Postprandial plasma glucose excursion is associated with an atherogenic lipid profile in individuals with type 2 diabetes mellitus: A cross-sectional study

Coronary heart disease (CHD) is a prevalent complication of type 2 diabetes mellitus (T2DM). The atherogenic low-density lipoprotein (LDL) cholesterol is an established risk factor of cardiovascular disease, and evidence also suggests that postprandial plasma glucose (PPG) levels closely delineate CHD mortality in diabetes. The investigators hypothesized that postprandial plasma glucose excursion (PPGE), defined as the difference between 2-hour PPG and fasting plasma glucose (FPG), may be associated with plasma LDL cholesterol levels in patients with T2DM. This study enrolled diabetic participants for whom FPG and lipid profile were sampled after a 12-hour fast, followed by PPG sampling two hours after consuming a standard meal with 75 grams of carbohydrates. The study enrolled 379 participants who were divided into PPGE tertiles according to the difference between their 2-hour PPG and FPG. Participants in the highest PPGE tertile had considerably greater plasma LDL cholesterol levels than patients in the lowest tertile (126.7 mg/dL vs. 99.5 mg/dL, P <0.001). Linear regression analysis also demonstrated that the PPGE was positively correlated with plasma LDL cholesterol levels (β coefficient: 0.165, P < 0.001). Postprandial glucose excursion positively correlated with plasma LDL cholesterol levels in individuals with T2DM. Participants with raised PPGE harbored greater LDL cholesterol levels than those with lower postprandial glucose fluctuations. Therefore, postprandial glucose excursion is associated with an atherogenic lipid profile and may be a modifiable risk factor of diabetic CHD.

Hyperhomocysteinemia Is Associated With Lipid Profiles and Lipid Ratio in Patients With Coronary Artery Disease

Objective: This study aimed to investigate the correlation of Hyperhomocysteinemia (HHcy) or serum homocysteine (Hcy) levels with lipid levels and lipid ratios in individuals with coronary artery disease(CAD).Methods: A total of 1646 subjects with suspected CAD were divided into CAD or control groups. Serum Hcy, total cholesterol(TC), triglycerides(TGs), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), apolipoprotein(Apo)AI and ApoB concentrations were detected.Results: Serum TC, LDL-C and ApoB in control subjects with HHcy were lower than those in individuals with normal Hcy, and serum HDL-C and ApoAI in CAD subjects with HHcy were lower than those in individuals with normal Hcy(P < 0.05). The correlation analysis showed that serum TGs, LDL-C, ApoAI and HDL-C were correlated with Hcy(P <0.05). There are different HHcy trends affecting the ratios of TC/HDL-C and LDL/HDL-C between the CAD and controls(Pinteraction for TC/HDL-C=0.025; Pinteraction for LDL/HDL-C=0.033). CAD patients with HHcy had a higher ratio of TC/HDL-C(P=0.022) and LDL/HDL-C(P=0.045) than those with normal Hcy, but in the controls, the subjects with HHcy exhibited a trend toward a decreased ratio of TC/HDL-C(P=0.481) and LDL/HDL-C(P=0.303).Conclusion: HHcy was related to the atherogenic lipid profile in patients with CAD. The lipid ratio is more suitable for assessing the effect of HHcy on CAD.

Differences in Lipoprotein Profiles Between Palestinian and Israeli Adults

Background: Palestinians exhibit a substantially greater prevalence of type 2 diabetes mellitus, cardiovascular disease (CVD) incidence and CVD mortality in comparison to Israelis. In view of Palestinians' increased insulin resistance, known to be associated with an adverse lipoprotein profile, we aimed at showing lipoprotein variations between Palestinian and Israelis residing in Jerusalem. Methods: The study included, 968 Palestinians and 707 Israelis, ages 25-74 years, who underwent fasting and 2h post oral challenge plasma glucose determinations. We evaluated metabolic risk by measuring sub-populations of VLDL, LDL and HDL particles, using nuclear magnetic resonance spectroscopic analysis. Results: Palestinians exhibit higher levels of very large VLDL including chylomicrons, in comparison to their Israeli counterparts, whereas levels of medium and small VLDL were similar between the two populations. Small oxidized LDL levels were higher among Palestinians while intermediate and large LDL were similar between the two groups. Levels of large HDL were higher among Israelis while levels of medium and small HDL were similar between the two populations. Small oxidized LDL levels were higher among Palestinians in comparison to Israeli participants. Levels of large HDL were higher among Israelis in comparison to Palestinians. Limiting the analysis to young participants with normal glucose tolerance, showed greater levels of large VLDL including chylomicrons, medium and small VLDL and oxidized LDL in Palestinians. Conclusions: Palestinians, including healthy young participants, exhibit an adverse pro-atherogenic lipid profile compared to Israelis. These findings may explain the increased CVD morbidity and mortality observed in Palestinians.

Lipoprotein distribution of Apo CIII glycoforms in healthy men is linked with low TG and increased insulin sensitivity

ABSTRACTGlycosylation of Apo CIII modulates its function in triglyceride metabolism, and some variants are associated with a protective or pro-atherogenic lipid profile. These associations have been studied in whole plasma Apo CIII proteoforms, but the proportion of Apo CIII proteoforms in individual lipoprotein fractions has been rarely evaluated. In the present study, we aim to measure the relative content of Apo CIII proteoforms in each lipoprotein fraction (VLDL, IDL, LDL and HDL) in a group of healthy subjects as a potential biomarker for triglyceride metabolism, cardiovascular risk and diabetes. Lipoprotein fractions were separated by differential ultracentrifugation of plasma samples. The relative concentrations of seven Apo CIII variants were measured by mass spectrometric immunoassay, and the complete lipoprotein profile was determined by NMR. The results showed high interindividual variability in the distribution of Apo CIII proteoforms across the study population but a uniform proportion in all lipoprotein fractions. Two Apo CIII variants, Apo CIII0b and Apo CIII1d, were negatively correlated with plasma and VLDL triglycerides regardless of VLDL size and were associated with increased LDL size when transported in LDL particles. Apo CIII0b also showed a negative correlation with lipoprotein-insulin resistance score. Therefore, Apo CIII variants can be reliably measured in lipoprotein fractions, and our results suggest that Apo CIII0b and Apo CIII1d have a protective role in triglyceride metabolism and insulin resistance in healthy individuals.

Coronavirus Disease 2019 Induced Inflammatory Response are Associated with Changes in Lipid Profiles

Background: Previous studies have found some evidence of association between changes in lipids and lipoprotein and viral pneumonia. No data are available about the effect of coronavirus disease 2019 (Covid-19) on lipids. The aim of this study was to investigate the relationships between lipid profiles and inflammation markers among patients with Covid-19. Methods: In this retrospective analysis, Covid-19 patients in Jin-yin-tan Hospital and healthy individuals from Daping Hospital were enrolled. The clinical and biochemical characteristics of Covid-19 patients and healthy controls were compared. We correlated lipid parameters to disease severity and inflammatory markers. The severity of Covid-19 for all patients were stipulated according to the diagnostic and treatment guideline for Covid-19 issued by Chinese National Health Committee (the 7th edition).Results: A total of 242 Covid-19 patients and 242 sex-age matched controls were enrolled. Compared with controls, Covid-19 patients had lower lymphocyte counts as well as total cholesterol (TC), high density lipoprotein (HDL-c), low density lipoprotein cholesterol (LDL-c), non-high density lipoprotein cholesterol (non-HDL-c) and apoA-I levels on admission. Whereas apolipoprotein B (apoB) and apoB/apoA-I ratio were slightly higher in patients with Covid-19. There was no difference in lipid levels between the moderate and severe groups. The total lymphocytes were weakly positively associated with TC, LDL-c and apoA-I. Conclusion: Patients with Covid-19 are associated with decreased lipid and lipoprotein levels. Covid-19 infection induced inflammation response and cytokine storm were associated with a shift of lipids, lipoproteins toward a more atherogenic lipid profile.

Folate and Vitamin B12 in Morbid Obesity: The Influence of Folate on Anti-Atherogenic Lipid Profile

Previous studies showed a high prevalence of micronutrient deficiencies in obese subjects, with low folate and vitamin B12 serum levels and intakes. Correlations between vitamins and lipids have been investigated both in animal and human studies. The aim of our study is to evaluate the influence of dietetic and serum levels of folate and vitamin B12 on lipid pattern in morbidly obese subjects. We also analysed the relationship between serum concentrations and dietary intake of these micronutrients, and compared the intakes to the Recommended Levels of Nutrients and Energy Intakes (LARN). In 122 morbidly obese patients, mean BMI 45 ± 7 kg/m2, we evaluated anthropometric parameters, hepatic, glyco/lipid profile, total folate and vitamin B12, blood pressure, and finally nutritional intakes in a subgroup of 68 patients using a food frequency questionnaire about the frequency of food consumption and daily water intake. These values were determined in obese patients before and one year after sleeve gastrectomy. Both before and after surgery, levels of vitamins and minerals remained in normal range compared to LARN. According to univariate analysis, at baseline folate showed a significantly positive correlation with high-density lipoprotein cholesterol (p = 0.028, ρ = 0.204), apolipoprotein A-I (p = 0.006, ρ = 0.268) and vitamin B12 (p = 0.040, ρ = 0.192), and a significantly negative correlation with triglycerides (p = 0.049, ρ = −0.184). Folate and vitamin B12 levels do not correlate with their nutritional intakes, which remain within recommended range after surgery. In conclusion the correlation between folate and anti-atherogenic lipid profile is confirmed also in a large group of morbid obese patients.

Influence of Negative Calorie Foods on Atherogenic Indices in Overweight Women

Objective: The present study aimed to determine the effects of diet of negative calorie foods (NCF) on weight, atherogenic lipids, and atherogenic ratio and compare its efficiency with diet of low calorie foods (LCF). Materials and Methods: In this randomized clinical trial, the participants were randomly selected from inactive overweight females (age 45-75 years) by parallel assignment were distributed randomly into two groups: NCF group that received a highcarbohydrate (75%), and low-fat (10%) diet, and LCF group had a dietary recipe with 55% of carbohydrate and a little fat (30%) content. Both groups had a healthy calorie restriction (15%) from their daily caloric requirements within three months. Evaluation of body weight, atherogenic lipids (total-C, HDL-C and LDL-C), and atherogenic ratio (total-C to HDL-C) were performed pre- and postintervention for all subjects and compared to each other. Results: The results of the within-group comparison of NCF and LCF on weight (respectively, P -value= 0.04; P -value= 0.03), total-C (respectively, P -value= 0.02; P -value= 0.03), HDL-C (respectively, P -value= 0.04; P -value= 0.01) and LDL-C (respectively, P -value= 0.01; P -value= 0.03) revealed significant effects. Also, significant differences were observed between groups in atherogenic lipid profile, total-C ( P -value: 0.03), HDL-C ( P -value: 0.001), and LDL-C ( P -value: 0.03). The result of the between-group comparison was also significant in atherogenic ratio ( P -value: 0.04). Conclusion: Contrary to expectation, dietary regimen demonstrated a similar pattern of weight loss in females. The NCF when compared to the LCF, is not a healthy choice for weight loss in sedentary females with overweight.