Residual Lipid Research Articles

TCT-379 Impact of the Residual Lipid Burden on the Clinical and Angiographic Outcomes After Percutaneous Coronary Intervention

TCT-379 Impact of the Residual Lipid Burden on the Clinical and Angiographic Outcomes After Percutaneous Coronary Intervention

Association between multiple inflammatory biomarkers and remnant cholesterol levels in patients with percutaneous coronary intervention: A large-scale real-world study

Background and aimRemnant cholesterol (RC) has garnered increasing attention recently due to its association with adverse cardiovascular events. However, the relationship between RC levels and inflammation remains unclear. The goal of this study was to investigate and compare the predictive value of multiple inflammatory biomarkers for high RC in patients with percutaneous coronary intervention (PCI). Methods and resultsInitially, a total of 10,724 consecutive individuals hospitalized for PCI at Fu Wai Hospital in 2013 were enrolled. Finally, 9983 patients receiving dual antiplatelet therapy and drug-eluting stent were selected for analysis. The inflammatory biomarkers included high-sensitivity C-reactive protein (hs-CRP), hs-CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), lymphocyte-to-hs-CRP ratio (LCR), and systemic immune-inflammation index (SII). Patients were divided into higher RC and lower RC groups based on the median RC level. Multivariate logistic regression showed that hs-CRP (OR per SD: 1.254), CAR (OR per SD: 1.245), PLR (OR per SD: 1.139), and SII (OR per SD: 1.077) were associated with high RC (≥median), while LCR (OR per SD: 0.792) was associated with low RC (<median). However, NLR and LMR were not associated with RC levels. After comparing these inflammatory biomarkers, hs-CRP demonstrated the highest predictive ability for high RC (AUC: 0.612). ConclusionsIn PCI patients, hs-CRP, CAR, PLR, LCR, and SII were independently associated with RC levels. Among these inflammatory biomarkers, hs-CRP conferred better prediction for high RC. This investigation further supports the close relationship between inflammation and residual lipid risk biomarker RC.

Oxysterol: Residual Lipid Risk for Interventional Cardiology.

Oxysterol: Residual Lipid Risk for Interventional Cardiology.

Usefulness of impedanciometry for the assessment of obesity in a high risk dyslipidemia screening unit

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Residual risk is related to future events in already treated patients. In addition, obesity increases cardiovascular risk. Body mass index (BMI) is the OMS-defined measure for the diagnosis of obesity, but not the only one, as body fat percentage (%BF) allows a more accurate estimation of visceral fat. Objective To identify the clinical utility of adding body fat percentage (%BF) measured by impedanciometry to the assessment of obesity, and to compare the residual lipid profile of obese versus non-obese patients according to the measurement methods. Methods Prospective observational study, which analysed 213 patients included in a High Risk Dyslipidemia Screening Unit. Three groups were classified: group A (BMI &amp;lt;30 and %BF &amp;lt;25%-35% according to gender; group B (BMI &amp;lt;30 but %BF ≥25% -35%) and group C (BMI ≥30 and %BF ≥25-35%). Clinical characteristics, screening unit inclusion variables and residual lipid profile were analysed, as well as the association with early coronary heart disease and with the development of cardiovascular disease among the three groups. Results Of the 213 patients included, 91 belonged to Group A (non-obese patients), 80 belonged to Group C (obese according to BMI and %BF) and 42 patients belonged to Group B (classified as obese according to %BF but with BMI &amp;lt;30). When comparing the three groups, it was observed that the patients in group B had a residual lipid profile more similar to that of group C patients. They had higher levels of TG, remnant cholesterol and VLDL; with lower levels of HDL (p&amp;lt;0.05), with no statistically significant differences in the levels of Lp(a), ApoB, LDL and non-HDL in relation to those in group A. Fifty percent of group B patients developed coronary heart disease, compared to 56% of group C and 36% of group A patients (p= 0.029). There were no differences in the development of early coronary heart disease. There were 31.6% of patients with BMI&amp;lt;30 who were reclassified as obese according to %BF. If we classified the obese according to BMI, 45.5% developed cardiovascular disease and 45.2% developed early coronary heart disease. If we reclassify the obese according to %BF, the percentage rises to 65.7% and 65.6% respectively. All data are shown in table 1. Conclusion Adding the % of BF by impedanciometry for the diagnosis of obesity in a high risk dyslipidemia screening unit allows the identification of an important percentage of patients with a higher cardiovascular risk and a worse residual lipid profile. BMI is insufficient as a single parameter for the assessment of obesity and for stratifying cardiovascular risk.

Managing lipid risk in acute coronary syndrome patients in the real world: results from the BEST consensus

The gap between the targets recommended by current guidelines and the lipid values observed in the real world among patients at very high or extreme cardiovascular risk has called into question the effectiveness of the stepwise lipid-lowering strategy. The BEST (Best Evidence with Ezetimibe/statin Treatment) project supported an expert panel of Italian cardiologists to investigate the different clinical-therapeutic pathways in the management of the residual lipid risk of post-acute coronary syndrome (ACS) patients at discharge and to analyze potential critical issues. Among the members of the panel, 37 cardiologists were selected to participate in a consensus process using the mini-Delphi technique. A 9-statement questionnaire, focusing on the early use of combination lipid-lowering therapies in post-ACS patients, was built up based on a previous survey that involved all members of the BEST project. For each proposed statement, participants anonymously expressed their personal level of disagreement/agreement, according to a 7-point Likert scale. The relative degree of agreement and consensus was calculated based on the median and the 25th percentile values and the interquartile range (IQR). The administration of the questionnaire was repeated twice: the second one after general discussion and analysis of the answers given in the first round in order to obtain as much consensus as possible. With the exception of a single item, the responses of the participants were in agreement with a broad consensus already at the first round with a median value of 6, a 25th percentile of 5 and an IQR of 2. This trend resulted more evident at the second round (median 7, 25th percentile 6, IQR 1). In particular, there was unanimous agreement (median 7, IQR 0-1) on the statements in favor of a lipid-lowering therapy that guarantees the achievement of the targets as much and as soon as possible by the systematic early utilization of the high-dose/intensity statin + ezetimibe combination and, when needed, PCSK9 inhibitors. The percentage of the experts who changed their responses between the first and second round was 39% overall, ranging from 16% to 69%. According to the mini-Delphi results, there is a broad agreement and consensus to manage the lipid risk in post-ACS patients by lipid-lowering treatments that guarantee an early and "robust" lipid reduction which can be achieved only by the systematic use of combination therapies.

Differential distribution of surface proteins/lipids between wheat A- and B-starch granule contributes to their difference in pasting and rheological properties

The distribution of surface proteins/lipids and their effect on physicochemical properties of wheat A- and B-starch were investigated. Small B-starch with higher surface protein (~1.8 %) and lipid (~0.4 %) contents did not differ significantly from specific surface area of large A-starch (~0.2 % protein and ~0.1 % lipid), indicating surface lipids/proteins for starch are characteristic of their biological origin, not directly related to granule size. The surface of A-starch granule was an integrated membrane structure (lipids covered by proteins). B-starch showed a greater decrease in peak and trough viscosity (130 and 82 cP) than A-starch (99 and 52 cP) after removing surface proteins, perhaps because the presence of residual surface lipid as a membrane protected the rigidity of A-starch granule. B-starch showed a greater increase in consistency coefficient (K) (47.01 Pa·sn) than A-starch (20.33 Pa·sn) after removing surface lipids, possibly because the greater loss of surface lipid as complex with amylose in B-starch retarded retrogradation and reduced K. These results show that different distributions and contents of surface proteins/lipids between wheat A- and B-starch granule contribute to the pasting and rheological properties.

Changes of lipid composition from culture fluid during the production of antibiotic salinomycin

A major step in the biotechnological process of production of antibiotic salinomycin is fermentation, which has the greatest impact on the quality of the final product. Vegetable oils (rapeseed or soybean) are used as nutrient medium during fermentation, with some of the lipids embedded in the final product. Data on their effect on product quality is missing, which is why a study of the changes in the composition of lipids in cultural fluid during the fermentation process was conducted. The composition of the residual lipids isolated from three samples of the culture fluid during fermentation (213, 405 and 490 hours), was investigated before drying the final product. The lipid content of the samples was 6.3%, 3.5% and 6.2%. The main trend is an increase in the amount of saturated fatty acids at the expense of a decrease in unsaturated acids. The amount of tocopherols during the fermentation process increased as well as γ-tocopherol, while the amount of α-tocopherol decreased. The content of carotenoids decreased twice during fermentation. Phosphatidylcholine and phosphatidylethanolamine were identified as major polar lipid components. The main phospholipid classes contain mainly palmitic, stearic and oleic acids. Significant changes in general lipid composition were observed during the biosynthesis process.

Glucuronic acid: not just another brick in the cell wall.

This article is a Commentary on Debra‐Maceluch et al. (2023), 238: 297–312.

Bone Marrow Adipose Tissue Is Increased in Postmenopausal Women With Postsurgical Hypoparathyroidism.

Suppression of bone turnover, greater trabecular volume, and normal-high normal all-site bone mineral density (BMD) are hallmarks of postsurgical hypoparathyroidism (HypoPT). Impairment in the trabecular microarchitecture with possible higher risk of vertebral fractures (VF) in women with postmenopausal HypoPT has also been described. Currently, no data on bone marrow adipose tissue (BMAT) are available in HypoPT. To assess BMAT by magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS) in postmenopausal women with chronic postsurgical HypoPT. This cross-sectional pilot study, conducted at an ambulatory referral center, included 29 postmenopausal women (mean age 66 ± 8.4 years) with postsurgical HypoPT and 31 healthy postmenopausal women (mean age 63 ± 8.5). Lumbar spine MRI was performed and BMAT was measured by applying PRESS sequences on the L3 body. Lumbar spine, femoral neck, and total hip BMD were measured by dual x-ray absorptiometry (DXA); site-matched spine trabecular bone score (TBS) was calculated by TBS iNsight (Medimaps, Switzerland); VF assessment was performed with lateral thoracic and lumbar spine DXA. Fat content (FC) and saturation level (SL%) were higher (P <.0001 and P <.001), while water content (W) was lower in HypoPT compared to controls (P <.0001). FC significantly correlated with years since menopause and body weight (P <.05) in HypoPT, while TBS negatively correlated with FC and SL% (P <.05) and positively with residual lipids (RL) and W (P <.05). We demonstrate for the first time that BMAT is increased in postmenopausal women with postsurgical hypoparathyroidism and negatively associated with trabecular microarchitecture.

Substrates of Opposite Polarities and Downstream Processing for Efficient Production of the Biosurfactant Mannosylerythritol Lipids from Moesziomyces spp.

Biosurfactants can replace fossil-driven surfactants with positive environmental impacts, owing to their low eco-toxicity and high biodegradability. However, their large-scale production and application are restricted by high production costs. Such costs can be reduced using renewable raw materials and facilitated downstream processing. Here, a novel strategy for mannosylerythritol lipid (MEL) production explores the combination of hydrophilic and hydrophobic carbon sources sideways with a novel downstream processing strategy, based on nanofiltration technology. Co-substrate MEL production by Moesziomyces antarcticus was threefold higher than using D-glucose with low levels of residual lipids. The use of waste frying oil instead of soybean oil (SBO) in co-substrate strategy resulted in similar MEL production. Moesziomyces antarcticus cultivations, using 3.9 M of total carbon in substrates, yields 7.3, 18.1, and 20.1 g/L of MEL, and 2.1, 10.0, and 5.1 g/L of residual lipids, for D-glucose, SBO, and a combination of D-Glucose and SBO, respectively. Such approach makes it possible to reduce the amount of oil used, offset by the equivalent molar increase in D-glucose, improving sustainability and decreasing residual unconsumed oil substrates, facilitating downstream processing. Moesziomyces spp. also produces lipases that broken down the oil and, thus, residual unconsumed oils are in the form of free fatty-acids or monoacylglycerol, which are smaller molecules than MEL. Therefore, nanofiltration of ethyl acetate extracts from co-substrate-based culture broths allows to improve MEL purity (ratio of MEL per total MEL and residual lipids) from 66 to 93% using 3-diavolumes.

Improving the Effective Spatial Resolution in 1H-MRSI of the Prostate with Three-Dimensional Overdiscretized Reconstructions.

In in vivo 1H-MRSI of the prostate, small matrix sizes can cause voxel bleeding extending to regions far from a voxel, dispersing a signal of interest outside that voxel and mixing extra-prostatic residual lipid signals into the prostate. To resolve this problem, we developed a three-dimensional overdiscretized reconstruction method. Without increasing the acquisition time from current 3D MRSI acquisition methods, this method is aimed to improve the localization of metabolite signals in the prostate without compromising on SNR. The proposed method consists of a 3D spatial overdiscretization of the MRSI grid, followed by noise decorrelation with small random spectral shifts and weighted spatial averaging to reach a final target spatial resolution. We successfully applied the three-dimensional overdiscretized reconstruction method to 3D prostate 1H-MRSI data at 3T. Both in phantom and in vivo, the method proved to be superior to conventional weighted sampling with Hamming filtering of k-space. Compared with the latter, the overdiscretized reconstructed data with smaller voxel size showed up to 10% less voxel bleed while maintaining higher SNR by a factor of 1.87 and 1.45 in phantom measurements. For in vivo measurements, within the same acquisition time and without loss of SNR compared with weighted k-space sampling and Hamming filtering, we achieved increased spatial resolution and improved localization in metabolite maps.

Residual risk in patients with atherosclerotic cardiovascular disease

The residual risk in patients with atherosclerosis, despite the its controversial aspects, remains an urgent problem of modern cardiology. The article presents a review of publications on the prevalence and significance for determining the prognosis of residual risk, which is currently interpreted as the risk of macroand microvascular complications in patients with atherosclerotic cardiovascular disease (ACVD) taking standard therapy, with the achievement of optimal levels of low-density lipoprotein cholesterol, blood pressure and glucose. Based on available publications, we highlighted current views on the factors associated with residual inflammatory and lipid risks in ACVD patients, including those associated with heart failure and diabetes, and the prognostic significance of residual risk in such patients. An attempt was made to rationale the significance of determining the residual risk for secondary prevention of cardiovascular events.

Open-source perfusion system for medium-scale fabrication of demineralized bone matrix chip grafts

Demineralized bone matrix (DBM) is considered one of the most reliable bone tissue grafts for regular surgical use, as it provides a scaffold that is structurally like native bone, and that enhances bone regeneration. However, commercially available DBM products are not suited for surgical restitutions of large bones. Therefore, each Tissue Bank is urged to implement their own demineralization protocol, which usually does not meet the high demand for bone grafting. In this project, we developed an open source system for medium-scale manufacturing of DBM grafts from human cadaveric donors to automate the demineralization protocol and improve its reproducibility. The device consists in (1) unidirectional flow reaction chamber, where the demineralization protocol takes place; (2) automated syringe pump, which controls the reagent́s inlet and vacuum; and (3) reagent dispenser, for the management of the reagents need for the demineralization protocol. Validation of the device included histological analysis, DNA quantification temperature regulation, electrochemiluminescence and colorimetric protocols, followed by the optimization of physicochemical parameters based on Response Surface Methodology. The results showed values of residual lipids and calcium within standardized ranges, and the maintenance of the structural integrity of the DBM, demonstrating the capacity of the system to support the proposed demineralization protocol.

Remnant cholesterol contributes to residual lipid risk after acute coronary syndromes

Abstract Background Increasing evidence indicates that cholesterol transported in triglyceride-rich lipoproteins (remnant cholesterol) is a causal risk factor for major adverse cardiovascular events (MACE) independent from other lipid fractions. To date, the relationship between remnant cholesterol (remnant-C) levels and cardiovascular (CV) outcomes after acute coronary syndromes (ACS) in patients with adequate low-density lipoprotein cholesterol (LDL-C) control is uncertain. Purpose This study evaluated the contribution of remnant-C to residual lipid risk after ACS. Methods Nested within 4'787 ACS patients in the prospective multicentre SPUM-ACS study (NCT0100070) we examined all patients presenting with LDL-C levels &amp;lt;100 mg/dl under lipid lowering therapy (n=756). Remnant-C was calculated as non-high-density lipoprotein cholesterol (non-HDL-C) minus calculated LDL-C using the Martin/Hopkins modified equation. The predefined primary outcome was a composite of CV death, myocardial infarction, and ischemia-driven revascularization at 12 months. Events were adjudicated by an independent external endpoint committee blinded to the lipid measurements. Multivariable-adjusted Cox models were fitted using smoothing splines for absolute remnant-C levels (continuous), log-transformed absolute remnant-C levels (continuous), remnant-C tertiles (categorical) and a prespecified cutoff (75th percentile) for high remnant-C (categorical). Bias-corrected bootstrapping was used for internal validation. Results Eighty-seven (11.5%) patients had an event, 14 (1.9%) patients withdrew consent, and 5 (0.7%) patients were lost to follow up at 12 months. In multivariable-adjusted analyses, remnant-C (hazard ratio [HR]: 1.63; 95% confidence interval [CI]: 1.04 to 2.74; per log2 increase; p=0.020), triglycerides (HR: 1.41; 95% CI: 1.04 to 1.96; per log2 increase; p=0.017), and low high-density lipoprotein (HDL)-C (HR: 0.56; 95% CI: 0.33 to 0.86; per log2 increase; p&amp;lt;0.040), but not LDL-C (HR: 1.41; 95% CI: 0.78 to 2.84; per log2 increase; p=0.272), were associated with MACE. High remnant-C was independently associated with elevated risk of MACE when adjusting for clinical and demographic factors including GRACE 2.0 risk estimates (HR: 2.43; 95% CI: 1.42 to 4.27; above vs. below 75th percentile; p&amp;lt;0.001; HR: 2.10; 95% CI: 1.09 to 4.70; tertile 3 vs. tertile 1; p=0.014). Conclusion In patients who develop ACS with LDL-C levels &amp;lt;100 mg/dl, levels of remnant-C and triglycerides, but not LDL-C, were associated with adverse CV outcomes independent of other risk factors. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Swiss National Science FoundationSwiss Heart Foundation

Effect on cholesterol remnants and residual lipid risk with PCSK9 inhibitors: the LIPID-REAL Registry

Abstract Background Monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 55%, regardless of baseline treatments. Nonetheless, the effect of other lipid parameters, as cholesterol remnants or, the so-called residual lipid risk, are unknown. Methods Multicenter and retrospective registry of patients treated with PCSK9 inhibitors from 14 different hospitals from Spain. Before and on-treatment lipid parameters were recorded. Cholesterol remnants were calculated by the equation: total cholesterol minus LDLc minus HDLc and values ≥30 were considered high. Residual lipid risk was estimated by 1) the estimation of LDL particle size, by the triglycerides/HDLc ratio (TG/HDL) and values &amp;lt;2 were assumed as low and dense LDL particles; 2) total cholesterol/HDLc (TC/HDL) and values &amp;gt;3 were considered high; and; 3) the triglycerides-to-glucose (TG/Gluc) index, obtained as the natural logarithm of (triglycerides * glucose/2) Results A total of 652 patients were analyzed, mean age 60.0 (10.5) years and 161 (24.69%) women. Baseline LDLc was 149.2 (49.9) mg/dl, cholesterol remnants 29.9 (20.3) mg/dl, TG/HDL 3.9 (4.1), TC/HDL 4.9 (1.9) and TG/Gluc index 8.9 (0.7). Most patients (92.3%) were on statins; 54.8% with ezetimibe, 8.5% with fibrates. Evolocumab was initiated in 318 (56.6%) patients; 229 (40.7%) alirocumab 75 mg and 15 (2.7%) alirocumab 150 mg. Median time to second blood determination were 187.5 (IQR 101–242) days. Mean on-treatment LDLc was 67.46 (45.78) mg/dl what represented a 55% reduction. As shown in the figure, significant reduction in cholesterol remnants (p=0.017), TG/HDL ratio (p=0.020), TC/HDL ratio (p&amp;lt;0.001) and TG/Gluc index (p&amp;lt;0.001). The percentage of patients with remnants &amp;gt;30 mg/dl decreased: 34.62% to 30.07 (p&amp;lt;0.01). Significant reductions were also observed in the percentage of patients with TG/HDL &amp;gt;2 (71.25% to 61.98%; p&amp;lt;0.01) or TC/HDL &amp;gt;3 (94.28% to 38.97%; p&amp;lt;0.01) Conclusions This multicenter and retrospective registry of real-world patients treated with PCSK9 inhibitors demonstrates a positive effect on cholesterol remnants and lipid-residual risk beyond LDLc reductions. Funding Acknowledgement Type of funding sources: None.

Effect of PCSK9 inhibitors on remnant cholesterol and lipid residual risk: The LIPID‐REAL registry

Monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 55%, regardless of baseline treatments. Nonetheless, the effect of other lipid parameters, such as cholesterol remnants or, the so-called lipid residual risk, is unknown. Multicenter and retrospective registry of patients treated with PCSK9 inhibitors from 14 different hospitals in Spain. Before and on-treatment lipid parameters were recorded. Residual lipid risk was estimated by (1) cholesterol remnants, (2) triglycerides/HDLc ratio (TG/HDL), (3) total cholesterol/HDLc (TC/HDL) and (4) the triglycerides-to-glucose index (TGGi). Six hundred fifty-two patients were analysed, mean age of 60.2 (9.63)years, 24.69% women and mean LDLc before treatment 149.24 (49.86)mg/dl. Median time to second blood determination was 187.5 days. On-treatment LDLc was 67.46 (45.78)mg/dl, which represented a 55% reduction. Significant reductions were observed for TG/HDL ratio, cholesterol remnants, TC/HDL ratio and TGGi. As consequence, 34.61% patients had LDLc <55 mg/dl and cholesterol remnants <30 mg/dl; additionally, 31.95% had cholesterol remnants <30 mg/dl but LDLc >55 mg/dl. Patients who had levels of cholesterol remnants >30 mg/dl before initiating the treatment with PCSK9 had higher reductions in cholesterol remnants, TG/HDL ratio, TC/HDL and TGGi. By contrast, no reduction differences were observed according to baseline LDLc (< or > the mean), age, gender or obesity. This multicenter and retrospective registry of real-world patients treated with PCSK9 inhibitors demonstrates a positive effect on cholesterol remnants and lipid residual risk beyond LDLc reductions.

Effect of Novel Stratified Lipid Risk by "LDL-Window" and Flow-Mediated Dilation on the Prognosis of Coronary Artery Disease Using the FMD-J Study A Data.

Elevated levels of triglyceride (TG) and non-high-density lipoprotein cholesterol (non-HDL-C) are regarded as a residual lipid risk in low-density lipoprotein cholesterol (LDL-C)-lowering therapy. This study investigated the association between lipid risk stratified by TG and non-HDL-C and the prognosis of patients with coronary artery disease (CAD), and the association between stratified lipid risk and flow-mediated dilatation (FMD) index. The 624 CAD patients enrolled in flow-mediated dilation (FMD)-J study A were divided into 4 groups: low-risk group (n=413) with TG <150 mg/dL and non-HDL-C <170 mg/dL; hyper-TG group (n=180) with TG ≥150 mg/dL and non-HDL-C <170 mg/dL; hyper-non-HDL group (n=12) with TG <150 mg/dL and non-HDL-C ≥170 mg/dL; and high-risk group (n=19) with TG ≥150 mg/dL and non-HDL-C ≥170 mg/dL. Comparison of the groups showed the cumulative incidence of a 3-point major adverse cardiovascular event (MACE) was different and highest in the high-risk group in all the patients (P=0.009), and in patients with a FMD index ≥7.0% (P=0.021), but not in those with a FMD index <7.0%. Multivariable regression analysis showed that high lipid risk (P=0.019) and FMD <7.0% (P=0.040) were independently correlated with the incidence of a 3-point MACE. Novel stratification of lipid risk, simply using TG and non-HDL-C levels, combined with FMD measurement, is useful for predicting cardiovascular outcomes in patients with CAD.

Remnant Cholesterol and Its Visit-to-Visit Variability Predict Cardiovascular Outcomes in Patients With Type 2 Diabetes: Findings From the ACCORD Cohort

OBJECTIVERemnant cholesterol (remnant-C) predicts atherosclerotic cardiovascular disease, regardless of LDL-cholesterol (LDL-C) levels. This study assessed the associations between remnant-C and cardiovascular outcomes in type 2 diabetes.RESEARCH DESIGN AND METHODSThis post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial used patient (type 2 diabetes >3 months) remnant-C and major adverse cardiovascular event (MACE) data from the study database. The associations between remnant-C and MACEs were evaluated using Cox proportional hazards regression analyses. We examined the relative MACE risk in remnant-C versus LDL-C discordant/concordant groups using clinically relevant LDL-C targets by discordance analyses.RESULTSThe baseline analysis included 10,196 participants, with further visit-to-visit variability analysis including 9,650 participants. During follow-up (median, 8.8 years), 1,815 patients (17.8%) developed MACEs. After adjusting for traditional cardiovascular risk factors, each 1-SD increase in remnant-C was associated with a 7% higher MACE risk (hazard ratio [HR] 1.07, 95% CI 1.02–1.12, P = 0.004). In the fully adjusted model, the visit-to-visit remnant-C variability calculated using logSD (HR 1.41, 95% CI 1.18–1.69, P < 0.001) and logARV (HR 1.45, 95% CI 1.22–1.73, P < 0.001) was associated with MACEs. Residual lipid risk (remnant-C ≥31 mg/dL) recognized individuals at a higher MACE risk, regardless of LDL-C concentrations. Within each LDL-C subgroup (>100 or ≤100 mg/dL), high baseline remnant-C was associated with a higher MACE risk (HR 1.37, 95% CI 1.09–1.73, P = 0.007; HR 1.22, 95% CI 1.04–1.41, P = 0.015, respectively).CONCLUSIONSRemnant-C levels were associated with MACEs in patients with type 2 diabetes independent of LDL-C, and visit-to-visit remnant-C variability helped identify those with higher cardiovascular risk.

Diets Partially Replaced With Cassava Residue Modulate Antioxidant Capacity, Lipid Metabolism, and Gut Barrier Function of Huanjiang Mini-Pigs.

Agricultural by-products have been identified as potential feed resources in animal production. The present study investigated the effects of cassava residue (CR) or fermented CR (FCR) on antioxidant capacity, immunity, gut barrier functions, and lipid metabolism in pigs. A total of 120 healthy Huanjiang mini-piglets were assigned into three groups, including control group (basal diet), CR group (basal diet + 5% CR), and FCR group (basal diet + 5% FCR). The experiment lasted for 30 days. The results showed that, dietary CR or FCR supplementation increased the jejunal catalase (CAT, P = 0.063) and glutathione peroxidase (GSH-Px, P < 0.05) levels and hepatic superoxide dismutase (SOD, P < 0.05) level while decreased (P = 0.077) ileal malondialdehyde (MDA) level, when compared with the control group. Dietary CR supplementation increased intestinal SOD and hepatic GSH-Px levels, whereas decreased jejunal and hepatic MDA levels (P < 0.05). Dietary CR supplementation increased the levels of secretory immunoglobulin A (sIgA) in the intestine and liver, as well as jejunal interleukin (IL)-10, ileal tumor necrosis factor (TNF)-α, and hepatic interferon (IFN)-γ, whereas dietary CR or FCR supplementation decreased the jejunal IL-1β level and increased hepatic IL-10 level (P < 0.05). In the intestinal microbiota analysis, dietary CR or FCR supplementation enhanced the colonic α-diversity and ileal Actinobacteria abundance, whereas decreased ileal Verrucomicrobia and colonic Tenericutes abundances (P < 0.05). In addition, dietary FCR supplementation increased Firmicutes and decreased Bacteroidetes abundances in the ileum and colon, whereas CR supplementation increased Escherichia-Shigella and decreased Terisporobacter abundances in the ileum (P < 0.05). Moreover, dietary CR or FCR supplementation up-regulated (P < 0.05) the gene expressions related to gut barrier functions of piglets. However, dietary CR supplementation showed negative impacts on hepatic lipid metabolism by up-regulating the expression of genes associated with fatty acid synthesis and triglyceride and lipid metabolism. In conclusion, dietary CR or FCR supplementation can maintain the health of piglets by increasing antioxidant capacity, gut barrier function, and altering the intestinal microbiota composition, but CR supplementation may increase the potential risk of abnormal lipid metabolism.

Effects of Pleurotus ostreatus on Physicochemical Properties and Residual Nitrite of the Pork Sausage

In this work, a novel sausage incorporated with the Pleurotus ostreatus (PO) puree was successfully developed to reduce the residual nitrite and lipid oxidation during refrigerated storage (4 ± 1 °C) for 20 days. Five recipes with the supplement proportion of 0 wt.%, 10 wt.%, 20 wt.%, 30 wt.%, and 40 wt.% PO were produced and their physicochemical properties, nitrite residue, and sensory characteristics were measured. The results show that the content of moisture and all the essential amino acids (especially lysine and leucine) and the non-essential amino acids (especially aspartic and glutamic), lightness, springiness, and water holding capacity of the sausages were increased. However, the content of protein, fat, ash, pH, redness, hardness, gumminess, and chewiness of the sausages was decreased. For the sensory evaluation, the sausage with 20 wt.% PO had better sensory performance including flavor, aroma, and acceptability compared with other experimental groups and the control group. Moreover, the sausages with PO reduced the residual nitrite and inhibited lipid oxidation during storage. All of these results indicate that adding PO puree into pork sausage is a realizable and effective way to obtain nutritional and healthy pork sausages.