The Ratio of Free Fatty Acids (Ffas) Divided By High-Density Lipoprotein Cholesterol (HDL-C) Is A Promising Pre-Treatment Biomarker For Predicting Worse Overall Survival (OS) of Neuroendocrine Tumours (Nets) In The Colorectum: A Retrospective Study.

Background: free fatty acids (FFAs) and high-density lipoprotein cholesterol (HDL-C) were associated with various malignancy. However, whether FFA, HDL-C and FFA/HDL-C can play a potiential role in predicting patients with colorectal neuroendocrine tumours (NETs) was unclear. Meanwhile, FFA/HDL-C has a superior prognosis ability was unknown, too.Methods: One hundred patients with pathologically diagnosed colorectal NETs in 2011-2017 were enrolled, and the levels of FFA, HDL-C, low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), cholesterol (CHOL), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) between colorectal NET patients and healthy controls matched by age and sex were compared. In addition, the association of clinicopathological characteristics and follow-up data with FFA, HDL-C and FFA/HDL-C was analysed.Results: FFA was overexpressed (0.55±0.23 vs. 0.48±0.11, P= 0.006), and HDL-C was underexpressed (1.31±0.41 vs. 1.41±0.29, P=0.046) in colorectal NETs. FFA ≥0.52 mmol/L predicted lymph node metastasis (LNM) (P=0.015), HDL-C ≤1.0 mmol/L predicted tumour size ≥2 cm (P=0.017), and FFA/HDL-C>0.75 predicted tumour grade (P=0.030), LNM (P=0.014), and tumour size(P=0.018). No significant association was found between FFA and tumour grade (P=0.613) or HDL-C and tumour grade (P=0.594) or FFA and tumour size (P=0.142) or HDL-C and LNM (P=0.443). FFA ≥0.52 mmol/L (P=0.014) and HDL-C ≤1.0 mmol/L predicted worse overall survival (OS) (P=0.019). FFA/HDL-C predicted an even worse prognosis in terms of OS (P<0.001).Conclusion: FFA ≥0.52 mmol/L HDL-C ≤1.0 mmol/L and FFA/HDL-C>0.75 were promising cut-off values in predicting LNM, tumour size and worse OS in colorectal NETs.

Nonlinear Relationship of Non-High-Density Lipoprotein Cholesterol and Cognitive Function in American Elders: A Cross-Sectional NHANES Study (2011–2014)

Background: Serum non-high-density lipoprotein-cholesterol (non-HDL-C) levels may be associated with cognitive function. Objective: The objective of this study was to evaluate the association between non-HDL-C and cognitive function among American elders. Methods: We used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). A total of 3,001 participants aged over 60 years were enrolled in our analysis. The cognitive function was evaluated with the word learning subtest from the Consortium to Establish a Registry for Alzheimer’s disease (CERAD W-L), the Animal Fluency Test (AFT), and the digit symbol substitution test (DSST). We also created a composite cognitive z-score to represent a global cognition. We applied multivariate linear regression analyses to estimate the associations between non-HDL-C levels and all domains of cognitive function. Further, the generalized additive model and the smooth curve were conducted to investigate the dose-response relationship between non-HDL-C and global cognition. Results: Serum non-HDL-C was positively associated with global cognition (β= 0.20, 95% CI: 0.11, 0.28), AFT score (β= 0.54, 95% CI: 0.33, 0.76), and DSST score (β= 1.13, 95% CI: 0.56, 1.69) after fully adjusted. While non-HDL-C was not related to CERAD W-L score. In addition, an inverted U-shape curve was observed in the dose-response relationship between non-HDL-C and global cognition (p for non-linearity < 0.001). Conclusion: Serum non-HDL-C is positively and nonlinearly associated with cognitive function among American older adults. Maintaining serum cholesterol levels at an appropriate range may be helpful to the cognitive health of the elderly.

The Association Between Diabetes Coexisting With Low Levels of High-density Lipoprotein Cholesterol and Peritoneal Dialysis-related Peritonitis

BackgroundLow levels of high-density lipoprotein-cholesterol (HDL-C) and diabetes are common in patients undergoing peritoneal dialysis (PD). The aim of this study was to investigate the association between diabetes coexisting with a low level of HDL-C and the first episode of peritoneal dialysis-related peritonitis (PDRP) in patients with PD.MethodsWe retrospectively investigated patients with PD from January 1, 2003, to May 31, 2020 in four PD centers. Patients with PD were divided into four groups: no comorbidity, low HDL-C only, diabetes only, and diabetes plus low HDL-C. The clinical and laboratory baseline data of the four groups were collected and compared. The association between diabetes coexisting with low HDL-C levels and the first episode of PDRP was analysed by multivariate Cox regression analysis. ResultsA total of 1013 patients with PD were recorded in our study. The mean age was 49.94±14.32 years, and 597 (58.99%) were males. A total of 301 (29.7%) patients had their first episodes of PDRP, and low HDL-C levels existed with diabetes in 72 patients with PD. After adjusting for confounding factors, a low level of HDL-C coexisting with diabetes was significantly associated with the first episode of PDRP in our study (hazard ratio: 1.93, 95% CI: 1.03-3.61, p<0.05). The associations between HDL-C, diabetes and PDRP were consistent in the following subgroups: sex, age, pre-existing CVD (all P interaction > 0.05).ConclusionsLow levels of HDL-C alone or diabetes alone were not independent risk factors for PDRP. Patients with both diabetes and low HDL-C levels were at high risk for PDRP.

Comparison of the Diagnostic Value Between Triglyceride-Glucose Index and Triglyceride-to-High Density Lipoprotein Cholesterol Ratio in MAFLD Patients: A Retrospective Cross-Sectional Study

Background The triglyceride and glucose index (TyG) and triglyceride-to-high density lipoprotein cholesterol ratio (TG/HDL-C) were found to be substitute markers of insulin resistance (IR). We aimed to compare the efficacy of the two indicators in the diagnosis of Metabolic-Associated Fatty Liver Disease (MAFLD), which was rarely covered in the literature, and to construct a novel disease diagnosis model.Methods A retrospective cross-sectional study was carried out in West China Hospital of Sichuan University and 229 people (97 MAFLD and 132 Non-MAFLD) were included. Biochemical indexes were collected and analyzed by logistic regression to screen out indicators that expressed differently in MAFLD patients and healthy controls and incorporate them into a diagnostic model. MAFLD was diagnosed by Ultrasound.Results After adjusting for age, gender and BMI, Serum ALT, AST, AST/ALT (A/A), FPG, Cys-C, URIC, TG, HDL-C, ALP, GGT, nonHDL-C, LDL-C/HDL-C, nonHDL-C/HDL-C, TG/HDL-C, TC/HDL-C, TyG and TyG-BMI were risk factors of MAFLD through binary logistics regression analysis. The odds ratio of TG/HDL-C and TyG were 5.387 (95%CI: 2.986-9,718) and 107.945 (95% CI: 25.824-451.222). In identifying MAFLD, TyG, TG/HDL-C and TG were found to be the most vital indexes by the random forest method and the area under the curve (AUC) of them are all greater than 0.9 respectively. In addition, the combination of gender, BMI, ALT, TG, HDL-C, TyG and TyG-BMI had a great diagnostic efficiency for MAFLD.Conclusions TyG and TG/HDL-C were potential risk factors for MAFLD and the former made a better performance in diagnosing MAFLD. The combination of gender, BMI, ALT, TG, HDL-C, TyG and TyG-BMI improved the diagnostic capability of MAFLD.

Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients

This study evaluated the association of the serum total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) with mortality in incident peritoneal dialysis (PD) patients. We performed a multi-center, prospective cohort study of 630 incident PD patients from 2008 to 2015 in Korea. Participants were stratified into quintiles according to baseline TC, HDL-C, LDL-C and TC/HDL-C. The association between mortality and each lipid profile was evaluated using multivariate Cox regression analysis. During a median follow-up period of 70.3 ± 25.2 months, 185 deaths were recorded. The highest TC/HDL-C group had the highest body mass index, percentage of diabetes and serum albumin level. Multivariate analysis demonstrated that the highest quintile of TC/HDL-C was associated with increased risk of all-cause mortality (hazard ratio 1.69, 95% confidence interval 1.04–2.76; p = 0.036), whereas TC, HDL-C and LDL-C were not associated with mortality. Linear regression analysis showed a positive correlation between TC/HDL-C and body mass index. Increased serum TC/HDL-C was an independent risk factor for mortality in the subgroup of old age, female, cardiovascular disease and low HDL-C. The single lipid marker of TC or HDL-C was not able to predict mortality in PD patients. However, increased serum TC/HDL-C was independently associated with all-cause mortality in PD patients.

Role of High-Density Lipoprotein Cholesterol (HDL-C) as a Clinical Predictor of Decompensation in Patients with Chronic Liver Disease (CLD)

Introduction. Systemic inflammation triggered by bacterial products like lipopolysaccharides (LPS) in the circulation is an important factor leading to decompensation in patients with chronic liver disease (CLD). High-density lipoprotein cholesterol (HDL-C) has a significant role in innate immune response to LPS in the circulation and could therefore increase the risk for decompensation in patients with CLD. In this study, we have explored the role of HDL-C as a prognostic marker for decompensation. Methods. This was a prospective, observational, cohort study where consecutive patients with CLD were included. Patients with cholestatic liver disease and hepatocellular carcinoma were excluded. Fasting lipids were measured in all patients at the time of recruitment. Each patient was carefully followed up for development of decompensation events such as new-onset/worsening ascites, hepatic encephalopathy, or variceal bleed during follow-up. Results. A total of 170 patients were included (mean age 60 ± 11.5 years, M : F = 6 : 1 ). At the end of follow-up, 97/170 patients (57%) had decompensation events. Mean HDL-C levels were significantly lower among patients with decompensation ( 27.5 ± 15 mg/dL vs. 43.5 ± 13.9 mg/dL; p value 0.004). Using ROC analysis, cut-off for HDL-C of 36.4 mg/dL was identified. On multivariate analysis, HDL-C ( OR = 6.072 ; 95% CI 2.39-15.39) was found to have an independent association with risk of decompensation. Conclusions. HDL-C level (<36.4 mg/dL) is a reliable marker for risk of decompensation and can be a useful addition to existing prognostic scoring systems in CLD. It can be a valuable tool to streamline treatment protocols and prioritise liver transplantation.