Increased trunk fat along with decreased peripheral fat as an important predictor of hypertriglyceridaemia & hypercholesterolaemia in Indians with HIV infection

Background & objectives: Dyslipidaemia is a major contributor to cardiovascular morbidity, which is increased in HIV. Data on dyslipidaemia in Indians with HIV are scant. This study was undertaken to determine the predictors of dyslipidaemia and lipoatrophy in Indians with HIV infection and their relation with body composition parameters. Methods: A total of 382 consecutive patients with HIV infection were screened, of whom 257 clinically stable patients, without any acute comorbidity, having at least one year follow up underwent biochemical and DEXA analysis. Results: The most common dyslipidaemia was hypertriglyceridaemia (47.08%), followed by hypercholesterolaemia [total cholesterol (TC)] (38.91%) and low high-density lipoprotein (HDL) cholesterol (38.52%), in patients having median age 37 (32-42) yr and HIV duration 57 (33-101) months. Patients with at least one dyslipidaemia (78.99%) had significantly higher insulin resistance (IR), per cent body fat, per cent trunk fat (PTF) and trunk limb fat ratio (TLFR). Baseline CD4 count and delta CD4 count (change in CD4 count 6-12 months following ART) had significant inverse correlation with triglycerides and TC. Patients with highest triglycerides and cholesterol quartiles had significantly higher immune reconstitution, metabolic syndrome, IR, trunk fat mass (FM), PTF and TLFR, with comparable total FM. Logistic regression revealed that body mass index, HIV duration and PTF were independent predictors of hypertriglyceridaemia, with only PTF being significant predictor of hypercholesterolaemia. Every unit increase in PTF was associated with 13 and 4.1 per cent increased hypertriglyceridaemia and hypercholesterolaemia. Lipoatrophy was present in 8.57 per cent patients and was a poor predictor of dyslipidaemia. Interpretation & conclusions: High occurrence of dyslipidaemia was observed in patients with HIV on anti retroviral therapy. Central adiposity (TFM) was the most important predictor of dyslipidaemia in these patients.

Importancia de la interpretación del colesterol total y de los triglicéridos para el diagnóstico de las dislipidemias / Importance of the interpretation of the total cholesterol and triglyceride content for the diagnosis of dyslipidemias

Objetivo: describir la importancia de la interpretación del colesterol total y de los triglicéridos para el diagnóstico de las dislipidemias. Métodos: se evaluaron 2 159 resultados de lipidogramas, realizados en el Laboratorio de Bioquímica, del Instituto de Angiología y Cirugía Vascular entre enero-2008-2009. Se utilizaron las recomendaciones de expertos y las referencias de los diagnosticadores para decidir la positividad o no del resultado. Resultados: se encontró que el colesterol fue positivo en el 32 por ciento de las órdenes según las recomendaciones y el 9,96 por ciento según la referencia. En el mismo orden los triglicéridos fueron positivos en el 43,14 por ciento y en el 38,96 por ciento, respectivamente. Estos hallazgos denotaron que al seguir los criterios de las referencias se deja de diagnosticar una hipercolesterolemia o una hipertrigliceridemia en el 68,88 y 9,68 por ciento respectivamente. Por las recomendacione de expertos se encontró que el orden de frecuencias de las dislipidemias fue: hipertrigliceridemia (42,42 por ciento), hipercolesterolemia (30,33 por ciento) e hiperlipemia combinada (27,25 por ciento). Al constatar la gravedad de las dos primeras se observó que la hipercolesterolemia era: leve (59,89 por ciento), moderada (31,59 por ciento) y grave (8,52 por ciento), mientras que la hipertrigliceridemia era moderada (51,67 por ciento) y grave (48,33 por ciento). Conclusiones: la interpretación correcta de los resultado del estudio lipídico es de gran importancia y representa un aporte social para el diagnóstico de una dislipidemia(AU)

Objective: to describe the importance of right interpretation of the total cholesterol and triglyceride content for the diagnosis of the dyslipidemias. Methods: evaluation of 2 159 results of study of lipid analyses made at the laboratory of biochemistry of the Institute of Angiology and Vascular Surgery from January 2008 to January 2009. The experts' recommendations and diagnosticians' references were used to decide whether the results were positive or not. Results: it was found that the cholesterol indexes were positive in 32 percent of the analyses according to the recommendations and in 9.96 percent according to the references. Similarly, triglycerides indexes were positive in 43.14 percent and 38.96 percent, respectively. These findings indicated that applying the criteria of the diagnosticians' references, hypercholesterolemia or hypertriglyceridemia was not duly diagnosed in 68.88 percent and 9.68 of analyses, respectively. According to the experts' recommendations, the order of frequency of dyslipidemias was hypertriglyceridaemia (42.42 percent), hypercholesterolemia (30.33 percent) and combined hyperlipidemia (27.25 percent). Considering the severity of the two first, it was observed that hypercholesterolemia was mild (59.89 percent), moderate (31.59 percent) and severe (8.52 percent) whereas hypertriglyceridemia was moderate (51.67 percent) and severe (48.33 percent). Conclusions: the correct interpretation of results of the lipid study is highly significant and represents a social contribution to diagnosis of dyslipidemia(AU)

Influence of hypertriglyceridaemia on the pahtological types and prognosis of acute pancreatitis / 中国实用内科杂志

Objective The author investigated the clinical features of the the patients with acute pancreatitis and hyperlipaemia (hypertriglyceridaemia),in order to intensify the knowledge of the condition.Methods Forty-three patients with acute pancreatitis were randomly selected and assigned into 2 grups,i.e.,those with hyperlipaemia (11cases) and those with billiary type (32 cases).Results Among the 43 cases,7 were acute necrotizing pancreatitis (5 in hyperlipaemia group).Enumeration correlation demonstrated significant positive correlation between hyperglyceridaemia and the necrotizing type of acute pancreatitis (? 2=6.58,P)or diabetics were significantly higher in hyperglyceridaemia group than in acute billiary pancreatitis group, and so was the life-threatening complications.Conclusion ①Hyperglyceridaemia bears significant positive correlation to the necrotizing type of acute pancreatitis and its life-threatening complications as well.②Diet control,reducing body weight and application of anti-hyperlipaemia drugs will be helpful in prevention and treatment of the relapse of the disease.