Plasma Lipid Levels In Patients Research Articles

Correlation between plasma lipid levels in patients with different oral pre-cancerous lesions

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> Oral precancerous lesions could be defined as the lesions present in oral cavity that have a potential to become cancer. Recognition of precancerous lesions has its own significance as it helps in early detection of risk of cancer which in itself is quite useful for formulating appropriate preventive strategies that could assure better survival rates. The aim of the study was to assess the correlation of lipid levels in patients with different oral precancerous lesions.</span></p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> A total of 150 patients with oral lesions attending the department of otorhinolaryngology at Era’s Lucknow Medical college and Hospital, Lucknow, were included in the study. A biopsy specimen was taken from each patient along with 5 ml fasting blood sample for serum lipid estimation which was done by dry chemistry Chemino Heinz method.</span><span lang="EN-US"> </span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> A total of 150 patients with age ranging from 13-70 years and a male is to female ratio of 1.68 was studied. Burning sensation was the most common symptom and OSMF being the most common diagnosis. All the components of lipid profile except HDL of patients with different histopathological diagnosis were found to be comparable. No association of derangement in any of the components of lipid levels and histopathological diagnosis was observed.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> The findings of present study showed that lipid levels in patients with precancerous oral lesions are generally of lower order. However, the present study could not assess a significant association between lipid levels and different types of oral premalignant lesions.</span></p>

Baseline plasma lipid levels in patients with acute coronary syndrome: Association with 20‐year mortality. The ABC‐5a* Study on Heart Disease

The relationship between baseline plasma lipid levels during acute coronary syndrome and the outcome has clinical relevance. To evaluate their long-term prognostic value, we examined 589 patients admitted with acute coronary syndrome at three hospitals. Baseline plasma lipids were assessed on days 1 and 7. Patients were followed for 20years or until death. Virtually, all patients completed follow-up; 437 (74%) had died: 24% from coronary artery disease/heart failure (CAD/HF), 21% sudden cardiac death (SCD), 16% from other cardiovascular causes and 39% had non-cardiac death. The incidence rate (IR) of all-cause mortality was not different among patients with baseline plasma lipids less or greater than the median value. The IR of CAD/HF mortality was not significantly higher among patients with greater than median low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels. The IR of non-cardiac death tended to be lower among patients with greater than median total cholesterol (TC) and LDL levels. Using three levels of adjusted Cox survival models, baseline plasma lipids had no consistent independent or inverse association with all-cause mortality, even after excluding patients who received statins. Competitive risk survival models for each cause of death revealed that the only hazard of non-cardiac death was consistently higher among patients with less than or equal to median TC and LDL levels. In the present prospective long-term study, after acute coronary syndrome, baseline plasma lipid levels seem not to be associated with long-term global mortality. Only an independent inverse association between TC and LDL and non-cardiac death has been observed.

Is PCSK9 Associated with Plasma Lipid Levels in a Sub-Saharan African Population of Patients with Obesity and Type 2 Diabetes?

PurposeProprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of circulating LDL cholesterol. There are inconsistent data in some populations concerning the association between PCSK9, LDL and CRP. The emerging importance of the inhibition of PCSK9 for the treatment of hypercholesterolemia warrants investigations in different populations. The aim of this study from a Sub-Saharan African population was to evaluate the association between PCSK9 and hs-CRP levels and plasma lipid levels in patients with type 2 diabetes (T2D) and obese and lean controls.Patients and methodsA cross-sectional analytical study was conducted in a major hospital in Yaoundé, Cameroon in a cohort of 162 participants (53% females). There were 54 non-obese T2D patients matched for age and sex to 54 obese nondiabetic and 54 nondiabetic lean subjects. PCSK9 level was assessed by sandwich ELISA method and hsCRP by nephelometry.ResultsPCSK9 and hs-CRP levels were significantly higher in obese and T2D subjects when compared to lean controls (p<0.001 and p=0.002, respectively). The association between PCSK9 and triglyceride levels in the overall population was gender dependent (p=0.04) and subgroup analysis showed a significant positive correlation between PCSK9 and triglyceride levels in males but not in females (r=0.56, p=0.02 and r=0.2 and p=0.1, respectively). Multilinear regression analysis identified BMI as an independent predictor for PCSK9 levels and this association was maintained after adjustment for confounders; adjusted β-coefficient; 36.1 (95% CI; 29.2–47.4). We did not find an association between PCSK9 and any plasma lipid levels in obese and T2D subjects, nor between PCSK9 and hs-CRP levels.ConclusionObese and type 2 diabetes subjects have higher PCSK9 levels when compared to lean controls, suggesting that these metabolic states potentially impact PCSK9 levels in Cameroonian patients.

Lingguizhugan decoction attenuates diet-induced obesity and hepatosteatosisviagut microbiota

BACKGROUNDObesity is a major risk factor for a variety of diseases such as diabetes, nonalcoholic fatty liver disease, and cardiovascular diseases. Restricting energy intake, or caloric restriction (CR), can reduce body weight and improve metabolic parameters in overweight or obese patients. We previously found that Lingguizhugan decoction (LZD) in combination with CR can effectively lower plasma lipid levels in patients with metabolic syndrome. However, the mechanism underlying CR and LZD treatment is still unclear.AIMTo investigate whether CR and LZD improve metabolic parameters by modulating gut microbiota.METHODSWe extracted the water-soluble components out of raw materials and dried as LZD extracts. Eight-week old male C57BL/6 mice were treated with a 3-d treatment regime that included 24 h-fasting followed by gavage of LZD extracts for 2 consecutive days, followed by a normal diet (ND) ad libitum for 16 wk. To test the effects of gut microbiota on diet-induced obesity, 8-wk old male C57BL/6 mice received fecal microbiota transplantation (FMT) from CR and LZD-treated mice every 3 d and were fed with high-fat diet (HFD) ad libitum for 16 wk. Control mice received either saline gavage or FMT from ND-fed mice receiving saline gavage as mentioned above. Body weight was monitored bi-weekly. Food consumption of each cage hosting five mice was recorded weekly. To monitor blood glucose, total cholesterol, and total triglycerides, blood samples were collected via submandibular bleeding after 6 h fasting. Oxygen consumption rate was monitored with metabolic cages. Feces were collected, and fecal DNA was extracted. Profiles of gut microbiota were mapped by metagenomic sequencing.RESULTSWe found that CR and LZD treatment significantly reduced the body weight of mice fed with ND (28.71 ± 0.29 vs 28.05 ± 0.15, P < 0.05), but did not affect plasma total cholesterol or total triglyceride levels. We then transplanted the fecal microbiota collected from CR and LZD-treated mice under ND feeding to HFD-fed mice. Intriguingly, transplanting the mice with fecal microbiota from CR and LZD-treated mice potently reduced body weight (44.95 ± 1.02 vs 40.53 ± 0.97, P < 0.001). FMT also reduced HFD-induced hepatosteatosis, in addition to improved glycemic control. Mechanistic studies found that FMT increased OCR of the mice and suppressed the expression and protein abundance of lipogenic genes in the liver. Metagenomic analysis revealed that HFD drastically altered the profile of gut microbiota, and FMT modified the profile of the gut microbiota.CONCLUSIONOur study suggests that CR and LZD improve metabolic parameters by modulating gut microbiota.

Correlation of plasma lipid levels and histopathological grading in patients with oral squamous cell carcinoma and its pre-cancerous lesions

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Lower levels of lipid in proliferating tissues and in blood compartments may occur due to ongoing process of oncogenesis. The evidence regarding hypolipidemia as a predisposing factor for malignancy is scarce. Therefore, this study was undertaken to study alteration of plasma lipid levels in patients diagnosed with oral squamous cell carcinoma (OSCC) and its oral pre-cancerous (OPC) lesions and also to compare the plasma lipid profile in different grades of OSCC.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A single centre prospective cross sectional study was carried out among 150 consecutive patients of OSCC and OPC lesions. The diagnosis of all lesions was confirmed histopathologically and grading was also done for each lesion based on degree of differentiation and keratinization of tumour cells. Serum total cholesterol, HDL, TG, LDL was estimated by using semi-automated chemical analyzer. The lipid levels were compared by using unpaired t-test between two strata whereas one way analysis of variance (ANOVA) with Tukey’s post-hoc tests was used among more than two strata. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Total cholesterol, TG, HDL, and LDL were significantly reduced in OSCC and OPC groups when compared with the reference values. Serum TC, LDL and HDL levels were found to be decreased with the loss of differentiation in histological grading but with no statistical significance.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; It can be inferred that there is an inverse relationship between the serum lipid profile values of TC, HDLC, TG, LDL and OSCC as well as OPC patients. The lower serum lipid status may be considered a useful indicator for initial changes occurring in neoplastic cells.&lt;/p&gt;

The effect of ABCA1 rs2230806 common gene variant on plasma lipid levels in patients with dyslipidemia.

The aim of this work was to assess the relationship of rs2230806 SNP of ABCA1 with lipid profile in patients with severe dyslipidemia. The study included 363 patients (42.8% of males), the average age was 48.7 years, 35.5% of patients received hypolipidemic drugs (mainly statins). Quantitative determination of total cholesterol (ТС) and triglycerides (TG) in fasting serum was carried out by a unified enzymatic method, and high density lipoproteins (HDL) - by a direct homogeneous method. Genotype according to the rs2230806 position in the ABCA1 gene was determined by polymerase chain reaction (PCR) «in real time» using adjacent samples and melting reaction products after PCR. The frequencies of alleles and genotypes of variant rs2230806 of ABCA1 gene in patients with dyslipidemia did not differ from those in the control group of healthy individuals (athletes). The levels of plasma lipids - TC, TG and HDL cholesterol, on average, in patients with dyslipidemia were 7.8±3,4, 3,4±6,5 and 1.29±0.4 mmol/l, respectively. Compared to different genotypes, the plasma lipid concentrations did not differ significantly, but the analysis of different inheritance models of the allelic variant studied showed a significant association with the level of TG in the additive model, in which each minor allele (a) further enhanced the effect on the level of plasma TG at 1.02 mmol/l (p=0.044). The results of this study demonstrate the effect of a common variant rs2230806 of the ABCA1 gene on the plasma TG level in patients with severe dyslipidemia.

Plasma Lipid Levels in Patients with Cataract, with and without Pseudoexfoliation Syndrome

Purpose: Pseudoexfoliation syndrome (PES) is an age-related condition characterized by the deposit of an abnormal fibrillar material on many ocular tissues. The current study aimed to assess plasma lipid levels including cholesterol, triglyceride (TG), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and high-density lipoprotein (HDL) in patients with cataract, with and without pseudoexfoliation syndrome. Methods: Patients with the diagnosis of senile cataract and indication of surgery were included in the current case-control study. Following the examination, the patients were classified into two groups; the PES group and the non-PES group. From all participants, blood samples were taken after 12 hours of fasting to measure TG, cholesterol, LDL, HDL and VLDL. Mean of plasma lipids were compared between the two groups. Results: Two hundred and fifteen patients with cataract were enrolled in the study in which 74 were diagnosed as having PES (58.1% male) and 141 were non-PES (54.6%) and were selected as control group. Differences between PES and non-PES groups were not statistically significant when considering the mean concentrations of cholesterol, LDL, VLDL and HDL (P = 0.899, 0.403, 0.392 and 0.878 respectively). Mean concentration of TG in non-PES group was 127.07 ± 6.59 mg/dL, which was lower than the mean TG of PES group (149.78 ± 6.15 mg/dL). The difference was statistically significant (P = 0.021). Conclusions: The study found that Increased TG values were significantly associated with PES. The study results showed that checking and controlling the dyslipidemia in patients with cataract and PES may be helpful. Further studies with larger sample sizes are recommended.

Elevated Plasma Lipid Levels in Patients with Epidermoid Cysts

Introduction: Epidermoid cysts are the most common type of skin cysts. We aimed to investigate whether there are any plasma lipid level differences in patients with epidermoid cysts. Material and methods: Three-hundred and forty-two patients (147 female and 195 male) were included in the study. Patients’ data (including plasma lipid levels) were evaluated retrospectively and the results were compared with the average plasma lipid levels of the Turkish population. Results: There were significant increase found in plasma LDL-cholesterol and triglyceride levels (p < 0.05) in patients with epidermoid cysts. Conclusion: Since presence of elevated LDL-cholesterol and triglyceride levels may be accepted as a significant risk factor for coronary heart disease, we may claim that the risk of coronary heart disease may be increased in patients with epidermoid cysts. Also high levels of plasma lipid levels may be a result of sebaceous cysts or high levels of plasma lipid levels may be an effective mechanism on sebaceous cyst formation. Larger series of patients should be analyzed to evaluate this relation.

Antiepileptic drug use for treatment of epilepsy and dyslipidemia: Systematic review

To characterize the association between commonly used anti-epileptic drugs (AEDs) and plasma lipid levels in patients with epilepsy. We sought observational studies that reported association between commonly used AEDs and plasma lipid levels in patients. The primary outcome was low-density lipoprotein (LDL) cholesterol. High-density lipoprotein (HDL), total cholesterol and triglyceride were secondary outcomes. The control group included healthy controls, pre-treatment patients or patients treated with other AEDs. We conducted a systematic search of major bibliographic databases and review of reference lists of primary articles and reviews. Primary comparisons of interest were: AED monotherapy vs. no AED use, monotherapy with one AED vs. other AED, and AED polytherapy vs. no AED use. 31 studies in 4126 people were identified. Carbamazepine, phenytoin and valproic acid were the most commonly studied drugs and were also implicated in causing considerable changes in plasma lipid levels in treated patients. There was an increase in LDL and total cholesterol levels with use of these three drugs; however, carbamazepine and phenytoin were also associated with higher levels of HDL. We could not identify one particular AED which was worse than the other in head-to-head comparison. We were unable to identify a particular polytherapy regimen that was worse than others. We found evidence to suggest that some AEDs may negatively alter lipids levels in patients with epilepsy. Both treating physicians and people with epilepsy need to be vigilant in managing their vascular risk factors to avoid vascular disease.

Human plasma lipid modulation in schistosomiasis mansoni depends on apolipoprotein E polymorphism.

BackgroundSchistosomiasis mansoni is a parasitic liver disease, which causes several metabolic disturbances. Here, we evaluate the influence of Apolipoprotein E (APOE) gene polymorphism, a known modulator of lipid metabolism, on plasma lipid levels in patients with hepatosplenic schistosomiasis.Methodology/Principal FindingsBlood samples were used for APOE genotyping and to measure total cholesterol (TC), LDL-C, HDL-C and triglycerides. Schistosomiasis patients had reduced TC, LDL-C and triglycerides (25%, 38% and 32% lower, respectively; P<0.0001) compared to control individuals, whereas HDL-C was increased (10% higher; P = 0.0136). Frequency of the common alleles, ε2, ε3 and ε4, was similar (P = 0.3568) between controls (n = 108) and patients (n = 84), implying that APOE genotype did not affect susceptibility to the advanced stage of schistosomiasis. Nevertheless, while patient TC and LDL-C levels were significantly reduced for each allele (except TC in ε2 patients), changes in HDL-C and triglycerides were noted only for the less common ε2 and ε4 alleles. The most striking finding, however, was that accepted regulation of plasma lipid levels by APOE genotype was disrupted by schistosomiasis. Thus, while ε2 controls had higher TC and LDL-C than ε3 carriers, these parameters were lower in ε2 versus ε3 patients. Similarly, the inverse relationship of TG levels in controls (ε2>ε3>ε4) was absent in patients (ε2 or ε4>ε3), and the increase in HDL-C of ε2 or ε4 patients compared to ε3 patients was not seen in the control groups.Conclusion/SignificanceWe confirm that human schistosomiasis causes dyslipidemia and report for the first time that certain changes in plasma lipid and lipoprotein levels depend on APOE gene polymorphism. Importantly, we also concluded that S. mansoni disrupts the expected regulation of plasma lipids by the different ApoE isoforms. This finding suggests ways to identify new metabolic pathways affected by schistosomiasis and also potential molecular targets to treat associated morbidities.

Influence of APOE-2 genotype on the relation between adiposity and plasma lipid levels in patients with vascular disease.

Apolipoprotein E (APOE) genotypes are associated with different plasma lipid levels. People with the APO ɛ2 genotype can develop a disorder called dysbetalipoproteinemia (DBL). A possible predisposing factor for DBL is adiposity. We evaluated whether and to what extent the APOE genotype modifies the relation between adiposity and lipids in patients with manifest arterial disease and we looked at possible determinants of DBL in ɛ2 homo- and heterozygote patients. This prospective cohort study was performed in 5450 patients with manifest arterial disease from the Secondary Manifestations of ARTerial disease (SMART) study. The APOE genotype was measured in all patients and revealed 58 ɛ2 homozygotes, 663 ɛ2 heterozygotes, 3181 ɛ3 homozygotes and 1548 ɛ4 carriers. The main dependent variable was non-high-density lipoprotein cholesterol (non-HDL-c). The relation between adiposity (including body mass index (BMI), waist circumference (waist), visceral adipose tissue (VAT) and metabolic syndrome (MetS)) and lipids was evaluated with linear regression analyses. Determinants of DBL were evaluated using logistic regression. There was significant effect modification by the APOE genotype on the relation between non-HDL-c and BMI, waist, VAT and MetS. There was an association between BMI and non-HDL-c in ɛ2 homozygotes (β 0.173, 95% confidence interval (CI) 0.031-0.314, P=0.018) and ɛ4 carriers (β 0.033, 95% CI 0.020-0.046, P<0.001). In all genotypes, there was an effect of waist, VAT and MetS on non-HDL-c, but these effects were most distinct in ɛ2 homozygotes (waist β 0.063, 95% CI 0.015-0.110, P=0.011; VAT β 0.580, 95% CI 0.270-0.889, P=0.001; MetS β 1.760, 95% CI 0.668-2.852, P=0.002). Determinants of DBL in ɛ2 homo- and heterozygotes were VAT and MetS. The APOE genotype modifies the relation between adiposity and plasma lipid levels in patients with vascular disease. The relation between adiposity and lipids is present in all patients, but it is most distinct in ɛ2 homozygote patients. Abdominal fat and MetS are determinants of DBL.

Metabolic surgery for the treatment of hypertriglyceridemia-related pancreatitis due to familial lipoprotein lipase deficiency

Familial lipoprotein lipase deficiency (LPLD) is an autosomal recessive disorder characterized by severely elevated serum triglyceride (TG) levels with an associated risk of recurrent pancreatitis. The prevalence is approximately 1–2 in 1,000,000 [1]. LPLD usually presents in childhood with severe hypertriglyceridemia (HTG) and associated episodes of abdominal pain, recurrent pancreatitis, eruptive cutaneous xanthomata, and hepatosplenomegaly [1]. Metabolic surgery, defined as surgery resulting in anatomic and functional changes with the goal of treating metabolic disorders [2], has been proposed as an effective treatment for severe HTG. Gastric bypass, as a bariatric surgery, has been shown to be highly effective for reducing plasma lipid levels in patients with hyperlipidemia [3,4]. Therefore, gastric bypass should be a viable treatment option for recurrent pancreatitis secondary to LPLDinduced HTG. To the best of the authors’ knowledge, this is the first report of a patient with LPLD undergoing laparoscopic mini-gastric bypass (LMGB) as a metabolic surgery for the treatment of intractable HTG-related pancreatitis.

Author reply to: serum ischaemic-modified albumin levels might not be a marker of oxidative stress in patients with hypothyroidism

To the Editor, We have read the critics of Reddy et al. [1] with a great interest. We are grateful for the inspiring comments on our manuscript reported in the April 2013 issue of the Endocrine [2]. The patients in our study were divided into three groups: hypothyroid, subclinical hypothyroid and control. No significant difference was determined among these three groups in terms of the parameters hyperlipidemia and metabolic syndrome. Hypothyroidism can give rise to hypercholesterolemia, and this has been shown to be reversible with thyroid hormone replacement [3]. The data concerning the relation between subclinical hypothyroidism and hyperlipidemia are inconsistent. There are studies reporting no significant difference in plasma lipid levels in patients with subclinical hypothyroidism compared to controls [4, 5]. While in our study low-density lipoprotein (LDL) cholesterol levels were slightly higher in patients with evident hypothyroidism compared to those with subclinical hypothyroidism and the control group, no statistically significant difference was determined. We already have highlighted that as our groups did not differ for lipid levels on contrary to Ma and colleaugues’ study [6] we think that the possible effect that may arise from different lipid levels have been excluded in our study. The relatively low patient numbers in our study may have been involved in this. While a relation is reported between total cholesterol levels and ischaemic-modified albumin (IMA), this was not evaluated in our study since it is not a component of metabolic syndrome. While metabolic syndrome was slightly higher in evidently hypothyroid patients in our study, no statistically significant difference was determined among the three groups in terms of metabolic syndrome. There was no significant difference between the metabolic patient and control groups in terms of IMA levels. The authors pointed the study by Gottlieb and colleagues in which IMA levels were found to be higher than control group among patients with metabolic syndrome; however, in that study also similar to Ma and colleagues’ study [6] body mass index (BMI), waist circumference, blood pressure (systolic and diastolic), glucose levels and lipid levels (total cholesterol, LDL and HDL) were higher among patients with metabolic syndrome [7]. Although they have performed multivariate analysis for BMI and lipids they do not ignore the potential effect of these parameters on IMA levels in the discussion section [7]. It has been reported that hypothyroidism and subclinical hypothyroidism may be associated with an atherosclerotic process and chronic ischaemia [8]. In addition, a rise in metabolic rate as a result of the biological effect of thyroid hormones and a rise in oxygen radicals with calorigenesis has been reported [9]. It has also been reported that metabolic processes decelerating in hypothyroidism and decreasing oxygen radical production may have a protective effect against ischaemia [10]. The authors emphasised that the level of albumin is correlated with IMA levels and the absence of albumin levels of our patients. They are completely right, but our study group had no other diseases, other than thyroid disease; patients with abnormal albumin levels were not included in the study. Testing the binding of albumin to cobalt is a technique that measures IMA levels indirectly, and low albumin levels have been reported to be capable of affecting IMA levels. Gaze et al. reported a negative correlation between serum albumin levels and IMA levels, but I. Anaforoglu (&) K. Ersoy E. Algun Department of Endocrinology and Metabolism, Trabzon Kanuni Education and Research Hospital, 61000 Trabzon, Turkey e-mail: ianaforoglu@hotmail.com

Estimation of plasma lipids and its significance on histopathological grades in oral cancer: Prognostic significance an original research

Background Objectives:Alterations in the lipid profile have long been associated with various cancers because lipids play a key role in maintenance of cell integrity. This study was to estimate the plasma lipid levels in patients with oral cancer and to correlate the values with the histopathological grades.Materials and Methods:The study group included 50 patients with oral cancer aged between 20 and 60 years who had visited the Department of Oral Medicine and Radiology during the period of September 2005 to July 2007. After the histotopathological confirmation, their plasma lipid levels were estimated using auto analyzer and the data was statistically analyzed.Results:The study revealed a significant decrease in the total plasma lipid levels in patients with oral cancer in comparison with the standard values. Comparing the plasma lipid levels with the histopathological grades, we observed a significant variation in the levels of total cholesterol, very low density lipoprotein, low-density lipoprotein, high-density lipoprotein and triglyceridesConclusion:The variation in the levels of plasma cholesterol and other lipid constituents in patients with cancer might be due to their increased utilization by neoplastic cells for new membrane biosynthesis. This study was an attempt to estimate the plasma lipids in oral cancer patients and its significance on histopathological grades. We observed a relationship between lower plasma lipids and oral cancer. The result of our study strongly warrants an in-depth research with larger samples and a longer follow-up to consider the low plasma lipid status in oral cancer patients as a useful indicator to assess the course and prognosis of the disease.

Plasma lipid levels in patients with acute bacterial infections

To assess the impact of acute bacterial infections on plasma lipid levels and to determine the value of plasma lipid measurements in the diagnosis of acute bacterial infection. Materials and methods: A cross-sectional study was conducted involving 112 patients with acute bacterial infections admitted in hospital and 112 healthy individuals as controls. Levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein, and triglycerides were measured in blood samples of all subjects. Mean levels of serum lipids were compared in both groups. Results: Both groups were matched based on age (P = 0.10), sex (P = 0.789), BMI (P = 0.515), and history of diabetes mellitus (P = 0.231). Compared with control subjects, in patients with acute bacterial infections, significantly lower levels of total cholesterol (P = 0.013) and high-density lipoprotein cholesterol (P = 0.001) were found. There was no statistically significant differences in triglycerides (P = 0.194) and low-density lipoprotein (P = 0.075) serum levels between patients and controls. Conclusion: These results suggested that acute bacterial infections are associated with decreased serum cholesterol and high-density lipoprotein level. Therefore plasma lipids levels may serve as indicators of acute bacterial infections.

Beneficial Effects of Periodontal Treatment on Metabolic Control of Hypercholesterolemia

The authors aimed to evaluate whether local periodontal therapy may influence plasma lipid levels in patients with periodontitis. Fifty patients (31 females and 19 males, age 36-66 yr) were randomly assigned to the treatment and control groups. Lipid profile and dental variables were measured at baseline and at the end of the study in both groups. In the third month, there was a significant decrease in total and low density lipoprotein (LDL) cholesterol levels of the treatment group compared with baseline values. Also, the reduction in bleeding on probing, pocket depth, attachment loss, plaque index and gingival index were statistically significant in the treatment group. The present study indicates that periodontitis causes changes in total and LDL cholesterol levels and local periodontal treatment resulted in a significant decrease in these markers. These results suggest a potential effect of periodontitis-driven systemic inflammation on lipid metabolism.

Surveillance and treatment of dyslipidemia in the post-infarct patient: Can a nurse-led management approach make a difference?

Lowering plasma lipid levels in patients in the months following hospital discharge for a myocardial infarction (MI) is clearly beneficial if recurrent cardiac events and mortality are to be prevented; traditionally, however, there has been a large gap between guidelines and levels achieved in routine practice. A randomized, open-label clinical trial was conducted to assess the impact of nurse-centred surveillance and treatment in achieving nationally recognized lipid targets in post-MI patients. This program had the following features: systematic telephone follow-up of patients discharged from the University of Sherbrooke (Sherbrooke, Quebec) after an MI; systematic lipid testing three months after discharge; close liaison with, and guidance of, patients' primary care physicians to intervene on results of this test if targets were not obtained; and continued monitoring of patients until lipid profiles consistent with consensus targets were achieved. The impact of this approach was tested and compared with that of a control group that continued to be followed by a primary care physician for up to 18 months. A total of 127 patients were randomly assigned into an intervention group (n=64) or a control group (n=63). The intervention group was followed by telephone for an average (+/-SD) of 4.4+/-2.0 months post-MI. At this point, when intervention was optimized, the mean low-density lipoprotein cholesterol (LDL-C) level was 2.19+/-0.65 mmol/L in the intervention group, and 87.3% of patients had LDL-C levels of less than 2.5 mmol/L. Patients from both experimental groups returned at 12 months and 18 months post-MI for a new blood lipid assessment. In total, 12.5% of patients in each group were lost to follow-up. At 12 months and 18 months, the mean LDL-C level was not different between the two groups, nor was there a significant difference in the proportion of patients achieving LDL-C levels of less than 2.5 mmol/L (51.6% in the intervention group and 65% in the control group at 18 months; P>0.05). When the combined end point of an LDL-C level of less than 2.5 mmol/L, a triglyceride level of less than 2.0 mmol/L and a total cholesterol to high-density lipoprotein cholesterol ratio of less than 4.0 was considered, the proportion of patients achieving this composite at 18 months was low and not different between the two groups (23.4% in the intervention group and 38.3% in the control group; P>0.05). Over 95% of patients in both groups were on a lipid-lowering medication, and more than 90% had complied with their medication regimen at 18 months. This trial did not support the role of nurse-managers and a system of telephone-based contacts to ensure the continuity of care and aggressive intervention when considering cardiovascular risk factors in post-MI patients. This trial also re-emphasized the important remaining treatment gap in secondary prevention of coronary artery disease, particularly if composite lipid end points are to be targeted.

Cholesterol control in stroke prevention in Italy: a cross-sectional study in family practice

Stroke represents worldwide the second and seventh cause of death and invalidity, respectively. Patients with ischaemic stroke or transitory ischaemic attack (TIA) are at high risk of recurrence, therefore requiring intensive treatment. Hypercholesterolaemia is a modifiable risk factor for stroke. The general practitioners attitude towards detection and treatment of dyslipidaemia among patients with stroke or TIA in Italy is unknown; we therefore aimed to address this issue taking advantage of the database of The Italian College of General Practitioners. Prevalence of the monitored factors (lipid levels, statin prescription, and lipid level control with hypolipidaemic agents prescription) were analysed on a patient population of 465 061. A total of 2555 (49% women and 51% men) patients with a diagnosis of stroke and 2755 patients (52% women and 48% men) with a diagnosis of TIA were included in the study. Total plasma cholesterol (TC) was reported in more than 60% of the patients and low-density lipoprotein cholesterol (LDLc) and high-density lipoprotein cholesterol (HDLc) in less than half. Total plasma cholesterol and LDLc were controlled in 70.3 and 72.8% of the patients, respectively. The percentage of controlled patients decreased to 64% when both LDLc and TC were considered. Statins and fibrates were prescribed in a small proportion of patients (16.9 and 3.5%, respectively). An acceptable control of blood lipids was achieved in a majority of those patients (60.2%). However a relatively large number of patients (646) with high plasma lipids remained untreated. Monitoring and intervention strategies on plasma lipid levels in patients with a diagnosis of stroke or TIA need to be improved.

Plasma lipid levels in patients with venous thrombosis

Plasma lipid levels in patients with venous thrombosis

Variation in the lipoprotein receptor-related protein, alpha2-macroglobulin and lipoprotein receptor-associated protein genes in relation to plasma lipid levels and risk of early myocardial infarction.

The lipoprotein receptor-related protein (LRP) is an endocytic receptor for several ligands, such as alpha2-macroglobulin (alpha2 M) and apolipoprotein E. LRP is involved in the clearance of lipids from the bloodstream and is expressed in the atherosclerotic plaque. The LRP-associated protein (LRPAP in humans, RAP in mice) acts as a chaperone protein, stabilizing the nascent LRP peptide in the endoplasmic reticulum and Golgi complex. In mice, the amount of LRP activity was modulated by RAP, and RAP-null mice showed higher levels of total cholesterol. To evaluate the association between DNA polymorphisms at the LRP, LRPAP and alpha2 M genes and early myocardial infarction (MI). We genotyped 210 patients with early MI (<55 years) and 200 healthy control participants for three polymorphisms in the LRP, LRPAP and alpha2 M genes. No association was found between these polymorphisms and plasma lipid levels in patients and control participants. Only the LRPAP-intron 1 polymorphism (a 21 bp insertion/deletion) was associated with MI (P = 0.0065; odds ratio = 2.18, 95% confidence intervals = 1.22-3.90). According to our data, the variation at the LRPAP1 gene could contribute to the risk of developing an early episode of MI.