Triglyceride Ratio Research Articles

Correlation between atherogenic index of plasma and cardiovascular disease risk across Cardiovascular–kidney–metabolic syndrome stages 0–3: a nationwide prospective cohort study

BackgroundThe Cardiovascular–kidney–metabolic (CKM) syndrome, a concept recently proposed by the American Heart Association (AHA), highlights the intricate connection between metabolic, renal, and cardiovascular illnesses. Furthermore, the Atherogenic Index of Plasma (AIP), a useful biomarker for evaluating the risk of Cardiovascular Diseases (CVDs), has been associated with the risk of Adverse Cardiovascular Events (ACEs). Nonetheless, its precise function in populations in CKM syndrome Stages 0–3 remains unknown.MethodsThis prospective study analyzed the data of 7,708 eligible participants (aged ≥ 45 years) from the Chinese Longitudinal Research of Ageing (CHARLS), particularly the 2011–2012 baseline survey (Wave 1). The primary exposure variable was AIP—a natural logarithm of the ratio of Triglycerides (TGs) to High-Density Lipoprotein Cholesterol (HDL-C). On the other hand, the primary endpoint was CVD incidence, which was determined based on self-reported past diagnoses. The relationship between AIP and CVD risk in the population in CKM syndrome stages 0–3 was examined using a Cox proportional risk model. Subgroup and mediation analyses were performed to further elucidate the interactions among these factors.ResultsThis study involved 7,708 participants in the CKM syndrome stages 0–3 [Mean age = 58.00 years; Interquartile Range (IQR) = 52.00–65.00 years]. The risk of developing CVD increased significantly with higher AIP levels. Specifically, the risk ratio for each unit increase in AIP was 1.31 (95% CI 1.11–1.55), while the Hazard Ratio (HR) for the group with the highest AIP levels compared to the group with the lowest AIP levels was 1.22 (95% CI 1.08–1.39). Mediation analysis revealed that metabolic syndrome accounted for 12.3% of the association between AIP levels and CVD risk (p = 0.024), highlighting its significance in CVD risk assessment.ConclusionHerein, AIP levels correlated significantly positively with CVD risk in individuals in CKM stages 0–3, with metabolic syndrome as a key mediating factor. These findings suggest that AIP levels could be valuable not only for CVD risk assessment but also for clinical screening.

Evaluating atherogenic index of plasma as a predictor for metabolic syndrome: a cross-sectional analysis from Northern Taiwan.

The rising global prevalence of metabolic syndrome (MetS), characterized by a constellation of cardiovascular risk factors, underscores the urgent need to identify reliable predictive biomarkers. We hypothesize that an elevated atherogenic index of plasma (AIP) predicts MetS risk through lipid imbalance, but population-specific variations in its predictive strength remain unexplored. Our study aimed to assess AIP), a ratio of triglycerides to high-density lipoprotein cholesterol, as a predictor of MetS. Between 2014 and 2018, our cross-sectional study collected and analyzed health examination data from 9,202 Northern Taiwan Medical Center employees without cardiovascular diseases, diabetes, and end-stage renal disease (ESRD). Our study classified AIP levels equally into three tertiles and evaluated their impact on MetS through a logistic regression model. After adjusting for age, gender, BMI, SBP, FPG, and LDL in our models, the ORs for MetS in the second and third tertiles of the AIP were 3.81 (95% CI: 2.33 to 6.21; OR: 37.14, 95%: 23.22 to 59.39). In addition, women have a higher MetS risk associated with elevated AIP than men across all models. Our research identified the AIP as a significant predictive marker for the prevalence of MetS, suggesting its potential utility in clinical risk assessment and indicating the need for further research to explore its application in preventive strategies and therapeutic interventions.

Prognostic value of atherogenic index of plasma in pulmonary hypertension.

The atherogenic index of plasma (AIP) is a brand-new lipid parameter that has been used to assess various cardiovascular events. This study aimed to investigate the prognostic value of AIP in patients with pulmonary hypertension (PH). This retrospective study was conducted at Shanghai Jiao Tong University School of Medicine affiliated Renji Hospital, and included data from 125 PH patients treated during 2014-2018. The endpoint events of this study were clinical worsening outcomes. PH patients include those from group 1 and group 4. AIP was determined as the logarithm of the blood triglycerides ratio to high-density lipoprotein cholesterol. The 1-year, 3-year, and 5-year incidence rates of clinical worsening outcomes in PH patients in this study were 20.0, 44.8, and 54.4%, respectively. The median age of the PH patients was 38.00 years, with females accounting for 90.4%. After controlling for multivariable factors, the results of Cox regression analysis indicated that AIP was an independent predictor of adverse outcomes with a hazard ratio and 95% confident interval (CI) of 2.426 (1.021-5.763). The positive linear relationship of AIP was evaluated using restricted cubic spline analysis. Kaplan-Meier curves showed a significantly higher events rate in patients with AIP ≥ 0.144 compared to those with AIP < 0.144 (p = 0.002). Four potential prognostic variables, including AIP, were identified by LASSO regression to construct a nomogram. Compared to the model minus AIP, the AUC of the nomogram displayed a non-significant improvement (0.749 vs. 0.788, p = 0.298). In contrast, the results of net reclassification improvement (0.306, 95% CI: 0.039-0.459, p < 0.001) and integrated discrimination improvement (0.049, 95% CI: 0.006-0.097, p = 0.020) demonstrated significant enhancements in the predictive ability of the model when AIP was added to the clinical model. AIP is an independent predictor of long-term clinical worsening in PH patients, and its inclusion in prognostic models could improve risk stratification and management.

The Relationship Between Ambulatory Blood Pressure and Atherogenic Index with LV Geometry Pattern in Obese Children: Results from a Cross-Sectional Study in Serbia.

Arterial hypertension and increased atherogenic index of plasma (AIP) are strong predictors of cardiovascular risk associated in individuals with obesity both in adults and children. Thus, we aimed to explore the relationship between AIP and systolic ambulatory blood pressure index (sABPI) with left ventricular geometry pattern in obese children. In this cross-sectional study, a total of 129 obese children (BMI greater or equal to the 95th percentile for age and sex) were examined. Fasting blood samples were taken to measure plasma glucose level, lipid profile, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), serum uric acid (SUA), and insulin level. Two-dimensional (2-D) transthoracic echocardiography was performed to determine left ventricular geometry pattern. Ambulatory blood pressure recording wasobtained for 24h in all obese children. Linear regression analyses were conducted to explore relationships between AIP (calculated as logarithmic transformation of the ratio of TG to HDL-C) and sABPI with left ventricular myocardial mass index (LVMI) and relative wall thickness (RWT). We also used sex as a potential effect modifier, and calculated stratum-specific estimates of the effect. We demonstrated independent and positive association of age and AIP with RWT (Age: effect size = 0.83 (CI 0.22 - 1.45) p = 0.008; AI effect size 8.9 (CI 3.6 - 14.3); p = 0.01). In a subgroup analysis with sex as an effect modifier, independent positive association of borderline significance at p = 0.011 was found between AIP and RWT only in boys AIP: effect size 9.5 (CI 2.3 - 16.7) p = 0.01. LVMI was significantly associated with sex and BMI (sex: effect size = 6.8 CI (2.6 - 11) p = 0.002; BMI z score: effect size = 6.8 CI (3.2-10.4) p < 0.001). Independent positive association was also found between BMI and LVMI for girls, effect size = 11.9 (CI 4.1-19.8) (p = 0.005). AIP and age are independently associated with the presence of concentric left ventricular geometry with girls seeming more protected from atherogenic hypertrophic stimulus than boys. BMI and sex are independently associated with eccentric left ventricular remodeling, with BMI being a greater risk factor for girls.

The association between triglyceride to high-density-lipoprotein cholesterol ratio and calcific aortic valve disease: a retrospective study

BackgroundThe ratio of triglycerides to high-density-lipoprotein cholesterol (TG/HDL-C) is increasingly recognized as a practical marker for insulin resistance and cardiovascular risk assessment. This retrospective study investigates the potential of the TG/HDL-C ratio to predict the development of calcific aortic valve disease (CAVD), thereby extending its applicability in cardiovascular diagnostics.MethodsData from 400 individuals, comprising 200 patients with diagnosed CAVD and 200 matched healthy controls, were analyzed. Clinical parameters were compared between groups, and logistic regression was utilized to explore the association of the TG/HDL-C ratio with CAVD. The diagnostic performance of the TG/HDL-C ratio was assessed using receiver operating characteristic (ROC) curves.ResultsThe TG/HDL-C ratio was notably higher in the CAVD group than in the controls (Z = -7.98, P < 0.001). Multivariable logistic regression analysis indicated that the TG/HDL-C ratio is an independent predictor of CAVD after adjusting for confounders including gender. The ROC curve analysis revealed that the TG/HDL-C ratio achieved a sensitivity of 80.5%, a specificity of 59.5%, and an area under the curve (AUC) of 0.731 (P < 0.001), confirming its efficacy in predicting CAVD.ConclusionsHigh TG/HDL-C ratio was significantly associated with the occurrence of CAVD, and the TG/HDL-C ratio could be used as a potential diagnostic tool and risk assessment indicator for CAVD.Clinical trial numberNot applicable.

Optimizing treatment of cardiovascular risk factors in cerebral small vessel disease using genetics.

Cerebral small vessel disease (cSVD) causes lacunar stroke (LS), intracerebral haemorrhage, and is the most common pathology underlying vascular dementia. However, there are few trials examining whether treating conventional cardiovascular risk factors reduce stroke risk in cSVD, as opposed to stroke as a whole. We used Mendelian randomization techniques to investigate which risk factors are causally related to cSVD and to evaluate whether specific drugs may be beneficial in cSVD prevention. We identified genetic proxies for blood pressure traits, lipids, glycaemic markers, anthropometry measures, smoking, alcohol consumption, and physical activity from large-scale genome-wide association studies of European ancestry. We also selected genetic variants as proxies for drug target perturbation in hypertension, dyslipidaemia, hyperglycaemia, and obesity. Mendelian randomization was performed to assess their associations with LS from the GIGASTROKE Consortium (n = 6811) and in a sensitivity analysis in a cohort of patients with MRI-confirmed LS (n = 3306). We also investigated associations with three neuroimaging features of cSVD, namely, white matter hyperintensities (n = 55 291), fractional anisotropy (n = 36 460), and mean diffusivity (n = 36 012). Genetic predisposition to higher systolic and diastolic blood pressure was associated with LS and cSVD imaging markers. Genetically predicted liability to diabetes, obesity, smoking, higher triglyceride levels, and the ratio of triglycerides to high density lipoprotein (HDL) also showed detrimental associations with LS risk, while genetic predisposition to higher HDL concentrations and moderate-to-vigorous physical activity showed protective associations. Genetically proxied blood pressure-lowering through calcium channel blockers (CCBs) was associated with cSVD imaging markers, while genetically proxied HDL-raising through Cholesteryl Ester Transfer Protein (CETP) inhibitors, triglyceride-lowering through lipoprotein lipase (LPL), and weight-lowering through gastric inhibitory polypeptide receptor (GIPR) were associated with lower risk of LS. Our findings highlight the importance of some conventional cardiovascular risk factors, including blood pressure and BMI, in cSVD, but not other e.g. LDL. The findings further demonstrate the potential beneficial effects of CCBs on cSVD imaging markers and CETP inhibitors, LPL enhancement, and GIPR obesity-targeted drugs on LS. They provide useful information for initiating future clinical trials examining secondary prevention strategies in cSVD.

L-shaped relationship between atherogenic index of plasma with uric acid levels and hyperuricemia risk

BackgroundHyperuricemia is a major risk factor for cardiovascular disease. This study aimed to investigate the relationship between the atherogenic index of plasma (AIP) and serum uric acid (SUA) levels, as well as the risk of hyperuricemia.MethodsUtilizing data from the National Health and Nutrition Examination Survey (NHANES), we conducted a cross-sectional study involving 9,439 participants aged 18 years and above with complete triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) data. AIP was calculated as the logarithm of the ratio of TG to HDL-C. Weighted linear regression, weighted logistic regression, subgroup analysis, generalized additive model, restricted cubic spline and two-part linear and logistic regression were utilized to examine the relationships between AIP and SUA levels and hyperuricemia risk.ResultsWe identified a non-linear and L-shaped relationship between AIP and both SUA levels and hyperuricemia prevalence, with significant increasing observed up to a saturation point (0.588 for uric acid levels and 0.573 for hyperuricemia prevalence). Below these thresholds, the odds ratios (OR) for increased SUA and hyperuricemia were 0.854 (95% confidence interval [CI]: 0.762, 0.946) and 4.4 (95% CI: 3.528, 5.488), respectively (P&amp;lt;0.001). Beyond these points, the associations were not statistically significant.ConclusionOur findings suggest that AIP is significantly and non-linear associated with SUA levels and hyperuricemia risk, with a saturation effect observed beyond specific thresholds. These insights could inform clinical strategies for managing cardiovascular and metabolic risks associated with elevated AIP. Further longitudinal studies are warranted to confirm these associations and elucidate the underlying mechanisms.

Effect of blood flow restriction training on insulin resistance in men with metabolic syndrome: a randomized controlled trial

Introduction. Metabolic syndrome is defined as a pathological condition characterized by abdominal obesity, hypertension, dyslipidemia, and impaired glucose tolerance. Insulin resistance is hypothesized to underlie metabolic syndrome. Modern studies, including Mendelian randomization, have demonstrated that muscle strength and muscle mass may play an important role in the mechanisms of insulin resistance. Aim. To establish the relationship between relative upper limb muscle strength and triglyceride/glucose index, and to evaluate the effects of different resistance exercise regimens on alternative measures of insulin resistance in men with metabolic syndrome. Materials and methods. At the first stage of the study, 216 men aged from 25 to 50 years were examined. The relative muscle strength of the upper limbs in the bench press exercise and the triglyceride/glucose index were assessed. At the second stage, a randomized controlled trial was conducted, for which 60 men who met the criteria for metabolic syndrome. Men with metabolic syndrome were divided into three groups: low-intensity strength training with blood flow restriction (n = 20), high-intensity strength training (n = 20), low-intensity strength training without blood flow restriction (n = 20). Training was carried out 2 times a week for 12 weeks. Before and after the study, the triglycerides/glucose index, the ratio of triglycerides to high-density lipoproteins, and the combination of the triglycerides/glucose index with body mass index were assessed. Results and discussion. It was found that the relative muscle strength of the upper limbs was inversely proportional to the triglycerides/glucose index (r = –0.52; p 0.05) in the examined men. After 12 weeks of resistance training, statistically significant reductions in triglyceride/glucose index, triglyceride/high-density lipoprotein ratio, and triglyceride/glucose index/body mass index combination were found for the low-intensity resistance training with blood flow restriction and high-intensity resistance training groups (both, p 0,01). Changes in body composition, an increase in the proportion of muscle fibers I and IIa and a decrease in the proportion of muscle fibers IIx, an increase in the activity of glucose transporters, and a decrease in systemic inflammation are the main potential mechanisms for the beneficial effects of resistance training, including in combination with blood flow restriction, on insulin resistance in men with metabolic syndrome. Conclusion. There is an inverse relationship between muscle strength and triglycerides/glucose index; resistance training is an effective and safe tool for reducing alternative indicators of insulin resistance and can be included in comprehensive correction programs for men with metabolic syndrome.

The triglyceride-to-high-density lipoprotein cholesterol ratio is associated with an increased risk of peripartum cardiomyopathy.

Peripartum cardiomyopathy (PPCM) is a form of heart failure that severely affects women during the late stages of pregnancy and in the postpartum period. Currently, the diagnosis of PPCM is not fully understood and is likely multifactorial. Abnormal lipid metabolism plays an important role in the onset of cardiovascular diseases, especially in patients with heart failure. Moreover, animal experiments have confirmed a possible association between abnormal lipid metabolism and PPCM onset. However, clinical evidence is currently lacking, and reliable and effective indicators for predicting the onset of PPCM are insufficient. The ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) is a novel metabolic marker that is associated with the risk of coronary heart disease. However, the relationship between the TG/HDL-C ratio and the risk of PPCM in parturients remains unknown. Therefore, this study aimed to explore the role of the TG/HDL-C ratio in predicting the risk of PPCM. This study included 600 parturients hospitalized at Qilu Hospital of Shandong University between January 2010 and August 2023 (150 patients with PPCM and 450 healthy parturients). The TG/HDL-C ratio was calculated as triglyceride levels (mmol/L)/high-density lipoprotein cholesterol levels (mmol/L). The relationship between the TG/HDL-C ratio and PPCM was analyzed using logistic regression analysis and receiver operating characteristic curve analysis. Significant differences were observed in the TG/HDL-C ratio between patients with PPCM and healthy parturients. The TG/HDL-C ratio was higher in patients with PPCM than in healthy parturients (p < 0.001). Logistic regression analysis revealed that the TG/HDL-C ratio increased the risk of PPCM and had predictive accuracy for the onset of PPCM (odds ratio, 1.249; 95% confidence interval, 1.004-1.553; p = 0.046). Moreover, the TG/HDL-C ratio was positively correlated with the NT-proBNP levels at the onset of PPCM (R 2 = 0.081, p = 0.008). A higher TG/HDL-C ratio was significantly associated with the risk of PPCM.

Correlation between cardiometabolic index and female infertility: a cross-sectional analysis

BackgroundObesity and adverse lipid profile leads to female infertility. The cardiometabolic index (CMI) is a promising indicator for predicting obesity-related diseases. The correlation between CMI and female infertility merits further investigation.MethodsThe data for this study were acquired from the 2013–2020 National Health and Nutrition Examination Survey (NHANES), with 2333 women enrolled. The cardiometabolic index (CMI) of each participant was calculated as the ratio of triglycerides and high-density lipoprotein cholesterol multiplied by waist-to-height ratio. Weighted multivariate logistic regression models were used to assess the independent correlation between the log-transformed CMI and infertility. Subgroup analyses were carried out to assess the reliability of the findings. Interaction tests were employed to determine whether variables affected infertility by interacting with log CMI.ResultsA total of 2333 participants aged 18–45 years were enrolled, 274 of whom were infertile. Log CMI of the infertility group was significantly higher than that of the non-infertility group (P < 0.001). After adjustment for potential confounders, women with higher CMI were at an increased risk of infertility (OR = 2.411, 95% CI: 1.416–4.112), and this correlation was still consistent in subgroups aged under 35 years (P < 0.001). Furthermore, restricted cubic spline analysis showed a positive non-linear relationship between log CMI and infertility.ConclusionsCardiometabolic index levels are positively correlated with increased risk of infertility in American females. Our study demonstrates the predictive capacity of CMI for female infertility.

Triglyceride and Glucose Index as an Optimal Predictor of Metabolic Syndrome in Lebanese Adults.

Background: Globally, the prevalence of metabolic syndrome (MetS) is on the rise, especially in Arab countries, which emphasizes the need for reliable ethnic-specific biochemical screening parameters. Methods: Two hundred twenty-one Lebanese adults were enrolled in this cross-sectional study. Biochemical parameters including Homeostasis Model Assessment (HOMA), Triglyceride and Glucose index (TyG), ratio of Triglycerides to High-Density Lipoprotein Cholesterol (TG/HDL-C), Atherogenic Index of Plasma (AIP), and Visceral Adiposity Index (VAI) were assessed for their prediction of MetS. Analysis of covariance, logistic regression, expected-versus-observed case ratio were used to determine model calibration, concordance statistic, area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs), sensitivity, specificity, and negative and positive predictive values (PPV, NPV). Results: The prevalence of MetS was 44.3%. All biochemical parameters were significantly associated with MetS, with a strong model discrimination (c-statistic between 0.77 and 0.94). In both sex categories, TyG best predicted MetS (females: cut-off value, 8.34; males: cut-off value, 8.43) and showed good estimation among females, but overestimation among males. HOMA had the lowest discriminatory power in both sex categories. Conclusions: This study suggests that TyG best predicts MetS, while HOMA has the lowest predictive power. Future larger studies need to focus on harmonizing ethnic specific cut-offs and further validating our results.

Predicting atrial fibrillation within 7 years follow-up using machine learning models

Abstract Background The prevalence of atrial fibrillation (AF), the most common type of cardiac arrhythmia, has increased globally. AF is also the leading cardiac factor for several cardiovascular and cerebrovascular events. Early prediction and treatment of AF prevents major cardiovascular and cerebrovascular events. Purpose Our objective is to predict AF risk within 7-years follow-up using only twelve basic factors and applying machine learning (ML) models. Methods Data from the German epidemiological trial on ankle brachial index (getABI) were utilized in this work. GetABI includes 6,457 patients with mean age of 72.53 years. 3,985 individuals were assessed for AF of which 393 patients suffered from AF at 7-years follow-up. The feature selection was initially done manually, ending up in 45 features. The 10 best features were extracted from this dataset according to the SHAP (SHapley Additive exPlanations) values. The final features were body mass index, sensitive CRP, cholesterol, LDL-cholesterol, troponin I, NT-pro-BNP, glomerular filtration rate, ratio of triglycerides and HDL-cholesterol, gamma-GT, heart rate, including age and sex as major factors. The handling of missing values was achieved by SimpleImputer, estimating the mean values. XGBoost and Random Forest predicted AF. Logistic Regression was also used as a baseline model. The data were split into training and test set and ML models were applied for 100 iterative runs, extracting results with mean values. Results XGBoost was the most accurate model, predicting the AF with 71.19 % mean accuracy, 66.37 % mean sensitivity and 75.61 % mean specificity. Figure 1 depicts the performance of all models. Additionally, Receiver Operating Characteristic Curve (ROC) and Area Under Curve (AUC) for each model are presented in Figure 2. XGBoost also outperformed all the others models, achieving the highest mean AUC value, equal to 70.99 %. Contrariwise, logistic regression had the lowest overall performance. Conclusion ML models, specifically XGBoost, achieved accurate AF prediction in 3,985 individuals utilizing only twelve clinical-routine data.Evaluation results of each used model.ROC curve and AUC value of each model.

Associations between pre-diagnostic plasma metabolites and biliary tract cancer risk in the prospective UK Biobank cohort.

Biliary tract cancer (BTC) is potentially influenced by metabolic dysregulation yet previous metabolomic evaluations are limited. To address this gap, we prospectively investigated associations of blood metabolites and BTC risk in the UK biobank cohort study. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) between 249 plasma metabolites per standard deviation and BTC risk in 232,781 participants. We implemented exploratory factor analyses and evaluated associations between factors and BTC risk. Associations at p-value<0.001 were considered statistically significant after multiple comparison adjustments. In a median follow-up of 11.8 years, we identified 268 first primary incident BTC cases. Of 49 biomarkers significantly associated with BTC risk, 12% were fatty acids, and 49%, 31%, and 8% were cholesterol, triglyceride, and phospholipid to total lipids ratios, respectively. Multiple cholesterol ratios were inversely associated with BTC with HRs (95% CIs) of 0.74 (0.65-0.84), p<6.0x10-6. Conversely, a triglyceride ratio was positively associated with BTC with an HR (95% CI) of 1.40 (1.22-1.61), p=2.5x10-6. Congruently, a factor high in cholesterol measures and low in triglyceride measures was inversely associated with BTC. Multiple metabolite biomarkers were associated with BTC risk, suggesting metabolism has a substantial role in BTC etiology.

Prevalence and clinical correlates of impaired fasting blood glucose in children and adolescents with depressive disorder and relationship with triglyceride and high-density lipoprotein ratio

Depressive disorder is a significant public health problem worldwide, which adversely affects children and adolescents’ health. Impaired fasting blood glucose (IFG) is more common in depressive disorder, which becomes a clinical problem that needs to be focused on. The study purposed to determine the prevalence and related factors of IFG in Chinese children and adolescents with depressive disorder and the relationship between triglyceride and high-density lipoprotein cholesterol (TG/HDL-C) ratio and IFG. This research encompassed 756 individuals aged 8 to 18 with major depressive disorders, all diagnosed under DSM-5 criteria at the Third People’s Hospital of Fuyang from January 2020 to December 2021. We detected fasting blood glucose (FBG) and lipid levels and assessed the suicidal behaviors and depressive symptoms severity of each participant. The sociodemographic and included study variables were collected and analyzed. Our study employed multiple logistic regression to discern independent factors affecting IFG in conjunction with depressive disorders among children and adolescents. The prevalence of IFG was 6.5% (49/756). IFG was positively correlated with FBG, BMI, TG, TG/HDL-C, and was negatively correlated with gender and the type of antidepressant drug taken. Binary logistic analysis showed that male (OR = 2.57, 95% CI: 1.43–4.63, P = 0.002) and higher levels of TG (OR = 1.63, 95% CI: 1.11–2.38, P = 0.013) were independently associated with IFG in children and adolescents with depressive disorder. The incidence of IFG in children and adolescents with depressive disorder was high and was positively related to the TG/HDL-C ratio. The evaluation and management of IFG in pediatric depression should extend beyond pharmacological interventions. Comprehensive strategies in both assessment and management of IFG are essential to address this condition effectively in young patients facing depressive disorders.

Mendelian randomization reveals that abnormal lipid metabolism mediates the causal relationship between body mass index and keratoconus

Previous studies suggest that a high body mass index (BMI) may be a risk factor for keratoconus (KC), but the causal relationship remains unclear. This study used Mendelian randomization (MR) to investigate this connection and explore the mediating role of circulating serum metabolites and inflammatory factors in this association. Two-sample MR analysis was conducted to assess the relationship between BMI and KC. The study employed a two-step MR approach to evaluate the mediating roles of 91 inflammatory markers and 249 serum metabolites in the BMI-KC relationship. Inverse variance weighting (IVW) was the primary method, and multiple sensitivity analyses were performed to ensure robustness. IVW analysis revealed a positive causal relationship between BMI and KC (OR IVW = 1.811, 95% CI 1.005–3.262, P = 0.048). Although IL-12β and IL-4 were causally associated with KC, they did not mediate the BMI-KC relationship. Five serum metabolites were identified as potential mediators, with HDL cholesterol and triglyceride ratios showing significance. This study clarified the causal relationship between high BMI and KC, suggesting that high BMI may induce KC through lipid metabolism abnormalities. These findings underscore the importance of managing BMI for KC prevention.

Assessing the Serum Triglyceride and Fasting plasma Glucose Ratio as a Predictor of Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus, A Cross-sectional study.

Introduction: Cardiovascular complications, including left ventricular diastolic dysfunction (LVDD), are major concerns in Type 2 Diabetes Mellitus (T2DM) patients, often preceding heart failure and increasing mortality. Early detection of LVDD is essential to improving outcomes, yet current diagnostic methods are often costly and impractical for routine screening. This study aimed to evaluate the correlation between the serum triglyceride to fasting plasma glucose (TG/FPG) ratio and LVDD in T2DM patients, as a potential cost-effective biomarker for cardiovascular risk stratification. Methodology: This observational analytical study was conducted over a period of one year at a tertiary care hospital in northeast India to assess the correlation of TG/FPG ratio with LVDD in patients with T2DM. A total of 100 participants, aged 18 years or above and diagnosed with T2DM, were included. Exclusion criteria comprised Type 1 Diabetes Mellitus, pregnancy, pre-existing hypertension, cardiovascular diseases, and patients denying consent. Participants were recruited using convenient sampling, with every alternate eligible patient enrolled until the target sample size was reached. Data collection included measuring fasting plasma glucose (FPG) and postprandial blood glucose, HbA1c, fasting lipid profile, kidney function test, and urinalysis. The cardiovascular evaluation consisted of chest radiography, electrocardiogram, and echocardiography using standardized parameters to classify LVDD into grades I, II, and III, based on E/A and E/e’ ratios. Statistical analysis was performed using SPSS version 15, with Chi-square test and student’s t-tests applied for significance (p-value &lt; 0.05), and regression analysis was used to identify associations. Ethical approval was obtained, and participant confidentiality was maintained throughout the study. Result: A cross-sectional study was conducted over one years at a tertiary hospital in northeast India, enrolling 100 participants with T2DM, excluding those with comorbidities or cardiovascular symptoms. The mean age of participants was 45.52 years, with a male-to-female ratio of 1.21:1. Diastolic dysfunction was evaluated using echocardiography, and the TG/FPG ratio was calculated for each patient. LVDD was found in 58.7% of the participants, classified into grade I (40.4%), grade II (13.5%), and grade III (4.8%). Statistical analysis revealed a significant positive correlation between the TG/FPG ratio and LVDD (p- value= 0.0001). Higher TG/FPG ratios were associated with worse diastolic function, suggesting that this ratio reflects combined metabolic disturbances contributing to myocardial dysfunction. Patients with LVDD had significantly higher lipid profiles and poorer glycemic control compared to those with normal LV function. The TG/FPG ratio, being easily obtainable from routine laboratory tests, offers a convenient tool for identifying individuals at higher risk for LVDD. Conclusion: The TG/FPG ratio may serve as a simple, accessible, and cost-effective marker for early detection of LVDD in T2DM patients. Incorporating this ratio in clinical practice could improve cardiovascular risk stratification and facilitate timely interventions, ultimately reducing the burden of cardiovascular disease in diabetic populations.

High-density lipoprotein functionality in cholesterol efflux in early childhood is related to the content ratio of triglyceride to cholesterol

Cholesterol efflux capacity (CEC), commonly measured as a useful risk marker of atherosclerotic cardiovascular disease, depends on high-density lipoprotein (HDL) functionality and its concentration. We defined the relative HDL functionality in cholesterol efflux, not influenced by HDL concentration, as the ratio of measured CEC to standardized CEC (stCEC) based on HDL-cholesterol (HDL-C) of each individual using the curve regression equation obtained from the correlation. HDL-C, CEC, and CEC/stCEC levels in the < 28-day-old participants (neonates) were significantly low compared to those of the ≥ 28-day-old participants, indicating that the low CEC levels in the neonates depend on not only lower HDL-C but also lower HDL functionality. The low level of CEC/stCEC was remarkable in neonates born at < 34 weeks of gestation and did not improved to the reference level (1.000) until the infantile period. The relatively low or high CEC/stCEC ratios in neonates and infants were associated with lower or higher HDL-TG and HDL-TG/HDL-C ratio, respectively. However, no apparent effect of HDL-TG and HDL-TG/HDL-C ratio on CEC/stCEC was observed in the ≥ 1-year-old participants, indicating that HDL functionality in cholesterol efflux could be associated with the various HDL particles with various lipid compositions, but not just with HDL-TG and HDL-TG/HDL-C ratio.

Efficacy and Safety of Adding Empagliflozin to Liraglutide on Renal Function in Patients with Advanced-Stage Type 2 Diabetic Kidney Disease: A Randomized Controlled Trial.

The aim of this study was to investigate the additional effects of empagliflozin on liraglutide in patients with advanced-stage type 2 diabetic kidney disease. Forty-one patients were randomly assigned (1:1) to treatment with liraglutide alone during the first 6 months and subsequent treatment with liraglutide plus empagliflozin during the next 6 months (liraglutide plus empagliflozin group) (n = 20) or treatment with liraglutide alone for 12 months (liraglutide group) (n = 21). Liraglutide was administered subcutaneously once daily at a starting dose of 0.3 mg/day and up-titrated weekly by 0.3 mg to a maximum dose of 0.9 mg/day. Empagliflozin was administered orally at a dose of 10 mg once daily. The primary outcome was the change in renal function (estimated glomerular filtration rate) during the latter 6 months. Secondary outcomes were changes in body weight, systolic blood pressure, hemoglobin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, uric acid, blood glucose, hemoglobin A1c, and urine protein creatinine ratio during the latter 6 months. Empagliflozin significantly increased the hemoglobin concentration (from 12.9 ± 1.9 to 13.7 ± 1.9 g/dL; p<0.05) and decreased body weight (from 66.1 ± 12.9 to 64.5 ± 12.6 kg; p<0.05). No significant differences were observed between the groups for estimated glomerular filtration rate, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, uric acid, blood glucose, hemoglobin A1c, and urine protein creatinine ratio. Empagliflozin increased hemoglobin concentration and decreased body weight in patients with advanced-stage type 2 diabetic kidney disease who received liraglutide. However, empagliflozin did not provide short-term benefits with regard to renal function decline, urinary protein excretion, or glycemic control in these patients.

HTLV1 infection and long term association with liver function and lipid indices; 10 years’ follow-up

BackgroundHuman T-cell leukemia virus type 1 (HTLV-1) is a well-known retrovirus, particularly prevalent in northeastern Iran, where it is associated with a range of disorders, including liver dysfunction. Previous studies have demonstrated that HTLV-1 infection can alter lipid profiles, yet no research has examined lipid indices and liver function tests in these patients in the long term.MethodsThis data is part of the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study. A total of 1116 participants were randomly selected, including 837 healthy individuals and 279 HTLV-1-infected patients. Following a 10-year follow-up period, Serum levels of liver enzymes were measured. Lipid indices such as the Atherogenic Index of Plasma (AIP), Body Adiposity Index (BAC), Castelli risk index (CRI-I, CRI-II), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), Triglyceride-glucose index (TyG), and Triglyceride and HDL-C Ratio (THR) were calculated.ResultsMultivariable-adjusted regression analysis demonstrated a significant coefficient for the Visceral Adiposity Index (VAI) in HTLV-infected patients compared to healthy controls (B: -0.014, 95% CI: -0.02, 0.00, p = 0.046). However, no significant differences were observed in other lipid indices between HTLV-infected patients and healthy individuals. Regarding liver enzymes, significant variations were noted in HTLV-infected patients compared to healthy controls: Aspartate Aminotransferase (AST) (B: 2.978, 95% CI: 1.34, 4.61, p < 0.001), Alanine Aminotransferase (ALT) (B: 3.687, 95% CI: 1.59, 5.78, p = 0.001), Alkaline Phosphatase (ALP) (B: 18.232, 95% CI: 6.81, 29.65, p = 0.002), and Gamma-Glutamyl Transferase (GGT) (B: 3.714, 95% CI: 0.18, 7.24, p = 0.039).ConclusionIndividuals with HTLV-1 infection exhibit reduced VAI but elevated levels of liver enzymes such as AST, ALT, ALP, and GGT, indicating liver damage. These findings emphasize the virus’s involvement in liver pathology. Also, HTLV-I is associated with reduced visceral fat tissue.

Mendelian randomization analysis reveals causal effects of blood lipidome on gestational diabetes mellitus

BackgroundObservational studies have revealed associations between maternal lipid metabolites and gestational diabetes mellitus (GDM). However, whether these associations are causal remain uncertain.ObjectiveTo evaluate the causal relationship between lipid metabolites and GDM.MethodsA two-sample Mendelian randomization (MR) analysis was performed based on summary statistics. Sensitivity analyses, validation analyses and reverse MR analyses were conducted to assess the robustness of the MR results. Additionally, a phenome-wide MR (Phe-MR) analysis was performed to evaluate potential side effects of the targeted lipid metabolites.ResultsA total of 295 lipid metabolites were included in this study, 29 of them had three or more instrumental variables (IVs) suitable for sensitivity analyses. The ratio of triglycerides to phosphoglycerides (TG_by_PG) was identified as a potential causal biomarker for GDM (inverse variance weighted (IVW) estimate: odds ratio (OR) = 2.147, 95% confidential interval (95% CI) 1.415–3.257, P = 3.26e−4), which was confirmed by validation and reverse MR results. Two other lipid metabolites, palmitoyl sphingomyelin (d18:1/16:0) (PSM(d18:1/16:0)) (IVW estimate: OR = 0.747, 95% CI 0.583–0.956, P = 0.021) and triglycerides in very small very low-density lipoprotein (XS_VLDL_TG) (IVW estimate: OR = 2.948, 95% CI 1.197–5.215, P = 0.015), were identified as suggestive potential biomarkers for GDM using a conventional cut-off P-value of 0.05. Phe-MR results indicated that lowering TG_by_PG had detrimental effects on two diseases but advantageous effects on the other 13 diseases.ConclusionGenetically predicted elevated TG_by_PG are causally associated with an increased risk of GDM. Side-effect profiles indicate that TG_by_PG might be a target for GDM prevention, though caution is advised due to potential adverse effects on other conditions.Graphical