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1.
BMC Gastroenterol ; 22(1): 20, 2022 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-35021995

RESUMO

BACKGROUND: Emerging evidence suggests that cardiometabolic index (CMI) is closely related to diabetes, hypertension, stroke, cardiovascular disease, and kidney disease, which implies that CMI has the value as an indicator of metabolic diseases. However, data on the relationships between CMI and non-alcoholic fatty liver disease (NAFLD) risks have not been reported. This study is designed to examine the association between CMI and NAFLD in the general population. METHODS: The current study included 14,251 subjects whose CMI was the product of triglyceride/high-density lipoprotein cholesterol ratio and waist-to-height ratio. Linear regression was used to analyze the correlation between baseline information and CMI, logistic regression was used to study the relationship between CMI and NAFLD, and subgroup analysis was used to explore potential high-risk groups. RESULTS: After adjusted for potential confounding factors, higher CMI was independently associated with NAFLD, in which every additional standard deviation (SD) of CMI increased the risk of NAFLD by 28% (OR 1.28 per SD increase, 95% CI 1.19-1.37, P for trend < 0.0001). There were also significant differences in CMI-related NAFLD risk among different ages and genders, in which the CMI-related NAFLD risk in young people was significantly higher than that in other age groups (OR = 2.63 per SD increase for young people, OR = 1.38 per SD increase for young and middle-aged people, OR = 1.18 per SD increase for middle-aged and elderly people; OR = 1.14 per SD increase for elderly people, P for interaction = 0.0010), and the CMI-related NAFLD risk in women was significantly higher than that in men (OR = 1.58 per SD increase for women, OR = 1.26 per SD increase for men, P for interaction = 0.0045). CONCLUSIONS: Current studies have found that after excluding potential confounding factors, higher CMI in the general population is independently associated with NAFLD risk.


Assuntos
Doenças Cardiovasculares , Hepatopatia Gordurosa não Alcoólica , Adolescente , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , HDL-Colesterol , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fatores de Risco , Triglicerídeos
2.
Maturitas ; 155: 40-53, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34876248

RESUMO

OBJECTIVES: Menopause is accompanied by many metabolic changes, increasing the risk of cardiometabolic diseases. The impact of diet, as a modifiable lifestyle factor, on cardiovascular health in general populations has been well established. The purpose of this systematic review is to summarize the evidence on the effects of whole diet on lipid profile, glycemic indices, and blood pressure in postmenopausal women. METHODS: Embase, Medline, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from inception to February 2021. We included controlled clinical trials in postmenopausal women that assessed the effect of a whole-diet intervention on lipid profile, glycemic indices, and/or blood pressure. The risk of bias in individual studies was assessed using RoB 2 and ROBINS-I tools. SUMMARY OF EVIDENCE: Among 2,134 references, 21 trials met all eligibility criteria. Overall, results were heterogenuous and inconsistent. Compared to control diets, some studies showed that participants experienced improvements in total cholesterol (TC), low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), fasting blood sugar (FBS), and apolipoprotein A (Apo-A) after following fat-modified diets, but some adverse effects on triglycerides (TG), very low-density lipoprotein cholesterol (VLDL), lipoprotein(a) (Lp(a)), and high-density lipoprotein cholesterol (HDL) concentrations were also observed. A limited number of trials found some effects of the Paleolithic, weight-loss, plant-based, or energy-restricted diets, or of following American Heart Association recommendations on TG, TC, HDL, insulin, FBS, or insulin resistance. CONCLUSION: Current evidence suggests that diet may affect levels of some lipid profile markers, glycemic indices, and blood pressure among postmenopausal women. However, due to the large heterogeneity in intervention diets, comparison groups, intervention durations, and population characteristics, findings are inconclusive. Further well-designed clinical trials are needed on dietary interventions to reduce cardiovascular risk in postmenopausal women.


Assuntos
Doenças Cardiovasculares , Doenças Cardiovasculares/prevenção & controle , HDL-Colesterol , Dieta , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Pós-Menopausa , Fatores de Risco , Triglicerídeos
3.
Nutrition ; 93: 111425, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34481288

RESUMO

OBJECTIVES: Youngsters who are overweight or obese (YOO) have become an important global health concern. Some micronutrients may be modifiable influential factors. This study aimed to investigate the individual and joint association of whole-blood magnesium (WBMg) and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), or high-density lipoprotein cholesterol (HDL-C) in YOO. METHODS: This is a propensity score matching-based case-control study. YOO was defined depending on age- and sex-specific body mass index z-score, calculated with SAS macros (%group_standard and %WHO2007) from the World Health Organization website. WBMg, blood lipids, and covariates were carefully measured by trained technicians using a whole-blood, five-element, basic analyzer and atomic absorption spectrometer or automatic biochemical analyzer. Locally weighted scattered plot smoothing and multivariable conditional logistic regression models were applied to estimate the associations of WBMg and blood lipids in YOO. RESULTS: WBMg was positively associated with YOO. The adjusted likelihood of YOO significantly increased by 21% (odds ratio: 1.21; 95% confidence interval [CI], 1.10-1.33) with per-interquartile range elevation of WBMg. Compared with the 1st quartile, adjusted odds ratios among youngsters in the 2nd, 3rd, and 4th quartiles of WBMg were 1.11 (95% CI, 0.92-1.35), 1.29 (95% CI, 1.06-1.57), and 1.47 (95% CI, 1.18-1.83), respectively. Furthermore, the relationship between WBMg and YOO was moderated by lipid profiles. Compared with those having lower (< median) WBMg and TC, TG, LDL-C, or higher (≥ median) HDL-C, youngsters with both higher WBMg and TC, TG, LDL-C, or lower HDL-C had higher YOO odds, which averagely increased by 188%, 250%, 339%, and 369%, respectively. CONCLUSIONS: WBMg was an independent risk factor of YOO, and the associations were stronger among those with unhealthy blood lipids. Our findings can help to guide clinical and public health policies on the relevance of magnesium nutritional status.


Assuntos
Lipídeos/sangue , Magnésio , Sobrepeso , Obesidade Pediátrica/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , HDL-Colesterol/sangue , Feminino , Humanos , Magnésio/sangue , Masculino , Sobrepeso/epidemiologia , Pontuação de Propensão , Fatores de Risco , Triglicerídeos/sangue
4.
Chemosphere ; 286(Pt 2): 131791, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34371361

RESUMO

Exposure to acrolein was reported to be related with adverse health effects. However, the associations between acrolein exposure and blood lipids remain largely unknown. We assessed the associations of urinary acrolein metabolites with blood lipids using data from the National Health and Nutrition Examination Survey (NHANES) and further investigated the existence of mediation by systemic inflammation in the associations. Urinary acrolein metabolites, N-acetyl-S-(carboxyethyl)-l-cysteine (CEMA) and N-acetyl-S-(3-hydroxypropyl)-l-cysteine (3-HPMA), blood lipids, and serum high sensitivity C-reactive protein (hs-CRP) were measured in the NHANES. The associations of urinary acrolein metabolites with blood lipids and dyslipidemia and hs-CRP were estimated by multiple linear and logistic regression models. Mediation analysis was conducted to evaluate the mediating effects of hs-CRP on the associations between urinary acrolein metabolites and blood lipids. We found urinary CEMA+3-HPMA (∑acrolein) was significantly associated with higher levels of serum triglycerides (TG), hs-CRP, and lower levels of high-density lipoprotein cholesterol (HDL-C). Each 1-unit increment in ln-transformed level of ∑acrolein was associated with a 0.06 mmol/L increment in TG and 0.02 mmol/L decrement in HDL-C (all P <0.05). A positive dose-response relationship was observed between urinary ∑acrolein and dyslipidemia risk. In addition, hs-CRP significantly mediated the associations of urinary ∑acrolein with serum TG and HDL-C, with mediated proportions of 22.12% and 41.41%, respectively. In conclusion, acrolein exposure is associated with the levels of serum TG, HDL-C, and hs-CRP. Hs-CRP may mediate acrolein-associated alterations of blood lipids. Our results indicated that decreased exposure to acrolein may reduce systemic inflammation and dyslipidemia risk.


Assuntos
Acroleína , Lipídeos , HDL-Colesterol , Humanos , Inflamação/induzido quimicamente , Inquéritos Nutricionais
5.
Artigo em Inglês | MEDLINE | ID: mdl-34624513

RESUMO

The inverse association between plasma HDL cholesterol (HDL-C) levels and risk for cardiovascular disease (CVD) has been demonstrated by numerous epidemiological studies. However, efforts to reduce CVD risk by pharmaceutically manipulating HDL-C levels failed and refused the HDL hypothesis. HDL-C levels in the general population are highly heterogeneous and are determined by a combination of genetic and environmental factors. Insights into the causes of HDL-C heterogeneity came from the study of monogenic HDL deficiency syndromes but also from genome wide association and Μendelian randomization studies which revealed the contribution of a large number of loci to low or high HDL-C cases in the general or in restricted ethnic populations. Furthermore, HDL-C levels in the plasma are under the control of transcription factor families acting primarily in the liver including members of the hormone nuclear receptors (PPARs, LXRs, HNF-4) and forkhead box proteins (FOXO1-4) and activating transcription factors (ATFs). The effects of certain lipid lowering drugs used today are based on the modulation of the activity of specific members of these transcription factors. During the past decade, the roles of small or long non-coding RNAs acting post-transcriptionally on the expression of HDL genes have emerged and provided novel insights into HDL regulation and new opportunities for therapeutic interventions. In the present review we summarize recent progress made in the genetics and the regulation (transcriptional and post-transcriptional) of HDL metabolism.


Assuntos
HDL-Colesterol/metabolismo , Lipoproteínas HDL/metabolismo , Fígado/metabolismo , RNA Longo não Codificante/genética , Fatores Ativadores da Transcrição/sangue , Fatores Ativadores da Transcrição/genética , HDL-Colesterol/sangue , HDL-Colesterol/genética , Fatores de Transcrição Forkhead/sangue , Fatores de Transcrição Forkhead/genética , Heterogeneidade Genética , Fatores de Risco de Doenças Cardíacas , Humanos , Lipoproteínas HDL/sangue , Lipoproteínas HDL/genética , Fígado/patologia , RNA Longo não Codificante/sangue , Receptores Citoplasmáticos e Nucleares/sangue , Receptores Citoplasmáticos e Nucleares/genética
6.
Artigo em Inglês | MEDLINE | ID: mdl-34637925

RESUMO

The ability to accept cholesterol from cells and to promote reverse cholesterol transport (RCT) represents the best characterized antiatherogenic function of HDL. Studies carried out in animal models have unraveled the multiple mechanisms by which these lipoproteins drive cholesterol efflux from macrophages and cholesterol uptake to the liver. Moreover, the influence of HDL composition and the role of lipid transporters have been clarified by using suitable transgenic models or through experimental design employing pharmacological or nutritional interventions. Cholesterol efflux capacity (CEC), an in vitro assay developed to offer a measure of the first step of RCT, has been shown to associate with cardiovascular risk in several human cohorts, supporting the atheroprotective role of RCT in humans as well. However, negative data in other cohorts have raised concerns on the validity of this biomarker. In this review we will present the most relevant data documenting the role of HDL in RCT, as assessed in classical or innovative methodological approaches.


Assuntos
HDL-Colesterol/metabolismo , Colesterol/metabolismo , Lipoproteínas HDL/metabolismo , Fígado/metabolismo , Animais , Transporte Biológico/genética , HDL-Colesterol/genética , Humanos , Lipoproteínas HDL/genética
7.
Artigo em Inglês | MEDLINE | ID: mdl-34637926

RESUMO

Through seven decades the inverse association between HDL cholesterol concentrations and risk of atherosclerotic cardiovascular disease (ASCVD) has been observed in case-control and prospective cohort studies. This robust inverse association fuelled the enthusiasm towards development of HDL cholesterol increasing drugs, exemplified by the cholesteryl ester transfer protein (CETP) inhibitor trials and the extended-release niacin HPS2-THRIVE trial. These HDL cholesterol increasing trials were launched without conclusive evidence from human genetics, and despite discrepant species dependent evidence from animal studies. Evidence from human genetics and from randomized clinical trials over the last 13 years now point in the direction that concentrations of HDL cholesterol, do not appear to be a viable future path to target therapeutically for prevention of ASCVD. A likely explanation for the strong observational association between low HDL cholesterol and high ASCVD risk is the concomitant inverse association between HDL cholesterol and atherogenic triglyceride-rich lipoproteins. The purpose of the present review is to bring HDL cholesterol increasing trials into a human genetics context exemplified by candidate gene studies of key players in HDL biogenesis as well as by HDL cholesterol related genome-wide association studies.


Assuntos
Complexo 3 de Proteínas Adaptadoras/genética , Subunidades beta do Complexo de Proteínas Adaptadoras/genética , Aterosclerose/sangue , Proteínas de Transferência de Ésteres de Colesterol/genética , HDL-Colesterol/genética , Aterosclerose/epidemiologia , Aterosclerose/genética , HDL-Colesterol/sangue , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Fatores de Risco de Doenças Cardíacas , Humanos , Niacina/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Artigo em Inglês | MEDLINE | ID: mdl-34653581

RESUMO

High-density lipoproteins (HDL) are well known for their protective role against the development and progression of atherosclerosis. Atheroprotection is mainly due to the key role of HDL within the reverse cholesterol transport, and to their ability to exert a series of antioxidant and anti-inflammatory activities. Through the same mechanisms HDL could also affect cancer cell proliferation and tumor progression. Many types of cancers share common alterations of cellular metabolism, including lipid metabolism. In this context, not only fatty acids but also cholesterol and its metabolites play a key role. HDL were shown to reduce cancer cell content of cholesterol, overall rewiring cholesterol homeostasis. In addition, HDL reduce oxidative stress and the levels of pro-inflammatory molecules in cancer cells and in the tumor microenvironment (TME). Here, HDL can also help in reverting tumor immune escape and in inhibiting angiogenesis. Interestingly, HDL are good candidates for drug delivery, targeting antineoplastic agents to the tumor mass mainly through their binding to the scavenger receptor BI. Since they could affect cancer development and progression per se, HDL-based drug delivery systems may render cancer cells more sensitive to antitumor agents and reduce the development of drug resistance.


Assuntos
HDL-Colesterol/uso terapêutico , Colesterol/metabolismo , Lipoproteínas HDL/uso terapêutico , Neoplasias/tratamento farmacológico , Neovascularização Patológica/tratamento farmacológico , Colesterol/uso terapêutico , HDL-Colesterol/metabolismo , Sistemas de Liberação de Medicamentos , Resistencia a Medicamentos Antineoplásicos/genética , Humanos , Lipoproteínas HDL/metabolismo , Neoplasias/metabolismo , Neoplasias/patologia , Neovascularização Patológica/metabolismo , Neovascularização Patológica/patologia , Estresse Oxidativo/efeitos dos fármacos , Evasão Tumoral/efeitos dos fármacos , Microambiente Tumoral/efeitos dos fármacos
9.
BMC Gastroenterol ; 21(1): 482, 2021 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-34923965

RESUMO

BACKGROUND: Lipid metabolism disorders play a critical role in the progression of non-alcoholic fatty liver disease (NAFLD). However, the number of studies on the relationships among blood lipid-related indexes and NAFLD is limited, and few studies have emphasized the comparison of blood lipid-related indexes in the same population to identify the optimal index for NAFLD screening. This study aimed to investigate the relationships among several blood lipid-related indexes and NAFLD, and to find the index with the best screening value for NAFLD. METHODS: Based on a general health examination at community health service agencies in the Pearl River Delta region of China in 2015, 3239 women were recruited in this cross-sectional study. The relationships among blood lipid-related indexes and NAFLD were assessed separately by constructing multivariate logistic regression models. Receiver operating characteristic analysis was used to evaluate and compare the screening abilities of the indexes for NAFLD. All data analyses were conducted in SPSS and MedCalc software. RESULTS: Whether in the crude model or each model adjusted for possible confounding factors, the risk of NAFLD significantly rose with increasing cardiometabolic index (CMI), triglyceride glucose index (TyG), triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C), total cholesterol (TC) to HDL-C ratio (TC/HDL-C) and low-density lipoprotein (LDL-C) to HDL-C ratio (LDL-C/HDL-C). Moreover, the area under the curve (AUC) of CMI was 0.744, which was better than that of TyG (0.725), TG/HDL-C (0.715), TC/HDL-C (0.650), and LDL-C/HDL-C (0.644) (P < 0.001). In addition, the optimal cut-off points were 0.62 for CMI, 8.55 for TyG, 1.15 for TG/HDL-C, 4.17 for TC/HDL-C, and 2.22 for LDL-C/HDL-C. CONCLUSIONS: CMI is easy to obtain, is a recommended index in the screening of NAFLD in women and may be useful for detecting populations that are at high risk of NAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica , China , HDL-Colesterol , Estudos Transversais , Feminino , Humanos , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Triglicerídeos
10.
Artigo em Inglês | MEDLINE | ID: mdl-34948819

RESUMO

Background: Both obesity and alcohol consumption are strongly associated with dyslipidemia; however, it remains unclear whether their joint effect on lipid profiles is through mediation, interaction, or a combination of the two. Methods: In total, 9849 subjects were selected from the 2009 panel of China Health and Nutrition Survey (CHNS). A four-way decomposition method was used to validate the pathways of drinking and body mass index (BMI) on lipids (total cholesterol, TC; triglyceride, TG; low-density lipoprotein cholesterol, LDL-C; high-density lipoprotein cholesterol, HDL-C; apolipoprotein A, APO-A; and apolipoprotein B, APO-B). Results: According to four-way decomposition, the total effects of drinking on lipids were found to be statistically significant, except for LDL-C. The components due to reference interaction were 0.63, 0.48, 0.60, -0.39, -0.30, and 0.20 for TC, TG, LDL-C, HDL-C, APO-A and APO-B, respectively (p < 0.05 for all). The effect size of pure indirect effect and mediated interaction were 0.001~0.006 (p > 0.05 for all). Further, linear regression models were used to examine the effect of BMI on lipid profiles in drinkers and non-drinkers. The associations of BMI and lipids were higher in all drinkers than in non-drinkers (0.069 versus 0.048 for TC, 0.079 versus 0.059 for TG, 0.057 versus 0.037 for LDL-C, -0.045 versus -0.029 for HDL-C, -0.024 versus -0.011 for APO-A and 0.026 versus 0.019 for APO-B, p interaction <0.05 for all). Conclusions: The joint effect of alcohol consumption and obesity on lipid profiles is through interaction rather than mediation. Alcohol consumption amplifies the harmful effect of BMI on lipid profiles. Greater attention should be paid to lipid health and cardiovascular risk in obese individuals regarding alcohol consumption. For obese individuals, we do not recommend alcohol consumption.


Assuntos
Consumo de Bebidas Alcoólicas , Lipídeos , Índice de Massa Corporal , HDL-Colesterol , LDL-Colesterol , Humanos , Triglicerídeos
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(12): 1461-1467, 2021 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-34963244

RESUMO

Objective: To analyze the association between high density lipoprotein cholesterol (HDL-C) and the risk of cardiovascular disease mortality. Methods: A total of 71 618 residents aged over 18 years with complete baseline data, who were filed on the health information big data platform of Yinzhou district, Ningbo city, Zhejiang Province from 2009 to 2014, were selected as the research population. The research population were divided into four groups according to the level of HDL-C: low-level group (HDL-C<1.0 mmol/L), intermediate-level group (1.0 mmol/L≤HDL-C<1.5 mmol/L), medium-high-level group (1.5 mmol/L≤HDL-C<2.0 mmol/L) and high-level group (HDL-C≥2.0 mmol/L). Cox proportional hazard model was used to calculate the risk ratio of cardiovascular diseases mortality in different groups. Results: The study population was followed up for a total of 427 989.4 person-years, follow-up time of (5.98±1.04)years. During the follow-up period, there were 799 deaths due to cardiovascular diseases. After adjusting for confounding factors, compared with the medium-high-level group as the reference group, the HR (95%CI) for cardiovascular diseases mortality was 1.43 (1.13-1.82) in the low-level group and 1.22 (1.02-1.46) in the high-level group. Conclusion: The low level of HDL-C (<1.5 mmol/L) is associated with a higher risk of cardiovascular disease deaths. The level of HDL-C can be used as a biological indicator to monitor the development of cardiovascular diseases and guide treatment.


Assuntos
Doenças Cardiovasculares , Adulto , HDL-Colesterol , Humanos , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco
12.
Nat Commun ; 12(1): 7274, 2021 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-34907193

RESUMO

Mendelian Randomisation (MR) is an increasingly popular approach that estimates the causal effect of risk factors on complex human traits. While it has seen several extensions that relax its basic assumptions, most suffer from two major limitations; their under-exploitation of genome-wide markers, and sensitivity to the presence of a heritable confounder of the exposure-outcome relationship. To overcome these limitations, we propose a Latent Heritable Confounder MR (LHC-MR) method applicable to association summary statistics, which estimates bi-directional causal effects, direct heritabilities, and confounder effects while accounting for sample overlap. We demonstrate that LHC-MR outperforms several existing MR methods in a wide range of simulation settings and apply it to summary statistics of 13 complex traits. Besides several concordant results with other MR methods, LHC-MR unravels new mechanisms (how disease diagnosis might lead to improved lifestyle) and reveals new causal effects (e.g. HDL cholesterol being protective against high systolic blood pressure), hidden from standard MR methods due to a heritable confounder of opposite effect direction.


Assuntos
Estudo de Associação Genômica Ampla/métodos , Causalidade , HDL-Colesterol/genética , Simulação por Computador , Pleiotropia Genética , Estudo de Associação Genômica Ampla/estatística & dados numéricos , Humanos , Hipertensão/epidemiologia , Hipertensão/genética , Análise da Randomização Mendeliana , Modelos Estatísticos , Herança Multifatorial
13.
J Int Med Res ; 49(11): 3000605211058861, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34791914

RESUMO

OBJECTIVE: High monocyte to high-density lipoprotein cholesterol ratio (MHR) is known to be a risk factor for cardiovascular (CV) complications. We aimed to evaluate the relationship between MHR and CV outcomes in patients commencing dialysis. METHODS: The medical records of patients who started maintenance dialysis between January 2006 and July 2017 were reviewed. The primary outcomes were all-cause mortality and overall CV mortality and the secondary outcomes were CV event-free survival and the incidence of CV complications. RESULTS: Five hundred ninety-seven patients were enrolled and allocated to low- or high-MHR groups. All-cause mortality did not differ between the groups during a mean follow-up period of 3.9 years. In addition, overall CV mortality did not differ between the groups. However, CV event-free survival was significantly lower in the high-MHR group than in the low-MHR group (47.5% vs. 59.0%). Multivariate Cox regression analysis showed that high MHR was an independent predictor of CV events (HR 1.886, 95% CI 1.015-3.505). CONCLUSION: High MHR at the time of initiation of dialysis may represent a useful predictor of CV complications.


Assuntos
Monócitos , Diálise Renal , HDL-Colesterol , Humanos , Contagem de Leucócitos , Fatores de Risco
14.
BMC Surg ; 21(1): 396, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772381

RESUMO

BACKGROUND: Surgery remains the major treatment for early breast cancer (BC), but surgery itself is also a trauma which might induce alterations in lipid metabolism. The aim of this study was to investigate the changes in lipid profiles and to explore factors associated with lipid changes pre- and postoperation. METHODS: We retrospectively analyzed the pre- and postoperative serum lipid profiles of 1934 BC patients. RESULTS: The levels of triglycerides (TG) (p < 0.001) and low-density lipoprotein cholesterol (LDL) (p < 0.001) were significantly elevated after surgery, while the levels of high-density lipoprotein cholesterol (HDL) (p < 0.001) were significantly decreased. After surgery, 27.76% of patients with preoperative ortholiposis developed dyslipidemia. Postmenopausal BC patients had a higher incidence of dyslipidemia (32.31%) after surgery than premenopausal BC patients (26.07%; p = 0.041). Additionally, patients with BMI > 24 (34.92%) had a higher incidence of dyslipidemia than patients with BMI ≤ 24 (24.84%; p = 0.001). Moreover, the magnitudes of the TG increase (p < 0.001), cholesterol (TC) increase (p = 0.013) and LDL increase (p = 0.015) in the premenopausal group were all greater than those in the postmenopausal group. After adjusting for multiple baseline covariates, preoperative hyperlipidemia and progesterone receptor (PR)-positive status were significantly associated with elevated TG, TC and LDL levels after surgery. CONCLUSIONS: Serum lipid profiles of BC patients may increase after surgery, especially premenopausal patients. Additionally, postmenopausal and overweight patients may have a higher risk of being diagnosed with dyslipidemia after surgery. Therefore, lipid monitoring, dyslipidemia prevention and corresponding interventions should be taken into consideration during the perioperative period.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/cirurgia , HDL-Colesterol , Feminino , Humanos , Lipídeos , Período Perioperatório , Estudos Retrospectivos
15.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(4): 656-661, 2021 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814446

RESUMO

Objective: To explore the relationship between lipid indicators and the incidence of diabetes, and to compare the diabetes prediction and identification power of traditional lipid combined lipid indicators, in order to explore the best alternative indicators for identifying and predicting diabetes. Methods: Based on the Jinchang cohort, a nested case-control study was conducted in 1 025 new cases of diabetes after excluding patients with malignant tumor and related endocrine, circulatory system disease, then an age (±2 years), gender matched 1∶1 control group of 1 025 cases was set to analyze the relationship between the incidence of diabetes and lipid parameters. Results: Among the traditional lipid parameters, the fourth quartile of TG, TC, and LDL-C indicated higher risks of developing diabetes, which was 14.00 times (95%CI: 9.73-20.15), 2.15 times (95%CI: 1.65-2.79) and 1.66 times (95%CI: 1.29-2.14) than that of the first quartile, respectively. The risk of developing diabetes indicated by the fourth quartile of HDL-C was 0.21 times than that indicated by the first quartile (95%CI: 0.15-0.28). In the combined lipid parameters, the fourth quartile of TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C indicated higher risks of developing diabetes, which was 14.86 times (95%CI: 10.35-21.34), 8.12 times (95%CI: 5.94-11.01), 5.85 times (95%CI:4.34-7.88) and 5.20 times (95%CI: 3.85-7.03) than that indicated by the first quartile, respectively. The areas under the ROC curve of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 0.76 (95%CI: 0.74-0.78), 0.59 (95%CI: 0.57-0.61), 0.67 (95%CI: 0.65-0.69), 0.57 (95%CI: 0.55-0.59), 0.77 (95%CI: 0.75-0.78), 0.73 (95%CI: 0.71-0.75), 0.69 (95%CI: 0.67-0.71) and 0.66 (95%CI: 0.64-0.68), respectively. The optimal diabetes predicting point cuts of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 1.40, 4.70, 1.28, 3.25, 1.17, 3.43, 2.46, and 3.58 mmol/L, respectively. Conclusions: Lipid metabolic disorder is a risk factor for diabetes. TG and TG/HDL-C are the good lipid metabolism indicators for the prediction of diabetic.


Assuntos
Diabetes Mellitus , Metabolismo dos Lipídeos , Estudos de Casos e Controles , HDL-Colesterol , Diabetes Mellitus/epidemiologia , Humanos , Incidência
16.
Eur J Gastroenterol Hepatol ; 33(12): 1517-1523, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34723873

RESUMO

BACKGROUND: Evidence is limited concerning the association between serum concentrations of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (APO A-I) and severe acute pancreatitis (SAP). This study was designed to explore whether HDL-C and APO A-I were independently correlated to SAP after adjusting for covariates. METHODS: There were 1127 patients with acute pancreatitis who were recruited from a tertiary teaching hospital in Wenzhou from 1 January 2018 to 30 April 2020. The independent variables were baseline levels of HDL-C, and APO A-I collected within 24 h after admission. The dependent variable was the occurrence of SAP during hospitalization. Univariate and multivariate binary logistic regression were conducted to analyze the relationship between HDL-C and APO A-I and SAP. The receiver operating characteristic curve was applied to analyze the prediction power of lipid parameters and C-reactive protein for SAP. RESULTS: The incidence of SAP was 11.5% among the 678 patients included in the final analysis. The serum levels of APO A-I and HDL-C were negatively related to SAP after adjusting for confounders with an odds ratio of 0.24 [95% confidence interval (CI): 0.06-0.95] and 0.16 (95% CI, 0.04-0.56), respectively. APO A-I (area under the curve = 0.69; 95% CI, 0.63-0.76) and HDL-C (area under the curve = 0.72; 95% CI, 0.66-0.79) showed higher predictive value for SAP compared with other lipid parameters. CONCLUSIONS: Decreased serum concentrations of HDL-C and APO A-I are associated with SAP after adjusting for covariates.


Assuntos
Apolipoproteína A-I , Pancreatite , Doença Aguda , Estudos de Casos e Controles , HDL-Colesterol , Humanos , Pancreatite/diagnóstico
17.
Wei Sheng Yan Jiu ; 50(5): 775-780, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34749871

RESUMO

OBJECTIVE: Used low density lipoprotein receptor knockout(LDLR KO) hamster as the model similar to human dyslipidemia to observe the lipid-lowering effect of equol on heterozygotes. METHODS: With soy-free high cholesterol high fat diet, 12-week-old LDLR KO female heterozygous hamsters were randomly divided into negative control group(no addition), positive control group(add 0.004% ezetimibe), genistein group(add 0.1%), and low, medium and high-dose groups of equol(add 0.025%, 0.05%, 0.1% respectively). Body weight, food consumption and blood lipid were continuously monitored for 12 weeks after feeding each group. Finally, liver morphology and lipid metabolism related genes expressions were checked. RESULTS: There was no significant difference in body weight and average weekly food intake among the groups. The blood lipids in negative control group increased over time, and the cholesterol and triglyceride levels of LDLR KO heterozygous hamsters were significantly reduced by ezetimibe in the second week, while the high-density lipoprotein cholesterol was also significantly decreased. The lipid-lowering effects of genistein and equol were weaker than ezetimibe, and there was significant difference between the two groups after 12 weeks, but the decrease of HDL-c was not as significant as ezetimibe. Compared with genistein, the effect of medium and high dose equol was stronger. At 12 weeks, the liver weight ratio also decreased significantly, and the liver lipid accumulation was inhibited, especially in the high dose of equol. The expression of ApoAI, SREBP-2 and HMGCR were significantly up-regulated by equol and genistein. CONCLUSION: Equol could reduce female LDLR KO hamster blood lipid. It may play a role in lipid lowering by inhibiting cholesterol absorption besides estrogen receptor pathway, but it is weaker than NPC1 L1 inhibitor. At the same time, up-regulation of ApoAI inhibits the decrease of high-density lipoprotein and reduces lipid accumulation in liver.


Assuntos
Equol , Receptores de LDL , Animais , Colesterol , HDL-Colesterol , Cricetinae , Feminino , Humanos , Lipídeos , Fígado , Receptores de LDL/genética
18.
BMC Cancer ; 21(1): 1084, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620113

RESUMO

BACKGROUND & AIMS: Little is known on the gender-specific effect and potential role of non-linear associations between metabolic syndrome (MetS) components and liver cancer risk. We evaluated these associations based on the UK Biobank cohort. METHODS: We included 474,929 individuals without previous cancer based on the UK Biobank cohort. Gender-specific hazard ratios (HRs) and 95% confidence interval (CIs) were calculated by Cox proportional hazards regression, adjusting for potential confounders. Non-linear associations for individual MetS components were assessed by the restricted cubic spline method. RESULTS: Over a median follow-up of 6.6 years, we observed 276 cases of liver cancer (175 men, 101 women). MetS [HR 1.48, 95% CI 1.27-1.72] and central obesity [HR 1.65, 95% CI 1.18-2.31] were associated with higher risk of liver cancer in men but not in women. Participants with hyperglycaemia has higher risk of liver cancer. High waist circumference and blood glucose were dose-dependently associated with increased liver cancer risk in both genders. For high density lipoprotein (HDL) cholesterol (both genders) and blood pressure (women), U-shaped associations were observed. Low HDL cholesterol (< 1.35 mmol/L) in men and high HDL cholesterol in women (> 1.52 mmol/L) were associated with increased liver cancer risk. CONCLUSIONS: MetS components showed gender-specific linear or U- shaped associations with the risk of liver cancer. Our study might provide evidence for individualized management of MetS for preventing liver cancer.


Assuntos
Neoplasias Hepáticas/etiologia , Síndrome Metabólica/complicações , Fatores Sexuais , Adulto , Idoso , Glicemia , HDL-Colesterol/sangue , Intervalos de Confiança , Feminino , Seguimentos , Humanos , Hiperglicemia/complicações , Hipertensão/complicações , Hipertrigliceridemia/complicações , Neoplasias Hepáticas/epidemiologia , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Obesidade Abdominal/complicações , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Reino Unido/epidemiologia , Circunferência da Cintura
19.
Clin Nutr ESPEN ; 45: 91-101, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34620375

RESUMO

BACKGROUND: Coronavirus disease-2019 (COVID-19) is a global pandemic. Studies reported dyslipidemia in patients with COVID-19. Herein, we conducted a systematic review and meta-analysis of published articles to evaluate the association of the lipid profile with the severity and mortality in COVID-19 patients. METHODS: PubMed/Medline, Europe PMC, and Google Scholar were searched for studies published between January 1, 2020 and January 13, 2021. Random or Fixed effects models were used to calculate the mean difference (MD) and 95% confidence intervals (CIs). Statistical heterogeneity was assessed using Cochran's Q test and I2 statistics. RESULTS: This meta-analysis included 19 studies. Of which, 12 studies were categorized by severity, 04 studies by mortality, and 03 studies by both severity and mortality. Our findings revealed significantly decreased levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in the severe group when compared with the non-severe group in a random effect model. Similarly, random effect model results demonstrated significantly lower levels of HDL-C and LDL-C in the non-survivor group when compared with the survivor group. The level of TC was also found to be decreased in the non-survivor group when compared to the survivor group in a fixed-effect model. CONCLUSION: In conclusion, the lipid profile is associated with both the severity and mortality in COVID-19 patients. Hence, the lipid profile may be used for assessing the severity and prognosis of COVID-19. PROSPERO REGISTRATION NUMBER: CRD42021216316.


Assuntos
COVID-19 , HDL-Colesterol , LDL-Colesterol , Humanos , Lipídeos , SARS-CoV-2
20.
PLoS One ; 16(10): e0258507, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34644368

RESUMO

INTRODUCTION: There is limited data on the effects of low carbohydrate diets on renal outcomes particularly in patients with underlying diabetic kidney disease. Therefore, this study determined the safety and effects of very low carbohydrate (VLCBD) in addition to low protein diet (LPD) on renal outcomes, anthropometric, metabolic and inflammatory parameters in patients with T2DM and underlying mild to moderate kidney disease (DKD). MATERIALS AND METHODS: This was an investigator-initiated, single-center, randomized, controlled, clinical trial in patients with T2DM and DKD, comparing 12-weeks of low carbohydrate diet (<20g daily intake) versus standard low protein (0.8g/kg/day) and low salt diet. Patients in the VLCBD group underwent 2-weekly monitoring including their 3-day food diaries. In addition, Dual-energy x-ray absorptiometry (DEXA) was performed to estimate body fat percentages. RESULTS: The study population (n = 30) had a median age of 57 years old and a BMI of 30.68kg/m2. Both groups showed similar total calorie intake, i.e. 739.33 (IQR288.48) vs 789.92 (IQR522.4) kcal, by the end of the study. The VLCBD group showed significantly lower daily carbohydrate intake 27 (IQR25) g vs 89.33 (IQR77.4) g, p<0.001, significantly higher protein intake per day 44.08 (IQR21.98) g vs 29.63 (IQR16.35) g, p<0.05 and no difference in in daily fat intake. Both groups showed no worsening of serum creatinine at study end, with consistent declines in HbA1c (1.3(1.1) vs 0.7(1.25) %) and fasting blood glucose (1.5(3.37) vs 1.3(5.7) mmol/L). The VLCBD group showed significant reductions in total daily insulin dose (39(22) vs 0 IU, p<0.001), increased LDL-C and HDL-C, decline in IL-6 levels; with contrasting results in the control group. This was associated with significant weight reduction (-4.0(3.9) vs 0.2(4.2) kg, p = <0.001) and improvements in body fat percentages. WC was significantly reduced in the VLCBD group, even after adjustments to age, HbA1c, weight and creatinine changes. Both dietary interventions were well received with no reported adverse events. CONCLUSION: This study demonstrated that dietary intervention of very low carbohydrate diet in patients with underlying diabetic kidney disease was safe and associated with significant improvements in glycemic control, anthropometric measurements including weight, abdominal adiposity and IL-6. Renal outcomes remained unchanged. These findings would strengthen the importance of this dietary intervention as part of the management of patients with diabetic kidney disease.


Assuntos
Nefropatias Diabéticas/dietoterapia , Dieta com Restrição de Carboidratos , Absorciometria de Fóton , Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/fisiologia , Adulto , Idoso , Glicemia/análise , Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Creatinina/sangue , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/complicações , Nefropatias Diabéticas/patologia , Dieta com Restrição de Carboidratos/efeitos adversos , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento
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