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Zheng W, Zhang J, Jiang Y, Wang S, Yang Z. Overlapping Pattern of the Four Individual Components of Dyslipidemia in Adults: Analysis of Nationally Representative Data. J Clin Med 2024; 13:3624. [PMID: 38930152 PMCID: PMC11204754 DOI: 10.3390/jcm13123624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/28/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objectives: Dyslipidemia is a well-established risk factor for cardiovascular disease (CVD). However, among available drug treatments, only those targeted at lowering LDL-C and consequently TC have demonstrated efficacy in preventing CVD. This is to say that the benefit for those with isolated high TG or low HDL-C is limited. The objective of this study is to examine the overlapping pattern of the four dyslipidemia components in US adult populations, which is important for quantifying the proportion of those who are less likely to benefit from lipid-lowering drugs and for a more precise use of the drug. Methods: A total of 7822 participants aged over 20 with abnormalities in any of the four lipid parameters, excluding those on lipid-lowering medications, were included from the National Health and Nutrition Examination Survey (NHANES) cycles spanning 1999-2000 through 2017-2018. The proportions of different combinations of them were calculated and presented using area-proportional Euler plots. Results: High TC, high LDL-C, high TG, and low HDL-C were seen in 32.8% (95% CI: 31.3%-34.2%), 28.1% (95% CI: 26.6%-29.6%), 26.7% (95% CI: 25.4%-28.0%), and 65.9% (95% CI: 64.0%-67.7%) of the people with dyslipidemia, respectively. The proportions of dyslipidemia cases attributable to "high LDL-C or high TC" (irrespective of HDL-C and TG levels), "normal LDL-C, normal TC, but high TG" (irrespective of HDL-C level), and "normal LDL-C, normal TC, normal TG, but low HDL-C" (i.e., isolated low HDL-C) accounted for 37.5% (95% CI: 35.9%-39.1%), 18.3% (95% CI: 17.2%-19.4%), and 44.2% (95% CI: 42.5%-46.0%), respectively. Conclusions: Some two-thirds of those with dyslipidemia had low HDL-C or high TG but normal LDL-C and normal TC. As these people are less likely to benefit from currently available drug treatments in terms of CVD prevention, it is important to identify other effective strategies or interventions targeted at them in order to achieve more precise and cost-effective management of dyslipidemia.
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Affiliation(s)
- Wenxiao Zheng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; (W.Z.); (S.W.)
| | - Jiayue Zhang
- Faculty of Medicine, Macau University of Science of Technology, Macau SAR, China;
| | - Ying Jiang
- Chronic Disease Research Institute, The Children’s Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310052, China;
| | - Shuting Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; (W.Z.); (S.W.)
| | - Zuyao Yang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; (W.Z.); (S.W.)
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He Q, Pan J, Wang L, Fang Y, Hu R. Prospective study: Aldehyde dehydrogenase 2 gene is associated with cardio-cerebrovascular complications in type 2 diabetes patients. J Diabetes Investig 2021; 12:1845-1854. [PMID: 33651448 PMCID: PMC8504900 DOI: 10.1111/jdi.13538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/02/2021] [Accepted: 02/28/2021] [Indexed: 01/16/2023] Open
Abstract
AIMS/INTRODUCTION Most studies have shown that aldehyde dehydrogenase 2 (ALDH2) mutations were associated with cardio-cerebrovascular complications of diabetes based on cross-sectional investigations, but few studies based on cohorts were carried out. The aim of this study was to explore the correlation between the ALDH2 gene and the occurrence of and death from cardio-cerebrovascular complications in type 2 diabetes patients through a prospective cohort study. MATERIALS AND METHODS According to a community-based and disease-based prospective cohort study design, a baseline cohort of 10,339 persons with type 2 diabetes was established in 2016, and the occurrence of and death from cardio-cerebrovascular complications were followed up until December 2018. A total of 2,500 diabetes patients without cardio-cerebrovascular complications were randomly selected from the baseline cohort to detect the rs671 polymorphism of the ALDH2 gene. Cox regression analysis was carried out on the effect of different ALDH2 rs671 single-nucleotide polymorphisms on the risk and survival time of cardio-cerebrovascular complications among diabetes patients. RESULTS There were 215 cardio-cerebrovascular complications, including 10 deaths, that occurred in the 2,500 diabetes patients during the follow-up period. Cox regression analysis showed that rs671 GA/AA genotype, sex (male), poor control of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, blood pressure and glycated were risk factors, whereas drinking alcohol was a protective factor for cardio-cerebrovascular complications (P < 0.05). After adjusting for age and sex, the risk of the rs671 GA/AA genotype was 1.314-fold (95% confidence interval 1.000-1.727) that of the GG genotype. CONCLUSION The G-A mutation of ALDH2 rs671 is a risk factor for the occurrence of and death from cardio-cerebrovascular complications in type 2 diabetes patients. Further studies with larger cohorts and longer follow up will be necessary to reveal a consensus.
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Affiliation(s)
- Qingfang He
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Jin Pan
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Lixin Wang
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Yujia Fang
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
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Garrido-Gimenez C, Mendoza M, Cruz-Lemini M, Galian-Gay L, Sanchez-Garcia O, Granato C, Rodriguez-Sureda V, Rodriguez-Palomares J, Carreras-Moratonas E, Cabero-Roura L, Llurba E, Alijotas-Reig J. Angiogenic Factors and Long-Term Cardiovascular Risk in Women That Developed Preeclampsia During Pregnancy. Hypertension 2020; 76:1808-1816. [PMID: 33012203 DOI: 10.1161/hypertensionaha.120.15830] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Preeclampsia is caused by placental impairment with increased expression of sFlt-1 (soluble fms-like tyrosine kinase 1) and decreased PlGF (placental growth factor); it has been associated with cardiovascular morbidity and mortality later in life, but the underlying mechanism remains unknown. The aim of this study was to determine whether sFlt-1 and PlGF levels during preeclampsia are associated to long-term cardiovascular risk. We prospectively recruited 43 women with previous preeclampsia and 21 controls with uncomplicated pregnancies. Cardiovascular risk assessment ≈12 years later included maternal hemodynamic, cardiac function and structure, biomarker analysis, and carotid-intima thickness evaluation. Women with previous preeclampsia had higher prevalence of hypertensive disorders and dyslipidemia than controls. In addition, they had worse global longitudinal strain, thicker left ventricular septal and posterior walls, more myocardial mass and increased carotid intima-media thickness compared with controls. PlGF during pregnancy correlated positively with high-density lipoprotein (r=0.341; P=0.006), and negatively with global longitudinal strain (r=-0.581; P<0.001), carotid intima-media thickness (r=-0.251; P=0.045), and mean arterial blood pressure (r=-0.252; P=0.045), when adjusted by study group. sFlt correlated negatively with high-density lipoprotein (r=-0.372; P=0.002) and apolipoprotein A-1 (r=-0.257; P=0.040), and positively with carotid intima-media thickness (r=0.269; P=0.032) and left ventricular posterior wall thickness (r=0.368; P=0.003). The antiangiogenic state present in preeclampsia is related to greater prevalence of cardiovascular risk factors ≈12 years after delivery. The knowledge of altered angiogenic factors may help detect women with a higher risk for premature cardiovascular disease, who will require earlier follow-up after delivery.
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Affiliation(s)
- Carmen Garrido-Gimenez
- From the Maternal-Fetal Medicine Unit, Sant Pau University Hospital (C.G.-G., M.C.-L., E.L.), Universitat Autònoma de Barcelona, Spain.,Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Spain (C.G.-G., O.S.-G., E.L.).,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Manel Mendoza
- Maternal-Fetal Medicine Unit Vall d'Hebron University Hospital (M.M., E.C.-M.), Universitat Autònoma de Barcelona, Spain
| | - Monica Cruz-Lemini
- From the Maternal-Fetal Medicine Unit, Sant Pau University Hospital (C.G.-G., M.C.-L., E.L.), Universitat Autònoma de Barcelona, Spain.,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Laura Galian-Gay
- Cardiology Department (L.G.-G., C.G., J.R.-P.) Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain.,Centro de Investigación Biomédica en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Spain (L.G.-G., J.R.-P.)
| | - Olga Sanchez-Garcia
- Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Spain (C.G.-G., O.S.-G., E.L.).,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Chiara Granato
- Cardiology Department (L.G.-G., C.G., J.R.-P.) Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
| | - Victor Rodriguez-Sureda
- Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.).,Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Spain (V.R.-S.).,Biochemistry and Molecular Biology Research Centre for Nanomedicine, Vall d'Hebron University Hospital, Barcelona, Spain (V.R.-S.)
| | - Jose Rodriguez-Palomares
- Cardiology Department (L.G.-G., C.G., J.R.-P.) Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain.,Centro de Investigación Biomédica en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Spain (L.G.-G., J.R.-P.)
| | - Elena Carreras-Moratonas
- Maternal-Fetal Medicine Unit Vall d'Hebron University Hospital (M.M., E.C.-M.), Universitat Autònoma de Barcelona, Spain
| | - Lluis Cabero-Roura
- Chairman Obstetrics and Gynecology, Universitat Autònoma de Barcelona, Department of Obstetrics and Gynecology, Quironsalud Hospital Barcelona (L.C.-R.)
| | - Elisa Llurba
- From the Maternal-Fetal Medicine Unit, Sant Pau University Hospital (C.G.-G., M.C.-L., E.L.), Universitat Autònoma de Barcelona, Spain.,Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Spain (C.G.-G., O.S.-G., E.L.).,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Internal Medicine Department, and Vall d'Hebron Research Institute (J.A.-R.), Universitat Autònoma de Barcelona, Spain
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Fang Y, Li XH, Qiao Y, Wang N, Xie P, Zhou G, Su P, Ma HY, Song JY. Prevalence of Dyslipidemia in Tibetan Monks from Gansu Province, Northwest China. Open Life Sci 2020; 15:152-158. [PMID: 33987472 PMCID: PMC8114783 DOI: 10.1515/biol-2020-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 11/22/2019] [Indexed: 11/15/2022] Open
Abstract
Tibetan monks have a special way of life and food habits, however, little is known about their dyslipidemia. This study aimed to investigate the prevalence of dyslipidemia and risk factors of this population. A cross-sectional study of dyslipidemia was conducted in 876 Tibetan monks and 912 local residents in the same area. All subjects underwent interviews and physical examinations. The total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) of the subjects were analyzed. Compared to local residents, the overall prevalence of dyslipidemia in monks was 29.5%, which was significantly lower (p<0.05). It was increased with higher age and BMI, but reduced with higher educational level (p<0.05). The typical forms of dyslipidemia in monks were elevated TG and low HDL-C, while it was lower HDL-C in residents (p<0.05). Our study demonstrated that monks in Gannan Tibetan autonomous district had a lower prevalence of dyslipidemia. It suggested that the relatively healthy lifestyle and food habits of monks were mainly responsible of the lower prevalence of dyslipidemia.
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Affiliation(s)
- Yan Fang
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Xing-Hui Li
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Yan Qiao
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Nan Wang
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Ping Xie
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Gang Zhou
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Peng Su
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Hui-Yuan Ma
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Ji-Yang Song
- Department of Cardiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, Gansu, 730000, China
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