Reevaluating elevated HDL cholesterol levels in healthy older persons as a risk factor for various disease states.

This article reviews the role of high-density lipoprotein cholesterol (HDL-C) in the elderly population, questioning the established view that advocates the ubiquitous health benefits of HDL cholesterol. High levels of HDL-C have been found to be associated with an increased risk of debilitating fractures, dementia, and cardiovascular disease, predominantly affecting older men, through the use of large population-based studies such as the ASPREE trial and the UK Biobank. Possible mechanisms are closely linked to cholesterol crystallization and altered HDL particle function. These findings call for a refinement of the understanding of high-density lipoprotein cholesterol (HDL-C), which implies adjustments to clinical guidelines and risk assessment strategies in older populations.

Age-dependent association of metabolic dyslipidemia with clinical expression of hypertrophic cardiomyopathy.

BACKGROUND: Previous studies have shown that the clinical expression of hypertrophic cardiomyopathy (HCM) can be determined by obesity and metabolic syndrome. The present study aimed to investigate the association between triglyceride and high-density lipoprotein cholesterol (HDLC) level, the two dyslipidemia-related components of metabolic syndrome, and the incidence of HCM. We also explored an age-dependent association between them. METHODS: Individuals without previous HCM diagnosis who underwent a designated national health examination in 2009 were recruited. Individuals who used lipid-lowering medications within 1-year of the baseline were excluded. The outcome of interest was a newly diagnosed HCM. RESULTS: Our cohort consisted of 8,652,709 individuals (mean 46 years, 55.6% men). During the median 9.3 years of follow-up, 5932 (0.07%) individuals were newly diagnosed with HCM. There was a gradual increase in the incidence of HCM towards higher triglyceride and lower HDL-C levels (log-rank p < 0.001). When stratified by age, the incidence of HCM was highest in individuals aged ≥65 years, followed by those aged 40-64 and 20-39 years (0.22% vs. 0.07% vs. 0.03%, log-rank p < 0.001). In individuals aged 20-39 years, a higher triglyceride level was associated with a higher incidence of HCM (i.e., ≥200 vs. <100 mg/dL: adjusted hazard ratio 2.28, 95% confidence interval 1.89-2.75), whereas there was no significant association in older groups (p-for-interaction<0.001). Similarly, a lower HDL-C level was associated with a higher incidence of HCM, particularly in individuals aged 20-39 years (p-for-interaction = 0.001). CONCLUSIONS: High triglyceride and low HDL-C levels are associated with a higher incidence of HCM, particularly in young individuals.

Obicetrapib: Reversing the Tide of CETP Inhibitor Disappointments.

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

Visit-to-visit variability of metabolic parameters and progression of atherosclerosis in computed tomography: follow up of an asymptomatic cohort.

Background: We aimed to examine whether intra-individual variability in traditional risk factors affects the progression of atherosclerosis on subsequent coronary computed tomography angiography (CCTA). Methods: We conducted a retrospective cohort study using asymptomatic health examination cohort data from Haeundae Paik Hospital in Korea collected between 2010-2020. A total of 387 adults met the inclusion criteria of having at least two CCTAs without specific symptoms with an interval of more than one year and having completed three or more health examinations. Visit-to-visit variability was evaluated using the average real variability (ARV) of body mass index, waist circumference, systolic and diastolic blood pressure, and plasma glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol. Progression of coronary artery atherosclerosis was defined as worsening of coronary artery stenosis from baseline to final CCTA. ARV values for various metabolic parameters were stratified into quartiles, and hazard ratios (HRs) and 95% confidence intervals (CIs) for coronary atherosclerosis progression were analyzed using multiple Cox proportional hazards models. Results: There were 126 cases of coronary artery stenosis progression (32.56%) assessed using the Coronary Artery Disease Reporting and Data System during a mean follow up of 3.91 (range, 1-9) years. In the multivariate analysis comparing ARV quartiles for LDL-cholesterol after adjusting for covariates, individuals with higher variability showed an increased risk of stenosis progression: HR 2.23 (95% CI: 1.33-3.73) for the third quartile, HR 1.56 (95% CI: 0.91-2.66) for the fourth quartile (P for trend =0.005). Triglycerides also showed a significant linear trend (P for trend =0.04), and Q4 had a greater risk of stenosis progression (HR, 2.09; 95% CI: 1.24-3.52). Meanwhile, the risk of stenosis progression was significantly reduced as the ARV of HDL-cholesterol increased: HR 0.56 (95% CI: 0.35-0.89) for the third quartile, HR 0.47 (95% CI: 0.27-0.81) for the fourth quartile (P for trend =0.01). Conclusions: High variability in LDL-cholesterol and triglyceride was an independent predictor of coronary artery stenosis progression on subsequent CCTA in our cohort. This finding highlights the importance of maintaining stable state to effectively prevent the progression of coronary artery stenosis in clinical settings.

Effect of isotretinoin treatment on inflammatory and hematological parameters in patients with acne vulgaris.

PURPOSE: Although the inflammatory and anti-inflammatory effects of isotretinoin (ISO) treatment in patients with acne vulgaris have been discussed in the literature in recent years, no sensitive and specific marker has been found in studies so far. Neutrophil/HDL (high-density lipoprotein) (NHR), lymphocyte/HD L(LHR), platelet/HDL (PHR), and lymphocyte/monocyte (LMR) are new biomarkers related to inflammation. Triglyceride/HDL (TG/HDL), LDL/HDL, and total cholesterol/HDL have been shown to be cardiometabolic risk factors predicting both cardiovascular disease risk and metabolic risk, rather than just a simple dyslipidemia scale. To our knowledge, the relationship between these parameters and ISO treatment has never been studied before. We aimed to evaluate the immuno-inflammatory response of ISO treatment in patients with acne vulgaris with NHR, LHR, PHR, LMR, TG/HDL, LDL/HDL, and total cholesterol/HDL parameters. MATERIALS AND METHODS: In this study, 153 patients who received oral ISO treatment for at least 3 months with a diagnosis of moderate-severe acne vulgaris were evaluated retrospectively. Patients were given oral isotretinoin at a dose of 0.5-1 mg/kg. Pre and post-treatment leukocyte (WBC), neutrophil (NE), lymphocyte (LY), platelet (PLT), red cell distribution width (RDW), plateletcrit (PCT), neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), mean platelet volume (MPV), monocyte/lymphocyte (MLR), LMR, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, MHR, NHR, LHR, PHR, TG/HDL, total cholesterol/HDL, LDL/HDL parameters were evaluated. RESULTS: It was found that post-treatment WBC and MPV values increased statistically significantly; NLR, neutrophil, and PCT values, on the other hand, decreased significantly (p < 0.05). No statistically significant change was detected in PLR, MLR, LMR, MHR, NHR, LHR, PHR, lymphocyte, monocyte, platelet, and RDW parameters (p > 0.05). It was determined that post-treatment total cholesterol, triglyceride, VLDL, and LDL levels increased statistically significantly; however, the HDL level decreased significantly (p < 0.05). Levels of total cholesterol/HDL, TG/HDL, and LDL/HDL were also found to increase statistically significantly (p < 0.05). CONCLUSION: Our study suggests that the MPV and NLR ratio as biomarkers can be used as indicators of atherosclerosis-related inflammation due to ISO treatment, but the MHR, NHR, LHR, PHR, MLR, LMR ratios cannot be used. Moreover, we believe that the ratios of TG/HDL, LDL/HDL, and total cholesterol/HDL offer a new contribution as indicators of cardiovascular risk and systemic inflammation related to ISO treatment.

Effect of combining sST2/HDL-C ratio with risk factors of coronary heart disease on the detection of angina pectoris in Chinese: a retrospective observational study.

Background: Soluble suppression of tumorigenicity 2 (sST2), a member of the interleukin-1 receptor family, binds IL-33, preventing its interaction with membrane-bound form ST2 (ST2L), thereby blocking its protection against atherosclerosis. High-density lipoprotein cholesterol (HDL-C), a variety of lipoproteins with mean size of 8-10 nm and density of 1.063-1.21 g/mL, not only acts as lipid transporters that transport cholesterol reversely, but also carries a variety of proteins and microRNAs endowing it with the ability to prevent cardiovascular disease. Most studies on the relationship between sST2 and coronary heart disease (CHD) are limited to acute myocardial infarction (AMI). The present study set out to investigate the association between the sST2/HDL-C ratio and angina pectoris. Methods: A retrospective single-center cohort study was conducted and a total of 250 patients with chest pain that formed a convenience series, hospitalized between January 2018 and August 2020, were enrolled. Patients with AMI, acute and chronic heart failure, structural heart disease, renal insufficiency [estimate glomerular filtration rate (eGFR) <60 mL/min/1.73 m2], rheumatic immune diseases, malignant tumors and severe infections were excluded. Patients with missing data were also excluded. Two hundred and nine patients were finally enrolled. Levels of sST2, HDL-C and sST2/HDL-C ratio were measured and calculated after admission. The angina pectoris was diagnosed by combining clinical features, coronary angiography results and cardiac troponin I levels. The diagnosis value of sST2/HDL-C on angina pectoris was analyzed by binary logistic analysis and the receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) assesses. Results: Patients with stable angina pectoris (SAP) or unstable angina pectoris (UAP) accounted for a larger proportion (28.8% vs. 42.9%, P=0.035) in patients with the higher sST2/HDL-C ratio. Binary logistics regression showed that for every unit of sST2/HDL-C increase, the risk of angina pectoris increased by 38.8% (OR =1.388, P=0.018). By subgroup analysis, a stronger association was found in non-diabetic patients (OR =1.551, P=0.006), non-hypertension patients (OR =1.700, P=0.025), non-smokers (OR =1.527, P=0.049) and patients aged <65 y (OR =1.693, P=0.019). ROC curve showed that AUC was higher [0.643 (0.566, 0.719) vs. 0.618 (0.540, 0.696)] and the sensitivity of diagnosis increased significantly (84.0% vs. 49.3%) by combining sST2/HDL-C with risk factors of CHD. Conclusions: A higher ratio of sST2/HDL-C was associated with an increased risk of angina pectoris. sST2/HDL-C combined with CHD risk factors showed increased diagnostic value in identifying angina pectoris. Trial Registration: Clinical trial: ChiCTR-DDD-17013908.

Factors Associated With the Development of Dyslipidemia Among Pediatric Patients With Diabetes: A Single-centre-based Study.

OBJECTIVES: The prevalence of pediatric diabetes is increasing. Dyslipidemia is an important modifiable cardiovascular disease risk factor often present in children with diabetes. In this study, we evaluated the adherence to Diabetes Canada 2018 lipid screening guidelines in a pediatric diabetes program to determine the prevalence of dyslipidemia in youth with diabetes and to identify risk factors related to dyslipidemia. METHODS: This retrospective chart review included patients at McMaster Children's Hospital with diabetes (types 1 and 2), who were at least 12 years of age as of January 1, 2019. Extracted data included age, sex, family history of diabetes or dyslipidemia, date of diagnosis, body mass index, glycemia monitoring system used, lipid profile, glycated hemoglobin (A1C), and thyroid-stimulating hormone values at the time the lipid profile was measured. Statistical methods included descriptive statistics and logistic regression modelling. RESULTS: Of the 305 patients included, 61% had a lipid profile measured according to guidelines, 29% had lipid screening completed outside of the recommended window, and 10% had no lipid profile on record. Among screened patients, 45% had dyslipidemia, most commonly hypertriglyceridemia (35%). Dyslipidemia was highest amongst those with type 2 diabetes, obesity, older age, short duration of diabetes, higher A1C, and those who used capillary blood glucose for monitoring (p<0.05). CONCLUSIONS: A high proportion of patients were screened for dyslipidemia, but many outside the recommended window. Dyslipidemia is highly prevalent in this patient population and was associated with the presence of obesity, but 44% of patients without obesity also had dyslipidemia.

Benefits and Meaning of Lipids Profile in Relation to Oxidative Balance and Brain Morphology in Schizophrenia.

Schizophrenia is characterized by complex metabolic dysregulations and their consequences. Until now, numerous theories have explained its pathogenesis, using a spectrum of available technologies. We focused our interest on lipid profile-periphery high-density cholesterol level and lipoproteins in the human brain and compared magnetic resonance imaging (MRI) scans of patients with schizophrenia and the healthy group. Detailed analysis of biochemical parameters was performed using magnetic resonance spectroscopy. Our study aimed to reveal correlations between periphery high-density lipoproteins levels and lipoproteins in the brain, depicted in MRI scans, and parameters of peripheral oxidative stress expressed as paraoxonase. Patients with schizophrenia have decreased levels of high-density lipoproteins, low paraoxonase activity, and slightly raised sodium in the blood. Positive significant correlations between serum high-density cholesterol and anterior cingulate cortex, unique brain area for schizophrenia pathophysiology, MR spectroscopy signals, and diffusion have been revealed. To our knowledge, this is the first study to describe the effect of an anterior cingulate disorder on high-density cholesterol levels on the development of schizophrenia.

Metabolic Syndrome in Type 2 Diabetes Mellitus Patients: Prevalence, Risk Factors, and Associated Microvascular Complications.

Background The chronic macro and microvascular complications of diabetes mellitus pose serious health challenges. Metabolic syndrome (MetSy) is characterized by central obesity, glucose intolerance, hyperinsulinemia, low high-density lipoproteins (HDLs), high triglycerides (TGs), and hypertension. MetSy precedes or accompanies diabetes, and it has been linked to an increased risk of cardiovascular disease and premature death. This study aimed to estimate prevalence, identify risk factors, and evaluate associated microvascular complications among MetSy patients with type 2 diabetes mellitus (T2DM). Methodology Over the period of March 20, 2022, to March 31, 2023, a prospective cohort study was conducted at the Outdoor Clinic and Medicine Department of Sheikh Zayed Hospital, Rahim Yar Khan. Based on the International Diabetes Federation MetSy criteria, a total of 160 patients fulfilling the inclusion criteria were selected. A special proforma was used to obtain sociodemographic, clinical, and laboratory variables of MetSy in diabetic participants. Blood pressure and anthropometric measurements such as waist circumference (WC) and body mass index (BMI) were measured. Fasting venous blood was collected to analyze biochemical variables such as fasting blood sugar (FBS), TG, and high-density lipoprotein-cholesterol (HDL-C). The microvascular complications of T2DM were established using fundus ophthalmoscopy and neurological and kidney function assessments with the help of laboratory tests. These variables were matched between MetSy and no MetSy groups along with the presence or absence of diabetes microvascular complications. This information was analyzed based on these assessments and patient interviews. Results Of the 160 T2DM patients, the mean age was 52 years with a predominance of females (51.8%) in the 50-59-year age group (56.8%). The average BMI for females was 29.38 ± 0.54 kg/m², and 32 (20%) had obesity. Females exhibited a large WC of 93.52 ± 1.58 cm, and 48 of 83 females had reported diabetes microvascular complications. A significant p-value was observed for hypertension, high TG, low HDL-C, large WC, obesity, BMI, age, and female gender on comparing diabetics with metabolic syndrome (MetSy+) and those without metabolic syndrome (MetSy-). The prevalence of microvascular complications in T2DM patients with MetSy+ was 52.5% compared with 47.5% in MetSy-. The prevalence of diabetic retinopathy was 24.9% (95% confidence interval (CI) = 20.3%-29.6%), nephropathy was 16.8% (95% CI = 12.8%-20.7%), and neuropathy was 10.8% (95% CI = 7.4%-13.3%). Conclusions The prevalence of MetSy observed among T2DM patients was 65%, with married obese females in the 50-59-year age group being more likely to be affected than males. Hypertension, poor glycemic control, high TG, low HDL-C, and greater anthropometric waist measurements and BMI were additional risk factors that tended to increase the MetSy burden in T2DM. Diabetic retinopathy, nephropathy, and neuropathy were the most prevalent microvascular complications of diabetes, and immediate attention is needed to stop their detrimental effects. Longer uncontrolled diabetes, increasing age, and hypertension were independent predictors of microvascular complications. To further reduce the risks of complications that threaten healthy aging and prognosis for these patients, MetSy screening, health education, and better diabetic management are crucial.

High density lipoprotein-cholesterol is inversely associated with blood eosinophil counts among asthmatic adults in the USA: NHANES 2011-2018.

Background: A growing number of research strongly suggest that metabolic syndrome and dyslipidemia contribute to the establishment of a pro-inflammatory state in asthma, according to accumulating data. However, the majority of recent research has focused on the association between lipids and asthma in children and adolescents, with contradictory findings. Consequently, we analyzed the relationship between serum lipid and blood eosinophil counts using data from the NHANES in the USA. Methods: After screening the individuals from the 2011 to 2018 NHANES survey, a total of 2,544 out of 39156 participants were eligible for our study. The potential association was discussed using the linear regression model, XGBoost algorithm model, generalized additive model, and two-piecewise linear regression model. In addition, we ran stratified analysis to identify specific demographics. Results: After adjusting for covariates, the result indicated that blood eosinophil counts decreased by 45.68 (-68.56, -22.79)/uL for each additional unit of HDL-C (mmol/L). But serum LDL-C, total cholesterol or triglyceride was not correlated with blood eosinophil counts. Furthermore, we used machine learning of the XGBoost model to determine LDL-C, age, BMI, triglyceride, and HDL-C were the five most critical variables in the blood eosinophil counts. The generalized additive model and two-piecewise linear regression model were used to further identify linear relationship between the serum HDL-C and blood eosinophil counts. Conclusions: Our study elucidated a negative and linear correlation between serum HDL-C and blood eosinophil counts among American asthmatic adults, suggesting that serum HDL-C levels might be associated with the immunological condition of asthmatic adults. There was no correlation between serum LDL-C, total cholesterol, or triglyceride levels and blood eosinophil counts.

Neutrophil and monocyte ratios to high-density lipoprotein cholesterol as biomarkers in non-dipping hypertension.

OBJECTIVE: To investigate the level and significance of neutrophils to high-density lipoprotein cholesterol ratio (NHR) and monocytes to high-density lipoprotein cholesterol ratio (MHR) in patients with non-dipping hypertension. METHODS: A total of 228 patients were retrospectively enrolled in the study. They were divided into the dipping hypertension group (n = 76), the non-dipping hypertension group (n = 77) and the control group (n = 75) according to 24-h ambulatory blood pressure monitoring system (ABPM) recordings. NHR and MHR were calculated and compared statistically. Receiver operating characteristic (ROC) curve analyses were performed for NHR and MHR. Binary logistic regression analyses were introduced to investigate the independent associations of NHR and MHR with non-dipping hypertension. RESULTS: The NHR and MHR were significantly higher in the non-dipping hypertension group compared with the control group (p = .001, p < .001, respectively) and the dipping hypertension group (p = .039, p = .003, respectively). According to ROC curve analyses, NHR>73.35 and MHR>7.54 were regarded as high-risk groups. The area under the curve (AUC) was 0.642 (p < .001) for NHR and 0.718 (p < .001) for MHR. In multivariate analysis, compared with NHR, only MHR was still recognized as a marker for detection of non-dipping hypertension (odds ratio [OR]: 1.208, 95% confidence interval [CI]: 1.076 to 1.356, p = .001). CONCLUSIONS: Our data indicated that not NHR but MHR as new composite marker of inflammation and lipid metabolism may predict non-dipping hypertension to some extent.

Resistance training responses across race and ethnicity: a narrative review.

OBJECTIVES: Although the physiological mechanisms are not fully understood, race/ethnicity differences vary across cardiometabolic disease risk factors. Resistance training (RT) is an effective therapy for improving these risk factors in addition to body composition and physical performance. Thus, the purpose of this study was to determine the effects of RT over time on different racial and ethnic populations across cardiometabolic, body composition, and physical performance outcomes. DESIGN: Electronic databases Scopus and PubMed were searched for studies that compared different racial/ethnic responses to RT across cardiometabolic, body composition, and physical performance parameters. Inclusion criteria for the studies were as follows: (1) published in the English language; (2) compared races or ethnicities across cardiometabolic risk factors, body composition, or physical performance variables following a RT intervention; (3) included adults 18 years or older, and (4) included an isolated RT intervention group. RESULTS: Nine studies were found that met the inclusion criteria. The identified studies involved cohorts of White American (WA), South Asian, European Chilean, Mapuche Chilean, White Scottish, and African American (AA) males and females. Race/ethnicity differences following a RT intervention were found for fat-free mass preservation and changes in blood pressure, endothelial function, brachial artery stiffness, cardiac autonomic function, inflammatory and oxidative stress markers, insulin sensitivity, body mass index, waist circumference, % body fat, and muscular strength. With the exception of changes in systolic blood pressure and brachial artery stiffness, AAs consistently showed more beneficial adaptations compared to WAs to RT across studies. CONCLUSION: Race and ethnicity play a role in how adults adapt to chronic RT. These data may aid in better understanding the social, biological, and environmental factors that likely influenced these racial/ethnic differences in response to RT, assist in creating tailored exercise prescriptions for various racial/ethnic populations, and inform policies for determining resource allocations to address health inequities.

A commentary on the paper, 'Development and validation of a novel automatable assay for cholesterol efflux capacity'.

The determination of functionality or quality of high-density lipoproteins (HDL) is assuming a central stage in the prediction of cardiovascular diseases (CVD). To assess HDL quality, several attempts have been made to develop an automated, cost-effective cholesterol efflux capacity (CEC) system with few operational steps that might be used in clinical settings for large throughput testing. The work of Dr. Ohkawa and co-workers seems to address this issue and provide a solution for the same (Bioscience Reports (2023), 43 BSR20221519, https://doi.org/10.1042/BSR20221519). Earlier work from the author's lab utilized a radioisotope and cell-free CEC assay known as the immobilized liposome-bound gel beads (ILGs) method. However, this assay required a centrifugation step to separate the cells and was not suitable for automation. To overcome these limitations, two very important changes were made: (i) magnetic beads were used instead of gel beads that allowed them to avoid the centrifugation process that would allow ease of setting up an autonomous analyzer; (ii) porous magnetic beads were coated with liposomes containing fluorescently tagged cholesterol instead radiolabeled cholesterol. These two changes can be considered not only significant but also novel as they were highly suitable for CEC testing. The authors reported the successful development of a simple immobilized liposome-based magnetic beads (ILMs) automated system to measure CEC, which provided both consistent performance and satisfactory correlation with the other methods. Thus, we feel the present study will open newer avenues for measuring the quality of HDL in addition to the quantity of HDL-cholesterol in clinical settings in a more robust way.

Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants.

BACKGROUND: High-density lipoprotein cholesterol's (HDL-C) long-held status as a cardiovascular disease (CVD) preventative has been called into question. Most of the evidence, however, focused on either the risk of death from CVD, or on single time point level of HDL-C. This study aimed to determine the association between changes in HDL-C levels and incident CVD in individuals with high baseline HDL-C levels (≥ 60 mg/dL). METHODS: 77,134 people from the Korea National Health Insurance Service-Health Screening Cohort were followed for 517,515 person-years. Cox proportional hazards regression was used to evaluate the association between change in HDL-C levels and the risk of incident CVD. All participants were followed up until 31 December 2019, CVD, or death. RESULTS: Participants with the greatest increase in their HDL-C levels had higher risks of CVD (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.05-1.25) and CHD (aHR 1.27, CI 1.11-1.46) after adjusting for age, sex, household income, body mass index, hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol consumption, moderate-to-vigorous physical activity, Charlson comorbidity index, and total cholesterol than those with the lowest increase in HDL-C levels. Such association remained significant even among participants with decreased low-density lipoprotein cholesterol (LDL-C) levels for CHD (aHR 1.26, CI 1.03-1.53). CONCLUSIONS: In people with already high HDL-C levels, additional increases in HDL-C levels may be associated with an increased risk of CVD. This finding held true irrespective of the change in their LDL-C levels. Increasing HDL-C levels may lead to unintentionally elevated risk of CVD.

Effects of dietary counselling on lipid profile among liposuction patients.

Objectives: To observe the effects of dietary counselling on weight management after liposuction. METHODS: The case-control study was conducted at the La Chirurgie Cosmetic Surgery Centre and Hair Transplant Institute, F-8/3, Islamabad, Pakistan, from January to July 2018, and comprised adults (100) of either gender undergoing liposuction and/or abdominoplasty who were followed for three months in the postoperative period. The subjects were divided into dietary-counselled group A, which received diet plans, and control group B, which followed up without any dietary advice. Lipid profile was done at baseline and three months post-liposuction. Data was analysed using SPSS 20. RESULTS: Of the 100 subjects enrolled, 83(83%) completed the study; 43(51.8%) in group A and 40(48.2%) in group B. Overall, there were 19(22.9%) males, 64(77.1%) females, and 55(66.3%) were aged <40 years, while 28(33.7%) were aged ≥40 years. Intra-group improvement was significant for total cholesterol, low-density lipoprotein, and triglycerides for both the groups (p<0.05). The change for very low-density lipoprotein in group B was not significant (p>0.05). Change in high-density lipoprotein was for the better in group A, while it decreased in group B and the change in both cases was significant (p<0.05). Inter-group differences were not significant (p>0.05) except for total cholesterol (p<0.05). CONCLUSIONS: Liposuction alone resulted in the improvement of lipid profile, while dietary intervention resulted in better values with respect to very low-density lipoprotein and high-density lipoprotein.

Associations between serum high-density lipoprotein cholesterol levels and cause-specific mortality in a general population of 345 000 men and women aged 20-79 years.

BACKGROUND: Benefits of elevated high-density lipoprotein cholesterol (HDL-C) levels are challenged by reports demonstrating U-shaped relations between HDL-C levels and all-cause mortality; the association with cause-specific mortality is less studied. METHODS: A total of 344 556 individuals (20-79 years, 52 % women) recruited from population-based health screening during 1985-2003 were followed until the end of 2018 for all-cause and cause-specific mortality by serum HDL-C level at inclusion of <30, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, 90-99 and >99 mg/dl (< 0.78, 0.78-1.01, 1.04-1.27, 1.30-1.53, 1.55-1.79, 1.81-2.04, 2.07-2.31, 2.33-2.56, >2.56 mmol/L). Hazard ratios (HRs) were adjusted for sex, age, calendar period, smoking, total cholesterol, triglycerides, systolic blood pressure, physical activity, educational length, body mass index and ill health. RESULTS: During a mean follow-up of 22 years, 69 505 individuals died. There were U-shaped associations between HDL-C levels and all-cause, cancer and non-cardiovascular disease/non-cancer mortality (non-CVD/non-cancer), whereas for CVD there was increased risk of death only at lower levels. With HDL-C stratum 50-59 mg/dl (1.30-1.53 mmol/L) as reference, HRs [95% confidence intervals (CIs)] for levels >99 mg/dl (>2.56 mmol/L) were 1.32 (1.21-1.43), 1.05 (0.89-1.24), 1.26 (1.09-1.46) and 1.68 (1.48-1.90) for all-cause, CVD, cancer and non-CVD/non-cancer mortality, respectively. For HDL-C levels <30 mg/dl (0.78 mmol/L), the corresponding HRs (95% CIs) were 1.30 (1.24-1.36), 1.55 (1.44-1.67), 1.14 (1.05-1.23) and 1.19 (1.10-1.29). The mortality from alcoholic liver disease, cancers of mouth-oesophagus-liver, chronic liver diseases, chronic obstructive pulmonary disease, accidents and diabetes increased distinctly with increasing HDL-C above the reference level. HDL-C levels lower than the reference level were mainly associated with increased mortality of ischaemic heart disease (IHD), other CVDs, stomach cancer and diabetes. CONCLUSIONS: Higher HDL-C levels were associated with increased mortality risk of several diseases which also have been associated with heavy drinking, and lower HDL-C levels were associated with increased mortality from IHD, other CVDs, gastric cancer and diabetes.

Assessing the Mediterranean diet adherence during pregnancy: Practical considerations based on the associations with cardiometabolic risk.

OBJECTIVE: The aim of the present study was to provide practical considerations for assessing MD adherence during pregnancy based on the association with cardiometabolic risk. STUDY DESIGN: Longitudinal study. MAIN OUTCOME MEASURES: A food frequency questionnaire was fulfilled by 152 pregnant women at the 16th gestational week (g.w.). We calculated the Mediterranean Food Pattern (MFP), the MD Scale (MDScale), the Short MD questionnaire (SMDQ), the MD Score (MedDietScore), and the MD scale for pregnant women (MDS-P). The cardiometabolic risk score consisted of pre-pregnancy body mass index, blood pressure, glucose, triglycerides, and high-density lipoprotein-cholesterol (at 16th and 34th g.w.). RESULTS: Multiple linear regression models showed that the MFP, the MedDietScore, and the SMDQ were associated with lower cardiometabolic risk at the 16th and 34th g.w. (ß's: -0.193 to -0.415, all p < 0.05); and the MDS-P at the 34th g.w. (ß = -0.349, p < 0.01). A comparison of these models with the J test showed that the MFP and the MedDietScore outperformed the SMDQ at the 16th g.w. (p's < 0.05); while the MedDietScore outperformed the SMDQ, MFP, and MDS-P (p's < 0.05) at the 34th g.w. Receiver-Operating-Characteristic-derived thresholds for the MFP, MedDietScore and MDS-P indices were 21, 30, and 6 points, respectively, to identify women with high cardiometabolic risk. CONCLUSION: The MFP and MedDietScore are recommended to assess MD adherence during pregnancy, as these showed the strongest associations with cardiometabolic risk. Our validated thresholds might assist in the detection of poor dietary patterns during pregnancy.

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

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

Monocyte-to-high-density lipoprotein cholesterol ratio predicts early neurological deterioration and hemorrhagic transformation after intravenous thrombolytic therapy in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the predictive value of monocyte-to-high-density lipoprotein cholesterol ratio (MHR) for early neurological deterioration (END) and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received IVT in Hefei Second People's Hospital from May 2020 to January 2022 were retrospectively enrolled. Blood collection was completed and MHR was calculated before intravenous thrombolysis. END was defined as an increase of ≥2 from the baseline in the National Institutes of Health Stroke Scale (NIHSS) score or ≥1 from the baseline in motor function score at any time within 7 d after admission. HT was defined as intracranial hemorrhage newly found by CT/MRI within 24 h after intravenous thrombolysis. Multivariate logistic regression analysis was used to determine the independent predictors of END and HT, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of MHR for END and HT. Results:A total of 186 patients with AIS treated with IVT were included, of which 50 (26.9%) had END and 31 (16.7%) had HT. The median MHR was 0.43. The MHR in the END group was significantly higher than that in the non-END group (0.49 vs. 0.40; P=0.008), and the MHR in the HT group was significantly higher than that in the non-HT group (0.52 vs. 0.40; P=0.013). All patients were divided into 4 groups (MHR1, MHR2, MHR3 and MHR4) according to the MHR quartile from low to high. Multivariate logistic regression analysis showed that after adjusting for confounding factors, taking MHR1 as a reference, MHR3 (odds ratio [ OR] 6.317, 95% confidence interval [ CI] 1.465-27.237; P=0.013) and MHR4 ( OR 8.064, 95% CI 1.910-34.051; P=0.005) were the significant independent predictors of END; Taking MHR1 as a reference, MHR4 ( OR 5.147, 95% CI 1.194-22.182; P=0.028) was the significant independent predictor of HT. The ROC curve analysis showed that the area under the curve of MHR for predicting END was 0.628 (95% CI 0.554-0.698; P=0.008). When the optimal MHR cutoff value was 0.41, its sensitivity and specificity for predicting END was 74.0% and 53.7% respectively. The area under the curve of MHR for predicting HT was 0.642 (95% CI 0.569-0.711; P=0.013). When the best cutoff value was 0.44, the sensitivity and specificity of MHR for predicting HT were 77.4% and 58.1% respectively. Conclusion:Higher MHR is a risk factor for END and HT after intravenous thrombolysis in patients with AIS, but the predictive value of MHR for END and HT is limited.

Evaluation of the relationship between monocyte to high-density lipoprotein cholesterol ratio and thrombus burden in patients with deep vein thrombosis

SUMMARY OBJECTIVE: The purpose of this study was to evaluate monocyte count and high-density lipoprotein cholesterol levels and their ratio (monocyte/high-density lipoprotein ratio) in patients with deep venous thrombosis as well as to determine whether this ratio at the time of diagnosis can be an indicator of thrombus burden in terms of thrombus location in deep venous thrombosis. METHODS: We retrospectively analyzed the patient's diagnosis of deep venous thrombosis confirmed with venous Doppler ultrasound, using a database query for outpatients between 2018 and 2022. Of 378 patients included, blood count results at the time of diagnosis were available for 356. We recruited 300 age- and sex-matched patients with appropriate blood counts, without a diagnosis of deep venous thrombosis, as the control group, by querying the outpatient clinic database. The monocyte/high-density lipoprotein ratio was computed from the ratio of monocyte count to high-density lipoprotein-C. Patients were categorized based on the level of thrombus and the number of vein segments involved as evidenced by Doppler ultrasound findings. RESULTS: The serum level of monocyte/high-density lipoprotein ratio was significantly higher in the patient group compared to the control group (p<0.01). Patients with proximal deep venous thrombosis had a higher mean monocyte/high-density lipoprotein ratio (19.6±5.1 vs. 17.1±5.5; p<0.01) than patients with distal deep venous thrombosis. Monocyte/high-density lipoprotein ratio increased with the number of vein segments involved (p<0.01). CONCLUSION: Monocyte/high-density lipoprotein ratio is significantly elevated in patients with deep venous thrombosis when compared to the control group. Monocyte/high-density lipoprotein ratio levels were correlated with disease burden reflected by thrombus location and the number of vein segments involved in deep venous thrombosis patients.