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Braz. j. biol ; 83: e248910, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1339342


Abstract This study determines the associations among serum lipid profiles, risk of cardiovascular disease, and persistent organic pollutants. Using Gas chromatography technique, the intensity of toxic pollutant residues in serum samples of Hypertensive patients were measured. Based on statistical analysis, the effects of different covariates namely pesticides, age, systolic blood pressure, diastolic blood pressure, and lipid profile duration was checked using the logistic regression model. Statistical computation was performed on SPSS 22.0. The P-values of F-Statistic for each lipid profile class are greater than 0.01 (1%), therefore we cannot reject the null hypothesis for all cases. The estimated coefficients, their standard errors, Wald Statistic, and odds ratio of the binary logistic regression model for different lipid profile parameters indicate if pesticides increase then the logit value of different lipid profile parameters changes from -0.46 to -0.246 except LDL which increases by 0.135. The study reports a significantly increased threat of cardiovascular disease with increased concentrations of toxic pollutants.

Resumo Este estudo determina as associações entre o perfil lipídico sérico, o risco de doença cardiovascular e os poluentes orgânicos persistentes. Por meio da técnica de cromatografia gasosa, mediu-se a intensidade dos resíduos de poluentes tóxicos em amostras de soro de pacientes hipertensos. Com base na análise estatística, os efeitos de diferentes covariáveis ​​- ou seja, pesticidas, idade, pressão arterial sistólica, pressão arterial diastólica e duração do perfil lipídico - foram verificados usando o modelo de regressão logística. O cálculo estatístico foi realizado no SPSS 22.0. Os valores P da estatística F para cada classe de perfil lipídico são maiores que 0,01 (1%), portanto não podemos rejeitar a hipótese nula para todos os casos. Os coeficientes estimados, seus erros padrão, estatística de Wald e odds ratio do modelo de regressão logística binária para diferentes parâmetros do perfil lipídico indicam se os pesticidas aumentam, então o valor logit de diferentes parâmetros do perfil lipídico muda de -0,46 para -0,246, exceto LDL, que aumenta em 0,135. O estudo relata um aumento significativo da ameaça de doença cardiovascular com aumento das concentrações de poluentes tóxicos.

Humans , Pesticides , Environmental Pollutants , Persistent Organic Pollutants , Lipids , Lipoproteins
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 56-62, Jan.-Mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364891


Abstract Introduction Lipoprotein apheresis (LA) is an extracorporeal therapy which removes apolipoprotein B-containing particles from the circulation. We evaluated techniques and efficiency of lipoprotein apheresis procedures applied to patients with familial and non-familial hypercholesterolemia (FH) at our center. Methods We retrospectively evaluated 250 LA procedures applied to 27 patients with dyslipidemia between March 2011 and August 2019. Results A total of 27 patients, of whom 19 (70.4%) were male and 8 (29.6%), female, were included. Eighteen (66.7%), 6 (22.2%) and 3 (11.1%) patients were diagnosed with non-FH, homozygous FH (HoFH) and heterozygous FH (HeFH), respectively. Two different apheresis techniques, direct adsorption of lipoproteins (DALI) (48.8%) and double filtration plasmapheresis (DFPP) (51.2%), were used. The change in the serum total cholesterol (TC) level was the median 302 mg/dl (171-604 mg/dl) (60.4%) in HoFH patients, 305 mg/dl (194-393 mg/dl) (60.8%) in HeFH patients and 227 mg/dl (75-749 mg/dl) (65.3%) in non-FH patients. The change in the serum low-density lipoprotein (LDL) level was the median 275 mg/dl (109-519 mg/dl) (64.2%), 232 mg/dl (207-291 mg/dl) (64.5%) and 325 mg/dl (22-735 mg/dl) (70.9%) in patients with HoFH, HeFH and non-FH, respectively. A significantly effective reduction in serum lipid levels, including TC, LDL and triglycerides, was achieved in all patients, regardless of the technique, p< .001. The decrease in the serum TC and LDL levels was significantly higher in the DFPP, compared to the DALI, being 220 mg/dl (-300 to 771) vs 184 mg/dl (64-415), p< .001 and 196 mg/dl (11-712) vs 157 mg/dl (54-340), p< .001, respectively. Conclusions Our results showed that LA is a highly effective treatment in reducing serum lipid levels and safe, without any major adverse event.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Blood Component Removal , Lipoproteins , Hyperlipidemias
Article in English | WPRIM | ID: wpr-880652


OBJECTIVES@#To analyze the effect of hyperlipoproteinemia (α) on immediate expansion after coronary stent implantation guided by intravascular ultrasound (IVUS).@*METHODS@#A total of 160 patients (175 lesions) with coronary heart disease diagnosed by coronary artery angiography, who were performed percutaneous intervention guided by IVUS in the Department of Cardiology, Third Xiangya Hospital, Central South University, were enrolled retrospectively.According to the concentration of lipoproteina, the patients were divided into 2 groups: a hyperlipoproteinemia (α) group and a control group. Cardiac ejection fraction was measured with echocardiography. Logistic regression was used to analyze the influential factors for hyperlipoproteinemia (α). The target vessel was examined by IVUS to analyze the immediate expansion effect of hyperlipoproteinemia (α) after stent implantation.@*RESULTS@#The mean stent expansion index, lesion length, stent number, stent symmetry index and posterior balloon diameter were (94.73±18.9)%, (52.92±29.1) mm, (2.11±0.85), (83.62±13.07)%, and (9.46±2.00) mm in the hyperlipoproteinemia (α) group, respectively. Compared with the control group, there were significantly difference (all @*CONCLUSIONS@#Hyperlipoproteinemia (α) appears to be a predictor of stent underexpansion, and the decreased creatinine clearance rate is an independent risk factor for hyperlipoproteinemia (α).

Coronary Angiography , Coronary Artery Disease/surgery , Humans , Lipoproteins , Percutaneous Coronary Intervention/adverse effects , Retrospective Studies , Risk Factors , Stents/adverse effects , Treatment Outcome , Ultrasonography, Interventional
Article in English | WPRIM | ID: wpr-888616


BACKGROUND@#Remnant-like particle cholesterol (RLP-C) is highly atherogenic, which is associated with atherosclerosis. However, RLP-C has not been routinely measured in the clinical practice. We estimated RLP-C levels using conventional lipid profiles and examined the association between estimated RLP-C and related factors including nutrient intake.@*METHODS@#This study was performed in Uku town, Nagasaki prefecture, Japan in 2019. A total of 225 subjects were enrolled and directly measured RLP-C levels. Estimated RLP-C levels were defined as the following formula [total cholesterol - (LDL-cholesterol) - (HDL-cholesterol)]. Multivariate analyses were used to assess the relationship between estimated RLP-C and atherogenic factors. We calculated cut-off values on dichotomized RLP-C (< 7.5 mg/dL vs. ≥ 7.5 mg/dL) by receiver operating characteristic (ROC) curve.@*RESULTS@#The mean values of directly measured RLP-C levels and estimated RLP-C were 4.0 mg/dL and 16.4 mg/dL, respectively. In the multiple stepwise linear regression analysis, directly measured and estimated RLP-C levels were independently and commonly associated with apolipoprotein E, triglycerides, and vegetable fat intake (inversely). Using ROC curves, we found the cut-off value of estimated RLP-C was 22.0 mg/dL.@*CONCLUSION@#We demonstrated that the estimated RLP-C levels using conventional lipid profiles may substitute for directly measured RLP-C and these levels were independently and inversely associated with vegetable fat intake in the community-dwelling Japanese population.

Aged , Aged, 80 and over , Cholesterol/blood , Dietary Fats/blood , Female , Humans , Japan , Lipids/blood , Lipoproteins/blood , Male , Middle Aged , Triglycerides/blood , Vegetables
São Paulo; s.n; 2021. 147 p.
Thesis in English | LILACS | ID: biblio-1352373


Background: Cardiovascular disease is the leading cause of morbidity and mortality in women worldwide. Cardiovascular risk prediction is incomplete and new markers may help in the early identification of atherosclerosis. Brazilian epidemiological data in women are scarce. Objectives: To review the impact of menopause and diabetes on lipids, lipoprotein subfractions and cardiovascular risk; evaluate cardiometabolic risk in women from the ELSA-Brasil, as well as associations of blood biomarkers [lipoprotein subfractions, insulin resistance index (HOMA-IR) and branched-chain amino acids (BCAA)] and structural changes of atherosclerosis [presence of calcium in the coronary arteries (CAC)] according to age and menopausal status. Methods: Cross-sectional baseline analyzes of 2,258 female participants from the São Paulo site of the ELSA-Brasil, stratified by age and menopausal status, with specific sample and eligibility criteria for each paper. Descriptive statistics, between-group comparisons and multiple regression were performed according to the nature and distribution of the variables for each paper. Results: Paper 1: Literature revision enabled conclusions regarding the association of menopause and diabetes with a worse lipid profile, including hypertriglyceridemia, lower levels of HDL-c and HDL2-c, higher levels of HDL3-c and small dense LDL-c. Postmenopausal diabetic women consist of the highest cardiovascular risk level. Paper 2: Comparing pre- and postmenopausal women categorized according to time since menopause [menopausal duration <2 years, 2-5.9 years, 6-9.9 years or ≥ 10 years (n=1916)], postmenopausal women had a worse lipid and lipoprotein subfraction profile and duration of menopause <2 years was independently associated with remnant lipoprotein cholesterol (TRL-c) [7.21 mg/dL (95% CI 3.5910.84)] and smaller denser VLDL3-c [2.43 mg/dL (95%CI 1.023.83)], but no associations of menopausal categories with HDL-c or LDL-c subfractions were found, when taking premenopausal women as reference. Paper 3: Comparing premenopausal ≤ or >45 years and postmenopausal women (n=2047), postmenopausal ones had the worst cardiometabolic risk profile. CAC>0 was found to be associated with TRL-c and dense LDL-c, but not with BCAA levels nor HOMA-IR. Postmenopausal women were about twice as likely to have CAC>0 than younger premenopausal ones [OR 2.37 (95%CI 1.17-4.81)]. Discussion: Our findings suggest that natural menopause is associated with changes in lipoprotein fractions and subfractions (especially in the first 2 years post-menopause) and with calcium deposition in the coronary arteries independently of age and other risk factors, but not with BCAA nor HOMA-IR. Deep investigation on lipid profile and other biomarkers in women approaching to menopause is needed in order to identify cardiovascular risk, prevent cardiovascular outcomes and provide better health conditions.

Introdução: A doença cardiovascular se constitui na principal causa de morbimortalidade em mulheres globalmente. A predição de evento cardiovascular é incompleta e novos marcadores de risco cardiometabólico podem auxiliar na identificação precoce da aterosclerose. Dados epidemiológicos brasileiros no sexo feminino são mais escassos. Objetivos: Revisar o impacto da menopausa e diabetes nas lipoproteínas, subfrações e risco cardiovascular; avaliar o perfil de risco cardiometabólico de mulheres do ELSA-Brasil, bem como associações de marcadores sanguíneos [subfrações de lipoproteínas circulantes, índice de resistência à insulina (HOMA-IR) e aminoácidos de cadeia ramificada (BCAA)] e estruturais [cálcio nas artérias coronárias (CAC)] de aterosclerose segundo sua idade e estado menopausal. Métodos: Análise transversal de dados basais de 2258 mulheres acompanhadas no centro de São Paulo do ELSA-Brasil, estratificadas por idade e estado menopausal, respeitando características amostrais estabelecidas para cada artigo. Estatística descritiva, testes de comparação entre grupos e análises de regressão múltipla foram realizadas conforme natureza e distribuição das variáveis para cada artigo. Resultados: Artigo 1: A revisão da literatura permitiu concluir sobre a associação de menopausa e diabetes com pior perfil lipídico, consistindo de hipertrigliceridemia, baixos níveis de HDL-c e HDL2-c e elevados de HDL3-c e LDL-c pequena e densa. Mulheres menopausadas com diabetes apresentam o maior risco cardiovascular. Artigo 2: Comparando-se mulheres pré-menopausadas com as menopausadas, categorizadas segundo tempo de menopausa [duração <2 anos; 2-5,9 anos; 6-9,9 anos e ≥ 10 anos (n=1916)], aquelas na pós-menopausa apresentaram perfil de lipoproteínas e suas subfrações mais aterogênico e a duração da menopausa <2 anos associou-se independentemente com remanescentes de lipoproteínas ricas em triglicérides (TRL-c) [7,21 mg/dL (IC95% 3,5910,84)] e com a partícula pequena e densa de VLDL3-c [2,43 mg/dL (IC95% 1,023,83)], mas não foram encontradas associações de categorias de menopausa com as subfrações de HDL-c ou LDL-c, considerando-se as pré-menopausadas como referência. Artigo 3: Comparando mulheres pré-menopausadas com idade ≤ ou >45 anos e as menopausadas (n=2047), pior perfil de risco cardiometabólico foi encontrado em mulheres na pós- menopausa. Observou-se associação entre CAC>0 com TRL-c e LDL-c densa, mas não com HOMA-IR e BCAA. Mulheres menopausadas tiveram cerca de 2 vezes mais chance de apresentar CAC>0 quando comparadas com mulheres mais jovens na pré-menopausa [OR 2,37 (IC95% 1,17-4,81)]. Discussão: Nossos achados sugerem que a menopausa natural está associada a alterações no perfil lipídico tradicional e subfrações (especialmente nos primeiros 2 anos pós-menopausa) e ao depósito de cálcio nas artérias coronárias independentemente da idade e de outros fatores de risco, mas não com BCAA e HOMA-IR. Investigação aprofundada do perfil lipídico e outros marcadores de risco cardiovascular em mulheres que se aproximam da menopausa pode melhorar a identificação de risco, prevenção de desfechos cardiovasculares e proporcionar melhores condições de saúde.

Women , Menopause , Biomarkers , Atherosclerosis , Heart Disease Risk Factors , Amino Acids, Branched-Chain , Lipoproteins , Women's Health
Braz. j. med. biol. res ; 54(10): e11035, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285659


In this eight-year retrospective study, we evaluated the associations between climatic variations and the biological rhythms in plasma lipids and lipoproteins in a large population of Campinas, São Paulo state, Brazil, as well as temporal changes of outcomes of cardiovascular hospitalizations. Climatic variables were obtained at the Center for Meteorological and Climatic Research Applied to Agriculture (University of Campinas - Unicamp, Brazil). The plasma lipid databases surveyed were from 27,543 individuals who had their lipid profiles assessed at the state university referral hospital in Campinas (Unicamp). The frequency of hospitalizations was obtained from the Brazilian Public Health database (DATASUS). Temporal statistical analyses were performed using the methods Cosinor or Friedman (ARIMA) and the temporal series were compared by cross-correlation functions. In normolipidemic cases (n=11,892), significantly different rhythmicity was observed in low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (C) both higher in winter and lower in summer. Dyslipidemia (n=15,651) increased the number and amplitude of lipid rhythms: LDL-C and HDL-C were higher in winter and lower in summer, and the opposite occurred with triglycerides. The number of hospitalizations showed maximum and minimum frequencies in winter and in summer, respectively. A coincident rhythmicity was observed of lower temperature and humidity rates with higher plasma LDL-C, and their temporal series were inversely cross-correlated. This study shows for the first time that variations of temperature, humidity, and daylight length were strongly associated with LDL-C and HDL-C seasonality, but moderately to lowly associated with rhythmicity of atherosclerotic outcomes. It also indicates unfavorable cardiovascular-related changes during wintertime.

Humans , Cardiovascular Diseases/epidemiology , Climate , Lipids/blood , Lipoproteins/blood , Periodicity , Seasons , Triglycerides/blood , Brazil/epidemiology , Retrospective Studies , Cholesterol, HDL/blood
NAJFNR ; 4(7): 268-279, 2020.
Article in English | AIM, AIM | ID: biblio-1266919


Aim : The main objective of our work was to assess the relationship between type 2 diabetes, hyperuricemia and dyslipidemia in the population of Tizi-Ouzou. By evaluating the relationship between hyperuricemia and some blood lipid parameters, we thus establish, in type 2 diabetes, the correlation between uremia and these lipid parameters. Subjects and methods: The survey was carried out by means of an individual questionnaire. We excluded from our study pregnant women, patients with cancer, patients with end-stage renal disease and subjects who did not respond to the questionnaire. Results: Serum uric acid level increased with age (p = 0.025). Hyperuricemia was associated with heart disease (p = 0.0007). All patients with gout presented an elevated serum uric acid (p = 0.000001). Dyslipidemia was more common in patients with elevated serum uric acid levels (p = 0.0008). Triglyceridemia was significantly associated with hyperuricemia (p = 0.025). The relationship between type 2 diabetes and glomerular filtration rate was not significant, while the latter was decreased in patients with elevated serum uric acid levels (p = 0.0001). In, stratified analysis, age was effect modifier, the age-dependent results make us understand that resistance to insulin constitutes a significant factor of hyperuricemia. Conclusion: The association between hyperuricemia and dyslipidemia in type 2 diabetes emphasizes that insulin resistance acts on both lipid parameters and uricemia. A diet correcting dyslipidemia may also correct the uricemia

Algeria , Dyslipidemias , Hyperuricemia , Lipoproteins
Article in Korean | WPRIM | ID: wpr-811453


Research on physical activity and health is actively being conducted. In the Korea National Health and Nutrition Examination Survey (KNHANES), the Global Physical Activity Questionnaire (GPAQ) was newly introduced in 2014. The purpose of this study was to investigate the levels of physical activity and related factors in Koreans who were assessed through the GPAQ by dividing the physical activity by occupation, leisure, and transport domain. This study used data from the KNHANES (2014–2016), the study population of which included 17,357 participants aged 12 to 80 years. We compared the differences in physical activity by sociodemographic factors, health-related factors, and psychological health-related factors. Moreover, we also compared the mean metabolic equivalent of task and daily sitting time according to physical activity domain by sex and age group. Finally, we investigated the sociodemographic factors, health-related factors, and psychological health-related factors that significantly affect the average physical activity per week. The various factors were found to differ in the frequency of physical activity levels. In addition, there was a difference in the amount of physical activity per occupation, leisure, and transport domain in each age group. Finally, age, sex, high-density lipoprotein cholesterol levels, arthritis, allergic rhinitis and sinusitis, sleeping time, and perceived health status significantly affected physical activity. The levels of physical activity significantly differed by sociodemographic factors, health-related factors, and psychological health-related factors. There was also a difference in the physical activity levels according to the age and sex per each domain of physical activity.

Arthritis , Cholesterol , Humans , Korea , Leisure Activities , Lipoproteins , Metabolic Equivalent , Motor Activity , Nutrition Surveys , Occupations , Physical Fitness , Public Health , Rhinitis, Allergic , Risk Factors , Sinusitis , Social Determinants of Health , Surveys and Questionnaires
Korean Circulation Journal ; : 236-247, 2020.
Article in English | WPRIM | ID: wpr-811355


BACKGROUND AND OBJECTIVES: Recent studies have examined the structure-function relationship of high-density lipoprotein (HDL). This study aimed to identify and rank HDL-associated proteins involved in several biological function of HDL.METHODS: HDLs isolated from 48 participants were analyzed. Cholesterol efflux capacity, effect of HDL on nitric oxide production, and vascular cell adhesion molecule-1 expression were assessed. The relative abundance of identified proteins in the highest vs. lowest quartile was expressed using the normalized spectral abundance factor ratio.RESULTS: After adjustment by multiple testing, six proteins, thyroxine-binding globulin, alpha-1B-glycoprotein, plasma serine protease inhibitor, vitronectin, angiotensinogen, and serum amyloid A-4, were more abundant (relative abundance ratio ≥2) in HDLs with the highest cholesterol efflux capacity. In contrast, three proteins, complement C4-A, alpha-2-macroglobulin, and immunoglobulin mu chain C region, were less abundant (relative abundance ratio <0.5). In terms of nitric oxide production and vascular cell adhesion molecule-1 expression, no proteins showed abundance ratios ≥2 or <0.5 after adjustment. Proteins correlated with the functional parameters of HDL belonged to diverse biological categories.CONCLUSIONS: In summary, this study ranked proteins showing higher or lower abundance in HDLs with high functional capacities and newly identified multiple proteins linked to cholesterol efflux capacity.

Amyloid , Angiotensinogen , Atherosclerosis , Cardiovascular Diseases , Cholesterol , Complement System Proteins , Immunoglobulin mu-Chains , Lipoproteins , Nitric Oxide , Plasma , Proteomics , Serine Proteases , Thyroxine-Binding Globulin , Vascular Cell Adhesion Molecule-1 , Vitronectin
Korean Circulation Journal ; : 248-249, 2020.
Article in English | WPRIM | ID: wpr-811354


No abstract available.

Lipoproteins , Wind
Article in English | WPRIM | ID: wpr-811204


Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

Adolescent , Anesthesia, Dental , Blood Component Removal , Cholesterol , Female , Heart Diseases , Hemorrhage , Heparin , Humans , Hyperlipoproteinemia Type II , Lipoproteins , Molar , Outpatients , Patient Safety , Plasma , Surgery, Oral
Article in English | WPRIM | ID: wpr-811146


BACKGROUND: Cardiovascular risk remains increased despite optimal low density lipoprotein cholesterol (LDL-C) level induced by intensive statin therapy. Therefore, recent guidelines recommend non-high density lipoprotein cholesterol (non-HDL-C) as a secondary target for preventing cardiovascular events. The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (OM3-FAs) in combination with atorvastatin compared to atorvastatin alone in patients with mixed dyslipidemia.METHODS: This randomized, double-blind, placebo-controlled, parallel-group, and phase III multicenter study included adults with fasting triglyceride (TG) levels ≥200 and <500 mg/dL and LDL-C levels <110 mg/dL. Eligible subjects were randomized to ATOMEGA (OM3-FAs 4,000 mg plus atorvastatin calcium 20 mg) or atorvastatin 20 mg plus placebo groups. The primary efficacy endpoints were the percent changes in TG and non-HDL-C levels from baseline at the end of treatment.RESULTS: After 8 weeks of treatment, the percent changes from baseline in TG (−29.8% vs. 3.6%, P<0.001) and non-HDL-C (−10.1% vs. 4.9%, P<0.001) levels were significantly greater in the ATOMEGA group (n=97) than in the atorvastatin group (n=103). Moreover, the proportion of total subjects reaching TG target of <200 mg/dL in the ATOMEGA group was significantly higher than that in the atorvastatin group (62.9% vs. 22.3%, P<0.001). The incidence of adverse events did not differ between the two groups.CONCLUSION: The addition of OM3-FAs to atorvastatin improved TG and non-HDL-C levels to a significant extent compared to atorvastatin alone in subjects with residual hypertriglyceridemia.

Adult , Atorvastatin , Cholesterol , Cholesterol, LDL , Dyslipidemias , Fasting , Fatty Acids, Omega-3 , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypertriglyceridemia , Incidence , Lipoproteins , Triglycerides
Article in English | WPRIM | ID: wpr-786074


OBJECTIVE: Postmenopausal women show a more atherogenic lipid profile and elevated cardiovascular risk compared to premenopausal women. The aim of this study was to investigate the efficacy and safety of high-dose atorvastatin on the improvement of the blood lipid profile of postmenopausal women in Korea.METHODS: This study is a prospective, open-label, single-arm clinical trial that was conducted in 3 teaching hospitals. Postmenopausal women with a moderate-to-high cardiovascular risk, according to guidelines from the Korean Society of Lipid & Atherosclerosis, were enrolled. Participants were administered 20 mg of atorvastatin daily for the first 8 weeks, and if the targeted low-density lipoprotein cholesterol (LDL-C) level was not achieved, the dose was increased to 40 mg for the second 8 weeks. The primary endpoint was percentage change of LDL-C from baseline after 16 weeks of drug administration.RESULTS: Forty-four women were enrolled, 28 of whom (75.6%) had diabetes mellitus. By the end of treatment period (16 weeks) all patients had achieved LDL-C target levels, with 33 (94.2%) of the participants achieving it after only 8 weeks of administration. After 16 weeks, LDL-C decreased by 45.8±16.7% (p<0.001) from the baseline, and total cholesterol (33.2±10.9%; p<0.001), triglyceride (24.2±37.5%; p=0.001), and apolipoprotein B (34.9±15.6%; p<0.001) also significantly decreased. Blood glucose and liver enzyme levels slightly increased, but none of the participants developed serious adverse events that would cause them to prematurely withdraw from the clinical trial.CONCLUSION: 20 and 40 mg atorvastatin was effective and safe for treating dyslipidemia in postmenopausal Korean women with moderate-to-high cardiovascular risk.

Apolipoproteins , Asian Continental Ancestry Group , Atherosclerosis , Atorvastatin , Blood Glucose , Cholesterol , Diabetes Mellitus , Dyslipidemias , Female , Hospitals, Teaching , Humans , Korea , Lipoproteins , Liver , Postmenopause , Prospective Studies , Triglycerides
Article in English | WPRIM | ID: wpr-786071


OBJECTIVE: This study investigated whether serum bilirubin levels can predict the progression of carotid atherosclerosis in individuals with type 2 diabetes mellitus (T2DM).METHODS: This observational study included 1,381 subjects with T2DM in whom serial measurements of carotid intima-media thickness (CIMT) were made at 1- to 2-year intervals for 6–8 years. The progression of carotid atherosclerosis was defined as newly detected plaque lesions on repeat ultrasonography. After dividing total serum bilirubin levels into tertiles, the association between total serum bilirubin at baseline and plaque progression status was analyzed.RESULTS: Among 1,381 T2DM patients, 599 (43.4%) were categorized as having plaque progression in their carotid arteries. Those with plaque progression were significantly older; showed a higher prevalence of hypertension, abdominal obesity, and chronic kidney disease; and had a longer duration of T2DM, higher levels of total cholesterol (TC), triglycerides, and insulin resistance, and lower total bilirubin concentrations than those with no plaque progression. When total serum bilirubin levels were divided into tertiles, the highest tertile group was younger than the lowest tertile group, with higher levels of TC and high-density lipoprotein cholesterol. Multiple logistic regression analysis demonstrated that higher serum bilirubin levels were associated with a significantly lower risk of CIMT progression (odds ratio, 0.584; 95% confidence interval, 0.392–0.870; p=0.008). Age (p<0.001), body mass index (p=0.023), and TC (p=0.019) were also associated with the progression of carotid atherosclerosis in T2DM patients.CONCLUSION: Total serum bilirubin is independently associated with progression of atherosclerosis in the carotid arteries in T2DM patients.

Atherosclerosis , Bilirubin , Body Mass Index , Carotid Arteries , Carotid Artery Diseases , Carotid Intima-Media Thickness , Cholesterol , Diabetes Mellitus, Type 2 , Humans , Hypertension , Insulin Resistance , Lipoproteins , Logistic Models , Obesity, Abdominal , Observational Study , Prevalence , Renal Insufficiency, Chronic , Triglycerides , Ultrasonography
Article in English | WPRIM | ID: wpr-786070


OBJECTIVE: Previous studies have separately reported the contributions of dietary factors to the risk of cardiovascular disease (CVD) and its markers, including blood pressure (BP) and lipid profile. This study systematically reviewed the current evidence on this issue in the Korean population.METHODS: Sixty-two studies from PubMed and Embase were included in this meta-analysis. We performed a random-effects model to analyze pooled odds ratios (ORs) and hazard ratios (HRs) and their 95% confidence intervals (CIs) for the consumption of 14 food items, three macro- and eight micro-nutrients, two dietary patterns, and three dietary indices.RESULTS: An analysis of pooled effect sizes from at least four individual study populations showed significant associations between coffee consumption and CVD (OR/HR, 0.71; 95% CI, 0.52–0.97) and elevated/high triglycerides (TG) (OR, 0.84; 95% CI, 0.78–0.90), sugar-sweetened beverage intake and elevated BP (OR/HR, 1.20; 95% CI, 1.09–1.33), and milk and dairy intake and elevated/high TG and elevated high-density lipoprotein cholesterol (HDL-C) (OR/HR, 0.82; 95% CI, 0.76–0.89 for both). Carbohydrate consumption and the low-carbohydrate-diet score were consistently related to an approximately 25% risk reduction for elevated TG and HDL-C. A lower risk of elevated total cholesterol, but not low-density lipoprotein, was additionally observed for those with a higher low-carbohydrate-diet score. A healthy dietary pattern was only associated with a reduced risk of elevated TG in the Korea National Cancer Screenee Cohort (OR, 0.81; 95% CI, 0.67–0.98).CONCLUSION: This study showed that milk and dairy and coffee had protective effects for CVD and its risk factors, such as BP and lipid profile, while sugar-sweetened beverages exerted harmful effects.

Asian Continental Ancestry Group , Beverages , Blood Pressure , Cardiovascular Diseases , Cholesterol , Coffee , Cohort Studies , Dyslipidemias , Humans , Hypertension , Korea , Lipoproteins , Milk , Odds Ratio , Risk Factors , Risk Reduction Behavior , Triglycerides
São Paulo; s.n; 2020. 187 p.
Thesis in Portuguese | LILACS | ID: biblio-1147573


Introdução: Há necessidade de métodos para avaliar a qualidade de alimentos à base de cereais a fim de promover a conscientização dos consumidores, a reformulação de alimentos e esforços políticos como diretrizes, rotulagem e alegações de saúde. Nesse sentido, a presença de 1 g de fibra em 10 g de carboidrato (razão ≤10:1) tem sido proposta na identificação de alimentos à base de cereais com melhor qualidade nutricional. Objetivo: O objetivo do presente estudo foi investigar a aplicação da razão ≤10:1 na identificação de alimentos à base de cereais saudáveis, sua associação com fatores de risco cardiometabólico, avaliar o panorama do consumo desses alimentos e seus determinantes, assim como o potencial impacto nutricional de estratégias para aumentar o seu consumo na população do município de São Paulo. Métodos: Foram utilizados dados provenientes do Inquérito de Saúde de São Paulo de 2003, 2008 e 2015. Trata-se de um estudo transversal de base populacional com amostra representativa de indivíduos de 12 anos ou mais residentes na área urbana do município. Participantes responderam a um questionário semiestruturado, a pelo menos um recordatório alimentar de 24 horas, e tiveram coletadas amostras de sangue, antropometria e medidas de pressão arterial. Alimentos do grupo dos cereais que atenderam à razão ≤10:1 tiveram o valor nutricional comparado aos alimentos que não se enquadraram nesse critério por meio de regressão linear com variância robusta. Investigamos a associação entre o consumo de alimentos ≤10:1 e fatores de risco cardiometabólico por meio de regressão linear múltipla (primeiro manuscrito). O consumo desses alimentos nos anos 2003, 2008 e 2015 foi comparado por meio de testes de tendência e sua associação com características sociodemográficas foi investigada por meio de regressão logística, assim como a predição de consumo para os próximos anos (segundo manuscrito). O impacto nutricional da substituição do arroz branco e do pão branco por seus correspondentes integrais foi avaliado por meio de mudanças na média de ingestão de alimentos que atenderam à razão ≤10:1, energia e nutrientes (terceiro manuscrito). Resultados: Alimentos que atenderam à razão ≤10:1 apresentaram menor carboidrato disponível (-3,0 g/porção), açúcar total (-7,4 g/porção), açúcar de adição (-7,2 g/porção) e gordura saturada (-0,7 g/porção); e maior fibra alimentar (+3,5 g/porção), proteína (+2,1 g/porção), potássio (+100,1 mg/porção), ferro (+0,9 mg/porção), selênio (+4,2 µg/porção), magnésio (+38,7 mg/porção) e zinco (+1,1 mg/porção). Cada aumento de 1% de energia (E) desses alimentos foi associado a níveis sanguíneos mais baixos de triacilglicerol (-10,7%), razão triacilglicerol/HDL-c (-14,9%), insulinemia de jejum (-13,6%) e HOMA-IR (-14,0%). De 2003 a 2015, houve aumento no consumo cereais que atenderam à razão ≤10:1 (de 0,9%E para 1,5%E) e na proporção da população consumindo esses alimentos (de 8,7% para 15,8%). Estima-se que 19,9% da população consumirá algum tipo de cereal atendendo ao critério ≤10:1 em 2030. Maior chance de consumo desses alimentos foi observada entre indivíduos mais velhos (+78%), mulheres (+28%), pessoas com ensino superior (+137%) e níveis mais altos de renda familiar (+135%), enquanto participantes que relataram etnia negra, parda ou indígena apresentaram menor chance (-30%). A substituição do arroz branco e do pão branco por arroz integral e pão integral, respectivamente, resultaria em aumento da ingestão de zinco (9,1%), cálcio (9,3%), vitamina E (18,8%), fibra alimentar (27,0%) e magnésio (52,9%), e na diminuição de carboidratos totais (-6,1%), folato (-6.6%), carboidratos disponíveis (-8,5%), vitamina B6 (-12,5%), vitamina B2 (-17,4%), e vitamina B1 (-20,7%). A ingestão de alimentos que atenderam à razão ≤10:1 pré e pós-modelagem foi de 4,0% e 69,4% da ingestão de cereais totais, respectivamente, um aumento de 220 g/d. Conclusões: A razão ≤10:1 identificou alimentos à base cereais com maior qualidade nutricional e a maior ingestão desses alimentos foi associada à redução de fatores de risco cardiometabólico relacionados à dislipidemia aterogênica e resistência à insulina. De 2003 a 2015, houve aumento no consumo de cereais que atenderam à razão ≤10:1, mas esse consumo permanece abaixo dos níveis recomendados. Menor probabilidade de ingestão de alimentos que atenderam à razão ≤10:1 foi observada entre mais jovens, sexo masculino, com menor escolaridade e renda familiar e de etnia negra, parda e indígena, nesse período. A substituição de alimentos à base de cereais por opções equivalentes que atenderam à razão ≤10:1 pode levar a mudanças favoráveis no conteúdo nutricional da dieta, além de notável aumento na proporção de cereais que atenderam à razão ≤10:1 em relação aos cereais totais.

Introduction: There is a pressing need for methods to assess the healthfulness of grain foods to promote consumer awareness, evidence-informed industry reformulations, and policy efforts such as guidelines, labeling, and health claims. In this sense, the presence per 10 g of carbohydrate of at least 1 g of fiber (≤10:1-ratio) has been proposed as a pragmatic metric to identify healthier grain products. Objective: To investigate the application of the ≤10:1-ratio to identify healthful grain foods, and its association with cardiometabolic risk factors, to evaluate trends and determinants of this intake, as well as to estimate the potential nutritional impact of strategies to increase the consumption of these foods in São Paulo population. Methods: Data came from the population-based study Health Survey of São Paulo (2003, 2008 and 2015). This is a cross-sectional, population-based study including a probabilistic sample of urban residents in São Paulo. Participants aged 12+ years answered a structured questionnaire, at least one 24-h dietary recall, had blood sample, anthropometric and blood pressure measurements collected. The nutritional value of grain foods meeting the ≤10:1-ratio was compared to grain foods not meeting this criterion using univariate linear regressions with robust variance. The association between the intake of grain foods meeting the ≤10:1-ratio and cardiometabolic risk factors was assessed by multivariable linear regression models (First manuscript). The consumption of grain foods meeting the ≤10:1-ratio from 2003 to 2015 was investigated using linear regression models. Determinants of these intakes and prediction of the prevalence of intake for the next years were estimated using multivariable logistic regression models (Second manuscript). We estimated the potential nutritional impact of replacing white rice and white bread with healthful equivalent options in mean change of healthful grain foods, energy and nutrients intake (Third manuscript). Results: Foods meeting the ≤10:1-ratio had lower available carbohydrate (-3.0 g/serving), total sugar (-7.4 g/serving), added sugar (-7.2 g/serving) and saturated fatty acids (-0.7 g/serving), as well as more dietary fiber (+3.5 g/serving), protein (+2.1 g/serving), potassium (+100.1 mg/serving), iron (+0.9 mg/serving), selenium (+4.2 µg/serving), magnesium (+38.7 mg/serving) and zinc (+1.1 mg/serving). Each increase in 1% of energy (E) of these foods was associated with lower levels of blood triacylglycerol (-10.7%), the triacylglycerol/HDL-c ratio (-14.9%), fasting insulin (-13.6%), and HOMA-IR (-14.0%). From 2003 to 2015, a growing trend in the intake of grain foods meeting the ≤10:1-ratio (from 0.9 %E to 1.5%E) was observed. Also, the proportion of the population consuming at least one-grain food meeting the ≤10:1-ratio increased from 8,7% in 2003 to 15,8% in 2015, and 19,9% of the population would be consuming some kind of healthful gain food by 2030. Older individuals (+78%), females (+28%), those with higher education (+137%), and higher family income (+135%) were more likely to consume grain foods meeting the ratio, whereas participants who self-reported black, brown or indigenous ethnicity were less likely to consume these foods (-30%). The substitution of white rice and white bread for brown rice and whole wheat bread, respectively, would result in increased intake of zinc (9.1%), calcium (9.3%), vitamin E (18.8%), dietary fiber (27.0%) and magnesium (52,9%), while decreased intake of total carbohydrate (-6.1%), available carbohydrate (-8.5%), vitamin B6 (-12,5%), vitamin B2 (-17,4%), and vitamin B1 (-20,7%) would be seen. Pre- and post-modeled healthful grain foods intake were 4,0% and 69,4% of total grain intake, respectively, an increase of 220 g/d. Conclusion: The ≤10:1-ratio identified grain foods with higher nutritional quality, and higher intakes of these foods were associated with cardiometabolic risk factors related to atherogenic dyslipidemia and insulin resistance. There was a growing trend to consume grain foods meeting the ≤10:1-ratio from 2003 to 2015, but this consumption continues to be far from recommended levels. Overall, younger individuals, males, those with lower education levels, lower family income, and who self-reported black, brown or indigenous ethnicity were less likely to consume grain foods meeting the ≤10:1-ratio from 2003 to 2015. Shifting consumption from usually eaten grain foods to healthful equivalent options may lead to favorable changes in nutrient content of the diet, in addition to a remarkable increase in healthful grain foods intake.

Socioeconomic Factors , Insulin Resistance , Carbohydrates , Dietary Fiber , Whole Foods , Nutritional Sciences , Lipoproteins
Acta bioquím. clín. latinoam ; 53(4): 469-476, dic. 2019. graf, tab
Article in Spanish | LILACS | ID: biblio-1124024


El propósito de este estudio fue analizar los cambios post prandiales en el perfil lipídico en respuesta a una comida típica argentina. Se extrajo sangre a 33 mujeres voluntarias después de 12 h de ayuno (T0), 1 h después de un desayuno estandarizado (T1) y 1 h después de un almuerzo estandarizado (T2). Se midieron los niveles de: colesterol total, colesterol de lipoproteínas de alta densidad (C-HDL), colesterol de lipoproteínas de baja densidad (C-LDL) y triglicéridos. Los datos se analizaron utilizando la prueba t de Student pareada. Para cada analito se calculó la diferencia porcentual media (DM%) en T1 y T2 respecto de T0 y se comparó con el valor de referencia del cambio (VRC). Las DM% mayores al VRC se consideraron clínicamente significativas. En T1 y T2, los valores de C-HDL fueron más bajos que en T0, mientras que los valores de C-LDL en T1 fueron más bajos que en T0. Los niveles de triglicéridos fueron significativamente más altos en T1 que en T0. En todos los casos, la variabilidad fue estadísticamente significativa, aunque no clínicamente. En este estudio puede observarse que el perfil de lípidos en T1 y T2 no mostró diferencias clínicamente significativas con respecto a los valores basales.

The purpose of the present study was to analyze postprandial lipid profile changes in response to a typical Argentine meal. Blood was collected from 33 female volunteers after a 12 h fasting period (T0), 1 h after a standardized breakfast (T1) and 1 h after a standardized lunch (T2). The levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides were measured. Data were analyzed using paired Student's t-test. Mean difference % (MD %) was calculated for each analyte at T1 and T2 and was further compared with reference change value (RCV). MDs % higher than RCV were considered clinically significant. At T1 and T2, HDL-C values were lower than at T0, whereas LDL-C values at T1 were lower than at T0. Triglycerides levels were significantly higher at T1 than baseline values. In all cases, variability was statistically, though not clinically, significant. This study demonstrates that at T1 and T2 lipid profile showed no clinically significant differences with respect to basal values.

O objetivo do presente estudo foi analisar as alterações do perfil lipídico pós-prandial em resposta a uma refeição típica argentina. O sangue foi coletado de 33 mulheres voluntárias após um período de jejum de 12 horas (T0),1 h após um café da manhã padronizado (T1) e 1 h após um almoço padronizado (T2). Foram medidos os níveis de: colesterol total (CT), colesterol HDL (C-HDL), colesterol LDL (C-LDL) e triglicérides. Os dados foram analisados utilizando o teste t de Student pareado. A diferença média% (DM%) foi calculada para cada analito em T1 e T2 e foi comparada com o valor de mudança de referência (VRC). Os MDs% maiores que o VRC foram considerados clinicamente significativos. Em T1 e T2, os valores de C-HDL foram menores que em T0, enquanto os valores de C-LDL em T1 foram menores que em T0. Os níveis de triglicérides foram significativamente maiores em T1 do que os valores basais. Em todos os casos, a variabilidade foi estatisticamente, embora não clinicamente, significativa. Este estudo demonstra que no perfil lipídico em T1 e T2 não houve diferenças clinicamente significativas em relação aos valores basais.

Humans , Triglycerides , Blood , Cholesterol , Fasting , Fasting/blood , Determination , Meals , Breakfast , Pre-Analytical Phase/statistics & numerical data , Lipids , Lipids/analysis , Lipoproteins , Cholesterol, HDL , Cholesterol, LDL , Powders , Referral and Consultation , Coffee , Lunch , Lipoproteins, LDL
Acta méd. colomb ; 44(3): 8-15, July-Sept. 2019. tab
Article in English | LILACS, COLNAL | ID: biblio-1098019


Abstract Introduction: Free thyroxine (T4), free triiodothyronine thyroid (T3) and thyroid stimulating hormone (TSH) are recognized as regulators of lipid synthesis, mobilization and degradation. Objective: To find a relationship between dyslipidemia and thyroid disease in an adult population. Methods: This was a cross-sectional study of 819 individuals. TSH, free T4, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured. Results: The general population showed normal TC, normal LDL-C, low HDL-C, and elevated TG. The prevalence of dyslipidemia was as follows: elevated TC 31.9%, HDL-C <40 mg/dL 57.9%, elevated LDL-C 24.3% and TG ≥200 mg/dL 26%. The prevalence of TSH ≥4.6 mIU/L was 8.1%. The prevalence of overt hypothyroidism was 1.2%, and that of subclinical hypothyroidism was 6.7%. The prevalences of elevated TC in individuals with overt hypothyroidism and normal thyroid levels were 50.0% and 31.6%, respectively. However, in those with subclinical hypothyroidism, the prevalences were 43.6% and 31.0% (p=0.04) for elevated TC and 40.0% and 23.2% (p=0.006) for elevated LDL-C. A significant relationship was found between TSH ≥4.6 mIU/L and elevated TC (OR=1.9, p=0.01) and elevated LDL-C (OR=2.5, p=0.001); the frequency of elevated LDL-C was 2.2 times greater in people with subclinical hypothyroidism than in people with normal TSH levels. Conclusion: Given agricultural workers' particular socioeconomic conditions and access to the health system, it is important to design screening programs for biomarkers that allow early detection of changes in thyroid hormones, TSH and lipid profiles to provide this population with preventive interventions to reduce morbimortality due to cardiovascular events (Acta Med Colomb 2019; 44. DOI:

Resumen Introducción: tiroxina libre (T4L), triyodo tironina libre (T3L) y hormona estimulante del tiroides (TSH), se reconocen como reguladoras de síntesis, movilización y degradación de lípidos. Objetivo: encontrar una relación entre dislipidemias y enfermedad tiroidea en una población adulta. Métodos: este fue un estudio de corte transversal, en 819 individuos. Se midieron TSH, T4L, colesterol total (CT), colesterol en lipoproteínas de baja densidad (C-LDL), colesterol en lipopro-teínas de alta densidad (C-HDL) y triglicéridos (TG). Resultados: la población general mostró CT, C-LDL normales, C-HDL bajo y TG elevados. La prevalencia de dislipidemia fue: CT elevado 31.9%, C-HDL < 40 mg/dL 57.9%. C-LDL alto 24.3% y TG ≥200 mg/dL, 26%. La frecuencia de TSH ≥ 4.6 mIU/L fue 8.1%. La prevalencia de hipotiroidismo manifiesto fue de 1.2% y la de hipotiroidismo subclínico de 6.7%. La prevalencia de CT elevado en individuos con hipotiroidismo manifiesto y en normales fue de 50.0% y 31.6% respectivamente. Mientras en hipotiroidismo subclínico fue de 43.6% y 31.0% p: 0.04 para CT (elevado); 40.0% y 23.2% p: 0.006 para C-LDL elevado. Se encontró relación significativa entre TSH ≥4.6 mIU/L con CT elevado (OR 1.9 p 0.01) y C-LDL elevada (OR 2.5 p: 0.001); la frecuencia de C-LDL elevado fue de 2.2 veces en personas con hipotiroidismo subclínico con relación a personas con niveles normales de TSH. Conclusión: en los trabajadores del agro, por sus particulares condiciones socioeconómicas y de acceso al sistema de salud, es importante diseñar programas de tamizaje de biomarcadores que permitan avizorar de manera precoz cambios en las hormonas tiroideas, TSH y perfil lipídico, para realizar intervenciones de prevención secundaria que contribuyan a la disminución de la morbimortalidad por eventos cardiovasculares. (Acta Med Colomb 2019; 44. DOI:

Humans , Male , Female , Middle Aged , Dyslipidemias , Hypothyroidism , Thyroid Hormones , Unified Health System , Farmers , Lipoproteins