Exploring the Interplay between Diabetes and Lp(a): Implications for Cardiovascular Risk.

PURPOSE OF REVIEW: The objective of this manuscript is to review and describe the relationship between Lp(a) and diabetes, exploring both their association and synergy as cardiovascular risk factors, while also describing the current evidence regarding the potential connection between low levels of Lp(a) and the presence of diabetes. RECENT FINDINGS: Epidemiological studies suggest a potential relationship between low to very low levels of Lp(a) and diabetes. Lipoprotein(a), or Lp(a), is an intriguing lipoprotein of genetic origin, yet its biological function remains unknown. Elevated levels of Lp(a) are associated with an increased risk of cardiovascular atherosclerosis, and coexisting diabetes status confers an even higher risk. On the other hand, epidemiological and genetic studies have paradoxically suggested a potential relationship between low to very low levels of Lp(a) and diabetes. While new pharmacological strategies are being developed to reduce Lp(a) levels, the dual aspects of this lipoprotein's behavior need to be elucidated in the near future.

Applicability of Artificial Intelligence in the Field of Clinical Lipidology:A Narrative Review

The development of advanced technologies in artificial intelligence (AI) has expanded its applications across various fields. Machine learning (ML), a subcategory of AI, enables computers to recognize patterns within extensive datasets. Furthermore, deep learning, a specialized form of ML, processes inputs through neural network architectures inspired by biological processes. The field of clinical lipidology has experienced significant growth over the past few years, and recently, it has begun to intersect with AI. Consequently, the purpose of this narrative review is to examine the applications of AI in clinical lipidology. This review evaluates various publications concerning the diagnosis of familial hypercholesterolemia, estimation of low-density lipoprotein cholesterol (LDL-C) levels, prediction of lipid goal attainment, challenges associated with statin use, and the influence of cardiometabolic and dietary factors on the discordance between apolipoprotein B and LDL-C. Given the concerns surrounding AI techniques, such as ethical dilemmas, opacity, limited reproducibility, and methodological constraints, it is prudent to establish a framework that enables the medical community to accurately interpret and utilize these emerging technological tools.

Elevated Lipoprotein(a) Levels and Atrial Fibrillation: A Systematic Review

Objective@#The role of lipoprotein(a) (Lp[a]) as a possibly causal risk factor for atherosclerotic cardiovascular disease has been well established. However, the clinical evidence regarding the association between Lp(a) levels and atrial fibrillation (AF) remains limited and inconsistent. This study aimed to analyze the association between elevated Lp(a) levels or single-nucleotide polymorphisms (SNPs) related to high levels of Lp(a) and AF. @*Methods@#This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was performed to identify studies that evaluated the association between Lp(a) levels or SNPs related to high levels of Lp(a) and AF. Observational studies with a cross-sectional, casecontrol, or cohort design were included in this systematic review, without limitations according to language, country, or publication type. @*Results@#Eleven observational studies including 1,246,817 patients were eligible for this systematic review. Two cross-sectional studies, 5 prospective/retrospective cohort studies, and 4 Mendelian randomization studies were analyzed. Two cross-sectional studies that compared Lp(a) levels between patients with and without AF showed conflicting results.Cohort studies that evaluated the incidence of AF according to Lp(a) levels showed different results: no association (3 studies), a positive association (1 study), and an inverse relationship (1 study). Finally, Mendelian randomization studies also showed heterogeneous results (positive association: 2 studies; inverse association: 1 study; no association: 1 study). @*Conclusion@#Although there could be an association between Lp(a) levels and AF, the results of the studies published to date are contradictory and not yet definitive. Therefore, further research should clarify this issue.

Aging induced changes in ice nucleation activity of combustion aerosol as determined by near edge X-ray absorption fine structure (NEXAFS) spectroscopy.

Fresh soot particles are generally hydrophobic, however, particle hydrophilicity can be increased through atmospheric aging processes. At present little is known on how particle chemical composition and hydrophilicity change upon atmospheric aging and associated uncertainties governing the ice cloud formation potential of soot. Here we sampled two propane flame soots referred to as brown and black soot, characterized as organic carbon rich and poor, respectively. We investigated how the ice nucleation activity of these particles changed through aging in water and aqueous acidic solutions, using a continuous flow diffusion chamber operated at cirrus cloud temperatures (T ≤ 233 K). Single aggregates of both unaged and aged soot were chemically characterized by scanning transmission X-ray microscopy and near edge X-ray absorption fine structure (STXM/NEXAFS) measurements. Particle wettability was determined through water sorption measurements. Unaged black and brown soot particles exhibited significantly different ice nucleation activities. Our experiments revealed significantly enhanced ice nucleation activity of the aged soot particles compared to the fresh samples, lowering the required relative humidities at which ice formation can take place at T = 218 K by up to 15% with respect to water (ΔRHi ≈ 25%). We observed an enhanced water uptake capacity for the aged compared to the unaged samples, which was more pronounced for the black soot. From these measurements we concluded that there is a change in ice nucleation mechanism when aging brown soot. Comparison of the NEXAFS spectra of unaged soot samples revealed a unique spectral feature around 287.5 eV in the case of black soot that was absent for the brown soot, indicative of carbon with hydroxyl functionalities. Comparison of the NEXAFS spectra of unaged and aged soot particles indicates changes in organic functional groups, and the aged spectra were found to be largely similar across soot types, with the exception of the water aged brown soot. Overall, we conclude that atmospheric aging is important to representatively assess the ice cloud formation activity of soot particles.

Influence of humidity and iron(iii) on photodegradation of atmospheric secondary organic aerosol particles.

The absorption of solar actinic radiation by atmospheric secondary organic aerosol (SOA) particles drives condensed-phase photochemical processes, which lead to particle mass loss by the production of CO, CO2, hydrocarbons, and various oxygenated volatile organic compounds (OVOCs). We examined the influence of relative humidity (RH) and Fe(iii) content on the OVOC release and subsequent mass loss from secondary organic aerosol material (SOM) during UV irradiation. The samples were generated in a flow tube reactor from the oxidation of d-limonene by ozone. The SOM was collected with a Micro Orifice Uniform Deposit Impactor (MOUDI) on CaF2 windows. To selected samples, a variable amount of FeCl3 was added before irradiation. The resulting SOM samples, with or without added FeCl3, were irradiated with a 305 nm light-emitting diode and the release of several OVOCs, including acetic acid, acetone, formic acid and acetaldehyde, was measured with a Proton Transfer Reaction Time-of-Flight Mass Spectrometer (PTR-ToF-MS). The release of OVOCs from photodegradation of SOM at typical ambient mid-values of RH (30-70%) was 2-4 times higher than under dry conditions. The release of OVOCs was slightly enhanced in the presence of low concentrations of iron (0.04 Fe molar ratio) but it was suppressed at higher concentrations (0.50 Fe molar ratio) of iron indicating the existence of a complicated radical chemistry driving the photodegradation of SOM. Our findings suggest that the presence of iron in atmospheric aerosol particles will either increase or decrease release of OVOCs due to the photodegradation of SOM depending on whether the relative iron concentration is low or high, respectively. At atmospherically relevant RH conditions, the expected fractional mass loss induced by these photochemical processes from limonene SOA particles would be between 2 and 4% of particle mass per hour. Therefore, photodegradation is an important aging mechanism for this type of SOA.