National Cholesterol Education Program Guidelines Research Articles

Association between serum Klotho concentration and hyperlipidemia in adults: a cross-sectional study from NHANES 2007-2016.

The Klotho protein is a well-documented anti-aging protein known for its diverse biological functions. Hyperlipidemia is an established independent risk factor for various chronic diseases. However, there is limited understanding of the connection between Klotho and hyperlipidemia. The aim was to assess the association between serum Klotho levels and hyperlipidemia among adults. The study included 11,618 individuals from the NHANES database from 2006 to 2017. Hyperlipidemia was diagnosed following the National Cholesterol Education Program guidelines. Serum Klotho concentration was measured by an enzyme-linked immunosorbent assay kit, and the association between Klotho and hyperlipidemia was assessed by a multivariable logistic regression model. Fitted smoothing curves and threshold-effect analysis were employed to describe nonlinear relationships. In our multiple logistic regression models, serum Klotho concentration was significantly associated with hyperlipidemia after adjusting for comprehensive confounders (per SD increment odds ratio (OR): 0.91; 95% confidence interval (CI): 0.86-0.97). Compared to individuals in the lowest Klotho quartile, those in the highest quartile exhibited a substantially decreased prevalence of hyperlipidemia (OR: 0.72; 95% CI: 0.58-0.90). Using a two-segment logistic regression model, we identified a U-shaped relationship between serum Klotho concentration and hyperlipidemia, with an inflection point at 1,365.5 pg/mL. Subgroup analysis did not reveal any potential moderating effects. This study revealed an inverse relationship between Klotho levels and hyperlipidemia. Further investigation is warranted to explore the underlying mechanism between serum Klotho and hyperlipidemia.

Pattern of dyslipidemia and associated factors in coronary artery disease patients in Khyber Pakhtunkhwa: A cross-sectional secondary data analysis.

To assess the prevalence, pattern, and associated factors of dyslipidemia in patients with coronary artery disease (CAD) in the Northwest region of Pakistan. A cross-sectional secondary data analysis was performed on CAD patients visiting cardiology clinics in selected hospitals from July to December 2019. A total of 362 patients were included via consecutive sampling. Dyslipidemia was operationalized according to the "National Cholesterol Education Program (NCEP ATP III) guidelines". Mixed dyslipidemia was recorded in 92.26% of the patients, while isolated dyslipidemia was observed in 5.24%. A high prevalence of combined dyslipidemia with increased LDL-C, TG, and low HDL-C was noted. Contrarily, elevated LDL-C was the commonest single lipid disorder (84.25%). Hypercholesterolemia was the least common disorder. Increasing BMI was found to be independently associated with hypercholesterolemia (OR: 1.19). Similarly, age (OR: 0.97) and being a rural resident (OR: 2.61) were independent factors associated with hypertriglyceridemia. Furthermore, being an urban resident (OR: 2.25) and increasing BMI (OR: 1.77) were also significantly associated with high LDL-C. Mixed dyslipidemias were observed in the majority of the patients. Age, BMI, and residence were noted to be independently associated with abnormal lipids. Early screening and proper management should be encouraged to minimize this significant cardiovascular risk.

Prevalence of Metabolic Syndrome among Apparently Healthy Adult Population in Pakistan: A Systematic Review and Meta-Analysis.

Metabolic syndrome (MetS) is considerably higher worldwide. It varies greatly in different populations geographically and based on criteria used to diagnose the disease. This review was conducted to determine the prevalence of MetS among apparently healthy adults of Pakistan. A systematic review was performed on Medline/PubMed, SCOPUS, ScienceDirect, Google Scholar, and Web of Science databases until July 2022. Articles published on Pakistani healthy adult population reporting MetS were included. Pooled prevalence was reported with 95% confidence interval (CI). Of 440 articles, 20 articles met the eligibility. The pooled prevalence of MetS was 28.8% (95% CI: 17.8-39.7). The maximum prevalence was from a sub-urban village of Punjab (68%, 95% CI: 66.6-69.3) and Sindh province (63.7%, 95% CI: 61.1-66.3). International Diabetes Federation guidelines had shown 33.2% (95% CI: 18.5-48.0) whereas National Cholesterol Education Program guidelines showed 23.9% (95% CI: 8.0-39.8) prevalence of MetS. Furthermore, individuals with low high-density lipoprotein (HDL) 48.2% (95% CI: 30.8-65.6), central obesity 37.1% (95% CI: 23.7-50.5), and high triglyceride 35.8% (95% CI: 24.3-47.3) showed higher prevalence. A considerably higher prevalence of MetS was observed among apparently healthy individuals in Pakistan. High triglyceride, low HDL, and central obesity were found as significant risk factors. (Registration # CRD42022335528).

Examining dyslipidaemia, metabolic syndrome and liver enzyme levels in patients with prediabetes and type 2 diabetes in population from Hoveyzeh cohort study: A case-control study in Iran.

Type 2 diabetes mellitus (T2DM) is among the world's top 10 leading causes of death. Additionally, prediabetes is a major risk factor for diabetes. Identifying diabetes co-occurring disorders can aid in reducing adverse effects and facilitating early detection. In this study, we evaluated dyslipidaemia, metabolic syndrome (MetS), and liver enzyme levels in pre-diabetic and T2DM patients in the Persian cohort compared to a control group. In this cross-sectional study, 2259 pre-diabetes, 1664 T2DM and 5840 controls (35-70 years) who were selected from the Hoveyzeh cohort centre were examined. Body mass index, blood pressure, fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) and liver enzymes: γ-glutamyltransferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined using the standard protocols. MetS subjects were also identified based on the National Cholesterol Education Program guidelines. Prediabetes and T2MD were closely correlated with the lipid profile, MetS, and liver enzymes (ALT, GGT, ALT/AST). MetS increases the risk of T2DM by 12.45 [95% CI: 10.88-14.24] fold, while an increase in ALT/AST ratio increases the risk of T2DM by 3.68 [95% CI: 3.159-4.154] fold. ROC curve analysis also revealed the diagnostic roles of GGT, ALT, AST and the ALT/AST ratio among pre-diabetics, diabetics and the control group. The GGT level corresponds to the highest AUCs (0.685) with the highest sensitivity (70.25%). Our results indicated a significant increase in liver enzymes, lipid profile and MetS status in both pre-diabetic and T2MD subjects, with the differences being more pronounced in diabetic individuals. Consequently, on the one hand, these variables may be considered predictive risk factors for diabetes, and on the other hand, they may be used as diagnostic factors. In order to confirm the clinical applications of these variables, additional research is required.

Prevalence and factors associated with dyslipidemia among adolescents in Saudi Arabia

Dyslipidemia is a major risk factor for atherosclerosis. Screening for dyslipidemia at an early age is essential to prevent and control its consequences. This study aimed to determine prevalence of dyslipidemia and its correlates among adolescents in Saudi Arabia. Data of 5854 adolescents aged 10–19 years from all 13 regions of Saudi Arabia were obtained from the Jeeluna study; a national cross-sectional, multistage stratified cluster sample survey. Dyslipidemia was defined based on the National Heart Lung and Blood Institute and National Cholesterol Education Program guidelines for adolescents. We found that a quarter of Saudi adolescents have dyslipidemia (males: 33.3%, females: 17.9%). Significant variation was observed by region (p < 0.001). Prevalence of abnormal Total Cholesterol was 6.7%, LDL-C 7.1%, HDL-C 12.8%, Non-HDL-C 8.3%, and Triglycerides 9.6%. Factors independently associated with dyslipidemia were male gender (OR = 2.19, 95% CI 1.78–2.70, p < 0.001), BMI (underweight OR = 0.80, 95% CI 0.69–0.94, overweight OR = 1.76, 95% CI 1.50–2.06, obese OR = 2.80, 95% CI 2.34–3.34, p < 0.001, vs. normal) and serum ferritin (high OR = 7.02, 95% CI 1.49–34.79, low OR = 0.82, 95% CI 0.67–1.01, p = 0.04 vs. normal) and ≥ 1 daily intake of carbonated beverage (OR = 1.10, 95% CI 1.00–1.20, p = 0.03 vs. no or not daily intake). Public health interventions for improving lipid profile of adolescents are urgently needed.

Association between blood lead levels and hyperlipidemiais: Results from the NHANES (1999-2018).

BackgroundResearch on the association between blood lead (Pb) and lipid biomarkers have yielded inconsistent results, and epidemiological studies on blood Pb levels and hyperlipidemia are scarce. The present study aimed to examine the association between blood Pb levels and hyperlipidemia in adults from the National Health and Nutrition Examination Survey (NHANES).MethodsA total of 43,196 participants in the NHANES from 1999 to 2018 were included in the final analysis. Hyperlipidemia was determined based on the National Cholesterol Education Program guidelines. Blood Pb levels were assessed using inductively-coupled plasma mass spectrometry. Weighted multivariable logistic regression analysis and subgroup analysis were conducted to determine the correlation between blood Pb levels and hyperlipidemia.ResultsIn the multivariable logistic regression model, high blood Pb levels were significantly associated with hyperlipidemia after adjusting for confounders (OR 1.41; 95%CI: 1.18–1.67). Furthermore, elevated blood Pb levels were associated with an increased risk of hyperlipidemia across the four quartile (Q) groups (Q1: OR 1.00; Q2: OR 1.16 [95%CI: 1.04–1.29]; Q3: OR 1.39 [95%CI: 1.21–1.59]; and Q4: OR 1.33 [95%CI: 1.15–1.54]; P for trend <0.05). Significant moderating effects were found in the subgroup analysis stratified by age, education, hypertension, and diabetes (P < 0.05). In sensitivity analysis, the ORs for hyperlipidemia across the quartiles of blood Pb levels were 1.00, 1.17 (95%CI: 1.05–1.30), 1.42 (95%CI: 1.24–1.62), and 1.38 (95%CI: 1.19–1.60) for Q1, Q2, Q3, and Q4, respectively (P for trend <0.001) after removing adults with arteriosclerotic cardiovascular disease, and the ORs were 1.00, 1.13 (95%CI: 1.01–1.25), 1.38 (95%CI: 1.21–1.56), and 1.32 (95%CI: 1.16–1.52) for Q1, Q2, Q3, and Q4, respectively (P for trend <0.001) after including pregnant women.ConclusionThe current study showed a positive association between blood lead levels and hyperlipidemia.

The Metabolic Syndrome Is Associated With Lower Cognitive Performance and Reduced White Matter Integrity in Midlife: The CARDIA Study.

BackgroundCardiovascular disease risk factors play a critical role in brain aging. The metabolic syndrome (MetS), a constellation of cardiovascular risk factors, has been associated with poorer cognition in old age; however, it is unclear if it is connected to brain health earlier in life.MethodsWe investigated the association of MetS (n = 534, 18.5%) vs. no MetS (n = 2,346, 81.5%) with cognition in midlife within the prospective study, Coronary Artery Risk Development in Young Adults (CARDIA). At midlife (mean age 50), MetS was defined using National Cholesterol Education Program guidelines. At the 5-year follow-up, a cognitive battery was administered including tests of processing speed (Digit Symbol Substitution Test, DSST), executive function (the Stroop Test), verbal memory (Rey Auditory Verbal Learning Test, RAVLT), verbal fluency (category and letter fluency), and global cognitive function (Montreal Cognitive Assessment, MoCA). A sub-sample (n = 453) underwent brain MRI.ResultsParticipants with MetS had worse performance on tests of verbal fluency, processing speed, executive function, and verbal memory (p < 0.05), but not on global cognition. MetS was also associated with lower frontal, parietal, temporal, and total white matter integrity (p < 0.05), as assessed with fractional anisotropy.ConclusionsMetS is associated with lower cognition and microstructural brain alterations already at midlife, suggesting that MetS should be targeted earlier in life in order to prevent adverse brain and cognitive outcomes.

Impact of Secondhand smoking on Dyslipidaemia among non-smokers: findings from the 2015-2016 NHANES dataset in the United States

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This research was supported by the Brain Pool Program supported through the National Research Foundation of Korea, funded by the Ministry of Science and ICT (2020H1D3A1A04081265). Background Dyslipidemia is a prominent risk factor of mortality globally. While active smoking has been implicated in the burden of cardiovascular disease (CVD) worldwide, there is little understanding on the impact of subtle secondhand smoke exposure (SHSE) on dyslipidaemia among non-smokers. Purpose This study assessed the association of SHSE with dyslipidaemia among non-smoking adults from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) in the United States. Method Participants for this study were 3,064 non-smoking adults (≥18years) identified through a multistage sampling method in the United States. Data on sociodemographic, lifestyle and history of CVD were collected using standard operating principles. Also, fasting blood samples were collected by trained personnel to determine blood lipid profiles. SHSE was defined as exposure to smoke from a burning cigarette (exhaled by a smoker) in an indoor environment or a blood cotinine concentration ≥ 0.05 ng/ml. Dyslipidemia was defined according to the National Cholesterol Education Program guidelines. Logistic regression was adopted to estimate the multivariable-adjusted odds ratio (aOR) and 95% confidence interval (CI) for the association between SHSE and dyslipidaemia at a two-sided P &amp;lt; 0.05. Results The mean age of respondents was 46.4 ± 18.0years, 63.2% were females, 36.2% reported SHSE, and 59.6% had dyslipidemia. The aOR and 95% CI among respondents with SHSE was 1.148 (1.147-1.149) in the entire sample. Similarly, odds of dyslipidaemia in the light of SHSE was 1.130 (1.129-1.131) among those &amp;lt; 60 years, 1.304 (1.300-1.308)] among those ≥ 60 years, 1.165 (1.163-1.167) among males and 1.214 (1.212-1.215) among females. Conclusion(s) SHSE was associated with higher odds of dyslipidaemia and might be an often missed risk factor in the risk of dyslipidaemia. Primary prevention strategies(s) might be necessary to reduce the impact of SHSE on the burden of dyslipidaemia and CVD worldwide.

Metabolic syndrome in relation to cognitive function and white matter integrity in midlife: The CARDIA study

AbstractBackgroundMetabolic syndrome (MetS) has been associated with poorer cognition in old age, however this association has yet to be defined in midlife. We aimed to investigate the relationship of early adulthood to midlife MetS in relation to cognition and white matter integrity in midlife.MethodsWithin the prospective study of Coronary Artery Risk Development in Young Adults, 2882 participants were identified with follow‐up of 30 years (age 18–30 years at baseline). MetS was defined using National Cholesterol Education Program guidelines and assessed across 9 follow‐ups over 25 years. Cognitive function was assessed at Year 30 using the Rey Auditory Verbal Learning Test (verbal memory), Digit Symbol Substitution Test (processing speed), Stroop test (executive function) and Verbal Fluency. Using logistic regression, we examined the association of MetS at Year 25, and persistent MetS (at least two assessments over the follow‐up) with poor mid‐life cognition, defined as ≥1 standard deviation below the mean in each domain. In a sub‐sample (n=453), brain MRI measures of total and region‐specific white matter integrity (fractional anisotropy [FA] and mean diffusivity [MD]) were assessed at Year 30 (mean age of 55±3.5 years) and converted to standardized z‐scores.ResultsMetS at Year 25 (n=534, 18.54%) was associated with poor cognitive function five years later in verbal memory (OR: 1.32, 95% CI: 1.04; 1.67) and processing speed (OR: 1.59, 95% CI: 1.23; 2.05), adjusting for age, sex, education, race, income, and smoking. Similarly, participants with persistent MetS over 25 years had lower cognitive performance in verbal memory (OR: 1.38, 95% CI: 1.10;1.73) and processing speed (OR: 1.72, 95% CI: 1.34; 2.22). In the MRI sub‐sample, MetS at Year 25 (n=60, 13.3%) was associated with lower total FA (β: ‐0.31, 95% CI: ‐0.57; ‐0.05). Persistent and non‐persistent MetS was associated with lower frontal FA (β: ‐0.36, 95% CI: ‐0.62; ‐0.09, β: ‐0.21, 95% CI: ‐0.62; ‐0.08, respectively) and higher total MD (β: 0.30, 95% CI: 0.03; 0.56, β: 0.26, 95% CI: 0.01; 0.51, respectively).ConclusionMetS from early adulthood to midlife may be a risk factor for poor cognitive function in midlife and is associated with microstructural white matter differences.

Standardization Status of Total Cholesterol Concentration Measurement: Analysis of Korean External Quality Assessment Data.

BackgroundTotal cholesterol concentration measurement is important in the diagnosis of dyslipidemia and evaluation of cardiovascular disease risk factors. Measurement reliability for obtaining an accurate total cholesterol concentration requires procedure standardization. We evaluated the standardization status for total cholesterol concentration measurement through Korean external quality assessment (EQA) data analysis.MethodsThis study involved 1,670 laboratories that participated in the EQA of total cholesterol concentration measurements in 2019 for 32 products from different manufacturers. The target concentrations of three quality control (QC) materials (samples A, B, and C) were measured using the reference method and compared with EQA data. The performance criteria for total cholesterol concentration measurement were based on the National Cholesterol Education Program guidelines, with ±3% inaccuracy.ResultsThe target values and inaccuracies of the QC material based on the reference method measurements were 254.65±7.64, 108.30±3.25, and 256.29±7.69 mg/dL (6.59±0.20, 2.80±0.08, and 6.63±0.20 mmol/L) for samples A, B, and C, respectively. The performance criteria were not met in 42.7% laboratories for sample A, 68.4% of laboratories for sample B, and 38.0% laboratories for sample C.ConclusionsDespite significant efforts to accurately measure total cholesterol concentrations, further actions are needed for measurement standardization. Manufacturers reporting values that differ from target values should check calibrator traceability; additional efforts to accurately measure total cholesterol concentrations are required for laboratories that use products from these manufacturers.

IMPACT OF CLINICAL PHARMACIST EDUCATION ON EVALUATION OF PREVALENCE, MONITORING AND LIPID CONTROL IN DYSLIPIDEMIC PATIENTS

Background: The importance of treating dyslipidemias based on cardiovascular risk factors is highlighted by the National Cholesterol Education Program guidelines. Dyslipidemia is dened as a disorder of lipoprotein metabolism. In India ,the prevalence of dyslipidemia was found to be higher in males 38.7% than in females which is 23.3%. The hypercholesterolemia and hyper triglyceridemia are more prominent in the age group 31-40 years in both the age groups. objective: The main objective of the study is to assess clinical pharmacist education on evaluation of prevalence, monitoring and lipid control in dyslipidemic patients in a tertiary care hospital.method: The present study is a prospective observational study. Participants were randomly assigned to the experimental group and non-experimental group. Data were collected by using proforma and questionnaire after admission to the hospital and at the time of follow up in out-patient department. result: A total of 150 patients were recruited and 147 patients completed the study. Three patients in the non-experimental group dropped out of the study because they moved to another hospital. In the present study, we have analyzed 147 dyslipidemic patients. Among them in the experimental group, there were 75 participants. The patients aged above 18 years were included in the study. Prevalence of dyslipidemia was found to be highest in the patients aged above 61 years (56%) and least in the patients aged between 20-30 years (1%). All the Pvalues (p&lt;0.05) considered statistically signicant. Results were analyzed by Graphpad prism

Metabolic Syndrome and Physical Activity Levels in College Students.

Background: It is estimated that >30% of young adults attending college are overweight or obese and do not participate in enough physical activity (PA) to maintain a healthy body mass. Many of the known risk factors that are often associated with obesity also place an individual at risk for developing metabolic syndrome (MetS). The purpose of this study was to examine the prevalence of MetS and the magnitude and rate of PA levels in college students. Methods: Seventy-six college-aged students participated in the study. The following information was obtained from each participant: body anthropometrics, fasting glucose and lipoproteins, and accelerometer-measured activity levels. Participants wore, at the waist, the wireless activity monitor (wGT3X-BT; ActiGraph, Pensacola, FL) for seven consecutive days to monitor PA levels. MetS was determined if the participant met three of the five criteria utilizing the National Cholesterol Education Program guidelines. Results: More than half of the participants had at least one criterion, with the overall prevalence of MetS being 9.2%. MetS participants were more sedentary (84.8% vs. 91.0%, P < 0.001) and engaged in less light activities (8.9% vs. 6.0%, P < 0.001). Conclusions: Current activity levels in college students do not meet the established guidelines for total steps per day, elevating the risk of acquiring metabolic disorders.

Changes in cardiovascular risk and clinical outcomes in a HIV/AIDS cohort study over a 1-year period at a specialized clinic in Mexico.

IntroductionThe third report of the National Cholesterol Education Program guidelines recommends calculating the 10-year morbidity of atherosclerotic cardiovascular disease (ASCVD) using risk calculators when treating high blood cholesterol in adults. We analyzed the changes in cardiovascular risk (CVR) among Mexican patients with HIV.Patients and methodsThis observational, prospective cohort study compared the CVR after 1 year of antiretroviral treatment among 460 HIV patients from a Mexican clinic. Changes using the ASCVD risk estimator and changes in clinical outcomes were analyzed. The results were categorized as low or high CVR using a cutoff of 7.5%.ResultsThe CVR initially had a median of 2.3% (interquartile range [IQR]: 1%–4.8%), which changed to 2.4% (IQR: 1.5%–5.5%) after 1 year (P=0.001). After CVR stratification, we found that 84.3% of the patients had a low CVR, and 18% in this subgroup had metabolic syndrome (MS). Moreover, 15.7% had high CVR, and 47% in this subgroup had MS. The 4.3% of patients had an increase in CVR from the low to high subgroup, and 2.6% had a decrease in CVR from the high to low subgroup. Out of all patients, 22.3% had MS.ConclusionMore than 50% of the population had an increase in CVR after 1 year. Of these patients, 4.3% changed from the low to high CVR group. Although the guidelines proposed different time periods for performing CVR estimations, this study showed that such assessments offered valuable clinical data over a relatively short-term period.

ASSESSMENT OF RISK FACTORS OF HYPERTENSION AMONG ADULTS RESIDING IN URBAN SLUM OF DELHI.

Objective: The objective of this study is to assess the risk factors of hypertension among adults residing in urban slums of West Delhi.Methods: A cross-sectional study was carried out among adult population of 18–59 years residing in urban slums of West Delhi. Blood pressure was measured twice using digital machine (OMRON). Height, waist circumference, and hip circumference were measured, weight was taken, and body mass index (BMI) was calculated. The Joint National Committee VII criteria were used to define hypertension, and the National Cholesterol Education Program and Adult Treatment Panel-III guidelines were used to define different categories of dyslipidemia. The World Health Organization (2014) criteria were used to classify the BMI.Results: The overall prevalence of hypertension among adults (n=423) was 25.3%. Among hypertensive adults, the prevalence of obesity was 22.7%, while among non-hypertensives, it was 10.9%. Similarly, overweight prevalence was higher (27.3%) in hypertensive adults compared to non-hypertensive adults (20.6%). The overall prevalence of hypercholesterolemia, hypertriglyceridemia, high-density lipoprotein-cholesterol &lt;40/&lt;50 mg/dl, and low-density lipoprotein-cholesterol (LDL-C) ≥130 was 19.7%, 33.7%, 75.7%, and 21.8%, respectively. The prevalence of hypercholesterolemia, hypertriglyceridemia, and serum LDL-C ≥130 mg/dl was 38%, 50%, and 32% among hypertensive adults, while among non-hypertensive adults, it was 15%, 29%, and 19%, respectively.Conclusion: Hypertensive adults had higher BMI, serum cholesterol, triglycerides, and LDL-C compared to non-hypertensives.

ASSESSMENT OF RISK FACTORS OF HYPERTENSION AMONG ADULTS RESIDING IN URBAN SLUM OF DELHI.

Objective: The objective of this study is to assess the risk factors of hypertension among adults residing in urban slums of West Delhi.Methods: A cross-sectional study was carried out among adult population of 18–59 years residing in urban slums of West Delhi. Blood pressure was measured twice using digital machine (OMRON). Height, waist circumference, and hip circumference were measured, weight was taken, and body mass index (BMI) was calculated. The Joint National Committee VII criteria were used to define hypertension, and the National Cholesterol Education Program and Adult Treatment Panel-III guidelines were used to define different categories of dyslipidemia. The World Health Organization (2014) criteria were used to classify the BMI.Results: The overall prevalence of hypertension among adults (n=423) was 25.3%. Among hypertensive adults, the prevalence of obesity was 22.7%, while among non-hypertensives, it was 10.9%. Similarly, overweight prevalence was higher (27.3%) in hypertensive adults compared to non-hypertensive adults (20.6%). The overall prevalence of hypercholesterolemia, hypertriglyceridemia, high-density lipoprotein-cholesterol &lt;40/&lt;50 mg/dl, and low-density lipoprotein-cholesterol (LDL-C) ≥130 was 19.7%, 33.7%, 75.7%, and 21.8%, respectively. The prevalence of hypercholesterolemia, hypertriglyceridemia, and serum LDL-C ≥130 mg/dl was 38%, 50%, and 32% among hypertensive adults, while among non-hypertensive adults, it was 15%, 29%, and 19%, respectively.Conclusion: Hypertensive adults had higher BMI, serum cholesterol, triglycerides, and LDL-C compared to non-hypertensives.

Evaluation of the Effectiveness of a Patient-Centered Educational Mailer Designed to Improve Statin Adherence: A Pragmatic Trial.

Background:Patients with high total cholesterol have increased risk of cardiovascular disease. National Cholesterol Education Program (NCEP) and American Heart Association (AHA) guidelines recommend cholesterol lowering with statin medications; however, statin adherence remains poor. We hypothesized that patient-centered education on the 10-year risk for each of the major constituents of cardiovascular disease would increase statin adherence and achievement of the low-density lipoprotein cholesterol (LDL-C) goal.Methods:Veterans within the Salt Lake City Veterans Affairs (VA) Medical Center initiating statin therapy from October 2008 to December 2011 were randomized in a pragmatic design to receive either an educational mailer or usual care. The mailer outlined their 10-year global cardiovascular risk, separated into coronary heart disease, stroke, and congestive heart failure. The study was unblinded and followed an intention-to-treat analysis where outcome measures were obtained during normal care process. The primary outcome measure was the achievement of the LDL-C goal during the 12-month follow-up.Results:Two hundred and seven patients were randomly assigned to either the intervention arm (95) or the control arm (112). No differences in the proportion of patients meeting the LDL-C goal were detected during 12-months [Relative Risk (RR): 0.95 (95 percent confidence interval (CI): 0.77–1.17)] or 18-months [RR: 1.03 (95 percent CI: 0.84, 1.25)]. Patients in the intervention arm had higher adherence on average, e.g., intervention patients were more likely to have 70 percent or more days of statin therapy compared to patients who received standard care—though this did not reach statistical significance—RR: 1.33 (95 percent CI: 1.00, 1.78). There were no statistical differences in cardiovascular outcomes or mortality.Conclusion:Patient education mailers sent to patients starting statin treatment did not have a clear impact on LDL-C goal achievement or adherence to statin therapy.

Commentary on Comparison of Coronary Artery Calcification Scores, National Cholesterol Education Program Guidelines for Coronary Heart Disease Risk Assessment, Treatment Paradigms in Individuals with Chronic Traumatic Spinal Injury

This commentary considers the implications of the findings related to the effect of a study related to coronary heart disease (CHD) risk assessment in individuals with a chronic spinal cord injury (SCI). The findings from the study suggest that there is poor agreement in CHD risk assessment between the previously used guidelines, the National Cholesterol Education Program (NCEP) Guidelines, and coronary artery calcium scores (CACS). Since this publication, a new atherosclerotic cardiovascular disease (ASCVD) risk estimator has been developed. This has not been used in any study with SCI participants. The study also showed that 18 (47.4%) of the participants had some element of CAC, indicating the presence of CHD. Many previous articles have discussed CHD risk factors and mortality in the SCI population. Despite this, there have been very few interventions to decrease the CHD risk in the chronic SCI population.

Effect of Levothyroxine Therapy on Hypothyroidism-induced Dyslipidemia

ABSTRACTObjectiveThe aims of the present study were to determine the prevalence of hypothyroidism, both subclinical hypothyroidism (SH) and overt hypothyroidism (OH), its correlation with dyslipidemia, and whether replacement therapy with levothyroxine has an effect on plasma lipid profile, i.e., total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) of hypothyroid patients.Materials and methodsA prospective, open-label, observational, clinical study was conducted by the Department of Pharmacology in collaboration with the Department of Medicine, Rohilkhand Medical College &amp; Hospital, for a period of 10 months. A total of 50 patients, age 18 to 65 years, of both genders, who were newly diagnosed cases of hypothyroidism with dyslipidemia (Adult Treatment Panel III National Cholesterol Education Program guidelines) were recruited for the study. Levothyroxine replacement therapy was administered and the patients were reassessed at 6 and 36 weeks for an effect on lipid profile and body mass index.ResultsIn cases of OH, baseline TC, TG, LDL, and HDL were 231.01 ± 27.84, 148.18 ± 10.72, 149.07 ± 12.38, and 35.42 ± 6.73 mg/dL, which was reduced to 177.33 ± 23.17, 123.15 ± 29.50, 118.44 ± 29.85, and 47.86 ± 8.53 mg/dL after 36 weeks of levothyroxine therapy (p &lt; 0.05).ConclusionIn cases of OH associated with dyslipidemia, levothyroxine therapy achieved a favorable lipid profile in significant number of cases.How to cite this articleShekhar A, Singh HK, Chandra S, Shaifali I, Mehra D. Effect of Levothyroxine Therapy on Hypothyroidism-induced Dyslipidemia. Int J Adv Integ Med Sci 2017;2(3):107-110.

Association between upper leg length and metabolic syndrome among US elderly participants-results from the NHANES (2009-2010).

ObjectiveTo examine the relationship between upper leg length (ULL) and metabolic syndrome (MetS) in older adults.MethodsData was collected from National Health and Nutritional Examination Survey (NHANES, 2009–2010). 786 individuals (385 males and 401 females) who were 60 years of age or older were included in this analysis. MetS was defined as having at least three of following conditions, i.e., central obesity, dyslipidemia, insulin resistance, and hypertension based on National Cholesterol Education Program guidelines. ULL was grouped into gender-specific tertiles.Results328 (41.7%) of participants were categorized as having MetS (38.7% in men and 49.1% in women, P = 0.002). Compared to individuals in the 1st tertile (T1) of ULL, those in the 3rd tertile (T3) had lower levels of triglycerides (120.8 vs. 153.1 mg/dL, P = 0.045), waist circumference (100.7 vs. 104.2 cm, P = 0.049), and systolic blood pressure (126.7 vs. 131.4 mmHg, P = 0.005), but higher levels of high-density-lipoprotein cholesterol (58.1 vs. 52.4 mg/dL, P = 0.024). The odds ratios (95% CI) of MetS from multivariate logistic regression were 0.57 (0.32–1.03) for individuals in the T2 of ULL and 0.39 (0.24–0.64) for individuals in the T3 of ULL, respectively (P-value for the trend 0.022).ConclusionsULL was negatively associated with MetS in older adults. Further research is needed to identify potential mechanisms.

Increased statin eligibility based on ACC/AHA versus NCEP guidelines for high cholesterol management in Chile

In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) jointly released new guidelines for cardiovascular risk assessment and cholesterol management that substantially modified the previous recommendations proposed by the National Cholesterol Education Program (NCEP) in 2001. The relative impact of these new guidelines on potential statin use has not been estimated in Latin American populations. To estimate and compare eligibility for statin therapy based on ACC/AHA and NCEP guidelines in adult Chilean population. Using data from the last National Health Survey (2009-2010 NHS), we conducted a cross-sectional analysis in a ​representative sample of the Chilean adult population and calculated the proportion of individuals that would receive statins under each set of guidelines. According to ACC/AHA guidelines, the population eligible for statin treatment increased from 21.7% (NCEP guidelines) to 33.2% (overall 53% increase). This effect was more pronounced among women (29.6% under ACC/AHA vs 15.6% under NCEP) and with those of advanced age (75% of the subjects >60 years of age compared with 46% under NCEP). The newly eligible group included more women and older subjects and individuals with lower LDL cholesterol levels. Compared with NCEP recommendations, the new ACC/AHA guidelines significantly increased the number of Chilean adults eligible for statin therapy. Full implementation of the new recommendations may have important public health implications in Chile and other Latin American countries, as more women and older subjects without cardiovascular disease would qualify for statin treatment.