Lipids profile in children and adolescents with β-thalassemia major

ABSTRACT Introduction: Patients with β-thalassemia major (β-TM) are at risk of developing abnormal lipid profiles. Lipid abnormalities, in turn, have a potential role in the pathogenesis of some clinical aspects of thalassemia Objectives: To evaluate lipid levels and atherogenic indices in β-TM patients compared to healthy children and for any association between lipid levels, lipid peroxidation and inflammatory biomarkers Methods: This case-control study was carried out on 79 patients with β-TM, aged 6 to 16 years, registered at the Basrah Center for Hereditary Blood Diseases and 85 age- and sex-matched apparently healthy children and adolescents. Complete blood count, serum lipids and ferritin, liver function tests, C-reactive protein (CRP), high-sensitivity CRP (hs-CRP) and serum malondialdehyde (MDA) were evaluated Results: Patients with β-TM had significantly lower hemoglobin (Hb), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and non-high-density lipoprotein (non-HDL) and significantly higher very low-density lipoprotein (VLDL), triglycerides (TGs), LDL/HDL ratio, MDA, hs-CRP, total serum bilirubin (TSB), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) than the control group (p < 0.05). A bivariate analysis revealed that TC has a significant positive association with Hb. The TG has a significant negative association with Hb and a positive association with serum ferritin. Furthermore, MDA, TG, TSB, ALT and AST were significantly positively correlated with serum ferritin (p < 0.05) Conclusions: Atherogenic dyslipidemia, defined as a high low-density lipoprotein cholesterol (LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio and high TG level, is common among pediatric β-TM patients, it is associated with iron overload and places patients at an increased cardiovascular risk.

Impact of COVID-19-related lockdown on metabolic syndrome variables in healthcare workers with pre-existing metabolic syndrome: A prospective study

Background: An extraordinary impact on health-care personnel has been caused by the coronavirus disease-2019 (COVID-19) pandemic, a health-care crisis. Aims and Objectives: Our aim was to assess the effects of a changing lifestyle on anthropometric measurements, blood glucose levels, atherogenic lipid profiles, and blood pressure over the course of a year in Indian healthcare workers (HCWs). Materials and Methods: A prospective study was carried out on 40 HCWs including 23 male and 17 females between the age of 22 and 59 years. The study was conducted in the Department of Physiology and the Department of Biochemistry, Government Medical College, Kathua, UT of Jammu and Kashmir. Informed written consent was obtained from the subjects and ethical clearance was obtained from the Institutional Ethics Committee. Height, weight, waist circumference, and systolic and diastolic blood pressure were measured using standard methods. Body mass index was calculated as weight in kilograms divided by the square of height in meters. Results: The present study found statistically significant increase in systolic blood pressure and statistically significant decrease in mean HDL-cholesterol before and after COVID-19 pandemic in HCWs. Conclusion: The onset of metabolic syndrome and its potential effects could be stopped by early use of preventative interventions in the changed parameters.

Effect of aluminium on lipid profile and atherogenic index in prepubertal and young adult female rats: A pilot study

Objectives: Exposure of aluminium (Al) to mankind is inescapable, and its dyslipidaemic impact is a possible contributing factor to health hazards like cardiovascular diseases. The health effects due to the metalloestrogenic property of the metal need imperative consideration. The current experimental work was undertaken to explore Al-induced dyslipidaemia due to its metalloestrogenic property. Materials and Methods: To fulfil this objective, prepubertal (PP) and young adult (YA) female Wistar rats were intraperitoneally administered to two doses of Al [5 and 10 mg/Kg body weight (BW)] once daily for 2 weeks. After the completion of the acute exposure protocol, plasma and hepatic tissue lipid profiles were estimated. Analysis of variance was carried out by the Kruskal–Wallis test and the differences between the groups were analysed by Mann–Whitney U post hoc test Results: Increased triglyceride, total cholesterol, low-density lipoprotein (LDL) cholesterol and very-LDL cholesterol in plasma were found in YAs treated with both doses of Al in a dose-dependent manner. Similar changes were not present in PP female rats. Decreased levels of lipid levels were observed in the case of hepatic lipid profile. Conclusion: The study ushers light towards the dyslipidaemic alterations in experimental female rats after acute Al exposure. Impacts of Al on the growth and organosomatic index during the vital developmental days were significantly decided by the pubertal status of the female rats. The results of this study indicate the impact of puberty on the Al-induced modifications in lipid profile parameters and cardiovascular risk factors.

Relationship between blood uric acid level and plasma atherogenic index in patients with type 2 diabetes / 中国综合临床

Objective:To explore the correlation between serum uric acid level and atherogenic index of plama (AIP) in patients with type 2 diabetes mellitus (T2DM).Methods:A retrospective analysis of 485 T2DM patients hospitalized in the First Hospital of Qin Huangdao was performed in August 2019 to August 2021. They were divided into atherogenic phenotype group (the case group, AIP≥0.06, n=326) and non atherogenic phenotype group (the control group, AIP<0.06, n=159) with AIP=0.06 as the cut-off point. The age, sex, body mass index, uric acid, triglyceride, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, glycosylated hemoglobin, smoking history and coronary heart disease history were compared between the two groups. The data processing using sample t-test and chi-square test. Pearson correlation analysis and multivariate logistic regression analysis were performed. Results:Body mass index (27.7±3.6) kg/m 2, systolic pressure (138.4±17.5) mmHg, uric acid (351.6±93.0) μmol/L, triglyceride (3.0±3.4) mmol/L and the proportion of men (61.6%(201/326)), coronary heart disease history (24.3%(79/326)) and smoking history (33.5%(109/326)) in case group were higher than those in control group (25.8±3.5) kg/m 2, (132.2±17.7) mmHg, (291.6±73.8) μmol/L, (1.0±0.3) mmol/L, (51.6%(82/159)), (15.7%(25/159)), (19.5%(31/159)) and the level of high density lipoprotein-cholesterol (1.1±0.3) mmol/L was lower than that in control group (1.3±0.3) mmol/L,with all statistically significant differences ( t=5.43, P<0.001; t=3.64, P<0.001; t=7.70, P=0.001; t=10.40, P<0.001; χ 2=4.47, P=0.034;χ 2=4.60, P=0.032;χ 2=10.11, P=0.001; t=5.18, P<0.001). The prevalence of hyperuricemia in case group (21.5%(70/326)) was 4.3 times higher than that in control group (5.0%(8/159)). AIP was positively correlated with body mass index ( r=0.300, P<0.001), uric acid ( r=0.343, P<0.001), systolic pressure ( r=0.117, P=0.010), diastolic pressure (r=0.119, P=0.009), triglyceride ( r=0.724, P<0.001), total cholesterol ( r=0.226, P<0.001), while that was negatively correlated with high density lipoprotein-cholesterol ( r=-0.185, P<0.001). Logistic regression analysis showed that after excluding the interference of other factors, uric acid was still related to AIP ( OR=3.727, 95% CI=1.702-8.158, P=0.001), and the risk of AIP increase increased with the increase of uric acid level. Conclusion:The level of serum uric acid in T2DM patients is related to AIP, and high uric acid is an independent risk factor for AIP in T2DM patients.

Predictive value of atherogenic index of plasma in the assessment of acute pancreatitis / 中国医师杂志

Objective:To investigate the predictive value of atherogenic index of plasma (AIP) in the assessment of acute pancreatitis (AP).Methods:598 patients diagnosed with AP admitted to the Affiliated Hospital of Yangzhou University between January 2016 and December 2020 were recruited and divided into severe acute pancreatitis group (SAP group, n=57) and non-severe acute pancreatitis group (non SAP group, n=541) according to the Atlanta Classification (2012 revision). General clinical data and related biochemical indicators of all enrolled patients were collected, and Bedside Index of Acute Pancreatitis Severity (BISAP) score, Ranson score and CT Severity Index (CTSI) score were performed. The risk factors of SAP were analyzed by logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the evaluation value of AIP and various scoring systems on the severity of pancreatitis. Results:The AIP, white blood cell (WBC), neutrophil count (NEUT), fasting blood glucose (FBG), serum total cholesterol (TC) level, proportion of hyperlipidemia, proportion of diabetes, Ranson score, BISAP score, CTSI score of patients in SAP group were higher than those in non SAP group, and the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that AIP was an independent risk factor for SAP ( P<0.05). ROC curve showed that the are under the curve (AUC) of SAP predicted by AIP was 0.706(95% CI: 0.631-0.782, P<0.001). Conclusions:AIP is an independent risk factor for SAP, which helps to assess the severity of AP.

Value of atherogenic index of plasma combined with Bedside Index for Severity in Acute Pancreatitis in the early prediction of severe hypertriglyceridemic acute pancreatitis / 临床肝胆病杂志

Objective To investigate the correlation between atherogenic index of plasma (AIP) and the severity of hypertriglyceridemic acute pancreatitis (HTG-AP) and the value of AIP combined with Bedside Index for Severity in Acute Pancreatitis (BISAP) score in the early prediction of severe HTG-AP (sHTG-AP). Methods A retrospective analysis was performed for the clinical data of 170 patients with HTG-AP who were hospitalized in The General Hospital of Central Theater Command from January 2017 to December 2021, and according to related guidelines, they were divided into the sHTG-AP group with 28 patients and non-sHTG-AP group with 142 patients. Peripheral blood samples were collected from all patients within 24 hours after admission, and the two groups were compared in terms of sex, age, laboratory test results, AIP, BISAP score, and modified CT severity index (MCTSI) score. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; the Mann-Whitney U test was used for comparison of continuous data between groups. The Spearman rank correlation test was used to investigate the correlation between each factor and the severity of HTG-AP, and the binary logistic regression analysis were used to investigate the independent risk factors for sHTG-AP. The receiver operating characteristic (ROC) curve was plotted to assess the predictive efficacy of each indicator. Results There were significant differences between the two groups in the medical history of diabetes, lymphocyte count, albumin, Ca 2+ , triglyceride, high-density lipoprotein cholesterol, AIP, BISAP score, MCTSI score, length of hospital stay, and hospital costs (all P < 0.05). The sHTG-AP group had a longer length of hospital stay, higher hospital costs, and a higher AIP value. AIP (odds ratio [ OR ]=1.244, 95% confidence interval [ CI ]: 1.062-1.458, P =0.007), BISAP score ( OR =5.525, 95% CI : 1.646-18.543, P =0.006), and MCTSI score ( OR =2.029, 95% CI : 1.245-3.305, P =0.004) were risk factors for sHTG-AP. AIP, BISAP score, and MCTSI score were positively correlated with the severity of HTG-AP ( r =0.291, 0.631, and 0.649, all P < 0.001), and AIP was positively correlated with BISAP score and MCTSI score ( r =0.190 and 0.215, both P < 0.05). AIP had an optimal cut-off value of 1.095 in predicting sHTG-AP, and AIP, BISAP score, and AIP combined with BISAP score had an area under the ROC curve of 0.759, 0.887, 0.925, respectively, a sensitivity of 0.821, 0.857, and 0.786, respectively, and a specificity of 0.627, 0.817, and 0.937, respectively (all P < 0.001). Conclusion AIP is a risk factor for sHTG-AP and is correlated with disease severity, and AIP combined with BISAP score has a relatively high value in the early prediction of sHTG-AP.

Value of atherogenic index of plasma in predicting metabolic associated fatty liver disease in patients with type 2 diabetes mellitus / 临床肝胆病杂志

Objective To investigate the association between atherogenic index of plasma (AIP) and metabolic associated fatty liver (MAFLD) in type 2 diabetes mellitus (T2DM). Methods A total of 375 patients with T2DM who were hospitalized and treated in Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, from September 2021 to September 2022 were enrolled, and according to the presence or absence of MAFLD, they were divided into T2DM+MAFLD group with 245 patients and T2DM group with 130 patients. Related clinical data were recorded, and AIP was calculated. According to the quartiles of AIP, the patients were divided into Q1 group (AIP≤0.20), Q2 group (0.20 0.48). The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups; the trend chi-square test was used for the trend analysis of categorical data. The multivariate logistic regression analysis was used to investigate the effect of AIP on MAFLD, and the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to assess the value of the indicators such as AIP, body mass index (BMI), and alanine aminotransferase (ALT) in predicting T2DM with MAFLD. Results Compared with the T2DM group, the T2DM+MAFLD group had significant increases in BMI, systolic pressure, uric acid, fasting blood glucose, glycosylated hemoglobin, ALT, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, triglyceride, low-density lipoprotein, and AIP and a significant reduction in high-density lipoprotein (all P < 0.05). The trend chi-square test showed that the prevalence rate of MAFLD in T2DM patients tended to increase with the increase in AIP level ( χ trend 2 =20.338, P < 0.05). The multivariate logistic regression analysis showed that compared with the Q1 group, the Q4 group had a significant increase in the risk of MAFLD (odds ratio =2.396, 95% confidence interval: 1.018-5.640, P =0.045). The ROC curve analysis showed that the diagnostic model of AIP combined with BMI and ALT had the best diagnostic performance (AUC=0.816), with a sensitivity of 70.2% and a specificity of 78.5% at the optimal cut-off value of 0.670. Conclusion AIP is an independent risk factor for MAFLD in T2DM patients, and AIP combined with BMI and ALT has a good predictive value for T2DM with MAFLD.

Relationship between atherogenic index of plasma and childhood asthma / 中国当代儿科杂志

OBJECTIVES@#To explore the relationship between atherogenic index of plasma (AIP) and childhood asthma.@*METHODS@#This retrospective study included 86 children with asthma admitted to the Changzhou Second People's Hospital Affiliated to Nanjing Medical University from July 2020 to August 2022 as the asthma group and 149 healthy children undergoing physical examination during the same period as the control group. Metabolic parameters including total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and blood glucose, as well as general information of the children such as height, weight, body mass index, presence of specific dermatitis, history of inhalant allergen hypersensitivity, family history of asthma, and feeding history, were collected. Multivariable logistic regression analysis was used to study the relationship between AIP, triglycerides, and high-density lipoprotein cholesterol and asthma. The value of AIP, triglycerides, and high-density lipoprotein cholesterol for predicting asthma was assessed using receiver operating characteristic (ROC) curve analysis.@*RESULTS@#The AIP and triglyceride levels in the asthma group were significantly higher than those in the control group, while high-density lipoprotein cholesterol was significantly lower (P<0.05). However, there was no significant difference in total cholesterol and low-density lipoprotein cholesterol between the two groups (P>0.05). Before and after adjusting for height, weight, presence of specific dermatitis, history of inhalant allergen hypersensitivity, family history of asthma, feeding method, and blood glucose, multivariable logistic regression analysis showed that AIP, triglycerides, and high-density lipoprotein cholesterol were associated with asthma (P<0.05). ROC curve analysis showed that the optimal cutoff value for predicting asthma with AIP was -0.333, with a sensitivity of 80.2%, specificity of 55.0%, positive predictive value of 50.71%, and negative predictive value of 82.85%. The area under the curve (AUC) for AIP in predicting asthma was significantly higher than that for triglycerides (P=0.009), but there was no significant difference in AUC between AIP and high-density lipoprotein cholesterol (P=0.686).@*CONCLUSIONS@#AIP, triglycerides, and high-density lipoprotein cholesterol are all associated with asthma. AIP has a higher value for predicting asthma than triglycerides and comparable value to high-density lipoprotein cholesterol.

Utilidad de los índices aterogénicos del perfil lipídico en el diagnóstico de aterosclerosis subclínica / Utility of the atherogenic indices of the lipid profile in the diagnosis of subclinical atherosclerosis

Introducción: Los índices aterogénicos hacen referencia a un conjunto de indicadores bioquímicos que a partir de la relación entre variables lipídicas permiten predecir el riesgo de daño aterosclerótico. Objetivo: Evaluar la utilidad de los índices aterogénicos en el diagnóstico de aterosclerosis subclínica en pacientes con dislipidemia. Métodos: Se realizó un estudio descriptivo en 812 pacientes con diagnóstico clínico de dislipidemia en el Hospital Clínico Quirúrgico Hermanos Ameijeiras, en el período 2015-2020. Resultados: La edad media de los pacientes fue de 56,79 ± 10,24 años, predominó el grupo de 60 y más años con un 40,9 por ciento y el sexo femenino para un 73,8 por ciento. El 61,2 por ciento de los pacientes tienen presente algún tipo de obesidad. La presencia de HTA y el consumo de tabaco afectan el 52 por ciento y 24,6 por ciento de la población estudiada. El 74,8 por ciento (607 casos) fue clasificado como riesgo cardiovascular medio según los criterios de Framingham, mientras que el 12,9 por ciento fue clasificado como riesgo alto. Se identificaron 323 (39,8 por ciento) pacientes con presencia de aterosclerosis subclínica. Las diferencias de los valores medios de los índices aterogénicos entre los grupos con presencia de aterosclerosis subclínica fueron estadísticamente significativas para los índices cCtotal/ cHDL y cLDL/cHDL (p<0,05). En el análisis multivariado los índices asociados al riesgo de presentar aterosclerosis subclínica fueron la relación cCtotal/cHDL (R=1,11) y cLDL/cHDL (R=1,12) (p<0,05). Conclusiones: Los índices aterogénicos son de utilidad en el diagnóstico de aterosclerosis subclínica, los cocientes cCtotal/cHDL y cLDL/cHDL son los que están asociados significativamente con la probabilidad de presentar daño aterosclerótico carotideo(AU)

Introduction: Atherogenic indices refer to a set of biochemical indicators that, based on the relationship between lipid variables, allow predicting the risk of atherosclerotic damage. Objective: To evaluate the usefulness of atherogenic indices in the diagnosis of subclinical atherosclerosis in patients with dyslipidemia. Methods: A descriptive study was carried out in 812 patients with clinical diagnosis of dyslipidemia at Hermanos Ameijeiras Surgical Clinical Hospital, from 2015 to 2020. Results: The mean age of the patients was 56.79 ± 10.24 years, the group of 60 and over predominated with 40.9percent and the female sex with 73.8percent. Some type of obesity was present in 61.2percent of the patients. The presence of hypertension and tobacco consumption affect 52percent and 24.6percent of the population studied, respectively. 74.8percent (607 cases) were classified as medium cardiovascular risk according to Framingham criteria, while 12.9percent were classified as high risk. Three hundred twenty three (39.8percent) patients with subclinical atherosclerosis were identified. The differences in the mean values of the atherogenic indices between the groups with subclinical atherosclerosis were statistically significant for the total C/HDLc and LDLc/HDLc indices (p<0.05). In the multivariate analysis, the indices associated with the risk of subclinical atherosclerosis were the ratio of Total C/HDLc (R=1.11) and LDLc/HDLc (R=1.12) (p<0.05). Conclusions: The atherogenic indices are useful in the diagnosis of subclinical atherosclerosis; cCtotal/cHDL and cLDL/cHDL ratios are those that are significantly associated with the probability of carotid atherosclerotic damage(AU)

Comparison of plasma lipid profiles and atherogenic indices among hypertensives with or without type 2 diabetes

Background: Several atherogenic indices derived from the lipid profiles are postulated to better detect dyslipidemias and predict the risk of having cardiovascular events even in the presence of insignificant changes in individual lipid parameters. Objective: To compare the lipid ratios and atherogenic index of plasma (AIP) to conventional atherogenic indices among hypertensive type 2 diabetics to hypertensive nondiabetes (HND) controls. Materials and Methods: A case­control study in which 210 participants with type 2 diabetes mellitus with hypertension (hypertensive­diabetic [HD]) compared with 150 (n = 155) hypertensive without diabetes (HND) with similar ages were enrolled. Blood samples for fasting lipid profile were collected and analyzed, and the following indices and ratios were calculated: (TC/high­density lipoprotein­cholesterol [HDL­C]), (low­density lipoprotein­cholesterol [LDL­C]/HDL­C), (HDL­C/ LDL­C), and AIP. The indices were compared in both the participants and control group. Results: There was no significant difference in the clinical characteristics of HD compared to the HND except the systolic blood pressure, weight, and HDL­C which were lower in the HND group. The frequency of dyslipidemia was found to be significantly higher in the HD group except elevated LDL­C in males (25.8% vs. 17.4%, χ2 = 0.055, respectively). Furthermore, all the lipid ratios, except (Castelli risk index II [CRI­ II] were found to be significantly different among HD as compared to HND group (P = 0.002, P = 0.045, respectively). Conclusions: This study concludes that Nigerians with both type 2 diabetes and hypertension have worse dyslipidemia and abnormal lipid ratios compared to those with only hypertension.

The relationships among atherogenic index of plasma and inflammatory adipocytokines with the severity of coronary artery calcification in coronary artery disease / 中国医师杂志

Objective:The aims of the study were to investigate the relationship among atherogenic index of plasma (AIP) and inflammatory adipocytokines with the severity of coronary artery calcification (CAC) score in coronary artery disease (CAD). And then we analyzed the diagnostic value of the new markers on CAC.Methods:A total of 241 patients with CAD diagnosed by coronary CT angiography (CTA) and coronary angiography in Baoding First Central Hospital from June 2019 to June 2020 were retrospectively enrolled. According to the presence of calcification in coronary CTA, they were divided into CAC group ( n=63) and non-CAC group ( n=178). The clinical data of the patients were collected, and the levels of serum inflammatory factors were measured by enzyme-linked immunosorbent assay (ELISA). The correlation between CAC score and AIP and inflammatory cytokines was analyzed. The diagnostic value of AIP and inflammatory factors in the formation of CAC in patients with CAD. Results:The levels of AIP, serum osteoprotegerin (OPG) and oligomeric matrix protein (COMP) in CAC group were higher than those in non-CAC group, while the levels of serum fibroblast growth factor 21 (FGF21) were lower than those in non-CAC group, with statistically significant difference (all P<0.01). Correlation analysis showed that CAC score of CAD patients was positively correlated with AIP, OPG and COMP ( r=0.581, 0.451, 0.326, P<0.05), and negatively correlated with FGF21 ( r=-0.294, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that AIP, OPG, COMP and FGF21 had diagnostic value for CAC in CAD patients (all P<0.05). AIP>0.387, OPG>5.150 ng/ml, FGF21>136.35 pg/ml, COMP>733.16 ng/ml were independent factors affecting the formation of CAC (all P<0.05). Conclusions:The increase of AIP and the change of inflammatory factors can be used as markers for the diagnosis of CAC formation in CAD patients.

Evaluation value of atherogenic index of plasma for long-term prognosis of coronary artery disease / 中国医师杂志

Objective:To determine the predictive value of atherogenic index of plasma (AIP) on the long-term prognosis of patients with coronary artery disease (CAD).Methods:A total of 2 500 patients with coronary heart disease who underwent coronary angiography in Affiliated Hospital of Jining Medical University from May 2013 to November 2015 were retrospectively analyzed. According to the AIP value, the subjects were divided into low AIP group (AIP<0.06) and high AIP group (AIP≥0.06). The incidence of major adverse cardiovascular events (MACE) was compared between the two groups. Kaplan-meier method was used to evaluate the MACE-free survival rate, and multivariate Cox survival analysis was used to evaluate the independent predictors of MACE.Results:A total of 2 427 patients were followed up, with a follow-up rate of 97.08% and a median follow-up time of 4.29 years. There were 1 123 cases in the low AIP group and 1 304 cases in the high AIP group, among which 624 patients (25.7%) had MACE. The total incidence of MACE in the high AIP group was higher than that in the low AIP group ( HR=1.43, 95% CI: 1.22-1.68, P<0.01). Kaplan-meier curves showed that the MACE-free survival rate was significantly lower in the high AIP group ( P<0.01). After adjusting for multiple confounding factors, AIP was still associated with the prognosis of CHD patients. Increased AIP (≥0.06) was an independent predictor of MACE in CHD patients within 4 years ( HR=1.34, 95% CI: 1.14-1.58, P<0.01). Conclusions:AIP (≥0.06) was an independent predictor of MACE occurrence in patients with CAD within 4 years. AIP has a certain value in the long-term prognosis of patients with CAD.

Effect of LSG on insulin resistance and atherogenic index of plasma in patients with type 2 diabetes mellitus complicated with obesity / 中华内分泌外科杂志

Objective:By comparing the changes of metabolic parameters before and after laparoscopic sleeve gastectomy (LSG) in patients with type 2 diabetes mellitus (T2DM) and obesity, the insulin resistance index (HOMA-IR) and atherogenic index of plasma (AIP) were calculated to evaluate the effect of metabolic surgery on insulin resistance and atherosclerosis in patients with type 2 diabetes mellitus (T2DM) and obesity.Methods:LSG treatment were retrospectively analyzed in 54 patients with type 2 diabetes mellitus and obesity, detection of preoperative and postoperative 1 month, 6 month of fasting plasma glucose (FPG), fasting insulin (FINS), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), measuring blood pressure, body weight, calculating body mass index, and according to the steady state evaluation model and the formula for calculating HOMA-IR and AIP. Before and after surgery, paired t test was used, and Pearson correlation analysis and multiple stepwise regression analysis.Results:FPG, FINS, TG, HOMA-IR and AIP were (6.38±2.03) mmol/L and (5.36±1.33) mmol/L, (20.42±25.77) uU/mLand (11.22±3.62) uU/mL, (1.94±2.81) mmol/Land (1.70±2.33) mmol/L, (5.60±7.52) and (2.58±0.80), (0.15±0.27) and (0.08±0.25) ,which were significantly lower than those before surgery ( P<0.05) ,HDL-C was (1.04±0.20) mmol/L and (1.10±0.18) mmol/L at 1 and 6 months after operation, respectively, which was higher than that before operation ( P<0.05) .Preoperative correlation analysis showed that AIP was positively correlated with FPG, TG and HOMA-IR ( P<0.05), and negatively correlated with HDL-C ( P<0.05) .The results of multiple stepwise regression analysis showed that FPG, TG and HDL-C were independent influencing factors of AIP ( P<0.05) . Conclusion:LSG surgery can effectively reduce the blood glucose and lipid levels in patients with type 2 diabetes complicated with obesity, improve insulin resistance and reduce the plasma atherosclerosis index.

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.

Correlations between C-peptide insulin resistance index, very low density lipoprotein-cholesterol and atherogenic index in type 2 diabetic patients / 中国医师杂志

Objective:To investigate the correlation between multiple parameters of islet function evaluation and atherogenic index (AIP) in patients with type 2 diabetes mellitus (T2DM).Methods:A cross-sectional study was conducted to observe 216 T2DM patients hospitalized in Tianjin Medical University Chu Hsien-I Memorial Hospital in 2019. They were divided into non atherogenic phenotype group (N Group, AIP<0.06) and atherogenic phenotype group (A group, AIP≥0.06) with AIP=0.06 as the cut-off point. The general clinical indexes and evaluation indexes of oral glucose tolerance test (OGTT), such as insulin action index (IAI), quantitative insulin sensitivity check index (QUICKI), homeostasis model of insulin resistance index (HOMA-IR), homeostasis model assessment-β (HOMA-β), C peptide insulin resistance index (HOMA IR-CP) and C peptide islet function index suitable to diabetes patients (HOMA islet-CP DM) were compared between two groups. Pearson correlation analysis and multiple stepwise regression analysis were performed.Results:Compared with the N group, the very low density lipoprotein-cholesterol (VLDL-C), ln (HOMA IR-CP) and ln (HOMA islet-CP DM) in A group were higher ( P<0.01), while ln (QUICKI) was lower ( P<0.05), with statistical significance. AIP was positively correlated with VLDL-C ( r=0.765), ln (HOMA-IR) ( r=0.257), ln (HOMA-β) ( r=0.189), ln (HOMA IR-CP) ( r=0.418) and ln (HOMA islet-CP DM) ( r=0.377, P<0.01), and negatively correlated with IAI ( r=-0.145, P<0.05) and ln (QUICKI) ( r=-0.254, P<0.01). Multiple stepwise regression analysis showed that VLDL-C and ln (HOMA IR-CP) were independent influencing factors of AIP in type 2 diabetic patients ( P<0.01) . Conclusions:AIP is positively correlated with insulin resistance and negatively correlated with insulin sensitivity. VLDL-C and HOMA IR-CP are independent predictors of AIP.

Enfermedad arterial de miembros inferiores detectada por Eco-doppler en pacientes asintomáticos / Lower limb arterial disease detected by Echo-doppler in asymptomatic patients

Introducción: La enfermedad arterial de miembros inferiores es un marcador de riesgo coronario, causa de invalidez y muerte en quienes la padecen, su identificación temprana puede atenuar estos efectos. Objetivo: Identificar la enfermedad arterial de miembros inferiores no diagnosticada a través de Eco-Doppler en pacientes con factores de riesgo aterogénicos. Método: Se realizó un estudio descriptivo de tipo transversal que incluyó a 100 pacientes de 40 años o más, fumadores, diabéticos y/o hipertensos, sin diagnóstico de enfermedad arterial de miembros inferiores, a quienes se le realizó Eco-Doppler de miembro inferior. Resultados: Se identificaron lesiones compatibles con EAMI en 69 por ciento de los estudiados, cuya edad media fue de 64,81 ± 10,12 años, y discreto predominio del sexo masculino. Las arterias más afectadas fueron la tibial posterior y la pedia con 43 por ciento y 39 por ciento respectivamente, las medidas de asociación mostraron OR (IC 95 por ciento) de 4,15 para la diabetes mellitus, 1,63 para el tabaquismo seguido de la hipertensión arterial con 0,27. Conclusiones: Seis de cada diez pacientes presentaron lesiones ateroscleróticas identificables por Eco-Doppler, predominaron las del sector tibial posterior y pedio en fumadores y diabéticos, estos últimos tuvieron cuatro veces más riesgo de padecer la enfermedad(AU)

Introduction: Arterial disease of the lower limbs is a marker of coronary risk, causing disability and death in those who suffer from it. Early detection can mitigate these effects. Objective: To identify undiagnosed lower limb arterial disease through Echo-Doppler in patients with atherogenic risk factors. Method: A descriptive, cross-sectional study was carried out in 100 patients aged 40 years or older, smoking habits history, and diabetic and / or hypertensive patients, with no diagnosis of arterial disease in the lower limbs, who underwent Eco-Doppler of the lower limb. Results: EAMI compatible lesions were identified in 69 percent of those studied, whose mean age was 64.81 ± 10.12 years, and a discrete male predominance. The most affected arteries were the posterior tibial and pediatric arteries in 43 percent and 39 percent respectively, the association measures showed OR (95 percent CI) of 4.15 for diabetes mellitus, 1.63 for smoking followed by arterial hypertension with 0.27. Conclusions: Six out of ten patients showed atherosclerotic lesions identifiable by Echo-Doppler, those of the posterior tibial sector and pedium predominated in smokers and diabetics, the latter had four times the risk of suffering from the disease(AU)

Prevalencia de alteraciones del metabolismo glucídico en familiares de primer grado de pacientes diabéticos tipo 2 / Prevalence of glucidic metabolism alterations in first- degree relatives of type 2 diabetic patients

Introducción: La diabetes mellitus se considera un síndrome heterogéneo con etiología compleja en el que influyen factores genéticos y ambientales. Objetivo: Identificar la presencia de alteraciones del metabolismo glucídico y factores de riesgo aterogénicos en familiares de primera línea de pacientes diabéticos tipo 2. Métodos: Se realizó un estudio descriptivo de corte transversal que incluyó a 120 pacientes adultos, hijos de pacientes diabéticos, en los que no se encontraban antecedentes de alteraciones del metabolismo glucídico, pertenecientes al Policlínico Universitario Héroes del Moncada, del municipio Plaza de la Revolución. Se estudiaron variables sociodemográficas, variables clínicas y relacionadas con los estilos de vida como la tensión arterial, el índice de masa corporal, colesterol, triglicéridos, glucemias (ayunas y posprandial), hábito de fumar, actividad física y hábitos dietéticos. Resultados: Los pacientes tenían una edad promedio de 54,42 años y predominó el sexo femenino. Se detectaron alteraciones del metabolismo glucídico en 28,3 por ciento de los cuales 23,3 por ciento se consideraron prediabéticos y 5 por ciento diabéticos. Los factores de riesgo que predominaron fueron la dieta inadecuada, obesidad abdominal, hipercolesterolemia e hipertrigliceridemia que fueron más evidentes en los pacientes diagnosticados como diabéticos. Conclusiones: Los familiares de primer grado de pacientes diabéticos pueden presentar una alta prevalencia de alteraciones del metabolismo glucídico y factores de riesgo aterogénicos, aún sin sintomatología evidente, lo que refuerza la necesidad de realizar un diagnóstico temprano para evitar la progresión de la enfermedad(AU)

Introduction: Diabetes mellitus is considered a heterogeneous syndrome with a complex etiology, influenced by genetic and environmental factors. Objective: To identify the presence of alterations of the glucidic metabolism and atherogenic risk factors in first- degree relatives of type 2 diabetic patients. Methods: A descriptive cross-sectional study was carried out at Heroes del Moncada University Polyclinic, in Plaza de la Revolution municipality. The study included 120 adult patients, descendants of diabetic patients. They had no history of alterations of the glucidic metabolism. Sociodemographic, clinical variables were studied, and those related to lifestyles such as blood pressure, body mass index, cholesterol, triglycerides, (fasting and postprandial) glycaemia, smoking, physical activity and dietary habits. Results: These patients had average age of 54.42 years and the female sex predominated. Alterations of the glucidic metabolism were detected in 28.3 percent, 23.3 percent of them were considered pre-diabetic and 5 percent diabetic. The predominant risk factors were inadequate diet, abdominal obesity, hypercholesterolemia, and hypertriglyceridemia, which was much evident in patients diagnosed as diabetic. Conclusions: The first-degree relatives of diabetic patients may present high prevalence of alterations of glucidic metabolism and atherogenic risk factors, even with no evident symptoms, which reinforces the need of early diagnosis to avoid the progression of the disease(AU)

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.

A pilot study on pattern B lipoprotein profile in Malaysia

@# Dyslipidaemia is a recognised conventional risk factor for cardiovascular disease (CVD). However, even when traditional lipid parameters are normal, CVD risk can exist. Small dense lowdensity lipoprotein cholesterol (sdLDL) has appeared as a significant risk marker for CVD. This study aimed to determine the prevalence and associated factors of atherogenic lipoprotein Pattern B in the Malaysian population. Materials and Methods: This cross-sectional study included 150 subjects aged 30 years and above who attended a health screening in a Malaysian tertiary institution. Sociodemographics, clinical characteristics and laboratory parameters (lipids, glucose, and sdLDL) were obtained. Lipoprotein subfraction was analysed using the polyacrylamide gel electrophoresis method. Results: Malays and females made up the majority of subjects and the median age was 37 years. Normolipidaemic Pattern B was significantly higher in women (p=0.008). Significant independent predictors of Pattern B were gender (p=0.02), race (p=0.01), body mass index (BMI) [p=0.02] and lipid status (p=0.01). Triglyceride was the only independent predictor of sdLDL (p=0.001). Conclusion: The prevalence of Pattern B of 33% in this study was comparatively high, of which 6.7% were normolipidaemic. Chinese males with dyslipidaemia and increased BMI independently predicted Pattern B. Differences in triglyceride levels alone among these ethnic groups do not fully explain the differences in the prevalence of Pattern B although it was the only lipid parameter to independently predict sdLDL. Individuals with atherogenic normolipidaemia are at greater risk for a CVD event as they are not included in the protective measures of primary CVD prevention.