Median Total Cholesterol Research Articles

Association Between Xanthelasma Palpebrarum with Cardiovascular Risk and Dyslipidemia: A Case Control Study

ObjectiveTo determine whether Xanthelasma palpebrarum (XP) is associated with dyslipidemia, cardiovascular disease (CVD) and other systemic conditions in a large population. DesignCase-control study conducted at a single tertiary care center. ParticipantsIndividuals who were examined at a medical screening institute from 2001 to 2020. MethodsMedical records were reviewed to extract data on ophthalmic evaluations, blood tests, and systemic diagnoses. Patients identified with XP in at least one eye comprised the study group. A control group without XP was established matched by age and sex at a 10:1 ratio to allow robust statistical analysis. Main Outcome MeasuresAssociations between XP and dyslipidemia and CVD. Lipid profiles, diagnosis of dyslipidemia and CVD were compared between the case and control groups. ResultsThe database included 35,452 individuals, 24,287 males (69%), mean age 52.2±12.2 years. The study population included 203 XP patients (0.6%) and 2030 matched controls. The prevalence of dyslipidemia diagnosis and the usage rates of statins, fibrates, or other cholesterol-lowering medications was similar between the two groups. Lipid profiles were similar between the groups, including median total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglyceride levels (187 controls vs. 192 XP, 48 controls vs. 47 XP, 120 controls vs. 125 XP, 111 controls vs. 105 XP, respectively, P>0.05 for all). The rate of CVD was similar as well (10% controls vs. 8.9%, XP P=0.56). The prevalences of related conditions, including hypertension, diabetes mellitus, and history of cerebrovascular accident, were similar between groups (24% controls vs. 23% XP, 14% controls vs. 10% XP, 1.3% controls vs. 1% XP, respectively P>0.05). ConclusionsXP was not associated with increased rates of dyslipidemia or CVD. This questions the extent to which XP serves as an indicative marker for heightened systemic risk.Introduction

Abstract P242: The Effects of Wellness Coaching on Lowering Stroke Risk Factors in a Wisconsin Native American Population

Objective: Native Americans are disproportionally affected by obesity, diabetes and stroke. This study tests the hypothesis that weight loss and change in BMI are related to coaching participation in the first 52 weeks of a two-year study. Methods: Participants of the “Stroke Prevention in the Wisconsin Native American Population” study age ≥55 years with three or more stroke risk factors were assigned to a High Risk-Intensive Coaching arm (n=49); informed consent was obtained for all participants. These participants engaged in routine wellness coaching visits centered around lifestyle modification in an effort to reduce risk factors for stroke. Data analysis was performed with SPSS (SPSS, IBM Corporation, Armonk, NY, US) and R (RStudio, PBC, Boston, MA, US). Continuous variables are reported with median and interquartile range (IQR). A participation score (total coaching sessions attended ÷ 52 weeks) was calculated for each participant and total weight loss for the first 52 weeks was also calculated (baseline weight in pounds - the weight in pounds at the last coaching session closest to week 52), (n=49). The Wilcoxon Signed Rank test was used to test the hypothesis that weight loss or change in BMI was significantly different than baseline. A smoothing spline was used to assess a potential dose-response relationship between participation score and weight loss and change in BMI. Results: Of the 49 participants examined, 36 were female and 13 were male, with a median age of 66 (IQR =10.0) years. Risk factors observed at baseline included smoking (n=11, 22.4%), median BMI of 31.6 lb/in 2 (IQR=7.7), and median physical activity of 90 minutes per week (IQR=210.0). Biometric measures were also recorded at baseline, with a median systolic blood pressure of 149 mmHg (IQR=26.0) and median diastolic of 80 mmHg (IQR=14.0), median total cholesterol of 156 mg/dL (IQR=57.0), median LDL of 87 mg/dL (IQR=57.0), median HDL of 46 mg/dL (IQR=16.0), median non-HDL of 110 mg/dL (IQR=61.0), and median hemoglobin A1C of 6.5 mg/dL (IQR=1.2). Participation score median of 0.33 (IQR=0.375) range 0.06-0.87. Weight loss median 3.6 (IQR=9.45) range -41 to 35 pounds. A spline analysis found a significant dose-response relationship between participation score in the first 52 weeks of the study and weight loss (r 2 =0.199 deviance 23%, p=0.006) and BMI (r 2 =0.145, deviance 16.7%, p=0.010). Conclusion: Preliminary results suggest that participation in a wellness coaching program may be associated with weight loss and change in BMI in this study population. Future work will continue to examine how coaching is related to weight loss and change in BMI in a larger cohort and with a wider age range.

Associations of micronutrients and lipids with prediabetes and glycemic parameters in adolescent girls of the rural DERVAN cohort (DERVAN-9).

We investigated the associations of micronutrients and lipids with prediabetes, glycemic parameters, and glycemic indices among the adolescent girls of the DERVAN (aDolescent and prEconception health peRspectiVe of Adult Non-communicable diseases) cohort study from rural India. We recruited 1,520 adolescent girls aged 16-18 years. We measured glycemic parameters (glucose, insulin and HbA1C), lipids (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and triglycerides), and micronutrients (vitamin B12, folate, and vitamin D). Prediabetes was defined using American Diabetes Association criteria (fasting glucose ≥100 mg/dL or HbA1C ≥5.7%). Glycemic indices (insulin resistance, insulin sensitivity, and β cell function) were calculated using the homeostasis model. Associations of prediabetes, glycemic parameters and glycemic indices with micronutrients and lipids were analyzed by multiple logistic regressions. The median age and Body Mass Index (BMI) were 16.6 years and 17.6 kg/m2, respectively. Overall, 58% of girls had a low BMI. Median vitamin B12, folate, and vitamin D concentrations were 249.0 pg/mL, 6.1 ng/mL, and 14.2 ng/mL, respectively. The deficiencies observed were 32.1% for vitamin B12, 11.8% for folate, and 33.0% for vitamin D. Median total cholesterol, LDL, HDL, and triglyceride concentrations were 148.0 mg/dL, 81.5 mg/dL, 50.8 mg/dL, and 61.5 mg/dL, respectively. Elevated total cholesterol, LDL, and triglycerides were observed in 4.8, 4.0, and 3.8%, respectively, while low HDL was observed in 12.8%. Prediabetes was observed in 39.7% of the girls. Among lipids, total cholesterol and LDL were higher in girls with prediabetes (p < 0.01 for both). In a multivariate model containing cholesterol and vitamin B12/folate/vitamin D, prediabetes was associated with high cholesterol. Prediabetes was also associated with high LDL, independent of folate and vitamin D. Poor insulin secretion was high in those with low vitamin B12. Elevated insulin resistance was associated with low HDL. The likelihood of high insulin sensitivity was reduced in those with high triglycerides. The likelihood of poor β cell function was high in those with high LDL. Statistical interactions between micronutrients and lipids for prediabetes and glycemic outcomes were not significant. There was a substantial deficiency of micronutrients and an absence of dyslipidemia. Our results indicate the need for lipid and micronutrient-based interventions in adolescence to improve glycemic outcomes. Maintaining adequate storage of not only micronutrients but also lipids in adolescent girls is likely to reduce diabetes risk in adulthood.

TRENDS IN CHOLESTEROL AND LIPOPROTEINS ARE ASSOCIATED WITH ACUTE RESPIRATORY DISTRESS SYNDROME INCIDENCE AND DEATH AMONG SEPSIS PATIENTS.

Objective: Compare changes in cholesterol and lipoprotein levels occurring in septic patients with and without acute respiratory distress syndrome (ARDS) and by survivorship. Methods: We reanalyzed data from prospective sepsis studies. Cholesterol and lipoprotein levels were analyzed using univariate testing to detect changes between septic patients with or without ARDS, and among ARDS survivors compared with nonsurvivors at enrollment (first 24 h of sepsis) and 48 to 72 h later. Results: 214 patients with sepsis were included of whom 48 had ARDS and 166 did not have ARDS. Cholesterol and lipoproteins among septic ARDS versus non-ARDS showed similar enrollment levels. However, 48 to 72 h after enrollment, change in median total cholesterol (48/72 h - enrollment) was significantly different between septic ARDS (-4, interquartile range [IQR] -23.5, 6.5, n = 35) and non-ARDS (0, -10.0, 17.5, P = 0.04; n = 106). When compared by ARDS survivorship, ARDS nonsurvivors (n = 14) had lower median total cholesterol levels (75.5, IQR 68.4, 93.5) compared with ARDS survivors (113.0, IQR 84.0, 126.8, P = 0.022), and lower median enrollment low-density lipoprotein cholesterol (LDL-C) levels (27, IQR 19.5-34.5) compared with ARDS survivors (43, IQR 27-67, P = 0.013; n = 33). Apolipoprotein A-I levels were also significantly lower in ARDS nonsurvivors (n = 14) (87.6, IQR 76.45-103.64) compared with ARDS survivors (130.0, IQR 73.25-165.47, P = 0.047; n = 33). At 48 to 72 h, for ARDS nonsurvivors, median levels of low-density lipoprotein cholesterol (9.0, IQR 4.3, 18.0; n = 10), LDL-C (17.0, IQR 5.0, 29.0; n = 9), and total cholesterol (59.0, 45.3, 81.5; n = 10) were significantly lower compared with ARDS survivors' (n = 25) levels of low-density lipoprotein cholesterol (20.0, IQR 12.0-39.0, P = 0.014), LDL-C (42.0, IQR 27.0-58.0, P = 0.019), and total cholesterol (105.0, IQR 91.0, 115.0, P = 0.003). Conclusions: Change in total cholesterol was different in septic ARDS versus non-ARDS. Total cholesterol, LDL-C, and apolipoprotein A-I levels were lower in ARDS nonsurvivors compared with survivors. Future studies of dysregulated cholesterol metabolism in septic ARDS patients are needed to understand biology and links to potential therapies.

Outcomes of Dolutegravir-Based Antiretroviral Therapy in Thai Youth Aged 18 to 24 Years Living with HIV in Bangkok: A Retrospective Cohort Study

Objective: Dolutegravir (DTG) is recommended globally for people living with HIV. The present study aimed to describe the efficacy and safety of DTG-based regimens among youth aged 18 to 24 years. Materials and Methods: A retrospective cohort study was conducted among youth aged 18 to 24 years living with HIV at Chulalongkorn Hospital. Participants were divided into antiretroviral naïve (AN), antiretroviral experienced with treatment failure (AETF), and antiretroviral experienced and virally suppressed (AEVS). DTG was prescribed as a daily individual tablet or as part of a fixed-dose combination. The primary outcome was virological suppression defined as VL of less than 200 copies/mL within 12 months after DTG initiation. Secondary outcomes included body weight and lipid profile changes. Results: Between 2017 and 2022, 87 youth with a median age of 20.6 (IQR 19.6 to 21.9) years were initiated on DTG. Fifty-six (64.3%) were male. Twelve participants were AN, 18 were AETF, and 57 were AEVS. HIV viral suppression was 100% and 96.2% among those AN and AEVS, but only 54.5% amongst the AETF group (p&lt;0.001). CD4 lymphocyte counts increased in all groups at follow-up. Median body weight change was +0.4 (IQR –1.8 to 3.6) kg in males and +0.5 (IQR –2.8 to 1.7) kg in females. Median total cholesterol declined from 167 (IQR 142 to 186) to 152 (IQR 135 to 170) mg/dL, p=0.003. Median triglycerides declined from 83 (IQR 60 to 129) to 66 (IQR 46 to 78), p&lt;0.001. No hospitalizations or mortalities were observed in the study. Conclusion: DTG was effective and well-tolerated in youth living with HIV, with no significant weight gain and improved lipid profiles. DTG implementation among youth living with HIV should be continued. Keywords: Dolutegravir; Antiretroviral therapy; Adolescents living with HIV

SAT400 Evaluation Of Lipid Profile Of Transgender Women On Long-Term Estrogen Therapy

Abstract Disclosure: L.A. Alvares: None. L.M. Santos: None. B.B. Mendonça: None. E.M. Costa: None. S. Domenice: None. Introduction: For transgender women (TW), previous exposed to male puberty, on long-term estrogen therapy, the knowledge about the lipid profile is important since it impacts on cardiovascular risk. Methods: A cross-sectional study was carried out with 15 TW (34.2 +/- years old), 14 CW and 13 CM. The TW received hormone therapy for 14.4 +/- 3.5 years. The IPAQ was used to measure the level of physical activity. Body composition was assessed by an InBody 720 device. The subjects (TW, CW and CM) were classified into five categories (sedentary, insufficiently active A and B, active and very active) according to IPAQ recommendations. Results: Age (years) TW: 34.2 SD +/- 5.2; CW: 35.6 SD +/- 4.1 and CM: 36.7 SD +/- 3.8. BMI (kg/m2) TW 25.5 SD +/- 2.8, CW 23.1 SD +/- 3.3 and CM 26.3 SD +/- 3,0. Total testosterone (ng/dL) TW 18.0 (range 12-637), CW 19 (range 12-40.1) and CM 524 (SD+/- 169). Median total cholesterol analysis (mg/dL): TW 154 SD +/- 33.0, CW 177 SD +/- 18.7 and CM 173 SD +/- 23.0 (p&amp;gt;0.05 in all subanalyses), HDL (mg/dL) TW: 46.5 SD +/- 10.9; CW:67.0 SD +/- 15.6 and CM: 46.5 SD +/- 9.8 p value &amp;lt;0.05; significant difference between TW and CW; between CW and CM; LDL (mg/dL) TW: 93 SD +/- 30.4; CW 94.5 SD +/- 14.2 and CM 104 SD +/- 22.0. The % FAt mass of TW was lower than that of CW (29.5±5.7 vs 32.9±5.7; p&amp;gt;0.05) and higher than that of CM (20.2±5.7; p&amp;lt;0.001). There was no significant difference in the level of physical activity between the groups (TW vs CW, p&amp;gt;0.05; TW vs CM, p&amp;gt;0.05; CW vs CM, p&amp;gt;0.05), with most participants being active or very active in all groups. Discussion: studies show that in the first few months of estrogen therapy HDLc increases about 10%. Conclusion: after long term on estrogen therapy, TW present HDLc pattern similar to CM, different of the usually observed in the first months analyses. Presentation: Saturday, June 17, 2023

Efficacy and Safety of Switching to Dolutegravir/Lamivudine in Virologically Suppressed People Living with HIV-1 Aged Over 65 Years.

Clinical trials of dual regimen dolutegravir/lamivudine (DOL/3TC) demonstrated potent efficacy and favorable safety in both antiretroviral therapy-naïve and -experienced patients, but data on older people are lacking. We aimed to evaluate virological efficacy and safety of DOL/3TC in suppressed older patients over a 12-month period. We performed a retrospective cohort study evaluating people living with HIV (PLWHIV) aged ≥65 years at our HIV Clinic who were switched to DOL/3TC. Eligible patients had baseline HIV-1 RNA <20 copies/mL, and no previous virological failures or known resistance mutations for lamivudine or dolutegravir. Inclusion criteria were met by 72 patients: 59 were men, median age was 69.2 years, and one or more comorbidities were present in 89% of patients. The most common reason for switch was simplification, followed by drug-drug interactions (DDIs) and toxicities. After 12 months, 64 (88.9%, by the intention-to-treat analysis) patients maintained HIV-1 RNA <20 copies/mL, and reasons for treatment failure were virological failure in three cases, adverse events in three, and missing data in two. Genotype resistance testing showed no resistance mutations for lamivudine or dolutegravir in subjects with virological failure. The number of potential DDIs decreased from 92 to 12 after switching to DOL/3TC, and a significant reduction in median total and low-density lipoprotein cholesterol was reported, while median change in body weight was not significant. In this real-life cohort, switching to DOL/3TC was associated with maintenance of virological control and good tolerability among persons aged >65 years, supporting use of this dual regimen in older PLWHIV.

Bictegravir/emtricitabine/tenofovir alafenamide as initial treatment for HIV-1: five-year follow-up from two randomized trials.

Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is a single-tablet regimen recommended for HIV-1 treatment. The safety and efficacy of B/F/TAF as initial therapy was established in two Phase 3 studies: 1489 (vs dolutegravir [DTG]/abacavir/lamivudine) and 1490 (vs DTG+F/TAF). After 144 weeks of randomized follow-up, an open-label extension evaluated B/F/TAF to 240 weeks. Of 634 participants randomized to B/F/TAF, 519 completed the double-blinded treatment, and 506/634 (80%) chose the 96-week open-label B/F/TAF extension, which was completed by 444/506 (88%) participants. Efficacy was based on the secondary outcome of the proportion of participants with HIV-1 RNA <50 copies/mL at Week 240 by missing=excluded and missing=failure methods. All 634 participants who were randomized to B/F/TAF and received at least one dose of B/F/TAF were included in efficacy and safety analyses. (Study 1489: ClinicalTrials.govNCT02607930; EudraCT 2015-004024-54. Study 1490: ClinicalTrials.govNCT02607956; EudraCT 2015-003988-10). Of those with available virologic data, 98.6% (95% CI [97.0%-99.5%], 426/432) maintained HIV-1 RNA <50 copies/mL at Week 240 (missing=excluded); when missing virologic data were considered as failure, 67.2% (95% CI [63.4%-70.8%], 426/634) maintained HIV-1 RNA <50 copies/mL. Mean (SD) change in CD4+ count from baseline was+338 (236.2) cells/μL. No treatment-emergent resistance to B/F/TAF was detected. Adverse events led to drug discontinuation in 1.6% (n=10/634) of participants (n=5 with events considered drug-related). No discontinuations were due to renal adverse events. Median (IQR) total cholesterol increased 21 (1,42) mg/dL from baseline; the change in total cholesterol:HDL was 0.1 (-0.5,0.6). Median (IQR) weight change from baseline was+6.1kg (2.0, 11.7) at Week 240. In Study 1489, hip and spine bone mineral density mean percent changes from baseline were ≤0.6%. Through 5 years of follow-up, B/F/TAF maintained high rates of virologic suppression with no treatment-emergent resistance and rare drug discontinuations due to adverse events. These results demonstrate the durability and safety of B/F/TAF in people with HIV. Gilead Sciences.

Hepatitis C virus eradication by direct-acting antivirals causes a simultaneous increase in the prevalence of fatty liver and hyper low-density lipoprotein cholesterolemia without an increase in body weight.

Hepatitis C virus (HCV) infection has been reported to cause liver steatosis. Thus, eradicating HCV with direct-acting antivirals (DAAs) is expected to reduce liver steatosis. We aimed to clarify long-term changes in the prevalence of fatty liver and hyper-low-density lipoprotein (LDL) cholesterolemia and their associations in patients who achieve successful HCV eradication using DAAs. This retrospective study included patients with HCV who achieved sustained virologic response after interferon-free DAA and analyzed the changes in the prevalence of fatty liver diagnosed with controlled attenuation parameter (CAP), hyper-LDL cholesterolemia, and their relationships at baseline (n=100) and 24weeks (SVR24, n=100), 96weeks (SVR96, n=100), and 144weeks (SVR144, n=90) after DAA. In 100 participants, the prevalence of fatty liver (19% vs. 32%, p=0.0349) and hyper-LDL cholesterolemia (6% vs. 15%, p=0.0379) significantly increased without changes in body weight at SVR96. Median total cholesterol, low-density lipoprotein cholesterol (LDL-C), and small-dense-LDL (sdLDL) levels and CAP values were significantly greater at SVR24, SVR96, and SVR144 than at baseline. Baseline CAP values and changes in CAP values were significantly negatively correlated at every observation point: r=-0.5305, p<0.0001 at SVR24; r=-0.3617, p=0.0005 at SVR96; and r=-0.4735, p<0.0001 at SVR144. A similar relationship was observed in cholesterol levels. Unlike at baseline, CAP values were significantly positively correlated with LDL-C and sdLDL-C levels at all observation points after DAAs. Direct-acting antivirals may cause an increased prevalence of fatty liver accompanying hyper-LDL cholesterolemia without increased body weight. As post-SVR liver steatosis could cause HCC, careful follow-up may be required.

Plasma Fat Status is Associated with the Prevalence of Opportunistic Infections and may Predict Disease Progression in HIV/AIDS

Objective: To establish the association between plasma fat status and the prevalence of opportunistic infections in HIV/AIDS patients. Design and Methods: A Cross Sectional and Quantitative study involving 174 adult HIV/AIDS patients recruited over a period of 18 months at a University Teaching Hospital in Ndola, Zambia. Participants were subjected to clinical assessments with anthropometry, CD4+ count, viral load and plasma fat measurements at baseline and repeated on a follow-up visit. The Wilcoxon rank sum test for continuous variables and the Chi square test for categorical variables were applied to compare the study population by gender. The main research question was addressed by establishing the association between Plasma fat and Opportunistic infections, adjusted for potential confounders using the multiple linear regression model. Results: The plasma fat status revealed a higher median total cholesterol of [3.86(3.02,4.62) mmol/l], median triglyceride [1.19(0.87,1.51) mmol/l] and LDL-c [2.31(1.58,2.90) mmol/l] for females than that for the males [3.53(3.06,4.61) mmol/l], [0.96(0.71,1.60) mmol/l] and [1.86(1.36,2.80) mmol/l] individually. In contrast, median HDL-c concentration were higher in the male [1.4(1.21,1.55) mmol/l] than the female gender [1.33(1.13,1.51) mmol/l]. The results per clinical status revealed relatively more males [17(27%)] than females [15(15.2%)], p=0.06 presenting with opportunistic infections. Results in both the overall and by gender regression analyses suggested a consistent inverse interaction involving most of the plasma fat types and BMI with opportunistic infections. Conclusion: Plasma fat status was not significantly predictive of the prevalence of opportunistic infections. However, the consistent inverse association reported between plasma fat and opportunistic infections, may suggest a potential role of plasma fat in immune mechanisms or viral suppression and corresponding clinical outcomes.

Comparison of a pre-bariatric surgery very low-calorie ketogenic diet and the Mediterranean diet effects on weight loss, metabolic parameters, and liver size reduction

This study compared the effects on weight as well as on metabolic parameters and liver size of a very low-calorie ketogenic diet versus a Mediterranean diet in patients with morbid obesity preparing to undergo bariatric surgery. This prospective comparison study evaluated patients 18–65 years of age who enrolled for bariatric surgery. Study duration was limited to an immediate preoperative period of 15 days. The very low-calorie ketogenic diet incorporated 10–12 kcal/kg/day of energy and 1–1.2 g/kg of protein using Kalibra (Societa Dietetica Medica) (VLCKD-SDM). The Mediterranean diet (MD) included 15–20% protein, 45–50% carbohydrate, and 25–35% fat. Changes in body mass index (BMI), liver size, and anthropometric and metabolic measurements were assessed. Between January 2016 and March 2017, of 45 patients enrolled, 30 completed the study (VLCKD-SDM, n = 15; MD, n = 15). Respective median BMI loss after VLCKD-SDM was 2.7 kg/m2 versus MD 1.4 kg/m2 (p < 0.05); median fat percentage reduction was 3.2 units versus 1.7 units (p < 0.05). Median liver size decreased 5.5% in the VLCKD-SDM group versus 1.7% in the MD group (p < 0.05). Median total cholesterol, and LDL levels decreased in both groups (p < 0.05), with greater relative decreases in the VLCKD-SDM group. Short-term preoperative diet-based weight loss in patients with morbid obesity preparing for bariatric surgery was significantly greater following a very low-calorie ketogenic diet versus a Mediterranean diet. The very low-calorie diet also significantly improved anthropometric and metabolic parameters and reduced preoperative liver size above that of the MD.

Evaluation of endothelial function in patients with Behçet's disease in remission: A cross-sectional study.

Endothelial dysfunction is an initial stage of the atherogenic process, which can be evaluated by a noninvasive method (flow-mediated dilation - FMD) and has a well-established prognostic value for cardiovascular (CV) risk. Currently, there is no evidence of increased CV mortality in Behc¸et's disease (BD), although its association with endothelial dysfunction has been described. There are still doubts in the literature whether the presence of chronic vascular inflammation might trigger the development of atherosclerosis, despite BD remission, which is why this study was conducted. We analyzed 24 subjects in this cross-sectional study (12 patients with BD in remission and 12 subjects matched by gender age). Endothelial function was analyzed via FMD. The lowest median for FMD was presented by the BD group (2.025% - interquartile range (IQR) 7.785 versus 5.46% - IQR 3.625, P ¼ .18). The median total cholesterol in the BD group was lower than the controls (168 mg dL-1 - IQR 46 and 216.5 mg dL-1 - IQR 54, respectively, P ¼ .0193). In the right carotid artery, the intima-media thickness was equal to 0.740 - IQR 0.16 for the patients and 0.740 - IQR 0.11 for the controls (P ¼ .9473); on the left, 0.725 - IQR 0.13 and 0.745 - IQR 0.120 (P ¼ .4333), respectively. The lower median trend of FMD in patients with BD suggests endothelial dysfunction, despite clinical remission of the inflammatory disease, although our study is limited by the sample size and greater use of statins in BD group.

Abstract CT171: Can supervised exercise impact on metabolic markers and physical activity during androgen-deprivation therapy in prostate cancer patients? - randomized controlled pilot trial

Abstract Introduction: Androgen-deprivation therapy (ADT) is standard in treatment of advanced prostate cancer (PCa). Common adverse effects include fatigue, weight gain, sarcopenia, and decreased libido leading to lowered quality of life (QoL). Supervised exercise improves overall QoL among PCa patients. Less is known, however, how it may affect metabolic adverse effects of ADT.The aim of the study was to explore the effect of exercise intervention on glucose and cholesterol levels, body composition, and to find out whether supervised exercise leads to greater physical activity in long-term compared to self-administered exercise in men with ADT. Materials and methods: Altogether, 45 men were recruited. One man withdrew the consent at baseline and 5 dropped out during the study. Thus, 39 men completed the study. Subjects were randomly assigned into either supervised exercise for 3 months (n=27) or control group of self-administered exercise (n=17). In the supervised group, participants attended 1.5-hour group exercise session twice per week. Training program included both aerobic and muscle strength exercises. The 3-month intervention was followed by 3-month follow-up of self-administered exercise. Control group received the same introduction to exercise and training instruction as the supervised group but exercised independently for the entire study period. Fasting cholesterol, plasma glucose, and body composition were evaluated at the baseline, 3 months after randomization, and at the end of the study, 6 months after randomization. Physical activity during the study period was measured using activity bracelets (Polar A370). Study protocol was approved by Pirkanmaa hospital ethics committee (R18021) and registered to Clinicaltrials.gov (NCT04050397). Results: Median total cholesterol increased during 6-month follow-up in both groups, but less in the supervised group compared to the control group (0.1 vs 0.4 mmol/l, respectively, p=0.02). LDL remained stable in supervised group but increased slightly in the control group (0 vs. 0.4 mmol/l, respectively, p=0.01). Fasting plasma glucose lowered slightly in both groups (-0.2 vs -0.4 mmol/l). Total active time per day was slightly higher in the supervised group compared to the control group after 3-month intervention (median 364 vs 293 min/day, respectively). This difference persisted after intervention stopped (median 331 vs 267 min/day, respectively). Median change in body fat percentage at 6 months was 0 in the supervised arm and -0.9 in the control arm. None of the participants dropped out due to exercise-related side-effects. Conclusion: This pilot study showed that it is safe to perform strength exercise in men with ADT. Supervised exercise is likely more effective in mitigating metabolic adverse effect of ADT and inducing long-term changes in physical activity than self-administered exercise. Larger studies with longer follow-up are needed to investigate whether this leads to survival advantage. Citation Format: Lauri Rantaniemi, Aino Siltari, Eeva Harju, Teemu J. Murtola. Can supervised exercise impact on metabolic markers and physical activity during androgen-deprivation therapy in prostate cancer patients? - randomized controlled pilot trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT171.

Hyperlipidemia-post-initiation-of-nilotinib-among-chronic-myeloid-leukemia-patients-in-a-tertiary-hospital-of-malaysia

Introduction: Nilotinib is effective in patients with chronic myeloid leukemia (CML), but is also associated with hyperlipidemia, which can be a risk factor for atherosclerotic vascular events. Objective: To determine the completeness in monitoring the fasting lipid profile (FLP), changes in lipid levels before and after the initiation of nilotinib, and changes in lipid levels after statin therapy. Method: This was a retrospective cohort study that included all patients with CML in the chronic or accelerated phase, who were receiving follow up under the haematology clinic of a regional referral hospital in the state of Perak, Malaysia. Patients who had been prescribed nilotinib from the beginning of January 2010 to June 2020 were included in the study, including patients who were still on treatment as well as those who, despite having their treatment discontinued during the observation period, still followed up in the clinic. The monitoring of FLP was defined as either “complete” (with both pre-initiation and post-initiation FLP available); or “incomplete” (with either one of pre-initiation or post-initiation FLP available); or “not ordered”. An LDL level of ≥ 2.6 mmol / L was considered suboptimal. Since the changes in FLP parameters were found to not be normally distributed, the data were evaluated using the Wilcoxon test, whereby a two-tailed p-value of P < 0.05 was considered statistically significant. Result: 61 patients who met the inclusion criteria were included. The FLP test was not ordered in 16 patients, incomplete in 33 patients and complete in 11 patients (18%). Patients who had completed the test displayed a significant increase in median HDL, LDL, and total cholesterol level from 1.27 to 1.46 mmol / L (p = 0.009), 2.10 to 3.30 mmol / L (p = 0.003) and 3.90 to 5.33 mmol / L (p = 0.005) respectively after the initiation of nilotinib. Statin was prescribed to 6 patients with a baseline mean LDL of 4.77 mmol / L, whereby the mean LDL was significantly reduced by 1.82 mmol / L (p = 0.003) after treatment. Conclusion: Patients experienced a significant increase in total cholesterol and LDL levels with nilotinib. Treatment with statin has elicited a significant reduction in LDL. Only a small proportion of patients received complete FLP monitoring, which warrants attention from the health authority.

MO147: Fat Check: Lipid Abnormalities in Nephrotic Primary Glomerulopathies

Abstract BACKGROUND AND AIMS Lipid abnormalities are a defining feature of nephrotic syndrome. In nephrotic patients, changes such as increased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) as well as decreased HDL-C: TC ratio are more frequently found than in healthy subjects. The aims of this study were to evaluate the differences in the serum lipidic profile at baseline (diagnosis) among each primary glomerulopathies (PG) presenting with nephrotic syndrome (NS) and its association with several clinical parameters such as serum albumin (SAbl) and proteinuria. METHOD We conducted a retrospective cohort study with patients older than 18 years who presented with nephrotic syndrome and diagnosed with a PG by kidney biopsy in the last 10 years in a tertiary-level hospital. RESULTS The study included 60 patients: 38 were male (63.3%), with median age of 52 (IQR 27) years, 43.3% had hypertension, median serum creatinine (SCr) was 1.11 mg/dL (IQR 0.86), median protein-creatinine ratio was 7443 (IQR 5033.5) mg/g and median SAlb of 2.0 (IQR 1.03) mg/dL. At baseline, the median TC was 320.5 mg/dL (IQR 184.5), HDL-C 55 (IQR 25.5) mg/dL, LDL-C 225mg/dL (IQR 174), TG 176 (IQR 122.6) mg/dL and HDL: TC ratio 0.19 (IQR 0.13). Median follow-up time was 24 (IQR 51) months. Patients were grouped in four categories regarding the PG subtype: membranous nephropathy (MN, 38.3%), minimal change disease (MCD, 38.3%), IgA nephropathy (IgAN, 11.7%) and focal segmental glomerulosclerosis (FSGS, 11.7%). Evaluating all the patients enrolled, we found a strong negative correlation between SAlb and TC (r = –0.511, P &amp;lt; .001), LDL-C (r = –0.529, P &amp;lt; .001) and a weaker negative correlation with TG (r = –0.282, P = .030), but not with HDL-C. We did not find a statistically significant correlation between proteinuria and each cholesterol subtype or TG levels. A Kruskal–Wallis test showed that different subtypes of PG were associated with different median HDL-C (H(3) = 12.073, P = .007) and TG serum levels (H(3) = 10.128, P = .018). No statistically significant differences in the TC, LDL-C or HDL-C: TC ratio were found. Comparing all pairs of groups, we found that HDL-C levels were statistically different between MN and MCD (45.5 versus 67 mg/dL, P &amp;lt; .001), but not in the other pairs. The same analysis found that TG serum levels were only significantly different between IgAN and MN (114 versus 187 mg/dL, P = .008) and between IgAN and FSGS (114 versus 200 mg/dL, P = .012). MN patients that progressed to CKD stage 5D had lower median HDL-C levels at diagnosis, when compared to the patients who did not progress (41 versus 49 mg/dL, P = .037). This difference was not observed in IgA, FSGS or MCD. CONCLUSION Each GP subtype presents a different lipid profile, particularly differing on HDL and TG. Patients with MCD presented with the highest levels of HDL-C, while MN with the lowest. Regarding TG levels, FSGS presented with the highest levels while IgAN presented with the lowest. In the membranous nephropathy group, patients that progressed to ESRD had statistically significantly lower serum levels of HDL-C. As expected, SAlb is significantly associated with TC, LDL-C and TG levels, in nephrotic patients. This could be due to different levels of lecithin–cholesterol acyltransferase (an enzyme responsible for the maturation of HDL), which is increasingly lost through urine in nephrotic syndromes. The differences found in the lipidic profile between PG subtypes could have screening, therapeutic and prognosis implications in the management of cardiovascular risk in these patients. More studies are needed to understand the pathophysiology and the prognosis significance of each lipid profile.

Results of a multidisciplinary strategy to improve the management of cardiovascular risk factors after liver transplantation.

Although liver transplantation (LT) recipients are at high cardiovascular risk (CVR), the management of CVR factors (CVRF) after LT is far from optimal and needs to be improved. For this reason, we developed a multidisciplinary protocol to standardize the identification, risk stratification, management, and targets of therapy of CVRF during the first post-LT year. The grade of identification and control of CVRF 12months after LT in the postintervention cohort (LT January 2018-January 2020, n=150) were compared with a control cohort who underwent LT between July 2015 and December 2016 (n=100). Before LT, the prevalence of metabolic-associated fatty liver disease as the indication of LT and the presence of obesity were significantly higher in the postintervention cohort, whereas the prevalence of other CVRF and renal dysfunction tended to be higher. Cyclosporine A was used less frequently in the postintervention cohort, whereas everolimus tended to increase. At 12 months after LT, the proportion of patients with measured blood pressure (88% vs. 56%), glycosilated hemoglobin (HbA1c; 96% vs. 72%), and high-density lipoprotein/low-density lipoprotein cholesterol (67% vs. 33%) was higher in the postintervention than in the control cohort (all p<0.001). Blood pressure (64% vs. 36%, p=0.02) and HbA1c (85% vs. 70%, p=0.1) were within target in more individuals with hypertension and diabetes mellitus, respectively, in the postintervention cohort. Median total cholesterol levels were lower in the postintervention (184 mg/dl; interquartile range [IQR], 160-210 mg/dl) than in the control cohort (212 mg/dl; IQR, 186-240 mg/dl; p=0.02). At 2 years after LT, the incidence of cardiovascular events was 14% in the control cohort and 6% in the postintervention cohort (p=0.063). In conclusion, a multidisciplinary, multiprofessional strategy can achieve a higher grade of assessment and management of post-LT CVR despite a worsening metabolic profile of LT recipients.

Predictors of Peripheral Artery Disease Progression. Is there Any Role for Vascular Age?

Predictors of Peripheral Artery Disease Progression. Is there Any Role for Vascular Age?

Association of total cholesterol and atherosclerotic cardiovascular disease in patients with follicular thyroid cancer: A real-world study from Chinese populations.

The association between serum total cholesterol (TC) level and incident atherosclerotic cardiovascular disease (ASCVD) in patients with follicular thyroid cancer postthyroidectomy is unknown.This was a retrospective study and patients (n = 384) were divided into low and high TC groups according to the median TC level. Incidence of composite ASCVD (myocardial infarction, ischemic stroke, and cardiovascular death) was compared between these 2 groups and factors contributing to the association of TC and ASCVD were evaluated.Patients in the high TC group were older and more likely to have diabetes and have higher C-reactive protein level. After thyroidectomy, serum levels of free triiodothyronine and free thyroxine were lower while thyroid-stimulating hormone level was higher in the high TC group. 31.6% and 39.7% of patients developed hypothyroidism in the low and high TC groups (P < .05) postthyroidectomy. The incidence rate of composite ASCVD was higher in the high TC versus low TC groups, with incidence rate ratio of 1.69 (95% confidence interval [CI]: 1.07–2.69), which was mainly driven by a higher incidence rate of myocardial infarction in the high TC group (incidence rate ratio: 2.11 and 95% CI: 1.10–4.20). In unadjusted model, higher TC was associated with 73% higher risk of composite ASCVD. After adjustment for hypothyroidism, the association of higher TC and composite ASCVD was attenuated into insignificance, with hazard ratio of 0.92 and 95% CI: 0.81 to 1.34.Increased TC level was associated with composite ASCVD, which might be attributed to hypothyroidism postthyroidectomy. The use of levothyroxine might help to prevent hypercholestemia and reduce the incidence of ASCVD.

Gambaran Castelli’s Risk Index-1 pada Pasien Sindrom Koroner Akut di RSUP Dr. M. Djamil Padang

Atherogenic dyslipidemia is one of the risk factors for the acute coronary syndrome (ACS). Castelli's risk index-1 (CRI-1) is one of which risk markers for ACS. Castelli's risk index-1 is the ratio of total cholesterol and HDL cholesterol. The test is cheap and easy to do in the hospital setting. Objectives: To described CRI-1 in ACS patients in Dr. M. Djamil Padang Hospital. Methods: This descriptive study was carried out in the central laboratory and the CardioVascular Care Unit (CVCU) of Dr. M. Djamil Hospital Padang from September 2017 to September 2018. The population was all ACS patients who have been diagnosed by the clinician. The samples were part of the population that meet the inclusion and exclusion criteria. Colorimetric enzymatic method using automated clinical chemistry used to measure total cholesterol and HDL cholesterol. Results: This study used CRI-1&gt; 4. Data were presented descriptively in a frequency distribution table. Seventy ACS patients were consisting of 50 (71.43%) males and 20 (28.57%) females, with a median age of 60.1 (8.93) years old. The median total cholesterol and HDL cholesterol levels were 178.66 (46.84) mg / dL respectively and 35.71 (10.86) mg / dL. CRI-1 mean is 5.43 (2.27). 81.43% CRI-1 subject results were more than four. Conclusion: The low levels of HDL cholesterol and within normal median total cholesterol level made CRI-1 value increased.Keywords: Acute coronary syndrome, Castelli’s risk index-1

SERUM TRIGLYCERIDES AND TOTAL CHOLESTEROL ARE ASSOCIATED WITH ANTIMULLERIAN HORMONE LEVELS

To determine if serum lipid levels (high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), triglycerides (TG), or total cholesterol (TC)) are associated with antimullerian (AMH) levels in a reproductive aged population of women from the Midwest in order to identify potential modifiable targets to improve ovarian reserve. A cohort of 199 women between the ages of 18 and 44 were enrolled into a cross-sectional cohort study. Women with regular menstrual cycles were included, women who were currently pregnant or had a history of major chronic illness or ovarian surgery were excluded. Fasting blood was drawn and stored at -80 degrees celsius for batched analysis. AMH values were measured using the Roche cobas e411 analyzer. The lipid values were measured using Roche cobas 6000 automated platform with a c501 analyzer using FDA-approved kits from Roche Diagnostics, with the exception of LDL cholesterol, which was calculated by the Friedewald equation. Bivariate statistics were used to assess associations between lipid and AMH levels. SPSS v26 was used for analysis. This study was approved by the Washington University IRB. On average, participants were 30.9 ± 6.7 years and had a body mass index of 28.3±7.1 kg/m2. Most of the study participants were white (n=136, 68%) and approximately one third were black (n=60, 30%). AMH values were not normally distributed and were negatively skewed. The median AMH level was 2.5ng/mL (IQR 1.44-4.01). The median TC and TG were significantly higher in those with AMH levels <1ng/mL compared to those with AMH levels ≥1ng/mL (p = 0.023 and p = 0.002, respectively). When stratified by BMI greater than or less than 25, TG levels were higher in the AMH <1ng/mL group compared to the AMH ≥ 1ng/mL group (p=0.007). LDL and TC levels were also higher in the BMI < 25 group with a trend towards significance (p=0.055, p=0.070). In the BMI ≥ 25 group, TG levels were higher in the AMH <1 group compared to the AMH > 1 group with a trend towards significance (p=0.057). Our data suggest that for healthy, reproductive aged women from the Midwest, total cholesterol and triglycerides could be potential targets to modify with lifestyle changes and/or medication that could potentially improve AMH. With a healthy BMI, lower AMH values were associated with higher LDL, TG, and TC levels. Perhaps women with a lower BMI who have a diet that is high in fats have impacted their ovarian reserve. Future interventional studies are needed.