Influência da menopausa, idade, etnia e do sexo sobre as lipoproteínas e suas subfrações nas três fases da vida (adolescentes, adultos e idosos) / Influence of menopause, age, ethnicity and sex on lipoproteins and their subfractions in the three stages of life (adolescents, adults and the elderly)

Introdução: A prevalência de doenças cardiovasculares tem crescido em todo o mundo. Além da hipercolesterolemia, fatores como o envelhecimento, menopausa, diferenças no metabolismo do colesterol entre homens e mulheres e entre etnias, provavelmente contribuem para as prevalências dessas doenças. Objetivo: Avaliar a influência da menopausa, da idade (adolescentes, adultos e idosos), do sexo e da etnia sobre as subfrações lipoproteicas aterogênicas. Métodos: Trata-se de um estudo transversal, de base populacional e amostra probabilística de residentes da cidade de São Paulo. Foram utilizados dados de participantes "ISA-CAPITAL 2015" que tiveram coleta de dados bioquímicos. Foram realizadas análises de partículas de LDL e HDL respectivamente, em 827 amostras. O tamanho das partículas de LDL e HDL foi determinado pelo sistema Lipoprint® System (Quantimetrix Corporation. Todos os testes estatísticos foram realizados com o auxílio do programa SPSS 16. Foi considerado significativo p<0,05. Resultados: As análises com adolescentes mostraram que as meninas apesar de possuírem maior IMC, CC e concentração de TG, apresentaram melhor perfil de subfrações de LDL (LDL grande% 17,8; LDL pequena% 1,7) do que os meninos (LDL grande% 13,5; LDL pequena% 3,4) p<0,001 e p=0,002, respectivamente. Entre os indivíduos adultos, foi identificado um perfil mais aterogênico entre homens, com maior percentual de LDL pequena, quando comparados às mulheres (4,9% vs 2,7%; p<0,001, respectivamente). Com relação à população idosa, os resultados demonstraram que apesar do avanço da idade, as idosas quando comparadas aos idosos possuíam maior concentração LDL grande (32,5mg/dL vs 28,5mg/dL; p=0,007 respectivamente). As mulheres idosas tiveram uma piora das subfrações lipoproteicas se comparadas com as mulheres adultas (razão de LDL mg/dL=12,3 mulheres adultas vs 10,7 mulheres idosas; p=0,002) se aproximando ao perfil mais aterogênico encontrado entre os homens (razão de LDLmg/dL=9,9 homens adultos vs 9,0 homens idosos; p=0,027). Entretanto, quando pareadas por homens de mesma idade, as mulheres idosas, ainda assim, demonstraram um perfil menos aterogênico do que os homens idosos (razão de LDL mg/dL=10,7 mulheres idosas vs 9,0 homens idosos; p=0,001). Ao analisar a presença de menopausa, foi identificado que as mulheres no período pós menopausa tiveram piora do perfil lipídico clássico com aumento do IMC (p=0,025), CC (p<0,001), glicose (p<0,001), PAS (p<0,001), PAD (p=0,005) e TG (p<0,001), assim como tiveram piora do perfil lipoproteico com diminuição de LDL grande% quando comparadas com as mulheres no período pré menopausa (17,6% vs 14,6%; p=0,001). Quanto à etnia, foi identificado que os indivíduos brancos apresentaram valores maiores para IMC (p=0,005), CC (p=0,001), glicose (p=0,015) e TG (p=0,010). Após ajustes para etnia, idade e IMC, houve associação positiva com HDL grande (=0,122; R2=0,013; p=0,001), demonstrando maior aterogenicidade entre os indivíduos brancos. Conclusão: Em todas as faixas etárias o sexo feminino apresentou perfil menos aterogênico quando comparado ao masculino. A presença de menopausa e da etnia branca demonstrou um perfil lipídico clássico e lipoproteico mais aterogênico.

Introduction: The prevalence of cardiovascular diseases has increased throughout the world. In addition to hypercholesterolemia, factors such as aging, menopause, differences in cholesterol metabolism between men and women and between ethnicities probably contribute to the prevalence of these diseases. Objective: To evaluate the influence of menopause, age (adolescents, adults and elderly), sex and ethnicity on atherogenic lipoprotein subfractions. Methods: This is a cross-sectional, population-based study with a probabilistic sample of residents of the city of São Paulo. Data from "ISA-CAPITAL 2015" participants who had biochemical data collected were used. LDL and HDL particle analyzes were carried out respectively in 827 samples. The size of LDL and HDL particles was determined using the Lipoprint® System (Quantimetrix Corporation. All statistical tests were performed with the aid of the SPSS 16 program. Was considered significant p<0.05. Results: Analyzes with adolescents showed that girls, despite having higher BMI, WC and TG concentration, presented a better profile of LDL subfractions (LDL large% 17.8; LDL small% 1.7) than boys (LDL large% 13.5; LDL small% 3.4) p<0.001 and p=0.002, respectively. Among adult individuals, a more atherogenic profile was identified among men, with a higher percentage of LDL small, when compared to women (4.9% vs 2.7%; p<0.001, respectively). Regarding the elderly population, the results demonstrated that despite advancing age, elderly women, when compared to elderly men, had a higher large LDL concentration (32.5mg/dL vs 28.5mg/dL; p=0.007 respectively). Elderly women had a worsening of lipoprotein subfractions compared to adult women (LDL ratio mg/dL=12.3 adult women vs 10.7 elderly women; p=0.002) approaching the more atherogenic profile found among men (LDLmg/dL ratio=9.9 adult men vs 9.0 elderly men; p=0.027). However, when paired with men of the same age, elderly women still demonstrated a less atherogenic profile than elderly men (LDL ratio mg/dL=10.7 elderly women vs 9.0 elderly men; p=0.001). When analyzing the presence of menopause, it was identified that women in the postmenopausal period had a worsening of the classic lipid profile with an increase in BMI (p=0.025), WC (p<0.001), glucose (p<0.001), SBP (p< 0.001), DBP (p=0.005) and TG (p<0.001), as well as a worsening of the lipoprotein profile with a reduction in LDL large when compared to women in the premenopausal period (17.6% vs 14.6%; p=0.001). Regarding ethnicity, it was identified that white individuals presented higher values for BMI (p=0.005), WC (p=0.001), glucose (p=0.015) and TG (p=0.010). After adjustments for ethnicity, age and BMI, there was a positive association with HDL large (=0.122; R2=0.013; p=0.001), demonstrating greater atherogenicity among white individuals. Conclusion: In all age groups, females presented a less atherogenic profile when compared to males. The presence of menopause and white ethnicity demonstrated a more atherogenic classic lipid and lipoprotein profile.

Clinical value of arterial stiffness assessment on risk prediction of vascular stiffness in the octogenarian elderly / 中华心血管病杂志

Objective: This study aimed to analyze clinical factors related to arterial stiffening and establish a risk prediction nomogram of arterial stiffening in the octogenarian(≥80 years). Methods: This study was a retrospective cross-sectional study, which enrolled the octogenarian elderly who underwent physical examination and secondary prevention intervention in the outpatient department of Chinese People's Liberation Army General Hospital from April 2022 to August 2022. Clinical data including demographics, biochemical indicators and medical history were collected. Brachial-ankle pulse wave velocity (baPWV) was detected during the clinical visit. Participants were divided into the control group (baPWV≤1 800 cm/s) and vascular sclerosis group (baPWV>1 800 cm/s). The risk factors of arterial stiffness were analyzed by univariate and logistic regression analysis, and the nomogram model was constructed by R programming language. The predictive effect of the nomogram model was evaluated by the receiver operating characteristic curve (ROC). Results: The median age of the 525 participants was 87.0 (82.0, 92.0) years, 504 (96.0%) were male, 82 in the control group, 443 in the vascular sclerosis group. The baPWV, age, systolic blood pressure, mean arterial pressure and diastolic blood pressure were significantly lower in the control group than those in the vascular sclerosis group (all P<0.05). Logistic regression analysis showed that high-density lipoprotein cholesterol, alanine aminotransferase and amylase were protective factors, and alkaline phosphatase and creatinine were risk factors of arterial stiffening (all P<0.05). The combined nomogram model scores including age, mean arterial pressure and the above five laboratory indicators indicated that mean arterial pressure and serum creatinine levels were strongly correlated with vascular sclerosis. The ROC curve suggested that the nomogram model had good prediction ability. Conclusions: Age, mean arterial pressure, high-density lipoprotein cholesterol, alanine aminotransferase, alkaline phosphatase, amylase and creatinine are independently determinants for increased vascular stiffness. The combined prediction model in this study can provide reference for individualized clinical risk prediction of vascular sclerosis in the octogenarian elderly.

Advances in clinical significance and detection methods research of high density lipoprotein subfractions / 中华预防医学杂志

High density lipoprotein (HDL) is an important biochemical index of clinical cardiovascular disease. Many new studies have demonstrated abnormalities of plasma HDL subfractions in patients with this disease,and their clinical significance is greater than the overall abnormalities of HDL. Therefore,the HDL subfraction as an important factor in cardiovascular disease has attracted extensive research and attention. This article summarizes current research on HDL subfractions,their measurements and their relationships with atherosclerosis and coronary artery disease.

Clinical value of arterial stiffness assessment on risk prediction of vascular stiffness in the octogenarian elderly / 中华心血管病杂志

Objective: This study aimed to analyze clinical factors related to arterial stiffening and establish a risk prediction nomogram of arterial stiffening in the octogenarian(≥80 years). Methods: This study was a retrospective cross-sectional study, which enrolled the octogenarian elderly who underwent physical examination and secondary prevention intervention in the outpatient department of Chinese People's Liberation Army General Hospital from April 2022 to August 2022. Clinical data including demographics, biochemical indicators and medical history were collected. Brachial-ankle pulse wave velocity (baPWV) was detected during the clinical visit. Participants were divided into the control group (baPWV≤1 800 cm/s) and vascular sclerosis group (baPWV>1 800 cm/s). The risk factors of arterial stiffness were analyzed by univariate and logistic regression analysis, and the nomogram model was constructed by R programming language. The predictive effect of the nomogram model was evaluated by the receiver operating characteristic curve (ROC). Results: The median age of the 525 participants was 87.0 (82.0, 92.0) years, 504 (96.0%) were male, 82 in the control group, 443 in the vascular sclerosis group. The baPWV, age, systolic blood pressure, mean arterial pressure and diastolic blood pressure were significantly lower in the control group than those in the vascular sclerosis group (all P<0.05). Logistic regression analysis showed that high-density lipoprotein cholesterol, alanine aminotransferase and amylase were protective factors, and alkaline phosphatase and creatinine were risk factors of arterial stiffening (all P<0.05). The combined nomogram model scores including age, mean arterial pressure and the above five laboratory indicators indicated that mean arterial pressure and serum creatinine levels were strongly correlated with vascular sclerosis. The ROC curve suggested that the nomogram model had good prediction ability. Conclusions: Age, mean arterial pressure, high-density lipoprotein cholesterol, alanine aminotransferase, alkaline phosphatase, amylase and creatinine are independently determinants for increased vascular stiffness. The combined prediction model in this study can provide reference for individualized clinical risk prediction of vascular sclerosis in the octogenarian elderly.

Advances in clinical significance and detection methods research of high density lipoprotein subfractions / 中华预防医学杂志

High density lipoprotein (HDL) is an important biochemical index of clinical cardiovascular disease. Many new studies have demonstrated abnormalities of plasma HDL subfractions in patients with this disease,and their clinical significance is greater than the overall abnormalities of HDL. Therefore,the HDL subfraction as an important factor in cardiovascular disease has attracted extensive research and attention. This article summarizes current research on HDL subfractions,their measurements and their relationships with atherosclerosis and coronary artery disease.

Synthesis and In Vivo Hypolipidemic Effect of Some N-(Benzoylphenyl)-Carboxamide Derivatives in Triton WR-1339-Induced Hyperlipidemic Rats

A series of N-(benzoylphenyl)-carboxamide derivatives (2a, 2b, 3a, 3b, 4a, 4b, 5a, 5b, 6a and 6b) was prepared with good yields by reacting the corresponding carbonyl chlorides with aminobenzophenones at room temperature. This was followed by evaluating the hypotriglyceridemic and hypocholesterolemic effects of 3b, 5a and 5b. Triton WR-1339 (300 mg/kg) was intraperitoneally administered to overnight-fasted rats to induce hyperlipidemia. Rats were divided into six groups: control, hyperlipidemic, hyperlipidemic plus compounds 3b, 5a and 5b and hyperlipidemic plus bezafibrate. Results showed that after 18 h of treatment at a dose of 15 mg/kg body weight of each of the test compounds, the elevated plasma levels of triglycerides (TG) and total cholesterol (TC) were significantly lowered by compounds 5b and 3b (p < 0.001) and by 5a (p < 0.0001), compared to the hyperlipidemic control group. Compounds 3b and 5a significantly increased levels of high-density lipoprotein cholesterol (HDL-C) by 58 and 71%, respectively. In addition, compounds 3b and 5a caused significant reduction (p < 0.0001) of low-density lipoprotein cholesterol (LDL-C) levels compared to the control group. These results suggest a promising potential for compounds 3b, 5a and 5b as lipid-lowering agents, which may contribute to reducing the risk of atherosclerosis and cardiovascular disease

Cholesteryl ester transfer protein inhibitory oxoacetamido-benzamide derivatives: Glide docking, pharmacophore mapping, and synthesis

Abstract Dyslipidemia is an abnormal lipid profile associated with many common diseases, including coronary heart disease and atherosclerosis. Cholesteryl ester transfer protein (CETP) is a hydrophobic plasma glycoprotein that is responsible for the transfer of cholesteryl ester from high-density lipoprotein athero-protective particles to pro-atherogenic very low-density lipoprotein and low-density lipoprotein particles. The requirement for new CETP inhibitors, which block this process has driven our current work. Here, the synthesis as well as the ligand-based and structure-based design of seven oxoacetamido-benzamides 9a-g with CETP inhibitory activity is described. An in vitro study demonstrated that most of these compounds have appreciable CETP inhibitory activity. Compound 9g showed the highest inhibitory activity against CETP with an IC50 of 0.96 µM. Glide docking data for compounds 9a-g and torcetrapib provide evidence that they are accommodated in the CETP active site where hydrophobic interactions drive ligand/CETP complex formation. Furthermore, compounds 9a-g match the features of known CETP active inhibitors, providing a rationale for their high docking scores against the CETP binding domain. Therefore, these oxoacetamido-benzamides show potential for use as novel CETP inhibitors

Vulnerabilidad cardiometabólica e indicadores bioquímicos en el momento de la captación de la embarazada y en el posparto / Cardiometabolic vulnerability and biochemical indicators during recruitment of pregnant women and in the postpartum period

Introducción: Son escasos los estudios sobre acumulaciones excesivas de tejido adiposo y su asociación con cambios en indicadores bioquímicos estudiados durante el embarazo y el posparto. Objetivo: Determinar asociaciones de la vulnerabilidad cardiometabólica por adiposidad corporal con indicadores bioquímicos en el momento de la captación de la embarazada y el posparto. Métodos: Se realizó estudio observacional prospectivo de la vulnerabilidad cardiometabólica por adiposidad corporal e indicadores bioquímicos en 773 mujeres captadas como sanas de peso adecuado, de ellas 119 al posparto, en el policlínico Chiqui Gómez Lubián. Se estudiaron por grupo de vulnerabilidad cardiometabólica indicadores bioquímicos a la captación y el posparto. Se aplicó prueba estadística de Kruskal-Wallis. Resultados: Gestantes captadas con vulnerabilidad global por adiposidad general intermedia y central alta tuvieron valores medios más bajos del ácido úrico (238,78 mmol/L), más altos de triglicéridos (1,37 mmol/L), colesterol (4,70 mmol/L) y resistencia a la insulina (8,32). Mujeres con vulnerabilidad global por adiposidad general intermedia y central alta al posparto presentaron valores medios más elevados de triglicéridos (1,18 mmol/L) y lipoproteínas de muy baja densidad (0,54 mmol/L), más bajos de lipoproteínas de alta densidad (1,06 mmol/L); mujeres con vulnerabilidad global extrema por adiposidad general y central alta, tuvieron valores medios más elevados: glicemia (4,90 mmol/L), colesterol (4,30 mmol/L), lipoproteínas de baja densidad (2,76 mmol/L), producto de acumulación de lípidos (42,63 mmol/L) e índice de adiposidad visceral (2,32 mmol/L). Conclusiones: Evaluar vulnerabilidad cardiometabólica por técnicas antropométricas, complementadas con indicadores bioquímicos, facilita orientar acciones preventivas sobre daños cardiometabólicos progresivos en la gestación y su posparto(AU)

Introduction: Few studies are available about excessive accumulation of adipose tissue and its association to changes in biochemical indicators in pregnancy and the postpartum period. Objective: Determine the association between cardiometabolic vulnerability due to body adiposity and biochemical indicators during recruitment of pregnant women and in the postpartum period. Methods: An observational prospective study was conducted of cardiometabolic vulnerability due to body adiposity and biochemical indicators in 773 women recruited as healthy and adequate weight, 119 of them in the postpartum period, at Chiqui Gómez Lubián polyclinic. Biochemical indicators were studied by cardiometabolic vulnerability group at recruitment and in the postpartum period. Statistical analysis was based on the Kruskal-Wallis test. Results: Pregnant women recruited with overall vulnerability due to high general intermediate and central adiposity had lower uric acid mean values (238.78 mmol/l), higher triglyceride mean values (1.37 mmol/l), cholesterol (4.70 mmol/l) and insulin resistance (8.32). Women with overall vulnerability due to high general intermediate and central adiposity in the postpartum period had higher triglyceride mean values (1.18 mmol/l), very low density lipoproteins (0.54 mmol/l), and lower high density lipoprotein mean values (1.06 mmol/l). Women with extreme overall vulnerability due to high general and central adiposity had higher mean values: glycemia (4.90 mmol/l), cholesterol (4.30 mmol/l), low density lipoproteins (2.76 mmol/l), lipid accumulation product (42.63 mmol/l) and visceral adiposity index (2.32 mmol/l). Conclusions: Evaluating cardiometabolic vulnerability using anthropometric techniques complemented with biochemical indicators, facilitates aiming preventive actions at progressive cardiometabolic damage during pregnancy and the postpartum period(AU)

Associação entre Atividade Física no Tempo Livre e HDL-C em Participantes do Elsa-Brasil: Existem Diferenças entre Homens e Mulheres no Efeito Dose-Resposta? / Association between Leisure Time Physical Activity and HDL-C in the Elsa-Brasil Study Participants: Are There Any Gender Differences in the Dose-Response Effect?

Resumo Fundamento Níveis elevados de lipoproteína de alta densidade (HDL-C) podem ter efeitos positivos para proteção de agravos cardiovasculares, e prática regular de atividade física no tempo livre (AFTL) tem sido associada ao seu aumento. Objetivo Verificar a existência de possíveis diferenças entre homens e mulheres no efeito dose-resposta na associação entre AFTL e HDL-C. Métodos Estudo transversal com dados de 13,931 participantes de ambos os sexos (7,607 mulheres) do Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil). A AFTL foi mensurada por meio do International Physical Activity Questionnary (IPAQ) e classificada em quatro categorias: inativos, pouco ativos, ativos e muito ativos. O poder discriminatório da AFTL para HDL-C elevado, nas diferentes intensidades analisadas (caminhada, atividade física moderada e atividade física vigorosa) foi testado por meio das curvas ROC. As associações, ajustadas por variáveis de confundimento entre AFTL e HDL-C foram analisadas por meio de regressão logística, estimando-se a odds ratio (OR) com intervalo de confiança (IC) de 95%. Resultados Observou-se associação positiva, com efeito dose-resposta, entre AFTL e HDL-C tanto em homens quanto em mulheres. Com relação à intensidade, apenas a atividade física vigorosa discriminou o HDL-C elevado em homens, enquanto tanto a atividade física de caminhada quanto a moderada e a vigorosa discriminaram o HDL-C elevado em mulheres. Conclusão A AFTL apresenta associação positiva com gradiente dose-resposta com HDL-C; no entanto, entre os homens, a associação não é observada para aqueles classificados como pouco ativos fisicamente. Nas mulheres, tanto a intensidade da caminhada quanto a atividade física moderada ou vigorosa podem discriminar níveis de HDL-C mais altos; já nos homens, essa relação é observada apenas na intensidade vigorosa.

Abstract Background High levels of high-density lipoprotein (HDL-C) are known for their protective effect against cardiovascular diseases and the regular practice of leisure time physical activity (LTPA) may be associated with their increase. Objective To verify the existence of differences between genders in the dose-response effect regarding the association between LTPA and HDL-C in the ELSA-Brasil study cohort. Methods Cross-sectional study with data from wave 2 of 13,931 participants of both genders (7,607 women) from the Longitudinal Study of Adult Health ELSA-Brasil. The LTPA was measured using the International Physical Activity Questionnaire (IPAQ) and classified into four categories: sedentary, low active, active and very active. The discriminatory power of LTPA at different intensities analyzed for high HDL-C was tested using ROC curves. Associations, adjusted for confounders between LTPA and HDL-C were analyzed by logistic regression. A 95% confidence interval was used. Results A positive association, with a dose-response effect, was observed between LTPA and HDL-C in both men and women. With regard to intensity, only vigorous physical activity discriminated high HDL-C in men, while both walking and moderate and vigorous physical activity discriminated high HDL-C in women. Conclusions LTPA shows a positive association with gradient dose-response and HDL-C, but in men, the association is not observed for those classified as physically unfit. In women, both walking intensity and moderate or vigorous physical activity can discriminate high HDL-C levels, whereas only vigorous intensity-exercise discriminate elevated HDL-C levels in men, demonstrating that males need to do more physical activity for this benefit to be observed.

Correlation between GPR, MHR and elderly essential hypertension with unstable angina pectoris / 中南大学学报(医学版)

OBJECTIVES@#To investigate the level and significance of serum γ-glutamyl transferase-to-platelet ratio (GPR) and monocyte count to high-density lipoprotein ratio (MHR) in patients with essential hypertension (EH) and unstable angina (UA).@*METHODS@#A total of 218 patients with coronary angiography aged ≥60 years, who were admitted to the EH hospital of the Department of Cardiac Medicine, Affiliated Hospital of Chengde Medical College, were selected from September 2018 to September 2019. They were divided into an EH+UA group (@*RESULTS@#Compared with the control group, patients in the EH+UA group and the EH group had higher body mass index (BMI), tyiglyceride (TG), GPR, and MHR, and lower high-density lipoprotein-cholesterol (HDL-C) (all @*CONCLUSIONS@#There is a correlation between GPR, MHR and EH combined with UA pectoris, and the combined detection of the two indicators has adjuvant diagnostic value for elderly EH combined with UA.

Alteration in Serum Lipid Profile Pattern in Oral Squamous Cell Carcinoma and Potentially Malignant Disorders

ABSTRACT Objective: To evaluate and compare lipid profile level in oral submucous fibrosis (OSMF), oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) patients. Material and Methods: Thirty histopathologically diagnosed subjects each of OL, OSMF, OSCC were recruited along with 30 healthy controls. 5ml of venous blood is collected and estimated using standard diagnostic kits. Results: The mean of Total cholesterol level in controls was 219.03 mg%, in OSCC, OL and OSMF was 142.89 ± 10.21mg%, 155.44 ± 17.63 mg% and 180.60 ± 13.25 mg%, respectively. The mean low-density lipid level in controls was 137.24 mg and in OSCC, OL and OSMF groups were 109.28 ± 2.16 mg%, 126.63 ± 0.85 mg% and 119.15 ± 0.93 mg%, respectively. The mean of high-density lipid level in controls, OSCC, OL and OSMF was 42.87 ± 0.42 mg%, 36.50 ± 2.31 mg%, 21.13 ± 0.77 mg% and 28.37 ± 1.11mg%, respectively. The mean of very low density lipids level in controls, OSCC, OL and OSMF was 30.12 ± 1.51 mg%, 17.24 ± 0.80 mg%, 22.25 ± 0.93 mg% and 25.89 ± 0.43 mg%, respectively. The mean triglyceride level in controls, OSCC, OL and OSMF was 118.80 ± 9.47 mg%, 91.2 ± 3.03 mg%, 105.05 ± 2.96 mg% and 106.19 ± 3.09 mg%, respectively. Conclusion: Lipid profile levels could be early indicators of precancer and cancer.

Associação entre a razão de monócitos por HDL e TIMI frame count e a trombose de stent em pacientes com primeiro infarto do miocárdio / Association of the monocyte to HDL ratio and TIMI frame count and stent thrombosis in patients with first myocardial infarction

Objetivo: Avaliar a associação entre marcadores de gravidade e complexidade, assim como de desfechos em 30 dias, com a razão de monócitos por HDL em pacientes com primeiro infarto agudo do miocárdio. Métodos: Foram selecionados 580 pacientes com primeiro infarto agudo do miocárdio submetidos a questionário durante a internação e seguimento em 30 dias. Os dados laboratoriais foram obtidos de 312 pacientes na entrada e de 237 em 72 horas. A gravidade e a complexidade foram avaliadas pelo TIMI frame count, pela fração de ejeção do ventrículo esquerdo e pelo escore Syntax. Resultados: O estudo evidenciou correlação positiva entre a razão de monócitos por HDL em 72 horas e o TIMI frame count, com r de 0,219 (p=0,018). Também evidenciou maior mediana de razão de monócitos por HDL nos pacientes que apresentaram trombose de stent em até 30 dias da internação ­ 35,8 (30,0-43,9) ­ comparados àqueles que não apresentaram, com 18,27 (12,98-26,74), p=0,038. Não houve correlação significativa entre a razão de monócitos por HDL da entrada com TIMI frame count, escore SYNTAX ou fração de ejeção do ventrículo esquerdo. Conclusão: Houve correlação positiva entre a razão de monócitos por HDL em 72 horas e o TIMI frame count em pacientes com primeiro infarto agudo do miocárdio submetidos à angioplastia primária. Verificou-se, também, associação entre maiores níveis de razão de monócitos por HDL na entrada com trombose de stent em 30 dias.

Objective: To investigate the association between complexity and severity markers, as well as 30-day outcomes with the monocytes to HDL-cholesterol ratio in patients with first myocardial infarction. Methods: A total of 580 patients with first myocardial infarction was selected and answered a questionnaire during hospitalization and 30-day follow up. Laboratory data were obtained at admission for 312 patients and for 237 in 72 hours. Severity and complexity were assessed by TIMI frame count, left ventricular ejection fraction, and Syntax score. Results: The study showed that the monocyte to HDL ratio in 72 hours was significantly positively correlated with TIMI frame count, with r of 0.219 (p=0.018). It also showed higher monocyte to HDL ratio median in patients presenting stent thrombosis within 30 days of hospitalization ­ 35,8 (30,0-43,9) ­ compared to those who did not develop it 18,27 (12,98-26,74), p=0.038. No correlation was found between admission monocytes to HDL ratio and TIMI frame count, Syntax score, or left ventricular ejection fraction. Conclusion: There was a positive correlation between Monocytes to HDL ratio in 72 hours and TIMI frame count in patients with first myocardial infarction undergoing primary percutaneous coronary intervention. An association between higher levels of admission monocyte to HDL ratio and stent thrombosis in 30 days was also observed.

Prevalencia de dislipidemias en pacientes obesos / Dylispidemia prevalence in obese patients

Introducción: Las dislipidemias asociadas a la obesidad constituyen factores de riesgo de varias enfermedades especialmente del sistema cardiovascular. Objetivo: Determinar la prevalencia de dislipidemias en pacientes obesos. Métodos: Se realizó un estudio correlacional, retrospectivo y transversal de150 pacientes obesos, quienes acudieron a la consulta externa de la Clínica Medina del Hospital Básico de Guayaquil, desde el 2018 hasta el 2019. Las variables analizadas fueron edad, sexo, índice de masa corporal y resultados de laboratorio, tales como colesterol total, triglicéridos, colesterol LDL y dislipidemia mixta (colesterol HDL y VLDL). Resultados: En la serie predominaron el sexo masculino (62,6%), los pacientes con más de 65 años de edad (42,0 %), los niveles entre rango crítico y alto riesgo (66 pacientes); 16,0 % se clasificaron de alto riesgo con niveles de colesterol superior a 240 mg/dL. Mostraron resultados anormales en cuanto a los triglicéridos 62 afectados, en un rango mayor de 150 con niveles y limítrofe altos. Conclusiones: Se observó una correspondencia entre las dislipidemias y la obesidad, pues todos los pacientes presentaron algún tipo de alteración en los lípidos.

Introduction: Dyslipidemias associated to obesity constitute risk factors of several diseases specially from the cardiovascular system. Objective: To determine the prevalence of dyslipidemias in obese patients Methods: A correlational restrospective and cross-sectional study of 150 obese patients, who visited the outpatients department of Medina Clinic from Hospital Básico in Guayaquil, from 2018 to 2019. Variables used were age, sex, body mass index and laboratory results such as total cholesterol, triglycerids. LDL colesterol and mixed dyslipidemias (cholesterol HDL and VLDL). Results: In the serie, male sex (62.6 %), patients over 65 years (42.0 %), levels between critical and high risk (66 patients) prevailed, 16.0 % were classified as high risk patients with cholesterol level over 240 mg/dL. Sixty two patients showed subnormal results regarding triglycerids, in a rank higher than 150 with high limits and levels. Conclusions: A correspondance between dyslipidemias and obesity was observed, as all patients presented some type of change in lipids.

Influence of weight gain on the lipid profile of adolescents / Influencia de la ganancia de peso sobre el perfil lipídico en adolescentes

The objective of this study was to assess the influence of weight gain on the lipid profile of 135 adolescents between 10 - 14 years at baseline and 15 - 19 years at follow-up, enrolled in public schools in Recife, Brazil. The results showed that a BMI z-score correlated with triglycerides (TG) and with high density trigliceride lipopoteine ratio (TG/HDL-c) in males. In females, high z-score correlated with total cholesterol (TC) and low density lipoprotein (LDL-c). In males, for each unit increase in z-score, TG increased by 14.7 mg/dL and the TG/HDL-c ratio increased by 0.4. Among females, TC increased by 9.4 mg/dL, LDL-c increased by 11.6 mg/dL, non-HDL cholesterol increased by 11.8 mg/dL, and HDL-c decreased by 2.3 mg/dL. In males, excessive weight gain was associated with an increase in TG and TG/HDL-c; in females, it was associated with a higher increase in TG/HDL-c and non-HDL cholesterol. However, z-score variation can be a good predictor of lipid profile changes, even in those that are within the normal range.

El objetivo de este estudio fue evaluar la influencia del aumento de peso en el perfil lipídico de 135 adolescentes de edades entre 10 y 14 años de edad al inicio del estudio y de 15 a 19 años en el seguimiento. Los adolescentes pertenecían a escuelas públicas de Recife, Brasil. Los resultados mostraron que el alto puntaje z de indice de masa corporase (IMC) correlacionaba con triglicéridos (TG) y con relación de triglicéridos con lipoproteínas de alta densidad (TG/HDL-c) en los hombres. En las mujeres, puntaje z de IMC se correlacionó con CT y lipoproteína de baja densidad (LDL-c). En los hombres, por cada unidad de aumento en el puntaje z, los TG aumentaron en 14,7 mg/dL y la relación TG / HDL-c aumentó en 0,4; en las mujeres, el CT aumentó en 9,4 mg/dL, el LDL-c aumentó en 11,6 mg/dL, el colesterol no HDL aumentó en 11,8 mg / dL y el HDL-c disminuyó en 2,3 mg/dL. En los hombres, el aumento de peso excesivo se asoció con un aumento de TG y TG/HDL-c; en las mujeres, con un aumento mayor en TG/HDL-c y colesterol no HDL. Sin embargo, la variación z-score puede ser un buen predictor de cambios en el perfil lipídico, incluso en aquellos que se encuentran dentro del rango normal.

Perfil lipídico e consumo de bebida alcoólica: estudo longitudinal de saúde do adulto (ELSA-BRASIL) / Lipid profile and alcohol consumption: longitudinal study on adults' health (ELSA-BRASIL) / Perfil lipídico y consumo de bebida alcohólica: Estudio Longitudinal de Salude do Adulto

OBJETIVO: investigar o efeito do consumo de álcool em geral e do tipo de bebida alcoólica consumida, em diferentes medidas lipídicas. MÉTODO: o efeito do consumo de álcool foi investigado, bem como do tipo de bebida alcoólica, em diferentes medidas lipídicas, em ambos os sexos de população do Estudo Longitudinal de Saúde do Adulto. RESULTADOS: foram realizadas análises em relação ao tipo e quantidade de consumo de bebida alcoólica por sexo. O consumo baixo-a-moderado de álcool, independentemente do tipo de bebida alcoólica consumida, resultou em níveis mais elevados de HDL-colesterol, HDL2-colesterol e HDL3-colesterol em homens e mulheres. Não houve participantes da pesquisa que consumiam quantidade baixa a moderada de bebidas alcoólicas destiladas. Os triglicerídeos tiveram efeitos inversos para homens e mulheres no perfil lipídico. Para homens, bebidas destiladas contribuíram para melhor perfil dos triglicerídeos, enquanto para mulheres foi o contrário. Homens que consumiam bebidas alcoólicas destiladas tiveram níveis menores de triglicerídeos e mulheres que consumiam bebidas alcóolicas destiladas tiveram níveis maiores. Nossos resultados estão de acordo com os de estudos anteriores. CONCLUSÃO: o consumo de álcool resultou em níveis diferentes de medidas lipídicas séricas em homens e mulheres. Dessa forma, conclui-se que a resposta ao álcool tem diferenças biológicas.

OBJECTIVE: to investigate the effect of general alcohol consumption and of the type of alcoholic beverage consumed, in different lipid measurements. METHOD: the effect of alcohol consumption as well as that of the type of alcoholic beverage consumed were investigated, in different lipid measurements, for the participants in the Longitudinal Study on Adults' Health for both sexes. RESULTS: analyses were conducted on the type and amount of alcoholic beverage consumed by sex. Low-to-moderate alcohol consumption, regardless of the type of alcoholic beverage, resulted in higher levels of HDL-cholesterol, HDL2- cholesterol and HDL3-cholesterol in males and females. No participants in the study consumed low-to-moderate amounts of spirits. Triglycerides showed inverse effects for men and women according to the lipid profile. For men, spirits contributed to a better triglyceride profile while for women it was the opposite. Men who consumed spirits showed lower triglyceride levels, and women who consumed that beverage type had higher levels. Our results are in agreement with those of previous studies. CONCLUSION: alcohol consumption resulted in different levels of serum lipid measurements in men and women. Thus, it is concluded that response to alcohol has biological differences.

OBJETIVO: investigar el efecto del consumo de alcohol general, así como el tipo de bebida alcohólica consumida, en diferentes medidas lipídicas. MÉTODO: el efecto del consumo de alcohol fue investigado, así como el tipo de bebida alcohólica, en diferentes medidas lipídicas en ambos sexos de población del Estudio Longitudinal de Salud del Adulto. RESULTADOS: se realizaron análisis en relación al tipo y cantidad de consumo de bebida alcohólica por sexo. El consumo bajo a moderado de alcohol, independientemente del tipo de bebida alcohólica consumida, resultó en niveles más altos de HDL-colesterol, HDL2-colesterol y HDL3-coleseterol en hombres y mujeres. No hubo participantes de investigación que consumían en cantidad baja a moderada de bebidas alcohólicas destiladas. Los triglicéridos tuvieron efectos inversos para hombres y mujeres en el perfil lipídico. Para los hombres, las bebidas destiladas contribuyeron a un mejor perfil de los triglicéridos, mientras que para las mujeres fue lo contrario. Los hombres que consumían bebidas alcohólicas destiladas tenían niveles más pequeños de triglicéridos y las mujeres que consumían bebidas alcohólicas destiladas tuvieron niveles más altos. Nuestros resultados están de acuerdo con estudios anteriores. CONCLUSIÓN: el consumo de alcohol resultó en niveles significativamente mayores de HDL-colesterol, HDL2-colesterol y HDL3-colesterol, tanto en mujeres como en hombres. De esta forma, se concluye que la respuesta al alcohol tiene diferencias biológicas.

Trastornos lipídicos en pacientes hispanoamericanos en el primer nivel de atención sanitaria de Lima, Perú / Lipid disorders in Hispanic Americans patients in the primary health care level in Lima, Peru

Introducción: Las dislipidemias constituyen un factor de riesgo para el desarrollo de las enfermedades cardiovasculares, las que se consideran la principal causa de muerte a nivel mundial. Objetivos: Evaluar los trastornos lipídicos en pacientes hispanoamericanos en el primer nivel de atención sanitaria de Lima. Métodos: En el periodo de 2015-2016 se realizó una investigación prospectiva en 117 pacientes del Servicio de Laboratorio Clínico, Policlínico La Fe en Lima. Se tuvieron en cuenta las guías National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), US Preventive Services Task Force y la guía de práctica clínica del Instituto Mexicano del Seguro Social. De acuerdo con cada guía se establecieron las variables lipídicas: triglicéridos (TG) elevados (TG ≥ 150 mg/dl) y colesterol total elevado (CT ≥ 200 mg/dl), colesterol LDL-C elevado (LDL-C ≥ 130 mg/dl) y HDL-C disminuido (HDL-C ≤ 40 mg/dl). Resultados: El 71 por ciento de los pacientes presentaron HDL-C disminuido, el 41 por ciento hipertriacilgliceridemia, el 35,9 por ciento hipercolesterolemia y el 33,3 por ciento LDL-C elevado. Según la guía US Preventive Services Task Force se determinaron 9 pacientes con dislipidemia grado B, por la guía National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), 99 pacientes en 4 grupos de dislipidemia y 5 pacientes sin trastornos lipídicos según la guía de práctica clínica del Instituto Mexicano del Seguro Social. Conclusiones: Se observa una alta frecuencia de pacientes con trastornos lípidos principalmente por HDL-C disminuido y se evidencia las ventajas de la guía de práctica clínica en el primer nivel de atención sanitaria(AU)

Introduction: Dyslipidemia is a risk factor for the development of cardiovascular diseases, which are considered to be the main cause of death at the global level. Objectives: To assess lipid disorders in Hispanic Americans patients in the primary health care level in Lima. Methods: In the period 2015-2016 a prospective research was made in 117 patients of the Service of Clinical Laboratory, La Fe Policlinic in Lima. There were used the guides named National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), US Preventive Services Task Force, and the clinical practice guidelines of the Mexican Institute of Social Security. The lipid variables were established in accordance with each guide: High Triglycerides (TG) (TG ≥150 mg/dl) and high total cholesterol (CT ≥ 200 mg/dl), High LDL-C cholesterol (LDL-C ≥ 130 mg/dl) and decreased HDL-C (HDL-C ≤ 40 mg/dl). Results: 71 percent of the patients presented decreased HDL-C, 41 percent hypertriacilglyceridemia, 35.9 percent hypercholesterolemia and 33.3 percent high LDL-C. According to the US Preventive Services Task Force guide 9 patients with dyslipidemia grade B were identified by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guide, and 99 patients in 4 groups of dyslipidemia and 5 patients without lipid disorders were identified according to the clinical practice guidelines of the Mexican Institute of Social Security. Conclusions: It is observed a high frequency of patients with lipid disorders mainly by decreased HDL-C and there is evidence of the advantages of the clinical practice guidelines in the primary level of health care(AU)

Evaluation of monocyte to high-density lipoprotein ratio, lymphocytes, monocytes, and platelets in psoriasis,

Abstract Background: Psoriasis is a chronic immune-mediated inflammatory skin disease that is associated with cardiovascular comorbidities. Objectives: The objective of this retrospective study is to assess the C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio as inflammatory markers in patients with psoriasis and to search for a relationship between these parameters and psoriasis severity, as defined by the psoriasis area and severity index. Methods: There were 94 patients with psoriasis and 118 healthy controls enrolled in the study. The C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio values of two groups were retrospectively evaluated. Results: Statistically significant differences were observed in terms of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio between the patient and control groups (p = 0.001, p = 0.003, p = 0.038, and p = 0.007, respectively). Positive correlations were found between the psoriasis area and severity index and the values of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio (r: 0.381; p < 0.01, r: 0.203; p < 0.05, r: 0.268; p < 0.01, r: 0.374; p < 0.01, r: 0.294; p < 0.01, respectively). Study limitations: The small sample size and the retrospective design of the study are limitations. Conclusion: Elevated C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were significantly associated with psoriasis. A positive correlation between C-reactive protein and monocyte-to-high-density-lipoprotein ratio leads to the suggestion that monocyte-to-high-density-lipoprotein ratio might be a reliable parameter in psoriasis during the follow-up. The relationship between the diasease and inflammatory parameters might provide early detection of cardiovascular morbidities in psoriasis patients.

Fibroblast Growth Factor-23 is associated with High-density lipoprotein in Systemic sclerosis Female patients

@#INTRODUCTION: Fibroblast growth factor-23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and has been implicated as a putative pathogenic factor in cardiovascular disease. The objectives of this study were: to compare serum FGF23 levels between systemic sclerosis (SSc) patients and healthy controls and to investigate possible associations between FGF23 and serum lipid profile in SSc patients. METHODS: This cross-sectional study was performed in San Cecilio Hospital, Granada (Spain) from November 2017 to May 2019. We enrolled 62 consecutive female patients affected by SSc and 62 healthy women who served as controls. Cardiovascular risk factors and related biochemical parameters were collected. Serum FGF23 was analyzed using enzyme- linked immunosorbent assay (ELISA). Linear regression was used to examine the cross-sectional associations of serum FGF23 concentrations with high density lipoprotein-cholesterol (HDL-c). RESULTS: There was no significant differences in FGF23 levels between the patients and controls (78.2 ± 60.5 vs. 80.3 ± 56.3 pg/mL, p= 0.662), but we found a statistically significant inverse relationship between FGF23 and HDL-c measurements (r= -0.27; p= 0.03) in women with SSc. In addition, in the linear regression model, higher FGF23 concentrations were associated with lower HDL-c [β = -1.45 95% CI (-2.81, -0.08); p < 0.05]. CONCLUSIONS: We report an association between circulating FGF23 and HDL-c in SSc female patients, representing a novel pathway linking high FGF23 to an increased cardiovascular risk.

Renoprotective Effects of Gallic Acid Against Gentamicin Nephrotoxicity Through Amelioration of Oxidative Stress in Rats

Abstract Gallic acid (GA), as a strong antioxidant, was selected in this study to investigate its possible nephroprotective effects against gentamicin (GM)-induced nephrotoxicity. Twenty-four rats were separated into three groups (n=8): group 1 (control group) received saline (0.5 mL/day), group 2 (GM group) received GM (100 mg/kg/day), and group 3 (treated group) received GM (100 mg/kg/day) and GA (100mg/kg/day). All treatments were performed intraperitoneally for 12 days. After 12 days, the rats were euthanized, and kidneys were removed immediately. For serum preparation, blood samples were collected before killing. Kidney paraffin sections were prepared from one of the kidneys and stained by the periodic acid-Schiff process. GA significantly decreased GM-induced renal histopathological injuries, including tubular necrosis, tubular cast, and leucocyte infiltration compared with the GM group. Additionally, GA significantly improved proteinuria, serum levels of urea and creatinine, and serum activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) compared with nephrotoxic animals. Furthermore, GA caused a significant improvement in the levels of cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and cardiac risk ratios 1 and 2 in comparison with nephrotoxic animals. GA administration was observed to significantly improve the levels of lipid peroxidation, nitric oxide (NO), and glutathione (GSH) compared with the GM group. Finally, the activities and gene expression levels of catalase (CAT) and glutathione peroxidase (GPX) significantly increased following GA administration compared with the GM group. Our results indicated that GA has potential protective effects against GM nephrotoxicity by reducing oxidative stress in rats.

Metabolic syndrome in pregnancy and postpartum: prevalence and associated factors

SUMMARY OBJECTIVE Evaluate the prevalence of metabolic syndrome (MS) and the main associated maternal factors in women without pre-gestational conditions, in early pregnancy and in the immediate postpartum. METHODS Two hundred pregnant women were evaluated at the 16th week of pregnancy, and 187 were reassessed postpartum. MS was diagnosed according to the criteria by the National Cholesterol Education Program Adult Treatment Panel III. In addition to the diagnostic criteria, anthropometric measures, blood pressure, metabolic profile, and visceral and subcutaneous fat thickness (by ultrasonography) were collected from the pregnant woman. The student's t-test was used to compare the prevalence of MS and its components in the 16th week and in the postpartum. Multiple logistic regression was performed to identify the principal factors associated with the syndrome. RESULTS The prevalence of the MS was 3.0% in early pregnancy and 9.7% postpartum (p=0.01). Following multiple logistic regression, the prepregnancy body mass index (BMI) (p=0.04) and high-density lipoprotein cholesterol (HDL-c) (p=0.02) remained associated with MS at 16 weeks, and triglyceride levels evaluated in postpartum (p<0.001) with MS in postpartum. CONCLUSION The frequency of the MS was high in the immediate postpartum. The factors associated were prepregnancy BMI and HDL-c at the 16th week, as well as triglyceride levels postpartum.

RESUMO OBJETIVO Avaliar a prevalência da SM e os principais fatores maternos associados em mulheres sem doenças pré-gestacionais, no início da gravidez e no pós-parto imediato. MÉTODOS Foram avaliadas 200 mulheres na 16a semana de gravidez, sendo 187 reavaliadas no pós-parto. A SM foi diagnosticada de acordo com os critérios do National Cholesterol Education Program Adult Treatment Panel III. Além dos critérios diagnósticos da síndrome, foram coletadas medidas antropométricas, pressão arterial, perfil metabólico e espessura de gordura visceral e subcutânea (através de ultrassonografia) da gestante. O teste t de Student foi usado para comparar a prevalência de SM e dos seus componentes nos dois momentos. Os modelos de regressão logística múltipla, para investigar os principais fatores associados à síndrome na 16a semana de gestação e no pós-parto. RESULTADOS A prevalência da SM foi de 3,0% no início da gravidez e 9,7% no pós-parto (p=0,01). O índice de massa corporal (IMC) pré-gravídico (p=0,04) e o colesterol lipoproteínas de alta densidade (HDL-c) (p=0,02) permaneceram associados à SM na 16a semana. Após o parto, os níveis de triglicerídeos permaneceram associados à SM no pós-parto (p<0,001). CONCLUSÃO A prevalência da SM foi alta no pós-parto imediato e os fatores associados à síndrome foram IMC pré-gravídico e HDL-c na 16a semana, e níveis triglicerídeos no pós-parto.