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Gao Y, Wang M, Wang R, Jiang J, Hu Y, Wang W, Wang Y, Li H. The predictive value of the hs-CRP/HDL-C ratio, an inflammation-lipid composite marker, for cardiovascular disease in middle-aged and elderly people: evidence from a large national cohort study. Lipids Health Dis 2024; 23:66. [PMID: 38429790 PMCID: PMC10908181 DOI: 10.1186/s12944-024-02055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) is associated with inflammation and abnormal lipid metabolism. However, a single inflammatory index or a single lipid index cannot accurately predict the prognosis of CVD independently because it is prone to be affected by various confounding factors. METHODS This population-based cohort study included 6,554 participants from the China Health and Retirement Longitudinal Study (CHARLS) to investigate correlations. In the present study, the occurrence of CVD events such as stroke and heart disease was evaluated by considering self-reported diagnoses at the beginning of the study and during wave 4, and a restricted cubic spline model was used to investigate potential nonlinear relationships in addition to multivariate logistic regression models. Stratified analyses were performed to examine how sociodemographic characteristics may influence the results. RESULTS Seven years of follow-up (2011-2018) revealed that 786 people (11.99%) developed CVD. According to the adjusted model, the high-sensitivity C-reactive protein (hs-CRP)-to-high-density lipoprotein cholesterol (HDL-C) ratio is a contributing factor to CVD risk (OR 1.31, 95% CI 1.05-1.64). In addition, a nonlinear relationship was observed between the hs-CRP/HDL-C ratio and the occurrence of new CVD, stroke, or cardiac issues (Poverall <0.05, Pnonlinear <0.05). Moreover, noteworthy associations between the hs-CRP/HDL-C ratio and age were detected in the stratified analysis (P = 0.048), indicating that younger participants had more negative effects of a high hs-CRP/HDL-C ratio. CONCLUSIONS According to the present cohort study, a high hs-CRP/HDL-C ratio is a significant risk factor for CVD, new stroke, and heart problems. Early intervention in patients with increased hs-CRP/HDL-C ratios may further reduce the incidence of CVD, in addition to focusing on independent lipid markers or independent inflammatory markers.
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Affiliation(s)
- Yu Gao
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
- Key Laboratory of TCM Syndrome and Formula, Beijing University of Chinese Medicine, Ministry of Education, Beijing, 100029, China
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Miyuan Wang
- School of public health, Huazhong University of Science and Technology, Hubei, 430074, China
| | - Ruiting Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Jinchi Jiang
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yueyao Hu
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Wei Wang
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
- Key Laboratory of TCM Syndrome and Formula, Beijing University of Chinese Medicine, Ministry of Education, Beijing, 100029, China.
- Guangzhou University of Chinese Medicine, Guangdong, 510006, China.
| | - Yong Wang
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
- Key Laboratory of TCM Syndrome and Formula, Beijing University of Chinese Medicine, Ministry of Education, Beijing, 100029, China.
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Haijing Li
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
- Key Laboratory of TCM Syndrome and Formula, Beijing University of Chinese Medicine, Ministry of Education, Beijing, 100029, China.
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Hsu CL, Pei W, Chen TC, Hsu MC, Chen PC, Kuo HM, Hung JF, Chen YJL. Optimized Sugar-Free Citrus Lemon Juice Fermentation Efficiency and the Lipid-Lowering Effects of the Fermented Juice. Nutrients 2023; 15:5089. [PMID: 38140348 PMCID: PMC10745609 DOI: 10.3390/nu15245089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/01/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
Aging and obesity make humans more prone to cardiovascular and metabolic syndrome diseases, leading to several serious health conditions, including hyperlipidemia, high blood pressure, and sleep disturbance. This study aimed to explore the hypolipidemic effect of fermented citrus lemon juice using a hyperlipidemic hamster model. The sugar-free lemon juice's fermentation was optimized, and the characteristics of fresh and fermented lemon juice (FLJ) were evaluated and compared, which contained polyphenols and superoxide dismutase-like activity. Results showed that the absorption and utilization efficiency of FLJ was higher compared with the unfermented lemon juice. This study's prefermentation efficiency evaluation found that 21-30 days of bacterial DMS32004 and DMS32005 fermentation of fresh lemon juice provided the best fermentation benefits, and 21-day FLJ was applied as a remedy after the efficiency compassion. After six weeks of feeding, the total cholesterol (TC) and triglyceride (TG) values in the blood and liver of the FLJ treatment groups were decreased compared with the high-fat diet (HFD) group. In addition, the blood low-density lipoprotein cholesterol (LDL-C) levels were significantly reduced in the FLJ treatment groups compared with the HFD group. In contrast, the blood high-density lipoprotein (HDL-C) to LDL-C ratio increased considerably in the FLJ treatment groups, and the total to HDL ratio was significantly lower than in the HFD group. Compared with the HFD group, the TC content in the FLJ treatment groups' feces increased significantly. This study demonstrated that the sugar-free fermentation method and fermentation cycle management provided FLJ with the potential to regulate blood lipids. Further research and verification will be carried out to isolate specific substances from the FLJ and identify their mechanisms of action.
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Affiliation(s)
- Chang-Lu Hsu
- College of Management, Chung Hua University, Hsinchu 30012, Taiwan; (C.-L.H.); (W.P.)
| | - Wen Pei
- College of Management, Chung Hua University, Hsinchu 30012, Taiwan; (C.-L.H.); (W.P.)
| | - Tzu-Chun Chen
- Graduate Institute of Science Education & Environmental Education, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan; (T.-C.C.); (P.-C.C.); (M.-C.H.); (J.-F.H.)
| | - Ming-Chieh Hsu
- Graduate Institute of Science Education & Environmental Education, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan; (T.-C.C.); (P.-C.C.); (M.-C.H.); (J.-F.H.)
| | - Pei-Chun Chen
- Graduate Institute of Science Education & Environmental Education, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan; (T.-C.C.); (P.-C.C.); (M.-C.H.); (J.-F.H.)
| | - Heng-Miao Kuo
- Institute of Phytochemicals Jianmao Biotech Co., Ltd., Kaohsiung 80672, Taiwan;
| | - Jeng-Fung Hung
- Graduate Institute of Science Education & Environmental Education, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan; (T.-C.C.); (P.-C.C.); (M.-C.H.); (J.-F.H.)
| | - Yi-Jinn Lillian Chen
- Institute of Phytochemicals Jianmao Biotech Co., Ltd., Kaohsiung 80672, Taiwan;
- Department of Physics, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan
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Liang Y, Zhou R, Chen H, Cao B, Fan W, Liu K, Zhong Q, Huang Y, Wu X, Zou M. Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population-based study. J Diabetes 2023; 15:853-865. [PMID: 37329140 PMCID: PMC10590681 DOI: 10.1111/1753-0407.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/16/2023] [Accepted: 05/24/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Arterial stiffness contributes to additional cardiovascular risks in diabetic patients by triggering the loss of vascular and myocardial compliance and promoting endothelial dysfunction. Thus, prevention of arterial stiffness is a public health priority, and the identification of potential biomarkers may provide benefits for early prevention. This study investigates the relationships between serum laboratory tests and pulse wave velocity (PWV) tests. We also investigated the associations between PWV and all-cause mortality. METHODS We examined a panel of 33 blood biomarkers among diabetic populations in the Atherosclerosis Risk in Communities Study. The carotid-femoral (cfPWV) and femoral-ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The aortic-femoral arterial stiffness gradient (afSG) was calculated as faPWV divided by cfPWV. Biomarker levels were log-transformed and correlated with PWV. Cox proportional hazard models were employed for survival analysis. RESULTS Among 1079 diabetic patients, biomarkers including high-density lipoprotein cholesterol, glycated hemoglobin, high-sensitivity troponin T, cystatin C, creatinine, and albuminuria were significantly correlated with afSG (R = 0.078, -0.193, -0.155, -0.153, -0.116, and -0.137, respectively) and cfPWV (R = -0.068, 0.175, 0.128, 0.066, 0.202, and 0.062, respectively). Compared with the lowest tertile of afSG, the risk of all-cause mortality was lower in the highest tertile (hazard ratio 0.543; 95% confidence interval 0.328-0.900). CONCLUSION Certain biomarkers related to blood glucose monitoring, myocardial injury, and renal function significantly correlated with PWV, suggesting that these putative risk factors are likely to be important atherosclerosis mechanisms in diabetic patients. AfSG may be an independent predictor of mortality among diabetic populations.
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Affiliation(s)
- Yong‐Qi Liang
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Rui Zhou
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Hao‐Wen Chen
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Bi‐Fei Cao
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Wei‐Dong Fan
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Kuan Liu
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Qi Zhong
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Yi‐Ning Huang
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Xian‐Bo Wu
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Meng‐Chen Zou
- Department of Endocrinology and Metabolism, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
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Ren X, Wang X. Association of the low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and major adverse cardiac and cerebrovascular events in patients with coronary heart disease undergoing percutaneous coronary intervention: a cohort study. Curr Med Res Opin 2023; 39:1175-1181. [PMID: 37560911 DOI: 10.1080/03007995.2023.2246889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Although dyslipidemia increases the risk of coronary heart disease (CHD) and its adverse prognosis, the association between the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) and major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in patients with CHD has not been adequately demonstrated. Therefore, the aim of this study was to assess the role of LDL-C/HDL-C in the risk of MACCE after PCI in patients with CHD. METHODS In this large cohort observational study, we enrolled 2226 patients with CHD treated with PCI. LDL-C/HDL-C was considered as an exposure variable and MACCE was considered as an outcome variable. Univariate and multivariate Logistic regression models and subgroup analyses were used to assess the relationship between LDL-C/HDL-C and the risk of MACCE. RESULTS A total of 2226 patients (mean age: 60.02 years; 68.00% male) were included in the analysis, and 373 patients suffered MACC. Patients who developed MACCE had higher levels of LDL-C/HDL-C compared to patients who did not develop MACCE [(2.79 ± 1.15) vs (2.64 ± 1.09), p = 0.023]. Univariate Logistic regression analysis showed a correlation between LDL-C/HDL-C and the risk of MACCE (OR: 1.121, 95% CI: 1.019-1.233, p = 0.019). Multivariate Logistic regression analysis showed that higher levels of LDL-C/HDL-C remained strongly associated with a higher risk of MACCE after stepwise adjustment for confounding variables [Model 4: T3 vs T1, OR: 1.455, 95% CI: 1.095-1.933, p = 0.010; per unit increase, OR: 1.158, 95% CI: 1.047-1.281, p = 0.004]. Further subgroup analysis showed that the association between LDL-C/HDL-C and MACCE risk remained in the subgroup ≤60 years, male, without diabetes, and with hypertension (p < 0.05). CONCLUSION Higher LDL-C/HDL-C was closely associated with a higher risk of MACCE after PCI in patients with CHD.
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Affiliation(s)
- Xiaomei Ren
- Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, P.R. China
| | - Xia Wang
- Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, P.R. China
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Ciplak S, Adiguzel A, Deniz YZ, Aba M, Ozturk U. The Role of the Low-Density Lipoprotein/High-Density Lipoprotein Cholesterol Ratio as an Atherogenic Risk Factor in Young Adults with Ischemic Stroke: A Case-Control Study. Brain Sci 2023; 13:1180. [PMID: 37626536 PMCID: PMC10452716 DOI: 10.3390/brainsci13081180] [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: 06/06/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Dyslipidemia is a major atherogenic risk factor for ischemic stroke. Stroke patients tend to have high levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). Therefore, it is noteworthy that there has been an increase in ischemic stroke cases in young and elderly individuals in recent years. This study investigated the TC/HDL-C ratio and the LDL-C/HDL-C ratio, which may be more specific and common lipid parameters in young patients with ischemic stroke. This study aimed to demonstrate the sensitivity and specificity of TC/HDL-C and LDL-C/HDL-C ratios as atherogenic markers for young adult ischemic strokes. This trial was conducted as a retrospective case-control study. A total of 123 patients (patient group) and 86 healthy individuals (control group) aged 18-50 years were randomly selected from four different hospitals. Lipid parameters and TC/HDL-C and LDL-C/HDL-C ratios were compared between these two groups. The mean age was 38.8 ± 7.3 years in patients and 37.7 ± 9 years in controls (p > 005). The HDL-C levels were 39.1 ± 10.8 mg/dL in patients and 48.4 ± 13.8 mg/dL in controls (p < 0.001). LDL-C/HDL-C ratios were 3.23 ± 1.74 and 2.38 ± 0.87, and TC/HDL-C ratios were 5.24 ± 2.31 and 4.10 ± 1.25 in the patient and control groups, respectively (p < 0.001). The LDL-C/HDL-C and TC/HDL-C cutoff values in ROC analyses were 2.61 and 4.40 respectively; the AUCs (95% CI) were determined to be 0.680 (0.608-0.753) and 0.683 (0.610-0.755) (p < 0.001), respectively. An increased risk of stroke was observed in those with a high LDL-C/HDL-C ratio (OR = 1.827; 95% CI = 1.341-2.488; p < 0.001). Our study obtained similar results when we compared the mean TC and LDL-C levels between the two groups. However, considering the TC/HDL-C and LDL-C/HDL-C ratios, it is noteworthy that there was a significant difference between the patient and control groups.
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Affiliation(s)
- Sibel Ciplak
- Department of Neurology, Turgut Ozal University Faculty of Medicine, Malatya 44090, Turkey
| | - Ahmet Adiguzel
- Department of Neurology, Inonu University Faculty of Medicine, Malatya 44210, Turkey
| | - Yusuf Ziya Deniz
- Department of Neurology, Siirt Education and Research Hospital, Siirt 56000, Turkey
| | - Melike Aba
- Department of Neurology, Mehmet Akif Inan Education and Research Hospital, Sanliurfa 63330, Turkey
| | - Unal Ozturk
- Department of Neurology, University of Health Sciences, Gazi Yasargil Education and Research Hospital, Diyarbakir 21070, Turkey;
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