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Las enfermedades cardiovasculares (Cv), son las causantes de la mayor parte de fallecimientos, como consecuencia de dislipidemia y enfermedad renal crónica (ERC). En Ecuador uno de cada cinco individuos padece de hipertensión arterial, patología que está directamente relacionada con las enfermedades cardiovasculares y la enfermedad renal crónica. Objetivo. Caracterizar el perfil de riesgo cardiovascular en pacientes con enfermedad renal crónica y su asociación con la presencia de dislipidemia, atendidos en el Hospital Homero Castanier de la ciudad de Azogues, durante el periodo de enero a diciembre de 2021. Materiales y Métodos. Se llevó a cabo una investigación de diseño observacional, descriptivo y retrospectivo donde se analizaron 104 historias clínicas de pacientes, correspondientes al periodo comprendido entre enero y diciembre de 2021. Para el cálculo del riesgo cardiovascular se empleó la tabla de predicción del riesgo AMR-D de la Organización Mundial de la Salud/Sociedad Internacional de Hipertensión para el continente americano categoría D. Los datos fueron analizados en el programa SPSS, mediante estadística descriptiva e inferencial. Resultados. De los datos analizados de los 104 pacientes con enfermedad renal crónica el 44,2% presentaron dislipidemia, al mismo tiempo el 74% de los pacientes en estudio manifestaron un riesgo cardiovascular bajo, seguido del 13,5% con riesgo moderado; destacando entre las principales comorbilidades la hipertensión arterial y la diabetes mellitus. Conclusiones. Se caracterizó el riesgo cardiovascular de los pacientes con ERC atendidos en el Hospital Homero Castanier de la ciudad de Azogues en el periodo enero - diciembre 2021, encontrando una baja prevalencia de desarrollar riesgo cardiovascular.
Cardiovascular diseases (CVD) are responsible for most deaths as a consequence of dyslipidemia and chronic kidney disease (CKD). In Ecuador, one out of every five individuals suffers from arterial hypertension, a pathology that is directly related to cardiovascular diseases and chronic kidney disease. Objective. To characterize the cardiovascular risk profile in patients with chronic kidney disease and its association with the presence of dyslipidemia, attended at the Homero Castanier Hospital in the city of Azogues, during the period from January to December 2021. Materials and Methods. An observational, descriptive and retrospective research design was carried out in which 104 clinical histories of patients were analyzed, corresponding to the period between January and December 2021. The AMR-D risk prediction table of the World Health Organization/International Society of Hypertension for the Americas category D was used to calculate cardiovascular risk. The data were analyzed in the SPSS program, using descriptive and inferential statistics. Results. Of the data analyzed, 44.2% of the 104 patients with chronic kidney disease presented dyslipidemia; at the same time, 74% of the patients in the study showed low cardiovascular risk, followed by 13.5% with moderate risk, with arterial hypertension and diabetes mellitus standing out among the main comorbidities. Conclusions. The cardiovascular risk of patients with CKD treated at the Homero Castanier Hospital in the city of Azogues during the period January-December 2021 was characterized, finding a low prevalence of developing cardiovascular risk.
As doenças cardiovasculares (DCV) são responsáveis pela maioria das mortes como consequência da dislipidemia e da doença renal crônica (DRC). No Equador, um em cada cinco indivíduos sofre de hipertensão arterial, uma patologia que está diretamente relacionada às doenças cardiovasculares e à doença renal crônica. Objetivo. Caracterizar o perfil de risco cardiovascular em pacientes com doença renal crônica e sua associação com a presença de dislipidemia, atendidos no Hospital Homero Castanier, na cidade de Azogues, durante o período de janeiro a dezembro de 2021. Materiais e métodos. Foi realizado um desenho de pesquisa observacional, descritivo e retrospectivo, no qual foram analisados 104 históricos clínicos de pacientes, correspondentes ao período entre janeiro e dezembro de 2021. A tabela de previsão de risco AMR-D da Organização Mundial da Saúde/Sociedade Internacional de Hipertensão para as Américas categoria D foi usada para calcular o risco cardiovascular. Os dados foram analisados no SPSS usando estatísticas descritivas e inferenciais. Resultados. Dos 104 pacientes com doença renal crônica, 44,2% apresentavam dislipidemia, enquanto 74% dos pacientes em estudo tinham baixo risco cardiovascular, seguidos por 13,5% com risco moderado; as principais comorbidades foram hipertensão e diabetes mellitus. Conclusões. Foi caracterizado o risco cardiovascular dos pacientes com DRC atendidos no Hospital Homero Castanier da cidade de Azogues no período de janeiro a dezembro de 2021, encontrando uma baixa prevalência de desenvolvimento de risco cardiovascular.
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Humans , Male , Female , Dyslipidemias , Arterial Pressure , Anthropometry , Renal Insufficiency, ChronicABSTRACT
Introducción. Las enfermedades crónicas no transmisibles representan la principal causa de muerte en el mundo y su prevalencia va en aumento debido a la transición epidemiológica. A pesar de los avances en su manejo, las cifras de control son deficientes y esto se atribuye a múltiples factores, como el cumplimiento del tratamiento farmacológico, que es uno de los más representativos y menos estudiados en la población colombiana. Objetivo. Establecer la frecuencia de casos que cumplieron con el tratamiento farmacológico en pacientes colombianos con hipertensión arterial, enfermedad cerebrovascular, diabetes mellitus, asma, enfermedad pulmonar obstructiva crónica y dislipidemia, entre el 2005 y el 2022. Materiales y métodos. Se llevó a cabo una revisión sistemática de la literatura y un metaanálisis de los estudios identificados mediante las bases de datos Medline y LILACS para sintetizar cuantitativamente el porcentaje de cumplimiento del tratamiento. Resultados. Catorce estudios cumplieron los criterios de inclusión y se analizaron 5.658 pacientes. El cumplimiento del tratamiento fue del 59 %, con una heterogeneidad alta entre los estudios incluidos (IC95% = 46-71 %; I2 = 98,8 %, p<0,001). Se obtuvo un mayor cumplimiento para la diabetes mellitus" (79 %; IC95% = 65-90 %) y la dislipidemia (70 %; IC95% = 66-74 %). En los pacientes con hipertensión arterial el cumplimiento fue del 51 % (IC95% = 31-72 %). Conclusiones. La revisión sistemática muestra un bajo cumplimiento de las recomendaciones sobre el manejo farmacológico de enfermedades crónicas no transmisibles, lo que puede repercutir en los resultados clínicos y en la carga de la enfermedad a largo plazo.
Introduction. Non-communicable chronic diseases represent the leading cause of death worldwide, and their prevalence is increasing due to the epidemiological transition. Despite the advances in their management, control rates are deficient, attributed to multiple factors like adherence to pharmacological treatment, one of the most significant and least studied in the Colombian population. Objective. To calculate adherence to treatment in Colombian patients with arterial hypertension, cerebrovascular disease, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and dyslipidemia between 2005 and 2022. Materials and methods. We performed a systematic literature review and a meta-analysis of studies identified through the Medline and LILACS databases to quantitatively synthesize treatment adherence percentage. Results. Fourteen studies met the inclusion criteria, and 5,658 patients were analyzed. The treatment adherence was 59%, with significant heterogeneity among the included studies (95% CI= 46- 71%; I2 = 98.8%, p< 0.001). Higher adherence rates were observed for diabetes mellitus (79%; 95% CI = 65- 90%) and dyslipidemia (70%; 95% CI = 66- 74%). Adherence to arterial hypertension treatment was 51% (95 %; CI = 31- 72%). Conclusions. This systematic review showed low adherence to recommendations regarding pharmacological management in non-communicable chronic diseases, which can have implications for long-term clinical outcomes and disease burden.
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Background: Androgen deprivation therapy (ADT) is indispensable part of treatment for metastatic prostate cancer (MPC) patients. There is documented association between ADT and adverse cardiovascular (CV) events, with variability between the different modes. However, there is dearth of evidence on the background CV risk factors of these group of patients at diagnosis. Aims and Objectives: We envisaged this retrospective observational study in the department of oncology to document the background CV risk factors of MPC patients at diagnosis, to help us better select the available ADTs based on their CV risks. Materials and Methods: Over a period of 2 years, all patients registered for treatment with a diagnosis of MPC, indicated for ADT, and available detailed history and background cardiological evaluation at presentation, were included in the study. As indirect indicators of CV risks, history of smoking, presence and treatment of dyslipidemia, and type 2 diabetes mellitus (T2DM), were documented. As direct indicators of CV risks, presence and treatment of hypertension, ischemic heart disease (IHD), congestive cardiac failure (CCF), ECG, and echocardiography changes suggesting cardiac morbidity were documented and the data were analyzed using descriptive statistical methods. Results: Indirect indicators: dyslipidemia, habit of smoking, and T2DM were found in 74%, 29.3%, and 13.3% patients, respectively. Direct indicators: Presence of hypertension, IHD, CCF, abnormalities in ECG, and echocardiography were found in 38.7%, 10.6%, 4%, 28%, and 34.6% patients, respectively. ST-T changes on ECG, low EF, and IHD on echocardiography were seen in 28.5%, 23%, and 26.9%, respectively. Conclusions: MPC patients have a substantial pre-existing CV risk at diagnosis. Our findings warrant a meticulous screening of all MPC patients for CV risk factors, to help in judicious selection of their ADT.
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ABSTRACT In individuals with very low high-density lipoprotein (HDL-C) cholesterol, such as Tangier disease, LCAT deficiency, and familial hypoalphalipoproteinemia, there is an increased risk of premature atherosclerosis. However, analyzes based on comparisons of populations with small variations in HDL-C mediated by polygenic alterations do not confirm these findings, suggesting that there is an indirect association or heterogeneity in the pathophysiological mechanisms related to the reduction of HDL-C. Trials that evaluated some of the HDL functions demonstrate a more robust degree of association between the HDL system and atherosclerotic risk, but as they were not designed to modify lipoprotein functionality, there is insufficient data to establish a causal relationship. We currently have randomized clinical trials of therapies that increase HDL-C concentration by various mechanisms, and this HDL-C elevation has not independently demonstrated a reduction in the risk of cardiovascular events. Therefore, this evidence shows that (a) measuring HDL-C as a way of estimating HDL-related atheroprotective system function is insufficient and (b) we still do not know how to increase cardiovascular protection with therapies aimed at modifying HDL metabolism. This leads us to a greater effort to understand the mechanisms of molecular action and cellular interaction of HDL, completely abandoning the traditional view focused on the plasma concentration of HDL-C. In this review, we will detail this new understanding and the new horizon for using the HDL system to mitigate residual atherosclerotic risk.
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Resumo Fundamento A obesidade eutrófica (OE) é caracterizada por índice de massa corporal (IMC) normal, mas com alto percentual de gordura corporal (%GC), o que aumenta os riscos de comorbidades cardiometabólicas. A avaliação e interpretação precisas dos dados de composição corporal são necessárias para reduzir esses riscos. Objetivos Comparar o perfil cardiometabólico de indivíduos com OE e %GC normal e avaliar os fatores de risco associados. Métodos Foi realizado estudo transversal com 222 adultos brasileiros de uma comunidade universitária, dos quais 157 tinham OE e 65 tinham IMC e %GC normais (grupo sem OE). Todos os participantes relataram ser assintomáticos e sem problemas de saúde subjacentes. Foram avaliadas características socioeconômicas, estilo de vida, consumo alimentar, antropometria, medidas de composição corporal (por meio de absorciometria radiológica de dupla energia) e perfis lipídico e glicêmico. Valor de p < 0,05 foi estabelecido como significativo. Resultados A mediana de idade dos participantes foi de 23 anos (intervalo interquartil: 21 a 25), sendo a maioria do sexo feminino (67,1%). Não foram encontradas diferenças significativas na pressão arterial, idade ou nível de atividade física entre os grupos com e sem OE. No entanto, a frequência de distúrbios do perfil lipídico foi maior no grupo com OE (54%) em comparação com o grupo sem OE (34%) (p < 0,006). Circunferência do pescoço, %GC e distúrbios do perfil lipídico foram positivamente associados com a OE. Conclusão Indivíduos com OE apresentam pior perfil cardiometabólico do que aqueles sem OE, e essa condição está associada a importantes biomarcadores. Torna-se importante abordar esses resultados para prevenir complicações cardiometabólicas de longo prazo. A avaliação e a interpretação precisas dos dados da composição corporal, independentemente do IMC, são cruciais nesse cenário.
Abstract Background Normal-weight obesity (NWO) is characterized by normal body mass index (BMI) but high body fat percentage (%BF) that increases the risks of cardiometabolic comorbidities. Accurate assessment and interpretation of body composition data are necessary to reduce these risks. Objectives To compare the cardiometabolic profile of individuals with NWO and normal %BF and evaluate the associated risk factors. Methods A cross-sectional study was conducted with 222 Brazilian adults from a university community, of whom 157 had NWO and 65 had normal BMI and %BF (non-NWO). All participants reported being asymptomatic and without underlying health conditions. Socioeconomic, lifestyle, food intake, anthropometry, body composition measures (using dual-energy radiological absorptiometry), and lipid and glycemic profiles were evaluated. A p < 0.05 was established as significant. Results The median age of the participants was 23 years (interquartile range: 21 to 25), and most were female (67.1%). No significant differences were found in blood pressure, age, or physical activity levels between the NWO and non-NWO groups. However, the frequency of lipid profile disturbances was higher in the NWO group (54%) compared to the non-NWO group (34%) (p < 0.006). Neck circumference, %BF, and lipid profile disturbances were positively associated with NWO. Conclusion Individuals with NWO have a worse cardiometabolic profile than those without NWO, and this condition is associated with important biomarkers. Addressing these outcomes is important for preventing long-term cardiometabolic complications. Accurate assessment and interpretation of body composition data, regardless of BMI, are crucial in this scenario.
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Introducción: El hipotiroidismo es la insuficiente producción de hormona tiroidea, para satisfacer las necesidades corporales. Este puede ser primario (con pérdida de la función de la glándula tiroidea) o secundario (por falta de estimulación de la glándula). Dada la alta prevalencia del hipotiroidismo, y frecuentes asociaciones con otras enfermedades, se realizó una revisión que puntualiza aspectos de interés clínico en esta patología, que pueden resultar útiles en la práctica médica. Metodología: Se efectuó una búsqueda bibliográfica en PubMed, PubMed Central, MEDLINE Complete, Epistemonikos, Europe PMC y Scielo. Se buscaron los términos "hipotiroidismo" y "tiroides", y se acortaron los artículos a los últimos 5 años. Resultados: Se incluyeron en total 36 artículos publicados en Inglés y en Español. Se seleccionaron aquellos relacionados al hipotiroidismo que exponen asociaciones con otras patologías. Entre estas patologías se encuentra la diabetes, las dislipidemias, enfermedades cardiovasculares, hepáticas, entre otras. Conclusiones: El hipotiroidismo es una patología prevalente que se asocia de forma frecuente con muchas otras comorbilidades que hay que tener en cuenta a la hora de abordar estos pacientes, y con ello tomar las mejores decisiones diagnósticas y terapéuticas.
Introduction: Hypothyroidism is the insufficient production of thyroid hormone to meet the bodily needs. This can be primary (with loss of function of the thyroid glands) or secondary (due to lack of stimulation of the glands). Given the high prevalence of hypothyroidism, and frequent associations with other diseases, a review was carried out that points out aspects of clinical interest in this pathology, which may be useful in medical practice. Methodology: A bibliographic search was carried out in PubMed, PubMed Central, MEDLINE Complete, Epistemonikos, Europe PMC and Scielo. The terms "hypothyroidism" and "thyroid" were searched, and the articles were shortened to the last 5 years. Results: A total of 36 articles published in English and Spanish were included. Those related to hypothyroidism that exhibit associations with other pathologies were selected. These pathologies include diabetes, dyslipidemia, cardiovascular and liver diseases, among others. Conclusions: Hypothyroidism is a prevalent pathology that is frequently associated with many other comorbidities that must be taken into account when dealing with these patients, and thus make the best diagnostic and therapeutic decisions.
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Dentre os fatores associados à dislipidemia, destacam-se os determinantes sociodemográficos, como escolaridade e renda e, nessa perspectiva, as populações menos favorecidas economicamente, como por exemplo as residentes em favelas, apresentam mais chances de serem acometidas pelas doenças crônicas não transmissíveis quando comparadas as de renda mais alta. Nesse sentido, considerando a escassez de estudos relacionados à prevalência de dislipidemia e seus fatores associados em habitantes de áreas faveladas, objetivou-se analisar os fatores associados à dislipidemia em adultos assistidos pela Estratégia Saúde da Família (ESF), residentes em área de favela, em Recife, Pernambuco. Estudo transversal, de base secundária. Analisaram-se possíveis associações da dislipidemia (hipercolesterolemia isolada ou hipertrigliceridemia isolada) com variáveis demográficas, socioeconômicas, comportamentais, composição corporal e morbidades, por meio de Regressão de Poisson, considerando-se valor de p<0,05. Dos 491 adultos, 46,2% apresentaram dislipidemia, sendo maior nos homens em relação às mulheres (RP=1,70; IC95%:1,41-2,03), com aumento progressivo a partir dos 30 anos, estabilizando a partir da faixa dos 40 anos. A prevalência foi maior entre aqueles insuficientemente ativos (RP=1,21; IC95%:1,01-1,45), com circunferência de cintura muito aumentada (RP=1,78; IC95%:1,36-2,34) e com pressão arterial aumentada (RP=1,35; IC95%:1,11-1,63). É preciso reforçar atividades de promoção da saúde no âmbito da ESF para a população investigada, bem como incentivar a prática de atividade física nas academias da saúde, além de divulgar informações relativas ao combate dos fatores associados à dislipidemia.
Among the factors associated with dyslipidemia, sociodemographic characteristics stand out, such as education and income and, from this perspective, less economically favored populations, such as those living in slums, are more likely to be affected by chronic non-communicable diseases when compared higher income populations. Therefore, considering the scarcity of studies related to the prevalence of dyslipidemia and its associated factors in inhabitants of slum areas, the objective of this study was to analyze the factors associated with dyslipidemia in adults assisted by the Family Health Strategy (FHS), living in slum areas, in Recife, Pernambuco. This is a cross-sectional, secondary-based study. Possible associations of dyslipidemia (isolated hypercholesterolemia or isolated hypertriglyceridemia) with demographic, socioeconomic and behavioral variables, body composition, and morbidities were analyzed using Poisson Regression, considering p<0.05. Of the 491 adults, 46.2% had dyslipidemia, which was higher in men compared to women (PR=1.70; 95%CI:1.41-2.03), with a progressive increase from the age of 30 and stabilizing around the 40-year-old range. Prevalence was higher among those who were insufficiently active (PR=1.21; 95%CI:1.01-1.45), with greatly increased waist circumference (PR=1.78; 95%CI:1.36-2.34), and with increased blood pressure (PR=1.35; 95%CI:1.11-1.63). It is necessary to reinforce health promotion activities within the scope of the FHS for the investigated population, as well as to encourage the practice of physical activity in health academies, in addition to disseminating information regarding the fight against factors associated with dyslipidemia.
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ABSTRACT Purpose: To evaluate the modulatory properties of Calendula officinalis L. (Asteraceae) (C. officinalis) extract on cafeteria diet-fed rats. Methods: A cafeteria diet was administered ad libitum for 45 days to induce dyslipidemia. Then, the rats were treated with the formulations containing C. officinalis in the doses of 50, 100, and 150 mg/kg or only with the vehicle formulation; the control group received a commercial ration. Results: The cafeteria diet decreased glutathione S-transferase activity and high-density lipoprotein plasmatic levels and damaged the hepatic architecture. The C. officinalis extract was able to reduce lipid infiltration in liver tissue and to modulate oxidative stress and lipid profile markers. Conclusions: The correlations between the variables suggest a pathological connection between oxidative stress markers and serum lipid profile.
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Objective:To investigate the relationship between peripheral blood lipid levels and hepatitis B-related liver cancer, and to provide a theoretical basis for the early prevention and treatment of liver cancer.Methods:A total of 188 patients with hepatitis B-related liver cancer who received treatment in The First Hospital of Shanxi Medical University from June 2018 to June 2021 met the inclusion and exclusion criteria and had complete data, were included in this study. They were divided into three groups: chronic hepatitis B group ( n = 72), hepatitis B cirrhosis group ( n = 62), and hepatitis B-related liver cancer group ( n = 54) according to different stages of the disease. All patients' medical records were obtained from the medical data room. Fasting venous blood was collected in all patients on the second day after admission to detect peripheral blood lipid, liver function, and other relevant indicators. General data and biochemical indicators were collected. The Kruskal-Wallis test was performed to compare the measurement data among groups. The chi-squared test was performed to compare the count data among groups. Spearman's correlation (bivariate) was performed. Binary logistic regression was performed to analyze the influential factors of liver cancer. Results:There were significant differences in the levels of total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) among the three groups ( F = 32.14, 27.59, 10.88, 34.09, all P < 0.05). TC and LDL-C levels in the hepatitis B-related liver cancer group were significantly higher than those in the hepatitis B cirrhosis group ( F = -32.31, -50.19, both P < 0.05). There were no significant differences in TG and HDL-C levels between hepatitis B-related liver cancer and hepatitis B cirrhosis groups ( F = -10.69, 4.46, both P > 0.05). TC, TG, HDL-C and LDL-C levels in the hepatitis B cirrhosis group were significantly lower than those in the chronic hepatitis B group ( F = 53.30, 46.98, 24.61, 48.57, all P < 0.05). LDL-C level was positively correlated with the occurrence of liver cancer ( r = 0.20, P < 0.05). HDL-C level was negatively correlated with the occurrence of liver cancer ( r = -0.15, P < 0.05). LDL-C was an independent risk factor for liver cancer ( OR = 3.35, P < 0.05), and HDL-C was a protective factor for liver cancer ( OR = 0.12, P < 0.05). Conclusion:Compared with patients with chronic hepatitis B and hepatitis B cirrhosis, patients with hepatitis B-related liver cancer had abnormal peripheral blood lipid levels, which may be related to the abnormal lipid metabolism of tumor cells. Moreover, peripheral blood lipid levels may affect the occurrence and development of tumor cells.
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Objective:To investigate the clinical efficacy of liraglutide combined with metformin in the treatment of type 2 diabetes mellitus in overweight or obese patients.Methods:The clinical data of 120 overweight or obese patients with type 2 diabetes mellitus admitted to Bayannur Hospital from January 2020 to June 2021 was retrospectively analyzed. They were divided into study and control groups ( n = 60/group) according to different treatments. The study group was treated with liraglutide combined with metformin, and the control group was treated with metformin alone. All patients were treated for 12 weeks. Clinical efficacy was compared between the two groups. Results:After treatment, body mass, body mass index, fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, total cholesterol, triglyceride, low-density lipoprotein cholesterol, visceral fat area, and insulin resistance index in the study group were (71.51 ± 10.12) kg, (25.98 ± 2.63) kg/m 2, (6.09 ± 0.99) mmol/L, (9.08 ± 2.39) mmol/L, (6.75 ± 1.13)%, (4.43 ± 0.88) mmol/L, (1.76 ± 0.68) mmol/L, (2.29 ± 0.90) mmol/L, (108.21 ± 26.46) cm 2 and (3.57 ± 1.45), respectively, which were significantly lower than (75.57 ± 7.11) kg, (27.91 ± 2.46) kg/m 2, (7.02 ± 0.95) mmol/L, (11.26 ± 2.86) mmol/L, (7.28 ± 1.04)%, (5.24 ± 1.11) mmol/L, (2.19 ± 0.70) mmol/L, (2.86 ± 0.97) mmol/L, (118.32 ± 28.63) cm 2, and (4.28 ± 2.07) respectively in the control group ( t = 2.54, 4.15, 5.23, 4.53, 2.66, 4.45, 3.43, 3.39, 2.01, 2.19, all P < 0.05). High-density lipoprotein cholesterol in the study group was significantly higher than that in the control group [(1.55 ± 0.28) mmol/L vs. (1.20 ± 0.32) mmol/L, t = -6.38, P < 0.05]. The grade of nonalcoholic fatty liver disease in the study group was significantly superior to that in the control group ( Z =-2.16, P < 0.05). Conclusion:Liraglutide combined with metformin can effectively improve blood glucose and lipid levels, and reduce insulin resistance, body weight, visceral adipose tissue and liver hepatocellular fatty deposits in overweight or obese patients with type 2 diabetes mellitus.
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Objective:To investigate the relationship between serum thyroid hormone levels in the normal range and body weight, blood glucose, blood lipids, and other obesity-related indexes in patients with type 2 diabetes mellitus.Methods:Seventy obese patients with type 2 diabetes mellitus and ninety-two patients with type 2 diabetes mellitus with normal weight who were treated in the Nangang Branch of Heilongjiang Provincial Hospital from May 2020 to May 2021 were included in this study. Thyroid-stimulating hormone level was in the normal range (0.35-4.94 mU/L) in all participants. Serum levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibody, thyroglobulin antibody, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, glycosylated hemoglobin, fasting C peptide, fasting insulin, systolic blood pressure, diastolic blood pressure, and serum uric acid were measured in all participants.Results:Free triiodothyronine level was positively correlated with fasting blood glucose and glycosylated hemoglobin levels ( r = 0.19, P = 0.021; r = 0.21, P = 0.017). Free thyroxine level was positively correlated with serum glycosylated hemoglobin level ( r = 0.25, P = 0.009) and negatively correlated with total cholesterol ( r = -0.17, P = 0.029). Thyroid-stimulating hormone level was positively correlated with body mass index as well as total cholesterol and low-density lipoprotein cholesterol levels ( r = 0.33, P < 0.001; r = 0.33, P < 0.001; r = 0.32, P < 0.001). Conclusion:Thyroid hormones in the normal range play an important role in the regulation of body weight, blood glucose, and blood lipids in patients with type 2 diabetes mellitus. Blood glucose level increases markedly in patients with relatively high free triiodothyronine and free thyroxine levels. The risks of obesity and dyslipidemia increase in patients with relatively high serum thyroid-stimulating hormone levels
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Objective:To investigate the relationship between histone deacetylase (HDAC) gene polymorphism and type 2 diabetes mellitus (T2DM) in Bai and Han populations in Dali of Yunnan province.Methods:A total of 148 patients with T2DM of Bai and Han nationalities who received treatment in Dali Bai Autonomous Prefecture People's Hospital from May 2019 to March 2021 were included in the T2DM group. An additional 100 healthy controls of Bai and Han nationalities who concurrently received physical examination in the same hospital from May 2019 to December 2020 were included in the normal control group. The susceptibility genes of T2DM were detected using the Taqman MGB probe method. The susceptibility gene loci were amplified using polymerase chain reaction. The whole sequence of susceptibility gene was sequenced.Results:There were no significant differences in the distribution frequencies of rs2530223 genotype, rs11741808 genotype, rs2547547 genotype, and rs1741981 genotype between Bai and Han populations (all P > 0.05). There was a significant difference in blood lipid level between four loci ( t = -1.06, -0.19, 0.39, -2.12, -2.04, 0.16, 1.47, < 0.01, -0.16, -3.17, -2.93, 0.69, -2.58, -2.33, all P < 0.05). There was a significant difference in homeostasis model assessment of insulin resistance between different states (all P < 0.05). The frequency distributions of each genotype and each allele did not differ significantly between healthy control people of Bai nationality and T2DM patients of Bai nationality and between healthy control people of Han nationality and T2DM patients of Han nationality (all P > 0.05). Logistic regression analysis showed that the polymorphism was not an independent risk factor for T2DM. Conclusion:The relationships between HDAC gene polymorphism and T2DM, obesity and dyslipidemia differ between Bai and Han populations.
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Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death of urban and rural residents in China, and dyslipidemia is the most important pathogenic risk factor for the occurrence and development of ASCVD. Faced with the increasing ASCVD burden in China, there is an urgent need to improve the lipid management in China. Clinical blood lipid testing is an important component of lipid management, and the accurate test results are a fundamental requirement for effective lipid management. The "China guidelines for clinical lipid profile testing" and "China guidelines for lipid management (2023)" are newly published. With the continuous updating of concepts on clinical lipid profile testing and lipid management, it is essential to further strengthen the communication and cooperation between clinical medicine and laboratory medicine, widely promote and apply the new concepts of updated guidelines, in order to better guide clinical practice, comprehensively improve the level of clinical lipid profile testing and lipid management in China, and assist in the standardized prevention and treatment of ASCVD in China and the early arrival of the turning points.
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Objective:To evaluate the influence of 25-hydroxyvitamin D[25(OH)D]on dyslipidemia in elderly female patients with type 2 diabetes(T2DM)mellitus aged 60 or over.Methods:We retrospectively reviewed the clinical records of 175 type 2 diabetic older women meeting the inclusion criteria, admitted to the Department of Endocrinology, Beijing Chuiyangliu Hospital, between January and December 2020, with an average age of 66(63, 70)years.According to the diagnostic criteria of dyslipidemia(cholesterol ≥6.2 mmol/L, high density lipoprotein cholesterol <1.0 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L or triglycerides ≥2.3 mmol/L), 110 participants(62.9%)were divided into a dyslipidemia group and 65 participants(37.1%)were assigned into a normal blood lipid group.Logistic regression was employed to investigate factors influencing dyslipidemia.Spearman correlation analysis was employed to analyze the correlation between serum 25(OH)D and blood lipid indexes.Results:The median serum 25(OH)D level of the 175 subjects was 10.92(8.1, 15.2)μg/L.For the dyslipidemia group, it was 9.1(5.8, 12.9)μg/L, lower than 11.9(8.4, 22.6)μg/L in the normal blood lipid group.The proportion of people with hypertension in the dyslipidemia group was higher than in the normal blood lipid group.The dyslipidemia group also had higher BMI, waist circumference and homocysteine levels( P<0.05). Results of multivariate logistic regression analysis demonstrated that hypertension, waist circumference, and homocysteine were significant risk factors for dyslipidemia in elderly women with T2DM, whereas serum 25(OH)D was a protective factor( P<0.05). Correlation analysis results identified that cholesterol and low density lipoprotein cholesterol were inversely correlated to 25(OH)D while high density lipoprotein cholesterol was positively correlated to it( P<0.05). Conclusions:There is a serious deficiency of serum 25(OH)D in older women with T2DM.25(OH)D is protective factor in elderly T2DM women against dyslipidemia.Clinicians should pay attention to vitamin D deficiency in patients during diagnosis and treatment and correct the deficiency.
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Objective:To explore the interaction between hyperuricemia and gender on dyslipidemia in the elderly.Methods:A cross-sectional study. The permanent residents aged≥65 years in Kunshan City were selected by the cluster sampling method. The selected residents underwent physical examination and blood biochemical tests such as blood glucose, blood lipid, uric acid, hyaluronic acid, gamma glutamyltransferase and creatinine, and history of schistosomiasis infection was investigated. Multivariate logistic regression analysis was used to analyze the relationship between various factors and dyslipidemia. Synergy index (S), relative excess risk of interaction (RERI) and the attributable proportion due to interaction (AP) were used to evaluate the association between hyperuricemia and female interaction on dyslipidemia.. The dose-response relationship between serum uric acid level and dyslipidemia was analyzed by a restricted cubic spline regression model.Results:The prevalence of dyslipidemia in the elderly aged 65 years and obove was 31.9% (1 450/4 536), and it was 23.7% (517/2 180) and 39.6% (933/2 356) in men and women, respectively ( χ2=131.38, P<0.001). Multivariate regression showed that female, high waist circumference, overweight and obesity, hypertension, diabetes, low glomerular filtration rate, high gamma-glutamyltranspeptidase, high uric acid to creatinine ratio, low neutral to lymphocyte ratio were associated with dyslipidemia (all P<0.05). Additionally, additive interaction association was found between the dyslipidemia and advanced uric acid levels ( OR=1.09, 95% CI: 1.07-1.12) and female ( OR=1.12, 95% CI: 1.11-1.14), and the contribution rate of interaction effects was 19.8% (RERI=0.74, 95% CI: 0.06-1.42; AP=0.20, 95% CI: 0.04-0.36, S=1.37, 95% CI: 1.02-1.84). Non-linear dose response relationship was identified by the restricted cubic spline regression model between the continuously rising serum uric acid and dyslipidemia ( χ2=101.23, P<0.001). Conclusions:The proportion of dyslipidemia in elderly permanent residents is high. Demographics and physical measurement indicators comprehensively affected the prevalence of dyslipidemia. In addition, both hyperuric acid and female have additive interaction on dyslipidemia.
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Objective:To compare the relationship between non-high-density lipoprotein cholesterol (non-HDL-C) and bone mass in different body parts in the physical examination population.Methods:It was a cross-sectional study. The data of 595 physical examiners who visited the Institute of Health Management, PLA General Hospital from June to September 2016 were retrospectively analyzed. The bone mass levels of lumbar 1-4 vertebral body (spine) and femur, average bone density were measured by double light energy X-ray bone density instrument. The basic information and biochemical indices of the physical examiners were collected. The difference between blood lipid components (including Non-HDL-C) and bone mass level of each body part were analyzed.Results:According to blood lipid stratification, there were significant differences in spine T value (T-spine) between triglyceride (TG) groups (-0.15±1.41 vs -0.38±1.3), Non-HDL-C groups (-1.01±0.74 vs -1.21±0.59, -1.04±0.73 vs -1.30±0.45,-1.07±0.71 vs -1.30±0.26) and low-density lipoprotein cholesterol (LDL-C) groups (-1.01±0.71 vs -1.32±0.56)(all P<0.05). There was no statistically significant difference in other lipid groups and femoral T values in each component′s blood lipids. The T-spine decreased significantly in the LDL-C≥3.4 mmol/L group, and the differences were all significant among the Non-HDL-C group (all P<0.05). In binary logistic regression analysis, LDL-C≥3.4 mmol/L ( OR=3.961,95% CI:1.310-11.974) and Non-HDL-C>4.1 mmol/L ( OR=3.600,95% CI:1.035-12.524) were risk factors for vertebral bone mass loss (both P<0.05). Conclusion:People with elevated serum TG, Non-HDL-C and LDL-C in the physical examination population are prone to bone abnormalities. Non-HDL-C≥4.1 mmol/L and LDL-C≥3.4 mmol/L are more closely related to the vertebral bone mass loss and are the risk factors for vertebral bone mass loss.
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Abstract Introduction: Patients with chronic kidney disease (CKD) are known to have increased cardiovascular risk but there are few data on the risk of pediatric kidney transplant recipients. We aimed to assess the impact of pre- and post-transplant overweight on allograft function and to characterize the evolution of several cardiovascular risk variables over time and their impact. Methods: A retrospective analysis of the records of 23 children/adolescents followed at a tertiary center after kidney transplant was conducted. Data on anthropometry and cardiometabolic variables were analyzed before transplant, six and 12 months after the transplant, and at the last follow-up visit. The impact of the variables on allograft function (glomerular filtration rate (GFR)) was estimated by creatinine-based revised Schwartz formula (Cr-eGFR) and was evaluated using nonparametric tests. Results: The 23 patients included in the study had a median age of 6.3 (4.4-10.1) years. Both systolic and diastolic BP z-score values significantly decreased between BMI groups [1.2 (-0.2 - 2.3) vs. 0.3 (-0.4 - 0.6), p=0.027 and 0.8 (-0.4 - 1.3) vs. 0.1 (-0.6 - 0.7), p=0.028, pre-transplant and at the final evaluation, respectively]. During follow-up, GFR values decreased (Cr-GFR: 68.9 (57.7-76.8) vs. 58.6 (48.9-72.9), p=0.033 at 6-months and at the end, respectively). Significant negative correlations between triglycerides and cystatin C-based eGFR (ρ=-0.47, p=0.028) and Cr-Cys-eGFR (ρ=-0.45, p=0.043) at the end of the study were found. Conclusion: Our study showed a high number of overweight children undergoing kidney transplant. A negative correlation between triglycerides and GFR was found, which highlights the importance of managing nutritional status and regular blood lipids evaluation after kidney transplant.
Resumo Introdução: Sabe-se que pacientes com doença renal crônica (DRC) têm maior risco cardiovascular, mas há poucos dados sobre risco de receptores de transplante renal pediátrico. Visamos avaliar o impacto do sobrepeso pré/pós-transplante na função do aloenxerto e caracterizar a evolução de diversas variáveis de risco cardiovascular com o tempo e seus impactos. Métodos: Realizou-se análise retrospectiva dos registros de 23 crianças/adolescentes acompanhados em um centro terciário após transplante renal. Foram analisados dados sobre antropometria e variáveis cardiometabólicas antes do transplante, seis e 12 meses após transplante, e na última consulta de acompanhamento. O impacto das variáveis na função do aloenxerto (taxa de filtração glomerular (TFG)) foi estimado pela fórmula de Schwartz revisada e baseada na creatinina (TFGe-Cr), e avaliado usando testes não paramétricos. Resultados: Os 23 pacientes incluídos no estudo tinham idade média de 6,3 (4,4-10,1) anos. Valores do escore Z das pressões arteriaissistólica e diastólica diminuíram significativamente entre grupos de índice de massa corporal [1,2 (-0,2 - 2,3) vs. 0,3 (-0,4 - 0,6), p=0,027 e 0,8 (-0,4 - 1,3) vs. 0,1 (-0,6 - 0,7), p=0,028, pré-transplante e na avaliação final, respectivamente]. Durante acompanhamento, valores da TFG diminuíram [TFG-Cr: 68,9 (57,7-76,8) vs. 58,6 (48,9-72,9), p=0,033 aos 6 meses e ao final, respectivamente]. Encontramos correlações negativas significativas entre triglicerídeos, TFGe baseada na cistatina C (ρ=-0,47, p=0,028) e TFGe-Cr-Cis (ρ=-0,45, p=0,043) ao final do estudo. Conclusão: Nosso estudo mostrou alto número de crianças com sobrepeso submetidas a transplante renal. Verificou-se correlação negativa entre triglicerídeos e TFG, destacando a importância de controlar o estado nutricional e da avaliação regular dos lipídios sanguíneos após transplante renal.
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Introdução: o estresse percebido foi sugerido como um fator de risco para o desenvolvimento da Síndrome Metabólica (SM). No entanto, pouco se sabe desta associação entre mulheres. Objetivo: avaliar o estresse percebido em mulheres com SM. Materiais e Métodos: estudo transversal, a partir do recorte de um ensaio clínico não-randomizado, com pacientes de um centro de saúde público (RBR-43K52N). A variável de desfecho foi a SM, utilizando os critérios do NCEP/ATPIII. Foram coletados dados sociodemográficos, antropométricos, bioquímicos, hemodinâmicos e aplicação da PSS. Resultados: A amostra constituiu-se de 75 mulheres acometidas por SM (47,69±8,15 anos de idade; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,54±7,28). Encontrou-se valores elevados de RCQ entre as mulheres estressadas e não-estressadas. A pontuação média da PSS foi de 27,73±9,17. Nos agrupamentos, verificou-se diferença significativa para PSS entre as mulheres estressadas e não-estressadas (35,24±5,22 e 20,42±5,53, respectivamente; p=0,001). Observou-se também que mulheres estressadas tinham níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas, embora sem diferença estatística. Discussões: Os achados sugerem que as mulheres categorizadas como estressadas tinham maior pontuação da PSS, níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas. Conclusões: a pontuação da PSS foi significativamente maior entre mulheres com parâmetros lipídicos da SM alterados, com menores níveis de HDL- e aumento de triglicerídeos.
Introduction: Perceived stress has been suggested as a risk factor for the development of Metabolic Syndrome (MS). However, little is known about this association among women. Objective: to evaluate perceived stress in women with Metabolic Syndrome (MS). Materials and Methods: cross-sectional study, based on a non-randomized clinical trial, with patients from a public health center (RBR-43K52N). The outcome variable was MS, using the NCEP/ATPIII criteria. Sociodemographic, anthropometric, biochemical, hemodynamic data and PSS application were collected. Results: The sample consisted of 75 women affected by MetS (47.69± 8.15 years old; 155.65±0.07 cm; 82.43±17.79 kg; BMI of 33.96±6 ,42). High WHR values were found among stressed and non-stressed women. The average PSS score was 27.73±9.17. In the groups, there was a significant difference for PSS between stressed and non-stressed women (35.24±5.22 and 20.42±5.53, respectively; p=0.001). It was also observed that stressed women had higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women, although without statistical difference. Discussions: The findings suggest that women categorized as stressed had higher PSS scores, higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women. Conclusions: the PSS score was significantly higher among women with altered MS lipid parameters, with lower levels of HDL- and increased triglycerides.
Introducción: El estrés percibido ha sido sugerido como un factor de riesgo para el desarrollo del Síndrome Metabólico (SM). Sin embargo, poco se sabe sobre esta asociación entre las mujeres. Objetivo: evaluar el estrés percibido en mujeres con Síndrome Metabólico (SM). Materiales y Métodos: estudio transversal, basado en un ensayo clínico no aleatorizado, con pacientes de un centro de salud pública (RBR-43K52N). La variable resultada fue SM, utilizando los criterios NCEP/ATPIII. Se recogieron datos sociodemográficos, antropométricos, bioquímicos, hemodinámicos y aplicación de PSS. Resultados: La muestra estuvo compuesta por 75 mujeres afectadas por SMet (47,69± 8,15 años; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,96±6,42). Se encontraron valores altos de WHR entre mujeres estresadas y no estresadas. La puntuación media de PSS fue de 27,73±9,17. En los grupos, hubo una diferencia significativa para PSS entre mujeres estresadas y no estresadas (35,24±5,22 y 20,42±5,53, respectivamente; p=0,001). También se observó que las mujeres estresadas tenían niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con las mujeres no estresadas, aunque sin diferencia estadística. Discusiones: Los hallazgos sugieren que las mujeres categorizadas como estresadas tenían puntajes PSS más altos, niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con mujeres no estresadas. Conclusiones: la puntuación de PSS fue significativamente mayor entre las mujeres con parámetros lipídicos de SM alterados, con niveles de HDL más bajos y triglicéridos elevados.
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Women , Metabolic Syndrome , Dyslipidemias , Obesity, AbdominalABSTRACT
Objetivo : Evaluar la relación entre control metabólico y enfermedad arterial periférica (EAP) en pacientes con diabetes mellitus tipo 2 (DM2) del hospital María Auxiliadora (HMA). Material y métodos : Estudio caso-control pareado para sexo, de un análisis secundario basado en datos del servicio de endocrinología del HMA, Lima-Perú. Los casos con EAP, fueron aquellos con índice tobillo-brazo (ITB) < 0,9. Los controles fueron aquellos con ITB entre 0,9 y 1,3 en una relación 4:1 con respecto a los casos. Se definió como mal control metabólico si presentaron al menos uno de las siguientes: hemoglobina glicosilada ≥ 7 %, presión arterial sistólica ≥ 140 mm Hg, presión arterial diastólica ≥ 90 mm Hg, colesterol HDL< 40 mg/dl (varón) o < 50 mg/dl (mujer), colesterol LDL ≥ 100 mg/dl y triglicéridos ≥ 150 mg/dl. Se calculó el Odds ratio (OR) de mal control metabólico, tanto crudo como ajustado, según presencia de EAP mediante regresión logística. Resultados : Incluimos a 39 casos y 157 controles. Un 94,9 % y 82,2 % de los casos y controles presentaron mal control metabólico respectivamente (p<0,05). Al ajustar a edad, tiempo de diabetes, índice de masa corporal y antecedente de tabaco, los pacientes con mal control metabólico presentaron un OR de 5,45; (IC 95 % 1,17 - 25,2); p=0,030 de presentar enfermedad arterial periférica definido por ITB<0,9. Conclusión : El mal control metabólico presenta una relación independiente con EAP en pacientes con DM2 del Hospital María Auxiliadora. Metas terapéuticas centradas solo en la glicemia, elevarían la carga de enfermedad de complicaciones macrovasculares.
Objective : To assess the relationship between metabolic control and peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (DM2) in Maria Auxiliadora Hospital (MAH). Material and methods : This is a sex-matched case control study with a secondary analysis based on data from the endocrinology service of MAH, Lima, Peru. Cases with PAD were defined as those with 50 mg/dL (females), LDL cholesterol ≥100 mg/dL and triglycerides ≥150 mg/dL. Odds ratio values for poor metabolic control were calculated, both crude and adjusted, according to the presence or PAD, by using logistic regression. Results : We included 39 cases and 157 controls. A great majority of cases (94.9%) and of controls (82.2%) had poor metabolic control, respectively (p<0.05). When adjusting for age, time with diabetes, body mass index, and history of tobacco use, patients with poor metabolic control had OR at 5.45 (95% CI: 1.17 - 25.2) and p= 0.030 for having peripheral arterial disease, as defined by ATAI <0.9. Conclusion : Poor metabolic control showed and independent relationship with PAD in DM2 patients in Maria Auxiliadora Hospital. If therapy was only centered in glycemic control, it would increase the burden of disease of macrovascular complications.