Blood Total Cholesterol Research Articles

Increased risk of vascular complications in patients with type 2 diabetes and fatty liver disease

BackgroundThe prevalence of steatotic liver disease (SLD) in patients with type 2 diabetes (T2DM) exceeds 50%. This study aimed to investigate the clinical characteristics of SLD and liver fibrosis in Chinese patients with T2DM.MethodsInpatients from 2021 to 2023 were included in the study. Fatty liver index (FLI) and fibrosis-4 (FIB-4) were calculated to assess hepatic steatosis and fibrosis respectively. Statistical analysis was completed by SPSS v25 and GraphPad Prism v8.0.1.ResultsOf the 1466 participants, about one-third of the patients in T2DM-SLD group were diagnosed with liver fibrosis (LF), and the percentage of patients over 50 years old was 85.9%. Patients with SLD had higher levels of BMI, blood pressure, liver enzymes, fasting blood glucose (FBG), HbA1c, C-peptide, total cholesterol (TC) and triglyceride (TG) (P<0.05 for all). Patients with liver fibrosis had lower TC, TG, hemoglobin (Hb), erythrocyte count (RBC), leukocyte count (WBC) and platelet (PLT) levels (P<0.05 for all). Compared with simple T2DM and SLD-NLF (non-liver fibrosis) groups, for patients over 50 years old, the prevalence of coronary heart disease, stroke, tumor, and diabetic nephropathy was higher in patients with liver fibrosis. Liver fibrosis might be the risk factor of arterial stiffness, stroke, coronary heart disease and numbness based on multivariable logistic regression analysis.ConclusionHepatic steatosis and fibrosis were common in patients with T2DM. Liver fibrosis was relevant to many macrovascular and microvascular diabetic complications.

Impact of Genetic Risk Information for Cardiovascular Disease on Behavioural, Psychological Responses, and Risk Factor Modification: A Systematic Review.

Cardiovascular disease (CVD) remains a significant public health concern, influenced by both genetic susceptibility and lifestyle factors. Integrating genetic risk information into clinical practice shows promise but has yielded mixed results regarding its impact on CVD prevention and management. This systematic review aimed to assess the impact of providing genetic CVD risk information on health behaviours, psychological outcomes, and risk factors. Following JBI methodology and PRISMA 2020 guidelines, four electronic databases and two trial registries were searched for randomised controlled trials evaluating the impact of genetic risk information on the CVD risk profile. Data was synthesised using a narrative synthesis approach. Of the 3,596 articles retrieved, 11 studies were eligible. Genetic risk information showed modest improvements in dietary behaviour but had inconclusive effects on physical activity and medication adherence. Minimal changes in psychological outcomes were noted, including a slight decrease in depression. The impact on traditional risk factors, such as systolic blood pressure and total cholesterol was also limited. Bias across all studies was noted. Genetic CVD risk information has limited effects on clinical outcomes and psychological factors, despite its potential to encourage some health behaviour changes. These findings suggest that genetic risk information alone may not be sufficient to significantly reduce cardiovascular risk, highlighting the need for further research to better understand its long-term effects.

Using Lipid Parameters in Predicting Preterm Infants with Respiratory Distress Syndrome

Background: Respiratory distress syndrome is a clinical diagnosis which is warranted in a preterm newborn with respiratory difficulty, including tachypnea (&gt;60 breaths/min), chest retractions, and cyanosis in room air that persist or progress over the first 48-96 hr of life, and a characteristic chest radiographic appearance. Objective: to assess the cord blood lipid profile for predicting of preterm infants with respiratory distress syndrome. Methods: This is a case control study which was conducted on 50 preterm neonates admitted to the neonatal intensive care unit of Shebin El-Kom teaching hospital between January 2011 and October 2011. Results: the mean of weight gain during pregnancy in mothers of preterm with RDS was lower than the control group and the difference was statistically highly significant (P&lt;0.01). Also, there was significant difference (P&lt;0.05) regarding mode of delivery and antenatal steroid, however; no statistical significant difference was detected regarding maternal age, maternal weight, maternal BMI, pre-gravid height, the ruptured membrane &gt; 24 hr and parity between both groups. the mean of total cholesterol, HDL-cholesterol and LDL-cholesterol in the cord blood was lower in group A than in group B and the difference was statistically highly significant (P &lt;0.01), but there was no significant difference regarding the mean of both triglycerides and VLDL-cholesterol in both groups (P&gt;0.05).the mean of total cholesterol, HDL-cholesterol and LDL-cholesterol was lower in mothers of preterm infants with RDS than in control group and the difference was statistically highly significant (P &lt;0.01), but there was no significant difference was detected regarding the mean of levels triglycerides and VLDL-cholesterol in both groups (P &gt;0.05).the cutoff values of cord blood (total Cholesterol, HDL-C, and LDL-C) below which RDS can be predicted are 80, 45.5 and 23.2 mg/dl respectively with a sensitivity of 83.3%, 86.7% and 86.7% and with specificity of 95%, 80% and 70% respectively. Conclusion: We conclude that RDS is accompanied with lipid alteration in the infants and their mothers. The results of this study point to the importance of measuring of maternal serum and cord blood lipid profile as a predictor for the occurrence of RDS.

Immune response to GeneVac-B® (rDNA I.P. hepatitis B vaccine) in vaccinated persons with a standard schedule in Bobo-Dioulasso, Burkina Faso

Background: GeneVac-B® was recently licensed in Burkina Faso and is widely used for population vaccination. This study aimed to evaluate the immune response in people fully vaccinated against hepatitis B with the GeneVac-B® vaccine in Burkina Faso under actual conditions of use. Material and Methods: This cross-sectional study included individuals fully vaccinated with GeneVac-B®. For each consenting participant, sociodemographic and clinical data were collected using a structured questionnaire. Approximately 4 mL of whole blood was collected for immunological (anti-HBs, HBsAg, anti-HCV and anti-HIV) and biochemical (blood glucose, total cholesterol, and triglycerides) testing. The anti-HBs titer was used to determine the immune response. Results: A total of 392 participants were included in the study. The mean age was 35.5±15.3 years. Approximately 56% had been previously exposed to HBV. Three hundred eighty (380) participants had an anti-HBs titer ≥ 12 mIU/mL indicating a seroprotection rate of 96.9%, and 12 had a titer < 12 mIU/mL, a nonresponse rate of 3.1%. Among the nonresponders, 11 (11/12; 91.7%) had high total cholesterol levels (> 240 mg/dL), and 8 (8/12; 66.7%) were older than 40 years of age. Conclusions: The results showed an excellent immune response to GeneVac-B® in our study population. However, age > 40 and high total cholesterol appear to be factors associated with nonresponse.

10-Year Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score Calculation in Out-Patient Department

Objective: To calculate 10-year Atherosclerotic Cardiovascular Disease risk score in outdoor department of a tertiary care hospital and identify individuals at high risk of cardiovascular disease. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Malir, Pakistan, from Oct 2020 to Mar 2021. Methodology: 116 patients presenting to Out-Patient Department of General Medicine of CMH, Malir, Pakistan, without previous evidence of cardiovascular disease were included. Previous history of diabetes, smoking, use of anti-hypertensives, Aspirin and statins was recorded. Systolic and diastolic blood pressures, waist circumference, HbA1c, fasting blood sugar, fasting LDL, HDL and total cholesterol were tested for each patient. 10-year ASCVD risk score was calculated using online ASCVD Risk Estimator calculator. Results: Mean age of the patients was 58.6±9.92 years with 62.1% being males and 37.9% being females. Mean 10-year ASCVD risk score was 13.37±7.1, of which 21 patients (18.1%) had Very High, 66(56.9%) had Intermediate and 29(25%) had Low 10-year ASCVD risk score. Among Very High cases, 80.9% were males, all were in age group 50-79 years, 61.9% were diabetic, 33.3% were smokers and 66.7% were obese. Conclusion: A very high percentage of study group had Intermediate or Very High 10-year ASCVD risk score. Identifying those individuals at high risk early and controlling the modifiable risk factors can help lessen the morbidity and mortality associated with cardiovascular diseases.

Efficacy of Myricetin Supplementation on Glucose and Lipid Metabolism: A Systematic Review and Meta-Analysis of In Vivo Mice Studies

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a disorder characterized by insulin resistance, hyperglycemia, and dyslipidemia. Myricetin, a flavonoid found in various plants, has shown potential anti-diabetic effects in murine studies. This meta-analysis aimed to evaluate the impact of myricetin supplementation on glucose metabolism and lipid profiles in mouse models of metabolic diseases. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPERO: CRD42084518999). Studies involving mice with metabolic disease models and exclusively using myricetin supplementation were checked across four databases (Embase, Scopus, PubMed, and WoS) until 23rd September 2024. The primary outcomes assessed were blood glucose (BG), insulin levels, triacylglycerol (TAG), total cholesterol (TC), HDL, and LDL. A random-effects model was applied to estimate standardized mean differences (SMD), and SYRCLE’s risk-of-bias tool for animal studies was used. Results: Twenty-one studies with 514 mice met the inclusion criteria. Myricetin supplementation significantly reduced BG (SMD = −1.45, CI: −1.91 to −0.99, p &lt; 0.00001, I2 = 74%), insulin (SMD = −1.78, CI: −2.89 to −0.68, p = 0.002, I2 = 86%), TAG (SMD = −2.60, CI: −3.24 to −1.96, p &lt; 0.00001, I2 = 81%), TC (SMD = −1.86, CI: −2.29 to −1.44, p &lt; 0.00001, I2 = 62%), and LDL (SMD = −2.95, CI: −3.75 to −2.14, p &lt; 0.00001, I2 = 74%). However, the effect on HDL was not statistically significant (SMD = 0.71, CI: −0.01 to 1.43, p = 0.05, I2 = 83%). Conclusions: Myricetin supplementation improved glucose metabolism and lipid profiles in mouse models, suggesting its potential as a therapeutic agent for managing T2DM. However, further research is needed to confirm these findings in human studies.

Взаємозв’язок між хронічною хворобою нирок та серцево-судинною патологією у хворих на цукровий діабет 2-го типу різного віку

The aim – to analyze the relationship between chronic kidney disease (CKD) and cardiovascular pathology in patients with type 2 diabetes (T2D) of different ages.Materials and methods. A total of 233 patients with T2D aged 30-80 years were examined. Anthropometric indicators, blood pressure, glucose levels, glycated hemoglobin, C-peptide, total cholesterol, triglycerides, low-density and high-density lipoprotein cholesterol, creatinine, glomerular filtration rate, AST, and ALT were measured in all patients. Groups of patients were compared based on the presence of CKD and age using Student’s t-test and Pearson’s chi-squared test.Results and discussion. In patients with T2D and CKD, the incidence of coronary heart disease (CHD) (OR 1.8; 95 % CI 1.02–3.23; p=0.044), myocardial infarction (OR 2.0; 95 % CI 1.01–3.95; p=0.046), and strokes (OR 2.66; 95 % CI 1.07–6.63; p=0.036) is significantly higher compared to patients with T2D without kidney pathology. When comparing the clinical indicators of patients with T2D combined with CKD and those without it, no significant differences were found in anthropometric measurements, blood pressure, blood glucose levels, glycated hemoglobin, or C-peptide levels. The levels of total cholesterol, hemoglobin, and red blood cell count in the blood were significantly lower (р&lt;0.05), while the levels of creatinine and glomerular filtration rate were significantly higher (р&lt;0.001) in patients with kidney pathology.Conclusion. In patients with T2D, a relationship between CKD and cardiovascular pathology has been established. It can be assumed that the development of kidney pathology in patients with T2D is a significant risk factor for cardiovascular diseases.

The Cardiometabolic Multimorbidity Risk Profile of Females Living in Glendale, ILembe District of Kwa-Zulu Natal

Background: Empirical studies have indicated that cardiometabolic multimorbidity risk profiles are upsurging among the South African population. However, there is a limited number of studies that have been conducted to validate these findings in rural communities. Aim: To study the prevalence of cardiometabolic risk factors of females residing in rural Glendale in the ILembe District, South Africa. Methods: One hundred females (aged 18–40 years) voluntarily participated in a cross-sectional observational study. All participants completed an ISAK somatotype profiling, and measured their fasting cholesterol, glucose, blood pressure and resting heart rate. Results: Participants’ average age, body mass index, stature, and body mass, were 28.34 ± 7.07 years, 29.5 ± 8.06 kg/m2, 157.26 ± 6.09 cm, and 72.9 ± 21.12 kg, respectively. The cohort had a mean waist circumference of 94.2 ± 22.1 cm, hip circumference of 108.4 ± 20.9 cm, and waist-to-hip ratio of 0.86. Participants’ mean heart rate, systolic blood pressure, and diastolic blood pressure were 86.31 ± 8.68 bpm, 116.79 ± 16.34 mmHg, and 82.14 ± 10.87 mmHg, respectively. Eleven participants recorded a resting heart rate greater than 100 bpm. Average blood glucose, total cholesterol, low-density lipoprotein, and high-density lipoprotein recorded were 4.87 ± 1.26 mmol/L, 3.78 ± 0.94 mmol/L, 1.76 ± 1.86 mmol/L, and 1.31 ± 0.4 mmol/L. Eighty-three participants HDL-C were below the recommended normative value of 1.55 mmol/L. Conclusion: The average participant presented as overweight, with elevated diastolic blood pressure, and a resting heart rate that has been proven to increase one’s cardiometabolic multimorbidity risk profile. Additionally, a small portion of the cohort were identified to be prediabetic and diabetic. Large proportion of participants had low HDL-C levels suggestive of poor cardiovascular disease protection.

Prognostic role of remnant cholesterol and traditional cardiovascular risk factors in young adults: results of long-term follow-up of a cohort of 30-year-old norwegians

Abstract Background There are limited data on the prevalence and impact of traditional cardiovascular (CV) risk factors among young adults. In addition, more knowledge on novel CV risk factors is needed to explain the residual risk beyond that of the traditional risk factors. Increasing evidence suggest a causal role of remnant cholesterol (RC) in the development of atherosclerotic cardiovascular disease (CVD) and subsequent clinical events. However, the role of RC in young adults is unresolved. Purpose We aimed to evaluate the prevalence of traditional risk factors and the respective sex-differences in young adults, as well as their association with long-term CV events. Further, we hypothesized that higher RC concentrations are associated with impaired CV prognosis. Methods In year 2000, all 30-year-old inhabitants of our city were invited to a cross-sectional study including assessment of health status, anthropometric measurements, and non-fasting blood samples. RC was calculated as total cholesterol minus (LDL-C + HDL-C). Long-term clinical follow-up was performed through linkage with mandatory national registries, 22 years after inclusion. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, hospitalization for unstable angina and coronary revascularization. Results A total of 5950 individuals were included (56% women). At baseline, men displayed significantly higher systolic and diastolic blood pressure, total cholesterol, LDL-C and triglycerides, as compared with women (Table 1). Also, men had higher levels of RC (Table 1). During a mean follow-up time of 22 years, 108 events (1.8%) occurred. In multivariable Cox regression analysis, non-West-European ancestry (adjusted [a] HR 1.76, 95% confidence interval [CI] 1.03-2.99), diabetes mellitus (aHR 6.39, 95% CI 2.52-16.2), systolic blood pressure (aHR 1.03, 95% CI 1.01-1.04), and LDL-cholesterol (aHR 1.37, 95% CI 1.11-1.68) were associated with an increased risk of CV events during long-term follow-up. Female gender was associated with a reduced risk of CV events (aHR 0.38, 95% CI 0.23-0.64), whereas smoking status did not show any significant association. RC was identified as a significant predictor of CV events (aHR 1.55, 95% CI 1.11-2.18, per 1.0 mmol/L increase). The highest RC quartile (mean RC: 1.1 mmol/L), had the highest event rate (Figure 1, p&amp;lt;0.001 with log-rank test). Conclusion This study uncovers significant sex-differences in modifiable CV risk factors among young adults at the age of 30, which are associated with increased risk for long-term CV events. Interestingly, increasing concentrations of RC at the age of 30 were strongly associated with impaired long-term CV outcome and should be accounted for in early risk prediction.Baseline characteristics.Remnant cholesterol and CVD events.

The association of inflammation, triglycerides and lipoprotein(a) with cardiovascular events in the UK Biobank

Abstract Background Recent trial data has suggested that high-sensitivity C-reactive protein (hsCRP) is, at least, as strong a predictor of future cardiovascular events as LDL cholesterol in patients on lipid-lowering therapy1,2. There are limited data however on how hsCRP and other additional risk factors perform in patients at different levels of CVD risk. Purpose To evaluate the relationship of hsCRP, triglyceride and lipoprotein(a) [Lp(a)] levels with cardiovascular events in guideline-defined, clinically distinct cohorts. Such a study will improve the understanding of CVD risk prediction and provide essential information on the role of these pathways in CVD. Methods Data from the UK Biobank were used. In accordance with the 2021 ESC CVD prevention guidelines, four risk groups were derived based on clinical data and 10-year CVD risk, calculated from the recently derived SCORE2 model (Figure 1)3. Those not falling into one of the four cohorts were excluded as further risk stratification in these individuals would not influence management. For increasing quartiles (Q) of each biomarker, hazard ratios (HR), 95% confidence intervals (CI) and p-values were calculated relative to the lowest Q, using Cox proportional hazards models, adjusted for age, sex, smoking status, systolic blood pressure, HDL cholesterol and total cholesterol. Interactions between sex and biomarker were explored. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, myocardial infarction, and ischaemic stroke. Secondary endpoints were the individual components of the primary endpoint. Results A total of 229,339 participants were included across the four risk groups, with a total of 24,133 primary endpoint events over the mean follow-up period of 14 years. In all four groups there was a robust linear relationship of hsCRP with MACE (p&amp;lt;0.001 [Figure2]) – strongest in the secondary prevention population (Q4 v Q1 HR=1.79 [95%CI:1.60, 2.02]). Of the secondary endpoints, hsCRP was most strongly associated with cardiovascular death (Q4 v Q1 secondary prevention cohort HR=1.97 [1.68, 2.30]). Lp(a) was associated with MACE in the primary prevention cohorts only (Q4 vs Q1 high-risk cohort HR=1.35 [1.27, 1.44]), driven by its strong association with myocardial infarction (Q4 vs Q1 HR 1.61 [1.48, 1.75]) but not other secondary endpoints. After adjustment, triglyceride levels were not associated with MACE in the four cohorts. There was no evidence of sex interactions in any analysis (p&amp;gt;0.05). Conclusions After adjustment for traditional CVD risk factors, hsCRP is a more robust predictor of cardiovascular events than Lp(a) or triglycerides in both primary and secondary prevention settings. Consideration should be given to evaluating whether hsCRP, Lp(a) and other ‘non-traditional’ risk factors can improve CVD risk reclassification and/or be used to guide allocation to targeted anti-atherosclerotic therapies.Figure 1:Participant FlowFigure 2:Main effects

AI-enabled cardiac chambers volumetry in coronary calcium scans (AI-CAC) predicts heart failure and outperforms NT-proBNP: The Multi-Ethnic Study of Atherosclerosis

Abstract Introduction Coronary artery calcium (CAC) scans contain useful information beyond the Agatston CAC score that is not currently reported. We recently reported that artificial intelligence (AI)-enabled cardiac chambers volumetry in CAC scans (AI-CAC) predicted incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis (MESA). In this study, we investigated the performance of AI-CAC for prediction of incident heart failure (HF) and compared it with 10 known clinical risk factors, NT-proBNP, and the Agatston CAC score. Methods We applied AI-CAC to 5750 CAC scans of asymptomatic individuals (52% women, White 40%, Black 26%, Hispanic 22% Chinese 12%) free of known cardiovascular disease at the MESA baseline examination (2000-2002). We used the 15-year outcomes data and compared the time-dependent area under the curve (AUC) of AI-CAC versus NT-proBNP, Agatston score, and 10 known clinical risk factors (age, gender, diabetes, current smoking, hypertension medication, systolic and diastolic blood pressure, LDL, HDL, total cholesterol, and hs-CRP) for predicting incident HF over 15 years. Results Over 15 years of follow-up, 256 HF events accrued. The AUC for predicting HF with AI-CAC (0.826) was significantly higher than NT-proBNP (0.742) and Agatston score (0.712) (p&amp;lt;.0001), and comparable to clinical risk factors (0.818, p=0.4141). AI-CAC category-free Net Reclassification Index (NRI) significantly improved on clinical risk factors (0.32), NT-proBNP (0.46), and Agatston score (0.71) for HF prediction at 15 years (p&amp;lt;0.0001). Conclusion AI-CAC significantly outperformed NT-proBNP and the Agatston CAC score, and significantly improved the AUC and category-free NRI of clinical risk factors for incident HF prediction.

Evaluating trends and insights in cardiovascular risk among the polish population

Abstract Introduction Cardiovascular diseases (CVD) are the leading cause of death in Poland and worldwide. Lifestyle changes and early diagnosis can reverse this unfavorable trend. In the face of escalating global health challenges, the identification of CVD risk factors becomes paramount, especially within national contexts where demographic shifts and lifestyle changes can significantly impact the health profile of the population. Aim of the study. Determining the prevalence of CVD risk factors in the Polish population and analyzing their changes over time. Material and Methods Data of 705,420 Poles aged 35-55 years who were enrolled in CVD disease prevention programme between 2012 and 2021 were analysed. The prevalence of the following CVD risk factors was determined: nicotinism, hypertension, elevated total cholesterol, elevated LDL, reduced HDL, elevated triglycerides, elevated glucose (indicating pre-diabetes), low physical activity, overweight, obesity, SCORE ≥5%. In addition, we assessed how the mean SCORE, BMI, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL cholesterol, LDL cholesterol, triglycerides, glucose levels and waist circumference changed over time. Results Nicotinism affected 17.98%-24% of women (W) and 27.29%-36% of men (M). Hypertension was in 7.04%-8.58% of W and 17.45%-19.62% of M. Elevated total cholesterol were in 55.69%-63.64% of W and 65.91%-72.68% of M. Elevated LDL were in 44.77%-54.2% of W and 58.26%-65.48% of M. Reduced HDL were in 9.84%-11.52% of W and 14.48%-16.57% of M. Elevated triglyceride were in 13.44%-15.37% of W and in 33.81%-36.29% of M. Elevated glucose indicating a pre-diabetic status were in 10.70%-13.16% of W and in 18.91%-22.76% of M. Low physical activity was in 75.96%-82.2% of W and 73.32%-81.67% of M. Overweight conditions were in 30.37%-31.67% of W and 48.61%-49.45% of M. Obesity affected 14.04%-17.12% of W and 20.67%-24.69% of M. SCORE ≥ 5% was in 0.23%-0.38% of W and in 13.08%-18.72% of M. There was a decrease in the mean SCORE value (-0.08; 95%CI: -0.09 - -0.06) from 2012. An increase over time was noted in mean BMI (-0.01; 95%CI: -0.05 - 0.04). There was a slight decrease followed by a notable increase over time in mean systolic (-0.35; 95%CI: -0.47 - -0.24) and diastolic blood pressure (-0.25; 95%CI: -0.32 - -0.18). There was a decrease in mean total cholesterol (-3.29; 95%CI: -4.27 - -2.31) and mean LDL cholesterol (-3.11 95%CI: -4.22 - -2.01). A notable increase was observed in mean glucose values (0.01; 95%CI: 0-0.01). Over time, there was an increase in mean waist circumference value (-0.19; 95%CI: -0.54-0.16). Conclusions The escalation of CVD risk among the Polish population is illustrated, with a marked increase in obesity, sedentary lifestyles and indicators of metabolic syndrome. These trends highlight the urgent need for targeted public health initiatives and for the implementation of comprehensive strategies to mitigate these risks

Exploring the efficacy of al-hijamah (wet cupping) in managing hypertension and dyslipidemia among indonesian population: a meta-analysis

Background: In Indonesia, wet cupping therapy has been thoroughly investigated as a treatment for hypertension and dyslipidemia. Nevertheless, the outcomes across these studies are contradictory. Objectives: To appraise the effectiveness of wet cupping therapy in the management of hypertension and dyslipidemia among the Indonesian population. Methods: We examined papers sourced from Google Scholar, the Indonesian Scientific Journal Database, and Garba Rujukan Digital until September 5, 2020. These papers investigated blood pressure and lipid profile levels both pre- and post-wet cupping treatment. The collective data underwent Z-test analysis to assess associations. Results: In total, we included 26 papers examining the correlation between wet cupping therapy and blood pressure, as well as 16 papers assessing lipid profile levels. Our combined analysis revealed significantly reduced systolic blood pressure (MD: 13.86; 95% CI: 10.01, 17.71), diastolic blood pressure (MD: 6.31; 95% CI: 3.84, 8.79), and lower total cholesterol levels (MD: 21.56; 95% CI: 10.32, 32.80]) in the post-treatment group compared to the pre-treatment group. However, we were unable to elucidate the impact of wet cupping therapy on the concentrations of low-density lipoprotein and triglyceride. Conclusions: Wet cupping therapy exhibits potential efficacy in reducing blood pressure and total cholesterol levels among individuals in Indonesia. Keyword: blood pressure, dyslipidemia, hypertension, lipid profile, wet cupping therapy

Prevention of dementia using mobile phone applications (PRODEMOS): a multinational randomised controlled effectiveness-implementation trial

Abstract Background The expected increase of dementia prevalence in the coming decades will mainly be within low-and middle-income countries and those with low socioeconomic status (SES) in high income countries. Forty percent of dementia is associated with modifiable, lifestyle-related cardiovascular risk factors. Mobile health interventions with remote coaching can help reach underserved high-risk populations globally. Methods This open label, blinded endpoint, hybrid effectiveness-implementation randomised controlled trial (RCT) investigated whether a coach-supported mHealth intervention can reduce dementia risk in persons aged 55-75 years of low SES in UK or from the general population in China with at least two dementia risk factors. The primary effectiveness outcome was change in CAIDE dementia risk score (including age, education, sex, systolic blood pressure, total cholesterol, BMI, physical exercise) after 12-18 months of intervention. Main implementation outcomes were coverage, acceptability, appropriateness, adoption, feasibility, sustainability, fidelity, and costs using a mixed methods approach. Findings Between 15th January 2021 and 18th April 2023, 1,488 persons were included and randomised (734 intervention, 754 control), with 1,229 (82·6%) available for analysis of the primary effectiveness outcome. After a mean follow-up of 16 months, the mean CAIDE score improved by 0·16 points in the intervention group vs. 0·01 in the control group (Mean Difference (MD) 0·16, 95% Confidence Interval (CI) 0·03-0·29). The effect was larger in those who adhered to the intervention (MD 0·27, 95%CI 0·12-0·44) and those planning to change lifestyle (MD 0·33, 95%CI 0·10-0·57). Ten percent of those invited participated; of these, 81% adopted the intervention and 50% continued active participation throughout the study. For the individual components of the CAIDE score, there were no statistically significant differences for systolic blood pressure, total cholesterol and BMI, but in the intervention group physical inactivity was reduced more than in the control group (MD 6·7%, 95%CI 2·1 to 11·2) and more participants quit smoking (MD -3·1%, 95%CI -4·8 to -1·5). Interpretation A coach-supported mHealth intervention to improve lifestyle is modestly effective in reducing dementia risk factors in those with low SES in the UK and any SES in China. Implementation is challenging in these populations, but those reached actively participated. Whether this will result in less cognitive decline and dementia requires a larger RCT with long follow-up.

Artificial intelligence-enhanced electrocardiography predicts 10-year risk of atherosclerotic cardiovascular disease

Abstract Background The ACC/AHA pooled cohort equations (PCE) calculates the 10-year primary risk of atherosclerotic cardiovascular disease (ASCVD), an indication to initiate primary prevention statin therapy in international guidelines. The validity of PCE is limited by its overestimation of risk in high-risk cohorts and an ethnic heterogeneity. Electrocardiography (ECG) has not been incorporated in current ASCVD risk estimation tools. Artificial Intelligence (AI)-based models are capable to capture patterns that are informative for cardiovascular prognosis. Purpose We explored the predictive value of a discrete-time survival model in 10-year ASCVD risk in comparison to PCE. Methods We developed an AI-ECG model to predict the 10-year ASCVD risk in an unselected secondary care population from the USA comprised of 1,163,401 ECGs from 189,539 patients. Data was split into training/validation and hold-out test sets by patient ID. Our AI-ECG model uses deep learning with a residual convolutional neural network with a discrete-time survival loss function to output subject-specific survival curves, accounting for both time to event and censorship (i.e., loss to follow up). We compared the performance of out AI-ECG model using a subset of outpatient data (n=4590) of the BIDMC dataset to PCE and ASCVD risk factors including systolic blood pressure, total cholesterol, HDL cholesterol, hypertension, smoking history, diabetes mellitus, and ethnicity. Performances were evaluated using cox survival analysis. Our AI-ECG model was externally validated in the UKB Biobank (UKB), where we compared the performance of our AI-ECG model to predictions of existing AI-ECG models such as the Stanford Estimator of Electrocardiogram Risk (SEER) model. Results Our AI-ECG successfully predicted future ASCVD events in individuals (C-index 0.721 (0.719-0.723), 5-year AUC 0.761 (0.758-0.763), and differentiated between high and low risk group with an adjusted HR of 2.33 (2.26-2.41). Upon internal validation our AI-ECG model showed a superior performance (C-index 0.679 (0.651-0.708)) than PCE (0.605 (0.577-0.634)) and all risk factors combined (C index 0.642 (0.613-0.672)). When combining AI-ECG predictions with all risk factors, the model showed additional predictive value (0.686 (0.657-0.715)) (Figure 1). Our AI-ECG model showed modest predictive value within the UKB dataset (C-index 0.655 (0.637-0.673)), but significantly outperformed the SEER model (C-index 0.547 (0.527-0.567), p &amp;lt;0.0001 for comparison with AIRE). Conclusion We have shown the potential of AI-ECG models in predicting future ASCVD risks. AI-ECG models demonstrated accurate discrete time survival prediction and good classification performance superior to that of the SEER model, as well as PCE and ASCVD risk factors. . Accurate risk assessment of ASCVD may help prevent adverse events in high risk subjects and save unnecessary pharmacological interventios in low risk subjects.Figure 1

Burden and sociodemographic disparities in cardiovascular mortality rates associated with hypercholesterolemia in united states: a nationwide county-level analysis from 2010 to 2019

Abstract Background Hypercholesterolemia (HC), a major public health concern, has seen a rising prevalence in US adults and globally, leading to increased morbidity and mortality. Despite well-established links between HC and cardiovascular mortality (CVM), the specific impacts and disparities at the population level remain poorly understood. Purpose This study aims to assess the independent effects of HC on VM across the overall US population, examining variations across sociodemographic groups and geographic locations. Methods Age-adjusted county-level CV rates (ACVM per 100,000 individuals) between 2010 to 2019 were obtained using the Center for Disease Control and Prevention (CDC) database. Using the CDC surveillance system, HC rates per county were assessed as the proportion of adults (+18) with high total blood cholesterol. County health ranking project databases were utilized to acquire county characteristics and demographics. Poison generalized estimating equation models were employed to assess incidence rate ratios (IRR). Results Of 307,045,656 residents who lived in 3142 US counties in 2010, a total of 8,157,580 (2.7%) CV deaths occurred between 2010-2019. In a fully adjusted model*, high HC rates associated with high ACVM (Standardized IRR: 1.049; Figure 1). In subgroup analyses, HC rates associated with a greater ACVM among counties with high minority (IRR: 1.070) versus low (IRR: 1.043), and in rural areas (IRR: 1.052) versus urban (IRR: 1.041). Notably, this association was prominent in areas with high poverty (Q4 vs. Q1) (IRR: 1.062 vs. 1.035; p interaction &amp;lt;0.001; Figure 1). Further, higher ACVM rates related to HC were observed in the South and Northeast U.S. regions. Conclusions HC rates are independently associated with high ACVM across most sociodemographic groups and locations, with the most pronounced effect in areas with high poverty levels and minority populations. These findings call on targeted interventions and policymaking aimed at mitigating the prevalence of HC and cardiovascular burden, particularly in vulnerable populations.

Analysis of risk factors for carotid artery plaque in asymptomatic adults

ObjectiveThis study aimed to investigate the risk factors affecting the presence of carotid plaque in asymptomatic adults.MethodsAsymptomatic adults (age > 40 years, no symptoms of cardiovascular and cerebrovascular diseases) undergoing routine health examinations from physical examination department were included in this study. Carotid plaque was measured by Resona 7OB and Resona 8EXP color Doppler ultrasound and L9-3U and L4-5WU probes. The focal carotid intima–media thickness was greater than 1.1 mm, and the local protrusion of the artery wall into the artery lumen suggested the presence of carotid atherosclerotic plaque. According to their ultrasound results, 1077 asymptomatic adults were divided into a group with carotid plaque (477) and a group without carotid plaque (600).ResultsA total of 1077 asymptomatic adults were included in this study, of whom 44.3% had carotid plaque. The proportion of men with carotid plaque was 84.5%. Multifactorial logistic analysis suggested that age, fasting blood glucose (FBG), total cholesterol (TC), homocysteine (Hcy) and male gender were risk factors for carotid atherosclerosis. The predictive probability of these risk factor indicators derived from the multifactorial model was calculated using receiver operating characteristic (ROC) curves with SPSS 25.0 software. The calculated area under the receiver operating characteristic curve (AUC) was 0.715 (95% CI, 0.685–0.746).ConclusionAge, FBG, TC, Hcy and male gender are risk factors for carotid atherosclerosis in asymptomatic adults. Gender differences in carotid atherosclerosis deserve further attention.

Relationship between the risk of atherosclerotic cardiovascular disease and decreased functional bladder capacity.

Cardiovascular diseases (CVD) are among the leading causes of death worldwide. Recently, non-classical risk factors for cardiovascular disease, such as lower urinary tract symptoms (LUTS), have gained attention. Both CVD and LUTS are prevalent among aging populations and share common vascular risk factors. The purpose of this study was to investigate the potential relationship between Atherosclerotic Cardiovascular Disease risk and functional bladder capacity among men with LUTS. This study was conducted on 86 men aged 40-79 with complaints of LUTS who were asked for digital rectal examinations, blood tests on serum total cholesterol and high-density lipoprotein (HDL), and mid-stream urine tests for microscopy and culture. For evaluating patients' LUTS, a 24-h voiding diary was asked. The atherosclerotic cardiovascular diseases (ASCVD) score comprises the patient's current age, sex, race, diabetes mellitus status, smoking status, hypertension status, systolic and diastolic blood pressure, total cholesterol, and HDL levels. According to the ASCVD score, 46 and 40 patients were categorized as low and high risks for cardiovascular diseases, respectively. Based on the FBC, 47 patients had decreased FBC and the rest were normal. According to logistic regression, it was determined that age can be considered a predictive variable for decreased FBC and the lower FBC can be considered as a predictive factor in the high-risk group for cardiovascular diseases (p = 0.002). It seems that decreased FBC is related to a higher predicted cardiovascular event rate in men with LUTS and could be considered a predictor of ASCVD risk.

Online and Face-to-Face Mat Pilates Training for Long COVID-19 Patients: A Randomized Controlled Trial on Health Outcomes

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing (p &lt; 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity (p &lt; 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure (p &gt; 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities.

Loureirin B Reduces Insulin Resistance and Chronic Inflammation in a Rat Model of Polycystic Ovary Syndrome by Upregulating GPR120 and Activating the LKB1/AMPK Signaling Pathway.

Polycystic ovary yndrome (PCOS) is a common metabolic disorder in women, which is usually associated with insulin resistance (IR) and chronic inflammation. Loureirin B (LrB) can effectively improve insulin resistance and alleviate chronic inflammation, and in order to investigate the therapeutic effect of LrB on polycystic ovary syndrome with insulin resistance (PCOS-IR), we conducted animal experiments. A PCOS-IR rat model was established by feeding a high-fat diet combined with letrozole (1 mg/kg·d for 21 days). The rats were treated with the GPR120 agonists TUG-891 and LrB for 4 weeks. Biochemical parameters (fasting blood glucose, total cholesterol, triglycerides, high- and low-density lipoprotein), hormone levels (serum insulin, E2, T, LH, and FSH), and inflammatory cytokines (TNF-α, IL-1β, IL-6, and IL-18) were analyzed. Histopathological analyses of ovaries were performed using hematoxylin/eosin (H&E) staining. Real-time PCR and western blotting were used to assess GPR120, NLRP3, and caspase-1 expression in ovaries, and immunohistochemistry was used to evaluate LKB1 and AMPK protein expression. LrB reduced body weight, Lee's index, ovarian index, ovarian area, and volume in PCOS-IR rats. It lowered fasting blood glucose, serum insulin, and HOMA-IR. LrB decreased total serum cholesterol, triglyceride, and LDL levels and increased HDL levels. It reduced serum T, LH, and LH/FSH and raised serum E2 and FSH levels. LrB downregulated the mRNA and protein expression levels of NLRP3 and Caspase-1, increased the protein and mRNA expression levels of GPR120 in rat ovaries, and increased LKB1 and AMPK protein expression in ovaries, ameliorating ovarian histopathological changes in PCOS-IR rats. Taken together, LrB upregulated GPR120, LKB1, and AMPK protein expression, downregulated NLRP3 and Caspase-1 protein expression, reduced insulin resistance and chronic inflammation, and ameliorated histopathological changes in ovarian tissues in PCOS rats, suggesting its potential as a treatment for PCOS.