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1.
Curr Probl Cardiol ; 46(4): 100737, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33412349

RESUMEN

BACKGROUND: The COVID-19 pandemic's mental health consequences remain unknown. AIM: To assess the mental health status of ambulatory cardiometabolic patients during COVID-19 pandemic lockdown in Spanish speaking Latin American countries. METHODS: Cardiometabolic patients without COVID-19 evidence in 13 Latin American countries answered a survey between June 15th and July 15th, 2020. The Diagnosis Manual of Mental Disorders fifth edition was used to identify the presence of major depressive symptoms. RESULTS: The sample included 4216 patients, 1590 (37.71%; IC95% 36.24-39.19) were considered suffering major depression. Female gender, consuming ≥5 medications day, physical activity <100 minutes weekly, low fruits and vegetables intake, poor treatment adherence, reduced food consumption were independently associated to the presence of major depressive symptoms. CONCLUSIONS: The CorCOVID Latam Psy study showed that one-third of the Latin American Spanish speaking population is suffering from major depressive symptoms during the COVID-19 outbreak.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Depresión/epidemiología , Trastorno Depresivo Mayor/epidemiología , Diabetes Mellitus/epidemiología , Síndrome Metabólico/epidemiología , Adulto , Anciano , Enfermedades Cardiovasculares/psicología , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/psicología , Depresión/psicología , Trastorno Depresivo Mayor/psicología , Diabetes Mellitus/psicología , Dieta/estadística & datos numéricos , Dislipidemias/epidemiología , Dislipidemias/psicología , Ingestión de Alimentos , Ejercicio Físico/psicología , Femenino , Frutas , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/psicología , Humanos , Hipertensión/epidemiología , Hipertensión/psicología , América Latina/epidemiología , Masculino , Salud Mental , Síndrome Metabólico/psicología , Persona de Mediana Edad , Factores Sexuales , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/psicología , Encuestas y Cuestionarios , Cumplimiento y Adherencia al Tratamiento/psicología , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Verduras
2.
Ecotoxicol Environ Saf ; 208: 111682, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33396014

RESUMEN

Iodine is important in both thyroid function and lipid metabolism. Some studies have explored the effect of thyroid hormones (THs) and urinary iodine concentration (UIC) on serum lipid levels. However, the association between iodine intake and dyslipidemia has not been well established. This study aimed to investigate the relationship between water iodine concentration (WIC) and dyslipidemia, including hypercholesterolemia, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C) and high low-density lipoprotein cholesterol (LDL-C). A cross-sectional survey was conducted involving 409, 390 and 436 adults (≥18 years) from the iodine-deficient (median water iodine, MWI < 10 µg/L), iodine-adequate (MWI between 40 and 100 µg/L) and iodine-excess (MWI > 100 µg/L) areas, respectively. WIC, total cholesterol (TC), triglyceride (TRIG), HDL-C and LDL-C were measured. The prevalence of dyslipidemia were calculated based on the level of WIC using the chi-square method. To further explore whether prevalence was associated with WIC, simple linear regressions and multiple logistic regression models were used. Compared to those with WIC of 40-100 µg/L, a WIC of >100 µg/L was found to be protective associated with against the occurrence of hypertriglyceridemia [adjusted odds ratio (AOR) = 0.649, 95% confidence interval (CI): 0.455-0.924] and low HDL-C (AOR = 0.429, 95% CI: 0.264-0.697). The prevalence of hypertriglyceridemia, low HDL-C and high LDL-C as a function of WIC was found to be an inverted U-shaped association with a zenith at a WIC of 40-100 µg/L. Collectively, our research showed that serum lipid levels are related to WIC. The benefit effect association between WIC and dyslipidemia appears in cases of iodine excess (>100 µg/L).


Asunto(s)
Agua Potable/química , Dislipidemias/epidemiología , Yodo/análisis , Lípidos/sangre , Adulto , China , HDL-Colesterol/sangre , Estudios Transversales , Agua Potable/normas , Dislipidemias/sangre , Femenino , Humanos , Metabolismo de los Lípidos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Prevalencia , Encuestas y Cuestionarios , Triglicéridos/sangre
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(1): 80-87, 2021 Jan 10.
Artículo en Chino | MEDLINE | ID: mdl-33503701

RESUMEN

Objective: To explore the prevalence of lipid profile and the influencing factors of dyslipidemia in centenarians in Hainan province, and provide basic data for the study of the lipid profile in centenarians. Methods: The data of this study were from the baseline data of China Hainan Centenarian Cohort Study from June 2014 to December 2016. A total of 1 002 centenarians were recruited. According to the guidelines for the prevention and treatment of dyslipidemia in Chinese adults in 2016, the prevalence of lipid profile were described and the prevalence of dyslipidemia with different clinical classifications were compared, and the main influencing factors were analyzed. Results: The median levels of TC, TG, LDL-C and HDL-C were 4.60 mmol/L, 1.05 mmol/L, 2.77 mmol/L and 1.41 mmol/L, respectively, in centenarians in Hainan. Blood lipid profile level was higher in females than in males. With the increase of BMI, TC, TG and LDL-C increased significantly, while HDL-C decreased significantly. The total prevalence of dyslipidemia was 19.1%. Smoking, BMI and area distribution were the main influencing factors of dyslipidemia. Conclusion: The prevalence of dyslipidemia in centenarians in Hainan was at a low level compared with other countries, and the blood lipid profile level was higher in females than in males.


Asunto(s)
Metabolismo de los Lípidos , Anciano de 80 o más Años , China/epidemiología , HDL-Colesterol , Estudios de Cohortes , Dislipidemias/epidemiología , Femenino , Humanos , Lípidos , Masculino , Prevalencia , Factores de Riesgo , Triglicéridos
4.
Zhonghua Yi Xue Za Zhi ; 101(2): 127-130, 2021 Jan 12.
Artículo en Chino | MEDLINE | ID: mdl-33455128

RESUMEN

Objective: To analyze the prevalence and the related factors of dyslipidemia in 21-hydroxylase deficiency (21-OHD) patients. Methods: A total of 205 patients with 21-OHD were recruited in Peking Union Medical College Hospital from January 2016 to January 2018. The basic information, glucocorticoid replacement therapy, and laboratory examination results of patients were obtained from medical records. The genotypes of CYP21A2 were identified by Sanger sequencing and multiplex ligation dependent probe amplification. The prevalence of dyslipidemia among 21-OHD patients, basic information and related hormone levels of 21-OHD patients with different status of blood lipid were described. Logistic regression model was used to analyze the related factors of dyslipidemia in 21-OHD patients. Results: The age of subjects was 17.0 (8.3, 25.0) years old, including 51 males (24.9%). According to CYP21A2 genotypes, there were 16 cases in Null group, 26 cases in Group A, 105 cases in group B, 27 cases in group C, and 31 cases in group D. The incidence of dyslipidemia was 29.3% (60/205), among which 37.3% (19/51) in male and 26.6% (41/154) in female patients, respectively. The M (Q1, Q3) of total cortisol level (nmol/L) and body mass index (kg/m2) of male 21-OHD patients with dyslipidemia were 0.17 (0.06, 0.35) and 25.76 (17.01, 30.45), respectively, which were higher than those with ortholiposis [0.04 (0.02, 0.21) and 18.83 (16.53, 23.88)] (all P<0.05). The M (Q1, Q3) of progesterone level (nmol/L), body mass index (kg/m2) and age (years) of female 21-OHD patients with dyslipidemia were 74.40 (50.97, 98.52), 23.09 (21.78, 27.78) and 23.00 (16.50, 28.00), respectively, which were higher than those with ortholiposis [52.81 (33.41, 68.85), 21.55 (18.63, 25.71) and 18.00 (9.50, 25.00)] (all P<0.05). The risk of dyslipidemia increased by 5.0% [OR (95%CI): 1.05 (1.01, 1.09)] for every 1 nmol/L increase of progesterone. Conclusion: The incidence of dyslipidemia is high in 21-OHD patients, and progesterone level is positively correlated with dyslipidemia.


Asunto(s)
Hiperplasia Suprarrenal Congénita , Dislipidemias , Hiperplasia Suprarrenal Congénita/epidemiología , Adulto , Dislipidemias/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Esteroide 21-Hidroxilasa
5.
Mymensingh Med J ; 30(1): 21-27, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397846

RESUMEN

Patients with Diabetes Mellitus are at high risk of cardiovascular events because of abnormal lipid metabolism. Dyslipidemia is common in patients with Diabetes Mellitus (DM). However; in Bangladesh this issue is not yet properly addressed. The aim of this study is to determine the prevalence and patterns of dyslipidaemia in patients with DM in a divisional city Mymensingh. This cross-sectional study was conducted in randomly selected eligible patients from the indoor registry of the Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Bangladesh from April 2012 to March 2013. A well structured questionnaire and blood investigation for lipid profile and blood sugar were the tools of data collection from 120 randomly selected DM patients registered in the department of cardiology, MMCH. Out of 120 enrolled participants the prevalence of dyslipidemia in DM patients was 86.0%, prevalence of dyslipidemia in males was 88.0% while in females was 85.0% but the difference was not significant (p=0.42). Regarding age group, BMI and duration of DM, there is no significant association exists with dyslipidemia. About half of the studied DM patients have high serum total cholesterol level (50.83%), while 22.5% had low serum HDL-C levels and 35.0% had high serum LDC-C level, most of patients had serum triglyceride levels above normal range (67.5%) and so the common patterns of dyslipidemia in this study were serum triglyceride level followed by total cholesterol. High prevalence of dyslipidemia among diabetes mellitus in Mymensingh city were observed and so the common patterns of dyslipidemia is triglyceride followed by total cholesterol. This study emphasizes the importance of screening of lipid profile as these abnormalities may lead to development of cardiovascular diseases.


Asunto(s)
Cardiología , Diabetes Mellitus Tipo 2 , Dislipidemias , Bangladesh/epidemiología , Estudios Transversales , Dislipidemias/epidemiología , Femenino , Hospitales , Humanos , Masculino , Prevalencia
6.
Mymensingh Med J ; 30(1): 48-55, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397850

RESUMEN

Dyslipidemia is a common problem in chronic kidney disease patients. Dyslipidemia in chronic kidney disease patients has been known to be a major risk factor of their cardiovascular disease and may contribute to progressive renal dysfunction. The result of the study might be of interest in improving preventive strategies and in management of dyslipidemia in chronic kidney disease patients. This cross sectional study was conducted to evaluate changes in lipid profile in patients with chronic kidney disease stage-3 to stage-5 patients and to correlate the biochemical abnormalities with progression of the disease in Mymensingh Medical College Hospital, Bangladesh from October, 2016 to April, 2017. In this study 200 patients were including and subjected to do complete blood count, erythrocyte sedimentation rate, random blood sugar, routine examination of urine, serum creatinine and fasting lipid profile. Two hundred (200) patients (134 males, 66 females) with the mean age were 50.5±12.43 years. 44.5% patients were in CKD stage-5, 37.5% patients were in CKD stage-4, 18% patients were in CKD stage-3. Mean value of Triglyceride (TG) was 194±47.20. Eighty nine percent (89%) patient had hyper-triglyceridemia and 11% had normal triglyceride level. It was statistically significant increased in triglyceride level (p<0.05). Mean value of High density lipoprotein cholesterol (HDL-C) was 34±6.10. Low HDL-C had in 87.5% patients, normal in 12.5% patients and was statistically significant reduction in HDL-C level (p<0.05). Low Density Lipoprotein cholesterol (LDL-C) mean was 113±35.6. High level of LDL-C had optimal/or near optimal in 47% patients, 39% patients had borderline high and 14% patients had that was not statistically significant (p>0.10). Total cholesterol (TC) mean was 212±45.3. In 38% patients had within desirable level, 62% patients had high level of Total cholesterol (TC). It was not statistically significant change (p>0.01).


Asunto(s)
Dislipidemias , Insuficiencia Renal Crónica , Adulto , Bangladesh , HDL-Colesterol , Estudios Transversales , Dislipidemias/epidemiología , Femenino , Humanos , Lípidos , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/epidemiología , Triglicéridos
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(12): 2066-2071, 2020 Dec 10.
Artículo en Chino | MEDLINE | ID: mdl-33378818

RESUMEN

Objective: To explore the screening effect of obesity assessed by body fat indicators on persistent dyslipidemia among children. Methods: Data were obtained from the baseline and follow-up survey of 'School-based Cardiovascular and Bone Health Promotion Program.' BMI, fat mass index (FMI), and fat mass percentage (FMP) were used to define obesity. Dyslipidemia, diagnosed both in the baseline and a follow-up survey, was defined as persistent dyslipidemia. The area under the receiver operating characteristic curve (AUC) was used to compare the predictive capabilities of obesity defined by different indicators on persistent dyslipidemia. Results: A total of 10 783 children (boys accounted for 49.6%) were included in the analysis, with the average age as (10.9±3.3) years old. The detection rates of persistent high TC, high LDL-C, low HDL-C, high TG, and high non-HDL-C were 1.3%, 1.2%, 4.3%, 1.3%, and 0.8%, respectively. In boys, the capabilities of FMI- and FMP-defined obesity in the prediction of persistent high LDL-C [FMI: AUC=0.626 (95%CI: 0.558-0.694), P=0.024; FMP: AUC=0.642 (95%CI: 0.574-0.710), P=0.004] and high non-HDL-C [FMI: AUC=0.637 (95%CI: 0.584-0.689), P=0.017; FMP: AUC=0.641 (95%CI: 0.588- 0.693), P=0.018] were significantly higher than BMI-defined obesity. Besides, obese boys defined by FMI had the stronger capability in predicting persistent low HDL-C than that defined by BMI [AUC=0.784 (95%CI: 0.742-0.826) vs. 0.750 (95%CI: 0.726-0.773), P=0.047]. In girls, the capabilities of FMI- and FMP-defined obesity in the prediction of persistent dyslipidemia were not statistically different from BMI. Conclusions: The obesity assessed by body fat performed better in predicting persistent high LDL-C, low HDL-C, and high non-HDL-C than that assessed by BMI among boys, which can be further applied to cardiovascular disease prevention.


Asunto(s)
Tejido Adiposo , Dislipidemias , Tamizaje Masivo , Obesidad Pediátrica , Adolescente , Niño , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Obesidad Pediátrica/diagnóstico , Obesidad Pediátrica/epidemiología
9.
Orv Hetil ; 161(50): 2117-2123, 2020 12 13.
Artículo en Húngaro | MEDLINE | ID: mdl-33310925

RESUMEN

Összefoglaló. Bevezetés és célkituzés: Az obstruktív alvási apnoe (OSA) a felnott lakosság jelentos részét érinto betegség, mely ismert rizikófaktora a cardiovascularis és metabolicus betegségeknek és a korai halálozásnak. Mindazonáltal kevés magyarországi adat áll rendelkezésre az OSA-ban szenvedo betegek demográfiai és klinikai jellemzoirol, így vizsgálatunk célja ennek bemutatása volt. Módszer: Retrospektív vizsgálatunkban a Semmelweis Egyetem Pulmonológiai Klinikájának Alváslaboratóriumában kivizsgált 394 személy (58 [46-66] év, 73% férfi, testtömegindex [BMI] = 32,5 [29,2-37,5]) adatait elemeztük, akik kitöltötték az Epworth Álmosság Skálát, poliszomnográfiás vizsgálaton estek át; felvettük az anamnézist, és 255 esetben reggeli éhomi vérvétel történt. Eredmények: 282 esetben igazolódott OSA. Ebben a csoportban magasabb volt a férfiak aránya (66 vs. 35%), magasabb volt az életkor (59 [48-66] vs. 47 [39-60] év) és a BMI (32,11 [27,78-37,18] vs. 25,29 [22,04-29,03] kg/m2), magasabbak voltak a C-reaktív protein értékek (3,0 [1,71-5,34] mg/l vs. 1,71 [0,91-3,31] mg/l), illetve a betegek gyakrabban szenvedtek társbetegségekben a kontrollcsoporthoz képest (magas vérnyomás 74% vs. 39%, cukorbetegség 24% vs. 11%, dyslipidaemia 46% vs. 30%, szív- és érrendszeri betegség 22% vs. 5%, szívritmuszavar 27% vs. 16%; minden p<0,05). Bár az OSA valószínusége progresszívan nott az életkorral és az Epworth Álmosság Skála emelkedésével, a trendekben szignifikáns különbségeket észleltünk a férfiak és a nok között (mindketto p<0,05). Ezzel szemben az OSA valószínuségének BMI-függése nemektol független volt (p = 0,94). Következtetés: Az OSA valószínusége progresszívan emelkedik a kor, a BMI és a nappali aluszékonyság függvényében, ugyanakkor ezt befolyásolja a nem is. Közleményünk rámutat a társbetegségek szurésének fontosságára is az OSA különbözo súlyossági fokaiban. Orv Hetil. 2020; 161(50): 2117-2123. INTRODUCTION AND OBJECTIVE: Obstructive sleep apnoea (OSA) is a common disease which is a known risk factor for cardiovascular and metabolic disease and mortality as well. However, the demographic and clinical characteristics of Hungarian patients with OSA are less known. The aim of this study was to describe them. METHOD: We analysed the data of 394 subjects (58 [46-66] years, 73% male, body mass index [BMI] = 32.5 [29.2-37.5]) who attended the Sleep Laboratory of the Department of Pulmonology at Semmelweis University. The volunteers filled out the Epworth Sleepiness Scale, we performed a polysomnography and took medical history. In 255 subjects, fasting blood samples were collected. RESULTS: OSA was diagnosed in 282 cases. This group had higher proportion of males (66 vs. 35%) and comorbidities (hypertension 74% vs. 39%, diabetes 24% vs. 11%, dyslipidaemia 46% vs. 30%, cardiovascular diseases 22% vs. 5%, arrhythmia 27% vs. 16%), the patients were older (59 [48-66] vs. 47 [39-60] years) and had higher BMI (32.11 [27.78-37.18] vs. 25.29 [22.04-29.03] kg/m2) and C-reactive protein levels (3.0 [1.71-5.34] mg/l vs. 1.71 [0.91-3.31] mg/l, all p<0.05). There was a significant relationship between the propensity of OSA along increasing age, BMI and Epworth Sleepiness Scale; however, the relationship depended on gender for age and Epworth Sleepiness Scale (both p<0.05). CONCLUSION: The propensity of OSA increases with age, BMI and symptoms burden and it is affected by the gender. Our study highlights the importance of screening comorbidities in different severity grades of OSA. Orv Hetil. 2020; 161(50): 2117-2123.


Asunto(s)
Arritmias Cardíacas/epidemiología , Hipertensión/epidemiología , Apnea Obstructiva del Sueño/diagnóstico , Factores de Edad , Anciano , Índice de Masa Corporal , Proteína C-Reactiva/metabolismo , Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Dislipidemias/epidemiología , Femenino , Humanos , Hungría/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Apnea Obstructiva del Sueño/epidemiología
10.
Eur Rev Med Pharmacol Sci ; 24(23): 12510-12515, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33336770

RESUMEN

OBJECTIVE: Almost all countries announced social restrictions and distancing measures which could unintentionally lead to a decline in admissions to hospital for acute disorders other than signs of pneumonia. We aimed to evaluate lipid profile, neutrophil to lymphocyte ratio (NLR) and cardiovascular admissions to the coronary care unit (CCU) of a tertiary center in Turkey during the COVID-19 era and to compare these results with admissions in the same time interval of the previous year. MATERIALS AND METHODS: We retrospectively analyzed CCU admissions due to new-onset atrial fibrillation, ST-elevation myocardial infarction, non-ST elevation acute coronary syndrome (NSTEACS) and acute heart failure during the COVID-19 outbreak and the same time interval of the past year. Laboratory measurements including lipid profile and NLR values were retrieved from the institutional digital database. RESULTS: Compared to the same time interval of 2019 (March-April, 2019), the number of patients admitted to the CCU with acute cardiovascular disorders (atrial fibrillation, STEMI, NSTEACS and acute heart failure) were lower in the COVID-19 period. The levels of NLR, total cholesterol, and low-density lipoprotein (LDL) cholesterol were significantly higher and high-density lipoprotein (HDL) cholesterol was significantly lower in subjects admitted to the CCU during March-April 2020 compared to subjects admitted in March-April 2019. CONCLUSIONS: Our findings show that subjects admitted to the CCU in the COVID-19 era have an unfavorable lipid profile and elevated NLR compared to those admitted in 2019. These patients appear to be at high risk for future cardiovascular events.


Asunto(s)
Síndrome Coronario Agudo/sangre , Fibrilación Atrial/sangre , Dislipidemias/sangre , Insuficiencia Cardíaca/sangre , Recuento de Linfocitos , Neutrófilos , Infarto del Miocardio con Elevación del ST/sangre , Síndrome Coronario Agudo/epidemiología , Anciano , Fibrilación Atrial/epidemiología , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Estudios de Cohortes , Control de Enfermedades Transmisibles , Unidades de Cuidados Coronarios , Dislipidemias/epidemiología , Femenino , Insuficiencia Cardíaca/epidemiología , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Infarto del Miocardio con Elevación del ST/epidemiología , Turquia/epidemiología
11.
J Stroke Cerebrovasc Dis ; 29(11): 105198, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33066946

RESUMEN

PURPOSE: Single subcortical infarction (SSI) in the middle cerebral artery (MCA) territory can be classified into proximal SSI (pSSI) and distal SSI (dSSI) based on the heterogeneous pathogenesis. It is hypothesized that pSSI is more relevant with atherosclerosis, as low-density lipoprotein cholesterol (LDL-C) is the major atherogenic lipoprotein, we conducted the present study to investigate the association between LDL-C levels and pSSI in comparison with dSSI. PATIENTS AND METHODS: This study is a subset of the Chinese Intracranial Atherosclerosis study. A total of 380 with SSI in the MCA territory classified as small artery occlusion stroke were enrolled in this study. 3.0-T magnetic resonance imaging (MRI) was performed to categorize the participants into two groups, pSSI (extending to the basal surface of MCA) and dSSI (not extending to the basal surface of MCA). RESULTS: Out of the 380 enrolled participants (273 men and 107 women), the proportion of pSSI and dSSI were 53.2% (202/380) versus 46.8% (178/380) based on MRI. The results of univariate and multivariate logistic regression were both at the borderline level of statistical significance. Further stratified analyses revealed that age is an interaction factor (P = 0.03), the association between LDL-C levels and the pSSI in participants aged over 65 had a significant positive relation (OR: 1.56; 95%CI: 1.14-2.12). CONCLUSION: LDL-C level is an independent risk factor for pSSI in patients aged over 65. Our result is in accordance with the hypothesis that pSSI is more relevant with atherosclerosis, thus appropriate treatment should be applied differently to pSSI and dSSI.


Asunto(s)
LDL-Colesterol/sangre , Dislipidemias/sangre , Infarto de la Arteria Cerebral Media/epidemiología , Factores de Edad , Anciano , Biomarcadores/sangre , Angiografía Cerebral , China/epidemiología , Imagen de Difusión por Resonancia Magnética , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Femenino , Humanos , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Recurrencia , Medición de Riesgo , Factores de Riesgo
12.
Vasc Health Risk Manag ; 16: 403-418, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33116551

RESUMEN

Cardiovascular (CV) disease remains the leading cause of morbidity and mortality worldwide and poses an ongoing challenge with the aging population. Elevated low-density lipoprotein cholesterol (LDL-C) is an established risk factor for atherosclerotic cardiovascular disease (ASCVD), and the expert consensus is the use of statin therapy (if tolerated) as first line for LDL-C reduction. However, patients with ASCVD may experience recurrent ischemic events despite receiving maximally tolerated statin therapy, including those whose on-treatment LDL-C remains ≥70 mg/dL, patients with familial hypercholesterolemia, high-risk subgroups with comorbidities such as diabetes mellitus, and those who have an intolerance to statin therapy. Optimal therapeutic strategies for this unmet need should deploy aggressive lipid lowering to minimize the contribution of dyslipidemia to their CV risk, particularly for very high-risk populations with additional risk factors beyond hypercholesterolemia and established ASCVD. To understand the current clinical climate and guidelines regarding ASCVD, we primarily searched PubMed for articles published in English regarding lipid-lowering therapies and CV risk reduction, including emerging therapies, and CV outcomes trials with proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. This review discusses the findings of recent clinical trial evidence for CV risk reduction with cholesterol-lowering therapies, with a focus on CV outcomes trials with PCSK9 inhibitors, and considers the impact of the study results for secondary prevention and future strategies in patients with hypercholesterolemia and CV risk despite maximally tolerated statin therapy.


Asunto(s)
Anticolesterolemiantes/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , LDL-Colesterol/sangre , Dislipidemias/tratamiento farmacológico , Proproteína Convertasa 9/antagonistas & inhibidores , Inhibidores de Serina Proteinasa/uso terapéutico , Anticolesterolemiantes/efectos adversos , Biomarcadores/sangre , Enfermedades Cardiovasculares/epidemiología , Quimioterapia Combinada , Dislipidemias/sangre , Dislipidemias/epidemiología , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Factores de Riesgo , Inhibidores de Serina Proteinasa/efectos adversos , Resultado del Tratamiento
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1250-1255, 2020 Aug 10.
Artículo en Chino | MEDLINE | ID: mdl-32867431

RESUMEN

Objective: To investigate the status quo of sleelated problems and relationship with dyslipidemia among adults in Beijing. Methods: From August to December 2017, 13 188 residents aged 18-79 years old were randomly selected as the subjects of this study, by stratified multi-stage cluster sampling method. Questionnaire, physical examination and laboratory testing were used in this study. The questionnaire included demographic characteristics and status quo of sleep. Height and weight were measured, with fasting venous blood collected to test the levels of TC, HDL-C, LDL-C and TG. Results: In Beijing, 52.1% of the adults involved in this study were having sleep-related problems which appeared higher in patients with dyslipidemia (55.1%) than those without (50.7%). Rates of sleep-related problems as snoring, difficult to get into sleep, waking at night, waking early and taking sleeping pills were 30.1%, 18.8%, 24.6%, 20.1% and 3.0%, respectively. The prevalence rates of high TC, high TG and high LDL-C were 7.5%, 23.5% and 6.6%, respectively among subjects with snoring and as, 5.7%, 15.5% and 4.9%, respectively among those without. The average level of TC of people easy to wake at night was 4.74 mmol/L, higher than that of those without (4.66 mmol/L). The prevalence of high TC among those waking at night was 7.5%, higher than that of those without (5.8%). After controlling potential confounding factors as age, sex, smoking, overweight and obesity, snoring was significantly positively correlated to the levels of TC, TG and LDL-C (P<0.05) and presenting as risk factor for dyslipidemia, with OR=1.248 (P<0.05). Conclusion: Sleep-related problems appeared serious, with snoring and waking at night the main ones among adults in Beijing. Snoring was significantly positively correlated with the levels of TC, TG and LDL-C and served an independent risk factor for dyslipidemia.


Asunto(s)
Dislipidemias/epidemiología , Trastornos del Sueño-Vigilia/epidemiología , Adolescente , Adulto , Anciano , Beijing/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Adulto Joven
14.
Medicine (Baltimore) ; 99(35): e21574, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-32871873

RESUMEN

The prevalence of the metabolic syndrome (MS) is increasing in China, but there are disparities between urban and rural populations, and across different regions.To examine the prevalence and risk factors of MS in the rural area of Qianjiang (Southwest China).From March 2016 to June 2018, 6 townships in the Qianjiang District of Chongqing Municipality were selected for a cross-sectional study of the residents in rural areas. Demographics and medical history were collected using a questionnaire. Anthropometry and blood pressure were obtained by physical examination. Blood lipids, fasting plasma glucose, and 2-h postprandial glucose were measured.A total of 2949 (1067 males and 1882 females) were included. The mean age was 63.8 ±â€Š10.7 years. The prevalence of MS in the study population was 16.8% (496/2949). The prevalence of MS was 7.4% in men, 22.2% in women, 15.7% in Han, 18.1% in Tujia, and 14.8% in Miao. According to age, the prevalence of MS was 10.6%, 17.0%, and 18.3% in the 30-50, 50-69, and ≥ 70 years groups. The multivariable analysis showed that female sex (OR = 33.36, 95%CI: 17.0-65.53), dyslipidemia (OR = 4.71, 95%CI: 1.73-12.82), kidney diseases (OR = 2.32, 95%CI: 1.37-3.94), waistline (OR = 1.39, 95%CI: 1.33-1.46), high-density lipoprotein cholesterol (OR = 0.12, 95%CI: 0.06-0.23), triglycerides (OR = 1.52, 95%CI: 1.31-1.76), alanine aminotransferase (OR = 0.98, 95%CI: 0.97-1.00), γ-glutamyltransferase (OR = 1.00, 95%CI: 1.00-1.01), and glycated hemoglobin (OR = 1.31, 95%CI: 1.08-1.59) were independently associated with MS.The prevalence of MS was 16.8% in Qianjiang. Female sex, kidney diseases, alanine aminotransferase, and γ-glutamyltransferase were independent risk factors for MS.


Asunto(s)
Síndrome Metabólico/sangre , Síndrome Metabólico/epidemiología , Población Rural/tendencias , Anciano , Alanina Transaminasa/sangre , Antropometría , Glucemia/análisis , Presión Sanguínea/fisiología , China/epidemiología , HDL-Colesterol/sangre , Estudios Transversales , Dislipidemias/epidemiología , Ayuno/sangre , Femenino , Humanos , Enfermedades Renales/epidemiología , Lípidos/sangre , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Factores Sexuales , Triglicéridos/sangre , gamma-Glutamiltransferasa/sangre
15.
Arch Cardiovasc Dis ; 113(10): 617-629, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32873522

RESUMEN

BACKGROUND: Patients with type 2 diabetes mellitus characteristically display an atherogenic lipid profile with high triglyceride concentrations, low high-density lipoprotein cholesterol (HDL-C) concentrations and low-density lipoprotein cholesterol (LDL-C) concentrations not always elevated. It is unclear if patients with diabetes who present with an acute coronary syndrome (ACS) receive different or more-potent lipid-lowering therapy (LLT). AIMS: To investigate lipid abnormalities in patients with and without type 2 diabetes hospitalised for an ACS, and use of LLT before admission and 4 months after the event. METHODS: Patients were included in the observational DYSIS II study if they were hospitalised for an ACS and had a full lipid profile. RESULTS: Of 3803 patients, diabetes was documented in 1344 (54.7%). Compared to patients without diabetes, those with diabetes had a lower mean LDL-C (101.2 vs. 112.0mg/dL; 2.6 vs. 2.9mmol/L; P<0.0001), with a greater proportion attaining concentrations<70mg/dL (1.8mmol/L) (23.9% vs. 16.0%; P<0.0001) and<55mg/dL (1.4mmol/L) (11.3% vs. 7.3%; P<0.0001), a higher mean triglyceride concentration (139.0 vs. 121.0mg/dL; 1.6 vs. 1.4mmol/L; P<0.0001) and a lower HDL-C concentration. LLT was more commonly given to patients with diabetes (77.5% vs. 58.8%; P<0.0001); there were no differences in types of therapy prescribed. Four months after hospitalisation, most patients from both groups were being treated with LLT (predominantly statin monotherapy). CONCLUSIONS: Despite the different lipid profiles, the type of LLT prescribed did not vary depending on the presence or absence of type 2 diabetes. There was no difference in LLT in patients with and without diabetes at 4-month follow-up, except for fibrates, which were used in 2% of patients with and 1% of patients without diabetes. Statin monotherapy of intermediate potency was the predominant treatment in both groups.


Asunto(s)
Síndrome Coronario Agudo/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Dislipidemias/tratamiento farmacológico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Lípidos/sangre , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/terapia , Anciano , Biomarcadores/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Admisión del Paciente , Factores de Riesgo , Resultado del Tratamiento
16.
Medicine (Baltimore) ; 99(38): e21786, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32957307

RESUMEN

The present study is a retrospective cohort study. Metabolic syndrome (MetS) is a clustering of clinical findings that has been shown to increase the risk of the surgical outcomes. Our study aimed to evaluate whether MetS was a risk factor for increased perioperative outcomes in patients undergoing posterior lumbar interbody fusion (PLIF).We retrospectively analyzed patients over 18 years following elective posterior lumbar spine fusion from January 2014 to December 2018. Emergency procedures, infections, tumor, fracture, and revision surgeries were excluded. Patients were divided into 2 groups with and without MetS. The MetS was defined by having 3 of the following 4 criteria: obesity (body mass index ≥30 kg/m), dyslipidemia, hypertension, and diabetes. The follow-up period lasted up to 30 days after surgery. The outcomes of demographics, comorbidities, perioperative complications, and length of stay were compared between the 2 groups. Multivariate logistic regression analysis was used to identify perioperative outcomes that were independently associated with MetS.The overall prevalence of MetS was 12.5% (360/2880). Patients with MetS was a significantly higher risk factor for perioperative complications, and longer length of stay cmpared with patients without MetS (P < .05). The MetS group had a higher rate of cardiac complications (P = .019), pulmonary complication (P = .035), pneumonia (P = .026), cerebrovascular event (P = .023), urinary tract infection (P = .018), postoperative ICU admission (P = .02), and deep vein thrombosis (P = .029) than non-MetS group. The patients with MetS had longer hospital stays than the patients without MetS (22.16 vs 19.99 days, P < .001). Logistic regression analysis revealed that patients with MetS were more likely to experience perioperative complications (odds ratio [OR] 1.31; 95% confidence interval [CI]: 1.06-2.07; P < .001), and extend the length of stay (OR: 1.69; 95% CI: 1.25-2028; P = .001).The MetS is a significant risk factor for increased perioperative complications, and extend length of stay after PLIF. Strategies to minimize the adverse effect of MetS should be considered for these patients.


Asunto(s)
Vértebras Lumbares/cirugía , Síndrome Metabólico/epidemiología , Complicaciones Posoperatorias/epidemiología , Fusión Vertebral/efectos adversos , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Comorbilidad , Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Procedimientos Quirúrgicos Electivos , Femenino , Humanos , Hipertensión/epidemiología , Tiempo de Internación , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Reoperación , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Fumar/epidemiología , Factores Socioeconómicos , Adulto Joven
17.
Intern Med ; 59(18): 2221-2228, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32938849

RESUMEN

Objective Snoring is a common physical condition in active workers. However, the link between snoring and health problems is poorly understood. Therefore, the prevalence of snoring in Japanese workers and the relationships between snoring and lifestyle-related diseases were investigated. Methods This was a retrospective, single-center, cross-sectional study. The results of a single year's medical examinations were investigated for 25,141 Japanese active office workers 20 to 59 years old. The presence and duration of snoring were investigated using a personal computer at a medical interview before the medical checkup. The snoring frequency was investigated for each gender. In addition, the relationships between snoring and hypertension, diabetes, and dyslipidemia were also analyzed. Results Men (21,774) were a mean 46±6 years old with a snoring prevalence of 43%. Women (3,367) were a mean 46±6 years old with a snoring prevalence of 20%. In men, snoring was an independent comorbid factor of hypertension and dyslipidemia. In particular, a long snoring vintage (multiple years) was an independent comorbid factor for hypertension [odds ratio (OR), 1.14; 95% confidence interval (CI), 1.05-1.24; p=0.002; and OR, 1.20; 95% CI, 1.07-1.34; p=0.001]. In women, snoring was not an independent comorbid factor for lifestyle-related diseases when adjusted for the age and body mass index. Conclusion Snoring was shown to be a frequent pathophysiology in active workers. It was a health indicator for active workers, and especially in men, intervention for snoring may reduce the risk of developing lifestyle-related diseases.


Asunto(s)
Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Hipertensión/epidemiología , Estilo de Vida , Ronquido/epidemiología , Adulto , Índice de Masa Corporal , Comorbilidad , Estudios Transversales , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Estudios Retrospectivos , Ronquido/fisiopatología , Adulto Joven
18.
19.
Stroke ; 51(9): 2664-2673, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32755347

RESUMEN

BACKGROUND: Anecdotal reports suggest fewer patients with stroke symptoms are presenting to hospitals during the coronavirus disease 2019 (COVID-19) pandemic. We quantify trends in stroke code calls and treatments at 3 Connecticut hospitals during the local emergence of COVID-19 and examine patient characteristics and stroke process measures at a Comprehensive Stroke Center (CSC) before and during the pandemic. METHODS: Stroke code activity was analyzed from January 1 to April 28, 2020, and corresponding dates in 2019. Piecewise linear regression and spline models identified when stroke codes in 2020 began to decline and when they fell below 2019 levels. Patient-level data were analyzed in February versus March and April 2020 at the CSC to identify differences in patient characteristics during the pandemic. RESULTS: A total of 822 stroke codes were activated at 3 hospitals from January 1 to April 28, 2020. The number of stroke codes/wk decreased by 12.8/wk from February 18 to March 16 (P=0.0360) with nadir of 39.6% of expected stroke codes called from March 10 to 16 (30% decrease in total stroke codes during the pandemic weeks in 2020 versus 2019). There was no commensurate increase in within-network telestroke utilization. Compared with before the pandemic (n=167), pandemic-epoch stroke code patients at the CSC (n=211) were more likely to have histories of hypertension, dyslipidemia, coronary artery disease, and substance abuse; no or public health insurance; lower median household income; and to live in the CSC city (P<0.05). There was no difference in age, sex, race/ethnicity, stroke severity, time to presentation, door-to-needle/door-to-reperfusion times, or discharge modified Rankin Scale. CONCLUSIONS: Hospital presentation for stroke-like symptoms decreased during the COVID-19 pandemic, without differences in stroke severity or early outcomes. Individuals living outside of the CSC city were less likely to present for stroke codes at the CSC during the pandemic. Public health initiatives to increase awareness of presenting for non-COVID-19 medical emergencies such as stroke during the pandemic are critical.


Asunto(s)
Isquemia Encefálica/epidemiología , Hemorragias Intracraneales/epidemiología , Accidente Cerebrovascular/epidemiología , Tiempo de Tratamiento/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Betacoronavirus , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/fisiopatología , Isquemia Encefálica/terapia , Estudios de Cohortes , Comorbilidad , Connecticut/epidemiología , Enfermedad de la Arteria Coronaria/epidemiología , Infecciones por Coronavirus/epidemiología , Dislipidemias/epidemiología , Servicios Médicos de Urgencia , Grupos Étnicos , Femenino , Humanos , Hipertensión/epidemiología , Renta , Seguro de Salud , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/fisiopatología , Hemorragias Intracraneales/terapia , Masculino , Pacientes no Asegurados , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Pandemias , Neumonía Viral/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/terapia , Trastornos Relacionados con Sustancias/epidemiología , Telemedicina , Trombectomía , Terapia Trombolítica
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