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BACKGROUNDS AND OBJECTIVE: Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase, are pivotal in managing hypercholesterolemia and reducing cardiovascular risk. While rosuvastatin demonstrates superior efficacy and tolerability compared to other statins, its safety profile in elderly patients older than 75 years old with acute coronary syndrome (ACS) remains underexplored. So, the objective of this study is to evaluate the frequency of adverse reactions and investigate the efficacy of high-dose rosuvastatin on lipid profiles in elderly patients aged over 75 with ACS. METHODS: In this observational study, 110 consecutive elderly ACS patients attending Modarres Hospital in Tehran, Iran, in 2019 were enrolled. The effects of high-dose rosuvastatin were assessed in elderly patients older than 75 years old by comparison of the adverse effects, lipid profile, cardiac function, and other biomarkers at the baseline and after 6 weeks of rosuvastatin therapy with a dose of 40 mg. RESULTS: Following 6 weeks of treatment, there was a significant reduction in total cholesterol (136.2 ± 24.3 to 115.5 ± 24.0, p = 0.001) and LDL levels (72.6 ± 17.5 to 50.9 ± 18.9, p = 0.001), accompanied by a notable increase in HDL levels (38.3 ± 7.1 to 47.2 ± 7.4, p = 0.001). Cardiac function, as measured by ejection fraction (EF), significantly improved from 43.4 ± 8.8 to 48.5 ± 8.5 (p = 0.001). Adverse effects such as cramps (N = 12, p = 0.001), weakness (N = 28, p = 0.001), and anorexia (N = 12, p = 0.001) were reported but did not warrant discontinuation of therapy. Notably, no cases of jaundice were observed. Two deaths occurred due to major adverse cardiac events (MACE) during the study period, unrelated to stroke or recurrent myocardial infarction. CONCLUSION: Totally, high-dose rosuvastatin therapy effectively improved lipid profiles, cardiac function, and liver enzyme levels in elderly ACS patients, with manageable adverse effects. These findings underscore the importance of rosuvastatin in optimizing cardiovascular health in this vulnerable population.
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Síndrome Coronario Agudo , Biomarcadores , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Rosuvastatina Cálcica , Humanos , Rosuvastatina Cálcica/efectos adversos , Rosuvastatina Cálcica/administración & dosificación , Rosuvastatina Cálcica/uso terapéutico , Síndrome Coronario Agudo/tratamiento farmacológico , Síndrome Coronario Agudo/sangre , Síndrome Coronario Agudo/diagnóstico , Anciano , Masculino , Femenino , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Resultado del Tratamiento , Anciano de 80 o más Años , Irán , Biomarcadores/sangre , Factores de Tiempo , Factores de Edad , Dislipidemias/tratamiento farmacológico , Dislipidemias/diagnóstico , Dislipidemias/sangre , Lípidos/sangre , Estudios ProspectivosRESUMEN
BACKGROUND: There is a growing burden of non-obese people with diabetes mellitus (DM). However, their cardiovascular risk (CV), especially in the presence of cardiovascular-kidney-metabolic (CKM) comorbidities is poorly characterised. The aim of this study was to analyse the risk of major CV adverse events in people with DM according to the presence of obesity and comorbidities (hypertension, chronic kidney disease, and dyslipidaemia). METHODS: We analysed persons who were enrolled in the prospective Silesia Diabetes Heart Project (NCT05626413). Individuals were divided into 6 categories according to the presence of different clinical risk factors (obesity and CKM comorbidities): (i) Group 1: non-obese with 0 CKM comorbidities; (ii) Group 2: non-obese with 1-2 CKM comorbidities; (iii) Group 3: non-obese with 3 CKM comorbidities (non-obese "extremely unhealthy"); (iv) Group 4: obese with 0 CKM comorbidities; (v) Group 5: obese with 1-2 CKM comorbidities; and (vi) Group 6: obese with 3 CKM comorbidities (obese "extremely unhealthy"). The primary outcome was a composite of CV death, myocardial infarction (MI), new onset of heart failure (HF), and ischemic stroke. RESULTS: 2105 people with DM were included [median age 60 (IQR 45-70), 48.8% females]. Both Group 1 and Group 6 were associated with a higher risk of events of the primary composite outcome (aHR 4.50, 95% CI 1.20-16.88; and aHR 3.78, 95% CI 1.06-13.47, respectively). On interaction analysis, in "extremely unhealthy" persons the impact of CKM comorbidities in determining the risk of adverse events was consistent in obese and non-obese ones (Pint=0.824), but more pronounced in individuals aged < 65 years compared to older adults (Pint= 0.028). CONCLUSION: Both non-obese and obese people with DM and 3 associated CKM comorbidities represent an "extremely unhealthy" phenotype which are at the highest risk of CV adverse events. These results highlight the importance of risk stratification of people with DM for risk factor management utilising an interdisciplinary approach.
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Enfermedades Cardiovasculares , Comorbilidad , Diabetes Mellitus , Obesidad , Humanos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Obesidad/epidemiología , Obesidad/diagnóstico , Obesidad/mortalidad , Medición de Riesgo , Estudios Prospectivos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/mortalidad , Diabetes Mellitus/epidemiología , Diabetes Mellitus/diagnóstico , Factores de Tiempo , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/mortalidad , Dislipidemias/epidemiología , Dislipidemias/diagnóstico , Dislipidemias/sangre , Hipertensión/epidemiología , Hipertensión/diagnóstico , Hipertensión/mortalidad , Italia/epidemiología , Pronóstico , Factores de Riesgo , Factores de Riesgo de Enfermedad CardiacaRESUMEN
The risk of cardiovascular disease (CVD) is approximately doubled in subjects with hypercholesterolemia compared to those with normal blood cholesterol levels. Monacolin K (MK), the main active substance in rice fermented by the Monascus purpureus, acts on cholesterol metabolism. Rice also contains other bioactive compounds such as γ-oryzanol (OZ) and γ-aminobutyric acid (GABA). In a randomized, placebo-controlled, double-blind trial, the efficacy and tolerability of a food supplement (FS) based on an ingredient standardized to contain monacolins (4.5%), OZ, and GABA were evaluated in subjects with mild dyslipidemia. For the duration of the trial, enrolled subjects (n = 44, each group) received the FS or placebo and were instructed to use an isocaloric diet. Compared to the placebo group, after a 3 months of the FS, the mean low-density lipoprotein cholesterol and mean TC values were reduced by 19.3 and 8.3%, respectively, while the mean high-density lipoprotein cholesterol value increased by 29.3%. On average, the subjects shifted from very high to moderate CVD risk. Glucose metabolism and hepatic and renal parameters did not change after the treatment and no adverse events were reported. Guidelines to handle hypercholesterolemia with food supplements in specific clinical settings are needed to better manage mild dyslipidemia.
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Suplementos Dietéticos , Dislipidemias , Fenilpropionatos , Ácido gamma-Aminobutírico , Humanos , Método Doble Ciego , Masculino , Femenino , Persona de Mediana Edad , Dislipidemias/tratamiento farmacológico , Dislipidemias/sangre , Fenilpropionatos/uso terapéutico , Adulto , Lovastatina/uso terapéutico , LDL-Colesterol/sangre , Resultado del Tratamiento , HDL-Colesterol/sangreRESUMEN
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.
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Consenso , Dislipidemias , Hipolipemiantes , Humanos , Hipolipemiantes/uso terapéutico , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/tratamiento farmacológico , Dislipidemias/terapia , Biomarcadores/sangre , Hipertrigliceridemia/diagnóstico , Hipertrigliceridemia/sangre , Hipertrigliceridemia/terapia , Factores de Riesgo , Hipercolesterolemia/sangre , Hipercolesterolemia/complicaciones , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/tratamiento farmacológico , Resultado del Tratamiento , Triglicéridos/sangreRESUMEN
BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women. Dyslipidemia is a prevalent metabolic abnormality in individuals with PCOS. Moreover, vitamin D deficiency is widespread across all societal strata, with a particularly heightened prevalence observed in patients afflicted with PCOS. The present study aimed to investigate the level of vitamin D and its correlation with lipid profiles in Iranian women diagnosed with PCOS. METHODS: This cross-sectional study was carried out at the PCOS and infertility clinic of Arash Women's Hospital in Tehran. The study encompassed the medical records of PCOS patients who attended the clinic from March 2021 to December 2023. All patients underwent blood tests, which included assessments of fasting blood sugar levels, lipid profiles, and 25-hydroxyvitamin D (25(OH)D) levels. The investigation focused on evaluating the relationship between vitamin D levels and lipid profiles. Statistical analyses, including the chi-square test and Spearman's correlation coefficient, were employed to analyze the data. RESULTS: A total of 1004 women diagnosed with PCOS were included in the study. The age range of the participants was 14 to 46 years. The majority of the participants had a body mass index (BMI) within the normal range (n = 555, 55.3%). The median vitamin D level among the participants was 26.00 (IQR: 19.00-34.00). The relationship between vitamin D levels and lipid profile parameters was assessed, revealing no significant correlation between vitamin D levels and low-density lipoprotein (LDL) (r = 0.021, p = 0.505), high-density lipoprotein (HDL) (r = 0.011, p = 0.719), or triglyceride (TG) (r = -0.026, p = 0.417) levels, both in non-adjusted and age-adjusted analyses. CONCLUSION: According to the present study, there was no significant correlation between serum 25(OH)D deficiency and elevated TG or LDL levels or decreased HDL levels in PCOS patients. Nevertheless, further prospective studies are needed to determine whether there is a causal relationship between vitamin D deficiency and lipid profile alterations, specifically among PCOS patients.
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Lípidos , Síndrome del Ovario Poliquístico , Deficiencia de Vitamina D , Vitamina D , Humanos , Síndrome del Ovario Poliquístico/sangre , Síndrome del Ovario Poliquístico/complicaciones , Femenino , Adulto , Estudios Transversales , Vitamina D/sangre , Vitamina D/análogos & derivados , Adulto Joven , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología , Irán/epidemiología , Adolescente , Lípidos/sangre , Persona de Mediana Edad , Índice de Masa Corporal , Dislipidemias/sangre , Dislipidemias/epidemiologíaRESUMEN
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 < 0.001), triglyceride (TG)(WMD = -0.17mmol/L, 95%CI = -0.26 --0.09, P < 0.001), low-density lipoprotein(LDL-C)(WMD = -0.44mmol/L, 95%CI = -0.57 --0.31, P < 0.001) while slightly increased high-density lipoprotein (HDL-C)(WMD = 0.04mmol/L, 95%CI = -0.00 - 0.08, P < 0.001). And subgroup analyses showed that TC, TG and LDL-C significantly decreased in patients aged > 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.
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Dislipidemias , Ajo , Ensayos Clínicos Controlados Aleatorios como Asunto , Dislipidemias/prevención & control , Dislipidemias/sangre , Dislipidemias/tratamiento farmacológico , Humanos , Triglicéridos/sangre , Persona de Mediana Edad , Femenino , Masculino , LDL-Colesterol/sangre , Adulto , Lípidos/sangreRESUMEN
Atherosclerotic cardiovascular disease (ASCVD) is a significant health challenge, and apolipoprotein B (ApoB)-containing lipoproteins are increasingly recognized as central to its progression. Initially labelled as the "low-density lipoprotein hypothesis," our understanding of the etiology of ASCVD has evolved into the "ApoB principle," which highlights the causal and consistent role of all ApoB lipoproteins in ASCVD development. We review the large body of data from genetic studies, to epidemiologic studies, to clinical trials that support this foundational principle. We also provide an overview of the recommendations from guideline committees across the globe on dyslipidemia management and compare these with recent Canadian guidelines. With a few key differences, recent guidelines worldwide provide largely concordant recommendations for diagnosing and managing dyslipidemia with general consensus regarding the need for optimal control of low-density lipoprotein cholesterol and ApoB-containing lipoproteins to prevent cardiovascular events and improve patient care.
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Dislipidemias , Guías de Práctica Clínica como Asunto , Humanos , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/terapia , Apolipoproteínas B/sangre , Aterosclerosis/prevención & control , Conducta de Reducción del Riesgo , Enfermedades Cardiovasculares/prevención & control , Canadá/epidemiología , LDL-Colesterol/sangre , Hipolipemiantes/uso terapéuticoRESUMEN
PURPOSE OF REVIEW: To provide perspective on the current development status, and potential future role, of obicetrapib, a third-generation cholesterylester transfer protein (CETP) inhibitor. Obicetrapib has received recent attention following positive Phase II clinical trial data and initiation of Phase III trials for the treatment of dyslipidemia and atherosclerotic cardiovascular disease (ASCVD). RECENT FINDINGS: The ROSE and ROSE2 trials are Phase II studies that examined the lipid lowering effects of obicetrapib in patients on pre-existing high-intensity statin therapy. Obicetrapib significantly reduced key dyslipidemia biomarkers including low density lipoprotein cholesterol (LDL-C), Apolipoprotein B (Apo B), and non-high-density lipoprotein cholesterol (non-HDL-C) while increasing high-density lipoprotein cholesterol (HDL-C). Four phase III clinical trials, including a cardiovascular outcomes trial, are ongoing. Preliminary data for obicetrapib shows favorable effects on dyslipidemia, which could theoretically lead to a decrease in ASCVD clinical events. Short-term safety data in preliminary studies shows no significant safety signals.
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Anticolesterolemiantes , Proteínas de Transferencia de Ésteres de Colesterol , Humanos , Proteínas de Transferencia de Ésteres de Colesterol/antagonistas & inhibidores , Anticolesterolemiantes/uso terapéutico , Dislipidemias/tratamiento farmacológico , Dislipidemias/sangre , Aterosclerosis/tratamiento farmacológicoAsunto(s)
Grosor Intima-Media Carotídeo , Humanos , Lípidos/sangre , Enfermedades Asintomáticas , Biomarcadores/sangre , Factores de Riesgo , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Medición de Riesgo , Valor Predictivo de las Pruebas , MasculinoRESUMEN
BACKGROUND AND AIM: Adequate serum vitamin D levels correlate with a more favorable lipid profile compared to deficient levels. Despite the well-established prevalence of vitamin D deficiency in children with obesity, studies investigating its influence on lipid profiles in this population are scarce. We explored the impact of vitamin D status on lipid profiles and markers of atherogenic dyslipidemia in a cohort of children and adolescents with obesity. METHODS AND RESULTS: A total of 271 Caucasian children and adolescents with overweight/obesity and a control group of 54 pediatric patients with normal weight. All participants underwent outpatient visits for the assessment of clinical parameters and venous blood collection for biochemical analysis such as triglycerides (TG)/HDL-C ratio, LDL-C/HDL-C ratio, atherogenic index of plasma AIP), vitamin D level. Individuals with obesity displayed severe vitamin D deficiency (25-OH-D ≤10 ng/ml) at a higher frequency compared to those with normal weight (p = 0.03). In patients with overweight/obesity and low 25-OH-D levels show higher values of glycemia (p = 0.001), insulin resistance (HOMA-IR and TRYG p < 0.001), TG (p < 0.001), TG/HDL-C (p = 0.001), AIP (p < 0.001), SBP (p = 0.01), and DBP (p = 0.04). In normal-weight individuals with low 25-OH- D levels an increased values of glycemia (p = 0.01), insulin resistance (HOMA-IR p = 0.01 and TRYG p = 0.002), TG (p = 0.01), TG/HDL-C (p = 0.02), AIP (p = 0.01). A direct correlation between 25-OH-D levels and metabolic parameters is observed. CONCLUSIONS: A correlation between vitamin D levels and the lipid/atherosclerotic profile was recorded. Vitamin D deficiency may represent a preventable and easily treatable cardiometabolic risk factor, emphasizing the importance of early intervention and preventive measures.
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Aterosclerosis , Biomarcadores , Dislipidemias , Lípidos , Obesidad Infantil , Deficiencia de Vitamina D , Vitamina D , Humanos , Niño , Masculino , Femenino , Adolescente , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/diagnóstico , Vitamina D/sangre , Vitamina D/análogos & derivados , Obesidad Infantil/sangre , Obesidad Infantil/diagnóstico , Obesidad Infantil/epidemiología , Biomarcadores/sangre , Dislipidemias/sangre , Dislipidemias/epidemiología , Dislipidemias/diagnóstico , Lípidos/sangre , Aterosclerosis/sangre , Aterosclerosis/epidemiología , Aterosclerosis/diagnóstico , Estudios de Casos y Controles , Factores de Edad , Medición de Riesgo , Estudios Transversales , Prevalencia , Factores de RiesgoRESUMEN
BACKGROUND: Cardiovascular diseases are the leading cause of death worldwide. Obesity and atherosclerosis are considered risk factors for this pathology. There are multiple methods to evaluate obesity, in the same way as there are different formulas to determine atherogenic risk. Since both pathologies are closely related, the objective of our work was to evaluate whether the ECORE-BF scale is capable of predicting atherogenic risk. METHODS: Observational, descriptive, and cross-sectional study in which 386,924 workers from several autonomous communities in Spain participated. The association between the ECORE-BF scale and five atherogenic risk indices was evaluated. The relationship between variables was assessed using the chi-square test and Student's t test in independent samples. Multivariate analysis was performed with the multinomial logistic regression test, calculating the odds ratio and 95% confidence intervals, with the Hosmer-Lemeshow goodness-of-fit test. ROC curves established the cut-off points for moderate and high vascular age and determined the Youden index. RESULTS: The mean values of the ECORE-BF scale were higher in individuals with atherogenic dyslipidemia and the lipid triad, as well as in those with elevated values of the three atherogenic indices studied, with p <0.001 in all cases. As atherogenic risk increased across the five evaluated scales, the prevalence of obesity also significantly increased, with p <0.001 in all cases. In the ROC curve analysis, the AUCs for atherogenic dyslipidemia and the lipid triad were above 0.75, indicating a good association between these scales and the ECORE-BF. Although the Youden indices were not exceedingly high, they were around 0.5. CONCLUSIONS: There is a good association between atherogenic risk scales, atherogenic dyslipidemia, and lipid triad, and the ECORE-BF scale. The ECORE-BF scale can be a useful and quick tool to evaluate atherogenic risk in primary care and occupational medicine consultations without the need for blood tests.
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Aterosclerosis , Obesidad , Humanos , España/epidemiología , Aterosclerosis/epidemiología , Estudios Transversales , Femenino , Masculino , Persona de Mediana Edad , Adulto , Obesidad/epidemiología , Factores de Riesgo , Medición de Riesgo , Dislipidemias/epidemiología , Dislipidemias/sangre , Prevalencia , Curva ROCRESUMEN
INTRODUCTION: Serum lipid profiles play a crucial role in diagnosing and evaluating cardiovascular diseases. However, the presence of paraprotein can lead to inaccurate dyslipidemia results on automated analyzers. CASE REPORT: A 65-year-old woman whose combined concentrations of HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) consistently surpassed her total serum cholesterol levels over a period of three months presented with unusual lipid component detection. Further analysis revealed the presence of a monoclonal paraprotein, identified as an IgMλ band, with a concentration of 28.0 g/L. The patient was subsequently diagnosed with Waldenström macroglobulinemia. The use of abnormal reaction kinetic curves and the ß quantification method, along with an alternative method that did not suffer from interference, revealed that the monoclonal paraprotein interfered with the measurements of HDL-C, LDL-C, apolipoprotein A-I (apoA-I), and apolipoprotein B (apoB) when using the Roche detection system. This interference led to spurious elevated HDL-C concentrations and falsely decreased apoA-I and apoB concentrations, while the LDL-C results were minimally affected. Although diluting the sample normalized the HDL-C and LDL-C measurements, the interference with the apoA-I and apoB assays persisted. No other common biochemical tests were interfered with this paraprotein. CONCLUSION: Caution is advised when using a homogenous method for direct measurement of HDL-C and LDL-C in patients with monoclonal paraprotein. Techniques to recognize and eliminate this interference are available. However, immunoturbidimetric detection of apoA-I and apoB levels is also susceptible to this interference, which is not readily removable.
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Dislipidemias , Paraproteínas , Macroglobulinemia de Waldenström , Humanos , Macroglobulinemia de Waldenström/sangre , Macroglobulinemia de Waldenström/diagnóstico , Macroglobulinemia de Waldenström/complicaciones , Anciano , Femenino , Paraproteínas/análisis , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/complicaciones , HDL-Colesterol/sangre , LDL-Colesterol/sangreRESUMEN
BACKGROUND: Dyslipidemia remains the major cause of atherosclerotic cardiovascular disease (ASCVD). Lipid management in patients with increased cardiovascular (CV) risk needs improvement across Europe, and data gaps are noticeable at the country level. HYPOTHESIS: We described the current treatment landscape in Belgium, hypothesizing that lipid management in patients with ASCVD remains inadequate and aiming to understand the reasons. METHODS: Using data from an anonymized primary care database in Belgium derived from 494 750 individuals, we identified those with any CV risk factor between November 2019 and October 2022 and described the clinical features of patients with ASCVD. The main outcomes were the proportion of patients (i) receiving lipid-lowering therapies (LLTs), (ii) per low-density lipoprotein cholesterol (LDL-C) threshold, stratified per LLT, (iii) reaching the 2021 ESC recommended LDL-C goals, and (iv) LDL-C reduction per type of LLT was also determined. RESULTS: Among 40 888 patients with very high CV risk, 24 859 had established ASCVD. Most patients with ASCVD were either receiving monotherapy (59.6%) or had no documented LLT (25.1%). Further, 64.2% of those with no documented LLT exhibited LDL-C levels ≥ 100 mg/dL. Among common treatment options, one of the greatest improvements in LDL-C levels was achieved with combination therapy of statin and ezetimibe, reducing LDL-C levels by 41.5% (p < 0.0001). Yet, in this group, 24.8% of patients had still LDL-C levels ≥ 100 mg/dL and only 20.7% were at goal. CONCLUSION: Our study emphasizes the importance of developing strategies to help patients achieve their LDL-C goals, with a focus on supporting the implementation of combination LLT in routine clinical practice.
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Aterosclerosis , LDL-Colesterol , Humanos , Bélgica/epidemiología , Masculino , LDL-Colesterol/sangre , Femenino , Persona de Mediana Edad , Aterosclerosis/sangre , Aterosclerosis/epidemiología , Aterosclerosis/tratamiento farmacológico , Anciano , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Biomarcadores/sangre , Estudios Retrospectivos , Dislipidemias/tratamiento farmacológico , Dislipidemias/sangre , Dislipidemias/epidemiología , Factores de Riesgo , Hipolipemiantes/uso terapéutico , Pautas de la Práctica en Medicina , Resultado del TratamientoRESUMEN
BACKGROUND: The present study aimed to evaluate the effects of 24 weeks of moderate aerobic exercise on lipids and lipoprotein levels; Lipo (a) markers, and their association with cognitive performance in healthy older adults. METHODS: A total of 150 healthy subjects (100 males and 50 females; age range: 65-95 years) were recruited for this study. Based on the LOTCA test score, subjects were classified into two groups: the control group (n = 50) and the cognitive impairment group (n = 100). Cognitive functioning, leisure-time physical activity (LTPA), lipid profile, total cholesterol, TG, HDL-c, LDL-C, and lipo(a) were assessed at baseline and post-24-week aerobic exercise interventions using LOTCA battery, pre-validated Global Physical Activity Questionnaire (GPAQ) version II, colorimetric, and immunoassay techniques, respectively. RESULTS: Significant improvements in cognitive function and modulation in lipid profile and lipoprotein (a) markers were reported in all older subjects following 24 weeks of moderate exercise. LOTCA-7-sets scores significantly correlated with physical activity status and the regulation of lipids and Lipo (a) markers. Physically active persons showed higher cognitive performance along with a reduction in the levels of T-Cholest., TG, LDL-C, Lipo (a), and an increase in the levels of HDL-C and aerobic fitness VO2max compared with sedentary participants. Cognitive performance correlated positively with increased aerobic fitness, HDL-C, and negatively with T-Cholest., TG, LDL-C, and Lipo (a). However, a significant increase in the improvement of motor praxis, vasomotor organization, thinking operations, attention, and concentration were reported among older adults. CONCLUSIONS: The study findings revealed that supervised moderate aerobic training for 24 weeks significantly enhances cognitive functions via mitigating older adults' lipid profiles and lipoprotein (a). Cognitive performance is positively correlated with aerobic fitness and HDL-C level and negatively with T-Cholest., TH, LDL-C, and Lipo (a).
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Cognición , Dislipidemias , Ejercicio Físico , Conducta Sedentaria , Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Cognición/fisiología , Ejercicio Físico/fisiología , Ejercicio Físico/psicología , Dislipidemias/terapia , Dislipidemias/sangre , Dislipidemias/psicologíaRESUMEN
BACKGROUND: Preterm birth is the leading cause of neonatal mortality worldwide, and dyslipidemia is associated with preterm birth in observational studies. We use Mendelian randomization (MR) analyses to uncover the causal association between blood lipid levels and preterm birth. METHODS: We extracted uncorrelated (R2â¯<â¯0.001) single-nucleotide polymorphisms strongly associated (pâ¯<â¯5â¯×â¯10-8) with blood lipids from genome wide association studies of FinnGen database and UK Biobank participants. Inverse variance weighted method was the main MR analysis. Sensitivity analyses including genetic pleiotropy, heterogeneity, and directionality of causality were conducted. RESULTS: The study included 115,082 participants with lipid measurements, 8,507 patients with preterm birth. Increasing apolipoprotein B (odds ratio (OR), 1.12[95â¯% CI, 1.02-1.23]; pâ¯=â¯0.019), low-density lipoprotein cholesterol (OR, 1.11[95â¯% CI, 1.00-1.22]; pâ¯=â¯0.040), non-high-density lipoprotein cholesterol (OR, 1.12[95â¯% CI, 1.01-1.24]; pâ¯=â¯0.026), remnant cholesterol (OR, 1.11[95â¯% CI, 1.00-1.23]; pâ¯=â¯0.047) and total free cholesterol (OR, 1.11[95â¯% CI, 1.01-1.23]; pâ¯=â¯0.037) were associated with increased risk of preterm delivery. Moreover, triglycerides in low-density lipoprotein were causally associated with the risk of PTB. Our sensitivity analysis yielded robust results, uncovering no evidence of horizontal pleiotropy or reverse causal relationships. CONCLUSION: Our investigation unveils the adverse impact of dyslipidemia on preterm birth, with a particular emphasis on the detrimental effect of elevated low-density lipoprotein cholesterol.
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LDL-Colesterol , Dislipidemias , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Polimorfismo de Nucleótido Simple , Nacimiento Prematuro , Humanos , Nacimiento Prematuro/sangre , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/genética , Dislipidemias/genética , Dislipidemias/sangre , Dislipidemias/epidemiología , Femenino , LDL-Colesterol/sangre , Embarazo , Adulto , Factores de RiesgoRESUMEN
BACKGROUND: Cytomegalovirus (CMV) infection is widely prevalent worldwide, which may have relationship with dyslipidemia. The aim of this study is to explore the association between CMV infection and dyslipidemia. METHODS: The total observed population of this study included 14,163 participants aged 6-49 years from 1999 to 2004 National Health and Nutritional Examination Surveys (NHANES). Immunoglobulin G (IgG) levels and four lipid parameters (triglyceride, low density lipoprotein-cholesterol (LDL-C), total cholesterol, and high density lipoprotein-cholesterol (HDL-C)) were analyzed by performing multiple logistic regression and subgroup analysis. RESULTS: The median values of triglycerides, LDL-C and total cholesterol levels in the CMV positive group were higher than those in CMV negative group while a lower median value of HDL-C existed in positive group. After controlling for potential confounders (sex, age, race, country of birth, education, poverty-to-income ratio(PIR)), a close association between CMV infection and low HDL-C was observed, which persisted in the men aged 30-49 and women aged 12-19, 30-49. CONCLUSIONS: CMV infection is related to dyslipidemia, and this association is more significant in the serum HDL-C. Further cohort studies and experimental evidences can be conducted to test this association and then guide clinical practice.
Asunto(s)
Infecciones por Citomegalovirus , Dislipidemias , Encuestas Nutricionales , Humanos , Dislipidemias/epidemiología , Dislipidemias/sangre , Masculino , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/sangre , Femenino , Adolescente , Persona de Mediana Edad , Adulto , Niño , Adulto Joven , Estados Unidos/epidemiología , Triglicéridos/sangre , HDL-Colesterol/sangre , Inmunoglobulina G/sangre , CitomegalovirusRESUMEN
BACKGROUND: The abnormal low-density protein cholesterol (LDL-C) level in the development of atherosclerosis is often comorbid in individuals with type 2 diabetes mellitus(T2DM). This study aimed to investigate the aggravating effect of abnormal LDL-C levels on coronary artery plaques assessed by coronary computed tomography angiography (CCTA) in T2DM. MATERIALS AND METHODS: This study collected 3439 T2DM patients from September 2011 to February 2022. Comparative analysis of differences in coronary plaque characteristics was performed for the patients between the normal LDL-C level group and the abnormal LDL-C level group. Factors with P < 0.1 in the univariable linear regression analyses were included in the multivariable linear stepwise regression. RESULTS: A total of 2820 eligible T2DM patients were included and identified as the normal LDL-C level group (n = 973) and the abnormal LDL-C level group (n = 1847). Compared with the normal LDL-C level group, both on a per-patient basis and per-segment basis, patients with abnormal LDL-C level showed more calcified plaques, partially calcified plaques, low attenuation plaques, positive remodellings, and spotty calcifications. Multivessel obstructive disease (MVD), nonobstructive stenosis (NOS), obstructive stenosis (OS), plaque involvement degree (PID), segment stenosis score (SSS), and segment involvement scores (SIS) were likely higher in the abnormal LDL-C level group than that in the normal LDL-C level group (P < 0.001). In multivariable linear stepwise regression, the abnormal LDL-C level was validated as an independent positive correlation with high-risk coronary plaques and the degree and extent of stenosis caused by plaques (low attenuation plaque: ß = 0.116; positive remodelling: ß = 0.138; spotty calcification: ß = 0.091; NOS: ß = 0.427; OS: ß = 0.659: SIS: ß = 1.114; SSS: ß = 2.987; PID: ß = 2.716, all P value < 0.001). CONCLUSIONS: Abnormal LDL-C levels aggravate atherosclerotic cardiovascular disease (ASCVD) in patients with T2DM. Clinical attention deserves to be caught by the tailored identification of cardiovascular risk categories in T2DM individuals and the achievement of the corresponding LDL-C treatment goal.
Asunto(s)
Biomarcadores , LDL-Colesterol , Angiografía por Tomografía Computarizada , Angiografía Coronaria , Enfermedad de la Arteria Coronaria , Diabetes Mellitus Tipo 2 , Placa Aterosclerótica , Valor Predictivo de las Pruebas , Calcificación Vascular , Humanos , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/epidemiología , Anciano , LDL-Colesterol/sangre , Biomarcadores/sangre , Calcificación Vascular/diagnóstico por imagen , Calcificación Vascular/epidemiología , Calcificación Vascular/sangre , Factores de Riesgo , Medición de Riesgo , Dislipidemias/sangre , Dislipidemias/epidemiología , Dislipidemias/diagnóstico , Estudios Retrospectivos , Vasos Coronarios/diagnóstico por imagen , Índice de Severidad de la Enfermedad , Pronóstico , Estudios TransversalesRESUMEN
Excess body weight in pediatric patients and the resulting dyslipidemia, if left untreated, are a serious risk factor for cardiovascular disease in young adults. Despite this, there is still no effective and validated nutritional strategy for the treatment of overweight/obesity and comorbid dyslipidemia in children and adolescents. A low-glycemic index (LGI) diet may be recommended, but evidence for its effectiveness in the pediatric population is limited. The aim of this study was to evaluate the effectiveness of nutritional intervention in children and adolescents with excess body weight and dyslipidemia. The study was conducted in patients aged 8-16 with overweight or obesity and lipid disorders (n = 64), of which 40 participants who completed the entire 8-week study were included in the analysis. Patients were randomly selected and allocated to one of the two dietary groups: the LGI diet or the standard therapy (ST) diet. Both diets were based on the principal recommendation of Cardiovascular Health Integrated Lifestyle Diet-2 (CHILD-2). This study showed that both LGI and ST diets were equally beneficial in reducing body weight, body fat, blood pressure, total cholesterol (TC), and triglyceride (TG) levels. The LGI diet, compared to the ST diet, was less effective in reducing blood TG levels but more effective in reducing diastolic blood pressure (DBP). Therefore, the choice of the type of diet in the treatment of children and adolescents with excess body weight and dyslipidemia may be individual. However, it should be based on the recommendation of CHILD-2. Further long-term, larger-scale studies are needed.