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Statins have been used in clinical practice for more than 40 years to treat and prevent atherosclerosis and its complications. The results of observational studies indicate that, despite a large evidence base, statins in Russia are still prescribed in low doses, for a maximum of 6 months, leading to a low percentage of achieving the target levels of low-density lipoprotein cholesterol and, thus, to a high residual risk of cardiovascular complications. This paper presents a literature review and analysis of the basic principles of statin therapy in primary prevention, intensive lipid-lowering therapy in patients with very high cardiovascular risk, as well as key safety updates on cholesterol decrease for various organs and systems (liver, kidneys, muscles, nervous system), and carbohydrate metabolism. The article also provides a brief overview of new international guidelines to optimize the diagnosis and treatment of dyslipidemias, which can be useful in the day-to-day practice of an internal medicine specialist.

Introduction: An altered serum lipid profile and lipoprotein levels are major modifiable risk factors for hypertension. Apolipoprotein A1 and B100 (ApoA1 and ApoB100) are the chief structural proteins of High-density Lipoprotein Cholesterol (HDL-C) and Low-density Lipoprotein Cholesterol (LDL-C), respectively. The level of ApoB in the serum represents overall atherogenicity, whereas the level of ApoA1 can indicate total antiatherogenicity. Aim: To evaluate the serum levels of ApoA1 and ApoB in the first-degree relatives of individuals with essential hypertension. Materials and Methods: This cross-sectional observational study was conducted in the Clinical Biochemistry laboratory in association with the Department of General Medicine at SCB Medical College and Hospital, Cuttack, Odisha, India, from February 2018 to March 2019. It consisted of 165 participants: group I included hypertensive patients (n=55); group II included first-degree relatives of the above hypertensive patients (n=55); and group III included non hypertensive healthy age-matched controls (n=55). The waist-hip ratio, Blood Pressure (BP), fasting plasma glucose, serum cholesterol, triglycerides, HDL-C, LDL-C, ApoA1, ApoB, and the ApoB/ApoA1 ratio were all measured. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 25.0. Results: The mean age of subjects in groups I, II, and III was 49±8.3, 38±5.2, and 37±5.4 years, respectively, with males constituting 56% and females 44% of the total participants. The ApoA1 levels were lowest in group I (104.9±16.3 mg/dL) and highest in group III (117.4±7.3 mg/dL). The serum ApoB levels and the ratio of ApoB/ApoA1 were highest in group I (104.2±14.1; 1.1±0.64 mg/dL) and lowest in group III (60.9±18.2; 0.5±0.15 mg/dL). A highly significant negative correlation (r=-0.40, p

Abstract Background While previous reports have shown that hepatitis B virus (HBV) infection affects lipid metabolism and vice versa, the impact of dyslipidemia on the functional cure of HBV infection following peginterferon alfa (PegIFNα) therapy remains unknown. Hence, this study aimed to investigate the effect of dyslipidemia on hepatitis B surface antigen (HBsAg) clearance and develop a nomogram model for predicting patients for whom PegIFNα therapy is indicated. Methods A total of 160 nucleos(t)ide analogues (NAs)- experienced chronic hepatitis B (CHB) patients treated with PegIFNα (180 µg/week) were enrolled in this study. The relationship between serum lipid and HBsAg clearance was analysed. Univariate and multivariate COX analyses were used to construct and plot the nomogram model. The area under the receiver operating characteristic curve (AUC) and calibration curve were used to evaluate the discrimination and calibration of the model, respectively. Results After 48 weeks of PegIFNα therapy, a total of 33 patients in the cohort achieved HBsAg clearance. Univariate and multivariate COX analyses indicated that dyslipidemia was significantly associated with HBsAg clearance and was an independent predictor of HBsAg clearance (HR = 0.243, P = 0.001). Kaplan-Meier survival analyses show that cumulative HBsAg clearance was significantly higher in the normolipidemic group than in the dyslipidemia group (log-rank test, P = 0.007). During the treatment, triglyceride showed an increasing trend, while the levels of total cholesterol, high-density lipoprotein, low-density lipoprotein, apolipoprotein A1 and apolipoprotein B decreased. Dyslipidemia and other indicators independently associated with HBsAg clearance were used to construct the nomogram model. The AUC of the model at 36-week and 48-week were 0.879 and 0.856, and the model demonstrated good discrimination and calibration. Conclusion Dyslipidemia can affect the antiviral efficacy of PegIFNα in NAs-experienced CHB patients. Our findings suggest that the nomogram model constructed using serum lipid has good predictive power and may help physicians to identify the superior patients for PegIFNα therapy.

Abstract Background Chronic kidney disease is associated with several complications with higher prevalence and intensity at lower glomerular filtration rate. Albuminuria is the traditional biomarker of kidney damage. Although albuminuria can contribute to renal function decline, only a few studies have been published on whether albuminuria is associated with concurrent complications of chronic kidney disease. The aim of this work was to identify the relation between albuminuria and some of concurrent complications of chronic kidney disease among children. Methods A cross-sectional study included fifty children with chronic kidney disease stages 2–5. Measurement of blood pressure, hemoglobin, serum bicarbonate, calcium, phosphorus, albumin, and lipid profile was done. Urinary albumin/creatinine ratio was determined. The relation between albuminuria and some of the complications of chronic kidney disease among children was studied. Results The study included 50 patients aged 3–14 years. Dyslipidemia was present in 62% of the patients, acidosis in 56%, anemia in 38%, hyperphosphatemia in 34%, hypertension in 28%, and hypocalcemia in 22%. Eighty-eight percent had albuminuria, 26% had microalbuminuria, and 62% had macroalbuminuria. A statistically significant relation was found between the degree of albuminuria and presence of anemia and hyperphosphatemia. But no significant relation was found between the degree of albuminuria and presence of hypertension, dyslipidemia, acidosis, or hypocalcemia. Conclusion There is a significant relation between the degree of albuminuria and presence of anemia and hyperphosphatemia among children with chronic kidney disease.

Abstract Previous studies have reported that a potential association between exposure to outdoor light at night (LAN) and diseases. However, there is no evidence regarding the impacts of outdoor LAN exposure on lipid metabolism in humans. This study aims to evaluate the associations between outdoor LAN exposure and the prevalence of dyslipidemia, using a nationwide sample of 10,894 adults aged ≥ 45 years from 150 investigated sites across China in 2011–2012. Outdoor LAN exposure was assessed by using satellite imaging data. The prevalence ratio (PR) was calculated. The present study found that a per-quintile LAN exposure was positively associated with the prevalence of high LDL-cholesterol (PR = 1.10, 95% CI = 1.04–1.16), high triglyceride (PR = 1.07, 95% CI = 1.03–1.12), low HDL-cholesterol (PR = 1.11, 95% CI = 1.08–1.16), and dyslipidemia (PR = 1.06, 95% CI = 1.03–1.09). The fifth quintile of LAN exposure was associated with a significantly increased prevalence of dyslipidemia (PR = 1.20, 95% CI = 1.07–1.35) compared with the first quintile of exposure. Long-term exposure to outdoor LAN was positively associated with dyslipidemia prevalence. Public policies aimed at reducing light pollution at night, guided by the spatial distribution patterns, could lessen the adverse effects.

Abstract Backgrounds High-intensity statin is recommended for patients undergoing percutaneous coronary intervention (PCI), and ezetimibe is recommended to be added in patients not achieving low-density lipoprotein cholesterol (LDL-C) targets. Moderate-intensity statin plus ezetimibe can reduce LDL-C levels similar to high-intensity statin. The aim of this study is to examine the long-term efficacy and safety of moderate-intensity statin plus ezetimibe as the first-line strategy compared to high-intensity statin in patients undergoing PCI. Method Data was obtained from the Health Insurance Review and Assessment Service database of South Korea. Patients who underwent PCI from 2012 to 2017 were included. The primary efficacy endpoint was major adverse cardiac cerebrovascular events (MACCEs), a composite of all-cause death, revascularization, or ischemic stroke. The safety endpoint was new-onset diabetes mellitus (DM). Results A total of 45,501 patients received high-intensity statin (n = 38,340) or moderate-intensity statin plus ezetimibe (n = 7,161). Among propensity-score-matched 7,161 pairs, MACCEs occurred in 1,460 patients with high-intensity statin and 1,406 patients with moderate-intensity statin plus ezetimibe (33.8% vs. 31.9%, hazard ratio 0.96, 95% confidence interval 0.89–1.03, P = 0.27) at a median follow-up of 2.7 years. DM was newly diagnosed in 398 patients with high-intensity statin and 342 patients with moderate-intensity statin plus ezetimibe (12.5% vs. 10.7%; hazard ratio 0.84, 95% confidence interval 0.73–0.97, P = 0.02). Conclusion In patients undergoing PCI, moderate-intensity statin plus ezetimibe demonstrated a similar risk of MACCEs but a lower risk of new-onset DM than high-intensity statin. Early combination treatment of moderate-intensity statin and ezetimibe may be a useful and safe lipid-lowering strategy after PCI. Graphical abstract Cumulative incidence according to the first-line lipid-lowering strategy in patients undergoing percutaneous coronary intervention. Abbreviation: MACCE, major adverse cardiac cerebrovascular events; PCI, percutaneous coronary intervention.

Abstract Chronic kidney disease (CKD) is a complex disease that affects the global population’s health, with dyslipidemia being one of its major complications. High density lipoprotein (HDL) is regarded as the “hero” in the bloodstream due to its role in reverse cholesterol transport, which lowers cholesterol levels in the blood and prevents atherosclerosis. However, in the complex internal environment of CKD, even this “hero” may struggle to perform its beneficial functions and could potentially become harmful. This article reviews HDL heterogeneity, HDL subclasses, functional changes in HDL during the progression of CKD, and the application of HDL in CKD treatment. This review aims to deepen understanding of lipid metabolism abnormalities in CKD patients and provide a basis for new therapeutic strategies.

Abstract This study investigates the prevalence of dyslipidemia and its association with disease activity in children with Juvenile Dermatomyositis (JDM). A retrospective chart review of 142 JDM patients who had fasting lipid profiles was conducted. Clinical, and laboratory indicators of disease activity at the time of lipid assessment were obtained. JDM patients displayed a high prevalence (72%) of abnormal or borderline fasting lipid profiles, particularly involving HDL and triglycerides. Treatment-naïve patients exhibited the most significant dyslipidemia, with significantly lower median HDL levels compared to those on medication (30 vs. 49 mg/dL, p

Abstract This study aimed to compare the serum lipid profiles between tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) in the long-term treatment of chronic hepatitis B (CHB). We analyzed data from treatment-naïve CHB patients administered with TDF or TAF, collected from electronic medical records between May 2017 and September 2022. Serum lipid indices, including total cholesterol (TC), triglycerides (TG), low-density (LDL) and high-density lipoprotein (HDL), and their ratios (TC/HDL, LDL/HDL), were assessed at baseline, and at 48 and 96 weeks. Propensity score matching (PSM) adjusted for baseline differences between groups. From 2344 patients initially screened, 418 were included for the 48-week analysis (265 on TDF, 153 on TAF) and 292 for the 96-week analysis (238 on TDF, 54 on TAF). At 48 weeks, comparing the serum lipid indicators between the pre- and post-treatment, TDF significantly reduced TC and TC/HDL, whereas TAF induced widespread dyslipidemia, characterized by elevated levels of TC, TG, LDL, LDL/HDL, and TC/HDL, and reduced HDL (P

Objective To assess the efficacy and safety of Semaglutide (a GLP-1 receptor agonist) in obese patients with and without Type-II Diabetes Mellitus. Methods This observational analytic cohort study was conducted in a private medical institute in Karachi Pakistan; from August 2022 to January 2023. A total of 65 obese individuals >18 years of age, with or without T2D were included. Semaglutide was started with an initial dose of 0.25 mg with an increase in dose to 0.5 mg, 1 mg and 2 mg with gap of 4 weeks between each dose escalation. Patients were kept on the maximally tolerated dose, not exceeding 2 mg/week. Patients were evaluated on the first and second follow-up at 3 and 6 months respectively, for the same parameters as noted at the initial visit, along with documentation of any adverse effect. Results Out of 65 patients, 49.2% were female and 50.8% were male. Mean age was 49.16 ± 14.20 years. 47.7% of the patients had hypertension, 46.2% had diabetes mellitus, 35.4% had dyslipidemia and 13.8% had ischemic heart disease. All patients were using 0.5 mg of semaglutide after three months, however by six months 33.8% were using 1 mg, and 24.6% were on 2 mg, whereas 40% decided to adhere to 0.5 mg and only 1.5% decided to reduce the dose to 0.25 mg due to adverse effects. Patients reported start of the first adverse effect by 3.44 ± 2.27 weeks of starting the drug. By the end of three months, 55.4% of patients in our study reported adverse effect, which declined to 34.5% by the end of six months, and the majority being mild to moderate and the most frequent side effects were gastrointestinal in origin. There was no significant difference in side effect profile in between those with and without diabetes mellitus. The average weight loss was 5.81 ± 2.64 kg and 9.86 ± 3.54 kg after three and six months respectively and the amount of weight loss was almost equal in those with and without T2D. A significant decline was observed in the average HbA1c levels, body mass index (p =

Abstract Objective Cytochrome P450 2C19 (CYP2C19) plays an vital role in the course of cardiovascular and cerebrovascular diseases by affecting lipid metabolism. Triglyceride-glucose (TyG) is a comprehensive index composed of triglyceride and blood glucose, has relationship with some diseases. There was no research report on the association CYP2C19 polymorphisms, TyG with premature cerebral infarction (CI) (onset ≤ 65 years old) susceptibility. Methods This study retrospectively analyzed 1953 CI patients aged ≤ 65 years old from December 2018 to March 2024, and 1919 age-matched individuals with non-CI as controls. The relationship between CYP2C19 polymorphisms, TyG and premature CI risk were analyzed. Results The proportion of hypertension, and diabetes mellitus in patients with premature CI was higher than those in controls. The serum total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), and TyG levels in patients with premature CI were significantly higher than those in controls (all p

Abstract Background Currently, studies on the formation mechanism for the enlargement of arachnoid granulation (AG) are lacking. The impact of dyslipidemia on the formation of multiple large arachnoid granulations (LAGs) was studied in this research. Methods The study included patients diagnosed with cerebral venous sinus stenosis (CVSS) related to LAG. The number of LAGs was assessed via high-resolution black blood magnetic resonance imaging. The relationships between blood lipids and multiple LAGs were explored to evaluate the effects of dyslipidemia on the formation of multiple LAGs. Results A total of 163 participants with a diagnosis of LAG were included. The levels of total cholesterol (TC) (P = 0.004) and low-density lipoprotein cholesterol (LDL-c) (P = 0.01) in the multiple LAGs group were greater than those in the non-multiple LAGs group. Multivariate logistic regression analysis revealed that TC (odds ratio (OR), 2.19; 95% confidence interval (CI), 1.26–3.80; P = 0.006) and LDL-c (OR, 2.18; 95% CI, 1.16–4.07; P = 0.02) were independently associated with multiple LAGs. Conclusions TC and LDL-c are independently related to multiple LAGs, indicating that dyslipidemia may be a potential cause of CVSS. Therefore, monitoring blood lipids may be necessary for patients with LAGs.

Abstract Background Cardiovascular diseases are a leading cause of mortality and a significant contributor to temporary and permanent disabilities worldwide. This study aimed to investigate the burden of primary and residual cardiometabolic risk factors in a sample of young adults in the Russian city of Kazan. Methods This case-control study used the Cardiometabolic Disease Staging (CMDS) classification system, which has been validated in several countries. The study included 191 individuals aged 25–44 years who met the inclusion criteria but did not meet any exclusion criteria. Data collection involved a patient card with questions from the World Health Organization’s STEPS instrument, face-to-face patient interviews, and a physical examination. Anthropometric assessments included height, weight, and waist circumference measurements. Body composition was evaluated using bioelectrical impedance measurements. Patients also underwent in-depth laboratory biochemical analyses. Results The study cohort was comprised of 97 females (50.8%) and 94 males (49.2%). The median age of participants was 35.00 years [IQR: 30.00–39.00]. The study cohort showed an increase in all anthropometric parameters, with abdominal obesity and overweight reaching 100% in the CMDS 3. Apart from atherogenic lipids and raised blood pressure, other risk factors that precipitate residual risk and were not part of CMDS, such as insulin levels, insulin resistance, leptin values, and hyperuricemia, increased as CMDS levels increased. Conclusions The prevalence of cardiometabolic risk factors was high in young adults in Kazan. This study highlights the need for the early identification and management of cardiometabolic risk factors in young adults to prevent the development of cardiovascular diseases later in life.

Abstract Background Polycystic ovary syndrome(PCOS) is one of the main factors leading to infertility in women of reproductive age, which is often accompanied by metabolic changes such as obesity and chronic low-grade inflammation. Chronic inflammation may play an important role in the occurrence and development of metabolic diseases. Therefore, it is of great significance to explore the relationship between abnormal lipid metabolism and inflammation in PCOS patients. This study aims to analyze the correlation between systemic immune-inflammatory(SII) markers and dyslipidemia in patients with PCOS and their value in early diagnosis. Methods A total of 617 PCOS patients aged 20–35 years (according to the Rotterdam diagnostic criteria) who visited the Reproductive Center of the First Hospital of Lanzhou University from January 2020 to December 2022 were included. According to the presence or absence of dyslipidemia, the patients were divided into normal lipid metabolism group and abnormal lipid metabolism group. The clinical data of the patients were collected and analyzed by SPSS software. Results There were 454 patients with normal lipid metabolism and 163 patients with abnormal lipid metabolism. The SII level of the abnormal lipid metabolism group was higher than that of the normal group. As the SII quartile increased, TC, TG and LDL increased, while HDL decreased accordingly. The SII level was positively correlated with TC, TG and LDL, and negatively correlated with HDL (all P

The article (letter to the editor) presents current data on the prevalence of arterial hypertension and dyslipidemia according to domestic and foreign epidemiological studies. It is advisable for a clinical practitioner to consider these two leading cardiovascular pathologies (they are also the most common risk factors for the development and progression of atherosclerosis) together for further active correction with drug and non-drug methods of treatment. According to the studies presented in the article, the association of high blood pressure with the risk of myocardial infarction, stroke, heart failure, sudden cardiac death, atherosclerosis of peripheral arteries, chronic kidney disease, regardless of the age of patients with hypertension, is shown. There is no doubt about the positive effect of long-term maintenance of target blood pressure values in patients with an established diagnosis of arterial hypertension in relation to the prevention of cardiovascular complications.At the same time, up to 40 % of patients with arterial hypertension are characterized by the presence of one or another type of dyslipidemia. The opinion was expressed about the legality of using the term "lipitension" in connection with the convenience of designating these two pathologies in the form of a single pro-atherogenic comorbidity. The article presents the opinion of a practicing cardiologist, which is the advisability of distinguishing the term "lipitension" (as a pathological-nosological combination (comorbidity) of two leading risk factors in the population of developed countries – arterial hypertension and dyslipidemia. Understanding the commonality of two key factors limiting the prognosis of patients with cardiovascular diseases allows the practitioner to more confidently, with pathogenetic justification, apply the polytablet strategy (containing lipid-lowering and antihypertensive components), which allows not only to achieve more effective control of blood pressure and lipid profile indicators, but also to improve the prognosis and quality of life of patients in the framework of primary and secondary prevention.

Weiyong Xu,1,2 Zhenchang Wang,3 Huaqing Yao,1,2 Zifeng Zeng,1,2 Xinping Lan1,2 1Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou, People’s Republic of China; 2Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou, People’s Republic of China; 3Department of Emergency Medicine, Meizhou People’s Hospital, Meizhou, People’s Republic of ChinaCorrespondence: Xinping Lan, Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China, Email lan-xinping@163.comObjective: To investigate the distribution of arteriosclerotic vessels of arteriosclerosis, differential serum lipid profiles, and differences in the proportion of dyslipidaemia between patients with single-site arteriosclerosis and multi-site arteriosclerosis (significant hardening of ≥ 2 arteries).Methods: The data of 6581 single-site arteriosclerosis patients and 5940 multi-site arteriosclerosis patients were extracted from the hospital medical record system. Serum total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (Apo) A1, ApoB concentrations and C-reactive protein (CRP) between patients with single-site arteriosclerosis and multi-site arteriosclerosis were collected and analyzed.Results: The most diseased arteries were coronary arteries (n=7099, 33.7%), limb arteries (n=6546, 31.1%), and carotid arteries (n=5279, 25.1%). TC, LDL-C, TC/HDL-C, and LDL-C/HDL-C levels were higher and CRP level was lower in multi-site arteriosclerosis patients than those in single-site arteriosclerosis patients. The TC, LDL-C levels in non-elderly (< 65 years old) female patients were higher and TG/HDL-C, TC/HDL-C, LDL-C/HDL-C levels were lower than those in non-elderly male patients, while the TG, TC, LDL-C, and TG/HDL-C levels in elderly (≥ 65 years old) female patients were higher and LDL-C/HDL-C level was lower than those in elderly male patients. The proportion of dyslipidemia in descending order was as follows: low HDL-C (31.9%), elevated TG (16.9%), elevated TC (9.0%), and elevated LDL-C (4.2%). The levels of TC, LDL-C, TC/HDL-C, and LDL-C/HDL-C in patients with peripheral arteriosclerosis were higher than those in patients with cardio-cerebrovascular arteriosclerosis.Conclusion: There were differences in serum lipid levels in patients with arteriosclerosis with different age, gender and distribution of arteriosclerotic vessels.Keywords: arteriosclerosis, arteriosclerotic vessels, dyslipidemia, serum lipid, CRP

Abstract Background Sickle cell disease (SCD) is the most common hemoglobinopathy caused by an autosomal recessive genetic disorder leading to increased morbidity and mortality rates. SCD is prevalent in the Tharu community in the lowland (Terai) region of Nepal. Prevalence of metabolic syndrome among adults with SCD is poorly studied. Methodology This prospective cross‐sectional study was conducted at Seti Provincial Hospital in Dhangadhi, Nepal, among 140 adolescents and adults with SCD, aged 15–60 years. Anthropometric and laboratory data were collected using an assisted questionnaire, and the SPSS software version 23 was used for data analysis. Descriptive and inferential statistics were used to summarize the presence of metabolic syndrome and were stratified in separate analyses by age and sex. National Cholesterol Education Program‐Adult Treatment Panel III criteria were used to define metabolic syndrome. Aim This cross‐sectional study aimed to assess the prevalence of metabolic syndrome among SCD patients with SCD registered at the Seti Provincial Hospital in Dhangadhi, Nepal. Results The prevalence of metabolic syndrome in the study participants was 7.8%. Our study revealed 5% of the patients overweight, and 1.4% obese. In this study, the mean triglyceride level was 118.5 mg/dL, and the mean high‐density lipoprotein (HDL) level was 36.2 mg/dL (men) and 36.7 mg/dL (women). This study found that the mean fasting blood glucose level was 88.6 gm/dL. Similarly, 3.5% of patients had increased systolic blood pressure, and 7.8% had raised diastolic blood pressure. Study shows that changes in triglyceride level (p = 0.013), waist circumference, and HDL level (p = 0.0001 and 0.0048, respectively) are significantly associated with smoking or alcohol consumption; however, change in blood pressure (p = 0.013) and fasting blood sugar level (p = 0.086) are not associated with smoking or alcohol consumption. Conclusion Study concluded that though a lower proportion of SCD patients met the criteria for metabolic syndrome than in studies conducted in developed countries, it is crucial to consider metabolic syndrome while managing patients with SCD. Nevertheless, the authors advocate a more comprehensive study to draw significant conclusions.

Abstract Background Glucomannan has been studied for various health benefits, but its effects on lipid profile in adults are not well understood. This meta-analysis aims to evaluate the impact of glucomannan supplementation on serum/plasma levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), Apo B1, Apo A1, APO-B/ A1 ratio, and LDL-C/ HDL-C in adults. Methods A comprehensive search was conducted across Scopus, PubMed, Embase, and Web of Science from inception to June 2024 to identify randomized controlled trials (RCTs) assessing glucomannan supplementation on lipid profile in adults. Data were extracted and analyzed using random effects model to determine the standardized mean differences (SMDs) and 95% confidence intervals (CIs) for each biomarker. Results Glucomannan supplementation significantly decreased TC (SMD: -3.299; 95% CI: -4.955, -1.664, P

Abstract Despite the implementation of preventive measures to counteract the obesity epidemics, the prevalence of childhood obesity is still alarming all over the world. Childhood obesity is the most common risk factor for both cardiovascular and metabolic diseases. In fact, an earlier onset of obesity can cause a greater risk of adiposity tracking across the lifespan and consequently a longer exposure to cardiometabolic risk factors. Accumulating evidence provided by prospective and intervention studies demonstrated the link between pediatric obesity and selected subclinical signs of cardiovascular damage (atherosclerosis and left ventricular hypertrophy), or fatal and not fatal cardiovascular events as early as 40 years of age. The numerous guidelines and scientific documents published in the last years demonstrate the relevance of assessing cardiometabolic risk factors in children and adolescents with OB. This Position paper, released by experts of the “Childhood Obesity study group” within the Italian Society for Pediatric Endocrinology and Diabetology, aims to review the assessment of cardiometabolic risk factors and comorbidities in children and adolescents with OW/OB on the light of the most recent scientific evidence. The main recommendations are: (a) early detection of comorbidities, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, polycystic ovary syndrome, inactivity, obstructive sleep apnea and decline in kidney function; (b) weight loss treatment, which is associated with a reduction of all cardiometabolic risk factors; (c) specific treatment of comorbidities, through lifestyle modifications or pharmacological treatment added to lifestyle for suitable individuals; d). monitoring comorbidities for mitigating future morbidity and mortality.

Hong-Jing Zhu,1,&ast; Sheng-Yu Zhou,1,&ast; Yang Qu,1 Ying-Ying Sun,1 Ke-Jia Zhang,1 Shu-Yan Pang,1 Yi Yang,1 Zhen-Ni Guo1,2 1Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China; 2Neuroscience Research Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhen-Ni Guo; Yi Yang, Stroke Center, Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1&num;, Changchun, 130021, People’s Republic of China, Tel +86-18186872986 ; +86-13756661217, Fax +86-431-88782378, Email zhen1ni2@163.com; yang_yi@jlu.edu.cnPurpose: Although recombinant tissue plasminogen activator (rt-PA) treatment is efficient in patients with acute ischemic stroke (AIS), a significant percentage of patients who received rt-PA intravenous thrombolysis (IVT) do not achieve a good prognosis. Therefore, the factors that affect the poor prognosis of patients with IVT are needed. The Fibrosis-4 (FIB-4) index has been used as a liver fibrosis biomarker. We aimed to investigate the relationship between the FIB-4 index and functional outcomes in patients with AIS receiving IVT.Patients and Methods: This study prospectively included consecutive patients with AIS receiving IVT between April 2015 and May 2022. We collected clinical and laboratory data and calculated the FIB-4 index. Clinical outcome was poor functional outcome (mRS ≥ 3) at 3 months after IVT. Multivariate logistic regression analysis was used to analyze the association between FIB-4 and outcome. We explored the interactive effect of FIB-4 and dyslipidemia on poor outcomes, and subgroup analysis was performed. Furthermore, an individualized prediction model based on the FIB-4 for functional outcome was established in the dyslipidemia group.Results: A total of 1135 patients were included, and 41.50% had poor 3-month outcomes. After adjusted by other variants that P value < 0.05 in univariable analysis, FIB-4 was independently associated with poor outcomes (OR=1.420; 95% CI: 1.113– 1.812; P=0.004). There was a significant interaction between FIB-4 and dyslipidemia on poor outcome (P=0.036), and the independent association between FIB-4 and poor outcome was maintained in the dyslipidemia subgroup (OR=1.646; 95% CI: 1.228– 2.206; P=0.001). Furthermore, in the dyslipidemia group, the FIB-4-based prediction model had good predictive value (the AUC of the training and validation sets were 0.767 and 0.708, respectively), good calibration (P-values for the Hosmer–Lemeshow test > 0.05), and clinical usefulness.Conclusion: FIB-4 is an independent risk factor for poor outcomes in IVT patients with dyslipidemia, which can be used as a simple predictor of their prognosis.Keywords: Fibrosis-4, acute ischemic stroke, intravenous thrombolysis, prognosis, dyslipidemia

Aim. To study the features of lipid metabolism disorders in patients with acute coronary syndrome (ACS), depending on glomerular filtration rate (GFR) and smoking factor. Materials and methods. The study included 142 ACS patients (mean age – 59.66 ± 0.78 years). All the patients were divided into two groups according to GFR. Group I comprised 57 individuals with GFR

Metabolic syndrome (MetS) is a widespread global epidemic that affects individuals across all age groups and presents a significant public health challenge. Comprising various cardio-metabolic risk factors, MetS contributes to morbidity and, when inadequately addressed, can lead to mortality. Current therapeutic approaches involve lifestyle changes and the prolonged use of pharmacological agents targeting the individual components of MetS, posing challenges related to cost, compliance with medications, and cumulative side effects. To overcome the challenges associated with these conventional treatments, herbal medicines and phytochemicals have been explored and proven to be holistic complements/alternatives in the management of MetS. Thymoquinone (TQ), a prominent bicyclic aromatic compound derived from Nigella sativa emerges as a promising candidate that has demonstrated beneficial effects in the treatment of the different components of MetS, with a good safety profile. For methodology, literature searches were conducted using PubMed and Google Scholar for relevant studies until December 2023. Using Boolean Operators, TQ and the individual components of MetS were queried against the databases. The retrieved articles were screened for eligibility. As a result, we provide a comprehensive overview of the anti-obesity, anti-dyslipidaemic, anti-hypertensive, and anti-diabetic effects of TQ including some underlying mechanisms of action such as modulating the expression of several metabolic target genes to promote metabolic health. The review advocates for a paradigm shift in MetS management, it contributes valuable insights into the multifaceted aspects of the application of TQ, fostering an understanding of its role in mitigating the global burden of MetS.

Background. Among the heterogeneous types of diabetes, latent autoimmune diabetes in adults (LADA) attracts the most attention today. Despite the large number of studies on dyslipidemia in diabetes and its relationship with vitamin D deficiency, data on the course of these conditions in patients with LADA are practically absent. The purpose of our study was to determine the characteristics of lipid metabolism in patients with LADA and its phenotypes compared to classical type 1 diabetes mellitus (T1DM) depending on vitamin D status. Materials and methods. We study 56 patients with DM: 34 individuals with LADA and 22 with classical T1DM. They underwent a number of general clinical laboratory tests, study of carbohydrate metabolism, liver function, the blood lipid spectrum, vitamin D status. Results. Analysis of the lipid metabolism indicators in patients with LADA compared to data of patients with classical T1DM showed that dyslipidemia was observed in all experimental groups. In the LADA group, the degree of dyslipidemia according to indicators of lipid metabolism (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), atherogenic index) was higher than in T1DM, which indicates a higher frequency of dyslipidemia in this subtype of autoimmune diabetes in particular and, accordingly, the metabolic syndrome in general. These changes, in our opinion, are caused by the heterogeneous nature of LADA with the involvement of mechanisms of insulin resistance in its development and course. Conclusions. Vitamin D deficiency is associated with lipid metabolism disorders, in particular, with an increase in TG and a decrease in HDL-C, as well as with LADA decompensation, which indicates the need for its normalization in this type of diabetes regardless of the phenotype.

Introduction: Dyslipidemia comprises disorders of lipoprotein metabolism, which is usually characterized by increased plasma levels of total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL), or reduced plasma level of high-density lipoprotein (HDL). Dyslipidemia is commonly found in Type 2 Diabetes Mellitus (T2DM) patients causing an increased risk of atherosclerosis and cardiovascular disease. Many studies done previously show variable prevalence of dyslipidemia (68 to 85 %) in known diagnosed patients of T2DM (with unknown history of onset), however, only limited studies have been done for finding prevalence of dyslipidemia in newly detected T2DM patients. AIM: This study is a cross-sectional observational study done in a tertiary care hospital in Mumbai (India), aiming to study prevalence and pattern in newly detected T2DM patients. The secondary objective is to compare the prevalence and pattern of dyslipidemia in newly detected T2DM patients with non-diabetic controls. Material and Method: For this, 100 newly detected T2DM patients were chosen along with 100 cases of age & gender-matched non-diabetic controls. Their clinical profile and lipid profile of both groups were observed and compared. Result: Results showed higher prevalence of dyslipidemia in newly detected T2DM patients (64%) which was significantly more than the control group (32%). Moreover, the pattern of dyslipidemia showed greater mean levels of TC, TG, and LDL and low mean levels of HDL in T2DM patients compared to the control group. Conclusion: These findings show that there is an increased risk of Dyslipidemia in new onset T2DM patients.

Abstract Background Low-density lipoprotein cholesterol (LDL-C) is acknowledged as an independent risk factor (IRF) for atherosclerotic cardiovascular disease. Nevertheless, studies on the impact of LDL-C on microvasculature are still scarce. The retina, abundant in microvasculature, can now be examined for microvascular alterations through the novel, non-invasive, and quantitative optical coherence tomography angiography (OCTA) technique. Methods In this cross-sectional study, 243 patients from the geriatric department were recruited (between December 2022 and December 2023). Individuals were classified into four groups based on their LDL-C levels: Group 1 (≤ 1.8 mmol/L), Group 2 (> 1.8 mmol/L to ≤ 2.6 mmol/L), Group 3 (> 2.6 mmol/L to ≤ 3.4 mmol/L), and Group 4 (> 3.4 mmol/L). The OCTA results including retinal vessel density (VD), foveal avascular zone (FAZ) area, macula thickness, and retinal nerve fiber layer (RNFL) thickness were contrasted across these groups. T-tests, analysis of variance, Welch’s tests, or rank-sum tests were employed for statistical comparisons. In cases where significant differences between groups were found, post-hoc multiple comparisons or rank-sum tests were performed for pairwise group comparisons. Spearman’s correlation coefficient was employed to perform bivariate correlation analysis to evaluate the relationship between LDL-C levels and various OCTA measurements. Multivariable regression analysis was used to evaluate the association between LDL-C levels and various OCTA measurements. Linear regression analysis or mixed-effects linear models were applied. Results It was discovered that individuals with LDL-C levels exceeding 2.6 mmol/L (Groups 3 and 4) exhibited reduced VD in the retina, encompassing both the optic disc and macular regions, compared to those with LDL-C levels at or below 2.6 mmol/L (Groups 1 and 2). A negative correlation among LDL-C levels and retinal VD was identified, with r values spanning from − 0.228 to -0.385. Further regression analysis presented β values between − 0.954 and − 2.378. Additionally, no notable disparities were detected among the groups regarding FAZ area, macular thickness, and RNFL thickness. Conclusions The outcomes of this study suggest that elevated LDL-C levels constitute an IRF for decreased VD across the entire retina. Trial registration NCT05644548, December 1, 2022.

Introduction. The health of centenarians is a major focus in global studies. Dyslipidemia is directly linked to the risk of cardiovascular diseases, which pose a growing burden on healthcare due to the increasing elderly population. Studying the lipid profiles of centenarians is important for preventing circulatory system diseases and promoting healthy aging. This research aims to compare the prevalence of dyslipidemia in centenarians (median age 96 [95-97]) with elderly individuals (median age was 69 [64 – 74]) in the Republic of Kazakhstan and examine potential predictors of dyslipidemia in the centenarian group. Methods. The study involved 46 centenarians (study group) and 82 elderly individuals (control group). Statistical analysis was used to process the data, including blood markers and demographic variables, to identify factors contributing to dyslipidemia. Results and conclusion. The prevalence of hypercholesterolemia in centenarians was 32.6% (15 people - 3 men; 12 women), with elevated LDL levels in 4.3% (2 women). In the control group, hypercholesterolemia prevalence was 29.3% (24 people - 6 men; 18 women) and elevated triglycerides in 6.1% (3 women; 2 men). The study and control groups were compared based on their lipid profile characteristics, which showed similarities as indicated by all p-values being above 0.05: Cholesterol (p=0.348), HDL (p=0.975), LDL (p=0.161), and Triglycerides (p=0.159). Decreased physical activity was a predictor of dyslipidemia in centenarians. Excessive cholesterol levels were significantly higher among women than men in both groups. The primary factor for dyslipidemia was low physical activity, with other predictors having no significant impact on the lipid profiles of centenarians. This factor should be considered when assessing cardiovascular disease risks and all-cause mortality.

Background : Peroxisome proliferator-activated receptor α (PPARα) is a nuclear transcription factor responsible for gene expression, particularly those associated with lipid metabolism. The lipoprotein lipase enzyme (LPL) is considered a key enzyme in lipid metabolism and transport. The link between dyslipidemia and obesity is well understood. Dyslipidemia is also an established risk feature for cardiovascular disease. Thus, it becomes progressively essential to identify the role of genetic factors as risk markers for the development of dyslipidemia among obese males. Methods : A case-control study was performed including 469 males. Anthropometric characteristics and serum lipid profiles such as triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were evaluated. Genomic DNA extraction and purification were performed using whole blood samples. Restriction enzyme fragment length polymorphism was used to genotype PPARα and LPL single nucleotide polymorphisms. The associations between these polymorphisms and dyslipidemia were examined. Results : The CC and CG genotypes of PPARα gene polymorphisms were significantly associated with higher TC and LDL-C levels (P

Abstract Introduction Sleep disorders, particularly insomnia and obstructive sleep apnea, are associated with dyslipidemia in the general population. The study’s aim was to explore the association between pathological Cholesterol and Triglyceride levels, and sleep and nighttime behavior disorders (SNBD) in older adults, whether they might predict SNBD onset, and to emphasize the role of body mass index (BMI) in this association. Methods Alzheimer’s Disease Neuroimaging Initiative (ADNI) population with complete Cholesterol, Triglyceride, SNBD, and neurocognitive data were included. Logistic regression was performed to study the association between hypercholesterolemia, hypertriglyceridemia, and SNBD at baseline and at 12 months. Relevant confounders, particularly BMI, were adjusted for. Results Among the 2,216 included cases, 1,045 (47%) were females, and the median age was 73 years (IQR: 68, 78). At baseline, 357 (16%) had SNBD and 327 (18%) at 12 months; 187 of them were incident cases. There were more cases of baseline SNBD in the hypertriglyceridemia group than in those without (19% vs. 14%, P-value = 0.003). Similarly, more follow-up SNBD cases had hypertriglyceridemia at baseline (21% vs. 16%, P-value = 0.025). SNBD cases at baseline had significantly higher serum Triglyceride levels than those without (132 vs. 118mg/dL, P-value

Abstract Background Maternal lipid metabolism has been implicated in elevating the risk of adverse pregnancy outcomes, which is a particularly significant concern in twin pregnancies. However, the precise relationship between early pregnancy dyslipidemia and the risk of preterm birth (PTB) in twin pregnancies remains unclear. Methods This retrospective cohort study included women with twin pregnancies between January 2018 and December 2023. Early pregnancy blood lipid profiles, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C), were examined. Dyslipidemia was diagnosed based on the diagnostic criteria outlined in the 2016 guidelines for the prevention and treatment of dyslipidemia in Chinese adults. PTB was defined as birth occurring before 37 weeks of pregnancy. Logistic regression models were used to evaluate the association of early pregnancy dyslipidemia with PTB in twin pregnancies. Results A total of 613 women with twin pregnancies were included, and 141 women were complicated with dyslipidemia. The incidence of PTB

Dyslipidemia is a major risk factor for atherosclerotic cardiovascular diseases. Recent advancements in lipid-lowering therapies have seen progress with statins, cholesterol absorption inhibitors, PCSK9 inhibitors, and omega-3 fatty acids becoming widely utilized. Emerging new lipid-lowering drugs, including angiopoietin-like protein 3 (ANGPTL3) inhibitors, apolipoprotein C3 inhibitors, monoclonal antibodies, antisense oligonucleotides (ASOs), small interfering RNA (siRNA), and cholesterol vaccines, have diversified the therapeutic landscape, showing promising efficacy. This review explores the development and application of these lipidlowering drugs, offering new insights for therapeutic strategies.

Abstract Current data suggest that oxidative stress may play an important role in the occurrence of acute central serous chorioretinopathy (CSC), as chorioretinal integrity may be affected by disruption of the patient’s metabolic redox balance, indicating the need for biomarkers. In addition to oxidative stress, high-density lipoprotein (HDL) dysfunction due to dyslipidemia can also lead to many types of physical discomfort. However, little is known about the pathophysiology of the disease resulting from oxidative stress and HDL dysfunction in CSC. The aim of this study was to investigate whether serum oxidative stress and HDL functionality markers have an impact on CSC disease. The case series of this study included 33 consecutive patients with treatment-naïve acute CSC. Thirty-five healthy volunteers of similar age were included in this study as non-CSC controls. Serum samples of the participants were taken and routine lipid values, serum Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Oxidized Low Density Lipoprotein (ox-LDL), and Paraoxonase (PON1) levels were measured quantitatively. Serum oxidative stress index (OSI) was then calculated. Serum Ox-LDL, TOS and OSI levels in the acute CSC group, consisting of patients who had never been treated before and had no other disease, were statistically significantly higher than the control group. Conversely, serum PON1 and TAS levels were lower in CSC than in the control group. The relationship between CSC and deterioration in serum redox balance and decrease in PON1 activity, an important marker of HDL functionality, was demonstrated for the first time through this study. According to the literature, serum levels of these biomarkers, which identify acute/chronic inflammation and oxidative stress, have not been measured before in CSC disease. Finally, it is conceivable that redox balance and HDL functionality may be important in the diagnosis and treatment of the acute phase of CSC.

Abstract Background Dyslipidemia represents an important risk factor for cardiovascular diseases, although its optimal management after kidney transplantation remains unclear. The present meta-analysis aimed to shed light on the efficacy and safety of statins among kidney transplant recipients, evaluating their potential effects on the risk of cardiovascular events, mortality and graft survival. Methods Medline, Scopus, Web of Science, CENTRAL, Clinicaltrials.gov and Google Scholar were systematically searched from their inception through April 20, 2024. Both randomized controlled trials and observational studies evaluating the effects of statin administration after kidney transplantation were held eligible. Random-effects models were fitted using the maximum likelihood method, while the certainty of evidence was appraised following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. Results Overall, 27 studies (10 randomized controlled trials and 17 observational studies) were included. Statin use compared to no use was associated with a lower risk of major adverse cardiovascular events [Relative risk (RR): 0.87, 95% confidence interval (CI): 0.67–0.96, moderate certainty] and overall mortality (RR: 0.84, 95% CI: 0.74–0.94, low certainty). The risk of graft loss did not differ between the compared groups (RR: 0.72, 95% CI: 0.48–1.08, very low certainty). Regarding safety endpoints, statin use was associated with a lower risk of hepatotoxicity (RR: 0.81, 95% CI: 0.70–0.93, moderate certainty), but with a greater risk of rhabdomyolysis (RR: 1.37, 95% CI: 1.10–1.70, low certainty) and cataract (RR: 1.22, 95% CI: 1.14–1.31, moderate certainty). No statistically significant differences between the compared groups with and without statin use were observed concerning the risk of creatine kinase elevation, post-transplant diabetes mellitus, hip fracture, venous thromboembolism, or cancer. Conclusions Among kidney transplant recipients, statin use is associated with a lower risk of cardiovascular events and better patient survival, presenting an acceptable safety profile. Further large-scale studies are needed to determine the optimal statin dosing strategy and lipid-lowering goals, depending on comorbidities and immunosuppression regimens. Registration https://doi.org/10.17504/protocols.io.5qpvok3yzl4o/v1 .

Introduction: Type 2 diabetes is associated with obesity and dyslipidemia, which are risk factors for cardiovascular disease. The Food and Drug Administration (FDA)-approved indications for statins are being broadened due to their lipid-lowering and pleiotropic effects; statins are currently among the most widely used drugs in patients with and without diabetes. Aim: To evaluate the role of atorvastatin at different doses in the development and progression of glucose intolerance or diabetes in albino rabbits. Materials and Methods: An in-vivo experimental study on rabbits was conducted over a total duration of eight months in the Department of Pharmacology at SCB Medical College, Cuttack, Odisha, India. The animals were divided into five groups of six rabbits each. Atorvastatin at 4 mg/kg and 2 mg/kg was calculated based on human doses corresponding to 80 mg and 40 mg, respectively. Both doses were administered to non diabetic rabbits, and 4 mg/kg atorvastatin was administered to alloxan-induced diabetic rabbits orally for six months daily. Diabetes was induced in two groups of rabbits by administering 100 mg/kg alloxan monohydrate in a 5% (w/v) solution in sterile saline intravenously. Rabbits with stabilised moderate diabetes, characterised by a fasting blood glucose level above 200 mg/dL (at least one month after alloxan injection), were used for the experiments. The effect of atorvastatin on glucose tolerance was assessed by determining Fasting Blood Sugar (FBS) and Glycated Haemoglobin (HbA1c) levels. The results were compared with those of normal and diabetic control rabbits and statistically analysed using Analysis of Variance (ANOVA) and Repeated Measures ANOVA (RMANOVA), followed by appropriate post-hoc analysis. Results: Atorvastatin at a high dose resulted in a 26.74% increase in FBS and a 20.50% increase in HbA1c; at the standard dose, it produced a 21.3% increase in FBS and a 17.99% increase in HbA1c, respectively. The diabetic group receiving high doses also showed a significant increase in FBS (11.7%) and HbA1c (10.25%). The increase in blood glucose parameters was significant in the high-dose group from the fourth month of statin therapy and in the standard-dose group at six months of therapy. Conclusion: The study revealed that atorvastatin at both doses significantly contributed to the initiation and progression of glucose intolerance in diabetic and non diabetic rabbits.

Background/Aims Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI. Methods A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups. Results The percentage change of LDL-C level at 1–3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of −33.5% between the groups (95% CI: −42.6 to −24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1–3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001). Conclusions Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.

Objective:To study the features of chronic hepatitis C in a 17-year-old patient with metabolic syndrome. Results: The article presents a clinical example of the course of chronic hepatitis C (HCV) in a 17-year-old patient with metabolic syndrome. He fell ill at the age of 13 and was seen by an infectious disease specialist. Antiviral therapy was not prescribed. A complete examination was conducted with an assessment of laboratory data. Biochemical activity, severity of liver fibrotic changes and signs of metabolic syndrome (MS) were compared. To assess the component composition of the body, a bioimpedance analysis was performed. Additionally, in order to identify associative links between gene polymorphism and MS components, the genetic profile of the patient and his parents was studied. Conclusion: A patient with genetic predictors of metabolic syndrome should be previously prescribed antiviral therapy for chronic hepatitis C.

Abstract Cardiovascular disease (CVD) is the leading cause of mortality globally. Low-density lipoprotein (LDL) plays an important role in CVD pathophysiology. Research has shown the safety and efficacy of keeping LDL at very low levels for CVD prevention. Therefore, experts recommend intense LDL-lowering approaches starting at young ages, promoting the mantras “the lower, the better” and “the earlier, the better.” This commentary discusses the challenges regarding applying aggressive LDL-lowering approaches in the general population, including pharmacological efficacy and side effects, the cost-effectiveness of interventions, and patient adherence to treatment regimens.

Background: While Reddy proposed the H2FPEF diagnostic algorithm to aid in diagnosing heart failure with preserved ejection fraction (HFpEF), certain parameters like age and obesity are not suitable for Asian population, especially given the increasing incidence of HFpEF in younger individuals. Therefore, this study aimed to develop an easy-to-use nomogram with non-invasive indices that can be used in outpatient clinics in Taiwan to quickly estimate the probability of HFpEF and help decide whether further invasive cardiopulmonary exercise test (CPET) is needed. Methods: Outpatients with unexplained dyspnea and fatigue were recruited divided into HFpEF (n = 64) and non-HFpEF (n = 34) groups based on invasive CPET and echocardiography. Multivariate logistic regression analyses identified independent noninvasive variables for developing an HFpEF nomogram. The nomogram's performance was assessed and validated using the concordance index (C-index), area under the curve (AUC), calibration curves, and decision curve analysis. Results: Multivariate logistic regression analyses identified five independent noninvasive variables for developing an HFpEF nomogram, including dyslipidemia (OR = 5.264, p = 0.010), diabetes (OR = 3.929, p = 0.050), left atrial area (OR = 1.130, p = 0.046), hemoglobin

Background and aims: The 2019 European Society of Cardiology guidelines for the management of dyslipidemia consider the use of high-dose marine omega-3 fatty acid (FA) eicosapentaenoic acid (EPA) supplementation (icosapent ethyl 2 × 2g/day) to lower residual cardiovascular risk in high-risk patients with hypertriglyceridemia. This study aimed to assess the eligibility for omega-3 FA-EPA supplementation in patients with acute coronary syndromes (ACS). Methods: In a prospective Swiss cohort of patients hospitalized for ACS, eligibility for marine omega-3 FA-EPA, defined as plasma triglyceride levels ranging from 1.5 to 5.6 mmol/l, was assessed at baseline and one-year follow-up and compared across subgroups. Lipid-lowering therapy intensification with statin and ezetimibe was modelled to simulate a hypothetical systematic treatment and its effect on omega-3 FA-EPA supplementation eligibility. Results: Of 2643 patients, 98 % were prescribed statin therapy at discharge, including 62 % at a high-intensity regimen; 93 % maintained it after one year, including 53 % at a high-intensity regimen. The use of ezetimibe was 3 % at discharge and 7 % at one year. Eligibility was observed in 32 % (32 % men, 29 % women) one year post-ACS. After modelling systematic treatment with statins, ezetimibe, and both, eligibility decreased to 31 %, 25 % and 24 %, respectively. Eligibility was higher in individuals aged

Background Cardiovascular disease, mainly atherosclerotic cardiovascular disease, is the first cause of death for urban and rural residents in China. Low density lipoprotein cholesterol is the pathogenic risk factor of ASCVD. Objective By establishing a new outpatient model for blood lipid management, to analyze the awareness rate of abnormal blood lipids in patients before and after the establishment of the new model, the proportion of rational drug use, patient compliance, and medication compliance rate. Methods From September 1, 2023 to February 28, 2024, has established a comprehensive outpatient model for managing blood lipid abnormalities based on scientific research projects by integrating medical resources. The model takes the outpatient service of "patients with dyslipidemia" as the carrier, and collaborates with specialized doctors and general practitioners to standardize the management of dyslipidemia patients, optimize the consultation and follow-up process, effectively screen the population with dyslipidemia, diagnose hyperlipidemia patients, and provide correct treatment methods. Results The model of patients with dyslipidemia included in the management of chronic diseases has shifted from a dispersed model to a comprehensive, standardized, and centralized management of lipid management outpatient services, and the number of patients managed has significantly increased compared to before. The proportion of standardized medication for first-time patients in our blood lipid management outpatient department has increased from 25.3% (147/580) to 30.3% (242/798), the proportion of adherence to medication has increased from 32.7% (190/580) to 41.6% (332/798), and the compliance rate of medication has increased from 15.8% (92/580) to 22.5% (180/798) (P

Dyslipidemia constitutes an essential risk factor for atherosclerotic disorders. From employing diverse types of blood lipid indicators as markers for risk prediction to subsequently applying low-density lipoprotein cholesterol as the primary lipid-lowering target in both primary and secondary prevention of cardiovascular diseases, relevant research and clinical practices indicate that the dyslipidemia management system grounded on hierarchical medical care is a significant measure for effective blood lipid control and efficient reduction of cardiovascular diseases. Continuously optimizing the prediction model for cardiovascular diseases, enhancing the construction of the medical consortium specializing in dyslipidemia disorders, and promoting the dyslipidemia management and control system based on hierarchical medical treatment will facilitate elevating the overall prevention and treatment level of dyslipidemia in China, and mitigate the health menace of cardiovascular diseases for Chinese residents.

Purpose: The production/excretion rate of Amyloid-β (Aβ) is the basis of the plaque burden in alzheimer's disease (AD), which depends on both central and peripheral clearance. In this study, the effect of silymarin and rosuvastatin on serum markers and clinical outcomes in dyslipidemic AD patients was investigated. Methods: Participants (n=36) were randomized to silymarin (140 mg), placebo, and rosuvastatin 10 mg orally three times a day for 6 months. Serum collection and clinical outcome tests were performed at baseline and after completion of treatment. Lipid profile markers, oxidative stress markers, Aβ1–42/Aβ1–40 ratio, and Soluble Low-density lipoprotein receptor-Related Protein-1 (sLRP1)/Soluble Receptor for Advanced Glycation End Products (sRAGE) ratio were measured. Results: There was a statistically significant increase in Δ-high density lipoprotein (ΔHDL) between silymarin and placebo (P

Background: Dyslipidemia and hard exudates of the retina have an intricate association. Increased lipid levels cause increased hard exudates. Many studies found dyslipidemia as an independent risk factor for the development of hard exudates in maculopathy. Objectives: The objective of this study was the association between dyslipidemia and the presence of hard exudates among focal maculopathy patients with and without hard exudates. Materials and Methods: This was a hospital-based case–control study. This study included 60 patients with focal maculopathy in type 2 diabetes mellitus (DM) with hard exudates. Sixty patients with Focal maculopathy in type 2 DM without hard exudates were taken as control. Results: Dyslipidemia was significantly seen (P < 0.05) in cases compared to participants. Total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and very LDL-C were significantly higher in cases compared to controls. High-density lipoprotein cholesterol (HDL-C) had the opposite outcome. HDL-C was significantly lower in cases compared to controls. Conclusion: Dyslipidemia was a strong risk factor for the formation of hard exudates in the macula. An increase in lipid levels increased the hard exudates concentration in the macula and retina.

Dexter Tadiwanashe Chiveto,1,2 Cuthbert Musarurwa,3 Herbert T Mapira,3 Farayi Kaseke,4 Tawanda Nyengerai,5 Timothy Kaseke,6 Elizabeth Gori7 1Department of Laboratory Diagnostic and Investigative Sciences - Chemical Pathology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe; 2Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; 3Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; 4Department of Physiotherapy, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; 5The Best Health Solutions, Johannesburg, Gauteng, South Africa; 6Zimbabwe Aids Prevention Project, ZAPP, Harare, Zimbabwe; 7Department of Medical Biochemistry, Molecular Biology and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, RwandaCorrespondence: Elizabeth Gori, Department of Medical Biochemistry, Molecular Biology & Genetics, College of Medicine and Health Sciences-School of Medicine and Pharmacy, University of Rwanda, P.O. Box 117-Butare, Huye, Rwanda, Tel +250 7920 47482, Email e.gori@ur.ac.rwPurpose: Type 2 diabetes mellitus (T2DM) frequently presents with modified cardiometabolic risk profiles, indicative of an elevated susceptibility to cardiovascular disease (CVD). Cardiometabolic risk factors such as obesity, hyperglycemia, hypertension, insulin resistance and dyslipidemia are known contributors to increased CVD hazard in individuals with T2DM. This study evaluated the glycemic control-based cardiometabolic risk profiles of black Zimbabweans with T2DM.Patients and Methods: A cross-sectional study of 116 T2DM patients recruited from diabetic clinics at Parirenyatwa and Sally Mugabe Hospitals, Harare, Zimbabwe, was conducted. Blood samples were collected for glycated hemoglobin (HbA1c) and lipid profile assessment. The Framingham risk scores (FRS) based on body mass index (BMI) and lipid profile were used to determine CVD risk. Parametric variables were analyzed using one-way analysis of variance (ANOVA) with post hoc Bonferroni correction, while non-parametric variables were compared using the Kruskal–Wallis test with post hoc Dunn test for multiple comparisons.Results: The overall frequency of dyslipidemia was 83.6% (n=97) and hypoalphalipoproteinemia was the most prevalent dyslipidemia (79.3%). Median HDLC levels were significantly lower in participants with poor glycemic control (1.12 mmol/L) compared to those with good glycemic control group (1.37 mmol/L) (p=0.011). Despite lack of significant variations in Framingham Risk Scores, there was a trend towards lower FRS-BMI in the good control group (29.8%) compared to the inadequate control (35.4%) and poor control (32.7%) groups (p=0.078).Conclusion: Duration since DM diagnosis was observed to be an important risk factor for poor glycemic control being significantly shorter in those with good glycemic control compared to those with inadequate and poor control. Overall, there was no significant difference in HbA1c status by age but individuals with poor glycemic control were significantly older than those with good control. The most prevalent dyslipidemia among the study participants was hypoalphalipoproteinemia which is reportedly associated with genetic predisposition, warranting further investigations.Keywords: glycated hemoglobin, dyslipidemia, hypoalphalipoproteinemia, Framingham risk score

Although vitamin D insufficiency has been correlated with an increased risk of cardiovascular disease (CVD), there are few data on the association between 25-hydroxyvitamin D (25(OH)D) and atherogenic indices predictive of CVD. This study investigated the relationship of vitamin D status with lipid profile and atherogenic indices in adult women in Morocco. Three hundred women aged 18 to 50 years from Meknes were included. Fasting 25(OH)D and lipid concentrations were assayed by a one-step electrochemiluminescence-based immunoassay and an enzymatic method, respectively. Atherogenic indices (atherogenic index of plasma (AIP), atherogenic coefficient (AC), non-HDL cholesterol (non-HDL-C), Castelli risk indices I and II (CRI-I and II), and CHOLIndex (CI)) were calculated using conventional lipid parameters. Logistic regression models and operating characteristic curve (ROC) analysis were used to assess the relationship of the variables and estimate the threshold of 25(OH)D levels associated with high atherogenic indices. 25(OH) D below 20 ng/mL was significantly associated with an enhanced risk of hypertriglyceridemia and elevated values of AIP, AC, non-HDL-C, and CRI-I with an OR (95% CI) of 4.904 (1.856–12.959), 3.637 (2.149–6.158), 3.589 (1.673–7.700), 2.074 (1.215–3.540), and 2.481 (1.481–4.123), respectively. According to the ROC analysis, the likelihood of hypertriglyceridemia and high values of AIP, AC, non-HDL-C, and CRI-I were associated with 25(OH)D thresholds ≤15.15 ng/mL, ≤17.5 ng/mL, ≤19.8 ng/mL, ≤20.1 ng/mL, and ≤19.5 ng/mL, respectively, all p < 0.01. Based on the atherogenic indices, this study indicates that vitamin D below 20 ng/mL may increase the risk of cardiovascular disease in adult women. Additional health measures are essential to raise awareness among women and health professionals of preventing and controlling cardiovascular risk factors, particularly among young individuals.

Abstract Background Sleep deprivation (SD) due to an unhealthy lifestyle poses an oxidative challenge and is closely associated with an increased risk and prevalence of different metabolic disorders. Although the negative consequences of SD are well reported on mental health little is known about its detrimental effects on liver function and lipid metabolism. Tinospora cordifolia is reported for its hepatoprotective activity in different pre-clinical model systems. The current study was designed to elucidate the cumulative effects of aging and acute SD on liver functions, oxidative stress, and lipid metabolism, and their management by butanol extract of T. cordifolia (B-TCE) using middle-aged female acyclic rats as the model system. Results Rats were divided into 4 groups: (1) Vehicle-undisturbed (VUD) (2) Vehicle-sleep deprived (VSD) (3) B-TCE pre-treated sleep-deprived (TSD) (4) B-TCE pre-treated undisturbed sleep (TUD). TSD and TUD groups were given 35 mg/kg of B-TCE once daily for 15 days followed by 12 h of sleep deprivation (6 a.m.–6 p.m.) of VSD and TSD group animals using the gentle-handling method while VUD and TUD group animals were left undisturbed. SD of VSD group animals increased oxidative stress, liver function disruption, and dyslipidemia which were ameliorated by B-TCE pre-treatment. Further, B-TCE was observed to target AMPK and its downstream lipid metabolism pathways as well as the p-Akt/cyclinD1/p-bad pathway of cell survival as possible underlying mechanisms of its hepatoprotective activity. Conclusions These findings suggest that B-TCE being a multi-component extract may be a potential agent in curtailing sleep-related problems and preventing SD-associated hepatotoxicity and dyslipidemia in postmenopausal women. Graphical abstract Graphical abstract to depict mechanism of action of B-TCE on liver function and lipid metabolism.

Abstract Background Understanding the potential risk factors of heart diseases is key to effectively managing cardiac diseases. The present study quantifies the association of identified risk factors. In addition, the study has compared the association of mortality with hypertension, uncontrolled diabetes, and uncontrolled hyperlipidemia using Grey Relational Approach (GRA) for stroke, lung diseases, smoking, stress, obesity, and lack of exercise. Method Data on risk factors of heart failure were collected from the Global Burden of Disease (GBD) study (2001–2017). From the GBD database, variables have selected the top leading risk factors responsible for mortality from cardiac diseases. Data on risk factors was analyzed using the GRA procedure (utilizing Grey [8.0] software). In the GRA method, the correlation was categorized into three components: GRA – Deng (assesses the effect of one variable specified by data on the other variables), GRA- absolute (assesses the association between variables measured), and GRA-SS (assessed the overall association between the variables measured). Stroke, lung diseases, smoking, stress, obesity, and lack of exercise were taken as dependent variables and their impact was assessed. Hypertension (high grade) uncontrolled diabetes, and uncontrolled hyperlipidemia were considered as independent variables. The relationship between dependent and independent variables was assessed. Results Overall correlational analysis showed that type 2 diabetes (T2DM) is the risk factor that has a strong relationship with causing heart failure and thereby increases morbidity and mortality among Chinese patients. After T2DM, the second highest risk factor associated was severe dyslipidemia which is responsible for causing heart failure. High-grade hypertension is one-third most common risk factor in causing heart failure. GRA – Deng analysis showed that T2DM is the top risk factor associated with heart failure, followed by high-grade hypertension and severe dyslipidemia (uncontrolled). GRA-absolute analysis showed that severe dyslipidemia is the top risk factor associated with heart failure, followed by high-grade hypertension and T2DM (uncontrolled). GRA-SS analysis showed that high-grade hypertension is the top risk factor associated with heart failure, followed by severe dyslipidemia and T2DM (uncontrolled). Conclusions The study reported that T2DM, severe dyslipidemia, and high-grade hypertension as strongly correlated with the development of heart failure after considering other several key risk factors (stroke, lung diseases, smoking, stress, obesity, and lack of exercise). Level of evidence IV. Technical efficacy Stage 5.

Abstract Purpose The atherogenic index of plasma (AIP) is a novel comprehensive lipid index. We aimed to investigate a possible relationship between AIP index and kidney stones in US adults. Methods This cross-sectional study was conducted among adults with complete AIP index and questionnaire records on kidney stones from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2018. The AIP index served as the exposure variable, defined as the logarithm of the ratio between triglycerides (TG, mmol/L) and high-density lipoprotein cholesterol (HDL-c, mmol/L). Self-reported history of kidney stones was utilized as the outcome variable. The independent relationship between AIP index and the risk of kidney stones was fully assessed. Results A total of 14,833 participants were included in this study, with an average AIP index of -0.07 ± 0.01. The proportion of kidney stones progressively increased with higher AIP index tertile intervals (7.33% vs. 9.97% vs. 12.57%, P 0.05). Conclusions The AIP index may be a potential epidemiological tool to quantify the role of dyslipidemia in the risk of kidney stones in US adults.

Abstract Background Numerous studies have revealed the role of dietary fatty acids in human health. However, few studies have evaluated dietary fatty acid patterns and their association with metabolic parameters. The current study aimed to explore the association between dietary fatty acid patterns and risk factors for metabolic syndrome (MetS) among overweight and obese adults. Methods This cross-sectional study involved 340 participants who were overweight or obese. The study included assessments of body composition and anthropometric measurements. Dietary fatty acid consumption was evaluated using a validated Food Frequency Questionnaire (FFQ) containing 168 items. Additionally, biochemical parameters, including serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were measured using enzymatic methods. Fatty acid patterns were determined by principal component analysis (PCA), and the association between these dietary FA patterns and risk factors related to MetS components was assessed using logistic regression. Results Factor analysis conducted in this study explored three dietary fatty acid patterns: saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), and long-chain combined fatty acids (LC-CFA). Those at the highest tertile of the SFA pattern had lower diastolic blood pressure (DBP) (P = 0.03). Low-density lipoprotein cholesterol (LDL) was lower in the second and third tertiles (P ≤ 0.05). Also, higher fasting blood glucose (FBS) was observed in the second and third tertiles (P

Abstract Background and purpose Garlic is used as an important medicinal food for treatment of many diseases, however, the association between garlic consumption and dyslipidemia have yielded inconsistent results. So we carried this meta-analysis to explore the blood lipid-lowering effects of garlic. Methods Databases such as PubMed, Scopus, Web of science, Embase, Cochrane Library were systematically searched until June 2024. Heterogeneity among studies was examined using Q and I2 statistics. Also subgroup analysis were conducted to explore the potential heterogeneity. Combined weighted mean differences (WMD) with their 95% confidence interval (CI) were calculated using a random-effects model. The GRADE approach was used to evaluate the overall certainty of the evidence in the meta-analyses. Results A total of 21 RCTs studies involved association between garlic consumption and blood lipids level of dyslipidemia patients were included in the meta-analysis. The pooled results showed that garlic consumption significantly reduced total cholesterol (TC)(WMD = -0.64mmol/L, 95%CI = -0.75 −-0.54, P 50 years compared to those aged ≤ 50 years. And garlic oil greatly reduced TC and LDL-C compared with garlic power. Finally, sensitivity analysis and publication bias showed that the results were reliable. Conclusions Evidence from this meta-analysis suggested that garlic consumption could be effective in reducing the risk of dyslipidemia and preventing CVDs. Particularly the older people were more susceptible to the protective effects of garlic.

Abstract Background Previous findings have revealed that disorders of lipid metabolism may be a risk factor for pulmonary function damage; however, the combined effect of dyslipidemia and central obesity on pulmonary function is unclear. The cardiometabolic index (CMI) is a composite of serum lipids (triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C)) and visceral fat parameters (waist-to-height ratio (WHtR)). This research aimed to investigate the link between CMI and pulmonary function, employing large-scale demographic data sourced from the National Health and Nutrition Examination Survey (NHANES) database. Methods This cross-sectional study used data involving 4125 adults aged 20 and above collected by NHANES between 2007 and 2012. We defined CMI as the exposure variable and measured outcomes using forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC to evaluate pulmonary function. Weighted multiple linear regression models and subgroup analyses were employed to investigate separate relationships between CMI and pulmonary function. In addition, to investigate variations across different strata and evaluate the robustness of the findings, interaction tests and sensitivity analyses were conducted. Results Results from the weighted multiple linear regression analysis indicated a unit increase in log2-CMI was associated with a reduction of 82.63 mL in FEV1 and 112.92 mL in FVC. The negative association remained significant after transforming log2-CMI by quartile (Q). When the log2-CMI level reached Q4, β coefficients (β) were -128.49 (95% CI: -205.85, -51.13), -169.01 (95% CI: -266.72, -71.30), respectively. According to the interaction test findings, the negative association linking log2-CMI with FEV1 and FVC persists regardless of confounding factors including age, gender, BMI, physical activity (PA), and smoking status. A subsequent sensitivity analysis provided additional confirmation of the stability and reliability of the results. For females, the inflection points for the nonlinear relationships between log2-CMI and FEV1, as well as log2-CMI and FVC, were identified at 2.33 and 2.11, respectively. While in males, a consistent negative association was observed. Conclusions Our findings suggest that higher CMI is associated with lower FEV1 and FVC. CMI may serve as a complementary consideration to the assessment and management of pulmonary function in clinical practice.