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ABSTRACT Background: Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a novel inflammatory biomarker which has been associated with cardiovascular diseases. Objective: To study MHR in patients with psoriasis treated with biological agents. Methods: Between April 2019 and August 2022, MHR was retrospectively evaluated in patients with psoriasis before and 3 months after treatment with infliximab, adalimumab, etanercept, ixekizumab, secukinumab, and ustekinumab in a university hospital in Ankara, Turkey. Results: This study included 128 patients, 53 females and 75 males. 39 (30.5%) patients were treated with infliximab, 26 (20.3%) with adalimumab, 8 (6.3%) with etanercept, 18 (14.1%) with ixekizumab, 12 (9.4%) with secukinumab, and 25 (19.5%) with ustekinumab. The median MHR was 0.0127 (0.0086-0.0165) in females and 0.0146 (0.0119-0.0200) in males (p = 0.011). The median MHR decreased after treatment with adalimumab, ixekizumab, secukinumab, and ustekinumab, whereas it increased after treatment with infliximab and etanercept (p = 0.790, p = 0.015, p = 0.754, p = 0.221, p = 0.276, p = 0.889, respectively). Conclusion: MHR significantly decreased in patients with psoriasis after treatment with ixekizumab. Since high MHR levels have been associated with poor clinical outcomes in patients with cardiovascular diseases, ixekizumab might have a positive impact in the treatment of psoriasis patients who had cardiovascular diseases. We suggest that MHR may be useful both in establishing appropriate biological agent treatment and in the follow-up of patients with psoriasis treated with biological agents.
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Background: Thyroid diseases are among the most common endocrine disorders worldwide. Thyroid hormones play a key role in regulating the synthesis, metabolism, and mobilization of lipids. Levels of circulating lipids may alter in thyroid dysfunction. Aim and Objectives: The aim of the study was to find out the alterations of lipid levels in thyroid dysfunction. Materials and Methods: The study was designed as cross-sectional observational study and analysis of values was done by significant tests difference in means. 20 patients with hypothyroidism, 20 patients with hyperthyroidism, and 20 normal were participated in the study. Levels of total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), LDL-C, and LDL/HDL ratio were estimated and compared. Results: In patients with hypothyroidism, there was an increase in total cholesterol, LDL-C, and triglyceride levels and decrease in HDL-C levels. In hyperthyroidism, total cholesterol, triglycerides, LDL-C, VLDL-C, and LDL/HDL ratio were found to be significantly decreased. Conclusion: Altered thyroid function can lead to significant changes in the lipid profile. Hypothyroidism is an important risk factor for heart diseases. Hence, routine screening of thyroid hormones may be of considerable help for early intervention and treatment of thyroid dysfunction-related cardiac disease.
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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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@#Abstract: Objective To explore the correlation between monocyte to high-density lipoprotein cholesterol ratio (MHR) and insulin resistance (IR) in male patients with type 2 diabetes mellitus (T2DM) combined with metabolic-related fatty liver disease (MAFLD). Methods A total of 454 male patients with T2DM combined with MAFLD in National Metabolic Management Center (MMC) of the Affiliated Hospital of Jiangsu University from May 2018 to July 2020 were enrolled. The general clinical data of subjects were collected, blood routine and biochemical indexes were tested, homeostasis model insulin resistance index (HOMA-IR) was calculated, visceral fat area (VFA) and subcutaneous fat area (SFA) were measured. Accordingtothe MHR quartile, patients were divided into group Q1 (MHR≤0.38), group Q2 (0.38<MHR≤0.48), group Q3 (0.48<MHR≤0.64) and group Q4 (MHR>0.64) to compare the differences in measured indicators above. In addition, patients were divided into two groups according to HOMA-IR, HOMA-IR<2.5 and HOMA-IR≥2.5, and the differences in MHR were compared. Results The patients were divided into four groups according to MHR:group Q1 (n=115), group Q2 (n=110), group Q3 (n=120) and group Q4 (n=109). Fasting insulin (FINS) were respectively 6.17(4.20,9.76), 7.73(4.94,10.66), 8.92(5.32,11.33) and 9.13(5.25,12.27) mU/L, 2-hour postprandial insulin were 22.75(12.87,39.59), 27.55(16.44,39.77), 30.98(17.46,43.11) and 31.28(18.54,45.92) U/L. HOMA-IR were 3.12(1.63,4.25), 3.72(2.26,4.66), 3.87(2.48,5.44) and 3.95(2.42,5.31). Neutrophil (Neu) were 3.10(2.60,3.70), 3.20(2.50,3.93), 3.60(2.80,4.28), 4.20(3.30,5.00)×109/L. Subcutaneous fat area (SFA) were (181.27±53.60), (192.64±62.41), (199.53±61.40) and (203.69±71.51) cm2. They all increased gradually. However, the levels of high-density lipoprotein cholesterol (HDL-c) [1.18(1.06,1.35), 1.02(0.86,1.17), 0.96(0.80,1.03) and 0.80(0.69,0.92) mmol/L] and low-density lipoprotein cholesterol (LDL-c) [(3.00±0.79), (2.76±0.83), (2.67±0.85) and (2.59±0.92) mmol/L] decreased gradually. Pearson's or Spearman's correlation analysis showed that MHR was positively correlated with FINS, 2-hour postprandial insulin (2hINS), HOMA-IR, VFA and SFA (r=0.190, 0.153, 0.184, 0.114, 0.127, P<0.05). The coronary heart disease history, systolic blood pressure,diastolic blood pressure,fasting plasmaglucose (FPG), FINS, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood uric acid (Ur), body mass index (BMI), VFA, SFA and MHR of patients in group HOMA-IR≥2.5 were higher than group HOMA-IR<2.5 (P<0.05). Conclusion MHR is positively correlated with IR in male patients with T2DM combined with MAFLD, and as MHR increases, the degree of IR is higher.
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AIM: To explore the relationship between the changes of serum circFTO and microRNA-141-3p(miR-141-3p)levels and the different disease stages of diabetes retinopathy.METHODS: A total of 198 patients with type 2 diabetes admitted to our hospital from October 2019 to November 2022 were collected as the study subjects, the patients were grouped into non diabetes retinopathy(NDR)group(70 cases), non proliferative diabetes retinopathy(NPDR)group(66 cases)and proliferative diabetes retinopathy(PDR)group(62 cases)according to different stages; meantime, 67 volunteers with normal physical examination results were collected as the control group. The levels of serum circFTO and miR-141-3p were detected by real-time fluorescent quantitative PCR(qRT-PCR); Pearson correlation analysis was used to examine the correlation between the serum circFTO, miR-141-3p and various indicators in patients with diabetes retinopathy; multivariate Logistic regression analysis was applied to explore the influencing factors of diabetes retinopathy.RESULTS: CircFTO, systolic blood pressure(SBP), and diastolic blood pressure(DBP)in PDR group were higher than those in control group, NDR group and NPDR group, while miR-141-3p and high-density lipoprotein cholesterol(HDL-C)were lower than those in control group, NDR group and NPDR group(P<0.05). Fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)in NDR group, NPDR group and PDR group were higher than those in the control group(all P<0.05). The course of disease in PDR group was longer than that in NDR group and NPDR group(P<0.05). Serum circFTO in patients with diabetes retinopathy was positively correlated with SBP, DBP, FPG, HbA1c, and miR-141-3p was negatively correlated with SBP, DBP, FPG, HbA1c(all P<0.05). CircFTO was a risk factor for diabetes retinopathy, and miR-141-3p was a protective factor for diabetes retinopathy(P<0.05).CONCLUSION: Serum circFTO is obviously increased and miR-141-3p is obviously decreased in patients with diabetes retinopathy, both of them are closely related to disease stage, and are expected to become important indicators for evaluating disease progress.
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Dyslipidaemia has been implicated in the pathophysiology of sickle cell disease (SCD) complications; hence its role requires further elucidation. Objectives: To investigate the relationship between disease severity and plasma lipid levels of patients with sickle cell anaemia. Methods: A cross-sectional study design was used for the survey. A total of 50 patients with sickle cell anaemia and 50 controls without SCD were recruited for the study. The clinical data and plasma lipid levels of lipids and haemoglobin parameters were analysed. Results: The majority of the participants were aged 18-25 years. Total plasma cholesterol and HDL-C were significantly lower in individuals with SCA compared with the controls (3.3±1.2 vs 4.2±1.2; p<0.001) and (1.3±0.5 vs 1.5±0.4; p = 0.038) respectively. Most patients with SCA had moderate disease severity (24; 48%). There was no statistically significant difference in the plasma levels of total cholesterol and HDL-C across the disease severity groups of SCA (p = 0.694 and 0.262). There was also no significant correlation between total cholesterol, HDL-C, and markers ofhaemolysis, haemoglobin F, and haemoglobin S levels. Conclusion: SCA is characterised by lower mean plasma TC and HDL than controls. However, no relationship was found between TC, HDL levels and SCD disease severity, markers of haemolysis, HbF and HbS levels. Further studies are required to ascertain the implications of plasma lipid levels in SCD
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Humans , Cholesterol , Anemia, Sickle Cell , Anemia, Aplastic , LipidsABSTRACT
Objective:To analyze the risk factors of three-vessel disease (TVD) in patients with stable coronary artery disease (SCAD).Methods:The clinical data of 447 patients with SCAD diagnosed in Zhongshan Hospital from May 2019 to April 2020 were retrospectively analyzed, including 108 cases with the single-vessel disease (SVD), 136 cases with the two-vessel disease, and 203 cases with three-vessel disease. The general data and hematological indexes were compared between patients with SVD and those with TVD; the related factors for TVD in SCAD patients were analyzed with univariate and multivariate logistic regression.Results:There were 244 males (78.5%) and 67 females (21.5%) with a median age of 57 years (64, 69). Univariate analysis showed that there were significant differences in diabetes history ( χ2=7.75, P=0.005), uric acid ( Z=-2.10, P=0.036), glycosylated hemoglobin ( Z=-2.77, P=0.006) and high density lipoprotein cholesterol (HDL-C) ( Z=-2.99, P=0.003) levels between SVD and TVD groups. Multivariate analysis showed that the high level of blood uric acid ( OR=1.01, 95% CI: 1.00-1.01, P<0.05) and the low level of HDL-C ( OR=3.29, 95% CI:1.23-8.85, P<0.05) were related risk factors of TVD. Conclusion:High blood uric acid level and low HDL-C level are related factors for TVD in patients with SCAD.
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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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Objective:To assess the value of serum uric acid combined with high-density lipoprotein cholesterol (HDL-C) for the diagnosis of nonalcoholic fatty liver disease (NAFLD) in health examination population.Methods:A cross-sectional study was conducted. Total of 3 903 subjects who underwent health examination in the health management center of the First Affiliated Hospital of Zhejiang University School of Medicine from January to November 2022 were retrospectively selected for this study. The demography and somatology examination, laboratory tests and transient elastography of the liver were carried out in all the subjects. The indices were compared in people with and without NAFLD with t test, single factor analysis of variance or Wilcoxon rank sum test. And the levels of uric acid and HDL-C under different degrees of fatty liver were analyzed. The diagnostic value of uric acid combined with HDL-C for NAFLD was examined with the receiver operator characteristic (ROC) curve and area under the ROC curve (AUC). Results:Body mass index, uric acid and glutathione transaminase in the NAFLD group were all higher than those in the non-NAFLD group, and HDL-C was lower (all P<0.001). Blood uric acid in normal liver group (303.62±77.65) μmol/L <mild fatty liver group (336.82±82.43) μmol/L <moderate fatty liver group (364.25±79.62) μmol/L <severe fatty liver group (392.98±83.90) μmol/L ( F=202.614, P<0.001); HLD-C in normal liver group (1.43±0.37) mmol/L >mild fatty liver group (1.25±0.31) mmol/L >moderate fatty liver group (1.16±0.28) mmol/L >severe fatty liver group (1.04±0.25) mmol/L ( F=239.24, P<0.001).The proportion of NAFLD in hyperuricemia group (HUA group) (75.0%), low HDL-C group (76.3%), and HUA and low HDL-C group (86.9%) was significantly higher than that in normal uric acid and HDL-C groups (49.2%), and the proportion of NAFLD in HUA and low HDL-C group was the highest ( χ 2=302.109, P<0.001). The diagnostic value of the combination of serum uric acid and HDL-C for NAFLD is higher than that of serum uric acid or HDL-C alone (the AUC was 0.741, 0.692 and 0.288, respectively) (both P<0.001). Conclusion:Serumuric acid and HDL-C were correlated with the severity of NAFLD, and uric acid combined with HDL-C had some diagnostic value for NAFLD.
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Objective:To evaluate the relationship between the blood uric acid/high-density lipoprotein cholesterol ratio (UHR) and diabetes retinopathy (DR) in diabetic and pre-diabetic population.Methods:A cross-sectional study. The data from a health survey from 2010 to 2011 on chronic diseases and risk factors in Changping District in Beijing was used in this study. Total of 2 507 pre-diabetic and diabetic patients who met the inclusion and exclusion criteria were screened out in this study, included 1 212 men and 1 295 women. The patients were divided into DR group and non-DR (NDR) group according to whether DR was present or not. Independent sample t-test, chi-square test and multivariate logistic regression were used for case-control study to investigate whether there was independent correlation between UHR and DR. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of UHR for DR. Results:There were gender differences in the relationship between uric acid related indicators and DR, no significant correlation was found in women. In males, the age, duration of diabetes,fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), serum uric acid, UHR levels and the proportion of diabetes and hypertension history in DR group were all significantly higher than those in NDR group (all P<0.05). Logistic regression analysis showed that SUR ( OR=1.054, 95%CI: 1.004-1.106, P=0.033) and UHR ( OR=1.391, 95%CI: 1.061-1.823, P=0.017) were the relative risk factors of DR. After adjusting for age, registered residence, education level, smoking, drinking, physical exercise, waist circumference, hypertension history, SBP, DBP, total cholesterol and other risk factors, UHR was still associated to DR [ OR ( 95%CI): 1.438 (1.084-1.908), P=0.012]. The area under the ROC curve of UHR was 0.610 ( 95%CI: 0.514-0.707, P=0.030). When the cut-off value of UHR for predicting DR was 0.24, the sensitivity and specificity were the highest, which was 78.8% and 58.7%, respectively. Conclusion:UHR is significantly correlated with the risk of DR in men with pre-diabetes and diabetes, but not in women. The risk of DR increases with the elevated level of UHR. UHR is helpful to diagnose DR and screen people with DR risk.
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Abstract Objective: We evaluated whether cholesteryl ester transfer protein (CETP) gene polymorphisms are associated with the presence of coronary artery disease (CAD) and/or restenosis in patients with coronary stent. Methods: Two polymorphisms of the CETP gene [−971 A/G (rs4783961), and Taq1B A/G (rs708272)] were genotyped by 5'exonuclease TaqMan assays in 219 patients with CAD (66 patients with restenosis and 153 without restenosis) and 607 control individuals. Results: The distribution of polymorphisms was similar in patients with and without restenosis. However, when the whole group of patients (with and without restenosis) was compared to healthy controls, under dominant model, the G allele of the Taq1B A/G polymorphism was associated with increased risk of CAD (odds ratio [OR] = 1.48, pCDom = 0.032). In the same way, under codominant, dominant, and additive models, the A allele of the −971 A/G polymorphisms was associated with an increased risk of developing CAD (OR = 2.03, pCCo-dom = 0.022, OR = 1.83, pCDom = 0.008, and OR = 1.39, pCAdd = 0.011, respectively). In addition, the linkage disequilibrium showed that the "AG" haplotype was associated with increased risk of developing CAD (OR = 1.28, p = 0.03). Conclusion: This study demonstrates that CETP Taq1B A/G and CETP −971 A/G polymorphisms are associated with an increased risk of developing CAD, but no association with restenosis was observed.
Resumen Objetivo: Evaluamos si los polimorfismos del gen CETP están asociados con la presencia de enfermedad arterial coronaria (EAC) y/o restenosis en pacientes con stent coronario. Métodos: En este estudio se genotiparon dos polimorfismos del gen CETP [−971 A/G (rs4783961) y Taq1B A/G (rs708272)] mediante ensayos de 5'exonucleasa TaqMan en 219 pacientes con EAC (66 pacientes con restenosis y 153 sin restenosis), y 607 individuos de control. Resultados: La distribución de polimorfismos fue similar en pacientes con y sin restenosis. Sin embargo, cuando se comparó todo el grupo de pacientes (con y sin restenosis) con controles sanos, bajo el modelo dominante el alelo G del polimorfismo Taq1B A/G se asocia con un mayor riesgo de EAC (OR = 1.48, pCDom = 0.032). De la misma manera, bajo los modelos co-dominante, dominante y aditivo, el alelo A de los polimorfismos −971 A/G se asocia con un mayor riesgo de desarrollar EAC (OR = 2.03, pCCo-dom = 0.022, OR = 1.83, pCDom = 0,008 y OR = 1.39, pCAdd = 0.011, respectivamente). Adicionalmente, el desequilibrio de ligamiento mostró que el haplotipo "AG" se asocia con un mayor riesgo de desarrollar EAC (OR = 1.28, p = 0.03). Conclusión: En resumen, este estudio demuestra que los polimorfismos CETP Taq1B A/G y CETP −971 A/G están asociados con un mayor riesgo de desarrollar CAD, pero no se observó asociación con restenosis.
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Objective:To investigate the correlation between neutrophil/lymphocyte ratio (NLR) combined with low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and severity of coronary lesions in patients with acute coronary syndrome (ACS).Methods:Patients who were diagnosed with ACS due to chest pain and received emergency coronary angiography in the First Affiliated Hospital of University of Science and Technology of China and the Affiliated Hospital of Anhui Medical University from January 2017 to June 2020 were enrolled in the final analysis. The data of gender, age, body mass index (BMI), past history, emergency blood routine indicators [neutrophil (NEU), lymphocyte (LYM), monocyte (MON), eosinophil (EOS), basophil (BAS), red blood cell (RBC), mean corpuscular volume (MCV), blood red cell distribution width (RDW), mean platelet volume (MPV), platelet volume distribution width (PDW)], blood lipid index [triglyceride (TG), total cholesterol (TC), HDL-C, LDL-C, very low-density lipoprotein cholesterol (VLDL-C)], and coronary angiography were collected. The results of coronary angiography were evaluated by the Gensini score. According to the Gensini score, the patients were divided into the control group (Gensini score = 0, 55 cases) and the study group (Gensini score > 0, 889 cases), and then the patients in the study group were divided into the low-Gensini-score group (Gensini score < 66, 419 cases) and the high-Gensini-score group (Gensini score ≥ 66, 470 cases). The differences in the general baseline data of the four groups were compared, and the correlation between the statistically significant data and the Gensini score was linearly analyzed, and then the combined diagnostic factors (NLR combined with LDL-C/HDL-C ratio) were obtained by Logistic regression analysis. The receiver operator characteristic curve (ROC curve) was used to evaluate the predictive value of NLR combined with LDL-C/HDL-C ratio in predicting the severity of coronary artery lesions in patients with ACS. Finally, multivariate linear regression analysis was used to establish the predictive model between NLR combined with LDL-C/HDL-C ratio and Gensini score.Results:A total of 944 patients were finally included. The differences in gender, age, BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, EOS, RDW, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C ratio between the control group and the study group were statistically significant. The differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, EOS, TG, TC, HDL-C, LDL-C, NLR and LDL-C/HDL-C ratio between the low-Gensini-score group and the high-Gensini-score group were statistically significant. Linear regression analysis showed that compared with other indicators, the correlation between NLR, LDL-C/HDL-C ratio and Gensini score was stronger in the study group ( r values were 0.634 and 0.663, respectively, both P < 0.05). Binary Logistic regression analysis of the indicators related to Gensini score showed that NEU, LYM, HDL-C and LDL-C were independent risk factors for coronary stenosis in patients with ACS [odds ratio ( OR) were 0.189, 10.309, 13.993, 0.251, 95% confidence intervals (95% CI) were 0.114-0.313, 4.679-22.714, 3.402-57.559, 0.121-0.519, respectively, all P < 0.05]. ROC curve analysis showed that NLR combined with LDL-C/HDL-C ratio had higher predictive value in predicting the severity of coronary lesions in ACS patients [area under the ROC curve (AUC) was 0.952, 95% CI was 0.93-0.969], when the cutoff value was -3.152, the sensitivity was 98.20%, and the specificity was 81.60%. According to the results of multivariate linear regression analysis, the prediction model between NLR, LDL-C/HDL-C ratio and Gensini score was established, and the formula was Gensini score = -7.772+15.675×LDL-C/HDL-C ratio+8.288×NLR ( R2 = 0.862). Conclusion:There is a significant correlation between emergency NLR combined with LDL-C/HDL-C ratio and Gensini score in patients with ACS at admission, which has a certain predictive value for the severity of coronary artery stenosis in patients with ACS, and can be used as a predictor for evaluating the severity of coronary artery disease.
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Objective:To compare the ability of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and triglyceride-glucose index (TyG) in identifying nonalcoholic fatty liver disease (NAFLD).Methods:A total of 11 524 eligible subjects who underwent physical examination in the Affiliated Hospital of Qingdao University from January to December in 2018 were selected in this research. The correlation between TG/HDL-C, TyG and NAFLD was analyzed by using binary logistic regression. The receiver operating characteristic (ROC) curves of TyG and TG/HDL-C were drawn for identifying NAFLD in male and female, and their diagnostic value for NAFLD was compared.Results:The prevalence of NAFLD increased with TG/HDL-C and TyG. After adjusting for confounding factors, when compared with that in the first quartile group of TG/HDL-C, the odds ratios (OR) and 95% confidence intervals ( CI) of NAFLD risk in the second, third and fourth quartile groups of TG/HDL-C was 2.380 (2.039-2.779), 3.902 (3.342-4.555) and 7.903 (6.745-9.259), respectively. Compared with that in the first quartile group of TyG, the OR (95% CI) of NAFLD risk in the second, third and fourth quartile groups of TyG was 2.243 (1.923-2.617), 3.918 (3.363-4.565) and 9.002 (7.676-10.559), respectively. The area under the curve (AUC) of TG/HDL-C and TyG in identifying NAFLD in male was 0.746 and 0.744, respectively, and there was no significant difference between the two indexes ( P=0.509 1). The AUCs of TG/HDL-C and TyG in identifying NAFLD in female was 0.785 and 0.799, respectively, and the difference was statistically significant ( P<0.001). The cut-off point of TG/HDL-C for identifying NAFLD in male was 1.02, and the cut-off point of TyG for identifying NAFLD in female was 8.55. Conclusions:TG/HDL-C and TyG are closely related to NAFLD in adults. There is no difference between TG/HDL-C and TyG in evaluating NAFLD in male, while TyG is better than TG/HDL-C in evaluating NAFLD in female.
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Objective:To determine the predictive value of atherogenic index of plasma (AIP) on the long-term prognosis of patients with coronary artery disease (CAD).Methods:A total of 2 500 patients with coronary heart disease who underwent coronary angiography in Affiliated Hospital of Jining Medical University from May 2013 to November 2015 were retrospectively analyzed. According to the AIP value, the subjects were divided into low AIP group (AIP<0.06) and high AIP group (AIP≥0.06). The incidence of major adverse cardiovascular events (MACE) was compared between the two groups. Kaplan-meier method was used to evaluate the MACE-free survival rate, and multivariate Cox survival analysis was used to evaluate the independent predictors of MACE.Results:A total of 2 427 patients were followed up, with a follow-up rate of 97.08% and a median follow-up time of 4.29 years. There were 1 123 cases in the low AIP group and 1 304 cases in the high AIP group, among which 624 patients (25.7%) had MACE. The total incidence of MACE in the high AIP group was higher than that in the low AIP group ( HR=1.43, 95% CI: 1.22-1.68, P<0.01). Kaplan-meier curves showed that the MACE-free survival rate was significantly lower in the high AIP group ( P<0.01). After adjusting for multiple confounding factors, AIP was still associated with the prognosis of CHD patients. Increased AIP (≥0.06) was an independent predictor of MACE in CHD patients within 4 years ( HR=1.34, 95% CI: 1.14-1.58, P<0.01). Conclusions:AIP (≥0.06) was an independent predictor of MACE occurrence in patients with CAD within 4 years. AIP has a certain value in the long-term prognosis of patients with CAD.
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In clinical practice, we need to develop new tools to identify the residual cardiovascular risk after acute coronary syndrome (ACS). This study aimed to evaluate whether the monocyte to high-density lipoprotein cholesterol ratio (MHR) variation (ΔMHR) obtained during hospital admission (MHR1) and repeated in the first outpatient evaluation (MHR2) is a predictor of major adverse cardiovascular events (MACE) after ACS. One hundred ninety-one patients admitted for ACS were prospectively included. The ΔMHR was calculated by subtracting MHR1 from MHR2. Patients were followed for 166±38 days in which the occurrence of MACE was observed. The best cutoff for ΔMHR was zero (0), and individuals were divided into two groups: ΔMHR<0 (n=113) and ΔMHR≥0 (n=78). The presence of MACE was higher in the ΔMHR≥0 (22%) than in the ΔMHR<0 (7%), with a hazard ratio (HR) of 3.96 (95% confidence interval [CI]: 1.74-8.99; P=0.0004). After adjusting for confounders, ΔMHR≥0 remained an independent MACE predictor with an adjusted HR of 3.13 (95%CI: 1.35-7.26, P=0.008). In conclusion, our study showed that ΔMHR was an independent MACE predictor after ACS. Thus, ΔMHR is a potential marker of residual cardiovascular risk after ACS.
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Low-density lipoprotein cholesterol (LDL-C) has been recommended as the primary treatment target on lipid management in coronary heart disease (CHD) patients for several decades. However, even by aggressive LDL-C lowering treatment, patients still present a significant residual risk of major adverse cardiovascular events. Non-high-density lipoprotein cholesterol (non-HDL-C) contained all the atherogenic lipoproteins. Non-HDL-C is superior to LDL-C for the prediction of cardiovascular events and has many other compelling advantages over LDL-C and other traditional lipid parameters. This review mainly discusses the definition and test advantages of non-HDL-C, the predictive value of non-HDL-C, recommended value of non-HDL-C goals, and related guideline recommendations of non-HDL-C.
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Objective:To investigate the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and the thrombolysis in myocardial infarction(TIMI)risk score in elderly patients with ST elevation myocardial infarction(STEMI).Methods:This was a prospective clinical trial.A total of 152 patients admitted to Tangshan Workers' Hospital were enrolled between January 2015 to February 2018.Of these, 102 STEMI patients undergone primary percutaneous coronary intervention(PCI)were selected as the STEMI group and 50 patients with angiographically normal coronary arteries were selected as the control group.The STEMI patients were divided into two subgroups based on TIMI risk scores.The relationship between MHR and TIMI risk scores in patients with STEMI was analyzed.Logistic regression was used to analyze whether MHR could be used as an independent predictor of acute STEMI and high TIMI scores.Results:The MHR level was significantly higher in the STEMI group than in the control group( P<0.05)and was significantly higher in the high TIMI score subgroup than in the low TIMI score subgroup( P<0.05). In multivariate Logistic regression analysis, MHR was an independent predictor of high TIMI scores in acute STEMI(P<0.05). In correlation analysis, there was a significant positive correlation between MHR and TIMI score in STEMI patients( r=0.396, P<0.01). The ROC curve showed that the area under the curve of MHR was 0.815(95% CI: 0.734-0.896, Z=7.613, P<0.01). When the MHR optimal cut-off value was 2.380, the sensitivity was 55.22% and the specificity was 97.14%. Conclusions:MHR is significantly associated with the TIMI score in patients with STEMI.MHR may be used as a supplementary parameter for assessing the prognosis of STEMI patients.
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Objective To explore the effect of typical hot spring bathing of Guizhou Province on dyslipidemia, which could provide scientific basis for clarifying the physiotherapy effect of hot springs. Methods The typical hot spring sites of three main types(hydrothermal hot spring, warm mineral hot spring and metasilicate hot spring)in Guizhou Province were selected as investigation sites. 189 residents with hyperlipidemia near the investigation sites were selected as subjects and were treated with hot spring baths for 4 weeks, once a day, 5 times a week and 40-50 minutes each time. The age and gender distribution of the subjects were obtained by a questionnaire. The levels of TC, TG, LDL-C and HDL-C in serum were measured by automatic biochemical analyzer at baseline and at the end of hot spring baths. The differences of the three kinds of hot spring baths on improvement rate of dyslipidemia, the changes of abnormal blood lipid indexes and their improvement rates were compared. Results After baths of hydrothermal hot springs, warm mineral hot springs and metasilicate hot springs, the improvement rates of abnormally elevated lipids were 15.6%, 40.4% and 47.9%, respectively. The improvement rates of abnormally elevated lipids after baths of warm mineral hot springs and metasilicate hot springs were significantly higher than that after hydrothermal spring baths(all P < 0.05). Compared with before hot spring bathing, the levels of TC, TG, LDL-C and non-HDL-C in serum significantly decreased in all three kinds of hot springs. Moreover, the degree of decrease of TG in serum and the improvement rate of abnormal TG after baths of warm mineral spring and metasilicate hot spring were significantly higher than that after hydrothermal spring baths. The degree of decrease of LDL-C in serum and the improvement rate of abnormal LDL-C after baths of metasilicate hot spring were significantly higher than that after baths of hydrothermal spring and warm mineral spring(all P < 0.05). Conclusion The three types of typical hot spring baths in Guizhou Province can mitigate the elevation of blood lipid. Compared with hydrothermal spring, warm mineral spring and metasilicate hot spring may have better improvement effect on blood lipid elevation due to their more significant improvement effect on abnormal elevation of TG and LDL-C in serum.
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OBJECTIVE@#Ipomoea batatas (L.) Lam. is a food plant used in African traditional medicine to treat cardiovascular diseases and related conditions. We assessed the hypolipidemic and anti-atherosclerogenic properties of the aqueous extract of I. batatas leaves in a rat model of diet-induced hypercholesterolemia.@*METHODS@#Hypercholesterolemia was induced in male Wistar rats by exclusive feeding with a cholesterol-enriched (1%) standard diet for four weeks. Then, rats were treated once daily (per os) with I. batatas extract at doses of 400, 500 and 600 mg/kg or with atorvastatin (2 mg/kg), for four weeks. Following treatment, animals were observed for another four weeks and then sacrificed. Aortas were excised and processed for histopathological studies, and blood glucose level and lipid profile were measured.@*RESULTS@#Hypercholesterolemic animals experienced a 21.5% faster increase in body weight, significant increases in blood glucose and blood lipids (148.94% triglycerides, 196.97% high-density lipoprotein cholesterol, 773.04% low-density lipoprotein cholesterol, 148.93% very low-density lipoprotein cholesterol and 210.42% total cholesterol), and increases in aorta thickness and atherosclerotic plaque sizes compared to rats fed standard diet. Treatment of hypercholesterolemic rats with the extract mitigated these alterations and restored blood glucose and blood lipid levels to normocholesterolemic values.@*CONCLUSION@#Our findings suggest that I. batatas leaves have hypolipidemic and anti-atherosclerogenic properties and justify their use in traditional medicine.
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Objective:To investigate the correlation between gamma-glutamyl transferase/high-density lipoprotein cholesterol ratio (GHR), neutrophil/lymphocyte ratio (NLR) and coronary heart disease (CHD), and evaluated its pathogenic risk and predictive value for CHD.Methods:A total of 694 patients admitted to our hospital from December 2017 to December 2018 for suspected CHD and coronary angiography were selected. According to the results of coronary angiography,the patients were divided into CHD group ( n=527) and non-CHD group ( n=167). The clinical data of all patients were recorded. Gamma-glutamyl transferase (GGT), high-density lipoprotein cholesterol (HDL-C) and other biochemical indicators were recorded. Neutrophils, lymphocyte count and other hematological indicators were recorded. GHR, NLR and Gensini scores of the patients were calculated. Clinical data and GHR, NLR and other indicators were compared between the two groups. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of GHR, NLR in CHD, and to determine the optimal cut-off value; Logstic regression analysis was used to investigate the risk factors of CHD.Spearman correlation analysis was used to analyze the correlation between serum OPN, OPG and Gensini score in patients with CHD. Results:The GHR and NLR were 32.59(21.05, 48.24) and 3.53(2.18, 8.46) significantly higher in the CHD group than in the non-CHD group 16.56(10.07, 25.21) and 2.20(1.45, 3.28) respectively, with statistically significant differences ( Z=11.094, 9.055, P<0.05). ROC curve analysis showed that the AUC of NLR and MLR in diagnosing CHD was 0.785 and 0.732( P<0.05). When the critical values of GHR and NLR respectively were 19.805 and 2.678, respectively, the diagnostic efficiency of CHD was the highest, and the sensitivity and specificity were 79.30%, 62.90% and 63.80%, 68.30%, and the AUC of GGT in diagnosing CHD was 0.628. When the critical value was 19.500, the sensitivity and specificity were 80.50% and 39.50%, respectively,the AUC of GHR was greater than that of GGT ( Z=12.973, P<0.05). Multivariate Logistic regression analysis showed that Smoking ( OR=2.887, 95% CI:1.850-4.505, P<0.05), hypertension ( OR=2.009, 95% CI: 1.311-3.080, P<0.05), fasting plasma glucose ( OR=1.109, 95% CI:1.034-1.189, P<0.05), age ≥60 years ( OR=1.567, 95% CI:1.179-2.415, P<0.05), NLR ≥2.687 ( OR=3.152, 95% CI:2.066-4.808, P<0.05) and GHR ≥19.805 ( OR=4.768, 95% CI:3.131-7.262, P<0.05) was an independent risk factor for CHD. After gradually adjustment for risk factors such as smoking, hypertensive, fasting plasma glucose, age ≥60 years and NLR ≥2.687, GHR ≥19.805 was still an independent risk factor for coronary heart disease(OR and 95% CI were 4.620 (3.049-7.000), 4.768 (3.131-7.262), 6.567 (4.408-9.810), 4.768 (3.131-7.262), 4.768 (3.131-7.262), respectively; all P<0.001). Spearman correlation analysis showed that GHR and NLR were positively correlated with Gensini score ( r=0.312, 0.394; all P<0.05). Conclusion:GHR and NLR were positively correlated with the severity of coronary artery disease, which is of significance in the diagnosis of coronary heart disease. NLR ≥2.687 and GHR ≥19.805 were independent risk factors for CHD. GHR was superior to GGT and HDL-C alone in the diagnosis of CHD,and has certain clinical application value