Reduced HDL Cholesterol Research Articles

Organic beet leaves and stalk juice attenuates HDL-C reduction induced by high-fat meal in dyslipidemic patients: A pilot randomized controlled trial.

Beet leaves and stalks are rich in polyphenols; however, their effect on risk factors for cardiovascular disease in humans, to our knowledge, has not yet been investigated. The aim of this study was to analyze the acute effect of beet leaves and stalk juice, containing different concentrations of polyphenols, on lipemia, glycemic control, nitric oxide concentration, and blood pressure in patients with dyslipidemia after a high-fat meal. In a randomized double-blind, placebo-controlled, crossover pilot study, patients 20 to 59 y of age with dyslipidemia were fed a single high-fat meal supplemented with either a placebo or one of two organic beet leaves and stalk juices rich in polyphenols (32 or 77.5 mg EAG/100 mL) with a 1-wk washout. Thus, each group was composed of 13 patients. Blood samples were obtained at fasting and 30, 60, 120, and 180 min after intervention. Total cholesterol, high-density lipoprotein, triacylglycerols, glucose, insulin, nitrite and nitrate, and blood pressure were assessed at each time period. The high-fat meal increased triacylglycerol levels after 120 (P < 0.001) and 180 min (P < 0.001) and reduced high-density lipoprotein cholesterol after 60 min (P < 0.05). This reduction was attenuated in both groups that received BLS juices after 120 min (P = 0.005). A reduction in diastolic blood pressure within groups that received BLS juice was also observed. There was no significant difference between groups for other biomarkers. The beet leaves and stalk juice attenuated the reduction of high-density lipoprotein cholesterol induced by a high-fat meal.

Effects of Momordica Charantia (Bitter gourd) on Oxidative Stress and Pro-Inflammatory Marker in Metabolic Syndrome Using a High-Ffructose Diet Induced Rat Model

To understand the biological basis of the effect of Momordica charantia and also it’s effectiveness as a mono-therapy for metabolic syndrome. Thirty‑four adult male Sprague-Dawley rats weighing were divided into Groups I, II, III and IV having 10, 10, 8 and 6 animals respectively. Pellets with 66% fructose were fed to 28 animals [Groups I, II, III] while 6 normal control animals [Group IV] were fed with standard rat chow diet for 6 weeks. Later, for next 6 weeks, animals in Groups I, II and III were treated with M.charantia 300 mg/kg/day, and 600mg/kg/day and Standard treatment respectively. Serial measurements of body weight, BMI, fasting blood sugar, noninvasive blood pressure, serum lipid profile, LDA, SOD and serum NF-κB were assessed at the base line, at the end of 6 weeks of fructose diet and following treatment (12 weeks). Following induction, there was statistically significant increase in body weight, BMI, FBS, serum triglycerides, total cholesterol, LDL, lipid derived aldehydes and serum NF-κB while there was reduction in HDL cholesterol and SOD compared to baseline values. Following treatment Group II and III shown reversal of the parameters to the level of normalization. M. charantia 600 mg/kg/day had exclusively matched the therapeutic efficacy of the standard therapy given in combination. The biological basis of the effects of M.charantia was by inhibiting the inflammatory pathway in metabolic syndrome both at the levels of ROS generation and transcription of pro-inflammatory marker NF-κB.

Prevalence of metabolic syndrome among school children aged 6–18 years in Ein Al-Helwa Palestinian Refugee Camp, Lebanon: a cross-sectional study

BackgroundMetabolic syndrome is characterised by the presence of several metabolic abnormalities, including hyperglycaemia, central obesity (also known as abdominal obesity), elevated blood pressure, and an abnormal blood lipid profile. The prevalence of metabolic syndrome is rising rapidly around the world as childhood obesity is increasing. The aim of this study is to determine the prevalence of metabolic syndrome in school children aged 6–18 years residing in Ein Alhelwe Refugee camp in Saida, Lebanon. MethodsSchool children aged 6–18 years from the first to twelfth grades from two United Nations Relief and Works Agency (UNRWA) schools were randomly chosen. We used a school-based cross-sectional study design with two stages. The first stage included measurements of weight, height, body mass index (BMI), waist circumference, and blood pressure. In the second stage, blood tests were carried out for fasting blood sugar, triglycerides, and high-density lipoprotein (HDL). Approval was obtained from the ethics committee at Al Hamshari Hospital in Saida, Lebanon. Written permission was obtained from the UNRWA and the principals of the two schools for the first stage, and informed written consent was obtained from parents on behalf of the children involved in the second stage of the study. FindingsThe first stage of the research included 487 participants (258 female, 229 male) and the second stage included 73 participants (36 overweight participants [12 male, 24 female] and 37 obese participants [19 male, 18 female]). The prevalence of overweight and obesity were 15·2% (74 of 487) and 14·4% (70 of 487) among all age groups, respectively. Among Palestinian refugee school children in Saida aged 10–18 years, the prevalence of metabolic syndrome was more pronounced when the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) definition was used (30·9%; 21 of 68) compared to the International Diabetes Federation (IDF) definition (11·8%; eight of 68), with no statistical differences between male and female participants. Note that the IDF definition can be applied to children aged 10–18 years, of whom there were 68 participants, and for comparison between IDF and NCEP ATP-III, prevalence of metabolic syndrome was calculated for participants in this age range. Low HDL cholesterol (52·1%; 38 of 73), central obesity (46·6%; 34 of 73), and raised blood pressure (42·5%; 31 of 73) were the leading three common metabolic abnormalities among children who were overweight or obese. InterpretationThis study has shown that metabolic syndrome is common among children who are obese or overweight, who are aged 10–18 years, living in Ein Al-Helwa Refugee Camp in Saida, Lebanon. These data raise the importance of early prevention and treatment of metabolic syndrome and its components (abdominal obesity, elevated triglycerides, reduced HDL cholesterol, elevated blood pressure, and elevated blood glucose) to reduce the risk of diabetes and cardiovascular complications in susceptible individuals. A potential limitation of this study is that the small sample size may not accurately reflect the prevalence of metabolic syndrome. FundingPalestinian Civil Society Organizations Commission, Life Hope Center, and Palestinian Red Crescent Society Al Hamshari Hospital.

Cafeteria-diet induced obesity results in impaired cognitive functioning in a rodent model

ObjectivesThis study seeks to characterize the progressive course of physiological and behavioural outcomes in rodents following excessive caloric intake through the chronic consumption of a highly palatable diet, the cafeteria (CAF) diet. MethodsMale Sprague Dawley rats were maintained on either CAF or chow (CON) diets for 20 weeks. Metabolic and physiological parameters were monitored throughout the feeding period. From week 18, rats were subjected to behavioural testing, which included the Morris water maze (MWM) and novel object recognition (NOR) tasks. ResultsCAF rats consistently showed higher food intakes and consumed six times the energy of chow-fed rats, being significantly heavier by week 5. CAF rats further exhibited greater abdominal widths, fat pads, and larger fatty livers, as well as compromised glucose tolerance. Hyperinsulinemia and dyslipidaemia with elevated serum cholesterol and triglyceride levels and reduced HDL cholesterol were also evident along with a pro-inflammatory profile in the CAF rats. Cognitive decline in CAF rats manifested as a decline in long-term retention memory in the MWM. Further, CAF rats exhibited deficits in recognition memory as they spent less time exploring the novel object than chow-fed rats in the NOR task. DiscussionThis model of obesity is a robust paradigm for producing an obese animal phenotype that closely mimics the evolution of human obesity, complete with metabolic dysfunctions that are indicative of pre-diabetes. Additionally, chronic CAF-diet induced obesity promotes cognitive impairments in hippocampal-dependent reference and working memory.

Potential Gains of Screening Family Members of Suspected Coronary Artery Disease: A Pilot Study.

Background:Early diagnosis of asymptomatic coronary artery disease (CAD) is presently targeted in preventive cardiology. A positive family history though not modifiable can provide a window of opportunity for intervening on modifiable risk factors. We assessed the prevalence of risk factors among the family members of suspected CAD patients and estimated their 10 years CAD risk.Methods:In a hospital-based cross-sectional study, socio-demographic, personal data and blood samples for total and HDL cholesterol were collected. The risk of having a heart attack in the next 10 years was calculated using Framingham Risk Score.Results:The mean age of participants (n = 60) was 40.55 ± 1.78 years. 85% were physically inactive. Smoking (13%), alcohol use (12%), history of CAD (2%), HTN (12%) and diabetes (22%) were the observed risk factors. A family history of CAD at <40 years of age was reported by 7% of subjects. Prevalence of overweight was 21% and 11% were obese. Increased waist-hip ratio (43%), diabetes (22%), hypercholesterolemia (28%), reduced HDL Cholesterol (48%) were other prevalent risk factors. Risk of CAD of >1% in the next 10 years was noted among 60% of subjects.Conclusions:Window of opportunity for secondary prevention exists among the family members of suspected CAD.

A Prospective, Multicentre, Single Arm Clinical Study to Evaluate the Effect of Saroglitazar on Non High-Density Lipoprotein Cholesterol in Patients with Diabetic Dyslipidemia Inadequately Controlled with Diet, Exercise, and Statin-The GLIDDER Study

Objective: Diabetic dyslipidemia is highly atherogenic as it is associated with high triglyceride (TG), high small dense low-density lipoprotein (sd-LDL) particles and low high-density lipoprotein cholesterol (HDL-C). Saroglitazar, a dual peroxisome proliferator activated receptor agonist (predominant PPAR-α agonist and modest PPAR-γ agonist), is approved in India for the management of diabetic dyslipidemia. The GLIDDER study was done to evaluate the effects of Saroglitazar 4 mg on non HDL-C as the primary endpoint and sd-LDL particles as a secondary endpoint in diabetic patients with dyslipidemia. Methods: This study was a 24 weeks, prospective, multicentre, single arm study conducted in 104 patients with diabetic dyslipidemia (TG ≥ 200 mg/dL) inadequately controlled with diet, exercise, and statins. It was conducted from April 2015 to November 2017 at three Indian centres. All the selected patients were given Saroglitazar 4 mg once daily before breakfast for 24 weeks. Efficacy evaluations of non HDL-C (calculated as total cholesterol (TC) minus HDL-C) (primary endpoint) and other lipid parameters (sd-LDL particles, TC, TG, HDL-C) and glycemic parameters (glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG)) were conducted after 24 weeks and compared to the baseline levels. Results: Total 104 patients (22% female) with mean age of 59.1 ± 11.4 years were enrolled in this study. In the per-protocol population, there was a significant reduction in non HDL-C (from 142.3 ± 59.3 mg/dL (baseline) to 109.9 ± 45.5 mg/dL (week-24); p<0.0001) and sd-LDL (from 32.5 ± 11.3 mg/dL (baseline) to 25.9 ± 11.8 mg/dL (week-24); p<0.0001). There was a significant reduction in TG, TC, HbA1c, and FPG with a significant increase in HDL-C at week-24 from baseline levels (p<0.05). Conclusion: Saroglitazar effectively reduces non HDL-C and sd-LDL particles in patients with diabetic dyslipidemia.

Extremely Low HDL Cholesterol and Increased LDL Cholesterol Induced by the use of Anabolic Steroids in a Body Builder: A Case Study

A man engaged in body building repeatedly used anabolic steroids over a 5-year period. His initial lipids were HDL-C of 0.4 mmol/L and LDL-C of 4.6 mmol/L. After 10 weeks of discontinuation of anabolic steroid, his HDL-C markedly increased to 1.0 mmol/L and LDL-C was reduced to normal at 3.3 mmol/L. In the subsequent follow-up visits, he resumed anabolic steroid use several times with the lowest levels of HDL-C of 0.2-0.1 mmol/L accompanied by the highest levels of LDL-C at 5.8-6.5 mmol/L. This represented a 100% increase in LDL and a 90% reduction in HDL cholesterol. High LDL-C is universally accepted to be linked to atherosclerosis and low HDL-C is a risk factor for cardiovascular disease.

Metabolic Alterations in Celiac Disease Occurring after Following a Gluten-Free Diet

Background and Aim: Many investigations have demonstrated that changes in body weight are frequent in patients with coeliac disease (CD) after a gluten-free diet (GFD); conversely data on the metabolic syndrome (MS) and hepatic steatosis (HS) are still rare. The aim is to evaluate the prevalence of MS and HS in patients with CD, before and after a GFD. Methods: One hundred eighty-five coeliac adult patients were enrolled in the study. Diagnosis of MS was made according to the current international criteria including waist circumference (WC), hypertension, reduction of high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, and hyperglycemia. Body mass index (BMI), hypercholesterolemia, and HS were also assessed. Results: CD patients showed an increased risk of developing both MS and HS after following a GFD. MS was reported in 3.24% of the cases at the time of CD diagnosis and in 14.59% after GFD (p < 0.0001). HS was reported in 1.7% at the time of diagnosis and in 11.1% after GFD (p < 0.0001). With regard to metabolic sub-categories, the prevalence of the increase in WC, hypertension, reduction of HDL cholesterol, hyperglycemia, hypercholesterolemia, and BMI > 25 was significantly higher after GFD compared to baseline at CD diagnosis. Conclusion: In CD patients, following a GFD maybe can contribute to the development of MS and HS. Patients should be informed about this possible risk.

A novel splicing mutation in the ABCA1 gene, causing Tangier disease and familial HDL deficiency in a large family

Tangier disease is a rare disorder of lipoprotein metabolism that presents with extremely low levels of HDL cholesterol and apoprotein A-I. It is caused by mutations in the ATP-binding cassette transporter A1 (ABCA1) gene. Clinical heterogeneity and mutational pattern of Tangier disease are poorly characterized. Moreover, also familial HDL deficiency may be caused by mutations in ABCA1 gene.ATP-binding cassette transporter A1 (ABCA1) gene mutations in a patient with Tangier disease, who presented an uncommon clinical history, and in his family were found and characterized. He was found to be compound heterozygous for two intronic mutations of ABCA1 gene, causing abnormal pre-mRNAs splicing. The novel c.1510-1G > A mutation was located in intron 12 and caused the activation of a cryptic splice site in exon 13, which determined the loss of 22 amino acids of exon 13 with the introduction of a premature stop codon. Five heterozygous carriers of this mutation were also found in proband's family, all presenting reduced HDL cholesterol and ApoAI (0.86 ± 0.16 mmol/L and 92.2 ± 10.9 mg/dL respectively), but not the typical features of Tangier disease, a phenotype compatible with the diagnosis of familial HDL deficiency. The other known mutation c.1195-27G > A was confirmed to cause aberrant retention of 25 nucleotides of intron 10 leading to the insertion of a stop codon after 20 amino acids of exon 11. Heterozygous carriers of this mutation also showed the clinical phenotype of familial HDL deficiency.Our study extends the catalog of pathogenic intronic mutations affecting ABCA1 pre-mRNA splicing. In a large family, a clear demonstration that the same mutations may cause Tangier disease (if in compound heterozygosis) or familial HDL deficiency (if in heterozygosis) is provided.

Safety and tolerability of carvacrol in healthy subjects: a phase I clinical study

This study was designed to assess safety and tolerability of carvacrol in healthy individuals. Subjects were randomly divided into two groups receiving 1 and 2 mg/kg/day carvacrol. Before and after carvacrol administration, routine blood and urine laboratory tests and spirometry were performed for all participants. The results showed that one-month treatment with carvacrol did not significantly affect the measured variables. In the group receiving 1 mg/kg/day carvacrol, calcium, erythrocyte sedimentation rate (ESR), mean cell volume (MCV), hemoglobin (Hb), and hematocrit (HCT) levels were significantly reduced but creatinine phosphokinase (CPK) was significantly increased, after treatment compared to baseline values (p < 0.05–p < 0.001). There was significant reductions in high-density lipoprotein cholesterol (HDL), total bilirubin, amylase, iron, red blood cells (RBC) count, and HCT after one-month treatment with 2 mg/kg/day carvacrol compared to pretreatment values (p < 0.05–p < 0.01). Although, triglyceride (TG), phosphorus, lactate dehydrogenase (LDH), prothrombin time (PT), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly increased after treatment with carvacrol 1 mg/kg/day (p < 0.05–p < 0.001), all post-treatment measured parameters were within normal range. Treatment with carvacrol 2 mg/kg/day for one month increased FEV1 (p < 0.05). Nevertheless, there was no significant difference in measured variables except LDH, MCH, MCHC, and MCV (p < 0.05–p < 0.01), between the two groups. The results of this phase I study regarding carvacrol effects on healthy subjects, showed clinical safety and tolerability for this agent.

Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium

It has been argued that metabolically healthy obesity (MHO) does not increase cardiovascular disease (CVD) risk. This study examines the association of MHO with carotid intima-media thickness (cIMT), a proxy of CVD risk, in children and adolescents. Data were available for 3,497 children and adolescents aged 6-17 years from five population-based cross-sectional studies in Brazil, China, Greece, Italy, and Spain. Weight status categories (normal, overweight, and obese) were defined using BMI cutoffs from the International Obesity Task Force. Metabolic status (defined as "healthy" [no risk factors] or "unhealthy" [one or more risk factors]) was based on four CVD risk factors: elevated blood pressure, elevated triglyceride levels, reduced HDL cholesterol, and elevated fasting glucose. High cIMT was defined as cIMT ≥90th percentile for sex, age, and study population. Logistic regression model was used to examine the association of weight and metabolic status with high cIMT, with adjustment for sex, age, race/ethnicity, and study center. In comparison with metabolically healthy normal weight, odds ratios (ORs) for high cIMT were 2.29 (95% CI 1.58-3.32) for metabolically healthy overweight and 3.91 (2.46-6.21) for MHO. ORs for high cIMT were 1.44 (1.03-2.02) for unhealthy normal weight, 3.49 (2.51-4.85) for unhealthy overweight, and 6.96 (5.05-9.61) for unhealthy obesity. Among children and adolescents, cIMT was higher for both MHO and metabolically healthy overweight compared with metabolically healthy normal weight. Our findings reinforce the need for weight control in children and adolescents irrespective of their metabolic status.

Effects of Consumption of Various Fatty Acids on Serum HDL-Cholesterol Levels

Since HDL is an anti-atherogenic lipoprotein which plays a role in reversing cholesterol transport from the peripheral tissues to the liver, low HDL-cholesterol (HDL-C) levels are associated with the development of cardiovascular diseases. We previously studied effects of intake of various dietary fat on serum HDL-C levels to make “Dietary Reference Intakes for Japanese 2015”, and found that the substitution of fatty acids (FAs) for carbohydrates is beneficially associated with HDL-C, monounsaturated FA (MUFA) intake may not affect HDL-C and trans FA (TFA) is significantly associated with reduction of HDL-C. Consumption of n-3 poly-unsaturated FA (PUFA) was favorably associated with HDL-C. Here we review meta-analyses on the effects of various FA consumption on serum HDL-C levels, to make “Dietary Reference Intakes for Japanese 2020”. Consumption of ruminant-TFA may not affect HDL; however, increased industrially produced TFA intake was associated with a significant decrease in HDL and a significant increase in LDL. An intake of n-3 PUFA and MUFA was associated with an increase of HDL. An intake of saturated FA (SFA) was associated with an increase of HDL; however, SFA was also associated with an increase of LDL. J Endocrinol Metab. 2018;8(5):94-99 doi: https://doi.org/10.14740/jem534

Prevalence of Type 2 Diabetes Mellitus in Metabolic Syndrome Individuals

Metabolic Syndrome (MetS) can be defined as a cluster of cardio-metabolic dysfunctions characterized by the increase in fasting blood sugar, abdominal circumference, hypertension (HTN), triglycerides (TG) and reduction in high-density lipoprotein cholesterol (HDL) [1]. The prevalence of MetS is increasing all over the world with different regions having individual clusters of epidemic risk factors and there is evidence of a high prevalence of MS and diabetes in Asians [2,3]. Affecting approximately 25% of the world population, MetS accounts for 7% of overall mortality and 17% of deaths associated with cardiovascular disease (CVD). The literature emphasizes that individuals with MetS are two times more likely to die, regardless of the cause; three times more likely to have a heart attack and/or stroke; and five times more likely to develop type 2 diabetes (T2DM) [4,5].

A14654 Prevalence and relative factors of metabolic syndrome in occupational population of heavy industry in northern China

Objectives: To investigate the prevalence and relative factors of metabolic syndrome (MS) for the heavy industry workers in northern coastal district of China. Methods: We performed an observational study on the heavy industry workers in Leting County, Hebei Province of China. The standard epidemiologic method for cardiovascular diseases was used. Items of survey included questionnaire, physical examination, fasting blood sample collection. Metabolic syndrome was defined in accordance with the International Diabetes Federation (IDF) criteria in 2004. Results: Totally 2045 participants (men 1651, women 394) with aged 37.5 ± 8.2 yrs were included in the data analysis. The mean age was 37.3 ± 8.3 yrs and 38.1 ± 8.0 years (P > 0.05) for men and women respectively. The total prevalence of MS was 19.1%, for men and women were 20.4% and 13.7%, respectively (P = 0.002). When compared the differences of prevalence of MS between age groups, there were no significant differences in men, but not in women. In the subjects with MS, a higher prevalence of alcohol drinking, snoring, higher salt taste, lower dairy intake and lower tea drinking were observed. The individual components rank order of MS in men was raised triglycerides, raised blood pressure, raised fasting glucose and reduced HDL cholesterol, and the order in women was raised triglycerides, reduced HDL cholesterol, raised blood pressure, and raised fasting glucose. Conclusion: The prevalence of MS in occupational population of heavy industry was higher than normal population, especially in young men below 30 years old. Unhealthy lifestyle such as alcohol drinking, higher salt taste, less drinking tea and so on should be the risks of higher prevalence of MS. Intervention to the risk factors of MS would be important in the prevention and control of cardiovascular diseases.

Serum Lipid Profile and Its Association with Hypertension among Mongolian Adults

Objective: The purpose of this study was to investigate the relationship between serum lipid profile and hypertension among Mongolian adults. Methods: This population-based cross-sectional study was conducted between January and June 2018 in Mongolia. According to current European Society of Cardiology guidelines, hypertension was defined as an average systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg. Lipid profile (total cholesterol (TC), triglycerides (TG), high-density lipid [HDL], cholesterol and low-density lipid [LDL]-cholesterol) and fasting plasma glucose as well as Apolipoprotein B (ApoB), Apolipoprotein A (ApoA) and a ratio of apoB/apoA1 were estimated. Results: This study included 998 participants with a mean age ± SD of 49.4±14.8 years. Serum levels of TC, TG, and LDL were 4.8±0.93, 1.58±1.19 and 3.23±0.9 mmol/L, respectively among males, and 4.5±0.96, 1.22±0.48 and 2.95±1, respectively in females, which were significantly lower (p&lt;0.05). The serum HDL was significantly lower (p&lt;0.01) in males (1.67±0.22mmol/L) than in females (1.85±0.21). Conclusion: The results of this study demonstrate that people with hypertension are more likely have higher dyslipidemia, including elevated TC, TG, LDL and reduced HDL cholesterol level compared to a normotensive group. However, according to the binary logistic regression analysis, the most significant elevations of BP were attributed to age and reduced HDL.

Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5years of administration.

To retrospectively evaluate and compare safety and efficacy of short and long-acting testosterone (T) parenteral formulations over 5years in transmen. Fifty transmen between 21 and 42years of age were enrolled. Twenty-five received T undecanoate 1000mg IM (weeks 0 and 6 then every 12-16weeks), and 25 received T enanthate 250mg IM (every 3-4weeks). Hormonal and biochemical parameters, anthropometric characteristics and blood pressure were assessed at baseline and then every 12months. Body composition was evaluated at baseline and then after 1, 3 and 5years of T treatment. Global satisfaction was assessed at baseline and after 1 and 5years. Both T formulations led to amenorrhoea in all subjects within 1year of T administration. Both T treatments led to a similar increase in haemoglobin and haematocrit which always remained within the physiological range. T administration was associated with an increase in total cholesterol, low-density lipoprotein cholesterol and triglycerides and a slight reduction in high-density lipoprotein cholesterol. Coagulative and glucidic profiles and blood pressure did not change significantly in either group. Body weight and BMI showed a slight but not significant increase in both groups, while lean mass rose significantly in both groups. Global satisfaction was increased at years 1 and 5 in both groups. Preliminary results from this pilot study suggest that administration of either TU or TE for 5years in young transmen is both effective and safe. Our study presents the longest follow-up published so far reporting no adverse events and these data are consistent with previous reports with a shorter follow-up.

Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes (PREVIEW).

AimsThe PREVIEW lifestyle intervention study (http://clinicaltrials.gov Identifier: NCT01777893) is, to date, the largest, multinational study concerning prevention of type‐2 diabetes. We hypothesized that the initial, fixed low‐energy diet (LED) would induce different metabolic outcomes in men vs women.Materials and methodsAll participants followed a LED (3.4 MJ/810 kcal/daily) for 8 weeks (Cambridge Weight Plan). Participants were recruited from 8 sites in Europe, Australia and New Zealand. Those eligible for inclusion were overweight (BMI ≥ 25 kg/m2) individuals with pre‐diabetes according to ADA‐criteria. Outcomes of interest included changes in insulin resistance, fat mass (FM), fat‐free mass (FFM) and metabolic syndrome Z‐score.ResultsIn total, 2224 individuals (1504 women, 720 men) attended the baseline visit and 2020 (90.8%) completed the follow‐up visit. Following the LED, weight loss was 16% greater in men than in women (11.8% vs 10.3%, respectively) but improvements in insulin resistance were similar. HOMA‐IR decreased by 1.50 ± 0.15 in men and by 1.35 ± 0.15 in women (ns). After adjusting for differences in weight loss, men had larger reductions in metabolic syndrome Z‐score, C‐peptide, FM and heart rate, while women had larger reductions in HDL cholesterol, FFM, hip circumference and pulse pressure. Following the LED, 35% of participants of both genders had reverted to normo‐glycaemia.ConclusionsAn 8‐week LED induced different effects in women than in men. These findings are clinically important and suggest gender‐specific changes after weight loss. It is important to investigate whether the greater decreases in FFM, hip circumference and HDL cholesterol in women after rapid weight loss compromise weight loss maintenance and future cardiovascular health.

Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases.

Inflammation and lipid accumulation are two basic hallmarks of atherosclerosis as a chronic disease. Inflammation not only is a local response but can also be considered as a systemic process followed by an elevation of inflammatory mediators. Monocytes are a major source of proinflammatory species during atherogenesis. In atherosclerosis, modified low-density lipoproteins (LDLs) are removed by macrophages; these are recruited in the vessel wall, inducing the release of inflammatory cytokines in inflamed tissue. Hence, inflammatory cholesterol ester-loaded plaque is generated. High-density lipoprotein-cholesterol (HDL-C) exhibits antiatherosclerotic effects by neutralizing the proinflammatory and pro-oxidant effects of monocytes via inhibiting the migration of macrophages and LDL oxidation in addition to the efflux of cholesterol from these cells. Furthermore, HDL plays a role in suppressing the activation of monocytes and proliferation-differentiation of monocyte progenitor cells. Thus, accumulation of monocytes and reduction of HDL-C may participate in atherosclerosis and cardiovascular diseases (CVD). Given that the relationship between the high number of monocytes and low HDL-C levels has been reported in inflammatory disorders, this review focused on understanding whether the monocyte-to-HDL ratio could be a convenient marker to predict atherosclerosis development and progression, hallmarks of CV events, instead of the individual monocyte count or HDL-C level.

Weight gain prevention buffers the impact of CETP rs3764261 on high density lipoprotein cholesterol in young adulthood: The Study of Novel Approaches to Weight Gain Prevention (SNAP)

Background and AimsTwo weight gain prevention strategies, one targeting small changes to diet and physical activity and a second targeting large changes, significantly reduced weight gain in young adulthood. We examined whether weight gain prevention blunts genetic risk for body weight increase and/or high density lipoprotein cholesterol (HDL-C) lowering over two years. Methods and ResultsParticipants were 524 male and female young adults (mean age = 28.2, SD = 4.3; mean BMI = 25.5, SD = 2.6). Obesity-related SNPs accounting for ≥ 0.04% of the variance were genotyped and combined into a genetic risk score. For HDL-C, SNPs within CETP, LIPC and FADS2 were genotyped. The obesity-related genetic risk score did not predict change in BMI independently or in interaction with treatment arm. However, consistent with the prior literature, each copy of the HDL-C risk, C, allele at CETP rs3764261 was associated with lower HDL-C at baseline. Moreover, significant interaction between SNP and treatment arm for change in HDL-C was observed (p = 0.02). In the control group, HDL-C change was dependent upon rs3764261 (p = 0.004) with C allele carriers showing a continued reduction in HDL-C. In contrast, within the two intervention groups, HDL-C increased on average with no differential effect of rs3764261 (p > 0.24). Notably, even among carriers of the CC genotype, small and large change arms were associated with increased HDL-C and the control arm a reduction (p = 0.013). ConclusionsThe C allele at CETP rs3764261 is a strong risk factor for low HDL-C in young adulthood but weight gain prevention may mitigate this risk. Clinical Trial Registry number and websiteclinicaltrials.gov Identifier: NCT01183689, https://clinicaltrials.gov/

Working (longer than) 9 to 5: are there cardiometabolic health risks for young Australian workers who report longer than 38-h working weeks?

The average Australian working week in middle-aged and older workers exceeds government recommendations. Long working weeks are associated with poor health outcomes; however, the relationship between long working weeks and health in young Australian workers is unknown. Data were drawn from the 22-year follow-up of the Western Australian Pregnancy Cohort (Raine) Study in Perth, Western Australia. Information was available from 873 young adults about working hours per week, shift work and sleep duration. Blood samples provided measures of cardiometabolic risk (CMR) factors. Almost one-third (32.8%) of young workers reported > 38h working weeks. This was commonly reported in mining and construction industries for males; health and social assistance, mining and retail trade industries for females. CMR factors including increased waist circumference, higher fasting plasma glucose and reduced HDL cholesterol were associated with > 38h working weeks. These relationships were not moderated by gender or by BMI for glucose and HDL cholesterol. Total sleep time was significantly lower in both male and female workers reporting > 38h working weeks, but did not mediate the relationships seen with CMR factors. These findings point to early associations between > 38h working weeks and CMR risk, and highlight the potential benefit of making young employees aware of the health associations with working arrangements to reduce the longer-term relationships seen with working hours and poor cardiometabolic health in population studies.