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Xie Y, Qu P, Guo L, Xu J, Zhu L, Tan Y, Wen T, Liu L. Comparison between Fasting and Non-Fasting Cut-Off Values of Triglyceride in Diagnosing High Triglyceride in Chinese Hypertensive Outpatients. J Clin Med 2023; 12:jcm12072539. [PMID: 37048623 PMCID: PMC10095265 DOI: 10.3390/jcm12072539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/30/2023] Open
Abstract
Background: Hypertension (HBP) often occurs together with hypertriglyceridemia which indicates elevated triglyceride (TG) and remnant cholesterol (RC) levels. Non-fasting (i.e., postprandial) blood lipid test after a daily meal has been recommended by the European Atherosclerosis Society (EAS). However, little is known about the difference between fasting and non-fasting cut-off values in assessing high TG (HTG) and high RC (HRC) in HBP outpatients. Methods: 225 Chinese outpatients with HBP, including 119 fasting patients (i.e., fasting group) and 106 non-fasting patients (i.e., non-fasting group) were enrolled in this study. Non-fasting levels of blood lipids at 2 h after a daily breakfast were also tested in 33 patients among the fasting group. Venous blood samples were collected. Results: The non-fasting group had significantly higher levels of TG and RC while lower levels of total cholesterol, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol than the fasting group (p < 0.05). According to the TG and RC cut-off values of the EAS, the percentages of HTG and HRC in the non-fasting group were 72.6% and 70.8%, respectively, whereas those in the fasting group were 57.1% and 52.9%, respectively. According to the cut-off value of marked HTG commonly used in the Chinese population in clinical practice, the percentage of marked HTG in the non-fasting group was 57.5%, whereas that in the fasting group was 34.5%. However, the percentages of HTG (57.6% vs. 51.5%) and HRC (51.5% vs. 51.5%) marked HTG (30.3% vs. 33.3%) in the fasting state and at 2 h after a daily breakfast in 33 outpatients did not reach statistical significance. Conclusion: Non-fasting blood lipid tests could find more individuals with HTG as well as those with marked HTG among Chinese outpatients with HBP. It indicates that non-fasting blood lipid tests are worth being recommended in patients with HBP.
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2
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Postprandial triglyceride-rich lipoproteins promote the adipogenic differentiation of adipose-derived mesenchymal stem cells via the LRP1/caveolin-1/AKT1 pathway. Biochim Biophys Acta Mol Cell Biol Lipids 2023; 1868:159236. [PMID: 36179802 DOI: 10.1016/j.bbalip.2022.159236] [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: 05/30/2022] [Revised: 09/02/2022] [Accepted: 09/21/2022] [Indexed: 11/22/2022]
Abstract
Diet-induced obesity (OB) is usually accompanied by hypertriglyceridemia, which is characterized by the accumulation of triglyceride (TG)-rich lipoprotein (TRL) particles in the circulation. We previously found that postprandial TRL combined with insulin induced the adipogenic differentiation of 3T3-L1 preadipocytes, which may represent a key mechanism underlying obesity. However, the specific mechanism and signaling pathway involved in this process remain to be fully elucidated. In this study, we found that, in the postprandial state, patients with obesity had significantly higher levels of TG and remnant cholesterol (RC) than normal-weight controls. In vitro, we found that postprandial TRL, together with insulin, promoted the adipogenic differentiation of adipose-derived mesenchymal stem cells (AMSCs), as evidenced by the increased expression of lipogenesis-related genes and their protein products, including low-density lipoprotein related protein 1 (LRP1). Besides, caveolin-1 (Cav-1) expression was also significantly upregulated under this condition. Cav-1 and LRP1 were observed to interact, and then led to the activation of the PI3K/AKT1 signaling pathway. Meanwhile, the inhibition of LRP1 or Cav-1 significantly attenuated the adipogenic differentiation of AMSCs and downregulated AKT1 phosphorylation levels. Moreover, treatment with a selective AKT1 inhibitor significantly suppressed postprandial TRL and insulin-induced adipogenesis in AMSCs. Combined, our results demonstrated that, in association with insulin, postprandial TRL can promote the adipogenic differentiation of AMSCs in a manner that is dependent on the LRP1/Cav-1-mediated activation of the PI3K/AKT1 signaling pathway. Our findings indicated that a postprandial increase in TRL content is a critical factor in the pathogenesis of hypertriglyceridemia and diet-induced obesity.
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Xiang Q, Tian F, Xu J, Du X, Zhang S, Liu L. New insight into dyslipidemia‐induced cellular senescence in atherosclerosis. Biol Rev Camb Philos Soc 2022; 97:1844-1867. [PMID: 35569818 PMCID: PMC9541442 DOI: 10.1111/brv.12866] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/18/2022] [Accepted: 04/28/2022] [Indexed: 11/28/2022]
Abstract
Atherosclerosis, characterized by lipid‐rich plaques in the arterial wall, is an age‐related disorder and a leading cause of mortality worldwide. However, the specific mechanisms remain complex. Recently, emerging evidence has demonstrated that senescence of various types of cells, such as endothelial cells (ECs), vascular smooth muscle cells (VSMCs), macrophages, endothelial progenitor cells (EPCs), and adipose‐derived mesenchymal stem cells (AMSCs) contributes to atherosclerosis. Cellular senescence and atherosclerosis share various causative stimuli, in which dyslipidemia has attracted much attention. Dyslipidemia, mainly referred to elevated plasma levels of atherogenic lipids or lipoproteins, or functional impairment of anti‐atherogenic lipids or lipoproteins, plays a pivotal role both in cellular senescence and atherosclerosis. In this review, we summarize the current evidence for dyslipidemia‐induced cellular senescence during atherosclerosis, with a focus on low‐density lipoprotein (LDL) and its modifications, hydrolysate of triglyceride‐rich lipoproteins (TRLs), and high‐density lipoprotein (HDL), respectively. Furthermore, we describe the underlying mechanisms linking dyslipidemia‐induced cellular senescence and atherosclerosis. Finally, we discuss the senescence‐related therapeutic strategies for atherosclerosis, with special attention given to the anti‐atherosclerotic effects of promising geroprotectors as well as anti‐senescence effects of current lipid‐lowering drugs.
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Affiliation(s)
- Qunyan Xiang
- Department of Geriatrics, The Second Xiangya Hospital Central South University Changsha Hunan 410011 PR China
- Institute of Aging and Age‐related Disease Research Central South University Changsha Hunan 410011 PR China
| | - Feng Tian
- Department of Geriatric Cardiology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450000 PR China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital Central South University Changsha Hunan 410011 PR China
- Research Institute of Blood Lipid and Atherosclerosis Central South University Changsha Hunan 410011 PR China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province Changsha Hunan 410011 PR China
- Cardiovascular Disease Research Center of Hunan Province Changsha Hunan 410011 PR China
| | - Xiao Du
- Department of Cardiovascular Medicine, The Second Xiangya Hospital Central South University Changsha Hunan 410011 PR China
- Research Institute of Blood Lipid and Atherosclerosis Central South University Changsha Hunan 410011 PR China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province Changsha Hunan 410011 PR China
- Cardiovascular Disease Research Center of Hunan Province Changsha Hunan 410011 PR China
| | - Shilan Zhang
- Department of Gastroenterology, The Second Xiangya Hospital Central South University Changsha Hunan 410011 PR China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital Central South University Changsha Hunan 410011 PR China
- Research Institute of Blood Lipid and Atherosclerosis Central South University Changsha Hunan 410011 PR China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province Changsha Hunan 410011 PR China
- Cardiovascular Disease Research Center of Hunan Province Changsha Hunan 410011 PR China
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Tan Y, Lin Q, Xu J, Zhu L, Guo L, Xie Y, Du X, Zhang S, Wen T, Liu L. Non-fasting Changes in Blood Lipids After Three Daily Meals Within a Day in Chinese Inpatients With Cardiovascular Diseases. Front Cardiovasc Med 2022; 9:799300. [PMID: 35498036 PMCID: PMC9039513 DOI: 10.3389/fcvm.2022.799300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Non-fasting (i.e., postprandial) lipid detection is recommended in clinical practice. However, the change in blood lipids in Chinese patients with cardiovascular diseases after three daily meals has never been reported yet. Methods Serum levels of blood lipids were measured or calculated in 77 inpatients (48 men and 29 women) at high or very high risk of atherosclerotic cardiovascular disease (ASCVD) in the fasting state and at 4 h after three meals within a day according to their diet habits. Results Female patients showed significantly higher level of high-density lipoprotein cholesterol (HDL-C) than male patients, and the gender difference in other lipid parameters did not reach statistical significance at any time-point. Levels of triglyceride (TG) and remnant cholesterol (RC) increased, while that of low-density lipoprotein cholesterol (LDL-C) decreased significantly after three meals (p < 0.05). Levels of HDL-C, total cholesterol (TC), and non-high-density lipoprotein cholesterol (non-HDL-C) showed smaller changes after three meals. Percent reductions in the non-fasting LDL-C levels after lunch and supper were around 20%, which were greater than that after breakfast. The percent reductions in the non-fasting non-HDL-C levels after three meals were smaller than those in the non-fasting LDL-C levels. Patients with TG level ≥ 2.0 mmol/L (177 mg/dL) after lunch had significantly greater absolute reduction of LDL-C level than those with TG level < 2.0 mmol/L (177 mg/dL) after lunch [–0.69 mmol/L (–27 mg/dL) vs. –0.36 mmol/L (–14 mg/dL), p<0.01]. There was a significant and negative correlation between absolute change in LDL-C level and that in TG level (r = −0.32) or RC level (r = −0.67) after lunch (both p<0.01). Conclusion LDL-C level decreased significantly after three daily meals in Chinese patients at high or very high risk of ASCVD, especially when TG level reached its peak after lunch. Relatively, non-HDL-C level was more stable than LDL-C level postprandially. Therefore, when LDL-C level was measured in the non-fasting state, non-HDL-C level could be evaluated simultaneously to reduce the interference of related factors, such as postprandial hypertriglyceridemia, on detection.
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Affiliation(s)
- Yangrong Tan
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qiuzhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Liyuan Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Liling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Yingying Xie
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Xiao Du
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Shilan Zhang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Tie Wen
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, The Second Xiangya Hospital, Central South University, Changsha, China
- Tie Wen,
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
- *Correspondence: Ling Liu,
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Hou X, Song A, Guan Y, Tian P, Ren L, Tang Y, Wang C, Gao L, Song G, Xing X. Identification of the Chinese Population That Can Benefit Most From Postprandial Lipid Testing: Validation of the Use of Oral Fat Tolerance Testing in Clinical Practice. Front Endocrinol (Lausanne) 2022; 13:831435. [PMID: 35250883 PMCID: PMC8894673 DOI: 10.3389/fendo.2022.831435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dyslipidemia has become increasingly prevalent in recent decades. Blood lipid concentrations are significantly influenced by diet; however, postprandial triglyceride concentration (PTG) is not often measured. PTG can reflect the risks of diabetes and cardiovascular disease, but not all individuals would benefit from PTG testing. OBJECTIVE The aim of the present study was to determine the PTG response in a Chinese cohort and identify who would benefit from diagnostic PTG measurement. METHODS A total of 400 Chinese adults were enrolled and underwent oral fat tolerance test (OFTT), which was well tolerated. The participants were assigned to groups according to their fasting triglyceride concentration to evaluate the usefulness of PTG testing. A PTG concentration > 2.5 mmol/L was defined as high (HPTG). RESULTS Of the 400 participants, 78.9% showed an undesirable PTG response. Those with FTG ≥1.0 mmol/L had a delayed PTG peak and higher peak values. Seventy-five percent of those with 1.0 mmol/L ≤FTG <1.7 mmol/L had HPTG, of whom 18.6% had impaired glucose tolerance. CONCLUSIONS The present data confirm the previously reported predictive value of PTG testing. Moreover, the findings indicate that Chinese people with FTGs of 1.0 -1.7 mmol/L may benefit most from the identification of postprandial hyperlipidemia through OFTT because more than half of them have occult HPTG, which may require treatment. Thus, the detection of HPTG using an OFTT represents a useful means of identifying dyslipidemia and abnormal glucose metabolism early. CLINICAL TRIAL REGISTRATION [http://www.chictr.org.cn/index.aspx], identifier ChiCTR1800019514.
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Affiliation(s)
- Xiaoyu Hou
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - An Song
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yunpeng Guan
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Peipei Tian
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, China
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Yong Tang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Chao Wang
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, China
| | - Ling Gao
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Guangyao Song
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
- *Correspondence: Guangyao Song, ; Xiaoping Xing,
| | - Xiaoping Xing
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Guangyao Song, ; Xiaoping Xing,
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6
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Guo LL, Zhu LY, Xu J, Xie YY, Xiang QY, Jiang ZY, Tan YR, Liu L. Determination of the Optimal Cutoff Value of Triglyceride That Corresponds to Fasting Levels in Chinese Subjects With Marked Hypertriglyceridemia. Front Cardiovasc Med 2021; 8:736059. [PMID: 34631833 PMCID: PMC8498036 DOI: 10.3389/fcvm.2021.736059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/20/2021] [Indexed: 12/27/2022] Open
Abstract
The level of triglyceride (TG) ≥ 2. 3 mmol/L is suggestive of marked hypertriglyceridemia (HTG) and requires treatment with a triglyceride-lowering agent in high-risk and very high-risk patients as recommended by the 2019 ESC/EAS guidelines for the management of dyslipidemia. However, the optimal cutoff value required to diagnose non-fasting HTG that corresponds to the fasting goal level of 2.3 mmol/L in Chinese subjects is unknown. This study enrolled 602 cardiology inpatients. Blood lipid levels, including calculated non-high-density lipoprotein cholesterol (non-HDL-C) and remnant cholesterol (RC), were measured at 0, 2, and 4 h after a daily Chinese breakfast. Of these, 482 inpatients had TG levels of <2.3 mmol/L (CON group) and 120 inpatients had TG levels of ≥2.3 mmol/L (HTG group). Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values for postprandial HTG that corresponded to a target fasting level of 2.3 mmol/L. Marked hypertriglyceridemia (≥2.3 mmol/L) was found in 120 (19.9%) patients in this study population. The levels of non-fasting TG and RC increased significantly in both groups and reached the peak at 4 h after a daily meal, especially in the HTG group (p < 0.05). The optimal cutoff value of TG at 4 h, which corresponds to fasting TG of ≥2.3 mmol/L, that can be used to predict HTG, was 2.66 mmol/L. According to the new non-fasting cutoff value, the incidence of non-fasting HTG is close to its fasting level. In summary, this is the first study to determine the non-fasting cutoff value that corresponds to a fasting TG of ≥2.3 mmol/L in Chinese patients. Additionally, 2.66 mmol/l at 4 h after a daily meal could be an appropriate cutoff value that can be used to detect non-fasting marked HTG in Chinese subjects.
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Affiliation(s)
- Li-Ling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Li-Yuan Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Ying-Ying Xie
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qun-Yan Xiang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Zhe-Yi Jiang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yang-Rong Tan
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
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Zhang SL, Du X, Xu J, Xiang QY, Liu L. Non-fasting lipid profile for cardiovascular risk assessments using China ASCVD risk estimator and Europe SCORE risk charts in Chinese participants. Cardiovasc Diagn Ther 2021; 11:991-1001. [PMID: 34527522 DOI: 10.21037/cdt-20-1012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/20/2021] [Indexed: 01/12/2023]
Abstract
Background Previous studies have shown that non-fasting lipids have similar values in cardiovascular risk estimation as fasting, but it is not clear whether this could also be applicable to Chinese participants. Methods A total of 127 (76 men, 51 women) participants without atherosclerotic cardiovascular diseases (ASCVD) were enrolled in the study. Serum levels of blood lipids were monitored at 0 h, 2 h and 4 h after a daily breakfast. Ten-year cardiovascular disease (CVD) risk was estimated with China ASCVD risk estimator and European SCORE risk charts. Kappa statistic was used to determine agreement among estimators. Results China ASCVD risk estimator assessed half of the participants as low risk, while European risk charts assessed half of the participants as moderate risk in the same participants. Reliability analysis in China ASCVD risk estimator and Europe SCORE risk charts based on fasting and or non-fasting lipids profile were relatively high (Kappa =0.731 or 0.718, P<0.001), (Kappa =0.922 or 0.935, P<0.001) (Kappa =0.886 or 0.874, P<0.001), but agreement between two were relatively poor in both fasting and non-fasting states (Kappa =0.339 or 0.300, P<0.001), (Kappa =0.364 or 0.286, P<0.001). Conclusions Promoting use of non-fasting lipids in diagnosis, evaluation, and prediction of CVD are feasible. Furthermore, non-fasting lipids could be used in China ASCVD risk estimator to evaluate 10-year risk of ASCVD among Chinese general participants.
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Affiliation(s)
- Shi-Lan Zhang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Human Province; Changsha, China
| | - Xiao Du
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Human Province; Changsha, China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Human Province; Changsha, China
| | - Qun-Yan Xiang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Human Province; Changsha, China
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8
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Zhu LY, Wen XY, Xiang QY, Guo LL, Xu J, Zhao SP, Liu L. Comparison of the Reductions in LDL-C and Non-HDL-C Induced by the Red Yeast Rice Extract Xuezhikang Between Fasting and Non-fasting States in Patients With Coronary Heart Disease. Front Cardiovasc Med 2021; 8:674446. [PMID: 34434972 PMCID: PMC8381279 DOI: 10.3389/fcvm.2021.674446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/14/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Xuezhikang, an extract of red yeast rice, effectively lowers fasting blood lipid levels. However, the influence of Xuezhikang on the non-fasting levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) has not been explored in Chinese patients with coronary heart disease (CHD). Methods: Fifty CHD patients were enrolled and randomly divided into two groups (n = 25 each) to receive 1,200 mg/d of Xuezhikang or a placebo for 6 weeks as routine therapy. Blood lipids were repeatedly measured before and after 6 weeks of treatment at 0, 2, 4, and 6 h after a standard breakfast containing 800 kcal and 50 g of fat. Results: The serum LDL-C levels significantly decreased, from a fasting level of 3.88 mmol/L to non-fasting levels of 2.99, 2.83, and 3.23 mmol/L at 2, 4, and 6 h, respectively, after breakfast (P < 0.05). The serum non-HDL-C level mildly increased from a fasting level of 4.29 mmol/L to non-fasting levels of 4.32, 4.38, and 4.34 mmol/L at 2, 4, and 6 h post-prandially, respectively, and the difference reached statistical significance only at 4 and 6 h after breakfast (P < 0.05). After 6 weeks of Xuezhikang treatment, the patients had significantly lower fasting and non-fasting serum levels of LDL-C and non-HDL-C (P < 0.05) than at pretreatment. The LDL-C levels were reduced by 27.8, 28.1, 26.2, and 25.3% at 0, 2, 4, and 6 h, respectively, and the non-HDL-C levels were reduced by 27.6, 28.7, 29.0, and 28.0% at 0, 2, 4, and 6 h, respectively, after breakfast. No significant difference was found in the percent reductions in the LDL-C and non-HDL-C levels among the four different time-points. Conclusions: Six weeks of Xuezhikang treatment significantly decreased LDL-C and non-HDL-C levels, with similar percent reductions in fasting and non-fasting states in CHD patients, indicating that the percent change in non-fasting LDL-C or non-HDL-C could replace that in the fasting state for evaluation the efficacy of cholesterol control in CHD patients who are unwilling or unable to fast.
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Affiliation(s)
- Li-Yuan Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, The Second Xiangya Hospital, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Xing-Yu Wen
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Qun-Yan Xiang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, The Second Xiangya Hospital, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Li-Ling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, The Second Xiangya Hospital, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, The Second Xiangya Hospital, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Shui-Ping Zhao
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, The Second Xiangya Hospital, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, The Second Xiangya Hospital, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
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9
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Lin Q, Fu Y, Zang X, Liu Q, Liu L. The Role of Fasting LDL-C Levels in Their Non-fasting Reduction in Patients With Coronary Heart Disease. Front Cardiovasc Med 2021; 8:686234. [PMID: 34222380 PMCID: PMC8241924 DOI: 10.3389/fcvm.2021.686234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
The level of low-density lipoprotein cholesterol (LDL-C) decreases to a certain extent after daily meals; however, the influencing factor of this phenomenon has not been fully elucidated. This study included 447 patients with coronary heart disease (CHD). Serum levels of blood lipid parameters at 0, 2, and 4 hours (h) after a daily breakfast were monitored in all subjects. The levels of total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C) and non-HDL-C significantly decreased, while those of triglycerides (TG) and remnant cholesterol (RC) significantly increased from baseline to 4 h in both male and female patients (P < 0.05). Multiple linear regression analysis showed that fasting LDL-C level, the non-fasting change in RC level at 4 h and fasting TG level were significant predictors of the non-fasting change in LDL-C level at 4 h in patients with CHD, and fasting LDL-C level was the most significantly associated with the non-fasting change in LDL-C level. Patients with lower levels of fasting LDL-C had smaller non-fasting changes in LDL-C levels. When the fasting LDL-C level was <1.4 mmol/L, both absolute reduction and percent reduction in LDL-C level at 4 h were almost zero, which means that the non-fasting LDL-C level at 4 h was approximately equivalent to its fasting value (P < 0.05). This result indicated that the non-fasting changes in LDL-C levels were influenced by fasting LDL-C levels in patients with CHD. When the fasting LDL-C level was <1.4 mmol/L, the non-fasting LDL-C level could replace the fasting value to guide treatment.
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Affiliation(s)
- Qiuzhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Yan Fu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - XueYan Zang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qiming Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
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10
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Xu J, Qu P, Du X, Xiang Q, Guo L, Zhu L, Tan Y, Fu Y, Wen T, Liu L. Change in Postprandial Level of Remnant Cholesterol After a Daily Breakfast in Chinese Patients With Hypertension. Front Cardiovasc Med 2021; 8:685385. [PMID: 34212015 PMCID: PMC8239280 DOI: 10.3389/fcvm.2021.685385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/11/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Hypertension (HBP) is usually accompanied by hypertriglyceridemia that represents the increased triglyceride-rich lipoproteins and cholesterol content in remnant lipoproteins [i.e., remnant cholesterol (RC)]. According to the European Atherosclerosis Society (EAS), high RC (HRC) is defined as fasting RC ≥0.8 mmol/L and/or postprandial RC ≥0.9 mmol/L. However, little is known about postprandial change in RC level after a daily meal in Chinese patients with HBP. Methods: One hundred thirty-five subjects, including 90 hypertensive patients (HBP group) and 45 non-HBP controls (CON group), were recruited in this study. Serum levels of blood lipids, including calculated RC, were explored at 0, 2, and 4 h after a daily breakfast. Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff point of postprandial HRC. Results: Fasting TG and RC levels were significantly higher in the HBP group (P < 0.05), both of which increased significantly after a daily meal in the two groups (P < 0.05). Moreover, postprandial RC level was significantly higher in the HBP group (P < 0.05). ROC curve analysis showed that the optimal cutoff point for RC after a daily meal to predict HRC corresponding to fasting RC of 0.8 mmol/L was 0.91 mmol/L, which was very close to that recommended by the EAS, i.e., 0.9 mmol/L. Fasting HRC was found in 31.1% of hypertensive patients but not in the controls. According to the postprandial cutoff point, postprandial HRC was found in approximately half of hypertensive patients and ~1-third of the controls. Conclusion: Postprandial RC level increased significantly after a daily meal, and hypertensive patients had higher percentage of HRC at both fasting and postprandial states. More importantly, the detection of postprandial lipids could be helpful to find HRC.
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Affiliation(s)
- Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Peiliu Qu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Xiao Du
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qunyan Xiang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Liling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Liyuan Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Yangrong Tan
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Yan Fu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Tie Wen
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China.,Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
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11
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Hou X, Guan Y, Tang Y, Song A, Zhao J, Ren L, Chen S, Wei L, Ma H, Song G. A correlation study of the relationships between nonalcoholic fatty liver disease and serum triglyceride concentration after an oral fat tolerance test. Lipids Health Dis 2021; 20:54. [PMID: 34034748 PMCID: PMC8152134 DOI: 10.1186/s12944-021-01483-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/18/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases worldwide. Triglyceride (TG) accumulation is central to NAFLD development. People now spend most of their day in the postprandial state, and the measurement of postprandial blood lipid concentration can make up for the lack of simple detection of fasting blood lipids. Postprandial triglyceride (PTG) is commonly used as a surrogate for postprandial blood lipid concentrations, and many studies have shown that PTG is a risk factor for NAFLD. The aim of the present study was to investigate the relationship between PTG concentration during oral fat tolerance testing (OFTT) and NAFLD. METHODS A total of 472 Chinese adults, aged 25 to 65 years, were enrolled in the study. All the participants underwent OFTT. The serum concentrations of TG and other lipids were measured, and their relationships with NAFLD were analyzed. RESULTS Of the 472 participants, 155 were diagnosed with NAFLD. The fasting and postprandial TG concentrations of the participants with NAFLD were higher than those of healthy participants (P < 0.05). The TG concentrations of the healthy participants peaked 4 h postprandially, whereas those of the participants with NAFLD peaked 6 h postprandially and reached higher peak values. Postprandial TG concentration was significantly associated with a higher risk of NAFLD. CONCLUSIONS High PTG is positively related to a higher risk of NAFLD, and the PTG concentrations of patients with NAFLD are higher than in healthy individuals, with a delayed peak. Therefore, 4-h PTG may represent a potential marker of NAFLD. TRIAL REGISTRATION ChiCTR1800019514 .
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Affiliation(s)
- Xiaoyu Hou
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China.,Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Yunpeng Guan
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China.,Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Yong Tang
- Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - An Song
- Key laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiajun Zhao
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Shuchun Chen
- Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Limin Wei
- Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Guangyao Song
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China. .,Department of Endocrinology, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People's Republic of China.
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12
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Guo LL, Chen YQ, Lin QZ, Tian F, Xiang QY, Zhu LY, Xu J, Wen T, Liu L. Non-HDL-C Is More Stable Than LDL-C in Assessing the Percent Attainment of Non-fasting Lipid for Coronary Heart Disease Patients. Front Cardiovasc Med 2021; 8:649181. [PMID: 33869310 PMCID: PMC8049565 DOI: 10.3389/fcvm.2021.649181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022] Open
Abstract
This study aimed to compare the percentage attainment of fasting and non-fasting LDL-C and non-HDL-C target levels in coronary heart disease (CHD) patients receiving short-term statin therapy. This study enrolled 397 inpatients with CHD. Of these, 197 patients took statins for <1 month (m) or did not take any statin before admission (CHD1 group), while 204 patients took statins for ≥1 m before admission (CHD2 group). Blood lipid levels were measured at 0, 2, and 4 h after a daily breakfast. Non-fasting LDL-C and non-HDL-C levels significantly decreased after a daily meal (P < 0.05). Both fasting and non-fasting LDL-C or non-HDL-C levels were significantly lower in the CHD2 group. The percentage attainment of LDL-C <1.4 mmol/L at 2 and 4 h after a daily breakfast was significantly higher than that during fasting (P < 0.05), but the percent attainment of non-fasting non-HDL-C <2.2 mmol/L was close to its fasting value (P > 0.05). Analysis of c-statistic showed that non-fasting cut-off points for LDL-C and non-HDL-C were 1.19 and 2.11 mmol/L, corresponding to their fasting goal levels of 1.4 and 2.2 mmol/L, respectively. When post-prandial LDL-C and non-HDL-C goal attainments were re-evaluated using non-fasting cut-off points, there were no significant differences in percentage attainment between fasting and non-fasting states. Non-HDL-C is more stable than LDL-C in assessing the percent attainment of non-fasting lipid for coronary heart disease patients. If we want to use LDL-C to assess the percent attainment of post-prandial blood lipids, we may need to determine a lower non-fasting cut-off point.
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Affiliation(s)
- Li-Ling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Yan-Qiao Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qiu-Zhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Feng Tian
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qun-Yan Xiang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Li-Yuan Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Tie Wen
- Department of Emergency, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
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13
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Xiang QY, Tian F, Du X, Xu J, Zhu LY, Guo LL, Wen T, Liu YS, Liu L. Postprandial triglyceride-rich lipoproteins-induced premature senescence of adipose-derived mesenchymal stem cells via the SIRT1/p53/Ac-p53/p21 axis through oxidative mechanism. Aging (Albany NY) 2020; 12:26080-26094. [PMID: 33316776 PMCID: PMC7803527 DOI: 10.18632/aging.202298] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 11/06/2020] [Indexed: 12/26/2022]
Abstract
The accumulation of senescent adipose-derived mesenchymal stem cells (AMSCs) in subcutaneous white adipose tissue (WAT) is the main cause for the deterioration of WAT and the subsequent age-related disorders in obesity. The number of AMSCs staining positively for senescence-associated-β-galactosidase (SA-β-Gal) increased significantly after incubation with postprandial triglyceride-rich lipoproteins (TRL), accompanied by an impaired cell proliferation capacity and increased expression of inflammatory factors. Besides, the expression of anti-aging protein, silent mating-type information regulation 2 homolog 1 (SIRT1), was downregulated significantly, while those of acetylated p53 (Ac-p53), total p53, and p21 proteins were upregulated significantly during postprandial TRL-induced premature senescence of AMSCs. Furthermore, the production of intracellular reactive oxygen species (ROS) in the TRL group increased significantly, while pretreatment with the ROS scavenger N-acetyl-L-cysteine effectively attenuated the premature senescence of AMSCs by decreasing ROS production and upregulating SIRT1 level. Thus, postprandial TRL induced premature senescence of AMSCs through the SIRT1/p53/Ac-p53/p21 axis, partly through increased oxidative stress.
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Affiliation(s)
- Qun-Yan Xiang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha 410011, Hunan, PR China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Cardiovascular Disease Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Department of Geriatrics, Institute of Aging and Geriatrics, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China
| | - Feng Tian
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha 410011, Hunan, PR China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Cardiovascular Disease Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Department of Geriatric Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, PR China
| | - Xiao Du
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha 410011, Hunan, PR China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Cardiovascular Disease Research Center of Hunan Province, Changsha 410011, Hunan, PR China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha 410011, Hunan, PR China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Cardiovascular Disease Research Center of Hunan Province, Changsha 410011, Hunan, PR China
| | - Li-Yuan Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha 410011, Hunan, PR China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Cardiovascular Disease Research Center of Hunan Province, Changsha 410011, Hunan, PR China
| | - Li-Ling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha 410011, Hunan, PR China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Cardiovascular Disease Research Center of Hunan Province, Changsha 410011, Hunan, PR China
| | - Tie Wen
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Emergency Medicine and Difficult Disease Institute, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China
| | - You-Shuo Liu
- Department of Geriatrics, Institute of Aging and Geriatrics, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, PR China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha 410011, Hunan, PR China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha 410011, Hunan, PR China.,Cardiovascular Disease Research Center of Hunan Province, Changsha 410011, Hunan, PR China
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14
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Determination of optimal cut-off points after a high-fat meal corresponding to fasting elevations of triglyceride and remnant cholesterol in Chinese subjects. Lipids Health Dis 2019; 18:206. [PMID: 31767005 PMCID: PMC6876091 DOI: 10.1186/s12944-019-1146-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postprandial high triglyceride (HTG), marking elevated level of remnant cholesterol (RC), is an independent risk factor of coronary heart disease (CHD). The postprandial cut-off points for HTG and high RC (HRC) after a daily meal are recommended as 2.0 mmol/L and 0.9 mmol/L, respectively, by the European Atherosclerosis Society (EAS), while those after a high-fat meal in Chinese subjects were not explored. METHODS Ninety subjects, including 60 CHD patients (CHD group) and 30 non-CHD controls (CON group), were enrolled in this study. Serum levels of blood lipids, including calculated RC, were monitored at 0, 2, 4 and 6 h after a high-fat meal with 800 kcal and 50 g fat. Analysis of c-statistic was used to determine the cut-off points for postprandial HTG and HRC. RESULTS Postprandial levels of triglyceride (TG) and RC significantly increased and peaked at 4 h after a high-fat meal in two groups, although those in CHD group were significantly higher (P < 0.05). The optimal cut-off point to predict HTG at 4 h corresponding to fasting TG ≥ 1.7 mmol/L was 3.12 mmol/L, and that to predict HRC at 4 h corresponding to fasting RC ≥ 0.8 mmol/L was 1.36 mmol/L. According to the new cut-off points, the omissive diagnosis rates of postprandial HTG and HRC decreased obviously. CONCLUSION The cut-off points of postprandial HTG and HRC in Chinese subjects after a high-fat meal were higher than those after a daily meal recommended by the EAS, indicating that specific cut-off points should be determined after a certain high-fat meal.
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15
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Comparison of remnant cholesterol levels estimated by calculated and measured LDL-C levels in Chinese patients with coronary heart disease. Clin Chim Acta 2019; 500:75-80. [PMID: 31655058 DOI: 10.1016/j.cca.2019.09.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/19/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Evidence about whether remnant cholesterol (RC), especially non-fasting RC, is a causal risk factor for coronary heart disease (CHD) in Chinese subjects is rare. Recently, estimated RC level (RCe) was applied in many studies with large population. We aimed to compare fasting and non-fasting RCe calculated by LDL-C level determined by different methods in Chinese subjects, and investigate their contributions to CHD. METHODS Levels of TC, TG and HDL-C were measured directly in 273 CHD patients (CHD group) and 136 controls (CON group) before and at 4 h after a daily breakfast. LDL-C level was measured directly or calculated by Friedewald equation at TG < 4.5 mmol/L. RC level estimated by calculated or measured LDL-C was termed as RCe1 or RCe2. Contributions of different RC levels to CHD were evaluated by multivariable logistic regression analysis. RESULTS Both RCe1 and RCe2 increased significantly at 4 h after breakfast (both p < 0.05). RCe1 was significantly higher than RCe2 in fasting or non-fasting state (p < 0.05). RCe1 was closely related to RCe2, especially in the highest quartile of RCe1 (p < 0.05). Non-fasting RCe1 or RCe2 and fasting RCe2 independently predicted CHD after adjustment for traditional risk factors (all p < 0.05). CONCLUSIONS Although RCe1 was significantly higher than RCe2, non-fasting RCe, no matter RCe1 or RCe2, after a daily breakfast was an independent predictor for CHD risk in Chinese subjects, indicating that the non-fasting state is critical in the development of atherosclerosis.
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Lin QZ, Chen YQ, Guo LL, Xiang QY, Tian F, Wen T, Liu L. Comparison of non-fasting LDL-C levels calculated by Friedewald formula with those directly measured in Chinese patients with coronary heart disease after a daily breakfast. Clin Chim Acta 2019; 495:399-405. [PMID: 31085187 DOI: 10.1016/j.cca.2019.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND LDL-C level can be measured by direct methods (LDL-CM) or calculated by Friedewald formula (LDL-CC). The aim of this study was to investigate the difference between LDL-CM and LDL-CC after a daily breakfast in Chinese patients with coronary heart disease (CHD). METHODS Three hundred and three inpatients, including 203 CHD patients (CHD group) and 100 non-CHD controls (CON group), were enrolled in this study. Serum levels of blood lipid parameters, including LDL-CC and LDL-CM, at 0, 2 and 4 h (h) were monitored after a daily breakfast in all subjects. RESULTS LDL-CM was significantly higher than LDL-CC in fasting state in each group and at 4 h postprandially in CHD group (P < .05). Postprandial LDL-CM and LDL-CC significantly decreased in each group (P < .05). Postprandial decline in LDL-CM was significantly greater than that of LDL-CC (P < .05). For CHD patients taking statins for ≥1 month before admission, non-fasting percent attainment of LDL-CM or LDL-CC was significantly higher than its fasting value, especially at 4 h (P < .05). The percent deviation of LDL-CM from 1.8 mmol/L at 4 h was significantly different from its fasting value. However, there was no significant difference in percent deviation of LDL-CC from 1.8 mmol/L between fasting and non-fasting states. CONCLUSIONS It indicated that the clinical monitoring of non-fasting LDL-C level in CHD patients could be relatively complex, and the judgement may depend not only on the method to acquire LDL-C level, but also on the evaluation method.
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Affiliation(s)
- Qiu-Zhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, Hunan 410011, PR China
| | - Yan-Qiao Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, Hunan 410011, PR China
| | - Li-Ling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, Hunan 410011, PR China
| | - Qun-Yan Xiang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, Hunan 410011, PR China
| | - Feng Tian
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, Hunan 410011, PR China
| | - Tie Wen
- Department of Emergency, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, Hunan 410011, PR China.
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