Non-fasting State Research Articles

Diagnostic accuracy of DIPSI criteria for diagnosing gestational diabetes mellitus in Puducherry

ABSTRACT Context: Gestational diabetes mellitus (GDM) is a major concern in recent years. During pregnancy, it is difficult to consume 75 g of glucose in the fasting state as pregnant women may experience symptoms such as vomiting. The Diabetes in Pregnancy Study Group India (DIPSI) criterion requires a single prick in the non-fasting state to collect the sample for diagnosing GDM. Aims: This study aimed to assess the diagnostic accuracy of DIPSI criteria compared to the WHO criteria for GDM diagnosis. Settings and Design: A community-based cross-sectional study was conducted among pregnant mothers attending the primary health centers in Puducherry from August 2022 to November 2022. Methods and Material: A total of 384 samples were selected, and 75 g of anhydrous glucose was given after 8 hours of overnight fasting. Both fasting and postprandial venous blood sugar levels were measured to determine the prevalence of GDM as per the WHO 2013 criteria. After 2 days, GDM was diagnosed among all study participants based on the DIPSI criteria. Further analysis was done. Results: The prevalence of GDM was 14.1% and 12.8% per the WHO 2013 and DIPSI criteria, respectively. In comparison to the WHO 2013 criteria, DIPSI had 79.63% sensitivity, 98.18% specificity, 87.76% positive predictive value, and 96.72% negative predictive value. The results of kappa statistics showed that there was almost perfect agreement between the WHO 2013 criteria and DIPSI criteria. Conclusions: The present study shows that the DIPSI criteria can be used to screen and diagnose GDM as there is no need for overnight fasting. The blood glucose value can be measured easily with a single prick, which is comfortable for both pregnant women and treating doctors.

7814 Non-fasting and Fasting Mixed Meal Tolerance Tests Equally Capture the Triglyceride Response in Participants With and Without MASLD

Abstract Disclosure: L.A. Gonzalez Ramirez: None. Z. He: None. J.N. Binongo: None. H.E. Huneault: None. A. Ramirez Tovar: None. J.A. Welsh: None. M.B. Vos: Consulting Fee; Self; Boehringer Ingelheim, Prosciento, Target Real World Solutions, Intercept Pharmaceuticals, INC, Novo Nordisk. Grant Recipient; Self; Target Real World Solutions. Mixed meal tolerance tests (MMTTs) are functional assessments that may identify metabolic dysregulation earlier than fasting tests during the progression to metabolic dysfunction-associated steatotic liver disease (MASLD). Although standards to conduct MMTTs in adults are readily available, the knowledge gap for children is quite large. Furthermore, conducting this type of study in children is challenging because they are less tolerant of long fasting intervals, long periods of testing, and early morning visits that interrupt school attendance. The objective of this study was to assess if conducting an MMTT in a non-fasting state will equally identify variance in the metabolic response of triglycerides (TG) between healthy children and those living with MASLD when compared to a 12-hour fasting MMTT. We collected blood samples every two hours in our 2-day randomized crossover feeding study. During each visit, 9 children with MASLD and 10 healthy controls aged 10 to 18 y underwent 1 standardized MMTT after a 12-hour overnight fasting (breakfast), followed by 2 standardized MMTTs in a non-fasting state (lunch and dinner). Participants were randomized to receive a glucose or fructose beverage at visit 1 and the other at visit 2. For uniformity, we only used data from the glucose beverage visit. We found that TG levels were statistically higher in the MASLD participants when compared to the non-MASLD group at each time point (p= 0.01). The maximum TG metabolic response peak for each MMTT was higher and more delayed in the MASLD group compared to the non-MASLD group. Within groups, postprandial TG level patterns were not significantly different when comparing breakfast, lunch, and dinner. Although TG levels varied throughout the day, the pattern after every meal was similar. These findings suggest that it is possible to identify differences in the TG metabolic response between children living with MASLD and healthy participants in the postprandial state. The results from our study also support the use of non-fasting MMTTs when examining TG metabolism in children, though further research to validate these findings is needed. Presentation: 6/1/2024

64Cu]Copper chloride PET-CT: a comparative evaluation of fasting and non-fasting states in patients of prostate carcinoma.

Altered copper metabolism in cancer has been linked to increased intracellular copper uptake mediated by human copper transporter 1, with [64Cu]Cu2+ as a potential biomarker for cancer theranostics. [64Cu]CuCl2 PET-CT though explored in various malignancies, a lack of standardized protocol exists, particularly regarding fasting status before imaging. This analysis aimed to evaluate the requirement of fasting for [64Cu]CuCl2 PET-CT along with temporal changes in physiological organ uptake in delayed scans. A total of 26 patients of prostate carcinoma who underwent [64Cu]CuCl2 PET-CT imaging were divided into two groups: (1) nonfasting (n = 12) and (2) fasting (n = 14). The nonfasting group received an average dose of 350 MBq, while the fasting group received 300 MBq of [64Cu]CuCl2, and PET-CT images acquired approximately 60-90 min (1 h image) and 3-3.5 h (delayed image) after intravenous injection of the tracer. An experienced nuclear medicine physician evaluated the images for qualitative assessment between the groups. Multiple spherical regions of interest were placed at sites of physiological organ uptake of the tracer and over the diseased lesions to measure the mean SUVmax. No significant difference was observed in the qualitative assessment of the images between the two groups (except for a slight predilection towards more hepatic tracer retention observed in the fasting group), including in the delayed images. The liver demonstrated the highest tracer uptake in all patients, with a mean SUVmax of 21.5 in the fasting group and 19.7 in the nonfasting group, showing no significant difference (P = 0.32). The kidneys, intestines, and salivary glands also showed similar trends of tracer uptake in both groups. The study illustrated that the fasting or nonfasting status did not affect image quality or semiquantitative measurements significantly in physiological organs and diseased lesions in patients with carcinoma prostate.

Effect of Ramadan Fasting on Biometric Readings of Eye

Purpose: To determine change in biometric values of eye after fasting and to elucidate whether this change is significant enough to delay the refractive and cataract surgeries during fasting. Study Design: Cross sectional observational. Place and Duration of Study: Eye department, DHQ-UTH, Gujranwala, from April 2021 to May 2021. Methods: Thirty subjects of either gender between 20-40 years of age who participated in both phases were enrolled in this study. Phase 1 was conducted one week before Ramadan and 2nd phase in the last week of Ramadan. After routine ophthalmic examination, keratometric(K) values were obtained with Auto Ref-Keratometer (Canon), while Axial length (AL), Anterior chamber depth (ACD), andIntraocular lens power (IOLp)were obtained from Master-Vu A-scan (Sonomed, Model # MV4500). Data was analyzed using SPSS version 25. Results: Out of 30 participants, 66.6% were female and 33.3%were male with mean age of 29.8 years. Mean K1 increased to 43.03 D during fasting from non-fasting reading of 42.24 D, while Mean K2 increased to 43.87 D during fasting from non-fasting reading of 43.28 Dwith significantp-value (<0.05). Mean ACD was 3.15mm in non-fasting that also increased to 3.21D in fasting state. Mean AL in non-fasting state was 23.41mm that remains the same in fasting state as well. Mean IOLp in non-fasting state was 21.18D that reduced to 20.42D in fasting state with significant p-value. Conclusion: Fastingincreased thekeratometry andACD values with no effect on AL but that reduced overall intraocular lens power.

Establishing non-fasting reference values for plasma lipids levels based on age, sex, and puberty stage in a French-Canadian pediatric population

BackgroundDyslipidemias, including familial hypercholesterolemia (FH), are a significant risk factor for cardiovascular diseases. FH is a genetic disorder resulting in elevated levels of low-density lipoprotein cholesterol (LDL-C) and an increased probability of early cardiovascular disorders. Heterozygous familial hypercholesterolemia (HeFH) is the most common form, affecting approximately 1 in 250 individuals worldwide, with a higher prevalence among the French-Canadian population. Childhood is a critical period for screening risk factors, but the recommendation for non-fasting screening remains controversial due to a lack of specific reference values for this state. This study aims to establish reference values for lipid levels in non-fasting children from Sherbrooke, Quebec, Canada, that will be specific for sex, age, and pubertal stages.MethodsBlood samples and corresponding anthropometric data were collected from 356 healthy children aged from 6 to 13. They were categorized either into two age groups: Cohort 6–8 and Cohort 9–13, or into pubertal stages. Reference values, specifically the 2.5th, 5th, 10th, 50th, 90th, 95th, and 97.5th percentiles were determined using the CLSI C28-A3 guidelines.ResultsLipid profiles did not significantly differ between sexes, except for higher levels of high-density lipoprotein (HDL-C) in boys within Cohort 6–8. HDL-C levels significantly increased, while LDL-C and non-HDL-C levels significantly decreased in both sexes with age. Non-fasting age- and pubertal stages-specific reference values were established.ConclusionThis study established reference intervals for lipid markers in non-fasting state within the pediatric French-Canadian population. These findings could be used in dyslipidemia screening in daily practice.

Clinical and Prognostic Value of Non-Fasting Lipoproteins and Apolipoproteins in Chinese Patients with Coronary Heart Disease.

Lipid profiles differ naturally between individuals and between populations. So far, the data relating to non-fasting lipid profiles has been derived predominantly from studies on Western population. The characteristics and clinical significance of non-fasting lipids in Chinese patients with coronary heart disease (CHD) in response to traditional Chinese diets remain poorly understood. A total of 1022 Chinese CHD patients with coronary artery luminal stenosis 40% as diagnosed by coronary artery angiography were enrolled in the study. All patients received standard treatment for CHD, including statins. They were divided into an intermediate stenosis group (luminal stenosis 40-70%, n = 486) or a severe stenosis group (luminal stenosis 70%, n = 536). Their blood lipid profiles were measured in the fasting state, and 4 hours after normal breakfast. All participants were followed up for five years. Major adverse cardiovascular events (MACE) including all-cause death, cardiac death, myocardial infarction, unscheduled coronary revascularization and stroke were recorded. After normal breakfast intake, patients with intermediate or severe stenosis showed an apparent increase in the levels of triglyceride (TG), remnant cholesterol (RC) and Apo (apolipoprotein) A1 compared to the fasting state, but a significant reduction in the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), Apo B and Apo E. In addition to the traditional risk factors (older age, male, diabetes and smoking) and coronary artery stenosis, the fasting levels of LDL-C and Apo B, as well as non-fasting levels of HDL-C and Apo A1, were identified as independent predictors of 5-year MACE occurrence by multivariate Cox proportional hazards analysis. Patients in the 1st tertile of the non-fasting HDL-C group ( 0.86 mmol/L) showed a significantly higher risk of MACE than 3rd tertile ( 1.07 mmol/L) (1st tertile: 2.786, 95% CI (confidence intervals) [1.808, 4.293], p 0.001). This prospective observational study found that lipid profiles in either the fasting or non-fasting states were associated with the long-term risk of MACE in Chinese CHD patients. In addition to the fasting LDL-C level, a low non-fasting HDL-C level may also be an independent risk factors for cardiovascular events. Measurement of lipid profiles during the non-fasting state may be feasible for the management of CHD patients in routine clinical practice in China.

Assessment of three equations to calculate plasma LDL cholesterol concentration in fasting and non-fasting hypertriglyceridemic patients.

Low-density lipoprotein cholesterol (LDL-C) concentration was calculated for many years using the Friedewald equation, but those from Sampson and extended-Martin-Hopkins perform differently. Their accuracy in fasting hypertriglyceridemia and non-fasting state were compared and the clinical impact of implementing these equations on risk classification and on the setting of lipid treatment goals was assessed. Seven thousand six standard lipid profiles and LDL-C concentrations measured after ultracentrifugation (uLDL-C) were retrospectively included. uLDL-C were compared to calculated LDL-C in terms of correlation, root mean square error, residual error, mean absolute deviations and cardiovascular stratification. In fasting state (n=5,826), Sampson equation was the most accurate, exhibited the highest percentage of residual error lower than 0.13 mmol/L (67 vs. 57 % and 63 % using Friedewald, or extended-Martin-Hopkins equations respectively) and the lowest misclassification rate. However, the superiority of this equation was less pronounced when triglyceride concentration (TG) <4.5 mmol/L were considered. In post-prandial state (n=1,180), extended-Martin-Hopkins was the most accurate equation, exhibited the highest percentage of residual error lower than 0.13 mmol/L (73 vs. 39 % and 57 % using Friedewald and Sampson equation respectively). Overall, the negative bias with Sampson equation may lead to undertreatment. Conversely, a positive bias was observed with extended Martin-Hopkins. None of the equations tested are accurate when TG>4.52 mmol/L. When TG<4.52 mmol/L both Sampson and Martin-Hopkins equations performed better than Friedewald. The switch to one or the other should take in account their limitations, their ease of implementation into the lab software and the proportion of non-fasting patients.

The stability of C-peptide and insulin in plasma and serum samples under different storage conditions.

C-peptide and insulin are peptide hormones and their stability is affected by a number of pre-analytical factors. The study aimed to investigate the impact of sample type, storage temperature and time delays before centrifugation and analysis on the stability of C-peptide and insulin. Ten healthy non-diabetic adults in fasting and non-fasting state were enrolled. 40 mL of blood was collected from each participant into SST and dipotassium EDTA tubes. Samples were centrifuged immediately or at timed intervals (8, 12, 48 and 72 h). After baseline measurements on the Roche Cobas e602 analyzer using electrochemiluminescence immunoassays, aliquots were stored at room temperature (RT), 2-8 and-20 °C for 4 h to 30 days. The percentage deviation (PD) from baseline was calculated and a change greater than desirable biological variation total error was considered clinically significant. C-peptide was more stable in separated serum than plasma (PD of-5 vs.-13 %) samples stored at 2-8 °C for 7 days and was most unstable at RT when centrifugation was delayed (PD-46 % in plasma and-74 % in serum after 48 h). Insulin was more stable in plasma than in serum under the different storage conditions with a minimum PD of-1% when stored at-20 °C for 30 days. When samples were kept unspun at RT for 72 h, PD was-23 and-80 % in plasma and serum, respectively. C-peptide was more stable in serum provided the sample was centrifuged immediately and stored in the fridge or freezer while insulin was found to be more stable in EDTA plasma.

The LIPL Study Postprandial lipid profile, inflammation and platelet activity in patients with chronic coronary syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In general, most people spend their day in a non-fasting state. Hence, it is suggested that the changes in atherosclerosis happen mainly under the influence of non-fasting lipids. Up to date, the studies in the postprandial state were primarily performed on healthy subjects. Aim This exploratory, cross-sectional study investigates the change in lipid profile, in biomarkers of inflammation, as well as markers of platelet activation in patients with different cardiovascular risk profiles in the postprandial state. Methods The studied population consists of 66 patients with different cardiovascular risk: patients with a history of chronic coronary syndrome (CCS) and diabetes mellitus type 2 (DM2) (n=20), CCS without DM2 (n=25), and a healthy control group (n=21). Lipid variables and markers of platelet function were assessed during the fasting state (baseline) and three and five hours after a standardized fat meal using a standardized oral fat tolerance test (OFTT), a milkshake with 90g of fat. Platelet activity was measured with the Multiplate Assay using adenosine diphosphate (ADP), arachidonic acid (ASPI) and thrombin-receptor activating peptide (TRAP) as stimulants. Results Patients with CCS and DM2 were significantly older and had the highest BMI. All patients with CCS were on acetylsalicylic acid, and 95% of CCS patients were on high-dose statins. HDL-c decreased significantly during the OFTT, with a peak after five hours (3.46±0.4 mg/dL, p&amp;lt;0.001). Triglycerides (TG) increased significantly during the OFTT, with a peak after five hours (130.2 ± 14.5 mg/dL, p&amp;lt;0.001) irrespective of the group. All other variables of the lipid profile remained stable during the OFTT. The absolute leucocyte and neutrophile count and the neutrophile to lymphocyte ratio (NLR) increased significantly during the OFTT in the whole study population, whereas the absolute lymphocyte count increased significantly only in the control group. A significant increase in platelet activity during OFTT was shown in the control group by the increased absolute platelet count, increased reticulated thrombocytes, and increased platelet reactivity measured by the ASPI and TRAP tests, respectively. There was no significant change in the markers of platelet activity during the OFTT in patients with CCS with/without DM2. Conclusion This study showed that a standardized fatty meal changes HDL-c and TG concentrations and leads to an increased postprandial inflammation response irrespective of the cardiovascular risk and to increased platelet activity in healthy subjects, while there was no increase in platelet activity in higher-risk CCS patients.

The Effect of Fasting on Body Composition Assessment in Hospitalized Cancer Patients

Guidelines for bioelectrical impedance analysis (BIA) recommend fasting before measurements, but how it affects the outcomes is unclear. This descriptive, before-and-after study examines the effect of fasting on BIA results and its impact on the diagnosis of malnutrition in hospitalized cancer patients. Fifty-three oncology patients (admitted in January–March 2020) were consecutively enrolled regardless of their nutritional status. Patients were assessed by the same dietician 24–48 h after admission, following the usual clinical practice. The measurements were taken after 12-h fasting (fasting state) and 60–90 min after breakfast (non-fasting state). Bioimpedance parameters (resistance [R], reactance [Xc], phase angle [PA]) and body composition indices (free-fat mass index [FFMI] and appendicular skeletal muscle index [ASMI]) were calculated. On average, R values did not significantly differ between fasting and non-fasting states (mean difference: +1.82 Ω; p = 0.64). The non-fasting Xc and PA were reduced (mean differences: −1.55 Ω, p = 0.93 and 0.09°, p = 0.82, respectively). Fasting and non-fasting FFMI and ASMI were similar (mean differences: −0.13 kg/m2 (p = 0.5) and −0.10 kg/m2 (p not calculated)). These results suggest that BIA does not require fasting, facilitating its routine use in hospitalized cancer patients.

Association of remnant cholesterol with risk of cardiovascular disease events, stroke, and mortality: A systemic review and meta-analysis

Background and aimsLipid disorders are associated with the risk of cardiovascular diseases (CVDs). Remnant cholesterol (RC), a non-traditional previously neglected risk factor for CVD, has received much attention in recent years. The aim of this study is to evaluate the association of RC with the risks of CVD, stroke, and mortality. MethodsMEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and Cochrane Central Register for Controlled Trials were searched. We included randomized controlled trials (RCTs), non-RCTs, and observational cohort studies assessing the association of RC with the risks of cardiovascular (CV) events, coronary heart disease (CHD), stroke, and mortality. ResultsOverall, 31 studies were included in this meta-analysis. Compared with low RC, elevated RC was associated with an increased risk of CVD, CHD, stroke, CVD mortality, and all-cause mortality (RR = 1.53, 95% CI 1.41–1.66; RR = 1.41, 95% CI 1.19–1.67; RR = 1.43, 95% CI 1.24–1.66; RR = 1.83, 95% CI 1.53–2.19; and RR = 1.39, 95% CI 1.27–1.50; respectively). A subgroup analysis demonstrated that each 1.0 mmol/L increase in RC was associated with an increased risk of CVD events and CHD. The association of RC with an increased CVD risk was not dependent on the presence or absence of diabetes, a fasted or non-fasted state, total cholesterol, or triglyceride or ApoB stratification. ConclusionsElevated RC is associated with an increased risk of CVD, stroke, and mortality. In addition to the traditional cardiovascular risk factors, such as total cholesterol and LDL-C, clinicians should also pay attention to RC in clinics.

Impact of Breathing Phase, Liver Segment, and Prandial State on Ultrasound Shear Wave Speed, Shear Wave Dispersion, and Attenuation Imaging of the Liver in Healthy Volunteers.

Measurement location and patient state can impact noninvasive liver assessment and change clinical staging in ultrasound examinations. Research into differences exists for Shear Wave Speed (SWS) and Attenuation Imaging (ATI), but not for Shear Wave Dispersion (SWD). The aim of this study is to assess the effect of breathing phase, liver lobe, and prandial state on SWS, SWD, and ATI ultrasound measurements. Two experienced examiners performed SWS, SWD, and ATI measurements in 20 healthy volunteers using a Canon Aplio i800 system. Measurements were taken in the recommended condition (right lobe, following expiration, fasting state), as well as (a) following inspiration, (b) in the left lobe, and (c) in a nonfasting state. SWS and SWD measurements were strongly correlated (r = 0.805, p < 0.001). Mean SWS was 1.34 ± 0.13 m/s in the recommended measurement position and did not change significantly under any condition. Mean SWD was 10.81 ± 2.05 m/s/kHz in the standard condition and significantly increased to 12.18 ± 1.41 m/s/kHz in the left lobe. Individual SWD measurements in the left lobe also had the highest average coefficient of variation (19.68%). No significant differences were found for ATI. Breathing and prandial state did not significantly affect SWS, SWD, and ATI values. SWS and SWD measurements were strongly correlated. SWD measurements in the left lobe showed a higher individual measurement variability. Interobserver agreement was moderate to good.

Fasting Versus Non-Fasting Total Testosterone Levels in Women During the Childbearing Period.

Background Total testosterone in men should be measured in the fasting stateearly in the morning with at least two samples according to guidelines. For women, no such a recommendation is available despite the importance of testosterone in this demographic. The aim of this study is to evaluate the effect of fasting versus non-fasting state on the total testosterone levels in women during the reproductive period. Methods This study was conducted at Faiha Specialized Diabetes, Endocrine and Metabolism Centerin Basrah, (Southern Iraq) betweenJanuary 2022 to November 2022. The total enrolled women were 109; their age was 18-45 years. The presentation was for different complaints; 56 presented for medical consultation with 45 apparently healthy women accompanying the patients as well as eight volunteering female doctors. Testosterone levels were measured by electrochemiluminescence immunoassays using the Roche Cobas e411 platform (Roche Holding, Basel, Switzerland). Two samples were collected from each woman; one was fasting and another was non-fasting the following day, and allsamples were taken before 10 am. Results For all of the participants, the mean ± SD fasting was significantly higher as compared to the non-fasting testosterone (27.39±18.8 ng/dL and 24.47±18.6 ng/dLrespectively,p-value 0.01). The mean fasting testosterone level was also significantly higher in the apparently healthy group, (p-value 0.01). In women who presented with hirsutism, menstrual irregularities and or hair fall, no difference was seen in the testosterone levels between fasting and non-fasting states (p-value 0.4). Conclusion In the apparently healthy women of childbearing age, serum testosterone levels were higher in the fasting versus the non-fasting states. In women who presented with complaints of hirsutism, menstrual irregularities, and or hair fall, the serum testosterone levels were not affected by the fasting states.

Impact of Fasting Status and Circadian Variation on the Pharmacokinetics of Mycophenolate Mofetil and the Glucuronide Metabolite in Renal Transplant Recipients.

RTRs with stable graft function treated with tacrolimus, prednisolone, and MMF (750 mg BID) were included in this open, nonrandomized study. Two 12-h pharmacokinetic investigations were conducted in succession following morning and evening doses, both in a fasting and in a real-life nonfasting condition. A total of 30 (22 men) RTRs performed one 24-h investigation, and 16 repeated the investigation within 1 mo. In a real-life nonfasting state, MPA area under the curve (AUC)0-12 and C 0 failed to meet the bioequivalence criteria. Following the evening dose, mean MPA AUC12-24 was 16% lower (P < 0.001) compared with AUC0-12, and a shorter T max was observed (P = 0.09). Under fasting conditions, MPA AUC12-24 was 13% lower than AUC0-12, and the absorption rate was slower after the evening dose (P < 0.05). MPAG displayed circadian variation only under real-life conditions with lower AUC0-12 following the evening dose (P < 0.001). Both MPA and MPAG showed circadian variation with somewhat lower systemic exposures following the evening dose with limited clinical relevance in the dosing of MMF in RTRs. Fasting status affects MMF absorption rate differently, but with similar results in systemic exposure.

Correlation between Levels of Remnant Cholesterol versus LDL, A Cross-Sectional study

Background: High levels of LDL cholesterol were directly related to the risk of atherosclerosis, metabolic diseases, and cardiovascular complications. However, in some groups of patients with low levels, they were also found. Lead to the risk of other lipid components, including Remnant cholesterol. A recent study found related to cardiovascular risk as well. Currently, no direct comparison between Remnant cholesterol and LDL cholesterol level.&#x0D; Objective: To study the correlation between Remnant cholesterol and LDL levels both in fasting and non-fasting states with the medical conditions that increase the risk of cardiovascular disease.&#x0D; Materials and methods: To determine the association between remnant cholesterol and LDL. 200 cases of Thai begins at the age of 18 years old were tested for total cholesterol, LDL, HDL, and TG level both in the fasting and non-fasting states. The obtained values were calculated for Remnant cholesterol levels and analysed for a direct correlation between the two levels, which also includes a comparative analysis. The AUC was used to assess the prognostic accuracy of lipid levels to diagnose the condition that poses cardiovascular risks.&#x0D; Results: In the sample of 200 patients tested for lipid. At a mean age of 64.5 years, 42 percent were female and 76.5 percent received statins. We found that remnant cholesterol had a poor correlation with LDL levels when compared among the fasting conditions (r=0.164, 0.119), as well as among the statin used or not (r=0.118, 0.293). The analysis found that remnant cholesterol does well correlate with TG levels (r=0.770). Also, the predictive value of Remnant cholesterol over LDL levels for detect diabetes mellitus, coronary artery disease, and overweight (AUC=0.610, 0.588, 0.593).&#x0D; Conclusion: In this study. We found that remnant cholesterol does correlate poorly with LDL in any fasting state. Prediction of the incidence of diabetes mellitus, coronary heart disease, and overweight has seemed better with remnant cholesterol. More studies may need for decreasing the knowledge gap and provide a better guide for disease prevention.

Non-fasting changes of Hs-CRP level in Chinese patients with coronary heart disease after a daily meal

High-sensitivity C-reactive protein (hs-CRP) is a key inflammatory factor in atherosclerotic cardiovascular diseases. In Chinese patients with coronary heart disease (CHD), the changes in hs-CRP levels after a daily meal and the effect of statins on those were never explored. A total of 300 inpatients with CHD were included in this study. Hs-CRP levels were measured in the fasting and non-fasting states at 2 h and 4 h after a daily breakfast. All inpatients were divided into two groups according to fasting hs-CRP ≤ 3 mg/L or not. Group with fasting hs-CRP ≤ 3 mg/L had a significantly higher percentage of patients with statins using ≥ 1 month (m) before admission than that with fasting hs-CRP > 3 mg/L (51.4% vs. 23.9%, P < 0.05). Hs-CRP levels increased significantly in the non-fasting state in two groups (P < 0.05). About 32% of patients with non-fasting hs-CRP > 3 mg/L came from those with fasting hs-CRP ≤ 3 mg/L. In conclusion, hs-CRP levels increased significantly in CHD patients after a daily meal. It suggested that the non-fasting hs-CRP level could be a better parameter to evaluate the inflammation state of CHD patients rather than fasting hs-CRP level.

Nobiletin ameliorates glucose tolerance by protecting against β-cell loss in type-2 diabetic db/db mice

BackgroundNobiletin, a polymethoxy flavone contained in the peel of Citrus reticulata, has been known to have health benefits especially those related to improvement of type 2 diabetes. Our previous in vitro study demonstrated the insulinotropic and anti-apoptotic effects of nobiletin in pancreatic β-cells. These effects of nobiletin are postulated to be responsible for its anti-diabetic activity. PurposeWe evaluated the anti-diabetic effects of nobiletin on pancreatic β-cells of type 2 diabetic db/db mice. MethodsNobiletin was filled into an osmotic pump and implanted subcutaneously in the back of db/db mice for 2 weeks with continuous administration. The mice were then used for the experiments to elucidate the in vivo effects of nobiletin on glucose intolerance. ResultsThe continuous subcutaneous administration of nobiletin using osmotic pumps significantly reduced blood glucose levels in non-fasting state and during an oral glucose tolerance test. The nobiletin administration also ameliorated insulin sensitivity determined by insulin tolerance test, which was likely due to a reduction of white adipose tissue weight. In addition, β-cell mass was significantly larger in nobiletin-administered db/db mice compared to vehicle-administered db/db mice. These results suggest that continuous administration of nobiletin ameliorates glucose tolerance in type 2 diabetes, which is mediated by improving not only insulin resistance but also insulin secretion, the latter being due to protection against β-cell loss in diabetes. ConclusionNobiletin would have a valuable effect on the prevention of type 2 diabetes.

Exploring the Novelty in Lipid Profiling of Patients: A Non-fasting Approach from Eastern India.

Objective To date, no reference interval is available for lipid profile, including total cholesterol (TC), triglycerides (TGs), high-density lipoprotein (HDL), or low-density lipoprotein (LDL)-cholesterol, etc., in a non-fasting state. Hence, the study was taken up with the objective of exploring the possibility of establishing a reference interval for non-fasting lipid profile consisting of serum TC, TG, LDL, HDL, and very low-density lipoprotein (VLDL) cholesterol. Materials and Methods A total of 1,350 apparently healthy subjects, including 636 healthy men and 714 healthy women of 18 years and beyond of age, were enrolled in the study. Reference individuals were recruited using cluster sampling method from various villages and semi-urban regions irrespective of their sex, religion, socioeconomic status, or any other demographic profile, and samples were analyzed in Beckman Coulter AU480 analyzer. Results The mean age of 1,350 participants was 38.23 ± 15.94 years. We found that all the test parameters require a different reference interval than the established fasting reference range, except for HDL cholesterol in females. The data were subdivided into subjects below 40 years, between 40 and 60 years, and older than 60 years of age. All five parameters in the lipid profile were individually analyzed and were compared age group-wise and gender-wise with the total study population. Significant differences in the various dataset were found. Conclusion A shift toward non-fasting lipid interval measurement is, thus, a piece of evidence-driven mechanism. Even from a patient's perspective, it sets in ease and convenience in lipid-profile testing, subsequently leading to a more compliant cardiovascular management and monitoring.

Anacardium occidentale Bark as an Antidiabetic Agent.

Anacardium occidentale L. is used throughout the world to treat type 2 diabetes. In Portugal, a traditional herbal preparation made with stem bark of this species (AoBTHP) has been used for more than 30 years to treat this pathology. The AoBTHP was standardized on total phenolic content, and its hypoglycemic activity was assessed using db/db mice (n = 26) for 92 days. Three doses (40.2, 71.5, and 127.0 mg/kg/day, per os) were tested, and glibenclamide (5 mg/kg/day) was used as positive control. During the study, glycemia was measured under non-fasting or fasting states. In sequence, thin-layer chromatography bioautographic assays were used for the detection of possible alpha- and beta-glucosidase inhibitors. A significant hypoglycemic effect in fasting glycemia in days 31 and 57 was observed with the three tested doses. The 71.5 mg/kg and 127.0 mg/kg AoBTHPs significantly reduced non-fasting glycemia on day 24. The highest dose showed the most significant hypoglycemic effect. Gallic acid was identified as the major alpha- and beta-glucosidase inhibitor. The 127 mg/kg/day AoBTHP dose showed a greater glucose-lowering effect than glibenclamide. For the first time, a standardized AoBTHP was tested using an in vivo diabetes model, and its usage was preclinically validated for type 2 diabetes treatment. The hypoglycemic activity of an AoBTHP can be related to the presence of alpha- and beta-glucosidase inhibitors, such as gallic acid, but other mechanisms can also be involved.

The LIPL study lipid panels and platelet activity in coronary heart disease

Abstract Introduction Measuring lipid panel in the fasting state can be inconvenient for patients and may aggravate their compliance. Moreover, people spend most of the day in the nonfasting state. Hence, it suggests that the changes in the process of atherosclerosis happen mainly under the influence of nonfasting lipids. Up to date, the studies in the postprandial state were primarily performed in healthy subjects. Aim This exploratory study investigates the change in lipid profile and platelet activity in patients with different cardiovascular risk profiles in the postprandial state. Methods The studied population consists of 66 patients with different cardiovascular risks: patients with coronary artery disease (CAD) and diabetes mellitus type 2 (DM2) (n=20), CAD without DM2 (n=25), and a healthy control group (n=21). Lipid variables and markers of platelet function were assessed during the fasting state and 3 and 5 hours after a standardized fat meal using a standardized oral fat tolerance test (OFTT), a milkshake with 90g of fat. The platelet activity was measured with a Multiplate test using ADP, ASPI and TRAP reagents. Results Patients with CAD and DM2 were significantly older and had the highest BMI. All patients with CAD were on acetylsalicylic acid, and 95% of CAD patients were on high-dose statins. Total cholesterol, LDL-c, Apolipoprotein A1, and Apolipoprotein B did not change during the OFTT, irrespective of the group. However, HDL-c decreased statistically significantly three and five hours after the fat loading with a peak after five hours (3.46±0.4 mg/dL, p&amp;lt;0.001). The lowest HDL-c was in the CAD and DM2 group (p=0.006). Triglycerides (TG) increased significantly during the OFTT, with a peak after 5 hours (130.2±14.5 mg/dL, p&amp;lt;0.001) irrespective of the group. There was no difference in TG concentration between the groups. Differences stayed statistically significant even after adjustment for age and BMI. Platelet activity increased after fat loading, as shown by a significantly increased thrombocyte count after three hours (p&amp;lt;0.001). Platelet activity measured by multiplate test with ADP (7.16±2.17 AU, p=0.005), ASPI (4.60±1.40 AU, p=0.005), and TRAP (11.41±3.10 AU, p=0.001) reagents increased statistically significant three hours after the fat loading. The platelet activity measured by all three reagents remained increased even after the adjustment for age and BMI (ADP: 7.14±2.10 AU, p=0.004, ASPI: 4.60±1.40 AU, p=0.006, TRAP: 11.40±3.10 AU, p=0.002). Moreover, the platelet activity measured by ADP (−13.12±4.93, p=0.030), and TRAP (−14.6±15.51, p=0.031) reagents was lower in the control group. When adjusted for age and BMI, there was no difference in the platelet activity between the three groups. Conclusion This study showed that fatty meal causes worsening of lipid profile and leads to increased platelet activity in subjects irrespective of cardiovascular risk profile. Funding Acknowledgement Type of funding sources: None.