Correlation Between Neutrophil/HDL-C Ratio and Severity of Coronary Artery Lesion in Young Adults with Acute Myocardial Infarction / 华中科技大学学报(医学版)

Objective To investigate the relationship between neutrophil/high-density lipoprotein cholesterol ratio(NHR)and the severity of coronary artery lesions in young adults with acute myocardial infarction.Methods A total of 109 young a-dults(aged 18～45 years)with acute myocardial infarction admitted to the First Affiliated Hospital of Anhui Medical University from June 2019 to June 2023 were selected and divided into Syntax low-risk group(n=85)and Syntax medium-high-risk group(n=24)according to Syntax score.Patients with negative coronary angiography during the same period were negative control group(n=52).General clinical data and related serum markers were collected,and NHR value was calculated.Pearson correla-tion analysis and logistics regression analysis were performed to examine the correlation between NHR and the severity of coro-nary artery lesions.Subgroup analysis and interaction testing were further conducted.The receiver operating curve(ROC)was performed to evaluate the value of NHR in predicting the severity of coronary artery lesions in young adults with acute myocar-dial infarction.Results Gender,smoking rate,alcohol consumption rate,diabetes history,absolute number of neutrophils,tri-glyceride,HDL-C,NHR,VLDL-C,apolipoprotein B(APOB),fasting blood glucose and glycosylated hemoglobin were signifi-cantly different among the three groups(P＜0.05).In pairwise comparison,the absolute number of neutrophil and NHR were significantly different among the three groups.BMI was significant different between non-CHD group and Syntax medium-high-risk group.HDL-C,fasting blood glucose and glycosylated hemoglobin were significant different between Syntax low-risk group and non-CHD group,as well as between Syntax medium-high-risk group and non-CHD group(P＜0.05).Creatinine and APOB were significant different between Syntax low-risk group and non-CHD group.Triglyceride,VLDL-C and LP(a)were significant different between Syntax low-risk group and Syntax medium-high-risk group(P＜0.05).Pearson correlation analysis showed a positively correlation between NHR and Syntax score(r=0.322,P＜0.01).Univariate and multivariate binary logistic regres-sion analysis showed that NHR(OR=1.265,95％CI1.097～1.458,P＜0.05)was an independent risk factor for the severity of coronary artery lesions in young adults with acute myocardial infarction.Subgroup analysis showed that NHR was significantly associated with the severity of coronary artery lesions in patients with BMI≥24 kg/m2,smokers,drinkers and non-drinkers(P＜0.05).No significant difference was observed in interaction analysis.The ROC curve showed that the area under the curve(AUC)predicted by NHR for acute myocardial infarction in young adults was 0.758,with a cut-off value of 7.0319,sensitivity of 83.3％,and specificity of 63.53％.Conclusion NHR has a certain value in predicting the severity of coronary artery lesions in young adults with acute myocardial infarction.

Correlation Between RC/HDL-C Ratio and Ct-Derived Fractional Flow Reserve in Coronary Heart Disease Patients with Critical Lesions / 中山大学学报(医学科学版)

ObjectiveTo investigate the effect of remnant cholesterol （RC）/high-density lipoprotein cholesterol （HDL-C） ratio on coronary computed tomography-derived fractional flow reserve （FFRct） in coronary heart disease （CHD） patients with critical lesions. MethodsA retrospective study was done on patients who were admitted to our department and underwent coronary computed tomography angiography （CCTA） from January 1， 2022 to December 31， 2022. All the 304 culprit vessels from the 219 patients with moderate coronary artery stenosis （50%~70%） were divided into FFRct ischemia group （FFRct≤0.8， N=108） and FFRct non-ischemia group （FFRct>0.8， N=111）. Multivariate logistic regression analysis was used to explore the influencing factors of FFRct≤0.8 in CHD patients with critical lesions. Receiver operating characteristic （ROC） curve was drawn to evaluate the predictive value of RC/HDL-C for FFRct≤0.8. Pearson correlation analysis was used to assess whether there was a correlation between RC/HDL-C and FFRct. ResultsThere were significantly more diabetic patients in FFRct ischemia group （P<0.001）. RC/HDL-C ratio， levels of RC， non-HDL-C， APOB， HbA1c and FPG in FFRct ischemic group were significantly increased （P<0.05）. Pearson correlation analysis showed that the RC/HDL-C ratio， levels of RC， Non-HDL-C， TC， TG， LDL-C， HDL-C， LP（a）， HbA1c， and FPG were all significantly negatively correlated with FFRct values （P<0.05）. Univariate logistic regression analysis showed that diabetes mellitus， RC/HDL-C ratio， levels of RC， non-HDL-C， TG， LP（a）， HbA1c and FPG were significantly correlated with FFRct≤0.8 （P<0.05）. Multivariate logistic regression analysis showed that RC/HDL-C ratio was a predictor of FFRct≤0.80 （OR=4.682， 95%CI 1.197~18.316， P<0.05）. ConclusionsRC/HDL-C ratio is independently correlated with FFRct≤0.8 in CHD patients with moderate stenosis and it is a potential indicator for evaluating coronary functional ischemia.

Impact of Baseline Non-high-density Lipoprotein Cholesterol Level on New-onset Cardiovascular Disease Among Postmenopausal Women / 中国循环杂志

Objectives:To investigate the impact of baseline non-high-density lipoprotein cholesterol(non-HDL-C)levels on new-onset cardiovascular disease(CVD)in postmenopausal women. Methods:This prospective cohort study selected 8 893 postmenopausal women who participated from 2006 to 2018 employee health examination of Kailuan Group and had complete total cholesterol(TC)and HDL-C data and no history of CVD.Participants were followed up to 31 December,2021.The primary endpoint was the occurrence of CVD or death.According to the Chinese Lipid Management Guidelines(2023),the participants were divided into non-HDL-C<4.1 mmol/L group(n=6 079),4.1 mmol/L≤non-HDL-C<4.9 mmol/L group(n=1 824)and non-HDL-C≥4.9 mmol/L group(n=990).The cumulative incidence of CVD in different groups of non-HDL-C levels was calculated using the Kaplan-Meier method and tested by log-rank analysis.Multivariate Cox regression model was used to analyze the effects of different non-HDL-C levels on CVD. Results:The mean follow-up time was(10.78±4.48)years,the cumulative incidence of CVD in different non-HDL-C level groups was 1.82%,3.24%and 2.89%,respectively.Kaplan-Meier survival curve showed a statistically significant difference in cumulative incidence among the three groups(log-rank P<0.0001).The results of Cox regression analysis showed that after adjusting for confounding factors such as age and sex,the HR(95%CI)values for CVD in the 4.1≤non-HDL-C<4.9 mmol/L group and the non-HDL-C≥4.9 mmol/L group were 1.40(1.13-1.74)and 1.35(1.03-1.78),respectively. Conclusions:High non-HDL-C levels are an independent risk factor for new-onset CVD in postmenopausal women.

Receptor soluble para productos finales de glicación avanzada y perfil lipídico como marcadores de riesgo cardiovascular en niños con obesidad / Soluble receptor for advanced glycation end products and lipid profile ratio as cardiovascular risk markers in children with obesity

Resumen Introducción: Se ha mostrado que la obesidad está asociada a niveles bajos de la forma soluble del receptor para productos finales de glicación avanzada (sRAGE). Objetivo: Evaluar los niveles de sRAGE y su asociación con el índice lipídico en niños con obesidad. Métodos: Estudio transversal de niños de seis a 11 años de edad con obesidad. Se evaluaron medidas antropométricas, glucosa, perfil lipídico, insulina y sRAGE; también se calculó índice de masa corporal, colesterol total/C-HDL, triglicéridos/glucosa, triglicéridos/C-HDL y HOMA-IR.] Resultados: Se estudiaron 80 niños, 50 % hombres y 50 % mujeres. Las mujeres presentaron mayor perímetro de cintura, HOMA-IR, triglicéridos/C-HDL y triglicéridos/glucosa. No se encontraron diferencias significativas en sRAGE. Al comparar las variables conforme a los terciles de la relación triglicéridos/C-HDL, en el tercil superior se encontraron mayores valores de colesterol total/HDL, triglicéridos/glucosa y sRAGE. Se observó correlación significativa entre sRAGE y HOMA-IR (p < 0.03) en los hombres y entre sRAGE, triglicéridos/C-HDL (p < 0.01) y triglicéridos/glucosa (p < 0.008) en las mujeres. Conclusiones: El sexo femenino mostró más factores de riesgo cardiovascular y mayor sRAGE en el tercil superior de triglicéridos/C-HDL. Se requieren más estudios para probar el posible efecto predictor de mayor riesgo para desarrollar complicaciones metabólicas y cardiovasculares.

Abstract Introduction: Obesity has been shown to be associated with low levels of soluble receptor for advanced glycation end products (sRAGE). Objective: To evaluate the levels of sRAGE and its association with the lipid index in children with obesity. Methods: Cross-sectional study of children with obesity aged between six and 11 years. Anthropometric measurements, glucose, lipid profile, insulin and sRAGE were evaluated; body mass index, total cholesterol/high-density cholesterol (TC/HDL-C), triglycerides/glucose (TG/glucose), and triglycerides/HDL-C (TG-HDL-C) ratios and HOMA-IR were also calculated. Results: Eighty children were studied, among which 50% were males and 50% females. Females had higher values for waist circumference, HOMA-IR, and TG/HDL-C and TG/glucose ratios. No significant differences were found for sRAGE. When the variables were compared according to TG/HDL-C ratio tertiles, higher TC/HDL, TG/glucose, and sRAGE values were found at upper tertile. A significant correlation was observed between sRAGE and HOMA-IR (p < 0.03) in males, and between sRAGE and TG/HDL-C (p < 0.01) and TG/glucose ratios (p < 0.008) in females. Conclusions: The female gender showed more cardiovascular risk factors and higher sRAGE at TG/HDL-C upper tertile. Further studies are required to test the possible predictive effect of higher risk for developing metabolic and cardiovascular complications.

Corn (Zea mays L) Boiled Water Provides Good Evidence for Lowering of Lipid Profile (HDL-C, LDL-C, Triglycerides, and Total Cholesterol) in Dyslipidemia

@#Introduction: Dyslipidemia is a significant factor in cardiovascular and other diseases. Corn can be used to treat dyslipidemia. This study is to determine the effect of boiled corn water on levels of HDL-C, LDL-C, triglycerides (TG), and total cholesterol (TC) in people with dyslipidemia in certain areas in Indonesia. Methods: We used a quasi-experimental pretest-posttest control group design. A sample of 40 people for each group was taken using a purposive sampling technique. The group was given the intervention of corn-boiled water @ 200cc twice daily for seven days. Blood lipid profile using fasting and examined by Fluorometric-enzymatic assay method. All procedures are carried out based on operational standards. Within-group comparisons used the Wilcoxon test, while between-group comparisons used the Mann-Whitney U and Independent T-Test. Results: The LDL-C control group experienced an increase of 65.1 mg/dL, and the entire group’s lipid profile variation showed no difference between the pretest and posttest (p>.05). The intervention group showed an increase in HDL-C (0.1 mg/dL), a decrease in LDL-C (30.2 mg/ dL), TG (27.0 mg/dL), and TC (35.6 mg/dL). Within-group comparison of the intervention group showed HDL-C (p.153), LDL-C (p.001), TG (p.023), and TC (p<.001). A between-group comparison showed HDL-C (p.101), LDL-C (p.034), TG (p.003), and TC (p.006). Conclusion: Whole corn boiled water provides good evidence that it is effective in lowering LDL-C, TG, and TC, as well as improving dyslipidemia in HDL-C patients. This intervention can be used as an alternative treatment for dyslipidemia in terms of nutrition.

Valor Prognóstico do Colesterol não HDL na Pneumonia por COVID-19 / Prognostic Value of Non-HDL Cholesterol in COVID-19 Pneumonia

Resumo Fundamento Além da doença arterial coronariana, a lipoproteína de não alta densidade (não-HDL-C) fornece informações preditivas de curto e longo prazo para muitas doenças inflamatórias crônicas, como acidente vascular cerebral, hemodiálise, pós-transplante renal, hepatoesteatose não alcoólica e vírus da imunodeficiência humana. Objetivos Este estudo examinou o valor preditivo do não-HDL-C medido antes do SARS-CoV-2 para mortalidade na infecção por COVID-19. Métodos Este estudo incluiu retrospectivamente 1.435 pacientes diagnosticados com COVID-19 e tratados na enfermaria de doenças torácicas em um único centro entre janeiro de 2020 e junho de 2022. Todos os pacientes incluídos no estudo apresentavam características clínicas e radiológicas e sinais de pneumonia por COVID-19. O diagnóstico de COVID-19 de todos os pacientes foi confirmado por uma reação em cadeia da polimerase estudada a partir de um swab orofaríngeo. A significância estatística foi estabelecida em p < 0,05. Resultados Os pacientes do estudo, incluindo 1.435 indivíduos, foram divididos em 712 pacientes no grupo de não sobreviventes e 723 no grupo de sobreviventes. Embora não tenha havido diferença entre os grupos em relação ao sexo, houve uma diferença de idade estatisticamente significativa. O grupo que não sobreviveu era mais velho. Idade, lactato desidrogenase (LDH), proteína C reativa (PCR), triglicerídeos, D-dímero e não-HDL-C foram fatores de risco independentes para mortalidade em análises de regressão. Na análise de correlação, idade, PCR e LDH foram positivamente correlacionados com não-HDL-C. Na análise ROC, a sensibilidade para não-HDL-C foi de 61,6% e a especificidade foi de 89,2%. Conclusão Acreditamos que o nível de não HDL-C estudado antes da infecção por COVID-19 pode ser usado como um biomarcador prognóstico para a doença.

Abstract Background In addition to coronary artery disease, non-high-density lipoprotein(non-HDL-C) provides short and long-term predictive information for many chronic inflammatory diseases such as stroke, hemodialysis, post-renal transplant, non-alcoholic hepatosteatosis, and human immunodeficiency virus. Objectives This study examined the predictive value of non-HDL-C measured before SARS-CoV-2 for mortality in COVID-19 infection. Methods This study retrospectively included 1435 patients diagnosed with COVID-19 and treated in the thoracic diseases ward in a single center between January 2020 and June 2022. All patients included in the study had clinical and radiological features and signs of COVID-19 pneumonia. The COVID-19 diagnosis of all patients was confirmed by a polymerase chain reaction studied from an oropharyngeal swab. Statistical significance was set at p < 0.05. Results The study patients, including 1435 subjects, were divided into 712 patients in the non-surviving group and 723 in the surviving group. While there was no difference between the groups regarding gender, there was a statistically significant age difference. The non-surviving group was older. Age, lactate dehydrogenase(LDH), C reactive protein(CRP), triglycerides, D-dimer, and non-HDL-C were independent risk factors for mortality in regression analyses. In correlation analysis, age, CRP, and LDH were positively correlated with non-HDL-C. In the ROC analysis, sensitivity for non-HDL-C was 61.6%, and specificity was 89.2%. Conclusion We believe that the non-HDL-C level studied before COVID-19 infection can be used as a prognostic biomarker for the disease.

Correlation of Metabolic Syndrome and Low-level High-density Lipoprotein Cholesterol with Adverse Pathological Features of Prostate Cancer After Radical Prostatectomy / 肿瘤防治研究

Objective To assess the association of metabolic syndrome (MetS) and low-level high density lipoprotein-cholesterol (HDL-C) with the invasion of prostate cancer (PCa) in the patients after radical prostatectomy (RP). Methods We collected and analyzed the data of 232 PCa patients treated with RP for prospective multicenter clinical study.The MetS was assessed according to NCEP-ATP Ⅲ.Patients were divided into MetS group and non-MetS group.Locally advanced PCa was defined as a pT-stage≥3.ISUP Gleason grading system (GS) were used for pathological grading.Logistic regression analyses assessed the association of MetS and its components with pathological data. Results MetS was an independent risk factor for GS≥8 after RP.Low HDL-C level was associated with locally advanced PCa.The risks of adverse pathological features increased with the number of MetS components. Conclusion Low HDL-C level and 4 or more MetS components are associated with higher risk of adverse pathological features of PCa.

Trigliceridos/colesterol HDL: utilidad en la deteccion de sujetos obesos con riesgo para diabetes mellitus tipo 2 y enfermedad cardiovascular / Triglycerides/HDL cholesterol: utility for the detection of obese subjects with risk for diabetes mellitus type 2 and cardiovascular diseases / Triglicerideos/colesterol HDL: utilidade na deteccao de sujeitos obesos com risco para a diabetes mellitus tipo 2 e doenca cardiovascular

En la Republica Argentina, la prevalencia de obesidad se ha incrementado considerablemente y la de diabetes mellitus tipo 2 (DMT2) alcanza 12,7%. La obesidad presenta heterogeneidad y el aumento de la grasa abdominal puede incluir hipertrigliceridemia, hiperglucemia, disminucion de C-HDL, aumentos de apolipoproteina B (Apo B), aumento de lipoproteinas LDL pequenas y densas, hiperinsulinemia, insulino-resistencia (IR), estado inflamatorio cronico, estado protrombotico y otras alteraciones metabolicas, que se han reunido en el llamado sindrome metabolico con prevalencia del 20 al 40%. La resistencia a la insulina (IR) esta presente en 10 al 25% de la poblacion y se asocia con esas alteraciones. La determinacion de IR es compleja, necesita de internacion en clinicas y debe ser realizada por especialistas. En el laboratorio se puede estimar a traves del dosaje de insulina, pero no esta estandarizado, por lo que es necesario disponer de tecnicas sencillas y accesibles. La relacion trigliceridos (TG)/colesterol HDL (C-HDL) puede ser una opcion utilizando como valores de corte TG/C-HDL ≥2,5 en mujeres y ≥3,5 en varones. Se asocia significativamente con IR y enfermedad cardiovascular (ECV), tiene buena especificidad aunque bajo poder discriminador por lo cual cuando esta presente y existe riesgo de DMT2 o ECV deberia complementarse con el calculo del colesterol-no-HDL o Apo B y el colesterol remanente. Teniendo en cuenta la pandemia de obesidad y DMT2 y la elevada frecuencia de ECV, la relacion TG/C-HDL podria ser un marcador que deberia ser informado por el laboratorio bioquimico-clinico.

In Argentina, the prevalence of obesity has increased considerably and type 2 diabetes mellitus (DMT2) reaches 12.7%. Obesity presents heterogeneity and the increase in abdominal fat may include hypertriglyceridemia, hyperglycemia, decrease in HDL-C, increases in apolipoprotein B (Apo B), increase in small and dense LDL lipoproteins, hyperinsulinemia, insulin resistance (IR), chronic inflammatory state, prothrombotic state and other metabolic alterations, which have been included in the so-called metabolic syndrome with 20 to 40% prevalence. Insulin resistance is present in 10 to 25% of the population and is associated with these alterations. The determination of IR is complex; it needs hospitalization and must be performed by specialists. In the laboratory, it can be estimated through insulin dosing, but it is not standardized, so it is necessary to have simple and accessible techniques. The triglycerides (TG)/HDL cholesterol (HDL-C) ratio can be an option using TG/C-HDL cutoff values ≥2.5 in women and ≥3.5 in men. It is significantly associated with IR and CVD and has good specificity but low discriminating power. So when it is present and there is a risk of T2DM or cardiovascular disease, CVD should be complemented with the calculation of non-HDL cholesterol or Apo B and the remaining cholesterol. Considering the pandemic of obesity and DMT2 and the high frequency of CVD, the TG/C-HDL ratio marker should be reported by the biochemical-clinical laboratory.

Na Republica Argentina, a prevalencia de obesidade aumentou em forma consideravel e a de diabetes mellitus tipo 2 (DMT2) atinge 12,7%. A obesidade apresenta heterogeneidade e o aumento da gordura abdominal pode incluir hipertrigliceridemia, hiperglicemia, diminuicao do HDL-C, aumentos da apolipoproteina B (Apo B), aumento das lipoproteinas LDL pequenas e densas, hiperinsulinemia, resistencia a insulina, estado inflamatorio cronico, estado pro-trombotico e outras alteracoes metabolicas, que se encontraram na chamada sindrome metabolica, com prevalencia de 20 a 40%. A resistencia a insulina (RI) esta presente em 10 a 25% da populacao e esta associada a essas alteracoes. A determinacao da RI e complexa, precisa da hospitalizacao em clinicas e deve ser realizada por especialistas. No laboratorio, isso pode ser estimado atraves da dosagem de insulina, mas nao e padronizado, portanto e necessario ter tecnicas simples e acessiveis. A relacao triglicerideos (TG)/colesterol HDL (C-HDL) pode ser uma opcao usando como valores de corte TG/C-HDL ≥2,5 em mulheres e ≥3,5 em homens. Esta significativamente associado a RI e a doenca cardiovascular (DCV), possui boa especificidade, embora apresente baixo poder discriminador; portanto, quando esta presente e ha risco de DMT2 ou DCV, deveria ser complementado com o calculo do colesterol nao-HDL ou Apo B e o restante colesterol. Considerando a pandemia de obesidade e DMT2 e a alta frequencia de DCV, a relacao TG/C-HDL poderia ser um marcador que deveria ser relatado pelo laboratorio bioquimico-clinico.

Utilidad del índice triglicéridos/HDL-C desde los primeros años de vida en el diagnóstico de síndrome metabólico en niños obesos / Utility of the triglycerides/HDL-C index from the first years of age in the diagnosis of metabolic syndrome in obese children

Objetivo: Determinar la utilidad del índice triglicéridos/HDL-C (TG/HDL-C) para el diagnóstico de síndrome metabólico (SM) en niños obesos de 2 a 14 años. Material y métodos: Estudio transversal tipo prueba de diagnóstico. Fueron incluidos 360 niños obesos exógenos (199M/161F), divididos en tres grupos etarios: 2 a <6 años, 6 a <10 años y 10 a 14 años. Se definió SM según los criterios de la International Diabetes Federation y se evaluó al índice TG/HDL-C como diagnóstico en dos puntos de corte: ≥2,32 y ≥3,5, en cada grupo etario. Se aplicó Chi cuadrado, considerándose significativo p<0,05. Se determinó la sensibilidad, especificidad y valores predictivos positivo y negativo, para cada punto de corte. Resultados: La frecuencia de SM fue 15,79% de 2 a <6 años, 20,25% de 6 a <10 años, 19,63% de 10 a 14 años. En los niños con SM el 97,1% presentó HDL bajo, 83,8% triglicéridos elevados. Se encontró diferencia significativa en la frecuencia del índice TG/HDL-C en ambos puntos de corte, entre los niños con y sin SM en todos los grupos etarios. La sensibilidad para ambos puntos de corte fue alta (86-100%) y la especificidad fue mejor para el punto de corte ≥3,5 (72-80%). Conclusiones: El índice TG/HDL-C ≥3,5 representaría un marcador sensible y específico para el diagnóstico de síndrome metabólico desde los primeros años de vida.

Objective: To determine the utility of the triglycerides/HDL-C index for the diagnosis of metabolic syndrome (MS) in obese 2-14 years of age children. Methods: Cross-sectional diagnostic study. We included 360 exogenous obese children (199M/161F) divided in three age groups: 2 to <6; 6 to <10 and 10-14 years. MS was defined according to the International Diabetes Federation and the TG/HDL-C index was evaluated using two cutoffs by age group, ≥2.32 and ≥3.5. Chi squared was used accepting a p value <0.05 as statistically significant. Fir each cut-off we determined sensitivity, specificity and predictive values. Results: Frequency of MS was 15.79% in the 2 to <6 years age group; 20.25% in the 6 to<10 years age group and 19.63% in the 10-14 years age group. Among children with SM, 97.1% had low HDL and 83.8% had elevated triglycerides. A statistically significant difference was found in the frequency of the TG/HDL-C index in children with or without MS in all age groups. Sensitivity for all cut-offs was high (86-100%) and specificity was best for the cut-off of ≥3.5 (72-80%). Conclusions: The TG/HDL-C index is a sensitive and specific marker of MS from the first years of age.

Lipids A Triggering Factor Responsible For Coronary Artery Disease In Patients With Type 2 Diabetes

Diabetes is a major global epidemic, currently affecting approximately 451 million adults worldwide. The present study was undertaken to establish the relation between lipid profile and the risk of cardiac diseases. Cardiac issues and stroke are said to be more prevalent and different from that of non-diabetic perspectives and heavy alcohol consumption affects all the metabolism. 400 subjects were included in the study of which 200 were healthy controls non-alcoholics and control alcoholics 100 in each respectively under the name - Group I and the remaining 200 were diabetic non-alcoholics and diabetic alcoholics 100 in each labeled under- Group II, both from the age group of 35-55 years. The result specified that there is a strong alliance between alcohol consumption in diabetes, lipid profile and its effect leading to cardiac diseases.

Waist-to-height ratio is as reliable as biochemical markers to discriminate pediatric insulin resistance / A razão cintura/estatura é tão confiável quanto marcadores bioquímicos para discriminar resistência à insulina

Abstract Objective: Given the importance of incorporating simple and low-cost tools into the pediatric clinical setting to provide screening for insulin resistance, the present study sought to investigate whether waist-to-height ratio is comparable to biochemical markers for the discrimination of insulin resistance in children and adolescents. Methods: This cross-sectional study involved students from nine public schools. In total, 296 children and adolescents of both sexes, aged 8 -14 years, composed the sample. Waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio were determined according to standard protocols. Insulin resistance was defined as homeostatic model assessment for insulin resistance with cut-off point ≥ 3.16. Results: Age, body mass index, frequency of overweight, waist circumference, waist-to-height ratio, insulin, glucose, homeostatic model assessment for insulin resistance, triglycerides, triglycerides/glucose index, and triglycerides-to-HDL-C were higher among insulin resistant boys and girls. Moderate correlation of all indicators (waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio) with homeostatic model assessment for insulin resistance was observed for both sexes. The areas under the receiver operational characteristic curves ware similar between waist-to-height ratio and biochemical markers. Conclusion: The indicators provided similar discriminatory power for insulin resistance. However, taking into account the cost-benefit ratio, we suggest that waist-to-height ratio may be a useful tool to provide screening for insulin resistance in pediatric populations.

Resumo Objetivo: Considerando a importância de incorporar ferramentas simples e de baixo custo no cenário clínico-pediátrico para a triagem de resistência à insulina, o presente estudo buscou investigar se a razão cintura/estatura é comparável a marcadores bioquímicos na discriminação de resistência à insulina em crianças e adolescentes. Métodos: Este estudo transversal envolveu estudantes de nove escolas públicas. No total, 296 crianças e adolescentes, de ambos os sexos, com idades entre 8 e 14 anos, compuseram a amostra. A razão cintura/estatura, o índice triglicerídeos/glicose e a razão triglicerídeos/HDL-C foram determinados de acordo com protocolos padrão. A resistência à insulina foi definida por meio do modelo de avaliação homeostática para resistência insulínica, com ponto de corte ≥ 3.16. Resultados: Idade, índice de massa corporal, frequência de excesso de peso, circunferência da cintura, razão cintura/estatura, insulina, glicemia, modelo de avaliação homeostática para resistência insulínica, triglicerídeos, índice triglicerídeos/glicose e razão triglicerídeos/HDL-C foram maiores entre meninos e meninas com resistência à insulina. Também foram observadas, em ambos os sexos, correlações moderadas de todos os indicadores (razão cintura/estatura, índice triglicerídeos/glicose e razão triglicerídeos/HDL-C) com o modelo de avaliação homeostática para resistência à insulina. As áreas sob as curvas ROC foram semelhantes entre a razão cintura/estatura e os marcadores bioquímicos. Conclusão: Os indicadores forneceram poder discriminatório similar para a resistência à insulina. No entanto, levando em conta o custo-benefício, sugerimos que a razão cintura/estatura pode ser uma ferramenta útil para a triagem de resistência à insulina em populações pediátricas.

Lipid profile in type 2 diabetes mellitus: a case-controlled study

Background: Atherosclerosis is caused by the combination of type 2 diabetes mellitus and dyslipidemia. Combination of DM and dyslipidemia is associated with increased mortality and morbidity. Hence, it is of utmost importance to know the nature of dyslipidemia in DM for its effective management. The major lipid abnormalities seen in DM are elevated triglyceride levels and lowered HDL-C levels.Methods: A case-controlled study was initiated in Vinayaka Missions Medical college and hospital for a period of 2 year. Pre-prandial and post-prandial lipid profile was assessed in 50 cases of type 2 DM and was compared with age and sex matched healthy controls satisfying the inclusion and exclusion criteria.Results: At the end of the study, the mean age±SD was 48.5±5.68 years. The mean HbA1c±SD of the study population was found to be 7.48±1.517. Looking at the lipid profile all cases in fasting state had elevated VLDL-C levels (mean 50.39±60.27), elevated TC (mean 169.70±39.917), elevated TGL (mean 146.04±60.140) and low LDL-C (mean 92.3±27.699) when compared to control group. In the postprandial state, there was a significant raise in TGL level (mean 188±68.59), raised TC (mean 180.74±38.46), decreased HDL-C (mean 38.761±9.028) compared to the fasting state.Conclusions: Lipid profile of type 2 DM in pre-prandial 12 hour fasting state showed elevated TC, VLDL-C levels and low LDL-C and HDL-C levels. Where as in post prandial state TGL levels were markedly elevated with elevated TC and low HDL-C levels.

Effects of herbal-cake-separated moxibustion on the repair of vascular endothelial and SDF-1 in rabbits with atherosclerosis / 中国针灸

OBJECTIVE@#To observe the effects of herbal-cake-separated moxibustion on the repair of damaged vascular endothelium structure and the content of stromal cells derived factor 1 (SDF-1) in rabbits with atherosclerosis.@*METHODS@#A total of 75 rabbits were randomly divided into a normal group, a model group, a direct moxibustion group, an atorvastatin calcium group and a herbal-cake-separated moxibustion group, 15 rabbits in each one. The rabbits in the normal group were fed with normal diet, and the remaining rabbits were fed with high-cholesterol diet for 12 weeks to prepare atherosclerotic model. Two groups of acupoints, one was "Juque" (CV 14), "Tianshu" (ST 25) and "Fenglong" (ST 40), the other one was "Xinshu" (BL 15), "Ganshu" (BL 18) and "Pishu" (BL 20), were applied in the direct moxibustion group and herbal-cake-separated moxibustion group; the two groups of acupoints were selected alternatively every other day. The moxibustion was given for 30 min per treatment, once a day for 4 weeks. The rabbits in the atorvastatin calcium group were treated with atorvastatin calcium tablets (1.96 mg•kg•d) which were crushed into powder and mixed into breakfast. After modeling, the rabbits in the normal group and model group received no treatment, and immobilized at the time when moxibustion was applied in other three groups. The levels of total cholesterol (TC) and triglyceride (TG) were measured by enzymic method; the low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured by colorimetric method; the morphological structure of aortic wall was observed under optical microscope; the serum level of SDF-1 was determined by enzyme-linked immunosorbent assay (ELISA).@*RESULTS@#After treatment, compared with the normal group, the levels of TC, TG and LDL-C were significantly increased in the model group (all <0.01), and the level of HDL-C was decreased (<0.01). Compared with the model group, the levels of TC, TG and LDL-C were significantly decreased (all <0.01), and the level of HDL-C was significantly increased in the direct moxibustion group, atorvastatin calcium group and herbal-cake-separated moxibustion group (<0.01, <0.05). Compared with the normal group, the morphological structure of aortic wall was significantly damaged in the model group. Compared with the model group, the vascular endothelial structure was improved in the atorvastatin calcium group and herbal-cake-separated moxibustion group, and the pathological change of aorta endothelial in the direct moxibustion group was relieved. After treatment, compared with the model group, the level of SDF-1 was increased in the direct moxibustion group, atorvastatin calcium group and herbal-cake-separated moxibustion group (<0.05, <0.01); the level of SDF-1 in the herbal-cake- separated moxibustion group was higher than that in the direct moxibustion group (<0.05).@*CONCLUSION@#The herbal- cake-separated moxibustion can promote the expression of SDF-1 in serum and repair the damaged aortic endothelial structure.

Study on Protective Effect of Atorvastatin-induced Increase of EPC-MVs on Myocardial Cells in STEMI Patients / 中国药房

OBJECTIVE： To observe the protective effect of atorvastatin-induced increase of EPC-MVs on myocardial cells in ST-segment elevation myocardial infarction （STEMI） patients， and to investigate its potential mechanism. METHODS： Totally 168 STEMI patients was collected from our hospital during Feb. 2015-Feb. 2018， and then divided into group A （88 cases） and group B （94 cases） according to the dose of atorvastatin. All patients received percutaneous coronary intervention， and then given Bivaleridine for injection， Clopidogrel bisulfate tablets and Atorvastatin calcium tablets. Group A was given Atorvastatin calcium tablets 20 mg， once a day. Group B was given Atorvastatin calcium tablets 20 mg， twice a day. A treatment course lasted for 30 d， and two groups were treated for 3 courses at least. The levels of blood lipid （TC， LDL-C， HDL-C） （before treatment and 30th， 60th， 90th day after treatment） and the number of EPCs positive cells （30th， 60th day after treatment） were observed in 2 groups. The expression of miRNA of EPC-MVs （60th day after treatment） was detected， and the expression difference of miRNA were validated. Target gene and KEGG pathway enrichment of miRNA with most significant expression difference were analyzed， and the effects of it on the proliferation of cardiac HCM-a cells were evaluated. The occurrence of ADR was recorded in 2 groups. RESULTS： Totally 8 patients withdrew from the study in group A， and 6 patients in group B. There was no statistical significance in the levels of TC， LDL-C and HDL-C or the number of EPCs positive cells in peripheral blood between 2 groups before treatment or 30th day after treatment （P＞0.05）. After treatment， the level of HDL-C in 2 group （60th and 90th day after treatment） and the number of EPCs positive cells in peripheral blood in group B （60th day after treatment） were increased significantly， and group B was significantly higher or more than group A at the same time point （P＜0.05）. Microarray analysis showed that compared with group A， 16 miRNAs expressed more than 1.5 times differentially in EPC-MVs of group B， 7 of which were up-regulated and 9 down-regulated. Top five differentially expressed genes were hsa-miR-126 （up-regulated）， hsa-miR-1275 （up-regulated）， hsa-miR-7704 （down-regulated）， hsa-miR-105-5p （down-regulated）， and hsa-miR-3180 （down-regulated）. Fluorescence quantitative polymerase chain reaction results showed that compared with group A， relative expression of hsa-miR-126 and hsa-miR-1275 in group B were increased significantly； and relative expression of hsa-miR-7704， hsa-miR-105-5p and hsa-miR-3108 were decreased significantly （P＜0.05）. The expression difference of hsa-miR-126 was the most significant， and its target genes included Ang-1， PDGF， p38 MAPK， Smad2/3， HIF-1， TGF-β， etc. The signaling pathways involved in regulation mainly included angiogenesis signaling pathway， chronic myelogenous leukemia related pathway， renal epithelial cell carcinoma related pathway and so on. CCK-8 test showed that the optical density （OD） of cells in hsa-miR-126 specific interfering substance group was decreased significantly， and the OD value of cells in simulated substance group was increased significantly， compared with blank group （P＜0.05）. There was no statistical significance in the incidence of ADR as diarrhea， nausea and vomiting， rash， etc. （P＞0.05）. CONCLUSIONS： Different doses of atorvastatin can regulate the level of HDL-C， and large dose of atorvastatin can increase the number of EPCs significantly， but dose not influence the safety of drug use. This effect may be associated with up-regulating the expression of hsa-miR-126 in EPC-MVs so as to promoting the proliferation of myocardial cells.

HDL-C and non-HDL-C levels are associated with anthropometric and biochemical parameters / Associação de níveis de HDL-c e não HDL-c com parâmetros antropométricos e bioquímicos

Dyslipidemias are associated with atherosclerosis and cardiovascular diseases. Recently, non-high-density lipoprotein cholesterol (non-HDL-c) has emerged as a new target for assessment and prediction of risk of cardiovascular disease (CVD) and is closely associated with atheroma plaque progression. Objectives To evaluate associations between HDL-c and non-HDL-c levels and anthropometric and biochemical parameters and with the Castelli risk indexes I and II. Methods 300 randomly selected people were subdivided into two groups: patients with normal values for non-HDL-c and patients with altered values for non-HDL-c. These parameters were analyzed for associations with glycemia, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-c), Castelli Index I (CI-I), Castelli Index II (CI-II), waist circumference (WC), body mass index (BMI) and presence of metabolic syndrome (MS). Results Glycemia,TC, TG, LDL-c, CI-I, CI-II, WC and BMI were all significantly different between subjects with normal and altered values of HDL-c and non-HDL-c. TC and WC both exhibited significantly higher values among patients with abnormal non-HDL-c when compared to patients with abnormal HDL-c. A significant difference was observed in occurrence of MS among patients with altered values of HDL-c and non-HDL-c. Conclusions Our results show that both HDL-c and non-HDL-c are associated with insulin resistance, dyslipidemia, atherogenic indices, and obesity. There is therefore a need for randomized clinical intervention trials examining the potential role of non-HDL-c as a possible primary therapeutic target

A dislipidemia está associada à aterosclerose e às doenças cardiovasculares. Recentemente, a lipoproteína de não alta-densidade de colesterol (não HDL-c) emergiu como um novo alvo para avaliação da predição de risco de doença cardiovascular, intimamente associada à progressão da placa de ateroma. Objetivos Avaliar as associações de níveis de HDL-c e não HDL-c com parâmetros antropométricos e bioquímicos, bem como com índices de Castelli I e II (CI-I e CI-II). Métodos Trezentas pessoas selecionadas aleatoriamente foram divididas em dois grupos: pacientes com valores normais de não HDL-c e pacientes com valores alterados de não HDL-c. Esses parâmetros foram associados a glicemia, colesterol total (CT), triglicerídeos (TG), lipoproteína de baixa densidade (LDL-c), CI-I, CI-II, circunferência de cintura (CC), índice de massa corporal (IMC) e presença de síndrome metabólica (SM). Resultados Glicemia, CT, TG, LDL-c, CI-I, CI-II, CC e IMC exibiram valores significativamente maiores para o não HDL-c quando comparado ao HDL-c. Uma diferença significativa na ocorrência de SM foi encontrada em pacientes com valores alterados de HDL-c e não HDL-c. Conclusões Nossos resultados mostram que tanto o HDL-c quanto o não HDL-c estão associados a resistência à insulina, dislipidemia, índices de aterogênese e obesidade. Assim, há uma necessidade de futuros ensaios randomizados de intervenção clínica examinando o papel potencial do não HDL-c como possível alvo terapêutico primário

A lipid profile study amongst the patients of type 2 diabetes mellitus – A cross sectional study

Introduction: India leads the world with largest number of diabetic patients and is often referred to as the diabetes capital. Diabetic dyslipidemia in India is one of the main causes for Coronary Artery Disease (CAD) mortality of the world. Dyslipidemia are disorders of lipoprotein metabolism, including lipoprotein overproduction or deficiency. It is a preventable risk factor which is mostly observed in diabetes patients and that may precipitate the cardiovascular disorders. Our aim of the study is to determine the impact of type 2 diabetes mellitus (T2DM) on lipid profile of diabetic patients reporting at tertiary care hospital. Materials and methods: It was a cross sectional study conducted at Civil Hospital and Gujarat Medical Education Research Society, Medical College, Valsad, Gujarat, India. Total 140 diabetic patients were randomly selected form OPD and IPD of our hospital and they were examined for dyslipidemia. Fasting blood glucose concentration and Lipid Profile [Total Cholesterol (TC), High Density Lipoprotein (HDL), Very Low Density Lipoprotein (VLDL) and Triglycerides (TG)] were investigated by using commercially available reagent kits in Biochemistry analyzer. Collected data was analyzed by using appropriate software. Results: Out of total 140 diabetic patients examined, the mean age of patients was 48.93 ± 12.1 years. In present study we found the mean Fasting Blood Sugar (FBS) was 188.76 ± 54.63 mg/dl. The prevalence rates in our study for high Total Cholesterol (TC) and Triglycerides (TG) were 13.6% and 41.4% respectively. The prevalence rates for high LDL-C, very high LDL-C and low HDL-C in the diabetic subjects were 8.6%, 5.0% and 72.9% respectively. Conclusion: The diabetic patients had elevated serum total cholesterol, elevated triglyceride (triacylglycerol) and slightly elevated low density lipoprotein (LDL-C) and reduced levels of high Gamit DN, Mishra A. A lipid profile study amongst the patients of type 2 diabetes mellitus - A cross sectional study. IAIM, 2018; 5(2): 1-5. Page 2 density lipoprotein (HDL-C) indicating that diabetic patients were more prone to cardiovascular diseases.

Relationship Between Monocyte to HDL-Cholesterol Ratio and Thrombus Burden in Patients With ST-segment Elevation Myocardial Infarction / 中国循环杂志

Objective: To analyze the relationship between monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) in patients with ST-segment elevation myocardial infarction(STEMI) in order to explore the predictive value of MHR in thrombus burden level in STEMI patients. Methods: A total of 357 STEMI patients treated in our hospital from 2015-01 to 2016-12 were enrolled. Thrombus burden was confirmed by angiography and the patients were divided into 2 groups: Low thrombus burden group, n=156 and High thrombus burden group, n=201. MHR was compared between 2 groups; the predictive value of MHR in thrombus burden level was studied by multivariate Logistic regression analysis and ROC curve assessment. Results: MHR was higher in High thrombus burden group than that in Low thrombus burden group [M (Q1, Q3) 25.4 (13.5, 44.6) vs 16.0 (9.2, 22.1)], P<0.001; multivariate Logistic regression analysis indicated that MHR was the independent predictor for high thrombus burden occurrence (OR=1.067, 95％ CI 1.031-1.105), P<0.001; the area under ROC curve for MHR was 0.688 in STEMI patients. Conclusion: MHR was the independent predictor for high thrombus burden occurrence in STEMI patients.

The value of HDL particles,the concordance of HDL-C and apoA-Ⅰ in assessing the severity of coronary artery disease / 实用医学杂志

Objective The study was to analyze the relationship between HDL particles,the level of HDL-C and the concordance of HDL-C and apoA-Ⅰand the degree of coronary stenosis,then to explore their values in predicting coronary artery disease.Methods 591 patients were collected for coronary angiography,and calculated Gensini score respectively.HDL particles and the level of HDL-C,apoA-Ⅰwere analyzed in coronary artery disease (CAD)group and non-CAD group,stable angina pectoris(SAP)group and acute coronary syndrome(ACS)group and four groups divided by quartile of Gensini score(A,B,C,D).To investigate the relationship between the con-cordance of HDL-C and apoA-Ⅰand the severity of coronary artery disease,HDL-C,apoA-Ⅰwere divided into low and high group according to the 50 percentile,then pair wise combination was done into four groups. Results Compared with non-CAD group,HDL particles,the level of HDL-C,apoA-Ⅰwere significantly reduced in CAD group(P<0.001).Compared with SAP group,similar results were found in ACS group.HDL particles,the level of HDL-C,apoA-Ⅰwere decreased gradually in A,B,C,D group(P<0.001).The concordance of HDL-C and apoA-Ⅰwas related to the risk of CAD(P<0.001).The area under curve(AUC)of HDL particles was higher than that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.Conclusions HDL particles,HDL-C,the concordance of HDL-C and apoA-Ⅰwere related to coronary stenosis.The value of HDL particles in predicting CAD risk was su-perior to that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.

Correlation between TG, HDL-C, TC and diabetic peripheral neuropathy / 中国现代医生

Objective To explore the correlation between Triglyceride (TG), high density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and diabetic Peripheral neuropathy, and to provide a clinical basis for the diagnosis of diabetic peripheral neuropathy. Methods A total of 48 patients with diabetic peripheral neuropathy diagnosed in our hospital from January 2017 to January 2018 were retrospectively analyzed and enrolled into the DPN group. Another 48 patients with type 2 diabetes admitted to our hospital during the same period were included in the T2DM group. The differences of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),and apolipoprotein B (ApoB) between the two groups were analyzed. And the correlation between these indicators and diabetic peripheral neuropathy were analyzed by logistic regression equation. Results The levels of TG, TC, LDL-C and ApoB in the DPN group were significantly higher than those in the T2DM group, and HDL-C was significantly lower in the DPN group than that in the T2DM group (P<0.05). Logistic regression equation analysis showed that TG, TC, and HDL-C, LDL-C, ApoB were risk factors for the onset of DPN (P<0.05). Conclusion The level of blood lipids in patients with diabetic peripheral neuropathy is higher than that in patients with diabetes alone. The levels of TG, TC and HDL-C,LDL-C, ApoB are closely related to the pathogenesis of DPN, which are important factors leading to neuromicrovascular disease.