LDL-C/HDL-C Ratio Predicts Carotid Intima-Media Thickness Progression Better Than HDL-C or LDL-C Alone

Serum endocan, asymmetric dimethylarginine and lipid profile in children with familial Mediterranean fever

BACKGROUND

Familial Mediterranean fever (FMF) is a chronic inflammatory disease, and it is thought that subclinical inflammation persists even when there are no attacks, eventually causing endothelial dysfunction (ED) and atherosclerosis. Limited data are available about serum endocan, asymmetric dimethylarginine (ADMA) and lipid profile in children with FMF, so we aimed to evaluate these markers in children with FMF during the attack-free period.

METHODS

A total of 50 patients diagnosed with FMF and 50 age and sex-matched healthy children were recruited. Serum endocan, ADMA and lipid profiles were measured. Also, atherogenic indices (Castelli's risk indices I and II [CRI I and II], atherogenic index of plasma [AIP] and atherogenic coefficient [AC]) were calculated.

RESULTS

Serum endocan, ADMA levels, low-density lipoprotein cholesterol, triglycerides, CRI II and AIP of the FMF patients were significantly higher than controls (p < 0.001). Unlike serum endocan, serum ADMA showed a positive significant correlation with total cholesterol, non-high density lipoprotein cholesterol, CRI I, AIP and AC (p < 0.001, p < 0.001, p = 0.004, p = 0.028, p = 0.004 respectively).

CONCLUSION

Serum ADMA and lipid profile might be used as potential markers for endothelial dysfunction and increased cardiovascular risk in FMF patients.

IMPACT

Theoretically, serum ADMA may affect lipid profiles and serum endocan represents an intriguing biomarker related to inflammation. Coexistence of dyslipidemia represents an additional risk factor that contributes to the onset of early atherosclerosis. A few studies investigated the role of changes in lipid profile and lipid ratios in accelerated atherosclerosis pathogenesis in FMF patients. The relationship between colchicine and lipid profile is contradictory. Although colchicine can cause dyslipidemia, it also has anti-atherosclerosis effects. Elevated ADMA level and atherogenic indices in FMF children reflect their potential role in the early detection of cardiovascular affection in FMF patients.

Low- and High-Density Lipoprotein Cholesterol and Dementia Risk Over 17 Years of Follow-up Among Members of a Large Health Care Plan

BACKGROUND AND OBJECTIVES

The associations of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) with dementia risk in later life may be complex, and few studies have sufficient data to model nonlinearities or adequately adjust for statin use. We evaluated the observational associations of HDL-C and LDL-C with incident dementia in a large and well-characterized cohort with linked survey and electronic health record (EHR) data.

METHODS

Kaiser Permanente Northern California health plan members aged 55 years and older who completed a health behavior survey between 2002 and 2007, had no history of dementia before the survey, and had laboratory measurements of cholesterol within 2 years after survey completion were followed up through December 2020 for incident dementia (Alzheimer disease-related dementia [ADRD]; Alzheimer disease, vascular dementia, and/or nonspecific dementia) based on ICD-9 or ICD-10 codes in EHRs. We used Cox models for incident dementia with follow-up time beginning 2 years postsurvey (after cholesterol measurement) and censoring at end of membership, death, or end of study period. We evaluated nonlinearities using B-splines, adjusted for demographic, clinical, and survey confounders, and tested for effect modification by baseline age or prior statin use.

RESULTS

A total of 184,367 participants [mean age at survey = 69.5 years, mean HDL-C = 53.7 mg/dL (SD = 15.0), mean LDL-C = 108 mg/dL (SD = 30.6)] were included. Higher and lower HDL-C values were associated with elevated ADRD risk compared with the middle quantile: HDL-C in the lowest quintile was associated with an HR of 1.07 (95% CI 1.03-1.11), and HDL-C in the highest quintile was associated with an HR of 1.15 (95% CI 1.11-1.20). LDL-C was not associated with dementia risk overall, but statin use qualitatively modified the association. Higher LDL-C was associated with a slightly greater risk of ADRD for statin users (53% of the sample, HR per 10 mg/dL increase = 1.01, 95% CI 1.01-1.02) and a lower risk for nonusers (HR per 10 mg/dL increase = 0.98; 95% CI 0.97-0.99). There was evidence for effect modification by age with linear HDL-C (p = 0.003) but not LDL-C (p = 0.59).

DISCUSSION

Both low and high levels of HDL-C were associated with elevated dementia risk. The association between LDL-C and dementia risk was modest.

Osteopontin as an early predictor of atherosclerosis in attack-free Familial Mediterranean fever patients

Familial Mediterranean fever (FMF) is an autoinflammatory disease that is associated with endothelial dysfunction and atherosclerosis. Osteopontin which is a multifunctional protein involved in the modulation of inflammatory processes may contribute to the development of atherosclerosis in FMF patients. Therefore, this cross-sectional study investigated the relationship of osteopontin with carotid intima media thickness (CIMT) and atherogenic indices in patients with FMF. Serum osteopontin levels, CIMT, Castelli risk index I and II, plasma atherogenic index (PAI), non - high-density lipoprotein cholesterol, and atherogenic coefficient (AC) in 64 attack-free FMF patients were compared with levels in 23 healthy control subjects. The serum osteopontin level, CIMT, Castelli risk index I, AC and PAI were significantly higher, and high-density lipoprotein cholesterol was significantly lower in FMF patients (P < .001, P < .001, P = .045, P = .016, P = .045, and P = .024; respectively). There were significant positive correlations between osteopontin and CIMT, PAI, AC, and Castelli risk index I (R = 0.580, R = 0.259, R = 0.233, R = 0.277; respectively) and there was significant negative correlation between osteopontin and high-density lipoprotein cholesterol (r= -0.309). Patients who had homozygote mutations had significantly higher osteopontin, PAI, Castelli risk index I and II level. The current study is the first to demonstrate significantly increased serum osteopontin levels in attack-free FMF patients compared with healthy controls. It was also associated with CIMT and many atherogenic indices. This finding provides a new experimental basis to understand the pathogenesis of inflammation-induced atherosclerosis in FMF patients. Furthermore, patients who had homozygote mutations had worse atherogenic indices than those with heterozygote mutations.

Genetic Determinants of Atherogenic Indexes

Atherogenesis and dyslipidemia increase the risk of cardiovascular disease, which is the leading cause of death in developed countries. While blood lipid levels have been studied as disease predictors, their accuracy in predicting cardiovascular risk is limited due to their high interindividual and interpopulation variability. The lipid ratios, atherogenic index of plasma (AIP = log TG/HDL-C) and the Castelli risk index 2 (CI2 = LDL-C/HDL-C), have been proposed as better predictors of cardiovascular risk, but the genetic variability associated with these ratios has not been investigated. This study aimed to identify genetic associations with these indexes. The study population (n = 426) included males (40%) and females (60%) aged 18-52 years (mean 39 years); the Infinium GSA array was used for genotyping. Regression models were developed using R and PLINK. AIP was associated with variation on APOC3, KCND3, CYBA, CCDC141/TTN, and ARRB1 (p-value < 2.1 × 10^-6). The three former were previously associated with blood lipids, while CI2 was associated with variants on DIPK2B, LIPC, and 10q21.3 rs11251177 (p-value 1.1 × 10^-7). The latter was previously linked to coronary atherosclerosis and hypertension. KCND3 rs6703437 was associated with both indexes. This study is the first to characterize the potential link between genetic variation and atherogenic indexes, AIP, and CI2, highlighting the relationship between genetic variation and dyslipidemia predictors. These results also contribute to consolidating the genetics of blood lipid and lipid indexes.

Therapeutic effects of resveratrol and Omega-3 in mice atherosclerosis: focus on histopathological changes

BACKGROUND

Resveratrol and omega-3 have been shown to prevent atherosclerosis. However, histopathological changes and their comparison have not been studied well. This study investigated the therapeutic effects of resveratrol and omega-3 in experimental atherosclerosis of mice.

METHODS

We divided sixty 6-week-old male C57BL/6 mice into six groups and followed for 10 weeks: (1) standard diet, (2) atherogenic diet, (3) atherogenic diet along with resveratrol from the start of the sixth week, (4) atherogenic diet along with omega-3 from the start of the sixth week, (5) standard diet along with resveratrol from the start of the sixth week, (6) standard diet along with omega-3 from the start of the sixth week.

RESULTS

The mice fed on an atherogenic diet had a larger fat area and a thicker aortic wall thickness than mice fed on a standard diet. The use of omega-3 and resveratrol in the mice with an atherogenic diet resulted in a significantly reduced fat area (p-value = 0.003), and resveratrol had a significantly higher effect. Omega-3 or resveratrol induced a significant reduction in aortic wall thickness in mice on an atherogenic diet, and there was no significant difference between them. Among the mice with a standard diet, this study did not observe any significant changes in the fat area or the aortic wall thickness with the consumption of omega-3 or resveratrol.

CONCLUSIONS

Resveratrol and omega-3 had a regressive and therapeutic role in atherosclerosis, with a more significant effect in favor of resveratrol.

Predictive effect of different blood lipid parameters combined with carotid intima-media thickness on coronary artery disease

Background

Blood lipids disorder and atherosclerosis are closely related to coronary artery disease (CAD). This study aims to compare different blood lipid parameters combined with carotid intima-media thickness (cIMT) in predicting CAD.

Methods

This was a retrospective study including patients who underwent coronary angiography for highly suspected CAD. Blood samples were taken for lipid profile analysis and cIMT was evaluated by carotid ultrasound. Logistic analysis was used to establish different models of different lipid parameters in predicting CAD. The area under the receiver operating characteristic curve (AUC) was used to examine the predictive value. The optimal lipid parameter was also used to explore the relationship with multi-vessel CAD.

Results

Patients were classified into two groups based on whether CAD existed. Compared with non-CAD patients, the CAD group had higher lipoprotein (a) [Lp (a)], apolipoprotein B/apolipoprotein A, total cholesterol/high-density lipoprotein cholesterol (HDL-C), triglyceride/HDL-C and LDL-C/HDL-C. According to the AUCs, Lp (a) combined with cIMT (AUC: 0.713, P < 0.001) had the best performance in predicting CAD compared to other lipid parameters. High level of Lp (a) was also associated with multi-vessel CAD (odds ratio: 1.41, 95% confidence interval: 1.02-1.95, P = 0.036).

Conclusion

For patients with highly suspected CAD, Lp (a) better improved the predictive value of CAD rather than most of blood lipid indices, especially in the absence of high levels of LDL-C. Lp (a) also can be used to predict the multi-vessel CAD.

Impact of Traditional and Non-Traditional Lipid Parameters on Outcomes after Intravenous Thrombolysis in Acute Ischemic Stroke

Contradicting evidence exists regarding the role of lipids in outcomes following intravenous (IV) thrombolysis with tissue plasminogen activator (tPA). Restricted cubic spline curves and adjusted logistic regression were used to evaluate associations of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and LDL-C/HDL-C ratio with poor functional outcome, symptomatic intracranial hemorrhage (SICH) and 90-day mortality, among 1004 acute ischemic stroke (AIS) patients who received IV tPA in a comprehensive stroke center. Quartile (Q) 1, Q2 and Q3 of HDL-C were associated with increased odds of poor functional outcome (adjusted odds ratio (adjOR) 1.66, 95% CI 1.06-2.60, p = 0.028, adjOR 1.63, 95% CI 1.05-2.53, p = 0.027, adjOR 1.56, 95% CI 1.01-2.44, p = 0.048) compared to Q4. Q2 and Q4 of non-HDL-C were associated with increased odds of SICH (adjOR 4.28, 95% CI 1.36-18.90, p = 0.025, adjOR 5.17, 95% CI 1.64-22.81, p = 0.011) compared to Q3. Q1 and Q2 of LDL-C was associated with increased odds of mortality (adjOR 2.57, 95% CI 1.27-5.57, p = 0.011 and adjOR 2.28, 95% CI 1.10-5.02, p = 0.032) compared to Q3. In AIS patients who received IV tPA, low LDL-C was associated with increased odds of mortality while HDL-C may be protective against poor functional outcome.

Relationship of the Low-Density Lipoprotein Cholesterol/High-Density Lipoprotein Cholesterol Ratio with a Vulnerable Plaque in Patients with Severe Carotid Artery Stenosis: A Case-Control Study in the Han Chinese Population

BACKGROUND

Carotid plaque is often an important factor in ischemic stroke after it changes from stable to vulnerable, and low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) are associated with plaque vulnerability. We aimed to investigate whether the LDL-c/HDL-c ratio, an easily available and novel biomarker, is associated with vulnerable plaques and enhances the warning effect on vulnerability compared to LDL-c or HDL-c alone.

METHODS

We conducted a retrospective study of 187 patients with severe CAS admitted to the Department of Vascular Surgery at the Nanjing Drum Tower Hospital from January 2019 to July 2021. They were divided into a stable plaque group and a vulnerable plaque group according to carotid ultrasonography, carotid angiography (CTA), and plaque pathology. Baseline information was collected and compared between the two groups. Correlation analysis was used to determine the degree of correlation between clinical variables. Univariate and multifactor logistic regression analyses were used to examine independent risk factors for vulnerable plaque in patients with severe CAS. Receiver operating characteristic (ROC) curves were used to assess the capacity of LDL-c/HDL-c to predict the occurrence of vulnerable plaque.

RESULTS

The age of the vulnerable plaque group was 68.12 ± 8.90 years, with 85 males (89.91%); the age of the stable plaque group was 68.77 ± 8.43 years, with 70 males (89.74%). Multivariate logistic regression analysis showed that LDL-c/HDL-c, smoking and diabetes were independent risk factors for vulnerable plaque (all P <0.05). The risk of vulnerable plaque was 4.78-fold greater in the highest LDL-c/HDL-c quartile (≥ 2.63) than in the lowest quartile (≤ 1.31) (P-trend <0.001), and the area under the ROC curve for LDL-c/HDL-c (AUC=0.681, P <0.001) was higher than that for LDL-c and HDL-c.

CONCLUSION

LDL-c/HDL-c, smoking and diabetes were independent risk factors for vulnerable plaque in patients with severe CAS, and LDL-c/HDL-c had a higher predictive value for the presence of vulnerable plaque compared with other lipid parameters.

A Comparative Study of the Triglycerides/HDL Ratio and Pseudocholinesterase Levels in Patients with Bladder Cancer

BACKGROUND

Lipid alterations may serve as potential tumour biomarkers. The ratio of triglycerides to HDL cholesterol (TG/HDL ratio) is associated with various cancers. Pseudocholinesterase (PChE) activity, involved in TG hydrolysis, plays an important role in the metabolism of lipoprotein. There is scarce data assessing the reliability of both the TG/HDL ratio and PChE levels in correctly classifying patients suffering from bladder cancer.

METHODS

Three hundred and ninety-six patients undergoing cystoscopy or transurethral resection of the bladder (TURB), broken into two major groups, i.e., patients with histologically confirmed, non-metastatic bladder cancer (n = 208) and without bladder cancer (no bladder cancer, n = 188), formed the study population. The last group was split into two subgroups consisting of a cohort of patients never suffering from bladder cancer but with other bladder diseases (no CaBD, n = 100) and another cohort formed by patients characterised by eradicated bladder cancer after TURB with no recurrence during a three-month follow-up (previous bladder cancer, n = 88). Pieces of information by both metabolic derangement (the presence of type 2 diabetes mellitus), hypertension and lipid profile were retrieved from patient records upon entry to the study. Sensitivity, specificity, areas under the ROC (AUROC) of the TG/HDL ratio, and PChE levels were used in diagnostic decision making.

RESULTS

The TG/HDL ratio as well as PChE concentrations of bladder cancer patients were significantly different when compared to those with previous bladder cancer and the no CaBD patients (p = 0.023 and 0.0004, respectively). There was an independent role of both the TG/HDL ratio and PChE levels in predicting the presence of bladder cancer (OR: 1.22 and 0.99, respectively), but the reliability of the TG/HDL ratio (AUROC: 0.587) was superior to that of PChE levels (AUROC: 0.374). The AUROC of a new parameter resulting from the combination of the TG/HDL ratio with PChE levels showed a further increment in the discriminant power of the bladder cancer presence (0.6298), interestingly with a negative predictive value (89%) according to the Bayesian approach. The cut-off of the TG/HDL ratio, the main marker of the present study that better distinguishes bladder cancer from no bladder cancer patients, was 2.147.

DISCUSSION AND CONCLUSIONS

The reliability of the TG/HDL ratio is based on the fact that this parameter likely mirrors the insulin resistance (IR) underlying bladder cancer patients. Furthermore, PChE levels evidence both IR and the associated non-alcoholic fatty liver disease. The TG/HDL ratio and PChE levels as well as their combined use could help physicians to assess/confirm the presence of this very common cancer, where early detection is important to ensure the best therapeutical approach.

Low-/high-density lipoprotein cholesterol ratio and carotid plaques in patients with coronary heart disease: a Chinese cohort study

Background

Evidence on the relationship between the low−/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and carotid plaques remains limited. This study aimed to examine the association between LDL-C/HDL-C and carotid plaques in participants with coronary heart disease (CHD) and to further explore the extent to which a healthy lifestyle reduces the risk of LDL-C/HDL-C-related carotid plaques.

Methods

This large-scale and multi-centre retrospective study included 9426 CHD patients (aged 35–75 years) between January 1, 2014 and September 30, 2020. The LDL-C/HDL-C values were converted to the following tertiles: lowest (< 2.15), middle (2.15–3), and highest (> 3). Healthy lifestyle-related factors referred to whether or not the participant was a non-smoker and non-drinker. Participants were divided into an unfavourable group (those who did not adhere to healthy lifestyle factors), intermediate (only one unhealthy factor), and favourable (neither of the two unhealthy factors). Logistic regression was used for statistical analyses.

Results

Of the 9426 participants, 6989 (74.15%) CHD patients had carotid plaques. After adjustment for confounders, each unit increase in the LDL-C/HDL-C was significantly associated with carotid plaques (OR: 1.61; 95%CI: 1.43–1.84; P <  0.001). Multivariate logistic regression revealed that carotid plaques risk for the highest tertile (> 3) was 1.18 times that of the lowest quartile (< 2.15). Compared with an unfavourable lifestyle, an intermediate or a favourable lifestyle was associated with a significant 30% (OR: 0.70; 95%CI: 0.64–0.78; P <  0.001) or 67% (OR: 0.33; 95%CI: 0.29–0.37; P <  0.001) reduction in carotid plaques risk, respectively, among CHD patients with high LDL-C/HDL-C. There were significantly additive and multiplicative interactions between lifestyle and LDL-C/HDL-C with regards to carotid plaques.

Conclusion

A high LDL-C/HDL-C is associated with a risk of carotid plaques developing in CHD patients. Adhering to a healthy lifestyle has additive beneficial effects on reducing the risk of carotid plaques, especially in relation to the highest LDL-C/HDL-C.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-021-01575-w.

Helianthus Annuus L. Alleviates High-Fat Diet Induced Atherosclerosis by Regulating Intestinal Microbiota, Inhibiting Inflammation and Restraining Oxidative Stress

Helianthus Annuus L. (HAL) is composed of flavonoids and polysaccharides. Flavonoids have demonstrated beneficial effects on atherosclerosis (AS). The objective of this study was to investigate the anti-atherosclerosis effect and the related mechanism of HAL. In this study, the AS model induced by high-fat diet (HFD) mice that lacked apolipoprotein E (Apoe[Formula: see text] received feed containing 5% HAL for 24 weeks. After administration, the analysis of plaque on aorta was conducted, and the possible mechanisms were further explored. With HAL treatment, the size of atherosclerotic lesions in HFD-induced AS model mice was reduced. HAL ameliorated dyslipidemia and decreased the combined ratio. HAL up-regulated concentrations of superoxide dismutase (SOD), nitric oxide (NO) and glutathione peroxidase (GSH-Px) and down-regulated concentrations of malondialdehyde (MDA) in the aorta. In addition, 16S rRNA analysis showed that HAL also reduced diversity of the intestinal microbiota, decreased the Firmicutes-to-Bacteroidetes ratio, and increased the relative abundance of probiotics such as Akkermansia muciniphila and Lactobacillus. In the end, HAL decreased the permeability of intestine by increasing the levels of occludin and tight junction protein 1 (ZO-1) in the colon, consequently decreasing concentration of interleukin (IL)-6, IL-1[Formula: see text] and tumor necrosis factor-alpha (TNF-[Formula: see text] in serum and mRNA expressions in the aorta. Data showed that HAL alleviates AS by restraining oxidative stress, regulating intestinal microbiota, decreasing intestinal permeability and inhibiting inflammation. Our findings provided novel insights into the role and mechanism of anti-atherogenic potential of HAL.

The prognostic significance of the lipid profile after an ischemic stroke

BACKGROUND

The role that cholesterol levels play in stroke is still uncertain, especially in secondary prevention. The aim was to determine how a comprehensive analysis of the lipid profile can be associated with post-stroke outcomes.

Consecutive patients diagnosed with ischemic stroke were included in our cohort and followed up for 24months. Baseline clinical and demographic data were collected as well as a complete lipid profile 6-months after the index stroke. Lipid variables were analyzed quantitatively and qualitatively. Clinical outcomes included stroke recurrence, major cardiovascular events, and functional performance (assessed with the modified Rankin scale).

RESULTS

The study included 588 patients with an average age of 58.3 years. There were 148 (25.2%) patients with high total cholesterol, 260 (44.2%) with low HDL, 180 (30.6%) with high LDL, and 204 (34.7%) with high triglycerides. There were 164 (27.9%) patients with no abnormalities in the lipid profile. After the follow-up, 108 (18.3%) had another stroke, 32 (5.4%) had major cardiovascular events, and 360 (61.2%) presented good functional outcomes. A higher LDL-C/HDL-C ratio and a low HDL-C level were significantly associated with worse cardiovascular outcomes. The detection of LDL-C > 70 mg/dL was an independent predictor of a higher risk of stroke recurrence and worse functional performance. The greater the number of altered lipid variables, the greater the chance of developing an unfavorable composite outcome and presenting cardiovascular events after the stroke.

CONCLUSIONS

The complete analysis of the lipid panel allows the determination of the prognosis of patients who suffered a stroke.

Association between extremely high high-density lipoprotein-cholesterol and hypertensive retinopathy: results of a cross-sectional study from Kanagawa Investigation of Total Checkup Data from the National Database-6 (KITCHEN-6)

OBJECTIVES

Doubt has been cast on the atheroprotective effect of very high high-density lipoprotein cholesterol (HDL-C). Hypertensive retinopathy (HR) is caused by persistent systemic hypertension. Therefore, we aimed to investigate the association between extremely high HDL-C (EH-HDL) and HR.

DESIGN

A cross-sectional study.

PARTICIPANTS

A total of 4072 general Japanese population aged 40-74 years who underwent regular medical check-ups including fundus examinations.

OUTCOME MEASURES

HR and clinical parameters including serum HDL-C were investigated. HR was determined by the Keith-Wagener classification and the Scheie classifications for Hypertension and Atherosclerosis (n=4054 available). Serum HDL-C was divided into five categories: 30-49, 50-69, 70-89, 90-109 and ≥110 mg/dL.

RESULTS

Overall, 828 (20.3%) subjects had Keith-Wagener-HR, 578 (14.3%) had hypertension-HR, and 628 (15.5%) had atherosclerosis-HR. Blood pressure decreased as HDL-C level increased, whereas the prevalences of HRs showed U-shaped curves against HDL-C with minimum values for HDL-C 90-109 mg/dL. In logistic regression analyses, EH-HDL ≥110 mg/dL was significantly associated with Keith-Wagener-HR and atherosclerosis-HR, compared with HDL-C 90-109 mg/dL after adjustments for age, sex and systolic blood pressure (OR 3.01, 95% CI 1.45 to 6.27 and OR 2.23, 95% CI 1.03 to 4.86). The hypertension-HR was not significantly associated with EH-HDL regardless of adjustment for the confounding factors (p=0.05-0.08). Although serum HDL-C as a continuous variable was inversely associated with three HRs, which disappeared after adjustment for the confounding factors.

CONCLUSION

EH-HDL may be associated with HR independently of blood pressure, suggesting that EH-HDL reflects a special atherosclerotic condition.

Association of LDLc to HDLc ratio with carotid plaques in a community-based population with a high stroke risk: A cross-sectional study in China

BACKGROUND AND AIMS

The association between low-density lipoprotein cholesterol (LDLc) to high-density lipoprotein cholesterol (HDLc) ratio (LDLc/HDLc) and carotid plaques remains controversial. We conducted a cross-sectional study to evaluate whether LDLc/HDLc is associated with carotid plaques in individuals with a high-stroke-risk.

METHODS AND RESULTS

The study initially enrolled 5529 residents aged 40 years or older from Yangzhou, China in 2013-2014. All participants received a questionnaire interview, physical examination, and laboratory tests. Risk factors for stroke included hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, smoking, less exercise, overweight/obesity, and family stroke history. Subjects with at least three of the risk factors or a history of stroke/transient ischemic attack (TIA) were defined as a high-stroke-risk population. Carotid ultrasonography was only conducted for this high-stroke-risk population. Logistic regression was used to examine the association of LDLc/HDLc with the presence of carotid plaques. Final analysis included 839 high-stroke-risk subjects and 40.6% were identified to have carotid plaques. Subjects with the highest tertiles group of LDLc/HDLc had a higher proportion of carotid plaques than the other two groups (47.1% vs. 34.6% and 40.4%, P < 0.001). With each unit increase of LDLc/HDLc, the chance of having carotid plaques increased by 65% (OR 1.65, 95%CI 1.31-2.08) after adjusted for potential confounders. Among most subgroups, a higher LDLc/HDLc was significantly correlated with the presence of carotid plaques.

CONCLUSION

Higher LDLc/HDLc was significantly associated with the presence of carotid plaques in the Chinese population with a high risk of stroke.

A U-shaped association between the LDL-cholesterol to HDL-cholesterol ratio and all-cause mortality in elderly hypertensive patients: a prospective cohort study

Background

The low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking the LDL-C/HDL-C ratio to mortality have yielded inconsistent results and been limited by short follow-up periods. Therefore, the aim of the present study was to determine whether the LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients.

Methods

A total of 6941 hypertensive patients aged 65 years or older who were not treated with lipid-lowering drugs were selected from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between the LDL-C/HDL-C ratio and all-cause mortality was determined using multivariate Cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve analysis.

Results

During a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between the LDL-C/HDL-C ratio and all-cause mortality. Patients were divided according to the quintiles of the LDL-C/HDL-C ratio. Compared to the reference group (Q3: 1.67–2.10), patients with both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios had higher all-cause mortality (< 1.67: HR 1.81, 95% CI: 1.08–3.03; ≥2.10: HR 2.00, 95% CI: 1.18–3.39). Compared with the lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratios of 1.67–2.10 had a significantly higher survival probability (log-rank P = 0.038).

Conclusions

The results suggest that there is a U-shaped association between the LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-020-01413-5.

LDL-C/HDL-C ratio associated with carotid intima-media thickness and carotid plaques in male but not female patients with type 2 diabetes

BACKGROUND

We investigated the associations between low-density lipoprotein cholesterol (LDL-C) to high-density cholesterol (HDL-C) ratio (LDL-C/HDL-C) with structural and functional early atherosclerosis vascular changes in patients with type 2 diabetes mellitus (T2DM).

METHODS

This hospital-based cross-sectional study included 814 patients with T2DM. Structural atherosclerotic parameters included carotid intima-media thickness (CIMT) and carotid plaque, the cardio-ankle vascular index (CAVI) was considered as the functional parameter. Multiple linear regression and logistic regression models were preformed to identify the associations between LDL-C/HDL-C with atherosclerotic parameters.

RESULTS

Increased LDL-C/HDL-C corresponded with the increase levels in CIMT and percentage of carotid plaque. LDL-C/HDL-C was found to be positively associated with CIMT both in female and male patients in unadjusted model. This association persisted in male patients but not in female patients after adjusted for other related factors. No association was found between LDL-C/HDL-C with CAVI both in female and male patients. LDL-C/HDL-C was positively associated with the presence of carotid plaque in male patients. However, this association was not found in female patients.

CONCLUSION

LDL-C/HDL-C was positively associated with CIMT and presence of carotid plaque though not with CAVI in male T2DM patients. However, these associations were not observed in female patients.

The Atherogenic Index of Plasma is Independently Associated with Symptomatic Carotid Artery Stenosis

INTRODUCTION

Small, dense low-density lipoprotein (sdLDL) is strongly associated with symptomatic carotid artery stenosis, but is not routinely evaluated in ischemic stroke patients. A method using the logarithmic transformation of the ratio of the plasma concentration of triglycerides (TGY) to HDL-cholesterol (HDL-C)[(Log[TGY/HDL-C])] has been described as a surrogate marker for sdLDL termed the atherogenic index of plasma (AIP).

OBJECTIVE

To determine if the AIP is independently associated with symptomatic carotid artery stenosis.

METHODS

We conducted a single center case-controlled study using a sample of ischemic stroke patients and compared risk factors of patients with and without symptomatic carotid artery stenosis. A multivariate logistic regression model was used to determine if the AIP divided into four quartiles was independently associated with symptomatic carotid artery stenosis. This model was compared to three other lipid models. Associations between non-lipid variables and the AIP were also identified.

RESULTS

31 cases of ischemic stroke due to symptomatic carotid artery stenosis and 236 controls of ischemic stroke not due to carotid artery stenosis were identified. Of the four lipid models assessed, only the model including the AIP (model 4) was found to be significantly associated with symptomatic carotid artery stenosis. The odd's ratio (OR) for quartile 3 was 3.82 (95% CI 1.03-14.17) and the OR for quartile 4 was 4.13 (95% CI 1.09-15.54) using quartile 1 as a reference. Metabolic syndrome was the only variable associated with the AIP (OR 5.06 95% CI 2.6-9.7).

CONCLUSION

At our single center, the AIP was the only lipid parameter independently associated with symptomatic carotid artery stenosis; and metabolic syndrome was independently associated with the AIP. The AIP may serve as a useful surrogate of sdLDL in patients with symptomatic carotid artery stenosis.

Early prediction of the 3-month outcome for individual acute ischemic stroke patients who received intravenous thrombolysis using the N2H3 nomogram model

Background:

The aim of this study was to establish a nomogram model for individualized early prediction of the 3-month prognosis in patients with acute ischemic stroke (AIS) who were treated with intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis.

Methods:

A total of 691 patients were included in this study; 564 patients were included in the training cohort, while 127 patients were included in the test cohort. The main outcome measure was a 3-month unfavorable outcome (modified Rankin Scale 3–6). To construct the nomogram model, stepwise logistic regression analysis was applied to select the significant predictors of the outcome. The discriminative performance of the model was assessed by calculating the area under the receiver operating characteristic curve (AUC-ROC). A decision curve analysis was used to evaluate prognostic value of the model.

Results:

The initial National Institutes of Health Stroke Scale [NIHSS, odds ratio (OR), 1.35; 95% confidence interval (CI), 1.28–1.44; p < 0.001], delta NIHSS (changes in the NIHSS score from baseline to 24 h, OR, 0.75; 95% CI, 0.70–0.79; p < 0.001), hypertension (OR, 2.07; 95% CI, 1.32–3.31; p = 0.002), hyperhomocysteinemia (Hhcy, OR, 2.18; 95% CI, 1.20–4.11; p = 0.013), and the ratio of high-density lipoprotein cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) (HDL-C/LDL-C, OR, 3.29; 95% CI, 1.00–10.89; p = 0.049) (N2H3) were found to be independent predictors of a 3-month unfavorable outcome from multivariate logistic regression analysis and were incorporated in the N2H3 nomogram model. The AUC-ROC of the training cohort was 0.872 (95% CI, 0.841–0.902), and the AUC-ROC of the test cohort was 0.900 (95% CI, 0.848–0.953).

Conclusion:

The study presented the N2H3 nomogram model, with initial NIHSS score, delta NIHSS, hypertension, Hhcy, and HDL-C/LDL-C as predictors. It therefore provides an individualized early prediction of the 3-month unfavorable outcome in AIS patients treated with intravenous rt-PA thrombolysis.

Low-density lipoprotein cholesterol : high-density lipoprotein cholesterol ratio is associated with incident diabetes in Chinese adults: A retrospective cohort study

Aims/Introduction

Dyslipidemia plays a critical role in the pathogenesis of metabolic syndrome and diabetes. Evidence has increasingly shown that the ratio of low‐ to high‐density lipoprotein cholesterol (LDL‐C/HDL‐C) is a novel marker for increased risk of insulin resistance and cardiovascular diseases. However, the correlation between the LDL‐C/HDL‐C ratio and diabetes risk is rarely reported. This is the first study to investigate the association between the LDL‐C/HDL‐C ratio and new‐onset diabetes in a large community‐based cohort.

Materials and Methods

In this retrospective cohort study, a total of 116,661 adults without baseline diabetes were enrolled. Participants were stratified into four groups based on LDL‐C/HDL‐C ratio quartiles. The outcome of interest was new‐onset diabetes.

Results

During a median follow‐up period of 2.98 years, 2,681 (2.3%) new diabetes cases were recorded. The total cumulative incidence of diabetes progressively increased alongside LDL‐C/HDL‐C ratio quartiles (0.31, 0.43, 0.68 and 0.88%, respectively, P‐value for trend <0.001). After adjusting for potential confounders, using the lowest quartile of the LDL‐C/HDL‐C ratio as the reference, the risk of diabetes increased with LDL‐C/HDL‐C ratio quartiles (P‐value for trend <0.001); in particular, from the second to fourth quartile, hazard ratios were 1.18 (95% confidence interval 0.87–1.59), 1.42 (95% confidence interval 1.07–1.90) and 1.92 (95% confidence interval 1.43–2.59), respectively. The results were also robust to challenges in multiple sensitivity analyses.

Conclusions

Among the Chinese population, elevated LDL‐C/HDL‐C ratio might be an independent risk factor for new‐onset diabetes.

Importance of lipid ratios for predicting intracranial atherosclerotic stenosis

BACKGROUND

This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population.

METHODS

This cross-sectional study included 658 consecutive patients with ischemic stroke. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated.

RESULTS

The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I ratios (all P < 0.05) were significantly associated with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Receiver operating characteristic (ROC) curves analysis revealed that the apo B/apo A-I ratio had the largest area under the ROC curve (AUC) among lipid levels alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for lipid levels alone for the identification of ICAS.

CONCLUSION

The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C, and apo B/apo A-I ratios were significantly related to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be a better discriminator for identifying ICAS risk in stroke patients.

Green coffee extract modifies body weight, serum lipids and TNF-α in high-fat diet-induced obese rats

OBJECTIVE

Currently, there are many efforts to find functional nutrients for obesity management, and the green coffee extract is a potential candidate. This study aimed to examine the effect of low dose administration of  green coffee extract on body weight, serum lipids, and TNF-α level in high-fat diet-induced obese rats.

RESULTS

Administration of green coffee extract to high-fat diet-induced obese male Wistar rats (Rattus norvegicus) reduced body weight, total serum cholesterol, and triglyceride at the dose of 10, 20, and 40 mg/kg BW/day; lowered serum LDL-cholesterol at the treatment dose of 20 mg/kg BW/day (p < 0.05). The effective dose to decrease serum TNF-α level was 40 mg/kg BW/day, while the effective dose to improve the lipid profile was 10 mg/kg BW/day. These results support the potential use of green coffee extract as a functional nutrient in the management of obesity.

Effect of Prepubertal Exposure to CdCl2 on the Liver, Hematological, and Biochemical Parameters in Female Rats; an Experimental Study

The examination chemical factors including industrial toxins and heavy metals seem to be crucial during the prepubertal period. In order to investigate the effects of prepubertal exposure to toxic doses of Cd on liver, hematological, and biochemical parameters in the serum, 16 female rats weaned on postnatal day (PND) 21 were randomly divided into four groups with four rats in each (n = 4). The treatments were as follows: control (0.5 mL distilled water), 25, 50, and 75 mg/kg/day received cadmium chloride (CdCl2). The CdCl2 were administered orally from PND 21 days until observed first vaginal opening (VO). The result showed that the treatment of 75 mg/kg CdCl2 dramatically increased the serum level of LDL (P < 0.0001) and LDL/HDL ratio (P = 0.0004). Conversely, treatment of 75 mg/kg CdCl2 considerably decreased the serum level of HDL in comparison with control group (P = 0.0002). Nevertheless, the rats that received different doses of CdCl2 showed no significant differences in Glu, TG, and TC compared to control group. Number of RBC and Hb of rats treated with 75 mg/kg CdCl2 were significantly less than the other groups (P < 0.0001), whereas a number of WBCs in rats treated with 75 mg/kg CdCl2 (5.27 ± 0.13 10³/μL) showed significant difference (P < 0.0001) compared to control group (4.23 ± 0.09 10³/μL). Histopathological exams showed nodular accumulation of lymphocytes in the liver (lymphocytic hepatitis) of rats, treated with 75 mg/kg CdCl2. These results showed that CdCl2 could cause change in serum lipidome and hematological parameters. What is more, exposure to Cd triggers liver injury and cardiovascular disease during the prepubertal period.

The predictive study of the relation between elevated low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and mortality in peritoneal dialysis

Background

The low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio constitutes a strong risk predictor of cardiovascular events. However, the association between this ratio and cardiovascular death in peritoneal dialysis (PD) patients is uncertain. The study aimed to investigate whether a high LDL-C/HDL-C ratio could predict both cardiovascular and all-cause mortalities in patients on PD.

Methods

A total of 1616 incident patients on PD included from January 1, 2006 to December 31, 2013 were followed up with until 31 December 2018 in this single-center prospective cohort study. Participants were divided into three categories according to LDL-C/HDL-C ratio tertile. The primary endpoint was cardiovascular mortality; the secondary endpoint was all-cause mortality.

Results

The mean age of the study cohort was 47.5 years and the mean body mass index (BMI) was 21.6 kg/m². During a median follow-up period of 47.6 months, 492 patients died, including 246 (50.0%) due to cardiovascular disease (CVD). A multivariate analysis revealed that the highest LDL-C/HDL-C ratio tertile was significantly associated with increased CVD mortality [hazard ratio (HR): 1.69, 95% CI: 1.24–2.29; P = 0.001] and all-cause mortality (HR: 1.46, 95% CI: 1.18–1.81; P = 0.001) relative to the lowest tertile. After adjusting for covariates, the HRs of cardiovascular and all-cause mortalities were 1.84 (95% CI: 1.25–2.71; P = 0.002) and 1.35 (95% CI: 1.03–1.77; P = 0.032). Subgroup analysis showed that the risk of CVD death rose with a higher LDL-C/HDL-C ratio among PD patients who were female, younger than 65 years old, without being malnourished (BMI ≥ 18.5 kg/m² or albumin ≥35 g/L), and with a history of diabetes or CVD, respectively.

Conclusions

A high LDL-C/HDL-C ratio is an independent risk factor for both cardiovascular and all-cause mortalities among PD patients.

Anti-Atherosclerosis Effect of Angong Niuhuang Pill via Regulating Th17/Treg Immune Balance and Inhibiting Chronic Inflammatory on ApoE-/- Mice Model of Early and Mid-Term Atherosclerosis

Angong Niuhuang Pill (ANP) is a well-known patented Chinese medicine which is used for hundreds of years for treating the central nervous system diseases. Atherosclerosis is a poly-aetiological chronic inflammatory vascular disease. Preventing inflammation is fundamental for treating atherosclerosis in early stages. In this study, we investigated the protective effects and possible mechanisms of ANP action on a high-fat diet induced early and mid-term atherosclerosis ApoE^-/- mice. The effects of ANP were compared with accepted drug simvastatin. Twelve male C57BL/6J mice were used as the control group, and 60 male ApoE^-/- mice were randomly divided into five groups: Model group, Simvastatin group, Low-, Medium-, and High-dose ANP group these groups received, respectively, saline, simvastatin (3.0mg/kg), low-dose ANP (0.25 g/kg), medium-dose ANP (0.50 g/kg), and high-dose ANP (1.0 g/kg), once every other day for 10 weeks. After administration, serum biochemical indices were detected by the automatic biochemical analyzer, the concentrations of IL-6 and IL-10 in the serum were assayed by ELISA, expression levels of IL-1β, TNF-α, MMP-2, MMP-9, CCL2, and its receptor CCR2 in the full-length aorta, and expression levels of transcription factors Foxp3, RORγt in the spleen were assayed via western blotting and RT-qPCR. Flow cytometry was used to analyze Th17 cells and Treg cells. Pathological and histological analysis was completed on aortic root. ANP decreased LDL/HDL ratio, concentrations of IL-6 while increased IL-10 in serum. Moreover, ANP down-regulated the expression levels of IL-1β, TNF-α, MMP-2, MMP-9, CCL2, and CCR2 receptor in the full-length aorta. In addition, ANP decreased Th17 cells and expression levels of transcription factor RORγt, increased Treg cells and expression levels of transcription factor Foxp3. ANP decreased content of collagen fibers and infiltration of inflammatory cells in the aortic root. In conclusion, we demonstrated that ANP has anti-atherosclerosis effects on a high-fat diet induced ApoE^-/- mice early and mid-term AS model via regulating Th17/Treg balance, inhibiting chronic inflammation, reducing plaque collagen fibers, and reducing inflammatory cells infiltration, to exert its multi-channel multi-target anti-early and mid-term AS effects.

Comparison of anthropometric indices as predictors of the risk factors for cardiovascular disease in Iran: The PERSIAN Guilan Cohort Study

OBJECTIVE

This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults.

METHODS

A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), conicity index, hip circumference (HC), waist to hip to height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out of range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model.

RESULTS

The mean of all anthropometric indices was higher in women than in men (p<0.01). After adjusting for confounders, the risk of diabetes mellitus, hypertension, and hypertriglyceridemia increased with an increase in all anthropometric indices. The highest risk of diabetes mellitus and hypertriglyceridemia was found in higher WHHR. The highest risk of low high density lipoprotein cholesterol (HDL C) and high low density lipoprotein cholesterol (LDL C) was found in an increase in the WHR and ABSI, respectively.

CONCLUSION

Our findings emphasize higher levels of general and central obesity in adults in the north of Iran. The WHHR and WHtR seem to be more valuable indices than BMI and WC for predicting distinct risk factors for CVD. However, the WHR was the strongest index for the prediction of high LDL C/HDL C ratio.

Modeling the natural history of fatty liver using lifestyle-related risk factors: Effects of body mass index (BMI) on the life-course of fatty liver

Background

Incident fatty liver increases the risk of non–alcoholic fatty liver disease (NAFLD), which may lead to end-stage liver diseases, and increase the risk of cardiovascular disease and diabetes. For its prevention, modeling the natural history of fatty liver is useful to demonstrate which lifestyle-related risk factors (e.g. body mass index and cholesterol) play the greatest role in the life-course of fatty liver.

Methods

Model predictors and their predictive algorithms were determined by prospective regression analyses using 5–year data from approximately 2000 Japanese men aged 20–69 years. The participants underwent health examinations and completed questionnaires on their lifestyle behaviors annually from 2012 to 2016. The life–course of fatty liver was simulated based on this participant data using Monte Carlo simulation methods. Sensitivity analyses were performed. The validity of the model was discussed.

Results

The body mass index (BMI) and low–density/high–density lipoprotein cholesterol (LDL–C/HDL–C) ratio significantly aided in predicting incident fatty liver. When the natural history of fatty liver was simulated using the data of participants aged 30–39 years, the prevalence increased from 20% to 32% at 40–59 years before decreasing to 24% at 70–79 years. When annual updates of BMI and LDL–C/HDL–C ratio decreased/increased by 1%, the peak prevalence of fatty liver (32%) changed by −8.0/10.7% and −1.6/1.4%, respectively.

Conclusions

We modeled the natural history of fatty liver for adult Japanese men. The model includes BMI and LDL‒C/HDL‒C ratio, which played a significant role in predicting the presence of fatty liver. Specifically, annual changes in BMI of individuals more strongly affected the life‒course of fatty liver than those in the LDL–C/HDL–C ratio. Sustainable BMI control for individuals may be the most effective option for preventing fatty liver in a population.

Optimal Dietary Ferulic Acid for Suppressing the Obesity-Related Disorders in Leptin-Deficient Obese C57BL/6J -ob/ob Mice

Ferulic acid (FA) is a major polyphenolic compound and has been shown to improve the glucose and lipid homeostasis in high-fat diet-induced obese mice. Here, we found the optimal level of dietary FA to ameliorate obesity and obesity-correlated disorders, and identified the responses of gut microbiota to dietary FA in genetic leptin-deficient obese ( ob/ob) mice. The ob/ob mice exhibited persistent higher body weights, feed efficiency, white adipose tissue weights, and hepatic lipid accumulation, compared to those of the wild-type mice. However, 0.5% dietary FA suppressed these symptoms in ob/ob mice. The diversity of gut microbiota and the total abundance of obesity- and anti-obesity-related genera were not influenced after FA intervention in ob/ob mice. These data suggest that sufficient intake of FA (0.5%) could be useful for treating obesity or obesity-related diseases, and this weight-control effect is possibly not correlated with the gut-brain axis.

Contribution and interaction of the low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and triglyceride to diabetes in hypertensive patients: A cross-sectional study

AIMS/INTRODUCTION

Hypertension is one of the most significant risk factors for diabetes. The present study aimed to investigate the associations of lipid profiles, including the ratio of low-density lipoprotein cholesterol (LDL-C)-to-high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels, as well as their interactions, with type 2 diabetes in hypertensive patients.

MATERIALS AND METHODS

Hypertensive patients without a history of diabetes and hypolipidemic agents were enrolled continuously at the Hypertension Clinic, Zhongshan Hospital, Fudan University (Shanghai, China) from 2014 to 2016. General clinical data, including body mass index, blood pressure, fasting glucose and 2-h post-load glucose levels, and lipid profiles, were collected. The LDL-C/HDL-C ratio, TG/HDL-C ratio and TC/HDL-C ratio were separately calculated. Statistical analyses were carried out by using SPSS software (version 13.0).

RESULTS

In total, 935 hypertensive patients were included, of which 114 patients (12.2%) were diagnosed with diabetes. After multivariate adjustments, the LDL-C/HDL-C ratio and TG levels had the most significant and independent associations with diabetes. In the multivariate logistic regression, the LDL-C/HDL-C ratio and TG were independently associated with diabetes. After the interaction variable was included, the LDL-C/HDL-C ratio remained independently associated with diabetes, but TG was replaced by TG*LDL-C/HDL-C.

CONCLUSIONS

In conclusion, elevated LDL-C/HDL-C ratios and TG levels were associated with diabetes in patients with hypertension, with an interactive effect of the LDL-C/HDL-C ratio and TG on diabetes in the hypertensive population.

LDL-C:HDL-C ratio and common carotid plaque in Xinjiang Uygur obese adults: a cross-sectional study

OBJECTIVE

The aim of this study was to explore the relationship between low-density lipoprotein cholesterol:high-density lipoprotein cholesterol (LDL-C:HDL-C) ratio and common carotid atherosclerotic plaque (CCAP) among obese adults of Uygur community in Xinjiang, China.

DESIGN

A hospital-based cross-sectional study.

SETTING

First Affiliated Hospital of Xinjiang Medical University.

PARTICIPANTS

A total of 1449 obese adults of Uygur population who were free of coronary artery disease were included in our study from 1 January 2014 to 31 December 2016.

METHODOLOGY

Lipid profiles, other routine laboratory parameters and intima-media thickness of the common carotid artery were measured in all participants. Multivariate logistic regression analysis was used to examine the association between LDL-C:HDL-C ratio and CCAP.

RESULTS

Four hundred and fifteen (28.64%) participants had CCAP. Participants with CCAP had significantly higher LDL-C:HDL-C ratio compared with those without CCAP (3.21 [2.50, 3.88] vs 2.33 [1.95, 2.97], p<0.001). Multivariate logistic regression analysis showed high LDL-C:HDL-C ratio as independent predictor of CCAP after adjusting for conventional cardiovascular risk factors. The top LDL-C:HDL-C ratio quartile (≥3.25) had an OR of 9.355 (95% CI 6.181 to 14.157) compared with the bottom quartile (<2.07) of LDL-C:HDL-C ratio (p<0.001) after adjustment for age, body mass index, smoking, diabetes mellitus and serum level of total cholesterol.

CONCLUSION

CCAP is highly prevalent in Uygur obese adults. A high LDL-C:HDL-C ratio is an independent predictor of CCAP. It may help identify obese individuals who are at high risk of CCAP and who may benefit from intensive LDL-lowering therapy.

Mice Fed a High-Cholesterol Diet Supplemented with Quercetin-3-Glucoside Show Attenuated Hyperlipidemia and Hyperinsulinemia Associated with Differential Regulation of PCSK9 and LDLR in their Liver and Pancreas

SCOPE

Hepatic LDL receptor (LDLR) and proprotein convertase subtilisin/kexin type 9 (PCSK9) regulate the clearance of plasma LDL-cholesterol (LDL-C): LDLR promotes it, and PCSK9 opposes it. These proteins also express in pancreatic β cells. Using cultured hepatocytes, we previously showed that the plant flavonoid quercetin-3-glucoside (Q3G) inhibits PCSK9 secretion, stimulated LDLR expression, and enhanced LDL-C uptake. Here, we examine whether Q3G supplementation could reverse the hyperlipidemia and hyperinsulinemia of mice fed a high-cholesterol diet, and how it affects hepatic and pancreatic LDLR and PCSK9 expression.

METHODS AND RESULTS

For 12 weeks, mice are fed a low- (0%) or high- (1%) cholesterol diet (LCD or HCD), supplemented or not with Q3G at 0.05 or 0.1% (w/w). Tissue LDLR and PCSK9 is analyzed by immunoblotting, plasma PCSK9 and insulin by ELISA, and plasma cholesterol and glucose by colorimetry. In LCD-fed mice, Q3G has no effect. In HCD-fed mice, it attenuates the increase in plasma cholesterol and insulin, accentuates the decrease in plasma PCSK9, and increases hepatic and pancreatic LDLR and PCSK9. In cultured pancreatic β cells, however, it stimulates PCSK9 secretion.

CONCLUSION

In mice, dietary Q3G could counter HCD-induced hyperlipidemia and hyperinsulinemia, in part by oppositely modulating hepatic and pancreatic PCSK9 secretion.

Associations of Cardiovascular Risk Factors with Carotid Intima-Media Thickness in Middle-Age Adults and Elders

Aims: Elevated carotid intima-media thickness (cIMT) is a preclinical phenotype of atherosclerotic diseases. There are significant sex differences in the morbidities of cardiovascular diseases and their major determinants, and we explored the sex-specific effects of cardiovascular factors on cIMT by a community-based study.

Methods: We measured the cIMT and cardiovascular profiles of 1579 residents aged 40–74 years in northern Taiwan. Multivariate regression analyses were used to assess the effects and contributions of these factors on cIMT.

Results: Males had significantly higher mean (± SD) of cIMT than females (0.668 ± 0.113 vs. 0.632 ± 0.100 nm, p < 0.0001). The common factors of the best-fit regression models in both sexes were age, BMI, and LDL-/HDL-C ratio; however, their contributions and effects were different. The partial coefficients of determination (r²) were 17.9, 5.8, and 4.1%, respectively, for males and were 27.8, 1.4, and 1.2%, respectively, for females. Test statistics showed that the regression coefficients of BMI and LDL-/HDL-C ratio of males were significantly higher than those of females. As compared with females, per 1.0 SD increases of BMI and LDL-/HDL-C in males resulted in 0.0971 (p = 0.030) and 0.1177 (p = 0.0087), respectively, SD increases in cIMT. There was no difference in the means of cIMT between pre- and post-menopausal women of the same age groups.

Conclusions: There was a significant sex difference in cIMT. The contributions and effects of LDL-/HDL-C ratio and BMI on cIMT were more profound in males. Our findings indicate that sex-specific factors, but possibly not menstrual status-related factors, contribute to thicker cIMT.

Effect of Collagen Tripeptide on Atherosclerosis in Healthy Humans

AIM

Collagen tripeptide (CTP) is a functional food with a high content of Gly-X-Y tripeptides derived from collagen. The objective of this study was to evaluate the effect of CTP administration on the development of atherosclerosis in healthy individuals.

METHODS

The present study was conducted in the form of an open-label, single-dose trial for 6 months. All subjects ingested CTP twice daily: at breakfast and supper (total intake per day: 16 g). The effect of CTP on atherosclerosis was verified by measuring several indices, including serum lipid levels, toxic advanced glycation end-products (TAGE), and the cardio-ankle vascular index (CAVI), at baseline and 6 months.

RESULTS

The low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (LDL-C/HDL-C ratio) was significantly reduced in patients with an initial ratio of ≥2.5 (p=0.025). A significant reduction in TAGE was observed in all the subjects (p=0.031) and in the high-risk group (p=0.024). A significant reduction in CAVI was observed in all the subjects (right side: p=0.048, left side: p=0.047). As a result of multiple regression analysis, a significant relationship between the change in CAVI and that in each factor was not observed. No adverse events were observed during the study period.

CONCLUSIONS

The results of the present study indicate that CTP contributes to the prevention and treatment of atherosclerosis in healthy humans (UMIN000018525).

Hypolipidemic Effect of Tomato Juice in Hamsters in High Cholesterol Diet-Induced Hyperlipidemia

Tomato is a globally famous food and contains several phytonutrients including lycopene, β-carotene, anthocyanin, and flavonoids. The increased temperature used to produce tomato juice, ketchup, tomato paste and canned tomato enhances the bioactive composition. We aimed to verify the beneficial effects of processed tomato juice from Kagome Ltd. (KOT) on hypolipidemic action in hamsters with hyperlipidemia induced by a 0.2% cholesterol and 10% lard diet (i.e., high-cholesterol diet (HCD)). Male Golden Syrian hamsters were randomly divided into two groups for treatment: normal (n = 8), standard diet (control); and experimental (n = 32), HCD. The 32 hamsters were further divided into four groups (n = 8 per group) to receive vehicle or KOT by oral gavage at 2787, 5573, or 13,934 mg/kg/day for six weeks, designated the HCD-1X, -2X and -5X groups, respectively. The efficacy and safety of KOT supplementation was evaluated by lipid profiles of serum, liver and feces and by clinical biochemistry and histopathology. HCD significantly increased serum levels of total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), LDL-C/HDL-C ratio, hepatic and fetal TC and TG levels, and degree of fatty liver as compared with controls. KOT supplementation dose-dependently decreased serum TC, TG, LDL-C levels, LDL-C/HDL-C ratio, hepatic TC and TG levels, and fecal TG level. Our study provides experiment-based evidence to support that KOT may be useful in treating or preventing the onset of hyperlipidemia.

Salvia libanotica improves glycemia and serum lipid profile in rats fed a high fat diet

BACKGROUND

Salvia libanotica (S. Libanotica) is a commonly used herb in folk medicine in Lebanon and the Middle East. The present study aimed to assess the scientific basis for the therapeutic use of S. libanotica in glycemia and to evaluate its effects on lipemia and abdominal fat.

METHODS

Animals were fed a high-fat diet and allocated into a control and three experimental groups (GI, GII and GIII) receiving incremental doses of the plant water extract in drinking water (50, 150 and 450 mg/Kg body weight respectively) for six weeks.

RESULTS

The intake of S. libanotica extract was associated with a significant decrease in fasting serum glucose (102.9 ± 10.8 in GII and 87.5 ± 6.4 in GIII vs. 152.1 ± 7.9 mg/dl in controls) and a two fold increase in fasting serum insulin (GIII) and liver glycogen content (GII and GIII). Group III also had better glucose tolerance following intraperitoneal glucose challenges. Additionally, the plant extract intake produced a significant improvement in serum HDL (34.4 ± 2.4 in GIII vs. 27.2 ± 1.9 mg/dl in controls) and HDL/LDL cholesterol ratio (2.79 ± 0.32 in GII and 3.02 ± 0.31 in GIII vs. 1.74 ± 0.18 in controls), as well as a decrease in abdominal fat.

CONCLUSION

The current study is the first to demonstrate that the chronic intake of S. libanotica infusion helps in the prevention of high fat-induced hyperglycemia and dyslipidemia. This supports the plant use as a remedy for the prevention of type 2 diabetes and cardiovascular diseases.

Is the ratio of apoB/apoA-1 the best predictor for the severity of coronary artery lesions in Chinese diabetics with stable angina pectoris? An assessment based on Gensini scores

Background

There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease (CAD) in patients with diabetes mellitus. We determined the relationship between five conventional lipid ratios and the extent of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris (SAP).

Methods

A prospective cohort study within 373 type 2 diabetic patients diagnosed with stable CAD by coronary angiography was performed. All patients were classified into three groups according to the tertiles of Gensini scores (GS, low group < 8 points n = 143; intermediate group 8–28 points, n = 109; high group > 28 points, n = 121). Association between the ratios of apolipoprotein (apo) B and apoA-1, total cholesterol and high density lipoprotein cholesterol (TC/HDL-C), triglycerides and HDL-C (TG/HDL-C), low density lipoprotein cholesterol and HDL-C (LDL-C/HDL-C), Non-HDL-C/HDL-C and GS were evaluated using the receivers operating characteristic (ROC) curves and multivariate logistic regression models.

Results

The ratio of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C, and Non-HDL-C/HDL-C were correlated with Gensini scores. Area under the ROC curves for predicting high Gensini scores in the ratios of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C and Non-HDL-C/HDL-C were 0.62, 0.60, 0.59 and 0.60, respectively (P < 0.005 for all). According to multivariate logistic regression analysis after adjusted with demographic characteristic and other lipid parameters, the ratio of apoB/apoA-1 is qualified as an independent discriminator for the severity of CAD. However, after further adjusting different baseline variables, such as left ventricular ejective fraction, hemoglobin A1c, leukocytes count and serum creatinine, none of the above lipid ratios remained.

Conclusions

Compared with other lipid parameters, the ratio of apoB/apoA-1 appears to be more significantly correlated with the extent of coronary artery lesions in Chinese diabetics, but it was not an independent predictor in these settings.

Effects of combined dietary supplementation with fenofibrate and Schisandrae Fructus pulp on lipid and glucose levels and liver function in normal and hypercholesterolemic mice

Background

Currently, combined therapy using herbs and synthetic drugs has become a feasible therapeutic intervention against some diseases. The purpose of this study was to assess the effects of supplementation with fenofibrate (FF), a chemical drug used for the treatment of hyperlipidemia, and the aqueous extract of Schisandrae Fructus (SF, a Chinese herb) pulp (AqSF-P) or an SF-related synthetic analog, bicyclol (BY), on serum/hepatic lipid levels and liver status in normal and hypercholesterolemic (HCL) mice.

Methods

Male mice obtained from the Institute of Cancer Research (ICR) were fed on a normal diet (ND) or high cholesterol/bile salt (0.5%/0.15%, w/w) diet (HCBD) containing FF (0.03% or 0.1%, w/w) with or without AqSF-P (0.3%−9.0%, based on crude herbal material, w/w) or BY (0.025%, w/w) for 10 days. Then serum lipid levels and alanine aminotransferase (ALT) activity, as well as hepatic triglyceride (TG), total cholesterol (TC), and glucose levels, were measured.

Results

Oral supplementation with FF significantly reduced serum and hepatic TG, TC, and hepatic glucose levels (approximately 79%) in mice fed with ND or HCBD. FF supplementation combined with AqSF-P or BY increased FF-induced reduction in hepatic TC and TG contents in ND-fed mice (up to 67%) and in HCBD-fed mice (up to 54%), when compared with FF supplementation alone. Hepatic glucose-lowering effect of FF was enhanced (up to 19%) by AqSF-P cosupplementation in both normal and HCL mice. FF supplementation enhanced the excretion of fecal TC (by 75%) in mice fed with HCBD. Fecal TC contents were increased by 14%/9% in the combination therapy with FF and AqSF-P in ND-/HCBD-fed mice. Serum ALT activity was elevated by 45% in HCBD-fed mice. FF caused a significant increase in ALT activity by 198% and 120% in normal and HCL mice, respectively. BY markedly attenuated the ALT activity by 54% in mice fed with ND supplemented with 0.1% FF and by 42% in mice fed with HCBD supplemented with 0.03% FF.

Conclusion

AqSF-P cosupplementation augmented the hepatic lipid-/glucose-lowering effects of FF. BY ameliorated FF-induced liver injury in normal and HCL mice.

Circulating malondialdehyde-modified LDL-related variables and coronary artery stenosis in asymptomatic patients with type 2 diabetes

AIMS

To elucidate the levels of malondialdehyde-modified LDL (MDA-LDL)-related variables for predicting coronary artery stenosis (CAS) by coronary CT angiography (CCTA) in asymptomatic patients with type 2 diabetes (T2DM).

METHODS

Enrolled were 36 Japanese patients with T2DM who underwent CCTA and in whom MDA-LDL levels were measured. Definition of CAS was luminal narrowing of ≥50%. Trends through tertiles of each MDA-LDL-related variable were analyzed with a general linear model. The ability of each MDA-LDL-related variable to predict CAS was compared to areas under the curve (AUCs) in receiver operating characteristic curve (ROC) analysis.

RESULTS

Seventeen patients had CAS. Each MDA-LDL-related variable was an independent predictor of CAS (P = 0.039 for MDALDL, P = 0.013 for MDA-LDL/LDL-C, P = 0.047 for MDA-LDL/HDL-C, and P = 0.013 for (MDA-LDL/LDL-C)/HDL-C). AUCs of MDA-LDL, MDA-LDL/LDL-C, MDA-LDL/HDL-C, and (MDA-LDL/LDL-C)/HDL-C were 0.675 (95% CI 0.496-0.854), 0.765 (0.602-0.927), 0.752 (0.592-0.913), and 0.799 (0.643-0.955), respectively, for predicting CAS. Trends throughout the tertiles showed significant associations between MDA-LDL/LDL-C, MDA-LDL/HDL-C, or (MDALDL/LDL-C)/HDL-C and CAS (P = 0.003 for MDA-LDL/LDL-C, P = 0.042 for MDA-LDL/HDL-C, and P = 0.001 for (MDA-LDL/LDL-C)/HDL-C).

CONCLUSIONS

Data suggest that measurements of MDA-LDL/LDL-C, MDA-LDL/HDLC, and (MDA-LDL/LDL-C)/HDL-C are useful for predicting CAS.

Lipoprotein (a) and atherogenic indices in Sudanese patients with type 2 diabetes

BACKGROUND & AIMS

Type 2 diabetes is associated with significant cardiac morbidity and mortality with a more than threefold increased risk of coronary artery disease (CAD). We aimed to assess the serum concentrations of lipoprotein (a) and lipid profile indexes as predictors for CAD in Sudanese type 2 diabetics compared to healthy subjects.

MATERIALS & METHODS

This case-control study was conducted at Jabir Abu-Aliz Specialized Center, Khartoum State, Sudan. After overnight fasting, 4 ml blood samples were collected in plain vials through venous puncture from each subject. Lipid profile parameters were estimated by standard laboratory procedures. Serum lipoprotein (a) was measured by immunoturbidimetric method. Statistical analyses were performed using SPSS software (version 17).

RESULTS

Compared to healthy controls, type 2 diabetics showed significantly higher serum lipids and lipoprotein fractions. The mean values of lipoprotein (a), TC: HDL-C (5.55±.8 vs. 3.89±.6) and LDL-C: HDL-C (3.80±0.7 vs. 2.32±0.5) were significantly increased in patients. Lipoprotein (a) was significantly correlated with TG (p=.025), HDL-C (inversely, p<.001), VLDL-C (p= .025), and TC: HDL-C ratio (p= 016). Moreover, LDL-C: HDL-C ratio and TC were the most common risk factors distributed among the study patients (80% and 71.4% respectively).

CONCLUSION

Diabetic patients characterized by higher ratios of TC: HDL -C and LDL: HDL and Lipoprotein (a) compared to healthy controls. The evaluation of these lipid indices in diabetics, beside the routine lipid profile analysis, may be a crucial helpful step in the prevention of coronary artery disease since these atherogenic factors can be reduced by lifestyle modifications.

Cognitive Avoidant Coping Is Associated with Higher Carotid Intima Media Thickness Among Middle-Aged Adults

BACKGROUND

Cognitive avoidant coping (CAV) has been associated with elevated autonomic stress reactivity, thus presumably elevating risk for cardiovascular diseases. However, more direct evidence for this hypothesis is lacking.

PURPOSE

The purpose of this study was to relate carotid intima media thickness (IMT) to CAV in nonclinical participants.

METHODS

A total of 124 participants (61 women) with a mean age of 37.52 years (SD = 7.93, MIN = 30, MAX = 60) participated in the study. IMT was assessed by ultrasonic imaging and CAV via questionnaire (Mainz Coping Inventory; MCI).

RESULTS

Regression analysis revealed that although CAV was not significantly associated with IMT, there was a significant interaction of CAV and age. Whereas for younger adults, there was no significant relation for older individuals, CAV and IMT were significantly positively associated.

CONCLUSIONS

Findings suggest that CAV could constitute a risk factor for cardiovascular diseases with increasing age.

Insulin resistance and adipokine levels correlate with early atherosclerosis - a study in prediabetic patients

Cardiovascular risk of prediabetes is still subject to controversies. We analyzed the associations between insulin resistance, adipokines and incipient atherosclerosis estimated by intima-media thickness (IMT) in a cross-sectional study on 122 prediabetic subjects without clinical signs of atherosclerotic disease. Homeostasis model assessment of insulin resistance (HOMA-IR, calculated as fasting insulin × fasting plasma glucose / 22.5), adiponectin, leptin, leptin-to-adiponectin ratio, carotid and femoral IMT were evaluated. We also assessed other parameters related to insulin resistance and adipokines (HbA_1c, anthropometric and lipid parameters), as they may also influence atherosclerosis. Carotid IMT was correlated to adiponectin and leptin-to-adiponectin ratio (all p < 0.05), but not with HOMA-IR or leptin, while femoral IMT showed no relationship with these factors. After adjusting for leptin, leptin-to-adiponectin ratio, triglycerides, HDL-cholesterol, cholesterol-to-HDL ratio, triglycerides-to-HDL ratio and HbA_1c, IMT values became correlated with HOMA-IR. Adjustment for HOMA-IR induced the appearance of new correlations between adipokines and both IMT values. In conclusion, insulin resistance and adipokines seem related to IMT in prediabetic subjects without clinical signs of arterial obstruction.

A Comparative Study of Serum Uric Acid levels and Lipid Ratios in Coronary Artery Disease Patients

INTRODUCTION

Coronary Artery Disease (CAD) appears to be common in the Indian population of different geographical origins, religions and languages. Measurement of lipid fractions and ratios are widely recommended for risk assessment. A few studies have shown that serum uric acid plays a role in the development of cardiovascular morbidity. Very few reports are cited linking serum uric acid with the lipid fraction in CAD.

OBJECTIVES

To find the significance of non-HDL cholesterol, LDL-c/HDL-c ratio, TC/HDL ratio and serum uric acid level in CAD patients.

SUBJECTS AND METHODOLOGY

In this study, we included fifty CAD patients as subjects and an equal number of controls. Both subjects and controls were assessed for anthropometric, physiological and biochemical parameters.

RESULTS

The present study showed significant increased levels of total cholesterol (p=0.002), TAGs (p<0.001), HDL (p=0.005), LDL (p<0.006) and non-HDL cholesterol (p<0.001). LDL-c/HDL-c ratio (p<0.001) and TC/HDL ratio (p<0.001) in CAD patients (subjects) were also significant when compared to controls. Uric acid level in CAD patients was increased (p<0.001).

CONCLUSION

Serum Uric Acid, TC/HDL and LDL/HDL ratios could be regarded as objective markers, in association with existing atherogenic dyslipidemia in patients with CAD.

Cardiovascular risk factor profiles for peripheral artery disease and carotid atherosclerosis among Chinese older people: a population-based study

OBJECTIVES

Epidemiological data concerning atherosclerotic disease among older people in rural China are sparse. We seek to determine prevalence and cardiovascular risk factor profiles for peripheral artery disease (PAD) and carotid atherosclerosis (CAS) among Chinese older people living in a rural community.

METHODS

This cross-sectional study included 1499 participants (age ≥60 years, 59.0% women) of the Confucius Hometown Aging Project in Shandong, China. From June 2010-July 2011, data were collected through interviews, clinical examinations, and laboratory tests. PAD was defined as an ankle-brachial index ≤0.9. Carotid intima-media thickness (cIMT) and carotid artery stenosis were assessed by ultrasonography. We defined moderate stenosis as carotid stenosis ≥50%, and severe stenosis as carotid stenosis ≥70%. cIMT≥1.81 mm was considered as an increased cIMT (a measure of CAS). Data were analyzed with multiple logistic models.

RESULTS

The prevalence was 5.7% for PAD, 8.9% for moderate stenosis, 1.8% for severe stenosis, and 11.2% for increased cIMT. After controlling for multiple potential confounders, diabetes, an increased low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio, and hypertension were significantly or marginally associated with PAD. Ever smoking, hypertension, and an increased LDL-C/HDL-C ratio were significantly associated with an increased likelihood of increased cIMT. An increasing number of those cardiovascular risk factors were significantly associated with an increasing odds ratio of PAD and increased cIMT, respectively (p for linear trend <0.001).

CONCLUSION

Among Chinese older people living in a rural community, PAD, carotid artery stenosis, and an increased cIMT are relatively uncommon. Cardiovascular risk factor profiles for PAD and CAS are slightly different, with hypertension and an increased LDL-C/HDL-C ratio being associated with an increased likelihood of both PAD and increased cIMT.

Protective role for Toll-like receptor-9 in the development of atherosclerosis in apolipoprotein E-deficient mice

OBJECTIVE

Atherosclerosis is driven by inflammatory reactions that are shared with the innate immune system. Toll-like receptor-9 (TLR9) is an intracellular pattern recognition receptor of the innate immune system that is currently under clinical investigation as a therapeutic target in inflammatory diseases. Here, we investigated whether TLR9 has a role in the development of atherosclerosis in apolipoprotein E-deficient (ApoE(-/-)) mice.

APPROACH AND RESULTS

Newly generated double-knockout ApoE(-/-):TLR9(-/-) mice and control ApoE(-/-) mice were fed a high-fat diet from 8 weeks and effects on lesion size, cellular composition, inflammatory status, and plasma lipids were assessed after 8, 12, 15, and 20 weeks. All 4 time points demonstrated exacerbated atherosclerotic lesion severity in ApoE(-/-):TLR9(-/-) mice, with a corresponding increase in lipid deposition and accumulation of macrophages, dendritic cells, and CD4(+) T cells. Although ApoE(-/-):TLR9(-/-) mice exhibited an increase in plasma very low-density lipoprotein/low-density-lipoprotein cholesterol, the very low-density lipoprotein/low-density lipoprotein:high-density lipoprotein ratio was unaltered because of a parallel increase in plasma high-density lipoprotein cholesterol. As a potential mechanism accounting for plaque progression in ApoE(-/-):TLR9(-/-) mice, CD4(+) T-cell accumulation was further investigated and depletion of these cells in ApoE(-/-):TLR9(-/-) mice significantly reduced lesion severity. As a final translational approach, administration of a TLR9 agonist (type B CpG oligodeoxynucleotide 1668) to ApoE(-/-) mice resulted in a reduction of lesion severity.

CONCLUSIONS

Genetic deletion of the innate immune receptor TLR9 exacerbated atherosclerosis in ApoE(-/-) mice fed a high-fat diet. CD4(+) T cells were identified as potential mediators of this effect. A type B CpG oligodeoxynucleotide TLR9 agonist reduced lesion severity, thus identifying a novel therapeutic approach in atherosclerosis.

Associations among total and food additive phosphorus intake and carotid intima-media thickness--a cross-sectional study in a middle-aged population in Southern Finland

Background

Dietary phosphorus (P) intake in Western countries is 2- to 3-fold higher than recommended, and phosphate is widely used as a food additive in eg. cola beverages and processed meat products. Elevated serum phosphate concentrations have been associated with cardiovascular disease (CVD) risk factors and CVD itself in several studies in patients with renal dysfunction and in a few studies in the general population. Carotid intima-media thickness (IMT) is a CVD risk factor, thus the aim of the study was to determine if an association between dietary P, especially food additive phosphate (FAP), intake, and IMT exists.

Methods

Associations among total phosphorus (TP) and FAP intake and carotid IMT were investigated in a cross-sectional study of 37- to 47-year-old females (n = 370) and males (n = 176) in Finland. Associations among TP intake, FAP intake, and IMT were tested by analysis of covariance (ANCOVA) in quintiles (TP) and sextiles (FAP) using sex, age, low-density/high-density lipoprotein cholesterol ratio, smoking status, and IMT sonographer as covariates.

Results

No significant associations were present between TP or FAP intake and IMT (p > 0.05, ANCOVA), but in between-group comparisons some differences were found indicating higher IMT among subjects with higher P intake. When testing for a significant linear trend with contrast analysis, a positive trend was observed between energy-adjusted TP intake and IMT among all subjects (p = 0.039), and among females a tendency for a trend existed (p = 0.067). Among all subjects, a significant positive linear trend was also present between FAP intake and IMT (p = 0.022); this trend was also seen in females (p = 0.045). In males, no significant associations or trends were noted between TP or FAP intake and IMT (p > 0.05).

Conclusions

Our results indicate that a significant linear trend exists between energy-adjusted TP intake and FAP intake, and IMT among all subjects. Based on these results, high dietary P intake should be further investigated due to its potential association with adverse cardiovascular health effects in the general population.

Dyslipidemia is associated with tunneled-cuffed catheter-related central venous thrombosis in hemodialysis patients: a retrospective, multicenter study

The aim of this study was to explore the risk factors of tunneled-cuffed catheter (TCC)-related central venous thrombosis (CVT) for the maintenance of hemodialysis patients. In this study, 285 patients on maintenance hemodialysis were enrolled who had received their first TCC in the right jugular vein. Patients were divided into CVT and control groups according to the diagnosis of TCC-related CVT 6 months after catheterization. Patients with CVT had a higher prevalence of dyslipidemia (50.74 vs. 26.85%, respectively) and low protein store compared with the control group. After adjusting for confounders, serum triglycerides (OR: 3.632; 95% CI: 2.105-6.267), non-HDL cholesterol (OR: 1.463; 95% CI:1.067-2.007), and low-density lipoprotein/high-density lipoprotein (LDL/HDL) cholesterol ratio (OR: 2.904; 95% CI: 1.797-4.692) were positively correlated with TCC-related CVT, while serum HDL cholesterol (OR: 0.097; 95% CI: 0.037-0.257) and serum albumin (OR: 0.922; 95% CI: 0.864-0.985) were negatively correlated. Dyslipidemia and low serum albumin levels were significantly associated with TCC-related CVT in hemodialysis patients.

LDL decreases the membrane compliance and cell adhesion of endothelial cells under fluid shear stress

Atherosclerosis is an inflammatory disease of large and medium sized arteriole walls that is precipitated by elevated levels of low-density lipoprotein (LDL) cholesterol in the blood. However, the mechanisms that lead to the initiation of atherosclerosis are not fully understood. In this study, endothelial cells (ECs) were incubated with LDL for 24 h, and then the lipid was detected with Oil Red O staining and cholesterol ester was assayed with high-performance liquid chromatography (HPLC). F-actin was examined by fluorescence microscopy and the viscoelasticity of ECs was investigated using the micropipette aspiration technique. Then, a parallel-plate flow chamber device was used to observe the adhesion and retention of ECs under shear stress. The results demonstrated that elevated LDL significantly increased the cellular lipid content and induced the rearrangement of cytoskeletal F-actin. The initial rapid deformability (l/K 1 + l/K 2) was reduced by elevated cellular LDL levels, while membrane viscosity (μ) was increased by LDL accumulation. After treatment with 150 mg L(-1) LDL for 24 h, the adhesion of ECs under fluid shear stress was significantly decreased (p < 0.05). These results suggested that LDL induced cellular lipid accumulation and cytoskeleton reorganization which increased the cellular stiffness and decreased the adhesion of ECs.

Maternal and paternal family history of type 2 diabetes differently influence lipid parameters in young nondiabetic Japanese women

OBJECTIVES

We assessed the association of family history of type 2 diabetes (T2D) with parameters used for health checkups in young Japanese women.

METHODS

The subjects were 497 nondiabetic women aged 19-39 years. Among them, the mothers of 34 subjects and fathers of 50 had T2D (MD group and PD group, respectively). The subjects were assessed for levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG).

RESULTS

TC and LDL-C level showed a tendency to increase in the MD group compared with subjects without family history of T2D. LDL-C/HDL-C ratio ≥2.14 was found in 32.4 and 18.0 % of subjects in the MD and PD groups, respectively. When adjusted for differences in age, body mass index, smoking status, and drinking habits, the MD group was found to have a higher risk of abnormal TC and LDL-C levels than the PD group. LDL-C/HDL-C ratio was independently associated with maternal family history but not with paternal family history (odds ratio 3.44 [99 % confidence interval 1.11-10.6] and 1.21 [0.38-3.89], respectively). There was no association between TG/HDL-C ratio and family history type of T2D.

CONCLUSIONS

Maternal family history of T2D had a more pronounced effect on the lipid parameters generally evaluated during health checkups than did paternal family history of T2D. Therefore, we recommend systematic screening for early detection and appropriate healthcare guidance for Japanese women, particularly those with maternal family history of T2D.