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Objective:To explore the association between serum high density lipoprotein subtype 3 cholesterol (HDL3-C) levels and the severity and in-stent restenosis of patients with coronary artery disease.Methods:124 patients with coronary artery diseases and 62 healthy controls were included in this clinical case-control retrospective study. Participants were hospitalized from November 2020 to November 2021 at Jinling Hospital, Medical School of Nanjing University were enrolled. Patients with coronary artery disease were as follows: 28 patients with acute coronary syndrome and 96 patients with stable coronary heart disease. Serum HDL3-C levels as well as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were determined. According to the coronary artery angiography results of all patients at the time of admission, Gensini scores were calculated and patients were divided into in-stent restenosis group ( n=22), no in-stent stenosis group ( n=23) and non-stent implantation group ( n=79). The correlation between HDL3-C levels and other parameters was analyzed by Pearson or Spearman correlation analyses. Multivariate Logistic regression analyses were used to determine the impact of HDL3-C on the in-stent restenosis of coronary artery diseases. Results:Compared with controls, serum levels of HDL3-C and HDL-C were significantly decreased in patients with coronary artery diseases (all P<0.05). There was a significantly negative correlation between HDL3-C levels and Gensini scores ( r=-0.201, P=0.043). Among patients with coronary artery disease, serum levels of HDL3C, TC and TG in the in-stent restenosis group were significantly lower than in no in-stent stenosis group as well as than in the non-stent implantation group (all P<0.05). Multivariate Logistic regression analyses showed that after adjusting for age, sex, lipid-lowering drugs and TC, TG, LDLC parameters, HDL3-C ( OR=0.885, 95% CI 0.791-0.990, P=0.033) and HDL-C ( OR=0.018, 95% CI 0.001-0.426, P=0.013) levels were both independently associated with the occurrence of coronary artery disease; only HDL3-C levels (no in-stent stenosis group as the reference: OR=0.833, 95% CI 0.698-0.994, P=0.042; non-stent implantation group as the reference: OR=0.812, 95% CI 0.685-0.963, P=0.017) were independently associated with the presence of in-stent restenosis ( P<0.05). Conclusions:Serum HDL3-C levels are decreased in patients with coronary artery disease, especially in patients with in-stent restenosis. HDL3-C levels are associated with the severity of coronary artery lesions and the presence of in-stent restenosis of coronary arteries.
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Objective:To investigate the association of non-high-density lipoprotein cholesterol (non-HDL-C) level with non-alcoholic fatty liver disease (NAFLD) in patients with early-onset type 2 diabetes.Methods:The clinical data of 100 patients with early-onset type 2 diabetes who were admitted to Beijing Chaoyang Diabetes Hospital from June 2008 to June 2012 were retrospectively analyzed. These patients were divided into a NAFLD group and a non-NAFLD group, with 50 patients in each group, according to the presence or absence of NAFLD. Clinical data, biochemical indices [blood lipids, blood glucose, liver function, uric acid, high-sensitivity C-reactive protein], and glycosylated hemoglobin were collected. Body mass index and non-HDL-C levels were recorded. The association of non-HDL-C level with NAFLD in patients with early-onset type 2 diabetes was analyzed using logistic regression analysis. The predictive value and optimal cut-off point of non-HDL-C for early-onset T2 diabetes complicated by NAFLD were evaluated using the receiver operating characteristic curve.Results:Body mass index, waist-to-hip ratio, systolic blood pressure, and diastolic blood pressure in the NAFLD group were (28.55 ± 3.47) kg/m 2, (0.94 ± 0.05), (121.00 ± 10.25) mmHg (1 mmHg = 0.133 kPa), and (80.00 ± 8.51) mmHg respectively, which were significantly higher than (23.95 ± 2.87) kg/m 2, (0.90 ± 0.07), (115.20 ± 13.36) mmHg, and (73.70 ± 7.75) mmHg in the non-NAFLD group ( t = -7.23, -3.11, -2.44, -3.87, all P < 0.05). Non-HDL-C, total cholesterol, triglyceride, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, uric acid, high-density lipoprotein cholesterol, and glycosylated hemoglobin levels in the NAFLD group were (4.88 ± 3.01) mmol/L, (6.33 ± 3.23) mmol/L, (4.50 ± 6.03) mmol/L, (3.27 ± 1.26) mmol/L, (39.80 ± 23.58) U/L, (27.72 ± 13.83) U/L, (52.96 ± 46.16) U/L, (350.32 ± 102.12) μmol/L, (1.26 ± 0.88) mg/L, and (9.3 ± 2.5)%, respectively, which were significantly higher than (3.35 ± 1.03) mmol/L, (4.81±1.24) mmol/L, (1.87 ± 2.29) mmol/L, (2.70 ± 0.71) mmol/L, (23.76 ± 13.45) U/L, (21.98 ± 10.13) U/L, (35.24 ± 35.41) U/L, (296.04 ± 88.26) μmol/L, (0.22 ± 1.54) mg/L, (8.2 ± 2.7)% in the non-NAFLD group ( t = -3.40, -3.11, -2.88, -2.81, -4.18, -2.36, -2.14, -2.85, -4.12, -2.08, all P < 0.05). Logistic regression analysis showed that the increase in non-HDL-C level was an independent risk factor for T2 diabetes mellitus complicated by NAFLD ( OR = 3.064, 95% CI: 1.604-5.852, P = 0.001). The receiver operating characteristic curve analysis results showed that the optimal cut-off point, sensitivity, and specificity of non-HDL-C level to predict NAFLD were 3.60 mmol/L, 0.700, and 0.620 respectively. Conclusion:An increase in non-HDL-C level is an independent risk factor for NAFLD complicated by early-onset type 2 diabetes When non-HDL-C is > 3.60 mmol/L, NAFLD can be predicted.
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Objective:To explore the effect of dyslipidemia on the clinical outcome of intracytoplasmic sperm injection-embryo transfer (ICSI-ET) in infertility patients receiving donor eggs.Methods:A total of 118 patients were selected to receive egg donors and ICSI-ET at the First Affiliated Hospital of Nanjing Medical University between April 2007 and December 2020. According to the levels of triacylglycerol, serum cholesterol, high density lipoprotein (HDL), and low density lipoprotein, they were divided into dyslipidemia group (35 cases) and normal blood lipids group (83 cases). The influence of body mass index (BMI) and age was adjusted by 1∶1 propensity score matching, and the general condition and clinical outcome of the two groups were analyzed retrospectively. Finally, the relationship between lipid composition and clinical outcome was analyzed according to patients′ age and BMI.Results:(1) Comparing the pre-matching dyslipidemia group with the normal blood lipids group, the BMI of the dyslipidemia group was significantly higher than that of the normal blood lipids group [(23.5±2.4) vs (22.4±2.7) kg/m 2], and the embryo implantation rate was significantly lower than that of the normal blood lipids group [13.6% (8/59) vs 27.3% (36/132)], the differences were statistically significant (both P<0.05). (2) There were no significant differences in years of infertility, number of pregnancies, number of abortions, number of transplanted embryos, protocol of endometrial preparation, endometrial thickness on transplantation day and high quality embryo rate between the two groups, through propensity score matching (all P>0.05). The biochemical pregnancy rate [28.6% (10/35)], embryo implantation rate [13.6% (8/59)] and live birth rate [20.0% (7/35)] in dyslipidemia group were significantly lower than those in the normal blood lipids group ( P<0.05). The clinical pregnancy rate was lower than that of the normal blood lipids group ( P>0.05). (3) The results of stratified analysis showed that the level of HDL in the clinically non-pregnant group was significantly lower than that in the pregnant group in patients ≤ 35 years old [(1.5±0.3) vs (1.8±0.5) mmol/L; P<0.05]. In the overweight recipient patients, the level of HDL of the clinically non-pregnant group was lower than that of the pregnant group ( P>0.05). Conclusions:Dyslipidemia significantly reduces the biochemical pregnancy rate, embryo implantation rate and live birth rate in patients with receiving donor eggs. Especially in patients aged ≤35 years old, the reduction of HDL is closely related to adverse pregnancy outcomes.
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Objective:To investigate the clinical value of serum monocyte/high-density lipoprotein ratio (MHR) level in the diagnosis of coronary heart disease(CHD).Methods:A total of 127 patients who underwent coronary angiography in the cardiology department of the Third Hospital of Changsha were enrolled as subjects. Patients with coronary artery stenosis ≥50% were included in the CHD group ( n=97), and patients with coronary artery stenosis <50% were included in the control group ( n=30). According to the clinical classification of CHD, the patients were divided into stable angina group ( n=31), unstable angina group ( n=35) and acute myocardial infarction group ( n=31). The general clinical data of the selected cases were collected, and the serum MHR, myeloperoxidase (MPO) and high sensitivity C-reactive protein (hs-CRP) were detected. The degree of coronary artery lesions was scored by Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) score system, and the number of coronary artery lesions was counted. The relationship between MHR level, MPO, hs-CRP and the degree of coronary artery stenosis in CHD group was analyzed. The MHR level of CHD was divided into three subgroups by triquartile: the differences of SYNTAX score and the number of coronary artery lesions were compared in the low MHR group (≤0.41, n=40), the middle MHR group (0.41<MHR≤0.48, n=30) and the high MHR group (MHR>0.48, n=27). The value of serum MHR in diagnosing CHD was analyzed by receiver operating characteristic (ROC) curve. The risk factors of CHD were analyzed by multivariate logistic regression. Results:(1) The serum MHR level in CHD group was higher than that in non-CHD group ( P<0.001). In different clinical subgroups of CHD: the levels of serum MHR were significantly higher in acute myocardial infarction group than unstable angina group and stable angina group ( P<0.001). (2) There was a positive correlation between serum MHR, MPO level with SYNTAX score in CHD group ( r=0.878, 0.477, 0.285, all P<0.001). (3) The SYNTAX score in high MHR group was higher than those in middle MHR and low MHR group; the SYNTAX score in middle MHR group was higher than that of low MHR group ( P<0.001); There was no significant difference in the number of coronary artery lesions among the three MHR level subgroups ( P>0.05). (4) Multivariate logistic regression analysis showed that LDL-C ( OR=1.107, 95% CI: 0.974-1.259), MHR ( OR=1.873, 95% CI: 1.352-2.496) were independent risk factors for CHD (all P<0.05). (5) ROC curve showed that the area under the curve of MHR in diagnosing CHD was 0.987, and the sensitivity was 82.8%. Conclusions:Serum MHR level is higher in patients with CHD, which is closely related to the severity of coronary artery disease and is an independent risk factor of CHD.
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Objective:To investigate the monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) for the predictive value of early neurological deterioration (END) and poor outcome in patients with acute anterior circulation ischemic stroke (AACIS).Methods:Patients with AACIS admitted to Henan Provincial People's Hospital from January 2021 to January 2022 were included retrospectively. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score within 7 d of onset increase ≥2 compred with baseline or the increase of motor function score ≥1. The patients were divided into END group and non-END group according to the presence or absence of END. The patients were also divided into good outcome group (0-2 points) and poor outcome group (3-6 points) according to the modified Rankin Scale score 3 months after onset. Multivariate logistic regression analysis was used to determine the independent risk factors for END and poor outcome, and the predictive value of MHR for END and poor outcome was evaluated by receiver operating characteristic (ROC) curve. Results:A total of 522 patients were enrolled, including 338 male (64.8%), aged 61.99±11.39 years old. One hundred and five patients (20.1%) had END, 123 (23.6%) had poor outcome. Multivariate logistic regression analysis showed that baseline NIHSS score (odds ratio [ OR] 1.075, 95% confidence interval [ CI] 1.017-1.137; P=0.010) and MHR (with the lowest quartile as the reference, the third quartile: OR 2.778, 95% CI 1.255-6.151, P=0.012; the fourth quartile: OR 12.645, 95% CI 5.942-26.912; P<0.001) were the independent risk factors for END; the baseline NIHSS score ( OR 1.075, 95% CI 1.021-1.132; P=0.006), END ( OR 2.306, 95% CI 1.010-6.261; P=0.047) and MHR (with the first quartile as reference, the fourth quartile: OR 2.769, 95% CI 1.167-6.569; P=0.021) were the independent risk factors for poor outcomes. ROC curve analysis showed that area under the curve of MHR for predicting END and poor outcome in patients with AACIS were 0.805 (95% CI 0.750-0.860; P<0.001) and 0.747 (95% CI 0.690-0.803; P<0.001) respectively. The best cutoff value was 0.435, the sensitivity was 73.3% and 64.2%, and the specificity was 79.6% and 78.7% respectively. The area under the curve of MHR for predicting END and poor outcome was higher than that of monocyte and HDL-C alone. Conclusion:MHR can be used as a predictor of END and poor outcome in patients with AACIS, and its predictive value is higher than that of monocytes or HDL-C.
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Objective:To investigate the relationship between monocyte/high-density lipoprotein ratio (MHR) and clinical parameters and the prognosis of patients with chronic kidney disease (CKD).Methods:Clinical data were collected of CKD patients who were diagnosed and followed up regularly in Henan Provincial People's Hospital from January 1, 2017 to June 30, 2020. According to the median baseline MHR of the selected patients, they were divided into two groups: low-level MHR group (MHR≤0.347 8) and high-level MHR group (MHR>0.347 8). The patients were regularly followed up for 3-42 months, the renal adverse prognostic events were defined as serum creatinine doubled, estimated glomerular filtration rate (eGFR) reduced to at least 50% of the original, new entry into end-stage renal disease (ESRD), starting renal replacement therapy, death due to renal or cardiovascular events. The Kaplan-Meier method was used to compare the differences in survival rates between the two groups, and Cox regression analysis method was used to explore the influencing factors of renal adverse prognosis in CKD patients. Stratified analysis was used to find special factors that might affect the relationship between MHR and renal adverse prognosis in CKD patients.Results:A total of 405 patients were included in this study. Their age was (49.77±14.82) years old. Body mass index was (25.18±4.22) kg/m 2. Women accounted for 30.62%(124/405). The proportion of patients with smoking, drinking, hypertension and diabetes was 39.51%(160/405), 35.06%(142/405), 73.33%(297/405) and 38.27%(155/405), respectively. Compared with the low-level MHR group ( n=202), the high-level MHR group ( n=203) had more people in late CKD, males, and hypertension (all P<0.01), and body mass index, white blood cells, monocytes, serum creatinine, serum uric acid, serum urea nitrogen, retinol binding protein, cystatin C, blood phosphorus were higher (all P<0.05), while hemoglobin, high density lipoprotein and eGFR were lower (all P<0.05). Spearman rank correlation results show that MHR level was positively correlated with white blood cells, serum creatinine, serum uric acid, serum urea nitrogen, retinol-binding protein, cystatin C, serum phosphorus (all P<0.01), and negatively correlated with hemoglobin and eGFR (both P<0.01). The median follow-up time was 8(4, 16) months. To the end of the follow-up, 113 patients (27.90%) had renal adverse prognostic events. Kaplan-Meier survival analysis results showed that the renal cumulative survival rate of the high-level MHR group was lower than that of the low-level MHR group ( χ2=8.277, P=0.004). Multivariate Cox regression analysis showed that high MHR level was an independent influencing factor for poor renal prognosis in CKD patients ( HR=1.628, 95% CI 1.050-2.523, P=0.029). Stratified analysis showed that, without hypertension, MHR had a more significant effect on the prognosis of the kidneys ( HR=3.414, 95% CI 1.091-10.686, P for interaction=0.001). Conclusions:The level of MHR is related to the severity and poor renal prognosis of CKD, and the high MHR level is an independent predictor for poor renal prognosis in CKD patients.
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Objective:To correlate homocysteine (Hcy) and blood lipid levels with neurological function in patients with progressive ischemic stroke.Methods:A total of 400 patients with ischemic stroke who received treatment between June 2018 and June 2020 in Linhai Second People's Hospital were included in this study. Progressive ischemic stroke ( n = 126) and non-progressive ischemic stroke ( n = 274) groups were designated. Hcy level was determined by enzyme-linked immunosorbent assay. High-density lipoprotein cholesterol, triacylglycerol, low-density lipoprotein cholesterol and cholesterol levels were measured using a biochemical analyzer. Hcy and blood lipid levels as well as National Institute Health of Stroke Scale (NIHSS) score were determined in each group. Hcy and blood lipid levels were correlated with NIHSS score. Results:Hcy level in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(28.39 ± 4.36) μmol/L vs. (20.17 ± 3.24) μmol/L, t = 18.894, P < 0.05]. Low-density lipoprotein cholesterol , triacylglycerol and TC levels in the progressive ischemic stroke group were (3.29 ± 0.45) mmol/L, (2.08 ± 0.34) mmol/L and (4.82 ± 0.79) mmol/L, respectively, which were significantly higher than those in the non-progressive ischemic stroke group [(2.48 ± 0.37) mmol/L, (1.56 ± 0.29) mmol/L and (4.08 ± 0.43) mmol/L, t = 17.644, 14.859, 9.860, P < 0.05]. High-density lipoprotein cholesterol level in the progressive ischemic stroke group was significantly lower than that in the non-progressive ischemic stroke group [(1.03 ± 0.13) mmol/L vs. (1.19 ± 0.14) mmol/L, t =11.158, P < 0.05]. NIHSS score in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(21.72 ± 4.35) points vs. (15.52 ± 2.89) points, t = 14.582, P < 0.05]. Hcy, low-density lipoprotein cholesterol, cholesterol and triacylglycerol levels were linearly and positively correlated with NIHSS score ( r = 0.846, 0.724, 0.718, 0.765, all P < 0.05), while igh-density lipoprotein cholesterol level was linearly and negatively correlated with NIHSS score ( r = -0.710, P < 0.05). Conclusion:In patients with progressive ischemic stroke, Hcy level is increased and blood lipid level is obviously abnormal. Hcy and blood lipid levels are greatly correlated with neurological function.
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SUMMARY OBJECTIVE: Inflammation has been suggested as a potential mechanism in the pathogenesis of arrhythmia. Hemogram parameters such as monocyte count to high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have been considered to be markers of inflammation and new cardiovascular risk predictors. This retrospective study aimed to investigate the relationship between MHR, NLR, and MLR in patients with paroxysmal supraventricular tachycardia (PSVT). METHODS: A retrospective study conducted at a university hospital in Bolu, Turkey, between 2017 and 2019. Our study included 196 patients who underwent electrophysiological study (EPS) due to palpitation or documented PSVT on electrocardiography (ECG). Patients having documented atrioventricular nodal re-entrant tachycardia (AVNRT) on ECG or inducible AVNRT on EPS were included in the PSVT group (n=130), and patients with palpitation but without inducible arrhythmia on EPS (n=66) were included in the control group. Routine biochemical and hemogram tests were performed before the EPS procedure. RESULTS: When hemogram parameters were compared, there was no statistically significant difference in MHR values [0.010 (0.001-0.030) vs 0.010 (0.001-0.020) p =0.67]. Additionally, both NLR [2.21(0.74-11.36) vs 1.98(0.72-24.87) p=0.13] and MLR [0.25 (0.03-1.05) vs 0.24(0.07-1.39) p=0.41] were not statistically significant between the two groups. CONCLUSION: There is no significant difference in PSVT patients regarding hemogram parameters including white blood cell subtypes, MLR, NLR, and MHR. Therefore the evaluation of hemogram parameters may not be clinically relevant for PSVT patients.
RESUMO OBJETIVO: A inflamação tem sido sugerida como um mecanismo potencial na patogênese da arritmia. Parâmetros do hemograma, como contagem de monócitos e razão de colesterol lipoproteína de alta densidade (MHP), proporção de neutrófilos / linfócitos (NLP) e proporção de monócitos / linfócitos (MLR), foram considerados marcadores de inflamação e novos preditores de risco cardiovascular. Este estudo retrospectivo teve como objetivo investigar a relação entre MHP, NLP e MLP em pacientes com taquicardia paroxística supraventricular (PSVT). MÉTODOS: Estudo retrospectivo realizado em um hospital universitário em Bolu, Turquia, entre 2017 e 2019. Nosso estudo incluiu 196 pacientes submetidos a estudo eletrofisiológico (EPS) devido a palpitações ou PSVT documentada na eletrocardiografia (ECG). Os pacientes com taquicardia nodal atrioventricular reentrante (AVNRT) no ECG ou AVNRT indutível no EPS foram incluídos no grupo PSVT (n = 130) e os pacientes com palpitações sem arritmia induzível no EPS (n = 66) foram incluídos no grupo controle. Testes bioquímicos e de hemograma de rotina foram realizados antes do procedimento de EPS. RESULTADOS: Quando os parâmetros do hemograma foram comparados, não houve diferença estatisticamente significante nos valores de MHP (0,010 (0,001-0,030) vs 0,010 (0,001-0,020) p = 0,67). Além disso, tanto o NLP (2,21 (0,74-11,36) vs 1,98 (0,72-24,87) p = 0,13) quanto o MLP (0,25 (0,03-1,05) vs 0,24 (0,07-1,39) p = 0,41) não foram estatisticamente significantes entre os dois grupos. CONCLUSÃO: Não há diferença significativa nos pacientes com PSVT em relação aos parâmetros do hemograma, incluindo os subtipos de glóbulos brancos, MHP, NLP e MHP. Portanto, a avaliação dos parâmetros do hemograma pode não ser clinicamente relevante para pacientes com PSVT.
Subject(s)
Tachycardia, Paroxysmal , Tachycardia, Supraventricular , Tachycardia, Ventricular , Turkey , Retrospective Studies , ElectrocardiographyABSTRACT
RESUMEN Objetivo: Realizar un análisis clínico-epidemiológico de las subfracciones de colesterol unido a lipoproteinas de alta densidad (HDL-C, por sus siglas en inglés) en adultos de la ciudad de Maracaibo, Venezuela. Materiales y métodos: Se realizó un estudio descriptivo y transversal de la base de datos del Estudio de Prevalencia de Síndrome Metabólico de Maracaibo, que incluyó 359 individuos de ambos sexos, mayores de 18 años, a quienes se les determinó la concentración sérica de HDL3 y HDL2, así como el índice HDL2/HDL3; evaluando sus niveles según características sociodemográficas, clínicas y bioquímicas. Resultados: La edad promedio de la población era 39,4 ± 15,2 años, y 51,5% era de sexo femenino. Solo se observaron diferencias en los niveles de HDL-C en aquellos sujetos con HDL-C bajas. Las mujeres con hipertriacilgliceridemia mostraron concentraciones séricas de HDL3 y HDL2 significativamente menores con respecto a aquellas con triacilglicéridos normales (p=0,033); asimismo, se encontró una concentración menor de HDL3 y relación HDL2/HDL3 en aquellas con proteína C reactiva ultrasensible (PCR-us) elevada (p<0,001). En hombres, se evidenció una concentración significativamente menor de HDL2 en aquellos con algún grado de hipertensión arterial (p=0,031), insulinorresistencia (p=0,050) y síndrome metabólico (p=0,003); mientras que aquellos con PCR-us elevada mostraron una menor concentración de HDL3 (p=0,011). Conclusión: Las subfracciones de HDL-C muestran un comportamiento clínico epidemiológico variable en adultos de la población de Maracaibo, con promedios más bajos en los hombres, diferencias en los niveles únicamente en aquellos con HDL-C bajas, y sin predominio de alguna subclase según las características sociodemográficas, clínicas y bioquímicas.
ABSTRACT Objective: To carry out a clinical-epidemiological analysis of high-density lipoprotein cholesterol subfractions (HDL-C) in adults from Maracaibo, Venezuela. Materials and methods: A descriptive and cross-sectional study of the database from the Metbolic Syndrome Prevalence in Maracaibo Study was carried out. HDL3 and HDL2 serum concentration, as well as the HDL2/HDL3 ratio, were determined in 359 individuals of both sexes, over 18 years of age. Values obtained were evaluated according to sociodemographic, clinical and biochemical characteristics. Results: Mean population age was 39.4 ± 15.2 years, and 51.5% were female. Differences in HDL-C subfraction levels were only observed in those subjects with low HDL-C levels. Women with hypertriglyceridemia showed significantly lower serum HDL3 and HDL2 concentrations than those with normal triglycerides (p=0.033), as well as a lower HDL3 level and HDL2 / HDL3 ratio in those with higher levels of ultra-sensitive C-reactive protein (us-CRP) (p<0.001). A significantly lower concentration of HDL2 was observed in men with some degree of hypertension (p=0.031), insulin resistance (p=0.050) and metabolic syndrome (p=0.003); while those with elevated us-CRP showed a lower concentration of HDL3 (p=0.011). Conclusion: HDL-C subfractions show varying clinical-epidemiological behavior in adults from Maracaibo. Lower serum levels are observed in men, differences only in those with low HDL-C; and no predominance of any subclass was observed according to sociodemographic, clinical and biochemical characteristics.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Venezuela , Clinical Laboratory Techniques , Lipoproteins, HDL2 , Lipoproteins, HDL3 , Venezuela/epidemiology , Epidemiology , Cross-Sectional Studies , Risk Factors , Cities/epidemiology , Lipoproteins, HDL2/blood , Lipoproteins, HDL3/blood , Cholesterol, HDL , Cholesterol, HDL/bloodABSTRACT
Abstract Background: A sizeable proportion of patients have discordant low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C). Objectives: We assessed the relationship between discordance of LDL-C and non-HDL-C and coronary artery disease (CAD) severity. Methods: We retrospectively evaluated the data of 574 consecutive patients who underwent coronary angiography. Fasting serum lipid profiles were recorded, SYNTAX and Gensini scores were calculated to establish CAD complexity and severity. We determined the medians for LDL-C and non-HDL-C to examine the discordance between LDL-C and non-HDL-C. Discordance was defined as LDL-C greater than or equal to the median and non-HDL-C less than median; or LDL-C less than median and non-HDL-C greater than or equal to median. A p value < 0.05 was accepted as statistically significant. Results: LDL-C levels were strongly and positively correlated with non-HDL-C levels (r = 0.865, p < 0.001) but 15% of patients had discordance between LDL-C and non-HDL-C. The percentage of patients with a Gensini score of zero or SYNTAX score of zero did not differ between discordant or concordant groups (p = 0.837, p = 0.821, respectively). Mean Gensini and SYNTAX scores, percentage of patients with Gensini score ≥20 and SYNTAX score >22 were not different from group to group (p = 0.635, p = 0.733, p = 0.799, p = 0.891, respectively). Also, there was no statistically significant correlation between LDL-C and Gensini or SYNTAX scores in any of the discordant or concordant groups. Additionally, no correlation was found between non-HDL-C and Gensini or SYNTAX score. Conclusions: While there was discordance between LDL-C and non-HDL-C (15% of patients), there is no difference regarding CAD severity and complexity between discordant and concordant groups.
Resumo Fundamento: Uma proporção considerável de pacientes apresenta níveis discordantes de colesterol de lipoproteína de baixa densidade (LDL) e de não alta densidade (não HDL). Objetivos: Avaliar a relação da discordância entre colesterol LDL e não HDL com a gravidade da doença arterial coronariana (DAC). Métodos: Avaliamos retrospectivamente os dados de 574 pacientes submetidos consecutivamente à angiografia coronariana. Foram registrados os perfis lipídicos séricos em jejum, e depois foram calculados os escores SYNTAX e Gensini para estabelecer a complexidade e a gravidade da DAC. Determinamos as medianas para colesterol LDL e não-HDL para examinar a discordância entre ambos. Discordância foi definida como LDL maior ou igual à mediana e não-HDL menor que mediana; ou LDL menor que a mediana e não-HDL maior ou igual à mediana. Valor de p < 0,05 foi aceito como estatisticamente significante. Resultados: Os níveis de colesterol LDL estiveram forte e positivamente correlacionados com os níveis de colesterol não-HDL (r = 0,865, p < 0,001), mas 15% dos pacientes apresentaram discordância entre LDL e não-HDL. A porcentagem de pacientes com escore Gensini ou SYNTAX zero não diferiu entre os grupos discordantes ou concordantes (p = 0,837, p = 0,821, respectivamente). Escores médios de Gensini e SYNTAX, porcentagem de pacientes com escore Gensini ≥ 20 e SYNTAX > 22 não foram diferentes de grupo para grupo (p = 0,635, p = 0,733, p = 0,799, p = 0,891, respectivamente). Além disso, não houve correlação estatisticamente significativa entre os escores de cholesterol LDL e Gensini ou SYNTAX em nenhum dos grupos discordantes ou concordantes. Também não foi encontrada correlação entre cholesterol não HDL e escore Gensini ou SYNTAX. Conclusões: Embora tenha havido discordância entre colesterol LDL e não-HDL (15% dos pacientes), não há diferença quanto à gravidade e complexidade da DAC entre os grupos discordantes e concordantes.
Subject(s)
Humans , Coronary Artery Disease , Retrospective Studies , Risk Factors , Coronary Angiography , Cholesterol, HDL , Cholesterol, LDLABSTRACT
OBJETIVO: investigar o efeito do consumo de álcool em geral e do tipo de bebida alcoólica consumida, em diferentes medidas lipídicas. MÉTODO: o efeito do consumo de álcool foi investigado, bem como do tipo de bebida alcoólica, em diferentes medidas lipídicas, em ambos os sexos de população do Estudo Longitudinal de Saúde do Adulto. RESULTADOS: foram realizadas análises em relação ao tipo e quantidade de consumo de bebida alcoólica por sexo. O consumo baixo-a-moderado de álcool, independentemente do tipo de bebida alcoólica consumida, resultou em níveis mais elevados de HDL-colesterol, HDL2-colesterol e HDL3-colesterol em homens e mulheres. Não houve participantes da pesquisa que consumiam quantidade baixa a moderada de bebidas alcoólicas destiladas. Os triglicerídeos tiveram efeitos inversos para homens e mulheres no perfil lipídico. Para homens, bebidas destiladas contribuíram para melhor perfil dos triglicerídeos, enquanto para mulheres foi o contrário. Homens que consumiam bebidas alcoólicas destiladas tiveram níveis menores de triglicerídeos e mulheres que consumiam bebidas alcóolicas destiladas tiveram níveis maiores. Nossos resultados estão de acordo com os de estudos anteriores. CONCLUSÃO: o consumo de álcool resultou em níveis diferentes de medidas lipídicas séricas em homens e mulheres. Dessa forma, conclui-se que a resposta ao álcool tem diferenças biológicas.
OBJECTIVE: to investigate the effect of general alcohol consumption and of the type of alcoholic beverage consumed, in different lipid measurements. METHOD: the effect of alcohol consumption as well as that of the type of alcoholic beverage consumed were investigated, in different lipid measurements, for the participants in the Longitudinal Study on Adults' Health for both sexes. RESULTS: analyses were conducted on the type and amount of alcoholic beverage consumed by sex. Low-to-moderate alcohol consumption, regardless of the type of alcoholic beverage, resulted in higher levels of HDL-cholesterol, HDL2- cholesterol and HDL3-cholesterol in males and females. No participants in the study consumed low-to-moderate amounts of spirits. Triglycerides showed inverse effects for men and women according to the lipid profile. For men, spirits contributed to a better triglyceride profile while for women it was the opposite. Men who consumed spirits showed lower triglyceride levels, and women who consumed that beverage type had higher levels. Our results are in agreement with those of previous studies. CONCLUSION: alcohol consumption resulted in different levels of serum lipid measurements in men and women. Thus, it is concluded that response to alcohol has biological differences.
OBJETIVO: investigar el efecto del consumo de alcohol general, así como el tipo de bebida alcohólica consumida, en diferentes medidas lipídicas. MÉTODO: el efecto del consumo de alcohol fue investigado, así como el tipo de bebida alcohólica, en diferentes medidas lipídicas en ambos sexos de población del Estudio Longitudinal de Salud del Adulto. RESULTADOS: se realizaron análisis en relación al tipo y cantidad de consumo de bebida alcohólica por sexo. El consumo bajo a moderado de alcohol, independientemente del tipo de bebida alcohólica consumida, resultó en niveles más altos de HDL-colesterol, HDL2-colesterol y HDL3-coleseterol en hombres y mujeres. No hubo participantes de investigación que consumían en cantidad baja a moderada de bebidas alcohólicas destiladas. Los triglicéridos tuvieron efectos inversos para hombres y mujeres en el perfil lipídico. Para los hombres, las bebidas destiladas contribuyeron a un mejor perfil de los triglicéridos, mientras que para las mujeres fue lo contrario. Los hombres que consumían bebidas alcohólicas destiladas tenían niveles más pequeños de triglicéridos y las mujeres que consumían bebidas alcohólicas destiladas tuvieron niveles más altos. Nuestros resultados están de acuerdo con estudios anteriores. CONCLUSIÓN: el consumo de alcohol resultó en niveles significativamente mayores de HDL-colesterol, HDL2-colesterol y HDL3-colesterol, tanto en mujeres como en hombres. De esta forma, se concluye que la respuesta al alcohol tiene diferencias biológicas.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Triglycerides , Alcohol Drinking , Cholesterol , Adult Health , Longitudinal Studies , Sex Distribution , Substance-Related Disorders , Alcoholism , Lipoproteins, HDL , Cholesterol, HDLABSTRACT
Objective@#To investigate the clinical significance of the monocyte count/high-density lipoprotein cholesterol ratio(MHR)in evaluating imperfect ST-segment resolution in elderly patients with acute ST-elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).@*Methods@#This was a retrospective cohort study.A total of 274 elderly patients with STEMI underwent PCI in our hospital from December 2015 to December 2018 were enrolled.Based on the extent of the ST-segment resolution of the postoperative electrocardiogram, patients were divided into an imperfect ST-segment resolution group(observation group, n=79)and a favorable ST-segment resolution group(control group, n=195). General clinical data were compared between the two groups, and logistic regression equation was used to analyze the association of MHR with ST-segment resolution.Receiver operating characteristic(ROC)curve was performed to assess the predictive value of MHR for imperfect ST-segment resolution.@*Results@#Compared with patients in the control group, patients in the observation group were associated with a significantly higher proportion of anterior wall myocardial infarction and heart failure(≥Killip 2), A longer duration of chest pain to balloon expansion, higher levels of creatine kinase isoenzyme, N-terminal pro-brain natriuretic peptide, hypersensitive C-reactive protein, blood sugar, blood uric acid, fibrinogen, triglyceride and mononuclear cell count, and lower levels of high density lipoprotein cholesterol and lymphocyte count(all P<0.05). Meanwhile, there was a significant difference in MHR between the observation group and the control group [(0.75±0.22)vs.(0.48±0.19), t=9.831, P=0.001]. Multivariate Logistic regression analysis showed that MHR was an independent risk factor for imperfect ST-segment resolution(OR=1.950, 95%CI: 1.646-5.430, P=0.003)and ROC curve showed the threshold value of MHR at 0.67, the area under the curve at 0.867, the sensitivity at 79.72%, and the specificity at 79.61%.@*Conclusions@#MHR may be an independent risk factor and a good predictive index for imperfect ST-segment resolution in elderly patients with STEMI after PCI.
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Objective To investigate the clinical significance of the monocyte count/high-density lipoprotein cholesterol ratio(MHR)in evaluating imperfect ST-segment resolution in elderly patients with acute ST-elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods This was a retrospective cohort study.A total of 274 elderly patients with STEMI underwent PCI in our hospital from December 2015 to December 2018 were enrolled.Based on the extent of the ST-segment resolution of the postoperative electrocardiogram,patients were divided into an imperfect ST-segment resolution group (observation group,n =79)and a favorable ST-segment resolution group (control group,n =195).General clinical data were compared between the two groups,and logistic regression equation was used to analyze the association of MHR with ST-segment resolution.Receiver operating characteristic(ROC)curve was performed to assess the predictive value of MHR for imperfect ST-segment resolution.Results Compared with patients in the control group,patients in the observation group were associated with a significantly higher proportion of anterior wall myocardial infarction and heart failure (≥ Killip 2),A longer duration of chest pain to balloon expansion,higher levels of creatine kinase isoenzyme,N-terminal pro-brain natriuretic peptide,hypersensitive C-reactive protein,blood sugar,blood uric acid,fibrinogen,triglyceride and mononuclear cell count,and lower levels of high density lipoprotein cholesterol and lymphocyte count (all P＜0.05).Meanwhile,there was a significant difference in MHR between the observation group and the control group [(0.75 ± 0.22) vs.(0.48 ± 0.19),t =9.831,P =0.001].Multivariate Logistic regression analysis showed that MHR was an independent risk factor for imperfect ST-segment resolution(OR =1.950,95％Cl:1.646-5.430,P =0.003)and ROC curve showed the threshold value of MHR at 0.67,the area under the curve at 0.867,the sensitivity at 79.72％,and the specificity at 79.61％.Conclusions MHR may be an independent risk factor and a good predictive index for imperfect ST-segment resolution in elderly patients with STEMI after PCI.
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BACKGROUND: Recent studies have suggested that high density lipoprotein (HDL) cholesterol is inversely associated with the development of hypertension. We aimed to determine the association between different HDL cholesterol subclasses and risk of future hypertension. METHODS: A total of 270 Japanese Americans (130 men, 140 women) without hypertension between the ages of 34 to 75 years were enrolled. Blood pressure was measured with a mercury sphygmomanometer, and average blood pressure was calculated. Incident hypertension was determined 5 to 6 and 10 to 11 years after enrollment. HDL2, HDL3, and total HDL cholesterol were measured at baseline. RESULTS: During 10 years of follow-up, the cumulative incidence of hypertension was 28.1% (76/270). In univariate analysis, age, diabetes, waist circumference, systolic and diastolic blood pressure, fasting glucose, insulin resistance index, total and low density lipoprotein cholesterol, and visceral adipose tissue were significant predictors for incident hypertension. Among the HDL cholesterol subclass, HDL2 cholesterol was inversely associated with hypertension incidence, but both total and HDL3 cholesterol were not. In addition, HDL2/HDL cholesterol was inversely associated with future hypertension risk. In multivariate analysis, age (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.26 to 2.31; P=0.001), systolic blood pressure (OR, 1.83; 95% CI, 1.31 to 2.56; P < 0.001), and HDL2/HDL cholesterol (OR, 0.71; 95% CI, 0.52 to 0.98; P=0.035), were associated with future development of hypertension. CONCLUSION: A higher proportion of HDL2 cholesterol among total HDL cholesterol predicted a lower risk for incident hypertension. However, concentrations of total HDL, HDL2, and HDL3 cholesterol were not independent predictors of incident hypertension.
Subject(s)
Humans , Male , Asian , Blood Pressure , Cholesterol , Cholesterol, HDL , Cholesterol, LDL , Fasting , Follow-Up Studies , Glucose , Hypertension , Incidence , Insulin Resistance , Intra-Abdominal Fat , Lipoproteins , Lipoproteins, HDL2 , Lipoproteins, HDL3 , Multivariate Analysis , Sphygmomanometers , Waist CircumferenceABSTRACT
Objective@#To study the effect of atorvastatin combined with Zhibitai in the treatment of coronary heart disease with hyperlipidemia and its influence on the level of high-sensitivity C-reactive protein(hsCRP).@*Methods@#A total of 136 patients with coronary heart disease and hyperlipidemia admitted to the Third People's Hospital of Jingdezhen from September 2016 to September 1818 were randomly divided into control group and combination group using stochastic comprehensive balance method, with 68 cases in each group.The control group was treated with atorvastatin and the combination group was treated with lipidine plus atorvastatin. The patient's treatment effect, including the blood lipid compliance rate and the occurrence of adverse reactions during the treatment were observed, as well as the patient's pre-and post-treatment triglyceride(TG), 12h serum total cholesterol(TC), high-density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C)and high-sensitivity C-reactive protein(hsCRP)and other indicators were measured.@*Results@#(1)The blood lipid compliance rate(89.86%) in the combined group was higher than that in the control group(59.70%), the difference was statistically significant(χ2=14.915, P=0.000). (2)The incidence of adverse reactions in the combined group(1.45%) was lower than that in the control group(17.91%), the difference was statistically significant(χ2=8.836, P=0.003). (3)The results showed that the TC, TG, LDL-C, hsCRP and other indicators of the combined group were lower than those of the control group and before treatment, while the HDL-C index of the combined groupwas higher than that of the control group and before treatment, the differences were statistically significant(t=20.800, 4.903, 11.657, 4.346, 6.262, P=0.000, 0.000, 0.000, 0.000, 0.000).@*Conclusion@#Zhibitai combined with atorvastatin in the treatment of coronary heart disease patients with hyperlipidemia has remarkable effect.It can accurately control TC, TG, LDL-C, HDL-C and hsCRP, improve blood lipid control rate.
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Objective To study the effect of atorvastatin combined with Zhibitai in the treatment of coronary heart disease with hyperlipidemia and its influence on the level of high-sensitivity C-reactive protein ( hsCRP). Methods A total of 136 patients with coronary heart disease and hyperlipidemia admitted to the Third People 's Hospital of Jingdezhen from September 2016 to September 1818 were randomly divided into control group and combi-nation group using stochastic comprehensive balance method , with 68 cases in each group.The control group was treated with atorvastatin and the combination group was treated with lipidine plus atorvastatin .The patient's treatment effect,including the blood lipid compliance rate and the occurrence of adverse reactions during the treatment were observed,as well as the patient's pre-and post-treatment triglyceride ( TG),12h serum total cholesterol ( TC), high-density lipoprotein-cholesterol ( HDL-C), low density lipoprotein-cholesterol ( LDL-C) and high-sensitivity C-reactive protein(hsCRP)and other indicators were measured.Results (1)The blood lipid compliance rate(89.86%) in the combined group was higher than that in the control group (59.70%),the difference was statis-tically significant(χ2 ＝14.915,P＝0.000).(2)The incidence of adverse reactions in the combined group (1.45%) was lower than that in the control group (17.91%), the difference was statistically significant ( χ2 ＝8.836, P ＝ 0.003).(3)The results showed that the TC,TG,LDL-C,hsCRP and other indicators of the combined group were lower than those of the control group and before treatment ,while the HDL-C index of the combined groupwas higher than that of the control group and before treatment ,the differences were statistically significant ( t＝20.800,4.903, 11.657,4.346,6.262,P＝0.000,0.000,0.000,0.000,0.000).Conclusion Zhibitai combined with atorvastatin in the treatment of coronary heart disease patients with hyperlipidemia has remarkable effect .It can accurately control TC,TG,LDL-C,HDL-C and hsCRP,improve blood lipid control rate.
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Abstract Introduction: For decades, low levels of muscle strength (MS) have been associated with an increased risk of mortality from all causes. Objective: To identify the correlation between values of different manifestations of MS and metabolic risk markers (MRM) in young university students. Materials and methods: The study included 50 participants (37 men, 13 women), aged between 19 and 23 years. The grip strength of both hands and the muscular strength of upper and lower limbs were evaluated, as well as height, weight, body mass index (BMI), skin folds, HDL, cholesterol and triglycerides. Results: No significant associations between MRM and the different manifestations of MS were found. Conclusion: MS and MRM are separately associated with mortality risk factors and with suffering from cardiovascular diseases.
Resumen Introducción. Desde hace varias décadas, los bajos niveles de fuerza muscular (FM) han sido asociados al incremento en el riesgo de mortalidad por todas las causas. Objetivo. Identificar la relación entre los valores de diferentes manifestaciones de FM con biomarcadores de riesgo metabólico (BRM). Materiales y métodos. El estudio estuvo compuesto por 50 participantes (37 hombres, 13 mujeres) con edades entre 19 y 23 años. Se evaluó la fuerza prensil de ambas manos, la potencia y la fuerza máxima de miembros superiores e inferiores, colesterol y triglicéridos. Además, se midió talla, peso, índice de masa corporal y pliegues cutáneos. Resultados. No se identificaron relaciones significativas entre los BRM y las diferentes manifestaciones de la FM. Conclusión. La FM y los BRM se relacionan con el riesgo de mortalidad y enfermedades cardiovasculares de forma separada.