy for hypertriglyceridemia and for prevention of hypertriglyceridemia-induced pancreatitis. Long-term randomized trials are urgently needed to examine the effects of olezarsen on CV events and mortality and establish its long-term safety.

Lipid profile of chronic kidney disease patients on two different modalities of treatment: Conservative versus hemodialysis

Background: Chronic kidney disease (CKD) is an irreversible deterioration of renal function and cardiovascular disease is the leading cause of mortality in CKD patients. Aims and Objectives: The aim of this study was to assess the pattern of lipid profile among cases of CKD. Materials and Methods: A cross-sectional study was conducted for 1 year covering total 200 cases (males and females) of newly diagnosed or known cases of CKD. Parameters recorded were as follows: Fasting blood sugar, Serum urea (S. Urea), Serum Creatinine (S. Creatinine), and lipid profile. Estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault formula. Results: Mean age was 51.04 years in conservative management patients and 53.20 years in hemodialysis patients. Overall, male-to-female ratio was 1.82:1. S. Creatinine, S. Urea, and eGFR were deranged more in patients on hemodialysis (Group 2). Mean values of low-density lipoprotein (LDL)-cholesterol, very low-density lipoproteins (VLDL), and serum triglycerides (TG) were significantly higher in patients on hemodialysis compared to those on conservative management, while mean high-density lipoprotein cholesterol was significantly lower. Dyslipidemia was more common in female CKD patients (P = 0.02). Conclusion: Dyslipidemia in CKD worsened as patients progressed to severe stages with significant increase in TG, LDL, and VLDL levels in hemodialysis cases in comparison to conservatively managed, confirming presence of atherogenic lipid profile needing early intervention to prevent cardiovascular complications.

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<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.

Sociodemographic and clinical predictors of refractory type 2 diabetes patients: Findings from a case-control study.

Objectives:To identify the sociodemographic and clinical predictors of uncontrolled diabetic patients, to identify high-risk and people with impaired glycemic control, to establish more effective strategies for reducing morbidity and mortality.Methods:This case-control study of 8209 enrolled patients were included from the diabetes registry by Chronic Illness Center (CIC), Family and Community Medicin, Prince Sultan Military Medical City, Riyadh Saudi Arabia between February 2019 and February 2020. Cases are defined as patients with type II refractory diabetes having persistent HbA1c >9, not reach adequate glycemic control despite intensified therapy under specialist care (CIC) for at least 6 months. Controls were defined as patients with Hba1c ≤9. Multivariable regression analysis was used to identify predictors for patients with the persistent outcome of HbA1c >9%.Results:Overall, a total of 1152 cases and 4555 controls were included. Patients with refractory diabetes were younger (mean: 58.5, standard deviation [SD]: 11.7) and females (63.4%). Duration of diabetes (13.3, SD: 7.4, p<0.001) and the mean value of low-density lipoprotein (LDL) (2.7, SD: 0.91, p<0.001) were significantly higher in the refractory group. The findings from the final model revealed that with every unit increase in age (odds ratio [OR]: 0.97, [95% confidence interval [CI]: 0.96-0.98]) and body mass index the odds of having refractory diabetes significantly reduced by 0.97 times (OR: 0.97, [95% CI: 0.95-0.99]). While with every unit increase in the duration of diabetes (OR: 1.03, [95% CI: 1.01-1.05]), systolic blood pressure (OR: 1.01, [95% CI: 1.00-1.02]) and LDL (OR: 1.42, [95% CI: 1.23-.62]) the odds of having refractory diabetes significantly increased by 1.03 and 1.42 times respectively compared to controls when adjusted for gender, albumin creatinine, diastolic blood pressure.Conclusion:The findings from this study helped classify the predictors of refractory patients with diabetes. Understanding refractory patients’ predictors may help to develop new therapeutic strategies to boost their glycemic status safely.

Effect of Ramadan on glucose levels, serum lipid profile, and blood pressure among fasting and nonfasting medical students in a public university of Karachi

Objective: The objective of this study was to assess the effect of Ramadan fasting on blood pressure, fasting glucose, lipid profile, and serum proteins between non-Muslim and fasting Muslim students. Methodology: The study was conducted on undergraduate medical students of a medical university of Karachi. Participants were invited for data collection: in the last 10 days of Shaban, Ramadan, and Shawwal. Along with blood pressure, height, and weight were measured and a sample of 10 cc blood was also drawn in each visit. Blood samples were analyzed for glucose, lipid profile, and serum protein. Two samples, “t”-test and repeated measure design analysis of variance were utilized for statistical analysis. Results: Sixty Muslims and 15 non-Muslim students completed all the three visits. Seventy-five percent were females. Mean systolic blood pressure reduced significantly in Ramadan. Mean diastolic blood pressure reduced noticeably in Ramadan and Shawwal for non-Muslim students and minor changes occurred in Muslim students. Even though the fasting blood sugar increased insignificantly from Shaban to Ramadan in the total sample, but the increment among Muslim students showed a significant increase. The mean cholesterol value of Muslim students significantly increased in Ramadan but decreased in Ramadan for non-Muslim students. The mean value of low-density lipoprotein increased significantly in Ramadan for Muslim students but decreased in Ramadan for non-Muslim. The mean values of triglyceride showed a significant reduction from Shaban to Ramadan and then increased in Shawwal. Conclusion: The study revealed that the environment of Ramadan was helpful to the non-Muslim students more than the Muslim students, with respect to the biochemical parameters.

Serum lipid profile in patients with oral potentially malignant disorders

Aim: To estimate serum lipid profile in patients with oral potentially malignant disorders. Materials and Methods: Around 100 patients with oral potentially malignant disorders and 20 patients as controls were subjected to serum lipid profile after obtaining institutional ethical clearance. Estimation of lipid profile value was done for total serum cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and triglycerides (TG) using Endpoint method. Results: HDL levels were significantly lower in females with oral potentially malignant disorders (P = 0.047). The mean value of total cholesterol, HDL, VLDL, and TG was lower in leukoplakia compared to lichen planus, smoker's palate, combined leukoplakia, and smoker's palate lesion and oral submucous fibrosis, i.e. 140.78, 32.444, 28.444, 141.33, respectively. The mean value of LDL was low in lichen planus compared to other groups, i.e. 73.167. Conclusion: This study concluded that the lower serum lipid levels might serve as a diagnostic indicator or marker in the early diagnosis of oral potentially malignant disorders in females.

Helicobacter Pylori Infection is a Significant Risk for Modified Lipid Profile in Japanese Male Subjects

Helicobacter Pylori infection was associated with the risk of cardiovascular disease; however, the relation between Helicobacter Pylori infection and the lipid profile has not been fully established. We measured anti-Helicobacter Pylori antibody concentration and lipid profiles in 6,289 Japanese subjects aged 21-64 years (5,077 male and 1,212 female). The prevalence of Helicobacter Pylori-seropositive subjects was 46.8% and 39.6% in men and women, respectively. Adjusted mean values of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol in men were significantly higher and lower in Helicobacter Pylori-seropositive than-negative subjects, respectively, (LDL-cholesterol: 129.0±0.8 vs. 125.3±0.7 mg/dL, p< 0.001, HDL-cholesterol: 54.6±0.3 vs. 56.6±0.3 mg/dL, p< 0.01), whereas these associations were not significant in female subjects. Moreover, the odds ratio of Helicobacter Pylori infection for high LDL-cholesteremia and low HDL-cholesteremia in male subjects was 1.23 (95% CI (confidence interval): 1.08-1.40, p< 0.05) and 1.29 (95% CI: 1.03-1.59, p< 0.05), respectively. Female subjects did not have such associations. The present study demonstrates that Helicobacter Pylori infection is significantly associated with high LDL-cholesteremia and low HDL-cholesteremia in Japanese male subjects.

The effect of the apolipoprotein E polymorphism on lipid levels in patients with familial defective apolipoprotein B-100.

Serum lipid concentrations of patients with familial defective apolipoprotein B-100 (FDB) show a high interindividual variability although the underlying defect is caused by a single point mutation. On the other hand, several genetic factors modulating serum cholesterol levels are known, such as DNA polymorphisms of the apolipoprotein B or the apolipoprotein E (apo E) gene. To assess the effect of the apo E polymorphism on serum cholesterol, lipid levels of FDB patients (n = 36) were compared with those of a normolipidemic control group (n = 272) according to their apo E genotype. For the FDB group mean values of low-density lipoprotein (LDL) cholesterol (mg/dl) were 225.7 +/- 53.7 for E3/2 genotype (n = 3), 234.2 +/- 48.3 for E3/3 genotype (n = 20), and 252.4 +/- 73.8 for E4/3 genotype (n = 13). Means of triglycerides (mg/dl) were 121.0 +/- 21.2, 114.8 +/- 60.7, and 110.0 +/- 62.8 for the respective apo E genotypes. The calculated average effect of the apo E alleles on LDL cholesterol levels was -6.0% for allele e2 and +3.7% for e4 relative to the whole FDB group. The effect on triglyceride levels was +7.5% for e2 and -3.6% for e4. The control group showed a similar variation in LDL cholesterol depending on the different apo E genotypes. About 6% of the total variation in LDL cholesterol can be accounted for by the apo E locus in normolipidemic and hypercholesterolemic individuals alike.

Risk factors for the progression of diabetic nephropathy: role of hyperlipidaemia and its correction

Hypertension, proteinuria and hyperlipidaemia are major factors implicated in the progression of chronic renal failure towards uraemia. All of these factors are frequently more pronounced in diabetic nephropathy. We evaluated the rate of progression of renal insufficiency in 12 patients with diabetic nephropathy (DN group) and 18 patients with non-diabetic chronic nephropathy (CN group) during a 2-year period. All patients had high blood pressure on angiotensin-converting enzyme (ACE) inhibitor therapy, hypercholesterolaemia and proteinuria in the non-nephrotic range. Basal glomerular filtration rate (GFR) had an overlapping range in the two groups. The rate of GFR decline during the 2-year period was similar for the DN and CN groups (0.23 vs 0.21 ml/min per month) and correlated with the mean values of low-density lipoprotein (LDL)-cholesterol for both groups (DNr=0.569, CNr=0.511,P<0.05). After 1 year of ACE inhibitor therapy we randomly allocated a subset of patients in each group (6 DN and 9 CN) to receive HMG-CoA-reductase inhibitor (simvastatin or pravastatin 10 mg/day). We observed a decrease in total (−21%) and LDL-cholesterol (−32%) and triglycerides (−11%) and an increase in high-density lipoprotein (HDL)-cholesterol (+8%). The rate of GFR decline was lower in the statin-treated group compared with the previous period (DN−0.21 vs −0.25 ml/min per month; CN −0.18 vs −0.22 ml/min per month). Our data support the hypothesis that associated risk factors rather than diabetes per se are responsible for the rate of progression of renal failure in DN and that the correction of lipid abnormalities may play a key role in slowing the rate of renal function decline.