Serum HDL-cholesterol Concentrations Research Articles

Strain, Sex, and Diet Dependent Responses to American and Ketogenic Diets in Mice

Abstract Objectives Carbohydrate restriction is a widely used dietary intervention to treat chronic diseases like metabolic syndrome. The ketogenic diet represents a severe type of carbohydrate restriction and is being rapidly adopted by metabolically healthy individuals. Recently, different responses to American (35% of energy from fat, 50% from carbohydrate) and ketogenic (80% of energy from fat, and 0% from carbohydrate) were observed between C57BL/6 J and FVB/NJ mice suggesting that genetic background effects response and non-response to carbohydrate restriction. Methods To further investigate the apparent response and non-response to carbohydrate restriction, we generated a C57BL/6 J x FVB/NJ intercross (F2) population (250 females and 264 males) to identify quantitative trait loci (QTL) involved in response to these two high fat diets. All animals were genotyped on the Mouse Universal Genotyping Array. Results Genetic analyses for fat gain during 3 months on diet revealed a diet and sex dependent (pdiet: Chr5 = 0.0013, psex: Chr5 = 0.0087) QTL on Chromosome (Chr) 5 at 73.7 Mb that results in a male-specific response to the ketogenic diet. There is an additional QTL on distal Chr1 at 191.6 Mb for fat mass gain in both males and females, on on both diets that overlaps with a QTL for serum HDL cholesterol concentration after 3 months on diet at 168.6 Mb. Conclusions This distal locus on Chr1 has previously been associated with Apoa2 and serum HDL cholesterol concentration in these strains. Additional candidate genes in these regions include Hsd11b1 and Srd5a3 and are associated with steroid hormone biosynthesis. These candidates are of primary interest given the relationship between cholesterol and synthesis of steroid hormones. These results demonstrate that the response to American and ketogenic diets is strain and sex specific. Our ongoing efforts to validate the regulatory role of these loci in response to carbohydrate restriction will be used to assess the utility of the relevant genotypes and analytes as biomarkers for response to carbohydrate restriction. Funding Sources National Institutes of Health.

Effect of Blueberry Consumption on Cardiometabolic Health Parameters in Men with Type 2 Diabetes: An 8-Week, Double-Blind, Randomized, Placebo-Controlled Trial.

ABSTRACTBackgroundBlueberries are dietary sources of polyphenols, specifically anthocyanins. Anthocyanins have been identified as having a strong association with type 2 diabetes risk reduction; however, to date few human clinical trials have evaluated the potential beneficial health effects of blueberries in populations with type 2 diabetes.ObjectivesWe investigated the effects of blueberry consumption for 8 wk on cardiometabolic parameters in men with type 2 diabetes.MethodsIn a double-blind, parallel-arm, randomized controlled trial, 52 men who are US veterans [mean baseline characteristics: age, 67 y (range: 51–75 y); weight, 102 kg (range: 80–130 kg); BMI (in kg/m2), 34 (range: 26–45)] were randomly assigned to 1 of 2 intervention groups. The interventions were either 22 g freeze-dried blueberries or 22 g placebo. The study participants were asked to consume 11 g freeze-dried blueberries or placebo with each of their morning and evening meals along with their typical diet.ResultsMean ± SE hemoglobin A1c (7.1% ± 0.1% compared with 7.5% ± 0.2%; P = 0.03), fructosamine (275.5 ± 4.1 compared with 292.4 ± 7.9 µmol/L; P = 0.04), triglycerides (179.6 ± 10.1 compared with 199.6 ± 19.9 mg/dL; P = 0.03), aspartate transaminase (23.2 ± 1.4 compared with 30.5 ± 2.7 units/L; P = 0.02), and alanine transaminase (35.6 ± 1.5 compared with 48.3 ± 2.9 units/L; P = 0.0003) were significantly lower for those consuming blueberries for 8 wk than for those consuming the placebo. Fasting plasma glucose concentrations; serum insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and C-reactive protein concentrations; blood pressure; and body weight were not significantly different after 8 wk consumption of blueberries compared with the placebo.ConclusionsConsumption of 22 g freeze-dried blueberries for 8 wk may beneficially affect cardiometabolic health parameters in men with type 2 diabetes.This trial was registered at clinicaltrials.gov as NCT02972996.

Effectiveness of germinated brown rice on metabolic syndrome: A randomized control trial in Vietnam.

To treating Metabolic Syndrome (MetS) in the human body by using cooked pre-germinated brown rice (PGBR), a randomized control trial was done in Vietnam. 80 subjects (65.1 ± 3.81 years old) separated into two groups in pairs were assigned a daily intake of 200 g PGBR, and the subjects in the placebo group were kept in normal living ways (consuming white rice). Before baseline and after 3 months of the intervention, anthropometric measurements, blood chemical examinations, a nutrition survey, and physical activity measurements were conducted. The main finding showed that the percentages of patients with MetS in the PGBR group were reduced significantly compared to the placebo group (p < 0.05). Serum HDL cholesterol concentrations were significantly increased from 1.11 (mmol/l) to 1.44 (mmol/l) compared to the placebo group (p < 0.05). The findings suggest that PGBR may affect HDL cholesterol, PGBR might be considered in reducing the risk of MetS in Vietnam.

Growth Performance, Intestinal Morphology, Serum Biochemical and Hematological Parameters in Japanese quail (Coturnix japonica) Fed Supplemental L-Arginine

This experiment was conducted to examine the effects of dietary L-arginine (Arg) supplementation on growth performance, intestinal morphology, serum biochemical and hematological parameters in meat-type quails. A total of one hundred and sixty 7-d-old male quail chicks were weighed and allocated to four treatment groups of four replicates, with 10 chicks/replicate. Four groups of quail chicks were fed basal diet containing 12.44 g lysine (Lys)/kg of diet (control), basal diet supplemented with 0.4, 1.21 and 1.84 g Arg/kg of diet (for Arg to Lys ratios of 100, 103, 109 and 114) for 28 days. The birds were fed diets from 7 to 38 d of age. Final body weight and feed:gain tended to improve by increasing Arg:Lys ratio to 109. Relative weight of spleen and bursa were significantly (p<0.05) increased by the addition of 0.4 g Arg/kg of diet. Morphometric parameters of jejunum were not affected by the dietary treatments. The uric acid, and triglyceride concentration of the serum significantly (p<0.05) decreased by increasing the Arg:Lys ratio to 114. Serum HDL-cholesterol concentration were significantly (p<0.05) increased by increasing the Arg:Lys ratio to 114. Monocytes were decreased by increasing the Arg:Lys ratio to 114. In conclusion, our results indicated that Arg supplementation in the quail diets did not appear to have any significant positive effects on performance criteria and although increasing Arg:Lys ratio to 114 could improve serum biochemical parameters.

Carbohydrate and sodium intake and physical activity interact with genetic risk scores of four genetic variants mainly related to lipid metabolism to modulate metabolic syndrome risk in Korean middle-aged adults.

Metabolic syndrome (MetS) risk is influenced by genetic and environmental factors. The present study explored genetic risk scores (GRS) of genetic variants that influence the MetS and the effect of interactions between GRS and nutrient intake on MetS risk. The genetic variants that influence MetS risk were selected by genome-wide association study after adjusting for age, sex, area of residence and BMI in 8840 middle-aged adults. GRS were calculated by summing the risk alleles of the selected SNP and divided into low (0-1), medium (2-3) and high (4-7) risk groups, and the relationships between the MetS and GRS were determined by logistic regression after adjusting covariates involved in MetS risk. We also analysed the interaction between GRS and lifestyles. Four genetic variants (APOA5_rs651821, EFCAB4B_rs4766165, ZNF259_rs2160669 and APOBEC1_rs10845640) were selected because they increased MetS risk after adjusting for covariates. Individuals with medium-GRS and high-GRS alleles had a higher MetS risk by 1·48- and 2·23-fold, respectively, compared with those with low-GRS after adjusting for covariates. The increase in MetS risk was mainly related to serum TAG and HDL-cholesterol concentrations. The GRS had an interaction with carbohydrate (CHO) and Na intakes and daily physical activities for MetS risk. In conclusion, Asian middle-aged adults with high-GRS alleles were at increased MetS risk mainly due to dyslipidaemia. High daily physical activity (≥1 h moderate activity per d) reduced the MetS risk but a low-CHO diet (<65 % of total energy intake) increased the risk in carriers with high-GRS alleles. Low Na intake (<1·6 g Na intake/4 MJ) did not decrease its risk.

Tofacitinib in the treatment of active rheumatoid arthritis - single-centre experience.

ObjectivesTo assess the efficacy and safety profile of tofacitinib taken orally at a dose of 10 mg/day in patients with severe active rheumatoid arthritis (RA).Material and methodsThe retrospective observational study included 10 patients (6 women and 4 men) with RA treated with tofacitinib. All the patients had high disease activity (DAS28 [ESR] > 5.1), despite therapy with two synthetic disease-modifying antirheumatic drugs (DMARDs). Before the initiation of treatment, routine laboratory tests were performed, and disease activity was assessed in all the subjects.ResultsThe mean age of the patients in the study group was 58.18 years (43–67). The average duration of RA was 9.9 years (2–24). The mean baseline value of DAS28 (ESR) was 6.37. Tofacitinib was used in combination with a conventional DMARD in all study subjects: with methotrexate in the majority of patients, and with leflunomide and an antimalarial drug in three patients. The mean duration of therapy with tofacitinib was 7.57 months (3.9–10.8). A significant decrease in the disease activity was observed (p < 0.05). A reduction in DAS28 (ESR) score was seen already after the first month of therapy, and the trend was maintained during subsequent months of follow-up. The mean value of DAS28 (ESR) after 6 months was 2.78. A slight increase in the serum concentration of HDL cholesterol was observed during treatment. In one patient symptoms of chronic upper respiratory tract infection led to discontinuation of the drug. The observed adverse events were of mild/moderate degree.ConclusionsThe results of our retrospective observational study conducted in the setting of daily clinical practice confirm a good clinical response to tofacitinib. Despite the observed adverse effects, in the light of the available data tofacitinib demonstrates a favourable safety profile. JAK kinase inhibitors – a new class of drugs – will enable a wider population of patients to achieve remission or low disease activity.

Serum concentration of full-length- and carboxy-terminal fragments of endothelial lipase predicts future cardiovascular risks in patients with coronary artery disease

Endothelial lipase (EL), a regulator of plasma high-density lipoprotein cholesterol (HDL-C), is secreted as a 68-kDa mature glycoprotein, and then cleaved by proprotein convertases. However, the clinical significance of the circulating EL fragments remains unclear. The objective of this study was to analyze the impact of serum EL fragments on HDL-C levels and major adverse cardiovascular events (MACE). Using novel monoclonal antibodies (RC3A6) against carboxy-terminal EL protein, we have established a new enzyme-linked immunosorbent assay (ELISA) system, which can detect both full-length EL protein (full EL) and carboxy-terminal truncated fragments (total EL) in serum. The previous sandwich ELISA detected only full EL. The full and total EL mass were measured in 556 patients with coronary artery disease. Among them, 272 patients who underwent coronary intervention were monitored for 2years for MACE. There was a significant correlation between serum full and total EL mass (R=0.45, P<.0001). However, the total EL mass showed a stronger inverse correlation with serum HDL-cholesterol concentration than the full EL mass (R=-0.17 vs -0.02). Kaplan-Meier analysis documented an association of serum total EL mass and MACE (log-rank P=.037). When an optimal cutoff value was set at 96.23ng/mL, total EL mass was an independent prognostic factor for MACE in the Cox proportional hazard model (HR; 1.75, 95% CI; 1.10-2.79, P=.018). Serum total EL mass could be a predictor for MACE in patients with coronary artery disease. This novel ELISA will be useful for further clarifying the impact of EL on HDL metabolism and atherosclerosis.

The Effects of Vitamin D Supplementation on Glycemic Control, Lipid Profiles and C-Reactive Protein Among Patients with Cardiovascular Disease: a Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Insulin resistance, dyslipidemia and chronic inflammation are important risk factors for cardiovascular diseases (CVD). Hence, vitamin D supplementation might be an appropriate approach to decrease the complications of CVD. This systematic review and meta-analysis aimed to determine the effects of vitamin D supplementation on glycemic control, lipid profiles, and C-reactive protein among patients with coronary artery disease. Two independent authors systematically searched online databases including EMBASE, Scopus, Pub- Med, Cochrane Library, and Web of Science until 20th September 2018. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. The heterogeneity among the included studies was assessed using Cochran's Q test and I-square (I2) statistic. Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size. A total of eight trials (305 participants in the intervention group and 325 in placebo group) were included in the current meta-analysis. Pooling effect sizes from studies revealed a significant reduction in fasting glucose (WMD): -15.67; 95% CI: -29.32, -2.03), insulin concentrations (WMD: -3.53; 95% CI: -4.59, -2.46) and homeostatic model assessment of insulin resistance (WMD: -1.07; 95% CI: -1.49, -0.66), and significant increase in the quantitative insulin-sensitivity check index (WMD: 0.02; 95% CI: 0.01, 0.03) following the administration of vitamin D. In addition, pooled analysis revealed a significant increase in serum HDL-cholesterol concentrations following vitamin D therapy (WMD: 3.08; 95% CI: 1.42, 4.73). Additionally, vitamin D supplementation significantly reduced C-reactive protein (CRP) levels (WMD: -0.75; 95% CI: -1.28, -0.23). This meta-analysis demonstrated the beneficial effects of vitamin D supplementation on improving glycemic control, HDL-cholesterol and CRP levels among patients with CVD, though it did not affect triglycerides, total- and LDL-cholesterol levels.

Protein and fat intake interacts with the haplotype of PTPN11_rs11066325, RPH3A_rs886477, and OAS3_rs2072134 to modulate serum HDL concentrations in middle-aged people

Low serum HDL cholesterol (HDL-C) concentration is a risk factor for cardiovascular diseases and it is influenced by genetic and environmental factors. We hypothesized that genetic variants that decrease serum HDL-C concentrations may interact with nutrient intakes in ways that increase or decrease the risk of cardiovascular disease. Candidate genetic variants that can lower serum HDL-C concentrations were explored by genome-wide association studies (GWAS), after adjusting for covariates, in the Ansan/Ansung cohort (n=8842) from KoGES. The best genetic variants were selected and used to form a haplotype. According to the haplotype frequencies of SNPs, they were divided into major allele, heterozygote allele, and minor allele. The association of haplotype with serum HDL-C levels was determined using logistic regression after adjusting for confounding factors. Interaction of the haplotype with nutrient intake was also determined. PTPN11_rs11066325, RPH3A_rs886477 and OAS3_rs2072134 were selected to modulate serum HDL-C levels from GWAS(P=1.09E-09, 7.04E-10, and 1.27E-09, respectively). The adjusted odds ratios (ORs) for a decrease in serum HDL-C concentration in the minor-allele group of the haplotype were elevated by 1.534 fold, compared to the major-allele group of the haplotype. Furthermore, the adjusted ORs for serum LDL cholesterol and levels increased by 1.645 in the minor-alleles compared to the major-alleles of the haplotype without a significant change of serum cholesterol levels. Interestingly, the adjusted ORs for serum triglyceride were lower in the minor-alleles than in the major-alleles. The haplotype had a significant interaction with the intake of protein, fat, saturated fatty acids (SAF) and polyunsaturated fatty acids (PUFA; P<0.05). In particular, the minor alleles of the haplotype decreased serum HDL-C levels compared to the major-alleles in the high intake of protein, fat, SFA, and PUFA, not in the low intake. People carrying the minor-allele of haplotypes should avoid diets that are high in protein and fat, especially rich in SFA and PUFA.

High Density Lipoprotein from Egg Yolk (EYHDL) Improves Dyslipidemia by Mediating Fatty Acids Metabolism in High Fat Diet-induced Obese Mice.

We investigated the effect of high density lipoprotein from egg yolk (EYHDL) on serum, hepatic and fecal lipid and fatty acids (FAs) levels and on gene expression involved in FAs metabolism. Male KM mice were fed either normal diet (ND; n=20), high fat diet (HFD; n=20), or high fat diet containing EYHDL (EYHDL; 0.6 mg/g, every day by oral gavage, n=20) for 100 days. At the end of the experiment, the effects of treatments on biochemical parameters, FAs profiles and involved gene expression were analyzed. Our results revealed that EYHDL markedly suppressed the body weight gain, accumulation of abdominal fat tissues, serum concentrations of LDL-cholesterol (LDL-C) and triglycerides, hepatic triglycerides and cholesterol accumulation, while increased serum concentration of HDL-cholesterol (HDL-C). EYHDL intake also increased total cholesterol (TC) excretions compared with HFD group. Moreover, it alleviated the severity of fatty liver and improved glucose and insulin tolerance compared with HFD. More importantly, EYHDL partially normalized FAs profiles in serum, liver and fecaces and neutralized the HFD-induced upregulation of SREBP-1c, Acaca, Fasn, GPAT and Scd1. In conclusion, our findings indicate that EYHDL may have the potential to improve metabolic disturbances that occur in HFD mice and can be considered as an appropriate dietary recommendation for the treatment of metabolic syndrome (MetS).

Serum Lipid Metabolic Derangement is Associated with Disease Progression During Chronic HBV Infection.

To investigate the relationship between serum lipid levels and disease progression during chronic hepatitis B virus infection. We selected 73 healthy controls and 163 patients with chronic HBV infection as the study subjects. The chronic HBV infection patients were divided into the HBV carrier group (74 patients), chronic hepatitis B group (71 patients), and liver cirrhosis group (21 patients). The age, gender, body mass index, blood lipid index, liver function index, and HBV DNA levels of all participants were tested and recorded. A t-test or the Mann-Whitney U test was used to compare the data between two groups; data from multiple groups were compared using one-way ANOVA or the Kruskal-Wallis Test. We observed that the serum HDL cholesterol (1.00 ± 0.30 mmol/L in the HBV-infected group, 1.29 ± 0.23 mmol/L in the control group) and APOA (1.29 ± 0.35 mmol/L, 1.36 ± 0.21 mmol/L, respectively) concentrations were significantly lower in the HBV-infected group than in the control group (p < 0.05). As the disease progressed, the blood lipid and lipoprotein values were significantly lower in the cirrhosis group TC (3.26 ± 1.00 mmol/L), HDL cholesterol (0.77 ± 0.33 mmol/L), LDL cholesterol (2.09 ± 0.62 mmol/L), and APOB (0.57 ± 0.18 mmol/L) compared with the control group, the carrier group, and the chronic hepatitis B group (p < 0.05). The serum HBV DNA level was significantly, positively correlated with the blood HDL concentration (carrier group R = 0.340, p = 0.02; chronic hepatitis B group R = 0.329, p = 0.014). There was no correlation between the HBV DNA and lipid levels in patients with cirrhosis. Serum lipid metabolic derangement was associated with disease progression during chronic HBV infection. Liver function and blood lipid levels were significantly lower in patients with hepatitis B-related cirrhosis.

Dermal microvessel density and maturity is closely associated with atherogenic dyslipidemia and accumulation of advanced glycation end products in adult patients with type 1 diabetes

In patients with diabetes, functional changes in microcirculation and subclinical vascular pathology precede clinical manifestation of microangiopathic complications. The objective of this study was to evaluate the association between established vascular risk factors and density, maturity, and reactivity of dermal blood vessels in adults with type 1 diabetes (DM1). We included 148 DM1 patients (87 men) with a median (IQR) age of 40.5 (30.5–49) years and a median diabetes duration of 21 (17–29.5) years. The control group consisted of 13 healthy volunteers (6 men) with a median (IQR) age of 36 (31–43). Accumulation of advanced glycation end products (AGEs) was assessed using the AGE-Reader device. In the immunohistochemical (IHC) analyses, anti-CD133, anti-CD34, anti-CD31, and anti-vWF autoantibodies were used. Microvessel density (MVD) in the skin was calculated using the “hot spots technique”. Microvascular function was examined by single-point laser-Doppler flowmetry (LDF). Median MVD, calculated for both papillary and reticular dermis, for CD31 antigen expression was 38 (19–56) per 1 mm2. The median CD34+ blood vessel density was 121 (100–155) per 1 mm2, CD133+ was 79 (63–92) per 1 mm2, and vWF+ was 50 (40–69) per 1 mm2. The average CD34/CD31 index was 2.78, the vWF/CD31 ratio was 1.32 and the CD133/CD31 ratio was 1.75. The CD34/CD31 index was positively associated with serum triglyceride concentration (Beta: 0.26, p = 0.012) and negatively associated with serum HDL cholesterol concentration (Beta: −0.22, p = 0.027), both independently from age, sex, diabetes duration, BMI, HbA1c value, presence of hypertension, and eGFR. We found a negative correlation between MVD assessed by CD31 and skin AF (r = −0.21, p = 0.016). In LDF, the area under the blood flow/time curve (AUC) correlated positively with CD31+ MVD (r = 0.21, p = 0.011) and negatively with CD34+ MVD (r = −0.20, p = 0.017). The MVD did not differ between participants with diabetes and healthy controls, and it did not differ according to the presence of retinopathy among the participants with diabetes. Atherogenic dyslipidemia is associated with increased formation of new blood vessels, characterized by high expression of CD34 and low reactivity in LDF. Conversely, chronic hyperglycemia and excessive formation of AGEs may result in decreased vascularity.

Retracted: High-dose ω-3 Fatty Acid Plus Vitamin D3 Supplementation Affects Clinical Symptoms and Metabolic Status of Patients with Multiple Sclerosis: A Randomized Controlled Clinical Trial

Combined omega-3 fatty acid and vitamin D supplementation may improve multiple sclerosis (MS) by correcting metabolic abnormalities and attenuating oxidative stress and inflammation. This study aimed to determine the effects of ω-3 fatty acid and vitamin D cosupplementation on the disability score and metabolic status of patients with MS. This was a randomized, placebo-controlled clinical trial with Expanded Disability Status Scale (EDSS) score and inflammation as primary outcomes and oxidative stress biomarkers and metabolic profile as secondary outcomes. Patients, aged 18-55 y, were matched for disease EDSS scores, gender, medications, BMI, and age (n=53) and randomly received a combined 2×1000 mg/d ω-3 fatty acid and 50,000 IU/biweekly cholecalciferol supplement or placebo for 12 wk. The placebos were matched in colour, shape, size, packaging, smell, and taste with supplements. Fasting blood samples were collected at baseline and end of intervention to measure different outcomes. Multiple linear regression models were used to assess treatment effects on outcomes adjusting for confounding variables. Patients taking ω-3 fatty acid plus vitamin D supplements showed a significant improvement in EDSS (β -0.18; 95% CI: -0.33, -0.04; P=0.01), compared with placebo. Serum high-sensitivity C-reactive protein (β -1.70 mg/L; 95% CI: -2.49, -0.90 mg/L; P<0.001), plasma total antioxidant capacity (β +55.4 mmol/L; 95% CI: 9.2, 101.6 mmol/L; P=0.02), total glutathione (β +51.14 µmol/L; 95% CI: 14.42, 87.87 µmol/L; P=0.007), and malondialdehyde concentrations (β -0.86 µmol/L; 95% CI: -1.10, -0.63 µmol/L; P<0.001) were significantly improved in the supplemented group compared with the placebo group. In addition, ω-3 fatty acid and vitamin D cosupplementation resulted in a significant reduction in serum insulin, insulin resistance, and total/HDL-cholesterol, and a significant increase in insulin sensitivity and serum HDL-cholesterol concentrations. Overall, taking ω-3 fatty acid and vitamin D supplements for 12 wk by patients with MS had beneficial effects on EDSS and metabolic status. This trial was registered at the Iranian website (www.irct.ir) for registration of clinical trials as IRCT2017090133941N20.

Leptin Concentration Predicts Future Metabolic Syndrome Risk in Japanese Americans Independent of Body Composition

Aims: Leptin has been shown to predict risk of metabolic syndrome (MetS), but it is not known whether this association is independent of body composition. Thus, we examined whether plasma leptin concentration predicted risk of MetS after adjustment for body composition measured using imaging. Methods: We used the modified ATP III MetS criteria for an Asian population to classify participants in the longitudinal Japanese-American Community Diabetes Study as to presence of MetS. Participants without MetS at baseline (n=283) were followed for its development over 5 years. CT-measured adipose depots included baseline and 5-year intra-abdominal and abdominal subcutaneous fat areas at the level of the umbilicus, subcutaneous mid-thigh fat area, and subcutaneous thorax fat area at the nipple level. Other measurements included fasting plasma leptin and serum HDL-cholesterol and triglyceride concentrations, fasting and 2 hour glucose from a 75 g OGTT, systolic blood pressure (SBP), and medication use. Logistic regression analysis was used to estimate the odds of incident MetS by leptin concentration, body composition, and baseline MetS features. Results: 65 participants developed MetS at 5-year follow-up. Multivariable logistic regression models showed a lower odds of incident MetS with 1-SD greater leptin concentration (OR = 0.45; 95% CI = 0.25-0.79; p = 0.006) adjusting for age, sex, CT-fat areas at baseline, and 5-year change in CT-fat areas. Additional adjustment for other MetS features at baseline (fasting and 2 hour glucose, triglycerides, HDL-cholesterol, SBP) yielded similar results (OR = 0.38; 95% CI = 0.20-0.71; p = 0.002). Conclusions: Leptin concentration predicts MetS risk in Japanese Americans independent of body composition. Further research is needed to confirm this association in other populations and to understand potential underlying biologic mechanisms. Disclosure C. Liao: None. W.Y. Fujimoto: None. S.E. Kahn: Advisory Panel; Self; Boehringer Ingelheim GmbH, Elcelyx Therapeutics, Inc., Eli Lilly and Company, Intarcia Therapeutics, Inc., Janssen Research &amp; Development, Merck &amp; Co., Inc., Novo Nordisk A/S. D.L. Leonetti: None. E.J. Boyko: None.

DIFFERENCES IN LABORATORY FINDINGS OF HYPERTENSIVE PATIENTS DEPENDING ON RISK FACTORS, SETTLEMENT AND AGE

Objective: Hypertension is a chronic disease with growing incidence. Monitoring of laboratory parameters is important in global cardiovascular risk assessment of hypertensive patients and prevention of complications. Evaluation and comparison of laboratory results and risks in patients included in distinct age groups and those from urban and rural settlements. Design and method: The study was conducted on 127 hypertensive patients during the first three months of 2017 at an urban outpatient unit specialized on cardiovascular diseases. Serum samples of patients were processed with Konelab20XTi analyzer using photometric method. Glycemia and lipid profile, kidney and liver function were determined. Urine tests were performed using the HandUReader equipment. Statistical processing of data was made using the GraphPad InStat program. Threshold of significance was set at p < 0.05. Results: Mean age of the patients was 63 years, 56.7% were male subjects. Significant difference (p = 0.0475) occured between serum HDL-cholesterol concentration of rural (average 75.6 mg/dl ± 12.5 SD) and urban patients (average 49.1 mg/dl ± 13.0 SD). Significantly higher serum urea levels were found in the rural subgroup (mean: 44.3 mg/dl ± 13.0 SD) compared to those from urban settlements (mean: 36.4 mg/dl ± 15.0 SD). Pathological urine compounds were found in 43.3% of rural patients and in 29.9% of urban subjects. Significant difference could be observed between the comorbidities present in these subgroups: diabetes was twice as frequent in the rural subgroup compared to urban subjects, prevalence of dislipidemia was three times higher in the urban group compared to rural patients. Significant difference could be observed between creatinine-based glomerular filtration rate (average 57.7 mL/min) of elderly subjects (>70 years) compared to higher values of younger patients, especially those under 60 years of age. No significant difference could be noticed between glycemia, serum uric acid, triglyceride, total cholesterol concentration and transaminase activity of different subgroups based on age or settlement. Conclusions: We can conclude that rural patients present higher protective HDL-cholesterol level compared to urban subjects and lower prevalence of dislipidemia, probably related to their different diet, this might also be the background of their higher serum urea concentration.

Prevalence and severity of nonalcoholic fatty liver disease by transient elastography: Genetic and metabolic risk factors in a general population.

The worldwide spread of obesity is leading to a dramatic increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) and its complications. We aimed to evaluate both prevalence and factors associated with NAFLD in a general population in a Mediterranean area. We considered 890 consecutive individuals included in the community-based ABCD (Alimentazione, Benessere Cardiovascolare e Diabete) study (ISRCTN15840340). Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were measured with FibroScan. Participants were genotyped for PNPLA3 rs738409 and TM6SF2 rs58542926 variants. The prevalence of NAFLD in the cohort was 48%. NAFLD participants exhibited elevated LSM values, suggesting advanced fibrosis (6.5% of cases). Both NAFLD and advanced fibrosis were independently associated with traditional risk factors (NAFLD: age >50years, obesity, hypertension, elevated ALT and low HDL-cholesterol serum concentrations. Advanced fibrosis: IFG/diabetes, elevated ALT serum concentrations). A high prevalence (>60%) of NAFLD was found in obese people, while it varied widely in non-obese people according to the presence of metabolic risk factors. PNPLA3G variant (OR=1.33, 95% C.I.=1.01-1.8; P<.05) was independently associated with NAFLD. Prevalence of advanced fibrosis (high LSM values) ranged from 3.4% (no risk factors) to 60% (presence of all risk factors). TM6SF2 T variant (OR=3.06, 95% C.I.=1.08-8.65, P<.05) was independently associated with advanced fibrosis (high LSM values). In a cohort of a general population, the prevalence of NAFLD was very high, and among NAFLD patients a significant proportion had advanced fibrosis (high LSM values). Apart from traditional risk factors, genetic factors may have a significant role that needs to be further investigated.

Avocado consumption and risk factors for heart disease: a systematic review and meta-analysis

Nutrients in avocados are associated with cardiovascular benefits. The aim of this study was to determine the effect of avocado intake on cardiovascular disease (CVD) risk with the use of a systematic review and meta-analysis. MEDLINE, Cochrane Central, and Commonwealth Agricultural Bureau abstracts were searched from 1946 through September 2017 for publications on avocado intake and CVD risk. All designs except for cross-sectional studies that evaluated avocado intake were included. Two investigators independently screened citations and extracted data. Random-effects models meta-analysis was used when ≥3 studies reported the same outcome. Of 18 eligible studies (481 subjects), 7 studies compared avocado intake with no intake, 3 studies compared avocado plus monounsaturated fat intake with a control, and 8 studies reported data for qualitative synthesis. In 7 studies, avocado intake significantly increased HDL cholesterol (summary net change: 2.84 mg/dL; 95% CI: 0.18, 5.49 mg/dL), with significant heterogeneity. This remained consistent in sensitivity and subgroup analyses. There was no significant difference between avocado intake and the control for the outcomes of serum total cholesterol (TC), LDL cholesterol, triglycerides (TGs), ratios of TC to HDL cholesterol and LDL cholesterol to HDL cholesterol, and body weight. In qualitative synthesis, there was no significant difference between groups for blood glucose (2 studies), homeostasis model assessment (1 of 2 studies), oxidized LDL (2 studies), high-sensitivity C-reactive protein (2 studies), or apolipoprotein B (2 studies) or, in 1 study each, for body mass index, systolic and diastolic blood pressure, arterial compliance, fibrinogen, interleukin 6, tumor necrosis factor α, and serum nitric oxide. No studies reported incident clinical outcomes of CVD, including myocardial infarction, stroke, and other clinical endpoints. Avocado intake resulted in no difference in serum TC, LDL-cholesterol, and TG concentrations, but it did increase serum HDL-cholesterol concentrations, with significant heterogeneity. The association between avocado intake and CVD risk should be confirmed by well-conducted prospective observational studies or long-term trials.

Body composition and lipid profile of regular recreational table tennis participants: a cross-sectional study of older adult men

The aim of the present study was to investigate the effects of regular participation in recreational table tennis training on bone health, body composition and lipid profile of elderly men. 20 regular recreational table tennis players (11.6 ± 3.6 years of experience) and 20 sedentary older adults (age, mass and sex matched of 65–75 years) participated in the study. Serum triglycerides, total cholesterol, HDL-cholesterol, and LDL-cholesterol concentrations were determined after 12 h fasting. Body composition was analyzed using dual-energy X-ray absorptiometry. Regular recreational table tennis participants displayed higher HDL-cholesterol (p = 0.03) and lower LDL-cholesterol (p = 0.04) and triglycerides (p = 0.002) compared to sedentary participants. In the regular recreational table tennis participants compared with sedentary participants, total (p = 0.001), sub-regional [lumbar spines (p = 0.001), arm (p = 0.006), leg (p 0.05). This study offers preliminary evidence to suggest that recreational table tennis training, with the potential for permanent implementation, is associated with beneficial effects on body composition and lipid profile in older adult men. Further research regarding recreational table tennis to be used as a health-promoting activity for older adults is warranted.

Short-Term Overfeeding with Dairy Cream Does Not Modify Gut Permeability, the Fecal Microbiota, or Glucose Metabolism in Young Healthy Men

BackgroundHigh-fat diets (HFDs) have been linked to low-grade inflammation and insulin resistance. ObjectiveThe main purpose of the present study was to assess whether acute overfeeding with an HFD affects insulin sensitivity, gut barrier function, and fecal microbiota in humans. MethodsIn a prospective intervention study, 24 healthy men [mean ± SD: age 23.0 ± 2.8 y, body mass index (in kg/m2) 23.0 ± 2.1] received an HFD (48% of energy from fat) with an additional 1000 kcal/d (as whipping cream) above their calculated energy expenditure for 7 d. Insulin sensitivity (hyperinsulinemic euglycemic clamp), gut permeability (sugar and polyethylene glycol absorption tests, plasma zonulin), and gut microbiota profiles (high-throughput 16S rRNA gene sequencing) were assessed before and after overfeeding, and 14 d after intervention. Additionally, inflammation markers such as high-sensitivity C-reactive protein, lipopolysaccharide-binding protein, leptin, high-molecular-weight adiponectin, calprotectin, regulated on activation normal, T cell expressed and secreted (RANTES), and monocyte chemoattractant protein-1 were measured in plasma by ELISA. Finally, lipid parameters were analyzed in serum by a laboratory service. ResultsAlthough participants gained 0.9 ± 0.6 kg (P < 0.001) body weight, overnutrition was not associated with a significant change in insulin sensitivity (M value and glucose disposal). Overfeeding for 7 d resulted in elevated serum total (10.2%), LDL (14.6%) and HDL (14.8%) cholesterol concentrations (P < 0.01). In contrast, fasting plasma triglyceride significantly declined (29.3%) during overfeeding (P < 0.001). In addition, there were no significant changes in inflammatory markers. Urine excretion of 4 sugars and polyethylene glycol, used as a proxy for gut permeability, and plasma concentration of zonulin, a marker of paracellular gut permeability, were unchanged. Moreover, overfeeding was not associated with consistent changes in gut microbiota profiles, but marked alterations were observed in a subgroup of 6 individuals. ConclusionsOur findings suggest that short-term overfeeding with an HFD does not significantly impair insulin sensitivity and gut permeability in normal-weight healthy men, and that changes in dominant communities of fecal bacteria occur only in certain individuals. The study was registered in the German Clinical Trial Register as DRKS00006211.

Factors associated with circulating concentrations of irisin in the general population cohort of the ABCD study.

Animal studies have shown that irisin is a myokine secreted following physical exercise, and that it induces the remodeling of white adipose tissue toward brown adipose tissue. Therefore, a protective role of irisin against obesity, diabetes, and other metabolic and cardiovascular conditions has been hypothesized. However, data in humans are contradictory and few data are available concerning the general population. We aimed to evaluate the association between serum irisin concentrations and habitual physical activity, as well as other metabolic and cardiovascular factors in a general population in a Mediterranean area. We considered 858 consecutive individuals included in the ABCD (Alimentazione, Benessere Cardiovascolare e Diabete) study (ISRCTN15840340), a longitudinal observational single-center study of a cohort representative of the general population of Palermo, Sicily. Irisin serum concentrations (Phoenix Europe, Germany), habitual physical activity (HPA) level, and other blood and clinical variables were measured. The irisin serum concentrations were not normally distributed in the cohort (Shapiro-Wilk test=0.94; P<0.001). A significant association between irisin concentrations and HPA was observed (P<0.001). Irisin concentrations were higher in women than in men (P<0.01), and significantly correlated with serum concentrations of HDL-cholesterol (P<0.05) and hs-C-reactive protein (hs-CRP; P<0.05). Binary logistic regression analysis demonstrated that high (⩾ median value) irisin serum concentrations were significantly associated with female gender (OR=1.63; 95% CI=1.16-2.28), high serum hs-CRP concentrations (OR=1.61; 95% CI=1.02-2.54) and the HPA level (OR=1.42; 95% CI=1.02-1.96). Our study confirms, in a cohort of a general population, that irisin concentrations gradually increase with the usual level of habitual physical activity.