Gut microbiota-metabolic axis insight into the hyperlipidemic effect of lotus seed resistant starch in hyperlipidemic mice.

We investigated the hyperlipidemic effect of different doses of lotus seed resistant starch (low-, medium and high-dose LRS, named as LLRS, MLRS and HLRS, respectively) in hyperlipidemic mice using gut microbiota-metabolic axis compared to high-fat diet mice (model control group, MC). Allobaculum was significantly decreased in LRS groups compared to MC group, while MLRS promoted the abundance of norank_f_Muribaculaceae and norank_f_Erysipelotrichaceae. Moreover, supplementation of LRS promoted cholic acid (CA) production and inhibited deoxycholic acid compared to MC group. Among, LLRS promoted formic acid, MLRS inhibited 20-Carboxy-leukotriene B4, while HLRS promoted 3, 4-Methyleneazelaic acid and inhibited Oleic acid and Malic acid. Finally, MLRS regulate microbiota composition, and this promoted cholesterol catabolism to form CA, which inhibited serum lipid index by gut microbiota-metabolic axis. In conclusion, MLRS can promote CA and inhibit medium chain fatty acids, so as to play the best role in lowering blood lipids in hyperlipidemia mice.

Associations of novel serum lipid index with epithelial ovarian cancer chemoresistance and prognosis.

Purpose: To evaluate the relationship between novel serum lipid index and chemoresistance as well as prognosis of epithelial ovarian cancer (EOC). Patients and methods: Patients' serum lipid profiles of 249 cases diagnosed with epithelial ovarian cancer, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) as well as their ratios, the novel indicators HDL-C/TC and HDL-C/LDL-C, and clinicopathologic characteristics were retrospectively collected and calculated from January 2016 to January 2020 and correlation between serum lipid index and clinicopathological features such as chemoresistance as well as prognosis were evaluated. Results: 249 patients pathologically diagnosed EOC who underwent cytoreductive surgery were included in our cohort. The mean age of these patients was 55.20 ± 11.07 years. Binary logistic regression analyses indicated Federation International of Gynecology and Obstetrics (FIGO(stage and HDL-C/TC ratio had significant association with chemoresistance. Univariate analyses demonstrated pathological type, chemoresistance, FIGO stage, neoadjuvant chemotherapy, maintenance treatment, HDL-C/LDL-C ratio, HDL-C/TC ratio were related to Progression-Free Survival (PFS) and Overall Survival (OS) (P<0. 05). Particularly, multivariate analyses indicated that HDL-C/LDL-C ratio was independent protective factors for both PFS and OS. Conclusion: The complex serum lipid index HDL-C/TC ratio has a significant correlation with chemoresistance. HDL-C/LDL-C ratio is closely related to the clinicopathological characteristics and prognosis of patients with EOC and is an independent protective factor indicating better outcome.

[Serum Lipid Levels and Their Prognostic Significance in Patients with Multiple Myeloma].

OBJECTIVE: To investigate the serum lipid levels and their prognostic significance in patients with multiple myeloma (MM). METHODS: A total of 87 newly diagnosed MM patients and 87 healthy controls in our hospital from January 2012 to April 2021 were selected. Serum lipid levels were compared between MM patients and healthy controls. The differences of serum lipid levels in patients among two groups of sex, age, hemoglobin (Hb), albumin (ALB), platelet (PLT), ß2-microglobulin (ß2-MG) and bone marrow plasma cell ratio (BMPC), different immune types, different ISS stages, before and after chemotherapy were analyzed. Univariate and COX multivariate regression analysis were used to analyze the influence of clinical parameters such as serum lipid indexes on prognosis of MM. RESULTS: The serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) in MM patients were significantly lower than those in healthy controls (P<0.05). Anemia, low protein and low PLT in patients were related to low cholesterol. The levels of TC, LDL-C, HDL-C, Apo A1 and Apo B in patients with low Hb and ALB were significantly lower than those in patients with high Hb and ALB (P<0.05). The Apo B level of low PLT patients was significantly lower than that of high PLT patients (P<0.05). The levels of TC, LDL-C, HDL-C, Apo A1 and Apo B in patients with different immune types were significantly different, the above indexes of IgA type were significantly lower than IgG type(P<0.05), IgG type were significantly lower than light chain type(P<0.05), double clone type were significantly lower than light chain type (P<0.05). The levels of TC, LDL-C, and Apo B in patients with different ISS stages were significantly different, stage Ⅱ were lower than those of stage Ⅰ (P>0.05), stage Ⅲ were significantly lower than those of stage Ⅱ and stageⅠ(P<0.05). The levels of TC, TG, LDL-C, HDL-C, Apo A1 and Apo B in patients after chemotherapy were significantly higher than those before chemotherapy (P<0.05). Univariate analysis showed that Hb, PLT, ß2-MG, BMPC, LDL-C and Apo B affected the prognosis of MM. Multivariate analysis showed that BMPC and Apo B were independent factors affecting the prognosis of MM. CONCLUSION: The serum cholesterol level is decreased in MM patients, and hypocholesterolemia is related to the classification and staging of the disease. With the improvement of the disease, the serum cholesterol level is increased, and low serum Apo B level predicts a poor prognosis.

Hyperspectral imaging for quantitative assessment of hepatic steatosis in human liver allografts.

INTRODUCTION: In liver transplantation (LT), steatosis is commonly judged to be a risk factor for graft dysfunction, and quantitative assessment of hepatic steatosis remains crucial. Liver biopsy as the gold standard for evaluation of hepatic steatosis has certain drawbacks, that is, invasiveness, and intra- and inter-observer variability. A non-invasive, quantitative modality could replace liver biopsy and eliminate these disadvantages, but has not yet been evaluated in human LT. METHODS: We performed a pilot study to evaluate the feasibility and accuracy of hyperspectral imaging (HSI) in the assessment of hepatic steatosis of human liver allografts for transplantation. Thirteen deceased donor liver allografts were included in the study. The degree of steatosis was assessed by means of conventional liver biopsy as well as HSI, performed at the end of back-table preparation, during normothermic machine perfusion (NMP), and after reperfusion in the recipient. RESULTS: Organ donors were 51 [30-83] years old, and 61.5% were male. Donor body mass index was 24.2 [16.5-38.0] kg/m2 . The tissue lipid index (TLI) generated by HSI at the end of back-table preparation correlated significantly with the histopathologically assessed degree of overall hepatic steatosis (R2 = .9085, P < .0001); this was based on a correlation of TLI and microvesicular steatosis (R2 = .8120; P < .0001). There is also a linear relationship between the histopathologically assessed degree of overall steatosis and TLI during NMP (R2 = .5646; P = .0031) as well as TLI after reperfusion (R2 = .6562; P = .0008). CONCLUSION: HSI may safely be applied for accurate assessment of hepatic steatosis in human liver grafts. Certainly, TLI needs further assessment and validation in larger sample sizes.

Usefulness of Novel Atherogenic Lipid Indices for the Evaluation of Metabolic Status Leading to Coronary Heart Disease in a Real-World Survey of the Japanese Population.

We evaluated the usefulness of two novel cholesterol-triglyceride subgroup (CTS) indices, CTSqlt and CTSqnt, that potentially reflect the metabolic status regarding risk of coronary heart disease (CHD) using a retrospective longitudinal study of the Japanese general population. We recruited 12,373 individuals from the annual users of our healthcare center. Among them, the first onset of CHD was recorded in 131 individuals between April 2014 and March 2020. The multivariate Cox proportional hazards regression analyses for all normalized lipid indices revealed that the CTSqnt index showed a comparable hazard ratio for the CHD outcome to non-high-density lipoprotein cholesterol (nonHDL-c) and triglycerides. The HR of the CTSqlt index was significantly lower than for CTSqnt, but still comparable to that for low-density lipoprotein cholesterol (LDL-c). In comparison with the other indices, CTSqlt is more sensitive to risk increment while the index value increases. Linear regression analyses for the CTS indices and previously known lipid indices suggest that the CTSqnt and CTSqlt indices reflect the quantity of atherogenic lipoproteins and particle size (quality) of smaller and denser LDLs, respectively. Furthermore, the CTSqnt/HDL-c index can be used as a comprehensive risk indicator that may represent the status of lipid metabolism determined by the CTSqlt and CTSqnt indices and thus may be useful for screening. The CTS indices can be used to evaluate the metabolic status of individuals, which may increase the risk of future CHD.

Lipid Indexes and Quality Evaluation of Omega-3 Rich Oil from the Waste of Japanese Spanish Mackerel Extracted by Supercritical CO2.

Japanese Spanish mackerel (JSM) (Scomberomorus niphonius) is a marine fish species containing health-beneficial polyunsaturated fatty acids (PUFAs). In the present study, the quality of JSM by-products oils extracted by supercritical CO2 (SC-CO2) and organic solvent extraction was compared in terms of physico-chemical properties of the oils. Eicosapentaenoic acid (EPA) is one of the important polyunsaturated fatty acids present in SC-CO2-extracted skin and muscle oil 5.81 ± 0.69% and 4.93 ± 0.06%, respectively. The amount of docosahexaenoic acid (DHA) in SC-CO2-extracted skin and muscle oil was 12.56 ± 0.38% and 15.01 ± 0.28%, respectively. EPA and DHA are considered as important PUFAs for the development of brain function and the prevention of coronary heart diseases. Extracted oils showed considerable antioxidant activity. In the obtained oils, atherogenic index (AI) values varied from 0.72 to 0.93 and thrombogenic index (TI) ranged from 0.75 to 0.92, which is considered an acceptable level. Fatty acid composition, bio potentiality, thermogravimetric, and vitamin D analysis showed that oils extracted from JSM by-products can be a good source of oil for application in food, pharmaceutical and cosmetic industries. Therefore, the present research revealed the potentiality of green valorisation of S. niphonius by-products as a possible sustainable approach for targeting the era of zero waste.

Synergistic Effects of Lotus Seed Resistant Starch and Sodium Lactate on Hypolipidemic Function and Serum Nontargeted Metabolites in Hyperlipidemic Rats.

The synergistic effects of lotus seed resistant starch (LRS3) and sodium lactate (SL; a postbiotics of RS3) on hypolipidemic function and serum nontargeted metabolites of hyperlipidemia rats were investegated. Rats fed a high-fat diet were orally administered with LRS3 (HLRS group) or SL (HSL group) either alone or in combination (HLRSSL group) for consecutive 4 weeks. HLRSSL was found to control weight gain, regulate blood lipid levels, reduce accumulation of fat in liver cells, and improve lesions in rat cardiac arteries, liver, small intestine, and colon tissues more effectively compared to HLRS or HSL group alone. Compared to the high-fat control group (HMC), l-phenylalanine and LysoPC(22:6(4Z,7Z,10Z,13Z,16Z,19Z)) in serum were upregulated in HLRSSL rats, while aconitic acid and suberic acid were decreased. Correlation analysis showed that SM(d18:0/16:1(9Z)), taurochenodeoxycholic acid, LysoPC(22:6(4Z,7Z,10Z,13Z,16Z,19Z)), oleic acid, and retinol were negatively correlated with total cholesterol (TCHO), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) and positively correlated with high-density lipoprotein cholesterol (HDL-C). Moreover, glutamic acid and serine showed a significant positive correlation with LDL-C and negative correlation with HDL-C. These differential metabolites were associated with reducing serum lipid levels in hyperlipidemia rats potentially through metabolic pathways such as linoleic acid, glutamine and glutamate, pyruvate, citric acid cycle, and glycerophospholipid.

Consistency changes of potential lipid markers in acne patients of different ages and their role in acne pathogenesis.

BACKGROUND: With the development of studies on skin lipid profile changes in acne patients, changes of skin surface lipidome are considered to be another important factor in acne pathogenesis. However, the studies of skin surface lipidome in acne patients of different ages have not been precisely discussed. AIMS: The mechanism of potential lipid markers in acne patients with different ages was further discussed. METHODS: On the basis of our previous studies, the changes of skin surface lipidome in acne patients of different ages were analyzed by comprehensive statistics. RESULTS: By counting the skin lipid markers of acne patients of different ages, it is found that seven lipid indexes are dominant in acne patients and play a vital role in the pathogenesis of acne. CONCLUSIONS: The analysis found that there was potential consistency in the changes of skin surface lipidome in acne patients of different ages. Moreover, the main lipid markers play an important role in the pathogenesis of acne.

A novel method to eliminate the influence of absorbed lipids on the characterization of ultra-high molecular weight polyethylene using Fourier-transform infrared spectroscopy.

BACKGROUND: Fourier-transform infrared spectroscopy (FTIR) is one of the standard methods to analyze ultra-high molecular weight polyethylene (UHMWPE) in orthopedic implants. For retrieved components, lipid extraction using an organic solvent prior to the measurement is necessary to eliminate the influence of lipids absorbed in vivo. However, its influence on the measurement has not been substantially investigated. OBJECTIVE: To investigate the influence of lipid extraction on the FTIR analysis of UHMWPE and to develop a novel method to obtain reliable results without inconvenient lipid extraction. METHODS: FTIR analysis was repeatedly performed on UHMWPE specimens from retrieved components before and after lipid extraction under various conditions. A method to calculate the extent of influence of the absorbed lipids from the FTIR spectra was developed using a peak separation technique. RESULTS: An elevated temperature was necessary for lipid extraction; however, it had the potential to influence the results if the conditions were not properly controlled. The results obtained using the peak separation technique coincided with those obtained after lipid extraction. CONCLUSION: The use of the peak separation technique enables the efficient acquisition of reliable results without the need for lipid extraction.

Fatty acid profiles and health lipid indices in the breast muscles of local Polish goose varieties.

The aim of this study was to evaluate the fatty acid profile and health lipid indices of meat from 3 Polish local goose varieties (Romanian-RO, Pomeranian-PO, and Subcarpathian-SB) and the commercial cross White Koluda goose (W31). Birds were fed ad libitum with the same complete feeds until 17 wk of age. The geese (n = 72) with body weight close to the arithmetic mean in particular flock were fasted for 12 h and slaughtered in an experimental slaughterhouse (18 females in each flock). Carcasses were stored at 2 to 4°C for 24 h. The breast muscles (m. pectoralis major) were cut out from the left side of carcass, separately vacuum-packed, and stored at -80°C until analysis. Fatty acid profile of meat was determined by gas chromatography and health lipid indices were calculated. The W31 muscles had a higher percentage of C 18:0 and a lower of C 16:0 than those of RO, PO, and SB geese. The W31 muscles were characterized by a significantly higher proportion of monounsaturated fatty acids (46.5%) than remaining ones (43.28%-PO, 43.38%-SB, and 44.24%-RO). The lowest proportion of polyunsaturated fatty acids was established for W31 muscles (22.05%). The breast muscles of RO, SB, and PO had more favorable polyunsaturated n-6 and n-3 fatty acid (PUFA)/ saturated fatty acid (SFA) ratio (0.85, 0.82, 0.83, respectively) than W31 geese (0.72). The current findings showed that UFA/SFA, PUFA/SFA, and PUFA n-6/n-3 ratios in RO and SB muscles were within the optimum values for human diets. No significant differences were observed in the atherogenic, thrombogenic, and hypocholesterolemic/hypercholesterolemic indices between the analyzed muscles. Commercial W31 geese breast muscles showed a lower value (43.90%) of peroxidizability index (PI) compared to SB (52.88%), PO (53.93%), and RO (53.47%). However, the higher values of the PUFA/SFA and PI in the meat of SB, PO, and RO birds may indicate a higher prohealth value of their meat.

Association of cholesterol uptake capacity, a novel indicator for HDL functionality, and coronary plaque properties: An optical coherence tomography-based observational study.

BACKGROUND: Cholesterol efflux from atherosclerotic lesion is a key function of high-density lipoprotein (HDL). Recently, we established a simple, high-throughput, cell-free assay to evaluate the capacity of HDL to accept additional cholesterol, which is herein referred to as "cholesterol uptake capacity (CUC)". OBJECTIVE: To clarify the cross-sectional relationship between CUC and coronary plaque properties. METHODS: We enrolled 135 patients to measure CUC and assess the morphological features of angiographic stenosis by optical coherence tomography (OCT). We estimated the extent of the lipid-rich plaque by multiplying the mean lipid arc by lipid length (lipid index). The extent of the OCT-detected macrophage accumulation in the target plaque was semi-quantitatively estimated using a grading system. RESULTS: Lipid-rich plaque lesions were identified in 125 patients (92.6%). CUC was inversely associated with the lipid index (R = -0.348, P < 0.0001). In addition, CUC was also inversely associated with macrophage score (R = -0.327, P < 0.0001). Conversely, neither circulating levels of HDL cholesterol nor apoA1 showed a similar relationship. CONCLUSIONS: We demonstrated that CUC was inversely related to lipid-rich plaque burden and the extent of macrophage accumulation, suggesting that CUC could be useful for cardiovascular risk stratification.

A retrospective cohort study of preoperative lipid indices and their impact on new-onset diabetes after liver transplantation.

BACKGROUND: The correlation between preoperative lipid profiles and new-onset diabetes after transplantation (NODAT) remains relatively unexplored in liver transplant recipients (LTRs). Thus, we aimed to investigate the preoperative lipid profiles in Chinese LTRs and evaluate the different influences of preoperative total cholesterol, total triglycerides (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol on the development of NODAT in both sexes. METHODS: A total of 767 Chinese LTRs from Zhongshan Hospital were retrospectively evaluated. NODAT was defined according to the American Diabetes Association guidelines; the relationship between each preoperative lipid index and NODAT development was analyzed separately in men and women. RESULTS: Pretransplant hypotriglyceridemia was observed in 35.72% of the total LTRs. In men, only the preoperative TG level was significantly associated with incident NODAT after adjusting for potential confounders (hazard ratio 1.37, 95% confidence interval 1.13-1.66, P = .001). There was a nonlinear relationship between the preoperative TG level and NODAT risk. The risk of NODAT significantly increased with preoperative a TG level above 0.54 mmol/L (log-likelihood ratio test, P = .043). In women, no significant association was observed. CONCLUSION: Among male LTRs, a higher preoperative TG level, even at a low level within the normal range, was significantly and nonlinearly associated with an increased risk of NODAT.

[Review on the relationship between major air pollutants and related indicators of type 2 diabetes mellitus].

The situation of air pollution has become increasingly serious and its relationship with diabetes becomes a new research concern, in China. After going through a large number of epidemiological studies published in recent years, this paper reviews the relationship between major air pollutants and both blood glucose and blood lipid, related to type 2 diabetes. It also summarizes the relationships among the main pollutants of the atmosphere so as to propose the research directions in this field. Hopefully, this paper can provide reference for forming policies on air pollution, prevention and treatment of type 2 diabetes in the country.

Utility of three novel insulin resistance-related lipid indices for predicting type 2 diabetes mellitus among people with normal fasting glucose in rural China.

BACKGROUND: Inexpensive and easily measured indices are needed for the early prediction of type 2 diabetes mellitus (T2DM) in rural areas of China. The aim of this study was to compare triglyceride glucose (TyG), visceral adiposity (VAI), and lipid accumulation product (LAP) with traditional individual measures and their ratios for predicting T2DM. METHODS: Data for 11 113 people with baseline normal fasting glucose in a rural Chinese cohort were followed for a median of 6.0 years. Cox proportional hazards regression was used to calculate covariate-adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) and receiver operating characteristic analysis was used to compare the ability of traditional measures and TyG, VAI, and LAP at baseline to predict T2DM at follow-up. RESULTS: Among individual measures, fasting plasma glucose (FPG) and waist circumference (WC) were strongly associated with T2DM. Of all lipid ratios, an elevated triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio was associated the most with T2DM. Compared with the first quartiles of TyG, VAI, and LAP, their fourth quartiles were associated with T2DM for men (aHR 3.54 [95% CI 2.08-6.03], 2.89 [1.72-4.87], and 5.02 [2.85-8.85], respectively) and women (6.15 [3.48-10.85], 4.40 [2.61-7.42], and 6.49 [3.48-12.12], respectively). For predicting T2DM risk, TyG, VAI, and LAP were mostly superior to the TG: HDL-C ratio, but did not differ from FPG and WC. CONCLUSIONS: Prediction of T2DM was not improved by TyG, VAI, and LAP versus FPG or WC alone. Therefore, TyG, VAI, and LAP may not be inexpensive tools for predicting T2DM in rural Chinese people.

Cardiovascular manifestations of anabolic steroids in association with demographic variables in body building athletes.

BACKGROUND: The most common drug abuse among athletes is anabolic steroids which lead to the development of cardiovascular diseases and sudden death. Thus, the aim of this study was to evaluate cardiovascular outcomes of anabolic consumption in body building athletes. MATERIALS AND METHODS: Totally, 267 male athletes at the range of 20-45 years old with the regular consumption of anabolic steroids for >2 months with at least once weekly. High-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and hematocrit (Hct) levels were measured after 10 h of fasting. Data analysis was performed using K2, t-test, ANOVA and correlation coefficient through SPSS 17. RESULTS: There was a nonsignificant difference between groups regarding HDL, TG, and total cholesterol. There was a significant decrease in the total and categorized LDL and Hct levels in consumers of anabolic steroid versus nonusers (P = 0.01 and P = 0.041, respectively). Results showed a significant increase in systolic and diastolic blood pressure (SBP and DBP) in anabolic steroid users which associates with duration of abuse (P = 0.02 and P = 0.03, respectively). No significant electrocardiography changes were found within the follow-up period. CONCLUSION: Increase in SBP or DBP is a common complication of these drugs which can lead serious vascular disorders. The lower LDL cholesterol level might be due to the higher amounts of lipid consumption in these athletes.

Riesgo Cardiovascular en la Anorexia Nerviosa y en otras formas de Amenorrea Hipotalámica Funcional Relacionadas con la Desnutrición / Cardiovascular risk in anorexia nerviosa and other forms of functional hypothalamic amenorrhea related to undernutrition

El disbalance entre el consumo/gasto energético observado en mujeres con amenorrea hipotalámica funcional (AHF) mal nutridas o francamente desnutridas, desencadena una mayor actividad de las hormonas hipotalámicas y neuropéptidos periféricos, destinada a facilitar el aporte de metabolitos energéticos endágenos. La osteoporosis, la inmunodepresión, la amenorrea hipotalámica y el aumento del riesgo cardiovascular (RCV), pueden ser interpretados como efectos secundarios a las reacciones de adaptación homeostática ejercidas por las hormonas centrales y periféricas. El grado de insuficiencia del eje somatotráfico, el hipoestrogenismo y tiempo de evolución, condicionan el tenor de las alteraciones de la circulación coronaria y el compromiso estructural y funcional del miocardio. Un perfil lipídico aterogénico (relación LDL col normal/ HDL col bajo e hipertrigliceridemia) y el ascenso de los marcadores periféricos de procesos inflamatorios y fibrinolíticos, instauran un medio proateroesclerático y protrombático. Frecuentemente es posible observar una prematura presencia de placas de ateroma en las paredes de las carátidas, engrosamiento de su íntima media y la consiguiente rigidez de estas arterias. Ello dificulta la circulación del flujo sanguíneo, induciendo así, la isquemia coronaria y una predisposición al accidente cerebrovascular. Estudios ecocardiográficos exhiben una reducción de la masa muscular de las paredes del ventrículo izquierdo y del septum interventricular. Estos cambios estructurales se correlacionan con una disminución del volumen sanguíneo de la fracción de eyección sistálica postesfuerzo, para presentarse luego en reposo. La alteración del volumen de llenado diastálico puede ser observada si el curso de la enfermedad es relativamente prolongado, evidenciando entonces, un grave compromiso de la performance cardíaca. Si bien, la incidencia de extrasístoles supraventriculares, fibrilación auricular y la bradicardia, no es estadísticamente significativa, la presencia de estas arritmias aumentan el RCV y la posibidad de una eventual muerte súbita.

The imbalance between energy intake and energy expenditure observed in malnourished or frankly under-nourished women with functional hypothalamic amenorrhea triggers an increased activity of hypothalamic hormones and peripheral neuropeptides, at facilitating the availability of endogenous energy metabolites. Osteoporosis, immune depression, hypothalamic amenorrhea and increased cardiovascular risk can be interpreted as secondary effects of the homeosthatic adaptation reactions by central and peripheral hormones. The extent of somatotropic axis deficiency, hypoestrogenism and time of evolution condition the nature of coronary circulation alterations and myocardial structural and functional involvement. An unfavorable lipid profile (normal LDL/ low HDL and hypertriglyceridemia), the rise in peripheral markers of fibrinolytic and inflammatory processes, results in a proatherosclerotic and prothrombotic environment. A premature presence of atheroma plaques in carotid walls, intima media thickness and subsequent artery stiffness may be frequently observed. This makes blood flow difficult, leading to coronary ischemia and predisposition to stroke. Echocardiographic studies show a decrease in the muscle mass of the left ventricle walls and the interventricular septum. These structural changes correlate with a volume reduction in the post-stress systolic ejection fraction, which subsequently occurs at rest at rest.The reduction in diastolic filling volume can be observed if the course of the disease is relatively long, showing, a serious compromise of cardiac performance. Even if the incidence of supraventricular extrasystoles, atrial fibrillation and bradycardia is not statistically significant, the presence of such arrhythmias increases CVR and the possibility of potential sudden death.