Lipid Profile Screening Research Articles

Metabolic parameters in psoriatic patients treated with interleukin-12/23 blockade (ustekinumab).

The associations between psoriasis, metabolic syndrome and cardiovascular events are increasingly recognized. Studies have shown decreased cardiovascular events with the treatment of methotrexate and anti-tumor necrosis factor, however, effects of interleukin (IL)-12/23 blockade remain debatable. Our study investigated the effect of IL-12/23 blockade on the metabolic parameters in patients with psoriasis. We performed a retrospective cohort study to assess 93 consecutive patients with moderate to severe plaque type psoriasis who received IL-12/23 blockade (ustekinumab) for 24 weeks between January 2012 and May 2016. Metabolic parameters and disease activity (Psoriasis Area and Severity Index [PASI] score) at baseline and 24 weeks of treatment were collected. At week 24, the disease activity improved significantly (P < 0.0001), with a significant reduction of erythrocyte sedimentation rate. Conversely, body mass index was significantly elevated in PASI-75 responders at week 24 of treatment and was independent of disease severity. Fasting sugar and triglyceride levels were also elevated at week 24 in both PASI-75 responders and PASI-75 non-responders. Cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) remained unchanged. These metabolic parameters were not correlated with the improvement in disease severity after ustekinumab treatment. Nonetheless, the atherogenic index, LDL/HDL ratio and cholesterol/HDL ratio remained unchanged. Male sex and cigarette smoking are predictors of elevated plasma triglyceride levels. Our results suggest that despite tremendous improvement in disease activity after ustekinumab treatment, obesity, fasting sugar and hypertriglyceridemia still present in these patients. Regular screening of lipid profile, obesity control and smoking cessation are advised during the treatment of ustekinumab especially in male psoriatic patients with predisposing cardiovascular risks.

Detecting familial hypercholesterolemia by serum lipid profile screening in a hospital setting: Clinical, genetic and atherosclerotic burden profile

Background and aimsFamilial hypercholesterolemia (FH) is underdiagnosed and public cholesterol screening may be useful to find new subjects. In this study, we aim to investigate the prevalence of FH patients in a hospital screening program and evaluate their atherosclerotic burden using intima-media thickness (IMT). Methods and resultsWe screened 1575 lipid profiles and included for genetic analysis adults with a low-density lipoprotein (LDL) cholesterol >190 mg/dL and triglycerides <200 mg/dL and first-degree child relatives with LDL cholesterol >160 mg/dL and triglycerides <200 mg/dL. The diagnosis of FH was presumed by Dutch Lipid Clinic Network (DLCN) criteria and confirmed by the presence of the genetic variant. Mean common carotid intima-media thickness (IMT) was assessed using consensus criteria. After confirming LDL cholesterol value and excluding secondary hypercholesterolemia, 56 subjects with a DLCN ≥4 performed genetic analysis. Of these, 26 had an FH genetic variant. The proportion of patients with a mutation having a DLCN score of 6–8 was 75%; in individuals with a DLCN score >8 it was 100%. Mean IMT was higher in FH patients compared to non FH (0.73 [0.61–0.83] vs 0.71 [0.60–0.75] mm, p < 0.01). Moreover, we detected two mutations not previously described. Finally, simple regression analysis showed a correlation of IMT with LDL cholesterol >190 mg/dL and corneal arcus (p < 0.01 and p < 0.001, respectively). ConclusionsA hospital screening was useful to detect FH subjects with increased atherosclerosis. Also, next-generation sequencing was able to detect new FH mutations.

Abstract P128: Serum Lipid Levels at Adolescence can Predict Adult Dyslipidemia in South Korea - The Kangwha Study

Introduction: Several studies have examined tracking pattern of lipid profile level during long follow-up periods in Western countries. However, there have been few such studies in East Asia. Hypothesis: We assessed the hypothesis that there exists tracking pattern of lipid profile level from adolescence to adulthood, and lipid measurements in adolescence can predict adult dyslipidemia in South Korea. Methods: The Kangwha Study was a community-based prospective cohort study that started in 1986 in Kangwha County, South Korea . A total of 400 participants (54% women) whose serum total cholesterol, triglyceride, and high density lipoprotein (HDL) cholesterol level were measured at least once during adolescence (1992-1996), and repeatedly measured at least once during adulthood (2005-2015) were enrolled in our study. Body mass index, waist circumstance, and blood pressure were measured at all measurements. Family history of cardiovascular disease, smoking history, and presence of adult dyslipidemia were checked at adulthood. The tracking pattern of lipid profile level was determined by tracking coefficients (low: &lt;0.30; moderate: 0.30-0.59; moderately high: 0.60-0.89; high: ≥0.90). The tracking coefficients were calculated by Generalized Estimating Equation. The predictability of adult dyslipidemia was assessed by multiple logistic regression and area under curve (AUC) value. Additional analyses were performed to find out whether repeated lipid measurements during adolescence can enhance the predictability of adult dyslipidemia or not. Results: The presence of adult dyslipidemia was 26.3% (105 of 400). Mean age of study participants at enrollment is 13.8 years (SD, 1.6 years), and that at adulthood is 30.1 years (SD, 3.7 years). When adjusted for age, body mass index, waist circumstance, and blood pressure, the tracking coefficient of total cholesterol was 0.59 (95% confidence interval (CI), 0.54-0.63), that of triglyceride was 0.39 (95% CI, 0.28-0.49), and that of HDL cholesterol was 0.51 (95% CI, 0.46-0.55). The AUC value of our multiple logistic regression model on adult dyslipidemia without lipid profile levels at adolescence was 0.77 (95% CI, 0.72-0.83), and that with lipid profile levels at adolescence was 0.80 (95% CI, 0.75-0.85). P value for AUC comparison was significant (p=0.02). In additional analyses, using the average lipid profile levels in multiple lipid measurements at adolescence did not significantly improve the AUC value (p&gt;0.09). Conclusion: In conclusion, moderate tracking patterns of serum lipid profile level were shown in this study. Serum lipid profile measurements at adolescence could help the prediction of adult dyslipidemia. The results of this study supported the need of lipid profile screening at adolescence.

Correlation of Altered Lipid Profile, Uric Acid and Fasting Plasma Glucose Levels in Females with Hypothyroidism

Introduction: Hypothyroidism is a common endocrinal disorder in which thyroid gland does not produce enough thyroid hormones. The disease mainly occurs in female and its prevalence rises with age. Hypothyroidism may be the underlying cause of dyslipidemia and alteration of plasma glucose levels as thyroid hormones plays a key role in lipid and carbohydrate metabolism. It also helps in the growth and development of kidney; hence hypothyroidism may alter the uric acid level in serum due to altered secretion of uric acid at renal tubules. Aims and Objectives: To evaluate if there is any significant correlation between lipid parameters, uric acid, fasting plasma glucose with thyroid parameters in female. Methodology: We included 35 cases and 35 controls (Aged between 20-45 years) and estimated their serum TSH, FT4 by ELISA method and total cholesterol, triglycerides, LDL-c, HDL-c, VLDL-c, uric acid and fasting plasma glucose levels by chemical methods using random access auto-analyzer. Results: Results showing positive and negative correlation of TSH and FT4 with TC, TG, LDL-C and VLDL-C in cases compared to controls, whereas, HDL-C, UA and FPG didn’t show any positive/negative correlation with hypothyroid parameters in either cases or controls. Conclusion: Hypothyroid status is associated with dyslipidemia. So, earlier biological screening for lipid profile can be done in those patients.

Increased Levels of Inflammatory Marker hsCRP, MDA and Lipid Profile in Non-obese Hypertension Subjects

Introduction: High sensitive C-reactive protein (hsCRP) is a very sensitive marker of inflammation, which is synthesized in the liver and has been a widely used biomarker for risk stratifying in Cardio vascular disease (CVD). It is positively correlated with abdominal fat and closely correlated with increased risk of cardiovascular events and obesity had the predominant association with cytokine levels. Obesity induces systemic oxidative stress and causes dysregulation of adipo cytokines and development of metabolic syndrome. In our study, we investigated hsCRP levels in non-obese hypertensive subjects on treatment and its relationship with oxidative stress and lipid profile. Methods: Patients with secondary hypertension, past history of stroke, coronary artery disease, myocardial infarction, and diabetes mellitus were excluded. Serum lipid profile and thiobarbituric acid reactive substances, hsCRP were estimated in these patients by standard procedures and the values were compared with healthy controls. Totally 160 subjects were included in the study.115 were considered as Hypertension with blood pressure >140/90 mmHg and 45 as healthy controls after obtaining consent. Results: There is significant difference in hsCRP levels between study groups, and hsCRP levels correlate with blood pressure. The level of MDA and hsCRP levels were significantly increased in hypertensive subjects compared to control group. Conclusion: Our study shows that even in non-obese hypertensive subjects there was significant increase of hsCRP, LDL Cholesterol. Hence elevated hsCRP levels in addition to lipid profile screening may be a valuable tool for prediction of CVD risk in hypertensive subjects.

Assessment Of Lipid Profile In Hypertensive And Non-Hypertensive Males: A Case Control Study

Elevated percentage of lipid profile in both hypertensive and nonhypertensive groups indicate that there should be active screening for lipid profile in the community. Lower HDL levels and higher LDL levels confirm that subjects should pay more attention on physical activities and food habits. Although other lipid parameters were not significantly higher in hypertensive subjects compared to non-hypertensive subjects, in hypertensive group 60% or more subjects had a higher level of LDL and TC/HDL ratio as mentioned in the table below. Further 60% or more non-hypertensive subjects had higher LDL levels and lower HDL levels.

Assessment of lipid profile in middle and upper class individuals in Abia State, Nigeria based on life-style and dietary habits

Assessment of lipid profile in some middle and upper class individuals based on their life-style and dietary habit was carried out using 35 volunteer human 19 males and 16 females. Their life-style and dietary habit were determined using a questionnaire. Anthropometric measurements of weight, height, waist and hip circumferences were taken, Body Mass Index (BMI) and waist hip ratio (WHR) were calculated, while the lipid profile was determined using standard biochemical proce-dures. The results of the anthropometric measurements showed that the mean weight, height and Body Mass Index (BMI) were 80.1±13.8 kg, 1.7±1.1 m, 26.4±4.9 kg m-2, respectively for the males and 78.5±16.5 kg, 1.6±1.2 m and 25.8±5.5 kg m-2, respectively for the females. There was no statisti-cally significant difference (p &gt; 0.05) in all the anthropometric parameters measured for both sexes except for waist/height ratio (WHR). The results of the lipid profile showed that the mean total cholesterol (TC), High density lipoprotein-cholesterol (HDL-C) and triglycerides (TRG) were within normal reference range. Both sexes however, had mean low density lipoprotein-cholesterol (LDL-C) of 101.8±45.2 mg dL-1 and 119.5±43.7 mg dL-1 for males and females respectively. The total cholesterol/high density lipoprotein (TC/HDL-C) ratio revealed that mean values for the males and the females were 4.5±1.1 and 4.9±2.1 respectively. Correlation analysis showed positive correlations between BMI and LDL-C (r=0439; p=0.018), WHR and TAG (r=0.488; p=0.003), waist circumference (WC) and TRG (r=0.379; p=0.025). A high prevalence of overweight/obesity and dyslipidaemia (high LDL-C and triglycerides) were observed among the adults. Appropriate interventions such as regular exercise and periodic lipid profile screening should be advocated.Keywords: Lipid profile, dietary habit, anthropometry, Abia State

Dyslipidemia Prevalence in Iranian Adult Men: The Impact of Population-Based Screening on the Detection of Undiagnosed Patients.

PurposeDyslipidemia has been established as one of the most important modifiable risk factors for cardiovascular disease. Due to the higher prevalence of dyslipidemia in males, this study aimed to estimate the prevalence of dyslipidemia in Iranian urban men.Materials and MethodsA screening program was conducted in 845 Iranian men 25 years of age and older in 2014. A health interview survey was conducted to evaluate the prevalence of self-reported dyslipidemia and to collect demographic data, as well as serum lipid profile screening by a reference laboratory. Lipoprotein levels was categorized based on the Adult Treatment Panel III criteria and the data were analyzed using the chi-square test and analysis of variance.ResultsThe overall prevalence of dyslipidemia was 51.8%, and the prevalence of various forms of dyslipidemia was as follows: hypercholesterolemia (≥240 mg/dL), 11.4%; hyper-low-density lipoprotein cholesterol (≥160 mg/dL), 9.6%; hypertriglyceridemia (≥200 mg/dL), 25%; and hypo-high-density lipoprotein (HDL) cholesterol (<40 mg/dL), 34.3%. With the exception of hypo-HDL, all forms of dyslipidemia were significantly less common in men over 65 years of age (p<0.05).ConclusionsThe prevalence of hypo-HDL and hypertriglyceridemia was higher than expected in Iranian adult men, with half of men 25 years of age and older affected by at least one form of dyslipidemia. A large gap in primary and secondary care was observed, because nearly 80% of patients with dyslipidemia were unaware of their status. Urgent preventive programs and lifestyle changes are necessary to reduce the prevalence of cardiovascular risk factors.

An update on lipid profile screening in second-generation antipsychotic users in the USA

Second-generation antipsychotics (SGAs) are commonly prescribed for the treatment of schizophrenia, bipolar disorder, major depression and other behavioral and neuropsychiatric conditions. Treatment with SGA medications can induce adverse metabolic side effects, including clinically significant weight gain, hyperglycemia/diabetes mellitus and dyslipidemia. Product labeling and medical guidelines recommend that patients be routinely monitored for weight gain and serum glucose and lipid abnormalities. This review provides an update on lipid profile screening for patients taking SGA medications. The review focuses primarily on evidence from the USA, including data on risk awareness, physician intent to screen patients and population-based estimates of testing rates. Patient, provider and system barriers to lipid screening are also discussed. Quality improvement examples are provided to illustrate the progress being made in improving metabolic screening of SGA users.

Physician adherence to the dyslipidemia guidelines is as challenging an issue as patient adherence

A wide therapeutic gap exists between evidence-based guidelines and their practice in the primary care, which is primarily attributed to physician and patient adherence. This study aims to differentiate physician and patient adherence to dyslipidemia secondary prevention guidelines and various factors affecting it. A post hoc analysis of data collected by a prospective cluster randomized trial with 7041 patients diagnosed with clinical atherosclerosis requiring secondary prevention of dyslipidemia and 127 primary care physicians over an 18-month period. Adherence was measured by physicians' and patients' actions taken according to the guidelines and correlated using multivariate logistic regressions. Physician adherence was 36.9% for lipid profile screening, 27.6% for pharmacotherapy up-titration and 21.0% for pharmacotherapy initiation. Physician adherence was positively correlated with frequent patient visits [odds ratios (OR = 1.304)], having more dyslipidemic patients (OR = 1.304) and treating immigrants (OR = 1.268). Patient adherence was 83.8%, 71.9% and 62.6% for medication up-titration, lipid profile screening and pharmacotherapy initiation, respectively. Patient adherence was affected by attending clinics with many dyslipidemic patients (OR = 1.542), being older (OR = 1.271) and being treated by a male physician (OR = 0.870). We learn from this study that (i) physician non-adherence was a major cause for the failure to follow guidelines, (ii) pharmacotherapy initiation was the most challenging issue to tackle and (iii) greater adherence occurred mainly in high volume conditions (patients and visits). Practical implications are designated focus on metabolic condition prevention in primary care by cardiologists or primary care clinics specializing in metabolic conditions and the need to facilitate more frequent follow-up visits.

Lipid profile screening in second-generation antipsychotic users: the gap between policy and practice

“Given the significant cardiometabolic risks associated with the use of second-generation antipsychotic drugs, it is particularly troubling that rates of dyslipidemia screening and monitoring are s...

Hyperlipidaemia following treatment with antipsychotic medications

This study estimated the relative risk of developing hyperlipidaemia after treatment with antipsychotics, in comparison with cases and controls not on antipsychotics. Two hundred and twenty (220) subjects were selected for this study, comprising 80 newly diagnosed patients who were not on medical treatment, another 80 patients diagnosed as having psychiatric disorders, based on the International Classification of Diseases (ICD-10), and were receiving medical treatment. Another 60 non-psychiatrically ill individuals were used as control. Anthropometric indices; body mass index (BMI), waist-to-hip ratio (WHR) and blood pressure (BP) were measured. Fasting blood samples were taken and the lipid profile assayed by enzymatic methods. Females represented 57.50% and 63.75% of newly diagnosed and those on treatment respectively. Majority of the patients were single (72.5%) and unemployed (57.5%). Though hypertriglyceridaemia and low high density lipoprotein (HDL) cholesterol are generally risk factors for mental illness among the newly diagnosed as well as those who have been on treatment for at least 3 months, the prevalence of hypertriglyceridaemia was much higher among the latter whereas low HDL cholesterol was more prevalent among the former. These findings suggest that most commonly prescribed antipsychotic medications in this study increase the risk of developing hyperlipidaemia in patients with mental illness. Therefore, routine screening for lipid profile in psychiatric patients is recommended.

Prevalence of dyslipidaemia in apparently healthy professionals in Asaba, South South Nigeria.

Hypercholesterolaemia is a major risk factor for coronary heart disease (CHD) especially in industrialized societies. Coronary heart disease is becoming an increasing cause of death even in the developing world. To determine the prevalence of dyslipidaemia in apparently healthy professionals in a developing economy. One hundred apparently healthy professionals were recruited from several professions by stratified random sampling. This population was believed to be at higher risk of dyslipidaemia considering their more likely "western diet" lifestyle. Total cholesterol, LDL-cholesterol, HDL-cholesterol and Triglycerides were determined using standard cholesterol LDL precipitating reagents/kits. The mean age of the subjects was 41.59 +/- 8.22 years (range 29 to 58 years) with male to female ratio of 1:1.2. Mean total cholesterol was 180.69 +/- 36.248 mg/dl (4.67 +/- 0.94 mmol/L), LDL cholesterol 122.68 +/- 44.42 mg/dl (3.17 +/- 1.15 mmol/L), HDL-cholesterol 37.47 +/- 9.91 mg/dl (0.96 +/- 0.26 mmol/L) and Triglyceride 83.139 +/- 66.888 mg/dl (0.94 +/- 0.76 mmol/L). Using the Third Report of the NCEP Expert Panel on Detection. Evaluation and Treatment of high blood cholesterol in Adults (ATP III) definition and risk classification, 5% of the study population had hypercholesterolaemia, 23% elevated total serum cholesterol, 51% elevated LDL-cholesterol and 60% low HDL-cholesterol, with females recording better overall lipid profile. Dyslipidaemia was highly prevalent in the population studied, with low HDL-cholesterol being the most frequent lipid abnormality. Dyslipidaemia is becoming a serious health problem in the developing world also, even among the apparently healthy, and necessitates periodic lipid profile screening.

Desempenho da solicitação do perfil lipídico entre os setores público e privado

To evaluate the performance of lipid profile screening according to the mode of financing of medical appointments - public or private. A population-based cross-sectional study was carried out with a multi-stage sampling strategy. The study included 3,136 adults (>or=20 years old) from the city of Pelotas, Southern Brazil, in 2006. The following indicators were calculated: coverage (proportion of screened individuals among those meeting screening criteria), focus (proportion of individuals meeting screening criteria among those who were tested), screening errors (tests in individuals not meeting screening criteria - overscreening - and no screening of individuals meeting the screening criteria - underscreening), and screening ratio (ratio between number of individuals who met screening criteria and the number who failed to meet screening criteria among all individuals tested). Bivariate analyses were performed using Chi-squared tests. 95% confidence intervals (95% CI) were calculated for all parameters assessed. General coverage was 73.0% (95%CI: 70.8;75.2), and focus was 67.2% (95% CI: 64.7;69.3). In the public sector, compared to the private/health plan sector, coverage was lower (65.2% vs. 82.2%; p<0.001), focus was higher (74.7% vs. 62.3%; p<0.001), overscreening was lower (33.1% vs. 56.4%; p<0.0001), and underscreening was higher (34.8% vs. 17.8%; p<0.0001). Screening ratio was higher in the public (1.97) than in the private sector (1.46). The evaluation of adequacy of lipid profile requests among the population can provide important information regarding the following of protocols for screening and following-up dyslipidemias in different healthcare systems and, within a same system, between different modes of financing. Evaluations of this type provide an opportunity to diagnose inequalities and plan efforts to ensure greater equity of care.

Reducing the Risks of Cardiovascular Disease in Liver Allograft Recipients

Liver allograft recipients are at increased risk of death from cerebrovascular and cardiovascular disease. We propose the following strategy of risk-reduction, based on currently available literature. Lifestyle: standard advice should be given (avoidance of smoking, excess alcohol and obesity, adequate exercise, reduction of excess sodium intake). Hypertension: target blood pressure should be 140/90 mmHg or lower, but for those with diabetes or renal disease, 130/80 mmHg or lower. For patients without proteinuria, antihypertensive therapy should be initiated with a calcium channel blocker and for those with proteinuria, an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker. If monotherapy fails to achieve adequate response, calcium channel blockers and ACE-inhibitors or angiotensin II receptor blockers should be combined. If hypertension remains uncontrolled, an alpha-blocker may be added. Consideration should be given to changing immunosuppression and avoiding use of calcineurin inhibitors. Diabetes: recipients should be regularly screened for diabetes. For patients with new-onset diabetes after transplant, stepwise therapy should be guided by HbA1c concentrations, as with type II diabetes mellitus. Hyperlipidemia: annual screening of lipid profile should be undertaken, with treatment thresholds and targets based on those advocated for the high risk general population. Dietary intervention is appropriate for all patients. A statin should be considered as the first line treatment to achieve specified targets. In patients receiving a calcineurin inhibitor, Pravastatin should be commenced at a dose of 10 mg/day. In patients receiving other forms of immunosuppression, pravastatin may be commenced at a dose of 20 mg/day. Liver tests should be monitored and patients warned to report myalgia. If monotherapy is inadequate, ezetimibe or a fibrate may be added. Consideration may be given to change in immunosuppression if combination lipid-lowering therapy proves inadequate.

Serum lipids in hypothyroidism: Our experience

In order to determine whether the screening of lipid profile is justified in patients with hypothyroidism we estimated serum lipids in cases having different levels of serum TSH. 60 patients of hypothyroidism in the age group of 20 to 60 yrs were studied for thyroid profile over a period of one year. On the basis of serum TSH level the cases were divided into three groups: In the first group TSH concentration was 8.8±2.99 μlU/ml, 95% confidence interval (Cl) 8.8±1.07, whereas serum total cholesterol and LDL-chol levels were 196±37.22 and 126±29.17 mg/dl respectively. The statistical analysis of these two groups showed a significant correlation between raised TSH levels and serum total cholesterol and LDL-chol (P<0.05 & P<0.01) respectively. We conclude that hypothyrodism is associated with changes in lipid profile.

Dyslipidemia in Industrial Workers in Hot Environments

The aim of the study was to follow the rate and manifestation of dyslipidemia in industrial workers exposed to heat. One hundred and two male industrial workers exposed to heat and a control group of 102 male workers were studied. The microclimate components were followed and Wet Bulb Globe Temperature (WBGT) was calculated. The mean WGBT was 35.4 degrees C (28.4-41.7 degrees C) for the studied heat exposed work places. The lipid indices: total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triacylglycerols were assayed with enzymatic tests. TC/HDL-C ratio was calculated, too. Arterial pressure, anthropometric variables, smoking, alcohol use were followed and no significant differences between the studied groups were found. Significantly higher TC, LDL-C and TC/HDL-C were found with the heat exposed industrial workers. Odds ratio indicated higher risk in heat exposed industrial workers of becoming dyslipidemic [for TC OR = 1.481 (1.097-2.002) and for LDL-C OR = 1.539 (1,123-2.111)]. Regular screening of lipid profile in heat exposed workers is recommended.