Association of LpPLA2 with coronary artery disease a hospital-based case control study

Coronary artery disease (CAD) in Asian-Indians is characterised by an earlier onset and more severe disease when compared to Western populations. It is estimated that about 20% of patients presenting with an acute coronary syndrome do not have any of the conventional risk factors for CAD. To assess the risk posed by each of the newer risk factors; alongside conventional risk factors namely diabetes, hypertension, dyslipidaemia for coronary artery disease and to compare the relative risk in a case-control design. Department of Cardiology, XXX Institute of Medical sciences (XXX). Case control study design. Cases are as any individual with coronary artery disease and controls included patients with non-coronary conditions. Dependant variable: coronary artery disease (CAD); Independent variables: Lp PLA2, Lp(a), Apo(a), Apo(b), Ratio (Apo B/Apo A); Other predictors- diabetes mellitus, hypertension, dyslipidaemia, tobacco use Categorical variables were presented as frequencies and percentages. Chi-square test and binary logistic regression analysis was used to study the comparison and association of the categorical risk factors with the disease status, respectively. Software used was SPSS version 20.0. A total of 253 participants aged between 19 and 90 years; 140 cases and 113 controls were enrolled in this study. Except for the hs-CRP level, alcohol consumption and LDL, all the other risk factors were seen significantly associated with the coronary artery disease; dyslipidaemia (10.8, 95% CI 3.29-35.37), gender- male (4.68, 95% CI 2.12-10.30), diabetes mellitus (3.3, 95% CI 1.6 -6.77), lipoprotein(a) more than 30mg% (2.34, 95% CI 1.06-5.15) and hypertension (2.48, 95% CI 1.14-5.39). Conventional risk factors namely diabetes, hypertension and dyslipdaemia showed a statistically significant association with CAD while from among the biochemical markers the association was statistically significant only for Lp(a) when compared both between cases and controls and also in cases < age 50 years. The other biochemical risk factors namely Lp-PLA2, Apo(A1) and Apo(b) showed a weak degree of association with CAD. In the present study we analyse the role of inflammatory mediators of CAD (hs-CRP, Lp-PLA2), pro-thrombotic markers [Lp(a)] alongside the lipid fractions apoB, apo A and their ratio to assess which of these biochemical markers predisposed one to CAD through assessment of the relative risk.

Lipoprotein Profile in Populations from Regions of the Russian Federation: ESSE-RF Study

This study aimed to describe the dyslipidemia prevalence and pattern among adult populations from different regions (n = 13) of the Russian Federation (RF). Randomly selected samples (n = 22,258, aged 25–64) were studied according to the ESSE-RF protocol. Lipoprotein parameters were estimated by routine methods. Statistical analyses were performed using R software (v.3.5.1). The overall dyslipidemia prevalence was 76.1% (76.9/75.3% for men/women). In women, total cholesterol (TC) and low-density lipoprotein (LDL)-C levels gradually increased with age (from 4.72 to 5.93 and from 2.76 to 3.79 mmol/L, respectively); in men, they reached a maximum by 45–54 (5.55 and 3.55 mmol/L, respectively) and then decreased. No differences in high-density lipoprotein (HDL)-C in men of different ages were found, but slight decreases in HDL-C and apo AI were observed in women by 55–64 years. No pronounced associations between education and lipid levels in men were observed; higher-educated women showed significantly better lipoprotein profiles. Similar associations between lipids and income level were detected. Women from rural areas had higher TC and triglycerides than urban residents. Regardless of sex, rural residents had higher HDL-C and apo AI, and reduced apo B/apo AI. Conclusion: Information on the peculiarities of dyslipidemia prevalence and lipoprotein profile depending on sex, age, residential place, and socioeconomic status is useful for assessing the global ASCVD risk, and for risk modeling based on national data.

Trends in Nutritional Biomarkers by Demographic Characteristics Across 14 Years Among US Adults

Background: Understanding trend in nutritional status is crucial to inform national health priorities to improve diets and reduce related diseases. The present study aimed to analyze trends in the concentrations of all measured nutritional biomarkers and their status among US adults across 14 years.Methods: Trends on the concentrations of nutritional biomarkers and nutritional status evaluated by the prevalence of deficiency, inadequacy, excess, and dyslipidemia were analyzed among US adults in 7 cross-sectional National Health and Nutrition Examination Surveys (NHANES 2003–2016) and by age, sex, race/ethnicity, and socioeconomic status.Results: A total of 38,505 participants (weighted mean age of 47.2 years, 51.4% women) were included in the present study. Across 14 years, increased trends were found in red blood cell (RBC) folate, serum vitamin B12, vitamin D and albumin, the prevalence of iodine deficiency, vitamin B6 inadequacy, and hypophosphatemia, whereas decreased trends were observed in serum vitamin E, phosphorus, total calcium, total protein, apolipoprotein B (Apo B), low-density-lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), blood lead, cadmium, mercury, and the prevalence of vitamin C deficiency, vitamin D inadequacy, iodine excess, and dyslipidemia with elevated LDL-C, TC, TG, and lowered HDL/LDL. Non-Hispanic blacks (NHB) and participants with low socioeconomic status were accounted for the poor nutritional status of most biomarkers compared to their comparts.Conclusion: Most nutritional biomarkers and their status were improved among US adults from 2003 to 2016, but some specific populations should be paid much attention to improve their nutritional status, especially for NHB and participants with low socioeconomic status.

Four-Way Decomposition of Effect of Alcohol Consumption and Body Mass Index on Lipid Profile

Background: Both obesity and alcohol consumption are strongly associated with dyslipidemia; however, it remains unclear whether their joint effect on lipid profiles is through mediation, interaction, or a combination of the two. Methods: In total, 9849 subjects were selected from the 2009 panel of China Health and Nutrition Survey (CHNS). A four-way decomposition method was used to validate the pathways of drinking and body mass index (BMI) on lipids (total cholesterol, TC; triglyceride, TG; low-density lipoprotein cholesterol, LDL-C; high-density lipoprotein cholesterol, HDL-C; apolipoprotein A, APO-A; and apolipoprotein B, APO-B). Results: According to four-way decomposition, the total effects of drinking on lipids were found to be statistically significant, except for LDL-C. The components due to reference interaction were 0.63, 0.48, 0.60, −0.39, −0.30, and 0.20 for TC, TG, LDL-C, HDL-C, APO-A and APO-B, respectively (p < 0.05 for all). The effect size of pure indirect effect and mediated interaction were 0.001~0.006 (p > 0.05 for all). Further, linear regression models were used to examine the effect of BMI on lipid profiles in drinkers and non-drinkers. The associations of BMI and lipids were higher in all drinkers than in non-drinkers (0.069 versus 0.048 for TC, 0.079 versus 0.059 for TG, 0.057 versus 0.037 for LDL-C, −0.045 versus −0.029 for HDL-C, −0.024 versus −0.011 for APO-A and 0.026 versus 0.019 for APO-B, p interaction <0.05 for all). Conclusions: The joint effect of alcohol consumption and obesity on lipid profiles is through interaction rather than mediation. Alcohol consumption amplifies the harmful effect of BMI on lipid profiles. Greater attention should be paid to lipid health and cardiovascular risk in obese individuals regarding alcohol consumption. For obese individuals, we do not recommend alcohol consumption.

The Differences of Lipoprotein-Associated Phospholipase A2, Apolipoprotein B and Low Density Lipoprotein In Obese and Lean Men

ABSTRACT Background: An increase in fat accumulation in obesity has been suggested to link with an increase in inflammation. This inflammation may be associated with an elevated of Lipoprotein-Associated Phospholipase A2 (Lp-PLA2), Apolipoprotein B (Apo B), and Low-Density Lipoprotein (LDL), thereby associated with the risk of atherosclerosis.Objective: To investigate the differences between Lp-PLA2, Apo B, and LDL levels in obese and lean men.Methods: A cross-sectional study was conducted on 74 men (obese and lean) at the Faculty of Medicine, Diponegoro University, Indonesia, in 2020. The concentration of LDL was measured using the homogenous enzymatic colourimetric method, whereas the levels of Lp-PLA2 and Apo B were determined using the ELISA method. Data were analyzed using an Independent t-test, setting statistical significance at p <0.05.Results: This study showed that Lp-PLA2 levels were significantly different between obese and lean men (p = 0.039). Furthermore, LDL levels were also significantly different between obese and lean men (p = 0.002). However, we did not find any differences in Apo B between obese and lean men (p = 0.640).Conclusion: Lp-PLA2 and LDL levels were slightly higher in obese compared to lean men, but no difference of Apo B.

Characterization of Cardiac, Vascular, and Metabolic Changes in Young Childhood Cancer Survivors

Background: Childhood cancer survivors (CCS) are at an increased risk for cardiovascular diseases (CVD). It was the primary aim of this study to determine different measures of cardiac, carotid, lipid, and apolipoprotein status in young adult CCS and in healthy controls.Methods: Cardiac and common carotid artery (CCA) structure and function were measured by ultrasonography. Lipids and apolipoproteins were measured in the blood. Peripheral arterial endothelial vasomotor function was assessed by measuring digital reactive hyperemia index (PAT-RHI) using the Endo-PAT 2000.Results: Fifty-three CCS (20–30 years, 35 men) and 53 sex-matched controls were studied. The CCS cohort was divided by the median dose of anthracyclines into a low anthracycline dose (LAD) group (50–197 mg/m2, n = 26) and a high anthracycline dose (HAD) group (200–486 mg/m2, n = 27). Carotid distensibility index (DI) and endothelial function determined by PAT-RHI were both lower in the CCS groups compared with controls (p &lt; 0.05 and p = 0.02). There was no difference in carotid intima media thickness. Atherogenic apolipoprotein-B (Apo-B) and the ratio between Apo-B and Apoliprotein-A1 (Apo-A1) were higher in the HAD group compared with controls (p &lt; 0.01). Apo-B/Apo-A1-ratio was over reference limit in 29.6% of the HAD group, in 15.4% of LAD group, and in 7.5% of controls (p = 0.03). Measured lipid markers (low density lipoprotein and total cholesterol and triglycerides) were higher in both CCS groups compared with controls (p &lt; 0.05). Systolic and diastolic function were measurably decreased in the HAD group, as evidenced by lower EF (p &lt; 0.001) and lower é-wave (p &lt; 0.005) compared with controls. CCA DI correlated with Apo-B/Apo-A1-ratio and Apo-A1. Follow-up time after treatment correlated with decreased left ventricular ejection fraction (p = 0.001).Conclusion: Young asymptomatic CCS exhibit cardiac, vascular, lipid, and apolipoprotein changes that could account for increased risk for CVD later in life. These findings emphasize the importance of cardiometabolic monitoring even in young CCS.

Circulating lipids and breast cancer prognosis in the Malmö diet and cancer study

Purpose Examine the association between circulating lipids and breast cancer outcomes in patients enrolled in the Malmö Diet and Cancer Study (MDCS). Patients and methods Circulating lipid levels were measured in blood sampled upon enrollment in the female MDCS cohort (N = 17,035). We identified all MDCS participants with incident invasive breast cancer diagnosed between 1991 and 2014. Follow-up time began at breast cancer diagnosis and continued until the first event of breast cancer recurrence, death, emigration, or 5 years of follow-up. We estimated the incidence rates of recurrence at 5 years and fit Cox regression models to compute crude and adjusted hazard ratios (HRs) with 95% confidence intervals (95% CI) of breast cancer recurrence as well as all-cause mortality according to cohort-specific tertiles of apolipoprotein A-1 (Apo A-1) and apolipoprotein B (Apo B). Results We enrolled 850 eligible patients. During the 5 years of follow-up, 90 invasive breast cancer recurrences were diagnosed over 3807 person-years. In multivariable analyses, high baseline levels of Apo B were associated with an increased rate of recurrence (tertile 3 vs. 1, HR = 2.30 [95% CI 1.13–4.68]). However, high baseline levels of Apo B were not associated with all-cause mortality (tertile 3 vs. 1, HR = 1.23 [95% CI 0.68–2.25]). We observed no associations between levels of Apo A-1 and recurrence (tertile 3 vs. 1, HR = 1.34 [95% CI 0.70–2.58]) or all-cause mortality (tertile 3 vs. 1, HR = 1.12 [95% CI 0.61–2.05]). Conclusion High pre-diagnostic levels of Apo B were associated with an increased risk of recurrence among breast cancer patients. Circulating Apo A-1 was not associated with breast cancer outcomes.

Effects of diets rich in ghee or olive oil on cardiometabolic risk factors in healthy adults: A 2-period, crossover, randomized trial

This study aimed to evaluate the cardiovascular health-related effects of consuming ghee in the usual diet. Thirty healthy men and women were studied in a free-living outpatient regimen. The participants were instructed for the isocaloric inclusion of ghee or olive oil in their diets for 4 weeks using a randomized crossover design. At the end of run-in (baseline), 2-week wash-out, and interventions, fasting blood samples were drawn. In addition, 2-h postprandial blood samples were collected after ingestion of a meal containing olive oil or ghee at week 4 of each dietary intervention. Body weight was not different between the two interventions. Compared to the olive oil, the diet with ghee increased fasting plasma apolipoprotein-B (apo B) (0.09, 95% CI 0.02 to 0.17 g/L, p= 0.018) and non-high-density lipoprotein cholesterol (non-HDL-C) (0.53, 95% CI 0.01 to 1.05 mmol/L, p= 0.046) and low-density lipoprotein cholesterol did not differ significantly between diet groups (0.29, 95% CI –0.05 to 0.63 mmol/L, p= 0.092), but had no significant effect on total cholesterol/HDL-C ratio (0.75, 95% CI −0.24 to 1.74 mmol/L, p= 0.118). No significant difference was observed in fasting as well as 2-h postprandial plasma triacylglycerol, glucose, insulin, and plasminogen activator inhibitor-1 concentrations. This study showed that ghee which is predominantly saturated fats had an increasing effect on plasma apo B and non-HDL-C compared to olive oil, adding further evidence to the existing recommendations to replace dietary fats high in SFA with dietary fats high in unsaturated fats to reduce cardiovascular disease risk.

A New Prediction Model Integrated Serum Lipid Profile for Patients with Multiple Myeloma

This study aimed to explore a predictive risk-stratification model combing clinical characteristics and lipid profiles in multiple myeloma (MM) patients. The data of 275 patients in Sun Yat-Sen University Cancer Center were retrospectively analyzed and randomly divided into the training (n = 138) and validation (n = 137) cohorts. Triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), lactate dehydrogenase (LDH), Apolipoprotein B (Apo B) and Apo B / Apolipoprotein A1 (Apo A1) ratio were the prognostic factors identified through univariate and multivariate Cox analysis. A 6-prognostic factor model was constructed based on Lasso regression. Patients were divided into low- and high-risk groups and the former group showed longer overall survival (OS) time (p<0.05). The area under the curve (AUC) of the risk score model for 5-and 10-year OS were 0.756 [95% CI: 0.661-0.850] and 0.940 [95% CI: 0.883-0.997], which exhibited better accuracy than International Staging System (ISS) and Durie and Salmon (DS) stage. The nomogram integrating ISS stage and risk score increased the prediction accuracy. The model can be used to help monitor the metabolic state and to establish primary prevention strategies to identify new therapeutic targets.

A Systematic Review and Meta-Analysis of Therapeutic Efficacy and Safety of Alirocumab and Evolocumab on Familial Hypercholesterolemia

Objectives. The aim of this study was to provide the first study to systematically analyze the efficacy and safety of PCSK9-mAbs in the treatment of familial hypercholesterolemia (FH). Methods. A computer was used to search the electronic Cochrane Library, PubMed/MEDLINE, and Embase databases for clinical trials using the following search terms: “AMG 145”, “evolocumab”, “SAR236553/REGN727”, “alirocumab”, “RG7652”, “LY3015014”, “RN316/bococizumab”, “PCSK9”, and “familial hypercholesterolemia” up to November 2020. Study quality was assessed with the Cochrane Collaboration’s tool, and publication bias was evaluated by a contour-enhanced funnel plot and the Harbord modification of the Egger test. After obtaining the data, a meta-analysis was performed using R software, version 4.0.3. Results. A meta-analysis was performed on 7 clinical trials (926 total patients). The results showed that PCSK9-mAbs reduced the LDL-C level by the greatest margin, WMD −49.14%, 95% CI: −55.81 to −42.47%, on FH versus control groups. PCSK9-mAbs also significantly reduced lipoprotein (a) (Lp (a)), total cholesterol (TC), triglycerides (TG), apolipoprotein-B (Apo-B), and non-high-density lipoprotein cholesterol (non-HDL-C) levels and increased HDL-C and apolipoprotein-A1 (Apo-A1) levels of beneficial lipoproteins. Moreover, no significant difference was found between PCSK9-mAbs treatment and placebo in common adverse events, serious events, and laboratory adverse events. Conclusion. PCSK9-mAbs significantly decreased LDL-C and other lipid levels with satisfactory safety and tolerability in FH treatment.