Cholesterol and lipids in the risk of coronary artery disease. The Framingham Heart Study

CORRELATION OF LOW HDL AND HIGH LDL-C LEVELS WITH SEVERITY OF CORONARY ARTERY DISEASE ON CORONARY ANGIOGRAM

Article

Jan 2024

Sher Wali Khan

Mechanism of Hypercholesterolemia-Induced Atherosclerosis

Article

Full-text available

Jun 2022
REV CARDIOVASC MED

Hypercholesterolemia is involved in the development of atherosclerosis and is a risk factor for coronary artery disease, stroke, and peripheral vascular disease. This paper deals with the mechanism of development of hypercholesterolemic atherosclerosis. Hypercholesterolemia increases the formation of numerous atherogenic biomolecules including reactive oxygen species (ROS), proinflammatory cytokines [interleukin (IL)-1, IL-2, IL-6, IL-8, tumor necrosis factor-alpha (TNF-α)], expression of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, monocyte chemoattractant protein-1 (MCP-1), granulocyte macrophage-colony stimulating factor (GM-CSF) and numerous growth factors [insulin-like growth factor-1 (IGF-1), platelet-derived growth factor-1 (PDGF-1) and transforming growth factor-beta (TGF-β)]. ROS mildly oxidizes low-density lipoprotein-cholesterol (LDL-C) to form minimally modified LDL (MM-LDL) which is further oxidized to form oxidized LDL (OX-LDL). Hypercholesterolemia also activates nuclear factor-kappa-B (NF-κB). The above atherogenic biomolecules are involved in the development of atherosclerosis which has been described in detail. Hypercholesterolemia also assists in the development of atherosclerosis through AGE (advanced glycation end-products)-RAGE (receptor for AGE) axis and C-reactive protein (CRP). Hypercholesterolemia is associated with increases in AGE, oxidative stress [AGE/sRAGE (soluble receptor for AGE)] and C-reactive protein, and decreases in the sRAGE, which are known to be implicated in the development of atherosclerosis. In conclusion, hypercholesterolemia induces atherosclerosis through increases in atherogenic biomolecules, AGE-RAGE axis and CRP.

Evaluating modifiable hypertension risk in Nigerian adults—The Nigerian diet risk score

Article

Full-text available

Feb 2025
TROP MED INT HEALTH

Aims Our study aimed to derive and validate a diet risk score for clinical use in Nigeria to screen for hypertension risk and evaluate its association against a panel of cardiovascular biomarkers. Methods The Nigerian dietary screening tool was used to collect dietary intake data from 151 participants visiting the River State University Teaching Hospital, Port Harcourt, Nigeria, for routine medical care. Blood samples were collected from a subsample (n = 94) for biomarker assessment. Multiple logistic regression was used to derive the Nigerian diet risk score for hypertension. Internal validation of the Nigerian diet risk score for hypertension was performed using measures of discrimination and calibration. Mediation analysis was used to evaluate the biomarker‐mediated effects of the diet risk score for hypertension on hypertension. All statistical analyses were performed in R. Results Each one‐point increment in Nigerian diet risk score (on a scale of 0 to 30) was associated with a twofold increase in odds of hypertension (odds ratio: 2.04, 95% confidence interval [CI]: 1.16, 3.58, p = 0.01), with the highest score associated with >18‐fold increased odds of hypertension, compared to lowest Nigerian diet risk score for hypertension. The score demonstrated good discrimination (area under the curve: 0.92, 95% CI: 0.80, 1.00) with a high sensitivity (0.85) and specificity (0.94). Additionally, mediation analysis suggested that the association between Nigerian diet risk score for hypertension and blood pressure is partly explained by shared biological pathways that mediate cholesterol, triglycerides, LDL‐C, CRP and homocysteine levels. Conclusion The resulting Nigerian diet risk score for hypertension is a valuable tool for clinicians to identify individuals at risk of hypertension, and will advance community efforts in the prevention and management of hypertension in Nigeria.

Cardiovascular Risk Assessment in the Immediate Postoperative Period of Bariatric Surgery

Article

Full-text available

Jan 2025

Objectives: Since obesity and overweight are strongly associated with cardiovascular diseases, we investigated cardiovascular events risk in individuals who lost weight through bariatric surgery. Methods: Serum levels of glucose, insulin, triacylglycerol, HDL cholesterol, non-HDLDL cholesterol, and lipoprotein ratios were assessed in patients with obesity before and after bariatric surgery, including a 6-month follow-up period. Results: Bariatric surgery significantly improved BMI, triglyceride levels, glucose, and insulin sensitivity. However, HDL cholesterol levels dropped sharply in the first month (p < 0.0001), coinciding with elevated atherogenic indices, indicating a transient increase in cardiovascular risk. By 6 months, indices improved significantly, HDL recovered, and LDL particle size increased, suggesting reduced atherogenic potential. Conclusions: Individuals undergoing bariatric surgery have a higher cardiovascular events risk in the immediate postoperative period. Health professionals should be aware of and monitor these patients closely.

Association of the Monocyte to High-Density Lipoprotein Cholesterol Ratio and Neutrophil to High-Density Lipoprotein Cholesterol Ratio With the Severity of New-Onset Coronary Artery Disease

Article

Full-text available

Jan 2025

Background The monocyte to high-density lipoprotein cholesterol (MHR) and neutrophil to high-density lipoprotein cholesterol ratio (NHR) are novel comprehensive indicators reflecting the body’s inflammation and lipid metabolism. Previous studies have found that MHR and NHR are associated with the risk of cardiovascular and cerebrovascular events and death. However, the correlation between MHR, NHR, and the severity of newly diagnosed coronary artery disease (CAD) has not been thoroughly explored. Methods In this retrospective study, we enrolled 1489 patients who underwent coronary angiography for the first time between January 2022 and December 2023, of which 1143 were diagnosed with CAD. The severity of CAD was gauged by the Gensini score (GS). The relationship between MHR and NHR with CAD was validated through logistic regression analysis, adjusting for traditional cardiovascular risk factors and medication therapy. The nonlinear relationship between MHR and NHR with CAD and GS was assessed by using restricted cubic spline (RCS) models. Their independent and combined predictive effects on CAD were evaluated through receiver operating characteristic (ROC) curve analysis. Results MHR and NHR were independently associated with CAD (both P<0.001). In the fully adjusted model, an increase in MHR was significantly associated with an increased odds ratio (OR) for CAD (OR=4.29, 95% CI 2.72–6.78, P<0.001). Sensitivity analysis revealed a consistent trend (P for trend<0.05). RCS curve analysis indicated a nonlinear relationship between the two biomarkers and GS (P<0.05) and there were clear inflection points. The area under the curve for predicting CAD was 0.68 for MHR and 0.69 for NHR, with optimal cut-off values of 0.42 (Youden index:0.29) and 5.43 (Youden index:0.31) respectively. Combined MHR and NHR has higher predictive value. Conclusion MHR and NHR are independently associated with CAD, and there is a nonlinear correlation with the GS. Both have some predictive value for the severity of CAD.

FTO rs1121980 polymorphism contributes to coronary artery disease susceptibility in a Chinese Han population

Article

Full-text available

Jan 2025
LIPIDS HEALTH DIS

Background The fat mass and obesity-associated protein (FTO) has been showed to be involved in the pathogenesis and progression of coronary artery disease (CAD). However, the effects of FTO variants on CAD risk remain poorly understood. We herein genotyped three SNPs (rs1121980, rs72803657, and rs4783818) in FTO to investigate the influence of FTO polymorphisms on individual susceptibility to CAD. Methods Genotyping for the three SNPs (rs1121980, rs72803657, and rs4783818) was conducted in a cohort of 712 CAD cases with 349 myocardial infarction (MI) cases and 701 control participants, utilizing the polymerase chain reaction-ligation detection reaction (PCR-LDR) technique. The associations of these SNPs with CAD were analyzed using multivariate logistic regression, and the associations with lipid profiles were assessed by the Kruskal-Wallis or Wilcoxon-Mann-Whitney tests. Results The A allele (OR = 1.26, 95% CI = 1.01–1.57, and P = 0.044) and the AA genotype (OR = 3.13, 95% CI = 1.53–6.38, and P = 0.002) of FTO rs1121980 were significantly associated with an elevated risk of CAD. Similarly, the A allele (OR = 1.54, 95% CI = 1.18–2.02, and P = 0.002) and the AA genotype (OR = 5.61, 95% CI = 2.57–12.27, and P < 0.001) of rs1121980 exhibited increased MI risk. This SNP also showed significant associations under recessive genetic models for both CAD and MI (OR = 3.09, 95% CI = 1.52–6.27, P = 0.002 for CAD; OR = 5.40, 95% CI = 2.49–11.71, P < 0.001 for MI). However, the other two SNPs did not show significant associations with CAD or MI risks under any genetic model tested. Stratified analyses indicated a more pronounced association of the A allele with increased CAD/MI risk among younger participants, non-smokers, and non-drinkers. Interestingly, A allele carriers in younger subjects exhibited higher triglyceride (TG) levels and lower high-density lipoprotein cholesterol (HDL-C) levels compared to non-carriers (P < 0.05). Conclusions Our data provides the first evidence that the FTO rs1121980 polymorphism is associated with an increased risk of CAD in the Chinese population. This association is more significant in younger subjects, likely due to the elevated TG levels and reduced HDL-C levels.

ALTERAÇÕES ELECTROCARDIOGRÁFICAS E SUA ASSOCIAÇÃO COM FACTORES DE RISCO CARDIOVASCULAR EM ESTUDO DE BASE POPULACIONAL NO NORTE DE ANGOLA

Thesis

Full-text available

Jun 2022

Mauer A. A. Gonçalves

Introduction: The presence of changes in the resting electrocardiogram (ECG) is an independent factor for the onset of coronary artery disease and is associated with an increased mortality rate and increased risk for cardiovascular disease. The importance of identifying electrocardiographic changes and their relationship with cardiovascular disease has been extensively studied in the Caucasian, Latino and African American population. Despite this, there is no information on the parameters of normality, as well as on electrocardiographic abnormalities and their relationship with cardiovascular risk factors in Angolans; although there are some data from studies in some African populations, local studies are necessary, given the variation of environmental and behavioral conditions of different population groups. Objectives: To evaluate the ECG in a population of the Bengo province, North of Angola, in its baseline, regarding the parameters of normality, and the presence of electrocardiographic alterations and their association with cardiovascular risk factors. Methods: The data analyzed in this work come from the database of a population-based study called CardioBengo, carried out at the Health Research Center of Angola. This is a cross-sectional community-based study conducted from September 2013 to March 2014. Data were analyzed considering stratification by gender. Continuous variables were expressed as mean±SD and categorical variables were expressed as number and proportions. The normal limits of the ECG parameters were taken as the 2nd and 98th percentiles of the distribution by age group and sex, the Mann-Whitney and Kruskal-Wallis tests were used to compare the medians. Differences between groups were assessed by Student's t test and the difference between two independent population proportions assessed by Chi-square test. Multivariate logistic regression analysis was performed to estimate the association between any minor or major electrocardiographic change with age and the sum of cardiovascular risk factors by sex. Adjusted odds ratios (ORs) were presented with a 95% confidence interval. Student's t-test and Chi-square, one-way ANOVA and Kruskal-Wallis non-parametric tests were used for comparison between the pregnant and non-pregnant groups, as appropriate. Statistical analysis was performed using the IBM SPSS version 26 software and the R software (version 4.0.5). Results: The study involved 2 379 participants (880 men and 1449 women), aged between 15 and 84 years, 63% female. The mean age was 35.0±14.4 years. The normal limits of measurements were different between men and women: HR 49 to 100 bpm vs. 55 to 108 bpm, P wave duration 81 to 130 ms vs. 84 to 130 ms, PR interval 119 to 210 ms vs. 120 to 202 ms, QRS duration 74 to 110 ms vs. 70 to 104 ms, QT interval 324 to 441 ms vs. 314 to 438 ms, P wave axis -290 to 850 vs. -180 to 810, QRS axis -130 to 850 vs. -180 to 820, T wave axis 00 to 720 vs. -80 to 730, Sokolow-Lyon index 2.13 to 6.21 mV vs. 1.60 to 4.87 mV, Cornell index 0.17 to 6.24 mV vs. 0.14 mV to 4.35 mV. It was found that 4.58% of the participants had major electrocardiographic alterations, especially in women, and 22.3% had minor electrocardiographic alterations, which were more frequent in men. The most common major electrocardiographic abnormalities were left ventricular hypertrophy with major ST-T abnormalities, ventricular conduction defect and major Q wave abnormalities. The most common minor electrocardiographic abnormalities were abnormal T wave inversion, isolated minor ST abnormalities and premature beats. The study identified two individuals with atrial fibrillation, which represents an estimated prevalence of 0.084% (0.11% in males and 0.067% in females). High blood pressure, diabetes mellitus, hypercholesterolemia, alcohol consumption and smoking were significantly associated with major and minor electrocardiographic changes. Comparing pregnant vs non-pregnant women, we found the following mean values: Heart rate (83 bpm vs. 74 bpm, p<0.001), PR interval (146 ms vs. 151 ms, p=0.034), QT interval (360 ms vs. 378 ms, p<0.001), QTIc Fridericia (398 ms vs. 403, p=0.017), QTIc Framingham (399 ms vs. 404 ms, p=0.013) and T wave axis (340 vs. 410, p=0.001). The main changes found were: sinus tachycardia (4.4% vs. 2.5%), T wave inversion (14.9% vs. 1.7%) and left ventricular hypertrophy (11.4% vs. 11.7 %, p=0.726). Conclusion: Our results suggest that the normal ranges of most ECG parameters vary according to age and sex, and ECG diagnostic criteria should therefore be specific for these demographic measures. Most participants had minor electrocardiographic abnormalities. Major abnormalities were more prevalent in women and minor electrocardiographic abnormalities were more prevalent in men. Electrocardiographic changes had significant associations with major cardiovascular risk factors. Pregnant women had significantly higher values of heart rate, and significantly lower values of systolic and diastolic blood pressure, PR interval, QT interval, QT interval corrected by Fridericia and Framingham's formula and T wave axis. The duration of the P wave was reduced as the pregnancy progressed from the first to the third trimester. Sinus tachycardia, T wave inversion, ST-segment alteration and left ventricular hypertrophy were the main alterations found. The values described for the analyzed electrocardiographic measurements can be used as a reference for Angolan adults without established heart disease. The ECG, being a safe test, with good accuracy, inexpensive and wide availability, can be used in cardiovascular epidemiology to predict cardiovascular risk and the implementation of preventative strategies in Angolans. Key-words: Normal ECG, Electrocardiographic changes, Cardiovascular Risk factors, Angola

Short-term HIIT impacts HDL function differently in lean, obese, and diabetic subjects

Article

Full-text available

Aug 2024

Introduction High density lipoproteins (HDL) exert cardiovascular protection in part through their antioxidant capacity and cholesterol efflux function. Effects of exercise training on HDL function are yet to be well established, while impact on triacylglycerol (TG)-lowering has been often reported. We previously showed that a short-term high-intensity interval training (HIIT) program improves insulin sensitivity but does not inhibit inflammatory pathways in immune cells in insulin-resistant subjects. The purpose of this study is to evaluate HDL function along with changes of lipoproteins after the short-term HIIT program in lean, obese nondiabetic, and obese type 2 diabetic (T2DM) subjects. Methods All individuals underwent a supervised 15-day program of alternative HIIT for 40 minutes per day. VO2peak was determined before and after this training program. A pre-training fasting blood sample was collected, and the post-training fasting blood sample collection was performed 36 hours after the last exercise session. Results Blood lipid profile and HDL function were analyzed before and after the HIIT program. Along with improved blood lipid profiles in obese and T2DM subjects, the HIIT program affected circulating apolipoprotein amounts differently. The HIIT program increased HDL-cholesterol levels and improved the cholesterol efflux capacity only in lean subjects. Furthermore, the HIIT program improved the antioxidant capacity of HDL in all subjects. Data from multiple logistic regression analysis showed that changes in HDL antioxidant capacity were inversely associated with changes in atherogenic lipids and changes in HDL-TG content. Discussion We show that a short-term HIIT program improves aspects of HDL function depending on metabolic contexts, which correlates with improvements in blood lipid profile. Our results demonstrate that TG content in HDL particles may play a negative role in the anti-atherogenic function of HDL.

Сравнительный анализ результатов прямого измерения и расчётного определения холестерина липопротеинов низкой плотности

Article

Full-text available

Mar 2024

Цель. Целью настоящего исследования была оценка влияния результатов определения холестерина липопротеидов низкой плотности, полученных прямым и расчетным по Фридвальду методами, на классифицирование пациентов по группам тяжести гиперхолестеринемии.Материалы и методы. Анализировались данные 161051 результата исследований липидного профиля, выполненных в крупной централизованной лаборатории, без учета интервенций. Статистическая обработка данных проводилась с использованием регрессионного анализа и метода Бленда-Альтмана.Результаты. Регрессионный анализ показал высокую степень связи (R2=0,91) между уровнями холестерина липопротеидов низкой плотности, полученными прямым методом и рассчитанными по формуле Фридвальда. Однако выявленная тенденция (наклон регрессионной прямой и прямой при анализе по Бленду-Альтману) показала, что ниже 3,5 ммоль/л ХС ЛНП для прямого метода в целом характерны более высокие значения, по сравнению с методом Фридвальда, а выше 3,5 ммоль/л – более низкие.Заключение. По всем диапазонам уровней ХС ЛНП различия в классификации пациентов по значениям прямого определения и по расчетным значениям не превышали 3,2% что может быть рассмотрено как прямое подтверждение достаточности формулы Фридвальда.

Association between Atherogenic Dyslipidemia and Subclinical Myocardial Injury in the General Population

Preprint

Full-text available

Jul 2024

Background: Subclinical myocardial injury (SCMI) is associated with an increased risk of poor cardiovascular disease (CVD) outcomes. Understanding the underlying risk factors for SCMI is crucial for the prevention and management of CVD. We hypothesized that atherogenic dyslipidemia, a combination of high triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C), is associated with an increased risk of SCMI. Methods: This analysis from the third National Health and Nutrition Examination Survey (NHANES-III) included 7,093 participants (age 59.3±13.4 years, 52.8% women, and 49.4% White) free of CVD. Atherogenic dyslipidemia was defined as TG ≥150 mg/dL and HDL-C <40 mg/dL in men or <50 mg/dL in women. A validated electrocardiographic-based cardiac infarction injury score (CIIS) ≥10 was considered positive for SCMI. Multivariable logistic regression analysis was used to examine the association of different combinations of TG and HDL-C groups, including atherogenic dyslipidemia with SCMI. Results: About 22.5% (n=1,594) of participants had atherogenic dyslipidemia, and 26.3% (n=1862) had SCMI. Compared to participants with normal TG and normal HDL-C, those with atherogenic dyslipidemia had a higher prevalence of SCMI (31.2% vs. 23.9%, p-value <0.001). In a multivariable logistic regression model, atherogenic dyslipidemia was associated with the highest odds of SCMI followed by high TG/normal HDL-C, then low HDL-C/normal TG [OR (95% CI): 131 (1.14,1.52), 1.13 (0.97,1.33), and 1.01(0.86,1.20), respectively). Conclusions: Atherogenic dyslipidemia is associated with a higher risk of SCMI, which highlights the role of nontraditional risk factors in the development of subclinical CVD.

Microbial community-scale metabolic modelling predicts personalized short-chain fatty acid production profiles in the human gut

Article

Full-text available

Jun 2024

Microbially derived short-chain fatty acids (SCFAs) in the human gut are tightly coupled to host metabolism, immune regulation and integrity of the intestinal epithelium. However, the production of SCFAs can vary widely between individuals consuming the same diet, with lower levels often associated with disease. A systems-scale mechanistic understanding of this heterogeneity is lacking. Here we use a microbial community-scale metabolic modelling (MCMM) approach to predict individual-specific SCFA production profiles to assess the impact of different dietary, prebiotic and probiotic inputs. We evaluate the quantitative accuracy of our MCMMs using in vitro and ex vivo data, plus published human cohort data. We find that MCMM SCFA predictions are significantly associated with blood-derived clinical chemistries, including cardiometabolic and immunological health markers, across a large human cohort. Finally, we demonstrate how MCMMs can be leveraged to design personalized dietary, prebiotic and probiotic interventions aimed at optimizing SCFA production in the gut. Our model represents an approach to direct gut microbiome engineering for precision health and nutrition.

Foundations of Lifestyle Medicine and its Evolution

Article

Full-text available

Feb 2024

Lifestyle Medicine (LM) is a rapidly growing discipline that focuses on the role of lifestyle factors in preventing, managing, and reversing chronic disease. At this point in the field’s evolution, there is strong evidence that the 6 pillars of LM—a whole-food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections—are central in the creation and maintenance of health. Previous publications, many of them randomized controlled studies and meta-analyses, have solidified the evidence base for the use of the 6 pillars within the field of LM. As data emerged, so did its governing body, the American College of Lifestyle Medicine (ACLM), and with it a rich history began to unfold. Several articles have been written on the early history of the ACLM and the growth of the field; however, this review article explores the history and foundation of LM, aiming to provide a comprehensive understanding of its relevance and impact on health care. It underscores landmark studies that have defined the field and provides a road map detailing national and global barriers and areas of potential future growth.

Obicetrapib: Reversing the Tide of CETP Inhibitor Disappointments

Article

Full-text available

Dec 2023
Curr Atherosclerosis Rep

Purpose of Review To discuss the history of cardiovascular outcomes trials of cholesteryl ester transfer protein (CETP) inhibitors and to describe obicetrapib, a next-generation, oral, once-daily, low-dose CETP inhibitor in late-stage development for dyslipidemia and atherosclerotic cardiovascular disease (ASCVD). Recent Findings Phase 1 and 2 trials have evaluated the safety and lipid/lipoprotein effects of obicetrapib as monotherapy, in conjunction with statins, on top of high-intensity statins (HIS), and with ezetimibe on top of HIS. In ROSE2, 10 mg obicetrapib monotherapy and combined with 10 mg ezetimibe, each on top of HIS, significantly reduced low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B, total LDL particles, small LDL particles, small, dense LDL-C, and lipoprotein (a), and increased HDL-C. Phase 3 pivotal registration trials including a cardiovascular outcomes trial are underway. Summary Obicetrapib has an excellent safety and tolerability profile and robustly lowers atherogenic lipoproteins and raises HDL-C. As such, obicetrapib may be a promising agent for the treatment of ASCVD.

Associations between body composition and cardiovascular disease risk in pre- and postmenopausal women

Article

Full-text available

Oct 2023
J HEALTH POPUL NUTR

Background Menopause transition is a critical phase of women’s life since body composition and cardiovascular risk factors begin to change during this period. This study investigated the associations between body composition and cardiovascular disease risk (CVDR) in pre (PrMW) and postmenopausal women (PMW). Methods A community-based cross-sectional study involving 184 PrMW and 166 PMW, selected randomly from Bope-Poddala area in Galle, Sri Lanka was carried out. Total-body fat mass (TBFM, kg), total body skeletal muscle mass (TBSMM, kg), total body bone mineral density (TBBMD, g/cm²) and total body bone mineral content (TBBMC, g) were measured with total body DXA scanner and they were taken as indices of body composition. CVDR was evaluated using Framingham risk score (FRS%) and individual CVDR factors, such as systolic blood pressure (SBP, mmHg), diastolic blood pressure (DBP, mmHg), fasting blood sugar (FBS, mg/dl), total cholesterol, (TC, mg/dl), tryglycerides (TG, mg/dl), high-density lipoprotein (HDL, mg/dl) and low-density lipoprotein (LDL, mg/dl). Correlations between indices of body composition and CVDR factors were assessed with adjusted partial correlation (adjusted for socio-demographic and gynecologic status, age, daily calorie consumption and physical activity level). Results Mean(SD) age of PrMW and PMW were 42.4(6.0) and 55.8(3.8) years respectively. TBFM correlated with SBP and DBP (r range; 0.15 to 0.21) and TBSMM correlated with SBP, DBP and HDL (r range; − 0.24 to 0.17) only in PrMW (p < 0.05). TBBMD correlated only with FBS in PMW (r; − 0.21, p = 0.01). TBBMC did not show correlations with CVDR factors (p > 0.05). Body composition indices did not show correlations with total CVDR estimated by FRS and in both groups of women (p > 0.05). Conclusions Both SBP and DBP are associated with FM and SMM in different ways among PrMW. This association, however, was not seen among PMW. FBS is associated with BMD only in PMW.

Aspartame induced dyslipidemia and plasma hyperviscosity in Albino Wistar rats

Article

Full-text available

Oct 2023

Aspartame is a low-calorie sweetener that has been used for decades in place of sugar. However, there has been conflicting reports on the use and safety profile of aspartame associated with several diseases especially cancer and cardiovascular diseases. This study therefore aims to determine the effects of aspartame on some cardiovascular indices. Thirty seven (37) young Albino Wistar rats weighing between 110g-140g were used for this study. The rats were divided into five groups; control (5) received 5 ml of distilled water. Group 1 (n=8) received 5 ml of diet soda, group 2 (n=8) received 5 ml diluted (1:1) diet soda, Group 3 (n=8) received 5 ml aspartame 45 mg/kg b.w, Group 4 (n=8) received 5 ml of aspartame 22.5 mg/kg b.w. The various doses of aspartame and diet soda were administered orally daily for ten weeks. Weight of the rats were taken weekly, at the end of the experimental period, the rats were sacrificed and blood samples collected into plain sample bottles and tri sodium citrate bottles. Lipid profile (total cholesterol, HDL-C, LDL-C &.triglyceride) were analyzed spectrophotometrically, fibrinogen and blood viscosity were also measured. Results showed that the aspartame and diet soda significantly increased total cholesterol, triglyceride, LDL-C, fibrinogen and plasma viscosity and significantly decreased HDL cholesterol. In conclusion, consumption of aspartame as a sweetener can impact negatively on cardiovascular haemodymic factors. Therefore, its intake should be discouraged.

Effect of Isoenergetic Substitution of Cheese with Other Dairy Products on Blood Lipid Markers in the Fasted and Postprandial State: An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials in Adults

Article

Sep 2023

Consumption of fat as part of a cheese matrix may differentially affect blood lipid responses when compared with other dairy foods. This systematic review was conducted to compare the impact of consuming equal amounts of fat from cheese and other dairy products on blood lipid markers in the fasted and postprandial state. Searches of PubMed (Medline), Cochrane Central and Embase databases were conducted up to mid-June 2022. Eligible human randomized controlled trials (RCTs) investigated the effect of isoenergetic substitution of hard or semi-hard cheese with other dairy products on blood lipid markers. Risk of bias (RoB) was assessed using the Cochrane RoB 2.0 tool. Random-effects meta-analyses assessed the effect of ≥2 similar dietary replacements on the same blood lipid marker. Of 1491 identified citations, 10 articles were included (RoB: all some concerns). Pooled analyses of 7 RCTs showed a reduction in fasting total cholesterol, LDL-C and HDL-C concentrations after ≥14 d mean daily intake of 135 g cheese (weighted mean difference [WMD]: −0.24 mmol/L; 95% confidence interval (CI): −0.34, −0.15; I² = 59.8%, WMD: −0.19 mmol/L; 95% CI: −0.27, −0.12; I² = 42.8%, and WMD: −0.04 mmol/L; 95% CI: −0.08, −0.00; I² = 58.6%, respectively) relative to ∼52 g/d butter. We found no evidence of a benefit from replacing cheese for ≥14 d with milk on fasting blood lipid markers (n = 2). Limited postprandial RCTs, described in narrative syntheses, suggested that cheese-rich meals may induce differential fed-state lipid responses compared with some other dairy matrix structures, but not butter (n ≤ 2). In conclusion, these findings indicate that dairy fat consumed in the form of cheese has a differential effect on blood lipid responses relative to some other dairy food structures. However, owing to considerable heterogeneity and limited studies, further confirmation from RCTs is warranted. Trial Registration Number This systematic review protocol was registered at https://www.crd.york.ac.uk/PROSPERO/ as CRD42022299748.

Primer és szekunder hyperlipoproteinaemiák jelentősége fokozott kardiovaszkuláris kockázatú betegben

Article

Full-text available

Apr 2023

György Paragh

Aspartame induced dyslipidemia and plasma hyperviscosity in Albino Wistar Rats

Article

Jun 2023

Aspartame is a low-calorie sweetener that has been used for decades in place of sugar. However, there has been conflicting reports on the use and safety profile of aspartame associated with several diseases especially cancer and cardiovascular diseases. This study therefore aims to determine the effects of aspartame on some cardiovascular indices. Thirty seven (37) young Albino Wistar rats weighing between 110g-140g were used for this study. The rats were divided into five groups; control (5) received 5 ml of distilled water. Group 1 (n=8) received 5 ml of diet soda, group 2 (n=8) received 5 ml diluted (1:1) diet soda, Group 3 (n=8) received 5 ml aspartame 45 mg/kg b.w, Group 4 (n=8) received 5 ml of aspartame 22.5 mg/kg b.w. The various doses of aspartame and diet soda were administered orally daily for ten weeks. Weight of the rats were taken weekly, at the end of the experimental period, the rats were sacrificed and blood samples collected into plain sample bottles and tri sodium citrate bottles. Lipid profile (total cholesterol, HDL-C, LDL-C and triglyceride) were analyzed spectrophotometrically, fibrinogen and blood viscosity were also measured. Results showed that the aspartame and diet soda significantly increased total cholesterol, triglyceride, LDL-C, fibrinogen and plasma viscosity and significantly decreased HDL cholesterol. In conclusion, consumption of aspartame as a sweetener can impact negatively on cardiovascular haemodymic factors. Therefore, its intake should be discouraged.

CETP Taq1B polymorphism and its association with cardiovascular risk factors in an Iranian population under angiography, A Cross-Sectional Study

Preprint

Full-text available

Feb 2023

Background: Several studies have assessed the association of the cholesterol ester transfer protein (CETP) (rs708272) TaqIB gene polymorphism with risk factors of CVDs; however, their results are inconsistent. The current study investigated the relationship between CVD risk factors and the Taq1B variant in a population from Iran that was undergoing coronary angiography. Methods: This cross-sectional study was conducted on 476 subjects aged (30-76) years of both sexes. Genotypes for Taq1B polymorphism were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using extracted DNA from whole blood. Cardio-metabolic markers were measured by standard protocols. To determine the association between CVDs risk factors and the rs708272 variant, binary logistic regression was used in crude and adjusted models. Results: Genotype frequencies of the Taq1B polymorphism were 10.7% for B1B1, 72.3% for B1B2, and 17% for B2B2. No significant association was observed between abnormal levels of CVDs risk factors and different genotypes of the Taq1B variant, Gensini score (p= 0.64), Syntax score (p = 0.79), systolic blood pressure (p = 0.55), diastolic blood pressure (p = 0.58), waist circumference (p = 0.79). None of the abnormal serum levels were related to genotypes of the rs708272 variant. Results remained not significant after adjusting for confounders. Conclusion: Risk factors for CVDs were not associated with CETP rs708272 polymorphism in our population. Various findings reported in different populations that it suggested more studies in various regions in connection with CETP gene variants which are linked to CVD events.

Speeding up interval estimation for R2-based mediation effect of high-dimensional mediators via cross-fitting

Preprint

Full-text available

Feb 2023

Mediation analysis is a useful tool in biomedical research to investigate how molecular phenotypes, such as gene expression, mediate the effect of an exposure on health outcomes. However, commonly used mean-based total mediation effect measures may suffer from cancellation of component-wise mediation effects of opposite directions in the presence of high-dimensional omics mediators. To overcome this limitation, a variance-based R-squared total mediation effect measure has been recently proposed, which, nevertheless, relies on the computationally intensive nonparametric bootstrap for confidence interval estimation. In this work, we formulate a more efficient two-stage cross-fitted estimation procedure for the R-squared measure. To avoid potential bias, we perform iterative Sure Independence Screening (iSIS) in two subsamples to exclude the non-mediators, followed by ordinary least squares (OLS) regressions for the variance estimation. We then construct confidence intervals based on the newly-derived closed-form asymptotic distribution of the R-squared measure. Extensive simulation studies demonstrate that the proposed procedure is hundreds of times more computationally efficient than the resampling-based method with comparable coverage probability. Furthermore, when applied to the Framingham Heart Study, the proposed method replicated the established finding of gene expression mediating age-related variation in systolic blood pressure and discovered the role of gene expression profiles in the relationship between sex and high-density lipoprotein cholesterol. The proposed cross-fitted interval estimation procedure is implemented in R package RsqMed.

Relationship between the neutrophil to high-density lipoprotein cholesterol ratio and severity of coronary artery disease in patients with stable coronary artery disease

Article

Full-text available

Nov 2022

Objective To evaluate the link between the neutrophil to HDL-C ratio (NHR) and the degree of coronary stenosis in patients with stable coronary artery disease (CAD). Materials and methods Totally 766 individuals who attended our clinic for coronary angiography between January 2019 and January 2021 were included in this study. The participants were divided into two groups, including the CAD group and control group. Spearman correlation analysis was used to investigate the association between NHR and Gensini score and logistic regression analysis was performed to determine the influence of NHR on CAD and severe CAD. Receiver operating characteristic (ROC) curve was constructed to analyze the predictive value of NHR for severe CAD. Results The CAD group had a substantially higher median NHR than the control group (3.7 vs. 3.2, P < 0.01). There was a positive correlation between NHR and Gensini score, as well as the frequency of coronary artery plaques. Logistic regression demonstrated that NHR was an independent contributor for CAD and severe CAD. In ROC analysis, the area under the ROC curve (AUC) for NHR was larger than that for neutrophil, HDL-C or LDL-C/HDL-C, and the differences were statistically significant (all P < 0.05). The NHR limit that offered the most accurate prediction of severe CAD according to the greatest possible value of the Youden index, was 3.88, with a sensitivity of 62.6% and a specificity of 66.2%. Conclusion NHR was not only associated with the occurrence and seriousness of CAD, but also a better predictor of severe CAD than neutrophil, HDL-C or LDL-C/HDL-C.

Dietary diversity in primary schoolchildren of south-central Côte d’Ivoire and risk factors for non-communicable diseases

Article

Full-text available

Nov 2022
BMC Pediatr

Abstract Background A balanced nutrition is important for children’s physical and cognitive development; yet, remains a challenge in many parts of low- and middle-income countries (LMICs). Early detection of nutritional deficiency and metabolic syndrome in school-aged children is necessary to prevent non-communicable diseases (NCDs) in later life. This study aimed at obtaining baseline data on health, nutritional status, and metabolic markers of NCDs among primary schoolchildren in Côte d’Ivoire. Methods A cross-sectional survey was conducted among 620 children from 8 public primary schools located in the south-central part of Côte d’Ivoire. Underweight and overweight were defined as a body mass index (BMI; kg/m2)

SNPs in apolipoproteins contribute to sex-dependent differences in blood lipids before and after a high-fat dietary challenge in healthy U.S. adults

Article

Full-text available

Sep 2022

Background The effect of genetic polymorphisms on fasting blood lipid levels have been widely studied but the effects of these within the context of a high-fat meal challenge remain less characterized. The current study aimed to investigate the association of SNPs in lipoprotein-related genes with blood lipid profiles in healthy adults in the U.S. Methods Subjects ( n = 393) between 18–66 years of age with BMIs ranging from 18.5–45 kg/m ² were enrolled the cross-sectional Nutritional Phenotyping Study. Among them, 349 subjects (men: 48%; women: 52%) gave consent for genotyping. SNPs in APOA5 , APOB , APOC3 , APOE , and LDLR were assessed. The association between lipid markers and genotypes was tested separately for each SNP with analysis of variance (ANOVA), adjusted for sex, age, and BMI. We also examined two-factor interactions between SNPs and sex, age, or BMI. Results Women carrying the C allele of rs3135506 in APOA5 or men carrying the C allele of rs429358 in APOE had reduced HDL-cholesterol levels during fasting and postprandially. The C allele in APOE was also correlated to increased LDL-C levels. The TT genotype of rs2854116 in APOC3 was associated with elevated total cholesterol. Additive effect of the risk alleles of APOA5 and APOE or APOC3 and APOE was detected. Nevertheless, the tested SNPs had little impact on the postprandial triglyceride responses to the high-fat challenge meal. We found no significant effects of SNPs in APOB (rs1042034) or LDLR (rs2228671) on triglycerides, cholesterol, or free fatty acid levels. Conclusions In healthy adults, fasting and postprandial cholesterol levels are strongly correlated with the tested APOA5 , APOE , and APOC3 genotypes. Sex contributes to the genetic impact of the tested SNPs on lipid profiles. Trial registration ClinicalTrials.gov, NCT02367287. Registered February 20, 2015, https://clinicaltrials.gov/ct2/show/NCT02367287 .

Young Age Onset Multivascular Pathology in a Patient with Severe Dyslipidemia: an Incidental Case or a Particular Type of Familial Hypercholesterolemia?

Article

Full-text available

Aug 2022

Familial hypercholesterolemia (FH) is a genetic disorder that affects about 1 in 250 people and increases the likelihood of having coronary heart disease at a younger age. We present the case of a 55-year-old patient, known with inferior and anterior myocardial infarction treated by percutaneous coronary intervention and coronary artery bypass grafts, Leriche syndrome, aortic abdominal aneurysm, and bilateral renal stents—pathologies with onset at a young age—who was admitted for fast-paced palpitations, accompanied by increased fatigue. The coronarography did not reveal any acute lesions, but the presence of ventricular tachycardia at admission required the implantation of a cardiac defibrillator. Since the patient presented with early onset severe systemic atherosclerosis, with a lipid profile dominated by hypo-HDL, doubled by an apolipoprotein A1 deficiency, we considered the diagnosis of familial hypercholesterolemia. Due to the high-risk profile, the association between a statin and a PCSK9 inhibitor was initiated at discharge. At the 1-month follow-up control, a significant reduction of LDL-C has been achieved, with a simultaneous increase of HDL-C serum levels.

Cholesteryl Ester Transfer Protein Inhibition Reduces Major Adverse Cardiovascular Events by Lowering Apolipoprotein B Levels

Article

Full-text available

Aug 2022
INT J MOL SCI

Cholesteryl ester transfer protein (CETP) facilitates the exchange of cholesteryl esters and triglycerides (TG) between high-density lipoprotein (HDL) particles and TG-rich, apolipoprotein (apo) B-containing particles. Initially, these compounds were developed to raise plasma HDL cholesterol (HDL-C) levels, a mechanism that was previously thought to lower the risk of atherosclerotic cardiovascular disease (ASCVD). More recently, the focus changed and the use of pharmacologic CETP inhibitors to reduce low-density lipoprotein cholesterol (LDL-C), non-HDL-C and apoB concentrations became supported by several lines of evidence from animal models, observational investigations, randomized controlled trials and Mendelian randomization studies. Furthermore, a cardiovascular outcome trial of anacetrapib demonstrated that CETP inhibition significantly reduced the risk of major coronary events in patients with ASCVD in a manner directly proportional to the substantial reduction in LDL-C and apoB. These data have dramatically shifted the attention on CETP away from raising HDL-C instead to lowering apoB-containing lipoproteins, which is relevant since the newest CETP inhibitor, obicetrapib, reduces LDL-C by up to 51% and apoB by up to 30% when taken in combination with a high-intensity statin. An ongoing cardiovascular outcome trial of obicetrapib in patients with ASCVD is expected to provide further evidence of the ability of CETP inhibitors to reduce major adverse cardiovascular events by lowering apoB. The purpose of the present review is to provide an up-to-date understanding of CETP inhibition and its relationship to ASCVD risk reduction.

Residual Risk of Coronary Atherosclerotic Heart Disease and Severity of Coronary Atherosclerosis Assessed by ApoB and LDL-C in Participants With Statin Treatment: A Retrospective Cohort Study

Article

Full-text available

Apr 2022

Background Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy on the management of hypercholesterolemia in the United States and European guidelines, while apolipoprotein B (apoB) is the secondary target. The objective was to determine if elevated levels of apoB is superior to LDL-C in assessing residual risk of coronary atherosclerotic heart disease and severity of coronary atherosclerosis in participants with statin treatment. Methods This study included 131 participants with statin treatment. The generalized linear model and relative risk regression (generalized linear Poisson model with robust error variance) were used to analyze the association of the levels of apoB and LDL-C with the severity of coronary atherosclerosis and residual risk of coronary atherosclerotic heart disease. Results Categorizing apoB and LDL-C based on tertiles, higher levels of apoB were significantly associated with the severity of coronary atherosclerosis (Ptrend = 0.012), whereas no such associations were found for elevated levels of LDL-C (Ptrend = 0.585). After multivariate adjustment, higher levels of apoB were significantly associated with residual risk of coronary atherosclerotic heart disease. When compared with low-level apoB (≤0.66 g/L), the multivariate adjusted RR and 95% CI of intermediate-level apoB (0.67–0.89 g/L) and high-level apoB (≥0.90 g/L) were 1.16 (1.01, 1.33) and 1.31 (1.08, 1.60), respectively (Ptrend = 0.011). There was a 45% increased residual risk of coronary atherosclerotic heart disease per unit increment in natural log-transformed apoB (Ptrend <0.05). However, higher levels of LDL-C were not significantly associated with residual risk of coronary atherosclerotic heart disease. When compared with low-level LDL-C (≤1.56 mmol/L), the multivariate adjusted RR and 95% CI of intermediate-level LDL-C (1.57–2.30 mmol/L) and high-level LDL-C (≥2.31 mmol/L) were 0.99 (0.84, 1.15) and 1.10 (0.86, 1.42), respectively (Ptrend = 0.437). Similar results were observed in the stratified analyses and sensitivity analyses. No significant interactions were detected for both apoB and LDL-C (all Pinteraction >0.05). Conclusions Elevated apoB are superior in assessing the residual risk of coronary atherosclerotic heart disease and severity of coronary atherosclerosis in participants with statin treatment.

Neutrophil to high-density lipoprotein ratio associates with higher all-cause mortality and new onset cardiovascular events in peritoneal dialysis patients

Article

Full-text available

Apr 2022
INT UROL NEPHROL

Background Neutrophil to high-density lipoprotein ratio (NHR), a new inflammatory marker, is associated with poor clinical prognosis. However, the correlation of NHR and adverse outcomes in peritoneal dialysis (PD) patients remains unclear. Methods In this retrospective cohort study, a total of 1051 PD patients were recruited from three centers during Jan 1, 2009 to Dec 31, 2017. Eligible patients were distributed according to quartiles of the NHR. Kaplan–Meier cumulative incidence curves, multivariate COX regression, competitive risk analysis and restricted cubic spline (RCS) were applied to analyze the relationship between NHR and all-cause mortality as well as cardiovascular events (CVE). In addition, forest plots were used to calculate the interaction between different subgroups. Results During follow-up, a total of 240 all-cause mortality and 157 new-onset CVE were recorded. The all-cause mortality in the highest quartile of NHR (> 5.43) were higher than those in the other groups. RCS showed a non-linear relationship between NHR and adverse outcomes. Multivariate COX regression indicated elevated NHR was an independent risk factor for all-cause mortality. Compared to the highest quartile, hazard ratio (HR) of new-onset CVE equals to 0.522 (95% CI 0.321–0.849) in the secondary quartile (2.43 < NHR ≤ 3.57), and the HR of all-cause mortality analysis is 0.551 (95% CI 0.378–0.803) in the third quartile (3.57 < NHR ≤ 5.43). Kaplan–Meier analysis suggested there were significant differences in all-cause mortality and new-onset CVE among four NHR groups. Conclusions NHR was a new independent risk factor for all-cause mortality in PD patients.

Brazil and cashew nuts intake improve body composition and endothelial health in women at cardiometabolic risk (Brazilian Nuts Study): a randomized controlled trial

Article

Feb 2022
BRIT J NUTR

Several mechanisms have been proposed for the beneficial effect of nuts on health. However, Brazil and cashew nuts remain the least studied. We aim to evaluate the effect of these nuts within an energy-restricted diet on body weight, body composition, cardiometabolic markers, and endothelial function in cardiometabolic risk women. Brazilian nuts study is a randomized controlled parallel 8-week dietary intervention trial. Forty women were randomly allocated to 1) Control group: Energy-restricted diet without nuts, n= 19 or, 2) Brazil and cashew nuts group (BN-Group): Energy-restricted diet containing daily 45 g of nuts (15 g of Brazil nuts + 30g of cashew nuts), n= 21. At the beginning and final intervention, anthropometry, body composition, and blood pressure were measured. Fasting blood sampling was obtained to evaluate lipid profile, glucose homeostasis, and endothelial function markers. After 8-week, plasma selenium concentration increased in BN-group (∆ = + 31.5 ± 7.8 μg/L; p= 0.001). Brazil and cashew nuts intake reduced total body fat (-1.3 ± 0.4 %) parallel to improvement of lean mass percentage in BN-group compared to the control. Besides, the soluble adhesion molecule VCAM-1 decreased (24.03 ± 15.7 pg/mL vs. -22.2 ± 10.3 pg/mL; p= 0.019) after Brazil and cashew nuts intake compared to the control. However, lipid and glucose profile markers, apolipoproteins, and blood pressure remained unchanged after the intervention. Thus, the addition of Brazil and cashew nuts to an energy-restricted diet can be a healthy strategy to improve body composition, selenium status, and endothelial inflammation in cardiometabolic risk women.

C-Reactive Protein, Lipid Profile and Body Mass Index in Patients of Liver Cirrhosis

Article

Full-text available

Jan 2022

Background: Liver cirrhosis leads to the abnormalities in liver function. Objective: This study aimed to determine the C-reactive protein (CRP) and lipid profile in cirrhotic patients as well as their correlation with patients age and body mass index. Methodology: This case- control study was conducted in the Chittagong Medical College Hospital and People’s Hospital Limited, Chattogram from October 2017 to March 2018 for a period of six months. Venous blood was collected from 25 patients and 25 controls after 8 hours overnight fasting. Inflammatory marker (CRP) and Serum lipid status were recorded for each participant. Results: The mean serum C-reactive protein; total cholesterol; Triglycerides; High Density Lipoprotein and Low Density Lipoprotein level were 2.448 ± 1.174; 132.228 ± 15.352; 100.228 ± 20.564 mg/dl; 53.081 ± 9.994 mg/dl and 59.108 ± 18.634 mg/dl in cirrhotic patients. CRP value was significantly higher in patients compared to healthy individuals (p < 0.05). The extent of decreasing lipid profile (except HDL) was also significantly related to the progress in cirrhosis (p < 0.05). The positive correlation of age and BMI of patients were associated with CRP and various lipid variables. Conclusion: The higher CRP value and extent of decreasing lipid profile (except HDL) in patients may serve as a baseline for further studies that required to determine the predictive values of lipid profiles as a means to estimate the extent of liver damage in cirrhotic patients. Bangladesh Journal of Infectious Diseases June 2021;8(1):27-31

New evidences on the association between HDL-C and cardiovascular risk: a never ending research story

Article

Jan 2022

Efficacy of Weight Reduction on Lipid parameters in Egyptian Type-2 Diabetic Obese Women

Article

Full-text available

Jan 2015

Excess body weight is the sixth most important risk factor for health in the world. Obesity amplifies the risks of type 2 diabetes (T2DM), hypertension, cardiovascular disease, dyslipidemia, arthritis, and several cancers and is estimated to reduce average life expectancy. Weight-loss is an important goal for overweight or obese persons, particularly those with type 2 diabetes. Lifestyle interventions, in the form of dietary modification and exercise, are effective means of managing and treating high serum levels of cholesterol and triglycerides in individuals diagnosed with dyslipidemia. Aim of the work: To investigate the efficacy of weight reduction and decreasing waist circumference on improving lipid profile and blood glucose level. Subjects and methods: this study included forty Egyptian obese women with type II diabetes mellitus. BMI ranged from 30 to 39.9kg/m 2 (class I & II obesity according to WHO classification 2000). Their age ranged from 35 to 50 years. They were subjected to weight reduction program (diet restriction regimen by 1200Kcal/day balanced diet and exercise by walking on treadmill for 40min thrice weekly) for eight weeks. Blood sugar, lipid profile, BMI and waist circumference were measured before and at the end of the program. Results: the mean baseline total cholesterol (TC) level was statistically significant (p-<0.05). Also, the mean baseline readings for HbA1c was 8.4±0.56 gm% and at the end of the study it was 7.8±0.49 gm %& the difference was statistically significant (p-<0.05) There was no significant differences for the effect of weight reduction on dyslipidemia between class I and class II obesity groups exceptionally here was a significant difference in the effect of weight reduction on the 2HPP blood sugar between the two groups. Conclusion: This study demonstrated that the diet regimen and the exercise program that were applied in our study had a significant effect in weight and waist circumference reduction, which resulted in a significant decrease in blood sugar, total cholesterol, LDL and triglycerides and significant increase in HDL. There was no significant difference in the effect of weight reduction on dyslipidemia between class I and class II obesity groups. While there was a significant difference in the effect of weight reduction on the 2HPP blood sugar between the groups.

Nutraceutical Intervention of Phytosterols in Cardiovascular Aging

Chapter

Jan 2022

Phytosterols and phytostanols are a large group of compounds that are found exclusively in plants. They are structurally and functionally related to cholesterol but differ from cholesterol in the structure of the side chain. Phytosterols lower total and low-density lipoprotein (LDL) blood cholesterol by preventing cholesterol absorption from the intestine, so they have been known as blood cholesterol-lowering agents. Phytosterols are naturally found in fruits, vegetables, nuts, and mainly oils. Dietary phytosterol intakes normally range from 160-400 mg/day with variations depending on food culture and major food sources. Dairy foods remain a food of choice for use as delivery vehicle for many functional ingredients including phytosterols and there are many dairy products available in the global markets which are enriched with phytosterols. The use of phytosterols in commonly consumed dairy products may soon provide an effective tool against CVD and its introduction to our food products is worth anticipating in the near future as nutraceuticals for healthy ageing.

High-Sensitivity C-Reactive Protein to HDL-C Ratio: A Predictor of Coronary Artery Disease

Article

Nov 2021

Inflammation and lipid signaling are involved in the pathogenesis and progression of coronary artery disease (CAD). We proposed that high-sensitivity C-reactive proteins, as a marker of the pro-inflammatory state, and high-density lipoprotein cholesterol (HDL-C), as an anti-atherosclerosis component, should be integrated into a single novel biomarker. Our work was conducted to discuss and compare the predictive ability of the high-sensitivity C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) with other existing indices, for example, neutrophil high-density lipoprotein ratio (NHR) and neutrophil lymphocyte ratio (NLR), in the severity of CAD patients. Based on the results of coronary angiography, patients were divided into the CAD⁺ group, CAD⁻ group, and control group. The relationship between various serum markers and the severity of coronary artery disease was examined via Spearman's correlation analysis. Logistic regression analysis was conducted to identify the influencing factors of the coronary artery disease severity. This study included 420 patients. The Gensini score was positively correlated with CHR. Multiple regression analysis revealed that the CHR was significantly associated with CAD. CHR is an independent predictor of CAD. The receiver operating characteristic (ROC) analysis provided a cut-off value of 1.17 for CHR to predict CAD, with a specificity of 86.7%, Yoden index of 0.264, and area under the ROC curve of 0.662 (95% confidence intervals 0.606-0.719, P < 0.001). At the same time, the area under the ROC curve of the NHR was 0.652, and that of the NLR was 0.579. The results of the DeLong test indicated that the area under the ROC curve of the CHR was larger than that of the NLR (P = 0.0306). This suggests that the CHR as a predictor of CAD has better diagnostic performance than the NLR. CHR was not only closely related to the presence and severity of CAD but also an independent predictor of severe CAD.

ASSESSMENT OF LIPIDS AND ITS ARTHEROGENIC INDEX IN FEMALE INFERTILITY IN OWERRI, SOUTH EAST NIGERIA

Article

Full-text available

Jan 2016

Development and validation of a predictive model for carotid atherosclerosis in postmenopausal women

Article

Full-text available

Feb 2025

With the global aging of the population, menopausal women face higher cardiovascular disease (CVD) risks, with carotid atherosclerosis as the primary pathological basis. However, no effective tools exist for assessing carotid atherosclerosis risk, and this study fills the gap in predictive tools in this field. Using data from 4,446 menopausal women in Shenzhen, we developed and validated a Nomogram model for carotid atherosclerosis risk. The sample was divided into training (2,178), internal validation (934), and external validation (1,334) sets. Variables were selected using logistic regression and LASSO, including age, systolic blood pressure (SBP), lipoprotein a (LPa), non-HDL cholesterol (Non-HDL-C), TC/HDL-C ratio, glycosylated hemoglobin (HbA1c), and blood glucose (GLU). Random Forest validation confirmed the model’s robustness. The Nomogram’s C-index was 0.706 (training), 0.664 (internal), and 0.668 (external), with Random Forest results of 0.721, 0.662, and 0.661, respectively. Calibration and decision curve analyses demonstrated the model’s accuracy and clinical utility. Additionally, a slight negative correlation between age and GLU (OR = 0.689, P = 0.068) suggested reduced glycemic risk with age. This model provides a scientific basis for early risk assessment and personalized interventions for menopausal women, guiding future research on related biological mechanisms.

Antihyperlipidemic and cardioprotective effects of n-hexane extract of Terminalia catappa nuts in hyperlipidaemic and hyperglycemic Wister rats

Article

Full-text available

Jan 2025

Background: Dyslipidaemia and diabetes mellitus are significant risk factors for cardiometabolic disease. This study evaluates the lipid-lowering and cardioprotective effects of the n-hexane extract of Terminalia catappa nuts (TCN) in hyperlipidaemic and hyperglycaemic Wistar rats. Methods: Wistar rats were divided into two groups: negative control and induced groups. The induced group was further subdivided into positive control, standard drug-treated, and TCN-treated groups with 200, 400, and 800 mg/kg/day for six weeks. Serum lipid profiles were assessed using standard biochemical methods after 42 days of treatment with TCN. Data were analysed using one-way ANOVA followed by Tukey’s post-hoc test for multiple comparisons, with significance set at p<0.05. Results: The untreated positive control group exhibited significant elevations in total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) levels, alongside reductions in high-density lipoprotein (HDL) levels (p<0.05). Treatment with TCN at 400 mg/kg and 800 mg/kg significantly improved lipid profiles, with reductions in TC, TG, and LDL (p<0.001) and an increase in HDL (p<0.001) compared to the positive control group. At 800 mg/kg, the most substantial improvements were observed. Similarly, TCN treatment significantly reduced atherogenic indices, including the atherogenic index of plasma (AIP), atherogenic coefficient (AC), and Castelli risk indices I (CRI-I) and II (CRI-II). Improvements were dose-dependent, with the greatest reductions at 400 mg/kg and 800 mg/kg doses (p<0.001). Conclusions: Terminalia catappa nuts demonstrates significant lipid-lowering and cardioprotective effects in hyperlipidaemic and hyperglycaemic conditions, supporting its potential as a natural therapeutic for managing cardiovascular risks and metabolic syndrome.

Lipid Pattern and atherogenic index among medicalstudents

Article

Mar 2014

Background & Objective: In Bangladesh young age group has received little attention in relation to lipid profile & atherogenic index. For this purpose we decided to see lipid pattern & atherogenic index of plasma (AIP) among medical students. Method: In a cross sectional approach, 90 apparently healthy medical students voluntarily recruited from Ist year of Dhaka National Medical college during the period of June,2013 to December,2013. Height, weight, BMI, blood pressure were measured. Total cholesterol (TC), and the various sub fractions; high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were determined. Atherogenic index of plasma (AIP); log (TG/HDL-C) was calculated, in accordance with the most recent guidelines issued by the American Heart Association (AHA)/American College of Cardiology (ACC) and the National Cholesterol Education Program (NCEP). Results: Among the total students 56.66% had normal BMI, 13.33% were found to be underweight. 23.33% & 6.66% were overweight & obese respectively. Out of 90 students, 22 had low HDL (<40 mg/dl), 11 had increased TG (>150 mg/dl), 5 had increased Cholesterol (>200 mg/dl), 3 had increased LDL (>130mg/dl). Among the students 41 had low cardiovascular risk which represents 45.5%, 45 had increased cardiovascular risk which represents 50%, & 4 had intermediate cardiovascular risk which represents 4.44%. Conclusion: By assessing AIP we found that 41 subjects had low cardiovascular risk which represents 45.5%, 45 had increased cardiovascular risk which represents 50%, & 4 had intermediate cardiovascular risk which represents 4.44%, A high prevalence of cardiovascular risk factors; family history of elevated blood pressure was present. J. Dhaka National Med. Coll. Hos. 2014;20(01):37-40

Effects of phytosterol supplementation on lipid profiles and apolipoproteins: A meta-analysis of randomized controlled trials

Article

Oct 2024
MEDICINE

Background: The use of phytosterols and phytostanols (PS) as food supplements to control plasma cholesterol concentrations has recently received attention as its efficacy has been endorsed by scientific authorities and leading guidelines. However, the effects of phytosterols on lipid profiles and atherosclerosis remain incomplete and controversial. This study aims to investigate the effects of PS supplementation on lipid profiles and apolipoproteins in adults based on a systematic review of the literature and a meta-analysis of randomized controlled trials (RCTs). Methods: A comprehensive search was conducted for RCTs published in PubMed, Embase, Cochrane Library, and Web of Science as of May 2024. Random effects model was utilized to determine the mean differences and 95% confidence interval for changes in circulating lipid profiles and apolipoproteins. Results: Twenty-eight RCTs with a total of 1777 participants (895 cases and 882 controls) are included in the qualitative synthesis. PS supplementation significantly reduced total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and apolipoprotein B (Apo-B) levels, as well as Apo-B/apolipoprotein A1 ratios, but increased high-density lipoprotein cholesterol levels. PS supplementation dose is associated with TC, LDL-c, and Apo-B levels in a dose-response manner. Conclusion: Our findings suggest that dietary phytosterols can effectively promote the reduction of TC, LDL-c, and Apo-B, along with increased high-density lipoprotein cholesterol in adults.

Speeding up interval estimation for R2-based mediation effect of high-dimensional mediators via cross-fitting

Article

Oct 2024
BIOSTATISTICS

Mediation analysis is a useful tool in investigating how molecular phenotypes such as gene expression mediate the effect of exposure on health outcomes. However, commonly used mean-based total mediation effect measures may suffer from cancellation of component-wise mediation effects in opposite directions in the presence of high-dimensional omics mediators. To overcome this limitation, we recently proposed a variance-based R-squared total mediation effect measure that relies on the computationally intensive nonparametric bootstrap for confidence interval estimation. In the work described herein, we formulated a more efficient two-stage, cross-fitted estimation procedure for the R2 measure. To avoid potential bias, we performed iterative Sure Independence Screening (iSIS) in two subsamples to exclude the non-mediators, followed by ordinary least squares regressions for the variance estimation. We then constructed confidence intervals based on the newly derived closed-form asymptotic distribution of the R2 measure. Extensive simulation studies demonstrated that this proposed procedure is much more computationally efficient than the resampling-based method, with comparable coverage probability. Furthermore, when applied to the Framingham Heart Study, the proposed method replicated the established finding of gene expression mediating age-related variation in systolic blood pressure and identified the role of gene expression profiles in the relationship between sex and high-density lipoprotein cholesterol level. The proposed estimation procedure is implemented in R package CFR2M.

Potencial hipocolesterolêmico e antioxidante da folha de Taioba (Xanthosoma sagittifolium (L.) Schott ) em camundongos dislipidêmicos induzidos por dieta

Article

Full-text available

Feb 2024

A taioba (Xanthosoma sagittifolium (L.) Schott) é uma planta alimentícia não convencional cultivada tanto para fins alimentícios como medicinais. Portanto, este estudo objetivou avaliar o efeito hipocolesterolêmico e antioxidante da folha de taioba em camundongos dislipidêmicos induzido por dieta. Os camundongos Swiss foram alimentados por 90 dias com dieta hipercolesterolêmica e após 30 dias de tratamento (gavagem) com 500mg/kg de taioba, verificou-se resultado semelhante ao tratamento com 20mg/kg da droga padrão (sinvastatina), reduzindo significativamente o colesterol total, LDL-c, colesterol não HDL, triglicerídeos e o risco cardiovascular, medido pelo índice Castelli I. Além disso, a taioba mostrou-se superior à sinvastatina, pois apresentou ainda atividade hipoglicemiante, antioxidante e nefroprotetora.

Long-Term Mortality in Patients With Severe Hypercholesterolemia Phenotype From a Racial and Ethnically Diverse US Cohort

Article

Nov 2023
CIRCULATION

BACKGROUND Tools for mortality prediction in patients with the severe hypercholesterolemia phenotype (low-density lipoprotein cholesterol ≥190 mg/dL) are limited and restricted to specific racial and ethnic cohorts. We sought to evaluate the predictors of long-term mortality in a large racially and ethnically diverse US patient cohort with low-density lipoprotein cholesterol ≥190 mg/dL. METHODS We conducted a retrospective analysis of all patients with a low-density lipoprotein cholesterol ≥190 mg/dL seeking care at Montefiore from 2010 through 2020. Patients <18 years of age or with previous malignancy were excluded. The primary end point was all-cause mortality. Analyses were stratified by age, sex, and race and ethnicity. Patients were stratified by primary and secondary prevention. Cox regression analyses were used to adjust for demographic, clinical, and treatment variables. RESULTS A total of 18 740 patients were included (37% non-Hispanic Black, 30% Hispanic, 12% non-Hispanic White, and 2% non-Hispanic Asian patients). The mean age was 53.9 years, and median follow-up was 5.2 years. Both high-density lipoprotein cholesterol and body mass index extremes were associated with higher mortality in univariate analyses. In adjusted models, higher low-density lipoprotein cholesterol and triglyceride levels were associated with an increased 9-year mortality risk (adjusted hazard ratio [HR], 1.08 [95% CI, 1.05–1.11] and 1.04 [95% CI, 1.02–1.06] per 20–mg/dL increase, respectively). Clinical factors associated with higher mortality included male sex (adjusted HR, 1.31 [95% CI, 1.08–1.58]), older age (adjusted HR, 1.19 per 5-year increase [95% CI, 1.15–1.23]), hypertension (adjusted HR, 2.01 [95% CI, 1.57–2.57]), chronic kidney disease (adjusted HR, 1.68 [95% CI, 1.36–2.09]), diabetes (adjusted HR, 1.79 [95% CI, 1.50–2.15]), heart failure (adjusted HR, 1.51 [95% CI, 1.16–1.95]), myocardial infarction (adjusted HR, 1.41 [95% CI, 1.05–1.90]), and body mass index <20 kg/m ² (adjusted HR, 3.36 [95% CI, 2.29–4.93]). A significant survival benefit was conferred by lipid-lowering therapy (adjusted HR, 0.57 [95% CI, 0.42–0.77]). In the primary prevention group, high-density lipoprotein cholesterol <40 mg/dL was independently associated with higher mortality (adjusted HR, 1.49 [95% CI, 1.06–2.09]). Temporal trend analyses showed a reduction in statin use over time ( P <0.001). In the most recent time period (2019–2020), 56% of patients on primary prevention and 85% of those on secondary prevention were on statin therapy. CONCLUSIONS In a large, diverse cohort of US patients with the severe hypercholesterolemia phenotype, we identified several patient characteristics associated with increased 9-year all-cause mortality and observed a decrease in statin use over time, in particular for primary prevention. Our results support efforts geared toward early recognition and consistent treatment for patients with severe hypercholesterolemia.

Lipids, atherosclerosis, and microvascular disease: Translating basic science into pharmacotherapeutics

Chapter

Jan 2023

Residual risks and evolving atherosclerotic plaques

Article

Full-text available

Mar 2023
MOL CELL BIOCHEM

Atherosclerotic disease of the coronary and carotid arteries is the primary global cause of significant mortality and morbidity. The chronic occlusive diseases have changed the epidemiological landscape of health problems both in developed and the developing countries. Despite the enormous benefit of advanced revascularization techniques, use of statins, and successful attempts of targeting modifiable risk factors, like smoking and exercise in the last four decades, there is still a definite “residual risk” in the population, as evidenced by many prevalent and new cases every year. Here, we highlight the burden of the atherosclerotic diseases and provide substantial clinical evidence of the residual risks in these diseases despite advanced management settings, with emphasis on strokes and cardiovascular risks. We critically discussed the concepts and potential underlying mechanisms of the evolving atherosclerotic plaques in the coronary and carotid arteries. This has changed our understanding of the plaque biology, the progression of unstable vs stable plaques, and the evolution of plaque prior to the occurrence of a major adverse atherothrombotic event. This has been facilitated using intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy in the clinical settings to achieve surrogate end points. These techniques are now providing exquisite information on plaque size, composition, lipid volume, fibrous cap thickness and other features that were previously not possible with conventional angiography.

Extensive diet-induced atherosclerosis in scavenger receptor class B type 1-deficient mice is associated with substantial leukocytosis and elevated vascular cell adhesion molecule-1 expression in coronary artery endothelium

Article

Full-text available

Jan 2023

High levels of low density lipoprotein (LDL) cholesterol and low levels of high density lipoprotein (HDL) cholesterol are risk factors for cardiovascular disease. Mice that lack genes involved in the clearance of LDL from the bloodstream, such as the LDL receptor and apolipoprotein E, are widely used models of experimental atherosclerosis. Conversely, mice that lack the HDL receptor, scavenger receptor class B type I, and therefore have disrupted HDL functionality, also develop diet-inducible atherosclerosis but are a seldom-used disease model. In this study, we compared atherosclerosis and associated phenotypes in scavenger receptor class B type I knockout mice with those of wild type, LDL receptor knockout, and apolipoprotein E knockout mice after 20 weeks of being fed an atherogenic diet containing sodium cholate. We found that while scavenger receptor class B type I knockout mice had substantially lower plasma cholesterol than LDL receptor and apolipoprotein E knockout mice, they developed atherosclerotic plaques with similar sizes and compositions in their aortic sinuses, and more extensive atherosclerosis in their descending aortas and coronary arteries. This was associated with elevated tumor necrosis factor alpha levels in scavenger receptor class B type I knockout mice compared to wild type and LDL receptor knockout mice, and lymphocytosis, monocytosis, and elevated vascular cell adhesion molecule expression in coronary artery endothelial cells compared to the other mice examined. We conclude that extensive atherosclerosis in arteries that are not generally susceptible to atherosclerosis in scavenger receptor class B type I knockout mice is driven by factors in addition to hypercholesterolemia, including inflammation, dysregulation of the immune system and increased sensitivity of endothelial cells in arteries that are normally resistant to atherosclerosis. Scavenger receptor class B type I knockout mice fed a cholate containing atherogenic diet may prove to be a useful model to study mechanisms of atherosclerosis and evaluate treatments that rely on intact LDL clearance pathways.

AGE-RAGE Stress in the Pathophysiology of Atherosclerosis and Its Treatment

Chapter

Jun 2022

Kailash Prasad

AGE-RAGE stress induces atherosclerosis through the production of numerous atherogenic factors including reactive oxygen species (ROS), minimally modified low-density lipoprotein (MM-LDL), oxidized LDL (OX-LDL), monocyte chemoattractant protein-1, adhesion molecules, cytokines, monocyte colony-stimulating factor, growth factors, endothelin-1, and reduction in nitric oxide. All of the above factors except nitric oxide and endothelin-1 are involved in the oxidative hypothesis of atherosclerosis. Treatment of AGE-RAGE stress-induced atherosclerosis should be targeted at the reduction in AGE intake, prevention of AGE formation, degradation of AGE in vivo, suppression of RAGE expression, blockade of AGE binding with RAGE, elevation of sRAGE by increasing sRAGE expression and exogenous administration, and use of antioxidants. These treatment modalities would prevent, regress, and slow the progression of AGE-RAGE stress-induced atherosclerosis and hence would assist in the treatment of coronary artery disease and stroke.KeywordsAtherosclerosisReactive oxygen speciesAdvanced glycation end product (AGE)Receptor for AGE (RAGE)Soluble receptor for AGE (sRAGE)NF-kBCytokinesAdhesion moleculesChemoattractant protein-1Growth factorsEndothelinNitric oxidePrevention of AGE formationDownregulation of RAGE, and sRAGE expression

Longitudinal relationships of Polycyclic Aromatic Hydrocarbons Exposure and Genetic Susceptibility with Blood Lipid Profiles

Article

Apr 2022
ENVIRON INT

Objective We aim to analyze the effects of polycyclic aromatic hydrocarbons (PAHs) exposure and genetic predisposition on blood lipid through a longitudinal epidemiological study. Methods We enrolled 4,356 observations who participated at baseline (n=2,435) and 6-year follow-up (n=1,921) from Wuhan-Zhuhai cohort. Ten urinary PAHs metabolites and blood lipid (i.e., total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) were measured at both baseline and follow-up. The polygenic risk scores (PRS) of blood lipid were constructed by the corresponding genome-wide association studies. Linear mixed models were fit to identify associations between urinary PAHs metabolites, blood lipid, and lipid-PRSs in the repeated-measure analysis. Besides, longitudinal relationships of blood lipid with urinary PAHs metabolites and respective lipid-PRSs were examined by using linear regression models. Results Compared with subjects who had persistently low urinary total hydroxyphenanthrene (ΣOHPh), those with persistently high levels had an average increase of 0.137 mmol/l for TC and 0.129 mmol/l for LDL-C over 6 years. Each 1-unit increase of TC-, TG-, LDL-C-, and HDL-C-specific PRS were associated with an average increase of 0.438 mmol/l for TC, 0.264 mmol/l for TG, 0.198 mmol/l for LDL-C, and 0.043 mmol/l for HDL-C over 6 years, respectively. Compared with subjects who had low genetic risk and persistently low ΣOHPh, subjects with high LDL-specific PRS and persistently high ΣOHPh had an average increase of 0.652 mmol/l for LDL-C. Conclusions Our results suggest that high-level ΣOHPh exposure is associated with an average increase of LDL-C over 6 years, and those relationships can be aggravated by a higher LDL-C-genetic risk. No significant relationships were observed between other PAHs metabolites (including hydroxynaphthalene, hydroxyfluorene, and hydroxypyrene) and blood lipid changes over 6 years. Our findings emphasize the importance of preventing PAHs exposure, particularly among those with a higher genetic predisposition of hyperlipidemia.

SNPs in Apolipoproteins Contribute to Sex-dependent Differences in Blood Lipids Before and After a High-fat Dietary Challenge in Healthy U.S. Adults

Preprint

Full-text available

Oct 2021

Background: The effect of genetic polymorphisms on fasting blood lipid levels have been widely studied but the effects of these within the context of a high-fat meal challenge remain less characterized. The current study aimed to investigate the association of SNPs in lipoprotein-related genes with blood lipid profiles in healthy adults in the U.S. Methods: Subjects (n=393) between 18-66 years of age with BMIs ranging from 18.5-45 kg/m² completed the cross-sectional Nutritional Phenotyping Study. Among them, 349 subjects (men: 48%; women: 52%) gave consent for genotyping. SNPs in APOA5, APOB, APOC3, APOE, and LDLR were assessed. The association between lipid markers and genotypes was tested separately for each SNP with analysis of variance (ANOVA), adjusted for sex, age, and BMI. We also examined two-factor interactions between SNPs and sex, age, or BMI. Results: Women carrying the C allele of rs3135506 in APOA5 or men carrying the C allele of rs429358 in APOE had reduced HDL-cholesterol levels during fasting and postprandially. The C allele in APOE was also correlated to increased LDL-C levels. The TT genotype of rs2854116 in APOC3 was associated with elevated total cholesterol. Additive effect of the risk alleles of APOA5 and APOE or APOC3 and APOE was detected. Nevertheless, the tested SNPs had little impact on the postprandial triglyceride responses to the high-fat challenge meal. We found no significant effects of SNPs in APOB (rs1042034) or LDLR (rs2228671) on triglycerides, cholesterol, or free fatty acid levels. Conclusions: In healthy adults, fasting and postprandial cholesterol levels are strongly correlated with the tested APOA5, APOE, and APOC3 genotypes. Sex attributes to the genetic impact of the tested SNPs on lipid profiles. Trial registration: ClinicalTrials.gov, NCT02367287. Registered February 20, 2015, https://clinicaltrials.gov/ct2/show/NCT02367287.

Choice of antithrombotic therapy for patients with atrial fibrillation undergoing carotid angioplasty and stenting: a nationwide population-based study

Article

Full-text available

Jan 2022

Nonvalvular atrial fibrillation (NVAF) and carotid stenosis are important risk factors for stroke. Carotid angioplasty and stent placement (CAS) is recommended for patients with symptomatic high-grade carotid stenosis. The optimal medical management for patients with NVAF after CAS remains unclear. We aimed to clarify this issue using real-world data from the Taiwanese National Health Insurance Research Database (NHIRD). In total, 2116 consecutive NVAF patients who received CAS between January 1, 2010, and December 31, 2016, from NHIRD were divided into groups based on post-procedure medication as follows: only antiplatelet agent (OAP, n = 587); only anticoagulation agent (OAC, n = 477); dual antiplatelet agents (DAP, n = 49); and a combination of antiplatelet and anticoagulation agents (CAPAC, n = 304). Mortality, vascular events, and major bleeding episodes were compared after matching with the Charlson comorbidity index and CHA2DS2-VASc score. The CAPAC and the OAC groups had lower mortality rates than the OAP group ( P = 0.0219), with no statistical differences in major bleeding, ischemic stroke, or vascular events. Conclusively, OAC therapy after CAS appears suitable for NVAF patients. CAPAC therapy might be considered as initial therapy or when there is concern about vascular events.

Obesity, Smoking, Physical Activity, Hypertension: Models of Stroke Causes in South Sulawesi Province

Article

Full-text available

Dec 2021

Lifestyle changes have led to an increase in cases of non-communicable diseases in Indonesia, including hypertension and stroke. Unhealthy eating behavior, smoking habits, alcohol consumption, stress, and lack of physical activity are risk factors for degenerative diseases, besides the other risk factors such as age, gender, and heredity. This research aimed to determine the factor of obesity, smoking behavior, physical activity, and hypertension on the incidence of stroke in South Sulawesi Province. The method of research was analytic observational with a case-control approach. The case group was stroke patients as many as 750 cases and the control group was non-stroke patients as many as 750 cases. Data analysis using Path analysis. The results showed that there was a significant relationship between stroke and hypertension with a path coefficient value of 0.33, the relationship between physical activity and the incidence of stroke through hypertension with a path coefficient value of 0.13, obesity and the incidence of stroke through hypertension with a path coefficient value of 0, 21, there is a relationship between smoking and the incidence of stroke through hypertension with a path coefficient value of 0.08. Hypertension is a risk factor that directly affects the incidence of stroke compared to other risk factors. however, all of these risk factors can be reduced, especially by doing routine and regular physical activity every day.

Serum Lipid Profile status of Type 2 Diabetic Patients in the cross section population in Dhaka City of Bangladesh

Article

Full-text available

Jul 2012

Objectives: Serum lipid profile viz the level of total cholesterol (TC), Triglyceride (TG), HDL-cholesterol and LDL-cholesterol of type2 diabetic patients have been studied and compares them with levels of control subjects. Results: The mean value of the TG level for male diabetics was higher than that for the female diabetics and the mean values of TC, HDL-C and LDL-C were not found significantly different between male and female diabetics. Hyperlipidemia has a documented causative relation with CAD, but the major risk associated with diabetes may be due to the associated hyperlipidemia. The study revealed that dyslipi-demia is very common in type2 diabetics and the most common abnormality observed was increased serum triglyceride levels (58%). The next common abnormality was decreased serum high-density lipoprotein cholesterol (HDL-C) levels and increased serum low-density lipoprotein cholesterol (LDL-C) levels. A high total serum cholesterol levels was found in 41% patients. 39% of the patients examined were overweight, and 7% were overtly obese. Conclusion: Thus, the study clearly shows the relationship between type2 diabetes and hyperlipidemia, which may influence the mechanism by which type2 diabetes is associated with increased CAD risk.

Cholesterol and lipids in the risk of coronary artery disease. The Framingham Heart Study

Abstract

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