Raised Triglyceride Levels Research Articles

STUDY OF SERUM URIC ACID LEVELS IN PATIENTS DIAGNOSED WITH METABOLIC SYNDROME IN A HOSPITAL-BASED STUDY IN WEST BENGAL

Objective: The occurrence of hyperuricemia is growing even in developing countries. It has been known to be associated with metabolic syndrome (MetS). MetS is a bunch of numerous metabolic disorders including reduced high-density lipoprotein cholesterol (HDL-C), hypertension, hyperglycemia, abdominal obesity, and raised triglyceride level in serum. Methods: The present work was done in the Department of Biochemistry in combination with Medicine Department, SRIMS and Sanaka Hospital, Durgapur, WB, India. A total of 50 diagnosed MetS patients were selected for further studies and same number (50) of healthy volunteers controls without MetS were selected. Diagnosis of MetS was done according to the National Cholesterol Education Program Adult Treatment Panel-III. Results: In our study, the level of serum uric acid (SUA) is high in MetS patients (7.8 mg/dL) compared to control group (4.6 mg/dL). The compared between two groups was statistically significant (p<0.000). Conclusion: Our study showed that the components of MetS are increased with rise in the concentrations of SUA.

Assessment and Predictors of Metabolic Syndrome in Patients of Xanthelasma Palpebrarum: An Observational Study.

Xanthelasma palpebrarum is considered to be a cutaneous marker for cardiovascular diseases, and there is a known association with hypertension, insulin resistance, diabetes mellitus, obesity, and stroke. Our aim was to study the association and identify the predictors of metabolic syndrome in patients with xanthelasma palpebrarum. An observational study was conducted on 55 patients in which patients of both sexes ages 20-70 years without any other skin condition were included after written informed consent. After history and examination, blood pressure and waist circumference were measured in all the subjects. Investigations were sent for fasting blood sugar levels and serum lipid profile. The 2006 IDF Definition of metabolic syndrome was used as assessment criteria. Among the 55 patients, metabolic syndrome was present in 23 patients (41.82%). There was a statistically significant (P<0.05) difference in the values of waist circumference (100% vs. 59.38%, P=0.0003), elevated blood pressure (82.61% vs. 9.38%, P<.0001), raised fasting blood sugar (47.83% vs. 18.75%, P=0.021), and raised triglyceride levels (56.52% vs. 25%, P=0.018) between patients with metabolic syndrome and those without. However, HDL cholesterol levels (34.78% vs. 50%, P=0.262) were comparable between groups. Also, a patient aged 41 years or more with even a single xanthelasma of more than one year's duration has a 76.1% chance of developing metabolic syndrome. Metabolic syndrome develops in a sizeable number of xanthelasma palpebrarum patients, and this therefore gives us an opportunity for early diagnosis and intervention to prevent the development of cardiovascular complications.

EP110 - Chyloperitoneum in Follicular lymphoma – presenting as an inguinal hernia

Abstract Introduction Follicular lymphoma is one of the subtypes of slow growing Non-Hodgkin Lymphoma. Rarely, follicular lymphoma can present with chyloperitoneum or chylous ascites which is characterized by a milky-white coloured fluid with raised triglyceride levels. Case Report We present a case of a 60-year-old diabetic male, complaining of a right sided inguinal swelling for 1 year. Examination revealed a reducible right inguinal swelling with a positive cough impulse. The laboratory workup was unremarkable. Ultrasound scan of anterior abdominal wall showed a defect of 2.1 cm in right inguinal region with protrusion of abdominal contents and a positive cough impulse. A diagnosis of right sided reducible direct inguinal hernia was made. Patient was scheduled for Lichtenstein repair. Per-operatively, the hernial sac contained healthy omentum with milky-white ascitic fluid. Omentum was reduced and suture repair was performed. A drain was placed intra-peritoneally. The postoperative course of the patient was uneventful. Ascitic fluid analysis showed high triglyceride levels and no evidence of malignant cells, suggesting chylous ascites. Contrast enhanced CT scan of abdomen and pelvis revealed a large homogenous minimally enhancing soft tissue density retroperitoneal mass in peri aortic and paravertebral location with abdominal lymphadenopathy suggesting retroperitoneal lymphoma. Excisional biopsy of an enlarged inguinal lymph node confirmed follicular lymphoma with positive BCL2 and CD10 markers. Conclusion Follicular lymphoma presents in a variety of ways including chylous ascites in an inguinal hernia and a high index of suspicion is required to diagnose it.

Glycemic Profile and Lipid Profile in Chronic Obstructive Pulmonary Disease (COPD) Patients With and Without Metabolic Syndrome.

There is a lack of Indian data regarding the frequency of metabolic syndrome (MetS) or its components in chronic obstructive pulmonary disease (COPD). As a result, the present study aimed to determine the prevalence of MetS in COPDcases and investigate its association with COPD severity. After receiving ethical approval fromIndex Medical College and Hospital, we conducted this cross-sectional study in Indore. We recruited 100 participants with a history of COPD and divided them into two groups: those with MetS and those without. Researchers examined the subjects' fasting blood glucose, serum high-density lipoprotein, triglyceride(TG), systolic and diastolic blood pressure (SBP/DBP), waist circumference, and fasting blood glucose levels. We discovered that 59% of patients with COPD and 52% of individuals with impaired fasting glucose (IFG) had MetS (mean ± SD = 110.8 ± 32.8). In comparison, 48% (mean ± SD = 98.2 ± 24.8) of individuals with normal fasting glucose do not experience this. The incidence of MetS was higher in both groups, those with IFG and those without, but the difference was not statistically significant (t = 1.7088, df = 98; p = 0.0907). We observed X2 = 1.336, df = 1, and p = 0.2476 when we tested the association between IFGand COPD with the Chi-square test. Individuals with MetS were more likely to have high BP, raised TG levels, low HDL cholesterol, abdominal obesity, and other risk factors.

428 Progressive shortness of breath in a post CABG patient: Thinking beyond the obvious

Abstract Background Post-coronary artery bypass graft (CABG) chylothorax is rare accounting for 0.06-0.09% of the cases. Case presentation A 62 year old male patient presented with progressive shortness of breath (mMRC grade 1 to 3) for 6 months. He underwent CABG surgery 7 months prior due to ischemic heart disease. Clinical examination supplemented with radiological imaging revealed evidence of progressive bilateral pleural effusion. Pleural fluid aspiration showed bloody appearance of fluid on right side. Lipid analysis of the aspirate confirmed presence of chylomicrons along with a raised triglyceride level(138mg/dL). Clinical outcome A diagnosis of right-sided post CABG chylothorax with left sided transudative fluid was made. Patient was managed with ICD insertion on the right side and started on total parenteral nutrition (TPN). This was followed by permissible carbohydrate intake and TPN for 11 days. Gradual decrease in collection was noticed in the follow-up x-ray with no recurrence of symptoms. Discussion Most likely that the anterior mediastinal lymphatic chain got injured during the harvesting of internal mammary artery causing leakage of chyle into the thoracic cavity leading to dyspnoea and chest discomfort. Conclusion Lipid measurements may be indicated in all patients with undiagnosed pleural effusion in order to rule out chylothorax. Chylothorax can meet criteria of transudate if associated with congestive cardiac failure, cirrhosis, or nephrotic syndrome. However, the colour of pleural fluid is not always indicative of a chylothorax. While most of the patients can be managed conservatively, surgery is recommended if drainage lasts for more than 1-3 weeks, and daily drainage is 200-500mL.

Familial Hemophagocytic Lymphohistiocytosis secondary to UNC13D mutation: a report of two cases

BackgroundHemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease characterized by some clinical signs (e.g., non-remitting fever, hepatosplenomegaly) and laboratory findings (e.g., cytopenia, increased ferritin level, hypofibrinogenemia, lipid disorders, coagulopathy, and multiple organ failure). Depending on the etiology, HLH is divided into familial (i.e., primary) and acquired (i.e., secondary) forms. Familial HLH (FHL), an autosomal recessive condition, is classified into five subtypes based on underlying genetic defects. The PRF1, STX11, UNC13D, HPLH1, and STXBP2 are the most well-known genes of this type which are related to granule-mediated cytotoxic T and Natural killer (NK) cells. The treatment is based on the HLH-2004 protocol.Case presentationThe current report presents two cases of HLH with presentations different from each other and previously reported cases. Case 1 was a 15-month-old boy with fever, skin rash, splenomegaly, and bicytopenia, raised triglyceride levels, AST (aspartate transaminase), and ALT (alanine aminotransferase), normal ferritin, and abundant hemophagocytic cell in bone marrow aspiration. He was diagnosed with HLH and received HLH protocol as treatment. The patient had a homozygous intronic mutation; NM_199242: c.2448-13G > A in UNC13D. The associated disease was Familial Hemophagocytic Lymphohistiocytosis 3 (FHL3). Case 2, a 37-day-old female presented with fever, a history of neonatal cholestasis, and huge hepatosplenomegaly. Her whole-exome sequencing report manifested that the patient had the same mutation as case 1. Unfortunately, both patients passed away.ConclusionThe sequencing of the entire UNC13D gene (coding and non-coding regions) is an applicable and valuable diagnostic procedure for the detection of deep intronic splicing variants and large inversions in patients with atypical manifestations of HLH (such as normal ferritin or triglyceride and cholesterol).

Risk Factor Evaluation of Non Alcoholic Fatty Liver Disease in Lean Individual

Background : Non-Alcoholic Fatty Liver Disease (NAFLD) is epidemic around the world. Bangladesh is also experiencing an increasing trend of NAFLD. Obesity is a common clinical phenotype associated with NAFLD, which is linked to metabolic syndrome and related comorbidities, including type II diabetes, hypertension and dyslipidemia. Clearly, not all obese subjects develop NAFLD and NAFLD also can be found in non-obese patients. This subset of individuals, known to have ‘lean NAFLD’ or ‘non-obese NAFLD’, is growing increasingly prevalent. NAFLD in lean patients appears to be more common among Asians. So it is important to look for risk factors for NAFLD in lean patients for prevention of advanced liver disease. The objective of our study was to find out the risk factors of NAFLD in lean (Nonobese) individual.&#x0D; Materials and methods: It was prospective observational study done on 100 patients attending in the Gastroenterology Department and OPD of Chittagong Medical College Hospital after approval of Ethical and Review Committee of CMC and grant from DGHS. Total 100 patients having 18 to 65 years of age, were taken as study subjects who met inclusion criteria. Informed written consent was obtained from the patients or attendant after full explanation of the purpose of the study. Fasting Blood Glucose (FBS) Fasting lipid profile, SGPT, SGOT, Ultrasonography of hepatobiliary system and Fibrosan were done. All necessary data was included in the data collection sheet and was analyzed by Microsoft excel and SPSS-23.&#x0D; Results: 100 patients were included in this study. Mean age of this study with age was in between 18 years to 65 years.Male to female ratio was 3:1 in the studied population.The majority of the lean patient with NAFLD (31%) was in the age group 40-49 years. The majority of the lean patient with NAFLD (83%) was in normal BMI range 18.5-22.99 kg/m2 and 13% had BMI &lt;18.50 kg/m. Out of 100patients diabetes and hypertension were found 22% and 17% of patients respectively. 22% and 17% patients. 65% and 37% patients had raised SGPT and SGOT respectively. Out of 100 subjects, 50% had raised triglyceride level (50%) and 18% had raised LDL cholesterol (18%) level.According to Ultrasonography findings 68% were in Grade I, 11% in Grade II and only 1 patient was in Grade III fatty liver. Fibroscan of 100 subjects, Significant fibrosis ( ³2 F) was observed in 9%, while advanced fibrosis (F4) was seen in 4% of patients. As per steatosis score 36% was in S2 and 34% were in S3 grade. Median fibrosis score and steatosis score was significantly higher in patients with high SGPT compared to patients with normal SGPT (p &lt;0.005) whereas median fibrosis score and steatosis score was higher in patients with high SGOT compared to patients with normal SGOT, but only the difference in steatosis score reached statistical significance (p&lt;.042). AUC of SGPT for discriminating fibrosis grade F0-F1 from Grade F2-F4 was 0.565 (95% CI: 0.404-0.726, p=0.519). AUC of SGOT for discriminating fibrosis grade F0-F1 from Grade F2-F4 was 0.573 (95% CI: 0.342-0.803, p=0.474). This indicated that there was no significant role of SGPT or SGOT values for prediction of significant fibrosis ( ³2F).AUC of SGPT for discriminating steatosis grade S0-S2 from Grade S3-S4 was 0.565 (95% CI: 0.404-0.726; p=0.519). AUC of SGOT for discriminating steatosis grade S0-S2 from Grade S3-S4 was 0.573 (95% CI: 0.342-0.803, p=0.474). This indicated that both SGPT and SGOT had significant role for prediction of significant steatosis ( ³3S).Higher age (p &lt;0.028) and female sex (p&lt;0.013) were revealed as independent predictive factors for significant fibrosis ( ³F2) in non-obese NAFLD patients on performing multivariate binary logistic regression.&#x0D; Conclusion Lean NAFLD is now frequently recognized in day-to-day clinical practice, however, the data on epidemiology, risk factors, physiopathology, distinctive histologic changes, natural history and treatment of this entity are still scanty. From a biological point of view, lean NAFLD be haves much like obese NAFLD. Our study may help to find out risk factors in nonobese NAFLD which may help prevention of advance liver disease by early intervention.&#x0D; JCMCTA 2022 ; 33 (1) : 56-65

Abstract 154: Correlation of quality of life and metabolic syndrome using WHO QOL BREF version

Background: The metabolic syndrome has been linked to psychosocial stress along with poor quality of life in a number of studies.Materials and Methods: The present study conducted in tertiary care health centre of northern India to study the correlation of Metabolic syndrome with quality-of-life assessment. The WHOQOL-BREF (Field Trial Version) produces a quality-of-life profile.Results: Difference in WHO Quality of Life score of Cases and controls with Central obesity, raised Blood Pressure, reduced HDL cholesterol and raised fasting plasma glucose were found to be statistically significant, however Difference in WHO Quality of Life score of Cases and controls with raised triglyceride levels was found to be statistically non-significant.Conclusion: Central obesity and raised blood pressure were associated with significantly poorer quality of life with respect to all the 4 domains while reduced HDL Cholesterol and raised fasting plasma glucose levels were associated with poorer quality of life with respect to physical health and psychological domains only.

ASSOCIATION OF DYSLIPIDEMIA WITH ANXIETY AND DEPRESSION IN PATIENTS OF POLYCYSTIC OVARIAN SYNDROME

OBJECTIVE: To find-out the association of dyslipidemia with anxiety and depression in patients with polycystic ovarian syndrome (PCOS). METHODS: This descriptive cross-sectional study was conducted at Mardan Medical Complex, Mardan, Pakistan from December-2019 to March-2020. One hundred &amp; forty diagnosed cases of PCOS, ranging in age from 20-40 years, were selected through purposive sampling. Anxiety and depression were calculated using hospital anxiety and depression scale (HADS) score. Total cholesterol (TC), triglycerides, low-density-lipoproteins (LDL), high-density-lipoproteins (HDL) and testosterone were tested through fasting blood samples. RESULTS: Anxiety and depression were documented in 102 (72.9%) &amp; 99 (70.7%) cases respectively. Primary infertility, oligomenorrhoea, Hirsutism &amp; acne were present in 69 (49.3%), 111 (73.5%), 81 (57.9%) and 55 (39.3%) patients respectively. Twenty-two (15.7%) patients were overweight/obese. All patients had raised testosterone levels and polycystic ovaries on ultrasound. Raised triglyceride levels (≥150 mg/dl), Low levels of HDL (≤ 60mg/dl), raised levels of LDL (≥130 mg/dl), raised cholesterol levels (≥200 mg/dl) were reported in 71/99 (71.7%), 56/99 (56.6%), 38/99 (38.4%) &amp; 10/99 (10.2%) cases with depression as compared to 27/41 (65.9%), 13/41 (31.7%), 21/41 (51.2%) &amp; 14/41(34.1%) non-depressed patients respectively. Similarly raised triglyceride levels, low levels of HDL, raised levels of LDL, raised cholesterol levels were reported in 73/102 (71.6%), 58/102 (56.9%), 40/102 (39.2%) &amp; 12/102 (11.76%) cases with anxiety as compared to 25/38 (65.8%), 11/38 (28.9%), 19/38 (50%) and 12/38 (31.6%) patients without anxiety respectively. CONCLUSION: Dyslipidemia, anxiety and depression &nbsp;are very common in PCOS. Dyslipidemia is associated with anxiety and depression in PCOS patients.

ACUTE PANCREATITIS IN PATIENTS WITH DIABETIC KETOACIDOSIS PRESENTING AT A TERTIARY CARE UNIT

Objective: To determine the frequency of acute pancreatitis among the patients diagnosed with diabetic ketoacidosis at our tertiary care hospital.&#x0D; Study Design: Co-relational study.&#x0D; Place and Duration of Study: Medicine department, Pak Emirates Military Hospital Rawalpindi, from Jun to Dec 2019.&#x0D; Methodology: A total of 40 cases presenting with diabetic ketoacidosis were included in our study. Diabetic ketoacidosis was diagnosed by consultant medical specialist. All patients underwent baseline investigations including serum amylase, lipid profile and CT scan abdomen in order to diagnose acute pancreatitis. Relationship of age, gender, duration of diabetes mellitus and triglyceride levels was assessed with the presence of acute pancreatitis among the patients of diabetic ketoacidosis.&#x0D; Results: A total of forty patients were managed as diabetic ketoacidosis in our hospital during the study period. Out of them 8 (20%) had acute pancreatitis while 32 (80%) were not diagnosed with acute pancreatitis. Confusion (55%) was the commonest presenting complaint followed by abdominal pain (25%). With binary logistic regression analysis, we found that female gender and raised triglyceride levels had a statistically significant relationship with presence of acute pancreatitis among the patients of diabetic ketoacidosis included in this study.&#x0D; Conclusion: Considerable number of patients were diagnosed with acute pancreatitis who presented with diabetic ketoacidosis. Special attention should be paid towards female patients and those with raised triglyceride levels to look for the sign and symptoms of acute pancreatitis in order to diagnose and manage this condition.

Prevalence of Metabolic Syndrome in Chronic Obstructive Pulmonary Disease in Rural Population of Developing Country-A Cross-sectional Study

Introduction: Metabolic Syndrome (MetS) is characterised by the clustering of central obesity, hypertension, dyslipidemia, and hyperglycemia that predisposes patients to Cardiovascular Disease (CVD). It is a representative group of conditions with systemic inflammation, which is a potential mechanism responsible for both Chronic Obstructive Pulmonary Disease (COPD) and MetS. Aim: To detect incidence of MetS in COPD patients and its correlation with severity of COPD. Materials and Methods: The present study was an observational cross-sectional study which was conducted on 62 COPD patients in SS Hospital, BHU, Varanasi, Uttar Pradesh, India, from June 2015 to June 2017, diagnosed on basis of Global initiative for Lung Disease (GOLD) guidelines. 62 age and sex matched control having no cardio-respiratory history were included. All relevant investigations were done for all selected subjects and modified Medical Research Council (mMRC) dyspnoea grading was done in all the subjects. Standardised treatment modules were followed and spirometry and post-bronchodialater spirometry was performed 15-30 mins after inhalation of 400 mcg Salbutamol. Patients obstruction was classified according to the severity of airflow limitation based on post-bronchodilator Forced Expiratory Volume in one second (FEV1) as follows: mild (≥80% predicted); moderate (80&gt;FEV1 ≥50% predicted); severe (50%&gt; FEV1 ≥30% predicted); very severe (&lt;30% predicted). Complete work-up and data collection were analysed by using Statistical Package for the Social Sciences (SPSS) version 23.0 software, descriptive cross tables, univariate and multivariate analysis. Independent Student’s t-test was used to compare the means of cases and controls. The p-value &lt;0.05 was considered statistically significant. Results: Total 62 patients along with age and sex matched 62 healthy control in 1:1 ratio have been taken in the study, majority were in age group of 50-70 years. On comparing the mean values of different parametres of MetS in COPD cases and controls, significantly raised triglyceride level and fasting blood sugar in COPD cases (p-value &lt;0.001 and 0.005 respectively) were observed. MetS was present in 29 cases (46.8%) of COPD whereas in healthy control population only 19 people (30.6%) were positive for MetS. Total of 55.2% cases of COPD with MetS was in group D whereas 84.8% cases of COPD without MetS were in group B of GOLD staging. Statistically significant (p&lt;0.001) higher incidence of acute exacerbation was observed in cases of COPD with MetS. Conclusion: MetS was more prevalent among the COPD patient in 50-70 years age group with mild to moderate airflow limitation. More waist circumference i.e., central obesity, impaired fasting glucose, dyslipidemia, increases the risk of cardiovascular complication in these patients. MetS is an important co-morbidity in patients of COPD which fasten the natural course of disease by increasing the frequency of acute exacerbation.

GLYCATED HEMOGLOBIN LEVELS IN METABOLIC SYNDROME PATIENTS

Objectives: Metabolic syndrome (MetS) is a cluster of several metabolic disorders including hyperglycemia, reduced high-density lipoprotein cholesterol, and raised triglyceride level in serum, hypertension, and abdominal obesity. Glycated hemoglobin (HbA1c) is used as one of the diagnostic criteria for diabetes and diagnostic tool for MetS.&#x0D; Methods: The present study was conducted at Prasad Institute of Medical Sciences. The study includes 150 patients with MetS as a case and 150 healthy volunteers as a control. MetS was diagnosed according to National Cholesterol Education Program’s Adult Treatment Panel III criteria. HbA1c was assayed in various components of MetS.&#x0D; Results: It was found that HbA1c was significantly higher in MetS patients when compared to control group.&#x0D; Conclusion: Our study suggests that HbA1c might be used as a diagnostic criterion for MetS. Therefore, proper glycemic control should be maintained by maintaining HbA1c level &lt;6.5% to prevent from diabetes and MetS.

A Comprehensive Update on the Chylomicronemia Syndrome.

The chylomicronemia syndrome is characterized by severe hypertriglyceridemia and fasting chylomicronemia and predisposes affected individuals to acute pancreatitis. When due to very rare monogenic mutations in the genes encoding the enzyme, lipoprotein lipase, or its regulators, APOC2, APOA5, GPIHBP1, and LMF1, it is referred to as the familial chylomicronemia syndrome. Much more frequently, the chylomicronemia syndrome results from a cluster of minor genetic variants causing polygenic hypertriglyceridemia, which is exacerbated by conditions or medications which increase triglyceride levels beyond the saturation point of triglyceride removal systems. This situation is termed the multifactorial chylomicronemia syndrome. These aggravating factors include common conditions such as uncontrolled diabetes, overweight and obesity, alcohol excess, chronic kidney disease and pregnancy and several medications, including diuretics, non-selective beta blockers, estrogenic compounds, corticosteroids, protease inhibitors, immunosuppressives, antipsychotics, antidepressants, retinoids, L-asparaginase, and propofol. A third uncommon cause of the chylomicronemia syndrome is familial forms of partial lipodystrophy. Development of pancreatitis is the most feared complication of the chylomicronemia syndrome, but the risk of cardiovascular disease as well as non-alcoholic steatohepatitis is also increased. Treatment consists of dietary fat restriction and weight reduction combined with the use of triglyceride lowering medications such as fibrates, omega 3 fatty acids and niacin. Effective management of aggravating factors such as improving diabetes control, discontinuing alcohol and replacing or reducing the dose of medications that raise triglyceride levels is essential. Importantly, many if not most cases of the chylomicronemia syndrome can be prevented by effective identification of polygenic hypertriglyceridemia in people with conditions that increase its likelihood or before starting medications that may increase triglyceride levels. Several new pharmacotherapeutic agents are being tested that are likely to considerably improve treatment of hypertriglyceridemia in people at risk.

To Study Various Complications Present amongst Metabolic Syndrome Patients and Control Subjects

Objectives: Metabolic syndrome (MetS) is a cluster of several metabolic disorders including hyperglycemia, reduced high density lipoprotein cholesterol, raised triglyceride level in serum, hypertension and abdominal obesity. Methods: The present study was conducted at the MM Institute of Medical Sciences and Research. The study includes 300 patients with MetS as a case and 300 healthy volunteers as a control. MetS was diagnosed according to international diabetes federation. Results: In our study 103 MetS patients of 300 have shown the complications like DM (Diabetes Mellitus), HTN (Hypertension) and obesity which are predisposing factors for atherosclerosis and other cardiovascular diseases which lead to morbidity and mortality. Conclusions: Our study found that diabetes Mellitus, hypertension, dyslipidemia and obesity are the predisposing factors for metabolic syndrome.

Prevalence of metabolic syndrome and its different components in patients with acute coronary syndrome

Background: Several components of the Metabolic Syndrome (MetS) are risk factor for cardiovascular diseases. So, this study was conducted to evaluate the prevalence of MetS and its components in patients with CAD.Methods: Author included all patients admitted with Acute Coronary Syndrome (ACS), who had CAD confirmed by coronary angiography. They were divided into two groups according to presence or absence of MetS based on International Diabetes Federation criteria. The prevalence of MetS and its individual components was estimated.Results: It was observed that there is a high prevalence of MetS (66%) in patients admitted with ACS. Metabolic syndrome is more prevalent in female patients (82.4%) than in male patients (57.6%) with ACS. Hypertension is the most prevalent (87.9) component of MetS. Diabetes Mellitus (DM) is the 2nd most prevalent (83.3%) component of MetS. About 65.2% patients with MetS had abnormally raised triglyceride levels and 32(48.5%) had abnormally low HDL-cholesterol level. Among the MetS 38(57.6%) had abnormal waist circumference. Among the study group, the most common triad of MetS components was DM + HTN + abnormal TG. There is significant association between MetS and microalbuminuria, with incidence of 22(33.3%) in this study. Similarly, a significant association between DM and microalbuminuria, 23(33.8%) was observed.Conclusions: This study confirms a very high prevalence of MetS in Indian patients with CAD. The prevalence of the risk factors was higher in CAD patients with MetS.

Obesity, Dyslipidemia and Insulin Resistance in Survivors of Childhood Cancer

Abstract Background: With the increased survival rates following the treatment of childhood cancer, it becomes equally important that the need for evidence based surveillance of long term effects of cancer therapy is addressed. This includes the risk of development of metabolic syndrome features like obesity, altered lipid and sugar profile, which was attempted in the present study. Materials and Methods: In this cross sectional case study, 50 survivors of childhood cancer aged between 5 – 18 years were recruited. Positive history of obesity, diabetes mellitus, dyslipidemia, and stroke in family were recorded and their anthropometry was noted with calculation of their Body Mass Index (BMI). Fasting lipid profile, blood sugar, and serum insulin levels were tested; the Homeostatic model assessment of Insulin Resistance (HOMA IR) value and the Fasting Glucose to Insulin Ratio(FGIR) were derived as markers of insulin sensitivity. The data were analyzed using SPSS (version 17.0). Results: In these fifty children, the risk factors studied for dyslipidemia and insulin resistance due to chemotherapy were: age at diagnosis, sex, radiation exposure, steroid, and L-asparaginase use during the treatment for cancer. Among the fifty survivors, 7 were found obese, 32 normal, and 11 underweight as per the age specific BMI charts. Their metabolic parameters showed that 12 had raised cholesterol levels, 8 had raised triglyceride levels, and 4 had lowered HDL-C levels. Nine survivors also had raised HOMA-IR levels. However, these metabolic derangements were not found to be statistically significant (p value&gt;0.05) and no correlation was found between the risk factors and obesity, dyslipidemia, or insulin resistance. Conclusion: As against the prior evidence, there was no risk of developing obesity, dyslipidemia, and insulin resistance in survivors of childhood cancers. Keywords: Dyslipidemias, Insulin Resistance, Obesity, Survivors of childhood cancer

OVERVIEW OF MODERN STUDIES OF COMORBIDITY IN PSORIASIS

Psoriasis is a multifactorial inflammatory skin disease associated with various medical conditions. The article presents an overview associations between psoriasis and ulcerative colitis, diabetes, chronic neuropathy, depressions, lymphomas, malignant processes, especially lymphoproliferation, metabolic syndrome. Patients with psoriasis, particularly if disease is severe, are at increased risk of cardiovascular diseases, such as hypertension, myocardial infarction, and stroke. Have examined the association between psoriasis and glomerulonephritis as well as chronic kidney disease. Factors influencing the course of psoriasis include age, stress, smoking, alcohol, a violation of diet, the presence of chronic obstructive pulmonary disease, sleep apnea, mental disorders The article presents an overview associations between psoriasis and metabolic syndrome. When a subject has three of the five listed criteria, a diagnosis of the metabolic syndrome can be made. The criteria listed include glucose intolerance presenting higher fasting glucose 6,1; increased waist circumference or abdominal obesity (≥ 102 cm for men and ≥ 88 cm for women); raised triglyceride levels ≥ 1.7 mmol/l; reduced high-density lipoprotein &lt; 1.04 mmol/l for men and &lt; 1.30 mmo/l for women; and elevated blood pressure 130/85 mmHg. In patients with psoriasis found a significantly increased prevalence and severity of coronary artery calcification.

Plasma triglycerides as a risk factor for chronic kidney disease in type 2 diabetes mellitus: Evidence from northeastern Thailand

AimsTo investigate the observational association between plasma triglyceride and CKD in patients with T2DM. MethodsA hospital-based retrospective registry was used to obtain data of 3,748 T2DM patients from May 2016 to October 2016. Anthropometric measurements and biochemical reports of T2DM patients with CKD were obtained by data extraction of medical records. CKD was defined according to the estimated glomerular filtration rate (eGFR< 60 mL/min/1.73 m2). Multiple logistic regression was used to determine the association between plasma triglyceride and CKD. ResultsThe mean age of the participants was 61.4 ± 11.0 years, and a majority of them was female (64%) with poor glycemic control (83%), increased plasma triglyceride (51%) and 27% of T2DM patients had CKD. There was a significant trend towards deteriorating renal function (lower eGFR) with categorically raised triglyceride levels. After controlling for age, sex and other confounders, ‘borderline high’ (adjusted odds ratio (OR): 1.24, 95% confidence interval (CI): 1.01–1.54), ‘high’ (adjusted OR: 1.52, 95% CI: 1.24–1.85) and ‘very high’ (adjusted OR: 3.40, 95% CI: 1.94–5.94) triglyceride level groups had higher likelihood to have CKD compared to normal triglyceride level. ConclusionCKD was associated with a higher level of plasma triglyceride among patients with T2DM. These results support the rationale to screen and manage increased triglyceride in routine clinical practices among persons with diabetes to prevent CKD.

Frequencies of the T-455C and C-482T apoCIII gene polymorphisms in different South African population groups and their relationship to fasting serum triglyceride levels

Studies have demonstrated that serum triglyceride levels are higher in Indian and White than Black South African subjects. Polymorphisms in the apoCIII gene have been associated with raised triglyceride levels. This study investigated the prevalence of apoCIII polymorphisms and their effect on triglyceride levels in three South African population groups and in subjects with fasting hypertriglyceridaemia (HT). Two apoCIII polymorphic sites (T-455C and C-482T) were studied in 78 European, 24 Indian and 25 African subjects. Each ethnic group included HT and non-HT (control) patients. Although triglyceride levels were much higher in the HT subjects, no significant differences were noted between the groups for allele or genotype frequencies at either apoCIII locus. Furthermore, at neither locus was there an association between the genotype and serum triglyceride levels. The HT and control subjects were therefore combined and ethnic differences in allele frequencies were investigated. The African subjects had a higher frequency (0.79) of the unfavourable C allele at position 455 than both Indian (0.56; p‹0.05) and European (0.41; p‹0.0005) subjects. Furthermore, African subjects had a higher frequency (0.77) of the unfavourable T allele at locus 482 than Indian (0.44, p‹0.005) and European (0.36, p‹0.0005) subjects despite triglyceride levels being lower in the African (0.60 [1.60] mmol/l) than European (0.90 [0.40] mmol/l; p‹0.05) control subjects. These results suggest that the apoCIII polymorphisms studied do not contribute to the raised triglyceride levels in HT subjects and do not explain the ethnic differences observed in fasting serum triglyceride levels.

Microalbuminuria in Type-2 Diabetes Mellitus; the tip of iceberg of diabetic complications.

Objective:To determine the prevalence of microalbuminuria and its association with hypertension and other diabetic complications among Type-2 diabetic patients attending at Aga Khan University Hospital Karachi.Methods:1280 Type-2 diabetes patients who visited the outpatient department of Aga Khan University Hospital from September 2014 to August 2016 were included in the study. Microalbuminuria was diagnosed if spot urinary microalbumin excretion was confirmed to be more than 20mg/l. Hypertension was diagnosed if BP >140/90 or already on antihypertensive medications. Other demographic, clinical and laboratory data were also recorded.Results:Microalbuminuria was diagnosed in 404(31.56%) patients and among these albuminuric patients 335(82.9%) had hypertension. They were also dyslipidemic, having raised triglyceride levels, lower HDL levels, with more prevalence of background diabetic retinopathy and peripheral neuropathy. They also showed higher HbA1C levels and longer duration of diabetes.Conclusion:The prevalence of the microalbuminuria in our patients with Type-2 diabetes is 31.56% and is not only an early sign of diabetic nephropathy but also a host of other diabetic complications and should be dealt early with strict control of their hyperglycemia and hypertension to help prevent the future complications.