Use of FGF21 analogs for the treatment of metabolic disorders: a systematic review and meta-analysis

ABSTRACT FGF21 is a hormone produced primarily by the liver with several metabolic functions, such as induction of heat production, control of glucose homeostasis, and regulation of blood lipid levels. Due to these actions, several laboratories have developed FGF21 analogs to treat patients with metabolic disorders such as obesity and diabetes. Here, we performed a systematic review and meta-analysis of randomized controlled trials that used FGF21 analogs and analyzed metabolic outcomes. Our search yielded 236 articles, and we included eight randomized clinical trials in the meta-analysis. The use of FGF21 analogs exhibited no effect on fasting blood glucose, glycated hemoglobin, HOMA index, blood free fatty acids or systolic blood pressure. However, the treatment significantly reduced fasting insulinemia, body weight and total cholesterolemia. None of the included studies were at high risk of bias. The quality of the evidence ranged from moderate to very low, especially due to imprecision and indirection issues. These results indicate that FGF21 analogs can potentially treat metabolic syndrome. However, more clinical trials are needed to increase the quality of evidence and confirm the effects seen thus far.

Myopathy due to carnitine palmitoyltransferase II deficiency: updating genetic aspects of the first publication in Brazil / Miopatia por deficiência de carnitina palmitoiltransferase II: atualizando os aspectos genéticos da primeira publicação no Brasil

Abstract Carnitine palmitoyltransferase II (CPT II) deficiency is an autosomal recessive inherited disorder related to lipid metabolism affecting skeletal muscle. The first cases of CPT II deficiency causing myopathy were reported in 1973. In 1983, Werneck et al published the first two Brazilian patients with myopathy due to CPT II deficiency, where the biochemical analysis confirmed deficient CPT activity in the muscle of both cases. Over the past 40 years since the pioneering publication, clinical phenotypes and genetic loci in the CPT2 gene have been described, and pathogenic mechanisms have been better elucidated. Genetic analysis of one of the original cases disclosed compound heterozygous pathogenic variants (p.Ser113Leu/p.Pro50His) in the CPT2 gene. Our report highlights the historical aspects of the first Brazilian publication of the myopathic form of CPT II deficiency and updates the genetic background of this pioneering publication.

Resumo Deficiência de carnitina palmitoiltransferase II (CPT II) é uma desordem de herança autossômica recessiva relacionada com o metabolismo do lipídio afetando músculo esquelético. Os primeiros dois casos de deficiência de CPT II causando miopatia foram relatados em 1973. Em 1983, Werneck et al. publicaram os primeiros pacientes brasileiros com miopatia por deficiência de CPT II, nos quais a análise bioquímica confirmou a atividade deficiente da CPT nos músculos em ambos os casos. Após 40 anos desde a publicação pioneira, fenótipos clínicos e loci genético no gene CPT2 foram descritos, bem com os mecanismos patológicos foram melhor elucidados. A análise genética de um dos casos da publicação original apresentou variantes patogênicas em heterozigose composta (p.Ser113Leu/p.Pro50His) no gene CPT2. O nosso relato destaca os aspectos históricos da primeira publicação brasileira da forma miopática da deficiência de CPT II e atualiza as bases genéticas dessa publicação pioneira.

Correlation analysis of serum lipids, HbA1C levels and insulin resistance in obese type 2 diabetes patients / 公共卫生与预防医学

Objective To investigate the changes of blood lipid and glycosylated hemoglobin (HbA1c) levels in obese type 2 diabetes (T2DM) patients and their relationship with insulin resistance (Homa-IR). Methods A total of 120 cases of T2DM newly diagnosed in Motuo County, Tibet from February to October 2022 were selected as the observation group. According to BMI, the patients were divided into diabetes normal weight group (46 cases), overweight group (43 cases) and obesity group (31 cases); 145 healthy subjects were selected as the control group. The levels of HbA1c, fasting blood glucose (FPG), fasting insulin (FINS), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) were detected in the study subjects, and Homa-IR and Homa-β indices were calculated. The height, weight, and abdominal circumference were measured. The differences in the levels of the above indicators between the observation group patients and the control group, as well as among various subgroups within the observation group were compared. The influencing factors of Homa-IR in obese T2DM patients were analyzed. Results Compared with the control group, a significant increase in BMI, abdominal circumference, blood pressure, HbA1c, FBG, FINS, TC, TG, LDL-C, UA, visceral fat area, and the levels of Home-IR and Home-β was found in the observation group (all P<0.05). There were significant differences in BMI, abdominal circumference, and the levels of FINS, Homa IR, Homa-β, and HbA1c in diabetes patients with different BMI (all P<0.05). Correlation analysis showed that TG levels in obese T2DM patients in the observation group were significantly correlated with HbA1c (r=0.396, P=0.027), Homa-IR (r=0.405, P=0.024), and Home-β (r=-0.401, P=0.025); LDL-C was significantly correlated with Homa-IR (r=0.411, P=0.022) and Homa-β (r=-0.412, P=0.021); HbA1c was significantly positively correlated with BMI (r=0.371, P=0.040). Conclusion Insulin resistance is closely related to TG, LDL-C, and BMI in obese T2DM patients from the Motuo ethnic minority of Tibet, suggesting that these factors may play a role in the occurrence of T2DM.

Correlation between ocular surface status and blood lipids in patients with meibomian gland dysfunction during pregnancy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P&#x0026;#x003C;0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P&#x0026;#x003C;0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P&#x0026;#x003C;0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.

Estimation of Lipid and Fatty Acids Composition over the Ground Part of Nepeta olgae Regel (L.) Plants Growing in Namangan Region

The article is devoted to the study of lipids and fatty acid composition of the above-ground part of the Nepeta olgae Regel (L.) plant of the Laminaceae family. It was found that the content of neutral lipids (NL) is 5.54%, PL - 6.12%, and total lipids (NL, PL) - 11.66%. Of the neutral lipids, the unsaponifiable substances (HB) had a bright yellow color, which is explained by a small amount of carotenoids (88.87 mg%). Glycolipids dominate in PL. Among the unsaponifiable substances were found biologically active components such as hydrocarbons, carotenoids, aliphatic alcohols, sterols and triterpenols. Phytosterols were the main component of unsaponifiable NS. Quantitative and qualitative analysis of fatty acids from the plant Nepeta olgae Regel (L.) was carried out by gas chromatography (GC). 28 acids were identified, of which 11 compounds are saturated, and 7 compounds are unsaturated fatty acids. Of the fatty acids, the main ones are linolenic 18:3 (35.48), palmitic 16:0 (33.38%), as well as ?-3 polyunsaturated fatty acids, including eicosanoic 20:1, cis-11,14-eicosadienoic 20:2, 8,11,14-eicosatriene 20:3 + arachidonic 20:4. Extracts of Nepeta olgae Regel (L.) were distinguished by a high content of polyunsaturated acids, which determines their potential biological activity.

Trends and Race/Ethnic Differences in Levels of TC/HDL-C Ratio in the US Among Individuals Aged 6-80 Years: NHANES 2005-2020.

Objective: Reliable and disaggregated population-based data for cholesterol trends are needed to evaluate overall cardiovascular health, assess the effects of nutritional policies and pharmacological interventions, and guide priority setting. This study aimed to examine the trends and differences in serum total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) ratio among U.S. residents by race/ethnicity. Study Design and Setting: Blood lipid measurements, taken from 53,964 noninstitutionalized participants, aged 6 to 80, were obtained from the National Health and Nutrition Examination Survey (NHANES) study. We described the distributions of TC/HDL-C ratio across the life span in four distinct cross-sectional surveys during 2005-2008, 2009-2012, 2013-2016, and 2017-2020, and compared the ratio levels by race/ethnicity. Results: Between 2005 and 2020, favorable trends in lipid ratio levels were observed. In youth aged < 20 years, mean TC/HDL-C ratios were 3.17, 3.15, 3.02, and 3.06 in males; and 3.12, 3.13, 3.03, and 3.02 in females from 2005 to 2020. In adults 20 years old and older, mean TC/HDL ratios declined from 4.30 in 2005-2008, to 4.27 in 2009-2012, 4.17 in 2013-2016, to 3.96 in 2017-2020 in males; while mean TC/HDL-C ratios declined from 3.67 in 2005-2008, to 3.66 in 2009-2012, to 3.54 in 2013-2016, to 3.46 in 2017-2020 in females. Overall, non-Hispanic black individuals tended to have lower mean TC/HDL ratio levels than other groups, while Mexican American individuals tended to have higher TC/HDL ratio levels on average. Conclusion: Further research is needed to determine how racial/ethnic differences in cholesterol ratio affect racial/ethnic differences in cardiovascular disease rates.

Investigation of associations between apolipoprotein A5 and C3 gene polymorphisms with plasma triglyceride and lipid levels

SUMMARY OBJECTIVE: The aim of this study was to determine frequency and associations between APOA5 c.56C>G, −1131T>C, c.553G>T, and APOC3 −482C>T and SstI gene polymorphisms with hypertriglyceridemia. METHODS: Under a case-control study model, 135 hypertriglyceridemic and 178 normotriglyceridemic control participants were recruited. Polymerase chain reaction and restriction fragment length polymorphism methods were utilized for genotyping. Statistical calculations were performed by comparing allele and genotype frequencies between groups. Clinical characteristics were compared between groups and intra-group genotypes. RESULTS: APOC3 gene −482C>T and SstI polymorphic genotypes and allele frequencies were significantly higher in hypertriglyceridemic group (genotype frequencies, p=0.035, p=0.028, respectively). Regression analysis under unadjusted model confirmed that APOC3 −482C>T and SstI polymorphisms were significantly contributing to have hypertriglyceridemia (p=0.02, odds ratio [OR]=1.831 (95% confidence interval [CI] 1.095-3.060); p=0.04, OR=1.812 (1.031-3.183), respectively). APOA5 c.56C>G was in complete linkage disequilibrium with APOA5 c.553G>T polymorphism (D'=1). CONCLUSION: For the first time in a population sample from Turkey, among the five polymorphisms of APOA5 and APOC3 genes investigated, APOC3 −482C>T and SstI polymorphisms were associated with elevated serum TG levels, while APOA5 c.56C>G, −1131T>C, and c.553G>T polymorphisms were not.

Relación del consumo de calcio con el síndrome metabólico en adultos de la Amazonía Ecuatoriana / Relationship of calcium consumption with metabolic syndrome in adults from the Ecuadorian Amazon

Introducción. El Síndrome Metabólico (SM) comprende un conjunto de factores de riesgo cardiometabólico representado por obesidad central, dislipidemia, hipertensión arterial y glucosa alterada, se ha evidenciado que el consumo adecuado de calcio representa una disminución del riesgo para este síndrome. Objetivo. Analizar la relación entre el consumo de calcio total, de origen animal y vegetal con el SM y sus indicadores. Materiales y métodos. Estudio transversal de eje correlacional, con una muestra de 100 adultos de la región amazónica ecuatoriana, durante el último trimestre del 2020. La ingesta dietética de calcio se determinó mediante un recordatorio de 24 horas y el SM según los criterios de Adult Treatment Panel-IV (ATP-IV). Resultados. La población estuvo conformada por adultos maduros (40 a 60 años) que evidenciaron una ingesta de calcio deficiente (182,50 mg y 228,60 mg en mujeres y hombres respectivamente). Se evidenció, además, una relación directamente proporcional entre la circunferencia abdominal (r=0,391 ­ p=0,000), presión arterial sistólica (r=0,290 ­ p=0,000) y glucosa en ayuno (r=0,326 ­ p=0,000) con la edad. La ingesta de calcio total se relacionó positivamente con los triglicéridos, (r=0,221 ­ p=0,027). Conclusiones. La ingesta dietética de calcio en ambos sexos no alcanza el requerimiento diario y se relaciona positivamente con los triglicéridos(AU)

Introduction. The Metabolic Syndrome (MS) comprises a set of cardiometabolic risk factors represented by central obesity, dyslipidemia, high blood pressure and altered glucose, it has been shown that adequate calcium intake represents a decreased risk for this syndrome. Objective. To analyze the relationship between the consumption of total calcium, animal and vegetable origin, with MS and its indicators. Materials and methods. Cross-sectional study of correlational axis, with a sample of 100 adults from the Ecuadorian Amazon region, during the last quarter of 2020. Dietary calcium intake was determined through a 24-hour recall and the diagnosis of MS according to the Adult Treatment Panel- IV (ATP-IV) criteria. Results. The population consisted of mature adults (40 to 60 years) who showed a deficient calcium intake in both sexes (182.50 mg and 228.60 mg in women and men respectively). There is also evidence of a directly proportional relationship between abdominal circumference (r=0.391 - p=0.000), systolic blood pressure (r=0.290 - p=0.000) and fasting glucose (r=0.326 - p=0.000) with age. Total calcium intake was positively related to triglycerides (r=0.221 ­ p=0.027). Conclusions. Calcium dietary intake in both sexes does not reach the daily requirement and is positively related to triglycerides(AU)

Increase in the volume of the breast implant by passing organic material into it / Aumento do volume do implante mamário por passagem de material orgânico para seu interior

Introduction: The search for an anatomical substitute for the breast, for the purpose of correcting aesthetic problems has a long history of failure until the arrival of silicone. Since the beginning of its use, in the 1960s, many complications have appeared, such as infection, rejection, rupture, in addition to silicone leakage. We did not find in the literature, however, any report on the passage of materials from the human organism to the interior of implants. The objective is to identification by infrared spectrophotometry (FTIR) and clinical analysis, reporting the passage of organic substances into breast implants without any violation of their capsule. Methods: 1500 pairs of breast implants were analyzed, surgically removed from 1998 to 2018. Of which six were included in the study. Results: Three materials were analyzed showing macroscopic changes in their interior, without violating the capsule. A second sample was performed on a similar implant, but without use. The third material was a sample of fatty breast tissue removed from the patient during the surgery. Materials compatible with fat, animal protein and hemoglobin were found inside the implant. Conclusions: The change evidenced in the material inside the two implants indicates the occurrence of the passage of organic materials through an intact capsule.

Introdução: A busca de um substituto anatômico para a mama, para fins de correção de problemas estéticos, tem longa história de insucessos até a chegada do silicone. Desde o início de seu uso, na década de 1960, muitas complicações surgiram, como infecção, rejeição, rotura, além do extravasamento de silicone. Não encontramos na literatura, porém, relato algum sobre a passagem de materiais do organismo humano para o interior de implantes. O objetivo é a identificação por espectrofotometria de infravermelho (FTIR) e análise clínica, relatando a passagem de substâncias orgânicas para o interior de implantes mamários sem que os mesmos apresentem violação qualquer de sua cápsula. Método: Foram analisados 1500 pares de implantes mamários, removidos cirurgicamente no período de 1998 a 2018. Destes, seis foram encaminhados incluídos no estudo. Resultados: Foram analisados três materiais apresentando alterações macroscópicas em seu interior, sem que houvesse violação da cápsula. Uma segunda amostra foi realizada em implante semelhante, porém sem uso. O terceiro material foi uma amostra de tecido gorduroso mamário removido da própria paciente durante o ato cirúrgico. Foram encontrados materiais compatíveis com gordura, proteína animal e hemoglobina no interior do implante. Conclusões: A alteração evidenciada no material do interior dos dois implantes nos indica a ocorrência de passagem de materiais orgânicos através de cápsula intacta.

Monocyte/High-Density Lipoprotein Ratio Is Associated with Atrial High-Rate Episodes within One Year Detected by Cardiac Implantable Electronic Devices

ABSTRACT Objective: To investigate the risk factors for predicting atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs). Methods: A total of 140 patients with CIED in our hospital from June 2013 to June 2018 were included and were followed up to observe whether they had AHREs. AHRE are defined as atrial rate ≥ 175 times/minute, lasting > 5 minutes, and reviewed by an experienced electrophysiologist with unclear clinical diagnosis. The patients fasted for 12 hours after implantation, and blood samples were collected for biochemical, lipid, and whole blood count detection. Follow-up was regular after discharge to record follow-up data of each patient and conduct statistical analysis. Results: One hundred and forty patients were implanted with dual-chamber pacemakers, their median age was 70 years old, 44.29% were male, 27 patients had AHRE within one year, and AHRE incidence rate was 19.29%. The microcytic to hypochromic (M/H) ratio was calculated for all AHRE patients and compared with the patients without AHRE; the M/H value of AHRE patients was significantly higher. Throughout the entire follow-up period, a total of 44 patients developed AHRE; when adjusted by multivariate analysis, only M/H ratio ≥ 4.5 vs. < 4.5 had statistical significance, and the adjusted hazard ratio value was 4.313 (1.675-11.105). Conclusion: As an indicator, M/H ratio may play an important role in the occurrence and development of atrial fibrillation and can be used as a predictor of AHRE in patients with CIED.

Effectiveness of cinnamon in the reduction of lipid levels in people with diabetes: a randomized clinical trial / Eficacia de la canela en la reducción de los niveles de lípidos en personas con diabetes: un ensayo clínico aleatorizado / Efetividade da canela na redução de níveis lipídicos em pessoas com diabetes: ensaio clínico aleatorizado

ABSTRACT Objective: To evaluate the effectiveness of cinnamon in reducing lipid levels in people with diabetes. Method: Randomized clinical trial of parallel groups, triple-blind, conducted in Basic Health Units in the state of Piauí in 2019. People with Type 2 Diabetes Mellitus, between 18 and 80 years old, using oral antidiabetics, were included, and divided into two groups. The experimental group tested 3g of cinnamon for 90 days. Results: 140 people participated in the study. From these, the experimental group (n= 71) showed a reduction in mean levels of total cholesterol (p= 0.316 - CI 95% -24.9-8.1), LDL (p= 0.024 - CI 95% -29.3 -2.1) and triglycerides (p= 0.969 - 95% CI -28.6-27.5), and increased HDL (p= 0.001 - 95% CI 4.2-10.2). Conclusion: The use of 3g of cinnamon per day, for 90 days, seems to help reduce LDL values and increase HDL levels in patients with diabetes.

RESUMEN Objetivo: Evaluar la efectividad de la canela en la reducción de los niveles de lípidos en personas con diabetes. Método: Ensayo clínico aleatorizado, triple ciego, de grupos paralelos, realizado en Unidades Básicas de Salud de Piauí en 2019. Personas con Diabetes Mellitus tipo 2, entre 18 y 80 años, usuarias de antidiabéticos orales, fueron divididas en dos grupos. El grupo experimental probó 3g de canela durante 90 días. Resultados: 140 personas participaron en el estudio. De estos, el grupo experimental (n= 71) mostró una reducción en los niveles medios de colesterol total (p= 0,316 - IC 95% -24,9-8,1), LDL (p= 0,024 - IC 95% -29,3 - 2,1) y triglicéridos (p= 0,969 - IC 95% -28,6-27,5) y HDL elevado (p= 0,001 - IC 95% 4,2-10,2). Conclusión: El uso de 3g de canela al día durante 90 días parece ayudar a reducir los valores de LDL y aumentar los niveles de HDL en pacientes con diabetes.

RESUMO Objetivo: Avaliar a efetividade da canela na redução dos níveis lipídicos em pessoas com diabetes. Método: Ensaio clínico aleatorizado de grupos paralelos, triplo cego, realizado em Unidades Básicas de Saúde do estado do Piauí em 2019. Foram incluídas pessoas com Diabetes Mellitus tipo 2, entre 18 e 80 anos, em uso de antidiabéticos orais, e divididos em dois grupos. No grupo experimental testou-se 3g de canela por 90 dias. Resultados: 140 pessoas participaram do estudo. Destas, o grupo experimental (n= 71) apresentou redução na média dos níveis de colesterol total (p= 0,316 - IC 95% -24,9-8,1), LDL (p= 0,024 - IC 95% -29,3-2,1) e triglicerídeos (p= 0,969 - IC 95% -28,6-27,5), e aumento do HDL (p= 0,001 - IC95% 4,2-10,2). Conclusão: O uso de 3g de canela por dia, durante 90 dias, parece auxiliar na diminuição dos valores de LDL e aumento dos níveis de HDL em pacientes com diabetes.

Fisiología respiratoria: fisiología del surfactante pulmonar / Physiology of pulmonary surfactant

El proceso de respiración y el intercambio gaseoso requiere la interacción de variadas fuerzas en los distintos tejidos y órganos involucrados. La tensión superficial a nivel alveolar provocaría colapso de dichas estructuras de no ser por las características del surfactante que lo recubre. Revisaremos en este articulo la fisiología involucrada en su estructura física, producción y efectos pulmonares.

The process of breathing and gas exchange requires the interaction of various forces in the different tissues and organs involved. The surface tension at the alveolus would cause collapse of these structures without of the surfactant that covers it. We will review in this article the physiology involved in its physical structure, production, and pulmonary effects.

The molecular machinery required to process endocannabinoids lipid signaling and their respective receptors / A maquinaria molecular necessária para processar mensageiros lipídicos endocanabinoides e seus respectivos receptores

ABSTRACT BACKGROUND AND OBJECTIVES: Pharmaceutical preparations of cannabis have been used by mankind since long time ago, and recently they have been the pharmaceutical industry's focus. However, for proper therapeutic application, in-depth knowledge of the endocannabinoid system, which is made mainly by lipid signaling, is needed. The purpose of this study was to explore the current understanding of the players in this system, paying special attention to the molecular machinery required to process it. CONTENTS: This is a narrative review of the current literature regarding major components of the endocannabinoid system, in particular: the receptors, main endogenous ligands, and the enzymes responsible for its components processing. The pharmacological and preclinical aspects were emphasized. CONCLUSION: The better comprehension of the molecular structure of receptors and enzymes will be crucial to developing new pharmacological strategies. A detailed description of the machinery responsible for endocannabinoid lipid metabolization will pave the way for the discovery of new drugs that act on the endogenous system and that can be applied effectively in clinical practice.

RESUMO JUSTIFICATIVA E OBJETIVOS: Os preparados medicinais canabinoides são há muito utilizados pela humanidade e têm sido objeto de interesse da indústria farmacológica recente. Para a aplicação terapêutica adequada é necessário, no entanto, o conhecimento aprofundado do sistema canabinoide endógeno, o qual em sua grande parte é constituído por mensageiros lipídicos. O objetivo deste estudo foi explorar o conhecimento vigente a respeito dos constituintes desse sistema, com especial atenção à maquinaria molecular necessária para processá-los. CONTEÚDO: Trata-se de uma revisão narrativa da literatura atual acerca dos integrantes do sistema canabinoide endógeno, notadamente: seus receptores, os principais ligantes endógenos e as enzimas responsáveis pelo processamento de seus componentes. Os aspectos farmacológicos e pré-clínicos foram enfatizados. CONCLUSÃO: O melhor entendimento da ultraestrutura de receptores e enzimas contribuirá de forma decisiva para o desenvolvimento de novas estratégias farmacológicas. A partir da descrição pormenorizada da maquinaria responsável pela metabolização lipídica endocanabinoide é que se pavimentará o caminho para a descoberta de novos fármacos que atuem no sistema endógeno e que possam ser aplicados de forma eficaz na prática clínica.

Geographic Variations in the Prevalence, Awareness, Treatment, and Control of Dyslipidemia among Chinese Adults in 2018-2019: A Cross-sectional Study / 生物医学与环境科学（英文）

OBJECTIVE@#To investigate the spatial patterns of the prevalence, awareness, treatment, and control rates of dyslipidemia at the provincial level in China.@*METHODS@#A national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in mainland China in 2018-2019, using a multi-stage, stratified, cluster-randomized sampling design. Subjects, as households, were selected, followed by a home visit to collect information. Both descriptive and linear regression procedures were applied in the analyses.@*RESULTS@#The overall prevalence of dyslipidemia was 35.6%, and wide geographic variations of prevalence, treatment, and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1 ± 13.8 years. The highest-lowest difference regarding the provincial level prevalence rates were 19.7% vs. 2.1% for high low-density lipoprotein cholesterol, 16.7% vs. 2.5% for high total cholesterol, 35.9% vs. 5.4% for high triglycerides, and 31.4% vs. 10.5% for low high-density lipoprotein cholesterol. The treatment rate of dyslipidemia was correlated with the socio-demographic index ( P < 0.001), urbanization rate ( P = 0.01), and affordable basic technologies and essential medicines ( P < 0.001).@*CONCLUSION@#Prevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence, treatment, and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.

Effects of Calendula officinalis extract on liver histopathology, lipid profile, and oxidative stress in rats submitted to a diet rich in cholesterol and carbohydrates

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.

Clinical significance of blood lipids, lipoproteins, PTX-3, TTF-1, NSE, and CYFRA21-1 levels in patients with advanced gastric cancer / 中国医师杂志

Objective:To investigate the significance of blood lipids [triglyceride (TG), total cholesterol (TC)], lipoproteins [high-density lipoprotein (HDL), low-density lipoprotein (LDL)], and serum levels of pentraxin-3 (PTX-3), thyroid transcription factor-1 (TTF-1), neuron specific enolase (NSE), and human cytokeratin 21-1 fragment (CYFRA21-1) in patients with advanced gastric cancer, and to provide a basis for the early, middle, and late diagnosis and treatment of gastric cancer.Methods:127 gastric cancer patients admitted to 3201 Hospital from January 2019 to January 2022 were selected as the research subjects. They were divided into early stage group ( n=45), mild stage group ( n=43), and late stage group ( n=39) based on their condition. Enzyme linked immunosorbent assay (ELISA) was used to detect blood lipids (TG, TC), PTX-3, TTF-1, NSE, CYFRA21-1, and chemical precipitation method was used to detect lipoprotein metabolism (HDL, LDL) in the three groups of patients. The differences in blood lipids, lipoproteins, PTX-3, TTF-1, NSE, and CYFRA21-1 between three groups of gastric cancer patients and the late stage group of gastric cancer patients before and after surgery were analyzed. Logistic regression analysis was conducted to investigate the correlation between blood lipids (TG, TC), lipoprotein (HDL, LDL), PTX-3, TTF-1, NSE, CYFRA21-1, and gastric cancer incidence. The predictive value of individual and combined detection of the above indicators for gastric cancer was analyzed using the receiver operating characteristic (ROC) curve analysis. Results:The results showed that the TG, TC, and LDL levels in the late stage group were higher than those in the mild stage and early stage groups (all P<0.05), while the HDL levels were lower than those in the mild stage and early stage groups (all P<0.05). The serum levels of PTX-3, TTF-1, NSE, and CYFRA21-1 were higher than those in the mild stage and early stage groups (all P<0.05). The postoperative levels of TG, PTX-3, TTF-1, NSE, CYFRA21-1, TC, and LDL in the late stage group were significantly lower than those before surgery (all P<0.05) and the HDL level was higher than that before surgery ( P<0.05). The levels of TG, TC, HDL, LDL, PTX-3, TTF-1, NSE, and CYFRA21-1 were correlated with the late onset of gastric cancer (all P<0.05). The ROC curve showed that the area under the ROC curve (AUC) of PTX-3, TTF-1, NSE, and CYFRA21-1 combined detection was significantly higher than that of PTX3, TTF1, NSE, and CYFRA211 alone. Among them, PTX-3+ TTF-1+ NSE+ CYFRA21-1 combined detection had the highest AUC, sensitivity, and specificity. Conclusions:Patients with advanced gastric cancer have abnormal levels of blood lipids (TG, TC), lipoprotein (HDL, LDL), and serum PTX-3, TTF-1, NSE, and CYFRA21-1. Effective intervention measures need to be developed based on the above indicators to improve survival rate.

Correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia / 中国学校卫生

Objective@#To explore the correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia, so as to providing a scientific basis for guiding rational vitamin D supplementation among primary and middle school students in Inner Mongolia Region.@*Methods@#A total of 2 206 students of primary and middle school students from 8 counties (districts) in Inner Mongolia were enrolled for a questionnaire survey, physical examination, and laboratory test by a multi stage stratified random sampling approach.The levels of fasting blood glucose, blood lipid and other related indexes with different vitamin D levels were analyzed, and their correlation was further discussed.@*Results@#The deficiency and insufficiency rates of vitamin D among primary and middle school students were 33.2% and 42.8%, respectively, and the suitable rate was 24.0%. The body mass index (BMI) and waist height ratio (WHtR) of the vitamin D deficiency group [(22.87±7.41) kg/m 2 , 0.46±0.08)]were higher than the insufficiency [(20.59±8.00)kg/m 2, 0.44±0.09)] and suitable group [(18.01±7.38)kg/m 2, 0.43 ±0.08)] ( P <0.05). Compared with the vitamin D suitable group [(3.87±0.85) mmol/L], the total cholesterol (TC) level in the deficiency group [(3.73±0.67)mmol/L] decreased, with a statistically significant difference ( P <0.05). The levels of high density lipoproteins (HDL) in the vitamin D insufficiency[(1.40±0.33)mmol/L] and deficiency groups [(1.34±0.31)mmol/L] were lower than the suitable group [(1.48±0.34)mmol/L], with a statistically significant difference ( P <0.05). The detection rate of hyperuricemia (HUA) in the vitamin D deficiency group (22.95%) was higher than the suitable group (17.20%), with a statistically significant difference ( P <0.016 7). Pearson correlation analysis showed that vitamin D was negatively correlated with BMI and WHtR ( r =-0.23, -0.11), and positively correlated with TC and HDL level ( r =0.06, 0.16) ( P <0.05).@*Conclusions@#The deficiency and insufficiency rates of serum vitamin D among primary and middle school students in Inner Mongolia are high which are associated with several indicators of blood lipids. Therefore, it is recommended to supplement vitamin D preparations in moderation in daily life.

Effect of Electroacupuncture at “Fenglong”（ST 40） on Liver Lipid Synthesis and Insulin Resistance in Hyperlipidemic Model Rats / 中医杂志

ObjectiveTo explore the effect and possible mechanism of electroacupuncture （EA） at Fenglong （ST40） on liver lipid synthesis and insulin resistance （IR） in hyperlipidemic （HLP） rats. MethodEighteen rats were randomly divided into three groups， blank group， model group， and EA group， each consisting of six rats. The blank group rats were with fed a basic diet， while those in the model group and EA group were fed high-fat diet for 8 weeks. After modeling， the rats in the EA group received bilateral EA treatment at “Fenglong” （ST 40）. The rats in the model group underwent daily binding treatment， once a day， continuously 5 days a week， for a total of 4 weeks. Following the intervention， the levels of triglycerides （TG） and free fatty acids （FFA） in liver tissue was determined using ELISA. Serum TG， FFA， fasting insulin （FINS）， alanine transaminase （ALT）， aspartate Transaminase （AST）， tumor necrosis factor-ɑ （TNF-ɑ）and interleukin 6 （IL-6） were also measured. The fasting plasma glucose （FBG） assessed using a glucose meter and the homeostatic model assessment of insulin resistance （HOMA-IR） was calculated. Liver pathology was examined through HE staining and oil red O staining. The expression of hepatic sterol regulator binding protein 1c （SREBP1c）， recombinant fatty acid synthase （FASN） and stearoyl-CoA desaturase 1 （SCD1） were detected through immunofluorescence. The protein expression levels of liver insulin receptor substrate 1 （IRS1） and tyrosine-phosphorylated insulin receptor substrate 1 （p-IRS1-Tyr） were determined via Western blot. ResultsWhen compared to the blank group， the model group of rats exhibited elevated serum and liver tissue levels of TG and FFA， as well as increased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining revealed disordered arrangements of liver cells， indicating widespread fatty degeneration. Oil red O staining showed abundant bright red lipid droplets within liver cell cytoplasm， indicating severe lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly increased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly decreased （P＜0.05）. In comparison to the model group， the EA group of rats showed significantly reduced serum and liver tissue levels of TG and FFA， along with decreased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining indicated more regular arrangements of liver cells， and oil red O staining revealed a significant reduction in liver cell lipid droplets， indicating a less severe degree of lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly decreased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly increased （P＜0.05）， with no significant difference in IRS1 protein expression （P＞0.05）. ConclusionEA at “Fenglong” （ST 40） can significantly decrease serum lipid in HLP rats， improves liver fat accumulation， and also ameliorate insulin resistance. The mechanism may be related to the inhibition of hepatic lipid synthesis molecule expression， reduced serum inflammatory factors， and an increase in insulin substrate receptor phosphorylation levels.

Metabolomics study on occupational acute methyl acetate poisoning using patient plasma / 中国职业医学

Objective: To investigate the specificity of endogenous metabolic profile in plasma of patients with occupational acute methyl acetate poisoning using non-targeted metabolomics. Methods: A total of six patients with occupational acute methyl acetate poisoning were selected as the poisoning group, while 10 healthy workers without occupational exposure history of chemical hazards in the same industry were selected as the control group using the judgment sampling method. Metabolites in patient plasma of the two groups were detected using ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry, and non-targeted metabolomics analysis was performed. Principal component analysis and partial least squares discriminant analysis were used to identify differential metabolites and analyze their metabolic pathways. Results: There were significant differences in metabolite profiles in patient plasma between poisoning group and control group. A total of 195 differentially expressed metabolites were screened in plasma of patients in poisoning group, including 119 upregulated and 76 downregulated metabolites. Lipid substances (lipids and lipid-like molecules) accounted for the highest proportion (21.5%). The differential metabolites of poisoning group were related to folate biosynthesis, amino acid metabolism, pyrimidine metabolism, sphingolipid biosynthesis and other metabolic pathways in plasma compared with the control group (all P<0.05). Conclusion: Occupational acute methyl acetate poisoning affects metabolism of the body. The folic acid biosynthesis, amino acid and lipid metabolism and other pathways may be involved in the occurrence and development of poisoning.

A retrospective cohort study on blood lipid changes and their influencing factors in HIV/AIDS patients after receiving antiretroviral therapy in Wuhan / 公共卫生与预防医学

Objective To investigate the prevalence and influencing factors of HIV/AIDS patients with hyperlipidemia before and after receiving antiviral therapy in Wuhan. Methods A retrospective cohort study was used to analyze the data of HIV/AIDS patients in Wuhan from 2004 to 2021. Elevated levels of either TG or TC were determined as hyperlipidemia. Logistic regression model was used to analyze the influencing factors of baseline hyperlipidemia, and Cox proportional risk model was used to analyze the influencing factors of new-onset hyperlipidemia after receiving antiviral therapy. Results A total of 7 562 HIV/AIDS patients were enrolled, 30.61% (2 315/7 562) with hyperlipidemia at baseline and 69.39% (5 247/7 562) without hyperlipidemia. The mean person-years of follow-up for those patients without hyperlipidemia at baseline were 3.48, of whom 33.14% (1 739/5 247) developed hyperlipidemia during follow-up, with an overall density of 9.53/100 person-years. Multivariate logistic regression analysis showed that age ≥30 years and BMI ≥24 kg/m2 were positively correlated with baseline hyperlipidemia, while CD4 cell count ≥ 200 μL was negatively correlated with baseline hyperlipidemia. Multivariate Cox model analysis showed that new-onset hyperlipidemia after receiving antiviral therapy was significantly positively correlated with BMI between 18.5-23.9 and ≥24 kg/m2, the initial antiviral treatment regimen containing LPV/r, efavirenz and other factors A baseline CD4 cell count of 200 to 349 cells /μL was negatively correlated with new-onset hyperlipidemia. Conclusion HIV/AIDS patients with high BMI and an initial antiviral regimen including Kaletra or efavirenz have a significantly higher risk of hyperlipidemia. Follow-up monitoring of blood lipid in these patients should be strengthened.