Nuevo índice aterogénico para la predicción de aterosclerosis carotídea basado en la ratio proteína C reactiva no ultrasensible/HDL / New atherogenic index for the prediction of carotid atherosclerosis based on the non-ultrasensitive c-reactive protein/HDL ratio

Introducción La valoración del riesgo cardiovascular aparece en las guías clínicas como medida de prevención de enfermedades cardiovasculares, cuya etiología fundamental es la arteriosclerosis. Una de las herramientas que se utiliza para estimar el riesgo en práctica clínica son los índices aterogénicos (IA), cocientes entre fracciones lipídicas con rangos de referencia bien establecidos. A pesar de su uso extendido, existe todavía información limitada sobre su utilidad clínica. En los últimos años, algunas investigaciones han reforzado el papel de la inflamación en la etiología y cronicidad del proceso aterosclerótico. La inclusión de parámetros inflamatorios en el cálculo de IA podría mejorar su rendimiento diagnóstico en la detección de arteriosclerosis. Nos propusimos evaluar un nuevo IA en forma de ratio entre los valores de proteína C reactiva (PCR) no ultrasensible y las cifras de colesterol unido a lipoproteínas de alta densidad (HDL). Métodos Se incluyeron en el estudio 282 pacientes, asintomáticos, y sin historia de enfermedad cardiovascular. Se realizó en todos ellos analítica con perfil lipídico y PCR, y en el plazo inferior a un mes, ecografía carotídea para evaluar la presencia de ateromatosis. El nuevo IA se estableció como el cociente entre el valor de PCR no ultrasensible en mg/dL (multiplicado por 100) y el valor de HDL en mg/dL. Se comparó con los índices de Castelli I y II, y el índice aterogénico del plasma. La curva ROC determinó que el punto de corte óptimo del nuevo IA fue valor=1, con un área bajo la curva de 0,678 (IC 95% 0,60-0,75; p<0,001). ResultadosLa edad media de la muestra fue 60,4±14,5 años. Un total de 118 pacientes (41,8% del total) tenían arteriosclerosis carotídea. Al evaluar el rendimiento diagnóstico de los IA, encontramos que la ratio PCR·100/HDL mostró los valores más elevados de sensibilidad y valor predictivo positivo (0,73 y 0,68, respectivamente) ... Conclusiones... (AU)

Introduction Current guidelines recommend cardiovascular risk assessment as a preventive measure for cardiovascular diseases, whose fundamental etiology is arteriosclerosis. One of the tools used to estimate risk in clinical practice are atherogenic indices (AI), ratios between lipid fractions with well-established reference ranges. Despite its widespread use, there is still limited information on its clinical utility. In recent years, some research has reinforced the role of inflammation in the etiology and chronicity of the atherosclerotic process. The inclusion of inflammatory parameters in the AI calculation could improve its diagnostic performance in the detection of arteriosclerosis. We sought to evaluate a new AI as a ratio between C-reactive protein (CRP) values and high-density lipoprotein cholesterol (HDL) values. Methods A total of 282 asymptomatic patients with no history of cardiovascular disease were included in the study. Laboratory tests with lipid profile and CRP, and carotid ultrasound to assess the presence of atheromatosis were performed in all of them. The new AI is established as the ratio between non-ultrasensitive CRP value in mg/dL (multiplied by 100) and HDL value in mg/dL. It was compared with the Castelli I and II indices, and the plasma atherogenic index. The optimal cut-off point of the new AI was value=1 as determined by ROC curve, with an area under the curve of 0.678 (95% CI 0.60-0.75; p<0.001).Results Mean age of patients was 60.4±14.5 years. A total of 118 patients (41.8% of total) had carotid arteriosclerosis. When evaluating the diagnostic performance of different AIs, we found that CRP·100/HDL ratio showed the highest values of sensitivity and positive predictive value (0.73 and 0.68, respectively) compared to the Castelli I and II indices, and the plasma atherogenic index. ... Conclusions ... (AU)

New atherogenic index for the prediction of carotid atherosclerosis based on the non-ultrasensitive c-reactive protein/HDL ratio. / Nuevo índice aterogénico para la predicción de aterosclerosis carotídea basado en la ratio proteína C reactiva no ultrasensible/HDL.

INTRODUCTION: Current guidelines recommend cardiovascular risk assessment as a preventive measure for cardiovascular diseases, whose fundamental etiology is arteriosclerosis. One of the tools used to estimate risk in clinical practice are atherogenic indices (AI), ratios between lipid fractions with well-established reference ranges. Despite its widespread use, there is still limited information on its clinical utility. In recent years, some research has reinforced the role of inflammation in the etiology and chronicity of the atherosclerotic process. The inclusion of inflammatory parameters in the AI calculation could improve its diagnostic performance in the detection of arteriosclerosis. We sought to evaluate a new AI as a ratio between C-reactive protein (CRP) values and high-density lipoprotein cholesterol (HDL) values. METHODS: A total of 282 asymptomatic patients with no history of cardiovascular disease were included in the study. Laboratory tests with lipid profile and CRP, and carotid ultrasound to assess the presence of atheromatosis were performed in all of them. The new AI is established as the ratio between non-ultrasensitive CRP value in mg/dL (multiplied by 100) and HDL value in mg/dL. It was compared with the Castelli I and II indices, and the plasma atherogenic index. The optimal cut-off point of the new AI was value=1 as determined by ROC curve, with an area under the curve of 0.678 (95% CI 0.60-0.75; p<0.001). RESULTS: Mean age of patients was 60.4±14.5 years. A total of 118 patients (41.8% of total) had carotid arteriosclerosis. When evaluating the diagnostic performance of different AIs, we found that CRP·100/HDL ratio showed the highest values of sensitivity and positive predictive value (0.73 and 0.68, respectively) compared to the Castelli I and II indices, and the plasma atherogenic index. It was also the only predictor of carotid atheromatosis both when considering its values quantitatively (with OR 1.4 [95% CI 1.1-1.7]; p=0.005), and qualitatively (with OR 2.9 [95% CI 1.5-5.5]; p<0.001) in patients with a CRP·100/HDL ratio>1. CONCLUSIONS: The new PCR·100/HDL index showed the best diagnostic performance in the detection of carotid atheromatosis compared to other classic AIs in this Spanish population of asymptomatic patients.

La ingesta materna de fructosa modula el metabolismo del colesterol en respuesta a una dieta occidental en la descendencia / Maternal fructose intake modulates cholesterol metabolism in response to a western diet in the offspring

Fructose consumption has increased during the last decades, while a simultaneous rise in the incidence of pathologies such as type 2 diabetes and metabolic syndrome has also taken place. Although there is evidence that fructose can cause alterations in the offspring related to the development of the aforementioned diseases, exposure to fructose during pregnancy is not contraindicated for women. This effect is explained by the concept of foetal programming, which suggests that changes that occur during the embryogenic and foetal stages are permanent in the adult, due to maternal health, diet and other environmental factors.Therefore, the effect of fructose on cholesterol metabolism in the offspring of mothers fed with or without fructose during gestation was studied. In addition, the progeny also received different diets: fructose (with and without supplementation of cholesterol) or tagatose solutions.Tagatose increased non-HDL cholesterol in the offspring of water-fed mothers, whereas fructose consumption during gestation dampened this effect, indicating foetal programming. In addition, fructose and tagatose feeding increased atherogenic indices by decreasing HDL-cholesterol concentration and increasing triglycerides levels.On the other hand, the addition of cholesterol to fructose consumption caused an increase in total cholesterol and a change in its distribution: higher concentration of non-HDL cholesterol and lower concentration of HDL cholesterol, independently of maternal feeding. This also caused an increase in atherogenic indices.Ultimately, the results indicate that cholesterol metabolism is influenced by both maternal fructose consumption, and the subsequent intake of fructose (alone or in combination with cholesterol) and tagatose in the offspring. (AU)

El consumo de fructosa ha aumentado en las últimas décadas, en paralelo a la incidencia de síndrome metabólico y diabetes tipo 2. Múltiples evidencias sugieren que la ingesta materna de fructosa provoca alteraciones en la descendencia favoreciendo el desarrollo de síndrome metabólico. Sin embargo, la ingesta de fructosa durante el embarazo no está contraindicada. Este efecto se produce a través de la programación fetal, según la cual cambios como la dieta materna y ambientales durante las etapas embrionaria y fetal conducen a alteraciones en la etapa adulta de la descendencia. Con estos antecedentes, estudiamos el efecto de la ingesta materna de fructosa sobre el metabolismo del colesterol en la descendencia. Además, la progenie también se sometió a diferentes tratamientos dietéticos: fructosa, fructosa con colesterol y tagatosa.La tagatosa provocó un aumento del colesterol no HDL en la descendencia de madres control, mientras que el consumo materno de fructosa amortiguó este efecto, sugiriendo una programación fetal. Además, la suplementación con fructosa y con tagatosa provocaron un aumento de los índices aterogénicos disminuyendo la concentración de colesterol HDL y aumentando la de triglicéridos.Además, la suplementación con colesterol y fructosa provocó un aumento en los niveles plasmáticos de colesterol total y colesterol no HDL y una disminución del colesterol HDL, independientemente de la alimentación materna, provocando un aumento de los índices aterogénicos.En definitiva, los resultados indican que el metabolismo del colesterol está influenciado tanto por el consumo materno de fructosa como por los tratamientos dietéticos posteriores de la descendencia: fructosa, fructosa con colesterol y tagatosa. (AU)

A New Predictor of Obstructive Coronary Artery Ectasia in Patients with Non-ST-Elevation Acute Coronary Syndrome: The Atherogenic Index of Plasma / Un nuevo predictor de ectasia obstructiva de la arteria coronaria en pacientes con síndrome coronario agudo sin elevación del segmento ST: el índice aterogénico del plasma

Introduction: Coronary artery ectasia (CAE) is one of the uncommon cardiovascular disorders with a clinical spectrum ranging from asymptomatic cases to myocardial infarction. Atherosclerosis plays a pivotal role in the pathogenesis of CAE. Recently, it has been determined that the atherogenic index of plasma (AIP) is a strong predictive marker for atherosclerosis. The aim of this study was to investigate whether there is a relationship between obstructive CAE and AIP in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Materials and methods: In this retrospective study, hospital electronic patient records were retrospectively examined. A total of 213 NSTE-ACS patients were included in the study. Patients were divided into two groups according to non-obstructive and obstructive CAE. The AIP value was compared between groups and regression analysis evaluated whether it is an indicator to predict the risk of obstructive CAE. Results: The AIP value was found to be numerically and statistically significant in the obstructive CAE group compared to the non-obstructive CAE group. The multivariate logistic regression analysis identified AIP as a predictor of obstructive CAE in NSTE-ACS patients in the receiver operating curve analysis, AIP values above 0.33 had 90% sensitivity and 68% specificity to predict obstructive CAE in NSTE-ACS patients. Conclusions: AIP values were increased in the presence of obstructive CAE in NSTE-ACS patients. Our findings suggest that AIP may be involved in the pathogenesis of obstructive CAE. (AU)

Introducción: La ectasia arterial coronaria (EAC) es uno de los trastornos cardiovasculares poco frecuentes con un espectro clínico que va desde casos asintomáticos hasta infarto de miocardio. La aterosclerosis juega un papel fundamental en la patogenia de la CAE. Recientemente, se ha determinado que el índice aterogénico del plasma (AIP) es un fuerte marcador predictivo de aterosclerosis. El objetivo de este estudio fue investigar si existe una relación entre el CAE obstructivo y la PAI en pacientes con síndrome coronario agudo sin elevación del segmento ST (SCASEST). Materiales y métodos: En este estudio retrospectivo, se examinaron retrospectivamente las historias clínicas electrónicas de los pacientes. Se incluyeron en el estudio un total de 213 pacientes con SCASEST. Los pacientes se dividieron en dos grupos según el CAE obstructivo y no obstructivo. El valor de AIP se comparó entre grupos y el análisis de regresión evaluó si es un indicador para predecir el riesgo de EAC obstructivo. Resultados: Se encontró que el valor AIP era numérica y estadísticamente significativo en el grupo CAE obstructivo en comparación con el grupo CAE no obstructivo. El análisis de regresión logística multivariable identificó a la AIP como predictor de EAC obstructiva en pacientes con SCASEST en el análisis de la curva operativa del receptor, valores de AIP superiores a 0,33 tenían una sensibilidad del 90 % y una especificidad del 68 % para predecir EAC obstructiva en pacientes con SCASEST. Conclusiones: Los valores de AIP se incrementaron en presencia de EAC obstructivo en pacientes con SCASEST. Nuestros hallazgos sugieren que AIP puede estar involucrado en la patogenia de CAE obstructivo. (AU)

La ingesta materna de fructosa modula el metabolismo del colesterol en respuesta a una dieta occidental en la descendencia / Maternal fructose intake modulates cholesterol metabolism in response to a western diet in the offspring

El consumo de fructosa ha aumentado en las últimas décadas, en paralelo a la incidencia de síndrome metabólico y diabetes tipo 2. Múltiples evidencias sugieren que la ingesta materna de fructosa provoca alteraciones en la descendencia favoreciendo el desarrollo de síndrome metabólico. Sin embargo, la ingesta de fructosa durante el embarazo no está contraindicada. Este efecto se produce a través de la programación fetal, según la cual cambios como la dieta materna y ambientales durante las etapas embrionaria y fetal conducen a alteraciones en la etapa adulta de la descendencia. Con estos antecedentes, estudiamos el efecto de la ingesta materna de fructosa sobre el metabolismo del colesterol en la descendencia. Además, la progenie también se sometió a diferentes tratamientos dietéticos: fructosa, fructosa con colesterol y tagatosa.La tagatosa provocó un aumento del colesterol no HDL en la descendencia de madres control, mientras que el consumo materno de fructosa amortiguó este efecto, sugiriendo una programación fetal. Además, la suplementación con fructosa y con tagatosa provocaron un aumento de los índices aterogénicos disminuyendo la concentración de colesterol HDL y aumentando la de triglicéridos.Además, la suplementación con colesterol y fructosa provocó un aumento en los niveles plasmáticos de colesterol total y colesterol no HDL y una disminución del colesterol HDL, independientemente de la alimentación materna, provocando un aumento de los índices aterogénicos.En definitiva, los resultados indican que el metabolismo del colesterol está influenciado tanto por el consumo materno de fructosa como por los tratamientos dietéticos posteriores de la descendencia: fructosa, fructosa con colesterol y tagatosa. (AU)

Fructose consumption has increased during the last decades, while a simultaneous rise in the incidence of pathologies such as type 2 diabetes and metabolic syndrome has also taken place. Although there is evidence that fructose can cause alterations in the offspring related to the development of the aforementioned diseases, exposure to fructose during pregnancy is not contraindicated for women. This effect is explained by the concept of foetal programming, which suggests that changes that occur during the embryogenic and foetal stages are permanent in the adult, due to maternal health, diet and other environmental factors.Therefore, the effect of fructose on cholesterol metabolism in the offspring of mothers fed with or without fructose during gestation was studied. In addition, the progeny also received different diets: fructose (with and without supplementation of cholesterol) or tagatose solutions.Tagatose increased non-HDL cholesterol in the offspring of water-fed mothers, whereas fructose consumption during gestation dampened this effect, indicating foetal programming. In addition, fructose and tagatose feeding increased atherogenic indices by decreasing HDL-cholesterol concentration and increasing triglycerides levels.On the other hand, the addition of cholesterol to fructose consumption caused an increase in total cholesterol and a change in its distribution: higher concentration of non-HDL cholesterol and lower concentration of HDL cholesterol, independently of maternal feeding. This also caused an increase in atherogenic indices.Ultimately, the results indicate that cholesterol metabolism is influenced by both maternal fructose consumption, and the subsequent intake of fructose (alone or in combination with cholesterol) and tagatose in the offspring. (AU)

Marcadores aterogénicos y de inflamación en pacientes con diabetes mellitus tipo 2 / Inflammation and atherogenic markers in patients with type 2 diabetes mellitus

La diabetes mellitus tipo 2 (DMT2) es una enfermedad caracterizada por un estado inflamatorio crónico en la que algunos marcadores como las concentraciones de lípidos se han encontrado frecuentemente alterados. Se han descrito otros marcadores de inflamación alterados como las interleucinas 6, 8 y el factor de necrosis tumoral, sin embargo, existe poca información acerca del comportamiento del índice neutrófilo/linfocito (INL), la relación plaquetas/linfocitos (RPL) y el índice monocitos/linfocitos (IML), los coeficientes lipídicos y el índice aterogénico en pacientes con DMT2. Objetivo: Describir los parámetros aterogénicos y de inflamación en un grupo de pacientes con DMT2. Materiales y métodos: Se incluyeron y analizaron los antecedentes clínicos (antecedentes de la enfermedad, comorbilidad, tabaquismo y otras variables relevantes), así como parámetros hematológicos, bioquímicos y antropométricos de 42 pacientes, y se calcularon y evaluaron los coeficientes aterogénicos e índices de inflamación. Resultados: Se encontraron concentraciones elevadas de citocinas proinflamatorias IL-6 e IL-8, factor de necrosis tumoral-α y elevado INL. El 88% de los pacientes fueron clasificados como de alto riesgo de acuerdo con el índice aterogénico. Los pacientes exfumadores exhibieron niveles menores de IL-8 y niveles más altos de INL comparados con los que nunca han fumado. Conclusión: La evaluación de marcadores aterogénicos y de inflamación tales como el índice aterogénico, IL-8 y la INL permiten identificar a un subgrupo de pacientes con un alto riesgo de complicaciones graves y mortalidad. (AU)

Type two diabetes mellitus (T2DM) is characterized by a chronic inflammation status. Altered markers such as lipid concentrations are usually found in this disease. Elevated inflammation markers have been described such as cytokines (interleukin 6, tumour necrosis factor-alpha, and IL-8). However, there is a lack of information about the behaviour of the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), lipid coefficients, and atherogenic index in T2DM. Objective: To describe the atherogenic and inflammation parameters in a group of patients with T2DM. Materials and methods: 42 patients with T2DM were included, all patients were surveyed on clinic history (disease history, comorbidity, smoking, and other relevant variables), measurements of haematological, biochemical, and anthropometric parameters were taken and atherogenic coefficients and inflammation ratios were calculated. Results: Inflammation markers such as interleukin 6 and 8, necrosis tumour factor, and NLR were elevated. Of the patients, 88% were classified as high risk according to the atherogenic index. Former smokers had lower levels of IL-8 and higher NLR than non-smokers. Conclusion: The atherogenic and inflammation markers such as atherogenic index, IL-8, and NLR make it possible to identify a subgroup of patients that are at risk of severe complications and mortality. (AU)

Inflammation and atherogenic markers in patients with type 2 diabetes mellitus. / Marcadores aterogénicos y de inflamación en pacientes con diabetes mellitus tipo 2.

Type two diabetes mellitus (T2DM) is characterized by a chronic inflammation status. Altered markers such as lipid concentrations are usually found in this disease. Elevated inflammation markers have been described such as cytokines (interleukin 6, tumour necrosis factor-alpha, and IL-8). However, there is a lack of information about the behaviour of the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), lipid coefficients, and atherogenic index in T2DM. OBJECTIVE: To describe the atherogenic and inflammation parameters in a group of patients with T2DM. MATERIALS AND METHODS: 42 patients with T2DM were included, all patients were surveyed on clinic history (disease history, comorbidity, smoking, and other relevant variables), measurements of haematological, biochemical, and anthropometric parameters were taken and atherogenic coefficients and inflammation ratios were calculated. RESULTS: Inflammation markers such as interleukin 6 and 8, necrosis tumour factor, and NLR were elevated. Of the patients, 88% were classified as high risk according to the atherogenic index. Former smokers had lower levels of IL-8 and higher NLR than non-smokers. CONCLUSION: The atherogenic and inflammation markers such as atherogenic index, IL-8, and NLR make it possible to identify a subgroup of patients that are at risk of severe complications and mortality.

Vulnerabilidad cardiometabólica por adiposidad corporal e índices aterogénicos en el posparto a corto plazo

RESUMEN Introducción: Acumulaciones excesivas de tejido adiposo constituyen una amenaza para la salud cardiometabólica, el estudio en la mujer orientaría mejor sobre su estado metabólico. Objetivo: Identificar asociaciones entre estados de vulnerabilidad cardiometabólica e índices aterogénicos en el posparto a corto plazo. Método: Se realizó un estudio observacional descriptivo, entre enero 2017 y agosto 2018, en 119 mujeres en el posparto a corto plazo, a partir de una población de 773 gestantes de peso adecuado y aparentemente sanas al momento de la captación, clasificadas por su vulnerabilidad cardiometabólica por adiposidad corporal en el Policlínico Chiqui Gómez Lubián, entre enero 2012 y diciembre 2016. Se estudió la asociación de la vulnerabilidad cardiometabólica con los índices aterogénicos: Castelli, Kannel y la relación TG/HDLc. Se aplicó la prueba de Kruskal-Wallis para la comparación de muestras independientes. Resultados: Los índices Castelli (3,37), Kannel (2,02) y TG/HDLc (0,71) tuvieron valores medios más bajos en las mujeres sin vulnerabilidad. Los índices Castelli (4,20) y Kannel (2,69) mostraron valores más elevados en mujeres con vulnerabilidad global extrema por adiposidad general alta y central alta. El índice TG/HDLc (1,18) tuvo los valores más elevados en mujeres con vulnerabilidad global por adiposidad general intermedia y central alta. Conclusiones: Los valores de los índices aterogénicos estudiados en el posparto a corto plazo estuvieron asociados con la vulnerabilidad cardiometabólica, con cifras más elevadas en mujeres con adiposidad general intermedia y alta, y adiposidad central alta. La vulnerabilidad cardiometabólica por adiposidad corporal en el posparto a corto plazo, puede alertar sobre alteraciones metabólicas aterogénicas, como riesgo cardiovascular.

ABSTRACT Introduction: Excessive accumulations of adipose tissue are a threat to cardiometabolic health; their assessment in women would better inform about their metabolic state. Objective: To identify associations between cardiometabolic vulnerability states and atherogenic indices in the short-term postpartum period. Method: A descriptive observational study was conducted from January 2017 to August 2018 on 119 women in short-term postpartum. The study population consisted of 773 pregnant women with adequate weight and apparently healthy at the time of recruitment, who were classified based on their cardiometabolic vulnerability due to body adiposity at the Policlínico Chiqui Gómez Lubián, between January 2012 and December 2016. The association of cardiometabolic vulnerability with the atherogenic indices was studied: Castelli, Kannel and the TG/HDLc ratio. The Kruskal-Wallis test was applied to compare independent samples. Results: The Castelli (3.37), Kannel (2.02) and TG/HDL (0.71) indices showed lower mean values in women without vulnerability. The Castelli (4.20) and Kannel (2.69) indices showed higher values in women with extreme global vulnerability due to high overall adiposity and high central adiposity. The TG/HDLc index (1.18) reached the highest values in women with global vulnerability due to intermediate and high central overall adiposity. Conclusions: The values of the atherogenic indices studied in the short-term postpartum period were associated with cardiometabolic vulnerability, with higher figures in women with intermediate and high general adiposity, and high central adiposity. Cardiometabolic vulnerability due to body adiposity in the short-term postpartum period may alert about atherogenic metabolic disorders, such as cardiovascular risk.

Are young Iranian women with metabolically healthy obesity at increased risk of CVD incidence? / Jovens iranianas obesas metabolicamente saudáveis têm maior risco de incidência de DCV?

Abstract Background The association between the Metabolically Healthy Obese (MHO) phenotype in the absence of metabolic syndrome and subsequent cardiovascular disease remains unclear. Objectives We examined the association between MHO and CVD risk in young Iranian women. Methods We studied 183 women aged 20-35 years from a population of 308 candidates. We classified participants into 4 phenotypes. We measured body composition, blood pressure, and biochemical factors in all participants. Results The Metabolically Healthy Normal Weight (MHNW) and Normal Weight Obese (NWO) phenotypes had no statistical differences in any biochemistry variables. FBS, TG, LDL/HDL, Cholesterol/HDL, hs-CRP, and atherogenic index of plasma (AIP) were all higher in Metabolically Unhealthy Obese (MUO) than MHO individuals, whereas HDL was higher in MHO than in MUO individuals. LDL/HDL and hs-CRP were higher in MHO participants than MHNW participants, whereas HDL-c was higher in MHNW than MHO. Conclusions Results of the present study demonstrate that young women displaying the MHO phenotype have a favorable metabolic profile as shown by lower FBS, TG, LDL-c/HDL, Cho/HDL, hs-CRP, and AIP and higher HDL levels than the MUO phenotype. However, MHO individuals were still at greater risk of CVD incidence (lower HDL and higher hs-CRP levels) than MHNW individuals.

Resumo Contexto A associação entre o fenótipo obeso metabolicamente saudável (OMS) na ausência de síndrome metabólica e doença cardiovascular subsequente permanece incerta. Objetivos Examinamos a associação entre o fenótipo OMS e risco de DCV em jovens iranianas. Métodos Analisamos 183 mulheres com idade de 20-35 anos de uma população de 308 candidatas. Classificamos as participantes em quatro fenótipos. Mensuramos composição corporal, pressão arterial e fatores bioquímicos em todas as participantes. Resultados Os fenótipos com peso normal metabolicamente saudável (PNMS) e obeso com peso normal não apresentaram diferenças estatísticas em nenhuma das variáveis bioquímicas. Os níveis de glicemia sanguínea em jejum (GSJ), triglicerídeos (TG), relação LDL/HDL, HDL, proteína C reativa ultrassensível (PCR-us) e índice aterogênico do plasma (IAP) foram mais elevados em obesas metabolicamente não saudáveis (OMNS) do que em indivíduos OMSs, enquanto o HDL foi maior em OMSs do que em indivíduos OMNSs. A relação LDL/HDL e o nível de PCR-us foram mais elevados em participantes OMSs do que em participantes com PNMS, enquanto o HDL foi maior naquelas com PNMS do que nas OMSs. Conclusões Os resultados do presente estudo demonstram que mulheres jovens com o fenótipo OMS têm um perfil metabólico favorável, conforme demonstrado pelos níveis menores de GSJ, TG, relação LDL/HDL, HDL, PCR-us e IAP e pelos níveis maiores de HDL em comparação às mulheres com o fenótipo OMNS. Entretanto, indivíduos OMSs ainda apresentavam maior risco de DCV incidente (níveis menores de HDL e maiores de PCR-us) do que indivíduos com PNMS.

Lipid profile of immunocastrated, castrated male and female pigs / Perfil lipídico de suínos machos castrados e imunocastrados e fêmeas

A presente pesquisa foi realizada com o objetivo de avaliar os níveis de colesterol, extrato etéreo, perfil de ácidos graxos e o índice aterogênico e trombogênico da gordura intramuscular de suínos machos imunocastrados em relação às fêmeas e aos machos castrados cirurgicamente. Utilizaram-se 45 animais, com peso inicial de 25,2±2,8kg, distribuídos em delineamento inteiramente ao acaso, com três tratamentos (machos castrados, machos e fêmeas imunocastrados) e três repetições de cinco animais cada. Os animais foram abatidos a 90,3±2,7kg. As amostras de Longissimus dorsi foram coletadas, liofilizadas e analisadas quanto ao perfil de ácidos gordos, colesterol e extrato etéreo. Não foram observadas diferenças (P>0,05) para nenhuma das variáveis analisadas entre a gordura intramuscular de machos castrados cirurgicamente, machos imunocastrados e fêmeas. A imunocastração não alterou os níveis intramusculares de extrato etéreo, colesterol, composição de ácidos graxos ou o índice aterogênico e trombogênico do Longissimus dorsi.(AU)

Net energy levels on the lipid profile of pork / Níveis de energia líquida no perfil lipídico da carne suína

ABSTRACT: This study was conducted to evaluate the effects of net energy levels on the lipid profile of adipose tissue and muscle of swines. A total of 90 animals, with initial weight of 71.94±4.43kg, were used, and distributed in a randomized block design in five net energy levels (2,300, 2,425, 2,550, 2,675, and 2,800Kcal kg-1 feed), with nine replicates and two animals per experimental unit. Lipid profiles of adipose tissue and muscle were analyzed using gas chromatography. Increasing the levels of net energy using soybean oil, improved the lipid profile of adipose tissue and muscle, increased linearly (P<0.05) the concentrations of polyunsaturated fatty acids, especially linoleic and α-linolenic acid, reduced linearly (P<0.05) the monounsaturated and saturated fatty acids and omega 6: omega 3. In adipose tissue was observed linear reduction (P<0.05) of atherogenic and thrombogenic indexes. In conclusion, increasing the level of net energy of the diet using soybean oil improved the lipid profile of adipose tissue and muscle.

RESUMO: Este estudo foi conduzido com o objetivo de avaliar o efeito dos níveis de energia líquida no perfil lipídico da gordura e carne suína. Foram utilizados 90 animais, com peso inicial de 71,94±4,43kg, distribuídos em delineamento de blocos ao acaso em cinco níveis de energia líquida (2.300, 2.425, 2.550, 2.675 e 2.800Kcal kg-1 de ração), com nove repetições e dois animais por unidade experimental. Foram analisados os perfis lipídicos da gordura subcutânea e da carne por cromatografia gasosa. O aumento do nível de energia líquida usando óleo de soja melhorou o perfil lipídico da gordura subcutânea e da carne, aumentando linearmente (P<0,05) a concentração dos ácidos graxos poli-insaturados, especialmente ácido linoleico e α-linolênico, reduzindo linearmente (P<0,05) os ácidos graxos monoinsaturados e saturados e ômega 6: ômega 3. No tecido adiposo foi observado redução linear (P<0,05) dos índices aterogênico e trombogênico. Em conclusão, o aumento do nível de energia líquida da dieta, com a utilização do óleo de soja, melhora o perfil lipídico da gordura subcutânea e da carne suína.

Influencia del consumo de pulpa de aguacate,Persea americana, sobre el metabolismo lipídico en ratones normolipémicos e hiperlipémicos inducidos por dieta / Influence of avocado (persea americana) pulp consumption on lipid metabolism in normolipidemic and diet induced hyperlipidemic mice

La dislipidemia es un factor de riesgo para el desarrollo de enfermedades cardiovasculares, una de las principales causas de muertes a nivel mundial. En este trabajo se estudió el efecto del aguacate (Persea americana) sobre el metabolismo lipídico de ratones normo e hiperlipémicos inducidos con dieta hiperlipídica. Ratones machos, fueron distribuidos en 4 grupos DE (dieta estándar), DEa (dieta estándar y aguacate); DH (dieta hiperlipídica) y DHa (dieta hiperlipídica y aguacate) y observados por 28 días. Luego de este periodo se determinaron los niveles de Colesterol Total, Triglicéridos y col-HDL y se calcularon los valores de col-LDL, VLDL e índices de riesgo aterogénico y de riesgo coronario. El grupo DH mostró niveles de CT, TG, col-LDLy VLDL significativamente superiores (p<0,001) a los valores alcanzados en el grupo DE. En los grupos DHa y DEa se redujeron significativamente (p<0,001) las concentraciones de CT, TG, col-LDL y VLDL, en comparación al grupo DH. Los grupos DEa y DHa difieren significativamente (p<0,005) en el nivel de CT, éste último presenta valores más bajos, los otros parámetros cuantificados no mostraron diferencias significativas. No hubo diferencias significativas para los valores del col-HDL en ningún grupo de estudio. La inducción a la hiperlipemia con un modelo de dieta hiperlipídica, generó incrementos importantes en el CT, TG, col-LDL y VLDL, además de aumentar el riesgo aterogénico. El consumo de la pulpa de aguacate redujo los niveles de CT, TG, col-LDL, VLDL y el índice de riesgo aterogénico en el grupo de ratones hiperlipémicos(AU)

Influence of avocado (Persea americana) pulp consumption on lipid metabolism in normolipidemic and diet induced hyperlipidemic mice . Dyslipidemia is a risk factor for developing cardiovascular disease, a major cause of deaths worldwide. The aim of this work is to study the effect of avocado (Persea americana), on lipid metabolism on normolipidemic and hyperlipidemic mice induced with high fat diet. Four groups of animals receiving standard diet (DE), standard and avocado diet (DEa), high fat diet (DH) and high fat and avocado diet (DHA) were used. All animals were observed for a period of 28 days. Blood sample was obtained at the end of experimentation period by cardiac puncture on anesthetized animals, and the levels of Cholesterol, triglycerides and col-HDL were de- termined and c-LDL, VLDL and atherogenic and coronary risk factors were calculated. DH group showed levels of TC, TG, c-LDL and VLDL significantly higher (p<0,001) than the values achieved in DHa group. DHa and DEa plasmatic values of TC, TG, c-LDL and VLDL were significantly reduced (p <0.001) compared to DH group. DEa and DHA groups differed significantly (p <0.005) in the level of CT, the latter has lower values, the other quantified parameters showed no significant differences. There were no significant differences for c-HDL values in any group. Hyperlipidemia induction with a model of high fat diet produced significantly increasing values of TC, TG, c-LDL and VLDL, besides of increasing the atherogenic risk. The benefit of avocado pulp consists in reduction of TC, TG, c-LDL, VLDL and the index of atherogenic risk(AU)

[Dyslipidaemia and atherogenic risk in patients with systemic lupus erythematosus]. / Dislipidemia y riesgo aterogénico en pacientes con lupus eritematoso sistémico.

INTRODUCTION: Dyslipidaemia is a common comorbidity in patients with systemic lupus erythematosus. PATIENTS AND METHODS: Fifty-one patients were included. Variables associated with the disease and the drugs used were recorded. Atherogenic risk was calculated. Chi square was used for categorical variables. ANOVA was performed and a logistic regression model to determine the association of the variables with the presence of dyslipidaemia. RESULTS: A percentage of 68.6 had dyslipidaemia. A significant difference between the presence of dyslipidaemia and activity index measured by SLEDAI was found, the presence of lupus nephritis, use of prednisone≥20mg/day, evolution of the disease<3 years. Significance between the absence of dyslipidaemia and use of hydroxychloroquine was found. SLEDAI≥4 and the use of prednisone≥20mg/day were independently associated with the presence of dyslipidaemia. The average of Castelli rate was 5.02, the Kannel index was 2.97 and triglyceride/HDL-C ratio was 5.24. CONCLUSIONS: Patients with systemic lupus erythematosus have a high prevalence of dyslipidaemia and a high atherogenic rate, which increases cardiovascular risk significantly.

[Dyslipidemia and atherogenic risk in patients with rheumatoid arthritis]. / Dislipidemia y riesgo aterogénico en pacientes con artritis reumatoide.

INTRODUCTION: Dyslipidaemia is one of the main risk factors for atherosclerotic cardiovascular disease. Patients with rheumatoid arthritis have 2-3 times more cardiovascular risk, which is partly due to the pattern of lipids which increase the atherogenic index. METHODS: A descriptive, cross-sectional, observational and prospective study was conducted on 82 patients, selected for their lipid profile. Variables associated with the disease and the drugs used were recorded. Atherogenic risk was calculated, with Chi square being used for categorical variables, and the Mann-Whitney test for the continuous ones. RESULTS: The dyslipidaemia frequency was 54.9%. The most frequent age range of dyslipidaemia was between 51 and 60 years. Patients with type i obesity had a higher frequency of dyslipidaemia. Less dyslipidaemia was found with a lower rate of disease activity. Patients with cyclic citrullinated anti-peptide antibodies and positive rheumatoid factor, erythrocyte sedimentation rate>13mm or CRP>2mg/L had a higher frequency of dyslipidaemia. The mean Castelli atherogenic index was 4.36, the index of Kannel was 2.59, and triglycerides/HDL-c ratio was 3.83.Patients with dyslipidaemia showed a higher frequency of positive rheumatoid factor (P=.0008), and those patients who were taking hydroxychloroquine had a lower frequency of dyslipidaemia P=.03. CONCLUSIONS: Patients with rheumatoid arthritis have a pro-atherogenic lipid profile. It is important to know this and treat it to reduce cardiovascular risk.

Circunferencia de cintura, perfil de lípidos y riesgo cardiovascular en adolescentes / Waist circumference, lipid profile and cardiovascular risk in adolescents

La obesidad abdominal y las dislipidemias son factores de riesgo de enfermedad cardiovascular (ECV). Se evaluó la relación de la circunferencia de cintura (CC), con los lípidos e índices de riesgo cardiovascular en 414 adolescentes (12-16,9 años). El estudio fue descriptivo, correlacional, transversal, y de campo. Se midió: peso, talla, CC y se calculó el índice de masa corporal (IMC). Se determinó colesterol total (CT), triglicéridos (TG) y lipoproteína de alta densidad (HDL-c). Se calculó: la lipoproteína de baja densidad (LDL-c), el colesterol no-HDL y las relaciones de riesgo aterogénico. Se realizaron estadísticos descriptivos, las pruebas de Mann Whitney, Chi cuadrado y Odds Ratio, con significancia estadística de p<0,05. 18,1% y 7,0% presentaron sobrepeso y obesidad, respectivamente y 38,9% tenían CC≥p90. Los adolescentes con CC≥p90 mostraron cifras más elevadas de peso, IMC y de CT, colesterol no-HDL, TG y de los índices CT/HDL-C y TG/HDL-C que los adolescentes con CC

Abdominal obesity and dyslipidemias have been considered cardiovascular risk factors. This descriptive and cross-sectional study was undertaken to assess the relationship between waist circumference (WC) and lipid profile, and Cardiovascular risk factors in 414 adolescents (ages 12 to16.9 years). Height, weight and WC were measured and body mass index was (BMI) estimated. Plasma levels for triglycerides, total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were determined. Low-density lipoprotein cholesterol (LDL-C) and non-HDL-C and atherogenic risk index were assessed. Mann-Whitney, Odds Ratio and Chi-square test were calculated and significance level p<0.05 was considered. 18.1% and 7% presented overweight and obesity, respectively and 38.9% had WC equal or greater than the 90th percentile (WC≥p90). Significant higher levels (p<0.05) for weight, IMC, TC, TG, non-HDL, TC/HDL-C index and TG/HDL-C Index were found in adolescents with WC≥p90. Males had higher mean values for weight, height, BMI and WC than females (p<0.05). Females had higher TC, HDL-C and LDL-C concentrations than males (p<0.05). Adolescents with WC≥p90 are more likely to have a higher atherogenic risk index than those with WC

[Atherogenic indices in workers of different occupational sectors of the Spanish Mediterranean area]. / Índices aterogénicos en trabajadores de diferentes sectores laborales del área Mediterránea Española.

INTRODUCTION: Atherogenic indices predict cardiovascular disease, as they provide a good reflection of the clinical and metabolic interactions of lipid fractions. MATERIAL AND METHOD: A descriptive cross-sectional study was conducted on 60,798 workers in the Spanish Mediterranean area on whom different atherogenic indices (cholesterol/HDL, LDL/HDL, triglycerides/HDL) were determined, and the influence they have in the different productive work sectors. RESULTS: In women, the mean values of the different atherogenic indices are better in the health sector, while they are better in men in the primary sector. The percentage of working women with low values is also greater in the healthcare sector, while in men there is no clear predominant sector, with the best values being shown in the hospitality and primary sector. CONCLUSION: The distribution of cardiovascular risk factors and the values of the different atherogenic indices analyzed vary in different industrial sectors.

[Atherogenic index of plasma in patients with preeclampsia and in healthy pregnant women]. / Índice aterogénico del plasma en pacientes con preeclampsia y embarazadas sanas.

BACKGROUND AND OBJECTIVE: To compare the values of the atherogenic index of plasma between preeclamptic patients and healthy pregnant women. PATIENTS AND METHOD: Seventy patients were selected. Twenty-three severe preeclamptic patients (group A), 12 mild preeclamptic patients (group B) and 35 healthy pregnant women with similar age and body mass index (group C). Blood samples for lipids and lipoproteins determination were taken and the atherogenic plasma index was calculated. RESULTS: We did not find differences in group A and B with regard to maternal age, gestational age at the time of evaluation and body mass index compared with pregnant women in group C (P=ns). Plasma concentrations of triglycerides and low-density lipoproteins were significantly higher in patients of groups A and B compared with group C (P<.05). Normotensive patients presented higher concentrations of high-density lipoproteins than patients with severe and mild preeclampsia (P<.05). There were no differences between groups in plasma cholesterol concentrations (P=ns). Patients in groups A (1.14±0.44) and in group B (0.95±0.46) presented significantly higher values of the atherogenic index of plasma compared with pregnant women in group C (0.62±0.20; P<.05). CONCLUSION: Patients with preeclampsia had higher values of the atherogenic index of plasma than healthy pregnant women.