Association between metabolic syndrome and incidence of cholelithiasis in the Korean population.

BACKGROUND AND AIM: Cholelithiasis is one of the most common gastrointestinal diseases worldwide. The metabolic syndrome (MetS), a combination of various metabolic abnormalities, is also common with a continually increasing prevalence. These diseases are associated with several risk factors. However, data on the association between MetS components and cholelithiasis are insufficient. This study aimed to analyze the association of MetS and its components with the incidence of cholelithiasis using national data from the Korean population. METHODS: Data were obtained from the National Health Insurance Corporation of Korea, and 207 850 individuals without cholelithiasis in 2009 were enrolled and followed up until 2013. A multivariate Cox proportional hazard model was used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of cholelithiasis according to the presence of MetS and the number of MetS components. Furthermore, the risk of cholelithiasis was evaluated in individuals with a single metabolic component. RESULTS: The multivariate adjusted HRs and 95% CIs for incident cholelithiasis according to 1, 2, 3, and 4-5 MetS components were 1.08 (0.93-1.24), 1.22 (1.06-1.41), 1.35 (1.17-1.57), and 1.35 (1.15-1.57), respectively (P < 0.001). This increasing trend was observed in both sexes. Compared with participants with no metabolic components, those with low high-density lipoprotein (HDL) cholesterol had a significantly increased risk for cholelithiasis (adjusted HR, 1.39 [95% CI, 1.05-1.85]). CONCLUSIONS: Metabolic syndrome is a potential risk factor for cholelithiasis. Low HDL cholesterol level is the most relevant factor among MetS components for incident cholelithiasis.

Niemann-Pick disease type-B: a unique case report with compound heterozygosity and complicated lipid management.

BACKGROUND: Niemann-Pick disease (NPD) is a rare autosomal recessive hereditary disease characterized by deficient activity of acid sphingomyelinase. CASE PRESENTATION: We present a case of NPD type B with a unique compound heterozygosity for SMPD1 (NM_000543.4:c.[84delC];[96G > A]) in which both mutations that induce an early stop codon are located before the second in-frame initiation codon. The clinical presentation of the patient is compatible with NPD type B. She was initially diagnosed of Gaucher Disease, but her altered lipid profile led to a clinical suspicion of NPD. Combined high doses of atorvastatin and ezetimibe were given to treat the severe hypercholesterolemia. CONCLUSIONS: The pharmacological management of the lipid profile in these patients is important. A unique compound mutation in SMPD1 gene is described.

Tangier disease in family with the phenotype of familial hypercholesterolemia.

Within the project MedPed (Make Early Diagnosis to Prevent Deaths) we have examined patient with familial hypercholesterolemia in our lipid ambulance. During the following investigation of the patients family we found out that her sister has on the contrary very low levels of  total and LDL-cholesterol. Concentration of  HDL-cholesterol was extreamly low (almost immeasurable). Differential diagnosis uttered a suspicion of rare form of familial hypoalfalipoproteinemia so-called Tangier disease. This suspicion was then confirmed by molecular genetic examination. Tangier disease is a rare lipoprotein metabolism disorder characterized biochemically by  almost complete absence of plasmatic HDL- cholesterol, extremely low level of apolipoprotein A-I and accumulation of cholesterol esters in macrophages. The first case was recorded on the Tangier island in 1961. In our research we describe the first case of a patient with homozygous form of Tangier disease in the history of the Czech Republic.

Cardiovascular risk profile of patients with atherogenic dyslipidemia in middle age Lithuanian population.

BACKGROUND: Atherogenic dyslipidemia (AD) is a blood serum lipid profile abnormality characterized by elevation of triglycerides and reduced levels of high density lipoprotein cholesterol (HDL-C). It is associated with residual cardiovascular risk. This study evaluated and compared the risk profiles of patients with hypertriglyceridemia, low-HDL-C levels or AD, in order to understand, which lipid profile is associated with greater risk. METHODS: During the period of 2009-2016 a population of 92,373 Lithuanian adults (men 40-54 years old and women 50-64 years old) without overt cardiovascular disease were analyzed. Data of 25,746 patients (68.6% women and 31.4% men) with hypertriglyceridemia and/or low HDL-C low levels were collected and used for further statistical analysis. RESULTS: Participants with AD tend to have more unfavorable risk profile than participants with hypertriglyceridemia or low-HDL-C. AD tends to cluster with other atherogenic risk factors, such as arterial hypertension [odds ratio (OR) 1.96, 95% confidence intervals (CI) 1.87-2.01], smoking [OR 1.20, 95% CI 1.14-1.27], diabetes mellitus [OR 2.74, 95% CI 2.58-2.90], obesity [OR 2.92, 95% CI 2.78-3.10], metabolic syndrome [OR 22.27, 95% CI 20.69-23.97], unbalanced diet [OR 1,59, 95% CI 1.51-1.68], low physical activity [OR 1.80, 95% CI 1.71-1,89], CHD history in first degree relatives [OR 1.18, 95% CI 1.12-1.25] and total number of risk factors [OR 1.47, 95% CI 1.38-1.57]. CONCLUSION: AD is associated with more unfavorable cardiovascular risk profile than hypertriglyceridemia or low-HDL cholesterol levels. Once identified AD should require additional medical attention since it is an important factor of residual cardiovascular risk.

A common variant association study reveals novel susceptibility loci for low HDL-cholesterol levels in ethnic Arabs.

The genetic susceptibility to acquiring low high density lipoprotein-cholesterol (LHDLC) levels is not completely elucidated yet. In this study, we performed a common variant association study for harboring this trait in ethnic Arabs. We employed the Affymetrix high-density Axiom Genome-Wide ASI Array (Asian population) providing a coverage of 598,000 single nucleotide variations (SNPs) to genotype 5495 individuals in a two-phase study involving discovery and validation sets of experiments. The rs1800775 [1.31 (1.22-1.42); p = 3.41E-12] in the CETP gene and rs359027 [1.26 (1.16-1.36); p = 2.55E-08] in the LMCD1 gene were significantly associated with LHDLC levels. Furthermore, rs3104435 [1.26 (1.15-1.38); p = 1.19E-06] at the MATN1 locus, rs9835344 [1.16 (1.08-1.26); p = 8.75E-06] in the CNTN6 gene, rs1559997 [1.3 (1.14-1.47); p = 9.48E-06] in the SDS gene and rs1670273 [1.2 (1.1-1.31); p = 4.81E-06] in the DMN/SYNM gene exhibited suggestive association with the disorder. Seven other variants including rs1147169 in the PLCL1 gene, rs10248618 in the DNAH11, rs476155 in the GLIS3, rs7024300 in the ABCA1, intergenic rs10836699, rs11603691 in P2RX3 and rs750134 in CORO1C gene exhibited borderline protective properties. Validation and joint meta-analysis resulted in rs1800775, rs3104435 and rs359027 retaining their predisposing properties, while rs10836699 and rs11603691 showed protective properties. Our data show several predisposing variants across the genome for LHDLC levels in ethnic Arabs.

An analysis of the risk factors for premature coronary artery disease in young and middle-age Chinese patients with hypertension.

BACKGROUND: Hypertension has become prevalent among young and middle-age individuals. Many studies have identified a variety of risk factors for cardiovascular diseases, yet there have been few reports focusing on the young and middle-age hypertensive population. OBJECTIVE: To investigate the epidemiological characteristics of conventional risk factors of premature coronary artery disease (PCAD) in patients with hypertension. METHODS: The clinical and laboratory data of 267 hypertensive patients with PCAD and 96 hypertensive patients without any visible coronary disease according to angiography were compared. Potential coronary risk factors were analyzed using logistic regression. RESULTS: The PCAD group had lower levels of high-density lipoprotein cholesterol (HDL-C) (P<0.05). Multivariate logistic analysis showed positive family history, low HDL-C, hypertriglyceridemia, duration of diabetes mellitus and male sex were significantly associated with PCAD (P<0.05), with ORs of 12.317, 3.267, 2.894, 1.140 and 0.088, respectively. Plasma renin activities in PCAD patients were significantly higher than in control hypertensive patients (P=0.027), but there was no significant difference in angiotensin II and aldosterone levels between the two groups. CONCLUSION: Low HDL-C and hypertriglyceridemia are important coronary risk factors in Chinese individuals with hypertension.

NHANES 2011-2014 Reveals Decreased Cognitive Performance in U.S. Older Adults with Metabolic Syndrome Combinations.

A relationship between metabolic syndrome and cognitive impairment has been evidenced across research; however, conflicting results have been observed. A cross-sectional study was conducted on 3179 adults older than 60 from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) to analyze the relationship between metabolic syndrome and cognitive impairment. In our results, we found that adults with abdominal obesity, high triglycerides, and low HDL cholesterol had 4.39 fewer points in the CERAD immediate recall test than adults without any metabolic syndrome factors [Beta = -4.39, SE = 1.32, 17.75 (1.36) vs. 22.14 (0.76)]. In addition, people with this metabolic syndrome combination exhibited 2.39 fewer points in the CERAD delayed recall test than those without metabolic syndrome criteria [Beta = -2.39, SE = 0.46, 4.32 (0.49) vs. 6.71 (0.30)]. It was also found that persons with high blood pressure, hyperglycemia, and low HDL-cholesterol levels reached 4.11 points less in the animal fluency test than people with no factors [Beta = -4.11, SE = 1.55, 12.67 (2.12) vs. 16.79 (1.35)]. These findings suggest that specific metabolic syndrome combinations are essential predictors of cognitive impairment. In this study, metabolic syndrome combinations that included obesity, fasting hyperglycemia, high triglycerides, and low HDL-cholesterol were among the most frequent criteria observed.

Sex-Dependent Effects of the Intake of NOVA Classified Ultra-Processed Foods on Syndrome Metabolic Components in Brazilian Adults.

Longitudinal studies evaluating the relationship between UPF consumption and the incidence of Metabolic Syndrome (MetS) and its components are still scarce. This study aimed to evaluate the effect of UPF consumption on the incidence of MetS and its components in adults. A prospective study was conducted with 896 participants from the 1978/79 Ribeirão Preto cohort, São Paulo, Brazil. UPF consumption was evaluated in %kcal and %g at ages 23-25 years. Incidence of MetS and its components were estimated at ages 37-39 years, according to the Joint Interim Statement criteria. Poisson regression was used to assess associations, and interactions with sex were investigated. UPF consumption had no association with MetS (%kcal Adjusted PR: 1.00; 95% CI: 0.99-1.01; %g Adjusted PR: 1.00; 95% CI: 0.99-1.01). However, women with higher UPF consumption, in %kcal and %g, had a higher risk of abdominal obesity (%kcal: p = 0.030; %g: p = 0.003); and women with higher UPF consumption, in %g, had a higher risk of low HDL-cholesterol (p = 0.041). For the other components of MetS, no significant associations were observed in either sex. These findings suggest evidence of no association between UPF consumption and MetS; however, consumption of UPF was associated with increased WC and low HDL-c, but only in women.

Prevalence, patterns and predictors of dyslipidaemia in Nigeria: a report from the REMAH study.

AIM: The aim of this study was to determine the prevalence and predictors of dyslipidaemia in adults in Nigeria. METHODS: Using the WHO criteria, we determined dyslipidaemia using serum lipid levels of 3 211 adult Nigerians, aged at least 18 years, obtained between March 2017 and February 2018 from two communities (rural and urban) in a state from each of the six geopolitical zones of Nigeria. RESULTS: The overall prevalence of low high-density lipoprotein cholesterol (l-HDL), elevated low-density lipoprotein cholesterol (e-LDL), hypertriglyceridaemia (h-TG) and hypercholesterolaemia (h-CHL) were 72.5,13.6, 21.4 and 7.5%, respectively. The adjusted odds of h-CHL [odds ratio (95% confidence interval) 1.47 (1.10-1.95)], h-TG [1.89 (1.48-2.41)] and e-LDL [1.51 (1.03-2.15)] increased with obesity. Being a rural dweller increased the odds of h-TG [1.55 (1.29-1.85)], e-LDL [1.38 (1.10-1.73)] and l-HDL [1.34 (1.14-1.58)]. The odds of h-CHL [2.16 (1.59-2.95)], h-TG [1.21 (1.01-1.47)], e-LDL [1.42 (1.13-1.80)] and l-HDL [0.78 (0.65-0.93)] increased with hypertension. Diabetes mellitus doubled only the odds of h-TG [2.04(1.36-3.03)]. CONCLUSION: The prevalence of dyslipidaemia, particularly low HDL-C, is high among adult Nigerians.

Current Status of Familial LCAT Deficiency in Japan.

Lecithin cholesterol acyltransferase (LCAT) is a lipid-modification enzyme that catalyzes the transfer of the acyl chain from the second position of lecithin to the hydroxyl group of cholesterol (FC) on plasma lipoproteins to form cholesteryl acylester and lysolecithin. Familial LCAT deficiency is an intractable autosomal recessive disorder caused by inherited dysfunction of the LCAT enzyme. The disease appears in two different phenotypes depending on the position of the gene mutation: familial LCAT deficiency (FLD, OMIM 245900) that lacks esterification activity on both HDL and ApoB-containing lipoproteins, and fish-eye disease (FED, OMIM 136120) that lacks activity only on HDL. Impaired metabolism of cholesterol and phospholipids due to LCAT dysfunction results in abnormal concentrations, composition and morphology of plasma lipoproteins and further causes ectopic lipid accumulation and/or abnormal lipid composition in certain tissues/cells, and serious dysfunction and complications in certain organs. Marked reduction of plasma HDL-cholesterol (HDL-C) and corneal opacity are common clinical manifestations of FLD and FED. FLD is also accompanied by anemia, proteinuria and progressive renal failure that eventually requires hemodialysis. Replacement therapy with the LCAT enzyme should prevent progression of serious complications, particularly renal dysfunction and corneal opacity. A clinical research project aiming at gene/cell therapy is currently underway.

Ultrasound measurement of intraabdominal fat thickness as a predictor of insulin resistance and low HDL cholesterol in Asians.

OBJECTIVES: Insulin resistance (IR) is important in the pathogenesis of diabetes, the prevalence of which has become a major public health threat in Asia. The aim of this study was to use ultrasound measurements of abdominal fat thickness to predict IR and low high-density lipoprotein cholesterol (HDL-C) levels among Singaporean adults. METHODS: A total of 399 healthy Singaporeans (mean age 36.7 ± 14.3 y; 43.4% men) took part in this study. Preperitoneal fat thickness (PFT) and subcutaneous fat thickness (SFT) were determined by ultrasound. RESULT: We found that both PFT and SFT had significant positive correlations (P < 0.05) with fasting insulin concentration, homeostasis model assessment of insulin resistance, triacylglycerol (TG), and blood pressure, and negatively correlated to serum HDL-C in all participants. Separating men and women, PFT was an independent determinant of IR and low HDL-C only in men. On receiver-operating characteristic curve analysis, PFT ≥1.2 cm was the optimal cutoff value to identify IR and low HDL-C in men. On the other hand, SFT was the determinant of IR, elevated TG, and low HDL-C only in women. An SFT of 1.1 cm was the optimal cutoff value to define IR, elevated TG, and low HDL-C in women. CONCLUSIONS: Results of this study suggested that ultrasound measurements of PFT and SFT could provide simple and useful indices of IR and lipid disorders for healthy Singaporean men and women. They might have the diagnostic values for predicting cardiovascular risks in this population.

Relationship between Metabolic Syndrome Components and Periodontal Disease in a Japanese General Population: the Suita Study.

AIM: A positive association between metabolic syndrome (MetS) and periodontal status has recently been noted. However, no study has evaluated the relationship by sex and in a general urban population using the uniform definition proposed in the 2009 Joint Interim Statement. The aim of this study was to clarify the relationship between MetS and periodontal status using the uniform definition in a general urban Japanese population. METHODS: A total of 1,856 Japanese men and women (mean age: 66.4 years) were studied using data from the Suita study. Periodontal status was evaluated by the Community Periodontal Index (CPI). MetS was defined using the 2009 Joint Interim Statement. The associations of the MetS and its components with periodontal disease were investigated using multiple logistic regression analysis adjusting for age, drinking, and smoking. RESULTS: Among the components of the MetS, low HDL cholesterol level was significantly associated with periodontal disease in men and women [odds ratios (OR)=2.39 and 1.53; 95% confidence intervals=1.36-4.19 and 1.06-2.19]. Furthermore, the risk of periodontal disease showed 1.43-, 1.42-, and 1.89-fold increases in those with 2, 3, and ≥4 components, respectively, compared with those having no components (Ptrend ＜0.001). For the analysis by sex, the risk of periodontal disease was increased 2.27- and 1.76-fold in those with ≥4 components in men and women, respectively (both Ptrend=0.001). CONCLUSION: These findings suggest that MetS and lower HDL cholesterol are associated with periodontal disease. Subjects with two or more MetS components had a significantly higher prevalence of periodontal disease.

Magnesium in metabolic syndrome: a review based on randomized, double-blind clinical trials.

A growing body of evidence shows the effect of magnesium on serum glucose, HDL-cholesterol, and triglycerides levels, as well as on blood pressure, which strongly suggests that magnesium might play an important role in metabolic syndrome (MetS), a cluster of risk factors for cardiovascular disease and type 2 diabetes. We performed a systematic review of clinical evidence derived from randomized, double-blind, controlled clinical trials, regarding the efficacy of magnesium supplementation on the components of MetS. Using the electronic databases of Medline, Embase, and the Cochrane Controlled Trials Register up to May 2016, we looked for randomized controlled trials focused on the effects of oral magnesium supplementation on insulin sensitivity, glucose, triglyceride and HDL-cholesterol levels, as well as its effects on high blood pressure, irrespective of the magnesium salt used, and with a duration of at least four weeks. Crossover studies, irrespective of blinding criteria, were not included. Results of this review show that magnesium supplementation in individuals with hypomagnesemia can be effective in the treatment of MetS.

Association of metabolic syndrome and its components with hyperuricemia in a Mediterranean population.

Several studies have found an association between hyperuricemia and metabolic syndrome (MS), although there are discrepancies as to which MS components play a pivotal role in this association. We aimed to investigate the association between serum uric acid (SUA) levels and MS in a Mediterranean population (eastern Spain). We performed a case-control study of 71 patients with MS and 122 healthy controls. MS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III modified criteria. Hyperuricemia was defined as SUA levels >6.55 mg/dL. We determined biochemical, lipidic and inflammatory parameters along with uric acid. Patients with MS showed a higher risk of hyperuricemia than those without MS (OR: 2.87 95% CI: 1.48- 5.55; p = 0.002). In turn, the unadjusted logistic regression analysis showed that hyperuricemia is associated with a higher risk of presenting all the MS components, except hypertension; i.e., hypertriglyceridemia, low HDL-cholesterol, abdominal obesity and glucose intolerance were predictors for hyperuricemia (OR: 3.15, 95% CI: 1.61- 6.15, p = 0.001; OR: 4.07, 95% CI: 1.77- 9.33, p = 0.001; OR: 2.81, 95% CI: 1.41- 5.58, p = 0.003 and OR: 2.82, 95% CI: 1.46- 5.45, p = 0.002 respectively). The adjusted logistic regression analysis revealed that only low HDL-cholesterol and glucose intolerance were independent predictors for hyperuricemia (OR: 2.71, 95% CI 1.06- 6.97, p = 0.038; OR: 2.14, 95% CI 1.01- 4.56, p = 0.049, respectively). In our geographical area, the patients with MS showed a nearly 3-fold risk of hyperuricemia than those without. Among all the MS components, low-HDL-cholesterol and high glucose independently increased more than twice the risk of hyperuricemia, and are the pivotal components involved in hyperuricemia.

The metabolic and pharmacologic bases for treating atherogenic dyslipidaemia.

Dyslipoproteinaemia is a cardinal feature of the metabolic syndrome that accelerates atherosclerosis. It is characterized by high plasma concentrations of triglyceride-rich and apolipoprotein (apo) B-containing lipoproteins, with depressed high-density lipoprotein (HDL) and increased small dense low-density lipoprotein (LDL) particle concentrations. Dysregulation of lipoprotein metabolism in the metabolic syndrome may be due to a combination of overproduction of very-low density lipoprotein (VLDL) apoB, decreased catabolism of apoB-containing particles, and increased catabolism of HDL apoA-I particles. These abnormalities are due to a global metabolic effect of insulin resistance and visceral obesity. Lifestyle modifications (dietary restriction and increased exercise) and pharmacological treatments favourably alter lipoprotein transport by decreasing the hepatic secretion of VLDL-apoB and the catabolism of HDL apoA-I, as well as by increasing the clearance of LDL-apoB. The safety and tolerability of combination drug therapy based on statins is important and merits further investigation. There are several pipeline therapies for correcting triglyceride-rich lipoprotein and HDL metabolism. However, their clinical efficacy, safety and cost-effectiveness remain to be demonstrated.

Low HDL cholesterol is associated with increased atherogenic lipoproteins and insulin resistance in women classified with metabolic syndrome.

Both metabolic syndrome (MetS) and elevated LDL cholesterol (LDL-C) increase the risk for cardiovascular disease (CVD). We hypothesized that low HDL cholesterol (HDL-C) would further increase CVD risk in women having both conditions. To assess this, we recruited 89 women with MetS (25-72 y) and LDL-C ≥ 2.6 mmol/L. To determine whether plasma HDL-C concentrations were associated with dietary components, circulating atherogenic particles, and other risk factors for CVD, we divided the subjects into two groups: high HDL-C (H-HDL) (≥ 1.3 mmol/L, n = 32) and low HDL-C (L-HDL) (< 1.3 mmol/L, n = 57). Plasma lipids, insulin, adiponectin, apolipoproteins, oxidized LDL, Lipoprotein(a), and lipoprotein size and subfractions were measured, and 3-d dietary records were used to assess macronutrient intake. Women with L-HDL had higher sugar intake and glycemic load (P < 0.05), higher plasma insulin (P < 0.01), lower adiponectin (P < 0.05), and higher numbers of atherogenic lipoproteins such as large VLDL (P < 0.01) and small LDL (P < 0.001) than the H-HDL group. Women with L-HDL also had larger VLDL and both smaller LDL and HDL particle diameters (P < 0.001). HDL-C was positively correlated with LDL size (r = 0.691, P < 0.0001) and HDL size (r = 0.606, P < 0.001), and inversely correlated with VLDL size (r = -0.327, P < 0.01). We concluded that L-HDL could be used as a marker for increased numbers of circulating atherogenic lipoproteins as well as increased insulin resistance in women who are already at risk for CVD.

Low high-density lipoprotein cholesterol: current status and future strategies for management.

Atherosclerotic cardiovascular disease is the foremost cause of death and disability in the Western world, and it is rapidly becoming so in the developing nations. Even though the use of statin therapy aiming at the low-density lipoprotein cholesterol (LDL) has significantly reduced cardiovascular events and mortality, substantial residual cardiac events still occur in those being treated to the currently recommended targets. In fact, residual risk is also seen in those who are treated "aggressively" such as the "high risk" patients so defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Consequently, one must look for the predictors of risk beyond LDL reduction. High-density lipoprotein cholesterol (HDL) is the next frontier. The protectiveness of elevated HDL against atherosclerosis is well described in the literature. HDL subdues several atherogenic processes, such as oxidation, inflammation, cell proliferation and thrombosis. It also helps mobilize the excess LDL via reverse cholesterol transport. Low levels of HDL have been shown to be independent predictors of risk. Thus, therapies to raise the HDL hold promise for additional cardiac risk reduction. In this regard, several randomized trials have recently tested this hypothesis, especially in patients at high risk. In addition to the use of aggressive lifestyle modification, clinical outcomes have been measured following augmentation of HDL levels with various treatment modalities, including aggressive statin therapy, combination therapy with fibrates and niacin, and direct HDL-raising drug treatments. These data for low HDL as an independent risk factor and as the new treatment target are reviewed in this paper.

Prevalencia de colesterol HDL-bajo asociado a otros factores de riesgo cardiovascular en una población adulta en la Policlínica del Hospital Central del Instituto de Previsión Central / Prevalence of low HDL cholesterol associated with other cardiovascular risks factors in an adult population in the IPS Polyclinic of the Central Hospital from the Central Previtional Institut

Introducción: el colesterol HDL (c-HDL) es una lipoproteína encargada de la remoción del colesterol en exceso a nivel de las arterias, por lo que sus niveles bajos promueven la formación de placas ateromatosas y si a esto le sumamos otros factores de riesgo cardiovascular, en su gran mayoría modificables, a nuestra población adulta, no es de extrañar que la enfermedad cardiovascular sea la primera causa de muerte en nuestro país. Con la intervención precoz sobre los factores de riesgo cardiovasculares se podría disminuir la mortalidad por esta causa. Objetivo: determinar la prevalencia del c-HDL-bajo en una población adulta aparentemente sana y su asociación a otros factores de riesgo cardiovascular. Material y método: estudio observacional, descriptivo de corte transverso con componente analítico de pacientes adultos que consultaron en la Policlínica del IPS Hospital Central por cualquier razón en el periodo abril-mayo 2013. Resultados: en una población adulta de 110 pacientes, aparentemente sanos, la frecuencia del c-HDL bajo fue del 48%, las mujeres fueron más asiduas a consulta (83%), y en su mayoría tuvieron tendencia al HDL normal. Los varones acudieron menos a consulta y presentaron porcentajes más elevados de c-HDL bajo. La mitad de los pacientes presentaban hipercolesterolemia; predomino del sobrepeso y la obesidad sobre el peso normal; 95% de los pacientes eran sedentarios. Hubo un bajo porcentaje de intolerantes a la glucosa y elevado de hipertensos no controlados. El c-LDL no fue elevado en promedio y no arrojó diferencias entre los grupos c-HDL normal y bajo. Conclusiones: los sujetos eran procedentes de la capital y del Departamento Central, es decir de aéreas más bien urbanas. La mayoría de los pacientes en estudio eran mujeres adultas, con sobrepeso, sedentarias, con colesterol elevado e hipertensas. El grupo con c-HDL bajo se encontraba asociado a otros factores de riesgo como: sexo masculino, sobrepeso u obesidad, sedentarismo, hipercolesterolemia, hipertrigliceridemia e hipertensión arterial. Los pacientes de peso normal presentaba c-HDL bajo en una proporción importante. Las mujeres, sedentarias, con sobrepeso u obesas, presentaban c-HDL normal en una proporción significativa. La mayoría de los factores de riesgo cardiovascular encontrados en los pacientes son modificables.

Introduction: HDL cholestero (HDL-C) is a lipoprotein responsible for the remoral of excess cholesterol from arteries, low promote the formation of atheromatous plaques and if we add other cardiovascular risk factors, the vast majority to our adult population, it is no wonder how cardiovascular disease is the leading cause of death in our country. With early intervention on cardiovascular risk factors we could reduce mortality from this cause.Objetive: To determine the prevalence of low HDL-C in apparently healthy adult population and its association with other cardiovascular risk factors. Methods: Observational descriptive cross sectional study with analytical component of adult patients concurrent the Central Polyclinic Hospital IPS for any reason in the period April-May 2013. Results: In a population of 110 adult patients, apparently healthy, the frequency of low HDL-C was 48%, women were assiduous to consulation (83%) and majority had normal HDL-C tendency. The male came less to consultation and presented higher percentages of low HDL-C. Half of the patients had hypercholesterolemia; predominance of overweight and obesity over normal weigth, 95% of patients were sedentary. There was a low porcentage of glucose intolerance and high uncontrolled hypertension. The LDL-C was not high on average and showed no difference between low and normal HDL groups. Conclusions: Subjects were from the capital and the Central Departament, predominantly from urban areas. Most patients studied were adult women, overweight, sedentary, with high cholesterol and hypertension. The group with low HDL-C was assiociated with other risk factors such as male gender, overweight or obesity, physical inactivity, hipercholesterolemia, hypertriglyceridemia and hypertension. Normal weight patients had low HDL-C in a significant proportion. Women, sedentary, overweight or obese, had normal HDL-C in a significant proportion. The majority of cardiovascular risk factors found in patients were modifiable.

Trend of Prevalence of Low HDL-Cholesterol and Related Factors in Korean Men: Using 3 Korean National Health and Nutrition Examination Survey Data (1998-2005) / 가정의학회지

BACKGROUND: Low high density lipoprotein-cholesterol (HDL-C) is one of the major risk factors for coronary heart disease. Using data from the Korean National Health and Nutrition Examination Survey (KNHANES), we assessed trend of the prevalence of low HDL-C and the factors which are associated with low HDL-C in Korean men. METHODS: We analyzed three serial KNHANES data which were conducted in year 1998, 2001, and 2005. Among all survey participants, we included men aged 30-79 years with laboratory data. Low HDL-C was defined by serum HDL-C < 40 mg/dL. We used multiple logistic regression analysis to assess the association between low HDL-C and related factors. We investigated trend of the prevalence of low HDL-C and associated factors among Korean men. RESULTS: The prevalence of low HDL-C in Korean men was increasing from 26.3% (1998) to 38.8% (2001) and 45.9% (2005). Low HDL-C was associated with non-alcohol drinker, current smoking, sedentary physical activity, obesity and hypertriglyceridemia. The prevalence of current smoking decreased linearly. The prevalence of sedentary physical activity and hypertriglyceridemia increased from year 1998 to year 2001, but decreased from year 2001 to year 2005. However, the prevalence of non-alcohol drinker and obesity increased continuously. The patterns of the increasing prevalence of low HDL-C were compatible to the increasing prevalence of obesity according to age in Korean men. CONCLUSION: From year 1998 to year 2005, the prevalence of low HDL-C in Korean men has increased. Obesity and non-alcohol drinking might be contributing factors of increasing prevalence of low HDL-C in Korean men. Management of obesity is needed to prevent increasing the prevalence of low HDL-C among Korean men.

Low HDL cholesterol is associated with increased atherogenic lipoproteins and insulin resistance in women classified with metabolic syndrome

Both metabolic syndrome (MetS) and elevated LDL cholesterol (LDL-C) increase the risk for cardiovascular disease (CVD). We hypothesized that low HDL cholesterol (HDL-C) would further increase CVD risk in women having both conditions. To assess this, we recruited 89 women with MetS (25-72 y) and LDL-C > or = 2.6 mmol/L. To determine whether plasma HDL-C concentrations were associated with dietary components, circulating atherogenic particles, and other risk factors for CVD, we divided the subjects into two groups: high HDL-C (H-HDL) (> or = 1.3 mmol/L, n = 32) and low HDL-C (L-HDL) (< 1.3 mmol/L, n = 57). Plasma lipids, insulin, adiponectin, apolipoproteins, oxidized LDL, Lipoprotein(a), and lipoprotein size and subfractions were measured, and 3-d dietary records were used to assess macronutrient intake. Women with L-HDL had higher sugar intake and glycemic load (P < 0.05), higher plasma insulin (P < 0.01), lower adiponectin (P < 0.05), and higher numbers of atherogenic lipoproteins such as large VLDL (P < 0.01) and small LDL (P < 0.001) than the H-HDL group. Women with L-HDL also had larger VLDL and both smaller LDL and HDL particle diameters (P < 0.001). HDL-C was positively correlated with LDL size (r = 0.691, P < 0.0001) and HDL size (r = 0.606, P < 0.001), and inversely correlated with VLDL size (r = -0.327, P < 0.01). We concluded that L-HDL could be used as a marker for increased numbers of circulating atherogenic lipoproteins as well as increased insulin resistance in women who are already at risk for CVD.