Global epidemiology of dyslipidaemias

Dietary Patterns and Non-Communicable Disease Biomarkers: A Network Meta-Analysis and Nutritional Geometry Approach

Quantitative rankings of multiple dietary patterns for their effects on non-communicable disease (NCD) biomarkers is lacking and would inform primary prevention strategies. Accordingly, a network meta-analysis (NMA) was conducted to compare and rank the effects of different dietary patterns on NCD biomarkers, and associations of dietary patterns’ underlying macronutrient composition with NCD biomarkers were determined by a nutritional geometry approach. Randomised controlled trials (RCTs) were eligible for inclusion if they enrolled healthy participants, employed food-based dietary pattern interventions without energy restriction, and reported NCD biomarker outcomes. NCD biomarkers were included as an outcome if ≥10 trials were available. A systematic search of five electronic databases identified 4008 records. Sixty-eight articles from 59 RCTs reporting lipids, glycemic, and inflammatory biomarkers were included for quantitative syntheses. Risk-of-bias was predominantly categorized as low or having some concerns, and confidence-of-evidence low. Relative to western habitual diet, the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), dietary guidelines-based, plant-based, and low-fat diets reduced low-density lipoprotein cholesterol (mean difference range: −0.29 to −0.17 mmol/L), total cholesterol (−0.36 to −0.24 mmol/L), and apolipoprotein B (−0.11 to −0.07 g/L) (all p < 0.05); the Paleo, plant-based and dietary guidelines-based diets reduced homeostasis model assessment of insulin resistance (−0.95 to −0.35, all p < 0.05). No dietary pattern ranked consistently highest. The Paleo diet received the highest all-outcomes-combined average Surface Under the Cumulative Ranking Curve value (67%), followed by DASH (62%) and Mediterranean diets (57%), whereas western habitual diet was lowest (36%). Our findings were independent of macronutrient composition, highlighting the significance of dietary pattern-level analysis.

Long-term prognostic value of LDL-C, HDL-C, lp(a) and TG levels on cardiovascular disease incidence, by body weight status, dietary habits and lipid-lowering treatment: the ATTICA epidemiological cohort study (2002-2012)

BACKGROUND

The link between blood lipids and cardiovascular disease (CVD) is complex. Our aim was to assess the differential effect of blood lipids on CVD risk according to age, sex, body weight, diet quality, use of lipid-lowering drugs and presence of hypercholesterolemia.

METHODS

In this secondary analysis of the ATTICA prospective cohort study, serum blood lipids, i.e., total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and liproprotein(a) [Lp(a)], and sociodemographic, anthropometric, lifestyle and clinical parameters were evaluated at baseline (2001/2002) in 2020 CVD-free men and women. CVD incidence was recorded at the 10-year follow-up (2011/2012).

RESULTS

All blood lipids assessed were univariately related to CVD risk; however, associations remained significant only for HDL-C and TG in multivariate models adjusted for age, sex, body mass index, smoking, Mediterranean Diet Score, physical activity, presence of hypercholesterolemia, hypertension and diabetes mellitus, use of lipid-lowering drugs, and family history of CVD [RR per 1 mg/dL (95% CI): 0.983 (0.967, 1.000) and 1.002 (1.001, 1.003), respectively]. In stratified analyses, TC and LDL-C predicted CVD risk in younger subjects, normal-weight subjects, and those not on lipid-lowering drugs, while HDL-C and TG were significant predictors in older subjects, those with low adherence to the Mediterranean diet, and hypercholesterolemic subjects; a significant effect on CVD risk was also observed for TG in males, overweight participants and lipid-lowering medication users and for Lp(a) in older subjects and females (all p ≤ 0.050).

CONCLUSIONS

The impact of blood lipids on CVD risk differs according to several biological, lifestyle and clinical parameters.

Effects of Coenzyme Q10 Supplementation on Lipid Profiles in Adults: A Meta-analysis of Randomized Controlled Trials

CONTEXT

Previous meta-analyses have suggested that the effects of coenzyme Q10 (CoQ10) on lipid profiles remain debatable. Additionally, no meta-analysis has explored the optimal intake of CoQ10 for attenuating lipid profiles in adults.

OBJECTIVE

This study conducted a meta-analysis to determine the effects of CoQ10 on lipid profiles and assess their dose-response relationships in adults.

METHODS

Databases (Web of Science, PubMed/Medline, Embase, and the Cochrane Library) were systematically searched until August 10, 2022. The random effects model was used to calculate the mean differences (MDs) and 95% CI for changes in circulating lipid profiles. The novel single-stage restricted cubic spline regression model was applied to explore nonlinear dose-response relationships.

RESULTS

Fifty randomized controlled trials with a total of 2794 participants were included in the qualitative synthesis. The pooled analysis revealed that CoQ10 supplementation significantly reduced total cholesterol (TC) (MD -5.53 mg/dL; 95% CI -8.40, -2.66; I2 = 70%), low-density lipoprotein cholesterol (LDL-C) (MD -3.03 mg/dL; 95% CI -5.25, -0.81; I2 = 54%), and triglycerides (TGs) (MD -9.06 mg/dL; 95% CI -14.04, -4.08; I2 = 65%) and increased high-density lipoprotein cholesterol (HDL-C) (MD 0.83 mg/dL; 95% CI 0.01, 1.65; I2 = 82%). The dose-response analysis showed an inverse J-shaped nonlinear pattern between CoQ10 supplementation and TC in which 400-500 mg/day CoQ10 largely reduced TC (χ2 = 48.54, P < .01).

CONCLUSION

CoQ10 supplementation decreased the TC, LDL-C, and TG levels, and increased HDL-C levels in adults, and the dosage of 400 to 500 mg/day achieved the greatest effect on TC.

Association between endocrine-disrupting chemical mixture and metabolic indices among children, adolescents, and adults: A population-based study in Korea

Exposure to endocrine-disrupting chemicals (EDCs) play a role in the etiology of obesity and dyslipidemia. However, few studies have analyzed the combined effects of EDC mixtures. This study explored the association between concurrent exposure to EDCs and obesity or dyslipidemia in children, adolescents, and adults. A total of 1454 children, 891 adolescents, and 3758 (for BMI) and 3424 (for TG/HDL) adults from the Korean National Environmental Health Survey 2015 to 2017 were included in this cross-sectional study. Urinary concentrations of eight phthalate metabolites, three phenols, three parabens, and one pyrethroid pesticides metabolite were quantified. Body mass index (BMI) was measured for all participants, and triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) levels were measured for adolescents and adults. Associations between combined EDC mixtures with the BMI and TG to HDL-c ratio were evaluated using Bayesian Kernel Machine Regression (BKMR). In all age groups, most of the chemical exposures, with the exception of BPF and BPS, were detected in more than 90% of participants. There were significant moderate to high correlations within phthalate metabolites and a high correlation within parabens. The BKMR showed that EDC mixtures were associated with higher BMI in both adolescents and adults, with greater significance in adults compared with adolescents, and a higher TG/HDL in male adolescents. In adolescents, MEP and MCPP drove the main effects on BMI and TG/HDL, respectively. In adults, 3PBA and BPA drove the main effects on BMI. The findings of this study suggest that exposure to EDC mixtures is associated with higher BMI and TG/HDL, and adolescence may be a critical period for EDC mixture in terms of both outcomes. Further studies are needed, but strategies to reduce EDC exposure from early life stages may be necessary to lower the risk of metabolic disease.

Circulating monocytes in acute pancreatitis

Acute pancreatitis is a common gastrointestinal disease characterized by inflammation of the exocrine pancreas and manifesting itself through acute onset of abdominal pain. It is frequently associated with organ failure, pancreatic necrosis, and death. Mounting evidence describes monocytes - phagocytic, antigen presenting, and regulatory cells of the innate immune system - as key contributors and regulators of the inflammatory response and subsequent organ failure in acute pancreatitis. This review highlights the recent advances of dynamic change of numbers, phenotypes, and functions of circulating monocytes as well as their underling regulatory mechanisms with a special focus on the role of lipid modulation during acute pancreatitis.

Dietary Fat Intake among Chinese Adults and Their Relationships with Blood Lipids: Findings from China Nutrition and Health Surveillance and Comparison with the PURE Study

Dietary fat intake in the Chinese population has increased. The PURE (prospective urban rural epidemiology) study concluded the potential advantage of total fat and saturated fats (SFA) over carbohydrates on blood lipids with the inaccurate assessment of dietary fats. We investigated the dietary fat profile among 48,315 participants (aged 30−70 years, national representative) from the China Nutrition and Health Surveillance (2015−2017), determined the relationship of various fats with blood lipid biomarkers in the selected 39,115 participants, and compared the results with the PURE study. Dietary fat intake was calculated by using 3 days of 24 h recalls and food inventory. Serum lipid biomarkers were assessed at morning fasting state by health professionals. Plant fats (21.5% of total energy (TE)) dominated in total fat intake (69.5 g/day, 35.6% TE), with monounsaturated fats (MUFA) in the largest (13.8% TE) portion and plant oils as the major source (43.7%). Two thirds of the population consumed more than 30% TE from dietary fats and nearly half more than 35%, while 26.4% of them exceeded 10% TE from SFA. Total fat was positively associated with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), but also high-density lipoprotein cholesterol (HDL-c), and negatively with triglyceride (TG)-to-HDL-c ratio (TGHDL) (all p-trend < 0.05). Replacing total fat with carbohydrate yielded adverse changes in most biomarkers (higher LDL-c, TG, and TGHDL, lower HDL-c, all p < 0.05) when total fat was low (<34.9% TE). Regardless of fat intake level, replacing plant fat or polyunsaturated fats (PUFA) with carbohydrate yielded the most adverse changes (higher TC, LDL-c, TG, TC-to-HDL-c ratio (TCHDL), and TGHDL, but lower HDL-c, all p < 0.01), while replacing animal fat/SFA with plant fat/PUFA yielded the most favorable changes (lower all biomarkers, all p < 0.01). The results suggested a less harmful effect of carbohydrate on blood lipids when total fat was high, and more beneficial effect of unsaturated fats, than the PURE. In conclusion, dietary fat intake in Chinese adults had reached quite a high level, but with a different profile from Western populations. Replacement of SFA (animal fat) with PUFA (plant fat) could most effectively improve blood lipids, while replacement with carbohydrate could slightly benefit only when total fat was high. The present results may be more applicable to the Chinese population than the PURE study.

Reduction of nucleolar NOC1 leads to the accumulation of pre-rRNAs and induces Xrp1, affecting growth and resulting in cell competition

NOC1 is a nucleolar protein necessary in yeast for both transport and maturation of ribosomal subunits. Here, we show that Drosophila NOC1 (annotated CG7839) is necessary for rRNAs maturation and for a correct animal development. Its ubiquitous downregulation results in a dramatic decrease in polysome level and of protein synthesis. NOC1 expression in multiple organs, such as the prothoracic gland and the fat body, is necessary for their proper functioning. Reduction of NOC1 in epithelial cells from the imaginal discs results in clones that die by apoptosis, an event that is partially rescued in a Minute/+ background, suggesting that reduction of NOC1 induces the cells to become less fit and to acquire a 'loser' state. NOC1 downregulation activates the pro-apoptotic Eiger-JNK pathway and leads to an increase of Xrp1, which results in the upregulation of DILP8, a member of the insulin/relaxin-like family known to coordinate organ growth with animal development. Our data underline NOC1 as an essential gene in ribosome biogenesis and highlight its novel functions in the control of growth and cell competition.

Undertreatment and Underachievement of LDL-C Target among Individuals with High and Very High Cardiovascular Risk in the Malaysian Community

Dyslipidaemia is a major cause of morbidity and mortality. The aims of this study are to determine the prevalence of dyslipidaemia subtypes, the proportions of lipid-lowering therapy (LLT) use, and the achievement of low-density lipoprotein cholesterol (LDL-C) treatment targets for high-risk (HR) and very high-risk (VHR) Malaysians. This cross-sectional study involves 5279 participants across 11 states in Malaysia. The data were obtained through a standardised questionnaire, anthropometric measurements, venous glucose and lipid profile. The participants with existing cardiovascular disease (CVD) or diabetes with at least one of the other major risk factors (smoking, hypertension or dyslipidaemia) were grouped into the VHR category. Other participants were risk-categorised using the Framingham General CVD Risk Score (FRS-CVD). The prevalence of elevated LDL-C, LLT use and LDL-C target were set according to respective risk categories. Pearson's chi-squared test was used to test the difference in the proportions. The mean ± standard deviation (SD) age was 41.1 ± 14.8 years, and 62.2% (3283/5279) of the group were females. Within the participant group, 51.5% were found to have elevated total cholesterol, 28.8% had low HDL-C, and 33.8% had high triglyceride. As for elevated LDL-C, 9.8% were in VHR, 8.6% in HR, 5.8% in MR and 34.9% in LR categories. Among the VHR group, 75.8% were not on LLT, and only 15.9% achieved the LDL-C target. As for the HR category, 87.7% were not on LLT, and only 16.1% achieved the LDL-C target. Dyslipidaemia is highly prevalent among Malaysians. The majority of VHR and HR participants were not on LLT and did not achieve LDL-C treatment targets. Proactive programs are warranted to combat dyslipidaemia-associated CVD events in these groups.

Percent Body Fat-Related Disparities of Serum Ferritin on the Risk of Lipid Metabolism Abnormalities in Children and Adolescents

OBJECTIVE

This study examined the association between serum ferritin and dyslipidemia in children and adolescents with different degrees of obesity.

METHOD

In this multi-stage, stratified, randomized, sampling cross-section cohort study, demographic data were collected by questionnaire from 4320 children and adolescents (aged 6-17 years) in Shanghai, China. Anthropometric measures and percent body fat (PBF) were recorded. Serum lipid parameters were detected by an automatic biochemical method, and ferritin levels were measured by an automatic immunoassay.

RESULTS

Our results showed 70.6%, 13.9%, and 15.5% of participants had a healthy body fat, low fat, and overweight/obese, respectively. Increasing ferritin quartiles were independently associated with a greater hazard of dyslipidemia, especially in overweight/obese participants, and the OR (95% CI) was 3.01 (1.29-7.00), 3.58 (1.59-8.04), and 5.66 (2.57-12.46) across the ferritin quartiles after adjustment for confounders. Ferritin was only a predictive value for dyslipidemia in overweight/obese participants (AUC = 0.64) and was consistent in boys (AUC = 0.61) and girls (AUC = 0.68). The significant positive correlation between ferritin value and lipid abnormalities profiles (except for low HDL-C) mainly appeared in the overweight/obesity group.

CONCLUSION

The results showed that serum ferritin can be considered an independent risk factor for dyslipidemia in children and adolescents with obesity.

HIGHLIGHTS

Ferritin overload had a greater risk of dyslipidemia, especially in children and adolescents with overweight/obesity.

Dyslipidemia and the preventive potential in the Greenlandic population

Background

Low-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for development of cardiovascular diseases. Based on available clinical data, we aimed to investigate the plasma lipid profile in the Greenlandic population, the proportion on cholesterol-lowering treatment and the adherence to local indications for cholesterol-lowering therapy.

Methods

This is an observational cross-sectional study of the adult (≥21 years) Greenlandic population with focus on clinically determined lipid levels from 2017 to early 2022. We investigated levels of dyslipidemia and assessed cholesterol-lowering medication usage in individuals with an indication according to current Greenlandic guidelines, which include a) LDL-C >5 mmol/l, b) diabetes, c) diagnosed atherosclerotic disease and 4) a SCORE2 >7.5%.

Results

In the adult Greenlandic population of 40,565 individuals a lipid profile was available in 13,895 with a mean LDL-C of 3.0 mmol/L and 976 (7%) had a LDL-C >5 mmol/l. One or more indications for cholesterol-lowering medication was present in 3988 individuals and a total of 5464 adult Greenlanders either fulfilled local criteria for statin therapy or received a statin (some without current indication) and among these, 2232 (41%) individuals received no statin.

Conclusion

These findings indicate that clinically significant dyslipidemia is common in the adult Greenlandic population and that the cardiovascular preventive potential of cholesterol-lowering therapy is currently underutilized.

Atorvastatin and ezetimibe protect against hypercholesterolemia-induced lung oxidative stress, inflammation, and fibrosis in rats

Background

Hypercholesterolemia is a major risk factor for interstitial lung disease (ILD). Atorvastatin and ezetimibe are antilipemic drugs that have pleiotropic effects. However, their effects on pulmonary fibrosis prevention and the mechanisms underlying hypercholesterolemia have not been fully investigated. This study aimed to evaluate the individual effects of atorvastatin and ezetimibe on lung inflammation and fibrosis in high-cholesterol diet (HCD)-fed rats.

Materials and methods

Male Sprague-Dawley rats were divided into four groups — standard diet (S), standard diet + 1% cholesterol (SC), standard diet + 1% cholesterol with 30 mg/kg/day atorvastatin (SCA), and standard diet + 1% cholesterol with 10 mg/kg/day ezetimibe (SCE). At the end of an 8-week dietary schedule, serum lipid parameters and the levels of lung oxidative stress, inflammatory cytokines, and fibrotic mediators were determined.

Results

Atorvastatin and ezetimibe treatment remarkably reduced serum lipid profiles with reversed pulmonary histological alterations, in addition to reducing the levels of lung oxidative stress, inflammation, and fibrosis in hypercholesterolemic rats.

Conclusion

Atorvastatin and ezetimibe treatment showed a protective effect against hypercholesterolemia-induced pulmonary fibrosis in rats. This information appears potentially useful in the prevention of PF in a hypercholesterolemia model; however, further rigorous investigations are needed to prove their clinical utility on antifibrosis.

Sex-related differences in single nucleotide polymorphisms associated with dyslipidemia in a Korean population

BACKGROUND

The prevalence of dyslipidemia has increased steadily in Korea, and the incidence of dyslipidemia differs by sex. In this study, we identified single nucleotide polymorphisms (SNPs) related to dyslipidemia in Korean cohorts through genome-wide association study (GWAS) analysis.

METHODS

Genotyping was conducted to determine the genotypes of 72,298 participants and investigate genotypes for 7,079,946 SNPs. Sex, age, and BMI were set as covariates for GWAS, and significant SNPs were identified in the discovery and replication stages using logistic regression.

RESULTS

GWAS of the entire cohort revealed a total of five significant SNPs: rs117026536 (LPL), rs651821 (APOA5), rs9804646 (APOA5), rs9926440 (CETP), and rs429358 (APOE). GWAS of the male subjects revealed a total of four significant SNPs. While rs9804646 (APOA5) and rs429358 (APOE) were significant for all the subjects, rs662799 (APOA5) and rs56156922 (CETP) were significant only for the male subjects. GWAS of the female subjects revealed two significant SNPs, rs651821 (APOA5) and rs9804646 (APOA5), both of which were significant in all the subjects.

CONCLUSION

This is the first study to identify sex-related differences in genetic polymorphisms in Korean populations with dyslipidemia. Further studies considering environmental variables will be needed to elucidate these sex-related genetic differences in dyslipidemia.

Pharmacogenomics of lipid-lowering agents: the impact on efficacy and safety

Hyperlipidemia is a significant risk factor for cardiovascular disease morbidity and mortality. The lipid-lowering drugs are considered the cornerstone of primary and secondary prevention of atherosclerotic cardiovascular disease. Unfortunately, the lack of efficacy and associated adverse effects, ranging from mild-to-moderate to potentially life-threatening, lead to therapy discontinuation. Numerous reports support the role of gene polymorphisms in drugs' pharmacokinetic parameters and their associated adverse reactions. Therefore, this study aims to understand the pharmacogenomics of lipid-lowering drugs and the impact of genetic variants of key genes on the drugs' efficacy and toxicity. Indeed, genetically guided lipid-lowering therapy enhances overall safety, improves drug adherence and achieves long-term therapy.

The effects of olive oil consumption on blood lipids: a systematic review and dose-response meta-analysis of randomised controlled trials

We performed a systematic review and dose-response meta-analysis of randomised trials on the effects of olive oil consumption on blood lipids in adults. A systematic search was performed in PubMed, Scopus and Web of Science databases until May 2021. Randomised controlled trials (RCT) evaluating the effect of olive oil intake on serum total cholesterol (TC), TAG, LDL-cholesterol and HDL-cholesterol in adults were included. The mean difference (MD) and 95 % CI were calculated for each 10 g/d increment in olive oil intake using a random-effects model. A total of thirty-four RCT with 1730 participants were included. Each 10 g/d increase in olive oil consumption had minimal effects on blood lipids including TC (MD: 0·79 mg/dl; 95 % CI (-0·08, 1·66); I² = 57 %; n 31, GRADE = low certainty), LDL-cholesterol (MD: 0·04 mg/dl, 95 % CI (-1·01, 0·94); I² = 80 %; n 31, GRADE = very low certainty), HDL-cholesterol (MD: 0·22 mg/dl; 95 % CI (-0·01, 0·45); I² = 38 %; n 33, GRADE = low certainty) and TAG (MD: 0·39 mg/dl; 95 % CI (-0·33, 1·11); I² = 7 %; n 32, GRADE = low certainty). Levels of TC increased slightly with the increase in olive oil consumption up to 30 g/d (MD_{30 g/d}: 2·76 mg/dl, 95 % CI (0·01, 5·51)) and then appeared to plateau with a slight downward curve. A trivial non-linear dose-dependent increment was seen for HDL-cholesterol, with the greatest increment at 20 g/d (MD_{20 g/d}: 1·03 mg/dl, 95 % CI (-1·23, 3·29)). Based on existing evidence, olive oil consumption had trivial effects on levels of serum lipids in adults. More large-scale randomized trials are needed to present more reliable results.

Bacillus subtilis-Fermented Amomum xanthioides Ameliorates Metabolic-Syndrome-Like Pathological Conditions in Long-Term HFHFD-Fed Mice

In modern society, numerous metabolic disorders are widespread globally. The present study aimed to demonstrate whether Bacillus subtilis-fermented Amomum xanthioides (BSAX) exerts anti-metabolic disturbance effects compared with the ethyl acetate fraction of Amomum xanthioides (EFAX), a previously verified functional fraction. Mice fed with a high-fat, high-fructose diet (HFHFD) for 10 wk presented a typical model of metabolic dysfunction, and BSAX significantly attenuated a string of metabolic-syndrome-related pathological parameters, such as body, fat, organ mass, lipid markers (TGs, TC, free fatty acids), and glucose metabolism (glucose, insulin), without influencing appetite. Further, BSAX markedly lowered malondialdehyde (MDA) and ROS in the blood and restored antioxidative parameters (SOD, GSH, and CAT in liver tissue, and total bilirubin in serum) by elevating Nrf2 and HO-1. Moreover, BSAX noticeably restored gut microbiota diversity and normalized lipid-metabolism-associated proteins, including SREBP-1, p-AMPK, and PPAR-α. Generally, most metabolic parameters were improved by BSAX to a greater extent than EFAX, except for liver weight and hepatic TC. In conclusion, BSAX alleviates metabolic dysfunction by enhancing lipid metabolism and antioxidative capacity and is more effective than EFAX. Therefore, the application of high-yield, effective BSAX might be a promising approach for curing and preventing metabolic disorders.

The effects of conjugated linoleic acid supplementation on lipid profile in adults: A systematic review and dose-response meta-analysis

Background

The findings of trials investigating the effect of conjugated linoleic acid (CLA) administration on lipid profile are controversial. This meta-analysis of randomized controlled trials (RCTs) was performed to explore the effects of CLA supplementation on lipid profile.

Methods

Two authors independently searched electronic databases including PubMed, Web of Science, and Scopus until March 2022, in order to find relevant RCTs. The random effects model was used to evaluate the mean and standard deviation.

Results

In total, 56 RCTs with 73 effect sizes met the inclusion criteria and were eligible for the meta-analysis. CLA supplementation significantly alter triglycerides (TG) (WMD: 1.76; 95% CI: -1.65, 5.19), total cholesterols (TC) (WMD: 0.86; 95% CI: -0.42, 2.26), low-density lipoprotein cholesterols (LDL-C) (WMD: 0.49; 95% CI: -0.75, 2.74), apolipoprotein A (WMD: -3.15; 95% CI: -16.12, 9.81), and apolipoprotein B (WMD: -0.73; 95% CI: -9.87, 8.41) concentrations. However, CLA supplementation significantly increased the density lipoprotein cholesterol (HDL-C) (WMD: -0.40; 95% CI: -0.72, -0.07) concentrations.

Conclusion

CLA supplementation significantly improved HDL-C concentrations, however, increased concentrations of TG, TC, LDL-C, apolipoprotein A, and apolipoprotein B.

Systematic review registration

https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42022331100.

Organokines, Sarcopenia, and Metabolic Repercussions: The Vicious Cycle and the Interplay with Exercise

Sarcopenia is a disease that becomes more prevalent as the population ages, since it is directly linked to the process of senility, which courses with muscle atrophy and loss of muscle strength. Over time, sarcopenia is linked to obesity, being known as sarcopenic obesity, and leads to other metabolic changes. At the molecular level, organokines act on different tissues and can improve or harm sarcopenia. It all depends on their production process, which is associated with factors such as physical exercise, the aging process, and metabolic diseases. Because of the seriousness of these repercussions, the aim of this literature review is to conduct a review on the relationship between organokines, sarcopenia, diabetes, and other metabolic repercussions, as well the role of physical exercise. To build this review, PubMed-Medline, Embase, and COCHRANE databases were searched, and only studies written in English were included. It was observed that myokines, adipokines, hepatokines, and osteokines had direct impacts on the pathophysiology of sarcopenia and its metabolic repercussions. Therefore, knowing how organokines act is very important to know their impacts on age, disease prevention, and how they can be related to the prevention of muscle loss.

Potential lipid-lowering effects of Ulmus macrocarpa Hance extract in adults with untreated high low-density lipoprotein cholesterol concentrations: A randomized double-blind placebo-controlled trial

INTRODUCTION

Ulmus macrocarpa Hance extract (UME) has demonstrated an antilipidemic effect via upregulation of the adenosine monophosphate-activated protein kinase pathway and regulation of lipid metabolism in both laboratory and animal studies. Therefore, we examined the effects and safety of UME on plasma lipids in adults with untreated high, low-density lipoprotein cholesterol (LDL-C) concentrations.

MATERIALS AND METHODS

In the current double-blind placebo-controlled randomized clinical trial, 80 patients with untreated high LDL-C concentrations (130-190 mg/dl) were randomly allocated to either the "UME group" (received 500 mg UME as two capsules per day) or the "Placebo group" (received placebo containing cornstarch as two capsules per day) for 12 weeks. The primary outcome was the change in LDL-C concentration within the 12-week treatment period; secondary outcomes included changes in total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol, apolipoprotein A1, and apolipoprotein B (ApoB) concentrations.

RESULTS

UME over 12 weeks led to a greater decrease in LDL-C, TC, and ApoB concentrations than did the placebo as follows: by 18.1 mg/dl (P < 0.001); 23.3 mg/dl (P < 0.001); 9.3 mg/dl (P = 0.018), respectively. When LDL-C, TC, and ApoB concentrations were expressed as a lsmeans percentage of the baseline concentration, they after 12 weeks of UME had greater % differences compared to the placebo as follows: by 11.9% (P < 0.001); 10.0% (P < 0.001); 8.6% (P < 0.05), respectively. However, no significant inter- and intra-group changes in liver enzyme, free fatty acid, anti-inflammatory marker, and fasting glucose concentrations were observed. None of the participants experienced notable adverse events.

DISCUSSION

UME causes a significant improvement in lipid profiles in adults with untreated high LDL-C concentrations.

CLINICAL TRIAL REGISTRATION

[www.clinicaltrials.gov/], identifier [NCT03773315].

The Role of By-Products of Fruit and Vegetable Processing for the Dietary Treatment of Cardiovascular Risk Factors: A Narrative Review

Polyphenols-rich food has been utilized to induce a positive effect on human health. Considering that fruit and vegetable by-products (seeds, pomace, and peels) are sources of polyphenols, previous studies have investigated the effect of dietary supplementation with food by-products on cardiometabolic disorders, such as high fasting blood glucose, dyslipidemia, and obesity. Endothelial dysfunction has also been considered a cardiometabolic parameter, given that it precedes cardiovascular disease. However, there is a scarcity of narrative reviews reporting the effect of food by-product supplementation on cardiometabolic disorders in animal and human clinical trials. In this sense, the present narrative review aims to investigate the impact of fruit and vegetable by-product supplementation on cardiometabolic disorders in humans and animals, exploring the possible mechanisms whenever possible. Research articles were retrieved based on a search of the following databases: PubMed, ScienceDirect, and Google Scholar using the following keywords and synonyms combined: (“fruit by-products” or “food waste” or “pomace” or “bagasse” or “seeds” or “waste products”) AND (“heart disease risk factors” or “endothelial dysfunction” or “atherosclerosis”). It was shown that fruit and vegetable by-products could efficiently improve cardiometabolic disorders in patients with chronic diseases, including hypertension, type II diabetes mellitus, and dyslipidemia. Such effects can be induced by the polyphenols present in food by-products. In conclusion, food by-product supplementation has a positive effect on cardiometabolic disorders. However, further studies investigating the effect of food by-products on cardiometabolic disorders in humans are still necessary so that solid conclusions can be drawn.

Plasma Exchange for the Treatment of Severe Hypertriglyceridemic Pancreatitis With Diabetic Ketoacidosis: A Case Report From Sub-Saharan Africa

The triad of acute pancreatitis, diabetic ketoacidosis, and hyperlipidemia is exceedingly rare. Case reports describing this uncommon triad have successfully been managed with insulin infusions only. Herein, we highlight the challenges in making this diagnosis and present Sub-Saharan Africa's first experience with therapeutic plasma exchange in the management of hypertriglyceridemic pancreatitis associated with diabetic ketoacidosis, which was initially refractory to insulin infusion alone.

Global Trends in the Epidemiology and Management of Dyslipidemia

Dyslipidemia, especially a circulating non-optimal level of cholesterol, is one of the most important risk factors for atherosclerotic cardiovascular disease (ASCVD), which accounts for the most deaths worldwide. Maintaining a healthy level of blood cholesterol is an important prevention strategy for ASCVD, through lifestyle intervention or cholesterol-lowering therapy. Over the past three decades, the epidemiology and management of dyslipidemia has changed greatly in many countries. Therefore, it is necessary to understand the current epidemiologic features of dyslipidemia and challenges from a global perspective.

Effect of natural polyphenols in Chinese herbal medicine on obesity and diabetes: Interactions among gut microbiota, metabolism, and immunity

With global prevalence, metabolic diseases, represented by obesity and type 2 diabetes mellitus (T2DM), have a huge burden on human health and medical expenses. It is estimated that obese population has doubled in recent 40 years, and population with diabetes will increase 1.5 times in next 25 years, which has inspired the pursuit of economical and effective prevention and treatment methods. Natural polyphenols are emerging as a class of natural bioactive compounds with potential beneficial effects on the alleviation of obesity and T2DM. In this review, we investigated the network interaction mechanism of "gut microbial disturbance, metabolic disorder, and immune imbalance" in both obesity and T2DM and systemically summarized their multiple targets in the treatment of obesity and T2DM, including enrichment of the beneficial gut microbiota (genera Bifidobacterium, Akkermansia, and Lactobacillus) and upregulation of the levels of gut microbiota-derived metabolites [short-chain fatty acids (SCFAs)] and bile acids (BAs). Moreover, we explored their effect on host glucolipid metabolism, the AMPK pathway, and immune modulation via the inhibition of pro-inflammatory immune cells (M1-like Mϕs, Th1, and Th17 cells); proliferation, recruitment, differentiation, and function; and related cytokines (TNF-α, IL-1β, IL-6, IL-17, and MCP-1). We hope to provide evidence to promote the clinical application of natural polyphenols in the management of obesity and T2DM.

In Vivo Assessments of Mesoblastic Nephroma (Ne/De) and Myelomonoblastic Leukaemia (My1/De) Tumour Development in Hypercholesterolemia Rat Models

Given the rising prevalence of lipid metabolic disorders and malignant diseases, we aimed to establish an in vivo hypercholesterinaemic tumour-bearing rat model for the induction and assessment of these conditions. A normal standard CRLT/N, 2 (baseline),- or 4 (2 + 2, pretreated)-week-long butter and cholesterol rich (BCR) diet was applied to mesoblastic nephroma (Ne/De) and myelomonoblastic leukaemia (My1/De) tumour-bearing and healthy control Long—Evans and Fischer 344 rats. The beginning of chow administration started in parallel with tumour induction and the 2 weeks of pre-transplantation in the baseline and pretreated groups, respectively. Fourteen days post-inoculation, the measurement of lipid parameters and [18F]F-FDG PET/MRI examinations was executed. The comparable lipid status of baseline healthy and tumorous rats proves that regardless of tumour presence, BCR-based hypercholesterolemia was achieved. A higher tumour mass among pretreated tumorous animals was found when compared to the control groups (p < 0.05, p < 0.01). Further, a visually greater [18F]F-FDG accumulation was observed in pretreated BCR tumorous animals; however, the quantitative data (SUVmean: 9.86 ± 0.98, 9.68 ± 1.24; SUVmax: 19.63 ± 1.20; 17.56 ± 3.21 for Ne/De and My1/De, respectively) were not statistically significantly different from those of the CRLT/N tumorous rats (SUVmean: 8.40 ± 1.42, 7.22 ± 1.06 and SUVmax: 15.99 ± 2.22, 12.46 ± 1.96 for control Ne/De and My1/De, respectively). Our model seems to be appropriate for simultaneously investigating hypercholesterolemia and cancer in the same rat.

Prevalence and factors associated with dyslipidemia among adolescents in Saudi Arabia

Dyslipidemia is a major risk factor for atherosclerosis. Screening for dyslipidemia at an early age is essential to prevent and control its consequences. This study aimed to determine prevalence of dyslipidemia and its correlates among adolescents in Saudi Arabia. Data of 5854 adolescents aged 10–19 years from all 13 regions of Saudi Arabia were obtained from the Jeeluna study; a national cross-sectional, multistage stratified cluster sample survey. Dyslipidemia was defined based on the National Heart Lung and Blood Institute and National Cholesterol Education Program guidelines for adolescents. We found that a quarter of Saudi adolescents have dyslipidemia (males: 33.3%, females: 17.9%). Significant variation was observed by region (p < 0.001). Prevalence of abnormal Total Cholesterol was 6.7%, LDL-C 7.1%, HDL-C 12.8%, Non-HDL-C 8.3%, and Triglycerides 9.6%. Factors independently associated with dyslipidemia were male gender (OR = 2.19, 95% CI 1.78–2.70, p < 0.001), BMI (underweight OR = 0.80, 95% CI 0.69–0.94, overweight OR = 1.76, 95% CI 1.50–2.06, obese OR = 2.80, 95% CI 2.34–3.34, p < 0.001, vs. normal) and serum ferritin (high OR = 7.02, 95% CI 1.49–34.79, low OR = 0.82, 95% CI 0.67–1.01, p = 0.04 vs. normal) and ≥ 1 daily intake of carbonated beverage (OR = 1.10, 95% CI 1.00–1.20, p = 0.03 vs. no or not daily intake). Public health interventions for improving lipid profile of adolescents are urgently needed.

Red meat consumption and risk for dyslipidaemia and inflammation: A systematic review and meta-analysis

Aim

The study (PROSPERO: CRD42021240905) aims to reveal the relationships among red meat, serum lipids and inflammatory biomarkers.

Methods and results

PubMed, EMBASE and the Cochrane databases were explored through December 2021 to identify 574 studies about red meat and serum lipids markers including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP) or hypersensitive-CRP (hs-CRP). Finally, 20 randomized controlled trials (RCTs) involving 1001 people were included, red meat and serum lipid markers and their relevant information was extracted. The pooled standard mean difference (SMD) was obtained by applying a random-effects model, and subgroup analyses and meta-regression were employed to explain the heterogeneity. Compared with white meat or grain diets, the gross results showed that the consumption of red meat increased serum lipid concentrations like TG (0.29 mmol/L, 95% CI 0.14, 0.44,P<0.001), but did not significantly influence the TC (0.13 mmol/L, 95% CI −0.07, 0.33, P = 0.21), LDL-C (0.11 mmol/L, 95% CI −0.23, 0.45, P = 0.53), HDL-C (−0.07 mmol/L, 95% CI −0.31, 0.17, P = 0.57),CRP or hs-CRP (0.13 mmol/L, 95% CI −0.10, 0.37,P = 0.273).

Conclusion

Our study provided evidence to the fact that red meat consumption affected serum lipids levels like TG, but almost had no effect on TC, LDL-C, HDL-C and CRP or hs-CRP. Such diets with red meat should be taken seriously to avoid the problem of high lipid profiles.

Systematic review registration

[https://www.crd.york.ac.uk/PROSPERO], identifier [CRD42021240905].

A novel nutritional score based on serum triglyceride and protein levels predicts outcomes of intrahepatic cholangiocarcinoma after curative hepatectomy: A multi-center study of 631 patients

Background

High serum triglyceride (STG) level is a well-established pathogenic factor for cardiovascular diseases and is associated with the risk of various malignancies. Nevertheless, the role of STG level in intrahepatic cholangiocarcinoma (ICC) remains uncertain.

Methods

A total of 631 ICC patients treated with curative hepatectomy in two centers (517 in the discovery set and 114 in the validation set) were retrospectively analyzed. Kaplan–Meier survival analysis was used to assess the outcomes of the patients with different STG levels. Time-dependent receiver operating characteristic (ROC) analysis was conducted to compare the prognostic value of STG with other established indexes. The Triglyceride-Albumin-Globulin (TAG) grade was introduced and evaluated using the time-dependent area under curves (AUC) analysis and decision curve analysis (DCA).

Results

Patients with increased STG levels and decreased albumin-globulin score (AGS) were correlated with improved overall survival (OS) and recurrence-free survival (RFS). STG level ≥ 1 mmol/L was an independent protective factor for surgically treated ICC patients. The predictive value of the TAG grade was superior to the STG or the AGS alone. In decision curve analysis, the net benefits of the TAG grade in the discovery and validation set were higher than STG and AGS.

Conclusion

The current study presented strong evidence that ICC patients with higher preoperative STG levels had preferred long-term surgical outcomes. The novel nutritional score based on serum triglyceride, albumin and globulin levels was inextricably linked to the prognosis of the surgically treated ICC patients. Evaluation of the TAG grade before curative hepatectomy may be beneficial for risk stratification and clinical decision support.

Sea cucumber-derived compounds for treatment of dyslipidemia: A review

Dyslipidemias are disorders of plasma levels of lipids, such as elevated levels of total cholesterol and triglyceride, that are associated with various human diseases including cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). Statins are the first-line drugs for treatment of dyslipidemia. However, a substantial proportion of patients cannot reach the recommended LDL-c level even with the highest tolerated doses of statins, and there is no available drug specifically for NAFLD therapy. Sea cucumbers are one of the widely distributed invertebrates, and are an important resource of food and medicine. Sea cucumbers have many valuable nutrients including saponins, fatty acids, phospholipids, cerebrosides, sulfated polysaccharides, as well as proteins and peptides. In recent years, these natural products derived from sea cucumbers have attracted attentions for treatment of CVD and NAFLD because of their lipid-lowering effect and low toxicity. However, the hypolipidemic mechanisms of action and the structure-activity relationship of these bioactive components have not been well-documented in literature. This review article summarizes the signaling pathways and the potential structure-activity relationship of sea cucumber-derived bioactive compounds including saponins, lipids, carbohydrates as well as peptides and proteins. This article will provide information useful for the development of sea cucumber-derived lipid-lowering compounds as well as for investigation of hypolipidemic compounds that are derived from other natural resources.

ANGPTL3 and Cardiovascular Outcomes in Patients With Acute Coronary Syndrome and Obstructive Sleep Apnea

Background The aim of this prospective study was to determine the impact of elevated ANGPTL3 (angiopoietin-like protein 3) on cardiovascular events (CVEs) following acute coronary syndrome (ACS) in patients with or without obstructive sleep apnea (OSA). Methods and Results A total of 1174 patients with ACS underwent successful percutaneous coronary intervention were included in this prospective cohort study (NCT03362385). Patients were categorized according to the apnea-hypopnea index (≥15 events/h, OSA) and further classified by ANGPTL3 levels. We analyzed the incidence of CVEs in patients with ACS according to the status of OSA and ANGPTL3. During a median of 3.1 years of follow-up, 217 (18.48%) CVEs occurred. The patients with ACS with OSA had higher ANGPTL3 levels than those without OSA (30.4 [20.9-43.2] versus 27.80 [19.1-41.5] ng/mL; P<0.001). In all patients with ACS, 29≤ANGPTL3<42 mg/dL and ANGPTL3≥42 mg/dL were associated with an increased risk of CVEs with hazard ratios (HRs) of 1.555 (95% CI, 1.010-2.498) and 2.489 (95% CI 1.613-3.840), respectively. When the status of OSA or not was incorporated in stratifying factors, 29≤ANGPTL3<42 mg/dL and ANGPTL3≥42 mg/dL were associated with a significantly higher risk of CVEs in patients with ACS with OSA (HR, 1.916 [95% CI, 1.019-3.601] and HR, 2.692 [95% CI, 1.379-4.503]) but not without OSA. Moreover, adding ANGPTL3 to the Cox model increased C-statistic values by 0.035 and 0.029 in the OSA group and all patients with ACS, respectively, but was not statistically improved in patients with ACS without OSA. Conclusions In conclusion, our study demonstrates a predictive impact of plasma ANGPTL3 on cardiovascular risk in patients with ACS, especially in patients with ACS with OSA. It might be of clinical value in refining risk stratification and tailoring treatment of patients with ACS and OSA. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03362385.

Reactive Oxygen Species Scavenging Nanomedicine for the Treatment of Ischemic Heart Disease

Ischemic heart disease (IHD) is the leading cause of disability and mortality worldwide. Reactive oxygen species (ROS) have been shown to play key roles in the progression of diabetes, hypertension, and hypercholesterolemia, which are independent risk factors that lead to atherosclerosis and the development of IHD. Engineered biomaterial-based nanomedicines are under extensive investigation and exploration, serving as smart and multifunctional nanocarriers for synergistic therapeutic effect. Capitalizing on cell/molecule-targeting drug delivery, nanomedicines present enhanced specificity and safety with favorable pharmacokinetics and pharmacodynamics. Herein, the roles of ROS in both IHD and its risk factors are discussed, highlighting cardiovascular medications that have antioxidant properties, and summarizing the advantages, properties, and recent achievements of nanomedicines that have ROS scavenging capacity for the treatment of diabetes, hypertension, hypercholesterolemia, atherosclerosis, ischemia/reperfusion, and myocardial infarction. Finally, the current challenges of nanomedicines for ROS-scavenging treatment of IHD and possible future directions are discussed from a clinical perspective.

Quantifying the burden of lipid anomalies among adolescents in India

Background

The present study’s aim is to quantify the burden of lipid abnormalities (excessive non-high-density lipoprotein (non-HDL) cholesterol and low-density lipoprotein (LDL) cholesterol) among Indian adolescents. Which has emerged as a significant covariate of coronary heart disease (CHD).

Methods

The present study aims to unearth the prevalence of any lipid anomalies, their level, and types of lipid profiles among adolescents in India using the Comprehensive National Nutrition Survey 2016–18 i.e., cross-sectional data. Descriptive and bivariate statistical analyses have been used to check the associations and significant differences between groups of individuals suffering from any type of lipid abnormalities.

Results

A total of 35,830 adolescents aged between 10 and 19 years (mean age:14.36 yrs.; SD = 2.81 for males and 14.39 yrs.; SD = 2.78 for females) were included. Roughly 77 percent of the adolescents are suffering from any lipid anomalies. Their mean lipid levels are 140.6 (SD = 32.9), 84.1 (SD = 24.8), 47.3 (SD = 10.7), and 95.3 (SD = 50.0) for total cholesterol, LDL, HDL, and triglycerides, respectively. A higher proportion of adolescents suffered from lipid anomalies among those who were overweight or obese (89%, 95% CI 85, 92) and pre-diabetics (81%, 95% CI 78, 83) compared to each of their counterparts. Furthermore, a considerable proportion of samples with vitamin A (70%, 95% CI 68, 73), D (81%, 95% CI 79, 82), and B12 deficits (73%,95% CI 72, 75), as well as zinc (77%, 95% CI 76, 77), folate (76%, 95% CI 74, 77), and iron deficits (75%,95% CI 73, 77), were suffering from any lipid anomalies. Of individuals who consume an unhealthy diet, 77% (95% CI 76, 78) of them were suffering from any lipid anomalies than others.

Conclusions

The study contends that preventing the increasing burden of lipid abnormalities among Indian adolescents is essential. Vitamin and mineral deficiencies and unhealthy dietary habits are significantly associated with high LDL and non-HDL levels. In the longer run, this might cause the early onset of hypertension, diabetes, and CHDs. Hence, appropriate interventions are needed to curtail these early onsets by primarily focusing on adolescents.

Therapeutic Effect of Fucoidan on Metabolic Diseases: Experimental Data and Clinical Evidence

The rising prevalence of metabolic diseases represents a major challenge to public health worldwide. Therefore, there is a strong need to conduct research on the effectiveness of complementary and alternative therapies for metabolic disorders. Fucoidan is a fucose-enriched and sulfated polysaccharide extracted from ubiquitous brown seaweed. The antihypertensive, antidiabetic, antiobesity, and hypolipidemic effects of fucoidan have been reported in preclinical research and clinical trials. This study aims to review the mechanisms of action and the experimental and clinical use of different types of fucoidan for the treatment of metabolic diseases.

Spontaneous coronary artery dissection and atherosclerosis in a young man with systemic lupus erythematosus: A case report and literature review

Background

Spontaneous coronary artery dissection (SCAD) is a rare coronary artery disease that frequently occurs in young, female patients without risk factors, and conservative treatment is often recommended for its management. The patient reported here is a male patient with systemic lupus erythematosus (SLE).

Case summary

We described a 28-year-old man with SLE who presented with acute ST-segment elevation myocardial infarction (STEMI), and was diagnosed with SCAD through a long dissection of the left anterior descending branch (LAD) by coronary angiography. The patient was treated with percutaneous coronary intervention (PCI) with stent implantation. Ten years later, he developed in-stent stenosis and other coronary atherosclerosis and was retreated with PCIs. Based on this case and according to the literature review, the existing treatment and prognosis of SLE with spontaneous coronary artery dissection and atherosclerosis are discussed.

Conclusion

Cardiovascular complications should be considered in patients with systemic lupus erythematosus, although they may not initially be atherosclerotic diseases. Attention should be paid to distinguish spontaneous coronary dissection in order to minimize missed or delayed diagnoses and take appropriate managements, as well as the development of atherosclerosis in SLE patients, and timely intervention has a better prognosis.

Dyslipidemia Increases the Risk of Incident Hypertension in a Large Taiwanese Population Follow-Up Study

Dyslipidemia is an important risk factor for hypertension and is strongly associated with an elevated risk of cardiovascular diseases including atherosclerosis and stroke. In this study, we investigated correlations between lipid profiles, including triglycerides, total cholesterol (Chol), high-and low-density lipoprotein cholesterol (HDL-C/LDL-C), and Chol/HDL-C, and baseline and incident hypertension. A total of 26,965 subjects with 4 years of follow-up data were enrolled from the Taiwan Biobank. In the cross-sectional cohort, associations between the prevalence of hypertension and lipid profiles were examined in all study participants (n = 26,965). In the longitudinal cohort, these associations were further assessed in the participants without baseline hypertension (n = 21,454). Multivariable analysis revealed that those in the second quartile (Q2) of triglycerides (compared to Q1; odds ratio (OR), 1.402; p < 0.001); Q3 of triglycerides (compared to Q1; OR, 1.365; p < 0.001); Q4 of triglycerides (compared to Q1; OR, 1.617; p < 0.001); Q3 of HDL-C (compared to Q1; OR, 0.886; p = 0.042); Q4 of HDL-C (compared to Q1; OR, 0.819; p = 0.002); Q2 of Chol/HDL-C (compared to Q1; OR, 1.144; p = 0.042); Q3 of Chol/HDL-C (compared to Q1; OR, 1.149; p = 0.034); and Q4 of Chol/HDL-C (compared to Q1; OR, 1.225; p = 0.002) were significantly associated with incident hypertension. In summary, high Chol/HDL-C, low HDL-C, and high triglycerides were associated with a higher risk of incident hypertension in the enrolled Taiwanese participants.

Lipid profile, apolipoproteins A-1 and B in owl monkeys (Aotus infulatus) in captivity

BACKGROUND

Owl monkeys (Aotus infulatus) are frequently affected by heart diseases and, as in humans, dyslipidemia is one of the predisposing factors for adverse cardiovascular events. In view of this, the study of the lipid profile and plasma apolipoproteins can contribute to the clinical management of this neotropical primate species.

METHODS

Lipid profile as well as A-1 and B apolipoprotein values were analyzed in 60 owl monkeys, studying their relationship with body biometry and the presence of cardiac alterations.

RESULTS

Animals suspected of having heart disease did not show significant differences (p < .05) in terms of biometry or in relation to lipid profile and apolipoproteins A-1 and B values; however, higher values of LDL and ApoB and ApoB/ApoA-1 were observed in this group.

CONCLUSIONS

This study is the first to describe the lipid profile and apolipoprotein values in owl monkeys, and further work will be needed to better elucidate the worthiness of LDL, ApoB, and the ApoB/ApoA-1 ratio in this primate species.

Prevalence, awareness, treatment, and control of dyslipidemia and associated factors among adults in Jordan: Results of a national cross-sectional survey in 2019

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The national prevalence of dyslipidemia was 81.6%,

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Among those with dyslipidemia, 9.3% were aware,

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Among those who knew, the proportion of lipid-lowering drug treatment was 50.3%,

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Among those taking lipid-lowering drugs, 25.4% had their dyslipidemia controlled.

Dyslipidaemia is increasing with low awareness and treatment in low resourced countries.

The aim of the study was to evaluate the prevalence, distribution, and correlates of dyslipidaemia and its awareness, treatment, and control among people (18–69 years) in Jordan.

In a national cross-sectional survey, a total of 3,132 individuals (mean age: 41.7 years) that took part in the Jordan cross-sectional STEPS survey in 2019 and had complete lipid measurements. Dyslipidemia was defined using the guidelines of the Adult Treatment Panel III.

The prevalence of dyslipidemia was 81.6%, 74.0% low high-density lipoprotein cholesterol (HDL-C), 28.2% high triglyceride (TG), 10.1% high total cholesterol (TC) and 8.7% high low-density lipoprotein cholesterol (LDL-C). Among those with dyslipidaemia, 9.3% were aware. Among those who knew, the proportion of lipid-lowering drug treatment was 50.3%, and among those taking lipid-lowering drugs, 25.4% had their dyslipidaemia controlled. In adjusted logistic regression, in both sexes, overweight (AOR: 2.14, 95% CI: 1.49–3.36), obesity (AOR: 2.47, 95% CI: 1.55–3.94), diabetes (AOR: 2.63, 95% CI: 1.30–5.34) were positively and moderate physical activity (AOR: 0.60, 95% CI: 0.37–0.95) was negatively associated with prevalence of dyslipidemia. Older age, overweight, obesity, hypertension, diabetes, and cardiovascular disease were positively associated, and moderate physical activity was negatively associated with awareness of dyslipidemia.

Four out of five adults in Jordan had dyslipidaemia and less than one in ten were aware. Several factors associated with the prevalence, awareness, and treatment of dyslipidaemia were identified that can be used to target public health interventions.

Dyslipidemia research landscape and socioeconomic facilitators of scientific productivity in Southeast Asia

BACKGROUND

The growing prevalence of lipid disorder in Southeast Asia (SEA) resulted in an increase in clinical and epidemiological studies on dyslipidemia in the region. Thus, there is a need to summarize the existing evidence from the literature.

AIMS

This paper determined the research landscape of dyslipidemia in SEA. This study also identified the socioeconomic facilitators of scientific productivity in dyslipidemia research in SEA.

METHODS

A database search of dyslipidemia literature in SEA countries was performed using the Scopus database. Bibliographic information was obtained, and network visualization of collaboration among countries and keywords was created using VOSviewer software.

RESULTS

This bibliometric analysis showed a continuous increase in published articles in SEA, most of which were from universities and hospitals in Thailand, Singapore, Malaysia, and Indonesia. The usual topics of dyslipidemia research in SEA include epidemiology, pathophysiology, comorbidities and complications, and treatment options for dyslipidemia. Research & development expenditure (total citations: p = 0.037; h-index: p = 0.031) and researchers in R&D (total citations: p = 0.005; h-index: p = 0.017) were positively correlated with citations and h-index for dyslipidemia publications from SEA countries. Moreover, the number of research collaborations within SEA and worldwide was positively correlated with the total publications, citations, and h-index of SEA countries for their dyslipidemia research outputs.

CONCLUSION

In summary, this bibliometrics study showed an increasing trend of dyslipidemia research in SEA countries. Policymakers and administrators should invest more in dyslipidemia studies to propose better strategies in curbing the prevalence of this condition in SEA.

Butter-Derived Ruminant Trans Fatty Acids Do Not Alleviate Atherosclerotic Lesions in High-Fat Diet-Fed ApoE-/- Mice

Atherosclerosis (AS) is the most common cardiovascular disease (CVD). Currently, it is widely believed that R-TFA and I-TFA may cause different biological effects. In the present study, we aim to elucidate the effect of mixed R-TFA derived from butter on the development of AS in high-fat diet-fed ApoE^-/- mice and find the possible mechanism. It was shown that butter-derived R-TFA promoted dyslipidemia, reduced thoracic and abdominal aorta diameters, and induced aortic lipid deposition and atherosclerotic lesions in high-fat diet-fed ApoE^-/- mice. Meanwhile, butter-derived R-TFA affected the serum lipid profile of high-fat diet-fed ApoE^-/- mice and the lipid metabolism of human umbilical vein endothelial cells (HUVECs). Through lipidomic techniques, we found that butter-derived R-TFA had a significant effect on the glycerophospholipid metabolic pathway. In conclusion, our results demonstrated that butter-derived R-TFA does not alleviate but promotes atherosclerotic lesions in high-fat diet-fed ApoE^-/- mice and that the glycerophospholipid metabolic pathway plays a major role in this pro-atherosclerotic effect.

New Therapeutic Approaches in Treatment of Dyslipidaemia—A Narrative Review

Dyslipidaemia is a well-known risk factor for the development of cardiovascular disease, a leading cause of morbidity and mortality in developed countries. As a consequence, the medical community has been dealing with this problem for decades, and traditional statin therapy remains the cornerstone therapeutic approach. However, clinical trials have observed remarkable results for a few agents effective in the treatment of elevated serum lipid levels. Ezetimibe showed good but limited results when used in combination with statins. Bempedoic acid has been thoroughly studied in multiple clinical trials, with a reduction in LDL cholesterol by approximately 15%. The first approved monoclonal antibodies for the treatment of dyslipidaemia, PCSK9 inhibitors, are currently used as second-line treatment for patients with unregulated lipid levels on statin or statin combination therapy. A new siRNA molecule, inclisiran, demonstrates great potential, particularly concerning compliance, as it is administered twice yearly and pelacarsen, an antisense oligonucleotide that targets lipoprotein(a) and lowers its levels. Volanesorsen is the first drug that was designed to target chylomicrons and lower triglyceride levels, and olezarsen, the next in-line chylomicron lowering agent, is currently being researched. The newest possibilities for the treatment of dyslipidaemia are ANGPTL3 inhibitors with evinacumab, already approved by the FDA, and EMA for the treatment of familial hypercholesterolemia. This article provides a short summary of new agents currently used or being developed for lipid lowering treatment.

Management of Dyslipidemia in Patients with Non-Alcoholic Fatty Liver Disease

PURPOSE OF REVIEW

Patients with non-alcoholic fatty liver disease (NAFLD), often considered as the hepatic manifestation of the metabolic syndrome, represent a population at high cardiovascular risk and frequently suffer from atherogenic dyslipidemia. This article reviews the pathogenic interrelationship between NAFLD and dyslipidemia, elucidates underlying pathophysiological mechanisms and focuses on management approaches for dyslipidemic patients with NAFLD.

RECENT FINDINGS

Atherogenic dyslipidemia in patients with NAFLD results from hepatic and peripheral insulin resistance along with associated alterations of hepatic glucose and lipoprotein metabolism, gut dysbiosis, and genetic factors. Since atherogenic dyslipidemia and NAFLD share a bi-directional relationship and are both major driving forces of atherosclerotic cardiovascular disease (ASCVD) development, early detection and adequate treatment are warranted. Thus, integrative screening and management programs are urgently needed. A stepwise approach for dyslipidemic patients with NAFLD includes (i) characterization of dyslipidemia phenotype, (ii) individual risk stratification, (iii) definition of treatment targets, (iv) lifestyle modification, and (v) pharmacotherapy if indicated.

Lipid-Lowering Effects of Carob Extracts (Ceratonia siliqua): Proposed Mechanisms and Clinical Importance

The global prevalence of dyslipidemia (elevated plasma levels of total cholesterol, LDL-Cholesterol, triglycerides, and lower plasma levels of HDL-Cholesterol) is constantly on the rise. Lately, carob pulp has been recognized as an effective natural product for the treatment of dyslipidemia. The two main components of the carob pulp, polyphenols, and insoluble fiber are believed to have beneficial effects on lipid metabolism. Studies on humans and animals confirmed its lipid-lowering effects. Several mechanisms have been proposed to explain this phenomenon, namely by affecting three organ systems: 1) gastrointestinal tract, 2) liver and 3) adipose tissue. Also, carob products have antioxidative, anti-inflammatory, and vascular-protective activity.

National high prevalence, and low awareness, treatment and control of dyslipidaemia among people aged 15-69 years in Mongolia in 2019

The aim of the study was to evaluate the prevalence, distribution and correlates of dyslipidaemia among people (15-69 years) in Mongolia. National data were analyzed from 4,895 individuals (15-69 years, median age = 35 years) that took part in the Mongolia cross-sectional STEPS survey in 2019, and had complete lipid measurements. Dyslipidaemia was defined using the guidelines of the Adult Treatment Panel III. The prevalence of dyslipidaemia was 58.6%, 31.7% high triglycerides (TG), 26.9% high low-density lipoprotein cholesterol (LDL-C), 26.9% high total cholesterol (TC) and 14.6% low high-density lipoprotein cholesterol (HDL-C). Among those with dyslipidaemia, 6.2% were aware. Among those who were aware, the proportion of lipid-lowering drug treatment was 18.9% and among those who took lipid-lowering drugs, 21.5% had their dyslipidaemia controlled. In adjusted logistic regression, older age (40-69 years) (AOR: 1.19, 95% CI 1.02-1.40), urban residence (AOR: 1.24, 95% CI 1.04-1.48), obesity call II (AOR: 2.89, 95% CI 2.29-3.66), hypertension (AOR: 1.33, 95% CI 1.11-1.59), and diabetes (AOR: 1.62, 95% CI 1.20-2.18) were positively, and male sex (AOR: 0.84, 95% CI 0.72-1.00) was negatively associated with dyslipidaemia prevalence. Six in ten Mongolians 15 years and older had dyslipidaemia. Several factors associated with dyslipidaemia that can be used to target public health interventions were identified.

Molecular Mechanism of Crataegi Folium and Alisma Rhizoma in the Treatment of Dyslipidemia Based on Network Pharmacology and Molecular Docking

Background

Dyslipidemia has become a critical global issue for public health, with elevating prevalence and morbidity closely related to many cardiovascular diseases (CVD) with high incidence rates. Crataegi Folium (known as Shanzhaye in China, SZ, the leaves of Crataegus pinnatifida Bge. var. major N.E. Br. or Crataegus pinnatifida Bge) and Alisma rhizoma (known as Zexie in China, ZX, the dried tuber of Alisma orientale (Sam.) Juzep or Alisma plantago-aquatica Linn), a classic combination of herbs, have been widely used to treat dyslipidemia. However, the therapeutic mechanism of this pair still remains unclear. Hence, this study aimed to elucidate the molecular mechanism of the Shanzhaye-Zexie herb pair (SZHP) in the treatment of dyslipidemia with the use of a network pharmacology analysis approach.

Methods

Active compounds, targets of the SZHP, and targets for dyslipidemia were screened based on the public database. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were performed on the database for annotation, visualization, and integrated discovery (DAVID 6.8). The compound-target-disease-pathway network was visualized using the Cytoscape software, and SYBYL was used for molecular docking.

Results

Twelve active compounds in the SZHP were screened out, which were closely connected to 186 dyslipidemia-related targets. The network analysis revealed that sitosterol, stigmasterol, isorhamnetin, kaempferol, and quercetin might be candidate agents and CCND1, CASP3, HIF1A, and ESR1 genes were potential drug targets. GO analysis revealed 856 biological processes (BP), 139 molecular functions (MF), and 89 cellular components (CC). The KEGG pathway enrichment analysis indicated that the lipid level and atherosclerosis might influence the treatment of dyslipidemia. Molecular docking showed that quercetin bound well to CCND1, HIF1A, MYC, AKT1, and EGFR genes. These findings were in accord with the prediction obtained through the network pharmacology approach.

Conclusions

This study revealed the primary pharmacological effects and relevant mechanisms of the SZHP in treating dyslipidemia. Our findings may facilitate the development of the SZHP or its active compounds as an alternative therapy for dyslipidemia. Still, more pharmacological experiments are needed for verification.

The Traditional Mongolian Medicine Qiqirigan-8 Effects on Lipid Metabolism and Inflammation in Obesity: Pharmacodynamic Evaluation and Relevant Metabolites

Objective: Traditional Mongolian Medicine Qiqirigan-8 (MMQ-8) is a Chinese botanical drug with effective pharmacological properties in obesity. However, the pharmacological mechanism of MMQ-8 remains unclear. This study aimed to determine the active metabolites of MMQ-8 and its therapeutic effects on lipid metabolism and inflammation.

Methods: The active metabolites of MMQ-8 were identified by ultrahigh-performance liquid chromatograph Q extractive mass spectrometry (UHPLC-QE-MS) assay and network analysis. An obesity rat model induced by high-fat diet was used in the study. Serum levels of lipids and inflammatory factors were detected using biochemical analysis and enzyme-linked immunosorbent assay (ELISA). Pathological analysis of liver tissues and arteries was conducted with hematoxylin and eosin (H&E) staining and immunohistochemistry. Protein expression of the tumor necrosis factor (TNF) signaling pathway was investigated by Western-blot. Simultaneously, bone marrow cells were used for RNA sequencing and relevant results were validated by cell culture and quantitative real-time polymerase chain reaction (RT-qPCR).

Results: We identified 69 active metabolites and 551 target genes of MMQ-8. Of these, there are 65 active metabolites and 225 target genes closely related to obesity and inflammation. In vivo, we observed that MMQ-8 had general decreasing effects on body weight, white adipose tissue weight, and serum lipids. MMQ-8 treatment notably decreased the liver function markers and hepatic steatosis, and significantly decreased inflammation. In serum, it notably decreased TNF-α, interleukin (IL)-6, and inducible nitric oxide synthase (INOS), while elevating IL-10 levels. MMQ-8 treatment also significantly inhibited proteins phosphorylation of nuclear factor-kappa B inhibitor alpha (IκBα), mitogen-activated protein kinase (p38), extracellular regulated kinase 1/2(ERK1/2), and stress-activated protein kinase/c-Jun N-terminal kinase (SAPK/JNK), and decreased vascular endothelium damage and macrophage infiltration and polarization to M1. These findings coincide with the RNA-sequencing data of bone marrow cells and results of in vitro experiments.

Conclusion: We determined the pharmacological actions and relevant metabolites of MMQ-8 in obesity for the first time. Our study revealed MMQ-8 can optimize lipid metabolism and reduce chronic inflammation in obesity. However, more in-depth research is needed, for example, to understand the principle of compound compatibility and the inhibition effects on hepatic steatosis, T cell differentiation, and inflammatory signal transduction.

Fermented Rosa Roxburghii Tratt Juice Alleviates High-Fat Diet-Induced Hyperlipidemia in Rats by Modulating Gut Microbiota and Metabolites

Hyperlipidemia endangers human health and has become a significant public health problem. This study aimed to investigate the mechanism of the hypolipidemic effects of Fermented Rosa roxburghii Tratt juice (FRRT) on hyperlipidemic rats and a new hypolipidemic intervention strategy was disclosed. The study revealed 12 weeks FRRT treatment significantly decreased the body weight, total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-c), while high-density lipoprotein cholesterol (HDL-c) increased. We integrated the 16S rDNA sequencing and metabolomic profiling to evaluate the changes in the gut microbiota and metabolites. Significant changes in microbial composition accompanied marked changes in 56 feces metabolites. The results showed that FRRT could decrease the ratio of Firmicutes to Bacteroidetes, while increase the abundance of some bacterial genera (Prevotella, Paraprevotellaceae_Prevotella, Ruminococcus, Oscillospira). Metabolomics analysis displayed that the metabolisms of bile acid, amino acid and lipid were significantly affected by FRRT. Correlation analysis suggest that the reductions in serum lipids by FRRT are associated with the gut microbial community and their associated metabolites (amino acid metabolites, bile acid metabolites, and lipid metabolites). This study confirmed FRRT could be used as a new dietary and therapeutic strategy to dyslipidemia by improving the gut microbiota dysbiosis, metabolomic disorders and regulating the dyslipidemia. Our study also extended the understanding of the relationship between gut microbiota, metabolites, and lipid-lowering functions.

Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors Use for Atherogenic Dyslipidemia in Solid Organ Transplant Patients

Dyslipidemia is a widespread risk factor in solid organ transplant patients, due to many reasons, such as the use of immunosuppressive drugs, with a consequent increase in cardiovascular diseases in this population. PCSK9 is an enzyme mainly known for its role in altering LDL levels, consequently increasing cardiovascular risk. Monoclonal antibody PCSK9 inhibitors demonstrated remarkable efficacy in the general population in reducing LDL cholesterol levels and preventing cardiovascular disease. In transplant patients, these drugs are still poorly used, despite having comparable efficacy to the general population and giving fewer drug interactions with immunosuppressants. Furthermore, there is enough evidence that PCSK9 also plays a role in other pathways, such as inflammation, which is particularly dangerous for graft survival. In this review, the current evidence on the function of PCSK9 and the use of its inhibitors will be discussed, particularly in transplant patients, in which they may provide additional benefits.

Association of blood lipids with coronary artery plaque among Saudi patients referred to computed tomography

Background

Blood lipids are strong risk factors for the progression of atherosclerotic plaques. However, data on gender-specific associations are limited.

Objectives

To examine gender-specific associations of coronary plaque with blood lipids among a large sample of Saudi patients without CAD.

Methods

Retrospective cross-sectional study was conducted among adult patients referred to (64 multidetector spiral) computed tomography (CT) for standard indications at the Prince Sultan Cardiac Centre (Riyadh, Saudi Arabia) between July 2007 and December 2017. Those with pre-existing CAD were excluded. Plaques were determined based on quantification of coronary calcium and Coronary CT angiography.

Results

A total 2421 patients (1498 males and 923 females) were included. The prevalence of any plaque was 36.6% with higher burden in males than females (41.3% versus 28.9%, p < 0.001). Approximately 78.9% of all plaques were calcified. Blood lipids (mmol/L) were 4.75 ± 1.14 for total cholesterol, 2.90 ± 0.96 for LDL cholesterol, 1.20 ± 0.36 for HDL cholesterol, and 1.64 ± 1.09 for triglycerides. Males had significantly higher triglycerides and lower HDL cholesterol compared with females. In adjusted models in males and all patients, soft and/or calcified plaques were significantly associated with lower HDL cholesterol and higher triglycerides. In females, the only significant association was between soft plaques and higher triglycerides.

Conclusions

Middle-aged patients without clinical CAD in Saudi Arabia have a high burden of plaques, specially calcified ones. The findings may impact the use of lipid lowering mediations, by underscoring the importance of assessing the risk of CAD in patients without clinical CAD even in case of lack of coronary calcification.

Comparative and Combined Effects of Epigallocatechin-3-gallate and Caffeine in Reducing Lipid Accumulation in Caenorhabditis elegans

Epigallocatechin-3-gallate (EGCG) and caffeine, two phytochemicals found in a wide range of natural dietary sources, have been reported to have protective effects against hyperlipidemia, a major risk factor for cardiovascular disease. However, their relative efficacy and synergy in lowering lipid level are unclear. This study intended to compare lipid-lowering activity of EGCG and caffeine and to elucidate their joint action using Caenorhabditis elegans (C. elegans) as a model organism. The worms were exposed to EGCG, caffeine or both agents, and lipid accumulation determined by levels of total lipids, triglycerides and cholesterol was monitored. A 3 × 3 factorial design combined with response surface methodology was used to characterize the nature of interactive effects. Total lipids, triglycerides and cholesterol in C. elegans were reduced by either EGCG or caffeine in a dose-dependent manner, with EGCG displaying a stronger lipid-lowering efficacy than caffeine. Overall, the EGCG/caffeine combination for lowering lipids was more effective than either substance alone. Factorial regression models revealed that the combination was antagonistic for total lipid reduction, perhaps due to a "ceiling" effect, and was synergistic for triglyceride-lowering and additive for cholesterol-lowering. Taken together, our work proposes the use of a combination of EGCG and caffeine as an alternative dietary intervention for the prevention of hyperlipidemia, and additionally highlights the suitability of C. elegans model for evaluating lipid-lowering capacity of natural products.

Approach to the Patient With Moderate Hypertriglyceridemia

Hypertriglyceridemia is a common lipid disorder encountered in clinical practice. Plasma triglycerides are a marker for the concentration of triglycerides carried in chylomicrons and very low-density lipoprotein particles. A fasting triglyceride level <150 mg/dL is accepted widely as the upper limit of normal range. Guidelines for hypertriglyceridemia are variable without a global consensus on classification and goals for triglyceride levels. A general classification of hypertriglyceridemia is mild < 200 mg/dL, moderate = 200 to 500 mg/dL, moderate to severe = 500 to 1000 mg/dL, and severe > 1000 mg/dL. Because moderate hypertriglyceridemia does increase atherosclerotic cardiovascular disease risk, it is important to determine the underlying etiology to guide appropriate and timely management. This article provides stepwise recommendations on the diagnosis and management of moderate hypertriglyceridemia, based on 3 common scenarios encountered in clinical practice. Initial steps in management include evaluating for secondary contributors, especially diabetes mellitus. Based on patient characteristics, appropriate management decisions include lifestyle adjustments aimed at weight loss and decreasing alcohol consumption and use of statin and nonstatin therapies.